DAFTAR OBAT DAN PERBEKALAN KESEHATAN

STOK OPNAME TANGGAL 30 DESEMBER 2017

NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan

Satuan Harga Volume Harga Kemasan
Terkecil Satuan
1 2 3 4 5
I.A. OBAT ESENSIAL/GENERIK
1 Air untuk injeksi steril, bebas pirogen vial 2,750 0
2 Albendazol suspensi 200 mg/5 ml botol 10 ml 3,849 0 botol 10 ml
3 Albendazol tablet 400 mg tablet 288 0
4 Alopurinol tablet 100 mg tablet 86 0 kotak-100 tablet
5 Alprazolam 0,25 mg tablet 126 0
6 Ambroksol sirup 15 mg/ml botol 60 ml 3,102 0 botol 60 ml
7 Ambroxol tablet 30 mg tablet 99 0 kotak-100 tablet
8 Aminofilin injeksi 24 mg/ml ampul 2,567 0 kotak-30 ampul
9 Aminofilin tablet 200 mg tablet 90 0 botol-100 tablet
10 Amitriptilin tablet 25 mg tablet 143 0 kotak-100 tablet
11 Amlodipin tablet 10 mg tablet 145 0 kotak-30 tablet
12 Amlodipin tablet 5 mg tablet 105 0
13 Amoksisilin 500 mg + klavulanat 125 mg tablet tablet/kaplet 6,600 0
14 Amoksisilin kaplet 500 mg tablet 190 0 kotak-100 kaplet
15 Amoksisilin kapsul 250 mg kapsul 180 0
16 Amoksisilin sirup kering 125 mg/5 ml Botol 60 ml 2,090 0 botol 60 ml
17 Amoksisilin sirup kering forte 250 mg/5 ml Botol 60 ml 3,984 0 botol 60 ml
18 Ampisilin serbuk injeksi I.M./I.V. 1000 mg/ml vial 5,100 0 kotak-10 vial
19 Antalgin (Metampiron) tablet 500 mg tablet 110 0
20 Antasida DOEN I tablet kunyah kombinasi tablet 62 0 kotak-100 tablet
21 Antasida DOEN II Suspensi, kombinasi botol-60ml 2,025 0 botol-60ml
22 Antibakteri DOEN salep komb : Basitrasin 500 IU/g + tube 2,924 0
polimiksin 10.000 IU/g
23 Antifungi DOEN kombinasi : Asam Benzoat 6% + Asam pot 4,158 0
Salisilat 3 %

24 Antihemoroid DOEN kombinasi (Generik) supp 2,750 0

25 Antimigrain : ergotamin tartrat 1 mg + kofein 60 mg tablet tablet 167 0
26 Asam Asetil Salisilat tablet 100 mg (Asetosal) tablet 96 0
27 Asam Asetil Salisilat tablet 80 mg (Miniaspi) tablet 114 0
28 Asam Askorbat (Vitamin C) tablet 50 mg tablet 39 0 kotak-100 tablet
29 Asam Folat 400 mcg tablet 55 0
30 Asam folat tablet 1 mg tablet 67 0 botol-100 tablet
31 Asam mefenamat kaplet 250 mg 106 0
32 Asam mefenamat kaplet 500 mg tablet 112 0 kotak-100 kaplet
33 Asam traneksamat injeksi 100 mg/ml ampul 2,489 0 dus, 10 ampul
34 Asam traneksamat injeksi 50 mg/ml ampul 2,445 0
35 Asiklovir krim 5 % tube 5 gram 2,911 0
36 Asiklovir tablet 200 mg tablet 226 0
37 Asiklovir tablet 400 mg tablet 336 0 kotak 50 tablet
38 Atapulgit tablet 600 mg tablet 200 0 kotak-50 tablet
39 Atropin injeksi i.m./i.v./s.c. 0,25 mg/ml ampul 1,672 0
40 Betahistin mesilat tablet 6 mg tablet 645 0
41 Betahistin mesilat tablet 8 mg tablet 149 0
42 Betametason cream 0,1 % tube 1,520 0 tube 5 gram
43 Bisakodil suppositoria 10 mg (Dulcolax) supp 5,800 0
44 Bisakodil suppositoria 5 mg (Dulcolax) supp 5,670 0
45 Bromheksin tablet 8 mg tablet 181 0 kotak-100 tablet
46 Cetirizine kapsul 10 mg kapsul 96 0 kotak-100
47 Cetirizine sirup 5 mg/5 ml botol 60 ml 3,150 0
48 Citicholin injeksi (Vasodilator perifer) ampul 7,709 0
49 Citicholin tablet 500 mg tablet 5,012 0
50 Deksametason injeksi i.v. 5 mg/ml ampul 1,567 0
51 Deksametason tablet 0,5 mg tablet 44 0 kotak-100 tablet
52 Diazepam injeksi 5 mg/ml ampul 2,344 0
53 Diazepam rektal 10 mg / 2,5 ml - Antikejang (Stesolid) rect tube 16,742 0
54 Diazepam rektal 5 mg / 2,5 ml - Antikejang (Stesolid) 11,517 0
55 Diazepam tablet 2 mg tablet 42 0
56 Difenhidramin injeksi i.m. 10 mg/ml (HCl) ampul 689 0
57 Digoksin tablet 0,25 mg tablet 104 0 kotak-100 tablet
58 Diltiazem HCl Tablet 30 mg tablet 134 0 kotak-100 tablet
59 Dimenhidrinat tablet 50 mg tablet 99 0

411506366.xls - Pusk 1
NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan
Satuan Harga Volume Harga Kemasan
60 Doksisiklin kapsul 100 mg kapsul 269 0
61 Domperidon suspensi 5 mg/5 ml botol-60ml 3,000 0 botol-60ml
62 Domperidon tablet 10 mg tablet 118 0 kotak-100 tablet
63 Dopamin injeksi 40 mg/ml - Cetadop ampul 7,480 0
64 Efedrin HCl tablet 25 mg tablet 51 0
65 Epinefrin (Adrenalin) injeksi 0,1 % sebagai HCl) ampul 691 0
66 Eritromisin kapsul 250 mg kapsul 645 0
67 Eritromisin kapsul 500 mg kapsul 645 0
68 Eritromisin sirup 200 mg/5 ml botol 6,150 0
69 Etakridin (Rivanol) larutan 0,1 % botol 300 ml 3,000 0
70 Etanol 70 % botol 100 ml 2,500 0 botol-100 ml
71 Etanol 70 % botol 1000 ml 25,000 0
72 Fenilbutason 200 mg tablet tablet 81 0
73 Fenitoin Natrium Kapsul 100 mg kapsul 133 0 botol-100 kapsul
74 Fenitoin Natrium Kapsul 30 mg - Decatona tablet 142 0
75 Fenobarbital tablet 30 mg tablet 165 0
76 Fenolgliserol tetes telinga 10 % botol 1,008 0
77 Fitomenadion (Vit. K) injeksi 10 mg/ml ampul 3,550 0 kotak-30 ampul
78 Fitomenadion (Vit. K) tablet salut gula 10 mg tablet 686 0 kotak-100 tablet
79 Furosemida injeksi 1.v/i.m 10 mg/ml ampul 1,516 0
80 Furosemida tablet 40 mg tablet 80 0
81 Gameksan lotion 1 % botol-30 ml/tube 2,200 0
82 Garam oralit serbuk kombinasi saset 260 0
83 Gemfibrosil kapsul 300 mg kapsul 362 0
84 Gemfibrozil kapsul 600 mg kapsul 679 0 kotak-100 tablet
85 Gentamisin injeksi 40 mg/ml ampul 3,083 0
86 Gentamisin salep kulit 0,1% tube 1,469 0
87 Gentamisin sulfat salep mata 0,3% tube 2,830 0
88 Gentamisin sulfat tetes mata 0,3% botol 5 ml 4,000 0
89 Gentian violet larutan 1 % botol 895 0
90 Glibenklamid tablet 5 mg tablet 99 0
91 Gliclazid 80 mg tablet tablet 242 0 kotak-50 tablet
92 Glimepirid tablet 2 mg tablet 231 0 kotak-50 tablet
93 Gliseril Guayakolat tablet 100 mg tablet 66 0
94 Gliserin lar 50 % botol-100 ml 5,333 0 botol-100 ml
95 Glukosa larutan infus 10 % botol 500 ml 5,700 0
96 Glukosa larutan infus 40 % ampul 1,452 0
97 Glukosa larutan infus 5 % botol 500 ml 6,900 0 botol 500 ml
98 Griseofulvin tablet 125 mg micronized tablet 240 0
99 Haloperidol injeksi 50 mg/ml ampul 83,333 0 dus 5 ampul
100 Haloperidol tablet 1,5 mg tablet 66 0 kotak-100 tablet
101 Haloperidol tablet 2 mg tablet 94 0
102 Haloperidol tablet 5 mg tablet 88 0
103 Hidroklorotiazida tablet 25 mg tablet 149 0
104 Hidrokortison krim 2,5% tube 2,640 0
105 Hyoscine-N-Butilbromide tablet 10 mg (Spashi) tablet 634 0
106 Ibuprofen sirup 100 mg/5 ml botol 2,475 0 botol 60 ml
107 Ibuprofen tablet 200 mg tablet 93 0
108 Ibuprofen tablet 400 mg tablet 111 0 kotak-100 tablet
109 Isoniasida tablet 100 mg tablet 37 0
110 Isosorbid dinitrat tablet sublingual 5 mg tablet 88 0 kotak-100 tablet
111 Kalium Aspartat 300 mg (Aspar K) tablet 647 0
112 Kalium diklofenak 50 mg tablet tablet 850 0
113 Kalsium glukonas injeksi 10 % ampul 9,955 0
114 Kalsium laktat tablet 500 mg tablet 63 0 kotak-100 tablet
115 Kaptopril tablet 12,5 mg tablet 62 0 kotak-100 tablet
116 Kaptopril tablet 25 mg tablet 84 0 kotak-100 tablet
117 Karbamazepin tablet 200 mg tablet 270 0
118 Karbo gliserin tetes telinga 10 % 2,500 0
119 Ketokonazol krim 2 % tube 15 gram 6,650 0
120 Ketokonazol tablet 200 mg tablet 385 0 kotak-50 tablet
121 Ketorolac injeksi 10 mg ampul 1 ml 8,080 0
122 Ketorolac injeksi 30 mg ampul 1 ml 2,300 0
123 Klindamisin kapsul 300 mg kapsul 1,514 0
124 Klonidin tablet 0,15 mg tablet 205 0
125 Kloramfenikol kapsul 250 mg kapsul 231 0
126 Kloramfenikol kapsul 500 mg kapsul 1,048 0

411506366.xls - Pusk 2
NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan
Satuan Harga Volume Harga Kemasan
127 Kloramfenikol salep kulit 2 % tube 3,091 0
128 Kloramfenikol salep mata 1 % tube 5 gram 1,810 0
129 Kloramfenikol suspensi 125 mg/5 ml botol 60 ml 4,700 0 botol 60 ml
130 Kloramfenikol tetes mata 0,5 % botol 5 ml 3,250 0
131 Kloramfenikol tetes mata 0,5 % - Reco 6,600 0
132 Kloramfenikol tetes telinga 3 % - Reco botol 5 ml 6,600 0
133 Klorfeniramin maleat (CTM) tablet 4 mg tablet 37 0
134 Klorpromazin tablet salut 100 mg (HCl) tablet 162 0
135 Klorpromazin tablet salut 25 mg (HCl) tablet 38 0
136 Klozapin tablet 25 mg tablet 1,550 0
137 Kodein tablet 10 mg tablet 550 0
138 Kombinasi fero fumarat 60 mg + asam folat 0,04 mg tablet 352 0
139 Kotrimoksasol DOEN I (dewasa) komb. tablet 151 0
140 Kotrimoksasol suspensi botol 60 ml 2,350 0 botol 60 ml
141 Kuinin tablet 222 mg (H2SO4.7H2O) tablet 670 0 kotak-60 tablet
142 Lamivudin tablet 150 mg tablet 2,533 0
143 Lanzoprazol kapsul 30 mg kapsul 473 0 kotak-20 kapsul
144 Larutan mengandung asam amino 500 ml - Aminofluid botol 64,990 0
145 Larutan mengandung elektrolit : (Asering) botol 500 ml 9,275 0 botol-500 ml
146 Larutan mengandung elektrolit : (KAEN 3A) botol 500 ml 10,000 0 botol-500 ml
147 Larutan mengandung elektrolit : (KAEN 3B) botol 500 ml 10,000 0 botol-500 ml
148 Levotiroksin 100 mcg tablet (Euthyrox) tablet 944 0 botol-100 tablet
149 Lidokain HCl jely 20 mg/ml botol 40,000 0
150 Lidokain injeksi 2 % ampul 1,110 0 kotak-100 ampul
151 Lidokain injeksi 2 % (HCl) + epinefrin 1 : 80.000-2 ml ampul 1,937 0
152 Lidokain spray - Xylocain botol 170,400 0
153 Lisol, mengandung kresol tersabun 50% botol 1000 ml 49,882 0
154 Loperamid tablet 2 mg tablet 80 0
155 Magnesium sulfat injeksi 20 % ampul 3,200 0
156 Magnesium sulfat injeksi 40 % ampul 3,200 0
157 Mebendazol sirup 100 mg/5 ml botol 30 ml 3,534 0
158 Mebendazol tablet 100 mg tablet 210 0
159 Mekobalamin injeksi 500 mg ampul 8,213 0
160 Mekobalamin kapsul 500 mg kapsul 719 0
161 Meloksikam tablet 7.5 mg generik 365 0
162 Metformin HCl tablet 500 mg tablet 94 0 kotak-100 tablet
163 Metil Prednisolon tablet 4 mg tablet 150 0 kotak-100 tablet
164 Metil Prednisolon tablet 8 mg tablet 295 0
165 Metilergometrin Maleat injeksi 0,200 mg - 1 ml ampul 2,684 0
166 Metilergometrin maleat tablet 0,125 mg tablet 121 0
167 Metoklopramid injeksi 5 mg/ml ampul 3,300 0
168 Metoklopramid tablet 10 mg tablet 108 0 kotak-100 tablet
169 Metoklopramid tablet 5 mg tablet 123 0
170 Metronidasol sirup 125 mg/5 ml (Novagyl) botol 60 ml 5,500 0 botol 60 ml
171 Metronidasol tablet 250 mg tablet 123 0
172 Metronidasol tablet 500 mg tablet 133 0 kotak-100 tablet
173 Metronidazol infus 500 mg/100 ml botol-100 ml 9,200 0 botol-100 ml
174 Mikonazol krim 2 % tube 3,000 0 tube 10 gram
175 Natrium Diklofenak tablet 25 mg tablet 0 0
176 Natrium Diklofenak tablet 50 mg tablet 122 0 kotak-50 tablet
177 Natrium Klorida Larutan Infus 0,9% steril botol-500 ml 6,410 0 botol-500 ml
178 Nifedipin tablet 10 mg tablet 99 0 kotak-100 tablet
179 Nistatin vaginal tablet 100.000 IU/g tablet 370 0
180 Obat Batuk Hitam (OBH) cairan botol-100 ml 1,815 0
181 Oksitetrasiklin salep kulit 3% tube 5 gram 2,653 0
182 Oksitetrasiklin salep mata 1% tube 1,239 0
183 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,900 0
184 Omeprazol injeksi 40 mg/10 ml vial 36,000 0 dus, 1 vial
185 Omeprazol kapsul 20 mg kapsul 160 0 kotak-30 kapsul
186 Ondansentron injeksi 4 mg / 2 ml ampul 1,650 0 kotak-5 ampul
187 Ondansentron tablet 4 mg tablet 455 0 kotak-5 ampul
188 Papaverin injeksi ampul 530 0
189 Papaverin tablet 40 mg tablet 119 0
190 Parasetamol sirup 120 mg/5 ml botol 1,010 0 botol-60ml
191 Parasetamol tablet 500 mg tablet 56 0 kotak-100 tablet
192 Petidin injeksi (Narkotika) ampul 11,992 0
193 Piracetam 800 mg tablet tablet 704 0

411506366.xls - Pusk 3
NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan
Satuan Harga Volume Harga Kemasan
194 Piracetam injeksi 1 gram/5 ml ampul 5,198 0
195 Pirantel suspensi 125 mg/mg botol 9,510 0
196 Pirantel tablet score 125 mg tablet 269 0
197 Piridoksin (Vit. B6) tablet 10 mg tablet 45 0
198 Piroksikam kapsul 20 mg tablet 106 0
199 Piroksikam tablet 10 mg tablet 60 0
200 Povidon iodida larutan 10 % 30 ml botol 30 ml 2,900 0 botol 30 ml
201 Povidon iodida larutan 10 % 300 ml botol 300 ml 18,000 0 botol 300 ml
202 Povidon iodida larutan 10 % 60 ml botol 60 ml 3,700 0
203 Prednison tablet 5 mg tablet 76 0
204 Propanolol tablet 10 mg tablet 58 0
205 Propanolol tablet 40 mg tablet 74 0
206 Propiltiourasil tablet 100 mg tablet 297 0
207 Ranitidin injeksi 25 mg/2 ml ampul 1,390 0 kotak-25 ampul
208 Ranitidin tablet 150 mg tablet 105 0 kotak-100 tablet
209 Retinol (Vitamin A) 100.000 IU kapsul lunak kapsul 284 0 botol-50 kapsul
210 Retinol (Vitamin A) 200.000 IU kapsul lunak kapsul 508 0 botol-50 kapsul
211 Rifampisin kaplet salut 450 mg kaplet 550 0
212 Rifampisin kapsul 300 mg kapsul 350 0
213 Ringer laktat larutan infus botol 500 ml 7,150 0 botol-500 ml
214 Risperidon tablet tablet 495 0 kotak-50 tablet
215 Salbutamol cairan inhales botol 2,5 ml 4,000 0 kotak-20 botol
216 Salbutamol tablet 4 mg tablet 80 0
217 Salep 2-4, Kombinasi Asam Salisilat 2% + Belerang endap pot 2,429 0 kotak-24 put
218 4%
Salisil bedak 2% kotak-50 gram 1,020 0 kotak-50 gram
219 Sefadroksil kapsul 500 mg kaplet 509 0 kotak-100 kapsul
220 Sefadroksil sirup kering 125 mg/5 ml botol 4,896 0 botol 60 ml
221 Sefotaksim serbuk injeksi 1000 mg/vial vial 4,898 0 kotak-10 vial
222 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (ABU I) vial 5 ml 530,706 0
223 Serum Anti Tetanus Injeksi 1500 IU/Ampul (ATS) vial 1.500 126,500 0
224 Sianokobalamin (Vitamin B12) injeksi 500 mcg/ml ampul 882 0
225 Simetidin tablet 200 mg tablet 135 0
226 Simvastatin tablet 10 mg tablet 131 0
227 Siprofloksasin tablet 250 mg tablet 237 0
228 Siprofloksasin tablet 500 mg tablet 281 0
229 Spironolakton tablet 25 mg tablet 315 0 kotak-100 tablet
230 Sukralfat suspensi (Ulsafate) botol 8,338 0 botol-100 ml
231 Sukralfat tablet 500 mg - Ulsidex tablet 296 0 botol-100 ml
232 Sulfasetamid Na tetes mata 15 % kotak-24 botol 3,445 0
233 Tetrasiklin kapsul 250 mg kapsul 166 0
234 Tetrasiklin kapsul 500 mg kapsul 310 0
235 Tiamfenikol kapsul 500 mg kapsul 726 0
236 Tiamin (Vitamin B1) injeksi 100 mg/ml ampul 767 0
237 Tiamin (Vitamin B1) tablet 50 mg tablet 82 0
238 Tramadol kapsul 50 mg tablet 378 0
239 Triheksifenidil tablet 2 mg tablet 80 0 botol 250 tablet
240 Vitamin B Kompleks tablet tablet 43 0 kotak-100 tablet
241 Zinc 20 mg tablet tablet 513 0
242 Zinckid sirup 10 mg/ml botol 14,980 0
243 Zink Dispersible 20 mg tablet 473 0 kotak-100 tablet
0
B OBAT DAN BAHAN KEDOKTERAN GIGI 0
1 Air raksa dental use botol 90,000 0
2 Amalgam Perak (Silver Alloy) botol 226,422 0
3 Bahan pensteril gigi : Trikresol formalin botol 405,999 0
4 Bahan tambalan sementara gigi siap pakai (Cavit) botol 28 gram 161,150 0
5 Dentin conditioner - Dentin botol 126,665 0
6 Devitalisasi pasta (Non Arsen) botol/kotak 509,652 0
7 Etil klorida spray vial/100 ml 287,200 0
8 Eugenol cairan botol@10 ml 16,667 0 botol 10 ml
9 Fuji IX Dus 817,465 0
10 Fuji VIII Dus 718,300 0
11 Glass inonomer cement ART set/botol 550,000 0
12 Kalsium hidroksida pasta kotak 2 tube 242,000 0
13 Klorfenol Kamfer Menthol (CHKM) botol 10 ml 111,078 0
14 Mummifying pasta botol/kotak 176,000 0
15 Pasta pengisi saliran akar botol 277,200 0

411506366.xls - Pusk 4
 NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan
Satuan Harga Volume Harga Kemasan
16 Semen Seng Fosfat serbuk dan cairan set/botol 172,700 0
17 Spon gelatin cubicles 1x1x1 box-10 (1x1x1 cm) 187,000 0
18 Temporary stoping fletcher serbuk+cairan botol @ 100 gram 34,000 0
19 Tooth mouse box 201,300 0
0
C OBAT TAMBAHAN / BRANDED 0
1 Multivitamin + mineral + biotin tablet (Caviplex) kaplet 407 0 kotak-100 kaplet
2 Multivitamin + minyak ikan (untuk ibu menyusui) Nulacta kaplet 3,135 0
3 Multivitamin + mineral utk ibu hamil (Vitalex) kaplet 440 0 kotak-100 kaplet
4 Multivitamin sirup (Anagen) botol 100 ml 12,870 0 botol 100 ml
5 Neurotropik 5000 injeksi ampul 8,250 0 ampul
6 Neurotropik kaplet (Grahabion) kaplet 429 0
7 Neurotropik kaplet (Nutrifar) kaplet 320 0 kotak-100 kaplet
8 Obat batuk / flu sirup : SAMCODRYL botol 60 ml 8,910 0
9 Obat batuk / flu sirup : WICOLD botol 60 ml 7,200 0
0
II PERBEKALAN KESEHATAN 0
1 Alat suntik sekali pakai 1 ml - Aximed set 830 0
2 Alat suntik sekali pakai 2,5 ml - Terumo set 1,138 0 kotak-100 buah
3 Alat suntik sekali pakai 5 ml - Terumo set 1,600 0 kotak-100 buah
4 Alkazyme sachet 25 mg pack 801,000 0
5 Alkohol swab dos 9,999 0
6 Alkohol swab - Aximed dos 11,000 0
7 Arm sling L buah 15,840 0
8 Arm sling M buah 15,840 0
9 Arm sling S buah 15,840 0
10 Bisturi (mata pisau) Pcs 600 0
11 Blood lancet 28 buah 2,750 0 box 100 buah
12 Blood Tranfusion set - MAS Pcs 14,300 0
13 Catgut / benang bedah No. 2/0 - 3/0 Kotak@24x75 cm 635,000 0
14 Cevical collar SR-N1 - Serenity Pcs 117,420 0
15 Chromic 2/0 75 C 30M R kotak 275,400 0
16 Chromic C. 3/0 75 C 22M R kotak 275,400 0
17 Demeslik 0 75C 36M R Box 255,000 0
18 Demeslik 2/0 75C 30M C Box 183,600 0
19 Demeslik 2/0 75C 30M R Box 255,000 0
20 Demeslik 3/0 75C 17M R Box 255,000 0
21 Demeslik 3/0 75C 26M C Box 183,600 0
22 Developer untuk Film Rontgen galon 1,375,000 0 2 x 20 liter
23 Film IV dressing 6 x 7 P (E-Care) box-100 pcs 224,400 0
24 Film Rontgen ukuran 24 x 30 lembar 5,909 0
25 Film Rontgen ukuran 30 x 40 lembar 38,500 0 kotak-100 buah
26 Fixer untuk Film Rontgen Galon 20 liter 825,000 0 2x25 liter
27 Folley catheter No. 16 - Northa Pcs 12,100 0 buah
28 Folley catheter No. 16 - Serenity Pcs 10,073 0 buah
29 Folley catheter No. 18 - Northa Pcs 12,100 0 buah
30 Folley catheter No. 18 - Serenity Pcs 10,073 0 buah
31 Hi Oxygen Mask Anak - Onemed buah 24,640 0
32 Hi Oxygen Mask Dws - Onemed buah 24,640 0
33 ID patient anak pcs 850 0
34 ID patient dewasa pcs 850 0
35 Infus set anak - aximed set/kantong 5,100 0 buah
36 Infus set dewasa - aximed set/kantong 4,800 0 set
37 IV catheter No. 18 G - Aximed buah 6,000 0 kotak-50 set
38 IV catheter No. 20 G - Aximed buah 6,000 0 kotak-50 set
39 IV catheter No. 22 G - Aximed buah 6,000 0 kotak-50 set
40 IV catheter No. 24 G - Aximed buah 6,000 0 kotak-50 set
41 IV- cannula 18 G - Polywin pcs 10,494 0
42 IV- cannula 20 G - Polywin pcs 10,494 0
43 IV- cannula 22 G - Polywin pcs 10,494 0
44 Jarum jahit kombinasi set 19,663 0 kotak-100 buah
45 Jelly 28 gram tube 29,550 0
46 Kantong jenazah buah 255,860 0
47 Kapas pembalut/absorben 250 gram bungkus 13,500 0 bungkus
48 Kasa hidrofil 80 cm x 40 yard rol 130,000 0 rol
49 Kasa Hidrofil DRC 2M x 80 CM - Ahmadaris pad 9,400 0
50 Kasa hidrofil steril ukuran 16 x 16 dos 7,900 0 bungkus

411506366.xls - Pusk 5
 NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan
Satuan Harga Volume Harga Kemasan
51 Kasa hidrofil ukuran 16 x 16 lembar 268 0 bungkus
52 Kasa kompres 40/40 steril bungkus 1,568 0
53 Kasa pembalut hidrofil 4 m x 10 cm roll 2,300 0
54 Kasa pembalut hidrofil 4 m x 15 cm elastic rol 3,800 0 rol
55 Kasa pembalut hidrofil 4 m x 3 cm elastic rol 1,250 0
56 Kasa pembalut hidrofil 4 m x 5 cm elastic rol 1,100 0
57 Kertas EKG ( 50 x 30) rol 33,000 0
58 Masker 3 ply, ear loop - MAS dos 19,800 0
59 Masker 3 ply, tie on - MAS dos 19,800 0
60 Masker N59 box 130,240 0
61 Masker nebulizer set anak - Besmed set 22,000 0
62 Masker nebulizer set anak - Stardec set 28,300 0
63 Masker nebulizer set dewasa - Besmed set 22,000 0
64 Masker nebulizer set dewasa - Stardec set 28,300 0
65 Masker oxygen dewasa - Stardec pcs 19,800 0
66 Masker oxygen pediatric - Stardec pcs 19,800 0
67 Mata Bor gigi buah 27,500 0
68 Nasal oksigen bayi - Serenity buah 4,944 0
69 Nasal oksigen dewasa - MAS 5,082 0
70 Nassal Oxygen Size L - Aximed Pcs 6,600 0
71 Nassal Oxygen Size M - Aximed Pcs 6,600 0
72 Nassal Oxygen Size S - Aximed Pcs 6,600 0
73 Nassal Oxygen Size XS - Aximed Pcs 6,600 0
74 Non woven fixation 20 x 10 cm - Aximed dos 127,000 0
75 Pembalut siku / mittela kain - OneMed buah 7,920 0
76 Penutup luka dengan antibiotika Pcs 16,291 0
77 Plester 10 cm x 5 m - Pharmafix/Hypafix rol 51,305 0
78 Plester 15 cm x 5 m - Pharmafix/Hypafix rol 78,155 0
79 Plester 2.5 cm x 4.5 m - Leukoplas trol 12,076 0
80 Plester 5 cm x 5 m - Pharmafix/Hypafix rol 27,000 0
81 Plester 5 yards x 2 inchi rol 26,500 0
82 Plester kain 1,25 cm x 4,5 m (Leukoplast) Rol 11,979 0
83 Pot sputum buah 1,045 0
84 Safety box 5 liter kuning buah 15,715 0
85 Sarung tangan steril nomor 6,5 MAS pasang 7,865 0
86 Sarung tangan steril nomor 7 - MAS pasang 7,865 0
87 Sarung tangan steril nomor 7,5 MAS pasang 7,865 0
88 Sarung tangan ukuran M - MAS Pcs 462 0
89 Sarung tangan ukuran S - MAS Pcs 462 0
90 Silk (benang bedah sutera no 3/0 dg jarum 12/kotak 60,000 0
91 Stericlin flat 15 cm / 200 M rol 1,266,000 0
92 Stericlin flat 20 cm / 200 M rol 1,538,000 0
93 Tabung oksigen 1 m3 + regulator set 962,500 0
94 Tips for micropipet MT - 1 - 200 uL kantong 180,927 0
95 Tips for micropipet MT - 11 - 1 mL kantong 233,100 0
96 Under Pad pcs 7,800 0
97 Urine bag Pcs 8,070 0
98 Wing needle 23 G - 25 G buah 5,770 0
0
TAMBAHAN PERBEKALAN KESEHATAN 0
1 Alat pengukur HB 201 + analizer unit 43,560,000 0
2 Microcuvet Hb 201 buah 2,750 0
3 Occu check (alat pemegang lancet ROCHE) kit 176,000 0
4 Tabung hematokrit botol 44,000 0
0
III REAGEN 0
1 Aquabidest steril botol 500 ml 12,750 0
2 Aquabidest steril botol 1000 ml 9,900 0
3 Larutan amonium oksalat 1 % Botol 100 ml 165,000 0
4 Larutan Asam Klorida 0,1 N Botol 100 ml 6,776 0
5 Larutan Benedict Botol 100 ml 35,000 0
6 Larutan EDTA 10 % Botol 100 ml 74,100 0
7 Larutan Eosin Botol 100 ml 176,225 0
8 Larutan Giemsa Stain Botol 100 ml 356,250 0
9 Larutan Karbol Fuksin Botol 100 ml 48,400 0
10 Larutan Metanol Botol 100 ml 35,200 0
11 Larutan Metilen Blue Botol 100 ml 20,680 0

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 NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan
Satuan Harga Volume Harga Kemasan
12 Larutan Na Sitrat 3.13 % Botol 100 ml 19,475 0
13 Larutan Perhidrol (H2O2) Botol 100 ml 3,630 0
14 Larutan Turk Botol 100 ml 47,157 0
15 Larutan Ziehl Neelsen set 155,200 0
16 Oil emersi botol 25 ml 79,200 0
17 Reagen pemeriksaan yodium botol 2,750 0
18 Pemeriksaan kadar gula darah 0
Glocodoctor box 409,376 0
Accutrand 25 strip 233,200 0
Easy Touch box/25 998,910 0
Nesco box/25 85,800 0
Glucosure test 6,320 0
19 Reagen Pemeriksaan Asam Urat 0
Nesco box 92,400 0
Easy Touch box 1,187,370 0
20 Reagen Pemeriksaan Kolesterol 0
Accutrand box/25 398,200 0
Nesco box 167,200 0
21 Accu check performa test botol 420,000 0
22 Hb Sahli set 486,398 0
23 Reagen Hemolyzer : 0
Hemolyzer - Diluent 1 kit 2,430,670 0
Hemolyzer 3 lyser 1 kit 2,860,000 0
Hemolyzer - 3 cleaner 1 liter 1 kit 1,641,200 0
Hemolyzer hipocleaner 1 kit 2,005,300 0
Hemolyzer - 3 control normal 1 kit 770,000 0
24 Reagen pemeriksaan trigliserida : 0
Trigliserida (Accutrend) box / 25 464,200 0
Trigliserida (Multicare) box / 25 537,350 0
25 Reagen pemeriksaan HBsAg : 0
Tes HBsAG S/P strip (Answer/OneMed) tes 4,048 0
Tes HBsAG Bioline tes 9,878 0
26 Reagen pemeriksaan fotometer 0
- reagen kolesterol 4 x 100 ml 2,003,870 0
- reagen glukosa 4 x 100 ml 937,200 0
- reagen asam urat 4 x 100 ml 1,969,000 0
- reagen trigliserida 4 x 100 ml 3,190,000 0
27 Tes Golongan darah 0
- Anti A Botol 10 ml 82,500 0
- Anti B Botol 10 ml 82,500 0
- Anti AB Botol 10 ml 82,500 0
28 Tes Kehamilan 0
PPTEST Box 40 tes 429,990 0
HCG strip (answer) kit/25 275,000 0
29 Tes Narkoba 0
- Metamfetamin Box-50 test 38,500 0
- Cannabidoid Box-50 test 38,500 0
- Benzodiasepin Box-50 test 38,500 0
- Babiturat Box-50 test 38,500 0
30 Tes HIV I & II Antibody Card (IR-100c) kit/25 979,000 0
31 Urine Test 10 Parameter botol 220,000 0 botol-100 tes
32 Widal Test Tg H (SS-01) Botol 5 ml 214,500 0
33 Widal Test Tg O (SS-90) Botol 5 ml 214,500 0
34 Reagen Mantoux ampul 396,000 0
0
IV OBAT PROGRAM MALARIA (P2M) 0
1 ACT (Artesunate tablet 50 mg + Amodiaquin Anhydrat tablet 1,375 0 kotak-24 tablet
tablet 200 mg)
2 Arteraquin (dihydro artemisin 40 mg tablet + diperaquin tablet 3,302 0
posphat 320) tablet
3 Artemeter injeksi 1 ml 80 mg ampul 3,667 0 dos-6 ampul
4 Artesunat injeksi vial 60 mg vial 10,364 0
5 Kloroquin tablet 150 mg tablet 85 0
6 Kombinasi Pirimetamin 25 mg + Sulfadoksin 500 mg tablet 483 0
7 Kuinin Dihidroklorida injeksi 25% - 2 ml ampul 3,152 0
9 Primaquin tablet 15 mg tablet 93 0
10 Doksisiklin kapsul 100 mg tablet 209 0

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 NO NAMA OBAT Satuan Terkecil STOK 29-12-2017 Keterangan
Satuan Harga Volume Harga Kemasan
0
V OBAT PROGRAM FILARIA (KAKI GAJAH) 0
1 Dietil karbamasin sitrat tablet 98 0
0
VI OBAT PROGRAM KELAMIN /SIFILIS (P2M) 0
1 Benzatin Benzil Penisilin injeksi 2,4 juta IU vial 0 0
0
VII OBAT ANTI TUBERKULOSIS 0
1 Obat Antituberkulosis kat. Dewasa 0 0
1 Obat FDC kategori 1 paket 360,000 0
2 Obat FDC kategori 2 paket 1,200,000 0
3 Obat FDC Sisipan paket 160,000 0
4 OAT Anak paket 172,000 0
5 OAT Kombipak 1 paket 288,200 0
JUMLAH TOTAL NILAI OBAT Rp0

…………..., Desember 2017

Mengetahui Yang melaksanakan Stok Opname
kepala Puskesmas ………………

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

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