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LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK

JANUARI 2015
NAMA PUSKESMAS : PANUNGGANGAN
ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936
STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

OBAT
1

Alopurinol tablet 100 mg

Tablet

305

400

705

321

384

Amlodipin tablet 5 mg

Tablet

234

400

634

326

308

Aminofillin tablet 200 mg

Tablet

200

400

600

326

274

Amoksilin kaplet 500 mg

Kaplet

2,075

400

2,475

326

2,149

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

66

400

466

326

140

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

1,748
400

2,148

326

1,822

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200
mg /5 ml - 60 ml

Botol

400

415

326

89

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g


+ Polimiksin 10.000 IU/g

Tube

400

456

326

130

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% +


Placenta Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

400

401

326

75

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

400

792

326

466

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60


ml

Botol

400

400

326

74

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot
400

400

326

74

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

400

435

326

109

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium


80% + Citrus Bioflavonoid 20% / Haemorogard

400

515

326

189

15

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr
/ Klorfeson

Tube

400

410

326

84

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

17

Aqua pro injeksi steril, bebas pirogen 20 ml

18

Kapsul

15

56

392

35

115

10

400

400

326

74

Vial

400

400

326

74

Asam Asetilsalisilat tablet 80 mg

Tablet

400

400

326

74

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,135

400

2,535

326

2,209

20

Asam Mefenamat kaplet 500 mg

Kaplet

630

400

1,030

326

704

21

Asiklovir krim 5 % - 5 gr

Tube

39

400

439

326

113

22

Asiklovir tablet 400 mg

Tablet

592

400

992

326

666

23

Atapulgit tablet 600 mg

Tablet

40

400

440

326

114

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet


tambah darah kombinasi)

Tablet

1,509

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

28

28

Bisoprolol tablet 5 mg

Tablet

12

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

30

Bromheksin tablet 8 mg / Bromifar

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

32

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

400

403

326

77

400

1,909

326

1,583

400

400

326

74

400

428

326

102

400

412

326

86

26

400

426

326

100

Tablet

63

400

463

326

137

Botol

400

401

326

75

Deksametason tablet 0,5 mg

Tablet

1,343

400

1,743

326

1,417

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

400

400

326

74

34

Difenhidramin injeksi 10 mg/ml

Ampul

400

400

326

74

35

Digoksin tablet 0,25 mg

Tablet

70

400

470

326

144

36

Domperidon tablet 10 mg

Tablet

296

400

696

326

370

37

Doksisiklin kapsul 100 mg

Kapsul

400

400

326

74

38

Efedrin tablet 25 mg (HCl)

Tablet

181

400

581

326

255

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

400

406

326

80

40

Eritromisin kapsul 500 mg

Kapsul

400

400

326

74

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

18

400

418

326

92

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

26

400

426

326

100

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

16

400

416

326

90

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

105

400

505

326

179

45

Furosemid tablet 40 mg

Tablet

51

400

451

326

125

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g,


Kalium klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g,
Glukosa anhidrat 2,7 g

Sach

639
400

1,039

326

713

47

Gemfibrozil 300 mg kapsul

Kapsul

225

400

625

326

299

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

15

400

415

326

89

49

Glibenklamid tablet 5 mg

Tablet

734

400

1,134

326

808

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,092

400

3,492

326

3,166

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

400

400

326

74

52

Griseofulvin tablet 125 mg / Gricin

Tablet

80

400

480

326

154

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

640

400

1,040

326

714

54

Hidrokortison krim 2,5 % - 5 gr

Tube

20

400

420

326

94

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

400

400

326

74

56

Ibuprofen tablet 400 mg

Tablet

375

400

775

326

449

57

Ichtyol salep kulit - 15 gr

Pot

17

400

417

326

91

STOK

NAMA OBAT

SATUAN
KEMASAN

Tablet

TERIMA

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

59

Kalium permanganat (PK) serbuk - 5 gr

150

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

61

Kaptopril tablet 25 mg

62

Ketokonazol tablet 200 mg

63

Klindamisin kapsul 150 mg

64

Kloramfenikol kapsul 250 mg

65

Kloramfenikol salep mata 1% - 5 gr

Tube

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

47

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

28

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

69

Klorfeniramin maleat (CTM) tablet 4 mg

70

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

400

550

326

400

400

326

74

1,225

400

1,625

326

1,299

Tablet

781

400

1,181

326

855

Tablet

69

400

469

326

143

Kapsul

400

400

326

74

Kapsul

400

400

326

74

400

400

326

74

400

447

326

121

400

428

326

102

34

400

434

326

108

Tablet

5,428

400

5,828

326

5,502

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

478
400

878

326

552

71

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet
400

400

326

74

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

27
400

427

326

101

73

Levertraan salep - 15 gr

Pot

400

407

326

81

74

Lidokain injeksi 2% - 2 ml

Ampul

400

400

326

74

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

400

400

326

74

76

Linkomisin kapsul 500 mg

Kapsul

400

400

326

74

77

Loperamid tablet 2 mg

Tablet

56

400

456

326

130

78

Loratadin tablet 10 mg

Tablet

53

400

453

326

127

79

Mebendazol tablet 100 mg

Tablet

400

400

326

74

80

Metampiron (Antalgin) tablet 500 mg

Tablet

619

400

1,019

326

693

81

Metformin HCl tablet 500 mg

Tablet

251

400

651

326

325

82

Metilergometrin Maleat (Metilergometrin) tablet salut


0,125 mg

Tablet

220

400

620

326

294

83

Metronidazol tablet 500 mg

Tablet

132

400

532

326

206

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

400

408

326

82

85

Multivit Sirup - 60 ml

Botol

82

400

482

326

156

86

Multivit Tablet

Tablet

400

400

326

74

87

Natrium Bikarbonat tablet 500 mg

Tablet

400

400

326

74

88

Natrium Diklofenak tablet 50 mg

Tablet

400

528

326

202

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

400

400

326

74

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

400

401

326

75

Pot

128

224

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

91

Nifedipin tablet 10 mg

Tablet

18

400

418

326

92

92

Nistatin tablet salut 500.000 IU/g

Tablet

118

400

518

326

192

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

112

400

512

326

186

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

54

400

454

326

128

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin


100 mg) / Librozym

Tablet

400

400

326

74

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

400

430

326

104

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

400

400

326

74

98

Omeprazol kapsul 20 mg

Kapsul

400

400

326

74

99

Papaverin tablet 40 mg

Tablet

333

400

733

326

407

100

Parasetamol drops

botol

57

400

457

326

131

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

66

400

466

326

140

102

Parasetamol tablet 100 mg

Tablet

400

400

326

74

103

Parasetamol tablet 500 mg

Tablet

2,980

400

3,380

326

3,054

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

816

400

1,216

326

890

105

Piroksikam tablet 10 mg

Tablet

88

400

488

326

162

106

Polikresulen (kondensasi) - 10 ml

Botol

400

401

326

75

107

Povidon Iodida larutan 10 % - 300 ml

Botol

400

401

326

75

108

Prednison tablet 5 mg

Tablet

697

400

1,097

326

771

109

Propanolol tablet 10 mg (HCl)

Tablet

100

400

500

326

174

110

Propiltiourasil tablet 100 mg

Tablet

45

400

445

326

119

111

Ranitidin tablet 150 mg

Tablet

400

404

326

78

112

Ringer Laktat larutan infus - 500 ml

Botol

400

400

326

74

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

400

540

326

214

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

400

400

326

74

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang


endap 4 % - 30 gr

Pot

15

400

415

326

89

116

Salisil Bedak 2 % - 50 gr

Kotak

79

400

479

326

153

117

Sefadroksil Kapsul 500 mg

Kapsul

118

400

518

326

192

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

144

400

544

326

218

119

Simvastatin tablet 10 mg

Tablet

400

400

326

74

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

400

735

326

409

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

400

400

326

74

122

Tetrasiklin kapsul 250 mg

Kapsul

400

400

326

74

123

Tetrasiklin kapsul 500 mg

Kapsul

400

563

326

237

124

Thiamfenikol kapsul 500 mg

Kapsul

400

400

326

74

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,597

400

1,997

326

1,671

126

Vitamin B Kompleks tablet

Tablet

1,667

400

2,067

326

1,741

30

140

335

Botol

163

STOK

NAMA OBAT
127

Zinc tablet 20 mg

SATUAN
KEMASAN

Tablet

TERIMA
420

OBAT PROGRAM TB PARU

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

400

820

326

494

400

400

326

74

128

Obat FDC Kategori 1

Paket

400

400

326

74

129

Obat FDC Kategori 2

Paket

400

400

326

74

130

Obat FDC Anak

Paket

400

400

326

74

131

Obat FDC Sisipan

Paket

400

400

326

74

400

400

326

74

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

Vial

133

400

401

326

75

Levofloksasin tablet 500 mg

Tablet

62

400

462

326

136

134

Sefiksim kapsul 100 mg

Kapsul

400

400

326

74

400

400

326

74

400

400

326

74

400

400

326

74

400

400

326

74

400

473

326

147

400

400

326

74

400

400

326

74

400

400

326

74

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

137

Pirantel tablet score (base) 125 mg

Tablet

73

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

OBAT KEJIWAAN

400

400

326

74

Alprazolam tablet 1 mg

Tablet

219

400

619

326

293

Amitriptilin tablet salut 25 mg (HCl)

Tablet

51

400

451

326

125

Clobazam tablet 10 mg

Tablet

162

400

562

326

236

Diazepam tablet 2 mg

Tablet

137

400

537

326

211

Diazepam tablet 5 mg

Tablet

400

400

326

74

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

400

400

326

74

Diazepam tube Rectal 5 mg/2.5 ml

Tube

400

401

326

75

Fenitoin Kapsul 100 mg

Kapsul

400

400

326

74

Fenobarbital tablet 30 mg

Tablet

400

423

326

97

10

Fluoxetin tablet 10 mg /

400

400

326

74

11

Haloperidol tablet 1,5 mg

Tablet

210

400

610

326

284

12

Haloperidol tablet 5 mg

Tablet

210

400

610

110

500

13

Imipramin tablet 25 mg / Tofranil

Tablet

400

400

326

74

14

Karbamazepin tablet 200 mg

Tablet

400

400

326

74

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

15

400

415

326

89

16

Kodein tablet 10 mg

Tablet

215

400

615

326

289

17

Risperidon tablet 2 mg

Tablet

400

400

326

74

18

Sertralin tablet / Nudep

Tablet

400

400

326

74

19

Triheksifenidil tablet 2 mg

Tablet

400

400

326

74

400

400

326

74

OBAT GIGI

Antiprestin

23

Tablet

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

Artikulating Paper

Buku

400

400

326

74

Bur diamond high Speed

Kotak

400

400

326

74

Bur arkansas high Speed

buah

400

400

326

74

Cavit / Dentorit (Tambalan Sementara)

Pot

400

401

326

75

Celluloid strip

Set

400

400

326

74

Cresopen - 13 ml

Botol

400

400

326

74

Dentin Conditioner

Botol

400

400

326

74

Devitalisasi Pasta (Non Arsen)

Btl / ktk

400

400

326

74

Disclosing Agent

Tube

400

400

326

74

10

Disposible saliva ejektor

Bungkus @
100 pcs

400

400

326

74

11

Etil Chlorida spray - 100 ml

Botol

400

401

326

75

12

Eugenol cairan

Botol

400

401

326

75

13

Glass Ionomer Radiopak / Fuji VII

Set

400

401

326

75

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

400

401

326

75

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

400

400

326

74

16

Macro gold + propylen + EDTA

Set

400

400

326

74

17

Oil Spray

Botol

400

400

326

74

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml +


Adrenalin 12.5 mcg )

Ampul

400

420

326

94

19

Pulperyl

Botol

400

400

326

74

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

400

400

326

74

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

400

400

326

74

22

Tetric N Ceram

Paket

400

400

326

74

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

400

400

326

74

24

Tetric Bonding - 6 gr

Botol

400

400

326

74

25

Tetric Etch Refill - 2 gr

Tube

400

400

326

74

26

Trikresol Formalin (TKF)

Botol

400

401

326

75

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

400

400

326

74

28

Xylestesin Non Adrenalin injeksi

Ampul

400

400

326

74

29

CHKM

Botol

400

400

326

74

30

Iodoform/Mumifying pasta

Botol

400

400

326

74

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

400

400

326

74

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

400

400

326

74

400

400

326

74
74

20

PERBEKALAN KESEHATAN
1

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

400

400

326

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

400

400

326

74

Alat Suntik sekali pakai 1 ml

Pcs

400

460

326

134

60

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

Alat Suntik sekali pakai 3 ml

Pcs

92

400

492

326

166

Alat Suntik sekali pakai 5 ml

Pcs

62

400

462

326

136

Blood set

Set

400

400

326

74

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

400

400

326

74

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

400

400

326

74

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

400

400

326

74

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

400

400

326

74

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

400

400

326

74

12

Dental Film Hanshin

Pcs

400

400

326

74

13

Etanol 70 % - 1 L

Botol

400

402

326

76

14

Gel USG / EKG

Botol

400

400

326

74

15

Infusion Set Anak

Pcs

400

400

326

74

16

Infusion Set Dewasa

Pcs

400

402

326

76

17

IV. Catheter No.18 G

Set

400

402

326

76

18

IV. Catheter No.20 G

Set

400

400

326

74

19

IV. Catheter No.22 G

Set

400

400

326

74

20

IV. Catheter No.24 G

Kotak

400

400

326

74

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

400

400

326

74

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

400

400

326

74

23

Kapas Pembalut / absorben 250 gram

Bungkus

400

400

326

74

24

Kassa Hidrofil Steril uk. 16 x 16

400

405

326

79

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

400

400

326

74

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

400

400

326

74

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

400

400

326

74

28

Kertas EKG

Roll

400

400

326

74

29

Kertas USG Sony 110 HG

Roll

400

400

326

74

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

400

401

326

75

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

400

400

326

74

32

Larutan antiseptik/ desinfektan handrub mengandung zat


aktif dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol
400

400

326

74

400

400

326

74

400

400

326

74

33

34

Larutan konsentrat untuk Antiseptik dan desinfektan


Instrumen/ peralatan kedokteran aldehyd free (mengandung
zat aktif: Cocospropilenediaminguanidine di acetat,
surfaktan, parfumes, coloring dsb).
Kassa steril mengandung obat (Framycetin) / Lomatulle

Kotak

Botol 1 ltr

Lembar

STOK

NAMA OBAT

SATUAN
KEMASAN

Kotak

TERIMA

STOK

PAKAI

AKHIR

KET

35

Masker

400

403

326

77

36

Masker O2

Pcs

400

400

326

74

37

Masker 95

Pcs

400

400

326

74

38

Masker nebulizer set dewasa

Pcs

400

401

326

75

39

Masker nebulizer set anak

Pcs

400

401

326

75

40

Plester 5 yard X 2 inch

Roll

400

400

326

74

41

Plester non alergi 0,5 inch / Micropore

Roll

400

403

326

77

42

Pot Urin

Pcs

400

400

326

74

43

Sarung Tangan

400

402

326

76

44

Safety Box

Pcs

400

400

326

74

45

Surgical blade no.11 (Pisau Bedah)

Pcs

400

400

326

74

400

400

326

74

Kotak

TOTAL
PERSEDIAAN

AWAL

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

400

400

326

74

Eter Alkohol

Botol 100 ml

400

400

326

74

Kaca Slide / Object Glass

Kotak

400

400

326

74

Pot dahak

Pcs

400

400

326

74

Reagen Zielnelsen

Set

400

400

326

74

Spiritus Bakar

Botol

400

400

326

74

Tissu Lensa

Kotak

400

400

326

74

Tissue lensa

Buku

400

400

326

74

Wadah Kaca Slide / Box Slide

Pcs

400

400

326

74

10

Xylol/ Xylene

Botol 100 ml

400

400

326

74

11

Xylol/ Xylene

Botol 500 ml

400

400

326

74

400

400

326

74

400

400

326

74

400

440

326

114
94

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

40

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

20

400

420

326

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

400

404

326

78

Sendok obat

Pcs

100

400

500

326

174

TAMBAHAN

400

400

326

74

Ambroksol tablet 30mg

Tablet

190

400

590

326

264

18

Klindamisin kapsul 150 mg

Kapsul

400

405

326

79

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

400

400

15

385

Botol

STOK

NAMA OBAT

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

SATUAN
KEMASAN

TERIMA
AWAL

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

KET

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


FEBRUARI 2015
NAMA PUSKESMAS : PANUNGGANGAN
ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

10

11

12

13

14

15

16

17

18 19

20

21

22

23

24

25

26

27

OBAT
1

Alopurinol tablet 100 mg

Tablet

384

400

784

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Amlodipin tablet 5 mg

Tablet

308

400

708

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Aminofillin tablet 200 mg

Tablet

274

400

674

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Amoksilin kaplet 500 mg

Kaplet

2,149

400

2,549

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

140

400

540

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

1,822
400

2,222

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200 mg /
5 ml - 60 ml

Botol

400

489

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g +


Polimiksin 10.000 IU/g

Tube

400

530

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta


Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

466

400

866

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot

74
400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

109

400

509

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80%


+ Citrus Bioflavonoid 20% / Haemorogard

Kapsul

189
400

589

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr /
Klorfeson

Tube

400

484

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

18

Asam Asetilsalisilat tablet 80 mg

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,209

400

2,609

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

20

Asam Mefenamat kaplet 500 mg

Kaplet

704

400

1,104

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

15

89

130

75

84

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

10

11

12

13

14

16

17

18 19

20

21

23

24

25

26

27

21

Asiklovir krim 5 % - 5 gr

Tube

113

400

513

10

10

55

20

25

45

30

15

36

20

30

10

22

40

10

56

25

22

Asiklovir tablet 400 mg

Tablet

666

400

1,066

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

23

Atapulgit tablet 600 mg

Tablet

114

400

514

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

77

400

477

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah


darah kombinasi)

Tablet

1,583

400

1,983

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

102

400

502

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

28

Bisoprolol tablet 5 mg

Tablet

86

400

486

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

100

400

500

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

30

Bromheksin tablet 8 mg / Bromifar

Tablet

137

400

537

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

Botol

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

32

Deksametason tablet 0,5 mg

Tablet

1,417

400

1,817

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

34

Difenhidramin injeksi 10 mg/ml

Ampul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

35

Digoksin tablet 0,25 mg

Tablet

144

400

544

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

36

Domperidon tablet 10 mg

Tablet

370

400

770

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

37

Doksisiklin kapsul 100 mg

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

38

Efedrin tablet 25 mg (HCl)

Tablet

255

400

655

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

80

400

480

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

40

Eritromisin kapsul 500 mg

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

92

400

492

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

100

400

500

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

90

400

490

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

179

400

579

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

45

Furosemid tablet 40 mg

Tablet

125

400

525

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium


klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g, Glukosa
anhidrat 2,7 g

Sach

713
400

1,113

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

47

Gemfibrozil 300 mg kapsul

Kapsul

299

400

699

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

89

400

489

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

49

Glibenklamid tablet 5 mg

Tablet

808

400

1,208

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,166

400

3,566

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

52

Griseofulvin tablet 125 mg / Gricin

Tablet

154

400

554

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

10

11

12

13

14

16

17

18 19

20

21

23

24

25

26

27

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

714

400

1,114

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

54

Hidrokortison krim 2,5 % - 5 gr

Tube

94

400

494

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

56

Ibuprofen tablet 400 mg

Tablet

449

400

849

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

57

Ichtyol salep kulit - 15 gr

Pot

91

400

491

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

224

400

624

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,299

400

1,699

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

61

Kaptopril tablet 25 mg

Tablet

855

400

1,255

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

62

Ketokonazol tablet 200 mg

Tablet

143

400

543

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

63

Klindamisin kapsul 150 mg

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

64

Kloramfenikol kapsul 250 mg

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

65

Kloramfenikol salep mata 1% - 5 gr

Tube

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

121

400

521

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

102

400

502

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

108

400

508

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,502

400

5,902

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

70

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

552
400

952

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

101
400

501

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

73

Levertraan salep - 15 gr

Pot

81

400

481

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

Lidokain injeksi 2% - 2 ml

Ampul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

76

Linkomisin kapsul 500 mg

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

77

Loperamid tablet 2 mg

Tablet

130

400

530

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

78

Loratadin tablet 10 mg

Tablet

127

400

527

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

79

Mebendazol tablet 100 mg

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

80

Metampiron (Antalgin) tablet 500 mg

Tablet

693

400

1,093

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

81

Metformin HCl tablet 500 mg

Tablet

325

400

725

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125


mg

Tablet

294

400

694

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

83

Metronidazol tablet 500 mg

Tablet

206

400

606

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

71

15

22

74

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

10

11

12

13

14

16

17

18 19

20

21

23

24

25

26

27

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

82

400

482

10

10

55

20

25

45

30

15

36

20

30

10

22

40

10

56

25

85

Multivit Sirup - 60 ml

Botol

156

400

556

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

86

Multivit Tablet

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

87

Natrium Bikarbonat tablet 500 mg

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

88

Natrium Diklofenak tablet 50 mg

Tablet

202

400

602

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

91

Nifedipin tablet 10 mg

Tablet

92

400

492

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

92

Nistatin tablet salut 500.000 IU/g

Tablet

192

400

592

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

186

400

586

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

128

400

528

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100


mg) / Librozym

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

104

400

504

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

98

Omeprazol kapsul 20 mg

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

99

Papaverin tablet 40 mg

Tablet

407

400

807

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

100

Parasetamol drops

botol

131

400

531

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

140

400

540

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

102

Parasetamol tablet 100 mg

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

103

Parasetamol tablet 500 mg

Tablet

3,054

400

3,454

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

890

400

1,290

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

105

Piroksikam tablet 10 mg

Tablet

162

400

562

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

106

Polikresulen (kondensasi) - 10 ml

Botol

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

107

Povidon Iodida larutan 10 % - 300 ml

Botol

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

108

Prednison tablet 5 mg

Tablet

771

400

1,171

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

109

Propanolol tablet 10 mg (HCl)

Tablet

174

400

574

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

110

Propiltiourasil tablet 100 mg

Tablet

119

400

519

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

111

Ranitidin tablet 150 mg

Tablet

78

400

478

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

112

Ringer Laktat larutan infus - 500 ml

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

214

400

614

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap


4 % - 30 gr

Pot

89

400

489

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

116

Salisil Bedak 2 % - 50 gr

Kotak

153

400

553

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

10

11

12

13

14

16

17

18 19

20

21

23

24

25

26

27

400

592

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

618

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

809

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

237

400

637

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,671

400

2,071

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

126

Vitamin B Kompleks tablet

Tablet

1,741

400

2,141

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

127

Zinc tablet 20 mg

Tablet

494

400

894

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

117

Sefadroksil Kapsul 500 mg

Kapsul

192

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

218

119

Simvastatin tablet 10 mg

Tablet

74

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

409

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

74

122

Tetrasiklin kapsul 250 mg

Kapsul

74

123

Tetrasiklin kapsul 500 mg

Kapsul

124

Thiamfenikol kapsul 500 mg

125

OBAT PROGRAM TB PARU

15

22

128

Obat FDC Kategori 1

Paket

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

129

Obat FDC Kategori 2

Paket

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

130

Obat FDC Anak

Paket

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

131

Obat FDC Sisipan

Paket

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Vial

75

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

133

Levofloksasin tablet 500 mg

Tablet

136

400

536

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

134

Sefiksim kapsul 100 mg

Kapsul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

136

Albendazole tablet 400 mg

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

137

Pirantel tablet score (base) 125 mg

Tablet

147

400

547

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

74

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

74

OBAT KEJIWAAN

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Alprazolam tablet 1 mg

Tablet

293

400

693

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Amitriptilin tablet salut 25 mg (HCl)

Tablet

125

400

525

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Clobazam tablet 10 mg

Tablet

236

400

636

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Diazepam tablet 2 mg

Tablet

211

400

611

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Diazepam tablet 5 mg

Tablet

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

10

11

12

13

14

475

10

10

55

20

25

45

30

400

474

10

10

55

400

497

10

10

55

20

25

45

20

25

45

74

400

474

10

10

Tablet

284

400

684

10

10

55

20

25

45

55

20

25

45

Haloperidol tablet 5 mg

Tablet

500

400

900

10

10

55

20

25

13

Imipramin tablet 25 mg / Tofranil

Tablet

74

400

474

10

14

Karbamazepin tablet 200 mg

Tablet

74

400

474

10

10

55

20

10

55

20

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

89

400

489

16

Kodein tablet 10 mg

Tablet

289

400

689

10

10

55

10

10

55

17

Risperidon tablet 2 mg

Tablet

74

400

18

Sertralin tablet / Nudep

Tablet

74

400

474

10

10

55

474

10

10

55

19

Triheksifenidil tablet 2 mg

Tablet

74

400

474

10

10

55

74

Diazepam tube Rectal 5 mg/2.5 ml

Tube

75

400

Fenitoin Kapsul 100 mg

Kapsul

74

Fenobarbital tablet 30 mg

Tablet

97

10

Fluoxetin tablet 10 mg /

Tablet

11

Haloperidol tablet 1,5 mg

12

Antiprestin

OBAT GIGI

15

16

17

18 19

20

21

36

20

30

30

30

36

20

36

20

30

30

36

36

45

30

36

25

45

25

45

30

30

20

25

20

25

45

30

45

30

20

20

25

45

25

45

20

25

45

22

23

24

25

26

27

10

40

10

56

25

30

10

40

10

56

25

30

10

40

10

56

25

20

30

10

40

10

56

25

20

30

10

40

10

56

25

20

30

10

40

10

56

25

36

20

30

10

40

10

56

25

36

20

30

10

40

10

56

25

36

20

30

10

40

10

56

25

36

20

30

10

40

10

56

25

30

36

20

30

10

40

10

56

25

30

36

20

30

10

40

10

56

25

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Artikulating Paper

Buku

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Bur diamond high Speed

Kotak

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Bur arkansas high Speed

buah

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Cavit / Dentorit (Tambalan Sementara)

Pot

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Celluloid strip

Set

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Cresopen - 13 ml

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Dentin Conditioner

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Devitalisasi Pasta (Non Arsen)

Btl / ktk

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Disclosing Agent

Tube

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

10

Disposible saliva ejektor

Bungkus @
100 pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

11

Etil Chlorida spray - 100 ml

Botol

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

12

Eugenol cairan

Botol

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

13

Glass Ionomer Radiopak / Fuji VII

Set

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

16

Macro gold + propylen + EDTA

Set

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

17

Oil Spray

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin


12.5 mcg )

Ampul

94
400

494

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

19

Pulperyl

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

74

22

Tetric N Ceram

Paket

74

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

74

24

Tetric Bonding - 6 gr

Botol

74

25

Tetric Etch Refill - 2 gr

Tube

74

26

Trikresol Formalin (TKF)

Botol

75

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

74

28

Xylestesin Non Adrenalin injeksi

Ampul

74

29

CHKM

Botol

30

Iodoform/Mumifying pasta

31
32

10

11

12

13

14

15

16

17

18 19

20

21

22

23

24

25

26

27

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Tambalan Sinar (4 syringe, etching, bonding)

Paket

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

PERBEKALAN KESEHATAN
1

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Alat Suntik sekali pakai 1 ml

Pcs

134

400

534

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Alat Suntik sekali pakai 3 ml

Pcs

166

400

566

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Alat Suntik sekali pakai 5 ml

Pcs

136

400

536

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Blood set

Set

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

12

Dental Film Hanshin

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

13

Etanol 70 % - 1 L

Botol

76

400

476

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

14

Gel USG / EKG

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

15

Infusion Set Anak

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

16

Infusion Set Dewasa

Pcs

76

400

476

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

17

IV. Catheter No.18 G

Set

76

400

476

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

18

IV. Catheter No.20 G

Set

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

19

IV. Catheter No.22 G

Set

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

20

IV. Catheter No.24 G

Kotak

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

74

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

74

23

Kapas Pembalut / absorben 250 gram

Bungkus

74

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

79

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

74

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

74

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

28

Kertas EKG

29

Kertas USG Sony 110 HG

30

10

11

12

13

14

15

16

17

18 19

20

21

22

23

24

25

26

27

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

479

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Roll

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Roll

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif


dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol

74
400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/


peralatan kedokteran aldehyd free (mengandung zat aktif:
Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Botol 1 ltr

74

Lembar

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Kotak

77

400

477

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Masker O2

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

37

Masker 95

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

38

Masker nebulizer set dewasa

Pcs

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

39

Masker nebulizer set anak

Pcs

75

400

475

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

40

Plester 5 yard X 2 inch

Roll

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

41

Plester non alergi 0,5 inch / Micropore

Roll

77

400

477

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

42

Pot Urin

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

43

Sarung Tangan

Kotak

76

400

476

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

44

Safety Box

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

45

Surgical blade no.11 (Pisau Bedah)

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

PEMERIKSAAN TB PARU

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Emersi

Botol 100 ml

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Eter Alkohol

Botol 100 ml

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Kaca Slide / Object Glass

Kotak

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

PERSEDIAAN

AWAL

10

11

12

13

14

16

17

18 19

20

21

23

24

25

26

27

Pot dahak

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Reagen Zielnelsen

Set

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Spiritus Bakar

Botol

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Tissu Lensa

Kotak

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Tissue lensa

Buku

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Wadah Kaca Slide / Box Slide

Pcs

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

10

Xylol/ Xylene

Botol 100 ml

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

11

Xylol/ Xylene

Botol 500 ml

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

514

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

EMBALAGE

15

22

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

74

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

114

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

94

400

494

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

78

400

478

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

Sendok obat

Pcs

174

400

574

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

74

400

474

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

664

10

10

55

20

25

45

30

36

20

30

10

40

10

56

25

400

785

10

55

20

25

45

30

36

20

30

10

40

10

56

25

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

264

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

385

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

Penanggung jawab apotek

Ria Susanti,AMF
NIP.19851219 200901 2 004

ULANAN PERBEKALAN KESEHATAN APOTEK


FEBRUARI 2015

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


FEBRUARI 2015

NAMA PUSKESMAS : PANUNGGANGAN


ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

28 29

30

31

FISIK

FISIK FIX

SELISIH

2-Feb

OBAT
1

Alopurinol tablet 100 mg

Tablet

384

422

362

374

10

384

(22)

Amlodipin tablet 5 mg

Tablet

308

422

286

160

10

170

116

Aminofillin tablet 200 mg

Tablet

274

422

252

175

10

185

67

Amoksilin kaplet 500 mg

Kaplet

2,149

422

2,127

1,234

10

1,244

883

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

140

422

118

58

10

68

50

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

1,822
0

422

1,800

1,190

10

1,200

600

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200 mg /
5 ml - 60 ml

Botol

422

67

10

15

52

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g +


Polimiksin 10.000 IU/g

Tube

422

108

27

10

37

71

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta


Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

422

53

10

11

42

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

466

422

444

509

10

519

(75)

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

74

422

52

10

10

42

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot

74
0

422

52

10

10

42

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

109

422

87

10

34

53

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80%


+ Citrus Bioflavonoid 20% / Haemorogard

Kapsul

189
0

422

167

143

10

153

14

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr /
Klorfeson

Tube

422

62

10

10

20

42

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

74

422

52

10

10

42

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

74

422

52

10

10

42

18

Asam Asetilsalisilat tablet 80 mg

Tablet

74

422

52

10

10

42

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,209

422

2,187

1,639

10

1,649

538

20

Asam Mefenamat kaplet 500 mg

Kaplet

704

422

682

407

10

417

265

15

89

130

75

84

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

28 29

30

31

FISIK

FISIK FIX

SELISIH

21

Asiklovir krim 5 % - 5 gr

Tube

113

422

91

44

10

54

37

22

Asiklovir tablet 400 mg

Tablet

666

422

644

188

10

198

446

23

Atapulgit tablet 600 mg

Tablet

114

422

92

40

10

50

42

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

77

422

55

10

13

42

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah


darah kombinasi)

Tablet

1,583

422

1,561

1,710

10

1,720

(159)

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

74

422

52

10

10

20

32

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

102

422

80

26

10

36

44

28

Bisoprolol tablet 5 mg

Tablet

86

422

64

11

10

21

43

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

100

422

78

34

10

44

34

30

Bromheksin tablet 8 mg / Bromifar

Tablet

137

422

115

112

10

122

(7)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

Botol

75

422

53

10

52

32

Deksametason tablet 0,5 mg

Tablet

1,417

422

1,395

10

650

745

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

74

422

52

10

10

42

34

Difenhidramin injeksi 10 mg/ml

Ampul

74

422

52

10

10

42

35

Digoksin tablet 0,25 mg

Tablet

144

422

122

70

10

80

42

36

Domperidon tablet 10 mg

Tablet

370

422

348

123

10

133

215

37

Doksisiklin kapsul 100 mg

Kapsul

74

422

52

10

10

42

38

Efedrin tablet 25 mg (HCl)

Tablet

255

422

233

172

10

182

51

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

80

422

58

10

16

42

40

Eritromisin kapsul 500 mg

Kapsul

74

422

52

10

10

42

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

92

422

70

15

10

25

45

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

100

422

78

15

10

25

53

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

90

422

68

30

10

40

28

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

179

422

157

74

10

84

73

45

Furosemid tablet 40 mg

Tablet

125

422

103

44

10

54

49

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium


klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g, Glukosa
anhidrat 2,7 g

Sach

713
0

422

691

315

10

325

366

47

Gemfibrozil 300 mg kapsul

Kapsul

299

422

277

184

10

194

83

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

89

422

67

24

10

34

33

49

Glibenklamid tablet 5 mg

Tablet

808

422

786

570

10

580

206

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,166

422

3,144

1,465

10

1,475

1,669

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

74

422

52

10

10

42

52

Griseofulvin tablet 125 mg / Gricin

Tablet

154

422

132

10

175

(43)

640

165

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

28 29

30

31

FISIK

FISIK FIX

SELISIH

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

714

422

692

640

10

650

42

54

Hidrokortison krim 2,5 % - 5 gr

Tube

94

422

72

28

10

38

34

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

74

422

52

10

10

42

56

Ibuprofen tablet 400 mg

Tablet

449

422

427

591

10

601

(174)

57

Ichtyol salep kulit - 15 gr

Pot

91

422

69

10

19

50

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

224

422

202

150

10

160

42

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

74

422

52

10

10

42

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,299

422

1,277

985

10

995

282

61

Kaptopril tablet 25 mg

Tablet

855

422

833

794

10

804

29

62

Ketokonazol tablet 200 mg

Tablet

143

422

121

69

10

79

42

63

Klindamisin kapsul 150 mg

Kapsul

74

422

52

10

31

21

64

Kloramfenikol kapsul 250 mg

Kapsul

74

422

52

10

10

42

65

Kloramfenikol salep mata 1% - 5 gr

Tube

74

422

52

13

10

23

29

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

121

422

99

31

10

41

58

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

102

422

80

31

10

41

39

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

108

422

86

10

12

74

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,502

422

5,480

4,619

10

4,629

851

70

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

552
0

422

530

350

10

360

170

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

422

52

10

10

42

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

101
0

422

79

52

10

62

17

73

Levertraan salep - 15 gr

Pot

81

422

59

27

10

37

22

74

Lidokain injeksi 2% - 2 ml

Ampul

74

422

52

10

10

42

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

74

422

52

10

10

42

76

Linkomisin kapsul 500 mg

Kapsul

74

422

52

10

10

42

77

Loperamid tablet 2 mg

Tablet

130

422

108

106

10

116

(8)

78

Loratadin tablet 10 mg

Tablet

127

422

105

45

10

55

50

79

Mebendazol tablet 100 mg

Tablet

74

422

52

10

10

42

80

Metampiron (Antalgin) tablet 500 mg

Tablet

693

422

671

290

10

300

371

81

Metformin HCl tablet 500 mg

Tablet

325

422

303

181

10

191

112

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125


mg

Tablet

294

422

272

195

10

205

67

83

Metronidazol tablet 500 mg

Tablet

206

422

184

197

10

207

(23)

71

74

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

28 29

30

31

FISIK

FISIK FIX

SELISIH

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

82

422

60

32

10

42

85

Multivit Sirup - 60 ml

Botol

156

422

134

26

10

36

98

86

Multivit Tablet

Tablet

74

422

52

83

10

93

(41)

87

Natrium Bikarbonat tablet 500 mg

Tablet

74

422

52

10

10

42

88

Natrium Diklofenak tablet 50 mg

Tablet

202

422

180

10

158

22

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

74

422

52

10

10

42

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

75

422

53

10

52

91

Nifedipin tablet 10 mg

Tablet

92

422

70

10

10

60

92

Nistatin tablet salut 500.000 IU/g

Tablet

192

422

170

119

10

129

41

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

186

422

164

26

10

36

128

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

128

422

106

44

10

54

52

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100


mg) / Librozym

Tablet

74

422

52

28

10

38

14

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

104

422

82

14

10

24

58

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

74

422

52

10

10

42

98

Omeprazol kapsul 20 mg

Kapsul

74

422

52

10

10

42

99

Papaverin tablet 40 mg

Tablet

407

422

385

333

10

343

42

100

Parasetamol drops

botol

131

422

109

66

10

76

33

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

140

422

118

67

10

77

41

102

Parasetamol tablet 100 mg

Tablet

74

422

52

10

10

42

103

Parasetamol tablet 500 mg

Tablet

3,054

422

3,032

2,294

10

2,304

728

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

890

422

868

782

10

792

76

105

Piroksikam tablet 10 mg

Tablet

162

422

140

150

10

160

(20)

106

Polikresulen (kondensasi) - 10 ml

Botol

75

422

53

10

11

42

107

Povidon Iodida larutan 10 % - 300 ml

Botol

75

422

53

10

12

41

108

Prednison tablet 5 mg

Tablet

771

422

749

427

10

437

312

109

Propanolol tablet 10 mg (HCl)

Tablet

174

422

152

100

10

110

42

110

Propiltiourasil tablet 100 mg

Tablet

119

422

97

111

Ranitidin tablet 150 mg

Tablet

78

422

56

112

Ringer Laktat larutan infus - 500 ml

Botol

74

422

52

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

214

422

192

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

74

422

52

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap


4 % - 30 gr

Pot

89

422

67

116

Salisil Bedak 2 % - 50 gr

Kotak

153

422

131

148

174

18

10

10

87

10

184

(128)

10

10

42

10

204

(12)

10

10

42

20

10

30

37

80

10

90

41

194

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

117

Sefadroksil Kapsul 500 mg

Kapsul

192

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

218

119

Simvastatin tablet 10 mg

Tablet

74

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

409

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

74

122

Tetrasiklin kapsul 250 mg

Kapsul

74

123

Tetrasiklin kapsul 500 mg

Kapsul

124

Thiamfenikol kapsul 500 mg

125

28 29

30

31

FISIK

FISIK FIX

SELISIH

422

170

38

10

48

122

422

196

1,059

10

1,069

(873)

422

52

70

10

80

(28)

422

387

255

10

265

122

422

52

10

10

42

422

52

10

10

42

237

422

215

122

10

132

83

Kapsul

74

422

52

250

10

260

(208)

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,671

422

1,649

561

10

571

1,078

126

Vitamin B Kompleks tablet

Tablet

1,741

422

1,719

796

10

806

913

127

Zinc tablet 20 mg

Tablet

494

422

472

315

10

325

147

74

422

52

10

10

42

OBAT PROGRAM TB PARU


128

Obat FDC Kategori 1

Paket

74

422

52

10

10

42

129

Obat FDC Kategori 2

Paket

74

422

52

10

10

42

130

Obat FDC Anak

Paket

74

422

52

10

10

42

131

Obat FDC Sisipan

Paket

74

422

52

10

10

42

74

422

52

10

10

42

Vial

75

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

422

53

10

11

42

133

Levofloksasin tablet 500 mg

Tablet

136

422

114

37

10

47

67

134

Sefiksim kapsul 100 mg

Kapsul

74

422

52

10

10

42

74

422

52

10

10

42

74

422

52

10

10

42

74

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN

422

52

10

10

42

136

Albendazole tablet 400 mg

Tablet

74

422

52

10

10

42

137

Pirantel tablet score (base) 125 mg

Tablet

147

422

125

10

70

55

74

422

52

10

10

42

422

52

10

10

42

52

10

10

42

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

74

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

74

OBAT KEJIWAAN

422

74

60

422

52

10

10

42

Alprazolam tablet 1 mg

Tablet

293

422

271

100

10

110

161

Amitriptilin tablet salut 25 mg (HCl)

Tablet

125

422

103

91

10

101

Clobazam tablet 10 mg

Tablet

236

422

214

147

10

157

57

Diazepam tablet 2 mg

Tablet

211

422

189

51

10

61

128

Diazepam tablet 5 mg

Tablet

74

422

52

10

10

42

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

74

422

52

10

10

42

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

28 29

30

31

FISIK

FISIK FIX

Diazepam tube Rectal 5 mg/2.5 ml

Tube

75

422

53

Fenitoin Kapsul 100 mg

Kapsul

74

422

52

Fenobarbital tablet 30 mg

Tablet

97

422

75

10

Fluoxetin tablet 10 mg /

Tablet

74

422

52

11

Haloperidol tablet 1,5 mg

Tablet

284

422

262

200

12

Haloperidol tablet 5 mg

Tablet

500

422

478

120

13

Imipramin tablet 25 mg / Tofranil

Tablet

74

422

14

Karbamazepin tablet 200 mg

Tablet

74

422

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

89

422

67

16

Kodein tablet 10 mg

Tablet

289

422

267

17

Risperidon tablet 2 mg

Tablet

74

422

18

Sertralin tablet / Nudep

Tablet

74

422

19

Triheksifenidil tablet 2 mg

Tablet

74

74

Antiprestin

OBAT GIGI

SELISIH

10

51

10

10

42

10

32

43

10

10

42

10

210

52

10

130

348

52

10

10

42

52

10

10

42

235

10

245

(178)

217

10

227

40

52

10

10

42

52

10

10

42

422

52

10

10

42

22

422

52

10

10

42

Artikulating Paper

Buku

74

422

52

10

10

42

Bur diamond high Speed

Kotak

74

422

52

10

10

42

Bur arkansas high Speed

buah

74

422

52

10

10

42

Cavit / Dentorit (Tambalan Sementara)

Pot

75

422

53

10

10

43

Celluloid strip

Set

74

422

52

10

10

42

Cresopen - 13 ml

Botol

74

422

52

10

10

42

Dentin Conditioner

Botol

74

422

52

10

10

42

Devitalisasi Pasta (Non Arsen)

Btl / ktk

74

422

52

10

10

42

Disclosing Agent

Tube

74

422

52

10

10

42

10

Disposible saliva ejektor

Bungkus @
100 pcs

74

422

52

10

10

42

11

Etil Chlorida spray - 100 ml

Botol

75

422

53

10

14

39

12

Eugenol cairan

Botol

75

422

53

10

11

42

13

Glass Ionomer Radiopak / Fuji VII

Set

75

422

53

10

14

39

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

75

422

53

10

11

42

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

74

422

52

10

10

42

16

Macro gold + propylen + EDTA

Set

74

422

52

10

10

42

17

Oil Spray

Botol

74

422

52

10

10

42

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin


12.5 mcg )

Ampul

94
0

422

72

40

10

50

22

19

Pulperyl

Botol

74

422

52

10

11

41

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

74

422

52

10

10

42

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

74

22

Tetric N Ceram

Paket

74

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

74

24

Tetric Bonding - 6 gr

Botol

74

25

Tetric Etch Refill - 2 gr

Tube

74

26

Trikresol Formalin (TKF)

Botol

75

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

74

28

Xylestesin Non Adrenalin injeksi

Ampul

74

29

CHKM

Botol

30

Iodoform/Mumifying pasta

31
32

28 29

30

31

FISIK

FISIK FIX

SELISIH

422

52

10

10

42

422

52

10

10

42

422

52

10

10

42

422

52

10

10

42

422

52

10

10

42

422

53

10

11

42

422

52

10

10

42

422

52

10

10

42

74

422

52

10

10

42

Botol

74

422

52

10

10

42

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

74

422

52

10

10

42

Tambalan Sinar (4 syringe, etching, bonding)

Paket

74

422

52

10

10

42

74

422

52

10

10

42

PERBEKALAN KESEHATAN

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

74

422

52

10

10

42

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

74

422

52

10

10

42

Alat Suntik sekali pakai 1 ml

Pcs

134

422

112

40

10

50

62

Alat Suntik sekali pakai 3 ml

Pcs

166

422

144

57

10

67

77

Alat Suntik sekali pakai 5 ml

Pcs

136

422

114

50

10

60

54

Blood set

Set

74

422

52

10

10

42

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

74

422

52

10

10

42

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

74

422

52

10

10

42

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

74

422

52

10

10

42

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

74

422

52

10

10

42

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

74

422

52

10

10

42

12

Dental Film Hanshin

Pcs

74

422

52

10

10

42

13

Etanol 70 % - 1 L

Botol

76

422

54

10

11

43

14

Gel USG / EKG

Botol

74

422

52

10

10

42

15

Infusion Set Anak

Pcs

74

422

52

10

10

42

16

Infusion Set Dewasa

Pcs

76

422

54

10

52

17

IV. Catheter No.18 G

Set

76

422

54

10

52

18

IV. Catheter No.20 G

Set

74

422

52

10

10

42

19

IV. Catheter No.22 G

Set

74

422

52

10

10

42

20

IV. Catheter No.24 G

Kotak

74

422

52

10

10

42

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

74

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

74

23

Kapas Pembalut / absorben 250 gram

Bungkus

74

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

79

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

74

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

74

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

28

Kertas EKG

29

Kertas USG Sony 110 HG

30

28 29

30

31

FISIK

FISIK FIX

SELISIH

422

52

10

10

42

422

52

10

10

42

422

52

10

10

42

422

57

10

13

44

422

52

10

10

42

422

52

10

10

42

74

422

52

10

10

42

Roll

74

422

52

10

10

42

Roll

74

422

52

10

10

42

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

75

422

53

10

11

42

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

74

422

52

10

10

42

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif


dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol

74
0

422

52

10

10

42

422

52

10

10

42

10

10

42

10

11

44

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/


peralatan kedokteran aldehyd free (mengandung zat aktif:
Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Botol 1 ltr

74

Lembar

74

422

52

Kotak

77

422

55

Masker O2

Pcs

74

422

52

10

10

42

37

Masker 95

Pcs

74

422

52

10

10

42

38

Masker nebulizer set dewasa

Pcs

75

422

53

10

52

39

Masker nebulizer set anak

Pcs

75

422

53

10

52

40

Plester 5 yard X 2 inch

Roll

74

422

52

10

10

42

41

Plester non alergi 0,5 inch / Micropore

Roll

77

422

55

10

13

42

42

Pot Urin

Pcs

74

422

52

10

10

42

43

Sarung Tangan

Kotak

76

422

54

10

10

44

44

Safety Box

Pcs

74

422

52

10

10

42

45

Surgical blade no.11 (Pisau Bedah)

Pcs

74

422

52

10

10

42

74

PEMERIKSAAN TB PARU

422

52

10

10

42

Emersi

Botol 100 ml

74

422

52

10

10

42

Eter Alkohol

Botol 100 ml

74

422

52

10

10

42

Kaca Slide / Object Glass

Kotak

74

422

52

10

10

42

PEMAKAIAN HARIAN

STOK

NAMA OBAT

SATUAN
KEMASAN

TOTAL

STOK

PAKAI

AKHIR

KET
AWAL

28 29

30

31

FISIK

FISIK FIX

SELISIH

Pot dahak

Pcs

74

422

52

10

10

42

Reagen Zielnelsen

Set

74

422

52

10

10

42

Spiritus Bakar

Botol

74

422

52

10

10

42

Tissu Lensa

Kotak

74

422

52

10

10

42

Tissue lensa

Buku

74

422

52

10

10

42

Wadah Kaca Slide / Box Slide

Pcs

74

422

52

10

10

42

10

Xylol/ Xylene

Botol 100 ml

74

422

52

10

10

42

11

Xylol/ Xylene

Botol 500 ml

74

422

52

10

10

42

74

422

52

10

10

42

422

52

10

10

42

422

92

10

20

72

72

10

10

62

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

74

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

114

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

94

422

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

78

422

56

10

12

44

Sendok obat

Pcs

174

422

152

100

10

110

42

74

422

52

10

10

42

422

242

144

10

154

88

412

373

10

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

264

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

385

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

Penanggung jawab apotek

NIP.19851219 200901 2 004

10

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


MARET 2015
NAMA PUSKESMAS : PANUNGGANGAN
ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936
STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

OBAT
1

Alopurinol tablet 100 mg

Tablet

362

200

562

435

127

Amlodipin tablet 5 mg

Tablet

286

200

486

435

51

Aminofillin tablet 200 mg

Tablet

252

200

452

435

17

Amoksilin kaplet 500 mg

Kaplet

2,127

200

2,327

435

1,892

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

118

200

318

435

(117)

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

1,800
200

2,000

435

1,565

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200 mg /
5 ml - 60 ml

Botol

200

267

435

(168)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g +


Polimiksin 10.000 IU/g

Tube

200

308

435

(127)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta


Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

200

253

435

(182)

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

444

200

644

435

209

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

52

200

252

435

(183)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot

52
200

252

435

(183)

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

200

287

435

(148)

200

367

435

(68)

200

262

435

(173)

13

67

108

53

87

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80%


+ Citrus Bioflavonoid 20% / Haemorogard

Kapsul

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr /
Klorfeson

Tube

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

52

200

252

435

(183)

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

52

200

252

435

(183)

18

Asam Asetilsalisilat tablet 80 mg

Tablet

52

200

252

435

(183)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,187

200

2,387

435

1,952

20

Asam Mefenamat kaplet 500 mg

Kaplet

682

200

882

435

447

21

Asiklovir krim 5 % - 5 gr

Tube

91

200

291

435

(144)

14

15

167

62

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

22

Asiklovir tablet 400 mg

Tablet

644

200

844

435

409

23

Atapulgit tablet 600 mg

Tablet

92

200

292

435

(143)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

55

200

255

435

(180)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah


darah kombinasi)

Tablet

1,561

200

1,761

435

1,326

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

52

200

252

435

(183)

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

80

200

280

435

(155)

28

Bisoprolol tablet 5 mg

Tablet

64

200

264

435

(171)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

78

200

278

435

(157)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

115

200

315

435

(120)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

Botol

53

200

253

435

(182)

32

Deksametason tablet 0,5 mg

Tablet

1,395

200

1,595

435

1,160

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

52

200

252

435

(183)

34

Difenhidramin injeksi 10 mg/ml

Ampul

52

200

252

435

(183)

35

Digoksin tablet 0,25 mg

Tablet

122

200

322

435

(113)

36

Domperidon tablet 10 mg

Tablet

348

200

548

435

113

37

Doksisiklin kapsul 100 mg

Kapsul

52

200

252

435

(183)

38

Efedrin tablet 25 mg (HCl)

Tablet

233

200

433

435

(2)

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

58

200

258

435

(177)

40

Eritromisin kapsul 500 mg

Kapsul

52

200

252

435

(183)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

70

200

270

435

(165)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

78

200

278

435

(157)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

68

200

268

435

(167)

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

157

200

357

435

(78)

45

Furosemid tablet 40 mg

Tablet

103

200

303

435

(132)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium


klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g, Glukosa
anhidrat 2,7 g

Sach

691
200

891

435

456

47

Gemfibrozil 300 mg kapsul

Kapsul

277

200

477

435

42

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

67

200

267

435

(168)

49

Glibenklamid tablet 5 mg

Tablet

786

200

986

435

551

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,144

200

3,344

435

2,909

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

52

200

252

435

(183)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

132

200

332

435

(103)

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

692

200

892

435

457

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA
AWAL

54

Hidrokortison krim 2,5 % - 5 gr

Tube

72

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

52

56

Ibuprofen tablet 400 mg

Tablet

427

57

Ichtyol salep kulit - 15 gr

Pot

69

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

202

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

52

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,277

61

Kaptopril tablet 25 mg

Tablet

62

Ketokonazol tablet 200 mg

Tablet

63

Klindamisin kapsul 150 mg

64

Kloramfenikol kapsul 250 mg

65

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

KET

200

272

435

(163)

200

252

435

(183)

200

627

435

192

200

269

435

(166)

200

402

435

(33)

200

252

435

(183)

200

1,477

435

1,042

833

200

1,033

435

598

121

200

321

435

(114)

Kapsul

52

200

252

435

(183)

Kapsul

52

200

252

435

(183)

Kloramfenikol salep mata 1% - 5 gr

Tube

52

200

252

435

(183)

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

99

200

299

435

(136)

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

80

200

280

435

(155)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

86

200

286

435

(149)

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,480

200

5,680

435

5,245

70

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

530
200

730

435

295

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

200

252

435

(183)

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

79
200

279

435

(156)

73

Levertraan salep - 15 gr

Pot

59

200

259

435

(176)

74

Lidokain injeksi 2% - 2 ml

Ampul

52

200

252

435

(183)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

52

200

252

435

(183)

76

Linkomisin kapsul 500 mg

Kapsul

52

200

252

435

(183)

77

Loperamid tablet 2 mg

Tablet

108

200

308

435

(127)

78

Loratadin tablet 10 mg

Tablet

105

200

305

435

(130)

79

Mebendazol tablet 100 mg

Tablet

52

200

252

435

(183)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

671

200

871

435

436

81

Metformin HCl tablet 500 mg

Tablet

303

200

503

435

68

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125


mg

Tablet

272

200

472

435

37

83

Metronidazol tablet 500 mg

Tablet

184

200

384

435

(51)

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

60

200

260

435

(175)

71

52

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

85

Multivit Sirup - 60 ml

Botol

134

200

334

435

(101)

86

Multivit Tablet

Tablet

52

200

252

435

(183)

87

Natrium Bikarbonat tablet 500 mg

Tablet

52

200

252

435

(183)

88

Natrium Diklofenak tablet 50 mg

Tablet

180

200

380

435

(55)

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

52

200

252

435

(183)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

53

200

253

435

(182)

91

Nifedipin tablet 10 mg

Tablet

70

200

270

435

(165)

92

Nistatin tablet salut 500.000 IU/g

Tablet

170

200

370

435

(65)

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

164

200

364

435

(71)

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

106

200

306

435

(129)

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100


mg) / Librozym

Tablet

52

200

252

435

(183)

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

82

200

282

435

(153)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

52

200

252

435

(183)

98

Omeprazol kapsul 20 mg

Kapsul

52

200

252

435

(183)

99

Papaverin tablet 40 mg

Tablet

385

200

585

435

150

100

Parasetamol drops

botol

109

200

309

435

(126)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

118

200

318

435

(117)

102

Parasetamol tablet 100 mg

Tablet

52

200

252

435

(183)

103

Parasetamol tablet 500 mg

Tablet

3,032

200

3,232

435

2,797

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

868

200

1,068

435

633

105

Piroksikam tablet 10 mg

Tablet

140

200

340

435

(95)

106

Polikresulen (kondensasi) - 10 ml

Botol

53

200

253

435

(182)

107

Povidon Iodida larutan 10 % - 300 ml

Botol

53

200

253

435

(182)

108

Prednison tablet 5 mg

Tablet

749

200

949

435

514

109

Propanolol tablet 10 mg (HCl)

Tablet

152

200

352

435

(83)

110

Propiltiourasil tablet 100 mg

Tablet

97

200

297

435

(138)

111

Ranitidin tablet 150 mg

Tablet

56

200

256

435

(179)

112

Ringer Laktat larutan infus - 500 ml

Botol

52

200

252

435

(183)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

192

200

392

435

(43)

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

52

200

252

435

(183)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap


4 % - 30 gr

Pot

67

200

267

435

(168)

116

Salisil Bedak 2 % - 50 gr

Kotak

131

200

331

435

(104)

117

Sefadroksil Kapsul 500 mg

Kapsul

170

200

370

435

(65)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

196

200

396

435

(39)

119

Simvastatin tablet 10 mg

Tablet

52

200

252

435

(183)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

387

200

587

435

152

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

52

200

252

435

(183)

122

Tetrasiklin kapsul 250 mg

Kapsul

52

200

252

435

(183)

123

Tetrasiklin kapsul 500 mg

Kapsul

215

200

415

435

(20)

124

Thiamfenikol kapsul 500 mg

Kapsul

52

200

252

435

(183)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,649

200

1,849

435

1,414

126

Vitamin B Kompleks tablet

Tablet

1,719

200

1,919

435

1,484

127

Zinc tablet 20 mg

Tablet

472

200

672

435

237

52

OBAT PROGRAM TB PARU

200

252

435

(183)

128

Obat FDC Kategori 1

Paket

52

200

252

435

(183)

129

Obat FDC Kategori 2

Paket

52

200

252

435

(183)

130

Obat FDC Anak

Paket

52

200

252

435

(183)

131

Obat FDC Sisipan

Paket

52

200

252

435

(183)

52

200

252

435

(183)

Vial

53

200

253

435

(182)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

114

200

314

435

(121)

134

Sefiksim kapsul 100 mg

Kapsul

52

200

252

435

(183)

52

200

252

435

(183)

52

200

252

435

(183)

52

200

252

435

(183)
(183)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

52

200

252

435

137

Pirantel tablet score (base) 125 mg

Tablet

125

200

325

435

(110)

52

200

252

435

(183)

200

252

435

(183)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

52

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

52

OBAT KEJIWAAN

200

252

435

(183)

52

200

252

435

(183)

Alprazolam tablet 1 mg

Tablet

271

200

471

435

36

Amitriptilin tablet salut 25 mg (HCl)

Tablet

103

200

303

435

(132)

Clobazam tablet 10 mg

Tablet

214

200

414

435

(21)

Diazepam tablet 2 mg

Tablet

189

200

389

435

(46)

Diazepam tablet 5 mg

Tablet

52

200

252

435

(183)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

52

200

252

435

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

Diazepam tube Rectal 5 mg/2.5 ml

Tube

53

200

253

435

(182)

Fenitoin Kapsul 100 mg

Kapsul

52

200

252

435

(183)

Fenobarbital tablet 30 mg

Tablet

75

200

275

435

(160)

10

Fluoxetin tablet 10 mg /

Tablet

52

200

252

435

(183)

11

Haloperidol tablet 1,5 mg

Tablet

262

200

462

435

27

12

Haloperidol tablet 5 mg

Tablet

478

200

678

435

243

13

Imipramin tablet 25 mg / Tofranil

Tablet

52

200

252

435

(183)

14

Karbamazepin tablet 200 mg

Tablet

52

200

252

435

(183)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

67

200

267

435

(168)

16

Kodein tablet 10 mg

Tablet

267

200

467

435

32

17

Risperidon tablet 2 mg

Tablet

52

200

252

435

(183)

18

Sertralin tablet / Nudep

Tablet

52

200

252

435

(183)

19

Triheksifenidil tablet 2 mg

Tablet

52

200

252

435

(183)

52

Antiprestin

OBAT GIGI

200

252

435

(183)

Artikulating Paper

Buku

52

200

252

435

(183)

Bur diamond high Speed

Kotak

52

200

252

435

(183)

Bur arkansas high Speed

buah

52

200

252

435

(183)

Cavit / Dentorit (Tambalan Sementara)

Pot

53

200

253

435

(182)

Celluloid strip

Set

52

200

252

435

(183)

Cresopen - 13 ml

Botol

52

200

252

435

(183)

Dentin Conditioner

Botol

52

200

252

435

(183)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

52

200

252

435

(183)

Disclosing Agent

Tube

52

200

252

435

(183)

10

Disposible saliva ejektor

Bungkus @
100 pcs

52

200

252

435

(183)

11

Etil Chlorida spray - 100 ml

Botol

53

200

253

435

(182)

12

Eugenol cairan

Botol

53

200

253

435

(182)

13

Glass Ionomer Radiopak / Fuji VII

Set

53

200

253

435

(182)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

53

200

253

435

(182)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

52

200

252

435

(183)

16

Macro gold + propylen + EDTA

Set

52

200

252

435

(183)

17

Oil Spray

Botol

52

200

252

435

(183)

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin


12.5 mcg )

Ampul

72
200

272

435

20

19

Pulperyl

Botol

52

200

252

435

(183)

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

52

200

252

435

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA
AWAL

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

52

22

Tetric N Ceram

Paket

52

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

52

24

Tetric Bonding - 6 gr

Botol

52

25

Tetric Etch Refill - 2 gr

Tube

52

26

Trikresol Formalin (TKF)

Botol

53

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

52

28

Xylestesin Non Adrenalin injeksi

Ampul

52

29

CHKM

Botol

30

Iodoform/Mumifying pasta

31
32

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

KET

200

252

435

(183)

200

252

435

(183)

200

252

435

(183)

200

252

435

(183)

200

252

435

(183)

200

253

435

(182)

200

252

435

(183)

200

252

435

(183)

52

200

252

435

(183)

Botol

52

200

252

435

(183)

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

52

200

252

435

(183)

Tambalan Sinar (4 syringe, etching, bonding)

Paket

52

200

252

435

(183)

52

200

252

435

(183)

PERBEKALAN KESEHATAN
1

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

52

200

252

435

(183)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

52

200

252

435

(183)

Alat Suntik sekali pakai 1 ml

Pcs

112

200

312

435

(123)

Alat Suntik sekali pakai 3 ml

Pcs

144

200

344

435

(91)

Alat Suntik sekali pakai 5 ml

Pcs

114

200

314

435

(121)

Blood set

Set

52

200

252

435

(183)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

52

200

252

435

(183)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

52

200

252

435

(183)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

52

200

252

435

(183)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

52

200

252

435

(183)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

52

200

252

435

(183)

12

Dental Film Hanshin

Pcs

52

200

252

435

(183)

13

Etanol 70 % - 1 L

Botol

54

200

254

435

(181)

14

Gel USG / EKG

Botol

52

200

252

435

(183)

15

Infusion Set Anak

Pcs

52

200

252

435

(183)

16

Infusion Set Dewasa

Pcs

54

200

254

435

(181)

17

IV. Catheter No.18 G

Set

54

200

254

435

(181)

18

IV. Catheter No.20 G

Set

52

200

252

435

(183)

19

IV. Catheter No.22 G

Set

52

200

252

435

(183)

20

IV. Catheter No.24 G

Kotak

52

200

252

435

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA
AWAL

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

52

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

52

23

Kapas Pembalut / absorben 250 gram

Bungkus

52

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

57

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

52

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

52

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

28

Kertas EKG

29

Kertas USG Sony 110 HG

30

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

KET

200

252

435

(183)

200

252

435

(183)

200

252

435

(183)

200

257

435

(178)

200

252

435

(183)

200

252

435

(183)

52

200

252

435

(183)

Roll

52

200

252

435

(183)

Roll

52

200

252

435

(183)

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

53

200

253

435

(182)

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

52

200

252

435

(183)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif


dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol

52
200

252

435

(183)

200

252

435

(183)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/


peralatan kedokteran aldehyd free (mengandung zat aktif:
Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Botol 1 ltr

52

Lembar

52

200

252

435

(183)

Kotak

55

200

255

435

(180)

Masker O2

Pcs

52

200

252

435

(183)

37

Masker 95

Pcs

52

200

252

435

(183)

38

Masker nebulizer set dewasa

Pcs

53

200

253

435

(182)

39

Masker nebulizer set anak

Pcs

53

200

253

435

(182)

40

Plester 5 yard X 2 inch

Roll

52

200

252

435

(183)

41

Plester non alergi 0,5 inch / Micropore

Roll

55

200

255

435

(180)

42

Pot Urin

Pcs

52

200

252

435

(183)

43

Sarung Tangan

Kotak

54

200

254

435

(181)

44

Safety Box

Pcs

52

200

252

435

(183)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

52

200

252

435

(183)

52

PEMERIKSAAN TB PARU

200

252

435

(183)

Emersi

Botol 100 ml

52

200

252

435

(183)

Eter Alkohol

Botol 100 ml

52

200

252

435

(183)

Kaca Slide / Object Glass

Kotak

52

200

252

435

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

KET

Pot dahak

Pcs

52

200

252

435

(183)

Reagen Zielnelsen

Set

52

200

252

435

(183)

Spiritus Bakar

Botol

52

200

252

435

(183)

Tissu Lensa

Kotak

52

200

252

435

(183)

Tissue lensa

Buku

52

200

252

435

(183)

Wadah Kaca Slide / Box Slide

Pcs

52

200

252

435

(183)

10

Xylol/ Xylene

Botol 100 ml

52

200

252

435

(183)

11

Xylol/ Xylene

Botol 500 ml

52

200

252

435

(183)

52

200

252

435

(183)

200

252

435

(183)

200

292

435

(143)

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

52

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

92

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

72

200

272

435

(163)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

56

200

256

435

(179)

Sendok obat

Pcs

152

200

352

435

(83)

52

200

252

435

(183)

200

442

435

200

573

435

138

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

242

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

373

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


APRIL 2015
NAMA PUSKESMAS : PANUNGGANGAN
ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936
STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

OBAT
1

Alopurinol tablet 100 mg

Tablet

127

600

727

665

Amlodipin tablet 5 mg

Tablet

51

600

651

660

(9)

Aminofillin tablet 200 mg

Tablet

17

600

617

660

(43)

Amoksilin kaplet 500 mg

Kaplet

1,892

600

2,492

660

1,832

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

(117)

600

483

660

(177)

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

1,565
600

2,165

660

1,505

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200 mg /
5 ml - 60 ml

Botol

600

432

660

(228)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g +


Polimiksin 10.000 IU/g

Tube

600

473

660

(187)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta


Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

600

418

660

(242)

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

209

600

809

660

149

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(183)

600

417

660

(243)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot

(183)
600

417

660

(243)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

(148)

600

452

660

(208)

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80%


+ Citrus Bioflavonoid 20% / Haemorogard

Kapsul

(68)
600

532

660

(128)

15

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr /
Klorfeson

Tube

600

427

660

(233)

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

(183)

600

417

660

(243)

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

(183)

600

417

660

(243)

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(183)

600

417

660

(243)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

1,952

600

2,552

660

1,892

20

Asam Mefenamat kaplet 500 mg

Kaplet

447

600

1,047

660

387

21

Asiklovir krim 5 % - 5 gr

Tube

(144)

600

456

660

(204)

22

Asiklovir tablet 400 mg

Tablet

409

600

1,009

660

349

23

Atapulgit tablet 600 mg

Tablet

(143)

600

457

660

(203)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(180)

600

420

660

(240)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah


darah kombinasi)

Tablet

1,326

600

1,926

660

1,266

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(183)

600

417

660

(243)

62

(168)

(127)

(182)

(173)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(155)

600

445

660

(215)

28

Bisoprolol tablet 5 mg

Tablet

(171)

600

429

660

(231)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(157)

600

443

660

(217)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(120)

600

480

660

(180)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

Botol

(182)

600

418

660

(242)

32

Deksametason tablet 0,5 mg

Tablet

1,160

600

1,760

660

1,100

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(183)

600

417

660

(243)

34

Difenhidramin injeksi 10 mg/ml

Ampul

(183)

600

417

660

(243)

35

Digoksin tablet 0,25 mg

Tablet

(113)

600

487

660

(173)

36

Domperidon tablet 10 mg

Tablet

113

600

713

660

53

37

Doksisiklin kapsul 100 mg

Kapsul

(183)

600

417

660

(243)

38

Efedrin tablet 25 mg (HCl)

Tablet

(2)

600

598

660

(62)

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(177)

600

423

660

(237)

40

Eritromisin kapsul 500 mg

Kapsul

(183)

600

417

660

(243)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(165)

600

435

660

(225)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(157)

600

443

660

(217)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(167)

600

433

660

(227)

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

(78)

600

522

660

(138)

45

Furosemid tablet 40 mg

Tablet

(132)

600

468

660

(192)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium


klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g, Glukosa
anhidrat 2,7 g

Sach

456
600

1,056

660

396

47

Gemfibrozil 300 mg kapsul

Kapsul

42

600

642

660

(18)

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

(168)

600

432

660

(228)

49

Glibenklamid tablet 5 mg

Tablet

551

600

1,151

660

491

50

Gliseril Guaiakolat tablet 100 mg

Tablet

2,909

600

3,509

660

2,849

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(183)

600

417

660

(243)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

(103)

600

497

660

(163)

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

457

600

1,057

660

397

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(163)

600

437

660

(223)

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(183)

600

417

660

(243)

56

Ibuprofen tablet 400 mg

Tablet

192

600

792

660

132

57

Ichtyol salep kulit - 15 gr

Pot

(166)

600

434

660

(226)

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

(33)

600

567

660

(93)

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(183)

600

417

660

(243)

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,042

600

1,642

660

982

61

Kaptopril tablet 25 mg

Tablet

598

600

1,198

660

1,086

62

Ketokonazol tablet 200 mg

Tablet

(114)

600

486

660

(174)

63

Klindamisin kapsul 150 mg

Kapsul

(183)

600

417

660

(243)

64

Kloramfenikol kapsul 250 mg

Kapsul

(183)

600

417

660

(243)

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(183)

600

417

660

(243)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(136)

600

464

660

(196)

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(155)

600

445

660

(215)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(149)

600

451

660

(209)

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,245

600

5,845

660

5,185

70

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

295
600

895

660

235

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

600

417

660

(243)

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

(156)
600

444

660

(216)

73

Levertraan salep - 15 gr

Pot

(176)

600

424

660

(236)

74

Lidokain injeksi 2% - 2 ml

Ampul

(183)

600

417

660

(243)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

(183)

600

417

660

(243)

76

Linkomisin kapsul 500 mg

Kapsul

(183)

600

417

660

(243)

77

Loperamid tablet 2 mg

Tablet

(127)

600

473

660

(187)

78

Loratadin tablet 10 mg

Tablet

(130)

600

470

660

(190)

79

Mebendazol tablet 100 mg

Tablet

(183)

600

417

660

(243)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

436

600

1,036

660

376

81

Metformin HCl tablet 500 mg

Tablet

68

600

668

660

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125


mg

Tablet

37

600

637

660

(23)

83

Metronidazol tablet 500 mg

Tablet

(51)

600

549

660

(111)

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(175)

600

425

660

(235)

85

Multivit Sirup - 60 ml

Botol

(101)

600

499

660

(161)

86

Multivit Tablet

Tablet

(183)

600

417

660

(243)

87

Natrium Bikarbonat tablet 500 mg

Tablet

(183)

600

417

660

(243)

88

Natrium Diklofenak tablet 50 mg

Tablet

(55)

600

545

660

(115)

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(183)

600

417

660

(243)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(182)

600

418

660

(242)

91

Nifedipin tablet 10 mg

Tablet

(165)

600

435

660

(225)

92

Nistatin tablet salut 500.000 IU/g

Tablet

(65)

600

535

660

(125)

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

(71)

600

529

660

(131)

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

(129)

600

471

660

(189)

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100


mg) / Librozym

Tablet

(183)

600

417

660

(243)

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(153)

600

447

660

(213)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(183)

600

417

660

(243)

98

Omeprazol kapsul 20 mg

Kapsul

(183)

600

417

660

(243)

99

Papaverin tablet 40 mg

Tablet

150

600

750

660

90

100

Parasetamol drops

botol

(126)

600

474

660

(186)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

(117)

600

483

660

(177)

102

Parasetamol tablet 100 mg

Tablet

(183)

600

417

660

(243)

71

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA
AWAL

103

Parasetamol tablet 500 mg

Tablet

2,797

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

633

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

Botol

107

Povidon Iodida larutan 10 % - 300 ml

Botol

(182)

108

Prednison tablet 5 mg

Tablet

109

Propanolol tablet 10 mg (HCl)

Tablet

110

Propiltiourasil tablet 100 mg

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

600

3,397

660

2,737

600

1,233

660

573

(95)

600

505

660

(155)

(182)

600

418

660

(242)

600

418

660

(242)

514

600

1,114

660

454

(83)

600

517

660

(143)

Tablet

(138)

600

462

660

(198)

111

Ranitidin tablet 150 mg

Tablet

(179)

600

421

660

(239)

112

Ringer Laktat larutan infus - 500 ml

Botol

(183)

600

417

660

(243)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

(43)

600

557

660

(103)

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(183)

600

417

660

(243)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap


4 % - 30 gr

Pot

(168)

600

432

660

(228)

116

Salisil Bedak 2 % - 50 gr

Kotak

(104)

600

496

660

(164)

117

Sefadroksil Kapsul 500 mg

Kapsul

(65)

600

535

660

(125)

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

(39)

600

561

660

(99)

119

Simvastatin tablet 10 mg

Tablet

(183)

600

417

660

(243)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

152

600

752

660

92

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

(183)

600

417

660

(243)

122

Tetrasiklin kapsul 250 mg

Kapsul

(183)

600

417

660

(243)

123

Tetrasiklin kapsul 500 mg

Kapsul

(20)

600

580

660

(80)

124

Thiamfenikol kapsul 500 mg

Kapsul

(183)

600

417

660

(243)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,414

600

2,014

660

1,354

126

Vitamin B Kompleks tablet

Tablet

1,484

600

2,084

660

1,424

127

Zinc tablet 20 mg

Tablet

237

600

837

660

177

(183)

OBAT PROGRAM TB PARU

600

417

660

(243)

128

Obat FDC Kategori 1

Paket

(183)

600

417

660

(243)

129

Obat FDC Kategori 2

Paket

(183)

600

417

660

(243)

130

Obat FDC Anak

Paket

(183)

600

417

660

(243)

131

Obat FDC Sisipan

Paket

(183)

600

417

660

(243)

(183)

600

417

660

(243)

Vial

(182)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

600

418

660

(242)

133

Levofloksasin tablet 500 mg

Tablet

(121)

600

479

660

(181)

134

Sefiksim kapsul 100 mg

Kapsul

(183)

600

417

660

(243)

(183)

600

417

660

(243)

(183)

600

417

660

(243)

(183)

600

417

660

(243)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

(183)

600

417

660

(243)

137

Pirantel tablet score (base) 125 mg

Tablet

(110)

600

490

660

(170)

(183)

600

417

660

(243)

(183)

600

417

660

(243)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

STOK

NAMA OBAT

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

SATUAN
KEMASAN

Kapsul

OBAT KEJIWAAN

TERIMA
AWAL

(183)

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

600

417

660

(243)

(183)

600

417

660

(243)

Alprazolam tablet 1 mg

Tablet

36

600

636

660

(24)

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(132)

600

468

660

(192)

Clobazam tablet 10 mg

Tablet

(21)

600

579

660

(81)

Diazepam tablet 2 mg

Tablet

(46)

600

554

660

(106)

Diazepam tablet 5 mg

Tablet

(183)

600

417

660

(243)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(183)

600

417

660

(243)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(182)

600

418

660

(242)

Fenitoin Kapsul 100 mg

Kapsul

(183)

600

417

660

(243)

Fenobarbital tablet 30 mg

Tablet

(160)

600

440

660

(220)

10

Fluoxetin tablet 10 mg /

Tablet

(183)

600

417

660

(243)

11

Haloperidol tablet 1,5 mg

Tablet

27

600

627

660

(33)

12

Haloperidol tablet 5 mg

Tablet

243

600

843

660

183

13

Imipramin tablet 25 mg / Tofranil

Tablet

(183)

600

417

660

(243)

14

Karbamazepin tablet 200 mg

Tablet

(183)

600

417

660

(243)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(168)

600

432

660

(228)

16

Kodein tablet 10 mg

Tablet

32

600

632

660

(28)

17

Risperidon tablet 2 mg

Tablet

(183)

600

417

660

(243)

18

Sertralin tablet / Nudep

Tablet

(183)

600

417

660

(243)

19

Triheksifenidil tablet 2 mg

Tablet

(183)

600

417

660

(243)

(183)

Antiprestin

OBAT GIGI

600

417

660

(243)

Artikulating Paper

Buku

(183)

600

417

660

(243)

Bur diamond high Speed

Kotak

(183)

600

417

660

(243)

Bur arkansas high Speed

buah

(183)

600

417

660

(243)

Cavit / Dentorit (Tambalan Sementara)

Pot

(182)

600

418

660

(242)

Celluloid strip

Set

(183)

600

417

660

(243)

Cresopen - 13 ml

Botol

(183)

600

417

660

(243)

Dentin Conditioner

Botol

(183)

600

417

660

(243)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(183)

600

417

660

(243)

Disclosing Agent

Tube

(183)

600

417

660

(243)

10

Disposible saliva ejektor

Bungkus @
100 pcs

(183)

600

417

660

(243)

11

Etil Chlorida spray - 100 ml

Botol

(182)

600

418

660

(242)

12

Eugenol cairan

Botol

(182)

600

418

660

(242)

13

Glass Ionomer Radiopak / Fuji VII

Set

(182)

600

418

660

(242)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(182)

600

418

660

(242)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(183)

600

417

660

(243)

16

Macro gold + propylen + EDTA

Set

(183)

600

417

660

(243)

17

Oil Spray

Botol

(183)

600

417

660

(243)

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin


12.5 mcg )

Ampul

20
600

620

660

(40)

19

Pulperyl

Botol

(183)

600

417

660

(243)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA
AWAL

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(183)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(183)

22

Tetric N Ceram

Paket

(183)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(183)

24

Tetric Bonding - 6 gr

Botol

(183)

25

Tetric Etch Refill - 2 gr

Tube

26

Trikresol Formalin (TKF)

27

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

(183)

600

417

660

(243)

Botol

(182)

600

418

660

(242)

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(183)

600

417

660

(243)

28

Xylestesin Non Adrenalin injeksi

Ampul

(183)

600

417

660

(243)

29

CHKM

Botol

(183)

600

417

660

(243)

30

Iodoform/Mumifying pasta

Botol

(183)

600

417

660

(243)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(183)

600

417

660

(243)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(183)

600

417

660

(243)

(183)

600

417

660

(243)

PERBEKALAN KESEHATAN
1

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(183)

600

417

660

(243)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(183)

600

417

660

(243)

Alat Suntik sekali pakai 1 ml

Pcs

(123)

600

477

660

(183)

Alat Suntik sekali pakai 3 ml

Pcs

(91)

600

509

660

(151)

Alat Suntik sekali pakai 5 ml

Pcs

(121)

600

479

660

(181)

Blood set

Set

(183)

600

417

660

(243)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(183)

600

417

660

(243)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(183)

600

417

660

(243)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(183)

600

417

660

(243)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(183)

600

417

660

(243)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(183)

600

417

660

(243)

12

Dental Film Hanshin

Pcs

(183)

600

417

660

(243)

13

Etanol 70 % - 1 L

Botol

(181)

600

419

660

(241)

14

Gel USG / EKG

Botol

(183)

600

417

660

(243)

15

Infusion Set Anak

Pcs

(183)

600

417

660

(243)

16

Infusion Set Dewasa

Pcs

(181)

600

419

660

(241)

17

IV. Catheter No.18 G

Set

(181)

600

419

660

(241)

18

IV. Catheter No.20 G

Set

(183)

600

417

660

(243)

19

IV. Catheter No.22 G

Set

(183)

600

417

660

(243)

20

IV. Catheter No.24 G

Kotak

(183)

600

417

660

(243)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(183)

600

417

660

(243)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(183)

600

417

660

(243)

23

Kapas Pembalut / absorben 250 gram

Bungkus

(183)

600

417

660

(243)

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(178)

600

422

660

(238)

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(183)

600

417

660

(243)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(183)

600

417

660

(243)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(183)

600

417

660

(243)

28

Kertas EKG

Roll

(183)

600

417

660

(243)

29

Kertas USG Sony 110 HG

Roll

(183)

600

417

660

(243)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(182)

600

418

660

(242)

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

(183)

600

417

660

(243)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif


dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol

(183)
600

417

660

(243)

600

417

660

(243)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/


peralatan kedokteran aldehyd free (mengandung zat aktif:
Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Botol 1 ltr

(183)

Lembar

(183)

600

417

660

(243)

Kotak

(180)

600

420

660

(240)

Masker O2

Pcs

(183)

600

417

660

(243)

37

Masker 95

Pcs

(183)

600

417

660

(243)

38

Masker nebulizer set dewasa

Pcs

(182)

600

418

660

(242)

39

Masker nebulizer set anak

Pcs

(182)

600

418

660

(242)

40

Plester 5 yard X 2 inch

Roll

(183)

600

417

660

(243)

41

Plester non alergi 0,5 inch / Micropore

Roll

(180)

600

420

660

(240)

42

Pot Urin

Pcs

(183)

600

417

660

(243)

43

Sarung Tangan

Kotak

(181)

600

419

660

(241)

44

Safety Box

Pcs

(183)

600

417

660

(243)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(183)

600

417

660

(243)

(183)

600

417

660

(243)

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

(183)

600

417

660

(243)

Eter Alkohol

Botol 100 ml

(183)

600

417

660

(243)

Kaca Slide / Object Glass

Kotak

(183)

600

417

660

(243)

Pot dahak

Pcs

(183)

600

417

660

(243)

Reagen Zielnelsen

Set

(183)

600

417

660

(243)

Spiritus Bakar

Botol

(183)

600

417

660

(243)

Tissu Lensa

Kotak

(183)

600

417

660

(243)

Tissue lensa

Buku

(183)

600

417

660

(243)

Wadah Kaca Slide / Box Slide

Pcs

(183)

600

417

660

(243)

10

Xylol/ Xylene

Botol 100 ml

(183)

600

417

660

(243)

11

Xylol/ Xylene

Botol 500 ml

(183)

600

417

660

(243)

(183)

600

417

660

(243)

600

417

660

(243)

600

457

660

(203)

600

437

660

(223)

600

421

660

(239)

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(183)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(143)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(163)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(179)

STOK

NAMA OBAT
5

Sendok obat

SATUAN
KEMASAN

Pcs

AKUPUNTUR

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

(83)

600

517

660

(143)

(183)

600

417

660

(243)

Jarum Akupuntur 13 mm

Kotak

(183)

600

417

660

(243)

Jarum Akupuntur 25 mm

Kotak

(183)

600

417

660

(243)

Jarum Akupuntur 40 mm

Kotak

(183)

600

417

660

(243)

Jarum telinga (press needle)

Kotak

(183)

600

417

660

(243)

Moxa Roll

Kotak

(183)

600

417

660

(243)

(183)

600

417

660

(243)

Pcs

(183)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(183)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/


Vit. K Neonatal

Ampul

(183)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(183)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(183)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(183)

MgSO4 40% injeksi

Vial

(183)

600

417

660

(243)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(183)

600

417

660

(243)

Natrium Bicarbonat injeksi

Ampul

(183)

600

417

660

(243)

10

Nasal dewasa / Maxyflow

Pcs

(183)

600

417

660

(243)

11

Nasal infant/ Oxyflow

Pcs

(183)

600

417

660

(243)

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

(183)

600

417

660

(243)

13

Penghisap Lendir Bayi Baru Lahir

Pcs

(183)

600

417

660

(243)

14

Sarung Tangan panjang obgyn No. 6,5

Pasang

(183)

600

417

660

(243)

15

Sarung Tangan panjang obgyn No. 7

Pasang

(183)

600

417

660

(243)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(183)

600

417

660

(243)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(183)

600

417

660

(243)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(183)

600

417

660

(243)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(183)

600

417

660

(243)

20

Sungkup bayi

Set

(183)

600

417

660

(243)

21

Tanda Pengenal (ID Band) Bayi

Psc

(183)

600

417

660

(243)

22

Tanda Pengenal (ID Band) Ibu

Psc

(183)

600

417

660

(243)

23

Under Pad 60 x 90 cm

Psc

(183)

600

417

660

(243)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(183)

TAMBAHAN

600

417

660

(243)

(183)

600

417

660

(243)

Ambroksol tablet 30mg

Tablet

600

607

660

(53)

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(183)

600

417

660

(243)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq,


Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)

Botol

(183)
600

417

660

(243)

Asiklovir tablet 200 mg

Tablet

(183)

600

417

660

(243)

Bisacodyl 5 mg / Bicolax

Tablet

(183)

600

417

660

(243)

Biskodil sup 10 mg

Supp

(183)

600

417

660

(243)

STOK

NAMA OBAT
7

Buskopan injeksi

SATUAN
KEMASAN

TERIMA

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

Ampul

(183)

600

417

660

(243)

Bur Fissure standart

Pcs

(183)

600

417

660

(243)

Bur Fissure panjang

Pcs

(183)

600

417

660

(243)

10

Cetirizin HCl 10 mg

Tablet

(183)

600

417

660

(243)

11

Cetirizin syrup 100 mg / 5 ml

botol

(183)

600

417

660

(243)

12

Cefixim / sefiksim 100 mg caplet

kaplet

(183)

600

417

660

(243)

13

Etanol 96 % - 1 L

Botol

(183)

600

417

660

(243)

14

Gentian Violet larutan 1 %

Botol

(183)

600

417

660

(243)

15

Glucose Larutan Infus 10% Steril

Botol

(183)

600

417

660

(243)

16

Jarum Suntik No. 27 G

Pcs

(183)

600

417

660

(243)

17

Ketokonazole Krim 2%

Tube

(183)

600

417

660

(243)

18

Klindamisin kapsul 150 mg

Kapsul

(178)

600

422

660

(238)

19

Klindamisin 300 MG

Kapsul

(183)

600

417

660

(243)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(183)

600

417

660

(243)

21

Kasa 2x80

22

Kapas 500 gram

23

Roll

(183)

600

417

660

(243)

Bungkus

(183)

600

417

660

(243)

Larutan H2O2

Botol

(183)

600

417

660

(243)

24

Methilprednisolon 4 mg

tablet

(183)

600

417

660

(243)

25

Metoklopramid injeksi / Primperan

Vial

(183)

600

417

660

(243)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(183)

600

417

660

(243)

27

Metronidazol tablet 250 mg

Tablet

(183)

600

417

660

(243)

28

Meylon injeksi

Botol

(183)

600

417

660

(243)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg,


Gliseril guayakolat 50 mg, Phenylpropanolamine HCL 12,5
mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(183)
600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

30

31

32

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) 20 gr / Thrombophob

Tube

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000


IU, NeomIsin sulfat 5 mg, Fludrokortison asetat 1 mg,
Lidokain Hcl 40 mg ) / Otopain / Otopraf

Botol

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg,


Lidocain HCl 10 mg)/Etamidon injeksi

Vial

(183)

(183)

(183)

33

Polymigel tablet 400 mg/Strocain P

Tablet

(183)

600

417

660

(243)

34

Propanolol tablet 40 mg (HCl)

Tablet

(183)

600

417

660

(243)

35

Ranitidin injeksi 25 mg/ml

Ampul

(183)

600

417

660

(243)

36

Saccaharine tablet

Tablet

(183)

600

417

660

(243)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(183)

600

417

660

(243)

38

Sefadroxil syrup 125 mg

botol

(183)

600

417

660

(243)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(183)

600

417

660

(243)

40

Teofilin tablet / Bronsolvan

Tablet

(183)

600

417

660

(243)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(183)

600

417

660

(243)

600

417

660

(243)

OBAT KESDA

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

TERIMA
AWAL

Kalium Diklofenak tablet 50 mg

tablet

(183)

Obat Tetes mata kombinasi antiseptik & kortikosteroid


(Dexamethason Sod.Phosfate 1,0 mg, Neomycin Sulphate
setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU)
- 5 ml

tube

(183)

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500


mg, Dextromethorphan HBr 15 mg, Phenylpropanolamine
HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

kaplet

Obat Analgetik kombinasi dengan Psikotropik kaplet


(Metampiron 500 mg, Diazepam 2 mg) / Metaneuron

kaplet

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol


500 mg, Vitamin B6 100 mg, Vitamin B1 50 mg, Vitamin
B12 100 mcg) / Erlagin

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg,


Phenylprophanolamine HCl 3.125 mg, Chlorpheniramine
Maleate 0.5 mg ) - 60 ml / Molexflu sirup

botol

Obat Antiinfluenza kaplet ( Paracetamol 500 mg.


Phenylpropanolamin HCl 12,5 mg+ Chlorpheniramin Maleat
2 mg ) / Molexflu kaplet

kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl


12,5 mg+ Ammonium Chlorida 125 mg+ Sodium Citrat 50
mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5


mg, Pseudoefedrin HCl 30mg)/Flutrop

tablet

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak


Belladona 10 mg, Papaverin HCl 25 mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet


( Phenylpropanolamin HCl 15 mg+ Chlorpheniramin Maleat
2 mg ) / Nalgestan

tablet

13

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%,


Eugenol 1,5%) - 30 gr / Painkilla

tube

14

Salep kulit kombinasi antiinfeksi dgn kortikosteroid


(Betamethasone 1 mg, Neomycin sulfat 5 mg) - 5 gr /
Bevalex

tube

11

12

15

16

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15


mg, Vit. B2 10 mg, Vit. B6 5 mg, Vit. B12 100 mcg, Vit. C 500
mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

STOK

PAKAI

AKHIR

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

417

660

(243)

600

738

660

78

(183)

(183)

(183)

(183)

(183)

(183)

(183)

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200


mg, Vit.B12 250 mcg )

10

TOTAL
PERSEDIAAN

kaplet

Botol

(183)

(183)

(183)

(183)

(183)

(183)

138

STOK

NAMA OBAT

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

SATUAN
KEMASAN

TERIMA
AWAL

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


APRIL 2015

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


APRIL 2015

NAMA PUSKESMAS : PANUNGGANGAN


ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936
STOK

NAMA OBAT

SATUAN
KEMASAN

KET
AWAL

OBAT
1

Alopurinol tablet 100 mg

Tablet

127

Amlodipin tablet 5 mg

Tablet

51

Aminofillin tablet 200 mg

Tablet

17

Amoksilin kaplet 500 mg

Kaplet

1,892

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

(117)

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

1,565

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200 mg /
5 ml - 60 ml

Botol

(168)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g +


Polimiksin 10.000 IU/g

Tube

(127)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta


Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

(182)

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

209

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(183)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot

(183)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

(148)

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80%


+ Citrus Bioflavonoid 20% / Haemorogard

Kapsul

(68)

15

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr /
Klorfeson

Tube

(173)

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

(183)

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

(183)

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(183)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

1,952

20

Asam Mefenamat kaplet 500 mg

Kaplet

447

21

Asiklovir krim 5 % - 5 gr

Tube

(144)

22

Asiklovir tablet 400 mg

Tablet

409

23

Atapulgit tablet 600 mg

Tablet

(143)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(180)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah


darah kombinasi)

Tablet

1,326

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

KET
AWAL

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(155)

28

Bisoprolol tablet 5 mg

Tablet

(171)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(157)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(120)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

Botol

(182)

32

Deksametason tablet 0,5 mg

Tablet

1,160

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(183)

34

Difenhidramin injeksi 10 mg/ml

Ampul

(183)

35

Digoksin tablet 0,25 mg

Tablet

(113)

36

Domperidon tablet 10 mg

Tablet

113

37

Doksisiklin kapsul 100 mg

Kapsul

(183)

38

Efedrin tablet 25 mg (HCl)

Tablet

(2)

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(177)

40

Eritromisin kapsul 500 mg

Kapsul

(183)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(165)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(157)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(167)

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

(78)

45

Furosemid tablet 40 mg

Tablet

(132)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium


klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g, Glukosa
anhidrat 2,7 g

Sach

456

47

Gemfibrozil 300 mg kapsul

Kapsul

42

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

(168)

49

Glibenklamid tablet 5 mg

Tablet

551

50

Gliseril Guaiakolat tablet 100 mg

Tablet

2,909

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(183)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

(103)

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

457

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(163)

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(183)

56

Ibuprofen tablet 400 mg

Tablet

192

57

Ichtyol salep kulit - 15 gr

Pot

(166)

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

(33)

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(183)

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,042

61

Kaptopril tablet 25 mg

Tablet

598

62

Ketokonazol tablet 200 mg

Tablet

(114)

63

Klindamisin kapsul 150 mg

Kapsul

(183)

64

Kloramfenikol kapsul 250 mg

Kapsul

(183)

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(183)

EXP.10-15

STOK

NAMA OBAT

SATUAN
KEMASAN

KET
AWAL

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(136)

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(155)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(149)

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,245

70

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

295

71

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

(183)

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

(156)

73

Levertraan salep - 15 gr

Pot

(176)

74

Lidokain injeksi 2% - 2 ml

Ampul

(183)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

(183)

76

Linkomisin kapsul 500 mg

Kapsul

(183)

77

Loperamid tablet 2 mg

Tablet

(127)

78

Loratadin tablet 10 mg

Tablet

(130)

79

Mebendazol tablet 100 mg

Tablet

(183)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

436

81

Metformin HCl tablet 500 mg

Tablet

68

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125


mg

Tablet

37

83

Metronidazol tablet 500 mg

Tablet

(51)

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(175)

85

Multivit Sirup - 60 ml

Botol

(101)

86

Multivit Tablet

Tablet

(183)

87

Natrium Bikarbonat tablet 500 mg

Tablet

(183)

88

Natrium Diklofenak tablet 50 mg

Tablet

(55)

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(183)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(182)

91

Nifedipin tablet 10 mg

Tablet

(165)

92

Nistatin tablet salut 500.000 IU/g

Tablet

(65)

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

(71)

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

(129)

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100


mg) / Librozym

Tablet

(183)

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(153)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(183)

98

Omeprazol kapsul 20 mg

Kapsul

(183)

99

Papaverin tablet 40 mg

Tablet

150

100

Parasetamol drops

botol

(126)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

(117)

102

Parasetamol tablet 100 mg

Tablet

(183)

EXP.JAN-17

STOK

NAMA OBAT

SATUAN
KEMASAN

KET
AWAL

103

Parasetamol tablet 500 mg

Tablet

2,797

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

633

105

Piroksikam tablet 10 mg

Tablet

(95)

106

Polikresulen (kondensasi) - 10 ml

Botol

(182)

107

Povidon Iodida larutan 10 % - 300 ml

Botol

(182)

108

Prednison tablet 5 mg

Tablet

514

109

Propanolol tablet 10 mg (HCl)

Tablet

(83)

110

Propiltiourasil tablet 100 mg

Tablet

(138)

111

Ranitidin tablet 150 mg

Tablet

(179)

112

Ringer Laktat larutan infus - 500 ml

Botol

(183)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

(43)

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(183)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap


4 % - 30 gr

Pot

(168)

116

Salisil Bedak 2 % - 50 gr

Kotak

(104)

117

Sefadroksil Kapsul 500 mg

Kapsul

(65)

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

(39)

119

Simvastatin tablet 10 mg

Tablet

(183)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

152

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

(183)

122

Tetrasiklin kapsul 250 mg

Kapsul

(183)

123

Tetrasiklin kapsul 500 mg

Kapsul

(20)

124

Thiamfenikol kapsul 500 mg

Kapsul

(183)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,414

126

Vitamin B Kompleks tablet

Tablet

1,484

127

Zinc tablet 20 mg

Tablet

OBAT PROGRAM TB PARU

237
(183)

128

Obat FDC Kategori 1

Paket

(183)

129

Obat FDC Kategori 2

Paket

(183)

130

Obat FDC Anak

Paket

(183)

131

Obat FDC Sisipan

Paket

(183)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133
134

(183)
Vial

(182)

Levofloksasin tablet 500 mg

Tablet

(121)

Sefiksim kapsul 100 mg

Kapsul

(183)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

(183)
Tablet

OBAT PROGRAM KECACINGAN

(183)
(183)

136

Albendazole tablet 400 mg

Tablet

(183)

137

Pirantel tablet score (base) 125 mg

Tablet

(110)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

(183)
Kapsul

(183)

STOK

NAMA OBAT

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

SATUAN
KEMASAN

Kapsul

OBAT KEJIWAAN

KET
AWAL

(183)
(183)

Alprazolam tablet 1 mg

Tablet

36

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(132)

Clobazam tablet 10 mg

Tablet

(21)

Diazepam tablet 2 mg

Tablet

(46)

Diazepam tablet 5 mg

Tablet

(183)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(183)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(182)

Fenitoin Kapsul 100 mg

Kapsul

(183)

Fenobarbital tablet 30 mg

Tablet

(160)

10

Fluoxetin tablet 10 mg /

Tablet

(183)

11

Haloperidol tablet 1,5 mg

Tablet

27

12

Haloperidol tablet 5 mg

Tablet

243

13

Imipramin tablet 25 mg / Tofranil

Tablet

(183)

14

Karbamazepin tablet 200 mg

Tablet

(183)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(168)

16

Kodein tablet 10 mg

Tablet

32

17

Risperidon tablet 2 mg

Tablet

(183)

18

Sertralin tablet / Nudep

Tablet

(183)

19

Triheksifenidil tablet 2 mg

Tablet

(183)

Antiprestin

OBAT GIGI

(183)

Artikulating Paper

Buku

(183)

Bur diamond high Speed

Kotak

(183)

Bur arkansas high Speed

buah

(183)

Cavit / Dentorit (Tambalan Sementara)

Pot

(182)

Celluloid strip

Set

(183)

Cresopen - 13 ml

Botol

(183)

Dentin Conditioner

Botol

(183)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(183)

Disclosing Agent

Tube

(183)

Bungkus @
100 pcs

(183)

10

Disposible saliva ejektor

11

Etil Chlorida spray - 100 ml

Botol

(182)

12

Eugenol cairan

Botol

(182)

13

Glass Ionomer Radiopak / Fuji VII

Set

(182)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(182)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(183)

16

Macro gold + propylen + EDTA

Set

(183)

17

Oil Spray

Botol

(183)

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin


12.5 mcg )

Ampul

20

19

Pulperyl

Botol

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

KET
AWAL

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(183)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(183)

22

Tetric N Ceram

Paket

(183)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(183)

24

Tetric Bonding - 6 gr

Botol

(183)

25

Tetric Etch Refill - 2 gr

Tube

(183)

26

Trikresol Formalin (TKF)

Botol

(182)

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(183)

28

Xylestesin Non Adrenalin injeksi

Ampul

(183)

29

CHKM

Botol

(183)

30

Iodoform/Mumifying pasta

Botol

(183)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(183)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(183)

PERBEKALAN KESEHATAN

(183)

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(183)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(183)

Alat Suntik sekali pakai 1 ml

Pcs

(123)

Alat Suntik sekali pakai 3 ml

Pcs

(91)

Alat Suntik sekali pakai 5 ml

Pcs

(121)

Blood set

Set

(183)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(183)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(183)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(183)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(183)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(183)

12

Dental Film Hanshin

Pcs

(183)

13

Etanol 70 % - 1 L

Botol

(181)

14

Gel USG / EKG

Botol

(183)

15

Infusion Set Anak

Pcs

(183)

16

Infusion Set Dewasa

Pcs

(181) EXP.10-17

17

IV. Catheter No.18 G

Set

(181) Exp.jul-15

18

IV. Catheter No.20 G

Set

(183)

19

IV. Catheter No.22 G

Set

(183)

20

IV. Catheter No.24 G

Kotak

(183)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(183)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(183)

23

Kapas Pembalut / absorben 250 gram

Bungkus

(183)

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(178)

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(183)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

KET
AWAL

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(183)

28

Kertas EKG

Roll

(183)

29

Kertas USG Sony 110 HG

Roll

(183)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(182)

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

(183)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif


dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol

(183)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/


peralatan kedokteran aldehyd free (mengandung zat aktif:
Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

Botol 1 ltr

(183)

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

Lembar

(183)

35

Masker

Kotak

(180)

36

Masker O2

Pcs

(183)

37

Masker 95

Pcs

(183)

38

Masker nebulizer set dewasa

Pcs

(182)

39

Masker nebulizer set anak

Pcs

(182)

40

Plester 5 yard X 2 inch

Roll

(183)

41

Plester non alergi 0,5 inch / Micropore

Roll

(180)

42

Pot Urin

Pcs

(183)

43

Sarung Tangan

Kotak

(181)

44

Safety Box

Pcs

(183)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(183)

PEMERIKSAAN TB PARU

(183)

Emersi

Botol 100 ml

(183)

Eter Alkohol

Botol 100 ml

(183)

Kaca Slide / Object Glass

Kotak

(183)

Pot dahak

Pcs

(183)

Reagen Zielnelsen

Set

(183)

Spiritus Bakar

Botol

(183)

Tissu Lensa

Kotak

(183)

Tissue lensa

Buku

(183)

Wadah Kaca Slide / Box Slide

Pcs

(183)

10

Xylol/ Xylene

Botol 100 ml

(183)

11

Xylol/ Xylene

Botol 500 ml

(183)

EMBALAGE

(183)

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(183)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(143)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(163)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(179)

STOK

NAMA OBAT
5

Sendok obat

SATUAN
KEMASAN

Pcs

AKUPUNTUR

KET
AWAL

(83)
(183)

Jarum Akupuntur 13 mm

Kotak

(183)

Jarum Akupuntur 25 mm

Kotak

(183)

Jarum Akupuntur 40 mm

Kotak

(183)

Jarum telinga (press needle)

Kotak

(183)

Moxa Roll

Kotak

(183)

OBAT PONED
1

Apron plastik

(183)
Pcs

(183)

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(183)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/


Vit. K Neonatal

Ampul

(183)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(183)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(183)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(183)

MgSO4 40% injeksi

Vial

(183)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(183)

Natrium Bicarbonat injeksi

Ampul

(183)

10

Nasal dewasa / Maxyflow

Pcs

(183)

11

Nasal infant/ Oxyflow

Pcs

(183)

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

(183)

13

Penghisap Lendir Bayi Baru Lahir

Pcs

(183)

14

Sarung Tangan panjang obgyn No. 6,5

Pasang

(183)

15

Sarung Tangan panjang obgyn No. 7

Pasang

(183)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(183)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(183)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(183)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(183)

20

Sungkup bayi

Set

(183)

21

Tanda Pengenal (ID Band) Bayi

Psc

(183)

22

Tanda Pengenal (ID Band) Ibu

Psc

(183)

23

Under Pad 60 x 90 cm

Psc

(183)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(183)

TAMBAHAN

(183)

Ambroksol tablet 30mg

Tablet

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(183)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq,


Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)

Botol

(183)

Asiklovir tablet 200 mg

Tablet

(183)

Bisacodyl 5 mg / Bicolax

Tablet

(183)

Biskodil sup 10 mg

Supp

(183)

STOK

NAMA OBAT
7

Buskopan injeksi

Bur Fissure standart

SATUAN
KEMASAN

KET
AWAL

Ampul

(183)

Pcs

(183)

Bur Fissure panjang

Pcs

(183)

10

Cetirizin HCl 10 mg

Tablet

(183)

11

Cetirizin syrup 100 mg / 5 ml

botol

(183)

12

Cefixim / sefiksim 100 mg caplet

kaplet

(183)

13

Etanol 96 % - 1 L

Botol

(183)

14

Gentian Violet larutan 1 %

Botol

(183)

15

Glucose Larutan Infus 10% Steril

Botol

(183)

16

Jarum Suntik No. 27 G

Pcs

(183)

17

Ketokonazole Krim 2%

Tube

(183)

18

Klindamisin kapsul 150 mg

Kapsul

(178)

19

Klindamisin 300 MG

Kapsul

(183)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(183)

21

Kasa 2x80

22

Kapas 500 gram

23

Roll

(183)

Bungkus

(183)

Larutan H2O2

Botol

(183)

24

Methilprednisolon 4 mg

tablet

(183)

25

Metoklopramid injeksi / Primperan

Vial

(183)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(183)

27

Metronidazol tablet 250 mg

Tablet

(183)

28

Meylon injeksi

Botol

(183)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg,


Gliseril guayakolat 50 mg, Phenylpropanolamine HCL 12,5
mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(183)

30

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) 20 gr / Thrombophob

Tube

(183)

31

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000


IU, NeomIsin sulfat 5 mg, Fludrokortison asetat 1 mg,
Lidokain Hcl 40 mg ) / Otopain / Otopraf

Botol

(183)

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg,


Lidocain HCl 10 mg)/Etamidon injeksi

Vial

(183)

33

Polymigel tablet 400 mg/Strocain P

Tablet

(183)

34

Propanolol tablet 40 mg (HCl)

Tablet

(183)

35

Ranitidin injeksi 25 mg/ml

Ampul

(183)

36

Saccaharine tablet

Tablet

(183)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(183)

38

Sefadroxil syrup 125 mg

botol

(183)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(183)

40

Teofilin tablet / Bronsolvan

Tablet

(183)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(183)

OBAT KESDA

(183)

STOK

NAMA OBAT

SATUAN
KEMASAN

KET
AWAL

Kalium Diklofenak tablet 50 mg

tablet

(183)

Obat Tetes mata kombinasi antiseptik & kortikosteroid


(Dexamethason Sod.Phosfate 1,0 mg, Neomycin Sulphate
setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU)
- 5 ml

tube

(183)

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500


mg, Dextromethorphan HBr 15 mg, Phenylpropanolamine
HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

kaplet

(183)

Obat Analgetik kombinasi dengan Psikotropik kaplet


(Metampiron 500 mg, Diazepam 2 mg) / Metaneuron

kaplet

(183)

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol


500 mg, Vitamin B6 100 mg, Vitamin B1 50 mg, Vitamin
B12 100 mcg) / Erlagin

kaplet

(183)

Obat Antiinfluenza syrup ( Parasetamol 125 mg,


Phenylprophanolamine HCl 3.125 mg, Chlorpheniramine
Maleate 0.5 mg ) - 60 ml / Molexflu sirup

botol

(183)

Obat Antiinfluenza kaplet ( Paracetamol 500 mg.


Phenylpropanolamin HCl 12,5 mg+ Chlorpheniramin Maleat
2 mg ) / Molexflu kaplet

kaplet

(183)

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl


12,5 mg+ Ammonium Chlorida 125 mg+ Sodium Citrat 50
mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

(183)

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5


mg, Pseudoefedrin HCl 30mg)/Flutrop

10

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200


mg, Vit.B12 250 mcg )

tablet

(183)

11

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak


Belladona 10 mg, Papaverin HCl 25 mg) / Spasminal

tablet

(183)

12

Obat Vasokonstriktor dan antihistamin tablet


( Phenylpropanolamin HCl 15 mg+ Chlorpheniramin Maleat
2 mg ) / Nalgestan

tablet

(183)

13

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%,


Eugenol 1,5%) - 30 gr / Painkilla

tube

(183)

14

Salep kulit kombinasi antiinfeksi dgn kortikosteroid


(Betamethasone 1 mg, Neomycin sulfat 5 mg) - 5 gr /
Bevalex

tube

(183)

15

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15


mg, Vit. B2 10 mg, Vit. B6 5 mg, Vit. B12 100 mcg, Vit. C 500
mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

kaplet

(183)

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

138

(183)

STOK

NAMA OBAT

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

SATUAN
KEMASAN

KET
AWAL

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


MEI 2015
NAMA PUSKESMAS : PANUNGGANGAN
ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936
STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL
3

OBAT
1

Alopurinol tablet 100 mg

Tablet

62

700

762

500

262

Amlodipin tablet 5 mg

Tablet

(9)

700

691

500

191

Aminofillin tablet 200 mg

Tablet

(43)

700

657

500

157

Amoksilin kaplet 500 mg

Kaplet

700

2,532

500

2,032

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

700

523

500

23

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

700

2,205

500

1,705

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200 mg /
5 ml - 60 ml

Botol

700

472

500

(28)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g +


Polimiksin 10.000 IU/g

Tube

700

513

500

13

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta


Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

700

458

500

(42)

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

149

700

849

500

349

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(243)

700

457

500

(43)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot

(243)
700

457

500

(43)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

(208)

700

492

500

(8)

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80%


+ Citrus Bioflavonoid 20% / Haemorogard

Kapsul

(128)
700

572

500

72

15

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr /
Klorfeson

Tube

700

467

500

(33)

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

(243)

700

457

500

(43)

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

(243)

700

457

500

(43)

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(243)

700

457

500

(43)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

1,892

700

2,592

500

2,092

20

Asam Mefenamat kaplet 500 mg

Kaplet

387

700

1,087

500

587

21

Asiklovir krim 5 % - 5 gr

Tube

(204)

700

496

500

(4)

22

Asiklovir tablet 400 mg

Tablet

349

700

1,049

500

549

23

Atapulgit tablet 600 mg

Tablet

(203)

700

497

500

(3)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(240)

700

460

500

(40)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah


darah kombinasi)

Tablet

700

1,966

500

1,466

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

700

457

500

(43)

1,832
(177)
1,505

(228)

(187)

(242)

(233)

1,266
(243)

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(215)

700

485

500

(15)

28

Bisoprolol tablet 5 mg

Tablet

(231)

700

469

500

(31)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(217)

700

483

500

(17)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(180)

700

520

500

20

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

Botol

(242)

700

458

500

(42)

32

Deksametason tablet 0,5 mg

Tablet

700

1,800

500

1,300

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(243)

700

457

500

(43)

34

Difenhidramin injeksi 10 mg/ml

Ampul

(243)

700

457

500

(43)

35

Digoksin tablet 0,25 mg

Tablet

(173)

700

527

500

27

36

Domperidon tablet 10 mg

Tablet

53

700

753

500

253

37

Doksisiklin kapsul 100 mg

Kapsul

(243)

700

457

500

(43)

38

Efedrin tablet 25 mg (HCl)

Tablet

(62)

700

638

500

138

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(237)

700

463

500

(37)

40

Eritromisin kapsul 500 mg

Kapsul

(243)

700

457

500

(43)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(225)

700

475

500

(25)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(217)

700

483

500

(17)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(227)

700

473

500

(27)

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

(138)

700

562

500

62

45

Furosemid tablet 40 mg

Tablet

(192)

700

508

500

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium


klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g, Glukosa
anhidrat 2,7 g

Sach

396
700

1,096

500

596

47

Gemfibrozil 300 mg kapsul

Kapsul

(18)

700

682

500

182

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

(228)

700

472

500

(28)

49

Glibenklamid tablet 5 mg

Tablet

491

700

1,191

500

691

50

Gliseril Guaiakolat tablet 100 mg

Tablet

2,849

700

3,549

500

3,049

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(243)

700

457

500

(43)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

(163)

700

537

500

37

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

397

700

1,097

500

597

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(223)

700

477

500

(23)

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(243)

700

457

500

(43)

56

Ibuprofen tablet 400 mg

Tablet

132

700

832

500

332

57

Ichtyol salep kulit - 15 gr

Pot

(226)

700

474

500

(26)

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

(93)

700

607

500

107

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(243)

700

457

500

(43)

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

982

700

1,682

500

1,182

61

Kaptopril tablet 25 mg

Tablet

1,086

700

1,786

500

1,286

62

Ketokonazol tablet 200 mg

Tablet

(174)

700

526

500

26

63

Klindamisin kapsul 150 mg

Kapsul

(243)

700

457

500

(43)

64

Kloramfenikol kapsul 250 mg

Kapsul

(243)

700

457

500

(43)

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(243)

700

457

500

(43)

1,100

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(196)

700

504

500

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(215)

700

485

500

(15)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(209)

700

491

500

(9)

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,185

700

5,885

500

5,385

70

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

235
700

935

500

435

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

700

457

500

(43)

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

(216)
700

484

500

(16)

73

Levertraan salep - 15 gr

Pot

(236)

700

464

500

(36)

74

Lidokain injeksi 2% - 2 ml

Ampul

(243)

700

457

500

(43)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

(243)

700

457

500

(43)

76

Linkomisin kapsul 500 mg

Kapsul

(243)

700

457

500

(43)

77

Loperamid tablet 2 mg

Tablet

(187)

700

513

500

13

78

Loratadin tablet 10 mg

Tablet

(190)

700

510

500

10

79

Mebendazol tablet 100 mg

Tablet

(243)

700

457

500

(43)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

376

700

1,076

500

576

81

Metformin HCl tablet 500 mg

Tablet

700

708

500

208

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125


mg

Tablet

(23)

700

677

500

177

83

Metronidazol tablet 500 mg

Tablet

(111)

700

589

500

89

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(235)

700

465

500

(35)

85

Multivit Sirup - 60 ml

Botol

(161)

700

539

500

39

86

Multivit Tablet

Tablet

(243)

700

457

500

(43)

87

Natrium Bikarbonat tablet 500 mg

Tablet

(243)

700

457

500

(43)

88

Natrium Diklofenak tablet 50 mg

Tablet

(115)

700

585

500

85

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(243)

700

457

500

(43)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(242)

700

458

500

(42)

91

Nifedipin tablet 10 mg

Tablet

(225)

700

475

500

(25)

92

Nistatin tablet salut 500.000 IU/g

Tablet

(125)

700

575

500

75

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

(131)

700

569

500

69

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

(189)

700

511

500

11

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100


mg) / Librozym

Tablet

(243)

700

457

500

(43)

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(213)

700

487

500

(13)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(243)

700

457

500

(43)

98

Omeprazol kapsul 20 mg

Kapsul

(243)

700

457

500

(43)

99

Papaverin tablet 40 mg

Tablet

90

700

790

500

290

100

Parasetamol drops

botol

(186)

700

514

500

14

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

(177)

700

523

500

23

102

Parasetamol tablet 100 mg

Tablet

(243)

700

457

500

(43)

71

(243)

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN
AWAL

103

Parasetamol tablet 500 mg

Tablet

2,737

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

573

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

Botol

107

Povidon Iodida larutan 10 % - 300 ml

Botol

108

Prednison tablet 5 mg

109

Propanolol tablet 10 mg (HCl)

110

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

700

3,437

500

2,937

700

1,273

500

773

(155)

700

545

500

45

(242)

700

458

500

(42)

(242)

700

458

500

(42)

Tablet

454

700

1,154

500

654

Tablet

(143)

700

557

500

57

Propiltiourasil tablet 100 mg

Tablet

(198)

700

502

500

111

Ranitidin tablet 150 mg

Tablet

(239)

700

461

500

(39)

112

Ringer Laktat larutan infus - 500 ml

Botol

(243)

700

457

500

(43)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

(103)

700

597

500

97

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(243)

700

457

500

(43)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap


4 % - 30 gr

Pot

(228)

700

472

500

(28)

116

Salisil Bedak 2 % - 50 gr

Kotak

(164)

700

536

500

36

117

Sefadroksil Kapsul 500 mg

Kapsul

(125)

700

575

500

75

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

(99)

700

601

500

101

119

Simvastatin tablet 10 mg

Tablet

(243)

700

457

500

(43)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

92

700

792

500

292

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

(243)

700

457

500

(43)

122

Tetrasiklin kapsul 250 mg

Kapsul

(243)

700

457

500

(43)

123

Tetrasiklin kapsul 500 mg

Kapsul

(80)

700

620

500

120

124

Thiamfenikol kapsul 500 mg

Kapsul

(243)

700

457

500

(43)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,354

700

2,054

500

1,554

126

Vitamin B Kompleks tablet

Tablet

1,424

700

2,124

500

1,624

127

Zinc tablet 20 mg

Tablet

177

700

877

500

377

(243)

OBAT PROGRAM TB PARU

700

457

500

(43)

128

Obat FDC Kategori 1

Paket

(243)

700

457

500

(43)

129

Obat FDC Kategori 2

Paket

(243)

700

457

500

(43)

130

Obat FDC Anak

Paket

(243)

700

457

500

(43)

131

Obat FDC Sisipan

Paket

(243)

700

457

500

(43)

(243)

700

457

500

(43)

Vial

(242)

(42)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

700

458

500

133

Levofloksasin tablet 500 mg

Tablet

(181)

700

519

500

19

134

Sefiksim kapsul 100 mg

Kapsul

(243)

700

457

500

(43)

(243)

700

457

500

(43)

(243)

700

457

500

(43)

(243)

700

457

500

(43)
(43)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

(243)

700

457

500

137

Pirantel tablet score (base) 125 mg

Tablet

(170)

700

530

500

30

(243)

700

457

500

(43)

(243)

700

457

500

(43)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN
AWAL

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

OBAT KEJIWAAN

(243)

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

700

457

500

(43)

(243)

700

457

500

(43)
176

Alprazolam tablet 1 mg

Tablet

(24)

700

676

500

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(192)

700

508

500

Clobazam tablet 10 mg

Tablet

(81)

700

619

500

119

Diazepam tablet 2 mg

Tablet

(106)

700

594

500

94

Diazepam tablet 5 mg

Tablet

(243)

700

457

500

(43)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(243)

700

457

500

(43)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(242)

700

458

500

(42)

Fenitoin Kapsul 100 mg

Kapsul

(243)

700

457

500

(43)

Fenobarbital tablet 30 mg

Tablet

(220)

700

480

500

(20)

10

Fluoxetin tablet 10 mg /

Tablet

(243)

700

457

500

(43)

11

Haloperidol tablet 1,5 mg

Tablet

(33)

700

667

500

167

12

Haloperidol tablet 5 mg

Tablet

183

700

883

500

383

13

Imipramin tablet 25 mg / Tofranil

Tablet

(243)

700

457

500

(43)

14

Karbamazepin tablet 200 mg

Tablet

(243)

700

457

500

(43)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(228)

700

472

500

(28)

16

Kodein tablet 10 mg

Tablet

(28)

700

672

500

172

17

Risperidon tablet 2 mg

Tablet

(243)

700

457

500

(43)

18

Sertralin tablet / Nudep

Tablet

(243)

700

457

500

(43)

19

Triheksifenidil tablet 2 mg

Tablet

(243)

700

457

500

(43)

(243)

Antiprestin

OBAT GIGI

700

457

500

(43)

Artikulating Paper

Buku

(243)

700

457

500

(43)

Bur diamond high Speed

Kotak

(243)

700

457

500

(43)

Bur arkansas high Speed

buah

(243)

700

457

500

(43)

Cavit / Dentorit (Tambalan Sementara)

Pot

(242)

700

458

500

(42)

Celluloid strip

Set

(243)

700

457

500

(43)

Cresopen - 13 ml

Botol

(243)

700

457

500

(43)

Dentin Conditioner

Botol

(243)

700

457

500

(43)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(243)

700

457

500

(43)

Disclosing Agent

Tube

(243)

700

457

500

(43)

10

Disposible saliva ejektor

Bungkus @ 100
pcs

(243)

700

457

500

(43)

11

Etil Chlorida spray - 100 ml

Botol

(242)

700

458

500

(42)

12

Eugenol cairan

Botol

(242)

700

458

500

(42)

13

Glass Ionomer Radiopak / Fuji VII

Set

(242)

700

458

500

(42)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(242)

700

458

500

(42)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(243)

700

457

500

(43)

16

Macro gold + propylen + EDTA

Set

(243)

700

457

500

(43)

17

Oil Spray

Botol

(243)

700

457

500

(43)

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin


12.5 mcg )

Ampul

(40)
700

660

500

160

19

Pulperyl

Botol

(243)

700

457

500

(43)

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN
AWAL

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(243)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(243)

22

Tetric N Ceram

Paket

(243)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(243)

24

Tetric Bonding - 6 gr

Botol

(243)

25

Tetric Etch Refill - 2 gr

Tube

26

Trikresol Formalin (TKF)

27

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

(243)

700

457

500

(43)

Botol

(242)

700

458

500

(42)

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(243)

700

457

500

(43)

28

Xylestesin Non Adrenalin injeksi

Ampul

(243)

700

457

500

(43)

29

CHKM

Botol

(243)

700

457

500

(43)

30

Iodoform/Mumifying pasta

Botol

(243)

700

457

500

(43)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(243)

700

457

500

(43)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(243)

700

457

500

(43)

(243)

700

457

500

(43)

PERBEKALAN KESEHATAN
1

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(243)

700

457

500

(43)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(243)

700

457

500

(43)

Alat Suntik sekali pakai 1 ml

Pcs

(183)

700

517

500

17

Alat Suntik sekali pakai 3 ml

Pcs

(151)

700

549

500

49

Alat Suntik sekali pakai 5 ml

Pcs

(181)

700

519

500

19

Blood set

Set

(243)

700

457

500

(43)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(243)

700

457

500

(43)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(243)

700

457

500

(43)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(243)

700

457

500

(43)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(243)

700

457

500

(43)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(243)

700

457

500

(43)

12

Dental Film Hanshin

Pcs

(243)

700

457

500

(43)

13

Etanol 70 % - 1 L

Botol

(241)

700

459

500

(41)

14

Gel USG / EKG

Botol

(243)

700

457

500

(43)

15

Infusion Set Anak

Pcs

(243)

700

457

500

(43)

16

Infusion Set Dewasa

Pcs

(241)

700

459

500

(41)

17

IV. Catheter No.18 G

Set

(241)

700

459

500

(41)

18

IV. Catheter No.20 G

Set

(243)

700

457

500

(43)

19

IV. Catheter No.22 G

Set

(243)

700

457

500

(43)

20

IV. Catheter No.24 G

Kotak

(243)

700

457

500

(43)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(243)

700

457

500

(43)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(243)

700

457

500

(43)

23

Kapas Pembalut / absorben 250 gram

Bungkus

(243)

700

457

500

(43)

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(238)

700

462

500

(38)

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(243)

700

457

500

(43)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(243)

700

457

500

(43)

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

AWAL

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(243)

700

457

500

(43)

28

Kertas EKG

Roll

(243)

700

457

500

(43)

29

Kertas USG Sony 110 HG

Roll

(243)

700

457

500

(43)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(242)

700

458

500

(42)

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

(243)

700

457

500

(43)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif


dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol

(243)
700

457

500

(43)

700

457

500

(43)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/


peralatan kedokteran aldehyd free (mengandung zat aktif:
Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Botol 1 ltr

(243)

Lembar

(243)

700

457

500

(43)

Kotak

(240)

700

460

500

(40)

Masker O2

Pcs

(243)

700

457

500

(43)

37

Masker 95

Pcs

(243)

700

457

500

(43)

38

Masker nebulizer set dewasa

Pcs

(242)

700

458

500

(42)

39

Masker nebulizer set anak

Pcs

(242)

700

458

500

(42)

40

Plester 5 yard X 2 inch

Roll

(243)

700

457

500

(43)

41

Plester non alergi 0,5 inch / Micropore

Roll

(240)

700

460

500

(40)

42

Pot Urin

Pcs

(243)

700

457

500

(43)

43

Sarung Tangan

Kotak

(241)

700

459

500

(41)

44

Safety Box

Pcs

(243)

700

457

500

(43)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(243)

700

457

500

(43)

(243)

700

457

500

(43)

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

(243)

700

457

500

(43)

Eter Alkohol

Botol 100 ml

(243)

700

457

500

(43)

Kaca Slide / Object Glass

Kotak

(243)

700

457

500

(43)

Pot dahak

Pcs

(243)

700

457

500

(43)

Reagen Zielnelsen

Set

(243)

700

457

500

(43)

Spiritus Bakar

Botol

(243)

700

457

500

(43)

Tissu Lensa

Kotak

(243)

700

457

500

(43)

Tissue lensa

Buku

(243)

700

457

500

(43)

Wadah Kaca Slide / Box Slide

Pcs

(243)

700

457

500

(43)

10

Xylol/ Xylene

Botol 100 ml

(243)

700

457

500

(43)

11

Xylol/ Xylene

Botol 500 ml

(243)

700

457

500

(43)

(243)

700

457

500

(43)

700

457

500

(43)

700

497

500

(3)

700

477

500

(23)

700

461

500

(39)

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(243)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(203)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(223)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(239)

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN
AWAL

Sendok obat

Pcs

AKUPUNTUR

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

(143)

700

557

500

57

(243)

700

457

500

(43)

Jarum Akupuntur 13 mm

Kotak

(243)

700

457

500

(43)

Jarum Akupuntur 25 mm

Kotak

(243)

700

457

500

(43)

Jarum Akupuntur 40 mm

Kotak

(243)

700

457

500

(43)

Jarum telinga (press needle)

Kotak

(243)

700

457

500

(43)

Moxa Roll

Kotak

(243)

700

457

500

(43)

(243)

700

457

500

(43)

Pcs

(243)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(243)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/


Vit. K Neonatal

Ampul

(243)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(243)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(243)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(243)

MgSO4 40% injeksi

Vial

(243)

700

457

500

(43)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(243)

700

457

500

(43)

Natrium Bicarbonat injeksi

Ampul

(243)

700

457

500

(43)

10

Nasal dewasa / Maxyflow

Pcs

(243)

700

457

500

(43)

11

Nasal infant/ Oxyflow

Pcs

(243)

700

457

500

(43)

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

(243)

700

457

500

(43)

13

Penghisap Lendir Bayi Baru Lahir

Pcs

(243)

700

457

500

(43)

14

Sarung Tangan panjang obgyn No. 6,5

Pasang

(243)

700

457

500

(43)

15

Sarung Tangan panjang obgyn No. 7

Pasang

(243)

700

457

500

(43)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(243)

700

457

500

(43)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(243)

700

457

500

(43)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(243)

700

457

500

(43)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(243)

700

457

500

(43)

20

Sungkup bayi

Set

(243)

700

457

500

(43)

21

Tanda Pengenal (ID Band) Bayi

Psc

(243)

700

457

500

(43)

22

Tanda Pengenal (ID Band) Ibu

Psc

(243)

700

457

500

(43)

23

Under Pad 60 x 90 cm

Psc

(243)

700

457

500

(43)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(243)

TAMBAHAN

700

457

500

(43)

(243)

700

457

500

(43)

Ambroksol tablet 30mg

Tablet

(53)

700

647

500

147

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(243)

700

457

500

(43)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq,


Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)

Botol

(243)
700

457

500

(43)

Asiklovir tablet 200 mg

Tablet

(243)

700

457

500

(43)

Bisacodyl 5 mg / Bicolax

Tablet

(243)

700

457

500

(43)

Biskodil sup 10 mg

Supp

(243)

700

457

500

(43)

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN
AWAL

Buskopan injeksi

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

Ampul

(243)

700

457

500

(43)

Bur Fissure standart

Pcs

(243)

700

457

500

(43)

Bur Fissure panjang

Pcs

(243)

700

457

500

(43)

10

Cetirizin HCl 10 mg

Tablet

(243)

700

457

500

(43)

11

Cetirizin syrup 100 mg / 5 ml

botol

(243)

700

457

500

(43)

12

Cefixim / sefiksim 100 mg caplet

kaplet

(243)

700

457

500

(43)

13

Etanol 96 % - 1 L

Botol

(243)

700

457

500

(43)

14

Gentian Violet larutan 1 %

Botol

(243)

700

457

500

(43)

15

Glucose Larutan Infus 10% Steril

Botol

(243)

700

457

500

(43)

16

Jarum Suntik No. 27 G

Pcs

(243)

700

457

500

(43)

17

Ketokonazole Krim 2%

Tube

(243)

700

457

500

(43)

18

Klindamisin kapsul 150 mg

Kapsul

(238)

700

462

500

(38)

19

Klindamisin 300 MG

Kapsul

(243)

700

457

500

(43)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(243)

700

457

500

(43)

21

Kasa 2x80

22

Kapas 500 gram

23

Roll

(243)

700

457

500

(43)

Bungkus

(243)

700

457

500

(43)

Larutan H2O2

Botol

(243)

700

457

500

(43)

24

Methilprednisolon 4 mg

tablet

(243)

700

457

500

(43)

25

Metoklopramid injeksi / Primperan

Vial

(243)

700

457

500

(43)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(243)

700

457

500

(43)

27

Metronidazol tablet 250 mg

Tablet

(243)

700

457

500

(43)

28

Meylon injeksi

Botol

(243)

700

457

500

(43)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg,


Gliseril guayakolat 50 mg, Phenylpropanolamine HCL 12,5
mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(243)
700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

30

31

32

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) 20 gr / Thrombophob

Tube

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000


IU, NeomIsin sulfat 5 mg, Fludrokortison asetat 1 mg,
Lidokain Hcl 40 mg ) / Otopain / Otopraf

Botol

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg,


Lidocain HCl 10 mg)/Etamidon injeksi

Vial

(243)

(243)

(243)

33

Polymigel tablet 400 mg/Strocain P

Tablet

(243)

700

457

500

(43)

34

Propanolol tablet 40 mg (HCl)

Tablet

(243)

700

457

500

(43)

35

Ranitidin injeksi 25 mg/ml

Ampul

(243)

700

457

500

(43)

36

Saccaharine tablet

Tablet

(243)

700

457

500

(43)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(243)

700

457

500

(43)

38

Sefadroxil syrup 125 mg

botol

(243)

700

457

500

(43)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(243)

700

457

500

(43)

40

Teofilin tablet / Bronsolvan

Tablet

(243)

700

457

500

(43)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(243)

700

457

500

(43)

700

457

500

(43)

OBAT KESDA

(243)

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN
AWAL

Kalium Diklofenak tablet 50 mg

tablet

(243)

Obat Tetes mata kombinasi antiseptik & kortikosteroid


(Dexamethason Sod.Phosfate 1,0 mg, Neomycin Sulphate
setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU)
- 5 ml

tube

(243)

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500


mg, Dextromethorphan HBr 15 mg, Phenylpropanolamine
HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

kaplet

Obat Analgetik kombinasi dengan Psikotropik kaplet


(Metampiron 500 mg, Diazepam 2 mg) / Metaneuron

kaplet

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol


500 mg, Vitamin B6 100 mg, Vitamin B1 50 mg, Vitamin
B12 100 mcg) / Erlagin

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg,


Phenylprophanolamine HCl 3.125 mg, Chlorpheniramine
Maleate 0.5 mg ) - 60 ml / Molexflu sirup

botol

Obat Antiinfluenza kaplet ( Paracetamol 500 mg.


Phenylpropanolamin HCl 12,5 mg+ Chlorpheniramin Maleat
2 mg ) / Molexflu kaplet

kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl


12,5 mg+ Ammonium Chlorida 125 mg+ Sodium Citrat 50
mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5


mg, Pseudoefedrin HCl 30mg)/Flutrop

tablet

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak


Belladona 10 mg, Papaverin HCl 25 mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet


( Phenylpropanolamin HCl 15 mg+ Chlorpheniramin Maleat
2 mg ) / Nalgestan

tablet

13

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%,


Eugenol 1,5%) - 30 gr / Painkilla

tube

14

Salep kulit kombinasi antiinfeksi dgn kortikosteroid


(Betamethasone 1 mg, Neomycin sulfat 5 mg) - 5 gr /
Bevalex

tube

11

12

15

16

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15


mg, Vit. B2 10 mg, Vit. B6 5 mg, Vit. B12 100 mcg, Vit. C 500
mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

STOK

PAKAI

AKHIR

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

457

500

(43)

700

778

500

278

(243)

(243)

(243)

(243)

(243)

(243)

(243)

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200


mg, Vit.B12 250 mcg )

10

TOTAL
PERSEDIAAN

kaplet

Botol

(243)

(243)

(243)

(243)

(243)

(243)

78

STOK

NAMA OBAT

TERIMA

SATUAN KEMASAN
AWAL

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

TOTAL

STOK

PAKAI

AKHIR

PERSEDIAAN

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


MEI 2015

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


MEI 2015

NAMA PUSKESMAS : PANUNGGANGAN


ALAMAT
: JL.KYAI MAJA NO.2 KOTA TANGERANG
TELEPON
: 021-70283936
STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

OBAT
1

Alopurinol tablet 100 mg

Tablet

62

Amlodipin tablet 5 mg

Tablet

(9)

Aminofillin tablet 200 mg

Tablet

Amoksilin kaplet 500 mg

Kaplet

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

Antasida DOEN I tablet kunyah, kombinasi : Aluminium


Hidroksida 200 mg + Magnesium Hidroksida 200 mg

Tablet

Antasida DOEN II suspensi, kombinasi : Aluminium


Hidroksida 200 mg /5 ml + Magnesium Hidroksida 200 mg /
5 ml - 60 ml

Botol

(228)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g +


Polimiksin 10.000 IU/g

Tube

(187)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta


Ekstrak 10 %) - 15 gr / Bioplacenton

Tube

(242)

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo


Diaform

Tablet

149

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(243)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat


3% - 30 gr / Whitefield

Pot

(243)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150


mg + Heksaklorofen 2,5 mg

Supp

(208)

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80%


+ Citrus Bioflavonoid 20% / Haemorogard

Kapsul

(128)

15

Antiinfeksi Topikal dengan Kortikosteroid krim


(Kloramfenikol base 20 mg + Prednisolon 2,5 mg) - 10 gr /
Klorfeson

Tube

(233)

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

(243)

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

(243)

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(243)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

1,892

20

Asam Mefenamat kaplet 500 mg

Kaplet

387

21

Asiklovir krim 5 % - 5 gr

Tube

(204)

22

Asiklovir tablet 400 mg

Tablet

349

23

Atapulgit tablet 600 mg

Tablet

(203)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(240)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah


darah kombinasi)

Tablet

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(43)
1,832
(177)
1,505

1,266
(243)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(215)

28

Bisoprolol tablet 5 mg

Tablet

(231)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(217)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(180)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml /


Bisolvon

Botol

(242)

32

Deksametason tablet 0,5 mg

Tablet

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(243)

34

Difenhidramin injeksi 10 mg/ml

Ampul

(243)

35

Digoksin tablet 0,25 mg

Tablet

(173)

36

Domperidon tablet 10 mg

Tablet

53

37

Doksisiklin kapsul 100 mg

Kapsul

(243)

38

Efedrin tablet 25 mg (HCl)

Tablet

(62)

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(237)

40

Eritromisin kapsul 500 mg

Kapsul

(243)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(225)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(217)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(227)

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

(138)

45

Furosemid tablet 40 mg

Tablet

(192)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium


klorida 0,30 g , Trinatrium sitrat dihidrat 0,58 g, Glukosa
anhidrat 2,7 g

Sach

396

47

Gemfibrozil 300 mg kapsul

Kapsul

(18)

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

(228)

49

Glibenklamid tablet 5 mg

Tablet

491

50

Gliseril Guaiakolat tablet 100 mg

Tablet

2,849

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(243)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

(163)

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

397

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(223)

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(243)

56

Ibuprofen tablet 400 mg

Tablet

132

57

Ichtyol salep kulit - 15 gr

Pot

(226)

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

(93)

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(243)

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

982

61

Kaptopril tablet 25 mg

Tablet

1,086

62

Ketokonazol tablet 200 mg

Tablet

(174)

63

Klindamisin kapsul 150 mg

Kapsul

(243)

64

Kloramfenikol kapsul 250 mg

Kapsul

(243)

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(243)

1,100

EXP.10-15

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(196)

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(215)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,185

70

Kotimoksazol DOEN I (dewasa) kombinasi :


Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

235

71

Kotimoksazol DOEN II (pedriatik) kombinasi :


Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

(243)

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200


mg + Trimetoprim 40 mg/ 5 ml - 60 ml

Botol

(216)

73

Levertraan salep - 15 gr

Pot

(236)

74

Lidokain injeksi 2% - 2 ml

Ampul

(243)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 :


80.000) - 2 ml

Ampul

(243)

76

Linkomisin kapsul 500 mg

Kapsul

(243)

77

Loperamid tablet 2 mg

Tablet

(187)

78

Loratadin tablet 10 mg

Tablet

(190)

79

Mebendazol tablet 100 mg

Tablet

(243)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

376

81

Metformin HCl tablet 500 mg

Tablet

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125


mg

Tablet

(23)

83

Metronidazol tablet 500 mg

Tablet

(111)

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(235)

85

Multivit Sirup - 60 ml

Botol

(161)

86

Multivit Tablet

Tablet

(243)

87

Natrium Bikarbonat tablet 500 mg

Tablet

(243)

88

Natrium Diklofenak tablet 50 mg

Tablet

(115)

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(243)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(242)

91

Nifedipin tablet 10 mg

Tablet

(225)

92

Nistatin tablet salut 500.000 IU/g

Tablet

(125)

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

(131)

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

(189)

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100


mg) / Librozym

Tablet

(243)

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(213)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(243)

98

Omeprazol kapsul 20 mg

Kapsul

(243)

99

Papaverin tablet 40 mg

Tablet

90

100

Parasetamol drops

botol

(186)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

(177)

102

Parasetamol tablet 100 mg

Tablet

(243)

(209)

EXP.JAN-17

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

103

Parasetamol tablet 500 mg

Tablet

2,737

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

573

105

Piroksikam tablet 10 mg

Tablet

(155)

106

Polikresulen (kondensasi) - 10 ml

Botol

(242)

107

Povidon Iodida larutan 10 % - 300 ml

Botol

(242)

108

Prednison tablet 5 mg

Tablet

454

109

Propanolol tablet 10 mg (HCl)

Tablet

(143)

110

Propiltiourasil tablet 100 mg

Tablet

(198)

111

Ranitidin tablet 150 mg

Tablet

(239)

112

Ringer Laktat larutan infus - 500 ml

Botol

(243)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

(103)

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(243)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap


4 % - 30 gr

Pot

(228)

116

Salisil Bedak 2 % - 50 gr

Kotak

(164)

117

Sefadroksil Kapsul 500 mg

Kapsul

(125)

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

(99)

119

Simvastatin tablet 10 mg

Tablet

(243)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

92

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

(243)

122

Tetrasiklin kapsul 250 mg

Kapsul

(243)

123

Tetrasiklin kapsul 500 mg

Kapsul

(80)

124

Thiamfenikol kapsul 500 mg

Kapsul

(243)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,354

126

Vitamin B Kompleks tablet

Tablet

1,424

127

Zinc tablet 20 mg

Tablet

OBAT PROGRAM TB PARU

177
(243)

128

Obat FDC Kategori 1

Paket

(243)

129

Obat FDC Kategori 2

Paket

(243)

130

Obat FDC Anak

Paket

(243)

131

Obat FDC Sisipan

Paket

(243)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133
134

(243)
Vial

(242)

Levofloksasin tablet 500 mg

Tablet

(181)

Sefiksim kapsul 100 mg

Kapsul

(243)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

(243)
Tablet

OBAT PROGRAM KECACINGAN

(243)
(243)

136

Albendazole tablet 400 mg

Tablet

(243)

137

Pirantel tablet score (base) 125 mg

Tablet

(170)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

(243)
Kapsul

(243)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

OBAT KEJIWAAN

(243)
(243)

Alprazolam tablet 1 mg

Tablet

(24)

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(192)

Clobazam tablet 10 mg

Tablet

(81)

Diazepam tablet 2 mg

Tablet

(106)

Diazepam tablet 5 mg

Tablet

(243)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(243)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(242)

Fenitoin Kapsul 100 mg

Kapsul

(243)

Fenobarbital tablet 30 mg

Tablet

(220)

10

Fluoxetin tablet 10 mg /

Tablet

(243)

11

Haloperidol tablet 1,5 mg

Tablet

(33)

12

Haloperidol tablet 5 mg

Tablet

183

13

Imipramin tablet 25 mg / Tofranil

Tablet

(243)

14

Karbamazepin tablet 200 mg

Tablet

(243)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(228)

16

Kodein tablet 10 mg

Tablet

(28)

17

Risperidon tablet 2 mg

Tablet

(243)

18

Sertralin tablet / Nudep

Tablet

(243)

19

Triheksifenidil tablet 2 mg

Tablet

(243)

Antiprestin

OBAT GIGI

(243)

Artikulating Paper

Buku

(243)

Bur diamond high Speed

Kotak

(243)

Bur arkansas high Speed

buah

(243)

Cavit / Dentorit (Tambalan Sementara)

Pot

(242)

Celluloid strip

Set

(243)

Cresopen - 13 ml

Botol

(243)

Dentin Conditioner

Botol

(243)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(243)

Disclosing Agent

Tube

(243)

Bungkus @ 100
pcs

(243)

10

Disposible saliva ejektor

11

Etil Chlorida spray - 100 ml

Botol

(242)

12

Eugenol cairan

Botol

(242)

13

Glass Ionomer Radiopak / Fuji VII

Set

(242)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(242)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(243)

16

Macro gold + propylen + EDTA

Set

(243)

17

Oil Spray

Botol

(243)

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin


12.5 mcg )

Ampul

(40)

19

Pulperyl

Botol

(243)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(243)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(243)

22

Tetric N Ceram

Paket

(243)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(243)

24

Tetric Bonding - 6 gr

Botol

(243)

25

Tetric Etch Refill - 2 gr

Tube

(243)

26

Trikresol Formalin (TKF)

Botol

(242)

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(243)

28

Xylestesin Non Adrenalin injeksi

Ampul

(243)

29

CHKM

Botol

(243)

30

Iodoform/Mumifying pasta

Botol

(243)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(243)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(243)

PERBEKALAN KESEHATAN

(243)

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(243)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(243)

Alat Suntik sekali pakai 1 ml

Pcs

(183)

Alat Suntik sekali pakai 3 ml

Pcs

(151)

Alat Suntik sekali pakai 5 ml

Pcs

(181)

Blood set

Set

(243)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(243)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(243)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(243)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(243)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(243)

12

Dental Film Hanshin

Pcs

(243)

13

Etanol 70 % - 1 L

Botol

(241)

14

Gel USG / EKG

Botol

(243)

15

Infusion Set Anak

Pcs

(243)

16

Infusion Set Dewasa

Pcs

(241) EXP.10-17

17

IV. Catheter No.18 G

Set

(241) Exp.jul-15

18

IV. Catheter No.20 G

Set

(243)

19

IV. Catheter No.22 G

Set

(243)

20

IV. Catheter No.24 G

Kotak

(243)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(243)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(243)

23

Kapas Pembalut / absorben 250 gram

Bungkus

(243)

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(238)

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(243)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(243)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(243)

28

Kertas EKG

Roll

(243)

29

Kertas USG Sony 110 HG

Roll

(243)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(242)

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan


Benzyl Chlorophenol 0,6%

Botol

(243)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif


dengan kadar minimal Chlorhexidine Gluconate 0,5%
( Aseptan 500 cc + Dispenser)

Botol

(243)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/


peralatan kedokteran aldehyd free (mengandung zat aktif:
Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

Botol 1 ltr

(243)

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

Lembar

(243)

35

Masker

Kotak

(240)

36

Masker O2

Pcs

(243)

37

Masker 95

Pcs

(243)

38

Masker nebulizer set dewasa

Pcs

(242)

39

Masker nebulizer set anak

Pcs

(242)

40

Plester 5 yard X 2 inch

Roll

(243)

41

Plester non alergi 0,5 inch / Micropore

Roll

(240)

42

Pot Urin

Pcs

(243)

43

Sarung Tangan

Kotak

(241)

44

Safety Box

Pcs

(243)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(243)

PEMERIKSAAN TB PARU

(243)

Emersi

Botol 100 ml

(243)

Eter Alkohol

Botol 100 ml

(243)

Kaca Slide / Object Glass

Kotak

(243)

Pot dahak

Pcs

(243)

Reagen Zielnelsen

Set

(243)

Spiritus Bakar

Botol

(243)

Tissu Lensa

Kotak

(243)

Tissue lensa

Buku

(243)

Wadah Kaca Slide / Box Slide

Pcs

(243)

10

Xylol/ Xylene

Botol 100 ml

(243)

11

Xylol/ Xylene

Botol 500 ml

(243)

EMBALAGE

(243)

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(243)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(203)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(223)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(239)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

Sendok obat

Pcs

AKUPUNTUR

(143)
(243)

Jarum Akupuntur 13 mm

Kotak

(243)

Jarum Akupuntur 25 mm

Kotak

(243)

Jarum Akupuntur 40 mm

Kotak

(243)

Jarum telinga (press needle)

Kotak

(243)

Moxa Roll

Kotak

(243)

OBAT PONED
1

Apron plastik

(243)
Pcs

(243)

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(243)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/


Vit. K Neonatal

Ampul

(243)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(243)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(243)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(243)

MgSO4 40% injeksi

Vial

(243)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(243)

Natrium Bicarbonat injeksi

Ampul

(243)

10

Nasal dewasa / Maxyflow

Pcs

(243)

11

Nasal infant/ Oxyflow

Pcs

(243)

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

(243)

13

Penghisap Lendir Bayi Baru Lahir

Pcs

(243)

14

Sarung Tangan panjang obgyn No. 6,5

Pasang

(243)

15

Sarung Tangan panjang obgyn No. 7

Pasang

(243)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(243)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(243)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(243)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(243)

20

Sungkup bayi

Set

(243)

21

Tanda Pengenal (ID Band) Bayi

Psc

(243)

22

Tanda Pengenal (ID Band) Ibu

Psc

(243)

23

Under Pad 60 x 90 cm

Psc

(243)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(243)

TAMBAHAN

(243)

Ambroksol tablet 30mg

Tablet

(53)

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(243)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq,


Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)

Botol

(243)

Asiklovir tablet 200 mg

Tablet

(243)

Bisacodyl 5 mg / Bicolax

Tablet

(243)

Biskodil sup 10 mg

Supp

(243)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

Buskopan injeksi

Bur Fissure standart

Ampul

(243)

Pcs

(243)

Bur Fissure panjang

Pcs

(243)

10

Cetirizin HCl 10 mg

Tablet

(243)

11

Cetirizin syrup 100 mg / 5 ml

botol

(243)

12

Cefixim / sefiksim 100 mg caplet

kaplet

(243)

13

Etanol 96 % - 1 L

Botol

(243)

14

Gentian Violet larutan 1 %

Botol

(243)

15

Glucose Larutan Infus 10% Steril

Botol

(243)

16

Jarum Suntik No. 27 G

Pcs

(243)

17

Ketokonazole Krim 2%

Tube

(243)

18

Klindamisin kapsul 150 mg

Kapsul

(238)

19

Klindamisin 300 MG

Kapsul

(243)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(243)

21

Kasa 2x80

22

Kapas 500 gram

23

Roll

(243)

Bungkus

(243)

Larutan H2O2

Botol

(243)

24

Methilprednisolon 4 mg

tablet

(243)

25

Metoklopramid injeksi / Primperan

Vial

(243)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(243)

27

Metronidazol tablet 250 mg

Tablet

(243)

28

Meylon injeksi

Botol

(243)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg,


Gliseril guayakolat 50 mg, Phenylpropanolamine HCL 12,5
mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(243)

30

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) 20 gr / Thrombophob

Tube

(243)

31

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000


IU, NeomIsin sulfat 5 mg, Fludrokortison asetat 1 mg,
Lidokain Hcl 40 mg ) / Otopain / Otopraf

Botol

(243)

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg,


Lidocain HCl 10 mg)/Etamidon injeksi

Vial

(243)

33

Polymigel tablet 400 mg/Strocain P

Tablet

(243)

34

Propanolol tablet 40 mg (HCl)

Tablet

(243)

35

Ranitidin injeksi 25 mg/ml

Ampul

(243)

36

Saccaharine tablet

Tablet

(243)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(243)

38

Sefadroxil syrup 125 mg

botol

(243)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(243)

40

Teofilin tablet / Bronsolvan

Tablet

(243)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(243)

OBAT KESDA

(243)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

Kalium Diklofenak tablet 50 mg

tablet

(243)

Obat Tetes mata kombinasi antiseptik & kortikosteroid


(Dexamethason Sod.Phosfate 1,0 mg, Neomycin Sulphate
setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU)
- 5 ml

tube

(243)

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500


mg, Dextromethorphan HBr 15 mg, Phenylpropanolamine
HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

kaplet

(243)

Obat Analgetik kombinasi dengan Psikotropik kaplet


(Metampiron 500 mg, Diazepam 2 mg) / Metaneuron

kaplet

(243)

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol


500 mg, Vitamin B6 100 mg, Vitamin B1 50 mg, Vitamin
B12 100 mcg) / Erlagin

kaplet

(243)

Obat Antiinfluenza syrup ( Parasetamol 125 mg,


Phenylprophanolamine HCl 3.125 mg, Chlorpheniramine
Maleate 0.5 mg ) - 60 ml / Molexflu sirup

botol

(243)

Obat Antiinfluenza kaplet ( Paracetamol 500 mg.


Phenylpropanolamin HCl 12,5 mg+ Chlorpheniramin Maleat
2 mg ) / Molexflu kaplet

kaplet

(243)

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl


12,5 mg+ Ammonium Chlorida 125 mg+ Sodium Citrat 50
mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

(243)

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5


mg, Pseudoefedrin HCl 30mg)/Flutrop

10

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200


mg, Vit.B12 250 mcg )

tablet

(243)

11

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak


Belladona 10 mg, Papaverin HCl 25 mg) / Spasminal

tablet

(243)

12

Obat Vasokonstriktor dan antihistamin tablet


( Phenylpropanolamin HCl 15 mg+ Chlorpheniramin Maleat
2 mg ) / Nalgestan

tablet

(243)

13

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%,


Eugenol 1,5%) - 30 gr / Painkilla

tube

(243)

14

Salep kulit kombinasi antiinfeksi dgn kortikosteroid


(Betamethasone 1 mg, Neomycin sulfat 5 mg) - 5 gr /
Bevalex

tube

(243)

15

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15


mg, Vit. B2 10 mg, Vit. B6 5 mg, Vit. B12 100 mcg, Vit. C 500
mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

kaplet

(243)

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub


mengandung zat aktif dengan kadar minimal
ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

78

(243)

STOK

NAMA OBAT

KET

SATUAN KEMASAN
AWAL

Mengetahui / Menyetujui
Kepala Puskesmas Panunggangan

dr.Hj.Harmayani, MPH
NIP.19770206 200604 2 019

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

OBAT
1

Alopurinol tablet 100 mg

Tablet

262

500

762

435

327

Amlodipin tablet 5 mg

Tablet

191

500

691

435

256

Aminofillin tablet 200 mg

Tablet

157

500

657

435

222

Amoksilin kaplet 500 mg

Kaplet

2,032

500

2,532

435

2,097

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

23

500

523

435

88

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,705
500

2,205

435

1,770

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

500

472

435

37

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

500

513

435

78

500

458

435

23

500

849

435

414

500

457

435

22

500

457

435

22

500

492

435

57

500

572

435

137

500

467

435

32

500

457

435

22

500

457

435

22

(28)

13

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

349

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(43)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

(43)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

(42)

Supp

(8)

Kapsul

72

Tube

(33)

Tablet

(43)

Vial

(43)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(43)

500

457

435

22

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,092

500

2,592

435

2,157

20

Asam Mefenamat kaplet 500 mg

Kaplet

587

500

1,087

435

652

21

Asiklovir krim 5 % - 5 gr

Tube

(4)

500

496

435

61

22

Asiklovir tablet 400 mg

Tablet

549

500

1,049

435

614

23

Atapulgit tablet 600 mg

Tablet

(3)

500

497

435

62

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(40)

500

460

435

25

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,466

500

1,966

435

1,531

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(43)

500

457

435

22

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(15)

500

485

435

50

28

Bisoprolol tablet 5 mg

Tablet

(31)

500

469

435

34

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(17)

500

483

435

48

30

Bromheksin tablet 8 mg / Bromifar

Tablet

20

500

520

435

85

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

(42)

500

458

435

23 EXP.10-15

32

Deksametason tablet 0,5 mg

Tablet

1,300

500

1,800

435

1,365

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(43)

500

457

435

22

34

Difenhidramin injeksi 10 mg/ml

Ampul

(43)

500

457

435

22

35

Digoksin tablet 0,25 mg

Tablet

27

500

527

435

92

36

Domperidon tablet 10 mg

Tablet

253

500

753

435

318

37

Doksisiklin kapsul 100 mg

Kapsul

(43)

500

457

435

22

38

Efedrin tablet 25 mg (HCl)

Tablet

138

500

638

435

203

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(37)

500

463

435

28

40

Eritromisin kapsul 500 mg

Kapsul

(43)

500

457

435

22

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(25)

500

475

435

40

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(17)

500

483

435

48

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(27)

500

473

435

38

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

62

45

Furosemid tablet 40 mg

Tablet

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

596

47

Gemfibrozil 300 mg kapsul

48

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

500

562

435

127

500

508

435

73

500

1,096

435

661

Kapsul

182

500

682

435

247

Gentamycin salep kulit 0,1% - 5 gr

Tube

(28)

500

472

435

37

49

Glibenklamid tablet 5 mg

Tablet

691

500

1,191

435

756

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,049

500

3,549

435

3,114

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(43)

500

457

435

22

52

Griseofulvin tablet 125 mg / Gricin

Tablet

37

500

537

435

102

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

597

500

1,097

435

662

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(23)

500

477

435

42

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(43)

500

457

435

22

56

Ibuprofen tablet 400 mg

Tablet

332

500

832

435

397

57

Ichtyol salep kulit - 15 gr

Pot

(26)

500

474

435

39

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

107

500

607

435

172

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(43)

500

457

435

22

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,182

500

1,682

435

1,247

61

Kaptopril tablet 25 mg

Tablet

1,286

500

1,786

435

1,351

62

Ketokonazol tablet 200 mg

Tablet

26

500

526

435

91

63

Klindamisin kapsul 150 mg

Kapsul

(43)

500

457

435

22

64

Kloramfenikol kapsul 250 mg

Kapsul

(43)

500

457

435

22

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(43)

500

457

435

22

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

500

504

435

69

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(15)

500

485

435

50

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(9)

500

491

435

56

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,385

500

5,885

435

5,450

KET

NAMA OBAT

70

71

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

SATUAN
KEMASAN

Tablet

Tablet

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

435
500

935

435

500

500

457

435

22

(43)

Botol

(16)
500

484

435

49

Pot

(36)

500

464

435

29

Lidokain injeksi 2% - 2 ml

Ampul

(43)

500

457

435

22

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

(43)

500

457

435

22

76

Linkomisin kapsul 500 mg

Kapsul

(43)

500

457

435

22

77

Loperamid tablet 2 mg

Tablet

13

500

513

435

78

78

Loratadin tablet 10 mg

Tablet

10

500

510

435

75

79

Mebendazol tablet 100 mg

Tablet

(43)

500

457

435

22

80

Metampiron (Antalgin) tablet 500 mg

Tablet

576

500

1,076

435

641

81

Metformin HCl tablet 500 mg

Tablet

208

500

708

435

273

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

177

500

677

435

242

83

Metronidazol tablet 500 mg

Tablet

89

500

589

435

154

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(35)

500

465

435

30

85

Multivit Sirup - 60 ml

Botol

39

500

539

435

104

86

Multivit Tablet

Tablet

(43)

500

457

435

22

87

Natrium Bikarbonat tablet 500 mg

Tablet

(43)

500

457

435

22

88

Natrium Diklofenak tablet 50 mg

Tablet

85

500

585

435

150

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(43)

500

457

435

22

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(42)

500

458

435

23 EXP.JAN-17

91

Nifedipin tablet 10 mg

Tablet

(25)

500

475

435

40

92

Nistatin tablet salut 500.000 IU/g

Tablet

75

500

575

435

140

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

69

500

569

435

134

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

STOK AWAL

PENERIMAAN

Botol

11

Tablet

(43)

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(13)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(43)

98

Omeprazol kapsul 20 mg

Kapsul

(43)

99

Papaverin tablet 40 mg

Tablet

290

100

Parasetamol drops

botol

14

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

23

102

Parasetamol tablet 100 mg

Tablet

(43)

103

Parasetamol tablet 500 mg

Tablet

2,937

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

773

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

107

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

500

511

435

76

500

457

435

22

500

487

435

52

500

457

435

22

500

457

435

22

500

790

435

500

514

435

79

500

523

435

88

500

457

435

22

500

3,437

435

3,002

500

1,273

435

838

45

500

545

435

110

Botol

(42)

500

458

435

23

Povidon Iodida larutan 10 % - 300 ml

Botol

(42)

500

458

435

23

108

Prednison tablet 5 mg

Tablet

654

500

1,154

435

719

109

Propanolol tablet 10 mg (HCl)

Tablet

57

500

557

435

122

110

Propiltiourasil tablet 100 mg

Tablet

500

502

435

67

111

Ranitidin tablet 150 mg

Tablet

(39)

500

461

435

26

112

Ringer Laktat larutan infus - 500 ml

Botol

(43)

500

457

435

22

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

97

500

597

435

162

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(43)

500

457

435

22

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

(28)

500

472

435

37

116

Salisil Bedak 2 % - 50 gr

Kotak

36

500

536

435

101

117

Sefadroksil Kapsul 500 mg

Kapsul

75

500

575

435

140

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

101

500

601

435

166

119

Simvastatin tablet 10 mg

Tablet

(43)

500

457

435

22

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

292

500

792

435

357

/ Librozym

KET

355 exp.10-15

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Botol

(43)

500

457

435

22

Tetrasiklin kapsul 250 mg

Kapsul

(43)

500

457

435

22

123

Tetrasiklin kapsul 500 mg

Kapsul

120

500

620

435

185

124

Thiamfenikol kapsul 500 mg

Kapsul

(43)

500

457

435

22

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,554

500

2,054

435

1,619

126

Vitamin B Kompleks tablet

Tablet

1,624

500

2,124

435

1,689

127

Zinc tablet 20 mg

Tablet

377

500

877

435

442

(43)

OBAT PROGRAM TB PARU

500

457

435

22

128

Obat FDC Kategori 1

Paket

(43)

500

457

435

22

129

Obat FDC Kategori 2

Paket

(43)

500

457

435

22

130

Obat FDC Anak

Paket

(43)

500

457

435

22

131

Obat FDC Sisipan

Paket

(43)

500

457

435

22

(43)

500

457

435

22

Vial

(42)

500

458

435

23

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

19

500

519

435

84

134

Sefiksim kapsul 100 mg

Kapsul

(43)

500

457

435

22

(43)

500

457

435

22

(43)

500

457

435

22

(43)

500

457

435

22

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

(43)

500

457

435

22

137

Pirantel tablet score (base) 125 mg

Tablet

30

500

530

435

95

(43)

500

457

435

22

500

457

435

22

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

(43)

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

(43)

OBAT KEJIWAAN

500

457

435

22

(43)

500

457

435

22

Alprazolam tablet 1 mg

Tablet

176

500

676

435

241

Amitriptilin tablet salut 25 mg (HCl)

Tablet

500

508

435

73

Clobazam tablet 10 mg

Tablet

119

500

619

435

184

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Diazepam tablet 2 mg

Tablet

94

500

594

435

159

Diazepam tablet 5 mg

Tablet

(43)

500

457

435

22

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(43)

500

457

435

22

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(42)

500

458

435

23

Fenitoin Kapsul 100 mg

Kapsul

(43)

500

457

435

22

Fenobarbital tablet 30 mg

Tablet

(20)

500

480

435

45

10

Fluoxetin tablet 10 mg /

Tablet

(43)

500

457

435

22

11

Haloperidol tablet 1,5 mg

Tablet

167

500

667

435

232

12

Haloperidol tablet 5 mg

Tablet

383

500

883

435

448

13

Imipramin tablet 25 mg / Tofranil

Tablet

(43)

500

457

435

22

14

Karbamazepin tablet 200 mg

Tablet

(43)

500

457

435

22

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(28)

500

472

435

37

16

Kodein tablet 10 mg

Tablet

172

500

672

435

237

17

Risperidon tablet 2 mg

Tablet

(43)

500

457

435

22

18

Sertralin tablet / Nudep

Tablet

(43)

500

457

435

22

19

Triheksifenidil tablet 2 mg

Tablet

(43)

500

457

435

22

(43)

Antiprestin

OBAT GIGI

500

457

435

22

Artikulating Paper

Buku

(43)

500

457

435

22

Bur diamond high Speed

Kotak

(43)

500

457

435

22

Bur arkansas high Speed

buah

(43)

500

457

435

22

Cavit / Dentorit (Tambalan Sementara)

Pot

(42)

500

458

435

23

Celluloid strip

Set

(43)

500

457

435

22

Cresopen - 13 ml

Botol

(43)

500

457

435

22

Dentin Conditioner

Botol

(43)

500

457

435

22

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(43)

500

457

435

22

Disclosing Agent

Tube

(43)

500

457

435

22

Bungkus @ 100
pcs

10

Disposible saliva ejektor

(43)

500

457

435

22

11

Etil Chlorida spray - 100 ml

Botol

(42)

500

458

435

23

12

Eugenol cairan

Botol

(42)

500

458

435

23

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

13

Glass Ionomer Radiopak / Fuji VII

Set

(42)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(42)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(43)

16

Macro gold + propylen + EDTA

Set

17

Oil Spray

18

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

500

458

435

23

500

458

435

23

500

457

435

22

(43)

500

457

435

22

Botol

(43)

500

457

435

22

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

160
500

660

435

225

19

Pulperyl

Botol

(43)

500

457

435

22

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(43)

500

457

435

22

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(43)

500

457

435

22

22

Tetric N Ceram

Paket

(43)

500

457

435

22

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(43)

500

457

435

22

24

Tetric Bonding - 6 gr

Botol

(43)

500

457

435

22

25

Tetric Etch Refill - 2 gr

Tube

(43)

500

457

435

22

26

Trikresol Formalin (TKF)

Botol

(42)

500

458

435

23

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(43)

500

457

435

22

28

Xylestesin Non Adrenalin injeksi

Ampul

(43)

500

457

435

22

29

CHKM

Botol

(43)

500

457

435

22

30

Iodoform/Mumifying pasta

Botol

(43)

500

457

435

22

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(43)

500

457

435

22

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(43)

500

457

435

22

(43)

PERBEKALAN KESEHATAN

500

457

435

22

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(43)

500

457

435

22

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(43)

500

457

435

22

Alat Suntik sekali pakai 1 ml

Pcs

17

500

517

435

82

Alat Suntik sekali pakai 3 ml

Pcs

49

500

549

435

114

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

Alat Suntik sekali pakai 5 ml

Pcs

19

500

519

435

84

Blood set

Set

(43)

500

457

435

22

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(43)

500

457

435

22

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(43)

500

457

435

22

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(43)

500

457

435

22

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(43)

500

457

435

22

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(43)

500

457

435

22

12

Dental Film Hanshin

Pcs

(43)

500

457

435

22

13

Etanol 70 % - 1 L

Botol

(41)

500

459

435

24

14

Gel USG / EKG

Botol

(43)

500

457

435

22

15

Infusion Set Anak

Pcs

(43)

500

457

435

22

16

Infusion Set Dewasa

Pcs

(41)

500

459

435

24 EXP.10-17

17

IV. Catheter No.18 G

Set

(41)

500

459

435

24 Exp.jul-15

18

IV. Catheter No.20 G

Set

(43)

500

457

435

22

19

IV. Catheter No.22 G

Set

(43)

500

457

435

22

20

IV. Catheter No.24 G

Kotak

(43)

500

457

435

22

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(43)

500

457

435

22

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(43)

500

457

435

22

23

Kapas Pembalut / absorben 250 gram

Bungkus

(43)

500

457

435

22

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(38)

500

462

435

27

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(43)

500

457

435

22

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(43)

500

457

435

22

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(43)

500

457

435

22

28

Kertas EKG

Roll

(43)

500

457

435

22

29

Kertas USG Sony 110 HG

Roll

(43)

500

457

435

22

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(42)

500

458

435

23

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

(43)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

(43)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Masker O2

37

Botol 1 ltr

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

(43)

Lembar

(43)

Kotak

(40)

500

460

435

25

Pcs

(43)

500

457

435

22

Masker 95

Pcs

(43)

500

457

435

22

38

Masker nebulizer set dewasa

Pcs

(42)

500

458

435

23

39

Masker nebulizer set anak

Pcs

(42)

500

458

435

23

40

Plester 5 yard X 2 inch

Roll

(43)

500

457

435

22

41

Plester non alergi 0,5 inch / Micropore

Roll

(40)

500

460

435

25

42

Pot Urin

Pcs

(43)

500

457

435

22

43

Sarung Tangan

Kotak

(41)

500

459

435

24

44

Safety Box

Pcs

(43)

500

457

435

22

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(43)

500

457

435

22

(43)

500

457

435

22

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

(43)

500

457

435

22

Eter Alkohol

Botol 100 ml

(43)

500

457

435

22

Kaca Slide / Object Glass

Kotak

(43)

500

457

435

22

Pot dahak

Pcs

(43)

500

457

435

22

Reagen Zielnelsen

Set

(43)

500

457

435

22

Spiritus Bakar

Botol

(43)

500

457

435

22

Tissu Lensa

Kotak

(43)

500

457

435

22

Tissue lensa

Buku

(43)

500

457

435

22

KET

NAMA OBAT
9

Wadah Kaca Slide / Box Slide

10
11

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Pcs

(43)

500

457

435

22

Xylol/ Xylene

Botol 100 ml

(43)

500

457

435

22

Xylol/ Xylene

Botol 500 ml

(43)

500

457

435

22

(43)

500

457

435

22

500

457

435

22

500

497

435

62

500

477

435

42

500

461

435

26

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(43)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(3)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(23)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(39)

Sendok obat

Pcs

57

500

557

435

122

(43)

500

457

435

22

AKUPUNTUR
1

Jarum Akupuntur 13 mm

Kotak

(43)

500

457

435

22

Jarum Akupuntur 25 mm

Kotak

(43)

500

457

435

22

Jarum Akupuntur 40 mm

Kotak

(43)

500

457

435

22

Jarum telinga (press needle)

Kotak

(43)

500

457

435

22

Moxa Roll

Kotak

(43)

500

457

435

22

(43)

500

457

435

22

Pcs

(43)

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(43)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

(43)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(43)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(43)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(43)

500

457

435

22

MgSO4 40% injeksi

Vial

(43)

500

457

435

22

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(43)

500

457

435

22

Natrium Bicarbonat injeksi

Ampul

(43)

500

457

435

22

10

Nasal dewasa / Maxyflow

Pcs

(43)

500

457

435

22

KET

NAMA OBAT
11

Nasal infant/ Oxyflow

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

13

Penghisap Lendir Bayi Baru Lahir

14

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

Pcs

(43)

Ampul

(43)

Pcs

Sarung Tangan panjang obgyn No. 6,5

15

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

500

457

435

22

500

457

435

22

(43)

500

457

435

22

Pasang

(43)

500

457

435

22

Sarung Tangan panjang obgyn No. 7

Pasang

(43)

500

457

435

22

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(43)

500

457

435

22

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(43)

500

457

435

22

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(43)

500

457

435

22

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(43)

500

457

435

22

20

Sungkup bayi

Set

(43)

500

457

435

22

21

Tanda Pengenal (ID Band) Bayi

Psc

(43)

500

457

435

22

22

Tanda Pengenal (ID Band) Ibu

Psc

(43)

500

457

435

22

23

Under Pad 60 x 90 cm

Psc

(43)

500

457

435

22

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(43)

500

457

435

22

(43)

500

457

435

22

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

147

500

647

435

212

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(43)

500

457

435

22

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

(43)
500

457

435

22

Asiklovir tablet 200 mg

Tablet

(43)

500

457

435

22

Bisacodyl 5 mg / Bicolax

Tablet

(43)

500

457

435

22

Biskodil sup 10 mg

Supp

(43)

500

457

435

22

Buskopan injeksi

Ampul

(43)

500

457

435

22

Bur Fissure standart

Pcs

(43)

500

457

435

22

Bur Fissure panjang

Pcs

(43)

500

457

435

22

10

Cetirizin HCl 10 mg

Tablet

(43)

500

457

435

22

11

Cetirizin syrup 100 mg / 5 ml

botol

(43)

500

457

435

22

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

12

Cefixim / sefiksim 100 mg caplet

kaplet

(43)

500

457

435

22

13

Etanol 96 % - 1 L

Botol

(43)

500

457

435

22

14

Gentian Violet larutan 1 %

Botol

(43)

500

457

435

22

15

Glucose Larutan Infus 10% Steril

Botol

(43)

500

457

435

22

16

Jarum Suntik No. 27 G

Pcs

(43)

500

457

435

22

17

Ketokonazole Krim 2%

Tube

(43)

500

457

435

22

18

Klindamisin kapsul 150 mg

Kapsul

(38)

500

462

435

27

19

Klindamisin 300 MG

Kapsul

(43)

500

457

435

22

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(43)

500

457

435

22

21

Kasa 2x80

Roll

(43)

500

457

435

22

22

Kapas 500 gram

Bungkus

(43)

500

457

435

22

23

Larutan H2O2

Botol

(43)

500

457

435

22

24

Methilprednisolon 4 mg

tablet

(43)

500

457

435

22

25

Metoklopramid injeksi / Primperan

Vial

(43)

500

457

435

22

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(43)

500

457

435

22

27

Metronidazol tablet 250 mg

Tablet

(43)

500

457

435

22

28

Meylon injeksi

Botol

(43)

500

457

435

22

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(43)
500

457

435

22

500

457

435

22

500

457

435

22

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Tube

Botol

(43)

(43)

Vial

(43)

500

457

435

22

Polymigel tablet 400 mg/Strocain P

Tablet

(43)

500

457

435

22

34

Propanolol tablet 40 mg (HCl)

Tablet

(43)

500

457

435

22

35

Ranitidin injeksi 25 mg/ml

Ampul

(43)

500

457

435

22

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

36

Saccaharine tablet

Tablet

(43)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(43)

38

Sefadroxil syrup 125 mg

botol

(43)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(43)

40

Teofilin tablet / Bronsolvan

Tablet

(43)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(43)

OBAT KESDA

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

(43)

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

500

457

tube

22

500

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

435

22

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

457

435

(43)

500

457

tablet

kaplet

STOK AKHIR

500

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

PEMAKAIAN

(43)

PERSEDIAAN

(43)

(43)

(43)

(43)

(43)

(43)

KET

NAMA OBAT

10

11

12

13

14

15

16

SATUAN
KEMASAN

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

tablet

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat
5 mg) - 5 gr / Bevalex

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

(43)

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

STOK AWAL

tube

tube

kaplet

Botol

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

457

435

22

500

778

435

343

(43)

(43)

(43)

(43)

(43)

(43)

278

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

Ria Susanti,AMF
NIP.198512119 200901 2 004

KET

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

OBAT
1

Alopurinol tablet 100 mg

Tablet

327

100

427

220

207

Amlodipin tablet 5 mg

Tablet

256

100

356

220

136

Aminofillin tablet 200 mg

Tablet

222

100

322

220

102

Amoksilin kaplet 500 mg

Kaplet

2,097

100

2,197

220

1,977

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

88

100

188

220

(32)

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,770
100

1,870

220

1,650

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

100

137

220

(83)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

100

178

220

(42)

100

123

220

(97)

100

514

220

294

100

122

220

(98)

100

122

220

(98)

100

157

220

(63)

100

237

220

17

100

132

220

(88)

100

122

220

(98)

100

122

220

(98)

37

78

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

414

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

22

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

22

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

23

Supp

57

Kapsul

137

Tube

32

Tablet

22

Vial

22

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

18

Asam Asetilsalisilat tablet 80 mg

Tablet

22

100

122

220

(98)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,157

100

2,257

220

2,037

20

Asam Mefenamat kaplet 500 mg

Kaplet

652

100

752

220

532

21

Asiklovir krim 5 % - 5 gr

Tube

61

100

161

220

(59)

22

Asiklovir tablet 400 mg

Tablet

614

100

714

220

494

23

Atapulgit tablet 600 mg

Tablet

62

100

162

220

(58)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

25

100

125

220

(95)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,531

100

1,631

220

1,411

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

22

100

122

220

(98)

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

50

100

150

220

(70)

28

Bisoprolol tablet 5 mg

Tablet

34

100

134

220

(86)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

48

100

148

220

(72)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

85

100

185

220

(35)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

23

100

123

220

(97) EXP.10-15

32

Deksametason tablet 0,5 mg

Tablet

1,365

100

1,465

220

1,245

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

22

100

122

220

(98)

34

Difenhidramin injeksi 10 mg/ml

Ampul

22

100

122

220

(98)

35

Digoksin tablet 0,25 mg

Tablet

92

100

192

220

(28)

36

Domperidon tablet 10 mg

Tablet

318

100

418

220

198

37

Doksisiklin kapsul 100 mg

Kapsul

22

100

122

220

(98)

38

Efedrin tablet 25 mg (HCl)

Tablet

203

100

303

220

83

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

28

100

128

220

(92)

40

Eritromisin kapsul 500 mg

Kapsul

22

100

122

220

(98)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

40

100

140

220

(80)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

48

100

148

220

(72)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

38

100

138

220

(82)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

127

45

Furosemid tablet 40 mg

Tablet

73

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

661

47

Gemfibrozil 300 mg kapsul

48

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

100

227

220

100

173

220

(47)

100

761

220

541

Kapsul

247

100

347

220

127

Gentamycin salep kulit 0,1% - 5 gr

Tube

37

100

137

220

(83)

49

Glibenklamid tablet 5 mg

Tablet

756

100

856

220

636

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,114

100

3,214

220

2,994

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

22

100

122

220

(98)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

102

100

202

220

(18)

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

662

100

762

220

542

54

Hidrokortison krim 2,5 % - 5 gr

Tube

42

100

142

220

(78)

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

22

100

122

220

(98)

56

Ibuprofen tablet 400 mg

Tablet

397

100

497

220

277

57

Ichtyol salep kulit - 15 gr

Pot

39

100

139

220

(81)

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

172

100

272

220

52

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

22

100

122

220

(98)

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,247

100

1,347

220

1,127

61

Kaptopril tablet 25 mg

Tablet

1,351

100

1,451

220

1,231

62

Ketokonazol tablet 200 mg

Tablet

91

100

191

220

(29)

63

Klindamisin kapsul 150 mg

Kapsul

22

100

122

220

(98)

64

Kloramfenikol kapsul 250 mg

Kapsul

22

100

122

220

(98)

65

Kloramfenikol salep mata 1% - 5 gr

Tube

22

100

122

220

(98)

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

69

100

169

220

(51)

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

50

100

150

220

(70)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

56

100

156

220

(64)

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,450

100

5,550

220

5,330

NAMA OBAT

70

71

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

SATUAN
KEMASAN

Tablet

Tablet

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

500
100

600

220

380

100

122

220

(98)

22

Botol

49
100

149

220

(71)

Pot

29

100

129

220

(91)

Lidokain injeksi 2% - 2 ml

Ampul

22

100

122

220

(98)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

22

100

122

220

(98)

76

Linkomisin kapsul 500 mg

Kapsul

22

100

122

220

(98)

77

Loperamid tablet 2 mg

Tablet

78

100

178

220

(42)

78

Loratadin tablet 10 mg

Tablet

75

100

175

220

(45)

79

Mebendazol tablet 100 mg

Tablet

22

100

122

220

(98)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

641

100

741

220

521

81

Metformin HCl tablet 500 mg

Tablet

273

100

373

220

153

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

242

100

342

220

122

83

Metronidazol tablet 500 mg

Tablet

154

100

254

220

34

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

30

100

130

220

(90)

85

Multivit Sirup - 60 ml

Botol

104

100

204

220

(16)

86

Multivit Tablet

Tablet

22

100

122

220

(98)

87

Natrium Bikarbonat tablet 500 mg

Tablet

22

100

122

220

(98)

88

Natrium Diklofenak tablet 50 mg

Tablet

150

100

250

220

30

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

22

100

122

220

(98)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

23

100

123

220

(97) EXP.JAN-17

91

Nifedipin tablet 10 mg

Tablet

40

100

140

220

(80)

92

Nistatin tablet salut 500.000 IU/g

Tablet

140

100

240

220

20

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

134

100

234

220

14

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

STOK AWAL

PENERIMAAN

Botol

76

Tablet

22

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

52

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

22

98

Omeprazol kapsul 20 mg

Kapsul

22

99

Papaverin tablet 40 mg

Tablet

355

100

Parasetamol drops

botol

79

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

88

102

Parasetamol tablet 100 mg

Tablet

22

103

Parasetamol tablet 500 mg

Tablet

3,002

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

838

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

107

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

100

176

220

(44)

100

122

220

(98)

100

152

220

(68)

100

122

220

(98)

100

122

220

(98)

100

455

220

235 exp.10-15

100

179

220

(41)

100

188

220

(32)

100

122

220

(98)

100

3,102

220

2,882

100

938

220

718

110

100

210

220

(10)

Botol

23

100

123

220

(97)

Povidon Iodida larutan 10 % - 300 ml

Botol

23

100

123

220

(97)

108

Prednison tablet 5 mg

Tablet

719

100

819

220

599

109

Propanolol tablet 10 mg (HCl)

Tablet

122

100

222

220

110

Propiltiourasil tablet 100 mg

Tablet

67

100

167

220

(53)

111

Ranitidin tablet 150 mg

Tablet

26

100

126

220

(94)

112

Ringer Laktat larutan infus - 500 ml

Botol

22

100

122

220

(98)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

162

100

262

220

42

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

22

100

122

220

(98)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

37

100

137

220

(83)

116

Salisil Bedak 2 % - 50 gr

Kotak

101

100

201

220

(19)

117

Sefadroksil Kapsul 500 mg

Kapsul

140

100

240

220

20

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

166

100

266

220

46

119

Simvastatin tablet 10 mg

Tablet

22

100

122

220

(98)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

357

100

457

220

237

/ Librozym

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Botol

22

100

122

220

(98)

Tetrasiklin kapsul 250 mg

Kapsul

22

100

122

220

(98)

123

Tetrasiklin kapsul 500 mg

Kapsul

185

100

285

220

65

124

Thiamfenikol kapsul 500 mg

Kapsul

22

100

122

220

(98)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,619

100

1,719

220

1,499

126

Vitamin B Kompleks tablet

Tablet

1,689

100

1,789

220

1,569

127

Zinc tablet 20 mg

Tablet

442

100

542

220

322

22

OBAT PROGRAM TB PARU

100

122

220

(98)

128

Obat FDC Kategori 1

Paket

22

100

122

220

(98)

129

Obat FDC Kategori 2

Paket

22

100

122

220

(98)

130

Obat FDC Anak

Paket

22

100

122

220

(98)

131

Obat FDC Sisipan

Paket

22

100

122

220

(98)

22

100

122

220

(98)

Vial

23

100

123

220

(97)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

84

100

184

220

(36)

134

Sefiksim kapsul 100 mg

Kapsul

22

100

122

220

(98)

22

100

122

220

(98)

22

100

122

220

(98)

22

100

122

220

(98)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

22

100

122

220

(98)

137

Pirantel tablet score (base) 125 mg

Tablet

95

100

195

220

(25)

22

100

122

220

(98)

100

122

220

(98)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

22

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

22

OBAT KEJIWAAN

100

122

220

(98)

22

100

122

220

(98)

Alprazolam tablet 1 mg

Tablet

241

100

341

220

121

Amitriptilin tablet salut 25 mg (HCl)

Tablet

73

100

173

220

(47)

Clobazam tablet 10 mg

Tablet

184

100

284

220

64

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Diazepam tablet 2 mg

Tablet

159

100

259

220

39

Diazepam tablet 5 mg

Tablet

22

100

122

220

(98)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

22

100

122

220

(98)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

23

100

123

220

(97)

Fenitoin Kapsul 100 mg

Kapsul

22

100

122

220

(98)

Fenobarbital tablet 30 mg

Tablet

45

100

145

220

(75)

10

Fluoxetin tablet 10 mg /

Tablet

22

100

122

220

(98)

11

Haloperidol tablet 1,5 mg

Tablet

232

100

332

220

112

12

Haloperidol tablet 5 mg

Tablet

448

100

548

220

328

13

Imipramin tablet 25 mg / Tofranil

Tablet

22

100

122

220

(98)

14

Karbamazepin tablet 200 mg

Tablet

22

100

122

220

(98)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

37

100

137

220

(83)

16

Kodein tablet 10 mg

Tablet

237

100

337

220

117

17

Risperidon tablet 2 mg

Tablet

22

100

122

220

(98)

18

Sertralin tablet / Nudep

Tablet

22

100

122

220

(98)

19

Triheksifenidil tablet 2 mg

Tablet

22

100

122

220

(98)

22

Antiprestin

OBAT GIGI

100

122

220

(98)

Artikulating Paper

Buku

22

100

122

220

(98)

Bur diamond high Speed

Kotak

22

100

122

220

(98)

Bur arkansas high Speed

buah

22

100

122

220

(98)

Cavit / Dentorit (Tambalan Sementara)

Pot

23

100

123

220

(97)

Celluloid strip

Set

22

100

122

220

(98)

Cresopen - 13 ml

Botol

22

100

122

220

(98)

Dentin Conditioner

Botol

22

100

122

220

(98)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

22

100

122

220

(98)

Disclosing Agent

Tube

22

100

122

220

(98)

Bungkus @ 100
pcs

10

Disposible saliva ejektor

22

100

122

220

(98)

11

Etil Chlorida spray - 100 ml

Botol

23

100

123

220

(97)

12

Eugenol cairan

Botol

23

100

123

220

(97)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

13

Glass Ionomer Radiopak / Fuji VII

Set

23

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

23

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

22

16

Macro gold + propylen + EDTA

Set

17

Oil Spray

18

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

100

123

220

(97)

100

123

220

(97)

100

122

220

(98)

22

100

122

220

(98)

Botol

22

100

122

220

(98)

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

225
100

325

220

105

19

Pulperyl

Botol

22

100

122

220

(98)

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

22

100

122

220

(98)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

22

100

122

220

(98)

22

Tetric N Ceram

Paket

22

100

122

220

(98)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

22

100

122

220

(98)

24

Tetric Bonding - 6 gr

Botol

22

100

122

220

(98)

25

Tetric Etch Refill - 2 gr

Tube

22

100

122

220

(98)

26

Trikresol Formalin (TKF)

Botol

23

100

123

220

(97)

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

22

100

122

220

(98)

28

Xylestesin Non Adrenalin injeksi

Ampul

22

100

122

220

(98)

29

CHKM

Botol

22

100

122

220

(98)

30

Iodoform/Mumifying pasta

Botol

22

100

122

220

(98)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

22

100

122

220

(98)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

22

100

122

220

(98)

22

PERBEKALAN KESEHATAN

100

122

220

(98)

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

22

100

122

220

(98)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

22

100

122

220

(98)

Alat Suntik sekali pakai 1 ml

Pcs

82

100

182

220

(38)

Alat Suntik sekali pakai 3 ml

Pcs

114

100

214

220

(6)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

Alat Suntik sekali pakai 5 ml

Pcs

84

100

184

220

(36)

Blood set

Set

22

100

122

220

(98)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

22

100

122

220

(98)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

22

100

122

220

(98)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

22

100

122

220

(98)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

22

100

122

220

(98)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

22

100

122

220

(98)

12

Dental Film Hanshin

Pcs

22

100

122

220

(98)

13

Etanol 70 % - 1 L

Botol

24

100

124

220

(96)

14

Gel USG / EKG

Botol

22

100

122

220

(98)

15

Infusion Set Anak

Pcs

22

100

122

220

(98)

16

Infusion Set Dewasa

Pcs

24

100

124

220

(96) EXP.10-17

17

IV. Catheter No.18 G

Set

24

100

124

220

(96) Exp.jul-15

18

IV. Catheter No.20 G

Set

22

100

122

220

(98)

19

IV. Catheter No.22 G

Set

22

100

122

220

(98)

20

IV. Catheter No.24 G

Kotak

22

100

122

220

(98)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

22

100

122

220

(98)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

22

100

122

220

(98)

23

Kapas Pembalut / absorben 250 gram

Bungkus

22

100

122

220

(98)

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

27

100

127

220

(93)

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

22

100

122

220

(98)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

22

100

122

220

(98)

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

22

100

122

220

(98)

28

Kertas EKG

Roll

22

100

122

220

(98)

29

Kertas USG Sony 110 HG

Roll

22

100

122

220

(98)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

23

100

123

220

(97)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

22

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

22

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Masker O2

37

Botol 1 ltr

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

22

Lembar

22

Kotak

25

100

125

220

(95)

Pcs

22

100

122

220

(98)

Masker 95

Pcs

22

100

122

220

(98)

38

Masker nebulizer set dewasa

Pcs

23

100

123

220

(97)

39

Masker nebulizer set anak

Pcs

23

100

123

220

(97)

40

Plester 5 yard X 2 inch

Roll

22

100

122

220

(98)

41

Plester non alergi 0,5 inch / Micropore

Roll

25

100

125

220

(95)

42

Pot Urin

Pcs

22

100

122

220

(98)

43

Sarung Tangan

Kotak

24

100

124

220

(96)

44

Safety Box

Pcs

22

100

122

220

(98)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

22

100

122

220

(98)

22

100

122

220

(98)

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

22

100

122

220

(98)

Eter Alkohol

Botol 100 ml

22

100

122

220

(98)

Kaca Slide / Object Glass

Kotak

22

100

122

220

(98)

Pot dahak

Pcs

22

100

122

220

(98)

Reagen Zielnelsen

Set

22

100

122

220

(98)

Spiritus Bakar

Botol

22

100

122

220

(98)

Tissu Lensa

Kotak

22

100

122

220

(98)

Tissue lensa

Buku

22

100

122

220

(98)

KET

NAMA OBAT
9

Wadah Kaca Slide / Box Slide

10
11

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

Pcs

22

100

122

220

(98)

Xylol/ Xylene

Botol 100 ml

22

100

122

220

(98)

Xylol/ Xylene

Botol 500 ml

22

100

122

220

(98)

22

100

122

220

(98)

100

122

220

(98)

100

162

220

(58)

100

142

220

(78)

100

126

220

(94)

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

22

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

62

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

42

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

26

Sendok obat

Pcs

122

100

222

220

22

100

122

220

(98)

AKUPUNTUR
1

Jarum Akupuntur 13 mm

Kotak

22

100

122

220

(98)

Jarum Akupuntur 25 mm

Kotak

22

100

122

220

(98)

Jarum Akupuntur 40 mm

Kotak

22

100

122

220

(98)

Jarum telinga (press needle)

Kotak

22

100

122

220

(98)

Moxa Roll

Kotak

22

100

122

220

(98)

22

100

122

220

(98)

Pcs

22

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

22

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

22

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

22

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

22

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

22

100

122

220

(98)

MgSO4 40% injeksi

Vial

22

100

122

220

(98)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

22

100

122

220

(98)

Natrium Bicarbonat injeksi

Ampul

22

100

122

220

(98)

10

Nasal dewasa / Maxyflow

Pcs

22

100

122

220

(98)

NAMA OBAT
11

Nasal infant/ Oxyflow

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

13

Penghisap Lendir Bayi Baru Lahir

14

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

Pcs

22

Ampul

22

Pcs

Sarung Tangan panjang obgyn No. 6,5

15

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

100

122

220

(98)

100

122

220

(98)

22

100

122

220

(98)

Pasang

22

100

122

220

(98)

Sarung Tangan panjang obgyn No. 7

Pasang

22

100

122

220

(98)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

22

100

122

220

(98)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

22

100

122

220

(98)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

22

100

122

220

(98)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

22

100

122

220

(98)

20

Sungkup bayi

Set

22

100

122

220

(98)

21

Tanda Pengenal (ID Band) Bayi

Psc

22

100

122

220

(98)

22

Tanda Pengenal (ID Band) Ibu

Psc

22

100

122

220

(98)

23

Under Pad 60 x 90 cm

Psc

22

100

122

220

(98)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

22

100

122

220

(98)

22

100

122

220

(98)

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

212

100

312

220

92

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

22

100

122

220

(98)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

22
100

122

220

(98)

Asiklovir tablet 200 mg

Tablet

22

100

122

220

(98)

Bisacodyl 5 mg / Bicolax

Tablet

22

100

122

220

(98)

Biskodil sup 10 mg

Supp

22

100

122

220

(98)

Buskopan injeksi

Ampul

22

100

122

220

(98)

Bur Fissure standart

Pcs

22

100

122

220

(98)

Bur Fissure panjang

Pcs

22

100

122

220

(98)

10

Cetirizin HCl 10 mg

Tablet

22

100

122

220

(98)

11

Cetirizin syrup 100 mg / 5 ml

botol

22

100

122

220

(98)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

12

Cefixim / sefiksim 100 mg caplet

kaplet

22

100

122

220

(98)

13

Etanol 96 % - 1 L

Botol

22

100

122

220

(98)

14

Gentian Violet larutan 1 %

Botol

22

100

122

220

(98)

15

Glucose Larutan Infus 10% Steril

Botol

22

100

122

220

(98)

16

Jarum Suntik No. 27 G

Pcs

22

100

122

220

(98)

17

Ketokonazole Krim 2%

Tube

22

100

122

220

(98)

18

Klindamisin kapsul 150 mg

Kapsul

27

100

127

220

(93)

19

Klindamisin 300 MG

Kapsul

22

100

122

220

(98)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

22

100

122

220

(98)

21

Kasa 2x80

Roll

22

100

122

220

(98)

22

Kapas 500 gram

Bungkus

22

100

122

220

(98)

23

Larutan H2O2

Botol

22

100

122

220

(98)

24

Methilprednisolon 4 mg

tablet

22

100

122

220

(98)

25

Metoklopramid injeksi / Primperan

Vial

22

100

122

220

(98)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

22

100

122

220

(98)

27

Metronidazol tablet 250 mg

Tablet

22

100

122

220

(98)

28

Meylon injeksi

Botol

22

100

122

220

(98)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

22
100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Tube

Botol

22

22

Vial

22

100

122

220

(98)

Polymigel tablet 400 mg/Strocain P

Tablet

22

100

122

220

(98)

34

Propanolol tablet 40 mg (HCl)

Tablet

22

100

122

220

(98)

35

Ranitidin injeksi 25 mg/ml

Ampul

22

100

122

220

(98)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

36

Saccaharine tablet

Tablet

22

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

22

38

Sefadroxil syrup 125 mg

botol

22

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

22

40

Teofilin tablet / Bronsolvan

Tablet

22

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

22

OBAT KESDA

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

22

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

100

122

tube

(98)

100

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

220

(98)

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

122

220

22

100

122

tablet

kaplet

STOK AKHIR

100

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

PEMAKAIAN

22

PERSEDIAAN

22

22

22

22

22

22

KET

NAMA OBAT

10

11

12

13

14

15

16

SATUAN
KEMASAN

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

tablet

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat
5 mg) - 5 gr / Bevalex

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

22

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

STOK AWAL

tube

tube

kaplet

Botol

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

122

220

(98)

100

443

220

223

22

22

22

22

22

22

343

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

Ria Susanti,AMF
NIP.198512119 200901 2 004

KET

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

OBAT
1

Alopurinol tablet 100 mg

Tablet

207

200

407

206

201

Amlodipin tablet 5 mg

Tablet

136

200

336

206

130

Aminofillin tablet 200 mg

Tablet

102

200

302

206

96

Amoksilin kaplet 500 mg

Kaplet

1,977

200

2,177

206

1,971

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

(32)

200

168

206

(38)

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,650
200

1,850

206

1,644

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

200

117

206

(89)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

200

158

206

(48)

200

103

206

(103)

200

494

206

288

200

102

206

(104)

200

102

206

(104)

200

137

206

(69)

200

217

206

11

200

112

206

(94)

200

102

206

(104)

200

102

206

(104)

(83)

(42)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

294

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(98)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

(98)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

(97)

Supp

(63)

Kapsul

17

Tube

(88)

Tablet

(98)

Vial

(98)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(98)

200

102

206

(104)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,037

200

2,237

206

2,031

20

Asam Mefenamat kaplet 500 mg

Kaplet

532

200

732

206

526

21

Asiklovir krim 5 % - 5 gr

Tube

(59)

200

141

206

(65)

22

Asiklovir tablet 400 mg

Tablet

494

200

694

206

488

23

Atapulgit tablet 600 mg

Tablet

(58)

200

142

206

(64)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(95)

200

105

206

(101)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,411

200

1,611

206

1,405

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(98)

200

102

206

(104)

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(70)

200

130

206

(76)

28

Bisoprolol tablet 5 mg

Tablet

(86)

200

114

206

(92)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(72)

200

128

206

(78)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(35)

200

165

206

(41)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

(97)

200

103

206

32

Deksametason tablet 0,5 mg

Tablet

1,245

200

1,445

206

1,239

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(98)

200

102

206

(104)

34

Difenhidramin injeksi 10 mg/ml

Ampul

(98)

200

102

206

(104)

35

Digoksin tablet 0,25 mg

Tablet

(28)

200

172

206

(34)

36

Domperidon tablet 10 mg

Tablet

198

200

398

206

192

37

Doksisiklin kapsul 100 mg

Kapsul

(98)

200

102

206

(104)

38

Efedrin tablet 25 mg (HCl)

Tablet

83

200

283

206

77

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(92)

200

108

206

(98)

40

Eritromisin kapsul 500 mg

Kapsul

(98)

200

102

206

(104)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(80)

200

120

206

(86)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(72)

200

128

206

(78)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(82)

200

118

206

(88)

KET

(103) EXP.10-15

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

45

Furosemid tablet 40 mg

Tablet

(47)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

541

47

Gemfibrozil 300 mg kapsul

48

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

200

207

206

200

153

206

(53)

200

741

206

535

Kapsul

127

200

327

206

121

Gentamycin salep kulit 0,1% - 5 gr

Tube

(83)

200

117

206

(89)

49

Glibenklamid tablet 5 mg

Tablet

636

200

836

206

630

50

Gliseril Guaiakolat tablet 100 mg

Tablet

2,994

200

3,194

206

2,988

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(98)

200

102

206

(104)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

(18)

200

182

206

(24)

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

542

200

742

206

536

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(78)

200

122

206

(84)

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(98)

200

102

206

(104)

56

Ibuprofen tablet 400 mg

Tablet

277

200

477

206

271

57

Ichtyol salep kulit - 15 gr

Pot

(81)

200

119

206

(87)

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

52

200

252

206

46

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(98)

200

102

206

(104)

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,127

200

1,327

206

1,121

61

Kaptopril tablet 25 mg

Tablet

1,231

200

1,431

206

1,225

62

Ketokonazol tablet 200 mg

Tablet

(29)

200

171

206

(35)

63

Klindamisin kapsul 150 mg

Kapsul

(98)

200

102

206

(104)

64

Kloramfenikol kapsul 250 mg

Kapsul

(98)

200

102

206

(104)

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(98)

200

102

206

(104)

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(51)

200

149

206

(57)

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(70)

200

130

206

(76)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(64)

200

136

206

(70)

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,330

200

5,530

206

5,324

NAMA OBAT

70

71

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

SATUAN
KEMASAN

Tablet

Tablet

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

380
200

580

206

374

200

102

206

(104)

(98)

Botol

(71)
200

129

206

(77)

Pot

(91)

200

109

206

(97)

Lidokain injeksi 2% - 2 ml

Ampul

(98)

200

102

206

(104)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

(98)

200

102

206

(104)

76

Linkomisin kapsul 500 mg

Kapsul

(98)

200

102

206

(104)

77

Loperamid tablet 2 mg

Tablet

(42)

200

158

206

(48)

78

Loratadin tablet 10 mg

Tablet

(45)

200

155

206

(51)

79

Mebendazol tablet 100 mg

Tablet

(98)

200

102

206

(104)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

521

200

721

206

515

81

Metformin HCl tablet 500 mg

Tablet

153

200

353

206

147

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

122

200

322

206

116

83

Metronidazol tablet 500 mg

Tablet

34

200

234

206

28

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(90)

200

110

206

(96)

85

Multivit Sirup - 60 ml

Botol

(16)

200

184

206

(22)

86

Multivit Tablet

Tablet

(98)

200

102

206

(104)

87

Natrium Bikarbonat tablet 500 mg

Tablet

(98)

200

102

206

(104)

88

Natrium Diklofenak tablet 50 mg

Tablet

30

200

230

206

24

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(98)

200

102

206

(104)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(97)

200

103

206

(103) EXP.JAN-17

91

Nifedipin tablet 10 mg

Tablet

(80)

200

120

206

(86)

92

Nistatin tablet salut 500.000 IU/g

Tablet

20

200

220

206

14

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

14

200

214

206

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

STOK AWAL

PENERIMAAN

Botol

(44)

Tablet

(98)

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(68)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(98)

98

Omeprazol kapsul 20 mg

Kapsul

(98)

99

Papaverin tablet 40 mg

Tablet

235

100

Parasetamol drops

botol

(41)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

(32)

102

Parasetamol tablet 100 mg

Tablet

(98)

103

Parasetamol tablet 500 mg

Tablet

2,882

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

718

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

107

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

200

156

206

(50)

200

102

206

(104)

200

132

206

(74)

200

102

206

(104)

200

102

206

(104)

200

435

206

229 exp.10-15

200

159

206

(47)

200

168

206

(38)

200

102

206

(104)

200

3,082

206

2,876

200

918

206

712

(10)

200

190

206

(16)

Botol

(97)

200

103

206

(103)

Povidon Iodida larutan 10 % - 300 ml

Botol

(97)

200

103

206

(103)

108

Prednison tablet 5 mg

Tablet

599

200

799

206

593

109

Propanolol tablet 10 mg (HCl)

Tablet

200

202

206

(4)

110

Propiltiourasil tablet 100 mg

Tablet

(53)

200

147

206

(59)

111

Ranitidin tablet 150 mg

Tablet

(94)

200

106

206

(100)

112

Ringer Laktat larutan infus - 500 ml

Botol

(98)

200

102

206

(104)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

42

200

242

206

36

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(98)

200

102

206

(104)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

(83)

200

117

206

(89)

116

Salisil Bedak 2 % - 50 gr

Kotak

(19)

200

181

206

(25)

117

Sefadroksil Kapsul 500 mg

Kapsul

20

200

220

206

14

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

46

200

246

206

40

119

Simvastatin tablet 10 mg

Tablet

(98)

200

102

206

(104)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

237

200

437

206

231

/ Librozym

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Botol

(98)

200

102

206

(104)

Tetrasiklin kapsul 250 mg

Kapsul

(98)

200

102

206

(104)

123

Tetrasiklin kapsul 500 mg

Kapsul

65

200

265

206

59

124

Thiamfenikol kapsul 500 mg

Kapsul

(98)

200

102

206

(104)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,499

200

1,699

206

1,493

126

Vitamin B Kompleks tablet

Tablet

1,569

200

1,769

206

1,563

127

Zinc tablet 20 mg

Tablet

322

200

522

206

316

(98)

OBAT PROGRAM TB PARU

200

102

206

(104)

128

Obat FDC Kategori 1

Paket

(98)

200

102

206

(104)

129

Obat FDC Kategori 2

Paket

(98)

200

102

206

(104)

130

Obat FDC Anak

Paket

(98)

200

102

206

(104)

131

Obat FDC Sisipan

Paket

(98)

200

102

206

(104)

(98)

200

102

206

(104)

Vial

(97)

200

103

206

(103)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

(36)

200

164

206

(42)

134

Sefiksim kapsul 100 mg

Kapsul

(98)

200

102

206

(104)

(98)

200

102

206

(104)

(98)

200

102

206

(104)

(98)

200

102

206

(104)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

(98)

200

102

206

(104)

137

Pirantel tablet score (base) 125 mg

Tablet

(25)

200

175

206

(31)

(98)

200

102

206

(104)

200

102

206

(104)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

(98)

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

(98)

OBAT KEJIWAAN

200

102

206

(104)

(98)

200

102

206

(104)

Alprazolam tablet 1 mg

Tablet

121

200

321

206

115

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(47)

200

153

206

(53)

Clobazam tablet 10 mg

Tablet

64

200

264

206

58

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Diazepam tablet 2 mg

Tablet

39

200

239

206

33

Diazepam tablet 5 mg

Tablet

(98)

200

102

206

(104)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(98)

200

102

206

(104)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(97)

200

103

206

(103)

Fenitoin Kapsul 100 mg

Kapsul

(98)

200

102

206

(104)

Fenobarbital tablet 30 mg

Tablet

(75)

200

125

206

(81)

10

Fluoxetin tablet 10 mg /

Tablet

(98)

200

102

206

(104)

11

Haloperidol tablet 1,5 mg

Tablet

112

200

312

206

106

12

Haloperidol tablet 5 mg

Tablet

328

200

528

206

322

13

Imipramin tablet 25 mg / Tofranil

Tablet

(98)

200

102

206

(104)

14

Karbamazepin tablet 200 mg

Tablet

(98)

200

102

206

(104)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(83)

200

117

206

(89)

16

Kodein tablet 10 mg

Tablet

117

200

317

206

111

17

Risperidon tablet 2 mg

Tablet

(98)

200

102

206

(104)

18

Sertralin tablet / Nudep

Tablet

(98)

200

102

206

(104)

19

Triheksifenidil tablet 2 mg

Tablet

(98)

200

102

206

(104)

(98)

Antiprestin

OBAT GIGI

200

102

206

(104)

Artikulating Paper

Buku

(98)

200

102

206

(104)

Bur diamond high Speed

Kotak

(98)

200

102

206

(104)

Bur arkansas high Speed

buah

(98)

200

102

206

(104)

Cavit / Dentorit (Tambalan Sementara)

Pot

(97)

200

103

206

(103)

Celluloid strip

Set

(98)

200

102

206

(104)

Cresopen - 13 ml

Botol

(98)

200

102

206

(104)

Dentin Conditioner

Botol

(98)

200

102

206

(104)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(98)

200

102

206

(104)

Disclosing Agent

Tube

(98)

200

102

206

(104)

Bungkus @ 100
pcs

10

Disposible saliva ejektor

(98)

200

102

206

(104)

11

Etil Chlorida spray - 100 ml

Botol

(97)

200

103

206

(103)

12

Eugenol cairan

Botol

(97)

200

103

206

(103)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

13

Glass Ionomer Radiopak / Fuji VII

Set

(97)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(97)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(98)

16

Macro gold + propylen + EDTA

Set

17

Oil Spray

18

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

200

103

206

(103)

200

103

206

(103)

200

102

206

(104)

(98)

200

102

206

(104)

Botol

(98)

200

102

206

(104)

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

105
200

305

206

99

19

Pulperyl

Botol

(98)

200

102

206

(104)

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(98)

200

102

206

(104)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(98)

200

102

206

(104)

22

Tetric N Ceram

Paket

(98)

200

102

206

(104)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(98)

200

102

206

(104)

24

Tetric Bonding - 6 gr

Botol

(98)

200

102

206

(104)

25

Tetric Etch Refill - 2 gr

Tube

(98)

200

102

206

(104)

26

Trikresol Formalin (TKF)

Botol

(97)

200

103

206

(103)

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(98)

200

102

206

(104)

28

Xylestesin Non Adrenalin injeksi

Ampul

(98)

200

102

206

(104)

29

CHKM

Botol

(98)

200

102

206

(104)

30

Iodoform/Mumifying pasta

Botol

(98)

200

102

206

(104)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(98)

200

102

206

(104)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(98)

200

102

206

(104)

(98)

PERBEKALAN KESEHATAN

200

102

206

(104)

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(98)

200

102

206

(104)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(98)

200

102

206

(104)

Alat Suntik sekali pakai 1 ml

Pcs

(38)

200

162

206

(44)

Alat Suntik sekali pakai 3 ml

Pcs

(6)

200

194

206

(12)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

Alat Suntik sekali pakai 5 ml

Pcs

(36)

200

164

206

(42)

Blood set

Set

(98)

200

102

206

(104)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(98)

200

102

206

(104)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(98)

200

102

206

(104)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(98)

200

102

206

(104)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(98)

200

102

206

(104)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(98)

200

102

206

(104)

12

Dental Film Hanshin

Pcs

(98)

200

102

206

(104)

13

Etanol 70 % - 1 L

Botol

(96)

200

104

206

(102)

14

Gel USG / EKG

Botol

(98)

200

102

206

(104)

15

Infusion Set Anak

Pcs

(98)

200

102

206

(104)

16

Infusion Set Dewasa

Pcs

(96)

200

104

206

(102) EXP.10-17

17

IV. Catheter No.18 G

Set

(96)

200

104

206

(102) Exp.jul-15

18

IV. Catheter No.20 G

Set

(98)

200

102

206

(104)

19

IV. Catheter No.22 G

Set

(98)

200

102

206

(104)

20

IV. Catheter No.24 G

Kotak

(98)

200

102

206

(104)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(98)

200

102

206

(104)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(98)

200

102

206

(104)

23

Kapas Pembalut / absorben 250 gram

Bungkus

(98)

200

102

206

(104)

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(93)

200

107

206

(99)

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(98)

200

102

206

(104)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(98)

200

102

206

(104)

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(98)

200

102

206

(104)

28

Kertas EKG

Roll

(98)

200

102

206

(104)

29

Kertas USG Sony 110 HG

Roll

(98)

200

102

206

(104)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(97)

200

103

206

(103)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

(98)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

(98)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Masker O2

37

Botol 1 ltr

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

(98)

Lembar

(98)

Kotak

(95)

200

105

206

(101)

Pcs

(98)

200

102

206

(104)

Masker 95

Pcs

(98)

200

102

206

(104)

38

Masker nebulizer set dewasa

Pcs

(97)

200

103

206

(103)

39

Masker nebulizer set anak

Pcs

(97)

200

103

206

(103)

40

Plester 5 yard X 2 inch

Roll

(98)

200

102

206

(104)

41

Plester non alergi 0,5 inch / Micropore

Roll

(95)

200

105

206

(101)

42

Pot Urin

Pcs

(98)

200

102

206

(104)

43

Sarung Tangan

Kotak

(96)

200

104

206

(102)

44

Safety Box

Pcs

(98)

200

102

206

(104)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(98)

200

102

206

(104)

(98)

200

102

206

(104)

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

(98)

200

102

206

(104)

Eter Alkohol

Botol 100 ml

(98)

200

102

206

(104)

Kaca Slide / Object Glass

Kotak

(98)

200

102

206

(104)

Pot dahak

Pcs

(98)

200

102

206

(104)

Reagen Zielnelsen

Set

(98)

200

102

206

(104)

Spiritus Bakar

Botol

(98)

200

102

206

(104)

Tissu Lensa

Kotak

(98)

200

102

206

(104)

Tissue lensa

Buku

(98)

200

102

206

(104)

KET

NAMA OBAT
9

Wadah Kaca Slide / Box Slide

10
11

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

Pcs

(98)

200

102

206

(104)

Xylol/ Xylene

Botol 100 ml

(98)

200

102

206

(104)

Xylol/ Xylene

Botol 500 ml

(98)

200

102

206

(104)

(98)

200

102

206

(104)

200

102

206

(104)

200

142

206

(64)

200

122

206

(84)

200

106

206

(100)

200

202

206

(4)

(98)

200

102

206

(104)

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(98)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(58)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(78)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(94)

Sendok obat

Pcs

AKUPUNTUR
1

Jarum Akupuntur 13 mm

Kotak

(98)

200

102

206

(104)

Jarum Akupuntur 25 mm

Kotak

(98)

200

102

206

(104)

Jarum Akupuntur 40 mm

Kotak

(98)

200

102

206

(104)

Jarum telinga (press needle)

Kotak

(98)

200

102

206

(104)

Moxa Roll

Kotak

(98)

200

102

206

(104)

(98)

200

102

206

(104)

Pcs

(98)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(98)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

(98)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(98)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(98)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(98)

200

102

206

(104)

MgSO4 40% injeksi

Vial

(98)

200

102

206

(104)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(98)

200

102

206

(104)

Natrium Bicarbonat injeksi

Ampul

(98)

200

102

206

(104)

10

Nasal dewasa / Maxyflow

Pcs

(98)

200

102

206

(104)

NAMA OBAT
11

Nasal infant/ Oxyflow

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

13

Penghisap Lendir Bayi Baru Lahir

14

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

Pcs

(98)

Ampul

(98)

Pcs

Sarung Tangan panjang obgyn No. 6,5

15

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

200

102

206

(104)

200

102

206

(104)

(98)

200

102

206

(104)

Pasang

(98)

200

102

206

(104)

Sarung Tangan panjang obgyn No. 7

Pasang

(98)

200

102

206

(104)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(98)

200

102

206

(104)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(98)

200

102

206

(104)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(98)

200

102

206

(104)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(98)

200

102

206

(104)

20

Sungkup bayi

Set

(98)

200

102

206

(104)

21

Tanda Pengenal (ID Band) Bayi

Psc

(98)

200

102

206

(104)

22

Tanda Pengenal (ID Band) Ibu

Psc

(98)

200

102

206

(104)

23

Under Pad 60 x 90 cm

Psc

(98)

200

102

206

(104)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(98)

200

102

206

(104)

(98)

200

102

206

(104)

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

92

200

292

206

86

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(98)

200

102

206

(104)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

(98)
200

102

206

(104)

Asiklovir tablet 200 mg

Tablet

(98)

200

102

206

(104)

Bisacodyl 5 mg / Bicolax

Tablet

(98)

200

102

206

(104)

Biskodil sup 10 mg

Supp

(98)

200

102

206

(104)

Buskopan injeksi

Ampul

(98)

200

102

206

(104)

Bur Fissure standart

Pcs

(98)

200

102

206

(104)

Bur Fissure panjang

Pcs

(98)

200

102

206

(104)

10

Cetirizin HCl 10 mg

Tablet

(98)

200

102

206

(104)

11

Cetirizin syrup 100 mg / 5 ml

botol

(98)

200

102

206

(104)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

12

Cefixim / sefiksim 100 mg caplet

kaplet

(98)

200

102

206

(104)

13

Etanol 96 % - 1 L

Botol

(98)

200

102

206

(104)

14

Gentian Violet larutan 1 %

Botol

(98)

200

102

206

(104)

15

Glucose Larutan Infus 10% Steril

Botol

(98)

200

102

206

(104)

16

Jarum Suntik No. 27 G

Pcs

(98)

200

102

206

(104)

17

Ketokonazole Krim 2%

Tube

(98)

200

102

206

(104)

18

Klindamisin kapsul 150 mg

Kapsul

(93)

200

107

206

(99)

19

Klindamisin 300 MG

Kapsul

(98)

200

102

206

(104)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(98)

200

102

206

(104)

21

Kasa 2x80

Roll

(98)

200

102

206

(104)

22

Kapas 500 gram

Bungkus

(98)

200

102

206

(104)

23

Larutan H2O2

Botol

(98)

200

102

206

(104)

24

Methilprednisolon 4 mg

tablet

(98)

200

102

206

(104)

25

Metoklopramid injeksi / Primperan

Vial

(98)

200

102

206

(104)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(98)

200

102

206

(104)

27

Metronidazol tablet 250 mg

Tablet

(98)

200

102

206

(104)

28

Meylon injeksi

Botol

(98)

200

102

206

(104)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(98)
200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Tube

Botol

(98)

(98)

Vial

(98)

200

102

206

(104)

Polymigel tablet 400 mg/Strocain P

Tablet

(98)

200

102

206

(104)

34

Propanolol tablet 40 mg (HCl)

Tablet

(98)

200

102

206

(104)

35

Ranitidin injeksi 25 mg/ml

Ampul

(98)

200

102

206

(104)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

36

Saccaharine tablet

Tablet

(98)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(98)

38

Sefadroxil syrup 125 mg

botol

(98)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(98)

40

Teofilin tablet / Bronsolvan

Tablet

(98)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(98)

OBAT KESDA

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

(98)

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

200

102

tube

(104)

200

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

206

(104)

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

102

206

(98)

200

102

tablet

kaplet

STOK AKHIR

200

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

PEMAKAIAN

(98)

PERSEDIAAN

(98)

(98)

(98)

(98)

(98)

(98)

KET

NAMA OBAT

10

11

12

13

14

15

16

SATUAN
KEMASAN

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

tablet

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat
5 mg) - 5 gr / Bevalex

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

(98)

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

STOK AWAL

tube

tube

kaplet

Botol

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

102

206

(104)

200

423

206

217

(98)

(98)

(98)

(98)

(98)

(98)

223

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

Ria Susanti,AMF
NIP.198512119 200901 2 004

KET

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

OBAT
1

Alopurinol tablet 100 mg

Tablet

201

600

801

400

401

Amlodipin tablet 5 mg

Tablet

130

600

730

400

330

Aminofillin tablet 200 mg

Tablet

96

600

696

400

296

Amoksilin kaplet 500 mg

Kaplet

1,971

600

2,571

400

2,171

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

(38)

600

562

400

162

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,644
600

2,244

400

1,844

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

600

511

400

111

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

600

552

400

152

600

497

400

97

600

888

400

488

600

496

400

96

600

496

400

96

600

531

400

131

600

611

400

211

600

506

400

106

600

496

400

96

600

496

400

96

(89)

(48)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

288

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(104)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

(104)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

(103)

Supp

(69)

Kapsul

11

Tube

(94)

Tablet

(104)

Vial

(104)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(104)

600

496

400

96

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,031

600

2,631

400

2,231

20

Asam Mefenamat kaplet 500 mg

Kaplet

526

600

1,126

400

726

21

Asiklovir krim 5 % - 5 gr

Tube

(65)

600

535

400

135

22

Asiklovir tablet 400 mg

Tablet

488

600

1,088

400

688

23

Atapulgit tablet 600 mg

Tablet

(64)

600

536

400

136

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(101)

600

499

400

99

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,405

600

2,005

400

1,605

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(104)

600

496

400

96

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(76)

600

524

400

124

28

Bisoprolol tablet 5 mg

Tablet

(92)

600

508

400

108

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(78)

600

522

400

122

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(41)

600

559

400

159

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

(103)

600

497

400

32

Deksametason tablet 0,5 mg

Tablet

1,239

600

1,839

400

1,439

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(104)

600

496

400

96

34

Difenhidramin injeksi 10 mg/ml

Ampul

(104)

600

496

400

96

35

Digoksin tablet 0,25 mg

Tablet

(34)

600

566

400

166

36

Domperidon tablet 10 mg

Tablet

192

600

792

400

392

37

Doksisiklin kapsul 100 mg

Kapsul

(104)

600

496

400

96

38

Efedrin tablet 25 mg (HCl)

Tablet

77

600

677

400

277

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(98)

600

502

400

102

40

Eritromisin kapsul 500 mg

Kapsul

(104)

600

496

400

96

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(86)

600

514

400

114

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(78)

600

522

400

122

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(88)

600

512

400

112

KET

97 EXP.10-15

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

45

Furosemid tablet 40 mg

Tablet

(53)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

535

47

Gemfibrozil 300 mg kapsul

48

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

600

601

400

201

600

547

400

147

600

1,135

400

735

Kapsul

121

600

721

400

321

Gentamycin salep kulit 0,1% - 5 gr

Tube

(89)

600

511

400

111

49

Glibenklamid tablet 5 mg

Tablet

630

600

1,230

400

830

50

Gliseril Guaiakolat tablet 100 mg

Tablet

2,988

600

3,588

400

3,188

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(104)

600

496

400

96

52

Griseofulvin tablet 125 mg / Gricin

Tablet

(24)

600

576

400

176

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

536

600

1,136

400

736

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(84)

600

516

400

116

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(104)

600

496

400

96

56

Ibuprofen tablet 400 mg

Tablet

271

600

871

400

471

57

Ichtyol salep kulit - 15 gr

Pot

(87)

600

513

400

113

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

46

59

Kalium permanganat (PK) serbuk - 5 gr

60

600

646

400

246

Pot

(104)

600

496

400

96

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,121

600

1,721

400

1,321

61

Kaptopril tablet 25 mg

Tablet

1,225

600

1,825

400

1,425

62

Ketokonazol tablet 200 mg

Tablet

(35)

600

565

400

165

63

Klindamisin kapsul 150 mg

Kapsul

(104)

600

496

400

96

64

Kloramfenikol kapsul 250 mg

Kapsul

(104)

600

496

400

96

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(104)

600

496

400

96

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(57)

600

543

400

143

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(76)

600

524

400

124

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(70)

600

530

400

130

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,324

600

5,924

400

5,524

KET

NAMA OBAT

70

71

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

SATUAN
KEMASAN

Tablet

Tablet

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

374
600

974

400

574

600

496

400

96

(104)

Botol

(77)
600

523

400

123

Pot

(97)

600

503

400

103

Lidokain injeksi 2% - 2 ml

Ampul

(104)

600

496

400

96

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

(104)

600

496

400

96

76

Linkomisin kapsul 500 mg

Kapsul

(104)

600

496

400

96

77

Loperamid tablet 2 mg

Tablet

(48)

600

552

400

152

78

Loratadin tablet 10 mg

Tablet

(51)

600

549

400

149

79

Mebendazol tablet 100 mg

Tablet

(104)

600

496

400

96

80

Metampiron (Antalgin) tablet 500 mg

Tablet

515

600

1,115

400

715

81

Metformin HCl tablet 500 mg

Tablet

147

600

747

400

347

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

116

600

716

400

316

83

Metronidazol tablet 500 mg

Tablet

28

600

628

400

228

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(96)

600

504

400

104

85

Multivit Sirup - 60 ml

Botol

(22)

600

578

400

178

86

Multivit Tablet

Tablet

(104)

600

496

400

96

87

Natrium Bikarbonat tablet 500 mg

Tablet

(104)

600

496

400

96

88

Natrium Diklofenak tablet 50 mg

Tablet

24

600

624

400

224

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(104)

600

496

400

96

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(103)

600

497

400

97 EXP.JAN-17

91

Nifedipin tablet 10 mg

Tablet

(86)

600

514

400

114

92

Nistatin tablet salut 500.000 IU/g

Tablet

14

600

614

400

214

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

600

608

400

208

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

STOK AWAL

PENERIMAAN

Botol

(50)

Tablet

(104)

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(74)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(104)

98

Omeprazol kapsul 20 mg

Kapsul

(104)

99

Papaverin tablet 40 mg

Tablet

229

100

Parasetamol drops

botol

(47)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

(38)

102

Parasetamol tablet 100 mg

Tablet

(104)

103

Parasetamol tablet 500 mg

Tablet

2,876

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

712

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

107

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

600

550

400

150

600

496

400

96

600

526

400

126

600

496

400

96

600

496

400

96

600

829

400

429 exp.10-15

600

553

400

153

600

562

400

162

600

496

400

96

600

3,476

400

3,076

600

1,312

400

912

(16)

600

584

400

184

Botol

(103)

600

497

400

97

Povidon Iodida larutan 10 % - 300 ml

Botol

(103)

600

497

400

97

108

Prednison tablet 5 mg

Tablet

593

600

1,193

400

793

109

Propanolol tablet 10 mg (HCl)

Tablet

(4)

600

596

400

196

110

Propiltiourasil tablet 100 mg

Tablet

(59)

600

541

400

141

111

Ranitidin tablet 150 mg

Tablet

(100)

600

500

400

100

112

Ringer Laktat larutan infus - 500 ml

Botol

(104)

600

496

400

96

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

36

600

636

400

236

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(104)

600

496

400

96

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

(89)

600

511

400

111

116

Salisil Bedak 2 % - 50 gr

Kotak

(25)

600

575

400

175

117

Sefadroksil Kapsul 500 mg

Kapsul

14

600

614

400

214

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

40

600

640

400

240

119

Simvastatin tablet 10 mg

Tablet

(104)

600

496

400

96

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

231

600

831

400

431

/ Librozym

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Botol

(104)

600

496

400

96

Tetrasiklin kapsul 250 mg

Kapsul

(104)

600

496

400

96

123

Tetrasiklin kapsul 500 mg

Kapsul

59

600

659

400

124

Thiamfenikol kapsul 500 mg

Kapsul

(104)

600

496

400

96

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,493

600

2,093

400

1,693

126

Vitamin B Kompleks tablet

Tablet

1,563

600

2,163

400

1,763

127

Zinc tablet 20 mg

Tablet

316

600

916

400

516

(104)

OBAT PROGRAM TB PARU

259 Exp.juli-15

600

496

400

96

128

Obat FDC Kategori 1

Paket

(104)

600

496

400

96

129

Obat FDC Kategori 2

Paket

(104)

600

496

400

96

130

Obat FDC Anak

Paket

(104)

600

496

400

96

131

Obat FDC Sisipan

Paket

(104)

600

496

400

96

(104)

600

496

400

96

Vial

(103)

600

497

400

97

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

(42)

600

558

400

158

134

Sefiksim kapsul 100 mg

Kapsul

(104)

600

496

400

96

(104)

600

496

400

96

(104)

600

496

400

96

(104)

600

496

400

96

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

(104)

600

496

400

96

137

Pirantel tablet score (base) 125 mg

Tablet

(31)

600

569

400

169

(104)

600

496

400

96

600

496

400

96

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

(104)

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

(104)

OBAT KEJIWAAN

KET

600

496

400

96

(104)

600

496

400

96

Alprazolam tablet 1 mg

Tablet

115

600

715

400

315

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(53)

600

547

400

147

Clobazam tablet 10 mg

Tablet

58

600

658

400

258

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Diazepam tablet 2 mg

Tablet

33

600

633

400

233

Diazepam tablet 5 mg

Tablet

(104)

600

496

400

96

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(104)

600

496

400

96

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(103)

600

497

400

97

Fenitoin Kapsul 100 mg

Kapsul

(104)

600

496

400

Fenobarbital tablet 30 mg

Tablet

(81)

600

519

400

10

Fluoxetin tablet 10 mg /

Tablet

(104)

600

496

400

96

11

Haloperidol tablet 1,5 mg

Tablet

106

600

706

400

306

12

Haloperidol tablet 5 mg

Tablet

322

600

922

400

522

13

Imipramin tablet 25 mg / Tofranil

Tablet

(104)

600

496

400

96

14

Karbamazepin tablet 200 mg

Tablet

(104)

600

496

400

96

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(89)

600

511

400

111

16

Kodein tablet 10 mg

Tablet

111

600

711

400

311

17

Risperidon tablet 2 mg

Tablet

(104)

600

496

400

96

18

Sertralin tablet / Nudep

Tablet

(104)

600

496

400

96

19

Triheksifenidil tablet 2 mg

Tablet

(104)

600

496

400

96

(104)

Antiprestin

OBAT GIGI

KET

96
119 exp.09-15

600

496

400

96

Artikulating Paper

Buku

(104)

600

496

400

96

Bur diamond high Speed

Kotak

(104)

600

496

400

96

Bur arkansas high Speed

buah

(104)

600

496

400

96

Cavit / Dentorit (Tambalan Sementara)

Pot

(103)

600

497

400

97

Celluloid strip

Set

(104)

600

496

400

96

Cresopen - 13 ml

Botol

(104)

600

496

400

96

Dentin Conditioner

Botol

(104)

600

496

400

96

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(104)

600

496

400

96

Disclosing Agent

Tube

(104)

600

496

400

96

Bungkus @ 100
pcs

10

Disposible saliva ejektor

(104)

600

496

400

96

11

Etil Chlorida spray - 100 ml

Botol

(103)

600

497

400

97

12

Eugenol cairan

Botol

(103)

600

497

400

97

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

13

Glass Ionomer Radiopak / Fuji VII

Set

(103)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(103)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(104)

16

Macro gold + propylen + EDTA

Set

17

Oil Spray

18

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

600

497

400

97

600

497

400

97

600

496

400

96

(104)

600

496

400

96

Botol

(104)

600

496

400

96

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

99
600

699

400

299

19

Pulperyl

Botol

(104)

600

496

400

96

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(104)

600

496

400

96

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(104)

600

496

400

96

22

Tetric N Ceram

Paket

(104)

600

496

400

96

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(104)

600

496

400

96

24

Tetric Bonding - 6 gr

Botol

(104)

600

496

400

96

25

Tetric Etch Refill - 2 gr

Tube

(104)

600

496

400

96

26

Trikresol Formalin (TKF)

Botol

(103)

600

497

400

97

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(104)

600

496

400

96

28

Xylestesin Non Adrenalin injeksi

Ampul

(104)

600

496

400

96

29

CHKM

Botol

(104)

600

496

400

96

30

Iodoform/Mumifying pasta

Botol

(104)

600

496

400

96

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(104)

600

496

400

96

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(104)

600

496

400

96

(104)

PERBEKALAN KESEHATAN

600

496

400

96

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(104)

600

496

400

96

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(104)

600

496

400

96

Alat Suntik sekali pakai 1 ml

Pcs

(44)

600

556

400

156

Alat Suntik sekali pakai 3 ml

Pcs

(12)

600

588

400

188

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET

Alat Suntik sekali pakai 5 ml

Pcs

(42)

600

558

400

158

Blood set

Set

(104)

600

496

400

96

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(104)

600

496

400

96

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(104)

600

496

400

96

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(104)

600

496

400

96

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(104)

600

496

400

96

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(104)

600

496

400

96

12

Dental Film Hanshin

Pcs

(104)

600

496

400

96

13

Etanol 70 % - 1 L

Botol

(102)

600

498

400

98

14

Gel USG / EKG

Botol

(104)

600

496

400

96

15

Infusion Set Anak

Pcs

(104)

600

496

400

96

16

Infusion Set Dewasa

Pcs

(102)

600

498

400

98 EXP.10-17

17

IV. Catheter No.18 G

Set

(102)

600

498

400

98 Exp.jul-15

18

IV. Catheter No.20 G

Set

(104)

600

496

400

96

19

IV. Catheter No.22 G

Set

(104)

600

496

400

96

20

IV. Catheter No.24 G

Kotak

(104)

600

496

400

96

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(104)

600

496

400

96

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(104)

600

496

400

96

23

Kapas Pembalut / absorben 250 gram

Bungkus

(104)

600

496

400

96

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(99)

600

501

400

101

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(104)

600

496

400

96

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(104)

600

496

400

96

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(104)

600

496

400

96

28

Kertas EKG

Roll

(104)

600

496

400

96

29

Kertas USG Sony 110 HG

Roll

(104)

600

496

400

96

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(103)

600

497

400

97

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

(104)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

(104)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Masker O2

37

Botol 1 ltr

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

(104)

Lembar

(104)

Kotak

(101)

600

499

400

99

Pcs

(104)

600

496

400

96

Masker 95

Pcs

(104)

600

496

400

96

38

Masker nebulizer set dewasa

Pcs

(103)

600

497

400

97

39

Masker nebulizer set anak

Pcs

(103)

600

497

400

97

40

Plester 5 yard X 2 inch

Roll

(104)

600

496

400

96

41

Plester non alergi 0,5 inch / Micropore

Roll

(101)

600

499

400

99

42

Pot Urin

Pcs

(104)

600

496

400

96

43

Sarung Tangan

Kotak

(102)

600

498

400

98

44

Safety Box

Pcs

(104)

600

496

400

96

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(104)

600

496

400

96

(104)

600

496

400

96

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

(104)

600

496

400

96

Eter Alkohol

Botol 100 ml

(104)

600

496

400

96

Kaca Slide / Object Glass

Kotak

(104)

600

496

400

96

Pot dahak

Pcs

(104)

600

496

400

96

Reagen Zielnelsen

Set

(104)

600

496

400

96

Spiritus Bakar

Botol

(104)

600

496

400

96

Tissu Lensa

Kotak

(104)

600

496

400

96

Tissue lensa

Buku

(104)

600

496

400

96

KET

NAMA OBAT
9

Wadah Kaca Slide / Box Slide

10
11

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

Pcs

(104)

600

496

400

96

Xylol/ Xylene

Botol 100 ml

(104)

600

496

400

96

Xylol/ Xylene

Botol 500 ml

(104)

600

496

400

96

(104)

600

496

400

96

600

496

400

96

600

536

400

136

600

516

400

116

600

500

400

100

(4)

600

596

400

196

(104)

600

496

400

96

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(104)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(64)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(84)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(100)

Sendok obat

Pcs

AKUPUNTUR
1

Jarum Akupuntur 13 mm

Kotak

(104)

600

496

400

96

Jarum Akupuntur 25 mm

Kotak

(104)

600

496

400

96

Jarum Akupuntur 40 mm

Kotak

(104)

600

496

400

96

Jarum telinga (press needle)

Kotak

(104)

600

496

400

96

Moxa Roll

Kotak

(104)

600

496

400

96

(104)

600

496

400

96

Pcs

(104)

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(104)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

(104)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(104)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(104)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(104)

600

496

400

96

MgSO4 40% injeksi

Vial

(104)

600

496

400

96

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(104)

600

496

400

96

Natrium Bicarbonat injeksi

Ampul

(104)

600

496

400

96

10

Nasal dewasa / Maxyflow

Pcs

(104)

600

496

400

96

KET

NAMA OBAT
11

Nasal infant/ Oxyflow

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

13

Penghisap Lendir Bayi Baru Lahir

14

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

Pcs

(104)

Ampul

(104)

Pcs

Sarung Tangan panjang obgyn No. 6,5

15

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

600

496

400

96

600

496

400

96

(104)

600

496

400

96

Pasang

(104)

600

496

400

96

Sarung Tangan panjang obgyn No. 7

Pasang

(104)

600

496

400

96

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(104)

600

496

400

96

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(104)

600

496

400

96

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(104)

600

496

400

96

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(104)

600

496

400

96

20

Sungkup bayi

Set

(104)

600

496

400

96

21

Tanda Pengenal (ID Band) Bayi

Psc

(104)

600

496

400

96

22

Tanda Pengenal (ID Band) Ibu

Psc

(104)

600

496

400

96

23

Under Pad 60 x 90 cm

Psc

(104)

600

496

400

96

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(104)

600

496

400

96

(104)

600

496

400

96

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

86

600

686

400

286

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(104)

600

496

400

96

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

(104)
600

496

400

96

Asiklovir tablet 200 mg

Tablet

(104)

600

496

400

96

Bisacodyl 5 mg / Bicolax

Tablet

(104)

600

496

400

96

Biskodil sup 10 mg

Supp

(104)

600

496

400

96

Buskopan injeksi

Ampul

(104)

600

496

400

96

Bur Fissure standart

Pcs

(104)

600

496

400

96

Bur Fissure panjang

Pcs

(104)

600

496

400

96

10

Cetirizin HCl 10 mg

Tablet

(104)

600

496

400

96

11

Cetirizin syrup 100 mg / 5 ml

botol

(104)

600

496

400

96

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

12

Cefixim / sefiksim 100 mg caplet

kaplet

(104)

600

496

400

96

13

Etanol 96 % - 1 L

Botol

(104)

600

496

400

96

14

Gentian Violet larutan 1 %

Botol

(104)

600

496

400

96

15

Glucose Larutan Infus 10% Steril

Botol

(104)

600

496

400

96

16

Jarum Suntik No. 27 G

Pcs

(104)

600

496

400

96

17

Ketokonazole Krim 2%

Tube

(104)

600

496

400

96

18

Klindamisin kapsul 150 mg

Kapsul

(99)

600

501

400

101

19

Klindamisin 300 MG

Kapsul

(104)

600

496

400

96

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(104)

600

496

400

96

21

Kasa 2x80

Roll

(104)

600

496

400

96

22

Kapas 500 gram

Bungkus

(104)

600

496

400

96

23

Larutan H2O2

Botol

(104)

600

496

400

96

24

Methilprednisolon 4 mg

tablet

(104)

600

496

400

96

25

Metoklopramid injeksi / Primperan

Vial

(104)

600

496

400

96

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(104)

600

496

400

96

27

Metronidazol tablet 250 mg

Tablet

(104)

600

496

400

96

28

Meylon injeksi

Botol

(104)

600

496

400

96

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(104)
600

496

400

96

600

496

400

96

600

496

400

96

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Tube

Botol

(104)

(104)

Vial

(104)

600

496

400

96

Polymigel tablet 400 mg/Strocain P

Tablet

(104)

600

496

400

96

34

Propanolol tablet 40 mg (HCl)

Tablet

(104)

600

496

400

96

35

Ranitidin injeksi 25 mg/ml

Ampul

(104)

600

496

400

96

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

36

Saccaharine tablet

Tablet

(104)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(104)

38

Sefadroxil syrup 125 mg

botol

(104)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(104)

40

Teofilin tablet / Bronsolvan

Tablet

(104)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(104)

OBAT KESDA

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

(104)

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

96

496

tube

400

600

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

496

96

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

600

400

(104)

STOK AKHIR

496

tablet

kaplet

PEMAKAIAN

600

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

PERSEDIAAN

(104)

PENERIMAAN

(104)

(104)

(104)

(104)

(104)

(104)

KET

NAMA OBAT

10

11

12

13

14

15

16

SATUAN
KEMASAN

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

tablet

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat
5 mg) - 5 gr / Bevalex

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

(104)

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

STOK AWAL

tube

tube

kaplet

Botol

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

496

400

96

600

817

400

417

(104)

(104)

(104)

(104)

(104)

(104)

217

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

Ria Susanti,AMF
NIP.198512119 200901 2 004

KET

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

OBAT
1

Alopurinol tablet 100 mg

Tablet

401

401

20

30

15

Amlodipin tablet 5 mg

Tablet

330

330

20

30

15

Aminofillin tablet 200 mg

Tablet

296

296

20

30

15

Amoksilin kaplet 500 mg

Kaplet

2,171

2,171

20

30

15

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

162

162

20

30

15

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,844
0

1,844

20

30

15

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

111

20

30

15

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

152

20

30

15

97

20

30

15

488

20

30

15

96

20

30

15

96

20

30

15

131

20

30

15

211

20

30

15

106

20

30

15

96

20

30

15

96

20

30

15

111

152

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

488

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

96

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

96

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

97

Supp

131

Kapsul

211

Tube

106

Tablet

96

Vial

96

SATUAN
KEMASAN

NAMA OBAT

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

96

20

30

15

2,231

20

30

15

726

135

20

30

15

20

30

15

688

688

20

30

15

Tablet

136

136

20

30

15

Loperamid tablet 2 mg

Tablet

152

152

20

30

15

78

Loratadin tablet 10 mg

Tablet

149

149

20

30

15

79

Mebendazol tablet 100 mg

Tablet

96

96

20

30

15

80

Metampiron (Antalgin) tablet 500 mg

Tablet

715

715

20

30

15

81

Metformin HCl tablet 500 mg

Tablet

347

347

20

30

15

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

316

316

20

30

15

83

Metronidazol tablet 500 mg

Tablet

228

228

20

30

15

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

104

104

20

30

15

85

Multivit Sirup - 60 ml

Botol

178

178

20

30

15

86

Multivit Tablet

Tablet

96

96

20

30

15

87

Natrium Bikarbonat tablet 500 mg

Tablet

96

96

20

30

15

88

Natrium Diklofenak tablet 50 mg

Tablet

224

224

20

30

15

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

96

96

20

30

15

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

97

97

20

30

15

91

Nifedipin tablet 10 mg

Tablet

114

114

20

30

15

92

Nistatin tablet salut 500.000 IU/g

Tablet

214

214

20

30

15

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

208

208

20

30

15

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

150

150

20

30

15

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

Tablet

96

96

20

30

15

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

126

126

20

30

15

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

96

96

20

30

15

18

Asam Asetilsalisilat tablet 80 mg

Tablet

96

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,231

20

Asam Mefenamat kaplet 500 mg

Kaplet

726

21

Asiklovir krim 5 % - 5 gr

Tube

135

22

Asiklovir tablet 400 mg

Tablet

23

Atapulgit tablet 600 mg

77

/ Librozym

11

12

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

96

20

30

15

429

20

30

15

153

162

20

30

15

20

30

15

96

96

20

30

15

Tablet

3,076

3,076

20

30

15

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

912

912

20

30

15

105

Piroksikam tablet 10 mg

Tablet

184

184

20

30

15

106

Polikresulen (kondensasi) - 10 ml

Botol

97

97

20

30

15

107

Povidon Iodida larutan 10 % - 300 ml

108

Prednison tablet 5 mg

Botol

97

97

20

30

15

Tablet

793

109

Propanolol tablet 10 mg (HCl)

793

20

30

15

Tablet

196

110

196

20

30

15

Propiltiourasil tablet 100 mg

Tablet

141

141

20

30

15

111

Ranitidin tablet 150 mg

Tablet

100

100

20

30

15

112

Ringer Laktat larutan infus - 500 ml

Botol

96

96

20

30

15

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

236

236

20

30

15

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

96

96

20

30

15

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

111

111

20

30

15

116

Salisil Bedak 2 % - 50 gr

Kotak

175

175

20

30

15

117

Sefadroksil Kapsul 500 mg

Kapsul

214

214

20

30

15

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

240

240

20

30

15

119

Simvastatin tablet 10 mg

Tablet

96

96

20

30

15

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

431

431

20

30

15

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

96

96

20

30

15

122

Tetrasiklin kapsul 250 mg

Kapsul

96

96

20

30

15

123

Tetrasiklin kapsul 500 mg

Kapsul

259

259

20

30

15

124

Thiamfenikol kapsul 500 mg

Kapsul

96

96

20

30

15

98

Omeprazol kapsul 20 mg

Kapsul

96

99

Papaverin tablet 40 mg

Tablet

429

100

Parasetamol drops

botol

153

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

162

102

Parasetamol tablet 100 mg

Tablet

103

Parasetamol tablet 500 mg

104

11

12

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,693

126

Vitamin B Kompleks tablet

Tablet

127

Zinc tablet 20 mg

Tablet

OBAT PROGRAM TB PARU

PERSEDIAAN
1

10

11

12

1,693

20

30

15

1,763

1,763

20

30

15

516

516

20

30

15

96

96

20

30

15

128

Obat FDC Kategori 1

Paket

96

96

20

30

15

129

Obat FDC Kategori 2

Paket

96

96

20

30

15

130

Obat FDC Anak

Paket

96

96

20

30

15

131

Obat FDC Sisipan

Paket

96

96

20

30

15

96

96

20

30

15

Vial

97

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

97

20

30

15

133

Levofloksasin tablet 500 mg

Tablet

158

158

20

30

15

134

Sefiksim kapsul 100 mg

Kapsul

96

96

20

30

15

96

96

20

30

15

96

96

20

30

15

96

96

20

30

15

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

96

96

20

30

15

137

Pirantel tablet score (base) 125 mg

Tablet

169

169

20

30

15

96

96

20

30

15

96

20

30

15

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

96

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

96

OBAT KEJIWAAN

96

20

30

15

96

96

20

30

15

Alprazolam tablet 1 mg

Tablet

315

315

20

30

15

Amitriptilin tablet salut 25 mg (HCl)

Tablet

147

147

20

30

15

Clobazam tablet 10 mg

Tablet

258

258

20

30

15

Diazepam tablet 2 mg

Tablet

233

233

20

30

15

Diazepam tablet 5 mg

Tablet

96

96

20

30

15

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

96

96

20

30

15

Diazepam tube Rectal 5 mg/2.5 ml

Tube

97

97

20

30

15

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

96

20

30

15

119

20

30

15

96

306

20

30

15

20

30

15

522

522

20

30

15

Tablet

96

96

20

30

15

Karbamazepin tablet 200 mg

Tablet

96

96

20

30

15

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

111

111

20

30

15

16

Kodein tablet 10 mg

Tablet

311

311

20

30

15

17

Risperidon tablet 2 mg

Tablet

96

96

20

30

15

18

Sertralin tablet / Nudep

Tablet

96

96

20

30

15

19

Triheksifenidil tablet 2 mg

Tablet

96

96

20

30

15

96

Fenitoin Kapsul 100 mg

Kapsul

96

Fenobarbital tablet 30 mg

Tablet

119

10

Fluoxetin tablet 10 mg /

Tablet

96

11

Haloperidol tablet 1,5 mg

Tablet

306

12

Haloperidol tablet 5 mg

Tablet

13

Imipramin tablet 25 mg / Tofranil

14

Antiprestin

OBAT GIGI

11

12

96

20

30

15

Artikulating Paper

Buku

96

96

20

30

15

Bur diamond high Speed

Kotak

96

96

20

30

15

Bur arkansas high Speed

buah

96

96

20

30

15

Cavit / Dentorit (Tambalan Sementara)

Pot

97

97

20

30

15

Celluloid strip

Set

96

96

20

30

15

Cresopen - 13 ml

Botol

96

96

20

30

15

Dentin Conditioner

Botol

96

96

20

30

15

Devitalisasi Pasta (Non Arsen)

Btl / ktk

96

96

20

30

15

Disclosing Agent

Tube

96

96

20

30

15

Bungkus @ 100
pcs

96

96

20

30

15

10

Disposible saliva ejektor

11

Etil Chlorida spray - 100 ml

Botol

97

97

20

30

15

12

Eugenol cairan

Botol

97

97

20

30

15

13

Glass Ionomer Radiopak / Fuji VII

Set

97

97

20

30

15

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

97

97

20

30

15

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

96

96

20

30

15

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
5

10

20

30

15

20

30

15

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

96

20

30

15

Botol

97

97

20

30

15

Xylestesin Adrenalin injeksi / Scandonest

Ampul

96

96

20

30

15

28

Xylestesin Non Adrenalin injeksi

Ampul

96

96

20

30

15

29

CHKM

Botol

96

96

20

30

15

30

Iodoform/Mumifying pasta

Botol

96

96

20

30

15

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

96

96

20

30

15

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

96

96

20

30

15

96

96

20

30

15

16

Macro gold + propylen + EDTA

17

96

96

299

Set

96

Oil Spray

Botol

96

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

299

19

Pulperyl

Botol

96

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

96

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

96

22

Tetric N Ceram

Paket

96

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

96

24

Tetric Bonding - 6 gr

Botol

96

25

Tetric Etch Refill - 2 gr

Tube

26

Trikresol Formalin (TKF)

27

PERBEKALAN KESEHATAN

11

12

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

96

96

20

30

15

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

96

96

20

30

15

Alat Suntik sekali pakai 1 ml

Pcs

156

156

20

30

15

Alat Suntik sekali pakai 3 ml

Pcs

188

188

20

30

15

Alat Suntik sekali pakai 5 ml

Pcs

158

158

20

30

15

Blood set

Set

96

96

20

30

15

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

96

96

20

30

15

NAMA OBAT

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

Sach

96

96

20

30

15

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

96

96

20

30

15

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

96

96

20

30

15

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

96

96

20

30

15

12

Dental Film Hanshin

Pcs

96

96

20

30

15

13

Etanol 70 % - 1 L

Botol

98

98

20

30

15

14

Gel USG / EKG

Botol

96

96

20

30

15

15

Infusion Set Anak

Pcs

96

96

20

30

15

16

Infusion Set Dewasa

Pcs

98

98

20

30

15

17

IV. Catheter No.18 G

Set

98

98

20

30

15

18

IV. Catheter No.20 G

Set

96

96

20

30

15

19

IV. Catheter No.22 G

Set

96

96

20

30

15

20

IV. Catheter No.24 G

Kotak

96

96

20

30

15

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

96

96

20

30

15

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

96

96

20

30

15

23

Kapas Pembalut / absorben 250 gram

24

Kassa Hidrofil Steril uk. 16 x 16

25

Bungkus

96

96

20

30

15

Kotak

101

101

20

30

15

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

96

96

20

30

15

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

96

96

20

30

15

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

96

96

20

30

15

28

Kertas EKG

Roll

96

96

20

30

15

29

Kertas USG Sony 110 HG

Roll

96

96

20

30

15

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

97

97

20

30

15

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

96

96

20

30

15

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

96
0

96

20

30

15

NAMA OBAT

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

SATUAN
KEMASAN

Botol 1 ltr

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

96
0

96

20

30

15

96

20

30

15

Lembar

96

Kotak

99

99

20

30

15

Masker O2

Pcs

96

96

20

30

15

37

Masker 95

Pcs

96

96

20

30

15

38

Masker nebulizer set dewasa

Pcs

97

97

20

30

15

39

Masker nebulizer set anak

Pcs

97

97

20

30

15

40

Plester 5 yard X 2 inch

Roll

96

96

20

30

15

41

Plester non alergi 0,5 inch / Micropore

Roll

99

99

20

30

15

42

Pot Urin

Pcs

96

96

20

30

15

43

Sarung Tangan

Kotak

98

98

20

30

15

44

Safety Box

Pcs

96

96

20

30

15

45

Surgical blade no.11 (Pisau Bedah)

Pcs

96

96

20

30

15

96

PEMERIKSAAN TB PARU

96

20

30

15

Emersi

Botol 100 ml

96

96

20

30

15

Eter Alkohol

Botol 100 ml

96

96

20

30

15

Kaca Slide / Object Glass

Kotak

96

96

20

30

15

Pot dahak

Pcs

96

96

20

30

15

Reagen Zielnelsen

Set

96

96

20

30

15

Spiritus Bakar

Botol

96

96

20

30

15

Tissu Lensa

Kotak

96

96

20

30

15

Tissue lensa

Buku

96

96

20

30

15

Wadah Kaca Slide / Box Slide

Pcs

96

96

20

30

15

10

Xylol/ Xylene

Botol 100 ml

96

96

20

30

15

11

Xylol/ Xylene

Botol 500 ml

96

96

20

30

15

96

96

20

30

15

EMBALAGE

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

96

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

136

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

116

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

100

Sendok obat

Pcs

196
96

AKUPUNTUR

PERSEDIAAN
1

10

11

12

96

20

30

15

136

20

30

15

116

20

30

15

100

20

30

15

196

20

30

15

96

20

30

15

Jarum Akupuntur 13 mm

Kotak

96

96

20

30

15

Jarum Akupuntur 25 mm

Kotak

96

96

20

30

15

Jarum Akupuntur 40 mm

Kotak

96

96

20

30

15

Jarum telinga (press needle)

Kotak

96

96

20

30

15

Moxa Roll

Kotak

96

96

20

30

15

96

96

20

30

15

Pcs

96

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

96

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

96

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

96

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

96

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

96

96

20

30

15

MgSO4 40% injeksi

Vial

96

96

20

30

15

Misoprostol tablet 0,2 mg / Noprostol

Tablet

96

96

20

30

15

Natrium Bicarbonat injeksi

Ampul

96

96

20

30

15

10

Nasal dewasa / Maxyflow

Pcs

96

96

20

30

15

11

Nasal infant/ Oxyflow

Pcs

96

96

20

30

15

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

96

96

20

30

15

13

Penghisap Lendir Bayi Baru Lahir

Pcs

96

96

20

30

15

14

Sarung Tangan panjang obgyn No. 6,5

Pasang

96

96

20

30

15

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

15

Sarung Tangan panjang obgyn No. 7

Pasang

96

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

96

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

96

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

96

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

96

20

Sungkup bayi

Set

96

21

Tanda Pengenal (ID Band) Bayi

Psc

96

22

Tanda Pengenal (ID Band) Ibu

Psc

96

23

Under Pad 60 x 90 cm

Psc

96

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

96

TAMBAHAN

11

12

96

20

30

15

96

96

20

30

15

Ambroksol tablet 30mg

Tablet

286

286

20

30

15

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

96

96

20

30

15

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

96
0

96

20

30

15

Asiklovir tablet 200 mg

Tablet

96

96

20

30

15

Bisacodyl 5 mg / Bicolax

Tablet

96

96

20

30

15

Biskodil sup 10 mg

Supp

96

96

20

30

15

Buskopan injeksi

Ampul

96

96

20

30

15

Bur Fissure standart

Pcs

96

96

20

30

15

Bur Fissure panjang

Pcs

96

96

20

30

15

10

Cetirizin HCl 10 mg

Tablet

96

96

20

30

15

11

Cetirizin syrup 100 mg / 5 ml

botol

96

96

20

30

15

12

Cefixim / sefiksim 100 mg caplet

kaplet

96

96

20

30

15

13

Etanol 96 % - 1 L

Botol

96

96

20

30

15

14

Gentian Violet larutan 1 %

Botol

96

96

20

30

15

15

Glucose Larutan Infus 10% Steril

Botol

96

96

20

30

15

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

96

20

30

15

96

20

30

15

101

96

20

30

15

20

30

15

96

96

20

30

15

Roll

96

96

20

30

15

Bungkus

96

96

20

30

15

Larutan H2O2

Botol

96

96

20

30

15

24

Methilprednisolon 4 mg

tablet

96

96

20

30

15

25

Metoklopramid injeksi / Primperan

26

Metoklopramid tablet 10 mg / Metolon

Vial

96

96

20

30

15

Tablet

96

27

Metronidazol tablet 250 mg

96

20

30

15

Tablet

96

28

96

20

30

15

Meylon injeksi

Botol

96

96

20

30

15

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

96
0

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

16

Jarum Suntik No. 27 G

Pcs

96

17

Ketokonazole Krim 2%

Tube

96

18

Klindamisin kapsul 150 mg

Kapsul

101

19

Klindamisin 300 MG

Kapsul

96

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

21

Kasa 2x80

22

Kapas 500 gram

23

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Polymigel tablet 400 mg/Strocain P

34
35

Tube

Botol

11

12

96

96

Vial

96

Tablet

96

96

20

30

15

Propanolol tablet 40 mg (HCl)

Tablet

96

96

20

30

15

Ranitidin injeksi 25 mg/ml

Ampul

96

96

20

30

15

36

Saccaharine tablet

Tablet

96

96

20

30

15

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

96

96

20

30

15

38

Sefadroxil syrup 125 mg

botol

96

96

20

30

15

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

96

96

20

30

15

NAMA OBAT

SATUAN
KEMASAN

PE
STOK AWAL

PENERIMAAN

40

Teofilin tablet / Bronsolvan

Tablet

96

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

96

OBAT KESDA

10

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

10

11

12

96

20

30

15

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

tube

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

96

96

tablet

kaplet

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

96

PERSEDIAAN

96

96

96

96

96

96

96

tablet

96

NAMA OBAT

11

12

13

14

15

16

SATUAN
KEMASAN

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat
5 mg) - 5 gr / Bevalex

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

tube

tube

kaplet

PE
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

96
0

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

20

30

15

96

96

96

96

Botol

417
0

417

20

30

15

17 alkohol 10ml

Botol

18 famokresol

Botol

Mengetahui,
Kepala Puskesmas Panunggangan

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


PEMAKAIAN HARIAN

STOK AWAL
13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

OBAT
1

Alopurinol tablet 100 mg

Tablet

401

20

20

20

15

10

10

Amlodipin tablet 5 mg

Tablet

330

20

20

20

15

10

10

Aminofillin tablet 200 mg

Tablet

296

20

20

20

15

10

10

Amoksilin kaplet 500 mg

Kaplet

2,171

20

20

20

15

10

10

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

162

20

20

20

15

10

10

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,844
0

20

20

20

15

10

10

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

20

20

20

15

10

10

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

111

152

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

488

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

96

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

96

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

97

Supp

131

Kapsul

211

Tube

106

Tablet

96

Vial

96

SATUAN
KEMASAN

NAMA OBAT

PEMAKAIAN HARIAN
STOK AWAL
13

15

16

17

19

20

21

22

23

24

20

20

20

0
0

20

20

688

20

Tablet

136

20

Loperamid tablet 2 mg

Tablet

152

20

78

Loratadin tablet 10 mg

Tablet

149

20

79

Mebendazol tablet 100 mg

Tablet

96

20

80

Metampiron (Antalgin) tablet 500 mg

Tablet

715

81

Metformin HCl tablet 500 mg

Tablet

347

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

316

83

Metronidazol tablet 500 mg

Tablet

228

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

104

85

Multivit Sirup - 60 ml

Botol

178

86

Multivit Tablet

Tablet

96

87

Natrium Bikarbonat tablet 500 mg

Tablet

96

88

Natrium Diklofenak tablet 50 mg

Tablet

224

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

96

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

97

91

Nifedipin tablet 10 mg

Tablet

114

92

Nistatin tablet salut 500.000 IU/g

Tablet

214

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

208

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

150

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

Tablet

96

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

126

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

96

18

Asam Asetilsalisilat tablet 80 mg

Tablet

96

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,231

20

Asam Mefenamat kaplet 500 mg

Kaplet

726

21

Asiklovir krim 5 % - 5 gr

Tube

135

22

Asiklovir tablet 400 mg

Tablet

23

Atapulgit tablet 600 mg

77

/ Librozym

14

18

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

15

16

17

19

20

21

22

23

24

26

27

28

29

30

31

20

20

20

15

10

10

20

20

20

15

10

10

0
0

20

20

20

20

15

10

10

20

20

15

10

10

96

20

20

20

15

10

10

Tablet

3,076

20

20

20

15

10

10

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

912

20

20

20

15

10

10

105

Piroksikam tablet 10 mg

Tablet

184

20

20

20

15

10

10

106

Polikresulen (kondensasi) - 10 ml

Botol

97

20

20

20

15

10

10

107

Povidon Iodida larutan 10 % - 300 ml

108

Prednison tablet 5 mg

Botol

97

Tablet

793

20

20

20

15

10

10

109

Propanolol tablet 10 mg (HCl)

Tablet

196

20

20

20

15

10

10

110

Propiltiourasil tablet 100 mg

Tablet

141

20

20

20

15

10

10

111

Ranitidin tablet 150 mg

Tablet

100

20

20

20

15

10

10

112

Ringer Laktat larutan infus - 500 ml

Botol

96

20

20

20

15

10

10

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

236

20

20

20

15

10

10

20

20

20

15

10

10

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

96

20

20

20

15

10

10

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

111

116

Salisil Bedak 2 % - 50 gr

Kotak

175

20

20

20

15

10

10

117

Sefadroksil Kapsul 500 mg

Kapsul

214

20

20

20

15

10

10

20

20

20

15

10

10

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

240

119

Simvastatin tablet 10 mg

Tablet

96

20

20

20

15

10

10

20

20

20

15

10

10

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

431

20

20

20

15

10

10

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

96

20

20

20

15

10

10

122

Tetrasiklin kapsul 250 mg

Kapsul

96

20

20

20

15

10

10

123

Tetrasiklin kapsul 500 mg

Kapsul

259

20

20

20

15

10

10

124

Thiamfenikol kapsul 500 mg

Kapsul

96

20

20

20

15

10

10

98

Omeprazol kapsul 20 mg

Kapsul

96

99

Papaverin tablet 40 mg

Tablet

429

100

Parasetamol drops

botol

153

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

162

102

Parasetamol tablet 100 mg

Tablet

103

Parasetamol tablet 500 mg

104

14

18

25

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

14

15

16

17

20

18

19

20

21

22

23

24

20

25

26

27

28

29

30

31

20

15

10

10

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,693

126

Vitamin B Kompleks tablet

Tablet

1,763

20

20

20

15

10

10

127

Zinc tablet 20 mg

Tablet

516

20

20

20

15

10

10

96

OBAT PROGRAM TB PARU

20

20

20

15

10

10

128

Obat FDC Kategori 1

Paket

96

20

20

20

15

10

10

129

Obat FDC Kategori 2

Paket

96

20

20

20

15

10

10

130

Obat FDC Anak

Paket

96

20

20

20

15

10

10

131

Obat FDC Sisipan

Paket

96

20

20

20

15

10

10

96

20

20

20

15

10

10

Vial

97

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

20

20

20

15

10

10

133

Levofloksasin tablet 500 mg

Tablet

158

20

20

20

15

10

10

134

Sefiksim kapsul 100 mg

Kapsul

96

20

20

20

15

10

10

96

20

20

20

15

10

10

96

20

20

20

15

10

10

96

20

20

20

15

10

10

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

96

20

20

20

15

10

10

137

Pirantel tablet score (base) 125 mg

Tablet

169

20

20

20

15

10

10

96

20

20

20

15

10

10

20

20

20

15

10

10

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

96

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

96

OBAT KEJIWAAN

20

20

20

15

10

10

96

20

20

20

15

10

10

Alprazolam tablet 1 mg

Tablet

315

20

20

20

15

10

10

Amitriptilin tablet salut 25 mg (HCl)

Tablet

147

20

20

20

15

10

10

Clobazam tablet 10 mg

Tablet

258

20

20

20

15

10

10

Diazepam tablet 2 mg

Tablet

233

20

20

20

15

10

10

Diazepam tablet 5 mg

Tablet

96

20

20

20

15

10

10

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

96

20

20

20

15

10

10

Diazepam tube Rectal 5 mg/2.5 ml

Tube

97

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

15

16

17

19

20

21

22

23

24

20

20

20

0
0

20

20

522

20

Tablet

96

20

Karbamazepin tablet 200 mg

Tablet

96

20

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

111

20

16

Kodein tablet 10 mg

Tablet

311

20

17

Risperidon tablet 2 mg

Tablet

96

18

Sertralin tablet / Nudep

Tablet

96

19

Triheksifenidil tablet 2 mg

Tablet

96
96

Fenitoin Kapsul 100 mg

Kapsul

96

Fenobarbital tablet 30 mg

Tablet

119

10

Fluoxetin tablet 10 mg /

Tablet

96

11

Haloperidol tablet 1,5 mg

Tablet

306

12

Haloperidol tablet 5 mg

Tablet

13

Imipramin tablet 25 mg / Tofranil

14

Antiprestin

OBAT GIGI

14

18

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

Artikulating Paper

Buku

96

20

20

20

15

10

10

Bur diamond high Speed

Kotak

96

20

20

20

15

10

10

Bur arkansas high Speed

buah

96

20

20

20

15

10

10

Cavit / Dentorit (Tambalan Sementara)

Pot

97

20

20

20

15

10

10

Celluloid strip

Set

96

20

20

20

15

10

10

Cresopen - 13 ml

Botol

96

20

20

20

15

10

10

Dentin Conditioner

Botol

96

20

20

20

15

10

10

Devitalisasi Pasta (Non Arsen)

Btl / ktk

96

20

20

20

15

10

10

Disclosing Agent

Tube

96

20

20

20

15

10

10

Bungkus @ 100
pcs

96

20

20

20

15

10

10

10

Disposible saliva ejektor

11

Etil Chlorida spray - 100 ml

Botol

97

20

20

20

15

10

10

12

Eugenol cairan

Botol

97

20

20

20

15

10

10

13

Glass Ionomer Radiopak / Fuji VII

Set

97

20

20

20

15

10

10

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

97

20

20

20

15

10

10

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

96

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

19

20

21

22

23

24

26

27

28

29

30

31

20

20

15

10

10

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

20

15

10

10

20

20

15

10

10

96

20

20

20

15

10

10

Botol

97

20

20

20

15

10

10

Xylestesin Adrenalin injeksi / Scandonest

Ampul

96

20

20

20

15

10

10

28

Xylestesin Non Adrenalin injeksi

Ampul

96

20

20

20

15

10

10

29

CHKM

Botol

96

20

20

20

15

10

10

30

Iodoform/Mumifying pasta

Botol

96

20

20

20

15

10

10

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

96

20

20

20

15

10

10

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

96

20

20

20

15

10

10

96

20

20

20

15

10

10

16

Macro gold + propylen + EDTA

Set

96

17

Oil Spray

Botol

96

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

299

19

Pulperyl

Botol

96

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

96

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

96

22

Tetric N Ceram

Paket

96

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

96

24

Tetric Bonding - 6 gr

Botol

96

25

Tetric Etch Refill - 2 gr

Tube

26

Trikresol Formalin (TKF)

27

PERBEKALAN KESEHATAN

14

15

16

17

20

20

18

25

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

96

20

20

20

15

10

10

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

96

20

20

20

15

10

10

Alat Suntik sekali pakai 1 ml

Pcs

156

20

20

20

15

10

10

Alat Suntik sekali pakai 3 ml

Pcs

188

20

20

20

15

10

10

Alat Suntik sekali pakai 5 ml

Pcs

158

20

20

20

15

10

10

Blood set

Set

96

20

20

20

15

10

10

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

96

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Sach

96

20

20

20

15

10

10

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

96

20

20

20

15

10

10

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

96

20

20

20

15

10

10

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

96

20

20

20

15

10

10

12

Dental Film Hanshin

Pcs

96

20

20

20

15

10

10

13

Etanol 70 % - 1 L

Botol

98

20

20

20

15

10

10

14

Gel USG / EKG

Botol

96

20

20

20

15

10

10

15

Infusion Set Anak

Pcs

96

20

20

20

15

10

10

16

Infusion Set Dewasa

Pcs

98

20

20

20

15

10

10

17

IV. Catheter No.18 G

Set

98

20

20

20

15

10

10

18

IV. Catheter No.20 G

Set

96

20

20

20

15

10

10

19

IV. Catheter No.22 G

Set

96

20

20

20

15

10

10

20

IV. Catheter No.24 G

Kotak

96

20

20

20

15

10

10

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

96

20

20

20

15

10

10

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

96

20

20

20

15

10

10

23

Kapas Pembalut / absorben 250 gram

24

Kassa Hidrofil Steril uk. 16 x 16

25

Bungkus

96

20

20

20

15

10

10

Kotak

101

20

20

20

15

10

10

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

96

20

20

20

15

10

10

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

96

20

20

20

15

10

10

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

96

20

20

20

15

10

10

28

Kertas EKG

Roll

96

20

20

20

15

10

10

29

Kertas USG Sony 110 HG

Roll

96

20

20

20

15

10

10

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

97

20

20

20

15

10

10

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

96

20

20

20

15

10

10

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

96
0

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Botol 1 ltr

14

15

16

17

20

20

18

19

20

21

22

23

24

20

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

96

Lembar

96

Kotak

99

20

20

20

15

10

10

Masker O2

Pcs

96

20

20

20

15

10

10

37

Masker 95

Pcs

96

20

20

20

15

10

10

38

Masker nebulizer set dewasa

Pcs

97

20

20

20

15

10

10

39

Masker nebulizer set anak

Pcs

97

20

20

20

15

10

10

40

Plester 5 yard X 2 inch

Roll

96

20

20

20

15

10

10

41

Plester non alergi 0,5 inch / Micropore

Roll

99

20

20

20

15

10

10

42

Pot Urin

Pcs

96

20

20

20

15

10

10

43

Sarung Tangan

Kotak

98

20

20

20

15

10

10

44

Safety Box

Pcs

96

20

20

20

15

10

10

45

Surgical blade no.11 (Pisau Bedah)

Pcs

96

20

20

20

15

10

10

96

PEMERIKSAAN TB PARU

20

20

20

15

10

10

Emersi

Botol 100 ml

96

20

20

20

15

10

10

Eter Alkohol

Botol 100 ml

96

20

20

20

15

10

10

Kaca Slide / Object Glass

Kotak

96

20

20

20

15

10

10

Pot dahak

Pcs

96

20

20

20

15

10

10

Reagen Zielnelsen

Set

96

20

20

20

15

10

10

Spiritus Bakar

Botol

96

20

20

20

15

10

10

Tissu Lensa

Kotak

96

20

20

20

15

10

10

Tissue lensa

Buku

96

20

20

20

15

10

10

Wadah Kaca Slide / Box Slide

Pcs

96

20

20

20

15

10

10

10

Xylol/ Xylene

Botol 100 ml

96

20

20

20

15

10

10

11

Xylol/ Xylene

Botol 500 ml

96

20

20

20

15

10

10

96

20

20

20

15

10

10

EMBALAGE

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

14

15

16

17

20

20

18

19

20

21

22

23

24

20

20

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

20

20

15

10

10

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

96

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

136

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

116

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

100

20

20

20

15

10

10

Sendok obat

Pcs

196

20

20

20

15

10

10

96

AKUPUNTUR

20

20

20

15

10

10

Jarum Akupuntur 13 mm

Kotak

96

20

20

20

15

10

10

Jarum Akupuntur 25 mm

Kotak

96

20

20

20

15

10

10

Jarum Akupuntur 40 mm

Kotak

96

20

20

20

15

10

10

Jarum telinga (press needle)

Kotak

96

20

20

20

15

10

10

Moxa Roll

Kotak

96

20

20

20

15

10

10

96

20

20

20

15

10

10

Pcs

96

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

96

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

96

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

96

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

96

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

96

20

20

20

15

10

10

MgSO4 40% injeksi

Vial

96

20

20

20

15

10

10

Misoprostol tablet 0,2 mg / Noprostol

Tablet

96

20

20

20

15

10

10

Natrium Bicarbonat injeksi

Ampul

96

20

20

20

15

10

10

10

Nasal dewasa / Maxyflow

Pcs

96

20

20

20

15

10

10

11

Nasal infant/ Oxyflow

Pcs

96

20

20

20

15

10

10

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

96

20

20

20

15

10

10

13

Penghisap Lendir Bayi Baru Lahir

Pcs

96

20

20

20

15

10

10

14

Sarung Tangan panjang obgyn No. 6,5

Pasang

96

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

15

Sarung Tangan panjang obgyn No. 7

Pasang

96

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

96

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

96

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

96

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

96

20

Sungkup bayi

Set

96

21

Tanda Pengenal (ID Band) Bayi

Psc

96

22

Tanda Pengenal (ID Band) Ibu

Psc

96

23

Under Pad 60 x 90 cm

Psc

96

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

96

TAMBAHAN

14

15

16

17

20

20

18

19

20

21

22

23

24

20

20

20

20

20

20

20

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

96

20

20

20

15

10

10

Ambroksol tablet 30mg

Tablet

286

20

20

20

15

10

10

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

96

20

20

20

15

10

10

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

96
0

20

20

20

15

10

10

Asiklovir tablet 200 mg

Tablet

96

20

20

20

15

10

10

Bisacodyl 5 mg / Bicolax

Tablet

96

20

20

20

15

10

10

Biskodil sup 10 mg

Supp

96

20

20

20

15

10

10

Buskopan injeksi

Ampul

96

20

20

20

15

10

10

Bur Fissure standart

Pcs

96

20

20

20

15

10

10

Bur Fissure panjang

Pcs

96

20

20

20

15

10

10

10

Cetirizin HCl 10 mg

Tablet

96

20

20

20

15

10

10

11

Cetirizin syrup 100 mg / 5 ml

botol

96

20

20

20

15

10

10

12

Cefixim / sefiksim 100 mg caplet

kaplet

96

20

20

20

15

10

10

13

Etanol 96 % - 1 L

Botol

96

20

20

20

15

10

10

14

Gentian Violet larutan 1 %

Botol

96

20

20

20

15

10

10

15

Glucose Larutan Infus 10% Steril

Botol

96

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

15

16

17

19

20

21

22

23

24

20

20

20

0
0

20

20

96

20

Roll

96

20

Bungkus

96

20

Larutan H2O2

Botol

96

20

24

Methilprednisolon 4 mg

tablet

96

20

25

Metoklopramid injeksi / Primperan

Vial

96

26

Metoklopramid tablet 10 mg / Metolon

Tablet

96

27

Metronidazol tablet 250 mg

Tablet

96

28

Meylon injeksi

Botol

96

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

96

16

Jarum Suntik No. 27 G

Pcs

96

17

Ketokonazole Krim 2%

Tube

96

18

Klindamisin kapsul 150 mg

Kapsul

101

19

Klindamisin 300 MG

Kapsul

96

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

21

Kasa 2x80

22

Kapas 500 gram

23

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Polymigel tablet 400 mg/Strocain P

34
35

Tube

Botol

14

18

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

96

96

Vial

96

Tablet

96

20

20

20

15

10

10

Propanolol tablet 40 mg (HCl)

Tablet

96

20

20

20

15

10

10

Ranitidin injeksi 25 mg/ml

Ampul

96

20

20

20

15

10

10

36

Saccaharine tablet

Tablet

96

20

20

20

15

10

10

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

96

20

20

20

15

10

10

38

Sefadroxil syrup 125 mg

botol

96

20

20

20

15

10

10

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

96

20

20

20

15

10

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

40

Teofilin tablet / Bronsolvan

Tablet

96

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

96

OBAT KESDA

10

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

22

23

24

20

20

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

20

20

20

15

10

10

96

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

21

tube

20

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

19

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

18

96

17

20

tablet

kaplet

16

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

15

96

14

96

96

96

96

96

96

96

tablet

96

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL
13

11

12

13

14

15

16

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat
5 mg) - 5 gr / Bevalex

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

tube

tube

kaplet

14

15

16

17

20

20

18

19

20

21

22

23

24

20

20

20

20

25

26

27

28

29

30

31

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

20

20

15

10

10

96

96

96

96

96

Botol

417
0

20

20

20

15

10

10

17 alkohol 10ml

Botol

20

20

20

15

10

18 famokresol

Botol

20

20

20

15

10

Mengetahui,
Kepala Puskesmas Panunggangan

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

N KESEHATAN APOTEK

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

STOK AKHIR

KET

OBAT
1

Alopurinol tablet 100 mg

Tablet

401

160

241

Amlodipin tablet 5 mg

Tablet

330

160

170

Aminofillin tablet 200 mg

Tablet

296

160

136

Amoksilin kaplet 500 mg

Kaplet

2,171

160

2,011

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

162

160

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,844
160

1,684

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

160

(49)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

160

(8)

160

(63)

160

328

160

(64)

160

(64)

160

(29)

160

51

160

(54)

160

(64)

160

(64)

111

152

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

488

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

96

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

96

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

97

Supp

131

Kapsul

211

Tube

106

Tablet

96

Vial

96

SATUAN
KEMASAN

NAMA OBAT

STOK AWAL

PEMAKAIAN

STOK AKHIR

KET

18

Asam Asetilsalisilat tablet 80 mg

Tablet

96

160

(64)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,231

160

2,071

20

Asam Mefenamat kaplet 500 mg

Kaplet

726

160

566

21

Asiklovir krim 5 % - 5 gr

Tube

135

160

(25)

22

Asiklovir tablet 400 mg

Tablet

688

160

528

23

Atapulgit tablet 600 mg

Tablet

136

160

(24)

77

Loperamid tablet 2 mg

Tablet

152

160

(8)

78

Loratadin tablet 10 mg

Tablet

149

160

(11)

79

Mebendazol tablet 100 mg

Tablet

96

160

(64)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

715

160

555

81

Metformin HCl tablet 500 mg

Tablet

347

160

187

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

316

160

156

83

Metronidazol tablet 500 mg

Tablet

228

160

68

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

104

160

(56)

85

Multivit Sirup - 60 ml

Botol

178

160

18

86

Multivit Tablet

Tablet

96

160

(64)

87

Natrium Bikarbonat tablet 500 mg

Tablet

96

160

(64)

88

Natrium Diklofenak tablet 50 mg

Tablet

224

160

64

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

96

160

(64)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

97

160

(63) EXP.JAN-17

91

Nifedipin tablet 10 mg

Tablet

114

160

(46)

92

Nistatin tablet salut 500.000 IU/g

Tablet

214

160

54

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

208

160

48

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

150

160

(10)

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

Tablet

96

160

(64)

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

126

160

(34)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

96

160

(64)

/ Librozym

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

STOK AKHIR

KET

98

Omeprazol kapsul 20 mg

Kapsul

96

160

(64)

99

Papaverin tablet 40 mg

Tablet

429

160

269 exp.10-15

100

Parasetamol drops

botol

153

160

(7)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

162

160

102

Parasetamol tablet 100 mg

Tablet

96

160

(64)

103

Parasetamol tablet 500 mg

Tablet

3,076

160

2,916

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

912

160

752

105

Piroksikam tablet 10 mg

Tablet

184

160

24

106

Polikresulen (kondensasi) - 10 ml

Botol

97

160

(63)

107

Povidon Iodida larutan 10 % - 300 ml

Botol

97

160

(63)

108

Prednison tablet 5 mg

Tablet

793

160

633

109

Propanolol tablet 10 mg (HCl)

Tablet

196

160

36

110

Propiltiourasil tablet 100 mg

Tablet

141

160

(19)

111

Ranitidin tablet 150 mg

Tablet

100

160

(60)

112

Ringer Laktat larutan infus - 500 ml

Botol

96

160

(64)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

236

160

76

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

96

160

(64)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

111

160

(49)

116

Salisil Bedak 2 % - 50 gr

Kotak

175

160

15

117

Sefadroksil Kapsul 500 mg

Kapsul

214

160

54

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

240

160

80

119

Simvastatin tablet 10 mg

Tablet

96

160

(64)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

431

160

271

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

Botol

96

160

(64)

122

Tetrasiklin kapsul 250 mg

Kapsul

96

160

(64)

123

Tetrasiklin kapsul 500 mg

Kapsul

259

160

99

124

Thiamfenikol kapsul 500 mg

Kapsul

96

160

(64)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,693

126

Vitamin B Kompleks tablet

Tablet

127

Zinc tablet 20 mg

Tablet

OBAT PROGRAM TB PARU

STOK AKHIR

KET

160

1,533

1,763

160

1,603

516

160

356

96

160

(64)

128

Obat FDC Kategori 1

Paket

96

160

(64)

129

Obat FDC Kategori 2

Paket

96

160

(64)

130

Obat FDC Anak

Paket

96

160

(64)

131

Obat FDC Sisipan

Paket

96

160

(64)

96

160

(64)

Vial

97

160

(63)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

158

160

(2)

134

Sefiksim kapsul 100 mg

Kapsul

96

160

(64)

96

160

(64)

96

160

(64)

96

160

(64)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

96

160

(64)

137

Pirantel tablet score (base) 125 mg

Tablet

169

160

96

160

(64)

160

(64)

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

96

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

96

OBAT KEJIWAAN

160

(64)

96

160

(64)

Alprazolam tablet 1 mg

Tablet

315

160

155

Amitriptilin tablet salut 25 mg (HCl)

Tablet

147

160

(13)

Clobazam tablet 10 mg

Tablet

258

160

98

Diazepam tablet 2 mg

Tablet

233

160

73

Diazepam tablet 5 mg

Tablet

96

160

(64)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

96

160

(64)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

97

160

(63)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

STOK AKHIR

KET

Fenitoin Kapsul 100 mg

Kapsul

96

160

(64)

Fenobarbital tablet 30 mg

Tablet

119

160

(41) exp.09-15

10

Fluoxetin tablet 10 mg /

Tablet

96

160

(64)

11

Haloperidol tablet 1,5 mg

Tablet

306

160

146

12

Haloperidol tablet 5 mg

Tablet

522

160

362

13

Imipramin tablet 25 mg / Tofranil

Tablet

96

160

(64)

14

Karbamazepin tablet 200 mg

Tablet

96

160

(64)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

111

160

(49)

16

Kodein tablet 10 mg

Tablet

311

160

151

17

Risperidon tablet 2 mg

Tablet

96

160

(64)

18

Sertralin tablet / Nudep

Tablet

96

160

(64)

19

Triheksifenidil tablet 2 mg

Tablet

96

160

(64)

96

Antiprestin

OBAT GIGI

160

(64)

Artikulating Paper

Buku

96

160

(64)

Bur diamond high Speed

Kotak

96

160

(64)

Bur arkansas high Speed

buah

96

160

(64)

Cavit / Dentorit (Tambalan Sementara)

Pot

97

160

(63)

Celluloid strip

Set

96

160

(64)

Cresopen - 13 ml

Botol

96

160

(64)

Dentin Conditioner

Botol

96

160

(64)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

96

160

(64)

Disclosing Agent

Tube

96

160

(64)

Bungkus @ 100
pcs

96

160

(64)

10

Disposible saliva ejektor

11

Etil Chlorida spray - 100 ml

Botol

97

160

(63)

12

Eugenol cairan

Botol

97

160

(63)

13

Glass Ionomer Radiopak / Fuji VII

Set

97

160

(63)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

97

160

(63)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

96

160

(64)

NAMA OBAT
16

Macro gold + propylen + EDTA

17

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

STOK AKHIR

KET

Set

96

160

(64)

Oil Spray

Botol

96

160

(64)

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

299
160

139

19

Pulperyl

Botol

96

160

(64)

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

96

160

(64)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

96

160

(64)

22

Tetric N Ceram

Paket

96

160

(64)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

96

160

(64)

24

Tetric Bonding - 6 gr

Botol

96

160

(64)

25

Tetric Etch Refill - 2 gr

Tube

96

160

(64)

26

Trikresol Formalin (TKF)

Botol

97

160

(63)

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

96

160

(64)

28

Xylestesin Non Adrenalin injeksi

Ampul

96

160

(64)

29

CHKM

Botol

96

160

(64)

30

Iodoform/Mumifying pasta

Botol

96

160

(64)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

96

160

(64)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

96

160

(64)

96

160

(64)

PERBEKALAN KESEHATAN
1

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

96

160

(64)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

96

160

(64)

Alat Suntik sekali pakai 1 ml

Pcs

156

160

(4)

Alat Suntik sekali pakai 3 ml

Pcs

188

160

28

Alat Suntik sekali pakai 5 ml

Pcs

158

160

(2)

Blood set

Set

96

160

(64)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

96

160

(64)

NAMA OBAT

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

STOK AKHIR

KET

Sach

96

160

(64)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

96

160

(64)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

96

160

(64)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

96

160

(64)

12

Dental Film Hanshin

Pcs

96

160

(64)

13

Etanol 70 % - 1 L

Botol

98

160

(62)

14

Gel USG / EKG

Botol

96

160

(64)

15

Infusion Set Anak

Pcs

96

160

(64)

16

Infusion Set Dewasa

Pcs

98

160

(62) EXP.10-17

17

IV. Catheter No.18 G

Set

98

160

(62) Exp.jul-15

18

IV. Catheter No.20 G

Set

96

160

(64)

19

IV. Catheter No.22 G

Set

96

160

(64)

20

IV. Catheter No.24 G

Kotak

96

160

(64)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

96

160

(64)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

96

160

(64)

23

Kapas Pembalut / absorben 250 gram

24

Kassa Hidrofil Steril uk. 16 x 16

25

Bungkus

96

160

(64)

Kotak

101

160

(59)

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

96

160

(64)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

96

160

(64)

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

96

160

(64)

28

Kertas EKG

Roll

96

160

(64)

29

Kertas USG Sony 110 HG

Roll

96

160

(64)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

97

160

(63)

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

96

160

(64)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

96
160

(64)

33

NAMA OBAT

SATUAN
KEMASAN

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

Botol 1 ltr

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

STOK AWAL

PEMAKAIAN

STOK AKHIR

96
160

(64)

160

(64)

Lembar

96

Kotak

99

160

(61)

Masker O2

Pcs

96

160

(64)

37

Masker 95

Pcs

96

160

(64)

38

Masker nebulizer set dewasa

Pcs

97

160

(63)

39

Masker nebulizer set anak

Pcs

97

160

(63)

40

Plester 5 yard X 2 inch

Roll

96

160

(64)

41

Plester non alergi 0,5 inch / Micropore

Roll

99

160

(61)

42

Pot Urin

Pcs

96

160

(64)

43

Sarung Tangan

Kotak

98

160

(62)

44

Safety Box

Pcs

96

160

(64)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

96

160

(64)

96

PEMERIKSAAN TB PARU

160

(64)

Emersi

Botol 100 ml

96

160

(64)

Eter Alkohol

Botol 100 ml

96

160

(64)

Kaca Slide / Object Glass

Kotak

96

160

(64)

Pot dahak

Pcs

96

160

(64)

Reagen Zielnelsen

Set

96

160

(64)

Spiritus Bakar

Botol

96

160

(64)

Tissu Lensa

Kotak

96

160

(64)

Tissue lensa

Buku

96

160

(64)

Wadah Kaca Slide / Box Slide

Pcs

96

160

(64)

10

Xylol/ Xylene

Botol 100 ml

96

160

(64)

11

Xylol/ Xylene

Botol 500 ml

96

160

(64)

96

160

(64)

EMBALAGE

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

96

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

136

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

116

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

100

Sendok obat

Pcs

196
96

AKUPUNTUR

STOK AKHIR

160

(64)

160

(24)

160

(44)

160

(60)

160

36

160

(64)

Jarum Akupuntur 13 mm

Kotak

96

160

(64)

Jarum Akupuntur 25 mm

Kotak

96

160

(64)

Jarum Akupuntur 40 mm

Kotak

96

160

(64)

Jarum telinga (press needle)

Kotak

96

160

(64)

Moxa Roll

Kotak

96

160

(64)

96

160

(64)

Pcs

96

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

96

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

96

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

96

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

96

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

96

160

(64)

MgSO4 40% injeksi

Vial

96

160

(64)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

96

160

(64)

Natrium Bicarbonat injeksi

Ampul

96

160

(64)

10

Nasal dewasa / Maxyflow

Pcs

96

160

(64)

11

Nasal infant/ Oxyflow

Pcs

96

160

(64)

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

96

160

(64)

13

Penghisap Lendir Bayi Baru Lahir

Pcs

96

160

(64)

14

Sarung Tangan panjang obgyn No. 6,5

Pasang

96

160

(64)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

STOK AKHIR

15

Sarung Tangan panjang obgyn No. 7

Pasang

96

160

(64)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

96

160

(64)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

96

160

(64)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

96

160

(64)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

96

160

(64)

20

Sungkup bayi

Set

96

160

(64)

21

Tanda Pengenal (ID Band) Bayi

Psc

96

160

(64)

22

Tanda Pengenal (ID Band) Ibu

Psc

96

160

(64)

23

Under Pad 60 x 90 cm

Psc

96

160

(64)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

96

TAMBAHAN

160

(64)

96

160

(64)

Ambroksol tablet 30mg

Tablet

286

160

126

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

96

160

(64)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

96
160

(64)

Asiklovir tablet 200 mg

Tablet

96

160

(64)

Bisacodyl 5 mg / Bicolax

Tablet

96

160

(64)

Biskodil sup 10 mg

Supp

96

160

(64)

Buskopan injeksi

Ampul

96

160

(64)

Bur Fissure standart

Pcs

96

160

(64)

Bur Fissure panjang

Pcs

96

160

(64)

10

Cetirizin HCl 10 mg

Tablet

96

160

(64)

11

Cetirizin syrup 100 mg / 5 ml

botol

96

160

(64)

12

Cefixim / sefiksim 100 mg caplet

kaplet

96

160

(64)

13

Etanol 96 % - 1 L

Botol

96

160

(64)

14

Gentian Violet larutan 1 %

Botol

96

160

(64)

15

Glucose Larutan Infus 10% Steril

Botol

96

160

(64)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

STOK AKHIR

16

Jarum Suntik No. 27 G

Pcs

96

160

(64)

17

Ketokonazole Krim 2%

Tube

96

160

(64)

18

Klindamisin kapsul 150 mg

Kapsul

101

160

(59)

19

Klindamisin 300 MG

Kapsul

96

160

(64)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

96

160

(64)

21

Kasa 2x80

Roll

96

160

(64)

22

Kapas 500 gram

Bungkus

96

160

(64)

23

Larutan H2O2

Botol

96

160

(64)

24

Methilprednisolon 4 mg

tablet

96

160

(64)

25

Metoklopramid injeksi / Primperan

Vial

96

160

(64)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

96

160

(64)

27

Metronidazol tablet 250 mg

Tablet

96

160

(64)

28

Meylon injeksi

Botol

96

160

(64)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

96
160

(64)

160

(64)

160

(64)

160

(64)

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Polymigel tablet 400 mg/Strocain P

34
35

Tube

Botol

96

96

Vial

96

Tablet

96

160

(64)

Propanolol tablet 40 mg (HCl)

Tablet

96

160

(64)

Ranitidin injeksi 25 mg/ml

Ampul

96

160

(64)

36

Saccaharine tablet

Tablet

96

160

(64)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

96

160

(64)

38

Sefadroxil syrup 125 mg

botol

96

160

(64)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

96

160

(64)

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PEMAKAIAN

40

Teofilin tablet / Bronsolvan

Tablet

96

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

96

OBAT KESDA

(64)

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

tablet

96

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

tube

96

10

kaplet

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

kaplet

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

(64)

160

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

160

96

STOK AKHIR

96

96

96

96

96

96

96

tablet

96

KET

11

12

13

14

15

16

NAMA OBAT

SATUAN
KEMASAN

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat
5 mg) - 5 gr / Bevalex

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

tube

tube

kaplet

STOK AWAL

PEMAKAIAN

STOK AKHIR

96
160

(64)

160

(64)

160

(64)

160

(64)

160

(64)

96

96

96

96

Botol

417
160

257

17 alkohol 10ml

Botol

85

(85)

18 famokresol

Botol

85

(85)

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

Ria Susanti,AMF
NIP.198512119 200901 2 004

KET

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

SELISIH

OBAT
1

Alopurinol tablet 100 mg

Tablet

241

300

541

228

313

313

Amlodipin tablet 5 mg

Tablet

170

300

470

228

242

209

33

Aminofillin tablet 200 mg

Tablet

136

300

436

228

208

90

118

Amoksilin kaplet 500 mg

Kaplet

2,011

300

2,311

228

2,083

1,954

129

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

300

302

228

74

72

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,684
300

1,984

228

1,756

631

1,125

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

300

251

228

23

14

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

300

292

228

64

300

237

228

300

628

228

400

400

300

236

228

300

236

228

300

271

228

43

84

(41)

300

351

228

123

123

300

246

228

18

14

300

236

228

300

236

228

(49)

(8)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

328

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(64)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

(64)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

64

(63)

Supp

(29)

Kapsul

51

Tube

(54)

Tablet

(64)

Vial

(64)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

SELISIH

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(64)

300

236

228

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,071

300

2,371

228

2,143

1,676

467

20

Asam Mefenamat kaplet 500 mg

Kaplet

566

300

866

228

638

645

(7)

21

Asiklovir krim 5 % - 5 gr

Tube

(25)

300

275

228

47

40

22

Asiklovir tablet 400 mg

Tablet

528

300

828

228

600

449

151

23

Atapulgit tablet 600 mg

Tablet

(24)

300

276

228

48

235

(187)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(61)

300

239

228

11

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,445

300

1,745

228

1,517

3,584

(2,067)

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(64)

300

236

228

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(36)

300

264

228

36

36

28

Bisoprolol tablet 5 mg

Tablet

(52)

300

248

228

20

20

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(38)

300

262

228

34

44

(10)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(1)

300

299

228

71

86

(15)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

(63)

300

237

228

32

Deksametason tablet 0,5 mg

Tablet

1,279

300

1,579

228

1,351

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(64)

300

236

228

34

Difenhidramin injeksi 10 mg/ml

Ampul

(64)

300

236

228

35

Digoksin tablet 0,25 mg

Tablet

300

306

228

78

60

18

36

Domperidon tablet 10 mg

Tablet

232

300

532

228

304

67

237

37

Doksisiklin kapsul 100 mg

Kapsul

(64)

300

236

228

38

Efedrin tablet 25 mg (HCl)

Tablet

117

300

417

228

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(58)

300

242

40

Eritromisin kapsul 500 mg

Kapsul

(64)

300

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(46)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(38)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(48)

794

9
557

189

100

89

228

14

11

236

228

300

254

228

26

26

300

262

228

34

29

300

252

228

24

25

(1)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

41

45

Furosemid tablet 40 mg

Tablet

(13)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

575

47

Gemfibrozil 300 mg kapsul

48

SELISIH

300

341

228

113

104

300

287

228

59

65

(6)

300

875

228

647

320

327

Kapsul

161

300

461

228

233

233

Gentamycin salep kulit 0,1% - 5 gr

Tube

(49)

300

251

228

23

37

(14)

49

Glibenklamid tablet 5 mg

Tablet

670

300

970

228

742

496

246

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,028

300

3,328

228

3,100

1,305

1,795

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(64)

300

236

228

52

Griseofulvin tablet 125 mg / Gricin

Tablet

16

300

316

228

88

158

(70)

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

576

300

876

228

648

591

57

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(44)

300

256

228

28

21

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(64)

300

236

228

56

Ibuprofen tablet 400 mg

Tablet

311

300

611

228

383

302

81

57

Ichtyol salep kulit - 15 gr

Pot

(47)

300

253

228

25

15

10

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

86

300

386

228

158

140

18

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(64)

300

236

228

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,161

300

1,461

228

1,233

527

706

61

Kaptopril tablet 25 mg

Tablet

1,265

300

1,565

228

1,337

256

1,081

62

Ketokonazol tablet 200 mg

Tablet

300

305

228

77

36

41

63

Klindamisin kapsul 150 mg

Kapsul

(64)

300

236

228

64

Kloramfenikol kapsul 250 mg

Kapsul

(64)

300

236

228

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(64)

300

236

228

32

(24)

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(17)

300

283

228

55

55

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(36)

300

264

228

36

23

13

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(30)

300

270

228

42

14

28

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,364

300

5,664

228

5,436

3,750

1,686

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

70

71

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

Tablet

Tablet

SELISIH

414
300

714

228

486

223

263

300

236

228

(64)

Botol

(37)
300

263

228

35

32

Pot

(57)

300

243

228

15

28

(13)

Lidokain injeksi 2% - 2 ml

Ampul

(64)

300

236

228

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

(64)

300

236

228

76

Linkomisin kapsul 500 mg

Kapsul

(64)

300

236

228

77

Loperamid tablet 2 mg

Tablet

(8)

300

292

228

64

84

(20)

78

Loratadin tablet 10 mg

Tablet

(11)

300

289

228

61

61

79

Mebendazol tablet 100 mg

Tablet

(64)

300

236

228

80

Metampiron (Antalgin) tablet 500 mg

Tablet

555

300

855

228

627

420

207

81

Metformin HCl tablet 500 mg

Tablet

187

300

487

228

259

190

69

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

156

300

456

228

228

140

88

83

Metronidazol tablet 500 mg

Tablet

68

300

368

228

140

146

(6)

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(56)

300

244

228

16

32

(16)

85

Multivit Sirup - 60 ml

Botol

18

300

318

228

90

77

13

86

Multivit Tablet

Tablet

(64)

300

236

228

87

Natrium Bikarbonat tablet 500 mg

Tablet

(64)

300

236

228

88

Natrium Diklofenak tablet 50 mg

Tablet

64

300

364

228

136

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(64)

300

236

228

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(63)

300

237

91

Nifedipin tablet 10 mg

Tablet

(46)

300

92

Nistatin tablet salut 500.000 IU/g

Tablet

54

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

48

80

56

228

254

228

26

39

(13)

300

354

228

126

80

46

300

348

228

120

66

54

SATUAN
KEMASAN

NAMA OBAT

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

Botol

(10)

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

Tablet

(64)

96

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(34)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(64)

98

Omeprazol kapsul 20 mg

Kapsul

(64)

99

Papaverin tablet 40 mg

Tablet

269

100

Parasetamol drops

botol

(7)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

102

Parasetamol tablet 100 mg

Tablet

(64)

103

Parasetamol tablet 500 mg

Tablet

2,916

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

752

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

107

SELISIH

300

290

228

62

63

(1)

300

236

228

300

266

228

38

12

26

300

236

228

300

236

228

25

(17)

300

569

228

341

341

300

293

228

65

73

(8)

300

302

228

74

74

300

236

228

300

3,216

228

2,988

1,107

1,881

300

1,052

228

824

1,380

(556)

24

300

324

228

96

278

(182)

Botol

(63)

300

237

228

Povidon Iodida larutan 10 % - 300 ml

Botol

(63)

300

237

228

108

Prednison tablet 5 mg

Tablet

633

300

933

228

705

396

309

109

Propanolol tablet 10 mg (HCl)

Tablet

36

300

336

228

108

100

110

Propiltiourasil tablet 100 mg

Tablet

(19)

300

281

228

53

53

111

Ranitidin tablet 150 mg

Tablet

(60)

300

240

228

12

185

112

Ringer Laktat larutan infus - 500 ml

Botol

(64)

300

236

228

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

76

300

376

228

148

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(64)

300

236

228

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

(49)

300

251

228

23

22

116

Salisil Bedak 2 % - 50 gr

Kotak

15

300

315

228

87

66

21

117

Sefadroksil Kapsul 500 mg

Kapsul

54

300

354

228

126

126

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

80

300

380

228

152

511

(359)

119

Simvastatin tablet 10 mg

Tablet

(64)

300

236

228

241

(233)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

271

300

571

228

343

283

60

/ Librozym

294
-

(173)
8
(146)
8

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SELISIH

Botol

(64)

300

236

228

Tetrasiklin kapsul 250 mg

Kapsul

(64)

300

236

228

123

Tetrasiklin kapsul 500 mg

Kapsul

99

300

399

228

171

171

124

Thiamfenikol kapsul 500 mg

Kapsul

(64)

300

236

228

220

(212)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,533

300

1,833

228

1,605

503

1,102

126

Vitamin B Kompleks tablet

Tablet

1,603

300

1,903

228

1,675

1,321

354

127

Zinc tablet 20 mg

Tablet

356

300

656

228

428

370

58

(64)

OBAT PROGRAM TB PARU

300

236

228

128

Obat FDC Kategori 1

Paket

(64)

300

236

228

129

Obat FDC Kategori 2

Paket

(64)

300

236

228

130

Obat FDC Anak

Paket

(64)

300

236

228

131

Obat FDC Sisipan

Paket

(64)

300

236

228

(64)

300

236

228

Vial

(63)

300

237

228

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

(2)

300

298

228

70

35

35

134

Sefiksim kapsul 100 mg

Kapsul

(64)

300

236

228

(64)

300

236

228

(64)

300

236

228

(64)

300

236

228

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

(64)

300

236

228

137

Pirantel tablet score (base) 125 mg

Tablet

300

309

228

81

23

58

(64)

300

236

228

300

236

228

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

(64)

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

(64)

OBAT KEJIWAAN

300

236

228

(64)

300

236

228

Alprazolam tablet 1 mg

Tablet

155

300

455

228

227

227

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(13)

300

287

228

59

179

(120)

Clobazam tablet 10 mg

Tablet

98

300

398

228

170

159

11

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

SELISIH

Diazepam tablet 2 mg

Tablet

73

300

373

228

145

Diazepam tablet 5 mg

Tablet

(64)

300

236

228

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(64)

300

236

228

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(63)

300

237

228

Fenitoin Kapsul 100 mg

Kapsul

(64)

300

236

228

100

(92)

Fenobarbital tablet 30 mg

Tablet

(41)

300

259

228

31

31

10

Fluoxetin tablet 10 mg /

Tablet

(64)

300

236

228

30

(22)

11

Haloperidol tablet 1,5 mg

Tablet

146

300

446

228

218

210

12

Haloperidol tablet 5 mg

Tablet

362

300

662

228

434

295

139

13

Imipramin tablet 25 mg / Tofranil

Tablet

(64)

300

236

228

14

Karbamazepin tablet 200 mg

Tablet

(64)

300

236

228

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(49)

300

251

228

23

237

(214)

16

Kodein tablet 10 mg

Tablet

151

300

451

228

223

200

23

17

Risperidon tablet 2 mg

Tablet

(64)

300

236

228

18

Sertralin tablet / Nudep

Tablet

(64)

300

236

228

19

Triheksifenidil tablet 2 mg

Tablet

(64)

300

236

228

(64)

Antiprestin

OBAT GIGI

342

(197)

300

236

228

Artikulating Paper

Buku

(64)

300

236

228

Bur diamond high Speed

Kotak

(64)

300

236

228

Bur arkansas high Speed

buah

(64)

300

236

228

Cavit / Dentorit (Tambalan Sementara)

Pot

(63)

300

237

228

Celluloid strip

Set

(64)

300

236

228

Cresopen - 13 ml

Botol

(64)

300

236

228

Dentin Conditioner

Botol

(64)

300

236

228

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(64)

300

236

228

Disclosing Agent

Tube

(64)

300

236

228

Bungkus @ 100
pcs

10

Disposible saliva ejektor

(64)

300

236

228

11

Etil Chlorida spray - 100 ml

Botol

(63)

300

237

228

12

Eugenol cairan

Botol

(63)

300

237

228

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

13

Glass Ionomer Radiopak / Fuji VII

Set

(63)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(63)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(64)

16

Macro gold + propylen + EDTA

Set

17

Oil Spray

18

SELISIH

300

237

228

300

237

228

300

236

228

(64)

300

236

228

Botol

(64)

300

236

228

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

139
300

439

228

211

19

Pulperyl

Botol

(64)

300

236

228

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(64)

300

236

228

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(64)

300

236

228

22

Tetric N Ceram

Paket

(64)

300

236

228

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(64)

300

236

228

24

Tetric Bonding - 6 gr

Botol

(64)

300

236

228

25

Tetric Etch Refill - 2 gr

Tube

(64)

300

236

228

26

Trikresol Formalin (TKF)

Botol

(63)

300

237

228

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(64)

300

236

228

28

Xylestesin Non Adrenalin injeksi

Ampul

(64)

300

236

228

29

CHKM

Botol

(64)

300

236

228

30

Iodoform/Mumifying pasta

Botol

(64)

300

236

228

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(64)

300

236

228

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(64)

300

236

228

(64)

PERBEKALAN KESEHATAN

20

191

300

236

228

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(64)

300

236

228

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(64)

300

236

228

Alat Suntik sekali pakai 1 ml

Pcs

(4)

300

296

228

68

11

57

Alat Suntik sekali pakai 3 ml

Pcs

28

300

328

228

100

145

(45)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

SELISIH

Alat Suntik sekali pakai 5 ml

Pcs

(2)

300

298

228

70

81

(11)

Blood set

Set

(64)

300

236

228

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(64)

300

236

228

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(64)

300

236

228

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(64)

300

236

228

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(64)

300

236

228

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(64)

300

236

228

12

Dental Film Hanshin

Pcs

(64)

300

236

228

13

Etanol 70 % - 1 L

Botol

(62)

300

238

228

10

14

Gel USG / EKG

Botol

(64)

300

236

228

15

Infusion Set Anak

Pcs

(64)

300

236

228

16

Infusion Set Dewasa

Pcs

(62)

300

238

228

10

17

IV. Catheter No.18 G

Set

(62)

300

238

228

10

18

IV. Catheter No.20 G

Set

(64)

300

236

228

19

IV. Catheter No.22 G

Set

(64)

300

236

228

20

IV. Catheter No.24 G

Kotak

(64)

300

236

228

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(64)

300

236

228

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(64)

300

236

228

23

Kapas Pembalut / absorben 250 gram

Bungkus

(64)

300

236

228

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(59)

300

241

228

13

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(64)

300

236

228

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(64)

300

236

228

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(64)

300

236

228

28

Kertas EKG

Roll

(64)

300

236

228

29

Kertas USG Sony 110 HG

Roll

(64)

300

236

228

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(63)

300

237

228

10

3
2

8 EXP.10-17
10 Exp.jul-15

10
8
6

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

(64)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

(64)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Masker O2

37

Botol 1 ltr

SELISIH

300

236

228

300

236

228

300

236

228

300

236

228

(64)

Lembar

(64)

Kotak

(61)

300

239

228

11

Pcs

(64)

300

236

228

Masker 95

Pcs

(64)

300

236

228

38

Masker nebulizer set dewasa

Pcs

(63)

300

237

228

39

Masker nebulizer set anak

Pcs

(63)

300

237

228

40

Plester 5 yard X 2 inch

Roll

(64)

300

236

228

41

Plester non alergi 0,5 inch / Micropore

Roll

(61)

300

239

228

11

11

42

Pot Urin

Pcs

(64)

300

236

228

43

Sarung Tangan

Kotak

(62)

300

238

228

10

10

44

Safety Box

Pcs

(64)

300

236

228

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(64)

300

236

228

(64)

300

236

228

PEMERIKSAAN TB PARU

Emersi

Botol 100 ml

(64)

300

236

228

Eter Alkohol

Botol 100 ml

(64)

300

236

228

Kaca Slide / Object Glass

Kotak

(64)

300

236

228

Pot dahak

Pcs

(64)

300

236

228

Reagen Zielnelsen

Set

(64)

300

236

228

Spiritus Bakar

Botol

(64)

300

236

228

Tissu Lensa

Kotak

(64)

300

236

228

Tissue lensa

Buku

(64)

300

236

228

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

Wadah Kaca Slide / Box Slide

10
11

SELISIH

Pcs

(64)

300

236

228

Xylol/ Xylene

Botol 100 ml

(64)

300

236

228

Xylol/ Xylene

Botol 500 ml

(64)

300

236

228

(64)

300

236

228

300

236

228

300

276

228

48

20

28

300

256

228

28

13

15

300

240

228

12

11

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(64)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(24)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(44)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(60)

Sendok obat

Pcs

36

300

336

228

108

108

(64)

300

236

228

AKUPUNTUR
1

Jarum Akupuntur 13 mm

Kotak

(64)

300

236

228

Jarum Akupuntur 25 mm

Kotak

(64)

300

236

228

Jarum Akupuntur 40 mm

Kotak

(64)

300

236

228

Jarum telinga (press needle)

Kotak

(64)

300

236

228

Moxa Roll

Kotak

(64)

300

236

228

(64)

300

236

228

Pcs

(64)

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(64)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

(64)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(64)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(64)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(64)

300

236

228

MgSO4 40% injeksi

Vial

(64)

300

236

228

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(64)

300

236

228

Natrium Bicarbonat injeksi

Ampul

(64)

300

236

228

10

Nasal dewasa / Maxyflow

Pcs

(64)

300

236

228

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

11

Nasal infant/ Oxyflow

Pcs

(64)

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

(64)

13

Penghisap Lendir Bayi Baru Lahir

Pcs

14

Sarung Tangan panjang obgyn No. 6,5

15

SELISIH

300

236

228

300

236

228

(64)

300

236

228

Pasang

(64)

300

236

228

Sarung Tangan panjang obgyn No. 7

Pasang

(64)

300

236

228

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(64)

300

236

228

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(64)

300

236

228

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(64)

300

236

228

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(64)

300

236

228

20

Sungkup bayi

Set

(64)

300

236

228

21

Tanda Pengenal (ID Band) Bayi

Psc

(64)

300

236

228

22

Tanda Pengenal (ID Band) Ibu

Psc

(64)

300

236

228

23

Under Pad 60 x 90 cm

Psc

(64)

300

236

228

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(64)

300

236

228

(64)

300

236

228

185

13

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

126

300

426

228

198

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(64)

300

236

228

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

(64)
300

236

228

Asiklovir tablet 200 mg

Tablet

(64)

300

236

228

Bisacodyl 5 mg / Bicolax

Tablet

(64)

300

236

228

Biskodil sup 10 mg

Supp

(64)

300

236

228

Buskopan injeksi

Ampul

(64)

300

236

228

Bur Fissure standart

Pcs

(64)

300

236

228

Bur Fissure panjang

Pcs

(64)

300

236

228

10

Cetirizin HCl 10 mg

Tablet

(64)

300

236

228

11

Cetirizin syrup 100 mg / 5 ml

botol

(64)

300

236

228

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

SELISIH

12

Cefixim / sefiksim 100 mg caplet

kaplet

(64)

300

236

228

13

Etanol 96 % - 1 L

Botol

(64)

300

236

228

14

Gentian Violet larutan 1 %

Botol

(64)

300

236

228

15

Glucose Larutan Infus 10% Steril

Botol

(64)

300

236

228

16

Jarum Suntik No. 27 G

Pcs

(64)

300

236

228

17

Ketokonazole Krim 2%

Tube

(64)

300

236

228

18

Klindamisin kapsul 150 mg

Kapsul

(59)

300

241

228

13

13

19

Klindamisin 300 MG

Kapsul

(64)

300

236

228

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(64)

300

236

228

21

Kasa 2x80

Roll

(64)

300

236

228

22

Kapas 500 gram

Bungkus

(64)

300

236

228

23

Larutan H2O2

Botol

(64)

300

236

228

24

Methilprednisolon 4 mg

tablet

(64)

300

236

228

25

Metoklopramid injeksi / Primperan

Vial

(64)

300

236

228

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(64)

300

236

228

27

Metronidazol tablet 250 mg

Tablet

(64)

300

236

228

28

Meylon injeksi

Botol

(64)

300

236

228

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(64)
300

236

228

300

236

228

300

236

228

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Tube

Botol

(64)

(64)

Vial

(64)

300

236

228

Polymigel tablet 400 mg/Strocain P

Tablet

(64)

300

236

228

34

Propanolol tablet 40 mg (HCl)

Tablet

(64)

300

236

228

35

Ranitidin injeksi 25 mg/ml

Ampul

(64)

300

236

228

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

36

Saccaharine tablet

Tablet

(64)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(64)

38

Sefadroxil syrup 125 mg

botol

(64)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(64)

40

Teofilin tablet / Bronsolvan

Tablet

(64)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(64)

OBAT KESDA

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

(64)

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

300

tube

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

228

(64)

228

236

tablet

kaplet

236

300

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

300

(64)

SELISIH

(64)

(64)

(64)

(64)

(64)

(64)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

10

11

12

13

14

15

16

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

(64)

tablet

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

tube

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat 5
mg) - 5 gr / Bevalex

tube

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

kaplet

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

300

236

228

329

(64)

(64)

(64)

(64)

(64)

257
300

557

228

329

17 alkohol 10ml

Botol

(85)

300

215

228

(13)

18 famokresol

Botol

(85)

300

215

228

(13)

Alkohol Swab

Accu-check Performa 100 strip

Accu-check safe T-ProUno 200 Pc

Aquabidest Steril/AQUA PRO INJEKSI 500 ml (Pelarut Sediaan Injeksi, Pelarut Reagen Laboratorium)

Eosin 2% - 100 ml

Hemoglobin C (Drabkin)

Kapiler Hematokrit Heparin

(64)

Botol

SELISIH

4
-

(17)
(13)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

PENERIMAAN

PERSEDIAAN

PEMAKAIAN

STOK AKHIR

KET
FISIK

Na.Citrat 3,31%

Pewarnaan Gram (GRAM SET) 3x100ml

10

Tip Biru

11

Tip Kuning

12

Tabung SST With Gel Minimal 3 ml

13

TURK - 100 ml

14

Urin Strip 3 Parameter

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

Ria Susanti,AMF
NIP.198512119 200901 2 004

SELISIH

ORAN BULANAN PERBEKALAN KESEHATAN APOTEK

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

OBAT
1

Alopurinol tablet 100 mg

Tablet

241

Amlodipin tablet 5 mg

Tablet

170

Aminofillin tablet 200 mg

Tablet

136

Amoksilin kaplet 500 mg

Kaplet

2,011

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,684

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

(49)

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

(8)

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

(63)

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

328

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

(64)

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

(64)

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

Supp

(29)

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

Kapsul

51

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

Tube

(54)

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

Tablet

(64)

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Vial

(64)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

18

Asam Asetilsalisilat tablet 80 mg

Tablet

(64)

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,071

20

Asam Mefenamat kaplet 500 mg

Kaplet

566

21

Asiklovir krim 5 % - 5 gr

Tube

(25)

22

Asiklovir tablet 400 mg

Tablet

528

23

Atapulgit tablet 600 mg

Tablet

(24)

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

(61)

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,445

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

(64)

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

(36)

28

Bisoprolol tablet 5 mg

Tablet

(52)

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

(38)

30

Bromheksin tablet 8 mg / Bromifar

Tablet

(1)

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

(63)

32

Deksametason tablet 0,5 mg

Tablet

1,279

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

(64)

34

Difenhidramin injeksi 10 mg/ml

Ampul

(64)

35

Digoksin tablet 0,25 mg

Tablet

36

Domperidon tablet 10 mg

Tablet

232

37

Doksisiklin kapsul 100 mg

Kapsul

(64)

38

Efedrin tablet 25 mg (HCl)

Tablet

117

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

(58)

40

Eritromisin kapsul 500 mg

Kapsul

(64)

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

(46)

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

(38)

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

(48)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

41

45

Furosemid tablet 40 mg

Tablet

(13)

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

575

47

Gemfibrozil 300 mg kapsul

Kapsul

161

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

(49)

49

Glibenklamid tablet 5 mg

Tablet

670

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,028

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

(64)

52

Griseofulvin tablet 125 mg / Gricin

Tablet

16

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

576

54

Hidrokortison krim 2,5 % - 5 gr

Tube

(44)

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

(64)

56

Ibuprofen tablet 400 mg

Tablet

311

57

Ichtyol salep kulit - 15 gr

Pot

(47)

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

86

59

Kalium permanganat (PK) serbuk - 5 gr

Pot

(64)

60

Kalsium laktat (Kalk) tablet 500 mg

Tablet

1,161

61

Kaptopril tablet 25 mg

Tablet

1,265

62

Ketokonazol tablet 200 mg

Tablet

63

Klindamisin kapsul 150 mg

Kapsul

(64)

64

Kloramfenikol kapsul 250 mg

Kapsul

(64)

65

Kloramfenikol salep mata 1% - 5 gr

Tube

(64)

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

(17)

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

(36)

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

(30)

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,364

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

70

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Tablet

414

71

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

(64)

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

Botol

(37)

73

Levertraan salep - 15 gr

Pot

(57)

74

Lidokain injeksi 2% - 2 ml

Ampul

(64)

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

(64)

76

Linkomisin kapsul 500 mg

Kapsul

(64)

77

Loperamid tablet 2 mg

Tablet

(8)

78

Loratadin tablet 10 mg

Tablet

(11)

79

Mebendazol tablet 100 mg

Tablet

(64)

80

Metampiron (Antalgin) tablet 500 mg

Tablet

555

81

Metformin HCl tablet 500 mg

Tablet

187

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

156

83

Metronidazol tablet 500 mg

Tablet

68

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

(56)

85

Multivit Sirup - 60 ml

Botol

18

86

Multivit Tablet

Tablet

(64)

87

Natrium Bikarbonat tablet 500 mg

Tablet

(64)

88

Natrium Diklofenak tablet 50 mg

Tablet

64

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

(64)

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

(63)

91

Nifedipin tablet 10 mg

Tablet

(46)

92

Nistatin tablet salut 500.000 IU/g

Tablet

54

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

48

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

STOK AWAL

Botol

(10)

Tablet

(64)

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

(34)

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

(64)

98

Omeprazol kapsul 20 mg

Kapsul

(64)

99

Papaverin tablet 40 mg

Tablet

269

100

Parasetamol drops

botol

(7)

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

102

Parasetamol tablet 100 mg

Tablet

(64)

103

Parasetamol tablet 500 mg

Tablet

2,916

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

752

105

Piroksikam tablet 10 mg

Tablet

24

106

Polikresulen (kondensasi) - 10 ml

Botol

(63)

107

Povidon Iodida larutan 10 % - 300 ml

Botol

(63)

108

Prednison tablet 5 mg

Tablet

633

109

Propanolol tablet 10 mg (HCl)

Tablet

36

110

Propiltiourasil tablet 100 mg

Tablet

(19)

111

Ranitidin tablet 150 mg

Tablet

(60)

112

Ringer Laktat larutan infus - 500 ml

Botol

(64)

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

76

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

(64)

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

(49)

116

Salisil Bedak 2 % - 50 gr

Kotak

15

117

Sefadroksil Kapsul 500 mg

Kapsul

54

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

80

119

Simvastatin tablet 10 mg

Tablet

(64)

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

271

/ Librozym

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

STOK AWAL

Botol

(64)

Tetrasiklin kapsul 250 mg

Kapsul

(64)

123

Tetrasiklin kapsul 500 mg

Kapsul

99

124

Thiamfenikol kapsul 500 mg

Kapsul

(64)

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,533

126

Vitamin B Kompleks tablet

Tablet

1,603

127

Zinc tablet 20 mg

Tablet

356

OBAT PROGRAM TB PARU

(64)

128

Obat FDC Kategori 1

Paket

(64)

129

Obat FDC Kategori 2

Paket

(64)

130

Obat FDC Anak

Paket

(64)

131

Obat FDC Sisipan

Paket

(64)

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133
134

(64)
Vial

(63)

Levofloksasin tablet 500 mg

Tablet

(2)

Sefiksim kapsul 100 mg

Kapsul

(64)

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

(64)
Tablet

OBAT PROGRAM KECACINGAN

(64)
(64)

136

Albendazole tablet 400 mg

Tablet

(64)

137

Pirantel tablet score (base) 125 mg

Tablet

OBAT PROGRAM GIZI

(64)

138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

(64)

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

(64)

OBAT KEJIWAAN

(64)

Alprazolam tablet 1 mg

Tablet

155

Amitriptilin tablet salut 25 mg (HCl)

Tablet

(13)

Clobazam tablet 10 mg

Tablet

98

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

Diazepam tablet 2 mg

Tablet

73

Diazepam tablet 5 mg

Tablet

(64)

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

(64)

Diazepam tube Rectal 5 mg/2.5 ml

Tube

(63)

Fenitoin Kapsul 100 mg

Kapsul

(64)

Fenobarbital tablet 30 mg

Tablet

(41)

10

Fluoxetin tablet 10 mg /

Tablet

(64)

11

Haloperidol tablet 1,5 mg

Tablet

146

12

Haloperidol tablet 5 mg

Tablet

362

13

Imipramin tablet 25 mg / Tofranil

Tablet

(64)

14

Karbamazepin tablet 200 mg

Tablet

(64)

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

(49)

16

Kodein tablet 10 mg

Tablet

151

17

Risperidon tablet 2 mg

Tablet

(64)

18

Sertralin tablet / Nudep

Tablet

(64)

19

Triheksifenidil tablet 2 mg

Tablet

(64)

Antiprestin

OBAT GIGI

(64)

Artikulating Paper

Buku

(64)

Bur diamond high Speed

Kotak

(64)

Bur arkansas high Speed

buah

(64)

Cavit / Dentorit (Tambalan Sementara)

Pot

(63)

Celluloid strip

Set

(64)

Cresopen - 13 ml

Botol

(64)

Dentin Conditioner

Botol

(64)

Devitalisasi Pasta (Non Arsen)

Btl / ktk

(64)

Disclosing Agent

Tube

(64)

Bungkus @ 100
pcs

(64)

10

Disposible saliva ejektor

11

Etil Chlorida spray - 100 ml

Botol

(63)

12

Eugenol cairan

Botol

(63)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

13

Glass Ionomer Radiopak / Fuji VII

Set

(63)

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

(63)

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

(64)

16

Macro gold + propylen + EDTA

Set

(64)

17

Oil Spray

Botol

(64)

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

139

19

Pulperyl

Botol

(64)

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

(64)

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

(64)

22

Tetric N Ceram

Paket

(64)

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

(64)

24

Tetric Bonding - 6 gr

Botol

(64)

25

Tetric Etch Refill - 2 gr

Tube

(64)

26

Trikresol Formalin (TKF)

Botol

(63)

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

(64)

28

Xylestesin Non Adrenalin injeksi

Ampul

(64)

29

CHKM

Botol

(64)

30

Iodoform/Mumifying pasta

Botol

(64)

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

(64)

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

(64)

PERBEKALAN KESEHATAN

(64)

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

(64)

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

(64)

Alat Suntik sekali pakai 1 ml

Pcs

(4)

Alat Suntik sekali pakai 3 ml

Pcs

28

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

Alat Suntik sekali pakai 5 ml

Pcs

(2)

Blood set

Set

(64)

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

(64)

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

(64)

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

(64)

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

(64)

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

(64)

12

Dental Film Hanshin

Pcs

(64)

13

Etanol 70 % - 1 L

Botol

(62)

14

Gel USG / EKG

Botol

(64)

15

Infusion Set Anak

Pcs

(64)

16

Infusion Set Dewasa

Pcs

(62)

17

IV. Catheter No.18 G

Set

(62)

18

IV. Catheter No.20 G

Set

(64)

19

IV. Catheter No.22 G

Set

(64)

20

IV. Catheter No.24 G

Kotak

(64)

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

(64)

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

(64)

23

Kapas Pembalut / absorben 250 gram

Bungkus

(64)

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

(59)

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

(64)

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

(64)

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

(64)

28

Kertas EKG

Roll

(64)

29

Kertas USG Sony 110 HG

Roll

(64)

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

(63)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

(64)

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

(64)

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

Botol 1 ltr

(64)

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

Lembar

(64)

35

Masker

Kotak

(61)

36

Masker O2

Pcs

(64)

37

Masker 95

Pcs

(64)

38

Masker nebulizer set dewasa

Pcs

(63)

39

Masker nebulizer set anak

Pcs

(63)

40

Plester 5 yard X 2 inch

Roll

(64)

41

Plester non alergi 0,5 inch / Micropore

Roll

(61)

42

Pot Urin

Pcs

(64)

43

Sarung Tangan

Kotak

(62)

44

Safety Box

Pcs

(64)

45

Surgical blade no.11 (Pisau Bedah)

Pcs

(64)

PEMERIKSAAN TB PARU

(64)

Emersi

Botol 100 ml

(64)

Eter Alkohol

Botol 100 ml

(64)

Kaca Slide / Object Glass

Kotak

(64)

Pot dahak

Pcs

(64)

Reagen Zielnelsen

Set

(64)

Spiritus Bakar

Botol

(64)

Tissu Lensa

Kotak

(64)

Tissue lensa

Buku

(64)

NAMA OBAT
9

Wadah Kaca Slide / Box Slide

10
11

SATUAN
KEMASAN

STOK AWAL

Pcs

(64)

Xylol/ Xylene

Botol 100 ml

(64)

Xylol/ Xylene

Botol 500 ml

(64)

EMBALAGE

(64)

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

(64)

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

(24)

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

(44)

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

(60)

Sendok obat

Pcs

36

AKUPUNTUR

(64)

Jarum Akupuntur 13 mm

Kotak

(64)

Jarum Akupuntur 25 mm

Kotak

(64)

Jarum Akupuntur 40 mm

Kotak

(64)

Jarum telinga (press needle)

Kotak

(64)

Moxa Roll

Kotak

(64)

OBAT PONED
1

Apron plastik

(64)
Pcs

(64)

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

(64)

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

(64)

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

(64)

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

(64)

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

(64)

MgSO4 40% injeksi

Vial

(64)

Misoprostol tablet 0,2 mg / Noprostol

Tablet

(64)

Natrium Bicarbonat injeksi

Ampul

(64)

10

Nasal dewasa / Maxyflow

Pcs

(64)

NAMA OBAT
11

Nasal infant/ Oxyflow

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

13

Penghisap Lendir Bayi Baru Lahir

14

SATUAN
KEMASAN

STOK AWAL

Pcs

(64)

Ampul

(64)

Pcs

(64)

Sarung Tangan panjang obgyn No. 6,5

Pasang

(64)

15

Sarung Tangan panjang obgyn No. 7

Pasang

(64)

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

(64)

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

(64)

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

(64)

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

(64)

20

Sungkup bayi

Set

(64)

21

Tanda Pengenal (ID Band) Bayi

Psc

(64)

22

Tanda Pengenal (ID Band) Ibu

Psc

(64)

23

Under Pad 60 x 90 cm

Psc

(64)

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

(64)

TAMBAHAN

(64)

Ambroksol tablet 30mg

Tablet

126

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

(64)

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

(64)

Asiklovir tablet 200 mg

Tablet

(64)

Bisacodyl 5 mg / Bicolax

Tablet

(64)

Biskodil sup 10 mg

Supp

(64)

Buskopan injeksi

Ampul

(64)

Bur Fissure standart

Pcs

(64)

Bur Fissure panjang

Pcs

(64)

10

Cetirizin HCl 10 mg

Tablet

(64)

11

Cetirizin syrup 100 mg / 5 ml

botol

(64)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

12

Cefixim / sefiksim 100 mg caplet

kaplet

(64)

13

Etanol 96 % - 1 L

Botol

(64)

14

Gentian Violet larutan 1 %

Botol

(64)

15

Glucose Larutan Infus 10% Steril

Botol

(64)

16

Jarum Suntik No. 27 G

Pcs

(64)

17

Ketokonazole Krim 2%

Tube

(64)

18

Klindamisin kapsul 150 mg

Kapsul

(59)

19

Klindamisin 300 MG

Kapsul

(64)

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

(64)

21

Kasa 2x80

Roll

(64)

22

Kapas 500 gram

Bungkus

(64)

23

Larutan H2O2

Botol

(64)

24

Methilprednisolon 4 mg

tablet

(64)

25

Metoklopramid injeksi / Primperan

Vial

(64)

26

Metoklopramid tablet 10 mg / Metolon

Tablet

(64)

27

Metronidazol tablet 250 mg

Tablet

(64)

28

Meylon injeksi

Botol

(64)

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

(64)

30

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Tube

(64)

31

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

Botol

(64)

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

Vial

(64)

33

Polymigel tablet 400 mg/Strocain P

Tablet

(64)

34

Propanolol tablet 40 mg (HCl)

Tablet

(64)

35

Ranitidin injeksi 25 mg/ml

Ampul

(64)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

36

Saccaharine tablet

Tablet

(64)

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

(64)

38

Sefadroxil syrup 125 mg

botol

(64)

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

(64)

40

Teofilin tablet / Bronsolvan

Tablet

(64)

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

(64)

OBAT KESDA

(64)

Kalium Diklofenak tablet 50 mg

tablet

(64)

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

tube

(64)

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

kaplet

(64)

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

kaplet

(64)

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

kaplet

(64)

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

botol

(64)

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

kaplet

(64)

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

(64)

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

10

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

tablet

(64)

11

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

(64)

12

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

(64)

13

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

tube

(64)

14

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat 5
mg) - 5 gr / Bevalex

tube

(64)

15

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

kaplet

(64)

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

257

17 alkohol 10ml

Botol

(85)

18 famokresol

Botol

(85)

Alkohol Swab

Accu-check Performa 100 strip

Accu-check safe T-ProUno 200 Pc

Aquabidest Steril/AQUA PRO INJEKSI 500 ml (Pelarut Sediaan Injeksi, Pelarut Reagen Laboratorium)

Eosin 2% - 100 ml

Hemoglobin C (Drabkin)

Kapiler Hematokrit Heparin

(64)

NAMA OBAT

Na.Citrat 3,31%

Pewarnaan Gram (GRAM SET) 3x100ml

10

Tip Biru

11

Tip Kuning

12

Tabung SST With Gel Minimal 3 ml

13

TURK - 100 ml

14

Urin Strip 3 Parameter

Mengetahui,
Kepala Puskesmas Panunggangan

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

SATUAN
KEMASAN

STOK AWAL

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

13

14

OBAT
1

Alopurinol tablet 100 mg

Tablet

313

500

813

110

10

15

10

15

20

10

Amlodipin tablet 5 mg

Tablet

242

500

742

110

10

15

10

15

20

10

Aminofillin tablet 200 mg

Tablet

208

500

708

110

10

15

10

15

20

10

Amoksilin kaplet 500 mg

Kaplet

2,083

500

2,583

110

10

15

10

15

20

10

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

74

500

574

110

10

15

10

15

20

10

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,756
500

2,256

110

10

15

10

15

20

10

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

500

523

110

10

15

10

15

20

10

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

500

564

110

10

15

10

15

20

10

500

509

110

10

15

10

15

20

10

500

900

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

543

110

10

15

10

15

20

10

500

623

110

10

15

10

15

20

10

500

518

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

23

64

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

400

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Supp

43

Kapsul

123

Tube

18

Tablet

Vial

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

508

110

10

15

10

15

20

10

500

2,643

110

10

15

10

15

20

10

500

1,138

110

500

547

110

10

10

15

10

15

20

10

15

10

15

20

10

600

500

1,100

110

10

15

10

15

20

10

Tablet

48

500

548

110

10

15

10

15

20

10

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

11

500

511

110

10

15

10

15

20

10

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,517

500

2,017

110

10

15

10

15

20

10

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

500

508

110

10

15

10

15

20

10

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

36

500

536

110

10

15

10

15

20

10

28

Bisoprolol tablet 5 mg

Tablet

20

500

520

110

10

15

10

15

20

10

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

34

500

534

110

10

15

10

15

20

10

30

Bromheksin tablet 8 mg / Bromifar

Tablet

71

500

571

110

10

15

10

15

20

10

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

500

509

110

10

15

10

15

20

10

32

Deksametason tablet 0,5 mg

Tablet

1,351

500

1,851

110

10

15

10

15

20

10

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

500

508

110

10

15

10

15

20

10

34

Difenhidramin injeksi 10 mg/ml

Ampul

500

508

110

10

15

10

15

20

10

35

Digoksin tablet 0,25 mg

Tablet

78

500

578

110

10

15

10

15

20

10

36

Domperidon tablet 10 mg

Tablet

304

500

804

110

10

15

10

15

20

10

37

Doksisiklin kapsul 100 mg

Kapsul

500

508

110

10

15

10

15

20

10

38

Efedrin tablet 25 mg (HCl)

Tablet

189

500

689

110

10

15

10

15

20

10

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

14

500

514

110

10

15

10

15

20

10

40

Eritromisin kapsul 500 mg

Kapsul

500

508

110

10

15

10

15

20

10

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

26

500

526

110

10

15

10

15

20

10

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

34

500

534

110

10

15

10

15

20

10

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

24

500

524

110

10

15

10

15

20

10

18

Asam Asetilsalisilat tablet 80 mg

Tablet

500

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,143

20

Asam Mefenamat kaplet 500 mg

Kaplet

638

21

Asiklovir krim 5 % - 5 gr

Tube

47

22

Asiklovir tablet 400 mg

Tablet

23

Atapulgit tablet 600 mg

24

13

14

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

113

45

Furosemid tablet 40 mg

Tablet

59

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

647

47

Gemfibrozil 300 mg kapsul

48

PERSEDIAAN
1

10

11

12

13

14

500

613

110

10

15

10

15

20

10

500

559

110

10

15

10

15

20

10

500

1,147

110

10

15

10

15

20

10

Kapsul

233

500

733

110

10

15

10

15

20

10

Gentamycin salep kulit 0,1% - 5 gr

Tube

23

500

523

110

10

15

10

15

20

10

49

Glibenklamid tablet 5 mg

Tablet

742

500

1,242

110

10

15

10

15

20

10

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,100

500

3,600

110

10

15

10

15

20

10

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

500

508

110

10

15

10

15

20

10

52

Griseofulvin tablet 125 mg / Gricin

Tablet

88

500

588

110

10

15

10

15

20

10

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

648

500

1,148

110

10

15

10

15

20

10

54

Hidrokortison krim 2,5 % - 5 gr

Tube

28

500

528

110

10

15

10

15

20

10

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

500

508

110

10

15

10

15

20

10

56

Ibuprofen tablet 400 mg

Tablet

383

500

883

110

10

15

10

15

20

10

57

Ichtyol salep kulit - 15 gr

Pot

25

500

525

110

10

15

10

15

20

10

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

158

59

Kalium permanganat (PK) serbuk - 5 gr

60

Kalsium laktat (Kalk) tablet 500 mg

61

500

658

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Tablet

1,233

500

1,733

110

10

15

10

15

20

10

Kaptopril tablet 25 mg

Tablet

1,337

500

1,837

110

10

15

10

15

20

10

62

Ketokonazol tablet 200 mg

Tablet

77

500

577

110

10

15

10

15

20

10

63

Klindamisin kapsul 150 mg

Kapsul

500

508

110

10

15

10

15

20

10

64

Kloramfenikol kapsul 250 mg

Kapsul

500

508

110

10

15

10

15

20

10

65

Kloramfenikol salep mata 1% - 5 gr

Tube

500

508

110

10

15

10

15

20

10

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

55

500

555

110

10

15

10

15

20

10

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

36

500

536

110

10

15

10

15

20

10

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

42

500

542

110

10

15

10

15

20

10

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,436

500

5,936

110

10

15

10

15

20

10

Pot

NAMA OBAT

70

71

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

SATUAN
KEMASAN

Tablet

Tablet

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

13

14

486
500

986

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Botol

35
500

535

110

10

15

10

15

20

10

Pot

15

500

515

110

10

15

10

15

20

10

Lidokain injeksi 2% - 2 ml

Ampul

500

508

110

10

15

10

15

20

10

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

500

508

110

10

15

10

15

20

10

76

Linkomisin kapsul 500 mg

Kapsul

500

508

110

10

15

10

15

20

10

77

Loperamid tablet 2 mg

Tablet

64

500

564

110

10

15

10

15

20

10

78

Loratadin tablet 10 mg

Tablet

61

500

561

110

10

15

10

15

20

10

79

Mebendazol tablet 100 mg

Tablet

500

508

110

10

15

10

15

20

10

80

Metampiron (Antalgin) tablet 500 mg

Tablet

627

500

1,127

110

10

15

10

15

20

10

81

Metformin HCl tablet 500 mg

Tablet

259

500

759

110

10

15

10

15

20

10

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

228

500

728

110

10

15

10

15

20

10

83

Metronidazol tablet 500 mg

Tablet

140

500

640

110

10

15

10

15

20

10

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

16

500

516

110

10

15

10

15

20

10

85

Multivit Sirup - 60 ml

Botol

90

500

590

110

10

15

10

15

20

10

86

Multivit Tablet

Tablet

500

508

110

10

15

10

15

20

10

87

Natrium Bikarbonat tablet 500 mg

Tablet

500

508

110

10

15

10

15

20

10

88

Natrium Diklofenak tablet 50 mg

Tablet

136

500

636

110

10

15

10

15

20

10

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

500

508

110

10

15

10

15

20

10

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

500

509

110

10

15

10

15

20

10

91

Nifedipin tablet 10 mg

Tablet

26

500

526

110

10

15

10

15

20

10

92

Nistatin tablet salut 500.000 IU/g

Tablet

126

500

626

110

10

15

10

15

20

10

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

120

500

620

110

10

15

10

15

20

10

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

PEMAKA
STOK AWAL

PENERIMAAN

Botol

62

Tablet

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

38

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

98

Omeprazol kapsul 20 mg

Kapsul

99

Papaverin tablet 40 mg

Tablet

341

100

Parasetamol drops

botol

65

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

74

102

Parasetamol tablet 100 mg

Tablet

103

Parasetamol tablet 500 mg

Tablet

2,988

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

824

105

Piroksikam tablet 10 mg

Tablet

106

Polikresulen (kondensasi) - 10 ml

107

PERSEDIAAN
1

10

11

12

13

14

500

562

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

538

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

841

110

10

15

10

15

20

10

500

565

110

10

15

10

15

20

10

500

574

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

3,488

110

10

15

10

15

20

10

500

1,324

110

10

15

10

15

20

10

96

500

596

110

10

15

10

15

20

10

Botol

500

509

110

10

15

10

15

20

10

Povidon Iodida larutan 10 % - 300 ml

Botol

500

509

110

10

15

10

15

20

10

108

Prednison tablet 5 mg

Tablet

705

500

1,205

110

10

15

10

15

20

10

109

Propanolol tablet 10 mg (HCl)

Tablet

108

500

608

110

10

15

10

15

20

10

110

Propiltiourasil tablet 100 mg

Tablet

53

500

553

110

10

15

10

15

20

10

111

Ranitidin tablet 150 mg

Tablet

12

500

512

110

10

15

10

15

20

10

112

Ringer Laktat larutan infus - 500 ml

Botol

500

508

110

10

15

10

15

20

10

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

148

500

648

110

10

15

10

15

20

10

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

500

508

110

10

15

10

15

20

10

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

23

500

523

110

10

15

10

15

20

10

116

Salisil Bedak 2 % - 50 gr

Kotak

87

500

587

110

10

15

10

15

20

10

117

Sefadroksil Kapsul 500 mg

Kapsul

126

500

626

110

10

15

10

15

20

10

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

152

500

652

110

10

15

10

15

20

10

119

Simvastatin tablet 10 mg

Tablet

500

508

110

10

15

10

15

20

10

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

343

500

843

110

10

15

10

15

20

10

/ Librozym

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

13

14

Botol

500

508

110

10

15

10

15

20

10

Tetrasiklin kapsul 250 mg

Kapsul

500

508

110

10

15

10

15

20

10

123

Tetrasiklin kapsul 500 mg

Kapsul

171

500

671

110

10

15

10

15

20

10

124

Thiamfenikol kapsul 500 mg

Kapsul

500

508

110

10

15

10

15

20

10

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,605

500

2,105

110

10

15

10

15

20

10

126

Vitamin B Kompleks tablet

Tablet

1,675

500

2,175

110

10

15

10

15

20

10

127

Zinc tablet 20 mg

Tablet

428

500

928

110

10

15

10

15

20

10

OBAT PROGRAM TB PARU

500

508

110

10

15

10

15

20

10

128

Obat FDC Kategori 1

Paket

500

508

110

10

15

10

15

20

10

129

Obat FDC Kategori 2

Paket

500

508

110

10

15

10

15

20

10

130

Obat FDC Anak

Paket

500

508

110

10

15

10

15

20

10

131

Obat FDC Sisipan

Paket

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Vial

500

509

110

10

15

10

15

20

10

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

70

500

570

110

10

15

10

15

20

10

134

Sefiksim kapsul 100 mg

Kapsul

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

500

508

110

10

15

10

15

20

10

137

Pirantel tablet score (base) 125 mg

Tablet

81

500

581

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

OBAT KEJIWAAN

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Alprazolam tablet 1 mg

Tablet

227

500

727

110

10

15

10

15

20

10

Amitriptilin tablet salut 25 mg (HCl)

Tablet

59

500

559

110

10

15

10

15

20

10

Clobazam tablet 10 mg

Tablet

170

500

670

110

10

15

10

15

20

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

645

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

509

110

10

15

10

15

20

10

500

508

500

531

110

110

10

15

10

15

20

10

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Tablet

218

500

718

110

10

15

10

15

20

10

Haloperidol tablet 5 mg

Tablet

434

500

934

110

10

15

10

15

20

10

13

Imipramin tablet 25 mg / Tofranil

Tablet

500

508

110

10

15

10

15

20

10

14

Karbamazepin tablet 200 mg

Tablet

500

508

110

10

15

10

15

20

10

15

Klorpromazin tablet salut 100 mg (HCl)

16

Kodein tablet 10 mg

Tablet

23

500

523

110

10

15

10

15

20

10

Tablet

223

17

500

723

110

10

15

10

15

20

10

Risperidon tablet 2 mg

Tablet

500

508

110

10

15

10

15

20

10

18

Sertralin tablet / Nudep

Tablet

500

508

110

10

15

10

15

20

10

19

Triheksifenidil tablet 2 mg

Tablet

500

508

110

10

15

10

15

20

10

Diazepam tablet 2 mg

Tablet

145

500

Diazepam tablet 5 mg

Tablet

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

Diazepam tube Rectal 5 mg/2.5 ml

Tube

Fenitoin Kapsul 100 mg

Kapsul

Fenobarbital tablet 30 mg

Tablet

31

10

Fluoxetin tablet 10 mg /

Tablet

11

Haloperidol tablet 1,5 mg

12

Antiprestin

OBAT GIGI

13

14

500

508

110

10

15

10

15

20

10

Artikulating Paper

Buku

500

508

110

10

15

10

15

20

10

Bur diamond high Speed

Kotak

500

508

110

10

15

10

15

20

10

Bur arkansas high Speed

buah

500

508

110

10

15

10

15

20

10

Cavit / Dentorit (Tambalan Sementara)

Pot

500

509

110

10

15

10

15

20

10

Celluloid strip

Set

500

508

110

10

15

10

15

20

10

Cresopen - 13 ml

Botol

500

508

110

10

15

10

15

20

10

Dentin Conditioner

Botol

500

508

110

10

15

10

15

20

10

Devitalisasi Pasta (Non Arsen)

Btl / ktk

500

508

110

10

15

10

15

20

10

Disclosing Agent

Tube

500

508

110

10

15

10

15

20

10

Bungkus @ 100
pcs

10

Disposible saliva ejektor

500

508

110

10

15

10

15

20

10

11

Etil Chlorida spray - 100 ml

Botol

500

509

110

10

15

10

15

20

10

12

Eugenol cairan

Botol

500

509

110

10

15

10

15

20

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

13

Glass Ionomer Radiopak / Fuji VII

Set

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

16

Macro gold + propylen + EDTA

Set

17

Oil Spray

18

PERSEDIAAN
1

10

11

12

13

14

500

509

110

10

15

10

15

20

10

500

509

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Botol

500

508

110

10

15

10

15

20

10

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

211
500

711

110

10

15

10

15

20

10

19

Pulperyl

Botol

500

508

110

10

15

10

15

20

10

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

500

508

110

10

15

10

15

20

10

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

500

508

110

10

15

10

15

20

10

22

Tetric N Ceram

Paket

500

508

110

10

15

10

15

20

10

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

500

508

110

10

15

10

15

20

10

24

Tetric Bonding - 6 gr

Botol

500

508

110

10

15

10

15

20

10

25

Tetric Etch Refill - 2 gr

Tube

500

508

110

10

15

10

15

20

10

26

Trikresol Formalin (TKF)

Botol

500

509

110

10

15

10

15

20

10

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

500

508

110

10

15

10

15

20

10

28

Xylestesin Non Adrenalin injeksi

Ampul

500

508

110

10

15

10

15

20

10

29

CHKM

Botol

500

508

110

10

15

10

15

20

10

30

Iodoform/Mumifying pasta

Botol

500

508

110

10

15

10

15

20

10

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

500

508

110

10

15

10

15

20

10

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

500

508

110

10

15

10

15

20

10

PERBEKALAN KESEHATAN

500

508

110

10

15

10

15

20

10

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

500

508

110

10

15

10

15

20

10

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

500

508

110

10

15

10

15

20

10

Alat Suntik sekali pakai 1 ml

Pcs

68

500

568

110

10

15

10

15

20

10

Alat Suntik sekali pakai 3 ml

Pcs

100

500

600

110

10

15

10

15

20

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

570

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

Cassete

110

10

15

10

15

20

10

500

Cassete

508

110

10

15

10

15

20

10

Pcs

500

508

110

10

15

10

15

20

10

Etanol 70 % - 1 L

Botol

10

500

508

110

10

15

10

15

20

10

14

Gel USG / EKG

Botol

500

510

110

10

15

10

15

20

10

15

Infusion Set Anak

Pcs

500

508

110

10

15

10

15

20

10

16

Infusion Set Dewasa

Pcs

10

500

508

110

10

15

10

15

20

10

500

510

110

10

15

10

15

20

10

17

IV. Catheter No.18 G

Set

10

500

510

110

10

15

10

15

20

10

18

IV. Catheter No.20 G

Set

500

508

110

10

15

10

15

20

10

19

IV. Catheter No.22 G

Set

500

508

110

10

15

10

15

20

10

20

IV. Catheter No.24 G

Kotak

500

508

110

10

15

10

15

20

10

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

500

508

110

10

15

10

15

20

10

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

500

508

110

10

15

10

15

20

10

23

Kapas Pembalut / absorben 250 gram

Bungkus

500

508

110

10

15

10

15

20

10

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

13

500

513

110

10

15

10

15

20

10

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

500

508

110

10

15

10

15

20

10

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

500

508

110

10

15

10

15

20

10

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

500

508

110

10

15

10

15

20

10

28

Kertas EKG

Roll

500

508

110

10

15

10

15

20

10

29

Kertas USG Sony 110 HG

Roll

500

508

110

10

15

10

15

20

10

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

500

509

110

10

15

10

15

20

10

Alat Suntik sekali pakai 5 ml

Pcs

70

500

Blood set

Set

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

10

Benang Bedah Catgut Plain 3/0 -100 m

11

Benang Bedah Silk Black 3/0 -100 m

12

Dental Film Hanshin

13

13

14

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Masker O2

37

Botol 1 ltr

PERSEDIAAN
1

10

11

12

13

14

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Lembar

Kotak

11

500

511

110

10

15

10

15

20

10

Pcs

500

508

110

10

15

10

15

20

10

Masker 95

Pcs

500

508

110

10

15

10

15

20

10

38

Masker nebulizer set dewasa

Pcs

500

509

110

10

15

10

15

20

10

39

Masker nebulizer set anak

Pcs

500

509

110

10

15

10

15

20

10

40

Plester 5 yard X 2 inch

Roll

500

508

110

10

15

10

15

20

10

41

Plester non alergi 0,5 inch / Micropore

Roll

11

500

511

110

10

15

10

15

20

10

42

Pot Urin

Pcs

500

508

110

10

15

10

15

20

10

43

Sarung Tangan

Kotak

10

500

510

110

10

15

10

15

20

10

44

Safety Box

Pcs

500

508

110

10

15

10

15

20

10

45

Surgical blade no.11 (Pisau Bedah)

Pcs

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

500

508

110

10

15

10

15

20

10

Eter Alkohol

Botol 100 ml

500

508

110

10

15

10

15

20

10

Kaca Slide / Object Glass

Kotak

500

508

110

10

15

10

15

20

10

Pot dahak

Pcs

500

508

110

10

15

10

15

20

10

Reagen Zielnelsen

Set

500

508

110

10

15

10

15

20

10

Spiritus Bakar

Botol

500

508

110

10

15

10

15

20

10

Tissu Lensa

Kotak

500

508

110

10

15

10

15

20

10

Tissue lensa

Buku

500

508

110

10

15

10

15

20

10

NAMA OBAT
9

Wadah Kaca Slide / Box Slide

10
11

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

508

110

10

15

10

500

508

110

10

15

500

508

110

500

508

110

10

10

500

508

110

10

500

548

110

500

528

110

500

512

Pcs

500

Xylol/ Xylene

Botol 100 ml

Xylol/ Xylene

Botol 500 ml

8
8

EMBALAGE

10

11

12

13

14

15

20

10

10

15

20

10

15

10

15

20

10

15

10

15

20

10

15

10

15

20

10

10

15

10

15

20

10

10

15

10

15

20

10

110

10

15

10

15

20

10

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

48

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

28

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

12

Sendok obat

Pcs

108

500

608

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

AKUPUNTUR
1

Jarum Akupuntur 13 mm

Kotak

500

508

110

10

15

10

15

20

10

Jarum Akupuntur 25 mm

Kotak

500

508

110

10

15

10

15

20

10

Jarum Akupuntur 40 mm

Kotak

500

508

110

10

15

10

15

20

10

Jarum telinga (press needle)

Kotak

500

508

110

10

15

10

15

20

10

Moxa Roll

Kotak

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Pcs

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

500

508

110

10

15

10

15

20

10

MgSO4 40% injeksi

Vial

500

508

110

10

15

10

15

20

10

Misoprostol tablet 0,2 mg / Noprostol

Tablet

500

508

110

10

15

10

15

20

10

Natrium Bicarbonat injeksi

Ampul

500

508

110

10

15

10

15

20

10

10

Nasal dewasa / Maxyflow

Pcs

500

508

110

10

15

10

15

20

10

NAMA OBAT
11

Nasal infant/ Oxyflow

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

13

Penghisap Lendir Bayi Baru Lahir

14

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

Pcs

Ampul

Pcs

Sarung Tangan panjang obgyn No. 6,5

15

PERSEDIAAN
1

10

11

12

13

14

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Pasang

500

508

110

10

15

10

15

20

10

Sarung Tangan panjang obgyn No. 7

Pasang

500

508

110

10

15

10

15

20

10

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

500

508

110

10

15

10

15

20

10

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

500

508

110

10

15

10

15

20

10

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

500

508

110

10

15

10

15

20

10

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

500

508

110

10

15

10

15

20

10

20

Sungkup bayi

Set

500

508

110

10

15

10

15

20

10

21

Tanda Pengenal (ID Band) Bayi

Psc

500

508

110

10

15

10

15

20

10

22

Tanda Pengenal (ID Band) Ibu

Psc

500

508

110

10

15

10

15

20

10

23

Under Pad 60 x 90 cm

Psc

500

508

110

10

15

10

15

20

10

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

TAMBAHAN
1

Ambroksol tablet 30mg

Tablet

198

500

698

110

10

15

10

15

20

10

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

500

508

110

10

15

10

15

20

10

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

8
500

508

110

10

15

10

15

20

10

Asiklovir tablet 200 mg

Tablet

500

508

110

10

15

10

15

20

10

Bisacodyl 5 mg / Bicolax

Tablet

500

508

110

10

15

10

15

20

10

Biskodil sup 10 mg

Supp

500

508

110

10

15

10

15

20

10

Buskopan injeksi

Ampul

500

508

110

10

15

10

15

20

10

Bur Fissure standart

Pcs

500

508

110

10

15

10

15

20

10

Bur Fissure panjang

Pcs

500

508

110

10

15

10

15

20

10

10

Cetirizin HCl 10 mg

Tablet

500

508

110

10

15

10

15

20

10

11

Cetirizin syrup 100 mg / 5 ml

botol

500

508

110

10

15

10

15

20

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

10

11

12

13

14

12

Cefixim / sefiksim 100 mg caplet

kaplet

500

508

110

10

15

10

15

20

10

13

Etanol 96 % - 1 L

Botol

500

508

110

10

15

10

15

20

10

14

Gentian Violet larutan 1 %

Botol

500

508

110

10

15

10

15

20

10

15

Glucose Larutan Infus 10% Steril

Botol

500

508

110

10

15

10

15

20

10

16

Jarum Suntik No. 27 G

Pcs

500

508

110

10

15

10

15

20

10

17

Ketokonazole Krim 2%

Tube

500

508

110

10

15

10

15

20

10

18

Klindamisin kapsul 150 mg

Kapsul

13

500

513

110

10

15

10

15

20

10

19

Klindamisin 300 MG

Kapsul

500

508

110

10

15

10

15

20

10

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

500

508

110

10

15

10

15

20

10

21

Kasa 2x80

Roll

500

508

110

10

15

10

15

20

10

22

Kapas 500 gram

Bungkus

500

508

110

10

15

10

15

20

10

23

Larutan H2O2

Botol

500

508

110

10

15

10

15

20

10

24

Methilprednisolon 4 mg

tablet

500

508

110

10

15

10

15

20

10

25

Metoklopramid injeksi / Primperan

Vial

500

508

110

10

15

10

15

20

10

26

Metoklopramid tablet 10 mg / Metolon

Tablet

500

508

110

10

15

10

15

20

10

27

Metronidazol tablet 250 mg

Tablet

500

508

110

10

15

10

15

20

10

28

Meylon injeksi

Botol

500

508

110

10

15

10

15

20

10

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

8
500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Tube

Botol

Vial

500

508

110

10

15

10

15

20

10

Polymigel tablet 400 mg/Strocain P

Tablet

500

508

110

10

15

10

15

20

10

34

Propanolol tablet 40 mg (HCl)

Tablet

500

508

110

10

15

10

15

20

10

35

Ranitidin injeksi 25 mg/ml

Ampul

500

508

110

10

15

10

15

20

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

36

Saccaharine tablet

Tablet

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

38

Sefadroxil syrup 125 mg

botol

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

40

Teofilin tablet / Bronsolvan

Tablet

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

OBAT KESDA

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

10

11

12

13

14

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

tube

10

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

110

508

tablet

kaplet

500

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

PERSEDIAAN

NAMA OBAT

10

11

12

13

14

15

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

10

11

12

13

14

tablet

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

PERSEDIAAN

tube

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

kaplet

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

500

508

110

10

15

10

15

20

10

tube

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat 5
mg) - 5 gr / Bevalex

500

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

329
500

829

110

10

15

10

15

20

10

17

alkohol 100ml

Botol

(13)

500

487

110

10

15

10

15

20

10

18

famokresol

Botol

(13)

500

487

110

10

15

10

15

20

10

19

Alkohol Swab

500

500

110

10

15

10

15

20

10

20

Accu-check Performa 100 strip

500

500

110

10

15

10

15

20

10

21

Accu-check safe T-ProUno 200 Pc

500

500

110

10

15

10

15

20

10

22

Aquabidest Steril/AQUA PRO INJEKSI 500 ml (Pelarut Sediaan Injeksi, Pelarut Reagen
Laboratorium)

500

500

110

10

15

10

15

20

10

23

Eosin 2% - 100 ml

500

500

110

10

15

10

15

20

10

24

Hemoglobin C (Drabkin)

500

500

110

10

15

10

15

20

10

NAMA OBAT

SATUAN
KEMASAN

PEMAKA
STOK AWAL

PENERIMAAN

PERSEDIAAN
1

500

110

10

500

500

110

10

500

500

110

500

500

110

500

500

110

Tabung SST With Gel Minimal 3 ml

500

500

31

TURK - 100 ml

500

32

Urin Strip 3 Parameter

500

25

Kapiler Hematokrit Heparin

500

26

Na.Citrat 3,31%

27

Pewarnaan Gram (GRAM SET) 3x100ml

28

Tip Biru

29

Tip Kuning

30

Mengetahui,
Kepala Puskesmas Panunggangan

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

15

10

15

10

10

10

110

500

110

500

110

10

11

12

13

14

15

20

10

10

15

20

10

15

10

15

20

10

15

10

15

20

10

15

10

15

20

10

10

15

10

15

20

10

10

15

10

15

20

10

10

15

10

15

20

10

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


PEMAKAIAN HARIAN

STOK AWAL

PEMAKAIAN
15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

OBAT
1

Alopurinol tablet 100 mg

Tablet

313

10

10

10

35

25

15

70

10

20

395

Amlodipin tablet 5 mg

Tablet

242

10

10

10

35

25

15

70

10

20

395

Aminofillin tablet 200 mg

Tablet

208

10

10

10

35

25

15

70

10

20

395

Amoksilin kaplet 500 mg

Kaplet

2,083

10

10

10

35

25

15

70

10

20

395

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

74

10

10

10

35

25

15

70

10

20

395

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,756
0

10

10

10

35

25

15

70

10

20

395

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

10

10

10

35

25

15

70

10

20

395

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

23

64

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

400

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Supp

43

Kapsul

123

Tube

18

Tablet

Vial

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

18

Asam Asetilsalisilat tablet 80 mg

Tablet

10

10

10

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,143

10

10

20

Asam Mefenamat kaplet 500 mg

Kaplet

638

10

21

Asiklovir krim 5 % - 5 gr

Tube

47

10

22

Asiklovir tablet 400 mg

Tablet

600

23

Atapulgit tablet 600 mg

Tablet

48

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

11

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,517

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

36

28

Bisoprolol tablet 5 mg

Tablet

29

Borax Glyserin ( GOM ) 10 % - 8 ml

30

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

10

10

35

25

10

10

10

35

10

10

10

10

10

10

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

15

70

10

20

395

25

15

70

10

20

395

35

25

15

70

10

20

395

10

35

25

15

70

10

20

395

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

20

10

10

10

35

25

15

70

10

20

395

Botol

34

10

10

10

35

25

15

70

10

20

395

Bromheksin tablet 8 mg / Bromifar

Tablet

71

10

10

10

35

25

15

70

10

20

395

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

10

10

10

35

25

15

70

10

20

395

32

Deksametason tablet 0,5 mg

Tablet

1,351

10

10

10

35

25

15

70

10

20

395

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

10

10

10

35

25

15

70

10

20

395

34

Difenhidramin injeksi 10 mg/ml

Ampul

10

10

10

35

25

15

70

10

20

395

35

Digoksin tablet 0,25 mg

Tablet

78

10

10

10

35

25

15

70

10

20

395

36

Domperidon tablet 10 mg

Tablet

304

10

10

10

35

25

15

70

10

20

395

37

Doksisiklin kapsul 100 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

38

Efedrin tablet 25 mg (HCl)

Tablet

189

10

10

10

35

25

15

70

10

20

395

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

14

10

10

10

35

25

15

70

10

20

395

40

Eritromisin kapsul 500 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

26

10

10

10

35

25

15

70

10

20

395

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

34

10

10

10

35

25

15

70

10

20

395

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

24

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

113

45

Furosemid tablet 40 mg

Tablet

59

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

647

47

Gemfibrozil 300 mg kapsul

48

15

16

17

18

19

10

10

10

10

10

10

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

Kapsul

233

10

10

10

35

25

15

70

10

20

395

Gentamycin salep kulit 0,1% - 5 gr

Tube

23

10

10

10

35

25

15

70

10

20

395

49

Glibenklamid tablet 5 mg

Tablet

742

10

10

10

35

25

15

70

10

20

395

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,100

10

10

10

35

25

15

70

10

20

395

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

10

10

10

35

25

15

70

10

20

395

52

Griseofulvin tablet 125 mg / Gricin

Tablet

88

10

10

10

35

25

15

70

10

20

395

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

648

10

10

10

35

25

15

70

10

20

395

54

Hidrokortison krim 2,5 % - 5 gr

Tube

28

10

10

10

35

25

15

70

10

20

395

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

10

10

10

35

25

15

70

10

20

395

56

Ibuprofen tablet 400 mg

Tablet

383

10

10

10

35

25

15

70

10

20

395

57

Ichtyol salep kulit - 15 gr

Pot

25

10

10

10

35

25

15

70

10

20

395

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

158

59

Kalium permanganat (PK) serbuk - 5 gr

60

Kalsium laktat (Kalk) tablet 500 mg

61

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

Tablet

1,233

10

10

10

35

25

15

70

10

20

395

Kaptopril tablet 25 mg

Tablet

1,337

10

10

10

35

25

15

70

10

20

395

62

Ketokonazol tablet 200 mg

Tablet

77

10

10

10

35

25

15

70

10

20

395

63

Klindamisin kapsul 150 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

64

Kloramfenikol kapsul 250 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

65

Kloramfenikol salep mata 1% - 5 gr

Tube

10

10

10

35

25

15

70

10

20

395

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

55

10

10

10

35

25

15

70

10

20

395

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

36

10

10

10

35

25

15

70

10

20

395

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

42

10

10

10

35

25

15

70

10

20

395

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,436

10

10

10

35

25

15

70

10

20

395

Pot

NAMA OBAT

70

71

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

SATUAN
KEMASAN

Tablet

Tablet

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

10

10

10

10

10

20

21

22

23

35

25

15

70

10

35

25

15

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

486

Botol

35
0

10

10

10

35

25

15

70

10

20

395

Pot

15

10

10

10

35

25

15

70

10

20

395

Lidokain injeksi 2% - 2 ml

Ampul

10

10

10

35

25

15

70

10

20

395

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

10

10

10

35

25

15

70

10

20

395

76

Linkomisin kapsul 500 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

77

Loperamid tablet 2 mg

Tablet

64

10

10

10

35

25

15

70

10

20

395

78

Loratadin tablet 10 mg

Tablet

61

10

10

10

35

25

15

70

10

20

395

79

Mebendazol tablet 100 mg

Tablet

10

10

10

35

25

15

70

10

20

395

80

Metampiron (Antalgin) tablet 500 mg

Tablet

627

10

10

10

35

25

15

70

10

20

395

81

Metformin HCl tablet 500 mg

Tablet

259

10

10

10

35

25

15

70

10

20

395

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

228

10

10

10

35

25

15

70

10

20

395

83

Metronidazol tablet 500 mg

Tablet

140

10

10

10

35

25

15

70

10

20

395

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

16

10

10

10

35

25

15

70

10

20

395

85

Multivit Sirup - 60 ml

Botol

90

10

10

10

35

25

15

70

10

20

395

86

Multivit Tablet

Tablet

10

10

10

35

25

15

70

10

20

395

87

Natrium Bikarbonat tablet 500 mg

Tablet

10

10

10

35

25

15

70

10

20

395

88

Natrium Diklofenak tablet 50 mg

Tablet

136

10

10

10

35

25

15

70

10

20

395

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

10

10

10

35

25

15

70

10

20

395

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

10

10

10

35

25

15

70

10

20

395

91

Nifedipin tablet 10 mg

Tablet

26

10

10

10

35

25

15

70

10

20

395

92

Nistatin tablet salut 500.000 IU/g

Tablet

126

10

10

10

35

25

15

70

10

20

395

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

120

10

10

10

35

25

15

70

10

20

395

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

10

10

10

20

21

22

23

35

25

15

70

24

25

26

27

28

29

30

31

10

20

395

Botol

62

Tablet

10

10

10

35

25

15

70

10

20

395

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

38

10

10

10

35

25

15

70

10

20

395

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

10

10

10

35

25

15

70

10

20

395

98

Omeprazol kapsul 20 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

99

Papaverin tablet 40 mg

Tablet

341

10

10

10

35

25

15

70

10

20

395

100

Parasetamol drops

botol

65

10

10

10

35

25

15

70

10

20

395

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

74

10

10

10

35

25

15

70

10

20

395

102

Parasetamol tablet 100 mg

Tablet

10

10

10

35

25

15

70

10

20

395

103

Parasetamol tablet 500 mg

Tablet

2,988

10

10

10

35

25

15

70

10

20

395

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

824

10

10

10

35

25

15

70

10

20

395

105

Piroksikam tablet 10 mg

Tablet

96

10

10

10

35

25

15

70

10

20

395

106

Polikresulen (kondensasi) - 10 ml

Botol

10

10

10

35

25

15

70

10

20

395

107

Povidon Iodida larutan 10 % - 300 ml

Botol

10

10

10

35

25

15

70

10

20

395

108

Prednison tablet 5 mg

Tablet

705

10

10

10

35

25

15

70

10

20

395

109

Propanolol tablet 10 mg (HCl)

Tablet

108

10

10

10

35

25

15

70

10

20

395

110

Propiltiourasil tablet 100 mg

Tablet

53

10

10

10

35

25

15

70

10

20

395

111

Ranitidin tablet 150 mg

Tablet

12

10

10

10

35

25

15

70

10

20

395

112

Ringer Laktat larutan infus - 500 ml

Botol

10

10

10

35

25

15

70

10

20

395

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

148

10

10

10

35

25

15

70

10

20

395

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

10

10

10

35

25

15

70

10

20

395

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

23

10

10

10

35

25

15

70

10

20

395

116

Salisil Bedak 2 % - 50 gr

Kotak

87

10

10

10

35

25

15

70

10

20

395

117

Sefadroksil Kapsul 500 mg

Kapsul

126

10

10

10

35

25

15

70

10

20

395

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

152

10

10

10

35

25

15

70

10

20

395

119

Simvastatin tablet 10 mg

Tablet

10

10

10

35

25

15

70

10

20

395

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

343

10

10

10

35

25

15

70

10

20

395

/ Librozym

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

Botol

10

10

10

35

25

15

70

10

20

395

Tetrasiklin kapsul 250 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

123

Tetrasiklin kapsul 500 mg

Kapsul

171

10

10

10

35

25

15

70

10

20

395

124

Thiamfenikol kapsul 500 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,605

10

10

10

35

25

15

70

10

20

395

126

Vitamin B Kompleks tablet

Tablet

1,675

10

10

10

35

25

15

70

10

20

395

127

Zinc tablet 20 mg

Tablet

428

10

10

10

35

25

15

70

10

20

395

OBAT PROGRAM TB PARU

10

10

10

35

25

15

70

10

20

395

128

Obat FDC Kategori 1

Paket

10

10

10

35

25

15

70

10

20

395

129

Obat FDC Kategori 2

Paket

10

10

10

35

25

15

70

10

20

395

130

Obat FDC Anak

Paket

10

10

10

35

25

15

70

10

20

395

131

Obat FDC Sisipan

Paket

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

Vial

10

10

10

35

25

15

70

10

20

395

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

70

10

10

10

35

25

15

70

10

20

395

134

Sefiksim kapsul 100 mg

Kapsul

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

10

10

10

35

25

15

70

10

20

395

137

Pirantel tablet score (base) 125 mg

Tablet

81

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

OBAT KEJIWAAN

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

Alprazolam tablet 1 mg

Tablet

227

10

10

10

35

25

15

70

10

20

395

Amitriptilin tablet salut 25 mg (HCl)

Tablet

59

10

10

10

35

25

15

70

10

20

395

Clobazam tablet 10 mg

Tablet

170

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

Diazepam tablet 2 mg

Tablet

145

10

10

10

Diazepam tablet 5 mg

Tablet

10

10

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

10

Diazepam tube Rectal 5 mg/2.5 ml

Tube

Fenitoin Kapsul 100 mg

Kapsul

Fenobarbital tablet 30 mg

Tablet

31

10

Fluoxetin tablet 10 mg /

21

22

23

28

29

30

31

35

25

15

70

10

20

395

10

35

25

15

70

10

20

395

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

10

10

10

35

25

15

70

10

20

395

35

25

15

70

10

20

395

Tablet

10

10

10

35

25

15

70

10

20

395

11

Haloperidol tablet 1,5 mg

Tablet

218

10

10

10

35

25

15

70

10

20

395

12

Haloperidol tablet 5 mg

Tablet

434

10

10

10

35

25

15

70

10

20

395

13

Imipramin tablet 25 mg / Tofranil

Tablet

10

10

10

35

25

15

70

10

20

395

14

Karbamazepin tablet 200 mg

Tablet

10

10

10

35

25

15

70

10

20

395

15

Klorpromazin tablet salut 100 mg (HCl)

16

Kodein tablet 10 mg

Tablet

23

10

10

10

35

25

15

70

10

20

395

Tablet

223

17

10

10

10

35

25

15

70

10

20

395

Risperidon tablet 2 mg

Tablet

10

10

10

35

25

15

70

10

20

395

18

Sertralin tablet / Nudep

Tablet

10

10

10

35

25

15

70

10

20

395

19

Triheksifenidil tablet 2 mg

Tablet

10

10

10

35

25

15

70

10

20

395

Antiprestin

OBAT GIGI

20

24

25

26

27

10

10

10

35

25

15

70

10

20

395

Artikulating Paper

Buku

10

10

10

35

25

15

70

10

20

395

Bur diamond high Speed

Kotak

10

10

10

35

25

15

70

10

20

395

Bur arkansas high Speed

buah

10

10

10

35

25

15

70

10

20

395

Cavit / Dentorit (Tambalan Sementara)

Pot

10

10

10

35

25

15

70

10

20

395

Celluloid strip

Set

10

10

10

35

25

15

70

10

20

395

Cresopen - 13 ml

Botol

10

10

10

35

25

15

70

10

20

395

Dentin Conditioner

Botol

10

10

10

35

25

15

70

10

20

395

Devitalisasi Pasta (Non Arsen)

Btl / ktk

10

10

10

35

25

15

70

10

20

395

Disclosing Agent

Tube

10

10

10

35

25

15

70

10

20

395

Bungkus @ 100
pcs

10

Disposible saliva ejektor

10

10

10

35

25

15

70

10

20

395

11

Etil Chlorida spray - 100 ml

Botol

10

10

10

35

25

15

70

10

20

395

12

Eugenol cairan

Botol

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

10

10

10

10

10

10

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

13

Glass Ionomer Radiopak / Fuji VII

Set

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

16

Macro gold + propylen + EDTA

Set

10

10

10

35

25

15

70

10

20

395

17

Oil Spray

Botol

10

10

10

35

25

15

70

10

20

395

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

211
0

10

10

10

35

25

15

70

10

20

395

19

Pulperyl

Botol

10

10

10

35

25

15

70

10

20

395

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

10

10

10

35

25

15

70

10

20

395

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

10

10

10

35

25

15

70

10

20

395

22

Tetric N Ceram

Paket

10

10

10

35

25

15

70

10

20

395

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

10

10

10

35

25

15

70

10

20

395

24

Tetric Bonding - 6 gr

Botol

10

10

10

35

25

15

70

10

20

395

25

Tetric Etch Refill - 2 gr

Tube

10

10

10

35

25

15

70

10

20

395

26

Trikresol Formalin (TKF)

Botol

10

10

10

35

25

15

70

10

20

395

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

10

10

10

35

25

15

70

10

20

395

28

Xylestesin Non Adrenalin injeksi

Ampul

10

10

10

35

25

15

70

10

20

395

29

CHKM

Botol

10

10

10

35

25

15

70

10

20

395

30

Iodoform/Mumifying pasta

Botol

10

10

10

35

25

15

70

10

20

395

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

10

10

10

35

25

15

70

10

20

395

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

10

10

10

35

25

15

70

10

20

395

PERBEKALAN KESEHATAN

10

10

10

35

25

15

70

10

20

395

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

10

10

10

35

25

15

70

10

20

395

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

10

10

10

35

25

15

70

10

20

395

Alat Suntik sekali pakai 1 ml

Pcs

68

10

10

10

35

25

15

70

10

20

395

Alat Suntik sekali pakai 3 ml

Pcs

100

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

Alat Suntik sekali pakai 5 ml

Pcs

70

10

10

10

Blood set

Set

10

10

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

10

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

12

Dental Film Hanshin

Pcs

13

Etanol 70 % - 1 L

Botol

10

14

Gel USG / EKG

Botol

15

Infusion Set Anak

Pcs

16

Infusion Set Dewasa

Pcs

10

17

IV. Catheter No.18 G

Set

18

IV. Catheter No.20 G

19

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

10

10

10

35

10

10

10

10

10

10

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

25

15

70

10

20

395

35

25

15

70

10

20

395

10

35

25

15

70

10

20

395

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

10

35

25

15

70

10

20

395

Set

10

10

10

35

25

15

70

10

20

395

IV. Catheter No.22 G

Set

10

10

10

35

25

15

70

10

20

395

20

IV. Catheter No.24 G

Kotak

10

10

10

35

25

15

70

10

20

395

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

10

10

10

35

25

15

70

10

20

395

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

10

10

10

35

25

15

70

10

20

395

23

Kapas Pembalut / absorben 250 gram

Bungkus

10

10

10

35

25

15

70

10

20

395

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

13

10

10

10

35

25

15

70

10

20

395

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

10

10

10

35

25

15

70

10

20

395

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

10

10

10

35

25

15

70

10

20

395

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

10

10

10

35

25

15

70

10

20

395

28

Kertas EKG

Roll

10

10

10

35

25

15

70

10

20

395

29

Kertas USG Sony 110 HG

Roll

10

10

10

35

25

15

70

10

20

395

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

35

Masker

36

Masker O2

37

Botol 1 ltr

15

16

17

18

19

10

10

10

10

10

10

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

10

10

10

35

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

25

15

70

10

20

395

Lembar

Kotak

11

10

10

10

35

25

15

70

10

20

395

Pcs

10

10

10

35

25

15

70

10

20

395

Masker 95

Pcs

10

10

10

35

25

15

70

10

20

395

38

Masker nebulizer set dewasa

Pcs

10

10

10

35

25

15

70

10

20

395

39

Masker nebulizer set anak

Pcs

10

10

10

35

25

15

70

10

20

395

40

Plester 5 yard X 2 inch

Roll

10

10

10

35

25

15

70

10

20

395

41

Plester non alergi 0,5 inch / Micropore

Roll

11

10

10

10

35

25

15

70

10

20

395

42

Pot Urin

Pcs

10

10

10

35

25

15

70

10

20

395

43

Sarung Tangan

Kotak

10

10

10

10

35

25

15

70

10

20

395

44

Safety Box

Pcs

10

10

10

35

25

15

70

10

20

395

45

Surgical blade no.11 (Pisau Bedah)

Pcs

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

PEMERIKSAAN TB PARU
1

Emersi

Botol 100 ml

10

10

10

35

25

15

70

10

20

395

Eter Alkohol

Botol 100 ml

10

10

10

35

25

15

70

10

20

395

Kaca Slide / Object Glass

Kotak

10

10

10

35

25

15

70

10

20

395

Pot dahak

Pcs

10

10

10

35

25

15

70

10

20

395

Reagen Zielnelsen

Set

10

10

10

35

25

15

70

10

20

395

Spiritus Bakar

Botol

10

10

10

35

25

15

70

10

20

395

Tissu Lensa

Kotak

10

10

10

35

25

15

70

10

20

395

Tissue lensa

Buku

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

Pcs

10

10

10

Xylol/ Xylene

Botol 100 ml

10

10

Xylol/ Xylene

Botol 500 ml

10

10

Wadah Kaca Slide / Box Slide

10
11

EMBALAGE

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

10

10

35

25

10

10

10

35

10

10

10

10

10

10

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

15

70

10

20

395

25

15

70

10

20

395

35

25

15

70

10

20

395

10

35

25

15

70

10

20

395

10

10

35

25

15

70

10

20

395

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

48

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

28

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

12

Sendok obat

Pcs

108

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

AKUPUNTUR
1

Jarum Akupuntur 13 mm

Kotak

10

10

10

35

25

15

70

10

20

395

Jarum Akupuntur 25 mm

Kotak

10

10

10

35

25

15

70

10

20

395

Jarum Akupuntur 40 mm

Kotak

10

10

10

35

25

15

70

10

20

395

Jarum telinga (press needle)

Kotak

10

10

10

35

25

15

70

10

20

395

Moxa Roll

Kotak

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

Pcs

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

10

10

10

35

25

15

70

10

20

395

MgSO4 40% injeksi

Vial

10

10

10

35

25

15

70

10

20

395

Misoprostol tablet 0,2 mg / Noprostol

Tablet

10

10

10

35

25

15

70

10

20

395

Natrium Bicarbonat injeksi

Ampul

10

10

10

35

25

15

70

10

20

395

10

Nasal dewasa / Maxyflow

Pcs

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

28

29

30

31

10

10

10

10

20

395

10

10

70

10

20

395

10

15

70

10

20

395

Pasang

25

15

70

10

20

395

Sarung Tangan panjang obgyn No. 7

Pasang

35

25

15

70

10

20

395

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

10

35

25

15

70

10

20

395

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

10

10

35

25

15

70

10

20

395

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

10

10

10

35

25

15

70

10

20

395

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

10

10

10

35

25

15

70

10

20

395

20

Sungkup bayi

Set

10

10

10

35

25

15

70

10

20

395

21

Tanda Pengenal (ID Band) Bayi

Psc

10

10

10

35

25

15

70

10

20

395

22

Tanda Pengenal (ID Band) Ibu

Psc

10

10

10

35

25

15

70

10

20

395

23

Under Pad 60 x 90 cm

Psc

10

10

10

35

25

15

70

10

20

395

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

11

Nasal infant/ Oxyflow

Pcs

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

Ampul

13

Penghisap Lendir Bayi Baru Lahir

Pcs

14

Sarung Tangan panjang obgyn No. 6,5

15

TAMBAHAN

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

10

10

10

35

10

10

10

10

10

10

24

25

26

27

Ambroksol tablet 30mg

Tablet

198

10

10

10

35

25

15

70

10

20

395

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

10

10

10

35

25

15

70

10

20

395

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

8
0

10

10

10

35

25

15

70

10

20

395

Asiklovir tablet 200 mg

Tablet

10

10

10

35

25

15

70

10

20

395

Bisacodyl 5 mg / Bicolax

Tablet

10

10

10

35

25

15

70

10

20

395

Biskodil sup 10 mg

Supp

10

10

10

35

25

15

70

10

20

395

Buskopan injeksi

Ampul

10

10

10

35

25

15

70

10

20

395

Bur Fissure standart

Pcs

10

10

10

35

25

15

70

10

20

395

Bur Fissure panjang

Pcs

10

10

10

35

25

15

70

10

20

395

10

Cetirizin HCl 10 mg

Tablet

10

10

10

35

25

15

70

10

20

395

11

Cetirizin syrup 100 mg / 5 ml

botol

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

12

Cefixim / sefiksim 100 mg caplet

kaplet

10

10

10

35

25

15

70

10

20

395

13

Etanol 96 % - 1 L

Botol

10

10

10

35

25

15

70

10

20

395

14

Gentian Violet larutan 1 %

Botol

10

10

10

35

25

15

70

10

20

395

15

Glucose Larutan Infus 10% Steril

Botol

10

10

10

35

25

15

70

10

20

395

16

Jarum Suntik No. 27 G

Pcs

10

10

10

35

25

15

70

10

20

395

17

Ketokonazole Krim 2%

Tube

10

10

10

35

25

15

70

10

20

395

18

Klindamisin kapsul 150 mg

Kapsul

13

10

10

10

35

25

15

70

10

20

395

19

Klindamisin 300 MG

Kapsul

10

10

10

35

25

15

70

10

20

395

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

10

10

10

35

25

15

70

10

20

395

21

Kasa 2x80

Roll

10

10

10

35

25

15

70

10

20

395

22

Kapas 500 gram

Bungkus

10

10

10

35

25

15

70

10

20

395

23

Larutan H2O2

Botol

10

10

10

35

25

15

70

10

20

395

24

Methilprednisolon 4 mg

tablet

10

10

10

35

25

15

70

10

20

395

25

Metoklopramid injeksi / Primperan

Vial

10

10

10

35

25

15

70

10

20

395

26

Metoklopramid tablet 10 mg / Metolon

Tablet

10

10

10

35

25

15

70

10

20

395

27

Metronidazol tablet 250 mg

Tablet

10

10

10

35

25

15

70

10

20

395

28

Meylon injeksi

Botol

10

10

10

35

25

15

70

10

20

395

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

8
0

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

30

31

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

33

Tube

Botol

Vial

10

10

10

35

25

15

70

10

20

395

Polymigel tablet 400 mg/Strocain P

Tablet

10

10

10

35

25

15

70

10

20

395

34

Propanolol tablet 40 mg (HCl)

Tablet

10

10

10

35

25

15

70

10

20

395

35

Ranitidin injeksi 25 mg/ml

Ampul

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN

36

Saccaharine tablet

Tablet

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

38

Sefadroxil syrup 125 mg

botol

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

40

Teofilin tablet / Bronsolvan

Tablet

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

OBAT KESDA

kaplet

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

kaplet

botol

23

10

10

10

35

25

15

70

10

10

10

35

25

15

10

10

10

35

25

10

10

10

35

10

10

10

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

25

15

70

10

20

395

35

25

15

70

10

20

395

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

10

10

10

35

25

15

70

10

20

395

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

22

25

tube

21

35

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

kaplet

20

10

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

19

10

18

10

tablet

kaplet

17

Kalium Diklofenak tablet 50 mg

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

16

15

NAMA OBAT

10

11

12

13

14

15

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

16

17

18

19

10

10

10

10

10

10

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

10

10

10

35

10

10

10

10

10

10

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

25

15

70

10

20

395

35

25

15

70

10

20

395

10

35

25

15

70

10

20

395

10

10

35

25

15

70

10

20

395

tablet

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

15

tube

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat 5
mg) - 5 gr / Bevalex

tube

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

kaplet

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

329
0

10

10

10

35

25

15

70

10

20

395

17

alkohol 100ml

Botol

(13)

10

10

10

35

25

15

70

10

20

395

18

famokresol

Botol

(13)

10

10

10

35

25

15

70

10

20

395

19

Alkohol Swab

10

10

10

35

25

15

70

10

20

395

20

Accu-check Performa 100 strip

10

10

10

35

25

15

70

10

20

395

21

Accu-check safe T-ProUno 200 Pc

10

10

10

35

25

15

70

10

20

395

22

Aquabidest Steril/AQUA PRO INJEKSI 500 ml (Pelarut Sediaan Injeksi, Pelarut Reagen
Laboratorium)

10

10

10

35

25

15

70

10

20

395

23

Eosin 2% - 100 ml

10

10

10

35

25

15

70

10

20

395

24

Hemoglobin C (Drabkin)

10

10

10

35

25

15

70

10

20

395

NAMA OBAT

SATUAN
KEMASAN

PEMAKAIAN HARIAN
STOK AWAL

PEMAKAIAN
15

16

17

18

19

25

Kapiler Hematokrit Heparin

10

10

10

26

Na.Citrat 3,31%

10

10

27

Pewarnaan Gram (GRAM SET) 3x100ml

10

28

Tip Biru

10

29

Tip Kuning

30

Tabung SST With Gel Minimal 3 ml

31

TURK - 100 ml

32

Urin Strip 3 Parameter

20

21

22

23

35

25

15

70

10

35

25

15

10

10

35

25

10

10

35

25

10

10

10

35

10

10

10

10

10

10

10

24

25

26

27

28

29

30

31

10

20

395

70

10

20

395

15

70

10

20

395

15

70

10

20

395

25

15

70

10

20

395

35

25

15

70

10

20

395

10

35

25

15

70

10

20

395

10

35

25

15

70

10

20

395

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

Ria Susanti,AMF
NIP.198512119 200901 2 004

N APOTEK

LAPORAN BULANAN PERBEKALAN KESEHATAN APOTEK


NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

OBAT
1

Alopurinol tablet 100 mg

Tablet

313

418

Amlodipin tablet 5 mg

Tablet

242

347

Aminofillin tablet 200 mg

Tablet

208

313

Amoksilin kaplet 500 mg

Kaplet

2,083

2,188

Amoksilin sirup kering 125 mg/ 5 ml - 60 ml

Botol

74

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg + Magnesium


Hidroksida 200 mg

Tablet

1,756

Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg /5 ml + Magnesium


Hidroksida 200 mg /5 ml - 60 ml

Botol

Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin 10.000 IU/g

Tube

179

1,861
23
128
64
169

Antibiotik Topikal Jelly ( Neomycin Sulfate 0,5% + Placenta Ekstrak 10 %) - 15 gr /


Bioplacenton

Tube

10

Antidiare tablet (Kaolin 550 mg + Pectin 20 mg ) / Neo Diaform

Tablet

400

11

Antidiare suspensi (Kaolin 700 mg + Pectin 66 mg) - 60 ml

Botol

12

Antifungi DOEN kombinasi As. Benzoat 6% + As. Salisilat 3% - 30 gr / Whitefield

Pot

9
114
505
113

113
13

Anti Hemmoroid DOEN kombinasi : Bismut subgalat 150 mg + Heksaklorofen 2,5 mg

14

Anti Hemmoroid Kapsul : Ekstrak Graptophylli Folium 80% + Citrus Bioflavonoid 20% /
Haemorogard

15

Antiinfeksi Topikal dengan Kortikosteroid krim (Kloramfenikol base 20 mg + Prednisolon 2,5


mg) - 10 gr / Klorfeson

Supp

43

Kapsul

123

148

228
Tube

18
123

16

Antimigren : Ergotamin Tartrat 1 mg + Kofein 50 mg

17

Aqua pro injeksi steril, bebas pirogen 20 ml

Tablet

Vial

113
113

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

18

Asam Asetilsalisilat tablet 80 mg

Tablet

113

19

Asam Askorbat (Vitamin C) tablet 50 mg

Tablet

2,143

2,248

20

Asam Mefenamat kaplet 500 mg

Kaplet

638

743

21

Asiklovir krim 5 % - 5 gr

Tube

47

152

22

Asiklovir tablet 400 mg

Tablet

600

705

23

Atapulgit tablet 600 mg

Tablet

48

153

24

Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml (sulfat) - 1 ml

Ampul

11

25

Besi II Sulfat 200 mg + Asam Folat 0,25 mg (tablet tambah darah kombinasi)

Tablet

1,517

26

Betahistin Mesilat tablet 6 mg / Noverty

Tablet

27

Betametason Krim 0.1 % (sebagai valerat) - 5 gr

Tube

36

28

Bisoprolol tablet 5 mg

Tablet

20

125

29

Borax Glyserin ( GOM ) 10 % - 8 ml

Botol

34

139

30

Bromheksin tablet 8 mg / Bromifar

Tablet

71

176

31

Bromheksin larutan 2mg/ml (untuk Nebulizer) - 50 ml / Bisolvon

Botol

32

Deksametason tablet 0,5 mg

Tablet

1,351

1,456

33

Deksametason injeksi 5 mg/ml-1ml

Ampul

113

34

Difenhidramin injeksi 10 mg/ml

Ampul

113

35

Digoksin tablet 0,25 mg

Tablet

78

183

36

Domperidon tablet 10 mg

Tablet

304

409

37

Doksisiklin kapsul 100 mg

Kapsul

113

38

Efedrin tablet 25 mg (HCl)

Tablet

189

294

39

Epinefrin (Adrenalin) injeksi 0,1 % (sebagai HCl) - 1 ml

Ampul

14

40

Eritromisin kapsul 500 mg

Kapsul

113

41

Eritromisin sirup 200 mg 5 /ml - 60 ml

Botol

26

131

42

Etakridin (Rivanol) Larutan 0,1 % - 300 ml

Botol

34

139

43

Fenol Gliserol tetes telinga 10 % - 5 ml

Botol

24

129

116
1,622
113
141

114

119

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

44

Fitomenadion(Vit. K1) tablet salut gula 10 mg

Tablet

113

45

Furosemid tablet 40 mg

Tablet

59

46

Garam Oralit I serbuk, kombinasi : Natrium 0,52 g, Kalium klorida 0,30 g , Trinatrium sitrat
dihidrat 0,58 g, Glukosa anhidrat 2,7 g

Sach

647

218
164

752
47

Gemfibrozil 300 mg kapsul

Kapsul

233

338

48

Gentamycin salep kulit 0,1% - 5 gr

Tube

23

128

49

Glibenklamid tablet 5 mg

Tablet

742

847

50

Gliseril Guaiakolat tablet 100 mg

Tablet

3,100

3,205

51

Glucose Larutan Infus 5% steril - 500 ml

Botol

113

52

Griseofulvin tablet 125 mg / Gricin

Tablet

88

193

53

Hidroklortiazid (HCT) tablet 25 mg

Tablet

648

753

54

Hidrokortison krim 2,5 % - 5 gr

Tube

28

133

55

Hyoscine - N - Butilbromide tablet 10 mg / Scopma

Tablet

56

Ibuprofen tablet 400 mg

Tablet

383

488

57

Ichtyol salep kulit - 15 gr

Pot

25

130

58

Isosorbid dinitrat (ISDN) tablet sublingual 5 mg

Tablet

158

59

Kalium permanganat (PK) serbuk - 5 gr

60

Kalsium laktat (Kalk) tablet 500 mg

61

Pot

113

263

113

Tablet

1,233

1,338

Kaptopril tablet 25 mg

Tablet

1,337

1,442

62

Ketokonazol tablet 200 mg

Tablet

77

182

63

Klindamisin kapsul 150 mg

Kapsul

113

64

Kloramfenikol kapsul 250 mg

Kapsul

113

65

Kloramfenikol salep mata 1% - 5 gr

Tube

113

66

Kloramfenikol suspensi 125 mg/5ml - 60 ml

Botol

55

67

Kloramfenikol tetes mata 0,5 % - 5 ml

Botol

36

141

68

Kloramfenikol tetes telinga 3 % - 5 ml

Botol

42

147

69

Klorfeniramin maleat (CTM) tablet 4 mg

Tablet

5,436

5,541

160

KET

NAMA OBAT

70

Kotimoksazol DOEN I (dewasa) kombinasi : Sulfametoksazol 400 mg + Trimetoprim 80 mg

SATUAN
KEMASAN

Tablet

STOK AWAL

STOK AKHIR

486
591

71

Kotimoksazol DOEN II (pedriatik) kombinasi : Sulfametoksazol 100 mg + Trimetoprim 20 mg

Tablet

8
113

72

Kotimoksazol Suspensi kombinasi : Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml - 60


ml

73

Levertraan salep - 15 gr

74

Botol

35

Pot

15

120

Lidokain injeksi 2% - 2 ml

Ampul

113

75

Lidokain comp injeksi (Lidocain 2% (HCl) + Epinefrin 1 : 80.000) - 2 ml

Ampul

76

Linkomisin kapsul 500 mg

Kapsul

113

77

Loperamid tablet 2 mg

Tablet

64

169

78

Loratadin tablet 10 mg

Tablet

61

166

79

Mebendazol tablet 100 mg

Tablet

113

80

Metampiron (Antalgin) tablet 500 mg

Tablet

627

732

81

Metformin HCl tablet 500 mg

Tablet

259

364

82

Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg

Tablet

228

83

Metronidazol tablet 500 mg

Tablet

140

245

84

Mikonazol krim/ salep 2 % (Nitrat) - 10 gr

Tube

16

121

85

Multivit Sirup - 60 ml

Botol

90

195

86

Multivit Tablet

Tablet

113

87

Natrium Bikarbonat tablet 500 mg

Tablet

113

88

Natrium Diklofenak tablet 50 mg

Tablet

136

241

89

Natrium Klorida larutan infus 0,9% - 500 ml

Botol

90

Natrium Klorida larutan 0,9% - 25 ml (untuk Nebulizer)

Botol

91

Nifedipin tablet 10 mg

Tablet

26

131

92

Nistatin tablet salut 500.000 IU/g

Tablet

126

231

93

Nistatin vaginal tablet 100.000 IU/g

Tablet

120

225

140

113

333

113
114

KET

SATUAN
KEMASAN

NAMA OBAT

94

Obat batuk Hitam (OBH) Cairan -100 ml non Alkohol

95

Obat Pencernaan tablet (Diastase 200 mg, Pankreatin 100 mg)

96

STOK AWAL

STOK AKHIR

Botol

62

Tablet

Oksitetrasiklin HCl salep kulit 3 % - 5 gr

Tube

38

143

97

Oksitetrasiklin HCl salep mata 1 % - 5 gr

Tube

113

98

Omeprazol kapsul 20 mg

Kapsul

113

99

Papaverin tablet 40 mg

Tablet

341

446

100

Parasetamol drops

botol

65

170

101

Parasetamol sirup 120 mg / 5ml - 60 ml

Botol

74

179

102

Parasetamol tablet 100 mg

Tablet

113

103

Parasetamol tablet 500 mg

Tablet

2,988

3,093

104

Piridoksin (Vitamin B6) tablet 10 mg (HCl)

Tablet

824

105

Piroksikam tablet 10 mg

Tablet

96

201

106

Polikresulen (kondensasi) - 10 ml

Botol

114

107

Povidon Iodida larutan 10 % - 300 ml

Botol

114

108

Prednison tablet 5 mg

Tablet

705

810

109

Propanolol tablet 10 mg (HCl)

Tablet

108

213

110

Propiltiourasil tablet 100 mg

Tablet

53

158

111

Ranitidin tablet 150 mg

Tablet

12

117

112

Ringer Laktat larutan infus - 500 ml

Botol

113

113

Salbutamol tablet 2 mg (sebagai sulfat)

Tablet

148

253

114

Salbutamol 2.5 mg/ ml (untuk Nebulizer) / Ventolin

Botol

115

Salep 2-4 kombinasi : Asam Salisilat 2 % + Belerang endap 4 % - 30 gr

Pot

23

116

Salisil Bedak 2 % - 50 gr

Kotak

87

192

117

Sefadroksil Kapsul 500 mg

Kapsul

126

231

118

Sianokobalamin (vitamin B12) tablet 50 mcg

Tablet

152

119

Simvastatin tablet 10 mg

Tablet

113

120

Siprofloksasin tablet 500 mg (sebagai HCl)

Tablet

343

448

/ Librozym

167
113

929

113
128

257

KET

NAMA OBAT

121

Sulfasetamida Natrium tetes mata 15 % - 5 ml

122

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

Botol

Tetrasiklin kapsul 250 mg

Kapsul

113

123

Tetrasiklin kapsul 500 mg

Kapsul

171

276

124

Thiamfenikol kapsul 500 mg

Kapsul

113

125

Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat)

Tablet

1,605

126

Vitamin B Kompleks tablet

Tablet

1,675

1,780

127

Zinc tablet 20 mg

Tablet

428

533

113

OBAT PROGRAM TB PARU

113

1,710

128

Obat FDC Kategori 1

Paket

113

129

Obat FDC Kategori 2

Paket

113

130

Obat FDC Anak

Paket

113

131

Obat FDC Sisipan

Paket

113

113

Vial

114

OBAT PROGRAM IMS


132

Kanamisin injeksi 1 gr

133

Levofloksasin tablet 500 mg

Tablet

70

175

134

Sefiksim kapsul 100 mg

Kapsul

113

113

113

113

OBAT PROGRAM FILARIASIS


135

Dietilkarbamazin Sitrat tablet 100 mg

Tablet

OBAT PROGRAM KECACINGAN


136

Albendazole tablet 400 mg

Tablet

113

137

Pirantel tablet score (base) 125 mg

Tablet

81

186

113
113

OBAT PROGRAM GIZI


138

Retinol (Vitamin A) 100.000 IU kapsul lunak

Kapsul

139

Retinol (Vitamin A) 200.000 IU kapsul lunak

Kapsul

OBAT KEJIWAAN

113

113

Alprazolam tablet 1 mg

Tablet

227

332

Amitriptilin tablet salut 25 mg (HCl)

Tablet

59

164

Clobazam tablet 10 mg

Tablet

170

275

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

Diazepam tablet 2 mg

Tablet

145

250

Diazepam tablet 5 mg

Tablet

113

Diazepan injeksi 5 mg /ml - 2 ml

Ampul

113

Diazepam tube Rectal 5 mg/2.5 ml

Tube

Fenitoin Kapsul 100 mg

Kapsul

113

Fenobarbital tablet 30 mg

Tablet

31

136

10

Fluoxetin tablet 10 mg /

Tablet

113

11

Haloperidol tablet 1,5 mg

Tablet

218

323

12

Haloperidol tablet 5 mg

Tablet

434

539

13

Imipramin tablet 25 mg / Tofranil

Tablet

113

14

Karbamazepin tablet 200 mg

Tablet

113

15

Klorpromazin tablet salut 100 mg (HCl)

Tablet

23

128

16

Kodein tablet 10 mg

Tablet

223

328

17

Risperidon tablet 2 mg

Tablet

113

18

Sertralin tablet / Nudep

Tablet

113

19

Triheksifenidil tablet 2 mg

Tablet

113

113

Antiprestin

OBAT GIGI

114

Artikulating Paper

Buku

113

Bur diamond high Speed

Kotak

113

Bur arkansas high Speed

buah

113

Cavit / Dentorit (Tambalan Sementara)

Pot

114

Celluloid strip

Set

113

Cresopen - 13 ml

Botol

113

Dentin Conditioner

Botol

113

Devitalisasi Pasta (Non Arsen)

Btl / ktk

113

Disclosing Agent

Tube

113

Bungkus @ 100
pcs

10

Disposible saliva ejektor

113

11

Etil Chlorida spray - 100 ml

Botol

114

12

Eugenol cairan

Botol

114

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

13

Glass Ionomer Radiopak / Fuji VII

Set

14

Glass Ionomer Cement ART / Fuji IX / Ketac Molar

Set

15

Kalsium Hidroksida pasta / Calcidor / Dycal

Set

16

Macro gold + propylen + EDTA

Set

113

17

Oil Spray

Botol

113

18

Obat Anestesi Lokal Injeksi ( Lidokain HCl 20 ml + Adrenalin 12.5 mcg )

Ampul

211

19

Pulperyl

Botol

20

Spon Gelatin Cubicels / Spongostan/ Haemospon

Pcs

21

Temporary Stopping Fletcher (Fletcher) serbuk dan cairan

Set

22

Tetric N Ceram

Paket

23

Tetric N Ceram Refill (A2, A3, A3,5) - 3,5 gr

Tube

24

Tetric Bonding - 6 gr

Botol

113

25

Tetric Etch Refill - 2 gr

Tube

113

26

Trikresol Formalin (TKF)

Botol

114

27

Xylestesin Adrenalin injeksi / Scandonest

Ampul

28

Xylestesin Non Adrenalin injeksi

Ampul

113

29

CHKM

Botol

113

30

Iodoform/Mumifying pasta

Botol

113

31

Semen zink phosphat (Powder 30 gram, Liquid 10 ml)

Botol

32

Tambalan Sinar (4 syringe, etching, bonding)

Paket

113

113

114
114
113

316

PERBEKALAN KESEHATAN

113
113
113
113
113

113

113

Alat Suntik sekali pakai 0,05 ml (ADS)

Pcs

113

Alat Suntik sekali pakai 0,5 ml (ADS)

Pcs

113

Alat Suntik sekali pakai 1 ml

Pcs

68

173

Alat Suntik sekali pakai 3 ml

Pcs

100

205

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

KET

Alat Suntik sekali pakai 5 ml

Pcs

70

175

Blood set

Set

113

Benang Bedah Catgut No. 2/0 - 3/0 dengan jarum bedah

Sach

Benang Bedah Silk No. 2/0 - 3/0 dengan jarum bedah

Sach

Benang Bedah Catgut Chromic 2/0 -100 m

Cassete

113

10

Benang Bedah Catgut Plain 3/0 -100 m

Cassete

113

11

Benang Bedah Silk Black 3/0 -100 m

Cassete

113

12

Dental Film Hanshin

Pcs

113

13

Etanol 70 % - 1 L

Botol

10

115

14

Gel USG / EKG

Botol

113

15

Infusion Set Anak

Pcs

113

16

Infusion Set Dewasa

Pcs

10

115 EXP.10-17

17

IV. Catheter No.18 G

Set

10

115 Exp.jul-15

18

IV. Catheter No.20 G

Set

113

19

IV. Catheter No.22 G

Set

113

20

IV. Catheter No.24 G

Kotak

113

21

Jarum Jahit Bedah No. 9 s/d 14 (Kulit) - GT

Sach

22

Jarum Jahit Bedah No. 9 s/d 14 (Otot) - GR

Sach

23

Kapas Pembalut / absorben 250 gram

Bungkus

113

24

Kassa Hidrofil Steril uk. 16 x 16

Kotak

13

118

25

Kassa Hidrofil uk. 36 m x 40 cm / 40 yard x 80 cm

Roll

26

Kassa pembalut hidrofil 4m x 10 cm

Roll

113

27

Kasa Hidrofil ukuran 40 yard x 40 cm

Roll

113

28

Kertas EKG

Roll

113

29

Kertas USG Sony 110 HG

Roll

113

30

Larutan Clorin 5,25% - 1 L (Desinfektan Alat)

Botol

113
113

113
113

113

114

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

31

Larutan desinfectan ruangan mengandung : pine oil 7% dan Benzyl Chlorophenol 0,6%

Botol

32

Larutan antiseptik/ desinfektan handrub mengandung zat aktif dengan kadar minimal
Chlorhexidine Gluconate 0,5% ( Aseptan 500 cc + Dispenser)

Botol

113

113

33

Larutan konsentrat untuk Antiseptik dan desinfektan Instrumen/ peralatan kedokteran aldehyd
free (mengandung zat aktif: Cocospropilenediaminguanidine di acetat, surfaktan, parfumes,
coloring dsb).

Botol 1 ltr

8
113

34

Kassa steril mengandung obat (Framycetin) / Lomatulle

Lembar

35

Masker

36

Masker O2

Kotak

11

116

Pcs

37

113

Masker 95

Pcs

113

38

Masker nebulizer set dewasa

Pcs

114

39

Masker nebulizer set anak

Pcs

114

40

Plester 5 yard X 2 inch

Roll

113

41

Plester non alergi 0,5 inch / Micropore

Roll

11

116

42

Pot Urin

Pcs

113

43

Sarung Tangan

Kotak

10

115

44

Safety Box

Pcs

113

45

Surgical blade no.11 (Pisau Bedah)

Pcs

113

113

PEMERIKSAAN TB PARU

113

Emersi

Botol 100 ml

113

Eter Alkohol

Botol 100 ml

113

Kaca Slide / Object Glass

Kotak

113

Pot dahak

Pcs

113

Reagen Zielnelsen

Set

113

Spiritus Bakar

Botol

113

Tissu Lensa

Kotak

113

Tissue lensa

Buku

113

KET

NAMA OBAT
9

Wadah Kaca Slide / Box Slide

10
11

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

Pcs

113

Xylol/ Xylene

Botol 100 ml

113

Xylol/ Xylene

Botol 500 ml

113

113

EMBALAGE
1

Kantong Kresek obat + cetakan, ukuran 15 x 30

Lembar

Plastik Obat dg klip + cetakan, ukuran 7 x 10 cm

Pak /100lbr

48

Plastik Obat dg klip + cetakan, ukuran 10 x 15 cm

Pak /100lbr

28

Kertas Perkamen ( ukuran 8 x 11 )

Pak /1000lbr

12

Sendok obat

Pcs

108

213

113

AKUPUNTUR

113
153
133
117

Jarum Akupuntur 13 mm

Kotak

113

Jarum Akupuntur 25 mm

Kotak

113

Jarum Akupuntur 40 mm

Kotak

113

Jarum telinga (press needle)

Kotak

113

Moxa Roll

Kotak

113

113

Pcs

113

OBAT PONED
1

Apron plastik

Asam Traneksamat Injeksi 500 mg/ 5 ml / Hemostatik

Ampul

Fitomenadion (Vit. K ) Neonatal Injeksi 2 mg/ml / Vitka/ Vit. K Neonatal

Ampul

Fitomenadion (Vit. K) Dewasa injeksi 10 mg/ml

Ampul

Ikat Tali Pusat ( Umbilical Cord klem )

Pcs

Metilergometrin maleat injeksi 0,200 mg - 1 ml

Ampul

MgSO4 40% injeksi

Vial

113

Misoprostol tablet 0,2 mg / Noprostol

Tablet

113

Natrium Bicarbonat injeksi

Ampul

113

10

Nasal dewasa / Maxyflow

Pcs

113

113
113
113
113
113

KET

NAMA OBAT
11

Nasal infant/ Oxyflow

12

Oksitosin injeksi 10 IU/ml - 1 ml / Pitogin

13

Penghisap Lendir Bayi Baru Lahir

14

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

Pcs

Ampul

Pcs

113

Sarung Tangan panjang obgyn No. 6,5

Pasang

113

15

Sarung Tangan panjang obgyn No. 7

Pasang

113

16

Sarung Tangan panjang obgyn No. 7,5

Pasang

113

17

Sarung tangan steril/Surgical gloves steril No. 6,5

Pasang

18

Sarung tangan steril/Surgical gloves steril No. 7

Pasang

19

Sarung tangan steril/Surgical gloves steril No.7,5

Pasang

20

Sungkup bayi

Set

113

21

Tanda Pengenal (ID Band) Bayi

Psc

113

22

Tanda Pengenal (ID Band) Ibu

Psc

113

23

Under Pad 60 x 90 cm

Psc

113

24

Valethamate Br 8 mg /ml injeksi / Epidosin

Ampul

TAMBAHAN

113
113

113
113
113

113

113

Ambroksol tablet 30mg

Tablet

198

303

Asam Mefenamat Sirup - 60 ml / Pondex

Botol

113

Asering infus/ Larutan mengandung elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq, Asetat
28 mEq)

Botol

Asiklovir tablet 200 mg

Tablet

113

Bisacodyl 5 mg / Bicolax

Tablet

113

Biskodil sup 10 mg

Supp

113

Buskopan injeksi

Ampul

113

Bur Fissure standart

Pcs

113

Bur Fissure panjang

Pcs

113

10

Cetirizin HCl 10 mg

Tablet

113

11

Cetirizin syrup 100 mg / 5 ml

botol

113

113

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

12

Cefixim / sefiksim 100 mg caplet

kaplet

13

Etanol 96 % - 1 L

Botol

113

14

Gentian Violet larutan 1 %

Botol

113

15

Glucose Larutan Infus 10% Steril

Botol

113

16

Jarum Suntik No. 27 G

Pcs

113

17

Ketokonazole Krim 2%

Tube

113

18

Klindamisin kapsul 150 mg

Kapsul

13

118

19

Klindamisin 300 MG

Kapsul

113

20

Kasa Pembalut Hidrofil 4 m x 6 cm

Roll

113

21

Kasa 2x80

Roll

113

22

Kapas 500 gram

Bungkus

113

23

Larutan H2O2

Botol

113

24

Methilprednisolon 4 mg

tablet

113

25

Metoklopramid injeksi / Primperan

Vial

113

26

Metoklopramid tablet 10 mg / Metolon

Tablet

113

27

Metronidazol tablet 250 mg

Tablet

113

28

Meylon injeksi

Botol

113

29

Obat Batuk Pilek kaplet ( Dextromethorphan HBr 10 mg, Gliseril guayakolat 50 mg,
Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 1 mg ) / Dextral

Tablet

113

113
30

Obat Preparat Flebitis dan Varises ( Heparin 20.000 IU ) - 20 gr / Thrombophob

Tube

8
113

31

Obat tetes telinga kombinasi (( Polikmisin B sulfat 10.000 IU, NeomIsin sulfat 5 mg,
Fludrokortison asetat 1 mg, Lidokain Hcl 40 mg ) / Otopain / Otopraf

Botol

8
113

32

Obat analgetik (Antalgin 250 mg, Amidopyrin 50 mg, Lidocain HCl 10 mg)/Etamidon injeksi

Vial

33

Polymigel tablet 400 mg/Strocain P

Tablet

113

34

Propanolol tablet 40 mg (HCl)

Tablet

113

35

Ranitidin injeksi 25 mg/ml

Ampul

113

113

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

36

Saccaharine tablet

Tablet

37

Salep Kulti Anti Jamur ( Klotrimazole 1 % ) / Erphamazole

Tube

38

Sefadroxil syrup 125 mg

botol

113

39

Sianokobalamin (Vit B12) Inj Dewasa

Ampul

113

40

Teofilin tablet / Bronsolvan

Tablet

113

41

Terbutalin tablet 2,5 mg / Astherin

Tablet

OBAT KESDA

113
113

113

113
113

Kalium Diklofenak tablet 50 mg

tablet

Obat Tetes mata kombinasi antiseptik & kortikosteroid (Dexamethason Sod.Phosfate 1,0
mg, Neomycin Sulphate setara Neomycin base 3,5 mg, Polymixin B Sulfat 6000 IU) - 5 ml

tube

8
113

Obat Analgetik - antipiretik - batuk kaplet (Paracetamol 500 mg, Dextromethorphan HBr 15
mg, Phenylpropanolamine HCL 12,5 mg, Chlorpeniramine Maleat 2 mg, ) / Alpara

kaplet

8
113

Obat Analgetik kombinasi dengan Psikotropik kaplet (Metampiron 500 mg, Diazepam 2 mg)
/ Metaneuron

kaplet

Obat Analgetik - vitamin B kompleks kaplet (Parasetamol 500 mg, Vitamin B6 100 mg,
Vitamin B1 50 mg, Vitamin B12 100 mcg) / Erlagin

kaplet

8
113
8
113

Obat Antiinfluenza syrup ( Parasetamol 125 mg, Phenylprophanolamine HCl 3.125 mg,
Chlorpheniramine Maleate 0.5 mg ) - 60 ml / Molexflu sirup

botol

8
113

Obat Antiinfluenza kaplet ( Paracetamol 500 mg. Phenylpropanolamin HCl 12,5 mg+
Chlorpheniramin Maleat 2 mg ) / Molexflu kaplet

kaplet

8
113

Obat Antitusif - ekspektorant sirup ( Diphenhydramin HCl 12,5 mg+ Ammonium Chlorida 125
mg+ Sodium Citrat 50 mg+ Menthol 1 mg ) - 60 ml / Molexdryl sirup

botol

8
113

KET

NAMA OBAT

10

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

Obat dekongestan, antiinfluenza tablet (tripolidin HCl 2,5 mg, Pseudoefedrin HCl
30mg)/Flutrop

Obat Neuramialgikum tablet (Vit.B1 100 mg, Vit.B6 200 mg, Vit.B12 250 mcg )

8
113
tablet

8
113

11

12

Obat spasmodikum tablet (Metampiron 500 mg, Ekstrak Belladona 10 mg, Papaverin HCl 25
mg) / Spasminal

tablet

Obat Vasokonstriktor dan antihistamin tablet ( Phenylpropanolamin HCl 15 mg+


Chlorpheniramin Maleat 2 mg ) / Nalgestan

tablet

8
113
8
113

13

Salep kulit analgetika (Metil salilsilat 11%, Mentol 6%, Eugenol 1,5%) - 30 gr / Painkilla

tube

8
113

14

15

Salep kulit kombinasi antiinfeksi dgn kortikosteroid (Betamethasone 1 mg, Neomycin sulfat 5
mg) - 5 gr / Bevalex

tube

Vitamin B Komplek dengan Vit. C dosis tinggi Kaplet (Vit. B1 15 mg, Vit. B2 10 mg, Vit. B6 5
mg, Vit. B12 100 mcg, Vit. C 500 mg, Vit. E 30 mg, Ca. Pantothenate 20 mg, Nikotinamide 50
mg) / Becefort

kaplet

8
113

8
113

16

Larutan Antiseptik (ASEPTAN)/Desinfectan Handrub mengandung zat aktif dengan kadar


minimal ChlorhexidineGluconate 0,5 % (Aseptan 500 cc + Dispenser)

Botol

329

17

alkohol 100ml

Botol

(13)

92

18

famokresol

Botol

(13)

92

19

Alkohol Swab

105

20

Accu-check Performa 100 strip

105

21

Accu-check safe T-ProUno 200 Pc

105

22

Aquabidest Steril/AQUA PRO INJEKSI 500 ml (Pelarut Sediaan Injeksi, Pelarut Reagen
Laboratorium)

23

Eosin 2% - 100 ml

105

24

Hemoglobin C (Drabkin)

105

434

105

KET

NAMA OBAT

SATUAN
KEMASAN

STOK AWAL

STOK AKHIR

25

Kapiler Hematokrit Heparin

105

26

Na.Citrat 3,31%

105

27

Pewarnaan Gram (GRAM SET) 3x100ml

105

28

Tip Biru

105

29

Tip Kuning

105

30

Tabung SST With Gel Minimal 3 ml

105

31

TURK - 100 ml

105

32

Urin Strip 3 Parameter

105

Mengetahui,
Kepala Puskesmas Panunggangan

Petugas Pengelola Apotek

dr.Hj.Harmayahi,MPH
NIP.19770206 200604 2 019

NIP.198512119 200901 2 004

KET

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