Laporan Tahunan LPLPO 2020 [PDF]

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) Kode Puskesmas Puskesmas Kecamatan Kabupaten Provinsi



No 1 1 3 5 6 7 8 9 11 16 17 18 19 20 21 23 24 29 30 34 35 36 37



: 3517603 : Blimbing Kesamben : Kesamben : Jombang : Jawa Timur



Nama Obat & Perbekalan Kesehatan 2



Bulan Jan - Des Tahun : 2019



Kelas Satuan terapi 3



OBAT Albendazol tablet 400 mg tablet Alopurinol tablet 100 mg tablet Aminofilin tablet 200 mg tablet Aminofilina injeksi 24 mg/ml - 10 ml ampul Amitriptilin HCl tablet salut 25 mg tablet Amlodipin tablet 5 mg tablet Amoksisilin kaplet 500 mg kaplet Amoksisilin sirup kering 125 mg/5ml botol Antasida DOEN suspensi botol Antasida DOEN tab,kombinasi:Mg-Hidroksida 200mg+tablet Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU tube Anti Hemoroid DOEN Kombinasi supp Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam pot Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tablet Aqua pro Injeksi steril 25 ml, bebas pirogen vial Aquadest steril 500 ml botol Asam Askorbat (Vit C) tablet 50 mg tablet Asam Mefenamat tablet salut selaput 500 mg tablet Asam Asetilsalisilat (Asetosal) 80 mg tablet Asiklovir krim 5% tube Asiklovir tablet 400 mg tablet Atapulgit tablet 600 mg tablet Atropin injeksi im/iv/sk 0,25 mg/ml - 1 ml ( Sulfat ) vial



4 6.1.1 1 26 26 23 6 6 25 25 18 25 18 7 20 30 29



25



Stok Awal 5



Peneri Persedi Pemak Pemakaia maan aan aian n Rata2 6



7



0 5,790 5,790 5,670 2,178 4,600 6,778 3,613 0 1,000 1,000 115 29 5 34 29 780 900 1,680 830 1,494 900 2,394 2,014 0 42,000 42,000 19,806 0 0 0 0 300 300 155 3,370 12,300 15,670 10,557 0 0 0 50 0 50 26 22 48 70 35 0 0 0 236 120 356 65 6 6 2 7,825 8,000 15,825 10,773 3,848 38,800 42,648 28,178 0 100 100 0 0 0 0 438 200 638 354 396 2,800 3,196 1,947 7 7 0



8



Pemberian



Sisa Stok



Stok Opt



Permin taan



I



9



10



11



12



2,835 120 8,505 301 3,165 903 19 885 -455 0 5 -5 69 850 -593 168 380 54 2,201 22,194 -9,398 0 0 0 39 145 66 880 5,113 1,939 0 0 0 2 24 -14 3 35 6 0 0 0 5 291 -284 0 4 -4 898 5,052 -907 2,348 14,470 1,045 0 100 -100 0 0 0 30 284 -112 162 1,249 87 0 7 -2



Askes APBD Lain2 13



14



15



Jumlah 16



KET



ED



28



100 2,000 885 29



3,000



100 3,500



24 100



1,000 7,000



500



25 tablet tablet tube Bisacodyl suppositoria 10 mg dewasa suppo Bisacodyl supposituria anak suppo Bisacodyl tab. 5 mg ampul 3 Deksametason injeksi iv. 5 mg/ml - 1 ml ampul 16 Deksametason tablet 0,5 mg tablet 11 Dekstran 70 - larutan infus 6% steril botol 5 Diazepam lar rektal 10mg/ 2,5 ml (Stesolid) tube 5 Diazepam tablet 2 mg tablet 5 Diazepam tablet 5 mg tablet Dietilkarbamazin Sitrat ta.100 mg tablet 6.1.2 3 Difenhidramin inj im.10 mg/ml-1 ml ( HCl ) ampul 18 Digoksin tablet 0,25 mg tablet Dimenhidrinat tablet 50 mg tablet Domperidon tablet 10 mg tablet 3 Epinefrina ( Adrenalina ) Injeksi 0,1% - 1 ml ( HCl ) ampul Erytromycin kapsul 500 mg tablet Erytromycin kapsul 250 mg tablet Erytromycin sirup 200 mg/5 ml botol Etakridin ( Rivanol ) larutan 0,1% botol 6.2.4 Etanol 70% botol 6.2.4 5 Fenitoin Natrium kapsul 100 mg kapsul Fenol Gliserol tetes telinga 10% 10 Fitomenadion (Vit.K1) injeksi 2 mg/ml - 1 ml ampul 10 Fitomenadion (Vit.K1) tablet salut gula 10 mg tablet 14 Furosemid tablet 40 mg tablet 20 Garam Oralit untuk 200 ml air sak 16.1.1 Glibenklamid tablet 5 mg tablet Glimepirid tab 1 mg tablet Grisiofulvin 125 mg Mikronize tablet 20 Glukosa larutan infus 5 % botol Haldol Decanoat 50 mg/ml inj ampul 23 Haloperidol 5mg/ml inj ampul 23 Haloperidol tablet 0,5 mg tablet 23 Haloperidol tablet 1,5 mg tablet 23 Haloperidol tablet 5 mg tablet



38 Atropin Sulfat tablet 0,5 mg 39 Bekarbon tablet 42 Betametason krim 0,5 mg/g 43 44 45 48 49 50 54 55 56 57 58 59 60 61 64 65 66 67 68 69 71 77 78 81 83 88



91 93 94 95 96 97



0 0 0 0 0 0 70 150 220 178 0 0 0 0 0 0 0 100 100 0 10 30 40 0 9,286 11,000 20,286 13,689 0 0 0 0 0 0 100 1,400 1,500 1,500 0 0 0 0 0 0 22 30 52 22 599 310 909 620 657 2,300 2,957 1,987 249 1,800 2,049 1,045 19 6 25 6 1,309 9,500 10,809 3,413 0 0 0 0 0 0 0 0 0 667 300 967 967 1,400 1,400 0 0 0 0 0 60 60 60 177 100 277 138 325 1,000 1,325 462 793 4,200 4,993 3,509 1,024 7,600 8,624 4,935 0 500 500 200 0 2,000 2,000 160 6 0 6 6 40 80 120 100 0 0 0 0 384 5,100 5,484 3,934 0 0 0 1,500 7,400 8,900 6,165



0 0 15 0 0 0 0 1,141 0 0 150 0 0 0 35 166 87 1 379 0 0 0 17 0 0 7 12 46 170 449 0 0 0 14 0 328 0 514



0 0 0 0 42 -6 0 0 0 0 100 -100 40 -32 6,597 1,922 3,000 0 0 0 0 0 450 0 0 0 0 30 -29 289 -295 970 97 500 1,004 -39 300 19 -5 7,396 -562 10,000 0 0 0 0 0 0 0 50 1,400 -1,400 0 0 0 20 139 -66 863 -261 1,484 -790 3,689 1,346 3,000 300 0 1,840 -1,500 0 -6 20 23 30 0 0 1,550 984 1,500 0 0 2,735 541 1,000



19 200



768



1640



6



98 Hidrogen Peroksida cairan 3% 100 Hidrokortison krim 2,5 % 104 Isosorbid Dinitrat tablet sublingual 5 mg 105 106 107 108 110 112 114 115 116 119 122 124 128 129 134 135



138 140 141 142 145 146 147



150 151 152 153 154 159



Kalium Permanganat serbuk Kalsium Glukonat inj 100mg/ml / Ca Gluconas Kalsium Laktat (Kalk) tablet 500 mg Kaptopril tablet 25 mg Karbamazepin tablet 200 mg Karbogliserin tts telinga 10% Ketokonazol tablet 200 mg Ketoprofen supp Kloramfenikol kapsul 250 mg Kloramfenikol salep mata 1 % Kloramfenikol suspensi 125 mg/5 ml Kloramfenikol salep kulit Klorfeniramin Maleat (CTM) tablet 4 mg Klorpromazin HCl tablet salut 100 mg(HCl) Kodein tablet 10 mg Kotrimoksazol Suspensi komb: Sulfametoksazol 200 Loratadin tablet 10 mg Kotrimoksazol tablet kombinasi: Sulfametoksazol 4 Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + Lisol, mengandung Kresol tersabun 50% Magnesium Sulfat injeksi (iv) 40 % - 25 ml Metformin HCl tablet 500 mg Metilergometrin Maleat (Metilergometrin) tablet sa Metilergometrin Maleat inj 0,200 mg-1 ml Metronidazol tablet 250 mg Metronidazol tablet 500 mg Mikonazol cream Mineral mix N- Asetilsistein Natrium Diklofenak tablet 50 mg Natrium Klorida larutan infus 0,9 % steril Nifedipin tablet 10 mg Nistatin tablet salut 500.000 IU/g Nistatin tablet vaginal 100.000 IU/g Oksitosin injeksi 10 IU/ml - 1 ml



botol tube tablet botol botol tablet tablet tablet botol ampul supp kapsul tube botol tablet tablet tablet botol tablet tablet ampul botol ampul tablet tablet ampul tablet tablet tube tablet tablet botol tablet tablet tablet ampul



18 17 13 29



6.2.2 21



3 25 26 6.2.2 6.2.2 14 13 5 22 22 6.2.2 6.2.2



20



6 22



0 0 0 46 120 166 118 0 300 300 0 8 8 0 7 7 0 3,545 16,400 19,945 16,359 2,062 3,200 5,262 4,385 1,210 3,700 4,910 3,575 0 24 24 5 300 300 43 10 10 2 1,000 1,000 1,000 60 144 204 178 50 550 600 398 96 96 11 6,547 23,900 30,447 20,647 2,099 2,900 4,999 2,104 190 300 490 190 92 92 92 100 100 0 6,830 6,830 6,830 286 286 121 0 0 0 7 7 3 2,942 5,500 8,442 4,712 300 200 500 300 30 30 30 0 0 0 142 142 142 73 120 193 113 14,400 14,400 14,400 0 14,000 14,000 2,401 0 5,800 5,800 2,679 18 18 6 1,873 1,873 1,873 0 0 0 73 73 18 0 40 40 40



0 0 0 10 48 30 0 300 0 0 8 -8 0 7 -5 1,363 3,586 3,090 365 877 696 260 1,335 279 0 19 0 4 257 11 0 8 -8 83 0 250 15 26 24 33 202 25 2 85 -43 1,721 9,800 962 160 2,895 -2,421 16 300 -53 46 0 138 0 100 -100 231 0 693 10 165 -120 0 0 0 0 4 -2 258 3,730 -227 18 200 -145 3 0 -18 0 0 0 36 0 107 19 80 22 0 0 0 200 11,599 -4,400 447 3,121 390 1 12 -11 375 0 1,124 0 0 0 2 55 5 1 0 3



6 48 100



2,000 1,000



460



3,000 100 5,000 187 200



5445



1,500



1620 100



0 1,000 57 0 5,000 1,000



30



161 Omeprazol kapsul 20 mg 162 Parasetamol sirup 120 mg/5 ml 164 Parasetamol tablet 500 mg 168 169 172 173 175 179 181 182 183 185 187 188 190 191 198 199 204 205 209 210 211 213



214 215 216 220 221 222 225 226 227 229 230



kapsul botol tablet Piridoksin (Vit.B6) tablet 10 mg ( HCl ) tablet Piroksikam tablet 20 mg tablet Povidon Iodida 10 %, 300 ml botol Prednison tablet 5 mg tablet Propanolol tablet 10 mg (HCl) tablet Ranitidin tablet 150 mg tablet Ringer Laktat larutan infus steril botol Risperidon 2 mg tablet Salbutamol 2,5 mg respulles (Komb Ipratropium B ampul Salbutamol tablet 2 mg ( sebagai sulfat ) tablet Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang pot Salisil Bedak 2 % kotak Sefadroksil kapsul 500 mg kapsul Sefadroksil sirup kering 125 mg/ 5 ml botol Simvastatin tablet 10 mg tablet Siprofloksasin tablet 500 mg (sebagai HCl) tablet Tiamfenikol kapsul 500 mg kapsul Tiamin (Viamin B1) tablet 50 mg (HCl / Mononitrat ) tablet Trifluoperazine tablet 5 mg tablet Triheksifenidil Hidroklorida tablet 2 mg tablet Vitamin B Kompleks tablet tablet Zinc tablet 20 mg tablet PERBEKALAN KESEHATAN Alat suntik sekali pakai 1 ml set Alat suntik sekali pakai 2,5 ml/3 ml set Alat suntik sekali pakai 5 ml set Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum biji Catgut / Benang Bedah No. 3/0 plain biji Catgut / Benang Bedah No. 3/0 chromic biji Hansaplast biji Hands shoen non steril No. 7 biji Hands shoen steril No. 7 pasang Infusion set dewasa set IV Catether No. 18 set



1 1 29



16 7 20 26 26 18 19



29 9 29



32 32 32 32 32



0 309 13,470 4,396 0 15 795 763 0 10 220 49 614 36 3 0 0 1,905 0 1,960 4,665 0 1,150 3,127 400



600 950 38,500 21,200



300 0 170 0 0 0 0 0 0 4 0



700



3 7,500 200 20 80 1,300 216



8,400



16,200 8,100 29,000 200



600 1,259



0 18 8,295 963 0 30 220 129 1,914 252 3 0 0 10,305 0 1,960 20,865 0 9,250 32,127 600



178 1,041 36,928 19,333 0 5 5,506 351 0 18 220 89 1,281 161 3 0 0 2,887 0 1,960 20,865 0 9,250 27,070 350



1,000 0 170 0 0 0 0 0 0 4 0



1,000 0 5 0 0 0 0 0 0 4 0



51,970 25,596



178 422 234 87 218 260 320 3,077 15,042 4,532 10,000 1,611 6,263 1,833 5,000 0 0 0 0 13 -13 459 2,789 -324 29 612 -112 100 0 0 0 2 12 -8 220 0 660 5,000 8 40 -16 40 107 633 120 300 13 91 -17 2 0 5 0 0 0 7,000 0 0 0 50 241 7,418 -2,698 1,000 0 0 0 5,000 653 0 1,960 5,000 1,739 0 5,216 7,000 0 0 0 5,000 771 0 2,313 5,000 2,256 5,057 6,368 7,000 29 250 -113 0 0 83 0 150 500 0 0 0 1,000 0 165 -169 0 0 0 10 0 0 0 10 0 0 0 10 0 0 0 0 0 0 0 500 0 0 0 0 0 0 1 10 0 0 0 10



231 IV Catether No. 20 232 IV Catether No. 22 234 Jarum jahit bedah No. 9 s/d 14 236 238 242 243 244 247 250 251



set set biji Kapas Pembalut / Absorben 250 gram bungkus Kasa Pembalut 2 m x 80 cm biji Kasa Pembalut Hidrofil 4 m x 3 cm hidrofil/elastic rol Kasa Pembalut Hidrofil 4 m x 15 cm hidrofil/elastic rol Kasa Steril 16 x 16 cm rol Masker biji Plester 5 yards x 2 inch roll Silk (Benang Bedah Sutera) No. 3/0 dengan jarum b biji



REAGEN LABORATORIUM 284 Reagen RPR Syphilis/Titer (Plasmatec/RPR tes kit, R 285 Rapid Syphilis/ Standar Diagnostic (Alere) Bioline Reagen HBSAg (Fokus) Human Hexagon Syphilis Reagen HIV R1 (Standart Diagnostic) Iodina Test



286 287 288 289 290 291 292 293 294 295 296 297 298



OBAT GIGI Dentorit Etil Klorida spray Eugenol cairan Fluor tablet 0,5 mg Glass Ionomer Cement ART Kalsium Hidroksida Pasta Monochlorkamfer mentol ( CHKM ) Mummifying Pasta Povidon Iodine obat kumur Semen Seng Fosfat serbuk dan cairan Silver Amalgam serbuk 65 - 75 % Temporary Stopping Fletcher (Fletcher) serbuk dan Tri Kresol Formalin



0 0 0 4 0 80 0 531 0 0 0



set



30 480



200 0 500 200 500 16



botol botol botol tablet set set botol botol botol botol botol botol botol



14 14 14 14 14 14 14



0 0 4 0 0 0 4 0 0 0 0 0 0



3 4 3



0 0 0 4 0 110 0 1,011 0 0 0



0 0 0 4 0 80 0 435 0 0 0



0 0 0 1 0 7 0 36 0 0 0



0 0 0 0 0 30 0 576 0 0 0



0 0 0 2 0 10 0 -291 0 0 0



10 0 1 10 10 30 30 160 150 6 10



200 0 500 200 500



0 0 200 100 200 -16



0 0 29 14 25 0



200 0 300 100 300 16



-200 0 -14 -57 75 0



0 500 500 500 10



0 0 7 0 4 0 7 0 0 0 0 0 0



0 0 6 0 1 0 7 0 0 0 0 0 0



0 0 1 0 0 0 2 0 0 0 0 0 0



0 0 1 0 3 0 0 0 0 0 0 0 0



0 0 1 0 0 0 5 0 0 0 0 0 0



2 6



2,050



2,050



171



0



513



513



0 5 2 2 6 1 1 1 1



OBAT PROGRAM Gizi : 300 Retinol Kapsul ( Vitamin A ) 100.000 IU



kapsul



0



2,050



301 Retinol kapsul ( Vitamin A ) 200.000 IU 302 Tablet Tambah Darah ( TTD )



kapsul tablet



0 3,450 3,450 3,450 ### 11,200 130,065 130,065



Anti Lepra : 304 305 306 307



MB Anak MB Dewasa PB Anak PB Dewasa



blister blister blister blister



0 3 0 0



tablet tablet paket paket



0 0 5 0



42



0 45 0 0



0 33 0 0



0 0 33 3



0 0 27 3



Anti TBC : 316 Ethambutol tablet 400 mg 317 Ethambutol tablet 500 mg 318 FDC KIT I / III 319 FDC kit II



28 3



UMUM JUMLAH KUNJUNGAN RESEP



BAYAR GRATIS



JKN PBI



NON PBI



JAMKE SDA



288 10,839 0 0 17 0 0 0 0 0 5 1 0



jumlah



0 863 0 32,516



863 32,516



0 12 0 0



0 50 0 0



0 12 0 0



0 0 6 0



0 0 13 3



0 0 16



R/



Jombang, 26 Desember 2019 Mengetahui Kepala Puskesmas Blimbing Kesamben



Pengelola Obat Puskesmas Blimbing Kes



MUCHTAR EFFENDY



MUSABBIHAH



NIP. 197103132000031004



NIP. 19650510 198603 2 026



KOSONG



10 0 6 7 0 0 3 12 8 0 12 0 1 12 0 0 0 0 12 8 0 0 0



12 12 0 12 12 8 0 0 12 12 2 12 12 1 0 0 0 0 3 12 12 12 0 10 12 3 0 2 1 1 12 12 2 5 12 0 12 0



12 0 12 0 0 0 0 0 12 0 0 0 0 0 6 0 0 0 10 12 6 0 12 0 0 1 0 12 8 6 12 6 0 7 12 0 1



11 0 0 0 12 0 0 0 12 0 11 1 0 0 10 12 12 0 12 9 0 12 0 0 0



0 12 0



0



5 0 0 12 0



8 5 5 4 12



0 7 8



0



10



7 9



LAPORAN PEMAKAIAN DAN LEMBAR PERMINT (LPLPO) Kode Puskesmas Puskesmas Kecamatan Kabupaten Provinsi



No 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33



: 3517603 : Blimbing Kesamben : Kesamben : Jombang : Jawa Timur



Nama Obat & Perbekalan Kesehatan 2



Satuan



Kelas terapi



Stok Awal



3



4



5



OBAT Albendazol tablet 400 mg tablet Alopurinol tablet 100 mg tablet Aminofilin tablet 200 mg tablet Aminofilina injeksi 24 mg/ml - 10 ml ampul Amitriptilin HCl tablet salut 25 mg tablet Amlodipin tablet 5 mg tablet Amoksisilin kaplet 500 mg kaplet Amoksisilin sirup kering 125 mg/5ml botol Antasida DOEN suspensi botol Antasida DOEN tab,kombinasi:Mg-Hidroksida 200mg+tablet Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU tube Anti Hemoroid DOEN Kombinasi supp Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam pot Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tablet Aqua pro Injeksi steril 25 ml, bebas pirogen vial Aquadest steril 500 ml botol Asam Askorbat (Vit C) tablet 50 mg tablet Asam Mefenamat tablet salut selaput 500 mg tablet Asam Asetilsalisilat (Asetosal) 80 mg tablet N- Asetilsistein tablet Asiklovir krim 5% tube Asiklovir tablet 400 mg tablet Atapulgit tablet 600 mg tablet Atropin injeksi im/iv/sk 0,25 mg/ml - 1 ml ( Sulfat ) vial Atropin Sulfat tablet 0,5 mg tablet Bekarbon tablet tablet Betametason krim 0,5 mg/g tube Bisacodyl suppositoria 10 mg dewasa suppo Bisacodyl supposituria anak suppo Bisacodyl tab. 5 mg ampul Captopril tablet 25 mg tablet Deksametason injeksi iv. 5 mg/ml - 1 ml ampul Deksametason tablet 0,5 mg tablet



6.1.1 1 26 26 23



120 3,165 885 5 850 380



6 6 25 25 18 25 18 7 20 30 29



22,194



0 145 5,113 0 17 35 0 291 4 5,052 14,470



100 11,599



25 25



3 16



0 284 1,249 7 0 0 42 0 100 3,586 40 6,597



Peneri Persed Pemak maan iaan aian 6



7 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



120 3,165 885 5 850 380 22,194 0



145 5,113 0 17 35 0 291 4 5,052 14,470 100



11,599 0 284 1,249 7 0 0 42 0 0 100 3,586 40 6,597



0 175 0 0 45 268 1,680 0 40 976 0 0 4 0 7 1 987 2,512 0 2,242 0 0 633 0 0 0 10 0 0 0 3,486 0 1,125



34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 76 77 78 79 80 81 82



Dekstran 70 - larutan infus 6% steril Diazepam injeksi 5 mg/ml - 2 ml Diazepam lar rektal 10mg/ 2,5 ml (Stesolid) Diazepam tablet 2 mg Diazepam tablet 5 mg Dietilkarbamazin Sitrat ta.100 mg Difenhidramin inj im.10 mg/ml-1 ml ( HCl ) Digoksin tablet 0,25 mg Dimenhidrinat tablet 50 mg Domperidon tablet 10 mg Epinefrina ( Adrenalina ) Injeksi 0,1% - 1 ml ( HCl ) Erytromycin kapsul 500 mg Erytromycin kapsul 250 mg Erytromycin sirup 200 mg/5 ml Etakridin ( Rivanol ) larutan 0,1% Etanol 70% Fenitoin Natrium kapsul 100 mg Fenol Gliserol tetes telinga 10% Fitomenadion (Vit.K1) injeksi 2 mg/ml - 1 ml Fitomenadion (Vit.K1) tablet salut gula 10 mg Furosemid tablet 40 mg Garam Oralit untuk 200 ml air Glibenklamid tablet 5 mg Glimepirid tab 1 mg Grisiofulvin 125 mg Mikronize Glukosa larutan infus 5 % Haldol Decanoat 50 mg/ml inj Haloperidol 5mg/ml inj Haloperidol tablet 0,5 mg Haloperidol tablet 1,5 mg Haloperidol tablet 5 mg Hidrogen Peroksida cairan 3% Hidrokortison krim 2,5 % Ibuprofen suspensi 100mg/ 5 ml Ibuprofen tablet 200 mg Ibuprofen tablet 400 mg Isosorbid Dinitrat tablet sublingual 5 mg Kalium Permanganat serbuk Kalsium Glukonat inj 100mg/ml / Ca Gluconas Kalsium Laktat (Kalk) tablet 500 mg Karbamazepin tablet 200 mg Karbogliserin tts telinga 10% Ketokonazol tablet 200 mg Ketoprofen supp Kloramfenikol kapsul 250 mg Kloramfenikol salep mata 1 % Kloramfenikol suspensi 125 mg/5 ml Kloramfenikol tetes mata 1 %



botol



11



tube tablet tablet tablet ampul tablet tablet tablet ampul tablet tablet botol botol botol kapsul



5 5 5 6.1.2 3 18



3



6.2.4 6.2.4 5



10 ampul 10 tablet 14 tablet 20 sak tablet 16.1.1 tablet tablet 20 botol ampul 23 ampul 23 tablet 23 tablet 23 tablet botol 18 tube 1 botol 1 tablet 1 tablet 17 tablet 13 botol botol 29 tablet tablet botol ampul supp kapsul 6.2.2 21 tube botol botol



0 0 0 0 0 0 30 289 970 1,004 19 7,396 0 0 0 0 1,400 0 0 139 863 1,484 3,689 300 1,840 0 20 0 1,550 0 2,735 0 48 0 0 0 300 8 7 3,586 1,335 19 257 8 0 26 202 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 0 0 0 0 0 0 0 0 0 0 0 0 0



0 0 0 0 0 0 30 289 970 1,004 19 7,396 0 0 0 0 1,400 0 0 139 863 1,484 3,689 300 1,840 0 20 0 1,550 0 2,735 0 48 0 0 0 300 8 7 3,586 1,335 19 257 8 0 26 202 0



0 0 0 0 0 0 0 0 249 510 0 509 0 0 0 0 0 0 0 15 91 73 464 160 282 0 20 0 460 0 455 0 3 0 0 0 0 0 0 1,369 435 8 0 0 0 26 66 ###



83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130



Kloramfenikol tetes telinga 3 % botol Kloramfenikol salep kulit Klorfeniramin Maleat (CTM) tablet 4 mg tablet Klorpromazin injeksi 25 mg/ml - 1 ml ( HCl ) ampul Klorpromazin injeksi 5 mg/ml - 1 ml ( HCl ) ampul Klorpromazin HCl tablet salut 100 mg(HCl) tablet Klorpromazin tablet salut 25 mg ( HCl ) tablet Kodein tablet 10 mg tablet Kotrimoksazol Suspensi komb: Sulfametoksazol 200 botol Loratadin tablet 10 mg tablet Kotrimoksazol tablet kombinasi: Sulfametoksazol 4 tablet Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + ampul Lisol, mengandung Kresol tersabun 50% botol Magnesium Sulfat injeksi (iv) 20 % - 25 ml ampul Metformin HCl tablet 500 mg tablet Metilergometrin Maleat (Metilergometrin) tablet sa tablet Metilergometrin Maleat inj 0,200 mg-1 ml ampul Metoklopramide tablet 10 mg tablet Metronidazol tablet 250 mg tablet Metronidazol tablet 500 mg tablet Mikonazol cream tube Mineral mix Natrium Diklofenak tablet 50 mg tablet Natrium Klorida larutan infus 0,9 % steril botol Nifedipin tablet 10 mg tablet Nistatin tablet salut 500.000 IU/g tablet Nistatin tablet vaginal 100.000 IU/g tablet Oksitosin injeksi 10 IU/ml - 1 ml ampul Omeprazol kapsul 20 mg kapsul Parasetamol sirup 120 mg/5 ml botol Parasetamol tablet 500 mg tablet Piridoksin (Vit.B6) tablet 10 mg ( HCl ) tablet Piroksikam tablet 20 mg tablet Povidon Iodida 10 %, 300 ml botol Prednison tablet 5 mg tablet Propanolol tablet 10 mg (HCl) tablet Ranitidin tablet 150 mg tablet Ringer Laktat larutan infus steril botol Risperidon 2 mg tablet Salbutamol 2,5 mg respulles (Komb Ipratropium B ampul Salbutamol tablet 2 mg ( sebagai sulfat ) tablet Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang pot Salisil Bedak 2 % kotak Sefadroksil kapsul 500 mg kapsul Sefadroksil sirup kering 125 mg/ 5 ml botol Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) vial Serum Anti Difteri 20.000 SI/vial (A.D.S.) ampul Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) ampul



3 25 25 25 25 26 6.2.2 6.2.2 14 13 5 22 22 6.2.2 6.2.2



20



6 22 1 1 29



16 7 20 26 26 18 19



0 85 9,800 0 0 2,895 0 300 0 100 0 165 0 3 3,730 200 0 0 0 0 80 0 3,121 12 0 0 55 0 422 218 15,042



6,648 0 13 2,789 612 0 12 0 40 633 91 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0



0 85



9,800 0 0 2,895 0 300 0 100 0 165 0 3 3,730 200 0 0 0 0 80 0 3,121 12 0 0 55 0 422 218 15,042 6,648



0 13 2,789 612 0 12 0 40 633 91 0 0 0 0 0 0



0 0 1,723 0 0 180 0 0 0 0 0 0 0 0 1,295 0 0 0 0 0 2 0 1,436 0 0 0 0 0 259 98 3,188 2,993 0 0 247 27 0 3 0 0 425 10 0 0 0 0 0 0



131 132 133 134 135 136 137 138 139



140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167



168 169 170 171 172 173 174



Simetidin tablet 200 mg Simvastatin tablet 10 mg Siprofloksasin tablet 500 mg (sebagai HCl) Tiamfenikol kapsul 500 mg Tiamin (Viamin B1) tablet 50 mg (HCl / Mononitrat ) Trifluoperazine tablet 5 mg Triheksifenidil Hidroklorida tablet 2 mg Vitamin B Kompleks tablet Zinc tablet 20 mg



tablet tablet tablet kapsul tablet tablet tablet tablet tablet



PERBEKALAN KESEHATAN Alat suntik sekali pakai 1 ml set Alat suntik sekali pakai 2,5 ml/3 ml set Alat suntik sekali pakai 5 ml set Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum biji Catgut / Benang Bedah No. 3/0 plain biji Catgut / Benang Bedah No. 3/0 chromic biji Hansaplast biji Hands shoen non steril No. 7 biji Hands shoen steril No. 7 pasang Infusion set dewasa set IV Catether No. 18 set IV Catether No. 20 set IV Catether No. 22 set Jarum jahit bedah No. 9 s/d 14 biji Kapas Pembalut / Absorben 250 gram bungkus Kasa Pembalut 2 m x 80 cm biji KI 0.05 ml set KI 0.5 ml set KI 5 ml set Kasa Pembalut Hidrofil 4 m x 3 cm hidrofil/elastic rol Kasa Pembalut Hidrofil 4 m x 15 cm hidrofil/elastic rol Kasa Steril 16 x 16 cm rol Maag Slang No. 16 biji Maag Slang No. 18 biji Masker biji Plester 5 yards x 2 inch roll Silk (Benang Bedah Sutera) No. 3/0 dengan jarum b biji Safety Box 2,5 L lembar REAGEN LABORATORIUM EDTA Powder KOH 10 % Larutan Asam asetat 6% Larutan Asam Klorida 0,1 N Larutan Benedict Larutan Eosin 2% Larutan Ether Alkohol



botol botol botol botol botol botol botol



29 9 29



0 7,418 0 0 0 0 738 5,057 250



0 0 0 7,418 0 0 0 0 0 0 0 0 0 738 0 5,057 0 250



0 451 0 0 0 0 738 2,952 250



32 32 32 32 32



0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 576 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 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 576 0 0 0 0 0 0



0 0 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96 0 0 0 0 0 0



31 31 31 31 31 31 31



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



175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196



197 198 199 200 201 202 203 204 205 206 207 208 209



Larutan Giemsa Stain Larutan HCl-alkohol /Lart. Etanol asam Larutan Karbol Fuksin Larutan Metilen Biru Larutan Rees Ecker Larutan Turk Metanol Oil imersion Reagen Asam Urat / STIK Asam Urat Reagen Golongan Darah Antigen A Reagen Golongan Darah Antigen B Reagen Gula Darah/ STIK Reagen Kolesterol/ STIK Reagen Urin Stik 10 Parameter Reagen Widal (AO, BO,H,O) Xylol Reagen RPR Syphilis/Titer (Plasmatec/RPR tes kit, R Rapid Syphilis/ Standar Diagnostic (Alere) Bioline Reagen HBSAg (Fokus) Human Hexagon Syphilis Reagen HIV R1 (Standart Diagnostic) Iodina Test OBAT GIGI Dentorit Etil Klorida spray Eugenol cairan Fluor tablet 0,5 mg Glass Ionomer Cement ART Kalsium Hidroksida Pasta Monochlorkamfer mentol ( CHKM ) Mummifying Pasta Povidon Iodine obat kumur Semen Seng Fosfat serbuk dan cairan Silver Amalgam serbuk 65 - 75 % Temporary Stopping Fletcher (Fletcher) serbuk dan Tri Kresol Formalin



botol botol botol botol botol botol botol botol btl set set set set set set botol set



botol botol botol tablet set set botol botol botol botol botol botol botol



14 14 14 14 14 14 14



0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 300 200 300 16



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 0 0 0 0 300 200 300



0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 25 100 0



0 0 1 0 3 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 1 0 3 0 0 0 0 0 0 0 0



0 0 0 0 0 0 0 0 0 0 0 0 0



300 300 2,600 2,600 0 0 0 0 0



300 2,600



OBAT PROGRAM Gizi : 210 Retinol Kapsul ( Vitamin A ) 100.000 IU 211 Retinol kapsul ( Vitamin A ) 200.000 IU 212 Tablet Tambah Darah ( TTD ) 223 Yodiol



kapsul kapsul tablet kapsul



0 0 0 0



blister blister



0 12



Anti Lepra : 224 MB Anak 225 MB Dewasa



0



0



226 PB Anak 227 PB Dewasa



blister blister



0 0



tablet tablet ampul kotak kapsul ampul tablet tablet



0 0 0 0 0 0 0 0



tablet tablet paket paket paket paket paket paket paket tablet



0 0 6 0 0 0 0 0 0 0



Anti Malaria : 228 ACT ( Artesunate + Amodiaquin ) Arsuamoon 229 ACT ( Dehidro Artemisin + Piperaquin ) Arterakine 230 Artemeter inj. 80 mg/ml 231 232 233 234 235



Artesunate inj. Doksisiklin kapsul 100 mg Kina dihidroklorida inj. 25 %-2ml Kina tablet 200 mg Primakuin tablet 15 mg



Anti TBC : 236 Ethambutol tablet 400 mg



Ethambutol tablet 500 mg FDC KIT I / III FDC kit II OAT Anak OAT Kategori I OAT Kategori II 243 OAT Kategori III 244 OAT Sisipan 245 Pirazinamid tablet 500 mg 237 238 239 240 241 242



246 247 248 249



Imunisasi : Vaksin BCG bayi Vaksin Campak HB Uniject 0,5 ml



vial vial ampul



0 0 0



KIA : 250 Kondom 251 252 253 254 255 256 257 258 259 260 261 262 263



IUD Urine Rapid Test Progesteron Depo inj ( 3 bulan ) Spuit KB Metronidazole 500 mg inj Calcium Gluconas inj Catgut Chromic 1/0 Kantung Urine Dewasa Rapid Test Siphilis Urine Strip Implant KB / Levonogestrel 75 mg Transfusion Set Pil Kontrasepsi ( Microdiol )



264 ANTI RETROVIRAL: 265 Nevirapine (NVP) 200 mg 266 Zidofudine (ZDV) 300 mg + Lamivudine (3TC) 150 m



botol pak vial bj vial ampul set set set set set set strip



set set 267 Tenofovir 300 mg (TDF) + Emcitritabine 200 mg (FTC set



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 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 0



0 0 0 0 0 0 0 0



0 0 0 0 0 0 0 0



0 0 6 0 0 0 0 0 0 0



0 0 2 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 0 0 0 0 0



0 0 0



0 0 0



UMUM JUMLAH KUNJUNGAN RESEP



Mengetahui Kepala Puskesmas Blimbing Kesamben



MUCHTAR EFFENDY NIP. 197103132000031004



BAYAR GRATIS



JKN PBI



NON PBI



JAMKE SDA



AN LEMBAR PERMINTAAN OBAT LPLPO) Bulan : Jan - Des Tahun : 2020



Pemberian



Pemak aian Rata2



Sisa Stok



Stok Opt



Permin taan



I



8



9



10



11



12



0 120 0 15 2,990 44 0 885 0 0 5 -800 4 805 6 22 112 -733 140 20,514 -30 0 0 -16,000 0 105 0 81 4,137 194 0 0 -700 0 17 0 0 31 -19 0 0 -4 0 284 0 0 3 -300 82 4,065 243 209 11,958 -2,972 0 100 -6,000 0 9,357 -100 0 0 0 0 284 -200 53 616 -242 0 7 -2 0 0 0 0 0 0 0 32 0 0 0 0 0 0 0 100 -100 291 100 840 0 40 -1,500 0 5,472 0



100 2,000 0 885



3,000



100 3,500



24 100



1,000 7,000



500



3,000



Askes APBD Lain2 13



14



15



Jumlah 16



KET 28



ED



0 0 0 0 0 0 0 0 21 43 0 0 0 0 0 0 0 0 0 1 8 0 0 13 24 0 2 0 38 0 38 0 0 0 0 0 0 0 0 114 0 1 0 0 0 2 6 ###



0 0 0 0 0 0 30 289 721 494 19 6,887 0 0 0 0 1,400 0 0 124 772 1,411 3,225 140 1,558 0 0 0 1,090 0 2,280 0 45 0 0 0 300 8 7 2,217 900 11 257 8 0 0 136 ###



0 0 0 0 -30 -400 -400 500 -300 300 56 -1,573 10,000 0 0 0 0 -1,400 0 0 -100 -400 -1,296 23 3,000 0 -1,500 34 51 30 0 5 1,500 0 -885 1,000 0 6 114 48 0 1 0 0 100 -8 -5 -1,000 2,000 -400 -158 1,000 0 2 -8 0 3,000 -21 -69 100 17 ###



0 0 -48 0 85 -4,200 5,000 144 8,077 431 0 0 0 0 0 -2,900 15 2,715 45 0 0 -100 200 0 300 0 0 0 -100 0 100 0 0 0 -150 0 165 0 0 0 -3 0 3 -1,000 1,500 108 2,435 124 0 200 -25 0 0 0 0 0 0 0 0 0 0 0 1,000 0 0 -35 0 0 78 0 0 0 0 -5,000 5,000 120 1,685 -591 1,000 0 12 -12 0 0 0 0 0 0 55 0 0 0 0 22 163 -235 8 120 25 320 266 11,854 -3,903 10,000 249 3,655 -2,252 5,000 0 0 0 0 13 -14 21 2,542 -1,638 2 585 -193 100 0 0 0 0 9 -11 0 0 0 5,000 0 40 -40 40 35 208 -94 300 1 81 -55 0 0 0 0 0 0 7,000 0 0 0 50 0 0 0 0 0 0 0 0 0



0 38 0 0 0 0 62 246 21 0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0 0 0



0 0 0 0 0 0 0



0 0 6,967 -3,307 0 0 0 0 0 0 0 0 0 185 2,105 338 0 -138



1,000 5,000 5,000 7,000 5,000 5,000 7,000



0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 480 0 0 0 0 0 0



-100 0 -129 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -10 0 -376 0 0 0 0 0 0



500 1,000



0 0 0 0 0 0 0



0 0 0 0 0 0 0



0 0 0 0 0 0 0



10 10 10 0 500 0 10 10 10 0 1 10 10 0 0 0 30 30 160 0 0 150 6 10 0



0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 8 0



0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 275 175 200 0



0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -200 0 -94 -94 25 0



0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0



0 0 1 0 3 0 0 0 0 0 0 0 0



0 0 -1 0 -1 0 0 0 0 0 0 0 0



2 6



75 650 0 0



75 650



25 217 0 0 0



0 0 0 0



0 12



0 0 0 0 0 0 0 0 10 2 2 10 20 1 2 0 0 500 500 500 10



0 5 2 2 6 1 1 1 1



0



100



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 0 0 0 0 0 0 0 0 0 0 0 0



0 0



0 0 0 0 0 0 0 0



0 0 4 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 12 0 0



0 0 0 0 0 0 0 0



0 0 0 0 0 0 0 0



0 0 -3 0 0 0 0 0 0 0



0 0 1



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 0 0 0 0 0 0 0 0 0 0 0 0



jumlah



R/



Jombang, 26 Desember 2019 Pengelola Obat Puskesmas Blimbing Kes



MUSABBIHAH NIP. 19650510 198603 2 026



KOSONG Hari



1



1



1



1



0 0 0