Anda di halaman 1dari 497

: 0101

PUSKESMAS : PASANGKAYU 1
KECAMATAN : PASANGKAYU
KAB./KODYA : PASANGKAYU
PROVINSI : SULAWESI BARAT
HAL 1
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL

A B C D E F

1 Abocat 18 PCS Rp 8,750.00 2016 40


2 Abocat 18 PCS Rp 8,575.00 DAK 2016
3 Abocat 20 PCS Rp 16,249.99 2015 10
4 Abocat 20 PCS Rp 8,750.00 2016 53
5 Abocat 20 PCS Rp 8,575.00 DAK 2016 0
6 Abocat 22 PCS Rp 8,750.00 2016 130
7 Abocat 22 PCS Rp 8,575.00 DAK 2016 0
8 Abocat 24 PCS Rp 8,750.00 2016 101
9 Abocat 26 PCS Rp 27,134.00 DAK 2018
10 Acetosal TAB Rp 127.00 2015 3800
11 Acyclovir 200 mg TAB Rp 251.00 2014 1400
12 Acyclovir 400 mg TAB Rp 362.00 2015 200
13 Acyclovir 400 mg TAB Rp 630.50 2017
14 Alat suntik sekali pakai 0,5 ml PCS Rp 1,655.50 DAK 2016
15 Alat suntik sekali pakai 1 ml PCS Rp 1,540.00 2015 125
16 Alat suntik sekali pakai 1 ml PCS Rp 1,694.00 2016 150
17 Alat suntik sekali pakai 1 ml (AXIMED) PCS Rp 913.00 DAK 2018
18 Alat suntik sekali pakai 2.5 ml PCS Rp 1,141.80 2013 5
19 Alat suntik sekali pakai 3 ml PCS Rp 968.00 2016 73
20 Alat suntik sekali pakai 5 ml PCS Rp 1,348.00 2013 5
21 Alat suntik sekali pakai 5 ml PCS Rp 861.30 2017 0
22 Albendazol SYR Rp 4,234.00 2016 26
23 Albendazol tablet 400 mg TAB Rp 363.00 2016 932
24 Alginat BOT Rp 239,525.00 2017
25 Alkohol 100 ml BOT Rp 2,625.00 2016 91
26 Alkohol 1000 ml BOT Rp 25,800.00 2016 7
27 Alkohol Swab pcs Rp 245.00 2016 400
28 Alkohol Swab pcs Rp 242.00 2017 600
29 Alopurinol tablet 100 mg TAB Rp 96.00 BUFFER 1000
30 Alopurinol tablet 100 mg TAB Rp 90.00 2015 138
31 Alopurinol tablet 100 mg TAB Rp 96.00 2017
32 Alopurinol tablet 100 mg TAB Rp 96.00 DAK 2017
33 Alopurinol tablet 300 mg TAB Rp 249.00 DAK 2017
34 Ambroxol SYR BOT Rp 6,512.30 DAK 2018 88
35 Ambroxol tablet TAB Rp 242.00 DAK 2018 1168
36 Aminofilin INJ 24 mg/ml - 10 ml AMP Rp 4,200.00 2015 121
37 Aminofilin tablet 200 mg TAB Rp 86.00 2015 800
38 Amitripilin 25 mg TAB Rp 123.00 2015 800
39 Amlodipin 10 mg TAB Rp 168.00 2016 222
40 Amlodipin 10 mg TAB Rp 279.13 DAK 2018
41 Amlodipin 5 mg (HEXAVASK) TAB Rp 197.00 2015 1590
42 Amlodipin 5 mg (HEXAVASK) TAB Rp 1,050.00 2017
43 Amoksisilin 500 mg TAB Rp 279.00 2013 5496
44 Amoksisilin 500 mg TAB Rp 279.00 2016
45 Amoksisilin 250 mg CAP Rp 220.00 2014 1200
46 Amoksisilin SYR 125 mg/5 ml BOT Rp 2,560.00 2014 102
47 Amoksisilin SYR 125 mg/5 ml BOT Rp 8,900.00 DAK 2018
48 Amoksisilin SYR 125 mg/5 ml (SOLPENOX) BOT Rp 8,900.00 DAK 2018
49 Amoksisilin SYR 250 mg/5 ml BOT Rp 4,655.00 2017
50 Amoksisilin SYR 250 mg/5 ml BOT Rp 3,740.00 DAK 2018
51 Amoksisilin DROPS (SUPRAMOX) BOT Rp 28,500.00 DAK 2018
52 Ampisilin INJ AMP Rp 5,610.00 2015 40
53 Antalgin (metampiron) 500 mg TAB Rp 385.00 DAK 2016 2609
54 Antalgin (metamizole sodium 500 mg TAB Rp 385.00 DAK 2016
55 Antasida SYR Rp 2,135.00 2015 285
56 Antasida SYR Rp 2,135.00 DAK 2016
57 Antasida doen tablet kombinasi TAB Rp 78.00 2015 3435
58 Antasida doen tablet kombinasi 400 mg TAB Rp 72.00 2017
59 Anti Hemoroid SUPP Rp 2,200.00 2016 160
60 Aqua dest steril VIAL Rp 2,750.00 2017
61 As. Mefenamat TAB Rp 119.00 2014 294
62 As. Mefenamat TAB Rp 119.00 2016 3600
63 As. Mefenamat TAB Rp 117.00 2017
64 As. Mefenamat (BIRU) TAB Rp 176.00 2017
65 As. Mefenamat 500 mg TAB Rp 119.00 APBD 2018
66 Asam folat (AFOLAT) TAB Rp 52.00 2016 1670
67 Asam folat (Profolat) TAB Rp 64.00 DAK 2018 0
68 ASEPTIC GEL BTL Rp 1,581.25 2017 10
69 Atenolol (FARNORMIN) TAB Rp 387.00 2015 200
70 Atenolol (FARNORMIN) TAB Rp 342.00 DAK 2017 0
71 Atropin sulfat INJ 0.25 mg/ml - 1ml AMP Rp 1,400.00 2016 93
72 Atropin sulfat tab 0,5 mg TAB Rp 81.00 2016 1500
73 Attapulgit TAB Rp 220.00 2016 2793
74 Attapulgit TAB Rp 196.00 2017
75 Attapulgit (ARCAPEC) SYR Rp 1,581.25 2017 52
76 ABATE SCT Rp 6,380.00 DAK 2018
77 Bactivec (abate) BOT BS 0
78 Bacitracin polymixin TUBE Rp 2,767.00 2015 58
79 Bacitracin polymixin TUBE Rp 3,511.00 2017
80 Betahistin TAB Rp 1,062.60 2016 1160
81 Betahistin TAB Rp 177.00 2017
82 Betametason SALP 0.1 % TUBE Rp 1,596.00 2015 64
83 Betametason SALP 0.1 % TUBE Rp 1,596.00 2016
84 Betametason TTS MATA (BETAM) BTL Rp 19,600.00 DAK 2018
85 Bicolax TAB Rp 1,335.27 2016 468
86 BIOPLACENTon TUBE Rp 18,125.00 2017 8
87 Bisoprolol TAB Rp 2,553.83 2016 1900
88 Blood Lancet 265 PCS Rp 160.23 2016 200
89 Blood Lancet 266 PCS Rp 160.23 2016 600
90 Bronheksine (MIRAVAN) TAB Rp 354.20 2015 680
91 CALCII GLUCONAT AMP Rp 1,581.25 2016 23
92 Calsium Laktat TAB Rp 72.00 2015 3530
93 Calsium Laktat TAB Rp 72.00 2016
94 Calsium Laktat TAB Rp 64.00 buffer stok
95 Captopril 12.5 mg TAB Rp 69.00 2014 200
96 Captopril 12.5 mg TAB Rp 69.00 2015 1920
97 Captopril 12.5 mg TAB Rp 72.00 2017
98 Captopril 12.5 mg TAB Rp 68.00 DAK 2018
99 Captopril 25 mg TAB Rp 82.00 2015 900
100 Captopril 25 mg TAB Rp 82.00 2016
101 Captopril 25 mg TAB Rp 82.00 DAK 2018
102 Captopril 50 mg TAB Rp 147.00 2015 630
103 Captopril 50 mg TAB Rp 147.00 DAK 2017
104 Carbamazepin TAB Rp 269.00 2014 1022
105 Catgut/Benang bedah 3/0 plain SET Rp 33,250.00 2016 61
106 Catgut 3/0 CHOMIC SET Rp 6,420.33 DAK 2017
107 Catgut 2/0 CHOMIC SET Rp 6,420.83 DAK 2018
108 Plant Cutura 2/0 SET Rp 6,420.83 DAK 2018
109 PLAINCatgut 3/0 SET Rp 6,420.83 DAK 2018
110 Cefadroxil BOT Rp 5,286.00 2016 4
111 Cefadroxil CAP Rp 557.00 2016 4145
112 Cefadroxil CAP Rp 495.00 DAK 2018
113 Cefixime CAP Rp 700.00 2016 50
114 Cefotaxin INJ AMP Rp 6,785.00 2016 13
115 Ceftriaxone AMP Rp 6,785.00 2015 19
116 Cetirizin TAB Rp 156.00 2015 40
117 Cetirizin syr syr Rp 8,094.00 2017
118 Cetirizin syr Rp 13,956.00 DAK 2018
119 Ciprofloxacin TAB Rp 309.00 2016 3870
120 Ciprofloxacin BAQUINOR TTS MATA BTL Rp 10,250.00 2017
121 Clhorpromazine 100 mg TAB Rp 156.00 2015 350
122 Clhorpromazine 25 mg TAB Rp 75.00 2015 756
124 Clindamycin 150 mg CAP Rp 405.00 2015 630
125 Clindamycin 300 mg CAP Rp 693.00 DAK 2017 0
126 Clor Etil BOT Rp 158,125.00 2015 9
127 Clor Etil BOT Rp 506,000.00 DAK 2018
128 Cloramfenikol 250 mg CAP Rp 261.00 2015 1085
129 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2015 38
130 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2017
131 Cloramfenikol 3 % TUBE Rp 3,460.00 2016 48
132 Cloramfenikol 2 % TUBE Rp 3,416.00 DAK 2018
133 Cloramfenikol salp mata 1 % TUBE Rp 1,680.00 2015 67
134 Cloramfenikol salp mata 1 % TUBE Rp 2,013.00 DAK 2018 0
135 Cloramfenikol TTS MATA BOT Rp 12,600.00 2017 40
136 Cloramfenikol TTS telinga BOT Rp 6,424.00 2016 1
137 Clorfeniramin Maleat (CTM) TAB Rp 54.00 2015 960
138 Clorfeniramin Maleat (CTM) TAB Rp 46.00 2017
139 Clorfeniramin Maleat (CTM) Rp 46.00 DAK 2017
140 Composit A3 PCS Rp 749,320.00 2017
141 Composit A35 PCS Rp 749,320.00 2017
142 Cotrimoksazol 480 mg (DOEN) TAB Rp 158.00 2015 4168
143 Cotrimoksazol 480 mg (DOEN) TAB Rp 152.00 APBD 2018
144 Cotrimoksazol Pediatrik TAB Rp 83.49 2015 35
145 Cotrimoksazol SYR BOT Rp 7,810.00 2015 148
146 Cotrimoksazol SYR BOT Rp 2,250.00 DAK 2016
147 CURCUMA TAB Rp 1,644.00 2017 600
148 CUTIMED SORBACT SWAB PCS Rp 30,503.00 DAK 2018
149 Deksametason AMP Rp 1,820.00 2015 71
150 Deksametason tablet 0.5 mg TAB Rp 52.00 2015 3157
151 Deksametason tablet 0.5 mg TAB Rp 46.00 2017
152 Deksametason tablet 0.5 mg TAB Rp 35.00 DAK 2018
153 Diazepam 2 mg TAB Rp 35.09 2015 708
154 Diazepam 2 mg Rp 86.00 DAK 2018
155 Diazepam INJ 5 mg/ml AMP Rp 18,260.00 2015 14
156 Digoksin tablet 0.25 mg TAB Rp 103.00 2015 500
157 Dilteazem HCL tab 30 mg TAB Rp 141.00 2015 300
158 Dimenhidrinat TAB Rp 109.00 2015 500
159 DIPHENHIDRAMIN INJ Rp 1,156.00 2015 58
160 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 2,720.00 2016 50
161 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 3,594.25 2017
162 Domperidon syr BOT Rp 14,374.80 2015 112
163 Domperidon syr BOT Rp 2,970.00 DAK 2018
164 Domperidon Tab TAB Rp 174.00 2013 1720
165 Doxiciklin CAP Rp 298.00 2015 1100
166 DULCOLAX 5 mg SUPP Rp 5,670.00 2016 36
167 DULCOLAX 10 mg SUPP Rp 5,800.00 2016 77
168 Epinefrin hcl AMP Rp 8,910.00 buffer 178
169 Ergotamin Cafein TAB Rp 149.00 2015 2702
170 Eritromycin CAP Rp 679.00 2016 800
171 Eritromycin SYR Rp 7,391.00 2016 36
172 Eritromycin SYR Rp 7,391.00 2017
173 Eritromycin SYR Rp 2,490.00 DAK 2018
175 Etakridin /Rivanol 300 ml BOT Rp 3,060.00 2016
176 Etambutol hcl. Tablet 250 mg TAB Rp 330.00 2015 400
177 Etiket obat Biru LMBR Rp 61.00 2016 4600
178 Etiket Obat Putih LMBR Rp 61.00 2016 45000
179 ETSGEL Rp 395,532.50 DAK 2017
180 Eugenol BOT Rp 50,416.67 2014 3
181 Ferro Sulfat SCT Rp 425.00 2015 3199
182 Ferro Sulfat SCT Rp 425.00 2017 0
184 Folley cateter no.16 SET Rp 20,000.00 2016 7
186 Furosemid inj 10mg/ml AMP Rp 2,012.00 2015 49
187 Furosemid tablet 40 mg TAB Rp 84.00 2015 730
188 Furosemid tablet 40 mg TAB Rp 77.00 APBD 2018
FOMALIN TAB Rp 5,060.00 1
189 Garam oralit untuk 200 ml air SCT Rp 1,072.50 2015 60
190 Garam oralit untuk 200 ml air SCT Rp 278.00 DAK 2017
191 Gelang pasien warna pink PCS Rp 2,706.00 2016 299
192 Gentamycin inj. AMP Rp 3,699.00 20
193 Gentian Violet lar 1 % BOT Rp 3,750.00 DAK 2018
194 Glass Lonomer SET/BTL Rp 949,520.00 2017
195 Glibenclamid 5 mg TAB Rp 61.00 2014 390
196 Glibenclamid 5 mg TAB Rp 143.00 DAK 2018
197 Glibenclamid 5 mg TAB Rp 90.00 APBD 2018
198 Glimepirid 1 mg TAB Rp 1,576.00 2015 300
199 Glimepirid 2 mg TAB Rp 311.00 2015 1000
200 Gliseril Guayakolat TAB Rp 66.79 2750
201 Gliseril Guayakolat TAB Rp 66.79 2016 0
202 Gliseril Guayakolat Rp 66.79 DAK 2016
203 Gluko + protein test box PCS Rp 1,150.00 2016 210
204 Griseofulvin 125 mg TAB Rp 230.00 2015 640
205 Griseofulvin 125 mg TAB Rp 263.00 DAK 2017
206 Haloperidol tab 5 mg TAB Rp 105.00 2015 60
207 Handscoon 6 (T-SENSAURGE) STERIL SET Rp 7,254.50 DAK 2018
208 Handscoon 7 SET Rp 9,310.00 2016 50
209 Handscoon 7 Rp 9,120.00 DAK 2017
210 Handscoon 7 STERIL SET Rp 8,360.00 DAK 2018 0
211 Handscoon 7,5 (aximed) STERIL SET Rp 9,310.00 2016 204
212 Handscoon 7,5 (aximed) STERIL SET Rp 9,120.00 2017
213 Handscoon 7,5 (T-SENSAURGE) STERIL SET Rp 7,254.50 DAK 2017
214 Handscoon 8 STERIL SET Rp 9,310.00 2016 103
215 Handscoon non steril (M)AXIMED EXAMINAT SET Rp 508.20 2018
216 HBSAG Strip STRIP Rp 11,037.00 2017
217 Hidroklortiazid 25 mg TAB Rp 179.00 2016 400
218 Hidroklortiazid 25 mg TAB Rp 179.00 DAK 2017
219 Hidrokortison Salp TUBE Rp 2,938.00 2015 11
220 Hidrokortison Salp TUBE Rp 2,938.00 2016
221 Hidrokortison Salp 2,5% TUBE Rp 2,848.00 DAK 2017
222 HISTIGO TAB Rp 595.05 DAK 2018
223 Ibuprofen 400 mg TAB Rp 139.00 2014 1290
224 Ibuprofen 400 mg (ARFEN) TAB Rp 501.10 DAK 2018
225 Ibuprofen 400 mg TAB Rp 139.00 APBD 2018
226 Ibuprofen 400 mg (FASIFEN) TAB Rp 525.00 DAK 2018
227 Ibuprofen 200 mg TAB Rp 116.00 DAK 2017 0
228 Ibuprofen 200 mg TAB Rp 116.00 DAK 2018
229 Ibuprofen suspensi 200 mg/5 mg BOT Rp 4,949.00 2016 58
230 Infant muccus PCS Rp 37,988.50 2016 5
231 Infuset Makro SET Rp 5,880.00 2015 101
232 Infuset Makro (PIECES) SET Rp 3,190.00 APBD 2018
233 Infuset Mikro SET Rp 7,920.00 2016 101
234 isosorbid TAB Rp 98.00 2015 1660
235 JARUM HACTING NO. 08 LSN Rp 30,000.00 2016 12
236 JARUM HACTING NO. 10 LSN Rp 30,000.00 2016 12
237 JARUM HACTING NO. 12 LSN Rp 30,000.00 2016 13
238 JARUM HACTING NO. 15 LSN Rp 30,000.00 2016 13
239 Kaca Penutup (Deg Glass) pcs Rp 929.50 2016 100
240 Kalium Diklofenak TAB Rp 814.66 2015 39
241 Kalium permanganat BOT Rp 6,325.00 2016 11
242 Kapas 250 gr ROL Rp 14,375.00 2015 1
243 Kapas 250 gr ROL Rp 14,375.00 2016
244 Kapas 250 gr ROL Rp 14,375.00 DAK 2018
245 KARTU GOLONGAN DARAH PCS Rp 2,200.00 2016 600
246 Kasa gulung 30x60 cm ROL Rp 142,600.00 2016 8
247 Kasa gulung 30x60 cm ROL Rp 142,600.00 DAK 2016
248 Kasa gulung 36x80 cm Rp 142,600.00 DAK 2016
249 Kasa Steril 16x16 cm SET Rp 8,740.00 2016 8
250 Kasa Steril 16x16 cm Rp 575.00 DAK 2018
251 Kasa Steril 5x5 cm SET Rp 3,311.00 2017
252 Kertas puyer LBR Rp 123.20 2017
253 Ketamin INJ VIAL Rp 63,400.00 2015 2
254 Ketoconazole 200 mg TAB Rp 303.00 2015 640
255 Ketoconazole 200 mg TAB Rp 303.00 2016
256 Ketoconazole salp 2 % TUBE Rp 2,697.00 2014 56
257 Ketorolak inj 30 AMP Rp 1,450.00 2015 41
258 Kombinasi Prometamin 25 + Sulfadoxin 500 TAB Rp 572.00 DAK 2015 1000
259 Lansoprazol (DIGEST) CAP Rp 5,500.00 2017 0
260 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 2015 89
261 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 DAK 2016
262 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2015 31
263 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2017
264 Larutan NACL Lar infus 0,9 % Rp 6,410.00 DAK 2018
265 Larutan RL BOT Rp 7,150.00 2016 105
266 Larutan RL BOT Rp 7,150.00 DAK 2017
267 LARUTAN EDTA 10*Indoor BOT Rp 1,702,536.00 2016 2
268 LARUTAN Giemsa indoor BOT Rp 1,523,280.00 2016 2
269 LARUTAN Haemoglobin C indoor BOT Rp 296,956.00 2016 2
270 LARUTAN Hcl 0,1 N Indoor BOT Rp 236,808.00 2016 2
271 LARUTAN Metanol PA BOT Rp 686,697.00 2016 2
272 LARUTAN Trombosit Ao indoor BOT Rp 374,440.00 2016 2
273 LARUTAN Turk 500ml BOT Rp 444,015.00 2016 2
274 Lidocain INJ AMP Rp 929.00 2015 244
275 Lidocain INJ AMP Rp 2,215.00 DAK 2016
276 Loperamid TAB Rp 97.00 2016 1456
277 Loperamid Rp 97.00 2017
278 Loperamid 2 mg Rp 97.00 DAK 2017
279 Loratadin TAB Rp 159.00 2013 1385
280 Loratadin TAB Rp 159.00 DAK 2017
281 Lysol BOT Rp 49,200.00 2015 22
282 Litrol TTS mata BOT Rp 5,850.00 DAK 2018
283 Masker earloop SET Rp 440.00 2015 3
284 Masker earloop SET Rp 435.60 DAK 2018
285 Masker earloop (AXIMED) SET Rp 436.00 DAK 2018
286 Masker Standar tie on (IKAT) SET Rp 588.00 2016 5
287 Masker Standar tie on (IKAT) SET Rp 528.00 DAK 2018
288 Mebendazol (VERMOX) TAB Rp 8,800.00 2015 232
289 MEDLENCE plus extra 21 G/2,4 mm PCS Rp 3,991.90 2016 5
290 MEDLENCE plus lite 25 G/1,5 mm PCS Rp 3,991.90 2016 5
291 MEDLENCE plus special 0,8 (blade) 2,0 mm PCS Rp 3,991.90 2016 5
292 MEDLENCE plus universal 21 G/1.8 mm PCS Rp 3,991.90 2016 5
293 Meloxicam 7,5 mg TAB Rp 761.00 2015 97
294 Metformin CAP Rp 206.25 2015 990
295 Metformin CAP Rp 103.00 2017
296 Metformin 500 mg CAP Rp 336.00 DAK 2018
297 Methylprednisolon 16 mg Rp 1,325.00 2017
298 Methylprednisolon 4 mg TAB Rp 500.62 2015 1905
299 Methylprednisolon 4 mg TAB Rp 212.00 2017
300 Methylprednisolon 4 mg TAB Rp 170.00 APBD1 2017
301 Methylprednisolon 4 mg TAB Rp 170.00 APBD 2018
302 Metilergometrin maleat 0,125 mg TAB Rp 169.00 2015 520
303 Metilergometrin maleat INJ Rp 2,684.00 2015 77
304 Metoclopramid 10 mg TAB Rp 100.00 2015 400
305 Metoclopramid 10 mg TAB Rp 87.00 DAK 2018 0
306 Metoclopramid 5 mg TAB Rp 129.00 DAK 2018 0
307 Metronidazol 250 mg TAB Rp 116.00 2015 1874
308 Metronidazol 500 mg TAB Rp 143.00 2015 900
309 Metronidazol 500 mg TAB Rp 143.00 2017
310 Metronidazol INFUS BOT Rp 12,980.00 2017 3
311 Metronidazol SYR Rp 1,581.25 2017 10
312 MgSO4 20 % INJEKSI Rp 2,800.00 BUFFER 11
313 MgSO4 40 % INJEKSI Rp 3,650.00 APBD 2017
314 Miconazol TUBE Rp 3,150.00 2016 40
315 Miconazol 2% Cream TUBE Rp 4,097.00 DAK 2018
316 Miniaspi 80mg TAB Rp 163.00 2016 300
317 Miniaspi/asetosal Rp 163.00 DAK 2016
318 Nasal Oksigen M PCS Rp 8,085.00 2016 22
319 Nasal Oksigen XS PCS Rp 8,085.00 2016 10
320 Natrium Diklofenak 25 mg TAB Rp 162.00 2015 1624
321 Natrium Diklofenak 25 mg TAB Rp 178.00 DAK 2017
322 Natrium Diklofenak 25 mg TAB Rp 154.00 DAK 2018
323 Natrium Diklofenak 50 mg TAB Rp 146.00 DAK 2018
324 Nelaton catheter pcs Rp 5,330.00 2017 25
325 Nebulyzer mask DEWASA PCS Rp 16,704.00 2016 2
326 Nifedipin TAB Rp 127.00 2015 570
327 Nifedipin 10 mg TAB Rp 112.00 DAK 2018
328 Nistatin 100.000 TAB Rp 528.00 100
329 Nistatin Vaginal 100.000 Rp 628.00 DAK 2017
330 Nistatin 500.000 TAB Rp 895.00 2015 1000
331 Nistatin 500.000 TAB Rp 895.00 2016
332 Nistatin DROPS BOT Rp 40,030.00 DAK 2018
333 NOVABION KPSL Rp 395.42 2016 6093
334 ONELAB Objeck Glass 72 PCS pcs Rp 331.37 DAK 2018
335 OBH syr BOT Rp 3,740.00 2016 19
336 OBH syr Rp 2,925.00 DAK 2018
337 Ofloxacin TAB Rp 649.12 2015 30
338 Oksitertaciklin SALP 1 % TUBE Rp 4,901.00 2015 7
339 Oksitertaciklin SALP 3 % TUBE Rp 4,400.00 2015 6
340 Omeprasol CAP Rp 176.00 2016 70
341 Omeprasol 20 mg CAP Rp 176.00 2017
342 Omeprasol 20 mg CAP Rp 143.00 DAK 2018 0
343 Ondansetron inj Rp 1,254.00 2017 10
344 OXYTOCIN INJ Rp 1,900.00 2015 18
345 OXYTOCIN INJ Rp 1,287.00 DAK 2018
346 OXYTOCIN INJ Rp 1,287.00 DAK 2018
347 Otsu wi bot Rp 1,581.25 2016 14
348 Otsu wi bot Rp 2,860.00 DAK 2018
349 Paracetamol (FASIDOL)Droop BOT Rp 6,240.00 2016 5
350 Paracetamol (FASIDOL)Droop BOT Rp 7,979.00 DAK 2018
351 Paracetamol 500 mg TAB Rp 60.00 2015 1125
352 Paracetamol 500 mg TAB Rp 52.00 APBD 2017
353 Paracetamol 500 mg TAB Rp 52.00 APBD1 2017
354 Paracetamol 500 mg Rp 259.00 DAK 2018
355 Paracetamol SYR BOT Rp 1,338.00 2015 154
356 Paracetamol SYR BOT Rp 1,190.00 Dak 2018 0
357 Pipet Dirpo Rp 1,292.50 DAK 2017
358 Phenobarbital inj 50mg/ml AMP Rp 1,980.00 BUFFER 60
359 Piracetam 1200 mg TAB Rp 594.56 2015 1360
360 piroxicam 10 mg TAB Rp 165.78 2015 53
361 Plester ROL Rp 42,499.60 2015 39
362 Plain 3/0 pcs Rp 1,581.25 2016 30
363 Prednison TAB Rp 125.00 2015 4121
364 Prednison 5 mg TAB Rp 74.00 DAK 2018
365 PRIMAQUIN TAB Rp 205.00 2015 5000
366 PK (kalium pemanganat) 5 g BOT Rp 371,250.00 DAK 2018
367 Procrepe 15 cm x 4,55 m (perban) Rol Rp 41,910.00 2016 2
368 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 2015 300
369 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 BUFFER 0
370 Pyrantel TAB Rp 318.00 2015 175
371 Pyrantel 125 mg Rp 347.00 DAK 2018
372 Pyrantel SYR Rp 9,100.00 2015 6
373 RDT DBD iig sct Rp 1,581.25 2016 25
374 Ranitidin INJ AMP Rp 5,368.00 2015 92
375 Ranitidin TAB TAB Rp 119.00 2016 1110
376 Ranitidin 150 mg Rp 262.50 DAK 2018
377 RECO tts mata BOT Rp 20,360.00 DAK 2018
378 RECO tts Telinga BOT Rp 11,000.00 DAK 2018
379 Reagen diluent BOT Rp 4,770,000.00 DAK 2018
380 Reagen lyse BOT Rp 3,310,000.00 DAK 2018
381 Reagen RINSE Rp 1,950,455.00 DAK 2018
382 Reagen Asam urat BOT Rp 1,399,200.00 DAK 2017
383 RAJAWALI UIC ACID (REAGEN) BOT Rp 1,870,660.00 DAK 2018
384 Reagen Kimia Klinik Glucosa BOT Rp 698,500.00 DAK 2017
385 Reagen Kimia Klinik Kolesterol BOT Rp 748,000.00 DAK 2017
386 RYLES TUBE Rp 15,488.00 2017 10
387 Sak Besar (10x15 cm) PAK Rp 98,700.00 2017 600
388 Sak Besar (10x15 cm) PCS Rp 314.60 DAK 2017 0
389 Sak Sedang (6x10 cm) PAK Rp 96,900.00 2016 18
390 Sak Sedang (6x10 cm) PCS Rp 100.00 DAK 2016
391 Sak Kecil PCS Rp 100.00
392 Salbutamol 2 mg TAB Rp 69.00 2016 1474
393 Salbutamol 2 mg TAB Rp 69.00 2017
394 Salbutamol 2 mg TAB Rp 69.00 DAK 2017
395 Salbutamol 2 mg TAB Rp 64.00 DAK 2018
396 Salbutamol 4 mg TAB Rp 89.00 2015 413
397 Salbutamol 4 mg TAB Rp 89.00 2016
398 Salbutamol 4 mg Rp 89.00 DAK 2017
399 Salbutamol sirup 2mg/5ml BOT Rp 5,700.00 2015 78
400 Salbutamol sirup 2mg/5ml Rp 5,700.00 DAK 2017
401 Salicil talk SCT Rp 1,573.00 2015 44
402 Salicil talk SCT Rp 6,270.00 2016
403 Salicil talk 2% Rp 6,270.00 DAK 2016
404 Salp 24 TUBE Rp 2,200.00 2016 92
405 SCANDONEST AMP Rp 19,470.00 2016 9
406 Sefety box PCS Rp 18,072.35 2016 16
407 Sefety box 25 K 5 L Rp 18,072.25 DAK 2018
408 Silk SET Rp 15,750.00 2015 156
409 Silk SET Rp 37,289.00 2017 36
410 Simvastatin 10 mg TAB Rp 136.00 2016 1950
411 Simvastatin (SVT) TAB Rp 686.00 2017
412 Simvastatin 10 mg TAB Rp 110.00 DAK 2018
413 SPASMINAL Rp 750.00 2017
414 Sprinolakton Rp 212.00 DAK 2018
415 SPRITUS BOT Rp 1,581.25 2016 9
416 Strip Asam Urat (NESCO) PCS Rp 7,185.20 2016 95
417 Strip Glucosa (BENECHECK) PCS Rp 3,225.86 DAK 2017
418 Surgical Blade No.11 PCS Rp 974.05 2016 2
419 Strip Asam Urat (HUMASENS) STRIP Rp 22,252.00 DAK 2018
420 Strip Glucosa (HUMASENS) STRIP Rp 5,156.00 DAK 2018
421 Strip Kolesterol (HUMASENS) STRIP Rp 27,495.00 DAK 2018
423 Surgical Blade No.15 PCS Rp 974.05 2016 26
424 TEST NARKOBA/DRUG ABUSE STRIP Rp 78,999.00 2016 50
425 TEST NARKOBA STRIP Rp 78,999.80 DAK 2017
426 TEST HIV (SD BIOLINE HIV) STRIP Rp 37,600.00 APBN 2017
427 Tiamfenicol 500 KAP Rp 1,518.00 2016 1000
428 TIPS PIPET BIRU BKS Rp 594.00 2016 8
429 Ultra One test hamil strip PCS Rp 2,133.00 2016 22
430 Ultra One test hamil strip PCS Rp 2,228.60 2017
431 Ultrafix/ PHarmafix ROL Rp 27,000.00 2016 6
432 Ultrafix/ Pharmafix ROL Rp 27,000.00 DAK 2017
433 Ultrafix/ Pharmafix ROL Rp 29,700.00 DAK 2018
434 ULTRASOUN GEL (GEL USG) BTL Rp 14,471.60 DAK 2017
435 UMBILICAL C (PENJEPIT TP) PCS Rp 3,300.00 DAK2018
436 Urin bag/UROPLAS SET Rp 3,000.00 2015 10
437 VACUM TUBE PLAIN PCS Rp 2,200.00 DAK 2017
438 VACUM EDTA Rp 74,100.00 DAK 2018
439 VIT CALCIFAR TAB Rp 406.00 DAK 2018
440 VIT SYR (TAKANA) SYR Rp 39,223.80 2016 41
441 VIT SYR (TAKANA) SYR Rp 39,223.80 2017
442 Vitamin B 1 (tiamin) TAB Rp 95.00 BUFFER 2345
443 Vitamin B 1 (tiamin) TAB Rp 95.00 2016
444 Vitamin B 1 (tiamin) 50 mg TAB Rp 95.00 DAK 2016
445 Vitamin B 12 TAB Rp 63.00 BUFFER 410
446 Vitamin B 12 Rp 50.00 DAK 2018
447 Vitamin B 12 INJ AMP Rp 9,482.00 BUFFER 4
448 Vitamin B 12 INJ AMP Rp 1,283.00 2017
449 Vitamin B 6 (piridoksin) TAB Rp 175.00 BUFFER 1817
450 Vitamin B 6 (piridoksin) TAB Rp 142.00 2017
451 Vitamin B 6 (piridoksin) TAB Rp 142.00 DAK 2017
452 Vitamin B comp TAB Rp 138.00 2015 5336
453 Vitamin B comp TAB Rp 138.00 2016
454 Vitamin C (Asam askorbat) tablet 250 mg TAB Rp 139.00 2017 700
455 Vitamin C (Asam askorbat) tablet 250 mg Rp 139.00 DAK 2017
456 Vitamin C (Asam askorbat) tablet 50 mg TAB Rp 105.00 BUFFER 11622
457 Vitamin C (Asam askorbat) tablet 50 mg TAB Rp 125.00 DAK 2017
458 Vitamin C (Asam askorbat) tablet 25 mg TAB Rp 36.00 DAK 2017
459 Vitamin K INJ AMP Rp 3,754.00 2015 134
460 Vitamin K INJ AMP Rp 4,260.00 APBD1 2018
461 Vitamin K INJ AMP Rp 15,700.00 Dak 2018
462 Vitamin K TAB TAB Rp 690.00 2015 100
463 Vitamin K TAB 10 mg Rp 855.00 DAK 2018
464 VITROMEGA CAP Rp 1,472.00 2016 5000
465 VITROMEGA CAP Rp 1,472.69 2016 0
466 X. TRAGEN bot Rp 1,581.25 2017 10
467 Yodium Povidon 30 ml BOT Rp 2,344.00 2015 76
468 Yodium Povidon 60 ml BOT Rp 4,440.00 2017
469 Yodium Povidon 300 ml BOT Rp 4,440.00 2016 7
470 Zink Syrup 10mg/ml BOT Rp 16,478.00 2016 70
471 Zink Syrup 10mg/ml BOT Rp 16,478.00 2017
472 Zink TAB TAB Rp 521.00 2015 912
473 Zink TAB TAB Rp 1,100.00 BUFFER 1192
474 Zink 20 mg TAB Rp 618.00 DAK 2017
475 creatininKIN 2x100 ml kit Rp 977,900.00 DAK 2017
476 Vacum tube sterlite PCS Rp 74,100.00 DAK 2018
477 Procurma SYR Rp 11,350.00 DAK2018

II PROGRAM
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F

1 MDT MB DEWASA BLISTER Rp 30,595.00 APBN 2018 12


2 MDT MB DEWASA BLISTER Rp 31,570.00 APBD1 2018 0
3 MDT PB DEWASA BLISTER Rp 12,569.00 APBD1 2018
4 LACTOGEN 4 DUS Rp 67,500.00 2016 0
5 VIT A BIRU BOT Rp 341.00 DAK2016 0
6 VIT A MERAH BOT Rp 505.00 DAK2016 0
7 GLUCO PROTEIN (ONE MAD) DOS PROG
8 ULTRA ONE TEST (ONE MAD) PCS PROG
9 HB SAHLI (ONE MAD) DOS PROG
10 HCL 0,1 N 100 ML (ONE MAD) BOT PROG
11 BLOOD LANCET (ONE MAD) DOS PROG
12 AUTOCLIK (ONE MAD) BUAH PROG
13 IODIUM TEST BOT Rp 75,000.00 POGAM 8
14 QUININE TAB Rp 737.00 2015 200
15 RDT MALARIA TEST Rp 57,684.00 PROGRAM 114
16 RDT MALARIA TEST Rp 5,271.00 APBN2017 0
17 OAM (DHP-Frimal) TAB Rp 2,030.00 APBD1 2018
18 OBAT PAKET TB KATEGORI 1 DOS Rp 431,983.00 DAK 2016 0
19 OBAT PAKET TB KATEGORI 2 DOS Rp 1,557,469.00 DAK 2018 0
20 POT DAHAK POT Rp 1,818.00 program tb 0
21 REAGENS ZIEHL NEELSEN SET Rp 296,600.00 APBDI2017 1
22 MASKER IKAT PCS prog tb POV 0
23 ALAT SUNTIK 3 ml PCS Rp 1,212.00 BKKBN PROV 0
24 COPPER T/ UID BOX Rp 11,800.00 BKKBN PROV 1
25 KONDOM DOS Rp 4,000.00 BKKBN PROV 0
26 OBAT KB SUNTIK 3 BULAN VIAL Rp 6,120.00 BKKBN PROV 0
27 PIL KB 1 KOMBINASI STRP Rp 1,886.00 BKKBN PROV 0
28 SUSUK KB/IMPLAN SET Rp 212,500.00 BKKBN PROV 3
29 SUSUK KB/IMPLAN SET Rp 213,220.00 BKKBN PROV
30 MINERAL MIX SACHET Rp 2,450.00 PROG KIA 0
31 MINERAL MIX SACHET Rp 2,920.00 DAK 2018

Kepala UPT Puskesmas Pasangkayu 1

Fatmawati, SKM
NIP : 19820619 200312 2 003
LAPORAN TAHUN 2018
UPT Puskesmas Pasangkayu 1

HARGA PENE- HARGA PERSE- HARGA PENGEL


(Rp) RIMAAN (Rp) DIAAN (Rp) UARAN

G H I
Rp 350,000.00 Rp - 40 Rp 350,000.00 40
Rp - 50 Rp 428,750.00 50 Rp 428,750.00 4
Rp 162,499.92 Rp - 10 Rp 162,499.92 10
Rp 463,750.00 0 Rp - 53 Rp 463,750.00 53
Rp - 50 Rp 428,750.00 50 Rp 428,750.00 18
Rp 1,137,500.00 Rp - 130 Rp 1,137,500.00 79
Rp - 50 Rp 428,750.00 50 Rp 428,750.00 46
Rp 883,750.00 Rp - 101 Rp 883,750.00 16
Rp - 100 Rp 2,713,400.00 100 Rp 2,713,400.00 4
Rp 482,600.00 Rp - 3800 Rp 482,600.00 3800
Rp 351,400.00 Rp - 1400 Rp 351,400.00 1380
Rp 72,400.00 0 Rp - 200 Rp 72,400.00 200
Rp - 500 Rp 315,250.00 500 Rp 315,250.00 115
Rp - 100 Rp 165,550.00 100 Rp 165,550.00 10
Rp 192,500.00 Rp - 125 Rp 192,500.00 125
Rp 254,100.00 400 Rp 677,600.00 550 Rp 931,700.00 463
Rp - 500 Rp 456,500.00 500 Rp 456,500.00 0
Rp 5,709.00 Rp - 5 Rp 5,709.00 5
Rp 70,664.00 1600 Rp 1,548,800.00 1673 Rp 1,619,464.00 1639
Rp 6,740.00 Rp - 5 Rp 6,740.00 5
Rp - 500 Rp 430,650.00 500 Rp 430,650.00 263
Rp 110,084.00 Rp - 26 Rp 110,084.00 26
Rp 338,316.00 Rp - 932 Rp 338,316.00 307
Rp - 1 Rp 239,525.00 1 Rp 239,525.00 0
Rp 238,875.00 Rp - 91 Rp 238,875.00 38
Rp 180,600.00 Rp - 7 Rp 180,600.00 7
Rp 98,000.00 Rp - 400 Rp 98,000.00 400
Rp 145,200.00 200 Rp 48,400.00 800 Rp 193,600.00 451
Rp 96,000.00 Rp - 1000 Rp 96,000.00 1000
Rp 12,420.00 Rp - 138 Rp 12,420.00 138
Rp - 3000 Rp 288,000.00 3000 Rp 288,000.00 3000
Rp - 3300 Rp 316,800.00 3300 Rp 316,800.00 1235
Rp - 1000 Rp 249,000.00 1000 Rp 249,000.00 200
Rp 573,082.40 100 Rp 651,230.00 188 Rp 1,224,312.40 187
Rp 282,656.00 2000 Rp 484,000.00 3168 Rp 766,656.00 2217
Rp 508,200.00 30 Rp 126,000.00 151 Rp 634,200.00 121
Rp 68,800.00 Rp - 800 Rp 68,800.00 800
Rp 98,400.00 300 Rp 36,900.00 1100 Rp 135,300.00 710
Rp 37,296.00 Rp - 222 Rp 37,296.00 222
Rp - 1800 Rp 502,434.00 1800 Rp 502,434.00 0
Rp 313,230.00 Rp - 1590 Rp 313,230.00 1590
Rp - 1200 Rp 1,260,000.00 1200 Rp 1,260,000.00 1200
Rp 1,533,384.00 Rp - 5496 Rp 1,533,384.00 4906
Rp - 1000 Rp 279,000.00 1000 Rp 279,000.00 590
Rp 264,000.00 Rp - 1200 Rp 264,000.00 1200
Rp 261,120.00 Rp - 102 Rp 261,120.00 102
Rp - 15 Rp 133,500.00 15 Rp 133,500.00 15
Rp - 60 Rp 534,000.00 60 Rp 534,000.00 22
Rp - 100 Rp 465,500.00 100 Rp 465,500.00 100
Rp - 120 Rp 448,800.00 120 Rp 448,800.00 59
Rp - 24 Rp 684,000.00 24 Rp 684,000.00 0
Rp 224,400.00 Rp - 40 Rp 224,400.00 40
Rp 1,004,465.00 2000 Rp 770,000.00 4609 Rp 1,774,465.00 2710
Rp - 2000 Rp 770,000.00 2000 Rp 770,000.00 1375
Rp 608,475.00 Rp - 285 Rp 608,475.00 276
Rp - 100 Rp 213,500.00 100 Rp 213,500.00 31
Rp 267,930.00 Rp - 3435 Rp 267,930.00 3435
Rp - 3500 Rp 252,000.00 3500 Rp 252,000.00 971
Rp 352,000.00 Rp - 160 Rp 352,000.00 140
Rp - 16 Rp 44,000.00 16 Rp 44,000.00 16
Rp 34,986.00 Rp - 294 Rp 34,986.00 294
Rp 428,400.00 Rp - 3600 Rp 428,400.00 3600
Rp - 800 Rp 93,600.00 800 Rp 93,600.00 800
Rp - 1700 Rp 299,200.00 1700 Rp 299,200.00 1700
Rp - 3800 Rp 452,200.00 3800 Rp 452,200.00 1363
Rp 86,840.00 Rp - 1670 Rp 86,840.00 1670
Rp - 3500 Rp 224,000.00 3500 Rp 224,000.00 1460
Rp 15,812.50 Rp - 10 Rp 15,812.50 10
Rp 77,400.00 Rp - 200 Rp 77,400.00 200
Rp - 500 Rp 171,000.00 500 Rp 171,000.00 0
Rp 130,200.00 Rp - 93 Rp 130,200.00 4
Rp 121,500.00 Rp - 1500 Rp 121,500.00 1500
Rp 614,460.00 Rp - 2793 Rp 614,460.00 793
Rp - 1000 Rp 196,000.00 1000 Rp 196,000.00 261
Rp 82,225.00 Rp - 52 Rp 82,225.00 33
Rp - 250 Rp 1,595,000.00 250 Rp 1,595,000.00 0
Rp - 10 Rp - 10 Rp - 10
Rp 160,486.00 Rp - 58 Rp 160,486.00 58
Rp - 125 Rp 438,875.00 125 Rp 438,875.00 108
Rp 1,232,616.00 Rp - 1160 Rp 1,232,616.00 1160
Rp - 1350 Rp 238,950.00 1350 Rp 238,950.00 1110
Rp 102,144.00 Rp - 64 Rp 102,144.00 64
Rp - 150 Rp 239,400.00 150 Rp 239,400.00 139
Rp - 44 Rp 862,400.00 44 Rp 862,400.00 8
Rp 624,906.36 Rp - 468 Rp 624,906.36 306
Rp 145,000.00 Rp - 8 Rp 145,000.00 8
Rp 4,852,277.00 Rp - 1900 Rp 4,852,277.00 415
Rp 32,046.00 Rp - 200 Rp 32,046.00 200
Rp 96,138.00 500 Rp 80,115.00 1100 Rp 176,253.00 800
Rp 240,856.00 Rp - 680 Rp 240,856.00 680
Rp 36,368.75 Rp - 23 Rp 36,368.75 0
Rp 254,160.00 Rp - 3530 Rp 254,160.00 3530
Rp - 1500 Rp 108,000.00 1500 Rp 108,000.00 1500
Rp - 1000 Rp 64,000.00 1000 Rp 64,000.00 1000
Rp 13,800.00 Rp - 200 Rp 13,800.00 200
Rp 132,480.00 Rp - 1920 Rp 132,480.00 1920
Rp - 1500 Rp 108,000.00 1500 Rp 108,000.00 1421
Rp - 500 Rp 34,000.00 500 Rp 34,000.00 200
Rp 73,800.00 Rp - 900 Rp 73,800.00 900
Rp - 4000 Rp 328,000.00 4000 Rp 328,000.00 4000
Rp - 1500 Rp 123,000.00 1500 Rp 123,000.00 260
Rp 92,610.00 Rp - 630 Rp 92,610.00 630
Rp - 3000 Rp 441,000.00 3000 Rp 441,000.00 2315
Rp 274,918.00 Rp - 1022 Rp 274,918.00 1022
Rp 2,028,250.00 Rp - 61 Rp 2,028,250.00 51
Rp - 60 Rp 385,219.80 60 Rp 385,219.80 0
Rp - 24 Rp 154,099.92 24 Rp 154,099.92 11
Rp - 24 Rp 154,099.92 24 Rp 154,099.92 24
Rp - 24 Rp 154,099.92 24 Rp 154,099.92 12
Rp 21,144.00 Rp - 4 Rp 21,144.00 4
Rp 2,308,765.00 Rp - 4145 Rp 2,308,765.00 3745
Rp - 1000 Rp 495,000.00 1000 Rp 495,000.00 675
Rp 35,000.00 Rp - 50 Rp 35,000.00 50
Rp 88,205.00 Rp - 13 Rp 88,205.00 12
Rp 128,915.00 Rp - 19 Rp 128,915.00 0
Rp 6,240.00 Rp - 40 Rp 6,240.00 40
Rp - 100 Rp 809,400.00 100 Rp 809,400.00 100
Rp - 98 Rp 1,367,688.00 98 Rp 1,367,688.00 29
Rp 1,195,830.00 Rp - 3870 Rp 1,195,830.00 1790
Rp - 20 Rp 205,000.00 20 Rp 205,000.00 12
Rp 54,600.00 Rp - 350 Rp 54,600.00 90
Rp 56,700.00 Rp - 756 Rp 56,700.00 756
Rp 255,150.00 Rp - 630 Rp 255,150.00 630
Rp - 250 Rp 173,250.00 250 Rp 173,250.00 100
Rp 1,423,125.00 Rp - 9 Rp 1,423,125.00 9
Rp - 3 Rp 1,518,000.00 3 Rp 1,518,000.00 1
Rp 283,185.00 Rp - 1085 Rp 283,185.00 899
Rp 196,460.00 Rp - 38 Rp 196,460.00 30
Rp - 50 Rp 258,500.00 50 Rp 258,500.00 0
Rp 166,080.00 Rp - 48 Rp 166,080.00 48
Rp - 48 Rp 163,968.00 48 Rp 163,968.00 0
Rp 112,560.00 Rp - 67 Rp 112,560.00 67
Rp - 48 Rp 96,624.00 48 Rp 96,624.00 41
Rp 504,000.00 Rp - 40 Rp 504,000.00 40
Rp 6,424.00 Rp - 1 Rp 6,424.00 1
Rp 51,840.00 Rp - 960 Rp 51,840.00 960
Rp - 5000 Rp 230,000.00 5000 Rp 230,000.00 5000
Rp - 7000 Rp 322,000.00 7000 Rp 322,000.00 3109
Rp - 1 Rp 749,320.00 1 Rp 749,320.00 0
Rp - 1 Rp 749,320.00 1 Rp 749,320.00 0
Rp 658,544.00 Rp - 4168 Rp 658,544.00 3690
Rp - 500 Rp 76,000.00 500 Rp 76,000.00 0
Rp 2,922.15 Rp - 35 Rp 2,922.15 35
Rp 1,155,880.00 Rp - 148 Rp 1,155,880.00 28
Rp - 50 Rp 112,500.00 50 Rp 112,500.00 38
Rp 986,400.00 Rp - 600 Rp 986,400.00 600
Rp - 40 Rp 1,220,120.00 40 Rp 1,220,120.00 0
Rp 129,220.00 100 Rp 182,000.00 171 Rp 311,220.00 75
Rp 164,164.00 Rp - 3157 Rp 164,164.00 3157
Rp - 1000 Rp 46,000.00 1000 Rp 46,000.00 1000
Rp - 6000 Rp 210,000.00 6000 Rp 210,000.00 4861
Rp 24,843.72 Rp - 708 Rp 24,843.72 708
Rp - 500 Rp 43,000.00 500 Rp 43,000.00 110
Rp 255,640.00 Rp - 14 Rp 255,640.00 0
Rp 51,500.00 Rp - 500 Rp 51,500.00 0
Rp 42,300.00 Rp - 300 Rp 42,300.00 140
Rp 54,500.00 Rp - 500 Rp 54,500.00 263
Rp 67,048.00 Rp - 58 Rp 67,048.00 0
Rp 136,000.00 Rp - 50 Rp 136,000.00 50
Rp - 100 Rp 359,425.00 100 Rp 359,425.00 0
Rp 1,609,977.60 Rp - 112 Rp 1,609,977.60 112
Rp - 50 Rp 148,500.00 50 Rp 148,500.00 9
Rp 299,280.00 Rp - 1720 Rp 299,280.00 985
Rp 327,800.00 Rp - 1100 Rp 327,800.00 1100
Rp 204,120.00 Rp - 36 Rp 204,120.00 36
Rp 446,600.00 Rp - 77 Rp 446,600.00 39
Rp 1,585,980.00 Rp - 178 Rp 1,585,980.00 22
Rp 402,598.00 Rp - 2702 Rp 402,598.00 2702
Rp 543,200.00 Rp - 800 Rp 543,200.00 400
Rp 266,076.00 Rp - 36 Rp 266,076.00 36
Rp - 17 Rp 125,647.00 17 Rp 125,647.00 17
Rp - 15 Rp 37,350.00 15 Rp 37,350.00 8
Rp - 24 Rp 73,440.00 24 Rp 73,440.00 7
Rp 132,000.00 Rp - 400 Rp 132,000.00 400
Rp 280,600.00 Rp - 4600 Rp 280,600.00 4600
Rp 2,745,000.00 Rp - 45000 Rp 2,745,000.00 45000
Rp - 1 Rp 395,532.50 1 Rp 395,532.50 0
Rp 151,250.01 Rp - 3 Rp 151,250.01 3
Rp 1,359,575.00 Rp - 3199 Rp 1,359,575.00 3199
Rp - 30240 Rp 12,852,000.00 30240 Rp 12,852,000.00 30240
Rp 140,000.00 Rp - 7 Rp 140,000.00 2
Rp 98,588.00 Rp - 49 Rp 98,588.00 48
Rp 61,320.00 Rp - 730 Rp 61,320.00 330
Rp - 1000 Rp 77,000.00 1000 Rp 77,000.00 0
Rp 5,060.00 Rp - 1 Rp 5,060.00 1
Rp 64,350.00 Rp - 60 Rp 64,350.00 60
Rp - 1300 Rp 361,400.00 1300 Rp 361,400.00 1065
Rp 809,094.00 Rp - 299 Rp 809,094.00 0
Rp 73,980.00 Rp - 20 Rp 73,980.00 0
Rp - 5 Rp 18,750.00 5 Rp 18,750.00 4
Rp - 1 Rp 949,520.00 1 Rp 949,520.00 0
Rp 23,790.00 Rp - 390 Rp 23,790.00 390
Rp - 2000 Rp 286,000.00 2000 Rp 286,000.00 1050
Rp - 1000 Rp 90,000.00 1000 Rp 90,000.00 0
Rp 472,800.00 Rp - 300 Rp 472,800.00 250
Rp 311,000.00 Rp - 1000 Rp 311,000.00 500
Rp 183,672.50 Rp - 2750 Rp 183,672.50 2750
Rp - 7000 Rp 467,530.00 7000 Rp 467,530.00 7000
Rp - 5000 Rp 333,950.00 5000 Rp 333,950.00 1407
Rp 241,500.00 Rp - 210 Rp 241,500.00 0
Rp 147,200.00 Rp - 640 Rp 147,200.00 640
Rp - 500 Rp 131,500.00 500 Rp 131,500.00 150
Rp 6,300.00 Rp - 60 Rp 6,300.00 60
Rp - 500 Rp 3,627,250.00 500 Rp 3,627,250.00 204
Rp 465,500.00 Rp - 50 Rp 465,500.00 50
Rp - 100 Rp 912,000.00 100 Rp 912,000.00 100
Rp - 200 Rp 1,672,000.00 200 Rp 1,672,000.00 134
Rp 1,899,240.00 100 Rp 931,000.00 304 Rp 2,830,240.00 304
Rp - 300 Rp 2,736,000.00 300 Rp 2,736,000.00 90
Rp - 300 Rp 2,176,350.00 300 Rp 2,176,350.00 105
Rp 958,930.00 200 Rp 1,862,000.00 303 Rp 2,820,930.00 81
Rp - 2000 Rp 1,016,400.00 2000 Rp 1,016,400.00 1300
Rp - 100 Rp 1,103,700.00 100 Rp 1,103,700.00 100
Rp 71,600.00 Rp - 400 Rp 71,600.00 180
Rp - 700 Rp 125,300.00 700 Rp 125,300.00 0
Rp 32,318.00 Rp - 11 Rp 32,318.00 11
Rp - 240 Rp 705,120.00 240 Rp 705,120.00 60
Rp - 48 Rp 136,704.00 48 Rp 136,704.00 39
Rp - 500 Rp 297,525.00 500 Rp 297,525.00 0
Rp 179,310.00 Rp - 1290 Rp 179,310.00 1290
Rp - 600 Rp 300,660.00 600 Rp 300,660.00 600
Rp - 500 Rp 69,500.00 500 Rp 69,500.00 391
Rp - 2000 Rp 1,050,000.00 2000 Rp 1,050,000.00 0
Rp - 200 Rp 23,200.00 200 Rp 23,200.00 200
Rp - 1000 Rp 116,000.00 1000 Rp 116,000.00 1000
Rp 287,042.00 Rp - 58 Rp 287,042.00 58
Rp 189,942.50 Rp - 5 Rp 189,942.50 5
Rp 593,880.00 Rp - 101 Rp 593,880.00 89
Rp - 17 Rp 54,230.00 17 Rp 54,230.00 5
Rp 799,920.00 Rp - 101 Rp 799,920.00 30
Rp 162,680.00 Rp - 1660 Rp 162,680.00 811
Rp 360,000.00 Rp - 12 Rp 360,000.00 12
Rp 360,000.00 Rp - 12 Rp 360,000.00 12
Rp 390,000.00 Rp - 13 Rp 390,000.00 13
Rp 390,000.00 Rp - 13 Rp 390,000.00 13
Rp 92,950.00 Rp - 100 Rp 92,950.00 50
Rp 31,771.74 Rp - 39 Rp 31,771.74 39
Rp 69,575.00 Rp - 11 Rp 69,575.00 11
Rp 14,375.00 Rp - 1 Rp 14,375.00 1
Rp - 10 Rp 143,750.00 10 Rp 143,750.00 9
Rp - 5 Rp 71,875.00 5 Rp 71,875.00 1
Rp 1,320,000.00 Rp - 600 Rp 1,320,000.00 100
Rp 1,140,800.00 Rp - 8 Rp 1,140,800.00 8
Rp - 3 Rp 427,800.00 3 Rp 427,800.00 3
Rp - 5 Rp 713,000.00 5 Rp 713,000.00 3
Rp 69,920.00 Rp - 8 Rp 69,920.00 8
Rp - 80 Rp 46,000.00 80 Rp 46,000.00 69
Rp - 63 Rp 208,593.00 63 Rp 208,593.00 63
Rp - 8500 Rp 1,047,200.00 8500 Rp 1,047,200.00 5000
Rp 126,800.00 Rp - 2 Rp 126,800.00 2
Rp 193,920.00 Rp - 640 Rp 193,920.00 640
Rp - 1100 Rp 333,300.00 1100 Rp 333,300.00 250
Rp 151,032.00 50 Rp 134,850.00 106 Rp 285,882.00 98
Rp 59,450.00 Rp - 41 Rp 59,450.00 15
Rp 572,000.00 Rp - 1000 Rp 572,000.00 0
Rp - 1500 Rp 8,250,000.00 1500 Rp 8,250,000.00 1500
Rp 614,100.00 Rp - 89 Rp 614,100.00 37
Rp - 20 Rp 138,000.00 20 Rp 138,000.00 0
Rp 198,710.00 Rp - 31 Rp 198,710.00 31
Rp - 60 Rp 384,600.00 60 Rp 384,600.00 60
Rp - 60 Rp 384,600.00 60 Rp 384,600.00 11
Rp 750,750.00 20 Rp 143,000.00 125 Rp 893,750.00 114
Rp - 80 Rp 572,000.00 80 Rp 572,000.00 36
Rp 3,405,072.00 Rp - 2 Rp 3,405,072.00 0
Rp 3,046,560.00 Rp - 2 Rp 3,046,560.00 0
Rp 593,912.00 Rp - 2 Rp 593,912.00 0
Rp 473,616.00 Rp - 2 Rp 473,616.00 0
Rp 1,373,394.00 Rp - 2 Rp 1,373,394.00 0
Rp 748,880.00 Rp - 2 Rp 748,880.00 0
Rp 888,030.00 Rp - 2 Rp 888,030.00 0
Rp 226,676.00 Rp - 244 Rp 226,676.00 184
Rp - 390 Rp 863,850.00 390 Rp 863,850.00 20
Rp 141,232.00 Rp - 1456 Rp 141,232.00 356
Rp - 1000 Rp 97,000.00 1000 Rp 97,000.00 300
Rp - 500 Rp 48,500.00 500 Rp 48,500.00 65
Rp 220,215.00 Rp - 1385 Rp 220,215.00 1385
Rp - 7000 Rp 1,113,000.00 7000 Rp 1,113,000.00 4962
Rp 1,082,400.00 Rp - 22 Rp 1,082,400.00 18
Rp - 30 Rp 175,500.00 30 Rp 175,500.00 6
Rp 1,320.00 Rp - 3 Rp 1,320.00 3
Rp - 1100 Rp 479,160.00 1100 Rp 479,160.00 1100
Rp - 650 Rp 283,400.00 650 Rp 283,400.00 245
Rp 2,940.00 Rp - 5 Rp 2,940.00 5
Rp - 1200 Rp 633,600.00 1200 Rp 633,600.00 569
Rp 2,041,600.00 Rp - 232 Rp 2,041,600.00 182
Rp 19,959.50 Rp - 5 Rp 19,959.50 5
Rp 19,959.50 Rp - 5 Rp 19,959.50 5
Rp 19,959.50 Rp - 5 Rp 19,959.50 5
Rp 19,959.50 Rp - 5 Rp 19,959.50 5
Rp 73,817.00 Rp - 97 Rp 73,817.00 97
Rp 204,187.50 Rp - 990 Rp 204,187.50 990
Rp - 200 Rp 20,600.00 200 Rp 20,600.00 200
Rp - 500 Rp 168,000.00 500 Rp 168,000.00 500
Rp - 300 Rp 397,500.00 300 Rp 397,500.00 300
Rp 953,683.01 Rp - 1905 Rp 953,683.01 1905
Rp - 1000 Rp 212,000.00 1000 Rp 212,000.00 1000
Rp - 500 Rp 85,000.00 500 Rp 85,000.00 500
Rp - 500 Rp 85,000.00 500 Rp 85,000.00 40
Rp 87,880.00 500 Rp 84,500.00 1020 Rp 172,380.00 470
Rp 206,668.00 Rp - 77 Rp 206,668.00 77
Rp 40,000.00 Rp - 400 Rp 40,000.00 400
Rp - 1000 Rp 87,000.00 1000 Rp 87,000.00 10
Rp - 500 Rp 64,500.00 500 Rp 64,500.00 100
Rp 217,384.00 Rp - 1874 Rp 217,384.00 1874
Rp 128,700.00 Rp - 900 Rp 128,700.00 900
Rp - 2000 Rp 286,000.00 2000 Rp 286,000.00 100
Rp 38,940.00 Rp - 3 Rp 38,940.00 0
Rp 15,812.50 Rp - 10 Rp 15,812.50 10
Rp 30,800.00 Rp - 11 Rp 30,800.00 5
Rp - 10 Rp 36,500.00 10 Rp 36,500.00 0
Rp 126,000.00 Rp - 40 Rp 126,000.00 40
Rp - 48 Rp 196,656.00 48 Rp 196,656.00 48
Rp 48,900.00 Rp - 300 Rp 48,900.00 300
Rp - 500 Rp 81,500.00 500 Rp 81,500.00 0
Rp 177,870.00 Rp - 22 Rp 177,870.00 12
Rp 80,850.00 Rp - 10 Rp 80,850.00 0
Rp 263,088.00 Rp - 1624 Rp 263,088.00 1624
Rp - 250 Rp 44,500.00 250 Rp 44,500.00 250
Rp - 1300 Rp 200,200.00 1300 Rp 200,200.00 658
Rp - 3100 Rp 452,600.00 3100 Rp 452,600.00 3100
Rp 133,250.00 Rp - 25 Rp 133,250.00 25
Rp 33,408.00 Rp - 2 Rp 33,408.00 2
Rp 72,390.00 Rp - 570 Rp 72,390.00 570
Rp - 1500 Rp 168,000.00 1500 Rp 168,000.00 825
Rp 52,800.00 0 Rp - 100 Rp 52,800.00 100
Rp - 200 Rp 125,600.00 200 Rp 125,600.00 40
Rp 895,000.00 Rp - 1000 Rp 895,000.00 1000
Rp - 500 Rp 447,500.00 500 Rp 447,500.00 10
Rp - 2 Rp 80,060.00 2 Rp 80,060.00 2
Rp 2,409,294.06 Rp - 6093 Rp 2,409,294.06 6019
Rp - 216 Rp 71,575.92 216 Rp 71,575.92 144
Rp 71,060.00 Rp - 19 Rp 71,060.00 19
Rp - 55 Rp 160,875.00 55 Rp 160,875.00 55
Rp 19,473.60 Rp - 30 Rp 19,473.60 30
Rp 34,307.01 Rp - 7 Rp 34,307.01 7
Rp 26,400.00 Rp - 6 Rp 26,400.00 6
Rp 12,320.00 Rp - 70 Rp 12,320.00 70
Rp - 300 Rp 52,800.00 300 Rp 52,800.00 300
Rp - 900 Rp 128,700.00 900 Rp 128,700.00 870
Rp 12,540.00 25 Rp 31,350.00 35 Rp 43,890.00 11
Rp 34,200.00 Rp - 18 Rp 34,200.00 18
Rp - 100 Rp 128,700.00 100 Rp 128,700.00 100
Rp - 200 Rp 257,400.00 200 Rp 257,400.00 0
Rp 22,137.50 Rp - 14 Rp 22,137.50 14
Rp - 60 Rp 171,600.00 60 Rp 171,600.00 0
Rp 31,200.00 Rp - 5 Rp 31,200.00 5
Rp - 112 Rp 893,648.00 112 Rp 893,648.00 105
Rp 67,500.00 Rp - 1125 Rp 67,500.00 1125
Rp - 1000 Rp 52,000.00 1000 Rp 52,000.00 1000
Rp - 1000 Rp 52,000.00 1000 Rp 52,000.00 1000
Rp - 8000 Rp 2,072,000.00 8000 Rp 2,072,000.00 5184
Rp 206,052.00 Rp - 154 Rp 206,052.00 154
Rp - 400 Rp 476,000.00 400 Rp 476,000.00 324
Rp - 500 Rp 646,250.00 500 Rp 646,250.00 500
Rp 118,800.00 Rp - 60 Rp 118,800.00 60
Rp 808,601.60 Rp - 1360 Rp 808,601.60 790
Rp 8,786.34 Rp - 53 Rp 8,786.34 53
Rp 1,657,484.40 10 Rp 424,996.00 49 Rp 2,082,480.40 30
Rp 47,437.50 Rp - 30 Rp 47,437.50 30
Rp 515,125.00 Rp - 4121 Rp 515,125.00 3671
Rp - 2000 Rp 148,000.00 2000 Rp 148,000.00 457
Rp 1,025,000.00 Rp - 5000 Rp 1,025,000.00 5000
Rp - 2 Rp 742,500.00 2 Rp 742,500.00 2
Rp 83,820.00 Rp - 2 Rp 83,820.00 1
Rp 105,300.00 Rp - 300 Rp 105,300.00 300
Rp - 300 Rp 105,300.00 300 Rp 105,300.00 100
Rp 55,650.00 Rp - 175 Rp 55,650.00 175
Rp - 400 Rp 138,800.00 400 Rp 138,800.00 14
Rp 54,600.00 Rp - 6 Rp 54,600.00 6
Rp 39,531.25 Rp - 25 Rp 39,531.25 25
Rp 493,856.00 Rp - 92 Rp 493,856.00 31
Rp 132,090.00 4500 Rp 535,500.00 5610 Rp 667,590.00 5610
Rp - 5000 Rp 1,312,500.00 5000 Rp 1,312,500.00 3010
Rp - 5 Rp 101,800.00 5 Rp 101,800.00 2
Rp - 25 Rp 275,000.00 25 Rp 275,000.00 7
Rp - 1 Rp 4,770,000.00 1 Rp 4,770,000.00 0
Rp - 1 Rp 3,310,000.00 1 Rp 3,310,000.00 0
Rp - 1 Rp 1,950,455.00 1 Rp 1,950,455.00 0
Rp - 2 Rp 2,798,400.00 2 Rp 2,798,400.00 2
Rp - 1 Rp 1,870,660.00 1 Rp 1,870,660.00 1
Rp - 6 Rp 4,191,000.00 6 Rp 4,191,000.00 5
Rp - 5 Rp 3,740,000.00 5 Rp 3,740,000.00 4
Rp 154,880.00 Rp - 10 Rp 154,880.00 0
Rp 59,220,000.00 0 Rp - 600 Rp 59,220,000.00 600
Rp - 7000 Rp 2,202,200.00 7000 Rp 2,202,200.00 7000
Rp 1,744,200.00 Rp - 18 Rp 1,744,200.00 18
Rp - 4000 Rp 400,000.00 4000 Rp 400,000.00 4000
Rp - 2000 Rp 200,000.00 2000 Rp 200,000.00 2000
Rp 101,706.00 Rp - 1474 Rp 101,706.00 1474
Rp - 500 Rp 34,500.00 500 Rp 34,500.00 500
Rp - 500 Rp 34,500.00 500 Rp 34,500.00 500
Rp - 500 Rp 32,000.00 500 Rp 32,000.00 60
Rp 36,757.00 Rp - 413 Rp 36,757.00 413
Rp - 500 Rp 44,500.00 500 Rp 44,500.00 448
Rp - 500 Rp 44,500.00 500 Rp 44,500.00 0
Rp 444,600.00 Rp - 78 Rp 444,600.00 78
Rp - 49 Rp 279,300.00 49 Rp 279,300.00 45
Rp 69,212.00 Rp - 44 Rp 69,212.00 44
Rp - 48 Rp 300,960.00 48 Rp 300,960.00 48
Rp - 48 Rp 300,960.00 48 Rp 300,960.00 30
Rp 202,400.00 Rp - 92 Rp 202,400.00 18
Rp 175,230.00 Rp - 9 Rp 175,230.00 9
Rp 289,157.60 Rp - 16 Rp 289,157.60 16
Rp - 25 Rp 451,806.25 25 Rp 451,806.25 2
Rp 2,457,000.00 Rp - 156 Rp 2,457,000.00 50
Rp 1,342,404.00 Rp - 36 Rp 1,342,404.00 34
Rp 265,200.00 Rp - 1950 Rp 265,200.00 1950
Rp - 1500 Rp 1,029,000.00 1500 Rp 1,029,000.00 1500
Rp - 5640 Rp 620,400.00 5640 Rp 620,400.00 1405
Rp - 200 Rp 150,000.00 200 Rp 150,000.00 200
Rp - 500 Rp 106,000.00 500 Rp 106,000.00 0
Rp 14,231.25 Rp - 9 Rp 14,231.25 9
Rp 682,594.00 Rp - 95 Rp 682,594.00 95
Rp - 250 Rp 806,465.00 250 Rp 806,465.00 250
Rp 1,948.10 200 Rp 194,810.00 202 Rp 196,758.10 48
Rp - 300 Rp 6,675,600.00 300 Rp 6,675,600.00 200
Rp - 200 Rp 1,031,200.00 200 Rp 1,031,200.00 150
Rp - 300 Rp 8,248,500.00 300 Rp 8,248,500.00 200
Rp 25,325.30 200 Rp 194,810.00 226 Rp 220,135.30 41
Rp 3,949,950.00 Rp - 50 Rp 3,949,950.00 21
Rp - 25 Rp 1,974,995.00 25 Rp 1,974,995.00 5
Rp - 100 Rp 3,760,000.00 100 Rp 3,760,000.00 100
Rp 1,518,000.00 Rp - 1000 Rp 1,518,000.00 200
Rp 4,752.00 Rp - 8 Rp 4,752.00 8
Rp 46,926.00 Rp - 22 Rp 46,926.00 22
Rp - 300 Rp 668,580.00 300 Rp 668,580.00 91
Rp 162,000.00 5 Rp 135,000.00 11 Rp 297,000.00 11
Rp - 5 Rp 135,000.00 5 Rp 135,000.00 5
Rp - 15 Rp 445,500.00 15 Rp 445,500.00 8
Rp - 5 Rp 72,358.00 5 Rp 72,358.00 4
Rp - 100 Rp 330,000.00 100 Rp 330,000.00 76
Rp 30,000.00 Rp - 10 Rp 30,000.00 0
Rp - 300 Rp 660,000.00 300 Rp 660,000.00 300
Rp - 200 Rp 14,820,000.00 200 Rp 14,820,000.00 200
Rp - 2000 Rp 812,000.00 2000 Rp 812,000.00 681
Rp 1,608,175.80 Rp - 41 Rp 1,608,175.80 41
Rp - 48 Rp 1,882,742.40 48 Rp 1,882,742.40 48
Rp 222,775.00 Rp - 2345 Rp 222,775.00 2345
Rp - 1000 Rp 95,000.00 1000 Rp 95,000.00 785
Rp - 1500 Rp 142,500.00 1500 Rp 142,500.00 190
Rp 25,830.00 Rp - 410 Rp 25,830.00 410
Rp - 1000 Rp 50,000.00 1000 Rp 50,000.00 800
Rp 37,928.00 Rp - 4 Rp 37,928.00 4
Rp - 10 Rp 12,830.00 10 Rp 12,830.00 10
Rp 317,974.82 Rp - 1817 Rp 317,974.82 1817
Rp - 2000 Rp 284,000.00 2000 Rp 284,000.00 2000
Rp - 3400 Rp 482,800.00 3400 Rp 482,800.00 1800
Rp 736,368.00 Rp - 5336 Rp 736,368.00 5336
Rp - 1000 Rp 138,000.00 1000 Rp 138,000.00 1000
Rp 97,300.00 Rp - 700 Rp 97,300.00 700
Rp - 1000 Rp 139,000.00 1000 Rp 139,000.00 1000
Rp 1,220,310.00 Rp - 11622 Rp 1,220,310.00 11622
Rp - 500 Rp 62,500.00 500 Rp 62,500.00 12
Rp - 1200 Rp 43,200.00 1200 Rp 43,200.00 20
Rp 503,036.00 Rp - 134 Rp 503,036.00 99
Rp - 30 Rp 127,800.00 30 Rp 127,800.00 30
Rp - 20 Rp 314,000.00 20 Rp 314,000.00 5
Rp 69,000.00 Rp - 100 Rp 69,000.00 100
Rp - 500 Rp 427,500.00 500 Rp 427,500.00 10
Rp 7,360,000.00 0 Rp - 5000 Rp 7,360,000.00 5000
Rp - 1000 Rp 1,472,690.00 1000 Rp 1,472,690.00 940
Rp 15,812.50 Rp - 10 Rp 15,812.50 3
Rp 178,144.00 Rp - 76 Rp 178,144.00 76
Rp - 48 Rp 213,120.00 48 Rp 213,120.00 35
Rp 31,080.00 Rp - 7 Rp 31,080.00 7
Rp 1,153,460.00 Rp - 70 Rp 1,153,460.00 70
Rp - 48 Rp 790,944.00 48 Rp 790,944.00 44
Rp 475,152.00 Rp - 912 Rp 475,152.00 912
Rp 1,311,200.00 Rp - 1192 Rp 1,311,200.00 1192
Rp - 4000 Rp 2,472,000.00 4000 Rp 2,472,000.00 1185
Rp - 1 Rp 977,900.00 1 Rp 977,900.00 1
Rp - 100 Rp 7,410,000.00 100 Rp 7,410,000.00 100
Rp - 100 Rp 1,135,000.00 100 Rp 1,135,000.00 45

HARGA PENE- HARGA PERSE- HARGA PENGEL


(Rp) RIMAAN (Rp) DIAAN (Rp) UARAN
G H I
Rp 367,140.00 32 Rp 979,040.00 44 Rp 1,346,180.00 44
Rp - 60 Rp 1,894,200.00 60 Rp 1,894,200.00 24
Rp - 6 Rp 75,414.00 6 Rp 75,414.00 0
Rp - 48 Rp 3,240,000.00 48 Rp 3,240,000.00 48
Rp - 950 Rp 323,950.00 950 Rp 323,950.00 850
Rp - 3500 Rp 1,767,500.00 3500 Rp 1,767,500.00 3250
Rp - 10 Rp - 10 Rp - 10
Rp - 100 Rp - 100 Rp - 100
Rp - 1 Rp - 1 Rp - 1
Rp - 2 Rp - 2 Rp - 2
Rp - 2 Rp - 2 Rp - 2
Rp - 1 Rp - 1 Rp - 1
Rp 600,000.00 Rp - 8 Rp 600,000.00 8
Rp 147,400.00 Rp - 200 Rp 147,400.00 3
Rp 6,575,976.00 Rp - 114 Rp 6,575,976.00 114
Rp - 400 Rp 2,108,400.00 400 Rp 2,108,400.00 65
Rp - 27 Rp 54,810.00 27 Rp 54,810.00 18
Rp - 29 Rp 12,527,507.00 29 Rp 12,527,507.00 23
Rp - 2 Rp 3,114,938.00 2 Rp 3,114,938.00 2
Rp - 50 Rp 90,900.00 50 Rp 90,900.00 37
Rp 296,600.00 5 Rp 1,483,000.00 6 Rp 1,779,600.00 5
Rp - 250 Rp - 250 Rp - 250
Rp - 740 Rp 896,880.00 740 Rp 896,880.00 319
Rp 11,800.00 15 Rp 177,000.00 16 Rp 188,800.00 8
Rp - 56 Rp 224,000.00 56 Rp 224,000.00 9
Rp - 740 Rp 4,528,800.00 740 Rp 4,528,800.00 319
Rp - 400 Rp 754,400.00 400 Rp 754,400.00 170
Rp 637,500.00 3 Rp 637,500.00 6 Rp 1,275,000.00 6
40 Rp 8,528,800.00 40 Rp 8,528,800.00 32
Rp - 40 Rp 98,000.00 40 Rp 98,000.00 40
Rp - 80 Rp 233,600.00 80 Rp 233,600.00 0
Rp 183,435,752.78 Rp 229,218,235.63 Rp 412,653,988.41
Rp 412,653,988.41

Penanggung
UPT Puskes

Marwa
NIP : 1981
HARGA STOK TOTAL
(Rp) AKHIR
HARGA

Rp 350,000.00 0 Rp -
Rp 34,300.00 46 Rp 394,450.00
Rp 162,499.92 0 Rp -
Rp 463,750.00 0 Rp -
Rp 154,350.00 32 Rp 274,400.00
Rp 691,250.00 51 Rp 446,250.00
Rp 394,450.00 4 Rp 34,300.00
Rp 140,000.00 85 Rp 743,750.00
Rp 108,536.00 96 Rp 2,604,864.00
Rp 482,600.00 0 Rp -
Rp 346,380.00 20 Rp 5,020.00
Rp 72,400.00 0 Rp -
Rp 72,507.50 385 Rp 242,742.50
Rp 16,555.00 90 Rp 148,995.00
Rp 192,500.00 0 Rp -
Rp 784,322.00 87 Rp 147,378.00
Rp - 500 Rp 456,500.00
Rp 5,709.00 0 Rp -
Rp 1,586,552.00 34 Rp 32,912.00
Rp 6,740.00 0 Rp -
Rp 226,521.90 237 Rp 204,128.10
Rp 110,084.00 0 Rp -
Rp 111,441.00 625 Rp 226,875.00
Rp - 1 Rp 239,525.00
Rp 99,750.00 53 Rp 139,125.00
Rp 180,600.00 0 Rp -
Rp 98,000.00 0 Rp -
Rp 109,142.00 349 Rp 84,458.00
Rp 96,000.00 0 Rp -
Rp 12,420.00 0 Rp -
Rp 288,000.00 0 Rp -
Rp 118,560.00 2065 Rp 198,240.00
Rp 49,800.00 800 Rp 199,200.00
Rp 1,217,800.10 1 Rp 6,512.30
Rp 536,514.00 951 Rp 230,142.00
Rp 508,200.00 30 Rp 126,000.00
Rp 68,800.00 0 Rp -
Rp 87,330.00 390 Rp 47,970.00
Rp 37,296.00 0 Rp -
Rp - 1800 Rp 502,434.00
Rp 313,230.00 0 Rp -
Rp 1,260,000.00 0 Rp -
Rp 1,368,774.00 590 Rp 164,610.00
Rp 164,610.00 410 Rp 114,390.00
Rp 264,000.00 0 Rp -
Rp 261,120.00 0 Rp -
Rp 133,500.00 0 Rp -
Rp 195,800.00 38 Rp 338,200.00
Rp 465,500.00 0 Rp -
Rp 220,660.00 61 Rp 228,140.00
Rp - 24 Rp 684,000.00
Rp 224,400.00 0 Rp -
Rp 1,043,350.00 1899 Rp 731,115.00
Rp 529,375.00 625 Rp 240,625.00
Rp 589,260.00 9 Rp 19,215.00
Rp 66,185.00 69 Rp 147,315.00
Rp 267,930.00 0 Rp -
Rp 69,912.00 2529 Rp 182,088.00
Rp 308,000.00 20 Rp 44,000.00
Rp 44,000.00 0 Rp -
Rp 34,986.00 0 Rp -
Rp 428,400.00 0 Rp -
Rp 93,600.00 0 Rp -
Rp 299,200.00 0 Rp -
Rp 162,197.00 2437 Rp 290,003.00
Rp 86,840.00 0 Rp -
Rp 93,440.00 2040 Rp 130,560.00
Rp 15,812.50 0 Rp -
Rp 77,400.00 0 Rp -
Rp - 500 Rp 171,000.00
Rp 5,600.00 89 Rp 124,600.00
Rp 121,500.00 0 Rp -
Rp 174,460.00 2000 Rp 440,000.00
Rp 51,156.00 739 Rp 144,844.00
Rp 52,181.25 19 Rp 30,043.75
Rp - 250 Rp 1,595,000.00
Rp - 0 Rp -
Rp 160,486.00 0 Rp -
Rp 379,188.00 17 Rp 59,687.00
Rp 1,232,616.00 0 Rp -
Rp 196,470.00 240 Rp 42,480.00
Rp 102,144.00 0 Rp -
Rp 221,844.00 11 Rp 17,556.00
Rp 156,800.00 36 Rp 705,600.00
Rp 408,592.62 162 Rp 216,313.74
Rp 145,000.00 0 Rp -
Rp 1,059,839.45 1485 Rp 3,792,437.55
Rp 32,046.00 0 Rp -
Rp 128,184.00 300 Rp 48,069.00
Rp 240,856.00 0 Rp -
Rp - 23 Rp 36,368.75
Rp 254,160.00 0 Rp -
Rp 108,000.00 0 Rp -
Rp 64,000.00 0 Rp -
Rp 13,800.00 0 Rp -
Rp 132,480.00 0 Rp -
Rp 102,312.00 79 Rp 5,688.00
Rp 13,600.00 300 Rp 20,400.00
Rp 73,800.00 0 Rp -
Rp 328,000.00 0 Rp -
Rp 21,320.00 1240 Rp 101,680.00
Rp 92,610.00 0 Rp -
Rp 340,305.00 685 Rp 100,695.00
Rp 274,918.00 0 Rp -
Rp 1,695,750.00 10 Rp 332,500.00
Rp - 60 Rp 385,219.80
Rp 70,629.13 13 Rp 83,470.79
Rp 154,099.92 0 Rp -
Rp 77,049.96 12 Rp 77,049.96
Rp 21,144.00 0 Rp -
Rp 2,085,965.00 400 Rp 222,800.00
Rp 334,125.00 325 Rp 160,875.00
Rp 35,000.00 0 Rp -
Rp 81,420.00 1 Rp 6,785.00
Rp - 19 Rp 128,915.00
Rp 6,240.00 0 Rp -
Rp 809,400.00 0 Rp -
Rp 404,724.00 69 Rp 962,964.00
Rp 553,110.00 2080 Rp 642,720.00
Rp 123,000.00 8 Rp 82,000.00
Rp 14,040.00 260 Rp 40,560.00
Rp 56,700.00 0 Rp -
Rp 255,150.00 0 Rp -
Rp 69,300.00 150 Rp 103,950.00
Rp 1,423,125.00 0 Rp -
Rp 506,000.00 2 Rp 1,012,000.00
Rp 234,639.00 186 Rp 48,546.00
Rp 155,100.00 8 Rp 41,360.00
Rp - 50 Rp 258,500.00
Rp 166,080.00 0 Rp -
Rp - 48 Rp 163,968.00
Rp 112,560.00 0 Rp -
Rp 82,533.00 7 Rp 14,091.00
Rp 504,000.00 0 Rp -
Rp 6,424.00 0 Rp -
Rp 51,840.00 0 Rp -
Rp 230,000.00 0 Rp -
Rp 143,014.00 3891 Rp 178,986.00
Rp - 1 Rp 749,320.00
Rp - 1 Rp 749,320.00
Rp 583,020.00 478 Rp 75,524.00
Rp - 500 Rp 76,000.00
Rp 2,922.15 0 Rp -
Rp 218,680.00 120 Rp 937,200.00
Rp 85,500.00 12 Rp 27,000.00
Rp 986,400.00 0 Rp -
Rp - 40 Rp 1,220,120.00
Rp 136,500.00 96 Rp 174,720.00
Rp 164,164.00 0 Rp -
Rp 46,000.00 0 Rp -
Rp 170,135.00 1139 Rp 39,865.00
Rp 24,843.72 0 Rp -
Rp 9,460.00 390 Rp 33,540.00
Rp - 14 Rp 255,640.00
Rp - 500 Rp 51,500.00
Rp 19,740.00 160 Rp 22,560.00
Rp 28,667.00 237 Rp 25,833.00
Rp - 58 Rp 67,048.00
Rp 136,000.00 0 Rp -
Rp - 100 Rp 359,425.00
Rp 1,609,977.60 0 Rp -
Rp 26,730.00 41 Rp 121,770.00
Rp 171,390.00 735 Rp 127,890.00
Rp 327,800.00 0 Rp -
Rp 204,120.00 0 Rp -
Rp 226,200.00 38 Rp 220,400.00
Rp 196,020.00 156 Rp 1,389,960.00
Rp 402,598.00 0 Rp -
Rp 271,600.00 400 Rp 271,600.00
Rp 266,076.00 0 Rp -
Rp 125,647.00 0 Rp -
Rp 19,920.00 7 Rp 17,430.00
Rp 21,420.00 17 Rp 52,020.00
Rp 132,000.00 0 Rp -
Rp 280,600.00 0 Rp -
Rp 2,745,000.00 0 Rp -
Rp - 1 Rp 395,532.50
Rp 151,250.01 0 Rp -
Rp 1,359,575.00 0 Rp -
Rp 12,852,000.00 0 Rp -
Rp 40,000.00 5 Rp 100,000.00
Rp 96,576.00 1 Rp 2,012.00
Rp 27,720.00 400 Rp 33,600.00
Rp - 1000 Rp 77,000.00
Rp 5,060.00 0 Rp -
Rp 64,350.00 0 Rp -
Rp 296,070.00 235 Rp 65,330.00
Rp - 299 Rp 809,094.00
Rp - 20 Rp 73,980.00
Rp 15,000.00 1 Rp 3,750.00
Rp - 1 Rp 949,520.00
Rp 23,790.00 0 Rp -
Rp 150,150.00 950 Rp 135,850.00
Rp - 1000 Rp 90,000.00
Rp 394,000.00 50 Rp 78,800.00
Rp 155,500.00 500 Rp 155,500.00
Rp 183,672.50 0 Rp -
Rp 467,530.00 0 Rp -
Rp 93,973.53 3593 Rp 239,976.47
Rp - 210 Rp 241,500.00
Rp 147,200.00 0 Rp -
Rp 39,450.00 350 Rp 92,050.00
Rp 6,300.00 0 Rp -
Rp 1,479,918.00 296 Rp 2,147,332.00
Rp 465,500.00 0 Rp -
Rp 912,000.00 0 Rp -
Rp 1,120,240.00 66 Rp 551,760.00
Rp 2,830,240.00 0 Rp -
Rp 820,800.00 210 Rp 1,915,200.00
Rp 761,722.50 195 Rp 1,414,627.50
Rp 754,110.00 222 Rp 2,066,820.00
Rp 660,660.00 700 Rp 355,740.00
Rp 1,103,700.00 0 Rp -
Rp 32,220.00 220 Rp 39,380.00
Rp - 700 Rp 125,300.00
Rp 32,318.00 0 Rp -
Rp 176,280.00 180 Rp 528,840.00
Rp 111,072.00 9 Rp 25,632.00
Rp - 500 Rp 297,525.00
Rp 179,310.00 0 Rp -
Rp 300,660.00 0 Rp -
Rp 54,349.00 109 Rp 15,151.00
Rp - 2000 Rp 1,050,000.00
Rp 23,200.00 0 Rp -
Rp 116,000.00 0 Rp -
Rp 287,042.00 0 Rp -
Rp 189,942.50 0 Rp -
Rp 523,320.00 12 Rp 70,560.00
Rp 15,950.00 12 Rp 38,280.00
Rp 237,600.00 71 Rp 562,320.00
Rp 79,478.00 849 Rp 83,202.00
Rp 360,000.00 0 Rp -
Rp 360,000.00 0 Rp -
Rp 390,000.00 0 Rp -
Rp 390,000.00 0 Rp -
Rp 46,475.00 50 Rp 46,475.00
Rp 31,771.74 0 Rp -
Rp 69,575.00 0 Rp -
Rp 14,375.00 0 Rp -
Rp 129,375.00 1 Rp 14,375.00
Rp 14,375.00 4 Rp 57,500.00
Rp 220,000.00 500 Rp 1,100,000.00
Rp 1,140,800.00 0 Rp -
Rp 427,800.00 0 Rp -
Rp 427,800.00 2 Rp 285,200.00
Rp 69,920.00 0 Rp -
Rp 39,675.00 11 Rp 6,325.00
Rp 208,593.00 0 Rp -
Rp 616,000.00 3500 Rp 431,200.00
Rp 126,800.00 0 Rp -
Rp 193,920.00 0 Rp -
Rp 75,750.00 850 Rp 257,550.00
Rp 264,306.00 8 Rp 21,576.00
Rp 21,750.00 26 Rp 37,700.00
Rp - 1000 Rp 572,000.00
Rp 8,250,000.00 0 Rp -
Rp 255,300.00 52 Rp 358,800.00
Rp - 20 Rp 138,000.00
Rp 198,710.00 0 Rp -
Rp 384,600.00 0 Rp -
Rp 70,510.00 49 Rp 314,090.00
Rp 815,100.00 11 Rp 78,650.00
Rp 257,400.00 44 Rp 314,600.00
Rp - 2 Rp 3,405,072.00
Rp - 2 Rp 3,046,560.00
Rp - 2 Rp 593,912.00
Rp - 2 Rp 473,616.00
Rp - 2 Rp 1,373,394.00
Rp - 2 Rp 748,880.00
Rp - 2 Rp 888,030.00
Rp 170,936.00 60 Rp 55,740.00
Rp 44,300.00 370 Rp 819,550.00
Rp 34,532.00 1100 Rp 106,700.00
Rp 29,100.00 700 Rp 67,900.00
Rp 6,305.00 435 Rp 42,195.00
Rp 220,215.00 0 Rp -
Rp 788,958.00 2038 Rp 324,042.00
Rp 885,600.00 4 Rp 196,800.00
Rp 35,100.00 24 Rp 140,400.00
Rp 1,320.00 0 Rp -
Rp 479,160.00 0 Rp -
Rp 106,820.00 405 Rp 176,580.00
Rp 2,940.00 0 Rp -
Rp 300,432.00 631 Rp 333,168.00
Rp 1,601,600.00 50 Rp 440,000.00
Rp 19,959.50 0 Rp -
Rp 19,959.50 0 Rp -
Rp 19,959.50 0 Rp -
Rp 19,959.50 0 Rp -
Rp 73,817.00 0 Rp -
Rp 204,187.50 0 Rp -
Rp 20,600.00 0 Rp -
Rp 168,000.00 0 Rp -
Rp 397,500.00 0 Rp -
Rp 953,683.01 0 Rp -
Rp 212,000.00 0 Rp -
Rp 85,000.00 0 Rp -
Rp 6,800.00 460 Rp 78,200.00
Rp 79,430.00 550 Rp 92,950.00
Rp 206,668.00 0 Rp -
Rp 40,000.00 0 Rp -
Rp 870.00 990 Rp 86,130.00
Rp 12,900.00 400 Rp 51,600.00
Rp 217,384.00 0 Rp -
Rp 128,700.00 0 Rp -
Rp 14,300.00 1900 Rp 271,700.00
Rp - 3 Rp 38,940.00
Rp 15,812.50 0 Rp -
Rp 14,000.00 6 Rp 16,800.00
Rp - 10 Rp 36,500.00
Rp 126,000.00 0 Rp -
Rp 196,656.00 0 Rp -
Rp 48,900.00 0 Rp -
Rp - 500 Rp 81,500.00
Rp 97,020.00 10 Rp 80,850.00
Rp - 10 Rp 80,850.00
Rp 263,088.00 0 Rp -
Rp 44,500.00 0 Rp -
Rp 101,332.00 642 Rp 98,868.00
Rp 452,600.00 0 Rp -
Rp 133,250.00 0 Rp -
Rp 33,408.00 0 Rp -
Rp 72,390.00 0 Rp -
Rp 92,400.00 675 Rp 75,600.00
Rp 52,800.00 0 Rp -
Rp 25,120.00 160 Rp 100,480.00
Rp 895,000.00 0 Rp -
Rp 8,950.00 490 Rp 438,550.00
Rp 80,060.00 0 Rp -
Rp 2,380,032.98 74 Rp 29,261.08
Rp 47,717.28 72 Rp 23,858.64
Rp 71,060.00 0 Rp -
Rp 160,875.00 0 Rp -
Rp 19,473.60 0 Rp -
Rp 34,307.01 0 Rp -
Rp 26,400.00 0 Rp -
Rp 12,320.00 0 Rp -
Rp 52,800.00 0 Rp -
Rp 124,410.00 30 Rp 4,290.00
Rp 13,794.00 24 Rp 30,096.00
Rp 34,200.00 0 Rp -
Rp 128,700.00 0 Rp -
Rp - 200 Rp 257,400.00
Rp 22,137.50 0 Rp -
Rp - 60 Rp 171,600.00
Rp 31,200.00 0 Rp -
Rp 837,795.00 7 Rp 55,853.00
Rp 67,500.00 0 Rp -
Rp 52,000.00 0 Rp -
Rp 52,000.00 0 Rp -
Rp 1,342,656.00 2816 Rp 729,344.00
Rp 206,052.00 0 Rp -
Rp 385,560.00 76 Rp 90,440.00
Rp 646,250.00 0 Rp -
Rp 118,800.00 0 Rp -
Rp 469,702.40 570 Rp 338,899.20
Rp 8,786.34 0 Rp -
Rp 1,274,988.00 19 Rp 807,492.40
Rp 47,437.50 0 Rp -
Rp 458,875.00 450 Rp 56,250.00
Rp 33,818.00 1543 Rp 114,182.00
Rp 1,025,000.00 0 Rp -
Rp 742,500.00 0 Rp -
Rp 41,910.00 1 Rp 41,910.00
Rp 105,300.00 0 Rp -
Rp 35,100.00 200 Rp 70,200.00
Rp 55,650.00 0 Rp -
Rp 4,858.00 386 Rp 133,942.00
Rp 54,600.00 0 Rp -
Rp 39,531.25 0 Rp -
Rp 166,408.00 61 Rp 327,448.00
Rp 667,590.00 0 Rp -
Rp 790,125.00 1990 Rp 522,375.00
Rp 40,720.00 3 Rp 61,080.00
Rp 77,000.00 18 Rp 198,000.00
Rp - 1 Rp 4,770,000.00
Rp - 1 Rp 3,310,000.00
Rp - 1 Rp 1,950,455.00
Rp 2,798,400.00 0 Rp -
Rp 1,870,660.00 0 Rp -
Rp 3,492,500.00 1 Rp 698,500.00
Rp 2,992,000.00 1 Rp 748,000.00
Rp - 10 Rp 154,880.00
Rp 59,220,000.00 0 Rp -
Rp 2,202,200.00 0 Rp -
Rp 1,744,200.00 0 Rp -
Rp 400,000.00 0 Rp -
Rp 200,000.00 0 Rp -
Rp 101,706.00 0 Rp -
Rp 34,500.00 0 Rp -
Rp 34,500.00 0 Rp -
Rp 3,840.00 440 Rp 28,160.00
Rp 36,757.00 0 Rp -
Rp 39,872.00 52 Rp 4,628.00
Rp - 500 Rp 44,500.00
Rp 444,600.00 0 Rp -
Rp 256,500.00 4 Rp 22,800.00
Rp 69,212.00 0 Rp -
Rp 300,960.00 0 Rp -
Rp 188,100.00 18 Rp 112,860.00
Rp 39,600.00 74 Rp 162,800.00
Rp 175,230.00 0 Rp -
Rp 289,157.60 0 Rp -
Rp 36,144.50 23 Rp 415,661.75
Rp 787,500.00 106 Rp 1,669,500.00
Rp 1,267,826.00 2 Rp 74,578.00
Rp 265,200.00 0 Rp -
Rp 1,029,000.00 0 Rp -
Rp 154,550.00 4235 Rp 465,850.00
Rp 150,000.00 0 Rp -
Rp - 500 Rp 106,000.00
Rp 14,231.25 0 Rp -
Rp 682,594.00 0 Rp -
Rp 806,465.00 0 Rp -
Rp 46,754.40 154 Rp 150,003.70
Rp 4,450,400.00 100 Rp 2,225,200.00
Rp 773,400.00 50 Rp 257,800.00
Rp 5,499,000.00 100 Rp 2,749,500.00
Rp 39,936.05 185 Rp 180,199.25
Rp 1,658,979.00 29 Rp 2,290,971.00
Rp 394,999.00 20 Rp 1,579,996.00
Rp 3,760,000.00 0 Rp -
Rp 303,600.00 800 Rp 1,214,400.00
Rp 4,752.00 0 Rp -
Rp 46,926.00 0 Rp -
Rp 202,802.60 209 Rp 465,777.40
Rp 297,000.00 0 Rp -
Rp 135,000.00 0 Rp -
Rp 237,600.00 7 Rp 207,900.00
Rp 57,886.40 1 Rp 14,471.60
Rp 250,800.00 24 Rp 79,200.00
Rp - 10 Rp 30,000.00
Rp 660,000.00 0 Rp -
Rp 14,820,000.00 0 Rp -
Rp 276,486.00 1319 Rp 535,514.00
Rp 1,608,175.80 0 Rp -
Rp 1,882,742.40 0 Rp -
Rp 222,775.00 0 Rp -
Rp 74,575.00 215 Rp 20,425.00
Rp 18,050.00 1310 Rp 124,450.00
Rp 25,830.00 0 Rp -
Rp 40,000.00 200 Rp 10,000.00
Rp 37,928.00 0 Rp -
Rp 12,830.00 0 Rp -
Rp 317,974.82 0 Rp -
Rp 284,000.00 0 Rp -
Rp 255,600.00 1600 Rp 227,200.00
Rp 736,368.00 0 Rp -
Rp 138,000.00 0 Rp -
Rp 97,300.00 0 Rp -
Rp 139,000.00 0 Rp -
Rp 1,220,310.00 0 Rp -
Rp 1,500.00 488 Rp 61,000.00
Rp 720.00 1180 Rp 42,480.00
Rp 371,646.00 35 Rp 131,390.00
Rp 127,800.00 0 Rp -
Rp 78,500.00 15 Rp 235,500.00
Rp 69,000.00 0 Rp -
Rp 8,550.00 490 Rp 418,950.00
Rp 7,360,000.00 0 Rp -
Rp 1,384,328.60 60 Rp 88,361.40
Rp 4,743.75 7 Rp 11,068.75
Rp 178,144.00 0 Rp -
Rp 155,400.00 13 Rp 57,720.00
Rp 31,080.00 0 Rp -
Rp 1,153,460.00 0 Rp -
Rp 725,032.00 4 Rp 65,912.00
Rp 475,152.00 0 Rp -
Rp 1,311,200.00 0 Rp -
Rp 732,330.00 2815 Rp 1,739,670.00
Rp 977,900.00 0 Rp -
Rp 7,410,000.00 0 Rp -
Rp 510,750.00 55 Rp 624,250.00

HARGA STOK TOTAL


(Rp) AKHIR
HARGA
J

Rp 1,346,180.00 0 Rp -
Rp 757,680.00 36 Rp 1,136,520.00
Rp - 6 Rp 75,414.00
Rp 3,240,000.00 0 Rp -
Rp 289,850.00 100 Rp 34,100.00
Rp 1,641,250.00 250 Rp 126,250.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 600,000.00 Rp -
Rp 2,211.00 197 Rp 145,189.00
Rp 6,575,976.00 0 Rp -
Rp 342,615.00 335 Rp 1,765,785.00
Rp 36,540.00 9 Rp 18,270.00
Rp 9,935,609.00 6 Rp 2,591,898.00
Rp 3,114,938.00 0 Rp -
Rp 67,266.00 13 Rp 23,634.00
Rp 1,483,000.00 1 Rp 296,600.00
Rp - 0 Rp -
Rp 386,628.00 421 Rp 510,252.00
Rp 94,400.00 8 Rp 94,400.00
Rp 36,000.00 47 Rp 188,000.00
Rp 1,952,280.00 421 Rp 2,576,520.00
Rp 320,620.00 230 Rp 433,780.00
Rp 1,275,000.00 0 Rp -
Rp 6,823,040.00 8 Rp 1,705,760.00
Rp 98,000.00 0 Rp -
Rp - 80 Rp 233,600.00
Rp 301,612,509.53 Rp 111,041,478.88
111,041,478.88

Penanggung jawab Kefarmasian


UPT Puskesmas Pasangkayu 1

Marwah, S. Farm.,Apt
NIP : 19810523 200604 2 015
Alamat : Jl. Tan

LAPORAN PERSEDIAA

STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL

A B C D E F
1 ABATE KG Rp 105,000.00 JKN 2018 0
2 HANDSCOON NON STERIL DOS Rp 75,000.00 JKN 2018 0
3 LUMPANG SET Rp 110,000.00 JKN 2018 0
4 PARACETAMOL 500 mg BOX Rp 35,000.00 JKN 2018 0
5 AMLODIPIN 10 mg BOX Rp 9,000.00 JKN 2018 0
6 REAGEN ASAM URAT DIASYS BESAR KIT Rp 2,670,800.00 JKN 2018 0
7 REAGEN CHOLESTEROL DIASYS BESAR KIT Rp 2,170,300.00 JKN 2018 0
8 REAGEN DILUENT MINDRAY M-18 D PCS Rp 2,100,000.00 JKN 2018 0
9 REAGEN GLUCOSA DIASYS BESAR KIT Rp 1,284,000.00 JKN 2018 0
10 REAGEN LYSE PCS Rp 1,200,000.00 JKN 2018 0
11 SEDIPLAST ESR WESTERGEN BOX Rp 2,700,000.00 JKN 2018 0
12 TABUNG K3EDTA BUAH Rp 174,000.00 JKN 2018 0
13 TABUNG PLAIN BUAH Rp 174,000.00 JKN 2018 0
14 TRU LAB N (KONTROL) BOT Rp 600,000.00 JKN 2018 0
15 PARACETAMOL 500 mg BOX Rp 28,000.00 JKN 2018 0
16 MASKER IKAT BOX Rp 40,000.00 JKN 2018 0
17 HANDSCOON BOX Rp 67,000.00 JKN 2018 0
18 HANDSCOON NON STERIL BOX Rp 80,000.00 JKN 2018 0
19 HANDSCOON NON STERIL PCS Rp 1,000.00 JKN 2018 0
20 KAPAS LIDI PAK Rp 175,000.00 JKN 2018 0
21 FOUMEN BUAH Rp 35,000.00 JKN 2018 0
22 ASAM MEFENAMAT BOX Rp 48,000.00 JKN 2018 0
23 VIT B COM BOX Rp 14,000.00 JKN 2018 0
24 METFORMIN BOX Rp 55,000.00 JKN 2018 0
25 IBUPOFEN BOX Rp 55,000.00 JKN 2018 0
26 ASAM MEFENAMAT BOX Rp 26,800.00 JKN 2018 0
27 IBUPOFEN 200 mg BOX Rp 25,000.00 JKN 2018 0
28 IBUPOFEN 400 mg BOX Rp 27,000.00 JKN 2018 0
29 MELOXICAM BOX Rp 15,000.00 JKN 2018 0
30 METFOMIN BOX Rp 18,000.00 JKN 2018 0
TOTAL

Kepala UPT Puskesmas Pasangkayu 1

Fatmawati, SKM
NIP : 19820619 200312 2 003
PEMERINTAH KABUPATEN PASANGKAYU
DINAS KESEHATAN
UPT PUSKESMAS PASANGKAYU 1
Alamat : Jl. Tans Sulawesi Desa Kaya Besama Kec. Pasangkayu Kab. Pasangkayu

N PERSEDIAAN OBAT DAN PEMAKAIAN OBAT DAN BMHP BERSUMBER JKN


JANUARI s/d DESEMBER 2018

HARGA PENE- HARGA PERSE- HARGA PENGELUA


RAN
(Rp) RIMAAN (Rp) DIAAN (Rp)

G
Rp - 1 Rp 105,000.00 1 Rp 105,000.00 1
Rp - 2 Rp 150,000.00 2 Rp 150,000.00 2
Rp - 1 Rp 110,000.00 1 Rp 110,000.00 1
Rp - 2 Rp 70,000.00 2 Rp 70,000.00 2
Rp - 10 Rp 90,000.00 10 Rp 90,000.00 10
Rp - 1 Rp 2,670,800.00 1 Rp 2,670,800.00 1
Rp - 1 Rp 2,170,300.00 1 Rp 2,170,300.00 1
Rp - 1 Rp 2,100,000.00 1 Rp 2,100,000.00 1
Rp - 1 Rp 1,284,000.00 1 Rp 1,284,000.00 1
1 Rp 1,200,000.00 1 Rp 1,200,000.00 1
Rp - 1 Rp 2,700,000.00 1 Rp 2,700,000.00 1
Rp - 3 Rp 522,000.00 3 Rp 522,000.00 3
Rp - 10 Rp 1,740,000.00 10 Rp 1,740,000.00 10
Rp - 1 Rp 600,000.00 1 Rp 600,000.00 1
Rp - 4 Rp 112,000.00 4 Rp 112,000.00 4
Rp - 12 Rp 480,000.00 12 Rp 480,000.00 12
Rp - 5 Rp 335,000.00 5 Rp 335,000.00 5
Rp - 2 Rp 160,000.00 2 Rp 160,000.00 2
Rp - 45 Rp 45,000.00 45 Rp 45,000.00 45
Rp - 1 Rp 175,000.00 1 Rp 175,000.00 1
Rp - 3 Rp 105,000.00 3 Rp 105,000.00 3
Rp - 1 Rp 48,000.00 1 Rp 48,000.00 1
Rp - 1 Rp 14,000.00 1 Rp 14,000.00 1
Rp - 1 Rp 55,000.00 1 Rp 55,000.00 1
Rp - 1 Rp 55,000.00 1 Rp 55,000.00 1
Rp - 5 Rp 134,000.00 5 Rp 134,000.00 5
Rp - 3 Rp 75,000.00 3 Rp 75,000.00 3
Rp - 2 Rp 54,000.00 2 Rp 54,000.00 2
Rp - 4 Rp 60,000.00 4 Rp 60,000.00 4
Rp - 6 Rp 108,000.00 6 Rp 108,000.00 6
Rp 17,527,100.00 132 Rp 17,527,100.00 132

Penanggun
UPT Pusk

NIP : 198
R JKN

HARGA STOK TOTAL


AKHIR
(Rp) HARGA

J
Rp 105,000.00 0 Rp -
Rp 150,000.00 0 Rp -
Rp 110,000.00 0 Rp -
Rp 70,000.00 0 Rp -
Rp 90,000.00 0 Rp -
Rp 2,670,800.00 0 Rp -
Rp 2,170,300.00 0 Rp -
Rp 2,100,000.00 0 Rp -
Rp 1,284,000.00 0 Rp -
Rp 1,200,000.00 0 Rp -
Rp 2,700,000.00 0 Rp -
Rp 522,000.00 0 Rp -
Rp 1,740,000.00 0 Rp -
Rp 600,000.00 0 Rp -
Rp 112,000.00 0 Rp -
Rp 480,000.00 0 Rp -
Rp 335,000.00 0 Rp -
Rp 160,000.00 0 Rp -
Rp 45,000.00 0 Rp -
Rp 175,000.00 0 Rp -
Rp 105,000.00 0 Rp -
Rp 48,000.00 0 Rp -
Rp 14,000.00 0 Rp -
Rp 55,000.00 0 Rp -
Rp 55,000.00 0 Rp -
Rp 134,000.00 0 Rp -
Rp 75,000.00 0 Rp -
Rp 54,000.00 0 Rp -
Rp 60,000.00 0 Rp -
Rp 108,000.00 0 Rp -
Rp 17,527,100.00 0

Penanggung jawab Kefarmasian


UPT Puskesmas Pasangkayu 1

Marwah, S. Farm.,Apt
NIP : 19810523 200604 2 015
FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN
NAMA PUSKESMAS
PENANGGUNGJAWAB
ALAMAT
KABUPATEN
NO HP
BULAN
EMAIL
NO NAMA OBAT

1 ALBENDAZOL
2 AMOXICILLIN 500 mg
3 AMOXICILLIN 250mg
4 DEKSAMETHASONE
5 DIAZEPAM 5 mg/ml
6 EPINEPRIN(ADRENALIN) 0,1 % (Sebagai HCL)
7 FITOMENADION ( vitamin K )
8 FUROSEMID 40 mg
9 GARAM ORALIT
10 GLIBENCLAMIDE
11 KAPTOPRIL
12 MAGNESIUM SULFAT 20%
13 METIL ERGOMETRIN MALEAT 200 mg - 1 ml
14 OBAT ANTI TUBERCULOSIS DEWASA
15 OKSITOSIN
16 PARASETAMOL 500 mg

17 TABLET TAMBAH DARAH


18 VAKSIN BCG
19 VAKSIN TT

20 VAKSIN DPT/DPT-HB/DPT-HB-Hib

CATATAN:
JIKA ADA TULIS 1
JIKA TIDAK ADA TULIS 0

Mengetahui :
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003

FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN


NAMA PUSKESMAS
PENANGGUNGJAWAB
ALAMAT
KABUPATEN
NO HP
BULAN
EMAIL
NO NAMA OBAT
1 ALBENDAZOL
2 AMOXICILLIN 500 mg
3 AMOXICILLIN 250mg
4 DEKSAMETHASONE
5 DIAZEPAM 5 mg/ml
6 EPINEPRIN(ADRENALIN) 0,1 % (Sebagai HCL)
7 FITOMENADION ( vitamin K )
8 FUROSEMID 40 mg
9 GARAM ORALIT
10 GLIBENCLAMIDE
11 KAPTOPRIL
12 MAGNESIUM SULFAT 20%
13 METIL ERGOMETRIN MALEAT 200 mg - 1 ml
14 OBAT ANTI TUBERCULOSIS DEWASA
15 OKSITOSIN
16 PARASETAMOL 500 mg
17 TABLET TAMBAH DARAH
18 VAKSIN BCG
19 VAKSIN TT
20 VAKSIN DPT/DPT-HB/DPT-HB-Hib

CATATAN:
JIKA ADA TULIS 1
JIKA TIDAK ADA TULIS 0
Mengetahui :
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN
NAMA PUSKESMAS
PENANGGUNGJAWAB
ALAMAT
KABUPATEN
NO HP
BULAN
EMAIL
NO NAMA OBAT
1 ALBENDAZOL
2 AMOXICILLIN 500 mg
3 AMOXICILLIN 250mg
4 DEKSAMETHASONE
5 DIAZEPAM 5 mg/ml
6 EPINEPRIN(ADRENALIN) 0,1 % (Sebagai HCL)
7 FITOMENADION ( vitamin K )
8 FUROSEMID 40 mg
9 GARAM ORALIT
10 GLIBENCLAMIDE
11 KAPTOPRIL
12 MAGNESIUM SULFAT 20%
13 METIL ERGOMETRIN MALEAT 200 mg - 1 ml
14 OBAT ANTI TUBERCULOSIS DEWASA
15 OKSITOSIN
16 PARASETAMOL 500 mg
17 TABLET TAMBAH DARAH
18 VAKSIN BCG
19 VAKSIN TT
20 VAKSIN DPT/DPT-HB/DPT-HB-Hib

CATATAN:
JIKA ADA TULIS 1
JIKA TIDAK ADA TULIS 0
Mengetahui :
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN
NAMA PUSKESMAS
PENANGGUNGJAWAB
ALAMAT
KABUPATEN
NO HP
BULAN
EMAIL
NO NAMA OBAT
1 ALBENDAZOL
2 AMOXICILLIN 500 mg
3 AMOXICILLIN 250mg
4 DEKSAMETHASONE
5 DIAZEPAM 5 mg/ml
6 EPINEPRIN(ADRENALIN) 0,1 % (Sebagai HCL)
7 FITOMENADION ( vitamin K )
8 FUROSEMID 40 mg
9 GARAM ORALIT
10 GLIBENCLAMIDE
11 KAPTOPRIL
12 MAGNESIUM SULFAT 20%
13 METIL ERGOMETRIN MALEAT 200 mg - 1 ml
14 OBAT ANTI TUBERCULOSIS DEWASA
15 OKSITOSIN
16 PARASETAMOL 500 mg
17 TABLET TAMBAH DARAH
18 VAKSIN BCG
19 VAKSIN TT
20 VAKSIN DPT/DPT-HB/DPT-HB-Hib

CATATAN:
JIKA ADA TULIS 1
JIKA TIDAK ADA TULIS 0
Mengetahui :
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN
NAMA PUSKESMAS
PENANGGUNGJAWAB
ALAMAT
KABUPATEN
NO HP
BULAN
EMAIL
NO NAMA OBAT
1 ALBENDAZOL
2 AMOXICILLIN 500 mg
3 AMOXICILLIN 250mg
4 DEKSAMETHASONE
5 DIAZEPAM 5 mg/ml
6 EPINEPRIN(ADRENALIN) 0,1 % (Sebagai HCL)
7 FITOMENADION ( vitamin K )
8 FUROSEMID 40 mg
9 GARAM ORALIT
10 GLIBENCLAMIDE
11 KAPTOPRIL
12 MAGNESIUM SULFAT 20%
13 METIL ERGOMETRIN MALEAT 200 mg - 1 ml
14 OBAT ANTI TUBERCULOSIS DEWASA
15 OKSITOSIN
16 PARASETAMOL 500 mg
17 TABLET TAMBAH DARAH
18 VAKSIN BCG
19 VAKSIN TT
20 VAKSIN DPT/DPT-HB/DPT-HB-Hib

CATATAN:
JIKA ADA TULIS 1
JIKA TIDAK ADA TULIS 0
Mengetahui :
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
FORM PEMANTAUAN KETERSEDIAAN OBAT DAN VAKSIN
NAMA PUSKESMAS
PENANGGUNGJAWAB
ALAMAT
KABUPATEN
NO HP
BULAN
EMAIL
NO NAMA OBAT
1 ALBENDAZOL
2 AMOXICILLIN 500 mg
3 AMOXICILLIN 250mg
4 DEKSAMETHASONE
5 DIAZEPAM 5 mg/ml
6 EPINEPRIN(ADRENALIN) 0,1 % (Sebagai HCL)
7 FITOMENADION ( vitamin K )
8 FUROSEMID 40 mg
9 GARAM ORALIT
10 GLIBENCLAMIDE
11 KAPTOPRIL
12 MAGNESIUM SULFAT 20%
13 METIL ERGOMETRIN MALEAT 200 mg - 1 ml
14 OBAT ANTI TUBERCULOSIS DEWASA
15 OKSITOSIN
16 PARASETAMOL 500 mg
17 TABLET TAMBAH DARAH
18 VAKSIN BCG
19 VAKSIN TT
20 VAKSIN DPT/DPT-HB/DPT-HB-Hib

CATATAN:
JIKA ADA TULIS 1
JIKA TIDAK ADA TULIS 0
Mengetahui :
Kepala UPT Puskesmas Pasangkayu 1

Fatmawati, SKM
NIP : 19820619 200312 2 003
AN OBAT DAN VAKSIN DI PUSKESMAS
: PASANGKAYU
: Marwah
: JL. TRANS SULAWESI PASANGKAYU
: MAMUJU UTARA
: 082191919982
: JANUARI 2019
: aisyahmarwah62@gmail.com
KETERSEDIAAN
KET
ADA/TIDAK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

1
1
1

Pasangkayu, Februari 2019


Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.

Marwah
NIP : 19810523 200604 2 015

AN OBAT DAN VAKSIN DI PUSKESMAS


: PASANGKAYU
: Marwah
: JL. TRANS SULAWESI PASANGKAYU
: MAMUJU UTARA
: 082191919982
: FEBRUARI 2019
: aisyahmarwah62@gmail.com
KETERSEDIAAN
KET
ADA/TIDAK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Pasangkayu, Maret 2019
Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.

Marwah
NIP : 19810523 200604 2 015
AN OBAT DAN VAKSIN DI PUSKESMAS
: PASANGKAYU
: Marwah
: JL. TRANS SULAWESI PASANGKAYU
: MAMUJU UTARA
: 082191919982
: MARET 2019
: aisyahmarwah62@gmail.com
KETERSEDIAAN
KET
ADA/TIDAK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Pasangkayu, April 2019
Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.

Marwah
NIP : 19810523 200604 2 015
AN OBAT DAN VAKSIN DI PUSKESMAS
: PASANGKAYU
: Marwah
: JL. TRANS SULAWESI PASANGKAYU
: MAMUJU UTARA
: 082191919982
: APRIL 2019
: aisyahmarwah62@gmail.com
KETERSEDIAAN
KET
ADA/TIDAK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Pasangkayu, Mei 2019
Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.

Marwah
NIP : 19810523 200604 2 015
AN OBAT DAN VAKSIN DI PUSKESMAS
: PASANGKAYU
: Marwah
: JL. TRANS SULAWESI PASANGKAYU
: MAMUJU UTARA
: 082191919982
: MEI 2019
: aisyahmarwah62@gmail.com
KETERSEDIAAN
KET
ADA/TIDAK
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Pasangkayu, Juni 2019
Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.

Marwah
NIP : 19810523 200604 2 015
AN OBAT DAN VAKSIN DI PUSKESMAS
: PASANGKAYU 1
: Marwah
: JL. TRANS SULAWESI PASANGKAYU
: MAMUJU UTARA
: 082191919982
: JUNI 2019
: aisyahmarwah62@gmail.com
KETERSEDIAAN
KET
ADA/TIDAK
1
1
0
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
Pasangkayu, Juli 2019
Penanggung jawab Kefarmasian
UPT Puskesmas Pasangkayu 1

Marwah
NIP : 19810523 200604 2 015
Nama Puskesmas : PASANGKAYU
Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : JANUARI 2019

JUMLAH PENDERITA
NO NAMA PENYAKIT TOTAL
ANAK DEWASA

1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
JUMLAH 0 0 0

JMH KUNJUNGAN
JUMLAH KUNJUNGAN TOTAL
UMUM BPJS
KUNJUNGAN RESEP 0
KUNJUNGAN NON RESEP 0
TOTAL 0 0 0

Pasangkayu, Februari 2019


Mengetahui : Penanggung jawab Kefarmasian
Kepala UPTD Kesehatan Pasangkayu. UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : FEBRUARI 2019

JUMLAH PENDERITA
NO NAMA PENYAKIT TOTAL
ANAK DEWASA

1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
JUMLAH 0 0 0

JMH KUNJUNGAN
JUMLAH KUNJUNGAN TOTAL
UMUM BPJS
KUNJUNGAN RESEP 0
KUNJUNGAN NON RESEP 0
TOTAL 0 0 0

Pasangkayu, Maret 2019


Mengetahui : Penanggung jawab Kefarmasian
Kepala UPTD Kesehatan Pasangkayu. UPTD Kesehatan Pasangkayu.
Fatmawati, SKM Marwah
NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : MARET 2019

JUMLAH PENDERITA
NO NAMA PENYAKIT TOTAL
ANAK DEWASA

1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
JUMLAH 0 0 0

JMH KUNJUNGAN
JUMLAH KUNJUNGAN TOTAL
UMUM BPJS
KUNJUNGAN RESEP 0
KUNJUNGAN NON RESEP 0
TOTAL 0 0 0

Pasangkayu, April 2019


Mengetahui : Penanggung jawab Kefarmasian
Kepala UPTD Kesehatan Pasangkayu. UPTD Kesehatan Pasangkayu.
Fatmawati, SKM Marwah
NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : APRIL 2019

JUMLAH PENDERITA
NO NAMA PENYAKIT TOTAL
ANAK DEWASA

1 ISPA 34 26 60
2 HT 0 58 58
3 GASTRITIS 0 37 37
4 DERMATITITS 8 23 31
5 DISPEPSIA 0 31 31
6 OBS FEBRIS 12 11 23
7 DIARE 8 7 15
8 DM 0 14 14
9 HIPERURESEMIA 0 14 14
10 PERIODENTITIS 13 1 14
JUMLAH 75 222 297

JMH KUNJUNGAN
JUMLAH KUNJUNGAN TOTAL
UMUM BPJS
KUNJUNGAN RESEP 0
KUNJUNGAN NON RESEP 0
TOTAL 0 0 0

Pasangkayu,
Mengetahui : Penanggung jawab Kefarmasian
Kepala UPTD Kesehatan Pasangkayu. UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : MEI 2019

JUMLAH PENDERITA
NO NAMA PENYAKIT TOTAL
ANAK DEWASA

1
2
3
4
5
6
7
8
9
10
JUMLAH

JMH KUNJUNGAN
JUMLAH KUNJUNGAN TOTAL
UMUM BPJS
KUNJUNGAN RESEP 872
KUNJUNGAN NON RESEP
TOTAL 872
Pasangkayu, Juni 2019
Mengetahui : Penanggung jawab Kefarmasian
Kepala UPTD Kesehatan Pasangkayu. UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

Nama Puskesmas : PASANGKAYU 1


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : JUNI 2019

JUMLAH PENDERITA
NO NAMA PENYAKIT TOTAL
ANAK DEWASA

1 ISPA 83
2 HIPERTENSI 64
3 OBS FEBRIS 34
4 DISPEPSIA 33
5 HIPERKOLESTEROL 33
6 DERMATITIS 27
7 MIALGIA 23
8 DM 22
9 DIARE 20
10 CEFALGIA 19
JUMLAH

JMH KUNJUNGAN
JUMLAH KUNJUNGAN TOTAL
UMUM BPJS
KUNJUNGAN RESEP 845
KUNJUNGAN NON RESEP
TOTAL 845

Pasangkayu, Juli 2019


Mengetahui : Penanggung jawab Kefarmasian
Kepala UPT Puskesmas Pasangkayu 1 UPT Puskesmas Pasangkayu 1

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN INDIKATOR PERESEPAN DI PUSKESMAS

NAMA PUSKESMAS : PASANGKAYU


JENIS PUSKESMAS : BUKAN PERAWATAN
JUMLAH APOTEKER : 1 orang
JUMLAH AA/TTK : 0 orang
JUMLAH DOKTER : 1 (ORANG)
KAB/KOTA : MAMUJU UTARA
PROVINSI : SULAWESI BARAT

Bulan / Tahun : JANUARI 2019

% PENGGUNAAN % PENGGUNAAN % PENGGUNAAN RERATA ITEM/LEMBAR R


NO ANTIBIOTIK PADA ISPA ANTIBIOTIK PADA INJEKSI PADA
ISPA DIARE
NON-PNEUMONI DIARE NON SPESIFIK MYALGIA
1 2 3 4 5

1 0% 0% 0% 3 2.5

Pasangkayu, Februari 2019


Mengetahui, Petugas Pengelola Obat dan
Kepala UPTD Kesehatan Pasangkayu. Perbekalan Kesehatan UPTDK Puskesmas.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN INDIKATOR PERESEPAN DI PUSKESMAS

NAMA PUSKESMAS : PASANGKAYU


JENIS PUSKESMAS : BUKAN PERAWATAN
JUMLAH APOTEKER : 1 orang
JUMLAH AA/TTK : 0 orang
JUMLAH DOKTER : 1 (ORANG)
KAB/KOTA : MAMUJU UTARA
PROVINSI : SULAWESI BARAT

Bulan / Tahun : FEBRUARI 2019

% PENGGUNAAN % PENGGUNAAN % PENGGUNAAN RERATA ITEM/LEMBAR R


NO ANTIBIOTIK PADA ISPA ANTIBIOTIK PADA INJEKSI PADA
ISPA DIARE
NON-PNEUMONI DIARE NON SPESIFIK MYALGIA
1 2 3 4 5

1 0% 0% 0% 3 2

Pasangkayu, Maret 2019


Mengetahui, Petugas Pengelola Obat dan
Kepala UPTD Kesehatan Pasangkayu. Perbekalan Kesehatan UPTDK Puskesmas.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN INDIKATOR PERESEPAN DI PUSKESMAS

NAMA PUSKESMAS : PASANGKAYU


JENIS PUSKESMAS : BUKAN PERAWATAN
JUMLAH APOTEKER : 1 orang
JUMLAH AA/TTK : 0 orang
JUMLAH DOKTER : 1 (ORANG)
KAB/KOTA : MAMUJU UTARA
PROVINSI : SULAWESI BARAT

Bulan / Tahun : MARET 2019

% PENGGUNAAN % PENGGUNAAN % PENGGUNAAN RERATA ITEM/LEMBAR R


NO ANTIBIOTIK PADA ISPA ANTIBIOTIK PADA INJEKSI PADA
ISPA DIARE
NON-PNEUMONI DIARE NON SPESIFIK MYALGIA
1 2 3 4 5

1 0% 0% 0% 3 2

Pasangkayu, April 2019


Mengetahui, Petugas Pengelola Obat dan
Kepala UPTD Kesehatan Pasangkayu. Perbekalan Kesehatan UPTDK Puskesmas.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN INDIKATOR PERESEPAN DI PUSKESMAS

NAMA PUSKESMAS : PASANGKAYU


JENIS PUSKESMAS : BUKAN PERAWATAN
JUMLAH APOTEKER : 1 orang
JUMLAH AA/TTK : 0 orang
JUMLAH DOKTER : 1 (ORANG)
KAB/KOTA : MAMUJU UTARA
PROVINSI : SULAWESI BARAT

Bulan / Tahun : APRIL 2019

% PENGGUNAAN % PENGGUNAAN % PENGGUNAAN RERATA ITEM/LEMBAR R


NO ANTIBIOTIK PADA ISPA ANTIBIOTIK PADA INJEKSI PADA
ISPA DIARE
NON-PNEUMONI DIARE NON SPESIFIK MYALGIA
1 2 3 4 5

1 0% 0% 0% 3 0,5
Pasangkayu,
Mengetahui, Petugas Pengelola Obat dan
Kepala UPTD Kesehatan Pasangkayu. Perbekalan Kesehatan UPTDK Puskesmas.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

LAPORAN INDIKATOR PERESEPAN DI PUSKESMAS

NAMA PUSKESMAS : PASANGKAYU


JENIS PUSKESMAS : BUKAN PERAWATAN
JUMLAH APOTEKER : 1 orang
JUMLAH AA/TTK : 0 orang
JUMLAH DOKTER : 1 (ORANG)
KAB/KOTA : MAMUJU UTARA
PROVINSI : SULAWESI BARAT
Bulan / Tahun : MEI 2019

% PENGGUNAAN % PENGGUNAAN % PENGGUNAAN RERATA ITEM/LEMBAR R


NO ANTIBIOTIK PADA ISPA ANTIBIOTIK PADA INJEKSI PADA
ISPA DIARE
NON-PNEUMONI DIARE NON SPESIFIK MYALGIA
1 2 3 4 5

1 0% 0% 0% 2,4 3,4

Pasangkayu, Juni 2019


Mengetahui, Petugas Pengelola Obat dan
Kepala UPTD Kesehatan Pasangkayu. Perbekalan Kesehatan UPTDK Puskesmas.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN INDIKATOR PERESEPAN DI PUSKESMAS

NAMA PUSKESMAS : PASANGKAYU 1


JENIS PUSKESMAS : BUKAN PERAWATAN
JUMLAH APOTEKER : 1 orang
JUMLAH AA/TTK : 0 orang
JUMLAH DOKTER : 1 (ORANG)
KAB/KOTA : MAMUJU UTARA
PROVINSI : SULAWESI BARAT

Bulan / Tahun : JUNI 2019

% PENGGUNAAN % PENGGUNAAN % PENGGUNAAN RERATA ITEM/LEMBAR R


NO ANTIBIOTIK PADA ISPA ANTIBIOTIK PADA INJEKSI PADA
ISPA DIARE
NON-PNEUMONI DIARE NON SPESIFIK MYALGIA
1 2 3 4 5

1 0% 0% 0% 3,8 3,9

Pasangkayu, Juli 2019


Mengetahui, Penanggung jawab Kefarmasian
Kepala UPT Puskesmas Pasangkayu 1 UPT Puskesmas Pasangkayu 1

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
MAS

RERATA ITEM/LEMBAR RESEP

MYALGIA RATA-RATA

6 7

1 2.10
MAS

ARI 2019

RERATA ITEM/LEMBAR RESEP

MYALGIA RATA-RATA

6 7

1 2.00
MAS

RERATA ITEM/LEMBAR RESEP

MYALGIA RATA-RATA

6 7

1 2.00
MAS

RERATA ITEM/LEMBAR RESEP

MYALGIA RATA-RATA

6 7

1 2,1
MAS
RERATA ITEM/LEMBAR RESEP

MYALGIA RATA-RATA

6 7

2 2,6
MAS

RERATA ITEM/LEMBAR RESEP

MYALGIA RATA-RATA

6 7

2 3,2
LAPORAN PENGGUNAAN OBAT GENERIK DI PUSKESMAS
PADA DINAS KESEHATAN KABUPATEN MAMUJU UTARA

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : JANUARI 2019

R / OBAT
NO BULAN TOTAL LEMBAR RESEP Total R / Obat
Total / R
Generik
1 2 3 4 5
1 PUSKESMAS INDUK 407 1188 1163
2 2019 POSYANDU 0 0 0
3 PUSKEL 0 0 0
4 POSKESDES TARANJA 93 156 156
5 POSKESDES MARAMBEAU 131 238 209
6 POSKESDES TANJUNG 110 200 200

Pasangkayu, Februari 201

Kepala UPTD Kesehatan Pasangkayu Penanggung jawab Kefarmasian


UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN PENGGUNAAN OBAT GENERIK DI PUSKESMAS
PADA DINAS KESEHATAN KABUPATEN MAMUJU UTARA

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : FEBRUARI 2019

R / OBAT
NO BULAN TOTAL LEMBAR RESEP Total R / Obat
Total / R
Generik
1 2 3 4 5
1 PUSKESMAS INDUK 522 1349 1290
2 2019 POSYANDU 70 70 70
3 PUSKEL 30 30 30
4 POSKESDES TARANJA 77 156 150
5 POSKESDES MARAMBEAU 84 156 135
6 POSKESDES TANJUNG 95 236 230

Pasangkayu, Maret 2019

Kepala UPTD Kesehatan Pasangkayu Penanggung jawab Kefarmasian


UPTD Kesehatan Pasangkayu.
Fatmawati, SKM Marwah
NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

LAPORAN PENGGUNAAN OBAT GENERIK DI PUSKESMAS


PADA DINAS KESEHATAN KABUPATEN MAMUJU UTARA

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : MARET 2019
R / OBAT
NO BULAN TOTAL LEMBAR RESEP Total R / Obat
Total / R
Generik
1 2 3 4 5
1 MARET PUSKESMAS INDUK 451 1326 1299
2 2019 POSYANDU 75 75 75
3 PUSKEL 40 40 40
4 POSKESDES TARANJA 94 181 175
5 POSKESDES MARAMBEAU 107 192 180
6 POSKESDES TANJUNG 248 220 200

Pasangkayu, April 2019

Kepala UPTD Kesehatan Pasangkayu Penanggung jawab Kefarmasian


UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN PENGGUNAAN OBAT GENERIK DI PUSKESMAS
PADA DINAS KESEHATAN KABUPATEN MAMUJU UTARA

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : APRIL 2019

R / OBAT
NO BULAN TOTAL LEMBAR RESEP Total R / Obat
Total / R
Generik
1 2 3 4 5
1 APRIL 2019 PUSKESMAS INDUK 409 1225 1209
2 POSYANDU 80 80 80
3 PUSKEL 50 50 50
4 POSKESDES TARANJA 95 169 165
5 POSKESDES MARAMBEAU 108 214 188
6 POSKESDES TANJUNG 164 152 152

Pasangkayu, April 2019

Kepala UPTD Kesehatan Pasangkayu Penanggung jawab Kefarmasian


UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
LAPORAN PENGGUNAAN OBAT GENERIK DI PUSKESMAS
PADA DINAS KESEHATAN KABUPATEN MAMUJU UTARA

Nama Puskesmas : PASANGKAYU


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : MEI 2019

R / OBAT
NO BULAN TOTAL LEMBAR RESEP Total R / Obat
Total / R
Generik
1 2 3 4 5
1 MEI 2019 PUSKESMAS INDUK 432 1227 1214
2 POSYANDU 70 70 70
3 PUSKEL 0 0 0
4 POSKESDES TARANJA 95 169 169
5 POSKESDES MARAMBEAU 90 149 140
6 POSKESDES TANJUNG 185 162 162
872
Pasangkayu, Juni 2019

Kepala UPTD Kesehatan Pasangkayu Penanggung jawab Kefarmasian


UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

LAPORAN PENGGUNAAN OBAT GENERIK DI PUSKESMAS


PADA DINAS KESEHATAN KABUPATEN MAMUJU UTARA

Nama Puskesmas : PASANGKAYU 1


Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : JUNI 2019

R / OBAT
NO BULAN TOTAL LEMBAR RESEP Total R / Obat
Total / R
Generik
1 2 3 4 5
1 JUNI 2019 PUSKESMAS INDUK 425 1180 1163
2 POSYANDU 90 90 90
3 PUSKEL 20 45 45
4 POSKESDES TARANJA 38 77 77
5 POSKESDES MARAMBEAU 86 169 155
6 POSKESDES TANJUNG 186 250 245
845

Pasangkayu, Juli 2019

Kepala UPT Puskesmas Pasangkayu 1 Penanggung jawab Kefarma


UPT Puskesmas Pasangka

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
USKESMAS
JU UTARA

/ OBAT
%R / Obat Keterangan
Generik
6 = 5/4X100 7
98
0
0
100
88
100

gkayu, Februari 2019

gung jawab Kefarmasian


Kesehatan Pasangkayu.

9810523 200604 2 015


USKESMAS
JU UTARA

/ OBAT
%R / Obat Keterangan
Generik
6 = 5/4X100 7
96
100
100
96
87
97

gkayu, Maret 2019

gung jawab Kefarmasian


Kesehatan Pasangkayu.
9810523 200604 2 015

USKESMAS
JU UTARA
/ OBAT
%R / Obat Keterangan
Generik
6 = 5/4X100 7
98
100
100
97
94 42 65 107
91

gkayu, April 2019

gung jawab Kefarmasian


Kesehatan Pasangkayu.

9810523 200604 2 015


USKESMAS
JU UTARA

/ OBAT
%R / Obat Keterangan
Generik
6 = 5/4X100 7
99
100
100
98
88
100

gkayu, April 2019

gung jawab Kefarmasian


Kesehatan Pasangkayu.

9810523 200604 2 015


USKESMAS
JU UTARA

/ OBAT
%R / Obat Keterangan
Generik
6 = 5/4X100 7
99
100
#DIV/0!
100
94
100
gkayu, Juni 2019

gung jawab Kefarmasian


Kesehatan Pasangkayu.

9810523 200604 2 015

USKESMAS
JU UTARA
/ OBAT
%R / Obat Keterangan
Generik
6 = 5/4X100 7
99
100
100
100
92
98

gkayu, Juli 2019

ggung jawab Kefarmasian


Puskesmas Pasangkayu 1

9810523 200604 2 015


KERTAS KERJA PELAYANAN KEFARMASIAN DI PUSKESMAS
Nama Puskesmas : PASANGKAYU
Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : JANUARI 2019
Jumlah Resep
Tanggal Rawat Inap Konseling Informasi Obat
Rawat Jalan
1 3
2 7 7
3 28 5 28
4 17 5 17
5 12 5 12
6 5
7 22 22
8 27 4 27
9 10 10
10 16 4 16
11 19 4 19
12 15 4 15
13 4
14 14 4 14
15 14 4 14
16 11 11
17 15 3 15
18 9 5 9
19 8 4 8
20 4
21 18 5 18
22 20 5 20
23 11 11
24 16 16
25 18 18
26 10 4 10
27 4
28 23 4 23
29 13 4 13
30 19 19
31 15 7 15
TOTAL 407 0 100 407
Mengetahui : Pasangkayu, Februari 2019
Kepala UPTD Kesehatan Pasangkayu. Penanggung jawab kefarmasian
UPTD Kesehatan Pasangkayu.
Fatmawati, SKM Marwah
NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

KERTAS KERJA PELAYANAN KEFARMASIAN DI PUSKESMAS


Nama Puskesmas : PASANGKAYU
Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : FEBRUARI 2019
Jumlah Resep
Tanggal Rawat Inap Konseling Informasi Obat
Rawat Jalan
1 12 0 3 12
2 16 2 16
3
4 27 0 3 27
5
6 13 0 3 13
7 17 0 3 17
8 15 0 3 15
9 13 0 3 13
10
11 27 0 4 27
12 31 0 3 31
13 12 0 3 12
14 27 0 3 27
15 13 0 3 13
16 9 0 3 9
17
18 30 0 5 30
19 29 0 4 29
20 10 0 5 10
21 29 0 5 29
22 30 0 5 30
23 24 0 6 24
24
25 45 0 4 45
26 31 0 5 31
27 24 0 6 24
28 38 0 3 38
29
30
31
TOTAL 522 0 87 522
Mengetahui : Pasangkayu, Maret 2019
Kepala UPTD Kesehatan Pasangkayu. Penanggung jawab kefarmasian
UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

KERTAS KERJA PELAYANAN KEFARMASIAN DI PUSKESMAS


Nama Puskesmas : PASANGKAYU 1
Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : MARET 2019
Jumlah Resep
Tanggal Rawat Inap Konseling Informasi Obat
Rawat Jalan
1 19 4 19 3
2 23 5 23 2
3
4 25 4 25 4
5 27 4 27 7
6 19 4 19 3
7
8 24 6 24 5
9 13 6 13 4
10
11 16 5 16 2
12 18 7 18 1
13 17 5 17 1
14 17 5 17 3
15 20 4 20 2
16 8 4 8
17
18 18 4 18 3
19 14 4 14 3
20 25 4 25 2
21 19 5 19 4
22 13 4 13
23 12 5 12 3
24
25 32 3 32 3
26 18 6 18 3
27 15 3 15 4
28 11 6 11 1
29 14 3 14 2
30 14 3 14 2
31
TOTAL 451 0 113 451 67
Mengetahui : Pasangkayu, April 2019
Kepala UPTD Kesehatan Pasangkayu. Penanggung jawab kefarmasian
UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

KERTAS KERJA PELAYANAN KEFARMASIAN DI PUSKESMAS


Nama Puskesmas : PASANGKAYU 1
Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : APRIL 2019
Jumlah Resep
Tanggal Rawat Inap Konseling Informasi Obat pulv
Rawat Jalan
1 25 4 25 3
2 30 5 30 2
3
4 17 4 17 2
5 22 4 22 4
6 15 4 15 3
7
8 17 3 17 1
9 21 6 21
10 5 6 5
11 18 5 18 2
12 17 4 17 5
13 15 4 15
14
15 40 5 40 2
16 19 5 19 2
17 7 4 7
18 9 4 9 1
19
20 21 3 21
21
22 23 3 23 2
23 17 3 17 3
24 8 6 8 2
25 10 6 10 1
26 8 6 8 1
27 13 3 13 1
28
29 19 3 19 1
30 13 4 13 2
31
TOTAL 409 0 104 409 40
Mengetahui : Pasangkayu, April 2019
Kepala UPTD Kesehatan Pasangkayu. Penanggung jawab kefarmasian
UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

KERTAS KERJA PELAYANAN KEFARMASIAN DI PUSKESMAS


Nama Puskesmas : PASANGKAYU 1
Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : MEI 2019
Jumlah Resep
Tanggal Rawat Inap Konseling Informasi Obat
Rawat Jalan
1
2 16 0 5 16
3 16 0 4 16
4 19 0 4 19
5
6 18 0 4 18
7 15 0 3 15
8 18 0 3 18
9 24 0 6 24
10 6 0 4 6
11 21 0 4 21
12
13 22 0 4 22
14 19 0 3 19
15 24 0 3 24
16 14 0 3 14
17 14 0 3 14
18 18 0 2 18
19 26 0 5 26
20
21 21 0 5 21
22 24 0 5 24
23 11 0 3 11
24 14 0 3 14
25 20 0 3 20
26
27 11 0 3 11
28 10 0 3 10
29 11 0 4 11
30
31 20 0 5 20
TOTAL 432 94 432
Mengetahui : Pasangkayu, Juni 2019
Kepala UPTD Kesehatan Pasangkayu. Penanggung jawab kefarmasian
UPTD Kesehatan Pasangkayu.

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015

KERTAS KERJA PELAYANAN KEFARMASIAN DI PUSKESMAS


Nama Puskesmas : PASANGKAYU 1
Jenis Puskesmas : NON PERAWATAN
Kabupaten / Kota : MAMUJU UTARA
Provinsi : SULAWESI BARAT
Laporan Bulan / Tahun : JUNI 2019
Jumlah Resep
Tanggal Rawat Inap Konseling Informasi Obat
Rawat Jalan
1
2
3
4
5
6
7
8
9
10 38 5 38
11 28 6 28
12 15 7 15
13 15 6 15
14 28 6 28
15 12 6 12
16
17 29 4 29
18 29 5 29
19 27 5 27
20 28 5 28
21 17 5 17
22 12 7 12
23
24 28 7 28
25 28 7 28
26 19 6 19
27 42 5 42
28 20 5 20
29 10 5 10
30
31
TOTAL 425 102 425
Mengetahui : Pasangkayu, Juli 2019
Kepala UPT Puskesmas Pasangkayu 1 Penanggung jawab Kefarmasian
UPT Puskesmas Pasangkayu 1

Fatmawati, SKM Marwah


NIP : 19820619 200312 2 003 NIP : 19810523 200604 2 015
2 5 12 12
4 24 82 82
5 12 43 40
3 9 40 40

4 18 62 60
5 22 81 81
2 8 26 26
4 12 50 50
3 16 53 50
3 12 49 49

4 10 47 47
14 26 26
3 8 39 39
15 43 43
9 31 31
8 22 22

18 50 50
2 18 58 55
3 8 34 34
2 14 51 50
2 16 63 60
2 8 27 27
4 19 55 50

1 12 34 34
5 14 65 60
15 45 45
63 344 407 1188 1163 2351
bruari 2019
3 9 12 28 28
16 16 50 48

4 23 27 75 70

13 13 35 35
2 15 17 40 40
15 15 44 44
4 9 13 34 33

5 22 27 57 55
3 28 31 56 55
1 11 12 28 28
1 26 27 58 55
3 10 13 36 34
2 7 9 25 23

6 24 30 74 70
1 28 29 81 75
10 10 25 25
5 24 29 77 70
1 29 30 74 69
1 23 24 67 65

5 40 45 140 135
5 26 31 80 75
5 19 24 60 58
6 32 38 105 100
63 459 522 1349 1290
Maret 2019

3 16 19 53 53
1 22 23 55 53

7 18 25 75 70
7 20 27 89 85
2 17 19 63 60

4 20 24 66 64
3 10 13 32 30

2 14 16 49 47
1 17 18 46 46
4 13 17 55 55
1 16 17 47 47
1 19 20 58 58
8 8 23 23

2 16 18 58 58
4 10 14 50 50
5 20 25 74 70
2 17 19 53 50
13 13 38 38
12 12 31 31
6 26 32 99 99
2 16 18 62 62
1 14 15 37 37
1 10 11 35 35
2 12 14 36 36
2 12 14 42 42
63 388 451 1326 1299

pril 2019

2 23 25 89 89
9 21 30 60 60

4 13 17 55 55
5 17 22 69 60
2 13 15 48 48

4 13 17 65 60
1 20 21 69 65
1 4 5 3 13
2 16 18 60 58
3 14 17 39 39
4 11 15 36 35

4 36 40 130 125
2 17 19 60 60
7 7 20 20
9 9 39 39
1 20 21 64 64

3 20 23 73 73
3 14 17 46 46
1 7 8 22 22
1 9 10 27 27
1 7 8 25 25
1 12 13 46 46

1 18 19 50 50
0 13 13 30 30

1225 1209
pril 2019

PULV U JKN JML

1 1 15 16 56 55
1 15 16 45 40
2 2 17 19 46 46

2 4 14 18 46 46
3 1 14 15 37 37
4 3 15 18 48 48
3 5 19 24 66 66
1 6 6 15 15
1 4 17 21 59 59
3 1 21 22 54 53
2 17 19 57 57
8 2 22 24 70 68
3 4 10 14 40 40
1 3 11 14 40 40
1 3 15 18 72 72
2 7 19 26 79 79

1 3 18 21 57 57
3 3 21 24 69 69
2 9 11 35 35
3 11 14 39 39
5 5 15 20 49 49

4 4 7 11 34 34
3 7 10 25 25
1 1 10 11 40 36

3 1 19 20 49 49
52 1227 1214
uni 2019 380
5 4 34 38 107 105
4 4 24 28 75 75
3 15 15 35 35
2 1 14 15 48 47
8 5 23 28 60 60
1 11 12 42 42

2 6 23 29 78 77
3 7 22 29 83 80
4 5 22 27 67 65
2 4 24 28 80 80
1 3 14 17 50 50
3 3 9 12 35 35

4 1 27 28 82 81
2 7 21 28 88 85
1 5 14 19 48 47
4 3 39 42 118 115
2 3 17 20 58 58
3 2 8 10 26 26
1180 1163

uli 2019
ab Kefarmasian
s Pasangkayu 1
LAPORAN NARKOTIKA / PSIKOTROPIKA

BULAN / TAHUN : JANUARI 2019


NAMA PUSKESMAS : PASANGKAYU
KECAMATAN : PASANGKAYU
KAB / KODYA : MAMUJU UTARA

PENANGGUNG SALDO
NO NAMA OBAT TGL EXP SATUAN
JAWAB AWAL

1. Marwah AMITIPHILIN 25 mg TABLET 390

2 Marwah CARBAMAZEPINE 200 mg Maret 2018 TABLET 0

2 Marwah DIAZEPAM 2 mg TABLET 390

3 Marwah DIAZEPAM (STESOLID)10 mg Juli 2020 AMPUL 14

Marwah PHENOBARBITAL 30 mg TABLET 0


4

Marwah PHENOBARBITAL INJ 50 mg/ML AMPUL 0


5

6 Marwah HALOPERIDOL 5 mg TABLET 0


6 Marwah HALOPERIDOL 5 mg TABLET 0

7 Marwah HALOPERIDOL 0,5 mg Juni 2020 TABLET 0

8 Marwah HALOPERIDOL 1,5 mg Juni 2019 TABLET 0

9 Marwah HALOPERIDOL inj Januari 2020 TABLET 0

10 Marwah CODEIN TABLET 0

11 Marwah CLORPROMAZINE 25 mg Apr-18 TABLET 0

12 Marwah CLORPROMAZINE 100 mg Mei 2020 TABLET 260

13 Marwah CLORPROMAZINE inj 25mg/ml AMPUL 0

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
LAPORAN NARKOTIKA / PSIKOTROPIKA

BULAN / TAHUN : FEBRUARI 2019


NAMA PUSKESMAS : PASANGKAYU
KECAMATAN : PASANGKAYU
KAB / KODYA : MAMUJU UTARA

PENANGGUNG SALDO
NO NAMA OBAT TGL EXP SATUAN
JAWAB AWAL
1. Marwah AMITIPHILIN 25 mg TABLET 385

2 Marwah CARBAMAZEPINE 200 mg Maret 2018 TABLET 0

2 Marwah DIAZEPAM 2 mg TABLET 354

3 Marwah DIAZEPAM (STESOLID)10 mg Juli 2020 AMPUL 14

Marwah PHENOBARBITAL 30 mg TABLET 0


4
Marwah PHENOBARBITAL 30 mg TABLET 0
4

Marwah PHENOBARBITAL INJ 50 mg/ML AMPUL 0


5

6 Marwah HALOPERIDOL 5 mg TABLET 0

7 Marwah HALOPERIDOL 0,5 mg Juni 2020 TABLET 0

8 Marwah HALOPERIDOL 1,5 mg Juni 2019 TABLET 0

9 Marwah HALOPERIDOL inj Januari 2020 TABLET 0

10 Marwah CODEIN TABLET 0

11 Marwah CLORPROMAZINE 25 mg TABLET 0

12 Marwah CLORPROMAZINE 100 mg Mei 2020 TABLET 260

13 Marwah CLORPROMAZINE inj 25mg/ml AMPUL 0

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.
Fatmawati, SKM
NIP : 19820619 200312 2 003
LAPORAN NARKOTIKA / PSIKOTROPIKA

BULAN / TAHUN : MARET 2019


NAMA PUSKESMAS : PASANGKAYU
KECAMATAN : PASANGKAYU
KAB / KODYA : MAMUJU UTARA
PENANGGUNG SALDO
NO NAMA OBAT TGL EXP SATUAN
JAWAB AWAL
1. Marwah AMITIPHILIN 25 mg TABLET 381

2 Marwah CARBAMAZEPINE 200 mg Maret 2018 TABLET 0

2 Marwah DIAZEPAM 2 mg okt 2019 TABLET 256

3 Marwah DIAZEPAM (STESOLID)10 mg Juli 2020 AMPUL 14

Marwah PHENOBARBITAL 30 mg TABLET 0


4

Marwah PHENOBARBITAL INJ 50 mg/ML AMPUL 0


5

6 Marwah HALOPERIDOL 5 mg TABLET 0


7 Marwah HALOPERIDOL 0,5 mg TABLET 200

8 Marwah HALOPERIDOL 1,5 mg TABLET 200

9 Marwah HALOPERIDOL inj TABLET 0

10 Marwah CODEIN TABLET 0

11 Marwah CLORPROMAZINE 25 mg TABLET 0

12 Marwah CLORPROMAZINE 100 mg Mei 2020 TABLET 250

13 Marwah CLORPROMAZINE inj 25mg/ml AMPUL 0

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.
Fatmawati, SKM
NIP : 19820619 200312 2 003
LAPORAN NARKOTIKA / PSIKOTROPIKA

BULAN / TAHUN : APRIL 2019


NAMA PUSKESMAS : PASANGKAYU
KECAMATAN : PASANGKAYU
KAB / KODYA : MAMUJU UTARA
PENANGGUNG SALDO
NO NAMA OBAT TGL EXP SATUAN
JAWAB AWAL
1. Marwah AMITIPHILIN 25 mg TABLET 381

2 Marwah CARBAMAZEPINE 200 mg Maret 2018 TABLET 0

2 Marwah DIAZEPAM 2 mg okt 2019 TABLET 205

3 Marwah DIAZEPAM (STESOLID)10 mg Juli 2020 AMPUL 14

Marwah PHENOBARBITAL 30 mg TABLET 0


4

Marwah PHENOBARBITAL INJ 50 mg/ML AMPUL 0


5

6 Marwah HALOPERIDOL 5 mg TABLET 0


7 Marwah HALOPERIDOL 0,5 mg TABLET 110

8 Marwah HALOPERIDOL 1,5 mg TABLET 60

9 Marwah HALOPERIDOL inj TABLET 0

10 Marwah CODEIN TABLET 0

11 Marwah CLORPROMAZINE 25 mg TABLET 0

12 Marwah CLORPROMAZINE 100 mg Mei 2020 TABLET 140

13 Marwah CLORPROMAZINE inj 25mg/ml AMPUL 0

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.
Fatmawati, SKM
NIP : 19820619 200312 2 003
LAPORAN NARKOTIKA / PSIKOTROPIKA

BULAN / TAHUN : MEI 2019


NAMA PUSKESMAS : PASANGKAYU
KECAMATAN : PASANGKAYU
KAB / KODYA : MAMUJU UTARA
PENANGGUNG SALDO
NO NAMA OBAT TGL EXP SATUAN
JAWAB AWAL
1. Marwah AMITIPHILIN 25 mg TABLET 361

2 Marwah CARBAMAZEPINE 200 mg Maret 2018 TABLET 0

3 Marwah DIAZEPAM 2 mg okt 2019 TABLET 156

4 Marwah DIAZEPAM (STESOLID)10 mg Juli 2020 AMPUL 14

Marwah PHENOBARBITAL 30 mg TABLET 0


5

Marwah PHENOBARBITAL INJ 50 mg/ML AMPUL 0


6

7 Marwah HALOPERIDOL 5 mg TABLET 0


8 Marwah HALOPERIDOL 0,5 mg TABLET 110

9 Marwah HALOPERIDOL 1,5 mg TABLET 30

10 Marwah HALOPERIDOL inj TABLET 0

11 Marwah CODEIN TABLET 0

12 Marwah CLORPROMAZINE 25 mg TABLET 0

13 Marwah CLORPROMAZINE 100 mg Mei 2020 TABLET 0

14 Marwah CLORPROMAZINE inj 25mg/ml AMPUL 0

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.
Fatmawati, SKM
NIP : 19820619 200312 2 003

LAPORAN NARKOTIKA / PSIKOTROPIKA

BULAN / TAHUN : JUNI 2019


NAMA PUSKESMAS : PASANGKAYU 1
KECAMATAN : PASANGKAYU
KAB / KODYA : MAMUJU UTARA
PENANGGUNG SALDO
NO NAMA OBAT TGL EXP SATUAN
JAWAB AWAL
1. Marwah AMITIPHILIN 25 mg TABLET 200

2 Marwah CARBAMAZEPINE 200 mg TABLET 0

3 Marwah DIAZEPAM 2 mg okt 2019 TABLET 246

4 Marwah DIAZEPAM (STESOLID)10 mg Juli 2020 AMPUL 14


Marwah PHENOBARBITAL 30 mg TABLET 0
5

Marwah PHENOBARBITAL INJ 50 mg/ML AMPUL 0


6

7 Marwah HALOPERIDOL 5 mg TABLET 0

8 Marwah HALOPERIDOL 0,5 mg TABLET 580

9 Marwah HALOPERIDOL 1,5 mg TABLET 30

10 Marwah HALOPERIDOL inj TABLET 0

11 Marwah CODEIN TABLET 0

12 Marwah CLORPROMAZINE 25 mg TABLET 0

13 Marwah CLORPROMAZINE 100 mg Mei 2020 TABLET 0

14 Marwah CLORPROMAZINE inj 25mg/ml AMPUL 0


14 Marwah TRIHEXYPHENIDYL 2 MG TABLET 0

Mengetahui
Kepala UPT Puskesmas Pasangkayu 1

Fatmawati, SKM
NIP : 19820619 200312 2 003
A / PSIKOTROPIKA

PEMASUKAN PENGGUNAAN TOTAL EXP SALDO


PERSEDIAAN
DARI JMH UNTUK JMH PENGGUNAAN AKHIR

390 ACO 5 5 385

0 0

HENIK 5
SUIANI 5
CAHAYA 10
390 36 354
NIMALA 5
MAHUMA 5
HANIMA 6

14 14

0 0

0 0

0 0
0 0

0 0

0 0

0 0

0 0

0 0

260 260

0 0

Pasangkayu, Februari 2019


Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.

Marwah
NIP : 19810523 200604 2 015
A / PSIKOTROPIKA

PEMASUKAN PENGGUNAAN TOTAL EXP SALDO


PERSEDIAAN
DARI JMH UNTUK JMH PENGGUNAAN AKHIR
385 ACO 4 4 381

0 0
AKAS 10
TABANG 3
NUJANA 20
MAHUMA 10
354 98 256
AIK 20
SYAMSUDDIN 10
SULTAN 5
KIFLI 10
SAMAN 10

14 0 14

0 0
0 0

0 0

0 0

DAK 2018 200 200 200

DAK 2018 200 200 200

0 0

0 0

0 0

KIFLI 10
260 10 250

0 0

Pasangkayu, Maret 2019


Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.
Marwah
NIP : 19810523 200604 2 015
A / PSIKOTROPIKA

PEMASUKAN PENGGUNAAN TOTAL EXP SALDO


PERSEDIAAN
DARI JMH UNTUK JMH PENGGUNAAN AKHIR
381 381

0 0
hasna 5
salwa 3
aidah 20
256 asli 10 51 205
jamal 5
ahman 6
akila 2

14 0 14

0 0

0 0

0 0
200
kifli 60
90 110
pedda 30
kifli 30
kifli 60
pedda 10
200 140 60
pedda 10
ami 10
mumina 20
0 0

0 0

0 0

kifli 30
pedda 10
250 pedda 10 110 140
kifli 50
ami 10
0 0

Pasangkayu, April 2019


Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.
Marwah
NIP : 19810523 200604 2 015
A / PSIKOTROPIKA

PEMASUKAN PENGGUNAAN TOTAL EXP SALDO


PERSEDIAAN
DARI JMH UNTUK JMH PENGGUNAAN AKHIR
381 UDIN 20 20 361

0 0
mida 15
bayu 20
mahuma 10
205 ahman 3 49 156
bayu 1

14
0 14
0
0
0
0
0
0
110 0 110

dian 30

60 30 30

0
0
0
0
0
0

kifli 60
pedda 50
140 diana 30 140 0

0
0

Pasangkayu, April 2019


Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.
Marwah
NIP : 19810523 200604 2 015
A / PSIKOTROPIKA

PEMASUKAN PENGGUNAAN TOTAL EXP SALDO


PERSEDIAAN
DARI JMH UNTUK JMH PENGGUNAAN AKHIR
DAK 2018 200 561 361 200

0 0
BAYU 10

DAKL2018 100 256 10 246

14 14

0
DIAN 30
DAK 2018 500 610 30 580

30 30

Pasangkayu, Juni 2019


Penanggung jawab Kefarmasian
UPTD Kesehatan Pasangkayu.
Marwah
NIP : 19810523 200604 2 015

A / PSIKOTROPIKA

PEMASUKAN PENGGUNAAN TOTAL EXP SALDO


PERSEDIAAN
DARI JMH UNTUK JMH PENGGUNAAN AKHIR
DAK 2018 200 400 400

0 0
DIANA 10
BASO 5
MUKSAN 10
246 ABD AHMAN 6 33 213
DESITA 2

14 14
0

DIANA 10
DAK 2018 400 980 40 940
MUMINA 30

30 30

0
LAIN-LAIN 400 400 400

Pasangkayu, Juli 2019


Penanggung jawab Kefarmasian
UPT Puskesmas Pasangkayu 1

Marwah
NIP : 19810523 200604 2 015
: 0101
PUSKESMAS : PASANGKAYU 1
KECAMATAN : PASANGKAYU
KAB./KODYA : PASANGKAYU
PROVINSI : SULAWESI BARAT
HAL 1BULAN : JANUARI 2019
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
1 Abocat 18 PCS Rp 8,750.00 2016 0
2 Abocat 18 PCS Rp 8,575.00 DAK 2016 46
3 Abocat 20 PCS Rp 16,249.99 2015 0
4 Abocat 20 PCS Rp 8,750.00 2016 0
5 Abocat 20 PCS Rp 8,575.00 DAK 2016 32
6 Abocat 22 PCS Rp 8,750.00 2016 51
7 Abocat 22 PCS Rp 8,575.00 DAK 2016 4
8 Abocat 24 PCS Rp 8,750.00 2016 85
9 Abocat 26 PCS Rp 27,134.00 DAK 2018 96
10 Acetosal TAB Rp 127.00 2015 0
11 Acyclovir 200 mg TAB Rp 251.00 2014 20

12 Acyclovir 400 mg TAB Rp 362.00 2015 0


13 Acyclovir 400 mg TAB Rp 630.50 2017 385

14 Alat suntik sekali pakai 0,5 ml PCS Rp 1,655.50 DAK 2016 90


15 Alat suntik sekali pakai 1 ml PCS Rp 1,540.00 2015 0
16 Alat suntik sekali pakai 1 ml PCS Rp 1,694.00 2016 87
17 Alat suntik sekali pakai 1 ml (AXIME PCS Rp 913.00 DAK 2018 500
18 Alat suntik sekali pakai 2.5 ml PCS Rp 1,141.80 2013 0
19 Alat suntik sekali pakai 3 ml PCS Rp 968.00 2016 34
20 Alat suntik sekali pakai 3 ml PCS Rp 2,119.00 DAK 2018 500

21 Alat suntik sekali pakai 5 ml PCS Rp 1,348.00 2013 0


22 Alat suntik sekali pakai 5 ml PCS Rp 861.30 2017 237

23 Albendazol SYR Rp 4,234.00 2016 0


24 Albendazol tablet 400 mg TAB Rp 363.00 2016 625
25 Albendazol tablet 400 mg TAB Rp 266.80 APBN 2017
26 Alginat BOT Rp 239,525.00 2017 1
27 Aroma fine normal (Alginat aroma bks Rp 192,000.00 dak 2017
28 Alkohol 100 ml BOT Rp 2,625.00 2016 53
29 Alkohol 1000 ml BOT Rp 25,800.00 2016 0
30 Alkohol Swab pcs Rp 245.00 2016 0
31 Alkohol Swab pcs Rp 242.00 2017 349

32 Alopurinol tablet 100 mg TAB Rp 96.00 BUFFER 0


33 Alopurinol tablet 100 mg TAB Rp 90.00 2015 0
34 Alopurinol tablet 100 mg TAB Rp 96.00 2017 0
35 Alopurinol tablet 100 mg TAB Rp 96.00 DAK 2017 2065
36 Alopurinol tablet 300 mg TAB Rp 249.00 DAK 2017 800
37 Ambroxol SYR BOT Rp 6,512.30 DAK 2018 1
38 Ambroxol 30 mg TAB Rp 242.00 DAK 2018 951
39 Aminofilin INJ 24 mg/ml - 10 ml AMP Rp 4,200.00 2015 30
40 Aminofilin tablet 200 mg TAB Rp 86.00 2015 0
41 Amitripilin 25 mg TAB Rp 123.00 2015 390

42 Amlodipin 10 mg TAB Rp 168.00 2016 0


43 Amlodipin 10 mg TAB Rp 279.13 DAK 2018 1800

44 Amlodipin 5 mg (HEXAVASK) TAB Rp 197.00 2015 0


45 Amlodipin 5 mg (HEXAVASK) TAB Rp 1,050.00 2017 0
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
46 Amoksisilin 500 mg TAB Rp 279.00 2013 590
47 Amoksisilin 500 mg TAB Rp 279.00 2016 410
48 Amoksisilin 500 mg TAB Rp 239.00 DAK 2017
49 Amoksisilin 250 mg CAP Rp 220.00 2014 0
50 Amoksisilin SYR 125 mg/5 ml BOT Rp 2,560.00 2014 0
51 Amoksisilin SYR 125 mg/5 ml BOT Rp 8,900.00 DAK 2018 0
52 Amoksisilin SYR 125 mg/5 ml (SOL BOT Rp 8,900.00 DAK 2018 38
53 Amoksisilin SYR 125 mg/5 ml (YUSI BOT Rp 4,466.00 DAK 2018
54 Amoksisilin SYR 250 mg/5 ml BOT Rp 4,655.00 2017 0
55 Amoksisilin SYR 250 mg/5 ml BOT Rp 3,740.00 DAK 2018 61
56 Amoksisilin DROPS (SUPRAMOX) BOT Rp 28,500.00 DAK 2018 24
57 Ampisilin INJ AMP Rp 5,610.00 2015 0
58 Antalgin (metampiron) 500 mg TAB Rp 385.00 DAK 2016 1899
59 Antalgin (metamizole sodium 500 m TAB Rp 385.00 DAK 2016 625
60 Antasida SYR Rp 2,135.00 2015 9
61 Antasida SYR Rp 2,135.00 DAK 2016 69
62 Antasida SYR Rp 2,146.00 DAK 2018
63 Antasida doen tablet kombinasi TAB Rp 78.00 2015 0
64 Antasida doen tablet kombinasi 400 TAB Rp 72.00 2017 2529

65 Anti Hemoroid SUPP Rp 2,200.00 2016 20

66 Aqua dest steril VIAL Rp 2,750.00 2017 0


67 As. Mefenamat TAB Rp 119.00 2014 0
68 As. Mefenamat TAB Rp 119.00 2016 0
69 As. Mefenamat TAB Rp 117.00 2017 0
70 As. Mefenamat (BIRU) TAB Rp 176.00 2017 0
71 As. Mefenamat 500 mg TAB Rp 119.00 APBD 2018 2437
72 As. Mefenamat 500 mg TAB Rp 119.00 APBD 2019

73 Asam folat (AFOLAT) TAB Rp 52.00 2016 0


74 Asam folat (Profolat) TAB Rp 64.00 DAK 2018 2040
75 ASEPTIC GEL BTL Rp 1,581.25 2017 0
76 Atenolol (FARNORMIN) TAB Rp 387.00 2015 0
77 Atenolol (FARNORMIN) TAB Rp 342.00 DAK 2017 500
78 Atropin sulfat INJ 0.25 mg/ml - 1ml AMP Rp 1,400.00 2016 89
79 Atropin sulfat tab 0,5 mg TAB Rp 81.00 2016 0
80 Attapulgit TAB Rp 220.00 2016 2000
81 Attapulgit TAB Rp 196.00 2017 739
82 Attapulgit (ARCAPEC) SYR Rp 1,581.25 2017 19
83 ABATE SCT Rp 6,380.00 DAK 2018 250 1000

84 Bactivec (abate) BOT BS 0


85 Bacitracin polymixin TUBE Rp 2,767.00 2015 0
86 Bacitracin polymixin TUBE Rp 3,511.00 2017 17

87 Betahistin TAB Rp 1,062.60 2016 0


88 Betahistin TAB Rp 177.00 2017 240
89 Betametason SALP 0.1 % TUBE Rp 1,596.00 2015 0
90 Betametason SALP 0.1 % TUBE Rp 1,596.00 2016 11

91 Betametason TTS MATA (BETAM) BTL Rp 19,600.00 DAK 2018 36


92 Bicolax TAB Rp 1,335.27 2016 162
93 BIOPLACENTon TUBE Rp 18,125.00 2017 0
94 Bisoprolol TAB Rp 2,553.83 2016 1485
95 Blood Lancet 265 PCS Rp 160.23 2016 0
96 Blood Lancet 266 PCS Rp 160.23 2016 300
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
97 Bronheksine (MIRAVAN) TAB Rp 354.20 2015 0

98 CALCII GLUCONAT AMP Rp 1,581.25 2016 23


99 Calsium Laktat TAB Rp 72.00 2015 0
100 Calsium Laktat TAB Rp 72.00 2016 0
101 Calsium Laktat TAB Rp 64.00 buffer stok 0
102 Captopril 12.5 mg TAB Rp 69.00 2014 0
103 Captopril 12.5 mg TAB Rp 69.00 2015 0
104 Captopril 12.5 mg TAB Rp 72.00 2017 79
105 Captopril 12.5 mg TAB Rp 68.00 DAK 2018 300

106 Captopril 25 mg TAB Rp 82.00 2015 0


107 Captopril 25 mg TAB Rp 82.00 2016 0
108 Captopril 25 mg TAB Rp 137.75 DAK 2017
109 Captopril 25 mg TAB Rp 82.00 DAK 2018 1240
110 Captopril 50 mg TAB Rp 147.00 2015 0
111 Captopril 50 mg TAB Rp 147.00 DAK 2017 685

112 Carbamazepin TAB Rp 269.00 2014 0


113 Catgut/Benang bedah 3/0 plain SET Rp 33,250.00 2016 10
114 Catgut 3/0 CHOMIC SET Rp 6,420.33 DAK 2017 60
115 Catgut 2/0 CHOMIC SET Rp 6,420.83 DAK 2018 13
116 CHKM BOTOL Rp 126,500.00 DAK 2018
117 Plant Cutura 2/0 SET Rp 6,420.83 DAK 2018 0
118 PLAINCatgut 3/0 SET Rp 6,420.83 DAK 2018 12
119 Cefadroxil BOT Rp 5,286.00 2016 0
120 Cefadroxil CAP Rp 557.00 2016 400
121 Cefadroxil CAP Rp 495.00 DAK 2018 325
122 Cefixime CAP Rp 700.00 2016 0
123 Cefotaxin INJ AMP Rp 6,785.00 2016 1
124 Ceftriaxone AMP Rp 6,785.00 2015 19
125 Cetirizin TAB Rp 156.00 2015 0
126 Cetirizin syr syr Rp 8,094.00 2017 0
127 Cetirizin syr Rp 13,956.00 DAK 2018 69
128 Ciprofloxacin TAB Rp 309.00 2016 2080
129 Ciprofloxacin BAQUINOR TTS MATA BTL Rp 10,250.00 2017 8
130 Clhorpromazine 100 mg TAB Rp 156.00 2015 260
131 Clhorpromazine 25 mg TAB Rp 75.00 2015 0
132 Clindamycin 150 mg CAP Rp 405.00 2015 0
133 Clindamycin 150 mg CAP Rp 786.00 DAK 2018
134 Clindamycin 300 mg CAP Rp 693.00 DAK 2017 150
135 Clor Etil BOT Rp 158,125.00 2015 0
136 Clor Etil BOT Rp 506,000.00 DAK 2018 2
137 Cloramfenikol 250 mg CAP Rp 261.00 2015 186
138 Cloramfenikol 250 mg CAP Rp 341.00 DAK 2018
139 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2015 8
140 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2017 50
141 Cloramfenikol 3 % TUBE Rp 3,460.00 2016 0
142 Cloramfenikol 2 % TUBE Rp 3,416.00 DAK 2018 48
143 Cloramfenikol salp mata 1 % TUBE Rp 1,680.00 2015 0
144 Cloramfenikol salp mata 1 % TUBE Rp 2,013.00 DAK 2018 7
145 Cloramfenikol TTS MATA BOT Rp 12,600.00 2017 0
146 Cloramfenikol TTS telinga BOT Rp 6,424.00 2016 0
147 Clorfeniramin Maleat (CTM) TAB Rp 54.00 2015 0
148 Clorfeniramin Maleat (CTM) TAB Rp 46.00 2017 0
149 Clorfeniramin Maleat (CTM) Rp 46.00 DAK 2017 3891
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
150 Composit A3 PCS Rp 749,320.00 2017 1
151 Composit A35 PCS Rp 749,320.00 2017 1
152 Cotrimoksazol 480 mg (DOEN) TAB Rp 158.00 2015 478
153 Cotrimoksazol 480 mg (DOEN) TAB Rp 152.00 APBD 2018 500
154 Cotrimoksazol Pediatrik TAB Rp 83.49 2015 0
155 Cotrimoksazol SYR BOT Rp 7,810.00 2015 120
156 Cotrimoksazol SYR BOT Rp 2,250.00 DAK 2016 12
157 CURCUMA TAB Rp 1,644.00 2017 0
158 CUTIMED SORBACT SWAB PCS Rp 30,503.00 DAK 2018 40
159 COTTON ROLL ROLL Rp 100,150.00 DAK 2018
160 CRESOPHENE, SOLUTION,LIQUID BOTOL Rp 770,000.00 DAK 2017
161 Deksametason AMP Rp 1,820.00 2015 96

162 Deksametason tablet 0.5 mg TAB Rp 52.00 2015 0


163 Deksametason tablet 0.5 mg TAB Rp 46.00 2017 0
164 Deksametason tablet 0.5 mg TAB Rp 35.00 DAK 2018 1139
165 Deksametason tablet 0.5 mg TAB Rp 95.00 DAK 2018
166 Deksametason tablet 0.5 mg TAB Rp 95.00 APBD 2019

167 Diazepam 2 mg TAB Rp 35.09 2015 0


168 Diazepam 2 mg TAB Rp 86.00 DAK 2018 390
169 Diazepam INJ 5 mg/ml AMP Rp 18,260.00 2015 14
170 Digoksin tablet 0.25 mg TAB Rp 103.00 2015 500
171 Dilteazem HCL tab 30 mg TAB Rp 141.00 2015 160
172 Dimenhidrinat TAB Rp 109.00 2015 237
173 DIPHENHIDRAMIN INJ Rp 1,156.00 2015 58
174 DISPOSIBLE DENTAL (jarum citojeck PCS Rp 2,720.00 2016 0
175 DISPOSIBLE DENTAL (jarum citojeck PCS Rp 3,594.25 2017 100
176 jarum citojeck PCS Rp 1,705.00 DAK 2018
177 Domperidon syr BOT Rp 14,374.80 2015 0
178 Domperidon syr BOT Rp 2,970.00 DAK 2018 41
179 Domperidon Tab TAB Rp 174.00 2013 735
180 Domperidon 10 mg TAB Rp 90.00 DAK 2019
181 Doxiciklin CAP Rp 298.00 2015 0
182 DULCOLAX 5 mg SUPP Rp 5,670.00 2016 0
183 DULCOLAX 10 mg SUPP Rp 5,800.00 2016 38
184 DULCOLAX 10 mg SUPP Rp 5,900.00 DAK 2018
185 Epinefrin hcl AMP Rp 8,910.00 buffer 156
186 Ergotamin Cafein TAB Rp 149.00 2015 0
187 Eritromycin CAP Rp 679.00 2016 400
188 Eritromycin SYR Rp 7,391.00 2016 0
189 Eritromycin SYR Rp 7,391.00 2017 0
190 Eritromycin SYR Rp 2,490.00 DAK 2018 7

191 Etakridin /Rivanol 300 ml BOT Rp 3,060.00 2016 17


192 Etambutol hcl. Tablet 250 mg TAB Rp 330.00 2015 0

193 Etiket obat Biru LMBR Rp 61.00 2016 0


194 Etiket Obat Putih LMBR Rp 61.00 2016 0
195 ETSGEL Rp 395,532.50 DAK 2017 1
196 Eugenol BOT Rp 50,416.67 2014 0

197 ELITE CEMENT BOX Rp 370,620.00 DAK 2018


198 EXAFLEX PUTTY BOX Rp 2,100,000.00 DAK 2018
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
199 Ferro Sulfat SCT Rp 425.00 2015 0
200 Ferro Sulfat SCT Rp 425.00 2017 0
201 Ferro Sulfat SCT APBD1 2018 5600
202 Ferro Sulfat SCT Rp 427.00 APBD 2019

203 Folley cateter no.16 SET Rp 20,000.00 2016 5


204 Folley cateter no.18 SET Rp 20,000.00 2016
205 Furosemid inj 10mg/ml AMP Rp 2,012.00 2015 1
206 Furosemid tablet 40 mg TAB Rp 84.00 2015 400
207 Furosemid tablet 40 mg TAB Rp 77.00 APBD 2018 1000
208 FOMALIN TAB Rp 5,060.00 0
209 Garam oralit untuk 200 ml air SCT Rp 1,072.50 2015 0
210 Garam oralit untuk 200 ml air SCT Rp 278.00 DAK 2017 235
211 Gelang pasien warna pink PCS Rp 2,706.00 2016 299
212 Gentamycin inj. AMP Rp 3,699.00 20
213 Gentian Violet lar 1 % BOT Rp 3,750.00 DAK 2018 1
214 Glass Lonomer SET/BTL Rp 949,520.00 2017 1
215 Glass Lonomer SET/BTL Rp 1,050,000.00 DAK 2018
216 Glibenclamid 5 mg TAB Rp 61.00 2014 0
217 Glibenclamid 5 mg TAB Rp 143.00 DAK 2018 950
218 Glibenclamid 5 mg TAB Rp 90.00 APBD 2018 1000
219 Glimepirid 1 mg TAB Rp 1,576.00 2015 50
220 Glimepirid 2 mg TAB Rp 311.00 2015 500
221 Glimepirid 2 mg TAB Rp 207.00 DAK 2018
222 Gliseril Guayakolat TAB Rp 66.79 0
223 Gliseril Guayakolat TAB Rp 66.79 2016 0
224 Gliseril Guayakolat TAB Rp 66.79 DAK 2016 3593
225 Gluko + protein test box PCS Rp 1,150.00 2016 210
226 Griseofulvin 125 mg TAB Rp 230.00 2015 0
227 Griseofulvin 125 mg TAB Rp 263.00 DAK 2017 350
228 Griseofulvin 125 mg TAB Rp 231.00 DAK 2018
229 Haloperidol tab 5 mg TAB Rp 105.00 2015 0
230 Haloperidol tab 0.5 mg TAB Rp 55.00 DAK 2018
231 Haloperidol tab 1.5 mg TAB Rp 59.00 DAK 2018
232 Handscoon 6 (T-SENSAURGE) STER SET Rp 7,254.50 DAK 2018 296
233 Handscoon 7 SET Rp 9,310.00 2016 0
234 Handscoon 7 Rp 9,120.00 DAK 2017 0
235 Handscoon 7 STERIL SET Rp 8,360.00 DAK 2018 66

236 Handscoon 7,5 (aximed) STERIL SET Rp 9,310.00 2016 0


237 Handscoon 7,5 (aximed) STERIL SET Rp 9,120.00 2017 210
238 Handscoon 7,5 (T-SENSAURGE) STE SET Rp 7,254.50 DAK 2017 195
239 Handscoon 8 STERIL SET Rp 9,310.00 2016 222
240 Handscoon non steril (M)AXIMED SET Rp 508.20 2018 700

241 HBSAG Strip STRIP Rp 11,037.00 DAK 2018 0 50


242 Hidroklortiazid 25 mg TAB Rp 179.00 2016 220
243 Hidroklortiazid 25 mg TAB Rp 179.00 DAK 2017 700
244 Hidrokortison Salp TUBE Rp 2,938.00 2015 0
245 Hidrokortison Salp TUBE Rp 2,938.00 2016 180
246 Hidrokortison Salp 2,5% TUBE Rp 2,848.00 DAK 2017 9
247 HISTIGO TAB Rp 595.05 DAK 2018 500
248 HYDCAL PASTA BASE TUBE Rp 299,530.00 DAK 2017

STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
249 Ibuprofen 400 mg TAB Rp 139.00 2014 0
250 Ibuprofen 400 mg (ARFEN) TAB Rp 501.10 DAK 2018 0
251 Ibuprofen 400 mg TAB Rp 139.00 APBD 2018 109
252 Ibuprofen 400 mg (FASIFEN) TAB Rp 525.00 DAK 2018 2000
253 Ibuprofen 400 mg TAB Rp 139.00 APBD 2019

254 Ibuprofen 200 mg TAB Rp 116.00 DAK 2017 0


255 Ibuprofen 200 mg TAB Rp 116.00 DAK 2018 0
256 Ibuprofen suspensi 200 mg/5 mg BOT Rp 4,949.00 2016 0
257 Ibuprofen suspensi 200 mg/5 mg BOT Rp 5,509.00 DAK 2018 64
258 Infant muccus PCS Rp 37,988.50 2016 0
259 Infuset Makro SET Rp 5,880.00 2015 12
260 Infuset Makro (PIECES) SET Rp 3,190.00 APBD 2018 12
261 Infuset Makro (OTSU SET) SET Rp 13,200.00 DAK 2018
262 Infuset Mikro SET Rp 7,920.00 2016 71
263 isosorbid TAB Rp 98.00 2015 849

264 JARUM HACTING NO. 08 LSN Rp 30,000.00 2016 0


265 JARUM HACTING NO. 10 LSN Rp 30,000.00 2016 0
266 JARUM HACTING NO. 12 LSN Rp 30,000.00 2016 0
267 JARUM HACTING NO. 15 LSN Rp 30,000.00 2016 0
268 Kaca Penutup (Deg Glass) pcs Rp 929.50 2016 50
269 Kalium Diklofenak TAB Rp 814.66 2015 0
270 Kalium permanganat BOT Rp 6,325.00 2016 0
271 Kapas 250 gr ROL Rp 14,375.00 2015 0
272 Kapas 250 gr ROL Rp 14,375.00 2016 1
273 Kapas 250 gr ROL Rp 14,375.00 DAK 2018 4

274 KARTU GOLONGAN DARAH PCS Rp 2,200.00 2016 500


275 Kasa gulung 36x80 cm ROL Rp 142,600.00 DAK 2017
276 Kasa gulung 30x60 cm ROL Rp 142,600.00 2016 0
277 Kasa gulung 30x60 cm ROL Rp 142,600.00 DAK 2016 0
278 Kasa gulung 36x80 cm Rp 142,600.00 DAK 2016 2
279 Kasa Steril 16x16 cm SET Rp 8,740.00 2016 0
280 Kasa Steril 16x16 cm Rp 575.00 DAK 2018 11
281 Kasa Steril 5x5 cm SET Rp 3,311.00 2017 0
282 Kasa PEMBALUT 4x10 cm ROL Rp 1,725.00 DAK 2018
283 Kertas puyer LBR Rp 123.20 2017 3500
284 Ketamin INJ VIAL Rp 63,400.00 2015 0
285 Ketoconazole 200 mg TAB Rp 303.00 2015 0
286 Ketoconazole 200 mg TAB Rp 303.00 2016 850
287 Ketoconazole salp 2 % TUBE Rp 2,697.00 2014 8
288 Ketoconazole salp 2 % TUBE Rp 2,694.00 DAK 2018

289 Ketorolak inj 30 AMP Rp 1,450.00 2015 26


290 Kombinasi Prometamin 25 + Sulfado TAB Rp 572.00 DAK 2015 1000
291 Lansoprazol (DIGEST) CAP Rp 5,500.00 2017 0
292 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 2015 52
293 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 DAK 2016 20
294 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2015 0
295 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2017 0
296 Larutan NACL Lar infus 0,9 % Rp 6,410.00 DAK 2018 49

297 Larutan RL BOT Rp 7,150.00 2016 11


298 Larutan RL BOT Rp 7,150.00 DAK 2017 44

STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
299 LARUTAN EDTA 10*Indoor BOT Rp 1,702,536.00 2016 2
300 LARUTAN Giemsa indoor BOT Rp 1,523,280.00 2016 2
301 LARUTAN Giemsa indoor BOT Rp 356,250.00 DAK 2018
302 LARUTAN Haemoglobin C indoor BOT Rp 296,956.00 2016 2
303 LARUTAN Hcl 0,1 N Indoor BOT Rp 236,808.00 2016 2
304 LARUTAN Metanol PA BOT Rp 686,697.00 2016 2
305 LARUTAN Trombosit Ao indoor BOT Rp 374,440.00 2016 2
306 LARUTAN Turk 500ml BOT Rp 444,015.00 2016 2
307 Lidocain INJ AMP Rp 929.00 2015 60
308 Lidocain INJ AMP Rp 2,215.00 DAK 2016 370
309 Loperamid TAB Rp 97.00 2016 1100
310 Loperamid Rp 97.00 2017 700
311 Loperamid 2 mg Rp 97.00 DAK 2017 435
312 Loratadin TAB Rp 159.00 2013 0
313 Loratadin TAB Rp 159.00 DAK 2017 2038
314 Loratadin 10 mg TAB Rp 500.00 DAK 2018
315 Lysol BOT Rp 49,200.00 2015 4
316 Lysol 1000 Ml BOT Rp 49,200.00 DAK 2016

317 Litrol TTS mata BOT Rp 5,850.00 DAK 2018 24


318 Masker earloop SET Rp 440.00 2015 0
319 Masker earloop SET Rp 435.60 DAK 2018 0
320 Masker earloop (AXIMED) SET Rp 436.00 DAK 2018 405
321 Masker Standar tie on (IKAT) SET Rp 588.00 2016 0
322 Masker Standar tie on (IKAT) SET Rp 528.00 DAK 2018 631

323 Mebendazol (VERMOX) TAB Rp 8,800.00 2015 50


324 MEDLENCE plus extra 21 G/2,4 mm PCS Rp 3,991.90 2016 0
325 MEDLENCE plus lite 25 G/1,5 mm PCS Rp 3,991.90 2016 0
326 MEDLENCE plus special 0,8 (blade) PCS Rp 3,991.90 2016 0
327 MEDLENCE plus universal 21 G/1.8 PCS Rp 3,991.90 2016 0
328 Meloxicam 7,5 mg TAB Rp 761.00 2015 0
329 Metformin CAP Rp 206.25 2015 0
330 Metformin CAP Rp 103.00 2017 0
331 Metformin 500 mg CAP Rp 336.00 DAK 2018 0

332 Metformin 850 mg CAP Rp 168.00 DAK 2018 500


333 Methylprednisolon 16 mg Rp 1,325.00 2017 0
334 Methylprednisolon 4 mg TAB Rp 500.62 2015 0
335 Methylprednisolon 4 mg TAB Rp 212.00 2017 0
336 Methylprednisolon 4 mg TAB Rp 170.00 APBD1 2017 0
337 Methylprednisolon 4 mg TAB Rp 170.00 APBD 2018 460

338 Metilergometrin maleat 0,125 mg TAB Rp 169.00 2015 550


339 Metilergometrin maleat INJ Rp 2,684.00 2015 0
340 Metoclopramid 10 mg TAB Rp 100.00 2015 0
341 Metoclopramid 10 mg TAB Rp 87.00 DAK 2018 990
342 Metoclopramid 5 mg TAB Rp 129.00 DAK 2018 400
343 Metronidazol 250 mg TAB Rp 116.00 2015 0
344 Metronidazol 500 mg TAB Rp 143.00 2015 0
345 Metronidazol 500 mg TAB Rp 143.00 2017 1900
346 Metronidazol INFUS BOT Rp 12,980.00 2017 3
347 Metronidazol SYR Rp 1,581.25 2017 0
348 MgSO4 20 % INJEKSI Rp 2,800.00 BUFFER 6
349 MgSO4 40 % INJEKSI Rp 3,650.00 APBD 2017 10

STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
350 Miconazol TUBE Rp 3,150.00 2016 0
351 Miconazol 2% Cream TUBE Rp 4,097.00 DAK 2018 0
352 Miniaspi 80mg TAB Rp 163.00 2016 0
353 Miniaspi/asetosal Rp 163.00 DAK 2016 500
354 Nasal Oksigen M PCS Rp 8,085.00 2016 10
355 Nasal Oksigen XS PCS Rp 8,085.00 2016 10
356 Natrium Diklofenak 25 mg TAB Rp 162.00 2015 0
357 Natrium Diklofenak 25 mg TAB Rp 178.00 DAK 2017 0
358 Natrium Diklofenak 25 mg TAB Rp 154.00 DAK 2018 642
359 Natrium Diklofenak 25 mg TAB Rp 146.00 APBD 2019
360 Natrium Diklofenak 50 mg TAB Rp 146.00 DAK 2018 0
361 Nelaton catheter pcs Rp 5,330.00 2017 0
362 Nebulyzer mask DEWASA PCS Rp 16,704.00 2016 0
363 Nifedipin TAB Rp 127.00 2015 0
364 Nifedipin 10 mg TAB Rp 112.00 DAK 2018 675
365 Nistatin 100.000 TAB Rp 528.00 0
366 Nistatin Vaginal 100.000 Rp 628.00 DAK 2017 160
367 Nistatin 500.000 TAB Rp 895.00 2015 0
368 Nistatin 500.000 TAB Rp 895.00 2016 490
369 Nistatin DROPS BOT Rp 40,030.00 DAK 2018 0
370 NOVABION KPSL Rp 395.42 2016 74
371 ONELAB Objeck Glass 72 PCS PCS Rp 331.37 DAK 2018 72 432
372 Objeck Glass PCS Rp 278.00 APBD 2019
373 OBH syr BOT Rp 3,740.00 2016 0
374 OBH syr Rp 2,925.00 DAK 2018 0
375 Ofloxacin TAB Rp 649.12 2015 0
376 Oksitertaciklin SALP 1 % TUBE Rp 4,901.00 2015 0
377 Oksitertaciklin SALP 3 % TUBE Rp 4,400.00 2015 0
378 Omeprasol CAP Rp 176.00 2016 0
379 Omeprasol 20 mg CAP Rp 176.00 2017 0
380 Omeprasol 20 mg CAP Rp 143.00 DAK 2018 30

381 Ondansetron inj Rp 1,254.00 2017 24


386 OXYTOCIN INJ Rp 1,900.00 2015 0
387 OXYTOCIN INJ Rp 1,287.00 DAK 2018 0
388 OXYTOCIN INJ Rp 1,287.00 DAK 2018 200

389 Otsu wi bot Rp 1,581.25 2016 0


390 Otsu wi bot Rp 2,860.00 DAK 2018 60
391 Paracetamol (FASIDOL)Droop BOT Rp 6,240.00 2016 0
392 Paracetamol (FASIDOL)Droop BOT Rp 7,979.00 DAK 2018 7
393 Paracetamol DroopS BOT - DAK 2019
394 Paracetamol 500 mg TAB Rp 60.00 2015 0
395 Paracetamol 500 mg TAB Rp 52.00 APBD 2017 0
396 Paracetamol 500 mg TAB Rp 52.00 APBD1 2017 0
397 Paracetamol 500 mg TAB Rp 259.00 DAK 2018 2816
398 Paracetamol 500 mg TAB Rp 198.00 DAK 2018 2816
399 Paracetamol 500 mg TAB - DAK 2019
400 Paracetamol SYR BOT Rp 1,338.00 2015 0
401 Paracetamol SYR BOT Rp 1,190.00 Dak 2018 76

402 Pipet Dirpo Rp 1,292.50 DAK 2017 0


403 Phenobarbital inj 50mg/ml AMP Rp 1,980.00 BUFFER 0
404 Piracetam 1200 mg TAB Rp 594.56 2015 570
405 piroxicam 10 mg TAB Rp 165.78 2015 0

STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
406 Plester ROL Rp 42,499.60 2015 19
407 Plain 3/0 pcs Rp 1,581.25 2016 0
408 Prednison TAB Rp 125.00 2015 450
409 Prednison 5 mg TAB Rp 74.00 DAK 2018 1543

410 PRIMAQUIN TAB Rp 205.00 2015 0


411 PRIMAQUIN 15 mg TAB Rp 253.00 APBD1 2018 100
412 PK (kalium pemanganat) 5 g BOT Rp 371,250.00 DAK 2018 0
413 Procrepe 15 cm x 4,55 m (perban) Rol Rp 41,910.00 2016 1
414 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 2015 0
415 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 BUFFER 200

416 Pyrantel TAB Rp 318.00 2015 0


417 Pyrantel 125 mg Rp 347.00 DAK 2018 386

418 Pyrantel SYR Rp 9,100.00 2015 0


419 POT URINE POT Rp 6,600.00 DAK 2018 12
420 POT 50 ml POT Rp 5,890.00 APBD1 2018

421 PETERS SILK PCS Rp 37,209.00 DAK 2017


422 PULP-X V DEVITALIZER PASTE PCS Rp 443,200.00 DAK 2018
423 RDT DBD iig sct Rp 1,581.25 2016 0
424 RDT DBD COMO sct Rp 297,000.00 DAK 2019
425 Ranitidin INJ AMP Rp 5,368.00 2015 61
426 Ranitidin TAB TAB Rp 119.00 2016 0
427 Ranitidin 150 mg Rp 262.50 DAK 2018 1990
428 RECO tts mata BOT Rp 20,360.00 DAK 2018 3

429 RECO tts Telinga BOT Rp 11,000.00 DAK 2018 18


430 Reagen diluent BOT Rp 4,770,000.00 DAK 2018 1
431 Reagen lyse BOT Rp 3,310,000.00 DAK 2018 1
432 Reagen RINSE Rp 1,950,455.00 DAK 2018 1
433 Reagen Asam urat BOT Rp 1,399,200.00 DAK 2017 0
434 Reagen WIDAL TEST BOT - DAK 2019
435 RAJAWALI UIC ACID (REAGEN) BOT Rp 1,870,660.00 DAK 2018 0
436 Reagen Kimia Klinik Glucosa BOT Rp 698,500.00 DAK 2017 1
437 RAJAWALI Glucosa (REAGEN) BOT Rp 889,570.00 DAK 2018
438 Reagen Kimia Klinik Kolesterol BOT Rp 748,000.00 DAK 2017 1
439 RAJAWALI KOLES ( Kolesterol) BOT Rp 2,093,300.00 DAK 2018
440 RYLES TUBE Rp 15,488.00 2017 10
441 Sak Besar (10x15 cm) PAK Rp 98,700.00 2017 0
442 Sak Besar (10x15 cm) PCS Rp 314.60 DAK 2017 0
443 Sak Sedang (6x10 cm) PAK Rp 96,900.00 2016 0
444 Sak Sedang (6x10 cm) PCS Rp 100.00 DAK 2016 0
445 Sak Kecil PCS Rp 100.00 0
446 Salbutamol 2 mg TAB Rp 69.00 2016 0
447 Salbutamol 2 mg TAB Rp 69.00 2017 0
448 Salbutamol 2 mg TAB Rp 69.00 DAK 2017 0
449 Salbutamol 2 mg TAB Rp 64.00 DAK 2018 440

450 Salbutamol 4 mg TAB Rp 89.00 2015 0


451 Salbutamol 4 mg TAB Rp 89.00 2016 52
452 Salbutamol 4 mg TAB Rp 89.00 DAK 2017 500
453 Salbutamol 4 mg TAB Rp 81.00 DAK 2018
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
454 Salbutamol sirup 2mg/5ml BOT Rp 5,700.00 2015 0
455 Salbutamol sirup 2mg/5ml Rp 5,700.00 DAK 2017 4

456 Salicil talk SCT Rp 1,573.00 2015 0


457 Salicil talk SCT Rp 6,270.00 2016 0
458 Salicil talk 2% POT Rp 6,270.00 DAK 2016 18
459 Salp 24 TUBE Rp 2,200.00 2016 74

460 SCANDONEST AMP Rp 19,470.00 2016 0


461 Sefety box PCS Rp 18,072.35 2016 0
462 Sefety box 25 K 5 L Rp 18,072.25 DAK 2018 23
463 Silk SET Rp 15,750.00 2015 106
464 Silk SET Rp 37,289.00 2017 2
465 Simvastatin 10 mg TAB Rp 136.00 2016 0
466 Simvastatin (SVT) TAB Rp 686.00 2017 0
467 Simvastatin 10 mg TAB Rp 110.00 DAK 2018 4235

468 SPASMINAL Rp 750.00 2017 0


469 Sprinolakton Rp 212.00 DAK 2018 500
470 SPRITUS BOT Rp 1,581.25 2016 0
471 SPRITUS 250 ml BOT Rp 39,270.00 DAK 2017
472 Strip Asam Urat (NESCO) PCS Rp 7,185.20 2016 0

473 Strip Glucosa (BENECHECK) PCS Rp 3,225.86 DAK 2017 0


474 Surgical Blade No.11 PCS Rp 974.05 2016 154
475 Strip Asam Urat (HUMASENS) STRIP Rp 22,252.00 DAK 2018 100 100
476 Strip Glucosa (HUMASENS) STRIP Rp 5,156.00 DAK 2018 50 200
477 Strip Kolesterol (HUMASENS) STRIP Rp 27,495.00 DAK 2018 100 100
478 Surgical Blade No.15 PCS Rp 974.05 2016 185
479 TEST NARKOBA/DRUG ABUSE STRIP Rp 78,999.00 2016 29
480 TEST NARKOBA STRIP Rp 78,999.80 DAK 2017 20
481 TEST HIV (SD BIOLINE HIV) STRIP Rp 37,600.00 APBN 2017 0 100
482 TEST HIV (SD BIOLINE HIV) STRIP Rp 11,975.00 APBDI 2018
483 Tiamfenicol 500 KAP Rp 1,518.00 2016 800
484 TIPS PIPET BIRU BKS Rp 594.00 2016 0
485 TABUNG PLASTIK SEUM 1,5 ml PIECES Rp 605.00 DAK 2017 10

486 Ultra One test hamil strip PCS Rp 2,133.00 2016 0


487 Ultra One test hamil strip PCS Rp 2,228.60 2017 209
488 Ultrafix/ PHarmafix ROL Rp 27,000.00 2016 0
489 Ultrafix/ Pharmafix ROL Rp 27,000.00 DAK 2017 0
490 Ultrafix/ Pharmafix ROL Rp 29,700.00 DAK 2018 7

491 ULTRASOUN GEL (GEL USG) BTL Rp 14,471.60 DAK 2017 1


492 UMBILICAL C (PENJEPIT TP) PCS Rp 3,300.00 DAK2018 24

493 Urin bag/UROPLAS SET Rp 3,000.00 2015 10


494 UINE STIP 10 PAAMETE
495 VACUM TUBE PLAIN PCS Rp 2,200.00 DAK 2017 0 100
496 VACUM EDTA Rp 74,100.00 DAK 2018 0
497 VIT CALCIFAR TAB Rp 406.00 DAK 2018 1319
498 VIT SYR (TAKANA) SYR Rp 39,223.80 2016 0
499 VIT SYR (TAKANA) SYR Rp 39,223.80 2017 0
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
500 Vitamin B 1 (tiamin) TAB Rp 95.00 BUFFER 0
501 Vitamin B 1 (tiamin) TAB Rp 95.00 2016 215
502 Vitamin B 1 (tiamin) 50 mg TAB Rp 95.00 DAK 2016 1310
503 Vitamin B 12 TAB Rp 63.00 BUFFER 0
504 Vitamin B 12 Rp 50.00 DAK 2018 200

505 Vitamin B 12 INJ AMP Rp 9,482.00 BUFFER 0


506 Vitamin B 12 INJ AMP Rp 1,283.00 2017 0
507 Vitamin B 6 (piridoksin) TAB Rp 175.00 BUFFER 0
508 Vitamin B 6 (piridoksin) TAB Rp 142.00 2017 0
509 Vitamin B 6 (piridoksin) TAB Rp 142.00 DAK 2017 1600
510 Vitamin B comp TAB Rp 138.00 2015 0
511 Vitamin B comp TAB Rp 138.00 2016 0
512 Vitamin B comp TAB Rp 141.00 APBD 2019
513 Vitamin C (Asam askorbat) 250 mg TAB Rp 139.00 2017 0
514 Vitamin C (Asam askorbat)250 mg Rp 139.00 DAK 2017 0
515 Vitamin C (Asam askorbat)50 mg TAB Rp 105.00 BUFFER 0
516 Vitamin C (Asam askorbat)50 mg TAB Rp 125.00 DAK 2017 488
517 Vitamin C (Asam askorbat)25 mg TAB Rp 36.00 DAK 2017 1180
518 Vitamin K INJ AMP Rp 3,754.00 2015 35
519 Vitamin K INJ AMP Rp 4,260.00 APBD1 2018 0
520 Vitamin K INJ AMP Rp 15,700.00 Dak 2018 15

521 Vitamin K TAB TAB Rp 690.00 2015 0


522 Vitamin K TAB 10 mg Rp 855.00 DAK 2018 490
523 VITROMEGA CAP Rp 1,472.00 2016 0
524 VITROMEGA CAP Rp 1,472.69 2016 60
525 X. TRAGEN bot Rp 1,581.25 2017 7
526 Yodium Povidon 30 ml BOT Rp 2,344.00 2015 0
527 Yodium Povidon 60 ml BOT Rp 4,440.00 2017 13
528 Yodium Povidon 300 ml BOT Rp 4,440.00 2016 0
529 Yodium Povidon 300 ml BOT Rp 21,600.00 DAK 2018
530 ZINCPO dropS BOT Rp 6,369.00 DAK 2018
531 Zink Syrup 10mg/ml BOT Rp 16,478.00 2016 0
532 Zink Syrup 10mg/ml BOT Rp 16,478.00 2017 4
533 Zink TAB TAB Rp 521.00 2015 0
534 Zink TAB TAB Rp 1,100.00 BUFFER 0
535 Zink 20 mg TAB Rp 618.00 DAK 2017 2815

536 creatininKIN 2x100 ml kit Rp 977,900.00 DAK 2017 0


537 Vacum tube sterlite PCS Rp 74,100.00 DAK 2018 0
538 Procurma SYR Rp 11,350.00 DAK2018 55
539 WIDAL TES STRIP
540 3M ESPE CAVIT FILLING BOX Rp 359,535.00 DAK 2017
541 VASELINE SWAB 10MX10CM PCS Rp 35,832.50 DAK 2017
542 PROGRAM
STOK PENE-
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
A B C D E F G
MDT MB DEWASA BLISTER Rp 30,595.00 APBN 2018 0
MDT MB DEWASA BLISTER Rp 31,570.00 APBD1 2018 36

MDT PB DEWASA BLISTER Rp 12,569.00 APBD1 2018 6


LACTOGEN 4 DUS Rp 67,500.00 2016 0
VIT A BIRU BOT Rp 341.00 DAK2016 100
VIT A MERAH BOT Rp 505.00 DAK2016 250
VIT A MERAH BOT Rp 622.00 DAK2016
GLUCO PROTEIN (ONE MAD) DOS PROG 0
ULTRA ONE TEST (ONE MAD) PCS PROG 0
HB SAHLI (ONE MAD) DOS PROG 0
HCL 0,1 N 100 ML (ONE MAD) BOT PROG 0
BLOOD LANCET (ONE MAD) DOS PROG 0
AUTOCLIK (ONE MAD) BUAH PROG 0
IODIUM TEST BOT Rp 75,000.00 POGAM
QUININE TAB Rp 737.00 2015 197
RDT MALARIA TEST Rp 57,684.00 PROGRAM 0
RDT MALARIA TEST Rp 5,271.00 APBN2017 335
OAM (DHP-Frimal) TAB Rp 2,030.00 APBD1 2018 9 18
OBAT PAKET TB KATEGORI 1 DOS Rp 431,983.00 DAK 2016 6

OBAT PAKET TB KATEGORI 2 DOS Rp 1,557,469.00 DAK 2018 0


POT DAHAK POT Rp 1,818.00 program tb 13
REAGENS ZIEHL NEELSEN SET Rp 296,600.00 APBDI2017 1
MASKER IKAT PCS prog tb POV 0

ALAT SUNTIK 3 ml PCS Rp 1,212.00 BKKBN PROV 421


COPPER T/ UID BOX Rp 11,800.00 BKKBN PROV 8
KONDOM DOS Rp 4,000.00 BKKBN PROV 47
KONDOM DOS Rp 4,291.60 BKKBN PROV
OBAT KB SUNTIK 3 BULAN VIAL Rp 6,120.00 BKKBN PROV 421
OBAT KB SUNTIK 3 BULAN VIAL Rp 6,460.00 BKKBN PROV
PIL KB 1 KOMBINASI STRP Rp 1,886.00 BKKBN PROV 230
SUSUK KB/IMPLAN SET Rp 212,500.00 BKKBN PROV 0
SUSUK KB/IMPLAN SET Rp 213,220.00 BKKBN PROV 8

MINERAL MIX SACHET Rp 2,450.00 PROGRAM KIA 0


MINERAL MIX SACHET Rp 2,920.00 DAK 2018 80

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003

STOK PENE-
AWAL RIMAAN
F G
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
PUSKESMAS
KECAMATAN
KAB./KODYA
PROVINSI
HAL 1 BULAN
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 1 Abocat 18
46 0 40 6 46 2 Abocat 18
0 0 0 0 3 Abocat 20
0 0 0 0 4 Abocat 20
32 9 5 18 23 5 Abocat 20
51 9 27 15 42 6 Abocat 22
4 0 4 0 4 7 Abocat 22
85 0 81 4 85 8 Abocat 24
96 0 90 6 96 9 Abocat 26
0 0 0 0 10 Acetosal
20 0 0 20 20 11 Acyclovir 200 mg

0 0 0 0 12 Acyclovir 400 mg
385 40 200 145 345 13 Acyclovir 400 mg

90 0 90 90 14 Alat suntik sekali pakai 0,5 ml


0 0 0 0 15 Alat suntik sekali pakai 1 ml
87 22 30 35 65 16 Alat suntik sekali pakai 1 ml
500 0 470 30 500 17 Alat suntik sekali pakai 1 ml (AXIMED)
0 0 0 0 18 Alat suntik sekali pakai 2.5 ml
34 34 0 0 19 Alat suntik sekali pakai 3 ml
500 124 50 326 376 20 Alat suntik sekali pakai 3 ml

0 0 0 0 21 Alat suntik sekali pakai 5 ml


237 0 212 25 237 22 Alat suntik sekali pakai 5 ml

0 0 0 0 23 Albendazol
625 0 400 225 625 24 Albendazol tablet 400 mg
25 Albendazol tablet 400 mg
1 0 1 1 26 Alginat
27 Aroma fine normal (Alginat aroma
53 4 42 7 49 28 Alkohol 100 ml
0 0 0 0 29 Alkohol 1000 ml
0 0 0 0 30 Alkohol Swab
349 239 100 10 110 31 Alkohol Swab

0 0 0 0 32 Alopurinol tablet 100 mg


0 0 0 0 33 Alopurinol tablet 100 mg
0 0 0 0 34 Alopurinol tablet 100 mg
2065 305 1100 660 1760 35 Alopurinol tablet 100 mg
800 20 700 80 780 36 Alopurinol tablet 300 mg
1 0 0 1 1 37 Ambroxol SYR
951 603 0 348 348 38 Ambroxol 30 mg
30 0 30 30 39 Aminofilin INJ 24 mg/ml - 10 ml
0 0 0 0 40 Aminofilin tablet 200 mg
390 5 300 85 385 41 Amitripilin 25 mg

0 0 0 0 42 Amlodipin 10 mg
1800 31 1410 359 1769 43 Amlodipin 10 mg

0 0 0 0 44 Amlodipin 5 mg (HEXAVASK)
0 0 0 0 45 Amlodipin 5 mg (HEXAVASK)
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
590 0 590 590 46 Amoksisilin 500 mg
410 200 10 200 210 47 Amoksisilin 500 mg
48 Amoksisilin 500 mg
0 0 0 0 49 Amoksisilin 250 mg
0 0 0 0 50 Amoksisilin SYR 125 mg/5 ml
0 0 0 0 51 Amoksisilin SYR 125 mg/5 ml
38 20 9 9 18 52 Amoksisilin SYR 125 mg/5 ml (SOLPE
53 Amoksisilin SYR 125 mg/5 ml (YUSIMO
0 0 0 0 54 Amoksisilin SYR 250 mg/5 ml
61 6 39 16 55 55 Amoksisilin SYR 250 mg/5 ml
24 0 14 10 24 56 Amoksisilin DROPS (SUPRAMOX)
0 0 0 0 57 Ampisilin INJ
1899 199 1500 200 1700 58 Antalgin (metampiron) 500 mg
625 0 0 625 625 59 Antalgin (metamizole sodium 500 mg
9 9 0 0 60 Antasida
69 1 10 58 68 61 Antasida
62 Antasida
0 0 0 0 63 Antasida doen tablet kombinasi
2529 612 900 1017 1917 64 Antasida doen tablet kombinasi 400 m

20 9 11 11 65 Anti Hemoroid

0 0 0 0 66 Aqua dest steril


0 0 0 0 67 As. Mefenamat
0 0 0 0 68 As. Mefenamat
0 0 0 0 69 As. Mefenamat
0 0 0 0 70 As. Mefenamat (BIRU)
2437 979 800 658 1458 71 As. Mefenamat 500 mg
72 As. Mefenamat 500 mg

0 0 0 0 73 Asam folat (AFOLAT)


2040 330 1200 510 1710 74 Asam folat (Profolat)
0 0 0 0 75 ASEPTIC GEL
0 0 0 0 76 Atenolol (FARNORMIN)
500 0 500 500 77 Atenolol (FARNORMIN)
89 0 84 5 89 78 Atropin sulfat INJ 0.25 mg/ml - 1ml
0 0 0 0 79 Atropin sulfat tab 0,5 mg
2000 0 1600 400 2000 80 Attapulgit
739 179 100 460 560 81 Attapulgit
19 2 9 8 17 82 Attapulgit (ARCAPEC)
1250 1000 250 250 83 ABATE

0 0 0 0 84 Bactivec (abate)
0 0 0 0 85 Bacitracin polymixin
17 17 0 0 86 Bacitracin polymixin

0 0 0 0 87 Betahistin
240 80 0 160 160 88 Betahistin
0 0 0 0 89 Betametason SALP 0.1 %
11 10 0 1 1 90 Betametason SALP 0.1 %

36 5 20 11 31 91 Betametason TTS MATA (BETAM)


162 0 162 162 92 Bicolax
0 0 0 0 93 BIOPLACENTon
1485 0 1485 1485 94 Bisoprolol
0 0 0 0 95 Blood Lancet 265
300 50 200 50 250 96 Blood Lancet 266
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 97 Bronheksine (MIRAVAN)

23 0 23 23 98 CALCII GLUCONAT
0 0 0 0 99 Calsium Laktat
0 0 0 0 100 Calsium Laktat
0 0 0 0 0 101 Calsium Laktat
0 0 0 0 102 Captopril 12.5 mg
0 0 0 0 103 Captopril 12.5 mg
79 74 0 5 5 104 Captopril 12.5 mg
300 0 0 300 300 105 Captopril 12.5 mg

0 0 0 0 106 Captopril 25 mg
0 0 0 0 107 Captopril 25 mg
108 Captopril 25 mg
1240 240 300 700 1000 109 Captopril 25 mg
0 0 0 0 110 Captopril 50 mg
685 30 0 655 655 111 Captopril 50 mg

0 0 0 0 112 Carbamazepin
10 10 0 0 113 Catgut/Benang bedah 3/0 plain
60 1 38 21 59 114 Catgut 3/0 CHOMIC
13 0 13 13 115 Catgut 2/0 CHOMIC
116 CHKM
0 0 0 0 117 Plant Cutura 2/0
12 0 10 2 12 118 PLAINCatgut 3/0
0 0 0 0 119 Cefadroxil
400 0 0 400 400 120 Cefadroxil
325 80 100 145 245 121 Cefadroxil
0 0 0 0 122 Cefixime
1 1 0 0 123 Cefotaxin INJ
19 0 19 19 124 Ceftriaxone
0 0 0 0 0 125 Cetirizin
0 0 0 0 126 Cetirizin syr
69 6 43 20 63 127 Cetirizin syr
2080 180 1680 220 1900 128 Ciprofloxacin
8 0 0 8 8 129 Ciprofloxacin BAQUINOR TTS MATA
260 0 260 260 130 Clhorpromazine 100 mg
0 0 0 0 131 Clhorpromazine 25 mg
0 0 0 0 132 Clindamycin 150 mg
133 Clindamycin 150 mg
150 0 150 150 134 Clindamycin 300 mg
0 0 0 0 135 Clor Etil
2 0 2 2 136 Clor Etil
186 186 0 0 0 137 Cloramfenikol 250 mg
138 Cloramfenikol 250 mg
8 1 0 7 7 139 cloramfenicol syrup 125mg/5ml
50 0 50 0 50 140 cloramfenicol syrup 125mg/5ml
0 0 0 0 141 Cloramfenikol 3 %
48 2 24 22 46 142 Cloramfenikol 2 %
0 0 0 0 143 Cloramfenikol salp mata 1 %
7 0 0 7 7 144 Cloramfenikol salp mata 1 %
0 0 0 0 145 Cloramfenikol TTS MATA
0 0 0 0 146 Cloramfenikol TTS telinga
0 0 0 0 147 Clorfeniramin Maleat (CTM)
0 0 0 0 148 Clorfeniramin Maleat (CTM)
3891 501 1800 1590 3390 149 Clorfeniramin Maleat (CTM)
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
1 0 1 1 150 Composit A3
1 0 1 1 151 Composit A35
478 10 100 368 468 152 Cotrimoksazol 480 mg (DOEN)
500 0 500 0 500 153 Cotrimoksazol 480 mg (DOEN)
0 0 0 0 154 Cotrimoksazol Pediatrik
120 0 110 10 120 155 Cotrimoksazol SYR
12 0 0 12 12 156 Cotrimoksazol SYR
0 0 0 0 157 CURCUMA
40 0 40 40 158 CUTIMED SORBACT SWAB
159 COTTON ROLL
160 CRESOPHENE, SOLUTION,LIQUID
96 3 91 2 93 161 Deksametason

0 0 0 0 162 Deksametason tablet 0.5 mg


0 0 0 0 163 Deksametason tablet 0.5 mg
1139 470 0 669 669 164 Deksametason tablet 0.5 mg
165 Deksametason tablet 0.5 mg
166 Deksametason tablet 0.5 mg

0 0 0 0 167 Diazepam 2 mg
390 36 354 354 168 Diazepam 2 mg
14 0 14 14 169 Diazepam INJ 5 mg/ml
500 0 500 500 170 Digoksin tablet 0.25 mg
160 0 160 160 171 Dilteazem HCL tab 30 mg
237 100 100 37 137 172 Dimenhidrinat
58 0 58 58 173 DIPHENHIDRAMIN
0 0 0 0 174 DISPOSIBLE DENTAL (jarum citojeck)
100 0 100 100 175 DISPOSIBLE DENTAL (jarum citojeck)
176 jarum citojeck
0 0 0 0 177 Domperidon syr
41 11 25 5 30 178 Domperidon syr
735 375 100 260 360 179 Domperidon Tab
180 Domperidon 10 mg
0 0 0 0 181 Doxiciklin
0 0 0 0 182 DULCOLAX 5 mg
38 2 29 7 36 183 DULCOLAX 10 mg
184 DULCOLAX 10 mg
156 1 148 7 155 185 Epinefrin hcl
0 0 0 0 186 Ergotamin Cafein
400 56 300 44 344 187 Eritromycin
0 0 0 0 188 Eritromycin
0 0 0 0 189 Eritromycin
7 2 0 5 5 190 Eritromycin

17 0 13 4 17 191 Etakridin /Rivanol 300 ml


0 0 0 0 192 Etambutol hcl. Tablet 250 mg

0 0 0 0 193 Etiket obat Biru


0 0 0 0 194 Etiket Obat Putih
1 0 1 1 195 ETSGEL
0 0 0 0 196 Eugenol

197 ELITE CEMENT


198 EXAFLEX PUTTY
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 199 Ferro Sulfat
0 0 0 0 200 Ferro Sulfat
5600 4110 400 1090 1490 201 Ferro Sulfat
202 Ferro Sulfat

5 0 5 5 203 Folley cateter no.16


204 Folley cateter no.18
1 0 0 1 1 205 Furosemid inj 10mg/ml
400 0 100 300 400 206 Furosemid tablet 40 mg
1000 0 1000 0 1000 207 Furosemid tablet 40 mg
0 0 0 0 208 FOMALIN
0 0 0 0 209 Garam oralit untuk 200 ml air
235 1 0 234 234 210 Garam oralit untuk 200 ml air
299 0 299 299 211 Gelang pasien warna pink
20 0 15 5 20 212 Gentamycin inj.
1 1 0 0 213 Gentian Violet lar 1 %
1 0 1 1 214 Glass Lonomer
215 Glass Lonomer
0 0 0 0 216 Glibenclamid 5 mg
950 30 200 720 920 217 Glibenclamid 5 mg
1000 0 1000 0 1000 218 Glibenclamid 5 mg
50 45 0 5 5 219 Glimepirid 1 mg
500 10 400 90 490 220 Glimepirid 2 mg
221 Glimepirid 2 mg
0 0 0 0 222 Gliseril Guayakolat
0 0 0 0 223 Gliseril Guayakolat
3593 409 1000 2184 3184 224 Gliseril Guayakolat
210 0 210 210 225 Gluko + protein test box
0 0 0 0 226 Griseofulvin 125 mg
350 10 150 190 340 227 Griseofulvin 125 mg
228 Griseofulvin 125 mg
0 0 0 0 229 Haloperidol tab 5 mg
230 Haloperidol tab 0.5 mg
231 Haloperidol tab 1.5 mg
296 6 195 95 290 232 Handscoon 6 (T-SENSAURGE) STERIL
0 0 0 0 233 Handscoon 7
0 0 0 0 234 Handscoon 7
66 0 50 16 66 235 Handscoon 7 STERIL

0 0 0 0 236 Handscoon 7,5 (aximed) STERIL


210 20 190 190 237 Handscoon 7,5 (aximed) STERIL
195 2 132 61 193 238 Handscoon 7,5 (T-SENSAURGE) STERI
222 23 168 31 199 239 Handscoon 8 STERIL
700 200 500 500 240 Handscoon non steril (M)AXIMED EX

50 13 25 12 37 241 HBSAG Strip


220 0 100 120 220 242 Hidroklortiazid 25 mg
700 0 700 0 700 243 Hidroklortiazid 25 mg
0 0 0 0 244 Hidrokortison Salp
180 22 72 86 158 245 Hidrokortison Salp
9 9 0 0 0 246 Hidrokortison Salp 2,5%
500 140 240 120 360 247 HISTIGO
248 HYDCAL PASTA BASE

PERSE- PENGELU SISA STOK STOK PERMIN-


NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 249 Ibuprofen 400 mg
0 0 0 0 250 Ibuprofen 400 mg (ARFEN)
109 109 0 0 251 Ibuprofen 400 mg
2000 509 1000 491 1491 252 Ibuprofen 400 mg (FASIFEN)
253 Ibuprofen 400 mg

0 0 0 0 254 Ibuprofen 200 mg


0 0 0 0 255 Ibuprofen 200 mg
0 0 0 0 256 Ibuprofen suspensi 200 mg/5 mg
64 8 49 7 56 257 Ibuprofen suspensi 200 mg/5 mg
0 0 0 0 258 Infant muccus
12 6 0 6 6 259 Infuset Makro
12 0 3 9 12 260 Infuset Makro (PIECES)
261 Infuset Makro (OTSU SET)
71 0 57 14 71 262 Infuset Mikro
849 0 800 49 849 263 isosorbid

0 0 0 0 264 JARUM HACTING NO. 08


0 0 0 0 265 JARUM HACTING NO. 10
0 0 0 0 266 JARUM HACTING NO. 12
0 0 0 0 267 JARUM HACTING NO. 15
50 0 50 50 268 Kaca Penutup (Deg Glass)
0 0 0 0 269 Kalium Diklofenak
0 0 0 0 270 Kalium permanganat
0 0 0 0 271 Kapas 250 gr
1 1 0 0 272 Kapas 250 gr
4 0 3 1 4 273 Kapas 250 gr

500 0 500 500 274 KARTU GOLONGAN DARAH


275 Kasa gulung 36x80 cm
0 0 0 0 276 Kasa gulung 30x60 cm
0 0 0 0 277 Kasa gulung 30x60 cm
2 1 1 1 278 Kasa gulung 36x80 cm
0 0 0 0 279 Kasa Steril 16x16 cm
11 0 0 11 11 280 Kasa Steril 16x16 cm
0 0 0 0 281 Kasa Steril 5x5 cm
282 Kasa PEMBALUT 4x10 cm
3500 0 3500 3500 283 Kertas puyer
0 0 0 0 284 Ketamin INJ
0 0 0 0 285 Ketoconazole 200 mg
850 20 400 430 830 286 Ketoconazole 200 mg
8 1 0 7 7 287 Ketoconazole salp 2 %
288 Ketoconazole salp 2 %

26 0 26 26 289 Ketorolak inj 30


1000 0 1000 1000 290 Kombinasi Prometamin 25 + Sulfadoxi
0 0 0 0 291 Lansoprazol (DIGEST)
52 0 37 15 52 292 Larutan Glucosa lar infus 5 %
20 0 20 0 20 293 Larutan Glucosa lar infus 5 %
0 0 0 0 294 Larutan NACL Lar infus 0,9 %
0 0 0 0 295 Larutan NACL Lar infus 0,9 %
49 9 13 27 40 296 Larutan NACL Lar infus 0,9 %

11 1 0 10 10 297 Larutan RL
44 2 22 20 42 298 Larutan RL

PERSE- PENGELU SISA STOK STOK PERMIN-


NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
2 0 2 2 299 LARUTAN EDTA 10*Indoor
2 0 2 2 300 LARUTAN Giemsa indoor
301 LARUTAN Giemsa indoor
2 0 2 2 302 LARUTAN Haemoglobin C indoor
2 0 2 2 303 LARUTAN Hcl 0,1 N Indoor
2 0 2 2 304 LARUTAN Metanol PA
2 0 2 2 305 LARUTAN Trombosit Ao indoor
2 0 2 2 306 LARUTAN Turk 500ml
60 60 0 0 307 Lidocain INJ
370 5 365 0 365 308 Lidocain INJ
1100 152 900 48 948 309 Loperamid
700 0 700 700 310 Loperamid
435 0 0 435 435 311 Loperamid 2 mg
0 0 0 0 312 Loratadin
2038 530 300 1208 1508 313 Loratadin
314 Loratadin 10 mg
4 0 4 4 315 Lysol
316 Lysol 1000 Ml

24 4 20 20 317 Litrol TTS mata


0 0 0 0 318 Masker earloop
0 0 0 0 319 Masker earloop
405 55 350 350 320 Masker earloop (AXIMED)
0 0 0 0 321 Masker Standar tie on (IKAT)
631 56 400 175 575 322 Masker Standar tie on (IKAT)

50 3 0 47 47 323 Mebendazol (VERMOX)


0 0 0 0 324 MEDLENCE plus extra 21 G/2,4 mm
0 0 0 0 325 MEDLENCE plus lite 25 G/1,5 mm
0 0 0 0 326 MEDLENCE plus special 0,8 (blade) 2,
0 0 0 0 327 MEDLENCE plus universal 21 G/1.8 m
0 0 0 0 328 Meloxicam 7,5 mg
0 0 0 0 329 Metformin
0 0 0 0 330 Metformin
0 0 0 0 331 Metformin 500 mg

500 210 100 190 290 332 Metformin 850 mg


0 0 0 0 333 Methylprednisolon 16 mg
0 0 0 0 334 Methylprednisolon 4 mg
0 0 0 0 335 Methylprednisolon 4 mg
0 0 0 0 336 Methylprednisolon 4 mg
460 0 0 460 460 337 Methylprednisolon 4 mg

550 30 400 120 520 338 Metilergometrin maleat 0,125 mg


0 0 0 0 0 339 Metilergometrin maleat
0 0 0 0 340 Metoclopramid 10 mg
990 0 600 390 990 341 Metoclopramid 10 mg
400 0 400 400 342 Metoclopramid 5 mg
0 0 0 0 343 Metronidazol 250 mg
0 0 0 0 344 Metronidazol 500 mg
1900 0 1900 1900 345 Metronidazol 500 mg
3 0 3 3 346 Metronidazol INFUS
0 0 0 0 347 Metronidazol
6 0 4 2 6 348 MgSO4 20 %
10 0 10 10 349 MgSO4 40 %

PERSE- PENGELU SISA STOK STOK PERMIN-


NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 350 Miconazol
0 0 0 0 351 Miconazol 2% Cream
0 0 0 0 352 Miniaspi 80mg
500 0 500 500 353 Miniaspi/asetosal
10 0 10 10 354 Nasal Oksigen M
10 0 10 10 355 Nasal Oksigen XS
0 0 0 0 356 Natrium Diklofenak 25 mg
0 0 0 0 357 Natrium Diklofenak 25 mg
642 407 0 235 235 358 Natrium Diklofenak 25 mg
359 Natrium Diklofenak 25 mg
0 0 0 0 360 Natrium Diklofenak 50 mg
0 0 0 0 361 Nelaton catheter
0 0 0 0 362 Nebulyzer mask DEWASA
0 0 0 0 363 Nifedipin
675 65 200 410 610 364 Nifedipin 10 mg
0 0 0 0 365 Nistatin 100.000
160 0 0 160 160 366 Nistatin Vaginal 100.000
0 0 0 0 367 Nistatin 500.000
490 0 300 190 490 368 Nistatin 500.000
0 0 0 0 369 Nistatin DROPS
74 60 0 14 14 370 NOVABION
504 72 360 72 432 371 ONELAB Objeck Glass 72 PCS
372 Objeck Glass
0 0 0 0 373 OBH syr
0 0 0 0 0 374 OBH syr
0 0 0 0 375 Ofloxacin
0 0 0 0 376 Oksitertaciklin SALP 1 %
0 0 0 0 377 Oksitertaciklin SALP 3 %
0 0 0 0 378 Omeprasol
0 0 0 0 379 Omeprasol 20 mg
30 10 0 20 20 380 Omeprasol 20 mg

24 0 21 3 24 381 Ondansetron
0 0 0 0 386 OXYTOCIN
0 0 0 0 387 OXYTOCIN
200 12 170 18 188 388 OXYTOCIN

0 0 0 0 389 Otsu wi
60 0 60 60 390 Otsu wi
0 0 0 0 391 Paracetamol (FASIDOL)Droop
7 4 0 3 3 392 Paracetamol (FASIDOL)Droop
393 Paracetamol DroopS
0 0 0 0 394 Paracetamol 500 mg
0 0 0 0 395 Paracetamol 500 mg
0 0 0 0 396 Paracetamol 500 mg
2816 909 700 1207 1907 397 Paracetamol 500 mg
2816 909 700 1207 1907 398 Paracetamol 500 mg
399 Paracetamol 500 mg
0 0 0 0 400 Paracetamol SYR
76 49 0 27 27 401 Paracetamol SYR

0 0 0 0 402 Pipet Dirpo


0 0 0 0 403 Phenobarbital inj 50mg/ml
570 50 240 280 520 404 Piracetam 1200 mg
0 0 0 0 405 piroxicam 10 mg

PERSE- PENGELU SISA STOK STOK PERMIN-


NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
19 3 10 6 16 406 Plester
0 0 0 0 407 Plain 3/0
450 200 0 250 250 408 Prednison
1543 1 900 642 1542 409 Prednison 5 mg

0 0 0 0 410 PRIMAQUIN
100 0 100 100 411 PRIMAQUIN 15 mg
0 0 0 0 412 PK (kalium pemanganat) 5 g
1 1 0 0 413 Procrepe 15 cm x 4,55 m (perban)
0 0 0 0 414 PTU (Propiltiourasil) 100 mg
200 0 200 200 415 PTU (Propiltiourasil) 100 mg

0 0 0 0 416 Pyrantel
386 6 300 80 380 417 Pyrantel 125 mg

0 0 0 0 418 Pyrantel
12 0 12 12 419 POT URINE
420 POT 50 ml

421 PETERS SILK


422 PULP-X V DEVITALIZER PASTE
0 0 0 0 423 RDT DBD iig
424 RDT DBD COMO
61 3 49 9 58 425 Ranitidin INJ
0 0 0 0 426 Ranitidin TAB
1990 510 800 680 1480 427 Ranitidin 150 mg
3 1 0 2 2 428 RECO tts mata

18 1 17 0 17 429 RECO tts Telinga


1 0 1 1 430 Reagen diluent
1 1 0 0 431 Reagen lyse
1 0 1 1 432 Reagen RINSE
0 0 0 0 433 Reagen Asam urat
434 Reagen WIDAL TEST
0 0 0 0 435 RAJAWALI UIC ACID (REAGEN)
1 0 1 1 436 Reagen Kimia Klinik Glucosa
437 RAJAWALI Glucosa (REAGEN)
1 0 1 1 438 Reagen Kimia Klinik Kolesterol
439 RAJAWALI KOLES ( Kolesterol)
10 0 10 10 440 RYLES
0 0 0 0 441 Sak Besar (10x15 cm)
0 0 0 0 442 Sak Besar (10x15 cm)
0 0 0 0 443 Sak Sedang (6x10 cm)
0 0 0 0 444 Sak Sedang (6x10 cm)
0 0 0 0 445 Sak Kecil
0 0 0 0 446 Salbutamol 2 mg
0 0 0 0 447 Salbutamol 2 mg
0 0 0 0 448 Salbutamol 2 mg
440 0 200 240 440 449 Salbutamol 2 mg

0 0 0 0 450 Salbutamol 4 mg
52 43 0 9 9 451 Salbutamol 4 mg
500 0 200 300 500 452 Salbutamol 4 mg
453 Salbutamol 4 mg
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 454 Salbutamol sirup 2mg/5ml
4 4 0 0 455 Salbutamol sirup 2mg/5ml

0 0 0 0 456 Salicil talk


0 0 0 0 457 Salicil talk
18 8 0 10 10 458 Salicil talk 2%
74 11 38 25 63 459 Salp 24

0 0 0 0 460 SCANDONEST
0 0 0 0 461 Sefety box
23 0 23 23 462 Sefety box 25 K 5 L
106 0 84 22 106 463 Silk
2 0 0 2 2 464 Silk
0 0 0 0 465 Simvastatin 10 mg
0 0 0 0 466 Simvastatin (SVT)
4235 280 2820 1135 3955 467 Simvastatin 10 mg

0 0 0 0 468 SPASMINAL
500 0 500 500 469 Sprinolakton
0 0 0 0 470 SPRITUS
471 SPRITUS 250 ml
0 0 0 0 472 Strip Asam Urat (NESCO)

0 0 0 0 473 Strip Glucosa (BENECHECK)


154 14 124 16 140 474 Surgical Blade No.11
200 75 75 50 125 475 Strip Asam Urat (HUMASENS)
250 50 150 50 200 476 Strip Glucosa (HUMASENS)
200 60 120 20 140 477 Strip Kolesterol (HUMASENS)
185 0 175 10 185 478 Surgical Blade No.15
29 1 20 8 28 479 TEST NARKOBA/DRUG ABUSE
20 0 20 0 20 480 TEST NARKOBA
100 0 100 100 481 TEST HIV (SD BIOLINE HIV)
482 TEST HIV (SD BIOLINE HIV)
800 0 800 800 483 Tiamfenicol 500
0 0 0 0 484 TIPS PIPET BIRU
10 0 10 10 485 TABUNG PLASTIK SEUM 1,5 ml

0 0 0 0 486 Ultra One test hamil strip


209 50 30 129 159 487 Ultra One test hamil strip
0 0 0 0 488 Ultrafix/ PHarmafix
0 0 0 0 489 Ultrafix/ Pharmafix
7 2 1 4 5 490 Ultrafix/ Pharmafix

1 0 1 1 491 ULTRASOUN GEL (GEL USG)


24 6 5 13 18 492 UMBILICAL C (PENJEPIT TP)

10 0 10 10 493 Urin bag/UROPLAS


0 0 0 0 494 UINE STIP 10 PAAMETE
100 0 100 100 495 VACUM TUBE PLAIN
0 0 0 0 496 VACUM EDTA
1319 464 400 455 855 497 VIT CALCIFAR
0 0 0 0 498 VIT SYR (TAKANA)
0 0 0 0 499 VIT SYR (TAKANA)
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 500 Vitamin B 1 (tiamin)
215 215 0 0 501 Vitamin B 1 (tiamin)
1310 563 0 747 747 502 Vitamin B 1 (tiamin) 50 mg
0 0 0 0 503 Vitamin B 12
200 0 0 200 200 504 Vitamin B 12

0 0 0 0 505 Vitamin B 12 INJ


0 0 0 0 506 Vitamin B 12 INJ
0 0 0 0 507 Vitamin B 6 (piridoksin)
0 0 0 0 508 Vitamin B 6 (piridoksin)
1600 596 400 604 1004 509 Vitamin B 6 (piridoksin)
0 0 0 0 510 Vitamin B comp
0 0 0 0 511 Vitamin B comp
512 Vitamin B comp
0 0 0 0 513 Vitamin C (Asam askorbat) 250 mg
0 0 0 0 0 514 Vitamin C (Asam askorbat)250 mg
0 0 0 0 515 Vitamin C (Asam askorbat)50 mg
488 228 0 260 260 516 Vitamin C (Asam askorbat)50 mg
1180 540 400 240 640 517 Vitamin C (Asam askorbat)25 mg
35 0 35 35 518 Vitamin K INJ
0 0 0 0 519 Vitamin K INJ
15 8 5 2 7 520 Vitamin K INJ

0 0 0 0 521 Vitamin K TAB


490 0 400 90 490 522 Vitamin K TAB 10 mg
0 0 0 0 523 VITROMEGA
60 10 0 50 50 524 VITROMEGA
7 1 6 6 525 X. TRAGEN
0 0 0 0 526 Yodium Povidon 30 ml
13 13 0 0 0 527 Yodium Povidon 60 ml
0 0 0 0 528 Yodium Povidon 300 ml
529 Yodium Povidon 300 ml
530 ZINCPO dropS
0 0 0 0 531 Zink Syrup 10mg/ml
4 3 0 1 1 532 Zink Syrup 10mg/ml
0 0 0 0 533 Zink TAB
0 0 0 0 534 Zink TAB
2815 262 1600 953 2553 535 Zink 20 mg

0 0 0 0 536 creatininKIN 2x100 ml


0 0 0 0 537 Vacum tube sterlite
55 25 15 15 30 538 Procurma
0 0 0 0 539 WIDAL TES
540 3M ESPE CAVIT FILLING
541 VASELINE SWAB 10MX10CM
542 PROGRAM
PERSE- PENGELU SISA STOK STOK PERMIN-
NO NAMA OBAT
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M A B
0 0 0 0 MDT MB DEWASA
36 6 30 30 MDT MB DEWASA

6 2 4 4 MDT PB DEWASA
0 0 0 0 LACTOGEN 4
100 100 0 0 VIT A BIRU
250 250 0 0 VIT A MERAH
VIT A MERAH
0 0 0 0 GLUCO PROTEIN (ONE MAD)
0 0 0 0 ULTRA ONE TEST (ONE MAD)
0 0 0 0 HB SAHLI (ONE MAD)
0 0 0 0 HCL 0,1 N 100 ML (ONE MAD)
0 0 0 0 BLOOD LANCET (ONE MAD)
0 0 0 0 AUTOCLIK (ONE MAD)
0 0 0 0 IODIUM TEST
197 0 197 197 QUININE
0 0 0 0 RDT MALARIA
335 10 325 325 RDT MALARIA
27 9 18 0 18 OAM (DHP-Frimal)
6 1 5 5 OBAT PAKET TB KATEGORI 1

0 0 0 0 OBAT PAKET TB KATEGORI 2


13 0 13 13 POT DAHAK
1 0 1 1 REAGENS ZIEHL NEELSEN
0 0 0 0 MASKER IKAT

421 9 412 412 ALAT SUNTIK 3 ml


8 0 8 8 COPPER T/ UID
47 9 38 38 KONDOM
KONDOM
421 9 412 412 OBAT KB SUNTIK 3 BULAN
OBAT KB SUNTIK 3 BULAN
230 45 185 185 PIL KB 1 KOMBINASI
0 0 0 SUSUK KB/IMPLAN
8 0 0 8 8 SUSUK KB/IMPLAN

0 0 0 0 MINERAL MIX
80 0 80 80 MINERAL MIX

92553 Mengetahui
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003

SISA STOK
GUDANG SUB UNIT
J K
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
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
: 0101
: PASANGKAYU 1
: PASANGKAYU
: PASANGKAYU
: SULAWESI BARAT
: FEBRUARI 2019
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
PCS Rp 8,750.00 2016 0 0 0 0 0
PCS Rp 8,575.00 DAK 2016 46 46 0 40 6 46
PCS Rp 16,249.99 2015 0 0 0 0 0
PCS Rp 8,750.00 2016 0 0 0 0 0
PCS Rp 8,575.00 DAK 2016 23 23 3 5 15 20
PCS Rp 8,750.00 2016 42 42 12 22 8 30
PCS Rp 8,575.00 DAK 2016 4 4 0 4 4
PCS Rp 8,750.00 2016 85 85 2 81 2 83
PCS Rp 27,134.00 DAK 2018 96 96 0 90 6 96
TAB Rp 127.00 2015 0 0 0 0 0
TAB Rp 251.00 2014 20 20 0 0 20 20

TAB Rp 362.00 2015 0 0 0 0 0


TAB Rp 630.50 2017 345 345 30 200 115 315

PCS Rp 1,655.50 DAK 2016 90 90 0 90 90


PCS Rp 1,540.00 2015 0 0 0 0 0
PCS Rp 1,694.00 2016 65 65 5 30 30 60
PCS Rp 913.00 DAK 2018 500 500 11 465 24 489
PCS Rp 1,141.80 2013 0 0 0 0 0
PCS Rp 968.00 2016 0 0 0 0 0
PCS Rp 2,119.00 DAK 2018 376 600 976 176 600 200 800

PCS Rp 1,348.00 2013 0 0 0 0 0


PCS Rp 861.30 2017 237 237 1 212 24 236

SYR Rp 4,234.00 2016 0 0 0 0 0


TAB Rp 363.00 2016 625 625 26 400 199 599
TAB Rp 266.80 APBN 2017
BOT Rp 239,525.00 2017 1 1 0 1 1
bks Rp 192,000.00 dak 2017 1 1 1 0 0
BOT Rp 2,625.00 2016 49 49 7 37 5 42
BOT Rp 25,800.00 2016 0 0 0 0 0
pcs Rp 245.00 2016 0 0 0 0 0
pcs Rp 242.00 2017 110 110 110 0 0

TAB Rp 96.00 BUFFER 0 0 0 0 0


TAB Rp 90.00 2015 0 0 0 0 0
TAB Rp 96.00 2017 0 0 0 0 0
TAB Rp 96.00 DAK 2017 1760 1760 460 600 700 1300
TAB Rp 249.00 DAK 2017 780 780 150 500 130 630
BOT Rp 6,512.30 DAK 2018 1 1 0 0 1 1
TAB Rp 242.00 DAK 2018 348 3000 3348 239 2300 809 3109
AMP Rp 4,200.00 2015 30 30 0 30 30
TAB Rp 86.00 2015 0 0 0 0 0
TAB Rp 123.00 2015 385 385 4 300 81 381

TAB Rp 168.00 2016 0 0 0 0 0


TAB Rp 279.13 DAK 2018 1769 900 2669 455 1710 504 2214

TAB Rp 197.00 2015 0 0 0 0 0


TAB Rp 1,050.00 2017 0 0 0 0 0
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
TAB Rp 279.00 2013 590 590 0 190 400 590
TAB Rp 279.00 2016 210 210 170 10 30 40
TAB Rp 239.00 DAK 2017
CAP Rp 220.00 2014 0 0 0 0 0
BOT Rp 2,560.00 2014 0 0 0 0 0
BOT Rp 8,900.00 DAK 2018 0 0 0 0 0
BOT Rp 8,900.00 DAK 2018 18 18 9 9 9
BOT Rp 4,466.00 DAK 2018 60 60 1 50 9 59
BOT Rp 4,655.00 2017 0 0 0 0 0
BOT Rp 3,740.00 DAK 2018 55 55 6 39 10 49
BOT Rp 28,500.00 DAK 2018 24 24 0 14 10 24
AMP Rp 5,610.00 2015 0 0 0 0 0
TAB Rp 385.00 DAK 2016 1700 1700 120 1400 180 1580
TAB Rp 385.00 DAK 2016 625 625 0 0 625 625
SYR Rp 2,135.00 2015 0 0 0 0 0
SYR Rp 2,135.00 DAK 2016 68 68 58 10 10
SYR Rp 2,146.00 DAK 2018 100 100 2 55 43 98
TAB Rp 78.00 2015 0 0 0 0 0
TAB Rp 72.00 2017 1917 1917 145 700 1072 1772

SUPP Rp 2,200.00 2016 11 11 9 2 2

VIAL Rp 2,750.00 2017 0 0 0 0 0


TAB Rp 119.00 2014 0 0 0 0 0
TAB Rp 119.00 2016 0 0 0 0 0
TAB Rp 117.00 2017 0 0 0 0 0
TAB Rp 176.00 2017 0 0 0 0 0
TAB Rp 119.00 APBD 2018 1458 2000 3458 658 2800 2800
TAB Rp 119.00 APBD 2019 3000 3000 870 1200 930 2130

TAB Rp 52.00 2016 0 0 0 0 0


TAB Rp 64.00 DAK 2018 1710 1710 0 1000 710 1710
BTL Rp 1,581.25 2017 0 0 0 0 0
TAB Rp 387.00 2015 0 0 0 0 0
TAB Rp 342.00 DAK 2017 500 500 0 500 500
AMP Rp 1,400.00 2016 89 89 1 84 4 88
TAB Rp 81.00 2016 0 0 0 0 0
TAB Rp 220.00 2016 2000 2000 230 1600 170 1770
TAB Rp 196.00 2017 560 560 60 100 400 500
SYR Rp 1,581.25 2017 17 17 0 9 8 17
SCT Rp 6,380.00 DAK 2018 250 250 0 250 250

BOT BS 0 0 0 0 0
TUBE Rp 2,767.00 2015 0 0 0 0 0
TUBE Rp 3,511.00 2017 0 0 0 0 0

TAB Rp 1,062.60 2016 0 0 0 0 0


TAB Rp 177.00 2017 160 160 0 0 160 160
TUBE Rp 1,596.00 2015 0 0 0 0 0
TUBE Rp 1,596.00 2016 1 1 0 0 1 1

BTL Rp 19,600.00 DAK 2018 31 31 1 20 10 30


TAB Rp 1,335.27 2016 162 162 0 162 162
TUBE Rp 18,125.00 2017 0 0 0 0 0
TAB Rp 2,553.83 2016 1485 1485 0 1485 0 1485
PCS Rp 160.23 2016 0 0 0 0 0
PCS Rp 160.23 2016 250 250 150 100 100
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
TAB Rp 354.20 2015 0 0 0 0 0

AMP Rp 1,581.25 2016 23 23 0 23 23


TAB Rp 72.00 2015 0 0 0 0 0
TAB Rp 72.00 2016 0 0 0 0 0
TAB Rp 64.00 buffer stok 0 0 0 0 0 0
TAB Rp 69.00 2014 0 0 0 0 0
TAB Rp 69.00 2015 0 0 0 0 0
TAB Rp 72.00 2017 5 5 5 0 0
TAB Rp 68.00 DAK 2018 300 300 40 0 260 260

TAB Rp 82.00 2015 0 0 0 0 0


TAB Rp 82.00 2016 0 0 0 0 0
TAB Rp 137.75 DAK 2017 1000 1000 300 0 700 700
TAB Rp 82.00 DAK 2018 1000 1000 590 300 110 410
TAB Rp 147.00 2015 0 0 0 0 0
TAB Rp 147.00 DAK 2017 655 655 150 0 505 505

TAB Rp 269.00 2014 0 0 0 0 0


SET Rp 33,250.00 2016 0 0 0 0 0
SET Rp 6,420.33 DAK 2017 59 59 10 30 19 49
SET Rp 6,420.83 DAK 2018 13 13 0 13 13
BOTOL Rp 126,500.00 DAK 2018 0 1 1 1 0 0
SET Rp 6,420.83 DAK 2018 0 0 0 0 0
SET Rp 6,420.83 DAK 2018 12 12 0 10 2 12
BOT Rp 5,286.00 2016 0 0 0 0 0
CAP Rp 557.00 2016 400 400 145 0 255 255
CAP Rp 495.00 DAK 2018 245 245 245 0 0 0
CAP Rp 700.00 2016 0 0 0 0 0
AMP Rp 6,785.00 2016 0 0 0 0 0
AMP Rp 6,785.00 2015 19 19 0 19 19
TAB Rp 156.00 2015 0 0 0 0 0 0
syr Rp 8,094.00 2017 0 0 0 0 0
Rp 13,956.00 DAK 2018 63 63 13 38 12 50
TAB Rp 309.00 2016 1900 1900 0 1680 220 1900
BTL Rp 10,250.00 2017 8 8 1 0 7 7
TAB Rp 156.00 2015 260 260 10 250 250
TAB Rp 75.00 2015 0 0 0 0 0
CAP Rp 405.00 2015 0 0 0 0 0
CAP Rp 786.00 DAK 2018 400 400 0 400 400
CAP Rp 693.00 DAK 2017 150 300 450 0 450 450
BOT Rp 158,125.00 2015 0 0 0 0 0
BOT Rp 506,000.00 DAK 2018 2 3 5 4 1 1
CAP Rp 261.00 2015 0 0 0 0 0
CAP Rp 341.00 DAK 2018 500 500 100 300 100 400
BOT Rp 5,170.00 2015 7 7 1 0 6 6
BOT Rp 5,170.00 2017 50 50 0 50 0 50
TUBE Rp 3,460.00 2016 0 0 0 0 0
TUBE Rp 3,416.00 DAK 2018 46 46 8 24 14 38
TUBE Rp 1,680.00 2015 0 0 0 0 0
TUBE Rp 2,013.00 DAK 2018 7 7 0 0 7 7
BOT Rp 12,600.00 2017 0 0 0 0 0
BOT Rp 6,424.00 2016 0 0 0 0 0
TAB Rp 54.00 2015 0 0 0 0 0
TAB Rp 46.00 2017 0 0 0 0 0
Rp 46.00 DAK 2017 3390 3390 967 1000 1423 2423
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
PCS Rp 749,320.00 2017 1 1 0 1 1
PCS Rp 749,320.00 2017 1 1 0 1 1
TAB Rp 158.00 2015 468 468 100 100 268 368
TAB Rp 152.00 APBD 2018 500 500 0 500 0 500
TAB Rp 83.49 2015 0 0 0 0 0
BOT Rp 7,810.00 2015 120 120 10 110 110
BOT Rp 2,250.00 DAK 2016 12 12 1 0 11 11
TAB Rp 1,644.00 2017 0 0 0 0 0
PCS Rp 30,503.00 DAK 2018 40 40 0 40 40
ROLL Rp 100,150.00 DAK 2018 0 1 1 1 0 0
BOTOL Rp 770,000.00 DAK 2017 0 1 1 1 0 0
AMP Rp 1,820.00 2015 93 93 1 91 1 92

TAB Rp 52.00 2015 0 0 0 0 0


TAB Rp 46.00 2017 0 0 0 0 0
TAB Rp 35.00 DAK 2018 669 669 669 0 0
TAB Rp 95.00 DAK 2018 3000 3000 0 3000 3000
TAB Rp 95.00 APBD 2019 3000 3000 141 1600 1259 2859

TAB Rp 35.09 2015 0 0 0 0 0


TAB Rp 86.00 DAK 2018 354 354 98 256 256
AMP Rp 18,260.00 2015 14 14 0 14 14
TAB Rp 103.00 2015 500 500 0 500 500
TAB Rp 141.00 2015 160 160 0 160 160
TAB Rp 109.00 2015 137 137 0 100 37 137
INJ Rp 1,156.00 2015 58 58 0 58 58
PCS Rp 2,720.00 2016 0 0 0 0 0
PCS Rp 3,594.25 2017 100 100 0 100 100
PCS Rp 1,705.00 DAK 2018 0 1 1 1 0 0
BOT Rp 14,374.80 2015 0 0 0 0 0
BOT Rp 2,970.00 DAK 2018 30 30 12 15 3 18
TAB Rp 174.00 2013 360 360 163 0 197 197
TAB Rp 90.00 DAK 2019
CAP Rp 298.00 2015 0 0 0 0 0
SUPP Rp 5,670.00 2016 0 0 0 0 0
SUPP Rp 5,800.00 2016 36 36 0 29 7 36
SUPP Rp 5,900.00 DAK 2018 50 50 0 50 0 50
AMP Rp 8,910.00 buffer 155 155 2 148 5 153
TAB Rp 149.00 2015 0 0 0 0 0 0
CAP Rp 679.00 2016 344 344 0 300 44 344
SYR Rp 7,391.00 2016 0 0 0 0 0
SYR Rp 7,391.00 2017 0 0 0 0 0
SYR Rp 2,490.00 DAK 2018 5 5 5 0 0

BOT Rp 3,060.00 2016 17 17 4 13 13


TAB Rp 330.00 2015 0 0 0 0 0

LMBR Rp 61.00 2016 0 0 0 0 0


LMBR Rp 61.00 2016 0 0 0 0 0
Rp 395,532.50 DAK 2017 1 1 0 1 1
BOT Rp 50,416.67 2014 0 0 0 0 0

BOX Rp 370,620.00 DAK 2018 0 1 1 1 0 0


BOX Rp 2,100,000.00 DAK 2018 1 1 1 0 0
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
SCT Rp 425.00 2015 0 0 0 0 0
SCT Rp 425.00 2017 0 0 0 0 0
SCT APBD1 2018 1490 1500 2990 1090 1900 1900
SCT Rp 427.00 APBD 2019 11340 11340 3700 6660 980 7640

SET Rp 20,000.00 2016 5 10 15 0 15 15


SET Rp 20,000.00 2016 10 10 0 10 10
AMP Rp 2,012.00 2015 1 1 0 0 1 1
TAB Rp 84.00 2015 400 400 10 100 290 390
TAB Rp 77.00 APBD 2018 1000 1000 0 1000 0 1000
TAB Rp 5,060.00 0 0 0 0 0
SCT Rp 1,072.50 2015 0 0 0 0 0
SCT Rp 278.00 DAK 2017 234 500 734 0 500 234 734
PCS Rp 2,706.00 2016 299 299 0 299 299
AMP Rp 3,699.00 20 20 0 15 5 20
BOT Rp 3,750.00 DAK 2018 0 0 0 0 0
SET/BTL Rp 949,520.00 2017 1 1 0 1 1
SET/BTL Rp 1,050,000.00 DAK 2018 0 1 1 1 0 0
TAB Rp 61.00 2014 0 0 0 0 0
TAB Rp 143.00 DAK 2018 920 920 250 200 470 670
TAB Rp 90.00 APBD 2018 1000 1000 0 700 300 1000
TAB Rp 1,576.00 2015 5 5 0 0 5 5
TAB Rp 311.00 2015 490 490 79 400 11 411
TAB Rp 207.00 DAK 2018 500 500 0 500 500
TAB Rp 66.79 0 0 0 0 0
TAB Rp 66.79 2016 0 0 0 0 0
TAB Rp 66.79 DAK 2016 3184 3000 6184 240 3000 2944 5944
PCS Rp 1,150.00 2016 210 210 0 210 210
TAB Rp 230.00 2015 0 0 0 0 0
TAB Rp 263.00 DAK 2017 340 340 90 150 100 250
TAB Rp 231.00 DAK 2018 500 500 0 500 0 500
TAB Rp 105.00 2015 0 0 0 0 0
TAB Rp 55.00 DAK 2018 200 200 0 200 200
TAB Rp 59.00 DAK 2018 200 200 0 200 200
SET Rp 7,254.50 DAK 2018 290 290 28 175 87 262
SET Rp 9,310.00 2016 0 0 0 0 0
Rp 9,120.00 DAK 2017 0 0 0 0 0
SET Rp 8,360.00 DAK 2018 66 66 26 40 40

SET Rp 9,310.00 2016 0 0 0 0 0


SET Rp 9,120.00 2017 190 190 0 190 190
SET Rp 7,254.50 DAK 2017 193 193 18 132 43 175
SET Rp 9,310.00 2016 199 199 29 168 2 170
SET Rp 508.20 2018 500 500 0 500 500

STRIP Rp 11,037.00 DAK 2018 37 50 87 12 75 75


TAB Rp 179.00 2016 220 220 0 100 120 220
TAB Rp 179.00 DAK 2017 700 700 0 700 0 700
TUBE Rp 2,938.00 2015 0 0 0 0 0
TUBE Rp 2,938.00 2016 158 158 23 72 63 135
TUBE Rp 2,848.00 DAK 2017 0 0 0 0 0 0
TAB Rp 595.05 DAK 2018 360 1000 1360 120 1240 1240
TUBE Rp 299,530.00 DAK 2017 0 1 1 1 0 0

STOK PENE- PERSE- PENGELU SISA STOK STOK


SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
TAB Rp 139.00 2014 0 0 0 0 0
TAB Rp 501.10 DAK 2018 0 0 0 0 0
TAB Rp 139.00 APBD 2018 0 0 0 0 0
TAB Rp 525.00 DAK 2018 1491 1491 515 300 676 976
TAB Rp 139.00 APBD 2019 500 500 0 500 0 500

TAB Rp 116.00 DAK 2017 0 0 0 0 0


TAB Rp 116.00 DAK 2018 0 0 0 0 0
BOT Rp 4,949.00 2016 0 0 0 0 0
BOT Rp 5,509.00 DAK 2018 56 56 32 19 5 24
PCS Rp 37,988.50 2016 0 0 0 0 0
SET Rp 5,880.00 2015 6 6 0 0 6 6
SET Rp 3,190.00 APBD 2018 12 12 0 3 9 12
SET Rp 13,200.00 DAK 2018 100 100 0 97 3 100
SET Rp 7,920.00 2016 71 71 5 57 9 66
TAB Rp 98.00 2015 849 849 10 800 39 839

LSN Rp 30,000.00 2016 0 0 0 0 0


LSN Rp 30,000.00 2016 0 0 0 0 0
LSN Rp 30,000.00 2016 0 0 0 0 0
LSN Rp 30,000.00 2016 0 0 0 0 0
pcs Rp 929.50 2016 50 50 0 50 50
TAB Rp 814.66 2015 0 0 0 0 0
BOT Rp 6,325.00 2016 0 0 0 0 0
ROL Rp 14,375.00 2015 0 0 0 0 0
ROL Rp 14,375.00 2016 0 0 0 0 0
ROL Rp 14,375.00 DAK 2018 4 4 1 2 1 3

PCS Rp 2,200.00 2016 500 500 0 500 500


ROL Rp 142,600.00 DAK 2017 10 10 0 10 10
ROL Rp 142,600.00 2016 0 0 0 0 0
ROL Rp 142,600.00 DAK 2016 0 0 0 0 0
Rp 142,600.00 DAK 2016 1 1 0 1 1
SET Rp 8,740.00 2016 0 0 0 0 0
Rp 575.00 DAK 2018 11 11 0 0 11 11
SET Rp 3,311.00 2017 0 0 0 0 0
ROL Rp 1,725.00 DAK 2018 50 50 0 50 50
LBR Rp 123.20 2017 3500 3500 0 3500 3500
VIAL Rp 63,400.00 2015 0 0 0 0 0
TAB Rp 303.00 2015 0 0 0 0 0
TAB Rp 303.00 2016 830 830 260 300 270 570
TUBE Rp 2,697.00 2014 7 7 5 0 2 2
TUBE Rp 2,694.00 DAK 2018 50 50 0 40 10 50

AMP Rp 1,450.00 2015 26 26 0 26 26


TAB Rp 572.00 DAK 2015 1000 1000 0 1000 1000
CAP Rp 5,500.00 2017 0 0 0 0 0
BOT Rp 6,900.00 2015 52 52 0 37 15 52
BOT Rp 6,900.00 DAK 2016 20 20 0 20 0 20
BOT Rp 6,410.00 2015 0 0 0 0 0
BOT Rp 6,410.00 2017 0 0 0 0 0
Rp 6,410.00 DAK 2018 40 40 9 13 18 31

BOT Rp 7,150.00 2016 10 10 10 0 0


BOT Rp 7,150.00 DAK 2017 42 42 8 20 14 34

STOK PENE- PERSE- PENGELU SISA STOK STOK


SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
BOT Rp 1,702,536.00 2016 2 2 0 2 2
BOT Rp 1,523,280.00 2016 2 2 0 2 2
BOT Rp 356,250.00 DAK 2018 2 2 0 2 2
BOT Rp 296,956.00 2016 2 2 0 2 2
BOT Rp 236,808.00 2016 2 2 0 2 2
BOT Rp 686,697.00 2016 2 2 0 2 2
BOT Rp 374,440.00 2016 2 2 0 2 2
BOT Rp 444,015.00 2016 2 2 0 2 2
AMP Rp 929.00 2015 0 0 0 0 0
AMP Rp 2,215.00 DAK 2016 365 365 17 300 48 348
TAB Rp 97.00 2016 948 948 48 900 900
Rp 97.00 2017 700 700 0 700 700
Rp 97.00 DAK 2017 435 435 35 0 400 400
TAB Rp 159.00 2013 0 0 0 0 0
TAB Rp 159.00 DAK 2017 1508 1508 614 0 894 894
TAB Rp 500.00 DAK 2018
BOT Rp 49,200.00 2015 4 4 0 4 4
BOT Rp 49,200.00 DAK 2016

BOT Rp 5,850.00 DAK 2018 20 20 0 20 0 20


SET Rp 440.00 2015 0 0 0 0 0
SET Rp 435.60 DAK 2018 0 0 0 0 0
SET Rp 436.00 DAK 2018 350 350 150 200 200
SET Rp 588.00 2016 0 0 0 0 0
SET Rp 528.00 DAK 2018 575 575 85 350 140 490

TAB Rp 8,800.00 2015 47 47 3 0 44 44


PCS Rp 3,991.90 2016 0 0 0 0 0
PCS Rp 3,991.90 2016 0 0 0 0 0
PCS Rp 3,991.90 2016 0 0 0 0 0
PCS Rp 3,991.90 2016 0 0 0 0 0
TAB Rp 761.00 2015 0 0 0 0 0
CAP Rp 206.25 2015 0 0 0 0 0
CAP Rp 103.00 2017 0 0 0 0 0
CAP Rp 336.00 DAK 2018 0 0 0 0 0

CAP Rp 168.00 DAK 2018 290 1000 1290 800 300 190 490
Rp 1,325.00 2017 0 0 0 0 0
TAB Rp 500.62 2015 0 0 0 0 0
TAB Rp 212.00 2017 0 0 0 0 0
TAB Rp 170.00 APBD1 2017 0 0 0 0 0
TAB Rp 170.00 APBD 2018 460 460 290 0 170 170

TAB Rp 169.00 2015 520 520 30 400 90 490


INJ Rp 2,684.00 2015 0 0 0 0 0 0
TAB Rp 100.00 2015 0 0 0 0 0
TAB Rp 87.00 DAK 2018 990 990 200 600 190 790
TAB Rp 129.00 DAK 2018 400 400 0 400 400
TAB Rp 116.00 2015 0 0 0 0 0
TAB Rp 143.00 2015 0 0 0 0 0
TAB Rp 143.00 2017 1900 1900 20 1500 380 1880
BOT Rp 12,980.00 2017 3 3 0 3 3
SYR Rp 1,581.25 2017 0 0 0 0 0
INJEKSI Rp 2,800.00 BUFFER 6 6 0 4 2 6
INJEKSI Rp 3,650.00 APBD 2017 10 10 0 10 10

STOK PENE- PERSE- PENGELU SISA STOK STOK


SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
TUBE Rp 3,150.00 2016 0 0 0 0 0
TUBE Rp 4,097.00 DAK 2018 0 0 0 0 0
TAB Rp 163.00 2016 0 0 0 0 0
Rp 163.00 DAK 2016 500 500 0 500 500
PCS Rp 8,085.00 2016 10 10 0 10 10
PCS Rp 8,085.00 2016 10 10 0 10 10
TAB Rp 162.00 2015 0 0 0 0 0
TAB Rp 178.00 DAK 2017 0 0 0 0 0
TAB Rp 154.00 DAK 2018 235 235 0 0 235 235
TAB Rp 146.00 APBD 2019 250 250 0 0 250 250
TAB Rp 146.00 DAK 2018 0 0 0 0 0
pcs Rp 5,330.00 2017 0 0 0 0 0
PCS Rp 16,704.00 2016 0 0 0 0 0
TAB Rp 127.00 2015 0 0 0 0 0
TAB Rp 112.00 DAK 2018 610 610 105 200 305 505
TAB Rp 528.00 0 0 0 0 0
Rp 628.00 DAK 2017 160 160 50 0 110 110
TAB Rp 895.00 2015 0 0 0 0 0
TAB Rp 895.00 2016 490 490 0 300 190 490
BOT Rp 40,030.00 DAK 2018 0 0 0 0 0
KPSL Rp 395.42 2016 14 14 14 0 0
PCS Rp 331.37 DAK 2018 432 432 72 360 360
PCS Rp 278.00 APBD 2019 216 216 0 216 216
BOT Rp 3,740.00 2016 0 0 0 0 0
Rp 2,925.00 DAK 2018 0 0 0 0 0 0
TAB Rp 649.12 2015 0 0 0 0 0
TUBE Rp 4,901.00 2015 0 0 0 0 0
TUBE Rp 4,400.00 2015 0 0 0 0 0
CAP Rp 176.00 2016 0 0 0 0 0
CAP Rp 176.00 2017 0 0 0 0 0
CAP Rp 143.00 DAK 2018 20 20 0 0 20 20

inj Rp 1,254.00 2017 24 24 1 21 2 23


INJ Rp 1,900.00 2015 0 0 0 0 0
INJ Rp 1,287.00 DAK 2018 0 0 0 0 0
INJ Rp 1,287.00 DAK 2018 188 188 30 150 8 158

bot Rp 1,581.25 2016 0 0 0 0 0


bot Rp 2,860.00 DAK 2018 60 60 10 50 50
BOT Rp 6,240.00 2016 0 0 0 0 0
BOT Rp 7,979.00 DAK 2018 3 3 1 0 2 2
BOT - DAK 2019
TAB Rp 60.00 2015 0 0 0 0 0
TAB Rp 52.00 APBD 2017 0 0 0 0 0
TAB Rp 52.00 APBD1 2017 0 0 0 0 0
TAB Rp 259.00 DAK 2018 1907 1907 207 700 1000 1700
TAB Rp 198.00 DAK 2018 2000 2000 203 1400 397 1797
TAB - DAK 2019
BOT Rp 1,338.00 2015 0 0 0 0 0
BOT Rp 1,190.00 Dak 2018 27 100 127 37 45 45 90

Rp 1,292.50 DAK 2017 0 0 0 0 0


AMP Rp 1,980.00 BUFFER 0 0 0 0 0
TAB Rp 594.56 2015 520 520 40 240 240 480
TAB Rp 165.78 2015 0 0 0 0 0

STOK PENE- PERSE- PENGELU SISA STOK STOK


SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
ROL Rp 42,499.60 2015 16 16 3 8 5 13
pcs Rp 1,581.25 2016 0 0 0 0 0
TAB Rp 125.00 2015 250 250 250 0 0
TAB Rp 74.00 DAK 2018 1542 1542 28 700 814 1514

TAB Rp 205.00 2015 0 0 0 0 0


TAB Rp 253.00 APBD1 2018 100 100 0 100 100
BOT Rp 371,250.00 DAK 2018 0 0 0 0 0
Rol Rp 41,910.00 2016 0 0 0 0 0
TAB Rp 351.00 2015 0 0 0 0 0
TAB Rp 351.00 BUFFER 200 200 100 100 100

TAB Rp 318.00 2015 0 0 0 0 0


Rp 347.00 DAK 2018 380 380 1 300 79 379

SYR Rp 9,100.00 2015 0 0 0 0 0


POT Rp 6,600.00 DAK 2018 12 12 0 12 12
POT Rp 5,890.00 APBD1 2018

PCS Rp 37,209.00 DAK 2017 0 1 1 1 0 0


PCS Rp 443,200.00 DAK 2018 0 1 1 1 0 0
sct Rp 1,581.25 2016 0 0 0 0 0
sct Rp 297,000.00 DAK 2019
AMP Rp 5,368.00 2015 58 58 1 49 8 57
TAB Rp 119.00 2016 0 0 0 0 0
Rp 262.50 DAK 2018 1480 1480 700 0 780 780
BOT Rp 20,360.00 DAK 2018 2 2 0 0 2 2

BOT Rp 11,000.00 DAK 2018 17 17 0 10 7 17


BOT Rp 4,770,000.00 DAK 2018 1 1 0 1 1
BOT Rp 3,310,000.00 DAK 2018 0 0 0 0 0
Rp 1,950,455.00 DAK 2018 1 1 0 1 1
BOT Rp 1,399,200.00 DAK 2017 0 0 0 0 0
BOT - DAK 2019
BOT Rp 1,870,660.00 DAK 2018 0 1 1 0 1 1
BOT Rp 698,500.00 DAK 2017 1 1 0 1 1
BOT Rp 889,570.00 DAK 2018 1 1 0 1 1
BOT Rp 748,000.00 DAK 2017 1 1 0 1 1
BOT Rp 2,093,300.00 DAK 2018 1 1 0 1 1
TUBE Rp 15,488.00 2017 10 10 0 10 10
PAK Rp 98,700.00 2017 0 0 0 0 0
PCS Rp 314.60 DAK 2017 0 0 0 0 0
PAK Rp 96,900.00 2016 0 0 0 0 0
PCS Rp 100.00 DAK 2016 0 0 0 0 0
PCS Rp 100.00 0 0 0 0 0
TAB Rp 69.00 2016 0 0 0 0 0
TAB Rp 69.00 2017 0 0 0 0 0
TAB Rp 69.00 DAK 2017 0 0 0 0 0
TAB Rp 64.00 DAK 2018 440 440 90 200 150 350

TAB Rp 89.00 2015 0 0 0 0 0


TAB Rp 89.00 2016 9 9 9 0 0
TAB Rp 89.00 DAK 2017 500 500 0 200 300 500
TAB Rp 81.00 DAK 2018 500 500 51 300 149 449
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
BOT Rp 5,700.00 2015 0 0 0 0 0
Rp 5,700.00 DAK 2017 0 0 0 0 0

SCT Rp 1,573.00 2015 0 0 0 0 0


SCT Rp 6,270.00 2016 0 0 0 0 0
POT Rp 6,270.00 DAK 2016 10 60 70 0 50 20 70
TUBE Rp 2,200.00 2016 63 63 21 38 4 42

AMP Rp 19,470.00 2016 0 0 0 0 0


PCS Rp 18,072.35 2016 0 0 0 0 0
Rp 18,072.25 DAK 2018 23 23 0 23 0 23
SET Rp 15,750.00 2015 106 106 3 84 19 103
SET Rp 37,289.00 2017 2 2 2 0 0 0
TAB Rp 136.00 2016 0 0 0 0 0
TAB Rp 686.00 2017 0 0 0 0 0
TAB Rp 110.00 DAK 2018 3955 3955 710 2220 1025 3245

Rp 750.00 2017 0 0 0 0 0
Rp 212.00 DAK 2018 500 500 0 500 500
BOT Rp 1,581.25 2016 0 0 0 0 0
BOT Rp 39,270.00 DAK 2017 0 1 1 1 0 0
PCS Rp 7,185.20 2016 0 0 0 0 0

PCS Rp 3,225.86 DAK 2017 0 0 0 0 0


PCS Rp 974.05 2016 140 140 4 124 12 136
STRIP Rp 22,252.00 DAK 2018 125 150 275 50 225 225
STRIP Rp 5,156.00 DAK 2018 200 200 400 75 300 25 325
STRIP Rp 27,495.00 DAK 2018 140 200 340 60 280 280
PCS Rp 974.05 2016 185 185 0 175 10 185
STRIP Rp 78,999.00 2016 28 28 8 20 20
STRIP Rp 78,999.80 DAK 2017 20 20 13 5 2 7
STRIP Rp 37,600.00 APBN 2017 100 100 0 100 100
STRIP Rp 11,975.00 APBDI 2018 100 100 0 100 100
KAP Rp 1,518.00 2016 800 800 0 800 800
BKS Rp 594.00 2016 0 0 0 0 0
PIECES Rp 605.00 DAK 2017 10 10 0 10 10

PCS Rp 2,133.00 2016 0 0 0 0 0


PCS Rp 2,228.60 2017 159 159 40 30 89 119
ROL Rp 27,000.00 2016 0 0 0 0 0
ROL Rp 27,000.00 DAK 2017 0 0 0 0 0
ROL Rp 29,700.00 DAK 2018 5 5 3 0 2 2

BTL Rp 14,471.60 DAK 2017 1 5 6 1 5 5


PCS Rp 3,300.00 DAK2018 18 18 8 5 5 10

SET Rp 3,000.00 2015 10 10 0 10 10


0 0 0 0 0
PCS Rp 2,200.00 DAK 2017 100 100 0 100 100
Rp 74,100.00 DAK 2018 0 0 0 0 0
TAB Rp 406.00 DAK 2018 855 855 675 0 180 180
SYR Rp 39,223.80 2016 0 0 0 0 0
SYR Rp 39,223.80 2017 0 0 0 0 0
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
TAB Rp 95.00 BUFFER 0 0 0 0 0
TAB Rp 95.00 2016 0 0 0 0 0
TAB Rp 95.00 DAK 2016 747 2000 2747 1190 500 1057 1557
TAB Rp 63.00 BUFFER 0 0 0 0 0
Rp 50.00 DAK 2018 200 200 200 0 0

AMP Rp 9,482.00 BUFFER 0 0 0 0 0


AMP Rp 1,283.00 2017 0 0 0 0 0
TAB Rp 175.00 BUFFER 0 0 0 0 0
TAB Rp 142.00 2017 0 0 0 0 0
TAB Rp 142.00 DAK 2017 1004 2000 3004 774 1400 830 2230
TAB Rp 138.00 2015 0 0 0 0 0
TAB Rp 138.00 2016 0 0 0 0 0
TAB Rp 141.00 APBD 2019 1000 1000 0 1000 0 1000
TAB Rp 139.00 2017 0 0 0 0 0
Rp 139.00 DAK 2017 0 0 0 0 0
TAB Rp 105.00 BUFFER 0 0 0 0 0
TAB Rp 125.00 DAK 2017 260 1000 1260 280 800 180 980
TAB Rp 36.00 DAK 2017 640 1200 1840 155 1400 285 1685
AMP Rp 3,754.00 2015 35 35 7 15 13 28
AMP Rp 4,260.00 APBD1 2018 0 0 0 0 0
AMP Rp 15,700.00 Dak 2018 7 7 2 5 0 5

TAB Rp 690.00 2015 0 0 0 0 0


Rp 855.00 DAK 2018 490 490 0 400 90 490
CAP Rp 1,472.00 2016 0 0 0 0 0
CAP Rp 1,472.69 2016 50 50 50 0 0
bot Rp 1,581.25 2017 6 6 0 6 6
BOT Rp 2,344.00 2015 0 0 0 0 0
BOT Rp 4,440.00 2017 0 0 0 0 0
BOT Rp 4,440.00 2016 0 0 0 0 0 0
BOT Rp 21,600.00 DAK 2018
BOT Rp 6,369.00 DAK 2018 5 5 3 0 2 2
BOT Rp 16,478.00 2016 0 0 0 0 0
BOT Rp 16,478.00 2017 1 1 1 0 0
TAB Rp 521.00 2015 0 0 0 0 0
TAB Rp 1,100.00 BUFFER 0 0 0 0 0
TAB Rp 618.00 DAK 2017 2553 2553 120 1400 1033 2433

kit Rp 977,900.00 DAK 2017 0 0 0 0 0


PCS Rp 74,100.00 DAK 2018 0 0 0 0 0
SYR Rp 11,350.00 DAK2018 30 100 130 48 45 37 82
STRIP 0 0 0 0 0
BOX Rp 359,535.00 DAK 2017 1 1 1 0 0
PCS Rp 35,832.50 DAK 2017 20 20 0 20 20
STOK PENE- PERSE- PENGELU SISA STOK STOK
SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN DIAAN ARAN GUDANG SUB UNIT AKHIR
C D E F G H I J K L
BLISTER Rp 30,595.00 APBN 2018 0 0 0 0 0
BLISTER Rp 31,570.00 APBD1 2018 30 30 5 25 25

BLISTER Rp 12,569.00 APBD1 2018 4 4 2 2 2


DUS Rp 67,500.00 2016 0 0 0 0 0
BOT Rp 341.00 DAK2016 0 500 500 100 400 400
BOT Rp 505.00 DAK2016 0 0 0 0 0
BOT Rp 622.00 DAK2016 1750 1750 400 1350 1350
DOS PROG 0 0 0 0 0
PCS PROG 0 0 0 0 0
DOS PROG 0 0 0 0 0
BOT PROG 0 0 0 0 0
DOS PROG 0 0 0 0 0
BUAH PROG 0 0 0 0 0
BOT Rp 75,000.00 POGAM 0 0 0 0 0
TAB Rp 737.00 2015 197 197 0 197 197
TEST Rp 57,684.00 PROGRAM 0 0 0 0 0
TEST Rp 5,271.00 APBN2017 325 325 0 0 325 325
TAB Rp 2,030.00 APBD1 2018 18 18 0 0 18 18
DOS Rp 431,983.00 DAK 2016 5 5 0 0 5 5

DOS Rp 1,557,469.00 DAK 2018 0 0 0 0 0


POT Rp 1,818.00 program tb 13 13 0 13 13
SET Rp 296,600.00 APBDI2017 1 1 0 1 1
PCS prog tb POV 0 0 0 0 0

PCS Rp 1,212.00 BKKBN PROV 412 412 42 370 370


BOX Rp 11,800.00 BKKBN PROV 8 10 18 2 16 16
DOS Rp 4,000.00 BKKBN PROV 38 38 8 30 30
DOS Rp 4,291.60 BKKBN PROV 0 48 48 0 48 48
VIAL Rp 6,120.00 BKKBN PROV 412 412 42 370 370
VIAL Rp 6,460.00 BKKBN PROV
STRP Rp 1,886.00 BKKBN PROV 185 185 44 141 141
SET Rp 212,500.00 BKKBN PROV 0 0 0
SET Rp 213,220.00 BKKBN PROV 8 10 18 18

SACHET Rp 2,450.00PROGRAM KIA 0 0 0 0 0


SACHET Rp 2,920.00 DAK 2018 80 80 0 80 80

118501
asangkayu.

STOK PENE-
AWAL RIMAAN
F G
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
: 0101
PUSKESMAS : PASANGKAYU 1
KECAMATAN : PASANGKAYU
KAB./KODYA : PASANGKAYU
PROVINSI : SULAWESI BARAT
HAL 1 BULAN : MARET 2019
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
1 Abocat 18 PCS Rp 8,750.00
2 Abocat 18 PCS Rp 8,575.00
3 Abocat 20 PCS Rp 16,249.99
4 Abocat 20 PCS Rp 8,750.00
5 Abocat 20 PCS Rp 8,575.00
6 Abocat 22 PCS Rp 8,750.00
7 Abocat 22 PCS Rp 8,575.00
8 Abocat 24 PCS Rp 8,750.00
9 Abocat 26 PCS Rp 27,134.00
10 Acetosal TAB Rp 127.00
11 Acyclovir 200 mg TAB Rp 251.00

12 Acyclovir 400 mg TAB Rp 362.00


13 Acyclovir 400 mg TAB Rp 630.50

14 Alat suntik sekali pakai 0,5 ml PCS Rp 1,655.50


15 Alat suntik sekali pakai 1 ml PCS Rp 1,540.00
16 Alat suntik sekali pakai 1 ml PCS Rp 1,694.00
17 Alat suntik sekali pakai 1 ml (AXIMED) PCS Rp 913.00
18 Alat suntik sekali pakai 2.5 ml PCS Rp 1,141.80
19 Alat suntik sekali pakai 3 ml PCS Rp 968.00
20 Alat suntik sekali pakai 3 ml PCS Rp 2,119.00

21 Alat suntik sekali pakai 5 ml PCS Rp 1,348.00


22 Alat suntik sekali pakai 5 ml PCS Rp 861.30

23 Albendazol SYR Rp 4,234.00


24 Albendazol tablet 400 mg TAB Rp 363.00
25 Albendazol tablet 400 mg TAB Rp 266.80
26 Alginat BOT Rp 239,525.00
27 Aroma fine normal (Alginat aroma bks Rp 192,000.00
28 Alkohol 100 ml BOT Rp 2,625.00
29 Alkohol 1000 ml BOT Rp 25,800.00
30 Alkohol Swab pcs Rp 245.00
31 Alkohol Swab pcs Rp 242.00

32 Alopurinol tablet 100 mg TAB Rp 96.00


33 Alopurinol tablet 100 mg TAB Rp 90.00
34 Alopurinol tablet 100 mg TAB Rp 96.00
35 Alopurinol tablet 100 mg TAB Rp 96.00
36 Alopurinol tablet 300 mg TAB Rp 249.00
37 Ambroxol SYR BOT Rp 6,512.30
38 Ambroxol 30 mg TAB Rp 242.00
39 Aminofilin INJ 24 mg/ml - 10 ml AMP Rp 4,200.00
40 Aminofilin tablet 200 mg TAB Rp 86.00
41 Amitripilin 25 mg TAB Rp 123.00

42 Amlodipin 10 mg TAB Rp 168.00


43 Amlodipin 10 mg TAB Rp 279.13

44 Amlodipin 5 mg (HEXAVASK) TAB Rp 197.00


45 Amlodipin 5 mg (HEXAVASK) TAB Rp 1,050.00
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
46 Amoksisilin 500 mg TAB Rp 279.00
47 Amoksisilin 500 mg TAB Rp 279.00
48 Amoksisilin 500 mg TAB Rp 239.00
49 Amoksisilin 250 mg CAP Rp 220.00
50 Amoksisilin SYR 125 mg/5 ml BOT Rp 2,560.00
51 Amoksisilin SYR 125 mg/5 ml BOT Rp 8,900.00
52 Amoksisilin SYR 125 mg/5 ml (SOLPENOX) BOT Rp 8,900.00
53 Amoksisilin SYR 125 mg/5 ml (YUSIMOX) BOT Rp 4,466.00
54 Amoksisilin SYR 250 mg/5 ml BOT Rp 4,655.00
55 Amoksisilin SYR 250 mg/5 ml BOT Rp 3,740.00
56 Amoksisilin DROPS (SUPRAMOX) BOT Rp 28,500.00
57 Ampisilin INJ AMP Rp 5,610.00
58 Antalgin (metampiron) 500 mg TAB Rp 385.00
59 Antalgin (metamizole sodium 500 mg TAB Rp 385.00
60 Antasida SYR Rp 2,135.00
61 Antasida SYR Rp 2,135.00
62 Antasida SYR Rp 2,146.00
63 Antasida doen tablet kombinasi TAB Rp 78.00
64 Antasida doen tablet kombinasi 400 mg TAB Rp 72.00

65 Anti Hemoroid SUPP Rp 2,200.00

66 Aqua dest steril VIAL Rp 2,750.00


67 As. Mefenamat TAB Rp 119.00
68 As. Mefenamat TAB Rp 119.00
69 As. Mefenamat TAB Rp 117.00
70 As. Mefenamat (BIRU) TAB Rp 176.00
71 As. Mefenamat 500 mg TAB Rp 119.00
72 As. Mefenamat 500 mg TAB Rp 119.00

73 Asam folat (AFOLAT) TAB Rp 52.00


74 Asam folat (Profolat) TAB Rp 64.00
75 ASEPTIC GEL BTL Rp 1,581.25
76 Atenolol (FARNORMIN) TAB Rp 387.00
77 Atenolol (FARNORMIN) TAB Rp 342.00
78 Atropin sulfat INJ 0.25 mg/ml - 1ml AMP Rp 1,400.00
79 Atropin sulfat tab 0,5 mg TAB Rp 81.00
80 Attapulgit TAB Rp 220.00
81 Attapulgit TAB Rp 196.00
82 Attapulgit (ARCAPEC) SYR Rp 1,581.25
83 ABATE SCT Rp 6,380.00

84 Bactivec (abate) BOT


85 Bacitracin polymixin TUBE Rp 2,767.00
86 Bacitracin polymixin TUBE Rp 3,511.00

87 Betahistin TAB Rp 1,062.60


88 Betahistin TAB Rp 177.00
89 Betametason SALP 0.1 % TUBE Rp 1,596.00
90 Betametason SALP 0.1 % TUBE Rp 1,596.00

91 Betametason TTS MATA (BETAM) BTL Rp 19,600.00


92 Bicolax TAB Rp 1,335.27
93 BIOPLACENTon TUBE Rp 18,125.00
94 Bisoprolol TAB Rp 2,553.83
95 Blood Lancet 265 PCS Rp 160.23
96 Blood Lancet 266 PCS Rp 160.23
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
97 Bronheksine (MIRAVAN) TAB Rp 354.20

98 CALCII GLUCONAT AMP Rp 1,581.25


99 Calsium Laktat TAB Rp 72.00
100 Calsium Laktat TAB Rp 72.00
101 Calsium Laktat TAB Rp 64.00
102 Captopril 12.5 mg TAB Rp 69.00
103 Captopril 12.5 mg TAB Rp 69.00
104 Captopril 12.5 mg TAB Rp 72.00
105 Captopril 12.5 mg TAB Rp 68.00

106 Captopril 25 mg TAB Rp 82.00


107 Captopril 25 mg TAB Rp 82.00
108 Captopril 25 mg TAB Rp 137.75
109 Captopril 25 mg TAB Rp 82.00
110 Captopril 50 mg TAB Rp 147.00
111 Captopril 50 mg TAB Rp 147.00

112 Carbamazepin TAB Rp 269.00


113 Catgut/Benang bedah 3/0 plain SET Rp 33,250.00
114 Catgut 3/0 CHOMIC SET Rp 6,420.33
115 Catgut 2/0 CHOMIC SET Rp 6,420.83
116 CHKM BOTOL Rp 126,500.00
117 Plant Cutura 2/0 SET Rp 6,420.83
118 PLAINCatgut 3/0 SET Rp 6,420.83
119 Cefadroxil BOT Rp 5,286.00
120 Cefadroxil CAP Rp 557.00
121 Cefadroxil CAP Rp 495.00
122 Cefixime CAP Rp 700.00
123 Cefotaxin INJ AMP Rp 6,785.00
124 Ceftriaxone AMP Rp 6,785.00
125 Cetirizin TAB Rp 156.00
126 Cetirizin syr syr Rp 8,094.00
127 Cetirizin syr Rp 13,956.00
128 Ciprofloxacin TAB Rp 309.00
129 Ciprofloxacin BAQUINOR TTS MATA BTL Rp 10,250.00
130 Clhorpromazine 100 mg TAB Rp 156.00
131 Clhorpromazine 25 mg TAB Rp 75.00
132 Clindamycin 150 mg CAP Rp 405.00
133 Clindamycin 150 mg CAP Rp 786.00
134 Clindamycin 300 mg CAP Rp 693.00
135 Clor Etil BOT Rp 158,125.00
136 Clor Etil BOT Rp 506,000.00
137 Cloramfenikol 250 mg CAP Rp 261.00
138 Cloramfenikol 250 mg CAP Rp 341.00
139 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00
140 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00
141 Cloramfenikol 3 % TUBE Rp 3,460.00
142 Cloramfenikol 2 % TUBE Rp 3,416.00
143 Cloramfenikol salp mata 1 % TUBE Rp 1,680.00
144 Cloramfenikol salp mata 1 % TUBE Rp 2,013.00
145 Cloramfenikol TTS MATA BOT Rp 12,600.00
146 Cloramfenikol TTS telinga BOT Rp 6,424.00
147 Clorfeniramin Maleat (CTM) TAB Rp 54.00
148 Clorfeniramin Maleat (CTM) TAB Rp 46.00
149 Clorfeniramin Maleat (CTM) Rp 46.00
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
150 Composit A3 PCS Rp 749,320.00
151 Composit A35 PCS Rp 749,320.00
152 Cotrimoksazol 480 mg (DOEN) TAB Rp 158.00
153 Cotrimoksazol 480 mg (DOEN) TAB Rp 152.00
154 Cotrimoksazol Pediatrik TAB Rp 83.49
155 Cotrimoksazol SYR BOT Rp 7,810.00
156 Cotrimoksazol SYR BOT Rp 2,250.00
157 CURCUMA TAB Rp 1,644.00
158 CUTIMED SORBACT SWAB PCS Rp 30,503.00
159 COTTON ROLL ROLL Rp 100,150.00
160 CRESOPHENE, SOLUTION,LIQUID BOTOL Rp 770,000.00
161 Deksametason AMP Rp 1,820.00

162 Deksametason tablet 0.5 mg TAB Rp 52.00


163 Deksametason tablet 0.5 mg TAB Rp 46.00
164 Deksametason tablet 0.5 mg TAB Rp 35.00
165 Deksametason tablet 0.5 mg TAB Rp 95.00
166 Deksametason tablet 0.5 mg TAB Rp 95.00

167 Diazepam 2 mg TAB Rp 35.09


168 Diazepam 2 mg TAB Rp 86.00
169 Diazepam INJ 5 mg/ml AMP Rp 18,260.00
170 Digoksin tablet 0.25 mg TAB Rp 103.00
171 Dilteazem HCL tab 30 mg TAB Rp 141.00
172 Dimenhidrinat TAB Rp 109.00
173 DIPHENHIDRAMIN INJ Rp 1,156.00
174 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 2,720.00
175 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 3,594.25
176 jarum citojeck PCS Rp 1,705.00
177 Domperidon syr BOT Rp 14,374.80
178 Domperidon syr BOT Rp 2,970.00
179 Domperidon Tab TAB Rp 174.00
180 Domperidon 10 mg TAB Rp 90.00
181 Doxiciklin CAP Rp 298.00
182 DULCOLAX 5 mg SUPP Rp 5,670.00
183 DULCOLAX 10 mg SUPP Rp 5,800.00
184 DULCOLAX 10 mg SUPP Rp 5,900.00
185 Epinefrin hcl AMP Rp 8,910.00
186 Ergotamin Cafein TAB Rp 149.00
187 Eritromycin CAP Rp 679.00
188 Eritromycin SYR Rp 7,391.00
189 Eritromycin SYR Rp 7,391.00
190 Eritromycin SYR Rp 2,490.00

191 Etakridin /Rivanol 300 ml BOT Rp 3,060.00


192 Etambutol hcl. Tablet 250 mg TAB Rp 330.00

193 Etiket obat Biru LMBR Rp 61.00


194 Etiket Obat Putih LMBR Rp 61.00
195 ETSGEL Rp 395,532.50
196 Eugenol BOT Rp 50,416.67

197 ELITE CEMENT BOX Rp 370,620.00


198 EXAFLEX PUTTY BOX Rp 2,100,000.00
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
199 Ferro Sulfat SCT Rp 425.00
200 Ferro Sulfat SCT Rp 425.00
201 Ferro Sulfat SCT APBD1 2018
202 Ferro Sulfat SCT Rp 427.00

203 Folley cateter no.16 SET Rp 20,000.00


204 Folley cateter no.18 SET Rp 20,000.00
205 Furosemid inj 10mg/ml AMP Rp 2,012.00
206 Furosemid tablet 40 mg TAB Rp 84.00
207 Furosemid tablet 40 mg TAB Rp 77.00
208 FOMALIN TAB Rp 5,060.00
209 Garam oralit untuk 200 ml air SCT Rp 1,072.50
210 Garam oralit untuk 200 ml air SCT Rp 278.00
211 Gelang pasien warna pink PCS Rp 2,706.00
212 Gentamycin inj. AMP Rp 3,699.00
213 Gentian Violet lar 1 % BOT Rp 3,750.00
214 Glass Lonomer SET/BTL Rp 949,520.00
215 Glass Lonomer SET/BTL Rp 1,050,000.00
216 Glibenclamid 5 mg TAB Rp 61.00
217 Glibenclamid 5 mg TAB Rp 143.00
218 Glibenclamid 5 mg TAB Rp 90.00
219 Glimepirid 1 mg TAB Rp 1,576.00
220 Glimepirid 2 mg TAB Rp 311.00
221 Glimepirid 2 mg TAB Rp 207.00
222 Gliseril Guayakolat TAB Rp 66.79
223 Gliseril Guayakolat TAB Rp 66.79
224 Gliseril Guayakolat TAB Rp 66.79
225 Gluko + protein test box PCS Rp 1,150.00
226 Griseofulvin 125 mg TAB Rp 230.00
227 Griseofulvin 125 mg TAB Rp 263.00
228 Griseofulvin 125 mg TAB Rp 231.00
229 Haloperidol tab 5 mg TAB Rp 105.00
230 Haloperidol tab 0.5 mg TAB Rp 55.00
231 Haloperidol tab 1.5 mg TAB Rp 59.00
232 Handscoon 6 (T-SENSAURGE) STERIL SET Rp 7,254.50
233 Handscoon 7 SET Rp 9,310.00
234 Handscoon 7 Rp 9,120.00
235 Handscoon 7 STERIL SET Rp 8,360.00

236 Handscoon 7,5 (aximed) STERIL SET Rp 9,310.00


237 Handscoon 7,5 (aximed) STERIL SET Rp 9,120.00
238 Handscoon 7,5 (T-SENSAURGE) STERIL SET Rp 7,254.50
239 Handscoon 8 STERIL SET Rp 9,310.00
240 Handscoon non steril (M)AXIMED EXAMINATION SET Rp 508.20

241 HBSAG Strip STRIP Rp 11,037.00


242 Hidroklortiazid 25 mg TAB Rp 179.00
243 Hidroklortiazid 25 mg TAB Rp 179.00
244 Hidrokortison Salp TUBE Rp 2,938.00
245 Hidrokortison Salp TUBE Rp 2,938.00
246 Hidrokortison Salp 2,5% TUBE Rp 2,848.00
247 HISTIGO TAB Rp 595.05
248 HYDCAL PASTA BASE TUBE Rp 299,530.00

PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
249 Ibuprofen 400 mg TAB Rp 139.00
250 Ibuprofen 400 mg (ARFEN) TAB Rp 501.10
251 Ibuprofen 400 mg TAB Rp 139.00
252 Ibuprofen 400 mg (FASIFEN) TAB Rp 525.00
253 Ibuprofen 400 mg TAB Rp 139.00

254 Ibuprofen 200 mg TAB Rp 116.00


255 Ibuprofen 200 mg TAB Rp 116.00
256 Ibuprofen suspensi 200 mg/5 mg BOT Rp 4,949.00
257 Ibuprofen suspensi 200 mg/5 mg BOT Rp 5,509.00
258 Infant muccus PCS Rp 37,988.50
259 Infuset Makro SET Rp 5,880.00
260 Infuset Makro (PIECES) SET Rp 3,190.00
261 Infuset Makro (OTSU SET) SET Rp 13,200.00
262 Infuset Mikro SET Rp 7,920.00
263 isosorbid TAB Rp 98.00

264 JARUM HACTING NO. 08 LSN Rp 30,000.00


265 JARUM HACTING NO. 10 LSN Rp 30,000.00
266 JARUM HACTING NO. 12 LSN Rp 30,000.00
267 JARUM HACTING NO. 15 LSN Rp 30,000.00
268 Kaca Penutup (Deg Glass) pcs Rp 929.50
269 Kalium Diklofenak TAB Rp 814.66
270 Kalium permanganat BOT Rp 6,325.00
271 Kapas 250 gr ROL Rp 14,375.00
272 Kapas 250 gr ROL Rp 14,375.00
273 Kapas 250 gr ROL Rp 14,375.00

274 KARTU GOLONGAN DARAH PCS Rp 2,200.00


275 Kasa gulung 36x80 cm ROL Rp 142,600.00
276 Kasa gulung 30x60 cm ROL Rp 142,600.00
277 Kasa gulung 30x60 cm ROL Rp 142,600.00
278 Kasa gulung 36x80 cm Rp 142,600.00
279 Kasa Steril 16x16 cm SET Rp 8,740.00
280 Kasa Steril 16x16 cm Rp 575.00
281 Kasa Steril 5x5 cm SET Rp 3,311.00
282 Kasa PEMBALUT 4x10 cm ROL Rp 1,725.00
283 Kertas puyer LBR Rp 123.20
284 Ketamin INJ VIAL Rp 63,400.00
285 Ketoconazole 200 mg TAB Rp 303.00
286 Ketoconazole 200 mg TAB Rp 303.00
287 Ketoconazole salp 2 % TUBE Rp 2,697.00
288 Ketoconazole salp 2 % TUBE Rp 2,694.00

289 Ketorolak inj 30 AMP Rp 1,450.00


290 Kombinasi Prometamin 25 + Sulfadoxin 500 TAB Rp 572.00
291 Lansoprazol (DIGEST) CAP Rp 5,500.00
292 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00
293 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00
294 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00
295 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00
296 Larutan NACL Lar infus 0,9 % Rp 6,410.00

297 Larutan RL BOT Rp 7,150.00


298 Larutan RL BOT Rp 7,150.00

PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
299 LARUTAN EDTA 10*Indoor BOT Rp 1,702,536.00
300 LARUTAN Giemsa indoor BOT Rp 1,523,280.00
301 LARUTAN Giemsa indoor BOT Rp 356,250.00
302 LARUTAN Haemoglobin C indoor BOT Rp 296,956.00
303 LARUTAN Hcl 0,1 N Indoor BOT Rp 236,808.00
304 LARUTAN Metanol PA BOT Rp 686,697.00
305 LARUTAN Trombosit Ao indoor BOT Rp 374,440.00
306 LARUTAN Turk 500ml BOT Rp 444,015.00
307 Lidocain INJ AMP Rp 929.00
308 Lidocain INJ AMP Rp 2,215.00
309 Loperamid TAB Rp 97.00
310 Loperamid Rp 97.00
311 Loperamid 2 mg Rp 97.00
312 Loratadin TAB Rp 159.00
313 Loratadin TAB Rp 159.00
314 Loratadin 10 mg TAB Rp 500.00
315 Lysol BOT Rp 49,200.00
316 Lysol 1000 Ml BOT Rp 49,200.00

317 Litrol TTS mata BOT Rp 5,850.00


318 Masker earloop SET Rp 440.00
319 Masker earloop SET Rp 435.60
320 Masker earloop (AXIMED) SET Rp 436.00
321 Masker Standar tie on (IKAT) SET Rp 588.00
322 Masker Standar tie on (IKAT) SET Rp 528.00

323 Mebendazol (VERMOX) TAB Rp 8,800.00


324 MEDLENCE plus extra 21 G/2,4 mm PCS Rp 3,991.90
325 MEDLENCE plus lite 25 G/1,5 mm PCS Rp 3,991.90
326 MEDLENCE plus special 0,8 (blade) 2,0 mm PCS Rp 3,991.90
327 MEDLENCE plus universal 21 G/1.8 mm PCS Rp 3,991.90
328 Meloxicam 7,5 mg TAB Rp 761.00
329 Metformin CAP Rp 206.25
330 Metformin CAP Rp 103.00
331 Metformin 500 mg CAP Rp 336.00

332 Metformin 850 mg CAP Rp 168.00


333 Methylprednisolon 16 mg Rp 1,325.00
334 Methylprednisolon 4 mg TAB Rp 500.62
335 Methylprednisolon 4 mg TAB Rp 212.00
336 Methylprednisolon 4 mg TAB Rp 170.00
337 Methylprednisolon 4 mg TAB Rp 170.00

338 Metilergometrin maleat 0,125 mg TAB Rp 169.00


339 Metilergometrin maleat INJ Rp 2,684.00
340 Metoclopramid 10 mg TAB Rp 100.00
341 Metoclopramid 10 mg TAB Rp 87.00
342 Metoclopramid 5 mg TAB Rp 129.00
343 Metronidazol 250 mg TAB Rp 116.00
344 Metronidazol 500 mg TAB Rp 143.00
345 Metronidazol 500 mg TAB Rp 143.00
346 Metronidazol INFUS BOT Rp 12,980.00
347 Metronidazol SYR Rp 1,581.25
348 MgSO4 20 % INJEKSI Rp 2,800.00
349 MgSO4 40 % INJEKSI Rp 3,650.00

PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
350 Miconazol TUBE Rp 3,150.00
351 Miconazol 2% Cream TUBE Rp 4,097.00
352 Miniaspi 80mg TAB Rp 163.00
353 Miniaspi/asetosal Rp 163.00
354 Nasal Oksigen M PCS Rp 8,085.00
355 Nasal Oksigen XS PCS Rp 8,085.00
356 Natrium Diklofenak 25 mg TAB Rp 162.00
357 Natrium Diklofenak 25 mg TAB Rp 178.00
358 Natrium Diklofenak 25 mg TAB Rp 154.00
359 Natrium Diklofenak 25 mg TAB Rp 146.00
360 Natrium Diklofenak 50 mg TAB Rp 146.00
361 Nelaton catheter pcs Rp 5,330.00
362 Nebulyzer mask DEWASA PCS Rp 16,704.00
363 Nifedipin TAB Rp 127.00
364 Nifedipin 10 mg TAB Rp 112.00
365 Nistatin 100.000 TAB Rp 528.00
366 Nistatin Vaginal 100.000 Rp 628.00
367 Nistatin 500.000 TAB Rp 895.00
368 Nistatin 500.000 TAB Rp 895.00
369 Nistatin DROPS BOT Rp 40,030.00
370 NOVABION KPSL Rp 395.42
371 ONELAB Objeck Glass 72 PCS PCS Rp 331.37
372 Objeck Glass PCS Rp 278.00
373 OBH syr BOT Rp 3,740.00
374 OBH syr Rp 2,925.00
375 Ofloxacin TAB Rp 649.12
376 Oksitertaciklin SALP 1 % TUBE Rp 4,901.00
377 Oksitertaciklin SALP 3 % TUBE Rp 4,400.00
378 Omeprasol CAP Rp 176.00
379 Omeprasol 20 mg CAP Rp 176.00
380 Omeprasol 20 mg CAP Rp 143.00

381 Ondansetron inj Rp 1,254.00


386 OXYTOCIN INJ Rp 1,900.00
387 OXYTOCIN INJ Rp 1,287.00
388 OXYTOCIN INJ Rp 1,287.00

389 Otsu wi bot Rp 1,581.25


390 Otsu wi bot Rp 2,860.00
391 Paracetamol (FASIDOL)Droop BOT Rp 6,240.00
392 Paracetamol (FASIDOL)Droop BOT Rp 7,979.00
393 Paracetamol DroopS BOT -
394 Paracetamol 500 mg TAB Rp 60.00
395 Paracetamol 500 mg TAB Rp 52.00
396 Paracetamol 500 mg TAB Rp 52.00
397 Paracetamol 500 mg TAB Rp 259.00
398 Paracetamol 500 mg TAB Rp 198.00
399 Paracetamol 500 mg TAB -
400 Paracetamol SYR BOT Rp 1,338.00
401 Paracetamol SYR BOT Rp 1,190.00

402 Pipet Dirpo Rp 1,292.50


403 Phenobarbital inj 50mg/ml AMP Rp 1,980.00
404 Piracetam 1200 mg TAB Rp 594.56
405 piroxicam 10 mg TAB Rp 165.78

PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
406 Plester ROL Rp 42,499.60
407 Plain 3/0 pcs Rp 1,581.25
408 Prednison TAB Rp 125.00
409 Prednison 5 mg TAB Rp 74.00

410 PRIMAQUIN TAB Rp 205.00


411 PRIMAQUIN 15 mg TAB Rp 253.00
412 PK (kalium pemanganat) 5 g BOT Rp 371,250.00
413 Procrepe 15 cm x 4,55 m (perban) Rol Rp 41,910.00
414 PTU (Propiltiourasil) 100 mg TAB Rp 351.00
415 PTU (Propiltiourasil) 100 mg TAB Rp 351.00

416 Pyrantel TAB Rp 318.00


417 Pyrantel 125 mg Rp 347.00

418 Pyrantel SYR Rp 9,100.00


419 POT URINE POT Rp 6,600.00
420 POT 50 ml POT Rp 5,890.00

421 PETERS SILK PCS Rp 37,209.00


422 PULP-X V DEVITALIZER PASTE PCS Rp 443,200.00
423 RDT DBD iig sct Rp 1,581.25
424 RDT DBD COMO sct Rp 297,000.00
425 Ranitidin INJ AMP Rp 5,368.00
426 Ranitidin TAB TAB Rp 119.00
427 Ranitidin 150 mg Rp 262.50
428 RECO tts mata BOT Rp 20,360.00

429 RECO tts Telinga BOT Rp 11,000.00


430 Reagen diluent BOT Rp 4,770,000.00
431 Reagen lyse BOT Rp 3,310,000.00
432 Reagen RINSE Rp 1,950,455.00
433 Reagen Asam urat BOT Rp 1,399,200.00
434 Reagen WIDAL TEST BOT -
435 RAJAWALI UIC ACID (REAGEN) BOT Rp 1,870,660.00
436 Reagen Kimia Klinik Glucosa BOT Rp 698,500.00
437 RAJAWALI Glucosa (REAGEN) BOT Rp 889,570.00
438 Reagen Kimia Klinik Kolesterol BOT Rp 748,000.00
439 RAJAWALI KOLES ( Kolesterol) BOT Rp 2,093,300.00
440 RYLES TUBE Rp 15,488.00
441 Sak Besar (10x15 cm) PAK Rp 98,700.00
442 Sak Besar (10x15 cm) PCS Rp 314.60
443 Sak Sedang (6x10 cm) PAK Rp 96,900.00
444 Sak Sedang (6x10 cm) PCS Rp 100.00
445 Sak Kecil PCS Rp 100.00
446 Salbutamol 2 mg TAB Rp 69.00
447 Salbutamol 2 mg TAB Rp 69.00
448 Salbutamol 2 mg TAB Rp 69.00
449 Salbutamol 2 mg TAB Rp 64.00

450 Salbutamol 4 mg TAB Rp 89.00


451 Salbutamol 4 mg TAB Rp 89.00
452 Salbutamol 4 mg TAB Rp 89.00
453 Salbutamol 4 mg TAB Rp 81.00
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
454 Salbutamol sirup 2mg/5ml BOT Rp 5,700.00
455 Salbutamol sirup 2mg/5ml Rp 5,700.00

456 Salicil talk SCT Rp 1,573.00


457 Salicil talk SCT Rp 6,270.00
458 Salicil talk 2% POT Rp 6,270.00
459 Salp 24 TUBE Rp 2,200.00

460 SCANDONEST AMP Rp 19,470.00


461 Sefety box PCS Rp 18,072.35
462 Sefety box 25 K 5 L Rp 18,072.25
463 Silk SET Rp 15,750.00
464 Silk SET Rp 37,289.00
465 Simvastatin 10 mg TAB Rp 136.00
466 Simvastatin (SVT) TAB Rp 686.00
467 Simvastatin 10 mg TAB Rp 110.00

468 SPASMINAL Rp 750.00


469 Sprinolakton Rp 212.00
470 SPRITUS BOT Rp 1,581.25
471 SPRITUS 250 ml BOT Rp 39,270.00
472 Strip Asam Urat (NESCO) PCS Rp 7,185.20

473 Strip Glucosa (BENECHECK) PCS Rp 3,225.86


474 Surgical Blade No.11 PCS Rp 974.05
475 Strip Asam Urat (HUMASENS) STRIP Rp 22,252.00
476 Strip Glucosa (HUMASENS) STRIP Rp 5,156.00
477 Strip Kolesterol (HUMASENS) STRIP Rp 27,495.00
478 Surgical Blade No.15 PCS Rp 974.05
479 TEST NARKOBA/DRUG ABUSE STRIP Rp 78,999.00
480 TEST NARKOBA STRIP Rp 78,999.80
481 TEST HIV (SD BIOLINE HIV) STRIP Rp 37,600.00
482 TEST HIV (SD BIOLINE HIV) STRIP Rp 11,975.00
483 Tiamfenicol 500 KAP Rp 1,518.00
484 TIPS PIPET BIRU BKS Rp 594.00
485 TABUNG PLASTIK SEUM 1,5 ml PIECES Rp 605.00

486 Ultra One test hamil strip PCS Rp 2,133.00


487 Ultra One test hamil strip PCS Rp 2,228.60
488 Ultrafix/ PHarmafix ROL Rp 27,000.00
489 Ultrafix/ Pharmafix ROL Rp 27,000.00
490 Ultrafix/ Pharmafix ROL Rp 29,700.00

491 ULTRASOUN GEL (GEL USG) BTL Rp 14,471.60


492 UMBILICAL C (PENJEPIT TP) PCS Rp 3,300.00

493 Urin bag/UROPLAS SET Rp 3,000.00


494 UINE STIP 10 PAAMETE
495 VACUM TUBE PLAIN PCS Rp 2,200.00
496 VACUM EDTA Rp 74,100.00
497 VIT CALCIFAR TAB Rp 406.00
498 VIT SYR (TAKANA) SYR Rp 39,223.80
499 VIT SYR (TAKANA) SYR Rp 39,223.80
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
500 Vitamin B 1 (tiamin) TAB Rp 95.00
501 Vitamin B 1 (tiamin) TAB Rp 95.00
502 Vitamin B 1 (tiamin) 50 mg TAB Rp 95.00
503 Vitamin B 12 TAB Rp 63.00
504 Vitamin B 12 Rp 50.00

505 Vitamin B 12 INJ AMP Rp 9,482.00


506 Vitamin B 12 INJ AMP Rp 1,283.00
507 Vitamin B 6 (piridoksin) TAB Rp 175.00
508 Vitamin B 6 (piridoksin) TAB Rp 142.00
509 Vitamin B 6 (piridoksin) TAB Rp 142.00
510 Vitamin B comp TAB Rp 138.00
511 Vitamin B comp TAB Rp 138.00
512 Vitamin B comp TAB Rp 141.00
513 Vitamin C (Asam askorbat) 250 mg TAB Rp 139.00
514 Vitamin C (Asam askorbat)250 mg Rp 139.00
515 Vitamin C (Asam askorbat)50 mg TAB Rp 105.00
516 Vitamin C (Asam askorbat)50 mg TAB Rp 125.00
517 Vitamin C (Asam askorbat)25 mg TAB Rp 36.00
518 Vitamin K INJ AMP Rp 3,754.00
519 Vitamin K INJ AMP Rp 4,260.00
520 Vitamin K INJ AMP Rp 15,700.00

521 Vitamin K TAB TAB Rp 690.00


522 Vitamin K TAB 10 mg Rp 855.00
523 VITROMEGA CAP Rp 1,472.00
524 VITROMEGA CAP Rp 1,472.69
525 X. TRAGEN bot Rp 1,581.25
526 Yodium Povidon 30 ml BOT Rp 2,344.00
527 Yodium Povidon 60 ml BOT Rp 4,440.00
528 Yodium Povidon 300 ml BOT Rp 4,440.00
529 Yodium Povidon 300 ml BOT Rp 21,600.00
530 ZINCPO dropS BOT Rp 6,369.00
531 Zink Syrup 10mg/ml BOT Rp 16,478.00
532 Zink Syrup 10mg/ml BOT Rp 16,478.00
533 Zink TAB TAB Rp 521.00
534 Zink TAB TAB Rp 1,100.00
535 Zink 20 mg TAB Rp 618.00

536 creatininKIN 2x100 ml kit Rp 977,900.00


537 Vacum tube sterlite PCS Rp 74,100.00
538 Procurma SYR Rp 11,350.00
539 WIDAL TES STRIP
540 3M ESPE CAVIT FILLING BOX Rp 359,535.00
541 VASELINE SWAB 10MX10CM PCS Rp 35,832.50
542 PROGRAM
PERMIN-
NO NAMA OBAT SATUAN HARGA SATUAN
TAAN
M A B C D
MDT MB DEWASA BLISTER Rp 30,595.00
MDT MB DEWASA BLISTER Rp 31,570.00

MDT PB DEWASA BLISTER Rp 12,569.00


LACTOGEN 4 DUS Rp 67,500.00
VIT A BIRU BOT Rp 341.00
VIT A MERAH BOT Rp 505.00
VIT A MERAH BOT Rp 622.00
GLUCO PROTEIN (ONE MAD) DOS
ULTRA ONE TEST (ONE MAD) PCS
HB SAHLI (ONE MAD) DOS
HCL 0,1 N 100 ML (ONE MAD) BOT
BLOOD LANCET (ONE MAD) DOS
AUTOCLIK (ONE MAD) BUAH
IODIUM TEST BOT Rp 75,000.00
QUININE TAB Rp 737.00
RDT MALARIA TEST Rp 57,684.00
RDT MALARIA TEST Rp 5,271.00
OAM (DHP-Frimal) TAB Rp 2,030.00
OBAT PAKET TB KATEGORI 1 DOS Rp 431,983.00

OBAT PAKET TB KATEGORI 2 DOS Rp 1,557,469.00


POT DAHAK POT Rp 1,818.00
REAGENS ZIEHL NEELSEN SET Rp 296,600.00
MASKER IKAT PCS prog tb POV

ALAT SUNTIK 3 ml PCS Rp 1,212.00


COPPER T/ UID BOX Rp 11,800.00
KONDOM DOS Rp 4,000.00
KONDOM DOS Rp 4,291.60
OBAT KB SUNTIK 3 BULAN VIAL Rp 6,120.00
OBAT KB SUNTIK 3 BULAN VIAL Rp 6,460.00
PIL KB 1 KOMBINASI STRP Rp 1,886.00
SUSUK KB/IMPLAN SET Rp 212,500.00
SUSUK KB/IMPLAN SET Rp 213,220.00

MINERAL MIX SACHET Rp 2,450.00


MINERAL MIX SACHET Rp 2,920.00

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
SI BARAT
HAL 1
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2016 0 0 0 0 1
DAK 2016 46 46 0 30 16 46 2
2015 0 0 0 3
2016 0 0 0 4
DAK 2016 20 20 7 13 13 5
2016 30 30 0 22 8 30 6
DAK 2016 4 4 0 4 0 4 7
2016 83 83 3 68 12 80 8
DAK 2018 96 96 0 90 6 96 9
2015 0 0 0 0 0 10
2014 20 20 2 18 18 11

2015 0 0 0 12
2017 315 315 60 200 55 255 13

DAK 2016 90 90 0 90 90 14
2015 0 0 0 0 15
2016 60 60 12 48 48 16
DAK 2018 489 489 24 465 465 17
2013 0 0 0 18
2016 0 0 0 19
DAK 2018 800 800 205 425 170 595 20

2013 0 0 0 21
2017 236 236 17 200 19 219 22

2016 0 0 0 23
2016 599 599 405 194 194 24
APBN 2017 5000 5000 800 4200 4200 25
2017 1 1 0 1 1 26
dak 2017 0 0 0 27
2016 42 42 35 7 7 28
2016 0 0 0 29
2016 0 0 0 30
2017 0 0 0 31

BUFFER 0 0 0 32
2015 0 0 0 33
2017 0 0 0 34
DAK 2017 1300 1300 310 300 690 990 35
DAK 2017 630 630 150 300 180 480 36
DAK 2018 1 1 0 1 1 37
DAK 2018 3109 3109 471 1900 738 2638 38
2015 30 30 0 30 30 39
2015 0 0 0 40
2015 381 381 0 300 81 381 41

2016 0 0 0 42
DAK 2018 2214 2214 520 1350 344 1694 43

2015 0 0 0 44
2017 0 0 0 45
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2013 590 590 590 46
2016 40 40 40 0 0 47
DAK 2017 2000 2000 30 1900 70 1970 48
2014 0 0 0 49
2014 0 0 0 50
DAK 2018 0 0 0 51
DAK 2018 9 9 0 9 9 52
DAK 2018 59 59 5 50 4 54 53
2017 0 0 0 54
DAK 2018 49 49 18 19 12 31 55
DAK 2018 24 24 0 14 10 24 56
2015 0 0 0 57
DAK 2016 1580 1580 80 1100 400 1500 58
DAK 2016 625 625 60 565 565 59
2015 0 0 0 60
DAK 2016 10 10 10 61
DAK 2018 98 98 47 20 31 51 62
2015 0 0 0 63
2017 1772 1772 280 500 992 1492 64

2016 2 2 2 65

2017 0 0 0 66
2014 0 0 0 67
2016 0 0 0 68
2017 0 0 0 69
2017 0 0 0 70
APBD 2018 2800 2800 477 1200 1123 2323 71
APBD 2019 2130 2130 930 1200 0 1200 72

2016 0 0 0 73
DAK 2018 1710 1710 400 900 410 1310 74
2017 0 0 0 75
2015 0 0 0 76
DAK 2017 500 500 0 500 500 77
2016 88 88 0 84 4 88 78
2016 0 0 0 79
2016 1770 1770 40 1600 130 1730 80
2017 500 500 0 100 400 500 81
2017 17 17 2 9 6 15 82
DAK 2018 250 250 250 83

BS 0 0 0 84
2015 0 0 0 85
2017 0 0 0 86

2016 0 0 0 87
2017 160 160 160 0 0 88
2015 0 0 0 89
2016 1 1 1 0 0 90

DAK 2018 30 30 5 17 8 25 91
2016 162 162 0 162 162 92
2017 0 0 0 93
2016 1485 1485 0 1300 185 1485 94
2016 0 0 0 95
2016 100 100 0 100 100 96
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2015 0 0 0 97

2016 23 23 0 23 23 98
2015 0 0 0 99
2016 0 0 0 100
buffer stok 0 0 0 0 0 101
2014 0 0 0 102
2015 0 0 0 103
2017 0 0 0 104
DAK 2018 260 260 30 230 230 105

2015 0 0 0 0 106
2016 0 0 0 0 107
DAK 2017 700 700 0 700 700 108
DAK 2018 410 410 400 10 10 109
2015 0 0 0 110
DAK 2017 505 505 5 500 0 500 111

2014 0 0 0 112
2016 0 0 0 113
DAK 2017 49 49 2 30 17 47 114
DAK 2018 13 13 0 13 0 13 115
DAK 2018 0 0 0 116
DAK 2018 0 0 0 117
DAK 2018 12 12 6 6 6 118
2016 0 0 0 119
2016 255 255 255 120
DAK 2018 0 0 0 121
2016 0 0 0 122
2016 0 0 0 123
2015 19 19 0 19 19 124
2015 0 0 0 0 0 125
2017 0 0 0 126
DAK 2018 50 50 38 8 4 12 127
2016 1900 1900 190 1520 190 1710 128
2017 7 7 2 5 5 129
2015 250 250 110 140 140 130
2015 0 0 0 131
2015 0 0 0 132
DAK 2018 400 400 0 300 100 400 133
DAK 2017 450 450 0 450 450 134
2015 0 0 0 135
DAK 2018 1 1 0 1 0 1 136
2015 0 0 0 137
DAK 2018 400 400 70 300 30 330 138
2015 6 6 6 139
2017 50 50 0 50 50 140
2016 0 0 0 141
DAK 2018 38 38 0 24 14 38 142
2015 0 0 0 143
DAK 2018 7 7 1 6 6 144
2017 0 0 0 145
2016 0 0 0 146
2015 0 0 0 147
2017 0 0 0 148
DAK 2017 2423 2423 900 300 1223 1523 149
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2017 1 1 0 1 1 150
2017 1 1 0 1 1 151
2015 368 368 8 100 260 360 152
APBD 2018 500 500 0 500 0 500 153
2015 0 0 0 154
2015 110 110 0 110 110 155
DAK 2016 11 11 0 11 11 156
2017 0 0 0 157
DAK 2018 40 40 0 40 40 158
DAK 2018 0 0 0 159
DAK 2017 0 0 0 160
2015 92 92 0 86 6 92 161

2015 0 0 0 162
2017 0 0 0 163
DAK 2018 0 0 0 164
DAK 2018 3000 3000 1700 1300 1300 165
APBD 2019 2859 2859 70 1600 1189 2789 166

2015 0 0 0 167
DAK 2018 256 256 51 205 205 168
2015 14 14 0 14 14 169
2015 500 500 0 500 500 170
2015 160 160 0 160 160 171
2015 137 137 7 100 30 130 172
2015 58 58 0 58 58 173
2016 0 0 0 174
2017 100 100 0 100 100 175
DAK 2018 0 0 0 176
2015 0 0 0 177
DAK 2018 18 18 3 10 5 15 178
2013 197 197 18 179 179 179
DAK 2019 1000 1000 0 1000 0 1000 180
2015 0 0 0 0 181
2016 0 0 0 0 182
2016 36 36 36 0 183
DAK 2018 50 50 0 50 0 50 184
buffer 153 153 0 148 5 153 185
2015 0 0 0 186
2016 344 344 344 0 0 187
2016 0 0 0 188
2017 0 0 0 189
DAK 2018 0 0 0 0 0 190

2016 13 13 0 13 13 191
2015 0 0 0 192

2016 0 0 0 193
2016 0 0 0 194
DAK 2017 1 1 0 1 1 195
2014 0 0 0 196

DAK 2018 0 0 0 197


DAK 2018 0 0 0 198
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2015 0 0 0 199
2017 0 0 0 200
APBD1 2018 1900 1900 1900 201
APBD 2019 7640 7640 3780 2760 1100 3860 202

2016 15 15 5 10 10 203
2016 10 10 0 10 10 204
2015 1 1 0 1 1 205
2015 390 390 0 100 290 390 206
APBD 2018 1000 1000 0 1000 0 1000 207
0 0 0 208
2015 0 0 0 209
DAK 2017 734 734 57 400 277 677 210
2016 299 299 0 299 299 211
20 20 0 15 5 20 212
DAK 2018 0 0 0 213
2017 1 1 0 1 1 214
DAK 2018 0 0 0 215
2014 0 0 0 216
DAK 2018 670 670 670 217
APBD 2018 1000 1000 490 510 510 218
2015 5 5 5 0 0 219
2015 411 411 41 100 270 370 220
DAK 2018 500 500 0 500 0 500 221
0 0 0 222
2016 0 0 0 223
DAK 2016 5944 5944 1268 2000 2676 4676 224
2016 210 210 0 210 210 225
2015 0 0 0 226
DAK 2017 250 250 0 150 100 250 227
DAK 2018 500 500 0 500 0 500 228
2015 0 0 0 229
DAK 2018 200 200 90 110 110 230
DAK 2018 200 200 140 60 60 231
DAK 2018 262 262 62 175 25 200 232
2016 0 0 0 233
DAK 2017 0 0 0 234
DAK 2018 40 40 14 8 18 26 235

2016 0 0 0 236
2017 190 190 0 190 190 237
DAK 2017 175 175 9 132 34 166 238
2016 170 170 2 158 10 168 239
2018 500 500 150 300 50 350 240

DAK 2018 75 75 0 75 75 241


2016 220 220 0 100 120 220 242
DAK 2017 700 700 0 700 0 700 243
2015 0 0 0 244
2016 135 135 46 48 41 89 245
DAK 2017 0 0 0 0 0 246
DAK 2018 1240 1240 30 590 620 1210 247
DAK 2017 0 0 0 0 248

STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-


SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2014 0 0 0 0 249
DAK 2018 0 0 0 0 250
APBD 2018 0 0 0 0 251
DAK 2018 976 976 776 200 200 252
APBD 2019 500 500 64 436 436 253

DAK 2017 0 0 0 254


DAK 2018 0 0 0 255
2016 0 0 0 256
DAK 2018 24 24 1 19 4 23 257
2016 0 0 0 0 258
2015 6 6 6 0 259
APBD 2018 12 12 5 7 7 260
DAK 2018 100 100 0 90 10 100 261
2016 66 66 1 57 8 65 262
2015 839 839 50 500 289 789 263

2016 0 0 0 0 0 264
2016 0 0 0 0 0 265
2016 0 0 0 0 0 266
2016 0 0 0 0 0 267
2016 50 50 0 50 50 268
2015 0 0 0 269
2016 0 0 0 270
2015 0 0 0 271
2016 0 0 0 272
DAK 2018 3 3 3 273

2016 500 500 0 500 500 274


DAK 2017 10 10 1 9 9 275
2016 0 0 0 276
DAK 2016 0 0 0 277
DAK 2016 1 1 1 278
2016 0 0 0 279
DAK 2018 11 11 7 4 4 280
2017 0 0 0 281
DAK 2018 50 50 5 45 45 282
2017 3500 3500 1000 2500 2500 283
2015 0 0 0 284
2015 0 0 0 285
2016 570 570 0 300 270 570 286
2014 2 2 2 287
DAK 2018 50 50 20 20 10 30 288

2015 26 26 3 23 23 289
DAK 2015 1000 1000 0 1000 1000 290
2017 0 0 0 291
2015 52 52 0 37 15 52 292
DAK 2016 20 20 1 19 0 19 293
2015 0 0 0 294
2017 0 0 0 295
DAK 2018 31 31 12 3 16 19 296

2016 0 20 20 12 5 3 8 297
DAK 2017 34 34 0 20 14 34 298

STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-


SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2016 2 2 0 2 2 299
2016 2 2 0 2 2 300
DAK 2018 2 2 0 2 2 301
2016 2 2 0 2 2 302
2016 2 2 0 2 2 303
2016 2 2 0 2 2 304
2016 2 2 0 2 2 305
2016 2 2 0 2 2 306
2015 0 0 0 307
DAK 2016 348 348 17 295 36 331 308
2016 900 900 900 309
2017 700 700 700 310
DAK 2017 400 400 400 0 0 311
2013 0 0 0 312
DAK 2017 894 894 274 620 620 313
DAK 2018 300 300 300 300 314
2015 4 4 0 4 4 315
DAK 2016 2 2 0 2 2 316

DAK 2018 20 20 10 10 0 10 317


2015 0 0 0 318
DAK 2018 0 0 0 319
DAK 2018 200 200 75 100 25 125 320
2016 0 0 0 321
DAK 2018 490 490 105 250 135 385 322

2015 44 44 0 44 0 44 323
2016 0 0 0 324
2016 0 0 0 325
2016 0 0 0 326
2016 0 0 0 327
2015 0 0 0 328
2015 0 0 0 329
2017 0 0 0 330
DAK 2018 0 0 0 331

DAK 2018 490 490 490 0 0 332


2017 0 0 0 333
2015 0 0 0 334
2017 0 0 0 335
APBD1 2017 0 0 0 336
APBD 2018 170 170 0 170 170 337

2015 490 490 10 400 80 480 338


2015 0 0 0 0 0 339
2015 0 0 0 340
DAK 2018 790 790 0 600 190 790 341
DAK 2018 400 400 0 400 400 342
2015 0 0 0 343
2015 0 0 0 344
2017 1880 1880 40 1500 340 1840 345
2017 3 3 3 346
2017 0 0 0 347
BUFFER 6 6 0 2 4 6 348
APBD 2017 10 10 0 10 10 349

STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-


SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2016 0 0 0 350
DAK 2018 0 0 0 351
2016 0 0 0 352
DAK 2016 500 500 100 400 400 353
2016 10 10 0 10 10 354
2016 10 10 0 10 10 355
2015 0 0 0 356
DAK 2017 0 0 0 357
DAK 2018 235 235 235 358
APBD 2019 250 250 15 235 235 359
DAK 2018 0 0 0 360
2017 0 0 0 361
2016 0 0 0 362
2015 0 0 0 363
DAK 2018 505 505 30 200 275 475 364
0 0 0 365
DAK 2017 110 110 0 110 110 366
2015 0 0 0 367
2016 490 490 0 300 190 490 368
DAK 2018 0 0 0 369
2016 0 0 0 370
DAK 2018 360 360 0 360 360 371
APBD 2019 216 216 0 216 216 372
2016 0 0 0 373
DAK 2018 0 0 0 0 0 374
2015 0 0 0 375
2015 0 0 0 376
2015 0 0 0 377
2016 0 0 0 378
2017 0 0 0 379
DAK 2018 20 20 0 20 20 380

2017 23 23 6 16 1 17 381
2015 0 0 0 386
DAK 2018 0 0 0 387
DAK 2018 158 158 11 135 12 147 388

2016 0 0 0 389
DAK 2018 50 50 0 48 2 50 390
2016 0 0 0 391
DAK 2018 2 2 1 1 1 392
DAK 2019 112 112 0 96 16 112 393
2015 0 0 0 394
APBD 2017 0 0 0 395
APBD1 2017 0 0 0 396
DAK 2018 1700 1700 1700 397
DAK 2018 1797 1797 245 400 1152 1552 398
DAK 2019 2000 2000 0 2000 0 2000 399
2015 0 0 0 400
Dak 2018 90 90 46 44 44 401

DAK 2017 0 0 0 402


BUFFER 0 0 0 403
2015 480 480 20 240 220 460 404
2015 0 0 0 405

STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-


SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2015 13 13 13 406
2016 0 0 0 407
2015 0 0 0 408
DAK 2018 1514 1514 331 600 583 1183 409

2015 0 0 0 410
APBD1 2018 100 100 0 100 100 411
DAK 2018 0 0 0 412
2016 0 0 0 413
2015 0 0 0 414
BUFFER 100 100 0 100 100 415

2015 0 0 0 416
DAK 2018 379 379 4 300 75 375 417

2015 0 0 0 418
DAK 2018 12 12 12 419
APBD1 2018 40 40 0 40 40 420

DAK 2017 0 0 0 421


DAK 2018 0 0 0 422
2016 0 0 0 423
DAK 2019 30 30 3 27 27 424
2015 57 57 8 49 49 425
2016 0 0 0 426
DAK 2018 780 780 340 440 440 427
DAK 2018 2 2 0 2 2 428

DAK 2018 17 17 0 10 7 17 429


DAK 2018 1 1 1 430
DAK 2018 0 0 0 431
DAK 2018 1 1 1 432
DAK 2017 0 0 0 433
DAK 2019 1 1 1 434
DAK 2018 1 1 1 435
DAK 2017 1 1 1 436
DAK 2018 1 1 1 437
DAK 2017 1 1 1 438
DAK 2018 1 1 1 439
2017 10 10 0 10 10 440
2017 0 0 0 441
DAK 2017 0 0 0 442
2016 0 0 0 443
DAK 2016 0 0 0 444
0 0 0 445
2016 0 0 0 446
2017 0 0 0 447
DAK 2017 0 0 0 448
DAK 2018 350 350 200 150 150 449

2015 0 0 0 450
2016 0 0 0 451
DAK 2017 500 500 0 100 400 500 452
DAK 2018 449 449 4 300 145 445 453
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
2015 0 0 0 454
DAK 2017 0 0 0 455

2015 0 0 0 456
2016 0 0 0 457
DAK 2016 70 70 48 22 22 458
2016 42 42 0 38 4 42 459

2016 0 0 0 460
2016 0 0 0 461
DAK 2018 23 23 0 23 0 23 462
2015 103 103 7 81 15 96 463
2017 0 0 0 0 0 464
2016 0 0 0 465
2017 0 0 0 466
DAK 2018 3245 3245 570 1680 995 2675 467

2017 0 0 0 468
DAK 2018 500 500 0 400 100 500 469
2016 0 0 0 470
DAK 2017 0 0 0 471
2016 0 0 0 472

DAK 2017 0 0 0 473


2016 136 136 10 124 2 126 474
DAK 2018 225 225 25 175 25 200 475
DAK 2018 325 325 25 250 50 300 476
DAK 2018 280 360 640 380 220 40 260 477
2016 185 185 5 175 5 180 478
2016 20 20 20 479
DAK 2017 7 7 7 480
APBN 2017 100 100 100 481
APBDI 2018 100 100 0 100 100 482
2016 800 800 100 500 200 700 483
2016 0 0 0 484
DAK 2017 10 10 10 485

2016 0 0 0 486
2017 119 119 10 30 79 109 487
2016 0 0 0 488
DAK 2017 0 0 0 489
DAK 2018 2 2 0 2 2 490

DAK 2017 5 5 0 5 5 491


DAK2018 10 10 6 2 2 4 492

2015 10 10 0 10 10 493
0 0 0 494
DAK 2017 100 100 0 100 100 495
DAK 2018 0 0 0 496
DAK 2018 180 180 40 140 140 497
2016 0 0 0 498
2017 0 0 0 499
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
BUFFER 0 0 0 500
2016 0 0 0 501
DAK 2016 1557 1557 364 500 693 1193 502
BUFFER 0 0 0 503
DAK 2018 0 0 0 504

BUFFER 0 0 0 505
2017 0 0 0 506
BUFFER 0 0 0 507
2017 0 0 0 508
DAK 2017 2230 2230 305 1200 725 1925 509
2015 0 0 0 510
2016 0 0 0 511
APBD 2019 1000 1000 910 90 90 512
2017 0 0 0 513
DAK 2017 0 0 0 514
BUFFER 0 0 0 515
DAK 2017 980 980 310 600 70 670 516
DAK 2017 1685 1685 415 1000 270 1270 517
2015 28 28 2 15 11 26 518
APBD1 2018 0 0 0 519
Dak 2018 5 5 0 5 0 5 520

2015 0 0 0 521
DAK 2018 490 490 10 400 80 480 522
2016 0 0 0 523
2016 0 0 0 524
2017 6 6 0 6 6 525
2015 0 0 0 526
2017 0 0 0 0 0 527
2016 0 0 0 0 0 528
DAK 2018 24 24 3 21 21 529
DAK 2018 2 2 1 1 1 530
2016 0 0 0 531
2017 0 0 0 532
2015 0 0 0 533
BUFFER 0 0 0 534
DAK 2017 2433 2433 330 900 1203 2103 535

DAK 2017 0 0 0 536


DAK 2018 0 0 0 537
DAK2018 82 82 46 20 16 36 538
0 0 0 539
DAK 2017 0 0 0 540
DAK 2017 20 20 0 20 20 541
0 0 542
STOK PENE- PERSE- PENGEL SISA STOK STOK PERMIN-
SUMBER NO
AWAL RIMAAN DIAAN UARAN GUDANGSUB UNIT AKHIR TAAN
E F G H I J K L M A
APBN 2018 0 0 0
APBD1 2018 25 25 3 22 22

APBD1 2018 2 2 0 2 2
2016 0 0 0
DAK2016 400 400 300 100 100
DAK2016 0 0 0
DAK2016 1350 1350 1070 250 30 280
PROG 0 0 0
PROG 0 0 0
PROG 0 0 0
PROG 0 0 0
PROG 0 0 0
PROG 0 0 0
POGAM 0 0 0
2015 197 197 0 197 197
PROGRAM 0 0 0
APBN2017 325 325 0 325 325
APBD1 2018 18 18 0 18 18
DAK 2016 5 5 0 5 5

DAK 2018 0 0 0
program tb 13 13 13
APBDI2017 1 1 0 1 1
prog tb POV 0 0 0

BKKBN PROV 370 370 44 326 326


BKKBN PROV 16 16 8 8 8
BKKBN PROV 30 30 0 30 30
BKKBN PROV 48 48 0 48 48
BKKBN PROV 370 370 44 326 326
BKKBN PROV
BKKBN PROV 141 141 34 107 107
BKKBN PROV 0 0
BKKBN PROV 0 0

PROGRAM KIA 0 0 0
DAK 2018 80 80 0 80 80

95730
: 0101
PUSKESMAS : PASANGKAYU 1
KECAMATAN : PASANGKAYU
KAB./KODYA : PASANGKAYU
PROVINSI : SULAWESI BARAT
BULAN : APRIL 2019
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Abocat 18 PCS Rp 8,750.00 2016 0
Abocat 18 PCS Rp 8,575.00 DAK 2016 46
Abocat 20 PCS Rp 16,249.99 2015
Abocat 20 PCS Rp 8,750.00 2016
Abocat 20 PCS Rp 8,575.00 DAK 2016 13
Abocat 22 PCS Rp 8,750.00 2016 30
Abocat 22 PCS Rp 8,575.00 DAK 2016 4
Abocat 24 PCS Rp 8,750.00 2016 80
Abocat 26 PCS Rp 27,134.00 DAK 2018 96
Acetosal TAB Rp 127.00 2015 0
Acyclovir 200 mg TAB Rp 251.00 2014 18

Acyclovir 400 mg TAB Rp 362.00 2015


Acyclovir 400 mg TAB Rp 630.50 2017 255

Alat suntik sekali pakai 0,5 ml PCS Rp 1,655.50 DAK 2016 90


Alat suntik sekali pakai 1 ml PCS Rp 1,540.00 2015 0
Alat suntik sekali pakai 1 ml PCS Rp 1,694.00 2016 48
Alat suntik sekali pakai 1 ml (AXIMED PCS Rp 913.00 DAK 2018 465
Alat suntik sekali pakai 2.5 ml PCS Rp 1,141.80 2013
Alat suntik sekali pakai 3 ml PCS Rp 968.00 2016
Alat suntik sekali pakai 3 ml PCS Rp 2,119.00 DAK 2018 595

Alat suntik sekali pakai 5 ml PCS Rp 1,348.00 2013


Alat suntik sekali pakai 5 ml PCS Rp 861.30 2017 219

Albendazol SYR Rp 4,234.00 2016


Albendazol tablet 400 mg TAB Rp 363.00 2016 194
Albendazol tablet 400 mg TAB Rp 266.80 APBN 2017 4200
Alginat BOT Rp 239,525.00 2017 1
Aroma fine normal (Alginat aroma bks Rp 192,000.00 dak 2017
Alkohol 100 ml BOT Rp 2,625.00 2016 7
Alkohol 1000 ml BOT Rp 25,800.00 2016
Alkohol Swab pcs Rp 245.00 2016
Alkohol Swab pcs Rp 242.00 2017

Alopurinol tablet 100 mg TAB Rp 96.00 BUFFER


Alopurinol tablet 100 mg TAB Rp 90.00 2015
Alopurinol tablet 100 mg TAB Rp 96.00 2017
Alopurinol tablet 100 mg TAB Rp 96.00 DAK 2017 990
Alopurinol tablet 300 mg TAB Rp 249.00 DAK 2017 480
Ambroxol SYR BOT Rp 6,512.30 DAK 2018 1
Ambroxol 30 mg TAB Rp 242.00 DAK 2018 2638
Aminofilin INJ 24 mg/ml - 10 ml AMP Rp 4,200.00 2015 30
Aminofilin tablet 200 mg TAB Rp 86.00 2015
Amitripilin 25 mg TAB Rp 123.00 2015 381

Amlodipin 10 mg TAB Rp 168.00 2016


Amlodipin 10 mg TAB Rp 279.13 DAK 2018 1694

Amlodipin 5 mg (HEXAVASK) TAB Rp 197.00 2015


Amlodipin 5 mg (HEXAVASK) TAB Rp 1,050.00 2017
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Amoksisilin 500 mg TAB Rp 279.00 2013
Amoksisilin 500 mg TAB Rp 279.00 2016 0
Amoksisilin 500 mg TAB Rp 239.00 DAK 2017 1970
Amoksisilin 250 mg CAP Rp 220.00 2014
Amoksisilin SYR 125 mg/5 ml BOT Rp 2,560.00 2014
Amoksisilin SYR 125 mg/5 ml BOT Rp 8,900.00 DAK 2018
Amoksisilin SYR 125 mg/5 ml (SOLP BOT Rp 8,900.00 DAK 2018 9
Amoksisilin SYR 125 mg/5 ml (YUSIM BOT Rp 4,466.00 DAK 2018 54
Amoksisilin SYR 250 mg/5 ml BOT Rp 4,655.00 2017
Amoksisilin SYR 250 mg/5 ml BOT Rp 3,740.00 DAK 2018 31
Amoksisilin DROPS (SUPRAMOX) BOT Rp 28,500.00 DAK 2018 24
Ampisilin INJ AMP Rp 5,610.00 2015
Antalgin (metampiron) 500 mg TAB Rp 385.00 DAK 2016 1500
Antalgin (metamizole sodium 500 mg TAB Rp 385.00 DAK 2016 565
Antasida SYR Rp 2,135.00 2015
Antasida SYR Rp 2,135.00 DAK 2016
Antasida SYR Rp 2,146.00 DAK 2018 51
Antasida doen tablet kombinasi TAB Rp 78.00 2015
Antasida doen tablet kombinasi 400 TAB Rp 72.00 2017 1492

Anti Hemoroid SUPP Rp 2,200.00 2016

Aqua dest steril VIAL Rp 2,750.00 2017


As. Mefenamat TAB Rp 119.00 2014
As. Mefenamat TAB Rp 119.00 2016
As. Mefenamat TAB Rp 117.00 2017
As. Mefenamat (BIRU) TAB Rp 176.00 2017
As. Mefenamat 500 mg TAB Rp 119.00 APBD 2018 2323
As. Mefenamat 500 mg TAB Rp 119.00 APBD 2019 1200

Asam folat (AFOLAT) TAB Rp 52.00 2016


Asam folat (Profolat) TAB Rp 64.00 DAK 2018 1310
ASEPTIC GEL BTL Rp 1,581.25 2017
Atenolol (FARNORMIN) TAB Rp 387.00 2015
Atenolol (FARNORMIN) TAB Rp 342.00 DAK 2017 500
Atropin sulfat INJ 0.25 mg/ml - 1ml AMP Rp 1,400.00 2016 88
Atropin sulfat tab 0,5 mg TAB Rp 81.00 2016
Attapulgit TAB Rp 220.00 2016 1730
Attapulgit TAB Rp 196.00 2017 500
Attapulgit (ARCAPEC) SYR Rp 1,581.25 2017 15
ABATE SCT Rp 6,380.00 DAK 2018

Bactivec (abate) BOT BS


Bacitracin polymixin TUBE Rp 2,767.00 2015
Bacitracin polymixin TUBE Rp 3,511.00 2017

Betahistin TAB Rp 1,062.60 2016


Betahistin TAB Rp 177.00 2017 0
Betametason SALP 0.1 % TUBE Rp 1,596.00 2015
Betametason SALP 0.1 % TUBE Rp 1,596.00 2016 0

Betametason TTS MATA (BETAM) BTL Rp 19,600.00 DAK 2018 25


Bicolax TAB Rp 1,335.27 2016 162
BIOPLACENTon TUBE Rp 18,125.00 2017
Bisoprolol TAB Rp 2,553.83 2016 1485
Blood Lancet 265 PCS Rp 160.23 2016
Blood Lancet 266 PCS Rp 160.23 2016 100
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Bronheksine (MIRAVAN) TAB Rp 354.20 2015

CALCII GLUCONAT AMP Rp 1,581.25 2016 23


Calsium Laktat TAB Rp 72.00 2015
Calsium Laktat TAB Rp 72.00 2016
Calsium Laktat TAB Rp 64.00 buffer stok 0
Captopril 12.5 mg TAB Rp 69.00 2014
Captopril 12.5 mg TAB Rp 69.00 2015
Captopril 12.5 mg TAB Rp 72.00 2017
Captopril 12.5 mg TAB Rp 68.00 DAK 2018 230

Captopril 25 mg TAB Rp 82.00 2015 0


Captopril 25 mg TAB Rp 82.00 2016 0
Captopril 25 mg TAB Rp 137.75 DAK 2017 700
Captopril 25 mg TAB Rp 82.00 DAK 2018 10
Captopril 50 mg TAB Rp 147.00 2015
Captopril 50 mg TAB Rp 147.00 DAK 2017 500

Carbamazepin TAB Rp 269.00 2014


Catgut/Benang bedah 3/0 plain SET Rp 33,250.00 2016
Catgut 3/0 CHOMIC SET Rp 6,420.33 DAK 2017 47
Catgut 2/0 CHOMIC SET Rp 6,420.83 DAK 2018 13
CHKM BOTOL Rp 126,500.00 DAK 2018
Plant Cutura 2/0 SET Rp 6,420.83 DAK 2018
PLAINCatgut 3/0 SET Rp 6,420.83 DAK 2018 6
Cefadroxil BOT Rp 5,286.00 2016
Cefadroxil CAP Rp 557.00 2016
Cefadroxil CAP Rp 495.00 DAK 2018
Cefixime CAP Rp 700.00 2016
Cefotaxin INJ AMP Rp 6,785.00 2016
Ceftriaxone AMP Rp 6,785.00 2015 19
Cetirizin TAB Rp 156.00 2015 0
Cetirizin syr syr Rp 8,094.00 2017
Cetirizin syr Rp 13,956.00 DAK 2018 12
Ciprofloxacin TAB Rp 309.00 2016 1710
Ciprofloxacin BAQUINOR TTS MATA BTL Rp 10,250.00 2017 5
Clhorpromazine 100 mg TAB Rp 156.00 2015 140
Clhorpromazine 25 mg TAB Rp 75.00 2015
Clindamycin 150 mg CAP Rp 405.00 2015
Clindamycin 150 mg CAP Rp 786.00 DAK 2018 400
Clindamycin 300 mg CAP Rp 693.00 DAK 2017 450
Clor Etil BOT Rp 158,125.00 2015
Clor Etil BOT Rp 506,000.00 DAK 2018 1
Cloramfenikol 250 mg CAP Rp 261.00 2015
Cloramfenikol 250 mg CAP Rp 341.00 DAK 2018 330
cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2015
cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2017 50
Cloramfenikol 3 % TUBE Rp 3,460.00 2016
Cloramfenikol 2 % TUBE Rp 3,416.00 DAK 2018 38
Cloramfenikol salp mata 1 % TUBE Rp 1,680.00 2015
Cloramfenikol salp mata 1 % TUBE Rp 2,013.00 DAK 2018 6
Cloramfenikol TTS MATA BOT Rp 12,600.00 2017
Cloramfenikol TTS telinga BOT Rp 6,424.00 2016
Clorfeniramin Maleat (CTM) TAB Rp 54.00 2015
Clorfeniramin Maleat (CTM) TAB Rp 46.00 2017
Clorfeniramin Maleat (CTM) Rp 46.00 DAK 2017 1523
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Composit A3 PCS Rp 749,320.00 2017 1
Composit A35 PCS Rp 749,320.00 2017 1
Cotrimoksazol 480 mg (DOEN) TAB Rp 158.00 2015 360
Cotrimoksazol 480 mg (DOEN) TAB Rp 152.00 APBD 2018 500
Cotrimoksazol Pediatrik TAB Rp 83.49 2015
Cotrimoksazol SYR BOT Rp 7,810.00 2015 110
Cotrimoksazol SYR BOT Rp 2,250.00 DAK 2016 11
CURCUMA TAB Rp 1,644.00 2017
CUTIMED SORBACT SWAB PCS Rp 30,503.00 DAK 2018 40
COTTON ROLL ROLL Rp 100,150.00 DAK 2018
CRESOPHENE, SOLUTION,LIQUID BOTOL Rp 770,000.00 DAK 2017
Deksametason AMP Rp 1,820.00 2015 92

Deksametason tablet 0.5 mg TAB Rp 52.00 2015


Deksametason tablet 0.5 mg TAB Rp 46.00 2017
Deksametason tablet 0.5 mg TAB Rp 35.00 DAK 2018
Deksametason tablet 0.5 mg TAB Rp 95.00 DAK 2018 1300
Deksametason tablet 0.5 mg TAB Rp 95.00 APBD 2019 2789

Diazepam 2 mg TAB Rp 35.09 2015


Diazepam 2 mg TAB Rp 86.00 DAK 2018 205
Diazepam INJ 5 mg/ml AMP Rp 18,260.00 2015 14
Digoksin tablet 0.25 mg TAB Rp 103.00 2015 500
Dilteazem HCL tab 30 mg TAB Rp 141.00 2015 160
Dimenhidrinat TAB Rp 109.00 2015 130
DIPHENHIDRAMIN INJ Rp 1,156.00 2015 58
DISPOSIBLE DENTAL (jarum citojeck PCS Rp 2,720.00 2016
DISPOSIBLE DENTAL (jarum citojeck PCS Rp 3,594.25 2017 100
jarum citojeck PCS Rp 1,705.00 DAK 2018
Domperidon syr BOT Rp 14,374.80 2015
Domperidon syr BOT Rp 2,970.00 DAK 2018 15
Domperidon Tab TAB Rp 174.00 2013 179
Domperidon 10 mg TAB Rp 90.00 DAK 2019 1000
Doxiciklin CAP Rp 298.00 2015 0
DULCOLAX 5 mg SUPP Rp 5,670.00 2016 0
DULCOLAX 10 mg SUPP Rp 5,800.00 2016 0
DULCOLAX 10 mg SUPP Rp 5,900.00 DAK 2018 50
Epinefrin hcl AMP Rp 8,910.00 buffer 153
Ergotamin Cafein TAB Rp 149.00 2015
Eritromycin CAP Rp 679.00 2016 0
Eritromycin SYR Rp 7,391.00 2016
Eritromycin SYR Rp 7,391.00 2017
Eritromycin SYR Rp 2,490.00 DAK 2018 0

Etakridin /Rivanol 300 ml BOT Rp 3,060.00 2016 13


Etambutol hcl. Tablet 250 mg TAB Rp 330.00 2015

Etiket obat Biru LMBR Rp 61.00 2016


Etiket Obat Putih LMBR Rp 61.00 2016
ETSGEL Rp 395,532.50 DAK 2017 1
Eugenol BOT Rp 50,416.67 2014

ELITE CEMENT BOX Rp 370,620.00 DAK 2018


EXAFLEX PUTTY BOX Rp 2,100,000.00 DAK 2018
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Ferro Sulfat SCT Rp 425.00 2015
Ferro Sulfat SCT Rp 425.00 2017
Ferro Sulfat SCT APBD1 2018
Ferro Sulfat SCT Rp 427.00 APBD 2019 3860

Folley cateter no.16 SET Rp 20,000.00 2016 10


Folley cateter no.18 SET Rp 20,000.00 2016 10
Furosemid inj 10mg/ml AMP Rp 2,012.00 2015 1
Furosemid tablet 40 mg TAB Rp 84.00 2015 390
Furosemid tablet 40 mg TAB Rp 77.00 APBD 2018 1000
FOMALIN TAB Rp 5,060.00
Garam oralit untuk 200 ml air SCT Rp 1,072.50 2015
Garam oralit untuk 200 ml air SCT Rp 278.00 DAK 2017 677
Gelang pasien warna pink PCS Rp 2,706.00 2016 299
Gentamycin inj. AMP Rp 3,699.00 20
Gentian Violet lar 1 % BOT Rp 3,750.00 DAK 2018
Glass Lonomer SET/BTL Rp 949,520.00 2017 1
Glass Lonomer SET/BTL Rp 1,050,000.00 DAK 2018
Glibenclamid 5 mg TAB Rp 61.00 2014
Glibenclamid 5 mg TAB Rp 143.00 DAK 2018
Glibenclamid 5 mg TAB Rp 90.00 APBD 2018 510
Glimepirid 1 mg TAB Rp 1,576.00 2015 0
Glimepirid 2 mg TAB Rp 311.00 2015 370
Glimepirid 2 mg TAB Rp 207.00 DAK 2018 500
Gliseril Guayakolat TAB Rp 66.79
Gliseril Guayakolat TAB Rp 66.79 2016
Gliseril Guayakolat TAB Rp 66.79 DAK 2016 4676
Gluko + protein test box PCS Rp 1,150.00 2016 210
Griseofulvin 125 mg TAB Rp 230.00 2015
Griseofulvin 125 mg TAB Rp 263.00 DAK 2017 250
Griseofulvin 125 mg TAB Rp 231.00 DAK 2018 500
Haloperidol tab 5 mg TAB Rp 105.00 2015
Haloperidol tab 0.5 mg TAB Rp 55.00 DAK 2018 110
Haloperidol tab 1.5 mg TAB Rp 59.00 DAK 2018 60
Handscoon 6 (T-SENSAURGE) STERI SET Rp 7,254.50 DAK 2018 200
Handscoon 7 SET Rp 9,310.00 2016
Handscoon 7 Rp 9,120.00 DAK 2017
Handscoon 7 STERIL SET Rp 8,360.00 DAK 2018 26

Handscoon 7,5 (aximed) STERIL SET Rp 9,310.00 2016


Handscoon 7,5 (aximed) STERIL SET Rp 9,120.00 2017 190
Handscoon 7,5 (T-SENSAURGE) STE SET Rp 7,254.50 DAK 2017 166
Handscoon 8 STERIL SET Rp 9,310.00 2016 168
Handscoon non steril (M)AXIMED E SET Rp 508.20 2018 350

HBSAG Strip STRIP Rp 11,037.00 DAK 2018 75


Hidroklortiazid 25 mg TAB Rp 179.00 2016 220
Hidroklortiazid 25 mg TAB Rp 179.00 DAK 2017 700
Hidrokortison Salp TUBE Rp 2,938.00 2015
Hidrokortison Salp TUBE Rp 2,938.00 2016 89
Hidrokortison Salp 2,5% TUBE Rp 2,848.00 DAK 2017 0
HISTIGO TAB Rp 595.05 DAK 2018 1210
HYDCAL PASTA BASE TUBE Rp 299,530.00 DAK 2017 0

STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Ibuprofen 400 mg TAB Rp 139.00 2014 0
Ibuprofen 400 mg (ARFEN) TAB Rp 501.10 DAK 2018 0
Ibuprofen 400 mg TAB Rp 139.00 APBD 2018 0
Ibuprofen 400 mg (FASIFEN) TAB Rp 525.00 DAK 2018 200
Ibuprofen 400 mg TAB Rp 139.00 APBD 2019 436

Ibuprofen 200 mg TAB Rp 116.00 DAK 2017


Ibuprofen 200 mg TAB Rp 116.00 DAK 2018
Ibuprofen suspensi 200 mg/5 mg BOT Rp 4,949.00 2016
Ibuprofen suspensi 200 mg/5 mg BOT Rp 5,509.00 DAK 2018 23
Infant muccus PCS Rp 37,988.50 2016 0
Infuset Makro SET Rp 5,880.00 2015 0
Infuset Makro (PIECES) SET Rp 3,190.00 APBD 2018 7
Infuset Makro (OTSU SET) SET Rp 13,200.00 DAK 2018 100
Infuset Mikro SET Rp 7,920.00 2016 65
isosorbid TAB Rp 98.00 2015 789

JARUM HACTING NO. 08 LSN Rp 30,000.00 2016 0


JARUM HACTING NO. 10 LSN Rp 30,000.00 2016 0
JARUM HACTING NO. 12 LSN Rp 30,000.00 2016 0
JARUM HACTING NO. 15 LSN Rp 30,000.00 2016 0
Kaca Penutup (Deg Glass) pcs Rp 929.50 2016 50
Kalium Diklofenak TAB Rp 814.66 2015
Kalium permanganat BOT Rp 6,325.00 2016
Kapas 250 gr ROL Rp 14,375.00 2015
Kapas 250 gr ROL Rp 14,375.00 2016
Kapas 250 gr ROL Rp 14,375.00 DAK 2018

KARTU GOLONGAN DARAH PCS Rp 2,200.00 2016 500


Kasa gulung 36x80 cm ROL Rp 142,600.00 DAK 2017 9
Kasa gulung 30x60 cm ROL Rp 142,600.00 2016
Kasa gulung 30x60 cm ROL Rp 142,600.00 DAK 2016
Kasa gulung 36x80 cm Rp 142,600.00 DAK 2016
Kasa Steril 16x16 cm SET Rp 8,740.00 2016
Kasa Steril 16x16 cm Rp 575.00 DAK 2018 4
Kasa Steril 5x5 cm SET Rp 3,311.00 2017
Kasa PEMBALUT 4x10 cm ROL Rp 1,725.00 DAK 2018 45
Kertas puyer LBR Rp 123.20 2017 2500
Ketamin INJ VIAL Rp 63,400.00 2015
Ketoconazole 200 mg TAB Rp 303.00 2015
Ketoconazole 200 mg TAB Rp 303.00 2016 570
Ketoconazole salp 2 % TUBE Rp 2,697.00 2014
Ketoconazole salp 2 % TUBE Rp 2,694.00 DAK 2018 30

Ketorolak inj 30 AMP Rp 1,450.00 2015 23


Kombinasi Prometamin 25 + Sulfadox TAB Rp 572.00 DAK 2015 1000
Lansoprazol (DIGEST) CAP Rp 5,500.00 2017
Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 2015 52
Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 DAK 2016 19
Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2015
Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2017
Larutan NACL Lar infus 0,9 % Rp 6,410.00 DAK 2018 19

Larutan RL BOT Rp 7,150.00 2016 8


Larutan RL BOT Rp 7,150.00 DAK 2017 34

STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
LARUTAN EDTA 10*Indoor BOT Rp 1,702,536.00 2016 2
LARUTAN Giemsa indoor BOT Rp 1,523,280.00 2016 2
LARUTAN Giemsa indoor BOT Rp 356,250.00 DAK 2018 2
LARUTAN Haemoglobin C indoor BOT Rp 296,956.00 2016 2
LARUTAN Hcl 0,1 N Indoor BOT Rp 236,808.00 2016 2
LARUTAN Metanol PA BOT Rp 686,697.00 2016 2
LARUTAN Trombosit Ao indoor BOT Rp 374,440.00 2016 2
LARUTAN Turk 500ml BOT Rp 444,015.00 2016 2
Lidocain INJ AMP Rp 929.00 2015
Lidocain INJ AMP Rp 2,215.00 DAK 2016 331
Loperamid TAB Rp 97.00 2016
Loperamid Rp 97.00 2017
Loperamid 2 mg Rp 97.00 DAK 2017 0
Loratadin TAB Rp 159.00 2013
Loratadin TAB Rp 159.00 DAK 2017 620
Loratadin 10 mg TAB Rp 500.00 DAK 2018
Lysol BOT Rp 49,200.00 2015 4
Lysol 1000 Ml BOT Rp 49,200.00 DAK 2016 2

Litrol TTS mata BOT Rp 5,850.00 DAK 2018 10


Masker earloop SET Rp 440.00 2015
Masker earloop SET Rp 435.60 DAK 2018
Masker earloop (AXIMED) SET Rp 436.00 DAK 2018 125
Masker Standar tie on (IKAT) SET Rp 588.00 2016
Masker Standar tie on (IKAT) SET Rp 528.00 DAK 2018 385

Mebendazol (VERMOX) TAB Rp 8,800.00 2015 44


MEDLENCE plus extra 21 G/2,4 mm PCS Rp 3,991.90 2016
MEDLENCE plus lite 25 G/1,5 mm PCS Rp 3,991.90 2016
MEDLENCE plus special 0,8 (blade) PCS Rp 3,991.90 2016
MEDLENCE plus universal 21 G/1.8 PCS Rp 3,991.90 2016
Meloxicam 7,5 mg TAB Rp 761.00 2015
Metformin CAP Rp 206.25 2015
Metformin CAP Rp 103.00 2017
Metformin 500 mg CAP Rp 336.00 DAK 2018

Metformin 850 mg CAP Rp 168.00 DAK 2018 0


Methylprednisolon 16 mg Rp 1,325.00 2017
Methylprednisolon 4 mg TAB Rp 500.62 2015
Methylprednisolon 4 mg TAB Rp 212.00 2017
Methylprednisolon 4 mg TAB Rp 170.00 APBD1 2017
Methylprednisolon 4 mg TAB Rp 170.00 APBD 2018 170

Metilergometrin maleat 0,125 mg TAB Rp 169.00 2015 480


Metilergometrin maleat INJ Rp 2,684.00 2015 0
Metoclopramid 10 mg TAB Rp 100.00 2015
Metoclopramid 10 mg TAB Rp 87.00 DAK 2018 790
Metoclopramid 5 mg TAB Rp 129.00 DAK 2018 400
Metronidazol 250 mg TAB Rp 116.00 2015
Metronidazol 500 mg TAB Rp 143.00 2015
Metronidazol 500 mg TAB Rp 143.00 2017 1840
Metronidazol INFUS BOT Rp 12,980.00 2017
Metronidazol SYR Rp 1,581.25 2017
MgSO4 20 % INJEKSI Rp 2,800.00 BUFFER 6
MgSO4 40 % INJEKSI Rp 3,650.00 APBD 2017 10

STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Miconazol TUBE Rp 3,150.00 2016
Miconazol 2% Cream TUBE Rp 4,097.00 DAK 2018
Miniaspi 80mg TAB Rp 163.00 2016
Miniaspi/asetosal Rp 163.00 DAK 2016 400
Nasal Oksigen M PCS Rp 8,085.00 2016 10
Nasal Oksigen XS PCS Rp 8,085.00 2016 10
Natrium Diklofenak 25 mg TAB Rp 162.00 2015
Natrium Diklofenak 25 mg TAB Rp 178.00 DAK 2017
Natrium Diklofenak 25 mg TAB Rp 154.00 DAK 2018
Natrium Diklofenak 25 mg TAB Rp 146.00 APBD 2019 235
Natrium Diklofenak 50 mg TAB Rp 146.00 DAK 2018
Nelaton catheter pcs Rp 5,330.00 2017
Nebulyzer mask DEWASA PCS Rp 16,704.00 2016
Nifedipin TAB Rp 127.00 2015
Nifedipin 10 mg TAB Rp 112.00 DAK 2018 475
Nistatin 100.000 TAB Rp 528.00
Nistatin Vaginal 100.000 Rp 628.00 DAK 2017 110
Nistatin 500.000 TAB Rp 895.00 2015
Nistatin 500.000 TAB Rp 895.00 2016 490
Nistatin DROPS BOT Rp 40,030.00 DAK 2018
NOVABION KPSL Rp 395.42 2016
ONELAB Objeck Glass 72 PCS PCS Rp 331.37 DAK 2018 360
Objeck Glass PCS Rp 278.00 APBD 2019 216
OBH syr BOT Rp 3,740.00 2016
OBH syr Rp 2,925.00 DAK 2018 0
Ofloxacin TAB Rp 649.12 2015
Oksitertaciklin SALP 1 % TUBE Rp 4,901.00 2015
Oksitertaciklin SALP 3 % TUBE Rp 4,400.00 2015
Omeprasol CAP Rp 176.00 2016
Omeprasol 20 mg CAP Rp 176.00 2017
Omeprasol 20 mg CAP Rp 143.00 DAK 2018 20

Ondansetron inj Rp 1,254.00 2017 17


OXYTOCIN INJ Rp 1,900.00 2015
OXYTOCIN INJ Rp 1,287.00 DAK 2018
OXYTOCIN INJ Rp 1,287.00 DAK 2018 147

Otsu wi bot Rp 1,581.25 2016


Otsu wi bot Rp 2,860.00 DAK 2018 50
Paracetamol (FASIDOL)Droop BOT Rp 6,240.00 2016
Paracetamol (FASIDOL)Droop BOT Rp 7,979.00 DAK 2018 1
Paracetamol DroopS BOT - DAK 2019 112
Paracetamol 500 mg TAB Rp 60.00 2015
Paracetamol 500 mg TAB Rp 52.00 APBD 2017
Paracetamol 500 mg TAB Rp 52.00 APBD1 2017
Paracetamol 500 mg TAB Rp 259.00 DAK 2018
Paracetamol 500 mg TAB Rp 198.00 DAK 2018 1552
Paracetamol 500 mg TAB - DAK 2019 2000
Paracetamol SYR BOT Rp 1,338.00 2015
Paracetamol SYR BOT Rp 1,190.00 Dak 2018 44

Pipet Dirpo Rp 1,292.50 DAK 2017


Phenobarbital inj 50mg/ml AMP Rp 1,980.00 BUFFER
Piracetam 1200 mg TAB Rp 594.56 2015 460
piroxicam 10 mg TAB Rp 165.78 2015

STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Plester ROL Rp 42,499.60 2015
Plain 3/0 pcs Rp 1,581.25 2016
Prednison TAB Rp 125.00 2015
Prednison 5 mg TAB Rp 74.00 DAK 2018 1183

PRIMAQUIN TAB Rp 205.00 2015


PRIMAQUIN 15 mg TAB Rp 253.00 APBD1 2018 100
PK (kalium pemanganat) 5 g BOT Rp 371,250.00 DAK 2018
Procrepe 15 cm x 4,55 m (perban) Rol Rp 41,910.00 2016
PTU (Propiltiourasil) 100 mg TAB Rp 351.00 2015
PTU (Propiltiourasil) 100 mg TAB Rp 351.00 BUFFER 100

Pyrantel TAB Rp 318.00 2015


Pyrantel 125 mg Rp 347.00 DAK 2018 375

Pyrantel SYR Rp 9,100.00 2015


POT URINE POT Rp 6,600.00 DAK 2018
POT 50 ml POT Rp 5,890.00 APBD1 2018 40

PETERS SILK PCS Rp 37,209.00 DAK 2017


PULP-X V DEVITALIZER PASTE PCS Rp 443,200.00 DAK 2018
RDT DBD iig sct Rp 1,581.25 2016
RDT DBD COMO sct Rp 297,000.00 DAK 2019 27
Ranitidin INJ AMP Rp 5,368.00 2015 49
Ranitidin TAB TAB Rp 119.00 2016
Ranitidin 150 mg Rp 262.50 DAK 2018 440
RECO tts mata BOT Rp 20,360.00 DAK 2018 2

RECO tts Telinga BOT Rp 11,000.00 DAK 2018 17


Reagen diluent BOT Rp 4,770,000.00 DAK 2018
Reagen lyse BOT Rp 3,310,000.00 DAK 2018
Reagen RINSE Rp 1,950,455.00 DAK 2018
Reagen Asam urat BOT Rp 1,399,200.00 DAK 2017
Reagen WIDAL TEST BOT - DAK 2019
RAJAWALI UIC ACID (REAGEN) BOT Rp 1,870,660.00 DAK 2018
Reagen Kimia Klinik Glucosa BOT Rp 698,500.00 DAK 2017
RAJAWALI Glucosa (REAGEN) BOT Rp 889,570.00 DAK 2018
Reagen Kimia Klinik Kolesterol BOT Rp 748,000.00 DAK 2017
RAJAWALI KOLES ( Kolesterol) BOT Rp 2,093,300.00 DAK 2018
RYLES TUBE Rp 15,488.00 2017 10
Sak Besar (10x15 cm) PAK Rp 98,700.00 2017
Sak Besar (10x15 cm) PCS Rp 314.60 DAK 2017
Sak Sedang (6x10 cm) PAK Rp 96,900.00 2016
Sak Sedang (6x10 cm) PCS Rp 100.00 DAK 2016
Sak Kecil PCS Rp 100.00
Salbutamol 2 mg TAB Rp 69.00 2016
Salbutamol 2 mg TAB Rp 69.00 2017
Salbutamol 2 mg TAB Rp 69.00 DAK 2017
Salbutamol 2 mg TAB Rp 64.00 DAK 2018 150

Salbutamol 4 mg TAB Rp 89.00 2015


Salbutamol 4 mg TAB Rp 89.00 2016
Salbutamol 4 mg TAB Rp 89.00 DAK 2017 500
Salbutamol 4 mg TAB Rp 81.00 DAK 2018 445
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Salbutamol sirup 2mg/5ml BOT Rp 5,700.00 2015
Salbutamol sirup 2mg/5ml Rp 5,700.00 DAK 2017

Salicil talk SCT Rp 1,573.00 2015


Salicil talk SCT Rp 6,270.00 2016
Salicil talk 2% POT Rp 6,270.00 DAK 2016 22
Salp 24 TUBE Rp 2,200.00 2016 42

SCANDONEST AMP Rp 19,470.00 2016


Sefety box PCS Rp 18,072.35 2016
Sefety box 25 K 5 L Rp 18,072.25 DAK 2018 23
Silk SET Rp 15,750.00 2015 96
Silk SET Rp 37,289.00 2017 0
Simvastatin 10 mg TAB Rp 136.00 2016
Simvastatin (SVT) TAB Rp 686.00 2017
Simvastatin 10 mg TAB Rp 110.00 DAK 2018 2675

SPASMINAL Rp 750.00 2017


Sprinolakton Rp 212.00 DAK 2018 500
SPRITUS BOT Rp 1,581.25 2016
SPRITUS 250 ml BOT Rp 39,270.00 DAK 2017
Strip Asam Urat (NESCO) PCS Rp 7,185.20 2016

Strip Glucosa (BENECHECK) PCS Rp 3,225.86 DAK 2017


Surgical Blade No.11 PCS Rp 974.05 2016 126
Strip Asam Urat (HUMASENS) STRIP Rp 22,252.00 DAK 2018 200
Strip Glucosa (HUMASENS) STRIP Rp 5,156.00 DAK 2018 300
Strip Kolesterol (HUMASENS) STRIP Rp 27,495.00 DAK 2018 260
Surgical Blade No.15 PCS Rp 974.05 2016 180
TEST NARKOBA/DRUG ABUSE STRIP Rp 78,999.00 2016
TEST NARKOBA STRIP Rp 78,999.80 DAK 2017
TEST HIV (SD BIOLINE HIV) STRIP Rp 37,600.00 APBN 2017
TEST HIV (SD BIOLINE HIV) STRIP Rp 11,975.00 APBDI 2018 100
Tiamfenicol 500 KAP Rp 1,518.00 2016 700
TIPS PIPET BIRU BKS Rp 594.00 2016
TABUNG PLASTIK SEUM 1,5 ml PIECES Rp 605.00 DAK 2017

Ultra One test hamil strip PCS Rp 2,133.00 2016


Ultra One test hamil strip PCS Rp 2,228.60 2017 109
Ultrafix/ PHarmafix ROL Rp 27,000.00 2016
Ultrafix/ Pharmafix ROL Rp 27,000.00 DAK 2017
Ultrafix/ Pharmafix ROL Rp 29,700.00 DAK 2018 2

ULTRASOUN GEL (GEL USG) BTL Rp 14,471.60 DAK 2017 5


UMBILICAL C (PENJEPIT TP) PCS Rp 3,300.00 DAK2018 4

Urin bag/UROPLAS SET Rp 3,000.00 2015 10


UINE STIP 10 PAAMETE
VACUM TUBE PLAIN PCS Rp 2,200.00 DAK 2017 100
VACUM EDTA Rp 74,100.00 DAK 2018
VIT CALCIFAR TAB Rp 406.00 DAK 2018 140
VIT SYR (TAKANA) SYR Rp 39,223.80 2016
VIT SYR (TAKANA) SYR Rp 39,223.80 2017
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
Vitamin B 1 (tiamin) TAB Rp 95.00 BUFFER
Vitamin B 1 (tiamin) TAB Rp 95.00 2016
Vitamin B 1 (tiamin) 50 mg TAB Rp 95.00 DAK 2016 1193
Vitamin B 12 TAB Rp 63.00 BUFFER
Vitamin B 12 Rp 50.00 DAK 2018

Vitamin B 12 INJ AMP Rp 9,482.00 BUFFER


Vitamin B 12 INJ AMP Rp 1,283.00 2017
Vitamin B 6 (piridoksin) TAB Rp 175.00 BUFFER
Vitamin B 6 (piridoksin) TAB Rp 142.00 2017
Vitamin B 6 (piridoksin) TAB Rp 142.00 DAK 2017 1925
Vitamin B comp TAB Rp 138.00 2015
Vitamin B comp TAB Rp 138.00 2016
Vitamin B comp TAB Rp 141.00 APBD 2019 90
Vitamin C (Asam askorbat) 250 mg TAB Rp 139.00 2017
Vitamin C (Asam askorbat)250 mg Rp 139.00 DAK 2017
Vitamin C (Asam askorbat)50 mg TAB Rp 105.00 BUFFER
Vitamin C (Asam askorbat)50 mg TAB Rp 125.00 DAK 2017 670
Vitamin C (Asam askorbat)25 mg TAB Rp 36.00 DAK 2017 1270
Vitamin K INJ AMP Rp 3,754.00 2015 26
Vitamin K INJ AMP Rp 4,260.00 APBD1 2018
Vitamin K INJ AMP Rp 15,700.00 Dak 2018 5

Vitamin K TAB TAB Rp 690.00 2015


Vitamin K TAB 10 mg Rp 855.00 DAK 2018 480
VITROMEGA CAP Rp 1,472.00 2016
VITROMEGA CAP Rp 1,472.69 2016
X. TRAGEN bot Rp 1,581.25 2017 6
Yodium Povidon 30 ml BOT Rp 2,344.00 2015
Yodium Povidon 60 ml BOT Rp 4,440.00 2017 0
Yodium Povidon 300 ml BOT Rp 4,440.00 2016 0
Yodium Povidon 300 ml BOT Rp 21,600.00 DAK 2018 21
ZINCPO dropS BOT Rp 6,369.00 DAK 2018 1
Zink Syrup 10mg/ml BOT Rp 16,478.00 2016
Zink Syrup 10mg/ml BOT Rp 16,478.00 2017
Zink TAB TAB Rp 521.00 2015
Zink TAB TAB Rp 1,100.00 BUFFER
Zink 20 mg TAB Rp 618.00 DAK 2017 2103

creatininKIN 2x100 ml kit Rp 977,900.00 DAK 2017


Vacum tube sterlite PCS Rp 74,100.00 DAK 2018
Procurma SYR Rp 11,350.00 DAK2018 36
WIDAL TES STRIP
3M ESPE CAVIT FILLING BOX Rp 359,535.00 DAK 2017
VASELINE SWAB 10MX10CM PCS Rp 35,832.50 DAK 2017 20
PROGRAM
STOK PENE-
NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL RIMAAN
B C D E F G
MDT MB DEWASA BLISTER Rp 30,595.00 APBN 2018
MDT MB DEWASA BLISTER Rp 31,570.00 APBD1 2018 22

MDT PB DEWASA BLISTER Rp 12,569.00 APBD1 2018 2


LACTOGEN 4 DUS Rp 67,500.00 2016
VIT A BIRU BOT Rp 341.00 DAK2016 100
VIT A MERAH BOT Rp 505.00 DAK2016
VIT A MERAH BOT Rp 622.00 DAK2016 280
GLUCO PROTEIN (ONE MAD) DOS PROG
ULTRA ONE TEST (ONE MAD) PCS PROG
HB SAHLI (ONE MAD) DOS PROG
HCL 0,1 N 100 ML (ONE MAD) BOT PROG
BLOOD LANCET (ONE MAD) DOS PROG
AUTOCLIK (ONE MAD) BUAH PROG
IODIUM TEST BOT Rp 75,000.00 POGAM
QUININE TAB Rp 737.00 2015 197
RDT MALARIA TEST Rp 57,684.00 PROGRAM
RDT MALARIA TEST Rp 5,271.00 APBN2017 325
OAM (DHP-Frimal) TAB Rp 2,030.00 APBD1 2018 18
OBAT PAKET TB KATEGORI 1 DOS Rp 431,983.00 DAK 2016 5

OBAT PAKET TB KATEGORI 2 DOS Rp 1,557,469.00 DAK 2018


POT DAHAK POT Rp 1,818.00 program tb
REAGENS ZIEHL NEELSEN SET Rp 296,600.00 APBDI2017 1
MASKER IKAT PCS prog tb POV

ALAT SUNTIK 3 ml PCS Rp 1,212.00 BKKBN PROV 326 200


COPPER T/ UID BOX Rp 11,800.00 BKKBN PROV 8
KONDOM DOS Rp 4,000.00 BKKBN PROV 30
KONDOM DOS Rp 4,291.60 BKKBN PROV 48 0
OBAT KB SUNTIK 3 BULAN VIAL Rp 6,120.00 BKKBN PROV 326
OBAT KB SUNTIK 3 BULAN VIAL Rp 6,460.00 BKKBN PROV 200
PIL KB 1 KOMBINASI STRP Rp 1,886.00 BKKBN PROV 107 200
SUSUK KB/IMPLAN SET Rp 212,500.00 BKKBN PROV
SUSUK KB/IMPLAN SET Rp 213,220.00 BKKBN PROV

MINERAL MIX SACHET Rp 2,450.00 PROGRAM KIA


MINERAL MIX SACHET Rp 2,920.00 DAK 2018 80

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
46 5 25 16 41
0 0
0 0
13 4 9 9
30 0 22 8 30
4 0 4 4
80 0 68 12 80
96 90 6 96
0 0 0 0
18 0 18 18

0 0
255 100 100 55 155

90 0 90 90
0 0
48 48 40
465 0 465 0 465
0 0
0 0
595 55 298 242 540

0 0
219 100 100 19 119

0 0
194 0 194 194
4200 156 4044 4044
1 0 1 1
0 0
7 0 7 7
0 0
0 0
0 0

0 0
0 0
0 0
990 305 685 685
480 60 420 420
1 1 0 0
2638 661 800 1177 1977
30 0 30 30
0 0
381 20 300 61 361

0 0
1694 630 750 314 1064

0 0
0 0
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
0 0 0 0
1970 485 1400 85 1485
0 0
0 0
0 0
9 9 9
54 0 40 14 54
0 0
31 9 10 12 22
24 1 14 9 23
0 0
1500 0 600 900 1500
565 240 325 325
0 0
0 0
51 33 18 18
0 0
1492 738 754 754

0 0 0

0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
2323 1158 1165 1165
1200 500 700 0 700

0 0
1310 110 600 600 1200
0 0
0 0
500 0 500 500
88 0 84 4 88
0 0
1730 130 1600 1600
500 0 100 400 500
15 1 9 5 14
0 0

0 0
0 0
0 0

0 0
0 0 0 0
0 0
0 0 0 0

25 3 17 5 22
162 0 162 162
0 0
1485 0 1300 185 1485
0 0
100 100
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0

23 0 23 23
0 0
0 0
0 0 0 0
0 0
0 0
0 0
230 10 220 220

0 0 0
0 0 0
700 140 560 560
10 10 0 0
0 0 0
500 0 500 0 500

0 0
0 0
47 0 30 17 47
13 0 13 0 13
0 0
0 0
6 0 6 6
0 0
0 0
0 0
0 0
0 0
19 0 19 19
0 0 0 0
0 0
12 12 0 0
1710 160 1400 150 1550
5 1 4 4
140 140 0
0 0 0
0 0
400 20 300 80 380
450 0 450 0 450
0 0
1 0 1 0 1
0 0
330 20 100 210 310
0 0
50 0 30 20 50
0 0
38 1 24 13 37
0 0
6 1 5 5
0 0
0 0
0 0
0 0
1523 928 595 595
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
1 0 1 1
1 0 1 1
360 360 350
500 0 300 200 500
0 0
110 0 110 110
11 5 6 6
0 0
40 0 40 40
0 0
0 0
92 0 86 6 92

0 0
0 0
0 0
1300 1300
2789 216 1500 1073 2573

0 0 0
205 49 156
14 0 14
500 0 500 500
160 0 160 160
130 40 90 90
58 0 58 58
0 0
100 0 100 100
0 0
0 0
15 1 14 14
179 69 110 110
1000 195 800 5 805
0 0
0 0
0 0
50 43 7 7
153 0 148 5 153
0 0
0 0
0 0
0 0
0 0 0 0

13 0 13 13
0 0

0 0
0 0
1 0 1 1
0 0

0 0
0 0
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
0 0
0 0
3860 1420 1320 1120 2440

10 0 10 10
10 0 10 10
1 0 1 1
390 0 100 290 390
1000 0 1000 0 1000
0 0
0 0
677 15 400 262 662
299 0 299 299
20 0 15 5 20
0 0
1 0 1 1
0 0
0 0
0 0
510 0 510 510
0 0 0 0
370 30 340 340
500 100 400 0 400
0 0
0 0
4676 205 2000 2471 4471
210 0 210 210
0 0
250 20 150 80 230
500 0 500 0 500
0 0 0
110 0 110
60 30 30
200 10 165 25 190
0 0
0 0
26 9 0 17 17

0 0
190 0 190 190
166 2 130 34 164
168 0 158 10 168
350 300 0 50 50

75 25 25 25 50
220 0 100 120 220
700 0 700 0 700
0 0
89 17 24 48 72
0 0 0 0
1210 340 650 220 870
0 0

PERSE- PENGELU SISA STOK STOK PERMIN-


DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
0 0
0 0
200 200
436 130 306 306

0 0
0 0
0 0
23 5 12 6 18
0 0 0
0 0 0
7 6 1 1
100 0 90 10 100
65 0 57 8 65
789 0 500 289 789

0 0
0 0
0 0
0 0
50 0 50 50
0 0
0 0
0 0
0 0
0 0

500 0 500 500


9 1 8 8
0 0
0 0
0 0
0 0
4 4 0 0
0 0
45 0 45 45
2500 500 2000 2000
0 0
0 0
570 5 300 265 565
0 0
30 12 18 18

23 0 23 23
1000 0 1000 1000
0 0
52 0 37 15 52
19 9 10 0 10
0 0
0 0
19 4 15 15

8 8
34 3 20 11 31

PERSE- PENGELU SISA STOK STOK PERMIN-


DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
2 0 2 2
2 0 2 2
2 0 2 2
2 0 2 2
2 0 2 2
2 0 2 2
2 0 2 2
2 0 2 2
0 0
331 43 255 33 288
0 0
0 0
0 0 0 0
0 0
620 100 520 520
0 0
4 0 4 0 4
2 0 2 2

10 0 4 6 10
0 0
0 0
125 100 0 25 25
0 0
385 102 150 133 283

44 0 44 0 44
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
170 0 170 170

480 20 200 260 460


0 0 0 0
0 0
790 0 600 190 790
400 0 400 400
0 0
0 0
1840 78 1500 262 1762
0 0
0 0
6 0 2 4 6
10 0 10 10

PERSE- PENGELU SISA STOK STOK PERMIN-


DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
0 0
0 0
400 0 400 0 400
10 0 10 10
10 0 10 10
0 0
0 0
0 0
235 20 215 215
0 0
0 0
0 0
0 0
475 120 100 255 355
0 0
110 0 110 110
0 0
490 0 300 190 490
0 0
0 0
360 0 360 360
216 0 216 0 216
0 0
0 0 0 0
0 0
0 0
0 0
0 0
0 0
20 0 20 20

17 0 16 1 17
0 0
0 0
147 10 125 12 137

0 0
50 13 35 2 37
0 0
1 1 0 0
112 30 60 22 82
0 0
0 0
0 0
0 0
1552 601 951 951
2000 590 1400 10 1410
0 0
44 12 32 32

0 0
0 0
460 20 240 200 440
0 0

PERSE- PENGELU SISA STOK STOK PERMIN-


DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
0 0
0 0
1183 276 400 507 907

0 0
100 0 100 100
0 0
0 0
0 0
100 100

0 0
375 0 200 175 375

0 0
0 0
40 20 20 20

0 0
0 0
0 0
27 12 15 15
49 0 35 14 49
0 0
440 150 290 290
2 0 2 2

17 8 5 4 9
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
10 0 10 10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
150 30 120 120

0 0
0 0
500 500 500
445 109 300 36 336
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
0 0

0 0
0 0
22 6 16 16
42 4 38 0 38

0 0
0 0
23 0 23 0 23
96 1 81 14 95
0 0 0 0
0 0
0 0
2675 420 1320 935 2255

0 0
500 10 400 90 490
0 0
0 0
0 0

0 0
126 0 124 2 126
200 60 125 15 140
300 25 250 25 275
260 100 120 40 160
180 0 175 5 180
0 0
0 0
0 0
100 100
700 0 500 200 700
0 0
0 0

0 0
109 19 30 60 90
0 0
0 0
2 0 2 2

5 1 4 4
4 1 3 3

10 0 10 10
0 0
100 0 100 100
0 0
140 120 20 20
0 0
0 0
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
0 0
1193 760 433 433
0 0
0 0

0 0
0 0
0 0
0 0
1925 910 1015 1015
0 0
0 0
90 40 50 50
0 0
0 0
0 0
670 0 600 70 670
1270 487 400 383 783
26 2 10 14 24
0 0
5 5 0 0

0 0
480 0 400 80 480
0 0
0 0
6 1 5 5
0 0
0 0 0 0
0 0 0 0
21 2 18 1 19
1 0 1 1
0 0
0 0
0 0
0 0
2103 1203 800 100 900

0 0
0 0
36 29 7 7
0 0
0 0
20 0 20 20
0
PERSE- PENGELU SISA STOK STOK PERMIN-
DIAAN ARAN GUDANG SUB UNIT AKHIR TAAN
H I J K L M
0 0
22 3 22 19

2 1 2 1
0 0
100 0 100 100
0 0
280 30 250 0 250
0 0
0 0
0 0
0 0
0 0
0 0
0 0
197 0 197 197
0 0
325 0 325 325
18 0 18 18
5 3 5 2

0 0
0 0
1 0 1 0 1
0 0

526 269 257 257


8 0 8 8
30 0 30 30
48 0 48 48
326 69 257 257
200 200 0
307 221 86 86
0 0
0 0

0 0
80 0 80 80

75370
: 0101
PUSKESMAS : PASANGKAYU 1
KECAMATAN : PASANGKAYU
KAB./KODYA : PASANGKAYU
PROVINSI : SULAWESI BARAT
HAL 1BULAN : MEI 2019
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
1 Abocat 18 PCS Rp 8,750.00 2016
2 Abocat 18 PCS Rp 8,575.00 DAK 2016 41
3 Abocat 20 PCS Rp 16,249.99 2015
4 Abocat 20 PCS Rp 8,750.00 2016
5 Abocat 20 PCS Rp 8,575.00 DAK 2016 9
6 Abocat 22 PCS Rp 8,750.00 2016 30
7 Abocat 22 PCS Rp 8,575.00 DAK 2016 4
8 Abocat 24 PCS Rp 8,750.00 2016 80
9 Abocat 26 PCS Rp 27,134.00 DAK 2018 96
10 Acetosal TAB Rp 127.00 2015 0
11 Acyclovir 200 mg TAB Rp 251.00 2014 18
12 Acyclovir 200 mg TAB Rp 236.00 DAK 2018
13 Acyclovir 400 mg TAB Rp 362.00 2015
14 Acyclovir 400 mg TAB Rp 630.50 2017 155

15 Alat suntik sekali pakai 0,5 ml PCS Rp 1,655.50 DAK 2016 90


16 Alat suntik sekali pakai 1 ml PCS Rp 1,540.00 2015
17 Alat suntik sekali pakai 1 ml PCS Rp 1,694.00 2016
18 Alat suntik sekali pakai 1 ml (AXIMED) PCS Rp 913.00 DAK 2018 465
19 Alat suntik sekali pakai 2.5 ml PCS Rp 1,141.80 2013
20 Alat suntik sekali pakai 3 ml PCS Rp 968.00 2016
21 Alat suntik sekali pakai 3 ml PCS Rp 2,119.00 DAK 2018 540
22 Alat suntik sekali pakai 3 ml PCS Rp 778.74 DAK 2019
23 Alat suntik sekali pakai 5 ml PCS Rp 1,348.00 2013
24 Alat suntik sekali pakai 5 ml PCS Rp 861.30 2017 119

25 Albendazol SYR Rp 4,234.00 2016


26 Albendazol tablet 400 mg TAB Rp 363.00 2016 194
27 Albendazol tablet 400 mg TAB Rp 266.80 APBN 2017 4044
28 Alginat BOT Rp 239,525.00 2017 1
29 Aroma fine normal (Alginat aroma bks Rp 192,000.00 dak 2017
30 Alkohol 100 ml BOT Rp 2,625.00 2016 7
31 Alkohol 1000 ml BOT Rp 25,800.00 2016
32 Alkohol Swab pcs Rp 245.00 2016
33 Alkohol Swab pcs Rp 242.00 2017
34 Alkohol Swab pcs Rp 132.07 DAK 2019
35 Alopurinol tablet 100 mg TAB Rp 96.00 BUFFER
36 Alopurinol tablet 100 mg TAB Rp 90.00 2015
37 Alopurinol tablet 100 mg TAB Rp 96.00 2017
38 Alopurinol tablet 100 mg TAB Rp 96.00 DAK 2017 685
39 Alopurinol tablet 300 mg TAB Rp 249.00 DAK 2017 420
40 Ambroxol SYR BOT Rp 6,512.30 DAK 2018 0
41 Ambroxol 30 mg TAB Rp 242.00 DAK 2018 1977
42 Aminofilin INJ 24 mg/ml - 10 ml AMP Rp 4,200.00 2015 30
43 Aminofilin tablet 200 mg TAB Rp 86.00 2015
44 Amitripilin 25 mg TAB Rp 123.00 2015 361
45 Amitripilin 25 mg TAB Rp 168.00 2018
46 Amlodipin 10 mg TAB Rp 168.00 2016
47 Amlodipin 10 mg TAB Rp 279.13 DAK 2018 1064

48 Amlodipin 5 mg (HEXAVASK) TAB Rp 197.00 2015


49 Amlodipin 5 mg (HEXAVASK) TAB Rp 1,050.00 2017
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
50 Amoksisilin 500 mg TAB Rp 279.00 2013
51 Amoksisilin 500 mg TAB Rp 279.00 2016 0
52 Amoksisilin 500 mg TAB Rp 239.00 DAK 2017 1485
53 Amoksisilin 250 mg CAP Rp 220.00 2014
54 Amoksisilin SYR 125 mg/5 ml BOT Rp 2,560.00 2014
55 Amoksisilin SYR 125 mg/5 ml BOT Rp 8,900.00 DAK 2018
56 Amoksisilin SYR 125 mg/5 ml (SOLPENOX) BOT Rp 8,900.00 DAK 2018
57 Amoksisilin SYR 125 mg/5 ml (YUSIMOX) BOT Rp 4,466.00 DAK 2018 54
58 Amoksisilin SYR 250 mg/5 ml BOT Rp 4,655.00 2017
59 Amoksisilin SYR 250 mg/5 ml BOT Rp 3,740.00 DAK 2018 22
60 Amoksisilin DROPS (SUPRAMOX) BOT Rp 28,500.00 DAK 2018 23
57 Ampisilin INJ AMP Rp 5,610.00 2015
58 Antalgin (metampiron) 500 mg TAB Rp 385.00 DAK 2016 1500
59 Antalgin (metamizole sodium 500 mg TAB Rp 385.00 DAK 2016 325
60 Antasida SYR Rp 2,135.00 2015
61 Antasida SYR Rp 2,135.00 DAK 2016
62 Antasida SYR Rp 2,146.00 DAK 2018 18
63 Antasida doen tablet kombinasi TAB Rp 78.00 2015
64 Antasida doen tablet kombinasi 400 mg TAB Rp 72.00 2017 754
Antasida doen tablet kombinasi 400 mg TAB Rp 286.00 dak 2018
65 Anti Hemoroid SUPP Rp 2,200.00 2016 0
Anti Hemoroid SUPP - DAK 2019
66 Aqua dest steril VIAL Rp 2,750.00 2017 0
67 As. Mefenamat TAB Rp 119.00 2014 0
68 As. Mefenamat TAB Rp 119.00 2016 0
69 As. Mefenamat TAB Rp 117.00 2017 0
70 As. Mefenamat (BIRU) TAB Rp 176.00 2017 0
71 As. Mefenamat 500 mg TAB Rp 119.00 APBD 2018 1165
72 As. Mefenamat 500 mg TAB Rp 119.00 APBD 2019 700

73 Asam folat (AFOLAT) TAB Rp 52.00 2016


74 Asam folat (Profolat) TAB Rp 64.00 DAK 2018 1200
75 ASEPTIC GEL BTL Rp 1,581.25 2017
76 Atenolol (FARNORMIN) TAB Rp 387.00 2015
77 Atenolol (FARNORMIN) TAB Rp 342.00 DAK 2017 500
78 Atropin sulfat INJ 0.25 mg/ml - 1ml AMP Rp 1,400.00 2016 88
79 Atropin sulfat tab 0,5 mg TAB Rp 81.00 2016
80 Attapulgit TAB Rp 220.00 2016 1600
81 Attapulgit TAB Rp 196.00 2017 500
82 Attapulgit (ARCAPEC) SYR Rp 1,581.25 2017 14
83 ABATE SCT Rp 6,380.00 DAK 2018
Antiseptik gel bot - DAK 2019
84 Bactivec (abate) BOT BS
85 Bacitracin polymixin TUBE Rp 2,767.00 2015
86 Bacitracin polymixin TUBE Rp 3,511.00 2017
Bacitracin polymixin TUBE Rp 3,642.00 DAK 2018
87 Betahistin TAB Rp 1,062.60 2016
88 Betahistin TAB Rp 177.00 2017 0
89 Betametason SALP 0.1 % TUBE Rp 1,596.00 2015
90 Betametason SALP 0.1 % TUBE Rp 1,596.00 2016 0
Betametason SALP 0.1 % TUBE - DAK 2019
91 Betametason TTS MATA (BETAM) BTL Rp 19,600.00 DAK 2018 22
92 Bicolax TAB Rp 1,335.27 2016 162
93 BIOPLACENTon TUBE Rp 18,125.00 2017
94 Bisoprolol TAB Rp 2,553.83 2016 1485
95 Blood Lancet 265 PCS Rp 160.23 2016
96 Blood Lancet 266 PCS Rp 160.23 2016
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
97 Bronheksine (MIRAVAN) TAB Rp 354.20 2015

98 CALCII GLUCONAT AMP Rp 1,581.25 2016 23


99 Calsium Laktat TAB Rp 72.00 2015
100 Calsium Laktat TAB Rp 72.00 2016
101 Calsium Laktat TAB Rp 64.00 buffer stok 0
102 Captopril 12.5 mg TAB Rp 69.00 2014
103 Captopril 12.5 mg TAB Rp 69.00 2015
104 Captopril 12.5 mg TAB Rp 72.00 2017
105 Captopril 12.5 mg TAB Rp 68.00 DAK 2018 220
Captopril 12.5 mg TAB Rp 68.00 DAK 2019
106 Captopril 25 mg TAB Rp 82.00 2015 0
107 Captopril 25 mg TAB Rp 82.00 2016 0
108 Captopril 25 mg TAB Rp 137.75 DAK 2017 560
109 Captopril 25 mg TAB Rp 82.00 DAK 2018 0
110 Captopril 50 mg TAB Rp 147.00 2015 0
111 Captopril 50 mg TAB Rp 147.00 DAK 2017 500

112 Carbamazepin TAB Rp 269.00 2014


113 Catgut/Benang bedah 3/0 plain SET Rp 33,250.00 2016
114 Catgut 3/0 CHOMIC SET Rp 6,420.33 DAK 2017 47
115 Catgut 2/0 CHOMIC SET Rp 6,420.83 DAK 2018 13
116 CHKM BOTOL Rp 126,500.00 DAK 2018
117 Plant Cutura 2/0 SET Rp 6,420.83 DAK 2018
118 PLAINCatgut 3/0 SET Rp 6,420.83 DAK 2018 6
119 Cefadroxil BOT Rp 5,286.00 2016
120 Cefadroxil CAP Rp 557.00 2016
121 Cefadroxil CAP Rp 495.00 DAK 2018
122 Cefixime CAP Rp 700.00 2016
123 Cefotaxin INJ AMP Rp 6,785.00 2016
124 Ceftriaxone AMP Rp 6,785.00 2015 19
125 Cetirizin TAB Rp 156.00 2015 0
126 Cetirizin syr syr Rp 8,094.00 2017
127 Cetirizin syr Rp 13,956.00 DAK 2018 0
128 Ciprofloxacin TAB Rp 309.00 2016 1550
129 Ciprofloxacin BAQUINOR TTS MATA BTL Rp 10,250.00 2017 4
130 Clhorpromazine 100 mg TAB Rp 156.00 2015 0
131 Clhorpromazine 25 mg TAB Rp 75.00 2015 0
132 Clindamycin 150 mg CAP Rp 405.00 2015
133 Clindamycin 150 mg CAP Rp 786.00 DAK 2018 380
134 Clindamycin 300 mg CAP Rp 693.00 DAK 2017 450
135 Clor Etil BOT Rp 158,125.00 2015
136 Clor Etil BOT Rp 506,000.00 DAK 2018 1
137 Cloramfenikol 250 mg CAP Rp 261.00 2015
138 Cloramfenikol 250 mg CAP Rp 341.00 DAK 2018 310
139 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2015
140 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2017 50
141 Cloramfenikol 3 % TUBE Rp 3,460.00 2016
142 Cloramfenikol 2 % TUBE Rp 3,416.00 DAK 2018 37
143 Cloramfenikol salp mata 1 % TUBE Rp 1,680.00 2015
144 Cloramfenikol salp mata 1 % TUBE Rp 2,013.00 DAK 2018 5
145 Cloramfenikol TTS MATA BOT Rp 12,600.00 2017
146 Cloramfenikol TTS telinga BOT Rp 6,424.00 2016
147 Clorfeniramin Maleat (CTM) TAB Rp 54.00 2015
148 Clorfeniramin Maleat (CTM) TAB Rp 46.00 2017
149 Clorfeniramin Maleat (CTM) Rp 46.00 DAK 2017 595
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
150 Composit A3 PCS Rp 749,320.00 2017 1
151 Composit A35 PCS Rp 749,320.00 2017 1
152 Cotrimoksazol 480 mg (DOEN) TAB Rp 158.00 2015
153 Cotrimoksazol 480 mg (DOEN) TAB Rp 152.00 APBD 2018 500
154 Cotrimoksazol Pediatrik TAB Rp 83.49 2015
155 Cotrimoksazol SYR BOT Rp 7,810.00 2015 110
156 Cotrimoksazol SYR BOT Rp 2,250.00 DAK 2016 6
157 CURCUMA TAB Rp 1,644.00 2017
158 CUTIMED SORBACT SWAB PCS Rp 30,503.00 DAK 2018 40
159 COTTON ROLL ROLL Rp 100,150.00 DAK 2018
160 CRESOPHENE, SOLUTION,LIQUID BOTOL Rp 770,000.00 DAK 2017
161 Deksametason AMP Rp 1,820.00 2015 92

162 Deksametason tablet 0.5 mg TAB Rp 52.00 2015


163 Deksametason tablet 0.5 mg TAB Rp 46.00 2017
164 Deksametason tablet 0.5 mg TAB Rp 35.00 DAK 2018
165 Deksametason tablet 0.5 mg TAB Rp 95.00 DAK 2018
166 Deksametason tablet 0.5 mg TAB Rp 95.00 APBD 2019 2573

167 Diazepam 2 mg TAB Rp 35.09 2015 0


168 Diazepam 2 mg TAB Rp 86.00 DAK 2018 156
169 Diazepam INJ 5 mg/ml AMP Rp 18,260.00 2015 14
170 Digoksin tablet 0.25 mg TAB Rp 103.00 2015 500
171 Dilteazem HCL tab 30 mg TAB Rp 141.00 2015 160
172 Dimenhidrinat TAB Rp 109.00 2015 90
173 DIPHENHIDRAMIN INJ Rp 1,156.00 2015 58
174 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 2,720.00 2016
175 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 3,594.25 2017 100
176 jarum citojeck PCS Rp 1,705.00 DAK 2018
177 Domperidon syr BOT Rp 14,374.80 2015
178 Domperidon syr BOT Rp 2,970.00 DAK 2018 14
179 Domperidon Tab TAB Rp 174.00 2013 110
180 Domperidon 10 mg TAB Rp 90.00 DAK 2019 805
181 Doxiciklin CAP Rp 298.00 2015
182 DULCOLAX 5 mg SUPP Rp 5,670.00 2016
183 DULCOLAX 10 mg SUPP Rp 5,800.00 2016
184 DULCOLAX 10 mg SUPP Rp 5,900.00 DAK 2018 7
185 Epinefrin hcl AMP Rp 8,910.00 buffer 153
186 Ergotamin Cafein TAB Rp 149.00 2015
187 Eritromycin CAP Rp 679.00 2016
188 Eritromycin SYR Rp 7,391.00 2016
189 Eritromycin SYR Rp 7,391.00 2017
190 Eritromycin SYR Rp 2,490.00 DAK 2018 0

191 Etakridin /Rivanol 300 ml BOT Rp 3,060.00 2016 13


192 Etambutol hcl. Tablet 250 mg TAB Rp 330.00 2015

193 Etiket obat Biru LMBR Rp 61.00 2016


194 Etiket Obat Putih LMBR Rp 61.00 2016
195 ETSGEL Rp 395,532.50 DAK 2017 1
196 Eugenol BOT Rp 50,416.67 2014
Eugenol BOT Rp 22,589.00 2014
197 ELITE CEMENT BOX Rp 370,620.00 DAK 2018
198 EXAFLEX PUTTY BOX Rp 2,100,000.00 DAK 2018
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
199 Ferro Sulfat SCT Rp 425.00 2015
200 Ferro Sulfat SCT Rp 425.00 2017
201 Ferro Sulfat SCT APBD1 2018
202 Ferro Sulfat SCT Rp 427.00 APBD 2019 2440
Ferro Sulfat SCT Rp 372.00 DAK 2019
203 Folley cateter no.16 SET Rp 20,000.00 2016 10
204 Folley cateter no.18 SET Rp 20,000.00 2016 10
205 Furosemid inj 10mg/ml AMP Rp 2,012.00 2015 1
206 Furosemid tablet 40 mg TAB Rp 84.00 2015 390
207 Furosemid tablet 40 mg TAB Rp 77.00 APBD 2018 1000
208 FOMALIN TAB Rp 5,060.00
209 Garam oralit untuk 200 ml air SCT Rp 1,072.50 2015
210 Garam oralit untuk 200 ml air SCT Rp 278.00 DAK 2017 662
211 Gelang pasien warna pink PCS Rp 2,706.00 2016 299
212 Gentamycin inj. AMP Rp 3,699.00 20
213 Gentian Violet lar 1 % BOT Rp 3,750.00 DAK 2018
214 Glass Lonomer SET/BTL Rp 949,520.00 2017 1
215 Glass Lonomer SET/BTL Rp 1,050,000.00 DAK 2018
216 Glibenclamid 5 mg TAB Rp 61.00 2014
217 Glibenclamid 5 mg TAB Rp 143.00 DAK 2018
218 Glibenclamid 5 mg TAB Rp 90.00 APBD 2018 510
Glibenclamid 5 mg TAB Rp 342.00 DAK 2018
219 Glimepirid 1 mg TAB Rp 1,576.00 2015 0
220 Glimepirid 2 mg TAB Rp 311.00 2015 340
221 Glimepirid 2 mg TAB Rp 207.00 DAK 2018 400
222 Gliseril Guayakolat TAB Rp 66.79
223 Gliseril Guayakolat TAB Rp 66.79 2016
224 Gliseril Guayakolat TAB Rp 66.79 DAK 2016 4471
225 Gluko + protein test box PCS Rp 1,150.00 2016 210
226 Griseofulvin 125 mg TAB Rp 230.00 2015
227 Griseofulvin 125 mg TAB Rp 263.00 DAK 2017 230
228 Griseofulvin 125 mg TAB Rp 231.00 DAK 2018 500
229 Haloperidol tab 5 mg TAB Rp 105.00 2015 0
230 Haloperidol tab 0.5 mg TAB Rp 55.00 DAK 2018 110
231 Haloperidol tab 1.5 mg TAB Rp 59.00 DAK 2018 30
232 Handscoon 6 (T-SENSAURGE) STERIL SET Rp 7,254.50 DAK 2018 190
233 Handscoon 7 SET Rp 9,310.00 2016
234 Handscoon 7 Rp 9,120.00 DAK 2017
235 Handscoon 7 STERIL SET Rp 8,360.00 DAK 2018 17
Handscoon 7 STERIL SET Rp 3,987.88 DAK 2019
236 Handscoon 7,5 (aximed) STERIL SET Rp 9,310.00 2016
237 Handscoon 7,5 (aximed) STERIL SET Rp 9,120.00 2017 190
238 Handscoon 7,5 (T-SENSAURGE) STERIL SET Rp 7,254.50 DAK 2017 164
239 Handscoon 8 STERIL SET Rp 9,310.00 2016 168
240 Handscoon non steril (M)AXIMED EXAMINATIO SET Rp 508.20 2018 50

241 HBSAG Strip STRIP Rp 11,037.00 DAK 2018 50


242 Hidroklortiazid 25 mg TAB Rp 179.00 2016 220
243 Hidroklortiazid 25 mg TAB Rp 179.00 DAK 2017 700
244 Hidrokortison Salp TUBE Rp 2,938.00 2015
245 Hidrokortison Salp TUBE Rp 2,938.00 2016 72
246 Hidrokortison Salp 2,5% TUBE Rp 2,848.00 DAK 2017 0
247 HISTIGO TAB Rp 595.05 DAK 2018 870
248 HYDCAL PASTA BASE TUBE Rp 299,530.00 DAK 2017

STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
249 Ibuprofen 400 mg TAB Rp 139.00 2014
250 Ibuprofen 400 mg (ARFEN) TAB Rp 501.10 DAK 2018
251 Ibuprofen 400 mg TAB Rp 139.00 APBD 2018
252 Ibuprofen 400 mg (FASIFEN) TAB Rp 525.00 DAK 2018
253 Ibuprofen 400 mg TAB Rp 139.00 APBD 2019 306
Ibuprofen 400 mg TAB - DAK 2019
254 Ibuprofen 200 mg TAB Rp 116.00 DAK 2017
255 Ibuprofen 200 mg TAB Rp 116.00 DAK 2018
256 Ibuprofen suspensi 200 mg/5 mg BOT Rp 4,949.00 2016
257 Ibuprofen suspensi 200 mg/5 mg BOT Rp 5,509.00 DAK 2018 18
258 Infant muccus PCS Rp 37,988.50 2016 0
259 Infuset Makro SET Rp 5,880.00 2015 0
260 Infuset Makro (PIECES) SET Rp 3,190.00 APBD 2018 1
261 Infuset Makro (OTSU SET) SET Rp 13,200.00 DAK 2018 100
262 Infuset Mikro SET Rp 7,920.00 2016 65
263 isosorbid TAB Rp 98.00 2015 789
IV CANULA PCS Rp 3,554.52 DAK 2019
264 JARUM HACTING NO. 08 LSN Rp 30,000.00 2016
265 JARUM HACTING NO. 10 LSN Rp 30,000.00 2016
266 JARUM HACTING NO. 12 LSN Rp 30,000.00 2016
267 JARUM HACTING NO. 15 LSN Rp 30,000.00 2016
268 Kaca Penutup (Deg Glass) pcs Rp 929.50 2016 50
269 Kalium Diklofenak TAB Rp 814.66 2015
270 Kalium permanganat BOT Rp 6,325.00 2016
271 Kapas 250 gr ROL Rp 14,375.00 2015
272 Kapas 250 gr ROL Rp 14,375.00 2016
273 Kapas 250 gr ROL Rp 14,375.00 DAK 2018
Kapas ONEMED 250 gr ROL - DAK 2019
274 KARTU GOLONGAN DARAH PCS Rp 2,200.00 2016 500
275 Kasa gulung 36x80 cm ROL Rp 142,600.00 DAK 2017 8
276 Kasa gulung 30x60 cm ROL Rp 142,600.00 2016
277 Kasa gulung 30x60 cm ROL Rp 142,600.00 DAK 2016
278 Kasa gulung 36x80 cm Rp 142,600.00 DAK 2016
279 Kasa Steril 16x16 cm SET Rp 8,740.00 2016
280 Kasa Steril 16x16 cm Rp 575.00 DAK 2018 0
281 Kasa Steril 5x5 cm SET Rp 3,311.00 2017
282 Kasa PEMBALUT 4x10 cm ROL Rp 1,725.00 DAK 2018 45
283 Kertas puyer LBR Rp 123.20 2017 2000
284 Ketamin INJ VIAL Rp 63,400.00 2015
285 Ketoconazole 200 mg TAB Rp 303.00 2015
286 Ketoconazole 200 mg TAB Rp 303.00 2016 565
287 Ketoconazole salp 2 % TUBE Rp 2,697.00 2014
288 Ketoconazole salp 2 % TUBE Rp 2,694.00 DAK 2018 18

289 Ketorolak inj 30 AMP Rp 1,450.00 2015 23


290 Kombinasi Prometamin 25 + Sulfadoxin 500 TAB Rp 572.00 DAK 2015 1000
291 Lansoprazol (DIGEST) CAP Rp 5,500.00 2017
292 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 2015 52
293 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 DAK 2016 10
294 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2015
295 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2017
296 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 DAK 2018 15
Larutan NACL Lar infus 500 ml BOT - DAK 2019
297 Larutan RL BOT Rp 7,150.00 2016
298 Larutan RL BOT Rp 7,150.00 DAK 2017 31

STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
299 LARUTAN EDTA 10*Indoor BOT Rp 1,702,536.00 2016 2
300 LARUTAN Giemsa indoor BOT Rp 1,523,280.00 2016 2
301 LARUTAN Giemsa indoor BOT Rp 356,250.00 DAK 2018 2
302 LARUTAN Haemoglobin C indoor BOT Rp 296,956.00 2016 2
303 LARUTAN Hcl 0,1 N Indoor BOT Rp 236,808.00 2016 2
304 LARUTAN Metanol PA BOT Rp 686,697.00 2016 2
305 LARUTAN Trombosit Ao indoor BOT Rp 374,440.00 2016 2
306 LARUTAN Turk 500ml BOT Rp 444,015.00 2016 2
307 Lidocain INJ AMP Rp 929.00 2015
308 Lidocain INJ AMP Rp 2,215.00 DAK 2016 288
309 Loperamid TAB Rp 97.00 2016
310 Loperamid Rp 97.00 2017
311 Loperamid 2 mg Rp 97.00 DAK 2017 0
312 Loratadin TAB Rp 159.00 2013
313 Loratadin TAB Rp 159.00 DAK 2017 520
314 Loratadin 10 mg TAB Rp 500.00 DAK 2018
315 Lysol BOT Rp 49,200.00 2015 4
316 Lysol 1000 Ml BOT Rp 49,200.00 DAK 2016 2

317 Litrol TTS mata BOT Rp 5,850.00 DAK 2018 10


318 Masker earloop SET Rp 440.00 2015
319 Masker earloop SET Rp 435.60 DAK 2018
320 Masker earloop (AXIMED) SET Rp 436.00 DAK 2018 25
321 Masker Standar tie on (IKAT) SET Rp 588.00 2016
322 Masker Standar tie on (IKAT) SET Rp 528.00 DAK 2018 283

323 Mebendazol (VERMOX) TAB Rp 8,800.00 2015 44


324 MEDLENCE plus extra 21 G/2,4 mm PCS Rp 3,991.90 2016
325 MEDLENCE plus lite 25 G/1,5 mm PCS Rp 3,991.90 2016
326 MEDLENCE plus special 0,8 (blade) 2,0 mm PCS Rp 3,991.90 2016
327 MEDLENCE plus universal 21 G/1.8 mm PCS Rp 3,991.90 2016
328 Meloxicam 7,5 mg TAB Rp 761.00 2015
329 Metformin CAP Rp 206.25 2015
330 Metformin CAP Rp 103.00 2017
331 Metformin 500 mg CAP Rp 336.00 DAK 2018
Metformin 500 mg CAP - DAK 2019
332 Metformin 850 mg CAP Rp 168.00 DAK 2018 0
333 Methylprednisolon 16 mg Rp 1,325.00 2017
334 Methylprednisolon 4 mg TAB Rp 500.62 2015
335 Methylprednisolon 4 mg TAB Rp 212.00 2017
336 Methylprednisolon 4 mg TAB Rp 170.00 APBD1 2017
337 Methylprednisolon 4 mg TAB Rp 170.00 APBD 2018 170

338 Metilergometrin maleat 0,125 mg TAB Rp 169.00 2015 460


339 Metilergometrin maleat INJ Rp 2,684.00 2015 0
340 Metoclopramid 10 mg TAB Rp 100.00 2015
341 Metoclopramid 10 mg TAB Rp 87.00 DAK 2018 790
342 Metoclopramid 5 mg TAB Rp 129.00 DAK 2018 400
343 Metronidazol 250 mg TAB Rp 116.00 2015
344 Metronidazol 500 mg TAB Rp 143.00 2015
345 Metronidazol 500 mg TAB Rp 143.00 2017 1762
346 Metronidazol INFUS BOT Rp 12,980.00 2017
347 Metronidazol SYR Rp 1,581.25 2017
348 MgSO4 20 % INJEKSI Rp 2,800.00 BUFFER 6
349 MgSO4 40 % INJEKSI Rp 3,650.00 APBD 2017 10

STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
350 Miconazol TUBE Rp 3,150.00 2016
351 Miconazol 2% Cream TUBE Rp 4,097.00 DAK 2018
352 Miniaspi 80mg TAB Rp 163.00 2016
353 Miniaspi/asetosal Rp 163.00 DAK 2016 400
354 Nasal Oksigen M PCS Rp 8,085.00 2016 10
355 Nasal Oksigen XS PCS Rp 8,085.00 2016 10
356 Natrium Diklofenak 25 mg TAB Rp 162.00 2015
357 Natrium Diklofenak 25 mg TAB Rp 178.00 DAK 2017
358 Natrium Diklofenak 25 mg TAB Rp 154.00 DAK 2018
359 Natrium Diklofenak 25 mg TAB Rp 146.00 APBD 2019 215
360 Natrium Diklofenak 50 mg TAB Rp 146.00 DAK 2018
361 Nelaton catheter pcs Rp 5,330.00 2017
362 Nebulyzer mask DEWASA PCS Rp 16,704.00 2016
363 Nifedipin TAB Rp 127.00 2015
364 Nifedipin 10 mg TAB Rp 112.00 DAK 2018 355
365 Nistatin 100.000 TAB Rp 528.00
366 Nistatin Vaginal 100.000 Rp 628.00 DAK 2017 110
367 Nistatin 500.000 TAB Rp 895.00 2015
368 Nistatin 500.000 TAB Rp 895.00 2016 490
369 Nistatin DROPS BOT Rp 40,030.00 DAK 2018
370 NOVABION KPSL Rp 395.42 2016
371 ONELAB Objeck Glass 72 PCS PCS Rp 331.37 DAK 2018 360
372 Objeck Glass PCS Rp 278.00 APBD 2019 216
373 OBH syr BOT Rp 3,740.00 2016
374 OBH syr Rp 2,925.00 DAK 2018 0
375 Ofloxacin TAB Rp 649.12 2015
376 Oksitertaciklin SALP 1 % TUBE Rp 4,901.00 2015
377 Oksitertaciklin SALP 3 % TUBE Rp 4,400.00 2015
378 Omeprasol CAP Rp 176.00 2016
379 Omeprasol 20 mg CAP Rp 176.00 2017
380 Omeprasol 20 mg CAP Rp 143.00 DAK 2018 20

381 Ondansetron inj Rp 1,254.00 2017 17


386 OXYTOCIN INJ Rp 1,900.00 2015
387 OXYTOCIN INJ Rp 1,287.00 DAK 2018
388 OXYTOCIN INJ Rp 1,287.00 DAK 2018 137

389 Otsu wi bot Rp 1,581.25 2016


390 Otsu wi bot Rp 2,860.00 DAK 2018 37
391 Paracetamol (FASIDOL)Droop BOT Rp 6,240.00 2016
392 Paracetamol (FASIDOL)Droop BOT Rp 7,979.00 DAK 2018 0
393 Paracetamol DroopS BOT - DAK 2019 82
394 Paracetamol 500 mg TAB Rp 60.00 2015
395 Paracetamol 500 mg TAB Rp 52.00 APBD 2017
396 Paracetamol 500 mg TAB Rp 52.00 APBD1 2017
397 Paracetamol 500 mg TAB Rp 259.00 DAK 2018
398 Paracetamol 500 mg TAB Rp 198.00 DAK 2018 951
399 Paracetamol 500 mg TAB - DAK 2019 1410
400 Paracetamol SYR BOT Rp 1,338.00 2015
401 Paracetamol SYR BOT Rp 1,190.00 Dak 2018 32

402 Pipet Dirpo Rp 1,292.50 DAK 2017


403 Phenobarbital inj 50mg/ml AMP Rp 1,980.00 BUFFER
404 Piracetam 1200 mg TAB Rp 594.56 2015 440
405 piroxicam 10 mg TAB Rp 165.78 2015

STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
406 Plester ROL Rp 42,499.60 2015
407 Plain 3/0 pcs Rp 1,581.25 2016
408 Prednison TAB Rp 125.00 2015
409 Prednison 5 mg TAB Rp 74.00 DAK 2018 907

410 PRIMAQUIN TAB Rp 205.00 2015


411 PRIMAQUIN 15 mg TAB Rp 253.00 APBD1 2018 100
412 PK (kalium pemanganat) 5 g BOT Rp 371,250.00 DAK 2018
413 Procrepe 15 cm x 4,55 m (perban) Rol Rp 41,910.00 2016
414 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 2015
415 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 BUFFER
PTU (Propiltiourasil) 100 mg TAB Rp 351.00 DAK 2019
416 Pyrantel TAB Rp 318.00 2015
417 Pyrantel 125 mg Rp 347.00 DAK 2018 375

418 Pyrantel SYR Rp 9,100.00 2015


419 POT URINE POT Rp 6,600.00 DAK 2018
420 POT 50 ml POT Rp 5,890.00 APBD1 2018 20
POT URINE POT - DAK 2019
421 PETERS SILK PCS Rp 37,209.00 DAK 2017
422 PULP-X V DEVITALIZER PASTE PCS Rp 443,200.00 DAK 2018
423 RDT DBD iig sct Rp 1,581.25 2016
424 RDT DBD COMO sct Rp 297,000.00 DAK 2019 15
425 Ranitidin INJ AMP Rp 5,368.00 2015 49
426 Ranitidin TAB TAB Rp 119.00 2016
427 Ranitidin 150 mg Rp 262.50 DAK 2018 290
428 RECO tts mata BOT Rp 20,360.00 DAK 2018 2

429 RECO tts Telinga BOT Rp 11,000.00 DAK 2018 9


430 Reagen diluent BOT Rp 4,770,000.00 DAK 2018
431 Reagen lyse BOT Rp 3,310,000.00 DAK 2018
432 Reagen RINSE Rp 1,950,455.00 DAK 2018
433 Reagen Asam urat BOT Rp 1,399,200.00 DAK 2017
434 Reagen WIDAL TEST BOT - DAK 2019
435 RAJAWALI UIC ACID (REAGEN) BOT Rp 1,870,660.00 DAK 2018
436 Reagen Kimia Klinik Glucosa BOT Rp 698,500.00 DAK 2017
437 RAJAWALI Glucosa (REAGEN) BOT Rp 889,570.00 DAK 2018
438 Reagen Kimia Klinik Kolesterol BOT Rp 748,000.00 DAK 2017
439 RAJAWALI KOLES ( Kolesterol) BOT Rp 2,093,300.00 DAK 2018
440 RYLES TUBE Rp 15,488.00 2017 10
441 Sak Besar (10x15 cm) PAK Rp 98,700.00 2017
442 Sak Besar (10x15 cm) PCS Rp 314.60 DAK 2017
443 Sak Sedang (6x10 cm) PAK Rp 96,900.00 2016
444 Sak Sedang (6x10 cm) PCS Rp 100.00 DAK 2016
445 Sak Kecil PCS Rp 100.00
446 Salbutamol 2 mg TAB Rp 69.00 2016
447 Salbutamol 2 mg TAB Rp 69.00 2017
448 Salbutamol 2 mg TAB Rp 69.00 DAK 2017
449 Salbutamol 2 mg TAB Rp 64.00 DAK 2018 120
Salbutamol 2 mg TAB Rp 64.00 DAK 2019
450 Salbutamol 4 mg TAB Rp 89.00 2015
451 Salbutamol 4 mg TAB Rp 89.00 2016
452 Salbutamol 4 mg TAB Rp 89.00 DAK 2017
453 Salbutamol 4 mg TAB Rp 81.00 DAK 2018 336
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
454 Salbutamol sirup 2mg/5ml BOT Rp 5,700.00 2015
455 Salbutamol sirup 2mg/5ml BOT Rp 5,700.00 DAK 2017
Salbutamol sirup 2mg/5ml BOT Rp 4,446.00 DAK 2019
456 Salicil talk SCT Rp 1,573.00 2015
457 Salicil talk SCT Rp 6,270.00 2016
458 Salicil talk 2% POT Rp 6,270.00 DAK 2016 16
459 Salp 24 TUBE Rp 2,200.00 2016 38

460 SCANDONEST AMP Rp 19,470.00 2016


461 Sefety box PCS Rp 18,072.35 2016
462 Sefety box 25 K 5 L Rp 18,072.25 DAK 2018 23
463 Silk SET Rp 15,750.00 2015 95
464 Silk SET Rp 37,289.00 2017 0
465 Simvastatin 10 mg TAB Rp 136.00 2016
466 Simvastatin (SVT) TAB Rp 686.00 2017
467 Simvastatin 10 mg TAB Rp 110.00 DAK 2018 2255

468 SPASMINAL Rp 750.00 2017


469 Sprinolakton Rp 212.00 DAK 2018 490
470 SPRITUS BOT Rp 1,581.25 2016
471 SPRITUS 250 ml BOT Rp 39,270.00 DAK 2017
472 Strip Asam Urat (NESCO) PCS Rp 11,440.00 DAK 2019
Strip Glucosa (NESCO) PCS Rp 11,440.00 DAK 2019
Strip Kolesterol (NESCO) PCS Rp 7,185.20 2016
473 Strip Glucosa (BENECHECK) PCS Rp 3,225.86 DAK 2017
474 Surgical Blade No.11 PCS Rp 974.05 2016 126
475 Strip Asam Urat (HUMASENS) STRIP Rp 22,252.00 DAK 2018 140
476 Strip Glucosa (HUMASENS) STRIP Rp 5,156.00 DAK 2018 275
477 Strip Kolesterol (HUMASENS) STRIP Rp 27,495.00 DAK 2018 160
478 Surgical Blade No.15 PCS Rp 974.05 2016 180
479 TEST NARKOBA/DRUG ABUSE STRIP Rp 78,999.00 2016
480 TEST NARKOBA STRIP Rp 78,999.80 DAK 2017
481 TEST HIV (SD BIOLINE HIV) STRIP Rp 37,600.00 APBN 2017
482 TEST HIV (SD BIOLINE HIV) STRIP Rp 11,975.00 APBDI 2018
483 Tiamfenicol 500 KAP Rp 1,518.00 2016 700
484 TIPS PIPET BIRU BKS Rp 594.00 2016
485 TABUNG PLASTIK SEUM 1,5 ml PIECES Rp 605.00 DAK 2017

486 Ultra One test hamil strip PCS Rp 2,133.00 2016


487 Ultra One test hamil strip PCS Rp 2,228.60 2017 90
488 Ultrafix/ PHarmafix ROL Rp 27,000.00 2016
489 Ultrafix/ Pharmafix ROL Rp 27,000.00 DAK 2017
490 Ultrafix/ Pharmafix ROL Rp 29,700.00 DAK 2018 2
Ultrafix/ Pharmafix ROL Rp 25,204.48 DAK 2019
491 ULTRASOUN GEL (GEL USG) BTL Rp 14,471.60 DAK 2017 4
492 UMBILICAL C (PENJEPIT TP) PCS Rp 3,300.00 DAK2018 3
UMBILICAL C (PENJEPIT TP) PCS - DAK2019
493 Urin bag/UROPLAS SET Rp 3,000.00 2015 10
494 UINE STIP 10 PAAMETE
495 VACUM TUBE PLAIN PCS Rp 2,200.00 DAK 2017 100
496 VACUM EDTA Rp 74,100.00 DAK 2018
497 VIT CALCIFAR TAB Rp 406.00 DAK 2018 20
498 VIT SYR (TAKANA) SYR Rp 39,223.80 2016
499 VIT SYR (TAKANA) SYR Rp 39,223.80 2017
VIT SYR (TUVIT) SYR - DAK 2019
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
500 Vitamin B 1 (tiamin) TAB Rp 95.00 BUFFER
501 Vitamin B 1 (tiamin) TAB Rp 95.00 2016
502 Vitamin B 1 (tiamin) 50 mg TAB Rp 95.00 DAK 2016 433
503 Vitamin B 12 TAB Rp 63.00 BUFFER
504 Vitamin B 12 TAB Rp 50.00 DAK 2018
Vitamin B 12 TAB - DAK 2019
505 Vitamin B 12 INJ AMP Rp 9,482.00 BUFFER
506 Vitamin B 12 INJ AMP Rp 1,283.00 2017
507 Vitamin B 6 (piridoksin) TAB Rp 175.00 BUFFER
508 Vitamin B 6 (piridoksin) TAB Rp 142.00 2017
509 Vitamin B 6 (piridoksin) TAB Rp 142.00 DAK 2017 1015
510 Vitamin B comp TAB Rp 138.00 2015
511 Vitamin B comp TAB Rp 138.00 2016
512 Vitamin B comp TAB Rp 141.00 APBD 2019 50
513 Vitamin C (Asam askorbat) 250 mg TAB Rp 139.00 2017
514 Vitamin C (Asam askorbat)250 mg Rp 139.00 DAK 2017
515 Vitamin C (Asam askorbat)50 mg TAB Rp 105.00 BUFFER
516 Vitamin C (Asam askorbat)50 mg TAB Rp 125.00 DAK 2017 670
517 Vitamin C (Asam askorbat)25 mg TAB Rp 36.00 DAK 2017 783
518 Vitamin K INJ AMP Rp 3,754.00 2015 24
519 Vitamin K INJ AMP Rp 4,260.00 APBD1 2018
520 Vitamin K INJ AMP Rp 15,700.00 Dak 2018 0
Vitamin K INJ AMP - Dak 2019
521 Vitamin K TAB TAB Rp 690.00 2015
522 Vitamin K TAB 10 mg Rp 855.00 DAK 2018 480
523 VITROMEGA CAP Rp 1,472.00 2016
524 VITROMEGA CAP Rp 1,472.69 2016
525 X. TRAGEN bot Rp 1,581.25 2017 5
526 Yodium Povidon 30 ml BOT Rp 2,344.00 2015
527 Yodium Povidon 60 ml BOT Rp 4,440.00 2017 0
528 Yodium Povidon 300 ml BOT Rp 4,440.00 2016 0
529 Yodium Povidon 300 ml BOT Rp 21,600.00 DAK 2018 19
530 ZINCPO dropS BOT Rp 6,369.00 DAK 2018 1
531 Zink Syrup 10mg/ml BOT Rp 16,478.00 2016
532 Zink Syrup 10mg/ml BOT Rp 16,478.00 2017
533 Zink TAB TAB Rp 521.00 2015
534 Zink TAB TAB Rp 1,100.00 BUFFER
535 Zink 20 mg TAB Rp 618.00 DAK 2017 900

536 creatininKIN 2x100 ml kit Rp 977,900.00 DAK 2017


537 Vacum tube sterlite PCS Rp 74,100.00 DAK 2018
538 Procurma SYR Rp 11,350.00 DAK2018 7
539 WIDAL TES STRIP
540 3M ESPE CAVIT FILLING BOX Rp 359,535.00 DAK 2017
541 VASELINE SWAB 10MX10CM PCS Rp 35,832.50 DAK 2017 20
PROGRAM
STOK
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
AWAL
A B C D E F
1 MDT MB DEWASA BLISTER Rp 30,595.00 APBN 2018
2 MDT MB DEWASA BLISTER Rp 31,570.00 APBD1 2018 19

3 MDT PB DEWASA BLISTER Rp 12,569.00 APBD1 2018 1


4 LACTOGEN 4 DUS Rp 67,500.00 2016
5 VIT A BIRU BOT Rp 341.00 DAK2016 100
6 VIT A MERAH BOT Rp 505.00 DAK2016
7 VIT A MERAH BOT Rp 622.00 DAK2016 250
8 GLUCO PROTEIN (ONE MAD) DOS PROG
9 ULTRA ONE TEST (ONE MAD) PCS PROG
10 HB SAHLI (ONE MAD) DOS PROG
11 HCL 0,1 N 100 ML (ONE MAD) BOT PROG
12 BLOOD LANCET (ONE MAD) DOS PROG
13 AUTOCLIK (ONE MAD) BUAH PROG
14 IODIUM TEST BOT Rp 75,000.00 POGAM
15 QUININE TAB Rp 737.00 2015 197
16 RDT MALARIA TEST Rp 57,684.00 PROGRAM
17 RDT MALARIA TEST Rp 5,271.00 APBN2017 325
18 OAM (DHP-Frimal) TAB Rp 2,030.00 APBD1 2018 18
19 OBAT PAKET TB KATEGORI 1 DOS Rp 431,983.00 DAK 2016 2

20 OBAT PAKET TB KATEGORI 2 DOS Rp 1,557,469.00 DAK 2018


21 POT DAHAK POT Rp 1,818.00 program tb
22 REAGENS ZIEHL NEELSEN SET Rp 296,600.00 APBDI2017 1
23 MASKER IKAT PCS prog tb POV

24 ALAT SUNTIK 3 ml PCS Rp 1,212.00 BKKBN PROV 257


25 COPPER T/ UID BOX Rp 11,800.00 BKKBN PROV 8
26 KONDOM DOS Rp 4,000.00 BKKBN PROV 30
27 KONDOM DOS Rp 4,291.60 BKKBN PROV 48
28 OBAT KB SUNTIK 3 BULAN VIAL Rp 6,120.00 BKKBN PROV 257
29 OBAT KB SUNTIK 3 BULAN VIAL Rp 6,460.00 BKKBN PROV 0
30 PIL KB 1 KOMBINASI STRP Rp 1,886.00 BKKBN PROV 86
31 SUSUK KB/IMPLAN SET Rp 212,500.00 BKKBN PROV
32 SUSUK KB/IMPLAN SET Rp 213,220.00 BKKBN PROV
33 SUSUK KB/IMPLAN SET Rp 18,908.10 BKKBN PROV
34 MASKER PCS Rp 451.00 BKKBN PROV
35 POVIDON IODINE BOT Rp 3,045.00 BKKBN PROV
36 MINERAL MIX SACHET Rp 2,450.00 PROGRAM KIA
37 MINERAL MIX SACHET Rp 2,920.00 DAK 2018 80

Mengetahui
Kepala UPTD Kesehatan Pasangkayu.

Fatmawati, SKM
NIP : 19820619 200312 2 003
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
41 6 20 15 35
0 0 0 0
0 0 0 0
9 5 0 4 4
30 0 27 3 30
4 0 4 0 4
80 3 68 9 77
96 2 90 4 94
0 0 0 0
18 18 0 0
500 500 0 500 0 500
0 0 0 0
155 0 100 55 155

90 0 90 90
0 0 0 0
0 0 0 0
465 1 455 9 464
0 0 0 0
0 0 0 0
540 11 298 231 529
400 400 40 360 360
0 0 0 0
119 4 100 15 115

0 0 0 0
194 194 0 0 0
4044 44 0 4000 4000
1 0 1 1
0 0 0 0
20 27 13 12 2 14
0 0 0 0
0 0 0 0
0 0 0 0
200 200 0 200 200
0 0 0 0
0 0 0 0
0 0 0 0
685 215 0 470 470
420 90 0 330 330
50 50 0 40 10 50
2000 3977 373 2500 1104 3604
30 0 30 30
0 0 0 0
361 361 0 0
200 200 0 200 200
0 0 0 0
1064 82 750 232 982

0 0 0 0
0 0 0 0
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
0 0 0 0
2000 3485 445 2900 140 3040
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
54 0 40 14 54
0 0 0 0
22 11 0 11 11
23 2 14 7 21
0 0 0 0
1500 0 500 1000 1500
325 216 0 109 109
0 0 0 0
0 0 0 0
18 10 0 8 8
0 0 0 0
754 40 0 714 714
3000 3000 616 2000 384 2384
0 0 0 0
100 100 2 0 98 98
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1165 65 0 1100 1100
2000 2700 170 2000 530 2530

0 0 0 0
2000 3200 190 2400 610 3010
0 0 0 0
0 0 0 0
500 0 500 500
88 0 84 4 88
0 0 0 0
1600 0 1600 1600
500 0 100 400 500
14 1 9 4 13
0 0 0 0
5 5 1 4 4
0 0 0 0
0 0 0 0
0 0 0 0
50 50 8 25 17 42
0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
50 50 6 25 19 44
22 17 0 5 5
162 0 162 162
0 0 0 0
1485 1 1300 184 1484
0 0 0 0
300 300 0 300 300
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0

23 0 23 23
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
220 0 0 220 220
2000 2000 180 1400 420 1820
0 0 0 0
0 0 0 0
560 60 0 500 500
2000 2000 190 1500 310 1810
0 0 0 0
500 0 400 100 500

0 0 0 0
0 0 0 0
47 18 20 9 29
13 0 13 0 13
0 0 0 0
0 0 0 0
6 0 0 6 6
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
19 0 19 19
0 0 0 0 0
0 0 0 0
0 0 0 0 0
1550 160 900 490 1390
4 0 0 4 4
0 0 0 0
0 0 0 0
0 0 0 0
380 20 300 60 360
450 450 0 0
0 0 0 0
1 0 1 0 1
0 0 0 0
310 60 0 250 250
0 0 0 0
50 0 30 20 50
0 0 0 0
37 2 24 11 35
0 0 0 0
5 2 0 3 3
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2000 2595 228 1000 1367 2367
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
1 0 1 1
1 0 1 1
0 0 0 0
500 0 300 200 500
0 0 0 0
110 110 0 0
6 6 0 0 0
0 0 0 0
40 0 40 40
0 0 0 0
0 0 0 0
92 0 86 6 92

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2573 705 500 1368 1868

0 0 0 0
100 256 10 246 246
14 0 14 14
500 0 500 500
160 0 160 160
90 60 0 30 30
58 0 58 58
0 0 0 0
100 0 100 100
0 0 0 0
0 0 0 0
50 64 0 50 14 64
110 31 0 79 79
805 229 400 176 576
0 0 0 0
0 0 0 0
0 0 0 0
7 7 0 0
153 1 148 4 152
0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0
42 42 0 32 10 42

13 13 0 0
0 0 0 0

0 0 0 0
0 0 0 0
1 0 1 1
0 0 0 0
10 10 0 10 10
0 0 0 0
0 0 0 0
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
0 0 0 0
0 0 0 0
2440 1210 270 960 1230
7650 7650 0 7650 0 7650
10 0 10 10
10 0 10 10
1 0 0 1 1
390 30 100 260 360
1000 0 1000 0 1000
0 0 0 0
0 0 0 0
662 84 400 178 578
299 0 299 299
20 0 15 5 20
0 0 0 0
1 0 1 1
0 0 0 0
0 0 0 0
0 0 0 0
510 284 0 226 226
1000 1000 0 1000 0 1000
0 0 0 0
340 0 0 340 340
400 0 400 0 400
0 0 0 0
0 0 0 0
3000 7471 114 4000 3357 7357
210 210 0 0
0 0 0 0
230 0 150 80 230
500 0 500 0 500
0 0 0 0
500 610 30 580 580
30 0 30 30
190 45 140 5 145
0 0 0 0
0 0 0 0
17 9 0 8 8
200 200 15 185 185
0 0 0 0
190 10 180 180
164 18 130 16 146
168 17 151 0 151
50 50 0 0 0

50 25 0 25 25
220 0 100 120 220
700 0 700 0 700
0 0 0 0
72 21 0 51 51
0 0 0 0 0
870 220 350 300 650
0 0 0 0

PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-


RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
306 0 0 306 306
2000 2000 610 1100 290 1390
0 0 0 0
0 0 0 0
0 0 0 0
18 11 2 5 7
0 0 0 0
0 0 0 0
1 1 0 0
100 2 75 23 98
65 2 57 6 63
789 0 500 289 789
50 50 0 50 50
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
50 0 50 50
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
5 5 1 4 4
500 0 500 500
8 0 8 8
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
45 5 40 40
2000 0 2000 2000
0 0 0 0
0 0 0 0
565 0 300 265 565
0 0 0 0
18 6 0 12 12

23 23 0 0
1000 0 1000 1000
0 0 0 0
52 0 37 15 52
10 0 10 0 10
0 0 0 0
0 0 0 0
15 4 0 11 11
20 20 5 15 15
0 0 0 0
31 10 5 16 21

PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-


RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
2 2 0 0
2 2 0 0
2 0 2 2
2 2 0 0
2 2 0 0
2 2 0 0
2 2 0 0
2 2 0 0
0 0 0 0
288 52 195 41 236
0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0
520 100 0 420 420
0 0 0 0
4 0 4 0 4
2 0 2 2

10 2 4 4 8
0 0 0 0
0 0 0 0
25 25 0 0 0
0 0 0 0
283 85 100 98 198

44 0 44 0 44
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
2000 2000 260 0 1740 1740
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
170 0 0 170 170

460 0 200 260 460


0 0 0 0 0
0 0 0 0
790 0 600 190 790
400 0 400 400
0 0 0 0
0 0 0 0
1762 20 1500 242 1742
0 0 0 0
0 0 0 0
6 0 2 4 6
10 0 10 10

PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-


RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
0 0 0 0
0 0 0 0
400 0 400 0 400
10 0 10 10
10 0 10 10
0 0 0 0
0 0 0 0
0 0 0 0
215 0 0 215 215
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
355 21 100 234 334
0 0 0 0
110 0 0 110 110
0 0 0 0
490 0 300 190 490
0 0 0 0
0 0 0 0
360 0 360 360
216 0 216 0 216
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 20 20

17 0 13 4 17
0 0 0 0
0 0 0 0
137 16 90 31 121

0 0 0 0
37 0 35 2 37
0 0 0 0
0 0 0 0 0
82 14 55 13 68
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
951 93 0 858 858
2000 3410 503 2700 207 2907
0 0 0 0
32 4 0 28 28

0 0 0 0
0 0 0 0
440 40 240 160 400
0 0 0 0

PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-


RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
0 0 0 0
0 0 0 0
907 255 0 652 652

0 0 0 0
100 0 100 100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
300 300 0 300 300
0 0 0 0
375 17 200 158 358

0 0 0 0
0 0 0 0
20 0 20 20
100 100 0 100 100
0 0 0 0
0 0 0 0
0 0 0 0
15 0 0 15 15
49 6 35 8 43
0 0 0 0
290 110 0 180 180
2 0 0 2 2

9 4 5 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 0
0 0 0 0
0 0 0 0
10 0 10 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
120 30 0 90 90
1000 1000 10 700 290 990
0 0 0 0
0 0 0 0
500 500 0 500 500
500 836 36 800 0 800
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
0 0 0 0
20 20 0 20 20
0 0 0 0
0 0 0 0
16 5 0 11 11
38 0 38 0 38

0 0 0 0
0 0 0 0
23 0 23 0 23
95 3 72 20 92
0 0 0 0 0
0 0 0 0
0 0 0 0
2255 340 1020 895 1915

0 0 0 0
490 0 400 90 490
0 0 0 0
0 0 0 0
250 250 0 250 250
250 250 0 250 250
0 0 0 0
0 0 0 0
126 3 114 9 123
140 75 50 15 65
275 100 150 25 175
160 40 80 40 120
180 0 175 5 180
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0 0
700 0 500 200 700
0 0 0 0
0 0 0 0

0 0 0 0
90 25 20 45 65
0 0 0 0
0 0 0 0
2 0 0 2 2
10 10 3 7 7
4 0 3 1 4
3 1 0 2 2
50 50 10 40 40
10 0 10 10
0 0 0 0
100 0 100 100
0 0 0 0
20 0 0 20 20
0 0 0 0
0 0 0 0
60 60 0 30 30 60
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
0 0 0 0
2000 2433 260 1300 873 2173
0 0 0 0
0 0 0 0
500 500 10 0 490 490
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2000 3015 289 1800 926 2726
0 0 0 0
0 0 0 0
2000 2050 198 1500 352 1852
0 0 0 0
0 0 0 0
0 0 0 0
670 30 600 40 640
783 22 0 761 761
24 14 10 10
0 0 0 0
0 0 0 0 0
150 150 0 140 10 150
0 0 0 0
480 10 400 70 470
0 0 0 0
0 0 0 0
5 0 5 5
0 0 0 0
0 0 0 0 0
0 0 0 0 0
19 0 18 1 19
1 1 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
900 100 800 0 800

0 0 0 0
0 0 0 0
7 2 0 5 5
0 0 0 0
0 0 0 0
20 0 18 2 20
0 0 0 0
PENE- PERSE- PENGELUA SISA STOK STOK PERMIN-
RIMAAN DIAAN RAN GUDANG SUB UNIT AKHIR TAAN
G H I J K L M
0 0 0 0
19 7 0 12 12

1 0 0 1 1
0 0 0 0
100 100 0 0
0 0 0 0
250 50 200 0 200
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
197 197 0 0
0 0 0 0
325 325 0 0 0
18 0 0 18 18
2 2 0 0

0 0 0 0
0 0 0 0
1 0 1 0 1
0 0 0 0

257 14 0 243 243


8 0 0 8 8
30 30 0 0
48 0 0 48 48
257 14 0 243 243
0 0 0 0 0
86 0 0 86 86
0 0 0 0
0 0 0 0
10 10 0 0 10 10
1 1 0 1 1
1 1 0 1 1
0 0 0 0
80 0 80 80

Petugas Pengelola Obat dan


Perbekalan Kesehatan UPT Puskesmas Pasangkayu 1

Marwah
NIP : 19810523 200604 2 015
LAPORAN PEMAKAIAN OBAT DAN LEMBA

: 0101
PUSKESMAS : PASANGKAYU 1
KECAMATAN : PASANGKAYU
KAB./KODYA : PASANGKAYU
PROVINSI : SULAWESI BARAT
HAL 1 BULAN : JUNI 2019
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
1 Abocat 18 PCS Rp 8,750.00 2016
2 Abocat 18 PCS Rp 8,575.00 DAK 2016
3 Abocat 20 PCS Rp 16,249.99 2015
4 Abocat 20 PCS Rp 8,750.00 2016
5 Abocat 20 PCS Rp 8,575.00 DAK 2016
6 Abocat 22 PCS Rp 8,750.00 2016
7 Abocat 22 PCS Rp 8,575.00 DAK 2016
8 Abocat 24 PCS Rp 8,750.00 2016
9 Abocat 26 PCS Rp 27,134.00 DAK 2018
10 Acetosal TAB Rp 127.00 2015
11 Acyclovir 200 mg TAB Rp 251.00 2014
12 Acyclovir 200 mg TAB Rp 236.00 DAK 2018
13 Acyclovir 400 mg TAB Rp 362.00 2015
14 Acyclovir 400 mg TAB Rp 630.50 2017
15 Acyclovir 400 mg TAB Rp 440.00 DAK 2018
16 Alat suntik sekali pakai 0,5 ml PCS Rp 1,655.50 DAK 2016
17 Alat suntik sekali pakai 1 ml PCS Rp 1,540.00 2015
18 Alat suntik sekali pakai 1 ml PCS Rp 1,694.00 2016
19 Alat suntik sekali pakai 1 ml (AXIMED) PCS Rp 913.00 DAK 2018
20 Alat suntik sekali pakai 2.5 ml PCS Rp 1,141.80 2013
21 Alat suntik sekali pakai 3 ml PCS Rp 968.00 2016
22 Alat suntik sekali pakai 3 ml PCS Rp 2,119.00 DAK 2018
23 Alat suntik sekali pakai 3 ml PCS Rp 778.74 DAK 2019
24 Alat suntik sekali pakai 5 ml PCS Rp 1,348.00 2013
25 Alat suntik sekali pakai 5 ml PCS Rp 861.30 2017
26 ALAT DETEKSI KEHAMILAN BOX Rp 501,745.00 KEMENKES
27 Albendazol SYR Rp 4,234.00 2016
28 Albendazol tablet 400 mg TAB Rp 363.00 2016
29 Albendazol tablet 400 mg TAB Rp 266.80 APBN 2017
30 Alginat BOT Rp 239,525.00 2017
31 Aroma fine normal (Alginat aroma bks Rp 192,000.00 dak 2017
32 Alkohol 100 ml BOT Rp 2,625.00 2016
33 Alkohol 1000 ml BOT Rp 25,800.00 2016
34 Alkohol Swab pcs Rp 245.00 2016
35 Alkohol Swab pcs Rp 242.00 2017
36 Alkohol Swab pcs Rp 132.07 DAK 2019
37 Alopurinol tablet 100 mg TAB Rp 96.00 BUFFER
38 Alopurinol tablet 100 mg TAB Rp 90.00 2015
39 Alopurinol tablet 100 mg TAB Rp 96.00 2017
40 Alopurinol tablet 100 mg TAB Rp 96.00 DAK 2017
41 Alopurinol tablet 300 mg TAB Rp 249.00 DAK 2017
42 Ambroxol SYR BOT Rp 6,512.30 DAK 2018
43 Ambroxol 30 mg TAB Rp 242.00 DAK 2018
44 Aminofilin INJ 24 mg/ml - 10 ml AMP Rp 4,200.00 2015
45 Aminofilin tablet 200 mg TAB Rp 86.00 2015
EXP 46 Amitripilin 25 mg TAB Rp 123.00 2015
47 Amitripilin 25 mg TAB Rp 168.00 2018
48 Amlodipin 10 mg TAB Rp 168.00 2016
49 Amlodipin 10 mg TAB Rp 279.13 DAK 2018
50 Amlodipin 10 mg TAB DAK 2019
51 Amlodipin 5 mg (HEXAVASK) TAB Rp 197.00 2015
52 Amlodipin 5 mg (HEXAVASK) TAB Rp 1,050.00 2017

NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
53 Amoksisilin 500 mg TAB Rp 279.00 2013
54 Amoksisilin 500 mg TAB Rp 279.00 2016
55 Amoksisilin 500 mg TAB Rp 239.00 DAK 2017
56 Amoksisilin 250 mg CAP Rp 220.00 2014
57 Amoksisilin SYR 125 mg/5 ml BOT Rp 2,560.00 2014
58 Amoksisilin SYR 125 mg/5 ml BOT Rp 8,900.00 DAK 2018
59 Amoksisilin SYR 125 mg/5 ml (SOLPENOX) BOT Rp 8,900.00 DAK 2018
60 Amoksisilin SYR 125 mg/5 ml (YUSIMOX) BOT Rp 4,466.00 DAK 2018
61 Amoksisilin SYR 250 mg/5 ml BOT Rp 4,655.00 2017
62 Amoksisilin SYR 250 mg/5 ml BOT Rp 3,740.00 DAK 2018
63 Amoksisilin DROPS (SUPRAMOX) BOT Rp 28,500.00 DAK 2018
64 Ampisilin INJ AMP Rp 5,610.00 2015
65 Antalgin (metampiron) 500 mg TAB Rp 385.00 DAK 2016
66 Antalgin (metamizole sodium 500 mg TAB Rp 385.00 DAK 2016
67 Antasida SYR Rp 2,135.00 2015
68 Antasida SYR Rp 2,135.00 DAK 2016
69 Antasida SYR Rp 2,146.00 DAK 2018
70 Antasida doen tablet kombinasi TAB Rp 78.00 2015
71 Antasida doen tablet kombinasi 400 mg TAB Rp 72.00 2017
72 Antasida doen tablet kombinasi 400 mg TAB Rp 286.00 dak 2018
73 Anti Hemoroid SUPP Rp 2,200.00 2016
74 Anti Hemoroid SUPP - DAK 2019
75 Aqua dest steril VIAL Rp 2,750.00 2017
76 As. Mefenamat TAB Rp 119.00 2014
77 As. Mefenamat TAB Rp 119.00 2016
78 As. Mefenamat TAB Rp 117.00 2017
79 As. Mefenamat (BIRU) TAB Rp 176.00 2017
80 As. Mefenamat 500 mg TAB Rp 119.00 APBD 2018
81 As. Mefenamat 500 mg TAB Rp 119.00 APBD 2019
82 As. Mefenamat 500 mg TAB DAK 2019
83 Asam folat (AFOLAT) TAB Rp 52.00 2016
84 Asam folat (Profolat) TAB Rp 64.00 DAK 2018
85 ASEPTIC GEL BTL Rp 1,581.25 2017
86 Atenolol (FARNORMIN) TAB Rp 387.00 2015
87 Atenolol (FARNORMIN) TAB Rp 342.00 DAK 2017
88 Atropin sulfat INJ 0.25 mg/ml - 1ml AMP Rp 1,400.00 2016
89 Atropin sulfat tab 0,5 mg TAB Rp 81.00 2016
90 Attapulgit TAB Rp 220.00 2016
91 Attapulgit TAB Rp 196.00 2017
92 Attapulgit (ARCAPEC) SYR Rp 1,581.25 2017
93 ABATE SCT Rp 6,380.00 DAK 2018
94 Antiseptik gel bot - DAK 2019
95 Bactivec (abate) BOT BS
95 Bacitracin polymixin TUBE Rp 2,767.00 2015
96 Bacitracin polymixin TUBE Rp 3,511.00 2017
97 Bacitracin polymixin TUBE Rp 3,642.00 DAK 2018
98 Betahistin TAB Rp 1,062.60 2016
99 Betahistin TAB Rp 177.00 2017
100 Betametason SALP 0.1 % TUBE Rp 1,596.00 2015
101 Betametason SALP 0.1 % TUBE Rp 1,596.00 2016
102 Betametason SALP 0.1 % TUBE - DAK 2019
103 Betametason TTS MATA (BETAM) BTL Rp 19,600.00 DAK 2018
104 Bicolax TAB Rp 1,335.27 2016
105 BIOPLACENTon TUBE Rp 18,125.00 2017
106 Bisoprolol TAB Rp 2,553.83 2016
107 Blood Lancet 265 PCS Rp 160.23 2016
108 Blood Lancet 266 PCS Rp 160.23 2016
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
109 Bronheksine (MIRAVAN) TAB Rp 354.20 2015
110 BRAKET HAND SANITIZER PCS DAK 2019
111 CALCII GLUCONAT AMP Rp 1,581.25 2016
112 Calsium Laktat TAB Rp 72.00 2015
113 Calsium Laktat TAB Rp 72.00 2016
114 Calsium Laktat TAB Rp 64.00 buffer stok
115 Captopril 12.5 mg TAB Rp 69.00 2014
116 Captopril 12.5 mg TAB Rp 69.00 2015
117 Captopril 12.5 mg TAB Rp 72.00 2017
118 Captopril 12.5 mg TAB Rp 68.00 DAK 2018
119 Captopril 12.5 mg TAB Rp 68.00 DAK 2019
120 Captopril 25 mg TAB Rp 82.00 2015
121 Captopril 25 mg TAB Rp 82.00 2016
122 Captopril 25 mg TAB Rp 137.75 DAK 2017
123 Captopril 25 mg TAB Rp 82.00 DAK 2018
124 Captopril 50 mg TAB Rp 147.00 2015
125 Captopril 50 mg TAB Rp 147.00 DAK 2017
126 CAPREOMICIN INJ VIAL KEMENKES
127 Carbamazepin TAB Rp 269.00 2014
128 Catgut/Benang bedah 3/0 plain SET Rp 33,250.00 2016
129 Catgut 3/0 CHOMIC SET Rp 6,420.33 DAK 2017
130 Catgut 2/0 CHOMIC SET Rp 6,420.83 DAK 2018
131 CHKM BOTOL Rp 126,500.00 DAK 2018
132 Plant Cutura 2/0 SET Rp 6,420.83 DAK 2018
133 PLAINCatgut 3/0 SET Rp 6,420.83 DAK 2018
134 Cefadroxil BOT Rp 5,286.00 2016
135 Cefadroxil CAP Rp 557.00 2016
136 Cefadroxil CAP Rp 495.00 DAK 2018
137 Cefixime CAP Rp 700.00 2016
138 Cefotaxin INJ AMP Rp 6,785.00 2016
139 Ceftriaxone AMP Rp 6,785.00 2015
140 Cetirizin TAB Rp 156.00 2015
141 Cetirizin syr syr Rp 8,094.00 2017
142 Cetirizin syr Rp 13,956.00 DAK 2018
143 Ciprofloxacin TAB Rp 309.00 2016
144 Ciprofloxacin BAQUINOR TTS MATA BTL Rp 10,250.00 2017
145 Clhorpromazine 100 mg TAB Rp 156.00 2015
146 Clhorpromazine 25 mg TAB Rp 75.00 2015
147 Clindamycin 150 mg CAP Rp 405.00 2015
148 Clindamycin 150 mg CAP Rp 786.00 DAK 2018
149 Clindamycin 300 mg CAP Rp 693.00 DAK 2017
150 Clor Etil BOT Rp 158,125.00 2015
151 Clor Etil BOT Rp 506,000.00 DAK 2018
152 Cloramfenikol 250 mg CAP Rp 261.00 2015
153 Cloramfenikol 250 mg CAP Rp 341.00 DAK 2018
154 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2015
155 cloramfenicol syrup 125mg/5ml BOT Rp 5,170.00 2017
156 Cloramfenikol 3 % TUBE Rp 3,460.00 2016
157 Cloramfenikol 2 % TUBE Rp 3,416.00 DAK 2018
158 Cloramfenikol salp mata 1 % TUBE Rp 1,680.00 2015
159 Cloramfenikol salp mata 1 % TUBE Rp 2,013.00 DAK 2018
160 Cloramfenikol TTS MATA BOT Rp 12,600.00 2017
161 Cloramfenikol TTS telinga BOT Rp 6,424.00 2016
162 Clorfeniramin Maleat (CTM) TAB Rp 54.00 2015
163 Clorfeniramin Maleat (CTM) TAB Rp 46.00 2017
164 Clorfeniramin Maleat (CTM) TAB Rp 46.00 DAK 2017
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER
A B C D E
165 Composit A3 PCS Rp 749,320.00 2017
166 Composit A35 PCS Rp 749,320.00 2017
167 Cotrimoksazol 480 mg (DOEN) TAB Rp 158.00 2015
168 Cotrimoksazol 480 mg (DOEN) TAB Rp 152.00 APBD 2018
169 Cotrimoksazol Pediatrik TAB Rp 83.49 2015
170 Cotrimoksazol SYR BOT Rp 7,810.00 2015
171 Cotrimoksazol SYR BOT Rp 2,250.00 DAK 2016
172 CURCUMA TAB Rp 1,644.00 2017
173 CUTIMED SORBACT SWAB PCS Rp 30,503.00 DAK 2018
174 COTTON ROLL ROLL Rp 100,150.00 DAK 2018
175 CRESOPHENE, SOLUTION,LIQUID BOTOL Rp 770,000.00 DAK 2017
176 Deksametason AMP Rp 1,820.00 2015
177 Deksametason AMP DAK 2019
178 Deksametason tablet 0.5 mg TAB Rp 52.00 2015
179 Deksametason tablet 0.5 mg TAB Rp 46.00 2017
180 Deksametason tablet 0.5 mg TAB Rp 35.00 DAK 2018
181 Deksametason tablet 0.5 mg TAB Rp 95.00 DAK 2018
182 Deksametason tablet 0.5 mg TAB Rp 95.00 APBD 2019
183 Deksametason tablet 0.5 mg TAB Rp 52.00 APBD 2019
184 Diazepam 2 mg TAB Rp 35.09 2015
185 Diazepam 2 mg TAB Rp 86.00 DAK 2018
186 Diazepam INJ 5 mg/ml AMP Rp 18,260.00 2015
187 Digoksin tablet 0.25 mg TAB Rp 103.00 2015
188 Dilteazem HCL tab 30 mg TAB Rp 141.00 2015
189 Dimenhidrinat TAB Rp 109.00 2015
190 DIPHENHIDRAMIN INJ Rp 1,156.00 2015
191 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 2,720.00 2016
192 DISPOSIBLE DENTAL (jarum citojeck) PCS Rp 3,594.25 2017
193 jarum citojeck PCS Rp 1,705.00 DAK 2018
194 Domperidon syr BOT Rp 14,374.80 2015
195 Domperidon syr BOT Rp 2,970.00 DAK 2018
196 Domperidon Tab TAB Rp 174.00 2013
197 Domperidon 10 mg TAB Rp 90.00 DAK 2019
198 Doxiciklin CAP Rp 298.00 2015
199 DULCOLAX 5 mg SUPP Rp 5,670.00 2016
200 DULCOLAX 10 mg SUPP Rp 5,800.00 2016
201 DULCOLAX 10 mg SUPP Rp 5,900.00 DAK 2018
202 Epinefrin hcl AMP Rp 8,910.00 buffer
203 Ergotamin Cafein TAB Rp 149.00 2015
204 Eritromycin CAP Rp 679.00 2016
205 Eritromycin SYR Rp 7,391.00 2016
206 Eritromycin SYR Rp 7,391.00 2017
207 Eritromycin SYR Rp 2,490.00 DAK 2018
208 ELAMYCETIN (CHLOAMFENIKOL TT) BOT DAK 2019
209 Etakridin /Rivanol 300 ml BOT Rp 3,060.00 2016
210 Etambutol hcl. Tablet 250 mg TAB Rp 330.00 2015
211 Etambutol hcl. Tablet 500 mg TAB Rp 495.00 DAK 2015
212 ETHIONAMIDA 250 MG STRIP PROGRAM
213 Etiket obat Biru LMBR Rp 61.00 2016
214 Etiket Obat Putih LMBR Rp 61.00 2016
215 ETSGEL Rp 395,532.50 DAK 2017
216 Eugenol BOT Rp 50,416.67 2014
217 Eugenol BOT Rp 22,589.00 2014
218 ELITE CEMENT BOX Rp 370,620.00 DAK 2018
219 EXAFLEX PUTTY BOX Rp 2,100,000.00 DAK 2018
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
220 Ferro Sulfat SCT Rp 425.00 2015
221 Ferro Sulfat SCT Rp 425.00 2017
222 Ferro Sulfat SCT APBD1 2018
223 Ferro Sulfat SCT Rp 427.00 APBD 2019
224 Ferro Sulfat SCT Rp 372.00 DAK 2019
225 Folley cateter no.16 SET Rp 20,000.00 2016
226 Folley cateter no.18 SET Rp 20,000.00 2016
227 Furosemid inj 10mg/ml AMP Rp 2,012.00 2015
228 Furosemid tablet 40 mg TAB Rp 84.00 2015
229 Furosemid tablet 40 mg TAB Rp 77.00 APBD 2018
230 FOMALIN TAB Rp 5,060.00
231 Garam oralit untuk 200 ml air SCT Rp 1,072.50 2015
232 Garam oralit untuk 200 ml air SCT Rp 278.00 DAK 2017
233 Gelang pasien warna pink PCS Rp 2,706.00 2016
234 Gentamycin inj. AMP Rp 3,699.00
235 Gentian Violet lar 1 % BOT Rp 3,750.00 DAK 2018
236 Glass Lonomer SET/BTL Rp 949,520.00 2017
237 Glass Lonomer SET/BTL Rp 1,050,000.00 DAK 2018
238 Glibenclamid 5 mg TAB Rp 61.00 2014
239 Glibenclamid 5 mg TAB Rp 143.00 DAK 2018
240 Glibenclamid 5 mg TAB Rp 90.00 APBD 2018
241 Glibenclamid 5 mg TAB Rp 342.00 DAK 2018
242 Glimepirid 1 mg TAB Rp 1,576.00 2015
243 Glimepirid 2 mg TAB Rp 311.00 2015
244 Glimepirid 2 mg TAB Rp 207.00 DAK 2018
245 Gliseril Guayakolat TAB Rp 66.79
246 Gliseril Guayakolat TAB Rp 66.79 2016
247 Gliseril Guayakolat TAB Rp 66.79 DAK 2016
248 Gluko + protein test box PCS Rp 1,150.00 2016
249 Griseofulvin 125 mg TAB Rp 230.00 2015
250 Griseofulvin 125 mg TAB Rp 263.00 DAK 2017
251 Griseofulvin 125 mg TAB Rp 231.00 DAK 2018
252 Haloperidol tab 5 mg TAB Rp 105.00 2015
253 Haloperidol tab 0.5 mg TAB Rp 55.00 DAK 2018
254 Haloperidol tab 1.5 mg TAB Rp 59.00 DAK 2018
255 Handscoon 6 (T-SENSAURGE) STERIL SET Rp 7,254.50 DAK 2018
256 Handscoon 7 SET Rp 9,310.00 2016
257 Handscoon 7 Rp 9,120.00 DAK 2017
258 Handscoon 7 STERIL SET Rp 8,360.00 DAK 2018
259 Handscoon 7 STERIL SET Rp 3,987.88 DAK 2019
260 Handscoon 7,5 (aximed) STERIL SET Rp 9,310.00 2016
261 Handscoon 7,5 (aximed) STERIL SET Rp 9,120.00 2017
262 Handscoon 7,5 (T-SENSAURGE) STERIL SET Rp 7,254.50 DAK 2017
263 Handscoon 8 STERIL SET Rp 9,310.00 2016
264 Handscoon non steril (M)AXIMED EXAMINA SET Rp 508.20 2018
265 Handscoon non steril (M) PCS Rp 714.05 DAK 2019
266 Handscoon non steril (S) PCS Rp 811.73 DAK 2019
267 HBSAG Strip STRIP Rp 11,037.00 DAK 2018
268 Hidroklortiazid 25 mg TAB Rp 179.00 2016
269 Hidroklortiazid 25 mg TAB Rp 179.00 DAK 2017
270 Hidrokortison Salp TUBE Rp 2,938.00 2015
271 Hidrokortison Salp TUBE Rp 2,938.00 2016
272 Hidrokortison Salp 2,5% TUBE Rp 2,848.00 DAK 2017
273 HISTIGO TAB Rp 595.05 DAK 2018
274 HYDCAL PASTA BASE TUBE Rp 299,530.00 DAK 2017

NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
275 Ibuprofen 400 mg TAB Rp 139.00 2014
276 Ibuprofen 400 mg (ARFEN) TAB Rp 501.10 DAK 2018
277 Ibuprofen 400 mg TAB Rp 139.00 APBD 2018
278 Ibuprofen 400 mg (FASIFEN) TAB Rp 525.00 DAK 2018
279 Ibuprofen 400 mg TAB Rp 139.00 APBD 2019
280 Ibuprofen 400 mg TAB - DAK 2019
281 Ibuprofen 200 mg TAB Rp 116.00 DAK 2017
282 Ibuprofen 200 mg TAB Rp 116.00 DAK 2018
283 Ibuprofen suspensi 200 mg/5 mg BOT Rp 4,949.00 2016
284 Ibuprofen suspensi 200 mg/5 mg BOT Rp 5,509.00 DAK 2018
285 Infant muccus PCS Rp 37,988.50 2016
286 Infuset Makro SET Rp 5,880.00 2015
287 Infuset Makro (PIECES) SET Rp 3,190.00 APBD 2018
288 Infuset Makro (OTSU SET) SET Rp 13,200.00 DAK 2018
289 Infuset Mikro SET Rp 7,920.00 2016
290 isosorbid TAB Rp 98.00 2015
291 IV CANULA PCS Rp 3,554.52 DAK 2019
292 JARUM HACTING NO. 08 LSN Rp 30,000.00 2016
293 JARUM HACTING NO. 10 LSN Rp 30,000.00 2016
294 JARUM HACTING NO. 12 LSN Rp 30,000.00 2016
295 JARUM HACTING NO. 15 LSN Rp 30,000.00 2016
296 Kaca Penutup (Deg Glass) pcs Rp 929.50 2016
297 Kalium Diklofenak TAB Rp 814.66 2015
298 Kalium permanganat BOT Rp 6,325.00 2016
299 Kapas 250 gr ROL Rp 14,375.00 2015
300 Kapas 250 gr ROL Rp 14,375.00 2016
301 Kapas 250 gr ROL Rp 14,375.00 DAK 2018
302 Kapas ONEMED 250 gr ROL - DAK 2019
303 KARTU GOLONGAN DARAH PCS Rp 2,200.00 2016
304 Kasa gulung 36x80 cm ROL Rp 142,600.00 DAK 2017
305 Kasa gulung 30x60 cm ROL Rp 142,600.00 2016
306 Kasa gulung 30x60 cm ROL Rp 142,600.00 DAK 2016
307 Kasa gulung 36x80 cm Rp 142,600.00 DAK 2016
308 Kasa Steril 16x16 cm SET Rp 8,740.00 2016
309 Kasa Steril 16x16 cm Rp 575.00 DAK 2018
310 Kasa Steril 5x5 cm SET Rp 3,311.00 2017
311 Kasa PEMBALUT 4x10 cm ROL Rp 1,725.00 DAK 2018
312 Kertas puyer LBR Rp 123.20 2017
313 Ketamin INJ VIAL Rp 63,400.00 2015
314 Ketoconazole 200 mg TAB Rp 303.00 2015
315 Ketoconazole 200 mg TAB Rp 303.00 2016
316 Ketoconazole salp 2 % TUBE Rp 2,697.00 2014
317 Ketoconazole salp 2 % TUBE Rp 2,694.00 DAK 2018
318 Ketoconazole salp 2 % TUBE Rp 2,790.00 APBD 2019
319 Ketorolak inj 30 AMP Rp 1,450.00 2015
320 Kombinasi Prometamin 25 + Sulfadoxin 500 TAB Rp 572.00 DAK 2015
321 Lansoprazol (DIGEST) CAP Rp 5,500.00 2017
322 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 2015
323 Larutan Glucosa lar infus 5 % BOT Rp 6,900.00 DAK 2016
324 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2015
325 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 2017
326 Larutan NACL Lar infus 0,9 % BOT Rp 6,410.00 DAK 2018
327 Larutan NACL Lar infus 500 ml BOT - DAK 2019
328 Larutan RL BOT Rp 7,150.00 2016
329 Larutan RL BOT Rp 7,150.00 DAK 2017
330 Larutan RL BOT LAIN-LAIN

NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
331 LARUTAN EDTA 10*Indoor BOT Rp 1,702,536.00 2016
332 LARUTAN Giemsa indoor BOT Rp 1,523,280.00 2016
333 LARUTAN Giemsa indoor BOT Rp 356,250.00 DAK 2018
334 LARUTAN Haemoglobin C indoor BOT Rp 296,956.00 2016
335 LARUTAN Hcl 0,1 N Indoor BOT Rp 236,808.00 2016
336 LARUTAN Metanol PA BOT Rp 686,697.00 2016
337 LARUTAN Trombosit Ao indoor BOT Rp 374,440.00 2016
338 LARUTAN Turk 500ml BOT Rp 444,015.00 2016
339 Lidocain INJ AMP Rp 929.00 2015
340 Lidocain INJ AMP Rp 2,215.00 DAK 2016
341 Loperamid TAB Rp 97.00 2016
342 Loperamid Rp 97.00 2017
343 Loperamid 2 mg Rp 97.00 DAK 2017
344 Loratadin TAB Rp 159.00 2013
345 Loratadin TAB Rp 159.00 DAK 2017
346 Loratadin 10 mg TAB Rp 500.00 DAK 2018
347 Loratadin 10 mg TAB DAK 2019
348 Lysol BOT Rp 49,200.00 2015
349 Lysol 1000 Ml BOT Rp 49,200.00 DAK 2016
350 Lysol 1000 Ml BOT Rp 51,590.00 DAK 2018
351 Litrol TTS mata BOT Rp 5,850.00 DAK 2018
352 Masker earloop SET Rp 440.00 2015
353 Masker earloop SET Rp 435.60 DAK 2018
354 Masker earloop (AXIMED) SET Rp 436.00 DAK 2018
355 Masker Standar tie on (IKAT) SET Rp 588.00 2016
356 Masker Standar tie on (IKAT) SET Rp 528.00 DAK 2018
357 MASKER N95 PCS PROGRAM
358 Mebendazol (VERMOX) TAB Rp 8,800.00 2015
359 MEDLENCE plus extra 21 G/2,4 mm PCS Rp 3,991.90 2016
360 MEDLENCE plus lite 25 G/1,5 mm PCS Rp 3,991.90 2016
361 MEDLENCE plus special 0,8 (blade) 2,0 mm PCS Rp 3,991.90 2016
362 MEDLENCE plus universal 21 G/1.8 mm PCS Rp 3,991.90 2016
363 Meloxicam 7,5 mg TAB Rp 761.00 2015
364 Metformin CAP Rp 206.25 2015
365 Metformin CAP Rp 103.00 2017
366 Metformin 500 mg CAP Rp 336.00 DAK 2018
367 Metformin 500 mg CAP - DAK 2019
368 Metformin 850 mg CAP Rp 168.00 DAK 2018
369 Methylprednisolon 16 mg Rp 1,325.00 2017
370 Methylprednisolon 4 mg TAB Rp 500.62 2015
371 Methylprednisolon 4 mg TAB Rp 212.00 2017
372 Methylprednisolon 4 mg TAB Rp 170.00 APBD1 2017
373 Methylprednisolon 4 mg TAB Rp 170.00 APBD 2018
374 Methylprednisolon 4 mg TAB Rp 170.00 APBD 2019
375 Metilergometrin maleat 0,125 mg TAB Rp 169.00 2015
376 Metilergometrin maleat INJ Rp 2,684.00 2015
377 Metoclopramid 10 mg TAB Rp 100.00 2015
378 Metoclopramid 10 mg TAB Rp 87.00 DAK 2018
379 Metoclopramid 5 mg TAB Rp 129.00 DAK 2018
380 Metronidazol 250 mg TAB Rp 116.00 2015
381 Metronidazol 500 mg TAB Rp 143.00 2015
382 Metronidazol 500 mg TAB Rp 143.00 2017
383 Metronidazol INFUS BOT Rp 12,980.00 2017
384 Metronidazol SYR Rp 1,581.25 2017
385 MgSO4 20 % INJEKSI Rp 2,800.00 BUFFER
386 MgSO4 40 % INJEKSI Rp 3,650.00 APBD 2017

NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
387 Miconazol TUBE Rp 3,150.00 2016
388 Miconazol 2% Cream TUBE Rp 4,097.00 DAK 2018
389 Miniaspi 80mg TAB Rp 163.00 2016
390 Miniaspi/asetosal Rp 163.00 DAK 2016
391 Nasal Oksigen M PCS Rp 8,085.00 2016
392 Nasal Oksigen XS PCS Rp 8,085.00 2016
393 Natrium Diklofenak 25 mg TAB Rp 162.00 2015
394 Natrium Diklofenak 25 mg TAB Rp 178.00 DAK 2017
395 Natrium Diklofenak 25 mg TAB Rp 154.00 DAK 2018
396 Natrium Diklofenak 25 mg TAB Rp 146.00 APBD 2019
397 Natrium Diklofenak 50 mg TAB Rp 146.00 DAK 2018
398 Nelaton catheter pcs Rp 5,330.00 2017
399 Nebulyzer mask DEWASA PCS Rp 16,704.00 2016
400 Nifedipin TAB Rp 127.00 2015
401 Nifedipin 10 mg TAB Rp 112.00 DAK 2018
402 Nistatin 100.000 TAB Rp 528.00
403 Nistatin Vaginal 100.000 Rp 628.00 DAK 2017
404 Nistatin 500.000 TAB Rp 895.00 2015
405 Nistatin 500.000 TAB Rp 895.00 2016
406 Nistatin DROPS BOT Rp 40,030.00 DAK 2018
407 NOVABION KPSL Rp 395.42 2016
408 ONELAB Objeck Glass 72 PCS PCS Rp 331.37 DAK 2018
409 Objeck Glass PCS Rp 278.00 APBD 2019
410 OBH syr BOT Rp 3,740.00 2016
411 OBH syr Rp 2,925.00 DAK 2018
412 Ofloxacin TAB Rp 649.12 2015
413 Oksitertaciklin SALP 1 % TUBE Rp 4,901.00 2015
414 Oksitertaciklin SALP 3 % TUBE Rp 4,400.00 2015
415 Omeprasol CAP Rp 176.00 2016
416 Omeprasol 20 mg CAP Rp 176.00 2017
417 Omeprasol 20 mg CAP Rp 143.00 DAK 2018
418 Omeprasol 20 mg CAP Rp 154.00 APBD 2019
419 Ondansetron inj Rp 1,254.00 2017
420 OXYTOCIN INJ Rp 1,900.00 2015
421 OXYTOCIN INJ Rp 1,287.00 DAK 2018
422 OXYTOCIN INJ Rp 1,287.00 DAK 2018
423 OXYTOCIN INJ Rp 1,287.00 APBD 2019
424 Otsu wi bot Rp 1,581.25 2016
425 Otsu wi/AQUA P INJ bot Rp 2,860.00 DAK 2018
426 Paracetamol (FASIDOL)Droop BOT Rp 6,240.00 2016
427 Paracetamol (FASIDOL)Droop BOT Rp 7,979.00 DAK 2018
428 Paracetamol DroopS BOT - DAK 2019
429 Paracetamol 500 mg TAB Rp 60.00 2015
430 Paracetamol 500 mg TAB Rp 52.00 APBD 2017
431 Paracetamol 500 mg TAB Rp 52.00 APBD1 2017
432 Paracetamol 500 mg TAB Rp 259.00 DAK 2018
433 Paracetamol 500 mg TAB Rp 198.00 DAK 2018
434 Paracetamol 500 mg TAB - DAK 2019
435 Paracetamol SYR BOT Rp 1,338.00 2015
436 Paracetamol SYR BOT Rp 1,190.00 Dak 2018
437 Paracetamol SYR BOT Dak 2019
438 Pipet Dirpo Rp 1,292.50 DAK 2017
439 Phenobarbital inj 50mg/ml AMP Rp 1,980.00 BUFFER
440 Piracetam 1200 mg TAB Rp 594.56 2015
441 piroxicam 10 mg TAB Rp 165.78 2015

NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
442 Plester ROL Rp 42,499.60 2015
443 Plain 3/0 pcs Rp 1,581.25 2016
444 Prednison TAB Rp 125.00 2015
445 Prednison 5 mg TAB Rp 74.00 DAK 2018
446 Prednison 5 mg TAB Rp 100.00 APBD 2019
447 PRIMAQUIN TAB Rp 205.00 2015
448 PRIMAQUIN 15 mg TAB Rp 253.00 APBD1 2018
449 PK (kalium pemanganat) 5 g BOT Rp 371,250.00 DAK 2018
450 Procrepe 15 cm x 4,55 m (perban) Rol Rp 41,910.00 2016
451 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 2015
452 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 BUFFER
453 PTU (Propiltiourasil) 100 mg TAB Rp 351.00 DAK 2019
454 Pyrantel TAB Rp 318.00 2015
455 Pyrantel 125 mg Rp 347.00 DAK 2018
456 PYRAZINAMIDE BP 500 MG STRIP PROGRAM
457 PYRIDOXINE 100 MG TAB PROGRAM
458 Pyrantel SYR Rp 9,100.00 2015
459 POT URINE POT Rp 6,600.00 DAK 2018
460 POT 50 ml POT Rp 5,890.00 APBD1 2018
461 POT URINE POT - DAK 2019
462 PETERS SILK PCS Rp 37,209.00 DAK 2017
463 PULP-X V DEVITALIZER PASTE PCS Rp 443,200.00 DAK 2018
464 RDT DBD iig sct Rp 1,581.25 2016
465 RDT DBD COMO sct Rp 297,000.00 DAK 2019
466 Ranitidin INJ AMP Rp 5,368.00 2015
467 Ranitidin TAB TAB Rp 119.00 2016
468 Ranitidin 150 mg Rp 262.50 DAK 2018
469 RECO tts mata BOT Rp 20,360.00 DAK 2018
470 RECO tts mata BOT DAK 2019
471 RECO tts Telinga BOT Rp 11,000.00 DAK 2018
472 Reagen diluent BOT Rp 4,770,000.00 DAK 2018
473 Reagen lyse BOT Rp 3,310,000.00 DAK 2018
474 Reagen RINSE Rp 1,950,455.00 DAK 2018
475 Reagen Asam urat BOT Rp 1,399,200.00 DAK 2017
476 Reagen WIDAL TEST BOT - DAK 2019
477 RAJAWALI UIC ACID (REAGEN) BOT Rp 1,870,660.00 DAK 2018
478 Reagen Kimia Klinik Glucosa BOT Rp 698,500.00 DAK 2017
479 RAJAWALI Glucosa (REAGEN) BOT Rp 889,570.00 DAK 2018
480 Reagen Kimia Klinik Kolesterol BOT Rp 748,000.00 DAK 2017
481 RAJAWALI KOLES ( Kolesterol) BOT Rp 2,093,300.00 DAK 2018
482 RYLES TUBE Rp 15,488.00 2017
483 Sak Besar (10x15 cm) PAK Rp 98,700.00 2017
484 Sak Besar (10x15 cm) PCS Rp 314.60 DAK 2017
485 Sak Sedang (6x10 cm) PAK Rp 96,900.00 2016
486 Sak Sedang (6x10 cm) PCS Rp 100.00 DAK 2016
487 Sak Kecil PCS Rp 100.00
488 Salbutamol 2 mg TAB Rp 69.00 2016
489 Salbutamol 2 mg TAB Rp 69.00 2017
490 Salbutamol 2 mg TAB Rp 69.00 DAK 2017
491 Salbutamol 2 mg TAB Rp 64.00 DAK 2018
492 Salbutamol 2 mg TAB Rp 64.00 DAK 2019
493 Salbutamol 4 mg TAB Rp 89.00 2015
494 Salbutamol 4 mg TAB Rp 89.00 2016
495 Salbutamol 4 mg TAB Rp 89.00 DAK 2017
496 Salbutamol 4 mg TAB Rp 81.00 DAK 2018
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
497 Salbutamol sirup 2mg/5ml BOT Rp 5,700.00 2015
498 Salbutamol sirup 2mg/5ml BOT Rp 5,700.00 DAK 2017
499 Salbutamol sirup 2mg/5ml BOT Rp 4,446.00 DAK 2019
500 Salicil talk SCT Rp 1,573.00 2015
501 Salicil talk SCT Rp 6,270.00 2016
502 Salicil talk 2% POT Rp 6,270.00 DAK 2016
503 Salp 24 TUBE Rp 2,200.00 2016
504 Salp 24 TUBE Rp 5,450.00 DAK 2018
505 SCANDONEST AMP Rp 19,470.00 2016
506 Sefety box PCS Rp 18,072.35 2016
507 Sefety box 25 K 5 L Rp 18,072.25 DAK 2018
508 Silk SET Rp 15,750.00 2015
509 Silk SET Rp 37,289.00 2017
510 Simvastatin 10 mg TAB Rp 136.00 2016
511 Simvastatin (SVT) TAB Rp 686.00 2017
512 Simvastatin 10 mg TAB Rp 110.00 DAK 2018
513 Simvastatin 10 mg TAB Rp 116.00 APBD 2019
514 SPASMINAL Rp 750.00 2017
515 Sprinolakton Rp 212.00 DAK 2018
516 SPRITUS BOT Rp 1,581.25 2016
517 SPRITUS 250 ml BOT Rp 39,270.00 DAK 2017
518 Strip Asam Urat (NESCO) PCS Rp 11,440.00 DAK 2019
519 Strip Glucosa (NESCO) PCS Rp 11,440.00 DAK 2019
520 Strip Kolesterol (NESCO) PCS Rp 7,185.20 2016
521 Strip Glucosa (BENECHECK) PCS Rp 3,225.86 DAK 2017
522 Surgical Blade No.11 PCS Rp 974.05 2016
523 Strip Asam Urat (HUMASENS) STRIP Rp 22,252.00 DAK 2018
524 Strip Glucosa (HUMASENS) STRIP Rp 5,156.00 DAK 2018
525 Strip Kolesterol (HUMASENS) STRIP Rp 27,495.00 DAK 2018
526 Surgical Blade No.15 PCS Rp 974.05 2016
527 TEST NARKOBA/DRUG ABUSE STRIP Rp 78,999.00 2016
528 TEST NARKOBA STRIP Rp 78,999.80 DAK 2017
529 TEST HIV (SD BIOLINE HIV) STRIP Rp 37,600.00 APBN 2017
530 TEST HIV (SD BIOLINE HIV) STRIP Rp 11,975.00 APBDI 2018
531 Tiamfenicol 500 KAP Rp 1,518.00 2016
532 TIPS PIPET BIRU BKS Rp 594.00 2016
533 TABUNG PLASTIK SEUM 1,5 ml PIECES Rp 605.00 DAK 2017
534 TRIHEXYPHENIDYL 2 MG TAB LAIN-LAIN
535 Ultra One test hamil strip PCS Rp 2,133.00 2016
536 Ultra One test hamil strip PCS Rp 2,228.60 2017
537 Ultrafix/ PHarmafix ROL Rp 27,000.00 2016
538 Ultrafix/ Pharmafix ROL Rp 27,000.00 DAK 2017
539 Ultrafix/ Pharmafix ROL Rp 29,700.00 DAK 2018
540 Ultrafix/ Pharmafix ROL Rp 25,204.48 DAK 2019
541 ULTRASOUN GEL (GEL USG) BTL Rp 14,471.60 DAK 2017
542 UMBILICAL C (PENJEPIT TP) PCS Rp 3,300.00 DAK2018
543 UMBILICAL C (PENJEPIT TP) PCS - DAK2019
544 Urin bag/UROPLAS SET Rp 3,000.00 2015
545 UINE STIP 10 PAAMETE
546 VACUM TUBE PLAIN PCS Rp 2,200.00 DAK 2017
547 VACUM EDTA Rp 74,100.00 DAK 2018
548 VIT CALCIFAR TAB Rp 406.00 DAK 2018
549 VIT SYR (TAKANA) SYR Rp 39,223.80 2016
550 VIT SYR (TAKANA) SYR Rp 39,223.80 2017
551 VIT SYR (TUVIT) SYR - DAK 2019
NO NAMA OBAT SATUAN HARGA SATUAN SUMBER

A B C D E
552 Vitamin B 1 (tiamin) TAB Rp 95.00 BUFFER
553 Vitamin B 1 (tiamin) TAB Rp 95.00 2016
554 Vitamin B 1 (tiamin) 50 mg TAB Rp 95.00 DAK 2016
555 Vitamin B 12 TAB Rp 63.00 BUFFER
556 Vitamin B 12 TAB Rp 50.00 DAK 2018
557 Vitamin B 12 TAB - DAK 2019
558 Vitamin B 12 INJ AMP Rp 9,482.00 BUFFER
559 Vitamin B 12 INJ AMP Rp 1,283.00 2017
560 Vitamin B 6 (piridoksin) TAB Rp 175.00 BUFFER
561 Vitamin B 6 (piridoksin) TAB Rp 142.00 2017
562 Vitamin B 6 (piridoksin) TAB Rp 142.00 DAK 2017
563 Vitamin B comp TAB Rp 138.00 2015
564 Vitamin B comp TAB Rp 138.00 2016
565 Vitamin B comp TAB Rp 141.00 APBD 2019
566 Vitamin C (Asam askorbat) 250 mg TAB Rp 139.00 2017
567 Vitamin C (Asam askorbat)250 mg Rp 139.00 DAK 2017
568 Vitamin C (Asam askorbat)50 mg TAB Rp 105.00 BUFFER
569 Vitamin C (Asam askorbat)50 mg TAB Rp 125.00 DAK 2017
570 Vitamin C (Asam askorbat)25 mg TAB Rp 36.00 DAK 2017
571 Vitamin K INJ AMP Rp 3,754.00 2015
572 Vitamin K INJ AMP Rp 4,260.00 APBD1 2018
573 Vitamin K INJ AMP Rp 15,700.00 Dak 2018
574 Vitamin K INJ AMP - Dak 2019
575 Vitamin K TAB TAB Rp 690.00 2015
576 Vitamin K TAB 10 mg Rp 855.00 DAK 2018
577 VITROMEGA CAP Rp 1,472.00 2016
578 VITROMEGA CAP Rp 1,472.69 2016
579 X. TRAGEN bot Rp 1,581.25 2017
580 Yodium Povidon 30 ml BOT Rp 2,344.00 2015
581 Yodium Povidon 60 ml BOT Rp 4,440.00 2017
582 Yodium Povidon 300 ml BOT Rp 4,440.00 2016
583 Yodium Povidon 300 ml BOT Rp 21,600.00 DAK 2018
584 ZINCPO dropS BOT Rp 6,369.00 DAK 2018
585 Zink Syrup 10mg/ml BOT Rp 16,478.00 2016
586 Zink Syrup 10mg/ml BOT Rp 16,478.00 2017
587 Zink TAB TAB Rp 521.00 2015
588 Zink TAB TAB Rp 1,100.00 BUFFER
589 Zink 20 mg TAB Rp 618.00 DAK 2017
590 Zink 20 mg TAB Rp 562.00 APBD 2019
591 creatininKIN 2x100 ml kit Rp 977,900.00 DAK 2017
592 Vacum tube sterlite PCS Rp 74,100.00 DAK 2018
593 Procurma SYR Rp 11,350.00 DAK2018
594 WIDAL TES STRIP
595 3M ESPE CAVIT FILLING BOX Rp 359,535.00 DAK 2017
596 VASELINE SWAB 10MX10CM PCS Rp 35,832.50 DAK 2017
597 VIGEL LUBICATING GEL PCS DAK 2019
PROGRAM

NO NAMA OBAT SATUAN HARGA SATUAN SUMBER


A B C D E
1 MDT MB DEWASA BLISTER Rp 30,595.00 APBN 2018
2 MDT MB DEWASA BLISTER Rp 31,570.00 APBD1 2018
3 MDT MB DEWASA BLISTER Rp 31,570.00 APBD 2019
4 MDT PB DEWASA BLISTER Rp 12,569.00 APBD1 2018
5 LACTOGEN 4 DUS Rp 67,500.00 2016
6 VIT A BIRU BOT Rp 341.00 DAK2016
7 VIT A MERAH BOT Rp 505.00 DAK2016
8 VIT A MERAH BOT Rp 622.00 DAK2016
9 GLUCO PROTEIN (ONE MAD) DOS PROG
10 ULTRA ONE TEST (ONE MAD) PCS PROG
11 HB SAHLI (ONE MAD) DOS PROG
12 HCL 0,1 N 100 ML (ONE MAD) BOT PROG
13 BLOOD LANCET (ONE MAD) DOS PROG
14 AUTOCLIK (ONE MAD) BUAH PROG
15 IODIUM TEST BOT Rp 75,000.00 POGAM
16 QUININE TAB Rp 737.00 2015
17 RDT MALARIA TEST Rp 57,684.00 PROGRAM
18 RDT MALARIA TEST Rp 5,271.00 APBN2017
19 OAM (DHP-Frimal) TAB Rp 2,030.00 APBD1 2018
20 OBAT PAKET TB KATEGORI 1 DOS Rp 431,983.00 DAK 2016
21 OBAT PAKET TB KATEGORI 1 DOS APBD 2019
22 OBAT PAKET TB KATEGORI 2 DOS Rp 1,557,469.00 DAK 2018
23 POT DAHAK POT Rp 1,818.00 program tb
24 REAGENS ZIEHL NEELSEN SET Rp 296,600.00 APBDI2017
25 MASKER IKAT PCS prog tb POV
26 IMESION OIL BOTOL Rp 836,595.00 APBD 2019
27 ALAT SUNTIK 3 ml PCS Rp 1,212.00 BKKBN PROV
28 COPPER T/ UID BOX Rp 11,800.00 BKKBN PROV
29 KONDOM DOS Rp 4,000.00 BKKBN PROV
30 KONDOM DOS Rp 4,291.60 BKKBN PROV
31 OBAT KB SUNTIK 3 BULAN VIAL Rp 6,120.00 BKKBN PROV
32 OBAT KB SUNTIK 3 BULAN VIAL Rp 6,460.00 BKKBN PROV
33 PIL KB 1 KOMBINASI STRP Rp 1,886.00 BKKBN PROV
34 SUSUK KB/IMPLAN SET Rp 212,500.00 BKKBN PROV
35 SUSUK KB/IMPLAN SET Rp 213,220.00 BKKBN PROV
36 SUSUK KB/IMPLAN SET Rp 18,908.10 BKKBN PROV
37 MASKER PCS Rp 451.00 BKKBN PROV
38 POVIDON IODINE BOT Rp 3,045.00 BKKBN PROV
39 MINERAL MIX SACHET Rp 2,450.00 PROGRAM KIA
40 MINERAL MIX SACHET Rp 2,920.00 DAK 2018

Mengetahui
Kepala UPT Puskesmas Pasangkayu 1

Fatmawati, SKM
NIP : 19820619 200312 2 003
N OBAT DAN LEMBAR PERMINTAAN OBAT

STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-


STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
35 35 3 15 17 32
0 0 0 0 0
0 0 0 0 0
4 4 0 0 4 4
27 27 0 27 0 27
4 4 0 4 0 4
77 77 0 68 9 77
94 94 0 90 4 94
0 0 0 0 0
0 0 0 0 0
500 500 0 500 0 500
0 0 0 0 0
155 155 10 100 45 145
1000 1000 0 1000 1000
90 90 0 90 90
0 0 0 0 0
0 0 0 0 0
464 464 0 400 64 464
0 0 0 0 0
0 0 0 0 0
529 529 35 298 196 494
360 360 0 360 360
0 0 0 0 0
115 115 2 100 13 113
1 1 0 1 1
0 0 0 0 0
0 0 0 0 0 0
4000 4000 0 0 4000 4000
1 1 1 0 0
0 0 0 0 0
14 14 0 11 3 14
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 2000 2200 200 2000 2000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
470 470 30 0 440 440
330 330 220 0 110 110
50 50 0 35 15 50
3604 3604 302 2200 1102 3302
30 30 30 0 0 exp
0 0 0 0 0
0 0 0 0 0
200 200 400 0 400 0 400
0 0 0 0 0
982 982 278 0 704 704
1800 1800 50 1750 1750
0 0 0 0 0
0 0 0 0 0
STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-
STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
3040 3040 340 2100 600 2700
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
54 54 17 30 7 37
0 0 0 0 0
11 11 9 0 2 2
21 21 1 14 6 20
0 0 0 0 0
1500 1500 325 500 675 1175
109 109 9 0 100 100
0 0 0 0 0
0 0 0 0 0
8 8 0 0 8 8
0 0 0 0 0
714 714 14 0 700 700
2384 2384 620 1300 464 1764
0 0 0 0 0
98 98 18 0 80 80
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
1100 1100 490 0 610 610
2530 2000 4530 3110 1200 220 1420 2000exp
1000 1000 0 1000 1000
0 0 0 0 0
3010 3010 290 2400 320 2720
0 0 0 0 0
0 0 0 0 0
500 500 0 500 500
88 88 0 84 4 88
0 0 0 0 0
1600 1600 0 1600 1600
500 500 0 100 400 500
13 13 2 4 7 11
0 0 0 0 0
4 4 0 4 4
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
42 42 15 25 2 27
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
44 44 15 25 4 29
5 5 0 0 5 5
162 162 0 162 162
0 0 0 0 0
1484 1484 84 1300 100 1400
0 0 0 0 0
300 300 100 200 200
STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-
STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
5 5 0 5 5
23 23 0 23 23
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
220 220 80 0 140 140
1820 1820 200 1200 420 1620
0 0 0 0 0
0 0 0 0 0
500 500 0 0 500 500
1810 1810 0 1300 510 1810
0 0 0 0 0
500 500 0 400 100 500
14 14 0 14 0 14
0 0 0 0 0
0 0 0 0 0
29 29 21 0 8 8
13 13 0 13 13
0 0 0 0 0
0 0 0 0 0
6 6 0 0 6 6
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
19 19 0 19 19
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
1390 1390 125 900 365 1265
4 4 1 0 3 3
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
360 360 30 100 230 330
0 0 0 0 0
0 0 0 0 0
1 1 0 1 0 1
0 0 0 0 0
250 250 50 0 200 200
0 0 0 0 0
50 50 5 30 15 45
0 0 0 0 0
35 35 5 24 6 30
0 0 0 0 0
3 3 2 0 1 1
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2367 4000 6367 1467 3800 1100 4900
STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-
STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
1 1 1 0 0
1 1 0 1 1
0 0 0 0 0
500 500 500 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0
40 40 0 40 40
0 0 0 0 0
0 0 0 0 0
92 92 1 86 5 91
50 50 0 50 50
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1868 1868 1028 0 840 840
500 500 0 500 500
0 0 0 0 0
246 246 33 213 213
14 14 0 14 14
500 500 0 500 500
160 160 0 160 160
30 30 0 0 30 30
58 58 58 0 0 58exp
0 0 0 0 0
100 100 0 100 100
0 0 0 0 0
0 0 0 0 0
64 64 1 50 13 63
79 79 0 0 79 79
576 576 26 400 150 550
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
152 152 0 148 4 152
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
42 42 8 32 2 34
20 20 0 20 20
0 0 0 0 0
0 0 0 0 0
100 100 0 100 0 100
4 4 0 4 0 4
0 0 0 0 0
0 0 0 0 0
1 1 0 1 1
0 0 0 0 0
10 10 0 10 10
0 0 0 0 0
0 0 0 0 0
STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-
STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1230 1230 480 0 750 750
7650 3780 11430 810 10380 240 10620
10 10 0 10 10
10 10 0 10 10
1 1 0 0 1 1
360 360 140 0 220 220
1000 1000 0 1000 0 1000
0 0 0 0 0
0 0 0 0 0
578 578 220 200 158 358
299 299 0 299 299
20 20 0 15 5 20
0 0 0 0 0
1 1 1 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
226 226 226 0 0 0
1000 1000 80 500 420 920
0 0 0 0 0
340 340 100 0 240 240
400 400 0 400 400
0 0 0 0 0
0 0 0 0 0
7357 7357 200 4000 3157 7157
0 0 0 0 0
0 0 0 0 0
230 230 0 150 80 230
500 500 0 500 500
0 0 0 0 0
580 400 980 40 940 940
30 30 0 30 30
145 145 0 140 5 145
0 0 0 0 0
0 0 0 0 0
8 8 8 0 0 0
185 185 20 165 165
0 0 0 0 0
180 180 0 180 180
146 146 45 70 31 101
151 151 5 131 15 146
0 0 0 0 0 0
1000 1000 100 800 100 900
500 500 0 400 100 500
25 25 25 0 0 0
220 220 0 100 120 220
700 700 0 700 700
0 0 0 0 0
51 51 19 0 32 32
0 0 0 0 0
650 650 164 150 336 486
0 0 0 0 0

STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-


STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
306 306 0 0 306 306
1390 1390 100 900 390 1290
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
7 7 5 2 0 2
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
98 98 7 75 16 91
63 63 0 57 6 63
789 789 15 500 274 774
50 50 0 50 50
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
50 50 0 50 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
4 4 1 3 3
500 500 0 500 500
8 8 1 7 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 0
0 0 0 0 0
40 40 0 40 40
2000 2000 0 2000 2000
0 0 0 0 0
0 0 0 0 0
565 565 0 300 265 565
0 0 0 0 0
12 12 0 0 12 12
48 48 0 48 48
0 0 0 0 0
1000 1000 0 1000 1000
0 0 0 0 0
52 52 0 37 15 52
10 10 0 10 0 10
0 0 0 0 0
0 0 0 0 0
11 11 0 0 11 11
15 15 0 10 5 15
0 0 0 0 0
21 21 5 0 16 16
20 20 0 20 20

STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-


STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
2 2 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
236 236 21 165 50 215
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0
420 420 50 0 370 370
0 0 0 0 0 0
1500 1500 130 920 450 1370
4 4 0 4 0 4
2 2 1 1 1
6 6 0 5 1 6
8 8 4 4 0 4
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0
198 198 57 50 91 141
40 40 0 40 40
44 44 0 44 0 44
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
1740 1500 3240 1000 1500 740 2240
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
170 170 0 0 170 170
250 250 0 0 250 250
460 460 0 200 260 460
0 0 0 0 0 0
0 0 0 0 0
790 790 0 600 190 790
400 400 0 400 400
0 0 0 0 0
0 0 0 0 0
1742 1742 242 1500 1500
0 0 0 0 0
0 0 0 0 0
6 6 2 2 2 4
10 10 10 0 0

STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-


STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
400 400 0 400 0 400
10 10 0 10 10
10 10 0 10 10
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
215 215 10 0 205 205
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
334 334 10 100 224 324
0 0 0 0 0
110 110 0 0 110 110
0 0 0 0 0
490 490 70 300 120 420
0 0 0 0 0
0 0 0 0 0
360 360 0 360 360
216 216 0 216 0 216
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 20 0 0 20 20
150 150 0 0 150 150
17 17 0 10 7 17
0 0 0 0 0
0 0 0 0 0
121 121 4 90 27 117
100 100 0 100 100
0 0 0 0 0
37 6 43 0 41 2 43
0 0 0 0 0
0 0 0 0 0 0
68 68 13 45 10 55
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
858 858 858 0 0 0
2907 2907 733 700 1474 2174
0 0 0 0 0
28 28 28 0 0 0
50 50 35 15 15
0 0 0 0 0
0 0 0 0 0
400 400 10 240 150 390
0 0 0 0 0

STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-


STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
652 652 2 0 650 650
500 500 200 300 300
0 0 0 0 0
100 100 0 100 100
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
300 300 100 200 200
0 0 0 0 0
358 358 4 200 154 354
5 5 0 5 0 5
160 160 0 160 0 160
0 0 0 0 0
0 0 0 0 0
20 40 60 12 48 48
100 100 0 100 100
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
15 15 15 0 0 0
43 43 2 35 6 41
0 0 0 0 0
180 180 40 0 140 140
2 2 0 0 2 2
20 20 0 20 0 20
5 5 0 5 0 5
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1 1 0 1 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
10 10 0 10 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 0
90 90 0 0 90 90
990 990 300 400 290 690
0 0 0 0 0
0 0 0 0 0
500 500 0 300 200 500
800 800 0 800 0 800
STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-
STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
20 20 0 20 20
0 0 0 0 0
0 0 0 0 0
11 11 0 0 11 11
38 38 38 0 0 0 exp 38
12 12 0 0 12 12
0 0 0 0 0
0 0 0 0 0
23 23 0 23 0 23
92 92 2 72 18 90
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1915 1915 87 720 1108 1828
300 300 0 300 300
0 0 0 0 0
490 490 0 400 90 490
0 0 0 0 0
0 0 0 0 0
250 250 75 150 25 175
250 250 50 200 200
0 0 0 0 0
0 0 0 0 0
123 123 3 109 11 120
65 65 15 50 0 50
175 175 0 150 25 175
120 120 120 0 0 0
180 180 6 170 4 174
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 0
700 700 0 500 200 700
0 0 0 0 0
0 0 0 0 0
400 400 0 400 400
0 0 0 0 0
65 65 20 0 45 45
0 0 0 0 0
0 0 0 0 0
2 2 1 0 1 1
7 7 1 5 1 6
4 12 16 16 0 0 0
2 2 0 0 2 2
40 40 0 40 40
10 10 0 10 10
0 0 0 0 0
100 100 0 100 100
0 0 0 0 0
20 20 0 0 20 20
0 0 0 0 0
0 0 0 0 0
60 60 120 11 85 24 109
STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-
STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
0 0 0 0 0
2173 2173 5 1100 1068 2168
0 0 0 0 0
0 0 0 0 0
490 490 80 0 410 410
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2726 2726 7 1800 919 2719
0 0 0 0 0
0 0 0 0 0
1852 1852 596 800 456 1256
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
640 640 0 500 140 640
761 2400 3161 448 2200 513 2713
10 10 0 10 10
0 0 0 0 0
0 0 0 0 0 0
150 60 210 1 169 40 209
0 0 0 0 0
470 470 0 400 70 470
0 0 0 0 0
0 0 0 0 0
5 5 2 3 3
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
19 19 0 17 2 19
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
800 800 740 0 60 60 800exp
1000 1000 200 800 800
0 0 0 0 0
0 0 0 0 0
5 5 3 0 2 2
0 0 0 0 0
0 0 0 0 0
20 2 22 1 15 6 21
2 2 0 2 2
0 0
STOK PENE- PERSE- PENGELUAR SISA STOK PERMIN-
STOK AKHIR
AWAL RIMAAN DIAAN AN GUDANG SUB UNIT TAAN
F G H I J K L M
0 0 0 0 0
12 12 2 0 10 10
12 12 0 0 12 12
1 1 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 200 0 200 0 200
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
18 18 0 0 18 18
0 0 0 0 0 0
3 3 1 0 2 2
0 0 0 0 0
0 0 0 0 0
1 1 0 0 1 1
0 0 0 0 0
1 1 0 1 1
243 243 0 0 243 243
8 8 0 0 8 8
0 0 0 0 0
48 48 0 0 48 48
243 243 0 0 243 243
0 0 0 0 0 0
86 86 0 0 86 86
0 0 0 0 0
0 0 0 0 0
10 10 1 0 9 9
1 1 0 0 1 1
1 1 1 0 0 0
0 0 0 0 0
80 80 0 80 80

81493
Penanggung jawab Kefarmasian
UPT Puskesmas Pasangkayu 1

Marwah
NIP : 19810523 200604 2 015