4. Usulan Obat Januari 2016

7/25/2019 4. Usulan Obat Januari 2016

1/38

1/38

RENCANA KEBUTUHAN OBAT

BPJS 2016

PUSKESMAS : BELAWAN

BULAN : Januari

N Na!a O"a# Sa#uan1 2 3 4

1 A$"%n&a'$ (u()%n(i 200 !*/ + !$ "#$ 10 !$ ,-0,1.00

2 A$"%n&a'$ ,00 !* #a"$%#/a)$%#/a)(u$ #a"$%#/a)$%#/a)(u$ 3+0.00

3 A$)urin$ 100 !* #a"$%#/a)$%#/a)(u$ #a"$%#/a)$%#/a)(u$ 88.00

, A$)urin$ 300 !* #a"$%#/a)$%#/a)(u$ #a"$%#/a)$%#/a)(u$ 21.+0

+ A$ra'$a! 0-2+ !* #a"$%#/a)$%#/a)(u$ #a"$%#/a)$%#/a)(u$ ,10.00

6 A$ra'$a! 0-+ !* #a"$%#/a)$%#/a)(u$ #a"$%#/a)$%#/a)(u$ 180.00

A$ra'$a! 1 !* #a"$%#/a)$%#/a)(u$ #a"$%#/a)$%#/a)(u$ 233.00

8 A!in$in 200 !* #a" #a"$%# 82.00

A!in$in 1+0 !* #a" #a"$%# 82.0010 A!i#ri)#i$in 2+ !* #a"$%# (a$u# #a"$%# 11.00

11 A!$&i)in 10 !* #a"$%# 3,1.00

12 A!$&i)in + !* #a"$%# 12.00

13 A!(i(i$in 2+0 a)(u$/a)$%# a)(u$/ a)$%# 210.00

1, A!(i(i$in +00 a)(u$/a)$%#/#a"$%# #a"$%#/a)$%# 20.00

1+ A!(i(i$in (iru) %rin* r#% 2+0 !*/ + !$ "#$ 60 !$ ,-212.00

16 A!(i(i$in (iru) %rin* 12+ !*/ + !$ "#$ 60 !$ 2-+00.00

1 An#a(i&a 4OEN 5 #a"$%# una7- !"ina(i #a"$%# ,.00

18 An#a(i&a 4OEN 55 (u()%n(i "#$ 60 !$ 2-200.00

1 3-200.00

20 An#i "a#%ri 4OEN (a$%) !"ina(i #u"% + * 2-6,1.00

21#a"$%# +,6.00

22 An#i Mi*r%n #a"$%# 1,2.00

23 An#i Parin(n 4OEN #a"$%# 1-++.00

2, A(a! A(%#i$ Sa$i(i$a# a(%#(a$9 100 !* #a"$%# #a"$%# 122.00

2+ #a"$%# 1++.00

26 #a"$%# 1-++.00

2 A(a! A(r"a# i#a!in C9 #a"$%# 2+0 !* #a"$%# 1+.00

28 A(a! A(r"a# i#a!in C9 #a"$%# +0 !* #a"$%# 100.00

2 A(a! ;$a# #a"$%#/a)(u$/a)$%# 0-, !* #a"$%#/a)(u$/ a)$%# 3.00

30 A(a! ;$a# #a"$%#/a)(u$/a)$%# 1 !* #a"$%#/a)(u$/ a)$%# +0.00

31 A(a! M%%na!a# 2+0 !* a)(u$/ a)$%# a)(u$/ a)$%# 166.00

32 A(a! M%%na!a# +00 !* a)(u$/ a)$%# a)(u$/ a)$%# 116.00

33 A(i$ &u( +0 * 1-2+0.00

3 B%#a!%#a(n ri! 0-1> (%"a*ai a$%ra#9 #u"% + * 1-+20.00

38 Bi(a&i$ (u))(i#ria 10 !*/ S#$a= (u)) (u)) 6-0,+.00

3 Bi()r$$ #a"$%# 2-+ !*/ Cn?r 2-+ !* #a"$%# #a"$%# ,6.00

,0 Bi()r$$ #a"$%# + !* #a"$%# 66.00

,1 4%(a!%#a(n in@%(i i.


2/38

2/38

N Na!a O"a# Sa#uan

1 2 3 4

Har*aSa#uan

,8 4(i(i$in #a"$%#/a)(u$/a)$%# 100 !* #a"$%# 28+.00

, 4!)%ri&n (u()%n(i/(iru) + !*/+ ! "#$ 60 !$ 3-,10.00

+0 4!)%ri&n #a"$%# 10 !* #a"$%# 10.00

+1 E)in%rin A&r%na$in9 in@%(i i. ?airan "#$ 100 !$ 2-++.00


3/38

3/38

N Na!a O"a# Sa#uan

1 2 3 4

Har*aSa#uan

+6 Eu*%n$ ?airan "#$ 10 !$ 1-+00.00

+ ;%n"ar"i#a$ in@%(i i.!./i. "#$ 3-3+3.00

6 $i$a'i& #a" 30 !*/ 4ia!i?rn MR 30 #a"$%# 638.00

68 $i!%)iri&% #a"$%# 2 !* #a"$%# ,36.006 $i"%n$a!i& + !* #a" +8.00

0 $u(a $r# inu( +> "#$ +-,60.00

1 ri(%u$ #u"% + * 1-600.00

88 K$ra!%ni$ (a$%) u$i# 2>/ Bua?%#in (a$%) #u"% 1+ * 3-86.00

8#a"/a)$%#/ a)(u$ +3.00

0 K$r)r!a'in 100 !* #a" 1+8.00

1 K#ri!(a'$ 4OEN 5 &%a(a9 #a" 1,+.00

2 K#ri!(a'$ (u()%n(i "#$ 2-268.00

3 Lan()ra'$ 30 !* #a" ,3.00

, Li&ain !" %)in%rin in@%(i a!) 1-,31.00

+ Lra#a&in 10 !* #a" 16,.00

6 M%#r!in +00 #a" 11,.+0

M%#$)ra!i& 10 !* #a" 6.00

8 M%#$)ra!i& (iru) "#$ 2-800.00

M%#rni&a'$ 2+0 !* #a" 113.00

100 M%#rni&a'$ +00 !* #a" 16,.00

101 Mina'$ ri!/(a$%) 2 > Ni#ra#9 #u"% 10 * 3-000.00

102 Na#riu! 4i$%na 2+ !* #a" 1,0.00

103 Na#riu! 4i$%na +0 !* #a" 18+.00

10, Na#riu! K$ri&a $ar# inu( 0-> "#$ ,-3+.00

10+ Ni%&i)in 30 !*- r( #a" 3-+00.00

106 Ni(#a#in +00.000 5U/* #a" 62.00

10 O(i#(in in@%(i 10 5U/!$ in@%(i a!) 1-00.00108 O(i!%#a'$in #%#%( 7i&un* 0-02+>/ 5$$ia&in &r)( "#$ 10 !$ 28-28.00

10 O(i!%#a'$in #%#%( 7i&un* 0-0+>/ 5$$ia&in ()ra "#$ 1+ !$ 30-+00.00

ara! Ora$i# 5 (%r"u- !"ina(i : Na#riu! $ri&a0-+2 * a$iu! $ri&a 0-30 * Trina#riu! (i#ra#&i7i&ra# 0-+8 * $u(a An7i&ra# 2-0 *

K$r%nira!ina Ma$%a# CTM9 #a"$%#/a)(u$/a)$%# ,!*


4/38

,/38

N Na!a O"a# Sa#uan

1 2 3 4

Har*aSa#uan

110 Para(%#a!$ +00 !* #a" 8,.00

111 Para(%#a!$ (iru) 120 !*/ + !$ "#$ 1-,6.00

112 P D 30 !$ "#$ 2-2+0.00

113 P D 300 !$ "#$ 1,-1.00

11, Pr%&ni(n + !* #a" 11.0011+ Pr)i$#iura(i$ 100 !* #a" 33+.00


5/38

+/38

N Na!a O"a# Sa#uan

1 2 3 4

Har*aSa#uan

116 Rani#i&in 1+0 !* #a" 126.00

11 Rin*%r $a#a# $ar# inu( "#$ +-,60.00

118 Sa$"u#a!$ 2 !* #a" 62.00

11 Sa$"u#a!$ , !* #a" 8.00

120 Sa$%) 2, )# 30 * 2-100.00121 Siana"a$a!in i# B129 in@%(i +00 !?* a!) 1-132.00

122 Sian"a$a!in +0 !* #a" 60.00

123 Si! 1000 !$ B#$ 1 Li#%r 2-30+.00

13 On%!%& Ri


6/38

6/38

Pa"rian5 6 7

5n&ar!a 0 0.00

i!ia ar!a 0 0.00

)%r#ii a*un* 3-000 26,-000.00

)%r#ii a*un* 0 0.00

&%=a !%&ia 0 0.00

##) )7ar!a?%u#i?a$ 0 0.00

i!ia ar!a 0 0.00

%r%$a 2-000 16,-000.00

%r%$a 0 0.005n&ar!a 1-000 11-000.00

)%r#ii a*un* 8-000 2-28-000.00

)%r#ii a*un* 10-000 1-20-000.00

5n&ar!a 3-000 630-000.00

!%r(i TM 10-000 2-00-000.00

7$i ar!a 0 0.00

n


7/38

/38

Pa"rian

5 6 7

Ju!$a7K%"u#u7an

T#a$ Ju!$a7 Har*aSa#uan

arin& ar!a#a!a 0 0.00

n


8/38

8/38

Pa"rian

5 6 7

Ju!$a7K%"u#u7an


i!ia ar!a 0 0.00

)7a)r( 30 +6-00.00

5n&ar!a 1-000 231-000.00

)7a)r( 0 0.00

)7a)r( 3-000 1-80-000.00)7a)r( 100 3+8-200.00

5n&ar!a 3-000 282-000.00

)7a)r( 2-000 606-000.00

5n&ar!a 0 0.00

%r%$a 0 0.00

in&ar!a 100 33+-300.00

)ra&@a )7arin 0 0.00

i!ia ar!a 0 0.00in&ar!a 10-000 +80-000.00

i&a#ra "7a#i 0 0.00

in&ar!a 1-000 230-000.00

!%r(i TM 1-000 130-000.00

Ki!ia ;ar!a 100 2-800.00

in&ar!a 0 0.00

arin& 2-000 232-000.00

n


9/38

/38

Pa"rian

5 6 7

Ju!$a7K%"u#u7an


)r!%&ra7ar&@ 0 0.00

aar!a 1-200 1-+-200.00

aar!a 100 22+-000.00

aar!a 0 0.00

7$i )7ar!a 3-000 3+-000.00in&ar!a 2-000 60-000.00


10/38

10/38

Pa"rian

5 6 7

Ju!$a7K%"u#u7an


&%=a !%&i?a 10-000 1-260-000.00

i&a#ra "7a#i 101 ++1-,60.00

arin& ;ar!a#a!a +-000 310-000.00

Ki!ia ;ar!a 0 0.00

!arin $i'a ar!a(i 200 ,20-000.00Lu?a( 4@a@a 200 226-,00.00

aar!a 3-000 180-000.00

)%r#ii a*un* 10-000 1-,0-000.00

"%rnar! 10-+00 2-30-000.00

H$i ;ar!a 0 0.00

Aar!a 0 0.00

n


11/38

RENCANA KEBUTU

BPJS 201

PUSKESMAS : BELAWAN

BULAN : Januari

No Nama Umum Nama Dagang

1 2 4

1 Acyclovir cream Molavir

2 Alkohol 70% Alkohol 70%

3 Allupurinol 100 mg tab Selespurin 100 mg

4 Ambroxol 30 mg Intibrox 30 mg

Amok!i!ilin 12 mg" ml !irup kering Novamox syrup

# Amoxicilin 20 mg Arkamox

7 Antalgin 00 mg Novaron$ A!am A!korbat &it' () 0 mg Seles C 0 mg

* +e,ak -alicyl 2 % !e"ak Sali#yl $ %

10 +etahi!tin # mg !etahistin mg

11 +etameta!on 1 mg. Neomicyn mg !evalex

12 +loo,/ancet &'A

13 +romhexine . li!erilguaiacolat &raxine

14 (al!ium /aktat 00 mg Novakalk

1 (hloramenicol ete! ata 'rlami#etin ((M

1# ( 4 mg Selmetor ) mg

17 Diaepam mg *al"imex mg

1$ 5amoti,in 40 mg +a,i#o )0 mg

1* aram 6ralit ra!a eruk +amolit

20 entamicin !alep kulit gentalex -.

21 ri!eoulvin 12 mg tab &ri#in 1$ mg

22 8202 3 % /$0$ 3 %

23 8y,rokorti!on !alep exa#orton -.

24 9buproen 200 mg Novaxipen $00 mg

2 9buproen 400 mg Novaxipen )00 mg

2# 9buproen -yrup Novaxipen Syrup

27 :etokonaol 200 mg exa2ole $00 mg

2$ :loiramenicol 20 mg &ra,a#etin $0 mg

2* /i,okain inek!i ;ehacain 9nek!i

30 etormin 00 mg &lu"epati# 00 mg

31 etoklorpami, 10 mg *osea

32 etroni,aole 00 mg Novagyl

33 iconaole :rim Mola"erm -.

34 Natrium Dicloenac 2 +ena"ina# $ mg

3 Natrium Dicloenac 0 +ena"ina# 0 mg3# Nipe,ipin 10 mg armalat 10 mg

37 !/ !/

3$ ;iroxicam 20 mg &ra2eo $0 mg

3* ;yri,oxin 10 mg Sele"oxin 10 mg

,0


12/38

47

4$

4*

0

1

2

3


13/38

AN OBAT

:ema!an ;abrik 8arga :ema!an

5 6 7 8

ube olex *=$00 4 2*=200'00

+tl"1 liter olex";9 32=000 1# 12=000'00

+ox"100 ab -/5 71=$00 0 3=*0=000'00

+ox"100 eta 7=000 0 2=$0=000'00

+tl"#0 ml Nova 10=30 0 0'00

+ox"100 Armoxin,o 141=000 0 0'00

+ox"100 Nova 3*=00 20 7*0=000'00+tl"1000 -/5 12#=00 10 1=2#=000'00

;ot"100 gr ;9 #=000 0 0'00

+ox"30 Novel 2$=*00 30 $#7=000'00

ube gr olex Ayu! 11=300 #0 #7$=000'00

+ox"100 pc! >A 3=000 10 30=000'00

+ox"100 raha 3*=400 0 1=*70=000'00

+ox"100 Nova 2=$#0 0 0'00

+tl >rela 13=300 0 ##=000'00

+ox"100 -/5 31=000 20 #20=000'00

+ox"100 er!i 13*=10 $ 1=113=200'00

+ox"100


14/38

0 0'00

0 0'00

0 0'00

0 0'00

0 0'00

0 0'00

0 0'00


15/38


16/38

,3-623-2+0.00

1,-30+-200.00


17/38

RENCANA KEBUTUHAN OBAT 55

BPJS 2016

PUSKESMAS : BELAWAN

BULAN : Januari

No Nama Umum Nama Dagang :ema!an

1 2 4

1 (aviton hite 30 g Caviton 4hite +ox

2 >til (hlori,e !pray 'til Chlori"e (an" +tl

3 8emo!pon /emospon +ox"10

4 Nee,le 5or (arul (ranso"ent +ox"100 pc!

>lite (ement -ement Beng ;ho!pat ) 'lite Cement +ox"3"30 gr

# 5ui 9C inipack u5i I6 Minipa#k +ox

7 ixing ;a,! No' 22 Mixing a"s +ox"10

$ (elluloi, -trip Celluloi" Strip +ox

* -eptocain Septo"ont +ox"0 amp

10 Alvogyl Septo"ont box

11 umpatan


18/38

;abrik 8arga :ema!an ?umlah :ebutuhan

5 6 7 8

( (orp 30#=000 1 30#=000'00

;ro,uk luar 110=20 1 1=#3=70'00

ech Ne@ 12#=000 3 37$=000'00

ran!o,ent 234=000 1 3=10=000'00

( (orp 400=000 2=000=000'00

5ui #40=000 3=200=000'00

( (orp 11=000 3 34=000'00

Dentaire! 240=000 2 4$0=000'00

-epto,ont 700=000 3=00=000'00

-epto,ont 21=720 1=2$=#00'00

9ntro,uctory :it 2=#$#=700 1 2=#$#=700'00

0'00

0'00

0'00

0'00

0'000'00


19/38

268600

2-2-000.+0

,0300.+

3+.8

2++-,6

NAME

3-+6-300.00

R)6-36-+0.00

R),3-623-2+0.00


20/38

20/38

RENCANA KEBUTUHAN O

BPJS 2016

PUSKESMAS : BELAWAN

BULAN : @anuari

N Na!a O"a#1 2

1 A$"%n&a'$ (u()%n(i 200 !*/ + !$

2 A$"%n&a'$ ,00 !* #a"$%#/a)$%#/a)(u$

3 A$)urin$ 100 !* #a"$%#/a)$%#/a)(u$

, A$)urin$ 300 !* #a"$%#/a)$%#/a)(u$

+ A$ra'$a! 0-2+ !* #a"$%#/a)$%#/a)(u$

6 A$ra'$a! 0-+ !* #a"$%#/a)$%#/a)(u$

A$ra'$a! 1 !* #a"$%#/a)$%#/a)(u$

8 A!in$in 200 !* #a"

A!in$in 1+0 !* #a"10 A!i#ri)#i$in 2+ !* #a"$%# (a$u#

11 A!$&i)in 10 !*

12 A!$&i)in + !*

13 A!(i(i$in 2+0 a)(u$/a)$%#

1, A!(i(i$in +00 a)(u$/a)$%#/#a"$%#

1+ A!(i(i$in (iru) %rin* r#% 2+0 !*/ + !$

16 A!(i(i$in (iru) %rin* 12+ !*/ + !$

1 An#a(i&a 4OEN 5 #a"$%# una7- !"ina(i

18 An#a(i&a 4OEN 55 (u()%n(i

1

20 An#i "a#%ri 4OEN (a$%) !"ina(i

21

22 An#i Mi*r%n

23 An#i Parin(n 4OEN

2, A(a! A(%#i$ Sa$i(i$a# a(%#(a$9 100 !* #a"$%#

2+ A(a! A(%#i$ Sa$i(i$a# a(%#(a$9 80 !* #a"$%#/ Minia()i 80

26

2 A(a! A(r"a# i#a!in C9 #a"$%# 2+0 !*

28 A(a! A(r"a# i#a!in C9 #a"$%# +0 !*

2 A(a! ;$a# #a"$%#/a)(u$/a)$%# 0-, !*

30 A(a! ;$a# #a"$%#/a)(u$/a)$%# 1 !*

31 A(a! M%%na!a# 2+0 !* a)(u$/ a)$%#

32 A(a! M%%na!a# +00 !* a)(u$/ a)$%#

33 A(i$


21/38

21/38

N Na!a O"a#

1 2

,8 4(i(i$in #a"$%#/a)(u$/a)$%# 100 !*

, 4!)%ri&n (u()%n(i/(iru) + !*/+ !

+0 4!)%ri&n #a"$%# 10 !*

+1 E)in%rin A&r%na$in9 in@%(i i.


22/38

22/38

N Na!a O"a#

1 2

+6 Eu*%n$ ?airan

+ ;%n"ar"i#a$ in@%(i i.!./i.

1 ri(%u$ Ni#ra#9

102 Na#riu! 4i$%na 2+ !*

103 Na#riu! 4i$%na +0 !*

10, Na#riu! K$ri&a $ar# inu( 0->

10+ Ni%&i)in 30 !*- r(

106 Ni(#a#in +00.000 5U/*

10 O(i#(in in@%(i 10 5U/!$ in@%(i

108 O(i!%#a'$in #%#%( 7i&un* 0-02+>/ 5$$ia&in &r)(10 O(i!%#a'$in #%#%( 7i&un* 0-0+>/ 5$$ia&in ()ra

110 Para(%#a!$ +00 !*

ara! Ora$i# 5 (%r"u- !"ina(i : Na#riu! $ri&a 0-+2 *a$iu! $ri&a 0-30 * Trina#riu! (i#ra# &i7i&ra# 0-+8 * $u(aAn7i&ra# 2-0 *


23/38

23/38

N Na!a O"a#

1 2

111 Para(%#a!$ (iru) 120 !*/ + !$

112 P D 30 !$

113 P D 300 !$

11, Pr%&ni(n + !*

11+ Pr)i$#iura(i$ 100 !*


24/38

2,/38

N Na!a O"a#

1 2

116 Rani#i&in 1+0 !*

11 Rin*%r $a#a# $ar# inu(

118 Sa$"u#a!$ 2 !*

11 Sa$"u#a!$ , !*

120 Sa$%) 2,121 Siana"a$a!in i# B129 in@%(i +00 !?*

122 Sian"a$a!in +0 !*

123 Si!


25/38

2+/38

AT

Sa#uan3 6

"#$ 10 !$ 0

#a"$%#/a)$%#/a)(u$ 0

#a"$%#/a)$%#/a)(u$ 3-000

#a"$%#/a)$%#/a)(u$ 0

#a"$%#/a)$%#/a)(u$ 0

#a"$%#/a)$%#/a)(u$ 0

#a"$%#/a)$%#/a)(u$ 0

#a"$%# 2-000

#a"$%# 0#a"$%# 1-000

#a"$%# 8-000

#a"$%# 10-000

a)(u$/ a)$%# 3-000

#a"$%#/a)$%# 10-000

"#$ 60 !$ 0

"#$ 60 !$ +00

#a"$%# 8-000

"#$ 60 !$ 300

80

#u"% + * 0

#a"$%# 0

#a"$%# 0

#a"$%# 0

#a"$%# 0

#a"$%# 0

#a"$%# 0

#a"$%# 0

#a"$%# 0

#a"$%#/a)(u$/ a)$%# 0

#a"$%#/a)(u$/ a)$%# 8-000

a)(u$/ a)$%# 0

a)(u$/ a)$%# 10-000

#a"$%#/a)(u$/ a)$%# 0

#a"$%#/a)(u$/ a)$%# +-000

#a"$%# +-000

&u( +0 * 300

#u"% + * 200

(u)) +0

#a"$%# 0

#a"$%# 2-000

a!)u$ 80

a!)u$ 0

#a"$%#/a)(u$/ a)$%# 2-000

a!)u$ 0

#a"$%# 0

#a"$%# 0

#a"$%# 0

Ju!$a7

K%"u#u7an


26/38

26/38

Sa#uan

3 6

Ju!$a7K%"u#u7an

#a"$%# 0

"#$ 60 !$ 0

#a"$%# 1-200

a!)u$ 0

a)(u$/ a)$%# 0"#$ 60 !$ 0

a)(u$/ a)$%# 0

"#$ 100 !$ 0


27/38

2/38

Sa#uan

3 6

Ju!$a7K%"u#u7an

"#$ 10 !$ 0

a!)u$ 30

#a"$%#/a)(u$/ a)$%# 1-000

#a"$%# 0

#a"$%# 3-000a!)u$ 100

#a"$%# 3-000

(a 2-000

a)(u$/ a)$%# 0

#u"% 0

"#$ 100

#a"$%# 0

#a"$%# 0#a" 10-000

"#$ 0

#a" 1-000

#a"$%# 1-000

#u"% + * 100

"#$ 0

#a" 2-000

#a" ,-000

#a"$%#/a)(u$/ a)$%# 0

#a" +-000

#a" 0

#a" 8-000

#a" 2-000

"#$ 0

#a" 3-000

#u"% 10 * 200

#a" 2-000

#a" 2-000

#u"% + * 100

#u"% 1+ * 0

#a"/a)$%#/ a)(u$ 3-000

#a" 1-000

#a" 8-000

"#$ 1-000

#a" 3-000

a!) 80

#a" 2-000

#a" +-000

#a" 2-000

"#$ 0

#a" 0

#a" 3-000

#u"% 10 * 200

#a" 3-000

#a" 3-000

"#$ 80

#a" 0

#a" 0

a!) 0

"#$ 10 !$ 0"#$ 1+ !$ 0

#a" 0


28/38

28/38

Sa#uan

3 6

Ju!$a7K%"u#u7an

"#$ 1-200

"#$ 100

"#$ 0

#a" 3-000

#a" 2-000


29/38

2/38

Sa#uan

3 6

Ju!$a7K%"u#u7an

#a" 10-000

"#$ 101

#a" +-000

#a" 0

)# 30 * 200a!) 200

#a" 3-000

#a" 10-000

#a" 10-+00

a) 0

a) 0

#a" 0

#a" 0

#a" 3-000

#a" 1-000"#$ 30

"=/ 100 (%# +0

)?( 20

)?( 20

"=/ 100 )?( 30

)(* 30

&u( 0

r$$ 0

r$$ 0

"=/ 2, )?( 0

"=/ 36 )?( 0

"=/ +0 )?( 20

B#$ 1 Li#%r 0

B#$ 0

0

0

0

M%&an- ..........................

K%)a$a Pu(%(!a( B%$aan

&r. A&i Ra@a Bran& Lu"i(

Ni). 111126200312100,


30/38

RE

PUSKESMAS

BULAN

No Nama Umum1 2

1 Acyclovir cream

2 Alkohol 70%

3 Allupurinol 100 mg tab

4 Ambroxol 30 mg

Amok!i!ilin 12 mg" ml !irup kering

# Amoxicilin 20 mg

7 Antalgin 00 mg

$ A!am A!korbat &it' () 0 mg* +e,ak -alicyl 2 %

10 +etahi!tin # mg

11 +etameta!on 1 mg. Neomicyn mg

12 +loo,/ancet

13 +romhexine . li!erilguaiacolat

14 (al!ium /aktat 00 mg

1 (hloramenicol ete! ata

1# ( 4 mg

17 Diaepam mg

1$ 5amoti,in 40 mg

1* aram 6ralit ra!a eruk

20 entamicin !alep kulit

21 ri!eoulvin 12 mg tab

22 8202 3 %

23 8y,rokorti!on !alep

24 9buproen 200 mg

2 9buproen 400 mg

2# 9buproen -yrup

27 :etokonaol 200 mg

2$ :loiramenicol 20 mg

2* /i,okain inek!i

30 etormin 00 mg

31 etoklorpami, 10 mg

32 etroni,aole 00 mg

33 iconaole :rim

34 Natrium Dicloenac 2

3 Natrium Dicloenac 0

3# Nipe,ipin 10 mg37 !/

3$ ;iroxicam 20 mg

3* ;yri,oxin 10 mg

,0


31/38

4$

4*

0

1

2

3


32/38

CANA KEBUTUHAN OBAT

BPJS 2016

: BELAWAN

: Januari

Nama Dagang :ema!an ?umlah :ebutuhan4 7

Molavir ube 4

Alkohol 70% +tl"1 liter 1#

Selespurin 100 mg +ox"100 ab 0

Intibrox 30 mg +ox"100 0

Novamox syrup +tl"#0 ml 0

Arkamox +ox"100 0

Novaron +ox"100 20

Seles C 0 mg +tl"1000 10!e"ak Sali#yl $ % ;ot"100 gr 0

!etahistin mg +ox"30 30

!evalex ube gr #0

&'A +ox"100 pc! 10

&raxine +ox"100 0

Novakalk +ox"100 0

'rlami#etin ((M +tl 0

Selmetor ) mg +ox"100 20

*al"imex mg +ox"100 $

+a,i#o )0 mg +ox"100 20

+amolit +ox"100 !ak 0

gentalex -. ube gr #0

&ri#in 1$ mg +ox"100 0

/$0$ 3 % +tl"1 liter 1

exa#orton -. ube gr #0

Novaxipen $00 mg +ox"100 0

Novaxipen )00 mg +ox"100 0

Novaxipen Syrup +tl"#0 ml 0

exa2ole $00 mg +ox"30 tab 20

&ra,a#etin $0 mg +ox"100 10

;ehacain 9nek!i +ox"20 amp 0

&lu"epati# 00 mg +ox"100 #0

*osea +ox"100 20

Novagyl +ox"100 0

Mola"erm -. ube 10 mg 0

+ena"ina# $ mg +ox"100 30

+ena"ina# 0 mg +ox"100 30

armalat 10 mg +ox"100 30!/ +tl"100 ml 300

&ra2eo $0 mg +ox"100 #0

Sele"oxin 10 mg +tl"1000 10

+ivanol +tl"300 ml 10

&ara,alin $ mg +ox"100 20

&ra,alin ) mg +ox"100 20

Norpi" 10 mg +ox"30 tab 0

Seles !1 0 mg +tl"1000 10

'rlamy#etin tetes telinga +tl 00

0


33/38

0

0

0

0

0

0

e,an= ''''''''''''''''''''''''''

:epala ;u!ke!ma! +ela@an

,r' A,i


34/38


35/38

RE;

1,-30+-200.00


36/38

RENCANA KEBUTUHAN OBAT 55

BPJS 2016

PUSKESMAS : BELAWAN

BULAN : Januari

No Nama Umum Nama Dagang

1 2 4

1 (aviton hite 30 g Caviton 4hite

2 >til (hlori,e !pray 'til Chlori"e

3 8emo!pon /emospon

4 Nee,le 5or (arul (ranso"ent

>lite (ement -ement Beng ;ho!pat ) 'lite Cement

# 5ui 9C inipack u5i I6 Minipa#k

7 ixing ;a,! No' 22 Mixing a"s

$ (elluloi, -trip Celluloi" Strip

* -eptocain Septo"ont

10 Alvogyl Septo"ont

11 umpatan


37/38

:ema!an ?umlah :ebutuhan

7

+ox 1

(an" +tl 1

+ox"10 3

+ox"100 pc! 1

+ox"3"30 gr

+ox

+ox"10 3

+ox 2

+ox"0 amp

box

box"4!yringe 1

e,an= '''''''''''''''''''''''''' NAME

:epala ;u!ke!ma! +ela@an 3-+6-300.00

Err:+0

Err:+0

,r' A,i


38/38

268600

RE;

RE;

RE;

RE;

Documents

4. Usulan Obat Januari 2016