LAPORAN PENERIMAAN DAN PEMAKAIAN OBAT BPJS

PUSKESMAS : TRAGAH LAPORAN BUL

: FEBRUARI
KECAMATAN : TRAGAH TAHUN : 2025
KABUPATEN : BANGKALAN
PROPINSI : JAWA TIMUR
NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN
OBAT JKN
1 Acyclovir salep Ampul
2 Air untuk Injeksi 25 ml Tablet
3 Alopurinol tablet 100 mg Tablet
4 Alopurinol tablet 300 mg Tablet
5 Ambroxol Tablet Botol
6 Ambroxol syrup Tablet
7 Aminofilin Tablet Ampul
8 Aminofilin injeksi 24 mg/ml Tablet
9 Amitripyllin salut 25 mg Tablet
10 Amlodipin tablet 5 mg Vial
11 Amocixillin serbuk inj i.v 1000 mg / vial Botol
12 Amoksisilin sirup kering 125 mg/ 5 ml Botol
13 Amoksisilin sirup kering forte 250 mg/5 ml Tablet
14 Amoksisilin tablet 250 mg Tablet
15 Amoksisilin tablet 500 mg Tablet
16 Ampicillin 500 mg Botol
17 Ampicillin syrup kering 125mg Vial
18 Ampicillin serbuk inj i.v 1000 mg/ml Tablet
19 Antasida DOEN I tablet kunyah, kombinasi : Alumi Botol
20 Antasida DOEN II suspensi, kombinasi : Aluminium Tablet
21 Asam asetilsalisilat ( asetosal ) Tablet
22 Asam Askorbat (Vitamin C) tablet 250 mg Tablet
23 Asam Askorbat (Vitamin C) tablet 50 mg Kaplet ss
24 Asam Mefenamat kaplet 500 mg Ampul
25 Asam traneksamat injeksi 50 mg/ml Tablet
26 Asiklovir tablet 400 mg Tablet
27 Atapulgit tablet 600 mg Ampul
28 Atropin injeksi 0,25 mg/ml Botol
29 Atropin Sulfat tetes mata 0,5% Dus
30 Bedak salisil serbuk 2% tablet
31 Betahistin tab Tube
32 Betametason krim 0,1% (sebagai Valerat) supp
33 Bisakodil suppositoria 5 mg ( dulcolax supp ) supp
34 Bisakodil suppositoria 10 mg ( dulcolax supp ) Tablet
35 Bisoprolol tablet 2,5 mg ampul
36 Citicoline Botol
37 Cystone ( obat batu ginjal ) Ampul
38 Combivent UDV - Kombinasi : Ipratropium bromida in Ampul
39 Deksametason injeksi i.v./i.m. 5 mg/ml tablet
40 Deksametason tablet 0,5 mg Ampul
41 Diazepam larutan rektal 5 mg/2,5 mL ( Stesolid ) tablet
42 Diazepam tablet 5 mg Ampul
43 Diazepam inj Ampul
44 Difenhidramin injeksi i.v./i.m. Tablet
45 Digoksin tablet 0,25 mg tablet
46 Domperidon tablet 10 mg botol
47 Domperidon suspensi/sirup 5 mg/5 ml tablet
48 Dopamet tablet
49 Eritromisin kapsul 500 mg Botol
50 Eritromisin sirup kering 200 mg/ 5 ml vial
51 Esomeprazole sodium 40 mg / vial tablet
52 Etambutol tablet 500 mg Botol
53 Etanol 70% cairan Botol
54 Eugenol cairan tablet
55 Fitomenadion (Vit.K1) tablet salut gula 10 mg Ampul
56 Fitomenadion (Vitamin K1) injeksi i.m. 2 mg/ml Ampul
57 Furosemide inj tablet
58 Furosemide tablet 40 mg sach
59 Garam oralit I serbuk,kombinasi : Natrium klorida 0,5Ampul
60 Gentamisin injeksi 40 mg/ ml Tube
61 Gentamisin salep mata 0,3% Botol
62 Gentamisin tetes mata 0,3% Tube
63 Gentamicin salep kulit Botol
64 Gentian Violet 10ml Tablet
65 Glibenklamid tablet 5 mg Tablet
66 Glikazid tab 80 mg Tablet
67 Glimepiride tablet 1 mg Tablet
68 Glimepiride tablet 2 mg Tablet
69 Gliseryl Guaicolat / Guaifenesin Tablet Tablet
70 Glucodex tablet botol
71 Glukosa larutan infus 10 % steril botol
72 Glukosa larutan infus 5 % steril Botol
73 Glukosa larutan 40 % tablet
74 Griseofulvin tablet 125 mg tablet
75 Haloperidol tablet 0,5 mg tablet
76 Haloperidol tablet 1,5 mg Tube
77 Hidrokortison krim 2,5 % tablet
78 Hepagard Capsul ( kesehatan fungsi hati untuk pasietablet
79 Hidroklorotiazid 25 mg tablet
80 Hiosin butilbromid tab( SCOPMA ) tablet
81 Hiosin butilbromid injeksi 20 mg/ml ampul
82 Human tetanus imunoglobulinn injeksi i.m. 250 UI tablet
 83 Ibuprofen tablet 400 mg botol
84 Ibuprofen suspensi 200 mg/5 ml tablet
85 Isosorbid dinitrat 5 mg tablet
86 Kalsium Laktat (Kalk) tablet/kapsul/kaplet 500 mg tablet
87 Kaptopril tablet scored 12,5 mg tablet
88 Kaptopril tablet scored 25 mg tablet
89 Karbamazepin Tablet 200 mg supp
90 Ketoprofen suppositoria ( profenid ) Tube
91 Ketokonazol tablet 200 mg tablet
92 Ketokonazol krim 2% Tablet
93 Kloramfenikol kapsul 500 mg Tube
94 Kloramfenikol salep mata 1 % Botol
95 Klorampenikol TT ( Reco TT ) tablet
96 Klorfeniramina Maleat (CTM) 4 mg Tablet
97 Klorpromazin Tablet 100 mg Tablet
98 Kodein tablet 10 mg Tablet
99 Komb. Bronhexin Hcl 8mg, Diphenhidramin Hcl 25mgBotol
100 Komb. Parasetamol 125 mg, CTM 0.5 mg, PPA 3,125Ampul
101 Komb. Vit Neurotropik 5000 injeksi vit BI 100mg, vi Tablet
102 Komb. Vit Neurotropik tablet vit BI 100mg, vit B6 Tablet
103 Komb.Besi II Fumarat 300mg, Mangan sulfat 0,4mg, Tt ablet
104 Komb.Multivitamin Syr Curcuminoid 6mg,VitA,D,B1,botol
105 Komb.Obat Batuk Hitam Syr, Succus liguiritiac 50 Tablet
106 Komb. Calsium Lactat 250mg, Fe90mg, as.Folat, multiTablet
107 Komb. Multivitamin Vit B1 15 mg, Vit B2 10 mg, Vit tablet
108 Komb. Obat Flu Paracetamol 500mg, Tripolidine 2, tablet
109 Komb. Obat pilek Tab./Komb. Tripolidine 2,5 mg, Ps tablet
110 Komb. Tramodol Hcl 37, Paracetamol 325 mg. Tramptablet
111 Komb.Vit. Neurotropik, Vit.E, ATP; Bio ATP, tablet
112 Komb. Metamizol 500 mg dan diazepam 2 mg; Met tablet
113 Kombinasi tetes mata 2,5 mg/ml : Natrium klorida 8,tablet
114 Kotrimoksazol (dewasa) kombinasi : SulfametoksazoBotol
115 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 botol
116 Larutan mengandung Elektrolit ( Na 130 mEq,Cl 109 botol
117 Larutan mengandung Asam Amino (Asam Amino 30 g, botol
G
118 Larutan Mengandung karbohidrat + elektrolit (Nacl 1,Botol
119 Larutan mengandung Elektrolit ( Tiap 1000 ml mengaBotol
120 Laxadin syrup Ampul
121 Lidokain injeksi 2% tablet
122 Loperamid tablet 2 mg tablet
123 Loratadine 10 mg botol
124 Magnesium sulfat injeksi 20% botol
125 Magnesium sulfat injeksi 40% Ampul
126 Metamizol Sodium 500mg vial
127 Metamizol Sodium Liquid injeksi 500mg/1ml; Norages Tablet
128 Metampiron 500mg, Piramidon 75mg, lidocain HCL 20 Tablet
129 Metampiron 500mg Tablet
130 Metformin HCl tablet 500 mg ampul
131 Metilergometrin Maleat tablet salut 0,125 mg tablet
132 Metilergometrin inj 0,2 mg/ml tablet
133 Metilprednisolon tablet 4 mg Botol
134 Metilprednisolon tablett 8 mg Tablet
135 Metoklopramide sirup 5 mg/ 5 ml ampul
136 Metoklopramide tablet 5 mg tablet
137 Metoclopamide injeksi botol
138 Metronidazol tablet 500 mg tube
139 Metronidazol infus 500 mg/100 ml botol
140 Mikonazol krim/salep 2 % (Nitrat) tablet
141 Modified fluid gelatin BM 3000 lar inf 4 % ; Gelofusintablet
142 Nifedipin tablet 10 mg botol
143 Nifedipin tablet 30 mg, Adalat Oros tablet
144 Nacl 0,9% tablet
145 Natrium Diklofenak tablet 25 mg tablet
146 Natrium Diklofenak tablet 50 mg Botol
147 Nistatin Tablet botoll
148 Nistatin Drop Ampul
149 Ofloksasin tetes telinga 3 % Ampul
150 Oksitosin inj 10 IU/ml Kaplet ss
151 Omperazol injeksi Ampul
152 Omeprazol kapsul/ kaplet 20 mg tablet
153 Ondansetron inj 2 mg/ 2 mL ( 4mg/2ml ) tube
154 Ondansetron tablet 4 mg botol
155 Oxytetraxiliin salep kulit Tablet
156 Parasetamol sirup 120 mg / 5 ml botol
157 Parasetamol tablet 500 mg Ampul
158 Parasetamol tetes 60 mg/ 0,6 ml Tablet
159 Phenobarbital injeksi tube
160 Phenobarbital 30 mg Tablet
161 Permetrin krim 5% ; Scabimide Cream ampul
162 Piracetam 400 mg tablet
163 Piracetam 3 g injeksi Tablet
164 Pirantel tablet 125 mg Tablet
165 Piroxicam 20 mg Tablet
166 Piridoksin (Vitamin B6) tablet 10 mg (HCl) Tablet
167 Prednison tablet 5 mg Tablet
168 Propanolol tablet 10 mg ( HCl ) vial
169 Propanolol tablet 40 mg ( HCl ) Ampul
170 Prokain Benzilpenisilin injeksi tablet
171 Ranitidin injeksi 25 mg/ml tablet
172 Ranitidin tablet 150 mg botol
173 Rifampicin 450 mg Botol
174 Ringer Laktat larutan infus Vial
175 Salbutamol cairan ih 0,1 % Ventolin nebul tablet
176 Salbutamol inhalasi/aerosol 100 mcg/dosis ( Ventolintube
177 Salbutamol tablet 2 mg (sebagai Sulfat) kapsul
178 Salep 2-4 , Kombinasi : Asam Salisilat 2% + Beleran botol
179 Sefadroksil kapsul/kaplet 500 mg Kaplet ss
180 Sefadroksil sirup kering 125 mg/5ml botol
181 Sefiksim kapsul/kaplet 100 mg vial
182 Sefiksim sirup kering 100 mg/ 5 ml vial
183 Sefotaksim injeksi 1 g Kaplet ss
184 Seftriakson serbuk injeksi 1 g/vial botol
185 Setirizin 10 mg Tablet vial
186 Setirizin sirup 5 mg/5 ml ampul
187 Serum Anti Bisa Ular I Inj.5 ml ( ABU I ) ampul
188 Serum Anti Antitetanus 1.500 UI ( ATS ) tablet
189 Sianokobalamin (vitamin B12) injeksi tablet
190 Simvastatin tablet 10 mg tablet
191 Simvastatin tablet 20 mg botol
192 Siprofloksasin tablet scored 500 mg tablet
193 Siprofloksasin infus 2 % botol
194 Spironolakton 25 mg kapsul
195 Sukralfat susp 500 mg/5 mL kapsul
196 Tetrasiklin tablet/kapsul/kaplet 250 mg Tablet
197 Tetrasiklin tablet/kapsul/kaplet 500 mg Ampul
198 Terbutalin 2,5 mg tablet
199 Tramadol injeksi 50 mg/ml Ampul
200 Thiamin tablet ( Vit B1 ) tablet
201 Thiamin inj ( Vit B1 ) botol
202 Thiamphenicol 500mg tablet
203 Thiamphenicol syrup botol
204 Vitamin B Kompleks tablet botol
205 Zinc sir 10 mg/mL tablet
206 Zinc drop 10 mg/mL 0
207 Zinc Tablet dispersible 20 mg 0
208 Erlamycitin 1% salep mata 0
209 Vitalex kapsul 0
210 Gemfibrozil 0
211 Tetagam
212 Lanzoprazole
213 Phcain inj
214 Tera F
215 L Bio
216 RD5
OBAT dan BAHAN PERAWATAN GIGI Box
 1 Bonding Set
2 Artikulating Paper Box'50Ampul
3 Calpul citojeck Btl
4 Ch Km Box'10
5 Curaspon Box'20s
6 Dental Needle Pcs
7 Devitalisasi Pasta Set
8 Diamond Bor / Mata Bor Box
9 Ethca btl
10 Etil Klorida Semprot Botol 10 ml
11 Eugenol cairan pcs
12 Formokresol pcs
13 Glass Ionomer Cement Botol
14 H2O2 100ml Botol
15 H2O2 800ml Pcs
16 Kalsium Hidroksida Pasta Set
17 Komposit / Tumpatan dengan sinar / Lightcure Pcs
18 Mumifikasi Pasta Box
19 OCO (Pembersih karang gigi) Set
20 Polising Bor Pcs
21 Semen seng fosfat Set
22 Topical Floridasi / Preventive Carries Box
23 Tumpatan Sementara 0
BAHAN MEDIS HABIS PAKAI
1 Alat suntik sekali pakai 1 ml pcs
2 Alat suntik sekali pakai 3 ml pcs
3 Alat suntik sekali pakai 5 ml Pcs
4 Alat suntik sekali pakai 20 ml box
5 Alkohol Swab /100 pcz botol
6 Antiseptik Hand Rub 10 btl@ 500ml box
7 blood lancet pcs
8 Catgut Benang Bedah Plain 3/0HR 20 /37 pcs
9 Cathejell Lidocain 2% & CHG 0.05% pcs
10 Cucicell Classic 10 cm x 10 cm /Soffratulle pcs
11 Cutimed Sorbact Swab 7cm x 9cm pcs
12 Duoderm hydroactive gel 15 gr pcs
13 FolLey Chateter No. 14 pcs
14 FolLey Chateter No. 16 pcs
15 FolLey Chateter No.18 pcs
16 Handscoon Non Steril S pcs
17 Handscoon Non Steril M pcs
18 Handscoon Steril pcs
19 Infus Set, IV, Wing Neddle - Infusion Set Dewasa ( 20pcs
20 Infus Set, IV, Wing Neddle - Infusion Set Pediatric ( pcs
21 Jarum Jahit pcs
22 jell cateter dus
23 Kapas Pembalut hydrofil 250 gr pcs
24 Kasa Hydrofil steril 16 x16 cm pcs
25 Kasa pembalut hidrofil 2 x 80 cm pcs
26 Kasa pembalut hidrofil 4 x 10 cm pcs
27 Kasa pembalut hidrofil 4 x 5 cm pcs
28 Kasa pembalut hidrofil 4 x 80 cm pcs
29 Kasa pembalut hidrofil 4 x15 cm pcs
30 Leukomed IV Film pcs
31 Masker / box pcs
32 Masker Nebulizer Anak (M) pcs
33 Masker Nebulizer Dewasa (L) pcs
34 Medicut No. 18 pcs
35 Medicut No. 20 pcs
36 Medicut No. 22 pcs
37 Medicut No. 24 pcs
38 Mess/ Pisau Bedah pcs
39 Mucus extrator pcs
40 Nasal Anak - Nasal Oksigen, O2 cannula, size M pcs
41 Nasal Anak - Nasal Oksigen, O2 cannula, size S pcs
42 Nasal Anak - Nasal Oksigen, O2 cannula, size XS pcs
43 Nasal Dewasa - Nasal Oksigen,O2 cannula, size L pcs
44 Oksigen Masker Anak pcs
45 Oksigen Masker Dewasa pcs
46 Pharmafix Dos
47 plester 2,5 cm x 4,5 cm Dos
48 Sarung tangan obgyn botol
49 Silk Black 3/0 DS 24/biji botol
50 Strip asam urat botol
51 strip colesterol pcs
52 Strip Gula darah pcs
53 Stomach Tube FR 12 / NGT pcs
54 Stomach Tube FR 16 / NGT Pcs
55 Suction Catheter FR 12 / 16 box
56 Surgical Tape 1" ( Plaster /Leukoplast) Pcs
57 Test kehamilan Pcs
58 Umbilical Clamp Pcs
59 Underpad Pcs
60 Urine Bag Pcs
61 Jarum No.22 (Needle) botol
62 Jarum No.27 (Needle) botol
63 Urinoir Platik pcs
64 Tabung EDTA Botol
65 Medicut No. 26 Botol
66 H2O2 500 ml botol
 67 Lyse Medonic 5 LTR (900 cycles)
68 Handscoon L
Strip HB
1 TAMABAHAN
2 Master Flow (warna A3) botol
3 Etchant Gel Vial 9 Ml botol
4 Fuji IX botol
5 Tricresol Formalina botol
6 Cal LC botol
7 Caviton White botol
8 Paramono Clorofenol botol
9 Master Bond botol
10 Adper Single Bond 2 pcs
11 Silk Black 12 Pcs
RD 5%

MENGETAHUI
KEPALA PUSKESMAS TRAGAH

VIVIN SUFIANTI,S.ST.Bd
NIP: 197406152007012008
 JUMLAH KUNJUNGAN

PERSEDIAAN PEMAKAIAN SISA STOK