DAFTAR OBAT DAN ALKES BPJS

PENGELUAR
NO NAMA OBAT NO BATCH ED JUMLAH
APOTIK vk UGD LANSIA PBY
1 underpad 4
2 Celemek 20
3 Cotton rool 11
4 pembalut bersalin 15
5 Aqua pro inj 81F48B 12 JUNI 2021 36
6 Asam Tranexamat 70908 AGUSTUS 2020 100 5
7 GG N7001 NOP 2020 8600 300
8 Dopamet U2344103 JUNI 2019 1150
9 Imboost Kids 17F0044 JULI 2019 23 9
10 Fasidol Drops 70212 DES 2019 13
11 Nystatin Drops U171934 15 JULI 2020 3
12 Vitamin K4 5052009 AGUSTUS 2022 9100
13 Nystatin 95371004 JUNI 2019 1100
14 Proris SYR C8E934E MEI 2020 24 1
15 Proris Forte SYR C8E0F2F MEI 2020 2
16 Inpepsa Syr PD0781 Apr-21 13
17 Bioplacenton KCBPCA8 Jan-20 28
18 Gentamicin Zalf KUlit 18670680 Sep-21 50
19 OBH Syr 3110170 Sep-20 33
20 Neogenta Gel 70109 Sep-20 20
21 Hico Gel 70106 JULI 2020 28
22 Infus Set anak 21081588 JULI 2020 50
23 INERSON C004H018 Apr-22 12 2
24 TROMBOPOB 294D18 Apr-22 18
25 BORAGINOL 11398262 Sep-20 1
26 GENTAMICIN SM 1652051 AGUSTUS 2021 5 5
27 ALLETROL TM 2052034 AGUSTUS 2019 24
28 XYTROL TM 7X1030 Apr-20 48
29 DEMACOLIN 1817022 Sep-22 800
30 GEL ULTRASOUND 20170630 8
31 NEO K INJ 7BE009 MEI 2019 5
32 BUSCOPAN INJ 428151E JULI 2019 40
33 LIDOCAIN INJ P1D40846 MARET 2021 235
34 PRIMPERAN INJ 17170194 MARET 2019 90
35 PAMOL 250 SUPP 12002H008 Apr-20 72
36 PAMOL 125 SUPP 12001G0081 Feb-19 48
12001H017 MEI 2020 48
37 NEUROBION INJ J105198 Apr-19 260
K106249 MEI 2020 60
K103235 DES 2019
K104230 Jan-20
38 RANITIDIN INJ TIRNTB82218 Apr-20 420 80
39 CEFOTAXIME INJ 223245 MEI 2019 52 14
40 STIK KOLESTEROL JULI 2019 30 1 3
41 STIK GULA Apr-20 11 1
42 STIK ASAM URAT Sep-19 10 1
43 DEMACOLIN
44 PAMPERS
45 OTILON TETES TELINGA
46 CENDO FENICOL TETES MATA
47 Asam Tranexamat
48 BLOOD HB DES 2018 2
49 BLOOD LANCET 100
50 VASELINE SWAB Apr-22 15
51 ISOPLAST 12
52 SEPTOJECT Sep-19 300 100
Asam Tranexamat inj 10
slim heler 5
23-Nov-18
PENGELUARAN S
JUMLAH SISA
KOPE' PB 1 PB 2 TABANG BUNGKO POCIL MGONDW 29-Nov-18
0 4 12
0 20
0 11
0 15
0 36
5 95
300 8300
0 1150
9 14
0 13
0 3
0 9100
0 1100
1 23
0 2
0 13
0 28
0 50
0 33
0 20
0 28
0 50
2 10
0 18
0 1
5 0
0 24
0 48
 0 800
0 8
0 5
0 40
0 235
0 90
0 72
0 48
0 48
0 260
0 60
0 0
0 0
80 340
14 38
4 36 10 Jan-20
1 16 6 Apr-20
1 15 6 DES 2019
0 0 10
0 0 40
0 0 26
0 0 23
0 0 9
0 2
0 100
0 15
0 12
100 200
10 -10
5 -5
 STOK OPNAME BPJS
DESEMBER 2018

NO NAMA OBAT SATUAN JUMLAH HARGA TOTAL HARGA

1 ALLETROL TM 0
2 Alkohol swabs (2018) Rp 17,500 0
3 Aqua pro inj 0
4 Asam Tranexamat
5 Asam Tranexamat inj (2018) Rp 19,150 0
6 ATS profilaksis (2018) Rp 1,900,000 0
7 Betasone N (2018) Rp 15,000 0
8 Bioplasenton salep (2018) Rp 38,500 0
9 BLOOD HB 0
10 BLOOD LANCET (2018) Rp 35,000 0
11 BORAGINOL 0
12 BUSCOPAN INJ 0
13 CEFOTAXIME INJ 0
14 Celemek 0
15 CENDO FENICOL TETES MATA 0
16 CENDO XYTROL TM (2018) Rp 38,791 0
17 Clorampenicol Tetes Mata (2018) Rp 9,350 0
18 Clorampenicol Tetes Telinga (2018) Rp 9,350 0
19 Cotton rool 0
20 Curcuma Kaplet (2018) Rp 72,600 0
21 DEMACOLIN (2018) Rp 79,750 0
22 Dopamet (2018) Rp 3,000 0
23 Gentamicin salep kulit (2018) Rp 11,000 0
24 Gentamicin salep mata (2018) Rp 28,150 0
25 GG 0
26 Grafachlor (2018) Rp 116,864 0
27 Handscoen on (2018) Rp 47,500 0
28 Hico Gel 0
29 Histigo (2018) Rp 70,000 0
30 Imboost Kids 0
31 Inerson Salep (2018) Rp 39,325 0
32 Infus Set anak 0
33 Inpepsa sirup (2018) Rp 50,600 0
34 ISOPLAST 0
35 Jarum citojek (2018) Rp 203,500 0
36 Jelly USG (2018) Rp 40,000 0
37 Kasa steril (2018) Rp 8,000 0
38 Lanzoprasole (2018) Rp 15,400 0
39 LIDOCAIN INJ 0
40 Metergin (2018) Rp 49,506 0
41 Neogenta Gel 0
42 NEUROBION INJ (2018) Rp 13,200 0
43 Nystatin (2018) Rp 8,000 0
44 Nystatin Drops 0
45 OBH Syr (2018) Rp 8,047 0
46 OTILON TETES TELINGA 0
47 PAMOL 125 SUPP (2018) Rp 164,588 0
48 PAMOL 250 SUPP (2018) Rp 164,588 0
49 PAMPERS DEWASA (2018) Rp 96,500 0
50 Paracetamol drops (2018) Rp 6,831 0
51 Pitogin (2018) Rp 68,756 0
52 PRIMPERAN INJ 0
53 Proris Forte SYR (2018) Rp 22,500 0
54 Proris SYRUP (2018) Rp 22,500 0
55 RANITIDIN INJ (2018) Rp 71,500 0
56 Retivit plus (2018) Rp 87,350 0
57 Slim Seher (2018) Rp 11,000 0
58 SOFTEX MATERNITY (2018) Rp 16,500 0
59 Stik asam urat Autocheck (2018) Rp 200,475 0
60 Stik gula darah Autocheck (2018) Rp 200,475 0
61 Stik kolesterol Autocheck (2018) Rp 267,500 0
62 Tensi clock (2018) Rp 120,000 0
63 Tetagam (2018) Rp 268,900 0
64 Trombophop (2018) Rp 62,890 0
65 underpad (2018) Rp 33,000 0
66 VASELINE SWAB 0
67 Vit K infant (2018) Rp 97,058 0
68 Vitamin K4 0
No Nama barang Harga satuan Volume/Satuan brg Jumlah
 STOK OPNAME BPJS
DESEMBER 2018

NO NAMA OBAT SATUAN JUMLAH HARGA TOTAL HARGA

1 ALLETROL TM 0
2 Alkohol swabs (2018) Rp 17,500 0
3 Aqua pro inj 0
Asam Tranexamat 500 mg (20117) 100
4 Asam Tranexamat inj (2018) Rp 19,150 5 95750
5 ATS profilaksis (2018) Rp 1,900,000 0
6 Betasone N (2018) Rp 15,000 0
7 Bioplasenton salep (2018) Rp 38,500 0
8 BLOOD HB 2 0
9 BLOOD LANCET (2018) Rp 35,000 0
10 BORAGINOL 0
11 BUSCOPAN INJ 0
12 CEFOTAXIME INJ 0
13 Celemek 0
14 CENDO FENICOL TETES MATA 0
15 CENDO XYTROL TM (2018) Rp 38,791 0
16 Clorampenicol Tetes Mata (2018) Rp 9,350 0
17 Clorampenicol Tetes Telinga (2018) Rp 9,350 26 243100
18 Cotton rool 11 0
19 Curcuma Kaplet (2018) Rp 72,600 0
20 DEMACOLIN (2018) Rp 79,750 15 1196250
21 Dopamet (2018) Rp 3,000 0
22 Gentamicin salep kulit (2018) Rp 11,000 0
23 Gentamicin salep mata (2018) Rp 28,150 0
24 GG 0
25 Grafachlor (2018) Rp 116,864 0
26 Handscoen on (2018) Rp 47,500 0
27 Hico Gel 0
28 Histigo (2018) Rp 70,000 0
29 Imboost Kids 0
30 Inerson Salep (2018) Rp 39,325 0
31 Infus Set anak 0
32 Inpepsa sirup (2018) Rp 50,600 0
33 ISOPLAST 24 0
34 Jarum citojek (2018) Rp 203,500 2 407000
35 Jelly USG (2018) Rp 40,000 0
36 Kasa steril (2018) Rp 8,000 0
37 Lanzoprasole (2018) Rp 15,400 0
38 LIDOCAIN INJ 0
39 Metergin (2018) Rp 49,506 0
40 Neogenta Gel 0
41 NEUROBION INJ (2018) Rp 13,200 0
42 Nystatin (2018) 0
43 Nystatin Drops Rp 8,000 3 24000
44 OBH Syr (2018) Rp 8,047 0
46 PAMOL SUPP (2018) Rp 164,588 14 2304232
48 PAMPERS DEWASA (2018) Rp 96,500 36 3474000
49 Paracetamol drops (2018) Rp 6,831 0
50 Pitogin (2018) Rp 68,756 0
51 PRIMPERAN INJ 0
52 Proris Forte SYR (2018) Rp 22,500 0
53 Proris SYRUP (2018) Rp 22,500 0
54 RANITIDIN INJ (2018) Rp 71,500 34 2431000
55 Retivit plus (2018) Rp 87,350 0
56 Slim Seher (2018) Rp 11,000 13 143000
57 SOFTEX MATERNITY (2018) Rp 16,500 15 247500
58 Stik asam urat Autocheck (2018) Rp 200,475 16 3207600
59 Stik gula darah Autocheck (2018) Rp 200,475 15 3007125
60 Stik kolesterol Autocheck (2018) Rp 267,500 36 9630000
61 Tensi clock (2018) Rp 120,000 0
62 Tetagam (2018) Rp 268,900 0
63 Trombophop (2018) Rp 62,890 0
64 underpad (2018) Rp 33,000 0
65 VASELINE SWAB 16 0
66 Vit K infant (2018) Rp 97,058 0
67 Vitamin K4 0
 STOK OPNAME BPJS
DESEMBER 2018

NO NAMA OBAT SATUAN JUMLAH HARGA TOTAL HARGA

1 Alkohol swabs Rp 17,500 0
2 Asam tranexamat inj Rp 19,150 0
3 ATS profilaksis Rp 1,900,000 0
Betasone N Rp 15,000
4 Bioplasenton salep Rp 38,500 0
5 Blood lancet Rp 35,000 0
6 Cendocytrol 5 ml Rp 38,791 0
7 Clorampenicol Tetes Mata Rp 9,350 0
8 Clorampenicol Tetes Telinga Rp 9,350 0
9 Curcuma Kaplet Rp 72,600 0
10 Demacolin Rp 79,750 0
11 Demacoline Rp 79,750 0
12 Dopamet methildopa Rp 3,000 0
13 Gentamicin salep kulit Rp 11,000 0
14 Gentamicin salep kulit 1% Rp 11,000 0
15 Gentamicin salep mata Rp 28,150 0
16 Grafachlor Rp 116,864 0
17 Handscoen on Rp 47,500 0
18 Histigo Rp 70,000 0
19 Ibuprofen sirup Rp 22,500 0
20 Inerson Salep Rp 39,325 0
21 Inpepsa sirup Rp 50,600 0
22 Jarum citojek Rp 203,500 0
25 Jelly USG Rp 40,000 0
26 Kasa steril Rp 8,000 0
27 Lanzoprasole Rp 15,400 0
28 Metergin Rp 49,506 0
29 Neurobion injeksi Rp 13,200 0
30 Nistatin Rp 8,000 0
31 OBH Sirup Rp 8,047 0
32 OBH sirup Rp 8,047 0
34 Pamol Supositoria 125 mg Rp 164,588 0
36 Pamol Supositoria 250 mg Rp 164,588 0
38 Pampers Dewasa Rp 96,500 0
39 Pampers dewasa Rp 96,500 0
40 Paracetamol drops Rp 6,831 0
41 Pitogin Rp 68,756 0
42 Ranitidin injeksi Rp 71,500 0
43 Retivit plus Rp 87,350 0
44 Sftex Maternity Rp 16,500 0
46 Slim Seher Rp 11,000 0
48 Stik Asam Urat (Authochek) Rp 200,475 0
49 Stik asam urat Autocheck Rp 180,290 0
50 Stik Gula (Authochek) Rp 200,475 0
51 Stik gula darah Autocheck Rp 155,715 0
52 Stik Kolesterol (Authochek) Rp 267,500 0
53 Stik kolesterol Autocheck Rp 218,785 0
54 Tetagam Rp 268,900 0
55 Trombophop Rp 62,890 0
56 Underpad Rp 33,000 0
57 Vit K infant Rp 97,058 0
58 0
59 0
60 0
61 0
62 0
63 0
64 0
65 0
66 0
67 0
 STOK OPNAME BPJS
DESEMBER 2018

NO NAMA OBAT SATUAN Volume/Satuan brg

1 Alkohol swabs Rp 17,500 12 Dos
2 Asam tranexamat Rp 19,150 50 Dos
3 ATS profilaksis Rp 1,900,000 1 Dos
4 Betasone N Rp 15,000 50 Tube
5 Bioplasenton salep Rp 38,500 30 Tube
6 Blood lancet Rp 35,000 5 Dos
7 Cendocytrol 5 ml Rp 38,791 50 Botol
8 Clorampenicol Tetes Mata Rp 9,350 152 Botol
9 Clorampenicol Tetes Telinga Rp 9,350 150 Botol
10 Curcuma Kaplet Rp 72,600 20 Dos
11 Demacolin Rp 79,750 50 Buah
12 Demacoline Rp 79,750 50 Dos
13 Dopamet methildopa Rp 3,000 50 Bh
14 Gentamicin salep kulit Rp 11,000 50 Tube
15 Gentamicin salep kulit 1% Rp 11,000 50 Tube
16 Gentamicin salep mata Rp 28,150 50 Tube
17 Grafachlor Rp 116,864 10 kaleng
18 Handscoen on Rp 47,500 50 Dos
19 Histigo Rp 70,000 15 Dos
20 Ibuprofen sirup Rp 22,500 50 Botol
21 Inerson Salep Rp 39,325 50 Tube
22 Inpepsa sirup Rp 50,600 50 Botol
23 Jarum citojek Rp 203,500 3 Pak
24 Jelly USG Rp 40,000 20 Dos
25 Kasa steril Rp 8,000 97 Dos
26 Lanzoprasole Rp 15,400 25 Dos
27 Metergin Rp 49,506 23 Dos
28 Neurobion injeksi Rp 13,200 50 Ampul
29 Nistatin Rp 8,000 24 Dos
30 OBH Sirup Rp 8,047 150 Botol
31 OBH sirup Rp 8,047 150 Botol
32 Pamol Supositoria 125 mg Rp 164,588 5 Box
33 Pamol Supositoria 250 mg Rp 164,588 5 Box
34 Pamol suppositoria 125mg Rp 164,588 5 Box
35 Pamol suppositoria 250mg Rp 164,588 5 Box
36 Pampers dewasa Rp 96,500 20 pak
37 Pampers Dewasa Rp 96,500 40 Pak
38 Paracetamol drops Rp 6,831 99 botol
39 Pitogin Rp 68,756 23 Dos
40 Ranitidin injeksi Rp 71,500 62 Box
41 Retivit plus Rp 87,350 11 Dos
42 Sftex Maternity Rp 16,500 25 Pak
43 Slim Seher Rp 11,000 41 Bh
44 Stik Asam Urat Rp 200,475 6 Dos
45 Stik Asam Urat (Authochek) Rp 180,290 18 Dos
46 Stik asam urat Autocheck Rp 180,290 16 Dos
47 Stik Gula Rp 200,475 6 Dos
48 Stik Gula (Authochek) Rp 155,715 18 Dos
49 Stik gula darah Autocheck Rp 155,715 16 Dos
50 Stik Kolesterol Rp 267,500 10 Dos
51 Stik Kolesterol (Authochek) Rp 218,785 58 Dos
52 Stik kolesterol Autocheck Rp 218,785 42 Dos
53 Tetagam Rp 268,900 10 Ampul
54 Trombophop Rp 62,890 24 Tube
55 Underpad Rp 33,000 20 Pak
56 Vit K infant Rp 97,058 8 Dos
JUMLAH HARGA TOTAL HARGA
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
 STOK OPNAME BPJS
DESEMBER 2018

NO NAMA OBAT SATUAN Volume/Satuan brg

1 Alkohol swabs Rp 17,500 0 Dos
2 Asam tranexamat Rp 19,150 5 Dos
3 ATS profilaksis Rp 1,900,000 0 Dos
4 Betasone N Rp 15,000 0 Tube
5 Bioplasenton salep Rp 38,500 28 Tube
6 Blood lancet Rp 35,000 1 Dos
7 Cendocytrol 5 ml Rp 38,791 48 Botol
8 Clorampenicol Tetes Mata Rp 9,350 33 Botol
9 Clorampenicol Tetes Telinga Rp 9,350 26 Botol
10 Curcuma Kaplet Rp 72,600 0 Dos
11 Demacoline Rp 79,750 15 Dos
12 Dopamet methildopa Rp 3,000 50 Bh
13 Gentamicin salep kulit 1% Rp 11,000 50 Tube
14 Gentamicin salep mata Rp 28,150 23 Tube
15 Grafachlor Rp 116,864 0 kaleng
16 Handscoen on Rp 47,500 0 Dos
17 Histigo Rp 70,000 0 Dos
18 Ibuprofen sirup Rp 22,500 25 Botol
19 Inerson Salep Rp 39,325 10 Tube
20 Inpepsa sirup Rp 50,600 13 Botol
21 Jarum citojek Rp 203,500 2 Pak
22 Jelly USG Rp 40,000 8 Dos
23 Kasa steril Rp 8,000 0 Dos
24 Lanzoprasole Rp 15,400 0 Dos
25 Metergin Rp 49,506 1 Dos
26 Neurobion injeksi Rp 13,200 16 Ampul
27 Nistatin Rp 8,000 11 Dos
28 OBH Sirup Rp 8,047 73 Botol
29 Pamol Supositoria 125 mg Rp 164,588 8 Box
30 Pamol Supositoria 250 mg Rp 164,588 6 Box
31 Pampers Dewasa Rp 96,500 36 Pak
32 Paracetamol drops Rp 6,831 13 botol
33 Pitogin Rp 68,756 3 Dos
34 Ranitidin injeksi Rp 71,500 34 Box
35 Retivit plus Rp 87,350 0 Dos
36 Softex Maternity Rp 16,500 15 Pak
37 Slim Seher Rp 11,000 13 Bh
38 Stik Asam Urat (Authochek) Rp 200,475 15 Dos
39 Stik Gula (Authochek) Rp 200,475 14 Dos
40 Stik Kolesterol (Authochek) Rp 267,500 34 Dos
41 Tetagam Rp 268,900 6 Ampul
42 Trombophop Rp 62,890 18 Tube
43 Underpad Rp 33,000 14 Pak
44 Vit K infant Rp 97,058 1 Dos

Kotamobagu, Desember 2018

Mengetahui
Penanggung Jawab Gudang Obat Kepala Puskesmas Motoboi Kecil

Indah Maya Sari Soekarno, S. Si dr. Ulmiwidaya Sudibyo

Nip. 19850703 200902 2 002 Nip. 19801021 200802 2 001
TOTAL HARGA
Rp -
Rp 95,750
Rp -
Rp -
Rp 1,078,000
Rp 35,000
Rp 1,861,968
Rp 308,550
Rp 243,100
Rp -
Rp 1,196,250
Rp 150,000
Rp 550,000
Rp 647,450
Rp -
Rp -
Rp -
Rp 562,500
Rp 393,250
Rp 657,800
Rp 407,000
Rp 320,000
Rp -
Rp -
Rp 49,506
Rp 211,200
Rp 88,000
Rp 587,431
Rp 1,316,704
Rp 987,528
Rp 3,474,000
Rp 88,803
Rp 206,268
Rp 2,431,000
Rp -
Rp 247,500
Rp 143,000
Rp 3,007,125
Rp 2,806,650
 Rp 9,095,000
Rp 1,613,400
Rp 1,132,020
Rp 462,000
Rp 97,058

Desember 2018
ngetahui
smas Motoboi Kecil

widaya Sudibyo
21 200802 2 001