LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

TAHUN 2019
POLINDES : SUNGAI PANGKALAN 1 PELAPORAN BULAN :-
PUSKESMAS : SUNGAI DURI PERMINTAAN BULAN : JANUARI
KECAMATAN : SUNGAI RAYA
KABUPATEN : BENGKAYANG DOKUMEN NOMOR TGL/BLN/ THN
GFK 442/ /LPLPO-GFK 4/12/2018
PUSKESMAS SUNGAI DURI
SATU- HARGA STOK PENE- PERSE- PEMA- SISA STOK PERMIN- PEMBE-
NO NAMA OBAT AN SATUAN AWAL RIMAAN DIAAN KAIAN STOK OPTIMUM TAAN RIAN KET

1 2 3 4 5 8 7 8 9 10 11 12 13

PKD E-KATALOG
-
1 ACETYLCYSTEIN 200MG TAB 425.00 300 300 200 100 200
- 110
2 ALLOPURINOL 100 MG TAB 106.00 200 200 90 100
-
3 AMBROXOL 30 MG TAB 89.31 - - - - - -
- -
4 AMBROXOL SYRUP BTL 2,722.00 - - - - -
-
5 AMLODIPINE 10MG TAB 93.31 90 90 70 20 90
- -
6 AMINOPHYLLIN 24 MG / ML - 10 ML INJEKSI AMP 3,314.52 - - - -
- -
7 AMITRIPTILLIN 25 MG TAB 118.00 - - - -
- -
8 AMOKSISILLIN 125 MG / 5ML SYR KERING BTL 2,511.00 10 10 10 - 15
-
9 AMOKSISILLIN 250 MG KAPS 220.24 100 100 100 - 100
-
10 AMOKSISILLIN 500 MG KAPS 228.00 400 400 300 100 300
- -
11 AMPISILLIN 1 GRAM INJEKSI VIAL 4,700.00 - - - -
-
12 ANTALGIN ( METAMPIRON ) 500 MG TAB 154.00 - - - -
- -
13 ANTALGIN 250 MG /ML - 2 ML INJEKSI AMP 1,500.74 - - - -
73.12 -
14 ANTASIDA DOEN KOMBINASI TAB 400 400 400 - 400
BTL - -
15 ANTASIDA SUSPENSI 2,700.00 - - - - 10
TUBE 2,741.00 -
16 ANTI BAKTERI DOEN SALEP KOMBINASI - - - -
2,096.33 - -
17 ANTI FUNGI DOEN KOMBINASI TUBE - - - -
TAB - -
18 ANTIMIGRAIN 135.00 - - - -
-
19 AQUA PRO INJEKSI, BEBAS PIROGEN VIAL 5,900.00 - - - -
- -
20 ARTESUNAT INJEKSI VIAL 27,569.00 - - - -
 -
21 ASAM FOLAT 1 MG TAB 48.04 200 200 120 80 100
200 -
22 ASAM MEFENAMAT 500 MG TAB 114.84 300 300 280 20 300
- -
23 ASETOSAL 100 MG TAB 110.00 - - - -
- -
24 ASETOSAL 500 MG TAB 178.00 - - - -
-
25 ASIKLOVIR 200 MG TAB 288.00 - - - - 100
-
26 ASIKLOVIR KRIM 5% TUBE 2,367.00 - - - - -
- -
27 ATENOLOL 50 MG TAB 346.00 - - - -
- -
28 ATROPIN SULFAT INJEKSI 0,25 MG AMP 1,353.00 - - - -
- -
29 ATROPIN SULFAT O,5 MG TAB 75.00 - - - -
- -
30 BENZATIN BENZIL PENICILLIN 1,2 JUTA IU VIAL 9,829.00 - - - -
- -
31 BETAHISTIN MESILAT TAB TAB 1,016.00 300 300 270 30 300
-
32 BETAMETHASON 0,1 % KRIM/berloson TUBE 1,669.00 - - - - -
-
33 CEFADROXIL 500 MG KAPS 521.00 100 100 80 20 100
- -
34 CANDESARTAN CILEXETIL TAB 5,248.00 150 150 130 20 150
-
35 CETIRIZINE TABLET TAB 188.00 200 200 140 60 200
- -
36 DEKSTROMETHORPHAN 15 MG TAB 102.00 - - - -
- -
37 DEKSTROMETHORPHAN SYRUP BTL 1,467.40 - - - -
-
38 DEXAMETHASONE 0,5 MG TAB 71.89 200 200 200 - 300
-
39 DEXAMETHASONE 5 MG/ML INJEKSI AMP 1,850.00 - - - -
- -
40 DEXTRAN 70 -LARUTAN INFUS 6% 500 ML BTL 39,079.00 - - - -
- -
41 DIAZEPAM 2 MG TAB 39.00 - - - -
-
42 DIAZEPAM 5 MG TAB 65.00 - - - -
- -
43 DIAZEPAM INJEKSI (STESOLID INJ 5 MG/ML) AMP 2,578.00 - - - -
-
44 DIETILCARBAMAZIN (DEC) 100MG TAB 104.00 - - - -
-
45 DIGOXIN 0,25 TAB 96.48 - - - -
-
46 DIPHENHIDRAMIN HCL INJEKSI AMP 1,056.00 - - - -
-
47 DOKSISIKLIN 100 MG KAPS 250.00 - - - -
- -
48 DOMPERIDONE SUSPENSI BTL 3,766.00 - - - -
-
49 DOMPERIDONE TABLET 10MG TAB 192.13 100 100 50 50 100
- -
50 EFINEFRIN / ADRENALIN INJEKSI AMP 1,650.00 - - - -
- -
51 EKSTRAK BELLADONE 10 MG TAB 42.00 - - - -
-
52 ERITROMISIN 250 MG KAPS 451.00 - - - -
- -
53 ERITROMISIN 500 MG KAPS 912.94 100 100 60 40 100
 -
54 ERITROMISIN SYRUP 200 MG / 5 ML BTL 7,401.00 - - - -
-
55 ETAKRIDIN ( RIVANOL ) SOLUTIO BTL 2,354.22 - - - -
- -
56 ETHAMBUTOL 250 MG TAB 313.00 - - - -
- -
57 FAMOTIDINE 20 MG TAB 124.00 - - - -
- -
58 FENITOIN NATRIUM 100 MG KAPS 134.00 - - - -
- -
59 FENITOIN NATRIUM 30 MG / FLUTAMOL/masflu KAPS 101.00 - - - -
- -
60 FENOBARBITAL 30 MG TAB 71.00 - - - -
- -
61 FENOBARBITAL INJEKSI / FLUTAMOL SYR/protifed AMP 1,888.00 - - - -
- -
62 FENOKSIMETIL PENISILLIN 250 MG / hufagrip TAB 299.00 - - - -
- -
63 FENOKSIMETIL PENISILLIN 500 MG/ samcodryl sy. TAB 512.00 - - - -
- -
64 FENOL GLISEROL 10 % TETES TELINGA BTL 1,108.80 - - - -
- -
65 FITOMENADION / VITAMIN K INJEKSI AMP 1,723.00 10 10 - 10 10 ED
-
66 FITOMENADION / VITAMIN K TABLET TAB 640.59 200 200 60 140
-
67 FUROSEMIDE 40 MG TAB 92.00 - - - -
322.00 -
68 GARAM ORALIT 200 ML SACHET 100 100 60 40 100
- -
69 GEMFIBROZIL 300 MG TABLET TAB - - - -
- -
70 GENTAMICIN 0,1% SALEP KULIT TUBE 1,469.00 - - - -
- -
71 GENTAMICIN 40 MG / ML INJEKSI VIAL 3,415.00 - - - -
- -
72 GENTAMISIN SULFAT TETES MATA 0,3% BTL 3,194.00 - - - -
-
73 GENTIAN VIOLET BTL 985.00 10 10 8 2 10
- -
74 GLIBENKLAMIDE 5 MG TAB 59.00 - - - - 100
- -
75 GLISERIN 100 ML BTL 4,578.64 - - - -
- -
76 GLUKOSA 10 % INFUS 500 ML BTL 6,300.00 - - - -
- -
77 GLUKOSA 5 % INFUS 500 ML BTL 5,844.00 - - - -
- -
78 GRISEOFULVIN 125 MG TAB 199.00 - - - -
- -
79 HALOPERIDOL 0,5 MG TAB 55.70 - - - -
- -
80 HALOPERIDOL 1,5 MG TAB 64.43 - - - -
- -
81 HALOPERIDOL 5 MG TAB 94.21 - - - -
- -
82 HIDROKORTISON 2,5 % KRIM TUBE 2,459.00 - - - -
- -
83 HYOSCINE BUTILBROMIDE TAB 20 MG TAB 405.00 - - - -
- -
84 IBUPROFEN 200 MG TAB 96.21 - - - -
- -
85 IBUPROFEN 400 MG TAB 152.50 - - - - 200
- -
86 IBUPROFEN SYRUP 100MG/5ML BTL 3,811.00 - - - -
 - -
87 IODIAL KAPSUL LUNAK KAPS 1,023.00 - - - -
- -
88 INH 300 MG TAB 85.00 - - - -
-
89 ISOSORBID 5 MG SUBLINGUAL TAB 101.00 - - - -
-
90 KAPTOPRIL 12,5 MG TAB 63.00 200 200 150 50 -
- -
91 KAPTOPRIL 25 MG TAB 94.00 200 200 150 50 100
- -
92 KARBAMAZEPIN 200 MG TAB 267.00 - - - -
-
93 KETOCONAZOLE 200 MG TAB 267.00 100 100 80 20 100
-
94 KETOKONAZOLE 2 % KRIM 15 G TUBE 4,151.00 - - - - -
- -
95 KETOROLAC INJ 10 MG AMP 2,020.00 - - - -
- -
96 KLORAMFENIKOL 250 MG KAPS 264.00 - - - -
-
97 KLORAMFENIKOL 3% TETES TELINGA BTL 1,759.00 - - - -
-
98 KLORAMFENIKOL SALEP MATA TUBE 1,486.00 - - - -
-
99 KLORFENIRAMINI MALEAT ( CTM ) 4 MG TAB 23.00 400 400 300 100 300
- -
100 KLORPROMAZIN HCL 100 MG TAB 146.00 - - - -
- -
101 KLORPROMAZIN HCL 25 MG TAB 50.00 - - - -
- -
102 KODEIN 10 MG TAB 517.00 - - - -
525.00 - -
103 KOMBINASI PIRIMETAMIN + SULFADOXIN TAB - - - -
160.15 -
104 KOTRIMOKSAZOLE DEWASA TAB 200 200 50 150 100
79.00 -
105 KOTRIMOKSAZOLE PAEDIATRIK TAB - - - -
2,212.94 - -
106 KOTRIMOKSAZOLE SUSPENSI BTL - - - - -
- -
107 KUININ DIHIDROKLORIDA 25% INJEKSI AMP 4,333.00 - - - -
- -
108 LIDOCAIN 2 % INJEKSI AMP 1,000.00 10 10 - 5 10 ED
- -
109 LIDOKAIN KOMPOSITUM AMP 1,485.00 - - - -
- -
110 LOPERAMID TAB TAB 99.00 - - - -
- -
111 MAGNESIUM SULFAT 20% INJEKSI VIAL 2,078.00 - - - -
- -
112 MAGNESIUM SULFAT 40% INJEKSI VIAL 2,629.00 - - - -
- -
113 MEBENDAZOLE 100 MG TAB 248.00 - - - -
- -
114 MEBENDAZOLE SYRUP 100 MG / 5 ML BTL 3,887.00 - - - -
-
115 METFORMIN 500 MG TAB 105.00 100 100 100 - 200
- -
116 METIL PREDNISOLON 4MG TAB 198.00 200 200 150 50 200
-
117 METOCHLORPHAMIDE 10 MG TAB 91.00 - - - -
- -
118 METOCHLORPHAMIDE SUSPENSI 60ML BTL 2,830.00 - - - -
- -
119 METRONIDAZOLE 250 MG TAB 142.00 - - - -
 - -
120 METRONIDAZOLE 500 MG TAB 174.00 100 100 80 20 100
-
121 MICONAZOLE 2 % KRIM TUBE 3,300.00 - - - -
-
122 NATRIUM DIKLOFENAK 50 MG TAB 201.00 400 400 350 50 400
-
123 NATRIUM KLORIDA 0,9% INFUS 500 ML BTL 5,390.00 - - - -
-
124 NIFEDIPINE 10 MG TAB 115.00 200 200 20 180 - ED
- -
125 NISTATIN 500.000 IU TAB 704.00 - - - -
- -
126 NISTATIN VAGINAL 100.000 IU SUPP 448.00 - - - - 50
- -
127 OAT KAT. ANAK PAKET 236,398.00 - - - -
- -
128 OAT KAT.1 PAKET 395,900.00 - - - -
- -
129 OAT KAT.2 PAKET 1,318,400.00 - - - -
- -
130 OAT SISIPAN DEWASA PAKET 175,899.00 - - - -
-
131 OBAT BATUK HITAM ( O B H ) SYRUP BTL 1,339.80 - - - - 10
- -
132 OFLOXACIN 200 MG KAPS 519.00 - - - -
-
133 OKSITETRASIKLIN HCL 1% SALEP MATA TUBE 1,640.00 - - - - 10
- -
134 OKSITETRASIKLIN HCL 3% SALEP KULIT TUBE 1,646.00 - - - -
- -
135 OKSITOSIN INJEKSI AMP 2,000.00 10 10 5 5 ED
-
136 OMEPRAZOLE 20 MG KAPS 265.00 - - - -
- -
137 PAPAVERIN 40 MG TAB 125.00 - - - -
-
138 PARACETAMOL 100 MG TAB 34.51 - - - -
-
139 PARACETAMOL 500 MG TAB 84.80 500 500 450 50 500
- -
140 PARACETAMOL DROPS BTL 5,749.00 - - - -
- -
141 PARACETAMOL SYRUP 120 MG/ 5 ML BTL 1,403.60 10 10 4 6 10
-
142 PIRANTEL 125 MG KAPLET 343.00 100 100 30 70 100
- -
143 PIRANTEL SYRUP BTL 9,096.00 - - - -
-
144 PIROXICAM 10 MG KAPS 72.47 - - - -
-
145 POVIDONE 1ODIDA 10 % 30 ML BTL 2,050.00 - - - - 10
-
146 POVIDONE 1ODIDA 10 % 60 ML BTL 3,588.00 - - - -
-
147 POVIDONE 1ODIDA 10 % 300 ML BTL 14,350.00 - - - -
- -
148 PREDNISONE 5 MG TAB 57.00 100 100 40 60 100
- -
149 PRIMAKUIN 15 MG TAB 125.00 - - - -
- -
150 PROCAIN PENICILLIN G 1,3 JUTA iu VIAL 6,780.00 - - - -
- -
151 PROPANOLOL 10 MG TAB 85.00 - - - -
-
152 PROPANOLOL 40 MG TAB 119.00 - - - -
 -
153 PROPILTIOURASIL TABLET 100 MG TAB 297.00 - - - -
- -
154 RANITIDINE 150 MG TAB 119.00 200 200 160 40 200
- -
155 RANITIDINE INJ 25 MG / 2ML AMP 1,157.00 - - - -
-
156 RESERPIN 0,25 MG TAB 114.00 - - - -
-
157 RINGER LAKTAT INFUS 500 ML BTL 5,720.00 10 10 4 6
- -
158 SALBUTAMOL 2 MG TAB 69.00 200 200 40 160
-
159 SALEP 2 - 4 KOMBINASI TUBE 1,980.00 - - - -
-
160 SALISIL BEDAK 2% KOTAK 1,180.00 - - - -
-
161 SEFTRIAKSON INJEKSI 1GR VIAL 2,578.00 - - - -
- -
162 SIANOKOBALAMIN ( VIT. B12 ) INJEKSI AMP 1,067.00 - - - -
-
163 SIMVASTATIN TABLET 10 MG TAB 180.00 200 200 50 150 200 ED
-
164 SIPROFLOKSASIN 500 MG KAPS 241.00 100 100 40 60 100
- -
165 STREPTOMYCIN INJEKSI VIAL 4,035.00 - - - -
-
166 TETRASIKLIN HCL 250 MG KAPSUL KAPS 144.00 - - - -
-
167 TETRASIKLIN HCL 500 MG KAPSUL KAPS 226.00 - - - -
- -
168 THIAMFENIKOL 500 MG KAP 440.00 - - - -
-
169 THIAMIN HCL ( VIT. B1 ) INJEKSI AMP 750.00 - - - -
-
170 THIAMIN HCL MONONITRAT 50 MG TAB 83.00 200 200 200 - 200
- -
171 TRAMADOL INJ 50 MG / ML AMP 6,200.00 - - - -
-
172 TRAMADOL TABLET 50 MG TAB 196.35 - - - -
-
173 VITAMIN A 100.000 IU KAPS 248.00 - - - -
-
174 VITAMIN A 200.000 IU KAPS 402.00 - - - -
-
175 VITAMIN B 12 TAB 14.00 200 200 200 - 200
-
176 ZINC 20 MG TAB 503.00 200 200 40 160
OBAT NON E-KATALOG
177 AMPISILLIN 500 MG TAB 419.10 - - - -
178 AMPISILLIN SYRUP KERING BTL 4,840.00 - - -
179 ANTI HEMOROID DOEN KOMBINASI SUPP 2,200.00 - - - - - 100
180 ASAM ASKORBAT 250 MG TAB 1,397.11 - 200 200 200 - 200
181 ASAM ASKORBAT 50 MG TAB 35.20 - 200 200 150 50 200
182 ATTAPULGIT 650MG TAB 400.00 - - - -
183 ATROPIN SULFAT 0,5 % TETES MATA BTL 3,328.00 - - -
184 DIAZEPAM REKTAL (STESOLID RECTAL 5 MG/ML) SUPP 25,000.00 - - - -
185 ULSIDEX TAB 56.39 - 200 200 180 20 - 200
186 ETANOL 70 % 1000 ML BTL 28,426.20 - - - -
187 ETANOL 70 % 100 ML TAB 51.15 - - - -
188 FORMALIN CAIR LITER 19,250.00 - - - -
189 GAMEKSAN EMULSI 1% BTL 2,420.00 - - -
190 GLISERIL GUAIKOLAT 100 MG TAB 30.69 - - - - -
191 HIDROKLOROTHIAZID ( HCT ) 25 MG TAB 39.93 - - - -
192 KALSIUM LAKTAT ( KALK ) 500 MG TAB 57.20 - 300 300 300 - - 300
193 KETAMIN 10 MG / ML INJEKSI VIAL 12,122.00 - - - -
194 KLORAMFENIKOL 0,5% TETES MATA BTL 2,750.00 - - - -
195 KLOROQUIN FOSFAT 150 MG TAB 93.50 - - - -
196 KUININ ( KINA ) 200 MG TAB 641.67 - - - -
197 LISOL BTL 60,500.00 - - - - -
198 METILERGOMETRIN MALEAT 0,125 MG TAB 133.10 - - - -
199 METILERGOMETRIN MALEAT INJEKSI AMP 1,639.00 - - - -
200 NATRIUM BIKARBONAT 500 MG TAB 15.73 - - - -
201 NEOMISIN SALEP TUBE 20,000.00 - - - -
202 OKSITETRASIKLIN INJ 50 MG / ML-10 ML VIAL 3,410.00 - - - -
203 PIRIDOKSIN HCL ( VIT.B6 ) 10 MG TAB 19.14 - 200 200 100 100 - 200
204 SCABISID KRIM 10GRAM TUBE 9,359.00 - - - -
205 TETRACAIN 0,5% TETES MATA BTL 3,736.00 - - -
206 VITAMIN B KOMPLEKS TAB 24.42 - 200 200 200 - 200
207 RAMAbion TAB/siobion KAPS 427.00 - - - -
208 FERRO SULFAT 300 MG TAB 28.86 - 300 300 200 100 - 300
209 HUFABIONIC KAPS 470.80 - - - -
210 NUTRIVITA SYRUP/caviplex BTL 10,850.00 - - - - -
211 DULCOLAX TAB 21,710.00 5 - - 5 - 5 ED
212 ABATE gram 162.80 - - - -
213 ACT (ARSUAMON) TAB 1,512.50 - - - -
214 FLUTAMOL SYRUP BTL 13,860.00 - - - -
215 PEHAVRAL /SUPRABION KAPS 884.80 - - - -
216 HEMAFORT KAPS 907.50 - - - -
217 RAMAbion TAB TAB 900.00 - - - -
218 ARCAVIT C TAB 499.00 - - - -
219 PULAREX/NEW ANTIDES TAB 499.00 - 100 100 40 60
220 BIOLYSIN DRAGEE/gralisyn TAB 470.80 - - -
221 BIOVITAN SYRUP BTL 10,850.00 - - -
222 vidabion sy. - - -
223 vitabiol sy./bionix BTL - - -
OBAT GIGI :
224 ETIL KLORIDA SPRAY BTL 115,500.00 - - 1
225 EUGINOL CAIRAN BTL 3,492.25 - -
226 GLASS IONOMER CEMENT ART PAKET 434,500.00 - -
ALKES DAN BHP
227 ALAT SUNTIK SEKALI PAKAI 0,5 ML (IMUNISASI) SET 3,630.00 -
228 ALAT SUNTIK SEKALI PAKAI 1 ML (TUBERKULIN) SET 870.10 -
229 ALAT SUNTIK SEKALI PAKAI 1 ML SET 1,190.00 - 30 30 30 -
230 ALAT SUNTIK SEKALI PAKAI 3 ML SET 1,128.94 - 100 100 100 - 100
231 ALAT SUNTIK SEKALI PAKAI 5 ML SET 817.88 - 30 30 30 -
232 CATETER INFUS NO. 16 SET 7,620.00 - -
233 CATETER INFUS NO. 18 SET 7,620.00 - 50 50 5 45 -
234 CATETER INFUS NO. 20 SET 7,620.00 - -
235 CATETER INFUS NO. 22 SET 8,566.24 - -
236 CATETER INFUS NO. 24 SET 8,566.24 - -
237 CATGUT/BENANG BEDAH NO.2/0 SET 29,333.33 - -
238 CATGUT plain/BENANG BEDAH NO.3/0 SET 27,041.67 - 10 10 9 -
239 TRANFUSI SET SET 4,400.00 - 10 10 10 -
240 INFUSION SET DEWASA SET 3,850.00 - 10 10 10 -
241 KAPAS BERLEMAK 500 GRAM ROL 15,180.00 - -
242 KAPAS PEMBALUT / ADSOEBEN 250 GRAM ROL 8,250.00 - -
243 KASSA KOMPRES 40 / 40 STERIL ROL 1,400.00 - 10 10 2 8 -
244 KASSA PEMBALUT 2 M X 80 CM ROL 7,999.00 - -
245 KASSA PEMBALUT HIDROFIL 4 M X 3 CM ROL 666.00 - -
246 KASSA PEMBALUT HIDROFIL 4 M X 15 CM ROL 3,710.30 - -
247 MASKER/ SARUNG TANGAN STERIL PCS 495.00 - 10 10 5 5 - 5
248 UNDERPAD ROL 6,678.00 - 10 10 5 5 - 5
249 PISAU BEDAH STERIL NO 11 PCS 1,538.98 - -
250 PLESTER 5 YARDS X 2 INCH ROL 25,987.00 - - -
251 SARUNG TANGAN NON STERIL M PASANG 1,362.00 - 1 BOX 1 BOX 1 BOX - 1BOX
252 SILK BLACK NO. 3/0 DENGAN JARUM SET 6,318.00 - 5 5 1 4 -
253 SEMILAS UK 9 X 10 PCS 2,359.50 - 5 5 - 5 -
254 URINE BAG PCS 2,359.50 - 10 10 - 10 -
255 KATETER UK 16 PCS 2,359.50 - 10 10 - 10 -
256 KAPAS 250GR PCS 2,359.50 - 1 1 1 - 1
REAGENSIA
257 ZIEHL NIELSEN PAKET 271,645.00 - - - - -
258 GIEMSA BTL 422,290.00 - - - - -
259 LARUTAN EDTA 10% 500ML BTL 500ML 672,430.00 - - - - -
260 LARUTAN EOSIN 2% BTL 500ML 1,634,737.00 - - - - -
261 LARUTAN HAAYEM BTL 500ML 176,000.00 - - - - -
262 LARUTAN REESECKER BTL 500ML 394,212.00 - - - - -
263 LARUTAN TURK BTL 500ML 132,962.00 - - - - -
264 REAGEN GOLONGAN DARAH KIT 4 VIAL@10ML 521,000.00 - - - - -
265 REGEN HCL 0,1N (hb SAHLI) BTL 500ML 68,114.00 - - - - -
266 REAGEN WIDAL KIT 8 VIAL@5ML 1,100,000.00 - - - - -
267 LARUTAN OBAT UNTUK FOGGING LITER 247,500.00 - - - - -
SERUM
268 ABU I VIAL 240,449.00 - - - - -
269 ATS 20.000 VIAL 357,005.00 - - - - -
OBAT PROGRAM
MALARIA

270 Arthemeter Injeksi 1 ml : 80 mg AMP - - - - -

271 Artesunate Injeksi, vial 60 mg VIAL 24,843.75 - - - - -
272 Primakuin Tablet 15 mg TAB 109.00 - - - - -
273 Kina Tablet 200 mg TAB 583.33 - - - - -
274 Kina Injeksi 25% - 2 ml AMP 4,226.67 - - - - -
275 Doksisiklin 100 mg TAB 253.00 - - - - -
276 DHP* (Dehidro Artemisin + Piperaquin) TAB 3,611.11 - - - - -
277 Artemisin 250 mg +Naphtoquine 100 mg TAB 32,670.00 - - - - -
278 Artesunate Amodiaquin TAB - - - - -
FILARIASIS

279 DEC 100 mg (tablet) TAB 97.50 - - - - -

280 Paracetamol 500 mg (tablet) TAB 105.00 - - - - -
281 Albendazol tablet 400 mg TAB 403.33 - - - - -
282 Gentamisin salep kulit 0,1% TUBE 4,590.00 - - - - -
PENGENDALIAN PENYAKIT MENULAR (P2M)
1. DIARE

283 Garam oralit untuk 200 ml air SACHET 380.00 - - - - -

284 Zinc* Tab 20 mg TAB 475.00 - - - - -
2. KUSTA

285 Prednison tablet 5 mg TAB 62.50 - - - - -

286 Rifampisin tablet 300 mg TAB - - - - -
287 Rifampisin tablet 450 mg TAB - - - - -
288 Rifampisin tablet 600 mg TAB - - - - -
3. FRAMBUSIA

289 Benzatin Benzil Penisilin inj 1,2 juta IU/vial VIAL - - - - -

290 Adrenalin Injeksi AMP - - - - -
291 Aquades 20 cc VIAL - - - - -
292 Disposible syringe 5 ml SET - - - - -
TB PARU (OAT FDC)

293 Obat Anti Tuberculosis kategori 1 PKT 360,000.00 - - - - -

294 Obat Anti Tuberculosis kategori 2 PKT 1,200,000.00 - - - - -
295 Obat Anti Tuberculosis sisipan PKT 160,000.00 - - - - -
296 Obat Anti Tuberculosis anak PKT 215,000.00 - - - - -
297 OAT Kombipak - - - - -
298 Kategori 1 PKT 288,200.00 - - - - -
FLU BURUNG
299 Oseltamivir TAB - - - - -
KESEHATAN ANAK

300 Fitomenadion (Vit.K) injeksi 10 mg AMP 1,740.00 - - - - -

301 Natrium Tiroksin (tab) TAB 1,530.00 - - - - -
302 Ampisilin Serbuk Injeksi i.m/i.v. 1000 mg/ml VIAL 5,904.80 - - - - -
 303 Gentamisin Injeksi 40 mg/ml AMP 3,696.00 - - - - -
304 Prokain Benzil Penicillin G Injeksi 3 jt IU/vial VIAL 6,016.67 - - - - -
305 Fenobarbital Injeksi i.m/i.v 50 mg/ml AMP 1,560.00 - - - - -
306 Diazepam Injeksi 5 mg/ml AMP 14,208.60 - - - - -
307 Oxytetrasiklin Salep Mata 1% (HCl) TUBE 2,100.00 - - - - -
KESEHATAN IBU

308 Metil Ergometrin Maleat 0,200 mg TAB 1,354.53 - - - - -

309 Magnesium Sulfat 40 % VIAL 3,000.00 - - - - -
310 Glukonas Kalsikus 10 % AMP 7,400.25 - - - - -
311 Gentamisin Injeksi 80 mg/2 ml AMP 5,363.40 - - - - -
312 Oksitosin Injeksi AMP - - - - -
GIZI
Retinol (Vitamin A) 100.000 IU Kapsul Lunak - - - - -
313 TAB
Bayi (6-11 bln) - - -
Retinol (Vitamin A) 200.000 IU Kapsul Lunak - - - - -
314 TAB
Balita (11-59 bln) - - -
Retinol (Vitamin A) 200.000 IU Kapsul Lunak - - - - -
315 TAB
Ibu Nifas - - -
316 Tablet Tambah Darah TAB - - - - -
317 Mineral Mix SACHET - - - -

UMUM
jmlh JKN JAMKES ASKES JUMLAH
knjgn BAYAR TIDAK BAYAR DA

Yang Menyerahkan : Yang Menerima :

Petugas Gudang Farmasi Petugas Pengelola Obat
Puskesmas Sungai Duri Polindes Sungai Pangkalan 1

Aryani,A.Md.Far DIAN PURNAMA SARI, AMd.Keb

NIP.19850418 200803 2 001
 Mengetahui :
Kepala Dinas Kesehatan Yang Menerima / Melapor :
a.n Kabid Yankes Kepala Puskesmas
u.b Kasie Farmasi -------

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