lplpo pustu & polindes
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT( LPLPO )
PUSTU DAN POLINDES/PONKESDESNAMA PUSKESMAS : BANGILPUSTU/POLINDES :……………………….KECAMATAN : BANGILKABUPATEN : PASURUANPROPINSI : JAWA TIMUR
NO NAMA OBAT SATUANSTOK PENERI- PERSE- PEMA- SISA STOK
AWAL MAAN DIAAN KAIAN STOK OPT1 2 3 4 5 6 =(4+5) 7 8=(6-7) 9
Generik PKD1 A003 Aminoflin Injeksi 24 mg/ll Ampul 10 ml2 A004 Aminoflin Tablet 200 mg Tablet3 A006 Amoksisillin Kaplet 500 mg Kaplet4 A007 Amoksisillin Si up Ke ing 125 mg/5 ml !otol 60 ml5 A00" Antasi#a $%&' Tablet Kun(a) Tablet6 A010 Anti *ungi $%&' Kombinasi +ot7 A014 Asam Asko bat Tablet 50 mg Tablet" A015 Asam ,e-enamat Kaplet 500 mg Kaplet. A022 $eksametason Injeksi i 5 mg/ml Ampul 2 ml
10 A023 $eksametason Tablet 0 5 mg Tablet11 A02. $i-en)i# amin Injeksi i m 10 mg/ml l Ampul 2 ml
12 A032 $imen)i# inat Tablet 50 mg Tablet13 A036 &fne- in A# enalin Injeksi 0 1 Ampul 2 ml14 A037 &kst aks !ella#on Tablet 10 mg Tablet15 A04" *itomena#ion it K1 Injeksi 10 mg/ml Ampul 1 ml16 A04. *itomena#ion it K1 Tablet 10 mg Tablet17 A052 8a am % alit Se buk Sa9)et1" A056 8entian iolet :a utan 1 !otol 10 ml1. A05" 8lise il 8uaiakolat Tablet 100 mg Tablet20 A062 8lukosa :a utan In-us 5 Ste il !otol 500 ml21 A063 8 iseo-ul in Tablet 125 mg Tablet22 A06" i# oko tison K im 2 5 Tube23 A06. Ibup o-en Tablet 200 mg Tablet24 A070 Ibup o-en Tablet 400 mg Tablet25 A072 Kalsium :aktat Kalk Tablet 500 mg Tablet26 A073 Kaptop il Tablet 25 mg;; Tablet27 A07. Klo am-enikol Tetes ,ata 0 5 !otol 5 ml
l k l l
KodeObat
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Kl ik l T T li 3
NO NAMA OBAT SATUANSTOK PENERI- PERSE- PEMA- SISA STOK
AWAL MAAN DIAAN KAIAN STOK OPT1 2 3 4 5 6 =(4+5) 7 8=(6-7) 9
KodeObat
30 A0"7 Kot imoksa
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NO NAMA OBAT SATUANSTOK PENERI- PERSE- PEMA- SISA ST
AWAL MAAN DIAAN KAIAN STOK O1 2 3 4 5 6 =(4+5) 7 8=(6-7)
KodeObat
Per&eka'an Ke%e a an64 %001 Alat Suntik 0 05 ml Set65 %002 Alat Suntik 0 5 ml Set66 %003 Alat Suntik 1 ml Set67 %004 Alat Suntik 10 ml Set6" %005 Alat Suntik 2 5 ml Set6. %006 Alat Suntik 20 ml Set70 %007 Alat Suntik 5 ml Set71 %00" Alat Suntik 50 ml Set72 %012 !a(9lin !otol 100 ml73 %014 atgut / !enang !e#a) Sa9)et
74 %016 &tanol 70 100 ml !otol75 %017 &tanol 70 1000 ml !otol76 %021 an#s9)oon 'onste il !iji77 %022 an#s9)oon Ste il Set7" %025 I at)ete Set7. %026 In-usion Set Anak Set"0 %027 In-usion Set $e=asa Set"1 %030 Kapas 250 g !ungkus"2 %033
Kasa 2 m B "0 9m!iji
"3 %035 Kasa Ste il 16 C 16 Kotak"4 %036 Kasa e ban 4 m B 10 9m >ol"5 %037 Kasa e ban 4 m B 15 9m >ol"6 %03" Kasa e ban 4 m B 3 9m >ol"7 %03. Kasa e ban 4 m B 5 9m >ol"" %051 +o i#on Io#i#a 10 30 ml !otol 30 ml". %052 +o i#on Io#i#a 10 300 ml !otol 300 ml.0 %056 Sen#ok +lastik !iji.1 %057 Silk !enang Sut a >ol >ol.2 %05" Silk !enang Sut a Sa9)et Sa9)et
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NO NAMA OBAT SATUANSTOK PENERI- PERSE- PEMA- SISA S
AWAL MAAN DIAAN KAIAN STOK1 2 3 4 5 6 =(4+5) 7 8=(6-7)
KodeObat
1
2 Denis %bat K! (ang #ise#iakan #isesuaikan #engan p og am peme inta)
3
Kunjungan >esep!a(a ASK&S Damkesmas Total
,elapo kan / ,eminta obat ,engeta)ui / ,en(etujuitanggalEEEEEEEEEEEEEE Kepala +T$ +uskesmas !angil +etugas %bat
( r.Ar!" K#rn!ant$ % ( A"ra&' S. ar). A'I+ 1.6.021" 200012 1 003 'I+ 1."4042. 201001 1
;; F Kaptop il )an(a untuk pasien pengobatan lanjutan (ang sebelumn(a tela) men#apatkan te api anti)ipe tensi #a i puskesmas in#uk
+ustu/ +olin#es/ +onkes#es bole) men(e#iakan semua jenis aksin ke9uali aksin ! 8 #an ampak #engan s(a at apabila memiliki tempat pen(impanan aksin (ang sesuai stan#a su)u 2?"
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BULAN : ……………….TA+UN : ………………
KEGUNAAN OBAT
12
Obat Emergency Syok Anafilaktik
Bronkodilator (anti sesak)
Antibiotik
AntibiotikObat Gastritis
Antifungi
Roborantia/ Suplemen / Vitamin
Analgesik
Syok Anafilaktik (pengganti idrokortison in!)
"ortikosteroid oral
Obat Emergency Syok Anafilaktik
Antiemetik
Obat Emergency Syok Anafilaktik
Antispasmodik
"oagulansia
"oagulansia
Serbuk Re idrasi
Obat Saria#an
Eksapektoran (Obat Batuk)
$airan infus
Antifungi"ortikosteroid %opikal
Antipiretik
Antipiretik
Roborantia/ Suplemen / Vitamin
Anti &ipertensi
Obat 'ata
Obat %elinga
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KEGUNAAN OBAT
12
Antibiotik
Antibiotik
Anastesi okal
AnalgesikAntibiotik
Antibiotik
Eksapektoran (Obat Batuk)
Obat 'ata
Antispasmodik
Antipiretik
Antipiretik
Antipiretik
Roborantia/ Suplemen / Vitamin$airan infus
Antifungi
Bedak %abur
Obat 'ata
Antibiotik
Roborantia/ Suplemen / Vitamin
Roborantia/ Suplemen / Vitamin
Anti &ipertensi
Antidiare
Antidiare
Roborantia/ Suplemen / Vitamin
Antidiare
"oagulansia
terotonikterotonik
terotonik
Roborantia/ Suplemen / Vitamin
Roborantia/ Suplemen / Vitamin
Roborantia/ Suplemen / Vitamin
Roborantia/ Suplemen / Vitamin
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KEGUNAAN OBAT
12
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
+isinfektan
*erbekalan "ese atan &abis *akai
+isinfektan
+isinfektan*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*engganti ,- . ,- steril
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
$airan Antiinfeksi okal
$airan Antiinfeksi okal
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
*erbekalan "ese atan &abis *akai
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KEGUNAAN OBAT
12
+ene ima
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT TAHUN 20 2UPTD KESEHATAN PUSKESMAS !e KABUPATEN PASURUAN
NO Kode Obat NAMA OBAT SATUAN
1 2 3 4
Generik PKD
1 A001 Alopurinol Tablet 100 mg Tablet2 A002 Ambroxol Tablet 30 mg Tablet
3 A003 Aminofilin Injeksi 24 mg/ll Ampul 10 ml
4 A004 Aminofilin Tablet 200 mg Tablet
5 A005 Amitrip tilin Tablet Salut 25 mg Tablet
A00 Amoksisillin !aplet 500 mg !aplet
" A00" Amoksisill in Sirup !ering 125 mg/5 ml #otol 0 ml
$ A00$ Antasi%a &'() Tablet !un*a+ Tablet
, A00, Anti #akteri &'() Salep Tube
10 A010 Anti -ungi &'() !ombinasi .ot
11 A011 Anti emoroi% &'() !ombinasi Suppositoria
12 A012 Anti igrain/(rgotamin Tablet
13 A013 A ua .ro Inj #otol 25 ml
14 A014 Asam Askorbat Table t 50 mg Tablet
15 A015 Asam efenamat !aplet 500 mg !aplet
1 A01 Asetosal Tablet 100 mg Tablet
1" A01" Asiklo ir !rim 5 Tube
1$ A01$ Asiklo ir Tablet 400 mg Tablet1, A01, Atropin Sulfat Injeksi 0 25 mg/ml Ampul 2 ml
20 A020 Atropin Sulfat Table t 0 5 mg Tablet
21 A021 #etametason !rim 0 1 Tube
22 A022 &eksametason Injeksi i 5 mg/ml Ampul 2 ml
23 A023 &eksametason Tablet 0 5 mg Tablet
24 A024 &ekstrometorfan Sirup 10 mg/5 ml #otol 0 ml
25 A025 &ekstrometorfan Tablet 15 mg Tablet
2 A02 &ia6epam Injeksi 5 mg/ml Ampul 2 ml
2" A02" &ia6epam Tablet 2 mg Tablet
2$ A02$ &ia6epam Tablet 5 mg Tablet
2, A02, &ifen+i%ramin Injeksi i m 10 mg/ml 7 8l9 Ampul 2 ml
30 A030 &igoksin Tablet 0 25 mg Tablet
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NO Kode Obat NAMA OBAT SATUAN
31 A031 &ilt ia6em 8l Tablet 30 mg Tablet
32 A032 &imen+i%rinat Tablet 50 mg Tablet
33 A033 &oksisiklin !apsul 100 mg !apsul
34 A034 &omperi%on Tablet 10 mg Tablet
35 A035 (fe%rin Tablet 25 mg 7 8l9 Tablet
3 A03 (finefrin 7A%renalin9 Injeksi 0 1 Ampul 2 ml
3" A03" (kstraks #ella%on Tablet 10 mg Tablet
3$ A03$ (ritromisin !apsul 250 mg !apsul
3, A03, (ritromisin Sirup 200 mg/5 ml #otol 0 ml
40 A040 -enitoin !apsul 100 mg !apsul
41 A041 -enitoin !apsul 30 mg !apsul
42 A042 -enitoin )atrium Injeksi 50 mg/ml Ampul 2 ml
43 A043 -enobarbital Injeksi i m/i 50 mg/ml Ampul 1 ml
44 A044 -enobarbital Tablet 100 mg Tablet45 A045 -enobarbital Tablet 30 mg Tablet
4 A04 -enoksimetil .enisillin Tablet 500 mg Tablet
4" A04" -enol :l iserol Tetes Telinga 10 #otol 5 ml
4$ A04$ -itomena%ion 7;it !19 Injeksi 10 mg/ml Ampul 1 ml
4, A04, -itomena%ion 7;it !19 Tablet 10 mg Tablet
50 A050 -urosemi% Tablet 40 mg Tablet
51 A051 :ameksan
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NO Kode Obat NAMA OBAT SATUAN
A0 aloperi%ol Tablet 5 mg Tablet
" A0 " i%roklorot+ia6i%a 7 8T9 Tablet 25 mg Tablet
$ A0 $ i%rokortison !rim 2 5 Tube
, A0 , Ibuprofen Tablet 200 mg Tablet
"0 A0"0 Ibuprofen Tablet 400 mg Tablet
"1 A0"1 Isosorbi% &initrat Tablet Sublingual 5 mg Tablet
"2 A0"2 !alsium
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NO Kode Obat NAMA OBAT SATUAN
101 A101 )istatin ;agina Tablet 100 000 iu Tab;ag
102 A102 'bat #atuk itam 7'# 9 =airan #otol 100 ml
103 A103 'ksitetrasiklin 8l Salep !ulit 3 Tube
104 A104 'ksitetrasiklin 8l Salep ata 1 Tube
105 A105 .apa erin Injeksi 40 mg/ml Ampul 1 ml
10 A10 .apa erin Tablet 40 mg Tablet
10" A10" .araformal%e+i% Tablet 1 gram Tablet
10$ A10$ .arasetamol Sirup 120 mg/5 ml #otol 0 ml
10, A10, .arasetamol tablet 100 mg Tablet
110 A110 .arasetamol tablet 500 mg Tablet
111 A111 .eti%in Injeksi Ampul
112 A112 .iri%oksin 7;itamin # 9 tablet 10 mg 7 8l9 Tablet
113 A113 .re%nison Tablet 5 mg Tablet
114 A114 .ropanolol Tablet 10 mg Tablet115 A115 .ropanolol Tablet 40 mg Tablet
11 A11 .ropiltiourasil tablet 100 mg Tablet
11" A11" ?aniti%ine Tablet 150 mg Tablet
11$ A11$ ?eserpin Tablet 0 10 mg Tablet
11, A11, ?eserpin Tablet 0 25 mg Tablet
120 A120 ?inger
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NO Kode Obat NAMA OBAT SATUAN
13 A13 Tiamin 7;itamin #19 Injeksi 100 mg/ml Ampul 1 ml
13" A13" Tri+eksifeni%il Tablet 2 mg Tablet
13$ A13$ ;itamin # !ompleks Injeksi ;ial
13, A13, ;itamin # !ompleks Tablet Tablet
140 A140 in= 'xi%e Salep .ot
141 A141 !aptopril Tablet 12 5 mg Tablet
142 A142 (ritromisin !apsul 500 mg !apsul
Generik Penunjang PKD143 #001 Alpra6olam Tablet 0 5 mg Tablet
144 #002 Ambroxol Sirup 15 mg/ml #otol 0 ml
145 #003 Amoksisillin Serbuk Injeksi 1000 mg / Bi%e=illin ;ial
14 #004 Antasi%a &'() Suspensi #otol 0 ml
14" #005 Asam -olat Tablet 1 mg / Anemolat Tablet
14$ #00 #eta+istin esilat Tablet mg Tablet14, #00" #rom+eksin Sirup / osa on Sir #otol 0 ml
150 #00$ #rom+eksin Tablet $ mg / )o a+eksin Tablet
151 #00, 8etiri6ine Tablet 10 mg Tablet
152 #010 8lobetasol !rim 0 05 / Ika%erm !rim Tube
153 #011 &omperi%on Suspensi 5 mg/5 ml #otol 0 ml
154 #012 -urosemi% Injeksi i /i m 10 mg/ml / Silax Ampul 2 ml
155 #013 :emfibro6il !apsul 300 mg !apsul
15 #014 :limepiri%e Tablet 2 mg Tablet
15" #015 :lukosa 5 C 0 225 )atrium !lori%a #otol 500 ml
15$ #01 :lukosa 5 C 0 45 )atrium !lori%a #otol 500 ml
15, #01" *os=ineD)D#utilbromi%e Injeksi / S=opamin / #us=opan Ampul
1 0 #01$ *os=ineD)D#utilbromi%e Tablet 10 mg / S=opma Tablet
1 1 #01, !etokona6ole !rim 2 Tube
1 2 #020 !etokona6ole Tablet 200 mg Tablet
1 3 #021 !etoprofen Injeksi 100 mg / -etix Ampul
1 4 #022 !etorola= Injeksi 30 mg Ampul
1 5 #023 !lin%amisin !apsul 150 mg !apsul1 #024 !lin%amisin !apsul 300 mg !apsul
1 " #025
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NO Kode Obat NAMA OBAT SATUAN
1"0 #02$ eloksikam Suppositoria Suppositoria
1"1 #02, etformin 8l Tablet 500 mg Tablet
1"2 #030 etilpre%nisolon Tablet 4 mg Tablet
1"3 #031 etokloprami%e Injeksi / (t+iferan Ampul
1"4 #032 etokloprami%e Sirup #otol 0 ml
1"5 #033 etroni%a6ol Infus 500 mg/100 ml #otol 100 ml
1" #034 'mepera6ol !apsul 20 mg !apsul
1"" #035 .ira=etam Injeksi 1 g / 5 ml Ampul 5 ml
1"$ #03 .ira=etam Injeksi 3 g / 15 ml Ampul 15 ml
1", #03" .ira=etam tablet 1200 mg Tablet
1$0 #03$ .ira=etam tablet $00 mg Tablet
1$1 #03, ?aniti%ine Injeksi 25 mg/ml Ampul 2 ml
1$2 #040 Sefa%roksil Sirup !ering 125mg/5ml #otol 0 ml
1$3 #041 Sefa%roksil !apsul 500 mg !apsul1$4 #042 Sefiksim !apsul 100 mg !apsul
1$5 #043 Sefotaksim Injeksi 1 g ;ial
1$ #044 Seftriakson Serbuk Injeksi 1 g/;ial ;ial
1$" #045 Sim astatin Tablet 10 mg Tablet
1$$ #04 Terbutalin Tablet 2 5 mg Tablet
1$, #04" T+iamfenikol Sirup #otol 0 ml
1,0 #04$ Trama%ol Injeksi 50 mg/ml Ampul
1,1 #04, Trama%ol !apsul 50 mg !apsul
1,2 #050 Trifluopera6ine Tablet 1 mg / Stela6in Tablet
1,3 #051 Trifluopera6ine Tablet 5 mg / Stela6in Tablet
1,4 #052 ,ikona
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NO Kode Obat NAMA OBAT SATUAN
204 800, AS(?I): 500 ml #otol 500 ml
205 8010 Attapulgite / )e> &iatab / olagit Tablet
20 8011 #alsam .ot
20" 8012 #etason ) 8ream Tube
20$ 8013 #ioplasenton Tube
20, 8014 #isa=o%il Tablet 5 mg / &ul=olax 5 mg Tab Tablet
210 8015 #iso=o%il Supp Anak 5 mg / &ul=olax 5 mg Suppositoria
211 801 #iso=o%il Supp &e>asa 10 mg / &ul=olax 10 mg Suppositoria
212 801" 8ounterpain Tube
213 801$ &ektran"0Don #otol
22 8031 ulti itamin Sirup / !urkumex Sirup #otol 0 ml
22" 8032 )euro%ial !aplet Tablet
22$ 8033 )eurotropik Injeksi / ersibion / )eurosanbe Ampul 5 ml
22, 8034 )eurotropik Tablet / Sakaneuron / 8orsaneuron Tablet
230 8035 )e> :uanist rep Sirup #otol 0 ml
231 803 .ankreoflat Tablet
232 803" .+armaton -ormula !aplet
233 803$ .olikresulen Sol 3 0 mg/ml / Albot+*l Solution #otol 10 ml
234 803, ?inger &ekstrosa
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NO Kode Obat NAMA OBAT SATUAN
23, 8044 Tamba+ &ara+ !ombinasi )on :enerik / emafor% Tablet
240 8045 T+rombop+op :el Tube
241 804 ;i==illin Serbuk Injeksi 1 g ;ial
242 804" Eilomi%on Injeksi ;ia l ;ial
243 804$ Anti -ungi &rop / (n*stin &rop #otol
244 04. Abboti9 la it) om(9in Si up #otol 0 ml245 050 !iosanbe Kaplet !aplet24 051 !isol on :a -o 'ebuli
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NO Kode Obat NAMA OBAT SATUAN
2 , I00" (ugenol 8airan #otol 10 ml
2"0 I00$ -luori%e Tablet 0 5 mg Tablet
2"1 I00, :lass Ionomer 8ement A?T Set
2"2 I010 !alsium i%roksi%a .asta !otak
2"3 I011 !lorfenol !amfer ent+ol 78+! 9 #otol 10 ml
2"4 I012 !uas .engoles #on%ing #iji
2"5 I013 ummif*ing .asta !otak
2" I014 ' 8 ' 8airan #otol
2"" I015 Semen Seng -osfat serbuk %an =airan #otol
2"$ I01 Sil er Amalgam #otol 5 ml
2", I01" Spon :elatin #iji
2$0 I01$ Temporar* Stopping -let=+er #otol
2$1 I01, T!- 7-orinokresol9 #otol
2$2 I020 A ti9ulating +ape !otak 12 .ak2$3 I021 austinep/ oustine austi- .ot gr 2$4 I022 eso-at #otol " 5gr 2$5 I023 esop)en #otol 13 ml2$ I024 +ulpe (l #otol 13ml
Proga Ke,a,ingan2$" F001 Alben%a6ol Tablet 400 mg Tablet
2$$ F002 eben%a6ol Sirup #otol 30 ml
2$, F003 eben%a6ol Tablet Tablet
2,0 F004 .irantel tablet s=ore 7base9 125 g Tablet
Proga K!"#G!$! 2,1 !001 #esi Sirup #otol 150 ml
2,2 !002 8alsium :lukonas Injeksi Ampul 10 ml
2,3 !003 -itomena%ion 7;it !19 Injeksi 2mg/ml 7)eo !9 Ampul 1 ml
2,4 !004 Io%iol !apsul
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NO Kode Obat NAMA OBAT SATUAN
302 !012 ?etinol 7;itamin A9 100 000 I@ kapsul lunak !apsul
303 !013 ?etinol 7;itamin A9 200 000 I@ kapsul lunak !apsul
304 !014 Santa D ( Tablet
305 !015 Tablet Tamba+ &ara+ !ombinasi Sa=+et
Proga a'aria
30 i-ampisin 600 mg Kaplet !aplet
Per&eka'an Ke%e a an32" '001 Alat Suntik 0 05 ml Set
32$ '002 Alat Suntik 0 5 ml Set
32, '003 Alat Suntik 1 ml Set
330 '004 Alat Suntik 10 ml Set
331 '005 Alat Suntik 2 5 ml Set
332 '00 Alat Suntik 20 ml Set
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NO Kode Obat NAMA OBAT SATUAN
333 '00" Alat Suntik 5 ml Set
334 '00$ Alat Suntik 50 ml Set
335 '00, A ua%est Steril #otol 500 ml
33 '010 A uasoni= :el Tube
33" '011 Asam Sulfosalisilat 20 #otol
33$ '012 #AG8
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NO Kode Obat NAMA OBAT SATUAN
3 $ '042
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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT TAHUN 20 2UPTD KESEHATAN PUSKESMAS !e KABUPATEN PASURUAN
NO Kode Obat NAMA OBAT SATUAN
1 2 3 4
Generik PKD
1 A001 Alopurinol Tablet 100 mg Tablet2 A002 Ambroxol Tablet 30 mg Tablet
3 A003 Aminofilin Injeksi 24 mg/ll Ampul 10 ml
4 A004 Aminofilin Tablet 200 mg Tablet
5 A005 Amitrip tilin Table t Salut 25 mg Tablet
A00 Amoksisillin !aplet 500 mg !aplet
" A00" Amoksisillin Sirup !ering 125 mg/5 ml #otol 0 ml
$ A00$ Antasi%a &'() Tablet !un*a+ Tablet
, A00, Anti #akteri &'() Salep Tube
10 A010 Anti -ungi &'() !ombinasi .ot
11 A011 Anti emoroi% &'() !ombinasi Suppositoria
12 A012 Anti igrain/(rgotamin Tablet
13 A013 A ua .ro Inj #otol 25 ml
14 A014 Asam Askorbat Tablet 50 mg Tablet
15 A015 Asam efenamat !aple t 500 mg !aplet
1 A01 Asetosal Tablet 100 mg Tablet
1" A01" Asiklo ir !rim 5 Tube
1$ A01$ Asiklo ir Tablet 400 mg Tablet1, A01, Atropin Sulfat Injeksi 0 25 mg/ml Ampul 2 ml
20 A020 Atropin Sulfat Tablet 0 5 mg Tablet
21 A021 #etametason !rim 0 1 Tube
22 A022 &eksametason Injeksi i 5 mg/ml Ampul 2 ml
23 A023 &eksametason Tablet 0 5 mg Tablet
24 A024 &ekstrometorfan Sirup 10 mg/5 ml #otol 0 ml
25 A025 &ekstrometorfan Table t 15 mg Tablet
2 A02 &ia6epam Injeksi 5 mg/ml Ampul 2 ml
2" A02" &ia6epam Tablet 2 mg Tablet
2$ A02$ &ia6epam Tablet 5 mg Tablet
2, A02, &ifen+i%ramin Injeksi i m 10 mg/ml 7 8l9 Ampul 2 ml
30 A030 &igoksin Tablet 0 25 mg Tablet
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31 A031 &iltia6em 8l Tablet 30 mg Tablet
32 A032 &imen+i%rinat Tablet 50 mg Tablet
33 A033 &oksisiklin !apsul 100 mg !apsul
34 A034 &omperi%on Tablet 10 mg Tablet
35 A035 (fe%rin Tablet 25 mg 7 8l9 Tablet
3 A03 (finefrin 7A%renalin9 Injeksi 0 1 Ampul 2 ml
3" A03" (kstraks #ella%on Tablet 10 mg Tablet
3$ A03$ (ritromisin !apsul 250 mg !apsul
3, A03, (rit romisin Sirup 200 mg/5 ml #otol 0 ml
40 A040 -enitoin !apsul 100 mg !apsul
41 A041 -enitoin !apsul 30 mg !apsul
42 A042 -enitoin )atrium Injeksi 50 mg/ml Ampul 2 ml
43 A043 -enobarbital Injeksi i m/i 50 mg/ml Ampul 1 ml
44 A044 -enobarbital Tablet 100 mg Tablet45 A045 -enobarbital Tablet 30 mg Tablet
4 A04 -enoksimetil .enisillin Tablet 500 mg Tablet
4" A04" -enol :liserol Tetes Telinga 10 #otol 5 ml
4$ A04$ -itomena%ion 7;it !19 Injeksi 10 mg/ml Ampul 1 ml
4, A04, -itomena%ion 7;it !19 Tablet 10 mg Tablet
50 A050 -urosemi% Tablet 40 mg Tablet
51 A051 :ameksan
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NO Kode Obat NAMA OBAT SATUAN
A0 aloperi%ol Tablet 5 mg Tablet
" A0 " i%roklorot+ia6i%a 7 8T9 Tablet 25 mg Tablet
$ A0 $ i%rokortison !rim 2 5 Tube
, A0 , Ibuprofen Tablet 200 mg Tablet
"0 A0"0 Ibuprofen Tablet 400 mg Tablet
"1 A0"1 Isosorbi% &initrat Tablet Sublingual 5 mg Tablet
"2 A0"2 !alsium
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NO Kode Obat NAMA OBAT SATUAN
101 A101 )istatin ;agina Tablet 100 000 iu Tab;ag
102 A102 'bat #atuk itam 7'# 9 =airan #otol 100 ml
103 A103 'ksitetrasiklin 8l Salep !ulit 3 Tube
104 A104 'ksitetrasiklin 8l Salep ata 1 Tube
105 A105 .apa erin Injeksi 40 mg/ml Ampul 1 ml
10 A10 .apa erin Tablet 40 mg Tablet
10" A10" .araformal%e+i% Tablet 1 gram Tablet
10$ A10$ .arasetamol Sirup 120 mg/5 ml #otol 0 ml
10, A10, .arasetamol tablet 100 mg Tablet
110 A110 .arasetamol tablet 500 mg Tablet
111 A111 .eti%in Injeksi Ampul
112 A112 .iri%oksin 7;itamin # 9 tablet 10 mg 7 8l9 Tablet
113 A113 .re%nison Tablet 5 mg Tablet
114 A114 .ropanolol Tablet 10 mg Tablet115 A115 .ropanolol Tablet 40 mg Tablet
11 A11 .ropiltiourasil tablet 100 mg Tablet
11" A11" ?anit i%ine Tablet 150 mg Tablet
11$ A11$ ?eserpin Tablet 0 10 mg Tablet
11, A11, ?eserpin Tablet 0 25 mg Tablet
120 A120 ?inger
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NO Kode Obat NAMA OBAT SATUAN
13 A13 Tiamin 7;itamin #19 Injeksi 100 mg/ml Ampul 1 ml
13" A13" Tri+eksifeni%il Tablet 2 mg Tablet
13$ A13$ ;itamin # !ompleks Injeksi ;ial
13, A13, ;itamin # !ompleks Tablet Tablet
140 A140 in= 'xi%e Salep .ot
141 A141 !aptopril Tablet 12 5 mg Tablet
142 A142 (ritromisin !apsul 500 mg !apsul
Generik Penunjang PKD143 #001 Alpra6olam Tablet 0 5 mg Tablet
144 #002 Ambroxol Sirup 15 mg/ml #otol 0 ml
145 #003 Amoksisillin Serbuk Injeksi 1000 mg / Bi%e=illin ;ial
14 #004 Antasi%a &'() Suspensi #otol 0 ml
14" #005 Asam -olat Tablet 1 mg / Anemolat Tablet
14$ #00 #eta+istin esilat Tablet mg Tablet14, #00" #rom+eksin Sirup / osa on Sir #otol 0 ml
150 #00$ #rom+eksin Tablet $ mg / )o a+eksin Tablet
151 #00, 8et iri6ine Tablet 10 mg Tablet
152 #010 8lobetasol !rim 0 05 / Ika%erm !rim Tube
153 #011 &omperi%on Suspensi 5 mg/5 ml #otol 0 ml
154 #012 -urosemi% Injeksi i /i m 10 mg/ml / Silax Ampul 2 ml
155 #013 :emfibro6il !apsul 300 mg !apsul
15 #014 :limepiri%e Tablet 2 mg Tablet
15" #015 :lukosa 5 C 0 225 )atrium !lori%a #otol 500 ml
15$ #01 :lukosa 5 C 0 45 )atrium !lori%a #otol 500 ml
15, #01" *os=ineD)D#utilbromi%e Injeksi / S=opamin / #us=opan Ampul
1 0 #01$ *os=ineD)D#utilbromi%e Tablet 10 mg / S=opma Tablet
1 1 #01, !etokona6ole !rim 2 Tube
1 2 #020 !etokona6ole Tablet 200 mg Tablet
1 3 #021 !etoprofen Injeksi 100 mg / -etix Ampul
1 4 #022 !etorola= Injeksi 30 mg Ampul
1 5 #023 !lin%amisin !apsul 150 mg !apsul1 #024 !lin%amisin !apsul 300 mg !apsul
1 " #025
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NO Kode Obat NAMA OBAT SATUAN
1"0 #02$ eloksikam Suppositoria Suppositoria
1"1 #02, etformin 8l Tablet 500 mg Tablet
1"2 #030 etilpre%nisolon Tablet 4 mg Tablet
1"3 #031 etokloprami%e Injeksi / (t+iferan Ampul
1"4 #032 etokloprami%e Sirup #otol 0 ml
1"5 #033 etroni%a6ol Infus 500 mg/100 ml #otol 100 ml
1" #034 'mepera6ol !apsul 20 mg !apsul
1"" #035 .ira=etam Injeksi 1 g / 5 ml Ampul 5 ml
1"$ #03 .ira=etam Injeksi 3 g / 15 ml Ampul 15 ml
1", #03" .ira=etam tablet 1200 mg Tablet
1$0 #03$ .ira=etam tablet $00 mg Tablet
1$1 #03, ?aniti%ine Injeksi 25 mg/ml Ampul 2 ml
1$2 #040 Sefa%roksil Sirup !ering 125mg/5ml #otol 0 ml
1$3 #041 Sefa%roksil !apsul 500 mg!apsul
1$4 #042 Sefiksim !apsul 100 mg !apsul
1$5 #043 Sefotaksim Injeksi 1 g ;ial
1$ #044 Seftriakson Serbuk Injeksi 1 g/;ial ;ial
1$" #045 Sim astatin Tablet 10 mg Tablet
1$$ #04 Terbutalin Tablet 2 5 mg Tablet
1$, #04" T+iamfenikol Sirup #otol 0 ml
1,0 #04$ Trama%ol Injeksi 50 mg/ml Ampul
1,1 #04, Trama%ol !apsul 50 mg !apsul
1,2 #050 Trifluopera6ine Tablet 1 mg / Stela6in Tablet
1,3 #051 Trifluopera6ine Tablet 5 mg / Stela6in Tablet
1,4 #052 ,ikona
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NO Kode Obat NAMA OBAT SATUAN
204 800, AS(?I): 500 ml #otol 500 ml
205 8010 Attapulgite / )e> &iatab / olagit Tablet
20 8011 #alsam .ot
20" 8012 #etason ) 8ream Tube
20$ 8013 #ioplasenton Tube
20, 8014 #isa=o%il Tablet 5 mg / &ul=olax 5 mg Tab Tablet
210 8015 #iso=o%il Supp Anak 5 mg / &ul=olax 5 mg Suppositoria
211 801 #iso=o%il Supp &e>asa 10 mg / &ul=olax 10 mg Suppositoria
212 801" 8ounterpain Tube
213 801$ &ektran"0Don #otol
22 8031 ulti itamin Sirup / !urkumex Sirup #otol 0 ml
22" 8032 )euro%ial !aplet Tablet
22$ 8033 )eurotropik Injeksi / ersibion / )eurosanbe Ampul 5 ml
22, 8034 )eurotropik Tablet / Sakaneuron / 8orsaneuron Tablet
230 8035 )e> :uanis trep Sirup #otol 0 ml
231 803 .ankreoflat Tablet
232 803" .+armaton -ormula !aplet
233 803$ .olikresulen Sol 3 0 mg/ml / Albot+*l Solution #otol 10 ml
234 803, ?inger &ekstrosa
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NO Kode Obat NAMA OBAT SATUAN
23, 8044 Tamba+ &ara+ !ombinasi )on :enerik / emafor% Tablet
240 8045 T+rombop+op :el Tube
241 804 ;i==illin Serbuk Injeksi 1 g ;ial
242 804" Eilomi%on Injeksi ;ial ;ial
243 804$ Anti -ungi &rop / (n*stin &rop #otol
244 04. Abboti9 la it) om(9in Si up #otol 0 ml245 050 !iosanbe Kaplet !aplet24 051 !isol on :a -o 'ebuli
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NO Kode Obat NAMA OBAT SATUAN
2 , I00" (ugenol 8airan #otol 10 ml
2"0 I00$ -luori%e Tablet 0 5 mg Tablet
2"1 I00, :lass Ionomer 8ement A?T Set
2"2 I010 !alsium i%roksi%a .asta !otak
2"3 I011 !lorfenol !amfer ent+ol 78+! 9 #otol 10 ml
2"4 I012 !uas .engoles #on%ing #iji2"5 I013 ummif*ing .asta !otak
2" I014 ' 8 ' 8airan #otol
2"" I015 Semen Seng -osfat serbuk %an =airan #otol
2"$ I01 Sil er Amalgam #otol 5 ml
2", I01" Spon :elatin #iji
2$0 I01$ Temporar* Stopping -let=+er #otol
2$1 I01, T!- 7-orinokresol9 #otol
2$2 I020 A ti9ulating +ape !otak 12 .ak2$3 I021 austinep/ oustine austi- .ot gr 2$4 I022 eso-at #otol " 5gr 2$5 I023 esop)en #otol 13 ml2$ I024 +ulpe (l #otol 13ml
Proga Ke,a,ingan2$" F001 Alben%a6ol Tablet 400 mg Tablet
2$$ F002 eben%a6ol Sirup #otol 30 ml
2$, F003 eben%a6ol Tablet Tablet
2,0 F004 .irantel tablet s=ore 7base9 125 g Tablet
Proga K!"#G!$! 2,1 !001 #esi Sirup #otol 150 ml
2,2 !002 8alsium :lukonas Injeksi Ampul 10 ml
2,3 !003 -itomena%ion 7;it !19 Injeksi 2mg/ml 7)eo !9 Ampul 1 ml
2,4 !004 Io%iol !apsul
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NO Kode Obat NAMA OBAT SATUAN
302 !012 ?etinol 7;itamin A9 100 000 I@ kapsul lunak !apsul
303 !013 ?etinol 7;itamin A9 200 000 I@ kapsul lunak !apsul
304 !014 Santa D ( Tablet
305 !015 Tablet Tamba+ &ara+ !ombinasi Sa=+et
Proga a'aria
30 i-ampisin 600 mg Kaplet !aplet
Per&eka'an Ke%e a an32" '001 Alat Suntik 0 05 ml Set
32$ '002 Alat Suntik 0 5 ml Set
32, '003 Alat Suntik 1 ml Set
330 '004 Alat Suntik 10 ml Set
331 '005 Alat Suntik 2 5 ml Set
332 '00 Alat Suntik 20 ml Set
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NO Kode Obat NAMA OBAT SATUAN
333 '00" Alat Suntik 5 ml Set
334 '00$ Alat Suntik 50 ml Set
335 '00, A ua%est Steril #otol 500 ml
33 '010 A uasoni= :el Tube
33" '011 Asam Sulfosalisilat 20 #otol
33$ '012 #AG8
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3 $ '042