Dak Dau Semester 1

LAMPIRAN PERSEDIAAN OBAT DAK/DAU
PUSKESMAS MARUSU KAB MAROS

BULAN JANUARI 2017
STOK
NO NAMA OBAT KEMASAN MASUK KELUAR SISA STOK
AWAL
A. NAMA OBAT
ACT (Artesunate tablet 50 mg + 1
1 1 blister@24 tablet 0 0 1
Amodiaquine anhydrida tablet 200 mg)
2 Adona Injeksi 50 mg Kotak/10 Amp. 0
3 Albendazol tablet 400 mg Kotak/30 0
4 Albothyl Botol 10 ml 0
5 Albothyl Concentrate 5 ml Botol 5 ml 6 0 0 6
6 Allopurinol Tab 100 mg Kotak/100 5 0 5 0
7 Allopurinol Tab 300 mg Kotak/30 0
8 Allopurinol tab. 300 mg Kotak/100 0
9 Ambroksol Tablet Kotak/100 0
10 Ambroxol Syrup Botol/60 ml 0
12 Aminofillin Inj. Kotak/30 0
13 Aminofillin Tab. 200 mg Botol/100 0
14 Amlodipin 5mg Kotak/30 0
Dus, 10 blister @ 10
15 Amoksisilin kapsul/kaplet 250 mg 0
kapsul
Amoksisilin kapsul/kaplet/tablet scored Dus, 10 strip @ 10 108
16 0 27 81
500 mg kaptab
17 Amoksisillin Kapl. 250 mg Kapsul/100 0
18 Amoksisillin Kapl. 500 mg Kotak/100 0
19 Amoksisillin Syr. Kering Botol/60 ml 0
20 Ampicillin Injeksi Kotak/10 0
21 Ampisillin Kapl. 500 mg Kotak/100 0

22 Ampisillin Syrup Kering Botol/60 ml 0
23 Antalgin Tab. 500 mg (Metampiron) Kotak/100 0
24 Antasida DOEN Kotak/100 154 0 15 139
Antasida DOEN I tablet
kunyah,kombinasi: Alumunium Dus 10 Strip @ 10
25 0
Hidroksida 200 mg Magnesium tablet
Hidroksida 200 mg
26 Antasida DOEN Tab. Kotak/100 0
27 Antasida Syr. Botol 0
Anti bakteri Doen salep kombinasi : 3

28 Kotak/25 0 0 3
Basitrasin 100 IU + polimiksin 10.000 IU
Antifungi Doen Kombinasi : Asam 4

29 Kotak/24 Pot 0 1.05 2.95
benzoat 6% + asam salisilat 3%
30 Antihemoroid Doen Kombinasi Kotak/10 Supp. 3 0 0 3
Antihemoroid, kombinasi: bismut

DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 0
GRAM
lidokain 10 mg seng oksida 120 mg
32 Antimigrain Botol/100 7 0 7 0
33 Asam Ascorbat (Vit. C) 50 mg Botol/1000 0
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 0
35 Asam Folat Kaplet 1 mg Botol/100 2 0 0 2
36 Asam mefenamat 500 mg Kotak/100 90 0 0 90
Dus, 10 blister @ 10 50
37 Asam Mefenamat kapsul/kaplet 500 mg 0 20 30
kap
38 Asering Lar. Infus Botol/500 ml 0
STOK
AWAL
39 Asiklovir SK Kotak/25 0
40 Asiklovir Tab. 200 mg Kotak/100 43 0 0 43
41 Atropin Sulfat Inj. Kotak/30 1 0 0 1
42 Betahistin tab. 6 mg Kotak/30 2 0 0 2
43 Betametason Krim Kotak/25 0
44 Betametason Krim Tube/5g 0
45 Bisacodil tab Kotak/200 0
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 0
47 Bromheksin tab. 8 mg kotak/300 0
48 Bromheksin Tab. 8 mg Kotak/100 0
50 Cefadroxil syrup Botol 0
51 Cefotaxime injeksi 1 g kotak/10 0
52 Cefotaxime Injeksi 1 g Kotak/2 Vial 0
53 Cetirizin kotak/100 0
54 Cetirizine Tab. 10 mg Kotak/100 0
55 Cetirizine Tab. 10 mg Kotak/50 3 0 3 0
56 Chlorfeniramine Maleat (CTM) 4 mg 0
57 Chlorfeniramini Maleat (CTM) 4 mg Botol/1000 0
Cyanocobalamin (vitamin B12) injeksi Kotak/100 ampul @ 1
58 0
500 mcg ml
59 Cyanocobalamin Inj. Kotak/100 0.7 0 0 0.7
60 Cyanocobalamin Tab. Botol/1000 0
61 Cyanocobalamin Tablet KOTAK/100 0
62 Cyprofloxacin 500 mg Tab. Kotak/50 34 0 28 6
63 Cyprofloxacin 500 mg Tab. Kotak/100 0
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 5 0 5 0
Cyprofloxacin tablet 500 mg (sebagai Dus, 10 blister @ 10 tab
65 0
HCl) ss
66 Daryantula (Supratula) Box/20 Lmbr 0
67 Daryantull 10 x 10 cm Kotak/10 0
68 Daryantulle Box/10 Pcs 0
69 Deksametason Injeksi Kotak/100 0
70 Dekstran 70 - larutan infus 6% steril Botol 0
71 Dexamethason Tab. 0,5 mg Kotak/100 145 0 43 102
72 Dexamethason Tab. 0,5 mg Kotak/100 0
73 Dextrofen Syrup Botol 60 ml 0
Dextrometorphan Hydrobromide +
74 Dexchlorpheniramine Maleate + Botol/60 ml 0
Phenylephrine Hydrochloride Syrup
75 Dextrometrophan Syr. Botol 0
76 Dextrometrophan Tab. Kotak/100 0
77 Diazepam Injeksi Kotak/30 0.8 0 0 0.8
Diazepam larutan rektal 5 mg/2,5 ml Dus, 5 alubag @1 tube 8
78 0 0 8
(Stesolid) @ 2,5 ml
79 Diazepam Tab. 2 mg Kotak/100 0
80 Diazepam tablet/kapsul/kaplet 2 mg Botol 100 0
81 Difenhidramin Injeksi Kotak/30 1 0 0 1
82 Digoxin Tab. 0,25 mg Kotak/100 0
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 0
84 Domperidon Tab. 10 mg Kotak /100 5 0 1 4
85 Dulcolax Tab 0
86 Efedrin HCl 25 mg Botol/250 0
87 Ekstrak Belladon Botol/1000 0
88 Epinefrin (Adrenalin) Injeksi 0,1% Kotak/30 0
89 Ergotamine cafein Kotak/100 0
90 Eritromicin Kaps. 500 mg Kotak/100 0
91 Eritromicin Syrup Botol/60 ml 0
STOK
AWAL
92 Etakridin larutan 0,1% (Rivanol) Botol/300 ml 0
93 Ethanol Botol/1000 0
95 Eugenol Cairan Botol/10ml 0
96 Famotidine kotak/50 0
97 Fenilbutason Tab 200 mg (Novason) 0
98 Fenilbutason Tab. 200 mg Botol/1000 0
99 Fenilbutason Tab. 200 mg (Novason) Botol/100 0
100 Fenobarbital Inj. Kotak/30 0
101 Fenobarbital Tab. 30 mg Botol/100 0
102 Ferrosi sulfas 300 mg tab botol/1000 0
103 Fitomenadeon Tab. Botol/100 9 0 0 9
Fitomenadion (Vitamin K1) injeksi i.m. 2 1
104 Dus @ 30 ampul 0 0 1
mg/ml
105 Fitomenadion Injeksi Kotak/30 0
106 Fitomenadion Tab. Kotak/100 0

107 Folic Acid Botol/100 0
108 Furosemid Tab. 40 mg Kotak/100 0
109 Furosemid Tab. 40 mg Kotak/100 3 0 0 3
110 Garam oralit kotak/100 0
111 Gentamicin 0,1% Salep Kulit Kotak/25 Tube@5 g 0
112 Gentamicin SK. Kotak/10 0
113 Gentamycin 0,1 % SK Kotak/25 1 0 1 0
114 Gentian Violet Botol/10 ml 0
115 Glibenclamida 0
116 Glibenklamid Tab. 5 mg Kotak/100 0
117 Gliseril Guaiacolas Botol/1000 0
118 Gliseril Guaiacolat 13 0 2 11
119 Gliseryl Guaiacolas Tab. 100 mg Botol/1000 0
120 Glukosa larutan 5 % Botol 500 ml 173 0 0 173
121 Griseofulvin tablet 125 mg, micronized Kotak 0

122 Hidrochlortiazid Tab. 25 mg Botol/1000 0
Dus, 10 strip @ 10
123 Hidroklorotiazid tab 25 mg 0
tablet
124 Hidrokortison krim 2,5 % Tube 0
125 Hidrokortison SK Kotak/24 0
126 Ibuprofen 200 mg Botol/100 0
127 Ibuprofen 400 mg Kotak/100 0
128 Ibuprofen Suspensi 200 mg Botol/60 176 0 85 91
129 Ibuprofen tablet 200 mg Botol @ 100 tablet 12 0 2 10
130 Ichtiol SK Pot 0
131 Ichtiol SK 15 g Kotak/12 Pot 2 0 0 2
132 Ichtiol SK 15 g Kotak/12 Pot 0
133 Induksin Inj Kotak/10amp 0
134 Kalsium Laktat Tab. 500 mg Kotak/100 13 0 13 0
135 Kalsium Laktat Tab. 500 mg Botol/1000 0
136 Kaptopril 12,5 mg Kotak/100 9 0 1 8
137 Kaptopril 25 mg Kotak/100 0
138 Ketokonazole 0
139 Ketokonazole Tab. 200 mg Kotak/50 0
141 Ketorolac Injeksi 10 mg Kotak/5 Amp. 0
STOK
AWAL
143 Kloramfenicol Tetes Mata Kotak 0
144 Kloramfenicol Tetes Telinga 3% Botol 0
145 Kloramfenikol Kaps. 250 mg Kotak/100 0
146 Kloramfenikol salep mata kotak/24 0
147 Kloramfenikol salep mata Tube/5gr 0
148 Kloramfenikol Suspensi Botol/60 ml 0
149 Kloramfenikol Tetes Telinga botol/5ml 0
150 Klorpromazin HCl inj. 25mg/ml - 1 ml Kotak/Amp 0
151 Klorpromazin HCl inj. 5mg/ml - 2 ml Kotak/ 30 Amp 0
152 Klorpromazin HCl tab 100 mg kotak/100 0
153 Klorpromazin HCl tablet salut 100 mg Botol 0
155 Kotrimoksasol Tab. 120 mg Kotak/100 0
156 Kotrimoksazol 120 mg Kotak/100 0
157 Kotrimoksazol 480 Kotak/100 0
158 Kotrimoksazol Syr. Botol/60 0
159 Kuinin Dihidroklorida inj.25% - 2 ml Kotak/Amp. 0
160 Kuinin Sulfat tablet 222 mg (7H2O) Kotak 0
161 Lacto B Sachet Kotak/4x10 0
163 Lansoprasol 30 mg Kotak/ 30 0
164 Lansoprasole 30 mg Kotak/20 0
165 Larutan Ringer Laktat botol/100ml 0
166 Levertran Salep Pot 0
167 Levertran Salep Kulit Kotak/12 Pot 0
168 Lidocain inj kotak/100 2 0 0 2
169 Lidocain Injeksi Kotak/30 0
Lidokain injeksi 2% (HCl) + Epinefrin 1 :
170 Dus, 30 ampul @ 2 ml 0
80.000 - 2 ml
171 Lisol Botol/1000 0
172 Lisol Botol 800 ml 0
173 Loperamide Kotak/100 0
174 Loperamide Kotak/100 2 0 1 1
175 Lorazepam 2 mg Kotak/100 1.8 0 0 1.8
176 Malaria PF/PV casset Kotak 25 0
177 Meloksikam 7,5 mg Kotak/20 0
179 Meloksikam 7,5 mg Kotak/30 19 0 4 15
180 Meloxicam 7,5mg Kotak/30 0
181 Metamphyron (Antalgin) Tab. 500 mg Kotak/100 0
182 Metformin HCl tab 500 mg Kotak/100 0
183 Methylergometrin inj kotak/100 0
184 Methylprednisolon 4 mg Kotak/100 0

186 Metilergometrin Injeksi Kotak/30 0
Metilergometrin Maleat injeksi 0,200 mg- Kotak/100 Ampul @ 1
187 0
1 ml ml
188 Metilergometrin Tab 0,125 mg 0
189 Metilergometrin Tab. 0,125 mg Kotak/100 0
190 Metilergometrin Tab. 0,125 mg Kotak /100 0
191 Metoclorpramide injeksi kotak/5 0
192 Metokloperamid Injeksi Kotak/10 Amp @ 2 ml 0
193 Metokloperamid Tab. 5 mg Kotak/100 0
STOK
AWAL
Metoklopramid Injeksi 5 mg/ml
195 Kotak/5 Ampul 0
(Metolon)
196 Metronidazol 250 mg Kotak/100 0
199 Mikonazol Krim Tube/10 gr 0
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 0
201 Myomergin injk Kotak/10 0
202 Natrium Diclofenac Tab. 50 mg Kotak/50 10 0 0 10
203 Natrium Diklofenak 50 mg Kotak/50 0
204 Natrium Klorida (NaCl) 0,9 % Botol / 500 ml 0
205 Natrium Klorida (NaCl) 0,9% Botol 500 ml 28 0 0 28
206 Natrium Klorida Larutan Infus Botol 0

207 Nifedipin Tab. 20 mg Blister/30 1 0 1 0
208 Nistatin Tablet Salut 500.000 IU Kotak/100 0
209 Nistatin Vaginal Kotak/100 0
210 Nistatin vaginal tablet 100.000 IU/ g Dus @ 10 X 10 's 1 0 0 1
211 O.B.H. Indo Plus Botol/100 ml 0
212 O.B.H. Syr. Botol/100 ml 0
213 Obat antituberkulosis kategori 1 Paket 0
215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml 0
216 Oksitetra S.K Kotak/25 0
217 Oksitetra S.K Tube/10 gr 0
218 Oksitetra S.M 1% Kotak/25 1 0 0 1

219 Oksitetra S.M 1% Tube/3,5 gr 0
220 Oksitetra Salep Mata 1 % 20 0 16 4
221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g 0
222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g 0
223 Oksitosin Inj. Kotak/30 Amp. 0

Kotak/100 Ampul @ 1
224 Oksitosin injeksi 10 IU/ml 0
ml
225 Omeprazole Tab. 20 mg Kotak/30 0
226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.5 0 0.09 0.41
227 Papaverin Tab. Botol/1000 0
228 Papaverin Tab 40 mg Botol/1000 4 0 4 0
229 Parasetamol Drops Botol 15 ml 0

Parasetamol drops 100 mg/ml btl @15 ml 32
230 Botol 0 18 14
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 0
232 Parasetamol Tab. 500 mg Kotak/100 0
233 Pirantel Pamoat 125 mg Kotak/100 6 0 0 6
234 Pirantel Pamoat syr Botol/60 0
235 Pirantel suspensi Botol/60 0
236 Piridoksin HCl Tab 10 mg 0
237 Piridoksin HCl Tab. 10 mg Botol/1000 0
238 Piridoksin HCl Tab. 10 mg Kotak/100 0
239 Piroxicam Tab 20 mg 0
240 Piroxicam Tab. 20 mg Kotak/100 6 0 0 6

STOK
AWAL
242 Povidum Iodium Botol/300 ml 5 0 1 4
243 Povidum Iodium Botol/30ml 9 0 0 9
244 Povidum Iodium Botol/10ml 0
245 Povidum Iodium Botol /30 ml 0
246 Predmisone Botol / 100 0
247 Prednison Tab. 5 mg Botol/1000 0
248 Prednison Tab. 5 mg Kotak/100 0

Dus,10 blister @10 1
249 Primakuin tablet 15 mg 0 0 1
tablet
250 Propanolol Tab. 10 mg Kotak/100 11 0 0 11
251 Propiltiourasil Tab 10 mg 5 0 5 0

Botol/100
252 Propiltiourasil Tab. 100 mg Botol/100 4 0 4 0
253 Pyrantel syrp Botol 0
254 Pyrantel tab Kotak/100 0
255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp) 0
256 Ranitidin Tab. 150 mg Kotak/100 0
257 Reserpin tablet 0,10 mg Kotak 0
259 Ringer Laktat Botol 1000 ml 44 0 5 39
260 Ringer Laktat Lar. Infus Botol 500 ml 0
262 Ringer Laktat Lar. Infus (Tutup karet 3 lub Botol 500 ml 0
263 Salbutamol 2 mg Tab. Kotak/100 0
265 Salep 2 - 4 Kotak/24 0

Salep 2-4 , Kombinasi : Asam Salisilat 2%
266 Pot @ 30 gram 0
+ Belerang endap 4%
Salep 2-4 Kombinasi:Asam Salisilat 2% + 24
267 Pot @ 30 gram 0 5 19
Belerang Endap 4%
268 Salisil Bedak Kotak 0
269 Salisil Bedak 5 0 2 3
270 Sefadroksil 500 mg Kotak/100 0
271 Sefadroksil Syrp Botol 60 ml 0

Dus, 3 Strip @ 10 4
272 Simvastatin scored tablet 10 mg 0 4 0
Kaplet salut selaput
273 Simvastatin Tab. 10 mg Kotak/50 0
275 Stesolid Injeksi Kotak/5 Amp. 0
276 Stesolid Rektal Tub. Pcs 5 ml 8 0 2 6
277 Superhoid Kotak/100 0
278 Superoid Supp Kotak/6 0
279 Tablet Tambah Darah (SF) Botol/1000 0
280 Tetrasiklin 250 Kaplet Botol/1000 0
281 Tetrasiklin 250 Kaplet Kotak/100 0
282 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 1 0 1 0
283 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 0
284 Thiamin HCl Injeksi Kotak/30 0

STOK
AWAL
285 Thiamin HCl Tab. Botol/1000 10 0 1 9
286 Thiamin HCl Tab. 50 mg 0
287 Thiamin HCl Tablet 50 mg Botol/1000 0
288 Vaksin Rabies kuur 0
289 Vomitrol Syrup Botol 0
290 Zinc Syrup Botol/60 ml 0
291 Zink phosfat Set 0
0
B. PROGRAM GIZI 0
292 Becefort Botol 0
293 Hemafort Kotak/100 0
294 Livron kotak/100 19 0 16 3
295 lysmin Botol/60 ml 0
Multivitamin sirup (Vit.A 5000 IU +

Vit.B1 3g + Vit.B2 2.74 mg + Vit.B6 1 mg
296 + Vit.B12 5 mcg + Vit.C 50 mg + Vit.D Botol/60 ml 0
400 IU + Niaciamide 20 mg + L. Lysine
HCl 200 mg/5 ml). (Lysmin)
Multivitamin sirup (Vit.A 5000 UI + Vit.D

1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
Vit. B12 + Vit.C + Niaciamide + Lysine
HCl)
Multivitamin Syrup (B Complex + D
298 Botol/60 ml 0
Pantotenat, Vitamin C 100 mg)
Multivitamin Tab. (Ekstrak hati sapi 100,
Vit. B1,B2, B6, B12, Vit. C, Nikotinamid,
299 Kotak/100 0
As. Folat, Fe (II) Glukonat 7,5, MnSO4,
CuSO4 )
Multivitamin untuk anemia (Besi II

fumarat + MgSO4 + CuSO4 + Asam
300 Kotak/100 0
Ascorbat + Asam Folat + B12 + Faktor
intrinstik)

301 Kotak/100 0
intrinstik). (Hemafort)
302 Nistatin Tab salut 500000 IU Kotak/100 5 0 0 5
303 Retinol (Vitamin A) 100.000 IU Botol/50 Kaps 0
305 Retinol (Vitamin A) 100.000 IU Botol/50 kapsul 0
306 Vitamin B Complex Kotak/100 0
307 Vitamin B-Complex Botol/1000 0
C. OBAT GIGI 0
308 Air raksa dental use Botol 0
309 Albothyl 5 ml (obat gigi) Botol/5ml 0
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0
313 Calcinol / Urbical Box/2 Tube 0
314 Calcinol/ Urbical 0
315 Chlorphenol Kampher Menthol (CHKM) Botol/20 ml 0
316 Cresopen Botol/13 ml 0

STOK
AWAL
317 Cresopen 0
318 Dentorit/Caviton Botol/30gr 0
319 Dentorit/Caviton Botol 0
320 Dentorit/caviton 0
321 Devitasol Pasta (Devitac) Botol/4,5 0
322 Devitasol Pasta (Devitac) Botol 0
323 Etil klorida Kaleng 0
324 Etil klorida Kaleng 5 0 0 5
326 Etsha btl 0
327 Etsha Botol 0
328 Eugenol Cairan Kotak 12 Botol @ 15 ml 0
329 Glass Ionomer Cement Bungkus/Set 0

330 Glass Ionomer Cement (Vitro Molar) Bungkus/Set 0
331 Glass Ionomer Cement (Vitro Molar) 0
332 Gutta Percha Box/200 Stik 0
333 Gutta Percha Kotak 0
334 Jarum (Carefull) Set 0
337 Mata Bor High set 0
338 Mata Bor High Set 0
339 Natrium Hipoklorit 3% Liter 3 0 0 3
340 Paper Point No. 15 Kotak/200 stik 0
341 Paper Point No. 15 Kotak 0
343 Pehacain Injeksi Kotak/20 0
344 Rockless Botol 0
346 Spongostan Kotak/10 0
347 Spongostan Box/10 pcs 5 0 0 5
348 Spongostan Box/10 pcs 0
349 Tambalan Komposit Set 0
350 Tambalan komposit ( natural look) 0
351 Tambalan Komposit (Natural Look) Set 0
352 Xylestesin Kotak 0
353 Xylestesin 0
Zinc Phospate/Oxide Cement (Powder &
354 Set/Kotak 0
Liquid)
355 Zinc tablet kotak/100 0
0
D. BAHAN HABIS PAKAI 0
356 Alat Suntik / Spoit 1 cc Kotak/100 2 0 0.63 1.37
358 Alat Suntik / Spoit 20 cc Kotak/100 0
359 Alat suntik / Spoit 3 cc Kotak/100 0
362 Alkohol Swamb Dos 1 0 1 0
363 Aqua Pro Injeksi Botol 20 ml 0
364 Aquadest Steril Kotak/120@25 Botol 9 0 0 9
365 Asam Klorida (HCl) 0,1 N Botol/100 ml 0
366 Bisturi No. 15 Box/100 Pcs 0

STOK
AWAL
367 Bisturi No.15 Box/100 pcs 0
368 Blood Lancet Kotak/100 0
Cat Gut/Benang Bedah No.3/0 dengan

369 Kotak/24 0
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 4 0 0.125 3.875
371 Deck Glass Kotak/100 1 0 1 0
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 0
373 Disp. Syringe With Needle 10 cc Box/100 pcs 0

374 Disp. Syringe with Needle 3 cc Box/100 pcs 4 0 0 4
376 EDTA 10% Botol 100 ml 0

377 EDTA 10% Botol/100 ml 0
378 Elastis Perban 4 Inch Rol 0
379 Foley Catheter Pcs 13 0 5 8
380 Folley Catheter 2 way No. 18 Box/10 pcs 1 0 0 1
381 Giemsa Stain Botol/100 0
382 Giemsa Stain Botol/100 ml 0

383 Hifavix 5x5 cm Rol 0
384 Hipavix 5 x 5 cm Rol 0
385 Hipavix 5 x 5 cm Pcs 0
386 Infus set Anak Kantong/Set 27 0 0 27
387 Infus set Dewasa Kantong/Set 67 0 0 67
388 Infusion Set Anak/Pediatric (60 drops/ml) Buah 15 0 0 15
389 Infusion Set Dewasa (20 drops/ml) Buah 65 0 0 65

390 IV Catheter No. 18 Kotak/50 0
391 IV Catheter No. 18 G x 32 mm Buah 50 0 5 45
393 IV Catheter No. 20 G x 11/4 mm Buah 50 0 0 50
398 Jarum Ekstirpasi 0
399 Jarum Extirpasi 0
400 Jarum Extirpasi Set 0
401 Jarum Kulit No. 11 Pcs 0
402 Jarum Kulit No. 11 0
403 Jarum Kulit No.11 Set 0
404 Jarum Otot No. 11 Pcs 5 0 0 5
405 Jarum Otot No. 11 0
406 Jarum Otot No.11 Set 0
407 Kapas Pembalut/absorben 250 g Rol 4 0 1 3
408 Kapas pembalut/absorben 250 gram Roll 0
409 Kasa 40 x 80 cm Roll 1 0 1 0
410 Kasa Hydrofil Steril 18 m x 22 cm Kotak/12 Lmbr 0
411 Kasa Hydrofil Steril 18 m x 22 cm Box/12 40 0 3 37
412 Kasa Hydrofil Steril 36 m x 80 cm Rol 0
413 Kasa Hydrophil 40 x 80 cm Roll 0
STOK
AWAL
414 Kasa Pembalut 4 m x 10 cm Roll 0
415 Kasa Pembalut Elastis 3 inci Rol 7 0 0 7
416 Kasa Pembalut Elastis 3 inci Rol 0
417 Kasa Pembalut Hydrofil 4 m x 10 cm Rol/50 0
419 Kertas Puyer bks 0
420 Kertas Puyer Bungkus 0
421 Klip Plastik besar Kotak/100 0
422 Klip Plastik Obat Ukuran Kecil Bungkus/100 0
423 Klip Plastik Obat Ukuran Sedang Bungkus/100 10 0 10 0
424 Klip Plastik Obat Ukuran Sedang Bungkus/100 0
Larutan Carbol Fuchsin Decolorizer
425 Botol/100 ml 0
Conc. 30 ml
426 Larutan Eosin Botol/100 0
427 Larutan Hayem Botol 0
428 Larutan Hayem Botol/100 ml 0
430 Larutan karbol Fuchsin 0,3% Botol/100 ml 0
431 Larutan Methilen Blue Botol/100 ml 0
Larutan Methylene Blue Concentrate 130
432 Botol/100 ml 0
ml
433 Larutan Spiritus Liter 0
436 Larutan Turk Botol 0
437 Larutan Turk Botol/100 ml 0
Latex Examination Glove L (Sarung 9
439 Box/100 Buah 0 0 9
Tangan)
440 Latex Examination Glove L, M, S Box/100 Pcs 0
Latex Examination Glove M (Sarung 5
441 Box/100 Buah 0 5 0
Tangan)
Latex Examination Glove S (Sarung 1
442 Box/100 Buah 0 1 0
Tangan)
443 Lisol Botol/1000 ml 5 0 0 5
444 Masker Kotak/20 0
446 Methanol Liter 0
448 Methylen Blue Botol 0

449 Natrium Sitrat Liter 0
451 Needle 23 G x 1,5 cc Kotak/100 Pcs 2 0 0 2
452 Objeck Glass Kotak/100 0

454 Oil Emercy Botol/100 ml 0
456 Oksigen (O2) 6 Kubik 0
457 Oksigen (O2) 1 kubik 0
458 Oksigen (O2) 1 1/2 kubik 0
459 Oksigen (O2) 1 kubik Kubik 0
461 Perhidrol (H2O2) 13% Liter 1 0 0 1
STOK
AWAL
462 Perlak lembar 0
463 Plano Tes (Tes Kehamilan) Kotak/50 0

464 Plester 5 yard x 2 inci Roll 21 0 1 20
465 Plester 5 yard x 2 inci Roll 0
466 Plester 5 yards x 2 inci Rol 0
467 Porstex botol/1000 0
468 Portex Botol 0

469 Rapid Test Hepatitis Kotak/25 tes 0
470 RDT DBD IgG/IgM Kotak/25 0
471 RDT DBD NS1 Kotak/25 0
472 RDT DBD NS1 (Dengue Antigen) Kotak/25 0
473 Reagen Golongan Darah Botol/10 ml 0
474 Reagen Golongan Darah 0
475 Reagen Golongan Darah (A, B, AB) Botol/3X10 ml 0
476 Reagen Tidal Kotak/4 vial 0
478 Reagen Widal Kotak 8 Vial@5 ml 0

Rees Eker Liquid (Pemeriksaan
479 Botol/500 ml 0
Hemoglobin)
480 Rivanol (Etakridin larutan 0,1%) Botol/300 ml 11 0 1 10
481 Sarung Tangan (Hands Scoon) Kotak/25 0
482 Sarung Tangan L, M, S Kotak/100 0
483 Silk (Benang Bedah Sutra ) Kotak/24 0
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 2 0 0 2
485 Strip Asam Urat Botol/25 Strip 0
487 Strip Asam Urat 0
488 Strip Gula Botol/25 Strip 0
491 Strip Kolesterol Botol/10 Strip 0
494 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 8 0 3 5

495 Tes Tuberkulin Pcs 0
496 Test Pack Kotak/50 0

497 Uji Dengue IgG/IgM 25 Test 0
498 Uji Hepatitis BsAg Box/25 0
499 Uji Leptospira IgM Kotak/25 Test 0
500 Uji Malaria Box/25 0
501 Uji Tifoid IgM Box/25 0
502 Uji Tiphoid IgM Kotak/25 0
503 Urine Bag Pcs 0
504 Urine Bag Standard steril 2 Lt Buah 0
505 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 0
507 Urine reagen strip 10 lG Para Meter Botol/100 Stik 0
508 Anti migrain Botol/100 tab 4 0 0 4
509 Ambroksol syrup Botol 60ml 0
510 cyanocobalamine injeksi 1000mcg/ml kotak/100 1 0 1 0
511 Ibufropen tab 200 mg Botol 100 tab 0
512 kloramfenikol 3% tetes telinga botol 18 0 16 2
STOK
AWAL
513 Metformin Hcl tab 500 Kotak/10 blister/10tab 0
514 Oksitetrasiklin salep 3% kotak/25tb 5gr 0
516 Etanol 70% Cairan Botol/1000 4 0 0 4
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 0
519 Allopurinol 100 mg Kotak/100 10 0 10 0
520 Chlorpeniramine Maleat(CTM) Kotak/100 183 0 23 160
521 Ibufropen tab 400 mg Kotak/100 6 0 3 3
522 Kotrimoksaxole 480 Kotak/100 2 0 0 2
523 Metformine HCL tab 500 mg Kotak/100 0
524 Parasetamol Syrup Botol/60 ml 100 0 100 0
525 Ranitidine tab 150 mg Kotak/30 0
526 salbutamol 4mg Kotak/100 2 0 2 0
527 Sefadroksil Kapsul Kotak/100 3 0 3 0
528 Vit. B-complex Kotak/100 0
TOTAL 2283.8 0 575.945 1707.855

BULAN JANUARI 2017
STOK HARGA
AWAL SATUAN
A. NAMA OBAT
1 1 blister@24 tablet 0 0 1 34,656
2 Adona Injeksi 50 mg Kotak/10 Amp. 0 280,315
3 Albendazol tablet 400 mg Kotak/30 0 13,420
4 Albothyl Botol 10 ml 0 24,700
5 Albothyl Concentrate 5 ml Botol 5 ml 6 0 0 6 28,870
6 Allopurinol Tab 100 mg Kotak/100 5 0 5 0 9,000
7 Allopurinol Tab 300 mg Kotak/30 0 8,085
8 Allopurinol tab. 300 mg Kotak/100 0 22,500
10 Ambroxol Syrup Botol/60 ml 0 6,510
12 Aminofillin Inj. Kotak/30 0 126,000
13 Aminofillin Tab. 200 mg Botol/100 0 8,600
14 Amlodipin 5mg Kotak/30 0 5,910
15 Amoksisilin kapsul/kaplet 250 mg 0 22,000
kapsul
16 0 27 81 37,000
500 mg kaptab
17 Amoksisillin Kapl. 250 mg Kapsul/100 0 22,000
18 Amoksisillin Kapl. 500 mg Kotak/100 0 29,200
19 Amoksisillin Syr. Kering Botol/60 ml 0 2,560
20 Ampicillin Injeksi Kotak/10 0 59,048
21 Ampisillin Kapl. 500 mg Kotak/100 0 41,910

22 Ampisillin Syrup Kering Botol/60 ml 0 4,840
23 Antalgin Tab. 500 mg (Metampiron) Kotak/100 0 12,650
24 Antasida DOEN Kotak/100 154 0 15 139 7,800
25 0 7,800
Hidroksida 200 mg
26 Antasida DOEN Tab. Kotak/100 0 17,820
27 Antasida Syr. Botol 0 2,300

28 Kotak/25 0 0 3 69,175

29 Kotak/24 Pot 0 1.05 2.95 91,200
30 Antihemoroid Doen Kombinasi Kotak/10 Supp. 3 0 0 3 22,000

DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 0 3350
GRAM
32 Antimigrain Botol/100 7 0 7 0 13,563
33 Asam Ascorbat (Vit. C) 50 mg Botol/1000 0 35,200
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 0 10,500
35 Asam Folat Kaplet 1 mg Botol/100 2 0 0 2 5,200
36 Asam mefenamat 500 mg Kotak/100 90 0 0 90 12,200
37 Asam Mefenamat kapsul/kaplet 500 mg 0 20 30 21,978
kap
38 Asering Lar. Infus Botol/500 ml 0 19,800
STOK HARGA
AWAL SATUAN
39 Asiklovir SK Kotak/25 0 82,500
40 Asiklovir Tab. 200 mg Kotak/100 43 0 0 43 25,100
41 Atropin Sulfat Inj. Kotak/30 1 0 0 1 36,000
42 Betahistin tab. 6 mg Kotak/30 2 0 0 2 33,539
43 Betametason Krim Kotak/25 0 51,315
44 Betametason Krim Tube/5g 0 1,596
45 Bisacodil tab Kotak/200 0 257,070
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 0 1,362
47 Bromheksin tab. 8 mg kotak/300 0 66,517
48 Bromheksin Tab. 8 mg Kotak/100 0 23,830
50 Cefadroxil syrup Botol 0 5,286
51 Cefotaxime injeksi 1 g kotak/10 0 35,000
52 Cefotaxime Injeksi 1 g Kotak/2 Vial 0 15,246
53 Cetirizin kotak/100 0 38,000
54 Cetirizine Tab. 10 mg Kotak/100 0 14,000
55 Cetirizine Tab. 10 mg Kotak/50 3 0 3 0 19,000
56 Chlorfeniramine Maleat (CTM) 4 mg 0 Rp 45,298
57 Chlorfeniramini Maleat (CTM) 4 mg Botol/1000 0 26,400
58 0 122,500
500 mcg ml
59 Cyanocobalamin Inj. Kotak/100 0.7 0 0 0.7 114,070
60 Cyanocobalamin Tab. Botol/1000 0 14,412
61 Cyanocobalamin Tablet KOTAK/100 0 1,441.20
62 Cyprofloxacin 500 mg Tab. Kotak/50 34 0 28 6 14,300
63 Cyprofloxacin 500 mg Tab. Kotak/100 0 26,500
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 5 0 5 0 35,465
65 0 26,500
HCl) ss
66 Daryantula (Supratula) Box/20 Lmbr 0 312,000
67 Daryantull 10 x 10 cm Kotak/10 0 202,500
68 Daryantulle Box/10 Pcs 0 178,000
69 Deksametason Injeksi Kotak/100 0 173,800
71 Dexamethason Tab. 0,5 mg Kotak/100 145 0 43 102 7,400
72 Dexamethason Tab. 0,5 mg Kotak/100 0 9,570
73 Dextrofen Syrup Botol 60 ml 0 10,100
74 Dexchlorpheniramine Maleate + Botol/60 ml 0 11,810
75 Dextrometrophan Syr. Botol 0 3,152
76 Dextrometrophan Tab. Kotak/100 0 12,100
77 Diazepam Injeksi Kotak/30 0.8 0 0 0.8 78,147
78 0 0 8 12,751
(Stesolid) @ 2,5 ml
79 Diazepam Tab. 2 mg Kotak/100 0 4,400
80 Diazepam tablet/kapsul/kaplet 2 mg Botol 100 0 4,700
81 Difenhidramin Injeksi Kotak/30 1 0 0 1 34,680
82 Digoxin Tab. 0,25 mg Kotak/100 0 10,300
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 0 3,490
84 Domperidon Tab. 10 mg Kotak /100 5 0 1 4 17,400
85 Dulcolax Tab 0
86 Efedrin HCl 25 mg Botol/250 0 14,097
87 Ekstrak Belladon Botol/1000 0 34,848
88 Epinefrin (Adrenalin) Injeksi 0,1% Kotak/30 0 267,300
89 Ergotamine cafein Kotak/100 0 13,563
90 Eritromicin Kaps. 500 mg Kotak/100 0 102,300
91 Eritromicin Syrup Botol/60 ml 0 8,090
STOK HARGA
AWAL SATUAN
92 Etakridin larutan 0,1% (Rivanol) Botol/300 ml 0 1,980
93 Ethanol Botol/1000 0 22,720
95 Eugenol Cairan Botol/10ml 0 18,333
96 Famotidine kotak/50 0 6,221
97 Fenilbutason Tab 200 mg (Novason) 0 Rp 152,889
98 Fenilbutason Tab. 200 mg Botol/1000 0 89,100
99 Fenilbutason Tab. 200 mg (Novason) Botol/100 0 31,620
101 Fenobarbital Tab. 30 mg Botol/100 0 7,139
102 Ferrosi sulfas 300 mg tab botol/1000 0 28,855
103 Fitomenadeon Tab. Botol/100 9 0 0 9 69,000
104 Dus @ 30 ampul 0 0 1 112,620
mg/ml
105 Fitomenadion Injeksi Kotak/30 0 57,420
106 Fitomenadion Tab. Kotak/100 0 69,000

108 Furosemid Tab. 40 mg Kotak/100 0 8,400
109 Furosemid Tab. 40 mg Kotak/100 3 0 0 3 11,229
110 Garam oralit kotak/100 0 41,800
111 Gentamicin 0,1% Salep Kulit Kotak/25 Tube@5 g 0 58,030
112 Gentamicin SK. Kotak/10 0 20,207
113 Gentamycin 0,1 % SK Kotak/25 1 0 1 0 55,506
114 Gentian Violet Botol/10 ml 0 495
115 Glibenclamida 0 Rp 9,900
116 Glibenklamid Tab. 5 mg Kotak/100 0 6,100
117 Gliseril Guaiacolas Botol/1000 0 66,790
118 Gliseril Guaiacolat 13 0 2 11 Rp 52,635
119 Gliseryl Guaiacolas Tab. 100 mg Botol/1000 0 30,690
120 Glukosa larutan 5 % Botol 500 ml 173 0 0 173 5,720
121 Griseofulvin tablet 125 mg, micronized Kotak 0 24,100

122 Hidrochlortiazid Tab. 25 mg Botol/1000 0 27,104
Dus, 10 strip @ 10
123 Hidroklorotiazid tab 25 mg 0 16300
tablet
124 Hidrokortison krim 2,5 % Tube 0 2,938
125 Hidrokortison SK Kotak/24 0 78,650
126 Ibuprofen 200 mg Botol/100 0 12,705
127 Ibuprofen 400 mg Kotak/100 0 15,700
128 Ibuprofen Suspensi 200 mg Botol/60 176 0 85 91 4,949
129 Ibuprofen tablet 200 mg Botol @ 100 tablet 12 0 2 10 12,100
130 Ichtiol SK Pot 0 8,500
131 Ichtiol SK 15 g Kotak/12 Pot 2 0 0 2 49,720
132 Ichtiol SK 15 g Kotak/12 Pot 0 49,720
133 Induksin Inj Kotak/10amp 0 89,700
134 Kalsium Laktat Tab. 500 mg Kotak/100 13 0 13 0 7,600
135 Kalsium Laktat Tab. 500 mg Botol/1000 0 43,263
136 Kaptopril 12,5 mg Kotak/100 9 0 1 8 6,900
137 Kaptopril 25 mg Kotak/100 0 10,000
138 Ketokonazole 0 Rp 16,000
139 Ketokonazole Tab. 200 mg Kotak/50 0 22,550
141 Ketorolac Injeksi 10 mg Kotak/5 Amp. 0 41,250
STOK HARGA
AWAL SATUAN
144 Kloramfenicol Tetes Telinga 3% Botol 0 3,150
145 Kloramfenikol Kaps. 250 mg Kotak/100 0 29,315
146 Kloramfenikol salep mata kotak/24 0 41,256
147 Kloramfenikol salep mata Tube/5gr 0 1,680
148 Kloramfenikol Suspensi Botol/60 ml 0 4,950
149 Kloramfenikol Tetes Telinga botol/5ml 0 1,760
151 Klorpromazin HCl inj. 5mg/ml - 2 ml Kotak/ 30 Amp 0 34,650
152 Klorpromazin HCl tab 100 mg kotak/100 0 16,500
153 Klorpromazin HCl tablet salut 100 mg Botol 0 16,500
155 Kotrimoksasol Tab. 120 mg Kotak/100 0 8,349
156 Kotrimoksazol 120 mg Kotak/100 0 10,555
157 Kotrimoksazol 480 Kotak/100 0 15,200
158 Kotrimoksazol Syr. Botol/60 0 2,298
161 Lacto B Sachet Kotak/4x10 0 220,000
163 Lansoprasol 30 mg Kotak/ 30 0 10,420
164 Lansoprasole 30 mg Kotak/20 0 10,420
166 Levertran Salep Pot 0 4,000
167 Levertran Salep Kulit Kotak/12 Pot 0 37,015
168 Lidocain inj kotak/100 2 0 0 2 92,900
169 Lidocain Injeksi Kotak/30 0 37,510
170 Dus, 30 ampul @ 2 ml 0 63660
80.000 - 2 ml
171 Lisol Botol/1000 0 20,000
172 Lisol Botol 800 ml 0 20,000
173 Loperamide Kotak/100 0 10,071
174 Loperamide Kotak/100 2 0 1 1 9,700
175 Lorazepam 2 mg Kotak/100 1.8 0 0 1.8 142,300
176 Malaria PF/PV casset Kotak 25 0 1,953,485
177 Meloksikam 7,5 mg Kotak/20 0 15,222
179 Meloksikam 7,5 mg Kotak/30 19 0 4 15 26,500
180 Meloxicam 7,5mg Kotak/30 0 38,050
181 Metamphyron (Antalgin) Tab. 500 mg Kotak/100 0 12,650
182 Metformin HCl tab 500 mg Kotak/100 0 19,965
183 Methylergometrin inj kotak/100 0 16,868
184 Methylprednisolon 4 mg Kotak/100 0 23,000

186 Metilergometrin Injeksi Kotak/30 0 49,170
187 0 275,000
1 ml ml
188 Metilergometrin Tab 0,125 mg 0 Rp 16,868
189 Metilergometrin Tab. 0,125 mg Kotak/100 0 13,310
190 Metilergometrin Tab. 0,125 mg Kotak /100 0 17,715
191 Metoclorpramide injeksi kotak/5 0 61,864
192 Metokloperamid Injeksi Kotak/10 Amp @ 2 ml 0 11,000
193 Metokloperamid Tab. 5 mg Kotak/100 0 8,668
STOK HARGA
AWAL SATUAN
195 Kotak/5 Ampul 0 61,870
(Metolon)
196 Metronidazol 250 mg Kotak/100 0 15,730
199 Mikonazol Krim Tube/10 gr 0 3,300
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 0 3,150
201 Myomergin injk Kotak/10 0 42,500
202 Natrium Diclofenac Tab. 50 mg Kotak/50 10 0 0 10 9,650
203 Natrium Diklofenak 50 mg Kotak/50 0 92,333
204 Natrium Klorida (NaCl) 0,9 % Botol / 500 ml 0 4,545
205 Natrium Klorida (NaCl) 0,9% Botol 500 ml 28 0 0 28 5827
206 Natrium Klorida Larutan Infus Botol 0 4,545

207 Nifedipin Tab. 20 mg Blister/30 1 0 1 0 89,970
208 Nistatin Tablet Salut 500.000 IU Kotak/100 0 70,400
209 Nistatin Vaginal Kotak/100 0 40,700
210 Nistatin vaginal tablet 100.000 IU/ g Dus @ 10 X 10 's 1 0 0 1 52,800
211 O.B.H. Indo Plus Botol/100 ml 0 8,052
212 O.B.H. Syr. Botol/100 ml 0 1,573
213 Obat antituberkulosis kategori 1 Paket 0 395,900
214 Obat antituberkulosis kategori 2 Paket 0 1,319,900
215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml 0 13,400
216 Oksitetra S.K Kotak/25 0 45,403
217 Oksitetra S.K Tube/10 gr 0 3,686
218 Oksitetra S.M 1% Kotak/25 1 0 0 1 52,800

219 Oksitetra S.M 1% Tube/3,5 gr 0 2,310
220 Oksitetra Salep Mata 1 % 20 0 16 4 Rp 3,327

221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g 0 61,000
222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g 0 3,850
223 Oksitosin Inj. Kotak/30 Amp. 0 58,905

Kotak/100 Ampul @ 1
224 Oksitosin injeksi 10 IU/ml 0 242,000
ml
225 Omeprazole Tab. 20 mg Kotak/30 0 6,630
226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.5 0 0.09 0.41 312,500
227 Papaverin Tab. Botol/1000 0 264,100
228 Papaverin Tab 40 mg Botol/1000 4 0 4 0 109,450
229 Parasetamol Drops Botol 15 ml 0 5,808

230 Botol 0 18 14 5,720
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 0 1,535
232 Parasetamol Tab. 500 mg Kotak/100 0 8,800
233 Pirantel Pamoat 125 mg Kotak/100 6 0 0 6 31,800
234 Pirantel Pamoat syr Botol/60 0 9,100
235 Pirantel suspensi Botol/60 0 9,100
236 Piridoksin HCl Tab 10 mg 0 Rp 36,685

237 Piridoksin HCl Tab. 10 mg Botol/1000 0 33,000
238 Piridoksin HCl Tab. 10 mg Kotak/100 0 12,100
239 Piroxicam Tab 20 mg 0 Rp 19,816

240 Piroxicam Tab. 20 mg Kotak/100 6 0 0 6 11,550
STOK HARGA
AWAL SATUAN
242 Povidum Iodium Botol/300 ml 5 0 1 4 15,386
243 Povidum Iodium Botol/30ml 9 0 0 9 2,640
244 Povidum Iodium Botol/10ml 0 2,344
245 Povidum Iodium Botol /30 ml 0 2,344
246 Predmisone Botol / 100 0 68,750
247 Prednison Tab. 5 mg Botol/1000 0 68,750
248 Prednison Tab. 5 mg Kotak/100 0 12,500

249 Primakuin tablet 15 mg 0 0 1 20,500
tablet
250 Propanolol Tab. 10 mg Kotak/100 11 0 0 11 8,000
251 Propiltiourasil Tab 10 mg 5 0 5 0

Botol/100 Rp 35,100
252 Propiltiourasil Tab. 100 mg Botol/100 4 0 4 0 32,953
253 Pyrantel syrp Botol 0 9,100
254 Pyrantel tab Kotak/100 0 31,800
255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp) 0 13,400
256 Ranitidin Tab. 150 mg Kotak/100 0 13,200
257 Reserpin tablet 0,10 mg Kotak 0 20,680
259 Ringer Laktat Botol 1000 ml 44 0 5 39 8,000
260 Ringer Laktat Lar. Infus Botol 500 ml 0 5,720
262 Ringer Laktat Lar. Infus (Tutup karet 3 lub Botol 500 ml 0 12,000
263 Salbutamol 2 mg Tab. Kotak/100 0 9,243
265 Salep 2 - 4 Kotak/24 0 96,000

266 Pot @ 30 gram 0 2797
+ Belerang endap 4%
267 Pot @ 30 gram 0 5 19 2,200
Belerang Endap 4%
268 Salisil Bedak Kotak 0 1,573
269 Salisil Bedak 5 0 2 3 Rp 1,350

270 Sefadroksil 500 mg Kotak/100 0 52,900
271 Sefadroksil Syrp Botol 60 ml 0 5,286

Dus, 3 Strip @ 10 4
272 Simvastatin scored tablet 10 mg 0 4 0 3,690
273 Simvastatin Tab. 10 mg Kotak/50 0 28,215
275 Stesolid Injeksi Kotak/5 Amp. 0 78,147
276 Stesolid Rektal Tub. Pcs 5 ml 8 0 2 6 28,512
279 Tablet Tambah Darah (SF) Botol/1000 0 28,855
280 Tetrasiklin 250 Kaplet Botol/1000 0 183,425
281 Tetrasiklin 250 Kaplet Kotak/100 0 16,200
282 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 1 0 1 0 37,928
283 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 0 50,090
284 Thiamin HCl Injeksi Kotak/30 0 25,300

STOK HARGA
AWAL SATUAN
285 Thiamin HCl Tab. Botol/1000 10 0 1 9 41,580
286 Thiamin HCl Tab. 50 mg 0 Rp 71,351

287 Thiamin HCl Tablet 50 mg Botol/1000 0 74,455
288 Vaksin Rabies kuur 0 750,000
289 Vomitrol Syrup Botol 0 5,519
290 Zinc Syrup Botol/60 ml 0 8,140
291 Zink phosfat Set 0 276,750
0
B. PROGRAM GIZI 0
292 Becefort Botol 0 20,700
293 Hemafort Kotak/100 0 90,750
294 Livron kotak/100 19 0 16 3 25,300
295 lysmin Botol/60 ml 0 25,080

296 + Vit.B12 5 mcg + Vit.C 50 mg + Vit.D Botol/60 ml 0 25,080

1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0 26,120
HCl)
298 Botol/60 ml 0 21,700
299 Kotak/100 0 27,450
CuSO4 )

300 Kotak/100 0 90,700
intrinstik)

301 Kotak/100 0 90,750
302 Nistatin Tab salut 500000 IU Kotak/100 5 0 0 5 70,400
303 Retinol (Vitamin A) 100.000 IU Botol/50 Kaps 0 14,025
305 Retinol (Vitamin A) 100.000 IU Botol/50 kapsul 0 14,300
306 Vitamin B Complex Kotak/100 0 11,200
307 Vitamin B-Complex Botol/1000 0 24,420
C. OBAT GIGI 0
309 Albothyl 5 ml (obat gigi) Botol/5ml 0 24,700
310 Bonding 0 216,000
311 Bonding Botol 0 356,730
312 Bonding 0 Rp 283,500
313 Calcinol / Urbical Box/2 Tube 0 535,095
314 Calcinol/ Urbical 0 Rp 877,500
315 Chlorphenol Kampher Menthol (CHKM) Botol/20 ml 0 60,500
316 Cresopen Botol/13 ml 0 538,650

STOK HARGA
AWAL SATUAN
317 Cresopen 0 Rp 762,750

318 Dentorit/Caviton Botol/30gr 0 155,250
319 Dentorit/Caviton Botol 0 201,886
320 Dentorit/caviton 0 Rp 263,250
321 Devitasol Pasta (Devitac) Botol/4,5 0 610,200
322 Devitasol Pasta (Devitac) Botol 0 647,660
323 Etil klorida Kaleng 0 115,500
324 Etil klorida Kaleng 5 0 0 5 101,250
326 Etsha btl 0 101,250
327 Etsha Botol 0 262,683
328 Eugenol Cairan Kotak 12 Botol @ 15 ml 0 605,000
329 Glass Ionomer Cement Bungkus/Set 0 434,500

330 Glass Ionomer Cement (Vitro Molar) Bungkus/Set 0 1,119,375
331 Glass Ionomer Cement (Vitro Molar) 0 Rp 1,309,500
332 Gutta Percha Box/200 Stik 0 67,500
333 Gutta Percha Kotak 0 54,000
334 Jarum (Carefull) Set 0 168,750
337 Mata Bor High set 0 217,500
338 Mata Bor High Set 0 270,000
339 Natrium Hipoklorit 3% Liter 3 0 0 3 27,000
340 Paper Point No. 15 Kotak/200 stik 0 67,500
341 Paper Point No. 15 Kotak 0 60,750
343 Pehacain Injeksi Kotak/20 0 66,510
344 Rockless Botol 0 742,500
346 Spongostan Kotak/10 0 70,000
347 Spongostan Box/10 pcs 5 0 0 5 168,250
348 Spongostan Box/10 pcs 0 181,877
349 Tambalan Komposit Set 0 1,464,441
350 Tambalan komposit ( natural look) 0 Rp 1,650,800
351 Tambalan Komposit (Natural Look) Set 0 1,014,894
352 Xylestesin Kotak 0 528,000
353 Xylestesin 0 Rp 573,750
354 Set/Kotak 0 276,750
Liquid)
355 Zinc tablet kotak/100 0 52,250
0
356 Alat Suntik / Spoit 1 cc Kotak/100 2 0 0.63 1.37 120,175
358 Alat Suntik / Spoit 20 cc Kotak/100 0 185,000
359 Alat suntik / Spoit 3 cc Kotak/100 0 120,000
362 Alkohol Swamb Dos 1 0 1 0 29,563
363 Aqua Pro Injeksi Botol 20 ml 0 5,225
364 Aquadest Steril Kotak/120@25 Botol 9 0 0 9 327,600
365 Asam Klorida (HCl) 0,1 N Botol/100 ml 0 10,800
366 Bisturi No. 15 Box/100 Pcs 0 91,000

STOK HARGA
AWAL SATUAN
367 Bisturi No.15 Box/100 pcs 0 101,250
368 Blood Lancet Kotak/100 0 27,000

369 Kotak/24 0 649,000
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 4 0 0.125 3.875 174,870
371 Deck Glass Kotak/100 1 0 1 0 51,300
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 0 84,825
373 Disp. Syringe With Needle 10 cc Box/100 pcs 0 120,713

374 Disp. Syringe with Needle 3 cc Box/100 pcs 4 0 0 4 84,825
376 EDTA 10% Botol 100 ml 0 97,500

377 EDTA 10% Botol/100 ml 0 20,250
378 Elastis Perban 4 Inch Rol 0 88,150
379 Foley Catheter Pcs 13 0 5 8 9,345
380 Folley Catheter 2 way No. 18 Box/10 pcs 1 0 0 1 104,400
381 Giemsa Stain Botol/100 0 100,000
382 Giemsa Stain Botol/100 ml 0 47,250

383 Hifavix 5x5 cm Rol 0 76,050
384 Hipavix 5 x 5 cm Rol 0 79,446
385 Hipavix 5 x 5 cm Pcs 0 70,265
386 Infus set Anak Kantong/Set 27 0 0 27 3,850
387 Infus set Dewasa Kantong/Set 67 0 0 67 4,400
388 Infusion Set Anak/Pediatric (60 drops/ml) Buah 15 0 0 15 4,568
389 Infusion Set Dewasa (20 drops/ml) Buah 65 0 0 65 4,176

390 IV Catheter No. 18 Kotak/50 0 428,313
391 IV Catheter No. 18 G x 32 mm Buah 50 0 5 45 4,959
393 IV Catheter No. 20 G x 11/4 mm Buah 50 0 0 50 4,959
398 Jarum Ekstirpasi 0 Rp 142,750
399 Jarum Extirpasi 0 155,000
400 Jarum Extirpasi Set 0 199,985
401 Jarum Kulit No. 11 Pcs 0 1,950
402 Jarum Kulit No. 11 0 Rp 24,300
403 Jarum Kulit No.11 Set 0 17,405
404 Jarum Otot No. 11 Pcs 5 0 0 5 1,950
405 Jarum Otot No. 11 0 Rp 24,300
406 Jarum Otot No.11 Set 0 17,405
407 Kapas Pembalut/absorben 250 g Rol 4 0 1 3 8,250
408 Kapas pembalut/absorben 250 gram Roll 0 16,313
409 Kasa 40 x 80 cm Roll 1 0 1 0 118,800
410 Kasa Hydrofil Steril 18 m x 22 cm Kotak/12 Lmbr 0 5,225
411 Kasa Hydrofil Steril 18 m x 22 cm Box/12 40 0 3 37 7,700
412 Kasa Hydrofil Steril 36 m x 80 cm Rol 0 114,500
413 Kasa Hydrophil 40 x 80 cm Roll 0 137,025
STOK HARGA
AWAL SATUAN
414 Kasa Pembalut 4 m x 10 cm Roll 0 1,958
415 Kasa Pembalut Elastis 3 inci Rol 7 0 0 7 6,250
416 Kasa Pembalut Elastis 3 inci Rol 0 7,700
417 Kasa Pembalut Hydrofil 4 m x 10 cm Rol/50 0 33,385
419 Kertas Puyer bks 0 6,250
420 Kertas Puyer Bungkus 0 7,425
422 Klip Plastik Obat Ukuran Kecil Bungkus/100 0 3,500
423 Klip Plastik Obat Ukuran Sedang Bungkus/100 10 0 10 0 5,000
424 Klip Plastik Obat Ukuran Sedang Bungkus/100 0 5,000
425 Botol/100 ml 0 87,750
Conc. 30 ml
426 Larutan Eosin Botol/100 0 114,750
427 Larutan Hayem Botol 0 49,000
428 Larutan Hayem Botol/100 ml 0 60,750
430 Larutan karbol Fuchsin 0,3% Botol/100 ml 0 105,000
431 Larutan Methilen Blue Botol/100 ml 0 47,250
432 Botol/100 ml 0 55,941
ml
433 Larutan Spiritus Liter 0 38,475
436 Larutan Turk Botol 0 49,000
437 Larutan Turk Botol/100 ml 0 13,500
439 Box/100 Buah 0 0 9 42,413
Tangan)
440 Latex Examination Glove L, M, S Box/100 Pcs 0 42,413
441 Box/100 Buah 0 5 0 42,413
Tangan)
442 Box/100 Buah 0 1 0 42,413
Tangan)
443 Lisol Botol/1000 ml 5 0 0 5 53,505
444 Masker Kotak/20 0 24,750
445 Masker Kotak/50 0 21,533
446 Methanol Liter 0 16,250
448 Methylen Blue Botol 0 47,250

449 Natrium Sitrat Liter 0 136,000
451 Needle 23 G x 1,5 cc Kotak/100 Pcs 2 0 0 2 27,000
452 Objeck Glass Kotak/100 0 22,275

454 Oil Emercy Botol/100 ml 0 490,000
456 Oksigen (O2) 6 Kubik 0 162,500
457 Oksigen (O2) 1 kubik 0 75,000
458 Oksigen (O2) 1 1/2 kubik 0 85,000
459 Oksigen (O2) 1 kubik Kubik 0 74,345
461 Perhidrol (H2O2) 13% Liter 1 0 0 1 37,125
STOK HARGA
AWAL SATUAN
462 Perlak lembar 0
463 Plano Tes (Tes Kehamilan) Kotak/50 0 74,250

464 Plester 5 yard x 2 inci Roll 21 0 1 20 36,450
465 Plester 5 yard x 2 inci Roll 0 34,592
466 Plester 5 yards x 2 inci Rol 0 26,208
467 Porstex botol/1000 0 20,000
468 Portex Botol 0 21,620

469 Rapid Test Hepatitis Kotak/25 tes 0 773,795
470 RDT DBD IgG/IgM Kotak/25 0 3,819,338
472 RDT DBD NS1 (Dengue Antigen) Kotak/25 0 2,824,113
473 Reagen Golongan Darah Botol/10 ml 0 280,000
474 Reagen Golongan Darah 0 Rp 365,000
475 Reagen Golongan Darah (A, B, AB) Botol/3X10 ml 0 248,630
476 Reagen Tidal Kotak/4 vial 0 607,500
478 Reagen Widal Kotak 8 Vial@5 ml 0 1,730,916

479 Botol/500 ml 0 577,254
Hemoglobin)
480 Rivanol (Etakridin larutan 0,1%) Botol/300 ml 11 0 1 10 3,328
481 Sarung Tangan (Hands Scoon) Kotak/25 0 42,500
482 Sarung Tangan L, M, S Kotak/100 0 42,413
483 Silk (Benang Bedah Sutra ) Kotak/24 0 276,540
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 2 0 0 2 143,550
485 Strip Asam Urat Botol/25 Strip 0 120,000
487 Strip Asam Urat 0 Rp 121,500
488 Strip Gula Botol/25 Strip 0 117,000
491 Strip Kolesterol Botol/10 Strip 0 183,000
494 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 8 0 3 5 21,533

495 Tes Tuberkulin Pcs 0 881,250
496 Test Pack Kotak/50 0 100,000

497 Uji Dengue IgG/IgM 25 Test 0 1,932,287
498 Uji Hepatitis BsAg Box/25 0 505,367
499 Uji Leptospira IgM Kotak/25 Test 0 1,932,287
500 Uji Malaria Box/25 0 1,062,757
501 Uji Tifoid IgM Box/25 0 1,545,830
502 Uji Tiphoid IgM Kotak/25 0 1,799,875
503 Urine Bag Pcs 0 5,000
504 Urine Bag Standard steril 2 Lt Buah 0 3,915
505 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 0 459,000
507 Urine reagen strip 10 lG Para Meter Botol/100 Stik 0 195,000
508 Anti migrain Botol/100 tab 4 0 0 4 14,900
509 Ambroksol syrup Botol 60ml 0 6,226
510 cyanocobalamine injeksi 1000mcg/ml kotak/100 1 0 1 0 125,345
511 Ibufropen tab 200 mg Botol 100 tab 0 12,100
512 kloramfenikol 3% tetes telinga botol 18 0 16 2 2,607
STOK HARGA
AWAL SATUAN
513 Metformin Hcl tab 500 Kotak/10 blister/10tab 0 11,850
514 Oksitetrasiklin salep 3% kotak/25tb 5gr 0 60,775
516 Etanol 70% Cairan Botol/1000 4 0 0 4 27,272
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 0 10,500
519 Allopurinol 100 mg Kotak/100 10 0 10 0 9,000
520 Chlorpeniramine Maleat(CTM) Kotak/100 183 0 23 160 5,400
521 Ibufropen tab 400 mg Kotak/100 6 0 3 3 16,300
522 Kotrimoksaxole 480 Kotak/100 2 0 0 2 15,200
523 Metformine HCL tab 500 mg Kotak/100 0 27,500
524 Parasetamol Syrup Botol/60 ml 100 0 100 0 1,535
525 Ranitidine tab 150 mg Kotak/30 0 11,550
526 salbutamol 4mg Kotak/100 2 0 2 0 6,500
527 Sefadroksil Kapsul Kotak/100 3 0 3 0 52,900
528 Vit. B-complex Kotak/100 0 11,200
TOTAL 2283.8 0 575.945 1707.855

LAMPIRAN PERSEDIAAN OBAT JKN
LAMPIRAN PERSEDIAAN OBAT JKN
PER 31 DESEMBER 2016
NAMA OBAT KEMASAN
A. NAMA OBAT
Albothyl Conc. Kotak/ 5 ml
Ambroxol Syrup Botol/60 ml
Ambroxol Tablet Kotak/100
Antalgin Tab. 500 mg (Metampiron) Kotak/100
Antihemoroid Doen Kombinasi Kotak/6 Supp.
Asam Borat Serbuk kg
Asam salisilat kristal kg
Asam Ascorbat (Vit C) tablet 50 mg Kotak/100
Asiklovir tab/kapsul/kaplet 200 mg Kotak/25
Asiklovir Salep Kulit Kotak/100
Becefort Syrup Botol 60 ml
Bioplasenton salep Tube
Betahistin Maleat Kotak/30
Betametason Krim 0,1 % (sebagai valerat) Box/2 tube
Daryantulle Box
Dekstran 70 - larutan infus 6% steril Botol
Dextrofen Syrup Botol 60 ml
Diazepam Tab/Kapsul/kaplet 2 mg Botol/100
Dulcolax tab Kotak/200
Eugenol Cairan Botol 10 ml
Eritromicin Syrup kering 200 mg/ 5 ml Botol/60 ml
Fitomenadion (vitamin K) Bayi Kotak @ 10 amp
Gentian Violet Box/24@10 ml
Gliseryl Guaiacolas Tab. 100 mg Botol/1000 tab
Glukosa larutan 5 % steril Botol 500 ml
Hemafort Tablet Box
Hidrokortison krim 2,5 % tube/5gram
Kodein tablet 20 mg Kotak/100
Kloramfenikol salep mata 1 % tube/5gram
Lacto B Box/40
Livron Kotak/100
Lysmin Botol/60 ml
Meloksikam 7,5 mg Box 50 Tab
Meloklopramide Tab. 5 mg Kotak/100
Metokloperamid Injeksi/metolon Kotak/5 Amp
Metokloperamid Tab. 5 mg Kotak/100
Metronidazol 250 mg Kotak/100
Metronidazol 500 mg Kotak/100
Mikonazol Krim/salep 2 % (nitrat) Tube/10 gr
NaCI 0,9 % Botol / 500 ml
Oksitetrasiklin S.K Box/24
Oksitetrasiklin S.M 1% Tube/3,5 gr
Pehacain Injeksi Box
Papaverin Tb 40 mg Botol/1000
Pirasetam Kaps. 800 mg Kotak/100 tab
Piracetam Tablet 400 mg Botol/1000
Piroxicam Tab. 20 mg Box/100 tab
Ringer Laktat Lar. Infus Botol 500 ml
Thiamin HCl Tab. 100 ml Botol/1000
Trombhopob gel tube
Vitamin B-Complex dus 10 strip 10 tab
Vomitrol Syrup Botol/30 ml
B.OBAT GIGI
Bonding Botol
Dentorit/Caviton Botol/30gr
Dengue IgG/IgM (Strip) Kotak / 10
Etil klorida Kaleng
NAMA OBAT KEMASAN
Etsha btl
Glass Ionomer kecil Bungkus/Set
Gutta Percha Kotak
Komposite (a2, a3,a3,5) Set
MATA Bor High set
C. BAHAN HABIS PAKAI/ALAT KESEHATAN
Bisturi No. 15 Box/100 Pcs
Bak Intrumental dengan tutup Pcs
Clip Plastik obat uk. Kecil Bungkus/100
Clip Plastik obat uk. Sedang Bungkus/100
EDTA 10% Botol 100 ml
Gunting Jaringan Pcs
Gunting verban Botol/100
Hipafix Pcs
Jarum Extirpasi
Jarum Hecting (Kulit) Set
Jarum Hecting (Otot) Set
Kertas Puyer bks
Klem Arteri Lurus Pcs
Lancet GEA-1 Box
Lar. H2O2 Liter
Lar. Savion Botol
Larutan Eosin Botol / 100 ml
Larutan Hayem Botol/100 ml
Larutan HCI-Alkohol 3 % Botol/100 ml
Larutan Karbol Fuchsin 0,3 % Botol/100 ml
Larutan Methilen Blue Botol/100 ml
Larutan Spiritus Liter
Larutan Turk Botol/100 ml
Methanol Liter
Nasal Kanul Pcs
Natrium Sitrat Liter
Needle 23 G x 1,5 cc Kotak/ 100 Pcs
Oil Emercy Botol/100 ml
Perhidrol (H2O2) 13 % Liter
Perlak Lembar
Pinset anatomi Pcs
Pinset Chirungel Pcs
Pispot Pcs
Plano Tes (Tes Kehamilan) Kotak / 50
Plester 5 yards sedang Rol
Portex Liter
Rapid Test Hepatitis Kotak/25
Reagen Golongan Darah Box/ 3 x 10 ml
Kotak 8 Vial@5
Reagen Widal Potres
ml
Rees Eker Liquid Btl
Rockless Pot
Slim seher Set
Selimut Pasien Lembar
Stelirisator (Pemanas alkohol) Botol/25 Strip
Uji Tiphoid IgM Kotak/25
Allupurinol tab 100 mg Kotak/100
Ambroxol syrup botol/60 ml
Amlodipin 10 mg kotak/30
Amoxicilin kapsul 250 mg kotak/100
Amoxicilin 500 mg Kotak 100
Amoxicilin syrup kering Botol
Bromhexin tab 8 mg Kotak /100
Ciprofloxacin 500 mg kotak/100
Cefadroksil 500 mg kotak/100
Chrome injeksi kotak 1/10 ampul
Digoxin tab kotak/100
NAMA OBAT KEMASAN
Domperidon tab 10 mg kotak/ 100

Domperidon syrup Botol/60 ml
Eritromisin kapsul 500 mg Kotak/100
Eritromisin syrup kering 200 mg Botol /60 ml
Furosemide tab 40 mg Kotak /100 tab
Glibenclamide tab 5 mg kotak 100
Ibuprofen 200 mg Botol/100 tab
Ibuprofen 200 mg Kotak/100 tab
Ibuprofen suspensi 100 mg Botol 60 ml
kalk (kalsium laktat 500 mg) kotak /100 tab
Kotrimoksasole syrup 240 mg botol/60 ml
Metilergometrin injeksi kotak /100 ampul
Nifedipine tab Blister/30
OBH indoplus botol/100 ml
Omeprazole 20 mg kotak/30
Piridoxin vit B6 Botol 1000 tab
Zink syrup Botol /60 ml
Zink tab Kotak/100
Strip asam urat Botol/25 strip
Strip Kolesterol Botol/10 strip
Total keseluruhan
NAMA OBAT KEMASAN GUDANG DINKES PKM Turikale
OBAT CACING :
Albendazole 400 mg Kotak 30 Tablet 0
Albendazole 400 mg Kotak 30 Tablet 1224
total obat cacing
GIZI :
MP ASI BALITA 35
MPT BUMIL 10
total obat gizi
Total keseluruhan -
NAMA OBAT KEMASAN PKM Turikale
A. NAMA OBAT
Albothyl Conc. Kotak/ 5 ml 10
Ambroxol Syrup Botol/60 ml
Ambroxol Tablet Kotak/100 20
Antalgin Tab. 500 mg (Metampiron) Kotak/100
Antihemoroid Doen Kombinasi Kotak/6 Supp. 50
Asam Borat Serbuk kg
Asam salisilat kristal kg
Asam Ascorbat (Vit C) tablet 50 mg Kotak/100 30000
Asiklovir tab/kapsul/kaplet 200 mg Kotak/25
Asiklovir Salep Kulit Kotak/100
Becefort Syrup Botol 60 ml 50
Bioplasenton salep Tube
Betahistin Maleat Kotak/30
Betametason Krim 0,1 % (sebagai valerat) Box/2 tube 500
Daryantulle Box 5
Dekstran 70 - larutan infus 6% steril Botol
Dextrofen Syrup Botol 60 ml
Diazepam Tab/Kapsul/kaplet 2 mg Botol/100 1000
Dulcolax tab Kotak/200
Eugenol Cairan Botol 10 ml 3
Eritromicin Syrup kering 200 mg/ 5 ml Botol/60 ml
Fitomenadion (vitamin K) Bayi Kotak @ 10 amp
Gentian Violet Box/24@10 ml
Gliseryl Guaiacolas Tab. 100 mg Botol/1000 tab 20
Glukosa larutan 5 % steril Botol 500 ml
Hemafort Tablet Box
Hidrokortison krim 2,5 % tube/5gram 240
Kodein tablet 20 mg Kotak/100
Kloramfenikol salep mata 1 % tube/5gram 72
Lacto B Box/40
Livron Kotak/100
Lysmin Botol/60 ml 50
Meloksikam 7,5 mg Box 50 Tab 20
Meloklopramide Tab. 5 mg Kotak/100
Metokloperamid Injeksi/metolon Kotak/5 Amp 4
Metokloperamid Tab. 5 mg Kotak/100 1000
Metronidazol 250 mg Kotak/100 1000
Metronidazol 500 mg Kotak/100 5000
Mikonazol Krim/salep 2 % (nitrat) Tube/10 gr 150
NaCI 0,9 % Botol / 500 ml
Oksitetrasiklin S.K Box/24 10
Oksitetrasiklin S.M 1% Tube/3,5 gr 100
Pehacain Injeksi Box
Papaverin Tb 40 mg Botol/1000 3
Pirasetam Kaps. 800 mg Kotak/100 tab
Piracetam Tablet 400 mg Botol/1000
Piroxicam Tab. 20 mg Box/100 tab 50
Ringer Laktat Lar. Infus Botol 500 ml
Thiamin HCl Tab. 100 ml Botol/1000 10
Trombhopob gel tube
Vitamin B-Complex dus 10 strip 10 tab
Vomitrol Syrup Botol/30 ml 24
B.OBAT GIGI
Bonding Botol 2
Dentorit/Caviton Botol/30gr 1
Dengue IgG/IgM (Strip) Kotak / 10 2
Etil klorida Kaleng 18
NAMA OBAT KEMASAN PKM Turikale
Etsha btl 1
Glass Ionomer kecil Bungkus/Set
Gutta Percha Kotak 6
Komposite (a2, a3,a3,5) Set
MATA Bor High set 4
C. BAHAN HABIS PAKAI/ALAT KESEHATAN
Bisturi No. 15 Box/100 Pcs 1
Bak Intrumental dengan tutup Pcs
Clip Plastik obat uk. Kecil Bungkus/100
Clip Plastik obat uk. Sedang Bungkus/100
EDTA 10% Botol 100 ml 12
Gunting Jaringan Pcs
Gunting verban Botol/100
Hipafix Pcs
Jarum Extirpasi
Jarum Hecting (Kulit) Set 2
Jarum Hecting (Otot) Set 3
Kertas Puyer bks
Klem Arteri Lurus Pcs
Lancet GEA-1 Box
Lar. H2O2 Liter 2
Lar. Savion Botol
Larutan Eosin Botol / 100 ml
Larutan Hayem Botol/100 ml
Larutan HCI-Alkohol 3 % Botol/100 ml
Larutan Karbol Fuchsin 0,3 % Botol/100 ml
Larutan Methilen Blue Botol/100 ml
Larutan Spiritus Liter
Larutan Turk Botol/100 ml
Methanol Liter
Nasal Kanul Pcs
Natrium Sitrat Liter
Needle 23 G x 1,5 cc Kotak/ 100 Pcs
Oil Emercy Botol/100 ml
Perhidrol (H2O2) 13 % Liter 6
Perlak Lembar 50
Pinset anatomi Pcs
Pinset Chirungel Pcs
Pispot Pcs
Plano Tes (Tes Kehamilan) Kotak / 50
Plester 5 yards sedang Rol 10
Portex Liter
Rapid Test Hepatitis Kotak/25
Reagen Golongan Darah Box/ 3 x 10 ml 2
Reagen Widal Potres Kotak 8 Vial@5 ml
Rees Eker Liquid Btl
Rockless Pot
Slim seher Set
Selimut Pasien Lembar
Stelirisator (Pemanas alkohol) Botol/25 Strip
Uji Tiphoid IgM Kotak/25
Total keseluruhan 39,513.00
PKM
No. Nama Obat Kemasan Harga Satuan PKM Camba PKM Bontoa
Cenrana
A. NAMA OBAT
ACT (Artesunate tablet 50 mg +
1 1 blister@24 tablet 34,656 0 0
2 Adona Injeksi 50 mg Kotak/10 Amp. 280,315 0 0 0
3 Albendazol tablet 400 mg Kotak/30 13,420 0 0 0
4 Albothyl Botol 10 ml 24,700 0 8 0
5 Albothyl Concentrate 5 ml Botol 5 ml 28,870 0 0
6 Allopurinol Tab 100 mg Kotak/100 9,000 0 3 0
7 Allopurinol Tab 300 mg Kotak/30 8,085 0 0 0
8 Allopurinol tab. 300 mg Kotak/100 22,500 0 4 1
9 Ambroksol Tablet Kotak/100 0 0 0
10 Ambroxol Syrup Botol/60 ml 6,510 0 0
11 Ambroxol Syrup Botol/60 ml 3,630 0 66 10

12 Aminofillin Inj. Kotak/30 126,000 0 0 0
13 Aminofillin Tab. 200 mg Botol/100 8,600 0 4 7
14 Amlodipin 5mg Kotak/30 5,910 0 0 0
15 Amoksisilin kapsul/kaplet 250 mg 22,000 0 0
kapsul
Amoksisilin kapsul/kaplet/tablet scored Dus, 10 strip @ 10
16 37,000 136 0
500 mg kaptab
17 Amoksisillin Kapl. 250 mg Kapsul/100 22,000 0 16 5
18 Amoksisillin Kapl. 500 mg Kotak/100 29,200 0 34 71
19 Amoksisillin Syr. Kering Botol/60 ml 2,560 47 145 160
20 Ampicillin Injeksi Kotak/10 59,048 0 0 0
21 Ampisillin Kapl. 500 mg Kotak/100 41,910 0 0 0

22 Ampisillin Syrup Kering Botol/60 ml 4,840 0 0 0
23 Antalgin Tab. 500 mg (Metampiron) Kotak/100 12,650 0 0 0
24 Antasida DOEN Kotak/100 7,800 0 0
25 7,800 0 0
Hidroksida 200 mg
26 Antasida DOEN Tab. Kotak/100 17,820 211 221 175
27 Antasida Syr. Botol 2,300 100 95 6
Anti bakteri Doen salep kombinasi :
28 Kotak/25 69,175 4 3 5
Antifungi Doen Kombinasi : Asam
29 Kotak/24 Pot 91,200 1 0 0
30 Antihemoroid Doen Kombinasi Kotak/10 Supp. 22,000 0 0 1.2
DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 3,350 0 0
GRAM
32 Antimigrain Botol/100 13,563 0 2 1
33 Asam Ascorbat (Vit. C) 50 mg Botol/1000 35,200 0 0 0
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 10,500 0 0 0
35 Asam Folat Kaplet 1 mg Botol/100 5,200 2 1 4
36 Asam mefenamat 500 mg Kotak/100 12,200 86 204 16
37 Asam Mefenamat kapsul/kaplet 500 mg 21,978 50 50
kap
38 Asering Lar. Infus Botol/500 ml 19,800 0 160 0
39 Asiklovir SK Kotak/25 82,500 1 3 1
40 Asiklovir Tab. 200 mg Kotak/100 25,100 3 6 4
41 Atropin Sulfat Inj. Kotak/30 36,000 0 1 0
42 Betahistin tab. 6 mg Kotak/30 33,539 0 14 10
43 Betametason Krim Kotak/25 51,315 0 6 0
44 Betametason Krim Tube/5g 1,596 27 0 108
45 Bisacodil tab Kotak/200 257,070 0 1 0
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 1,362 0 0
47 Bromheksin tab. 8 mg kotak/300 66,517 10 3 1
48 Bromheksin Tab. 8 mg Kotak/100 23,830 0 0
49 Bromheksin Tab. 8 mg Kotak/100 4,237 0 3 21
50 Cefadroxil syrup Botol 5,286 0 0 0
51 Cefotaxime injeksi 1 g kotak/10 35,000 0 0 0
52 Cefotaxime Injeksi 1 g Kotak/2 Vial 15,246 0 0 0
53 Cetirizin kotak/100 38,000 0 12 0
54 Cetirizine Tab. 10 mg Kotak/100 14,000 0 0
55 Cetirizine Tab. 10 mg Kotak/50 19,000 0 0 0
56 Chlorfeniramine Maleat (CTM) 4 mg 45,298
57 Chlorfeniramini Maleat (CTM) 4 mg Botol/1000 26,400 0 2 0
58 122,500 0 0
500 mcg ml
59 Cyanocobalamin Inj. Kotak/100 114,070 1 1 0
60 Cyanocobalamin Tab. Botol/1000 14,412 0 15 0
61 Cyanocobalamin Tablet KOTAK/100 1,441 0 0
62 Cyprofloxacin 500 mg Tab. Kotak/50 14,300 0 0 0
63 Cyprofloxacin 500 mg Tab. Kotak/100 26,500 4 13 10
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 35,465 0 0 0
65 26,500 4 0
HCl) ss
66 Daryantula (Supratula) Box/20 Lmbr 312,000 0 3 0
67 Daryantull 10 x 10 cm Kotak/10 202,500 0 0
68 Daryantulle Box/10 Pcs 178,000 1 0 3
69 Deksametason Injeksi Kotak/100 173,800 0 0 0
70 Dekstran 70 - larutan infus 6% steril Botol 0 0 0
71 Dexamethason Tab. 0,5 mg Kotak/100 7,400 0 0
72 Dexamethason Tab. 0,5 mg Kotak/100 9,570 215 111 193
73 Dextrofen Syrup Botol 60 ml 10,100 0 118 45
74 Dexchlorpheniramine Maleate + Botol/60 ml 11,810 0 0
75 Dextrometrophan Syr. Botol 3,152 0 0 0
76 Dextrometrophan Tab. Kotak/100 12,100 0 0 0
77 Diazepam Injeksi Kotak/30 78,147 0 0 0
Diazepam larutan rektal 5 mg/2,5 ml Dus, 5 alubag @1 tube
78 12,751 0 0
(Stesolid) @ 2,5 ml
79 Diazepam Tab. 2 mg Kotak/100 4,400 9 0 2
80 Diazepam tablet/kapsul/kaplet 2 mg Botol 100 4,700 0 0
81 Difenhidramin Injeksi Kotak/30 34,680 17 1 0
82 Digoxin Tab. 0,25 mg Kotak/100 10,300 13 2 0
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 3,490 0 0
84 Domperidon Tab. 10 mg Kotak /100 17,400 0 14 1
85 Dulcolax Tab 0 0 0
86 Efedrin HCl 25 mg Botol/250 14,097 0 0 0
87 Ekstrak Belladon Botol/100 34,848 0 1 0
88 Epinefrin (Adrenalin) Injeksi 0,1% Kotak/30 267,300 0 1 1
89 Ergotamine cafein Kotak/100 13,563 0 0 0
90 Eritromicin Kaps. 500 mg Kotak/100 102,300 0 0 0
91 Eritromicin Syrup Botol/60 ml 8,090 0 0 7
92 Etakridin larutan 0,1% (Rivanol) Botol/300 ml 1,980 10 5 11
93 Ethanol Botol/1000 22,720 0 0 0
94 Ethanol Botol/100 2,626 0 25 0
95 Eugenol Cairan Botol/10ml 18,333 0 0 2
96 Famotidine kotak/50 6,221 0 0 0
97 Fenilbutason Tab 200 mg (Novason) 152,889
98 Fenilbutason Tab. 200 mg Botol/1000 89,100 0 3 1
99 Fenilbutason Tab. 200 mg (Novason) Botol/100 31,620 7 7
100 Fenobarbital Inj. Kotak/30 0 0 0
101 Fenobarbital Tab. 30 mg Botol/100 7,139 0 0 0
102 Ferrosi sulfas 300 mg tab botol/1000 28,855 0 0 0
103 Fitomenadeon Tab. Botol/100 69,000 3 2 4
Fitomenadion (Vitamin K1) injeksi i.m. 2
104 Dus @ 30 ampul 112,620 0 0
mg/ml
105 Fitomenadion Injeksi Kotak/30 57,420 0 3 3
106 Fitomenadion Tab. Kotak/100 69,000 0 0 0

107 Folic Acid Botol/100 0 0 0
108 Furosemid Tab. 40 mg Kotak/100 8,400 0 0
109 Furosemid Tab. 40 mg Kotak/100 11,229 0 0 0
110 Garam oralit kotak/100 41,800 0 13 0
111 Gentamicin 0,1% Salep Kulit Kotak/25 Tube@5 g 58,030 0 0
112 Gentamicin SK. Kotak/10 20,207 0 6 0
113 Gentamycin 0,1 % SK Kotak/25 55,506 1 0 0
114 Gentian Violet Botol/10 ml 495 3 25 0
115 Glibenclamida 9,900
116 Glibenklamid Tab. 5 mg Kotak/100 6,100 0 4 0
117 Gliseril Guaiacolas Botol/1000 66,790 0 0
118 Gliseril Guaiacolat 52,635
119 Gliseryl Guaiacolas Tab. 100 mg Botol/1000 30,690 9 11 4
120 Glukosa larutan 5 % Botol 500 ml 5,720 40 78 0
121 Griseofulvin tablet 125 mg, micronized Kotak 24,100 0 2 1

122 Hidrochlortiazid Tab. 25 mg Botol/1000 27,104 0 0 0
Dus, 10 strip @ 10
123 Hidroklorotiazid tab 25 mg 16,300 0 0
tablet
124 Hidrokortison krim 2,5 % Tube 2,938 25 50 72
125 Hidrokortison SK Kotak/24 78,650 0 0 0
126 Ibuprofen 200 mg Botol/100 12,705 2 14 14
127 Ibuprofen 400 mg Kotak/100 15,700 0 4 0
128 Ibuprofen Suspensi 200 mg Botol/60 4,949 0 182 25
129 Ibuprofen tablet 200 mg Botol @ 100 tablet 12,100 0 0
130 Ichtiol SK Pot 8,500 0 22 0
131 Ichtiol SK 15 g Kotak/12 Pot 49,720 0 0 0.83
132 Ichtiol SK 15 g Kotak/12 Pot 49,720 0 0
133 Induksin Inj Kotak/10amp 89,700 0 0 0
134 Kalsium Laktat Tab. 500 mg Kotak/100 7,600 13 0 20
135 Kalsium Laktat Tab. 500 mg Botol/1000 43,263 0 0 0
136 Kaptopril 12,5 mg Kotak/100 6,900 0 17 0
137 Kaptopril 25 mg Kotak/100 10,000 0 5 0
138 Ketokonazole 16,000
139 Ketokonazole Tab. 200 mg Kotak/50 22,550 0 6 4
140 Ketokonazole Tab. 200 mg Kotak/100 32,000 0 0 0
141 Ketorolac Injeksi 10 mg Kotak/5 Amp. 41,250 0 0 0
142 Ketorolac Injeksi 30 mg Kotak/6 Amp. 15,990 0 0 0
143 Kloramfenicol Tetes Mata Kotak 0 0 0
144 Kloramfenicol Tetes Telinga 3% Botol 3,150 0 0
145 Kloramfenikol Kaps. 250 mg Kotak/100 29,315 0 0 0
146 Kloramfenikol salep mata kotak/24 41,256 0 0 0
147 Kloramfenikol salep mata Tube/5gr 1,680 0 96 48
148 Kloramfenikol Suspensi Botol/60 ml 4,950 0 8 3
149 Kloramfenikol Tetes Telinga botol/5ml 1,760 10 43 0
150 Klorpromazin HCl inj. 25mg/ml - 1 ml Kotak/Amp 0 0 0
151 Klorpromazin HCl inj. 5mg/ml - 2 ml Kotak/ 30 Amp 34,650 0 0 0
152 Klorpromazin HCl tab 100 mg kotak/100 16,500 0 4 0
153 Klorpromazin HCl tablet salut 100 mg Botol 16,500 0 0 0
154 Klorpromazin HCl tablet salut 25 mg Botol 41,800 0 0 0
155 Kotrimoksasol Tab. 120 mg Kotak/100 8,349 0 0 0
156 Kotrimoksazol 120 mg Kotak/100 10,555 0 0
157 Kotrimoksazol 480 Kotak/100 15,200 5 33 0
158 Kotrimoksazol Syr. Botol/60 2,298 0 166 6
159 Kuinin Dihidroklorida inj.25% - 2 ml Kotak/Amp. 0 0 0
160 Kuinin Sulfat tablet 222 mg (7H2O) Kotak 0 0 0
161 Lacto B Sachet Kotak/4x10 220,000 0 1 1
162 Lacto B Sachet Kotak/4x10 243,510 0 0
163 Lansoprasol 30 mg Kotak/ 30 10,420 0 0 0
164 Lansoprasole 30 mg Kotak/20 10,420 0 2 0
165 Larutan Ringer Laktat botol/100ml 0 0 0
166 Levertran Salep Pot 4,000 0 42 0
167 Levertran Salep Kulit Kotak/12 Pot 37,015 1 0 0
168 Lidocain inj kotak/100 92,900 2 2 2
169 Lidocain Injeksi Kotak/30 37,510 0 0 0
170 Dus, 30 ampul @ 2 ml 63,660 0 0
80.000 - 2 ml
171 Lisol Botol/1000 20,000 1 7 7
172 Lisol Botol 800 ml 20,000 0 0 0
173 Loperamide Kotak/100 10,071 1 2 0
174 Loperamide Kotak/100 9,700 0 0
175 Lorazepam 2 mg Kotak/100 142,300 0 7 3
176 Malaria PF/PV casset Kotak 25 1,953,485 0 0 0
177 Meloksikam 7,5 mg Kotak/20 15,222 0 0 0
178 Meloksikam 7,5 mg Kotak/50 38,055 0 18 0
179 Meloksikam 7,5 mg Kotak/30 26,500 0 0
180 Meloxicam 7,5mg Kotak/30 38,050 0 0 0
181 Metamphyron (Antalgin) Tab. 500 mg Kotak/100 12,650 0 0 0
182 Metformin HCl tab 500 mg Kotak/100 19,965 1 6 0
183 Methylergometrin inj kotak/100 16,868 1 1 0
184 Methylprednisolon 4 mg Kotak/100 23,000 0 1 4
185 Methylprednisolon 8 mg Kotak/100 39,000 0 6 0
186 Metilergometrin Injeksi Kotak/30 49,170 0 0 0
187 275,000 0 0
1 ml ml
188 Metilergometrin Tab 0,125 mg 16,868
189 Metilergometrin Tab. 0,125 mg Kotak/100 13,310 1 5 0
190 Metilergometrin Tab. 0,125 mg Kotak /100 17,715 0 0
191 Metoclorpramide injeksi kotak/5 61,864 0 0 0
192 Metokloperamid Injeksi Kotak/10 Amp @ 2 ml 11,000 0 0 0
193 Metokloperamid Tab. 5 mg Kotak/100 8,668 0 15 1
194 Metokloperamid Tab. 5 mg Kotak/100 11,300 0 0
195 Kotak/5 Ampul 61,870 0 0
(Metolon)
196 Metronidazol 250 mg Kotak/100 15,730 0 0 0
197 Metronidazol 500 mg Kotak/100 24,200 4 9 8
198 Metronidazol 500 mg Kotak/100 16,900 0 0
199 Mikonazol Krim Tube/10 gr 3,300 10 98 64
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 3,150 0 0
201 Myomergin injk Kotak/10 42,500 0 0 0
202 Natrium Diclofenac Tab. 50 mg Kotak/50 9,650 2 23 0
203 Natrium Diklofenak 50 mg Kotak/50 92,333 0 0 0
204 Natrium Klorida (NaCl) 0,9 % Botol / 500 ml 4,545 0 38 19
205 Natrium Klorida (NaCl) 0,9% Botol 500 ml 5,827 0 0
206 Natrium Klorida Larutan Infus Botol 4,545 0 0 0

207 Nifedipin Tab. 20 mg Blister/30 89,970 1 3 4
208 Nistatin Tablet Salut 500.000 IU Kotak/100 70,400 3 0
209 Nistatin Vaginal Kotak/100 40,700 0 0 0
210 Nistatin vaginal tablet 100.000 IU/ g Dus @ 10 X 10 's 52,800 0 0
211 O.B.H. Indo Plus Botol/100 ml 8,052 0 40 3
212 O.B.H. Syr. Botol/100 ml 1,573 0 0 0
213 Obat antituberkulosis kategori 1 Paket 395,900 0 0 0
214 Obat antituberkulosis kategori 2 Paket 1,319,900 0 0 0
215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml 13,400 0 0
216 Oksitetra S.K Kotak/25 45,403 0 3 1
217 Oksitetra S.K Tube/10 gr 3,686 0 0 0
218 Oksitetra S.M 1% Kotak/25 52,800 0 0 0
219 Oksitetra S.M 1% Tube/3,5 gr 2,310 50 0 50
220 Oksitetra Salep Mata 1 % 3,327

221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g 61,000 0 0
222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g 3,850 0 0
223 Oksitosin Inj. Kotak/30 Amp. 58,905 0 0 0

Kotak/100 Ampul @ 1
224 Oksitosin injeksi 10 IU/ml 242,000 0 0
ml
225 Omeprazole Tab. 20 mg Kotak/30 6,630 0 0 0
226 Oxitosin inj 10 IU/ml Kotak/100 amp 312,500 0 0 3
227 Papaverin Tab. Botol/1000 264,100 0 0
228 Papaverin Tab 40 mg Botol/1000 109,450 1 2 1
229 Parasetamol Drops Botol 15 ml 5,808 0 0 0

Parasetamol drops 100 mg/ml btl @15 ml
230 Botol 5,720 0 0
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 1,535 20 140 148
232 Parasetamol Tab. 500 mg Kotak/100 8,800 113 155 0
233 Pirantel Pamoat 125 mg Kotak/100 31,800 4 4 6
234 Pirantel Pamoat syr Botol/60 9,100 0 0 0
235 Pirantel suspensi Botol/60 9,100 0 0 0
236 Piridoksin HCl Tab 10 mg 36,685

237 Piridoksin HCl Tab. 10 mg Botol/1000 33,000 2 20 3
238 Piridoksin HCl Tab. 10 mg Kotak/100 12,100 0 0
239 Piroxicam Tab 20 mg 19,816

240 Piroxicam Tab. 20 mg Kotak/100 11,550 7 31 19
241 Piroxicam Tab. 20 mg Kotak/100 21,000 0 0
242 Povidum Iodium Botol/300 ml 15,386 9 12 11
243 Povidum Iodium Botol/30ml 2,640 57 13 4
244 Povidum Iodium Botol/10ml 2,344 0 0 0
245 Povidum Iodium Botol /30 ml 2,344 0 0
246 Predmisone Botol / 100 68,750 8 44 0
247 Prednison Tab. 5 mg Botol/1000 68,750 0 0 0
248 Prednison Tab. 5 mg Kotak/100 12,500 0 12

Dus,10 blister @10
249 Primakuin tablet 15 mg 20,500 0 1
tablet
250 Propanolol Tab. 10 mg Kotak/100 8,000 0 4 0
251 Propiltiourasil Tab 10 mg 35,100

252 Propiltiourasil Tab. 100 mg Botol/100 32,953 6 8 0
253 Pyrantel syrp Botol 9,100 0 0 0
254 Pyrantel tab Kotak/100 31,800 0 0 0
255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp) 13,400 4 1 0
256 Ranitidin Tab. 150 mg Kotak/100 13,200 0 1 0
257 Reserpin tablet 0,10 mg Kotak 20,680 0 0 0
258 Reserpin tablet 0,25 mg Kotak 0 0 0
259 Ringer Laktat Botol 1000 ml 8,000 260 45 13
260 Ringer Laktat Lar. Infus Botol 500 ml 5,720 0 0 0
261 Ringer Laktat Lar. Infus Botol 500 ml 6,500 0 0
262 Ringer Laktat Lar. Infus (Tutup karet 3 lub Botol 500 ml 12,000 0 0 0
263 Salbutamol 2 mg Tab. Kotak/100 9,243 0 0 0
264 Salbutamol 4 mg Tab. Kotak/100 9,900 0 15 0
265 Salep 2 - 4 Kotak/24 96,000 0 0 0

266 Pot @ 30 gram 2,797 0 0
+ Belerang endap 4%
Salep 2-4 Kombinasi:Asam Salisilat 2% +
267 Pot @ 30 gram 2,200 42 0 152
Belerang Endap 4%
268 Salisil Bedak Kotak 1,573 0 36 0
269 Salisil Bedak 1,350

270 Sefadroksil 500 mg Kotak/100 52,900 0 3 0
271 Sefadroksil Syrp Botol 60 ml 5,286 0 42 0

Dus, 3 Strip @ 10
272 Simvastatin scored tablet 10 mg 3,690 0 0
273 Simvastatin Tab. 10 mg Kotak/50 28,215 0 0 0
274 Simvastatin Tab. 10 mg Kotak/100 17,700 0 2 0
275 Stesolid Injeksi Kotak/5 Amp. 78,147 0 0 0
276 Stesolid Rektal Tub. Pcs 5 ml 28,512 0 5 0
277 Superhoid Kotak/100 0 0 0
278 Superoid Supp Kotak/6 0 0 0
279 Tablet Tambah Darah (SF) Botol/1000 28,855 0 0 0
280 Tetrasiklin 250 Kaplet Botol/1000 183,425 0 0 0
281 Tetrasiklin 250 Kaplet Kotak/100 16,200 0 6 0
282 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 37,928 0 0
283 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 50,090 0 0
284 Thiamin HCl Injeksi Kotak/30 25,300 2 1 0
285 Thiamin HCl Tab. Botol/1000 41,580 2 11 16
286 Thiamin HCl Tab. 50 mg 71,351

287 Thiamin HCl Tablet 50 mg Botol/1000 74,455 0 0
288 Vaksin Rabies kuur 750,000 0 0 0
289 Vomitrol Syrup Botol 5,519 0 0 0
290 Zinc Syrup Botol/60 ml 8,140 5 72 82
291 Zink phosfat Set 276,750 0 0 0
B. PROGRAM GIZI 0
292 Becefort Botol 20,700 7 31 35
293 Hemafort Kotak/100 90,750 0 0 0
294 Livron kotak/100 25,300 1 16 8
295 lysmin Botol/60 ml 25,080 0 0 0

296 + Vit.B12 5 mcg + Vit.C 50 mg + Vit.D Botol/60 ml 25,080 10 88 4
Multivitamin
HCl 200 mg/5sirup
ml). (Vit.A 5000 UI + Vit.D
(Lysmin)
1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 26,120 0 0
HCl)
298 Botol/60 ml 21,700 0 0
299 Kotak/100 27,450 0 0
CuSO4 )

300 Kotak/100 90,700 0 0
intrinstik)

301 Kotak/100 90,750 0 55 12
302 Nistatin Tab salut 500000 IU Kotak/100 70,400 0 1 3
303 Retinol (Vitamin A) 100.000 IU Botol/50 Kaps 14,025 0 0 0
304 Retinol (Vitamin A) 200.000 IU Botol/50 Kaps 18,447 0 0 0
305 Retinol (Vitamin A) 100.000 IU Botol/50 kapsul 14,300 0 0
306 Vitamin B Complex Kotak/100 11,200 0 0
307 Vitamin B-Complex Botol/1000 24,420 0 6 0
C. OBAT GIGI 0 0
308 Air raksa dental use Botol 0 0 0
309 Albothyl 5 ml (obat gigi) Botol/5ml 24,700 0 0 4
310 Bonding 216,000 0 0 0
311 Bonding Botol 356,730 0 0
312 Bonding 283,500
313 Calcinol / Urbical Box/2 Tube 535,095 0 0 0
314 Calcinol/ Urbical 877,500
315 Chlorphenol Kampher Menthol (CHKM) Botol/20 ml 60,500 0 0 0
316 Cresopen Botol/13 ml 538,650 0 0 0

317 Cresopen 762,750
318 Dentorit/Caviton Botol/30gr 155,250 0 0 0
319 Dentorit/Caviton Botol 201,886 0 0
320 Dentorit/caviton 263,250
321 Devitasol Pasta (Devitac) Botol/4,5 610,200 0 0 1
322 Devitasol Pasta (Devitac) Botol 647,660 0 0
323 Etil klorida Kaleng 115,500 4 7 13
324 Etil klorida Kaleng 101,250 0 0
325 Etil klorida Kaleng 109,451 0 0
326 Etsha btl 101,250 0 0 2
327 Etsha Botol 262,683 0 0
328 Eugenol Cairan Kotak 12 Botol @ 15 ml 605,000 0 0 0
329 Glass Ionomer Cement Bungkus/Set 434,500 0 0 0

330 Glass Ionomer Cement (Vitro Molar) Bungkus/Set 1,119,375 0 0
331 Glass Ionomer Cement (Vitro Molar) 1,309,500
332 Gutta Percha Box/200 Stik 67,500 0 0 0
333 Gutta Percha Kotak 54,000 0 0
334 Jarum (Carefull) Set 168,750 0 0 0
335 Jarum (Carefull) Set 182,250 0 0
336 Jarum (Carefull) Set 208,093 0 0
337 Mata Bor High set 217,500 0 0 0
338 Mata Bor High Set 270,000 0 0
339 Natrium Hipoklorit 3% Liter 27,000 0 0
340 Paper Point No. 15 Kotak/200 stik 67,500 0 0 0
341 Paper Point No. 15 Kotak 60,750 0 0
342 Paper Point No. 20 Kotak/200 stik 37,000 0 0 0
343 Pehacain Injeksi Kotak/20 66,510 0 0
344 Rockless Botol 742,500 0 0 0
345 Rockless Botol 988,142 0 0
346 Spongostan Kotak/10 70,000 0 0 22
347 Spongostan Box/10 pcs 168,250 0 0
348 Spongostan Box/10 pcs 181,877 0 0
349 Tambalan Komposit Set 1,464,441 0 0 2
350 Tambalan komposit ( natural look) 1,650,800
351 Tambalan Komposit (Natural Look) Set 1,014,894 0 0
352 Xylestesin Kotak 528,000 0 16 5
353 Xylestesin 573,750
354 Set/Kotak 276,750 0 0 0
Liquid)
355 Zinc tablet kotak/100 52,250 0 8 0

356 Alat Suntik / Spoit 1 cc Kotak/100 120,175 0 2 0.63
358 Alat Suntik / Spoit 20 cc Kotak/100 185,000 0 0 0
359 Alat suntik / Spoit 3 cc Kotak/100 120,000 6 8 0.29
361 Alat Suntik / Spoit 50 cc Kotak/100 168,000 0 0 0
362 Alkohol Swamb Dos 29,563 0 0 0
363 Aqua Pro Injeksi Botol 20 ml 5,225 0 0 360
364 Aquadest Steril Kotak/120@25 Botol 327,600 2 40 0
365 Asam Klorida (HCl) 0,1 N Botol/100 ml 10,800 0 0 1
366 Bisturi No. 15 Box/100 Pcs 91,000 0 0 4
367 Bisturi No.15 Box/100 pcs 101,250 0 0
368 Blood Lancet Kotak/100 27,000 1 0 5

369 Kotak/24 649,000 4 3 1.792
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 174,870 0 0
371 Deck Glass Kotak/100 51,300 0 0 1
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 84,825 0 0
373 Disp. Syringe With Needle 10 cc Box/100 pcs 120,713 0 0

374 Disp. Syringe with Needle 3 cc Box/100 pcs 84,825 0 0
375 Disp. Syringe With Needle 5 cc Box/100 pcs 97,875 0 0
376 EDTA 10% Botol 100 ml 97,500 0 0 1

377 EDTA 10% Botol/100 ml 20,250 0 0
378 Elastis Perban 4 Inch Rol 88,150 0 2 0
379 Foley Catheter Pcs 9,345 0 0 6
380 Folley Catheter 2 way No. 18 Box/10 pcs 104,400 1 0
381 Giemsa Stain Botol/100 100,000 0 0 1
382 Giemsa Stain Botol/100 ml 47,250 0 0

383 Hifavix 5x5 cm Rol 76,050 4 2 10
384 Hipavix 5 x 5 cm Rol 79,446 0 0
385 Hipavix 5 x 5 cm Pcs 70,265 0 0
386 Infus set Anak Kantong/Set 3,850 33 75 0
387 Infus set Dewasa Kantong/Set 4,400 150 231 0
388 Infusion Set Anak/Pediatric (60 drops/ml) Buah 4,568 0 7

389 Infusion Set Dewasa (20 drops/ml) Buah 4,176 0 44
390 IV Catheter No. 18 Kotak/50 428,313 0 2 0.9
391 IV Catheter No. 18 G x 32 mm Buah 4,959 70 0
392 IV Catheter No. 20 Kotak/50 428,313 0 2 0
393 IV Catheter No. 20 G x 11/4 mm Buah 4,959 50 39
395 IV Catheter No. 22 G x 1 mm Buah 4,959 50 0
397 IV Catheter No. 24 G x 3/4 mm Buah 4,959 50 35
398 Jarum Ekstirpasi 142,750
399 Jarum Extirpasi 155,000 0 0 0
400 Jarum Extirpasi Set 199,985 0 0
401 Jarum Kulit No. 11 Pcs 1,950 0 0 48
402 Jarum Kulit No. 11 24,300
403 Jarum Kulit No.11 Set 17,405 0 0
404 Jarum Otot No. 11 Pcs 1,950 0 0 36
405 Jarum Otot No. 11 24,300
406 Jarum Otot No.11 Set 17,405 0 0
407 Kapas Pembalut/absorben 250 g Rol 8,250 7 10 7
408 Kapas pembalut/absorben 250 gram Roll 16,313 0 0
409 Kasa 40 x 80 cm Roll 118,800 0 0 9
410 Kasa Hydrofil Steril 18 m x 22 cm Kotak/12 Lmbr 5,225 88 66 100
411 Kasa Hydrofil Steril 18 m x 22 cm Box/12 7,700 0 0
412 Kasa Hydrofil Steril 36 m x 80 cm Rol 114,500 4 10 0
413 Kasa Hydrophil 40 x 80 cm Roll 137,025 0 0
414 Kasa Pembalut 4 m x 10 cm Roll 1,958 0 50
415 Kasa Pembalut Elastis 3 inci Rol 6,250 0 5 4
416 Kasa Pembalut Elastis 3 inci Rol 7,700 0 0
417 Kasa Pembalut Hydrofil 4 m x 10 cm Rol/50 33,385 0 4 1.6
418 Kasa Pembalut Hydrofil 4 m x 5 cm Rol/100 33,385 0 0 1
419 Kertas Puyer bks 6,250 0 0 15
420 Kertas Puyer Bungkus 7,425 0 0
421 Klip Plastik besar Kotak/100 0 0 0
422 Klip Plastik Obat Ukuran Kecil Bungkus/100 3,500 0 0 0
423 Klip Plastik Obat Ukuran Sedang Bungkus/100 5,000 0 0 40
424 Klip Plastik Obat Ukuran Sedang Bungkus/100 5,000 0 0
425 Botol/100 ml 87,750 0 0
Conc. 30 ml
426 Larutan Eosin Botol/100 114,750 0 0 0
427 Larutan Hayem Botol 49,000 0 0 1
428 Larutan Hayem Botol/100 ml 60,750 0 0
429 Larutan Hayem Botol/100 ml 64,860 0 0
430 Larutan karbol Fuchsin 0,3% Botol/100 ml 105,000 0 0 0
431 Larutan Methilen Blue Botol/100 ml 47,250 0 0 0
432 Botol/100 ml 55,941 0 0
ml
433 Larutan Spiritus Liter 38,475 0 0 4
434 Larutan Spiritus Liter 47,250 0 0
435 Larutan Spiritus Liter 32,430 0 0
436 Larutan Turk Botol 49,000 0 0 1
437 Larutan Turk Botol/100 ml 13,500 0 0
438 Larutan Turk Botol/100 ml 32,430 0 0
Latex Examination Glove L (Sarung
439 Box/100 Buah 42,413 3 8
Tangan)
440 Latex Examination Glove L, M, S Box/100 Pcs 42,413 0 0 0
Latex Examination Glove M (Sarung
441 Box/100 Buah 42,413 2 12
Tangan)
Latex Examination Glove S (Sarung
442 Box/100 Buah 42,413 3 13
Tangan)
443 Lisol Botol/1000 ml 53,505 0 0
444 Masker Kotak/20 24,750 0 0 0
445 Masker Kotak/50 21,533 2 7 0
446 Methanol Liter 16,250 0 0 1
447 Methanol Liter 33,750 0 0
448 Methylen Blue Botol 47,250 0 0 0

449 Natrium Sitrat Liter 136,000 0 0 0
450 Natrium Sitrat Liter 60,750 0 0
451 Needle 23 G x 1,5 cc Kotak/100 Pcs 27,000 0 0 0
452 Objeck Glass Kotak/100 22,275 0 0 5
453 Objeck Glass Kotak/72 21,620 0 0

454 Oil Emercy Botol/100 ml 490,000 0 0 0
455 Oil Emercy Botol/100 ml 371,250 0 0
456 Oksigen (O2) 6 Kubik 162,500 0 0 0
457 Oksigen (O2) 1 kubik 75,000 0 0 0
458 Oksigen (O2) 1 1/2 kubik 85,000 0 0 0
459 Oksigen (O2) 1 kubik Kubik 74,345 0 0
460 Oksigen (O2) 6 kubik Kubik 138,864 0 0
461 Perhidrol (H2O2) 13% Liter 37,125 0 0 0
462 Perlak lembar 0 0 0
463 Plano Tes (Tes Kehamilan) Kotak/50 74,250 0

464 Plester 5 yard x 2 inci Roll 36,450 0 0
465 Plester 5 yard x 2 inci Roll 34,592 0
466 Plester 5 yards x 2 inci Rol 26,208 7 11 9
467 Porstex botol/1000 20,000 0 6 4
468 Portex Botol 21,620 0

469 Rapid Test Hepatitis Kotak/25 tes 773,795 0 0 0
470 RDT DBD IgG/IgM Kotak/25 3,819,338 0 0 0
471 RDT DBD NS1 Kotak/25 0 0 0
472 RDT DBD NS1 (Dengue Antigen) Kotak/25 2,824,113 0
473 Reagen Golongan Darah Botol/10 ml 280,000 0 0 0
474 Reagen Golongan Darah 365,000
475 Reagen Golongan Darah (A, B, AB) Botol/3X10 ml 248,630 0
476 Reagen Tidal Kotak/4 vial 607,500 0 0 0
477 Reagen Tidal Kotak/4 vial 484,828 0
478 Reagen Widal Kotak 8 Vial@5 ml 1,730,916 0 0 0

479 Botol/500 ml 577,254 0
Hemoglobin)
480 Rivanol (Etakridin larutan 0,1%) Botol/300 ml 3,328 0
481 Sarung Tangan (Hands Scoon) Kotak/25 42,500 0 0 0
482 Sarung Tangan L, M, S Kotak/100 42,413 8 0
483 Silk (Benang Bedah Sutra ) Kotak/24 276,540 2 3 0
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 143,550 0 0 0.94
485 Strip Asam Urat Botol/25 Strip 120,000 0 0 2
486 Strip Asam Urat Botol/25 Strip 118,910 0
487 Strip Asam Urat 121,500
488 Strip Gula Botol/25 Strip 117,000 0 0 1
489 Strip Gula Botol/25 Strip 121,500 0
490 Strip Gula Botol/25 Strip 108,100 0
491 Strip Kolesterol Botol/10 Strip 183,000 0 0 0
492 Strip Kolesterol Botol/10 Strip 183,600 0
493 Strip Kolesterol Botol/10 Strip 183,770 0
494 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 21,533 15

495 Tes Tuberkulin Pcs 881,250 0 0 0
496 Test Pack Kotak/50 100,000 0 2 3

497 Uji Dengue IgG/IgM 25 Test 1,932,287 0
498 Uji Hepatitis BsAg Box/25 505,367 0
499 Uji Leptospira IgM Kotak/25 Test 1,932,287 0
500 Uji Malaria Box/25 1,062,757 0
501 Uji Tifoid IgM Box/25 1,545,830 0
502 Uji Tiphoid IgM Kotak/25 1,799,875 0 0 0
503 Urine Bag Pcs 5,000 20 25 1
504 Urine Bag Standard steril 2 Lt Buah 3,915 0
505 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 459,000 0
506 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 243,225 0
507 Urine reagen strip 10 lG Para Meter Botol/100 Stik 195,000 0 0 1
39,600,000.00
LAMPIRAN PERSEDIAAN OBAT
PUSKESMAS CENRANA KAB MAROS
PER 30 JUNI 2016
PKM PKM PKM PKM PKM PKM PKM PKM PKM PKM
Tompobulu Mallawa Tanralili Marusu Simbang Mandai Turikale Moncongloe Bantimurung Maros baru
0 2 1 0 0 0 0
2
2 8 1 0 0 0 0 2
0 0 0 0 0 0 0 0
0 0 0 0 3 13 0 1
0 10 0 0 0 0 0
0 0 0 0 2 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 298 0 0 0 0 17
47 30 0 0 72 40 0 23 33
0 5 1 0 0 0 0 2
0 14 0 0 6 0 8 4
4 0 0 0 0 0 0 1
0 0 0 0 0 0 0
320 638 0 0 0 0 0
0 15 2 0 42 0 0 7
0 210 81 44 585 149 0 115 51
0 190 0 0 0 17 33 75
236
0 0 0 0 0 0 0
0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 315
0 473 0 0 0 160 72
0 150 0 0 0 0 0
169 0 310 209 450 160 277 620 157

62 140 94 0 102 222 127 53 100
0 0 26 5 9 34 1 9.6 1
2 5 4 2 7 5 2 4
15
0 0 0 2 0 0 0 6
0 0 0 0 0 0 0
0 1 6 4 0 4 5 2
0 0 0 0 0 0 0 0
15 75 0 26 0 207 17 0
11 10 0 5 0 0 0 6
266 200 330 357 703 186 162 474 188
70 300 0 0 0 67 0
40 480 20 90 0 0 115 120

0 1 0 0 3 0 3 0 1
21 7 50 0 20 57 20 15 10
1 0 1 0 0 0 1 9
0 30 0 1 0 0 0 3
0 0 0 0 9 0 0 0
148 300 0 170 0 475 40 26
3 0 0 0 0 0 0 1.65
0 5 0 0 0 0 0
13 3 0 3 0 0 0 0
0 68 0 0 0 0 0
0 1 0 0 4 0 0 2 5
0 -80 0 0 0 135 0 0
0 2 0 0 0 0 0 0
0 0 0 0 0 0 0 10
21 0 0 0 0 18 0 18 10
0 40 0 0 0 18 0
0 5 0 0 0 0 5 0
3
5 0 0 0 7 0 0 0
0 3 0 0 0 0 0
1 0 1.5 1 0 0 0 3.8 5
0 0 0 0 8 0 0 0
5
0 0 0 0 0 0 0 0
0 0 0 0 0 42 0 3
33 55 0 12 0 42 25 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 20 0 0 0 0 0
7 0 0 0 2 8 1 5
0 0 0 0 0 0 0 0.75
0 0 0 0 0 0 0 0
0 300 0 0 0 100
119 20 374 311 432 478 353 471 146
51 0 0 0 0 18 0 70
0 300 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0.8 0 0 0 0 0
0 45 0 0 0 0 5
2 26 0 0 0 8 0 0
0 2 0 3 0 0 16
9 1 1 1 0 9 4 11
1 2 7 5 0 0 6 7
0 0 0 0 0 0 0
0 5 0 0 0 0 6 13 7
0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0
0 27 0 0 5 0 1 4 6
0 0 6 0 0 0 1 4.8
0 0 0 0 0 0 0 12 5
0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0
2 0 10 6 1 14 0 9
0 0 0 0 0 0 0 1
0 0 21 23 0 0 12 7
0 2 0 0 0 0 0 0
0 0 0 0 0 0 0 0
2
1 0 0.3 2.8 6 3 0 4
0 20 0 0 0 7 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 10
2 5 20 0 5 4 3 11 5
0 8 0 0 0 0 3
4 1 2 3 5 3 5 7
0 0 0 0 9 0 0
2 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 10 0 0 0 3 0 21
0 0 0 0 0 4 0 0
0 12 0 0 0 0 0
2 0 0 0 15 2 0 0 1
3 0 0 2 5 0 2 2.8
0 6 69 0 144 0 26 42
15
2 5 0 22 32 11 0 4
0 45 0 0 0 0 8
5
15 1 16 4 2 16 0 0 4
150 20 189 0 0 91 39 255 64
0 1 6 0 40 2 8 9 21
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 114 68 0 110 43
4.5 0 0 0 0 2 0 0
0 0 9 36 15 0 10 0
8 15 0 0 5 0 8 0
62 15 58 15 200 8 40 124 70
0 10 0 0 0 0 5
9 0 0 0 48 48 0 0 16
0 7 0 1 0 4 3 0.21
0 0 0 0 0 0 5
0 0 0 0 0 0 0 0
29 70 10 34 70 48 27 18
0 0 0 0 0 0 0 0
0 0 6 0 40 0 20 1
4 50 0 0 16 19 4 29
2
0 11 0 8 30 0 8 0 17
0 0 0 0 0 0 0 0
1 0 0 0 0 0 0 5
0 0 0 0 0 0 0 8.5
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 5 0 0 0 48 24 0
0 0 0 0 0 0 0 0
0 2 0 0 74 24 16 98
0 0 0 0 0 0 0 0
1 1 0 0 0 0 0 5
3 2 1 0 0 0 2 0
0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0
0 0 0 0 0 8 0 20
0 0 0 0 0 0 0
12 25 6 11 127 4 7 0
0 5 0 0 0 0 12 12 151
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 1 0.5 0 0 1 0 2.75
0 1 0 0 1 1 0
0 0 0 0 0 0 0 0 10
0 35 0 0 0 0 0 0
0 0 0 0 0 0 0
16 0 0 0 66 37 0 7
0 11 21 0 0 3.1 10 2.74
0 2 2.64 0.6 7 7 6 9.55
4 0 0 0 0 0 5 0
0 20 0 0 0 0 0
0 0 0 9 11 4 0 11 3
0 0 0 0 0 0 0 0
3 0 0 10 18 0 1 6 9
0 35 0 0 0 0 1
0 4 1 0 0 5 5 15 2
0 0 0 0 0 0 0 0
0 0 0 0 20 0 0 6.7 5
0 0 0 0 0 0 0 0
0 75 0 0 0 0 0
15 0 21 0 0 11.3 0 0
0 0 0 0 0 0 0 0
0 0 0 0 4 0 2 0 5
0 0 0 0 0 0 0
5 5 0 0 0 0 0 11 5
0 0 0 0 0 0 0 0
0 0 0 0 2 2 0 1
0 2 0 0 0 0 2
0
3 0 0 3 6 3 0 11
0 0 0 0 0 0 0
0 5 0 0 0 0 4 0.5
0 0 2 0 0 0 0
4 0 1.4 8 0 20 0 1
0 11 0 0 0 0 3
0 10 0 0 0 0 0
0.5
0 0 0 0 0 2 0 0
16 0 0 12 18 23 0 0
0 65 0 0 0 0 12
287 0 0 0 228 26 28 0
0 500 0 0 0 0 100
0 0 0 0 0 0 0 2
0 100 0 11 0 15 16 13 10
14 0 1 0 20 0 0 0
130 5 52 64 0 43 72 187 60
0 100 0 0 0 0 0
0 0 0 0 0 0 0 0
0 5 0 0 4 0 0 1
0 5 0 0 0 0 5
2 0 9 3 0 3 0 5
0 9 0 0 2 0 3
8 5 0 0 25 63 0 41 67
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 150 0 0 0 0 0
3 0 0 3 6 8 0 4.6
0 0 0 30 0 0 83 0
0 0 0 0 0 2 0 0
180 0 0 135 143 45 60
10
0 9 0 0 0 0 2
0 200 0 0 0 0 50
0 1 0 0 0 2 0 0 3
0 4 0.75 0 0 0 0
1 30 0 0 0 18 0 4 5
2 3 0 1 1 2 0 0
0 5 0 0 0 0 1
3 0 2.6 2 1 0 0 2 7
11 0 5 0 112 0 24 50
0 20 0 0 0 0 0
410 280 0 0 740 320 180 65 50
10 130 0 76 50 141 72 17
0 5 1 4 21 7 4 0 5
0 56 0 0 0 0 0 0
0 0 0 15 24 0 23 5
3
19 0 0 3 0 7 0 0 2
0 0 0 0 0 0 0
3
0 10 0 7 29 41 0 6 11
0 90 0 0 0 0 15
8 12 14 9 25 19 10 11 5
75 0 47 20 26 170 0 70 50
0 70 0 0 0 0 30 6
0 50 0 0 0 0 0
37 0 0 38 0 0 0 0 45
0 0 0 0 0 0 0 0
0 80 1 0 0 82 40
0 2 1 0 0 1 0 1
0 0 10 7 0 0 1 13
2
0 15 3.9 5 4 0 2 3
0 0 0 0 0 7 0 10
0 0 0 0 0 0 0 10
0 0 3 0 0 0 0 0
0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
250 50 100 96 0 42 50 0
200 0 101 0 0 0 0 372 30
0 1200 0 0 0 0 0
0 0 0 0 0 0 0 0 63
0 0 0 0 0 0 0 0
7 9 0 20 49 0 8 1
0 0 0 0 13 7 0 0 7
0 0 0 0 0 0 0
0 5 0 48 0 57 147
6 0 0 12 0 0 13 7
30
0 0 0 0 0 0 0 0
100 300 0 0 70 0 67 39
0 60 0 0 0 0 0 14
0 0 0 0 0 0 0 0 4
0 0 0 0 8 0 0
0 0 0 0 0 0 0
0 0 13 0 0 0 0 20
0 0 0 0 0 0 0 0
0 3 0 0 0 35 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
18 2 0 0 81 0 37 13 5
0 15 0 0 0 0 0
0 5 0 0 0 0 0
3 0 1.7 0 0 0 0 4
11 6 69 3 29 52 0 5
5
0 25 0 0 0 0 5
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 3
30 30 0 25 0 0 26 82 50
0 0 0 0 0 0 0 0
0 0 0 0 0 0
24 5 0 5 0 0 0 2 19
0 0 0 0 0 0 0 0
8 2 0 0 16 6 0
0
0 5 0 0 0 0 0
0
87 0 0 0 0 0 0 0
0 220 0 0 0 0 0
14
0 151 0 0 0 0 25
0 35 0 0 0 0 7
0 60 0 0 0 0 4
40 0 0 0 0 12 0
0
2 0 9 6 5 3 4 2 1
5 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0
0 0 0 0 0 0 0
0 30 0 0 0 0 0 8
5 10 7 0 96 0 14 0 9
0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 2 0 13 0 4
0 0 0 0 0 0 0 3
0 2 0 0 0 0 0
1
0 0 0 0 2 0 0
0
0 0 0 0 0 0 0
3
1 0 0 0 0 0 0 2
1
0 0 0 0 0 0 0 4
0 2 0 0 1 0 0
1
0 0 0 0 0 0 0 3
0 0 0 0 0 0 0
13 4 1 18 5 25 2 15
0 35 0 0 0 0 5
0 5 0 0 0 0 0
0 0 0 0 0 0 0 3
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0
1 0 0 0 1 0 0 7
0 3 0 0 0 0 0
0
0 0 0 0 10 10 0 2
0 0 0 0 0 0 2
1 0 3 4 0 2 0 2
0 5 0 0 0 0 2
0 0 0 0 0 0 0
0 0 0 1 5 0 0 2
0 2 0 0 0 0 0
0 0 3 2 0 0 0
0 0 0 2 0 5 0 12
0 3 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 2 0 1 1
0 3 0 0 0 0 0
1 0 4 12 9 3 0 4
0 10 0 0 0 0 4
0 0 0 0 0 0 0
0 0 0 0 0 0 0 2
0
0 2 0 0 0 0 0
0 0 0 5 0 17 0 3
5
0 0 0 0 0 0 0
6
0 0 0 0 0 0 0 0
0 0 0 0 0
2 0 3 6.5 2 1 1 5.8
2 0 1 0 4 0 2 9 6.77
0 0 0 0 0 2 0 0
11 2 4.3 5 2 0 0 6.35
8 0 0 2 4 2 5 2.5 5.95
0 0 0 0 0 0.8 0 0
0 0 0 4 14 0 5 4 4
0 30 0 89 0 56 26
0 0 26 0 0 0 0 7.85
0 5 0 2 0 0 1 18
1 0 1 3 4 1 0 1 1
0 6 0 0 0 0 1
4 2 0 8 9 12 2 7
7 0 3 3 6 3 2 8.09
0 22 0 0 0 0 2
0 0 0 10 0 0 0
0 21 0 0 0 0 0
0 1 0 0 0 0 0
0 45 0 0 0 0 8
0 19 0 0 0 0 0
0 0 0 2 0 15 0 19
0 0 0 0 0 0 0
0 0 3 0 0 9 0 0
1 0 13 0 20 34 1 17
0 2 1 0 0 0 0
0 0 0 3 0 3 0 4
0 0 0 0 0 0 1
10 0 10 10 10 7 5 3
0 50 0 0 0 0 5
0 10 0 0 0 0 0
73 0 27 83 50 46 2 126
214 25 75 80 50 95 20 12
0 250 15 0 0 7 10
0 850 55 0 0 44 30
4.4 0 0 0 2 0 0.54 0 1
0 450 90 0 0 0 50 89
5 2 0 2 0 0 0 1
0 300 35 50 0 39 0 135
2.4 1 0 1 0 0 0 0 1
0 100 36 50 0 0 0 57
3.4 0 0.75 0 1 0 0.14 0 3
0 350 90 50 0 35 50 42
0
0 0 0 0 0 5 0 13
0 3 0 0 0 0 0
0 0 0 0 6 2 0 0
12
0 10 0 0 0 0 0
0 0 2 0 8 3 0 0
12
0 10 0 0 0 0 0
12 0 7 13 10 5 0 4 7
0 25 0 0 0 0 8
7 0 14 13 0 3 5 0 2
13 10 39 169 216 3 28 98 5
0 40 0 0 0 0 0
0 0 0 0 7 3 0 0
0 40 0 0 0 0 0
0 150 0 0 0 50 0
0 0 7 0 0 0 17 10
0 5 0 0 0 0 0
20 0 0 5 19 0 3 14 6
0 0 13 0 0 21 0 64
10 2 0 28 0 0 30 10
0 30 0 0 0 0 15
0 0 0 0 0 0 0
0 2 0 0 0 0 18 10
0 5 0 20 0 0 22
0 30 0 0 0 0 0
0 5 0 0 0 0 1
0 0 0 0 0 0 1 7
0 0 0 0 0 2 0 20
0 0 0 0 0 0 1
0 0 0 0 0 0 0
5 0 0 0 0 0 0 0
0 0 0 0 0 0 1 9
0 0 0 0 0 0 0
2 0 1 2 2 0 0 11
0 0 0 0 0 0 2
0 0 0 0 0 0 0
0 0 0 0 0 0 1 13
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 19 9 0 0 8 0 1
9
17 0 0 0 0 8 1
0 10 3 0 0 12 10 4
5
0 5 6 0 0 13 10 5
13
0 2 5 0 0 0 5
0 0 0 0 9 0 0 0
11 10 3 10 0 10 0 4
0 0 0 0 0 0 0 8
0 0 0 0 0 0 2
0 0 0 0 0 0 0
2 0 0 0 0 0 0 7
0 0 0 0 0 0 0
0 0 1 0 0 0 0 0
0 0 0 2 8 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 8
0 0 0 0 0 0 0
0 0 0 0 10 0 0 0
0 0 0 0 10 0 0 0
0 0 0 0 0 0 0 0
0 40 0 0 0 0 0
0 40 0 0 0 0 0
2 0 1 0 0 11 3 14
0 0 0 0 0 40 0
0 21 0 0 0 0 6
0 70 0 0 0 0 6
0 0 0 0 0 0 0
4 0 25 6 14 9 1 15 3
0 5 0 3 0 0 0 3
0 15 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
1 1 0 0 0 0 0 3
0
0 3 0 0 0 0 0
0 2 0 0 0 0 0
0 2 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 14 0 0 0 0 2
1 0 0 0 27 0 0 0
0 0 0 43 0 0 0
2 0 0 1 4 4 2 0
0 6 0 0 0 0 1 3.24
0 0 0 0 4 0 0 1
0 0 0 0 0 0 0
3
0 0 0 0 3 0 0 4
0 38 0 0 0 0 4
0 0 0 0 0 0 0
0 0 0 0 5 0 0 5
0 30 0 0 0 0 0
0 10 0 0 0 0 0
0 20 0 0 0 15 4
0 0 5 0 0 0 0
4 0 0 6 10 0 2 3.9 4
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
7 3 41 0 20 5 25 69
0 25 0 0 0 0 0
0 3 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 1 4 0 0 2
klinik PKM
Total satuan Harga Satuan Jumlah
setda Lau
5 34,656 173,280
13 280,315 3,644,095
0 13,420 -
25 24,700 617,500
10 28,870 288,700
2 7 9,000 63,000
0 8,085 -
5 22,500 112,500
0 -
315 6,510 2,050,650
321 3,630 1,165,230

8 126,000 1,008,000
12 55 8,600 473,000
10 15 5,910 88,650
0 22,000 -
1094 37,000 40,478,000
87 22,000 1,914,000
14 1354 29,200 39,536,800
30 933 2,560 2,388,480
0 59,048 -
0 41,910 -
0 4,840 -
315 12,650 3,984,750
705 7,800 5,499,000
150 7,800 1,170,000
9 2968 17,820 52,889,760

12 1113 2,300 2,559,900
97.6 69,175 6,751,480
47 91,200 4,286,400
9.2 22,000 202,400
0 3350 -
25 13,563 339,075
0 35,200 -
13 353 10,500 3,706,500
39 5,200 202,800
9 3181 12,200 38,808,200
537 21,978 11,802,186
1025 19,800 20,295,000

13 82,500 1,072,500
3 216 25,100 5,421,600
13 36,000 468,000
58 33,539 1,945,262
15 51,315 769,725
2 1296 1,596 2,068,416
5.65 257,070 1,452,446
5 1,362 6,810
3 36 66,517 2,394,612
68 23,830 1,620,440
36 4,237 152,532
55 5,286 290,730
2 35,000 70,000
10 15,246 152,460
79 38,000 3,002,000
58 14,000 812,000
9 19 19,000 361,000
3 Rp 45,298 135,894
14 26,400 369,600
3 122,500 367,500
14.3 114,070 1,631,201

1 24 14,412 345,888
5 1,441.20 7,206
1 1 14,300 14,300
13 85 26,500 2,252,500
167 35,465 5,922,655
4 8 26,500 212,000
3 312,000 936,000
20 202,500 4,050,000
27 178,000 4,806,000
1 1.75 173,800 304,150
0 -
400 7,400 2,960,000
11 3234 9,570 30,949,380
302 10,100 3,050,200
300 11,810 3,543,000
0 3,152 -
0 12,100 -
0.8 78,147 62,518
50 12,751 637,550
47 4,400 206,800
2 23 4,700 108,100
54 34,680 1,872,720
1 44 10,300 453,200
0 3,490 -
2 48 17,400 835,200
0 -
1 14,097 14,097
44 34,848 1,533,312
1 14.8 267,300 3,956,040
17 13,563 230,571
2 102,300 204,600
7 8,090 56,630
68 1,980 134,640
1 22,720 22,720
7 95 2,626 249,470
4 18,333 73,332
0 6,221 -
2 Rp 152,889 305,778
21.1 89,100 1,880,010
41 31,620 1,296,420
0 -
0 7,139 -
10 28,855 288,550
64 69,000 4,416,000
11 112,620 1,238,820
36 57,420 2,067,120
9 69,000 621,000
2 -
0 8,400 -
2 36 11,229 404,244
17 41,800 710,600
12 58,030 696,360
26 20,207 525,382
15.8 55,506 876,995
315 495 155,925
15 Rp 9,900 148,500
7 87 6,100 530,700
4 57 66,790 3,807,030
5 Rp 52,635 263,175
82 30,690 2,516,580
3 929 5,720 5,313,880
90 24,100 2,169,000
0 27,104 -
0 16300 -
482 2,938 1,416,116

1 7.5 78,650 589,875
100 12,705 1,270,500
6 46 15,700 722,200
5 804 4,949 3,978,996
15 12,100 181,500
143 8,500 1,215,500
16.04 49,720 797,509
5 49,720 248,600
0 89,700 -
339 7,600 2,576,400
0 43,263 -
2 86 6,900 593,400
2 129 10,000 1,290,000
2 Rp 16,000 32,000
84 22,550 1,894,200
0 32,000 -
6 41,250 247,500
8.5 15,990 135,915
0 -
0 3,150 -
0 29,315 -
0 41,256 -
221 1,680 371,280
11 4,950 54,450
267 1,760 469,920
0 -
7 34,650 242,550
12 16,500 198,000
5 16,500 82,500
0 41,800 -
28 8,349 233,772
0 10,555 -
230 15,200 3,496,000
352 2,298 808,896
0 -
0 -
7.25 220,000 1,595,000
3 243,510 730,530
4 14 10,420 145,880
14 51 10,420 531,420
0 -
168 4,000 672,000
48.84 37,015 1,807,813
2 42.79 92,900 3,975,191
9 37,510 337,590
20 63660 1,273,200
53 20,000 1,060,000
0 20,000 -
50 10,071 503,550
36 9,700 349,200
2 44 142,300 6,261,200
0 1,953,485 -
31.7 15,222 482,537
18 38,055 684,990
75 26,500 1,987,500
36 38,050 1,369,800
0 12,650 -
1 19 19,965 379,335
2 16,868 33,736
4 35 23,000 805,000
6 39,000 234,000
5 49,170 245,850
4 275,000 1,100,000
0 Rp 16,868 -
32 13,310 425,920
0 17,715 -
9.5 61,864 587,708
2 11,000 22,000
50.4 8,668 436,867
14 11,300 158,200
10.5 61,870 649,635
2 15,730 31,460
1 91 24,200 2,202,200
77 16,900 1,301,300
48 789 3,300 2,603,700
600 3,150 1,890,000
2 42,500 85,000
190 9,650 1,833,500
15 50 92,333 4,616,650
670 4,545 3,045,150
100 5827 582,700
0 4,545 -
18 89,970 1,619,460
13 70,400 915,200
22 40,700 895,400
14 52,800 739,200
252 8,052 2,029,104
0 1,573 -
0 395,900 -
0 1,319,900 -
150 13,400 2,010,000
28.6 45,403 1,298,526
25 138 3,686 508,668
2 52,800 105,600
663 2,310 1,531,530
10 Rp 3,327 33,270
11 61,000 671,000
250 3,850 962,500
6 58,905 353,430
4.75 242,000 1,149,500
58 6,630 384,540
12 312,500 3,750,000
6 264,100 1,584,600
21.6 109,450 2,364,120
202 5,808 1,173,216

20 5,720 114,400
50 2403 1,535 3,688,605
5 769 8,800 6,767,200
5 66 31,800 2,098,800
56 9,100 509,600
67 9,100 609,700
3 Rp 36,685 110,055
4 60 33,000 1,980,000
0 12,100 -
3 Rp 19,816 59,448
10 171 11,550 1,975,050
105 21,000 2,205,000
145 15,386 2,230,970
532 2,640 1,404,480
106 2,344 248,464
50 2,344 117,200
172 68,750 11,825,000
0 68,750 -
215 12,500 2,687,500
6 20,500 123,000
35 8,000 280,000
2 Rp 35,100 70,200
46.9 32,953 1,545,496
17 9,100 154,700
10 31,800 318,000
8 13,400 107,200
5 10 13,200 132,000
0 20,680 -
0 -
906 8,000 7,248,000
703 5,720 4,021,160
1200 6,500 7,800,000
63 12,000 756,000
0 9,243 -
1 110 9,900 1,089,000
27 96,000 2,592,000
0 2797 -
451 2,200 992,200
10 84 1,573 132,132
30 Rp 1,350 40,500
3 52,900 158,700
618 5,286 3,266,748
74 3,690 273,060
4 28,215 112,860
10 17,700 177,000
0 78,147 -
38 28,512 1,083,456
0 -
38 -
0 28,855 -
0 183,425 -
162 16,200 2,624,400
15 37,928 568,920
5 50,090 250,450
11.7 25,300 296,010
204 41,580 8,482,320
5 Rp 71,351 356,755
4 34 74,455 2,531,470
0 750,000 -
3 5,519 16,557
20 422 8,140 3,435,080
0 276,750 -
0 -
128 20,700 2,649,600
4 4 90,750 363,000
57 25,300 1,442,100
5 25,080 125,400
189 25,080 4,740,120
234 26,120 6,112,080
176 21,700 3,819,200
1 43 27,450 1,180,350
64 90,700 5,804,800
119 90,750 10,799,250
36 70,400 2,534,400
5 14,025 70,125
1 18,447 18,447
0 14,300 -
38 11,200 425,600
10 157 24,420 3,833,940
0 -
0 -
23 24,700 568,100
3 216,000 648,000
2 356,730 713,460
1 Rp 283,500 283,500
2 535,095 1,070,190
0 Rp 877,500 -
3 60,500 181,500
3 538,650 1,615,950
1 Rp 762,750 762,750
4 155,250 621,000
3 201,886 605,658
1 Rp 263,250 263,250
4 610,200 2,440,800
0 647,660 -
107 115,500 12,358,500
40 101,250 4,050,000
5 109,451 547,255
5 101,250 506,250
0 262,683 -
0 605,000 -
9 434,500 3,910,500
3 1,119,375 3,358,125
0 Rp 1,309,500 -
22 67,500 1,485,000
2 54,000 108,000
12 168,750 2,025,000
7 182,250 1,275,750
0 208,093 -
8 217,500 1,740,000
2 270,000 540,000
5 27,000 135,000
19 67,500 1,282,500
3 60,750 182,250
0 37,000 -
0 66,510 -
4 742,500 2,970,000
3 988,142 2,964,426
55 70,000 3,850,000
14 168,250 2,355,500
0 181,877 -
4 1,464,441 5,857,764
0 Rp 1,650,800 -
2 1,014,894 2,029,788
46 528,000 24,288,000
5 Rp 573,750 2,868,750
6 276,750 1,660,500
8 52,250 418,000
0 -
23.93 120,175 2,875,788
25.46 175,000 4,455,500
2 185,000 370,000
44.94 120,000 5,392,800
31.14 114,180 3,555,565
0.8 168,000 134,400
31 29,563 916,453
561 5,225 2,931,225
75.85 327,600 24,848,460
27 10,800 291,600
16 91,000 1,456,000
7 101,250 708,750
50 27,000 1,350,000
40.882 649,000 26,532,418
24 174,870 4,196,880
11 51,300 564,300
21 84,825 1,781,325
1 120,713 120,713
53 84,825 4,495,725
19 97,875 1,859,625
37 97,500 3,607,500
0 20,250 -
14 88,150 1,234,100
92 9,345 859,740
4 104,400 417,600
11 100,000 1,100,000
1 47,250 47,250
71 76,050 5,399,550
55 79,446 4,369,530
10 70,265 702,650
515 3,850 1,982,750
952 4,400 4,188,800
289 4,568 1,320,152

1023 4,176 4,272,048
10.84 428,313 4,642,913
749 4,959 3,714,291
12 428,313 5,139,756
648 4,959 3,213,432
5.4 428,313 2,312,890
293 4,959 1,452,987
11.29 428,313 4,835,654
702 4,959 3,481,218
0 Rp 142,750 -
18 155,000 2,790,000
3 199,985 599,955
56 1,950 109,200
12 Rp 24,300 291,600
10 17,405 174,050
49 1,950 95,550
12 Rp 24,300 291,600
10 17,405 174,050
82 8,250 676,500
33 16,313 538,329
53 118,800 6,296,400
835 5,225 4,362,875
6 46 7,700 354,200
24 114,500 2,748,000
40 137,025 5,481,000
250 1,958 489,500
43 6,250 268,750
5 7,700 38,500
72.6 33,385 2,423,751
99 33,385 3,305,115
95 6,250 593,750
45 7,425 334,125
0 -
30 3,500 105,000
87 5,000 435,000
30 5,000 150,000
6 87,750 526,500
8 114,750 918,000
23 49,000 1,127,000
1 60,750 60,750
0 64,860 -
5 105,000 525,000
10 47,250 472,500
0 55,941 -
22 38,475 846,450
2 47,250 94,500
0 32,430 -
15 49,000 735,000
0 13,500 -
0 32,430 -
57 42,413 2,417,541
26 42,413 1,102,738
58 42,413 2,459,954
68 42,413 2,884,084
12 53,505 642,060
9 24,750 222,750
57 21,533 1,227,381
9 16,250 146,250
2 33,750 67,500
0 47,250 -
9 136,000 1,224,000
0 60,750 -
1 27,000 27,000
15 22,275 334,125
0 21,620 -
8 490,000 3,920,000
0 371,250 -
10 162,500 1,625,000
10 75,000 750,000
0 85,000 -
40 74,345 2,973,800
40 138,864 5,554,560
31 37,125 1,150,875
40 -
27 74,250 2,004,750
76 36,450 2,770,200
0 34,592 -
104 26,208 2,725,632
21 20,000 420,000
15 21,620 324,300
0 773,795 -
2 3,819,338 7,638,676
0 -
0 2,824,113 -
5 280,000 1,400,000
0 Rp 365,000 -
3 248,630 745,890
2 607,500 1,215,000
2 484,828 969,656
0 1,730,916 -
0 577,254 -
16 3,328 53,248
28 42,500 1,190,000
51 42,413 2,163,063
18 276,540 4,977,720
11.18 143,550 1,604,889
7 120,000 840,000
0 118,910 -
3 Rp 121,500 364,500
8 117,000 936,000
42 121,500 5,103,000
0 108,100 -
10 183,000 1,830,000
30 183,600 5,508,000
10 183,770 1,837,700
54 21,533 1,162,782
5 881,250 4,406,250
34.9 100,000 3,490,000

0 1,932,287 -
0 505,367 -
0 1,932,287 -
0 1,062,757 -
0 1,545,830 -
0 1,799,875 -
216 5,000 1,080,000
25 3,915 97,875
3 459,000 1,377,000
0 243,225 -
8 195,000 1,560,000
965,781,526
total 1,931,563,052
555,231,511
BULAN FEBRUARI 2017
STOK
AWAL
A. NAMA OBAT
8 Allopurinol tab. 300 mg Kotak/100 0
kapsul
16 0 40 41
500 mg kaptab
25 0
Hidroksida 200 mg

28 Kotak/25 0 0 3
Antifungi Doen Kombinasi : Asam 2.95

29 Kotak/24 Pot 0 0.625 2.325
DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 0
GRAM
32 Antimigrain Botol/100 0
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 0
37 Asam Mefenamat kapsul/kaplet 500 mg 0 30 0
kap
STOK
AWAL
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 0
58 0
500 mcg ml
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 0
65 0
HCl) ss
78 0 0 8
(Stesolid) @ 2,5 ml
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 0
85 Dulcolax Tab 0
STOK
AWAL
104 Dus @ 30 ampul 0 0 1
mg/ml
113 Gentamycin 0,1 % SK Kotak/25 0
115 Glibenclamida 0
117 Gliseril Guaiacolas Botol/1000 0
118 Gliseril Guaiacolat 11 0 3 8
Dus, 10 strip @ 10
123 Hidroklorotiazid tab 25 mg 0
tablet
134 Kalsium Laktat Tab. 500 mg Kotak/100 0
138 Ketokonazole 0
STOK
AWAL
147 Kloramfenikol salep mata Tube/5gr 0
156 Kotrimoksazol 120 mg Kotak/100 0
168 Lidocain inj kotak/100 2 0 0.25 1.75
170 Dus, 30 ampul @ 2 ml 0
80.000 - 2 ml
187 0
1 ml ml

195 Kotak/5 Ampul 0
(Metolon)
STOK
AWAL
207 Nifedipin Tab. 20 mg Blister/30 0
Kotak/100 Ampul @ 1
224 Oksitosin injeksi 10 IU/ml 0
ml
226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.41 0 0 0.41
228 Papaverin Tab 40 mg Botol/1000 0
230 Botol 0 14 0
(60 mg/0,6 ml)
233 Pirantel Pamoat 125 mg Kotak/100 6 0 0.5 5.5
241 Piroxicam Tab. 20 mg Kotak/100 0
249 Primakuin tablet 15 mg 0 0 1
tablet
251 Propiltiourasil Tab 10 mg Botol/100 0
STOK
AWAL
252 Propiltiourasil Tab. 100 mg Botol/100 0
265 Salep 2 - 4 Kotak/24 0
266 Pot @ 30 gram 0
+ Belerang endap 4%
267 Pot @ 30 gram 0 9 10
Belerang Endap 4%
Dus, 3 Strip @ 10
272 Simvastatin scored tablet 10 mg 0
287 Thiamin HCl Tablet 50 mg Botol/1000 0
0
B. PROGRAM GIZI 0
294 Livron kotak/100 3 0 3 0

STOK
AWAL


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
HCl)
298 Botol/60 ml 0
299 Kotak/100 0
CuSO4 )

300 Kotak/100 0
intrinstik)

301 Kotak/100 0
C. OBAT GIGI 0
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0

317 Cresopen 0
326 Etsha btl 0
327 Etsha Botol 0

STOK
AWAL
353 Xylestesin 0
354 Set/Kotak 0
Liquid)
0
356 Alat Suntik / Spoit 1 cc Kotak/100 1.37 0 0.36 1.01
357 Alat Suntik / Spoit 10 cc Kotak/100 0.95 0 0 0.95
362 Alkohol Swamb Dos 0
363 Aqua Pro Injeksi Botol 20 ml 0
368 Blood Lancet Kotak/100 0
369 Kotak/24 0
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 3.875 0 0.625 3.25
371 Deck Glass Kotak/100 0
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 0
374 Disp. Syringe with Needle 3 cc Box/100 pcs 4 0 1.05 2.95
380 Folley Catheter 2 way No. 18 Box/10 pcs 1 0 0.1 0.9
STOK
AWAL

409 Kasa 40 x 80 cm Roll 0
425 Botol/100 ml 0
Conc. 30 ml
432 Botol/100 ml 0
ml
STOK
AWAL
439 Box/100 Buah 0 1 8
Tangan)
441 Box/100 Buah 0
Tangan)
442 Box/100 Buah 0
Tangan)
443 Lisol Botol/1000 ml 5 0 1 4
462 Perlak lembar 0
468 Portex Botol 0
479 Botol/500 ml 0
Hemoglobin)
STOK
AWAL
503 Urine Bag Pcs 0
510 cyanocobalamine injeksi 1000mcg/ml kotak/100 0
516 Etanol 70% Cairan Botol/1000 4 0 3 1
519 Allopurinol 100 mg Kotak/100 0
524 Parasetamol Syrup Botol/60 ml 0
526 salbutamol 4mg Kotak/100 0
527 Sefadroksil Kapsul Kotak/100 0
TOTAL 1707.855 0 396.51 1311.345

BULAN FEBRUARI 2017
STOK HARGA
AWAL SATUAN
A. NAMA OBAT
1 1 blister@24 tablet 0 1 0 34,656
8 Allopurinol tab. 300 mg Kotak/100 0 22,500
14 Amlodipin 5mg Kotak/30 0 5,910
kapsul
16 0 40 41 37,000
500 mg kaptab
19 Amoksisillin Syr. Kering Botol/60 ml 0 2,560
25 0 7,800
Hidroksida 200 mg

28 Kotak/25 0 0 3 69,175
Antifungi Doen Kombinasi : Asam 2.95

29 Kotak/24 Pot 0 0.625 2.325 91,200
DUS, 10 SUPP @ 2
GRAM
32 Antimigrain Botol/100 0 13,563
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 0 10,500
37 Asam Mefenamat kapsul/kaplet 500 mg 0 30 0 21,978
kap
STOK HARGA
AWAL SATUAN
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 0 1,362
58 0 122,500
500 mcg ml
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 0 35,465
65 0 26,500
HCl) ss
78 0 0 8 12,751
(Stesolid) @ 2,5 ml
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 0 3,49
85 Dulcolax Tab 0
STOK HARGA
AWAL SATUAN
104 Dus @ 30 ampul 0 0 1 112,620
mg/ml
113 Gentamycin 0,1 % SK Kotak/25 0 55,506
117 Gliseril Guaiacolas Botol/1000 0 66,79
118 Gliseril Guaiacolat 11 0 3 8 Rp 52,635
Dus, 10 strip @ 10
123 Hidroklorotiazid tab 25 mg 0 1630
tablet
127 Ibuprofen 400 mg Kotak/100 0 15,700
134 Kalsium Laktat Tab. 500 mg Kotak/100 0 7,600
STOK HARGA
AWAL SATUAN
147 Kloramfenikol salep mata Tube/5gr 0 1,680
156 Kotrimoksazol 120 mg Kotak/100 0 10,555
168 Lidocain inj kotak/100 2 0 0.25 1.75 92,900
170 Dus, 30 ampul @ 2 ml 0 6366
80.000 - 2 ml
171 Lisol Botol/1000 0 20,000
172 Lisol Botol 800 ml 0 20,000
187 0 275,000
1 ml ml

195 Kotak/5 Ampul 0 61,87
(Metolon)
STOK HARGA
AWAL SATUAN
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 0 3,150
207 Nifedipin Tab. 20 mg Blister/30 0 89,970
212 O.B.H. Syr. Botol/100 ml 0 1,573
Kotak/100 Ampul @ 1
224 Oksitosin injeksi 10 IU/ml 0 242,000
ml
226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.41 0 0 0.41 312,500
228 Papaverin Tab 40 mg Botol/1000 0 109,450
230 Botol 0 14 0 5,720
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 0 1,535
233 Pirantel Pamoat 125 mg Kotak/100 6 0 0.5 5.5 31,800
241 Piroxicam Tab. 20 mg Kotak/100 0 21,00
249 Primakuin tablet 15 mg 0 0 1 20,500
tablet
251 Propiltiourasil Tab 10 mg Botol/100 0 Rp 35,100
STOK HARGA
AWAL SATUAN
252 Propiltiourasil Tab. 100 mg Botol/100 0 32,953
265 Salep 2 - 4 Kotak/24 0 96,000
266 Pot @ 30 gram 0 279
+ Belerang endap 4%
267 Pot @ 30 gram 0 9 10 2,200
Belerang Endap 4%
270 Sefadroksil 500 mg Kotak/100 0 52,900
Dus, 3 Strip @ 10
272 Simvastatin scored tablet 10 mg 0 3,690

287 Thiamin HCl Tablet 50 mg Botol/1000 0 74,45
290 Zinc Syrup Botol/60 ml 0 8,140
0
B. PROGRAM GIZI 0
294 Livron kotak/100 3 0 3 0 25,300

STOK HARGA
AWAL SATUAN


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0 26,120
HCl)
298 Botol/60 ml 0 21,700
299 Kotak/100 0 27,450
CuSO4 )

300 Kotak/100 0 90,700
intrinstik)

301 Kotak/100 0 90,750
C. OBAT GIGI 0
310 Bonding 0 216,000
312 Bonding 0 Rp 283,500

326 Etsha btl 0 101,250

STOK HARGA
AWAL SATUAN
354 Set/Kotak 0 276,750
Liquid)
0
356 Alat Suntik / Spoit 1 cc Kotak/100 1.37 0 0.36 1.01 120,175
357 Alat Suntik / Spoit 10 cc Kotak/100 0.95 0 0 0.95 175,000
362 Alkohol Swamb Dos 0 29,563
363 Aqua Pro Injeksi Botol 20 ml 0 5,225
368 Blood Lancet Kotak/100 0 27,000
369 Kotak/24 0 649,000
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 3.875 0 0.625 3.25 174,870
371 Deck Glass Kotak/100 0 51,300
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 0 84,825
374 Disp. Syringe with Needle 3 cc Box/100 pcs 4 0 1.05 2.95 84,825
376 EDTA 10% Botol 100 ml 0 97,500
377 EDTA 10% Botol/100 ml 0 20,250
380 Folley Catheter 2 way No. 18 Box/10 pcs 1 0 0.1 0.9 104,400
384 Hipavix 5 x 5 cm Rol 0 79,446
385 Hipavix 5 x 5 cm Pcs 0 70,265
STOK HARGA
AWAL SATUAN

404 Jarum Otot No. 11 Pcs 5 0 0 5 1,950
405 Jarum Otot No. 11 0 Rp 24,300
409 Kasa 40 x 80 cm Roll 0 118,800
413 Kasa Hydrophil 40 x 80 cm Roll 0 137,025
414 Kasa Pembalut 4 m x 10 cm Roll 0 1,958
425 Botol/100 ml 0 87,750
Conc. 30 ml
432 Botol/100 ml 0 55,941
ml
STOK HARGA
AWAL SATUAN
439 Box/100 Buah 0 1 8 42,413
Tangan)
441 Box/100 Buah 0 42,413
Tangan)
442 Box/100 Buah 0 42,413
Tangan)
443 Lisol Botol/1000 ml 5 0 1 4 53,505
444 Masker Kotak/20 0 24,750
445 Masker Kotak/50 0 21,533
456 Oksigen (O2) 6 Kubik 0 162,500
457 Oksigen (O2) 1 kubik 0 75,000
458 Oksigen (O2) 1 1/2 kubik 0 85,000
462 Perlak lembar 0
465 Plester 5 yard x 2 inci Roll 0 34,592
467 Porstex botol/1000 0 20,000
479 Botol/500 ml 0 577,254
Hemoglobin)
STOK HARGA
AWAL SATUAN
500 Uji Malaria Box/25 0 1,062,757
510 cyanocobalamine injeksi 1000mcg/ml kotak/100 0 125,345
516 Etanol 70% Cairan Botol/1000 4 0 3 1 27,272
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 0 10,500
519 Allopurinol 100 mg Kotak/100 0 9,000
524 Parasetamol Syrup Botol/60 ml 0 1,535
526 salbutamol 4mg Kotak/100 0 6,500
527 Sefadroksil Kapsul Kotak/100 0 52,900
TOTAL 1707.855 0 396.51 1311.345

BULAN MARET 2017
STOK
AWAL
A. NAMA OBAT
1 1 blister@24 tablet 0
8 Allopurinol tab. 300 mg Kotak/100 0 10 0 10
14 Amlodipin 5mg Kotak/30 0 5 5 0
kapsul
Amoksisilin kapsul/kaplet/tablet scored
16 Dus, 10 strip @ 10 kaptab 41 50 37 54
500 mg
19 Amoksisillin Syr. Kering Botol/60 ml 0 200 0 200
kunyah,kombinasi: Alumunium
25 Dus 10 Strip @ 10 tablet 0
Hidroksida 200 mg Magnesium
Hidroksida 200 mg

28 Kotak/25 3 5 2 6

29 Kotak/24 Pot 2.325 0 0 2.325
DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 0 5 0 5
GRAM
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 0 120 39 81
37 Asam Mefenamat kapsul/kaplet 500 mg Dus, 10 blister @ 10 kap

STOK
AWAL
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 0 5 0 5
48 Bromheksin Tab. 8 mg Kotak/100 0 10 4 6
Cyanocobalamin (vitamin B12) injeksi
58 Kotak/100 ampul @ 1 ml 0
500 mcg
65 0
HCl) ss
Diazepam larutan rektal 5 mg/2,5 ml Dus, 5 alubag @1 tube @
78 8 0 0 8
(Stesolid) 2,5 ml
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 0 30 0 30
85 Dulcolax Tab 0
STOK
AWAL
104 Dus @ 30 ampul 1 0 0 1
mg/ml
115 Glibenclamida 0
117 Gliseril Guaiacolas Botol/1000 0 10 0 10
118 Gliseril Guaiacolat 8 0 3.5 4.5
123 Hidroklorotiazid tab 25 mg Dus, 10 strip @ 10 tablet 0

127 Ibuprofen 400 mg Kotak/100 0 5 5 0
138 Ketokonazole 0
STOK
AWAL
147 Kloramfenikol salep mata Tube/5gr 0 100 0 100
156 Kotrimoksazol 120 mg Kotak/100 0 5 0 5
168 Lidocain inj kotak/100 1.75 0 0.1 1.65
170 Dus, 30 ampul @ 2 ml 0 5 0 5
80.000 - 2 ml
Metilergometrin Maleat injeksi 0,200 mg-
187 Kotak/100 Ampul @ 1 ml 0
1 ml
195 Kotak/5 Ampul 0
(Metolon)
198 Metronidazol 500 mg Kotak/100 0 3 2 1
STOK
AWAL
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 0 25 0 25
210 Nistatin vaginal tablet 100.000 IU/ g Dus @ 10 X 10 's 0
218 Oksitetra S.M 1% Kotak/25 0
220 Oksitetra Salep Mata 1 % 0
224 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml 0

230 Botol 0 5 5 0
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 0 200 168 32
233 Pirantel Pamoat 125 mg Kotak/100 5.5 3 4 4.5
249 Primakuin tablet 15 mg Dus,10 blister @10 tablet 1 0 0 1

STOK
AWAL
265 Salep 2 - 4 Kotak/24 0
266 Pot @ 30 gram 0 100 0 100
+ Belerang endap 4%
267 Pot @ 30 gram 10 0 5 5
Belerang Endap 4%
270 Sefadroksil 500 mg Kotak/100 0 30 5 25
Dus, 3 Strip @ 10 Kaplet
272 Simvastatin scored tablet 10 mg 0 30 17 13
salut selaput
285 Thiamin HCl Tab. Botol/1000 8 0 3.5 4.5
287 Thiamin HCl Tablet 50 mg Botol/1000 0 5 0 5
290 Zinc Syrup Botol/60 ml 0 50 10 40
0
B. PROGRAM GIZI 0
294 Livron kotak/100 0

STOK
AWAL


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
HCl)
298 Botol/60 ml 0
299 Kotak/100 0
CuSO4 )

300 Kotak/100 0
intrinstik)

301 Kotak/100 0
C. OBAT GIGI 0
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0

317 Cresopen 0
326 Etsha btl 0
327 Etsha Botol 0

STOK
AWAL
353 Xylestesin 0
354 Set/Kotak 0
Liquid)
0
356 Alat Suntik / Spoit 1 cc Kotak/100 1.01 0 0.1 0.91
357 Alat Suntik / Spoit 10 cc Kotak/100 0.95 0 0 0.95
363 Aqua Pro Injeksi Botol 20 ml 0 20 8 12
364 Aquadest Steril Kotak/120@25 Botol 0
368 Blood Lancet Kotak/100 0 3 2 1
369 Kotak/24 0
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 3.25 0 0.2 3.05
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 0 1 0 1
374 Disp. Syringe with Needle 3 cc Box/100 pcs 2.95 0 0.65 2.3
380 Folley Catheter 2 way No. 18 Box/10 pcs 0.9 0 0 0.9
STOK
AWAL

413 Kasa Hydrophil 40 x 80 cm Roll 0 5 1 4
414 Kasa Pembalut 4 m x 10 cm Roll 0 50 25 25
425 Botol/100 ml 0
Conc. 30 ml
432 Botol/100 ml 0
ml
STOK
AWAL
439 Box/100 Buah 8 0 0 8
Tangan)
441 Box/100 Buah 0
Tangan)
442 Box/100 Buah 0
Tangan)
443 Lisol Botol/1000 ml 4 0 0 4
462 Perlak lembar 0
468 Portex Botol 0
479 Botol/500 ml 0
Hemoglobin)
STOK
AWAL
503 Urine Bag Pcs 0
516 Etanol 70% Cairan Botol/1000 1 5 1.2 4.8
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 0 72 57 15
521 Ibufropen tab 400 mg Kotak/100 0
0
OBAT TAMBAHAN 2017 0
1 Amlodipin tablet 5 mg Box, 10 strips@10 tab 0 5 1 4
2 Kotak/24 Pot 0 2 0 2
Kotrimoksazol Suspensi Komb.
5 Sulfametoksazol 200 mg + Trimetoprim Dus, botol @ 60 ml 0 50 20 30
40 mg/5 ml
6 Kotrimoksazol Syrup Botol/60 ml 0 50 0 50
7 Kloramfenicol suspensi 125 mg/5 ml Botol @ 60 ml 0 5 0 5
8 Metformin HCl tab 500 mg Box, 10 strips@10 tab 0 5 0 5
9 Ranitidin tablet 150 mg Dus, 3 Strip@10 tab 0 20 20 0
10 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 0 5 3 2
12 Kapas pembalut/absorben 250 gram Roll 0 2 0 2
STOK
AWAL
13 Box/100 Buah 0 10 3 7
Tangan)
14 Box/100 Buah 0 5 2 3
Tangan)
TOTAL 1311.345 2064 746.25 2629.095

BULAN MARET 2017
STOK HARGA
AWAL SATUAN
A. NAMA OBAT
1 1 blister@24 tablet 0 34,65
8 Allopurinol tab. 300 mg Kotak/100 0 10 0 10 22,50
14 Amlodipin 5mg Kotak/30 0 5 5 0 5,91
kapsul
16 Dus, 10 strip @ 10 kaptab 41 50 37 54 37,00
500 mg
19 Amoksisillin Syr. Kering Botol/60 ml 0 200 0 200 2,56
25 Dus 10 Strip @ 10 tablet 0 7,80
Hidroksida 200 mg

28 Kotak/25 3 5 2 6 69,17

29 Kotak/24 Pot 2.325 0 0 2.325 91,20
DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 0 5 0 5 33
GRAM
32 Antimigrain Botol/100 0 13,56
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 0 120 39 81 10,50
37 Asam Mefenamat kapsul/kaplet 500 mg Dus, 10 blister @ 10 kap 21,97

STOK HARGA
AWAL SATUAN
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 0 5 0 5 1,36
48 Bromheksin Tab. 8 mg Kotak/100 0 10 4 6 23,83
58 Kotak/100 ampul @ 1 ml 0 122,50
500 mcg
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 0 35,46
65 0 26,50
HCl) ss
78 8 0 0 8 12,75
(Stesolid) 2,5 ml
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 0 30 0 30 3,4
85 Dulcolax Tab 0
STOK HARGA
AWAL SATUAN
104 Dus @ 30 ampul 1 0 0 1 112,62
mg/ml
113 Gentamycin 0,1 % SK Kotak/25 0 55,50
117 Gliseril Guaiacolas Botol/1000 0 10 0 10 66,7
118 Gliseril Guaiacolat 8 0 3.5 4.5 Rp 52,6
123 Hidroklorotiazid tab 25 mg Dus, 10 strip @ 10 tablet 0 163

127 Ibuprofen 400 mg Kotak/100 0 5 5 0 15,70
134 Kalsium Laktat Tab. 500 mg Kotak/100 0 7,60
STOK HARGA
AWAL SATUAN
147 Kloramfenikol salep mata Tube/5gr 0 100 0 100 1,68
156 Kotrimoksazol 120 mg Kotak/100 0 5 0 5 10,55
168 Lidocain inj kotak/100 1.75 0 0.1 1.65 92,90
170 Dus, 30 ampul @ 2 ml 0 5 0 5 636
80.000 - 2 ml
171 Lisol Botol/1000 0 20,00
172 Lisol Botol 800 ml 0 20,00
187 Kotak/100 Ampul @ 1 ml 0 275,00
1 ml
195 Kotak/5 Ampul 0 61,8
(Metolon)
198 Metronidazol 500 mg Kotak/100 0 3 2 1 16,90
STOK HARGA
AWAL SATUAN
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 0 25 0 25 3,15
207 Nifedipin Tab. 20 mg Blister/30 0 89,97
210 Nistatin vaginal tablet 100.000 IU/ g Dus @ 10 X 10 's 0 52,80
212 O.B.H. Syr. Botol/100 ml 0 1,57
218 Oksitetra S.M 1% Kotak/25 0 52,80
220 Oksitetra Salep Mata 1 % 0 Rp 3,32
224 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml 0 242,00

226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.41 0 0 0.41 312,50
228 Papaverin Tab 40 mg Botol/1000 0 109,45
230 Botol 0 5 5 0 5,72
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 0 200 168 32 1,53
233 Pirantel Pamoat 125 mg Kotak/100 5.5 3 4 4.5 31,80
240 Piroxicam Tab. 20 mg Kotak/100 0 11,55
249 Primakuin tablet 15 mg Dus,10 blister @10 tablet 1 0 0 1 20,50

251 Propiltiourasil Tab 10 mg Botol/100 0 Rp 35,10
252 Propiltiourasil Tab. 100 mg Botol/100 0 32,95
STOK HARGA
AWAL SATUAN
265 Salep 2 - 4 Kotak/24 0 96,00
266 Pot @ 30 gram 0 100 0 100 27
+ Belerang endap 4%
267 Pot @ 30 gram 10 0 5 5 2,20
Belerang Endap 4%
270 Sefadroksil 500 mg Kotak/100 0 30 5 25 52,90
272 Simvastatin scored tablet 10 mg 0 30 17 13 3,69
salut selaput
285 Thiamin HCl Tab. Botol/1000 8 0 3.5 4.5 41,58

287 Thiamin HCl Tablet 50 mg Botol/1000 0 5 0 5 74,4
290 Zinc Syrup Botol/60 ml 0 50 10 40 8,14
0
B. PROGRAM GIZI 0
294 Livron kotak/100 0 25,30

STOK HARGA
AWAL SATUAN


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0 26,12
HCl)
298 Botol/60 ml 0 21,70
299 Kotak/100 0 27,45
CuSO4 )

300 Kotak/100 0 90,70
intrinstik)

301 Kotak/100 0 90,75
C. OBAT GIGI 0
310 Bonding 0 216,00
312 Bonding 0 Rp 283,5

326 Etsha btl 0 101,25

STOK HARGA
AWAL SATUAN
354 Set/Kotak 0 276,75
Liquid)
0
356 Alat Suntik / Spoit 1 cc Kotak/100 1.01 0 0.1 0.91 120,17
357 Alat Suntik / Spoit 10 cc Kotak/100 0.95 0 0 0.95 175,00
362 Alkohol Swamb Dos 0 29,56
363 Aqua Pro Injeksi Botol 20 ml 0 20 8 12 5,22
364 Aquadest Steril Kotak/120@25 Botol 0 327,60
368 Blood Lancet Kotak/100 0 3 2 1 27,00
369 Kotak/24 0 649,00
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 3.25 0 0.2 3.05 174,87
371 Deck Glass Kotak/100 0 51,30
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 0 1 0 1 84,82
374 Disp. Syringe with Needle 3 cc Box/100 pcs 2.95 0 0.65 2.3 84,82
376 EDTA 10% Botol 100 ml 0 97,50
377 EDTA 10% Botol/100 ml 0 20,25
380 Folley Catheter 2 way No. 18 Box/10 pcs 0.9 0 0 0.9 104,40
384 Hipavix 5 x 5 cm Rol 0 79,44
385 Hipavix 5 x 5 cm Pcs 0 70,26
STOK HARGA
AWAL SATUAN

404 Jarum Otot No. 11 Pcs 5 0 0 5 1,95
405 Jarum Otot No. 11 0 Rp 24,3
409 Kasa 40 x 80 cm Roll 0 118,80
413 Kasa Hydrophil 40 x 80 cm Roll 0 5 1 4 137,02
414 Kasa Pembalut 4 m x 10 cm Roll 0 50 25 25 1,95
425 Botol/100 ml 0 87,75
Conc. 30 ml
432 Botol/100 ml 0 55,94
ml
STOK HARGA
AWAL SATUAN
439 Box/100 Buah 8 0 0 8 42,41
Tangan)
441 Box/100 Buah 0 42,41
Tangan)
442 Box/100 Buah 0 42,41
Tangan)
443 Lisol Botol/1000 ml 4 0 0 4 53,50
444 Masker Kotak/20 0 24,75
445 Masker Kotak/50 0 21,53
456 Oksigen (O2) 6 Kubik 0 162,50
457 Oksigen (O2) 1 kubik 0 75,00
458 Oksigen (O2) 1 1/2 kubik 0 85,00
462 Perlak lembar 0
467 Porstex botol/1000 0 20,00
479 Botol/500 ml 0 577,25
Hemoglobin)
STOK HARGA
AWAL SATUAN
500 Uji Malaria Box/25 0 1,062,75
510 cyanocobalamine injeksi 1000mcg/ml kotak/100 0 125,34
516 Etanol 70% Cairan Botol/1000 1 5 1.2 4.8 27,27
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 0 72 57 15 10,50
519 Allopurinol 100 mg Kotak/100 0 9,00
521 Ibufropen tab 400 mg Kotak/100 0 16,30
524 Parasetamol Syrup Botol/60 ml 0 1,53
526 salbutamol 4mg Kotak/100 0 6,50
527 Sefadroksil Kapsul Kotak/100 0 52,90
0
1 Amlodipin tablet 5 mg Box, 10 strips@10 tab 0 5 1 4 86,40
2 Kotak/24 Pot 0 2 0 2 88,71
5 Sulfametoksazol 200 mg + Trimetoprim Dus, botol @ 60 ml 0 50 20 30 4,96
40 mg/5 ml
6 Kotrimoksazol Syrup Botol/60 ml 0 50 0 50 3,60
7 Kloramfenicol suspensi 125 mg/5 ml Botol @ 60 ml 0 5 0 5 4,05
8 Metformin HCl tab 500 mg Box, 10 strips@10 tab 0 5 0 5 27,50
9 Ranitidin tablet 150 mg Dus, 3 Strip@10 tab 0 20 20 0 11,55
10 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 0 5 3 2 6,50
12 Kapas pembalut/absorben 250 gram Roll 0 2 0 2 13,06
STOK HARGA
AWAL SATUAN
13 Box/100 Buah 0 10 3 7 37,29
Tangan)
14 Box/100 Buah 0 5 2 3 37,29
Tangan)
TOTAL 1311.345 2064 746.25 2629.095

BULAN APRIL 2017
STOK
NO NAMA OBAT KEMASAN MASUK KELUAR
AWAL
A. NAMA OBAT
5 Albothyl Concentrate 5 ml Botol 5 ml 4 0 0
6 Allopurinol Tab 100 mg Kotak/100 2 10 6
8 Allopurinol tab. 300 mg Kotak/100 10 0 0
14 Amlodipin 5mg Kotak/30 0 0 0
kapsul
16 Dus, 10 strip @ 10 kaptab 54 0 34
500 mg
24 Antasida DOEN Kotak/100 165 0 48
Hidroksida 200 mg

28 Kotak/25 6 0 3

29 Kotak/24 Pot 2.325 0 1.3
30 Antihemoroid Doen Kombinasi Kotak/10 Supp. 0

DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 5 0 1
GRAM
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 81 0 28
35 Asam Folat Kaplet 1 mg Botol/100 2 0 0
36 Asam mefenamat 500 mg Kotak/100 150 0 25
37 Asam Mefenamat kapsul/kaplet 500 mg Dus, 10 blister @ 10 kap 0

40 Asiklovir Tab. 200 mg Kotak/100 41 0 0
41 Atropin Sulfat Inj. Kotak/30 1 0 0
42 Betahistin tab. 6 mg Kotak/30 2 0 0
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 5 0 1
48 Bromheksin Tab. 8 mg Kotak/100 6 0 6
54 Cetirizine Tab. 10 mg Kotak/100 1 0 1
500 mcg
59 Cyanocobalamin Inj. Kotak/100 0.7 0 0
63 Cyprofloxacin 500 mg Tab. Kotak/100 16 0 1
65 0
HCl) ss
71 Dexamethason Tab. 0,5 mg Kotak/100 218 0 48
77 Diazepam Injeksi Kotak/30 0.8
78 8
(Stesolid) 2,5 ml
81 Difenhidramin Injeksi Kotak/30 1 0 1
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 30 0 0
84 Domperidon Tab. 10 mg Kotak /100 6 0 4
85 Dulcolax Tab 0
103 Fitomenadeon Tab. Botol/100 6 0 1
104 Dus @ 30 ampul 1 0 0
mg/ml
109 Furosemid Tab. 40 mg Kotak/100 2 0 0
112 Gentamicin SK. Kotak/10 0 1 1
115 Glibenclamida 0
117 Gliseril Guaiacolas Botol/1000 10 0 0
118 Gliseril Guaiacolat 4.5 0 3
120 Glukosa larutan 5 % Botol 500 ml 173 0 17

128 Ibuprofen Suspensi 200 mg Botol/60 40 0 40
129 Ibuprofen tablet 200 mg Botol @ 100 tablet 4 0 4
136 Kaptopril 12,5 mg Kotak/100 3 0 0
138 Ketokonazole 0
147 Kloramfenikol salep mata Tube/5gr 100 0 0
156 Kotrimoksazol 120 mg Kotak/100 5 0 0
168 Lidocain inj kotak/100 1.65 0 0
170 Dus, 30 ampul @ 2 ml 5 0 0
80.000 - 2 ml
175 Lorazepam 2 mg Kotak/100 1.8 0 0.08
179 Meloksikam 7,5 mg Kotak/30 3 0 3
1 ml
195 Kotak/5 Ampul 0
(Metolon)
198 Metronidazol 500 mg Kotak/100 1 0 0
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 25 0 0
202 Natrium Diclofenac Tab. 50 mg Kotak/50 7 0 3
205 Natrium Klorida (NaCl) 0,9% Botol 500 ml 10 0 8

226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.41 0 0.19
230 Botol 0 0 0
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 32 50 82
233 Pirantel Pamoat 125 mg Kotak/100 4.5 0 1
241 Piroxicam Tab. 20 mg Kotak/100 4 0 4
242 Povidum Iodium Botol/300 ml 1 1
243 Povidum Iodium Botol/30ml 6 0 4
249 Primakuin tablet 15 mg Dus,10 blister @10 tablet 1 0 0
250 Propanolol Tab. 10 mg Kotak/100 11 0 0

259 Ringer Laktat Botol 1000 ml 29 0 9
265 Salep 2 - 4 Kotak/24 0
266 Pot @ 30 gram 100 0 0
+ Belerang endap 4%
267 Pot @ 30 gram 5 0 5
Belerang Endap 4%
269 Salisil Bedak 28 0 7
270 Sefadroksil 500 mg Kotak/100 25 0 9
salut selaput
276 Stesolid Rektal Tub. Pcs 5 ml 2
285 Thiamin HCl Tab. Botol/1000 4.5 0 2.35
287 Thiamin HCl Tablet 50 mg Botol/1000 5 0 1
290 Zinc Syrup Botol/60 ml 40 31
0
B. PROGRAM GIZI 0


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
HCl)
298 Botol/60 ml 0
299 Kotak/100 0
CuSO4 )

300 Kotak/100 0
intrinstik)
301 Kotak/100 0
302 Nistatin Tab salut 500000 IU Kotak/100 3 0 1
306 Vitamin B Complex Kotak/100 0 2 2
C. OBAT GIGI 0
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0

317 Cresopen 0
324 Etil klorida Kaleng 1 0 0
326 Etsha btl 0
327 Etsha Botol 0

339 Natrium Hipoklorit 3% Liter 3 0 0
347 Spongostan Box/10 pcs 5 0 5
353 Xylestesin 0
354 Set/Kotak 0
Liquid)
0
356 Alat Suntik / Spoit 1 cc Kotak/100 0.91 0 0.1
357 Alat Suntik / Spoit 10 cc Kotak/100 0.95
363 Aqua Pro Injeksi Botol 20 ml 12 0 0
364 Aquadest Steril Kotak/120@25 Botol 0 0 0
368 Blood Lancet Kotak/100 1 0 1
369 Kotak/24 0
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 3.05 0 0.4
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 1 0 0
374 Disp. Syringe with Needle 3 cc Box/100 pcs 2.3 0 1.05
379 Foley Catheter Pcs 4 0 0
380 Folley Catheter 2 way No. 18 Box/10 pcs 0.9 0 0
386 Infus set Anak Kantong/Set 26 0 0
387 Infus set Dewasa Kantong/Set 53 0 7
388 Infusion Set Anak/Pediatric (60 drops/ml) Buah 15 0 0
389 Infusion Set Dewasa (20 drops/ml) Buah 65 0 0

391 IV Catheter No. 18 G x 32 mm Buah 30 0 0
393 IV Catheter No. 20 G x 11/4 mm Buah 39 0 0
404 Jarum Otot No. 11 Pcs 5 0 0
407 Kapas Pembalut/absorben 250 g Rol 0 0 0
411 Kasa Hydrofil Steril 18 m x 22 cm Box/12 76 0 4
413 Kasa Hydrophil 40 x 80 cm Roll 4 0 2
414 Kasa Pembalut 4 m x 10 cm Roll 25 0 0
415 Kasa Pembalut Elastis 3 inci Rol 7 0 2
425 Botol/100 ml 0
Conc. 30 ml
432 Botol/100 ml 0
ml
439 Box/100 Buah 8 0 1
Tangan)
441 Box/100 Buah 0
Tangan)
442 Box/100 Buah 0
Tangan)
443 Lisol Botol/1000 ml 4 0 0
451 Needle 23 G x 1,5 cc Kotak/100 Pcs 1 0 1
461 Perhidrol (H2O2) 13% Liter 1 0 0
462 Perlak lembar 0
464 Plester 5 yard x 2 inci Roll 17 0 4
468 Portex Botol 0
479 Botol/500 ml 0
Hemoglobin)
480 Rivanol (Etakridin larutan 0,1%) Botol/300 ml 10 0 4
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 2 0 0.2
494 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 2 0 2
503 Urine Bag Pcs 0
508 Anti migrain Botol/100 tab 3 0 0
512 kloramfenikol 3% tetes telinga botol 0 0 0
516 Etanol 70% Cairan Botol/1000 4.8 0 0
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 15 15 30
520 Chlorpeniramine Maleat(CTM) Kotak/100 180 0 38
522 Kotrimoksaxole 480 Kotak/100 25 0 7
OBAT TAMBAHAN 2017

1 Amlodipin tablet 5 mg Box, 10 strips@10 tab 4 0 3
2 Kotak/24 Pot 2 0 0
3 Ichtiol SK 15 g Kotak/12 Pot 1 0 0
5 Sulfametoksazol 200 mg + Trimetoprim Dus, botol @ 60 ml 30 0 0
40 mg/5 ml
6 Kotrimoksazol Syrup Botol/60 ml 50 0 0
7 Kloramfenicol suspensi 125 mg/5 ml Botol @ 60 ml 5 0 0
8 Metformin HCl tab 500 mg Box, 10 strips@10 tab 5 0 1
9 Ranitidin tablet 150 mg Dus, 3 Strip@10 tab 0 15 5
10 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 2 0 0
11 Disp. Syringe with Needle 3 cc Box/100 pcs 5 0 0
12 Kapas pembalut/absorben 250 gram Roll 2 0 0
13 Box/100 Buah 7 0 3
Tangan)
14 Box/100 Buah 3 0 2
Tangan)
16 Alkohol swamb Kotak/100 0 5 0
Box, 10 strips@10
17 Cetirizin tablet 10 mg 0 10 6
capsules
18 Ibuprofen 400 mg Dus 10 X 10'S 0 10 5
19 Lansoprazole kapsul/kaplet 30 mg Dus , 2 strip @ 10 kapsul 0 10 10
20 Loperamide Kotak/100 0 1 1
22 Metronidazol tablet 500 mg 10 strip @ 10 tab 0 10 0
23 Povidum iodium Botol/300 ml 0 5 1
25 N-asetil sistein kapsul 200 mg Kotak/100 0
26 0
(Stesolid) 2,5 ml
27 Hidrokortison krim 2,5 % Tube 5 gr 0
29 Infusion Set Anak/Pediatric (60 drops/ml) Set 0
30 Ketorolac injeksi 30 mg/ml Dus, 6 ampul @ 1 ml 0

33 Metilergometrin Tab 0,125 mg Kotak/100 0
34 Natrium Diclofenac tablet 50 mg Dus @ 5 X 10 's 0
35 Natrium Klorida (NaCl) 0,9% Botol 500 ml 0
36 Nistatin vaginal tablet 100.000 iu/g tsb/vaginal 0
Piridoksin (Vitamin B6)

38 dus, 10 strip @ 10 tablet 0
tablet/kapsul/kaplet 10 mg (HCL)
42 Tablet Tambah Darah (Ferrosi Sulfat) Kotak/30 Tab 0
43 Dus, 15 Botol 0 5 5
(60 mg/0,6 ml)
TOTAL 2629.095 171 622.67

K/DAU
ROS
HARGA
SISA STOK JUMLAH
SATUAN
0 34,656 -
0 280,315 -
0 13,420 -
0 24,700 -
4 28,870 115,480
6 9,000 54,000
0 8,085 -
10 22,500 225,000
0 -
0 6,510 -
0 3,630 -
0 126,000 -
0 8,600 -
0 5,910 -
0 22,000 -
20 37,000 740,000
0 22,000 -
0 29,200 -
200 2,560 512,000
0 59,048 -
0 41,910 -
0 4,840 -
0 12,650 -
117 7,800 912,600
0 7,800 -
0 17,820 -
0 2,300 -
3 69,175 207,525
1.025 91,200 93,480
0 22,000 -
4 3350 13,400
0 13,563 -
0 35,200 -
53 10,500 556,500
2 5,200 10,400
125 12,200 1,525,000
21,978 -
0 19,800 -
0 82,500 -
41 25,100 1,029,100
1 36,000 36,000
2 33,539 67,078
0 51,315 -
0 1,596 -
0 257,070 -
4 1,362 5,448
0 66,517 -
0 23,830 -
0 4,237 -
0 5,286 -
0 35,000 -
0 15,246 -
0 38,000 -
0 14,000 -
0 19,000 -
0 Rp 45,298 -
0 26,400 -
0 122,500 -
0.7 114,070 79,849

0 14,412 -
0 1,441.20 -
0 14,300 -
15 26,500 397,500
0 35,465 -
0 26,500 -
0 312,000 -
0 202,500 -
0 178,000 -
0 173,800 -
0 -
170 7,400 1,258,000
0 9,570 -
0 10,100 -
0 11,810 -
0 3,152 -
0 12,100 -
0.8 78,147 62,518
8 12,751 102,008
0 4,400 -
0 4,700 -
0 34,680 -
0 10,300 -
30 3,490 104,700
2 17,400 34,800
0 -
0 14,097 -
0 34,848 -
0 267,300 -
0 13,563 -
0 102,300 -
0 8,090 -
0 1,980 -
0 22,720 -
0 2,626 -
0 18,333 -
0 6,221 -
0 Rp 152,889 -
0 89,100 -
0 31,620 -
0 -
0 7,139 -
0 28,855 -
5 69,000 345,000
1 112,620 112,620
0 57,420 -
0 69,000 -
0 -
0 8,400 -
2 11,229 22,458
0 41,800 -
0 58,030 -
0 20,207 -
0 55,506 -
0 495 -
0 Rp 9,900 -
0 6,100 -
10 66,790 667,900
1.5 Rp 52,635 78,953
0 30,690 -
156 5,720 892,320
0 24,100 -
0 27,104 -
0 16300 -
0 2,938 -
0 78,650 -
0 12,705 -
0 15,700 -
0 4,949 -
0 12,100 -
0 8,500 -
0 49,720 -
0 49,720 -
0 89,700 -
0 7,600 -
0 43,263 -
3 6,900 20,700
0 10,000 -
0 Rp 16,000 -
0 22,550 -
0 32,000 -
0 41,250 -
0 15,990 -
0 -
0 3,150 -
0 29,315 -
0 41,256 -
100 1,680 168,000
0 4,950 -
0 1,760 -
0 -
0 34,650 -
0 16,500 -
0 16,500 -
0 41,800 -
0 8,349 -
5 10,555 52,775
0 15,200 -
0 2,298 -
0 -
0 -
0 220,000 -
0 243,510 -
0 10,420 -
0 10,420 -
0 -
0 4,000 -
0 37,015 -
1.65 92,900 153,285
0 37,510 -
5 63660 318,300
0 20,000 -
0 20,000 -
0 10,071 -
0 9,700 -
1.72 142,300 244,756
0 1,953,485 -
0 15,222 -
0 38,055 -
0 26,500 -
0 38,050 -
0 12,650 -
0 19,965 -
0 16,868 -
0 23,000 -
0 39,000 -
0 49,170 -
0 275,000 -
0 Rp 16,868 -
0 13,310 -
0 17,715 -
0 61,864 -
0 11,000 -
0 8,668 -
0 11,300 -
0 61,870 -
0 15,730 -
0 24,200 -
1 16,900 16,900
0 3,300 -
25 3,150 78,750
0 42,500 -
4 9,650 38,600
0 92,333 -
0 4,545 -
2 5827 11,654
0 4,545 -
0 89,970 -
0 70,400 -
0 40,700 -
0 52,800 -
0 8,052 -
0 1,573 -
0 395,900 -
0 1,319,900 -
0 13,400 -
0 45,403 -
0 3,686 -
0 52,800 -
0 2,310 -
0 Rp 3,327 -
0 61,000 -
0 3,850 -
0 58,905 -
0 242,000 -
0 6,630 -
0.22 312,500 68,750
0 264,100 -
0 109,450 -
0 5,808 -
0 5,720 -
0 1,535 -
0 8,800 -
3.5 31,800 111,300
0 9,100 -
0 9,100 -
0 Rp 36,685 -
0 33,000 -
0 12,100 -
0 Rp 19,816 -
0 11,550 -
0 21,000 -
0 15,386 -
2 2,640 5,280
0 2,344 -
0 2,344 -
0 68,750 -
0 68,750 -
0 12,500 -
1 20,500 20,500
11 8,000 88,000
0 Rp 35,100 -
0 32,953 -
0 9,100 -
0 31,800 -
0 13,400 -
0 13,200 -
0 20,680 -
0 -
20 8,000 160,000
0 5,720 -
0 6,500 -
0 12,000 -
0 9,243 -
0 9,900 -
0 96,000 -
100 2797 279,700

0 2,200 -
0 1,573 -
21 Rp 1,350 28,350
16 52,900 846,400
0 5,286 -
14 3,690 51,660
0 28,215 -
0 17,700 -
0 78,147 -
2 28,512 57,024
0 -
0 -
0 28,855 -
0 183,425 -
0 16,200 -
0 37,928 -
0 50,090 -
0 25,300 -
2.15 41,580 89,397
0 Rp 71,351 -
4 74,455 297,820
0 750,000 -
0 5,519 -
9 8,140 73,260
0 276,750 -
0
0 -
0 20,700 -
0 90,750 -
0 25,300 -
0 25,080 -
0 25,080 -
0 26,120 -
0 21,700 -
0 27,450 -
0 90,700 -
0 90,750 -
2 70,400 140,800
0 14,025 -
0 18,447 -
0 14,300 -
0 11,200 -
0 24,420 -
0 -
0 -
0 24,700 -
0 216,000 -
0 356,730 -
0 Rp 283,500 -
0 535,095 -
0 Rp 877,500 -
0 60,500 -
0 538,650 -
0 Rp 762,750 -
0 155,250 -
0 201,886 -
0 Rp 263,250 -
0 610,200 -
0 647,660 -
0 115,500 -
1 101,250 101,250
0 109,451 -
0 101,250 -
0 262,683 -
0 605,000 -
0 434,500 -
0 1,119,375 -
0 Rp 1,309,500 -
0 67,500 -
0 54,000 -
0 168,750 -
0 182,250 -
0 208,093 -
0 217,500 -
0 270,000 -
3 27,000 81,000
0 67,500 -
0 60,750 -
0 37,000 -
0 66,510 -
0 742,500 -
0 988,142 -
0 70,000 -
0 168,250 -
0 181,877 -
0 1,464,441 -
0 Rp 1,650,800 -
0 1,014,894 -
0 528,000 -
0 Rp 573,750 -
0 276,750 -
0 52,250 -
0
0 -
0.81 120,175 97,342
0.95 175,000 166,250
0 185,000 -
0 120,000 -
0 114,180 -
0 168,000 -
0 29,563 -
12 5,225 62,700
0 327,600 -
0 10,800 -
0 91,000 -
0 101,250 -
0 27,000 -
0 649,000 -
2.65 174,870 463,406

0 51,300 -
1 84,825 84,825
0 120,713 -
1.25 84,825 106,031
0 97,875 -
0 97,500 -
0 20,250 -
0 88,150 -
4 9,345 37,380
0.9 104,400 93,960
0 100,000 -
0 47,250 -
0 76,050 -
0 79,446 -
0 70,265 -
26 3,850 100,100
46 4,400 202,400
15 4,568 68,520
65 4,176 271,440
0 428,313 -
30 4,959 148,770
0 428,313 -
39 4,959 193,401
0 428,313 -
24 4,959 119,016
0 428,313 -
40 4,959 198,360
0 Rp 142,750 -
0 155,000 -
0 199,985 -
0 1,950 -
0 Rp 24,300 -
0 17,405 -
5 1,950 9,750
0 Rp 24,300 -
0 17,405 -
0 8,250 -
0 16,313 -
0 118,800 -
0 5,225 -
72 7,700 554,400
0 114,500 -
2 137,025 274,050
25 1,958 48,950
5 6,250 31,250
0 7,700 -
0 33,385 -
0 33,385 -
0 6,250 -
0 7,425 -
0 -
0 3,500 -
0 5,000 -
0 5,000 -
0 87,750 -
0 114,750 -
0 49,000 -
0 60,750 -
0 64,860 -
0 105,000 -
0 47,250 -
0 55,941 -
0 38,475 -
0 47,250 -
0 32,430 -
0 49,000 -
0 13,500 -
0 32,430 -
7 42,413 296,891
0 42,413 -
0 42,413 -
0 42,413 -
4 53,505 214,020
0 24,750 -
0 21,533 -
0 16,250 -
0 33,750 -
0 47,250 -
0 136,000 -
0 60,750 -
0 27,000 -
0 22,275 -
0 21,620 -
0 490,000 -
0 371,250 -
0 162,500 -
0 75,000 -
0 85,000 -
0 74,345 -
0 138,864 -
1 37,125 37,125
0 -
0 74,250 -
13 36,450 473,850
0 34,592 -
0 26,208 -
0 20,000 -
0 21,620 -
0 773,795 -
0 3,819,338 -
0 -
0 2,824,113 -
0 280,000 -
0 Rp 365,000 -
0 248,630 -
0 607,500 -
0 484,828 -
0 1,730,916 -
0 577,254 -
6 3,328 19,968
0 42,500 -
0 42,413 -
0 276,540 -
1.8 143,550 258,390
0 120,000 -
0 118,910 -
0 Rp 121,500 -
0 117,000 -
0 121,500 -
0 108,100 -
0 183,000 -
0 183,600 -
0 183,770 -
0 21,533 -
0 881,250 -
0 100,000 -
0 1,932,287 -
0 505,367 -
0 1,932,287 -
0 1,062,757 -
0 1,545,830 -
0 1,799,875 -
0 5,000 -
0 3,915 -
0 459,000 -
0 243,225 -
0 195,000 -
3 14,900 44,700
0 6,226 -
0 125,345 -
0 12,100 -
0 2,607 -
0 11,850 -
0 60,775 -
0 90,700 -
4.8 27,272 130,906
0 118,910 -
0 10,500 -
0 9,000 -
142 5,400 766,800
0 16,300 -
18 15,200 273,600
0 27,500 -
0 1,535 -
0 11,550 -
0 6,500 -
0 52,900 -
0 11,200 -
1 86,400 86,400
2 88,715 177,430
1 55,310 55,310
50 4,949 247,450
30 4,960 148,800
50 3,600 180,000
5 4,050 20,250
4 27,500 110,000
10 11,550 115,500
2 6,500 13,000
5 67,954 339,770
2 13,068 26,136
4 37,293 149,172
1 37,293 37,293
4 17,250 69,000
5 11,500 57,500
4 15,400 61,600
5 13,300 66,500
0 6,820 -
0 9,700 -
5 6,800 34,000
10 14,000 140,000
4 21,600 86,400
0 2,106
0 47,400
0 12,749
0 2,812
0 11,100
0 3,659
0 1,383
0 120,750
0 14,375
0 9,700
0 8,050
0 6,410
0 60,200
0 190,000
0 5,200
0 149,600
0 231,000
0 126,500
0 12,300
0 5,980
2177.425 21935908.2
BULAN MEI 2017
STOK
AWAL
A. NAMA OBAT
kapsul
16 Dus, 10 strip @ 10 kaptab 20 0 20
500 mg
19 Amoksisillin Syr. Kering Botol/60 ml 200 0 31
Hidroksida 200 mg

28 Kotak/25 3 0 2

29 Kotak/24 Pot 1.025 0 0.541

DUS, 10 SUPP @ 2
GRAM

500 mcg
65 0
HCl) ss
77 Diazepam Injeksi Kotak/30 0.8 0 0
78 8 0 0
(Stesolid) 2,5 ml
81 Difenhidramin Injeksi Kotak/30 0
85 Dulcolax Tab 0
104 Dus @ 30 ampul 1 0 0
mg/ml
115 Glibenclamida 0
118 Gliseril Guaiacolat 1.5 0 0.75

128 Ibuprofen Suspensi 200 mg Botol/60 0
129 Ibuprofen tablet 200 mg Botol @ 100 tablet 0
138 Ketokonazole 0
168 Lidocain inj kotak/100 1.65 0 0.5
170 Dus, 30 ampul @ 2 ml 5 0 0
80.000 - 2 ml
175 Lorazepam 2 mg Kotak/100 1.72 0 0
1 ml
195 Kotak/5 Ampul 0
(Metolon)

230 Botol 0 0 0
(60 mg/0,6 ml)
233 Pirantel Pamoat 125 mg Kotak/100 3.5 0 0
242 Povidum Iodium Botol/300 ml 0

256 Ranitidin Tab. 150 mg Kotak/100 0 20 4
265 Salep 2 - 4 Kotak/24 0
266 Pot @ 30 gram 100 50 0
+ Belerang endap 4%
267 Pot @ 30 gram 0
Belerang Endap 4%
salut selaput
276 Stesolid Rektal Tub. Pcs 5 ml 2 1
290 Zinc Syrup Botol/60 ml 9 0 0
B. PROGRAM GIZI


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
HCl)
298 Botol/60 ml 0
299 Kotak/100 0
CuSO4 )

300 Kotak/100 0
intrinstik)
301 Kotak/100 0
C. OBAT GIGI 0
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0

317 Cresopen 0
326 Etsha btl 0
327 Etsha Botol 0

336 Jarum (Carefull) Set 0 2 2
353 Xylestesin 0
354 Set/Kotak 0
Liquid)
0
D. BAHAN HABIS PAKAI
357 Alat Suntik / Spoit 10 cc Kotak/100 0.95 0 0
369 Kotak/24 0
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 2.65 0 0

407 Kapas Pembalut/absorben 250 g Rol 0
425 Botol/100 ml 0
Conc. 30 ml
432 Botol/100 ml 0
ml
439 Box/100 Buah 7 0 1
Tangan)
441 Box/100 Buah 0
Tangan)
442 Box/100 Buah 0
Tangan)
451 Needle 23 G x 1,5 cc Kotak/100 Pcs 0
462 Perlak lembar 0
468 Portex Botol 0
479 Botol/500 ml 0
Hemoglobin)
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 1.8 0 0.5
494 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 0
503 Urine Bag Pcs 0
512 kloramfenikol 3% tetes telinga botol 0
516 Etanol 70% Cairan Botol/1000 4.8 5 1.3
OBAT TAMBAHAN 2017

2 Kotak/24 Pot 2 0 0
40 mg/5 ml
11 Disp. Syringe with Needle 3 cc Box/100 pcs 5 0 0
13 Box/100 Buah 4 5 4
Tangan)
14 Box/100 Buah 1 5 2
Tangan)
16 Alkohol Swamb Kotak/100 5 5 5
Box, 10 strips@10
capsules
24 Antasida Syr. Botol 0 150 50
25 N-asetil sistein kapsul 200 mg Kotak/100 0 10 1
26 0 5 0
(Stesolid) 2,5 ml
27 Hidrokortison krim 2,5 % Tube 5 gr 0 200 35
28 Ibuprofen 200 mg Kotak/100 0 10 2
29 Infusion Set Anak/Pediatric (60 drops/ml) Set 0 10 0
30 Ketorolac injeksi 30 mg/ml Dus, 6 ampul @ 1 ml 0 2 0

33 Metilergometrin Tab 0,125 mg Kotak/100 0 3 0
34 Natrium Diclofenac tablet 50 mg Dus @ 5 X 10 's 0 20 0
36 Nistatin vaginal tablet 100.000 iu/g tsb/vaginal 0 1 1
37 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml 0 1 0

38 dus, 10 strip @ 10 tablet 0 20 4
39 Strip Gula Botol/50 Strip 0 1 1
40 Strip Kolesterol Botol/10 Strip 0 5 5
41 Strip Asam Urat Botol/25 Strip 0 2 2
42 Tablet Tambah Darah (Ferrosi Sulfat) Kotak/30 Tab 0 1518 0
43 Dus, 15 Botol 0 30 20
(60 mg/0,6 ml)
TOTAL 2177.425 2576 624.451

K/DAU
ROS
HARGA
SISA STOK JUMLAH
SATUAN
0 34,656 -
0 280,315 -
0 13,420 -
0 24,700 -
4 28,870 115,480
17 9,000 153,000
0 8,085 -
8 22,500 180,000
0 -
0 6,510 -
0 3,630 -
0 126,000 -
0 8,600 -
0 5,910 -
0 22,000 -
0 37,000 -
0 22,000 -
0 29,200 -
169 2,560 432,640
0 59,048 -
0 41,910 -
0 4,840 -
0 12,650 -
101 7,800 787,800
0 7,800 -
0 17,820 -
0 2,300 -
1 69,175 69,175
0.484 91,200 44,141
0 22,000 -
3 3350 10,050
0 13,563 -
0 35,200 -
79 10,500 829,500
2 5,200 10,400
98 12,200 1,195,600
0 21,978 -
0 19,800 -
0 82,500 -
41 25,100 1,029,100
1 36,000 36,000
2 33,539 67,078
0 51,315 -
0 1,596 -
0 257,070 -
3 1,362 4,086
0 66,517 -
0 23,830 -
0 4,237 -
0 5,286 -
0 35,000 -
0 15,246 -
0 38,000 -
0 14,000 -
0 19,000 -
0 Rp 45,298 -
0 26,400 -
0 122,500 -
0.7 114,070 79,849

0 14,412 -
0 1,441.20 -
0 14,300 -
12 26,500 318,000
0 35,465 -
0 26,500 -
0 312,000 -
0 202,500 -
0 178,000 -
0 173,800 -
0 -
120 7,400 888,000
0 9,570 -
0 10,100 -
0 11,810 -
0 3,152 -
0 12,100 -
0.8 78,147 62,518
8 12,751 102,008
0 4,400 -
0 4,700 -
0 34,680 -
0 10,300 -
25 3,490 87,250
10 17,400 174,000
0 -
0 14,097 -
0 34,848 -
0 267,300 -
0 13,563 -
0 102,300 -
0 8,090 -
0 1,980 -
0 22,720 -
0 2,626 -
0 18,333 -
0 6,221 -
0 Rp 152,889 -
0 89,100 -
0 31,620 -
0 -
0 7,139 -
0 28,855 -
5 69,000 345,000
1 112,620 112,620
0 57,420 -
0 69,000 -
0 -
0 8,400 -
2 11,229 22,458
0 41,800 -
0 58,030 -
0 20,207 -
0 55,506 -
0 495 -
0 Rp 9,900 -
0 6,100 -
7 66,790 467,530
0.75 Rp 52,635 39,476
0 30,690 -
156 5,720 892,320
0 24,100 -
0 27,104 -
0 16300 -
0 2,938 -
0 78,650 -
0 12,705 -
0 15,700 -
0 4,949 -
0 12,100 -
0 8,500 -
0 49,720 -
0 49,720 -
0 89,700 -
0 7,600 -
0 43,263 -
31 6,900 213,900
0 10,000 -
0 Rp 16,000 -
0 22,550 -
0 32,000 -
0 41,250 -
0 15,990 -
0 -
0 3,150 -
0 29,315 -
0 41,256 -
100 1,680 168,000
0 4,950 -
0 1,760 -
0 -
0 34,650 -
0 16,500 -
0 16,500 -
0 41,800 -
0 8,349 -
5 10,555 52,775
0 15,200 -
0 2,298 -
0 -
0 -
0 220,000 -
0 243,510 -
0 10,420 -
0 10,420 -
0 -
0 4,000 -
0 37,015 -
1.15 92,900 106,835
0 37,510 -
5 63660 318,300
0 20,000 -
0 20,000 -
0 10,071 -
0 9,700 -
1.72 142,300 244,756
0 1,953,485 -
0 15,222 -
0 38,055 -
0 26,500 -
0 38,050 -
0 12,650 -
0 19,965 -
0 16,868 -
0 23,000 -
0 39,000 -
0 49,170 -
0 275,000 -
0 Rp 16,868 -
0 13,310 -
0 17,715 -
0 61,864 -
0 11,000 -
0 8,668 -
0 11,300 -
0 61,870 -
0 15,730 -
0 24,200 -
1 16,900 16,900
0 3,300 -
25 3,150 78,750
0 42,500 -
2 9,650 19,300
0 92,333 -
0 4,545 -
1 5827 5,827
0 4,545 -
0 89,970 -
0 70,400 -
0 40,700 -
0 52,800 -
0 8,052 -
0 1,573 -
0 395,900 -
0 1,319,900 -
0 13,400 -
0 45,403 -
0 3,686 -
0 52,800 -
0 2,310 -
0 Rp 3,327 -
0 61,000 -
0 3,850 -
0 58,905 -
0 242,000 -
0 6,630 -
0.17 312,500 53,125
0 264,100 -
0 109,450 -
0 5,808 -
0 5,720 -
23 1,535 35,305
0 8,800 -
3.5 31,800 111,300
0 9,100 -
0 9,100 -
0 Rp 36,685 -
0 33,000 -
0 12,100 -
0 Rp 19,816 -
0 11,550 -
0 21,000 -
0 15,386 -
2 2,640 5,280
0 2,344 -
0 2,344 -
0 68,750 -
0 68,750 -
0 12,500 -
1 20,500 20,500
11 8,000 88,000
0 Rp 35,100 -
0 32,953 -
0 9,100 -
0 31,800 -
0 13,400 -
16 13,200 211,200
0 20,680 -
0 -
18 8,000 144,000
0 5,720 -
0 6,500 -
0 12,000 -
0 9,243 -
0 9,900 -
0 96,000 -
150 2797 419,550

0 2,200 -
0 1,573 -
13 Rp 1,350 17,550
10 52,900 529,000
0 5,286 -
28 3,690 103,320
0 28,215 -
0 17,700 -
0 78,147 -
1 28,512 28,512
0 -
0 -
0 28,855 -
0 183,425 -
0 16,200 -
0 37,928 -
0 50,090 -
0 25,300 -
1.4 41,580 58,212
0 Rp 71,351 -
3 74,455 223,365
0 750,000 -
0 5,519 -
9 8,140 73,260
0 276,750 -
-
0 20,700 -
0 90,750 -
0 25,300 -
0 25,080 -
0 25,080 -
0 26,120 -
0 21,700 -
0 27,450 -
0 90,700 -
0 90,750 -
1 70,400 70,400
0 14,025 -
0 18,447 -
0 14,300 -
0 11,200 -
0 24,420 -
0 -
0 -
0 24,700 -
0 216,000 -
0 356,730 -
0 Rp 283,500 -
0 535,095 -
0 Rp 877,500 -
0 60,500 -
0 538,650 -
0 Rp 762,750 -
0 155,250 -
0 201,886 -
0 Rp 263,250 -
0 610,200 -
0 647,660 -
0 115,500 -
1 101,250 101,250
0 109,451 -
0 101,250 -
0 262,683 -
0 605,000 -
0 434,500 -
0 1,119,375 -
0 Rp 1,309,500 -
0 67,500 -
0 54,000 -
0 168,750 -
0 182,250 -
0 208,093 -
0 217,500 -
0 270,000 -
3 27,000 81,000
0 67,500 -
0 60,750 -
0 37,000 -
0 66,510 -
0 742,500 -
0 988,142 -
0 70,000 -
0 168,250 -
0 181,877 -
0 1,464,441 -
0 Rp 1,650,800 -
0 1,014,894 -
0 528,000 -
0 Rp 573,750 -
0 276,750 -
0 52,250 -
0
-
0.5 120,175 60,088
0.95 175,000 166,250
0 185,000 -
0 120,000 -
0 114,180 -
0 168,000 -
0 29,563 -
12 5,225 62,700
0 327,600 -
0 10,800 -
0 91,000 -
0 101,250 -
0 27,000 -
0 649,000 -
2.65 174,870 463,406

0 51,300 -
1 84,825 84,825
0 120,713 -
0.5 84,825 42,413
0 97,875 -
0 97,500 -
0 20,250 -
0 88,150 -
4 9,345 37,380
0.9 104,400 93,960
0 100,000 -
0 47,250 -
0 76,050 -
0 79,446 -
0 70,265 -
26 3,850 100,100
41 4,400 180,400
15 4,568 68,520
65 4,176 271,440
0 428,313 -
30 4,959 148,770
0 428,313 -
34 4,959 168,606
0 428,313 -
19 4,959 94,221
0 428,313 -
40 4,959 198,360
0 Rp 142,750 -
0 155,000 -
0 199,985 -
0 1,950 -
0 Rp 24,300 -
0 17,405 -
5 1,950 9,750
0 Rp 24,300 -
0 17,405 -
0 8,250 -
0 16,313 -
0 118,800 -
0 5,225 -
64 7,700 492,800
0 114,500 -
0 137,025 -
15 1,958 29,370
4 6,250 25,000
0 7,700 -
0 33,385 -
0 33,385 -
0 6,250 -
0 7,425 -
0 -
0 3,500 -
0 5,000 -
0 5,000 -
0 87,750 -
0 114,750 -
0 49,000 -
0 60,750 -
0 64,860 -
0 105,000 -
0 47,250 -
0 55,941 -
0 38,475 -
0 47,250 -
0 32,430 -
0 49,000 -
0 13,500 -
0 32,430 -
6 42,413 254,478
0 42,413 -
0 42,413 -
0 42,413 -
4 53,505 214,020
0 24,750 -
0 21,533 -
0 16,250 -
0 33,750 -
0 47,250 -
0 136,000 -
0 60,750 -
0 27,000 -
0 22,275 -
0 21,620 -
0 490,000 -
0 371,250 -
0 162,500 -
0 75,000 -
0 85,000 -
0 74,345 -
0 138,864 -
1 37,125 37,125
0 -
0 74,250 -
8 36,450 291,600
0 34,592 -
0 26,208 -
0 20,000 -
0 21,620 -
0 773,795 -
0 3,819,338 -
0 -
0 2,824,113 -
0 280,000 -
0 Rp 365,000 -
0 248,630 -
0 607,500 -
0 484,828 -
0 1,730,916 -
0 577,254 -
3 3,328 9,984
0 42,500 -
0 42,413 -
0 276,540 -
1.3 143,550 186,615
0 120,000 -
0 118,910 -
0 Rp 121,500 -
0 117,000 -
0 121,500 -
0 108,100 -
0 183,000 -
0 183,600 -
0 183,770 -
0 21,533 -
0 881,250 -
0 100,000 -
0 1,932,287 -
0 505,367 -
0 1,932,287 -
0 1,062,757 -
0 1,545,830 -
0 1,799,875 -
0 5,000 -
0 3,915 -
0 459,000 -
0 243,225 -
0 195,000 -
2 14,900 29,800
0 6,226 -
0 125,345 -
0 12,100 -
0 2,607 -
0 11,850 -
0 60,775 -
0 90,700 -
8.5 27,272 231,812
0 118,910 -
16 10,500 168,000
0 9,000 -
195 5,400 1,053,000
0 16,300 -
10 15,200 152,000
0 27,500 -
0 1,535 -
0 11,550 -
0 6,500 -
0 52,900 -
0 11,200 -
0 86,400 -
2 88,715 177,430
0 55,310 -
30 4,949 148,470
30 4,960 148,800
50 3,600 180,000
5 4,050 20,250
4 27,500 110,000
8 11,550 92,400
1 6,500 6,500
5 67,954 339,770
2 13,068 26,136
5 37,293 186,465
4 37,293 149,172
11 17,250 189,750
5 11,500 57,500
32 15,400 492,800
15 13,300 199,500
24 6,820 163,680
0 9,700 -
5 6,800 34,000
9 14,000 126,000
4 21,600 86,400
100 2,106 210,600
9 47,400 426,600
5 12,749 63,745
165 2,812 463,980

8 11,100 88,800
10 3,659 36,590
2 1,383 2,766
5 120,750 603,750
5 14,375 71,875
3 17,715 53,145
20 8,050 161,000
20 6,410 128,200
0 60,200 -
1 190,000 190,000
16 5,200 83,200
0 149,600 -
0 231,000 -
0 126,500 -
1518 12,300 18,671,400
10 5,980 59,800
4128.974 41,831,816
BULAN JUNI 2017
STOK
AWAL
A. NAMA OBAT
kapsul
16 Dus, 10 strip @ 10 kaptab 0
500 mg
Hidroksida 200 mg

28 Kotak/25 1 5 1

29 Kotak/24 Pot 0.484 0 0

DUS, 10 SUPP @ 2
GRAM

500 mcg
65 0
HCl) ss
78 8
(Stesolid) 2,5 ml
81 Difenhidramin Injeksi Kotak/30 0 0 0
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 25 0
85 Dulcolax Tab 0
104 Dus @ 30 ampul 1 0 0
mg/ml
115 Glibenclamida 0

138 Ketokonazole 0
168 Lidocain inj kotak/100 1.15 0 0.15
170 Dus, 30 ampul @ 2 ml 5 0 0
80.000 - 2 ml
1 ml
195 Kotak/5 Ampul 0
(Metolon)

230 Botol 0 0 0
(60 mg/0,6 ml)
233 Pirantel Pamoat 125 mg Kotak/100 3.5 0 1.5

265 Salep 2 - 4 Kotak/24 0
266 Pot @ 30 gram 150 0 25
+ Belerang endap 4%
267 Pot @ 30 gram 0
Belerang Endap 4%
salut selaput
0
B. PROGRAM GIZI 0


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
HCl)
298 Botol/60 ml 0
299 Kotak/100 0
CuSO4 )

300 Kotak/100 0
intrinstik)
301 Kotak/100 0
C. OBAT GIGI
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0

317 Cresopen 0
326 Etsha btl 0
327 Etsha Botol 0

353 Xylestesin 0
354 Set/Kotak 0
Liquid)
0
369 Kotak/24 0
Jarum Bedah
380 Folley Catheter 2 way No. 18 Box/10 pcs 0.9 0 0.2

425 Botol/100 ml 0
Conc. 30 ml
432 Botol/100 ml 0
ml
439 Box/100 Buah 6 0 0
Tangan)
441 Box/100 Buah 0
Tangan)
442 Box/100 Buah 0
Tangan)
462 Perlak lembar 0
468 Portex Botol 0
479 Botol/500 ml 0
Hemoglobin)
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 1.3 0 1.3
503 Urine Bag Pcs 0
OBAT TAMBAHAN 2017

1 Amlodipin tablet 5 mg Box, 10 strips@10 tab 0
2 Kotak/24 Pot 2 0 1.04
40 mg/5 ml
11 Disp. Syringe with Needle 3 cc Box/100 pcs 5 0 0.6
13 Box/100 Buah 5 0 2
Tangan)
14 Box/100 Buah 4 0 0
Tangan)
Box, 10 strips@10
capsules
26 5
(Stesolid) 2,5 ml

36 Nistatin vaginal tablet 100.000 iu/g tsb/vaginal 0

38 dus, 10 strip @ 10 tablet 16 10 8
43 Dus, 15 Botol 10 0 10
(60 mg/0,6 ml)
44 Dus, 10 strip @ 10 kaptab 0 50 11
500 mg
46 Methylprednisolon 4 mg dus, 10 strip @ 10 tablet 0 10 2
47 Zinc Syrup 20 mg/5 ml Dus, Botol 60 ml 0 50 0

TOTAL 4128.974 413 2313.54

K/DAU
ROS
HARGA
SISA STOK JUMLAH
SATUAN
0 34,656 -
0 280,315 -
0 13,420 -
0 24,700 -
4 28,870 115,480
13 9,000 117,000
0 8,085 -
8 22,500 180,000
0 -
0 6,510 -
0 3,630 -
0 126,000 -
0 8,600 -
0 5,910 -
0 22,000 -
0 37,000 -
0 22,000 -
0 29,200 -
105 2,560 268,800
0 59,048 -
0 41,910 -
0 4,840 -
0 12,650 -
78 7,800 608,400
0 7,800 -
0 17,820 -
0 2,300 -
5 69,175 345,875
0.484 91,200 44,141
0 22,000 -
1 3350 3,350
0 13,563 -
0 35,200 -
61 10,500 640,500
2 5,200 10,400
73 12,200 890,600
0 21,978 -
0 19,800 -
0 82,500 -
38 25,100 953,800
1 36,000 36,000
0 33,539 -
0 51,315 -
0 1,596 -
0 257,070 -
2 1,362 2,724
0 66,517 -
0 23,830 -
0 4,237 -
0 5,286 -
0 35,000 -
0 15,246 -
0 38,000 -
0 14,000 -
0 19,000 -
0 Rp 45,298 -
0 26,400 -
0 122,500 -
0.7 114,070 79,849

0 14,412 -
0 1,441.20 -
0 14,300 -
8 26,500 212,000
0 35,465 -
0 26,500 -
0 312,000 -
0 202,500 -
0 178,000 -
0 173,800 -
0 -
80 7,400 592,000
0 9,570 -
0 10,100 -
0 11,810 -
0 3,152 -
0 12,100 -
0.8 78,147 62,518
8 12,751 102,008
0 4,400 -
0 4,700 -
0 34,680 -
0 10,300 -
25 3,490 87,250
6 17,400 104,400
0 -
0 14,097 -
0 34,848 -
0 267,300 -
0 13,563 -
0 102,300 -
0 8,090 -
0 1,980 -
0 22,720 -
0 2,626 -
0 18,333 -
0 6,221 -
0 Rp 152,889 -
0 89,100 -
0 31,620 -
0 -
0 7,139 -
0 28,855 -
4 69,000 276,000
1 112,620 112,620
0 57,420 -
0 69,000 -
0 -
0 8,400 -
2 11,229 22,458
0 41,800 -
0 58,030 -
0 20,207 -
0 55,506 -
0 495 -
0 Rp 9,900 -
0 6,100 -
5 66,790 333,950
0.25 Rp 52,635 13,159
0 30,690 -
156 5,720 892,320
0 24,100 -
0 27,104 -
0 16300 -
0 2,938 -
0 78,650 -
0 12,705 -
0 15,700 -
0 4,949 -
0 12,100 -
0 8,500 -
0 49,720 -
0 49,720 -
0 89,700 -
0 7,600 -
0 43,263 -
23 6,900 158,700
0 10,000 -
0 Rp 16,000 -
0 22,550 -
0 32,000 -
0 41,250 -
0 15,990 -
0 -
0 3,150 -
0 29,315 -
0 41,256 -
85 1,680 142,800
0 4,950 -
0 1,760 -
0 -
0 34,650 -
0 16,500 -
0 16,500 -
0 41,800 -
0 8,349 -
4 10,555 42,220
0 15,200 -
0 2,298 -
0 -
0 -
0 220,000 -
0 243,510 -
0 10,420 -
0 10,420 -
0 -
0 4,000 -
0 37,015 -
1 92,900 92,900
0 37,510 -
5 63660 318,300
0 20,000 -
0 20,000 -
0 10,071 -
0 9,700 -
1.72 142,300 244,756
0 1,953,485 -
0 15,222 -
0 38,055 -
0 26,500 -
0 38,050 -
0 12,650 -
0 19,965 -
0 16,868 -
0 23,000 -
0 39,000 -
0 49,170 -
0 275,000 -
0 Rp 16,868 -
0 13,310 -
0 17,715 -
0 61,864 -
0 11,000 -
0 8,668 -
0 11,300 -
0 61,870 -
0 15,730 -
0 24,200 -
1 16,900 16,900
0 3,300 -
0 3,150 -
0 42,500 -
0 9,650 -
0 92,333 -
0 4,545 -
1 5827 5,827
0 4,545 -
0 89,970 -
0 70,400 -
0 40,700 -
0 52,800 -
0 8,052 -
0 1,573 -
0 395,900 -
0 1,319,900 -
0 13,400 -
0 45,403 -
0 3,686 -
0 52,800 -
0 2,310 -
0 Rp 3,327 -
0 61,000 -
0 3,850 -
0 58,905 -
0 242,000 -
0 6,630 -
0.07 312,500 21,875
0 264,100 -
0 109,450 -
0 5,808 -
0 5,720 -
22 1,535 33,770
0 8,800 -
2 31,800 63,600
0 9,100 -
0 9,100 -
0 Rp 36,685 -
0 33,000 -
0 12,100 -
0 Rp 19,816 -
0 11,550 -
0 21,000 -
0 15,386 -
2 2,640 5,280
0 2,344 -
0 2,344 -
0 68,750 -
0 68,750 -
0 12,500 -
1 20,500 20,500
11 8,000 88,000
0 Rp 35,100 -
0 32,953 -
0 9,100 -
0 31,800 -
0 13,400 -
10 13,200 132,000
0 20,680 -
0 -
18 8,000 144,000
0 5,720 -
0 6,500 -
0 12,000 -
0 9,243 -
0 9,900 -
0 96,000 -
125 2797 349,625

0 2,200 -
0 1,573 -
8 Rp 1,350 10,800
3 52,900 158,700
0 5,286 -
14 3,690 51,660
0 28,215 -
0 17,700 -
0 78,147 -
1 28,512 28,512
0 -
0 -
0 28,855 -
0 183,425 -
0 16,200 -
0 37,928 -
0 50,090 -
0 25,300 -
1.1 41,580 45,738
0 Rp 71,351 -
3 74,455 223,365
0 750,000 -
0 5,519 -
0 8,140 -
0 276,750 -
-
0 20,700 -
0 90,750 -
0 25,300 -
0 25,080 -
0 25,080 -
0 26,120 -
0 21,700 -
0 27,450 -
0 90,700 -
0 90,750 -
1 70,400 70,400
0 14,025 -
0 18,447 -
0 14,300 -
0 11,200 -
0 24,420 -
-
0 -
0 24,700 -
0 216,000 -
0 356,730 -
0 Rp 283,500 -
0 535,095 -
0 Rp 877,500 -
0 60,500 -
0 538,650 -
0 Rp 762,750 -
0 155,250 -
0 201,886 -
0 Rp 263,250 -
0 610,200 -
0 647,660 -
0 115,500 -
0 101,250 -
0 109,451 -
0 101,250 -
0 262,683 -
0 605,000 -
0 434,500 -
0 1,119,375 -
0 Rp 1,309,500 -
0 67,500 -
0 54,000 -
0 168,750 -
0 182,250 -
0 208,093 -
0 217,500 -
0 270,000 -
3 27,000 81,000
0 67,500 -
0 60,750 -
0 37,000 -
0 66,510 -
0 742,500 -
0 988,142 -
0 70,000 -
0 168,250 -
0 181,877 -
0 1,464,441 -
0 Rp 1,650,800 -
0 1,014,894 -
0 528,000 -
0 Rp 573,750 -
0 276,750 -
0 52,250 -
0
-
0.25 120,175 30,044
0.95 175,000 166,250
0 185,000 -
0 120,000 -
0 114,180 -
0 168,000 -
0 29,563 -
12 5,225 62,700
0 327,600 -
0 10,800 -
0 91,000 -
0 101,250 -
5 27,000 135,000
0 649,000 -
2.65 174,870 463,406

0 51,300 -
1 84,825 84,825
0 120,713 -
0 84,825 -
0 97,875 -
0 97,500 -
0 20,250 -
0 88,150 -
2 9,345 18,690
0.7 104,400 73,080
0 100,000 -
0 47,250 -
0 76,050 -
0 79,446 -
0 70,265 -
26 3,850 100,100
41 4,400 180,400
15 4,568 68,520
65 4,176 271,440
0 428,313 -
30 4,959 148,770
0 428,313 -
34 4,959 168,606
0 428,313 -
19 4,959 94,221
0 428,313 -
40 4,959 198,360
0 Rp 142,750 -
0 155,000 -
0 199,985 -
0 1,950 -
0 Rp 24,300 -
0 17,405 -
5 1,950 9,750
0 Rp 24,300 -
0 17,405 -
0 8,250 -
0 16,313 -
0 118,800 -
0 5,225 -
62 7,700 477,400
0 114,500 -
0 137,025 -
0 1,958 -
2 6,250 12,500
0 7,700 -
0 33,385 -
0 33,385 -
0 6,250 -
0 7,425 -
0 -
0 3,500 -
0 5,000 -
0 5,000 -
0 87,750 -
0 114,750 -
0 49,000 -
0 60,750 -
0 64,860 -
0 105,000 -
0 47,250 -
0 55,941 -
0 38,475 -
0 47,250 -
0 32,430 -
0 49,000 -
0 13,500 -
0 32,430 -
6 42,413 254,478
0 42,413 -
0 42,413 -
0 42,413 -
4 53,505 214,020
0 24,750 -
0 21,533 -
0 16,250 -
0 33,750 -
0 47,250 -
0 136,000 -
0 60,750 -
0 27,000 -
0 22,275 -
0 21,620 -
0 490,000 -
0 371,250 -
0 162,500 -
0 75,000 -
0 85,000 -
0 74,345 -
0 138,864 -
1 37,125 37,125
0 -
0 74,250 -
5 36,450 182,250
0 34,592 -
0 26,208 -
0 20,000 -
0 21,620 -
0 773,795 -
0 3,819,338 -
0 -
0 2,824,113 -
0 280,000 -
0 Rp 365,000 -
0 248,630 -
0 607,500 -
0 484,828 -
0 1,730,916 -
0 577,254 -
6 3,328 19,968
0 42,500 -
0 42,413 -
0 276,540 -
0 143,550 -
0 120,000 -
0 118,910 -
0 Rp 121,500 -
0 117,000 -
0 121,500 -
0 108,100 -
0 183,000 -
0 183,600 -
0 183,770 -
0 21,533 -
0 881,250 -
0 100,000 -
0 1,932,287 -
0 505,367 -
0 1,932,287 -
0 1,062,757 -
0 1,545,830 -
0 1,799,875 -
0 5,000 -
0 3,915 -
0 459,000 -
0 243,225 -
0 195,000 -
2 14,900 29,800
0 6,226 -
0 125,345 -
0 12,100 -
0 2,607 -
0 11,850 -
0 60,775 -
0 90,700 -
5.4 27,272 147,269
0 118,910 -
23 10,500 241,500
0 9,000 -
168 5,400 907,200
0 16,300 -
11 15,200 167,200
0 27,500 -
0 1,535 -
0 11,550 -
0 6,500 -
0 52,900 -
0 11,200 -
0 86,400 -
0.96 88,715 85,166
0 55,310 -
45 4,949 222,705
0 4,960 -
50 3,600 180,000
5 4,050 20,250
3 27,500 82,500
2 11,550 23,100
0 6,500 -
4.4 67,954 298,998
1 13,068 13,068
3 37,293 111,879
4 37,293 149,172
4 17,250 69,000
5 11,500 57,500
24 15,400 369,600
17 13,300 226,100
18 6,820 122,760
0 9,700 -
10 6,800 68,000
9 14,000 126,000
2 21,600 43,200
65 2,106 136,890
9 47,400 426,600
5 12,749 63,745
80 2,812 224,960
0 11,100 -
10 3,659 36,590
2 1,383 2,766
4 120,750 483,000
5 14,375 71,875
2 17,715 35,430
19 8,050 152,950
18 6,410 115,380
0 60,200 -
1 190,000 190,000
18 5,200 93,600
0 149,600 -
0 231,000 -
0 126,500 -
3 12,300 36,900
0 5,980 -
39 23,300 908,700
50 3,180 159,000
8 20,000 160,000
50 6,500 325,000
3 18,833 56,499
0 19,000 -
2228.434 20,572,583
BULAN JULI 2017
NO NAMA OBAT KEMASAN STOK AWAL MASUK KELUAR
A. NAMA OBAT
15 Amoksisilin kapsul/kaplet 250 mg Dus, 10 blister @ 10 kapsul 0

500 mg
17 Amoksisillin Kapl. 250 mg Kapsul/100 0 30 0
Hidroksida 200 mg

28 Kotak/25 5 10 2.6

29 Kotak/24 Pot 0.484 0 0
Antihemoroid, kombinasi: bismut subgalat

31 150 mg heksaklorofen 2,5 mg lidokain 10 DUS, 10 SUPP @ 2 GRAM 1 0 1
mg seng oksida 120 mg

42 Betahistin tab. 6 mg Kotak/30 0
Cyanocobalamin (vitamin B12) injeksi 500
mcg
Cyprofloxacin tablet 500 mg (sebagai
65 Dus, 10 blister @ 10 tab ss 0 0
HCl)
Diazepam larutan rektal 5 mg/2,5 ml Dus, 5 alubag @1 tube @ 2,5
78 8
(Stesolid) ml
85 Dulcolax Tab 0
104 Dus @ 30 ampul 1 0 1
mg/ml
115 Glibenclamida 0
117 Gliseril Guaiacolas Botol/1000 5 0 3.1
138 Ketokonazole 0
168 Lidocain inj kotak/100 1 0 1
170 Dus, 30 ampul @ 2 ml 5 0 0
80.000 - 2 ml
1 ml
195 Metoklopramid Injeksi 5 mg/ml (Metolon) Kotak/5 Ampul 0

202 Natrium Diclofenac Tab. 50 mg Kotak/50 0
226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.07 0 0
230 Botol 0
(60 mg/0,6 ml)
233 Pirantel Pamoat 125 mg Kotak/100 2 0 0.5
262 Ringer Laktat Lar. Infus (Tutup karet 3 luba Botol 500 ml 0
265 Salep 2 - 4 Kotak/24 0
266 Pot @ 30 gram 125 0 5
+ Belerang endap 4%
267 Pot @ 30 gram 0
Belerang Endap 4%
salut selaput
0
B. PROGRAM GIZI 0


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
HCl)
298 Botol/60 ml 0
299 Kotak/100 0
CuSO4 )

300 Kotak/100 0
intrinstik)

301 Kotak/100 0
C. OBAT GIGI 0
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0

317 Cresopen 0
326 Etsha btl 0
327 Etsha Botol 0
353 Xylestesin 0
354 Set/Kotak 0
Liquid)
0
369 Kotak/24 0
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 2.65 0 1.625
374 Disp. Syringe with Needle 3 cc Box/100 pcs 0

393 IV Catheter No. 20 G x 11/4 mm Buah 34
403 Jarum Kulit No.11 Set 0 2 0
Larutan Carbol Fuchsin Decolorizer Conc.
425 Botol/100 ml 0
30 ml
432 Botol/100 ml 0
ml
439 Box/100 Buah 6 0 0
Tangan)
441 Box/100 Buah 0
Tangan)
442 Box/100 Buah 0
Tangan)
462 Perlak lembar 0
468 Portex Botol 0
479 Botol/500 ml 0
Hemoglobin)
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 0
503 Urine Bag Pcs 0
OBAT TAMBAHAN 2017

2 Kotak/24 Pot 0.96 0 0.4
5 Sulfametoksazol 200 mg + Trimetoprim 40 Dus, botol @ 60 ml 0
mg/5 ml
10 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 0
13 Box/100 Buah 3 0 3
Tangan)
14 Box/100 Buah 4 0 4
Tangan)
17 Cetirizin tablet 10 mg Box, 10 strips@10 capsules 24 15 14

25 N-asetil sisitein kapsul 200 mg Kotak/100 9 0 4
26 5 0 0
(Stesolid) ml

37 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml 1 0 0.05
38 dus, 10 strip @ 10 tablet 18 20 15
43 Dus, 15 Botol 0 0 10
(60 mg/0,6 ml)
44 Dus, 10 strip @ 10 kaptab 39 100 47
500 mg
45 Amoksisilin sirup kering 125 mg/ 5 ml Btl@60 ml 200 0
46 Allopurinol Tablet/kapsul/kaplet 100 mg Kotak/100 15 0
47 Allopurinol Tablet/kapsul/kaplet 300 mg Dus 10 blister @10 tablet 5 0
48 Amlodipin tablet 5 mg Box, 3 strips@10 tablet 30 8
49 Betahistin tab. 6 mg Kotak/30 20 4
Cyanocobalamin (vitamin B12)
50 Dus, 10 strip @10 tablet 20 9
tablet/kapsul/kaplet 50 mcg
51 Domperidon Tab. 10 mg Kotak/100 10 2
53 Hidrokortison krim 2,5 % Tube 100 14
54 Kloramfenicol kaps 500 mg Kotak 10 strip@10 kaps 5 1
55 Lidokain injeksi 2% HCl Dus 100 ampul@2ml 1 0.2
56 Loperamid tablet 2 mg Dus, 10 strip@10tablet 5 1
57 Metilprednisolon tablet 4 mg Dus 10 blister @10 tablet 8 0 4
58 Metilprednisolon tablet 8 mg Dus 5 blister @10 tablet 3 2
59 Dus 15 ml/btl 50 25
(60 mg/0,6 ml)
60 Ranitidin tablet 150 mg Dus, 3 Strip@10 tab 20 0
61 Sefadroksil kapsul/kaplet 500 mg Dus 10 strip@10 kapsul 20 1

62 Simvastatin scored tablet 10 mg 10
salut selaput
63 Thiamin HCl Tab. 50 mg Kotak/100 30 1
64 Zinc syrup 20 mg/5 ml Dus, botol 60 ml 50 20 40
65 Disp. Syringe with Needle 3 cc Box/100 pcs 5 0
66 Kapas pembalut/absorben 250 gram Roll 5 0
67 Box/100 Buah 5 0
Tangan)
68 Box/100 Buah 5 0
Tangan)
70 Strip Kolesterol Botol/10 Strip 3 3
71 Albothyl Concentrate 5 ml Botol 5 ml 3 2
72 Ambroxol syrup Botol/60 ml 100 35
73 Bromheksin tab. 8 mg Kotak/300 5 4
74 Dexchlorpheniramine Maleate + Botol/60 ml 50 40
75 Daryantull Kotak/10 3 0
76 Meloksikam 7,5 mg Kotak/30 5 5
77 Piroxicam Tab. 20 mg Kotak/100 10 4

78 Kotak/100 25 11
intrinstik)

Vit.B1 + Vit.B2 2+ Vit.B6 + Vit.B12 +
79 Botol/100 ml 60 50
Vit.C + Vit.D + Niaciamide 20 mg + L.
Lysine HCl).

80 Kotak/100 20 1
CuSO4 )
81 Botol/60 ml 100 20
82 Calcinol / Urbical Box/2 Tube 1 1
83 Dentorit/Caviton Botol 1 1
84 Devitasol Pasta (Devitac) Botol 1 1
85 Spongostan Box/10 pcs 2 2
TOTAL 2078.434 307 510.485

DAU
S
HARGA
SISA STOK JUMLAH
SATUAN
0 34,656 -
0 280,315 -
0 13,420 -
0 24,700 -
4 28,870 115,480
9 9,000 81,000
0 8,085 -
8 22,500 180,000
0 -
0 6,510 -
0 3,630 -
0 126,000 -
0 8,600 -
0 5,910 -
0 22,000 -
0 37,000 -
30 22,000 660,000
0 29,200 -
45 2,560 115,200
0 59,048 -
0 41,910 -
0 4,840 -
0 12,650 -
84 7,800 655,200
0 7,800 -
0 17,820 -
0 2,300 -
12.4 69,175 857,770
0.484 91,200 44,141
0 22,000 -
0 3350 -
0 13,563 -
0 35,200 -
37 10,500 388,500
0 5,200 -
96 12,200 1,171,200
0 21,978 -
0 19,800 -
0 82,500 -
38 25,100 953,800
1 36,000 36,000
0 33,539 -
0 51,315 -
0 1,596 -
0 257,070 -
2 1,362 2,724
0 66,517 -
0 23,830 -
0 4,237 -
0 5,286 -
0 35,000 -
0 15,246 -
0 38,000 -
0 14,000 -
0 19,000 -
0 Rp 45,298 -
0 26,400 -
0 122,500 -
0.7 114,070 79,849

0 14,412 -
0 1,441.20 -
0 14,300 -
13 26,500 344,500
0 35,465 -
0 26,500 -
0 312,000 -
0 202,500 -
0 178,000 -
0 173,800 -
0 -
96 7,400 710,400
0 9,570 -
0 10,100 -
0 11,810 -
0 3,152 -
0 12,100 -
0.8 78,147 62,518
8 12,751 102,008
0 4,400 -
0 4,700 -
0 34,680 -
0 10,300 -
20 3,490 69,800
3 17,400 52,200
0 -
0 14,097 -
0 34,848 -
0 267,300 -
0 13,563 -
0 102,300 -
0 8,090 -
0 1,980 -
0 22,720 -
0 2,626 -
0 18,333 -
0 6,221 -
0 Rp 152,889 -
0 89,100 -
0 31,620 -
0 -
0 7,139 -
0 28,855 -
3 69,000 207,000
0 112,620 -
0 57,420 -
0 69,000 -
0 -
0 8,400 -
2 11,229 22,458
0 41,800 -
0 58,030 -
0 20,207 -
0 55,506 -
0 495 -
0 Rp 9,900 -
0 6,100 -
1.9 66,790 126,901
0 Rp 52,635 -
0 30,690 -
156 5,720 892,320
0 24,100 -
0 27,104 -
0 16300 -
0 2,938 -
0 78,650 -
0 12,705 -
0 15,700 -
0 4,949 -
0 12,100 -
0 8,500 -
0 49,720 -
0 49,720 -
0 89,700 -
0 7,600 -
0 43,263 -
27 6,900 186,300
0 10,000 -
0 Rp 16,000 -
0 22,550 -
0 32,000 -
0 41,250 -
0 15,990 -
0 -
0 3,150 -
0 29,315 -
0 41,256 -
25 1,680 42,000
0 4,950 -
0 1,760 -
0 -
0 34,650 -
0 16,500 -
0 16,500 -
0 41,800 -
0 8,349 -
4 10,555 42,220
0 15,200 -
0 2,298 -
0 -
0 -
0 220,000 -
0 243,510 -
0 10,420 -
0 10,420 -
0 -
0 4,000 -
0 37,015 -
0 92,900 -
0 37,510 -
5 63660 318,300
0 20,000 -
0 20,000 -
0 10,071 -
0 9,700 -
1.72 142,300 244,756
0 1,953,485 -
0 15,222 -
0 38,055 -
0 26,500 -
0 38,050 -
0 12,650 -
0 19,965 -
0 16,868 -
0 23,000 -
0 39,000 -
0 49,170 -
0 275,000 -
0 Rp 16,868 -
0 13,310 -
0 17,715 -
0 61,864 -
0 11,000 -
0 8,668 -
0 11,300 -
0 61,870 -
0 15,730 -
0 24,200 -
0 16,900 -
0 3,300 -
0 3,150 -
0 42,500 -
0 9,650 -
0 92,333 -
0 4,545 -
0 5827 -
0 4,545 -
0 89,970 -
0 70,400 -
0 40,700 -
0 52,800 -
0 8,052 -
0 1,573 -
0 395,900 -
0 1,319,900 -
0 13,400 -
0 45,403 -
0 3,686 -
0 52,800 -
0 2,310 -
0 Rp 3,327 -
0 61,000 -
0 3,850 -
0 58,905 -
0 242,000 -
0 6,630 -
0.07 312,500 21,875
0 264,100 -
0 109,450 -
0 5,808 -
0 5,720 -
0 1,535 -
0 8,800 -
1.5 31,800 47,700
0 9,100 -
0 9,100 -
0 Rp 36,685 -
0 33,000 -
0 12,100 -
0 Rp 19,816 -
0 11,550 -
0 21,000 -
0 15,386 -
1 2,640 2,640
0 2,344 -
0 2,344 -
0 68,750 -
0 68,750 -
0 12,500 -
1 20,500 20,500
11 8,000 88,000
0 Rp 35,100 -
0 32,953 -
0 9,100 -
0 31,800 -
0 13,400 -
3 13,200 39,600
0 20,680 -
0 -
18 8,000 144,000
0 5,720 -
0 6,500 -
0 12,000 -
0 9,243 -
0 9,900 -
0 96,000 -
120 2797 335,640
0 2,200 -
0 1,573 -
22 Rp 1,350 29,700
0 52,900 -
0 5,286 -
12 3,690 44,280
0 28,215 -
0 17,700 -
0 78,147 -
1 28,512 28,512
0 -
0 -
0 28,855 -
0 183,425 -
0 16,200 -
0 37,928 -
0 50,090 -
0 25,300 -
0.6 41,580 24,948
0 Rp 71,351 -
2 74,455 148,910
0 750,000 -
0 5,519 -
0 8,140 -
0 276,750 -
-
0 20,700 -
0 90,750 -
0 25,300 -
0 25,080 -
0 25,080 -
0 26,120 -
0 21,700 -
0 27,450 -
0 90,700 -
0 90,750 -
1 70,400 70,400
0 14,025 -
0 18,447 -
0 14,300 -
0 11,200 -
0 24,420 -
0 -
0 -
0 24,700 -
0 216,000 -
0 356,730 -
0 Rp 283,500 -
0 535,095 -
0 Rp 877,500 -
0 60,500 -
0 538,650 -
0 Rp 762,750 -
0 155,250 -
0 201,886 -
0 Rp 263,250 -
0 610,200 -
0 647,660 -
0 115,500 -
0 101,250 -
0 109,451 -
0 101,250 -
0 262,683 -
0 605,000 -
0 434,500 -
0 1,119,375 -
0 Rp 1,309,500 -
0 67,500 -
0 54,000 -
0 168,750 -
0 182,250 -
0 208,093 -
0 217,500 -
0 270,000 -
3 27,000 81,000
0 67,500 -
0 60,750 -
0 37,000 -
0 66,510 -
0 742,500 -
0 988,142 -
0 70,000 -
0 168,250 -
0 181,877 -
0 1,464,441 -
0 Rp 1,650,800 -
0 1,014,894 -
0 528,000 -
0 Rp 573,750 -
0 276,750 -
0 52,250 -
0
-
0.11 120,175 13,219
0.58 175,000 101,500
0 185,000 -
0 120,000 -
0 114,180 -
0 168,000 -
0 29,563 -
12 5,225 62,700
0 327,600 -
0 10,800 -
0 91,000 -
0 101,250 -
5 27,000 135,000
0 649,000 -
1.025 174,870 179,242

0 51,300 -
1 84,825 84,825
0 120,713 -
0 84,825 -
0 97,875 -
0 97,500 -
0 20,250 -
0 88,150 -
2 9,345 18,690
0.7 104,400 73,080
0 100,000 -
0 47,250 -
0 76,050 -
0 79,446 -
0 70,265 -
26 3,850 100,100
41 4,400 180,400
15 4,568 68,520
0 4,176 -
0 428,313 -
25 4,959 123,975
0 428,313 -
34 4,959 168,606
0 428,313 -
19 4,959 94,221
0 428,313 -
35 4,959 173,565
0 Rp 142,750 -
0 155,000 -
0 199,985 -
0 1,950 -
0 Rp 24,300 -
2 17,405 34,810
5 1,950 9,750
0 Rp 24,300 -
0 17,405 -
0 8,250 -
0 16,313 -
0 118,800 -
0 5,225 -
56 7,700 431,200
0 114,500 -
0 137,025 -
0 1,958 -
1 6,250 6,250
5 7,700 38,500
0 33,385 -
0 33,385 -
0 6,250 -
0 7,425 -
0 -
0 3,500 -
0 5,000 -
0 5,000 -
0 87,750 -
0 114,750 -
0 49,000 -
0 60,750 -
0 64,860 -
0 105,000 -
0 47,250 -
0 55,941 -
0 38,475 -
0 47,250 -
0 32,430 -
0 49,000 -
0 13,500 -
0 32,430 -
6 42,413 254,478
0 42,413 -
0 42,413 -
0 42,413 -
3 53,505 160,515
0 24,750 -
0 21,533 -
0 16,250 -
0 33,750 -
0 47,250 -
0 136,000 -
0 60,750 -
0 27,000 -
0 22,275 -
0 21,620 -
0 490,000 -
0 371,250 -
0 162,500 -
0 75,000 -
0 85,000 -
0 74,345 -
0 138,864 -
1 37,125 37,125
0 -
0 74,250 -
3 36,450 109,350
0 34,592 -
0 26,208 -
0 20,000 -
0 21,620 -
0 773,795 -
0 3,819,338 -
0 -
0 2,824,113 -
0 280,000 -
0 Rp 365,000 -
0 248,630 -
0 607,500 -
0 484,828 -
0 1,730,916 -
0 577,254 -
3 3,328 9,984
0 42,500 -
0 42,413 -
0 276,540 -
0 143,550 -
0 120,000 -
0 118,910 -
0 Rp 121,500 -
0 117,000 -
0 121,500 -
0 108,100 -
0 183,000 -
0 183,600 -
0 183,770 -
0 21,533 -
0 881,250 -
0 100,000 -
0 1,932,287 -
0 505,367 -
0 1,932,287 -
0 1,062,757 -
0 1,545,830 -
0 1,799,875 -
0 5,000 -
0 3,915 -
0 459,000 -
0 243,225 -
0 195,000 -
1 14,900 14,900
0 6,226 -
0 125,345 -
0 12,100 -
0 2,607 -
0 11,850 -
0 60,775 -
0 90,700 -
15 27,272 409,080
0 118,910 -
23 10,500 241,500
0 9,000 -
139 5,400 750,600
0 16,300 -
15 15,200 228,000
0 27,500 -
0 1,535 -
0 11,550 -
0 6,500 -
0 52,900 -
0 11,200 -
0 86,400 -
0.56 88,715 49,680
0 55,310 -
40 4,949 197,960
0 4,960 -
90 3,600 324,000
5 4,050 20,250
7 27,500 192,500
0 11,550 -
0 6,500 -
3.9 67,954 265,021
1 13,068 13,068
0 37,293 -
0 37,293 -
4 17,250 69,000
7 11,500 80,500
25 15,400 385,000
11 13,300 146,300
3 6,820 20,460
0 3,600 -
8 6,800 54,400
9 14,000 126,000
1 21,600 21,600
150 2,106 315,900
5 47,400 237,000
5 12,749 63,745
86 2,812 241,832
8 11,100 88,800
5 3,659 18,295
2 1,383 2,766
3 120,750 362,250
4 14,375 57,500
2 9,700 19,400
14 8,050 112,700
35 6,410 224,350
1 60,200 60,200
0.95 190,000 180,500
23 5,200 119,600
0 149,600 -
0 231,000 -
0 126,500 -
0 12,300 -
0 5,980 -
92 23,300 2,143,600
200 2,200 440,000

15 9,500 142,500
5 24,400 122,000
22 2,700 59,400
16 4,650 74,400
11 5,500 60,500
8 13,300 106,400
50 3,180 159,000
86 2,812 241,832
4 115,500 462,000
0.8 87,500 70,000
4 9,000 36,000
4 20,000 80,000
1 16,350 16,350
25 5,980 149,500
20 11,500 230,000
19 55,700 1,058,300
10 4,050 40,500
29 9,100 263,900
30 6,500 195,000
5 91,080 455,400
5 14,260
5 40,620
5 40,620
9 18,833
0 236,098
1 24,499 24,499
65 6,000 390,000
1 65,300 65,300
10 10,000 100,000
3 202,480 607,440
0 38,070 -
6 19,000 114,000
14 93,000 1,302,000
10 26,000 260,000
19 27,000 513,000
80 21,100 1,688,000
0 530,000 -
0 200,000 -
0 640,000 -
0 180,000 -
1426.589 14,205,934
LAMPIRAN OBAT MASUK DAK/DAU
SEMESTER 1 (JAN-JUN 2017)
NO NAMA OBAT KEMASAN 1 2 3 4
A. NAMA OBAT
1 1 blister@24 tablet
2 Adona Injeksi 50 mg Kotak/10 Amp.
3 Albendazol tablet 400 mg Kotak/30
4 Albothyl Botol 10 ml
5 Albothyl Concentrate 5 ml Botol 5 ml 0 0
6 Allopurinol Tab 100 mg Kotak/100 10 10
7 Allopurinol Tab 300 mg Kotak/30
8 Allopurinol tab. 300 mg Kotak/100 10 0
9 Ambroksol Tablet Kotak/100
10 Ambroxol Syrup Botol/60 ml
12 Aminofillin Inj. Kotak/30
13 Aminofillin Tab. 200 mg Botol/100
14 Amlodipin 5mg Kotak/30 5 0
15 Amoksisilin kapsul/kaplet 250 mg
kapsul
16 Dus, 10 strip @ 10 kaptab 50 0
500 mg
17 Amoksisillin Kapl. 250 mg Kapsul/100
18 Amoksisillin Kapl. 500 mg Kotak/100
20 Ampicillin Injeksi Kotak/10
21 Ampisillin Kapl. 500 mg Kotak/100
22 Ampisillin Syrup Kering Botol/60 ml
23 Antalgin Tab. 500 mg (Metampiron) Kotak/100
24 Antasida DOEN Kotak/100 100 0
25 Dus 10 Strip @ 10 tablet
Hidroksida 200 mg
26 Antasida DOEN Tab. Kotak/100
27 Antasida Syr. Botol

28 Kotak/25 5 0

29 Kotak/24 Pot 0 0
DUS, 10 SUPP @ 2
GRAM
32 Antimigrain Botol/100
33 Asam Ascorbat (Vit. C) 50 mg Botol/1000
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 120 0
35 Asam Folat Kaplet 1 mg Botol/100 0 0
36 Asam mefenamat 500 mg Kotak/100 100 0
37 Asam Mefenamat kapsul/kaplet 500 mg Dus, 10 blister @ 10 kap
38 Asering Lar. Infus Botol/500 ml

39 Asiklovir SK Kotak/25
40 Asiklovir Tab. 200 mg Kotak/100 0 0
41 Atropin Sulfat Inj. Kotak/30 0 0
42 Betahistin tab. 6 mg Kotak/30 0 0
43 Betametason Krim Kotak/25
44 Betametason Krim Tube/5g
45 Bisacodil tab Kotak/200
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 5 0
47 Bromheksin tab. 8 mg kotak/300
48 Bromheksin Tab. 8 mg Kotak/100 10 0
49 Bromheksin Tab. 8 mg Kotak/100
50 Cefadroxil syrup Botol
51 Cefotaxime injeksi 1 g kotak/10
52 Cefotaxime Injeksi 1 g Kotak/2 Vial
53 Cetirizin kotak/100
54 Cetirizine Tab. 10 mg Kotak/100 5 0
55 Cetirizine Tab. 10 mg Kotak/50
56 Chlorfeniramine Maleat (CTM) 4 mg
57 Chlorfeniramini Maleat (CTM) 4 mg Botol/1000
58 Kotak/100 ampul @ 1 ml
500 mcg
59 Cyanocobalamin Inj. Kotak/100 0 0
60 Cyanocobalamin Tab. Botol/1000
61 Cyanocobalamin Tablet KOTAK/100
62 Cyprofloxacin 500 mg Tab. Kotak/50
63 Cyprofloxacin 500 mg Tab. Kotak/100 20 0
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10
65
HCl) ss
66 Daryantula (Supratula) Box/20 Lmbr
67 Daryantull 10 x 10 cm Kotak/10
68 Daryantulle Box/10 Pcs
69 Deksametason Injeksi Kotak/100
70 Dekstran 70 - larutan infus 6% steril Botol
71 Dexamethason Tab. 0,5 mg Kotak/100 200 0
72 Dexamethason Tab. 0,5 mg Kotak/100
73 Dextrofen Syrup Botol 60 ml
74 Dexchlorpheniramine Maleate + Botol/60 ml
75 Dextrometrophan Syr. Botol
76 Dextrometrophan Tab. Kotak/100
77 Diazepam Injeksi Kotak/30 0
78 0
(Stesolid) 2,5 ml
79 Diazepam Tab. 2 mg Kotak/100
80 Diazepam tablet/kapsul/kaplet 2 mg Botol 100
81 Difenhidramin Injeksi Kotak/30 0 0
82 Digoxin Tab. 0,25 mg Kotak/100
84 Domperidon Tab. 10 mg Kotak /100 10 0
85 Dulcolax Tab
86 Efedrin HCl 25 mg Botol/250
87 Ekstrak Belladon Botol/1000
88 Epinefrin (Adrenalin) Injeksi 0,1% Kotak/30
89 Ergotamine cafein Kotak/100
90 Eritromicin Kaps. 500 mg Kotak/100
91 Eritromicin Syrup Botol/60 ml
92 Etakridin larutan 0,1% (Rivanol) Botol/300 ml
93 Ethanol Botol/1000
95 Eugenol Cairan Botol/10ml
96 Famotidine kotak/50
97 Fenilbutason Tab 200 mg (Novason)
98 Fenilbutason Tab. 200 mg Botol/1000
99 Fenilbutason Tab. 200 mg (Novason) Botol/100
100 Fenobarbital Inj. Kotak/30
101 Fenobarbital Tab. 30 mg Botol/100
102 Ferrosi sulfas 300 mg tab botol/1000
103 Fitomenadeon Tab. Botol/100 0 0
104 Dus @ 30 ampul 0 0
mg/ml
105 Fitomenadion Injeksi Kotak/30
106 Fitomenadion Tab. Kotak/100
107 Folic Acid Botol/100
108 Furosemid Tab. 40 mg Kotak/100
109 Furosemid Tab. 40 mg Kotak/100 0 0
110 Garam oralit kotak/100
111 Gentamicin 0,1% Salep Kulit Kotak/25 Tube@5 g
113 Gentamycin 0,1 % SK Kotak/25
114 Gentian Violet Botol/10 ml
115 Glibenclamida
116 Glibenklamid Tab. 5 mg Kotak/100
117 Gliseril Guaiacolas Botol/1000 10 0
118 Gliseril Guaiacolat 0 0
119 Gliseryl Guaiacolas Tab. 100 mg Botol/1000
120 Glukosa larutan 5 % Botol 500 ml 0 0
121 Griseofulvin tablet 125 mg, micronized Kotak
122 Hidrochlortiazid Tab. 25 mg Botol/1000
123 Hidroklorotiazid tab 25 mg Dus, 10 strip @ 10 tablet
124 Hidrokortison krim 2,5 % Tube

125 Hidrokortison SK Kotak/24
126 Ibuprofen 200 mg Botol/100
128 Ibuprofen Suspensi 200 mg Botol/60 0 0
129 Ibuprofen tablet 200 mg Botol @ 100 tablet 0 0
130 Ichtiol SK Pot
131 Ichtiol SK 15 g Kotak/12 Pot
133 Induksin Inj Kotak/10amp
134 Kalsium Laktat Tab. 500 mg Kotak/100
135 Kalsium Laktat Tab. 500 mg Botol/1000
136 Kaptopril 12,5 mg Kotak/100 0 0
137 Kaptopril 25 mg Kotak/100
138 Ketokonazole
139 Ketokonazole Tab. 200 mg Kotak/50
141 Ketorolac Injeksi 10 mg Kotak/5 Amp.
143 Kloramfenicol Tetes Mata Kotak
144 Kloramfenicol Tetes Telinga 3% Botol
145 Kloramfenikol Kaps. 250 mg Kotak/100
146 Kloramfenikol salep mata kotak/24
147 Kloramfenikol salep mata Tube/5gr 100 0
148 Kloramfenikol Suspensi Botol/60 ml
149 Kloramfenikol Tetes Telinga botol/5ml
150 Klorpromazin HCl inj. 25mg/ml - 1 ml Kotak/Amp
151 Klorpromazin HCl inj. 5mg/ml - 2 ml Kotak/ 30 Amp
152 Klorpromazin HCl tab 100 mg kotak/100
153 Klorpromazin HCl tablet salut 100 mg Botol
155 Kotrimoksasol Tab. 120 mg Kotak/100
156 Kotrimoksazol 120 mg Kotak/100 5 0
157 Kotrimoksazol 480 Kotak/100
158 Kotrimoksazol Syr. Botol/60
159 Kuinin Dihidroklorida inj.25% - 2 ml Kotak/Amp.
160 Kuinin Sulfat tablet 222 mg (7H2O) Kotak
161 Lacto B Sachet Kotak/4x10
163 Lansoprasol 30 mg Kotak/ 30
164 Lansoprasole 30 mg Kotak/20
165 Larutan Ringer Laktat botol/100ml
166 Levertran Salep Pot
167 Levertran Salep Kulit Kotak/12 Pot
168 Lidocain inj kotak/100 0 0
169 Lidocain Injeksi Kotak/30
170 Dus, 30 ampul @ 2 ml 5 0
80.000 - 2 ml
171 Lisol Botol/1000
172 Lisol Botol 800 ml
173 Loperamide Kotak/100
175 Lorazepam 2 mg Kotak/100 0 0
176 Malaria PF/PV casset Kotak 25
177 Meloksikam 7,5 mg Kotak/20
180 Meloxicam 7,5mg Kotak/30
181 Metamphyron (Antalgin) Tab. 500 mg Kotak/100
182 Metformin HCl tab 500 mg Kotak/100
183 Methylergometrin inj kotak/100
184 Methylprednisolon 4 mg Kotak/100
186 Metilergometrin Injeksi Kotak/30
187 Kotak/100 Ampul @ 1 ml
1 ml
188 Metilergometrin Tab 0,125 mg
189 Metilergometrin Tab. 0,125 mg Kotak/100
190 Metilergometrin Tab. 0,125 mg Kotak /100
191 Metoclorpramide injeksi kotak/5
192 Metokloperamid Injeksi Kotak/10 Amp @ 2 ml
193 Metokloperamid Tab. 5 mg Kotak/100
195 Kotak/5 Ampul
(Metolon)
196 Metronidazol 250 mg Kotak/100
198 Metronidazol 500 mg Kotak/100 3 0
199 Mikonazol Krim Tube/10 gr
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 25 0
201 Myomergin injk Kotak/10
202 Natrium Diclofenac Tab. 50 mg Kotak/50 0 0
203 Natrium Diklofenak 50 mg Kotak/50
204 Natrium Klorida (NaCl) 0,9 % Botol / 500 ml
205 Natrium Klorida (NaCl) 0,9% Botol 500 ml 0 0
206 Natrium Klorida Larutan Infus Botol
207 Nifedipin Tab. 20 mg Blister/30
208 Nistatin Tablet Salut 500.000 IU Kotak/100
209 Nistatin Vaginal Kotak/100
210 Nistatin vaginal tablet 100.000 IU/ g Dus @ 10 X 10 's
211 O.B.H. Indo Plus Botol/100 ml
212 O.B.H. Syr. Botol/100 ml
213 Obat antituberkulosis kategori 1 Paket
215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml
216 Oksitetra S.K Kotak/25
217 Oksitetra S.K Tube/10 gr
218 Oksitetra S.M 1% Kotak/25
219 Oksitetra S.M 1% Tube/3,5 gr
220 Oksitetra Salep Mata 1 %
221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g
222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g
223 Oksitosin Inj. Kotak/30 Amp.
224 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml
225 Omeprazole Tab. 20 mg Kotak/30

226 Oxitosin inj 10 IU/ml Kotak/100 amp 0 0
227 Papaverin Tab. Botol/1000
228 Papaverin Tab 40 mg Botol/1000
229 Parasetamol Drops Botol 15 ml
230 Botol 5 0
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 200 50
232 Parasetamol Tab. 500 mg Kotak/100
233 Pirantel Pamoat 125 mg Kotak/100 3 0
234 Pirantel Pamoat syr Botol/60
235 Pirantel suspensi Botol/60
236 Piridoksin HCl Tab 10 mg
237 Piridoksin HCl Tab. 10 mg Botol/1000
238 Piridoksin HCl Tab. 10 mg Kotak/100
239 Piroxicam Tab 20 mg
240 Piroxicam Tab. 20 mg Kotak/100
243 Povidum Iodium Botol/30ml 0 0
244 Povidum Iodium Botol/10ml
245 Povidum Iodium Botol /30 ml
246 Predmisone Botol / 100
247 Prednison Tab. 5 mg Botol/1000
248 Prednison Tab. 5 mg Kotak/100
249 Primakuin tablet 15 mg Dus,10 blister @10 tablet 0 0
250 Propanolol Tab. 10 mg Kotak/100 0 0

251 Propiltiourasil Tab 10 mg Botol/100
252 Propiltiourasil Tab. 100 mg Botol/100
253 Pyrantel syrp Botol
254 Pyrantel tab Kotak/100
255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp)
256 Ranitidin Tab. 150 mg Kotak/100
257 Reserpin tablet 0,10 mg Kotak
259 Ringer Laktat Botol 1000 ml 0 0
260 Ringer Laktat Lar. Infus Botol 500 ml
262 Ringer Laktat Lar. Infus (Tutup karet 3 lub Botol 500 ml
263 Salbutamol 2 mg Tab. Kotak/100
265 Salep 2 - 4 Kotak/24
266 Pot @ 30 gram 100 0
+ Belerang endap 4%
267 Pot @ 30 gram 0 0
Belerang Endap 4%
268 Salisil Bedak Kotak
269 Salisil Bedak 30 0
270 Sefadroksil 500 mg Kotak/100 30 0
271 Sefadroksil Syrp Botol 60 ml
272 Simvastatin scored tablet 10 mg 30 15
salut selaput
273 Simvastatin Tab. 10 mg Kotak/50
275 Stesolid Injeksi Kotak/5 Amp.
277 Superhoid Kotak/100
278 Superoid Supp Kotak/6
279 Tablet Tambah Darah (SF) Botol/1000
280 Tetrasiklin 250 Kaplet Botol/1000
281 Tetrasiklin 250 Kaplet Kotak/100
282 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul
284 Thiamin HCl Injeksi Kotak/30
285 Thiamin HCl Tab. Botol/1000 0 0
286 Thiamin HCl Tab. 50 mg
287 Thiamin HCl Tablet 50 mg Botol/1000 5 0
288 Vaksin Rabies kuur
289 Vomitrol Syrup Botol
291 Zink phosfat Set
B. PROGRAM GIZI
292 Becefort Botol
293 Hemafort Kotak/100
294 Livron kotak/100
295 lysmin Botol/60 ml
296 + Vit.B12 5 mcg + Vit.C 50 mg + Vit.D Botol/60 ml

1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml
HCl)
298 Botol/60 ml
299 Kotak/100
CuSO4 )

300 Kotak/100
intrinstik)
301 Kotak/100
302 Nistatin Tab salut 500000 IU Kotak/100 2 0
303 Retinol (Vitamin A) 100.000 IU Botol/50 Kaps
305 Retinol (Vitamin A) 100.000 IU Botol/50 kapsul
307 Vitamin B-Complex Botol/1000
C. OBAT GIGI
308 Air raksa dental use Botol
309 Albothyl 5 ml (obat gigi) Botol/5ml
310 Bonding
311 Bonding Botol
312 Bonding
313 Calcinol / Urbical Box/2 Tube
314 Calcinol/ Urbical
315 Chlorphenol Kampher Menthol (CHKM) Botol/20 ml
316 Cresopen Botol/13 ml

317 Cresopen
318 Dentorit/Caviton Botol/30gr
319 Dentorit/Caviton Botol
320 Dentorit/caviton
321 Devitasol Pasta (Devitac) Botol/4,5
322 Devitasol Pasta (Devitac) Botol
323 Etil klorida Kaleng
324 Etil klorida Kaleng 0 0
326 Etsha btl
327 Etsha Botol
328 Eugenol Cairan Kotak 12 Botol @ 15 ml
329 Glass Ionomer Cement Bungkus/Set

330 Glass Ionomer Cement (Vitro Molar) Bungkus/Set
331 Glass Ionomer Cement (Vitro Molar)
332 Gutta Percha Box/200 Stik
333 Gutta Percha Kotak
334 Jarum (Carefull) Set
337 Mata Bor High set
338 Mata Bor High Set
339 Natrium Hipoklorit 3% Liter 0 0
340 Paper Point No. 15 Kotak/200 stik
341 Paper Point No. 15 Kotak
343 Pehacain Injeksi Kotak/20
344 Rockless Botol
345 Rockless Botol
346 Spongostan Kotak/10
347 Spongostan Box/10 pcs 0 0
348 Spongostan Box/10 pcs
349 Tambalan Komposit Set
350 Tambalan komposit ( natural look)
351 Tambalan Komposit (Natural Look) Set
352 Xylestesin Kotak
353 Xylestesin
354 Set/Kotak
Liquid)
355 Zinc tablet kotak/100

356 Alat Suntik / Spoit 1 cc Kotak/100 0 0
358 Alat Suntik / Spoit 20 cc Kotak/100
359 Alat suntik / Spoit 3 cc Kotak/100
362 Alkohol Swamb Dos
363 Aqua Pro Injeksi Botol 20 ml 20 0
365 Asam Klorida (HCl) 0,1 N Botol/100 ml
366 Bisturi No. 15 Box/100 Pcs
367 Bisturi No.15 Box/100 pcs
368 Blood Lancet Kotak/100 3 0
369 Kotak/24
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 0 0
371 Deck Glass Kotak/100
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 1 0
373 Disp. Syringe With Needle 10 cc Box/100 pcs
376 EDTA 10% Botol 100 ml
377 EDTA 10% Botol/100 ml
378 Elastis Perban 4 Inch Rol
379 Foley Catheter Pcs 0 0
380 Folley Catheter 2 way No. 18 Box/10 pcs 0 0
381 Giemsa Stain Botol/100
382 Giemsa Stain Botol/100 ml
383 Hifavix 5x5 cm Rol
384 Hipavix 5 x 5 cm Rol
385 Hipavix 5 x 5 cm Pcs
386 Infus set Anak Kantong/Set 0 0
387 Infus set Dewasa Kantong/Set 0 0
388 Infusion Set Anak/Pediatric (60 drops/ml) Buah 0 0
389 Infusion Set Dewasa (20 drops/ml) Buah 0 0

390 IV Catheter No. 18 Kotak/50
391 IV Catheter No. 18 G x 32 mm Buah 0 0
393 IV Catheter No. 20 G x 11/4 mm Buah 0 0
395 IV Catheter No. 22 G x 1 mm Buah 0 0
397 IV Catheter No. 24 G x 3/4 mm Buah 0 0
398 Jarum Ekstirpasi
399 Jarum Extirpasi
400 Jarum Extirpasi Set
401 Jarum Kulit No. 11 Pcs
402 Jarum Kulit No. 11
403 Jarum Kulit No.11 Set
404 Jarum Otot No. 11 Pcs 0 0
405 Jarum Otot No. 11
406 Jarum Otot No.11 Set
407 Kapas Pembalut/absorben 250 g Rol 0 0
408 Kapas pembalut/absorben 250 gram Roll
409 Kasa 40 x 80 cm Roll
410 Kasa Hydrofil Steril 18 m x 22 cm Kotak/12 Lmbr
411 Kasa Hydrofil Steril 18 m x 22 cm Box/12 50 0
412 Kasa Hydrofil Steril 36 m x 80 cm Rol
413 Kasa Hydrophil 40 x 80 cm Roll 5 0
414 Kasa Pembalut 4 m x 10 cm Roll 50 0
415 Kasa Pembalut Elastis 3 inci Rol 0 0
416 Kasa Pembalut Elastis 3 inci Rol
417 Kasa Pembalut Hydrofil 4 m x 10 cm Rol/50
419 Kertas Puyer bks
420 Kertas Puyer Bungkus
421 Klip Plastik besar Kotak/100
422 Klip Plastik Obat Ukuran Kecil Bungkus/100
423 Klip Plastik Obat Ukuran Sedang Bungkus/100
425 Botol/100 ml
Conc. 30 ml
426 Larutan Eosin Botol/100
427 Larutan Hayem Botol
428 Larutan Hayem Botol/100 ml
430 Larutan karbol Fuchsin 0,3% Botol/100 ml
431 Larutan Methilen Blue Botol/100 ml
432 Botol/100 ml
ml
433 Larutan Spiritus Liter
436 Larutan Turk Botol
437 Larutan Turk Botol/100 ml
439 Box/100 Buah 0 0
Tangan)
440 Latex Examination Glove L, M, S Box/100 Pcs
441 Box/100 Buah
Tangan)
442 Box/100 Buah
Tangan)
443 Lisol Botol/1000 ml 0 0
444 Masker Kotak/20
445 Masker Kotak/50
446 Methanol Liter
447 Methanol Liter
448 Methylen Blue Botol
449 Natrium Sitrat Liter
451 Needle 23 G x 1,5 cc Kotak/100 Pcs 0 0
452 Objeck Glass Kotak/100
454 Oil Emercy Botol/100 ml
456 Oksigen (O2) 6 Kubik
457 Oksigen (O2) 1 kubik
458 Oksigen (O2) 1 1/2 kubik
459 Oksigen (O2) 1 kubik Kubik
461 Perhidrol (H2O2) 13% Liter 0 0
462 Perlak lembar
463 Plano Tes (Tes Kehamilan) Kotak/50
464 Plester 5 yard x 2 inci Roll 0 0
466 Plester 5 yards x 2 inci Rol
467 Porstex botol/1000
468 Portex Botol
469 Rapid Test Hepatitis Kotak/25 tes
470 RDT DBD IgG/IgM Kotak/25
471 RDT DBD NS1 Kotak/25
472 RDT DBD NS1 (Dengue Antigen) Kotak/25
473 Reagen Golongan Darah Botol/10 ml
474 Reagen Golongan Darah
475 Reagen Golongan Darah (A, B, AB) Botol/3X10 ml
476 Reagen Tidal Kotak/4 vial
478 Reagen Widal Kotak 8 Vial@5 ml
479 Botol/500 ml
Hemoglobin)
480 Rivanol (Etakridin larutan 0,1%) Botol/300 ml 5 0
481 Sarung Tangan (Hands Scoon) Kotak/25
482 Sarung Tangan L, M, S Kotak/100
483 Silk (Benang Bedah Sutra ) Kotak/24
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 0 0
485 Strip Asam Urat Botol/25 Strip
487 Strip Asam Urat
488 Strip Gula Botol/25 Strip
491 Strip Kolesterol Botol/10 Strip
494 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 0 0
495 Tes Tuberkulin Pcs
496 Test Pack Kotak/50
497 Uji Dengue IgG/IgM 25 Test
498 Uji Hepatitis BsAg Box/25
499 Uji Leptospira IgM Kotak/25 Test
500 Uji Malaria Box/25
501 Uji Tifoid IgM Box/25
502 Uji Tiphoid IgM Kotak/25
503 Urine Bag Pcs
504 Urine Bag Standard steril 2 Lt Buah
505 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik
507 Urine reagen strip 10 lG Para Meter Botol/100 Stik
508 Anti migrain Botol/100 tab 0 0
509 Ambroksol syrup Botol 60ml
510 cyanocobalamine injeksi 1000mcg/ml kotak/100
511 Ibufropen tab 200 mg Botol 100 tab
512 kloramfenikol 3% tetes telinga botol 0 0
513 Metformin Hcl tab 500 Kotak/10 blister/10tab
514 Oksitetrasiklin salep 3% kotak/25tb 5gr
516 Etanol 70% Cairan Botol/1000 5 0
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 72 15
519 Allopurinol 100 mg Kotak/100
520 Chlorpeniramine Maleat(CTM) Kotak/100 100 0
521 Ibufropen tab 400 mg Kotak/100
522 Kotrimoksaxole 480 Kotak/100 30 0
523 Metformine HCL tab 500 mg Kotak/100
524 Parasetamol Syrup Botol/60 ml
525 Ranitidine tab 150 mg Kotak/30
526 salbutamol 4mg Kotak/100
527 Sefadroksil Kapsul Kotak/100
528 Vit. B-complex Kotak/100
OBAT TAMBAHAN 2017

1 Amlodipin tablet 5 mg Box, 10 strips@10 tab 5 0
2 Kotak/24 Pot 2 0
3 Ichtiol SK 15 g Kotak/12 Pot 2 0
5 Sulfametoksazol 200 mg + Trimetoprim Dus, botol @ 60 ml 50 0
40 mg/5 ml
6 Kotrimoksazol Syrup Botol/60 ml 50 0
7 Kloramfenicol suspensi 125 mg/5 ml Botol @ 60 ml 5 0
8 Metformin HCl tab 500 mg Box, 10 strips@10 tab 5 0
10 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 5 0
13 Box/100 Buah 10 0
Tangan)
14 Box/100 Buah 5 0
Tangan)
16 Alkohol Swamb Kotak/100 5
Box, 10 strips@10
17 Cetirizin tablet 10 mg 10
capsules
18 Ibuprofen 400 mg Dus 10 X 10'S 10
19 Lansoprazole kapsul/kaplet 30 mg Dus , 2 strip @ 10 kapsul 10
22 Metronidazol tablet 500 mg 10 strip @ 10 tab 10
23 Povidum iodium Botol/300 ml 5
25 N-asetil sisitein kapsul 200 mg Kotak/100
26
(Stesolid) 2,5 ml
27 Hidrokortison krim 2,5 % Tube 5 gr
28 Ibuprofen 200 mg Kotak/100
29 Infusion Set Anak/Pediatric (60 drops/ml) Set
30 Ketorolac injeksi 30 mg/ml Dus, 6 ampul @ 1 ml

31 Kasa Hydrophil 40 x 80 cm Roll
33 Metilergometrin Tab 0,125 mg Kotak/100
34 Natrium Diclofenac tablet 50 mg Dus @ 5 X 10 's
35 Natrium Klorida (NaCl) 0,9% Botol 500 ml
36 Nistatin vaginal tablet 100.000 iu/g tsb/vaginal

38 dus, 10 strip @ 10 tablet
42 Tablet Tambah Darah (Ferrosi Sulfat) Kotak/30 Tab
43 Dus, 15 Botol 5
(60 mg/0,6 ml)
43 Dus, 10 strip @ 10 kaptab
500 mg
44 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml
45 Methylprednisolon 4 mg dus, 10 strip @ 10 tablet
46 Zinc Syrup 20 mg/5 ml Dus, Botol 60 ml

47 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs
TOTAL 0 0 2066 176

5 6 TOTAL
0
0
0
0
0 0 0
15 0 35
0
0 0 10
0
0
0
0
0
5
0
0 50
0
0
0 0 200
0
0
0
0
0 0 100
0
0
0 5 10
0 0 0
0
0 0 5
0
0
50 15 185
0 0 0
0 0 100
0
0
0
0 0 0
0 0 0
0 0 0
0
0
0
0 0 5
0
10
0
0
0
0
0
5
0
0
0
0
0 0 0
0
0
0
0 0 20
0
0
0
0
0
0
0
0 0 200
0
0
0
0
0 0 0
0 0
0
0
0 0
0
0 30
10 0 20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0 0 0
0
0
0
0
0 0 0
0
0
1
0
0
0
0
0 0 10
0 0 0
0
0 0 0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
30 0 30
0
0
0
0
0
0
0
0
0
0
0 0 100
0
0
0
0
0
0
0
0
0 0 5
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0
0 0 5
0
0
0
0
0 0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 3
0
0 0 25
0
0 0 0
0
0
0 0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0
0
0
0 0 5
100 50 400
0
0 0 3
0
0
0
0
0
0
0
10
0
0 0 0
0
0
0
0
0
0 0 0
0 0 0
0
0
0
0
0
20 0 20
0
0
0 0 0
0
0
0
0
0
0
50 0 150
0
0
0 0 30
0 0 30
0
30 0 75
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0
0 0 5
0
0
0 0 50
0
0
0
0
0
0
0
0
0
0 0 2
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0
0
0
0
0
0
0
0
0
0
0
2 2
0
0
0 0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0 0 0
0
0
0
0
0
0 0 20
0
0
0
0
5 5 13
0
0 0 0
0
0 0 1
0
0 0 0
0
0
0
0
0 0 0
0 0 0
0
0
0
0
0
0 0 0
0 0 0
0 0 0
0 0 0
0
0 0 0
0
0 0 0
0
0 0 0
0
0 0 0
0
0
0
0
0
0
0 0 0
0
0
0
0
0
0
0 0 50
0
0 5
0 0 50
0 0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0
0
0
0 0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0
0
0 0 0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 5 10
0
0
0
0 0 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 0
0
0
0
0
0
0
0
5 0 10
0
36 30 153
0
100 0 200
0
0 10 40
0
0
0
0
0
0
0
0
0 5
0 0 2
0 1 3
0 50 100
0 0 50
0 0 50
0 0 5
0 0 5
0 0 35
0 0 5
0 0 5
0 0 2
5 0 15
5 0 10
10 0 17
5 0 10
30 0 40
20 10 40
30 0 40
1
0 5 15
0 0 10
0 0 5
150 50 200
10 0 10
5 5
200 0 200
10 0 10
10 0 10
2 0 2
5 0 5
5 0 5
3 0 3
20 0 20
20 0 20
1 1
1 0 1
20 10 30
1 1
5 5
2 2
1518 0 1518
30 0 35
50 50
50 50
10 10
50 50
5 5
2 2
2576 413 5231

LAMPIRAN OBAT KELUAR DAK / DAU
SEMESTER 1 (JAN-JUN 2017)
NO NAMA OBAT KEMASAN 1 2 3 4
A. NAMA OBAT
1 1 blister@24 tablet 0 1
2 Adona Injeksi 50 mg Kotak/10 Amp.
3 Albendazol tablet 400 mg Kotak/30
4 Albothyl Botol 10 ml
7 Allopurinol Tab 300 mg Kotak/30
8 Allopurinol tab. 300 mg Kotak/100 0 0
9 Ambroksol Tablet Kotak/100
12 Aminofillin Inj. Kotak/30
13 Aminofillin Tab. 200 mg Botol/100
14 Amlodipin 5mg Kotak/30 5 0
15 Amoksisilin kapsul/kaplet 250 mg
kapsul
16 Dus, 10 strip @ 10 kaptab 27 40 37 34
500 mg
17 Amoksisillin Kapl. 250 mg Kapsul/100
18 Amoksisillin Kapl. 500 mg Kotak/100
20 Ampicillin Injeksi Kotak/10
21 Ampisillin Kapl. 500 mg Kotak/100
22 Ampisillin Syrup Kering Botol/60 ml
23 Antalgin Tab. 500 mg (Metampiron) Kotak/100
25 Dus 10 Strip @ 10 tablet
Hidroksida 200 mg
26 Antasida DOEN Tab. Kotak/100

28 Kotak/25 0 0 2 3

29 Kotak/24 Pot 1.05 0.625 0 1.3
30 Antihemoroid Doen Kombinasi Kotak/10 Supp. 0 1 2
DUS, 10 SUPP @ 2
GRAM
33 Asam Ascorbat (Vit. C) 50 mg Botol/1000
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 39 28
37 Asam Mefenamat kapsul/kaplet 500 mg Dus, 10 blister @ 10 kap 20 30
38 Asering Lar. Infus Botol/500 ml

39 Asiklovir SK Kotak/25
43 Betametason Krim Kotak/25
44 Betametason Krim Tube/5g
45 Bisacodil tab Kotak/200
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 0 1
47 Bromheksin tab. 8 mg kotak/300
48 Bromheksin Tab. 8 mg Kotak/100 4 6
49 Bromheksin Tab. 8 mg Kotak/100
50 Cefadroxil syrup Botol
51 Cefotaxime injeksi 1 g kotak/10
52 Cefotaxime Injeksi 1 g Kotak/2 Vial
53 Cetirizin kotak/100
54 Cetirizine Tab. 10 mg Kotak/100 4 1
56 Chlorfeniramine Maleat (CTM) 4 mg
57 Chlorfeniramini Maleat (CTM) 4 mg Botol/1000
58 Kotak/100 ampul @ 1 ml
500 mcg
59 Cyanocobalamin Inj. Kotak/100 0 0 0 0
60 Cyanocobalamin Tab. Botol/1000
61 Cyanocobalamin Tablet KOTAK/100
65
HCl) ss
66 Daryantula (Supratula) Box/20 Lmbr
67 Daryantull 10 x 10 cm Kotak/10
68 Daryantulle Box/10 Pcs
69 Deksametason Injeksi Kotak/100
70 Dekstran 70 - larutan infus 6% steril Botol
72 Dexamethason Tab. 0,5 mg Kotak/100
73 Dextrofen Syrup Botol 60 ml
74 Dexchlorpheniramine Maleate + Botol/60 ml
75 Dextrometrophan Syr. Botol
76 Dextrometrophan Tab. Kotak/100
77 Diazepam Injeksi Kotak/30 0 0 0
78 0 0 0
(Stesolid) 2,5 ml
79 Diazepam Tab. 2 mg Kotak/100
80 Diazepam tablet/kapsul/kaplet 2 mg Botol 100
82 Digoxin Tab. 0,25 mg Kotak/100
85 Dulcolax Tab
86 Efedrin HCl 25 mg Botol/250
87 Ekstrak Belladon Botol/1000
88 Epinefrin (Adrenalin) Injeksi 0,1% Kotak/30
89 Ergotamine cafein Kotak/100
90 Eritromicin Kaps. 500 mg Kotak/100
91 Eritromicin Syrup Botol/60 ml
92 Etakridin larutan 0,1% (Rivanol) Botol/300 ml
95 Eugenol Cairan Botol/10ml
96 Famotidine kotak/50
97 Fenilbutason Tab 200 mg (Novason)
98 Fenilbutason Tab. 200 mg Botol/1000
99 Fenilbutason Tab. 200 mg (Novason) Botol/100
100 Fenobarbital Inj. Kotak/30
101 Fenobarbital Tab. 30 mg Botol/100
102 Ferrosi sulfas 300 mg tab botol/1000
104 Dus @ 30 ampul 0 0 0 0
mg/ml
105 Fitomenadion Injeksi Kotak/30
106 Fitomenadion Tab. Kotak/100
107 Folic Acid Botol/100
108 Furosemid Tab. 40 mg Kotak/100
110 Garam oralit kotak/100
111 Gentamicin 0,1% Salep Kulit Kotak/25 Tube@5 g
114 Gentian Violet Botol/10 ml
115 Glibenclamida
116 Glibenklamid Tab. 5 mg Kotak/100
117 Gliseril Guaiacolas Botol/1000 0 0
118 Gliseril Guaiacolat 2 3 3.5 3
119 Gliseryl Guaiacolas Tab. 100 mg Botol/1000
121 Griseofulvin tablet 125 mg, micronized Kotak
122 Hidrochlortiazid Tab. 25 mg Botol/1000
123 Hidroklorotiazid tab 25 mg Dus, 10 strip @ 10 tablet
124 Hidrokortison krim 2,5 % Tube

125 Hidrokortison SK Kotak/24
126 Ibuprofen 200 mg Botol/100
130 Ichtiol SK Pot
133 Induksin Inj Kotak/10amp
135 Kalsium Laktat Tab. 500 mg Botol/1000
137 Kaptopril 25 mg Kotak/100
138 Ketokonazole
143 Kloramfenicol Tetes Mata Kotak
144 Kloramfenicol Tetes Telinga 3% Botol
145 Kloramfenikol Kaps. 250 mg Kotak/100
146 Kloramfenikol salep mata kotak/24
147 Kloramfenikol salep mata Tube/5gr 0 0
148 Kloramfenikol Suspensi Botol/60 ml
149 Kloramfenikol Tetes Telinga botol/5ml
150 Klorpromazin HCl inj. 25mg/ml - 1 ml Kotak/Amp
151 Klorpromazin HCl inj. 5mg/ml - 2 ml Kotak/ 30 Amp
152 Klorpromazin HCl tab 100 mg kotak/100
155 Kotrimoksasol Tab. 120 mg Kotak/100
156 Kotrimoksazol 120 mg Kotak/100 0 0
157 Kotrimoksazol 480 Kotak/100
158 Kotrimoksazol Syr. Botol/60
159 Kuinin Dihidroklorida inj.25% - 2 ml Kotak/Amp.
160 Kuinin Sulfat tablet 222 mg (7H2O) Kotak
163 Lansoprasol 30 mg Kotak/ 30
164 Lansoprasole 30 mg Kotak/20
165 Larutan Ringer Laktat botol/100ml
166 Levertran Salep Pot
167 Levertran Salep Kulit Kotak/12 Pot
168 Lidocain inj kotak/100 0 0.25 0.1 0
169 Lidocain Injeksi Kotak/30
170 Dus, 30 ampul @ 2 ml 0 0
80.000 - 2 ml
171 Lisol Botol/1000
172 Lisol Botol 800 ml
173 Loperamide Kotak/100
175 Lorazepam 2 mg Kotak/100 0 0 0 0.08
176 Malaria PF/PV casset Kotak 25
180 Meloxicam 7,5mg Kotak/30
181 Metamphyron (Antalgin) Tab. 500 mg Kotak/100
182 Metformin HCl tab 500 mg Kotak/100
183 Methylergometrin inj kotak/100
186 Metilergometrin Injeksi Kotak/30
187 Kotak/100 Ampul @ 1 ml
1 ml
188 Metilergometrin Tab 0,125 mg
189 Metilergometrin Tab. 0,125 mg Kotak/100
190 Metilergometrin Tab. 0,125 mg Kotak /100
191 Metoclorpramide injeksi kotak/5
192 Metokloperamid Injeksi Kotak/10 Amp @ 2 ml
195 Kotak/5 Ampul
(Metolon)
198 Metronidazol 500 mg Kotak/100 2 0
199 Mikonazol Krim Tube/10 gr
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 0 0
201 Myomergin injk Kotak/10
203 Natrium Diklofenak 50 mg Kotak/50
204 Natrium Klorida (NaCl) 0,9 % Botol / 500 ml
206 Natrium Klorida Larutan Infus Botol
208 Nistatin Tablet Salut 500.000 IU Kotak/100
209 Nistatin Vaginal Kotak/100
210 Nistatin vaginal tablet 100.000 IU/ g Dus @ 10 X 10 's 0 1
211 O.B.H. Indo Plus Botol/100 ml
212 O.B.H. Syr. Botol/100 ml
215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml
216 Oksitetra S.K Kotak/25
217 Oksitetra S.K Tube/10 gr
218 Oksitetra S.M 1% Kotak/25 0 1
219 Oksitetra S.M 1% Tube/3,5 gr
220 Oksitetra Salep Mata 1 % 16 4
221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g
222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g
223 Oksitosin Inj. Kotak/30 Amp.
225 Omeprazole Tab. 20 mg Kotak/30

227 Papaverin Tab. Botol/1000
229 Parasetamol Drops Botol 15 ml
230 Botol 18 14 5 0
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 168 82
232 Parasetamol Tab. 500 mg Kotak/100
233 Pirantel Pamoat 125 mg Kotak/100 0 0.5 4 1
234 Pirantel Pamoat syr Botol/60
235 Pirantel suspensi Botol/60
236 Piridoksin HCl Tab 10 mg
237 Piridoksin HCl Tab. 10 mg Botol/1000
238 Piridoksin HCl Tab. 10 mg Kotak/100
239 Piroxicam Tab 20 mg
244 Povidum Iodium Botol/10ml
245 Povidum Iodium Botol /30 ml
246 Predmisone Botol / 100
247 Prednison Tab. 5 mg Botol/1000
248 Prednison Tab. 5 mg Kotak/100

253 Pyrantel syrp Botol
254 Pyrantel tab Kotak/100
255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp)
256 Ranitidin Tab. 150 mg Kotak/100
262 Ringer Laktat Lar. Infus (Tutup karet 3 lub Botol 500 ml
265 Salep 2 - 4 Kotak/24
266 Pot @ 30 gram 0 0
+ Belerang endap 4%
267 Pot @ 30 gram 5 9 5 5
Belerang Endap 4%
268 Salisil Bedak Kotak
270 Sefadroksil 500 mg Kotak/100 5 9
271 Sefadroksil Syrp Botol 60 ml
salut selaput
275 Stesolid Injeksi Kotak/5 Amp.
276 Stesolid Rektal Tub. Pcs 5 ml 2 1 3
277 Superhoid Kotak/100
278 Superoid Supp Kotak/6
279 Tablet Tambah Darah (SF) Botol/1000
280 Tetrasiklin 250 Kaplet Botol/1000
281 Tetrasiklin 250 Kaplet Kotak/100
284 Thiamin HCl Injeksi Kotak/30
285 Thiamin HCl Tab. Botol/1000 1 1 3.5 2.35
286 Thiamin HCl Tab. 50 mg
287 Thiamin HCl Tablet 50 mg Botol/1000 0 1
288 Vaksin Rabies kuur
289 Vomitrol Syrup Botol
290 Zinc Syrup Botol/60 ml 10 31
291 Zink phosfat Set
B. PROGRAM GIZI
292 Becefort Botol
294 Livron kotak/100 16 3
295 lysmin Botol/60 ml
296 + Vit.B12 5 mcg + Vit.C 50 mg + Vit.D Botol/60 ml

1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml
HCl)
298 Botol/60 ml
299 Kotak/100
CuSO4 )

300 Kotak/100
intrinstik)

301 Kotak/100
305 Retinol (Vitamin A) 100.000 IU Botol/50 kapsul
307 Vitamin B-Complex Botol/1000
C. OBAT GIGI
308 Air raksa dental use Botol
309 Albothyl 5 ml (obat gigi) Botol/5ml
310 Bonding
311 Bonding Botol
312 Bonding
313 Calcinol / Urbical Box/2 Tube
314 Calcinol/ Urbical
315 Chlorphenol Kampher Menthol (CHKM) Botol/20 ml
316 Cresopen Botol/13 ml

317 Cresopen
318 Dentorit/Caviton Botol/30gr
319 Dentorit/Caviton Botol
320 Dentorit/caviton
321 Devitasol Pasta (Devitac) Botol/4,5
322 Devitasol Pasta (Devitac) Botol
326 Etsha btl
327 Etsha Botol
328 Eugenol Cairan Kotak 12 Botol @ 15 ml
329 Glass Ionomer Cement Bungkus/Set

330 Glass Ionomer Cement (Vitro Molar) Bungkus/Set
331 Glass Ionomer Cement (Vitro Molar)
332 Gutta Percha Box/200 Stik
333 Gutta Percha Kotak
337 Mata Bor High set
338 Mata Bor High Set
341 Paper Point No. 15 Kotak
343 Pehacain Injeksi Kotak/20
344 Rockless Botol
345 Rockless Botol
346 Spongostan Kotak/10
348 Spongostan Box/10 pcs
349 Tambalan Komposit Set
350 Tambalan komposit ( natural look)
351 Tambalan Komposit (Natural Look) Set
352 Xylestesin Kotak
353 Xylestesin
354 Set/Kotak
Liquid)
355 Zinc tablet kotak/100

356 Alat Suntik / Spoit 1 cc Kotak/100 0.63 0.36 0.1 0.1
359 Alat suntik / Spoit 3 cc Kotak/100
363 Aqua Pro Injeksi Botol 20 ml 8 0
364 Aquadest Steril Kotak/120@25 Botol 0 9 0
365 Asam Klorida (HCl) 0,1 N Botol/100 ml
366 Bisturi No. 15 Box/100 Pcs
367 Bisturi No.15 Box/100 pcs
368 Blood Lancet Kotak/100 2 1
369 Kotak/24
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 0.125 0.625 0.2 0.4
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 0 0
374 Disp. Syringe with Needle 3 cc Box/100 pcs 0 1.05 0.65 1.05
376 EDTA 10% Botol 100 ml
377 EDTA 10% Botol/100 ml
378 Elastis Perban 4 Inch Rol
380 Folley Catheter 2 way No. 18 Box/10 pcs 0 0.1 0 0
381 Giemsa Stain Botol/100
382 Giemsa Stain Botol/100 ml
383 Hifavix 5x5 cm Rol
384 Hipavix 5 x 5 cm Rol
385 Hipavix 5 x 5 cm Pcs

398 Jarum Ekstirpasi
399 Jarum Extirpasi
400 Jarum Extirpasi Set
401 Jarum Kulit No. 11 Pcs
402 Jarum Kulit No. 11
403 Jarum Kulit No.11 Set
405 Jarum Otot No. 11
406 Jarum Otot No.11 Set
410 Kasa Hydrofil Steril 18 m x 22 cm Kotak/12 Lmbr
412 Kasa Hydrofil Steril 36 m x 80 cm Rol
413 Kasa Hydrophil 40 x 80 cm Roll 1 2
414 Kasa Pembalut 4 m x 10 cm Roll 25 0
416 Kasa Pembalut Elastis 3 inci Rol
419 Kertas Puyer bks
420 Kertas Puyer Bungkus
421 Klip Plastik besar Kotak/100
422 Klip Plastik Obat Ukuran Kecil Bungkus/100
425 Botol/100 ml
Conc. 30 ml
426 Larutan Eosin Botol/100
427 Larutan Hayem Botol
430 Larutan karbol Fuchsin 0,3% Botol/100 ml
431 Larutan Methilen Blue Botol/100 ml
432 Botol/100 ml
ml
436 Larutan Turk Botol
439 Box/100 Buah 0 1 0 1
Tangan)
440 Latex Examination Glove L, M, S Box/100 Pcs
441 Box/100 Buah 5
Tangan)
442 Box/100 Buah 1
Tangan)
443 Lisol Botol/1000 ml 0 1 0 0
444 Masker Kotak/20
445 Masker Kotak/50
446 Methanol Liter
447 Methanol Liter
448 Methylen Blue Botol
456 Oksigen (O2) 6 Kubik
457 Oksigen (O2) 1 kubik
458 Oksigen (O2) 1 1/2 kubik
462 Perlak lembar
463 Plano Tes (Tes Kehamilan) Kotak/50
466 Plester 5 yards x 2 inci Rol
467 Porstex botol/1000
468 Portex Botol
469 Rapid Test Hepatitis Kotak/25 tes
470 RDT DBD IgG/IgM Kotak/25
471 RDT DBD NS1 Kotak/25
472 RDT DBD NS1 (Dengue Antigen) Kotak/25
473 Reagen Golongan Darah Botol/10 ml
474 Reagen Golongan Darah
475 Reagen Golongan Darah (A, B, AB) Botol/3X10 ml
478 Reagen Widal Kotak 8 Vial@5 ml
479 Botol/500 ml
Hemoglobin)
481 Sarung Tangan (Hands Scoon) Kotak/25
482 Sarung Tangan L, M, S Kotak/100
483 Silk (Benang Bedah Sutra ) Kotak/24
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 0 0 0 0.2
487 Strip Asam Urat
495 Tes Tuberkulin Pcs
496 Test Pack Kotak/50
497 Uji Dengue IgG/IgM 25 Test
498 Uji Hepatitis BsAg Box/25
499 Uji Leptospira IgM Kotak/25 Test
500 Uji Malaria Box/25
501 Uji Tifoid IgM Box/25
502 Uji Tiphoid IgM Kotak/25
503 Urine Bag Pcs
504 Urine Bag Standard steril 2 Lt Buah
507 Urine reagen strip 10 lG Para Meter Botol/100 Stik
509 Ambroksol syrup Botol 60ml
511 Ibufropen tab 200 mg Botol 100 tab
513 Metformin Hcl tab 500 Kotak/10 blister/10tab
514 Oksitetrasiklin salep 3% kotak/25tb 5gr
516 Etanol 70% Cairan Botol/1000 0 3 1.2 0
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 57 30
521 Ibufropen tab 400 mg Kotak/100 3 3
523 Metformine HCL tab 500 mg Kotak/100
525 Ranitidine tab 150 mg Kotak/30
528 Vit. B-complex Kotak/100
OBAT TAMBAHAN 2017

1 Amlodipin tablet 5 mg Box, 10 strips@10 tab 1 3
2 Kotak/24 Pot 0 0
5 Sulfametoksazol 200 mg + Trimetoprim Dus, botol @ 60 ml 20 0
40 mg/5 ml
6 Kotrimoksazol Syrup Botol/60 ml 0 0
7 Kloramfenicol suspensi 125 mg/5 ml Botol @ 60 ml 0 0
8 Metformin HCl tab 500 mg Box, 10 strips@10 tab 0 1
10 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 3 0
13 Box/100 Buah 3 3
Tangan)
14 Box/100 Buah 2 2
Tangan)
16 Alkohol Swamb Kotak/100 0
Box, 10 strips@10
17 Cetirizin tablet 10 mg 6
capsules
18 Ibuprofen 400 mg Dus 10 X 10'S 5
19 Lansoprazole kapsul/kaplet 30 mg Dus , 2 strip @ 10 kapsul 10
22 Metronidazol tablet 500 mg 10 strip @ 10 tab 0
23 Povidum iodium Botol/300 ml 1
25 N-asetil sisitein kapsul 200 mg Kotak/100
26
(Stesolid) 2,5 ml
27 Hidrokortison krim 2,5 % Tube 5 gr
28 Ibuprofen 200 mg Kotak/100
29 Infusion Set Anak/Pediatric (60 drops/ml) Set
30 Ketorolac injeksi 30 mg/ml Dus, 6 ampul @ 1 ml

31 Kasa Hydrophil 40 x 80 cm Roll
33 Metilergometrin Tab 0,125 mg Kotak/100
34 Natrium Diclofenac tablet 50 mg Dus @ 5 X 10 's
35 Natrium Klorida (NaCl) 0,9% Botol 500 ml
36 Nistatin vaginal tablet 100.000 iu/g tsb/vaginal

38 dus, 10 strip @ 10 tablet
42 Tablet Tambah Darah (Ferrosi Sulfat) Kotak/30 Tab
43 Dus, 15 Botol 5
(60 mg/0,6 ml)
44 Dus, 10 strip @ 10 kaptab
500 mg
45 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml
46 Methylprednisolon 4 mg dus, 10 strip @ 10 tablet
47 Zinc Syrup 20 mg/5 ml Dus, Botol 60 ml

48 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs
TOTAL 575.945 396.51 746.25 627.67

5 6 TOTAL
1
0
0
0
0 0 2
4 4 27
0
2 0 2
0
0
0
0
0
5
0
20 158
0
0
31 64 95
0
0
0
0
16 23 176
0
0
2 1 8
0.541 0 3.516
3
1 2 4
7
0
24 33 124
0 0 0
27 25 117
50
0
0
0 3 5
0 0 0
0 2 2
0
0
0
1 1 3
0
10
0
0
0
0
0
5
3
0
0
0
0 0 0
0
0
34
3 4 12
5
0
0
0
0
0
0
50 40 265
0
0
0
0
0
0 0 0
0 0
0
0
0 1
0
5 0 5
2 4 19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 1 5
0 0 0
0
0
0
0
0 0 1
0
0
1
1
0
0
0
3 2 5
0.75 0.5 12.75
0
0 0 17
0
0
0
0
0
0
5
176
12
0
2
0
0
13
0
2 8 16
0
0
0
0
0
0
0
0
0
0
0 15 15
0
0
0
0
0
0
0
0
0 1 1
0
0
0
0
0
0
0
0
0
0
0
0.5 0.15 1
0
0 0 0
0
0
0
2
0 0 0.08
0
0
0
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 0 2
0
0 25 25
0
2 2 10
0
0
1 0 27
0
1
0
0
1
0
0
0
0
0
0
0
1
0
20
0
0
0
0
0
0.05 0.1 0.43
0
4
0
0 0 37
77 51 378
0
0 1.5 7
0
0
0
0
0
0
6
35
5
0 0 7
0
0
0
0
0
0 0 0
0 0 0
5
4
0
0
0
4 6 10
0
0
2 0 26
0
0
0
0
0
0
0 25 25
24
0
8 5 27
6 7 27
0
16 14 65
0
0
0
1 7
0
0
0
0
0
1
0
0
0.75 0.4 9
0
1 0 2
0
0
0 9 50
0
0
0
0
0
19
0
1 0 4
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 1 5
0
0
0
0
0
0
0
0
0
0
0
2 2
0
0
0 0 0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0.31 0.25 1.75
0 0 0.05
0
0
0
0
1
0 0 8
9
0
0
0
5 0 8
0
0 0 1.35
1
0 0 0
0
0.75 0.5 4
0
0
0
0
0 2 11
0 0.2 0.3
0
0
0
0
0
0 0 1
5 0 26
0 0 0
0 0 0
0
0 0 20
0
5 0 16
0
5 0 19
0
0 0 10
0
0
0
0
0
0
0 0 0
0
0
4
0
1
0
8 2 28
0
2 5
10 15 50
1 2 5
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 0 3
0
5
1
0 0 1
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0 0 0
0
0
5 3 16
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3 2 15
0
0
0
0.5 1.3 2
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
1 0 2
0
1
0
18
0
0
0
1.3 3.1 8.6
0
20 23 130
10
47 27 215
6
8 9 31
0
100
0
2
3
0
0
0
1 5
0 1.04 1.04
1 1 3
20 35 55
0 30 50
0 0 0
0 0 0
0 1 2
2 6 33
1 1 5
0 0.6 0.6
0 1 1
4 2 12
2 0 6
3 9 15
5 0 5
2 8 16
10 8 23
6 6 22
1
0 0 5
1 0 1
0 2 3
50 85 135
1 0 1
0 0
35 85 120
2 8 10
0 0 0
0 0 0
0 1 1
0 0 0
0 1 1
0 1 1
0 2 2
1 1
0 0 0
4 8 12
1 1
5 5
2 2
0 1515 1515
20 10 35
11 11
0 0
2 2
0 0
0 0
2 2
624.451 2313.64 5284.466

LAMPIRAN PERSEDIAAN OBAT DAK / DAU
SEMESTER 1 (JAN - JUN 2017)
SISA STOK
STOK
NO NAMA OBAT KEMASAN MASUK KELUAR PER 30 JUNI
AWAL
2017
A. NAMA OBAT
2 Adona Injeksi 50 mg Kotak/10 Amp. 0 0 0
3 Albendazol tablet 400 mg Kotak/30 0 0 0
4 Albothyl Botol 10 ml 0 0 0
10 Ambroxol Syrup Botol/60 ml 0 0 0
11 Ambroxol Syrup Botol/60 ml 0 0 0
12 Aminofillin Inj. Kotak/30 0 0 0
13 Aminofillin Tab. 200 mg Botol/100 0 0 0
14 Amlodipin 5mg Kotak/30 5 5 0
15 Amoksisilin kapsul/kaplet 250 mg 0 0 0
kapsul
Amoksisilin kapsul/kaplet/tablet scored 108
16 Dus, 10 strip @ 10 kaptab 50 158 0
500 mg
18 Amoksisillin Kapl. 500 mg Kotak/100 0 0 0
20 Ampicillin Injeksi Kotak/10 0 0 0
21 Ampisillin Kapl. 500 mg Kotak/100 0 0 0
22 Ampisillin Syrup Kering Botol/60 ml 0 0 0
23 Antalgin Tab. 500 mg (Metampiron) Kotak/100 0 0 0
25 Dus 10 Strip @ 10 tablet 0 0 0
Hidroksida 200 mg
26 Antasida DOEN Tab. Kotak/100 0 0 0

28 Kotak/25 10 8 5

29 Kotak/24 Pot 0 3.516 0.484
DUS, 10 SUPP @ 2
GRAM
32 Antimigrain Botol/100 7 0 7 0
33 Asam Ascorbat (Vit. C) 50 mg Botol/1000 0 0 0
37 Asam Mefenamat kapsul/kaplet 500 mg Dus, 10 blister @ 10 kap 50 0 50 0
38 Asering Lar. Infus Botol/500 ml 0 0 0

39 Asiklovir SK Kotak/25 0 0 0
SISA STOK
STOK
AWAL
2017

43 Betametason Krim Kotak/25 0 0 0
44 Betametason Krim Tube/5g 0 0 0
45 Bisacodil tab Kotak/200 0 0 0
47 Bromheksin tab. 8 mg kotak/300 0 0 0
50 Cefadroxil syrup Botol 0 0 0
51 Cefotaxime injeksi 1 g kotak/10 0 0 0
52 Cefotaxime Injeksi 1 g Kotak/2 Vial 0 0 0
53 Cetirizin kotak/100 0 0 0
54 Cetirizine Tab. 10 mg Kotak/100 5 5 0
56 Chlorfeniramine Maleat (CTM) 4 mg 0 0 0
57 Chlorfeniramini Maleat (CTM) 4 mg Botol/1000 0 0 0
58 Kotak/100 ampul @ 1 ml 0 0 0
500 mcg
60 Cyanocobalamin Tab. Botol/1000 0 0 0
61 Cyanocobalamin Tablet KOTAK/100 0 0 0
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 5 0 5 0
65 0 0 0
HCl) ss
66 Daryantula (Supratula) Box/20 Lmbr 0 0 0
67 Daryantull 10 x 10 cm Kotak/10 0 0 0
68 Daryantulle Box/10 Pcs 0 0 0
69 Deksametason Injeksi Kotak/100 0 0 0
73 Dextrofen Syrup Botol 60 ml 0 0 0
74 Dexchlorpheniramine Maleate + Botol/60 ml 0 0 0
75 Dextrometrophan Syr. Botol 0 0 0
76 Dextrometrophan Tab. Kotak/100 0 0 0
Diazepam larutan rektal 5 mg/2,5 ml Dus, 5 alubag @1 tube @ 8
78 0 0 8
(Stesolid) 2,5 ml
79 Diazepam Tab. 2 mg Kotak/100 0 0 0
80 Diazepam tablet/kapsul/kaplet 2 mg Botol 100 0 0 0
82 Digoxin Tab. 0,25 mg Kotak/100 0 0 0
86 Efedrin HCl 25 mg Botol/250 0 0 0
87 Ekstrak Belladon Botol/1000 0 0 0
88 Epinefrin (Adrenalin) Injeksi 0,1% Kotak/30 0 0 0
89 Ergotamine cafein Kotak/100 0 0 0
SISA STOK
STOK
AWAL
2017
90 Eritromicin Kaps. 500 mg Kotak/100 0 0 0

91 Eritromicin Syrup Botol/60 ml 0 0 0
92 Etakridin larutan 0,1% (Rivanol) Botol/300 ml 0 0 0
93 Ethanol Botol/1000 0 0 0
94 Ethanol Botol/100 0 0 0
95 Eugenol Cairan Botol/10ml 0 0 0
96 Famotidine kotak/50 0 0 0
97 Fenilbutason Tab 200 mg (Novason) 0 0 0
98 Fenilbutason Tab. 200 mg Botol/1000 0 0 0
99 Fenilbutason Tab. 200 mg (Novason) Botol/100 0 0 0
101 Fenobarbital Tab. 30 mg Botol/100 0 0 0
102 Ferrosi sulfas 300 mg tab botol/1000 0 0 0
104 Dus @ 30 ampul 0 0 1
mg/ml
105 Fitomenadion Injeksi Kotak/30 0 0 0
106 Fitomenadion Tab. Kotak/100 0 0 0
110 Garam oralit kotak/100 0 0 0
111 Gentamicin 0,1% Salep Kulit Kotak/25 Tube@5 g 0 0 0
112 Gentamicin SK. Kotak/10 1 1 0
113 Gentamycin 0,1 % SK Kotak/25 1 0 1 0
114 Gentian Violet Botol/10 ml 0 0 0
115 Glibenclamida 0 0 0
116 Glibenklamid Tab. 5 mg Kotak/100 0 0 0
118 Gliseril Guaiacolat 13 0 12.75 0.25
119 Gliseryl Guaiacolas Tab. 100 mg Botol/1000 0 0 0
121 Griseofulvin tablet 125 mg, micronized Kotak 0 0 0
122 Hidrochlortiazid Tab. 25 mg Botol/1000 0 0 0
123 Hidroklorotiazid tab 25 mg Dus, 10 strip @ 10 tablet 0 0 0
124 Hidrokortison krim 2,5 % Tube 0 0 0

125 Hidrokortison SK Kotak/24 0 0 0
126 Ibuprofen 200 mg Botol/100 0 0 0
130 Ichtiol SK Pot 0 0 0
133 Induksin Inj Kotak/10amp 0 0 0
134 Kalsium Laktat Tab. 500 mg Kotak/100 13 0 13 0
135 Kalsium Laktat Tab. 500 mg Botol/1000 0 0 0
137 Kaptopril 25 mg Kotak/100 0 0 0
138 Ketokonazole 0 0 0
139 Ketokonazole Tab. 200 mg Kotak/50 0 0 0
140 Ketokonazole Tab. 200 mg Kotak/100 0 0 0
SISA STOK
STOK
AWAL
2017
141 Ketorolac Injeksi 10 mg Kotak/5 Amp. 0 0 0

142 Ketorolac Injeksi 30 mg Kotak/6 Amp. 0 0 0
144 Kloramfenicol Tetes Telinga 3% Botol 0 0 0
145 Kloramfenikol Kaps. 250 mg Kotak/100 0 0 0
146 Kloramfenikol salep mata kotak/24 0 0 0
148 Kloramfenikol Suspensi Botol/60 ml 0 0 0
149 Kloramfenikol Tetes Telinga botol/5ml 0 0 0
151 Klorpromazin HCl inj. 5mg/ml - 2 ml Kotak/ 30 Amp 0 0 0
152 Klorpromazin HCl tab 100 mg kotak/100 0 0 0
153 Klorpromazin HCl tablet salut 100 mg Botol 0 0 0
154 Klorpromazin HCl tablet salut 25 mg Botol 0 0 0
155 Kotrimoksasol Tab. 120 mg Kotak/100 0 0 0
157 Kotrimoksazol 480 Kotak/100 0 0 0
158 Kotrimoksazol Syr. Botol/60 0 0 0
161 Lacto B Sachet Kotak/4x10 0 0 0
162 Lacto B Sachet Kotak/4x10 0 0 0
163 Lansoprasol 30 mg Kotak/ 30 0 0 0
164 Lansoprasole 30 mg Kotak/20 0 0 0
166 Levertran Salep Pot 0 0 0
167 Levertran Salep Kulit Kotak/12 Pot 0 0 0
168 Lidocain inj kotak/100 2 0 1 1
169 Lidocain Injeksi Kotak/30 0 0 0
170 Dus, 30 ampul @ 2 ml 5 0 5
80.000 - 2 ml
171 Lisol Botol/1000 0 0 0
172 Lisol Botol 800 ml 0 0 0
175 Lorazepam 2 mg Kotak/100 1.8 0 0.08 1.72
176 Malaria PF/PV casset Kotak 25 0 0 0
180 Meloxicam 7,5mg Kotak/30 0 0 0
181 Metamphyron (Antalgin) Tab. 500 mg Kotak/100 0 0 0
182 Metformin HCl tab 500 mg Kotak/100 0 0 0
183 Methylergometrin inj kotak/100 0 0 0
184 Methylprednisolon 4 mg Kotak/100 0 0 0
185 Methylprednisolon 8 mg Kotak/100 0 0 0
186 Metilergometrin Injeksi Kotak/30 0 0 0
187 Kotak/100 Ampul @ 1 ml 0 0 0
1 ml
188 Metilergometrin Tab 0,125 mg 0 0 0
189 Metilergometrin Tab. 0,125 mg Kotak/100 0 0 0
190 Metilergometrin Tab. 0,125 mg Kotak /100 0 0 0
191 Metoclorpramide injeksi kotak/5 0 0 0
SISA STOK
STOK
AWAL
2017
192 Metokloperamid Injeksi Kotak/10 Amp @ 2 ml 0 0 0

193 Metokloperamid Tab. 5 mg Kotak/100 0 0 0
194 Metokloperamid Tab. 5 mg Kotak/100 0 0 0
195 Kotak/5 Ampul 0 0 0
(Metolon)
199 Mikonazol Krim Tube/10 gr 0 0 0
201 Myomergin injk Kotak/10 0 0 0
203 Natrium Diklofenak 50 mg Kotak/50 0 0 0
204 Natrium Klorida (NaCl) 0,9 % Botol / 500 ml 0 0 0
206 Natrium Klorida Larutan Infus Botol 0 0 0
207 Nifedipin Tab. 20 mg Blister/30 1 0 1 0
208 Nistatin Tablet Salut 500.000 IU Kotak/100 0 0 0
209 Nistatin Vaginal Kotak/100 0 0 0
211 O.B.H. Indo Plus Botol/100 ml 0 0 0
212 O.B.H. Syr. Botol/100 ml 0 0 0
213 Obat antituberkulosis kategori 1 Paket 0 0 0
214 Obat antituberkulosis kategori 2 Paket 0 0 0
215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml 0 0 0
216 Oksitetra S.K Kotak/25 0 0 0
217 Oksitetra S.K Tube/10 gr 0 0 0
219 Oksitetra S.M 1% Tube/3,5 gr 0 0 0
221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g 0 0 0
222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g 0 0 0
223 Oksitosin Inj. Kotak/30 Amp. 0 0 0
225 Omeprazole Tab. 20 mg Kotak/30 0 0 0

226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.5 0 0.43 0.07
227 Papaverin Tab. Botol/1000 0 0 0
228 Papaverin Tab 40 mg Botol/1000 4 0 4 0
229 Parasetamol Drops Botol 15 ml 0 0 0
230 Botol 5 37 0
(60 mg/0,6 ml)
232 Parasetamol Tab. 500 mg Kotak/100 0 0 0
233 Pirantel Pamoat 125 mg Kotak/100 6 3 7 2
234 Pirantel Pamoat syr Botol/60 0 0 0
235 Pirantel suspensi Botol/60 0 0 0
236 Piridoksin HCl Tab 10 mg 0 0 0
237 Piridoksin HCl Tab. 10 mg Botol/1000 0 0 0
238 Piridoksin HCl Tab. 10 mg Kotak/100 0 0 0
239 Piroxicam Tab 20 mg 0 0 0
SISA STOK
STOK
AWAL
2017

245 Povidum Iodium Botol /30 ml 0 0 0
246 Predmisone Botol / 100 0 0 0
247 Prednison Tab. 5 mg Botol/1000 0 0 0
248 Prednison Tab. 5 mg Kotak/100 0 0 0

251 Propiltiourasil Tab 10 mg Botol/100 5 0 5 0
252 Propiltiourasil Tab. 100 mg Botol/100 4 0 4 0
253 Pyrantel syrp Botol 0 0 0
254 Pyrantel tab Kotak/100 0 0 0
255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp) 0 0 0
260 Ringer Laktat Lar. Infus Botol 500 ml 0 0 0
261 Ringer Laktat Lar. Infus Botol 500 ml 0 0 0
262 Ringer Laktat Lar. Infus (Tutup karet 3 lub Botol 500 ml 0 0 0
263 Salbutamol 2 mg Tab. Kotak/100 0 0 0
264 Salbutamol 4 mg Tab. Kotak/100 0 0 0
265 Salep 2 - 4 Kotak/24 0 0 0
266 Pot @ 30 gram 150 25 125
+ Belerang endap 4%
267 Pot @ 30 gram 0 24 0
Belerang Endap 4%
268 Salisil Bedak Kotak 0 0 0
271 Sefadroksil Syrp Botol 60 ml 0 0 0
Dus, 3 Strip @ 10 Kaplet 4
salut selaput
273 Simvastatin Tab. 10 mg Kotak/50 0 0 0
274 Simvastatin Tab. 10 mg Kotak/100 0 0 0
275 Stesolid Injeksi Kotak/5 Amp. 0 0 0
279 Tablet Tambah Darah (SF) Botol/1000 0 0 0
280 Tetrasiklin 250 Kaplet Botol/1000 0 0 0
281 Tetrasiklin 250 Kaplet Kotak/100 0 0 0
282 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 1 0 1 0
283 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 0 0 0
284 Thiamin HCl Injeksi Kotak/30 0 0 0
286 Thiamin HCl Tab. 50 mg 0 0 0
288 Vaksin Rabies kuur 0 0 0
289 Vomitrol Syrup Botol 0 0 0
291 Zink phosfat Set 0 0 0
0 0
SISA STOK
STOK
AWAL
2017
B. PROGRAM GIZI 0 0
292 Becefort Botol 0 0 0
293 Hemafort Kotak/100 0 0 0
294 Livron kotak/100 19 0 19 0
295 lysmin Botol/60 ml 0 0 0
296 + Vit.B12 5 mcg + Vit.C 50 mg + Vit.D Botol/60 ml 0 0 0

1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0 0 0
HCl)
298 Botol/60 ml 0 0 0
299 Kotak/100 0 0 0
CuSO4 )

300 Kotak/100 0 0 0
intrinstik)

301 Kotak/100 0 0 0
303 Retinol (Vitamin A) 100.000 IU Botol/50 Kaps 0 0 0
304 Retinol (Vitamin A) 200.000 IU Botol/50 Kaps 0 0 0
305 Retinol (Vitamin A) 100.000 IU Botol/50 kapsul 0 0 0
306 Vitamin B Complex Kotak/100 2 2 0
307 Vitamin B-Complex Botol/1000 0 0 0
C. OBAT GIGI 0 0
309 Albothyl 5 ml (obat gigi) Botol/5ml 0 0 0
310 Bonding 0 0 0
311 Bonding Botol 0 0 0
312 Bonding 0 0 0
313 Calcinol / Urbical Box/2 Tube 0 0 0
314 Calcinol/ Urbical 0 0 0
315 Chlorphenol Kampher Menthol (CHKM) Botol/20 ml 0 0 0
316 Cresopen Botol/13 ml 0 0 0

317 Cresopen 0 0 0
318 Dentorit/Caviton Botol/30gr 0 0 0
319 Dentorit/Caviton Botol 0 0 0
320 Dentorit/caviton 0 0 0
321 Devitasol Pasta (Devitac) Botol/4,5 0 0 0
322 Devitasol Pasta (Devitac) Botol 0 0 0
326 Etsha btl 0 0 0
327 Etsha Botol 0 0 0
328 Eugenol Cairan Kotak 12 Botol @ 15 ml 0 0 0

SISA STOK
STOK
AWAL
2017
329 Glass Ionomer Cement Bungkus/Set 0 0 0

330 Glass Ionomer Cement (Vitro Molar) Bungkus/Set 0 0 0
331 Glass Ionomer Cement (Vitro Molar) 0 0 0
332 Gutta Percha Box/200 Stik 0 0 0
333 Gutta Percha Kotak 0 0 0
337 Mata Bor High set 0 0 0
338 Mata Bor High Set 0 0 0
340 Paper Point No. 15 Kotak/200 stik 0 0 0
341 Paper Point No. 15 Kotak 0 0 0
342 Paper Point No. 20 Kotak/200 stik 0 0 0
343 Pehacain Injeksi Kotak/20 0 0 0
344 Rockless Botol 0 0 0
345 Rockless Botol 0 0 0
346 Spongostan Kotak/10 0 0 0
348 Spongostan Box/10 pcs 0 0 0
349 Tambalan Komposit Set 0 0 0
350 Tambalan komposit ( natural look) 0 0 0
351 Tambalan Komposit (Natural Look) Set 0 0 0
352 Xylestesin Kotak 0 0 0
353 Xylestesin 0 0 0
354 Set/Kotak 0 0 0
Liquid)
355 Zinc tablet kotak/100 0 0 0
0 0 0
D. BAHAN HABIS PAKAI 0 0
358 Alat Suntik / Spoit 20 cc Kotak/100 0 0 0
359 Alat suntik / Spoit 3 cc Kotak/100 0 0 0
362 Alkohol Swamb Dos 1 0 1 0
365 Asam Klorida (HCl) 0,1 N Botol/100 ml 0 0 0
366 Bisturi No. 15 Box/100 Pcs 0 0 0
367 Bisturi No.15 Box/100 pcs 0 0 0
369 Kotak/24 0 0 0
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 4 0 1.35 2.65
371 Deck Glass Kotak/100 1 0 1 0
373 Disp. Syringe With Needle 10 cc Box/100 pcs 0 0 0
375 Disp. Syringe With Needle 5 cc Box/100 pcs 0 0 0
376 EDTA 10% Botol 100 ml 0 0 0
377 EDTA 10% Botol/100 ml 0 0 0
SISA STOK
STOK
AWAL
2017
378 Elastis Perban 4 Inch Rol 0 0 0

380 Folley Catheter 2 way No. 18 Box/10 pcs 1 0 0.3 0.7
381 Giemsa Stain Botol/100 0 0 0
382 Giemsa Stain Botol/100 ml 0 0 0
383 Hifavix 5x5 cm Rol 0 0 0
384 Hipavix 5 x 5 cm Rol 0 0 0
385 Hipavix 5 x 5 cm Pcs 0 0 0

390 IV Catheter No. 18 Kotak/50 0 0 0
398 Jarum Ekstirpasi 0 0 0
399 Jarum Extirpasi 0 0 0
400 Jarum Extirpasi Set 0 0 0
401 Jarum Kulit No. 11 Pcs 0 0 0
402 Jarum Kulit No. 11 0 0 0
405 Jarum Otot No. 11 0 0 0
406 Jarum Otot No.11 Set 0 0 0
409 Kasa 40 x 80 cm Roll 1 0 1 0
410 Kasa Hydrofil Steril 18 m x 22 cm Kotak/12 Lmbr 0 0 0
412 Kasa Hydrofil Steril 36 m x 80 cm Rol 0 0 0
417 Kasa Pembalut Hydrofil 4 m x 10 cm Rol/50 0 0 0
418 Kasa Pembalut Hydrofil 4 m x 5 cm Rol/100 0 0 0
419 Kertas Puyer bks 0 0 0
420 Kertas Puyer Bungkus 0 0 0
422 Klip Plastik Obat Ukuran Kecil Bungkus/100 0 0 0
423 Klip Plastik Obat Ukuran Sedang Bungkus/100 10 0 10 0
424 Klip Plastik Obat Ukuran Sedang Bungkus/100 0 0 0
425 Botol/100 ml 0 0 0
Conc. 30 ml
426 Larutan Eosin Botol/100 0 0 0
427 Larutan Hayem Botol 0 0 0
428 Larutan Hayem Botol/100 ml 0 0 0
SISA STOK
STOK
AWAL
2017
429 Larutan Hayem Botol/100 ml 0 0 0

430 Larutan karbol Fuchsin 0,3% Botol/100 ml 0 0 0
431 Larutan Methilen Blue Botol/100 ml 0 0 0
432 Botol/100 ml 0 0 0
ml
433 Larutan Spiritus Liter 0 0 0
436 Larutan Turk Botol 0 0 0
437 Larutan Turk Botol/100 ml 0 0 0
438 Larutan Turk Botol/100 ml 0 0 0
439 Box/100 Buah 0 3 6
Tangan)
440 Latex Examination Glove L, M, S Box/100 Pcs 0 0 0
441 Box/100 Buah 0 5 0
Tangan)
442 Box/100 Buah 0 1 0
Tangan)
443 Lisol Botol/1000 ml 5 0 1 4
444 Masker Kotak/20 0 0 0
445 Masker Kotak/50 0 0 0
446 Methanol Liter 0 0 0
447 Methanol Liter 0 0 0
448 Methylen Blue Botol 0 0 0
449 Natrium Sitrat Liter 0 0 0
450 Natrium Sitrat Liter 0 0 0
452 Objeck Glass Kotak/100 0 0 0
453 Objeck Glass Kotak/72 0 0 0
454 Oil Emercy Botol/100 ml 0 0 0
455 Oil Emercy Botol/100 ml 0 0 0
456 Oksigen (O2) 6 Kubik 0 0 0
457 Oksigen (O2) 1 kubik 0 0 0
458 Oksigen (O2) 1 1/2 kubik 0 0 0
459 Oksigen (O2) 1 kubik Kubik 0 0 0
460 Oksigen (O2) 6 kubik Kubik 0 0 0
463 Plano Tes (Tes Kehamilan) Kotak/50 0 0 0
466 Plester 5 yards x 2 inci Rol 0 0 0
467 Porstex botol/1000 0 0 0
468 Portex Botol 0 0 0
469 Rapid Test Hepatitis Kotak/25 tes 0 0 0
470 RDT DBD IgG/IgM Kotak/25 0 0 0
472 RDT DBD NS1 (Dengue Antigen) Kotak/25 0 0 0
473 Reagen Golongan Darah Botol/10 ml 0 0 0
474 Reagen Golongan Darah 0 0 0
475 Reagen Golongan Darah (A, B, AB) Botol/3X10 ml 0 0 0
476 Reagen Tidal Kotak/4 vial 0 0 0
477 Reagen Tidal Kotak/4 vial 0 0 0
478 Reagen Widal Kotak 8 Vial@5 ml 0 0 0
SISA STOK
STOK
AWAL
2017

479 Botol/500 ml 0 0 0
Hemoglobin)
481 Sarung Tangan (Hands Scoon) Kotak/25 0 0 0
482 Sarung Tangan L, M, S Kotak/100 0 0 0
483 Silk (Benang Bedah Sutra ) Kotak/24 0 0 0
487 Strip Asam Urat 0 0 0
495 Tes Tuberkulin Pcs 0 0 0
496 Test Pack Kotak/50 0 0 0
497 Uji Dengue IgG/IgM 25 Test 0 0 0
498 Uji Hepatitis BsAg Box/25 0 0 0
499 Uji Leptospira IgM Kotak/25 Test 0 0 0
500 Uji Malaria Box/25 0 0 0
501 Uji Tifoid IgM Box/25 0 0 0
502 Uji Tiphoid IgM Kotak/25 0 0 0
503 Urine Bag Pcs 0 0 0
504 Urine Bag Standard steril 2 Lt Buah 0 0 0
505 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 0 0 0
506 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 0 0 0
507 Urine reagen strip 10 lG Para Meter Botol/100 Stik 0 0 0
509 Ambroksol syrup Botol 60ml 0 0 0
510 cyanocobalamine injeksi 1000mcg/ml kotak/100 1 0 1 0
511 Ibufropen tab 200 mg Botol 100 tab 0 0 0
513 Metformin Hcl tab 500 Kotak/10 blister/10tab 0 0 0
514 Oksitetrasiklin salep 3% kotak/25tb 5gr 0 0 0
515 Hemafort Kotak/100 0 0 0
516 Etanol 70% Cairan Botol/1000 4 10 8.6 5.4
519 Allopurinol 100 mg Kotak/100 10 0 10 0
523 Metformine HCL tab 500 mg Kotak/100 0 0 0
524 Parasetamol Syrup Botol/60 ml 100 0 100 0
525 Ranitidine tab 150 mg Kotak/30 0 0 0
526 salbutamol 4mg Kotak/100 2 0 2 0
527 Sefadroksil Kapsul Kotak/100 3 0 3 0
528 Vit. B-complex Kotak/100 0 0 0
0 0
OBAT TAMBAHAN 2017 0 0
SISA STOK
STOK
AWAL
2017

2 Kotak/24 Pot 2 1.04 0.96
40 mg/5 ml
11 Disp. Syringe with Needle 3 cc Box/100 pcs 5 0.6 4.4
13 Box/100 Buah 15 12 3
Tangan)
14 Box/100 Buah 10 6 4
Tangan)
Box, 10 strips@10
capsules
26 5 0 5
(Stesolid) 2,5 ml


38 dus, 10 strip @ 10 tablet 30 12 18
43 Dus, 15 Botol 35 35 0
(60 mg/0,6 ml)
44 Dus, 10 strip @ 10 kaptab 50 11 39
500 mg
SISA STOK
STOK
AWAL
2017
46 Methylprednisolon 4 mg dus, 10 strip @ 10 tablet 10 2 8
47 Zinc Syrup 20 mg/5 ml Dus, Botol 60 ml 50 0 50

TOTAL 2283.8 5231 5284.466 2230.334
Mengetahui, Yang Membuat

Kepala UPT Puskesmas Marusu Petugas Gudang Obat PKM
drg. Andi. Ilham , M.Kes Fatmawati, S.Si

Nip. 19651231 200604 1 008 Nip. 19860426 201101 2 011
Penanggung Jawab Apotik PKM
ISKANDAR. M, S.Farm, Apt

Pangkat : Penata Tk. I/III.d
NIP : 19841209 201101 1 006
LAMPIRAN PERSEDIAAN OBAT DAK / DAU
SEMESTER 1 (JAN - JUN 2017)
SISA STOK
STOK HARGA
AWAL SATUAN
2017
A. NAMA OBAT
1 1 blister@24 tablet 0 1 0 34,656
2 Adona Injeksi 50 mg Kotak/10 Amp. 0 0 0 280,315
3 Albendazol tablet 400 mg Kotak/30 0 0 0 13,420
4 Albothyl Botol 10 ml 0 0 0 24,700
7 Allopurinol Tab 300 mg Kotak/30 0 0 0 8,085
8 Allopurinol tab. 300 mg Kotak/100 10 2 8 22,500
10 Ambroxol Syrup Botol/60 ml 0 0 0 6,510
11 Ambroxol Syrup Botol/60 ml 0 0 0 3,630
12 Aminofillin Inj. Kotak/30 0 0 0 126,000
13 Aminofillin Tab. 200 mg Botol/100 0 0 0 8,600
14 Amlodipin 5mg Kotak/30 5 5 0 5,910
15 Amoksisilin kapsul/kaplet 250 mg 0 0 0 22,000
kapsul
Amoksisilin kapsul/kaplet/tablet scored 108
16 Dus, 10 strip @ 10 kaptab 50 158 0 37,000
500 mg
17 Amoksisillin Kapl. 250 mg Kapsul/100 0 0 0 22,000
18 Amoksisillin Kapl. 500 mg Kotak/100 0 0 0 29,200
19 Amoksisillin Syr. Kering Botol/60 ml 200 95 105 2,560
20 Ampicillin Injeksi Kotak/10 0 0 0 59,048
21 Ampisillin Kapl. 500 mg Kotak/100 0 0 0 41,910
22 Ampisillin Syrup Kering Botol/60 ml 0 0 0 4,840
23 Antalgin Tab. 500 mg (Metampiron) Kotak/100 0 0 0 12,650
25 Dus 10 Strip @ 10 tablet 0 0 0 7,800
Hidroksida 200 mg
26 Antasida DOEN Tab. Kotak/100 0 0 0 17,820
27 Antasida Syr. Botol 0 0 0 2,300

28 Kotak/25 10 8 5 69,175

29 Kotak/24 Pot 0 3.516 0.484 91,200
DUS, 10 SUPP @ 2
31 subgalat 150 mg heksaklorofen 2,5 mg 5 4 1 3350
GRAM
32 Antimigrain Botol/100 7 0 7 0 13,563
33 Asam Ascorbat (Vit. C) 50 mg Botol/1000 0 0 0 35,200
34 Asam Ascorbat (Vit.C) 50 mg Kotak/100 185 124 61 10,500
37 Asam Mefenamat kapsul/kaplet 500 mg Dus, 10 blister @ 10 kap 50 0 50 0 21,978
38 Asering Lar. Infus Botol/500 ml 0 0 0 19,800

39 Asiklovir SK Kotak/25 0 0 0 82,500
SISA STOK
STOK HARGA
AWAL SATUAN
2017

43 Betametason Krim Kotak/25 0 0 0 51,315
44 Betametason Krim Tube/5g 0 0 0 1,596
45 Bisacodil tab Kotak/200 0 0 0 257,070
46 Bisakodil suppositoria 5 mg 1 Box @ 6's 5 3 2 1,362
47 Bromheksin tab. 8 mg kotak/300 0 0 0 66,517
48 Bromheksin Tab. 8 mg Kotak/100 10 10 0 23,830
49 Bromheksin Tab. 8 mg Kotak/100 0 0 0 4,237
50 Cefadroxil syrup Botol 0 0 0 5,286
51 Cefotaxime injeksi 1 g kotak/10 0 0 0 35,000
52 Cefotaxime Injeksi 1 g Kotak/2 Vial 0 0 0 15,246
53 Cetirizin kotak/100 0 0 0 38,000
54 Cetirizine Tab. 10 mg Kotak/100 5 5 0 14,000
56 Chlorfeniramine Maleat (CTM) 4 mg 0 0 0 Rp 45,298
57 Chlorfeniramini Maleat (CTM) 4 mg Botol/1000 0 0 0 26,400
58 Kotak/100 ampul @ 1 ml 0 0 0 122,500
500 mcg
60 Cyanocobalamin Tab. Botol/1000 0 0 0 14,412
61 Cyanocobalamin Tablet KOTAK/100 0 0 0 1,441.20
63 Cyprofloxacin 500 mg Tab. Kotak/100 20 12 8 26,500
64 Cyprofloxacin tab. 500 mg (sebagai HCl) Dus 10 x 10 5 0 5 0 35,465
65 0 0 0 26,500
HCl) ss
66 Daryantula (Supratula) Box/20 Lmbr 0 0 0 312,000
67 Daryantull 10 x 10 cm Kotak/10 0 0 0 202,500
68 Daryantulle Box/10 Pcs 0 0 0 178,000
69 Deksametason Injeksi Kotak/100 0 0 0 173,800
72 Dexamethason Tab. 0,5 mg Kotak/100 0 0 0 9,570
73 Dextrofen Syrup Botol 60 ml 0 0 0 10,100
74 Dexchlorpheniramine Maleate + Botol/60 ml 0 0 0 11,810
75 Dextrometrophan Syr. Botol 0 0 0 3,152
76 Dextrometrophan Tab. Kotak/100 0 0 0 12,100
Diazepam larutan rektal 5 mg/2,5 ml Dus, 5 alubag @1 tube @ 8
78 0 0 8 12,751
(Stesolid) 2,5 ml
79 Diazepam Tab. 2 mg Kotak/100 0 0 0 4,400
80 Diazepam tablet/kapsul/kaplet 2 mg Botol 100 0 0 0 4,700
82 Digoxin Tab. 0,25 mg Kotak/100 0 0 0 10,300
83 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 30 5 25 3,490
86 Efedrin HCl 25 mg Botol/250 0 0 0 14,097
87 Ekstrak Belladon Botol/1000 0 0 0 34,848
88 Epinefrin (Adrenalin) Injeksi 0,1% Kotak/30 0 0 0 267,300
89 Ergotamine cafein Kotak/100 0 0 0 13,563
SISA STOK
STOK HARGA
AWAL SATUAN
2017
90 Eritromicin Kaps. 500 mg Kotak/100 0 0 0 102,300

91 Eritromicin Syrup Botol/60 ml 0 0 0 8,090
92 Etakridin larutan 0,1% (Rivanol) Botol/300 ml 0 0 0 1,980
93 Ethanol Botol/1000 0 0 0 22,720
94 Ethanol Botol/100 0 0 0 2,626
95 Eugenol Cairan Botol/10ml 0 0 0 18,333
96 Famotidine kotak/50 0 0 0 6,221
97 Fenilbutason Tab 200 mg (Novason) 0 0 0 Rp 152,889
98 Fenilbutason Tab. 200 mg Botol/1000 0 0 0 89,100
99 Fenilbutason Tab. 200 mg (Novason) Botol/100 0 0 0 31,620
101 Fenobarbital Tab. 30 mg Botol/100 0 0 0 7,139
102 Ferrosi sulfas 300 mg tab botol/1000 0 0 0 28,855
104 Dus @ 30 ampul 0 0 1 112,620
mg/ml
105 Fitomenadion Injeksi Kotak/30 0 0 0 57,420
106 Fitomenadion Tab. Kotak/100 0 0 0 69,000
108 Furosemid Tab. 40 mg Kotak/100 0 0 0 8,400
110 Garam oralit kotak/100 0 0 0 41,800
111 Gentamicin 0,1% Salep Kulit Kotak/25 Tube@5 g 0 0 0 58,030
112 Gentamicin SK. Kotak/10 1 1 0 20,207
113 Gentamycin 0,1 % SK Kotak/25 1 0 1 0 55,506
114 Gentian Violet Botol/10 ml 0 0 0 495
115 Glibenclamida 0 0 0 Rp 9,900
116 Glibenklamid Tab. 5 mg Kotak/100 0 0 0 6,100
117 Gliseril Guaiacolas Botol/1000 10 5 5 66,790
118 Gliseril Guaiacolat 13 0 12.75 0.25 Rp 52,635
119 Gliseryl Guaiacolas Tab. 100 mg Botol/1000 0 0 0 30,690
121 Griseofulvin tablet 125 mg, micronized Kotak 0 0 0 24,100
122 Hidrochlortiazid Tab. 25 mg Botol/1000 0 0 0 27,104
123 Hidroklorotiazid tab 25 mg Dus, 10 strip @ 10 tablet 0 0 0 16300
124 Hidrokortison krim 2,5 % Tube 0 0 0 2,938

125 Hidrokortison SK Kotak/24 0 0 0 78,650
126 Ibuprofen 200 mg Botol/100 0 0 0 12,705
127 Ibuprofen 400 mg Kotak/100 5 5 0 15,700
130 Ichtiol SK Pot 0 0 0 8,500
132 Ichtiol SK 15 g Kotak/12 Pot 0 0 0 49,720
133 Induksin Inj Kotak/10amp 0 0 0 89,700
134 Kalsium Laktat Tab. 500 mg Kotak/100 13 0 13 0 7,600
135 Kalsium Laktat Tab. 500 mg Botol/1000 0 0 0 43,263
137 Kaptopril 25 mg Kotak/100 0 0 0 10,000
138 Ketokonazole 0 0 0 Rp 16,000
139 Ketokonazole Tab. 200 mg Kotak/50 0 0 0 22,550
140 Ketokonazole Tab. 200 mg Kotak/100 0 0 0 32,000
SISA STOK
STOK HARGA
AWAL SATUAN
2017
141 Ketorolac Injeksi 10 mg Kotak/5 Amp. 0 0 0 41,250

142 Ketorolac Injeksi 30 mg Kotak/6 Amp. 0 0 0 15,990
144 Kloramfenicol Tetes Telinga 3% Botol 0 0 0 3,150
145 Kloramfenikol Kaps. 250 mg Kotak/100 0 0 0 29,315
146 Kloramfenikol salep mata kotak/24 0 0 0 41,256
147 Kloramfenikol salep mata Tube/5gr 100 15 85 1,680
148 Kloramfenikol Suspensi Botol/60 ml 0 0 0 4,950
149 Kloramfenikol Tetes Telinga botol/5ml 0 0 0 1,760
151 Klorpromazin HCl inj. 5mg/ml - 2 ml Kotak/ 30 Amp 0 0 0 34,650
152 Klorpromazin HCl tab 100 mg kotak/100 0 0 0 16,500
153 Klorpromazin HCl tablet salut 100 mg Botol 0 0 0 16,500
154 Klorpromazin HCl tablet salut 25 mg Botol 0 0 0 41,800
155 Kotrimoksasol Tab. 120 mg Kotak/100 0 0 0 8,349
156 Kotrimoksazol 120 mg Kotak/100 5 1 4 10,555
157 Kotrimoksazol 480 Kotak/100 0 0 0 15,200
158 Kotrimoksazol Syr. Botol/60 0 0 0 2,298
161 Lacto B Sachet Kotak/4x10 0 0 0 220,000
162 Lacto B Sachet Kotak/4x10 0 0 0 243,510
163 Lansoprasol 30 mg Kotak/ 30 0 0 0 10,420
164 Lansoprasole 30 mg Kotak/20 0 0 0 10,420
166 Levertran Salep Pot 0 0 0 4,000
167 Levertran Salep Kulit Kotak/12 Pot 0 0 0 37,015
168 Lidocain inj kotak/100 2 0 1 1 92,900
169 Lidocain Injeksi Kotak/30 0 0 0 37,510
170 Dus, 30 ampul @ 2 ml 5 0 5 63660
80.000 - 2 ml
171 Lisol Botol/1000 0 0 0 20,000
172 Lisol Botol 800 ml 0 0 0 20,000
173 Loperamide Kotak/100 0 0 0 10,071
175 Lorazepam 2 mg Kotak/100 1.8 0 0.08 1.72 142,300
176 Malaria PF/PV casset Kotak 25 0 0 0 1,953,485
177 Meloksikam 7,5 mg Kotak/20 0 0 0 15,222
178 Meloksikam 7,5 mg Kotak/50 0 0 0 38,055
180 Meloxicam 7,5mg Kotak/30 0 0 0 38,050
181 Metamphyron (Antalgin) Tab. 500 mg Kotak/100 0 0 0 12,650
182 Metformin HCl tab 500 mg Kotak/100 0 0 0 19,965
183 Methylergometrin inj kotak/100 0 0 0 16,868
184 Methylprednisolon 4 mg Kotak/100 0 0 0 23,000
185 Methylprednisolon 8 mg Kotak/100 0 0 0 39,000
186 Metilergometrin Injeksi Kotak/30 0 0 0 49,170
187 Kotak/100 Ampul @ 1 ml 0 0 0 275,000
1 ml
188 Metilergometrin Tab 0,125 mg 0 0 0 Rp 16,868
189 Metilergometrin Tab. 0,125 mg Kotak/100 0 0 0 13,310
190 Metilergometrin Tab. 0,125 mg Kotak /100 0 0 0 17,715
191 Metoclorpramide injeksi kotak/5 0 0 0 61,864
SISA STOK
STOK HARGA
AWAL SATUAN
2017
192 Metokloperamid Injeksi Kotak/10 Amp @ 2 ml 0 0 0 11,000

193 Metokloperamid Tab. 5 mg Kotak/100 0 0 0 8,668
194 Metokloperamid Tab. 5 mg Kotak/100 0 0 0 11,300
195 Kotak/5 Ampul 0 0 0 61,870
(Metolon)
196 Metronidazol 250 mg Kotak/100 0 0 0 15,730
199 Mikonazol Krim Tube/10 gr 0 0 0 3,300
200 Mikonazol krim/salep 2 % (Nitrat) Tube 10 gram 25 25 0 3,150
201 Myomergin injk Kotak/10 0 0 0 42,500
203 Natrium Diklofenak 50 mg Kotak/50 0 0 0 92,333
204 Natrium Klorida (NaCl) 0,9 % Botol / 500 ml 0 0 0 4,545
206 Natrium Klorida Larutan Infus Botol 0 0 0 4,545
207 Nifedipin Tab. 20 mg Blister/30 1 0 1 0 89,970
208 Nistatin Tablet Salut 500.000 IU Kotak/100 0 0 0 70,400
209 Nistatin Vaginal Kotak/100 0 0 0 40,700
211 O.B.H. Indo Plus Botol/100 ml 0 0 0 8,052
212 O.B.H. Syr. Botol/100 ml 0 0 0 1,573
213 Obat antituberkulosis kategori 1 Paket 0 0 0 395,900
214 Obat antituberkulosis kategori 2 Paket 0 0 0 1,319,900
215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml 0 0 0 13,400
216 Oksitetra S.K Kotak/25 0 0 0 45,403
217 Oksitetra S.K Tube/10 gr 0 0 0 3,686
219 Oksitetra S.M 1% Tube/3,5 gr 0 0 0 2,310
221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g 0 0 0 61,000
222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g 0 0 0 3,850
223 Oksitosin Inj. Kotak/30 Amp. 0 0 0 58,905
224 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml 0 0 0 242,000
225 Omeprazole Tab. 20 mg Kotak/30 0 0 0 6,630

226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.5 0 0.43 0.07 312,500
227 Papaverin Tab. Botol/1000 0 0 0 264,100
228 Papaverin Tab 40 mg Botol/1000 4 0 4 0 109,450
229 Parasetamol Drops Botol 15 ml 0 0 0 5,808
230 Botol 5 37 0 5,720
(60 mg/0,6 ml)
231 Parasetamol Syrup Botol/60 400 378 22 1,535
232 Parasetamol Tab. 500 mg Kotak/100 0 0 0 8,800
233 Pirantel Pamoat 125 mg Kotak/100 6 3 7 2 31,800
234 Pirantel Pamoat syr Botol/60 0 0 0 9,100
235 Pirantel suspensi Botol/60 0 0 0 9,100
236 Piridoksin HCl Tab 10 mg 0 0 0 Rp 36,685
237 Piridoksin HCl Tab. 10 mg Botol/1000 0 0 0 33,000
238 Piridoksin HCl Tab. 10 mg Kotak/100 0 0 0 12,100
239 Piroxicam Tab 20 mg 0 0 0 Rp 19,816
SISA STOK
STOK HARGA
AWAL SATUAN
2017

244 Povidum Iodium Botol/10ml 0 0 0 2,344
245 Povidum Iodium Botol /30 ml 0 0 0 2,344
246 Predmisone Botol / 100 0 0 0 68,750
247 Prednison Tab. 5 mg Botol/1000 0 0 0 68,750
248 Prednison Tab. 5 mg Kotak/100 0 0 0 12,500
249 Primakuin tablet 15 mg Dus,10 blister @10 tablet 1 0 0 1 20,500

251 Propiltiourasil Tab 10 mg Botol/100 5 0 5 0 Rp 35,100
252 Propiltiourasil Tab. 100 mg Botol/100 4 0 4 0 32,953
253 Pyrantel syrp Botol 0 0 0 9,100
254 Pyrantel tab Kotak/100 0 0 0 31,800
255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp) 0 0 0 13,400
256 Ranitidin Tab. 150 mg Kotak/100 20 10 10 13,200
257 Reserpin tablet 0,10 mg Kotak 0 0 0 20,680
260 Ringer Laktat Lar. Infus Botol 500 ml 0 0 0 5,720
261 Ringer Laktat Lar. Infus Botol 500 ml 0 0 0 6,500
262 Ringer Laktat Lar. Infus (Tutup karet 3 lub Botol 500 ml 0 0 0 12,000
263 Salbutamol 2 mg Tab. Kotak/100 0 0 0 9,243
264 Salbutamol 4 mg Tab. Kotak/100 0 0 0 9,900
265 Salep 2 - 4 Kotak/24 0 0 0 96,000
266 Pot @ 30 gram 150 25 125 2797
+ Belerang endap 4%
267 Pot @ 30 gram 0 24 0 2,200
Belerang Endap 4%
268 Salisil Bedak Kotak 0 0 0 1,573
269 Salisil Bedak 5 30 27 8 Rp 1,350
270 Sefadroksil 500 mg Kotak/100 30 27 3 52,900
271 Sefadroksil Syrp Botol 60 ml 0 0 0 5,286
Dus, 3 Strip @ 10 Kaplet 4
272 Simvastatin scored tablet 10 mg 75 65 14 3,690
salut selaput
273 Simvastatin Tab. 10 mg Kotak/50 0 0 0 28,215
274 Simvastatin Tab. 10 mg Kotak/100 0 0 0 17,700
275 Stesolid Injeksi Kotak/5 Amp. 0 0 0 78,147
279 Tablet Tambah Darah (SF) Botol/1000 0 0 0 28,855
280 Tetrasiklin 250 Kaplet Botol/1000 0 0 0 183,425
281 Tetrasiklin 250 Kaplet Kotak/100 0 0 0 16,200
282 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 1 0 1 0 37,928
283 Thiamin HCl 100 mg/ml Injeksi Kotak/30 Ampul 0 0 0 50,090
284 Thiamin HCl Injeksi Kotak/30 0 0 0 25,300
286 Thiamin HCl Tab. 50 mg 0 0 0 Rp 71,351
287 Thiamin HCl Tablet 50 mg Botol/1000 5 2 3 74,455
288 Vaksin Rabies kuur 0 0 0 750,000
289 Vomitrol Syrup Botol 0 0 0 5,519
290 Zinc Syrup Botol/60 ml 50 50 0 8,140
291 Zink phosfat Set 0 0 0 276,750
0 0
SISA STOK
STOK HARGA
AWAL SATUAN
2017
B. PROGRAM GIZI 0 0
292 Becefort Botol 0 0 0 20,700
293 Hemafort Kotak/100 0 0 0 90,750
294 Livron kotak/100 19 0 19 0 25,300
295 lysmin Botol/60 ml 0 0 0 25,080
296 + Vit.B12 5 mcg + Vit.C 50 mg + Vit.D Botol/60 ml 0 0 0 25,080

1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0 0 0 26,120
HCl)
298 Botol/60 ml 0 0 0 21,700
299 Kotak/100 0 0 0 27,450
CuSO4 )

300 Kotak/100 0 0 0 90,700
intrinstik)

301 Kotak/100 0 0 0 90,750
303 Retinol (Vitamin A) 100.000 IU Botol/50 Kaps 0 0 0 14,025
304 Retinol (Vitamin A) 200.000 IU Botol/50 Kaps 0 0 0 18,447
305 Retinol (Vitamin A) 100.000 IU Botol/50 kapsul 0 0 0 14,300
306 Vitamin B Complex Kotak/100 2 2 0 11,200
307 Vitamin B-Complex Botol/1000 0 0 0 24,420
C. OBAT GIGI 0 0
309 Albothyl 5 ml (obat gigi) Botol/5ml 0 0 0 24,700
310 Bonding 0 0 0 216,000
311 Bonding Botol 0 0 0 356,730
312 Bonding 0 0 0 Rp 283,500
313 Calcinol / Urbical Box/2 Tube 0 0 0 535,095
314 Calcinol/ Urbical 0 0 0 Rp 877,500
315 Chlorphenol Kampher Menthol (CHKM) Botol/20 ml 0 0 0 60,500
316 Cresopen Botol/13 ml 0 0 0 538,650

317 Cresopen 0 0 0 Rp 762,750
318 Dentorit/Caviton Botol/30gr 0 0 0 155,250
319 Dentorit/Caviton Botol 0 0 0 201,886
320 Dentorit/caviton 0 0 0 Rp 263,250
321 Devitasol Pasta (Devitac) Botol/4,5 0 0 0 610,200
322 Devitasol Pasta (Devitac) Botol 0 0 0 647,660
323 Etil klorida Kaleng 0 0 0 115,500
325 Etil klorida Kaleng 0 0 0 109,451
326 Etsha btl 0 0 0 101,250
327 Etsha Botol 0 0 0 262,683
328 Eugenol Cairan Kotak 12 Botol @ 15 ml 0 0 0 605,000

SISA STOK
STOK HARGA
AWAL SATUAN
2017
329 Glass Ionomer Cement Bungkus/Set 0 0 0 434,500

330 Glass Ionomer Cement (Vitro Molar) Bungkus/Set 0 0 0 1,119,375
331 Glass Ionomer Cement (Vitro Molar) 0 0 0 Rp 1,309,500
332 Gutta Percha Box/200 Stik 0 0 0 67,500
333 Gutta Percha Kotak 0 0 0 54,000
334 Jarum (Carefull) Set 0 0 0 168,750
337 Mata Bor High set 0 0 0 217,500
338 Mata Bor High Set 0 0 0 270,000
340 Paper Point No. 15 Kotak/200 stik 0 0 0 67,500
341 Paper Point No. 15 Kotak 0 0 0 60,750
342 Paper Point No. 20 Kotak/200 stik 0 0 0 37,000
343 Pehacain Injeksi Kotak/20 0 0 0 66,510
344 Rockless Botol 0 0 0 742,500
345 Rockless Botol 0 0 0 988,142
346 Spongostan Kotak/10 0 0 0 70,000
348 Spongostan Box/10 pcs 0 0 0 181,877
349 Tambalan Komposit Set 0 0 0 1,464,441
350 Tambalan komposit ( natural look) 0 0 0 Rp 1,650,800
351 Tambalan Komposit (Natural Look) Set 0 0 0 1,014,894
352 Xylestesin Kotak 0 0 0 528,000
353 Xylestesin 0 0 0 Rp 573,750
354 Set/Kotak 0 0 0 276,750
Liquid)
355 Zinc tablet kotak/100 0 0 0 52,250
0 0 0
D. BAHAN HABIS PAKAI 0 0
358 Alat Suntik / Spoit 20 cc Kotak/100 0 0 0 185,000
359 Alat suntik / Spoit 3 cc Kotak/100 0 0 0 120,000
362 Alkohol Swamb Dos 1 0 1 0 29,563
363 Aqua Pro Injeksi Botol 20 ml 20 8 12 5,225
365 Asam Klorida (HCl) 0,1 N Botol/100 ml 0 0 0 10,800
366 Bisturi No. 15 Box/100 Pcs 0 0 0 91,000
367 Bisturi No.15 Box/100 pcs 0 0 0 101,250
368 Blood Lancet Kotak/100 13 8 5 27,000
369 Kotak/24 0 0 0 649,000
Jarum Bedah
370 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/24 pcs 4 0 1.35 2.65 174,870
371 Deck Glass Kotak/100 1 0 1 0 51,300
372 Disp. Syringe with needle 1 cc Tuberculin Box/100 pcs 1 0 1 84,825
373 Disp. Syringe With Needle 10 cc Box/100 pcs 0 0 0 120,713
375 Disp. Syringe With Needle 5 cc Box/100 pcs 0 0 0 97,875
376 EDTA 10% Botol 100 ml 0 0 0 97,500
377 EDTA 10% Botol/100 ml 0 0 0 20,250
SISA STOK
STOK HARGA
AWAL SATUAN
2017
378 Elastis Perban 4 Inch Rol 0 0 0 88,150

380 Folley Catheter 2 way No. 18 Box/10 pcs 1 0 0.3 0.7 104,400
381 Giemsa Stain Botol/100 0 0 0 100,000
382 Giemsa Stain Botol/100 ml 0 0 0 47,250
383 Hifavix 5x5 cm Rol 0 0 0 76,050
384 Hipavix 5 x 5 cm Rol 0 0 0 79,446
385 Hipavix 5 x 5 cm Pcs 0 0 0 70,265

390 IV Catheter No. 18 Kotak/50 0 0 0 428,313
398 Jarum Ekstirpasi 0 0 0 Rp 142,750
399 Jarum Extirpasi 0 0 0 155,000
400 Jarum Extirpasi Set 0 0 0 199,985
401 Jarum Kulit No. 11 Pcs 0 0 0 1,950
402 Jarum Kulit No. 11 0 0 0 Rp 24,300
403 Jarum Kulit No.11 Set 0 0 0 17,405
404 Jarum Otot No. 11 Pcs 5 0 0 5 1,950
405 Jarum Otot No. 11 0 0 0 Rp 24,300
406 Jarum Otot No.11 Set 0 0 0 17,405
408 Kapas pembalut/absorben 250 gram Roll 0 0 0 16,313
409 Kasa 40 x 80 cm Roll 1 0 1 0 118,800
410 Kasa Hydrofil Steril 18 m x 22 cm Kotak/12 Lmbr 0 0 0 5,225
412 Kasa Hydrofil Steril 36 m x 80 cm Rol 0 0 0 114,500
413 Kasa Hydrophil 40 x 80 cm Roll 5 5 0 137,025
414 Kasa Pembalut 4 m x 10 cm Roll 50 50 0 1,958
416 Kasa Pembalut Elastis 3 inci Rol 0 0 0 7,700
417 Kasa Pembalut Hydrofil 4 m x 10 cm Rol/50 0 0 0 33,385
418 Kasa Pembalut Hydrofil 4 m x 5 cm Rol/100 0 0 0 33,385
419 Kertas Puyer bks 0 0 0 6,250
420 Kertas Puyer Bungkus 0 0 0 7,425
422 Klip Plastik Obat Ukuran Kecil Bungkus/100 0 0 0 3,500
423 Klip Plastik Obat Ukuran Sedang Bungkus/100 10 0 10 0 5,000
424 Klip Plastik Obat Ukuran Sedang Bungkus/100 0 0 0 5,000
425 Botol/100 ml 0 0 0 87,750
Conc. 30 ml
426 Larutan Eosin Botol/100 0 0 0 114,750
427 Larutan Hayem Botol 0 0 0 49,000
428 Larutan Hayem Botol/100 ml 0 0 0 60,750
SISA STOK
STOK HARGA
AWAL SATUAN
2017
429 Larutan Hayem Botol/100 ml 0 0 0 64,860

430 Larutan karbol Fuchsin 0,3% Botol/100 ml 0 0 0 105,000
431 Larutan Methilen Blue Botol/100 ml 0 0 0 47,250
432 Botol/100 ml 0 0 0 55,941
ml
433 Larutan Spiritus Liter 0 0 0 38,475
436 Larutan Turk Botol 0 0 0 49,000
437 Larutan Turk Botol/100 ml 0 0 0 13,500
438 Larutan Turk Botol/100 ml 0 0 0 32,430
439 Box/100 Buah 0 3 6 42,413
Tangan)
440 Latex Examination Glove L, M, S Box/100 Pcs 0 0 0 42,413
441 Box/100 Buah 0 5 0 42,413
Tangan)
442 Box/100 Buah 0 1 0 42,413
Tangan)
443 Lisol Botol/1000 ml 5 0 1 4 53,505
444 Masker Kotak/20 0 0 0 24,750
445 Masker Kotak/50 0 0 0 21,533
446 Methanol Liter 0 0 0 16,250
447 Methanol Liter 0 0 0 33,750
448 Methylen Blue Botol 0 0 0 47,250
449 Natrium Sitrat Liter 0 0 0 136,000
450 Natrium Sitrat Liter 0 0 0 60,750
452 Objeck Glass Kotak/100 0 0 0 22,275
453 Objeck Glass Kotak/72 0 0 0 21,620
454 Oil Emercy Botol/100 ml 0 0 0 490,000
455 Oil Emercy Botol/100 ml 0 0 0 371,250
456 Oksigen (O2) 6 Kubik 0 0 0 162,500
457 Oksigen (O2) 1 kubik 0 0 0 75,000
458 Oksigen (O2) 1 1/2 kubik 0 0 0 85,000
459 Oksigen (O2) 1 kubik Kubik 0 0 0 74,345
460 Oksigen (O2) 6 kubik Kubik 0 0 0 138,864
463 Plano Tes (Tes Kehamilan) Kotak/50 0 0 0 74,250
465 Plester 5 yard x 2 inci Roll 1 1 0 34,592
466 Plester 5 yards x 2 inci Rol 0 0 0 26,208
467 Porstex botol/1000 0 0 0 20,000
468 Portex Botol 0 0 0 21,620
469 Rapid Test Hepatitis Kotak/25 tes 0 0 0 773,795
470 RDT DBD IgG/IgM Kotak/25 0 0 0 3,819,338
472 RDT DBD NS1 (Dengue Antigen) Kotak/25 0 0 0 2,824,113
473 Reagen Golongan Darah Botol/10 ml 0 0 0 280,000
474 Reagen Golongan Darah 0 0 0 Rp 365,000
475 Reagen Golongan Darah (A, B, AB) Botol/3X10 ml 0 0 0 248,630
476 Reagen Tidal Kotak/4 vial 0 0 0 607,500
477 Reagen Tidal Kotak/4 vial 0 0 0 484,828
478 Reagen Widal Kotak 8 Vial@5 ml 0 0 0 1,730,916
SISA STOK
STOK HARGA
AWAL SATUAN
2017

479 Botol/500 ml 0 0 0 577,254
Hemoglobin)
481 Sarung Tangan (Hands Scoon) Kotak/25 0 0 0 42,500
482 Sarung Tangan L, M, S Kotak/100 0 0 0 42,413
483 Silk (Benang Bedah Sutra ) Kotak/24 0 0 0 276,540
485 Strip Asam Urat Botol/25 Strip 0 0 0 120,000
487 Strip Asam Urat 0 0 0 Rp 121,500
488 Strip Gula Botol/25 Strip 0 0 0 117,000
491 Strip Kolesterol Botol/10 Strip 0 0 0 183,000
495 Tes Tuberkulin Pcs 0 0 0 881,250
496 Test Pack Kotak/50 0 0 0 100,000
497 Uji Dengue IgG/IgM 25 Test 0 0 0 1,932,287
498 Uji Hepatitis BsAg Box/25 0 0 0 505,367
499 Uji Leptospira IgM Kotak/25 Test 0 0 0 1,932,287
500 Uji Malaria Box/25 0 0 0 1,062,757
501 Uji Tifoid IgM Box/25 0 0 0 1,545,830
502 Uji Tiphoid IgM Kotak/25 0 0 0 1,799,875
503 Urine Bag Pcs 0 0 0 5,000
504 Urine Bag Standard steril 2 Lt Buah 0 0 0 3,915
505 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 0 0 0 459,000
506 Urine Reagen Strip 10 IG Para Meter Botol/100 Stik 0 0 0 243,225
507 Urine reagen strip 10 lG Para Meter Botol/100 Stik 0 0 0 195,000
509 Ambroksol syrup Botol 60ml 0 0 0 6,226
510 cyanocobalamine injeksi 1000mcg/ml kotak/100 1 0 1 0 125,345
511 Ibufropen tab 200 mg Botol 100 tab 0 0 0 12,100
513 Metformin Hcl tab 500 Kotak/10 blister/10tab 0 0 0 11,850
514 Oksitetrasiklin salep 3% kotak/25tb 5gr 0 0 0 60,775
515 Hemafort Kotak/100 0 0 0 90,700
516 Etanol 70% Cairan Botol/1000 4 10 8.6 5.4 27,272
518 Parasetamol Tab 500 mg Dus 10 strip x 10 tablet 153 130 23 10,500
519 Allopurinol 100 mg Kotak/100 10 0 10 0 9,000
523 Metformine HCL tab 500 mg Kotak/100 0 0 0 27,500
524 Parasetamol Syrup Botol/60 ml 100 0 100 0 1,535
525 Ranitidine tab 150 mg Kotak/30 0 0 0 11,550
526 salbutamol 4mg Kotak/100 2 0 2 0 6,500
527 Sefadroksil Kapsul Kotak/100 3 0 3 0 52,900
528 Vit. B-complex Kotak/100 0 0 0 11,200
0 0
OBAT TAMBAHAN 2017 0 0
SISA STOK
STOK HARGA
AWAL SATUAN
2017
1 Amlodipin tablet 5 mg Box, 10 strips@10 tab 5 5 0 86,400

2 Kotak/24 Pot 2 1.04 0.96 88,715
3 Ichtiol SK 15 g Kotak/12 Pot 3 3 0 55,310
4 Ibuprofen Suspensi 100 mg Botol/60 100 55 45 4,949
5 Sulfametoksazol 200 mg + Trimetoprim Dus, botol @ 60 ml 50 50 0 4,960
40 mg/5 ml
6 Kotrimoksazol Syrup Botol/60 ml 50 0 50 3,600
7 Kloramfenicol suspensi 125 mg/5 ml Botol @ 60 ml 5 0 5 4,050
8 Metformin HCl tab 500 mg Box, 10 strips@10 tab 5 2 3 27,500
9 Ranitidin tablet 150 mg Dus, 3 Strip@10 tab 35 33 2 11,550
10 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 5 5 0 6,500
11 Disp. Syringe with Needle 3 cc Box/100 pcs 5 0.6 4.4 67,954
13 Box/100 Buah 15 12 3 37,293
Tangan)
14 Box/100 Buah 10 6 4 37,293
Tangan)
15 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 17 15 2 17,250
16 Alkohol Swamb Kotak/100 10 5 5 11,500
Box, 10 strips@10
17 Cetirizin tablet 10 mg 40 16 24 15,400
capsules
18 Ibuprofen 400 mg Dus 10 X 10'S 40 23 17 13,300
19 Lansoprazole kapsul/kaplet 30 mg Dus , 2 strip @ 10 kapsul 40 22 18 6,820
20 Loperamide Kotak/100 1 1 0 9,700

21 Salbutamol tablet 2 mg (sebagai sulfat) Kotak/100 15 5 10 6,800
22 Metronidazol tablet 500 mg 10 strip @ 10 tab 10 1 9 14,000
23 Povidum iodium Botol/300 ml 5 3 2 21,600
24 Antasida Syr. Botol 200 135 65 2,106
25 N-asetil sistein kapsul 200 mg Kotak/100 10 1 9 47,400
26 5 0 5 12,749
(Stesolid) 2,5 ml
27 Hidrokortison krim 2,5 % Tube 5 gr 200 120 80 2,812
28 Ibuprofen 200 mg Kotak/100 10 10 0 11,100
29 Infusion Set Anak/Pediatric (60 drops/ml) Set 10 0 10 3,659
30 Ketorolac injeksi 30 mg/ml Dus, 6 ampul @ 1 ml 2 0 2 1,383

31 Kasa Hydrophil 40 x 80 cm Roll 5 1 4 120,750
33 Metilergometrin Tab 0,125 mg Kotak/100 3 1 2 17,715
34 Natrium Diclofenac tablet 50 mg Dus @ 5 X 10 's 20 1 19 8,050
35 Natrium Klorida (NaCl) 0,9% Botol 500 ml 20 2 18 6,410
36 Nistatin vaginal tablet 100.000 iu/g tsb/vaginal 1 1 0 60,200
37 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml 1 0 1 190,000

38 dus, 10 strip @ 10 tablet 30 12 18 5,200
42 Tablet Tambah Darah (Ferrosi Sulfat) Kotak/30 Tab 1518 1515 3 12,300
43 Dus, 15 Botol 35 35 0 5,980
(60 mg/0,6 ml)
44 Dus, 10 strip @ 10 kaptab 50 11 39 23,300
500 mg
45 Domperidon suspensi/sirup 5 mg/5 ml Btl @ 60 ml 50 0 50 3,180
SISA STOK
STOK HARGA
AWAL SATUAN
2017
46 Methylprednisolon 4 mg dus, 10 strip @ 10 tablet 10 2 8 20,000
47 Zinc Syrup 20 mg/5 ml Dus, Botol 60 ml 50 0 50 6,500

48 Surgical Mask 3 ply Tie on (Masker) Box/50 pcs 5 0 5 18,833
49 Piroxicam Tab. 20 mg Kotak/100 2 2 0 19,000
TOTAL 2283.8 5231 5284.466 2230.334
Mengetahui, Yang Membuat

Kepala UPT Puskesmas Marusu Petugas Gudang Obat PKM
drg. Andi. Ilham , M.Kes Fatmawati, S.Si

Nip. 19651231 200604 1 008 Nip. 19860426 201101 2 011
Penanggung Jawab Apotik PKM
ISKANDAR. M, S.Farm, Apt

Pangkat : Penata Tk. I/III.d
NIP : 19841209 201101 1 006
BULAN JULI 2017
NO NAMA OBAT KEMASAN STOK AWAL MASUK KELUAR
A. NAMA OBAT
15 Amoksisilin kapsul/kaplet 250 mg Dus, 10 blister @ 10 kapsul 0

500 mg
Hidroksida 200 mg

28 Kotak/25 12.4 0 3

29 Kotak/24 Pot 0.484 0 0
Antihemoroid, kombinasi: bismut subgalat

31 150 mg heksaklorofen 2,5 mg lidokain 10 DUS, 10 SUPP @ 2 GRAM 0
mg seng oksida 120 mg
35 Asam Folat Kaplet 1 mg Botol/100 0
42 Betahistin tab. 6 mg Kotak/30 0
Cyanocobalamin (vitamin B12) injeksi 500
mcg
Cyprofloxacin tablet 500 mg (sebagai
65 Dus, 10 blister @ 10 tab ss 0
HCl)
78 8 0 1
(Stesolid) ml
85 Dulcolax Tab 0
104 Dus @ 30 ampul 0
mg/ml
115 Glibenclamida 0
117 Gliseril Guaiacolas Botol/1000 1.9 0 1.9
118 Gliseril Guaiacolat 0
138 Ketokonazole 0
168 Lidocain inj kotak/100 0
170 Dus, 30 ampul @ 2 ml 5 0 0
80.000 - 2 ml
175 Lorazepam 2 mg Kotak/100 1.72
1 ml
195 Metoklopramid Injeksi 5 mg/ml (Metolon) Kotak/5 Ampul 0

202 Natrium Diclofenac Tab. 50 mg Kotak/50 0
205 Natrium Klorida (NaCl) 0,9% Botol 500 ml 0
226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.07
230 Botol 0
(60 mg/0,6 ml)
233 Pirantel Pamoat 125 mg Kotak/100 1.5 0 0.5
262 Ringer Laktat Lar. Infus (Tutup karet 3 luba Botol 500 ml 0
265 Salep 2 - 4 Kotak/24 0
266 Pot @ 30 gram 120 0 5
+ Belerang endap 4%
267 Pot @ 30 gram 0 s
Belerang Endap 4%
salut selaput
0
B. PROGRAM GIZI 0


1000 UI + Vit. B1 + Vit.B2 + Vit.B6 +
297 Botol/100 ml 0
HCl)
298 Botol/60 ml 0
299 Kotak/100 0
CuSO4 )

300 Kotak/100 0
intrinstik)

301 Kotak/100 0
C. OBAT GIGI 0
310 Bonding 0
311 Bonding Botol 0
312 Bonding 0

317 Cresopen 0
326 Etsha btl 0
327 Etsha Botol 0
353 Xylestesin 0
354 Set/Kotak 0
Liquid)
0
369 Kotak/24 0
Jarum Bedah
374 Disp. Syringe with Needle 3 cc Box/100 pcs 0
389 Infusion Set Dewasa (20 drops/ml) Buah 0

Larutan Carbol Fuchsin Decolorizer Conc.
425 Botol/100 ml 0
30 ml
432 Botol/100 ml 0
ml
439 Box/100 Buah 6 0 1
Tangan)
441 Box/100 Buah 0
Tangan)
442 Box/100 Buah 0
Tangan)
462 Perlak lembar 0
468 Portex Botol 0
479 Botol/500 ml 0
Hemoglobin)
484 Silk 3/0+Jarum 1/2 GT 35 mm Box/36 0
503 Urine Bag Pcs 0
516 Etanol 70% Cairan Botol/1000 15 0 1.1
0
2 Kotak/24 Pot 0.56 0 0
5 Sulfametoksazol 200 mg + Trimetoprim 40 Dus, botol @ 60 ml 0
mg/5 ml
9 Ranitidin tablet 150 mg Dus, 3 Strip@10 tab 0
13 Box/100 Buah 0
Tangan)
14 Box/100 Buah 0
Tangan)
17 Cetirizin tablet 10 mg Box, 10 strips@10 capsules 25 0 10

25 N-asetil sisitein kapsul 200 mg Kotak/100 5 0 0
26 5
(Stesolid) ml

37 Oksitosin injeksi 10 IU/ml Kotak/100 Ampul @ 1 ml 0.95 0 0
38 dus, 10 strip @ 10 tablet 23 0 13
42 Tablet Tambah Darah (Ferrosi Sulfat) Kotak/30 Tab 0
43 Dus, 15 Botol 0 0 10
(60 mg/0,6 ml)
43 Dus, 10 strip @ 10 kaptab 92 0 43
500 mg
44 Amoksisilin sirup kering 125 mg/ 5 ml Btl@60 ml 200 0 25
45 Allopurinol Tablet/kapsul/kaplet 100 mg Kotak/100 15 0 0
46 Allopurinol Tablet/kapsul/kaplet 300 mg Dus 10 blister @10 tablet 5 0 0
47 Amlodipin tablet 5 mg Box, 3 strips@10 tablet 22 0 5
Cyanocobalamin (vitamin B12)
49 Dus, 10 strip @10 tablet 11 0 11
tablet/kapsul/kaplet 50 mcg
50 Domperidon Tab. 10 mg 8 0 1
51 Domperidon suspensi/sirup 5 mg/5 ml Kotak/100 50 0 0
52 Hidrokortison krim 2,5 % Btl @ 60 ml 86 0 86
53 Kloramfenicol kaps 500 mg Tube 4 0 0
54 Lidokain injeksi 2% HCl Kotak 10 strip@10 kaps 0.8 0 0.1
55 Loperamid tablet 2 mg Dus 100 ampul@2ml 4 0 0
56 Metilprednisolon tablet 4 mg Dus, 10 strip@10tablet 4 0 4
57 Metilprednisolon tablet 8 mg Dus 10 blister @10 tablet 1 0 1
58 Dus 5 blister @10 tablet 25 0 25
(60 mg/0,6 ml)
59 Ranitidin tablet 150 mg Dus 15 ml/btl 20 0 7.5
60 Sefadroksil kapsul/kaplet 500 mg Dus, 3 Strip@10 tab 19 0 11
61 Simvastatin scored tablet 10 mg Dus 10 strip@10 kapsul 10 0 7
62 Thiamin HCl Tab. 50 mg 29 0 0
salut selaput
63 Zinc syrup 20 mg/5 ml Kotak/100 30 0 30
64 Disp. Syringe with Needle 3 cc Dus, botol 60 ml 5 0 0
65 Kapas pembalut/absorben 250 gram Box/100 pcs 5 0 0
66 Roll 5 0 3
Tangan)
67 Box/100 Buah 5 0 0
Tangan)
68 Surgical Mask 3 ply Tie on (Masker) Box/100 Buah 9 0 0
69 Strip Kolesterol Box/50 pcs 0
70 Albothyl Concentrate 5 ml Botol/10 Strip 1 0 1
71 Ambroxol syrup Botol 5 ml 65 0 65
72 Bromheksin tab. 8 mg Botol/60 ml 1 0 1
73 Dexchlorpheniramine Maleate + Kotak/300 10 0 10
74 Daryantull Botol/60 ml 3 0 1
77 Kotak/100 14 0 14
intrinstik)

Vit.B1 + Vit.B2 2+ Vit.B6 + Vit.B12 +
78 Kotak/100 10 0 10
Vit.C + Vit.D + Niaciamide 20 mg + L.
Lysine HCl).

79 Botol/100 ml 19 0 4
CuSO4 )
80 Kotak/100 80 0 40
81 Calcinol / Urbical Botol/60 ml 0 0
82 Dentorit/Caviton Box/2 Tube 0 0
83 Devitasol Pasta (Devitac) Botol 0 0
84 Spongostan Botol 0 0
TOTAL 1985.999 0 375.15

DAU
S
HARGA
SISA STOK JUMLAH
SATUAN
0 34,656 -
0 280,315 -
0 13,420 -
0 24,700 -
1 28,870 28,870
7 9,000 63,000
0 8,085 -
8 22,500 180,000
0 -
0 6,510 -
0 3,630 -
0 126,000 -
0 8,600 -
0 5,910 -
0 22,000 -
0 37,000 -
20 22,000 440,000
0 29,200 -
0 2,560 -
0 59,048 -
0 41,910 -
0 4,840 -
0 12,650 -
64 7,800 499,200
0 7,800 -
0 17,820 -
0 2,300 -
9.4 69,175 650,245
0.484 91,200 44,141
0 22,000 -
0 3350 -
0 13,563 -
0 35,200 -
5 10,500 52,500
0 5,200 -
72 12,200 878,400
0 21,978 -
0 19,800 -
0 82,500 -
36 25,100 903,600
1 36,000 36,000
0 33,539 -
0 51,315 -
0 1,596 -
0 257,070 -
2 1,362 2,724
0 66,517 -
0 23,830 -
0 4,237 -
0 5,286 -
0 35,000 -
0 15,246 -
0 38,000 -
0 14,000 -
0 19,000 -
0 Rp 45,298 -
0 26,400 -
0 122,500 -
0.7 114,070 79,849

0 14,412 -
0 1,441.20 -
0 14,300 -
7 26,500 185,500
0 35,465 -
0 26,500 -
0 312,000 -
0 202,500 -
0 178,000 -
0 173,800 -
0 -
55 7,400 407,000
0 9,570 -
0 10,100 -
0 11,810 -
0 3,152 -
0 12,100 -
0.8 78,147 62,518
7 12,751 89,257
0 4,400 -
0 4,700 -
0 34,680 -
0 10,300 -
0 3,490 -
2 17,400 34,800
0 -
0 14,097 -
0 34,848 -
0 267,300 -
0 13,563 -
0 102,300 -
0 8,090 -
0 1,980 -
0 22,720 -
0 2,626 -
0 18,333 -
0 6,221 -
0 Rp 152,889 -
0 89,100 -
0 31,620 -
0 -
0 7,139 -
0 28,855 -
3 69,000 207,000
0 112,620 -
0 57,420 -
0 69,000 -
0 -
0 8,400 -
1 11,229 11,229
0 41,800 -
0 58,030 -
0 20,207 -
0 55,506 -
0 495 -
0 Rp 9,900 -
0 6,100 -
0 66,790 -
0 Rp 52,635 -
0 30,690 -
151 5,720 863,720
0 24,100 -
0 27,104 -
0 16300 -
0 2,938 -
0 78,650 -
0 12,705 -
0 15,700 -
0 4,949 -
0 12,100 -
0 8,500 -
0 49,720 -
0 49,720 -
0 89,700 -
0 7,600 -
0 43,263 -
24 6,900 165,600
0 10,000 -
0 Rp 16,000 -
0 22,550 -
0 32,000 -
0 41,250 -
0 15,990 -
0 -
0 3,150 -
0 29,315 -
0 41,256 -
0 1,680 -
0 4,950 -
0 1,760 -
0 -
0 34,650 -
0 16,500 -
0 16,500 -
0 41,800 -
0 8,349 -
4 10,555 42,220
0 15,200 -
0 2,298 -
0 -
0 -
0 220,000 -
0 243,510 -
0 10,420 -
0 10,420 -
0 -
0 4,000 -
0 37,015 -
0 92,900 -
0 37,510 -
5 63660 318,300
0 20,000 -
0 20,000 -
0 10,071 -
0 9,700 -
1.72 142,300 244,756
0 1,953,485 -
0 15,222 -
0 38,055 -
0 26,500 -
0 38,050 -
0 12,650 -
0 19,965 -
0 16,868 -
0 23,000 -
0 39,000 -
0 49,170 -
0 275,000 -
0 Rp 16,868 -
0 13,310 -
0 17,715 -
0 61,864 -
0 11,000 -
0 8,668 -
0 11,300 -
0 61,870 -
0 15,730 -
0 24,200 -
0 16,900 -
0 3,300 -
0 3,150 -
0 42,500 -
0 9,650 -
0 92,333 -
0 4,545 -
0 5827 -
0 4,545 -
0 89,970 -
0 70,400 -
0 40,700 -
0 52,800 -
0 8,052 -
0 1,573 -
0 395,900 -
0 1,319,900 -
0 13,400 -
0 45,403 -
0 3,686 -
0 52,800 -
0 2,310 -
0 Rp 3,327 -
0 61,000 -
0 3,850 -
0 58,905 -
0 242,000 -
0 6,630 -
0.07 312,500 21,875
0 264,100 -
0 109,450 -
0 5,808 -
0 5,720 -
0 1,535 -
0 8,800 -
1 31,800 31,800
0 9,100 -
0 9,100 -
0 Rp 36,685 -
0 33,000 -
0 12,100 -
0 Rp 19,816 -
0 11,550 -
0 21,000 -
0 15,386 -
0 2,640 -
0 2,344 -
0 2,344 -
0 68,750 -
0 68,750 -
0 12,500 -
1 20,500 20,500
11 8,000 88,000
0 Rp 35,100 -
0 32,953 -
0 9,100 -
0 31,800 -
0 13,400 -
0 13,200 -
0 20,680 -
0 -
16 8,000 128,000
0 5,720 -
0 6,500 -
0 12,000 -
0 9,243 -
0 9,900 -
0 96,000 -
115 2797 321,655
#VALUE! 2,200 #VALUE!
0 1,573 -
16 Rp 1,350 21,600
0 52,900 -
0 5,286 -
3 3,690 11,070
0 28,215 -
0 17,700 -
0 78,147 -
1 28,512 28,512
0 -
0 -
0 28,855 -
0 183,425 -
0 16,200 -
0 37,928 -
0 50,090 -
0 25,300 -
0 41,580 -
0 Rp 71,351 -
1 74,455 74,455
0 750,000 -
0 5,519 -
0 8,140 -
0 276,750 -
0 -
0 -
0 20,700 -
0 90,750 -
0 25,300 -
0 25,080 -
0 25,080 -
0 26,120 -
0 21,700 -
0 27,450 -
0 90,700 -
0 90,750 -
1 70,400 70,400
0 14,025 -
0 18,447 -
0 14,300 -
0 11,200 -
0 24,420 -
0 -
0 -
0 24,700 -
0 216,000 -
0 356,730 -
0 Rp 283,500 -
0 535,095 -
0 Rp 877,500 -
0 60,500 -
0 538,650 -
0 Rp 762,750 -
0 155,250 -
0 201,886 -
0 Rp 263,250 -
0 610,200 -
0 647,660 -
0 115,500 -
0 101,250 -
0 109,451 -
0 101,250 -
0 262,683 -
0 605,000 -
0 434,500 -
0 1,119,375 -
0 Rp 1,309,500 -
0 67,500 -
0 54,000 -
0 168,750 -
0 182,250 -
0 208,093 -
0 217,500 -
0 270,000 -
3 27,000 81,000
0 67,500 -
0 60,750 -
0 37,000 -
0 66,510 -
0 742,500 -
0 988,142 -
0 70,000 -
0 168,250 -
0 181,877 -
0 1,464,441 -
0 Rp 1,650,800 -
0 1,014,894 -
0 528,000 -
0 Rp 573,750 -
0 276,750 -
0 52,250 -
0 -
0 -
0.11 120,175 13,219
0.53 175,000 92,750
0 185,000 -
0 120,000 -
0 114,180 -
0 168,000 -
0 29,563 -
6 5,225 31,350
0 327,600 -
0 10,800 -
0 91,000 -
0 101,250 -
5 27,000 135,000
0 649,000 -
1.025 174,870 179,242

0 51,300 -
1 84,825 84,825
0 120,713 -
0 84,825 -
0 97,875 -
0 97,500 -
0 20,250 -
0 88,150 -
0 9,345 -
0.7 104,400 73,080
0 100,000 -
0 47,250 -
0 76,050 -
0 79,446 -
0 70,265 -
0 3,850 -
29 4,400 127,600
0 4,568 -
0 4,176 -
0 428,313 -
25 4,959 123,975
0 428,313 -
34 4,959 168,606
0 428,313 -
19 4,959 94,221
0 428,313 -
35 4,959 173,565
0 Rp 142,750 -
0 155,000 -
0 199,985 -
0 1,950 -
0 Rp 24,300 -
2 17,405 34,810
5 1,950 9,750
0 Rp 24,300 -
0 17,405 -
0 8,250 -
0 16,313 -
0 118,800 -
0 5,225 -
54 7,700 415,800
0 114,500 -
0 137,025 -
0 1,958 -
1 6,250 6,250
5 7,700 38,500
0 33,385 -
0 33,385 -
0 6,250 -
0 7,425 -
0 -
0 3,500 -
0 5,000 -
0 5,000 -
0 87,750 -
0 114,750 -
0 49,000 -
0 60,750 -
0 64,860 -
0 105,000 -
0 47,250 -
0 55,941 -
0 38,475 -
0 47,250 -
0 32,430 -
0 49,000 -
0 13,500 -
0 32,430 -
5 42,413 212,065
0 42,413 -
0 42,413 -
0 42,413 -
3 53,505 160,515
0 24,750 -
0 21,533 -
0 16,250 -
0 33,750 -
0 47,250 -
0 136,000 -
0 60,750 -
0 27,000 -
0 22,275 -
0 21,620 -
0 490,000 -
0 371,250 -
0 162,500 -
0 75,000 -
0 85,000 -
0 74,345 -
0 138,864 -
1 37,125 37,125
0 -
0 74,250 -
3 36,450 109,350
0 34,592 -
0 26,208 -
0 20,000 -
0 21,620 -
0 773,795 -
0 3,819,338 -
0 -
0 2,824,113 -
0 280,000 -
0 Rp 365,000 -
0 248,630 -
0 607,500 -
0 484,828 -
0 1,730,916 -
0 577,254 -
3 3,328 9,984
0 42,500 -
0 42,413 -
0 276,540 -
0 143,550 -
0 120,000 -
0 118,910 -
0 Rp 121,500 -
0 117,000 -
0 121,500 -
0 108,100 -
0 183,000 -
0 183,600 -
0 183,770 -
0 21,533 -
0 881,250 -
0 100,000 -
0 1,932,287 -
0 505,367 -
0 1,932,287 -
0 1,062,757 -
0 1,545,830 -
0 1,799,875 -
0 5,000 -
0 3,915 -
0 459,000 -
0 243,225 -
0 195,000 -
0 14,900 -
0 6,226 -
0 125,345 -
0 12,100 -
0 2,607 -
0 11,850 -
0 60,775 -
0 90,700 -
13.9 27,272 379,081
0 118,910 -
23 10,500 241,500
0 9,000 -
107 5,400 577,800
0 16,300 -
12 15,200 182,400
0 27,500 -
0 1,535 -
0 11,550 -
0 6,500 -
0 52,900 -
0 11,200 -
0 -
0 -
0 86,400 -
0.56 88,715 49,680
0 55,310 -
0 4,949 -
0 4,960 -
50 3,600 180,000
5 4,050 20,250
7 27,500 192,500
0 11,550 -
0 6,500 -
2.4 67,954 163,090
1 13,068 13,068
0 37,293 -
0 37,293 -
0 17,250 -
6 11,500 69,000
15 15,400 231,000
0 13,300 -
0 6,820 -
0 3,600 -
0 6,800 -
8 14,000 112,000
0 21,600 -
50 2,106 105,300
5 47,400 237,000
5 12,749 63,745
0 2,812 -
0 11,100 -
5 3,659 18,295
0 1,383 -
3 120,750 362,250
4 14,375 57,500
1 9,700 9,700
8 8,050 64,400
31 6,410 198,710
1 60,200 60,200
0.95 190,000 180,500
10 5,200 52,000
0 149,600 -
0 231,000 -
0 126,500 -
0 12,300 -
-10 5,980 (59,800)
49 23,300 1,141,700
175 2,200 385,000

15 9,500 142,500
5 24,400 122,000
17 2,700 45,900
13 4,650 60,450
0 5,500 -
7 13,300 93,100
50 3,180 159,000
0 2,812 -
4 115,500 462,000
0.7 87,500 61,250
4 9,000 36,000
0 20,000 -
0 16,350 -
0 5,980 -
12.5 11,500 143,750

8 55,700 445,600
3 4,050 12,150
29 9,100 263,900
0 6,500 -
5 91,080 455,400
5 14,260 71,300
2 40,620 81,240
5 40,620 203,100
9 18,833 169,497
0 236,098 -
0 24,499 -
0 6,000 -
0 65,300 -
0 10,000 -
2 202,480 404,960
0 38,070 -
5 19,000 95,000
0 93,000 -
0 26,000 -
15 27,000 405,000
40 21,100 844,000
0 530,000 -
0 200,000 -
0 640,000 -
0 180,000 -
#VALUE! #VALUE!

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LAMPIRAN PERSEDIAAN OBAT DAK/DAU

PUSKESMAS MARUSU KAB MAROS

19 Amoksisillin Syr. Kering Botol/60 ml 0

20 Ampicillin Injeksi Kotak/10 0

21 Ampisillin Kapl. 500 mg Kotak/100 0

Anti bakteri Doen salep kombinasi : 3

Antifungi Doen Kombinasi : Asam 4

30 Antihemoroid Doen Kombinasi Kotak/10 Supp. 3 0 0 3

Antihemoroid, kombinasi: bismut

106 Fitomenadion Tab. Kotak/100 0

120 Glukosa larutan 5 % Botol 500 ml 173 0 0 173

121 Griseofulvin tablet 125 mg, micronized Kotak 0

185 Methylprednisolon 8 mg Kotak/100 0

205 Natrium Klorida (NaCl) 0,9% Botol 500 ml 28 0 0 28

206 Natrium Klorida Larutan Infus Botol 0

214 Obat antituberkulosis kategori 2 Paket 0

215 Obat Batuk Hitam (OBH) Indo Plus Botol/100 ml 0

216 Oksitetra S.K Kotak/25 0

217 Oksitetra S.K Tube/10 gr 0

218 Oksitetra S.M 1% Kotak/25 1 0 0 1

220 Oksitetra Salep Mata 1 % 20 0 16 4

221 Oksitetrasiklin Salep Kulit 3% Kotak/24 Tube@5 g 0

222 Oksitetrasiklin Salep Mata 1% Tube/3.5 g 0

223 Oksitosin Inj. Kotak/30 Amp. 0

226 Oxitosin inj 10 IU/ml Kotak/100 amp 0.5 0 0.09 0.41

227 Papaverin Tab. Botol/1000 0

228 Papaverin Tab 40 mg Botol/1000 4 0 4 0

229 Parasetamol Drops Botol 15 ml 0

232 Parasetamol Tab. 500 mg Kotak/100 0

233 Pirantel Pamoat 125 mg Kotak/100 6 0 0 6

234 Pirantel Pamoat syr Botol/60 0

235 Pirantel suspensi Botol/60 0

236 Piridoksin HCl Tab 10 mg 0

237 Piridoksin HCl Tab. 10 mg Botol/1000 0

238 Piridoksin HCl Tab. 10 mg Kotak/100 0

239 Piroxicam Tab 20 mg 0

240 Piroxicam Tab. 20 mg Kotak/100 6 0 0 6

241 Piroxicam Tab. 20 mg Kotak/100 25 0 25 0

242 Povidum Iodium Botol/300 ml 5 0 1 4

243 Povidum Iodium Botol/30ml 9 0 0 9

244 Povidum Iodium Botol/10ml 0

245 Povidum Iodium Botol /30 ml 0

246 Predmisone Botol / 100 0

247 Prednison Tab. 5 mg Botol/1000 0

248 Prednison Tab. 5 mg Kotak/100 0

251 Propiltiourasil Tab 10 mg 5 0 5 0

253 Pyrantel syrp Botol 0

254 Pyrantel tab Kotak/100 0

255 Ranitidin Injeksi 25 mg/2 ml Kotak/25 (10 amp) 0

256 Ranitidin Tab. 150 mg Kotak/100 0

257 Reserpin tablet 0,10 mg Kotak 0

258 Reserpin tablet 0,25 mg Kotak 0

259 Ringer Laktat Botol 1000 ml 44 0 5 39

260 Ringer Laktat Lar. Infus Botol 500 ml 0

261 Ringer Laktat Lar. Infus Botol 500 ml 0

263 Salbutamol 2 mg Tab. Kotak/100 0

264 Salbutamol 4 mg Tab. Kotak/100 0

265 Salep 2 - 4 Kotak/24 0

269 Salisil Bedak 5 0 2 3

270 Sefadroksil 500 mg Kotak/100 0

271 Sefadroksil Syrp Botol 60 ml 0

274 Simvastatin Tab. 10 mg Kotak/100 0

275 Stesolid Injeksi Kotak/5 Amp. 0

276 Stesolid Rektal Tub. Pcs 5 ml 8 0 2 6