LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PUSKESMAS ( LPLPO )

DOKUMEN NO TGL
PUSKESMAS : BUKATEJA PELAPORAN BULAN/PERIODE: September-21 GRF
KECAMATAN : BUKATEJA : PERMINTAAN BULAN/PERIODE: PUSK

KABUPATEN PURBALINGGA

PEMBERIAN KET
NO NAMA OBAT SATUAN KMS SISA AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK STOK OPT PERMINTAAN
APBD I APBD II LAIN2 JUMLAH

1 Acyclovir 200 mg tablet Tablet - - - - -

2 Acyclovir 400 mg tablet Tablet 3.170 - 3.170 42 3.128
3 Albendazol 400 mg Tablet - - - - -
4 Alopurinol 100mg Tablet - - - - -
5 Ambroxol Tablet - - - - -
6 Ambroxol syrup Botol - - - - -
7 Aminofilin 200 mg Tablet 3.237 - 3.237 - 3.237
8 Amitriptilin HCl 25 mg Tablet 1.183 - 1.183 60 1.123
9 Amlodipin 10mg Tablet 3.300 - 3.300 50 3.250
10 Amoksisilin 250 mg Capsul - - - - -
11 Amoksisilin 500 mg Caplet 35.563 - 35.563 1.573 33.990
12 Amoksisilin Srp Krng 125mg/5ml Botol 804 - 804 39 765
13 Amoksisilin Srp Krng 250mg/5ml Boto 60 ml - - - - -
14 Amoxiclav tablet Tablet - - - - -
15 Ampisilin 500 mg Caplet - - - - -
16 Ampisillin sirup kering 125mg/ml Botol - - - - -
17 Antalgin 500 mg Tablet - - - - -
18 Antasida Doen tab. Tablet - - - - -
19 Antasida sirop Botol - - - - -
20 Arterakine Dus @ 9tab - - - - -
21 As. Mefenamat 500 mg Kapsul 15.086 - 15.086 656 14.430
22 Asam Askorbat (Vit.C) tab.50 mg Tablet 9.076 - 9.076 238 8.838
23 Asam folat Tablet - - - - -
24 Asetosal 100 mg Tablet - - - - -
25 Batugin elixir botol 120ml - - - - -
26 Bekarbon Tablet - - - - -
27 Betahistin mesilat 6mg Tablet - - - - -
28 Biovision caps Kapsul - - - - -
29 Bromheksin 8 mg Tablet - - - - -
30 Captopril 25 mg Tablet - - - - -
31 Cefadroxil 500 mg Tablet - - - - -
32 Cefadroxil sirup 125 mg/5 ml Botol 60 ml - - - - -
33 Cefalexin 500 mg Kapsul - - - - -
34 Cimetidin Tablet Tablet - - - - -
35 Citerizine 10mg Tablet - - - - -
36 Clonidin Tablet - - - - -
37 Clozapine 25mg Tablet - - - - -
38 Cyprofloxacin 500 mg Tablet 1.886 - 1.886 40 1.846
39 Deksametason tab.0,5 mg Tablet 22.323 - 22.323 1.417 20.906
40 Dekstromethorphan 10 mg/ 5ml Botol - - - - -
41 Dekstrometorfan HBr tab.15 mg Tablet - - - - -
42 Diazepam tab. 2mg Tablet 150 - 150 61 89
43 Dietyl Carbamazepine Tablet - - - - -
44 Digoxin 0,25mg Tablet - - - - -
45 Dimenhydrinat 50mg Tablet - - - - -
46 Doksisiklin 100 mg Kapsul - - - - -
47 Donperidon 10mg Tablet - - - - -
48 Donperidon 5mg/5ml suspensi Botol - - - - -
49 Ephedrin HCl 25 mg Tablet - - - - -
50 Ergotamin cofein Tablet - - - - -
51 Erphakap Plus sirup Botol - - - - -
52 Erphakap tab Tablet - - - - -
53 Erytromicyn sirup Botol - - - - -
54 Erytromycin 500 mg Capsul - - - - -
55 Etambutol 500 mg Tablet - - - - -
56 Famotidin 40 mg Tablet - - - - -
57 Fenobarbital 30mg Tablet - - - - -
58 Fenoksimetil Penisiline 250 mg Tablet - - - - -
59 Fenoksimetil Penisiline 500 mg Tablet - - - - -
60 Fitogen Tablet - - - - -
61 Fitomenadion Vit K 1 tab.10 mg Tablet 160 - 160 - 160
62 Furosemid tab.40 mg Tablet - - - - -
63 Garam Oralit 200 ml air Bungkus 2.978 - 2.978 15 2.963
64 Gemfibrozil 300 mg Kapsul - - - - -
65 Glibenklamid tab. 5 mg Tablet 4.370 - 4.370 10 4.360
66 Gliseril Guaiakolat tab.100 mg Tablet - - - - -
67 Griseovulvin tab.125 mg Tablet 20 - 20 20 -
68 Haloperidol 1,5 mg Tablet - - - - -
69 Haloperidol 5 mg Tablet - - - - -
70 Hemorogad Kapsul - - - - -
71 Hepagard Kapsul - - - - -
72 Hidroklorotiazid (HCT) tab. 25mg Tablet 1.430 - 1.430 - 1.430
73 Ibuprofen tab.200 mg Tablet - - - - -
74 Ibuprofen tab.400 mg Tablet 5.817 - 5.817 726 5.091
75 Iburofen suspensi 100mg/5ml Botol 60ml - - - - -
76 Iburofen suspensi 200mg/5ml Botol 60ml - - - - -
77 Imulan (Immunomodular) Caps Kapsul - - - - -
78 Imulan (Immunomodular) sirup botol 60 ml - - - - -
79 Isorbid Dinitrat 5mg Tablet - - - - -
80 Kalium diklofenak 50 mg Tablet - - - - -
81 Kalsium Laktat (Kalk) tab.500 mg Tablet - - - - -
82 Kanina/Neo Kaominal sirup Botol 60 ml - - - - -
83 Ketokonasol 200mg Tablet 1.600 - 1.600 - 1.600
84 Ketoprofen 100 mg Tablet - - - - -
85 Klindamicyn 300 mg Kapsul 914 - 914 124 790
86 Kloramfenikol kap.250 mg Kapsul 1.070 - 1.070 - 1.070
87 Kloramphenikol suspensi 125mg/5ml Botol - - - - -
88 Klorfeneramin Maleat(CTM) 4 mg (A) Tab/Box@100 - - - - -
89 Klorfeneramin Maleat(CTM) 4 mg (B) Tab/Klg@100 - - - - -
90 Klorfeneramin Maleat(CTM) 4 mg (C) Tab/Klg@1000 - - - - -
91 Klorpromazin HCl 100mg tab. salut Tablet - - - - -
 92 Kotrimoksazol Pediatrik tab Komb. Tablet - - - - -
93 Kotrimoksazol Suspensi Botol - - - - -
94 Kotrimoksazol tab. Dws 480mg Tablet - - - - -
95 Kurkumex kaplet kaplet - - - - -
96 Kurkumex sirup Botol 60ml - - - - -
97 Laxadin sirup Botol - - - - -
98 Loperamid Tablet - - - - -
99 Loratadin 10mg Tablet - - - - -
100 Mebendazol sirup 100mg/5ml Botol 30ml - - - - -
101 Meloksicam 15 mg Tablet - - - - -
102 Metformin 500mg Tablet - - - - -
103 Metil Prednisolon 4mg Tablet - - - - -
104 Metilergometrin Maleat 0,125 mg Tablet 565 - 565 - 565
105 Metoklopropamid 10 mg Tablet - - - - -
106 Metoklopropamid sirup Botol - - - - -
107 Metronidazol 250mg Kapsul - - - - -
108 Metronidazol 500 mg Tablet 1.375 - 1.375 125 1.250
109 Mineral mix Sachet - - - - -
110 Na diklofenak 50 mg Tablet - - - - -
111 Natrium Bicarbonat Tablet - - - - -
112 Natrium Tiroksin 100mcg Tablet - - - - -
113 Neo Diaform/Stopdiar Tablet 1.218 - 1.218 99 1.119
114 Nifedipin 10mg Tablet - - - - -
115 Nistatin tablet salut 500.000 IU/gr Tablet 1.600 - 1.600 - 1.600
116 Nodiar Ktk '100tab - - - - -
117 Obat Anti TBC FDC Anak paket - - - - -
118 Obat Anti TBC Kat Anak (kombipak) paket - - - - -
119 Obat Anti TBC Kat I (FDC) paket - - - - -
120 Obat Anti TBC Kat I / Kombipak paket - - - - -
121 Obat Anti TBC Kat II paket - - - - -
122 Obat Anti TBC Kat Sisipan paket - - - - -
123 Obat Batuk Hitam (OBH) cairan Botol - - - - -
124 Obat Batuk Hitam (OBH) Plus Botol 100ml - - - - -
125 Ocugard kapsul Tablet - - - - -
126 Omepazole 20 mg Kapsul 600 - 600 600 -
127 Papaverin 40 mg Tablet (A) Tab/Box@100 - - - - -
128 Papaverin 40 mg Tablet (B) Tab/Klg@1000 - - - - -
129 Parasetamol 100 mg Tablet - - - - -
130 Parasetamol drop Botol 15ml - - - - -
131 Parasetamol sirup 120 mg/5 ml Botol 298 - 298 38 260
132 Parasetamol tab. 500 mg Tablet - - - - -
133 Pehavral (multivit/ sivit zink) tab. Kaplet 2.685 - 2.685 50 2.635
134 Phenitoin Natrium 100 mg Kapsul - - - - -
135 Phenyl Butason Tab Tablet - - - - -
136 Piracetam 400 mg Kapsul - - - - -
137 Pirantel Pamoat tab.125 mg Tablet - - - - -
138 Piridoksin Hcl.(Vit B6) 10 mg Tablet 22.295 - 22.295 300 21.995
139 Piroksikam 20 mg tab. Tablet - - - - -
140 Prednison tab.5 mg (A) Tab/Box@100 2.000 - 2.000 - 2.000
141 Prednison tab.5 mg (B) Tab/Klg@1000 - - - - -
142 Primaquin/Kloroquin Tablet - - - - -
143 Propanolol tab 40 mg Tablet - - - - -
144 PTU 100mg Tablet - - - - -
145 Pyrazinamid 500 mg. Tablet - - - - -
146 Quinin tablet Kotak @ 60 tab - - - - -
147 Ranitidin 150mg Tablet - - - - -
148 Reserpin 0,25mg tablet Tablet - - - - -
149 Retinol (Vit.A) 100.000 UI tab. Kapsul - - - - -
150 Retinol (Vit.A) 200.000 UI tab. Kapsul - - - - -
151 Rifampisin kapsul 300mg Kapsul - - - - -
152 Rifampisin kapsul 450 mg Kapsul - - - - -
153 Risperidone 2 mg Tablet 740 - 740 155 585
154 Salbutamol 2 mg Tablet - - - - -
155 Salbutamol 4 mg Tablet 211 - 211 36 175
156 Sianocobalamin 50 mg/Vit B12 (A) Tab/Box@100 41.140 - 41.140 536 40.604
157 Sianocobalamin 50 mg/Vit B12 (B) Tab/Klg@1000 - - - - -
158 Simvastatin 10 mg Tablet 1.429 - 1.429 26 1.403
159 spiramicyn 500mg Tablet - - - - -
160 Tablet Tambah Darah Tablet - - - - -
161 Tensigard Kapsul - - - - -
162 Tetrasiklin 250mg Tablet - - - - -
163 Tetrasiklin 500 mg Tablet - - - - -
164 Thiamin Hcl (Vit.B1)tab.100 mg Tablet - - - - -
165 Thiamin Hcl (Vit.B1)tab.50 mg (A) Tab/Box@100 3.279 - 3.279 783 2.496
166 Thiamin Hcl (Vit.B1)tab.50 mg (B) Tab/Klg@1000 - - - - -
167 Thiampenicole 500mg Kapsul - - - - -
168 Tramadol tab Kapsul - - - - -
169 Traneksamik Acid 500 mg Kapsul - - - - -
170 Trifluoperazine 5mg Tablet salut - - - - -
171 Triheksifenidil (THP) 2mg Tablet - - - - -
172 Truvit (multivit) syr Botol 60ml - - - - -
173 Vitamin B Complx tab (A) Tab/Box@100 - - - - -
174 Vitamin B Complx tab (B) Tab/Klg@1000 - - - - -
175 Xanvit sirup botol - - - - -
176 Zink Tablet Kotak 1.870 - 1.870 60 1.810
177 Asifit (pelancar asi) 0 - - - - -
178 Pasaba syrup botol - - - - -
INJEKSI / LARUTAN INFUS 0 - - - - -
1 Aminofilina inj. 24 mg/ml -10 ml Ampul - - - - -
2 Amoksisilin Inj 1 gram Vial - - - - -
3 Ampisilin Injeksi 1 Gram Vial - - - - -
4 Anti Bio Save (ABU) Vial @5ml - - - - -
5 Aqua Pro inj. Steril Vial 10 - 10 10 -
6 Artemeter inj Dus @ 6 amp - - - - -
7 Artesunate inj Dus @ 8 amp - - - - -
8 Asering lar. Infus Botol 500ml - - - - -
9 Atropin Sulfat Inj 0,25mg/ml-1ml Ampul - - - - -
10 Deksametason inj 5mg/ml-1ml ampul - - - - -
11 Depo Progestin Injeksi Vial - - - - -
12 Dextran 70% Botol - - - - -
13 Diazepam inj. 5mg/ml-2ml Ampul - - - - -
14 Difenhidramin HCl inj Ampul - - - - -
15 Ephineprin /Adrenalin inj Ampul 7 - 7 - 7
16 Erlamidon inj Vial - - - - -
17 Fenobarbital Inj. 50 mg /ml--2ml Ampul - - - - -
18 Fitomenadion (Vit. K1) Inj.10mg Ampul - - - - -
19 Fitomenadion (Vit. K1) Inj.2mg/ml Ampul 420 - 420 - 420
20 Furosemide inj Ampul - - - - -
21 Gentamycin inj 40mg/5ml Ampul - - - - -
22 Glukosa infus 40% Botol - - - - -
23 Glukosa larutan infus 5% steril Botol - - - - -
24 Glukosa calsicus 10%steril Ampul 20 ml - - - - -
25 KAEN 1B Botol 500ml - - - - -
26 Ketoprofen inj Ampul - - - - -
27 Kloramphenikol Inj 1g/ Colsancetin InjVial - - - - -
28 Lidocain Injeksi 2%-2ml Ampul 532 - 532 - 532
29 Metilergometrin Inj 0,2mg/ml - 1ml Ampul - - - - -
30 Metoklopropamid 5mg/ml inj ampul - - - - -
31 MgSO4 20% Botol 25 ml - - - - -
32 MgSO4 40 % Botol 25 ml - - - - -
33 Na Cl Infus 0.9% Botol - - - - -
34 Oksitetrasiklin HCl inj Vial - - - - -
35 Oksitocin inj 10 UI/ml Ampul - - - - -
36 Pehacain Inj/ lidocain comp inj Ampul 470 - 470 - 470
37 Piracetam inj Ampul - - - - -
38 Ringer Laktat lar. infus steril Botol - - - - -
39 PPC Inj Vial - - - - -
40 Quinin Inj Ampul - - - - -
41 Ranitidin inj 25mg/2ml Ampul - - - - -
42 Sefotaxim inj 1g Vial 1 gram - - - - -
43 Serum Bisa Ular (ABU) Bio Save Vial @5ml - - - - -
44 Serum Anti Dipteri (ADS) 20.000 Vial - - - - -
45 Serum Anti Tetanus 1500 IU/Amp. Ampul - - - - -
46 Serum Anti Tetanus20.000IU/Am. Vial - - - - -
47 Sianocobalamin inj 500mcg Ampul - - - - -
48 Sikzonoat inj 25 mg/ml Ampul - - - - -
49 Thiamin inj 100mg/ml Ampul - - - - -
50 Tramadol 50mg / ml inj ampul - - - - -
51 Haloperidol inj ampul 1 - 1 1 -
52 0 0 - - - - -
53 0 0 - - - - -
54 0 0 - - - - -
55 0 0 - - - - -
TOPIKAL 0 - - - - -
1 Acyclovir 5% Ceam Tube 382 - 382 7 375
2 Anti Bakteri DOEN salep Tube - - - - -
3 Anti Fungi DOEN Kombinasi. Pot 202 - 202 - 202
4 Antihaemoroid supp Supp - - - - -
5 Betametason krim 0,1% Tube - - - - -
6 Bisakodil suppo 10mg Suppo - - - - -
7 Borak Gliserin (GOM) Botol 10ml - - - - -
8 Diazepam lar. Rektal 5mg/2,5ml (stesolid)
Tube 2,5ml 11 - 11 - 11
9 Enkasari Botol 120ml - - - - -
10 Etakridin (Rivanol) larutan 0,1% Botol 300 ml - - - - -
11 Etanol 70 % (Alkohol 1L) Botol 1000 ml - - - - -
12 Ethyl chlorida spray Botol - - - - -
13 Flusinolon asetonid 0.025% krim Tube - - - - -
14 Gentamisin Salep Kulit Tube - - - - -
15 Gentian Violet larutan 1% Botol - - - - -
16 Hydrokortison Cream Tube 675 - 675 4 671
17 Ketokonasole/Solinfec cream Tube 184 - 184 5 179
18 Ketoprofen supp 100mg/Protofen Supp - - - - -
19 Kloramfenikol tetes telinga 3% Botol 229 - 229 15 214
20 Klorfeson cream Tube 10g - - - - -
21 Lisol/kresol tersaponofikasi 50% Botol 1 L 2 - 2 1 1
22 Minyak kayu putih Botol 30ml - - - - -
23 Minyak telon Botol 60ml - - - - -
24 Myconazole cream Tube 846 - 846 14 832
25 Nistatin tablet vagina 100.000 IU Tablet - - - - -
26 Nufasic cream) Tube - - - - -
27 Oksitetrasiklin Hcl salep Kulit 3% Tube 200 - 200 - 200
28 Povidon Iodine 30 ml Botol - - - - -
29 Povidon Iodine 300 ml Botol - - - - -
30 Povidon Iodine 60 ml Botol - - - - -
31 Salep 2-4 Kombinasi Pot 431 - 431 20 411
32 Salisil Bedak 2 % Botol 326 - 326 10 316
33 Scabisid salep kulit Tube - - - - -
- Stericide p 9 - 9 4 5
- one clean 1L 0 - - - - -
OBAT MATA 0 - - - - -
1 Gentamycin tetes mata Botol 150 - 150 14 136
2 Kloramfenikol salep mata 1% Tube 491 - 491 7 484
3 Kloramfenikol tetes mata 5ml Botol 5ml 18 - 18 12 6
4 Kloramfenikol tetes mata 10ml Botol 10ml - - - - -
5 Oksitetrasiklin Hcl salep mata Tube 200 - 200 - 200
6 Sulfasetamide Na Tes Mata 15% Botol 5ml - - - - -
- 0 0 - - - - -
GIGI 0 - - - - -
1 Devitalisasi pasta (Non Arsen) 0 - - - - -
2 Eugenol Cairan 0 - - - - -
3 Glass Ionomer Cement ant 0 - - - - -
4 Glass Ionomer Cement post 0 - - - - -
5 Kalsium Hidroksida Pasta 0 - - - - -
6 Monoklorkamfer Mentol Cairan Sak - - - - -
7 Mummifying pasta Sak - - - - -
8 Semen Seng Fosfat serbuk cairan 0 - - - - -
9 Silver Amalgam Serbuk 65-75% 0 - - - - -
10 Temporary Filling material/Cavit / caviton
Rol - - - - -
11 Temporary Stopping Fletcher Rol - - - - -
12 0 - - - - -
13 0 0 - - - - -
14 0 0 - - - - -
15 0 0 - - - - -
16 0 0 - - - - -
17 0 0 - - - - -
18 0 0 - - - - -
19 0 0 - - - - -
20 0 0 - - - - -
- 0 0 - - - - -
- 0 0 - - - - -
- 0 0 - - - - -
- 0 0 - - - - -
ALKES HABIS PAKAI 0 - - - - -
1 Alkohol swab Pcs 10.100 - 10.100 - 10.100
2 Aseptan 500cc + dispenser Botol 19 - 19 - 19
3 Blood Tranfusion set Pcs - - - - -
4 Catgut/benang bedah 3/0 cromic tanpa Pcs
jarum 42 - 42 - 42
5 Catgut/benang bedah 3/0 plain denganPcsjarum 27 - 27 - 27
6 Hanskun non steril L Box@100 1.400 - 1.400 100 1.300
7 Hanskun non steril M Box@100 400 - 400 200 200
8 Hanskun steril No. 7 dan 7,5 Pasang - - - 50 (50)
9 Hypafix/plester putih non alergenik 5cm
Roll
x1m 219 - 219 - 219
10 Infusion set Anak(PKD 2) Set 400 - 400 - 400
11 Infusion set Dewasa ( Set 1.050 - 1.050 - 1.050
12 Intravena Kateter no 20 Pcs 515 - 515 - 515
13 Intravena Kateter no 22 Pcs 1.706 - 1.706 - 1.706
14 Intravena Kateter no 24 Pcs 493 - 493 - 493
15 Jarum Citoject /carpul Pcs - - - - -
16 Jarum Disposible Pcs 100 - 100 - 100
17 Kapas Pembalut 250 mg Gulung 63 - 63 1 62
18 Kasa Panjang 40 x 80 cm Roll 12 - 12 - 12
19 Kasa Pembalut 2m x 80 cm Roll 10 - 10 - 10
20 Kasa Pembalut Hidrofil 4m x10cm Roll 480 - 480 - 480
21 Kasa Pembalut Hidrofil 4m x3cm Roll - - - - -
22 Kasa steril 16x16 Box 500 - 500 - 500
23 Masker Pcs 100 - 100 50 50
24 Masker tali/tie on Pcs - - - - -
25 Nelaton kateter Pcs - - - - -
26 Pembalut Elastis/ tensokrop 7cm Roll 26 - 26 - 26
27 Pembalut Gips Roll - - - - -
28 Plester 5 yards x 2 inc Roll - - - - -
29 Plester Kertas(Mikrospore)1 inc x 10 mRoll - - - - -
30 Pot sputum Pcs - - - - -
31 Safety box Pcs - - - - -
32 Silk (Benang Bedah Sutera ) no 3/0 Set 183 - 183 - 183
33 Softband Roll - - - - -
34 Soloschot Syringe/ADS 0,5 ml Set 2.300 - 2.300 - 2.300
35 Spuit 1ml Set 1.700 - 1.700 - 1.700
36 Spuit 3 ml Set 2.175 - 2.175 5 2.170
37 Spuit 5 ml Set 4.300 - 4.300 - 4.300
38 Spuit BCG/ADS 0,05 ml Set 2.800 - 2.800 - 2.800
39 Urine bag Set 145 - 145 - 145
40 Box Slide pcs - - - - -
41 Wing needle Set - - - - -
42 FolleyCat, 2 way latex No.16 Pcs - - - - -
43 FolleyCat, 2 way latex No.18 Pcs - - - - -
44 Nasa Canula L PCS 30 - 30 - 30
45 Nasa Canula M PCS 20 - 20 - 20
46 Nasa Canula S PCS - - - - -
47 Nasa Canula XS PCS - - - - -
48 Dressing tulle 10x10 ktk - - - - -
49 Hanskun steril panjang Pcs - - - - -
50 Hanskun non steril S Ktk '100tab 1.700 - 1.700 200 1.500
51 jarum hecting bks 12pcs - - - - -
52 refill aseptan galon 5 liter - - - - -
53 Leukomed pcs 500 - 500 - 500
0 0 - - -
Asam Asetil Salisilat tablet - - - - -
Asetil sistein tablet 4.200 - 4.200 200 4.000
Bisakodil tab tablet - - - - -
Glimepiride 1mg tablet - - - - -
Glimepiride 2mg tablet 3.000 - 3.000 - 3.000
 Glimepiride 4mg tablet - - - - -
Hiosciamin / Scopma tablet - - - - -
Isoniazid 100mg tablet 200 - 200 - 200
Nistatin drop botol - - - - -
Norit pcs 17 - 17 - 17
Vit C 500mg tablet 32.600 - 32.600 - 32.600
molagit tab tablet - - - - -
Neocenta gel tube - - - - -
Kloramfenikol Salep Kulit tube - - - - -
Pramolta Syr botol - - - - -
Coverplast latex pcs 900 - 900 - 900
Folley cath no 6 pcs - - - - -
Hand sanitizer Botol 100ml pcs - - - - -
Intravena Kateter no 18 pcs - - - - -
Leukoplast pcs 16 - 16 - 16
masker cantel pcs - - - - -
Oxycan pcs - - - - -
Paper tape pcs 30 - 30 - 30
Plasterin (plaster bulat) pcs - - - 200 (200)
sunction Connecting 3,6m pcs - - - - -
ultrasound gel pcs - - - - -
Underpad pcs 20 - 20 - 20
0 0 - - - - 25-Oct-15
1 0 0 - - - -
2 0 0 - - -
3 0 0 - - -
4 0 0 - - -
5 0 0 - - -
6 0 0 - - -
7 0 0 - - -
8 0 0 - - -
9 0 0 - - -
10 0 0 - - -
11 0 0 - - -
12 0 0 - - -
13 0 0 - - -
14 0 0 - - -
15 0 0 - - -
16 0 0 - - -
17 0 0 - - -
18 0 0 - - -
19 0 0 - - -
20 0 0 - - -
21 0 0 - - -
22 0 0 - - -
23 0 0 - - -
24 0 0 - - -
25 0 0 - - -
26 0 0 - - -
27 0 0 - - -
28 0 0 - - -
29 0 0 - - -
30 0 0 - - -
0 OBAT BELI MANDIRI 0 - - -
- - -
1 Acyclovir 200 mg tablet Tablet 4.070 - 4.070 13 4.057
Acyclovir 400 mg tablet Tablet - - - - -
Albendazol 400 mg Tablet - - - - -
Alopurinol 100mg Tablet 407 - 407 282 125
Ambroxol Tablet - - - - -
Ambroxol syrup Botol - - - - -
Aminofilin 200 mg Tablet - - - - -
Amitriptilin HCl 25 mg Tablet - - - - -
Amlodipin 10mg Tablet 3.660 - 3.660 1.060 2.600
Amoksisilin 250 mg Capsul - - - - -
Amoksisilin 500 mg Caplet - - - - -
Amoksisilin Srp Krng 125mg/5ml Botol - - - - -
Amoksisilin Srp Krng 250mg/5ml Boto 60 ml - - - - -
Amoxiclav tablet Tablet - - - - -
Ampisilin 500 mg Caplet - - - - -
Ampisillin sirup kering 125mg/ml Botol - - - - -
Antalgin 500 mg Tablet - - - - -
Antasida Doen tab. Tablet 7.945 - 7.945 1.591 6.354
Antasida sirop Botol 26 - 26 63 (37)
Arterakine Dus @ 9tab - - - - -
As. Mefenamat 500 mg Kapsul - - - - -
Asam Askorbat (Vit.C) tab.50 mg Tablet 2.200 - 2.200 - 2.200
Asam folat Tablet 4.940 - 4.940 20 4.920
Asetosal 100 mg Tablet - - - - -
Batugin elixir botol 120ml - - - - -
Bekarbon Tablet - - - - -
Betahistin mesilat 6mg Tablet 15.539 - 15.539 218 15.321
Biovision caps Kapsul - - - - -
Bromheksin 8 mg Tablet - - - - -
Captopril 25 mg Tablet 4.051 - 4.051 840 3.211
Cefadroxil 500 mg Tablet 4.480 - 4.480 390 4.090
Cefadroxil sirup 125 mg/5 ml Botol 60 ml - - - - -
Cefalexin 500 mg Kapsul - - - - -
Cimetidin Tablet Tablet - - - - -
Citerizine 10mg Tablet - - - - -
Clonidin Tablet - - - - -
Clozapine 25mg Tablet - - - - -
Cyprofloxacin 500 mg Tablet - - - - -
Deksametason tab.0,5 mg Tablet - - - - -
Dekstromethorphan 10 mg/ 5ml Botol - - - - -
Dekstrometorfan HBr tab.15 mg Tablet - - - - -
Diazepam tab. 2mg Tablet - - - - -
Dietyl Carbamazepine Tablet - - - - -
Digoxin 0,25mg Tablet 800 - 800 219 581
Dimenhydrinat 50mg Tablet 3.307 - 3.307 78 3.229
Doksisiklin 100 mg Kapsul - - - - -
Donperidon 10mg Tablet 1.883 - 1.883 161 1.722
Donperidon 5mg/5ml suspensi Botol 53 - 53 14 39
Ephedrin HCl 25 mg Tablet - - - - -
Ergotamin cofein Tablet - - - - -
Erphakap Plus sirup Botol - - - - -
Erphakap tab Tablet - - - - -
Erytromicyn sirup Botol - - - - -
Erytromycin 500 mg Capsul 4.246 - 4.246 80 4.166
Etambutol 500 mg Tablet - - - - -
Famotidin 40 mg Tablet - - - - -
Fenobarbital 30mg Tablet - - - - -
Fenoksimetil Penisiline 250 mg Tablet - - - - -
Fenoksimetil Penisiline 500 mg Tablet - - - - -
Fitogen Tablet - - - - -
Fitomenadion Vit K 1 tab.10 mg Tablet 2.800 - 2.800 - 2.800
Furosemid tab.40 mg Tablet 1.208 - 1.208 1.384 (176)
Garam Oralit 200 ml air Bungkus - - - - -
Gemfibrozil 300 mg Kapsul 623 - 623 30 593
Glibenklamid tab. 5 mg Tablet - - - - -
Gliseril Guaiakolat tab.100 mg Tablet - - - - -
Griseovulvin tab.125 mg Tablet 830 - 830 76 754
Haloperidol 1,5 mg Tablet - - - - -
Haloperidol 5 mg Tablet - - - - -
Hemorogad Kapsul - - - - -
Hepagard Kapsul - - - - -
Hidroklorotiazid (HCT) tab. 25mg Tablet - - - - -
Ibuprofen tab.200 mg Tablet - - - - -
Ibuprofen tab.400 mg Tablet - - - - -
Iburofen suspensi 100mg/5ml Botol 60ml 36 - 36 3 33
Iburofen suspensi 200mg/5ml Botol 60ml 158 - 158 - 158
Imulan (Immunomodular) Caps Kapsul - - - - -
Imulan (Immunomodular) sirup botol 60 ml - - - - -
Isorbid Dinitrat 5mg Tablet 2.412 - 2.412 75 2.337
Kalium diklofenak 50 mg Tablet - - - - -
Kalsium Laktat (Kalk) tab.500 mg Tablet 4.189 - 4.189 681 3.508
Kanina/Neo Kaominal sirup/GuanistrepBotol 60 ml 8 - 8 2 6
Ketokonasol 200mg Tablet 720 - 720 175 545
Ketoprofen 100 mg Tablet - - - - -
Klindamicyn 300 mg Kapsul 200 - 200 - 200
Kloramfenikol kap.250 mg Kapsul - - - - -
Kloramphenikol suspensi 125mg/5ml Botol - - - - -
Klorfeneramin Maleat(CTM) 4 mg (A) Tab/Box@100 - - - - -
Klorfeneramin Maleat(CTM) 4 mg (B) Tab/Klg@100 17.970 - 17.970 2.030 15.940
Klorfeneramin Maleat(CTM) 4 mg (C) Tab/Klg@1000 - - - - -
Klorpromazin HCl 100mg tab. salut Tablet 3.507 - 3.507 1.469 2.038
Kotrimoksazol Pediatrik tab Komb. Tablet - - - - -
Kotrimoksazol Suspensi Botol 26 - 26 6 20
Kotrimoksazol tab. Dws 480mg Tablet 802 - 802 50 752
Kurkumex kaplet kaplet - - - - -
Kurkumex sirup Botol 60ml - - - - -
Laxadin sirup Botol - - - - -
Loperamid Tablet - - - - -
Loratadin 10mg Tablet - - - - -
Mebendazol sirup 100mg/5ml Botol 30ml - - - - -
Meloksicam 15 mg Tablet - - - - -
Metformin 500mg Tablet 5.205 - 5.205 523 4.682
Metil Prednisolon 4mg Tablet 20.170 - 20.170 366 19.804
Metilergometrin Maleat 0,125 mg Tablet - - - - -
Metoklopropamid 10 mg Tablet 501 - 501 44 457
Metoklopropamid sirup Botol - - - - -
Metronidazol 250mg Kapsul - - - - -
Metronidazol 500 mg Tablet 1.800 - 1.800 - 1.800
Mineral mix Sachet - - - - -
Na diklofenak 50 mg Tablet 11.034 - 11.034 875 10.159
Natrium Bicarbonat Tablet 4.345 - 4.345 55 4.290
Natrium Tiroksin 100mcg Tablet - - - - -
Neo Diaform/Stopdiar Tablet - - - - -
Nifedipin 10mg Tablet 1.138 - 1.138 - 1.138
Nistatin tablet salut 500.000 IU/gr Tablet - - - - -
Nodiar Ktk '100tab - - - - -
Obat Anti TBC FDC Anak paket - - - - -
Obat Anti TBC Kat Anak (kombipak) paket - - - - -
Obat Anti TBC Kat I (FDC) paket - - - - -
Obat Anti TBC Kat I / Kombipak paket - - - - -
Obat Anti TBC Kat II paket - - - - -
Obat Anti TBC Kat Sisipan paket - - - - -
Obat Batuk Hitam (OBH) cairan Botol 46 - 46 (6) 52
Obat Batuk Hitam (OBH) Plus Botol 100ml 51 - 51 39 12
Ocugard kapsul Tablet - - - - -
Omepazole 20 mg Kapsul 16.913 - 16.913 672 16.241
Papaverin 40 mg Tablet (A) Tab/Box@100 - - - - -
Papaverin 40 mg Tablet (B) Tab/Klg@1000 - - - - -
Parasetamol 100 mg Tablet - - - - -
Parasetamol drop Botol 15ml - - - - -
Parasetamol sirup 120 mg/5 ml Botol - - - - -
Parasetamol tab. 500 mg Tablet 68.999 - 68.999 2.475 66.524
Pehavral (multivit/ Sivit zink) tab. Kaplet - - - - -
Phenitoin Natrium 100 mg Kapsul - - - - -
Phenyl Butason Tab Tablet - - - - -
Piracetam 400 mg Kapsul - - - - -
Pirantel Pamoat tab.125 mg Tablet - - - - -
Piridoksin Hcl.(Vit B6) 10 mg Tablet - - - - -
Piroksikam 20 mg tab. Tablet - - - - -
Prednison tab.5 mg (A) Tab/Box@100 - - - - -
Prednison tab.5 mg (B) Tab/Klg@1000 - - - - -
Primaquin/Kloroquin Tablet - - - - -
Propanolol tab 40 mg Tablet - - - - -
PTU 100mg Tablet - - - - -
Pyrazinamid 500 mg. Tablet - - - - -
Quinin tablet Kotak @ 60 tab - - - - -
Ranitidin 150mg Tablet - - - - -
Reserpin 0,25mg tablet Tablet - - - - -
Retinol (Vit.A) 100.000 UI tab. Kapsul - - - - -
Retinol (Vit.A) 200.000 UI tab. Kapsul - - - - -
Rifampisin kapsul 300mg Kapsul - - - - -
Rifampisin kapsul 450 mg Kapsul - - - - -
Risperidone 2 mg Tablet - - - - -
Salbutamol 2 mg Tablet - - - - -
Salbutamol 4 mg Tablet - - - - -
Sianocobalamin 50 mg/Vit B12 (A) Tab/Box@100 - - - - -
Sianocobalamin 50 mg/Vit B12 (B) Tab/Klg@1000 - - - - -
Simvastatin 10 mg Tablet 5.200 - 5.200 - 5.200
spiramicyn 500mg Tablet - - - - -
Tablet Tambah Darah Tablet - 10.000 10.000 - 10.000
Tensigard Kapsul - - - - -
Tetrasiklin 250mg Tablet - - - - -
Tetrasiklin 500 mg Tablet - - - - -
Thiamin Hcl (Vit.B1)tab.100 mg Tablet - - - - -
Thiamin Hcl (Vit.B1)tab.50 mg (A) Tab/Box@100 - - - - -
Thiamin Hcl (Vit.B1)tab.50 mg (B) Tab/Klg@1000 - - - - -
Thiampenicole 500mg Kapsul 414 - 414 70 344
Tramadol tab Kapsul - - - - -
Traneksamik Acid 500 mg Kapsul 534 - 534 22 512
Trifluoperazine 5mg Tablet salut - - - - -
Triheksifenidil (THP) 2mg Tablet 1.649 - 1.649 25 1.624
Truvit (multivit) syr Botol 60ml - - - - -
Vitamin B Complx tab (A) Tab/Box@100 11.098 - 11.098 2.593 8.505
Vitamin B Complx tab (B) Tab/Klg@1000 - - - - -
Xanvit sirup/ multivit syr botol 8 - 8 118 (110)
Zink Tablet Kotak - - - - -
Asifit (pelancar asi) 0 - - - - -
Pasaba Syr 0 - 234 234 24 210
INJEKSI / LARUTAN INFUS 0 - - - - -
Aminofilina inj. 24 mg/ml -10 ml Ampul 30 - 30 - 30
Amoksisilin Inj 1 gram Vial - - - - -
Ampisilin Injeksi 1 Gram Vial - - - - -
Anti Bio Save (ABU) Vial @5ml - - - - -
Aqua Pro inj. Steril Vial - - - - -
Artemeter inj Dus @ 6 amp - - - - -
Artesunate inj Dus @ 8 amp - - - - -
Asering lar. Infus Botol 500ml - - - - -
Atropin Sulfat Inj 0,25mg/ml-1ml Ampul - - - - -
Deksametason inj 5mg/ml-1ml ampul - 100 100 14 86
Depo Progestin Injeksi Vial - - - - -
Dextran 70% Botol - - - - -
Diazepam inj. 5mg/ml-2ml Ampul - - - - -
Difenhidramin HCl inj Ampul - 120 120 - 120
Ephineprin /Adrenalin inj Ampul 30 - 30 - 30
Erlamidon inj Vial - - - - -
Fenobarbital Inj. 50 mg /ml--2ml Ampul - - - - -
Fitomenadion (Vit. K1) Inj.10mg Ampul - - - - -
Fitomenadion (Vit. K1) Inj.2mg/ml Ampul - - - - -
Furosemide inj Ampul - - - - -
Gentamycin inj 40mg/5ml Ampul - - - - -
Glukosa infus 40% Botol - - - - -
Glukosa larutan infus 5% steril Botol - - - - -
Glukosa calsicus 10%steril Ampul 20 ml - - - - -
KAEN 1B Botol 500ml - - - - -
Ketoprofen inj Ampul - - - - -
Kloramphenikol Inj 1g/ Colsancetin InjVial - - - - -
Lidocain Injeksi 2%-2ml Ampul - - - - -
Metilergometrin Inj 0,2mg/ml - 1ml Ampul - - - - -
Metoklopropamid 5mg/ml inj ampul - - - - -
MgSO4 20% Botol 25 ml - - - - -
MgSO4 40 % Botol 25 ml - - - - -
Na Cl Infus 0.9% Botol - - - - -
Oksitetrasiklin HCl inj Vial - - - - -
Oksitocin inj 10 UI/ml Ampul - - - - -
Pehacain Inj/ lidocain comp inj Ampul - 400 400 - 400
Piracetam inj Ampul - - - - -
Ringer Laktat lar. infus steril Botol - - - - -
PPC Inj Vial - - - - -
Quinin Inj Ampul - - - - -
Ranitidin inj 25mg/2ml Ampul - - - - -
Sefotaxim inj 1g Vial 1 gram - - - - -
Serum Bisa Ular (ABU) Bio Save Vial @5ml - - - - -
Serum Anti Dipteri (ADS) 20.000 Vial - - - - -
Serum Anti Tetanus 1500 IU/Amp. Ampul - - - - -
Serum Anti Tetanus20.000IU/Am. Vial - - - - -
Sianocobalamin inj 500mcg Ampul - - - - -
Sikzonoat inj 25 mg/ml Ampul - - - - -
Thiamin inj 100mg/ml Ampul - - - - -
Tramadol 50mg / ml inj ampul - - - - -
Haloperidol inj ampul - - - - -
0 0 - - - - -
0 0 - - - - -
0 0 - - - - -
0 0 - - - - -
TOPIKAL 0 - - - - -
Acyclovir 5% Ceam Tube - - - - -
Anti Bakteri DOEN salep Tube - - - - -
Anti Fungi DOEN Kombinasi. Pot - - - - -
Antihaemoroid supp Supp - 500 500 15 485
Betametason krim 0,1% Tube 311 - 311 72 239
Bisakodil suppo 10mg Suppo - - - - -
Borak Gliserin (GOM) Botol 10ml - - - - -
Diazepam lar. Rektal 5mg/2,5ml (stesolid)
Tube 2,5ml - - - - -
Enkasari Botol 120ml - - - - -
Etakridin (Rivanol) larutan 0,1% Botol 300 ml 40 - 40 - 40
Etanol 70 % (Alkohol 1L) Botol 1000 ml 50 - 50 12 38
Ethyl chlorida spray Botol - - - - -
Flusinolon asetonid 0.025% krim Tube - - - - -
Gentamisin Salep Kulit Tube - - - - -
Gentian Violet larutan 1% Botol - - - - -
Hydrokortison Cream Tube - - - - -
Ketokonasole/Solinfec cream Tube - - - - -
Ketoprofen supp 100mg/Protofen Supp - - - - -
Kloramfenikol tetes telinga 3% Botol 40 - 40 - 40
Klorfeson cream Tube 10g - - - - -
Lisol/kresol tersaponofikasi 50% Botol 1 L 3 - 3 - 3
Minyak kayu putih Botol 30ml - - - - -
Minyak telon Botol 60ml - - - - -
Myconazole cream Tube - - - - -
Nistatin tablet vagina 100.000 IU Tablet 100 - 100 - 100
Nufasic cream) Tube - - - - -
Oksitetrasiklin Hcl salep Kulit 3% Tube - - - - -
Povidon Iodine 30 ml Botol 48 - 48 - 48
Povidon Iodine 300 ml Botol - - - - -
Povidon Iodine 60 ml Botol 25 - 25 - 25
Salep 2-4 Kombinasi Pot - - - - -
Salisil Bedak 2 % Botol - - - - -
Scabisid salep kulit Tube - - - - -
Stericide p - - - - -
one clean 1L 0 3 - 3 - 3
OBAT MATA 0 - - - - -
Gentamycin tetes mata Botol - - - - -
Kloramfenikol salep mata 1% Tube - - - - -
Kloramfenikol tetes mata 5ml Botol 5ml - - - - -
Kloramfenikol tetes mata 10ml Botol 10ml 125 - 125 - 125
Oksitetrasiklin Hcl salep mata Tube - - - - -
Sulfasetamide Na Tes Mata 15% Botol 5ml - - - - -
0 0 - - - - -
GIGI 0 - - - - -
Devitalisasi pasta (Non Arsen) 0 - - - - -
Eugenol Cairan 0 - - - - -
Glass Ionomer Cement ant 0 - - - - -
Glass Ionomer Cement post 0 - - - - -
Kalsium Hidroksida Pasta 0 - - - - -
Monoklorkamfer Mentol Cairan Sak - - - - -
Mummifying pasta Sak - - - - -
Semen Seng Fosfat serbuk cairan 0 - - - - -
Silver Amalgam Serbuk 65-75% 0 - - - - -
Temporary Filling material/Cavit / caviton
Rol - - - - -
Temporary Stopping Fletcher Rol - - - - -
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 - - - - -
ALKES HABIS PAKAI 0 - - - - -
Alkohol swab Pcs 4.000 - 4.000 - 4.000
Aseptan 500cc + dispenser Botol - - - - -
Blood Tranfusion set Pcs 82 - 82 - 82
Catgut/benang bedah 3/0 cromic tanpa Pcs
jarum - - - - -
Catgut/benang bedah 3/0 plain denganPcsjarum - - - - -
Hanskun non steril L Box@100 - - - - -
Hanskun non steril M Box@100 - - - - -
Hanskun steril No. 7 dan 7,5 Pasang 100 - 100 - 100
Hypafix/plester putih non alergenik 5cm
Roll
x1m - - - - -
Infusion set Anak(PKD 2) Set - - - - -
Infusion set Dewasa ( Set - - - - -
Intravena Kateter no 20 Pcs - - - - -
Intravena Kateter no 22 Pcs - - - - -
Intravena Kateter no 24 Pcs - - - - -
Jarum Citoject /carpul Pcs - - - - -
Jarum Disposible Pcs - - - - -
Kapas Pembalut 250 mg Gulung 12 - 12 - 12
Kasa Panjang 40 x 80 cm Roll 8 - 8 - 8
Kasa Pembalut 2m x 80 cm Roll - - - - -
Kasa Pembalut Hidrofil 4m x10cm Roll - - - - -
Kasa Pembalut Hidrofil 4m x3cm Roll - - - - -
Kasa steril 16x16 Box - - - - -
Masker Hijab Pcs 1.400 - 1.400 50 1.350
Masker tali/tie on Pcs - - - - -
Nelaton kateter Pcs - - - - -
Pembalut Elastis/ tensokrop 7cm Roll - - - - -
Pembalut Gips Roll - - - - -
Plester 5 yards x 2 inc Roll - - - - -
Plester Kertas(Mikrospore)1 inc x 10 mRoll - - - - -
Pot sputum Pcs - - - - -
Safety box Pcs - - - - -
Silk (Benang Bedah Sutera ) no 3/0 Set - - - - -
Softband Roll - - - - -
Soloschot Syringe/ADS 0,5 ml Set - - - - -
Spuit 1ml Set - - - - -
Spuit 3 ml Set 300 - 300 - 300
Spuit 5 ml Set - - - - -
Spuit BCG/ADS 0,05 ml Set - - - - -
Urine bag Set - - - - -
Box Slide pcs - - - - -
Wing needle Set 40 - 40 - 40
FolleyCat, 2 way latex No.16 Pcs - - - - -
FolleyCat, 2 way latex No.18 Pcs 11 - 11 - 11
Nasa Canula L PCS 40 - 40 - 40
Nasa Canula M PCS 9 - 9 - 9
Nasa Canula S PCS 11 - 11 - 11
Nasa Canula XS PCS - - - - -
Dressing tulle 10x10 ktk - - - - -
Hanskun steril panjang Pcs 16 - 16 - 16
Hanskun non steril S Ktk '100tab - - - - -
jarum hecting bks 12pcs - - - - -
refill aseptan galon 5 liter - - - - -
Leukomed pcs - - - - -
0 0 - - - - -
Asam Asetil Salisilat tablet 1.684 - 1.684 224 1.460
Asetil sistein tablet 1.597 - 1.597 140 1.457
Bisakodil tab tablet 2.500 - 2.500 1.364 1.136
Glimepiride 1mg tablet 1.932 - 1.932 339 1.593
Glimepiride 2mg tablet 1.717 - 1.717 (175) 1.892
Glimepiride 4mg tablet 4.100 - 4.100 2.820 1.280
Hiosciamin / Scopma tablet 1.661 - 1.661 225 1.436
Isoniazid 100mg tablet 1.800 - 1.800 - 1.800
Nistatin drop botol 93 - 93 (3) 96
Norit pcs - - - - -
Vit C 500mg tablet - - - - -
molagit 0 407 - 407 136 271
Neocenta gel tube 20 - 20 - 20
Kloramfenikol Salep Kulit tube 300 - 300 (26) 326
Pramolta Syr 0 63 - 63 54 9
Coverplast latex pcs - - - - -
Folley cath no 6 pcs 12 - 12 - 12
Hand sanitizer Botol 100ml pcs - - - - -
Intravena Kateter no 18 pcs - - - - -
Leukoplast pcs - - - - -
masker cantel pcs 1.700 - 1.700 250 1.450
Oxycan pcs - - - - -
Paper tape pcs - - - - -
Plasterin (plaster bulat) pcs - - - - -
sunction Connecting 3,6m pcs 2 - 2 - 2
ultrasound gel pcs 3 - 3 - 3
Underpad pcs - - - - -