Lplpo Sistem Ifk 2021 Sept Terbaru

FORMAT LPLPO TAHUN 2021
KABUPATEN PELALAWAN
Nama Puskesmas : BERSERI PANGKALAN KERINCI

JANUARI PEMBERIAN
NO NAMA OBAT SEDIAAN Stok Awal STOK
PERMINTAAN JUMLAH KET
OPTIMUM
Penerimaan Persediaan Pemakaian Sisa Stok Inpres Askes APBD Lain2 Jumlah
OBAT GENERIK PKD
1 Allopurinol 300 mg Tablet - -

2 Allopurinol tablet 100 mg Tablet 2,700 2,700 140 2,560
3 Ambroxol 30 mg tablet Tablet - - - 2000
4 Ambroxol syr Syrup 96 96 96 - 200
5 Aminofilin injeksi 24 mg/ml - 10 ml ampul - - -
6 Aminofilin tablet 200 mg Tablet - - -
7 Amitriptilin hcl tablet salut 25 mg Tablet 2,920 2,920 2,920
8 Amlodipin 5 mg Tablet - - - 3000
9 Amlodipin 10 mg Tablet 3,000 3,000 1500 1,500 3000
10 Amoksisilin Kaplet 500 mg Tablet 10,530 10,530 1109 9,421 exp sep 20 = 5500
11 Amoksisilin kapsul 250 mg capsul 3,240 3,240 160 3,080 1000
12 Amoksisilin syrup kering 125 mg/ 5 ml Syrup 60 60 60 - 300
13 Amoksisilin+As.Klavulanat 625 mg tablet - - -
14 Antalgin( metampiron) tab 500 mg Tablet - - -
15 Antalgin injeksi 250 mg/ ml - 2 ml ampul - - -
16 Antasida Doen II Suspensi Kombinasi syrup 425 425 63 362
17 Antasida doen tablet kombinasi tablet 5,300 5,300 955 4,345 3000 exp agus 20 = 3500
18 Antibakteri doen salap kombinasi/bacitrasin tube - - -
19 Antifungi doen kombinasi tube 100 100 100
20 Antihaemaroid doen kombinasi tablet 217 217 49 168 20
21 Antimigrain doen kombinasi tablet - - -
22 Aqua proinjeksi steril , bebas pirogen botol 10 10 10
23 Aquadest steril botol - - -
24 As.Traneksamat 250 mg inj ampul 10 10 10
25 As.Traneksamat 500 mg inj ampul - - -
26 As.Traneksamat 50 mg inj ampul 10 10 5 5
27 As.Traneksamat tab 500 mg /Transamin 500mg tablet 310 310 10 300 500
28 Asam folat/Anemolat 1mg tablet 590 590 220 370 1000
29 Asam askorbat ( vit c ) tablet 250 mg tablet - - - 3000
30 Asam askorbat ( vit c ) tablet 50 mg tablet 6,939 6,939 4880 2,059 1000 exp = juli 2020 = 1000
31 Asam Mefenamat 250 mg(Stanalin) capsul - - -
32 Asam Mefenamat 500 mg tablet 16,164 16,164 771 15,393 3000 exp agus 2019 = 7809 sep 19 = 7205
33 Asam Mefenamat 50mg/5mlSuspensi Botol - - -
34 Asetosal tablet 100 mg tablet 835 835 835 exp sept 2019 = 835
35 Asetosal tablet 500 mg tab - - -
36 Asetil sistein 200mg tab 5,860 5,860 615 5,245 3000
37 Asifit Kapsul - - -
38 Asiklovir cream 5 % tube - - -
39 Asiklovir tablet 200 mg tablet 1,649 1,649 35 1,614
40 Asiklovir tablet 400 mg tablet - - - 1000
41 Atropin sulfat injeksi 0,25 mg/ml - 1 ml ampul 100 100 100
42 Atropin sulfat tab 0,5 mg tablet - - -
43 Attapulgite 300 mg/Pularex tab tablet - - -
44 Attapulgite 600 mg tablet - - -
45 Atorvastatin 20mg tablet 480 480 480 exp feb 2020 = 480
46 Benzatin benzil penisilin in 2,4 juta iu/vial ampul - - -
47 Besi II Sulfat 250mg+As Folat 0,25mg tablet - - -
48 Betahistin Mesilat Tablet 6mg tablet - - -
49 Betametason krim 0,1 % tube 273 273 14 259
50 Bisoprolol tab 5mg tablet 110 110 50 60
51 Bisakodil 5mg supp/ Dulcokax/Stolax suppositoria 36 36 36
52 Bisakodil 10 mg supp/ Dulcokax/Stolax suppositoria - - -
53 Bisakodil 5Mg tablet/ Dulcokax/Stolax tablet 2,074 2,074 2,074 exp jun 2019= 660 juli 2019 = 900
54 Burnazin crem tube - - -
55 Bromheksin HCl syrup/ Hustab syr Syrup - - -
56 Ceterizine 10 mg tablet - - - 2000
57 Cetirizin syr 5 mg/5 ml Syrup 112 112 15 97 50
58 Deksametason inj. 5 mg/ml - 1 ml ampul 255 255 255 exp feb 2020 = 165 exp april 20 = 90
59 Deksametason tablet 0,5 mg tablet 1,900 1,900 830 1,070 2000
60 Deksametason + desklorpheniramin maleat/Dextamin/Etadexta/Pritacort tablet - - - 1000
61 Desoximethason crem/Denomix crem tube 69 69 69 exp agus 2019 = 69
62 Diazepam inj 5 mg/ml ampul 122 122 10 112
63 Diazepam tablet 2 mg tablet 100 100 100
65 Diazepam rektal tube 5 5 5
66 Dietilkarbamazin sitrat tablet 100 mg tablet 100 100 100
67 Difenhidramin hcl inj. 10 mg / ml -1 ml ampul 115 115 115 exp april 19 = 68
68 Digoksin tablet 0,25 mg tablet 700 700 700
69 Diltiazem tablet 30 mg tablet - - -
70 Domperidon 10 mg tablet 800 800 70 730 1000
71 Domperidon Drops syrup - - -
72 Domperidon Suspensi syrup - - - 50
73 Doxicyclin 100mg tablet 1,800 1,800 1,800 500 exp okt 19 = 1400
74 Echinature Kap Kapsul - - -
75 Echinature Kids syr Syrup - - -
76 Efedrin hcl tablet 25 mg tablet - - -
77 Ekstrak belladone tablet 10 mg tablet 1,064 1,064 1,064 exp mei 19 = 1064
78 Epinefrin hcl/bitatrat (adrenalin) in.0,1 % - 1 ml ampul - - -
79 Erithromicyn Syr Syrup - - -
80 Erytromicin 250 mg Kapsul - - -
81 Erytromicin 500 mg tablet 800 800 30 770 300
82 Etakridin ( rivanol ) larutan 0,1 % 100ml larutan 76 76 4 72
83 Etakridin ( rivanol ) larutan 0,1 % 300ml larutan - - -
84 Etambutol hcl tablet 250 mg tablet - - -
86 Etanol 70 % 100ml larutan - - -
87 Etanol 70 % 1000ml larutan 23 23 1 22 10
88 Famotidin 20 mg tablet - - -
89 Famotidin 40 mg tablet - - - 1000
90 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 180 180 180
91 Fenobarbital tablet 100 mg Tablet - - -
92 Fenobarbital tablet 30 mg Tablet 1,010 1,010 130 880 1000
93 Fenoksimetil penisilina tablet 250 mg Tablet - - -
95 Fenol gliserol tetes telinga 10 % larutan - - - 25
96 Fitomenadion (vit k 1) inj 10 mg/ml - 1ml ampul - - -
97 Fitomenadion (vit k 1) tab salut 10 mg tablet 1,130 1,130 40 1,090
98 Fitomenadion inj 2 mg/Infan ampul 2,683 2,683 2,683 exp juni 18 =122
99 Fituno Kapsul - - -
100 Flunarizine tab 5 mg tablet - - - 200
101 Furosemida injeksi ampul - - -
102 Furosemida tablet 40 mg tablet 498 498 14 484
103 Garam oralit untuk 200 ml air sacc 462 462 53 409 1000
104 Gentamycin Inj 80mg ampul 334 334 334 exp = okt 20 = 334
105 Gentamycin salp kulit tube - - - 100
106 Gentamycin Tts Mata 0,3% larutan 128 128 4 124
107 Gentian violet larutan 1 % larutan 24 24 24 25
108 Glibenklamid tablet 5 mg tablet 11,580 11,580 550 11,030
109 Gliseril guayakolat tablet 100 mg tablet - - - 2000
110 Gliserin larutan - - -
111 Glukosa larutan infus 10 % steril larutan - - -
113 Glukosa larutan infus 5 % steril larutan 57 57 57 exp= sept 20 = 57
114 Griseofulvin tablet 125 mg , micronized tablet 2,387 2,387 2,387
115 Haloperidol tablet 0,5 mg tablet 40 40 40
116 Haloperidol tablet 1,5 mg tablet 1,088 1,088 60 1,028 500
117 Haloperidol tablet 5 mg tablet 4,960 4,960 120 4,840 500 exp juli 19 =404 feb 20 = 90
118 Hidroklorotiazid ( hct ) tablet 25 mg tablet 388 388 388 500
119 Hidrokortison krim 2,5 % tube 317 317 39 278 50
120 Ibuprofen Suspensi syrup 50 50 50 exp juni 19 = 50
121 Ibuprofen tab tablet - - -
122 Ibuprofen tablet 200 mg tablet - - - 1000
123 Ibuprofen tablet 400 mg tablet 2,590 2,590 776 1,814 3000
124 Ichtiol zalf 30 gr pot - - - 50
125 Isoniazid tablet 100 mg tablet - - -
126 Isoniazid tablet 300 mg tablet 900 900 900
127 Isosorbit dinitrat tablet subligual 5 mg tablet 1,890 1,890 1,890
128 Itraconazole 100 mg tablet 240 240 240 exp sept 19 = 240
129 Kalium Diklofenak 50mg tablet - - -
130 Kalium Permanganat serbuk pot - - - 25
131 Kalsium laktat ( kalk ) tablet 500 mg tablet 5,865 5,865 1430 4,435 2000
132 Kaptopril 12,5 mg tablet 9,349 9,349 1085 8,264
133 Kaptopril 25 mg tablet 464 464 464 - 1000
134 Kaptopril 50 mg tablet 1,310 1,310 110 1,200 exp jun 2020 = 1310
135 Karbamazepin tablet 200 mg tablet 1,400 1,400 90 1,310 500
136 Karbogliserin Tetes Telinga 10 % larutan - - -
137 Ketoconazol 200 mg Tab tablet 1,232 1,232 140 1,092 300
138 Ketoconazol cream tube 273 273 9 264 25
139 Ketopropen tab 100 mg tablet - - -
140 Ketopropen supp/ suprafenid supp suppositoria 300 300 10 290
141 Ketorolac inj 30 mg ampul 43 43 10 33 30 exp mei 2020 = 33
142 Klindamisin 150 mg tablet 700 700 120 580 500
143 Klindamisin 300 mg tablet - - - 300
144 Kloramfenikol Tetes Mata larutan - - -
145 Kloramfenikol 125 mg/5 ml suspensi Botol - - -
146 Kloramfenikol kapsul 250 mg capsul - - -
147 Kloramfenikol salap mata 1 %/colme /erlamycetin tube - - -
148 Kloramfenikol tetes telinga 3 %/ colme/erlamicetin larutan - - - 20
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet 9,541 9,541 1247 8,294 2000
150 Kloramfenikol +Hidrocortison krim/ Chloramphecort crem tube - - -
151 Klorokuin fosfat tablet 150 mg tablet - - -
153 Klorpromazin 100 mg tablet tablet 1,800 1,800 150 1,650 300 exp aprl 19 = 1215
154 Klorpromazin 25mg tablet tablet 1,260 1,260 1,260 300
155 Klorpromazin inj 25 mg Ampul 540 540 540 exp mei 20 = 540
156 Kodein tablet 10 mg tablet - - -
157 Kombinasi pirimetamin 25 mg+ sulfadosin 500 mg tablet - - -
158 Kotrimoksazol dewasa tablet tablet 2,168 2,168 40 2,128 exp juni 19 =487
159 Kotrimoksazol pediatrik tablet tablet - - -
160 Kotrimoksazol suspensi syrup 75 75 12 63 50
161 Kuinin (Kina) tablet 200 mg tablet - - -
162 Kuinin dihidroklorida inj. 25 % - 2 ml tablet - - -
163 Lansoprazole Kapsul 30mg capsul 3,240 3,240 260 2,980 1000
164 Levofloksasin 500 mg tablet - - -
165 Levofolxacin infus 5 mg/ml larutan - - -
166 Lidokain 1 % ampul - - -
167 Lidokain 2 % + epinefrin 2ml ampul 1,050 1,050 32 1,018
168 Linkomisin 500mg Kapsul - - -
169 Loperamid 2mg tablet 76 76 76 500
170 Loratadine 10 mg tablet 550 550 185 365 1000
171 Lorazepam tablet Tablet - - -
172 Magnesium sulfat inj (iv) 20 % - 25 ml larutan - - -
173 Magnesium sulfat inj (iv) 40 % - 25 ml larutan 10 10 10
174 Mebendazole syp syrup - - -
175 Meloxicam 15 mg tablet - - - 2000
176 Meloxicam 7,5 mg tablet - - - 2000
177 Metformin Hcl tablet 500mg tablet 6,590 6,590 780 5,810 4000
178 Methilprednisolon 4 mg tablet 1,825 1,825 1825 - 2000
179 Methilprednisolon 8 mg tablet - - - 1000
180 Metiergometrin maleat inj.0,2 mg - 1 ml larutan 179 179 4 175 exp jun 2020 = 75
181 Metilergometrin maleat tab sal 0,125 mg tablet 200 200 200
182 Metoklopramide tab 10 mg tablet 2,771 2,771 110 2,661
183 Metronidazol tablet 250 mg tablet - - -
184 Metronidazol tablet 500 mg tablet - - - 500
185 Metronidazole Infus 500mg/100 ml larutan 1 1 1 exp okt 20 = 1
186 Mikonazol krim/salep 2 % tube - - - 100
187 Mikobalamin 500mg/Lanabal tablet - - - 500
188 Natrium bikarbonat tab 500 mg tablet 900 900 900 300 exp mei 20 = 900
189 Natrium diklofenak tab 25 mg tablet 1,300 1,300 330 970 3000
190 Natrium diklofenak tab 50 mg tablet 4,339 4,339 205 4,134
191 Natrium klorida larutan infus 0,9 % steril larutan 125 125 15 110 20 exp juni 19 =15
192 N.Acetyl Systein 200 mg tablet - - -
193 Nifedipin tablet tablet 566 566 10 556
194 Nistatin tablet vaginal 100.000 IU / g tablet 857 857 857
195 Nistatin tablet salut 500.000 IU tablet 186 186 186 exp agus 19 = 186
196 Obat batuk hitam ( o.b.h ) cairan larutan - - -
197 Ofloksasin tablet 200 mg tablet - - -
198 Oksitetrasiklin hcl inj. I.m 50 mg/ml - 10 ml larutan - - -
199 Oksitetrasiklin hcl salap 3 % tube - - -
200 Oksitetrasiklin hcl salap mata 1 % tube 1,160 1,160 1 1,159
201 Oksitosin injeksi 10 iu/ ml - 1 ml Ampul 20 20 20
202 Omeprazol injeksi 40 mg Ampul 32 32 32 exp juni 20 = 32
203 Omeprazol tablet 20 mg capsul - - -
204 Ondansetron tab 4 mg tablet - - -
205 Ondansetron tab 8 mg - - -
206 Ondansetron inj Ampul - - -
207 Papaverin 40 mg/Spasminal tablet tablet - - -
208 Parasetamol Drops syrup - - -
209 Parasetamol syrup 120 mg / 5 ml syrup 784 784 291 493 300
210 Parasetamol tablet 100 mg Tablet - - -
211 Parasetamol tablet 500 mg tablet 10,100 10,100 3700 6,400 5000
212 Paracetamol 120mg Eff/Sanmol Tube 10 tube - - -
213 Paracetamol 125 mg Supp/Pamol suppositoria - - - 50
214 Pirantel tablet 125 mg tablet - - -
215 Pirantel Suspensi 125 mg syrup - - -
216 Pirazinamid tablet 500 mg tablet - - -
217 Piridoksin hcl tablet 10 mg tablet 12,137 12,137 915 11,222 3000 exp juni 2020 = 5400
218 Piroksikam 10 mg tab tablet - - - 1000
219 Piroksikam 20 mg tab tablet - - -
220 Povidon Iodida lar 10 % - 300 ml larutan 23 23 2 21
222 Povidon Iodida lar 10 % - 60 ml larutan - - - 20
223 Prednison tablet 5 mg tablet 91 91 91 -
224 Primakuin tablet 15 mg tablet - - -
225 Propanolol hcl tablet 10 mg tablet 845 845 845 exp juni 19 = 845
226 Propanolol hcl tablet 40 mg tablet - - -
227 Propiltiourasil tablet 100 mg tablet - - -
228 Ranitidin inj 25 mg Ampul 109 109 10 99 20
229 Ranitidin tablet 150 mg tablet - - - 3000
230 Reserpin tab 0,10 mg tablet - - -
232 Retinol 100.000 ui capsul - - -
233 Retinol 200.000 ui capsul - -
234 Rifampisin kapsul 600 mg tablet - - -
235 Rimfampisin kapsul 300 mg tablet - - -
237 Ringer laktat larutan infus steril larutan 92 92 8 84 20
238 Risperidone 2mg tablet 1,680 1,680 300 1,380 500
239 Salbutamol tablet 2 mg tablet 6,977 6,977 120 6,857 exp juli 19 =700
240 Salbutamol tablet 4 mg tablet 1,400 1,400 65 1,335 500 exp juni 19 = 400
241 Salep 2-4 komb As.Salisilat 2 % +Belerang pot - - -
242 Salisil bedak 2 % pot - - - 50
243 Sefadroxyl 500 mg tablet - - - 500
244 Sefadroxyl sirup kering 125 mg / 5 ml syrup 85 85 85
245 Sefaleksin 500 mg tablet - - -
246 Sefiksim kapsul 100 mg capsul - - -
247 Sefiksim syr syrup - - -
248 Sefotaksim injeksi 1 gram vial - - -
249 Seftriason inj 1 gr vial - - -
250 Serum Anti Bisa Ular (ABU) Vial 5 ml 3 3 3
251 Serum Anti Tetanus (ATS) 1500 vial 1 ml 6 6 6 10
252 Sianokobalamin ( vit b 12 ) inj.500 mcg/ml Ampul 98 98 98
253 Simetidin tablet 200 mg tablet - - -
254 Simvastatin 10 mg tablet 1,200 1,200 1,200 1000 exp feb 20 = 1200
255 Simvastatin 20 mg tablet 1,345 1,345 320 1,025
256 Siprofloxasin infus larutan - - -
257 Siprofloxasin tab 500 mg tablet 500 500 500 exp maret 20 = 500
258 Streptomisin sulfat serbuk inj. 1000 mg/vial vial - - -
259 Sukralfat sirup/Ulsidex/Ulsafate syrup - - -
260 Sukralfat 500 mg tablet - - - 500
261 Sulfasetamida Natrium tetes Mata 15 % larutan - - -
262 Tetracain Hcl tetes mata larutan - - -
263 Thiampenikol tablet capsul - - -
264 Tiamin hcl ( vit b 1 ) inj. 100 mg/ml - 1 ml Ampul - - -
265 Tiamin hcl mononitrat ( vit b 1 ) tablet 100 mg tablet - - -
266 Tiamin hcl mononitrat ( vit b 1 ) tablet 50 mg tablet 2,027 2,027 215 1,812
267 Tramadol injeksi Ampul - - -
268 Tramadol tablet 50 mg tablet 50 50 50 exp juli 19 = 50
269 Triheksifenidil hcl tab 2 mg tablet 530 530 165 365 exp okt 19 = 255
270 Urea crem / Soft U Derm 10 % tube - - -
271 Vaksin Rabies Vero vial - - -
272 Vaksin Anti Bisa Ular (ABU) Vial - - -
273 Vitamin b komplek tablet tablet 12,265 12,265 3060 9,205 5000
274 Zink Dispersible 20 mg tablet 5,700 5,700 305 5,395 2000
275 Zinkpro Drops syrup - - -
276 Zink syrup/ Zirkum syrup syrup - - -
OBAT NON GENERIK

1 Anadex syr syr - - -
2 Alpara syr syrup - - -
3 Asering 500 cc larutan - - -
4 Baby cough syr syrup - - - 50
5 Becefort Suspensi syrup - - -
6 Becefort Tablet tablet - - -
7 Beneuron tablet - - -
8 Bionemi tab tablet - - -
9 Bioron tab tablet - - -
10 Becom C tablet - - -
11 Betafort Syr syrup - - -
12 Bio ATP tablet - - -
13 Bioplacenton Gel tube 10 10 10 5
14 Biovitan Syr syrup - - -
15 Bisolvon Extra Syr Botol 60 ml - - -
16 Calsidol syr Larutan 5ml - - -
17 Cendo Xitrol Tetes Mata botol 5ml - - 20
18 Cendo Xitrol Tts Mata mini dose Tube - - -
19 Cendo cetamid tts mata botol - - -
20 Colfin Tablet - - -
21 Curcuma tablet tablet - - -
22 Dasabion Tablet tablet - - -
23 Dextrosin tab tablet - - -
24 Dextrofen syr syrup - - - 50
25 Fg Troches tab hisap tablet 60 60 60
26 Fitbon Plus tablet - - -
27 Flucort N crem tube - - -
28 Fludane Tablet tube - - -
29 Formalin cair larutan - - -
30 Gerac tablet tablet - - -
31 Geriavita tablet - - -
32 Gericare kaplet tablet - - -
33 Good Proliver tablet - - -
34 H2O2 3 % larutan - - -
35 Hemafort kap tablet - - -
36 Hemorogard Kapsul kapsul - - -
37 Hexacort Crem Tube - - -
38 Hidrex Surgical 500 cc larutan - - -
39 Ikaneuron 5000/Nerva 5000 tablet - - -
40 Interhistin tablet tablet - - -
41 Isotic Clearens larutan - - -
42 Isotic Neolyson larutan - - -
43 Lexavit tab tablet - - -
44 Lisol larutan - - -
45 Livron B-Plex tablet tablet - - -
46 Lybex Syr syrup - - -
47 Merlopam 0,5 mg tablet - - -
48 Minyak Telon larutan - - -
49 Neurovit-E Tablet tablet - - -
50 Nodrof Flu Antitussive tablet - - -
51 Noza Tablet tablet - - - 1000
52 Oxfezin syr syrup - - -
53 Obat batuk hitam Indo Plus cairan larutan 96 96 96 -
54 Pain Kila / Stop Pain tube - - -
55 Pehapral tablet 300 300 300 - 1000
56 Pharmaton Formula capsul - - -
57 Polykresulen (albothyl) larutab - - -
58 Ponflu Kaplet tablet - - -
59 Ponflu Syr syrup - - -
60 Prolysin Syr syrup - - -
61 Risperidone 2 mg tablet - - -
62 Sagestam cream tube - - -
63 Sanbe Kids syr syrup - - -
64 Scabisid crem/scabimite crem tube 67 67 46 21 50
65 Topras Tablet tablet - -
66 Tremenza/*neo protifed tablet - - -
67 Tuzalos tab tablet - - -
68 Vitalex syrup - - -
69 Woods papermint antitusive syrup - - -
70 Xylocaine jelly 2% gel - - -
71 Xepavit tablet tablet - - - 3000
72 Vetolin Nebules /Salbutamol cairan larutan 19 19 10 9
73 Ventolin Rotacap /Salbutamol Serbuk capsul - - -
74 Salbutamol Inhalasi/ Fartolin Inhalasi fls - - -
75 Salbutamol syr/Salbron syrup - - -
76 Hustab tablet/Mucohexin/Bromheksin Hcl tablet 930 930 130 800 3000
77 Pratifar tablet - - - 3000
ALKES & BAHAN HABIS PAKAI ( BHP )
1 Abbocath No 16 pcs - - -
2 Abbocath No 18 pcs 265 265 265 exp sept 19 = 100
3 Abbocath No 20 pcs 66 66 66
5 Abbocath No 24 pcs 226 226 65 161 50
6 Alat suntik sekali pakai 1 ml pcs 1,799 1,799 35 1,764 300
7 Alat suntik sekali pakai 10 ml pcs 61 61 61
8 Alat suntik sekali pakai 1cc insulin pcs - - -
9 Alat suntik sekali pakai 2.5 ml pcs - - -
10 Alat suntik sekali pakai 20 ml pcs - - -
11 Alat suntik sekali pakai 3 ml pcs 147 147 125 22 300
13 Bisturi no 21 pcs 192 192 192
14 Bisturi no 10 pcs - - -
15 Bisturi no 15 pcs 230 230 230
16 Blood Lancet pcs 10,800 10,800 10,800
17 Blood Administrasi set pcs - - -
18 Catgut/benang bedah no.2/0 chromic pcs - -
19 Catgut/benang bedah no.2/0 plain pcs - - -
20 Catgut/benang bedah no.3/0 chromic pcs 300 300 300 24
21 Catgut/benang bedah no.3/0 plain pcs 72 72 72
22 Daryantule / Sofrattule/Bioplacenton Tulle pcs 90 90 90
23 Folley Cateter 2 Way 30 cc No. 14 pcs - - -
24 Folley Cateter 2 Way 30 cc No. 16 pcs 75 75 75 exp sept 19 = 75
27 Handscoend Ukuran L Mikro Touch pcs - - -
28 Handscoend Ukuran M Mikro Touch pcs - - -
29 Handscoend Ukuran S Mikro Touch pcs 400 400 400 - 400
30 Handscoend No. 6,5 pcs 166 166 166 -
31 Handscoend No. 7 pcs 150 150 150
32 Handscoend No. 7,5 pcs 34 34 34 - 200
33 Handscoend No. 8 pcs - - - 200
34 Handscoend Non Steril Ukuran L Pcs - - - 300
35 Handscoend Non Steril Ukuran M Pcs 1,300 1100 2,400 1100 1,300 500
36 Handscoend Non Steril Ukuran S Pcs - - - 500
37 Hcl 0,1 N larutan - - -
38 Infusion set anak Pcs - -
39 Infusion set dewasa Pcs 127 127 10 117 50
40 Jarum Jahit Kulit GT 1113 No 10 Pcs - - -
41 Jarum Jahit Kulit GR 1113 No 10 Pcs 84 84 84
43 Jarum Jahit Kulit GR 1113 No 11 48 48 48
48 Jarum Jahit Kulit GT 1113 No 14 Pcs 36 36 36
49 Jarum Jahit Kulit GR 1113 No 14 - - -
51 Jarum Jahit Kulit GR 1113 No 9 Pcs - - -
52 Kapas berlemak 500 mg bungkus 3 3 3
53 Kapas pembalut / absorben 250 mg bungkus 28 28 28 10
54 Kasa kompres 40/40 steril bungkus 172 172 172
55 Kasa pembalut 36 m x 80 cm rol - - -
56 Kasa pembalut 2 m x 80 cm rol 125 125 125
57 Kasa pembalut hidrofil 4 m x 10 cm bungkus 103 103 103
58 Kasa pembalut hidrofil 4 m x 15 cm bungkus 55 55 55 -
59 Kasa pembalut hidrofil 4 m x 3 cm rol - - -
61 Kasa steril 16 x 16 kotak 2,192 2,192 32 2,160
62 Liquicheck Hematology Control Normal Vial - - -
63 Lyse M-30 D-Diff Btl 500 ml - - -
64 Masker 25 pcs/ktk 4,276 2100 6,376 6376 - 500
65 Masker N 95 Pcs 20 80 100 10 90 100
66 Nald Inj, box 100 pcs - - -
67 Pastik (Alkohol Swab) box 100 pcs - - -
68 Plester 5 yard x 2 inch rol - - -
69 Plester Leukoplast 4,5 m X 1,25 cm/PHARMAPLAST 12 pcs/ktk 120 120 2 118
70 Plester Micropore Non Dispenser(Pharmaplast) 10x500 pcs 15 15 15 - 5
71 Plester Micropore WITH Dispenserer pcs 47 47 47
72 Pot Urine 50 cc pcs - - -
73 Silk ( benang bedah sutera ) no. 3/0 pcs 24 24 12 12
74 Terofusion Blood Set Pcs - - -
75 Urin Bag pcs - - -
76 Wing Nedle no 21 G pcs - - -
80 Silk ( benang bedah sutera ) no. 2/0 pcs - - -
81 Ventolin Rotahaler pcs 106 106 106
OBAT GIGI
1 Air Raksa Dental Use larutan - -

2 Devitalisasi pasta (non arsen) larutan - -
3 Dental Merkuri - -
4 Eter Anaestetik Botol - -
5 Etil klorida semprot Botol - -
6 Eugenol cairan larutan - -
7 Fluor tablet 0,5 mg tablet - -
8 Glass lonomer cement ( gc ix ) set /botol - -
9 Iodoform pasta Botol - -
10 Kalsium hidroksi pasta 2 tube/kotak - -
11 Monoklorkamfer mentol cairan (CHKM) botol 10 ml - -
12 Mummifying pasta botol / kotak - -
13 Semen seng fosfat serbuk dan cairan botol - -
14 Silver amalgam serbuk 65 - 75 % 1 oz / botol - -
15 Spon gelatin cubicle cubicles 1x1x1 cm 24 buah / kotak - -
16 Temporari stoping (fletcher) serbuk dan cairan - -
OBAT PROGRAM
1 Albendazole 400mg tablet - - -

2 Alkohol Swab Box 210 210 210
3 Azitromisin tablet - - -
4 Besi II Sulfat tablet tablet 432,220 432,220 3640 428,580 exp juni 2019 = 78400
5 Blood Glucosa Test Strip botol - - - 5
6 Fluconazole 150mg kapsul - - -
7 Filariasis Brugia Rapid - - -
8 Immunoassay Malaria Kotak 30 test - - -
9 Isoniazid 300mg tablet - - -
10 Kapas 1 kg Bungkus - - -
11 Kertas Whatman kotak - - -
12 Kolesterol Test Strip botol - - -
13 Kotrimoxazol 960 mg tablet - - -
14 Lancet Divece Kotak - - -
15 Larutan Giemsa 100 ml botol - - -
16 OAT FDC Kat I kotak 12 32 44 44 - 6
17 OAT FDC Kat II kotak - - -
18 OAT FDC Kat Sisipan kotak - - -
19 OAT Kat Anak kotak 5 10 15 15 - 4
20 OAT Kombipak Kat I kotak - - -
21 Oli Emersi - - -
22 Objec Glass/Mikroskope Slide kotak - - -
23 Piridoksin tab 50mg/vit B.6 - - -
24 Pot MDR pcs - - -
25 Pot Sputum pcs - - -
26 Pot Urine pcs - - -
27 Reagen Ziel Nelsen botol 86 20 106 20 86 4 exp feb 19 = 86
28 Retinol A 100 000 IU kapsul lunak capsul - - -
30 Slide box kotak - - -
31 Stick Narkoba - - -
32 Tabung Edta 3 ml botol - - -
33 Tissue gulung Kotak 100 - - -
34 Tissue Mikroskope Kotak 100 - - -
35 Uric Acid Test Strip botol - - -
36 Vikia HIV 1/2 Pcs - - -
OBAT PROGRAM JIWA
1 Flufenazine Decanoat inj 25 mg ampul 35 35 35 exp= Feb 2018 = 17
2 Clozapine 25mg tablet tablet - - - 1000
3 Clobazam 10 mg tablet 1,070 1,070 1,070 50
4 Triheksifenidil tablet 2 mg tablet - - -
REAGEN HAEMATOLOGY ANALIZER

1 Diluent-30 D-Diff botol 20l - -
2 Lyse M 30D-Diff botol - -
3 Probe clenser M-30P Botol - -
4 Liquichect Hematology Vial - -
5 EZ Cleanser M.30E Botol - -
6 Liquichect Hematology Vial - -
7 Rinse M.30 galon - -
TAMBAHAN
1 pritakort tablet - - -
2 masker thee on 3 play tablet - - -
3 piridoksin 50 tablet - - -
4 Stick Narkoba box - - -
5 Stick Glukosa box - - - 10
6 Stick Asam Urat box - - -
7 Stick Kolesterol box - - - 10
8 Trifluoperazine 5 mg box 3,092 3,092 3,092 exp april 19 = 2022
9 Haloperidol Injeksi ampul - -
10 HIV 1/2 3.0Multi Paket - - -
11 Descoderm Pade Pcs - 0 0 300
12 Vaksin Bcg kering serbuk injeksi 0,375 mg /ml vial - 0 0
13 Pentabio vaksin Dtp-hb-hib injeksi 2,5 ml vial - 0 0
14 Vaksin Polio Oral Trivalen Drops vial - 0 0
15 Vaksin campak keringserbuk injeksi 1000 Ccid vial - 0 0
16 Vaksin Hepatitis B 10 Mcg/ml vial - 0 0
17 Vaksin Jerap Td Vial - 0 0
18 Vaksin Ipv Vial - 0 0
19 MDT MB Adult blister 6 6 6
20 Dispose savety box 2,5 l Pcs - 0 0
21 Vaksin TT /DT vial - 0 0
22 pelarut Vaksin BCG vial - 0 0
23 Pelarut Vaksin Campak ampul 0
24 Dropper for oral vaccine bh 0
25 IPV Vial 0
21 Salbulin /salbutamol inhalasi/combiven inhalasi Pcs - 0 0 10
22 combiven Pcs 190 190 190 exp Nov 19 =190
23 Kasa 40x 80 Pcs - -
24 ONE JECT - ADS 0.05 ml - - -
25 ONE JECT - ADS 0.5 ml - - -
26 ONE JECT-ADS 5 ml - - -
27 silkom 3 - - -
28 silkom2 - - -
29 Oxicobal - - -
30 Pularex 630 mg tablet - - -
31 Selvi plex tablet - - -
32 Vaksin Measles Rubella Vial - - -
33 Skifa ADS 5 ml pcs - - -
34 Skifa ADS 0,5 ml pcs - - -
35 Safety Box 5 l pcs - - -
36 Xilocain jelly botol 1 1 1 - 3
37 RDT Hepatitis botol - - -
38 DHP-Frimal blister - - -
39 Methilprednisolon 16 mg tablet 600 600 600 -
40 SD BIOLIN HIV - - -
42 Hexagon sytrilis - - -
43 Vaksin HBIG VIal - - -
44 Sefixim 200 mg kapsul - - -
45 Tisu mikroskope pcs - - -
46 RDTMalaria - - -
47 eutyrox 500 mg tablet - - -
48 Kasa 40x 80 7 7 4 3
49 saypilis strip - - -
50 DEC - - -
51 dispose savety box 5 l - - -
52 OXYCAN BTL 16 16 16
53 Haloperidol 2 mg tablet 1,085 1,085 1,085
54 union ADS 0,05 ml pcs
55 Tips For Micropipette buah 18,000 18,000 18,000
56 Vacum Tube Edta 0,5 ml tube 1,500 1,500 1,500
57 Needle flashback 21 x 1 pcs 600 600 600
58 Fucilex 20 mg/G krim 5 G Mola Tube tube 9 9 9
59 Amoksisilin 100 mg drops botol - -
60 Ampisilin serbuk injeksi 1000 mg vial 433 433 433
61 Grisiofulvin 250 mg tablet 1,500 1,500 1,500 exp okt 20 = 1300
62 Mineral mix Sacchet - - - 100
63 APD SET - - -
64 Prokain benzile serbuk injeksi vial 8 8 8 exp nov 20 = 8
65 Baju Apron/hazmat buah 191 191 31 160
66 Tuberkulin PPD RT 23 SSI VIAL 1 1 1
67 Termometer Infrared Digital pcs - - -
67 Haloperidol injeksi 50 mg/ml ampul 19 19 19
68 sepatu/ safety boots buah 1 1 1
69 kacamata geogle buah - - -
70 handsanitaizer botol - - - 5
71 ACCU-CHEK SAFE PCS - - -
72 Rapit sars;COV 2 ( Rapit test corona) test - -
73 Alpara tablet 240 240 75 165 1000
74 Apecur 100 ml vitamin Anak botol - - - 50
75 new Antides Tablet tablet 1,271 1,271 51 1,220
76 Rapid tes + blood lanset test 80 100 180 180 -
77 Masker kain pcs 2,510 2,510 2,510
78 SD BIOLIN DANGUE pcs 75 75 75
79 SD BIOLIN HIV 30 pcs 71 71 71
80 Trepocheck sypilis pcs - -
81 Albendazole suspensi 200 mg/5 ml botol - - -
82 Oseltamivir 75 mg /kapsul kapsul 150 150 30 120
83 Face Shield - - -
84 desinfektan 3.8 l 0,20 #VALUE! 0,20 #VALUE!
85 Bufacetine 2% salep tube - - -
86 Fixomull 5 cmx 5 m Dressing penutup luka bakar pcs 20 20 20
87 miravon botol - - -
88 Azitromisin 500 mg tablet 1,100 1,100 90 1,010
89 Lopivia tablet - - -
90 Esomeprazole serbuk injeksi 40 E/56n82 vial 7 7 7
91 masker tb - - -
92 Rapid antigen 100 100 100 -
93 Tuberkulin PPD RT 23 SSI 1 1 1 -
94 Piridoksin 25 tablet 7,000 7,000 2300 4,700
95 Masker KN95 BUAH 80 80 80
96 virochecck HbsAg 200 200 200 -
- -
JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

ASKESKIN BPJS
MENGETAHUI/MENYETUJUI MENERIMA/MELAPOR YANG MENERIMA

KEPALA DINAS KESEHATAN KAB. PELALAWAN KEPALA PUSKESMAS PETUGAS PUSKESMAS
(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

NIP . 197411192003122002 NIP.19830622 2010 2 033
KABUPATEN PELALAWAN

Februari PEMBERIAN
OPTIMUM
OBAT GENERIK PKD
1 Allopurinol 300 mg Tablet - - -

2 Allopurinol tablet 100 mg Tablet 2,560 1000 3,560 390 3,170
4 Ambroxol syr Syrup - - - 200
9 Amlodipin 10 mg Tablet 1,500 1,500 1500 - 3000
10 Amoksisilin Kaplet 500 mg Tablet 9,421 10000 19,421 1864 17,557 exp sep 20 = 5500
11 Amoksisilin kapsul 250 mg capsul 3,080 2500 5,580 375 5,205 1000
12 Amoksisilin syrup kering 125 mg/ 5 ml Syrup - - - 300
16 Antasida Doen II Suspensi Kombinasi syrup 362 300 662 107 555 300
17 Antasida doen tablet kombinasi tablet 4,345 2000 6,345 2202 4,143 3000 exp agus 20 = 3250
20 Antihaemaroid doen kombinasi tablet 168 30 198 59 139 20 exp sep 2020 = 77
26 As.Traneksamat 50 mg inj ampul 5 5 5 -
28 Asam folat/Anemolat 1mg tablet 370 370 180 190 1000
30 Asam askorbat ( vit c ) tablet 50 mg tablet 2,059 2,059 1859 200 1000 exp = juli 2020 = 200
32 Asam Mefenamat 500 mg tablet 15,393 1000 16,393 1018 15,375 3000 exp agus 2019 = 7809 sep 19 = 7205
36 Asetil sistein 200mg tab 5,245 5280 10,525 1570 8,955 3000
41 Atropin sulfat injeksi 0,25 mg/ml - 1 ml ampul 100 100 5 95 exp feb 2021 = 95
49 Betametason krim 0,1 % tube 259 259 31 228
50 Bisoprolol tab 5mg tablet 60 60 60
51 Bisakodil 5mg supp/ Dulcokax/Stolax suppositoria 36 120 156 6 150
57 Cetirizin syr 5 mg/5 ml Syrup 97 97 78 19 50
58 Deksametason inj. 5 mg/ml - 1 ml ampul 255 50 305 20 285 exp feb 2020 = 165 exp april 20 = 90
59 Deksametason tablet 0,5 mg tablet 1,070 1500 2,570 2570 - 2000
62 Diazepam inj 5 mg/ml ampul 112 112 112
63 Diazepam tablet 2 mg tablet 100 100 20 80
68 Digoksin tablet 0,25 mg tablet 700 700 700
86 Etanol 70 % 100ml larutan - 96 96 96
92 Fenobarbital tablet 30 mg Tablet 880 880 179 701 1000
98 Fitomenadion inj 2 mg/Infan ampul 2,683 2,683 2,683 exp juni 18 = 122
102 Furosemida tablet 40 mg tablet 484 484 22 462
107 Gentian violet larutan 1 % larutan 24 24 19 5 25
116 Haloperidol tablet 1,5 mg tablet 1,028 1,028 240 788 500
119 Hidrokortison krim 2,5 % tube 278 72 350 40 310 50
123 Ibuprofen tablet 400 mg tablet 1,814 1500 3,314 3089 225 3000
127 Isosorbit dinitrat tablet subligual 5 mg tablet 1,890 1,890 50 1,840
131 Kalsium laktat ( kalk ) tablet 500 mg tablet 4,435 3000 7,435 1920 5,515 2000
133 Kaptopril 25 mg tablet - - - 1000
134 Kaptopril 50 mg tablet 1,200 1,200 1,200 exp jun 2020 = 1200
135 Karbamazepin tablet 200 mg tablet 1,310 1,310 180 1,130 500
137 Ketoconazol 200 mg Tab tablet 1,092 500 1,592 110 1,482 300
140 Ketopropen supp/ suprafenid supp suppositoria 290 290 290
141 Ketorolac inj 30 mg ampul 33 33 33 30 exp mei 2020 = 33
142 Klindamisin 150 mg tablet 580 500 1,080 30 1,050 500
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet 8,294 1000 9,294 3350 5,944 2000
160 Kotrimoksazol suspensi syrup 63 100 163 14 149 50
163 Lansoprazole Kapsul 30mg capsul 2,980 2720 5,700 710 4,990 1000
167 Lidokain 2 % + epinefrin 2ml ampul 1,018 1,018 50 968
169 Loperamid 2mg tablet 76 76 76 - 500
170 Loratadine 10 mg tablet 365 500 865 455 410 1000
180 Metiergometrin maleat inj.0,2 mg - 1 ml larutan 175 175 175 exp jun 2020 = 75
189 Natrium diklofenak tab 25 mg tablet 970 970 970 - 3000
191 Natrium klorida larutan infus 0,9 % steril larutan 110 20 130 9 121 20 exp juni 19 =15
193 Nifedipin tablet tablet 556 556 556
209 Parasetamol syrup 120 mg / 5 ml syrup 493 500 993 615 378 300
211 Parasetamol tablet 500 mg tablet 6,400 6,400 3100 3,300 5000
217 Piridoksin hcl tablet 10 mg tablet 11,222 7000 18,222 639 17,583 3000 exp juni 2020 = 5400
220 Povidon Iodida lar 10 % - 300 ml larutan 21 21 1 20 exp feb 21 =16 maret 21 4
223 Prednison tablet 5 mg tablet - - -
232 Retinol 100.000 ui capsul - 750 750 750 -
233 Retinol 200.000 ui capsul - 6150 6,150 3850 2,300 exp apr 19 = 6100 agus 19 = 4000
237 Ringer laktat larutan infus steril larutan 84 60 144 15 129 20
238 Risperidone 2mg tablet 1,380 1,380 330 1,050 500
244 Sefadroxyl sirup kering 125 mg / 5 ml syrup 85 85 67 18 exp maret 21 = 18
251 Serum Anti Tetanus (ATS) 1500 vial 1 ml 6 6 6 - 10
255 Simvastatin 20 mg tablet 1,025 1,025 610 415
266 Tiamin hcl mononitrat ( vit b 1 ) tablet 50 mg tablet 1,812 900 2,712 315 2,397
269 Triheksifenidil hcl tab 2 mg tablet 365 365 110 255 exp okt 19 = 255
273 Vitamin b komplek tablet tablet 9,205 10000 19,205 6398 12,807 5000
-
OBAT NON GENERIK -
13 Bioplacenton Gel tube 10 10 10 - 5
17 Cendo Xitrol Tetes Mata botol 5ml - - - 20
25 Fg Troches tab hisap tablet 60 60 40 20
34 H2O2 3 % larutan - - -
53 Obat batuk hitam Indo Plus cairan larutan - - -
55 Pehapral tablet - - - 1000
64 Scabisid crem/scabimite crem tube 21 10 31 18 13 50
65 Topras Tablet tablet - - -
72 Vetolin Nebules /Salbutamol cairan larutan 9 9 9 -
76 Hustab tablet/Mucohexin/Bromheksin Hcl tablet 800 800 800 - 3000
-
-
ALKES & BAHAN HABIS PAKAI ( BHP ) -
-
2 Abbocath No 18 pcs 265 265 265 exp sept 19 = 100 maret 21 165
5 Abbocath No 24 pcs 161 161 30 131 50 exp maret 20 =16
7 Alat suntik sekali pakai 10 ml pcs 61 61 5 56
13 Bisturi no 21 pcs 192 192 192 exp maret = 192
16 Blood Lancet pcs 10,800 10,800 10,800
18 Catgut/benang bedah no.2/0 chromic pcs - - -
20 Catgut/benang bedah no.3/0 chromic pcs 300 300 15 285 24
21 Catgut/benang bedah no.3/0 plain pcs 72 36 108 12 96
29 Handscoend Ukuran S Mikro Touch pcs - - - 400
30 Handscoend No. 6,5 pcs - - -
31 Handscoend No. 7 pcs 150 100 250 250 -
32 Handscoend No. 7,5 pcs - 100 100 100 - 200
35 Handscoend Non Steril Ukuran M Pcs 1,300 1600 2,900 2900 - 500
38 Infusion set anak Pcs - - -
39 Infusion set dewasa Pcs 117 50 167 7 160 50
53 Kapas pembalut / absorben 250 mg bungkus 28 5 33 33 10
58 Kasa pembalut hidrofil 4 m x 15 cm bungkus - - -
61 Kasa steril 16 x 16 kotak 2,160 1600 3,760 80 3,680
64 Masker 25 pcs/ktk - 1450 1,450 1450 - 500
65 Masker N 95 Pcs 90 100 190 30 160 100
70 Plester Micropore Non Dispenser(Pharmaplast) 10x500 pcs - - - 5
73 Silk ( benang bedah sutera ) no. 3/0 pcs 12 12 12
-
-
OBAT GIGI
-
1 Air Raksa Dental Use larutan - - -
2 Devitalisasi pasta (non arsen) larutan - - -
3 Dental Merkuri - - -
4 Eter Anaestetik Botol - - -
5 Etil klorida semprot Botol - - -
6 Eugenol cairan larutan - - -
7 Fluor tablet 0,5 mg tablet - - -
8 Glass lonomer cement ( gc ix ) set /botol - - -
9 Iodoform pasta Botol - - -
10 Kalsium hidroksi pasta 2 tube/kotak - - -
11 Monoklorkamfer mentol cairan (CHKM) botol 10 ml - - -
12 Mummifying pasta botol / kotak - - -
13 Semen seng fosfat serbuk dan cairan botol - - -
14 Silver amalgam serbuk 65 - 75 % 1 oz / botol - - -
15 Spon gelatin cubicle cubicles 1x1x1 cm 24 buah / kotak - - -
16 Temporari stoping (fletcher) serbuk dan cairan - - -
-
OBAT PROGRAM -
-
4 Besi II Sulfat tablet tablet 428,580 428,580 5770 422,810 exp juni 2019 = 78400
16 OAT FDC Kat I kotak - - - 6
19 OAT Kat Anak kotak - - - 4
21 Oli Emersi - - -
27 Reagen Ziel Nelsen botol 86 86 86 4 exp feb 19 = 86
-
OBAT PROGRAM JIWA -
-
REAGEN HAEMATOLOGY ANALIZER -
1 Diluent-30 D-Diff botol 20l - - -
2 Lyse M 30D-Diff botol - - -
3 Probe clenser M-30P Botol - - -
4 Liquichect Hematology Vial - - -
5 EZ Cleanser M.30E Botol - - -
7 Rinse M.30 galon - - -
-
TAMBAHAN -
9 Haloperidol Injeksi ampul - - -
23 Pelarut Vaksin Campak ampul - 0
24 Dropper for oral vaccine bh - 0
25 IPV Vial - 0
23 Kasa 40x 80 Pcs - - -
24 ONE JECT - ADS 0.05 ml - - -
27 silkom 3 - - -
28 silkom2 - - -
29 Oxicobal - - -
36 Xilocain jelly botol - - - 3
39 Methilprednisolon 16 mg tablet - - -
46 RDTMalaria - - -
48 Kasa 40x 80 3 3 1 2
50 DEC - - -
54 union ADS 0,05 ml pcs -
58 Fucilex 20 mg/G krim 5 G Mola Tube tube 9 9 9
59 Amoksisilin 100 mg drops botol - - -
60 Ampisilin serbuk injeksi 1000 mg vial 433 433 433
63 APD SET - - -
72 Rapit sars;COV 2 ( Rapit test corona) test - - -
73 Alpara tablet 165 165 165 - 1000
76 Rapid tes + blood lanset test - - -
77 Masker kain pcs 2,510 2,510 96 2,414
80 Trepocheck sypilis pcs - - -
82 Oseltamivir 75 mg /kapsul kapsul 120 120 80 40
84 desinfektan 3.8 l - - 0,20 #VALUE!
88 Azitromisin 500 mg tablet 1,010 1,010 125 885
91 masker tb - - -
92 Rapid antigen - 10 10 10 -
93 Tuberkulin PPD RT 23 SSI - - -
94 Piridoksin 25 tablet 4,700 4,700 2300 2,400
95 Masker KN95 BUAH 80 225 305 176 129
96 virochecck HbsAg - - -
-
- -

ASKESKIN BPJS
144 637 307 1088


NIP . 197411192003122002 NIP.19830622 2010 2 033
KABUPATEN PELALAWAN

Maret PEMBERIAN
OPTIMUM
OBAT GENERIK PKD

16 Antasida Doen II Suspensi Kombinasi syrup 555 555 124 431 300
20 Antihaemaroid doen kombinasi tablet 139 139 9 130 20 exp sep 2020 = 77
28 Asam folat/Anemolat 1mg tablet 190 190 190 - 1000
30 Asam askorbat ( vit c ) tablet 50 mg tablet 200 200 200 1000 exp = juli 2020 = 200
41 Atropin sulfat injeksi 0,25 mg/ml - 1 ml ampul 95 95 95 exp feb 2021 = 95
49 Betametason krim 0,1 % tube 228 228 228 exp feb 2021 =228
50 Bisoprolol tab 5mg tablet 60 60 60 exp des 2020 = 60
57 Cetirizin syr 5 mg/5 ml Syrup 19 19 19 - 50
58 Deksametason inj. 5 mg/ml - 1 ml ampul 285 285 10 275 exp feb 2020 = 165 exp april 20 = 90
59 Deksametason tablet 0,5 mg tablet - - - 2000
68 Digoksin tablet 0,25 mg tablet 700 700 700 expmaret 2021 = 700
86 Etanol 70 % 100ml larutan 96 96 5 91
102 Furosemida tablet 40 mg tablet 462 462 30 432 exp mei 2020 = 350
114 Griseofulvin tablet 125 mg , micronized tablet 2,387 2,387 20 2,367
116 Haloperidol tablet 1,5 mg tablet 788 788 280 508 500
123 Ibuprofen tablet 400 mg tablet 225 1000 1,225 1225 - 3000
135 Karbamazepin tablet 200 mg tablet 1,130 1,130 320 810 500
142 Klindamisin 150 mg tablet 1,050 1,050 82 968 500
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet 5,944 5,944 2289 3,655 2000
154 Klorpromazin 25mg tablet tablet 1,260 1,260 30 1,230 300
167 Lidokain 2 % + epinefrin 2ml ampul 968 968 12 956
169 Loperamid 2mg tablet - - - 500
170 Loratadine 10 mg tablet 410 410 345 65 1000
180 Metiergometrin maleat inj.0,2 mg - 1 ml larutan 175 175 175 exp jun 2020 = 75
189 Natrium diklofenak tab 25 mg tablet - - - 3000
190 Natrium diklofenak tab 50 mg tablet 3,619 2800 6,419 460 5,959
193 Nifedipin tablet tablet 556 556 556 exp maret 2021 = 556
194 Nistatin tablet vaginal 100.000 IU / g tablet 857 857 7 850
211 Parasetamol tablet 500 mg tablet 3,300 3,300 3300 - 5000
220 Povidon Iodida lar 10 % - 300 ml larutan 20 20 20 exp feb 21 =16 maret 21 4
233 Retinol 200.000 ui capsul 2,300 2,300 1770 530 exp apr 19 = 6100 agus 19 = 4000
238 Risperidone 2mg tablet 1,050 1,050 220 830 500
244 Sefadroxyl sirup kering 125 mg / 5 ml syrup 18 18 18 exp maret 21 = 18
251 Serum Anti Tetanus (ATS) 1500 vial 1 ml - - - 10
255 Simvastatin 20 mg tablet 415 415 320 95
269 Triheksifenidil hcl tab 2 mg tablet 255 255 255 - exp okt 19 = 255
-
OBAT NON GENERIK -
13 Bioplacenton Gel tube - - - 5
34 H2O2 3 % larutan - - -
55 Pehapral tablet - - - 1000
72 Vetolin Nebules /Salbutamol cairan larutan - - -
76 Hustab tablet/Mucohexin/Bromheksin Hcl tablet - - - 3000
-
-
-
3 Abbocath No 20 pcs 66 66 2 64
11 Alat suntik sekali pakai 3 ml pcs 222 222 222 - 300
16 Blood Lancet pcs 10,800 10,800 300 10,500
31 Handscoend No. 7 pcs - - -
32 Handscoend No. 7,5 pcs - - - 200
34 Handscoend Non Steril Ukuran L Pcs - 1300 1,300 700 600 300
35 Handscoend Non Steril Ukuran M Pcs - 1300 1,300 700 600 500
56 Kasa pembalut 2 m x 80 cm rol 125 125 2 123
64 Masker 25 pcs/ktk - 850 850 850 - 500
65 Masker N 95 Pcs 160 160 20 140 100
73 Silk ( benang bedah sutera ) no. 3/0 pcs 12 12 12
-
-
OBAT GIGI
-
-
OBAT PROGRAM -
-
1 Albendazole 400mg tablet - 8000 8,000 8,000 -
4 Besi II Sulfat tablet tablet 422,810 422,810 1410 421,400 exp juni 2019 = 78400 exp april 21 =343000
21 Oli Emersi - - -
-
OBAT PROGRAM JIWA -
-
-
TAMBAHAN -
25 IPV Vial - 0
23 Kasa 40x 80 Pcs - - -
24 ONE JECT - ADS 0.05 ml - - -
27 silkom 3 - - -
28 silkom2 - - -
29 Oxicobal - - -
46 RDTMalaria - - -
48 Kasa 40x 80 2 2 1 1
50 DEC - - -
58 Fucilex 20 mg/G krim 5 G Mola Tube tube 9 9 9 -
60 Ampisilin serbuk injeksi 1000 mg vial 433 433 433 exp okt 20 = 433
63 APD SET - - -
73 Alpara tablet - - - 1000
77 Masker kain pcs 2,414 2,414 2,414
82 Oseltamivir 75 mg /kapsul kapsul 40 40 40 -
84 desinfektan 3.8 l (0) (0) (0)
88 Azitromisin 500 mg tablet 885 885 110 775
91 masker tb - - -
92 Rapid antigen - - -
94 Piridoksin 25 tablet 2,400 2,400 2400 -
95 Masker KN95 BUAH 129 129 129 -
97 Albendazol syr botol - 100 100 100 -
-

ASKESKIN BPJS
141 514 194 849


NIP . 197411192003122002 NIP.19830622 2010 2 033
KABUPATEN PELALAWAN

April PEMBERIAN
OPTIMUM
OBAT GENERIK PKD

7 Amitriptilin hcl tablet salut 25 mg Tablet 2,920 2,920 13 2,907
28 Asam folat/Anemolat 1mg tablet - - - 1000
32 Asam Mefenamat 500 mg tablet 15,714 15,714 700 15,014 3000 exp agus 2019 = 7809 sep 19 = 7205
36 Asetil sistein 200mg tab 8,095 7920 16,015 1660 14,355 3000
53 Bisakodil 5Mg tablet/ Dulcokax/Stolax tablet 2,074 2,074 10 2,064 exp jun 2019= 660 juli 2019 = 900
57 Cetirizin syr 5 mg/5 ml Syrup - - - 50
65 Diazepam rektal tube 5 10 15 15
70 Domperidon 10 mg tablet 200 200 200 - 1000
71 Domperidon Drops syrup - 50 50 50
73 Doxicyclin 100mg tablet 1,800 500 2,300 70 2,230 500 exp okt 19 = 1400
86 Etanol 70 % 100ml larutan 91 91 15 76
87 Etanol 70 % 1000ml larutan 17 17 17 - 10
92 Fenobarbital tablet 30 mg Tablet 641 300 941 378 563 1000
108 Glibenklamid tablet 5 mg tablet 9,760 1000 10,760 450 10,310
118 Hidroklorotiazid ( hct ) tablet 25 mg tablet 388 500 888 100 788 500
119 Hidrokortison krim 2,5 % tube 278 240 518 31 487 50
120 Ibuprofen Suspensi syrup 50 50 100 100 exp juni 19 = 50
135 Karbamazepin tablet 200 mg tablet 810 810 90 720 500
138 Ketoconazol cream tube 216 75 291 16 275 25
142 Klindamisin 150 mg tablet 968 1000 1,968 110 1,858 500
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet 3,655 3,655 2753 902 2000
170 Loratadine 10 mg tablet 65 1000 1,065 600 465 1000
177 Metformin Hcl tablet 500mg tablet 3,880 4000 7,880 550 7,330 4000
180 Metiergometrin maleat inj.0,2 mg - 1 ml larutan 175 175 175 exp jun 2020 = 75 april21 = 100
181 Metilergometrin maleat tab sal 0,125 mg tablet 200 200 400 400 exp April 2020 = 200
182 Metoklopramide tab 10 mg tablet 2,423 500 2,923 176 2,747
191 Natrium klorida larutan infus 0,9 % steril larutan 119 40 159 52 107 20 exp juni 19 =15
201 Oksitosin injeksi 10 iu/ ml - 1 ml Ampul 20 20 2 18
211 Parasetamol tablet 500 mg tablet - - - 5000
233 Retinol 200.000 ui capsul 530 530 530 exp apr 19 = 6100 agus 19 = 4000
238 Risperidone 2mg tablet 830 830 335 495 500
251 Serum Anti Tetanus (ATS) 1500 vial 1 ml - 1 1 1 - 10
252 Sianokobalamin ( vit b 12 ) inj.500 mcg/ml Ampul 98 98 2 96
255 Simvastatin 20 mg tablet 95 1000 1,095 115 980
259 Sukralfat sirup/Ulsidex/Ulsafate syrup - 100 100 100
269 Triheksifenidil hcl tab 2 mg tablet - - - exp okt 19 = 255
274 Zink Dispersible 20 mg tablet 4,475 3000 7,475 480 6,995 2000
-
OBAT NON GENERIK -
34 H2O2 3 % larutan - - -
55 Pehapral tablet - 500 500 500 1000
-
-
-
2 Abbocath No 18 pcs 265 50 315 7 308 exp sept 19 = 100 maret 21 165
11 Alat suntik sekali pakai 3 ml pcs - 600 600 100 500 300
16 Blood Lancet pcs 10,500 10,500 100 10,400
31 Handscoend No. 7 pcs - - -
32 Handscoend No. 7,5 pcs - - - 200
34 Handscoend Non Steril Ukuran L Pcs 600 1200 1,800 1000 800 300
35 Handscoend Non Steril Ukuran M Pcs 600 800 1,400 1400 - 500
53 Kapas pembalut / absorben 250 mg bungkus 32 12 44 3 41 10
64 Masker 25 pcs/ktk - 1650 1,650 1650 - 500
65 Masker N 95 Pcs 140 140 31 109 100
73 Silk ( benang bedah sutera ) no. 3/0 pcs 12 12 12 -
-
-
OBAT GIGI
-
-
OBAT PROGRAM -
-
2 Alkohol Swab Box 210 210 160 50
4 Besi II Sulfat tablet tablet 421,400 3450 424,850 424,850 exp juni 2019 = 78400 exp april 21 =341590
21 Oli Emersi - - -
-
OBAT PROGRAM JIWA -
-
-
TAMBAHAN -
8 Trifluoperazine 5 mg box 3,092 3,092 90 3,002 exp april 19 = 2022
25 IPV Vial - 0
23 Kasa 40x 80 Pcs - 5 5 5
24 ONE JECT - ADS 0.05 ml - - -
27 silkom 3 - - -
28 silkom2 - - -
29 Oxicobal - - -
46 RDTMalaria - - -
48 Kasa 40x 80 1 1 1 -
50 DEC - - -
58 Fucilex 20 mg/G krim 5 G Mola Tube tube - - -
63 APD SET - - -
67 Termometer Infrared Digital / thermogun pcs - 3 3 3
75 new Antides Tablet tablet 1,072 1,072 165 907
77 Masker kain pcs 2,414 2,414 488 1,926
82 Oseltamivir 75 mg /kapsul kapsul - 1000 1,000 50 950
83 Face Shield - 20 20 20
84 desinfektan 3.8 l (0) (0) (0)
85 Bufacetine 2% salep tube - 48 48 48
88 Azitromisin 500 mg tablet 775 775 130 645
91 masker tb - - -
92 Rapid antigen - 15 15 15 -
94 Piridoksin 25 tablet - - -
95 Masker KN95 BUAH - 400 400 69 331
97 Albendazol syr botol - - -
98 hand sanitizer kemasan 250 ml botol 10 10 10
-

ASKESKIN BPJS


NIP . 197411192003122002 NIP.19830622 2010 2 033
KABUPATEN PELALAWAN

Mei PEMBERIAN
OPTIMUM
OBAT GENERIK PKD

7 Amitriptilin hcl tablet salut 25 mg Tablet 2,907 2,907 40 2,867
19 Antifungi doen kombinasi tube 100 100 100 exp mei 2021 = 100
24 As.Traneksamat 250 mg inj ampul 10 10 10 exp juni 2021 = 10
27 As.Traneksamat tab 500 mg /Transamin 500mg tablet 257 257 257 500
32 Asam Mefenamat 500 mg tablet 15,014 15,014 15,014 3000 exp agus 2019 = 7809 sep 19 = 7205
39 Asiklovir tablet 200 mg tablet 1,144 1,144 265 879
58 Deksametason inj. 5 mg/ml - 1 ml ampul 335 335 10 325 exp feb 2020 = 165 exp april 20 = 90
70 Domperidon 10 mg tablet - - - 1000
71 Domperidon Drops syrup 50 50 2 48
81 Erytromicin 500 mg tablet 575 575 76 499 300 exp meo 2021 = 499
86 Etanol 70 % 100ml larutan 76 192 268 268 -
87 Etanol 70 % 1000ml larutan - - - 10
118 Hidroklorotiazid ( hct ) tablet 25 mg tablet 788 788 70 718 500
140 Ketopropen supp/ suprafenid supp suppositoria 290 290 290 exp jun 2021 = 290
142 Klindamisin 150 mg tablet 1,858 1,858 90 1,768 500
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet 902 902 902 - 2000
170 Loratadine 10 mg tablet 465 465 465 - 1000
177 Metformin Hcl tablet 500mg tablet 7,330 7,330 710 6,620 4000 exp juni 2021 = 6354 mei 2021 =266
181 Metilergometrin maleat tab sal 0,125 mg tablet 400 400 400 exp April 2020 = 200
209 Parasetamol syrup 120 mg / 5 ml syrup 597 597 362 235 300
228 Ranitidin inj 25 mg Ampul 44 44 44 - 20
240 Salbutamol tablet 4 mg tablet 1,045 1,045 150 895 500 exp juni 19 = 400
252 Sianokobalamin ( vit b 12 ) inj.500 mcg/ml Ampul 96 96 96 exp mei 2021 = 96
255 Simvastatin 20 mg tablet 980 980 220 760
259 Sukralfat sirup/Ulsidex/Ulsafate syrup 100 100 100
-
OBAT NON GENERIK -
34 H2O2 3 % larutan - - -
55 Pehapral tablet 500 500 500 - 1000
-
-
-
6 Alat suntik sekali pakai 1 ml pcs 1,500 1,500 1,500 300
16 Blood Lancet pcs 10,400 10,400 10,400
22 Daryantule / Sofrattule/Bioplacenton Tulle pcs 90 90 90 exp april 2021 = 90
27 Handscoend Ukuran L Mikro Touch pcs - 300 300 300 -
31 Handscoend No. 7 pcs - 900 900 900 -
32 Handscoend No. 7,5 pcs - 200 200 200 - 200
34 Handscoend Non Steril Ukuran L Pcs 800 800 800 - 300
35 Handscoend Non Steril Ukuran M Pcs - - - 500
64 Masker 25 pcs/ktk - 1700 1,700 1700 - 500
65 Masker N 95 Pcs 109 40 149 149 100
69 Plester Leukoplast 4,5 m X 1,25 cm/PHARMAPLAST 12 pcs/ktk 108 108 108
-
-
OBAT GIGI
-
-
OBAT PROGRAM -
-
2 Alkohol Swab Box 50 50 50 -
3 Azitromisin tablet - -
21 Oli Emersi - - -
-
OBAT PROGRAM JIWA -
-
-
TAMBAHAN -
25 IPV Vial - 0
23 Kasa 40x 80 Pcs 5 5 5
24 ONE JECT - ADS 0.05 ml - - -
27 silkom 3 - - -
28 silkom2 - - -
29 Oxicobal - - -
46 RDTMalaria - - -
48 Kasa 40x 80 - - -
50 DEC - - -
63 APD SET - - -
65 Baju Apron/hazmat buah 150 150 150
67 Termometer Infrared Digital / thermogun pcs 3 5 8 8
75 new Antides Tablet tablet 907 907 64 843
77 Masker kain pcs 1,926 1,926 1542 384
82 Oseltamivir 75 mg /kapsul kapsul 950 400 1,350 380 970
83 Face Shield 20 20 20
84 desinfektan 3.8 l (0) (0) (0)
85 Bufacetine 2% salep tube 48 48 28 20
88 Azitromisin 500 mg tablet 645 600 1,245 610 635
90 Esomeprazole serbuk injeksi 40 E/56n82 vial 7 7 1 6
91 masker tb - - -
92 Rapid antigen - 465 465 465 -
95 Masker KN95 BUAH 331 250 581 150 431
98 hand sanitizer kemasan 250 ml botol 10 25 35 24 11
99 Comvit C tablet 2000 2,000 2000 -
100 Hepagard 250 mg tablet 600 600 600
101 Vitamin C 500 tablet 500 500 500 -
- -

ASKESKIN BPJS
185 507 258 950


NIP . 197411192003122002 NIP.19830622 2010 2 033
KABUPATEN PELALAWAN

Juni PEMBERIAN
OPTIMUM
OBAT GENERIK PKD

2 Allopurinol tablet 100 mg Tablet 1,458 1,458 570 888
7 Amitriptilin hcl tablet salut 25 mg Tablet 2,867 2,867 167 2,700 exp april 2021 = 1300
9 Amlodipin 10 mg Tablet - 5000 5,000 131 4,869 3000
12 Amoksisilin syrup kering 125 mg/ 5 ml Syrup - 200 200 14 186 300
27 As.Traneksamat tab 500 mg /Transamin 500mg tablet 257 257 257 500
29 Asam askorbat ( vit c ) tablet 250 mg tablet - 1000 1,000 200 800 3000
32 Asam Mefenamat 500 mg tablet 15,014 15,014 15,014 3000 exp agus 2019 = 7809 sep 19 = 7205
39 Asiklovir tablet 200 mg tablet 879 879 125 754
53 Bisakodil 5Mg tablet/ Dulcokax/Stolax tablet 2,064 2,064 36 2,028 exp jun 2019= 660 juli 2019 = 900
56 Ceterizine 10 mg tablet - 3000 3,000 245 2,755 2000
58 Deksametason inj. 5 mg/ml - 1 ml ampul 325 325 325 exp feb 2020 = 165 exp april 20 = 90
63 Diazepam tablet 2 mg tablet 8 8 8 -
70 Domperidon 10 mg tablet - - - 1000
71 Domperidon Drops syrup 48 20 68 68
72 Domperidon Suspensi syrup - 50 50 2 48 50
78 Epinefrin hcl/bitatrat (adrenalin) in.0,1 % - 1 ml ampul - 50 50 50
81 Erytromicin 500 mg tablet 499 499 499 300 exp meo 2021 = 499
86 Etanol 70 % 100ml larutan - 96 96 69 27
92 Fenobarbital tablet 30 mg Tablet 149 149 149 - 1000
97 Fitomenadion (vit k 1) tab salut 10 mg tablet 1,015 1,015 20 995
107 Gentian violet larutan 1 % larutan 1 1 1 - 25
127 Isosorbit dinitrat tablet subligual 5 mg tablet 1,810 200 2,010 2,010
132 Kaptopril 12,5 mg tablet 3,474 1500 4,974 1485 3,489
137 Ketoconazol 200 mg Tab tablet 1,162 1,162 200 962 300
140 Ketopropen supp/ suprafenid supp suppositoria 290 10 300 300 exp jun 2021 = 290
142 Klindamisin 150 mg tablet 1,768 300 2,068 100 1,968 500
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet - - - 2000
153 Klorpromazin 100 mg tablet tablet 1,035 1,035 120 915 300 exp aprl 19 = 700
158 Kotrimoksazol dewasa tablet tablet 1,320 1000 2,320 20 2,300 exp juni 19 =487
160 Kotrimoksazol suspensi syrup 95 100 195 10 185 50
169 Loperamid 2mg tablet - 500 500 14 486 500
170 Loratadine 10 mg tablet - - - 1000
177 Metformin Hcl tablet 500mg tablet 6,620 3000 9,620 1035 8,585 4000 exp juni 2021 = 6354 mei 2021 =266
186 Mikonazol krim/salep 2 % tube - 100 100 4 96 100
189 Natrium diklofenak tab 25 mg tablet - 500 500 160 340 3000
221 Povidon Iodida lar 10 % - 30 ml larutan 12 12 12 -
228 Ranitidin inj 25 mg Ampul - - - 20
239 Salbutamol tablet 2 mg tablet 6,137 1000 7,137 220 6,917 exp juli 19 =700
240 Salbutamol tablet 4 mg tablet 895 895 125 770 500 exp juni 19 = 400
255 Simvastatin 20 mg tablet 760 1000 1,760 440 1,320
259 Sukralfat sirup/Ulsidex/Ulsafate syrup 100 100 10 90
-
OBAT NON GENERIK -
25 Fg Troches tab hisap tablet 20 20 20 -
34 H2O2 3 % larutan - - -
55 Pehapral tablet - 500 500 175 325 1000
-
-
-
2 Abbocath No 18 pcs 308 100 408 408 exp sept 19 = 100 maret 21 165
5 Abbocath No 24 pcs 35 35 35 50 exp maret 20 =16
16 Blood Lancet pcs 10,400 10,400 10,400
31 Handscoend No. 7 pcs - 800 800 800 -
32 Handscoend No. 7,5 pcs - 500 500 300 200 200
36 Handscoend Non Steril Ukuran S Pcs - 1300 1,300 800 500 500
53 Kapas pembalut / absorben 250 mg bungkus 34 5 39 9 30 10
64 Masker 25 pcs/ktk - 2450 2,450 2000 450 500
65 Masker N 95 Pcs 149 320 469 49 420 100
69 Plester Leukoplast 4,5 m X 1,25 cm/PHARMAPLAST 12 pcs/ktk 108 108 108 exp mei 2020 108
71 Plester Micropore WITH Dispenserer pcs 47 47 47 exp sep 2020 = 47
73 Silk ( benang bedah sutera ) no. 3/0 pcs - 24 24 24
-
-
OBAT GIGI
-
-
OBAT PROGRAM -
-
2 Alkohol Swab Box - - -
21 Oli Emersi - - -
-
OBAT PROGRAM JIWA -
-
-
TAMBAHAN -
25 IPV Vial - 0
23 Kasa 40x 80 Pcs 5 5 1 4
24 ONE JECT - ADS 0.05 ml - - -
27 silkom 3 - - -
28 silkom2 - - -
29 Oxicobal - - -
46 RDTMalaria - - -
48 Kasa 40x 80 - - -
50 DEC - - -
53 Haloperidol 2 mg tablet 1,085 1,085 115 970
63 APD SET - - -
65 Baju Apron/hazmat buah 150 100 250 15 235
67 Termometer Infrared Digital / thermogun pcs 8 8 8
69 kacamata geogle buah - 10 10 10
77 Masker kain pcs 384 384 384 -
82 Oseltamivir 75 mg /kapsul kapsul 970 930 1,900 1410 490
83 Face Shield 20 250 270 30 240
84 desinfektan 3.8 l (0) (0) (0)
85 Bufacetine 2% salep tube 20 24 44 27 17
88 Azitromisin 500 mg tablet 635 1050 1,685 1410 275
91 masker tb - - -
92 Rapid antigen - 920 920 920 -
95 Masker KN95 BUAH 431 400 831 475 356
98 hand sanitizer kemasan 250 ml botol 11 60 71 31 40
99 Comvit C tablet - - -
101 Vitamin C 500 tablet - 3500 3,500 1800 1,700
102 benicom zink tablet - 2000 2,000 40 1,960
103 handsanitaizer 5 liter - 1 1 1
104 Cooler Box 5,5 l pcs 1 1 1 -
105 ice gel pcs 8 8 8 -
106 Oxymeter Pulse pcs 4 4 4
107 Plaster leukoplas ( 1x 5) rol 20 20 1 19
108 Calcii Glukonas 100 mg/ml ethi Ampul ampul 10 10 10
109 Metronidazol Suspensi botol 100 100 100
- -

ASKESKIN BPJS
126 584 375 1085


NIP . 197411192003122002 NIP.19830622 2010 2 033
KABUPATEN PELALAWAN

Juli PEMBERIAN
OPTIMUM
OBAT GENERIK PKD

2 Allopurinol tablet 100 mg Tablet 888 888 440 448
7 Amitriptilin hcl tablet salut 25 mg Tablet 2,700 2,700 2,700 exp april 2021 = 1300
9 Amlodipin 10 mg Tablet 4,869 2000 6,869 635 6,234 3000
10 Amoksisilin Kaplet 500 mg Tablet 10,683 5000 15,683 1825 13,858 exp sep 20 = 5500
12 Amoksisilin syrup kering 125 mg/ 5 ml Syrup 186 200 386 35 351 300
22 Aqua proinjeksi steril , bebas pirogen botol 10 20 30 20 10
29 Asam askorbat ( vit c ) tablet 250 mg tablet 800 800 800 - 3000
30 Asam askorbat ( vit c ) tablet 50 mg tablet 200 2000 2,200 247 1,953 1000 exp = juli 2020 = 200
39 Asiklovir tablet 200 mg tablet 754 754 20 734
56 Ceterizine 10 mg tablet 2,755 3000 5,755 1200 4,555 2000
57 Cetirizin syr 5 mg/5 ml Syrup - 200 200 200 50
63 Diazepam tablet 2 mg tablet - - -
64 Diazepam tablet 5 mg tablet 22 22 22 -
65 Diazepam rektal tube 15 15 2 13
66 Dietilkarbamazin sitrat tablet 100 mg tablet 100 100 10 90
70 Domperidon 10 mg tablet - 1000 1,000 120 880 1000
71 Domperidon Drops syrup 68 68 68
72 Domperidon Suspensi syrup 48 48 20 28 50
78 Epinefrin hcl/bitatrat (adrenalin) in.0,1 % - 1 ml ampul 50 50 50
81 Erytromicin 500 mg tablet 499 499 499 300 exp meo 2021 = 499
82 Etakridin ( rivanol ) larutan 0,1 % 100ml larutan 85 10 95 2 93
86 Etanol 70 % 100ml larutan 27 27 27 -
92 Fenobarbital tablet 30 mg Tablet - 500 500 500 1000
97 Fitomenadion (vit k 1) tab salut 10 mg tablet 995 995 20 975
102 Furosemida tablet 40 mg tablet 380 380 380 exp mei 2020 = 350
11 Garam oralit untuk 200 ml air sacc 30 30 30 - 1000
106 Gentamycin Tts Mata 0,3% larutan 85 20 105 2 103
107 Gentian violet larutan 1 % larutan - - - 25
123 Ibuprofen tablet 400 mg tablet - 500 500 400 100 3000
126 Isoniazid tablet 300 mg tablet 900 900 8 892
127 Isosorbit dinitrat tablet subligual 5 mg tablet 2,010 200 2,210 2,210
132 Kaptopril 12,5 mg tablet 3,489 1500 4,989 665 4,324
137 Ketoconazol 200 mg Tab tablet 962 962 20 942 300
140 Ketopropen supp/ suprafenid supp suppositoria 300 300 300 exp jun 2021 = 290
142 Klindamisin 150 mg tablet 1,968 1,968 150 1,818 500
143 Klindamisin 300 mg tablet - 1000 1,000 1,000 300
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet - 5000 5,000 792 4,208 2000
153 Klorpromazin 100 mg tablet tablet 915 915 90 825 300 exp aprl 19 = 700
169 Loperamid 2mg tablet 486 300 786 214 572 500
170 Loratadine 10 mg tablet - - - 1000
177 Metformin Hcl tablet 500mg tablet 8,585 300 8,885 1000 7,885 4000 exp juni 2021 = 6354 mei 2021 =266
178 Methilprednisolon 4 mg tablet - 600 600 600 - 2000
186 Mikonazol krim/salep 2 % tube 96 48 144 29 115 100
189 Natrium diklofenak tab 25 mg tablet 340 1000 1,340 620 720 3000
211 Parasetamol tablet 500 mg tablet - 1500 1,500 1500 - 5000
221 Povidon Iodida lar 10 % - 30 ml larutan - 20 20 3 17
223 Prednison tablet 5 mg tablet - 1500 1,500 1,500
228 Ranitidin inj 25 mg Ampul - - - 20
238 Risperidone 2mg tablet 135 135 135 - 500
240 Salbutamol tablet 4 mg tablet 770 770 190 580 500 exp juni 19 = 400
255 Simvastatin 20 mg tablet 1,320 1000 2,320 280 2,040
257 Siprofloxasin tab 500 mg tablet 500 200 700 100 600 exp maret 20 = 500
259 Sukralfat sirup/Ulsidex/Ulsafate syrup 90 90 11 79
-
OBAT NON GENERIK -
25 Fg Troches tab hisap tablet - - -
34 H2O2 3 % larutan - - -
55 Pehapral tablet 325 325 20 305 1000
-
-
-
2 Abbocath No 18 pcs 408 408 22 386 exp sept 19 = 100 maret 21 165
13 Bisturi no 21 pcs 192 192 27 165 exp maret = 192
16 Blood Lancet pcs 10,400 10,400 10,400
20 Catgut/benang bedah no.3/0 chromic pcs 333 24 357 12 345 24
31 Handscoend No. 7 pcs - 1500 1,500 500 1,000
32 Handscoend No. 7,5 pcs 200 250 450 250 200 200
36 Handscoend Non Steril Ukuran S Pcs 500 2400 2,900 2000 900 500
39 Infusion set dewasa Pcs 230 20 250 22 228 50
53 Kapas pembalut / absorben 250 mg bungkus 30 30 30 10
64 Masker 25 pcs/ktk 450 3150 3,600 3600 - 500
65 Masker N 95 Pcs 420 260 680 100 580 100
69 Plester Leukoplast 4,5 m X 1,25 cm/PHARMAPLAST 12 pcs/ktk 108 108 108 exp mei 2020 108
71 Plester Micropore WITH Dispenserer pcs 47 47 47 exp sep 2020 = 47
73 Silk ( benang bedah sutera ) no. 3/0 pcs 24 24 24 -
-
-
OBAT GIGI
-
-
OBAT PROGRAM -
-
2 Alkohol Swab Box - - -
4 Besi II Sulfat tablet tablet 422,250 23990 446,240 2780 443,460 exp juni 2019 = 78400 exp april 21 =341590
21 Oli Emersi - - -
-
OBAT PROGRAM JIWA -
-
-
TAMBAHAN -
25 IPV Vial - 0
23 Kasa 40x 80 Pcs 4 4 4 -
24 ONE JECT - ADS 0.05 ml - - -
27 silkom 3 - - -
28 silkom2 - - -
29 Oxicobal - - -
46 RDTMalaria - - -
48 Kasa 40x 80 - - -
50 DEC - - -
53 Haloperidol 2 mg tablet 970 970 30 940
63 APD SET - - -
65 Baju Apron/hazmat buah 235 235 235
67 Termometer Infrared Digital / thermogun pcs 8 8 8
69 kacamata geogle buah 10 10 5 5
76 Rapid tes + blood lanset test - 315 315 315
77 Masker kain pcs - - -
82 Oseltamivir 75 mg /kapsul kapsul 490 1800 2,290 2290 -
83 Face Shield 240 240 240
84 desinfektan 3.8 l (0) (0) (0)
85 Bufacetine 2% salep tube 17 48 65 17 48
88 Azitromisin 500 mg tablet 275 1900 2,175 2175 -
91 masker tb - - -
92 Rapid antigen - 449 449 449 -
95 Masker KN95 BUAH 356 475 831 831 -
98 hand sanitizer kemasan 250 ml botol 40 40 40 -
99 Comvit C tablet - - -
101 Vitamin C 500 tablet 1,700 1,700 1460 240
102 benicom zink tablet 1,960 4800 6,760 4680 2,080
103 handsanitaizer 5 liter 1 6 7 4 3
104 Cooler Box 5,5 l pcs - - -
105 ice gel pcs - - -
106 Oxymeter Pulse pcs 4 4 4
107 Plaster leukoplas ( 1x 5) rol 19 19 7 12
108 Calcii Glukonas 100 mg/ml ethi Ampul ampul 10 10 10
109 Metronidazol Suspensi botol 100 100 100
110 swab kit set - 500 500 500
111 ACCU-CHEK SAFE T PRD UNO PCS - 250 250 150
112 VIRUS TRANPORT MEDIA SET - 150 150 150
- -

ASKESKIN BPJS
194 596 361 1151

NIP . 197411192003122002 NIP.19830622 2010 2 033
NO NAMA OBAT SEDIAAN
OBAT GENERIK PKD
1 Allopurinol 300 mg Tablet

2 Allopurinol tablet 100 mg Tablet
3 Ambroxol 30 mg tablet Tablet
4 Ambroxol syr Syrup
5 Aminofilin injeksi 24 mg/ml - 10 ml ampul
6 Aminofilin tablet 200 mg Tablet
7 Amitriptilin hcl tablet salut 25 mg Tablet
8 Amlodipin 5 mg Tablet
10 Amoksisilin Kaplet 500 mg Tablet
11 Amoksisilin kapsul 250 mg capsul
12 Amoksisilin syrup kering 125 mg/ 5 ml Syrup
13 Amoksisilin+As.Klavulanat 625 mg tablet
14 Antalgin( metampiron) tab 500 mg Tablet
15 Antalgin injeksi 250 mg/ ml - 2 ml ampul
16 Antasida Doen II Suspensi Kombinasi syrup
17 Antasida doen tablet kombinasi tablet
18 Antibakteri doen salap kombinasi/bacitrasin tube
19 Antifungi doen kombinasi tube
20 Antihaemaroid doen kombinasi tablet
21 Antimigrain doen kombinasi tablet
22 Aqua proinjeksi steril , bebas pirogen botol
23 Aquadest steril botol
24 As.Traneksamat 250 mg inj ampul
27 As.Traneksamat tab 500 mg /Transamin 500mg tablet
28 Asam folat/Anemolat 1mg tablet
29 Asam askorbat ( vit c ) tablet 250 mg tablet
31 Asam Mefenamat 250 mg(Stanalin) capsul
32 Asam Mefenamat 500 mg tablet
33 Asam Mefenamat 50mg/5mlSuspensi Botol
34 Asetosal tablet 100 mg tablet
35 Asetosal tablet 500 mg tab
36 Asetil sistein 200mg tab
37 Asifit Kapsul
38 Asiklovir cream 5 % tube
39 Asiklovir tablet 200 mg tablet
41 Atropin sulfat injeksi 0,25 mg/ml - 1 ml ampul
42 Atropin sulfat tab 0,5 mg tablet
43 Attapulgite 300 mg/Pularex tab tablet
44 Attapulgite 600 mg tablet
45 Atorvastatin 20mg tablet
46 Benzatin benzil penisilin in 2,4 juta iu/vial ampul
47 Besi II Sulfat 250mg+As Folat 0,25mg tablet
48 Betahistin Mesilat Tablet 6mg tablet
49 Betametason krim 0,1 % tube
50 Bisoprolol tab 5mg tablet
51 Bisakodil 5mg supp/ Dulcokax/Stolax suppositoria
52 Bisakodil 10 mg supp/ Dulcokax/Stolax suppositoria
53 Bisakodil 5Mg tablet/ Dulcokax/Stolax tablet
54 Burnazin crem tube
55 Bromheksin HCl syrup/ Hustab syr Syrup
56 Ceterizine 10 mg tablet
57 Cetirizin syr 5 mg/5 ml Syrup
58 Deksametason inj. 5 mg/ml - 1 ml ampul
59 Deksametason tablet 0,5 mg tablet
60 Deksametason + desklorpheniramin maleat/Dextamin/Etadexta/Pritacort tablet
61 Desoximethason crem/Denomix crem tube
62 Diazepam inj 5 mg/ml ampul
63 Diazepam tablet 2 mg tablet
65 Diazepam rektal tube
66 Dietilkarbamazin sitrat tablet 100 mg tablet
67 Difenhidramin hcl inj. 10 mg / ml -1 ml ampul
68 Digoksin tablet 0,25 mg tablet
69 Diltiazem tablet 30 mg tablet
70 Domperidon 10 mg tablet
71 Domperidon Drops syrup
72 Domperidon Suspensi syrup
73 Doxicyclin 100mg tablet
74 Echinature Kap Kapsul
75 Echinature Kids syr Syrup
76 Efedrin hcl tablet 25 mg tablet
77 Ekstrak belladone tablet 10 mg tablet
78 Epinefrin hcl/bitatrat (adrenalin) in.0,1 % - 1 ml ampul
79 Erithromicyn Syr Syrup
80 Erytromicin 250 mg Kapsul
81 Erytromicin 500 mg tablet
82 Etakridin ( rivanol ) larutan 0,1 % 100ml larutan
84 Etambutol hcl tablet 250 mg tablet
86 Etanol 70 % 100ml larutan
88 Famotidin 20 mg tablet
90 Fenobarbital injeksi 50 mg/ml - 2 ml ampul
91 Fenobarbital tablet 100 mg Tablet
93 Fenoksimetil penisilina tablet 250 mg Tablet
95 Fenol gliserol tetes telinga 10 % larutan
96 Fitomenadion (vit k 1) inj 10 mg/ml - 1ml ampul
97 Fitomenadion (vit k 1) tab salut 10 mg tablet
98 Fitomenadion inj 2 mg/Infan ampul
99 Fituno Kapsul
100 Flunarizine tab 5 mg tablet
101 Furosemida injeksi ampul
102 Furosemida tablet 40 mg tablet
11 Garam oralit untuk 200 ml air sacc
104 Gentamycin Inj 80mg ampul
105 Gentamycin salp kulit tube
106 Gentamycin Tts Mata 0,3% larutan
107 Gentian violet larutan 1 % larutan
108 Glibenklamid tablet 5 mg tablet
109 Gliseril guayakolat tablet 100 mg tablet
110 Gliserin larutan
111 Glukosa larutan infus 10 % steril larutan
114 Griseofulvin tablet 125 mg , micronized tablet
115 Haloperidol tablet 0,5 mg tablet
117 Haloperidol tablet 5 mg tablet
118 Hidroklorotiazid ( hct ) tablet 25 mg tablet
119 Hidrokortison krim 2,5 % tube
120 Ibuprofen Suspensi syrup
121 Ibuprofen tab tablet
122 Ibuprofen tablet 200 mg tablet
124 Ichtiol zalf 30 gr pot
125 Isoniazid tablet 100 mg tablet
127 Isosorbit dinitrat tablet subligual 5 mg tablet
128 Itraconazole 100 mg tablet
129 Kalium Diklofenak 50mg tablet
130 Kalium Permanganat serbuk pot
131 Kalsium laktat ( kalk ) tablet 500 mg tablet
132 Kaptopril 12,5 mg tablet
133 Kaptopril 25 mg tablet
135 Karbamazepin tablet 200 mg tablet
136 Karbogliserin Tetes Telinga 10 % larutan
137 Ketoconazol 200 mg Tab tablet
138 Ketoconazol cream tube
139 Ketopropen tab 100 mg tablet
140 Ketopropen supp/ suprafenid supp suppositoria
141 Ketorolac inj 30 mg ampul
142 Klindamisin 150 mg tablet
144 Kloramfenikol Tetes Mata larutan
145 Kloramfenikol 125 mg/5 ml suspensi Botol
146 Kloramfenikol kapsul 250 mg capsul
147 Kloramfenikol salap mata 1 %/colme /erlamycetin tube
148 Kloramfenikol tetes telinga 3 %/ colme/erlamicetin larutan
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet
150 Kloramfenikol +Hidrocortison krim/ Chloramphecort crem tube
151 Klorokuin fosfat tablet 150 mg tablet
153 Klorpromazin 100 mg tablet tablet
154 Klorpromazin 25mg tablet tablet
155 Klorpromazin inj 25 mg Ampul
156 Kodein tablet 10 mg tablet
157 Kombinasi pirimetamin 25 mg+ sulfadosin 500 mg tablet
158 Kotrimoksazol dewasa tablet tablet
159 Kotrimoksazol pediatrik tablet tablet
160 Kotrimoksazol suspensi syrup
161 Kuinin (Kina) tablet 200 mg tablet
162 Kuinin dihidroklorida inj. 25 % - 2 ml tablet
163 Lansoprazole Kapsul 30mg capsul
164 Levofloksasin 500 mg tablet
165 Levofolxacin infus 5 mg/ml larutan
166 Lidokain 1 % ampul
167 Lidokain 2 % + epinefrin 2ml ampul
168 Linkomisin 500mg Kapsul
169 Loperamid 2mg tablet
170 Loratadine 10 mg tablet
171 Lorazepam tablet Tablet
172 Magnesium sulfat inj (iv) 20 % - 25 ml larutan
174 Mebendazole syp syrup
175 Meloxicam 15 mg tablet
176 Meloxicam 7,5 mg tablet
177 Metformin Hcl tablet 500mg tablet
178 Methilprednisolon 4 mg tablet
180 Metiergometrin maleat inj.0,2 mg - 1 ml larutan
181 Metilergometrin maleat tab sal 0,125 mg tablet
182 Metoklopramide tab 10 mg tablet
183 Metronidazol tablet 250 mg tablet
185 Metronidazole Infus 500mg/100 ml larutan
186 Mikonazol krim/salep 2 % tube
187 Mikobalamin 500mg/Lanabal tablet
188 Natrium bikarbonat tab 500 mg tablet
189 Natrium diklofenak tab 25 mg tablet
191 Natrium klorida larutan infus 0,9 % steril larutan
192 N.Acetyl Systein 200 mg tablet
193 Nifedipin tablet tablet
194 Nistatin tablet vaginal 100.000 IU / g tablet
195 Nistatin tablet salut 500.000 IU tablet
196 Obat batuk hitam ( o.b.h ) cairan larutan
197 Ofloksasin tablet 200 mg tablet
198 Oksitetrasiklin hcl inj. I.m 50 mg/ml - 10 ml larutan
199 Oksitetrasiklin hcl salap 3 % tube
200 Oksitetrasiklin hcl salap mata 1 % tube
201 Oksitosin injeksi 10 iu/ ml - 1 ml Ampul
202 Omeprazol injeksi 40 mg Ampul
203 Omeprazol tablet 20 mg capsul
204 Ondansetron tab 4 mg tablet
205 Ondansetron tab 8 mg
206 Ondansetron inj Ampul
207 Papaverin 40 mg/Spasminal tablet tablet
208 Parasetamol Drops syrup
209 Parasetamol syrup 120 mg / 5 ml syrup
210 Parasetamol tablet 100 mg Tablet
211 Parasetamol tablet 500 mg tablet
212 Paracetamol 120mg Eff/Sanmol Tube 10 tube
213 Paracetamol 125 mg Supp/Pamol suppositoria
214 Pirantel tablet 125 mg tablet
215 Pirantel Suspensi 125 mg syrup
216 Pirazinamid tablet 500 mg tablet
217 Piridoksin hcl tablet 10 mg tablet
218 Piroksikam 10 mg tab tablet
220 Povidon Iodida lar 10 % - 300 ml larutan
223 Prednison tablet 5 mg tablet
224 Primakuin tablet 15 mg tablet
225 Propanolol hcl tablet 10 mg tablet
227 Propiltiourasil tablet 100 mg tablet
228 Ranitidin inj 25 mg Ampul
229 Ranitidin tablet 150 mg tablet
230 Reserpin tab 0,10 mg tablet
232 Retinol 100.000 ui capsul
234 Rifampisin kapsul 600 mg tablet
235 Rimfampisin kapsul 300 mg tablet
237 Ringer laktat larutan infus steril larutan
238 Risperidone 2mg tablet
239 Salbutamol tablet 2 mg tablet
241 Salep 2-4 komb As.Salisilat 2 % +Belerang pot
242 Salisil bedak 2 % pot
243 Sefadroxyl 500 mg tablet
244 Sefadroxyl sirup kering 125 mg / 5 ml syrup
245 Sefaleksin 500 mg tablet
246 Sefiksim kapsul 100 mg capsul
247 Sefiksim syr syrup
248 Sefotaksim injeksi 1 gram vial
249 Seftriason inj 1 gr vial
250 Serum Anti Bisa Ular (ABU) Vial 5 ml
251 Serum Anti Tetanus (ATS) 1500 vial 1 ml
252 Sianokobalamin ( vit b 12 ) inj.500 mcg/ml Ampul
253 Simetidin tablet 200 mg tablet
254 Simvastatin 10 mg tablet
256 Siprofloxasin infus larutan
257 Siprofloxasin tab 500 mg tablet
258 Streptomisin sulfat serbuk inj. 1000 mg/vial vial
259 Sukralfat sirup/Ulsidex/Ulsafate syrup
260 Sukralfat 500 mg tablet
261 Sulfasetamida Natrium tetes Mata 15 % larutan
262 Tetracain Hcl tetes mata larutan
263 Thiampenikol tablet capsul
264 Tiamin hcl ( vit b 1 ) inj. 100 mg/ml - 1 ml Ampul
265 Tiamin hcl mononitrat ( vit b 1 ) tablet 100 mg tablet
267 Tramadol injeksi Ampul
268 Tramadol tablet 50 mg tablet
269 Triheksifenidil hcl tab 2 mg tablet
270 Urea crem / Soft U Derm 10 % tube
271 Vaksin Rabies Vero vial
272 Vaksin Anti Bisa Ular (ABU) Vial
273 Vitamin b komplek tablet tablet
274 Zink Dispersible 20 mg tablet
275 Zinkpro Drops syrup
276 Zink syrup/ Zirkum syrup syrup
OBAT NON GENERIK
1 Anadex syr syr
2 Alpara syr syrup
3 Asering 500 cc larutan
4 Baby cough syr syrup
5 Becefort Suspensi syrup
6 Becefort Tablet tablet
7 Beneuron tablet
8 Bionemi tab tablet
9 Bioron tab tablet
10 Becom C tablet
11 Betafort Syr syrup
12 Bio ATP tablet
13 Bioplacenton Gel tube
14 Biovitan Syr syrup
15 Bisolvon Extra Syr Botol 60 ml
16 Calsidol syr Larutan 5ml
17 Cendo Xitrol Tetes Mata botol 5ml
18 Cendo Xitrol Tts Mata mini dose Tube
19 Cendo cetamid tts mata botol
20 Colfin Tablet
21 Curcuma tablet tablet
22 Dasabion Tablet tablet
23 Dextrosin tab tablet
24 Dextrofen syr syrup
25 Fg Troches tab hisap tablet
26 Fitbon Plus tablet
27 Flucort N crem tube
28 Fludane Tablet tube
29 Formalin cair larutan
30 Gerac tablet tablet
31 Geriavita tablet
32 Gericare kaplet tablet
33 Good Proliver tablet
34 H2O2 3 % larutan
35 Hemafort kap tablet
36 Hemorogard Kapsul kapsul
37 Hexacort Crem Tube
38 Hidrex Surgical 500 cc larutan
39 Ikaneuron 5000/Nerva 5000 tablet
40 Interhistin tablet tablet
41 Isotic Clearens larutan
42 Isotic Neolyson larutan
43 Lexavit tab tablet
44 Lisol larutan
45 Livron B-Plex tablet tablet
46 Lybex Syr syrup
47 Merlopam 0,5 mg tablet
48 Minyak Telon larutan
49 Neurovit-E Tablet tablet
50 Nodrof Flu Antitussive tablet
51 Noza Tablet tablet
52 Oxfezin syr syrup
53 Obat batuk hitam Indo Plus cairan larutan
54 Pain Kila / Stop Pain tube
55 Pehapral tablet
56 Pharmaton Formula capsul
57 Polykresulen (albothyl) larutab
58 Ponflu Kaplet tablet
59 Ponflu Syr syrup
60 Prolysin Syr syrup
61 Risperidone 2 mg tablet
62 Sagestam cream tube
63 Sanbe Kids syr syrup
64 Scabisid crem/scabimite crem tube
65 Topras Tablet tablet
66 Tremenza/*neo protifed tablet
67 Tuzalos tab tablet
68 Vitalex syrup
69 Woods papermint antitusive syrup
70 Xylocaine jelly 2% gel
71 Xepavit tablet tablet
72 Vetolin Nebules /Salbutamol cairan larutan
73 Ventolin Rotacap /Salbutamol Serbuk capsul
74 Salbutamol Inhalasi/ Fartolin Inhalasi fls
75 Salbutamol syr/Salbron syrup
76 Hustab tablet/Mucohexin/Bromheksin Hcl tablet
77 Pratifar tablet

1 Abbocath No 16 pcs
6 Alat suntik sekali pakai 1 ml pcs
8 Alat suntik sekali pakai 1cc insulin pcs
9 Alat suntik sekali pakai 2.5 ml pcs
13 Bisturi no 21 pcs
16 Blood Lancet pcs
17 Blood Administrasi set pcs
18 Catgut/benang bedah no.2/0 chromic pcs
19 Catgut/benang bedah no.2/0 plain pcs
22 Daryantule / Sofrattule/Bioplacenton Tulle pcs
23 Folley Cateter 2 Way 30 cc No. 14 pcs
27 Handscoend Ukuran L Mikro Touch pcs
28 Handscoend Ukuran M Mikro Touch pcs
29 Handscoend Ukuran S Mikro Touch pcs
30 Handscoend No. 6,5 pcs
31 Handscoend No. 7 pcs
34 Handscoend Non Steril Ukuran L Pcs
35 Handscoend Non Steril Ukuran M Pcs
36 Handscoend Non Steril Ukuran S Pcs
37 Hcl 0,1 N larutan
38 Infusion set anak Pcs
39 Infusion set dewasa Pcs
40 Jarum Jahit Kulit GT 1113 No 10 Pcs
41 Jarum Jahit Kulit GR 1113 No 10 Pcs
43 Jarum Jahit Kulit GR 1113 No 11
52 Kapas berlemak 500 mg bungkus
53 Kapas pembalut / absorben 250 mg bungkus
54 Kasa kompres 40/40 steril bungkus
55 Kasa pembalut 36 m x 80 cm rol
57 Kasa pembalut hidrofil 4 m x 10 cm bungkus
59 Kasa pembalut hidrofil 4 m x 3 cm rol
61 Kasa steril 16 x 16 kotak
62 Liquicheck Hematology Control Normal Vial
63 Lyse M-30 D-Diff Btl 500 ml
64 Masker 25 pcs/ktk
65 Masker N 95 Pcs
66 Nald Inj, box 100 pcs
67 Pastik (Alkohol Swab) box 100 pcs
68 Plester 5 yard x 2 inch rol
69 Plester Leukoplast 4,5 m X 1,25 cm/PHARMAPLAST 12 pcs/ktk
70 Plester Micropore Non Dispenser(Pharmaplast) 10x500 pcs
71 Plester Micropore WITH Dispenserer pcs
72 Pot Urine 50 cc pcs
73 Silk ( benang bedah sutera ) no. 3/0 pcs
74 Terofusion Blood Set Pcs
75 Urin Bag pcs
76 Wing Nedle no 21 G pcs
81 Ventolin Rotahaler pcs
OBAT GIGI
1 Air Raksa Dental Use larutan

2 Devitalisasi pasta (non arsen) larutan
3 Dental Merkuri
4 Eter Anaestetik Botol
5 Etil klorida semprot Botol
6 Eugenol cairan larutan
7 Fluor tablet 0,5 mg tablet
8 Glass lonomer cement ( gc ix ) set /botol
9 Iodoform pasta Botol
10 Kalsium hidroksi pasta 2 tube/kotak
11 Monoklorkamfer mentol cairan (CHKM) botol 10 ml
12 Mummifying pasta botol / kotak
13 Semen seng fosfat serbuk dan cairan botol
14 Silver amalgam serbuk 65 - 75 % 1 oz / botol
15 Spon gelatin cubicle cubicles 1x1x1 cm 24 buah / kotak
16 Temporari stoping (fletcher) serbuk dan cairan
OBAT PROGRAM
1 Albendazole 400mg tablet

2 Alkohol Swab Box
3 Azitromisin tablet
4 Besi II Sulfat tablet tablet
5 Blood Glucosa Test Strip botol
6 Fluconazole 150mg kapsul
7 Filariasis Brugia Rapid
8 Immunoassay Malaria Kotak 30 test
9 Isoniazid 300mg tablet
10 Kapas 1 kg Bungkus
11 Kertas Whatman kotak
12 Kolesterol Test Strip botol
13 Kotrimoxazol 960 mg tablet
14 Lancet Divece Kotak
15 Larutan Giemsa 100 ml botol
16 OAT FDC Kat I kotak
17 OAT FDC Kat II kotak
18 OAT FDC Kat Sisipan kotak
19 OAT Kat Anak kotak
20 OAT Kombipak Kat I kotak
21 Oli Emersi
22 Objec Glass/Mikroskope Slide kotak
23 Piridoksin tab 50mg/vit B.6
24 Pot MDR pcs
25 Pot Sputum pcs
26 Pot Urine pcs
27 Reagen Ziel Nelsen botol
28 Retinol A 100 000 IU kapsul lunak capsul
30 Slide box kotak
31 Stick Narkoba
32 Tabung Edta 3 ml botol
33 Tissue gulung Kotak 100
34 Tissue Mikroskope Kotak 100
35 Uric Acid Test Strip botol
36 Vikia HIV 1/2 Pcs
OBAT PROGRAM JIWA

1 Flufenazine Decanoat inj 25 mg ampul
2 Clozapine 25mg tablet tablet
3 Clobazam 10 mg tablet
4 Triheksifenidil tablet 2 mg tablet

1 Diluent-30 D-Diff botol 20l
2 Lyse M 30D-Diff botol
3 Probe clenser M-30P Botol
4 Liquichect Hematology Vial
5 EZ Cleanser M.30E Botol
7 Rinse M.30 galon
TAMBAHAN
1 pritakort tablet
2 masker thee on 3 play tablet
3 piridoksin 50 tablet
4 Stick Narkoba box
5 Stick Glukosa box
6 Stick Asam Urat box
7 Stick Kolesterol box
8 Trifluoperazine 5 mg box
9 Haloperidol Injeksi ampul
10 HIV 1/2 3.0Multi Paket
11 Descoderm Pade Pcs
12 Vaksin Bcg kering serbuk injeksi 0,375 mg /ml vial
13 Pentabio vaksin Dtp-hb-hib injeksi 2,5 ml vial
14 Vaksin Polio Oral Trivalen Drops vial
15 Vaksin campak keringserbuk injeksi 1000 Ccid vial
16 Vaksin Hepatitis B 10 Mcg/ml vial
17 Vaksin Jerap Td Vial
18 Vaksin Ipv Vial
19 MDT MB Adult blister
20 Dispose savety box 2,5 l Pcs
21 Vaksin TT /DT vial
pelarut Vaksin BCG vial
23 Pelarut Vaksin Campak ampul
24 Dropper for oral vaccine bh
25 IPV Vial
21 Salbulin /salbutamol inhalasi/combiven inhalasi Pcs
22 combiven Pcs
23 Kasa 40x 80 Pcs
24 ONE JECT - ADS 0.05 ml
26 ONE JECT-ADS 5 ml
27 silkom 3
28 silkom2
29 Oxicobal
30 Pularex 630 mg tablet
31 Selvi plex tablet
32 Vaksin Measles Rubella Vial
33 Skifa ADS 5 ml pcs
34 Skifa ADS 0,5 ml pcs
35 Safety Box 5 l pcs
36 Xilocain jelly botol
37 RDT Hepatitis botol
38 DHP-Frimal blister
40 SD BIOLIN HIV
42 Hexagon sytrilis
43 Vaksin HBIG VIal
44 Sefixim 200 mg kapsul
45 Tisu mikroskope pcs
46 RDTMalaria
47 eutyrox 500 mg tablet
48 Kasa 40x 80
49 saypilis strip
50 DEC
51 dispose savety box 5 l
52 OXYCAN BTL
53 Haloperidol 2 mg tablet
55 Tips For Micropipette buah
56 Vacum Tube Edta 0,5 ml tube
57 Needle flashback 21 x 1 pcs
58 Fucilex 20 mg/G krim 5 G Mola Tube tube
59 Amoksisilin 100 mg drops botol
60 Ampisilin serbuk injeksi 1000 mg vial
61 Grisiofulvin 250 mg tablet
62 Mineral mix Sacchet
63 APD SET
64 Prokain benzile serbuk injeksi vial
65 Baju Apron/hazmat buah
66 Tuberkulin PPD RT 23 SSI VIAL
67 Termometer Infrared Digital / thermogun pcs
67 Haloperidol injeksi 50 mg/ml ampul
68 sepatu/ safety boots buah
69 kacamata geogle buah
70 handsanitaizer botol
71 ACCU-CHEK SAFE PCS
72 Rapit sars;COV 2 ( Rapit test corona) test
73 Alpara tablet
74 Apecur 100 ml vitamin Anak botol
75 new Antides Tablet tablet
76 Rapid tes + blood lanset test
77 Masker kain pcs
78 SD BIOLIN DANGUE pcs
79 SD BIOLIN HIV 30 pcs
80 Trepocheck sypilis pcs
81 Albendazole suspensi 200 mg/5 ml botol
82 Oseltamivir 75 mg /kapsul kapsul
83 Face Shield
84 desinfektan 3.8 l
85 Bufacetine 2% salep tube
86 Fixomull 5 cmx 5 m Dressing penutup luka bakar pcs
87 miravon botol
88 Azitromisin 500 mg tablet
89 Lopivia tablet
90 Esomeprazole serbuk injeksi 40 E/56n82 vial
91 masker tb
92 Rapid antigen
93 Tuberkulin PPD RT 23 SSI
94 Piridoksin 25 tablet
95 Masker KN95 BUAH
96 virochecck HbsAg
97 Albendazol syr botol
98 hand sanitizer kemasan 250 ml botol
99 Comvit C tablet
100 Hepagard 250 mg tablet
101 Vitamin C 500 tablet
102 benicom zink tablet
103 handsanitaizer 5 liter
104 Cooler Box 5,5 l pcs
105 ice gel pcs
106 Oxymeter Pulse pcs
107 Plaster leukoplas ( 1x 5) rol
108 Calcii Glukonas 100 mg/ml ethi Ampul ampul
109 Metronidazol Suspensi botol
110 swab kit set
111 ACCU-CHEK SAFE T PRD UNO PCS
112 VIRUS TRANPORT MEDIA SET
113 Nicecare desinfektan 5 l liter
114 Hand sanitazer 60 ml
115 Rampit c tablet
116 sivit zinc tablet
117 buscopan injeksi ampul
118 Nasal oxygen canula Adult pcs
119 Nasal oxygen canula child pcs
JUMLAH KUNJUNGAN RESEP

ASKESKIN
154
MENGETAHUI/MENYETUJUI
KEPALA DINAS KESEHATAN KAB. PELALAWAN
(…………………………………………………………..)
KABUPATEN PELALAWAN
Agustus PEMB
Stok Awal STOK
PERMINTAAN
OPTIMUM
Penerimaan Persediaan Pemakaian Sisa Stok Inpres
- - -
448 448 250 198
- - - 2000
- - - 200
- - -
- - -
2,700 2,700 60 2,640
- - - 3000
6,234 5000 11,234 645 10,589 3000
13,858 10000 23,858 1185 22,673
3,291 3,291 200 3,091 1000
351 100 451 29 422 300
- - -
- - -
- - -
467 467 53 414 300
7,175 3000 10,175 2875 7,300 3000
- - -
100 100 100
248 20 268 3 265 20
- - -
10 10 20 12 8
- - -
10 10 10
- - -
- - -
227 227 227 500
- - - 1000
- 1000 1,000 200 800 3000
1,953 1000 2,953 1113 1,840 1000
- - -
15,054 15,054 40 15,014 3000
- - -
835 835 835
- - -
2,260 23760 26,020 6260 19,760 3000
- - -
- - -
734 734 734
- - - 1000
95 95 95
- - -
- - -
- - -
480 480 480
- - -
- - -
- - -
228 228 228
60 60 60
150 150 9 141
- - -
2,028 2,028 18 2,010
- - -
- - -
4,555 3000 7,555 450 7,105 2000
200 50 250 4 246 50
345 50 395 10 385
- 2000 2,000 200 1,800 2000
- - - 1000
69 69 69
112 112 112
- - -
- 100 100 100
13 13 13
90 90 90
115 115 115
700 700 700
- - -
880 500 1,380 135 1,245 1000
68 68 2 66
28 28 3 25 50
2,230 2,230 20 2,210 500
- - -
- - -
- - -
1,064 1,064 1,064
50 50 50
- - -
- - -
499 499 499 300
93 93 1 92
- - -
- - -
- - -
- 96 96 8 88
- - - 10
- - -
- - - 1000
180 180 180
- - -
500 500 234 266 1000
- - -
- - -
- - - 25
- - -
975 975 10 965
2,683 2,683 2,683
- - -
- - - 200
- - -
380 200 580 580
- - - 1000
334 334 334
- - - 100
103 25 128 7 121
- - - 25
7,800 1000 8,800 575 8,225
- - - 2000
- - -
- - -
- - -
57 20 77 77
2,209 2,209 20 2,189
40 40 40
118 118 118 - 500
4,320 4,320 4,320 500
695 695 695 500
335 335 24 311 50
85 85 3 82
- - -
- - - 1000
100 100 100 - 3000
- - - 50
- - -
892 892 892
2,210 100 2,310 2,310
240 240 240
- - -
- - - 25
11,145 2000 13,145 760 12,385 2000
4,324 1000 5,324 480 4,844
- 1000 1,000 70 930 1000
1,200 1,200 1,200
80 1000 1,080 210 870 500
- - -
942 942 942 300
216 216 8 208 25
- - -
300 300 300
33 33 33 30
1,818 1,818 40 1,778 500
1,000 1,000 20 980 300
- - -
- - -
- - -
- - -
- - - 20
4,208 3000 7,208 898 6,310 2000
- - -
- - -
- - -
825 825 71 754 300
1,170 1,170 45 1,125 300
540 540 540
- - -
- - -
2,270 500 2,770 20 2,750
- - -
181 181 7 174 50
- - -
- - -
6,404 1360 7,764 680 7,084 1000
- - -
- - -
- - -
760 760 760
- - -
572 500 1,072 138 934 500
- - - 1000
- - -
- - -
10 10 10
- - -
- - - 2000
- - - 2000
7,885 7,885 410 7,475 4000
- - - 2000
- - - 1000
175 175 175
400 1000 1,400 1,400
1,990 1,990 110 1,880
- - -
- - - 500
1 1 1
115 48 163 5 158 100
- - - 500
900 900 900 300
720 1000 1,720 480 1,240 3000
9,206 2800 12,006 190 11,816
89 89 19 70 20
- - -
556 556 556
935 935 7 928
186 186 186
- - -
- - -
- - -
- - -
1,125 1,125 3 1,122
18 18 18
32 32 32
- - -
- - -
- - -
- - -
- - -
- - -
557 400 957 304 653 300
-
- 2500 2,500 200 2,300 5000
- - -
- - - 50
- - -
- - -
- - -
17,226 1000 18,226 155 18,071 3000
- - - 1000
- - -
20 20 20
17 20 37 2 35
- 10 10 10 20
1,500 1500 3,000 3,000
- - -
845 845 845
- - -
- - -
- - - 20
- - - 3000
- - -
- - -
- 1450 1,450 1450 -
530 530 530 -
- - -
- - -
- - -
138 20 158 13 145 20
- - - 500
6,707 500 7,207 460 6,747
580 580 125 455 500
- - -
- - - 50
- - - 500
18 18 18
- - -
- - -
- - -
- - -
- - -
3 3 3
- - - 10
96 96 96
- - -
1,200 1,200 1,200 1000
2,040 5000 7,040 210 6,830
- - -
600 600 100 500
- - -
79 79 10 69
- - - 500
- - -
- - -
- - -
- - -
- - -
1,121 2000 3,121 120 3,001
- - -
50 50 50
- - -
- - -
- - -
- - -
17,390 1500 18,890 2270 16,620 5000
5,785 10000 15,785 5380 10,405 2000
- - -
- - -
-
-
- - -
- - -
- - -
- - - 50
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - - 5
- - -
- - -
- - -
- - - 20
- - -
- - -
- - -
- - -
- - -
- - -
- - - 50
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - - 1000
- - -
- - -
- - -
305 305 305 - 1000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
58 10 68 10 58 50
- - -
- - -
- - -
- - -
- - -
- - -
- - - 3000
- - -
- - -
- - -
- - -
- - - 3000
- - - 3000
-
-
-
-
- - -
386 100 486 10 476
9 9 9 -
- - -
13 50 63 15 48 50
1,288 1,288 10 1,278 300
56 56 5 51
- - -
- - -
- - -
155 155 26 129 300
532 532 15 517
165 165 165
- - -
230 230 230
10,400 10,400 400 10,000
- - -
- - -
- - -
345 24 369 369 24
96 96 96
90 90 90
- - -
75 75 75
22 22 22
- - -
- - -
- - -
- - - 400
- - -
1,000 1000 2,000 800 1,200
200 200 200 - 200
- - - 200
- - - 300
- - - 500
900 400 1,300 1300 - 500
- - -
- - -
228 228 12 216 50
- - -
84 84 84
- - -
48 48 48
- - -
60 60 60
- - -
12 12 12
36 36 36
- - -
60 60 60
- - -
3 3 3
30 30 30 10
172 172 5 167
- - -
114 114 2 112
103 103 103
- - -
- - -
- - -
1,728 1,728 145 1,583
- - -
- - -
- 2600 2,600 2600 - 500
580 220 800 40 760 100
- - -
- - -
- - -
108 108 108
- - - 5
47 47 47
- - -
- 24 24 12 12
- - -
- - -
- - -
- - -
- - -
- - -
- - -
106 106 106
-
-
-
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
-
-
-
- - -
- - -
- -
443,460 443,460 2590 440,870
- - - 5
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 1 1 1 -
- - - 6
- - -
- - -
- - - 4
- - -
- - -
- - -
- - -
- - -
- - -
- - -
86 86 86 4
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
-
-
35 35 35
- - - 1000
1,070 1,070 1,070 50
- - -
-
-
- - -
- - -
- - -
- - -
- - -
- - -
- - -
-
-
- - -
- - -
- - -
- - -
- - - 10
- - -
- - - 10
2,822 2,822 60 2,762
- - -
- - -
- 0 0 300
- 0 0
- 0 0
- 0 0
- 0 0
- 0 0
- 0 0
- 0 0
6 6 6
- 0 0
- 0 0
- 0 0
- 0
- 0
- 0
- 0 0 10
190 190 190
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - - 3
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 100 100 100 -
- - -
- - -
- - -
- - -
- - -
16 16 16
940 940 50 890
-
18,000 18,000 18,000
1,500 1,500 1,500
600 600 600
- - -
- - -
433 433 433
1,500 1,500 1,500
- - - 100
- - -
8 8 8
235 50 285 10 275
1 1 1
8 8 8
19 19 19
1 1 1
5 5 2 3
- - - 5
- - -
- - -
- - - 1000
- - - 50
505 500 1,005 150 855
315 315 65 250
- - -
75 75 75
71 71 71
- - -
- - -
- 3150 3,150 1910 1,240
240 20 260 20 240
(0) (0) (0)
48 96 144 20 124
20 20 20
- - -
- 2720 2,720 2020 700
- - -
6 6 6 -
- - -
- 1500 1,500 800 700
- - -
- - -
- 345 345 275 70
- - -
- - -
- 50 50 50 -
- - -
600 600 60 540
240 1000 1,240 20 1,220
2,080 5500 7,580 4240 3,340
3 3 6 5 1
- - -
- - -
4 4 4
12 20 32 2 30
10 10 10
100 100 100
500 500 500
150 250 150
150 150 150
- 5 5 2 3
- 24 24 24 -
500 500 500
900 900 900
20 20 2 18
50 50 50
50 50 50
- -
-
ASKES UMUM JUMLAH
BPJS
523 185 862
MENERIMA/MELAPOR YANG MENERIMA

KEPALA PUSKESMAS PETUGAS PUSKESMAS
Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm

NIP . 197411192003122002 NIP.19830622 2010 2 03
PEMBERIAN
JUMLAH KET
Askes APBD Lain2 Jumlah
exp april 2021 = 1300
exp sep 20 = 7008 exp agus 2021 = 2375
exp agus 2021 = 411 sep 21 =3

exp agus 20 = 3250
exp mei 2021 = 100

exp sep 2020 = 77
exp juni 2021 = 10
exp = juli 2020 = 200

exp agus 2019 = 7809 sep 19 = 7205
exp sept 2019 = 835
exp feb 2021 = 95
exp feb 2020 = 480
exp feb 2021 =228

exp des 2020 = 60
exp jun 2019= 660 juli 2019 = 900 exp agus v2021 = 450
exp feb 2020 = 165 exp april 20 = 90
exp agus 2019 = 69
exp april 19 = 68
expmaret 2021 = 700
exp okt 19 = 1400
exp mei 19 = 1064
exp mei 2021 = 499
exp juni 18 = 2683
exp mei 2020 = 350
exp = okt 20 = 334

exp= sept 20 = 57
exp juli 19 =404 feb 20 = 90
exp juni 19 = 50
exp sept 19 = 240
exp jun 2020 = 1200
exp jun 2021 = 290

exp mei 2020 = 33
exp aprl 19 = 700

exp mei 20 = 540
exp juni 19 =487
exp juni 2021 = 6504 mei 2021 =266
exp jun 2020 = 75 april21 = 100

exp April 2020 = 200
exp okt 20 = 1
exp mei 20 = 900
exp juni 19 =15
exp maret 2021 = 556

exp agus 19 = 186
exp juni 20 = 32
exp juni 2020 = 5400
exp feb 21 =16 maret 21 4
exp juni 19 = 845
exp apr 19 = 6100 agus 19 = 4000

exp juli 19 =700
exp juni 19 = 400
exp maret 21 = 18
exp mei 2021 = 96
exp feb 20 = 1200
exp maret 20 = 500
exp juli 19 = 50
exp okt 19 = 255
exp sept 19 = 100 maret 21 165
exp maret 20 =16
exp maret = 192
exp maret = 230
exp april 2021 = 90
exp sept 19 = 75
exp sept 19 = 22
exp mei 2020 108
exp sep 2020 = 47

exp juni 2019 = 78400 exp april 21 =341590
exp feb 19 = 86
exp= Feb 2018 = 17

exp april 19 = 2022
exp Nov 19 =190

exp okt 20 = 433
exp okt 20 = 1300
exp nov 20 = 8
YANG MENERIMA
PETUGAS PUSKESMAS
Herryza Asrayuni S.Farm, Apt

NIP.19830622 2010 2 033
NO NAMA OBAT SEDIAAN
OBAT GENERIK PKD
1 Allopurinol 300 mg Tablet

2 Allopurinol tablet 100 mg Tablet
3 Ambroxol 30 mg tablet Tablet
4 Ambroxol syr Syrup
5 Aminofilin injeksi 24 mg/ml - 10 ml ampul
6 Aminofilin tablet 200 mg Tablet
7 Amitriptilin hcl tablet salut 25 mg Tablet
10 Amoksisilin Kaplet 500 mg Tablet
11 Amoksisilin kapsul 250 mg capsul
12 Amoksisilin syrup kering 125 mg/ 5 ml Syrup
13 Amoksisilin+As.Klavulanat 625 mg tablet
14 Antalgin( metampiron) tab 500 mg Tablet
15 Antalgin injeksi 250 mg/ ml - 2 ml ampul
16 Antasida Doen II Suspensi Kombinasi syrup
17 Antasida doen tablet kombinasi tablet
18 Antibakteri doen salap kombinasi/bacitrasin tube
19 Antifungi doen kombinasi tube
20 Antihaemaroid doen kombinasi tablet
21 Antimigrain doen kombinasi tablet
22 Aqua proinjeksi steril , bebas pirogen botol
23 Aquadest steril botol
27 As.Traneksamat tab 500 mg /Transamin 500mg tablet
28 Asam folat/Anemolat 1mg tablet
31 Asam Mefenamat 250 mg(Stanalin) capsul
32 Asam Mefenamat 500 mg tablet
33 Asam Mefenamat 50mg/5mlSuspensi Botol
34 Asetosal tablet 100 mg tablet
35 Asetosal tablet 500 mg tab
36 Asetil sistein 200mg tab
37 Asifit Kapsul
38 Asiklovir cream 5 % tube
41 Atropin sulfat injeksi 0,25 mg/ml - 1 ml ampul
42 Atropin sulfat tab 0,5 mg tablet
43 Attapulgite 300 mg/Pularex tab tablet
44 Attapulgite 600 mg tablet
45 Atorvastatin 20mg tablet
46 Benzatin benzil penisilin in 2,4 juta iu/vial ampul
47 Besi II Sulfat 250mg+As Folat 0,25mg tablet
48 Betahistin Mesilat Tablet 6mg tablet
49 Betametason krim 0,1 % tube
50 Bisoprolol tab 5mg tablet
51 Bisakodil 5mg supp/ Dulcokax/Stolax suppositoria
52 Bisakodil 10 mg supp/ Dulcokax/Stolax suppositoria
53 Bisakodil 5Mg tablet/ Dulcokax/Stolax tablet
54 Burnazin crem tube
55 Bromheksin HCl syrup/ Hustab syr Syrup
56 Ceterizine 10 mg tablet
57 Cetirizin syr 5 mg/5 ml Syrup
58 Deksametason inj. 5 mg/ml - 1 ml ampul
59 Deksametason tablet 0,5 mg tablet
60 Deksametason + desklorpheniramin maleat/Dextamin/Etadexta/Pritacort tablet
61 Desoximethason crem/Denomix crem tube
62 Diazepam inj 5 mg/ml ampul
65 Diazepam rektal tube
66 Dietilkarbamazin sitrat tablet 100 mg tablet
67 Difenhidramin hcl inj. 10 mg / ml -1 ml ampul
68 Digoksin tablet 0,25 mg tablet
69 Diltiazem tablet 30 mg tablet
70 Domperidon 10 mg tablet
71 Domperidon Drops syrup
72 Domperidon Suspensi syrup
73 Doxicyclin 100mg tablet
74 Echinature Kap Kapsul
75 Echinature Kids syr Syrup
76 Efedrin hcl tablet 25 mg tablet
77 Ekstrak belladone tablet 10 mg tablet
78 Epinefrin hcl/bitatrat (adrenalin) in.0,1 % - 1 ml ampul
79 Erithromicyn Syr Syrup
80 Erytromicin 250 mg Kapsul
81 Erytromicin 500 mg tablet
90 Fenobarbital injeksi 50 mg/ml - 2 ml ampul
95 Fenol gliserol tetes telinga 10 % larutan
96 Fitomenadion (vit k 1) inj 10 mg/ml - 1ml ampul
97 Fitomenadion (vit k 1) tab salut 10 mg tablet
98 Fitomenadion inj 2 mg/Infan ampul
99 Fituno Kapsul
100 Flunarizine tab 5 mg tablet
101 Furosemida injeksi ampul
102 Furosemida tablet 40 mg tablet
11 Garam oralit untuk 200 ml air sacc
104 Gentamycin Inj 80mg ampul
105 Gentamycin salp kulit tube
106 Gentamycin Tts Mata 0,3% larutan
107 Gentian violet larutan 1 % larutan
108 Glibenklamid tablet 5 mg tablet
109 Gliseril guayakolat tablet 100 mg tablet
110 Gliserin larutan
114 Griseofulvin tablet 125 mg , micronized tablet
117 Haloperidol tablet 5 mg tablet
118 Hidroklorotiazid ( hct ) tablet 25 mg tablet
119 Hidrokortison krim 2,5 % tube
120 Ibuprofen Suspensi syrup
121 Ibuprofen tab tablet
124 Ichtiol zalf 30 gr pot
127 Isosorbit dinitrat tablet subligual 5 mg tablet
128 Itraconazole 100 mg tablet
129 Kalium Diklofenak 50mg tablet
130 Kalium Permanganat serbuk pot
131 Kalsium laktat ( kalk ) tablet 500 mg tablet
132 Kaptopril 12,5 mg tablet
135 Karbamazepin tablet 200 mg tablet
136 Karbogliserin Tetes Telinga 10 % larutan
137 Ketoconazol 200 mg Tab tablet
138 Ketoconazol cream tube
139 Ketopropen tab 100 mg tablet
140 Ketopropen supp/ suprafenid supp suppositoria
141 Ketorolac inj 30 mg ampul
144 Kloramfenikol Tetes Mata larutan
145 Kloramfenikol 125 mg/5 ml suspensi Botol
146 Kloramfenikol kapsul 250 mg capsul
147 Kloramfenikol salap mata 1 %/colme /erlamycetin tube
148 Kloramfenikol tetes telinga 3 %/ colme/erlamicetin larutan
149 Klorfeniramin maleas ( ctm ) tablet 4 mg tablet
150 Kloramfenikol +Hidrocortison krim/ Chloramphecort crem tube
153 Klorpromazin 100 mg tablet tablet
154 Klorpromazin 25mg tablet tablet
155 Klorpromazin inj 25 mg Ampul
156 Kodein tablet 10 mg tablet
157 Kombinasi pirimetamin 25 mg+ sulfadosin 500 mg tablet
158 Kotrimoksazol dewasa tablet tablet
159 Kotrimoksazol pediatrik tablet tablet
160 Kotrimoksazol suspensi syrup
161 Kuinin (Kina) tablet 200 mg tablet
162 Kuinin dihidroklorida inj. 25 % - 2 ml tablet
163 Lansoprazole Kapsul 30mg capsul
164 Levofloksasin 500 mg tablet
165 Levofolxacin infus 5 mg/ml larutan
166 Lidokain 1 % ampul
167 Lidokain 2 % + epinefrin 2ml ampul
168 Linkomisin 500mg Kapsul
169 Loperamid 2mg tablet
170 Loratadine 10 mg tablet
171 Lorazepam tablet Tablet
174 Mebendazole syp syrup
175 Meloxicam 15 mg tablet
176 Meloxicam 7,5 mg tablet
177 Metformin Hcl tablet 500mg tablet
180 Metiergometrin maleat inj.0,2 mg - 1 ml larutan
181 Metilergometrin maleat tab sal 0,125 mg tablet
182 Metoklopramide tab 10 mg tablet
185 Metronidazole Infus 500mg/100 ml larutan
186 Mikonazol krim/salep 2 % tube
187 Mikobalamin 500mg/Lanabal tablet
188 Natrium bikarbonat tab 500 mg tablet
191 Natrium klorida larutan infus 0,9 % steril larutan
192 N.Acetyl Systein 200 mg tablet
193 Nifedipin tablet tablet
194 Nistatin tablet vaginal 100.000 IU / g tablet
195 Nistatin tablet salut 500.000 IU tablet
196 Obat batuk hitam ( o.b.h ) cairan larutan
197 Ofloksasin tablet 200 mg tablet
198 Oksitetrasiklin hcl inj. I.m 50 mg/ml - 10 ml larutan
199 Oksitetrasiklin hcl salap 3 % tube
200 Oksitetrasiklin hcl salap mata 1 % tube
201 Oksitosin injeksi 10 iu/ ml - 1 ml Ampul
202 Omeprazol injeksi 40 mg Ampul
203 Omeprazol tablet 20 mg capsul
204 Ondansetron tab 4 mg tablet
205 Ondansetron tab 8 mg
206 Ondansetron inj Ampul
207 Papaverin 40 mg/Spasminal tablet tablet
208 Parasetamol Drops syrup
209 Parasetamol syrup 120 mg / 5 ml syrup
210 Parasetamol tablet 100 mg Tablet
211 Parasetamol tablet 500 mg tablet
212 Paracetamol 120mg Eff/Sanmol Tube 10 tube
213 Paracetamol 125 mg Supp/Pamol suppositoria
214 Pirantel tablet 125 mg tablet
215 Pirantel Suspensi 125 mg syrup
216 Pirazinamid tablet 500 mg tablet
217 Piridoksin hcl tablet 10 mg tablet
223 Prednison tablet 5 mg tablet
224 Primakuin tablet 15 mg tablet
227 Propiltiourasil tablet 100 mg tablet
228 Ranitidin inj 25 mg Ampul
229 Ranitidin tablet 150 mg tablet
234 Rifampisin kapsul 600 mg tablet
237 Ringer laktat larutan infus steril larutan
238 Risperidone 2mg tablet
241 Salep 2-4 komb As.Salisilat 2 % +Belerang pot
242 Salisil bedak 2 % pot
243 Sefadroxyl 500 mg tablet
244 Sefadroxyl sirup kering 125 mg / 5 ml syrup
245 Sefaleksin 500 mg tablet
246 Sefiksim kapsul 100 mg capsul
247 Sefiksim syr syrup
248 Sefotaksim injeksi 1 gram vial
249 Seftriason inj 1 gr vial
250 Serum Anti Bisa Ular (ABU) Vial 5 ml
251 Serum Anti Tetanus (ATS) 1500 vial 1 ml
252 Sianokobalamin ( vit b 12 ) inj.500 mcg/ml Ampul
253 Simetidin tablet 200 mg tablet
256 Siprofloxasin infus larutan
257 Siprofloxasin tab 500 mg tablet
258 Streptomisin sulfat serbuk inj. 1000 mg/vial vial
259 Sukralfat sirup/Ulsidex/Ulsafate syrup
260 Sukralfat 500 mg tablet
261 Sulfasetamida Natrium tetes Mata 15 % larutan
262 Tetracain Hcl tetes mata larutan
263 Thiampenikol tablet capsul
264 Tiamin hcl ( vit b 1 ) inj. 100 mg/ml - 1 ml Ampul
267 Tramadol injeksi Ampul
268 Tramadol tablet 50 mg tablet
269 Triheksifenidil hcl tab 2 mg tablet
270 Urea crem / Soft U Derm 10 % tube
271 Vaksin Rabies Vero vial
272 Vaksin Anti Bisa Ular (ABU) Vial
273 Vitamin b komplek tablet tablet
274 Zink Dispersible 20 mg tablet
275 Zinkpro Drops syrup
276 Zink syrup/ Zirkum syrup syrup
OBAT NON GENERIK
1 Anadex syr syr
2 Alpara syr syrup
3 Asering 500 cc larutan
4 Baby cough syr syrup
5 Becefort Suspensi syrup
6 Becefort Tablet tablet
7 Beneuron tablet
8 Bionemi tab tablet
9 Bioron tab tablet
10 Becom C tablet
11 Betafort Syr syrup
12 Bio ATP tablet
13 Bioplacenton Gel tube
14 Biovitan Syr syrup
15 Bisolvon Extra Syr Botol 60 ml
16 Calsidol syr Larutan 5ml
17 Cendo Xitrol Tetes Mata botol 5ml
18 Cendo Xitrol Tts Mata mini dose Tube
19 Cendo cetamid tts mata botol
20 Colfin Tablet
21 Curcuma tablet tablet
22 Dasabion Tablet tablet
23 Dextrosin tab tablet
24 Dextrofen syr syrup
25 Fg Troches tab hisap tablet
26 Fitbon Plus tablet
27 Flucort N crem tube
28 Fludane Tablet tube
29 Formalin cair larutan
30 Gerac tablet tablet
31 Geriavita tablet
32 Gericare kaplet tablet
33 Good Proliver tablet
34 H2O2 3 % larutan
35 Hemafort kap tablet
36 Hemorogard Kapsul kapsul
37 Hexacort Crem Tube
38 Hidrex Surgical 500 cc larutan
39 Ikaneuron 5000/Nerva 5000 tablet
40 Interhistin tablet tablet
41 Isotic Clearens larutan
42 Isotic Neolyson larutan
43 Lexavit tab tablet
44 Lisol larutan
45 Livron B-Plex tablet tablet
46 Lybex Syr syrup
47 Merlopam 0,5 mg tablet
48 Minyak Telon larutan
49 Neurovit-E Tablet tablet
50 Nodrof Flu Antitussive tablet
51 Noza Tablet tablet
52 Oxfezin syr syrup
53 Obat batuk hitam Indo Plus cairan larutan
54 Pain Kila / Stop Pain tube
55 Pehapral tablet
56 Pharmaton Formula capsul
57 Polykresulen (albothyl) larutab
58 Ponflu Kaplet tablet
59 Ponflu Syr syrup
60 Prolysin Syr syrup
61 Risperidone 2 mg tablet
62 Sagestam cream tube
63 Sanbe Kids syr syrup
64 Scabisid crem/scabimite crem tube
65 Topras Tablet tablet
66 Tremenza/*neo protifed tablet
67 Tuzalos tab tablet
68 Vitalex syrup
69 Woods papermint antitusive syrup
70 Xylocaine jelly 2% gel
71 Xepavit tablet tablet
72 Vetolin Nebules /Salbutamol cairan larutan
73 Ventolin Rotacap /Salbutamol Serbuk capsul
74 Salbutamol Inhalasi/ Fartolin Inhalasi fls
75 Salbutamol syr/Salbron syrup
76 Hustab tablet/Mucohexin/Bromheksin Hcl tablet
77 Pratifar tablet

8 Alat suntik sekali pakai 1cc insulin pcs
9 Alat suntik sekali pakai 2.5 ml pcs
16 Blood Lancet pcs
17 Blood Administrasi set pcs
22 Daryantule / Sofrattule/Bioplacenton Tulle pcs
27 Handscoend Ukuran L Mikro Touch pcs
28 Handscoend Ukuran M Mikro Touch pcs
29 Handscoend Ukuran S Mikro Touch pcs
34 Handscoend Non Steril Ukuran L Pcs
35 Handscoend Non Steril Ukuran M Pcs
36 Handscoend Non Steril Ukuran S Pcs
37 Hcl 0,1 N larutan
38 Infusion set anak Pcs
39 Infusion set dewasa Pcs
52 Kapas berlemak 500 mg bungkus
53 Kapas pembalut / absorben 250 mg bungkus
54 Kasa kompres 40/40 steril bungkus
61 Kasa steril 16 x 16 kotak
62 Liquicheck Hematology Control Normal Vial
63 Lyse M-30 D-Diff Btl 500 ml
64 Masker 25 pcs/ktk
65 Masker N 95 Pcs
66 Nald Inj, box 100 pcs
67 Pastik (Alkohol Swab) box 100 pcs
68 Plester 5 yard x 2 inch rol
69 Plester Leukoplast 4,5 m X 1,25 cm/PHARMAPLAST 12 pcs/ktk
70 Plester Micropore Non Dispenser(Pharmaplast) 10x500 pcs
71 Plester Micropore WITH Dispenserer pcs
72 Pot Urine 50 cc pcs
74 Terofusion Blood Set Pcs
75 Urin Bag pcs
81 Ventolin Rotahaler pcs
OBAT GIGI
1 Air Raksa Dental Use larutan

2 Devitalisasi pasta (non arsen) larutan
3 Dental Merkuri
4 Eter Anaestetik Botol
5 Etil klorida semprot Botol
6 Eugenol cairan larutan
7 Fluor tablet 0,5 mg tablet
8 Glass lonomer cement ( gc ix ) set /botol
9 Iodoform pasta Botol
10 Kalsium hidroksi pasta 2 tube/kotak
11 Monoklorkamfer mentol cairan (CHKM) botol 10 ml
12 Mummifying pasta botol / kotak
13 Semen seng fosfat serbuk dan cairan botol
14 Silver amalgam serbuk 65 - 75 % 1 oz / botol
15 Spon gelatin cubicle cubicles 1x1x1 cm 24 buah / kotak
16 Temporari stoping (fletcher) serbuk dan cairan
OBAT PROGRAM
1 Albendazole 400mg tablet

2 Alkohol Swab Box
3 Azitromisin tablet
4 Besi II Sulfat tablet tablet
5 Blood Glucosa Test Strip botol
6 Fluconazole 150mg kapsul
7 Filariasis Brugia Rapid
8 Immunoassay Malaria Kotak 30 test
9 Isoniazid 300mg tablet
10 Kapas 1 kg Bungkus
11 Kertas Whatman kotak
12 Kolesterol Test Strip botol
13 Kotrimoxazol 960 mg tablet
14 Lancet Divece Kotak
15 Larutan Giemsa 100 ml botol
16 OAT FDC Kat I kotak
17 OAT FDC Kat II kotak
18 OAT FDC Kat Sisipan kotak
19 OAT Kat Anak kotak
20 OAT Kombipak Kat I kotak
21 Oli Emersi
22 Objec Glass/Mikroskope Slide kotak
23 Piridoksin tab 50mg/vit B.6
24 Pot MDR pcs
25 Pot Sputum pcs
26 Pot Urine pcs
27 Reagen Ziel Nelsen botol
30 Slide box kotak
31 Stick Narkoba
32 Tabung Edta 3 ml botol
33 Tissue gulung Kotak 100
34 Tissue Mikroskope Kotak 100
35 Uric Acid Test Strip botol
36 Vikia HIV 1/2 Pcs
OBAT PROGRAM JIWA

1 Flufenazine Decanoat inj 25 mg ampul
2 Clozapine 25mg tablet tablet
3 Clobazam 10 mg tablet
4 Triheksifenidil tablet 2 mg tablet

1 Diluent-30 D-Diff botol 20l
2 Lyse M 30D-Diff botol
3 Probe clenser M-30P Botol
5 EZ Cleanser M.30E Botol
7 Rinse M.30 galon
TAMBAHAN
1 pritakort tablet
2 masker thee on 3 play tablet
3 piridoksin 50 tablet
4 Stick Narkoba box
5 Stick Glukosa box
6 Stick Asam Urat box
7 Stick Kolesterol box
8 Trifluoperazine 5 mg box
9 Haloperidol Injeksi ampul
10 HIV 1/2 3.0Multi Paket
11 Descoderm Pade Pcs
12 Vaksin Bcg kering serbuk injeksi 0,375 mg /ml vial
13 Pentabio vaksin Dtp-hb-hib injeksi 2,5 ml vial
14 Vaksin Polio Oral Trivalen Drops vial
15 Vaksin campak keringserbuk injeksi 1000 Ccid vial
16 Vaksin Hepatitis B 10 Mcg/ml vial
17 Vaksin Jerap Td Vial
18 Vaksin Ipv Vial
19 MDT MB Adult blister
20 Dispose savety box 2,5 l Pcs
21 Vaksin TT /DT vial
22 pelarut Vaksin BCG vial
23 Pelarut Vaksin Campak ampul
24 Dropper for oral vaccine bh
25 IPV Vial
21 Salbulin /salbutamol inhalasi/combiven inhalasi Pcs
22 combiven Pcs
23 Kasa 40x 80 Pcs
26 ONE JECT-ADS 5 ml
27 silkom 3
28 silkom2
29 Oxicobal
30 Pularex 630 mg tablet
31 Selvi plex tablet
32 Vaksin Measles Rubella Vial
33 Skifa ADS 5 ml pcs
34 Skifa ADS 0,5 ml pcs
35 Safety Box 5 l pcs
36 Xilocain jelly botol
37 RDT Hepatitis botol
38 DHP-Frimal blister
40 SD BIOLIN HIV
42 Hexagon sytrilis
43 Vaksin HBIG VIal
44 Sefixim 200 mg kapsul
45 Tisu mikroskope pcs
46 RDTMalaria
47 eutyrox 500 mg tablet
48 Kasa 40x 80
49 SD BIOLIN SIFILIS 3.0 strip
50 DEC
51 dispose savety box 5 l
52 OXYCAN BTL
53 Haloperidol 2 mg tablet
55 Tips For Micropipette buah
56 Vacum Tube Edta 0,5 ml tube
57 Needle flashback 21 x 1 pcs
58 Fucilex 20 mg/G krim 5 G Mola Tube tube
59 Amoksisilin 100 mg drops botol
60 Ampisilin serbuk injeksi 1000 mg vial
61 Grisiofulvin 250 mg tablet
62 Mineral mix Sacchet
63 APD SET
64 Prokain benzile serbuk injeksi vial
65 Baju Apron/hazmat buah
66 Tuberkulin PPD RT 23 SSI VIAL
67 Termometer Infrared Digital / thermogun pcs
67 Haloperidol injeksi 50 mg/ml ampul
68 sepatu/ safety boots buah
69 kacamata geogle buah
70 handsanitaizer botol
71 ACCU-CHEK SAFE PCS
72 Rapit sars;COV 2 ( Rapit test corona) test
73 Alpara tablet
74 Apecur 100 ml vitamin Anak botol
75 new Antides Tablet tablet
76 Rapid tes + blood lanset test
77 Masker kain pcs
78 SD BIOLIN DANGUE pcs
79 SD BIOLIN HIV 30 pcs
80 Trepocheck sypilis pcs
81 Albendazole suspensi 200 mg/5 ml botol
82 Oseltamivir 75 mg /kapsul kapsul
83 Face Shield
84 desinfektan 3.8 l
85 Bufacetine 2% salep tube
86 Fixomull 5 cmx 5 m Dressing penutup luka bakar pcs
87 miravon botol
88 Azitromisin 500 mg tablet
89 Lopivia tablet
90 Esomeprazole serbuk injeksi 40 E/56n82 vial
91 masker tb
92 Rapid antigen
93 Tuberkulin PPD RT 23 SSI
94 Piridoksin 25 tablet
95 Masker KN95 BUAH
96 virochecck HbsAg
97 Albendazol syr botol
98 hand sanitizer kemasan 250 ml botol
99 Comvit C tablet
100 Hepagard 250 mg tablet
101 Vitamin C 500 tablet
102 benicom zink tablet
103 handsanitaizer 5 liter
104 Cooler Box 5,5 l pcs
105 ice gel pcs
106 Oxymeter Pulse pcs
107 Plaster leukoplas ( 1x 5) rol
108 Calcii Glukonas 100 mg/ml ethi Ampul ampul
109 Metronidazol Suspensi botol
110 swab kit set
111 ACCU-CHEK SAFE T PRD UNO PCS
112 VIRUS TRANPORT MEDIA SET
113 Nicecare desinfektan 5 l liter
114 Hand sanitazer 60 ml
115 Rampit c tablet
116 sivit zinc tablet
117 buscopan injeksi ampul
118 Nasal oxygen canula Adult pcs
119 Nasal oxygen canula child pcs
120 Arkavit tablet
121 Becefort tablet
122 caviplex tablet
123 hevit C tablet
124 Natures plus cal-mag zink kapsul
125 Natures plus Vit C 500 kapsul
126 Natures Plus Zinc kapsul
127 Ramvit C Tablet
128 Vicee 500 Tablet
129 Vitalife tablet
130 Vitalong C 500 tablet
131 Paket Isoman 1 cov-19 Paket
134 telura tablet
135 lamivudin 150 mg Zidovudine 300 mg tablet
136 tenofovir tablet
137 nevirapine tablet
138 lamivudin tablet
139 Imersion oil botol
140 Methanol 250 ml botol
141 SD BIOLINE MALARIA 30 S PCS
142 Trepocheck sypilis ( Rapid Test Spyhilis ) pcs
143 Apron putih ( celemek) pcs
JUMLAH KUNJUNGAN RESEP

ASKESKIN
130
MENGETAHUI/MENYETUJUI
KEPALA DINAS KESEHATAN KAB. PELALAWAN
(…………………………………………………………..)
KABUPATEN PELALAWAN
September PEMB
Stok Awal STOK
PERMINTAAN
OPTIMUM
Penerimaan Persediaan Pemakaian Sisa Stok Inpres
- - -
198 300 498 170 328
- - - 2000
- - - 200
- - -
- - -
2,640 2,640 2,640
- - - 3000
10,589 3000 13,589 1375 12,214 3000
22,673 22,673 875 21,798
3,091 3,091 391 2,700 1000
422 100 522 36 486 300
- - -
- - -
- - -
414 414 414 300
7,300 5000 12,300 1470 10,830 3000
- - -
100 100 100
265 265 17 248 20
- - -
8 8 2 6
- - -
10 10 10
- - -
- - -
227 227 20 207 500
- 2000 2,000 30 1,970 1000
800 50 850 40 810 3000
1,840 1000 2,840 156 2,684 1000
- - -
15,014 15,014 15,014 3000
- - -
835 835 835
- - -
19,760 2640 22,400 1090 21,310 3000
- - -
- - -
734 734 25 709
- 500 500 500 1000
95 95 95
- - -
- - -
- - -
480 480 480
- - -
- - -
- - -
228 100 328 2 326
60 60 60
141 141 141
- - -
2,010 300 2,310 2,310
- - -
- - -
7,105 2000 9,105 815 8,290 2000
246 246 3 243 50
385 30 415 10 405
1,800 1,800 1317 483 2000
- - - 1000
69 69 69
112 112 112
- - -
100 100 100
13 13 13
90 90 90
115 115 115
700 700 700
- - -
1,245 500 1,745 250 1,495 1000
66 66 66
25 25 4 21 50
2,210 2,210 2,210 500
- - -
- - -
- - -
1,064 1,064 1,064
50 50 50
- - -
- - -
499 499 499 300
92 92 3 89
- - -
- - -
- - -
88 88 13 75
- 20 20 1 19 10
- - -
- - - 1000
180 300 480 480
- - -
266 266 120 146 1000
- - -
- - -
- - - 25
- - -
965 300 1,265 50 1,215
2,683 2,683 2,683
- - -
- - - 200
- - -
580 580 580
- - - 1000
334 334 334
- - - 100
121 121 5 116
- - - 25
8,225 1000 9,225 730 8,495
- - - 2000
- - -
- - -
- - -
77 77 5 72
2,189 2,189 2,189
40 40 40
- - - 500
4,320 14000 18,320 120 18,200 500
695 695 10 685 500
311 311 37 274 50
82 82 82
- - -
- - - 1000
- - - 3000
- - - 50
- - -
892 500 1,392 1,392
2,310 2,310 10 2,300
240 240 240
- - -
- - - 25
12,385 12,385 990 11,395 2000
4,844 1000 5,844 450 5,394
930 1000 1,930 150 1,780 1000
1,200 1,200 1,200
870 1000 1,870 120 1,750 500
- - -
942 942 80 862 300
208 208 6 202 25
- - -
300 300 300
33 33 33 30
1,778 1,778 6 1,772 500
980 980 50 930 300
- - -
- - -
- - -
- - -
- - - 20
6,310 2000 8,310 2104 6,206 2000
- - -
- - -
- - -
754 1500 2,254 180 2,074 300
1,125 7000 8,125 8,125 300
540 540 540
- - -
- - -
2,750 2,750 170 2,580
- - -
174 174 9 165 50
- - -
- - -
7,084 1360 8,444 660 7,784 1000
- - -
- - -
- - -
760 760 90 670
- - -
934 300 1,234 134 1,100 500
- - - 1000
- - -
- - -
10 10 10
- - -
- - - 2000
- - - 2000
7,475 7,475 705 6,770 4000
- - - 2000
- - - 1000
175 175 175
1,400 1,400 1,400
1,880 1,880 10 1,870
- - -
- - - 500
1 1 1
158 158 31 127 100
- - - 500
900 900 900 300
1,240 1000 2,240 805 1,435 3000
11,816 1100 12,916 90 12,826
70 70 15 55 20
- - -
556 556 556
928 928 7 921
186 200 386 386
- - -
- - -
- - -
- - -
1,122 1,122 3 1,119
18 18 18
32 32 32
- - -
- - -
- - -
- - -
- - -
- - -
653 400 1,053 293 760 300
- - -
2,300 10000 12,300 2786 9,514 5000
- - -
- - - 50
- - -
- - -
- - -
18,071 1000 19,071 361 18,710 3000
- - - 1000
- - -
20 20 20
35 35 10 25
10 10 1 9 20
3,000 1000 4,000 320 3,680
- - -
845 845 845
- - -
- - -
- - - 20
- - - 3000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
145 20 165 14 151 20
- 6500 6,500 340 6,160 500
6,747 500 7,247 110 7,137
455 455 140 315 500
- - -
- 50 50 2 48 50
- - - 500
18 18 18
- - -
- - -
- - -
- - -
- - -
3 3 3
- - - 10
96 96 96
- - -
1,200 1,200 1,200 1000
6,830 1000 7,830 640 7,190
- - -
500 500 500
- - -
69 69 69 -
- - - 500
- - -
- - -
- - -
- - -
- - -
3,001 1000 4,001 292 3,709
- - -
50 50 50
- 4500 4,500 125 4,375
- - -
- - -
- - -
16,620 2300 18,920 1910 17,010 5000
10,405 10,405 277 10,128 2000
- - -
- - -
-
-
- - -
- - -
- - -
- - - 50
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - - 5
- - -
- - -
- - -
- - - 20
- - -
- - -
- - -
- - -
- - -
- - -
- - - 50
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - - 1000
- - -
- - -
- - -
- - - 1000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
58 20 78 5 73 50
- - -
- - -
- - -
- - -
- - -
- - -
- - - 3000
- - -
- - -
- - -
- - -
- - - 3000
- - - 3000
-
-
-
-
- - -
476 50 526 526
- 50 50 50
- - -
48 50 98 98 50
1,278 1,278 1,278 300
51 51 10 41
- - -
- - -
- - -
129 200 329 50 279 300
517 517 20 497
165 165 165
- - -
230 230 230
10,000 10,000 10,000
- - -
- - -
- - -
369 24 393 393 24
96 96 96
90 90 90
- - -
75 75 75
22 22 22
- - -
- - -
- - -
- - - 400
- - -
1,200 200 1,400 350 1,050
- - - 200
- - - 200
- 200 200 200 - 300
- 200 200 200 - 500
- 200 200 200 - 500
- - -
- - -
216 216 3 213 50
- - -
84 84 84
- - -
48 48 48
- - -
60 60 60
- - -
12 12 12
36 36 36
- - -
60 60 60
- - -
3 3 3
30 5 35 1 34 10
167 167 167
- - -
112 112 5 107
103 103 103
- - -
- - -
- - -
1,583 1,583 1583 -
- - -
- - -
- 2500 2,500 2,500 500
760 760 20 740 100
- - -
- - -
- - -
108 108 108
- - - 5
47 47 47
- - -
12 12 12
- - -
- - -
- - -
- - -
- - -
- - -
- - -
106 106 106
-
-
-
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
-
-
-
- - -
- - -
- -
440,870 440,870 3150 437,720
- - - 5
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 3 3 3
- 32 32 32 6
- 2 2 2
- - -
- 10 10 10 4
- 2 2 2
- - -
- 50 50 50
- - -
- - -
- 400 400 400
- - -
86 20 106 106 4
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
-
-
35 35 35
- - - 1000
1,070 1,070 100 970 50
- - -
-
-
- - -
- - -
- - -
- - -
- - -
- - -
- - -
-
-
- - -
- - -
- - -
- - -
- - - 10
- - -
- - - 10
2,762 1000 3,762 95 3,667
- - -
- - -
- 0 0 300
- 0 0
- 0 0
- 0 0
- 0 0
- 0 0
- 0 0
- 0 0
6 6 6
- 0 0
- 0 0
- 0 0
- 0
- 0
- 0
- 0 0 10
190 190 190
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - - 3
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 25 25 25
- - -
- 5 5 5
- 300 300 300
- - -
- - -
16 16 16
890 890 200 690
-
18,000 18,000 18,000
1,500 1,500 1,500
600 600 600
- - -
- - -
433 433 433
1,500 1,500 1,500
- - - 100
- - -
8 8 8
275 275 30 245
1 1 2 2
8 8 8
19 19 19
1 1 1
3 3 3
- - - 5
- - -
- - -
- - - 1000
- - - 50
855 500 1,355 30 1,325
250 250 250
- - -
75 75 75
71 300 371 371
- - -
- - -
1,240 600 1,840 440 1,400
240 240 40 200
(0) (0) (0)
124 48 172 19 153
20 20 20
- - -
700 300 1,000 400 600
- - -
- - -
- 4500 4,500 4500 -
700 700 250 450
- - -
- - -
70 60 130 130
- - -
- - -
- 10 10 2 8
- 700 700 700
540 300 840 840
1,220 1800 3,020 3,020
3,340 3600 6,940 2015 4,925
1 1 1 -
- - -
- - -
4 4 4
30 10 40 7 33
10 10 10
100 100 100
500 500 500
150 250 150
150 150 150
3 3 3
- - -
500 500 500
900 780 1,680 1,680
18 18 3 15
50 50 2 48
50 50 50
- 600 600 600
- 200 200 200
500 500 500
600 600 600
60 60 60
90 90 90
60 60 60
1300 1,300 1,300
300 300 300
60 60 60
100 100 100
4 4 4
4 4 4
4 4 4
90 90 90
120 120 120
60 60 60
120 120 120
120 120 120
2 2 2
4 4 4
125 125 125
50 50 50
100 100 100
- - -
- -
- UMUM JUMLAH
-
500 160 790
MENERIMA/MELAPOR YANG MENERIMA

KEPALA PUSKESMAS PETUGAS PUSKESMAS
Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm

NIP . 197411192003122002 NIP.19830622 2010 2 03
PEMBERIAN
JUMLAH KET
Askes APBD Lain2 Jumlah
exp april 2021 = 1300
exp sep 20 = 7008 exp agus 2021 = 2375

exp okt 2021 = 2700
exp agus 2021 = 411 sep 21 =3

exp agus 20 = 3250
exp mei 2021 = 100

exp sep 2020 = 77
exp juni 2021 = 10
exp = juli 2020 = 200

exp agus 2019 = 7809 sep 19 = 7205
exp sept 2019 = 835
exp feb 2021 = 95
exp feb 2020 = 480
exp feb 2021 =228

exp des 2020 = 60
exp jun 2019= 660 juli 2019 = 900 exp agus v2021 = 450
exp feb 2020 = 165 exp april 20 = 90
exp agus 2019 = 69
exp april 19 = 68
expmaret 2021 = 700
exp okt 19 = 1400
exp mei 19 = 1064
exp mei 2021 = 499
exp juni 18 = 2683
exp mei 2020 = 350
exp = okt 20 = 334

exp= sept 20 = 57
exp juli 19 =404 feb 20 = 90
exp juni 19 = 50
exp sept 19 = 240
exp jun 2020 = 1200
exp jun 2021 = 290

exp mei 2020 = 33
exp aprl 19 = 700

exp mei 20 = 540
exp juni 19 =487
exp juni 2021 = 6504 mei 2021 =266
exp jun 2020 = 75 april21 = 100

exp April 2020 = 200
exp okt 20 = 1
exp mei 20 = 900
exp juni 19 =15
exp maret 2021 = 556

exp agus 19 = 186
exp juni 20 = 32
exp juni 2020 = 5400
exp feb 21 =16 maret 21 4
exp juni 19 = 845
exp apr 19 = 6100 agus 19 = 4000

exp juli 19 =700
exp juni 19 = 400
exp maret 21 = 18
exp mei 2021 = 96
exp feb 20 = 1200
exp maret 20 = 500
exp juli 19 = 50
exp okt 19 = 255
exp sept 19 = 100 maret 21 165
exp maret 20 =16
exp maret = 192
exp maret = 230
exp april 2021 = 90
exp sept 19 = 75
exp sept 19 = 22
exp mei 2020 108
exp sep 2020 = 47

exp juni 2019 = 78400 exp april 21 =341590
exp feb 19 = 86
exp= Feb 2018 = 17

exp april 19 = 2022
exp Nov 19 =190

exp okt 20 = 433
exp okt 20 = 1300
exp nov 20 = 8
YANG MENERIMA
PETUGAS PUSKESMAS
Herryza Asrayuni S.Farm, Apt

NIP.19830622 2010 2 033

Lplpo Sistem Ifk 2021 Sept Terbaru

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FORMAT LPLPO TAHUN 2021

Nama Puskesmas : BERSERI PANGKALAN KERINCI

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet - -

OBAT NON GENERIK

ALKES & BAHAN HABIS PAKAI ( BHP )

1 Air Raksa Dental Use larutan - -

1 Albendazole 400mg tablet - - -

REAGEN HAEMATOLOGY ANALIZER

JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

MENGETAHUI/MENYETUJUI MENERIMA/MELAPOR YANG MENERIMA

(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

Nama Puskesmas : BERSERI PANGKALAN KERINCI

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet - - -

JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

MENGETAHUI/MENYETUJUI MENERIMA/MELAPOR YANG MENERIMA

(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

Nama Puskesmas : BERSERI PANGKALAN KERINCI

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet - - -

JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

MENGETAHUI/MENYETUJUI MENERIMA/MELAPOR YANG MENERIMA

(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

Nama Puskesmas : BERSERI PANGKALAN KERINCI

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet - - -

JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

MENGETAHUI/MENYETUJUI MENERIMA/MELAPOR YANG MENERIMA

(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

Nama Puskesmas : BERSERI PANGKALAN KERINCI

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet - - -

JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

MENGETAHUI/MENYETUJUI MENERIMA/MELAPOR YANG MENERIMA

(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

Nama Puskesmas : BERSERI PANGKALAN KERINCI

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet - - -

JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

MENGETAHUI/MENYETUJUI MENERIMA/MELAPOR YANG MENERIMA

(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

Nama Puskesmas : BERSERI PANGKALAN KERINCI

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet - - -

JUMLAH KUNJUNGAN RESEP ASKES UMUM JUMLAH

(…………………………………………………………..) Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm, Apt

NO NAMA OBAT SEDIAAN

OBAT GENERIK PKD

1 Allopurinol 300 mg Tablet

ALKES & BAHAN HABIS PAKAI ( BHP )

1 Air Raksa Dental Use larutan

1 Albendazole 400mg tablet

OBAT PROGRAM JIWA

REAGEN HAEMATOLOGY ANALIZER

JUMLAH KUNJUNGAN RESEP

MENERIMA/MELAPOR YANG MENERIMA

Nurmaini,SKM,M.Kes Herryza Asrayuni S.Farm

exp april 2021 = 1300

exp sep 20 = 7008 exp agus 2021 = 2375

exp agus 2021 = 411 sep 21 =3

exp mei 2021 = 100

exp juni 2021 = 10