DATA 155 DIAGNOSA YANG HARUS SELESAI DI FKTP

NAMA FKTP : PUSKESMAS BINANGA

BULAN NOPEMBER 2016
DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML
NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
1 TB PARU A15 Respiratory TB ciprofloxacin 500 mg 10
suspek 2 CTM 20
GG tab 20
Vitamin b kompleks 10
Dexametason tab 10
2 MORBILI B059 Measles without complication 1 Parasetamol 500 mg 10
CTM 10
Acyclovir 200 mg 12
Dexametason tab 10
3 VARISELA B019 Varicella without complication 3 CTM 30
Acyclovir 400 mg 10
Acyclovir 200 mg 30
Vitamin b kompleks 10
Vit. C 50 mg 10
4 MALARIA B54 Unspecified malaria
5 DEMAM DENGUE DAN DEMAM A90, A91 Dengue fever, DHF
6 BERDARAH DENGUE
LEPTOSPIROSIS A279
7 INFEKSI PADA UMBILIKUS
8 KANDIDIASIS MULUT B379 Candidiasis unspecified 1 Ibuprofen 200 mg tab 10
Griseofulvin tablet 125 mg 10
Amoxicillin 250 mg 10
CTM 10
9 LEPRA A30 Leprosy
10 KERACUNAN MAKANAN T622 Other ingested (parts of plant(s))
11 ALERGI MAKANAN
12 EXANTHEMATOUS DRUG ERUPTION L270 Generalized skin eruption due to drugs
13 FIXED DRUG ERUPTION L270 and medicaments
Generalized skin eruption due to drugs
14 REAKSI ANAFILAKTIK and medicaments
15 SYOK R579 Shock, unspecified
16 ANEMIA D649 Anaemia, unspecified (anemia defisiensi 17 SF tablet 70
besi-4A, anemia hemolitik-3A, anemia Vitamin B kompleks 10
makrositik-3A, anemia aplastik-2, anemia
megaloblastik-2) Parasetamol 500 mg 130
piridoksin tablet 10
 CTM 120
Vitamin b kompleks 120
B1 tablet 10
17 HIV/AIDS TANPA KOMPLIKASI Z21 Asymptomatic HIV infection status
18 LIMFADENITIS B70 Lymphadenitis Acute 4 ciprofloxacin 500 mg 20
Amoxicillin 500 mg 9
Prednison tablet 4
Vitamin b kompleks 4
Dexametason tab 25
CTM 5
Asam mefenamat 500 mg 10
Vit. C 50 mg 15
Parasetamol 500 mg 5
19 REFLUKS GASTROESOFAGEAL K219 Gastrooesophageal reflux disease without 1 Antasida sirup 1
oesophagitis Piridoksin tab 10
20 GASTRITIS K297 Gastritis, unspecified 125 Antasida sirup 86
Dispepsia 43 Amoxicillin 500 mg 60
Antasida tablet 693
B1 tablet 80
Cimetidin 200 mg 90
cotrimoxazol 480mg 32
Cotrimoxazol sirup 1
CTM 6
Dexametason tab 13
Diazepam 2 mg tab 25
Ibuprofen 400 mg tab 80
Natrium diklofenak 25 mg tab 30
Papaverin tablet 167
Parasetamol 500mg 389
Parasetamol sirup 1
Piridoksin tab 505
Ranitidin 150 mg tab 1165
SF tablet 40
Vit. C 50 mg 10
Vitamin b kompleks 529
21 INTOLERANSI MAKANAN
22 MALABSORBSI MAKANAN
23 DEMAM TIFOID A010 Typhoid fever 2 Antasida sirup 6 termasuk suspek
suspek 20 Antasida tablet 82
Ibuprofen 400 mg tab 10
cotrimoxazol 480mg 62
Cotrimoxazol sirup 6
 CTM 10
Dexametason tab 32
kloramfenikol 250 mg kapsul 75
kloramfenikol sirup 2
Parasetamol 500mg 129
Parasetamol sirup 2
Piridoksin tab 46
Ranitidin 150 mg tab 34
ciprofloxacin 500 mg 10
Amoxicillin sirup 1
Amoxicillin 250 mg 10
Ibuprofen 200 mg tab 10
Metoclopramid 5 mg 4
Vitamin b kompleks 45
24 GASTROENTERITIS ( TERMASUK DISENTRI, A09 Diarrhoea & gastroenteritis of presumed 171 Antasida sirup 9
KOLERA, GIARDIASIS) infection origin Antasida tablet 59
B1 tablet 10
Cotrimoxazol 120mg 27
cotrimoxazol 480mg 681
Cotrimoxazol sirup 66
CTM 5
Ibuprofen 200 mg tab 10
Metoclopramid 5 mg 11
Metronidazol 250 mg 10
Metronidazol 500 mg 13
Oralit 351
Papaverin tablet 328
Parasetamol 500mg 143
Parasetamol sirup 15
Piridoksin tab 178
Ranitidin 150 mg tab 38
SF tablet 15
Tetrasiklin 250 mg 10
Vitamin b kompleks 87
Zink tablet 1000
25 DISENTRI BASILER DAN DISENTRI AMUBA
26 APENDISITIS AKUT K359 Acute appendicitis
27 PERDARAHAN SALURAN MAKAN BAGIAN
28 ATAS
PERDARAHAN SALURAN MAKAN BAGIAN
29 BAWAH
HEMOROID GRADE 1-2 3 Antihemoroid suppo 14
Asam mefenamat 500 mg 10
Vit. C 50 mg 10
30 HEPATITIS A
31 HEPATITIS B
32 PAROTITIS K11.2 Sialoadenitis 3 Asam mefenamat 500 mg 10
CTM 10
Parasetamol 500mg 20
Vit. C 50 mg 10
ciprofloxacin 500 mg 10
Amoxicillin 500 mg 20
Dexametason tab 30
Parasetamol 500mg 20
33 ASKARIASIS B77.9 Ascariaris unspecified 7 pyrantel 125 mg 12
Papaverin tablet 4
CTM 10
34 CUTANEUS LARVA MIGRANS B76.9 Hookworm disease, unspecified
35 PENYAKIT CACING TAMBANG B76.0 Ankylostomiasis ,Necatoriasis 3 Albendazole 400 mg 3
36 SKISTOSOMIASIS B76.1
B65.9 Skistosomiasisunspecified , Schistomiasis
37 STRONGILOIDIASIS B65.2
B78.9 due to S. Japonicum
Strongyloidiasis
38 TAENIASIS B68.9 Taeniasis
39 PERITONISIS K65.9 Peritonitis, unspecified
40 KOLESISTITIS K81.9 Cholecystitis, unspecified
41 MATA KERING/DRY EYE H04.1 Other disorders of lacrimal gland
42 BUTA SENJA H53.5 Colour vision deficiencies
43 HORDEOLUM H00.0 Hordeolum and other deep inflammation 4 Amoxicillin 500 mg 24
of eyelid Dexametason tab 34
Parasetamol 500mg 24
CTM 24
Oxytetrasiklin 1% ZM 1
Metronidazol 500 mg 10
cotrimoxazol 480mg 10
Asam mefenamat 500 mg 10
Kloramfenikol ZM 2
44 KONJUNGTIVITIS H10.9 Conjunctivitis, unspecified,,, Acute 33 Amoxicillin 500 mg 129
H10.1 atopic conjunctivitis Amoxicillin sirup 1
CTM 147
Dexametason tab 72
Ibuprofen 400 mg tab 10
Ibuprofen sirup 1
Kloramfenikol ZM 10
Oxytetrasiklin 1% ZM 19
Parasetamol 500mg 38
Parasetamol sirup 1
Prednison tab 40
 Vit. C 50 mg 68
Vitamin b kompleks 40
45 BLEFARITIS H01.0 Blepharitis 1 CTM 3
Dexametason tab 3
Parasetamol 500mg 3
Vit. C 50 mg 3
Amoxicillin sirup 1
Oxytetrasiklin 1% ZM 1
46 PERDARAHAN SUBKONJUNGTIVA H57.8 Other specified disorders of eye and
47 BENDA ASING DI KONJUNGTIVA T15.9 adnexa
Foreign body on external eye, part
48 ASTIGMATISM H52.2 unspecified
Astigmatism
49 HIPERMETROPIA H52.0 Hypermetropia
50 MIOPIA RINGAN H52.1 Myopia
51 PRESBIOPIA H52.4 Presbyopia
52 KATARAK PADA PASIEN DEWASA H26.9 Cataract, unspecified
53 GLAUKOMA AKUT H40.2 Primary angle-closure glaucoma
54 OTITIS EKSTERNA H60.9 Otitis Externa, Unspecified 5 Amoxicillin 500 mg 50
Amoxicillin sirup 1
CTM 34
Dexametason tab 34
Ibuprofen sirup 1
Parasetamol 500mg 4
Asam mefenamat 500 mg 20
Prednison tab 10
Vit. C 50 mg 24
55 OTITIS MEDIA AKUT H66.0 Acute suppurative otitis media 21 Amoxicillin 250 mg 10
Amoxicillin 500 mg 119
Amoxicillin sirup 2
Asam mefenamat 500 mg 100
ciprofloxacin 500 mg 30
CTM 85
Dexametason tab 135
GG tab 3
Parasetamol 500mg 25
Prednison tab 20
Vit. C 50 mg 35
56 SERUMEN PROP H61.2 Impacted cerumen 3 Vit. C 50 mg 16
Amoxicillin 500 mg 3
CTM 3
Dexametason tab 3
Parasetamol 500mg 9
Prednison tab 6
57 BENDA ASING DI HIDUNG T17.1 Foreign body in nostril
58 ANGINA PEKTORIS I20.9 Angina pectoris
59 INFARK MIOKARD I21.9 Acute Myocardial Infarction
60 TAKIKARDIA I47.1 Supraventicular Tachicardy , Ventricular
61 GAGAL JANTUNG AKUT DAN KRONIK I50.9 Tachicardy
Heart failure Furosemid 40 mg 20
I47.2
CHF 1 Digoksin 0,5mg 20
62 CARDIORESPIRATORY ARREST K80 Cardiac arrhytmia
63 HIPERTENSI ESENSIAL I10 Essential (primary) hypertension 116 Asam mefenamat 500 mg 100
B1 tablet 220
Captopril 25 mg 1232
CTM 10
Dexametason tab 10
Diazepam 2 mg tab 8
Furosemid 40 mg 35
HCT tab 39
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 30
Natrium diklofenak 25 mg 36
Parasetamol 500 mg 190
Piridoksin tab 140
Vitamin b kompleks 10
64 INFARK SEREBRAL/STROKE I63.9 Cerebral infarction
65 FRAKTUR TERBUKA T14. Fracture of unspecified body
66 FRAKTUR TERTUTUP T14. Fracture of unspecified body
67 POLIMIALGIA REUMATIK M53.3 Polymyalgia rheumatica
68 ARTRITIS REUMATOID M53.3 Polymyalgia rheumatica 37 Antasida sirup 1
B1 tablet 239
CTM 108
Dexametason tab 89
Ibuprofen 200 mg tab 148
Ibuprofen 400 mg tab 50
Natrium diklofenak 25 mg 50
Parasetamol 500mg 10
Piroxicam 20 mg 120
Prednison tab 160
Ranitidin 150 mg tab 10
Vit. C 50 mg 30
vitamin b kompleks 80
69 ARTRITIS, OSTEOARTRITIS M19.9 Osteoarthrosis other 25 Piroxicam 20 mg 50
Prednison tab 110
B1 tablet 200
Ibuprofen 400 mg tab 40
 Dexametason tab 60
Natrium diklofenak 25 mg 140
ciprofloxacin 500 mg 70
Asam mefenamat 500 mg 20
Simvastatin 10 mg 20
Antasida sirup 3
CTM 20
70 LIPOMA D17.9 Benign lipomatous neoplasm
71 KEJANG DEMAM R56.0 Febrile convulsions
72 VERTIGO R42 Dizziness and giddiness Tidak tersedia obat spesifik
73 DELIRIUM F05.9 Delirium
74 TETANUS A35 Othertetanus
75 RABIES A82.9 Rabies
76 EPILEPSI G40.9 Epilepsy
77 STATUS EPILEPTIKUS G41.9 Status epilepticus, unspecified
78 MIGREN G43.9 Migraine, unspecified 2 Parasetamol 500mg 10
B1 tablet 20
Diazepam 2 mg tab 5
Asam mefenamat 500 mg 10
79 BELLS' PALSY G51.0 Bells’ palsy
80 TENSION HEADACHE G44.2 Tension–type headache 9 SF tablet 30
Natrium diklofenak 25 mg 30
Ibuprofen 400 mg tab 30
Vitamin b kompleks 10
Asam mefenamat 500 mg 30
Antasida sirup 2
B1 tablet 30
81 INSOMNIA G47.0 Disorders of initiating and maintaining 2 Diazepam 2 mg tab 16
sleep (insomnias) Vitamin b kompleks 10
82 DEMENSIA F03 Unspecified dementia
83 GANGGUAN CAMPURAN ANXIETAS DAN DEP F41.2 Mixed Anxiety and Depression Disorder
84 GANGGUAN PSIKOTIK F20 Chronic Psychotic Disorder
85 EPISTAKSIS R04.0 Epistaxis 2 Parasetamol 500 mg 20
Amoxicillin 500 mg 10
Vit. C 50 mg 20
Prednison tab 20
Vitamin b kompleks 10
SF tablet 10
GG tab 10
86 FURUNKEL PADA HIDUNG J34.0 Abscess, furuncle and carbuncle of nose
87 FARINGITIS J02.9 Acute pharyngitis, unspecified 24 Amoxicillin 250 mg 0
Amoxicillin 500 mg 110
 Amoxicillin sirup 3
Asam mefenamat 500 mg 40
ciprofloxacin 500 mg 30
CTM 104
Dexametason tab 88
cotrimoxazol 480mg 10
GG tab 44
Ibuprofen 400 mg tab 50
Ibuprofen sirup 1
Parasetamol 500mg 98
Prednison tablet 60
Piridoksin tab 10
Vit. C 50 mg 38
Vitamin b kompleks 60
Parasetamol sirup 1
Antasida sirup 3
88 RHINITIS AKUT J00 Acute nasopharingitis (common cold) 80 CTM 712
Amoxicillin sirup 3
Amoxicillin 500 mg 20
Asam mefenamat 500 mg 10
B1 tablet 30
Dexametason tab 325
GG tab 602
Parasetamol 500mg 561
Parasetamol sirup 2
Piridoksin tab 10
Prednison tablet 358
Vit. C 50 mg 225
Vitamin b kompleks 58
89 RHINITIS ALERGIK J30.0 Vasomotor rhinitis 11 Amoxicillin sirup 1
Amoxicillin 250 mg 3
CTM 54
Dexametason tab 25
GG tab 3
Parasetamol 500mg 24
Parasetamol sirup 2
Prednison tablet 30
Vit. C 50 mg 39
Vitamin b kompleks 40
90 RHINITIS VASOMOTOR J30.0 Vasomotor rhinitis
91 TONSILITIS R76 Acute tonsillitis, unspecified 24 Amoxicillin 250 mg 52
Amoxicillin 500 mg 88
 Amoxicillin sirup 5
CTM 111
Dexametason tab 102
GG tab 52
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 25
Parasetamol 500mg 98
Prednison tablet 32
Vit. C 50 mg 55
Vitamin b kompleks 17
92 LARINGITIS J04.0 Acute laryngitis
93 BRONKITIS AKUT J20.9 Acute bronchitis, unspecified 10 Ambroxol tablet 10
ciprofloxacin 500 mg 20
CTM 90
Dexametason tab 60
GG tab 120
Vitamin b kompleks 40
Parasetamol 500mg 35
salbutamol 2 mg 80
Ibuprofen 200 mg tab 20
Amoxicillin 500 mg 10
Amoxicillin 250 mg 12
94 INFLUENZA J11 Influenza 441 Ambroxol tablet 30
(ISPA) Amoxicillin 250 mg 376
Amoxicillin 500 mg 864
Amoxicillin sirup 57
Antasida sirup 8
B1 tablet 20
ciprofloxacin 500 mg 110
cotrimoxazol 480mg 82
Cotrimoxazol sirup 30
Cotriped 120 mg 97
CTM 2505
Dexametason tab 1058
GG tab 3053
Ibuprofen 200 mg tab 81
Ibuprofen sirup 16
Natrium diklofenak 25 mg 10
Parasetamol 500mg 1357
Parasetamol sirup 50
Piridoksin tab 92
Prednison tablet 767
 Salbutamol 2 mg 95
Vit. C 50 mg 937
Vitamin b kompleks 821
95 PNEUMONIA ASPIRASI J69.0 Pneumonitis due to food and vomit
96 PNEUMONIA DAN BRONKOPNEUMONIA J18.9 Pneumonia, unspecified 1 Amoxicillin 500 mg 10
Parasetamol 500mg 10
CTM 10
GG tab 10
Dexametason tab 10
Salbutamol 2 mg 10
97 PERTUSIS A37.8 Whooping cough
98 ASMA BRONKIAL J45 Asthma 5 CTM 40
Amoxicillin 500 mg 30
Dexametason tab 40
GG tab 40
Salbutamol 2 mg 50
99 MILIRIA L74.3 Miliaria
100 VERUKA VULGARIS B07 Viral warts
101 REAKSI GIGITAN SERANGGA T63.4 Venom of other arthropods
102 HERPES ZOSTER B02.9 Zoster without complication
103 HERPES SIMPLEKS B00.9 Herpesviral infection, unspecified
104 SKABIES B86 Scabies
105 PEDIKULOSIS KAPITIS B85.0 Pediculosis due to Pediculus humanus
106 DERMATOFITOSIS : TINEA KAPITIS B35.0 capitis
Tinea barbae and tinea capitis
107 DERMATOFITOSIS : TINEA BARBAE B35.0 Tinea barbae and tinea capitis
108 DERMATOFITOSIS : TINEA FASIALIS TINEA FASIALIS 1 Dexametason tab 10
Parasetamol 500mg 10
B1 tablet 10
109 DERMATOFITOSIS : TINEA KORPORIS B35.4 Tinea corporis 6 Griseofulvin tablet 125 mg 25
CTM 20
Ketokonazol ZK 6
Amoxicillin 500 mg 20
Oxytetrasiklin 3% ZK 1
ciprofloxacin 500 mg 10
110 DERMATOFITOSIS : TINEA MANUM B35.2 Tinea manuum
111 DERMATOFITOSIS : TINEA UNGUIUM B35.1 TINEA UNGUIUM
112 DERMATOFITOSIS : TINEA KRURIS B35.6 Tinea cruris
113 DERMATOFITOSIS : TINEA PEDIS B35.3 Tinea pedis 12 Amoxicillin 500 mg 50
Metronidazol 500 mg 10
Griseofulvin tablet 125 mg 55
Ketokonazol ZK 3
CTM 50
 Dexametason tab 20
Salep 2-4 1
Oxytetrasiklin 3% ZK 3
Miconazol cr 10
Ranitidin 150 mg tab 10
Asam mefenamat 500 mg 10
Prednison tab 10
114 PITIRIASIS VERSIKOLOR/TINEA VERSIKOLOR B36.0 Pityriasis versicolor
115 PIODERMA L08.0 Pyoderma
116 DERMATITIS SEBOROIK L21 Seborrhoeic dermatitis
117 DERMATITIS ATOPIK L20 Atopic dermatitis
118 DERMATITIS NUMULARIS L20.8 Other atopic dermatitis
119 LIKE SIMPLEKS KRONIK L28.0 Lichen simplex chronicus
120 (NEURODERMATITIS
DERMATITIS KONTAKSIRKUMKRIPTA)
ALERGIK L23 Allergic contact dermatitis 116 CTM 801
Amoxicillin 250 mg 20
Amoxicillin 500 mg 204
Amoxicillin sirup 6
Asam mefenamat 500 mg 40
B1 tablet 20
Basitrasin Zk 3
Betametason zk 9
ciprofloxacin 500 mg 50
Dexametason tab 631
Gentamisin Zk 3
Griseofulvin tablet 125 mg 130
Hidrocortison ZK 25
Ibuprofen 400 mg tab 30
Ketokonazol ZK 3
Kloramfenikol ZM 1
Myconazol cream 10
Oxytetrasiklin 3% ZK 18
Parasetamol 500mg 67
Parasetamol sirup 2
Prednison tab 191
Salep 2-4 3
Salisil bedak 3
Serbuk PK 2
Vit. C 50 mg 278
Vitamin b kompleks 46
121 DERMATITIS KONTAK IRITAN L24 Irritant contact dermatiti
122 NAPKIN ECZEMA 9DERMATITIS POPOK) L22 Diaper(napkin) dermatitis
123 PITIRIASIS ROSEA L42 Pityriasis rosea
124 MOLUSKUM KONTAGIOSUM B08.1 Molluscum contagiosum
125 URTIKARIA L50 Urticaria 3 CTM 30
Dexametason tab 30
Ranitidin 150 mg tab 10
126 FILARIASIS B74 Filariasis
127 LUKA BAKAR DERAJAT I DAN II S24 burn
128 OBESITAS E66.9 obesity unspecified
129 TIROTOKSIKOSIS E05.9 Tirotoksikosis unspecified
130 HIPERGLIKEMIA HIPEROSMOLAR NON KETO R73.9 Hyperglycaemia unspecified
131 HIPOGLIKEMIA E16.2 hypoglycaemia unspecified
132 DIABETES MELITUS 1 E10 Insulin-dependent diabetes mellitus
133 DIABETES MELITUS 2 E11 Non-insulin-dependent diabetes mellitus 61 Antasida sirup 1
Asam mefenamat 500 mg 10
B1 tablet 130
ciprofloxacin 500 mg 10
CTM 10
Glibenklamid 5 mg 490
Ibuprofen 400 mg tab 40
Metformin 500 mg 364
Natrium diklofenak 25 mg 30
Parasetamol 500mg 30
Prednison tab 10
Ranitidin 150 mg tab 10
Simvastatin 10 mg 40
Vit. C 50 mg 10
Vitamin b kompleks 100
134 MALNUTRISI ENERGI PROTEIN (MEP) E46 Unspecified protein-energy malnutrition
135 HIPERURICEMIA GOUT ARTHRITIS E79.0 Hyperuricemia without signs of 53 Alopurinol 100 mg 530
M10 inflammatory arthritis and tophaceous Antasida sirup 6
disease
B1 tablet 120
Dexametason tab 20
Ibuprofen 200 mg tab 10
Natrium diklofenak 25 mg 100
Parasetamol 500 mg 10
Piroxicam 20 mg 160
136 DISLIPIDEMIA E78.5 Hiperlipidemia 96 Simvastatin 10 mg 931
B1 tab 280
Piroxicam 20 mg 90
Parasetamol 500 mg 40
Ibuprofen 200 mg tab 0
Ibuprofen 400 mg tab 60
Antasida sirup 2
 Natrium diklofenak 25 mg 140
Vitamin b kompleks 10
Amoxicillin 500 mg 20
Prednison tab 20
Dexametason tab 30
Ranitidin 150 mg tab 40
137 INFEKSI SALURAN KEMIH N39.0 Urinary tarct infection, site not specified 15 Amoxicillin 500 mg 60
suspek ISK 4 Amoxicillin sirup 1
Asam mefenamat 500 mg 80
B1 tablet 70
ciprofloxacin 500 mg 110
Dexametason tab 20
Ibuprofen 400 mg tab 20
Ibuprofen sirup 1
Parasetamol 500mg 70
Prednison tab 60
SF tablet 20
Vit. C 50 mg 20
138 HIPERMEMESIS GRAVIDARUM O21.0 Mild hyperemis gravidarum
139 KEHAMILAN NORMAL O80.9 Single spontaneus delivery, unspecified 214 SF tablet 3597
Kalsium laktat 1324
Vitamin b kompleks 1715
Antasida sirup 32
Vit. C 50 mg 155
Piridoksin tab 483
B1 tablet 312
140 PRE-EKLAMPSIA O14.9 Pre-eclampsia, unspecified
141 EKLAMSIA O15.9 Eclampsia, unspecified as to time periode
142 ABORTUS SPONTAN KOMPLIT O03.9 Unspecified abortion complete, without
143 ABORTUS MENGANCAM/INSIPIENS O06.3 complication
Unspecified abortion incomplete, without
144 ABORTUS SPONTAN INKOMPLIT O06.4 complication
Unspecified abortion incomplete, without
145 ANEMIA DEFISIENSI BESI PADA KEHAMILAN D50 complication
Iron deficiency anemia
146 KETUBAN PECAH DINI 042.9 Premature rupture of membrane,
147 PERSALINAN LAMA O63.9 unspecified
long labour
148 PERDARAHAN POST PARTUM 072.1 Other Immediate Postpartum
149 RUPTUR PERINEUM TINGKAT 1-2 O70.0 haemorhage
First degree perineal laceration during 1 Amoxicillin 500 mg 10
delivery Asam mefenamat 500mg 10
Vit.C tab 10
150 MASTITIS N61 Inflammatory disorders of breast 7 ciprofloxacin 500 mg 50
Dexametason tab 50
Asam mefenamat 500 mg 40
CTM 30
 Parasetamol 500 mg 30
Prednison tab 20
B1 tablet 10
Oxytetrasiklin 3% ZK 1
Amoxicillin 500 mg 10
151 FLUOR ALBUS N98.9 5 Nistatin vaginal tab 14
CTM 30
Metronidazol 500 mg 20
152 SIFILIS A51 Early syphilis
153 GONORE A54.9 Gonococcal infection, unspecified
154 VAGINITIS N76.0 Acute Vaginitis
155 VULVITIS N76.0 Acute Vaginitis

Mengetahui Mamuju, 30 Nopember 2016

Kepala Puskesmas Penanggung Jawab Farmasi

NURHAIDAH A. HALIMAH USMAN,S.Si,Apt

NIP. 19661231 198803 2 239 NIP. 19831206 200912 2 002
 DATA DIAGNOSA LAIN YANG TERLAYANI DI FKTP
NAMA FKTP : PUSKESMAS BINANGA
BULAN NOPEMBER 2016
DIAGNOSA ICD X JUMLAH NAMA JUMLAH
NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS OBAT OBAT
1 Otalgia 5 CTM 20
Vit.C 50 mg 10
Asam mefenamat 500 mg 20
B1 tablet 10
Amoxicillin 500 mg 40
Ibuprofen 400 mg 30
Dexametason tab 30
2 Stomatiti 13 Amoxicillin 250 mg 12
Amoxicillin 500 mg 26
Amoxicillin sirup 1
CTM 19
Dexametason tab 30
Ibuprofen 200 mg 7
Ibuprofen sirup 2
Parasetamol 500 mg 48
Vit.C 50 mg 47
Vitamin B kompleks 31
3 Pterigium 4 Kloramfenikol ZM 4
CTM 40
Asam mefenamat 500 mg 10
Dexametason tab 30
Ibuprofen 400 mg 10
4 Trauma tumpul oculii 1 Dexametason tab 10
Amoxicillin 500 mg 10
Kloramfenikol ZM 1
Asam mefenamat 500 mg 10
5 LBP 17 Natrium diklofenak 25 mg 110
B1 tablet 110
Dexametason tab 20
Prednison tab 70
CTM 10
Ranitidin 150 mg 20
Antasida sirup 2
Piroxicam 20 mg 20
Diazepam 2 mg tab 15
 Ibuprofen 400 mg 40
Asam mefenamat 500 mg 10
7 Myalgia 142 Amoxicillin 250 mg 10
Amoxicillin 500 mg 126
Antalgin 500 mg 45
Antasida sirup 4
Antasida tablet 40
Asam mefenamat 500 mg 267
B1 tablet 966
CTM 120
Dexametason tab 86
Diazepam 2 mg tab 5
Ibuprofen 200 mg 96
Ibuprofen 400 mg 480
Natrium diklofenak 25 mg 280
Parasetamol 500 mg 26
Piroxicam 20 mg 50
Prednison tab 185
Ranitidin 150 mg 60
SF tablet 10
Simvastatin 10 mg 15
Vit.C 50 mg 70
Vitamin B kompleks 131
8 Cephalgia 84 Alopurinol 100 mg 10
Amoxicillin 500 mg 30
Antalgin 500 mg 95
Antasida sirup 3
Antasida tablet 90
Asam mefenamat 500 mg 135
B1 tablet 320
Captopril 25 mg 8
Ciprofloxazin 500 mg 10
CTM 50
Diazepam 2 mg tab 38
Ibuprofen 200 mg 93
Ibuprofen 400 mg 50
Natrium diklofenak 25 mg 10
Parasetamol 500 mg 380
Parasetamol sirup 2
Piridoksin tablet 45
Prednison tab 15
Ranitidin 150 mg 30
SF tablet 25
Simvastatin 10 mg 60
Vit.C 50 mg 30
 Vitamin B kompleks 200
9 Chest pain 6 Vitamin B kompleks 10
Parasetamol 500 mg 10
Ranitidin 150 mg 30
Natrium diklofenak 25 mg 10
Asam mefenamat 500 mg 20
Antasida sirup 2
Diazepam 2 mg tab 5
B1 tablet 10
Ibuprofen 400 mg 10
10 Hipotensi 29 B1 tablet 10
Antalgin 500 mg 10
CTM 20
Diazepam 2 mg tab 6
Parasetamol 500 mg 70
Piridoksin tablet 10
SF tablet 151
Vit.C 50 mg 20
Vitamin B kompleks 140
11 Post partum 5 Amoxicillin 500 mg 90
Aff implant 3 Asam mefenamat 500 mg 66
Dexametason tab 20
Parasetamol 500 mg 20
SF tablet 120
Vit.C 50 mg 60
Vitamin B kompleks 10
12 Sinusitis 1 Amoxicillin 500 mg 10
CTM 10
Prednison tab 10
Vit.C 50 mg 10
13 Tumor 1 Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
Dexametason tab 10
14 Malaise 2 Vitamin B kompleks 20
SF tablet 20
Vit.C 50 mg 10
Antasida sirup 10
15 Vomitus 9 CTM 36
Parasetamol sirup 3
Parasetamol 500 mg 10
Antasida sirup 1
Oralit 2
Piridoksin tablet 31
 GG tab 5
Ibuprofen 400 mg 10
Metoclopramod 5 mg 35
16 Dismenorhoe 1 SF tablet 10
Parasetamol 500 mg 10
Vitamin B kompleks 10
17 Infeksi genitalia 1 Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
CTM 10
Dexametason tab 10
18 Gangguan fungsi hati 1 Amoxicillin 500 mg 10
Antasida sirup 1
CTM 10
Ranitidin 150 mg 10
19 Poli gigi : Amoxicillin 250 mg 84
Necrose pulpa 3 Amoxicillin 500 mg 1322
Gingivitis 5 Amoxicillin sirup 1
Polip pulpa 2 Asam mefenamat 500 mg 1240
Gangren radix 36 B1 tablet 10
Periodontitis 14 Ciprofloxazin 500 mg 250
Abses 39 CTM 69
Post ekstraksi 1 Dexametason tab 1339
Pulpitis 64 Diazepam 2 mg tab 3
Gangren pulpa 7 Ibuprofen 400 mg 2
sakit gigi 17 Metronidazol 250 mg 170
Metronidazol 500 mg 60
Ibuprofen 200 mg 10
Natrium diklofenak 25 mg 20
Antalgin 500 mg 15
Parasetamol 500 mg 1010
Prednison tab 30
Vit.C 50 mg 134
Vitamin B kompleks 96
20 Resep UGD: Amoxicillin 250 mg 72
Vulnus ictum 11 Amoxicillin 500 mg 696
vulnus excoriatum 12 Amoxicillin sirup 13
vulnus laseratum 69 Asam mefenamat 500 mg 766
v. morsum 2 B1 tablet 20
V.scissum 2 Ciprofloxazin 500 mg 160
V.apperatum 1 Cotrimoxazol 480 mg 10
Post operasi 22 CTM 36
Post operasi SC 13 Dexametason tab 658
 Ulkus diabetik 9 Diazepam 2 mg tab 5
Cerumen ob 10 Ibuprofen 200 mg 20
Combutio 2 Ibuprofen 400 mg 20
Paronica 4 Metronidazol 500 mg 20
Keloid 1 Oxytetrasiklin 3% ZK 1
Parasetamol 500 mg 182
Piridoksin tablet 10
Prednison tab 30
Vit.C 50 mg 722
Vitamin B kompleks 40
21 Infeksi tali pusat 1 Oxytetrasiklin 3% ZK 1
22 Abses 20 Ciprofloxazin 500 mg 36
Dexametason tab 133
Vit.C 50 mg 53
Natrium diklofenak 25 mg 10
B1 tablet 10
Amoxicillin 500 mg 100
Asam mefenamat 500 mg 110
Amoxicillin sirup 1
Piroxicam 20 mg 10
Parasetamol 500 mg 3
CTM 13
Amoxicillin 250 mg 10
Oxytetrasiklin 3% ZK 3
Ibuprofen 200 mg 10
23 Ulkus 1 Ciprofloxazin 500 mg 10
Metronidazol 500 mg 10
Fitomenadion tablet 10
SF tablet 10
24 Udem palpebra 1 CTM 10
Udem serebral 1 Dexametason tab 50
Udem pretibie 3 Parasetamol 500 mg 10
Udem pd tangan 1 Amoxicillin 500 mg 20
Asam mefenamat 500 mg 40
Furosemid tablet 3
Ciprofloxazin 500 mg 10
Prednison tab 10
B1 tablet 10
Ibuprofen 400 mg 10
25 Melena 1 Metronidazol 500 mg 10
26 Hematome 2 SF tablet 10
Parasetamol 500 mg 10
 Amoxicillin 500 mg 20
Prednison tab 10
Dexametason tab 10
Asam mefenamat 500 mg 10
27 Kolik abdomen 1 Papaverin tablet 10
B1 tablet 10
Parasetamol sirup 1
28 Artralgia 10 Natrium diklofenak 25 mg 50
Prednison tab 70
B1 tablet 50
Piroxicam 20 mg 50
Ranitidin 150 mg 10
Antasida sirup 1
Simvastatin 10 mg 10
Diazepam 2 mg tab 5
Ibuprofen 400 mg 10
29 Struma 2 PTU 10
Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
Dexametason tab 10
30 Sariawan 2 Amoxicillin 500 mg 10
Vit.C 50 mg 20
Gentian violet 1
31 Konstipasi 1 Vit.C 50 mg 3
Vitamin B kompleks 3
Piridoksin tablet 3
32 Bengkak bagian leher 1 Parasetamol 500 mg 4
Dexametason tab 3
Amoxicillin 500 mg 4
Vit.C 50 mg 4
33 Acne vulgaris 1 Hidrocortison ZK 1
Oxytetrasiklin 3% ZK 1
Basitrasin+Polimiksin ZK 1
CTM 10
Dexametason tab 10
Amoxicillin 500 mg 10
34 Furunkel 9 Amoxicillin 250 mg 10
Amoxicillin 500 mg 33
Amoxicillin sirup 2
Asam mefenamat 500 mg 10
Betametason ZK 2
CTM 22
 Dexametason tab 39
Hidrocortison ZK 4
Ibuprofen 400 mg 3
Natrium diklofenak 25 mg 10
Oxytetrasiklin 3% ZK 1
Parasetamol 500 mg 9
Prednison tab 3
Vit.C 50 mg 19
Vitamin B kompleks 7
35 Intoksikasi 1 3 CTM 30
Dexametason tab 20
Prednison tab 10
36 Assesment pasca narkoba 2 Ibuprofen 400 mg 10
Vitamin B kompleks 10
Diazepam 2 mg tab 10
Diazepam 5 mg tab 5
37 Abdominal Pain 15 Antasida sirup 5
Cotrimoxazol 480 mg 32
Vitamin B kompleks 33
Papaverin tablet 43
B1 tablet 40
Ranitidin 150 mg 50
Natrium diklofenak 25 mg 30
Dexametason tab 10
CTM 23
Ibuprofen 400 mg 30
Parasetamol sirup 1
38 Menorhoe 1 SF tablet 10
Vitamin B kompleks 10
39 Dismenorhoe 5 Scopma tab 30
Papaverin tablet 10
Asam mefenamat 500 mg 10
B1 tablet 10
Vitamin B kompleks 10
SF tablet 10
40 Dislokasi panggul 3 Ciprofloxazin 500 mg 30
Dislokasi pedis 2 Asam mefenamat 500 mg 50
Dexametason tab 50
Natrium diklofenak 25 mg 10
 Amoxicillin 500 mg 20
Ibuprofen 400 mg 10
Prednison tab 10
41 Suspek tumor pipi 1 Amoxicillin 500 mg 10
Dexametason tab 10
CTM 10
42 Batuk darah 1 Amoxicillin 500 mg 10
Fitomenadion tablet 10
43 Batuk lama 2 Amoxicillin 500 mg 10
CTM 20
Dexametason tab 20
GG tab 20
Vitamin B kompleks 10
Vit.C 50 mg 10
44 PPOK 4 Amoxicillin 500 mg 20
GG tab 30
Salbutamol 2 mg 40
CTM 40
Vitamin B kompleks 10
Parasetamol 500 mg 40
Dexametason tab 30
Vit.C 50 mg 10
Ambroxol tab 10
Prednison tab 10
45 Obs. Febris 85 Amoxicillin 250 mg 40
Amoxicillin 500 mg 60
Amoxicillin sirup 3
Antasida sirup 2
B1 tablet 80
Ciprofloxazin 500 mg 40
Cotrimoxazol 480 mg 23
Cotrimoxazol sirup 1
CTM 154
 Dexametason tab 62
Ibuprofen 200 mg 10
Ibuprofen sirup 6
Parasetamol 500 mg 497
Parasetamol sirup 27
Piridoksin tablet 62
Prednison tab 30
SF tablet 10
Vit.C 50 mg 71
Vitamin B kompleks 328
46 Skizofrenia 2 2 Klorpromazin 100 mg 24
47 Infeksi 13 Asam mefenamat 500mg 10
Griseofulvin 125 mg 10
Amoxicillin 500 mg 15
Amoxicillin 250 mg 22
Amoxicillin sirup 2
CTM 37
Vit.C tab 18
Ibuprofen 200 mg 10
Ciprofloxacin 500 mg 10
Parasetamol 500mg 10
Hidrocortison ZK 2
Basitrasin ZK 1
Betametason ZK 3
48 Luka 12 Amoxicillin 500 mg 70
Amoxicillin sirup 1
Asam mefenamat 500mg 55
Dexametason tablet 10
Ibuprofen 200 mg 6
Ibuprofen sirup 1
Parasetamol 500mg 6
Parasetamol sirup 1
Vit.C tab 15
49 Kecelakaan dan ruda paksa 4 Amoxicillin 500 mg 40
Asam mefenamat 500mg 30
Dexametason tablet 30
Lidocain injeksi 1
Parasetamol 500mg 10
Prednison tablet 10
Vit.C tab 40

Mengetahui Mamuju, 30 Nopember 2016

Kepala Puskesmas Penanggung Jawab Farmasi

NURHAIDAH A. HALIMAH USMAN,S.Si,Apt

NIP. 19661231 198803 2 239 NIP. 19831206 200912 2 002
 DATA 155 DIAGNOSA YANG HARUS SELESAI DI FKTP
NAMA FKTP : PUSKESMAS BINANGA
BULAN OKTOBER 2016
DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML
NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
1 TB PARU A15 Respiratory TB 14 Fitomenadion tablet 10 suspek
suspek ciprofloxacin 500 mg 40 suspek
Ambroxol tablet 80 suspek
CTM 110 suspek
Natrium diklofenak 25 mg tab 20 suspek
B1 tablet 10 suspek
Salbutamol 2 mg tab 20 suspek
Vitamin b kompleks 50 suspek
GG tab 40 suspek
Dexametason tab 20 suspek
Prednison tab 30 suspek
Amoxicillin 500 mg 10 suspek
Parasetamol 500mg 10 suspek
Vit. C 50 mg 10 suspek
2 MORBILI B059 Measles without complication 0
3 VARISELA B019 Varicella without complication 5 CTM 18
Dexametason tab 18
Vit. C 50 mg 9
Amoxicillin 500 mg 2
Parasetamol sirup 3
Acyclovir 400 mg 64
Acyclovir salep 2
4 MALARIA B54 Unspecified malaria 0
5 DEMAM DENGUE DAN DEMAM A90, A91 Dengue fever, DHF 0
6 BERDARAH DENGUE
LEPTOSPIROSIS A279 0
7 INFEKSI PADA UMBILIKUS 0
8 KANDIDIASIS MULUT B379 Candidiasis unspecified 1 Amoxicillin 500 mg 2
Parasetamol sirup 1
CTM 2
Vit. C 50 mg 2
Vitamin b kompleks 2
9 LEPRA A30 Leprosy 2 Vit. C 50 mg 30
Piroxicam 10 mg 10
 B1 tablet 10
Piridoksin tab 10
10 KERACUNAN MAKANAN T622 Other ingested (parts of plant(s)) 0
11 ALERGI MAKANAN 0
12 EXANTHEMATOUS DRUG ERUPTION L270 Generalized skin eruption due to drugs 0
13 FIXED DRUG ERUPTION L270 and medicaments
Generalized skin eruption due to drugs 0
14 REAKSI ANAFILAKTIK and medicaments 0
15 SYOK R579 Shock, unspecified 0
16 ANEMIA D649 Anaemia, unspecified (anemia defisiensi 15 SF tablet 150
besi-4A, anemia hemolitik-3A, anemia Vitamin B kompleks 150
makrositik-3A, anemia aplastik-2, anemia
17 HIV/AIDS TANPA KOMPLIKASI Z21 Asymptomatic HIV infection status
megaloblastik-2) 0
18 LIMFADENITIS B70 Lymphadenitis Acute 5 Amoxicillin sirup 1
Asam mefenamat 500 mg 20
B1 tablet 20
ciprofloxacin 500 mg 20
CTM 2
Dexametason tab 32
Parasetamol 500mg 10
Vit. C 50 mg 2
Vitamin b kompleks 10
19 REFLUKS GASTROESOFAGEAL K219 Gastrooesophageal reflux disease without 0
20 GASTRITIS K297 oesophagitis
Gastritis, unspecified 237 Amoxicillin 500 mg 20
(dispepsia) Antalgin tab 10
Antasida sirup 40
Antasida tablet 1247
Asam mefenamat 500 mg 10
B1 tablet 90
cotrimoxazol 480mg 12
Cotrimoxazol sirup 2
CTM 10
Dexametason tab 33
Diazepam 2 mg tab 4
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 80
Natrium diklofenak 25 mg tab 70
Parasetamol 500mg 206
Parasetamol sirup 1
Piridoksin tab 576
Ranitidin 150 mg tab 1061
SF tablet 50
Vit. C 50 mg 13
Vitamin b kompleks 369
21 INTOLERANSI MAKANAN 0
22 MALABSORBSI MAKANAN 0
23 DEMAM TIFOID A010 Typhoid fever 14 Antasida sirup 1 termasuk suspek
Antasida tablet 87
ciprofloxacin 500 mg 10
cotrimoxazol 480mg 38
Cotrimoxazol sirup 6
CTM 10
Dexametason tab 31
kloramfenikol 250 mg kapsul 75
kloramfenikol sirup 4
Parasetamol 500mg 123
Parasetamol sirup 3
Piridoksin tab 34
Ranitidin 150 mg tab 30
SF tablet 10
Vit. C 50 mg 3
Vitamin b kompleks 36
24 GASTROENTERITIS ( TERMASUK DISENTRI, A09 Diarrhoea & gastroenteritis of presumed 196 Cotrimoxazol sirup 65
KOLERA, GIARDIASIS) infection origin cotrimoxazol 480mg 642
Ranitidin 150 mg tab 124
Papaverin tablet 120
CTM 35
Parasetamol sirup 15
Oralit 282
Parasetamol 500mg 109
Piridoksin tab 69
Antasida tablet 34
Zink tablet 385
Natrium diklofenak 25 mg tab 10
Vitamin b kompleks 42
Domperidon tab 10 mg 20
Metoclopramid 5 mg 19
Dexametason tab 3
Vit. C 50 mg 5
25 DISENTRI BASILER DAN DISENTRI AMUBA 14 Antasida tablet 21
B1 tablet 10
cotrimoxazol 480mg 80
Cotrimoxazol sirup 3
CTM 12
Metronidazol 250 mg 10
Metronidazol 500 mg 92
 Natrium diklofenak 25 mg tab 10
Papaverin tablet 30
Parasetamol 500mg 36
Piridoksin tab 3
Ranitidin 150 mg tab 20
SF tablet 10
Vitamin b kompleks 20
Zink tablet 30
26 APENDISITIS AKUT K359 Acute appendicitis 0
Post App 2 Amoxicillin 500 mg 20
Suspek 1 Prednison tablet 10
Asam mefenamat 500 mg 30
Vit. C 50 mg 10
cotrimoxazol 480mg 12
Dexametason tab 10
27 PERDARAHAN SALURAN MAKAN BAGIAN 0
28 ATAS
PERDARAHAN SALURAN MAKAN BAGIAN 0
29 BAWAH
HEMOROID GRADE 1-2 9 Antihemoroid suppo 19
ciprofloxacin 500 mg 10
Asam mefenamat 500 mg 40
Dexametason tab 20
Hidrocortison cream 1
cotrimoxazol 480mg 36
SF tablet 10
30 HEPATITIS A 0
31 HEPATITIS B 0
32 PAROTITIS K11.2 Sialoadenitis 2 Asam mefenamat 500 mg 14
Vit. C 50 mg 14
Parasetamol 500mg 4
CTM 4
Vitamin b kompleks 4
33 ASKARIASIS B77.9 Ascariaris unspecified 17 Pyrantel sirup 4
Pyrantel 125 mg 15
Vitamin b kompleks 40
Papaverin tablet 10
34 CUTANEUS LARVA MIGRANS B76.9 Hookworm disease, unspecified a
35 PENYAKIT CACING TAMBANG B76.0 Ankylostomiasis ,Necatoriasis a
36 SKISTOSOMIASIS B76.1
B65.9 Skistosomiasisunspecified , Schistomiasis a
37 STRONGILOIDIASIS B65.2
B78.9 due to S. Japonicum
Strongyloidiasis a
38 TAENIASIS B68.9 Taeniasis a
39 PERITONISIS K65.9 Peritonitis, unspecified a
40 KOLESISTITIS K81.9 Cholecystitis, unspecified a
41 MATA KERING/DRY EYE H04.1 Other disorders of lacrimal gland a
42 BUTA SENJA H53.5 Colour vision deficiencies a
43 HORDEOLUM H00.0 Hordeolum and other deep inflammation 2 Amoxicillin 500 mg 10
of eyelid Ibuprofen 200 mg tab 10
Dexametason tab 10
Kloramfenikol ZM 2
44 KONJUNGTIVITIS H10.9 Conjunctivitis, unspecified,,, Acute 15 Oxytetrasiklin 1% ZM 9
H10.1 atopic conjunctivitis Kloramfenikol ZM 6
Amoxicillin 500 mg 10
CTM 20
Vit. C 50 mg 20
Antasida tablet 10
Dexametason tab 10
45 BLEFARITIS H01.0 Blepharitis 1 CTM 10
Dexametason tab 10
Parasetamol 500mg 10
Vit. C 50 mg 10
46 PERDARAHAN SUBKONJUNGTIVA H57.8 Other specified disorders of eye and 1 Amoxicillin 500 mg 10
adnexa Dexametason tab 10
Vit. C 50 mg 10
Oxytetrasiklin 1% ZM 1
47 BENDA ASING DI KONJUNGTIVA T15.9 Foreign body on external eye, part a
48 ASTIGMATISM H52.2 unspecified
Astigmatism a
49 HIPERMETROPIA H52.0 Hypermetropia a
50 MIOPIA RINGAN H52.1 Myopia 10 a
51 PRESBIOPIA H52.4 Presbyopia a
52 KATARAK PADA PASIEN DEWASA H26.9 Cataract, unspecified a
53 GLAUKOMA AKUT H40.2 Primary angle-closure glaucoma a
54 OTITIS EKSTERNA H60.9 Otitis Externa, Unspecified 2 Ibuprofen 400 mg tab 10
Amoxicillin 500 mg 10
Amoxicillin sirup 1
CTM 3
Dexametason tab 3
Parasetamol 500mg 3
Vit. C 50 mg 4
55 OTITIS MEDIA AKUT H66.0 Acute suppurative otitis media 11 Amoxicillin 250 mg 12
Amoxicillin 500 mg 84
Amoxicillin sirup 5
Asam mefenamat 500 mg 40
ciprofloxacin 500 mg 10
CTM 83
Dexametason tab 119
 GG tab 20
Metronidazol 500 mg 3
Parasetamol 500mg 4
Parasetamol sirup 1
Prednison tab 4
Vit. C 50 mg 62
Vitamin b kompleks 14
56 SERUMEN PROP H61.2 Impacted cerumen 2 Amoxicillin 250 mg 10
CTM 20
Dexametason tab 10
Parasetamol 500mg
57 BENDA ASING DI HIDUNG T17.1 Foreign body in nostril a
58 ANGINA PEKTORIS I20.9 Angina pectoris a
59 INFARK MIOKARD I21.9 Acute Myocardial Infarction a
60 TAKIKARDIA I47.1 Supraventicular Tachicardy , Ventricular a
61 GAGAL JANTUNG AKUT DAN KRONIK I50.9 Tachicardy
Heart failure a
I47.2
62 CARDIORESPIRATORY ARREST K80 Cardiac arrhytmia a
63 HIPERTENSI ESENSIAL I10 Essential (primary) hypertension 184 Captopril 25 mg 1596
B1 tablet 1320
Antasida tablet 30
Asam mefenamat 500 mg 60
Ibuprofen 400 mg tab 40
Salbutamol 2 mg 10
Metronidazol 500 mg 10
CTM 20
Hidrocortison ZK 2
Natrium diklofenak 25 mg 10
Vitamin b kompleks 10
Piroxicam 10 mg 10
64 INFARK SEREBRAL/STROKE I63.9 Cerebral infarction a
65 FRAKTUR TERBUKA T14. Fracture of unspecified body a
66 FRAKTUR TERTUTUP T14. Fracture of unspecified body a
67 POLIMIALGIA REUMATIK M53.3 Polymyalgia rheumatica a
68 ARTRITIS REUMATOID M53.3 Polymyalgia rheumatica 51 Natrium diklofenak 25 mg 180
B1 tablet 510
Dexametason tab 210
ciprofloxacin 500 mg 60
Ibuprofen 400 mg tab 130
Ranitidin 150 mg tab 20
Prednison tab 130
Antasida tablet 20
Piroxicam 10 mg 190
 Diazepam 2 mg tab 4
Vitamin b kompleks 10
Alopurinol 100 mg 40
Simvastatin 10 mg 30
Parasetamol 500mg 10
69 ARTRITIS, OSTEOARTRITIS M19.9 Osteoarthrosis other 9 Piroxicam 10 mg 90
Prednison tab 50
B1 tablet 90
70 LIPOMA D17.9 Benign lipomatous neoplasm a
71 KEJANG DEMAM R56.0 Febrile convulsions a
72 VERTIGO R42 Dizziness and giddiness 2 SF tablet 10 Tidak tersedia obat
Ibuprofen 400 mg tab 10 spesifik vertigo
B1 tablet 10
Diazepam 2 mg tab 10
73 DELIRIUM F05.9 Delirium a
74 TETANUS A35 Othertetanus a
75 RABIES A82.9 Rabies a
76 EPILEPSI G40.9 Epilepsy 1 a
77 STATUS EPILEPTIKUS G41.9 Status epilepticus, unspecified a
78 MIGREN G43.9 Migraine, unspecified 2 Antalgin tab 10
Antasida tablet 10
Vitamin b kompleks 10
Natrium diklofenak 25 mg 10
Ranitidin 150 mg tab 10
79 BELLS' PALSY G51.0 Bells’ palsy 1 a
80 TENSION HEADACHE G44.2 Tension–type headache 6 Simvastatin 10 mg 30
B1 tablet 60
Ibuprofen 400 mg tab 20
Asam mefenamat 500 mg 10
Antalgin tab 10
SF tablet 10
Vitamin b kompleks 10
81 INSOMNIA G47.0 Disorders of initiating and maintaining 5 Diazepam 2 mg tab 20
sleep (insomnias) CTM 10
B1 tablet 50
82 DEMENSIA F03 Unspecified dementia a
83 GANGGUAN CAMPURAN ANXIETAS DAN DEP F41.2 Mixed Anxiety and Depression Disorder a
84 GANGGUAN PSIKOTIK F20 Chronic Psychotic Disorder a
85 EPISTAKSIS R04.0 Epistaxis a
86 FURUNKEL PADA HIDUNG J34.0 Abscess, furuncle and carbuncle of nose a
87 FARINGITIS J02.9 Acute pharyngitis, unspecified 20 Amoxicillin 500 mg 50
Ibuprofen 400 mg tab 10
 Ranitidin 150 mg tab 20
Vitamin b kompleks 50
Parasetamol 500mg 117
CTM 77
GG tab 33
Dexametason tab 100
Vit. C 50 mg 77
ciprofloxacin 500 mg 50
Asam mefenamat 500 mg 30
Prednison tablet 44
Amoxicillin 250 mg 20
Amoxicillin sirup 1
Ibuprofen sirup 1
Ibuprofen 200 mg tab 10
88 RHINITIS AKUT J00 Acute nasopharingitis (common cold) 30 CTM 213
Dexametason tab 109
Vit. C 50 mg 121
Parasetamol 500mg 122
GG tab 141
Prednison tablet 84
Vitamin b kompleks 43
Ibuprofen sirup 1
B1 tablet 20
Parasetamol sirup 1
Amoxicillin 500 mg 6
Ambroxol tablet 10
89 RHINITIS ALERGIK J30.0 Vasomotor rhinitis 5 CTM 40
ciprofloxacin 500 mg 10
Dexametason tab 20
Parasetamol 500mg 40
Prednison tablet 10
Vit. C 50 mg 40
Vitamin b kompleks 10
90 RHINITIS VASOMOTOR J30.0 Vasomotor rhinitis
91 TONSILITIS R76 Acute tonsillitis, unspecified 21 Amoxicillin 250 mg 32
Amoxicillin 500 mg 105
Amoxicillin sirup 5
Asam mefenamat 500 mg 10
CTM 88
Dexametason tab 104
GG tab 66
Ibuprofen 200 mg tab 20
 Ibuprofen 400 mg tab 10
Parasetamol 500mg 85
Parasetamol sirup 2
Prednison tablet 20
Vit. C 50 mg 88
Vitamin b kompleks 14
92 LARINGITIS J04.0 Acute laryngitis a
93 BRONKITIS AKUT J20.9 Acute bronchitis, unspecified 11 GG tab 20
CTM 40
Dexametason tab 60
Vit. C 50 mg 20
Ambroxol tablet 50
Salbutamol 2 mg 40
ciprofloxacin 500 mg 30
Amoxicillin 500 mg 10
Prednison tablet 10
94 INFLUENZA J11 Influenza 723 Amoxicillin sirup 80
(ISPA) Ambroxol tablet 480
Amoxicillin 250 mg 114
Amoxicillin 500 mg 1242
Antasida tablet 73
B1 tablet 130
ciprofloxacin 500 mg 200
cotrimoxazol 480mg 146
Cotrimoxazol sirup 38
Cotriped 120 mg 4
Dexametason tab 4062
Eritromisin 500mg 15
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 150
Natrium diklofenak 25 mg 40
Parasetamol 500mg 3424
Parasetamol sirup 76
Piridoksin tab 55
Piroxicam 10 mg 10
Prednison tablet 457
Ranitidin 150 mg tab 90
Salbutamol 2 mg 41
Salbutamol 4 mg 10
Vit. C 50 mg 2098
Vitamin b kompleks 319
GG tab 4056
 CTM 4056
95 PNEUMONIA ASPIRASI J69.0 Pneumonitis due to food and vomit a
96 PNEUMONIA DAN BRONKOPNEUMONIA J18.9 Pneumonia, unspecified 3 Cotrimoxazol sirup 2
Parasetamol 500mg 8
CTM 8
GG tab 8
Dexametason tab 3
Vit. C 50 mg 8
Salbutamol 2 mg 8
Prednison tab 5
ciprofloxacin 500 mg 10
Ambroxol tablet 10
97 PERTUSIS A37.8 Whooping cough a
98 ASMA BRONKIAL J45 Asthma 3 CTM 10
Prednison tab 13
GG tab 13
Salbutamol 2 mg 22
Parasetamol sirup 1
99 MILIRIA L74.3 Miliaria 2 CTM 13
Dexametason tab 4
Prednison tab 10
Saisil bedak 1
100 VERUKA VULGARIS B07 Viral warts a
101 REAKSI GIGITAN SERANGGA T63.4 Venom of other arthropods a
102 HERPES ZOSTER B02.9 Zoster without complication 3 Parasetamol 500mg 20
CTM 30
Dexametason tab 30
Acyclovir salep 3
Hidrocortison ZK 1
Amoxicillin 500 mg 10
Acyclovir 200mg 12
a
103 HERPES SIMPLEKS B00.9 Herpesviral infection, unspecified a
104 SKABIES B86 Scabies a
105 PEDIKULOSIS KAPITIS B85.0 Pediculosis due to Pediculus humanus a
106 DERMATOFITOSIS : TINEA KAPITIS B35.0 capitis
Tinea barbae and tinea capitis a
107 DERMATOFITOSIS : TINEA BARBAE B35.0 Tinea barbae and tinea capitis a
108 DERMATOFITOSIS : TINEA FASIALIS TINEA FASIALIS a
109 DERMATOFITOSIS : TINEA KORPORIS B35.4 Tinea corporis 4 Griseofulvin tablet 125 mg 10
CTM 20
Myconazol cream 3
Salep 2-4 1
 Parasetamol 500mg 10
Vit. C 50 mg 10
110 DERMATOFITOSIS : TINEA MANUM B35.2 Tinea manuum a
111 DERMATOFITOSIS : TINEA UNGUIUM B35.1 TINEA UNGUIUM a
112 DERMATOFITOSIS : TINEA KRURIS B35.6 Tinea cruris a
113 DERMATOFITOSIS : TINEA PEDIS B35.3 Tinea pedis 12 CTM 90
Dexametason tab 40
Griseofulvin tablet 125 mg 50
Myconazol cream 11
Vit. C 50 mg 10
B1 tablet 10
Salep 2-4 1
Metronidazol 500 mg 10
Amoxicillin 500 mg 20
114 PITIRIASIS VERSIKOLOR/TINEA VERSIKOLOR B36.0 Pityriasis versicolor a
115 PIODERMA L08.0 Pyoderma a
116 DERMATITIS SEBOROIK L21 Seborrhoeic dermatitis 8 CTM 54
Amoxicillin 250 mg 12
Amoxicillin 500 mg 20
Amoxicillin sirup 1
Dexametason tab 24
GG tab 4
Hidrocortison ZK 3
Myconazol cream 2
Prednison tab 30
Ranitidin 150 mg tab 10
Salep 2-4 1
Salisil bedak 1
Serbuk PK 1
Vit. C 50 mg 24
117 DERMATITIS ATOPIK L20 Atopic dermatitis a
118 DERMATITIS NUMULARIS L20.8 Other atopic dermatitis a
119 LIKE SIMPLEKS KRONIK L28.0 Lichen simplex chronicus a
120 (NEURODERMATITIS
DERMATITIS KONTAKSIRKUMKRIPTA)
ALERGIK L23 Allergic contact dermatitis 70 CTM 519
Amoxicillin 500 mg 167
Amoxicillin sirup 12
Antasida tablet 10
B1 tablet 20
Basitrasin polimiksin ZK 2
Betametason cream 2
ciprofloxacin 500 mg 20
Dexametason tab 420
 Hidrocortison ZK 25
Ibuprofen 400 mg tab 10
Metronidazol 500 mg 10
Myconazol cream 6
Natrium diklofenak 25 mg 10
Oxytetrasiklin 3% ZK 5
Parasetamol 500mg 21
Prednison tab 60
Ranitidin 150 mg tab 10
Salisil bedak 2
Serbuk PK 2
SF tablet 10
Vit. C 50 mg 234
Vitamin b kompleks 50
121 DERMATITIS KONTAK IRITAN L24 Irritant contact dermatiti a
122 NAPKIN ECZEMA 9DERMATITIS POPOK) L22 Diaper(napkin) dermatitis a
123 PITIRIASIS ROSEA L42 Pityriasis rosea a
124 MOLUSKUM KONTAGIOSUM B08.1 Molluscum contagiosum a
125 URTIKARIA L50 Urticaria a
126 FILARIASIS B74 Filariasis a
127 LUKA BAKAR DERAJAT I DAN II S24 burn a
128 OBESITAS E66.9 obesity unspecified a
129 TIROTOKSIKOSIS E05.9 Tirotoksikosis unspecified a
130 HIPERGLIKEMIA HIPEROSMOLAR NON KETO R73.9 Hyperglycaemia unspecified a
131 HIPOGLIKEMIA E16.2 hypoglycaemia unspecified a
132 DIABETES MELITUS 1 E10 Insulin-dependent diabetes mellitus a
133 DIABETES MELITUS 2 E11 Non-insulin-dependent diabetes mellitus 55 Glimepirid 2 mg 100
B1 tablet 70
Metformin 500 mg 310
Glibenklamid 5 mg 170
Vitamin b kompleks 20
Alopurinol 100 mg 20
Parasetamol 500mg 10
ciprofloxacin 500 mg 20
Prednison tab 20
134 MALNUTRISI ENERGI PROTEIN (MEP) E46 Unspecified protein-energy malnutrition a
135 HIPERURICEMIA GOUT ARTHRITIS E79.0 Hyperuricemia without signs of 61 Simvastatin 10 mg 90
M10 inflammatory arthritis and tophaceous Alopurinol 100 mg 610
disease
B1 tablet 140
Ibuprofen 400 mg tab 30
Natrium diklofenak 25 mg 140
Dexametason tab 40
 Ranitidin 150 mg tab 10
ciprofloxacin 500 mg 10
Piroxicam 10 mg 30
136 DISLIPIDEMIA E78.5 Hiperlipidemia 175 Simvastatin 10 mg 1650
B1 tab 630
Piroxicam 10 mg 130
Captopril 25 mg 85
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 170
Antasida tablet 150
Natrium diklofenak 25 mg 320
Vitamin b kompleks 70
GG tab 10
Prednison tab 60
CTM 20
Diazepam 2 mg tab 20
Asam mefenamat 500 mg 40
Metformin 500 mg 10
Salbutamol 2 mg 10
Parasetamol tablet 90
Ranitidin 150 mg tab 90
Dexametason tab 30
Amoxicillin 500 mg 10
Antalgin tab 40
cotrimoxazol 480mg 12
SF tablet 10
Vit. C 50 mg 10
Fitomenadion tab 10
137 INFEKSI SALURAN KEMIH N39.0 Urinary tarct infection, site not specified 25 ciprofloxacin 500 mg 120
Asam mefenamat 500 mg 180
B1 tablet 30
Dexametason tab 140
CTM 20
GG tab 10
cotrimoxazol 480mg 24
Ranitidin 150 mg tab 50
Amoxicillin 500 mg 80
Amoxicillin 250 mg 10
Parasetamol 500mg 50
Natrium diklofenak 25 mg 10
Vit. C 50 mg 60
Papaverin tablet 10
 Vitamin b kompleks 10
Prednison tab 30
Metronidazol 500 mg 10
138 HIPERMEMESIS GRAVIDARUM O21.0 Mild hyperemis gravidarum a
139 KEHAMILAN NORMAL O80.9 Single spontaneus delivery, unspecified 114 SF tablet 2610
Ranitidin 150 mg tab 10
Kalsium laktat 750
Vitamin b kompleks 1080
Antasida tablet 200
Vit. C 50 mg 80
Piridoksin tab 280
Parasetamol tablet 20
B1 tablet 40
140 PRE-EKLAMPSIA O14.9 Pre-eclampsia, unspecified a
141 EKLAMSIA O15.9 Eclampsia, unspecified as to time periode a
142 ABORTUS SPONTAN KOMPLIT O03.9 Unspecified abortion complete, without a
143 ABORTUS MENGANCAM/INSIPIENS O06.3 complication
Unspecified abortion incomplete, without a
144 ABORTUS SPONTAN INKOMPLIT O06.4 complication
Unspecified abortion incomplete, without a
145 ANEMIA DEFISIENSI BESI PADA KEHAMILAN D50 complication
Iron deficiency anemia a
146 KETUBAN PECAH DINI 042.9 Premature rupture of membrane, a
147 PERSALINAN LAMA O63.9 unspecified
long labour a
148 PERDARAHAN POST PARTUM 072.1 Other Immediate Postpartum a
149 RUPTUR PERINEUM TINGKAT 1-2 O70.0 haemorhage
First degree perineal laceration during a
150 MASTITIS N61 delivery
Inflammatory disorders of breast 1 ciprofloxacin 500 mg 10
Dexametason tab 10
Asam mefenamat 500 mg 10
Antasida tablet 10
151 FLUOR ALBUS N98.9 7 Nistatin vaginal tab 4
CTM 70
Metronidazol 500 mg 50
Vitamin b kompleks 10
Vit. C 50 mg 10
Asam mefenamat 500 mg 10
Ibuprofen 400 mg tab 10
152 SIFILIS A51 Early syphilis a
153 GONORE A54.9 Gonococcal infection, unspecified a
154 VAGINITIS N76.0 Acute Vaginitis a
155 VULVITIS N76.0 Acute Vaginitis a

Mengetahui, Yang Melaporkan, Yang Melaporkan,

Kepala Puskesmas Pengelola SP2TP Pengelola Obat
 ………………………………………………………………………………………… ……………………………………………………………………….. ………………………………………………………………………..

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
1 Struma 3 Propiltiourasil tab 100
Captopril 25 mg 10
Asam mefenamat 500 mg 10
Vitamin B kompleks 10
2 Gangguan hati 2 Amoxicillin 500 mg 40 R/perawat
Suspek Hepatits 3 Ibuprofen 400 mg 10
Dexametason tab 30
Vitamin B kompleks 40
Ciprofloxazin 500 mg 10
Ranitidin 150 mg 40
Antasida tablet 30
Antasida sirup 1
3 Acne vulgaris 1 Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
Dexametason tab 10
Hidrocortison Zk 1
4 Suspek Benigna 1 Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
Dexametason tab 10
5 Furukulitis 10 CTM 54
 Dexametason tab 79
Amoxicillin 500 mg 60
Hidrocortison Zk 4
Asam mefenamat 500 mg 40
Ciprofloxazin 500 mg 20
Ibuprofen 400 mg 10
Vit.C 50 mg 24
Amoxicillin 250 mg 10
Amoxicillin sirup 1
Prednison tab 10
Parasetamol 500 mg 24
Oxytetrasiklin 3% ZK 2
Vitamin B kompleks 4
6 Polip 1 Amoxicillin 500 mg 10
CTM 10
Dexametason tab 10
Salbutamol 2 mg 10
7 Myalgia 60 Natrium diklofenak 25 mg 300
B1 tablet 430
Prednison tab 70
Dexametason tab 130
Asam mefenamat 500 mg 50
Ibuprofen 400 mg 170
Parasetamol 500 mg 30
GG tab 10
CTM 10
Vitamin B kompleks 70
Ranitidin 150 mg 20
Piridoksin tablet 10
Antasida tablet 30
Vit.C 50 mg 10
Amoxicillin 500 mg 20
Gentian violet 1
8 Impetigo 1 Dexametason tab 3
Vit.C 50 mg 4
Vitamin B kompleks 4
Amoxicillin sirup 1
Gentamisin ZK 1
CTM 3
9 Stomatitis 4 Vit.C 50 mg 22
Vitamin B kompleks 10
Amoxicillin sirup 1
 Parasetamol 500 mg 12
CTM 2
Dexametason tab 2
Amoxicillin 500 mg 20
Asam mefenamat 500 mg 1`0
Prednison tab 10
10 Gangguan pada Gigi Amoxicillin 500 mg 843
Pulpitis irrevesibel 42 Parasetamol 500 mg 349
Gangren radix 50 Dexametason tab 713
Periodontitis 25 CTM 18
Vitamin B kompleks 203
Vit.C 50 mg 323
Amoxicillin 250 mg 12
Asam mefenamat 500 mg 740
Prednison tab 264
Ciprofloxazin 500 mg 162
Metronidazol 250 mg 10
Metronidazol 500 mg 10
Natrium diklofenak 25 mg 10
B1 tablet 10
11 Febris pro ev 44 Amoxicillin 500 mg 83
Amoxicillin sirup 3
Parasetamol 500 mg 230
Parasetamol sirup 19
Vitamin B kompleks 202
CTM 47
Dexametason tab 16
Vit.C 50 mg 68
Antasida tablet 20
B1 tablet 30
Piridoksin tablet 20
Salisik bedak 1
Ciprofloxazin 500 mg 30
Ibuprofen 400 mg 10
Oralit 5
Cotrimoxazol sirup 1
12 Polimenore 4 Amoxicillin 500 mg 20
Fitomenadion tablet 20
Vit.C 50 mg 20
Vitamin B kompleks 10
SF tablet 30
Asam mefenamat 500 mg 10
13 Hemoptoe 2 Ciprofloxazin 500 mg 10
Dexametason tab 10
Asam mefenamat 500 mg 10
GG tab 10
CTM 10
Vitamin B kompleks 10
14 Sembelit 1 Vitamin B kompleks 10
Vit.C 50 mg 10
15 Abdominal pain 20 Ranitidin 150 mg 70
Papaverin tab 60
Vitamin B kompleks 40
Antasida tablet 50
Cotrimoxazol 480 mg 46
Natrium diklofenak 25 mg 40
Dexametason tab 30
Amoxicillin 500 mg 60
Asam mefenamat 500 mg 50
Ciprofloxazin 500 mg 20
Ibuprofen 200 mg 10
SF tablet 10
B1 tablet 30
Oralit 6
Ibuprofen 400 mg 20
16 Vomiting 5 Metoclopramod 5 mg 28
CTM 20
Papaverin tab 20
Piridoksin tablet 3
Domperidon tab 3
Parasetamol sirup 3
Ranitidin 150 mg 10
Oralit 5
17 Hipotensi 4 Parasetamol 500 mg 10
SF tablet 40
Vit.C 50 mg 10
Natrium diklofenak 25 mg 10
B1 tablet 10
Vitamin B kompleks 20
18 Malaise 6 Vitamin B kompleks 60
Vit.C 50 mg 40
Pyrantel 125 mg 1
Parasetamol 500 mg 10
B1 tablet 20
19 PPOK 7 Ambroxol tablet 50
Salbutamol 2 mg 30
CTM 60
Ciprofloxazin 500 mg 20
GG tab 20
Prednison tab 40
Ranitidin 150 mg 20
Parasetamol 500 mg 20
Vit.C 50 mg 20
Cotrimoxazol 480 mg 12
Vitamin B kompleks 10
Salbutamol 4 mg 10
Antasida tablet 10
20 Cephalgia 28 Ibuprofen 400 mg 10
B1 tablet 70
Parasetamol 500 mg 200
Vitamin B kompleks 50
Dexametason tab 10
Asam mefenamat 500 mg 50
Amoxicillin 500 mg 10
CTM 10
Vit.C 50 mg 10
Diazepam 2 mg tab 20
Antasida tablet 40
Ranitidin 150 mg 20
SF tablet 30
Simvastatin 10 mg 30
Antalgin500 mg 10
21 Low Back Pain (LBP) 15 Ibuprofen 400 mg 20
B1 tablet 100
Natrium diklofenak 25 mg 120
Dexametason tab 120
Diazepam 2 mg tab 19
Ciprofloxazin 500 mg 20
Prednison tab 20
Asam mefenamat 500 mg 10
CTM 10
Antasida tablet 10
22 Otalgia 2 Ciprofloxazin 500 mg 10
Asam mefenamat 500 mg 10
Dexametason tab 10
Amoxicillin 250 mg 10
 Ibuprofen 200 mg 10
Vitamin B kompleks 10
23 Post pneumotorax 1 Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
24 Susp.hipertropi 1 Ranitidin 150 mg 10
Natrium diklofenak 25 mg 10
25 Ext.papiloma 1 Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
Dexametason tab 10
26 Penyakit jantung 2 Digoksin tablet 20
Furosemid tablet 20
Captopril 25 mg 10
27 Pemasangan & pelepasan KB 10 SF tablet 30
Vitamin B kompleks 20
Amoxicillin 500 mg 80
Asam mefenamat 500 mg 40
Vit.C 50 mg 70
Dexametason tab 30
Parasetamol 500 mg 10
Fitomenadion tablet 10
28 Abses 37 Amoxicillin 500 mg 320
Amoxicillin sirup 2
Metronidazol 500 mg 80
Dexametason tab 246
Asam mefenamat 500 mg 200
Hidrocortison Zk 1
Parasetamol 500 mg 106
Vit.C 50 mg 73
Vitamin B kompleks 20
Metronidazol 250 mg 40
Prednison tab 80
CTM 66
Amoxicillin 250 mg 10
Antasida tablet 10
Antalgin500 mg 10
Ciprofloxazin 500 mg 50
Oxytetrasiklin 3% ZK 3
29 UGD Metronidazol 500 mg 50
Vulnus lasertum 51 Amoxicillin 500 mg 784
Vulnus excoriatum 7 Ibuprofen 400 mg 50
Vulnus ictum 14 Vit.C 50 mg 498
Post hecting 9 Asam mefenamat 500 mg 820
 Luka bakar 1 Ciprofloxazin 500 mg 180
Extraksi kuku 4 Dexametason tab 584
Post trauma 11 Parasetamol sirup 2
Post operasi 11 Parasetamol 500 mg 124
Prednison tab 50
Natrium diklofenak 25 mg 30
B1 tablet 30
CTM 50
Myconazol cream 1
Vitamin B kompleks 30
Amoxicillin sirup 1
Amoxicillin 250 mg 10
Oxytetrasiklin 3% ZK 1
30 Chest pain 6 Parasetamol 500 mg 50
Vitamin B kompleks 30
Antasida tablet 20
Asam mefenamat 500 mg 10
Ranitidin 150 mg 20
B1 tablet 20
………………………..
 DATA 155 DIAGNOSA YANG HARUS SELESAI DI F
NAMA FKTP : PUSKESMAS BINANGA
BULAN DESEMBER 2016

DIAGNOSA ICD X JUMLAH

NO NAMA DIAGNOSA
KODE NAMA DIAGNOSA KASUS
1 TB PARU A15 Respiratory TB
suspek

2 MORBILI B059 Measles without complication

3 VARISELA B019 Varicella without complication

4 MALARIA B54 Unspecified malaria

5 DEMAM DENGUE DAN DEMAM A90, A91 Dengue fever, DHF
BERDARAH DENGUE
6 LEPTOSPIROSIS A279
7 INFEKSI PADA UMBILIKUS
8 KANDIDIASIS MULUT B379 Candidiasis unspecified
9 LEPRA A30 Leprosy

10 KERACUNAN MAKANAN T622 Other ingested (parts of plant(s))

11 ALERGI MAKANAN
12 EXANTHEMATOUS DRUG ERUPTION L270 Generalized skin eruption due to drugs
and medicaments
13 FIXED DRUG ERUPTION L270 Generalized skin eruption due to drugs
and medicaments
14 REAKSI ANAFILAKTIK
15 SYOK R579 Shock, unspecified
16 ANEMIA D649 Anaemia, unspecified (anemia defisiensi
besi-4A, anemia hemolitik-3A, anemia
makrositik-3A, anemia aplastik-2, anemia
megaloblastik-2)
17 HIV/AIDS TANPA KOMPLIKASI Z21 Asymptomatic HIV infection status
18 LIMFADENITIS B70 Lymphadenitis Acute

19 REFLUKS GASTROESOFAGEAL K219 Gastrooesophageal reflux disease without

oesophagitis

20 GASTRITIS K297 Gastritis, unspecified

Dispepsia

21 INTOLERANSI MAKANAN
22 MALABSORBSI MAKANAN
23 DEMAM TIFOID A010 Typhoid fever
suspek

24 GASTROENTERITIS ( TERMASUK DISENTRI, A09 Diarrhoea & gastroenteritis of presumed

KOLERA, GIARDIASIS) infection origin
25 DISENTRI BASILER DAN DISENTRI AMUBA

26 APENDISITIS AKUT K359 Acute appendicitis

27 PERDARAHAN SALURAN MAKAN BAGIAN
ATAS
28 PERDARAHAN SALURAN MAKAN BAGIAN
BAWAH
29 HEMOROID GRADE 1-2

30 HEPATITIS A
31 HEPATITIS B
32 PAROTITIS K11.2 Sialoadenitis

33 ASKARIASIS B77.9 Ascariaris unspecified

34 CUTANEUS LARVA MIGRANS B76.9 Hookworm disease, unspecified

35 PENYAKIT CACING TAMBANG B76.0 Ankylostomiasis ,Necatoriasis
B76.1
36 SKISTOSOMIASIS B65.9 Skistosomiasisunspecified , Schistomiasis
B65.2 due to S. Japonicum

37 STRONGILOIDIASIS B78.9 Strongyloidiasis

38 TAENIASIS B68.9 Taeniasis
39 PERITONISIS K65.9 Peritonitis, unspecified
40 KOLESISTITIS K81.9 Cholecystitis, unspecified
41 MATA KERING/DRY EYE H04.1 Other disorders of lacrimal gland
42 BUTA SENJA H53.5 Colour vision deficiencies
43 HORDEOLUM H00.0 Hordeolum and other deep inflammation
of eyelid

44 KONJUNGTIVITIS H10.9 Conjunctivitis, unspecified,,, Acute

H10.1 atopic conjunctivitis

45 BLEFARITIS H01.0 Blepharitis

46 PERDARAHAN SUBKONJUNGTIVA H57.8 Other specified disorders of eye and
adnexa
47 BENDA ASING DI KONJUNGTIVA T15.9 Foreign body on external eye, part
unspecified
48 ASTIGMATISM H52.2 Astigmatism
49 HIPERMETROPIA H52.0 Hypermetropia
50 MIOPIA RINGAN H52.1 Myopia

51 PRESBIOPIA H52.4 Presbyopia

52 KATARAK PADA PASIEN DEWASA H26.9 Cataract, unspecified
53 GLAUKOMA AKUT H40.2 Primary angle-closure glaucoma
54 OTITIS EKSTERNA H60.9 Otitis Externa, Unspecified

55 OTITIS MEDIA AKUT H66.0 Acute suppurative otitis media

56 SERUMEN PROP H61.2 Impacted cerumen

57 BENDA ASING DI HIDUNG T17.1 Foreign body in nostril

58 ANGINA PEKTORIS I20.9 Angina pectoris
59 INFARK MIOKARD I21.9 Acute Myocardial Infarction
60 TAKIKARDIA I47.1 Supraventicular Tachicardy , Ventricular
Tachicardy
I47.2
61 GAGAL JANTUNG AKUT DAN KRONIK I50.9 Heart failure
CHF
62 CARDIORESPIRATORY ARREST K80 Cardiac arrhytmia
63 HIPERTENSI ESENSIAL I10 Essential (primary) hypertension

64 INFARK SEREBRAL/STROKE I63.9 Cerebral infarction

65 FRAKTUR TERBUKA T14. Fracture of unspecified body
66 FRAKTUR TERTUTUP T14. Fracture of unspecified body
67 POLIMIALGIA REUMATIK M53.3 Polymyalgia rheumatica
68 ARTRITIS REUMATOID M53.3 Polymyalgia rheumatica

69 ARTRITIS, OSTEOARTRITIS M19.9 Osteoarthrosis other

70 LIPOMA D17.9 Benign lipomatous neoplasm
71 KEJANG DEMAM R56.0 Febrile convulsions
72 VERTIGO R42 Dizziness and giddiness

73 DELIRIUM F05.9 Delirium

74 TETANUS A35 Othertetanus
75 RABIES A82.9 Rabies
76 EPILEPSI G40.9 Epilepsy
77 STATUS EPILEPTIKUS G41.9 Status epilepticus, unspecified
78 MIGREN G43.9 Migraine, unspecified

79 BELLS' PALSY G51.0 Bells’ palsy

80 TENSION HEADACHE G44.2 Tension–type headache
81 INSOMNIA G47.0 Disorders of initiating and maintaining
sleep (insomnias)

82 DEMENSIA F03 Unspecified dementia

83 GANGGUAN CAMPURAN ANXIETAS DAN DEP F41.2 Mixed Anxiety and Depression Disorder

84 GANGGUAN PSIKOTIK F20 Chronic Psychotic Disorder

85 EPISTAKSIS R04.0 Epistaxis

86 FURUNKEL PADA HIDUNG J34.0 Abscess, furuncle and carbuncle of nose

87 FARINGITIS J02.9 Acute pharyngitis, unspecified

88 RHINITIS AKUT J00 Acute nasopharingitis (common cold)

89 RHINITIS ALERGIK J30.0 Vasomotor rhinitis

90 RHINITIS VASOMOTOR J30.0 Vasomotor rhinitis

91 TONSILITIS R76 Acute tonsillitis, unspecified

92 LARINGITIS J04.0 Acute laryngitis

93 BRONKITIS AKUT J20.9 Acute bronchitis, unspecified
94 INFLUENZA J11 Influenza
(ISPA)

95 PNEUMONIA ASPIRASI J69.0 Pneumonitis due to food and vomit

96 PNEUMONIA DAN BRONKOPNEUMONIA J18.9 Pneumonia, unspecified

97 PERTUSIS A37.8 Whooping cough

98 ASMA BRONKIAL J45 Asthma

99 MILIRIA L74.3 Miliaria

100 VERUKA VULGARIS B07 Viral warts
101 REAKSI GIGITAN SERANGGA T63.4 Venom of other arthropods
102 HERPES ZOSTER B02.9 Zoster without complication

103 HERPES SIMPLEKS B00.9 Herpesviral infection, unspecified

104 SKABIES B86 Scabies
105 PEDIKULOSIS KAPITIS B85.0 Pediculosis due to Pediculus humanus
capitis
106 DERMATOFITOSIS : TINEA KAPITIS B35.0 Tinea barbae and tinea capitis
107 DERMATOFITOSIS : TINEA BARBAE B35.0 Tinea barbae and tinea capitis
108 DERMATOFITOSIS : TINEA FASIALIS TINEA FASIALIS
109 DERMATOFITOSIS : TINEA KORPORIS B35.4 Tinea corporis
110 DERMATOFITOSIS : TINEA MANUM B35.2 Tinea manuum
111 DERMATOFITOSIS : TINEA UNGUIUM B35.1 TINEA UNGUIUM
112 DERMATOFITOSIS : TINEA KRURIS B35.6 Tinea cruris

113 DERMATOFITOSIS : TINEA PEDIS B35.3 Tinea pedis

Tinea

114 PITIRIASIS VERSIKOLOR/TINEA VERSIKOLOR B36.0 Pityriasis versicolor

115 PIODERMA L08.0 Pyoderma

116 DERMATITIS SEBOROIK L21 Seborrhoeic dermatitis

117 DERMATITIS ATOPIK L20 Atopic dermatitis
118 DERMATITIS NUMULARIS L20.8 Other atopic dermatitis

119 LIKE SIMPLEKS KRONIK L28.0 Lichen simplex chronicus

(NEURODERMATITIS SIRKUMKRIPTA)
120 DERMATITIS KONTAK ALERGIK L23 Allergic contact dermatitis

121 DERMATITIS KONTAK IRITAN L24 Irritant contact dermatiti

122 NAPKIN ECZEMA 9DERMATITIS POPOK) L22 Diaper(napkin) dermatitis
123 PITIRIASIS ROSEA L42 Pityriasis rosea
124 MOLUSKUM KONTAGIOSUM B08.1 Molluscum contagiosum
125 URTIKARIA L50 Urticaria
126 FILARIASIS B74 Filariasis
127 LUKA BAKAR DERAJAT I DAN II S24 burn
128 OBESITAS E66.9 obesity unspecified
129 TIROTOKSIKOSIS E05.9 Tirotoksikosis unspecified

130 HIPERGLIKEMIA HIPEROSMOLAR NON KETO R73.9 Hyperglycaemia unspecified

131 HIPOGLIKEMIA E16.2 hypoglycaemia unspecified
132 DIABETES MELITUS 1 E10 Insulin-dependent diabetes mellitus

133 DIABETES MELITUS 2 E11 Non-insulin-dependent diabetes mellitus

134 MALNUTRISI ENERGI PROTEIN (MEP) E46 Unspecified protein-energy malnutrition

135 HIPERURICEMIA GOUT ARTHRITIS E79.0 Hyperuricemia without signs of

M10 inflammatory arthritis and tophaceous
disease

136 DISLIPIDEMIA E78.5 Hiperlipidemia

137 INFEKSI SALURAN KEMIH N39.0 Urinary tarct infection, site not specified

Suspek
138 HIPERMEMESIS GRAVIDARUM O21.0 Mild hyperemis gravidarum
139 KEHAMILAN NORMAL O80.9 Single spontaneus delivery, unspecified

140 PRE-EKLAMPSIA O14.9 Pre-eclampsia, unspecified

141 EKLAMSIA O15.9 Eclampsia, unspecified as to time periode

142 ABORTUS SPONTAN KOMPLIT O03.9 Unspecified abortion complete, without

complication
143 ABORTUS MENGANCAM/INSIPIENS O06.3 Unspecified abortion incomplete, without
complication
144 ABORTUS SPONTAN INKOMPLIT O06.4 Unspecified abortion incomplete, without
complication
145 ANEMIA DEFISIENSI BESI PADA KEHAMILAN D50 Iron deficiency anemia
146 KETUBAN PECAH DINI 042.9 Premature rupture of membrane,
unspecified
147 PERSALINAN LAMA O63.9 long labour
148 PERDARAHAN POST PARTUM 072.1 Other Immediate Postpartum
haemorhage
149 RUPTUR PERINEUM TINGKAT 1-2 O70.0 First degree perineal laceration during
delivery
150 MASTITIS N61 Inflammatory disorders of breast

151 FLUOR ALBUS N98.9

152 SIFILIS A51 Early syphilis
153 GONORE A54.9 Gonococcal infection, unspecified
154 VAGINITIS N76.0 Acute Vaginitis
155 VULVITIS N76.0 Acute Vaginitis

DATA DIAGNOSA LAIN YANG TERLAYANI DI FKT

NAMA FKTP : PUSKESMAS BINANGA
BULAN NOPEMBER 2016
DIAGNOSA ICD X JUMLAH
NO NAMA DIAGNOSA
KODE NAMA DIAGNOSA KASUS
1 PPOK
2 Sinusitis

3 Selulitis

4 Stomatitis

5 Kolik abdomen

6 Suspek tumor

7 Acne vulgaris

8 Vulnus pedis
Ulkus pedis
9 Gangguan Somatoform

10 Menotragia

11 KIA:
Pasang & Off KB
Post partum

12 Skizofrenia

13 UGD:
Nyeri tekan
Post op
Luka lecet
V.laseratum
Abses diabetik
KLL
V. ictum
V.excoriatum
Ekstraksi kuku
Abses
Post trauma
Udem

14 POLI GIGI
Polip pulpa
Hiperemi pulpa
Abses periapikal
Pulpitis irreversibel
Gangren radix
Periodontitis
Stomatitis herpetika
Necrose pulpa
Impaksi
Stomatitis
Sakit gigi

15 Malaise
16 Kontraksi uterus

17 Pterygium

18 Dislokasi

19 Sariawan

20 Chest pain

21 Hipotensi

22 Gatal

23 Atralgia
24 Udem

25 Headache

26 Myalgia
27 Trauma tumpul

28 Cefalgia

29 Benjolan

30 LBP

31 Dismenorhoe

32 Vomiting

33 Otalgia

34 Batuk
35 Abses axila
Abses femur

36 Abdominal pain

37 Luka
Kecelakaan dan ruda paksa

38 Obs. Febris

39 Impetigo
40 Anoreksia
41 Nyeri mammae

Mengetahui, Yang Melaporkan,

Kepala Puskesmas Pengelola SP2TP

………………………………………………………………………………………… …………………………………………………………………
G HARUS SELESAI DI FKTP
ESMAS BINANGA
MBER 2016

JUMLAH NAMA JML

KET
KUNJUNGAN OBAT OBAT
15 Ambroxol tablet 26
5 CTM 20
GG tab 12
Amoxicillin 500 mg 10
Parasetamol 500mg 10
Dexametason tab 10
Vitamin b kompleks 26
Fitomenadin tablet 2
Vit. C 50 mg 10
2 Parasetamol 500 mg 10
Oxytetrasiklin 1% ZM 1
Vit. C 50 mg 20
Vitamin b kompleks 20
Ambroxol tablet 10
Parasetamol sirup 1
Amoxicillin sirup 1
1 Acyclovir 400 mg 12
Vitamin b kompleks 10
Vit. C 50 mg 10
a 0
a 0

a 0
a 0
a 0
2 Prednison tab 15
Dexametason tab 10
Vitamin b kompleks 10
0 0
0 0
0 0

0 0

0 0
0 0

23 SF tablet 170
Vitamin B kompleks 170
Amoxicillin 500 mg 10
Vit. C 50 mg 20
Parasetamol 500 mg 80
Kalsium laktat 10
Ranitidin 150 mg tab 10
 0 0
1 Asam mefenamat 500 mg 10
Amoxicillin 500 mg 10
Dexametason tab 10
2 Antasida sirup 3

cotrimoxazol 480mg 20
Ibuprofen 200 mg tab 10
Parasetamol 500 mg 10
Ranitidin 150 mg tab 40
SF tablet 10
Vitamin b kompleks 10
143 Amoxicillin 500 mg 90
40 Antasida sirup 92
Antasida tablet 1477
Asam mefenamat 500 mg 20
B1 tablet 70
cotrimoxazol 480mg 13
Dexametason tab 10
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 44
Metoclopramid 5 mg 38
Papaverin tablet 90
Parasetamol 500mg 200
Parasetamol sirup 1
Piridoksin tab 633
Ranitidin 150 mg tab 1129
SF tablet 30
Vit. C 50 mg 120
Vitamin b kompleks 586
0 0
0 0
6 Antasida sirup 11
18 Antasida tablet 24
cotrimoxazol 480mg 68
Antalgin tablet 10
Cotrimoxazol sirup 9
CTM 12
Dexametason tab 11
kloramfenikol 250 mg kapsul 80
Metoclopramid 5 mg 14
Parasetamol 500mg 148
Piridoksin tab 125
Ranitidin 150 mg tab 40
Vit. C 50 mg 20
Vitamin b kompleks 76
117 Amoxicillin 500 mg 15

Amoxicillin sirup 1
Antasida tablet 10
Antasida sirup 16
B1 tablet 4
Cotrimoxazol 120mg 24
cotrimoxazol 480mg 597
Cotrimoxazol sirup 41
CTM 95
Domperidon tab 3
 Kloramfenokol 250 mg 38
Metoclopramid 5 mg 28
Oralit 651
Metronidazol 250 mg 14
Papaverin tablet 205
Parasetamol 500mg 111
Parasetamol sirup 11
Piridoksin tab 395
Ranitidin 150 mg tab 72
SF tablet 10
Tetrasiklin 250 mg 10
Vit. C 50 mg 60
Vitamin b kompleks 167
Zink tablet 440
10 cotrimoxazol 480mg 26

Cotrimoxazol sirup 1
Metronidazol 250 mg 42
Metronidazol 500 mg 82
Papaverin tablet 10
Parasetamol 500 mg 20
Vit. C 50 mg 40
Oralit 100
Antasida sirup 2
Ranitidin 150 mg tab 20
Vitamin b kompleks 40
Zink tablet 35
0 0
0 0

0 0

10 Antihemoroid suppo 21
Papaverin tablet 3
Vit. C 50 mg 10
Fitomenadin tablet 12
Vitamin b kompleks 15
SF tablet 5
cotrimoxazol 480mg 32
Dexametason tab 20
ciprofloxacin 500 mg 10
Asam mefenamat 500 mg 20
Amoxicillin 500 mg 10
0 0
0 0
2 Parasetamol 500mg 20
Vit. C 50 mg 10
Dexametason tab 10
Vitamin b kompleks 20
18 Pyrantel sirup 5
Vitamin b kompleks 3
Pyrantel 125 mg tab 16
Albendazol 400 mg 4
a 0
a 0
 a 0

a 0
a 0
a 0
a 0
a 0
a 0
4 Amoxicillin 500 mg 23

CTM 13
Dexametason tab 13
Ibuprofen 400 mg tab 10
Kloramfenikol ZM 3
Parasetamol 500mg 3
Vit. C 50 mg 13
28 Asam mefenamat 500 mg 10

Amoxicillin 500 mg 15
Amoxicillin 250 mg 12
B1 tablet 20
CTM 114
Dexametason tab 94
Gentamisin TM 4
Ibuprofen 400 mg tab 10
Kloramfenikol ZM 20
Parasetamol 500mg 23
Prednison tab 20
Vit. C 50 mg 94
Vitamin b kompleks 20
a 0
a 0

a 0

a 0
a 0
1 CTM 10
Dexametason tab 10
Vit. C 50 mg 10
Vitamin b kompleks 10
a 0
a 0
a 0
1 Amoxicillin 500 mg 10

Asam mefenamat 500 mg 10

Dexametason tab 10
21 Amoxicillin 250 mg 34
Amoxicillin 500 mg 170
Asam mefenamat 500 mg 130
B1 tablet 10
CTM 102
Dexametason tab 156
Parasetamol 500mg 26
Parasetamol sirup 1
 Prednison tab 6
Ranitidin 150 mg tab 10
Vit. C 50 mg 60
Vitamin b kompleks 20
7 Amoxicillin 250 mg 10
Amoxicillin 500 mg 10
Asam mefenamat 500 mg 20
Dexametason tab 10
Ibuprofen sirup 1
Parasetamol sirup 1
Ranitidin 150 mg tab 10
Vit. C 50 mg 30
Vitamin b kompleks 30
a 0
a 0
a 0
a 0

1 Furosemid 40 mg 30
Digoksin 0,5mg 30
a 0
96 Asam mefenamat 500 mg 50
B1 tablet 120
Captopril 25 mg 832
CTM 30
HCT tab 8
Natrium diklofenak 25 mg 40
Parasetamol 500 mg 120
Piridoksin tab 80
Piroxicam 20 mg 30
Ranitidin 150 mg tab 80
Vit. C 50 mg 30
Vitamin b kompleks 65
a 0
a 0
a 0
a 0
39 Alopurinol 100 mg 20
Antasida sirup 1
B1 tablet 360
CTM 20
Dexametason tab 60
Ibuprofen 200 mg tab 140
Ibuprofen 400 mg tab 30
Natrium diklofenak 25 mg 110
Piroxicam 20 mg 80
Parasetamol 500 mg 70
Prednison tab 250
Ranitidin 150 mg tab 10
Vit. C 50 mg 30
Vitamin b kompleks 130
26 Amoxicillin 500 mg 30
Asam mefenamat 500 mg 20
B1 tablet 130
ciprofloxacin 500 mg 10
Ibuprofen 400 mg tab 20
Natrium diklofenak 25 mg 190
 Parasetamol 500 mg 10
Piroxicam 20 mg 50
Prednison tab 100
Ranitidin 150 mg tab 40
Vit. C 50 mg 40
Vitamin b kompleks 30
a 0
a 0
8 Parasetamol 500 mg 10
Captopril 25 mg 10
Metoclopramid 5 mg 60
Ranitidin 150 mg tab 30
Ibuprofen 200 mg tab 10
Diazepam 2 mg tab 10
Vit. C 50 mg 30
Vitamin b kompleks 30
a 0
a 0
a 0
a 0
a 0
4 Parasetamol 500mg 10
B1 tablet 10
Antalgin tablet 10
Ibuprofen 200 mg tab 20
Ranitidin 150 mg tab 20
Vitamin b kompleks 20
Vit. C 50 mg 10
a 0
a 0
4 Diazepam 2 mg tab 15

CTM 10
Vitamin b kompleks 30
Vit. C 50 mg 10
SF tablet 10
a 0
a 0

a 0
2 Amoxicillin sirup 1
CTM 3
Dexametason tab 3
Fitomenadin tablet 10
Parasetamol 500 mg 3
Vit. C 50 mg 3
Vitamin b kompleks 13
a 0

21 Amoxicillin 250 mg 15
Amoxicillin 500 mg 120
Ambroxol tablet 10
Asam mefenamat 500 mg 40
CTM 130
Dexametason tab 120
GG tab 40
Ibuprofen 400 mg tab 10
 Parasetamol 500mg 150
B1 tablet 10
Prednison tablet 50
Vit. C 50 mg 100
Vitamin b kompleks 50
112 Ambroxol tablet 79
Amoxicillin 500 mg 223
Amoxicillin 250 mg 24
Amoxicillin sirup 7
Antalgin tablet 10
Antasida sirup 2
CTM 732
Dexametason tab 150
GG tab 501
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 10
Oralit 11
Parasetamol 500mg 343
Parasetamol sirup 19
Prednison tablet 174
Ranitidin 150 mg tab 50
Salbutamol 2 mg 10
Vit. C 50 mg 387
Vitamin b kompleks 351
6 Amoxicillin sirup 1
CTM 34
Dexametason tab 10
Parasetamol 500mg 9
Prednison tablet 22
Vit. C 50 mg 16
Vitamin b kompleks 13
a 0
32 Amoxicillin 250 mg 60
Amoxicillin 500 mg 122
Amoxicillin sirup 11
Asam mefenamat 500 mg 50
CTM 100
Dexametason tab 111
GG tab 34
Ibuprofen 200 mg tab 20
Ibuprofen 400 mg tab 10
Ibuprofen sirup 2
Metoklopramid 5 mg 2
Metronidazol 500 mg 10
Parasetamol 500mg 84
Parasetamol sirup 9
Prednison tablet 20
Ranitidin 150 mg tab 20
Vit. C 50 mg 125
Vitamin b kompleks 69
a 0
7 ciprofloxacin 500 mg 10
CTM 10
Prednison tablet 40
Parasetamol 500mg 15
Amoxicillin 500 mg 5
Salbutamol 2 mg 70
 Vitamin b kompleks 50
Dexametason tab 30
GG tab 10
Ambroxol tablet 1833
501 Amoxicillin 250 mg 205
Amoxicillin 500 mg 1339
Amoxicillin sirup 56
Antasida sirup 4
B1 tablet 20
ciprofloxacin 500 mg 40
cotrimoxazol 480mg 153
Cotrimoxazol sirup 25
Cotriped 120 mg 12
CTM 4024
Dexametason tab 1736
GG tab 3565
Ibuprofen 400 mg tab 40
Ibuprofen 200 mg tab 20
Ibuprofen sirup 2
kloramfenikol 250 mg kapsul 6
Natrium diklofenak 25 mg 10
Parasetamol 500mg 2428
Parasetamol sirup 115
Piridoksin tab 120
Prednison tablet 631
Ranitidin 150 mg tab 80
Salbutamol 2 mg 95
Salbutamol 4 mg 36
SF tablet 10
Vit. C 50 mg 2150
Vitamin b kompleks 1419
a 0

2 ciprofloxacin 500 mg 20
CTM 20
GG tab 20
Dexametason tab 20
Salbutamol 2 mg 16
a 0
9 CTM 10
Amoxicillin 500 mg 10
Ambroxol tablet 10
Salbutamol 2 mg 43
Dexametason tab 20
Vitamin b kompleks 20
Vit. C 50 mg 10
a 0
a 0
a 0
2 Acyclovir 200 mg 20
Asam mefenamat 500 mg 10
Acyclovir 400 mg 10
a 0
a 0
a 0

a 0
 a 0
a 0
a 0
a 0
a 0
2 Griseofulvin tablet 125 mg 26
Ketokonazol ZK 2
Basitrasin ZK 1
7 Amoxicillin 500 mg 40
8 Asam mefenamat 500 mg 30
CTM 60
Dexametason tab 60
Griseofulvin tablet 125 mg 32
Ketokonazol ZK 16
Betametason zk 2
ciprofloxacin 500 mg 10
Vit. C 50 mg 10
a 0
1 Oxytetrasiklin 3% ZK 1
Amoxicillin 250 mg 12
CTM 10
Vit. C 50 mg 10
Parasetamol 500 mg 10
a 0
a 0
1 Amoxicillin 500 mg 10
Dexametason tab 10
CTM 10
Ranitidin 150 mg tab 10
Oxytetrasiklin 3% ZK 1
a 0

91 Amoxicillin 500 mg 186

Amoxicillin sirup 4
Amoxicillin 250 mg 12
Asam mefenamat 500 mg 10
Betametason zk 31
CTM 575
Dexametason tab 623
Gentamisin Zk 2
Griseofulvin tablet 125 mg 40
Hidrocortison ZK 22
Ibuprofen 400 mg tab 2
Ketokonazol ZK 7
Natrium diklofenak 25 mg 10
Oxytetrasiklin 3% ZK 11
Parasetamol 500mg 31
Prednison tablet 58
Parasetamol sirup 2
Salep 2-4 1
Salisil bedak 2
Vit. C 50 mg 215
Vitamin b kompleks 87
a 0
a 0
a 0
a 0
 a 0
a 0
a 0
a 0
1 PTU 10
Propranolol 10
a 0
a 0
a 0

62 B1 tablet 30

Glibenklamid 5 mg 120
Ibuprofen 400 mg tab 30
Ketokonazol ZK 1
Metformin 500 mg 550
Simvastatin 10 mg 20
Vitamin b kompleks 50
a 0

71 Alopurinol 100 mg 382

Antasida sirup 1
B1 tablet 120
ciprofloxacin 500 mg 10
Dexametason tab 20
Ibuprofen 200 mg tab 10
Natrium diklofenak 25 mg 440
Parasetamol 500 mg 10
Piroxicam 20 mg 240
Prednison tab 80
Ranitidin 150 mg tab 120
Vit. C 50 mg 140
Vitamin b kompleks 220
156 Alopurinol 100 mg 25
B1 tab 190
CTM 20
HCT tablet 5
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 30
Natrium diklofenak 25 mg 160
Piroxicam 20 mg 30
Ranitidin 150 mg tab 210
Simvastatin 10 mg 1503
Vit. C 50 mg 230
Vitamin b kompleks 150
17 Amoxicillin 500 mg 30

1 Asam mefenamat 500 mg 50

B1 tablet 30
ciprofloxacin 500 mg 70
Dexametason tab 60
Ibuprofen 400 mg tab 20
Metronidazol 500 mg 15
Prednison tab 10
Vit. C 50 mg 30
 Vitamin b kompleks 30
a 0
167 SF tablet 3701

Kalsium laktat 1190

Vitamin b kompleks 1216
Antasida sirup 18
Vit. C 50 mg 30
Parasetamol 500 mg 15
Piridoksin tab 336
B1 tablet 290
a 0
a 0

a 0

a 0

a 0

a 0
a 0

a 0
a 0

a 0

2 Amoxicillin 500 mg 10
Ibuprofen 400 mg tab 10
Dexametason tab 10
B1 tablet 20
Natrium diklofenak 25 mg 10
Prednison tab 10
Antasida sirup 1
1 Nistatin vaginal tab 7
a 0
a 0
a 0
a 0

NG TERLAYANI DI FKTP
ESMAS BINANGA
MBER 2016
JUMLAH NAMA
KET
KUNJUNGAN OBAT
2 Ciprofloxazin 500 mg
CTM
GG tab
Dexametason tab
 Vit.C 50 mg
Vitamin B kompleks
6 Asam mefenamat 500 mg
Ibuprofen 200 mg
Amoxicillin 500 mg
Ranitidin 150 mg
CTM
Dexametason tab
Vit.C 50 mg
Cotrimoxazol 480 mg
Parasetamol 500 mg
Vitamin B kompleks
2 Amoxicillin 500 mg
Dexametason tab
Vit.C 50 mg
CTM
10 Amoxicillin 500 mg
Asam mefenamat 500 mg
CTM
Dexametason tab
Gentian violet
Ibuprofen 200 mg
Ibuprofen sirup
Parasetamol 500 mg
Prednison tab
Tetrasiklin 500 mg
Vit.C 50 mg
Vitamin B kompleks
8 Parasetamol sirup
Vit.C 50 mg
Vitamin B kompleks
Natrium diklofenak 25 mg
Papaverin tablet
Ranitidin 150 mg
1 Parasetamol sirup
Amoxicillin 250 mg
Vit.C 50 mg
4 Amoxicillin 500 mg
CTM
Dexametason tab
Ranitidin 150 mg
Oxytetrasiklin 3% ZK
Hidrocortison ZK
Ketokonazol ZK
Basitrasin+Polimiksin ZK
5 Oxytetrasiklin 3% ZK
7 Asam mefenamat 500 mg
Ciprofloxazin 500 mg
Dexametason tab
Ranitidin 150 mg
Vit.C 50 mg
Amoxicillin 500 mg
CTM
Amoxicillin 250 mg
Vitamin B kompleks
Parasetamol 500 mg
Natrium diklofenak 25 mg
1 Vit.C 50 mg
Vitamin B kompleks
1 SF tablet
Vitamin B kompleks
Diazepam 2 mg tab
7 SF tablet
7 Amoxicillin 500 mg
Asam mefenamat 500 mg
Dexametason tab
Fitomenadion tablet
Parasetamol 500 mg
Vit.C 50 mg
Vitamin B kompleks
2 Klorpromazin 100 mg
Diazepam injeksi
Amoxicillin 250 mg
1 Amoxicillin 500 mg
16 Amoxicillin sirup
6 Antasida sirup
38 Asam mefenamat 500 mg
1 B1 tablet
1 Ciprofloxazin 500 mg
5 CTM
2 Dexametason tab
1 Gentamisin ZK
9 Glibenklamid
2 Ibuprofen 400 mg
3 Ibuprofen sirup
Metronidazol 250 mg
Oxytetrasiklin 3% ZK
Parasetamol 500 mg
Parasetamol sirup
Prednison tab
Ranitidin 150 mg
Vit.C 50 mg
Vitamin B kompleks
Acyclovir 200 mg
1 Amoxicillin 250 mg
1 Amoxicillin 500 mg
26 Amoxicillin sirup
48 Asam mefenamat 500 mg
34 Ciprofloxazin 500 mg
12 CTM
1 Dexametason tab
10 Gentian violet
2 Metronidazol 250 mg
2 Parasetamol 500 mg
30 Parasetamol sirup
Antalgin tablet
Prednison tab
Ibuprofen 200 mg
Ibuprofen sirup
B1 tablet
Tetrasiklin 500 mg
Vit.C 50 mg
Vitamin B kompleks
1 Vitamin B kompleks
 1 Papaverin tablet
Vitamin B kompleks
1 Amoxicillin 500 mg
Asam mefenamat 500 mg
Prednison tab
Kloramfenikol ZM
2 Dexametason tab
Asam mefenamat 500 mg
Ciprofloxazin 500 mg
Natrium diklofenak 25 mg
B1 tablet
Prednison tab
Amoxicillin 500 mg
1 Vit.C 50 mg
Vitamin B kompleks
3 Natrium diklofenak 25 mg
Prednison tab
Ibuprofen 400 mg
B1 tablet
28 SF tablet
Vitamin B kompleks
Kalsium laktat
Parasetamol 500 mg
Vitamin B kompleks
Natrium diklofenak 25 mg
1 CTM
Dexametason tab
Vit.C 50 mg
1 Natrium diklofenak 25 mg
3 Amoxicillin 500 mg
Prednison tab
Dexametason tab
CTM
Parasetamol 500 mg
Vit.C 50 mg
5 Prednison tab
Natrium diklofenak 25 mg
Vit.C 50 mg
CTM
SF tablet
Ibuprofen 400 mg
Antasida sirup
B1 tablet
Piroxicam 20 mg
118 Antasida sirup
Antalgin tablet
Asam mefenamat 500 mg
B1 tablet
CTM
Dexametason tab
Ibuprofen 200 mg
Ibuprofen 400 mg
Natrium diklofenak 25 mg
Parasetamol 500 mg
Parasetamol sirup
Piroxicam 20 mg
Prednison tab
 Ranitidin 150 mg
Vit.C 50 mg
Vitamin B kompleks
9 Amoxicillin 500 mg
Ibuprofen 400 mg
Parasetamol 500 mg
Dexametason tab
Ibuprofen sirup
Asam mefenamat 500 mg
Vit.C 50 mg
Parasetamol sirup
54 Antalgin tablet
Amoxicillin 500 mg
Amoxicillin 250 mg
Asam mefenamat 500 mg
B1 tablet
CTM
Captopril 25 mg
Dexametason tab
Ibuprofen 200 mg
Ibuprofen 400 mg
Ibuprofen sirup
Natrium diklofenak 25 mg
Parasetamol 500 mg
Piridoksin tablet
Prednison tab
Ranitidin 150 mg
Vit.C 50 mg
Vitamin B kompleks
1 Vitamin B kompleks
Dexametason tab
Vit.C 50 mg
19 Antasida sirup
B1 tablet
Ibuprofen 200 mg
Ibuprofen 400 mg
Natrium diklofenak 25 mg
Prednison tab
Ranitidin 150 mg
Vit.C 50 mg
Vitamin B kompleks
2 Asam mefenamat 500 mg
Vitamin B kompleks
Papaverin tablet
SF tablet
2 Metoclopramid 5 mg
Vitamin B kompleks
Amoxicillin sirup
Parasetamol sirup
Piridoksin tablet
1 Amoxicillin 500 mg
CTM
Dexametason tab
Ibuprofen 400 mg
9 Parasetamol 500 mg
Parasetamol sirup
GG tab
 Prednison tab
Vit.C 50 mg
CTM
Dexametason tab
Amoxicillin 500 mg
Vitamin B kompleks
1 Amoxicillin 500 mg
2 Asam mefenamat 500 mg
Vitamin B kompleks
Vit.C 50 mg
Ciprofloxazin 500 mg
Dexametason tab
CTM
1 Natrium diklofenak 25 mg
Dexametason tab
Ranitidin 150 mg
11 Amoxicillin 250 mg
10 Amoxicillin 500 mg
Amoxicillin sirup
Asam mefenamat 500mg
Ciprofloxacin 500 mg
CTM
Dexametason tablet
Ibuprofen 200 mg
Parasetamol 500 mg
Vitamin B kompleks
Vit.C tab
33 Amoxicillin 500 mg
Amoxicillin sirup
B1 tablet
CTM
Dexametason tablet
Cotrimoxazol 480 mg
Cotrimoxazol sirup
Parasetamol 500mg
Parasetamol sirup
Piridoksin tablet
Vit.C tab
Vitamin b kompleks
Ranitidin 150 mg
Oralit
3 Amoxicillin sirup
Parasetamol sirup
CTM
Vit.C 50 mg
Oxytetrasiklin 3% ZK
Oxytetrasiklin 1% ZM
Vitamin B kompleks
 2 Vitamin B kompleks
1 Asam mefenamat 500 mg
B1 tablet

ang Melaporkan,
engelola SP2TP

………………………………………………………………………..
 DATA 155 DIAGNOSA YANG HARUS SELESAI DI FKTP
NAMA FKTP : PUSKESMAS BINANGA
BULAN JANUARI 2017
DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML
NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
1 TB PARU A15 Respiratory TB 1 Ambroxol tablet 82
suspek 14 CTM 110
Dexametason tab 10
GG tab 105
Loratadin 10 mg 20
meloxicam 7,5 mg 10
Natrium diklofenak 25 mg 10
Parasetamol 500mg 35
prednison 5 mg 10
Salbutamol 2 mg 20
Vit. C 50 mg 90
Vitamin b kompleks 140
2 MORBILI B059 Measles without complication 1 GG tab 10
suspek 1 Loratadin 10 mg 10
Dexametason tab 10
Parasetamol 500 mg 10
CTM 10
Vit. C 50 mg 20
Vitamin b kompleks 10
3 VARISELA B019 Varicella without complication 6 Acyclovir 200 mg 15
Acyclovir 400 mg 70
Acyclovir salep kulit 7
Amoxicillin 500 mg 10
CTM 35
Dexametason tab 25
Parasetamol 500 mg 15
Vit. C 50 mg 25
Vitamin b kompleks 13
4 MALARIA B54 Unspecified malaria a
5 DEMAM DENGUE DAN DEMAM A90, A91 Dengue fever, DHF 2 Parasetamol 500 mg 32
BERDARAH DENGUE Amoxicillin 250 mg 10
Vit. C 50 mg 27
Vitamin B kompleks 22
Oralit 30
Ranitidin 150 mg tab 12
 DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML
NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
6 LEPTOSPIROSIS A279
7 INFEKSI PADA UMBILIKUS
8 KANDIDIASIS MULUT B379 Candidiasis unspecified
9 LEPRA A30 Leprosy
10 KERACUNAN MAKANAN T622 Other ingested (parts of plant(s))
11 ALERGI MAKANAN
12 EXANTHEMATOUS DRUG ERUPTION L270 Generalized skin eruption due to drugs
13 FIXED DRUG ERUPTION L270 and medicaments
Generalized skin eruption due to drugs
14 REAKSI ANAFILAKTIK and medicaments
15 SYOK R579 Shock, unspecified
16 ANEMIA D649 Anaemia, unspecified (anemia defisiensi 13 Antasida sirup 1
besi-4A, anemia hemolitik-3A, anemia sangobion 30
makrositik-3A, anemia aplastik-2, anemia
megaloblastik-2) SF tablet 60
B1 tablet 20
Parasetamol 500 mg 60
Piridoksin tab 60
CTM 30
Vit. C 50 mg 20
Vitamin B kompleks 80
17 HIV/AIDS TANPA KOMPLIKASI Z21 Asymptomatic HIV infection status
18 LIMFADENITIS B70 Lymphadenitis Acute 2 Amoxicillin 500 mg 25
CTM 10
Dexametason tab 20
Parasetamol 500 mg 15
Ranitidin 150 mg tab 10
Vit. C 50 mg 10
Vitamin b kompleks 10
19 REFLUKS GASTROESOFAGEAL K219 Gastrooesophageal reflux disease without 3 Antasida sirup 3
oesophagitis Domperidon tab 10
Natrium diklofenak 25 mg 10
Parasetamol 500 mg 10
Ranitidin 150 mg tab 30
20 GASTRITIS K297 Gastritis, unspecified 128 Amoxicillin 500 mg 30
Dispepsia 80 Antasida sirup 100
Antasida tablet 543
Asam mefenamat 500 mg 30
B1 tablet 60
 Cimetidin 200 mg 110
CTM 50

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
cotrimoxazol 480mg 20
Diazepam 2 mg tab 10
Domperidon tab 40
Ibuprofen 200 mg tab 20
Ibuprofen 400 mg tab 40
Metoclopramid 5 mg 30
Natrium diklofenak 25 mg 40
Papaverin tablet 150
Parasetamol 500mg 217
Piridoksin tab 240
Ranitidin 150 mg tab 1278
sangobion 5
SF tablet 20
Vit. C 50 mg 332
Vitamin b kompleks 657
21 INTOLERANSI MAKANAN 0
22 MALABSORBSI MAKANAN 0
23 DEMAM TIFOID A010 Typhoid fever 10 Antasida sirup 9
suspek 8 cloramfenikol sirup 2
cotrimoxazol 480mg 40
Cotrimoxazol sirup 3
CTM 10
Dexametason tab 86
GG tab 10
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 10
kloramfenikol 250 mg kapsul 130
Metoclopramid 5 mg 4
Parasetamol 500mg 123
Parasetamol sirup 2
Piridoksin tab 10
Vit. C 50 mg 10
Vitamin b kompleks 66
24 GASTROENTERITIS ( TERMASUK DISENTRI, A09 Diarrhoea & gastroenteritis of presumed 157 Amoxicillin 500 mg 15
KOLERA, GIARDIASIS) infection origin Antasida sirup 13
 Antasida tablet 10
B1 tablet 20
cotrimoxazol 480mg 866
Cotrimoxazol sirup 31
CTM 104

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
Domperidon tab 32
Metoclopramid 5 mg 10
Oralit 544
Papaverin tablet 363
Parasetamol 500mg 58
Parasetamol sirup 7
Piridoksin tab 116
Ranitidin 150 mg tab 60
SF tablet 10
Vit. C 50 mg 96
Vitamin b kompleks 143
Zink tablet 245
25 DISENTRI BASILER DAN DISENTRI AMUBA 6 Fitomenadin tablet 10
suspek 3 cotrimoxazol 480mg 22
B1 tablet 20
Cotrimoxazol sirup 1
Oralit 27
Metronidazol 250 mg 20
Metronidazol 500 mg 26
Papaverin tablet 43
Parasetamol 500 mg 10
Parasetamol sirup 1
Ranitidin 150 mg tab 20
Piridoksin tab 10
Vitamin b kompleks 6
Zink tablet 20
26 APENDISITIS AKUT K359 Acute appendicitis 0
27 PERDARAHAN SALURAN MAKAN BAGIAN 0
28 ATAS
PERDARAHAN SALURAN MAKAN BAGIAN 0
29 BAWAH
HEMOROID GRADE 1-2 3 Antihemoroid suppo 8
Fitomenadin tablet 10
Papaverin tablet 10
Vit. C 50 mg 10
 Vitamin b kompleks 10
30 HEPATITIS A 0
31 HEPATITIS B 0
32 PAROTITIS K11.2 Sialoadenitis 3 Parasetamol sirup 2
Vit. C 50 mg 12
CTM 13
Vitamin b kompleks 12

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
33 ASKARIASIS B77.9 Ascariaris unspecified 19 Pyrantel sirup 6
Pyrantel 125 mg tab 29
Vitamin b kompleks 30
Albendazol 400 mg 4
Vit. C 50 mg 30
Parasetamol sirup 1
34 CUTANEUS LARVA MIGRANS B76.9 Hookworm disease, unspecified
35 PENYAKIT CACING TAMBANG B76.0 Ankylostomiasis ,Necatoriasis
36 SKISTOSOMIASIS B76.1
B65.9 Skistosomiasisunspecified , Schistomiasis
37 STRONGILOIDIASIS B65.2
B78.9 due to S. Japonicum
Strongyloidiasis
38 TAENIASIS B68.9 Taeniasis
39 PERITONISIS K65.9 Peritonitis, unspecified
40 KOLESISTITIS K81.9 Cholecystitis, unspecified
41 MATA KERING/DRY EYE H04.1 Other disorders of lacrimal gland
42 BUTA SENJA H53.5 Colour vision deficiencies
43 HORDEOLUM H00.0 Hordeolum and other deep inflammation 2 Amoxicillin 500 mg 10
of eyelid CTM 10
Dexametason tab 10
Oxytetrasiklin 1% ZM 1
Parasetamol 500 mg 10
prednison 5 mg 10
Vit. C 50 mg 10
44 KONJUNGTIVITIS H10.9 Conjunctivitis, unspecified,,, Acute 19 Asam mefenamat 500 mg 10
H10.1 atopic conjunctivitis CTM 90
Amoxicillin 500 mg 50
Dexametason tab 50
Gentamisin TM 4
Kloramfenikol ZM 4

Loratadin 10 mg 10
 Oxytetrasiklin 1% ZM 7
Vit. C 50 mg 20
45 BLEFARITIS H01.0 Blepharitis a
46 PERDARAHAN SUBKONJUNGTIVA H57.8 Other specified disorders of eye and a
47 BENDA ASING DI KONJUNGTIVA T15.9 adnexa
Foreign body on external eye, part a
48 ASTIGMATISM H52.2 unspecified
Astigmatism a
49 HIPERMETROPIA H52.0 Hypermetropia a
50 MIOPIA RINGAN H52.1 Myopia a

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
51 PRESBIOPIA H52.4 Presbyopia a
52 KATARAK PADA PASIEN DEWASA H26.9 Cataract, unspecified a
53 GLAUKOMA AKUT H40.2 Primary angle-closure glaucoma a
54 OTITIS EKSTERNA H60.9 Otitis Externa, Unspecified 2 Amoxicillin 500 mg 10
Asam mefenamat 500 mg 10
Amoxicillin sirup 1
CTM 3
Vit. C 50 mg 15
Ranitidin 150 mg tab 10
Loratadin 10 mg 10
Vitamin b kompleks 10
55 OTITIS MEDIA AKUT H66.0 Acute suppurative otitis media 8 Amoxicillin 250 mg 10
Amoxicillin 500 mg 45
Asam mefenamat 500 mg 20
B1 tablet 10
CTM 50
ciprofloxacin 500 mg 10
Dexametason tab 40
Ibuprofen 400 mg tab 10
Amoxicillin sirup 1
Ranitidin 150 mg tab 10
Vit. C 50 mg 30
Vitamin b kompleks 20
56 SERUMEN PROP H61.2 Impacted cerumen 8 Amoxicillin 500 mg 20
Asam mefenamat 500 mg 20
B1 tablet 10
CTM 40
Dexametason tab 20
Parasetamol 500 mg 10
 prednison 5 mg 10
Ranitidin 150 mg tab 10
Vit. C 50 mg 50
Vitamin b kompleks 20
57 BENDA ASING DI HIDUNG T17.1 Foreign body in nostril a
58 ANGINA PEKTORIS I20.9 Angina pectoris a
59 INFARK MIOKARD I21.9 Acute Myocardial Infarction a
60 TAKIKARDIA I47.1 Supraventicular Tachicardy , Ventricular a
61 GAGAL JANTUNG AKUT DAN KRONIK I50.9 Tachicardy
Heart failure Furosemid 40 mg 30
I47.2
CHF 2 Digoksin 0,5mg 30
Ranitidin 150 mg tab 10

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
62 CARDIORESPIRATORY ARREST K80 Cardiac arrhytmia a
63 HIPERTENSI ESENSIAL I10 Essential (primary) hypertension 133 Antasida sirup 2
Asam mefenamat 500 mg 10
B1 tablet 80
Captopril 25 mg 1164
HCT tab 25
Ibuprofen 400 mg tab 20
meloxicam 7,5 mg 20
Metoclopramid 5 mg 10
Natrium diklofenak 25 mg 50
nifedipin tablet 20
Parasetamol 500 mg 120
prednison 5 mg 10
Piroxicam 20 mg 10
Piridoksin tab 60
Ranitidin 150 mg tab 30
Simvastatin 10 mg 30
Vit. C 50 mg 50
Vitamin b kompleks 120
64 INFARK SEREBRAL/STROKE I63.9 Cerebral infarction a
65 FRAKTUR TERBUKA T14. Fracture of unspecified body a
66 FRAKTUR TERTUTUP T14. Fracture of unspecified body a
67 POLIMIALGIA REUMATIK M53.3 Polymyalgia rheumatica a
68 ARTRITIS REUMATOID M53.3 Polymyalgia rheumatica 39 B1 tablet 323
ciprofloxacin 500 mg 20
CTM 117
 Dexametason tab 80
Diazepam 2 mg tab 5
Ibuprofen 200 mg tab 182
meloxicam 7,5 mg 70
Natrium diklofenak 25 mg 90
Parasetamol 500 mg 10
prednison 5 mg 126
Piroxicam 20 mg 80
Ranitidin 150 mg tab 20
Vit. C 50 mg 30
Vitamin b kompleks 100
69 ARTRITIS, OSTEOARTRITIS M19.9 Osteoarthrosis other 39 Alopurinol 100 mg 20
Asam mefenamat 500 mg 30

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
B1 tablet 210
Dexametason tab 10
Captopril 25 mg 10
Kalsium laktat 10
Ibuprofen 400 mg tab 20
Natrium diklofenak 25 mg 216
meloxicam 7,5 mg 70
Antasida sirup 1
Piridoksin tab 10
Piroxicam 20 mg 80
Prednison tab 200
Ranitidin 150 mg tab 64
Vit. C 50 mg 70
Vitamin b kompleks 70
70 LIPOMA D17.9 Benign lipomatous neoplasm a
71 KEJANG DEMAM R56.0 Febrile convulsions a
72 VERTIGO R42 Dizziness and giddiness 13 Antasida sirup 1
Asam mefenamat 500 mg 50
B1 tablet 120
Diazepam 2 mg tab 30
meloxicam 7,5 mg 10
Metoclopramid 5 mg 10
Natrium diklofenak 25 mg 30
Piridoksin tab 40
 Ranitidin 150 mg tab 10
Vit. C 50 mg 10
Vitamin b kompleks 10
73 DELIRIUM F05.9 Delirium a
74 TETANUS A35 Othertetanus a
75 RABIES A82.9 Rabies a
76 EPILEPSI G40.9 Epilepsy a
77 STATUS EPILEPTIKUS G41.9 Status epilepticus, unspecified a
78 MIGREN G43.9 Migraine, unspecified 2 Parasetamol 500mg 10
SF tablet 10
Asam mefenamat 500 mg 10
79 BELLS' PALSY G51.0 Bells’ palsy 2 B1 tablet 10
prednison 5 mg 10
80 TENSION HEADACHE G44.2 Tension–type headache 2 Captopril 25 mg 20
Ibuprofen 400 mg tab 10

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
Parasetamol 500 mg 10
Ranitidin 150 mg tab 10
CTM 10
Vit. C 50 mg 10
81 INSOMNIA G47.0 Disorders of initiating and maintaining 7 Diazepam 2 mg tab 25
sleep (insomnias) Vitamin b kompleks 60
Vit. C 50 mg 30
Parasetamol 500 mg 10
Ranitidin 150 mg tab 10
CTM 30
B1 tablet 10
82 DEMENSIA F03 Unspecified dementia a
83 GANGGUAN CAMPURAN ANXIETAS DAN DEP F41.2 Mixed Anxiety and Depression Disorder a
84 GANGGUAN PSIKOTIK F20 Chronic Psychotic Disorder a
85 EPISTAKSIS R04.0 Epistaxis 1 Fitomenadin tablet 3
Asam mefenamat 500 mg 10
86 FURUNKEL PADA HIDUNG J34.0 Abscess, furuncle and carbuncle of nose a
87 FARINGITIS J02.9 Acute pharyngitis, unspecified 45 Ambroxol tablet 20
Amoxicillin 250 mg 22
Amoxicillin 500 mg 200
Amoxicillin sirup 1
Antasida sirup 1
 Asam mefenamat 500 mg 30
B1 tablet 40
ciprofloxacin 500 mg 40
CTM 265
Dexametason tab 212
GG tab 70
Ibuprofen 400 mg tab 50
Loratadin 10 mg 20
Natrium diklofenak 25 mg 10
Parasetamol 500mg 251
Parasetamol sirup 2
Piridoksin tab 45
Prednison tablet 50
Ranitidin 150 mg tab 10
Vit. C 50 mg 120
Vitamin b kompleks 123

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
88 RHINITIS AKUT J00 Acute nasopharingitis (common cold) 74 Ambroxol tablet 52
Ambroxol sirup 1
Amoxicillin 500 mg 150
Amoxicillin sirup 2
CTM 475
Dexametason tab 200
GG tab 317
Ibuprofen sirup 3
Piridoksin tab 10
Parasetamol 500mg 286
Parasetamol sirup 5
Prednison tablet 151
Ranitidin 150 mg tab 50
sangobion 3
Vit. C 50 mg 295
Vitamin b kompleks 414
89 RHINITIS ALERGIK J30.0 Vasomotor rhinitis 21 Amoxicillin 500 mg 40
B1 tablet 30
ciprofloxacin 500 mg 10
CTM 70
Dexametason tab 50
 GG tab 30
Ibuprofen 400 mg tab 20
Loratadin 10 mg 50
Parasetamol 500mg 30
Prednison tablet 90
Vit. C 50 mg 90
Vitamin b kompleks 20
90 RHINITIS VASOMOTOR J30.0 Vasomotor rhinitis a
91 TONSILITIS R76 Acute tonsillitis, unspecified 41 Ambroxol tablet 9
Amoxicillin 250 mg 65
Amoxicillin 500 mg 147
Amoxicillin sirup 14
Asam mefenamat 500 mg 30
CTM 158
Dexametason tab 103
GG tab 49
Oralit 10
Parasetamol 500mg 153
Parasetamol sirup 14

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
Piridoksin tab 13
Prednison tablet 10
Ranitidin 150 mg tab 10
Vit. C 50 mg 288
Vitamin b kompleks 211
92 LARINGITIS J04.0 Acute laryngitis a
93 BRONKITIS AKUT J20.9 Acute bronchitis, unspecified 15 Ambroxol tablet 40
Antasida sirup 1
ciprofloxacin 500 mg 40
cotrimoxazol 480mg 12
CTM 76
Dexametason tab 30
GG tab 120
Ibuprofen 200 mg tab 20
Ibuprofen 400 mg tab 10
Loratadin 10 mg 40
Natrium diklofenak 25 mg 10
parasetamol 500 mg 55
 Piroxicam 20 mg 10
prednison 5 mg 30
Ranitidin 150 mg tab 10
Salbutamol 2 mg 65
Vitamin b kompleks 70
94 INFLUENZA J11 Influenza Ambroxol sirup 7
(ISPA) 618 Ambroxol tablet 1494
Amoxicillin 250 mg 225
Amoxicillin 500 mg 1077
Amoxicillin sirup 35
Antasida sirup 4
B1 tablet 30
ciprofloxacin 500 mg 120
cotrimoxazol 480mg 82
Cotrimoxazol sirup 12
cotriped 120 mg 76
CTM 3559
Dexametason tab 1369
GG tab 2486
Ibuprofen 200 mg tab 185
Ibuprofen 400 mg tab 40

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
Ibuprofen sirup 1
Loratadin 10 mg 175
meloxicam 7,5 mg 10
OBH sirup 1
Oralit 49
Parasetamol 500mg 1935
Parasetamol sirup 96
Piridoksin tab 72
Prednison tablet 749
Ranitidin 150 mg tab 70
Salbutamol 2 mg 203
Salbutamol 4 mg 10
Vit. C 50 mg 1957
Vitamin b kompleks 2019
95 PNEUMONIA ASPIRASI J69.0 Pneumonitis due to food and vomit a
96 PNEUMONIA DAN BRONKOPNEUMONIA J18.9 Pneumonia, unspecified 2 Cotrimoxazol sirup 2
 CTM 6
parasetamol 500 mg 3
GG tab 6
Dexametason tab 6
Salbutamol 2 mg 6
Parasetamol sirup 1
Vit. C 50 mg 3
97 PERTUSIS A37.8 Whooping cough a
98 ASMA BRONKIAL J45 Asthma 7 CTM 40
Parasetamol 500 mg 10
Ambroxol tablet 22
GG tab 10
prednison 5 mg 10
cotrimoxazol 480mg 10
Salbutamol 2 mg 66
Dexametason tab 26
Vitamin b kompleks 40
Vit. C 50 mg 40
99 MILIRIA L74.3 Miliaria a
100 VERUKA VULGARIS B07 Viral warts a
101 REAKSI GIGITAN SERANGGA T63.4 Venom of other arthropods 1 CTM 10
Dexametason tab 10
102 HERPES ZOSTER B02.9 Zoster without complication a

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
103 HERPES SIMPLEKS B00.9 Herpesviral infection, unspecified a
104 SKABIES B86 Scabies 3 CTM 10
Dexametason tab 10
salep 2-4 3
105 PEDIKULOSIS KAPITIS B85.0 Pediculosis due to Pediculus humanus a
106 DERMATOFITOSIS : TINEA KAPITIS B35.0 capitis
Tinea barbae and tinea capitis a
107 DERMATOFITOSIS : TINEA BARBAE B35.0 Tinea barbae and tinea capitis a
108 DERMATOFITOSIS : TINEA FASIALIS TINEA FASIALIS Dexametason tab
Parasetamol 500mg
B1 tablet
109 DERMATOFITOSIS : TINEA KORPORIS B35.4 Tinea corporis 15 Loratadin 10 mg 30
CTM 82
Vitamin b kompleks 20
Vit. C 50 mg 62
 Ketokonazol ZK 20
Griseofulvin tablet 125 mg 30
Metronidazol 500 mg 10
Dexametason tab 40
110 DERMATOFITOSIS : TINEA MANUM B35.2 Tinea manuum 1 Miconazol cream 3
Vit. C 50 mg 10
Loratadin 10 mg 10
111 DERMATOFITOSIS : TINEA UNGUIUM B35.1 TINEA UNGUIUM 1 Asam mefenamat 500 mg 10
Vit. C 50 mg 10
112 DERMATOFITOSIS : TINEA KRURIS B35.6 Tinea cruris 3 Miconazol cream 1
Ketokonazol ZK 3
Parasetamol 500 mg 10
salep 2-4 1
Loratadin 10 mg 10
113 DERMATOFITOSIS : TINEA PEDIS B35.3 Tinea pedis 1 Amoxicillin 500 mg 10
Tinea 4 Vit. C 50 mg 10
CTM 20
Dexametason tab 10
Hidrocortison ZK 1
Oxytetrasiklin 3% ZK 1
Ketokonazol ZK 6
Vitamin b kompleks 10
Vit. C 50 mg 10
114 PITIRIASIS VERSIKOLOR/TINEA VERSIKOLOR B36.0 Pityriasis versicolor a
115 PIODERMA L08.0 Pyoderma a

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
116 DERMATITIS SEBOROIK L21 Seborrhoeic dermatitis 2 Griseofulvin tablet 125 mg 10
Ketokonazol ZK 1
117 DERMATITIS ATOPIK L20 Atopic dermatitis 5 Oxytetrasiklin 3% ZK 1
CTM 17
Vit. C 50 mg 33
Vitamin b kompleks 10
Betametason zk 1
Loratadin 10 mg 20
Dexametason tab 15
Salisil bedak 1
118 DERMATITIS NUMULARIS L20.8 Other atopic dermatitis Amoxicillin 500 mg
Dexametason tab
 CTM
Ranitidin 150 mg tab
Oxytetrasiklin 3% ZK
119 LIKE SIMPLEKS KRONIK L28.0 Lichen simplex chronicus 3 Loratadin 10 mg 10
(NEURODERMATITIS SIRKUMKRIPTA) Amoxicillin 500 mg 15
CTM 30
Dexametason tab 10
Vit. C 50 mg 20
Vitamin b kompleks 10
Oxytetrasiklin 3% ZK 6
120 DERMATITIS KONTAK ALERGIK L23 Allergic contact dermatitis 93 Amoxicillin 250 mg 32
Amoxicillin 500 mg 167
Amoxicillin sirup 2
Asam mefenamat 500 mg 30
B1 tablet 10
Betametason zk 24
ciprofloxacin 500 mg 30
Cloramfenikol ZM 1
CTM 453
Dexametason tab 412
Hidrocortison ZK 19
Ketokonazol ZK 3
Loratadin 10 mg 140
Griseofulvin tablet 125 mg 100
Oxytetrasiklin 3% ZK 17
Parasetamol sirup 1
prednison 5 mg 28

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
Salep 2-4 1
Salisil bedak 3
Serbuk PK 2
Vit. C 50 mg 213
Vitamin b kompleks 80
121 DERMATITIS KONTAK IRITAN L24 Irritant contact dermatiti a
122 NAPKIN ECZEMA 9DERMATITIS POPOK) L22 Diaper(napkin) dermatitis a
123 PITIRIASIS ROSEA L42 Pityriasis rosea a
124 MOLUSKUM KONTAGIOSUM B08.1 Molluscum contagiosum a
125 URTIKARIA L50 Urticaria 2 CTM 16
 Vit. C 50 mg 6
Dexametason tab 10
Vitamin b kompleks 6
Betametason zk 1
126 FILARIASIS B74 Filariasis a
127 LUKA BAKAR DERAJAT I DAN II S24 burn a
128 OBESITAS E66.9 obesity unspecified a
129 TIROTOKSIKOSIS E05.9 Tirotoksikosis unspecified 3 PTU 70
Natrium diklofenak 25 mg 10
130 HIPERGLIKEMIA HIPEROSMOLAR NON KETO R73.9 Hyperglycaemia unspecified a
131 HIPOGLIKEMIA E16.2 hypoglycaemia unspecified a
132 DIABETES MELITUS 1 E10 Insulin-dependent diabetes mellitus a
133 DIABETES MELITUS 2 E11 Non-insulin-dependent diabetes mellitus 57 Antasida sirup 3
B1 tablet 90
Glibenklamid 5 mg 228
Loratadin 10 mg 10
meloxicam 7,5 mg 20
Metformin 500 mg 630
Natrium diklofenak 25 mg 52
Piridoksin tab 10
Ranitidin 150 mg tab 10
Simvastatin 10 mg 60
Vit. C 50 mg 50
Vitamin b kompleks 40
134 MALNUTRISI ENERGI PROTEIN (MEP) E46 Unspecified protein-energy malnutrition a
135 HIPERURICEMIA GOUT ARTHRITIS E79.0 Hyperuricemia without signs of 61 Alopurinol 100 mg 364
M10 inflammatory arthritis and tophaceous B1 tablet 110
disease
Dexametason tab 70

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
Ibuprofen 200 mg tab 10
Ibuprofen 400 mg tab 20
Natrium diklofenak 25 mg 355
Parasetamol 500 mg 10
Piroxicam 20 mg 40
Prednison tab 50
Ranitidin 150 mg tab 270
Vit. C 50 mg 250
 Vitamin b kompleks 270
136 DISLIPIDEMIA E78.5 Hiperlipidemia 104 Asam mefenamat 500 mg 10
B1 tab 120
Ibuprofen 200 mg tab 10
meloxicam 7,5 mg 30
Captopril 25 mg 60
Antasida sirup 1
Natrium diklofenak 25 mg 105
Piroxicam 20 mg 20
Ranitidin 150 mg tab 40
Simvastatin 10 mg 1324
Vit. C 50 mg 164
Vitamin b kompleks 164
137 INFEKSI SALURAN KEMIH N39.0 Urinary tarct infection, site not specified 20 Amoxicillin 250 mg 10
Suspek 6 Amoxicillin 500 mg 90
Amoxicillin sirup 1
Antasida sirup 3
Asam mefenamat 500 mg 120
B1 tablet 10
ciprofloxacin 500 mg 120
cotrimoxazol 480mg 22
CTM 43
Dexametason tab 60
Ibuprofen 400 mg tab 30
Metronidazol 250 mg 10
Natrium diklofenak 25 mg 20
papaverin tablet 10
Parasetamol 500 mg 33
prednison 5 mg 3

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
Ranitidin 150 mg tab 40
Vit. C 50 mg 80
Vitamin b kompleks 50
138 HIPERMEMESIS GRAVIDARUM O21.0 Mild hyperemis gravidarum 1 Vitamin b kompleks 10
Piridoksin tab 10
Antasida sirup 1
139 KEHAMILAN NORMAL O80.9 Single spontaneus delivery, unspecified 186 SF tablet 3211
Kalsium laktat 1135
Vitamin b kompleks 1535
Antasida sirup 17
Vit. C 50 mg 40
Piridoksin tab 330
B1 tablet 180
Parasetamol 500 mg 25
Antasida tablet 10
Betametason zk 1
140 PRE-EKLAMPSIA O14.9 Pre-eclampsia, unspecified a
141 EKLAMSIA O15.9 Eclampsia, unspecified as to time periode a
142 ABORTUS SPONTAN KOMPLIT O03.9 Unspecified abortion complete, without a
143 ABORTUS MENGANCAM/INSIPIENS O06.3 complication
Unspecified abortion incomplete, without a
144 ABORTUS SPONTAN INKOMPLIT O06.4 complication
Unspecified abortion incomplete, without a
145 ANEMIA DEFISIENSI BESI PADA KEHAMILAN D50 complication
Iron deficiency anemia a
146 KETUBAN PECAH DINI 042.9 Premature rupture of membrane, a
147 PERSALINAN LAMA O63.9 unspecified
long labour a
148 PERDARAHAN POST PARTUM 072.1 Other Immediate Postpartum a
149 RUPTUR PERINEUM TINGKAT 1-2 O70.0 haemorhage
First degree perineal laceration during a
150 MASTITIS N61 delivery
Inflammatory disorders of breast 2 Asam mefenamat 500 mg 20
Loratadin 10 mg 10
Dexametason tab 20
ciprofloxacin 500 mg 10
151 FLUOR ALBUS N98.9 2 Metronidazol 500 mg 10
ciprofloxacin 500 mg 10
CTM 10
Asam mefenamat 500 mg 10
Antasida sirup 1
Vit. C 50 mg 10
152 SIFILIS A51 Early syphilis a
153 GONORE A54.9 Gonococcal infection, unspecified a

DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML

NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
154 VAGINITIS N76.0 Acute Vaginitis 3 Asam mefenamat 500 mg 15
Metronidazol 500 mg 31
Ibuprofen 400 mg tab 10
 Vit. C 50 mg 30
Metronidazol 250 mg 15
Vitamin b kompleks 20
155 VULVITIS N76.0 Acute Vaginitis a

Mengetahui Mamuju, 31 Januari 2017

Kepala Puskesmas Penanggung Jawab Farmasi

NURHAIDAH A. HALIMAH USMAN,S.Si,Apt

NIP. 19661231 198803 2 239 NIP. 19831206 200912 2 002

DATA DIAGNOSA LAIN YANG TERLAYANI DI FKTP

NAMA FKTP : PUSKESMAS BINANGA
 BULAN JANUARI 2017
DIAGNOSA ICD X JUMLAH JUMLAH NAMA JML
NO NAMA DIAGNOSA KET
KODE NAMA DIAGNOSA KASUS KUNJUNGAN OBAT OBAT
1 Febris pro evaluasi 32 Parasetamol 500 mg 120
Oralit 58
Vit.C 50 mg 169
Vitamin B kompleks 195
Ranitidin 150 mg 10
Parasetamol sirup 18
Amoxicillin 500 mg 30
CTM 39
Dexametason tab 15
Prednison tab 10
GG tab 10
cotrimoxazol sirup 1
2 Batuk 2 GG tab 20
Vit.C 50 mg 20
Parasetamol 500 mg 10
CTM 10
Dexametason tab 10
3 PPOK 1 ambroxol tablet 10
Salbutamol 4 mg 10
loratadin 10 mg 10
Vitamin B kompleks 10
4 Sinusitis 2 Amoxicillin 250 mg 15
Amoxicillin 500 mg 10
Prednison tab 10
Vit.C 50 mg 20
Vitamin B kompleks 10
Parasetamol 500 mg 10
CTM 10
5 Kolik abdomen 10 Parasetamol sirup 2
Vit.C 50 mg 20
B1 tablet 10
Piridoksin tablet 12
Papaverin tablet 90
Vitamin B kompleks 30
CTM 2
Metronidazol 500mg 10
 Antasida sirup 1
6 Furunkel 4 Amoxicillin 500 mg 32
CTM 12
Dexametason tab 22
Asam mefenamat 500 mg 10
Vit.C 50 mg 24
Vitamin B kompleks 10
Ranitidin 150 mg 10
GG tab 2
Parasetamol 500 mg 2
Betametason ZK 1
7 Folikulitis 3 CTM 27
Vit.C 50 mg 21
Vitamin B kompleks 21
Oxytetrasiklin 3% ZK 2
Parasetamol sirup 1
Amoxicillin sirup 1
Ranitidin 150 mg 10
Betametason ZK 1
Prednison tab 10
8 Acne vulgaris 2 CTM 10
Dexametason tab 10
Vit.C 50 mg 20
Oxytetrasiklin 3% ZK 3
loratadin 10 mg 10
9 Tinea vesikolor 2 Ketokonazol ZK 4
Tinea vulgaris 1 Dexametason tab 3
CTM 3
Vit.C 50 mg 3
Metronidazol 500mg 10
10 Flebitis 1 Asam mefenamat 500 mg 10
Vit.C 50 mg 10
11 Campak 1 Vit.C 50 mg 10
Vitamin B kompleks 10
Oralit 10
Parasetamol 500 mg 12
12 KIA: Asam mefenamat 500 mg 50
post partum 6 Amoxicillin 500 mg 80
pasang implan 2 Vit.C 50 mg 60
SF tablet 150
Dexametason tab 20
Parasetamol 500 mg 30
 Vitamin B kompleks 20
13 UGD : Amoxicillin 250 mg 85
Post ekstraksi kuku 3 Amoxicillin 500 mg 667
Trauma patella 2 Amoxicillin sirup 5
V.excoriatum 4 Asam mefenamat 500 mg 773
V.laseratum 34 B1 tablet 30
Abses 26 Betametason ZK 1
Furunkel 2 Ciprofloxazin 500 mg 164
V.ictum 13 CTM 172
post sirkum 2 Dexametason tab 474
combutio 2 Ibuprofen 400 mg 20
luka lecet 1 Meloxicam 7,5 mg 10
V.morsum 1 Metronidazol 500mg 100
Paronicia kuku 1 Natrium diklofenak 25 mg 60
post trauma 1 Oxytetrasiklin 3% ZK 4
Parasetamol 500 mg 132
Parasetamol sirup 2
Prednison tab 30
Ranitidin 150 mg 70
Vit.C 50 mg 653
Vitamin B kompleks 295
14 POLI GIGI : Amoxicillin 250 mg 10
Perforasi apex 1 Amoxicillin 500 mg 1005
Abses periapikal 38 Amoxicillin sirup 5
pulpitis irreversibel 40 Asam mefenamat 500 mg 980
Impaksi 2 B1 tablet 20
Necrose pulpa 15 Ciprofloxazin 500 mg 276
Ulkus traumatik 1 CTM 33
Gangren radix 32 Dexametason tab 1240
Periodontitis 15 Diazepam 2 mg 3
polip pulpa 3 Ibuprofen 400 mg 10
traumatik dentoalveolar 1 Ibuprofen sirup 1
kalsium laktat 10
Metronidazol 250mg 221
Metronidazol 500mg 20
Natrium diklofenak 25 mg 30
Parasetamol 500 mg 363
Parasetamol sirup 1
Vit.C 50 mg 183
Vitamin B kompleks 272
15 Pterigyum 2 Gentamisin TM 1
sakit mata 2 kloramfenikol ZM 1
 Dexametason tab 30
CTM 30
Amoxicillin 500 mg 10
Oxytetrasiklin 1% ZM 1
Vit.C 50 mg 10
16 Otalgia 1 Parasetamol 500 mg 14
OMSK 4 Amoxicillin 500 mg 24
CTM 35
Dexametason tab 25
Vit.C 50 mg 15
GG 3
Amoxicillin 250 mg 15
27 Sistitis akut 2 Ciprofloxazin 500 mg 20
Ibuprofen 400 mg 10
Natrium diklofenak 25 mg 10
B1 tablet 10
28 Suspek uretritis 1 Vitamin B kompleks 10
uretritis 1 Papaverin tablet 10
Amoxicillin 500 mg 15
Asam mefenamat 500 mg 10
Parasetamol 500 mg 10
Ranitidin 150 mg 10
Oxytetrasiklin 3% ZK 1
CTM 20
Vit.C 50 mg 20
Erisanbe tab 15
29 Hipotensi 4 Vitamin B kompleks 30
Vit.C 50 mg 10
Diazepam 2 mg 5
B1 tablet 10
Piridoksin tablet 10
SF tablet 10
Ranitidin 150 mg 10
30 Mialgia 33 Dexametason tab 42
Natrium diklofenak 25 mg 152
Parasetamol 500 mg 40
Prednison tab 30
Ibuprofen 400 mg 30
Asam mefenamat 500 mg 70
Piroxicam 20 mg 30
Ranitidin 150 mg 130
Vitamin B kompleks 172
 Vit.C 50 mg 142
B1 tablet 110
31 LBP 27 Asam mefenamat 500 mg 30
B1 tablet 202
Dexametason tab 20
Ibuprofen 200 mg 20
Ibuprofen 400 mg 40
Meloxicam 7,5 mg 40
Natrium diklofenak 25 mg 125
Piridoksin tablet 10
Piroxicam 20 mg 10
Prednison tab 80
Ranitidin 150 mg 70
Vit.C 50 mg 40
Vitamin B kompleks 30
32 Dismenoroe 2 Vitamin B kompleks 20
Papaverin tablet 20
Vit.C 50 mg 10
Asam mefenamat 500 mg 10
33 Cefalgia 20 Diazepam 2 mg 10
antalgin 500 mg 7
Parasetamol 500 mg 75
CTM 60
Piridoksin tablet 23
Vitamin B kompleks 123
Vit.C 50 mg 80
Ibuprofen 400 mg 10
Asam mefenamat 500 mg 20
Natrium diklofenak 25 mg 20
Prednison tab 3
B1 tablet 10
34 sariawan 3 Vit.C 50 mg 30
Vitamin B kompleks 35
35 Tromboflebitis 1 Asam mefenamat 500 mg 10
Vit.C 50 mg 10
Ranitidin 150 mg 10
36 Gangguan somatoform 2 amitriptilin 5
Vit.C 50 mg 20
Vitamin B kompleks 20
CTM 10
37 Vitamin B kompleks
Papaverin tablet
 SF tablet
Metoclopramid 5 mg
Vitamin B kompleks
Amoxicillin sirup
Parasetamol sirup
Piridoksin tablet
Amoxicillin 500 mg
CTM
Dexametason tab
Ibuprofen 400 mg
Parasetamol 500 mg
Parasetamol sirup
GG tab
Prednison tab
Vit.C 50 mg
CTM
Dexametason tab
Amoxicillin 500 mg
Vitamin B kompleks
Amoxicillin 500 mg
Asam mefenamat 500 mg
Vitamin B kompleks
Vit.C 50 mg
Ciprofloxazin 500 mg
Dexametason tab
CTM
Natrium diklofenak 25 mg
Dexametason tab
Ranitidin 150 mg
Amoxicillin sirup
Parasetamol sirup
CTM
Vit.C 50 mg
Oxytetrasiklin 3% ZK
Oxytetrasiklin 1% ZM
Vitamin B kompleks

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