LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO

)
PUSKESMAS

PUSKESMAS : Jurangmangu
KECAMATAN :
KOTA : TANGERANG SELATAN
PROVINSI : BANTEN

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
1 2 3 4 5 6 7 8
1 Allopurinol tablet 100 mg 2014 Tablet - #DIV/0!
2 Allopurinol tablet 100 mg 2015 Tablet 810.00 100 910.00 830.00 29 28.620689655
3 Ambroksol Syrup 15 mg / ml 2014 Botol - - #DIV/0!
4 Ambroksol Syrup 15 mg / ml 2015 Botol 159.00 159.00 87.00 20 4.35
5 Ambroksol tablet 30 mg 2014 Tablet 155.00 8000 8,155.00 1,000.00 29 34.482758621
6 Ambroksol tablet 30 mg 2015 Tablet - - #DIV/0!
7 Aminofilin inj 24 mg /ml 2014 Ampul 30.00 30.00 - #DIV/0!
8 Aminofilin tab 200 mg 2014 Tablet 231.00 200 431.00 20.00 2 10
9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 100.00 100.00 - #DIV/0!
10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet - - #DIV/0!
11 Amlodipin 10 mg 2015 Tablet - - - #DIV/0!
12 Amlodipin 5 mg 2015 Tablet 175.00 3000 3,175.00 440.00 13 33.846153846
13 Amoksisilin + As. Klavulanat 2013 Tablet 896.00 896.00 134.00 12 11.166666667
14 Amoksisilin kaplet 250 mg 2013 Tablet 1,820.00 4320 6,140.00 1,970.00 20 98.5
15 Amoksisilin kaplet 500 mg 2014 Tablet 1,600.00 1,600.00 1,280.00 29 44.137931034
16 Amoksisilin kaplet 500 mg 2015 Tablet - - #DIV/0!
17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 203.00 203.00 108.00 19 5.6842105263
18 Amoksisilin sirup kering forte 250mg/ml 2015 botol - - - #DIV/0!
19 Antasida DOEN tablet 2014 Tablet 3,950.00 3,950.00 725.00 29 25
20 Antasida DOEN tablet 2015 Tablet - - #DIV/0!
21 Antasida DOEN Suspensi 2014 Botol - - #DIV/0!
22 Antasida DOEN Suspensi 2015 Botol 116.00 116.00 35.00 13 2.6923076923
23 Anti Bakteri DOEN salep 2013 Tube 57.00 57.00 57.00 29 1.9655172414
24 Anti Bakteri DOEN salep 2015 Tube 25 25.00 25.00 12 2.0833333333
25 Anti Fungi DOEN kombinasi salep 2013 Pot - - - #DIV/0!
26 Anti Hemmoroid DOEN supp 2014 Supp - - #DIV/0!
27 Anti Hemmoroid DOEN supp 2015 Supp - - - #DIV/0!
28 Anti migren / Ergotamin 2013 Tablet - - - #DIV/0!
29 Aqua Pro Injeksi steril @ 20 2014 Vial 13.00 13.00 13.00 #DIV/0!
30 Asam Asetilsalisilat 80 mg 2014 Tablet - - #DIV/0!
31 Asam Asetilsalisilat 80 mg 2015 Tablet 210.00 210.00 70.00 7 10
32 Asam Asetilsalisilat 100 mg 2011 Tablet - - - #DIV/0!
33 Asam Askorbat (Vit. C) tablet 100 mg Tablet - - - #DIV/0!
34 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet 1,720.00 1,720.00 1,005.00 25 40.2
35 Asam Folat tab 1 mg 2013 Tablet - - #DIV/0!
36 Asam Folat tab 1 mg 2015 Tablet - 1600 1,600.00 350.00 12 29.166666667
37 Asam Mefenamat Tablet 500 mg 2014 Tablet - - #DIV/0!
38 Asam Mefenamat Tablet 500 mg 2015 Tablet 130.00 500 630.00 610.00 15 40.666666667
39 Asam Mefenamat Tablet 500 mg 2015 Tablet - - #DIV/0!
40 Asam Tranexamat 250mg 2013 Tablet 790.00 790.00 668.00 15 44.533333333
41 Asam Tranexamat Injeksi 2013 Ampul - - - #DIV/0!
42 Asiklovir krim 5% 2013 Tube 123.00 123.00 30.00 13 2.3076923077
43 Asiklovir Tablet 200 mg 2013 Tablet 660.00 660.00 60.00 3 20
44 Asiklovir Tablet 200 mg 2015 Tablet - - #DIV/0!
45 Asiklovir Tablet 400 mg 2013 Tablet 450.00 450.00 150.00 5 30
46 Atapulgit 2011 Tablet - - #DIV/0!
47 Atapulgit 2015 Tablet 750.00 200 950.00 330.00 15 22
48 Atropin Injeksi 0.25 mg/ml-1 ml 2010 Ampul - - #DIV/0!

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
49 Atropin Injeksi 0.25 mg/ml-1 ml 2015 Ampul 10.00 10.00 10.00 #DIV/0!
50 Atropin sulfat tablet 0.5 mg 2014 Tablet 190.00 190.00 190.00 #DIV/0!
51 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2013 Tablet 2,250.00 6000 8,250.00 3,060.00 16 191.25
52 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2015 Tablet - - #DIV/0!
53 Betahistin mesilat 2014 Tablet 160.00 160.00 150.00 12 12.5
54 Betametason Krim 2013 Tube - - #DIV/0!
55 Betametason Krim 2015 Tube 35.00 100 135.00 64.00 20 3.2
56 Bisakodil supp 10 mg 2014 Supp - - #DIV/0!
57 Bisakodil supp 10 mg 2015 Supp 24.00 24.00 20.00 2 10
58 Bisoprolol tab 5 mg 2014 Tablet 300.00 30 330.00 - #DIV/0!
59 Bormheksin solution 2013 Botol 4.00 4.00 2.00 14 0.1428571429
60 Cetrizine Sirup 5 mg/5 ml 2013 Botol - - - #DIV/0!
61 Cetrizine 10 mg 2014 Tablet 850.00 1000 1,850.00 1,090.00 26 41.923076923
62 Deksametason injeksi 5 mg/ml 2013 Ampul - - - #DIV/0!
63 Deksametason injeksi 5 mg/ml 2015 Ampul - - #DIV/0!
64 Deksametason tablet 0.5 mg 2013 Tablet - - #DIV/0!
65 Deksametason tablet 0.5 mg 2015 Tablet 3,240.00 1500 4,740.00 3,970.00 26 152.69230769
66 Diazepam Inj 5 mg/ml 2013 Ampul 28.00 28.00 - #DIV/0!
67 Diazepam supp 2014 Supp - - #DIV/0!
68 Diazepam supp 2015 Supp 27.00 27.00 5.00 5 1
69 Diazepam tab 2 mg 2013 Tablet 564.00 564.00 - #DIV/0!
70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 59.00 59.00 - #DIV/0!
71 Digoksin tablet 0.25 mg 2014 Tablet 160.00 160.00 - #DIV/0!
72 Digoksin tablet 0.25 mg 2015 Tablet - - #DIV/0!
73 Dimenhidrinat tab 50 mg 2011 Tablet 100.00 100.00 - #DIV/0!
74 Doksisiklin kapsul 100 mg 2010 Kapsul - - - #DIV/0!
75 Domperidon suspensi 5 mg/5ml 2014 Botol - - #DIV/0!
76 Domperidon suspensi 5 mg/5ml 2015 Botol 125.00 125.00 61.00 20 3.05
77 Domperidon 10mg 2013 Tablet 395.00 300 695.00 186.00 21 8.8571428571
78 Efedrin HCl tablet 25 mg 2014 Tablet 250.00 250.00 - #DIV/0!
79 Ekstraks belladona tab 10 mg 2013 Tablet - - - #DIV/0!
80 Epinefrin / Adrenalin inj 0.1 % 2013 Ampul 34.00 34.00 - #DIV/0!
81 Eritromisin kapsul 250 mg 2013 Kapsul 430.00 430.00 20.00 2 10
82 Eritromisin kapsul 500 mg 2013 Kapsul - 300 300.00 80.00 5 16
83 Eritromisin sirup 200mg/5 ml 2014 Botol 115.00 115.00 4.00 4 1
84 Eritromisin sirup 200mg/5 ml 2015 Botol - - #DIV/0!
85 Etambutol tablet 250 mg 2011 Tablet - - - #DIV/0!
86 Fenobarbital tablet 30 mg 2010 Tablet - - #DIV/0!
87 Fenobarbital tablet 30 mg 2015 Tablet 100.00 100.00 - #DIV/0!
88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet - - - #DIV/0!
89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 200.00 200.00 - #DIV/0!
90 Fenol Gliserol tetes telinga 10-% 2013 Botol 51.00 51.00 1.00 1 1
91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet - - #DIV/0!
92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 224.00 224.00 30.00 6 5
93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul - - - #DIV/0!
94 Fitomenadion 2 mg inj 2013 Ampul - - #DIV/0!
95 Fitomenadion 2 mg inj 2015 Ampul - - - #DIV/0!
96 Furosemid tab 40 mg 2014 Tablet 635.00 635.00 280.00 14 20
97 Garam oralit serbuk kombinasi 2013 Bungkus - - #DIV/0!
98 Garam oralit serbuk kombinasi 2015 Bungkus 1,184.00 1,184.00 129.00 24 5.375
99 Gemfibrozil kapsul 300 mg 2014 Kapsul - - - #DIV/0!
100 Gentamisin inj 40 mg/ml 2014 Ampul - - - #DIV/0!
101 Gentamisin inj 40 mg/ml 2015 Ampul - - #DIV/0!
102 Gentamisin salep kulit 0.1 % 2014 Tube 42.00 15 57.00 57.00 18.0 3.1666666667
103 Gentamisin tetes mata 0.3% 2014 Botol - - - #DIV/0!
104 Gentian Violet larutan 1 % 2014 Botol 65.00 65.00 18.00 11.0 1.6363636364
105 Glibenklamid tablet 5 mg 2014 Tablet 570.00 570.00 110.00 14.0 7.8571428571

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
106 Glimepirid 2mg 2014 Tablet - - #DIV/0!
107 Glimepirid 2mg 2015 Tablet 240.00 100 340.00 10.00 1.0 10
108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 3,345.00 3,345.00 1,159.00 23.0 50.391304348
109 Gliseril Liquid 2014 Botol - - - #DIV/0!
110 Glukosa larutan infus 10% 2014 Botol 16.00 16.00 - #DIV/0!
111 Glukosa larutan infus 5% 2014 Botol 18.00 18.00 - #DIV/0!
112 Glukosa larutan infus 5% 2015 Botol - - #DIV/0!
113 Griseofulvin tablet 125 mg micronized 2014 Tablet - - #DIV/0!
114 Griseofulvin tablet 125 mg micronized 2015 Tablet 734.00 734.00 20.00 1.0 20
115 Haloperidol 2010 Tablet 460.00 460.00 - #DIV/0!
116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 789.00 789.00 56.00 9.0 6.2222222222
117 Hidrokortison cream 2,5 % 2013 Tube 48.00 96 144.00 120.00 21.0 5.7142857143
118 Hidrokortison cream 2,5 % 2015 Tube - - #DIV/0!
119 Ibuprofen suppositoria 2013 Supp 54.00 54.00 6.00 4.0 1.5
120 Ibuprofen suspensi 100mg/5ml 2013 Botol - - - #DIV/0!
121 Ibuprofen tablet 200 mg 2014 Tablet 710.00 800 1,510.00 1,000.00 21.0 47.619047619
122 Ibuprofen tablet 400 mg 2013 Tablet - - #DIV/0!
123 Ibuprofen tablet 400 mg 2015 Tablet 20.00 500 520.00 330.00 12.0 27.5
124 Isoniazid 100 mg 2011 Tablet - - - #DIV/0!
125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 165.00 165.00 43.00 7.0 6.1428571429
126 Kalium Diklofenak 50 mg 2014 Tablet 630.00 630.00 20.00 2.0 10
127 Kalsium Glukonat injkesi i.v 10% (100mg/ml) 2015 Tablet 5.00 5.00 - #DIV/0!
128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 730.00 3200 3,930.00 1,310.00 19.0 68.947368421
129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet - - #DIV/0!
130 Kaptopril tablet 12,5 mg 2013 Tablet - - #DIV/0!
131 Kaptopril tablet 12,5 mg 2015 Tablet 6,335.00 6,335.00 2,700.00 26.0 103.84615385
132 Kaptopril tablet 25 mg 2013 Tablet - - - #DIV/0!
133 Ketokonazol krim 2 % 2014 Tube 101.00 101.00 23.00 15.0 1.5333333333
134 Ketokonazol tablet 200 mg 2014 Tablet - - #DIV/0!
135 Ketokonazol tablet 200 mg 2015 Tablet 260.00 260.00 160.00 10.0 16
136 Ketorolac Injeksi 10 mg 2013 Ampul - - - #DIV/0!
137 Klindamisin kapsul 150 mg 2013 Kapsul 1,200.00 1,200.00 420.00 16.0 26.25
138 Klindamisin kapsul 300 mg 2014 Kapsul - - - #DIV/0!
139 Kloramfenikol kapsul 250 mg 2013 Kapsul 600.00 600.00 10.00 1.0 10
140 Kloramfenikol salep mata 1 % 2013 Tube - - #DIV/0!
141 Kloramfenikol salep mata 1 % 2015 Tube 35.00 24 59.00 16.00 12.0 1.3333333333
142 Kloramfenikol sirup 60 ml 2013 Botol - - - #DIV/0!
143 Kloramfenikol tetes mata 0.5 % 2014 Botol - - #DIV/0!
144 Kloramfenikol tetes mata 0.5 % 2015 Botol 14.00 25 39.00 28.00 15.0 1.8666666667
145 Kloramfenikol tetes telinga 3 % 2014 Botol - - - #DIV/0!
146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 4,544.00 4,544.00 2,254.00 26.0 86.692307692
147 Klorpromazin inj. i.m 25 mg/ml (HCL) 2014 Ampul 29.00 29.00 - #DIV/0!
148 Kodein 10 mg 2013 Tablet 94.00 94.00 - #DIV/0!
149 Kotrimoksazol suspensi 2014 Botol 225.00 225.00 22.00 15.0 1.4666666667
150 Kotrimoksazol suspensi 2015 Botol - - #DIV/0!
151 Kotrimoksazol tablet pead 2010 Tablet 200.00 200.00 200.00 #DIV/0!
Kotrimosazol tablet. Komb: Sulfametoksazol 400 mg +
152 2013 Tablet - - #DIV/0!
Trimetoprim 80 mg
Kotrimosazol tablet. Komb: Sulfametoksazol 400 mg +
153 2015 Tablet 1,110.00 1,110.00 110.00 12.0 9.1666666667
Trimetoprim 80 mg
154 Levofloksasin 500 mg Tablet - - - #DIV/0!
155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 199.00 199.00 12.00 12.0 1
156 Lidokain injeksi 2% 2013 Botol - - #DIV/0!
157 Lidokain injeksi 2% 2015 Botol 111.00 111.00 - #DIV/0!
158 Linkomisin kapsul 500 mg 2014 Kapsul - 700 700.00 90.00 6.0 15
159 Loperamid 2014 Tablet - - #DIV/0!
160 Loperamid 2015 Tablet 315.00 315.00 135.00 8.0 16.875

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
161 Loratadin tablet 2 mg 2015 Tablet 245.00 245.00 46.00 12.0 3.8333333333
162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 2.00 6 8.00 2.00 2.0 1
163 Meloksikam 15 mg 2013 Tablet - - #DIV/0!
164 Meloksikam 15 mg 2015 Tablet - 600 600.00 6.00 1.0 6
165 Meloksikam 7,5 mg 2014 Tablet 390.00 390.00 390.00 12.0 32.5
166 Metampiron Injeksi 2014 Ampul 29.00 29.00 - #DIV/0!
167 Metampiron Injeksi 2015 Ampul - - #DIV/0!
168 Metampiron tablet 500 mg 2014 Tablet 2,060.00 2,060.00 610.00 20.0 30.5
169 Metformin HCl tablet 500 mg 2015 Tablet 1,610.00 1,610.00 805.00 21.0 38.333333333
170 Metformin HCL tablet 850 mg 2015 Botol - - - #DIV/0!
171 Methisoprinol 250 mg/5ml 2014 Botol 12.00 12.00 3.00 3.0 1
172 Methisoprinol 500 mg 2013 Tablet - - #DIV/0!
173 Methisoprinol 500 mg 2015 Tablet 100.00 100.00 - #DIV/0!
174 Metilergometrin injeksi 0,200 mg-ml 2014 Ampul 60.00 60.00 60.00 #DIV/0!
175 Metilergometrin tablet salut 0,125 mg 2013 Tablet 200.00 200.00 - #DIV/0!
176 Metilergometrin tablet salut 0,125 mg 2015 Tablet - - #DIV/0!
177 Metilprednisolon 4 mg 2013 Tablet - - - #DIV/0!
178 Metoklopramide inj Ampul - - - #DIV/0!
179 Metoklopramide tablet 2013 Tablet - - #DIV/0!
180 Metoklopramide tablet 2015 Tablet 140.00 100 240.00 - #DIV/0!
181 Metronidazol infus 500 mg/100 ml 2014 Botol - - - #DIV/0!
182 Metronidazol tablet 250 mg 2014 Tablet 490.00 490.00 240.00 12.0 20
183 Metronidazol tablet 500 mg 2011 Tablet - - #DIV/0!
184 Metronidazol tablet 500 mg 2015 Tablet - - - #DIV/0!
185 Mikonazol cream 2014 Tube - - #DIV/0!
186 Mikonazol cream 2015 Tube 54.00 24 78.00 26.00 21.0 1.2380952381
187 Natrium Diklofenak tablet 25 mg 2013 Tablet - - - #DIV/0!
188 Natrium Diklofenak tablet 25 mg 2015 Tablet - - #DIV/0!
189 Natrium Diklofenak tablet 50 mg 2014 Tablet 3,400.00 3,400.00 360.00 14.0 25.714285714
190 Natrium Klorida larutan infus 0.9 % steril 2014 Botol - - #DIV/0!
191 Natrium Klorida larutan infus 0.9 % steril 2015 Botol 20.00 20.00 2.00 2.0 1
192 Nifedipin tablet 10 mg 2014 Tablet 524.00 524.00 120.00 13.0 9.2307692308
193 Nifedipin tablet 10 mg 2015 Tablet - - #DIV/0!
194 Nistatin Tablet salut 500.000 IU 2013 Tablet 380.00 380.00 - #DIV/0!
195 Nistatin tablet vaginal 100.000 IU/g 2013 Tablet - - #DIV/0!
196 Nistatin tablet vaginal 100.000 IU/g 2015 Tablet 147.00 147.00 10.00 2.0 5
197 OAT Kategori 2 2014 Paket - - - #DIV/0!
198 Obat Batuk Hitam 100 ml 2013 Botol - - #DIV/0!
199 Obat Batuk Hitam 100 ml 2015 Botol 199.00 199.00 - #DIV/0!
200 Obat Diare Dewasa 2010 Tablet - - - #DIV/0!
201 Obat FDC katagori sisipan 2013 Paket - - - #DIV/0!
202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube - - #DIV/0!
203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube - - - #DIV/0!
204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 50.00 50.00 - #DIV/0!
205 Oksitosin injeksi 10 IU/ml 2014 Ampul - 50 50.00 - #DIV/0!
206 Omeprazol kapsul 20 mg 2014 Kapsul - - #DIV/0!
207 Omeprazol kapsul 20 mg 2015 Kapsul - 1200 1,200.00 190.00 12.0 15.833333333
208 Ondansentron 4 mg 2014 Tablet - - #DIV/0!
209 Ondansentron 4 mg 2015 Tablet - - - #DIV/0!
210 Ondansentron inj 4 mg/2 ml 2014 Ampul - - #DIV/0!
211 Ondansentron inj 4 mg/2 ml 2015 Ampul 13.00 20 33.00 3.00 3.0 1
212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul - - #DIV/0!
213 Papaverin tablet 40 mg 2013 Tablet 454.00 454.00 89.00 8.0 11.125
214 Parasetamol drop 2014 Botol - - #DIV/0!
215 Parasetamol drop 2015 Botol 136.00 112 248.00 96.00 20.0 4.8
216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 206.00 168 374.00 243.00 26.0 9.3461538462
217 Parasetamol sirup 120 mg / 5 ml 2015 Botol - - #DIV/0!

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
218 Parasetamol Supp 2014 Supp - - - #DIV/0!
219 Parasetamol tablet 100 mg 2013 Tablet 200.00 200.00 - #DIV/0!
220 Parasetamol tablet 500 mg 2011 Tablet - - #DIV/0!
221 Parasetamol tablet 500 mg 2015 Tablet 11,335.00 11,335.00 5,915.00 26.0 227.5
222 Piracetam tablet 800 mg 2011 Tablet - - - #DIV/0!
223 Pirantel tablet 125 2013 Tablet 61.00 61.00 2.00 1.0 2
224 Pirazinamid tablet 500 mg 2013 Tablet - - - #DIV/0!
225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 2,436.00 2,436.00 357.00 20.0 17.85
226 Piroksikam tablet 10 mg 2013 Tablet - - - #DIV/0!
227 Piroksikam tablet 20 mg 2014 Tablet 1,134.00 1,134.00 1,044.00 21.0 49.714285714
228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 10.00 10.00 - #DIV/0!
229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 29.00 29.00 10.00 10.0 1
230 Prednison tablet 5 mg 2011 Tablet - - #DIV/0!
231 Prednison tablet 5 mg 2015 Tablet 4,330.00 4,330.00 706.00 16.0 44.125
232 Propanolol tablet 10 mg 2013 Tablet 190.00 190.00 - #DIV/0!
233 Pseudoefedrin Hcl Drop 2014 Botol - - #DIV/0!
234 Pseudoefedrin Hcl Drop 2015 Botol 33.00 33.00 8.00 8.0 1
235 Ramipril 5 mg 2014 Tablet 100.00 100.00 - #DIV/0!
236 Ranitidin Hcl Sirup 2014 Botol - - #DIV/0!
237 Ranitidin Hcl Sirup 2015 Botol 21.00 21.00 - #DIV/0!
238 Ranitidin injeksi 2014 Ampul - - - #DIV/0!
239 Ranitidin tablet 150 mg 2014 Tablet 1,870.00 1300 3,170.00 1,370.00 24.0 57.083333333
240 Ranitidin tablet 150 mg 2015 Tablet - - #DIV/0!
241 Retinol (VIT A) kapsul 100.000 IU 2014 Kapsul - 1050 1,050.00 - #DIV/0!
242 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul 3,800.00 9150 12,950.00 - #DIV/0!
243 Retinol (VIT A) tablet salut 200.000 IU 2015 Kapsul - - #DIV/0!
244 Rifampisin kapsul 300 mg 2013 Kapsul - - - #DIV/0!
245 Ringer laktat larutan infus steril 2014 Botol 183.00 100 283.00 283.00 29.0 9.7586206897
246 Saccarum Lactis 2013 Botol - - - #DIV/0!
247 Salbutamol nebules 2013 Kotak - - - #DIV/0!
248 Salbutamol nebules 2015 Kotak - - #DIV/0!
249 Salbutamol tab 4 mg 2013 Tablet - - #DIV/0!
250 Salbutamol tab 4 mg 2015 Tablet 350.00 200 550.00 125.00 10.0 12.5
251 Salbutamol tablet 2 mg Tablet - - - #DIV/0!
252 Salep 2-4 2011 Tube - - - #DIV/0!
253 Salisil Bedak 2 % 2014 Kotak - - #DIV/0!
254 Salisil Bedak 2 % 2015 Kotak 117.00 117.00 62.00 14.0 4.4285714286
255 Sefadroksil kapsul 500 mg 2014 Kapsul 410.00 800 1,210.00 470.00 14.0 33.571428571
256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 2.00 2.00 2.00 1.0 2
257 Seftazidim Injeksi Ampul - - - #DIV/0!
258 Seftriakson injeksi 1 gram 2013 Ampul - - - #DIV/0!
259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 30.00 30.00 - #DIV/0!
260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 7,081.00 7,081.00 901.00 21.0 42.904761905
261 Simetidin tab 200 mg 2014 Tablet 560.00 560.00 - #DIV/0!
262 Simvastatin tablet 10 mg 2015 Tablet 1,470.00 100 1,570.00 830.00 15.0 55.333333333
263 Simvastatin tablet 20 mg 2015 Tablet - - - #DIV/0!
264 Siprofloksasin tablet 500 mg 2014 Tablet - - #DIV/0!
265 Siprofloksasin tablet 500 mg 2015 Tablet 50.00 500 550.00 260.00 16.0 16.25
266 Siprofloksasin tablet 500 mg 2015 Tablet - - #DIV/0!
267 Sulfacetamida Natrium tetes mata 2013 Botol - - #DIV/0!
268 Sulfacetamida Natrium tetes mata 2015 Botol 48.00 48.00 - #DIV/0!
269 Teofilin Tablet 2013 Tablet 99.00 99.00 - #DIV/0!
270 Tetrasiklin kapsul 500 mg 2011 Kapsul - - - #DIV/0!
271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 2,018.00 3000 5,018.00 2,888.00 16.0 180.5
272 Tiampenikol kapsul 500 mg 2014 Kapsul 450.00 100 550.00 340.00 10.0 34
273 Tramadol inj 50 mg/ml 2014 Ampul - - - #DIV/0!
274 Tramadol kapsul 50 mg 2014 Kapsul 320.00 320.00 50.00 5.0 10

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
275 Triamcinolon Acetonide 1 mg krim 2014 Tube - - - #DIV/0!
276 Triamsinolon Tablet 2013 Tablet 30.00 30.00 - #DIV/0!
277 Triheksifenidil tab 2 mg 2014 Tablet 130.00 500 630.00 - #DIV/0!
278 Vitamin B Komplek 2014 Tablet 2,540.00 1000 3,540.00 2,235.00 19.0 117.63157895
279 Vitamin B Komplek 2015 Tablet - - #DIV/0!
280 Zink tablet 20 mg 2014 Tablet 2,850.00 2,850.00 110.00 10.0 11
281 Albendazol suspensi 200mg/5ml 2013 Botol - - - #DIV/0!
282 Anti Hipertensi Herbal 2015 Tablet 30.00 30.00 - #DIV/0!
283 Anti Oksidan Tablet 2013 Tablet 4,050.00 4,050.00 410.00 20.0 20.5
284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube - - - #DIV/0!
285 Antispasmodik Inj 2013 Ampul 10.00 10.00 10.00 10.0 1
286 Antispasmodik kombinasi 2014 Tablet - - #DIV/0!
287 Antispasmodik kombinasi 2015 Tablet - - - #DIV/0!
288 Budesonid respules/ cairan inhaler 2014 Pcs 5.00 5.00 - #DIV/0!
289 Cairan Elektrolit Kombinasi Na, Cl, Glucose 2013 Botol - - - #DIV/0!

290 Cairan Elektrolit Kombinasi Na, K, Cl, Lactate, Glucose 2014 Botol 25.00 25.00 3.00 3.0 1

291 Cairan Elektrolit Kombinasi Na, K, Cl, Lactate, Glucose 2015 Botol - - #DIV/0!
292 Cairan Elektrolit Kombinasi Na, K, Cl,Ca,Asetat 2014 Botol - - - #DIV/0!
293 Cairan Elektrolit Kombinasi Na, K, Cl,Ca,Asetat 2015 Botol - - #DIV/0!

294 Cairan Hydroxyethyl Strach (HES) 200/0.5 60 g, Nacl 9 g 2014 Botol 20.00 20.00 7.00 7.0 1

295 Cairan Hydroxyethyl Strach (HES )200/0.5 60 g, Nacl 9 g 2015 Botol - - #DIV/0!
296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 10.00 10.00 - #DIV/0!
297 Curcuma Tab 2013 Tablet - - - #DIV/0!
298 Enzim Pencernaan 2013 Tablet 2,010.00 2,010.00 920.00 15.0 61.333333333
299 Fenoterol nebules solution 2013 Botol 2.00 2.00 1.00 1.0 1
300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs - - - #DIV/0!
301 Isoxsuprine Hcl Tablet 2013 Tablet - - - #DIV/0!
302 Klopidogrel 75 mg 2014 Tablet 90.00 90.00 - #DIV/0!
303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 190.00 190.00 - #DIV/0!
304 Kombinasi Amino Acid,Vitamin,electrolytes 2013 Botol - - - #DIV/0!
Kombinasi CaCl2 anhidrat 0.075 gram, Kalium Iodida
0.075 gram, Natrium Tiosulfat 0.0075 gram, fenilmerkuri 2013
305 nitrat 0.3 mg Botol - - - #DIV/0!
Kombinasi Lactobacillus+
306 2013 Tablet 1,500.00 1,500.00 750.00 18.0 41.666666667
Bifidobacterium+Streptococcus
Kombinasi Policresulen (Condensation product of
metacresolsulfonic acid & methanal) 100 mg, 2013
307 cinchocaine HCl 2.5 mg Supp - - - #DIV/0!
308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet - - - #DIV/0!
309 Krim Analgesik 2013 Tube - - - #DIV/0!
310 Krim Antiinflamasi 2013 Tube - - - #DIV/0!
311 Lactulose Sirup 2014 Botol 25.00 25.00 1.00 1.0 1
312 Lactulose Sirup 2015 Botol - - #DIV/0!
313 Mineral mix, kombinasi 2014 Sachet - - - #DIV/0!
314 Mineral mix, kombinasi 2015 Sachet - - #DIV/0!
315 Mometasone Furoate Krim 2013 Tube - - - #DIV/0!
316 Multivitamin anak sirup 2014 Botol - - #DIV/0!
317 Multivitamin anak sirup 2015 Botol 75.00 120 195.00 157.00 18.0 8.7222222222
318 Multivitamin dewasa 2014 Tablet - - #DIV/0!
319 Multivitamin dewasa 2015 Tablet 30.00 300 330.00 105.00 10.0 10.5
320 Natrium Fe EDTA drop 2013 Botol - - - #DIV/0!
321 Nistatin dan Zn Oxide Salep 2013 Tube - - - #DIV/0!
322 Norethisterone Tablet 2013 Tablet - - - #DIV/0!

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
323 Obat Antianemia 2014 Tablet - - - #DIV/0!
324 Obat Antianemia 2015 Tablet - - #DIV/0!
325 Obat Antianemia 2015 Tablet - - #DIV/0!
326 Obat Antifungi Drop 2014 Botol 24.00 28 52.00 14.00 12.0 1.1666666667
327 Obat Antifungi Drop 2015 Botol - - #DIV/0!
328 Obat Batuk Hitam + Parasetamol 2014 Botol 74.00 74.00 43.00 19.0 2.2631578947
329 Obat Flu dan Batuk Sirup 2014 Botol 174.00 174.00 129.00 20.0 6.45
330 Obat Flu Tablet 2014 Tablet - - #DIV/0!
331 Obat Flu Tablet 2015 Tablet 310.00 1500 1,810.00 1,390.00 23.0 60.434782609
332 Obat Hepatoprotektor 2014 Tablet 180.00 600 780.00 360.00 14.0 25.714285714
333 Obat luka bakar 2014 Tube 11.00 11.00 11.00 11.0 1
334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul - - - #DIV/0!
335 Permetrin krim 5% 10 g 2014 Tube - 10 10.00 1.00 1 1
Policresulen (Produk kondensasi dari asam
336 2014 Botol - - #DIV/0!
metakresolsufonat dan Methanal)
Policresulen (Produk kondensasi dari asam
337 2015 Botol 27.00 27.00 3.00 3.0 1
metakresolsufonat dan Methanal)
338 Povidon iodin gargle 2014 Botol 3.00 3.00 - #DIV/0!
339 Procaterol Hcl, Hemihydrate 2013 Tablet 100.00 100.00 - #DIV/0!
Salep Kombinasi : Betametason valerat 0.1 % +
340 2014 Tube - - - #DIV/0!
Neomisin Sulfat
341 Siproheptadine Hcl Tablet 2013 Tablet 683.00 683.00 - #DIV/0!
342 Sirup Besi Kombinasi 2013 Botol - - - #DIV/0!
343 Suplemen Ibu Menyusui 2014 Tablet - - #DIV/0!
344 Suplemen Ibu Menyusui 2015 Tablet 174.00 60 234.00 24.00 2.0 12
345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet - - - #DIV/0!
346 Suplemen Untuk Gizi Anak 2014 Sachet - - - #DIV/0!
347 Suplemen Untuk Gizi Anak 2015 Sachet - - #DIV/0!
348 Suplemen untuk sendi dan tulang 2014 Tablet - - - #DIV/0!
Suplemen Untuk Stimulasi Sistem Imunitas Dewasa
349 Tablet 2013 Tablet 68.00 68.00 38.00 3.0 12.666666667
350 Tamsolusin Hcl Tablet 2013 Tablet - - - #DIV/0!
351 Terbutalin cairan ih 2. mg/ml 2014 Pcs 5.00 5.00 - #DIV/0!
352 Terbutalin Sulfate 0.5 mg/ml 2013 Ampul - - - #DIV/0!
353 Tiotropium Br 2013 Pcs - - - #DIV/0!
354 Valsartan 80 mg 2014 Tablet - - - #DIV/0!
355 Vitamin Neurotopik 2013 Tablet - - #DIV/0!
356 Vitamin Neurotopik 2015 Tablet 50.00 400 450.00 - #DIV/0!

357 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2014 Ampul - - #DIV/0!

358 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 50.00 50.00 8.00 8.0 1

359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol - - - #DIV/0!
360 Zink Syrup 2014 Botol 74.00 74.00 31.00 15.0 2.0666666667
361 Alveogyl 2014 Botol - - - #DIV/0!
362 Bonding 2013 Botol 1.00 1 2.00 1.00 25.0 0.04
363 Cairan Pembersih Gigi 2015 Botol - - #DIV/0!
364 Cresophen 2014 Botol 1.00 1 2.00 1.00 25.0 0.04
365 Devitalisasi pasta non arsen 2014 Kotak 1.00 1 2.00 1.00 25.0 0.04
366 Etching 2013 Pcs 1.00 1 2.00 1.00 25.0 0.04
367 Etching 2015 Pcs - - #DIV/0!
368 Etil klorida semprot 2014 Botol 1.00 2 3.00 2.00 25.0 0.08
369 Eugenol cairan 2012 Botol - 2 2.00 1.00 25.0 0.04
370 Fletcher Cairan 2014 Botol - 1 1.00 - #DIV/0!
371 Fletcher Serbuk 2014 Botol - 1 1.00 - #DIV/0!
372 Fletcher serbuk dan cairan 2012 Botol - - - #DIV/0!

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
373 Glass Ionomer cement Art 2014 Set 1.00 1 2.00 1.00 25.0 0.04
374 Glass Ionomer cement Art 2015 Set - - #DIV/0!
375 Kalsium Hidroksida pasta 2014 Set 1.00 1 2.00 1.00 25.0 0.04
376 Metronidazol Gel untuk Peridonitis 2014 Tube - 1 1.00 1.00 25.0 0.04
377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 1.00 1 2.00 1.00 25.0 0.04
378 Mummifying pasta 2014 Set 1.00 1 2.00 1.00 25.0 0.04
379 OCO 2014 Botol - - - #DIV/0!
380 Pasta Iodoform 2014 Kotak - 1 1.00 1.00 25.0 0.04
381 Pulperyl 2014 Botol - - - #DIV/0!
382 Semen seng fosfat serbuk 2014 Set 1.00 1 2.00 1.00 25.0 0.04
383 Tambal Sementara Untuk Gigi 2015 Botol - - #DIV/0!
384 Tambal Sementara Untuk Gigi Belakang 2014 Botol - - - #DIV/0!
385 Tambal Sementara Untuk Gigi Depan 2014 Botol - 2 2.00 - #DIV/0!
386 Tambal Sinar Warna A2 2013 Syringe - 1 1.00 - #DIV/0!
387 Tambal Sinar Warna A2 2015 Syringe - - #DIV/0!
388 Tambal Sinar Warna A3 2014 Syringe - 1 1.00 - #DIV/0!
389 Tambal Sinar Warna A3,5 2013 Syringe - 1 1.00 - #DIV/0!
390 Tambal Sinar Warna A3,5 2015 Syringe - - #DIV/0!
391 Trikresol Formalin 2014 Botol 1.00 1 2.00 1.00 25.0 0.04
392 Alat suntik sekali pakai 1 ml 2012 Pcs - - - #DIV/0!
393 Alat suntik sekali pakai 2.5 ml 2012 Pcs 59.00 600 659.00 149.00 25.0 5.96
394 Alat suntik sekali pakai 5 ml 2012 Pcs 800.00 800.00 400.00 25.0 16
395 Alat Suntik 3 cc 2013 Pcs - - - #DIV/0!
396 Alat Suntik 3 cc 2015 Pcs - - #DIV/0!
397 Alat Suntik 10 cc 2014 Pcs - - - #DIV/0!
398 Alkohol 1000 ml 2013 Botol - - #DIV/0!
399 Alkohol 1000 ml 2015 Botol - 5 5.00 1.00 1.0 1
400 Alkohol 70% 100 ml 2014 Botol - - - #DIV/0!
401 Alkohol Swab 2014 Pcs 1,600.00 1,600.00 - #DIV/0!
402 Alkohol Swab 2015 Pcs 500 500.00 - #DIV/0!
403 Aqua Jell (Ky Jelly) 2013 Tube - - - #DIV/0!
404 Aquabidest 500ml 2014 Botol 12.00 12.00 - #DIV/0!
405 Articulating paper 2014 Kotak - - - #DIV/0!
406 Aseptic Gel + Dispenser 500 ml 2015 Botol - 12 12.00 12.00 1.0 12
407 Blood transfusion set 2013 Pcs - - #DIV/0!
408 Blood transfusion set 2014 Pcs - - - #DIV/0!

409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol - - - #DIV/0!

410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol - - - #DIV/0!
Cairan desinfektan untuk sistem penyedotan pd alat
411 2014 Galon - - - #DIV/0!
dental
Cairan desinfektan untuk sistem penyedotan pd alat
412 2015 Botol - - #DIV/0!
dental
413 Cutgut 2/0 Chromic 2014 Pcs 48.00 48.00 - #DIV/0!
414 Cutgut 2/0 Plain 2014 Pcs 288.00 288.00 - #DIV/0!
415 Cutgut 3/0 Chromic 2014 Pcs 72.00 72.00 - #DIV/0!
416 Cutgut 3/0 Plain 2014 Pcs 304.00 304.00 2.00 2.0 1
417 Cutgut Plain 2/0 (roll) 2013 Roll 3.00 3.00 - #DIV/0!
418 Desinfektan Lantai 2014 Botol - - - #DIV/0!
419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 57.00 57.00 - #DIV/0!
420 Dressing retention 5 cm x 5 cm 2013 Roll - - - #DIV/0!
421 Dressing transparant untuk pemasang i.v catheter 2014 Pcs 350.00 350.00 - #DIV/0!
422 Etakridin larutan 0,1 % (Rivanol) 2013 Botol - - #DIV/0!
423 Etakridin larutan 0,1 % (Rivanol) 2015 Botol 2.00 2 4.00 - #DIV/0!
424 Foley Catheter # 16 2013 Pcs 26.00 26.00 - #DIV/0!
425 Foley Catheter # 18 2013 Pcs 26.00 26.00 - #DIV/0!

STOCK Lama Hari Pemakaian
No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN
AWAL Pemakaian Rata-Rata
426 H2O2 3% 2014 Botol 3.00 3.00 2.00 2.0 1
427 Hand Scoon (Steril) # 6.5 2014 Pcs - - #DIV/0!
428 Hand Scoon (Steril) # 6.5 2015 Pcs 600.00 600.00 200.00 25.0 8
429 Hand Scoon (Steril) # 7 2014 Pcs - - #DIV/0!
430 Hand Scoon (Steril) # 7 2015 Pcs 400.00 400.00 - #DIV/0!
431 Handscoon Non Steril L 2013 Pcs - - - #DIV/0!
432 Handscoon Non Steril L 2015 Pcs - - #DIV/0!
433 Handscoon Non Steril M 2013 Pcs - - - #DIV/0!
434 Handscoon Non Steril M 2015 Pcs - - #DIV/0!
435 Handscoon Non Steril S 2013 Pcs - - - #DIV/0!
436 Handscoon Non Steril S 2015 Pcs - - #DIV/0!
437 Handscoon Non Steril S 2015 Pcs - - #DIV/0!
438 Handscoon Non Steril XS 2013 Pcs - - - #DIV/0!
439 Handscoon panjang untuk manual plasenta 2014 Pasang - - - #DIV/0!
440 Handscoon panjang untuk manual plasenta 2015 Pasang - - #DIV/0!
441 ID Pasien bayi biru 2014 Pcs 200.00 200.00 - #DIV/0!
442 ID pasien bayi pink 2014 Pcs 200.00 200.00 - #DIV/0!
443 Infus Anak 2013 Pcs 60.00 60.00 - #DIV/0!
444 Infus set dewasa 2014 Pcs 1,164.00 1,164.00 7.00 3.0 2.3333333333
445 IUD 2010 Pcs 100.00 100.00 - #DIV/0!
446 IV Catheter 18 2012 Pcs 106.00 106.00 106.00 #DIV/0!
447 IV Catheter 20 2013 Pcs 36.00 36.00 24.00 15.0 1.6
448 IV Catheter 20 2015 Pcs - - #DIV/0!
449 IV Catheter 22 2013 Pcs - - - #DIV/0!
450 IV Catheter 22 2015 Pcs - - #DIV/0!
451 IV Catheter 24 2013 Pcs - - - #DIV/0!
452 IV Catheter 24 2015 Pcs - - #DIV/0!
453 IV Catheter 26 2013 Pcs 50.00 50.00 - #DIV/0!
454 IV Chateter No. 18 with injection Port 2014 Pcs 978.00 978.00 1.00 1.0 1
455 IV Chateter No. 20 with injection Port 2014 Pcs - - - #DIV/0!
456 IV Catheter no 22 with injection Port 2014 Pcs 130.00 130.00 98.00 25.0 3.92
457 IV Catheter no 24 with injection Port 2014 Pcs 48.00 48.00 15.00 11.0 1.3636363636
458 IV Catheter no 26 with injection Port 2014 Pcs - - - #DIV/0!
459 Jarum Hekting Kulit 2013 Lusin 15.00 15.00 - #DIV/0!
460 Jarum Hekting Kulit 2015 Kotak - - #DIV/0!
461 Jarum Hekting Otot 2013 Lusin 10.00 10.00 - #DIV/0!
462 Jarum Hekting Otot 2015 Kotak - - #DIV/0!
463 Jelly USG 2014 Botol 30.00 30.00 - #DIV/0!
464 Kapas 1 kg 2013 Roll - - #DIV/0!
465 Kapas 1 kg 2015 Roll 1.00 1.00 - #DIV/0!
466 Kapas 500 g 2014 Roll - - - #DIV/0!
467 Kapas pembalut 250 mg 2013 Pcs - - - #DIV/0!
468 Kapas pembalut 250 mg 2015 Pcs - - #DIV/0!
469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 13.00 13.00 - #DIV/0!
470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 90.00 90.00 30.00 15.0 2
471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak - - #DIV/0!
472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs - - - #DIV/0!
473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak - - #DIV/0!
474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 23.00 23.00 - #DIV/0!
475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 665.00 665.00 - #DIV/0!
476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 118,680.00 118,680.00 680.00 26.0 26.153846154
477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs - - #DIV/0!
478 Lisol 2011 Botol - - #DIV/0!
479 Lisol 2015 Botol - 5 5.00 5.00 5.0 1
480 Masker 2015 Pcs 300.00 300.00 - #DIV/0!
481 Masker Nebulizer Anak 2014 Pcs 30.00 30.00 1.00 1.0 1
482 Masker Nebulizer Dewasa 2014 Pcs 99.00 99.00 - #DIV/0!

.00 100. .00 165.00 .000. . #DIV/0! 492 Mata bor diamond tapered 2014 Pcs 66. . STOCK Lama Hari Pemakaian No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian Rata-Rata 483 Masker Tali 2013 Pcs 500. . #DIV/0! 534 Three way stopcock with 10 cm tube 2014 Pcs 69. .7 2015 . . .0 1 536 Underpad 60 x 90 2014 Pcs 170. . #DIV/0! 493 Mata bor poles 2014 Pcs . . . #DIV/0! 519 Plastik klip 13 x 8. #DIV/0! 526 Selang O2 Dewasa (nasal oxygen canula. . .00 .000. .00 . #DIV/0! 523 Plester roll kertas 1" 2014 Roll 420. .00 .00 98. #DIV/0! 490 Mata bor diamond rounded 2014 Pcs . . . #DIV/0! 510 Pisau bisturi 11 2014 Pcs . #DIV/0! 507 Pembalut Gips 4 Inchi 2013 roll . #DIV/0! 486 Mata bor diamond fissur 2015 Pcs .0 1 535 Umbilical Klem 2014 Pcs 8.adult) 2014 Pcs .00 2. #DIV/0! 499 Needle no.00 . #DIV/0! 494 Mata bor poles composite pear 2014 Pcs . #DIV/0! 527 Selang O2 Dewasa (nasal oxygen canula.00 420.00 66.00 . #DIV/0! 488 Mata bor diamond inverted 2014 Pcs . #DIV/0! 511 Pisau bisturi 15 2014 Pcs . .00 69. . #DIV/0! 497 Mata bor tulang gigi 2015 Pcs . #DIV/0! 539 Wing Needle No. #DIV/0! 487 Mata bor diamond high speed 2013 Set 2. .00 50 58. .00 . #DIV/0! 525 Selang O2 anak (nasal oxygen canula.00 68. #DIV/0! 506 Pembalut Gips 3 Inchi 2013 roll . #DIV/0! 498 Mucus Ekstractor 2014 Pcs . . #DIV/0! 516 Plastik klip 7 x 10 2015 Pcs 4. . #DIV/0! 495 Mata bor poles composite flame 2014 Pcs . #DIV/0! 496 Mata bor tulang gigi 2014 Pcs . #DIV/0! 533 Suction Catheter Canul 14 2013 Pcs . .27 2014 Pcs .6666666667 484 Mata bor diamond endo akses 2014 Pcs . . #DIV/0! 522 Plester kain 2 x 5y 2014 Pcs 165. #DIV/0! 500 NGT No.00 . #DIV/0! 538 Wing Needle No. #DIV/0! 502 NGT No. .000. . .000. .00 170.00 15.000. . .00 32. . . .child) 2014 Pcs . #DIV/0! 485 Mata bor diamond fissur 2014 Pcs 15. #DIV/0! 532 Suction Catheter Canul 12 2013 Pcs . 3/0 dengan jarum bedah 2014 Pcs 68. 8 2013 Pcs . #DIV/0! 491 Mata bor diamond rounded 2015 Pcs . 18 2013 Pcs . . .000. #DIV/0! 508 Pembalut Gips 6 Inchi 2013 roll . . . . .00 14. #DIV/0! 504 NGT No.00 8. . . . . .00 4. . .00 . . .00 23.00 8. . #DIV/0! 501 NGT No. .23 G 2013 Pcs 134. . 16 2013 Pcs . #DIV/0! 513 Pisau Bisturi 22 2013 Pcs 100.00 100. #DIV/0! 514 Plastik klip 4 x 6 2014 Pcs 23.adult) 2015 Pcs . . . . #DIV/0! 529 Suction Catheter Canul 6 2013 Pcs . . #DIV/0! 518 Plastik klip 13 x 8.00 14. #DIV/0! 505 NGT No. . 10 2013 Pcs . .00 . 12 2013 Pcs . #DIV/0! 521 Plastik Limbah Medis 2015 . #DIV/0! 509 Pisau Bisturi 10 2014 Pcs 98. #DIV/0! 530 Suction Catheter Canul 8 2013 Pcs .00 500. #DIV/0! 528 Silk Benang bedah no.00 .00 15.7 2014 Pcs . #DIV/0! 537 Urine Bag 2014 Pcs 32. .0 6. #DIV/0! 520 Plastik kresek obat 2013 Kg . #DIV/0! . . . . .00 .00 134. #DIV/0! 489 Mata bor diamond inverted 2015 Pcs . #DIV/0! 524 Safety Box 2015 Pcs .00 100.00 . #DIV/0! 517 Plastik klip 8 x 5 2014 Pcs 8.00 .00 . . #DIV/0! 512 Pisau Bisturi 20 2013 Pcs 100. #DIV/0! 515 Plastik klip 7 x 10 2014 Pcs . #DIV/0! 531 Suction Catheter Canul 10 2013 Pcs . . 14 2013 Pcs . . #DIV/0! 503 NGT No.21 G 2013 Pcs .00 8. . . .

M.Si.25 2013 Pcs 36. Suharno.Dyah Indriastuti BU. Yang Menyerahkan Yang Meminta Kepala Dinas Kesehatan Kepala UPT Farmasi Kepala UPT Puskesmas Kota Tangerang Selatan (Drs.S. #DIV/0! 541 Wing Needle no.00 .SiT.445 Pencabutan Pencabutan Tambal Tambal Jumlah Tindakan Yang Dilakukan gigi tetap gigi susu Tetap/Permanen sementara 12 30 19 31 92 Mengetahui..S.00 2. STOCK Lama Hari Pemakaian No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian Rata-Rata 540 Wing Needle no.27 2013 Pcs 38.00 . 19630808 198303 2 007 . 19600924 198501 1 001 NIP.Kes) (Irwan Hartono.MMKes) NIP.00 38. 19781102 200604 1 015 NIP.00 36. #DIV/0! Bayar BPJS Gratis Lain-Lain Jumlah JUMLAH KUNJUNGAN RESEP 130 2167 148.Apt) (Hj.

00 372. #DIV/0! #DIV/0! 0 14 190 140. #DIV/0! #DIV/0! 0 0 #DIV/0! 30.00 1647.96666667 (389.60 0 0 #DIV/0! .83) 0 0 #DIV/0! .00 237.00 452 (148.620689655 320.170.67 1500 0 #DIV/0! .0769231 (1.00 1504.00 1855.00 1969.793103448 80. #DIV/0! #DIV/0! 0 133.00 200 0 #DIV/0! .00 1539. #DIV/0! #DIV/0! 0 0 #DIV/0! .172413793 7.8 212.250.6 #DIV/0! .00 93.05 0 200 655. #DIV/0! #DIV/0! 50 7 51. #DIV/0! #DIV/0! 0 166 543.484.00) 0 0 #DIV/0! . #DIV/0! #DIV/0! 0 88 643.254.1724138 (5.00 1171.5 65. #DIV/0! #DIV/0! 0 21.5 4. #DIV/0! #DIV/0! 0 0 #DIV/0! .00 2374.00 #DIV/0! #DIV/0! 0 4 190 411.80 1500 0 #DIV/0! .7333333 1. #DIV/0! #DIV/0! 0 70 554.3448275862 . #DIV/0! #DIV/0! 0 0 #DIV/0! .666666667 20.166666667 1.153846154 12.4 82.133333333 122.74482759 105.8461538462 93. #DIV/0! #DIV/0! 0 2. #DIV/0! #DIV/0! 150 17.054.83) 0 0 #DIV/0! .1538461538 81.846153846 (13.00 974. #DIV/0! #DIV/0! 0 122 772. #DIV/0! #DIV/0! 0 0 #DIV/0! .74 0 5 39.563.05 115.79 1500 0 #DIV/0! . #DIV/0! #DIV/0! 0 201 763.00 4235. 69.15 0 11.00 79.6 108 95.58 175 0 #DIV/0! .65 72.5833333333 .6 142.50 1200 256 838. #DIV/0! #DIV/0! 0 0 #DIV/0! .459.00 0 0 #DIV/0! .00 187.225.155.7931034 1.00 814 194.16666667 (275.166666667 762.525.73 0 0 #DIV/0! .583333333 69.8 1. #DIV/0! #DIV/0! 0 30 570 300.6206897 2.299.00 274 134. #DIV/0! #DIV/0! 0 6 43.00 214 (197. #DIV/0! #DIV/0! 150 145 475 3.00 #DIV/0! #DIV/0! 0 0 #DIV/0! .6 846.880.4 37.8 715. #DIV/0! #DIV/0! 0 .00) 0 0 #DIV/0! 100. #DIV/0! #DIV/0! 0 0 #DIV/0! .03) 0 394 1871.076923077 2. 105. PELAPORAN BULAN : Januari 2016 PERMINTAAN BULAN : Februari 2016 STOCK STOCK Buffer Lead Time PERMINTAAN PEMBERIAN AKHIR OPTIMAL Hasil SO 9 10 11 12 0 #DIV/0! .62 2500 0 #DIV/0! .00 500 0 #DIV/0! .00 750 450.00 1345 (1.92) 0 26. #DIV/0! #DIV/0! 0 0 #DIV/0! .735.15) 0 12 380 600.6666667 1. #DIV/0! #DIV/0! 0 66 418 620.00) 0 0 #DIV/0! .

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#DIV/0! 29 Aqua Pro Injeksi steril @ 20 2014 Vial .00 #DIV/0! 35 Asam Folat tab 1 mg 2013 Tablet .00 1500 1.00 #DIV/0! 20 Antasida DOEN tablet 2015 Tablet .00 #DIV/0! 22 Antasida DOEN Suspensi 2015 Botol 81.00 #DIV/0! 4 Ambroksol Syrup 15 mg / ml 2015 Botol 72. C) tablet 50 mg 2014 Tablet 715.00 1200 5.00 2500 2.225. 150 150. 0 .00 #DIV/0! 23 Anti Bakteri DOEN salep 2013 Tube .00 0 81. 0 . 0 . 0 .00 #DIV/0! 46 Atapulgit 2011 Tablet .00 0 95. #DIV/0! 24 Anti Bakteri DOEN salep 2015 Tube . #DIV/0! 7 Aminofilin inj 24 mg /ml 2014 Ampul 30. 0 .00 #DIV/0! 19 Antasida DOEN tablet 2014 Tablet 3.00 0 30.00 #DIV/0! 32 Asam Asetilsalisilat 100 mg 2011 Tablet .00 #DIV/0! 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet . Klavulanat 2013 Tablet 762.00 #DIV/0! 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol .155. #DIV/0! 11 Amlodipin 10 mg 2015 Tablet .00 #DIV/0! 6 Ambroksol tablet 30 mg 2015 Tablet . 0 . 0 . 0 . #DIV/0! 2 Allopurinol tablet 100 mg 2015 Tablet 80.215. #DIV/0! 26 Anti Hemmoroid DOEN supp 2014 Supp . #DIV/0! 12 Amlodipin 5 mg 2015 Tablet 2. 0 . 0 . #DIV/0! 40 Asam Tranexamat 250mg 2013 Tablet 122.00 #DIV/0! 8 Aminofilin tab 200 mg 2014 Tablet 411.520.225.00 0 140. 0 . LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN STOCK Lama Hari Pemakaian No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian Rata-Rata 1 2 3 4 5 6 7 8 1 Allopurinol tablet 100 mg 2014 Tablet . 0 .00 1500 2. #DIV/0! 33 Asam Askorbat (Vit.00 #DIV/0! 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 100.00 #DIV/0! 3 Ambroksol Syrup 15 mg / ml 2014 Botol .580.00 #DIV/0! 16 Amoksisilin kaplet 500 mg 2015 Tablet . #DIV/0! 42 Asiklovir krim 5% 2013 Tube 93.00 0 600.00 #DIV/0! 43 Asiklovir Tablet 200 mg 2013 Tablet 600. #DIV/0! 28 Anti migren / Ergotamin 2013 Tablet . 50 50. #DIV/0! 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 95. #DIV/0! 30 Asam Asetilsalisilat 80 mg 2014 Tablet .00 0 7. 150 150. #DIV/0! 21 Antasida DOEN Suspensi 2014 Botol .170.250.155.00 #DIV/0! 44 Asiklovir Tablet 200 mg 2015 Tablet . 0 .00 0 100. #DIV/0! 34 Asam Askorbat (Vit.00 #DIV/0! 14 Amoksisilin kaplet 250 mg 2013 Tablet 4.250.00 #DIV/0! 41 Asam Tranexamat Injeksi 2013 Ampul .00 1500 1.00 #DIV/0! 15 Amoksisilin kaplet 500 mg 2014 Tablet 320.370. 0 . 0 . 0 .00 0 3.735. 175 175.00 #DIV/0! 25 Anti Fungi DOEN kombinasi salep 2013 Pot .00 #DIV/0! 37 Asam Mefenamat Tablet 500 mg 2014 Tablet . 0 .00 #DIV/0! 5 Ambroksol tablet 30 mg 2014 Tablet 7. #DIV/0! 27 Anti Hemmoroid DOEN supp 2015 Supp . #DIV/0! .00 #DIV/0! 13 Amoksisilin + As. #DIV/0! 31 Asam Asetilsalisilat 80 mg 2015 Tablet 140. 0 .820. #DIV/0! 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 20.00 0 1.00 0 411. #DIV/0! 36 Asam Folat tab 1 mg 2015 Tablet 1. 0 .00 0 72.00 0 93.735. 0 .00 0 122.00 #DIV/0! 39 Asam Mefenamat Tablet 500 mg 2015 Tablet . C) tablet 100 mg Tablet .00 500 800.00 0 762. #DIV/0! 45 Asiklovir Tablet 400 mg 2013 Tablet 300.00 0 2. 0 .

00 #DIV/0! 79 Ekstraks belladona tab 10 mg 2013 Tablet .00 #DIV/0! 56 Bisakodil supp 10 mg 2014 Supp .00 200 420.00 #DIV/0! 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet .25 mg 2014 Tablet 160.00 0 1. Folat (Tambah darah) 2015 Tablet . 0 .00 #DIV/0! 84 Eritromisin sirup 200mg/5 ml 2015 Botol .00 #DIV/0! 77 Domperidon 10mg 2013 Tablet 509.00 #DIV/0! 54 Betametason Krim 2013 Tube . 0 . 0 . #DIV/0! 64 Deksametason tablet 0.00 #DIV/0! 59 Bormheksin solution 2013 Botol 2.00 500 1. #DIV/0! 73 Dimenhidrinat tab 50 mg 2011 Tablet 100. 0 . #DIV/0! 95 Fitomenadion 2 mg inj 2015 Ampul . #DIV/0! 51 Besi II Sulfat 200 mg + As.00 #DIV/0! 67 Diazepam supp 2014 Supp .00 #DIV/0! 82 Eritromisin kapsul 500 mg 2013 Kapsul 220.260.25 mg/ml-1 ml 2015 Ampul .1 % 2013 Ampul 34. 0 . 0 . #DIV/0! 103 Gentamisin tetes mata 0. #DIV/0! . #DIV/0! 63 Deksametason injeksi 5 mg/ml 2015 Ampul . #DIV/0! 55 Betametason Krim 2015 Tube 71. 0 .00 0 410.25 mg/ml-1 ml 2010 Ampul .00 #DIV/0! 71 Digoksin tablet 0. 0 . 0 .00 #DIV/0! 58 Bisoprolol tab 5 mg 2014 Tablet 330.5 mg 2013 Tablet .47 Atapulgit 2015 Tablet 620.00 #DIV/0! 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul .00 #DIV/0! 52 Besi II Sulfat 200 mg + As.055. 0 .00 0 200. 0 .00 #DIV/0! 72 Digoksin tablet 0. #DIV/0! 80 Epinefrin / Adrenalin inj 0.00 #DIV/0! 97 Garam oralit serbuk kombinasi 2013 Bungkus .00 100 164.3% 2014 Botol .00 3000 8.00 #DIV/0! 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 59.5 mg 2014 Tablet .00 0 100. #DIV/0! 85 Etambutol tablet 250 mg 2011 Tablet . #DIV/0! 65 Deksametason tablet 0.055.00 #DIV/0! 66 Diazepam Inj 5 mg/ml 2013 Ampul 28.00 #DIV/0! 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet .00 0 59. #DIV/0! 86 Fenobarbital tablet 30 mg 2010 Tablet .00 100 171. #DIV/0! 102 Gentamisin salep kulit 0. #DIV/0! 96 Furosemid tab 40 mg 2014 Tablet 355.00 3 5. 0 .190.00 #DIV/0! 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 50.1 % 2014 Tube . 0 .00 #DIV/0! 83 Eritromisin sirup 200mg/5 ml 2014 Botol 111. 0 .00 100 609. #DIV/0! 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 200. #DIV/0! 68 Diazepam supp 2015 Supp 22.25 mg 2015 Tablet .00 0 160.5 mg 2015 Tablet 770.00 0 10.00 #DIV/0! 99 Gemfibrozil kapsul 300 mg 2014 Kapsul .00 #DIV/0! 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol . #DIV/0! 49 Atropin Injeksi 0.00 0 330. #DIV/0! 87 Fenobarbital tablet 30 mg 2015 Tablet 100. #DIV/0! 50 Atropin sulfat tablet 0. 0 . #DIV/0! 76 Domperidon suspensi 5 mg/5ml 2015 Botol 64. #DIV/0! 57 Bisakodil supp 10 mg 2015 Supp 4. #DIV/0! 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 194.00 0 564.00 0 111. #DIV/0! 75 Domperidon suspensi 5 mg/5ml 2014 Botol . #DIV/0! 61 Cetrizine 10 mg 2014 Tablet 760.00 #DIV/0! 69 Diazepam tab 2 mg 2013 Tablet 564.00 0 28. 0 . 0 . 0 . 0 .00 0 50. 0 . Folat (Tambah darah) 2013 Tablet 5. 0 . 0 . 0 .00 #DIV/0! 74 Doksisiklin kapsul 100 mg 2010 Kapsul .00 #DIV/0! 81 Eritromisin kapsul 250 mg 2013 Kapsul 410. 0 . #DIV/0! 53 Betahistin mesilat 2014 Tablet 10.00 0 194. 0 .00 0 34.00 200 820. 0 . 0 . #DIV/0! 94 Fitomenadion 2 mg inj 2013 Ampul .00 #DIV/0! 48 Atropin Injeksi 0.00 #DIV/0! 62 Deksametason injeksi 5 mg/ml 2013 Ampul .00 7000 7.00 24 28.00 0 100.00 0 250.190. 0 . #DIV/0! 101 Gentamisin inj 40 mg/ml 2015 Ampul .00 0 22.770. #DIV/0! 100 Gentamisin inj 40 mg/ml 2014 Ampul . 0 . #DIV/0! 98 Garam oralit serbuk kombinasi 2015 Bungkus 1.00 400 755.00 #DIV/0! 78 Efedrin HCl tablet 25 mg 2014 Tablet 250.

00 0 460.00 216 240.00 #DIV/0! 115 Haloperidol 2010 Tablet 460.00 0 2. 0 .00 0 122. 0 . 0 .00 #DIV/0! 117 Hidrokortison cream 2. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet . #DIV/0! 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 187.00 0 733.00 0 16.00 #DIV/0! 112 Glukosa larutan infus 5% 2015 Botol .00 #DIV/0! 136 Ketorolac Injeksi 10 mg 2013 Ampul .00 #DIV/0! 120 Ibuprofen suspensi 100mg/5ml 2013 Botol . 0 . #DIV/0! 135 Ketokonazol tablet 200 mg 2015 Tablet 100.00 0 610. #DIV/0! 137 Klindamisin kapsul 150 mg 2013 Kapsul 780. #DIV/0! Trimetoprim 80 mg Kotrimosazol tablet.00 #DIV/0! 109 Gliseril Liquid 2014 Botol .00 800 990.00 0 11.00 0 29.00 #DIV/0! 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 733.00 #DIV/0! 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 2.620. 0 . 0 . 0 .00 300 400.00 #DIV/0! 132 Kaptopril tablet 25 mg 2013 Tablet . #DIV/0! 113 Griseofulvin tablet 125 mg micronized 2014 Tablet . 0 . 0 . #DIV/0! 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 590.104 Gentian Violet larutan 1 % 2014 Botol 47.00 #DIV/0! 149 Kotrimoksazol suspensi 2014 Botol 203.290.00 0 187. 0 .5 % 2015 Tube .00 #DIV/0! 142 Kloramfenikol sirup 60 ml 2013 Botol .00 0 5. #DIV/0! 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 2. 0 . #DIV/0! 119 Ibuprofen suppositoria 2013 Supp 48.00 0 94.00 #DIV/0! 145 Kloramfenikol tetes telinga 3 % 2014 Botol . #DIV/0! 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 122.00 0 330.00 0 460.00 1600 5.00 #DIV/0! 111 Glukosa larutan infus 5% 2014 Botol 18.186.00 24 67.00 #DIV/0! 158 Linkomisin kapsul 500 mg 2014 Kapsul 610.00 #DIV/0! .5 % 2015 Botol 11.00 #DIV/0! 147 Klorpromazin inj. Komb: Sulfametoksazol 400 mg + 153 2015 Tablet 1.00 0 1. #DIV/0! 133 Ketokonazol krim 2 % 2014 Tube 78.5 mg 2013 Tablet .00 #DIV/0! Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet .00 #DIV/0! 138 Klindamisin kapsul 300 mg 2014 Kapsul .v 10% (100mg/ml) 2015 Tablet 5. #DIV/0! Kotrimosazol tablet. #DIV/0! 121 Ibuprofen tablet 200 mg 2014 Tablet 510.00 0 48.00 #DIV/0! 122 Ibuprofen tablet 400 mg 2013 Tablet . #DIV/0! 107 Glimepirid 2mg 2015 Tablet 330.m 25 mg/ml (HCL) 2014 Ampul 29.00 #DIV/0! 124 Isoniazid 100 mg 2011 Tablet . 0 .186.00 300 1. 0 .000. 0 .00 #DIV/0! 156 Lidokain injeksi 2% 2013 Botol .00 #DIV/0! 118 Hidrokortison cream 2.00 0 111. #DIV/0! 143 Kloramfenikol tetes mata 0. #DIV/0! 141 Kloramfenikol salep mata 1 % 2015 Tube 43. 0 .00 #DIV/0! 126 Kalium Diklofenak 50 mg 2014 Tablet 610. 500 500.00 0 203.620. #DIV/0! 144 Kloramfenikol tetes mata 0.290.00 #DIV/0! 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 2.00 #DIV/0! 105 Glibenklamid tablet 5 mg 2014 Tablet 460. #DIV/0! 110 Glukosa larutan infus 10% 2014 Botol 16.080.5 mg 2015 Tablet 3. i.00 50 97.00 0 2.00 0 78.110.00 #DIV/0! 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet .5 % 2013 Tube 24.00 #DIV/0! 134 Ketokonazol tablet 200 mg 2014 Tablet . 0 . #DIV/0! 123 Ibuprofen tablet 400 mg 2015 Tablet 190. #DIV/0! 151 Kotrimoksazol tablet pead 2010 Tablet .635. #DIV/0! 131 Kaptopril tablet 12.5 % 2014 Botol .00 #DIV/0! 148 Kodein 10 mg 2013 Tablet 94. 0 .00 #DIV/0! 130 Kaptopril tablet 12. 0 .00 #DIV/0! 140 Kloramfenikol salep mata 1 % 2013 Tube .00 3000 5. #DIV/0! 157 Lidokain injeksi 2% 2015 Botol 111.235. 0 .000.00 0 18. #DIV/0! 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 714.00 #DIV/0! 150 Kotrimoksazol suspensi 2015 Botol .00 #DIV/0! 127 Kalsium Glukonat injkesi i.00 0 610. 0 .00 1600 2.00 0 590.00 #DIV/0! 106 Glimepirid 2mg 2014 Tablet .00 0 714. 0 . 0 .

805. #DIV/0! 166 Metampiron Injeksi 2014 Ampul 29. #DIV/0! 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 30. 0 .00 #DIV/0! .00 0 100. 0 . 0 .000 IU 2013 Tablet 380.00 #DIV/0! 181 Metronidazol infus 500 mg/100 ml 2014 Botol . #DIV/0! 210 Ondansentron inj 4 mg/2 ml 2014 Ampul .00 0 3. #DIV/0! 194 Nistatin Tablet salut 500. 0 .00 #DIV/0! 174 Metilergometrin injeksi 0.00 20 38. 0 . #DIV/0! 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube .450.125 mg 2013 Tablet 200. 0 .00 0 380.00 0 200. 0 . #DIV/0! 173 Methisoprinol 500 mg 2015 Tablet 100. 0 . 0 . 0 .00 #DIV/0! 208 Ondansentron 4 mg 2014 Tablet .594.00 #DIV/0! 192 Nifedipin tablet 10 mg 2014 Tablet 404.00 #DIV/0! 190 Natrium Klorida larutan infus 0. 0 .00 0 29.9 % steril 2015 Botol 18. #DIV/0! 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 50. #DIV/0! 175 Metilergometrin tablet salut 0. #DIV/0! 209 Ondansentron 4 mg 2015 Tablet . 0 .000 IU/g 2015 Tablet 137. 0 . #DIV/0! 196 Nistatin tablet vaginal 100. #DIV/0! 207 Omeprazol kapsul 20 mg 2015 Kapsul 1. #DIV/0! 168 Metampiron tablet 500 mg 2014 Tablet 1.00 #DIV/0! 187 Natrium Diklofenak tablet 25 mg 2013 Tablet .00 #DIV/0! 206 Omeprazol kapsul 20 mg 2014 Kapsul . 0 . 0 .00 #DIV/0! 200 Obat Diare Dewasa 2010 Tablet .00 0 199.00 #DIV/0! 167 Metampiron Injeksi 2015 Ampul .00 0 50.00 56 208. #DIV/0! 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 3.00 #DIV/0! 183 Metronidazol tablet 500 mg 2011 Tablet . 0 . 0 . #DIV/0! 215 Parasetamol drop 2015 Botol 152. #DIV/0! 179 Metoklopramide tablet 2013 Tablet .00 0 6.00 #DIV/0! 170 Metformin HCL tablet 850 mg 2015 Botol . #DIV/0! 213 Papaverin tablet 40 mg 2013 Tablet 365. #DIV/0! 177 Metilprednisolon 4 mg 2013 Tablet .200 mg-ml 2014 Ampul .00 0 1. 0 .00 300 480.00 0 9. 0 .00 24 76.00 #DIV/0! 169 Metformin HCl tablet 500 mg 2015 Tablet 805.00 0 240. 0 .00 0 137. 0 .010. 0 . #DIV/0! 171 Methisoprinol 250 mg/5ml 2014 Botol 9.040.000 IU/g 2013 Tablet . 0 .00 0 50.00 0 365.00 0 199.010. 0 . #DIV/0! 160 Loperamid 2015 Tablet 180.00 0 30.00 1000 1. #DIV/0! 184 Metronidazol tablet 500 mg 2015 Tablet . 0 . #DIV/0! 182 Metronidazol tablet 250 mg 2014 Tablet 250. #DIV/0! 188 Natrium Diklofenak tablet 25 mg 2015 Tablet .00 0 1.450. #DIV/0! 198 Obat Batuk Hitam 100 ml 2013 Botol .00 #DIV/0! 161 Loratadin tablet 2 mg 2015 Tablet 199.00 #DIV/0! 193 Nifedipin tablet 10 mg 2015 Tablet . #DIV/0! 164 Meloksikam 15 mg 2015 Tablet 594. #DIV/0! 178 Metoklopramide inj Ampul .00 #DIV/0! 197 OAT Kategori 2 2014 Paket . 0 .00 #DIV/0! 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul . #DIV/0! 201 Obat FDC katagori sisipan 2013 Paket .125 mg 2015 Tablet .00 500 750.00 #DIV/0! 172 Methisoprinol 500 mg 2013 Tablet . 0 .00 #DIV/0! 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 6.040.159 Loperamid 2014 Tablet . #DIV/0! 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube .00 #DIV/0! 195 Nistatin tablet vaginal 100. #DIV/0! 180 Metoklopramide tablet 2015 Tablet 240.00 #DIV/0! 165 Meloksikam 7.5 mg 2014 Tablet .9 % steril 2014 Botol . #DIV/0! 191 Natrium Klorida larutan infus 0.00 #DIV/0! 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 50. #DIV/0! 185 Mikonazol cream 2014 Tube . 0 . #DIV/0! 186 Mikonazol cream 2015 Tube 52.00 #DIV/0! 163 Meloksikam 15 mg 2013 Tablet .00 1000 1. 0 . #DIV/0! 199 Obat Batuk Hitam 100 ml 2015 Botol 199.00 #DIV/0! 176 Metilergometrin tablet salut 0. 0 .00 0 404. 0 .00 #DIV/0! 214 Parasetamol drop 2014 Botol . 0 .

#DIV/0! 253 Salisil Bedak 2 % 2014 Kotak . #DIV/0! 258 Seftriakson injeksi 1 gram 2013 Ampul .00 0 740. 0 .00 0 1.050.00 0 10. #DIV/0! 247 Salbutamol nebules 2013 Kotak . #DIV/0! 227 Piroksikam tablet 20 mg 2014 Tablet 90.00 0 21.00 #DIV/0! 267 Sulfacetamida Natrium tetes mata 2013 Botol .00 #DIV/0! 262 Simvastatin tablet 10 mg 2015 Tablet 740.00 0 200.00 0 560. 0 . #DIV/0! 249 Salbutamol tab 4 mg 2013 Tablet .00 #DIV/0! 255 Sefadroksil kapsul 500 mg 2014 Kapsul 740. #DIV/0! 254 Salisil Bedak 2 % 2015 Kotak 55.050. #DIV/0! 218 Parasetamol Supp 2014 Supp . 0 . #DIV/0! 268 Sulfacetamida Natrium tetes mata 2015 Botol 48. 0 .00 0 290.00 #DIV/0! 266 Siprofloksasin tablet 500 mg 2015 Tablet .216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 131. 0 .00 #DIV/0! 239 Ranitidin tablet 150 mg 2014 Tablet 1. #DIV/0! 234 Pseudoefedrin Hcl Drop 2015 Botol 25. #DIV/0! 231 Prednison tablet 5 mg 2015 Tablet 3.800.00 #DIV/0! 246 Saccarum Lactis 2013 Botol .00 0 30.00 #DIV/0! 269 Teofilin Tablet 2013 Tablet 99. 0 . 0 . 0 .00 #DIV/0! 261 Simetidin tab 200 mg 2014 Tablet 560.00 #DIV/0! 238 Ranitidin injeksi 2014 Ampul .000 IU 2015 Kapsul . #DIV/0! 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 2.000 IU 2014 Kapsul 1. 0 .00 0 6.00 #DIV/0! 230 Prednison tablet 5 mg 2011 Tablet . #DIV/0! 257 Seftazidim Injeksi Ampul .079.00 #DIV/0! 240 Ranitidin tablet 150 mg 2015 Tablet .000 IU 2014 Kapsul 12.00 0 100.00 0 210. #DIV/0! 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 30.00 12 31. 0 .00 #DIV/0! 222 Piracetam tablet 800 mg 2011 Tablet .00 #DIV/0! .420.624. #DIV/0! 248 Salbutamol nebules 2015 Kotak . 0 . #DIV/0! 250 Salbutamol tab 4 mg 2015 Tablet 425.130. #DIV/0! 223 Pirantel tablet 125 2013 Tablet 59.00 6000 11.180.00 #DIV/0! 242 Retinol (VIT A) tablet salut 200.00 #DIV/0! 270 Tetrasiklin kapsul 500 mg 2011 Kapsul .00 #DIV/0! 263 Simvastatin tablet 20 mg 2015 Tablet .00 #DIV/0! 272 Tiampenikol kapsul 500 mg 2014 Kapsul 210. 600 600.00 0 3.00 #DIV/0! 236 Ranitidin Hcl Sirup 2014 Botol .950.00 0 12. 0 .00 #DIV/0! 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 10. 0 .950.800.00 #DIV/0! 235 Ramipril 5 mg 2014 Tablet 100.240. 0 . #DIV/0! 221 Parasetamol tablet 500 mg 2015 Tablet 5.420.00 1500 2. #DIV/0! 265 Siprofloksasin tablet 500 mg 2015 Tablet 290.00 #DIV/0! 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol .00 #DIV/0! 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol .130. 0 . #DIV/0! 264 Siprofloksasin tablet 500 mg 2014 Tablet . #DIV/0! 219 Parasetamol tablet 100 mg 2013 Tablet 200.00 420 551.00 0 190.00 0 25. 20 20.00 #DIV/0! 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 19. #DIV/0! 244 Rifampisin kapsul 300 mg 2013 Kapsul .079.00 #DIV/0! 224 Pirazinamid tablet 500 mg 2013 Tablet .00 100 155. 0 . 0 .00 0 425.00 #DIV/0! 233 Pseudoefedrin Hcl Drop 2014 Botol .00 0 90. #DIV/0! 241 Retinol (VIT A) kapsul 100. #DIV/0! 252 Salep 2-4 2011 Tube .00 0 48. 0 .00 1000 2. 0 .00 #DIV/0! 220 Parasetamol tablet 500 mg 2011 Tablet .00 #DIV/0! 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 6. 0 .00 #DIV/0! 226 Piroksikam tablet 10 mg 2013 Tablet . 0 . 0 . 300 300.00 #DIV/0! 243 Retinol (VIT A) tablet salut 200. #DIV/0! 245 Ringer laktat larutan infus steril 2014 Botol .00 #DIV/0! 232 Propanolol tablet 10 mg 2013 Tablet 190. #DIV/0! 237 Ranitidin Hcl Sirup 2015 Botol 21.180.00 0 99. 0 . 0 . #DIV/0! 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 2.00 0 59.00 #DIV/0! 251 Salbutamol tablet 2 mg Tablet . 0 . 0 .624.00 0 2.00 0 2.

0 .0075 gram.00 2000 3. 0 .305.00 0 90. 0 . #DIV/0! 309 Krim Analgesik 2013 Tube . Glucose 2015 Botol .640. #DIV/0! 290 Cairan Elektrolit Kombinasi Na. #DIV/0! 317 Multivitamin anak sirup 2015 Botol 38.00 #DIV/0! 283 Anti Oksidan Tablet 2013 Tablet 3. Nacl 9 g 2015 Botol . K.640. Cl. 0 . Kalium Iodida 0.00 #DIV/0! 297 Curcuma Tab 2013 Tablet .00 0 630.Vitamin. 0 . 0 .Asetat 2015 Botol . 0 .075 gram. fenilmerkuri 2013 305 nitrat 0. 0 . Natrium Tiosulfat 0. #DIV/0! 294 Cairan Hydroxyethyl Strach (HES) 200/0. Nacl 9 g 2014 Botol 13. 0 .00 #DIV/0! Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg.00 #DIV/0! 279 Vitamin B Komplek 2015 Tablet . 0 .00 300 338.00 #DIV/0! 295 Cairan Hydroxyethyl Strach (HES )200/0. #DIV/0! 287 Antispasmodik kombinasi 2015 Tablet .00 #DIV/0! 275 Triamcinolon Acetonide 1 mg krim 2014 Tube . #DIV/0! 274 Tramadol kapsul 50 mg 2014 Kapsul 270. #DIV/0! 319 Multivitamin dewasa 2015 Tablet 225.00 0 24. 0 . #DIV/0! 286 Antispasmodik kombinasi 2014 Tablet .Ca.00 0 750. Glucose 2014 Botol 22. 0 .090.00 #DIV/0! 320 Natrium Fe EDTA drop 2013 Botol .00 0 190. 0 .00 0 30. #DIV/0! 288 Budesonid respules/ cairan inhaler 2014 Pcs 5. 0 .5 mg Supp .Ca. 0 . #DIV/0! 314 Mineral mix.740.305. 0 . 0 . 0 . 0 . 0 . #DIV/0! 292 Cairan Elektrolit Kombinasi Na. K.090.00 0 10.00 #DIV/0! 304 Kombinasi Amino Acid.00 #DIV/0! 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 190. #DIV/0! 282 Anti Hipertensi Herbal 2015 Tablet 30. Lactate.00 #DIV/0! 318 Multivitamin dewasa 2014 Tablet .00 #DIV/0! 289 Cairan Elektrolit Kombinasi Na.00 0 270. #DIV/0! 301 Isoxsuprine Hcl Tablet 2013 Tablet .00 #DIV/0! 281 Albendazol suspensi 200mg/5ml 2013 Botol . #DIV/0! 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 10. #DIV/0! 302 Klopidogrel 75 mg 2014 Tablet 90.075 gram. #DIV/0! 311 Lactulose Sirup 2014 Botol 24. Cl. 0 .00 #DIV/0! 312 Lactulose Sirup 2015 Botol .00 #DIV/0! 277 Triheksifenidil tab 2 mg 2014 Tablet 630.00 #DIV/0! 299 Fenoterol nebules solution 2013 Botol 1.5 60 g. #DIV/0! 315 Mometasone Furoate Krim 2013 Tube . 0 . Cl.00 0 1.00 0 22. 0 . K. #DIV/0! 276 Triamsinolon Tablet 2013 Tablet 30. 0 . 0 . #DIV/0! 285 Antispasmodik Inj 2013 Ampul .740. #DIV/0! Kombinasi Lactobacillus+ 306 2013 Tablet 750. 0 . K.00 #DIV/0! 280 Zink tablet 20 mg 2014 Tablet 2. #DIV/0! 310 Krim Antiinflamasi 2013 Tube . Cl.00 #DIV/0! 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube .00 #DIV/0! 291 Cairan Elektrolit Kombinasi Na. #DIV/0! . #DIV/0! 293 Cairan Elektrolit Kombinasi Na.electrolytes 2013 Botol .Asetat 2014 Botol .00 0 2. Lactate.5 60 g. #DIV/0! 313 Mineral mix.00 60 73. #DIV/0! 298 Enzim Pencernaan 2013 Tablet 1. #DIV/0! 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet .00 0 5.00 #DIV/0! 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs .00 200 425. Glucose 2013 Botol . kombinasi 2015 Sachet .00 #DIV/0! 278 Vitamin B Komplek 2014 Tablet 1.000. Cl. #DIV/0! Kombinasi CaCl2 anhidrat 0.3 mg Botol .00 0 3. 0 .00 0 30. 2013 307 cinchocaine HCl 2. 0 .273 Tramadol inj 50 mg/ml 2014 Ampul .00 0 1. #DIV/0! 316 Multivitamin anak sirup 2014 Botol . kombinasi 2014 Sachet . 4000 4.

00 #DIV/0! 350 Tamsolusin Hcl Tablet 2013 Tablet . #DIV/0! 355 Vitamin Neurotopik 2013 Tablet .00 #DIV/0! metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 3. 0 .00 #DIV/0! 352 Terbutalin Sulfate 0.1 % + 340 2014 Tube . #DIV/0! metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol 24. 0 . #DIV/0! 347 Suplemen Untuk Gizi Anak 2015 Sachet .00 #DIV/0! Salep Kombinasi : Betametason valerat 0.00 0 683.00 0 9. mg/ml 2014 Pcs 5.00 1 2. 0 . 0 . #DIV/0! 335 Permetrin krim 5% 10 g 2014 Tube 9.00 #DIV/0! 366 Etching 2013 Pcs 1.5 mg/ml 2013 Ampul . 0 . #DIV/0! 326 Obat Antifungi Drop 2014 Botol 38.00 #DIV/0! . 0 .00 0 42. 0 .00 1 2.00 0 210. #DIV/0! 322 Norethisterone Tablet 2013 Tablet .00 #DIV/0! 369 Eugenol cairan 2012 Botol 1.00 1 2.00 72 115. #DIV/0! 324 Obat Antianemia 2015 Tablet . 0 .00 #DIV/0! Policresulen (Produk kondensasi dari asam 336 2014 Botol . 0 .00 0 5.00 #DIV/0! 329 Obat Flu dan Batuk Sirup 2014 Botol 45. #DIV/0! 368 Etil klorida semprot 2014 Botol 1. 0 . #DIV/0! 362 Bonding 2013 Botol 1.00 #DIV/0! 367 Etching 2015 Pcs . #DIV/0! 358 Vitamin Neurotopik inj.00 0 450. 0 .00 28 66. #DIV/0! Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 683. #DIV/0! 346 Suplemen Untuk Gizi Anak 2014 Sachet . 0 . #DIV/0! 325 Obat Antianemia 2015 Tablet . #DIV/0! 356 Vitamin Neurotopik 2015 Tablet 450.00 #DIV/0! 333 Obat luka bakar 2014 Tube .00 #DIV/0! 330 Obat Flu Tablet 2014 Tablet . 0 . #DIV/0! 331 Obat Flu Tablet 2015 Tablet 420. 10 10. #DIV/0! 360 Zink Syrup 2014 Botol 43. 0 .00 #DIV/0! 361 Alveogyl 2014 Botol . 0 .00 1 2.00 0 100. 0 . #DIV/0! 344 Suplemen Ibu Menyusui 2015 Tablet 210. #DIV/0! 328 Obat Batuk Hitam + Parasetamol 2014 Botol 31.00 0 31. 0 .020. #DIV/0! 354 Valsartan 80 mg 2014 Tablet . #DIV/0! 343 Suplemen Ibu Menyusui 2014 Tablet .00 #DIV/0! 357 Vitamin Neurotopik inj.00 0 30. #DIV/0! 323 Obat Antianemia 2014 Tablet .00 240 285. 0 . 0 .00 #DIV/0! 332 Obat Hepatoprotektor 2014 Tablet 420.00 2 3.420.00 #DIV/0! 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet . #DIV/0! 351 Terbutalin cairan ih 2.00 3 4. 0 . 0 .00 #DIV/0! 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul .00 #DIV/0! 365 Devitalisasi pasta non arsen 2014 Kotak 1.00 #DIV/0! 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol . 0 .00 0 24. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 42.00 #DIV/0! 363 Cairan Pembersih Gigi 2015 Botol . Hemihydrate 2013 Tablet 100. 0 .00 600 1. #DIV/0! 364 Cresophen 2014 Botol 1. #DIV/0! 353 Tiotropium Br 2013 Pcs .00 #DIV/0! 342 Sirup Besi Kombinasi 2013 Botol .00 #DIV/0! 339 Procaterol Hcl.00 2000 2. Kombinasi (vit B1+ B6+ B12) 2014 Ampul . 0 .00 0 3.321 Nistatin dan Zn Oxide Salep 2013 Tube . #DIV/0! 348 Suplemen untuk sendi dan tulang 2014 Tablet . 0 .00 #DIV/0! 327 Obat Antifungi Drop 2015 Botol .00 0 1. 0 . #DIV/0! Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 30.00 #DIV/0! 370 Fletcher Cairan 2014 Botol 1.

1 1. #DIV/0! dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol . #DIV/0! 373 Glass Ionomer cement Art 2014 Set 1.00 #DIV/0! 386 Tambal Sinar Warna A2 2013 Syringe 1.00 #DIV/0! 402 Alkohol Swab 2015 Pcs 500.1 % (Rivanol) 2013 Botol .00 1 2.00 #DIV/0! .00 #DIV/0! 418 Desinfektan Lantai 2014 Botol .00 #DIV/0! 422 Etakridin larutan 0. #DIV/0! 423 Etakridin larutan 0.00 #DIV/0! 416 Cutgut 3/0 Plain 2014 Pcs 302.00 #DIV/0! 405 Articulating paper 2014 Kotak . 0 . #DIV/0! 382 Semen seng fosfat serbuk 2014 Set 1. 0 .00 #DIV/0! 414 Cutgut 2/0 Plain 2014 Pcs 288. #DIV/0! 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol . #DIV/0! 375 Kalsium Hidroksida pasta 2014 Set 1.00 1 2. #DIV/0! 393 Alat suntik sekali pakai 2.00 #DIV/0! 381 Pulperyl 2014 Botol .371 Fletcher Serbuk 2014 Botol 1. #DIV/0! 391 Trikresol Formalin 2014 Botol 1.00 #DIV/0! 376 Metronidazol Gel untuk Peridonitis 2014 Tube . #DIV/0! 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol . #DIV/0! 398 Alkohol 1000 ml 2013 Botol . 500 500.00 #DIV/0! 397 Alat Suntik 10 cc 2014 Pcs .00 #DIV/0! 387 Tambal Sinar Warna A2 2015 Syringe . #DIV/0! 404 Aquabidest 500ml 2014 Botol 12.00 0 1. 0 . 0 . #DIV/0! 408 Blood transfusion set 2014 Pcs .00 #DIV/0! 378 Mummifying pasta 2014 Set 1. #DIV/0! 401 Alkohol Swab 2014 Pcs 1. 12 12. 0 .5 ml 2012 Pcs 510.00 #DIV/0! 390 Tambal Sinar Warna A3.00 #DIV/0! 374 Glass Ionomer cement Art 2015 Set .00 0 1. 0 .600.1 % (Rivanol) 2015 Botol 4. #DIV/0! 399 Alkohol 1000 ml 2015 Botol 4.00 2 3. 0 . #DIV/0! dental 413 Cutgut 2/0 Chromic 2014 Pcs 48.00 #DIV/0! 400 Alkohol 70% 100 ml 2014 Botol .00 0 510. 0 . 0 . 0 .00 0 48. 0 .00 0 1.00 3 7. 0 . 0 .600.00 400 800.00 1 2. 0 .00 #DIV/0! 415 Cutgut 3/0 Chromic 2014 Pcs 72.00 #DIV/0! 389 Tambal Sinar Warna A3.00 #DIV/0! 417 Cutgut Plain 2/0 (roll) 2013 Roll 3.00 #DIV/0! 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 1.00 0 288. #DIV/0! 396 Alat Suntik 3 cc 2015 Pcs . 0 . 0 . #DIV/0! 406 Aseptic Gel + Dispenser 500 ml 2015 Botol . 1 1. 0 .00 #DIV/0! 392 Alat suntik sekali pakai 1 ml 2012 Pcs .00 #DIV/0! 394 Alat suntik sekali pakai 5 ml 2012 Pcs 400.00 0 2. #DIV/0! 388 Tambal Sinar Warna A3 2014 Syringe 1.00 0 12. 0 .00 0 302.00 0 500.5 2015 Syringe .00 #DIV/0! 383 Tambal Sementara Untuk Gigi 2015 Botol .00 1 2. 0 . 0 .5 2013 Syringe 1.00 0 4. 0 .00 1 2.00 0 1. #DIV/0! 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 2.00 #DIV/0! 379 OCO 2014 Botol . #DIV/0! 380 Pasta Iodoform 2014 Kotak .v catheter 2014 Pcs 350.00 #DIV/0! 395 Alat Suntik 3 cc 2013 Pcs .00 0 57. #DIV/0! 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol .00 #DIV/0! 403 Aqua Jell (Ky Jelly) 2013 Tube . 0 . #DIV/0! Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon .00 #DIV/0! 372 Fletcher serbuk dan cairan 2012 Botol .00 0 72.00 2 3.00 #DIV/0! 407 Blood transfusion set 2013 Pcs . 0 .00 0 3. #DIV/0! 421 Dressing transparant untuk pemasang i. #DIV/0! 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 57. 0 .00 #DIV/0! 420 Dressing retention 5 cm x 5 cm 2013 Roll .00 0 350.

424 Foley Catheter # 16 2013 Pcs 26.00 0 26.00 #DIV/0! 433 Handscoon Non Steril M 2013 Pcs . #DIV/0! 432 Handscoon Non Steril L 2015 Pcs .00 #DIV/0! 435 Handscoon Non Steril S 2013 Pcs . 0 .00 #DIV/0! .00 #DIV/0! 431 Handscoon Non Steril L 2013 Pcs .00 #DIV/0! 425 Foley Catheter # 18 2013 Pcs 26. 100 100. #DIV/0! 430 Hand Scoon (Steril) # 7 2015 Pcs 400. #DIV/0! 436 Handscoon Non Steril S 2015 Pcs .00 #DIV/0! 429 Hand Scoon (Steril) # 7 2014 Pcs . #DIV/0! 428 Hand Scoon (Steril) # 6. 100 100. 0 .5 2014 Pcs .00 0 26.00 0 400. 0 .00 #DIV/0! 426 H2O2 3% 2014 Botol 1. 0 .5 2015 Pcs 400.00 0 400.00 #DIV/0! 427 Hand Scoon (Steril) # 6.00 2 3. 100 100. #DIV/0! 434 Handscoon Non Steril M 2015 Pcs . 0 .

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00 0 50. 0 .00 0 2.00 #DIV/0! 44 Asiklovir Tablet 200 mg 2015 Tablet .00 #DIV/0! 23 Anti Bakteri DOEN salep 2013 Tube . 0 .00 0 7.00 0 93.00 #DIV/0! 5 Ambroksol tablet 30 mg 2014 Tablet 7. #DIV/0! 47 Atapulgit 2015 Tablet 820.215. #DIV/0! . 0 . LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN STOCK Lama Hari Pemakaian No NAMA OBAT TAHUN SATUAN PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian Rata-Rata 1 2 3 4 5 6 7 8 1 Allopurinol tablet 100 mg 2014 Tablet .00 #DIV/0! 43 Asiklovir Tablet 200 mg 2013 Tablet 600.00 0 800. 0 .155. #DIV/0! 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 1. Klavulanat 2013 Tablet 762.00 0 95. 0 . 0 .225. #DIV/0! 11 Amlodipin 10 mg 2015 Tablet .00 0 150. 0 . #DIV/0! 2 Allopurinol tablet 100 mg 2015 Tablet 1. 0 . #DIV/0! 28 Anti migren / Ergotamin 2013 Tablet . 0 . #DIV/0! 26 Anti Hemmoroid DOEN supp 2014 Supp . #DIV/0! 36 Asam Folat tab 1 mg 2015 Tablet 1.00 0 1.00 #DIV/0! 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet .820. 0 .735.250.225.00 #DIV/0! 41 Asam Tranexamat Injeksi 2013 Ampul . 0 .00 0 5. #DIV/0! 7 Aminofilin inj 24 mg /ml 2014 Ampul 30.155. 0 .00 #DIV/0! 20 Antasida DOEN tablet 2015 Tablet .00 #DIV/0! 3 Ambroksol Syrup 15 mg / ml 2014 Botol 150.00 #DIV/0! 13 Amoksisilin + As. #DIV/0! 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 95. 0 . #DIV/0! 31 Asam Asetilsalisilat 80 mg 2015 Tablet 140.00 0 72.00 0 175.25 mg/ml-1 ml 2010 Ampul .00 0 762.250. 0 .00 #DIV/0! 32 Asam Asetilsalisilat 100 mg 2011 Tablet .370.00 #DIV/0! 37 Asam Mefenamat Tablet 500 mg 2014 Tablet .00 0 100. #DIV/0! 29 Aqua Pro Injeksi steril @ 20 2014 Vial .00 #DIV/0! 22 Antasida DOEN Suspensi 2015 Botol 81.00 #DIV/0! 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 150. #DIV/0! 21 Antasida DOEN Suspensi 2014 Botol 50.00 0 3. 0 . #DIV/0! 42 Asiklovir krim 5% 2013 Tube 93.520. #DIV/0! 30 Asam Asetilsalisilat 80 mg 2014 Tablet .520.00 0 600. #DIV/0! 33 Asam Askorbat (Vit. #DIV/0! 40 Asam Tranexamat 250mg 2013 Tablet 122.00 0 150. #DIV/0! 24 Anti Bakteri DOEN salep 2015 Tube 175.00 0 2. 0 .00 #DIV/0! 35 Asam Folat tab 1 mg 2013 Tablet .00 0 140.00 #DIV/0! 6 Ambroksol tablet 30 mg 2015 Tablet .00 #DIV/0! 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 100.00 0 2. 0 .00 0 1. #DIV/0! 27 Anti Hemmoroid DOEN supp 2015 Supp .00 #DIV/0! 46 Atapulgit 2011 Tablet .00 0 122. 0 .370.820.00 #DIV/0! 25 Anti Fungi DOEN kombinasi salep 2013 Pot .00 #DIV/0! 8 Aminofilin tab 200 mg 2014 Tablet 411. 0 . C) tablet 100 mg Tablet .00 #DIV/0! 48 Atropin Injeksi 0.00 #DIV/0! 19 Antasida DOEN tablet 2014 Tablet 3.00 #DIV/0! 4 Ambroksol Syrup 15 mg / ml 2015 Botol 72.580.00 #DIV/0! 16 Amoksisilin kaplet 500 mg 2015 Tablet .00 #DIV/0! 15 Amoksisilin kaplet 500 mg 2014 Tablet 2.00 0 1.735. #DIV/0! 45 Asiklovir Tablet 400 mg 2013 Tablet 800.00 0 820. #DIV/0! 34 Asam Askorbat (Vit.00 0 30.00 #DIV/0! 39 Asam Mefenamat Tablet 500 mg 2015 Tablet .215. 0 . #DIV/0! 12 Amlodipin 5 mg 2015 Tablet 2. 0 . C) tablet 50 mg 2014 Tablet 2.00 #DIV/0! 14 Amoksisilin kaplet 250 mg 2013 Tablet 5.00 0 411. 0 .580.00 0 81.

190. #DIV/0! 65 Deksametason tablet 0.00 #DIV/0! 52 Besi II Sulfat 200 mg + As.00 #DIV/0! 84 Eritromisin sirup 200mg/5 ml 2015 Botol . 0 .25 mg 2015 Tablet .055. #DIV/0! 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 194.00 0 100. #DIV/0! 80 Epinefrin / Adrenalin inj 0. #DIV/0! 57 Bisakodil supp 10 mg 2015 Supp 28.00 0 34. Folat (Tambah darah) 2015 Tablet . #DIV/0! 100 Gentamisin inj 40 mg/ml 2014 Ampul . 0 . 0 . #DIV/0! 85 Etambutol tablet 250 mg 2011 Tablet .00 0 194. #DIV/0! 73 Dimenhidrinat tab 50 mg 2011 Tablet 100.00 #DIV/0! 71 Digoksin tablet 0.00 #DIV/0! 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet . #DIV/0! 64 Deksametason tablet 0. #DIV/0! 53 Betahistin mesilat 2014 Tablet 10.00 0 5.00 #DIV/0! 77 Domperidon 10mg 2013 Tablet 609.00 #DIV/0! 69 Diazepam tab 2 mg 2013 Tablet 564.00 #DIV/0! 54 Betametason Krim 2013 Tube .00 0 97.00 #DIV/0! 74 Doksisiklin kapsul 100 mg 2010 Kapsul .00 0 460.260.00 0 28. 0 . 0 .00 0 410. #DIV/0! 102 Gentamisin salep kulit 0.00 0 22. #DIV/0! 98 Garam oralit serbuk kombinasi 2015 Bungkus 1. #DIV/0! 101 Gentamisin inj 40 mg/ml 2015 Ampul .00 #DIV/0! 97 Garam oralit serbuk kombinasi 2013 Bungkus . 0 . 0 .00 #DIV/0! 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul .00 #DIV/0! 82 Eritromisin kapsul 500 mg 2013 Kapsul 420.00 #DIV/0! 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet .00 #DIV/0! 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol .00 #DIV/0! 99 Gemfibrozil kapsul 300 mg 2014 Kapsul .00 #DIV/0! 72 Digoksin tablet 0. 0 . 0 . Folat (Tambah darah) 2013 Tablet 8.00 0 59. 0 .00 0 755.00 #DIV/0! 62 Deksametason injeksi 5 mg/ml 2013 Ampul .00 #DIV/0! 105 Glibenklamid tablet 5 mg 2014 Tablet 460. 0 . #DIV/0! 61 Cetrizine 10 mg 2014 Tablet 1.00 0 28.25 mg 2014 Tablet 160. #DIV/0! 68 Diazepam supp 2015 Supp 22.1 % 2014 Tube .190.00 #DIV/0! 67 Diazepam supp 2014 Supp .00 0 609.00 0 10.770.00 #DIV/0! 106 Glimepirid 2mg 2014 Tablet . #DIV/0! 104 Gentian Violet larutan 1 % 2014 Botol 97. #DIV/0! 75 Domperidon suspensi 5 mg/5ml 2014 Botol .00 #DIV/0! 66 Diazepam Inj 5 mg/ml 2013 Ampul 28.770.00 0 564.260.00 0 330. 0 . 0 .00 #DIV/0! 83 Eritromisin sirup 200mg/5 ml 2014 Botol 111. #DIV/0! 76 Domperidon suspensi 5 mg/5ml 2015 Botol 164.1 % 2013 Ampul 34. 0 .00 0 330.5 mg 2013 Tablet .00 #DIV/0! 81 Eritromisin kapsul 250 mg 2013 Kapsul 410.00 0 164.00 0 200.00 0 111.00 #DIV/0! . #DIV/0! 86 Fenobarbital tablet 30 mg 2010 Tablet .25 mg/ml-1 ml 2015 Ampul . #DIV/0! 103 Gentamisin tetes mata 0. #DIV/0! 55 Betametason Krim 2015 Tube 171. #DIV/0! 51 Besi II Sulfat 200 mg + As.00 #DIV/0! 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 59. 0 .00 #DIV/0! 58 Bisoprolol tab 5 mg 2014 Tablet 330.00 #DIV/0! 78 Efedrin HCl tablet 25 mg 2014 Tablet 250. #DIV/0! 95 Fitomenadion 2 mg inj 2015 Ampul . #DIV/0! 107 Glimepirid 2mg 2015 Tablet 330.00 0 7.5 mg 2014 Tablet . #DIV/0! 94 Fitomenadion 2 mg inj 2013 Ampul . 0 .00 0 171. 0 .00 #DIV/0! 56 Bisakodil supp 10 mg 2014 Supp . #DIV/0! 63 Deksametason injeksi 5 mg/ml 2015 Ampul .055. 0 .00 #DIV/0! 59 Bormheksin solution 2013 Botol 5.00 0 1.3% 2014 Botol .00 #DIV/0! 79 Ekstraks belladona tab 10 mg 2013 Tablet . 0 . 0 .00 0 160. 0 . #DIV/0! 87 Fenobarbital tablet 30 mg 2015 Tablet 100.00 0 50.00 0 8. 0 . 0 . 0 .00 0 1.49 Atropin Injeksi 0.00 0 100. #DIV/0! 96 Furosemid tab 40 mg 2014 Tablet 755. 0 . 0 . #DIV/0! 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 200.5 mg 2015 Tablet 7.00 #DIV/0! 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 50.00 0 250. 0 . 0 .00 0 420. 0 . #DIV/0! 50 Atropin sulfat tablet 0.

0 . 0 . 0 .00 #DIV/0! 132 Kaptopril tablet 25 mg 2013 Tablet .v 10% (100mg/ml) 2015 Tablet 5. #DIV/0! 113 Griseofulvin tablet 125 mg micronized 2014 Tablet . 0 .00 0 16. #DIV/0! 164 Meloksikam 15 mg 2015 Tablet 1.00 0 1. 0 .00 #DIV/0! 158 Linkomisin kapsul 500 mg 2014 Kapsul 610. #DIV/0! 141 Kloramfenikol salep mata 1 % 2015 Tube 67. #DIV/0! 119 Ibuprofen suppositoria 2013 Supp 48.00 0 11.108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 2.00 0 199.00 #DIV/0! 142 Kloramfenikol sirup 60 ml 2013 Botol . #DIV/0! 123 Ibuprofen tablet 400 mg 2015 Tablet 990.00 #DIV/0! 134 Ketokonazol tablet 200 mg 2014 Tablet . #DIV/0! 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 122.00 0 94. 0 . #DIV/0! 160 Loperamid 2015 Tablet 480. 0 . 0 .00 0 500.00 0 111.00 #DIV/0! 163 Meloksikam 15 mg 2013 Tablet .186.110.5 mg 2015 Tablet 5.00 #DIV/0! 138 Klindamisin kapsul 300 mg 2014 Kapsul .00 0 610.00 #DIV/0! 147 Klorpromazin inj.00 0 590.620.00 0 122.080. #DIV/0! Trimetoprim 80 mg Kotrimosazol tablet.00 #DIV/0! 120 Ibuprofen suspensi 100mg/5ml 2013 Botol .080.m 25 mg/ml (HCL) 2014 Ampul 29. 0 . Komb: Sulfametoksazol 400 mg + 152 2013 Tablet .00 0 187. #DIV/0! 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 714.00 #DIV/0! .00 0 480.00 #DIV/0! 161 Loratadin tablet 2 mg 2015 Tablet 199.00 0 78.00 #DIV/0! 111 Glukosa larutan infus 5% 2014 Botol 18.00 #DIV/0! 140 Kloramfenikol salep mata 1 % 2013 Tube .00 #DIV/0! Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet . 0 . #DIV/0! Kotrimosazol tablet.5 mg 2013 Tablet .00 #DIV/0! 148 Kodein 10 mg 2013 Tablet 94. 0 .620. 0 .00 0 6.00 #DIV/0! 145 Kloramfenikol tetes telinga 3 % 2014 Botol . #DIV/0! 133 Ketokonazol krim 2 % 2014 Tube 78.00 #DIV/0! 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 500.290.00 #DIV/0! 136 Ketorolac Injeksi 10 mg 2013 Ampul .00 0 5.00 #DIV/0! 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 733. 0 .00 0 203.5 % 2015 Tube . #DIV/0! 121 Ibuprofen tablet 200 mg 2014 Tablet 2. #DIV/0! 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 187.00 #DIV/0! 109 Gliseril Liquid 2014 Botol .000.110.235.00 0 2.00 0 5.00 0 5.186.00 0 990.594. 0 .5 % 2013 Tube 240.00 0 460.00 #DIV/0! 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 2.00 0 1. 0 .00 #DIV/0! 126 Kalium Diklofenak 50 mg 2014 Tablet 610.00 0 240. Komb: Sulfametoksazol 400 mg + 153 2015 Tablet 1.594.5 % 2015 Botol 11.00 #DIV/0! 117 Hidrokortison cream 2. 0 . #DIV/0! 131 Kaptopril tablet 12.00 #DIV/0! 156 Lidokain injeksi 2% 2013 Botol .00 0 610. 0 .00 #DIV/0! 112 Glukosa larutan infus 5% 2015 Botol . #DIV/0! 144 Kloramfenikol tetes mata 0. #DIV/0! 143 Kloramfenikol tetes mata 0. #DIV/0! 151 Kotrimoksazol tablet pead 2010 Tablet .00 0 48. 0 .00 0 733.00 #DIV/0! 122 Ibuprofen tablet 400 mg 2013 Tablet .00 #DIV/0! 149 Kotrimoksazol suspensi 2014 Botol 203.000.290.00 #DIV/0! 127 Kalsium Glukonat injkesi i.00 #DIV/0! 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 6. #DIV/0! 137 Klindamisin kapsul 150 mg 2013 Kapsul 1. #DIV/0! 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 5.00 0 18.00 0 1. 0 . #DIV/0! 157 Lidokain injeksi 2% 2015 Botol 111.00 #DIV/0! 115 Haloperidol 2010 Tablet 460.00 #DIV/0! 159 Loperamid 2014 Tablet .00 0 2.00 0 67.00 #DIV/0! 150 Kotrimoksazol suspensi 2015 Botol .00 0 29.00 0 2.5 % 2014 Botol .00 #DIV/0! 130 Kaptopril tablet 12. #DIV/0! 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 590. 0 . 0 .235.00 #DIV/0! 118 Hidrokortison cream 2.00 0 714. i. #DIV/0! 135 Ketokonazol tablet 200 mg 2015 Tablet 400. 0 .00 #DIV/0! 124 Isoniazid 100 mg 2011 Tablet . 0 .00 0 400. #DIV/0! 110 Glukosa larutan infus 10% 2014 Botol 16.

#DIV/0! 186 Mikonazol cream 2015 Tube 76. 0 . 0 .040. #DIV/0! 188 Natrium Diklofenak tablet 25 mg 2015 Tablet . 0 . 0 . #DIV/0! 180 Metoklopramide tablet 2015 Tablet 240.00 #DIV/0! 183 Metronidazol tablet 500 mg 2011 Tablet .00 0 29.450.00 #DIV/0! 170 Metformin HCL tablet 850 mg 2015 Botol .00 0 30.00 #DIV/0! 167 Metampiron Injeksi 2015 Ampul .010. 0 .00 #DIV/0! 208 Ondansentron 4 mg 2014 Tablet . #DIV/0! 219 Parasetamol tablet 100 mg 2013 Tablet 200. #DIV/0! 179 Metoklopramide tablet 2013 Tablet . #DIV/0! 196 Nistatin tablet vaginal 100. 0 . #DIV/0! 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 30.00 0 11. 0 .5 mg 2014 Tablet .00 #DIV/0! 169 Metformin HCl tablet 500 mg 2015 Tablet 1.00 #DIV/0! 206 Omeprazol kapsul 20 mg 2014 Kapsul .00 #DIV/0! 216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 551.040.00 0 100.00 #DIV/0! 195 Nistatin tablet vaginal 100. #DIV/0! 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube . #DIV/0! 201 Obat FDC katagori sisipan 2013 Paket . 0 .420.805. #DIV/0! 178 Metoklopramide inj Ampul . 0 . #DIV/0! 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube .00 #DIV/0! 193 Nifedipin tablet 10 mg 2015 Tablet . 0 .00 0 380. 0 . 0 . 0 .00 #DIV/0! 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 50. 0 .00 0 76. 0 . #DIV/0! 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 3. #DIV/0! 194 Nistatin Tablet salut 500.000 IU/g 2015 Tablet 137. 0 . #DIV/0! 207 Omeprazol kapsul 20 mg 2015 Kapsul 1.00 0 137.00 #DIV/0! . #DIV/0! 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 50.00 0 240.00 #DIV/0! 220 Parasetamol tablet 500 mg 2011 Tablet .00 0 59.00 0 200.00 #DIV/0! 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol . 0 . 0 . #DIV/0! 185 Mikonazol cream 2014 Tube .00 #DIV/0! 200 Obat Diare Dewasa 2010 Tablet . 0 .00 0 1.9 % steril 2015 Botol 38. #DIV/0! 177 Metilprednisolon 4 mg 2013 Tablet .00 0 1.00 0 50.00 #DIV/0! 222 Piracetam tablet 800 mg 2011 Tablet .00 0 365.00 0 208. 0 .200 mg-ml 2014 Ampul . #DIV/0! 182 Metronidazol tablet 250 mg 2014 Tablet 750.00 #DIV/0! 174 Metilergometrin injeksi 0. 0 .00 0 750.00 0 404. #DIV/0! 213 Papaverin tablet 40 mg 2013 Tablet 365. #DIV/0! 218 Parasetamol Supp 2014 Supp .805. 0 . #DIV/0! 198 Obat Batuk Hitam 100 ml 2013 Botol .00 0 38. 0 . 0 . 0 . #DIV/0! 215 Parasetamol drop 2015 Botol 208.420.125 mg 2013 Tablet 200. #DIV/0! 166 Metampiron Injeksi 2014 Ampul 29.00 #DIV/0! 192 Nifedipin tablet 10 mg 2014 Tablet 404.00 #DIV/0! 181 Metronidazol infus 500 mg/100 ml 2014 Botol .00 0 199. #DIV/0! 191 Natrium Klorida larutan infus 0.00 #DIV/0! 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul .00 0 3. 0 .00 #DIV/0! 172 Methisoprinol 500 mg 2013 Tablet .00 0 200.125 mg 2015 Tablet .00 0 551. #DIV/0! 209 Ondansentron 4 mg 2015 Tablet . 0 . 0 . #DIV/0! 171 Methisoprinol 250 mg/5ml 2014 Botol 9.00 #DIV/0! 176 Metilergometrin tablet salut 0.00 0 9. 0 . #DIV/0! 173 Methisoprinol 500 mg 2015 Tablet 100.000 IU 2013 Tablet 380.00 0 50.00 #DIV/0! 187 Natrium Diklofenak tablet 25 mg 2013 Tablet . 0 .9 % steril 2014 Botol . #DIV/0! 210 Ondansentron inj 4 mg/2 ml 2014 Ampul .00 #DIV/0! 214 Parasetamol drop 2014 Botol . 0 .000 IU/g 2013 Tablet . 0 . #DIV/0! 199 Obat Batuk Hitam 100 ml 2015 Botol 199. #DIV/0! 184 Metronidazol tablet 500 mg 2015 Tablet .00 #DIV/0! 197 OAT Kategori 2 2014 Paket . #DIV/0! 168 Metampiron tablet 500 mg 2014 Tablet 1.00 0 1.165 Meloksikam 7. #DIV/0! 221 Parasetamol tablet 500 mg 2015 Tablet 11. 0 . 0 . #DIV/0! 175 Metilergometrin tablet salut 0.00 #DIV/0! 190 Natrium Klorida larutan infus 0.450.010. #DIV/0! 223 Pirantel tablet 125 2013 Tablet 59.

00 #DIV/0! 267 Sulfacetamida Natrium tetes mata 2013 Botol .624.00 #DIV/0! 238 Ranitidin injeksi 2014 Ampul 20.305.00 #DIV/0! .00 0 270.240.00 0 99.00 0 90.000 IU 2014 Kapsul 1.00 0 600. 0 .180.00 0 1.00 #DIV/0! 280 Zink tablet 20 mg 2014 Tablet 2. #DIV/0! 234 Pseudoefedrin Hcl Drop 2015 Botol 25.00 #DIV/0! 273 Tramadol inj 50 mg/ml 2014 Ampul .00 0 48. 0 .00 #DIV/0! 246 Saccarum Lactis 2013 Botol . #DIV/0! 249 Salbutamol tab 4 mg 2013 Tablet . 0 .00 #DIV/0! 226 Piroksikam tablet 10 mg 2013 Tablet . 0 .00 0 2. #DIV/0! 253 Salisil Bedak 2 % 2014 Kotak .00 0 2. #DIV/0! 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 30.00 #DIV/0! 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 6.00 0 425.00 #DIV/0! 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 10. 0 .800.00 #DIV/0! 242 Retinol (VIT A) tablet salut 200. 0 .305.00 0 100.00 0 3.130. 0 . #DIV/0! 276 Triamsinolon Tablet 2013 Tablet 30.00 #DIV/0! 277 Triheksifenidil tab 2 mg 2014 Tablet 630.00 #DIV/0! 275 Triamcinolon Acetonide 1 mg krim 2014 Tube .800.00 0 2.000. 0 . 0 .00 0 2. 0 .00 #DIV/0! 230 Prednison tablet 5 mg 2011 Tablet . 0 .00 #DIV/0! 251 Salbutamol tablet 2 mg Tablet .00 #DIV/0! 233 Pseudoefedrin Hcl Drop 2014 Botol .00 #DIV/0! 279 Vitamin B Komplek 2015 Tablet 4.00 #DIV/0! 236 Ranitidin Hcl Sirup 2014 Botol .00 0 25.00 0 740. 0 .00 #DIV/0! 266 Siprofloksasin tablet 500 mg 2015 Tablet 300. #DIV/0! 282 Anti Hipertensi Herbal 2015 Tablet 30.00 #DIV/0! 243 Retinol (VIT A) tablet salut 200. #DIV/0! 244 Rifampisin kapsul 300 mg 2013 Kapsul .00 #DIV/0! 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 31. #DIV/0! 264 Siprofloksasin tablet 500 mg 2014 Tablet . #DIV/0! 265 Siprofloksasin tablet 500 mg 2015 Tablet 290.00 0 290. 0 .00 #DIV/0! 269 Teofilin Tablet 2013 Tablet 99.00 0 2.00 #DIV/0! 278 Vitamin B Komplek 2014 Tablet 1.00 #DIV/0! 263 Simvastatin tablet 20 mg 2015 Tablet . 0 .00 0 155. #DIV/0! 252 Salep 2-4 2011 Tube .00 #DIV/0! 272 Tiampenikol kapsul 500 mg 2014 Kapsul 210.00 0 10. #DIV/0! 237 Ranitidin Hcl Sirup 2015 Botol 21.000 IU 2015 Kapsul .00 #DIV/0! 261 Simetidin tab 200 mg 2014 Tablet 560.00 0 560. 0 .050. #DIV/0! 245 Ringer laktat larutan infus steril 2014 Botol 600.000. #DIV/0! 250 Salbutamol tab 4 mg 2015 Tablet 425.00 #DIV/0! 255 Sefadroksil kapsul 500 mg 2014 Kapsul 740.00 0 12.740.00 0 1. #DIV/0! 258 Seftriakson injeksi 1 gram 2013 Ampul .130.00 0 4.00 #DIV/0! 270 Tetrasiklin kapsul 500 mg 2011 Kapsul . 0 .00 0 300.079.950.00 0 31. #DIV/0! 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 2.00 0 21.050. #DIV/0! 241 Retinol (VIT A) kapsul 100. #DIV/0! 254 Salisil Bedak 2 % 2015 Kotak 155. #DIV/0! 257 Seftazidim Injeksi Ampul .00 0 20.00 0 190.00 0 30.224 Pirazinamid tablet 500 mg 2013 Tablet .00 #DIV/0! 262 Simvastatin tablet 10 mg 2015 Tablet 2.00 0 210. 0 . #DIV/0! 231 Prednison tablet 5 mg 2015 Tablet 3. #DIV/0! 248 Salbutamol nebules 2015 Kotak . 0 . 0 . 0 .180.00 #DIV/0! 240 Ranitidin tablet 150 mg 2015 Tablet .00 0 30.00 #DIV/0! 235 Ramipril 5 mg 2014 Tablet 100. #DIV/0! 274 Tramadol kapsul 50 mg 2014 Kapsul 270. 0 .00 #DIV/0! 239 Ranitidin tablet 150 mg 2014 Tablet 2.079.00 #DIV/0! 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol . 0 .00 #DIV/0! 281 Albendazol suspensi 200mg/5ml 2013 Botol . 0 .00 #DIV/0! 232 Propanolol tablet 10 mg 2013 Tablet 190.00 0 30.00 0 630. 0 .624. 0 . #DIV/0! 247 Salbutamol nebules 2013 Kotak .00 0 6.240.740.950. #DIV/0! 227 Piroksikam tablet 20 mg 2014 Tablet 90. #DIV/0! 268 Sulfacetamida Natrium tetes mata 2015 Botol 48. #DIV/0! 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 2.000 IU 2014 Kapsul 12.

00 #DIV/0! 297 Curcuma Tab 2013 Tablet . #DIV/0! 302 Klopidogrel 75 mg 2014 Tablet 90. 0 .00 #DIV/0! 320 Natrium Fe EDTA drop 2013 Botol .00 #DIV/0! 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube . #DIV/0! 331 Obat Flu Tablet 2015 Tablet 2. #DIV/0! 292 Cairan Elektrolit Kombinasi Na. kombinasi 2014 Sachet . #DIV/0! 319 Multivitamin dewasa 2015 Tablet 425. #DIV/0! 301 Isoxsuprine Hcl Tablet 2013 Tablet .00 0 66.640.640. #DIV/0! 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 10.Ca. #DIV/0! 298 Enzim Pencernaan 2013 Tablet 3. #DIV/0! 294 Cairan Hydroxyethyl Strach (HES) 200/0. 0 . Lactate.283 Anti Oksidan Tablet 2013 Tablet 3. 0 .00 0 5. #DIV/0! 325 Obat Antianemia 2015 Tablet . 0 .00 0 1. 0 . Cl. 0 . 0 . 0 .00 #DIV/0! 291 Cairan Elektrolit Kombinasi Na. K.Ca. #DIV/0! 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet . #DIV/0! Kombinasi CaCl2 anhidrat 0. kombinasi 2015 Sachet . Cl.090.00 0 24. 0 . #DIV/0! 328 Obat Batuk Hitam + Parasetamol 2014 Botol 31.5 60 g. Glucose 2013 Botol . 0 . #DIV/0! 324 Obat Antianemia 2015 Tablet . Glucose 2014 Botol 22. #DIV/0! 286 Antispasmodik kombinasi 2014 Tablet .00 0 73.00 #DIV/0! 304 Kombinasi Amino Acid. 0 . 0 .00 0 190. Nacl 9 g 2015 Botol .00 #DIV/0! 299 Fenoterol nebules solution 2013 Botol 1. 0 .020. 0 . fenilmerkuri 2013 305 nitrat 0. 0 . 0 . #DIV/0! 321 Nistatin dan Zn Oxide Salep 2013 Tube .00 #DIV/0! 312 Lactulose Sirup 2015 Botol . 0 .00 0 285. #DIV/0! 293 Cairan Elektrolit Kombinasi Na. K.00 #DIV/0! 330 Obat Flu Tablet 2014 Tablet .00 0 425. K.0075 gram.00 #DIV/0! 327 Obat Antifungi Drop 2015 Botol .5 60 g. #DIV/0! 323 Obat Antianemia 2014 Tablet . 0 .3 mg Botol . Lactate. #DIV/0! 311 Lactulose Sirup 2014 Botol 24.00 #DIV/0! 329 Obat Flu dan Batuk Sirup 2014 Botol 285.00 0 1. #DIV/0! 285 Antispasmodik Inj 2013 Ampul .00 #DIV/0! 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs .020.090. #DIV/0! 317 Multivitamin anak sirup 2015 Botol 338. 0 .420.00 #DIV/0! 295 Cairan Hydroxyethyl Strach (HES )200/0.00 0 22. Kalium Iodida 0. 0 .075 gram.00 #DIV/0! . 2013 307 cinchocaine HCl 2. 0 .00 0 10. K.00 #DIV/0! 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 190. #DIV/0! 315 Mometasone Furoate Krim 2013 Tube .075 gram. Cl. #DIV/0! 316 Multivitamin anak sirup 2014 Botol .5 mg Supp .00 0 31. #DIV/0! 287 Antispasmodik kombinasi 2015 Tablet . 0 . 0 . #DIV/0! 326 Obat Antifungi Drop 2014 Botol 66. #DIV/0! 314 Mineral mix. Natrium Tiosulfat 0. #DIV/0! 290 Cairan Elektrolit Kombinasi Na.00 0 2.electrolytes 2013 Botol .00 #DIV/0! 318 Multivitamin dewasa 2014 Tablet . Cl. #DIV/0! 309 Krim Analgesik 2013 Tube . 0 .00 0 338.420. 0 . Glucose 2015 Botol . 0 .Asetat 2014 Botol . 0 . #DIV/0! 310 Krim Antiinflamasi 2013 Tube . Cl. 0 .00 #DIV/0! Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg.00 0 3.00 0 3. #DIV/0! 288 Budesonid respules/ cairan inhaler 2014 Pcs 5. Nacl 9 g 2014 Botol 73. #DIV/0! Kombinasi Lactobacillus+ 306 2013 Tablet 750. 0 . #DIV/0! 313 Mineral mix. 0 . #DIV/0! 322 Norethisterone Tablet 2013 Tablet .00 0 750.Vitamin. 0 .00 #DIV/0! 332 Obat Hepatoprotektor 2014 Tablet 1.Asetat 2015 Botol .00 #DIV/0! 289 Cairan Elektrolit Kombinasi Na.00 0 90. 0 .

#DIV/0! 348 Suplemen untuk sendi dan tulang 2014 Tablet . #DIV/0! 355 Vitamin Neurotopik 2013 Tablet .00 #DIV/0! Policresulen (Produk kondensasi dari asam 336 2014 Botol .00 #DIV/0! 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol . #DIV/0! 353 Tiotropium Br 2013 Pcs .00 #DIV/0! 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 2. #DIV/0! 354 Valsartan 80 mg 2014 Tablet .00 #DIV/0! 370 Fletcher Cairan 2014 Botol 1. 0 . #DIV/0! 344 Suplemen Ibu Menyusui 2015 Tablet 210.00 0 9. #DIV/0! metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol 24.00 #DIV/0! 342 Sirup Besi Kombinasi 2013 Botol .00 0 1. #DIV/0! 382 Semen seng fosfat serbuk 2014 Set 2.00 #DIV/0! 383 Tambal Sementara Untuk Gigi 2015 Botol .00 0 2.00 0 2. #DIV/0! 335 Permetrin krim 5% 10 g 2014 Tube 9. 0 . Hemihydrate 2013 Tablet 100. 0 .00 #DIV/0! 361 Alveogyl 2014 Botol .00 0 24. #DIV/0! 373 Glass Ionomer cement Art 2014 Set 3. 0 .00 0 30.00 0 210.00 #DIV/0! 357 Vitamin Neurotopik inj. 0 .5 mg/ml 2013 Ampul .00 0 4. #DIV/0! 364 Cresophen 2014 Botol 2. 0 . 0 . 0 .00 0 1.00 #DIV/0! 381 Pulperyl 2014 Botol .00 #DIV/0! metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 3.00 #DIV/0! 379 OCO 2014 Botol . 0 . #DIV/0! 351 Terbutalin cairan ih 2. #DIV/0! 362 Bonding 2013 Botol 3. #DIV/0! 358 Vitamin Neurotopik inj.00 #DIV/0! 366 Etching 2013 Pcs 2.00 #DIV/0! 376 Metronidazol Gel untuk Peridonitis 2014 Tube 1.00 #DIV/0! 371 Fletcher Serbuk 2014 Botol 1.00 0 42. 0 . #DIV/0! . #DIV/0! 347 Suplemen Untuk Gizi Anak 2015 Sachet .00 #DIV/0! 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet . 0 . 0 . 0 . 0 . Kombinasi (vit B1+ B6+ B12) 2015 Ampul 42. 0 .00 0 2.00 #DIV/0! 365 Devitalisasi pasta non arsen 2014 Kotak 2.00 #DIV/0! 372 Fletcher serbuk dan cairan 2012 Botol . #DIV/0! 368 Etil klorida semprot 2014 Botol 4. 0 .00 0 3. 0 . 0 .00 0 3.00 #DIV/0! 352 Terbutalin Sulfate 0.00 0 100. #DIV/0! 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol .1 % + 340 2014 Tube . #DIV/0! Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 30.00 0 3.00 0 115.00 #DIV/0! 367 Etching 2015 Pcs . #DIV/0! 346 Suplemen Untuk Gizi Anak 2014 Sachet .00 0 2.00 #DIV/0! 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul .333 Obat luka bakar 2014 Tube 10. #DIV/0! 375 Kalsium Hidroksida pasta 2014 Set 2. 0 . 0 .00 #DIV/0! 350 Tamsolusin Hcl Tablet 2013 Tablet . #DIV/0! 360 Zink Syrup 2014 Botol 115. #DIV/0! 343 Suplemen Ibu Menyusui 2014 Tablet . 0 .00 0 2.00 0 450. #DIV/0! 356 Vitamin Neurotopik 2015 Tablet 450.00 #DIV/0! 363 Cairan Pembersih Gigi 2015 Botol . 0 . #DIV/0! 380 Pasta Iodoform 2014 Kotak 1. 0 .00 0 5. #DIV/0! Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 683.00 0 683.00 #DIV/0! 369 Eugenol cairan 2012 Botol 2.00 0 10.00 0 2. 0 . Kombinasi (vit B1+ B6+ B12) 2014 Ampul .00 0 2. 0 .00 #DIV/0! Salep Kombinasi : Betametason valerat 0.00 0 2.00 #DIV/0! 374 Glass Ionomer cement Art 2015 Set .00 0 1.00 #DIV/0! 339 Procaterol Hcl.00 #DIV/0! 378 Mummifying pasta 2014 Set 2.00 0 1. mg/ml 2014 Pcs 5.

v catheter 2014 Pcs 350.1 % (Rivanol) 2013 Botol .00 0 2. #DIV/0! 396 Alat Suntik 3 cc 2015 Pcs 500.600.00 #DIV/0! 405 Articulating paper 2014 Kotak . #DIV/0! 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol .00 0 288.00 #DIV/0! 427 Hand Scoon (Steril) # 6.00 #DIV/0! 390 Tambal Sinar Warna A3. #DIV/0! 421 Dressing transparant untuk pemasang i. #DIV/0! .00 #DIV/0! 437 Handscoon Non Steril S 2015 Pcs .00 0 2.00 #DIV/0! 397 Alat Suntik 10 cc 2014 Pcs .00 0 100.00 0 100.00 0 3.00 0 48. 0 . #DIV/0! 434 Handscoon Non Steril M 2015 Pcs 100.5 2015 Syringe .00 0 510.00 0 26.00 0 3.00 #DIV/0! 395 Alat Suntik 3 cc 2013 Pcs .00 #DIV/0! 403 Aqua Jell (Ky Jelly) 2013 Tube .00 0 100.600. #DIV/0! 428 Hand Scoon (Steril) # 6.00 0 26. #DIV/0! 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol . 0 .00 #DIV/0! 425 Foley Catheter # 18 2013 Pcs 26.00 #DIV/0! 426 H2O2 3% 2014 Botol 3. 0 . #DIV/0! 423 Etakridin larutan 0. 0 . #DIV/0! dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol . 0 . 0 . #DIV/0! 404 Aquabidest 500ml 2014 Botol 12. #DIV/0! 408 Blood transfusion set 2014 Pcs .00 #DIV/0! 429 Hand Scoon (Steril) # 7 2014 Pcs .00 #DIV/0! 420 Dressing retention 5 cm x 5 cm 2013 Roll .00 #DIV/0! 417 Cutgut Plain 2/0 (roll) 2013 Roll 3. 0 . #DIV/0! 399 Alkohol 1000 ml 2015 Botol 7.00 0 3. #DIV/0! 436 Handscoon Non Steril S 2015 Pcs 100.5 ml 2012 Pcs 510. #DIV/0! 393 Alat suntik sekali pakai 2.00 0 57. 0 .5 2014 Pcs .00 #DIV/0! 387 Tambal Sinar Warna A2 2015 Syringe . 0 .5 2013 Syringe 1. 0 . 0 .00 #DIV/0! 433 Handscoon Non Steril M 2013 Pcs . 0 .00 #DIV/0! 394 Alat suntik sekali pakai 5 ml 2012 Pcs 800. 0 .00 #DIV/0! 416 Cutgut 3/0 Plain 2014 Pcs 302.00 0 400.00 0 350. 0 .00 #DIV/0! 435 Handscoon Non Steril S 2013 Pcs .5 2015 Pcs 400.00 0 72. 0 .00 #DIV/0! 407 Blood transfusion set 2013 Pcs . 0 . 0 .00 #DIV/0! 431 Handscoon Non Steril L 2013 Pcs .00 0 400. #DIV/0! 388 Tambal Sinar Warna A3 2014 Syringe 1.00 0 302. 0 .00 #DIV/0! 386 Tambal Sinar Warna A2 2013 Syringe 3. #DIV/0! 432 Handscoon Non Steril L 2015 Pcs 100.00 #DIV/0! 389 Tambal Sinar Warna A3.00 0 1. #DIV/0! 398 Alkohol 1000 ml 2013 Botol . #DIV/0! 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 57.00 #DIV/0! 424 Foley Catheter # 16 2013 Pcs 26. #DIV/0! 391 Trikresol Formalin 2014 Botol 2.00 #DIV/0! 422 Etakridin larutan 0.00 #DIV/0! 392 Alat suntik sekali pakai 1 ml 2012 Pcs .00 0 1. #DIV/0! 401 Alkohol Swab 2014 Pcs 1. 0 .00 #DIV/0! 418 Desinfektan Lantai 2014 Botol .1 % (Rivanol) 2015 Botol 4.00 0 7. 0 . #DIV/0! dental 413 Cutgut 2/0 Chromic 2014 Pcs 48.00 #DIV/0! 414 Cutgut 2/0 Plain 2014 Pcs 288.385 Tambal Sementara Untuk Gigi Depan 2014 Botol 2.00 0 500.00 0 12.00 #DIV/0! 415 Cutgut 3/0 Chromic 2014 Pcs 72.00 #DIV/0! 402 Alkohol Swab 2015 Pcs 500.00 #DIV/0! 400 Alkohol 70% 100 ml 2014 Botol .00 0 4. 0 . 0 .00 0 800.00 0 1. #DIV/0! 430 Hand Scoon (Steril) # 7 2015 Pcs 400. 0 . #DIV/0! Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon .00 0 12.00 0 500. #DIV/0! 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 12. 0 .

#DIV/0! #DIV/0! 0 #DIV/0! 95.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 81.155. #DIV/0! #DIV/0! 0 #DIV/0! 140. #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 93. #DIV/0! #DIV/0! 0 #DIV/0! 2.520.00 #DIV/0! #DIV/0! 0 #DIV/0! 3.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 2.00 #DIV/0! #DIV/0! 0 #DIV/0! 150. #DIV/0! #DIV/0! 0 #DIV/0! 122.820.00 #DIV/0! #DIV/0! 0 #DIV/0! 7. #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 50.00 #DIV/0! #DIV/0! 0 #DIV/0! 762.00 #DIV/0! #DIV/0! 0 #DIV/0! 72.00 #DIV/0! #DIV/0! 0 #DIV/0! .735. #DIV/0! #DIV/0! 0 #DIV/0! 175.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 411.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 5.00 #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! 0 #DIV/0! 150.00 #DIV/0! #DIV/0! 0 #DIV/0! .215.00 #DIV/0! #DIV/0! 0 #DIV/0! 600.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 1.580.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 1.250.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .370. #DIV/0! #DIV/0! 0 #DIV/0! 800.225. #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 30. PELAPORAN BULAN : Maret 2016 PERMINTAAN BULAN : April 2016 STOCK STOCK Buffer Lead Time PERMINTAAN PEMBERIAN AKHIR OPTIMAL 9 10 11 12 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! 0 #DIV/0! 1. #DIV/0! #DIV/0! 0 #DIV/0! 820.

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00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 3.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 1. #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! 0 #DIV/0! 30. #DIV/0! #DIV/0! 0 #DIV/0! 1.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 2.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 683. #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 115.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! 0 #DIV/0! 24.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 2.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! 0 #DIV/0! 4. #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 450.00 #DIV/0! #DIV/0! 0 #DIV/0! 1.00 #DIV/0! #DIV/0! 0 #DIV/0! 1.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 2.00 #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 42. #DIV/0! #DIV/0! 0 #DIV/0! 5.0 #DIV/0! 10.00 #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! 0 #DIV/0! 3. #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 3. #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 9. #DIV/0! #DIV/0! 0 #DIV/0! 210.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! .

00 #DIV/0! #DIV/0! 0 #DIV/0! 500. #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 57.00 #DIV/0! #DIV/0! 0 #DIV/0! 3.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .600. #DIV/0! #DIV/0! 0 #DIV/0! 7.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 48. #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 350.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 1.00 #DIV/0! #DIV/0! 0 #DIV/0! 26.00 #DIV/0! #DIV/0! 0 #DIV/0! 26.0 #DIV/0! 2.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 288. #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 1. #DIV/0! #DIV/0! 0 #DIV/0! 1. #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 3. #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 72. #DIV/0! #DIV/0! 0 #DIV/0! 12. #DIV/0! #DIV/0! 0 #DIV/0! 510. #DIV/0! #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 4. #DIV/0! #DIV/0! 0 #DIV/0! 12.00 #DIV/0! #DIV/0! 0 #DIV/0! 800.00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 400.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! 0 #DIV/0! 302.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! 3. #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! 0 #DIV/0! 500. #DIV/0! #DIV/0! 0 #DIV/0! 400.

Klavulanat 2013 Tablet 14 Amoksisilin kaplet 250 mg 2013 Tablet 15 Amoksisilin kaplet 500 mg 2014 Tablet 16 Amoksisilin kaplet 500 mg 2015 Tablet 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 19 Antasida DOEN tablet 2014 Tablet 20 Antasida DOEN tablet 2015 Tablet 21 Antasida DOEN Suspensi 2014 Botol 22 Antasida DOEN Suspensi 2015 Botol 23 Anti Bakteri DOEN salep 2013 Tube 24 Anti Bakteri DOEN salep 2015 Tube 25 Anti Fungi DOEN kombinasi salep 2013 Pot 26 Anti Hemmoroid DOEN supp 2014 Supp 27 Anti Hemmoroid DOEN supp 2015 Supp 28 Anti migren / Ergotamin 2013 Tablet 29 Aqua Pro Injeksi steril @ 20 2014 Vial 30 Asam Asetilsalisilat 80 mg 2014 Tablet 31 Asam Asetilsalisilat 80 mg 2015 Tablet 32 Asam Asetilsalisilat 100 mg 2011 Tablet 33 Asam Askorbat (Vit. C) tablet 100 mg Tablet 34 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet 35 Asam Folat tab 1 mg 2013 Tablet 36 Asam Folat tab 1 mg 2015 Tablet 37 Asam Mefenamat Tablet 500 mg 2014 Tablet 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 39 Asam Mefenamat Tablet 500 mg 2015 Tablet 40 Asam Tranexamat 250mg 2013 Tablet 41 Asam Tranexamat Injeksi 2013 Ampul 42 Asiklovir krim 5% 2013 Tube .PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN No NAMA OBAT TAHUN SATUAN 1 2 3 4 1 Allopurinol tablet 100 mg 2014 Tablet 2 Allopurinol tablet 100 mg 2015 Tablet 3 Ambroksol Syrup 15 mg / ml 2014 Botol 4 Ambroksol Syrup 15 mg / ml 2015 Botol 5 Ambroksol tablet 30 mg 2014 Tablet 6 Ambroksol tablet 30 mg 2015 Tablet 7 Aminofilin inj 24 mg /ml 2014 Ampul 8 Aminofilin tab 200 mg 2014 Tablet 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet 11 Amlodipin 10 mg 2015 Tablet 12 Amlodipin 5 mg 2015 Tablet 13 Amoksisilin + As.

25 mg/ml-1 ml 2010 Ampul 49 Atropin Injeksi 0.25 mg 2015 Tablet 73 Dimenhidrinat tab 50 mg 2011 Tablet 74 Doksisiklin kapsul 100 mg 2010 Kapsul 75 Domperidon suspensi 5 mg/5ml 2014 Botol 76 Domperidon suspensi 5 mg/5ml 2015 Botol 77 Domperidon 10mg 2013 Tablet 78 Efedrin HCl tablet 25 mg 2014 Tablet 79 Ekstraks belladona tab 10 mg 2013 Tablet 80 Epinefrin / Adrenalin inj 0.43 Asiklovir Tablet 200 mg 2013 Tablet 44 Asiklovir Tablet 200 mg 2015 Tablet 45 Asiklovir Tablet 400 mg 2013 Tablet 46 Atapulgit 2011 Tablet 47 Atapulgit 2015 Tablet 48 Atropin Injeksi 0.5 mg 2013 Tablet 65 Deksametason tablet 0.5 mg 2015 Tablet 66 Diazepam Inj 5 mg/ml 2013 Ampul 67 Diazepam supp 2014 Supp 68 Diazepam supp 2015 Supp 69 Diazepam tab 2 mg 2013 Tablet 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 71 Digoksin tablet 0.25 mg 2014 Tablet 72 Digoksin tablet 0. Folat (Tambah darah) 2015 Tablet 53 Betahistin mesilat 2014 Tablet 54 Betametason Krim 2013 Tube 55 Betametason Krim 2015 Tube 56 Bisakodil supp 10 mg 2014 Supp 57 Bisakodil supp 10 mg 2015 Supp 58 Bisoprolol tab 5 mg 2014 Tablet 59 Bormheksin solution 2013 Botol 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol 61 Cetrizine 10 mg 2014 Tablet 62 Deksametason injeksi 5 mg/ml 2013 Ampul 63 Deksametason injeksi 5 mg/ml 2015 Ampul 64 Deksametason tablet 0.1 % 2013 Ampul 81 Eritromisin kapsul 250 mg 2013 Kapsul 82 Eritromisin kapsul 500 mg 2013 Kapsul 83 Eritromisin sirup 200mg/5 ml 2014 Botol 84 Eritromisin sirup 200mg/5 ml 2015 Botol 85 Etambutol tablet 250 mg 2011 Tablet 86 Fenobarbital tablet 30 mg 2010 Tablet 87 Fenobarbital tablet 30 mg 2015 Tablet 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul 94 Fitomenadion 2 mg inj 2013 Ampul 95 Fitomenadion 2 mg inj 2015 Ampul .25 mg/ml-1 ml 2015 Ampul 50 Atropin sulfat tablet 0. Folat (Tambah darah) 2013 Tablet 52 Besi II Sulfat 200 mg + As.5 mg 2014 Tablet 51 Besi II Sulfat 200 mg + As.

96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0.5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i.5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0.3% 2014 Botol 104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2.5 mg 2013 Tablet 131 Kaptopril tablet 12.1 % 2014 Tube 103 Gentamisin tetes mata 0.5 % 2014 Botol 144 Kloramfenikol tetes mata 0. i.5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj.v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12.5 % 2013 Tube 118 Hidrokortison cream 2.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet .

9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet.125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0.000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0.000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol . Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul 159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.125 mg 2013 Tablet 176 Metilergometrin tablet salut 0.

000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol 216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube .

K. Lactate.5 60 g. K. K.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na.Ca. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0. Cl. Cl. Lactate. Cl. Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na. Cl. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0.Ca. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na.253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul 273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na. Cl.5 60 g. K. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet .

075 gram. Natrium Tiosulfat 0.0075 gram.5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix.075 gram.302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid.Vitamin. fenilmerkuri 2013 305 nitrat 0.electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg. Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0. kombinasi 2014 Sachet 314 Mineral mix. 2013 307 cinchocaine HCl 2. kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol 321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl. Kalium Iodida 0.1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet .

mg/ml 2014 Pcs 352 Terbutalin Sulfate 0.347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2.5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2.5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol 371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3.5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs . Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj.5 2013 Syringe 390 Tambal Sinar Warna A3.

396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.5 2014 Pcs 428 Hand Scoon (Steril) # 6.1 % (Rivanol) 2015 Botol 424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs .v catheter 2014 Pcs 422 Etakridin larutan 0.

18 with injection Port 2014 Pcs 455 IV Chateter No.445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No. 20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs 481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs .

child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula.27 2014 Pcs 500 NGT No.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu . 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs 538 Wing Needle No.adult) 2015 Pcs 528 Silk Benang bedah no.498 Mucus Ekstractor 2014 Pcs 499 Needle no. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8. 14 2013 Pcs 504 NGT No. 12 2013 Pcs 503 NGT No.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula.25 2013 Pcs 541 Wing Needle no.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula. 8 2013 Pcs 501 NGT No.23 G 2013 Pcs 540 Wing Needle no.7 2014 Pcs 519 Plastik klip 13 x 8. 16 2013 Pcs 505 NGT No. 10 2013 Pcs 502 NGT No.21 G 2013 Pcs 539 Wing Needle No.

M.Apt) NIP. Mengetahui. Suharno.. 19600924 198501 1 001 NIP.Si.S. 19781102 200604 1 015 . Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs.Kes) (Irwan Hartono.

580.00 0 5. 0 - 50.520.00 81.00 .370.250.00 411.00 0 411.00 0 3.250.215. 0 - 1.00 0 72.00 0 140.00 3. 0 - .00 .820.00 2.00 . 0 - 30.00 762. LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 . 0 - 140. 0 - .00 .00 0 2.00 150.00 0 2. 0 - 175.00 . 0 - 2.00 0 93.00 0 175.00 0 7.820.00 0 1.00 0 150.370.00 0 95.735.00 .00 .00 0 122.00 .00 0 1.155.00 5.225.00 100.00 0 50. 0 - .735.00 0 2. 0 - 93. 0 - 1.00 . 0 - . 0 - .00 .215. 0 - .00 0 81.580.00 0 100. 0 - 95.00 0 30.225.00 0 150.520. 0 - 2.00 7.00 72.00 0 1.00 . 0 - 1.00 .00 150.155. 0 - . 0 - 122.00 0 762.

190.00 .190. 0 - 28.770. 0 - .00 0 10.00 564. 0 - 34.00 0 50. 0 - 800. 0 - 200.00 160.00 0 34. 0 - 164.00 0 420.00 .00 0 600.00 0 164.00 .00 0 820.00 . 0 - 171.00 0 111.00 0 8.00 0 100. 0 - 7.00 0 22.00 5. 0 - .00 0 7. 600.00 50.00 . 0 - . 0 - 8.00 0 564.00 28. 0 - . 0 - 194.00 . 0 - .00 .00 .00 . 0 - . 0 - 10. 0 - 22.00 0 410.00 0 194.00 . 0 - .00 111. 0 - .00 0 330.00 609.00 . 0 - .00 0 1.00 250.00 .00 .00 59.00 0 250.00 420. 0 - 1. 0 - 100.00 0 200. 0 - .00 0 5.00 410.00 0 800.00 .260.00 0 171. 0 - 100.00 0 609.00 . 0 - 820.00 0 100.00 0 59.00 0 28.00 0 28.260.00 330.770.00 0 160.00 .

755.080. 0 - 400.00 .00 500.00 .00 . 0 - 330.00 0 18.00 0 500.00 0 714.00 . 0 - 590.00 0 11. 0 - 5.00 .186.00 0 2. 0 - .00 0 16.00 .00 0 2.00 0 2.620. 0 - .235. 0 - 78. 0 - 2.00 .00 .00 0 990.110.235.00 0 1. 0 - .00 460.00 0 5.00 0 122.00 0 1.00 0 67.00 0 48.00 2.110.00 0 460.00 .00 .00 .00 .290.00 0 400.00 0 590.080. 0 - 48.00 0 94.00 .055. 0 - 11. 0 - 714. 0 - .055.00 0 610.00 460. 0 - 67.186.00 0 78. 0 - 97.00 610. 0 - 1.00 .00 .00 0 5. 0 - 1.00 0 460.00 .00 0 330.00 0 29.00 94. 0 - 990.290.00 18.00 .00 0 240.00 . 0 - 16.00 29.00 240.00 0 5. 0 - 5.00 2.00 5.00 0 97. 0 - . 0 - .00 0 733. 0 - 122.00 0 755.620.00 733.

450.00 0 380. 0 - 100. 0 - 3. 0 - 480.00 0 200.450.00 0 480.00 0 76. 0 - .00 . 0 - .00 0 1.00 . 0 - 1.040.00 0 203.00 0 38.000.00 0 1.00 404. 0 - 29.00 .805. 0 - . 0 - 187.00 .00 . 0 - 380. 0 - 9.00 . 0 - .00 .00 .00 0 610.00 0 750.00 0 187.000. 0 - .00 6. 0 - 1. 0 - 1.00 0 199. 0 - .00 .00 0 240.00 .00 .040.00 0 199.00 0 1.00 0 1.00 199. 0 - 199. 203.00 .00 .00 .00 .00 0 3. 0 - 111. 0 - 137.00 0 404.00 0 29. 0 - . 0 - 76.594.00 . 0 - .00 . 0 - . 0 - 240.00 0 137.00 0 9.00 0 111. 0 - 750.805.594.00 . 0 - 38.00 0 6.00 0 100.00 .00 610.00 1. 0 - 200.

079.00 31. 0 - .00 10. 0 - .00 .00 0 10. 0 - 90.00 0 208.00 0 12.00 .00 .00 50.00 .00 0 551.00 0 50. 0 - 208.00 2. 0 - 21.00 .00 . 0 - 25. 0 - 1.00 0 190.079.00 0 21.00 . 0 - .00 551. .00 100.00 0 1. 0 - 425.00 .00 0 25.00 .00 0 365.00 .00 0 20.00 0 3.00 . 0 - 2. 0 - 50. 0 - .00 0 90.00 . 0 - 3. 0 - 600.00 0 11.00 20.050.050.00 0 59.00 0 1.00 0 100.00 0 31.00 12.00 . 0 - .624. 0 - 30. 0 - .010. 0 - .800.00 0 200.00 . 0 - .624.420.950. 0 - 1.00 0 2. 0 - 59. 0 - .420. 0 - 11. 0 - .010. 0 - 200.00 0 30.800.00 190.00 . 0 - .00 0 600.00 .950. 0 - 365.00 0 50. 0 - .00 0 2.00 0 425.

0 - .00 0 4.00 2.00 0 630. 0 - .00 0 22.00 0 6.130.00 0 73.00 0 30.00 3.00 .00 . 0 - . 0 - 30.00 .00 . 0 - 30. .00 0 210.00 0 270.00 . 0 - .00 0 560.740.00 0 2.00 1.00 300.00 0 2.00 630.00 0 155.240.00 0 1. 0 - .000.00 0 30.00 0 1. 0 - .00 .00 6.130.180.740.00 .00 .00 0 2.00 210.090.640. 0 - 73.00 0 740.00 0 99.180. 0 - 48.240.000. 0 - 155. 0 - 270.00 1.00 0 300.00 0 3. 0 - .090. 0 - 10.640.305.00 .00 0 290.00 4.00 0 5. 0 - 3.00 740. 0 - 5.00 560.00 0 48.00 0 3.00 . 0 - . 0 - 290.00 . 0 - 30. 0 - 22.00 99. 0 - 2.00 0 10.00 2.305. 0 - . 0 - .00 .00 0 30.00 .

0 - . 0 - .00 3.00 0 683.00 .00 100.00 0 3.00 . 0 - . 0 - .00 .00 0 338. 0 - 338.420.00 .00 0 24.020.00 0 425.00 0 190. 0 - . 0 - 683.00 0 210.00 .00 190.00 0 285. 0 - 31. 0 - . 0 - 24.00 1. 0 - .00 0 1. 0 - .00 0 750. 0 - 24. 0 - .00 0 66.020.00 0 10. 0 - .00 .420. 90. 0 - 425.00 .00 . 0 - . 0 - 2.00 285.00 0 24.00 0 2.00 0 90. 0 - 66. 0 - .00 0 31.00 0 9. 0 - . 0 - 750. 0 - .00 10. 0 - . 0 - .00 .00 0 100.00 . 0 - 9.00 .00 . 0 - 210.

00 0 2.00 0 2.00 0 2.00 . 0 - .00 0 4.00 . 0 - .00 0 3.00 0 42.00 . 0 - 1.00 0 3. 0 - 3.00 2. 0 - 2.00 0 1. 0 - . 0 - 42.00 .00 .00 0 30. 0 - 2. 0 - 4.00 .00 0 2.00 0 2. 0 - 1.00 0 450.00 2. 0 - 115.00 3.00 .00 1. 0 - . 0 - 2.00 0 2.00 .00 2.00 0 1.00 0 2.00 .00 0 115.00 .00 .00 1.00 .00 .00 .00 0 1.00 0 1. 0 - 2.00 2.00 0 510.00 . 0 - 5.00 2. 0 - . 0 - 510.00 0 800. 0 - 450. . 0 - 3.00 0 1.00 0 5.00 0 1.00 .00 800. 0 - . 0 - 30.00 0 2.00 1.00 0 2.00 0 3. 0 - 2.00 1.00 0 2.

00 0 60.00 .600.00 288.00 0 200. 0 - 12. 500. 0 - .00 0 100.00 .00 0 3.00 0 48. 0 - 48.00 0 4.00 .00 0 400.00 0 350.00 3.00 0 12.00 60.00 0 400.00 0 3.00 500.00 3.00 26.157.00 0 7.00 . 0 - 200.00 1.00 0 288.00 . 0 - 57. 0 - . 0 - 7.00 .00 .00 .00 . 0 - 400.157.00 . 0 - 400. 0 - . 0 - .00 0 100. 0 - .00 0 12.600.00 . 0 - .00 0 500.00 0 26. 0 - 350.00 0 26. 0 - 4.00 .00 0 302. 0 - 12.00 .00 0 100.00 0 200.00 200.00 0 1. 0 - 1.00 0 72. 0 - .00 72.00 0 57.00 302. 0 - .00 26.00 0 500.00 . 0 - 100. 0 - .00 0 1.00 . 0 - 100. 0 - 100.

00 2. 0 - .00 .00 0 5.00 0 3.00 15.00 0 15.00 0 300.000.00 50. 0 - 5.00 .00 72. 0 - 3.00 .00 300.00 0 100.00 .00 977.00 33.00 0 23.00 0 10.00 0 30.00 29. 0 - . 0 - 13.00 0 400.00 .00 0 665.00 . 0 - .00 . 0 - . 100.00 .00 0 50. 0 - .00 0 60. 0 - .00 400.00 .00 0 5. 0 - 5.00 0 977.00 182.00 .00 0 33. 0 - 23.00 . 0 - . 0 - 30.00 50.00 0 99.00 0 118.00 0 5. 0 - 12.00 0 50.00 0 10. 0 - 50. 0 - . 0 - 10.00 99.00 0 72.00 0 15.00 .00 0 182. 0 - .00 0 3.00 0 12.00 665. 0 - .00 0 29. 0 - 3.00 0 13.00 0 2.000.00 60. 0 - .00 0 100. 0 - . 0 - 15.00 10.00 118.00 100.00 0 50.00 5.

00 0 100.00 36. 0 - .00 0 55.000. 0 - .00 0 50.00 23. 0 - .00 . 0 - . 0 - .00 .00 0 98. 0 - . 0 - 100.00 0 75.00 50.00 . 0 - . 0 - .000.00 0 8.000.00 0 134. 0 - .00 0 109. 0 - 165.000.00 0 36.00 420. 0 - 98. 0 - .00 170. 0 - .00 100.00 .00 68.00 0 23. 0 - 20. .00 8.00 0 100.00 0 165.00 . 0 - . 0 - 55.000. 0 - .00 0 170. 0 - 109.00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara .00 0 32.00 .00 32.000.00 . 0 - . 0 - . 0 - 134. 0 - .00 0 20.00 38.000. 0 - .00 0 38. 0 - .000.00 0 68.00 0 420. 0 - 75.

. Yang Meminta Kepala UPT Puskesmas (…………………………………….) 604 1 015 NIP.

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) NIP..……………….Tangerang Selatan .. . Yang Menerima Petugas Puskesmas (……………………….

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.) . enerima Puskesmas …….………………..

C) tablet 50 mg 2014 Tablet 35 Asam Folat tab 1 mg 2013 Tablet 36 Asam Folat tab 1 mg 2015 Tablet 37 Asam Mefenamat Tablet 500 mg 2014 Tablet 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 39 Asam Mefenamat Tablet 500 mg 2015 Tablet 40 Asam Tranexamat 250mg 2013 Tablet 41 Asam Tranexamat Injeksi 2013 Ampul 42 Asiklovir krim 5% 2013 Tube .PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN No NAMA OBAT TAHUN SATUAN 1 2 3 4 1 Allopurinol tablet 100 mg 2014 Tablet 2 Allopurinol tablet 100 mg 2015 Tablet 3 Ambroksol Syrup 15 mg / ml 2014 Botol 4 Ambroksol Syrup 15 mg / ml 2015 Botol 5 Ambroksol tablet 30 mg 2014 Tablet 6 Ambroksol tablet 30 mg 2015 Tablet 7 Aminofilin inj 24 mg /ml 2014 Ampul 8 Aminofilin tab 200 mg 2014 Tablet 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet 11 Amlodipin 10 mg 2015 Tablet 12 Amlodipin 5 mg 2015 Tablet 13 Amoksisilin + As. C) tablet 100 mg Tablet 34 Asam Askorbat (Vit. Klavulanat 2013 Tablet 14 Amoksisilin kaplet 250 mg 2013 Tablet 15 Amoksisilin kaplet 500 mg 2014 Tablet 16 Amoksisilin kaplet 500 mg 2015 Tablet 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 19 Antasida DOEN tablet 2014 Tablet 20 Antasida DOEN tablet 2015 Tablet 21 Antasida DOEN Suspensi 2014 Botol 22 Antasida DOEN Suspensi 2015 Botol 23 Anti Bakteri DOEN salep 2013 Tube 24 Anti Bakteri DOEN salep 2015 Tube 25 Anti Fungi DOEN kombinasi salep 2013 Pot 26 Anti Hemmoroid DOEN supp 2014 Supp 27 Anti Hemmoroid DOEN supp 2015 Supp 28 Anti migren / Ergotamin 2013 Tablet 29 Aqua Pro Injeksi steril @ 20 2014 Vial 30 Asam Asetilsalisilat 80 mg 2014 Tablet 31 Asam Asetilsalisilat 80 mg 2015 Tablet 32 Asam Asetilsalisilat 100 mg 2011 Tablet 33 Asam Askorbat (Vit.

1 % 2013 Ampul 81 Eritromisin kapsul 250 mg 2013 Kapsul 82 Eritromisin kapsul 500 mg 2013 Kapsul 83 Eritromisin sirup 200mg/5 ml 2014 Botol 84 Eritromisin sirup 200mg/5 ml 2015 Botol 85 Etambutol tablet 250 mg 2011 Tablet 86 Fenobarbital tablet 30 mg 2010 Tablet 87 Fenobarbital tablet 30 mg 2015 Tablet 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul 94 Fitomenadion 2 mg inj 2013 Ampul 95 Fitomenadion 2 mg inj 2015 Ampul .5 mg 2015 Tablet 66 Diazepam Inj 5 mg/ml 2013 Ampul 67 Diazepam supp 2014 Supp 68 Diazepam supp 2015 Supp 69 Diazepam tab 2 mg 2013 Tablet 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 71 Digoksin tablet 0. Folat (Tambah darah) 2015 Tablet 53 Betahistin mesilat 2014 Tablet 54 Betametason Krim 2013 Tube 55 Betametason Krim 2015 Tube 56 Bisakodil supp 10 mg 2014 Supp 57 Bisakodil supp 10 mg 2015 Supp 58 Bisoprolol tab 5 mg 2014 Tablet 59 Bormheksin solution 2013 Botol 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol 61 Cetrizine 10 mg 2014 Tablet 62 Deksametason injeksi 5 mg/ml 2013 Ampul 63 Deksametason injeksi 5 mg/ml 2015 Ampul 64 Deksametason tablet 0.43 Asiklovir Tablet 200 mg 2013 Tablet 44 Asiklovir Tablet 200 mg 2015 Tablet 45 Asiklovir Tablet 400 mg 2013 Tablet 46 Atapulgit 2011 Tablet 47 Atapulgit 2015 Tablet 48 Atropin Injeksi 0. Folat (Tambah darah) 2013 Tablet 52 Besi II Sulfat 200 mg + As.25 mg/ml-1 ml 2010 Ampul 49 Atropin Injeksi 0.5 mg 2013 Tablet 65 Deksametason tablet 0.25 mg/ml-1 ml 2015 Ampul 50 Atropin sulfat tablet 0.5 mg 2014 Tablet 51 Besi II Sulfat 200 mg + As.25 mg 2014 Tablet 72 Digoksin tablet 0.25 mg 2015 Tablet 73 Dimenhidrinat tab 50 mg 2011 Tablet 74 Doksisiklin kapsul 100 mg 2010 Kapsul 75 Domperidon suspensi 5 mg/5ml 2014 Botol 76 Domperidon suspensi 5 mg/5ml 2015 Botol 77 Domperidon 10mg 2013 Tablet 78 Efedrin HCl tablet 25 mg 2014 Tablet 79 Ekstraks belladona tab 10 mg 2013 Tablet 80 Epinefrin / Adrenalin inj 0.

5 % 2014 Botol 144 Kloramfenikol tetes mata 0.5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj.5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0.5 % 2013 Tube 118 Hidrokortison cream 2.5 mg 2013 Tablet 131 Kaptopril tablet 12.3% 2014 Botol 104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2. i.v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12.1 % 2014 Tube 103 Gentamisin tetes mata 0. 96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet .5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i.

200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0. Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul 159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0.5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100.125 mg 2013 Tablet 176 Metilergometrin tablet salut 0. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol .149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet.

000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol 216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube .

Ca. Cl.5 60 g. Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na. K. K. K. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0. Cl.Ca.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet . Lactate. Cl.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na. Cl.5 60 g. K. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na. Cl.253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul 273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na. Lactate.

5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix. Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0. Natrium Tiosulfat 0.0075 gram.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg. Kalium Iodida 0.075 gram. fenilmerkuri 2013 305 nitrat 0. kombinasi 2014 Sachet 314 Mineral mix.075 gram.electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0. 2013 307 cinchocaine HCl 2. kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol 321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl.302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid.Vitamin.1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet .

5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj.5 2013 Syringe 390 Tambal Sinar Warna A3.347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol 371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3. mg/ml 2014 Pcs 352 Terbutalin Sulfate 0.5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2.5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs .

1 % (Rivanol) 2015 Botol 424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.5 2014 Pcs 428 Hand Scoon (Steril) # 6.396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs .v catheter 2014 Pcs 422 Etakridin larutan 0.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.

20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs 481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs . 18 with injection Port 2014 Pcs 455 IV Chateter No.445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No.

21 G 2013 Pcs 539 Wing Needle No.25 2013 Pcs 541 Wing Needle no. 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs 538 Wing Needle No.7 2014 Pcs 519 Plastik klip 13 x 8.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu .27 2014 Pcs 500 NGT No.adult) 2015 Pcs 528 Silk Benang bedah no. 14 2013 Pcs 504 NGT No.23 G 2013 Pcs 540 Wing Needle no. 16 2013 Pcs 505 NGT No.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula.498 Mucus Ekstractor 2014 Pcs 499 Needle no.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula. 10 2013 Pcs 502 NGT No. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8. 8 2013 Pcs 501 NGT No. 12 2013 Pcs 503 NGT No.

Suharno. Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs. 19781102 200604 1 015 .Apt) NIP.. Mengetahui.S.Si. 19600924 198501 1 001 NIP.M.Kes) (Irwan Hartono.

00 0 81.370.215.00 7.00 .00 0 3.155.00 0 7.00 0 93.225.00 .00 0 50.00 0 100.00 0 411.820.00 3. 0 - 2.00 762. 0 - .580.735.00 0 1.250. 0 - .520.00 0 2. 0 - 175.370. 0 - 140. 0 - 30.00 0 150.00 411.00 .00 .00 . 0 - 1.520.00 0 140.00 0 5.00 0 95.00 0 150. 0 - 2.00 72.00 0 1.00 0 2. 0 - 1.250.00 150. 0 - 50.00 .00 150.00 0 72.00 2.00 .00 81.00 0 30.225.00 . 0 - .155.00 0 762. 0 - .00 . 0 - 122.580. 0 - 1. 0 - .00 100.00 5.820.00 . 0 - .215. 0 - . 0 - 95. 0 - 93.00 0 2.00 0 1.00 0 175.00 .00 . LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .735.00 0 122.

0 - 100.00 .00 0 800.00 0 609.00 0 171. 0 - 820.00 .190. 0 - 34.00 .00 0 420.00 0 330.00 0 8.00 .00 0 1.00 0 5.00 59.00 .00 0 194.00 0 111.00 0 200.00 .00 0 100.190.00 564.00 0 820. 0 - .00 0 10.00 .00 0 50. 0 - 22. 0 - 164. 0 - 200. 0 - 194.00 420.770.00 .00 0 28.00 330.00 0 7.00 250.00 0 59.00 609.00 410. 0 - . 0 - . 0 - 800. 0 - .00 0 164.00 5.00 111.00 .00 0 410.260.00 0 564. 0 - 1.770.00 160.260.00 28. 0 - 171. 0 - 28.00 0 250. 0 - 100.00 50. 0 - 8. 0 - 7.00 0 100.00 .00 .00 0 28. 0 - . 0 - . 600.00 .00 . 0 - . 0 - .00 . 0 - 10.00 .00 .00 0 34. 0 - . 0 - .00 0 160.00 0 22.00 0 600.

00 .00 0 2.00 0 590.00 733.00 0 460.00 .00 . 0 - 590.00 .00 .00 5. 0 - 400.00 0 2.110.00 .290.235.00 0 714.00 0 29.186. 755. 0 - 714. 0 - 1.235.00 0 97.00 18.620.00 460.00 0 48.00 0 5.00 0 610.00 2.00 . 0 - . 0 - 990.00 0 500.055.00 0 2.00 0 400.00 0 67.00 .00 0 16. 0 - 67. 0 - 1.00 29.00 0 122.00 .00 . 0 - .00 0 1.620.186.080. 0 - 2.00 0 5.055. 0 - 48.00 0 94. 0 - 5. 0 - .00 0 11. 0 - 330.00 610.00 0 5.00 0 460.110.080.00 94.00 2. 0 - .00 .00 0 755.00 . 0 - 16. 0 - .00 460. 0 - 97.00 0 733.00 500.00 0 330.00 .00 .00 0 78. 0 - 11.00 0 1.00 . 0 - 122.00 240. 0 - .00 0 240.00 0 990.290. 0 - 78.00 .00 . 0 - 5.00 0 18.00 .

805.00 0 3. 203. 0 - . 0 - 1.00 .00 .00 0 199.00 0 76.00 .00 .00 0 137.00 . 0 - 76. 0 - 240.00 .000. 0 - 187.00 0 203.00 0 240.00 . 0 - 750.040.00 . 0 - 137.00 . 0 - 380.450.00 0 1.00 . 0 - . 0 - 200.00 0 750.00 .00 0 187. 0 - .00 404. 0 - 29.00 1.00 0 29. 0 - 480.00 .00 . 0 - 100. 0 - 199.805.00 610.00 .00 0 1.00 0 100.00 199.594.00 0 380. 0 - 3. 0 - .040.00 0 6.00 .00 . 0 - 38. 0 - 111.450. 0 - 9.00 0 38.00 6. 0 - 1.00 0 404.00 0 199.00 . 0 - . 0 - . 0 - 1.00 .00 0 1.00 0 9.00 . 0 - .00 0 111.594.00 0 480. 0 - .000. 0 - .00 0 1.00 0 610.00 0 200.

0 - 200. 0 - 2.00 .00 .00 .00 .00 0 21. 0 - .079.420.00 0 11.00 . 0 - 25.800.950. 0 - . 0 - 1.00 .00 190.00 0 2.050.624.00 0 200.010. 0 - .950. 0 - 600. 0 - .00 0 25.00 0 50.00 .00 .00 0 100. 0 - 3.00 0 1. 0 - 59.00 0 20.00 .00 0 365. 0 - 11.00 .00 0 208. 0 - 365. 0 - .00 0 3.420. 0 - .00 100.00 .00 0 12.00 12. 0 - 425.050.00 0 10.00 .00 .00 0 1.00 0 190.00 0 90.00 50.00 20.624. 0 - 1. .00 0 59.00 0 30. 0 - . 0 - .00 .00 10.00 2.00 31.00 0 2. 0 - . 0 - 21. 0 - 50.00 . 0 - 208.010.00 0 31. 0 - . 0 - .00 0 425.00 0 551.00 551.00 0 50. 0 - 30. 0 - 90.079.00 .00 0 600. 0 - .800.

0 - .00 0 30.130.00 0 740. 0 - 73.00 0 3.00 .00 . .00 0 1.740.00 0 3.00 4.000.000.090.00 0 270.00 .00 . 0 - . 0 - .00 0 1.00 0 30.00 .00 0 22.00 .00 1.00 .00 3. 0 - 30. 0 - 48.00 0 210.740.640.00 1.305.00 .240.00 0 10. 0 - 270.00 .00 99.00 . 0 - 3.640. 0 - 10.00 .00 0 560.00 . 0 - .00 0 2. 0 - 2. 0 - 22.00 300. 0 - 155.00 0 48.00 0 99.00 0 73.00 210.240.090.180. 0 - 5.00 630.00 0 30. 0 - 30. 0 - 30.00 0 155.00 2.00 0 5.00 740.00 .00 560.00 0 6.180. 0 - .00 0 300.130. 0 - .00 0 290.00 0 2.00 0 4. 0 - . 0 - . 0 - .00 0 2.00 2.305. 0 - 290.00 6. 0 - .00 0 630.

00 .00 .00 0 338.00 0 683.00 100.00 0 190. 0 - .00 . 0 - 750.00 0 210. 0 - 24. 0 - . 0 - 66. 0 - .00 . 0 - 683.00 . 0 - . 0 - . 0 - .00 3.00 0 100.00 .00 . 0 - .00 .00 .00 0 90.00 0 24. 0 - . 0 - . 0 - . 0 - 9. 0 - .420.00 0 9. 0 - 425. 0 - 24.00 0 3. 0 - . 0 - .00 0 31.00 0 10.00 .00 0 285. 0 - 2.00 1. 0 - . 0 - .00 0 66. 0 - 210.00 0 1.00 190. 0 - . 0 - 338.00 0 425.00 0 2.00 0 750.00 0 24.00 .420. 90.020. 0 - 31.020.00 .00 10.00 285.

00 3. 0 - 2.00 1.00 .00 0 1.00 0 2.00 0 3. 0 - .00 . 0 - 510. 0 - 3.00 0 42.00 2. 0 - 2. 0 - . 0 - 2. 0 - .00 .00 0 2.00 .00 0 2. 0 - 30.00 .00 2.00 0 1.00 .00 0 2. 0 - .00 .00 0 450.00 .00 . 0 - 4.00 .00 0 2. 0 - . 0 - .00 .00 0 115. 0 - 2. 0 - 5.00 0 2.00 .00 .00 800.00 0 1.00 0 2. .00 0 1.00 0 1.00 0 510.00 1. 0 - 450.00 0 1. 0 - 42.00 .00 0 2.00 2. 0 - 115.00 . 0 - 3.00 .00 0 2. 0 - 1.00 0 3.00 2. 0 - 1. 0 - 2.00 0 2.00 0 3.00 1.00 1.00 0 800.00 2.00 0 4.00 0 30.00 0 5.

00 26.157.00 0 100.00 0 500.00 0 72.00 0 48.00 .157.00 3. 0 - 12.00 0 200.00 0 200.00 .00 0 1.00 0 350.00 .00 .00 302. 0 - 7. 0 - .00 0 4. 0 - .00 0 7.00 0 100.00 0 288. 0 - . 0 - .00 500.600. 0 - 100.00 0 500.00 0 400. 0 - 400.00 60.00 0 26.00 0 3.00 0 12.00 0 3. 0 - 100.00 0 60. 0 - 100.00 200. 0 - 200.00 .00 .00 3.00 0 1.00 .00 .00 .00 0 302. 0 - 4.00 0 26. 0 - . 0 - 1. 0 - 48.00 288.00 . 0 - 400. 500.00 72.00 . 0 - .00 . 0 - 350.00 . 0 - .00 26.00 . 0 - .600.00 0 12. 0 - 12.00 .00 0 100. 0 - 57. 0 - .00 0 400.00 0 57.00 1.

0 - . 0 - 13.00 0 13.00 665. 0 - .00 0 5.00 50. 0 - 5.00 .00 0 182. 0 - .00 .00 . 0 - .00 0 23. 0 - 3.00 0 72.00 99.00 29. 0 - . 0 - 30.00 50. 0 - 15. 0 - 23. 0 - 12.00 0 5.00 0 15. 0 - .00 0 665.00 977. 0 - .00 0 15. 0 - 3.00 10.00 0 977.00 0 5.00 182.00 0 3.00 0 50.00 0 60.00 . 0 - .00 2.00 0 10. 0 - 5.00 .00 .00 0 400.00 0 100.00 0 50. 0 - .00 118. 0 - .00 0 118.00 72. 0 - 10.00 15.00 0 100.00 .00 0 3.000.00 . 0 - .00 0 99.00 100. 0 - 50.00 300. 100.00 .00 .00 0 12.00 0 300.00 0 33.00 0 29.00 400. 0 - .00 0 30.000.00 33.00 .00 0 50.00 5.00 0 2.00 0 10.00 .00 60.

0 - . 0 - .00 0 38.00 0 68. 0 - 98.00 0 100.00 0 109.000.000. 0 - . 0 - .000.000.00 0 55.00 . 0 - 75.00 170. 0 - 165. 0 - 134.00 0 20.00 0 420. 0 - . 0 - . 0 - 100. 0 - 55.00 420.00 .00 23.000.00 100.00 0 165.00 0 50.00 0 32.00 0 170.000. 0 - .00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara .00 32. 0 - . .00 0 23. 0 - .00 0 8.000.00 .00 . 0 - . 0 - .00 0 98. 0 - .00 .00 36. 0 - . 0 - .00 38.00 68. 0 - . 0 - .00 0 36.00 .00 . 0 - 109.00 0 134.00 0 75. 0 - .00 8. 0 - 20.000.00 0 100. 0 - .00 50.

) 604 1 015 NIP. Yang Meminta Kepala UPT Puskesmas (……………………………………. .

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00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 72. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 13.#DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 2.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 182.000.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 99.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 3.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 5.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 400. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 5.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 29.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 15.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 5.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 665. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 30.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 12.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 977.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 10.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 60. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 300. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 118.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 33.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 3.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 15. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 23.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 10.

#DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 134. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 38.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 55. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 20. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 23.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 420. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 36. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 165.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 8. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 170. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 75. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 98. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! .000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .000.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 109.#DIV/0! 0 #DIV/0! .000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 68. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 32.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .

) NIP.. .……………….Tangerang Selatan . Yang Menerima Petugas Puskesmas (………………………..

PEMBERIAN 12 .

.

.

.

.

enerima
Puskesmas

……..………………..)

PUSKESMAS : Jurangmangu
KECAMATAN :
KOTA : TANGERANG SELATAN
PROVINSI : BANTEN

No NAMA OBAT TAHUN SATUAN
1 2 3 4
1 Allopurinol tablet 100 mg 2014 Tablet
2 Allopurinol tablet 100 mg 2015 Tablet
3 Ambroksol Syrup 15 mg / ml 2014 Botol
4 Ambroksol Syrup 15 mg / ml 2015 Botol
5 Ambroksol tablet 30 mg 2014 Tablet
6 Ambroksol tablet 30 mg 2015 Tablet
7 Aminofilin inj 24 mg /ml 2014 Ampul
8 Aminofilin tab 200 mg 2014 Tablet
9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet
10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet
11 Amlodipin 10 mg 2015 Tablet
12 Amlodipin 5 mg 2015 Tablet
13 Amoksisilin + As. Klavulanat 2013 Tablet
14 Amoksisilin kaplet 250 mg 2013 Tablet
15 Amoksisilin kaplet 500 mg 2014 Tablet
16 Amoksisilin kaplet 500 mg 2015 Tablet
17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol
18 Amoksisilin sirup kering forte 250mg/ml 2015 botol
19 Antasida DOEN tablet 2014 Tablet
20 Antasida DOEN tablet 2015 Tablet
21 Antasida DOEN Suspensi 2014 Botol
22 Antasida DOEN Suspensi 2015 Botol
23 Anti Bakteri DOEN salep 2013 Tube
24 Anti Bakteri DOEN salep 2015 Tube
25 Anti Fungi DOEN kombinasi salep 2013 Pot
26 Anti Hemmoroid DOEN supp 2014 Supp
27 Anti Hemmoroid DOEN supp 2015 Supp
28 Anti migren / Ergotamin 2013 Tablet
29 Aqua Pro Injeksi steril @ 20 2014 Vial
30 Asam Asetilsalisilat 80 mg 2014 Tablet
31 Asam Asetilsalisilat 80 mg 2015 Tablet
32 Asam Asetilsalisilat 100 mg 2011 Tablet
33 Asam Askorbat (Vit. C) tablet 100 mg Tablet
34 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet
35 Asam Folat tab 1 mg 2013 Tablet
36 Asam Folat tab 1 mg 2015 Tablet
37 Asam Mefenamat Tablet 500 mg 2014 Tablet
38 Asam Mefenamat Tablet 500 mg 2015 Tablet
39 Asam Mefenamat Tablet 500 mg 2015 Tablet
40 Asam Tranexamat 250mg 2013 Tablet
41 Asam Tranexamat Injeksi 2013 Ampul
42 Asiklovir krim 5% 2013 Tube

43 Asiklovir Tablet 200 mg 2013 Tablet
44 Asiklovir Tablet 200 mg 2015 Tablet
45 Asiklovir Tablet 400 mg 2013 Tablet
46 Atapulgit 2011 Tablet
47 Atapulgit 2015 Tablet
48 Atropin Injeksi 0.25 mg/ml-1 ml 2010 Ampul
49 Atropin Injeksi 0.25 mg/ml-1 ml 2015 Ampul
50 Atropin sulfat tablet 0.5 mg 2014 Tablet
51 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2013 Tablet
52 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2015 Tablet
53 Betahistin mesilat 2014 Tablet
54 Betametason Krim 2013 Tube
55 Betametason Krim 2015 Tube
56 Bisakodil supp 10 mg 2014 Supp
57 Bisakodil supp 10 mg 2015 Supp
58 Bisoprolol tab 5 mg 2014 Tablet
59 Bormheksin solution 2013 Botol
60 Cetrizine Sirup 5 mg/5 ml 2013 Botol
61 Cetrizine 10 mg 2014 Tablet
62 Deksametason injeksi 5 mg/ml 2013 Ampul
63 Deksametason injeksi 5 mg/ml 2015 Ampul
64 Deksametason tablet 0.5 mg 2013 Tablet
65 Deksametason tablet 0.5 mg 2015 Tablet
66 Diazepam Inj 5 mg/ml 2013 Ampul
67 Diazepam supp 2014 Supp
68 Diazepam supp 2015 Supp
69 Diazepam tab 2 mg 2013 Tablet
70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul
71 Digoksin tablet 0.25 mg 2014 Tablet
72 Digoksin tablet 0.25 mg 2015 Tablet
73 Dimenhidrinat tab 50 mg 2011 Tablet
74 Doksisiklin kapsul 100 mg 2010 Kapsul
75 Domperidon suspensi 5 mg/5ml 2014 Botol
76 Domperidon suspensi 5 mg/5ml 2015 Botol
77 Domperidon 10mg 2013 Tablet
78 Efedrin HCl tablet 25 mg 2014 Tablet
79 Ekstraks belladona tab 10 mg 2013 Tablet
80 Epinefrin / Adrenalin inj 0.1 % 2013 Ampul
81 Eritromisin kapsul 250 mg 2013 Kapsul
82 Eritromisin kapsul 500 mg 2013 Kapsul
83 Eritromisin sirup 200mg/5 ml 2014 Botol
84 Eritromisin sirup 200mg/5 ml 2015 Botol
85 Etambutol tablet 250 mg 2011 Tablet
86 Fenobarbital tablet 30 mg 2010 Tablet
87 Fenobarbital tablet 30 mg 2015 Tablet
88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet
89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet
90 Fenol Gliserol tetes telinga 10-% 2013 Botol
91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet
92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet
93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul
94 Fitomenadion 2 mg inj 2013 Ampul
95 Fitomenadion 2 mg inj 2015 Ampul

5 mg 2013 Tablet 131 Kaptopril tablet 12. 96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet . i.v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12.3% 2014 Botol 104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2.5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i.1 % 2014 Tube 103 Gentamisin tetes mata 0.5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj.5 % 2013 Tube 118 Hidrokortison cream 2.5 % 2014 Botol 144 Kloramfenikol tetes mata 0.5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0.

9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol .125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0.5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0. Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul 159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.125 mg 2013 Tablet 176 Metilergometrin tablet salut 0.000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100.000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.

000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube .200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol 216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.

K. Cl.5 60 g. K. Cl. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na. K.5 60 g. K. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet . Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na. Cl. Lactate.253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul 273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na.Ca. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na. Cl.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0. Lactate.Ca. Cl.

1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet .0075 gram. kombinasi 2014 Sachet 314 Mineral mix.302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid. 2013 307 cinchocaine HCl 2. Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0.075 gram. kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol 321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl. Natrium Tiosulfat 0.5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix. fenilmerkuri 2013 305 nitrat 0.075 gram.Vitamin.electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg. Kalium Iodida 0.

5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj.5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs .5 2013 Syringe 390 Tambal Sinar Warna A3.5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol 371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3. mg/ml 2014 Pcs 352 Terbutalin Sulfate 0.347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2.

5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs .5 2014 Pcs 428 Hand Scoon (Steril) # 6.396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.v catheter 2014 Pcs 422 Etakridin larutan 0.1 % (Rivanol) 2015 Botol 424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.

18 with injection Port 2014 Pcs 455 IV Chateter No.445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No. 20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs 481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs .

10 2013 Pcs 502 NGT No.adult) 2015 Pcs 528 Silk Benang bedah no. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8. 14 2013 Pcs 504 NGT No.498 Mucus Ekstractor 2014 Pcs 499 Needle no. 16 2013 Pcs 505 NGT No.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula.27 2014 Pcs 500 NGT No. 12 2013 Pcs 503 NGT No.23 G 2013 Pcs 540 Wing Needle no.25 2013 Pcs 541 Wing Needle no.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula. 8 2013 Pcs 501 NGT No.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu .7 2014 Pcs 519 Plastik klip 13 x 8. 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs 538 Wing Needle No.21 G 2013 Pcs 539 Wing Needle No.

Mengetahui. Suharno.Apt) NIP. 19781102 200604 1 015 .Si.Kes) (Irwan Hartono.M.S. 19600924 198501 1 001 NIP. Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs..

00 .520. 0 - 93.00 0 2.00 0 95. 0 - 122.00 0 122. 0 - 2.00 .00 0 411. 0 - .00 7.250.00 . 0 - 1.00 0 1.820. 0 - 140.00 0 50.215.00 3.00 0 30.00 2.00 .00 72.00 0 93.00 .00 0 81.00 0 100.735.155.00 0 2. 0 - 175. 0 - . 0 - 1.00 762.00 0 175.00 .00 .225.225.155.00 0 3.00 .00 150.00 0 140.00 . LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .00 .580.00 411.820.00 0 5.00 .520. 0 - 50. 0 - . 0 - .250. 0 - .370.00 5.00 0 1.00 0 150. 0 - 1.370.00 81.735. 0 - .00 0 150.00 0 762.00 .00 150.00 100. 0 - 30.215.00 0 72.00 0 7. 0 - 95.00 0 1. 0 - .00 0 2. 0 - 2.580.

0 - 164. 0 - .190.770. 0 - .00 0 5. 0 - 194.00 0 50.00 0 200. 0 - 7. 0 - 100.00 0 164.00 0 420.00 111. 0 - .190.00 420.00 0 8. 0 - .00 0 34. 0 - . 0 - 820.00 0 22. 0 - .00 0 330. 0 - 800.00 50. 0 - 100.00 250.00 0 100. 0 - 34. 600. 0 - .00 330.00 0 600.00 . 0 - 171.00 0 160.00 .260.00 . 0 - .00 0 410.00 .00 410.00 .00 .00 0 800.00 0 1.00 0 564.00 0 7.00 0 250.00 0 28.00 0 171.00 5.00 .00 0 59.00 0 28. 0 - 28. 0 - 1.00 . 0 - 8. 0 - 22.00 0 100.260.00 0 609.00 .00 .00 28. 0 - .00 . 0 - .00 160.00 564.00 0 111.00 .770. 0 - 10.00 . 0 - 200.00 59.00 609.00 0 820.00 .00 .00 .00 0 194.00 0 10.

00 0 5.00 .00 .110. 0 - 48. 0 - 590.00 5.00 0 1.055.235.00 0 78.00 2. 0 - .186.00 0 1. 0 - .186.00 .00 .00 0 460.00 .00 29.00 0 2.00 .00 240.290.00 0 5.00 0 755.00 0 610. 0 - 714.00 0 240.00 .00 .00 0 2.00 0 400.00 0 733.00 . 0 - . 0 - 11.080.00 0 18.00 0 714.00 0 67.00 0 5.00 .00 733.00 .00 2.055.00 460.00 . 0 - 5.290.235. 0 - 330.00 0 500.00 0 590.00 18.00 0 990.080. 0 - 400.00 0 11. 0 - 78.110. 0 - 2.00 .00 .00 .00 0 330.00 94. 0 - 5.00 0 29. 0 - .620.00 . 0 - 16.00 0 460.00 0 16.00 . 0 - 1. 0 - .00 0 94.00 0 2. 0 - 97. 0 - 990.00 500.00 0 97.00 0 122. 0 - 67. 0 - .00 . 0 - 1. 0 - 122.620.00 610.00 460. 755.00 0 48.

0 - 3.00 .00 0 199.00 6.00 0 100.00 .00 .00 0 38.594.00 . 0 - 1.00 0 610. 0 - 750. 0 - 380.000. 0 - 1.00 .594.00 0 111.00 . 0 - .00 0 480. 0 - . 0 - 480. 0 - 200. 0 - .00 0 76.00 0 1.00 0 404.450.00 0 29.00 .00 1.00 . 0 - .00 0 203.00 .00 0 9. 203.805.00 0 187.00 .000. 0 - .00 0 240.00 0 199.00 .00 610.00 0 380.00 .00 .00 0 200.450. 0 - . 0 - 76.00 0 137.00 . 0 - 199.00 0 750. 0 - 29. 0 - 1.00 . 0 - 240. 0 - 38.040.00 199. 0 - 137. 0 - .00 . 0 - 9.00 0 1.040.00 .00 0 1. 0 - 100. 0 - .00 .00 .00 0 3.00 404.805.00 0 6. 0 - 111. 0 - .00 0 1. 0 - 187.

00 .00 0 30.950.00 .010.00 0 25.00 0 1. 0 - 425.00 .00 10.00 .00 .00 0 50.00 0 3.800. 0 - 11. 0 - 365.00 0 21.00 .00 0 10.00 20. 0 - 200.00 0 90.00 0 12.00 190. 0 - 25.950.00 0 190.00 .00 0 600. 0 - 208.00 0 1.00 0 200. 0 - 30.00 . 0 - 2.00 31.420.800.010.00 0 11. 0 - . 0 - 21.00 50.00 0 31.00 .00 0 425.00 0 59. 0 - . 0 - .079.00 0 2.00 100.00 . 0 - . 0 - 1. 0 - . 0 - .00 .00 . 0 - 50.050.00 0 100. .00 .624. 0 - .00 551.050. 0 - 3.00 0 2. 0 - .00 0 50. 0 - 1. 0 - .00 0 365.00 .00 0 551.00 2.00 . 0 - .079.00 12.00 .420.00 0 20. 0 - .00 0 208. 0 - 90. 0 - 600. 0 - .624. 0 - 59.

0 - 5.00 0 48.00 0 740.00 2.00 1.00 0 2.00 0 1. 0 - 30.00 0 3. 0 - 48. 0 - 270.740. . 0 - .00 0 2.240. 0 - 30.00 0 73. 0 - . 0 - .000.090. 0 - 2.00 6.00 2.00 630.00 0 210. 0 - 3.00 .240.00 0 10. 0 - .00 0 290.00 0 2.00 .00 740.130.305.00 0 30.00 1.00 0 1. 0 - .00 0 22.090. 0 - .00 .00 . 0 - .00 0 99.00 0 270. 0 - 290.00 3.00 0 30.00 . 0 - 73. 0 - .00 0 300.00 .00 4.130.00 0 6.00 .00 0 5.00 .00 0 630. 0 - .640. 0 - 10.00 210.180. 0 - 22.740.00 .00 0 3.00 .640.00 .305.00 99.180.00 0 4. 0 - .000.00 .00 560.00 0 30. 0 - 30.00 .00 300.00 0 560.00 0 155. 0 - 155.

0 - 24.00 0 10. 0 - .00 . 90.00 285. 0 - . 0 - .00 0 3. 0 - . 0 - .00 10.00 0 1.00 0 190.00 . 0 - 31.00 0 100.420. 0 - . 0 - 425.00 0 90.00 0 2. 0 - 750. 0 - .00 0 9.00 .00 1. 0 - 66.00 0 750. 0 - . 0 - 2. 0 - .00 .00 3.00 0 24.00 0 338. 0 - .00 .00 .00 0 24. 0 - .00 0 285.00 0 210. 0 - .00 . 0 - 210.00 0 683.00 .00 0 66. 0 - .00 0 31.00 0 425.00 100.420.020.020. 0 - .00 190. 0 - 24. 0 - . 0 - 683.00 . 0 - 338. 0 - 9. 0 - .00 .00 .00 .

00 3.00 0 2. 0 - .00 0 2.00 0 1.00 1.00 0 2. 0 - 2.00 .00 0 3.00 2.00 0 30.00 0 115. 0 - .00 0 2. 0 - 2.00 . 0 - .00 .00 .00 .00 0 1.00 1.00 .00 .00 0 42.00 0 3. 0 - 1.00 0 2.00 .00 0 4. 0 - . 0 - 510.00 2. 0 - 1.00 0 5.00 .00 0 1.00 0 450. 0 - .00 . 0 - 2.00 0 800.00 0 2.00 0 2.00 0 1.00 2. 0 - 450.00 .00 0 3.00 2.00 .00 . 0 - 5.00 1. 0 - 3.00 0 510.00 800.00 .00 2. 0 - 42. 0 - .00 . .00 . 0 - 2. 0 - 3.00 1. 0 - 115.00 0 2. 0 - 30.00 0 2. 0 - 2. 0 - 4.00 0 2.00 0 1.00 0 1.

0 - .00 0 400. 0 - .600.00 0 350. 0 - .00 500. 0 - . 0 - 100. 0 - 12.00 .00 0 1.00 302.00 .00 0 72.00 .00 .00 288.00 0 12. 0 - 4. 0 - .00 .00 0 4. 500.00 .157.00 0 57.00 3. 0 - 200.00 26. 0 - 100. 0 - 350. 0 - 400.00 60.00 26.00 .00 0 200. 0 - .157. 0 - 57.00 0 7.00 72.00 .00 0 288. 0 - .00 0 1.00 0 60.00 .00 3.00 0 400.00 .00 .00 0 48.00 1.00 0 100. 0 - 400.00 .00 0 26.00 .00 0 500.00 0 200. 0 - 48.00 . 0 - 100. 0 - 7. 0 - .00 0 100.00 . 0 - 1.00 0 12.00 0 302.00 0 3.600.00 0 3.00 0 500. 0 - .00 0 100.00 0 26.00 200. 0 - 12.

00 72.00 0 3.00 0 15.00 2. 0 - 10.00 .00 0 15.00 0 23. 0 - .00 .00 0 72.00 300. 0 - .00 0 10.00 . 0 - .00 0 400. 100. 0 - .00 400.00 0 118. 0 - 30. 0 - .00 . 0 - .00 60.00 0 5.00 0 977. 0 - . 0 - 3.000.00 0 3. 0 - 13.00 . 0 - 12.00 .00 .00 .00 0 99.00 100.00 5.00 0 10.00 0 2.00 0 50.00 0 300.00 10. 0 - 3. 0 - 50.00 .00 977.00 .00 0 60.00 0 100. 0 - 5.00 0 5.00 50. 0 - .00 0 182. 0 - .00 118.00 99. 0 - 15.00 15. 0 - 23.00 0 29.00 0 30.00 0 100.00 0 12.000.00 0 665. 0 - .00 .00 182.00 0 5.00 .00 0 13. 0 - . 0 - .00 665.00 0 33.00 29.00 50. 0 - 5.00 0 50.00 0 50.00 33.

0 - 20. 0 - . 0 - 100.00 0 8.00 . 0 - .00 . 0 - .00 0 100.00 0 36. 0 - 165.00 .00 170.00 0 55.00 0 75. 0 - .00 0 32.00 50.00 23.000.00 .000. 0 - 98.000. 0 - . 0 - .00 100. 0 - .00 0 170. 0 - .00 0 109. 0 - 134.000.00 8.00 38.00 0 100.00 0 420. 0 - . 0 - 109.00 0 50. 0 - .00 36. 0 - .00 0 134. 0 - . 0 - . 0 - .000. 0 - 75. 0 - .00 32.00 0 68.000. .00 68.00 0 23. 0 - . 0 - .00 0 38.000.00 .000.00 0 20. 0 - .00 0 98.00 0 165.00 . 0 - 55.00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara .00 .00 420.

. Yang Meminta Kepala UPT Puskesmas (…………………………………….) 604 1 015 NIP.

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#DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 98. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 134.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 32.000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .000.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 20. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 165.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 109.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 8. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 170.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 36. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 75. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 23. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 420. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 55. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .#DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 38.000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 68.

.Tangerang Selatan .. Yang Menerima Petugas Puskesmas (………………………..) NIP.……………….

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Klavulanat 2013 Tablet 14 Amoksisilin kaplet 250 mg 2013 Tablet 15 Amoksisilin kaplet 500 mg 2014 Tablet 16 Amoksisilin kaplet 500 mg 2015 Tablet 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 19 Antasida DOEN tablet 2014 Tablet 20 Antasida DOEN tablet 2015 Tablet 21 Antasida DOEN Suspensi 2014 Botol 22 Antasida DOEN Suspensi 2015 Botol 23 Anti Bakteri DOEN salep 2013 Tube 24 Anti Bakteri DOEN salep 2015 Tube 25 Anti Fungi DOEN kombinasi salep 2013 Pot 26 Anti Hemmoroid DOEN supp 2014 Supp 27 Anti Hemmoroid DOEN supp 2015 Supp 28 Anti migren / Ergotamin 2013 Tablet 29 Aqua Pro Injeksi steril @ 20 2014 Vial 30 Asam Asetilsalisilat 80 mg 2014 Tablet 31 Asam Asetilsalisilat 80 mg 2015 Tablet 32 Asam Asetilsalisilat 100 mg 2011 Tablet 33 Asam Askorbat (Vit. C) tablet 100 mg Tablet 34 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet 35 Asam Folat tab 1 mg 2013 Tablet 36 Asam Folat tab 1 mg 2015 Tablet 37 Asam Mefenamat Tablet 500 mg 2014 Tablet 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 39 Asam Mefenamat Tablet 500 mg 2015 Tablet 40 Asam Tranexamat 250mg 2013 Tablet 41 Asam Tranexamat Injeksi 2013 Ampul 42 Asiklovir krim 5% 2013 Tube 43 Asiklovir Tablet 200 mg 2013 Tablet 44 Asiklovir Tablet 200 mg 2015 Tablet 45 Asiklovir Tablet 400 mg 2013 Tablet 46 Atapulgit 2011 Tablet .PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN No NAMA OBAT TAHUN SATUAN 1 2 3 4 1 Allopurinol tablet 100 mg 2014 Tablet 2 Allopurinol tablet 100 mg 2015 Tablet 3 Ambroksol Syrup 15 mg / ml 2014 Botol 4 Ambroksol Syrup 15 mg / ml 2015 Botol 5 Ambroksol tablet 30 mg 2014 Tablet 6 Ambroksol tablet 30 mg 2015 Tablet 7 Aminofilin inj 24 mg /ml 2014 Ampul 8 Aminofilin tab 200 mg 2014 Tablet 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet 11 Amlodipin 10 mg 2015 Tablet 12 Amlodipin 5 mg 2015 Tablet 13 Amoksisilin + As.

25 mg/ml-1 ml 2015 Ampul 50 Atropin sulfat tablet 0.5 mg 2014 Tablet 51 Besi II Sulfat 200 mg + As.1 % 2014 Tube 103 Gentamisin tetes mata 0. 47 Atapulgit 2015 Tablet 48 Atropin Injeksi 0.1 % 2013 Ampul 81 Eritromisin kapsul 250 mg 2013 Kapsul 82 Eritromisin kapsul 500 mg 2013 Kapsul 83 Eritromisin sirup 200mg/5 ml 2014 Botol 84 Eritromisin sirup 200mg/5 ml 2015 Botol 85 Etambutol tablet 250 mg 2011 Tablet 86 Fenobarbital tablet 30 mg 2010 Tablet 87 Fenobarbital tablet 30 mg 2015 Tablet 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul 94 Fitomenadion 2 mg inj 2013 Ampul 95 Fitomenadion 2 mg inj 2015 Ampul 96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0. Folat (Tambah darah) 2015 Tablet 53 Betahistin mesilat 2014 Tablet 54 Betametason Krim 2013 Tube 55 Betametason Krim 2015 Tube 56 Bisakodil supp 10 mg 2014 Supp 57 Bisakodil supp 10 mg 2015 Supp 58 Bisoprolol tab 5 mg 2014 Tablet 59 Bormheksin solution 2013 Botol 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol 61 Cetrizine 10 mg 2014 Tablet 62 Deksametason injeksi 5 mg/ml 2013 Ampul 63 Deksametason injeksi 5 mg/ml 2015 Ampul 64 Deksametason tablet 0.3% 2014 Botol .25 mg 2015 Tablet 73 Dimenhidrinat tab 50 mg 2011 Tablet 74 Doksisiklin kapsul 100 mg 2010 Kapsul 75 Domperidon suspensi 5 mg/5ml 2014 Botol 76 Domperidon suspensi 5 mg/5ml 2015 Botol 77 Domperidon 10mg 2013 Tablet 78 Efedrin HCl tablet 25 mg 2014 Tablet 79 Ekstraks belladona tab 10 mg 2013 Tablet 80 Epinefrin / Adrenalin inj 0.5 mg 2015 Tablet 66 Diazepam Inj 5 mg/ml 2013 Ampul 67 Diazepam supp 2014 Supp 68 Diazepam supp 2015 Supp 69 Diazepam tab 2 mg 2013 Tablet 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 71 Digoksin tablet 0. Folat (Tambah darah) 2013 Tablet 52 Besi II Sulfat 200 mg + As.25 mg/ml-1 ml 2010 Ampul 49 Atropin Injeksi 0.25 mg 2014 Tablet 72 Digoksin tablet 0.5 mg 2013 Tablet 65 Deksametason tablet 0.

5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i.5 % 2014 Botol 144 Kloramfenikol tetes mata 0.5 % 2013 Tube 118 Hidrokortison cream 2.5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0. Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul .5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj.v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12. i. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet 149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet.5 mg 2013 Tablet 131 Kaptopril tablet 12.

000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100.200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0.125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0.000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol 200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol .125 mg 2013 Tablet 176 Metilergometrin tablet salut 0.5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.

000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube 253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul .

K. 2013 307 cinchocaine HCl 2. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na.Ca.273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet 302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid. kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol . Lactate.5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix. K. Lactate. Cl.Ca. Cl.5 60 g.electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0.5 60 g. Cl. fenilmerkuri 2013 305 nitrat 0. Natrium Tiosulfat 0. Kalium Iodida 0. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na. K.0075 gram.075 gram. kombinasi 2014 Sachet 314 Mineral mix.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0. Cl.Vitamin. Cl. Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na.075 gram. K. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0.

Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol . Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj. mg/ml 2014 Pcs 352 Terbutalin Sulfate 0.321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl.1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet 347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2. Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0.5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj.

5 2013 Syringe 390 Tambal Sinar Warna A3.5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3.1 % (Rivanol) 2015 Botol .v catheter 2014 Pcs 422 Etakridin larutan 0.5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs 396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.

5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs 445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No. 20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs .5 2014 Pcs 428 Hand Scoon (Steril) # 6. 18 with injection Port 2014 Pcs 455 IV Chateter No.424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.

adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula.adult) 2015 Pcs 528 Silk Benang bedah no.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula.7 2014 Pcs 519 Plastik klip 13 x 8.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula.27 2014 Pcs 500 NGT No. 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs . 12 2013 Pcs 503 NGT No. 16 2013 Pcs 505 NGT No. 8 2013 Pcs 501 NGT No. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8.481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs 498 Mucus Ekstractor 2014 Pcs 499 Needle no. 10 2013 Pcs 502 NGT No. 14 2013 Pcs 504 NGT No.

Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu Mengetahui.Kes) (Irwan Hartono. 19781102 200604 1 015 .Apt) NIP. 538 Wing Needle No.Si.. Suharno.23 G 2013 Pcs 540 Wing Needle no. 19600924 198501 1 001 NIP.S.M.25 2013 Pcs 541 Wing Needle no.21 G 2013 Pcs 539 Wing Needle No.

00 0 140.370. 0 - 1.00 . 0 - 1.00 0 1. 0 - . 0 - 2.00 0 93.00 . 0 - 93. 0 - .00 5.580.00 762. 0 - .00 600.00 0 1.00 0 81. 0 - 122.225.215.00 0 7.225.00 .00 411.00 0 411.00 0 150.00 0 30.00 0 2. 0 - 800.00 150.00 0 100.00 .250.215.00 0 95.00 .820. 0 - . 0 - .00 0 122.520.250.155.00 0 2.00 0 1.735.00 3. 0 - 1. 0 - .00 . 0 - .00 100.00 81.00 .00 2.370.00 150. 0 - 140. 0 - 50.00 0 2.520.820. 0 - 2.00 0 5.00 .00 0 72.735.00 0 762.00 72. 0 - 95. LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .00 0 600.00 0 150. 0 - 175.00 0 175.00 0 3.00 .00 0 50.580. 0 - .00 .00 . 0 - 30.00 .00 .155.00 7.00 0 800.

0 - . 0 - .00 0 7.00 5.00 .00 160.00 0 330.00 0 28. 0 - .00 0 100.00 .00 0 250.00 . 0 - 34.00 .00 0 194. 0 - . 0 - . 0 - . 0 - . 0 - 100.00 . 0 - 28.00 0 10. 0 - 8. 0 - 755.00 0 200. 0 - . 0 - 10.00 0 160.00 0 34.00 .00 0 564.00 0 100.190.00 609. 0 - 7.190.00 . 0 - . 0 - 1.00 28.00 0 59. 0 - 200.00 0 410.00 . 0 - 22.770.00 330.00 50.00 59.260. 0 - .055.00 .00 .00 0 28. 0 - .00 0 50.00 250.00 0 820.00 111.00 .00 .00 0 420.00 420.00 0 755.00 0 609.055. 820.00 0 8.260.00 564. 0 - .00 .00 . 0 - 164.770.00 0 22. 0 - 194.00 0 5. 0 - 1.00 .00 . 0 - .00 410. 0 - .00 0 164.00 0 1. 0 - 171.00 0 1.00 0 111. 0 - 100.00 0 171.

00 0 460.00 0 5. 0 - 5.080.00 0 203.00 .00 0 2.00 18.00 0 11.00 0 48.110.235.00 .110.186.00 . 0 - .00 500.00 . 0 - 990.00 2.00 0 590.00 5.00 0 1.080.00 240. 0 - 111.00 0 733.00 0 610.00 . 0 - 1. 0 - 714.00 . 0 - . 0 - 16.290.00 .00 0 330.00 .00 0 240.00 . 0 - 187.00 0 460. 0 - 1.00 0 187. 0 - 78. 0 - 11.000. 0 - 590. 0 - 67.00 2.00 0 1.00 0 610.00 .000. 97.620.00 0 2.00 0 94.00 203.00 0 5.00 29.620.00 0 67.00 460. 0 - 2.00 0 78.00 . 0 - 48.00 0 111.00 0 500.00 610.00 0 18. 0 - 330.00 0 990.00 .00 .00 733. 0 - 5.00 460.00 94.00 .00 0 714.00 0 97. 0 - .00 0 2.00 0 29.00 . 0 - 122.00 .235.290.00 0 5.00 0 122.00 610.186.00 0 400.00 . 0 - 400.00 . 0 - .00 0 16.00 .

00 .00 6. 0 - 240.00 . 0 - .00 .00 .010.00 0 1. 0 - 480.00 . 0 - 750.00 0 200. 0 - 1.594.00 0 30.00 . 0 - 50. 0 - 208.00 0 29. 0 - 29.00 0 240. 0 - .00 1.00 .00 . 0 - 9.00 0 137. 0 - 76. 0 - 30. 0 - . 0 - . 0 - 3.00 0 1.040.00 0 365.00 0 208.805.00 199.00 0 3.00 . 0 - 38.00 .00 0 38. 0 - 199.00 . 0 - .00 .00 . 0 - . 0 - 100.00 0 9.805. 0 - 1.00 0 100. 0 - 200.00 . 0 - . 0 - .010.00 0 750. 0 - 1.00 0 199.00 .00 .00 0 404.00 0 380. 0 - 137.00 50.00 0 50. 0 - .00 .00 0 480.00 .00 . 0 - 365.450.040. 0 - .00 0 199. 0 - . 0 - 380. 0 - .00 0 1.450.00 0 1.594.00 . .00 404.00 0 50.00 0 6.00 0 76.

0 - 48.00 0 90.00 .624.00 .950.00 . 551.00 2. 0 - .079.00 .800.00 6.00 .00 0 12.00 0 210.130.00 0 560.00 0 2. 0 - .00 190.00 0 190.00 0 2.00 0 425.00 99.00 .00 .00 0 6.00 0 11.00 0 25. 0 - 30. 0 - 1.00 0 2. 0 - . 0 - 200.00 0 551. 0 - .00 . 0 - 3. 0 - . 0 - .00 .00 300.00 20.00 12. 0 - 90.050.00 . 0 - .240. 0 - 425. 0 - .00 0 99.00 0 1.00 2. 0 - 290. 0 - 600.00 .00 31.00 0 740.00 0 21.00 . 0 - . 0 - 2.00 . 0 - 155.00 0 2.420.00 0 31.00 0 200.00 100.00 0 3.00 560.00 0 48.00 740. 0 - 21.00 0 300.240. 0 - 2.00 0 30.00 0 20.00 210.079.00 .420.180. 0 - . 0 - 25.00 .624.00 10.180.130.00 0 100.950.00 0 290.00 .00 .00 0 600.00 0 59.00 0 155. 0 - 59.00 0 10. 0 - 11.050.800.

00 1.00 190. 0 - .00 0 30.00 0 5.00 3.00 0 10.00 .00 .00 .00 .00 0 30. 0 - . 0 - 338. 0 - 425. 0 - 5. 0 - 3.00 0 24. 0 - .00 . 0 - . . 0 - 10.00 0 3. 0 - 73.00 .00 0 2.00 4. 0 - . 0 - 30.640.00 .000.00 0 338. 0 - . 0 - 30.00 0 1.00 0 3.090.00 .00 0 750. 0 - 270. 0 - . 0 - 22.00 0 425.00 0 270. 0 - 24.00 0 90.00 1.740.305.00 0 1. 0 - .00 0 22. 0 - .00 . 0 - .00 .00 . 0 - .00 0 630.00 . 0 - .00 0 190.00 0 73.740.000. 0 - 90. 0 - 750. 0 - . 0 - .640.00 0 4.00 630.00 .00 2.305.090. 0 - .

- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
66.00 0 66.00
- 0 -
31.00 0 31.00
285.00 0 285.00
- 0 -
2,420.00 0 2,420.00
1,020.00 0 1,020.00
10.00 0 10.00
- 0 -
9.00 0 9.00

- 0 -

24.00 0 24.00
3.00 0 3.00
100.00 0 100.00

- 0 -
683.00 0 683.00
- 0 -
- 0 -
210.00 0 210.00
- 0 -
- 0 -
- 0 -
- 0 -

30.00 0 30.00
- 0 -
5.00 0 5.00
- 0 -
- 0 -
- 0 -
- 0 -
450.00 0 450.00

- 0 -

42.00 0 42.00

- 0 -
115.00 0 115.00
- 0 -
3.00 0 3.00
- 0 -
2.00 0 2.00
2.00 0 2.00
2.00 0 2.00
- 0 -
4.00 0 4.00
2.00 0 2.00
1.00 0 1.00

1.00 0 1.00
- 0 -
3.00 0 3.00
- 0 -
2.00 0 2.00
1.00 0 1.00
2.00 0 2.00
2.00 0 2.00
- 0 -
1.00 0 1.00
- 0 -
2.00 0 2.00
- 0 -
- 0 -
2.00 0 2.00
3.00 0 3.00
- 0 -
1.00 0 1.00
1.00 0 1.00
- 0 -
2.00 0 2.00
- 0 -
510.00 0 510.00
800.00 0 800.00
- 0 -
500.00 0 500.00
- 0 -
- 0 -
7.00 0 7.00
- 0 -
1,600.00 0 1,600.00
500.00 0 500.00
- 0 -
12.00 0 12.00
- 0 -
12.00 0 12.00
- 0 -
- 0 -

- 0 -

- 0 -

- 0 -

- 0 -
48.00 0 48.00
288.00 0 288.00
72.00 0 72.00
302.00 0 302.00
3.00 0 3.00
- 0 -
57.00 0 57.00
- 0 -
350.00 0 350.00
- 0 -
4.00 0 4.00

26.00 0 26.00
26.00 0 26.00
3.00 0 3.00
- 0 -
400.00 0 400.00
- 0 -
400.00 0 400.00
- 0 -
100.00 0 100.00
- 0 -
100.00 0 100.00
- 0 -
100.00 0 100.00
- 0 -
- 0 -
- 0 -
- 0 -
200.00 0 200.00
200.00 0 200.00
60.00 0 60.00
1,157.00 0 1,157.00
100.00 0 100.00
- 0 -
12.00 0 12.00
- 0 -
- 0 -
- 0 -
- 0 -
50.00 0 50.00
50.00 0 50.00
977.00 0 977.00
100.00 0 100.00
182.00 0 182.00
33.00 0 33.00
50.00 0 50.00
15.00 0 15.00
- 0 -
10.00 0 10.00
- 0 -
30.00 0 30.00
- 0 -
3.00 0 3.00
- 0 -
- 0 -
- 0 -
13.00 0 13.00
60.00 0 60.00
10.00 0 10.00
- 0 -
- 0 -
23.00 0 23.00
665.00 0 665.00
118,000.00 0 118,000.00
- 0 -
- 0 -
3.00 0 3.00
300.00 0 300.00

29.00 0 29.00
99.00 0 99.00
400.00 0 400.00
- 0 -
15.00 0 15.00
5.00 0 5.00
2.00 0 2.00
- 0 -
5.00 0 5.00
- 0 -
5.00 0 5.00
72.00 0 72.00
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
98.00 0 98.00
- 0 -
- 0 -
100.00 0 100.00
100.00 0 100.00
23,000.00 0 23,000.00
- 0 -
109,000.00 0 109,000.00
8,000.00 0 8,000.00
- 0 -
75,000.00 0 75,000.00
- 0 -
- 0 -
165.00 0 165.00
420.00 0 420.00
- 0 -
- 0 -
- 0 -
20.00 0 20.00
68.00 0 68.00
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
55.00 0 55.00
50.00 0 50.00
170.00 0 170.00
32.00 0 32.00

- 0 -
134.00 0 134.00
36.00 0 36.00
38.00 0 38.00

Gratis Lain-Lain Jumlah

Tambal Tambal
Jumlah
Tetap/Permanen sementara

Yang Meminta
Kepala UPT Puskesmas

(…………………………………….)
604 1 015 NIP.

PLPO)

PELAPORAN BULAN : Juli 2016
PERMINTAAN BULAN : Agustus 2016

Pemakaian STOCK STOCK
Buffer Lead Time PERMINTAAN
Rata-Rata AKHIR OPTIMAL
9 10 11
#DIV/0! 0 #DIV/0! - #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! 1,580.00 #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! 150.00 #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! 72.00 #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! 7,155.00 #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! - #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! 30.00 #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! 411.00 #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0!
#DIV/0! 0 #DIV/0! - #DIV/0! #DIV/0!
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00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 36..) NIP. Yang Menerima Petugas Puskesmas (……………………….00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 38.#DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 134..……………….00 #DIV/0! #DIV/0! Tangerang Selatan . .

Agustus 2016 PEMBERIAN 12 .

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enerima Puskesmas ……..) ..……………….

PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN No NAMA OBAT TAHUN SATUAN 1 2 3 4 1 Allopurinol tablet 100 mg 2014 Tablet 2 Allopurinol tablet 100 mg 2015 Tablet 3 Ambroksol Syrup 15 mg / ml 2014 Botol 4 Ambroksol Syrup 15 mg / ml 2015 Botol 5 Ambroksol tablet 30 mg 2014 Tablet 6 Ambroksol tablet 30 mg 2015 Tablet 7 Aminofilin inj 24 mg /ml 2014 Ampul 8 Aminofilin tab 200 mg 2014 Tablet 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet 11 Amlodipin 10 mg 2015 Tablet 12 Amlodipin 5 mg 2015 Tablet 13 Amoksisilin + As. C) tablet 100 mg Tablet 34 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet 35 Asam Folat tab 1 mg 2013 Tablet 36 Asam Folat tab 1 mg 2015 Tablet 37 Asam Mefenamat Tablet 500 mg 2014 Tablet 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 39 Asam Mefenamat Tablet 500 mg 2015 Tablet 40 Asam Tranexamat 250mg 2013 Tablet 41 Asam Tranexamat Injeksi 2013 Ampul 42 Asiklovir krim 5% 2013 Tube 43 Asiklovir Tablet 200 mg 2013 Tablet 44 Asiklovir Tablet 200 mg 2015 Tablet 45 Asiklovir Tablet 400 mg 2013 Tablet 46 Atapulgit 2011 Tablet . Klavulanat 2013 Tablet 14 Amoksisilin kaplet 250 mg 2013 Tablet 15 Amoksisilin kaplet 500 mg 2014 Tablet 16 Amoksisilin kaplet 500 mg 2015 Tablet 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 19 Antasida DOEN tablet 2014 Tablet 20 Antasida DOEN tablet 2015 Tablet 21 Antasida DOEN Suspensi 2014 Botol 22 Antasida DOEN Suspensi 2015 Botol 23 Anti Bakteri DOEN salep 2013 Tube 24 Anti Bakteri DOEN salep 2015 Tube 25 Anti Fungi DOEN kombinasi salep 2013 Pot 26 Anti Hemmoroid DOEN supp 2014 Supp 27 Anti Hemmoroid DOEN supp 2015 Supp 28 Anti migren / Ergotamin 2013 Tablet 29 Aqua Pro Injeksi steril @ 20 2014 Vial 30 Asam Asetilsalisilat 80 mg 2014 Tablet 31 Asam Asetilsalisilat 80 mg 2015 Tablet 32 Asam Asetilsalisilat 100 mg 2011 Tablet 33 Asam Askorbat (Vit.

25 mg/ml-1 ml 2015 Ampul 50 Atropin sulfat tablet 0.5 mg 2015 Tablet 66 Diazepam Inj 5 mg/ml 2013 Ampul 67 Diazepam supp 2014 Supp 68 Diazepam supp 2015 Supp 69 Diazepam tab 2 mg 2013 Tablet 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 71 Digoksin tablet 0.1 % 2013 Ampul 81 Eritromisin kapsul 250 mg 2013 Kapsul 82 Eritromisin kapsul 500 mg 2013 Kapsul 83 Eritromisin sirup 200mg/5 ml 2014 Botol 84 Eritromisin sirup 200mg/5 ml 2015 Botol 85 Etambutol tablet 250 mg 2011 Tablet 86 Fenobarbital tablet 30 mg 2010 Tablet 87 Fenobarbital tablet 30 mg 2015 Tablet 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul 94 Fitomenadion 2 mg inj 2013 Ampul 95 Fitomenadion 2 mg inj 2015 Ampul 96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0.1 % 2014 Tube 103 Gentamisin tetes mata 0.25 mg/ml-1 ml 2010 Ampul 49 Atropin Injeksi 0.5 mg 2013 Tablet 65 Deksametason tablet 0.5 mg 2014 Tablet 51 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2015 Tablet 53 Betahistin mesilat 2014 Tablet 54 Betametason Krim 2013 Tube 55 Betametason Krim 2015 Tube 56 Bisakodil supp 10 mg 2014 Supp 57 Bisakodil supp 10 mg 2015 Supp 58 Bisoprolol tab 5 mg 2014 Tablet 59 Bormheksin solution 2013 Botol 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol 61 Cetrizine 10 mg 2014 Tablet 62 Deksametason injeksi 5 mg/ml 2013 Ampul 63 Deksametason injeksi 5 mg/ml 2015 Ampul 64 Deksametason tablet 0.3% 2014 Botol . Folat (Tambah darah) 2013 Tablet 52 Besi II Sulfat 200 mg + As. 47 Atapulgit 2015 Tablet 48 Atropin Injeksi 0.25 mg 2014 Tablet 72 Digoksin tablet 0.25 mg 2015 Tablet 73 Dimenhidrinat tab 50 mg 2011 Tablet 74 Doksisiklin kapsul 100 mg 2010 Kapsul 75 Domperidon suspensi 5 mg/5ml 2014 Botol 76 Domperidon suspensi 5 mg/5ml 2015 Botol 77 Domperidon 10mg 2013 Tablet 78 Efedrin HCl tablet 25 mg 2014 Tablet 79 Ekstraks belladona tab 10 mg 2013 Tablet 80 Epinefrin / Adrenalin inj 0.

5 mg 2013 Tablet 131 Kaptopril tablet 12.5 % 2014 Botol 144 Kloramfenikol tetes mata 0.5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet 149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet.104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2.5 % 2013 Tube 118 Hidrokortison cream 2.v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12. i.5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj.5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i. Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul .

200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0.5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.125 mg 2013 Tablet 176 Metilergometrin tablet salut 0.125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0.000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol 200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol .9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100.

000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube 253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul .216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.

5 60 g.273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na.Ca.075 gram. Cl. kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol . K. kombinasi 2014 Sachet 314 Mineral mix. Kalium Iodida 0.Ca. Cl.electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na. Cl.5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix. Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na. Cl. Natrium Tiosulfat 0.075 gram.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0. 2013 307 cinchocaine HCl 2. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na. K.0075 gram. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet 302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid. Lactate. Cl.Vitamin.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg. Lactate. K. K.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na. fenilmerkuri 2013 305 nitrat 0.5 60 g.

321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl. Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol .5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj.1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet 347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2. Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj. mg/ml 2014 Pcs 352 Terbutalin Sulfate 0.

5 2013 Syringe 390 Tambal Sinar Warna A3.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3.5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs 396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.v catheter 2014 Pcs 422 Etakridin larutan 0.1 % (Rivanol) 2015 Botol .5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2.

424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6. 18 with injection Port 2014 Pcs 455 IV Chateter No.5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs 445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No. 20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs .5 2014 Pcs 428 Hand Scoon (Steril) # 6.

18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8.7 2014 Pcs 519 Plastik klip 13 x 8.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula. 10 2013 Pcs 502 NGT No.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula.adult) 2015 Pcs 528 Silk Benang bedah no. 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs .481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs 498 Mucus Ekstractor 2014 Pcs 499 Needle no. 16 2013 Pcs 505 NGT No.27 2014 Pcs 500 NGT No. 14 2013 Pcs 504 NGT No. 8 2013 Pcs 501 NGT No. 12 2013 Pcs 503 NGT No.

25 2013 Pcs 541 Wing Needle no.M.21 G 2013 Pcs 539 Wing Needle No. 538 Wing Needle No.Si.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu Mengetahui.S.Kes) (Irwan Hartono.Apt) NIP. Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs. 19600924 198501 1 001 NIP.23 G 2013 Pcs 540 Wing Needle no. Suharno.. 19781102 200604 1 015 .

00 .00 0 762. LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .370.00 0 72. 0 - . 0 - . 0 - . 0 - 2.00 0 50.00 0 95.820.735.215.00 .00 411. 0 - 2.00 0 1.580.155.250.00 .00 0 175. 0 - .00 0 411.00 .00 100.00 .00 150.00 0 600. 0 - .00 0 2.00 .00 5. 0 - 50. 0 - 800.520.00 .00 600.520.00 150.250.00 0 800. 0 - 95.735.00 0 5.00 .00 0 2.215.00 0 7. 0 - 1.00 72. 0 - 30.00 0 30.00 762.225.00 0 100.00 0 93.00 .370. 0 - .820.00 0 150.00 .00 0 150.00 .580. 0 - 1.225.00 0 122.00 .00 3.00 0 81. 0 - 175.00 0 1.00 0 3. 0 - . 0 - 140. 0 - .00 0 1. 0 - 122.00 0 2. 0 - 1.00 2.00 81.00 .00 0 140.00 7. 0 - 93.155.

0 - 28.00 0 330.00 . 820.055.00 0 1.00 .00 0 250. 0 - 34.00 .00 0 160.770.00 50. 0 - 164. 0 - . 0 - 7.00 .00 0 820. 0 - .00 410. 0 - 22.00 160.00 .00 0 171.00 0 5.00 0 410.00 0 50.00 0 22. 0 - . 0 - . 0 - . 0 - .00 .00 0 100.00 .00 0 111. 0 - 200.190.00 0 7.00 0 609.00 250.00 0 194. 0 - 1. 0 - .00 0 28. 0 - 100.00 0 10. 0 - 755. 0 - . 0 - .00 0 164.770. 0 - .00 .00 .260.00 . 0 - 10.00 0 59. 0 - 194.00 0 8.00 0 755.00 .00 0 100.00 0 28.00 .00 . 0 - 1.00 59.00 0 564.00 5.190.260. 0 - 100.00 0 1.00 0 420. 0 - .00 0 34. 0 - 171.00 564. 0 - . 0 - 8.00 111. 0 - .00 330.00 .00 28.00 420.00 .00 . 0 - .055.00 0 200.00 609.

0 - 1. 0 - 590.00 0 1.00 0 94.00 460.00 0 733.00 .00 610.235.00 0 610.00 0 18.00 0 48.00 240. 0 - 67.00 0 78.00 5.00 0 29.00 .00 .00 . 0 - 48.620.00 0 2. 0 - .00 0 122.00 .00 0 500.00 0 400.00 0 187.00 733.00 .290. 0 - 122.00 .000. 0 - 1.00 0 460.00 .00 0 2.00 .00 94.00 .00 0 1.00 .00 203. 0 - 11. 0 - 714.00 .00 .00 0 610.186.00 .00 500.00 .00 .00 0 240.00 0 97. 0 - 111.00 0 5.00 0 990.00 0 5.00 0 111.235. 0 - 5. 0 - 78.00 460. 0 - 16.620.00 0 590.00 610.00 18.00 .00 0 330. 0 - . 0 - .00 0 16.00 . 0 - 5.110.00 0 203.00 0 5.00 2.186.00 0 460. 97. 0 - 2. 0 - 400.00 29.00 2.00 0 2. 0 - .080. 0 - 330.00 0 11.080.00 .000.290.00 0 67. 0 - 187.00 0 714. 0 - 990.110.

00 0 380.040.00 0 1.00 . 0 - .00 0 200. 0 - .00 .00 404. 0 - 1.00 .00 0 6.00 0 1. 0 - 30.00 0 50. 0 - .00 6.00 0 404. 0 - .00 0 199.00 . 0 - . 0 - 100. 0 - . 0 - .00 0 199.00 0 137.00 .00 0 1. 0 - . 0 - 9.00 . 0 - .450.010. 0 - 365. 0 - 50.00 0 3. 0 - 380. 0 - 208.594.00 0 1.00 0 750.00 0 100.00 0 29.00 .00 .00 .00 . 0 - 199. 0 - 240. .00 .805.00 0 240.00 0 480. 0 - 76.00 0 9. 0 - . 0 - 3.00 0 30.00 0 38.00 .00 .00 . 0 - 200.010.805.00 . 0 - . 0 - 750.00 50. 0 - 38.00 .00 1. 0 - 29.594.00 0 365.00 . 0 - . 0 - 1.00 .00 0 208. 0 - 1. 0 - 137. 0 - 480.00 0 76.00 199.450.00 .00 .00 0 50.040.

0 - .00 0 425.00 .00 0 600.950.00 .00 .00 0 90. 0 - . 0 - .050.00 10. 551. 0 - . 0 - 11.00 0 99.00 .00 0 2.00 0 551.00 0 740.00 0 155.00 .00 0 210. 0 - 600. 0 - .00 300.00 0 25.00 0 30.00 0 190. 0 - 425. 0 - 25.00 0 11.240. 0 - 59.240.00 0 2.00 0 300.00 .00 20.00 0 6.624. 0 - .00 0 2. 0 - 200.00 99.00 31.420.00 . 0 - 3.050. 0 - 30. 0 - . 0 - . 0 - 155. 0 - 48.800.00 0 59.130.00 0 1.00 0 31.00 12. 0 - .00 0 20.00 190.00 2.00 .00 740.00 .00 0 48.00 . 0 - 2.079.00 0 2.00 100.180.00 0 12. 0 - 1.800.130.00 .079.00 . 0 - 90.00 0 3.00 560.00 210.420. 0 - 21.00 6.00 . 0 - 290.00 2.00 0 290.180.624.00 .00 0 560.00 0 200.00 0 10.00 0 100.00 .950. 0 - .00 .00 0 21. 0 - 2.00 .

00 0 10. 0 - .00 0 24.00 0 2. 0 - .00 .00 . 0 - .00 0 750.00 0 338. 0 - . 0 - .00 .00 0 30.00 . 0 - 425. 0 - . 0 - 3.000.00 0 22.00 . 0 - 750.00 0 1. 0 - . 0 - 270. 0 - 24.00 190. 0 - 22.00 0 30.640.305.00 0 630. 0 - 10.00 630.00 2.00 1. 0 - . 0 - .00 0 425.740. 0 - . 0 - . 0 - .00 0 90.00 0 5.00 . 0 - 73.00 0 1.00 .640.00 1.00 4.090.00 3.00 .00 . 0 - 90.00 . .00 0 270.305. 0 - .00 0 190.740.00 .00 .090. 0 - 5. 0 - .00 0 4.00 .00 0 3. 0 - 30.000. 0 - . 0 - 30.00 0 73.00 0 3. 0 - 338.

020.00 0 1.00 0 100.00 0 2.00 1.00 0 3.00 0 31.00 0 3. 0 - 2.00 3. 0 - 31.00 .00 . 0 - 4.00 0 1.00 0 10.00 0 24.00 100.00 . 0 - .00 0 9. 0 - . 0 - 115. 0 - . 0 - 2.00 0 450. 0 - . 0 - 42.00 2. 0 - 210. 0 - 450.00 0 2.00 0 30.00 0 66. 0 - .00 2.00 285.00 .00 . 0 - .00 .020.00 0 4. 0 - .00 .00 0 5. 0 - .00 .00 2.00 .00 .420. 0 - .00 0 2. 0 - 5. 0 - 683.00 0 2.00 .00 0 2. 0 - 66. 0 - 9. 0 - 30.00 .00 .00 0 210.420.00 0 115.00 0 683.00 . 0 - .00 1.00 10. 0 - 24. 0 - 3.00 0 42.00 . 0 - .00 0 285. .

600. 0 - 48.00 .00 0 48.00 .600.00 0 350.00 3.00 0 4. 0 - 2. 0 - 12.00 1. 0 - 1.00 0 2.00 .00 0 3. 0 - 350.00 302.00 0 1. 0 - 2.00 0 2. 0 - 2.00 0 12.00 .00 0 1.00 .00 288. 0 - 2.00 0 2.00 0 7.00 2.00 0 2.00 0 3.00 .00 .00 .00 0 57.00 2.00 0 288. 0 - 57. 0 - 7. 0 - 1. 0 - 1.00 .00 0 2.00 0 12.00 0 302.00 .00 . 0 - 3.00 0 1.00 72. 0 - 12.00 800.00 . 0 - . 1.00 1.00 0 510. 0 - .00 3. 0 - .00 0 2.00 0 1.00 .00 0 500. 0 - 500.00 .00 0 800.00 .00 500. 0 - .00 . 0 - .00 0 72.00 . 0 - .00 0 1.00 0 500. 0 - . 0 - 4.00 .00 0 1. 0 - 510.00 0 3.

00 .00 0 12. 0 - 30.00 . 0 - 10.00 50.00 .00 0 10.00 0 3. 0 - .157.000.00 0 60.00 .00 10.00 0 15.00 0 400.00 0 10. 0 - . 26.00 0 118. 0 - . 0 - 400.00 0 400.00 100.00 .00 .00 0 100. 0 - 50. 0 - 23. 0 - .00 0 977.00 .00 1.00 300.00 0 100.00 . 0 - 12.00 0 200.00 26.00 0 182. 0 - 200.00 .00 0 200. 0 - .000. 0 - 13. 0 - 100.00 .00 0 300.00 0 100.00 .00 665.00 .00 0 60.00 182. 0 - 100.00 0 26.00 0 13. 0 - . 0 - 3.00 0 665.00 60.00 0 26.00 50.00 .00 0 50.157.00 0 23.00 3. 0 - 3.00 0 3.00 0 1.00 0 100.00 0 30.00 15.00 0 3.00 200. 0 - 100.00 .00 118.00 0 50. 0 - 400. 0 - .00 100.00 . 0 - .00 0 33. 0 - .00 60. 0 - .00 0 50.00 33.00 977.00 0 100.

000. 0 - 5.00 2. 0 - . 0 - . 0 - 20.00 5. 0 - .000.00 0 400. 0 - 109. 0 - 100. 0 - .00 .00 .00 . 0 - 98.00 0 20.00 0 23.00 0 165. 0 - .00 0 98. 0 - 55.00 0 75. 0 - . 0 - . 0 - .000.00 0 29. 0 - .000.00 0 15.00 0 109.00 23.00 . 0 - .00 0 50. 0 - . 0 - 165. 0 - 75.00 0 99.00 0 170.00 0 420.00 0 2.00 32.00 0 100.00 0 8.000.00 170.00 100.00 0 5.00 .00 0 5.000. 0 - .00 .00 8. 0 - . 0 - . 0 - .00 420.00 50.00 0 55.00 400.00 68. 0 - 5. 0 - . 0 - .00 0 5. 0 - .00 0 72.00 .00 .00 99.00 0 68.000. 0 - .00 0 32.00 72.00 0 100. 0 - .00 . 29.00 . 0 - .000. 0 - 15. 0 - .00 . 0 - .

00 0 36. 0 - 134.00 36.00 0 38. . .00 0 134.00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara Yang Meminta Kepala UPT Puskesmas (…………………………………….00 38.) 604 1 015 NIP.

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Tangerang Selatan ,

Yang Menerima
Petugas Puskesmas

(………………………..………………..)
NIP.

Agustus 2016
September 2016

PEMBERIAN
12

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.) .. enerima Puskesmas …….……………….

PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN No NAMA OBAT TAHUN SATUAN 1 2 3 4 1 Allopurinol tablet 100 mg 2014 Tablet 2 Allopurinol tablet 100 mg 2015 Tablet 3 Ambroksol Syrup 15 mg / ml 2014 Botol 4 Ambroksol Syrup 15 mg / ml 2015 Botol 5 Ambroksol tablet 30 mg 2014 Tablet 6 Ambroksol tablet 30 mg 2015 Tablet 7 Aminofilin inj 24 mg /ml 2014 Ampul 8 Aminofilin tab 200 mg 2014 Tablet 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet 11 Amlodipin 10 mg 2015 Tablet 12 Amlodipin 5 mg 2015 Tablet 13 Amoksisilin + As. C) tablet 100 mg Tablet 34 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet 35 Asam Folat tab 1 mg 2013 Tablet 36 Asam Folat tab 1 mg 2015 Tablet 37 Asam Mefenamat Tablet 500 mg 2014 Tablet 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 39 Asam Mefenamat Tablet 500 mg 2015 Tablet 40 Asam Tranexamat 250mg 2013 Tablet 41 Asam Tranexamat Injeksi 2013 Ampul 42 Asiklovir krim 5% 2013 Tube . Klavulanat 2013 Tablet 14 Amoksisilin kaplet 250 mg 2013 Tablet 15 Amoksisilin kaplet 500 mg 2014 Tablet 16 Amoksisilin kaplet 500 mg 2015 Tablet 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 19 Antasida DOEN tablet 2014 Tablet 20 Antasida DOEN tablet 2015 Tablet 21 Antasida DOEN Suspensi 2014 Botol 22 Antasida DOEN Suspensi 2015 Botol 23 Anti Bakteri DOEN salep 2013 Tube 24 Anti Bakteri DOEN salep 2015 Tube 25 Anti Fungi DOEN kombinasi salep 2013 Pot 26 Anti Hemmoroid DOEN supp 2014 Supp 27 Anti Hemmoroid DOEN supp 2015 Supp 28 Anti migren / Ergotamin 2013 Tablet 29 Aqua Pro Injeksi steril @ 20 2014 Vial 30 Asam Asetilsalisilat 80 mg 2014 Tablet 31 Asam Asetilsalisilat 80 mg 2015 Tablet 32 Asam Asetilsalisilat 100 mg 2011 Tablet 33 Asam Askorbat (Vit.

43 Asiklovir Tablet 200 mg 2013 Tablet 44 Asiklovir Tablet 200 mg 2015 Tablet 45 Asiklovir Tablet 400 mg 2013 Tablet 46 Atapulgit 2011 Tablet 47 Atapulgit 2015 Tablet 48 Atropin Injeksi 0. Folat (Tambah darah) 2015 Tablet 53 Betahistin mesilat 2014 Tablet 54 Betametason Krim 2013 Tube 55 Betametason Krim 2015 Tube 56 Bisakodil supp 10 mg 2014 Supp 57 Bisakodil supp 10 mg 2015 Supp 58 Bisoprolol tab 5 mg 2014 Tablet 59 Bormheksin solution 2013 Botol 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol 61 Cetrizine 10 mg 2014 Tablet 62 Deksametason injeksi 5 mg/ml 2013 Ampul 63 Deksametason injeksi 5 mg/ml 2015 Ampul 64 Deksametason tablet 0.5 mg 2015 Tablet 66 Diazepam Inj 5 mg/ml 2013 Ampul 67 Diazepam supp 2014 Supp 68 Diazepam supp 2015 Supp 69 Diazepam tab 2 mg 2013 Tablet 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 71 Digoksin tablet 0.25 mg/ml-1 ml 2010 Ampul 49 Atropin Injeksi 0.5 mg 2013 Tablet 65 Deksametason tablet 0.25 mg 2015 Tablet 73 Dimenhidrinat tab 50 mg 2011 Tablet 74 Doksisiklin kapsul 100 mg 2010 Kapsul 75 Domperidon suspensi 5 mg/5ml 2014 Botol 76 Domperidon suspensi 5 mg/5ml 2015 Botol 77 Domperidon 10mg 2013 Tablet 78 Efedrin HCl tablet 25 mg 2014 Tablet 79 Ekstraks belladona tab 10 mg 2013 Tablet 80 Epinefrin / Adrenalin inj 0.5 mg 2014 Tablet 51 Besi II Sulfat 200 mg + As.25 mg/ml-1 ml 2015 Ampul 50 Atropin sulfat tablet 0.25 mg 2014 Tablet 72 Digoksin tablet 0.1 % 2013 Ampul 81 Eritromisin kapsul 250 mg 2013 Kapsul 82 Eritromisin kapsul 500 mg 2013 Kapsul 83 Eritromisin sirup 200mg/5 ml 2014 Botol 84 Eritromisin sirup 200mg/5 ml 2015 Botol 85 Etambutol tablet 250 mg 2011 Tablet 86 Fenobarbital tablet 30 mg 2010 Tablet 87 Fenobarbital tablet 30 mg 2015 Tablet 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul 94 Fitomenadion 2 mg inj 2013 Ampul 95 Fitomenadion 2 mg inj 2015 Ampul . Folat (Tambah darah) 2013 Tablet 52 Besi II Sulfat 200 mg + As.

5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet .1 % 2014 Tube 103 Gentamisin tetes mata 0.5 mg 2013 Tablet 131 Kaptopril tablet 12.5 % 2013 Tube 118 Hidrokortison cream 2.5 % 2014 Botol 144 Kloramfenikol tetes mata 0. 96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0.5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0.3% 2014 Botol 104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2.v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12.5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i. i.

000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol . Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul 159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet.9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0.000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100.5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0.9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.125 mg 2013 Tablet 176 Metilergometrin tablet salut 0. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.

000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube .000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol 216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.

Cl. Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na.5 60 g. K. Cl. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na. K. Cl. Lactate. Cl.Ca. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na.Ca. Lactate. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet .253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul 273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na. K. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0. Cl. K.5 60 g.

kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol 321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl.302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid.075 gram.electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0.0075 gram. fenilmerkuri 2013 305 nitrat 0.1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet . Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0. kombinasi 2014 Sachet 314 Mineral mix. 2013 307 cinchocaine HCl 2.075 gram.Vitamin.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg. Kalium Iodida 0.5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix. Natrium Tiosulfat 0.

347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol 371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3.5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2. mg/ml 2014 Pcs 352 Terbutalin Sulfate 0.5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj.5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs .5 2013 Syringe 390 Tambal Sinar Warna A3.

396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.v catheter 2014 Pcs 422 Etakridin larutan 0.5 2014 Pcs 428 Hand Scoon (Steril) # 6.1 % (Rivanol) 2015 Botol 424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs .

445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No. 18 with injection Port 2014 Pcs 455 IV Chateter No. 20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs 481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs .

adult) 2015 Pcs 528 Silk Benang bedah no. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula. 16 2013 Pcs 505 NGT No.21 G 2013 Pcs 539 Wing Needle No. 8 2013 Pcs 501 NGT No.27 2014 Pcs 500 NGT No.7 2014 Pcs 519 Plastik klip 13 x 8. 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs 538 Wing Needle No.23 G 2013 Pcs 540 Wing Needle no. 10 2013 Pcs 502 NGT No.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu .498 Mucus Ekstractor 2014 Pcs 499 Needle no.25 2013 Pcs 541 Wing Needle no. 14 2013 Pcs 504 NGT No.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula. 12 2013 Pcs 503 NGT No.

Apt) NIP.M. Mengetahui. 19600924 198501 1 001 NIP.S. Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs.Kes) (Irwan Hartono. 19781102 200604 1 015 .Si.. Suharno.

00 0 1.00 . 0 - . LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .00 3.00 . 0 - 1.370.00 . 0 - 2.00 0 2.00 .00 .580.735.215.580.00 0 122.735.00 0 411.00 .00 0 2. 0 - 50.00 .00 .250.00 0 1.155. 0 - 2.00 762.00 150.00 0 150.225.00 . 0 - 140.00 100.00 7.00 0 95.00 0 50.820.00 0 2.00 81.155.215.00 0 30.00 0 150.00 150. 0 - . 0 - . 0 - .00 0 175.820.00 0 7.00 0 93.520. 0 - 93.00 0 762. 0 - 122.00 411. 0 - 95. 0 - 30.00 72.00 .00 . 0 - 1. 0 - 175.00 0 81.00 0 100.370.00 5.00 0 5.00 0 72.00 0 140. 0 - .00 0 1.520. 0 - .00 .225.00 0 3.00 2.250. 0 - . 0 - 1.

00 0 111. 600.00 0 194.00 0 5.00 .00 0 1.00 0 7.00 0 800.770.00 0 250.00 0 34.00 . 0 - 1.00 . 0 - . 0 - . 0 - 10.00 0 28.00 .00 50.00 . 0 - 100. 0 - 7.00 0 171. 0 - 28.00 . 0 - 100.00 . 0 - 22.00 28. 0 - 8. 0 - . 0 - 171.00 0 600.190.00 .00 420.00 0 609. 0 - 820.00 0 8. 0 - 194.00 0 330.00 0 564. 0 - 800.00 .00 564. 0 - 34.00 0 10.00 . 0 - .00 0 164. 0 - .00 0 50. 0 - .00 0 160.00 .00 5.00 0 100. 0 - .00 0 420.00 160.00 0 59.00 250.00 .00 .770.00 0 28.00 330.00 .00 0 200. 0 - 164.260. 0 - .00 410.00 59. 0 - 200.00 111. 0 - .00 609.00 0 820.00 0 22. 0 - .00 0 100.00 .00 .260.190.00 0 410.

00 0 67. 0 - 1.080. 0 - 122.00 0 97.290. 0 - 48.00 0 16.00 94. 755.00 460.00 0 460.00 0 500.00 0 733.186.00 .00 0 714.00 0 48.00 0 5.620.00 0 400.00 . 0 - .00 . 0 - . 0 - 1.00 .00 240.00 0 11.00 0 18.00 .00 .00 733.00 .186.00 .00 0 2. 0 - 400.110.00 .00 0 1. 0 - .00 .00 500.00 0 2. 0 - 5.00 .00 0 78.00 0 330. 0 - .080. 0 - 97.00 .00 0 1. 0 - .235.055.00 0 122.110.00 .00 610.00 0 94.00 5.290.235.00 0 29.00 .00 0 990.00 0 5.620.00 460.00 0 2.00 29. 0 - . 0 - 5.055.00 0 460.00 . 0 - 16.00 2. 0 - 714.00 0 590. 0 - 78. 0 - 2.00 . 0 - 67.00 2. 0 - 990.00 0 240. 0 - 590.00 .00 0 610. 0 - 11.00 18. 0 - 330.00 0 755.00 .00 0 5.

00 .00 0 404.00 .000.00 .00 0 29.040.00 .00 404.00 0 111. 0 - .00 0 9.00 0 480.00 .00 . 0 - 9.00 0 380. 0 - 29.450.00 . 0 - 1.00 .00 . 0 - 3. 0 - 380.00 .00 0 137. 0 - .00 0 100. 0 - .00 0 76. 0 - 38.00 .805.00 199.450. 0 - 1.00 .00 0 200.594.00 0 1.00 0 610.00 .000.00 0 187. 0 - 187. 0 - 200.00 0 6.594.00 0 199. 0 - .00 0 1.00 .00 0 750.00 .00 . 203.00 0 38.00 0 1. 0 - .00 1. 0 - 137. 0 - 1.040. 0 - 100. 0 - 199. 0 - 480. 0 - 750. 0 - 240.00 0 199.00 0 203.00 0 240.00 . 0 - . 0 - .00 610.00 . 0 - . 0 - 76.00 0 3.805. 0 - .00 .00 6. 0 - 111.00 0 1.

00 0 208.00 .079.00 .00 100.050.00 0 3.00 0 2. 0 - 90.00 10.010. 0 - .00 .00 0 25.00 0 1.00 0 425.00 551. 0 - .00 50.00 0 551.00 0 2.00 . 0 - .00 0 20.420.00 0 12.00 0 21. 0 - . 0 - 50.00 .00 0 190.00 0 59.00 31. 0 - 3. 0 - 30.00 12.00 0 31.00 2.00 . 0 - 200.00 .00 0 50. 0 - 2. 0 - 1.00 0 100. 0 - 25.00 .00 0 1.00 0 30.624.00 0 50.00 .00 .00 0 11. 0 - 11. 0 - 21.00 .420.950.00 0 600.00 .624.800.00 .050.00 . 0 - . 0 - . 0 - . 0 - .00 0 10. 0 - 208.950. 0 - 425.00 190.079.00 0 90.00 0 200.00 .800. 0 - 59. 0 - . 0 - . 0 - .00 20. 0 - 1.010. 0 - 365. 0 - 600.00 .00 0 365. . 0 - .

.00 .00 0 290.00 .00 0 1.00 0 300. 0 - 30.00 0 22. 0 - .00 0 630.180.180.00 .130. 0 - 3.00 740.00 0 155.00 .00 0 210.640.00 1. 0 - .305.00 . 0 - .00 .00 300. 0 - 30. 0 - 73.00 4.130. 0 - .740.00 0 6. 0 - 30.000.240.00 0 10. 0 - .00 0 2.00 2.00 .00 0 740. 0 - .090.00 0 4.00 560.305.00 .00 0 2.00 .00 3.00 2.00 .00 . 0 - .00 99.00 .00 0 2.00 1.00 0 270. 0 - 10. 0 - . 0 - 270.00 630. 0 - .000.240.00 .00 6.090.00 0 1. 0 - 22.00 0 30.00 0 3.00 0 73. 0 - 5.00 0 30.00 0 3. 0 - 48.640.00 0 99. 0 - 290.00 0 560.00 0 30. 0 - 2.00 0 5.00 0 48. 0 - .00 210.740. 0 - 155.

00 100. 0 - .00 .00 0 100. 0 - 210.00 0 750. 0 - .00 0 683. 0 - 24. 0 - . 0 - .00 .00 .00 . 0 - .00 0 425.00 .00 0 3. 0 - 425. 0 - 683.00 0 10.00 . 0 - 9. 0 - .420.00 285.00 0 31.00 .00 3.00 0 24. 0 - .00 0 190.00 0 2.00 0 66. 0 - .00 . 0 - . 0 - 31. 0 - . 0 - .00 0 9.420. 0 - .00 0 285. 90.020.00 . 0 - 24. 0 - 750. 0 - .00 0 1. 0 - .00 0 210.00 1.00 . 0 - .00 0 24. 0 - 338.00 .00 10. 0 - .020.00 0 338.00 0 90. 0 - 2.00 190.00 . 0 - 66.

00 0 4.00 0 2. 0 - .00 .00 0 1.00 .00 0 800.00 1.00 . 0 - 4. 0 - 2.00 .00 . 0 - .00 2.00 3.00 .00 0 2.00 0 1. 0 - 450. 0 - 42. 0 - 510.00 0 2. 0 - 1.00 .00 .00 2. 0 - 30.00 .00 0 1.00 0 2. 0 - 1.00 1.00 0 1. 0 - .00 0 450. 0 - 2.00 . 0 - .00 .00 2. 0 - 3. 0 - . 0 - .00 0 2.00 .00 2.00 0 2.00 1. 0 - 5.00 0 115.00 0 2.00 . 0 - 3.00 0 2. 0 - 2.00 0 5.00 0 3. 0 - 2.00 0 2.00 0 30. . 0 - 2.00 .00 0 42. 0 - 115.00 0 3.00 0 3.00 0 1.00 0 2.00 .00 .00 0 1.00 2.00 800.00 0 510.00 1.

00 .00 0 500.00 0 100. 0 - 350.00 0 26.00 0 400.00 0 7.00 26.00 .00 200.00 0 1. 0 - .00 0 200.00 72.00 60.00 0 57. 0 - 400. 0 - 100.00 0 100. 0 - .00 0 12.00 0 26.00 .00 3.00 .00 0 302.00 .00 0 1. 0 - 1. 0 - 100. 500. 0 - 57. 0 - .00 26.600.00 302.00 .00 0 48.00 0 500. 0 - . 0 - . 0 - . 0 - 48.00 .00 1.157.157.00 0 288.00 0 400.00 .00 .00 0 60. 0 - 100.00 288.00 . 0 - 12.00 3. 0 - .00 0 200. 0 - 200.00 .00 0 72.00 0 12.600.00 . 0 - . 0 - 4.00 0 100.00 0 4. 0 - 7.00 0 3.00 0 3.00 . 0 - .00 500. 0 - 12.00 .00 0 350.00 . 0 - 400.

00 0 60. 0 - 10.00 100. 0 - .00 182.00 0 5.00 0 2.00 .00 0 100. 0 - .00 0 182. 0 - 12.00 0 50.00 665.00 0 10.00 0 665.00 33.00 0 72.00 0 99.00 0 300.00 0 100.00 0 5.00 0 15. 0 - .00 0 12.00 .00 99.00 . 0 - 5.00 0 29. 0 - .000.00 0 3. 100.00 0 13.00 0 118.00 2.00 0 30.00 118. 0 - .00 29.00 0 23.00 60. 0 - . 0 - 23.00 0 33. 0 - . 0 - . 0 - 5.00 0 977.00 0 50.00 72. 0 - 13.00 0 15.00 977. 0 - .00 400.00 .00 . 0 - .00 15.00 50.00 0 10. 0 - 3.00 0 5.00 0 50. 0 - 30.00 . 0 - 50.000.00 0 3. 0 - .00 5. 0 - 3.00 . 0 - .00 .00 10.00 .00 .00 .00 50.00 0 400.00 300.00 . 0 - 15.

0 - .00 0 170.00 0 109.00 170. 0 - 55. 0 - .00 0 50. 0 - .00 .00 0 32.000. 0 - .00 . 0 - . 0 - .000.00 0 100.00 0 134.00 0 68.00 23.00 0 23. 0 - . 0 - 165.00 0 38. 0 - .00 0 8.000. 0 - 100.00 420.00 . 0 - . 0 - . 0 - 75. 0 - .00 0 165.00 8.00 0 55.00 .00 36. 0 - 109.00 0 75.00 38.00 0 36.000.00 100. 0 - . 0 - 134.00 .00 0 20. 0 - 20. .000.00 0 100.00 . 0 - .00 0 420.000. 0 - . 0 - .00 68.00 50. 0 - .000. 0 - 98.000.00 32.00 .00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara .00 0 98. 0 - . 0 - .

.) 604 1 015 NIP. Yang Meminta Kepala UPT Puskesmas (…………………………………….

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.) NIP. Yang Menerima Petugas Puskesmas (……………………….……………….. .Tangerang Selatan .

September 2016 Oktober 2016 PEMBERIAN 12 .

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.………………..) . enerima Puskesmas …….

PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN No NAMA OBAT TAHUN SATUAN 1 2 3 4 1 Allopurinol tablet 100 mg 2014 Tablet 2 Allopurinol tablet 100 mg 2015 Tablet 3 Ambroksol Syrup 15 mg / ml 2014 Botol 4 Ambroksol Syrup 15 mg / ml 2015 Botol 5 Ambroksol tablet 30 mg 2014 Tablet 6 Ambroksol tablet 30 mg 2015 Tablet 7 Aminofilin inj 24 mg /ml 2014 Ampul 8 Aminofilin tab 200 mg 2014 Tablet 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet 11 Amlodipin 10 mg 2015 Tablet 12 Amlodipin 5 mg 2015 Tablet 13 Amoksisilin + As. Klavulanat 2013 Tablet 14 Amoksisilin kaplet 250 mg 2013 Tablet 15 Amoksisilin kaplet 500 mg 2014 Tablet 16 Amoksisilin kaplet 500 mg 2015 Tablet 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 19 Antasida DOEN tablet 2014 Tablet 20 Antasida DOEN tablet 2015 Tablet 21 Antasida DOEN Suspensi 2014 Botol 22 Antasida DOEN Suspensi 2015 Botol 23 Anti Bakteri DOEN salep 2013 Tube 24 Anti Bakteri DOEN salep 2015 Tube 25 Anti Fungi DOEN kombinasi salep 2013 Pot 26 Anti Hemmoroid DOEN supp 2014 Supp 27 Anti Hemmoroid DOEN supp 2015 Supp 28 Anti migren / Ergotamin 2013 Tablet 29 Aqua Pro Injeksi steril @ 20 2014 Vial 30 Asam Asetilsalisilat 80 mg 2014 Tablet 31 Asam Asetilsalisilat 80 mg 2015 Tablet 32 Asam Asetilsalisilat 100 mg 2011 Tablet 33 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet 35 Asam Folat tab 1 mg 2013 Tablet 36 Asam Folat tab 1 mg 2015 Tablet 37 Asam Mefenamat Tablet 500 mg 2014 Tablet 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 39 Asam Mefenamat Tablet 500 mg 2015 Tablet 40 Asam Tranexamat 250mg 2013 Tablet 41 Asam Tranexamat Injeksi 2013 Ampul 42 Asiklovir krim 5% 2013 Tube . C) tablet 100 mg Tablet 34 Asam Askorbat (Vit.

5 mg 2014 Tablet 51 Besi II Sulfat 200 mg + As.25 mg/ml-1 ml 2010 Ampul 49 Atropin Injeksi 0.25 mg/ml-1 ml 2015 Ampul 50 Atropin sulfat tablet 0.25 mg 2014 Tablet 72 Digoksin tablet 0.5 mg 2015 Tablet 66 Diazepam Inj 5 mg/ml 2013 Ampul 67 Diazepam supp 2014 Supp 68 Diazepam supp 2015 Supp 69 Diazepam tab 2 mg 2013 Tablet 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 71 Digoksin tablet 0.25 mg 2015 Tablet 73 Dimenhidrinat tab 50 mg 2011 Tablet 74 Doksisiklin kapsul 100 mg 2010 Kapsul 75 Domperidon suspensi 5 mg/5ml 2014 Botol 76 Domperidon suspensi 5 mg/5ml 2015 Botol 77 Domperidon 10mg 2013 Tablet 78 Efedrin HCl tablet 25 mg 2014 Tablet 79 Ekstraks belladona tab 10 mg 2013 Tablet 80 Epinefrin / Adrenalin inj 0. Folat (Tambah darah) 2013 Tablet 52 Besi II Sulfat 200 mg + As.5 mg 2013 Tablet 65 Deksametason tablet 0. Folat (Tambah darah) 2015 Tablet 53 Betahistin mesilat 2014 Tablet 54 Betametason Krim 2013 Tube 55 Betametason Krim 2015 Tube 56 Bisakodil supp 10 mg 2014 Supp 57 Bisakodil supp 10 mg 2015 Supp 58 Bisoprolol tab 5 mg 2014 Tablet 59 Bormheksin solution 2013 Botol 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol 61 Cetrizine 10 mg 2014 Tablet 62 Deksametason injeksi 5 mg/ml 2013 Ampul 63 Deksametason injeksi 5 mg/ml 2015 Ampul 64 Deksametason tablet 0.1 % 2013 Ampul 81 Eritromisin kapsul 250 mg 2013 Kapsul 82 Eritromisin kapsul 500 mg 2013 Kapsul 83 Eritromisin sirup 200mg/5 ml 2014 Botol 84 Eritromisin sirup 200mg/5 ml 2015 Botol 85 Etambutol tablet 250 mg 2011 Tablet 86 Fenobarbital tablet 30 mg 2010 Tablet 87 Fenobarbital tablet 30 mg 2015 Tablet 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul 94 Fitomenadion 2 mg inj 2013 Ampul 95 Fitomenadion 2 mg inj 2015 Ampul .43 Asiklovir Tablet 200 mg 2013 Tablet 44 Asiklovir Tablet 200 mg 2015 Tablet 45 Asiklovir Tablet 400 mg 2013 Tablet 46 Atapulgit 2011 Tablet 47 Atapulgit 2015 Tablet 48 Atropin Injeksi 0.

5 % 2013 Tube 118 Hidrokortison cream 2.5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj. 96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0.1 % 2014 Tube 103 Gentamisin tetes mata 0.5 % 2014 Botol 144 Kloramfenikol tetes mata 0.5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet .5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0.v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12.5 mg 2013 Tablet 131 Kaptopril tablet 12.3% 2014 Botol 104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2. i.

000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0.000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol .5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet. Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul 159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0.9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100.9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.125 mg 2013 Tablet 176 Metilergometrin tablet salut 0. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.

200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol 216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube .

253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul 273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na. Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na. Cl.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0. Lactate.Ca. Cl. K. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet . Cl. K. Cl. Cl.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na.Ca. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0.5 60 g. K. K. Lactate.5 60 g.

302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid.075 gram. Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0.0075 gram.1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet .electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0. kombinasi 2014 Sachet 314 Mineral mix. Kalium Iodida 0.5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix. 2013 307 cinchocaine HCl 2.Vitamin. fenilmerkuri 2013 305 nitrat 0.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg. Natrium Tiosulfat 0.075 gram. kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol 321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl.

5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs . mg/ml 2014 Pcs 352 Terbutalin Sulfate 0.5 2013 Syringe 390 Tambal Sinar Warna A3.347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2.5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol 371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3. Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj.5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj.

5 2014 Pcs 428 Hand Scoon (Steril) # 6.v catheter 2014 Pcs 422 Etakridin larutan 0.1 % (Rivanol) 2015 Botol 424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs .1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.

20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs 481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs .445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No. 18 with injection Port 2014 Pcs 455 IV Chateter No.

8 2013 Pcs 501 NGT No.25 2013 Pcs 541 Wing Needle no. 12 2013 Pcs 503 NGT No. 14 2013 Pcs 504 NGT No. 10 2013 Pcs 502 NGT No.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula.27 2014 Pcs 500 NGT No.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu . 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs 538 Wing Needle No. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8. 16 2013 Pcs 505 NGT No.21 G 2013 Pcs 539 Wing Needle No.498 Mucus Ekstractor 2014 Pcs 499 Needle no.23 G 2013 Pcs 540 Wing Needle no.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula.7 2014 Pcs 519 Plastik klip 13 x 8.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula.adult) 2015 Pcs 528 Silk Benang bedah no.

M.Kes) (Irwan Hartono. Suharno.Si. 19781102 200604 1 015 .S. Mengetahui.. 19600924 198501 1 001 NIP.Apt) NIP. Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs.

225. 0 - 50.00 0 1.00 0 762.00 0 150.00 .00 7.00 0 30. 0 - 1. 0 - .00 . 0 - 2.00 .00 762.735. 0 - .820.00 0 1.00 2.00 0 72.00 0 140.00 150.215.00 0 2. 0 - 95.00 0 7.00 0 5.00 100.580.155.520.00 5. 0 - . 0 - 175.155. 0 - 1.00 .00 81.520.00 .00 3.00 0 50. 0 - .00 0 411. 0 - 93. 0 - .00 150.00 0 93.00 0 2.370. 0 - 122. LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .820.00 0 81.00 0 150.00 0 122.00 .580.250.00 .00 . 0 - 1.00 .250. 0 - . 0 - .225.215.00 0 1.00 .735.00 72. 0 - 2.00 0 2.00 0 175.00 0 95.00 .00 0 100.00 0 3. 0 - 30.00 411.00 . 0 - 140.370.

0 - 100. 0 - .00 0 420.00 . 0 - 820.00 .00 .00 0 171.00 0 28.770.00 609.00 0 164.00 160.00 0 1. 0 - .00 250. 0 - . 0 - 10.00 0 200.00 0 100.00 0 59. 0 - .00 .190.00 410.00 0 7.00 0 28.00 0 609.00 .00 0 800. 0 - .00 .00 0 410. 0 - 8.00 0 5.00 564.00 0 330.00 0 250.00 0 820.00 0 111.00 0 34. 0 - 200.00 0 600.00 330. 0 - .00 . 0 - .00 111. 0 - 100.00 0 194.00 .00 0 8.00 0 564.260.00 . 0 - 194.00 420.00 . 0 - . 0 - 164.00 .00 0 160.00 .00 28.00 59.770. 0 - . 0 - 800.260.00 0 100.190. 0 - 171.00 . 0 - 28. 0 - 1.00 0 22.00 .00 0 50. 0 - 34.00 .00 .00 5. 0 - 7. 600. 0 - 22.00 0 10. 0 - .00 50.

0 - 16.080. 0 - .00 . 0 - 714.00 0 460.00 0 2.00 .110.186.00 . 0 - 330.00 .00 0 78.00 .00 18.290.00 0 29.00 .00 0 122. 0 - 590.00 240.620.00 5.00 460.055. 0 - 67.186. 0 - 1.235.00 0 330. 0 - 5.00 0 94.00 0 5. 0 - .00 29.00 .00 0 500.00 610.00 .00 94.00 0 714.00 0 11. 0 - 5. 0 - .00 0 18.00 0 1.00 0 240.00 0 48. 0 - 990. 0 - .00 .00 0 1.00 .00 .620.055.00 733.00 . 0 - 400.235.00 0 755.00 0 97.00 500.00 460.00 2. 0 - .00 0 2.00 .00 0 460. 0 - 97.00 .00 0 990.00 .00 0 610.080.00 0 5. 0 - 11. 0 - 2.00 .110.00 0 400.00 . 0 - 48. 755.00 .00 0 67. 0 - .00 0 590. 0 - 1. 0 - 78.00 2.290. 0 - 122.00 0 2.00 0 5.00 0 16.00 0 733.

0 - 480.805.040. 0 - 1.00 0 1. 0 - .00 0 380.00 . 0 - 199.00 .00 0 199. 0 - . 0 - .00 0 6. 0 - .000. 0 - .00 0 200.00 0 750.00 0 9.00 .00 0 187. 0 - . 0 - 76. 0 - 100.00 . 203.00 0 203.00 199. 0 - 750. 0 - 1.000. 0 - 380.00 0 76. 0 - 240.00 . 0 - 9.00 0 38.00 .805.00 0 199.00 0 1. 0 - 137. 0 - . 0 - 3.00 0 610. 0 - .00 .00 . 0 - 187. 0 - 200.00 . 0 - 111.00 6.00 0 240.00 0 111.00 .040.00 0 137. 0 - 1.00 0 1.00 .00 . 0 - 38.00 .00 .00 .00 404.00 0 3.00 1.00 .00 .00 0 404.594.00 0 29.00 0 480.00 0 1.00 610.594.450.00 0 100.00 . 0 - .00 .450. 0 - 29.

00 .950.00 .00 20. 0 - . 0 - 365. 0 - 1.00 0 551.00 0 100.00 0 365.00 . 0 - .050.050.00 0 12. 0 - 59.00 0 200.00 0 20.00 .00 12.00 . 0 - 25.010.00 . 0 - 11. 0 - 200.010.00 0 90. 0 - 208.00 0 3. 0 - 30. .00 0 59.00 0 50.00 0 208.800.00 0 31.00 50. 0 - 1.420. 0 - 425.00 .079.00 . 0 - .00 10.00 551.624. 0 - .00 .800.00 0 425.00 . 0 - .00 0 10.00 0 30.00 .00 . 0 - 600.00 100.00 0 50.420. 0 - 90. 0 - .00 0 190. 0 - .00 .00 0 600.00 . 0 - 3. 0 - .00 0 25. 0 - 21. 0 - .00 0 2.950. 0 - .00 0 21. 0 - .00 .00 2.00 0 1. 0 - 50.624.00 190.00 31.00 0 2. 0 - .00 .00 0 11. 0 - 2.079.00 0 1.

00 4.00 0 30.00 .00 0 290.00 1.00 .00 0 99. 0 - 30.00 0 210.00 0 73.00 . 0 - .305. 0 - 3. 0 - 73.740.00 0 10.00 .00 0 3. 0 - 48.00 210. 0 - .090. 0 - .00 0 2.00 0 3.00 0 300.00 2. .00 0 22. 0 - 10.00 0 2.00 740.240.00 99.00 .00 . 0 - 5.00 0 740.00 0 1. 0 - .000.00 0 48.00 0 5.00 .00 .00 3.00 0 2.180.00 6.00 . 0 - 270.00 0 6. 0 - .00 0 155.130. 0 - 155. 0 - .00 0 1.00 0 560.000.180.00 300.00 0 30.00 560. 0 - 2.305. 0 - 22.640.090.00 1.740.00 630.00 0 30.00 . 0 - . 0 - . 0 - .640.00 . 0 - 30.240.130. 0 - 290.00 0 4. 0 - 30.00 2.00 .00 0 270.00 0 630. 0 - .00 .

420.00 .00 0 24.00 0 285. 0 - .00 0 10.00 .00 0 190.00 .00 0 100. 0 - 750.00 0 9. 0 - 9. 0 - . 0 - .00 .00 0 210.00 0 750.00 .00 0 90. 0 - .00 0 425. 0 - 425.00 .00 0 338. 0 - 66. 0 - . 0 - 24.00 0 24. 0 - 24. 0 - . 0 - .00 0 66.00 190.00 10.00 . 0 - . 0 - 31.00 . 0 - 683.00 0 683. 0 - .00 .020.00 0 2.00 0 1.00 0 31.00 .00 0 3.00 3.420.00 1. 0 - . 90. 0 - .00 .020. 0 - 338. 0 - . 0 - . 0 - 210. 0 - . 0 - 2. 0 - .00 .00 285.00 100. 0 - .

00 .00 .00 .00 0 2.00 0 800. 0 - 4.00 .00 2. 0 - 2.00 0 2.00 0 2. 0 - 42.00 0 1.00 0 30.00 0 2.00 .00 0 42.00 0 1.00 0 2.00 1. 0 - 450.00 2.00 . 0 - 115.00 0 4. 0 - . .00 . 0 - 30.00 0 1. 0 - 2.00 0 3.00 1.00 . 0 - .00 0 1. 0 - 5.00 1.00 .00 0 2.00 800. 0 - 2. 0 - 3.00 0 2.00 .00 .00 .00 0 450.00 1.00 0 1.00 0 2. 0 - 510. 0 - 1. 0 - .00 2.00 0 2. 0 - .00 . 0 - 3. 0 - .00 0 115. 0 - 2.00 0 3.00 0 510.00 .00 .00 0 1. 0 - 2.00 2.00 .00 0 3.00 3.00 2.00 0 2.00 0 5. 0 - 1. 0 - .

157.00 .00 302.00 0 500. 0 - 48. 0 - 400.600. 0 - .00 0 100.00 0 1. 0 - 200.00 1. 0 - .00 0 200.00 200.00 0 4.00 0 288.00 . 0 - .00 . 0 - 100.00 . 0 - 4.00 0 3.00 0 200.00 3.00 .00 .00 26.00 3. 0 - 7. 0 - 12.00 60. 0 - 400. 0 - 100.00 0 302.00 0 26.00 288.600.00 0 350.00 . 0 - 1.00 .00 .00 . 0 - .00 0 1.00 0 400.00 0 100.00 .00 500.00 .00 .00 26. 0 - 100.00 0 26.157.00 0 60.00 .00 0 12.00 0 57.00 0 400.00 0 500. 0 - 57. 0 - . 0 - 12. 0 - .00 0 72.00 0 48.00 0 12. 0 - .00 72. 500. 0 - 350.00 0 7.00 0 100.00 0 3. 0 - . 0 - .00 .

00 29.00 2.00 15.00 0 13.00 0 29.00 0 100.00 0 15.00 99. 0 - 12.00 .00 0 5.00 0 23.00 33. 0 - 10.00 977.00 300. 0 - 3. 0 - 50.00 0 3.000.00 60.00 50.00 0 12.00 0 15.00 .00 665. 0 - .00 0 10.00 0 99.000.00 0 5.00 0 300. 0 - . 100. 0 - 15.00 0 5.00 .00 .00 182.00 0 10.00 100. 0 - 23.00 5.00 118.00 0 182.00 0 50. 0 - . 0 - .00 0 400.00 .00 50.00 0 72.00 0 30.00 .00 . 0 - .00 .00 . 0 - . 0 - . 0 - .00 0 118.00 .00 .00 400. 0 - 5. 0 - 5.00 0 977. 0 - 3.00 0 100. 0 - .00 0 50.00 .00 0 665. 0 - 30.00 0 3. 0 - . 0 - .00 72.00 0 2.00 0 60.00 10.00 0 33.00 0 50. 0 - 13. 0 - .

0 - .000. 0 - 98.000. .00 23.00 8.00 32.00 0 100.00 0 100.00 .00 36. 0 - .00 0 170.00 0 165.00 0 55.00 .00 68. 0 - 165.00 . 0 - .00 0 75. 0 - .000.000.000.00 . 0 - .00 50.00 0 23. 0 - .00 0 98. 0 - . 0 - 20.00 . 0 - . 0 - .00 0 50. 0 - . 0 - . 0 - . 0 - 100.000. 0 - .00 0 36.00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara .00 0 32.000. 0 - . 0 - . 0 - 75.00 0 68.00 0 38.00 420.00 38. 0 - 55.00 100.00 0 134. 0 - 134.00 .00 0 8.00 0 20. 0 - 109.000. 0 - . 0 - .00 0 109.00 0 420. 0 - .00 170.00 .

.) 604 1 015 NIP. Yang Meminta Kepala UPT Puskesmas (…………………………………….

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#DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 2.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 29. #DIV/0! #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 13.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 5.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 665.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 10.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 300. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 23.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 5.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 60.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 182.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 72.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 15. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 10. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 15.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 977. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 5. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 30.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 3. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 33.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .#DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 118.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .000.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 400. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 12.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 3.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 99.

#DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 134. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 68. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 38. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 55.000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .#DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 75.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 23.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 170. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 109.000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 20. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 165.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 36.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 8.000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 98.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 32.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 420.000. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .

.) NIP. .. Yang Menerima Petugas Puskesmas (……………………….……………….Tangerang Selatan .

Oktober 2016 November 2016 PEMBERIAN 12 .

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enerima Puskesmas ……..) ..……………….

C) tablet 100 mg Tablet 34 Asam Askorbat (Vit.PUSKESMAS : Jurangmangu KECAMATAN : KOTA : TANGERANG SELATAN PROVINSI : BANTEN No NAMA OBAT TAHUN SATUAN 1 2 3 4 1 Allopurinol tablet 100 mg 2014 Tablet 2 Allopurinol tablet 100 mg 2015 Tablet 3 Ambroksol Syrup 15 mg / ml 2014 Botol 4 Ambroksol Syrup 15 mg / ml 2015 Botol 5 Ambroksol tablet 30 mg 2014 Tablet 6 Ambroksol tablet 30 mg 2015 Tablet 7 Aminofilin inj 24 mg /ml 2014 Ampul 8 Aminofilin tab 200 mg 2014 Tablet 9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet 10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet 11 Amlodipin 10 mg 2015 Tablet 12 Amlodipin 5 mg 2015 Tablet 13 Amoksisilin + As. Klavulanat 2013 Tablet 14 Amoksisilin kaplet 250 mg 2013 Tablet 15 Amoksisilin kaplet 500 mg 2014 Tablet 16 Amoksisilin kaplet 500 mg 2015 Tablet 17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol 18 Amoksisilin sirup kering forte 250mg/ml 2015 botol 19 Antasida DOEN tablet 2014 Tablet 20 Antasida DOEN tablet 2015 Tablet 21 Antasida DOEN Suspensi 2014 Botol 22 Antasida DOEN Suspensi 2015 Botol 23 Anti Bakteri DOEN salep 2013 Tube 24 Anti Bakteri DOEN salep 2015 Tube 25 Anti Fungi DOEN kombinasi salep 2013 Pot 26 Anti Hemmoroid DOEN supp 2014 Supp 27 Anti Hemmoroid DOEN supp 2015 Supp 28 Anti migren / Ergotamin 2013 Tablet 29 Aqua Pro Injeksi steril @ 20 2014 Vial 30 Asam Asetilsalisilat 80 mg 2014 Tablet 31 Asam Asetilsalisilat 80 mg 2015 Tablet 32 Asam Asetilsalisilat 100 mg 2011 Tablet 33 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet 35 Asam Folat tab 1 mg 2013 Tablet 36 Asam Folat tab 1 mg 2015 Tablet 37 Asam Mefenamat Tablet 500 mg 2014 Tablet 38 Asam Mefenamat Tablet 500 mg 2015 Tablet 39 Asam Mefenamat Tablet 500 mg 2015 Tablet 40 Asam Tranexamat 250mg 2013 Tablet 41 Asam Tranexamat Injeksi 2013 Ampul 42 Asiklovir krim 5% 2013 Tube .

25 mg/ml-1 ml 2015 Ampul 50 Atropin sulfat tablet 0.25 mg 2014 Tablet 72 Digoksin tablet 0.1 % 2013 Ampul 81 Eritromisin kapsul 250 mg 2013 Kapsul 82 Eritromisin kapsul 500 mg 2013 Kapsul 83 Eritromisin sirup 200mg/5 ml 2014 Botol 84 Eritromisin sirup 200mg/5 ml 2015 Botol 85 Etambutol tablet 250 mg 2011 Tablet 86 Fenobarbital tablet 30 mg 2010 Tablet 87 Fenobarbital tablet 30 mg 2015 Tablet 88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet 89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet 90 Fenol Gliserol tetes telinga 10-% 2013 Botol 91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet 92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet 93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul 94 Fitomenadion 2 mg inj 2013 Ampul 95 Fitomenadion 2 mg inj 2015 Ampul .5 mg 2014 Tablet 51 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2013 Tablet 52 Besi II Sulfat 200 mg + As.25 mg 2015 Tablet 73 Dimenhidrinat tab 50 mg 2011 Tablet 74 Doksisiklin kapsul 100 mg 2010 Kapsul 75 Domperidon suspensi 5 mg/5ml 2014 Botol 76 Domperidon suspensi 5 mg/5ml 2015 Botol 77 Domperidon 10mg 2013 Tablet 78 Efedrin HCl tablet 25 mg 2014 Tablet 79 Ekstraks belladona tab 10 mg 2013 Tablet 80 Epinefrin / Adrenalin inj 0.25 mg/ml-1 ml 2010 Ampul 49 Atropin Injeksi 0. Folat (Tambah darah) 2015 Tablet 53 Betahistin mesilat 2014 Tablet 54 Betametason Krim 2013 Tube 55 Betametason Krim 2015 Tube 56 Bisakodil supp 10 mg 2014 Supp 57 Bisakodil supp 10 mg 2015 Supp 58 Bisoprolol tab 5 mg 2014 Tablet 59 Bormheksin solution 2013 Botol 60 Cetrizine Sirup 5 mg/5 ml 2013 Botol 61 Cetrizine 10 mg 2014 Tablet 62 Deksametason injeksi 5 mg/ml 2013 Ampul 63 Deksametason injeksi 5 mg/ml 2015 Ampul 64 Deksametason tablet 0.43 Asiklovir Tablet 200 mg 2013 Tablet 44 Asiklovir Tablet 200 mg 2015 Tablet 45 Asiklovir Tablet 400 mg 2013 Tablet 46 Atapulgit 2011 Tablet 47 Atapulgit 2015 Tablet 48 Atropin Injeksi 0.5 mg 2013 Tablet 65 Deksametason tablet 0.5 mg 2015 Tablet 66 Diazepam Inj 5 mg/ml 2013 Ampul 67 Diazepam supp 2014 Supp 68 Diazepam supp 2015 Supp 69 Diazepam tab 2 mg 2013 Tablet 70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul 71 Digoksin tablet 0.

v 10% (100mg/ml) 2015 Tablet 128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet 129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet 130 Kaptopril tablet 12.5 % 2015 Botol 145 Kloramfenikol tetes telinga 3 % 2014 Botol 146 Klorfeniramin maleat tablet 4 mg 2012 Tablet 147 Klorpromazin inj.5 % 2014 Botol 144 Kloramfenikol tetes mata 0.5 % 2015 Tube 119 Ibuprofen suppositoria 2013 Supp 120 Ibuprofen suspensi 100mg/5ml 2013 Botol 121 Ibuprofen tablet 200 mg 2014 Tablet 122 Ibuprofen tablet 400 mg 2013 Tablet 123 Ibuprofen tablet 400 mg 2015 Tablet 124 Isoniazid 100 mg 2011 Tablet 125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet 126 Kalium Diklofenak 50 mg 2014 Tablet 127 Kalsium Glukonat injkesi i.1 % 2014 Tube 103 Gentamisin tetes mata 0.5 mg 2015 Tablet 132 Kaptopril tablet 25 mg 2013 Tablet 133 Ketokonazol krim 2 % 2014 Tube 134 Ketokonazol tablet 200 mg 2014 Tablet 135 Ketokonazol tablet 200 mg 2015 Tablet 136 Ketorolac Injeksi 10 mg 2013 Ampul 137 Klindamisin kapsul 150 mg 2013 Kapsul 138 Klindamisin kapsul 300 mg 2014 Kapsul 139 Kloramfenikol kapsul 250 mg 2013 Kapsul 140 Kloramfenikol salep mata 1 % 2013 Tube 141 Kloramfenikol salep mata 1 % 2015 Tube 142 Kloramfenikol sirup 60 ml 2013 Botol 143 Kloramfenikol tetes mata 0.5 mg 2013 Tablet 131 Kaptopril tablet 12. 96 Furosemid tab 40 mg 2014 Tablet 97 Garam oralit serbuk kombinasi 2013 Bungkus 98 Garam oralit serbuk kombinasi 2015 Bungkus 99 Gemfibrozil kapsul 300 mg 2014 Kapsul 100 Gentamisin inj 40 mg/ml 2014 Ampul 101 Gentamisin inj 40 mg/ml 2015 Ampul 102 Gentamisin salep kulit 0.m 25 mg/ml (HCL) 2014 Ampul 148 Kodein 10 mg 2013 Tablet . i.3% 2014 Botol 104 Gentian Violet larutan 1 % 2014 Botol 105 Glibenklamid tablet 5 mg 2014 Tablet 106 Glimepirid 2mg 2014 Tablet 107 Glimepirid 2mg 2015 Tablet 108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet 109 Gliseril Liquid 2014 Botol 110 Glukosa larutan infus 10% 2014 Botol 111 Glukosa larutan infus 5% 2014 Botol 112 Glukosa larutan infus 5% 2015 Botol 113 Griseofulvin tablet 125 mg micronized 2014 Tablet 114 Griseofulvin tablet 125 mg micronized 2015 Tablet 115 Haloperidol 2010 Tablet 116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet 117 Hidrokortison cream 2.5 % 2013 Tube 118 Hidrokortison cream 2.

200 mg-ml 2014 Ampul 175 Metilergometrin tablet salut 0.149 Kotrimoksazol suspensi 2014 Botol 150 Kotrimoksazol suspensi 2015 Botol 151 Kotrimoksazol tablet pead 2010 Tablet Kotrimosazol tablet.000 IU/g 2015 Tablet 197 OAT Kategori 2 2014 Paket 198 Obat Batuk Hitam 100 ml 2013 Botol 199 Obat Batuk Hitam 100 ml 2015 Botol . Komb: Sulfametoksazol 400 mg + 153 2015 Tablet Trimetoprim 80 mg 154 Levofloksasin 500 mg Tablet 155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul 156 Lidokain injeksi 2% 2013 Botol 157 Lidokain injeksi 2% 2015 Botol 158 Linkomisin kapsul 500 mg 2014 Kapsul 159 Loperamid 2014 Tablet 160 Loperamid 2015 Tablet 161 Loratadin tablet 2 mg 2015 Tablet 162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul 163 Meloksikam 15 mg 2013 Tablet 164 Meloksikam 15 mg 2015 Tablet 165 Meloksikam 7.9 % steril 2015 Botol 192 Nifedipin tablet 10 mg 2014 Tablet 193 Nifedipin tablet 10 mg 2015 Tablet 194 Nistatin Tablet salut 500.125 mg 2015 Tablet 177 Metilprednisolon 4 mg 2013 Tablet 178 Metoklopramide inj Ampul 179 Metoklopramide tablet 2013 Tablet 180 Metoklopramide tablet 2015 Tablet 181 Metronidazol infus 500 mg/100 ml 2014 Botol 182 Metronidazol tablet 250 mg 2014 Tablet 183 Metronidazol tablet 500 mg 2011 Tablet 184 Metronidazol tablet 500 mg 2015 Tablet 185 Mikonazol cream 2014 Tube 186 Mikonazol cream 2015 Tube 187 Natrium Diklofenak tablet 25 mg 2013 Tablet 188 Natrium Diklofenak tablet 25 mg 2015 Tablet 189 Natrium Diklofenak tablet 50 mg 2014 Tablet 190 Natrium Klorida larutan infus 0. Komb: Sulfametoksazol 400 mg + 152 2013 Tablet Trimetoprim 80 mg Kotrimosazol tablet.000 IU 2013 Tablet 195 Nistatin tablet vaginal 100.000 IU/g 2013 Tablet 196 Nistatin tablet vaginal 100.125 mg 2013 Tablet 176 Metilergometrin tablet salut 0.5 mg 2014 Tablet 166 Metampiron Injeksi 2014 Ampul 167 Metampiron Injeksi 2015 Ampul 168 Metampiron tablet 500 mg 2014 Tablet 169 Metformin HCl tablet 500 mg 2015 Tablet 170 Metformin HCL tablet 850 mg 2015 Botol 171 Methisoprinol 250 mg/5ml 2014 Botol 172 Methisoprinol 500 mg 2013 Tablet 173 Methisoprinol 500 mg 2015 Tablet 174 Metilergometrin injeksi 0.9 % steril 2014 Botol 191 Natrium Klorida larutan infus 0.

200 Obat Diare Dewasa 2010 Tablet 201 Obat FDC katagori sisipan 2013 Paket 202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube 203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube 204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube 205 Oksitosin injeksi 10 IU/ml 2014 Ampul 206 Omeprazol kapsul 20 mg 2014 Kapsul 207 Omeprazol kapsul 20 mg 2015 Kapsul 208 Ondansentron 4 mg 2014 Tablet 209 Ondansentron 4 mg 2015 Tablet 210 Ondansentron inj 4 mg/2 ml 2014 Ampul 211 Ondansentron inj 4 mg/2 ml 2015 Ampul 212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul 213 Papaverin tablet 40 mg 2013 Tablet 214 Parasetamol drop 2014 Botol 215 Parasetamol drop 2015 Botol 216 Parasetamol sirup 120 mg / 5 ml 2014 Botol 217 Parasetamol sirup 120 mg / 5 ml 2015 Botol 218 Parasetamol Supp 2014 Supp 219 Parasetamol tablet 100 mg 2013 Tablet 220 Parasetamol tablet 500 mg 2011 Tablet 221 Parasetamol tablet 500 mg 2015 Tablet 222 Piracetam tablet 800 mg 2011 Tablet 223 Pirantel tablet 125 2013 Tablet 224 Pirazinamid tablet 500 mg 2013 Tablet 225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet 226 Piroksikam tablet 10 mg 2013 Tablet 227 Piroksikam tablet 20 mg 2014 Tablet 228 Povidon iodida larutan 10 % (30 ml) 2014 Botol 229 Povidon iodida larutan 10 % (300 ml) 2013 Botol 230 Prednison tablet 5 mg 2011 Tablet 231 Prednison tablet 5 mg 2015 Tablet 232 Propanolol tablet 10 mg 2013 Tablet 233 Pseudoefedrin Hcl Drop 2014 Botol 234 Pseudoefedrin Hcl Drop 2015 Botol 235 Ramipril 5 mg 2014 Tablet 236 Ranitidin Hcl Sirup 2014 Botol 237 Ranitidin Hcl Sirup 2015 Botol 238 Ranitidin injeksi 2014 Ampul 239 Ranitidin tablet 150 mg 2014 Tablet 240 Ranitidin tablet 150 mg 2015 Tablet 241 Retinol (VIT A) kapsul 100.000 IU 2014 Kapsul 243 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul 242 Retinol (VIT A) tablet salut 200.000 IU 2015 Kapsul 244 Rifampisin kapsul 300 mg 2013 Kapsul 245 Ringer laktat larutan infus steril 2014 Botol 246 Saccarum Lactis 2013 Botol 247 Salbutamol nebules 2013 Kotak 248 Salbutamol nebules 2015 Kotak 249 Salbutamol tab 4 mg 2013 Tablet 250 Salbutamol tab 4 mg 2015 Tablet 251 Salbutamol tablet 2 mg Tablet 252 Salep 2-4 2011 Tube .

5 60 g. K. Lactate. Cl. Cl. Cl. K.5 60 g. Glucose 2013 Botol 290 Cairan Elektrolit Kombinasi Na. K. Lactate.253 Salisil Bedak 2 % 2014 Kotak 254 Salisil Bedak 2 % 2015 Kotak 255 Sefadroksil kapsul 500 mg 2014 Kapsul 256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol 257 Seftazidim Injeksi Ampul 258 Seftriakson injeksi 1 gram 2013 Ampul 259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul 260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet 261 Simetidin tab 200 mg 2014 Tablet 262 Simvastatin tablet 10 mg 2015 Tablet 263 Simvastatin tablet 20 mg 2015 Tablet 264 Siprofloksasin tablet 500 mg 2014 Tablet 265 Siprofloksasin tablet 500 mg 2015 Tablet 266 Siprofloksasin tablet 500 mg 2015 Tablet 267 Sulfacetamida Natrium tetes mata 2013 Botol 268 Sulfacetamida Natrium tetes mata 2015 Botol 269 Teofilin Tablet 2013 Tablet 270 Tetrasiklin kapsul 500 mg 2011 Kapsul 271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet 272 Tiampenikol kapsul 500 mg 2014 Kapsul 273 Tramadol inj 50 mg/ml 2014 Ampul 274 Tramadol kapsul 50 mg 2014 Kapsul 275 Triamcinolon Acetonide 1 mg krim 2014 Tube 276 Triamsinolon Tablet 2013 Tablet 277 Triheksifenidil tab 2 mg 2014 Tablet 278 Vitamin B Komplek 2014 Tablet 279 Vitamin B Komplek 2015 Tablet 280 Zink tablet 20 mg 2014 Tablet 281 Albendazol suspensi 200mg/5ml 2013 Botol 282 Anti Hipertensi Herbal 2015 Tablet 283 Anti Oksidan Tablet 2013 Tablet 284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube 285 Antispasmodik Inj 2013 Ampul 286 Antispasmodik kombinasi 2014 Tablet 287 Antispasmodik kombinasi 2015 Tablet 288 Budesonid respules/ cairan inhaler 2014 Pcs 289 Cairan Elektrolit Kombinasi Na. K.Ca. Nacl 9 g 2015 Botol 296 Carbamazochrome Na Sulfonate Inj 2013 Ampul 297 Curcuma Tab 2013 Tablet 298 Enzim Pencernaan 2013 Tablet 299 Fenoterol nebules solution 2013 Botol 300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs 301 Isoxsuprine Hcl Tablet 2013 Tablet .Ca. Glucose 2015 Botol 292 Cairan Elektrolit Kombinasi Na.Asetat 2014 Botol 293 Cairan Elektrolit Kombinasi Na. Glucose 2014 Botol 291 Cairan Elektrolit Kombinasi Na. Nacl 9 g 2014 Botol 295 Cairan Hydroxyethyl Strach (HES )200/0. Cl. Cl.Asetat 2015 Botol 294 Cairan Hydroxyethyl Strach (HES) 200/0.

fenilmerkuri 2013 305 nitrat 0.5 mg Supp 308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet 309 Krim Analgesik 2013 Tube 310 Krim Antiinflamasi 2013 Tube 311 Lactulose Sirup 2014 Botol 312 Lactulose Sirup 2015 Botol 313 Mineral mix. Kalium Iodida 0. Natrium Tiosulfat 0.electrolytes 2013 Botol Kombinasi CaCl2 anhidrat 0.075 gram.1 % + 340 2014 Tube Neomisin Sulfat 341 Siproheptadine Hcl Tablet 2013 Tablet 342 Sirup Besi Kombinasi 2013 Botol 343 Suplemen Ibu Menyusui 2014 Tablet 344 Suplemen Ibu Menyusui 2015 Tablet 345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet 346 Suplemen Untuk Gizi Anak 2014 Sachet . kombinasi 2015 Sachet 315 Mometasone Furoate Krim 2013 Tube 316 Multivitamin anak sirup 2014 Botol 317 Multivitamin anak sirup 2015 Botol 318 Multivitamin dewasa 2014 Tablet 319 Multivitamin dewasa 2015 Tablet 320 Natrium Fe EDTA drop 2013 Botol 321 Nistatin dan Zn Oxide Salep 2013 Tube 322 Norethisterone Tablet 2013 Tablet 323 Obat Antianemia 2014 Tablet 324 Obat Antianemia 2015 Tablet 325 Obat Antianemia 2015 Tablet 326 Obat Antifungi Drop 2014 Botol 327 Obat Antifungi Drop 2015 Botol 328 Obat Batuk Hitam + Parasetamol 2014 Botol 329 Obat Flu dan Batuk Sirup 2014 Botol 330 Obat Flu Tablet 2014 Tablet 331 Obat Flu Tablet 2015 Tablet 332 Obat Hepatoprotektor 2014 Tablet 333 Obat luka bakar 2014 Tube 334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul 335 Permetrin krim 5% 10 g 2014 Tube Policresulen (Produk kondensasi dari asam 336 2014 Botol metakresolsufonat dan Methanal) Policresulen (Produk kondensasi dari asam 337 2015 Botol metakresolsufonat dan Methanal) 338 Povidon iodin gargle 2014 Botol 339 Procaterol Hcl. kombinasi 2014 Sachet 314 Mineral mix.3 mg Botol Kombinasi Lactobacillus+ 306 2013 Tablet Bifidobacterium+Streptococcus Kombinasi Policresulen (Condensation product of metacresolsulfonic acid & methanal) 100 mg. 2013 307 cinchocaine HCl 2. Hemihydrate 2013 Tablet Salep Kombinasi : Betametason valerat 0.Vitamin.075 gram.302 Klopidogrel 75 mg 2014 Tablet 303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet 304 Kombinasi Amino Acid.0075 gram.

5 mg/ml 2013 Ampul 353 Tiotropium Br 2013 Pcs 354 Valsartan 80 mg 2014 Tablet 355 Vitamin Neurotopik 2013 Tablet 356 Vitamin Neurotopik 2015 Tablet 357 Vitamin Neurotopik inj.5 2015 Syringe 391 Trikresol Formalin 2014 Botol 392 Alat suntik sekali pakai 1 ml 2012 Pcs 393 Alat suntik sekali pakai 2. Kombinasi (vit B1+ B6+ B12) 2015 Ampul 359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol 360 Zink Syrup 2014 Botol 361 Alveogyl 2014 Botol 362 Bonding 2013 Botol 363 Cairan Pembersih Gigi 2015 Botol 364 Cresophen 2014 Botol 365 Devitalisasi pasta non arsen 2014 Kotak 366 Etching 2013 Pcs 367 Etching 2015 Pcs 368 Etil klorida semprot 2014 Botol 369 Eugenol cairan 2012 Botol 370 Fletcher Cairan 2014 Botol 371 Fletcher Serbuk 2014 Botol 372 Fletcher serbuk dan cairan 2012 Botol 373 Glass Ionomer cement Art 2014 Set 374 Glass Ionomer cement Art 2015 Set 375 Kalsium Hidroksida pasta 2014 Set 376 Metronidazol Gel untuk Peridonitis 2014 Tube 377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol 378 Mummifying pasta 2014 Set 379 OCO 2014 Botol 380 Pasta Iodoform 2014 Kotak 381 Pulperyl 2014 Botol 382 Semen seng fosfat serbuk 2014 Set 383 Tambal Sementara Untuk Gigi 2015 Botol 384 Tambal Sementara Untuk Gigi Belakang 2014 Botol 385 Tambal Sementara Untuk Gigi Depan 2014 Botol 386 Tambal Sinar Warna A2 2013 Syringe 387 Tambal Sinar Warna A2 2015 Syringe 388 Tambal Sinar Warna A3 2014 Syringe 389 Tambal Sinar Warna A3.5 2013 Syringe 390 Tambal Sinar Warna A3. mg/ml 2014 Pcs 352 Terbutalin Sulfate 0. Kombinasi (vit B1+ B6+ B12) 2014 Ampul 358 Vitamin Neurotopik inj.347 Suplemen Untuk Gizi Anak 2015 Sachet 348 Suplemen untuk sendi dan tulang 2014 Tablet Suplemen Untuk Stimulasi Sistem Imunitas Dewasa 349 Tablet 2013 Tablet 350 Tamsolusin Hcl Tablet 2013 Tablet 351 Terbutalin cairan ih 2.5 ml 2012 Pcs 394 Alat suntik sekali pakai 5 ml 2012 Pcs 395 Alat Suntik 3 cc 2013 Pcs .

5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs .396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.1 % (Rivanol) 2015 Botol 424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.5 2014 Pcs 428 Hand Scoon (Steril) # 6.v catheter 2014 Pcs 422 Etakridin larutan 0.

445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No. 20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs 481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs . 18 with injection Port 2014 Pcs 455 IV Chateter No.

3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs 538 Wing Needle No. 14 2013 Pcs 504 NGT No.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu .23 G 2013 Pcs 540 Wing Needle no.21 G 2013 Pcs 539 Wing Needle No.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula. 8 2013 Pcs 501 NGT No.adult) 2015 Pcs 528 Silk Benang bedah no. 12 2013 Pcs 503 NGT No. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula. 16 2013 Pcs 505 NGT No.27 2014 Pcs 500 NGT No.7 2014 Pcs 519 Plastik klip 13 x 8.498 Mucus Ekstractor 2014 Pcs 499 Needle no.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula. 10 2013 Pcs 502 NGT No.25 2013 Pcs 541 Wing Needle no.

Si.S. 19781102 200604 1 015 . Suharno. Mengetahui.Kes) (Irwan Hartono..Apt) NIP. 19600924 198501 1 001 NIP. Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs.M.

0 - 95.155. 0 - 1.00 0 140. 0 - .00 72.520. 0 - .00 0 95.225.00 . 0 - .00 .00 0 100. 0 - . 0 - 140. 0 - 1.215.00 0 1.00 .00 100. 0 - 30.735.520.00 81. 0 - .00 .00 0 150.00 0 50.00 0 2.00 .00 .155.00 0 5.00 0 3.370.00 0 122.00 150.00 . 0 - 2.00 .00 . 0 - 93.00 5.00 0 411.00 0 30.215. 0 - 2. 0 - 1.00 762.370.00 7.580.00 411. 0 - . 0 - .225. 0 - 175.00 0 81.00 0 762.735.00 . LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .820.00 0 7.00 0 150. 0 - 50. 0 - 122.580.250.250.00 2.820.00 .00 0 2.00 150.00 0 1.00 .00 0 93.00 0 72.00 0 1.00 0 175.00 3.00 0 2.

00 59.00 0 200.00 0 171.00 0 22.00 . 0 - 34.00 420. 0 - 10. 0 - . 0 - 22.00 0 600. 0 - 28.00 0 820.00 0 28. 0 - . 0 - 194.00 .00 . 0 - . 0 - 100.00 111. 0 - 200.00 330. 0 - . 0 - 7.00 0 250.00 0 50.00 0 330.00 160. 0 - 164.00 0 194. 0 - 8.00 0 164.00 . 0 - .00 .00 .00 0 111. 0 - 171.00 0 564.00 .00 0 34.00 0 10.00 564.00 . 0 - .00 0 28.00 .00 . 0 - 1.00 50.00 0 800. 600.00 .00 410.00 0 7.190.00 0 100.00 0 410.00 0 1. 0 - .260.770.00 0 609.190.00 .00 0 59.00 .00 0 420. 0 - 820.260. 0 - .770.00 0 100. 0 - 800. 0 - .00 0 160.00 250.00 .00 . 0 - .00 0 8.00 609.00 0 5. 0 - 100.00 28.00 .00 5.

235.00 .00 0 16.00 . 0 - 5.00 460.00 0 29.00 0 78. 0 - .00 0 460.00 0 18.00 . 0 - 16. 0 - 1. 0 - 48.00 . 0 - 990.290. 0 - 97.00 733. 0 - .00 2.00 . 0 - 2.00 0 240.00 0 590.00 0 330.080.00 0 122.00 0 460.00 0 755.00 0 11.00 .186. 0 - 5. 0 - .055. 0 - .00 .00 0 990.00 0 67.00 0 5. 0 - 714.620.00 610.00 .00 500. 0 - 1.00 .00 0 2.00 .00 0 97.00 0 1.290.110.00 0 94.080.00 5.00 18.00 0 714. 0 - .00 . 0 - 11.00 0 733. 0 - .00 . 0 - 122.00 0 5.00 . 0 - 400.00 0 48.00 29.00 240.00 .055.00 0 2.110. 755. 0 - 78.00 .186.00 460.00 2.00 94.00 .00 0 1.00 0 500.620.00 0 610.00 .00 0 400.00 .235.00 0 5. 0 - 330. 0 - 67.00 0 2. 0 - 590.

0 - .00 0 200. 0 - .00 0 3.040. 0 - 38. 0 - 380.00 0 480.00 0 610. 0 - 1.00 404. 0 - . 0 - 111.594.00 .00 . 0 - 3.00 .00 . 0 - 187.00 .00 .00 .000. 0 - 29.450.00 0 380.00 0 750.00 610.805.000. 0 - 240.040. 0 - .00 0 111.00 0 9.00 .00 0 1.00 1.00 0 1.00 0 100. 0 - . 0 - 199.00 . 0 - 137.805.00 0 199.00 0 76.00 .00 0 203.594.00 0 199.00 6.00 0 404. 0 - 1.00 0 29.00 . 0 - 480.00 0 240.00 .00 199.00 0 1.00 . 0 - 100.00 .00 0 137.00 0 38. 0 - 200.450. 0 - . 0 - 1. 203. 0 - 76.00 0 187. 0 - . 0 - .00 .00 .00 . 0 - 750.00 . 0 - .00 0 1.00 . 0 - 9.00 0 6.

950. 0 - 50. 0 - .00 .00 . 0 - .00 .00 0 190.800.00 .00 0 1.00 .420.00 .00 .420.010.00 0 365.079.00 0 50. 0 - .079.00 .050. 0 - 21. 0 - . 0 - . 0 - .00 0 59.00 0 50.00 0 12. 0 - 90. 0 - 2.950.00 0 30. 0 - 11. 0 - .00 0 20.00 0 100.00 0 31.00 0 2.624. 0 - 59.00 .00 2.00 0 551.00 100.00 31.00 0 200. 0 - . 0 - 200.00 0 25. 0 - 1.00 190.00 . 0 - 208.00 .00 0 600.800.00 50.00 0 3.050.00 .00 .624.00 0 425. 0 - 3.00 20. 0 - 425.00 . 0 - .00 . 0 - 600. 0 - 365. 0 - . 0 - .00 12. 0 - . .00 0 11.00 .00 0 10.00 0 90.00 0 2. 0 - 25. 0 - 1.00 0 208.00 551. 0 - 30.010.00 0 1.00 0 21.00 10.

00 0 270.640.00 0 48.00 . 0 - .00 .240.00 0 3.00 0 5.00 560.00 6. 0 - 5.00 0 10.00 0 30.090.00 0 2.00 630. 0 - 30. 0 - .130. 0 - 270.00 0 630.00 .00 210. 0 - 30. 0 - 48.00 300.000.00 0 22.00 0 4.00 .00 0 2.00 0 2. 0 - . 0 - .00 0 300.00 0 210.00 740.00 0 30. 0 - . 0 - 73.00 0 1.00 0 3.00 1.00 4.00 .00 .00 0 30.180.00 0 99.000. 0 - 22.305.00 3.00 0 1.00 0 740.00 0 290.240.740.305. 0 - 290.00 0 73. 0 - .090.00 .00 .00 .00 1.00 99.00 .00 0 560. 0 - .00 2. 0 - 10. 0 - 2. 0 - 30. 0 - .130.00 2.00 0 155.640. .180. 0 - 3.00 0 6. 0 - .00 .00 .00 . 0 - 155. 0 - .740.

00 190. 0 - 2.420. 0 - .00 0 190. 0 - . 0 - 24.00 . 0 - . 0 - .00 3. 0 - 31.00 285.00 .00 0 31. 90.00 0 285. 0 - 210. 0 - .00 0 9.020.00 .00 .00 0 683.00 .00 .00 10. 0 - 9.00 0 10. 0 - .00 0 24.420. 0 - .00 . 0 - 425. 0 - . 0 - .00 . 0 - . 0 - . 0 - . 0 - . 0 - .00 .00 0 338.00 .00 0 425.00 1. 0 - 66.00 0 210. 0 - 338.00 0 750. 0 - 683. 0 - . 0 - 750.00 .00 0 90.00 0 24. 0 - 24.00 .00 0 66.00 0 1. 0 - .00 0 100.00 0 2.00 0 3.00 100.020.

00 0 1.00 .00 2. 0 - . 0 - 2.00 0 5. 0 - 115.00 1.00 0 2.00 0 4.00 0 2.00 .00 2. 0 - 2.00 0 2.00 .00 . 0 - 2. 0 - 3.00 3. 0 - .00 . 0 - 30. .00 0 1.00 . 0 - 2.00 1. 0 - .00 0 1.00 1. 0 - .00 .00 0 1.00 .00 800.00 .00 0 2.00 2.00 0 1.00 .00 0 2.00 0 800.00 0 3.00 . 0 - 1.00 0 2.00 0 115. 0 - 1.00 0 30.00 .00 0 3.00 0 450. 0 - 4.00 .00 2. 0 - 2.00 1.00 .00 . 0 - 510.00 0 2. 0 - 3. 0 - .00 2.00 0 1.00 .00 0 2.00 0 42. 0 - 5.00 0 2. 0 - 450.00 0 2. 0 - 42. 0 - .00 0 3.00 0 510.

157.600.00 60.00 .00 0 48.00 0 500. 0 - .157. 0 - 400.00 0 26. 0 - 7.00 0 3.00 0 100.600.00 0 1.00 0 7. 0 - 350.00 500.00 0 100. 0 - 48. 500. 0 - 200. 0 - 57.00 0 60. 0 - 100.00 0 72. 0 - .00 0 1.00 .00 26.00 0 350.00 1. 0 - 1. 0 - 100.00 .00 0 4.00 .00 .00 0 200.00 0 400.00 3.00 .00 .00 0 57.00 0 500.00 3.00 .00 .00 .00 .00 0 100.00 0 302.00 0 288.00 . 0 - 12.00 0 12.00 26.00 .00 0 26.00 302. 0 - 400. 0 - 12.00 . 0 - .00 0 200. 0 - . 0 - .00 . 0 - . 0 - .00 72. 0 - .00 0 400.00 200.00 0 12. 0 - 4.00 288.00 0 3. 0 - . 0 - 100.

00 118.00 0 118. 0 - 3.00 0 10.00 0 12.00 50.00 .00 .00 50. 0 - . 0 - 12. 100.00 .00 0 15. 0 - . 0 - 13.00 33.000.00 300.00 0 5.00 182.00 .00 2. 0 - .00 29.00 0 72.00 . 0 - 23.00 10. 0 - .00 0 33.00 . 0 - 10. 0 - 5.00 5.00 . 0 - .00 .00 . 0 - .00 977.00 0 15.00 0 30. 0 - 50.00 60.00 0 60.00 0 23.00 0 29.00 0 50.00 0 50.00 0 13.00 0 977. 0 - .00 0 10. 0 - .00 .00 0 400.00 0 5.00 0 5. 0 - .00 0 99.00 665.00 0 665.000.00 0 3. 0 - .00 .00 72. 0 - . 0 - 3. 0 - 5.00 0 100. 0 - 30.00 0 100.00 .00 15.00 100. 0 - .00 99.00 400.00 0 2.00 0 182.00 0 50. 0 - 15.00 0 300.00 0 3.

0 - 109. 0 - . 0 - .00 23. 0 - .000.00 170.00 0 20.00 0 75.00 0 98. 0 - 20.00 0 100.000. 0 - .00 0 134.00 0 32.00 0 165.00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara . 0 - . 0 - . 0 - 100.00 68. 0 - . 0 - 55.00 0 36.00 8.000. 0 - .00 0 55.00 0 170. . 0 - 134.00 .00 .00 0 8.00 420.000. 0 - .00 . 0 - .00 38. 0 - 98.00 0 38.00 0 100.00 100.00 . 0 - .00 32.00 .00 0 68.00 .000.000. 0 - .00 .000. 0 - . 0 - 165.00 50. 0 - .00 0 50.00 0 109. 0 - .000. 0 - . 0 - 75.00 0 420.00 36. 0 - . 0 - .00 0 23.

) 604 1 015 NIP. . Yang Meminta Kepala UPT Puskesmas (…………………………………….

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Tangerang Selatan . Yang Menerima Petugas Puskesmas (………………………..) NIP.………………. ..

November 2016 Desember 2016 PEMBERIAN 12 .

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enerima
Puskesmas

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PUSKESMAS : Jurangmangu
KECAMATAN :
KOTA : TANGERANG SELATAN
PROVINSI : BANTEN

No NAMA OBAT TAHUN SATUAN
1 2 3 4
1 Allopurinol tablet 100 mg 2014 Tablet
2 Allopurinol tablet 100 mg 2015 Tablet
3 Ambroksol Syrup 15 mg / ml 2014 Botol
4 Ambroksol Syrup 15 mg / ml 2015 Botol
5 Ambroksol tablet 30 mg 2014 Tablet
6 Ambroksol tablet 30 mg 2015 Tablet
7 Aminofilin inj 24 mg /ml 2014 Ampul
8 Aminofilin tab 200 mg 2014 Tablet
9 Amitriptilin HCl tablet salut 25 mg 2014 Tablet
10 Amitriptilin HCl tablet salut 25 mg 2015 Tablet
11 Amlodipin 10 mg 2015 Tablet
12 Amlodipin 5 mg 2015 Tablet
13 Amoksisilin + As. Klavulanat 2013 Tablet
14 Amoksisilin kaplet 250 mg 2013 Tablet
15 Amoksisilin kaplet 500 mg 2014 Tablet
16 Amoksisilin kaplet 500 mg 2015 Tablet
17 Amoksisilin sirup kering 125 mg/5 ml 2014 Botol
18 Amoksisilin sirup kering forte 250mg/ml 2015 botol
19 Antasida DOEN tablet 2014 Tablet
20 Antasida DOEN tablet 2015 Tablet
21 Antasida DOEN Suspensi 2014 Botol
22 Antasida DOEN Suspensi 2015 Botol
23 Anti Bakteri DOEN salep 2013 Tube
24 Anti Bakteri DOEN salep 2015 Tube
25 Anti Fungi DOEN kombinasi salep 2013 Pot
26 Anti Hemmoroid DOEN supp 2014 Supp
27 Anti Hemmoroid DOEN supp 2015 Supp
28 Anti migren / Ergotamin 2013 Tablet
29 Aqua Pro Injeksi steril @ 20 2014 Vial
30 Asam Asetilsalisilat 80 mg 2014 Tablet
31 Asam Asetilsalisilat 80 mg 2015 Tablet
32 Asam Asetilsalisilat 100 mg 2011 Tablet
33 Asam Askorbat (Vit. C) tablet 100 mg Tablet
34 Asam Askorbat (Vit. C) tablet 50 mg 2014 Tablet
35 Asam Folat tab 1 mg 2013 Tablet
36 Asam Folat tab 1 mg 2015 Tablet
37 Asam Mefenamat Tablet 500 mg 2014 Tablet
38 Asam Mefenamat Tablet 500 mg 2015 Tablet
39 Asam Mefenamat Tablet 500 mg 2015 Tablet
40 Asam Tranexamat 250mg 2013 Tablet
41 Asam Tranexamat Injeksi 2013 Ampul
42 Asiklovir krim 5% 2013 Tube

43 Asiklovir Tablet 200 mg 2013 Tablet
44 Asiklovir Tablet 200 mg 2015 Tablet
45 Asiklovir Tablet 400 mg 2013 Tablet
46 Atapulgit 2011 Tablet
47 Atapulgit 2015 Tablet
48 Atropin Injeksi 0.25 mg/ml-1 ml 2010 Ampul
49 Atropin Injeksi 0.25 mg/ml-1 ml 2015 Ampul
50 Atropin sulfat tablet 0.5 mg 2014 Tablet
51 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2013 Tablet
52 Besi II Sulfat 200 mg + As. Folat (Tambah darah) 2015 Tablet
53 Betahistin mesilat 2014 Tablet
54 Betametason Krim 2013 Tube
55 Betametason Krim 2015 Tube
56 Bisakodil supp 10 mg 2014 Supp
57 Bisakodil supp 10 mg 2015 Supp
58 Bisoprolol tab 5 mg 2014 Tablet
59 Bormheksin solution 2013 Botol
60 Cetrizine Sirup 5 mg/5 ml 2013 Botol
61 Cetrizine 10 mg 2014 Tablet
62 Deksametason injeksi 5 mg/ml 2013 Ampul
63 Deksametason injeksi 5 mg/ml 2015 Ampul
64 Deksametason tablet 0.5 mg 2013 Tablet
65 Deksametason tablet 0.5 mg 2015 Tablet
66 Diazepam Inj 5 mg/ml 2013 Ampul
67 Diazepam supp 2014 Supp
68 Diazepam supp 2015 Supp
69 Diazepam tab 2 mg 2013 Tablet
70 Difenhidramin inj 10 mg/5ml-1ml 2013 Ampul
71 Digoksin tablet 0.25 mg 2014 Tablet
72 Digoksin tablet 0.25 mg 2015 Tablet
73 Dimenhidrinat tab 50 mg 2011 Tablet
74 Doksisiklin kapsul 100 mg 2010 Kapsul
75 Domperidon suspensi 5 mg/5ml 2014 Botol
76 Domperidon suspensi 5 mg/5ml 2015 Botol
77 Domperidon 10mg 2013 Tablet
78 Efedrin HCl tablet 25 mg 2014 Tablet
79 Ekstraks belladona tab 10 mg 2013 Tablet
80 Epinefrin / Adrenalin inj 0.1 % 2013 Ampul
81 Eritromisin kapsul 250 mg 2013 Kapsul
82 Eritromisin kapsul 500 mg 2013 Kapsul
83 Eritromisin sirup 200mg/5 ml 2014 Botol
84 Eritromisin sirup 200mg/5 ml 2015 Botol
85 Etambutol tablet 250 mg 2011 Tablet
86 Fenobarbital tablet 30 mg 2010 Tablet
87 Fenobarbital tablet 30 mg 2015 Tablet
88 Fenoksimetil Penisilin tablet 250 mg 2010 Tablet
89 Fenoksimetil Penisilin tablet 500 mg 2013 Tablet
90 Fenol Gliserol tetes telinga 10-% 2013 Botol
91 Fitomenadion (Vit K1) tablet gula 10 mg 2013 Tablet
92 Fitomenadion (Vit K1) tablet gula 10 mg 2015 Tablet
93 Fitomenadion (Vit K1)inj 10 mg/ml-1ml 2013 Ampul
94 Fitomenadion 2 mg inj 2013 Ampul
95 Fitomenadion 2 mg inj 2015 Ampul

96 Furosemid tab 40 mg 2014 Tablet
97 Garam oralit serbuk kombinasi 2013 Bungkus
98 Garam oralit serbuk kombinasi 2015 Bungkus
99 Gemfibrozil kapsul 300 mg 2014 Kapsul
100 Gentamisin inj 40 mg/ml 2014 Ampul
101 Gentamisin inj 40 mg/ml 2015 Ampul
102 Gentamisin salep kulit 0.1 % 2014 Tube
103 Gentamisin tetes mata 0.3% 2014 Botol
104 Gentian Violet larutan 1 % 2014 Botol
105 Glibenklamid tablet 5 mg 2014 Tablet
106 Glimepirid 2mg 2014 Tablet
107 Glimepirid 2mg 2015 Tablet
108 Gliseril Guaiakolat tablet 100 mg 2014 Tablet
109 Gliseril Liquid 2014 Botol
110 Glukosa larutan infus 10% 2014 Botol
111 Glukosa larutan infus 5% 2014 Botol
112 Glukosa larutan infus 5% 2015 Botol
113 Griseofulvin tablet 125 mg micronized 2014 Tablet
114 Griseofulvin tablet 125 mg micronized 2015 Tablet
115 Haloperidol 2010 Tablet
116 Hidroklortiazid (HCT) tablet 25 mg 2012 Tablet
117 Hidrokortison cream 2,5 % 2013 Tube
118 Hidrokortison cream 2,5 % 2015 Tube
119 Ibuprofen suppositoria 2013 Supp
120 Ibuprofen suspensi 100mg/5ml 2013 Botol
121 Ibuprofen tablet 200 mg 2014 Tablet
122 Ibuprofen tablet 400 mg 2013 Tablet
123 Ibuprofen tablet 400 mg 2015 Tablet
124 Isoniazid 100 mg 2011 Tablet
125 Isorbid dinitrat tablet sublingual 5 mg 2014 Tablet
126 Kalium Diklofenak 50 mg 2014 Tablet
127 Kalsium Glukonat injkesi i.v 10% (100mg/ml) 2015 Tablet
128 Kalsium laktat (Kalk) tablet 500 mg 2013 Tablet
129 Kalsium laktat (Kalk) tablet 500 mg 2015 Tablet
130 Kaptopril tablet 12,5 mg 2013 Tablet
131 Kaptopril tablet 12,5 mg 2015 Tablet
132 Kaptopril tablet 25 mg 2013 Tablet
133 Ketokonazol krim 2 % 2014 Tube
134 Ketokonazol tablet 200 mg 2014 Tablet
135 Ketokonazol tablet 200 mg 2015 Tablet
136 Ketorolac Injeksi 10 mg 2013 Ampul
137 Klindamisin kapsul 150 mg 2013 Kapsul
138 Klindamisin kapsul 300 mg 2014 Kapsul
139 Kloramfenikol kapsul 250 mg 2013 Kapsul
140 Kloramfenikol salep mata 1 % 2013 Tube
141 Kloramfenikol salep mata 1 % 2015 Tube
142 Kloramfenikol sirup 60 ml 2013 Botol
143 Kloramfenikol tetes mata 0.5 % 2014 Botol
144 Kloramfenikol tetes mata 0.5 % 2015 Botol
145 Kloramfenikol tetes telinga 3 % 2014 Botol
146 Klorfeniramin maleat tablet 4 mg 2012 Tablet
147 Klorpromazin inj. i.m 25 mg/ml (HCL) 2014 Ampul
148 Kodein 10 mg 2013 Tablet

149 Kotrimoksazol suspensi 2014 Botol
150 Kotrimoksazol suspensi 2015 Botol
151 Kotrimoksazol tablet pead 2010 Tablet
Kotrimosazol tablet. Komb: Sulfametoksazol 400 mg +
152 2013 Tablet
Trimetoprim 80 mg
Kotrimosazol tablet. Komb: Sulfametoksazol 400 mg +
153 2015 Tablet
Trimetoprim 80 mg
154 Levofloksasin 500 mg Tablet
155 Lidokain Injeksi 2 % + Epinefrin 2014 Ampul
156 Lidokain injeksi 2% 2013 Botol
157 Lidokain injeksi 2% 2015 Botol
158 Linkomisin kapsul 500 mg 2014 Kapsul
159 Loperamid 2014 Tablet
160 Loperamid 2015 Tablet
161 Loratadin tablet 2 mg 2015 Tablet
162 Magnesium sulfat inj 25 ml-20 % 2012 Ampul
163 Meloksikam 15 mg 2013 Tablet
164 Meloksikam 15 mg 2015 Tablet
165 Meloksikam 7,5 mg 2014 Tablet
166 Metampiron Injeksi 2014 Ampul
167 Metampiron Injeksi 2015 Ampul
168 Metampiron tablet 500 mg 2014 Tablet
169 Metformin HCl tablet 500 mg 2015 Tablet
170 Metformin HCL tablet 850 mg 2015 Botol
171 Methisoprinol 250 mg/5ml 2014 Botol
172 Methisoprinol 500 mg 2013 Tablet
173 Methisoprinol 500 mg 2015 Tablet
174 Metilergometrin injeksi 0,200 mg-ml 2014 Ampul
175 Metilergometrin tablet salut 0,125 mg 2013 Tablet
176 Metilergometrin tablet salut 0,125 mg 2015 Tablet
177 Metilprednisolon 4 mg 2013 Tablet
178 Metoklopramide inj Ampul
179 Metoklopramide tablet 2013 Tablet
180 Metoklopramide tablet 2015 Tablet
181 Metronidazol infus 500 mg/100 ml 2014 Botol
182 Metronidazol tablet 250 mg 2014 Tablet
183 Metronidazol tablet 500 mg 2011 Tablet
184 Metronidazol tablet 500 mg 2015 Tablet
185 Mikonazol cream 2014 Tube
186 Mikonazol cream 2015 Tube
187 Natrium Diklofenak tablet 25 mg 2013 Tablet
188 Natrium Diklofenak tablet 25 mg 2015 Tablet
189 Natrium Diklofenak tablet 50 mg 2014 Tablet
190 Natrium Klorida larutan infus 0.9 % steril 2014 Botol
191 Natrium Klorida larutan infus 0.9 % steril 2015 Botol
192 Nifedipin tablet 10 mg 2014 Tablet
193 Nifedipin tablet 10 mg 2015 Tablet
194 Nistatin Tablet salut 500.000 IU 2013 Tablet
195 Nistatin tablet vaginal 100.000 IU/g 2013 Tablet
196 Nistatin tablet vaginal 100.000 IU/g 2015 Tablet
197 OAT Kategori 2 2014 Paket
198 Obat Batuk Hitam 100 ml 2013 Botol
199 Obat Batuk Hitam 100 ml 2015 Botol

200 Obat Diare Dewasa 2010 Tablet
201 Obat FDC katagori sisipan 2013 Paket
202 Oksitetrasiklin HCl salep kulit 3 % 2013 Tube
203 Oksitetrasiklin HCl salep kulit 3 % 2015 Tube
204 Oksitetrasiklin HCl salep mata 1 % 2014 Tube
205 Oksitosin injeksi 10 IU/ml 2014 Ampul
206 Omeprazol kapsul 20 mg 2014 Kapsul
207 Omeprazol kapsul 20 mg 2015 Kapsul
208 Ondansentron 4 mg 2014 Tablet
209 Ondansentron 4 mg 2015 Tablet
210 Ondansentron inj 4 mg/2 ml 2014 Ampul
211 Ondansentron inj 4 mg/2 ml 2015 Ampul
212 Ondansentron Injeksi 8 mg/ ml 2013 Ampul
213 Papaverin tablet 40 mg 2013 Tablet
214 Parasetamol drop 2014 Botol
215 Parasetamol drop 2015 Botol
216 Parasetamol sirup 120 mg / 5 ml 2014 Botol
217 Parasetamol sirup 120 mg / 5 ml 2015 Botol
218 Parasetamol Supp 2014 Supp
219 Parasetamol tablet 100 mg 2013 Tablet
220 Parasetamol tablet 500 mg 2011 Tablet
221 Parasetamol tablet 500 mg 2015 Tablet
222 Piracetam tablet 800 mg 2011 Tablet
223 Pirantel tablet 125 2013 Tablet
224 Pirazinamid tablet 500 mg 2013 Tablet
225 Piridoksin (Vitamin B6) tablet 10 mg 2013 Tablet
226 Piroksikam tablet 10 mg 2013 Tablet
227 Piroksikam tablet 20 mg 2014 Tablet
228 Povidon iodida larutan 10 % (30 ml) 2014 Botol
229 Povidon iodida larutan 10 % (300 ml) 2013 Botol
230 Prednison tablet 5 mg 2011 Tablet
231 Prednison tablet 5 mg 2015 Tablet
232 Propanolol tablet 10 mg 2013 Tablet
233 Pseudoefedrin Hcl Drop 2014 Botol
234 Pseudoefedrin Hcl Drop 2015 Botol
235 Ramipril 5 mg 2014 Tablet
236 Ranitidin Hcl Sirup 2014 Botol
237 Ranitidin Hcl Sirup 2015 Botol
238 Ranitidin injeksi 2014 Ampul
239 Ranitidin tablet 150 mg 2014 Tablet
240 Ranitidin tablet 150 mg 2015 Tablet
241 Retinol (VIT A) kapsul 100.000 IU 2014 Kapsul
242 Retinol (VIT A) tablet salut 200.000 IU 2014 Kapsul
243 Retinol (VIT A) tablet salut 200.000 IU 2015 Kapsul
244 Rifampisin kapsul 300 mg 2013 Kapsul
245 Ringer laktat larutan infus steril 2014 Botol
246 Saccarum Lactis 2013 Botol
247 Salbutamol nebules 2013 Kotak
248 Salbutamol nebules 2015 Kotak
249 Salbutamol tab 4 mg 2013 Tablet
250 Salbutamol tab 4 mg 2015 Tablet
251 Salbutamol tablet 2 mg Tablet
252 Salep 2-4 2011 Tube

253 Salisil Bedak 2 % 2014 Kotak
254 Salisil Bedak 2 % 2015 Kotak
255 Sefadroksil kapsul 500 mg 2014 Kapsul
256 Sefadroksil sirup kering 125 mg/5ml 2014 Botol
257 Seftazidim Injeksi Ampul
258 Seftriakson injeksi 1 gram 2013 Ampul
259 Sianokobalamin inj 500 mcg/ml-1 ml 2014 Ampul
260 Sianokobalamin tablet (vitamin B 12) 2011 Tablet
261 Simetidin tab 200 mg 2014 Tablet
262 Simvastatin tablet 10 mg 2015 Tablet
263 Simvastatin tablet 20 mg 2015 Tablet
264 Siprofloksasin tablet 500 mg 2014 Tablet
265 Siprofloksasin tablet 500 mg 2015 Tablet
266 Siprofloksasin tablet 500 mg 2015 Tablet
267 Sulfacetamida Natrium tetes mata 2013 Botol
268 Sulfacetamida Natrium tetes mata 2015 Botol
269 Teofilin Tablet 2013 Tablet
270 Tetrasiklin kapsul 500 mg 2011 Kapsul
271 Tiamin HCL / Mononitrat ( Vit B1 ) 2011 Tablet
272 Tiampenikol kapsul 500 mg 2014 Kapsul
273 Tramadol inj 50 mg/ml 2014 Ampul
274 Tramadol kapsul 50 mg 2014 Kapsul
275 Triamcinolon Acetonide 1 mg krim 2014 Tube
276 Triamsinolon Tablet 2013 Tablet
277 Triheksifenidil tab 2 mg 2014 Tablet
278 Vitamin B Komplek 2014 Tablet
279 Vitamin B Komplek 2015 Tablet
280 Zink tablet 20 mg 2014 Tablet
281 Albendazol suspensi 200mg/5ml 2013 Botol
282 Anti Hipertensi Herbal 2015 Tablet
283 Anti Oksidan Tablet 2013 Tablet
284 Antikonstipasi Anak dan Ibu Hamil 2013 Tube
285 Antispasmodik Inj 2013 Ampul
286 Antispasmodik kombinasi 2014 Tablet
287 Antispasmodik kombinasi 2015 Tablet
288 Budesonid respules/ cairan inhaler 2014 Pcs
289 Cairan Elektrolit Kombinasi Na, Cl, Glucose 2013 Botol

290 Cairan Elektrolit Kombinasi Na, K, Cl, Lactate, Glucose 2014 Botol

291 Cairan Elektrolit Kombinasi Na, K, Cl, Lactate, Glucose 2015 Botol
292 Cairan Elektrolit Kombinasi Na, K, Cl,Ca,Asetat 2014 Botol
293 Cairan Elektrolit Kombinasi Na, K, Cl,Ca,Asetat 2015 Botol

294 Cairan Hydroxyethyl Strach (HES) 200/0.5 60 g, Nacl 9 g 2014 Botol

295 Cairan Hydroxyethyl Strach (HES )200/0.5 60 g, Nacl 9 g 2015 Botol
296 Carbamazochrome Na Sulfonate Inj 2013 Ampul
297 Curcuma Tab 2013 Tablet
298 Enzim Pencernaan 2013 Tablet
299 Fenoterol nebules solution 2013 Botol
300 Ipatropium Br dan Salbutamol Sulphate udv 2013 Pcs
301 Isoxsuprine Hcl Tablet 2013 Tablet

302 Klopidogrel 75 mg 2014 Tablet
303 Klordiazepoksid dan Kidinium Br tablet 2013 Tablet
304 Kombinasi Amino Acid,Vitamin,electrolytes 2013 Botol
Kombinasi CaCl2 anhidrat 0.075 gram, Kalium Iodida
0.075 gram, Natrium Tiosulfat 0.0075 gram, fenilmerkuri 2013
305 nitrat 0.3 mg Botol
Kombinasi Lactobacillus+
306 2013 Tablet
Bifidobacterium+Streptococcus
Kombinasi Policresulen (Condensation product of
metacresolsulfonic acid & methanal) 100 mg, 2013
307 cinchocaine HCl 2.5 mg Supp
308 Kombinasi Vitamin dan Mineral Tablet 2013 Tablet
309 Krim Analgesik 2013 Tube
310 Krim Antiinflamasi 2013 Tube
311 Lactulose Sirup 2014 Botol
312 Lactulose Sirup 2015 Botol
313 Mineral mix, kombinasi 2014 Sachet
314 Mineral mix, kombinasi 2015 Sachet
315 Mometasone Furoate Krim 2013 Tube
316 Multivitamin anak sirup 2014 Botol
317 Multivitamin anak sirup 2015 Botol
318 Multivitamin dewasa 2014 Tablet
319 Multivitamin dewasa 2015 Tablet
320 Natrium Fe EDTA drop 2013 Botol
321 Nistatin dan Zn Oxide Salep 2013 Tube
322 Norethisterone Tablet 2013 Tablet
323 Obat Antianemia 2014 Tablet
324 Obat Antianemia 2015 Tablet
325 Obat Antianemia 2015 Tablet
326 Obat Antifungi Drop 2014 Botol
327 Obat Antifungi Drop 2015 Botol
328 Obat Batuk Hitam + Parasetamol 2014 Botol
329 Obat Flu dan Batuk Sirup 2014 Botol
330 Obat Flu Tablet 2014 Tablet
331 Obat Flu Tablet 2015 Tablet
332 Obat Hepatoprotektor 2014 Tablet
333 Obat luka bakar 2014 Tube
334 Peluruh Batu Urin / Saluran Kemih 2014 Kapsul
335 Permetrin krim 5% 10 g 2014 Tube
Policresulen (Produk kondensasi dari asam
336 2014 Botol
metakresolsufonat dan Methanal)
Policresulen (Produk kondensasi dari asam
337 2015 Botol
metakresolsufonat dan Methanal)
338 Povidon iodin gargle 2014 Botol
339 Procaterol Hcl, Hemihydrate 2013 Tablet
Salep Kombinasi : Betametason valerat 0.1 % +
340 2014 Tube
Neomisin Sulfat
341 Siproheptadine Hcl Tablet 2013 Tablet
342 Sirup Besi Kombinasi 2013 Botol
343 Suplemen Ibu Menyusui 2014 Tablet
344 Suplemen Ibu Menyusui 2015 Tablet
345 Suplemen Makanan Serbuk Kombinasi 2013 Sachet
346 Suplemen Untuk Gizi Anak 2014 Sachet

347 Suplemen Untuk Gizi Anak 2015 Sachet
348 Suplemen untuk sendi dan tulang 2014 Tablet
Suplemen Untuk Stimulasi Sistem Imunitas Dewasa
349 Tablet 2013 Tablet
350 Tamsolusin Hcl Tablet 2013 Tablet
351 Terbutalin cairan ih 2. mg/ml 2014 Pcs
352 Terbutalin Sulfate 0.5 mg/ml 2013 Ampul
353 Tiotropium Br 2013 Pcs
354 Valsartan 80 mg 2014 Tablet
355 Vitamin Neurotopik 2013 Tablet
356 Vitamin Neurotopik 2015 Tablet

357 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2014 Ampul

358 Vitamin Neurotopik inj. Kombinasi (vit B1+ B6+ B12) 2015 Ampul

359 Vitamin Untuk Pertumbuhan Tulang dan Gigi Anak Sirup 2013 Botol
360 Zink Syrup 2014 Botol
361 Alveogyl 2014 Botol
362 Bonding 2013 Botol
363 Cairan Pembersih Gigi 2015 Botol
364 Cresophen 2014 Botol
365 Devitalisasi pasta non arsen 2014 Kotak
366 Etching 2013 Pcs
367 Etching 2015 Pcs
368 Etil klorida semprot 2014 Botol
369 Eugenol cairan 2012 Botol
370 Fletcher Cairan 2014 Botol
371 Fletcher Serbuk 2014 Botol
372 Fletcher serbuk dan cairan 2012 Botol
373 Glass Ionomer cement Art 2014 Set
374 Glass Ionomer cement Art 2015 Set
375 Kalsium Hidroksida pasta 2014 Set
376 Metronidazol Gel untuk Peridonitis 2014 Tube
377 Monoklorkamfer Mentol cairan (CHKM) 2012 Botol
378 Mummifying pasta 2014 Set
379 OCO 2014 Botol
380 Pasta Iodoform 2014 Kotak
381 Pulperyl 2014 Botol
382 Semen seng fosfat serbuk 2014 Set
383 Tambal Sementara Untuk Gigi 2015 Botol
384 Tambal Sementara Untuk Gigi Belakang 2014 Botol
385 Tambal Sementara Untuk Gigi Depan 2014 Botol
386 Tambal Sinar Warna A2 2013 Syringe
387 Tambal Sinar Warna A2 2015 Syringe
388 Tambal Sinar Warna A3 2014 Syringe
389 Tambal Sinar Warna A3,5 2013 Syringe
390 Tambal Sinar Warna A3,5 2015 Syringe
391 Trikresol Formalin 2014 Botol
392 Alat suntik sekali pakai 1 ml 2012 Pcs
393 Alat suntik sekali pakai 2.5 ml 2012 Pcs
394 Alat suntik sekali pakai 5 ml 2012 Pcs
395 Alat Suntik 3 cc 2013 Pcs

396 Alat Suntik 3 cc 2015 Pcs 397 Alat Suntik 10 cc 2014 Pcs 398 Alkohol 1000 ml 2013 Botol 399 Alkohol 1000 ml 2015 Botol 400 Alkohol 70% 100 ml 2014 Botol 401 Alkohol Swab 2014 Pcs 402 Alkohol Swab 2015 Pcs 403 Aqua Jell (Ky Jelly) 2013 Tube 404 Aquabidest 500ml 2014 Botol 405 Articulating paper 2014 Kotak 406 Aseptic Gel + Dispenser 500 ml 2015 Botol 407 Blood transfusion set 2013 Pcs 408 Blood transfusion set 2014 Pcs 409 Cairan desinfektan siap pakai untuk tangan dan kulit 2014 Botol 410 Cairan desinfektan untuk perendaman instrumen gigi 2014 Botol Cairan desinfektan untuk sistem penyedotan pd alat 411 2014 Galon dental Cairan desinfektan untuk sistem penyedotan pd alat 412 2015 Botol dental 413 Cutgut 2/0 Chromic 2014 Pcs 414 Cutgut 2/0 Plain 2014 Pcs 415 Cutgut 3/0 Chromic 2014 Pcs 416 Cutgut 3/0 Plain 2014 Pcs 417 Cutgut Plain 2/0 (roll) 2013 Roll 418 Desinfektan Lantai 2014 Botol 419 Dressing Fiksasi untuk luka lebar 10 cm x 5 cm 2014 Roll 420 Dressing retention 5 cm x 5 cm 2013 Roll 421 Dressing transparant untuk pemasang i.v catheter 2014 Pcs 422 Etakridin larutan 0.1 % (Rivanol) 2015 Botol 424 Foley Catheter # 16 2013 Pcs 425 Foley Catheter # 18 2013 Pcs 426 H2O2 3% 2014 Botol 427 Hand Scoon (Steril) # 6.1 % (Rivanol) 2013 Botol 423 Etakridin larutan 0.5 2014 Pcs 428 Hand Scoon (Steril) # 6.5 2015 Pcs 429 Hand Scoon (Steril) # 7 2014 Pcs 430 Hand Scoon (Steril) # 7 2015 Pcs 431 Handscoon Non Steril L 2013 Pcs 432 Handscoon Non Steril L 2015 Pcs 433 Handscoon Non Steril M 2013 Pcs 434 Handscoon Non Steril M 2015 Pcs 435 Handscoon Non Steril S 2013 Pcs 436 Handscoon Non Steril S 2015 Pcs 437 Handscoon Non Steril S 2015 Pcs 438 Handscoon Non Steril XS 2013 Pcs 439 Handscoon panjang untuk manual plasenta 2014 Pasang 440 Handscoon panjang untuk manual plasenta 2015 Pasang 441 ID Pasien bayi biru 2014 Pcs 442 ID pasien bayi pink 2014 Pcs 443 Infus Anak 2013 Pcs 444 Infus set dewasa 2014 Pcs .

20 with injection Port 2014 Pcs 456 IV Catheter no 22 with injection Port 2014 Pcs 457 IV Catheter no 24 with injection Port 2014 Pcs 458 IV Catheter no 26 with injection Port 2014 Pcs 459 Jarum Hekting Kulit 2013 Lusin 460 Jarum Hekting Kulit 2015 Kotak 461 Jarum Hekting Otot 2013 Lusin 462 Jarum Hekting Otot 2015 Kotak 463 Jelly USG 2014 Botol 464 Kapas 1 kg 2013 Roll 465 Kapas 1 kg 2015 Roll 466 Kapas 500 g 2014 Roll 467 Kapas pembalut 250 mg 2013 Pcs 468 Kapas pembalut 250 mg 2015 Pcs 469 Kasa Hidrofil 40 y x 80 cm 2014 Roll 470 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2014 Kotak 471 Kasa Hidrofil steril 16 x 16 (isi 16 lbr) 2015 Kotak 472 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2013 Pcs 473 Kasa Hidrofil Steril 18 x22 (isi 22 lbr) 2015 Kotak 474 Kasa Pembalut Elastic 3 inchi 2014 Pcs 475 Kasa Pembalut Hidrofil 4 x 5 elastik 2011 Roll 476 Kertas Puyer Cetak (pocket medicine) 2014 Pcs 477 Kertas Puyer Cetak (pocket medicine) 2015 Pcs 478 Lisol 2011 Botol 479 Lisol 2015 Botol 480 Masker 2015 Pcs 481 Masker Nebulizer Anak 2014 Pcs 482 Masker Nebulizer Dewasa 2014 Pcs 483 Masker Tali 2013 Pcs 484 Mata bor diamond endo akses 2014 Pcs 485 Mata bor diamond fissur 2014 Pcs 486 Mata bor diamond fissur 2015 Pcs 487 Mata bor diamond high speed 2013 Set 488 Mata bor diamond inverted 2014 Pcs 489 Mata bor diamond inverted 2015 Pcs 490 Mata bor diamond rounded 2014 Pcs 491 Mata bor diamond rounded 2015 Pcs 492 Mata bor diamond tapered 2014 Pcs 493 Mata bor poles 2014 Pcs 494 Mata bor poles composite pear 2014 Pcs 495 Mata bor poles composite flame 2014 Pcs 496 Mata bor tulang gigi 2014 Pcs 497 Mata bor tulang gigi 2015 Pcs . 18 with injection Port 2014 Pcs 455 IV Chateter No.445 IUD 2010 Pcs 446 IV Catheter 18 2012 Pcs 447 IV Catheter 20 2013 Pcs 448 IV Catheter 20 2015 Pcs 449 IV Catheter 22 2013 Pcs 450 IV Catheter 22 2015 Pcs 451 IV Catheter 24 2013 Pcs 452 IV Catheter 24 2015 Pcs 453 IV Catheter 26 2013 Pcs 454 IV Chateter No.

16 2013 Pcs 505 NGT No.23 G 2013 Pcs 540 Wing Needle no.7 2014 Pcs 519 Plastik klip 13 x 8. 14 2013 Pcs 504 NGT No. 3/0 dengan jarum bedah 2014 Pcs 529 Suction Catheter Canul 6 2013 Pcs 530 Suction Catheter Canul 8 2013 Pcs 531 Suction Catheter Canul 10 2013 Pcs 532 Suction Catheter Canul 12 2013 Pcs 533 Suction Catheter Canul 14 2013 Pcs 534 Three way stopcock with 10 cm tube 2014 Pcs 535 Umbilical Klem 2014 Pcs 536 Underpad 60 x 90 2014 Pcs 537 Urine Bag 2014 Pcs 538 Wing Needle No.25 2013 Pcs 541 Wing Needle no.27 2014 Pcs 500 NGT No.27 2013 Pcs Bayar BPJS JUMLAH KUNJUNGAN RESEP Pencabutan Pencabutan Tindakan Yang Dilakukan gigi tetap gigi susu . 10 2013 Pcs 502 NGT No.child) 2014 Pcs 526 Selang O2 Dewasa (nasal oxygen canula. 18 2013 Pcs 506 Pembalut Gips 3 Inchi 2013 roll 507 Pembalut Gips 4 Inchi 2013 roll 508 Pembalut Gips 6 Inchi 2013 roll 509 Pisau Bisturi 10 2014 Pcs 510 Pisau bisturi 11 2014 Pcs 511 Pisau bisturi 15 2014 Pcs 512 Pisau Bisturi 20 2013 Pcs 513 Pisau Bisturi 22 2013 Pcs 514 Plastik klip 4 x 6 2014 Pcs 515 Plastik klip 7 x 10 2014 Pcs 516 Plastik klip 7 x 10 2015 Pcs 517 Plastik klip 8 x 5 2014 Pcs 518 Plastik klip 13 x 8. 12 2013 Pcs 503 NGT No. 8 2013 Pcs 501 NGT No.498 Mucus Ekstractor 2014 Pcs 499 Needle no.adult) 2014 Pcs 527 Selang O2 Dewasa (nasal oxygen canula.7 2015 520 Plastik kresek obat 2013 Kg 521 Plastik Limbah Medis 2015 522 Plester kain 2 x 5y 2014 Pcs 523 Plester roll kertas 1" 2014 Roll 524 Safety Box 2015 Pcs 525 Selang O2 anak (nasal oxygen canula.21 G 2013 Pcs 539 Wing Needle No.adult) 2015 Pcs 528 Silk Benang bedah no.

Yang Menyerahkan Kepala Dinas Kesehatan Kepala UPT Farmasi Kota Tangerang Selatan (Drs.Si.Apt) NIP.S. Suharno.M.. 19600924 198501 1 001 NIP. Mengetahui. 19781102 200604 1 015 .Kes) (Irwan Hartono.

0 - 50.00 .00 0 2.00 . 0 - 30.00 0 30.00 0 1. 0 - 140. 0 - 122.00 0 150.00 0 50. 0 - .00 .00 2.00 .00 .520. 0 - 1.00 0 122.00 0 150.00 81.00 411.215. 0 - .820.225.735.00 0 81.155.00 .250.370.00 762. 0 - .00 . 0 - .520.00 3.215.00 0 411.00 72. 0 - 1. LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS STOCK Lama Hari PENERIMAAN PERSEDIAAN PEMAKAIAN AWAL Pemakaian 5 6 7 8 .00 0 2.250.155.00 0 7.00 . 0 - .00 0 100.225. 0 - .00 7.00 0 5.00 0 2.00 .00 0 1.00 150. 0 - 1.00 0 762. 0 - 2.00 0 72.00 .820. 0 - 2.00 100.735.00 0 140.00 0 93.00 5. 0 - 175.00 0 95.00 0 175. 0 - 93.00 .00 150.580.00 .00 0 3. 0 - 95. 0 - .00 0 1.370.580.

0 - 164.00 564.00 0 800. 0 - . 0 - 7.00 0 194.00 0 609. 0 - 28.00 410.00 0 28. 0 - .00 0 5.00 .260.00 0 10. 600.770.00 .00 420.00 5.00 .00 .00 0 1.00 .00 0 50.00 0 34.190. 0 - 8.00 111. 0 - 171.00 0 420.190. 0 - . 0 - . 0 - 194. 0 - 22.260.00 .00 0 28. 0 - . 0 - 820. 0 - .00 .00 0 164.00 0 330.00 0 7.00 .00 0 111.00 250.00 0 160. 0 - .00 . 0 - .00 . 0 - 10.00 .00 28.00 0 8. 0 - 100.00 0 59.00 160.00 0 200.00 .00 59. 0 - 34. 0 - .00 330.00 0 820.00 0 100.00 .00 0 600. 0 - 1. 0 - 800.00 609.00 50.00 0 100.770. 0 - 100. 0 - . 0 - 200.00 0 410.00 .00 0 22.00 .00 0 171.00 0 250.00 .00 0 564.

00 . 0 - .186.00 0 460.00 0 2.00 .00 0 16.00 0 122.055.00 .00 2.00 .00 0 94. 0 - 400.00 0 590.00 0 11.00 5.00 0 67.290.00 .235.00 .00 18. 0 - .00 0 29.00 .00 460.055.00 0 5. 0 - 2.00 0 78. 755. 0 - 48.620.00 0 2.00 94. 0 - 590. 0 - 97.00 0 1.00 .00 .00 0 240.00 610. 0 - 122.00 0 5.00 0 990.00 . 0 - 1.00 0 610.080.00 733.00 .00 .00 .00 0 755.00 .00 0 500.00 0 18.00 0 48. 0 - 990.00 29. 0 - . 0 - 11. 0 - 330.00 500.00 0 400.00 .00 0 1.235.00 0 733. 0 - .00 .110.110.00 0 460.00 0 97.00 0 714. 0 - .00 240.00 2.186.00 .00 460.00 0 330. 0 - . 0 - 5. 0 - 1. 0 - 67. 0 - 16.00 0 5.080.620. 0 - 78. 0 - 714.290. 0 - 5.00 0 2.00 .

0 - 137.000. 0 - 380. 0 - .00 0 610.00 0 3.00 0 480.00 . 0 - 100.00 .00 .040.00 . 0 - 9. 0 - 1. 0 - . 0 - .805. 0 - 29. 203.00 0 9. 0 - 240. 0 - . 0 - .00 .000.00 610.00 .594.00 0 111. 0 - 1. 0 - .00 .00 .00 0 1. 0 - 480. 0 - 750. 0 - 187.00 0 404.00 0 6.00 0 137. 0 - 76.00 0 1.00 0 240.00 .00 .00 .00 .805.00 .00 0 76.00 0 100.00 0 1.00 0 38. 0 - . 0 - 200.00 6.00 0 187. 0 - .040.00 1. 0 - 199.00 0 199.00 0 29. 0 - . 0 - 111.00 .00 .00 0 380. 0 - 1.00 0 199.00 . 0 - 38.450.450.00 404.00 .00 0 200.00 . 0 - 3.00 .594.00 199.00 0 203.00 0 750.00 0 1.

0 - 3.00 0 31.050.00 0 12.00 0 10.00 .00 0 25.00 0 1.950.00 .00 .00 . 0 - .950.00 0 2.079.00 0 30.00 . 0 - 208.00 0 2. 0 - 1.00 0 365. 0 - .624. 0 - . 0 - .624.00 0 190.00 . 0 - .00 0 3. 0 - 2. 0 - 50.00 .050. 0 - . 0 - 200.00 190.00 0 11.00 31.420.079.00 0 59.00 100.00 0 50. 0 - 21. 0 - .00 12.00 0 90.010.00 . 0 - .00 0 21.010.00 0 200.00 2.00 .00 . 0 - 11. 0 - . 0 - 59.00 0 425.00 0 600. 0 - 30. 0 - 25.800.00 0 50.00 0 551. 0 - 425.00 551.00 10. 0 - 90.00 20. 0 - .00 0 100.00 . 0 - 365.00 50.00 0 20. .00 .00 . 0 - .00 0 208. 0 - 1. 0 - . 0 - 600.420.00 .00 .00 .00 0 1.800.

00 0 740.00 2.00 300.00 0 270. 0 - .00 560. 0 - 30.00 .00 0 1.00 . 0 - .00 0 22.00 1.00 740.00 0 290.00 630.00 99. 0 - 30.00 2.00 0 210.00 . 0 - .00 0 2.00 .00 . 0 - 48.00 3.180.00 0 155.00 0 30. 0 - 155.640.740.00 .00 0 300.090.00 . 0 - . 0 - 30.00 0 3.00 0 6. .00 0 30. 0 - .640. 0 - 2.00 0 2.00 0 99.00 . 0 - .00 0 73.00 0 48. 0 - . 0 - 3.00 0 30.305.130.00 6. 0 - 5.00 0 5.00 0 3.00 1. 0 - 10. 0 - 270. 0 - .090.00 0 10.00 0 1.305. 0 - 73.00 0 630.00 210.00 0 4.000.00 .00 0 560.130.000.00 .740.240. 0 - 290.00 0 2.00 .00 .180. 0 - .00 4.00 . 0 - . 0 - 22.240.

00 0 750.00 .020.00 0 24.00 0 210.00 0 24. 0 - 750.00 0 9.00 0 683. 0 - .00 3.00 .00 .00 0 425.00 . 0 - .00 0 90. 0 - . 0 - . 0 - 24. 0 - 31.00 0 1.00 10. 0 - . 0 - 425.00 .00 . 0 - .00 . 0 - . 0 - .420.420.00 0 3.00 . 0 - . 0 - .00 . 0 - 9.00 285.00 0 10.00 . 0 - .00 0 31. 0 - .00 100. 0 - 338.00 0 66.00 0 285.00 0 190.00 . 0 - .00 .00 0 338. 0 - 210.00 0 100.00 0 2. 0 - 2. 0 - 24. 90. 0 - 66. 0 - .00 190. 0 - . 0 - .020. 0 - 683.00 1.

00 0 30.00 0 2.00 2.00 0 2.00 0 2.00 .00 2.00 0 1.00 . 0 - 450.00 .00 2.00 0 2. 0 - 2.00 0 42. 0 - 2. 0 - 1.00 1.00 . 0 - . 0 - 2. 0 - .00 .00 .00 0 5.00 0 510.00 0 4. 0 - 3.00 1.00 2.00 0 2.00 2.00 .00 3.00 . 0 - .00 0 1.00 0 2.00 0 2.00 0 3. 0 - 5.00 1.00 0 1. 0 - 2. 0 - .00 0 115.00 0 2.00 0 1.00 0 450.00 .00 0 3. 0 - 115.00 .00 . 0 - 2.00 0 2.00 .00 .00 1. 0 - 3. 0 - 42.00 0 1. 0 - 1.00 0 1. . 0 - 4.00 .00 0 2. 0 - . 0 - 30.00 .00 800. 0 - .00 0 800. 0 - 510.00 .00 0 3.

00 26.00 . 0 - . 0 - .00 0 200.00 72.00 500.00 0 302.00 0 7. 0 - 100.600.00 .00 0 100.00 0 72. 0 - .00 0 100.00 .00 .00 .00 0 26. 0 - 12. 0 - 4.00 . 0 - .00 0 1. 0 - 1.00 . 0 - 100. 0 - 350.00 0 288.00 .00 .00 0 12. 0 - 7. 500.00 0 350.00 0 400. 0 - 200.00 3.00 0 500.00 . 0 - .00 0 12.600.00 0 3.00 0 100.157. 0 - .00 .00 .00 0 500. 0 - 12.00 302.00 0 3.00 0 400.00 .00 .00 0 200. 0 - 100. 0 - 57.00 0 48.00 0 4. 0 - 48. 0 - 400. 0 - 400.00 288.00 26.00 1. 0 - . 0 - .157.00 3.00 0 57. 0 - .00 .00 60.00 0 60.00 200.00 0 1.00 0 26.

00 .00 60.00 118.00 0 300.00 29. 0 - .00 .00 . 0 - 3.00 0 5.00 50. 0 - 12.00 400.00 0 15. 0 - 5.00 0 15. 0 - . 0 - . 0 - 15. 0 - .00 0 72.00 0 99.00 0 23.00 0 10.00 .00 50.00 100.00 0 5.00 0 400.00 .00 0 665.00 0 5.00 977.000. 0 - .00 .00 0 60.00 0 100. 0 - 13.00 0 50.00 .00 0 10.00 0 118.00 99.00 0 13. 0 - .00 0 50.00 . 0 - .00 0 30. 100. 0 - .00 15.00 0 12. 0 - 3.00 300.00 .00 5.00 72.00 0 50.00 33.00 182.00 10.00 0 182. 0 - .00 0 33. 0 - . 0 - .00 0 100. 0 - 5. 0 - 23.00 0 29.00 0 3.00 665.000. 0 - 10. 0 - 30.00 .00 .00 0 3.00 . 0 - 50.00 0 2.00 2.00 0 977. 0 - .

000.00 Gratis Lain-Lain Jumlah Tambal Tambal Jumlah Tetap/Permanen sementara .00 0 109.000.00 . 0 - .00 . 0 - .00 32. 0 - .000.000.000. 0 - . 0 - 100. 0 - 20. 0 - . 0 - .00 .00 170.00 0 55. 0 - 109.00 .00 0 100.00 100.00 0 23.00 0 98. 0 - . 0 - . 0 - .00 38. 0 - 134. 0 - 75. 0 - .00 36.00 50.00 .00 8.00 0 75.000.00 0 38.000.00 23. 0 - . 0 - 98.00 0 165.00 0 50.00 420.00 0 134.00 0 8.00 . 0 - 55. 0 - .00 0 68.00 0 100.00 . 0 - .00 0 36.00 0 420. .00 0 170. 0 - . 0 - 165. 0 - .00 0 20. 0 - .00 68. 0 - .000.00 0 32. 0 - .

Yang Meminta Kepala UPT Puskesmas (……………………………………. .) 604 1 015 NIP.

370.00 #DIV/0! #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 411.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 81. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 1.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 150. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 1. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 140.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 100.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 93. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 2. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 2.225. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 122.520.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 72.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 95. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 150.155.250.735. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 175.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! .820.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 7. #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 50.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 2.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 762.PLPO) PELAPORAN BULAN : Desember 2016 PERMINTAAN BULAN : Januari 2017 Pemakaian STOCK STOCK Buffer Lead Time PERMINTAAN Rata-Rata AKHIR OPTIMAL 9 10 11 #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 30.580.215.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 5.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! . #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0! 1.00 #DIV/0! #DIV/0! #DIV/0! 0 #DIV/0!