Rekapan Sp2d Obat 2017

PEMERINTAH KABUPATEN SUMBAWA
UPT. INSTALASI FARMASI KABUPATEN SUMBAWA

JL KEBAYAN NO. 47 TELP (0371) 21477 SUMBAWA BESAR
Obat e katalog yang belum datang per sept 2017
VOLUME E ONGKIR VOLUME RIIL JUMLAH HARGA

NO NAMA OBAT SATUAN NO ID PAKET HARGA (Rp) JUMLAH HARGA (Rp) YANG
PURCHASING DATANG
(Rp)
DULCOLAX SUPP ADULT 10MG BISAKODIL

1 SUPPOSITORIA 10 MG SUPPO OBT-P1703-428374 5,800 1,750 10,150,000 - -
OBT-P1703-428319
2 AMLODIPIN TABLET/KAPSUL/KAPLET 5 MG TABLET 105 112,500 11,812,500 10,237,500 15,000 1,575,000
3 METFORMIN HCl TABLET 500 MG TABLET 115 87,000 10,005,000 -
OBT-P1703-428296
4 RISPERIDON TABLET 1 MG TABLET 439 25,000 10,975,000 -
5 ASAM TRANEKSAMAT INJEKSI 100 MG/ML AMPUL 2,535 200 507,000 -
6 KLORAMFENIKOL SALEP MATA 1 % TUBE 1,800 2,700 4,860,000 -
7 KUININ TABLET 200 MG (222 MG SEBAGAI GARAM) TABLET 704 4,000 2,816,000 2,400 1,689,600
8 KETOKONAZOL KRIM 2 % TUBE 2,605 4,000 10,420,000 930 2,422,650
9 PARASETAMOL TABLET 500 MG TABLET 57 2,975,000 169,575,000

OBT-P1703-420667
10 ASAM MEFENAMAT TABLET 500 MG TABLET 112 217,500 24,360,000

PURCHASING DATANG
(Rp)
ANTI BAKTERI DOEN SALEP KOMBINASI : OBB-P1704-453894

11 BASITRASIN 500 iu/g + POLIMIKSIN 10.000 iu/g TUBE 3,071 5,200 15,969,200
12 METILPREDNISOLON TABLET 8 MG TABLET OBB-P1704-453909 305 50,000 15,250,000
13 MGSO4 MAGNESIUM SULFAT INJEKSI 40% AMPUL 3,650 960 3,504,000

OBB-P1704-453903
14 WI AIR UNTUK INJEKSI 25 ML AMPUL 2,750 120 330,000
15 DIGOKSIN TABLET 0,25 MG TABLET OBB-P1704-453896 107 8,000 856,000
16 SALBUTAMOL TAB. 2 MG TABLET OBB-P1704-453931 78 73,500 5,733,000
17 PRIMAKUIN TABLET 15 MG TABLET OBB-P1704-453937 235 16,500 3,877,500 8,600 2,021,000
18 DIAZEPAM TABLET 5 MG TABLET 105 45,000 4,725,000

ANTASIDA DOEN I TABLET KUNYAH, KOMBINASI:
ALUMINIUM HIDROKSIDA 200 MG+MAGNESIUM TABLET
HIDROKSIDA 200 MG
19 59 183,000 10,797,000
OBB-P1704-453889
ANTASIDA DOEN II SUSPENSI, KOMBINASI:
ALUMINIUM HIDROKSIDA 200 MG/5
20 ML+MAGNESIUM HIDROKSIDA 200 MG/5 ML BOTTLE 1,962 3,000 5,886,000
21 KLORPROMAZIN TAB SALUT 100 MG (HCl) TABLET 148 11,000 1,628,000
22 FENOBARBITAL INJEKSI i.m/i.v 50 MG/ML AMPUL OBT-P11704-453926 1,740 500 870,000
DECACETIN TETES MATA 0,5% KLORAMFENIKOL

23 TETES MATA 0,5 % BOTTLE OBT-P1704-453939 3,500 2,500 8,750,000
PURCHASING DATANG
(Rp)
TOTAL 332,081,200
2,905,000,000
2,565,561,517 2,426,528,945
TOTAL E KATALOG YANG BELUM PURCHASING 339,438,483 2,565,560,917

JADWAL
NAMA PENYEDIA NAMA DISTRIBUTOR KETERANGAN
KEDATANGAN
PT. Boehringer
Ingelheim PT. TEMPO CABANG
indonesia MATARAM
PT. kurang 97.500
PROMEDRAHARDJ PT. KIMIA FARMA 06 Mei 2017 tab
O FARMASI
PT. DEXA MEDICA PT. AAM DENPASAR
PT. MERSIFARMA
PT. MERAPI UTAMA
TIRMAKU PHARMA
MERCUSANA
JADWAL
KEDATANGAN
PT. INDOFARMA PT. INDOFARMA

Tbk GLOBAL MEDIKA
PT. TRI SAPTA JAYA

PT. BERNOFARM CABANG KOTA BIMA
PT. OTSUKA PT. MERAPI UTAMA

INDONESIA PHARMA
PT. YARINDO PT. PENTA VALENT

FARMATAMA MATARAM
PT. RAJAWALI
PT. PHAPROS Tbk NUSINDO
PT. RAJAWALI
PT. MERSIFARMA
TIRMAKU PT. INDOFARMA
MERCUSAN
PT. PHAPROS Tbk PT. RAJAWALI

NUSINDO
PT. HARSEN PT. PENTA VALENT
LABORATORIES MATARAM
JADWAL
KEDATANGAN
ITA
JADWAL
KEDATANGAN
INDAH KOMALASARI, S. FARM.,APT

NIP. 19790612 200604 2 018
PEMBAYARAN DI TRIWULAN 3 TAHUN ANGGARAN 2017
VOL JUMLAH HARGA TOTAL HARGA

NO ID PAKET NAMA BMHP KEMASAN HARGA (Rp) VOL RIIL NAMA PENYEDIA
ONGKIR FURCHASING (Rp) RIIL
42000000-AKS- E CARE ANTISEPTIK
1 gl 580,000 2,175,000 75 45,675,000 75 45,675,000
000039108 HANDRUB 5 Lt
PT.ENSEVAL MEDIKA
E CARE ANTISEPTIK PRATAMA
4200000-AKS- HANDRUB
2 10 btl@500 BOX 608,000 372,000 12 7,668,000 12 7,668,000
000038791
ml
TOTAL 53,343,000 53,343,000
1 IV CATETER 18 PCS 8,355.00 24,750.00 250 2,113,500 250 2,113,500
2 IV CATETER 22 PCS 8,355.00 24,750.00 250 2,113,500 250 2,113,500

3 IV CATETER 24 PCS 8,355.00 24,750.00 250 2,113,500 250 2,113,500
4 IV CATETER 20 PCS 8,355.00 49,500.00 500 4,227,000 500 4,227,000

42000000-AKS- PT.TERUMO
5 000047546 IV CATETER WING 18 PCS 14,575.00 41,250.00 250 3,685,000 250 3,685,000 INDONESIA
6 IV CATETER WING 22 PCS 14,575.00 41,250.00 250 3,685,000 250 3,685,000

TOTAL 25,458,750 25,458,750
42000000-AKS- 28
1 00007211 FIXOMULL 76993 5 CM ROLL 37,440.00 100 3,744,000.00 1,048,320.00
42000000-AKS- PT.BSN MEDICAL
2 ROLL 37,440.00 72 2,695,680.00
00007211 FIXOMULL 76993 5 CM INDONESIA
3 42000000-AKS- FIXOMULL 76992 10 CM ROLL 70,903.00 100 7,090,300.00 100 7,090,300.00

00007212
TOTAL 10,834,300.00 10,834,300.00
42000000-AKS- SARUNG TANGAN
1 PSG 19,360.00 3,872,000.00 2,000 42,592,000.00 2,000 42,592,000.00
0000408146 OBGYN PT. Jayamas Medika
TOTAL 42,592,000.00 42,592,000.00
NON E- TRIORESOLF
1 CATALOG FORMALINA 10 MG KOTAK 60,500 20 1,210,000 20 1,210,000
NON E- CHKM PARAMONO 20
2 CATALOG ML KOTAK 55,000 20 1,100,000 20 1,100,000
NON E-
3 CATALOG E LITE CEMENT 100 KOTAK 165,000 25 4,125,000 25 4,125,000
NON E- PT.COBRA DENTAL
4 CATALOG PUJI IX GP EXTRA A3 KOTAK 781,000 17 13,277,000 17 13,277,000 INDONESIA
NON E-
5 CATALOG CAVITON WHITE KOTAK 154,000 20 3,080,000 20 3,080,000
NON E- CELLUL OID STRIP
6 CATALOG SVENIKA PAC 137,500 20 2,750,000 20 2,750,000
NON E-
7 CATALOG COTTON ROLL PAC 32,100 500 16,050,000 500 16,050,000
TOTAL 41,592,000 41,592,000

42000000-AKS- NIPRO IV CATETER 20 PCS
1 000045140 7,018 1,066,500 750 6,330,000 750 6,330,000
2 000045143 7,018 1,066,500 750 6,330,000 750 6,330,000
PT SINAR RODA
UTAMA
3 000045139 7,018 1,066,500 750 6,330,000 750 6,330,000
42000000-AKS- NIPRO WING CATETER PT SINAR RODA
PCS
4 0000452604 18 11,000 2,200,000 1,000 13,200,000 1,000 13,200,000 UTAMA
42000000-AKS- NIPRO WING CATETER PCS
5 0000452605 20 11,000 2,750,000 1,250 16,500,000 1,250 16,500,000
42000000-AKS- NIPRO WING CATETER
6 0000452606 22 PCS 11,000 3,850,000 1,750 23,100,000 1,750 23,100,000
42000000-AKS- NIPRO WING CATETER
7 0000452607 24 PCS 11,000 2,200,000 1,000 13,200,000 1,000 13,200,000
42000000-AKS- NIPRO IV CATETER 24
000045138 PCS
8 7,018 1,065,500 750 6,329,000 750 6,329,000
TOTAL 91,319,000 91,319,000
AKS-P1705-
1 SPUIT 5 ML BOX 131,000.00 120 15,720,000 120 15,720,000 PT.AAM
500928
TOTAL 15,720,000 15,720,000
VASELINE ALBUM 250
1 GR BOTOL 45,000 10 450,000 10 450,000
PT.RIDHO ILAHI
2 H2O2 3% 1000 ML BOTOL 23,100 500 11,550,000 500 11,550,000 FARMA
NON E-CATALOG AQUADEST STERIL
3 GALON 20 LTR GALON 155,000 30 4,650,000 30 4,650,000
JUMLAH 16,650,000 16,650,000
PPN 10% 1,665,000 1,665,000
TOTAL 18,315,000 18,315,000
42000000-AKS- FIXOMULL 76992 10
1 PCS 70,903 105 7,444,815.00 105 7,444,815.00
00007211 CM
42000000-AKS- FIXOMULL 7699 10 CM
2 PCS 70,903 15 1,063,545.00 15 1,063,545.00 PT.BSN MEDICAL
00007211
INDONESIA
42000000-AKS- FIXOMULL 76993 5 CM
3 PCS 37,440 255 9,547,200.00 255 9,547,200.00
00007212
JUMLAH 18,055,560.00 18,055,560.00
41116002-AKS- SALMONELLA TYPHI O VIAL 66,660.00 470,000.00 75 5,469,500.00 75 5,469,500.00
1 000069704
41116002-AKS- SALMONELLA TYPHI H VIAL 66,660.00 470,000.00 75 5,469,500.00 75 5,469,500.00
2 000069701
41116002-AKS- SALMONELLA VIAL 66,660.00 470,000.00 75 5,469,500.00 75 5,469,500.00
3 000069708 PARATYPHI AO
41116002-AKS- SALMONELLA PT.RAFA TOPAZ
VIAL 66,660.00 470,000.00 75 5,469,500.00 75 5,469,500.00 UTAMA
4 000069746 PARATYPHI BO
41116002-AKS- GOLONGAN DARAH VIAL 68,200.00 470,000.00 50 3,880,000.00 50 3,880,000.00
5 00009080 ANTI -A
6 00009094 ANTI -B
7 00009098 ANTI -A,B
TOTAL 34,733,500.00
T OTAL PEMBAYARAN TRIWULAN 3 351,963,110.00

FURCHASING (Rp) RIIL
ONGKIR
AKS-P1707- SARUNG TANGAN PSG 19,360.00 3,872,000.00 2,000 42,592,000.00 2,000 42,592,000.00 PT. Jayamas Medika
593295 OBGYN
TOTAL 42,592,000.00 42,592,000.00
AWA
NAMA JADWAL TANGGAL NO SP2D

DISTRIBUTOR KEDATANGAN SP2D
2 juni 2017
PT.TRI SAPTA JAYA ### 09870/1.02.01.01/2017
2 juni 2017
PT.MENSA BINA 8 JUNI 2017

SUKSES 7/10/2017 08658/1.02.01.01/2017
24-5-2017
PT.ANUGRAH 24-5-2017 7/10/2017 08669/1.02.01.01/2017

ARGON MEDIKA
24-5-2017
PT.RIDHO ILAHI 24-5-17 8/1/2017 10040/1.02.01.01/2017
24-5-2017
24-5-2017
24-5-2017
PT.COBRA
8/16/2017 11329/1.02.01.01/2017
DENTAL 24-5-2017
24-5-2017
24-5-2017
24-5-2017
###
###
PT KIMIA FARMA 9/12/2017 12867/1.02.01.01/2017

###
PT KIMIA FARMA ### 9/12/2017 12867/1.02.01.01/2017
14/08/2017
14/08/2017
###
###
PT.AAM
23/08 2017 9/13/2017 12867/1.02.01.01/2017
PT.RIDHO ILAHI ### 8/16/2017 11325/1.02.01.01/2017
PT. ANUGERAH 8/2/2017 9/13/2017 12868/1.02.01.01/2017

ARGON MEDICA
20-6-17
20-6-17
20-6-17
PT.INDOFARMA
20-6-17 31-Jul-17 09869/1.02.01.01/2017
GLOBAL MEDIKA
20-6-17
20-6-17
20-6-17

PT.RIDHO ILAHI 8/23/2017 10/4/2017 14134/1.02.01.01/2017

REKAPAN SP2D BELANJA BAHAN OBAT-OBATAN
VOLUME E JUMLAH HARGA VOLUME RIIL JUMLAH HARGA
NO NAMA OBAT SATUAN NO ID PAKET HARGA (Rp) PURCHASING (Rp) YANG DATANG (Rp)
1
NaCl 0,9 % BOTTLE 6,410 22,000 141,020,000 22,000 141,020,000
OBT-P1703-420659
2 RINGER LAKTAT BOTTLE 7,150 86,000 614,900,000 86,000 614,900,000
TOTAL 755,920,000 755,920,000
3 SCABIMITE SALEP KULIT TUBE NON E KATALOG 57,500 140 8,050,000 140 8,050,000
4 ATROPINE INJ 0,25 MG/ML AMPUL 1,672 600 1,003,200 600 1,003,200
CALCIUM GLUCONAS 10 KALSIUM

5 GLUKONAT INJEKSI i.v 10% (100MG/ML) AMPUL 9,955 816 8,123,280 816 8,123,280
OBT-P1703-42867
6 METILERGOMETRIN INJ 0,2 MG/ML AMPUL 2,684 3,000 8,052,000 3,000 8,052,000
7 OXYTOCIN INJ 10 UI/ML AMPUL 1,900 7,300 13,870,000 7,300 13,870,000
TOTAL TOTAL 31,048,480 TOTAL 31,048,480
8 PULMICORT RESPULES CAN OBT-P1703-428373 9,725 2,000 19,450,000 2,000 19,450,000

BRICASMA RESPULES-TERBUTALIN
9 SULPHATE 2,5 MG/ML NEBULE OBT-P1703-428371 6,850 1,130 7,740,500 1,130 7,740,500
TOTAL 27,190,500 27,190,500
10 KAPTOPRIL TABLET 25 MG TABLET OBT-P1703-428368 71 50,000 3,550,000 50,000 3,550,000
11 RANITIDIN INJ 25 MG/ML AMPUL OBB-P1704-453934 1,531 20,000 30,620,000 20,000 30,620,000
12 KLORAMFENIKOL KAPSUL 500 MG TABLET OBT-P1703-428299 1,056 15,000 15,840,000 15,000 15,840,000
TOTAL BELANJA TRIWULAN 2 872,218,980 872,218,980

KOMBINASI: FERRO FUMARAT 60 MG+ AS.
FOLAT 0,4 MG TABLET SALUT GULA
13 (TABLET TAMBAH DARAH) TABLET OBB-P1704-453786 375 533,400 200,025,000 533,400 200,025,000
BIOSAVE SERUM ANTI BISA ULAR (A.B.U) I

14 CAIRAN INJ (i.m/i.v) VIAL OBT-P1705-475299 462,000 100 46,200,000 100 46,200,000
15 AMBROXOL 30 MG TABLET TABLET NON E KATALOG 225 27,000 6,075,000 27,000 6,075,000
16 THIAMPENICOL 500 MG KAPSUL KAPSUL NON E KATALOG 800 10,000 8,000,000 10,000 8,000,000
17 CEFTIAXONE 1 G INJEKSI 10 VIAL VIAL NON E KATALOG 15,000 140 2,100,000 140 2,100,000
18 AMBROXOL 15 MG / 5 ML ELIXIR BOTTLE NON E KATALOG 5,600 600 3,360,000 600 3,360,000
TOTAL 19,535,000 19,535,000
VICICILLIN SX KOMBINASI: AMPISILLIN

1000 MG + SULBAKTAM 500 MG SERB INJ
19 1500 MG VIAL OBT-P1705-475300 41,200 600 24,720,000 600 24,720,000
20 SEFADROKSIL TABLET 500 MG TABLET OBB-P1704-453930 451 50,000 22,550,000 50,000 22,550,000
INFUSAN D5 (250 ML) LARUTAN
MENGANDUNG KARBOHIDRAT (GLUKOSA
21 12,5 G/250 ML) SOFTBAG OBB-P1704-453905 11,400 1,225 13,965,000 1,225 13,965,000
ONDANSENTRON INJ 2 MG/ML (4 MG/2

22 ML) AMPUL OBB-P1704-453920 1,254 1,500 1,881,000 1,500 1,881,000
23 LISINOPRIL TABLET 5 MG TABLET 278 21,500 5,977,000 21,500 5,977,000

OBB-P1704-453924
24 NIFEDIPIN TABLET 10 MG TABLET 110 10,000 1,100,000 10,000 1,100,000
TOTAL 7,077,000 7,077,000
STESOLID - DIAZEPAM LARUTAN REKTAL 5

25 MG/2,5 ML TUBE OBT-P1703-428370 12,155 600 7,293,000 600 7,293,000
26 KETOKONAZOL TABLET 200 MG TABLET 288 24,600 7,084,800 24,600 7,084,800
OBB-P1704-453912
27 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTTLE 4,841 25 121,025 25 121,025
OBB-P1704-453912 VOLUME E JUMLAH HARGA VOLUME RIIL JUMLAH HARGA
28 OMEPRAZOL TABLET 20 MG TABLET 144 60,000 8,640,000 60,000 8,640,000
TOTAL 15,845,825 15,845,825
29 INTERZINC SYR ; ZINC SIRUP 10 MG/ML BOTTLE OBB-P1704-453915 6,600 2,500 16,500,000 2,500 16,500,000
30 GENTAMISIN I TETES MATA 0,3 % BOTTLE 4,380 500 2,190,000 500 2,190,000
GENOINT SALEP MATA: GENTAMISIN

31 SALEP MATA 0,3 % TUBE 3,110 100 311,000 100 311,000
OBB-P1704-453899
32 SETRIZIN SIRUP 5 MG/5ML BOTTLE 3,200 220 704,000 220 704,000
OPTIFLOX : LEVOFLOKSASIN TETES MATA

33 0,5 % BOTTLE 18,775 25 469,375 25 469,375
TOTAL 3,674,375 3,674,375

OBT-P1703-420655
35 NaCl 0,9 % BOTTLE 6,410 4,000 25,640,000 4,000 25,640,000
TOTAL 75,690,000 75,690,000
36 DEKSAMETASON INJEKSI i.m/i.v 5 MG/ML AMPUL 1,600 18,000 28,800,000 18,000 28,800,000
37 GARAM ORALIT KOMBINASI SACHET 269 51,500 13,853,500 51,500 13,853,500
38 KAPTOPRIL TABLET 12,5 MG TABLET 65 65,000 4,225,000 65,000 4,225,000
39 KLORPROMAZIN TAB SALUT 25 MG TABLET 155 17,000 2,635,000 17,000 2,635,000
40 LIDOKAIN INJEKSI 2% (HCl) AMPUL 870 15,000 13,050,000 15,000 13,050,000
TOTAL 62,563,500 62,563,500
WATER ONE LITER BOTTLE

41 AKS-P1705-496022 14,960 600 10,322,400 600 10,322,400
HCL 0,1 N BOTTLE 50

42 AKS-P1705-496022 10,560 607,200 50 607,200
TOTAL 10,929,600 10,929,600
107 POVIDONE IODINE 60 ML BOTTLE AKS-P1705-488409 3,700 600 600

2,553,000 2,553,000

10,350,000 10,350,000

416,875 416,875
TOTAL 13,319,875 13,319,875

NEW ANTIDES TABLET- ATTAPULGIT
TABLET
94 TABLET OBT-P1703-428376 164 50,000 8,200,000 50,000 8,200,000
79 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 122 100,000 12,200,000 100,000 12,200,000

OBB-P1704-453916
TOTAL 26,200,000 26,200,000
ASAM ASKORBAT (VITAMIN C) TABLET 50

MG TABLET 109 207,500 22,617,500 207,500 22,617,500
OBT-P1703-428284
SALBUTAMOL TAB. 4 MG TABLET 84 17,500 1,470,000 17,500 1,470,000
TOTAL 24,087,500 24,087,500
78 RISPERIDON TABLET 2 MG TABLET OBB-P1704-453919 347 25,000 8,675,000 8,000 2,776,000
12 DOMPERIDON TABLET 10 MG TABLET 118 60,300 7,115,400 60,300 7,115,400
OBT-P1703-428296
14 ALPRAZOLAM TABLET 0,25 MG TABLET 410 3,000 1,230,000 3,000 1,230,000
15 DESOKSIMETASON KRIM 0,25 % TUBE 10,800 50 540,000 50 540,000
8,885,400 8,885,400
BUFACETINE; KLORAMFENIKOL SALEP

52 KULIT 2% TUBE OBB-P1704-453940 3,140 3,000 9,420,000 3,000 9,420,000
1 SCOPMA TABLET TABLET 1800 10,000 18,000,000 10,000 18,000,000
2 METHERINAL TABLET TABLET 820 9,700 7,954,000 9,700 7,954,000
TOTAL 25,954,000 25,954,000
FITOMENADION (VITAMIN K1) INJ 10

51 MG/ML AMPUL OBB-P1704-453942 4,167 6,450 26,877,150 6,450 26,877,150
OBT-P1703-428319
9 DEKSAMETASON TABLET 0,5 MG TABLET 46 702,400 32,310,400 702,400 32,310,400
COTTON ROLL SIZE 2 PCS 52,000 40 40

2,080,000 2,080,000
DIAPEX PLUS TYPE A BOX 304,000 15 15

4,560,000 4,560,000
DIAPASTE TYPE A SET 355,200 15 15

5,328,000 5,328,000
SALIVA TRANSPARENT @100 PCS 92,000 5 5

460,000 460,000
NON E KATALOG
SALIVA TRANSPARENT BLUE @100 PCS 92,000 5 5
460,000 460,000
SALIVA TRANSPARENT GREEN @100 PCS 92,000 5 5

460,000 460,000
NON E KATALOG

SALIVA TRANSPARENT RED@100 PCS 92,000 10 10

920,000 920,000
DISPO COLD 150 ML BOTOL 388,800 20 20

7,776,000 7,776,000
JUMLAH 22,044,000 22,044,000
PPN 10% 2,204,400 2,204,400
TOTAL 24,248,400 24,248,400
95 KLORPROMAZIN INJ 5 MG AMPUL OBT-P1703-428372 1,483 300 444,900 300 444,900
96 KLORPRAMAZIN INJ 25 MG AMPUL OBT-P1703-428372 1,300 560 728,000 540 702,000
TOTAL 1,172,900 1,146,900
63 FUROSEMID TABLET 40 MG TABLET OBB-P1704-453910 81 22,000 1,782,000 22,000 1,782,000
81 ASIKLOVIR TABLET 200 MG TABLET OBB-P1704-453914 245 37,500 9,187,500 37,500 9,187,500
TETAGAM HUMAN TETANUS

19 IMUNOGLOBULIN INJ VIAL OBB-P1704-463920 170,000 150 25,500,000 150 25,500,000
47 GRISEOFULVIN TABLET 125 MG TABLET 245 25,000 6,125,000 25,000 6,125,000

OBB-P1704-453908
RETINOL (VITAMIN A) KAPSUL LUNAK
48 200.000 UI KAPSUL 531 33,500 17,788,500 33,500 17,788,500
TOTAL 23,913,500 23,913,500
HALDOL DECANOAS; HALOPERIDOL INJ 50

56 MG,ML AMPUL OBB-P1704-453925 97,500 150 14,625,000 150 14,625,000
DIFENHIDRAMIN INJEKSI i.v/i.m 10 MG/ML

69 (HCl) AMPUL 1,115 15,000 16,725,000 15,000 16,725,000
LIDOKAIN INJEKSI 2% (HCl)+EPINEFRIN

70 1:80.000 - 2 ML AMPUL 2,037 13,800 28,110,600 13,800 28,110,600
OBB-P1704-453895
SIANOKOBALAMIN (VITAMIN B12) INJ 500
71 mcg AMPUL 1,157 25,000 28,925,000 25,000 28,925,000
72 KARBOGLISERIN TETES TELINGA 10 % BOTTLE 2,500 30 75,000 30 75,000
TOTAL 73,835,600 73,835,600
TOTAL BELANJA TRIWULAN 3 886,643,525

880,718,525
ALLOPURINOL TABLET 93 150,000 13,950,000 150,000 13,950,000
BEDAK SALISIL KOTA 1,046 9,410 9,842,860 9,410 9,842,860

OBT- P1703 428277
COTRIMOKSASOL SUSPENSI BOTTLE 2,183 18,000 39,294,000 18,000 39,294,000

OBT- P1703 428277
COTRIMOKSASOL TABLET TABLET 154 300,000 46,200,000 300,000 46,200,000
TOTAL 109,286,860 109,286,860
97 IBUPROFEN TABLET 200 MG TABLET OBT-P1703-428336 108 147,000 15,876,000 147,000 15,876,000
98 CTM TABLET OBT-P1703-428336 43 1,250,000 53,750,000 1,250,000 53,750,000
SIFROFLOKSASIN 500 MG TABLET 289 125,000 125,000

99 OBT-P1703-428336 36,125,000 36,125,000
TETRASIKLIN 500 MG TABLET 319 32,300 32,300

100 OBT-P1703-428336 10,303,700 10,303,700
THIAMIN ( B1 ) TABLET TABLET 89 250,000 250,000

101 OBT-P1703-428336 22,250,000 22,250,000
TOTAL
138,304,700 138,304,700
196,400
82 IBUPROFEN TABLET 400 MG TABLET OBB-P1704-453911 112 196,400 21,996,800 21,996,800
OBB-P1708-626260
SIMVASTATIN TABLET 10 MG TABLET 113 100,050 11,305,650 100,050 11,305,650
MGSO4 MAGNESIUM SULFAT INJEKSI 40% AMPUL 3,650 960 3,504,000 960 3,504,000
OBB-P1704-453903
WI AIR UNTUK INJEKSI 25 ML AMPUL 2,750 120 330,000 120 330,000

SETRIZIN SIRUP 5 MG/5ML BOTTLE OBB-P1708-626290 3,200 2,000 6,400,000 2,000 6,400,000
PRIMAKUIN TABLET 15 MG TABLET OBB-P1704-453937 235 16,500 3,877,500 8,600 2,021,000
OBT-P1703-428319
8 AMLODIPIN TABLET/KAPSUL/KAPLET 5 MG TABLET 105 112,500 11,812,500 15,000 1,575,000
OBB-P1704-453889
LOPERAMID TABLET 2 MG TABLET OBB-P1704-453921 82 20,000 1,640,000 20,000 1,640,000
GENTAMISIN INJ. 40 MG/ML AMPUL OBT-P1703-428288 3,237 20 64,740 20 64,740
OBB-P1704-453894
ONDANSENTRON TABLET 4 MG TABLET 478 6,504 3,108,912 6,504 3,108,912
53 PROPANOLOL TABLET 40 MG TABLET 78 3,200 249,600 3,200 249,600

OBB-P1704-453935
54 PREDNISON TABLET 5 MG TABLET 82 250,000 20,500,000 250,000 20,500,000
LIDOKAIN INJ 2 % AMPUL OBB-P1708-626230 1,169 6,000 7,014,000 6,000 7,014,000
LORATADIN TABLET/KAPSUL/KAPLET 10
MG KAPLET OBB-P1708-626293 128 100,000 12,800,000 100,000 12,800,000

334,081,262
TOTAL YANG SUDAH TERBAYAR SAMPAI TW 4 2,087,018,767
TOTAL DANA DAK 2017 3,100,000,000 1,012,981,233

OBAT-OBATAN
GGARAN 2017
NAMA JADWAL
NAMA PENYEDIA TANGGAL SP2D KETERANGAN (NO. SP2D)
DISTRIBUTOR KEDATANGAN
7-4-2017;12-4-
2017
PT. WIDATRA BHAKTI PT. KIMIA FARMA 5/15/2017 (05140/1.02.01.01/2017)
7-4-2017;12-4-
2017;26-4-
2017;27-4-2017
APOTEK
APTOEK ANUGERAH 5/3/2017
ANUGERAH
04425/1.02.01.01/2017
PT. ANUGERAH
PT. ETHICA INDUSTRI PHARMINDO ### ### 07119/1.02.01.01/2017
FARMASI LESTARI DENPASAR
2-5-20017
PT. ANUGERAH
PT. ASTRAZENECA PHARMINDO ### 07120/1.02.01.01/2017
INDONESIA LESTARI DENPASAR
NAMA JADWAL
PT. ANUGERAH
INDONESIA LESTARI DENPASAR 5/2/2017
PT. PHAPROS Tbk PT. RAJAWALI 6/15/2017 07174/4/1.02.01.01/2017

NUSINDO 5/12/2017
PT. NATURA PT. DOS NI ROHA 6/15/2017 07175/1/02.01.01/2017
LABORATORIA PRIMA
###
PT. AAM DENPASAR 6/15/2017 07176/1.02.01.01/2017

PT. ACTAVIS INDONESIA 15 Mei 2017
GGARAN 2017
PT. RAJAWALI 07945/1.02.01.01/2017
NUSINDO
PT. PHAPROS TBK 17 Mei 2017 6/22/2017
PT. BIO FARMA PT. RAJAWALI

NUSINDO 5/26/2017 7/5/2017 08339/1.02.01.01/2017
PT. DOS NI ROHA PT. DOS NI ROHA 22-5-217 7/5/2017 08338/1.02.01.01/2017

PT. DOSPENYEDIA
NI ROHA NAMA
PT. DOS NI ROHA JADWAL
22-5-217 7/5/2017 08338/1.02.01.01/2017
NAMA TANGGAL SP2D KETERANGAN (NO. SP2D)
PT. MEIJI INDONESIA PT. MILLENIUM

PHARMACON
INTERNATIONAL 5/19/2017 7/12/2017 08813/1.02.01.01/2017
PT. PHARMA PT. MENSA BINA 08814/1.02.01.01/2017

LABORATORIES SUKSES DENPASAR
### 7/12/2017
PT. BINA SAN 08815/1.02.01.01/2017

PRIMA
PT. SANBE FARMA 18 Mei 2017 7/12/2017
PT. ANUGERAH
PT. SOHO INDUSTRI PHARMINDO 08816/1.02.01.01/2017
PHARMASI LESTARI ### 7/12/2017
PT. DEXA MEDICA PT. ANUGRAH 26 Mei 2017 7/12/2017 08817/1.02.01.01/2017

ARGON MEDICA
PT. AAM DENPASAR 08818/1.02.01.01/2017

PT. ACTAVIS INDONESIA ### 7/12/2017
PT. SAPTA SARI

PT. NOVAPHARIN ### 7/31/2017 09868/1.02.01.01/2017
TAMA
NAMA JADWAL
DISTRIBUTOR
PT. SAPTA SARI KEDATANGAN
PT. NOVAPHARIN ### 7/31/2017 09868/1.02.01.01/2017
TAMA
PT. TRI SAPTA JAYA

PT. INTERBAT CABANG KOTA 09871/1.02.01.01/2017
BIMA ### 7/31/2017
PT. SAPTA SARI

PT. ERELA ### 7/31/2017 09872/1.02.01.01/2017
TAMA
PT. WIDATRA BHAKTI PT. INDOFARMA ### 7/31/2017 09873/1.02.01.01/2017
###
PT. RAJAWALI
7/31/2017 09876/1.02.01.01/2017
NAMA JADWAL
4/27/2017
PT. RAJAWALI
4/27/2017
7/31/2017 09876/1.02.01.01/2017
7/5/2017
4/20/2017
PT RIDHO ILAHI
PT JAYAMAS MEDIKA 24 Mei 2017
FARMA
PT RIDHO ILAHI
PT JAYAMAS MEDIKA 24 Mei 2017 8/1/2017 10042/1.02.01.01/2017
FARMA
PT.RIDHO ILAHI
PT.JAYAMAS MEDIKA 24 Mei 2017
FARMA
PT.RIDHO ILAHI
PT.JAYAMAS MEDIKA 24 Mei 2017 8/16/2017 11332/1.02.01.01/2017
FARMA
PT.RIDHO ILAHI
FARMA
NAMA JADWAL
PT.TROPICA MAS 12262/1.02.01.01/2017

PHARMACEUTICALS
PT. INDOFARMA 6/16/2017 9/5/2017
PT. RAJAWALI
12 Mei 2017 9/5/2017 12266/1.02.01.01/2017
5/12/2017
PT. KIMIA FARMA PT. KIMIA FARMA
9/5/2017 123042/1.02.01.01/2017
5/12/2017
PT. ANUGRAH 9/5/2017 12319/1.02.01.01/2017

ARGON MEDICA
PT. DEXA MEDICA 15 Mei 2017
12 Mei 2017
PT. ANUGRAH 19 Mei 2017

PT. DEXA MEDICA 9/5/2017 12320/1.02.01.01/2017
ARGON MEDICA
12 Mei 2017
NAMA JADWAL
PT. BUFA ANEKA PT. INDOFARMA

9/5/2017 12344/1.02.01.01/2017
APTOEK ANUGERAH APTOEK ANUGERAH 9/5/2017 12357/1.02.01.01/2017
PT. RAJAWALI
PT. PHAPROS Tbk 9/5/2017
NUSINDO
8/2/2017 12359/1.02.01.01/2017
PT. PROMEDRAHARDJO PT. KIMIA FARMA 06 Mei 2017

FARMASI
9/5/2017 12360/1.02.01.01/2017
28/7/2017
28/7/2017
28/7/2017
28/7/2017
PT.BINTANG
PT.BINTANG SAUDARA SAUDARA 9/5/2017 12361/1.02.01.01/2017
SEMESTA JAYA SEMESTA JAYA
28/7/2017
28/7/2017
PT.BINTANG
PT.BINTANG SAUDARA
SAUDARA 9/5/2017 12361/1.02.01.01/2017
SEMESTA JAYA SEMESTA JAYA
NAMA JADWAL
28/7/2017
28/7/2017
6/6/2017
PT.RAJAWALI
PT.PHAPROS TBK 9/5/2017 12362/1.02.01.01/2017
NUSINDO
PT. SAMPHARINDO PT. INDOFARMA 12363/1.02.01.01/2017

PERDANA
9/5/2017
PT. RAJAWALI 12364/1.02.01.01/2017
NUSINDO
PT.DEXA MEDIKA PT.AAM 13/09/17 12865/1.02.01.01/2017
###
PT. KIMIA FARMA PT. KIMIA FARMA 9/13/2017 12866/1.02.01.01/2017

PT. KIMIA FARMA NAMA
PT. KIMIA FARMA JADWAL 9/13/2017 12866/1.02.01.01/2017
PT. SOHO INDUSTRI PT. PARIT PADANG 12941/1.02.01.01/2017

PHARMASI
### 9/13/2017
PT. LUCAS DJAJA PT. INDOFARMA 12942/1.02.01.01/2017
GGARAN 2017
16 juni 2017
PT. RAMA Emeral PT. INDOFARMA 10/2/2017 14133/1.02.01.01/2017

PT. RAMA Emeral NAMA
PT. INDOFARMA JADWAL 10/2/2017 14133/1.02.01.01/2017
PT.NOVAPHARIN PT INDOFARMA 14135/1.02.01.01/2017
PT. MERSIFARMA PT. MERAPI UTAMA SPD-748/BL/1.02.1.1/TW

TIRMAKU MERCUSANA PHARMA IV/2017
11/17/2017
PT. OTSUKA INDONESIA PT. MERAPI UTAMA SPD-748/BL/1.02.1.1/TW

### 11/17/2017
PHARMA IV/2017
NAMA JADWAL
PT. SAPTA SARI 11/17/2017 SPD-748/BL/1.02.1.1/TW

TAMA IV/2017
PT. ERELA ###
PT. RAJAWALI 10/27/2017 SPD-748/BL/1.02.1.1/TW
NUSINDO IV/2017
PT. PHAPROS Tbk
PT. PROMEDRAHARDJO PT. KIMIA FARMA SPD-748/BL/1.02.1.1/TW
06 Mei 2017 10/27/2017
FARMASI IV/2017
PT. MERSIFARMA SPD-748/BL/1.02.1.1/TW

PT. INDOFARMA 10/27/2017
TIRMAKU MERCUSAN IV/2017
09/11/17
PT. IFARS SPD-748/BL/1.02.1.1/TW
PHAMACEUTICAL PT. INDOFARMA 10/27/2017 IV/2017
LABORATORIES
SPD-748/BL/1.02.1.1/TW
PT. INDOFARMA GLOBAL PT. INDOFARMA 10/27/2017 IV/2017
MEDICA
PT. INDOFARMA SPD-748/BL/1.02.1.1/TW
PT. INDOFARMA Tbk 10/27/2017
GLOBAL MEDIKA IV/2017
11/10/2017
SPD-748/BL/1.02.1.1/TW
10/27/2017 IV/2017
PT. SAPTA SARI
PT. HOLI PHARMA TAMA
SPD-748/BL/1.02.1.1/TW
10/27/2017 IV/2017
PT. TRI SAPTA JAYA
CABANG KOTA
PT. BERNOFARM BIMA 10 Oktober 2017
PT. TRI SAPTA JAYA
CABANG KOTA
PT. BERNOFARM BIMA 10-101-17

ONGKIR FURCHASING (Rp) RIIL
1 LARUTAN EDTA BTL 55,000.00 25 1,375,000.00 25 1,375,000.00
2 LARUTAN GIEMSA BTL 210,000.00 25 5,250,000.00 25 5,250,000.00
3 BTL 20,000.00 25 500,000.00 25
LARUTAN AS ACETAT 6% 500,000.00 PT.RIDHO ILAHI
4 LARUTAN REES ECKER BTL 50,000.00 25 1,250,000.00 25 1,250,000.00 FARMA
6 LARUTAN HAYEM BTL 25,000.00 25 625,000.00 25 625,000.00
6 LARUTAN BENEDICT BTL 70,000.00 25 1,750,000.00 25 1,750,000.00
7 LARUTAN EOSIN BTL 175,000.00 25 4,375,000.00 25 4,375,000.00
TOTAL 15,125,000.00 15,125,000.00
1 LARUTAN TURK@100 BTL 24,500.00 25 612,500.00 25

ML 612,500.00
2 LARUTAN BACL2 BTL 58,000.00 25 1,450,000.00 25
10%@100 ML 1,450,000.00
3 LARUTAN AS AMONIUM BTL 30,000.00 25 750,000.00 25 PT.SYAHID HUSADA

OKSALAT 1%@100 ML 750,000.00 MEDIKA
LARUTAN OIL IMERSI @
4 BTL 418,000.00 25 10,450,000.00 25
50 ML 10,450,000.00
6 CHLORIN TABLET@5' BTL 420,000.00 25 10,500,000.00 25 10,500,000.00
JUMLAH 23,762,500.00 23,762,500.00
PPN 10% 2,376,250.00 2,376,250.00
TOTAL 26,138,750.00 26,138,750.00
AWA

24-5-17
24-5-17
24-5-17
PT.RIDHO ILAHI 12322/1.02.01.01/2017
24-5-17 9/5/2017
10/07/17
10/07/2017
10/07/2017
7/31/2017
7/31/2017
PT.SYAHID 7/31/2017
HUSADA MEDIKA 8/15/2017 11231/1.02.01.01/2017
7/31/2017
7/31/2017
8/15/2017 11231/1.02.01.01/2017
1
NaCl 0,9 % BOTTLE 6,410 22,000 141,020,000 22,000 141,020,000
OBT-P1703-420659
TOTAL 755,920,000 755,920,000

OBT-P1703-42867
TOTAL TOTAL 31,048,480 TOTAL 31,048,480

TOTAL 27,190,500 27,190,500
TOTAL BELANJA TRIWULAN 2 872,218,980 872,218,980


TOTAL 19,535,000 19,535,000

19 1500 MG VIAL OBT-P1705-475300 41,200 600 24,720,000 600 24,720,000
21 12,5 G/250 ML) SOFTBAG OBB-P1704-453905 11,400 1,225 13,965,000 1,225 13,965,000

22 ML) AMPUL OBB-P1704-453920 1,254 1,500 1,881,000 1,500 1,881,000

OBB-P1704-453924
TOTAL 7,077,000 7,077,000

25 MG/2,5 ML TUBE OBT-P1703-428370 12,155 600 7,293,000 600 7,293,000
OBB-P1704-453912
OBB-P1704-453912 VOLUME E JUMLAH HARGA VOLUME RIIL JUMLAH HARGA
TOTAL 15,845,825 15,845,825

31 SALEP MATA 0,3 % TUBE 3,110 100 311,000 100 311,000
OBB-P1704-453899

33 0,5 % BOTTLE 18,775 25 469,375 25 469,375
TOTAL 3,674,375 3,674,375

OBT-P1703-420655
35 NaCl 0,9 % BOTTLE 6,410 4,000 25,640,000 4,000 25,640,000
TOTAL 75,690,000 75,690,000
TOTAL 62,563,500 62,563,500

41 AKS-P1705-496022 14,960 600 10,322,400 600 10,322,400
HCL 0,1 N BOTTLE 50

42 AKS-P1705-496022 10,560 607,200 50 607,200
TOTAL 10,929,600 10,929,600

2,553,000 2,553,000

10,350,000 10,350,000

416,875 416,875
TOTAL 13,319,875 13,319,875

TABLET
94 TABLET OBT-P1703-428376 164 50,000 8,200,000 50,000 8,200,000

OBB-P1704-453916
TOTAL 26,200,000 26,200,000

MG TABLET 109 207,500 22,617,500 207,500 22,617,500
OBT-P1703-428284
TOTAL 24,087,500 24,087,500
OBT-P1703-428296
8,885,400 8,885,400

52 KULIT 2% TUBE OBB-P1704-453940 3,140 3,000 9,420,000 3,000 9,420,000
TOTAL 25,954,000 25,954,000

51 MG/ML AMPUL OBB-P1704-453942 4,167 6,450 26,877,150 6,450 26,877,150
OBT-P1703-428319
TOTAL 1,172,900 1,146,900


OBB-P1704-453908
48 200.000 UI KAPSUL 531 33,500 17,788,500 33,500 17,788,500
TOTAL 23,913,500 23,913,500

56 MG,ML AMPUL OBB-P1704-453925 97,500 150 14,625,000 150 14,625,000

69 (HCl) AMPUL 1,115 15,000 16,725,000 15,000 16,725,000

70 1:80.000 - 2 ML AMPUL 2,037 13,800 28,110,600 13,800 28,110,600
OBB-P1704-453895
71 mcg AMPUL 1,157 25,000 28,925,000 25,000 28,925,000
TOTAL 73,835,600 73,835,600
TOTAL BELANJA TRIWULAN 3 #REF!

856,470,125
OBT- P1703 428277


OBT- P1703 428277
TOTAL 109,286,860 109,286,860
98 CTM TABLET OBT-P1703-428336 43 1,250,000 53,750,000 1,250,000 53,750,000

99 OBT-P1703-428336 36,125,000 36,125,000

100 OBT-P1703-428336 10,303,700 10,303,700

101 OBT-P1703-428336 22,250,000 22,250,000
TOTAL
138,304,700 138,304,700
196,400
OBB-P1708-626260
OBB-P1704-453903
OBT-P1703-428319
OBB-P1704-453889
OBB-P1704-453894

OBB-P1704-453935

MG KAPLET OBB-P1708-626293 128 100,000 12,800,000 100,000 12,800,000

346,881,262
TOTAL DANA DAK 2017 3,100,000,000 1,024,429,633

OBAT-OBATAN
GGARAN 2017
NAMA JADWAL
7-4-2017;12-4-
2017
7-4-2017;12-4-
2017;26-4-
2017;27-4-2017
APOTEK
ANUGERAH
04425/1.02.01.01/2017
PT. ANUGERAH
2-5-20017
PT. ANUGERAH
NAMA JADWAL
PT. ANUGERAH
INDONESIA LESTARI DENPASAR 5/2/2017

NUSINDO 5/12/2017
LABORATORIA PRIMA
###
PT. AAM DENPASAR 6/15/2017 07176/1.02.01.01/2017

GGARAN 2017
PT. RAJAWALI 07945/1.02.01.01/2017
NUSINDO

NUSINDO 5/26/2017 7/5/2017 08339/1.02.01.01/2017

PT. DOSPENYEDIA
NI ROHA NAMA
PT. DOS NI ROHA JADWAL
22-5-217 7/5/2017 08338/1.02.01.01/2017
NAMA TANGGAL SP2D KETERANGAN (NO. SP2D)

PHARMACON
INTERNATIONAL 5/19/2017 7/12/2017 08813/1.02.01.01/2017

### 7/12/2017
PT. BINA SAN 08815/1.02.01.01/2017

PRIMA
PT. ANUGERAH
PT. DEXA MEDICA PT. ANUGRAH 26 Mei 2017 7/12/2017 08817/1.02.01.01/2017

ARGON MEDICA
PT. AAM DENPASAR 08818/1.02.01.01/2017

PT. SAPTA SARI

PT. NOVAPHARIN ### 7/31/2017 09868/1.02.01.01/2017
TAMA
NAMA JADWAL
DISTRIBUTOR
PT. NOVAPHARIN ### 7/31/2017 09868/1.02.01.01/2017
TAMA
PT. TRI SAPTA JAYA

BIMA ### 7/31/2017
PT. SAPTA SARI

PT. ERELA ### 7/31/2017 09872/1.02.01.01/2017
TAMA
###
PT. RAJAWALI
7/31/2017 09876/1.02.01.01/2017
NAMA JADWAL
4/27/2017
PT. RAJAWALI
4/27/2017
7/31/2017 09876/1.02.01.01/2017
7/5/2017
4/20/2017
PT RIDHO ILAHI
FARMA
PT RIDHO ILAHI
PT JAYAMAS MEDIKA 24 Mei 2017 8/1/2017 10042/1.02.01.01/2017
FARMA
PT.RIDHO ILAHI
FARMA
PT.RIDHO ILAHI
FARMA
PT.RIDHO ILAHI
FARMA
NAMA JADWAL
PT.TROPICA MAS 12262/1.02.01.01/2017

PHARMACEUTICALS
PT. INDOFARMA 6/16/2017 9/5/2017
PT. RAJAWALI
12 Mei 2017 9/5/2017 12266/1.02.01.01/2017
5/12/2017
PT. KIMIA FARMA PT. KIMIA FARMA
9/5/2017 123042/1.02.01.01/2017
5/12/2017
PT. ANUGRAH 9/5/2017 12319/1.02.01.01/2017

ARGON MEDICA
12 Mei 2017
PT. ANUGRAH 19 Mei 2017

PT. DEXA MEDICA 9/5/2017 12320/1.02.01.01/2017
ARGON MEDICA
12 Mei 2017
NAMA JADWAL

9/5/2017 12344/1.02.01.01/2017
PT. RAJAWALI
NUSINDO
8/2/2017 12359/1.02.01.01/2017

FARMASI
9/5/2017 12360/1.02.01.01/2017
6/6/2017
PT.RAJAWALI
PT.PHAPROS TBK 9/5/2017 12362/1.02.01.01/2017
NUSINDO

PERDANA
9/5/2017
PT. RAJAWALI 12364/1.02.01.01/2017
NUSINDO

NAMA JADWAL
###

PHARMASI
### 9/13/2017
GGARAN 2017
16 juni 2017

NAMA JADWAL

11/17/2017
NAMA JADWAL

### 11/17/2017
PHARMA IV/2017

TAMA IV/2017
PT. ERELA ###
NUSINDO IV/2017
PT. PHAPROS Tbk
06 Mei 2017 10/27/2017
FARMASI IV/2017

09/11/17
LABORATORIES
SPD-748/BL/1.02.1.1/TW
MEDICA
11/10/2017
SPD-748/BL/1.02.1.1/TW
10/27/2017 IV/2017
PT. SAPTA SARI
SPD-748/BL/1.02.1.1/TW
10/27/2017 IV/2017
PT. TRI SAPTA JAYA
CABANG KOTA
NAMA JADWAL
PT. TRI SAPTA JAYA
CABANG KOTA
1
NaCl 0,9 % BOTTLE 6,410 22,000 141,020,000 22,000 141,020,000
OBT-P1703-420659

OBT-P1703-42867

TOTAL BELANJA TRIWULAN 2 #REF! 872,218,980



19 1500 MG VIAL OBT-P1705-475300 41,200 600 24,720,000 600 24,720,000
21 12,5 G/250 ML) SOFTBAG OBB-P1704-453905 11,400 1,225 13,965,000 1,225 13,965,000

22 ML) AMPUL OBB-P1704-453920 1,254 1,500 1,881,000 1,500 1,881,000

OBB-P1704-453924

25 MG/2,5 ML TUBE OBT-P1703-428370 12,155 600 7,293,000 600 7,293,000
OBB-P1704-453912

31 SALEP MATA 0,3 % TUBE 3,110 100 311,000 100 311,000
OBB-P1704-453899
OBB-P1704-453899

33 0,5 % BOTTLE 18,775 25 469,375 25 469,375

OBT-P1703-420655
35 NaCl 0,9 % BOTTLE 6,410 4,000 25,640,000 4,000 25,640,000

41 AKS-P1705-496022 14,960 600 10,322,400 600 10,322,400
HCL 0,1 N BOTTLE 50

42 AKS-P1705-496022 10,560 607,200 50 607,200

2,553,000 2,553,000

10,350,000 10,350,000

416,875 416,875
TABLET
94 TABLET OBT-P1703-428376 164 50,000 8,200,000 50,000 8,200,000

OBB-P1704-453916

MG TABLET 109 207,500 22,617,500 207,500 22,617,500
OBT-P1703-428284
OBT-P1703-428296

52 KULIT 2% TUBE OBB-P1704-453940 3,140 3,000 9,420,000 3,000 9,420,000

51 MG/ML AMPUL OBB-P1704-453942 4,167 6,450 26,877,150 6,450 26,877,150
OBT-P1703-428319


OBB-P1704-453908
48 200.000 UI KAPSUL 531 33,500 17,788,500 33,500 17,788,500

56 MG,ML AMPUL OBB-P1704-453925 97,500 150 14,625,000 150 14,625,000

69 (HCl) AMPUL 1,115 15,000 16,725,000 15,000 16,725,000

70 1:80.000 - 2 ML AMPUL 2,037 13,800 28,110,600 13,800 28,110,600
OBB-P1704-453895
71 mcg AMPUL 1,157 25,000 28,925,000 25,000 28,925,000

856,470,125

OBT- P1703 428277
98 CTM TABLET OBT-P1703-428336 43 1,250,000 53,750,000 1,250,000 53,750,000


99 OBT-P1703-428336 36,125,000 36,125,000

100 OBT-P1703-428336 10,303,700 10,303,700

101 OBT-P1703-428336 22,250,000 22,250,000
196,400
OBB-P1708-626260
OBB-P1704-453903
OBT-P1703-428319
OBB-P1704-453889

OBB-P1704-453894

OBB-P1704-453935
MG KAPLET OBB-P1708-626293 128 100,000 12,800,000 100,000 12,800,000

346,881,262
TOTAL DANA DAK 2017 3,100,000,000 1,024,429,633

OBAT-OBATAN
GGARAN 2017
NAMA JADWAL
7-4-2017;12-4-
2017
7-4-2017;12-4-
2017;26-4-
2017;27-4-2017
APOTEK
ANUGERAH
04425/1.02.01.01/2017
PT. ANUGERAH
PT. ANUGERAH 2-5-20017

5/2/2017

NUSINDO 5/12/2017
NAMA JADWAL

LABORATORIA PRIMA
###
PT. AAM DENPASAR 6/15/2017 07176/1.02.01.01/2017

GGARAN 2017
PT. RAJAWALI 07945/1.02.01.01/2017
NUSINDO

NUSINDO 5/26/2017 7/5/2017 08339/1.02.01.01/2017

PHARMACON
INTERNATIONAL 5/19/2017 7/12/2017 08813/1.02.01.01/2017
NAMA JADWAL

### 7/12/2017
PT. BINA SAN 08815/1.02.01.01/2017

PRIMA
PT. ANUGERAH
PT. ANUGRAH
PT. DEXA MEDICA 26 Mei 2017 7/12/2017 08817/1.02.01.01/2017
ARGON MEDICA
PT. AAM DENPASAR 08818/1.02.01.01/2017

PT. SAPTA SARI

PT. NOVAPHARIN ### 7/31/2017 09868/1.02.01.01/2017
TAMA
PT. TRI SAPTA JAYA

BIMA ### 7/31/2017
PT. SAPTA SARI

PT. ERELA ### 7/31/2017 09872/1.02.01.01/2017
TAMA
NAMA JADWAL
DISTRIBUTOR
PT. ERELA ### 7/31/2017 09872/1.02.01.01/2017
TAMA
###
4/27/2017
PT. RAJAWALI
PT. PHAPROS Tbk 7/31/2017 09876/1.02.01.01/2017
NUSINDO
4/27/2017
7/5/2017
4/20/2017
PT RIDHO ILAHI
FARMA
8/1/2017 10042/1.02.01.01/2017
PT RIDHO ILAHI
FARMA
PT.RIDHO ILAHI
FARMA
8/16/2017 11332/1.02.01.01/2017
NAMA JADWAL
PT.RIDHO ILAHI
FARMA
PT.RIDHO ILAHI
FARMA
PT.TROPICA MAS 12262/1.02.01.01/2017

PHARMACEUTICALS
PT. INDOFARMA 6/16/2017 9/5/2017
PT. RAJAWALI
12 Mei 2017 9/5/2017 12266/1.02.01.01/2017
5/12/2017
5/12/2017
PT. ANUGRAH 9/5/2017 12319/1.02.01.01/2017
ARGON MEDICA
12 Mei 2017
PT. ANUGRAH
PT. DEXA MEDICA 9/5/2017 12320/1.02.01.01/2017
ARGON MEDICA
19 Mei 2017
12 Mei 2017

9/5/2017 12344/1.02.01.01/2017
NAMA JADWAL
PT. RAJAWALI
NUSINDO
8/2/2017 12359/1.02.01.01/2017

FARMASI
9/5/2017 12360/1.02.01.01/2017
PT.RAJAWALI 6/6/2017
PT.PHAPROS TBK 9/5/2017 12362/1.02.01.01/2017
NUSINDO

PERDANA
9/5/2017
PT. RAJAWALI 12364/1.02.01.01/2017
NUSINDO
###

PHARMASI
### 9/13/2017
NAMA JADWAL
GGARAN 2017
16 juni 2017

NAMA JADWAL

11/17/2017

### 11/17/2017
PHARMA IV/2017

TAMA IV/2017
PT. ERELA ###
NUSINDO IV/2017
PT. PHAPROS Tbk
06 Mei 2017 10/27/2017
FARMASI IV/2017

09/11/17
LABORATORIES
NAMA JADWAL
SPD-748/BL/1.02.1.1/TW
MEDICA
11/10/2017
SPD-748/BL/1.02.1.1/TW
10/27/2017 IV/2017
PT. SAPTA SARI
SPD-748/BL/1.02.1.1/TW
10/27/2017 IV/2017
PT. TRI SAPTA JAYA
CABANG KOTA
PT. TRI SAPTA JAYA
CABANG KOTA

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PEMERINTAH KABUPATEN SUMBAWA

UPT. INSTALASI FARMASI KABUPATEN SUMBAWA

Obat e katalog yang belum datang per sept 2017

VOLUME E ONGKIR VOLUME RIIL JUMLAH HARGA

DULCOLAX SUPP ADULT 10MG BISAKODIL

3 METFORMIN HCl TABLET 500 MG TABLET 115 87,000 10,005,000 -

5 ASAM TRANEKSAMAT INJEKSI 100 MG/ML AMPUL 2,535 200 507,000 -

6 KLORAMFENIKOL SALEP MATA 1 % TUBE 1,800 2,700 4,860,000 -

8 KETOKONAZOL KRIM 2 % TUBE 2,605 4,000 10,420,000 930 2,422,650

9 PARASETAMOL TABLET 500 MG TABLET 57 2,975,000 169,575,000

10 ASAM MEFENAMAT TABLET 500 MG TABLET 112 217,500 24,360,000

ANTI BAKTERI DOEN SALEP KOMBINASI : OBB-P1704-453894

12 METILPREDNISOLON TABLET 8 MG TABLET OBB-P1704-453909 305 50,000 15,250,000

13 MGSO4 MAGNESIUM SULFAT INJEKSI 40% AMPUL 3,650 960 3,504,000

14 WI AIR UNTUK INJEKSI 25 ML AMPUL 2,750 120 330,000

15 DIGOKSIN TABLET 0,25 MG TABLET OBB-P1704-453896 107 8,000 856,000

16 SALBUTAMOL TAB. 2 MG TABLET OBB-P1704-453931 78 73,500 5,733,000

17 PRIMAKUIN TABLET 15 MG TABLET OBB-P1704-453937 235 16,500 3,877,500 8,600 2,021,000

18 DIAZEPAM TABLET 5 MG TABLET 105 45,000 4,725,000

21 KLORPROMAZIN TAB SALUT 100 MG (HCl) TABLET 148 11,000 1,628,000

22 FENOBARBITAL INJEKSI i.m/i.v 50 MG/ML AMPUL OBT-P11704-453926 1,740 500 870,000

DECACETIN TETES MATA 0,5% KLORAMFENIKOL

TOTAL E KATALOG YANG BELUM PURCHASING 339,438,483 2,565,560,917

PT. DEXA MEDICA PT. AAM DENPASAR

PT. INDOFARMA PT. INDOFARMA

PT. TRI SAPTA JAYA

PT. OTSUKA PT. MERAPI UTAMA

PT. YARINDO PT. PENTA VALENT

PT. PHAPROS Tbk PT. RAJAWALI

INDAH KOMALASARI, S. FARM.,APT

PEMBAYARAN DI TRIWULAN 3 TAHUN ANGGARAN 2017

VOL JUMLAH HARGA TOTAL HARGA

1 IV CATETER 18 PCS 8,355.00 24,750.00 250 2,113,500 250 2,113,500

2 IV CATETER 22 PCS 8,355.00 24,750.00 250 2,113,500 250 2,113,500

4 IV CATETER 20 PCS 8,355.00 49,500.00 500 4,227,000 500 4,227,000

6 IV CATETER WING 22 PCS 14,575.00 41,250.00 250 3,685,000 250 3,685,000

7 IV CATETER WING 24 PCS 15,180.00 41,250.00 250 3,836,250 250 3,836,250

8 IV CATETER WING 20 PCS 14,575.00 41,250.00 250 3,685,000 250 3,685,000

3 42000000-AKS- FIXOMULL 76992 10 CM ROLL 70,903.00 100 7,090,300.00 100 7,090,300.00

TOTAL 41,592,000 41,592,000

PEMBAYARAN DI TRIWULAN 4 TAHUN ANGGARAN 2017

VOL JUMLAH HARGA TOTAL HARGA

NAMA JADWAL TANGGAL NO SP2D

PT.MENSA BINA 8 JUNI 2017

PT.ANUGRAH 24-5-2017 7/10/2017 08669/1.02.01.01/2017

PT.RIDHO ILAHI 24-5-17 8/1/2017 10040/1.02.01.01/2017

PT KIMIA FARMA 9/12/2017 12867/1.02.01.01/2017

PT KIMIA FARMA ### 9/12/2017 12867/1.02.01.01/2017

PT.RIDHO ILAHI ### 8/16/2017 11325/1.02.01.01/2017

PT. ANUGERAH 8/2/2017 9/13/2017 12868/1.02.01.01/2017

NAMA JADWAL TANGGAL NO SP2D

PT.RIDHO ILAHI 8/23/2017 10/4/2017 14134/1.02.01.01/2017

2 RINGER LAKTAT BOTTLE 7,150 86,000 614,900,000 86,000 614,900,000

TOTAL 755,920,000 755,920,000

CALCIUM GLUCONAS 10 KALSIUM

7 OXYTOCIN INJ 10 UI/ML AMPUL 1,900 7,300 13,870,000 7,300 13,870,000

TOTAL TOTAL 31,048,480 TOTAL 31,048,480

8 PULMICORT RESPULES CAN OBT-P1703-428373 9,725 2,000 19,450,000 2,000 19,450,000

TOTAL 27,190,500 27,190,500

10 KAPTOPRIL TABLET 25 MG TABLET OBT-P1703-428368 71 50,000 3,550,000 50,000 3,550,000

TOTAL BELANJA TRIWULAN 2 872,218,980 872,218,980

PEMBAYARAN DI TRIWULAN 3 TAHUN ANGGARAN 2017