RENCANA KEBUTUHAN OBAT TAHU

PUSKESMAS : UPT PUSKESMAS PU

STOK AWAL PER PENERIMAAN KETERSEDIAAN

NO. NAMA OBAT SATUAN
1 JANUARI 2022 TAHUN 2022 TAHUN 2022

(a) (b) (c) = (a) + (b)

1 Allupurinol tablet 300 mg 110,300 39,920 150,220

2 Alopurinol tablet 100 mg - 250 250
3 Ambroxol 30 mg tablet 120,300 70,000 190,300
4 Aminophyllin inj - - -
5 Aminophylline Tablet - 990 990
6 Amlodipin tab 5 mg 261,900 - 261,900
7 Amlodipin Tablet 10 mg 15,000 200,000 215,000
8 Amoksisilin kaplet 500 mg - - -
9 Amoksisilin kapsul 250 mg 740,000 500,000 1,240,000
10 Amoksisilin Syrup 125 mg 42,000 - 42,000
11 Amoxicilin Trihidrate Sirup 250 mg/ 5 ml 2,125,500 384,000 2,509,500
12 Ampicillin Sodium Serbuk Inj 1 gr - - -
13 Antalgin 500 mg inj - - -
14 Antasida doen Sirup - - -
15 Antasida doen tablet kombinasi 7,080 3,000 10,080
16 Antihemorroid suppos - 5,000 5,000
17 Asam Ascorbat tab 50 mg 20,050 10,000 30,050
18 Asam Folat ( profolat ) 1,861,700 - 1,861,700
19 Asam Mefenamat Tablet 500 mg - - -
20 Asam Traneksamat Inj 50 mg/ml - - -
21 Asetosal tab 80 mg 500,000 670,000 1,170,000
22 Asiklovir Tablet 400 mg (POVIRAL) tablet/kaplet/kapsul - 69,000 69,000
23 Asiklovir Tablet 400 mg (ACIFAR) - 1,500 1,500
24 Asimor tablet - - -
25 Atorvastatin Tablet 20 mg 4,300 4,300
26 Atropin inj 10 UI/ml 12,625 10,000 22,625
27 Attapulgite ( New Antides ) - - -
28 Azitromicin tablet 15,000 - 15,000
29 Batugin Elixir 298,500 24,700 323,200
30 Bedak Salisilk 2% (AMORE) 300,000 300,000 600,000
31 Benzatinbenzil Penicillin 2,4 UI/ml/PP - 500,000 500,000
32 Betahistin Tablet 6 mg 45,970 10,000 55,970
33 Betametason Krim 0,1 % - - -
34 Betominplex cdez - 10,000 10,000
35 Biocombin inj - 14,200 14,200
36 Biosat 1,5 (ATS) inj 1500 IU/amp (i.m) - 10,999 10,999
37 Biosave (ABU) Cairan inj (i.m/ i.v) 170,100 15,000 185,100
38 Bisakodil tab sal 5 mg 7,330 3,000 10,330
39 Bisoprolol Fumarat Tablet 2,5 mg - 30,000 30,000
40 Bisoprolol Fumarat Tablet 5 mg - - -
41 Calostrum Syr 13,300 - 13,300
42 Candesartan Cilexetil 16 mg - - -
43 Candesartan Cilexetil 8 mg - 288 288
44 Chlorfeniramine Maleat (ALLERGEN) 20,900 - 20,900
45 Ciprofloxacin HCL Tablet 500 mg - 310,000 310,000
46 Clopidogrel bisulfate Tablet 1,160 - 1,160
47 Curcuma tablet - 120 120
48 Dexametason inj 5 mg/ml-1ml 88,300 40,200 128,500
49 Dexametason tabt 0,5 mg (Novadex) - 35,000 35,000
50 Diabetadex 100 mg 12,680 4,992 17,672
51 Diastrix 2 mg tablet (Loperamid) - - -
52 Diazepam inj 5 mg/ml (i.v/i.m) 91,200 500,000 591,200
53 Difenhidramin HCl inj 10 mg/ml-1ml - 50,000 50,000
54 Digoksin tab 0,25 mg 672,200 250,000 922,200
55 Doksisiklin tab 100 mg 269,700 127,900 397,600
56 Domperidon Drop 5 mg/ml - 13,500 13,500
57 Domperidon suspensi 5 mg/5 ml - - -
58 Domperidone tablet 10 mg - - -
59 Epinefrin ( Adrenalin) inj 1 mg/ml - - -
60 Erytromicyn tablet 500 mg 1,386,000 400,000 1,786,000
61 Euginol Cairan 246,500 150,000 396,500
62 Fenobarbital Tablet 30 mg 8,035 475 8,510
63 Fenol Glyserol tetes Telinga 10% 7,270 - 7,270
64 Fitomenadion (vit K) inj 10 mg - - -
65 Fitomenadion (vit K) inj 2 mg - 45,000 45,000
66 Fitomenadion tablet/kaplet 10 mg 200,000 270,000 470,000
67 Fituno Capsul 212,450 200,000 412,450
68 Flutamol tablet 104,400 50,000 154,400
69 Furosemid tablet 40 mg - - -
70 Furosemid inj 10 mg/ml (i.v/i.m) - 70,000 70,000
71 Garam Oralit 512 9,984 10,496
72 Gasela tablet 150 mg 80,000 164,700 244,700
73 Gavistal drops - Metoklorpramid drop botol 10 ml - 5,500 5,500
74 Gentamisin inj - - -
75 Glibenklamide tablet 5 mg - - -
76 Gliklazide tab 5 mg 14,840 8,000 22,840
77 Glimepiride tab 2 mg - - -
78 Glukosa larutan infus 5 % steril 23,900 6,000 29,900
79 Griseofulvin tab 125 mg 10,600 5,000 15,600
80 Guafenesin - - -
81 Haloperidol tablet 5 mg - - -
82 Herbakof Sirup 98,500 2,150,000 2,248,500
83 Herbakof tablet 58,061 15,050 73,111
84 Hidrokortison krim 2,5 % 294,200 300,000 594,200
85 Hydrochlorothiazide tab 25 mg 49,100 81,600 130,700
86 Ibuprofen suspensi 100 mg/5 ml - - -
87 Ibuprofen Tablet 400 mg - 150,000 150,000
88 Iliadin Anak / Oksimetazolin 0,026 % 29,120 15,000 44,120
89 Iliadin Dewasa / Oksimetazolin 0,05 % 105,700 150,000 255,700
90 Isosorbid dinitrat SL tab 5 mg 4,690 8,000 12,690
91 Kalsium Glukonat 10 % - - -
92 Kalsium Laktat tab 500 mg - 50,000 50,000
93 Kaptopril 12,5 mg - 2,400 2,400
94 Ketokonazol SK 70,000 50,000 120,000
95 Ketokonazol Tablet 200 mg 2,000 - 2,000
96 Ketorolac inj 401,600 - 401,600
97 Kloramfenicol SM 56,200 1,000,000 1,056,200
98 Kloramfenicol Capsul 250 mg
99 Kloramfenicol suspensi 125 mg/5 ml
100 Kompolax Syr (parafin + Gliserin)
101 Kotrimoksazol dewasa kombinasi tablet
102 Kotrimoksazol suspensi
103 Lansoprazol Capsul
104 Levofloksasin Tablet
105 Lidocain inj HCL 2 %
106 Lytacur Sirup 60 ml
107 Magnesium sulfas inj 20 % - 25 ml
108 Magnesium sulfas inj 40 % - 25 ml
109 Matovit Tablet
110 Meloxicam 15
111 Metformin HCl tab 850 mg
112 Metformin tablet 500 mg
113 Metilergometrin maleat inj 0,2 mg - 1 ml
114 Metilergometrin maleat tab 1,125 mg
115 Metilprednisolon Tablet 4 mg
116 Metoklopramide Inj
117 Metoklopramide tab
118 Metrilprednisolon Sodium Succinate
119 Metronidazole tablet 500 mg
120 Metronidazole sirup 125 mg/5 ml
121 Miconazole Cream
122 Mometason Furoat Krim 0,1%
123 Natrium diklofenak tab/cap/kap 50 mg
124 Natrium klorida infus 0,9 % steril
125 Nistatin Tablet 500.000 UI
126 Nistatin Tablet Vaginal 100.000 UI
127 Ofloksasin tablet
128 Oksitosin inj
129 Oksiytetra SM
130 Omeprazol capsul 20 mg
131 OTSU-WI Air inj 25 ml
132 Oxyvit C+
133 Oxyvit D3
134 Parasetamol drops 100 mg/ml
135 Parasetamol sirup 120 mg/5 ml
136 Parasetamol Tablet 500 mg
137 Parasetamol Tablet 500 mg
138 Parasetamol Supp(Pyrexin 160)
139 Parasetamol Supp(Pyrexin 80)
140 Perak Sulfadiazin Krim 1 %
141 Permetrin Krim 5%
142 Pirantel tablet 125 mg
143 Piridoksin HCl tablet 10 mg
144 Polofar Plus
145 Prednison tab 5 mg
146 Propanolol tab 10 mg
147 Propiltiourasil Tablet 100 mg
148 Pulmicort (Budesonide) 0.25 mg/ml
149 Pulmicort (Budesonide) 200 ug/dose
150 Ranitidin inj
151 Ringer laktat lar infus steril
152 Risperidon tablet 2 mg
153 Salbutamol tab 2 mg
154 Salbutamol Tablet 4 mg
155 Salep 2-4
156 Samcorbex tablet
157 Scopma Tablet
158 Sefadroksil Sirup 125 mg/5 ml
159 Sefadroksil tablet 500 mg
160 Sefixim Sirup 100 mg/5 ml
161 Sefiksim kapsul/kaplet 100 mg
162 Sefotaksim serbuk injeksi 1000 mg
163 Seftriakson serb inj
164 Seretide 50
165 Seterizin sirup 5 mg/5 ml
166 Seterizine tab 10 mg
167 Sianocobalamin Inj
168 Sianocobalamin tablet
169 Simbicort
170 Simvastatin tablet 20 mg
171 Sodium Valproate Sirup 250 mg/ml
172 Sodium Valproate Sirup 250 mg/ml
173 Sodium Valproate tablet
174 Stesolid 5 mg/2.5 ml (Diazepam)
175 Sukralfat Sirup 500 mg/5 ml
176 Sukralfat Tablet
177 Sulfadoksin
178 Stimuno Forte
179 Stimuno Sirup Orange Berry 60
180 Synarcus krim (Flusinolon Asetonid) 0,025%
181 Tetrasiklin 500 mg
182 Thiamin tab 50 mg
183 Tramadol HCL Inj
184 Trihexyphenidyl Hcl 2 mg
185 Ulsafat Syr
186 Vitamin B Kompleks
187 Zink Sulfat Syr
188 Zink Tablet
189 Simvastatin tablet 10 mg
BUTUHAN OBAT TAHUN 2023
S : UPT PUSKESMAS PUJUD

USULAN
PENGELUARAN PEMAKAIAN RENCANA
SISA STOK PER RENCANA
SELAMA TAHUN RATA-RATA/BULA KEBUTUHAN KETERANGAN
31 DESEMBER PENGADAAN
2022 N TAHUN 2022 TAHUN 2023
2022 TAHUN 2023

(g) = ((e) x 18))

(d) (e) = (d)/12 (f) (h) (l)
- (f)

61,400 5,117 88,820 3,280 3,280

250 21 - 375 375
97,600 8,133 92,700 53,700 53,700
- - - - -
750 63 240 885 885
208,500 17,375 53,400 259,350 259,350
24,600 2,050 190,400 - 153,500 -
- - - - -
931,700 77,642 308,300 1,089,250 1,089,250
9,576 798 32,424 - 18,060 -
1,684,700 140,392 824,800 1,702,250 1,702,250
- - - - -
- - - - -
- - - - -
3,340 278 6,740 - 1,730 -
1,120 93 3,880 - 2,200 -
28,950 2,413 1,100 42,325 42,325
1,731,500 144,292 130,200 2,467,050 2,467,050
- - - - -
- - - - -
346,350 28,863 823,650 - 304,125 -
- - 69,000 - 69,000 -
320 27 1,180 - 700 -
- - - - -
- - 4,300 - 4,300 -
15,025 1,252 7,600 14,938 14,938
- - - - -
8,790 733 6,210 6,975 6,975
282,500 23,542 16,000 407,750 407,750
181,400 15,117 418,600 - 146,500 -
33,500 2,792 466,500 - 416,250 -
48,870 4,073 7,100 66,205 66,205
- - - - -
 7,900 658 2,100 9,750 9,750
9,900 825 4,300 10,550 10,550
7,199 600 3,800 6,999 6,999
117,200 9,767 67,900 107,900 107,900
10,330 861 - 15,495 15,495
21,800 1,817 8,200 24,500 24,500
- - - - -
4,100 342 9,200 - 3,050 -
- - - - -
288 24 - 432 432
20,900 1,742 - 31,350 31,350
- - 310,000 - 310,000 -
- 440 - 37 1,600 - 2,260 -
120 10 - 180 180
92,900 7,742 35,600 103,750 103,750
- - 35,000 - 35,000 -
6,368 531 11,304 - 1,752 -
- - - - -
146,900 12,242 444,300 - 223,950 -
40,360 3,363 9,640 50,900 50,900
585,800 48,817 336,400 542,300 542,300
209,300 17,442 188,300 125,650 125,650
13,500 1,125 - 20,250 20,250
- - - - -
- - - - -
- - - - -
1,375,200 114,600 410,800 1,652,000 1,652,000
96,800 8,067 299,700 - 154,500 -
7,140 595 1,370 9,340 9,340
7,270 606 - 10,905 10,905
- - - - -
- - 45,000 - 45,000 -
215,800 17,983 254,200 69,500 69,500
218,850 18,238 193,600 134,675 134,675
47,600 3,967 106,800 - 35,400 -
- - - - -
2,000 167 68,000 - 65,000 -
2,936 245 7,560 - 3,156 -
44,700 3,725 200,000 - 132,950 -
- - 5,500 - 5,500 -
- - - - -
- - - - -
9,000 750 13,840 - 340 -
- - - - -
21,100 1,758 8,800 22,850 22,850
 11,000 917 4,600 11,900 11,900
- - - - -
- - - - -
505,430 42,119 1,743,070 - 984,925 -
32,111 2,676 41,000 7,167 7,167
433,700 36,142 160,500 490,050 490,050
81,700 6,808 49,000 73,550 73,550
- - - - -
150,000 12,500 - 225,000 225,000
23,080 1,923 21,040 13,580 13,580
95,000 7,917 160,700 - 18,200 -
4,351 363 8,339 - 1,813 -
- 4,300 - 358 4,300 - 10,750 -
10,000 833 40,000 - 25,000 -
2,400 200 - 3,600 3,600
88,200 7,350 31,800 100,500 100,500
2,000 167 - 3,000 3,000
177,900 14,825 223,700 43,150 43,150
153,500 12,792 902,700 - 672,450 -
…................,Maret 2023
KEPALA PUSKESMAS…...........

(…......................)
NIP. ….....................
 RENCANA KEBUTUHAN BMHP PUSKESMAS TAH
PUSKESMAS :

STOK AWAL
PENERIMAAN KETERSEDIAAN
NO. NAMA OBAT DAN PERBEKKES SATUAN PER
TAHUN 2022 TAHUN 2022
1 JANUARI 2022

(a) (b) (c) = (a) + (b)

1 Alat suntik 1 cc 77,200 22,000 99,200

2 Alat suntik 10 cc 193,000 - 193,000
3 Alat suntik 2,5/ 3 cc 146,400 - 146,400
4 Alat suntik 5 cc - - -
5 Alkohol 70 % btl 100 ml 11,832 7,200 19,032
6 Arm Sling (S, M, L) 340 - 340
7 Aseptic Gel (Hand Hygiene) 650 300 950
8 Baygel 250 ml 210 200 410
9 Basic Dressing Pack 11,800 - 11,800
10 BeneCheck Plus Blood Glucose Test Strip 50 s 4,900 13,920 18,820
11 BeneCheck Plus Total Cholesterol Test Strip 10 s 8,600 5,000 13,600
12 BeneCheck Plus Uric Acid Test Strip 25 s 9,540 20,000 29,540
13 Blood Lancet 10,350 15,000 25,350
14 Blood Glucosa Test Strip 2,000 - 2,000
15 Catgut Chromic 2/0 ( 3 metric) - - -
16 Catgut Chromic 3/0 ( 3 metric) - - -
17 Catgut Plain 3/0 - - -
18 Chlorotulle - - -
19 Dermafix T 10 x 8 4,769 5,000 9,769
20 Elastic Crepe Bandage 7.5cm x 1.5cm - - -
21 Elastic Crepe Bandage M 10cm x 1.5cm - - -
22 Elastic Crepe Bandage M 15cm x 1.5cm - - -
23 Etanol 70% 1000 cc - - -
24 Flex Non Woven Roll 5 cm x 10 cm - - -
25 Gelang Nama Pasien Adult Blue / Pink - - -
26 Gelang Nama Pasien Child Blue / Pink 74,100 200,000 274,100
27 HCL 0,1 N 97,900 200,000 297,900
28 Hb Hemoglobin Test Strips - 3,000 3,000
29 HENCLIN Solution 2% 500 ml 1,200 500 1,700
30 HENCLIN Swab 0.5% - - -
31 I.V Canulla With Teflon Chateter 2 Way 20 G - - -
32 I.V Canulla With Teflon Chateter 2 Way 22 G - - -
33 I.V Canulla With Teflon Chateter 2 Way 24 G - - -
34 Infuset anak
35 Infuset Dewasa
36 Infusion set eco
37 IV Cannula Sise 20
38 IV Cannula Sise 22
39 IV Cannula Sise 24
40 IV Catheter NP,Pen Type, No 24
41 IV Chateter No. 18 G
42 IV Chateter No. 20 G
43 IV Chateter No. 22 G
44 IV Chateter No. 24 G
45 Jarum jahit No.11
46 Jarum jahit No.12
47 Jarum jahit No.9
48 Kapas
49 Kapas Alkohol
50 Kasa hidrofil 36 m x 80 cm
51 Kasa hidrofil 40 y x 80
52 Kasa Steril 10 X 10 cm
53 Masker
54 Masker Nebulizer Set Anak
55 Masker Nebulizer Set Dewasa
56 Medical Exam Glove Latex M / Sarung Tangan Steril M
57 MMP Chroma Balloon Catheter 2 Way Fr 14
58 MMP Chroma Balloon Catheter 2 Way Fr 16
59 MMP Chroma Balloon Catheter 2 Way Fr 18
60 My Jelly
61 Nasal Oxigen Canula Adult - L
62 Nasal Oxigen Canula Adult + Child
63 Nasal Oxigen Canula Child - M
64 Nasal Oxigen Canula Pediatrik - S
65 NGT Feeding tube 5 Fr
66 NGT Stomach Tube 14 Fr
67 NGT Stomach Tube 16 Fr
68 Nice Care ( Underpad ) 60 cm x 90 cm
69 Non Woven Fixation 10 cm X 10 m
70 Non Woven Fixation 5 cm X 10 m
71 Pisau Operasi No. 10
72 Pisau Operasi No. 11
73 Pisau Operasi No. 18
74 Pisau Operasi No. 22
75 Plester 1,25 cm
76 Plester 2 cm
77 Plesterin Roll non Woven roll 10 cm x 10 cm
78 Plesterin Roll non Woven roll 10 cm x 5 cm
79 Plesterin Roll non Woven roll 5 cm x 5 cm
80 Povidon Iodida larutan 10% 30 ml
81 Povidon Iodida larutan 10% 300 ml
82 Povidon Iodida larutan 10% 60 ml
83 Pro crep Pembalut elastis 15 cm x 4,55M
84 Rivanol/Etakridin
85 Safety Box
86 Sarung Tangan (Surgical Glove Steril Size 7.0)
87 Sarung tangan Non Steril ( M)
88 Sarung tangan Non Steril ( S )
89 Sarung tangan Non Steril (L)
90 Sarung tangan Obgine
91 Silk 3/0 (BIOSILK)
92 Spalak
93 Stardex Nasal Oxigen Canula Pediatric
94 Steril Lancet 30 G
95 Umbilical
96 Urine bag
97 Wove Roll 5 cm x 10 cm
P PUSKESMAS TAHUN 2023
MAS :

USULAN
PENGELUARAN PEMAKAIAN RATA- RENCANA
SISA STOK PER RENCANA
SELAMA TAHUN RATA/BULAN TAHUN KEBUTUHAN
31 DESEMBER PENGADAAN
2022 2022 TAHUN 2023
2022 TAHUN 2023

(g) = ((e) x
(d) (e) = (d)/12 (f) (h)
18)) - (f)

82,600 6,883 67,400 56,500 56,500

163,400 13,617 142,900 102,200 102,200
120,050 10,004 113,100 66,975 66,975
- - - - -
9,756 813 7,896 6,738 6,738
215 18 125 198 198
400 33 550 50 50
160 13 250 - 10 -
3,950 329 7,850 - 1,925 -
8,820 735 8,950 4,280 4,280
5,800 483 7,800 900 900
5,540 462 24,000 - 15,690 -
8,750 729 16,600 - 3,475 -
946 79 1,054 365 365
- - - - -
- - - - -
- - - - -
- - - - -
6,286 524 3,483 5,946 5,946
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
88,800 7,400 185,300 - 52,100 -
112,300 9,358 185,600 - 17,150 -
24 2 2,976 - 2,940 -
920 77 780 600 600
- - - - -
- - - - -
- - - - -
- - - - -
…................,Maret 2023
KEPALA PUSKESMAS…...........

(…......................)
NIP. ….....................