POLRI DAERAH JAWA TIMUR

BIDANG KEDOKTERAN DAN KESEHATAN

RS BHAYANGKARA WAHYU TUTUKO BOJONEGORO

LAPORAN PENERIMAAN, PENGELUARAN DAN SISA PEMAKAIAN OBAT SERTA ALKE

RSB WAHYU TUTUKO BOJONEGORO
BULAN : AGUSTUS TAHUN 2019
SUMBER ANGGARAN : PENGADAAN SENDIRI ( BLU )

SALDO AWAL PENERIMAAN

HARGA
NO NAMA OBAT SATUAN
SATUAN JUMLAH HARGA JUMLAH HARGA
1 2 3 4 5 6 7 8
A OBAT, CAIRAN DAN BHP
1 AcarBose 50mg tab dexa tablet Rp 771 - 500 385,500
2 AcarBose 100mg tab dexa tablet Rp 1,243 - 400 497,200
3 Acran 150mg tab tablet Rp 5,174 - 150 776,160
4 Acran inj ampul Rp 21,905 - 115 2,519,071
5 Akilen Tetes Telinga fls Rp 58,607 - 5 293,035
6 Alprazolam 0.5mg tablet Rp 585 - 1000 585,002
7 Aminophylin inj Phapros ampul Rp 4,554 - 24 109,296
8 Amlodipin 10 mg Dexa tablet Rp 761 - 1000 761,000
9 Amoxicillin 500mg amj tablet Rp 370 - 400 147,998
10 Amoxsan Syr fls Rp 23,608 - 20 472,164
11 Anbacim inj vial Rp 42,045 - 30 1,261,352
12 Antasida Syr 60ml btl Rp 4,235 - 30 127,050
13 Antasida Syr 60ml KF btl Rp 11,261 - 30 337,830
14 AquaSonic gel 5kg PARKER flash Rp 823,350 - 1 823,350
15 Arm Sling size( L,m) ITAK buah Rp 37,400 - 15 561,000
16 Atorvastatin 20mg tb novel tablet Rp 2,640 - 390 1,029,600
17 Beclov inj ampul Rp 36,825 - 85 3,130,125
18 Becom C cap tablet Rp 1,401 - 400 560,560
19 Benang Ecolene 2/0, R27cd240 vi sachet Rp 86,900 - 10 869,000
20 Betahistin 6 mg novel Tablet Rp 554 - 390 216,060
21 Betason N 5gr krim tube Rp 12,802 - 24 307,248
22 Biothicol 500 Tablet Rp 3,838 - 200 767,600
23 Bisoprolol fumarate5mg NOVEL Tablet Rp 495 - 500 247,500
24 Blood Lancet GEA(100/box) pcs Rp 330 - 500 165,000
25 Bufect Forte susp 60ml fls Rp 21,560 - 24 517,440
26 Bufect susp 60ml fls Rp 15,308 - 24 367,382
27 Bufect Tab Tablet Rp 701 - 1000 700,700
28 Cairan D 10 % Unicap kolf Rp 7,500 200 1,499,960 -
29 Cairan D 10 1/5 NS Otsu kolf Rp 16,825 120 2,018,940 -
30 Cairan Futrolit HRG NAIK sofbag Rp 56,529 96 5,426,784 48 2,713,392
Cairan Inf Ns 1000 ml Irigasi
31 Sofbag Rp 24,800 45 1,115,978 45 1,115,978
sanbe hrg naik
32 Cairan Ns 100ml sanbe hrg naik fls Rp 16,434 360 5,916,240 420 6,902,280
33 Cairan NS 500ml SP sanbe naik Sofbag Rp 16,929 96 1,625,184 1128 19,095,912
Cairan Infusan D5 1/2 NS sanbe
34 sofbag Rp 18,117 48 869,616 -
naik
35 Cairan Infusan D5 1/4 NS sanbe sofbag Rp 18,018 24 432,432 -
36 Cairan Infusan D5 sanbe hrg naik sofbag Rp 17,028 96 1,634,688 -
Cairan Infusan RD sanbe hrg
37 sofbag Rp 18,216 17 309,672 72 1,311,552
naik
38 Cairan Infusan RD sanbe sofbag Rp 17,325 72 1,247,400 -
39 Cairan Infusan RL sanbe hrg naik sofbag Rp 17,325 168 2,910,600 1080 18,711,000
40 Cairan RING AS Sanbe hrg naik sofbag Rp 19,751 288 5,688,144 360 7,110,180
41 Cairan Tridex 27 B sanbe Sofbag Rp 20,790 144 2,993,760 120 2,494,800
42 Candesartan 16mg novel tablet Rp 3,575 - 510 1,823,250
43 Candesartan 8mg dexa tablet Rp 3,465 - 150 519,750
44 Cartylo 80mg tab tablet Rp 616 - 1000 616,000
45 Cefadroxil 500mg tablet Rp 880 - 200 176,000
Cefadroxil syr 125mg/ 60ml
46 btl Rp 5,003 - 10 50,030
hexp
47 Cefat Dry Syr fls Rp 45,060 - 15 675,905
48 Cefat tab tablet Rp 10,667 - 300 3,200,043
49 Cefixime 100mg tab (novel) tablet Rp 958 - 500 479,000
50 Cefixime 100mg tab Hexp tablet Rp 750 - 1000 750,000
51 Cefixime 200mg tab (novel) tablet Rp 2,985 - 300 895,500
52 Cefixime 200mg tab Dexa tablet Rp 4,034 - 200 806,740
53 Cefixime dry syr 30ml hexp fls Rp 12,276 - 10 122,760
54 Ceftriaxon inj berno Rp 6,002 - 200 1,200,400
55 Ceftriaxon inj hexp vial Rp 4,700 - 200 940,000
56 Cerini Capsul tablet Rp 3,606 - 40 144,240
Cervical Colllor M,S,L
57 pcs Rp 138,600 - 8 1,108,800
MAKIDA
Cervical Colllor M,S,L
58 pcs Rp 165,000 - 2 330,000
HealtCare
59 Cetirizine 10mg novel tablet Rp 308 - 100 30,800
60 Cetirizine 10mg hexp tablet Rp 126 - 300 37,800
61 Cetirizine 10mg tb indo tablet Rp 313 - 100 31,300
62 Cinam Inj vial Rp 150,165 - 10 1,501,654
63 Ciprofloxacin 100ml Infus berno Flash Rp 23,100 - 5 115,500
64 Ciprofloxacin 500 mg hexp tablet Rp 320 - 300 96,000
65 Ciprofloxacin 500 mg novel tablet Rp 634 - 300 190,200
66 Citicolin 500mg hexp tablet Rp 4,620 - 300 1,386,000
67 Citicolin 500mg novel tablet Rp 5,610 - 90 504,900
68 Claneksi Capsul tablet Rp 12,667 - 390 4,939,935
69 Claneksi syr fls Rp 55,840 - 10 558,404
70 Claneksi Forte syr fls Rp 74,059 - 15 1,110,885
71 Clindamicyn 150mg indo tablet Rp 702 - 100 70,200
72 Clopidogrel 75mg tb dexa tablet Rp 2,993 - 150 448,920
73 Cortidex inj ampul Rp 6,565 - 150 984,753
74 Domperidone 10mg indofarma Tablet Rp 383 - 200 76,600
75 Durogesix 25mg inj ampul Rp 237,050 - 10 2,370,500
76 Elkana Syr btl Rp 22,638 - 24 543,312
77 Epexol 30mg tab tablet Rp 874 - 500 437,000
78 Episan Susp btl Rp 19,802 - 240 4,752,523
79 Erysanbe Dry Syr fl Rp 22,638 - 5 113,190
80 Film Rongent CR DHL Pcs Rp 22,000 - 200 4,400,000
81 Flamar 50mg tab tablet Rp 1,919 - 1000 1,918,840
82 Flamar Eye drop fls Rp 36,333 - 300 10,899,900
83 Fleet Enema fls Rp 35,750 - 3 107,250
84 Folavit 400mg tablet Rp 874 - 500 437,000
85 Forbetes 500 Tablet Rp 550 - 6000 3,301,158
86 Fusycom Cream 5gr tube Rp 44,000 - 10 440,000
87 Gabapetin 300mg novel tablet Rp 2,426 - 200 485,200
88 Gaforin TM fls Rp 131,274 - 5 656,370
89 Gigazyme 2ltr Botol Rp 671,550 - 2 1,343,100
90 Glauceta tab tablet Rp 4,376 - 500 2,187,900
 91 Glibenclamide 5mg indofarma Tablet Rp 153 - 500 76,500
92 Hansaplast pcs Rp 303 - 1500 453,750
93 Hypafix 15 x 5 cm Buah Rp 170,500 - 15 2,557,500
94 Iodon Povidon 300ml btl Rp 29,150 - 38 1,107,700
95 Jarum Heacting Nald G/R 14 pack Rp 36,850 - 1 36,850
96 Kanamycin 1gr inj vial Rp 12,282 - 10 122,815
97 Kapsul kosong 00 Pcs Rp 89 - 3000 267,000
98 Kasa Steril 16x16 Hexa pack Rp 4,224 - 100 422,400
99 Kenalog In Orabase 5gr parit pad tube Rp 54,450 - 4 217,800
100 Ketoconazol 200mg tab dexa tablet Rp 389 - 200 77,800
101 Kutoin tab tablet Rp 1,385 - 1300 1,800,500
102 Lacto B Sachet Rp 4,868 - 160 778,800
103 Lansoprazole 30mg tab novel hrg tablet Rp 676 - 300 202,800
104 Leukofix 0,5 x 5,5 bsn roll Rp 15,400 - 40 616,000
105 Lidodex inj ampul Rp 57,475 - 30 1,724,250
106 Lincomycin 500mg tb ind tablet Rp 1,485 - 120 178,200
107 Liproqy Cap tablet Rp 7,330 - 90 659,736
108 Lisinopril 5mg novel tablet Rp 334 - 150 50,160
109 Lisinopril 10mg novel tablet Rp 575 - 150 86,250
110 Lisinopril 5mg dexa tablet Rp 484 - 500 242,000
111 Lisinopril 10mg dexa tablet Rp 748 - 300 224,400
112 Livron B PLEX tablet Rp 281 - 100 28,100
113 Lomatull 10x10cm Pcs Rp 14,300 - 100 1,430,000
114 Masker Earlopp Jilbab Pcs Rp 550 - 1000 550,000
115 Mefinal tablet Rp 1,401 - 4500 6,306,300
116 Meloxicam 15 mg tab dexa tablet Rp 1,019 - 1000 1,019,000
117 Meloxicam 15 mg tab hexp tablet Rp 424 - 300 127,050
118 Meloxicam 15 mg tab indo tablet Rp 1,138 - 200 227,600
119 Meloxicam 15 mg tab novel tablet Rp 719 - 750 539,550
120 Meloxicam 7,5 mg tab indo tablet Rp 657 - 200 131,400
121 Metamizole sodium 500mg tablet Rp 256 - 200 51,200
122 Metronidazol 500mg tab indo tablet Rp 389 - 300 116,700
123 Neo Kaolana syr 120 btl Rp 13,367 - 5 66,835
124 Neurosanbe inj ampul Rp 5,358 - 200 1,071,532
125 Neurosanbe Plus tablet Rp 1,105 - 600 662,970
126 Neurosanbe tab tablet Rp 1,170 - 1500 1,754,445
127 NGT no. 16 ( Stomach tube ) Buah Rp 36,960 - 15 554,400
128 Omeprazol 20mg Hexp Tablet Rp 286 - 600 171,600
129 Omeprazol 20mg novel Tablet Rp 307 - 1500 460,500
130 Omeprazole 20 mg tab indo tablet Rp 502 - 600 301,200
131 Omeprazole 40mg Inj novel vial Rp 35,750 - 100 3,575,000
132 Omeprazole 40mg Inj dexa vial Rp 12,716 - 20 254,320
133 Otilon Tetes Telinga 8ml fls Rp 37,224 - 20 744,480
134 Overload tab tablet Rp 12,375 - 100 1,237,500
135 Pamol 125 mg supp naik supp Rp 12,007 - 12 144,078
136 Pamol 250 mg supp supp Rp 17,870 - 12 214,440
137 Pantoprazol inj BERNO vial Rp 22,000 - 30 660,000
138 Phospho Soda box Rp 72,600 - 10 726,000
139 Piracetam 1200mg novel tablet Rp 1,100 - 200 220,000
140 Plasminex inj ampul Rp 13,065 - 80 1,045,229
141 Postinor tab tablet Rp 11,000 - 20 220,000
142 Primasept 5 ltr Galon Rp 1,198,120 - 1 1,198,120
143 Probiokid sachet Sachet Rp 13,421 - 200 2,684,220
144 Prostam SR tablet Rp 8,697 - 90 782,694
145 Pumpitor Dry inj vial Rp 157,711 - 90 14,194,025
146 Ranitidin 150 mg BERNO tablet Rp 264 - 1000 264,000
147 Rativol 30mg inj ampul Rp 38,463 - 185 7,115,662
148 Regumen tab tablet Rp 3,967 - 30 119,011
149 Revolan 1200mg tablet Rp 4,765 - 100 476,476
150 Revolan 800mg tablet Rp 3,957 - 250 989,250
151 Sagestam Cream tube Rp 12,936 - 12 155,232
152 Sanbe Tears 8ml TM fls Rp 21,285 - 200 4,257,000
153 Sanmag syr btl Rp 26,303 - 45 1,183,644
154 Sanmol Drop fls Rp 16,494 - 15 247,404
155 Sanmol Infus fls Rp 64,249 - 72 4,625,913
156 Sanmol Syr fls Rp 12,289 - 24 294,941
157 Santa E 400 tablet Rp 3,795 - 300 1,138,500
158 Santagesik inj ampul Rp 9,788 - 525 5,138,700
159 Scopma plus tab tablet Rp 1,388 - 700 971,740
160 Selang O2 Anak B Med (putih) Buah Rp 10,450 - 20 209,000
161 Selang O2 Anak/nasal canulla adul Buah Rp 9,900 - 50 495,000
162 Selang O2 canulla pediatric Buah Rp 9,900 - 20 198,000
163 Selang O2 canulla neonatal Buah Rp 11,000 - 10 110,000
164 Selang O2 Bayi gea Buah Rp 12,100 - 10 121,000
165 Sistenol cap tablet Rp 2,420 - 60 145,200
166 Spalk ukuran 15 x 5 cm Pcs Rp 7,013 - 60 420,780
167 Spalk ukuran 40x80x7 pcs Rp 19,800 - 20 396,000
168 Spalk ukuran 50 x8x7 Pcs Rp 23,375 - 10 233,750
169 Spinocan 25 pcs Rp 44,000 - 25 1,100,000
170 Spironaloactone 25mg dexa tablet Rp 329 - 300 98,700
171 Spuit 1 cc terumo Pcs Rp 7,040 - 300 2,112,000
172 Spuit 10 cc terumo pcs Rp 8,030 - 500 4,015,000
173 Spuit 5 cc Terumo pcs Rp 6,160 - 500 3,080,000
174 ST Non Steril maxter S pasang Rp 1,144 - 500 572,000
175 ST. Steril TRO-SENS Sur Glo. 6. pasang Rp 11,990 - 50 599,500
Stekpan Plastik ( BAB ) BIRU
176 Buah Rp 54,155 - 10 541,550
OM
177 Stick Cholesterol.easy touch Pcs Rp 27,500 - 100 2,750,000
178 Stick GDA On Call plus amj Pcs Rp 5,874 - 300 1,762,200
179 Surflo no.24 terumo pcs Rp 29,700 - 150 4,455,000
180 Tantum Verde 60ml fls Rp 23,100 - 10 231,000
181 Tensinop 10mg tablet Rp 4,603 - 60 276,183
182 Tensocrepe 6 inci Buah Rp 96,250 - 10 962,500
183 Terfacef inj vial Rp 221,852 - 28 6,211,868
184 Thrombogel gel Tube Rp 36,812 - 10 368,120
185 Thrombophob 20 gr gell (mbs) Tube Rp 53,089 - 5 265,445
186 TIM-OPHTAL Eye Drop fls Rp 30,000 - 100 3,000,000
187 Tramadol 50mg indo tablet Rp 330 - 500 164,800
Tramadol 50mg inj ampul Rp 4,935 - 10 49,350
188 Tricodazol 500mg tab tablet Rp 1,747 - 300 524,100
189 Trovensis 2 ml inj ampul Rp 35,574 - 355 12,628,770
190 Tutup Kepala / Nurse Cap Pcs Rp 517 - 300 155,100
191 Underpad Dws OM pcs Rp 4,675 - 100 467,500
192 Underpad Dws Sen Sipad pcs Rp 3,355 - 100 335,500
193 Urinal Plastik L OM Buah Rp 5,170 - 25 129,250
194 Urinal Plastik P OM Buah Rp 5,170 - 5 25,850
195 Urine Bag SteriL 2L+hanger gea Buah Rp 6,325 - 50 316,250
196 Verban 4 x 10 cm Buah Rp 4,862 - 50 243,100
197 Vicillin SX inj(hrg khusus) vial Rp 33,996 - 30 1,019,891
198 Vipalbumin tablet Rp 6,468 - 30 194,040
199 Vitamin B1 50mg tablet Rp 156 - 1,000 156,365
200 Vitamin B6 tb 10mg tablet Rp 148 - 500 74,000
201 Vitamin C 50mg tablet Rp 126 - 500 62,920
202 Vitamin D komplex 50mg tablet Rp 144 - 2,500 360,000
203 Vosedon Suspensi fls Rp 30,616 - 10 306,160
204 Water for inj 25ml merapi hrg fls Rp 2,860 120 343,200 480 1,372,800
205 bpjs
Zamel Drop fls Rp 36,933 - 24 886,380
- -
B OBAT-OBATAN MATA - -
1 AILIN TM 10ml btl Rp 8,404 - 28 235,312
2 AILIN TM 10ml DISC btl Rp 7,003 - 120 840,360
3 AILIN TM 10ml Selaras K btl Rp 6,478 - 216 1,399,248
4 Bralifex Plus Eye Drop btl Rp 44,847 - 5 224,235
5 Cendo Asthenof 5ml penta btl Rp 21,483 - 15 322,245
6 Cendo Carpine 1% 5ml btl Rp 15,857 - 50 792,850
7 Cendo Carpine 2% 5ml btl Rp 19,437 - 5 97,185
8 Cendo Tropin 1% 5 ml btl Rp 12,788 - 50 639,375
9 Fukricin eye drop 5ml btl Rp 66,825 - 5 334,125
10 Lacyvir Salep Mata 3,5 grm tube Rp 21,153 - 10 211,530
11 OPTIFLOX TM 5% 5ml btl Rp 18,000 - 239 4,302,096
12 OPTIFLOX TM 5% 5ml btl Rp 18,654 - 300 5,596,200
13 Polidemicin Eye Drop btl Rp 26,730 - 400 10,692,000
14 Siloxan 5ml kf btl Rp 58,025 - 30 1,740,750
- -
C REAGEN LABORAT/BHP ( LG ) - -
1 CREATININ Kit Rp 4,900,500 - 1 4,900,500
2 DENGUE MONO DEVICE Test Rp 115,500 - 50 5,775,000
3 DEPROTEINEZER BOX Rp 990,000 - 1 990,000
4 EOSIN 2% 100ML BTL Rp 412,500 - 1 412,500
5 HBA1C Test Rp 104,500 - 25 2,612,500
6 HBS AG Box Rp 2,035,000 - 2 4,070,000
7 Pot Urine Steril pcs Rp 5,170 - 100 517,000
8 TWIS LANCET 28 G Box Rp 55,000 - 3 165,000
9 VACUNTAINER PLAIN Box Rp 302,500 - 5 1,512,500
- -
D ALKES RUANGAN/BHP - -
- -
E ALKES ORTOPEDI (BHP) - -
1 Acetabular Recontraction Plate 8 pcs Rp 1,084,774 - 1 1,084,774
2 CLAVICULA S-plate L9 kanan S pcs Rp 1,084,772 - 1 1,084,772
3 CLAVICULA S-plate L9 kiri SCA pcs Rp 1,084,772 1 1,084,772
4 CORTICAL Screw 3,5 Dia 14 SC pcs Rp 76,263 1 76,263
5 CORTICAL Screw 3,5 Dia 16 SC pcs Rp 76,263 - 7 533,841
6 CORTICAL Screw 3,5 Dia 18 SC pcs Rp 76,263 - 5 381,315
7 CORTICAL Screw 3,5 Dia 20 SC pcs Rp 76,263 - 3 228,789
8 CORTICAL Screw 3,5 Dia 22 SC pcs Rp 76,263 1 76,263
9 CORTICAL Screw 3,5 Dia 34 SC pcs Rp 76,263 1 76,263
10 K-WIRE 1,2 SCA pcs Rp 154,000 - 1 154,000
11 K-WIRE 1,4MM SCA pcs Rp 154,000 - 2 308,000
 12 K-WIRE 1,8 SCA pcs Rp 154,000 - 1 154,000

JUMLAH TOTAL 1894 Rp 34,032,598 65598 Rp 328,484,487

BOJON

BHAYANGKAR

Rp 328,484,487 reg
Rp 5,001,750 bpjs Dr.dr. R
Rp 333,486,237 KOMI
HTG Rp 333,486,237

Rp - selisih
AN OBAT SERTA ALKES HABIS PAKAI
GORO
019
ENDIRI ( BLU )

PENGELUARAN SALDO AKHIR

JUMLA KET
JUMLAH HARGA HARGA
H
9 10 11 12 13

500 385,500 0 Rp -
400 497,200 0 Rp -
150 776,160 0 Rp -
115 2,519,071 0 Rp -
5 293,035 0 Rp -
1000 585,002 0 Rp -
24 109,296 0 Rp -
1000 761,000 0 Rp -
400 147,998 0 Rp -
20 472,164 0 Rp -
30 1,261,352 0 Rp -
30 127,050 0 Rp -
30 337,830 0 Rp -
1 823,350 0 Rp -
15 561,000 0 Rp -
390 1,029,600 0 Rp -
85 3,130,125 0 Rp -
400 560,560 0 Rp -
10 869,000 0 Rp -
390 216,060 0 Rp -
24 307,248 0 Rp -
200 767,600 0 Rp -
500 247,500 0 Rp -
500 165,000 0 Rp -
24 517,440 0 Rp -
24 367,382 0 Rp -
1000 700,700 0 Rp -
- 200 Rp 1,499,960
- 120 Rp 2,018,940
96 5,426,784 48 Rp 2,713,392
15 371,993 75 Rp 1,859,963
180 2,958,120 600 Rp 9,860,400
600 10,157,400 624 Rp 10,563,696
- 48 Rp 869,616
- 24 Rp 432,432
24 408,672 72 Rp 1,226,016
- 89 Rp 1,621,224
 72 1,247,400 0 Rp -
720 12,474,000 528 Rp 9,147,600
288 5,688,144 360 Rp 7,110,180
72 1,496,880 192 Rp 3,991,680
510 1,823,250 0 Rp -
150 519,750 0 Rp -
1000 616,000 0 Rp -
200 176,000 0 Rp -
10 50,030 0 Rp -
15 675,905 0 Rp -
300 3,200,043 0 Rp -
500 479,000 0 Rp -
1000 750,000 0 Rp -
300 895,500 0 Rp -
200 806,740 0 Rp -
10 122,760 0 Rp -
200 1,200,400 0 Rp -
200 940,000 0 Rp -
40 144,240 0 Rp -
8 1,108,800 0 Rp -
2 330,000 0 Rp -
100 30,800 0 Rp -
300 37,800 0 Rp -
100 31,300 0 Rp -
10 1,501,654 0 Rp -
5 115,500 0 Rp -
300 96,000 0 Rp -
300 190,200 0 Rp -
300 1,386,000 0 Rp -
90 504,900 0 Rp -
390 4,939,935 0 Rp -
10 558,404 0 Rp -
15 1,110,885 0 Rp -
100 70,200 0 Rp -
150 448,920 0 Rp -
150 984,753 0 Rp -
200 76,600 0 Rp -
10 2,370,500 0 Rp -
24 543,312 0 Rp -
500 437,000 0 Rp -
240 4,752,523 0 Rp -
5 113,190 0 Rp -
200 4,400,000 0 Rp -
1000 1,918,840 0 Rp -
300 10,899,900 0 Rp -
3 107,250 0 Rp -
500 437,000 0 Rp -
6000 3,301,158 0 Rp -
10 440,000 0 Rp -
200 485,200 0 Rp -
5 656,370 0 Rp -
2 1,343,100 0 Rp -
500 2,187,900 0 Rp -
 500 76,500 0 Rp -
1500 453,750 0 Rp -
15 2,557,500 0 Rp -
38 1,107,700 0 Rp -
1 36,850 0 Rp -
10 122,815 0 Rp -
3000 267,000 0 Rp -
100 422,400 0 Rp -
4 217,800 0 Rp -
200 77,800 0 Rp -
1300 1,800,500 0 Rp -
160 778,800 0 Rp -
300 202,800 0 Rp -
40 616,000 0 Rp -
30 1,724,250 0 Rp -
120 178,200 0 Rp -
90 659,736 0 Rp -
150 50,160 0 Rp -
150 86,250 0 Rp -
500 242,000 0 Rp -
300 224,400 0 Rp -
100 28,100 0 Rp -
100 1,430,000 0 Rp -
1000 550,000 0 Rp -
4500 6,306,300 0 Rp -
1000 1,019,000 0 Rp -
300 127,050 0 Rp -
200 227,600 0 Rp -
750 539,550 0 Rp -
200 131,400 0 Rp -
200 51,200 0 Rp -
300 116,700 0 Rp -
5 66,835 0 Rp -
200 1,071,532 0 Rp -
600 662,970 0 Rp -
1500 1,754,445 0 Rp -
15 554,400 0 Rp -
600 171,600 0 Rp -
1500 460,500 0 Rp -
600 301,200 0 Rp -
100 3,575,000 0 Rp -
20 254,320 0 Rp -
20 744,480 0 Rp -
100 1,237,500 0 Rp -
12 144,078 0 Rp -
12 214,440 0 Rp -
30 660,000 0 Rp -
10 726,000 0 Rp -
200 220,000 0 Rp -
80 1,045,229 0 Rp -
20 220,000 0 Rp -
1 1,198,120 0 Rp -
200 2,684,220 0 Rp -
 90 782,694 0 Rp -
90 14,194,025 0 Rp -
1000 264,000 0 Rp -
185 7,115,662 0 Rp -
30 119,011 0 Rp -
100 476,476 0 Rp -
250 989,250 0 Rp -
12 155,232 0 Rp -
200 4,257,000 0 Rp -
45 1,183,644 0 Rp -
15 247,404 0 Rp -
72 4,625,913 0 Rp -
24 294,941 0 Rp -
300 1,138,500 0 Rp -
525 5,138,700 0 Rp -
700 971,740 0 Rp -
20 209,000 0 Rp -
50 495,000 0 Rp -
20 198,000 0 Rp -
10 110,000 0 Rp -
10 121,000 0 Rp -
60 145,200 0 Rp -
60 420,780 0 Rp -
20 396,000 0 Rp -
10 233,750 0 Rp -
25 1,100,000 0 Rp -
300 98,700 0 Rp -
300 2,112,000 0 Rp -
500 4,015,000 0 Rp -
500 3,080,000 0 Rp -
500 572,000 0 Rp -
50 599,500 0 Rp -
10 541,550 0 Rp -
100 2,750,000 0 Rp - 50
300 1,762,200 0 Rp -
150 4,455,000 0 Rp - 50
10 231,000 0 Rp -
60 276,183 0 Rp -
10 962,500 0 Rp -
28 6,211,868 0 Rp -
10 368,120 0 Rp -
5 265,445 0 Rp -
100 3,000,000 0 Rp - 50
500 164,800 0 Rp -
10 49,350 0 Rp -
300 524,100 0 Rp -
355 12,628,770 0 Rp -
300 155,100 0 Rp -
100 467,500 0 Rp -
100 335,500 0 Rp -
25 129,250 0 Rp -
5 25,850 0 Rp -
50 316,250 0 Rp -
 50 243,100 0 Rp -
30 1,019,891 0 Rp -
30 194,040 0 Rp -
1,000 156,365 0 Rp -
500 74,000 0 Rp -
500 62,920 0 Rp -
2,500 360,000 0 Rp -
10 306,160 0 Rp -
600 1,716,000 0 Rp -
24 886,380 0 Rp -
- 0 Rp -
- 0 Rp -
28 235,312 0 Rp -
120 840,360 0 Rp -
216 1,399,248 0 Rp -
5 224,235 0 Rp -
15 322,245 0 Rp -
50 792,850 0 Rp -
5 97,185 0 Rp -
50 639,375 0 Rp -
5 334,125 0 Rp -
10 211,530 0 Rp -
239 4,302,096 0 Rp -
300 5,596,200 0 Rp -
400 10,692,000 0 Rp -
30 1,740,750 0 Rp -
- 0 Rp -
- 0 Rp -
1 4,900,500 0 Rp -
50 5,775,000 0 Rp -
1 990,000 0 Rp -
1 412,500 0 Rp -
25 2,612,500 0 Rp -
2 4,070,000 0 Rp -
100 517,000 0 Rp -
3 165,000 0 Rp -
5 1,512,500 0 Rp -
- 0 Rp -
- 0 Rp -
- 0 Rp -
- 0 Rp -
1 1,084,774 0 Rp -
1 1,084,772 0 Rp -
1 1,084,772 0 Rp -
1 76,263 0 Rp -
7 533,841 0 Rp -
5 381,315 0 Rp -
3 228,789 0 Rp -
1 0 Rp -
1 0 Rp -
1 154,000 0 Rp -
2 308,000 0 Rp -
 1 154,000 0 Rp -

64512 Rp 309,449,460 2980 Rp 52,915,099

BOJONEGORO, SEPTEMBER 2019

KARUMKIT
BHAYANGKARA WAHYU TUTUKO BOJONEGORO

Dr.dr. ROMMY SEBASTIAN., M.Kes.

KOMISARIS POLISI NRP 75081286
 POLRI DAERAH JAWA TIMUR
BIDANG KEDOKTERAN DAN KESEHATAN
RS BHAYANGKARA WAHYU TUTUKO BOJONEGORO

LAPORAN PENERIMAAN, PEMAKAIAN DAN SISA PEMAKAIAN OBAT SERTA ALKES HA

RSB WAHYU TUTUKO BOJONEGORO
BULAN : AGUSTUS TAHUN 2019
SUMBER ANGGARAN : PENGADAAN SENDIRI ( BPJS )
HARGA SALDO AWAL PENERIMAAN
NO NAMA OBAT SATUAN
SATUAN JUMLAH HARGA JUMLAH HARGA
1 2 3 4 5 6 7 8
1 Amlodipin 10mg tempo tablet Rp 99 - 1500 148,500
2 Amlodipin 5mg tempo tablet Rp 75 - 1500 112,500
3 Glimepiride 1 mg kf tablet Rp 174 500 87,000
4 Glimepiride 4 mg tablet Rp 270 500 135,000
5 Infuset Dewasa OM pcs Rp 3,553 150 532,950
6 Inflo Cath no.20 G pcs Rp 3,366 250 841,500
7 Inflo Cath no.24 G pcs Rp 3,366 50 168,300
8 Spuit 3 CC kf (terumo) pcs Rp 1,139 500 569,500
9 Spuit 5 CC kf (terumo) pcs Rp 1,601 500 800,500
10 Spuit 10cc kf pcs Rp 1,870 500 935,000
11 Upad Dewasa Sensipad pcs Rp 3,355 200 671,000

JUMLAH TOTAL Rp - Rp 5,001,750

BOJONEGOR
K
BHAYANGKARA WAH

DR.Dr. ROMM
KOMISARIS
AN OBAT SERTA ALKES HABIS PAKAI
EGORO
2019
SENDIRI ( BPJS )
PENGELUARAN SALDO AKHIR KET
JUMLA
JUMLAH HARGA HARGA
H
9 10 11 12 13
1500 148,500 0 -
1500 112,500 0 -
500 87,000 0 -
500 135,000 0 -
150 532,950 0 -
250 841,500 0 -
50 168,300 0 -
500 569,500 0 -
500 800,500 0 -
500 935,000 0 -
200 671,000 0 -

Rp 5,001,750 0 Rp -

BOJONEGORO, SEPTEMBER 2019

KARUMKIT
BHAYANGKARA WAHYU TUTUKO BOJONEGORO

DR.Dr. ROMMY SEBASTIAN., M.Kes.

KOMISARIS POLISI NRP 75081286