Lplpo Bidan

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( L P L P O )
KODE PUSKESMAS : 3 5 2 8 1 2
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : MEI
KAB/KODYA : PAMEKASAN Permintaan Obat :
PROPINSI : JAWA TIMUR TAHUN : 2021
harga / STOCK PENERI - PERSE- PEMA- SISA STOCK PERMIN

NO. NAMA OBAT Rupiah KET
pcs AWAL MAAN DIAAN KAIAN STOCK OPT. TAAN
1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
1 ALBENDAZOLE 400 MG 344 -
2 ALBENDAZOLE SYIRUP 3,849 -
3 ALLOPURINOL 100 MG 104 -
5 AMBROXOL 30 MG 139 -
6 AMBROXOL DROP 29,370 -
7 AMBROXOL SYIRUP 5,866 -
8 AMLODIPIN 5 75 -
9 AMLODIPIN 10 MG 99 -
10 AMOXICILIN 125 mg SYIRUP 1,881 -
11 AMOXICILIN 250 mg 196 -
14 AMPICILIN 500 mg 398 -
15 AMPICILIN SYIRUP 4,900 -
16 ANTALGIN 500 mg 323 -
17 ANTASIDA DOEN TABLET 58 -
18 ANTASIDA DOEN SYIRUP 2,129 -
19 ANTI BACTERI DOEN SK 2,924 -
20 ANTI FUNGI SALEP 4,606 -
21 ANTI HAEMOROID SUPPOSITORIA 3,167 -
22 ASAM ASCORBAT 250 MG 164 -
24 ASAM MEFENAMAT 250 MG 300 -
26 ASIKLOVIR 200 mg 240 -
27 ASIKLOVIR 400 mg 405 100 100 100 - -
28 ASIKLOVIR SK 2,997 -
ASIKLOVIR SALEP MATA 3%
29 1,013 -
(temiral)
30 BETAHISTIN MESILAT 6 mg 110 -
31 BETAMETHASONE CREAM 1,430 -
32 CALSIUM GLUCONAS INJEKSI 10,425 -
33 CAPTOPRIL 12,5 MG 62 -
34 CAPTOPRIL 25 MG 75 200 200 100 100 7,500
35 CAPTOPRIL 50 MG 124 -
36 CETERIZINE 10 MG 90 100 100 50 50 4,500
37 CETERIZINE SYR 2,915 -
38 CIPROFLOXACIN 500 mg 1,200 -
39 DEXAMETHASONE 0,5 TAB 32 -
40 DEXAMETHASONE INJEKSI 1,097 -
41 DIFENHIDRAMIN HCL INJ 1,168 -
42 DIGOXIN 0,25 104 -
43 DIMENHIDRINAT 50 MG 112 -
44 DOMPERIDONE 10 MG 91 -
45 DOMPERIDONE SUSPENSI 2,700 -
46 ERITROMICYN 250 MG 546 -
47 ERITROMICYN 500 MG 770 200 200 0 200 154,000
48 ERITROMICYN SYIRUP 6,090 -
49 FENOL GLISEROL TT 10% 2,590 -
50 FITOMENADION 10 mg TAB 758 100 100 100 - -
51 FITOMENADION INJEKSI 3,682 10 10 10 - -
52 FUROSEMIDE 40 mg 82 100 100 0 100 8,200
53 GARAM ORALIT 200 274 50 50 50 - -
54 GENTAMICYN SK 2,126 -
55 GENTAMICYN TM 4,232 -
56 GENTIAN VIOLET 1 % 818 -
57 GLIBENCLAMIDE 5mg 119 100 -
58 GLISERIL GUAIACOLAT 100 mg 260 -
59 HIDROCORTISONE 2,5% 2,640 -
60 HIDROKLORTIAZID (HCT) 25 mg 155 300 300 100 200 31,000
61 IBU PROFEN 200 MG 102 -
62 IBU PROFEN 400 Mg 111 -
63 IBU PROFEN SYR 100 MG 2,721 -
64 ISOSORBID 5 MG 89 -
65 KALSIUM LACTAT 500 mg 63 100 100 100 - -
66 KETOKONAZOLE KRIM 2 % 2,518 -
67 KETOKONAZOLE 200 mg 288 50 50 50 - -
68 KLORAMFENIKOL / CLORAMEX 500 1,163 -
69 KLORAMFENIKOL 250 mg 310 -
70 KLORAMPHENICOL SYIRUP 5,015 10 10 10 - -
KLORAMPHENICOL
71 15,000 -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 -
73 KLORAMPHENICOL SM 2,007 -
74 KLORAMPHENICOL TM 0,5 % 3,250 -
75 KLORAMPHENICOL TT 3% 1,454 -
76 KLORFENIRAMIN/ CTM 4 mg 23 -
77 KOTRIMOXAZOL 120 mg 72 -
78 KOTRIMOXAZOL 480 mg 133 100 100 100 - -
79 KOTRIMOXAZOLE SYIRUP 2,190 -
80 LIDOCAIN INJ /COMB 2 % 1,222 20 20 20 - -
81 LOPERAMID 2 MG/LEXADIUM 400 -
82 MAGNESIUM SULFAS INJ.20% 3,328 -
84 MECOBALAMIN 500 MG -
85 METFORMIN 500 mg 102 100 100 100 - -
86 METFORMIN 850 mg 160 -
87 METHIL ERGOMETRIN 0,125 TAB 224 -
88 METIL ERGOMETRIN INJEKSI 2,959 -
89 METOKLORPAMIDE 10 MG 121 -
91 METOKLORPAMIDE DROP 3,900 -
92 METOKLORPAMIDE INJEKSI 3,960 -
93 METOKLORPAMIDE/LEXAPRAM SYI 2,530 -
94 METRONIDAZOLE SYIRUP 3,950 -
95 METRONIDAZOLE 250 mg 89 -
97 MICONAZOLE 2% CREAM 3,414 -
98 NA. BIC 500 MG 500 -
99 NA.DIKLOFENAC 25 mg 137 -
101 NISTATIN/ KANDISTATIN DROP 54,500 -
102 OBAT BATUK HITAM SYIRUP 5,566 -
103 OXITETRA INJEKSI 6,160 -
104 OXITETRA SK 1,529 -
105 OXITETRA SM 2,668 -
106 OXITOCIN INJ 1,199 -
107 PARASETAMOL 100 MG 290 -
108 PARASETAMOL 500 mg 81 -
109 PARASETAMOL DROP 6,649 -
110 PARASETAMOL SIRUP 1,181 -
111 PARASETAMOL/PROPYRETIC SUPP 8,000 -
112 PIRACETAM 400 MG 1,140 -
113 PIRACETAM 800 MG 8,091 -
114 PIRIDOXIN HCl 10 mg TAB 131 -
116 PREDNISON TAB 73 -
117 RANITIDIN 150 mg 98 -
118 RANITIDIN INJEKSI 1,188 -
119 RETINOL 100.000 IU 307 -
120 RETINOL 200.000 IU 414 -
121 RINGER LACTAT INFUS 7,150 -
122 SALBUTAMOL 2 mg 67 -
124 SALEP 2-4 2,796 -
125 SALICYL BEDAK 2% 1,250 -
126 SEFADROXIL 500 CAPSUL 450 -
127 SEFADROXIL SYIRUP KERING 4,185 -
128 SIANOKOBALAMIN HCL/B12 INJ. 1,104 -
129 SIANOKOBALAMIN HCL/B12 TAB 49 -
130 SIMVASTATIN 10 Mg 117 -
132 TAB.TAMBAH DARAH 106 1,000 1,000 500 500 53,000
133 THIAMIN HCL ( B1 ) 50 MG 91 -
134 THIAMPHENICOL 500 MG 2,110 -
135 VIT.B.COMPLEX INJEKSI 6,600 -
136 VIT.B.COMPLEX TAB 89 -
137 ZINK 20 MG TAB 524 -
138 ZINKID SIRUP 3,171 -
-
-
-
-
-
BMHP -
1 ALAT SUNTIK 2,5 ML 650 -
2 ALAT SUNTIK 3 ML 924 -
3 ALAT SUNTIK 5 ML 968 50 50 50 - -
5 AQUA PRO INJEKSI 2,750 -
6 CAT GUT CROMIC + PLAIN 36,234 -
7 DERMAFIX 5X7 CM 1,629 -
8 ETAKRIDIN LAR (RIVANOL) 0,1% 3,000 -
9 ETANOL 70% 1 LTR 25,000 -
10 HANDSCOON -
11 INFUS SET ANAK 7,920 -
12 INFUS SET DEWASA 8,400 -
13 IV. CATHETER NO. 18 8,250 -
14 IV. CATHETER NO. 20 11,400 -
15 IV. CATHETER NO. 22 10,395 -
16 KAPAS PEMBALUT 250 GR 12,500 -
17 KASA 2MX 80CM 9,870 -
18 KASA 4 X 15 CM 2,100 -
19 KASA 4 X 3 CM 590 -
20 KASA KOMPRES 40X40 1,600 -
21 KASA STERIL 16X16 CM 7,370 -
22 MASKER 3 PLY 1,800 -
23 PLESTER 5 YARD 35,532 -
24 POVIDON YODIDA 30 ML 2,900 -
25 SILK 23,921 -
26 UNDER PAD 4,851 -
27 URINE BAG 5,850 -
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MENGETAHUI / MENYETUJUI YANG MENERIMA
PENGELOLA OBAT BIDAN DESA
NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
KODE PUSKESMAS :
PUSKESMAS : WARU
KECAMATAN : Laporan LPLPO : JANUARI - MARET 2021
KAB/KODYA : PAMEKASAN Permintaan Obat : APRIL - JUNI 2021
harga / STOCK PENERI - PERSE- PEMA- SISA STOCK PERMIN PEMBERIAN

NO. NAMA OBAT Rupiah
pcs AWAL MAAN DIAAN KAIAN STOCK OPT. TAAN PKD BF LAIN 2 JMLH
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
OBAT PKD
1 ACETYLSISTEINE 200 MG 1,533 - - 0
2 ADALAT OROS/NIFEDIPIN 20 MG 1,187 - - 0
3 ALBENDAZOLE 400 MG 344 10,773 10,773 10,773 3705912
4 ALBENDAZOLE SYIRUP 3,849 - - - 0
5 ALLOPURINOL 100 MG 104 3,000 3,000 500 2,500 260000
6 ALLOPURINOL 300 MG 210 - - - 0
7 AMBROXOL 30 MG 139 900 900 900 125100
8 AMBROXOL DROP 29,370 - - - 0
9 AMBROXOL SYIRUP 5,866 - - - 0
10 AMINOFLUID CAIRAN 67,500 10 10 10 675000
11 AMINOPHILLIN 200 mg 95 700 700 700 66500
12 AMINOPHILLIN INJEKSI 2,976 60 60 60 178560
13 AMLODIPIN 5 75 - - - 0
14 AMLODIPIN 10 MG 99 1,100 1,100 600 500 49500
15 AMOXICILIN 1 GR INJEKSI 9,000 - - - 0
16 AMOXICILIN 125 mg SYIRUP 1,881 - - - 0
17 AMOXICILIN 250 mg 196 10,000 10,000 10,000 1960000
18 AMOXICILIN 250 mg SYIRUP 3,473 - - - 0
19 AMOXICILIN 500 mg 249 9,400 9,400 1000 8,400 2091600
20 AMPICILIN 500 mg 398 - - - 0
21 AMPICILIN 1 GR INJEKSI 8,237 10 10 10 82370
22 AMPICILIN SYIRUP 4,900 - - - 0
23 ANTALGIN 500 mg 323 - - - 0
STOCK PENERI - PERSE- PEMA- SISA STOCK PERMINT PEMBERIAN
NO. NAMA OBAT harga / pcs Rupiah
AWAL MAAN DIAAN KAIAN STOCK OPT. AAN PKD BF LAIN 2 JMLH
24 ANTALGIN / METAMIZOL INJEKSI 3,500 - - - 0
25 ANTASIDA DOEN TABLET 58 1,800 1,800 1000 800 46400
26 ANTASIDA DOEN SYIRUP 2,129 340 340 15 325 691925
27 ANTI BACTERI DOEN SK 2,924 43 43 25 18 52632
28 ANTI FUNGI SALEP 4,606 79 79 79 363874
29 ANTI HAEMOROID SUPPOSITORIA 3,167 10 10 10 31670
30 ASAM ASCORBAT 250 MG 164 - - - 0
31 ASAM ASCORBAT 50 MG 105 5,800 5,800 5,800 609000
32 ASAM MEFENAMAT 250 MG 300 - - - 0
33 ASAM MEFENAMAT 500 MG 160 5,900 5,900 1000 4,900 784000
34 ASAM TRANEXAMAT 500 MG 1,584 - - - 0
35 ASAM TRANEXAMAT INJEKSI 1,748 - - - 0
36 ASETOSAL 500 mg 200 - - - 0
37 ASETOSAL 100 MG 164 - - - 0
38 ASIKLOVIR 200 mg 240 - - - 0
39 ASIKLOVIR 400 mg 405 2,400 2,400 2,400 972000
40 ASIKLOVIR SK 2,997 - - - 0
41 1,013 - - - 0
(temiral)
42 ATROPIN SULFAS INJ 1,639 - - - 0
43 ATROPIN SULFAS TM 1,639 100 100 100 163900
44 BENZATIN BEN.P 1,2 JT 10,700 - - - 0
45 BENZATIN BEN.P 2,4 JT 14,500 - - - 0
46 BETAHISTIN MESILAT 6 mg 110 1,000 1,000 1,000 110000
47 BETAMETHASONE CREAM 1,430 70 70 70 100100
48 BRICASMA NEB 7,602 - - - 0
49 CALSIUM GLUCONAS INJEKSI 10,425 - - - 0
50 CAPTOPRIL 12,5 MG 62 100 100 100 6200
51 CAPTOPRIL 25 MG 75 - - - 0
52 CAPTOPRIL 50 MG 124 600 600 600 74400
53 CEFOTAXIM 1 GR INJ 4,482 550 550 550 2465100
54 CETERIZINE 10 MG 90 2,000 2,000 500 1,500 135000
55 CETERIZINE SYR 2,915 150 150 150 437250
56 CIPROFLOXACIN 500 mg 1,200 - - - 0
57 COMBIVENT NEBULASER 5,700 160 160 160 912000
58 DEXAMETHASONE 0,5 TAB 32 - - - 0
59 DEXAMETHASONE INJEKSI 1,097 210 210 20 190 208430
60 DIAZEPAM /STESOLID RECTAL 12,573 35 35 35 440055
61 DIAZEPAM 2 mg 86 400 400 400 34400
62 DIAZEPAM 5 mg 114 300 300 300 34200
63 DIAZEPAM INJEKSI 1,735 - - - 0
64 DIETILKARBAMAZIN SITRAT 100 MG - - 0
65 DIFENHIDRAMIN HCL INJ 1,168 1,530 1,530 180 1,350 1576800
66 DIGOXIN 0,25 104 200 200 200 20800
67 DIMENHIDRINAT 50 MG 112 700 700 700 78400
68 DOMPERIDONE 10 MG 91 600 600 600 54600
69 DOMPERIDONE SUSPENSI 2,700 100 100 100 270000
70 DOXICILIN 100 MG 270 - - - 0
71 DULCOLAX SUPP DEWASA 5,900 - - - 0
72 DULCOLAX SUPP ANAK 4,000 - - - 0
73 EPHEDRIN 25 mg 500 - - - 0
74 EPHINEPRINE INJ 1,408 600 600 600 844800
75 ERITROMICYN 250 MG 546 400 400 400 218400
76 ERITROMICYN 500 MG 770 1,100 1,100 1,100 847000
77 ERITROMICYN SYIRUP 6,090 - - - 0
78 FENOL GLISEROL TT 10% 2,590 62 62 62 160580
79 FENOXIPENICILIN 250 MG 290 - - - 0
80 FENOXIPENICILIN 500 MG 510 - - - 0
81 FITOMENADION 10 mg TAB 758 2,400 2,400 2,400 1819200
82 FITOMENADION INJEKSI 3,682 230 230 230 846860
83 FUROSEMIDE 40 mg 82 - - - 0
84 FUROSEMIDE INJEKSI 13,333 55 55 55 733315
85 GARAM ORALIT 200 274 1,500 1,500 1,500 411000
86 GEMFIBROZIL 300 MG 372 660 660 660 - 0
87 GENTAMICYN 80 MG INJ. 3,399 - - - 0
88 GENTAMICYN SK 2,126 - - - 0
89 GENTAMICYN TM 4,232 46 46 46 194672
90 GENTIAN VIOLET 1 % 818 - - - 0
91 GLIBENCLAMIDE 5mg 119 2,400 2,400 2,400 285600
92 GLIMEPIRIDE 1 MG 174 500 500 500 87000
93 GLIMEPIRIDE 2 MG 207 1,000 1,000 1,000 207000
94 GLIMEPIRIDE 3 MG 245 1,000 1,000 1,000 245000
95 GLIMEPIRIDE 4 MG 270 100 100 100 27000
96 GLISERIL GUAIACOLAT 100 mg 260 - - - 0
97 GLISERIN 3,780 - - - 0
98 GLUCOSE 5 % INFUS 6,900 330 330 330 2277000
99 GLUCOSE 10 % INFUS 8,003 60 60 60 480180
100 GLUCOSE 40 % INFUS 1,320 - - - 0
101 GRISEOFULVIN 125 mg 224 800 800 800 179200
102 GRISEOFULVIN 500 mg 906 - - - 0
103 HIDROCORTISONE 2,5% 2,640 113 113 113 298320
104 HIDROKLORTIAZID (HCT) 25 mg 155 400 400 400 62000
105 IBU PROFEN 200 MG 102 - - 0
106 IBU PROFEN 400 Mg 111 - - 0
107 IBU PROFEN SYR 100 MG 2,721 90 90 20 70 190470
108 INFUS ASERING 10,293 80 80 80 823440
109 INFUS KA-EN 3 B 10,696 120 120 120 1283520
110 IODIOL CAP.LUNAK 1,256 - - - 0
111 ISOSORBID 5 MG 89 100 100 100 - 0
112 KALSIUM LACTAT 500 mg 63 1,900 1,900 1,900 119700
113 KARBAMAZEPIN 200 mg 228 - - - 0
114 KETOKONAZOLE KRIM 2 % 2,518 49 49 49 123382
115 KETOKONAZOLE 200 mg 288 800 800 800 230400
116 KETOPROFEN 100 MG 553 - - - 0
117 KETOPROFEN INJ 100 MG 8,000 130 130 130 1040000
118 KETOROLAC INJEKSI 1,045 - - - 0
119 KLINDAMYCIN 150 mg 759 800 800 800 607200
120 KLORAMFENIKOL / CLORAMEX 500 1,163 900 900 500 400 465200
121 KLORAMFENIKOL 250 mg 310 - - 0
122 KLORAMPHENICOL SYIRUP 5,015 94 94 30 64 320960
KLORAMPHENICOL
123 15,000 - - - 0
INJ/CLORAMIDINE
124 KLORAMPHENICOL SK/ BUFACETIN 3,242 79 79 79 256118
125 KLORAMPHENICOL SM 2,007 116 116 116 232812
126 KLORAMPHENICOL TM 0,5 % 3,250 56 56 56 182000
127 KLORAMPHENICOL TT 3% 1,454 - - - 0
128 KLORFENIRAMIN/ CTM 4 mg 23 10,600 10,600 1000 9,600 220800
129 KOTRIMOXAZOL 120 mg 72 - - - 0
130 KOTRIMOXAZOL 480 mg 133 2,400 2,400 500 1,900 252700
131 KOTRIMOXAZOLE SYIRUP 2,190 327 327 20 307 672330
132 LIDOCAIN INJ /COMB 2 % 1,222 310 310 60 250 305500
133 LODOMER INJ 6,250 - - - 0
134 LOPERAMID 2 MG/LEXADIUM 400 900 900 500 400 160000
135 LORATADIN 10 MG 131 1,200 1,200 1,200 157200
136 MAGNESIUM SULFAS SERBUK. 1,027 - - - 0
137 MAGNESIUM SULFAS INJ.20% 3,328 13 13 13 43264
138 MAGNESIUM SULFAS INJ.40% 3,796 - - - 0
139 MEBENDAZOLE 100 MG 57 - - - 0
140 MEBENDAZOLE SIRUP 2,700 - - - 0
141 MECOBALAMIN 500 MG - - - 0
142 METFORMIN 500 mg 102 5,200 5,200 5,200 530400
143 METFORMIN 850 mg 160 - - - 0
144 METHIL ERGOMETRIN 0,125 TAB 224 100 100 100 22400
145 METIL ERGOMETRIN INJEKSI 2,959 714 714 714 2112726
146 METILPREDNISOLON INJEKSI 12,090 - - - 0
147 METILPREDNISOLON 4 MG 143 800 800 800 114400
148 METOKLORPAMIDE 10 MG 121 1,270 1,270 1,270 153670
149 METOKLORPAMIDE 5 MG 87 1,800 1,800 1,800 156600
150 METOKLORPAMIDE DROP 3,900 - - 0
151 METOKLORPAMIDE INJEKSI 3,960 210 210 20 190 752400
152 METOKLORPAMIDE/LEXAPRAM SYI 2,530 140 140 140 354200
153 METRONIDAZOLE SYIRUP 3,950 50 50 50 197500
154 METRONIDAZOLE 250 mg 89 - - - 0
155 METRONIDAZOLE 500 mg 113 - - - 0
156 METRONIDAZOLE INFUS 8,110 10 10 10 81100
157 MICONAZOLE 2% CREAM 3,414 57 57 57 194598
158 Na Cl INFUS 6,840 275 275 275 1881000
159 NA. BIC 500 MG 500 - - - 0
160 NA.DIKLOFENAC 25 mg 137 1,800 1,800 1,800 246600
161 NA.DIKLOFENAC 50 mg 123 1,100 1,100 1,100 135300
162 NIFEDIPIN 10 Mg 129 - - - 0
163 NISTATIN VAG. 100.000 IU 598 110 110 110 65780
164 NISTATIN/ KANDISTATIN DROP 54,500 - - - 0
165 OBAT BATUK HITAM SYIRUP 5,566 - - - 0
166 OCUGARD 5,927 - - - 0
167 OFLOXACIN 200 mg 348 - - 0
168 OFLOXACIN 400 MG 553 1,400 1,400 1,400 774200
169 OMEPRAZOLE 20 mg 139 1,620 1,620 1,620 225180
170 OXITETRA INJEKSI 6,160 - - - 0
171 OXITETRA SK 1,529 - - - 0
172 OXITETRA SM 2,668 142 142 142 378856
173 OXITOCIN INJ 1,199 66 66 66 79134
174 PAN AMIN G INFUS 45,950 - - - 0
175 PAPAVERIN 40 MG 400 - - - 0
176 PAPAVERIN INJEKSI 10,000 - - - 0
177 PARASETAMOL 100 MG 290 - - - 0
178 PARASETAMOL 500 mg 81 - - - 0
179 PARASETAMOL DROP 6,649 72 72 10 62 412238
180 PARASETAMOL SIRUP 1,181 234 234 234 276354
181 PARASETAMOL/PROPYRETIC SUPP 8,000 - - - 0
182 PENILBUTAZON 200 MG 100 - - - 0
183 PIRACETAM 400 MG 1,140 - - - 0
184 PIRACETAM 800 MG 8,091 - - - 0
185 PIRACETAM INJEKSI 6,600 - - - 0
186 PIRANTEL 125 MG 269 - - - 0
187 PIRANTEL SIRUP 9,510 - - - 0
188 PIRIDOXIN HCl 10 mg TAB 131 3,500 3,500 3,500 458500
189 PIRIDOXIN HCl 25 mg TAB 200 - - - 0
190 PIROKSIKAM 10 MG 300 - - - 0
191 PIROKSIKAM 20 MG 500 - - - 0
192 PPC INJEKSI 7,190 - - - 0
193 PREDNISON TAB 73 4,300 4,300 500 3,800 277400
194 PROPANOLOL HCL 10 MG 81 - - - 0
195 PROPANOLOL HCl 40 mg 107 500 500 500 53500
196 PTU 100 mg 319 - - - 0
197 PULMICORT 0,5 MG NEBULESER 14,131 - - 0
198 RANITIDIN 150 mg 98 - - - 0
199 RANITIDIN INJEKSI 1,188 100 100 100 118800
200 RETINOL 100.000 IU 307 1,450 1,450 1,450 445150
201 RETINOL 200.000 IU 414 1,400 1,400 1,400 579600
202 RIFAMPICIN 450 mg 790 - - - 0
203 RINGER LACTAT INFUS 7,150 175 100 275 270 5 35750
204 SABU I 512,204 2 2 2 1024408
205 SALBUTAMOL 2 mg 67 1,500 1,500 500 1,000 67000
206 SALBUTAMOL 4 mg 78 - - - 0
207 SALBUTAMOL/ VENTOLIN NEBULAS 9,000 74 74 74 666000
208 SALEP 2-4 2,796 76 76 76 212496
209 SALICYL BEDAK 2% 1,250 15 15 15 18750
210 SCABIMITE CREAM 11,825 184 184 184 2175800
211 SEFADROXIL 500 CAPSUL 450 - - - 0
212 SEFADROXIL SYIRUP KERING 4,185 285 285 35 250 1046250
213 SERUM ANTI TETANUS 1500 UI 130,999 16 16 2 14 1833986
214 SERUM ANTI TETANUS 20,000 UI - - 0
215 SIANOKOBALAMIN HCL/B12 INJ. 1,104 1,400 1,400 200 1,200 1324800
216 SIANOKOBALAMIN HCL/B12 TAB 49 500 500 500 24500
217 SIMVASTATIN 10 Mg 117 110 110 110 - 0
218 SIMVASTATIN 20 Mg 217 850 850 550 300 65100
219 SPIROLACTONE 100 MG TAB - - - 0
220 SULFASETAMID Na TM 0,5 % 2,933 - - - 0
221 TAB.TAMBAH DARAH 106 27,500 27,500 27,500 2915000
222 TETRACAIN TTS MATA 11,500 - - - 0
223 TETRACYCLIN HCL 250 mg 149 - - - 0
224 TETRACYCLIN HCL 500 mg 323 1,200 1,200 1,200 387600
225 THIAMIN HCL ( B1 ) 50 MG 91 1,000 1,000 500 500 45500
226 THIAMIN HCL ( B1 ) INJEKSI 1,139 - - - 0
227 THIAMPHENICOL 500 MG 2,110 - - 0
228 THIAMPHENICOL SIRUP 12,980 - - - 0
229 TRAMADOL 150 mg 172 - - 0
230 TRAMADOL INJEKSI 1,764 25 25 25 44100
231 VIT.B.COMPLEX INJEKSI 6,600 - - - 0
232 VIT.B.COMPLEX TAB 89 5,900 5,900 500 5,400 480600
233 ZINK 20 MG TAB 524 3,700 3,700 3,700 1938800
234 ZINKID SIRUP 3,171 5 5 5 - 0
235 ZINKID DROP 12,841 - - - 0
- - 0
- - 0
- - 0
- - 0
- - 0
NARKOTIK / PSOKOTROPIKA / OOT - - 0
236 ALPRAZOLAM 0,25 MG 336 - - 0
237 ALPRAZOLAM 0,5 MG 500 - - 0
238 AMITRIPTILIN 25 MG 167 2,600 2,600 2,600 434200
239 CLOBAZAM 10 MG 900 100 100 100 90000
240 CODEIN 10 MG 571 500 500 100 400 228400
241 FENITOIN INJ. 4,956 - - - 0
242 FENITOIN 30 MG 496 10 10 10 4960
243 FENOBARBITAL INJ. 1,716 - - - 0
244 FENOBARBITAL 100 MG - - 0
245 FENOBARBITAL 30 MG 171 200 200 200 34200
246 HALOPERIDOL INJEKSI 4,000 - - - 0
247 HALOPERIDOL 1,5 mg 59 400 400 400 23600
248 HALOPERIDOL 2 mg / LODOMER 90 - - - 0
249 HALOPERIDOL 5 mg 69 1,900 1,900 500 1,400 96600
250 KLORPROMAZIN 100mg 157 - - - 0
251 KLORPROMAZIN 25mg 181 - - - 0
252 KLORPROMAZIN INJ. 1,326 - - - 0
253 SIKZONOATE INJ. 63,813 10 10 10 638130
254 TRIFLUOPERAZIN 5 MG 405 - - 0
255 TRIHEXYPENIDIL 2 mg 91 - - - 0
BMHP
1 ALAT SUNTIK 0,05 ML 3,190 - - - 0
2 ALAT SUNTIK 0,5 ML 1,580 - - - 0
3 ALAT SUNTIK 1 ML 650 - - - 0
4 ALAT SUNTIK 2,5 ML 650 - - - 0
5 ALAT SUNTIK 3 ML 924 1,600 1000 2,600 1000 1,600 1478400
6 ALAT SUNTIK 5 ML 968 1,380 1,380 1,380 1335840
7 ALAT SUNTIK 10 ML 925 - - 0
8 ALKOHOL SWAB 120 200 200 200 24000
9 AQUA PRO INJEKSI 2,750 - - - 0
10 AQUADEST (Water One) 1 ltr 14,520 - - - 0
11 CAT GUT CROMIC + PLAIN 36,234 24 24 24 869616
12 CYBOW 138,250 10 10 10 1382500
13 DERMAFIX 5X7 CM 1,629 - - - 0
14 ETAKRIDIN LAR (RIVANOL) 0,1% 3,000 2 2 2 6000
15 ETANOL 70% 1 LTR 25,000 38 38 38 950000
16 ETANOL 70% 100 ML 3,000 - - - 0
17 ETHIL KLORIDA 375,000 - - - 0
18 FOLLEY CATETER NO 16 10,857 - - - 0
19 FOLLEY CATETER NO 18 11,435 - - 0
22 HAND RUB 500 ML/ E CARE / FRESCO 88,000 15 15 15 1320000
23 HAND SCOEN 7 -7,5 4,037 1,600 1,600 700 900 3633300
24 HAND SCOEN NON STERIL S/M/L 1,250 - - 0
25 HAND SCRUB / SABUN 45,000 5 5 5 225000
26 INFUS SET ANAK 7,920 600 600 600 4752000
27 INFUS SET DEWASA 8,400 233 233 85 148 1243200
28 IV. CATHETER NO. 18 8,250 215 215 215 1773750
29 IV. CATHETER NO. 20 11,400 155 155 155 1767000
30 IV. CATHETER NO. 22 10,395 108 108 67 41 426195
31 IV. CATHETER NO. 24 10,395 189 189 189 1964655
32 KAPAS BERLEMAK 500 GR 16,500 1 1 1 16500
33 KAPAS PEMBALUT 250 GR 12,500 80 80 80 1000000
34 KASA 2MX 80CM 9,870 80 80 80 789600
35 KASA BESAR ( 80X40 ) 108,500 6 6 2 4 434000
36 KASA 4 X 15 CM 2,100 240 240 240 504000
37 KASA 4 X 3 CM 590 100 100 100 59000
38 KASA KOMPRES 40X40 1,600 55 55 55 88000
39 KASA STERIL 16X16 CM 7,370 28 28 28 206360
40 LISOL 50 % 41,000 5 5 5 205000
41 MASKER 3 PLY 1,800 - - - 0
42 MASKER KAIN 7,000 - - 0
43 PLESTER 2,5 CM X 4 M 14,280 - - - 0
44 PLESTER 5 YARD 35,532 38 38 8 30 1065960
45 PLESTER 7,5 CM X 4 M 35,532 - - - 0
46 POVIDON YODIDA 1 LITER 79,650 1 1 1 79650
47 POVIDON YODIDA 30 ML 2,900 82 82 82 237800
48 POVIDON YODIDA 300 ML 18,000 20 20 20 360000
49 POVIDON YODIDA 60 mL 3,700 20 20 20 74000
50 SILK 23,921 12 12 12 287054.118
51 STIK ASAM URAT BENECHECK 6,043 - - - 0
52 STIK GDA BENECHECK 5,027 - - - 0
53 STIK KOLESTEROL BENECHECK 25,133 - - - 0
54 UNDER PAD 4,851 - - - 0
55 URINE BAG 5,850 20 20 20 117000
56 ZEIL NELSON 136,500 - - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
VAKSIN
1 CAMPAK (BIAS) 155,000 22 22 22 3410000
2 CAMPAK MR 166,265 - - 0
3 VAKSIN BCG 66,154 38 38 38 2513852
4 VAKSIN DPT-HB-Hib 84,282 40 40 40 3371280
5 VAKSIN DT BIAS 19,195 33 33 33 633435
6 VAKSIN HB UNIJEECT 25,597 54 54 54 1382238
7 VAKSIN IPV 169,653 51 51 51 8652303
8 VAKSIN POLIO 19,954 40 40 40 798160
9 VAKSIN Td BIAS 16,995 37 37 37 628815
10 VAKSIN TT 150,000 20 20 20 3000000
VAKSIN COVID 19 - - 0
RAPID TEST - - 0
VTM SWABB - - 0
- - 0
- - 0
PROGRAM : TB / HIV / PARU DLL - - - 0
1 ALKOHOL SWAB 120 - - 0
2 EUTHYROX 2,563 - - - 0
3 HB S Ag ( VIRO CHECK ) 3,245 - - 0
4 LATEX M SUPERCARE 660 - - 0
5 MALATION GALLON 5LITER 130,000 - - 0
6 MASKER 3 PLY ( PROGRAM TB ) 1,800 46 46 46 82800
7 MDT DEWASA 41,784 8 8 2 6 250704
8 MINERAL MIX - - 0
9 OBAT KATEGORI ANAK 248,120 1 1 1 248120
10 OBAT KATEGORI I 389,344 15 15 15 5840160
11 OBAT KATEGORI II 1,384,983 1 1 1 1384983
12 OBAT SISIPAN - - 0
13 PLESTERIN BULAT 35,000 - - - 0
14 POT DAHAK / SAMPLE CONTAINER 3,000 - - - 0
15 R2 ( KHB) 12,500 - - - 0
16 R3 (DIAGNOSTAR HIV 1/2) 13,353 - - - 0
17 RAPIDAN 54,040 175 175 175 9457000
18 REAGEN HB S Ag/VIRO CHECK 276,500 0 0 -
19 REAGEN ZEIL NELSON 136,500 0 0 -
20 SD HIV 90,000 0 0 -
21 SD SYPHILIS 48,880 0 0 -
22 SAFETY BOX 22,433 0 0 -
0 0 -
0 0 -
0 0 -
0 0 -
GIZI 0 0 -
1 TABURIA - 26 26 26 -
2 PITA LILA UNTUK BAYI 6,545 12 12 12 78,540
3 PITA LILA UNTUK WUS 6,545 12 12 12 78,540
4 PRENAGEN SUSU - 0 0 -
5 BISCUIT MILNA - 0 0 -
6 PAN ENTERNAL - 0 0 -
7 NUTRI DRINK - 0 0 -
0 0 -
0 0 -
0 0 -
0 0 -
OBAT KAPITASI 0 0 -
1 ACARBOSE 100 MG 990 0 0 -
2 ACETYLSISTEINE 200 MG 1,533 0 0 -
3 ALLOPURINOL 100 MG 104 0 0 -
4 ALLOPURINOL 300 MG 210 2,400 2400 2400 504,000
5 AMBROXOL 30 MG 139 4,100 4100 500 3600 500,400
6 AMBROXOL DROP 29,370 - 0 0 -
7 AMBROXOL SYR 5,866 260 260 260 1,525,160
8 AMINOFLUID CAIRAN 67,590 0 0 -
9 AMINOPHILIN 200 95 - 0 0 -
10 AMINOPHILIN INJ 2,976 - 0 0 -
11 AMLODIPIN 10 MG 99 - 0 0 -
12 AMLODIPIN 5 MG 75 - 0 0 -
13 AMOKSISILIN 250 mg 196 - - - 0
14 AMOKSISILIN 500 mg 249 - - - 0
15 AMOXICILIN 1 GR INJ 8,237 - - 0
16 AMOXICILIN 125 mg SYIRUP 1,881 - - 0
17 AMOXICILIN 250 mg SYIRUP 3,473 - - 0
18 ANTALGIN INJEKSI 3,500 1,200 1,200 400 800 2800000
19 ANTALGIN / METAMIZOL 500 MG 323 1,500 1,500 1,500 484500
20 ANTASIDA DOEN TABLET 580 - - 0
21 ANTI ANEMIA KOMBINASI (HEMAFO 1,071 - - 0
22 ANTI BACTERI / BACITRASIN DOEN 6,322 21 21 21 132762
23 ANTI HEMOROID SUP 2 G 3,167 - - 0
24 ANTI INFLAMASI (CENDO TROPIN 0 23,916 - - 0
25 ANTIBIOTIKA (THIAMPHENICOL SYR 12,980 - - 0
26 ANTITUSIF ANAK (SAMCODRIL SYRU 9,523 - - 0
27 APTOR / ASETOSAL/ASPILET 100 MG 164 1,900 1,900 300 1,600 262400
28 ASAM ASCORBAT 250 MG 164 - - 0
29 ASAM MEFENAMAT 250 MG 300 - - - 0
30 ASAM MEFENAMAT 500 MG 160 9,000 9,000 9,000 1440000
31 ASAM TRANEXAMAT INJEKSI 1,748 - - 0
32 ASIKLOVIR 200 Mg 240 - - - 0
33 ASIKLOVIR 400 Mg 405 - - - 0
34 ASIKLOVIR CREAM 3,997 265 265 265 1059205
35 BACITRACIN / ANTI BACTERI SALEP 2,934 - - 0
36 BETAHISTIN MESILAT 6 MG 110 - - - 0
37 BETAMETHASONE CREAM 1,430 - - - 0
38 BIO ATP 2,954 1,000 1,000 100 900 2658600
39 BIOCOMBIN 5000 INJ 6,875 - - - 0
40 BISOPROLOL 2,5 MG 746 - - - 0
41 BRICASMA NEB 7,602 - - 0
42 CAPTOPRIL 12,5 Mg 62 - - 0
43 CAPTOPRIL 25 Mg 75 7,700 7,700 700 7,000 525000
44 CAPTOPRIL 50 MG 124 - - - 0
45 CEFOTAKSIM 1 G INJEKSI 4,482 1,450 1,450 1,450 6498900
46 CETERIZINE 10 MG 90 - - - 0
47 CETERIZINE SIRUP 2,915 - - - 0
48 CHANNA 6,655 - - 0
49 CIPROFLOXACIN 500 mg 1,200 2,000 2,000 2,000 2400000
50 CITICOLIN INJK 1,188 - - - 0
51 CITICOLIN TAB 7,000 - - - 0
52 COMBIVEN NEBULAZER 5,700 - - - 0
53 CYSTONE/ UROLITAS 4,137 - - - 0
54 DEMACOLIN / ANTI INFLUENZA TAB 797 - - - 0
55 DEXAMETHASONE 0,5 TAB 32 - - - 0
56 DEXAMETHASONE INJEKSI 1,097 - - - 0
57 DIFENHIDRAMIN HCL INJ 1,168 - - - 0
58 DIMENHIDRINAT 50 MG 112 - - 0
59 DOMPERIDONE 10 MG 91 - - - 0
60 DOMPERIDONE SUSPENSI 2,700 - - - 0
61 EDEMIN 10 INJ 8,850 - - - 0
62 EPHINEPRINE INJ 1,408 - - - 0
63 ERITROMICIN 250 MG 546 - - - 0
64 ERITROMICIN 500 MG 770 - - - 0
65 ERITROMICYN SYRUP 200 MG/5ML 6,090 - - - 0
66 FITOMINADION 10 mg 758 - - - 0
67 FITOMINADION INJEKSI 3,683 - - 0
68 FLUDANE 690 - - 0
69 GEMFIBROZIL 300 MG 372 - - 0
70 GENTAMICIN SK 2,126 257 257 20 237 503862
71 GENTAMICIN TM 4,232 - - - 0
72 GENTIAN VIOLET 3,861 125 125 125 482625
73 GLIBENCLAMIDE 5Mg 119 - - - 0
74 GLICERYL GUAIACOLAT 260 5,900 5,900 5,900 1534000
75 GLIMEPIRIDE 1 MG 174 - - 0
76 GLIMEPIRIDE 2 MG 207 - - - 0
79 GLUCOSE 5 % INFUS 6,900 - - - 0
80 GLUKOSA 40% INFUS 1,320 91 91 91 120120
81 GUAIFENICIN TAB 373 - - 0
82 HALOPERIDOL 2 / LODOMER 90 - - 0
83 HALOPERIDOL 5 MG 69 - - 0
84 HCT 25 MG 155 - - 0
85 HEMAFORT 354 2,000 2,000 100 1,900 672600
86 HEPAGARD ( NATURAL HEPATOPRO 250 - - 0
87 HIDROCORTISONE CREAM 2,5% 2,640 - - 0
88 IBU PROFEN 200 MG 102 - - - 0
89 IBU PROFEN 400 Mg 111 3,500 3,500 1000 2,500 277500
90 IBU PROFEN SYR 100 MG 2,721 - - - 0
91 INFUS ASERING 10,293 - - 0
92 INFUS KA-EN 3 B 10,696 - - - 0
93 INFUS PAN AMIN-G 45,950 - - - 0
94 ISOSORBIDE 5 MG 89 2,000 2,000 2,000 178000
95 KALSIUM LACTAT 500 MG 63 - - - 0
96 KETOKONAZOLE 200 Mg 288 - - - 0
97 KETOKONAZOLE CREAM 5 G 2,518 - - 0
98 KETOPROFEN INJ 100 MG 8,000 - - 0
99 KETOPROFEN SUPP - - 0
100 KETOROLAC INJEKSI 1,045 - - 0
101 KLINDAMISIN KAPS 300 MG 759 1,500 1,500 1,500 1138500
102 KLINDAMISIN KAPS I50 MG 715 - - - 0
103 KLORAMPHENICOL 250 MG KAPSUL 310 - - - 0
104 KLORAMPHENICOL 500 MG KAPSUL 1,163 - - - 0
105 KLORAMPHENICOL INJEKSI 13,970 - - - 0
106 KLORAMPHENICOL SK/ BUFACETIN 3,242 - - - 0
107 KLORAMPHENICOL SYIRUP 5,015 - - 0
108 KLORAMPHENICOL TM 0,5 % (RECO) 3,250 - - 0
109 KLORAMPHENICOL TT 3% 1,454 120 120 15 105 152670
110 KLORPHENIRAMIN MALEAT 4 MG 23 - - - 0
111 KOTRIMOXAZOL 120 MG 72 - - - 0
112 KOTRIMOXAZOL 480 mg 133 - - - 0
113 KOTRIMOXAZOLE SYIRUP 2,190 - - - 0
114 LACTO B 22,330 - - - 0
115 LARUTAN HCL 0,1 N 22,450 - - 0
116 LARUTAN BENEDICT 22,450 - - 0
117 LARUTAN EDTA 10 % 76,600 - - 0
118 LARUTAN EMMERSIOAN OIL 370,150 - - 0
119 LARUTAN EOSIN 2 % 178,725 - - 0
120 LARUTAN TURK 26,250 - - 0
121 LIDOCAIN COMB 2 % INJEKSI 1,222 - - 0
122 LOPERAMID 2 MG/LEXADIUM 400 1,400 1,400 400 1,000 400000
123 LORATADIN 10 MG 131 - - - 0
124 METFORMIN 500 MG 102 - - - 0
125 METIL ERGOMETRIN INJEKSI 2,959 - - - 0
126 METILPREDNISOLON 4 MG 143 - - - 0
127 METILPREDNISOLON INJ 12,090 - - - 0
128 METOCLOPRAMEDE/ SOTATIK INJEK 396 - - - 0
129 METOKLOPRAMIDE/GAVISTAL DRO 39,000 - - - 0
130 METOKLORPAMIDE 10 MG 121 - - - 0
131 METOKLORPAMIDE 5 MG 87 - - - 0
132 METOKLORPAMIDE/LEXAPRAM SIR 2,530 - - 0
133 METRONIDAZOLE 250 MG 170 - - 0
134 METRONIDAZOLE 500 Mg 113 2,500 2,500 2,500 282500
135 METRONIDAZOLE INFUS 8,110 - - - 0
136 METRONIDAZOLE SIRUP 3,950 - - - 0
137 MG SO 20% - - 0
138 MG SO 40% - - - 0
139 MICONAZOLE 2% CREAM 3,277 - - - 0
140 Na Cl INFUS - - - 0
141 NA.DIKLOFENAC 25 mg 6,850 - - 0
142 NA.DIKLOFENAC 50 mg 6,150 - - 0
143 NEW ANTIDES (ATTAPULGITE) 230 - - 0
144 NIFEDIPIN TAB 129 1,000 1,000 1,000 129000
145 NORAGES / ANTRAIN/ PROGESOL INJ 9,240 - - 0
146 OBH SIRUP 5,566 143 143 143 795938
147 OCUGARD 5,927 - - - 0
148 OMEPRAZOLE 20 MG - - - 0
149 ONDANCETRON INJ 3,000 - - - 0
150 OXITOCIN INJ 1,199 - - - 0
151 OXYTETRACYCLIN 3% SK 5,100 - - 0
152 PAPAVERIN 40 MG 66 - - 0
153 PARASETAMOL 100 mg 49 - - 0
154 PARASETAMOL 500 mg 81 35,800 35,800 1500 34,300 2778300
155 PARASETAMOL DROP - - - 0
156 PARASETAMOL SIRUP 1,181 - - - 0
157 PARASETAMOL SUPP (PROPYRETIC) 667 20 20 20 13340
158 PHENZACOL TAB 605 - - 0
159 PIRACETAM 400 MG 1,140 400 400 400 456000
160 PIRACETAM 800 MG 2,000 - - - 0
161 PIRACETAM INJEKSI 6,600 20 20 20 132000
162 PIRIDOXIN 10 MG 131 - - - 0
163 PIROKSIKAM 10 MG 300 - - - 0
164 PIROKSIKAM 20 MG 400 2,000 2,000 2,000 800000
165 PREDNISON TABLET 5 MG 73 - - - 0
166 PTU 100 MG 432 - - 0
167 PULMICORT 14,131 - - 0
168 RANITIDIN 150 mg 214 1,700 1,700 1,700 363800
169 RANITIDIN INJEKSI 1,188 - - - 0
170 SALBUTAMOL 2 mg 67 - - - 0
171 SALBUTAMOL 4 mg 78 1,500 1,500 1,500 117000
172 SALBUTAMOL/VENTOLIN NEBULES 6,600 260 260 260 1716000
173 SALEP 2-4 2,796 - - - 0
174 SALICYL BEDAK 2% 2,420 90 90 90 217800
175 SEDIAAN ANTI INFLUENZA 869 - - - 0
176 SEFADROXIL 250 CAPSUL 300 - - 0
177 SEFADROXIL 500 CAPSUL 450 2,000 2,000 500 1,500 675000
178 SEFADROXIL SYIRUP KERING 4,185 - - - 0
179 SERUM ANTI TETANUS 1500 UITETAG 130,999 - - - 0
180 SIANOKOBALAMIN HCL/B12 INJ. 1,104 - - - 0
181 SIKSONOAT INJ 63,986 - - - 0
182 SIMVASTATIN 10 Mg 3,510 - - 0
183 SIMVASTATIN 20 Mg 10,850 - - - 0
184 TETRACYCLIN HCL 250 mg - - 0
185 TETRACYCLIN HCL 500 mg 323 - - 0
186 THIAMIN HCL ( B1 ) 50 MG 91 49,000 49,000 49,000 4459000
187 THIAMIN HCL ( B1 ) INJEKSI 1,139 - - - 0
THIAMPHENICOL 500 MG /
188 2,110 - - 0
SOLATHIM
189 THIAMPHENICOL SIRUP 34,100 - - - 0
190 TRAMADOL INJEKSI 7,000 - - - 0
191 VENTOLIN NEB 6,600 - - - 0
192 VIT.B.COMPLEX INJEKSI 6,600 - - - 0
193 VIT.B.COMPLEX TAB 83 - - - 0
194 ZINK DROP 4,788 - - - 0
195 ZINK SYR 3,171 - - - 0
196 ZINKC 20 MG TAB 524 - - - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
BHP KAPITASI - - 0
1 ALAT SUNTIK 0.05 ML 3,190 - - 0
2 ALAT SUNTIK 0.5 ML 1,580 200 200 100 100 158000
3 ALAT SUNTIK 1 ML 650 0 - - 0
4 ALAT SUNTIK 2.5 ML 650 - - 0
7 ALAT SUNTIK 10 ML 925 160 160 160 148000
8 ALKOHOL 70 % 1 LITER 25,000 - - 0
9 ALKOHOL SWAB 120 50 50 50 - 0
10 AQUA PRO INJEKSI 2,750 170 170 70 100 275000
11 BLOOD LANCET 1,750 - - 0
12 BLOOD TRANFUSION SET 4,200 0 - - 0
13 BLUE TIPS 2,367 0 - - 0
CATGUT CHROMIC 2/0- 3/0 HR 24-26
14 MM 6,985 0 0 0 -
CATGUT PLAIN 2/0- 3/0 Ds 24-26
15 MM 7,920 0 0 0 -
16 COVER GLASS 7,920 - 0 0 -
17 CYBOW (URINE TEST) 1,383 - 0 0 -
18 DACLON 6/0 DS 12 MM 3,213 0 0 0 -
19 DERMAFIX 10 X 8 1,629 0 0 0 -
20 DERMAFIX 5 X 7 1,678 0 0 -
21 ETHYL KLORIDA 375,000 10 10 9 1 375,000
22 FIXOMUL 90,000 0 0 -
23 FOLLEY CATETER NO 16 10,340 62 62 20 42 434,280
24 FOLLEY CATETER NO 18 10,890 62 62 20 42 457,380
25 FOLLEY CATETER NO 22 11,435 0 0 -
26 FOLLEY CATETER NO 24 12,496 0 0 0 -
27 GEL DOPLER 16,500 1 1 1 0 -
28 GEL ULTRASONIC 104,995 0 0 -
29 GELANG PASIEN/ID BAND BLUE/PIN 1,110 0 0 -
30 GLUCO PROTEIN URINE TEST 1,045 0 0 0 -
31 HAND RUB 5 L 880,000 0 0 -
32 HAND RUB 500 ML 88,000 0 0 0 -
33 HAND SCOEN (PP) 4,180 0 0 -
HAND SCOEN Non Steril S,M, L free
34 pwdr 1,250 5,950 5950 5700 250 312,500
35 HAND SCOEN STERIL (PF) 6,985 0 0 0 -
36 HAND SCOEN steril uk. 7/7,5 3,938 0 0 0 -
37 HAND SCRUB 5 L 450,000 10 10 9 1 450,000
38 HAND SCRUB 500 ML 45,000 8 8 7 1 45,000
39 HYPAFIX / ULTRAVIX 2,5X5 0 0 -
40 INFUS SET ANAK 7,920 0 0 -
41 INFUS SET DEWASA 8,400 0 0 -
42 IV DRESSING 2,200 0 0 -
43 IV. CATHETER NO 18 8,250 0 0 -
44 IV. CATHETER NO 20 11,400 0 0 -
45 IV. CATHETER NO 22 10,395 0 0 -
46 IV. CATHETER NO 24 10,395 0 0 0 -
47 JARUM NOVODISK/INSULIN 2,083 0 0 0 -
48 JELLY /CATHEJELL LIDOCAIN 41,600 25 25 20 5 208,000
49 KALIUM PERMANGANAT 5,145 - 0 0 -
50 KAPAS PEMBALUT 250 GR 12,500 10 10 10 0 -
51 KAPAS PEMBALUT 500 GR 16,500 0 0 0 -
52 KASA BESAR ( 80X40 ) 108,500 0 0 0 -
53 KASA 2M X 80CM 9,870 0 0 0 -
54 KASA 4 X 15 CM 2,100 0 0 0 -
55 KASA 4 X 3 CM 590 - 0 0 -
56 KASA KOMPRES 40X40 1,600 - 0 0 -
57 KASA STERIL 16 X 16 7,370 - 0 0 -
58 LEVEMIR FLEXPEN 1,845 0 0 -
59 LISOL 1,939 - 0 0 -
60 MASKER 3 PLY / BEDAH 1,800 2,650 2650 2600 50 90,000
61 MASKER N95 74,250 - 0 0 -
62 MESS SCALPEL 11/15 1,320 0 0 -
63 MIKRO PIPET MTSP 32,000 - 0 0 -
64 MIKROPIPET MT 11 32,000 0 0 -
65 NOVO MIX FLEXPEN 100 UI/ML INJ 3 106,000 130 130 108 22 2,332,000
66 NOVO RAPID FLEXPEN 87,000 0 0 -
67 OBJEK GLASS FROSTED 2,225 0 0 -
68 PERHIDROL /H2O2 3 % 19,800 52 52 17 35 693,000
69 PLESTER 2.5 X 4.5 14,280 - 0 0 -
70 PLESTER 7.5 CM X 4.5 CM 35,532 0 0 -
71 PLESTER E CARE 35,000 20 20 20 0 -
72 POVIDON YODIDA 30 ML 2,900 - 0 0 -
75 POVIDON YODIDA 1 LITER 79,650 - 0 0 -
76 RIVANOL 3,000 0 0 -
77 SELANG OXYGEN / NEBULIZER AN 9,631 104 104 53 51 491,156
78 SELANG OXYGEN MASKER DWS 24,360 25 25 20 5 121,798
79 SELANG OXYGEN / NEBULIZER DE 9,630 44 44 33 11 105,930
80 SELANG OXYGEN MASKER ANAK 24,360 0 0 -
81 SILK BLACK 2/0- 3/0 HR 26-30 MM 21,571 132 132 90 42 905,982
82 SILK BLACK 2/0-3/0 DS 24-26 MM 23,921 - 0 -
83 SPALEK KAYU 61,600 10 10 10 -
84 STERICLIN FLAT 20 CM X 200 M 1,538,000 - 0 -
85 STERICLIN FLAT 7,5 CM X 200 M 705,000 - 0 -
86 STERICLIN GUSSETE 15 X 5 CM 1,056,000 - - 0 -
87 STERICLIN GUSSETE 20 CM X 5 CM 1,271,000 - 0 -
88 STERICLIN GUSSETE 25 X 6,5 CM 1,542,000 - 0 -
89 STIK ASAM URAT BENECHECK 6,000 3 3 1 2 -
90 STIK GDA ON CALL 4,650 - - 0 -
91 STIK GULA DARAH BENECHECK 3,200 2 2 2 0 -
92 STIK KOLESTEROL BENECHECK 25,000 2 2 1 1 -
93 TABUNG EDTA / VACCUM TUBE 100,500 2 2 2 -
94 TALI PUSAT STERIL-umbilical cord 9,631 2 2 2 -
95 TEST KEHAMILAN 1,997 - 0 -
TEST TRIP CHOLESTEROL (EASY
96 TOUCH) 153,800 13 13 13 -
TEST TRIP GLUKOSA (EASY
97 TOUCH) 14,100 70 70 3 67 -
TEST TRIP URID ASID (EASY
98 TOUCH) 42,240 - - 0 -
99 UNDERPAD 4,851 45 45 45 -
100 URINE BAG 5,850 38 38 38 -
101 WHITE TIPS 973 - 0 -
102 YELLOW TIPS 1,852 8 8 8 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
- 0 -
REAGEN - -
1 ALBUMIN 739,200 1 1 -
2 BILIRUBIN 850,300 1 1 -
3 CHOLESTEROL 2,093,300 2 2 -
4 CREATININ 733,920 2 2 -
5 GLUCOSE 889,570 2 2 -
6 GOT (ASAT) 2,028,400 1 1 -
7 GPT(ALAT) 2,028,400 1 1 1 - 0
8 TOTAL PROTEIN 1,595,000 - - 0
9 TRIGLISERIDE 3,021,810 2 2 2 - 0
10 UREA FS 690,690 2 2 2 - 0
11 URIC ACID 1,870,660 2 2 2 - 0
12 ALKACIDE 1 L 2,702,700 - - 0
13 ALKAZYME 801,000 - - 0
14 BENEDICT 1 X 100 ML 22,450 - - 0
15 CELL CLEAN 1,210,000 - - 0
16 CELL PACK 1,980,000 - - 0
17 E-CHECK XS 2,643,300 - - 0
18 EDTA 10% 1X100 ML 76,600 - - 0
19 EOSIN 2% 1X100 ML 178,725 - - 0
20 HCL 100 ML 22,450 - - 0
21 HDL CHOLESTEROL (DIRECT) - - 0
22 HEMOGLOBIN 49,950 - - 0
23 IMMERSION OIL 1X100 ML 370,150 1 1 1 - 0
K3 EDTA 3ML / TABUNG
24 VACOUNTAINER 100,500 - - 0
25 KOH 23,400 - - 0
26 LDL - - 0
27 REAGEN DIASTRO CLEANER ABACUS 313,500 2 2 2 - 0
28 REAGEN DILUENT ABACUS 3 1,650,000 2 2 2 - 0
29 REAGEN FOTOMETER 1,498,640 - - 0
30 REAGEN HEMATOLOGI 418,000 1 1 1 - 0
31 REAGEN LYSE ABACUS 3 1,595,000 2 2 2 - 0
32 REAGEN SERUM KONTROL HEMATO 418,000 - - 0
33 REST ECKER 49,050 - - 0
34 STRIP HB - - 0
35 STROMATOLYSER-4DL (FFD-220A) 2,778,600 - - 0
36 STROMATOLYSER-4DL (FFS-800A) 2,599,300 - - 0
37 SULFOLYSER 500 ML 5LS-210A 679,800 - - 0
38 ZEIL NELSON 3X100 ML 136,500 - - 0
- - 0
- - 0
OBAT KAPITASI GIGI
1 ABDER SINGLE BOND 2 260,925 0 0 -
2 ALGENIUX 104,800 0 0 -
3 ALGINAT 64,000 0 0 -
4 ALVOGIL 208,725 0 0 -
5 ANTISEPTIK LIQUID 100 ML 66,000 0 0 -
6 ARTICULATING PAPER 6/12 276,246 0 0 -
7 ATTAQUE GEL 99,000 0 0 -
8 BIOCLASS C 358,000 0 0 -
9 CALCIDOR 123,200 0 0 -
10 CALSETIN 136,000 - 0 0 -
CALCIUM HYDROXIDE
11 PASTE/CITODUR/CALCIDOR 123,200 0 0 -
12 CALLPLUS 89,000 0 0 -
13 CAMPHENOL/CHKM 67,000 0 0 -
14 CAVIT BOTTLE W 109,714 - 0 0 -
15 CAVIT G BOTTLE RF 28G 122,400 2 2 2 0 -
16 CAVIT W 109,714 - 0 0 -
17 CAVITON 163,750 0 0 -
18 CEIVITRON PINK 75,900 0 0 -
19 CELLULOID STRIP 98,907 0 0 -
20 CHKM 75,900 0 0 -
21 CLOREXORAL 2 % 210,000 0 0 -
22 COTTON ROLL 160,500 0 0 -
23 CRESHOPENE 0 0 -
24 CRESOTIN LIQ NO 2 160,500 0 0 -
25 CRESOTIN LIQUID II TEHNODENT CRESOTIN PASTE 0 0 -
26 CRESOTIN PASTE 112,000 0 0 -
27 CURASPON 0 0 -
28 DENTAL GYPSUM TIPE II (PUTIH) 0 0 -
29 DENTAL GYPSUM TIPE III (BIRU) 0 0 -
30 DEVITALISASI PASTA 0 0 -
31 EDTA GEL 0 0 -
32 elite cement 167,000 0 0 -
33 EMAIL PREPARATOR BLUE 120,228 0 0 -
34 ENDOSEAL 159,000 0 0 -
35 EPOXIDIN ROOT CANAL 417,000 0 0 -
36 ETCHANT GEL VIAL 9 ML 120,237 0 0 -
37 EUGENOL 120,000 0 0 -
38 fg diamond mata bur high speed 133,000 0 0 -
39 FILLTEMP 122,000 0 0 -
40 FILTEK P60 A3 215,504 0 0 -
41 FILTEK 2250 XTA3 187,725 0 0 -
42 FORMOKRESOL 60,000 0 0 -
43 GIC ANTERIOR 53,500 0 0 -
44 GIC POSTERIOR 53,500 0 0 -
45 GUTTA PERCAPA NO 15-40 53,500 0 0 -
46 GUTTA PERCAPA NO 45-80 53,500 0 0 -
HYDCAL PASTE, BASE AND
47 135,000 0 0 -
CATALIST
48 IMMERSION OIL 1x100mL 370,150 0 0 -
49 IODOFORM 437,547 0 0 -
50 IODOTIN PASTE IN JAR 95,500 0 0 -
51 KETAC UNIVERSAL HM INTRO KIT A 437,547 2 2 2 0 -
52 KOMPOSITE ANTERIOR 361,000 0 0 -
53 KOMPOSITE POSTERIOR 361,000 0 0 -
54 k-reamers 15-40 L-21 237,000 0 0 -
55 MAJOR ALGENIUX 104,800 0 0 -
56 MASTER BOND 239,000 0 0 -
57 MASTER FLOW 176,000 0 0 -
58 MICRON SUPERIOR 272,000 0 0 -
59 multiflix 0 0 -
60 ORAFIL PLUS 54,000 0 0 -
61 PAPER POINT NO 15-40 55,660 0 0 -
62 PAPER POINT NO 45-80 55,660 0 0 -
63 PARAMONOCHLOROFENOL 67,000 0 0 -
64 POSTERIUR SYR 0 0 -
65 PULP X 219,000 0 0 -
66 POLIREN PASTA NO 1 167,000 0 0 -
67 PUPERIL 0 0 -
68 RELYX ULTIMATE CLIKER A1 636,833 - - 0
69 RELYX ULTIMATE CLIKER A3 657,241 - - 0
70 RETRAFLEX 142,000 - - 0
71 ROST SYR 3G - - 0
72 SALIVA EJECTOR 250,825 - - 0
73 SCAPEL BLADE 2,790 - - 0
74 SINGLE BOND 2 RF LA/APAC 41,282 - - 0
75 SOF LEX DIAMOND SPIRAL 893,806 - - 0
76 SOF LEX EXTRA XTHIN FINE 109,756 - - 0
77 SOF LEX PREPOLISH SPIRAL 389,275 - - 0
78 SOF LEX XTHIN COARSE 109,755 - - 0
79 SOF LEX XTHIN MEDIUM 109,751 - - 0
80 SOF LEX XTHIN/SFINE 109,754 - - 0
81 SPONGOSTON DENTAL (CURASPON) 126,800 - - 0
82 STAIN REMOVER - - 0
83 STAIN REMOVER - - 0
84 TEHNODENT - - 0
85 TRICRESOL FORMALINA 70,999 - - 0
86 TRIKRESOL FORMALIN 255,000 - - 0
87 VARNAL 151,000 - - 0
88 Z250 XT REST SYR 3G LA/APAC/MEA 189,750 - - 0
89 ZINC F 64,000 - - 0
90 ZINC PHOSPATE 155,000 - - 0
91 ZITEMP 66,000 - - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
- - 0
GOLONGAN DARAH
1 GOLONGAN DARAH A 440,000 0 0 -
2 GOLONGAN DARAH AB 440,000 0 0 -
3 GOLONGAN DARAH B 440,000 1 1 1 0 -
4 GOLONGAN DARAH 0 440,000 - 0 0 -
5 FEBRILE ANTIGEN H - TYPH 43,400 1 1 1 0 -
6 FEBRILE ANTIGEN O - A TYPH 43,400 1 1 1 0 -
7 FEBRILE ANTIGEN O - B TYPH 43,400 0 0 -
8 FEBRILE ANTIGEN O - D TYPH 43,400 1 1 1 0 -
0 0 -
0 0 -
KAPITASI COVID/ BOK 0 0 -
1 APD SET LENGKAP ( COVER ALL, VISOR,HAND SCOND SE SIKU, SEPA 0 0 -
2 BAJU COVER ALL 789,800 0 0 -
3 BAHAN DESINFEKTAN PERMUKAAN 5,632,000 0 0 -
4 FACE SHIELD 8,500 0 0 -
5 HAND SCOEN SESIKU 71,500 0 0 -
6 KACAMATA GOOGLE 31,500 0 0 -
7 MASKER 3 PLY 1,800 0 0 -
8 MASKER N 95 74,250 0 0 -
9 NURSE CUP (PELINDUNG RAMBUT P 25,000 0 0 -
10 SANOSIL 5 LTR DESINFEKTAN 5,632,000 0 0 -
11 SEPATU KHUSUS 175,000 0 0 -
12 TERMOMETER GUN 2,800,000 0 0 -
13 VISOR (PELINDUNG WAJAH) 259,000 0 0 -
14 BAJU BEDAH/SURGICAL GOWN 533,000 0 0 -
15 HELM SET 100,000 0 0 -
16 LAP. MICROFIBER 148,500 0 0 -
17 KACA MATA SAFETY SHIELD 35,000 0 0 -
18 HANDSCRUB GEL 45,000 0 0 -
0 0 -
0 0 -
0 0 -
0 0 -
HIBAH
1 ACCU CECK - - - 0
2 APD LENGKAP SATU SET - - 0
3 ALKOHOL SWABS - - 0
4 BAJU APD (COVER ALL) - - - 0
5 CLODINE 5 L - - 0
6 DESINFEKTAN @ 20 LITER - - 0
7 FACE SHIELD 5 5 5 0
8 HAND SANITIZER 5 5 5 0
9 HAZMAT PUTIH 131 131 131 0
10 HAZMAT - - 0
11 HELM SAFETY - - 0
12 KACAMATA GOOGLE - - 0
13 KRESEK LIMBAH - - 0
14 MASKER ANTIDEBU/N95 - - 0
15 MASKER KAIN GERMAS/HEADLOOP/EARLOOP - - 0
16 MASKER BEDAH / 3 PLY - - 0
17 RAPID TEST - - 0
18 SANOSIL 5 LITER - - 0
19 SARUNG TANGAN DISPOSIBLE - - 0
20 SARUNG TANGAN SESIKU 5 5 5 0
21 SEPATU BOOTH - - 0
22 SPANDUK - - 0
23 TERMOMETER GUN - - 0
24 VISOR(PELINDUNG WAJAH) - - 0
25 POMPA DESINFEKTAN - - 0
26 MASKER KN95 - - 0
- - 0
PROGRAM KB - - 0
1 IUD 312,500 - - 0
2 Kondom 90 - - 0
3 PIL KB 210 100 100 100 21000
4 SPUIT 3CC KB 990 581 581 581 575190
5 SUSUK 250,000 - - 0
ADRK : -
1 BLOOD LANCET
2 AUTOCLIK
3 HB SAHLI
4 TES KEHAMILAN
ALKES
1 ABN DM 500 DIGITAL ANAK
2 TROLI INSTRUMENT
3 ROSSMAX WEIGHSCALE DEWASA
4 Q. FLEXIBEL TERMOMETER
5 CHOLCEMMED MD-300 ( PULS OXYMETER )
6 CLASSIC STETHOSCOPE DEWASA
JUMLAH Rp. 182,584,924
MENGETAHUI / MENYETUJUI YANG MENYERAHKAN YANG MEMEMINTA/MELAPOR YANG MENERIMA

Plt.KEPALA DINAS KESEHATAN APOTEKER INSTALASI FARMASI KEPALA PUSKESMAS PETUGAS PUSKESMAS
DINAS KESEHATAN
dr. H. ACHMAD MARSUKI, MM IKA RUZAIQA N,S.Farm, Apt. H. ABD SYUKUR, S.Kep, MM NOVILITA TRISANTI, Amd. Farm
NIP.19641024 199703 1 002 NIP.19860309 201001 2 020 NIP.196905031990021002 NIP.198711232019022003
KET
16
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
316000 158,000
0 -
0 -
0 -
0 -
148000 -
0 -
6000 6,000
467500 192,500
0 -
0 -
0 -
0 -
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
3750000 3,375,000
0 -
641080 206,800
675180 217,800
0 -
0 -
16500 16,500
0 -
0 -
0 -
0 -
0 -
0 -
7437500 7,125,000
0 -
0 -
4500000 4,050,000
360000 315,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
KET
0 -
1040000 832,000
0 -
125000 125,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
4770000 4,680,000
0 -
0 -
0 -
0 -
13780000 11,448,000
0 -
0 -
1029600 336,600
0 -
0 -
700000 700,000
0 -
0 -
0 -
0 -
0 -
1001572 510,417
608987.5 487,190
423720 317,790
0 -
2847372 1,941,390
0 -
KET
0 -
0 -
616000 -
0 -
0 -
0 -
0 -
0 -
18000 6,000
0 -
6400 6,400
50000 25,000
201000 -
19262 -
0 -
1999400 -
987000 42,300
0 -
218295 -
222300 -
0 -
14816 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
739200 -
850300 -
4186600 -
1467840 -
1779140 -
2028400 -
0 -
KET
0 -
2028400 2,028,400
0 -
6043620 6,043,620
1381380 1,381,380
3741320 3,741,320
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
370150 370,150
0 -
0 -
0 -
627000 627,000
3300000 3,300,000
0 -
418000 418,000
3190000 3,190,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
244800 244,800
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
875094 875,094
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
KET
0 -
0 -
0 -
0 -
440000 440,000
0 -
43400 43,400
43400 43,400
0 -
43400 43,400
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
21000 -
575190 -
0 -
0 -
KET
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
MENERIMA 83434119 59,910,651

PUSKESMAS
I, Amd. Farm
9022003
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : JUNI
harga / STOCK PENERI - PERSE- PEMA- SISA STOCK PERMIN

pcs AWAL MAAN DIAAN KAIAN STOCK OPT. TAAN
1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
1 ALBENDAZOLE 400 MG 344 -
2 ALBENDAZOLE SYIRUP 3,849 -
5 AMBROXOL 30 MG 139 100 100 100 - -
6 AMBROXOL DROP 29,370 -
7 AMBROXOL SYIRUP 5,866 -
8 AMLODIPIN 5 75 -
9 AMLODIPIN 10 MG 99 -
10 AMOXICILIN 125 mg SYIRUP 1,881 20 20 10 10 18,810
13 AMOXICILIN 500 mg 249 500 500 300 200 49,800
14 AMPICILIN 500 mg 398 -
15 AMPICILIN SYIRUP 4,900 -
16 ANTALGIN 500 mg 323 -
17 ANTASIDA DOEN TABLET 58 300 300 200 100 5,800
18 ANTASIDA DOEN SYIRUP 2,129 10 10 10 - -
19 ANTI BACTERI DOEN SK 2,924 -
20 ANTI FUNGI SALEP 4,606 -
21 ANTI HAEMOROID SUPPOSITORIA 3,167 -
23 ASAM ASCORBAT 50 MG 105 300 300 100 200 21,000
25 ASAM MEFENAMAT 500 MG 160 100 100 100 - -
26 ASIKLOVIR 200 mg 240 -
27 ASIKLOVIR 400 mg 405 - 200 200 100 100 40,500
28 ASIKLOVIR SK 2,997 5 5 5 - -
29 1,013 -
(temiral)
30 BETAHISTIN MESILAT 6 mg 110 -
31 BETAMETHASONE CREAM 1,430 -
32 CALSIUM GLUCONAS INJEKSI 10,425 -
33 CAPTOPRIL 12,5 MG 62 -
34 CAPTOPRIL 25 MG 75 100 100 200 100 100 7,500
35 CAPTOPRIL 50 MG 124 -
36 CETERIZINE 10 MG 90 50 50 50 - -
37 CETERIZINE SYR 2,915 -
38 CIPROFLOXACIN 500 mg 1,200 -
39 DEXAMETHASONE 0,5 TAB 32 -
40 DEXAMETHASONE INJEKSI 1,097 20 20 0 20 21,940
41 DIFENHIDRAMIN HCL INJ 1,168 30 30 30 - -
42 DIGOXIN 0,25 104 -
43 DIMENHIDRINAT 50 MG 112 -
44 DOMPERIDONE 10 MG 91 -
45 DOMPERIDONE SUSPENSI 2,700 20 20 10 10 27,000
46 ERITROMICYN 250 MG 546 -
47 ERITROMICYN 500 MG 770 200 200 200 - -
48 ERITROMICYN SYIRUP 6,090 -
49 FENOL GLISEROL TT 10% 2,590 -
50 FITOMENADION 10 mg TAB 758 - 100 100 50 50 37,900
51 FITOMENADION INJEKSI 3,682 - 15 15 15 - -
52 FUROSEMIDE 40 mg 82 100 100 100 - -
53 GARAM ORALIT 200 274 - 100 100 50 50 13,700
54 GENTAMICYN SK 2,126 5 5 5 - -
55 GENTAMICYN TM 4,232 -
56 GENTIAN VIOLET 1 % 818 5 5 0 5 4,090
57 GLIBENCLAMIDE 5mg 119 - 300 300 100 200 23,800
58 GLISERIL GUAIACOLAT 100 mg 260 100 100 50 50 13,000
59 HIDROCORTISONE 2,5% 2,640 -
60 HIDROKLORTIAZID (HCT) 25 mg 155 200 200 100 100 15,500
61 IBU PROFEN 200 MG 102 200 200 200 - -
62 IBU PROFEN 400 Mg 111 -
63 IBU PROFEN SYR 100 MG 2,721 -
64 ISOSORBID 5 MG 89 -
65 KALSIUM LACTAT 500 mg 63 - 300 300 200 100 6,300
66 KETOKONAZOLE KRIM 2 % 2,518 5 5 5 - -
67 KETOKONAZOLE 200 mg 288 - - 0 - -
68 KLORAMFENIKOL / CLORAMEX 500 1,163 -
69 KLORAMFENIKOL 250 mg 310 -
70 KLORAMPHENICOL SYIRUP 5,015 - - 0 - -
KLORAMPHENICOL
71 15,000 -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 5 5 5 - -
73 KLORAMPHENICOL SM 2,007 -
74 KLORAMPHENICOL TM 0,5 % 3,250 20 20 10 10 32,500
75 KLORAMPHENICOL TT 3% 1,454 -
76 KLORFENIRAMIN/ CTM 4 mg 23 100 100 50 50 1,150
77 KOTRIMOXAZOL 120 mg 72 -
78 KOTRIMOXAZOL 480 mg 133 - 200 200 100 100 13,300
79 KOTRIMOXAZOLE SYIRUP 2,190 -
80 LIDOCAIN INJ /COMB 2 % 1,222 - 30 30 20 10 12,220
81 LOPERAMID 2 MG/LEXADIUM 400 100 100 50 50 20,000
84 MECOBALAMIN 500 MG -
85 METFORMIN 500 mg 102 - - 0 - -
86 METFORMIN 850 mg 160 -
87 METHIL ERGOMETRIN 0,125 TAB 224 500 500 300 200 44,800
88 METIL ERGOMETRIN INJEKSI 2,959 30 30 20 10 29,590
90 METOKLORPAMIDE 5 MG 87 100 100 100 - -
91 METOKLORPAMIDE DROP 3,900 -
92 METOKLORPAMIDE INJEKSI 3,960 -
93 METOKLORPAMIDE/LEXAPRAM SYI 2,530 -
94 METRONIDAZOLE SYIRUP 3,950 -
97 MICONAZOLE 2% CREAM 3,414 -
98 NA. BIC 500 MG 500 -
100 NA.DIKLOFENAC 50 mg 123 300 300 200 100 12,300
101 NISTATIN/ KANDISTATIN DROP 54,500 -
102 OBAT BATUK HITAM SYIRUP 5,566 3 3 3 - -
103 OXITETRA INJEKSI 6,160 -
104 OXITETRA SK 1,529 -
105 OXITETRA SM 2,668 5 5 5 - -
106 OXITOCIN INJ 1,199 -
107 PARASETAMOL 100 MG 290 -
108 PARASETAMOL 500 mg 81 300 300 200 100 8,100
109 PARASETAMOL DROP 6,649 20 20 10 10 66,490
110 PARASETAMOL SIRUP 1,181 20 20 10 10 11,810
111 PARASETAMOL/PROPYRETIC SUPP 8,000 -
112 PIRACETAM 400 MG 1,140 -
113 PIRACETAM 800 MG 8,091 -
116 PREDNISON TAB 73 -
117 RANITIDIN 150 mg 98 -
118 RANITIDIN INJEKSI 1,188 -
119 RETINOL 100.000 IU 307 -
120 RETINOL 200.000 IU 414 -
121 RINGER LACTAT INFUS 7,150 10 10 10 - -
124 SALEP 2-4 2,796 -
125 SALICYL BEDAK 2% 1,250 5 5 5 - -
126 SEFADROXIL 500 CAPSUL 450 -
127 SEFADROXIL SYIRUP KERING 4,185 -
128 SIANOKOBALAMIN HCL/B12 INJ. 1,104 20 20 10 10 11,040
129 SIANOKOBALAMIN HCL/B12 TAB 49 -
132 TAB.TAMBAH DARAH 106 500 500 1,000 500 500 53,000
133 THIAMIN HCL ( B1 ) 50 MG 91 -
134 THIAMPHENICOL 500 MG 2,110 -
135 VIT.B.COMPLEX INJEKSI 6,600 -
136 VIT.B.COMPLEX TAB 89 300 300 300 - -
137 ZINK 20 MG TAB 524 100 100 50 50 26,200
138 ZINKID SIRUP 3,171 -
139 OMEPRRAZOLE CAP 30 30 30 - -
140 OFLOXACIN TAB 100 100 0 100 -
141 PIL KB 100 100 0 100 -
-
-
BMHP -
1 ALAT SUNTIK 2,5 ML 650 -
2 ALAT SUNTIK 3 ML 924 300 300 200 100 92,400
3 ALAT SUNTIK 5 ML 968 - - 0 - -
5 AQUA PRO INJEKSI 2,750 -
6 CAT GUT CROMIC + PLAIN 36,234 12 12 10 2 72,468
7 DERMAFIX 5X7 CM 1,629 -
8 ETAKRIDIN LAR (RIVANOL) 0,1% 3,000 -
9 ETANOL 70% 1 LTR 25,000 2 2 2 - -
10 HANDSCOON -
11 INFUS SET ANAK 7,920 -
12 INFUS SET DEWASA 8,400 -
13 IV. CATHETER NO. 18 8,250 10 10 10 - -
14 IV. CATHETER NO. 20 11,400 -
15 IV. CATHETER NO. 22 10,395 -
16 KAPAS PEMBALUT 250 GR 12,500 1 1 1 - -
17 KASA 2MX 80CM 9,870 10 10 5 5 49,350
18 KASA 4 X 15 CM 2,100 -
19 KASA 4 X 3 CM 590 -
20 KASA KOMPRES 40X40 1,600 10 10 5 5 8,000
21 KASA STERIL 16X16 CM 7,370 1 1 1 - -
22 MASKER 3 PLY 1,800 50 50 50 - -
23 PLESTER 5 YARD 35,532 1 1 1 - -
24 POVIDON YODIDA 30 ML 2,900 -
25 SILK 23,921 5 5 5 - -
26 UNDER PAD 4,851 5 5 5 - -
27 URINE BAG 5,850 -
28 POVIDON YODIDA 6O ML 1 1 1 - -
-
-
-
-
-
-
-
-
-
-

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : JULI
harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

pcs AWAL MAAN DIAAN KAIAN STOCK TAAN IAN
1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
1 ALBENDAZOLE 400 MG 344 - - - -
2 ALBENDAZOLE SYIRUP 3,849 - - - -
3 ALLOPURINOL 100 MG 104 - - - -
5 AMBROXOL 30 MG 139 - - - -
6 AMBROXOL DROP 29,370 - - - -
7 AMBROXOL SYIRUP 5,866 - - - -
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
10 AMOXICILIN 125 mg SYIRUP 1,881 10 10 10 - -
11 AMOXICILIN 250 mg 196 - - - -
12 AMOXICILIN 250 mg SYIRUP 3,473 - - - -
13 AMOXICILIN 500 mg 249 200 200 200 - -
14 AMPICILIN 500 mg 398 - - - -
15 AMPICILIN SYIRUP 4,900 - - - -
16 ANTALGIN 500 mg 323 - - - -
17 ANTASIDA DOEN TABLET 58 100 100 100 - -
18 ANTASIDA DOEN SYIRUP 2,129 - - 0 - -
19 ANTI BACTERI DOEN SK 2,924 - - - -
20 ANTI FUNGI SALEP 4,606 - - - -
21 ANTI HAEMOROID SUPPOSITORIA 3,167 - - - -
22 ASAM ASCORBAT 250 MG 164 - - - -
23 ASAM ASCORBAT 50 MG 105 200 200 200 - -
24 ASAM MEFENAMAT 250 MG 300 - - - -
25 ASAM MEFENAMAT 500 MG 160 - - 0 - -
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 100 100 100 - -
28 ASIKLOVIR SK 2,997 - - 0 - -
29 1,013 - - - -
(temiral)
30 BETAHISTIN MESILAT 6 mg 110 - - - -
31 BETAMETHASONE CREAM 1,430 - - - -
32 CALSIUM GLUCONAS INJEKSI 10,425 - - - -
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 100 100 100 - -
35 CAPTOPRIL 50 MG 124 - - - -
36 CETERIZINE 10 MG 90 - - 0 - -
37 CETERIZINE SYR 2,915 - - - -
38 CIPROFLOXACIN 500 mg 1,200 - - - -
39 DEXAMETHASONE 0,5 TAB 32 - - - -
40 DEXAMETHASONE INJEKSI 1,097 20 20 20 - -
41 DIFENHIDRAMIN HCL INJ 1,168 - - 0 - -
42 DIGOXIN 0,25 104 - - - -
43 DIMENHIDRINAT 50 MG 112 - - - -
44 DOMPERIDONE 10 MG 91 - - - -
45 DOMPERIDONE SUSPENSI 2,700 10 10 10 - -
46 ERITROMICYN 250 MG 546 - - - -
47 ERITROMICYN 500 MG 770 - - 0 - -
48 ERITROMICYN SYIRUP 6,090 - - - -
49 FENOL GLISEROL TT 10% 2,590 - - - -
50 FITOMENADION 10 mg TAB 758 50 50 30 (20) (15,160)
51 FITOMENADION INJEKSI 3,682 - - 0 - -
52 FUROSEMIDE 40 mg 82 - - 0 - -
53 GARAM ORALIT 200 274 50 50 50 - -
54 GENTAMICYN SK 2,126 - - 0 - -
55 GENTAMICYN TM 4,232 - - - -
56 GENTIAN VIOLET 1 % 818 5 5 3 (2) (1,636)
57 GLIBENCLAMIDE 5mg 119 200 200 100 (100) (11,900)
58 GLISERIL GUAIACOLAT 100 mg 260 50 50 50 - -
59 HIDROCORTISONE 2,5% 2,640 - - - -
60 HIDROKLORTIAZID (HCT) 25 mg 155 100 100 100 - -
61 IBU PROFEN 200 MG 102 - - 0 - -
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
64 ISOSORBID 5 MG 89 - - - -
66 KETOKONAZOLE KRIM 2 % 2,518 - - 0 - -
67 KETOKONAZOLE 200 mg 288 - - 0 - -
68 KLORAMFENIKOL / CLORAMEX 500 1,163 - - - -
69 KLORAMFENIKOL 250 mg 310 - - - -
70 KLORAMPHENICOL SYIRUP 5,015 - - 0 - -
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 - - 0 - -
73 KLORAMPHENICOL SM 2,007 - - - -
74 KLORAMPHENICOL TM 0,5 % 3,250 10 10 10 - -
75 KLORAMPHENICOL TT 3% 1,454 - - - -
76 KLORFENIRAMIN/ CTM 4 mg 23 50 50 50 - -
77 KOTRIMOXAZOL 120 mg 72 - - - -
78 KOTRIMOXAZOL 480 mg 133 100 100 100 - -
79 KOTRIMOXAZOLE SYIRUP 2,190 - - - -
80 LIDOCAIN INJ /COMB 2 % 1,222 10 10 10 - -
81 LOPERAMID 2 MG/LEXADIUM 400 50 50 50 - -
82 MAGNESIUM SULFAS INJ.20% 3,328 - - - -
84 MECOBALAMIN 500 MG - - - -
85 METFORMIN 500 mg 102 - - 0 - -
86 METFORMIN 850 mg 160 - - - -
87 METHIL ERGOMETRIN 0,125 TAB 224 200 200 200 - -
88 METIL ERGOMETRIN INJEKSI 2,959 10 10 10 - -
89 METOKLORPAMIDE 10 MG 121 - - - -
90 METOKLORPAMIDE 5 MG 87 - - 0 - -
91 METOKLORPAMIDE DROP 3,900 - - - -
92 METOKLORPAMIDE INJEKSI 3,960 - - - -
93 METOKLORPAMIDE/LEXAPRAM SYI 2,530 - - - -
94 METRONIDAZOLE SYIRUP 3,950 - - - -
95 METRONIDAZOLE 250 mg 89 - - - -
97 MICONAZOLE 2% CREAM 3,414 - - - -
98 NA. BIC 500 MG 500 - - - -
99 NA.DIKLOFENAC 25 mg 137 - - - -
100 NA.DIKLOFENAC 50 mg 123 100 100 100 - -
101 NISTATIN/ KANDISTATIN DROP 54,500 - - - -
102 OBAT BATUK HITAM SYIRUP 5,566 - - 0 - -
103 OXITETRA INJEKSI 6,160 - - - -
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 - - 0 - -
106 OXITOCIN INJ 1,199 - - - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 100 100 100 - -
109 PARASETAMOL DROP 6,649 10 10 10 - -
110 PARASETAMOL SIRUP 1,181 10 10 10 - -
111 PARASETAMOL/PROPYRETIC SUPP 8,000 - - - -
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
114 PIRIDOXIN HCl 10 mg TAB 131 - - - -
116 PREDNISON TAB 73 - - - -
117 RANITIDIN 150 mg 98 - - - -
118 RANITIDIN INJEKSI 1,188 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
121 RINGER LACTAT INFUS 7,150 - - 0 - -
122 SALBUTAMOL 2 mg 67 - - - -
124 SALEP 2-4 2,796 - - - -
125 SALICYL BEDAK 2% 1,250 - - 0 - -
126 SEFADROXIL 500 CAPSUL 450 - - - -
127 SEFADROXIL SYIRUP KERING 4,185 - - - -
128 SIANOKOBALAMIN HCL/B12 INJ. 1,104 10 10 10 - -
129 SIANOKOBALAMIN HCL/B12 TAB 49 - - - -
130 SIMVASTATIN 10 Mg 117 - - - -
131 SIMVASTATIN 20 Mg 217 - - - -
132 TAB.TAMBAH DARAH 106 500 500 500 - -
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
134 THIAMPHENICOL 500 MG 2,110 - - - -
135 VIT.B.COMPLEX INJEKSI 6,600 - - - -
136 VIT.B.COMPLEX TAB 89 - - 0 - -
137 ZINK 20 MG TAB 524 50 50 50 - -
138 ZINKID SIRUP 3,171 - - - -
139 OMEPRRAZOLE CAP - - 0 - -
140 OFLOXACIN TAB 100 100 100 - -
141 PIL KB 100 100 100 - -
-
-
BMHP -
1 ALAT SUNTIK 2,5 ML 650 - -
2 ALAT SUNTIK 3 ML 924 100 100 100 - -
3 ALAT SUNTIK 5 ML 968 - - 0 - -
4 ALAT SUNTIK 10 ML 925 - - - -
5 AQUA PRO INJEKSI 2,750 - - - -
6 CAT GUT CROMIC + PLAIN 36,234 2 2 2 - -
7 DERMAFIX 5X7 CM 1,629 - - - -
8 ETAKRIDIN LAR (RIVANOL) 0,1% 3,000 - - - -
9 ETANOL 70% 1 LTR 25,000 - - 0 - -
10 HANDSCOON - - - -
11 INFUS SET ANAK 7,920 - - - -
12 INFUS SET DEWASA 8,400 - - - -
13 IV. CATHETER NO. 18 8,250 - - 0 - -
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
16 KAPAS PEMBALUT 250 GR 12,500 - - 0 - -
17 KASA 2MX 80CM 9,870 5 5 5 - -
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 5 5 5 - -
21 KASA STERIL 16X16 CM 7,370 - - 0 - -
22 MASKER 3 PLY 1,800 - - 0 - -
23 PLESTER 5 YARD 35,532 - - 0 - -
24 POVIDON YODIDA 30 ML 2,900 - - - -
25 SILK 23,921 - - 0 - -
26 UNDER PAD 4,851 - - 0 - -
27 URINE BAG 5,850 - - - -
28 POVIDON YODIDA 6O ML - - 0 - -
-
-
-
-
-
-
-
-
-
-

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : AGUSTUS

1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
5 AMBROXOL 30 MG 139 - - - -
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
11 AMOXICILIN 250 mg 196 - - - -
13 AMOXICILIN 500 mg 249 - - - -
14 AMPICILIN 500 mg 398 - - - -
16 ANTALGIN 500 mg 323 - - - -
17 ANTASIDA DOEN TABLET 58 - - - -
18 ANTASIDA DOEN SYIRUP 2,129 - - - -
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 - - - -
28 ASIKLOVIR SK 2,997 - - - -
29 1,013 - - - -
(temiral)
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 - - - -
35 CAPTOPRIL 50 MG 124 - - - -
36 CETERIZINE 10 MG 90 - - - -
40 DEXAMETHASONE INJEKSI 1,097 - - - -
41 DIFENHIDRAMIN HCL INJ 1,168 - - - -
42 DIGOXIN 0,25 104 - - - -
45 DOMPERIDONE SUSPENSI 2,700 - - - -
46 ERITROMICYN 250 MG 546 - - - -
47 ERITROMICYN 500 MG 770 - - - -
50 FITOMENADION 10 mg TAB 758 20 20 10 (10) (7,580)
51 FITOMENADION INJEKSI 3,682 - - - -
52 FUROSEMIDE 40 mg 82 - - - -
53 GARAM ORALIT 200 274 - - - -
54 GENTAMICYN SK 2,126 - - - -
55 GENTAMICYN TM 4,232 - - - -
56 GENTIAN VIOLET 1 % 818 2 2 2 - -
57 GLIBENCLAMIDE 5mg 119 100 100 100 - -
58 GLISERIL GUAIACOLAT 100 mg 260 - - - -
59 HIDROCORTISONE 2,5% 2,640 - - - -
60 HIDROKLORTIAZID (HCT) 25 mg 155 - - - -
61 IBU PROFEN 200 MG 102 - - - -
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
64 ISOSORBID 5 MG 89 - - - -
65 KALSIUM LACTAT 500 mg 63 - - - -
66 KETOKONAZOLE KRIM 2 % 2,518 - - - -
67 KETOKONAZOLE 200 mg 288 - - - -
70 KLORAMPHENICOL SYIRUP 5,015 - - - -
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 - - - -
74 KLORAMPHENICOL TM 0,5 % 3,250 - - - -
76 KLORFENIRAMIN/ CTM 4 mg 23 - - - -
80 LIDOCAIN INJ /COMB 2 % 1,222 - - - -
81 LOPERAMID 2 MG/LEXADIUM 400 - - - -
85 METFORMIN 500 mg 102 - - - -
86 METFORMIN 850 mg 160 - - - -
87 METHIL ERGOMETRIN 0,125 TAB 224 - - - -
88 METIL ERGOMETRIN INJEKSI 2,959 - - - -
97 MICONAZOLE 2% CREAM 3,414 - - - -
98 NA. BIC 500 MG 500 - - - -
102 OBAT BATUK HITAM SYIRUP 5,566 - - - -
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 - - - -
106 OXITOCIN INJ 1,199 - - - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 - - - -
109 PARASETAMOL DROP 6,649 - - - -
110 PARASETAMOL SIRUP 1,181 - - - -
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
117 RANITIDIN 150 mg 98 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
121 RINGER LACTAT INFUS 7,150 - - - -
124 SALEP 2-4 2,796 - - - -
125 SALICYL BEDAK 2% 1,250 - - - -
128 SIANOKOBALAMIN HCL/B12 INJ. 1,104 - - - -
130 SIMVASTATIN 10 Mg 117 - - - -
131 SIMVASTATIN 20 Mg 217 - - - -
132 TAB.TAMBAH DARAH 106 - - - -
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
136 VIT.B.COMPLEX TAB 89 - - - -
137 ZINK 20 MG TAB 524 - - - -
138 ZINKID SIRUP 3,171 - - - -
139 OMEPRRAZOLE CAP - - - -
140 OFLOXACIN TAB - - - -
141 PIL KB - - - -
-
-
BMHP -
2 ALAT SUNTIK 3 ML 924 - - - -
4 ALAT SUNTIK 10 ML 925 - - - -
6 CAT GUT CROMIC + PLAIN 36,234 - - - -
7 DERMAFIX 5X7 CM 1,629 - - - -
9 ETANOL 70% 1 LTR 25,000 - - - -
10 HANDSCOON - - - -
11 INFUS SET ANAK 7,920 - - - -
12 INFUS SET DEWASA 8,400 - - - -
13 IV. CATHETER NO. 18 8,250 - - - -
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
16 KAPAS PEMBALUT 250 GR 12,500 - - - -
17 KASA 2MX 80CM 9,870 - - - -
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 - - - -
21 KASA STERIL 16X16 CM 7,370 - - - -
22 MASKER 3 PLY 1,800 - - - -
23 PLESTER 5 YARD 35,532 - - - -
24 POVIDON YODIDA 30 ML 2,900 - - - -
25 SILK 23,921 - - - -
26 UNDER PAD 4,851 - - - -
27 URINE BAG 5,850 - - - -
28 POVIDON YODIDA 6O ML - - - -
-
-
-
-
-
-
-
-
-
-

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
KODE PUSKESMAS : 1 0 3 3 1 9 4
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : SEPTEMBER

1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
5 AMBROXOL 30 MG 139 - 100 100 100 - -
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
10 AMOXICILIN 125 mg SYIRUP 1,881 - 10 10 10 - -
11 AMOXICILIN 250 mg 196 - - - -
13 AMOXICILIN 500 mg 249 - 500 500 400 100 24,900
14 AMPICILIN 500 mg 398 - - - -
16 ANTALGIN 500 mg 323 - - - -
17 ANTASIDA DOEN TABLET 58 - 500 500 400 100 5,800
18 ANTASIDA DOEN SYIRUP 2,129 - 10 10 10 - -
19 ANTI BACTERI DOEN SK 2,924 - 10 10 10 - -
22 ASAM ASCORBAT 250 MG 164 - 300 300 100 200 32,800
23 ASAM ASCORBAT 50 MG 105 - 500 500 300 200 21,000
25 ASAM MEFENAMAT 500 MG 160 - 200 200 200 - -
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 - 200 200 100 100 40,500
28 ASIKLOVIR SK 2,997 - - - -
29 1,013 - - - -
(temiral)
31 BETAMETHASONE CREAM 1,430 - 10 10 10 - -
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 - - - -
35 CAPTOPRIL 50 MG 124 - - - -
41 DIFENHIDRAMIN HCL INJ 1,168 - 30 30 20 10 11,680
42 DIGOXIN 0,25 104 - - - -
46 ERITROMICYN 250 MG 546 - - -
47 ERITROMICYN 500 MG 770 - - - -
50 FITOMENADION 10 mg TAB 758 10 100 110 60 50 37,900
51 FITOMENADION INJEKSI 3,682 - 15 15 15 - -
53 GARAM ORALIT 200 274 - 100 100 50 50 13,700
54 GENTAMICYN SK 2,126 - 5 5 5 - -
55 GENTAMICYN TM 4,232 - 5 5 5 - -
56 GENTIAN VIOLET 1 % 818 - - - -
59 HIDROCORTISONE 2,5% 2,640 - 5 5 5 - -
60 HIDROKLORTIAZID (HCT) 25 mg 155 - 300 300 200 100 15,500
61 IBU PROFEN 200 MG 102 - - - -
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
64 ISOSORBID 5 MG 89 - 100 100 100 - -
66 KETOKONAZOLE KRIM 2 % 2,518 - 10 10 10 - -
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 - 5 5 5 - -
73 KLORAMPHENICOL SM 2,007 - 5 5 5 - -
78 KOTRIMOXAZOL 480 mg 133 - 300 300 200 100 13,300
79 KOTRIMOXAZOLE SYIRUP 2,190 - 15 15 5 100 219,000
80 LIDOCAIN INJ /COMB 2 % 1,222 - 30 30 30 - -
82 MAGNESIUM SULFAS INJ.20% 3,328 - 1 1 1 3,328
85 METFORMIN 500 mg 102 - - - -
86 METFORMIN 850 mg 160 - 50 50 50 - -
87 METHIL ERGOMETRIN 0,125 TAB 224 - 300 300 200 100 22,400
88 METIL ERGOMETRIN INJEKSI 2,959 - 30 30 20 10 29,590
90 METOKLORPAMIDE 5 MG 87 - 100 100 50 50 4,350
96 METRONIDAZOLE 500 mg 113 - 100 100 100 - -
97 MICONAZOLE 2% CREAM 3,414 - 5 5 5 - -
98 NA. BIC 500 MG 500 - - - -
99 NA.DIKLOFENAC 25 mg 137 - 500 500 400 100 13,700
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 - 5 5 5 - -
106 OXITOCIN INJ 1,199 - 20 20 20 - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 - 500 500 400 100 8,100
109 PARASETAMOL DROP 6,649 - 5 5 5 - -
110 PARASETAMOL SIRUP 1,181 - 20 20 10 10 11,810
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
117 RANITIDIN 150 mg 98 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
121 RINGER LACTAT INFUS 7,150 - 10 10 10 - -
122 SALBUTAMOL 2 mg 67 - 200 200 100 100 6,700
124 SALEP 2-4 2,796 - 10 10 10 - -
125 SALICYL BEDAK 2% 1,250 - 5 5 5 - -
130 SIMVASTATIN 10 Mg 117 - - - -
131 SIMVASTATIN 20 Mg 217 - - - -
132 TAB.TAMBAH DARAH 106 - 500 500 500 - -
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
136 VIT.B.COMPLEX TAB 89 - 300 300 300 - -
137 ZINK 20 MG TAB 524 - 300 300 200 100 52,400
138 ZINKID SIRUP 3,171 - - - -
140 OFLOXACIN TAB 131 - 200 200 200 - -
141 PIL KB - - - -
142 LORATADINE/CETIRIZINE 553 150 150 150 - -
-
BMHP -
2 ALAT SUNTIK 3 ML 924 - 300 300 200 100 92,400
4 ALAT SUNTIK 10 ML 925 - - - -
5 AQUA PRO INJEKSI 2,750 - 5 5 5 - -
7 DERMAFIX 5X7 CM 1,629 - - - -
9 ETANOL 70% 1 LTR 25,000 - 1 1 1 - -
10 HANDSCOON - 50 50 50 - -
11 INFUS SET ANAK 7,920 - - - -
12 INFUS SET DEWASA 8,400 - 5 5 5 - -
13 IV. CATHETER NO. 18 8,250 - 10 10 10 - -
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
16 KAPAS PEMBALUT 250 GR 12,500 - 1 1 1 - -
17 KASA 2MX 80CM 9,870 - 10 10 10 - -
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 - 10 10 10 - -
21 KASA STERIL 16X16 CM 7,370 - 1 1 1 - -
22 MASKER 3 PLY 1,800 - 50 50 30 20 36,000
23 PLESTER 5 YARD 35,532 - 1 1 1 - -
24 POVIDON YODIDA 30 ML 2,900 - 5 5 5 - -
25 SILK 23,921 - - - -
26 UNDER PAD 4,851 - - - -
27 URINE BAG 5,850 - - - -
29 ALKOHOL SWAB 120 1 BOX 1BOX - -
-
-
-
-
-
-
-
-
-

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : OKTOBER

1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
5 AMBROXOL 30 MG 139 - - - -
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
11 AMOXICILIN 250 mg 196 - - - -
13 AMOXICILIN 500 mg 249 100 100 100 - -
14 AMPICILIN 500 mg 398 - - - -
16 ANTALGIN 500 mg 323 - - - -
17 ANTASIDA DOEN TABLET 58 100 100 100 - -
18 ANTASIDA DOEN SYIRUP 2,129 - - -
19 ANTI BACTERI DOEN SK 2,924 - - -
22 ASAM ASCORBAT 250 MG 164 200 200 100 100 16,400
23 ASAM ASCORBAT 50 MG 105 200 200 100 100 10,500
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 100 100 100 - -
28 ASIKLOVIR SK 2,997 - - - -
29 1,013 - - - -
(temiral)
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 - - - -
35 CAPTOPRIL 50 MG 124 - - - -
41 DIFENHIDRAMIN HCL INJ 1,168 10 10 10 - -
42 DIGOXIN 0,25 104 - - - -
47 ERITROMICYN 500 MG 770 - - - -
50 FITOMENADION 10 mg TAB 758 50 50 50 - -
53 GARAM ORALIT 200 274 50 50 50 - -
54 GENTAMICYN SK 2,126 - - -
55 GENTAMICYN TM 4,232 - - -
56 GENTIAN VIOLET 1 % 818 - - - -
57 GLIBENCLAMIDE 5mg 119 100 100 100 - -
59 HIDROCORTISONE 2,5% 2,640 - - - -
60 HIDROKLORTIAZID (HCT) 25 mg 155 100 100 100 - -
61 IBU PROFEN 200 MG 102 - - - -
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
64 ISOSORBID 5 MG 89 - - -
66 KETOKONAZOLE KRIM 2 % 2,518 - - -
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 - - -
73 KLORAMPHENICOL SM 2,007 - - -
78 KOTRIMOXAZOL 480 mg 133 100 100 100 - -
79 KOTRIMOXAZOLE SYIRUP 2,190 10 10 10 - -
80 LIDOCAIN INJ /COMB 2 % 1,222 - - -
82 MAGNESIUM SULFAS INJ.20% 3,328 1 1 1 3,328
85 METFORMIN 500 mg 102 - - - -
86 METFORMIN 850 mg 160 - - -
87 METHIL ERGOMETRIN 0,125 TAB 224 100 100 100 - -
88 METIL ERGOMETRIN INJEKSI 2,959 10 10 10 - -
96 METRONIDAZOLE 500 mg 113 - - -
97 MICONAZOLE 2% CREAM 3,414 - - -
98 NA. BIC 500 MG 500 - - - -
99 NA.DIKLOFENAC 25 mg 137 100 100 100 - -
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 - - -
106 OXITOCIN INJ 1,199 - - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 100 100 100 -
109 PARASETAMOL DROP 6,649 - - -
110 PARASETAMOL SIRUP 1,181 10 10 10 -
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
117 RANITIDIN 150 mg 98 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
121 RINGER LACTAT INFUS 7,150 - - -
122 SALBUTAMOL 2 mg 67 100 100 100 -
124 SALEP 2-4 2,796 - - -
125 SALICYL BEDAK 2% 1,250 - - -
130 SIMVASTATIN 10 Mg 117 - - - -
131 SIMVASTATIN 20 Mg 217 - - - -
132 TAB.TAMBAH DARAH 106 - - -
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
136 VIT.B.COMPLEX TAB 89 - - -
137 ZINK 20 MG TAB 524 100 100 100 -
138 ZINKID SIRUP 3,171 - - - -
140 OFLOXACIN TAB 131 - - -
141 PIL KB - - - -
142 LORATADINE/CETIRIZINE 553 - -
-
BMHP -
2 ALAT SUNTIK 3 ML 924 100 100 100 - -
4 ALAT SUNTIK 10 ML 925 - - - -
7 DERMAFIX 5X7 CM 1,629 - - - -
9 ETANOL 70% 1 LTR 25,000 - - -
10 HANDSCOON - - -
11 INFUS SET ANAK 7,920 - - - -
12 INFUS SET DEWASA 8,400 - - -
13 IV. CATHETER NO. 18 8,250 - - -
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
16 KAPAS PEMBALUT 250 GR 12,500 - - -
17 KASA 2MX 80CM 9,870 - - -
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 - - -
21 KASA STERIL 16X16 CM 7,370 - - -
22 MASKER 3 PLY 1,800 20 20 20 - -
23 PLESTER 5 YARD 35,532 - - -
24 POVIDON YODIDA 30 ML 2,900 - - -
25 SILK 23,921 - - - -
26 UNDER PAD 4,851 - - - -
27 URINE BAG 5,850 - - - -
29 ALKOHOL SWAB 120 - -
-
-
-
-
-
-
-
-
-

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : NOVEMBER

1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
5 AMBROXOL 30 MG 139 - - - -
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
11 AMOXICILIN 250 mg 196 - - - -
13 AMOXICILIN 500 mg 249 - - - -
14 AMPICILIN 500 mg 398 - - - -
16 ANTALGIN 500 mg 323 - - - -
22 ASAM ASCORBAT 250 MG 164 100 100 100 - -
23 ASAM ASCORBAT 50 MG 105 100 100 100 - -
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 - - - -
28 ASIKLOVIR SK 2,997 - - - -
29 1,013 - - - -
(temiral)
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 - - - -
35 CAPTOPRIL 50 MG 124 - - - -
42 DIGOXIN 0,25 104 - - - -
47 ERITROMICYN 500 MG 770 - - - -
50 FITOMENADION 10 mg TAB 758 - - - -
53 GARAM ORALIT 200 274 - - - -
56 GENTIAN VIOLET 1 % 818 - - - -
57 GLIBENCLAMIDE 5mg 119 - - - -
59 HIDROCORTISONE 2,5% 2,640 - - - -
61 IBU PROFEN 200 MG 102 - - - -
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
85 METFORMIN 500 mg 102 - - - -
86 METFORMIN 850 mg 160 - - -
98 NA. BIC 500 MG 500 - - - -
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 - - -
106 OXITOCIN INJ 1,199 - - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 - - -
110 PARASETAMOL SIRUP 1,181 - - -
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
117 RANITIDIN 150 mg 98 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
122 SALBUTAMOL 2 mg 67 - - -
124 SALEP 2-4 2,796 - - -
125 SALICYL BEDAK 2% 1,250 - - -
130 SIMVASTATIN 10 Mg 117 - - - -
131 SIMVASTATIN 20 Mg 217 - - - -
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
137 ZINK 20 MG TAB 524 - - -
138 ZINKID SIRUP 3,171 - - - -
141 PIL KB - - - -
-
BMHP -
4 ALAT SUNTIK 10 ML 925 - - - -
7 DERMAFIX 5X7 CM 1,629 - - - -
9 ETANOL 70% 1 LTR 25,000 - - -
10 HANDSCOON - - -
11 INFUS SET ANAK 7,920 - - - -
13 IV. CATHETER NO. 18 8,250 - - -
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
17 KASA 2MX 80CM 9,870 - - -
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 - - -
21 KASA STERIL 16X16 CM 7,370 - - -
22 MASKER 3 PLY 1,800 - - - -
23 PLESTER 5 YARD 35,532 - - -
25 SILK 23,921 - - - -
26 UNDER PAD 4,851 - - - -
27 URINE BAG 5,850 - - - -
-
-
-
-
-
-
-
-
-

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : DESEMBER

1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
5 AMBROXOL 30 MG 139 - - - -
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
11 AMOXICILIN 250 mg 196 - - - -
13 AMOXICILIN 500 mg 249 - - - -
14 AMPICILIN 500 mg 398 - - - -
16 ANTALGIN 500 mg 323 - - - -
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 - - - -
28 ASIKLOVIR SK 2,997 - - - -
29 1,013 - - - -
(temiral)
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 - - - -
35 CAPTOPRIL 50 MG 124 - - - -
42 DIGOXIN 0,25 104 - - - -
47 ERITROMICYN 500 MG 770 - - - -
50 FITOMENADION 10 mg TAB 758 - - - -
53 GARAM ORALIT 200 274 - - - -
56 GENTIAN VIOLET 1 % 818 - - - -
57 GLIBENCLAMIDE 5mg 119 - - - -
59 HIDROCORTISONE 2,5% 2,640 - - - -
61 IBU PROFEN 200 MG 102 - - - -
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
85 METFORMIN 500 mg 102 - - - -
86 METFORMIN 850 mg 160 - - -
98 NA. BIC 500 MG 500 - - - -
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 - - -
106 OXITOCIN INJ 1,199 - - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 - - -
110 PARASETAMOL SIRUP 1,181 - - -
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
117 RANITIDIN 150 mg 98 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
122 SALBUTAMOL 2 mg 67 - - -
124 SALEP 2-4 2,796 - - -
125 SALICYL BEDAK 2% 1,250 - - -
130 SIMVASTATIN 10 Mg 117 - - - -
131 SIMVASTATIN 20 Mg 217 - - - -
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
137 ZINK 20 MG TAB 524 - - -
138 ZINKID SIRUP 3,171 - - - -
141 PIL KB - - - -
-
BMHP -
4 ALAT SUNTIK 10 ML 925 - - - -
7 DERMAFIX 5X7 CM 1,629 - - - -
9 ETANOL 70% 1 LTR 25,000 - - -
10 HANDSCOON - - -
11 INFUS SET ANAK 7,920 - - - -
13 IV. CATHETER NO. 18 8,250 - - -
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
17 KASA 2MX 80CM 9,870 - - -
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 - - -
21 KASA STERIL 16X16 CM 7,370 - - -
22 MASKER 3 PLY 1,800 - - - -
23 PLESTER 5 YARD 35,532 - - -
25 SILK 23,921 - - - -
26 UNDER PAD 4,851 - - - -
27 URINE BAG 5,850 - - - -
-
-
-
-
-
-
-
-
-

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : JANUARI
PROPINSI : JAWA TIMUR TAHUN 2022

1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
1 ALBENDAZOLE 400 MG 344 - 100 100 100 34,400
3 ALLOPURINOL 100 MG 104 - 200 200 200 20,800
5 AMBROXOL 30 MG 139 - 300 300 100 200 27,800
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
10 AMOXICILIN 125 mg SYIRUP 1,881 - 20 20 20 37,620
11 AMOXICILIN 250 mg 196 - - - -
13 AMOXICILIN 500 mg 249 - 500 500 100 400 99,600
14 AMPICILIN 500 mg 398 - - - -
16 ANTALGIN 500 mg 323 - - - -
17 ANTASIDA DOEN TABLET 58 - 500 500 100 400 23,200
18 ANTASIDA DOEN SYIRUP 2,129 - 10 10 10 21,290
20 ANTI FUNGI SALEP 4,606 - 5 5 5 23,030
21 ANTI HAEMOROID SUPPOSITORIA 3,167 - - -
22 ASAM ASCORBAT 250 MG 164 - 300 300 300 49,200
23 ASAM ASCORBAT 50 MG 105 - 300 300 300 31,500
25 ASAM MEFENAMAT 500 MG 160 - 200 200 50 150 24,000
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 - 100 100 100 40,500
28 ASIKLOVIR SK 2,997 - - - -
29 1,013 - - - -
(temiral)
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 - 200 200 200 15,000
35 CAPTOPRIL 50 MG 124 - - - -
37 CETERIZINE SYR 2,915 - 5 5 5 14,575
38 CIPROFLOXACIN 500 mg 1,200 - 200 200 200 240,000
40 DEXAMETHASONE INJEKSI 1,097 - 10 10 10 10,970
41 DIFENHIDRAMIN HCL INJ 1,168 - 30 30 30 35,040
42 DIGOXIN 0,25 104 - - - -
43 DIMENHIDRINAT 50 MG 112 - 100 100 100 11,200
47 ERITROMICYN 500 MG 770 - - - -
50 FITOMENADION 10 mg TAB 758 - 200 200 200 151,600
51 FITOMENADION INJEKSI 3,682 - 15 15 15 55,230
53 GARAM ORALIT 200 274 - 100 100 100 27,400
54 GENTAMICYN SK 2,126 - 5 5 5 10,630
55 GENTAMICYN TM 4,232 - 10 10 10 42,320
56 GENTIAN VIOLET 1 % 818 - - - -
59 HIDROCORTISONE 2,5% 2,640 - 10 10 10 26,400
60 HIDROKLORTIAZID (HCT) 25 mg 155 - 200 200 200 31,000
61 IBU PROFEN 200 MG 102 - 200 200 200 20,400
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
64 ISOSORBID 5 MG 89 - - - -
66 KETOKONAZOLE KRIM 2 % 2,518 - 300 300 300 755,400
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 - 10 10 10 32,420
76 KLORFENIRAMIN/ CTM 4 mg 23 - 200 200 200 4,600
78 KOTRIMOXAZOL 480 mg 133 - 300 300 300 39,900
79 KOTRIMOXAZOLE SYIRUP 2,190 - 20 20 20 43,800
80 LIDOCAIN INJ /COMB 2 % 1,222 - 30 30 30 36,660
85 METFORMIN 500 mg 102 - - - -
86 METFORMIN 850 mg 160 - 50 50 50 8,000
87 METHIL ERGOMETRIN 0,125 TAB 224 - 200 200 200 44,800
88 METIL ERGOMETRIN INJEKSI 2,959 - 15 15 15 44,385
90 METOKLORPAMIDE 5 MG 87 - 100 100 100 8,700
91 METOKLORPAMIDE DROP 3,900 - 5 5 5 19,500
97 MICONAZOLE 2% CREAM 3,414 - 5 5 5 17,070
98 NA. BIC 500 MG 500 - - -
100 NA.DIKLOFENAC 50 mg 123 - 300 300 300 36,900
102 OBAT BATUK HITAM SYIRUP 5,566 - 3 3 3 16,698
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 - 5 5 5 13,340
106 OXITOCIN INJ 1,199 - 30 30 30 - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 - 500 500 300 200 16,200
110 PARASETAMOL SIRUP 1,181 - 20 20 20 23,620
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
116 PREDNISON TAB 73 - 200 200 100 100 7,300
117 RANITIDIN 150 mg 98 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
121 RINGER LACTAT INFUS 7,150 - 10 10 10 - -
122 SALBUTAMOL 2 mg 67 - 100 100 100 6,700
124 SALEP 2-4 2,796 - 5 5 5 13,980
125 SALICYL BEDAK 2% 1,250 - 3 3 3 3,750
127 SEFADROXIL SYIRUP KERING 4,185 - 10 10 10 41,850
128 SIANOKOBALAMIN HCL/B12 INJ. 1,104 - 20 20 10 10 11,040
130 SIMVASTATIN 10 Mg 117 - 200 200 200 23,400
131 SIMVASTATIN 20 Mg 217 - - - -
132 TAB.TAMBAH DARAH 106 - 500 500 300 200 21,200
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
137 ZINK 20 MG TAB 524 - 200 200 200 104,800
138 ZINKID SIRUP 3,171 - - - -
140 OFLOXACIN TAB 131 - - - -
141 PIL KB - - - -
142 LORATADINE/CETIRIZINE 553 100 - -
- -
BMHP - -
1 ALAT SUNTIK 2,5 ML 650 - - -
2 ALAT SUNTIK 3 ML 924 - 200 200 50 150 138,600
4 ALAT SUNTIK 10 ML 925 - - - -
6 CAT GUT CROMIC + PLAIN 36,234 - 6 6 1 5 181,170
7 DERMAFIX 5X7 CM 1,629 - - - -
9 ETANOL 70% 1 LTR 25,000 - 1 1 1 - -
10 HANDSCOON - 1 1 1 -
11 INFUS SET ANAK 7,920 - - - -
12 INFUS SET DEWASA 8,400 - 10 10 6 4 33,600
13 IV. CATHETER NO. 18 8,250 - 10 10 6 4 33,000
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
16 KAPAS PEMBALUT 250 GR 12,500 - 1 1 1 12,500
17 KASA 2MX 80CM 9,870 - 10 10 10 98,700
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 - 10 10 10 16,000
21 KASA STERIL 16X16 CM 7,370 - 1 1 1 7,370
22 MASKER 3 PLY 1,800 - 100 100 30 70 126,000
23 PLESTER 5 YARD 35,532 - 1 1 1 35,532
24 POVIDON YODIDA 30 ML 2,900 - 1 1 1 2,900
25 SILK 23,921 - - - -
26 UNDER PAD 4,851 - 5 5 5 - -
27 URINE BAG 5,850 - - - -
30 HANDSANITIZER 5 - -
31 PROPANOLOL 100 - -
32 METRONIDAZOLE SYR 20 - -
33 SCABIMITE 10 - -
34 CALORTUSIN TAB 200 - -
35 SELKOM C 200 - -
36 GLIMEPERIDE 100 -
-
3,245,818

NIP.198711232019022003 NIP.198512152017042009
( L P L P O )
PUSKESMAS : WARU
SUB UNIT : Laporan LPLPO : FEBRUARI
PROPINSI : JAWA TIMUR TAHUN 2022

1 2 3 4 5 6 7 8 9 10 11 16
OBAT PKD
1 ALBENDAZOLE 400 MG 344 100 100 100 34,400
3 ALLOPURINOL 100 MG 104 200 200 200 20,800
5 AMBROXOL 30 MG 139 200 200 200 - -
8 AMLODIPIN 5 75 - - - -
9 AMLODIPIN 10 MG 99 - - - -
10 AMOXICILIN 125 mg SYIRUP 1,881 20 20 5 15 28,215
11 AMOXICILIN 250 mg 196 - - - -
13 AMOXICILIN 500 mg 249 400 400 100 300 74,700
14 AMPICILIN 500 mg 398 - - - -
16 ANTALGIN 500 mg 323 - - - -
17 ANTASIDA DOEN TABLET 58 400 400 200 200 11,600
18 ANTASIDA DOEN SYIRUP 2,129 10 10 10 - -
20 ANTI FUNGI SALEP 4,606 5 5 5 23,030
21 ANTI HAEMOROID SUPPOSITORIA 3,167 - - -
22 ASAM ASCORBAT 250 MG 164 300 300 300 49,200
23 ASAM ASCORBAT 50 MG 105 300 300 300 31,500
25 ASAM MEFENAMAT 500 MG 160 150 150 50 100 16,000
26 ASIKLOVIR 200 mg 240 - - - -
27 ASIKLOVIR 400 mg 405 100 100 100 40,500
28 ASIKLOVIR SK 2,997 - - - -
29 1,013 - - - -
(temiral)
33 CAPTOPRIL 12,5 MG 62 - - - -
34 CAPTOPRIL 25 MG 75 200 200 200 - -
35 CAPTOPRIL 50 MG 124 - - - -
37 CETERIZINE SYR 2,915 5 5 5 14,575
38 CIPROFLOXACIN 500 mg 1,200 200 200 100 100 120,000
40 DEXAMETHASONE INJEKSI 1,097 10 10 10 10,970
41 DIFENHIDRAMIN HCL INJ 1,168 30 30 20 10 11,680
42 DIGOXIN 0,25 104 - - - -
43 DIMENHIDRINAT 50 MG 112 100 100 100 11,200
47 ERITROMICYN 500 MG 770 - - - -
50 FITOMENADION 10 mg TAB 758 200 200 50 150 113,700
51 FITOMENADION INJEKSI 3,682 15 15 5 10 36,820
53 GARAM ORALIT 200 274 100 100 100 27,400
54 GENTAMICYN SK 2,126 5 5 5 10,630
55 GENTAMICYN TM 4,232 10 10 10 42,320
56 GENTIAN VIOLET 1 % 818 - - - -
57 GLIBENCLAMIDE 5mg 119 200 200 100 100 11,900
59 HIDROCORTISONE 2,5% 2,640 10 10 10 26,400
60 HIDROKLORTIAZID (HCT) 25 mg 155 200 200 200 31,000
61 IBU PROFEN 200 MG 102 200 200 100 100 10,200
62 IBU PROFEN 400 Mg 111 - - - -
63 IBU PROFEN SYR 100 MG 2,721 - - - -
64 ISOSORBID 5 MG 89 - - - -
65 KALSIUM LACTAT 500 mg 63 200 200 100 100 6,300
KLORAMPHENICOL
71 15,000 - - - -
INJ/CLORAMIDINE
72 KLORAMPHENICOL SK/ BUFACETIN 3,242 10 10 5 5 16,210
76 KLORFENIRAMIN/ CTM 4 mg 23 200 200 100 100 2,300
78 KOTRIMOXAZOL 480 mg 133 300 300 50 250 33,250
79 KOTRIMOXAZOLE SYIRUP 2,190 20 20 5 15 32,850
80 LIDOCAIN INJ /COMB 2 % 1,222 30 30 10 20 24,440
85 METFORMIN 500 mg 102 - - - -
86 METFORMIN 850 mg 160 50 50 50 8,000
87 METHIL ERGOMETRIN 0,125 TAB 224 200 200 100 100 22,400
88 METIL ERGOMETRIN INJEKSI 2,959 15 15 10 5 14,795
91 METOKLORPAMIDE DROP 3,900 5 5 5 19,500
97 MICONAZOLE 2% CREAM 3,414 5 5 5 17,070
98 NA. BIC 500 MG 500 - - -
100 NA.DIKLOFENAC 50 mg 123 300 300 100 200 24,600
102 OBAT BATUK HITAM SYIRUP 5,566 3 3 2 1 5,566
104 OXITETRA SK 1,529 - - - -
105 OXITETRA SM 2,668 5 5 5 - -
106 OXITOCIN INJ 1,199 - - 0 - -
107 PARASETAMOL 100 MG 290 - - - -
108 PARASETAMOL 500 mg 81 200 200 100 100 8,100
110 PARASETAMOL SIRUP 1,181 20 20 20 23,620
112 PIRACETAM 400 MG 1,140 - - - -
113 PIRACETAM 800 MG 8,091 - - - -
116 PREDNISON TAB 73 100 100 100 - -
117 RANITIDIN 150 mg 98 - - - -
119 RETINOL 100.000 IU 307 - - - -
120 RETINOL 200.000 IU 414 - - - -
121 RINGER LACTAT INFUS 7,150 - - - -
122 SALBUTAMOL 2 mg 67 100 100 100 6,700
124 SALEP 2-4 2,796 5 5 5 13,980
125 SALICYL BEDAK 2% 1,250 3 3 0 3 3,750
127 SEFADROXIL SYIRUP KERING 4,185 10 10 10 41,850
128 SIANOKOBALAMIN HCL/B12 INJ. 1,104 10 10 10 - -
130 SIMVASTATIN 10 Mg 117 200 200 100 100 11,700
131 SIMVASTATIN 20 Mg 217 - - - -
132 TAB.TAMBAH DARAH 106 200 200 200 - -
133 THIAMIN HCL ( B1 ) 50 MG 91 - - - -
137 ZINK 20 MG TAB 524 200 200 200 104,800
138 ZINKID SIRUP 3,171 - - - -
140 OFLOXACIN TAB 131 - - - -
141 PIL KB - - - -
142 LORATADINE/CETIRIZINE 553 100 100 100 55,300
- -
BMHP - -
1 ALAT SUNTIK 2,5 ML 650 - - -
2 ALAT SUNTIK 3 ML 924 150 150 100 50 46,200
4 ALAT SUNTIK 10 ML 925 - - - -
6 CAT GUT CROMIC + PLAIN 36,234 5 5 3 2 72,468
7 DERMAFIX 5X7 CM 1,629 - - - -
9 ETANOL 70% 1 LTR 25,000 - - 0 - -
10 HANDSCOON 1 1 1 - -
11 INFUS SET ANAK 7,920 - - - -
12 INFUS SET DEWASA 8,400 4 4 4 - -
13 IV. CATHETER NO. 18 8,250 4 4 4 - -
14 IV. CATHETER NO. 20 11,400 - - - -
15 IV. CATHETER NO. 22 10,395 - - - -
16 KAPAS PEMBALUT 250 GR 12,500 1 1 1 12,500
17 KASA 2MX 80CM 9,870 10 10 5 5 49,350
18 KASA 4 X 15 CM 2,100 - - - -
19 KASA 4 X 3 CM 590 - - - -
20 KASA KOMPRES 40X40 1,600 10 10 5 5 8,000
21 KASA STERIL 16X16 CM 7,370 1 1 1 - -
22 MASKER 3 PLY 1,800 70 70 20 50 90,000
23 PLESTER 5 YARD 35,532 1 1 1 - -
24 POVIDON YODIDA 30 ML 2,900 1 1 1 - -
25 SILK 23,921 - - - -
26 UNDER PAD 4,851 - - 0 - -
27 URINE BAG 5,850 - - - -
30 HANDSANITIZER 5 5 1 4 -
31 PROPANOLOL 100 100 100 -
32 METRONIDAZOLE SYR 20 20 20 -
33 SCABIMITE 10 10 5 5 -
34 CALORTUSIN TAB 200 200 200 - -
35 SELKOM C 200 200 50 150 -
36 GLIMEPERIDE 100 100 100 -
-
1,587,667

NIP.198711232019022003 NIP.198512152017042009

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

harga / STOCK PENERI - PERSE- PEMA- SISA STOCK PERMIN

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA STOCK PERMIN PEMBERIAN

MENGETAHUI / MENYETUJUI YANG MENYERAHKAN YANG MEMEMINTA/MELAPOR YANG MENERIMA

MENERIMA 83434119 59,910,651

harga / STOCK PENERI - PERSE- PEMA- SISA STOCK PERMIN

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

harga / STOCK PENERI - PERSE- PEMA- SISA PERMIN PEMBER

NOVILITA TRISANTI, Amd.Farm HERLINA SRI WAHYUTI,Amd.Keb

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