Mutasi GFK 2019 - KRM Ifk

DAFTAR PERSEDIAAN OBAT
DARI UPTD GUDANG FARMASI KABUPATEN

PUSKESMAS PULOREJO
TAHUN 2019
NAMA OBAT STOK AWAL 2019 MUTASI TAMBAH TAHUN 2019

HARGA SATUAN
No. SATUAN
(Rp) JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA
TOTAL (Rp) TOTAL (Rp)
OBAT
1 ACYCLOVIR TAB Rp 380.00 694 Rp 263,720.00 Rp -
2 ACYCLOVIR TAB Rp 349.00 0 Rp - Rp -
3 ACYCLOVIR SALEP Rp 3,000.00 Rp - Rp -
5 Albendazol tablet 400 mg Rp 231.00 Rp - Rp -
6 Albendazol tablet 400 mg Rp 344.00 780 Rp 268,320.00 Rp -
7 ALLOPURINOL TABLET 100 MG TAB Rp 132.00 Rp - Rp -
8 ALLOPURINOL TABLET 100 MG TAB Rp 90.00 2205 Rp 198,450.00 Rp -
10 AMBROXOL tab 30 mg TAB Rp 143.00 Rp - Rp -
11 AMINOFILIN TAB 200 MG TAB Rp 112.20 783 Rp 87,852.60 Rp -
12 AMINOFILIN TAB 200 MG TAB Rp 113.30 Rp - Rp -
13 AMINOFILIN INJ 24 MG/ML, 10 ML TAB Rp 3,345.00 23 Rp 76,935.00 Rp -
14 AMINOFILIN INJ 24 MG/ML, 10 ML AMP Rp 3,822.00 0 Rp - Rp -
15 Amitriptilin HCl tablet salut 25 mg AMP Rp 112.00 Rp - Rp -
Rp 167.00 100 Rp 16,700.00 1000 Rp 167,000.00
16 AMLODIPIN TAB TAB Rp 70.00 7243 Rp 507,010.00 Rp -
17 AMLODIPIN TAB TAB Rp 105.00 Rp - Rp -
18 AMOKSISILIN SIRUP 125 MG/ML BTL Rp 2,090.00 0 Rp - Rp -
19 Amoksisilin FORTE sirup kering 250 mg/5ml BTL Rp 4,070.00 Rp - Rp -
20 AMOKSISILIN SIRUP 125 MG/ML BTL Rp 2,445.00 Rp - Rp -
21 AMOKSISILIN KAPSUL 500 MG KAP Rp 369.34 Rp - Rp -
23 AMOKSISILIN KAPSUL 500 MG KAP Rp 261.00 0 Rp - Rp -
24 AMPICILIN INJ Rp 5,768.00 Rp - Rp -
28 ANTALGIN TABLET 500 MG TAB Rp 67.00 Rp - Rp -
30 ANTASID TAB, MGOH3 + ALOH3 AA200MG TAB Rp 30.53 Rp - Rp -
32 ANTASID TAB, MGOH3 + ALOH3 AA200MG TAB Rp 54.00 20407 Rp 1,101,978.00 Rp -
33 Antasida DOEN suspensi Rp 1,995.00 45 Rp 89,775.00 Rp -
34 ANTI FUNGI Rp 2,025.00 Rp - Rp -
35 ANTI HAEMORHOID SUPPOSITORIA SUP Rp 4,496.00 Rp - Rp -
36 Anti Hemoroid DOEN Kombinasi sup Rp 3,045.00 71 Rp 216,195.00 Rp -
37 Aqua pro Injeksi steril 25 ml/ OTSU SWI 25 ml AMP Rp 4,565.00 Rp - Rp -
38 Aquadest 500 ml BTL Rp 19,800.00 10 Rp 198,000.00 Rp -
39 AQUA PRO INJEKSI STERIL, BEBAS PIROGEN 20 AMP Rp 2,750.00 152 Rp 418,000.00 Rp -
40 ASAM ASKORBAT (VIT C) TAB 100 MG TAB Rp 51.00 Rp - Rp -
42 ASAM ASKORBAT (VIT C) TAB 50 MG TAB Rp 105.00 5954 Rp 625,170.00 Rp -
HARGA SATUAN
No. SATUAN
43 Asam Asetil salisilat 80 mg (asetosal ) Rp 99.00 0 Rp - Rp -
44 ASAM MEFENAMAT TAB 500 MG Rp 103.00 10111 Rp 1,041,433.00 Rp -
45 ASAM MEFENAMAT TAB 500 MG Rp 106.00 Rp - Rp -
46 Atapulgit tablet 600 mg Rp 136.00 2922 Rp 397,392.00 Rp -
47 Atapulgit tablet 600 mg AMP Rp 145.00 Rp - Rp -
48 BECARBON TAB Rp 115.51 Rp - Rp -
50 BETAMETASON CREAM 0,1 % TUB Rp 3,388.00 Rp - Rp -
51 BETAMETASON CREAM 0,1 % TUB Rp 3,350.00 97 Rp 324,950.00 Rp -
52 Bisacodyl tablet 5 mg TAB Rp 550.00 Rp - Rp -
53 Bisacodyl tablet 5 mg TAB Rp 495.00 61 Rp 30,195.00 Rp -
54 CAPTOPRIL Rp 284.00 Rp - Rp -
56 CAPTOPRIL 25 mg Rp 84.00 5002 Rp 420,168.00 Rp -
57 CAPTOPRIL tablet 50 mg Rp 140.00 Rp - Rp -
58 CIMETIDIN Rp 114.90 Rp - Rp -
60 CIPROFLOXACIN 500 MG Rp 284.00 Rp - Rp -
64 CEFOTAXIM INJ 1000 MG Rp 6,800.00 Rp - Rp -
65 DEKSAMETASON INJ 5 MG/ML-1 ML AMP Rp 143.89 Rp - Rp -
66 DEKSAMETASON INJ 5 MG/ML-1 ML AMP Rp 1,518.00 89 Rp 135,102.00 Rp -
67 DEKSAMETASON INJ 5 MG/ML-1 ML AMP Rp 1,097.00 Rp - 150 Rp 164,550.00
68 DEKSAMETASON TABLET 0.5 MG TAB Rp 69.00 Rp - Rp -
70 DEKSAMETASON TABLET 0.5 MG TAB Rp 32.00 673 Rp 21,536.00 Rp -
71 DEKTROMERFAN HBR SIRUP 10MG/ML BTL Rp 2,864.40 Rp - Rp -
72 DEKTROMERFAN HBR TAB 15 MG TAB Rp 68.98 Rp - Rp -
74 DIAZEPAM INJ 5 MG/ML-2 ML AMP Rp 4,180.00 10 Rp 41,800.00 Rp -
75 DIAZEPAM INJ 5 MG/ML-2 ML AMP Rp 2,365.00 Rp - Rp -
76 DIAZEPAM TABLET 2 MG TAB Rp 19.80 Rp - Rp -
78 DIAZEPAM TABLET 2 MG TAB Rp 45.00 225 Rp 10,125.00 Rp -
79 DIFENHIDRAMIN INJ 10MG/ML-1 ML AMP Rp 60.00 Rp - Rp -
80 DIFENHIDRAMIN INJ 10MG/ML-1 ML AMP Rp 1,095.00 Rp - 30 Rp 32,850.00
81 DIFENHIDRAMIN INJ 10MG/ML-1 ML AMP Rp 1,050.00 36 Rp 37,800.00 Rp -
82 DIGOKSIN TABLET 0.25 MG TAB Rp 104.00 Rp - Rp -
84 DIGOKSIN TABLET 0.25 MG TAB Rp 97.00 95 Rp 9,215.00 Rp -
85 Dimenhidrinat tablet 50 mg TAB Rp 99.00 Rp - Rp -
Rp 105.00 1690 Rp 177,450.00 Rp -
86 Domperidon tablet 10 mg TAB Rp 167.00 Rp - Rp -
87 Domperidon tablet 10 mg TAB Rp 85.00 1354 Rp 115,090.00 Rp -
88 EKSTRAK BELLADON TABLET 10 MG TAB Rp 26.40 Rp - Rp -
89 EPINEFRIN HCL/BITARTAT (ADRENALIN) INJ 0,1%-1ML AMP Rp - Rp -
90 ERGOTAMIN CAFEIN Rp 135.00 Rp - Rp -
91 Erytromycin kaplet 500 mg Rp 750.00 2889 Rp 2,166,750.00 Rp -
92 Erytromycin kaplet 500 mg Rp 730.00 Rp - Rp -
93 ETAKRIDIN LAR 0,1% BTL Rp - Rp -
HARGA SATUAN
No. SATUAN
94 ETANOL 70% BTL Rp 15,400.00 Rp - Rp -
95 ETANOL 70% BTL Rp 4,400.00 548 Rp 2,411,200.00 Rp -
97 EUGENOL CAIRAN BTL Rp 16,667.00 0 Rp - Rp -
98 EUGENOL CAIRAN BTL Rp 18,100.00 3 Rp 54,300.00 Rp -
99 FANITOIN NATRIUM 100 MG KAP Rp 154.00 485 Rp 74,690.00 Rp -
100 FANITOIN NATRIUM 100 MG KAP Rp 158.00 Rp - Rp -
101 FENOBARBITAL TABLET 30 MG TAB Rp 31.00 Rp - Rp -
104 Fitomenadion (Vit.K1) injeksi 2 mg/ml -1 m AMP Rp 3,682.00 Rp - Rp -
105 Fitomenadion (Vit.K1) injeksi 2 mg/ml -1 m AMP Rp 3,550.00 0 Rp - Rp -
106 FITOMENADION TAB SALUT 10 MG TAB Rp 680.61 Rp - Rp -
107 FITOMENADION TAB SALUT 10 MG TAB Rp 710.00 1131 Rp 803,010.00 Rp -
Fluphenazine Decanoate 25mg/ml
109 (SIKZONOATE Inj) Rp 59,758.79 100 Rp 5,975,878.99 Rp -
110 (SIKZONOATE Inj) Rp 59,800.00 14 Rp 837,200.00 Rp -
111 FUROSEMID TABLET 40 MG TAB Rp 78.00 2164 Rp 168,792.00 Rp -
112 FUROSEMID TABLET 40 MG TAB Rp 85.00 Rp - Rp -
113 GARAM ORALIT UNTUK 200 ML AIR SAK Rp - Rp -
114 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 292.00 Rp - Rp -
116 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 288.00 1358 Rp 391,104.00 Rp -
117 GENTIAN VIOLET 1 % BTL Rp 990.90 Rp - Rp -
118 Gentamisin injeksi 40 mg/ml (sbg Sulfat) AMP Rp 3,399.00 37 Rp 125,763.00 100 Rp 339,900.00
119 GLIBENKLAMID TABLET 5 MG TAB Rp 72.00 Rp - Rp -
120 GLIBENKLAMID TABLET 5 MG TAB Rp 80.30 0 Rp - Rp -
121 GLIBENKLAMID TABLET 5 MG TAB Rp 119.00 4006 Rp 476,714.00 Rp -
122 GLIMEPIRID 2 TAB Rp 207.00 Rp - Rp -
123 GLISERI GUAYAKOLAT TABLET 100 MG TAB Rp 27.90 Rp - Rp -
127 Gliserin 100 ml TAB Rp 6,600.00 Rp - Rp -
128 GLUKOSE LAR INFUS 5 % STERIL BTL Rp 5,313.00 Rp - Rp -
129 GLUKOSE LAR INFUS 5 % STERIL BTL Rp 5,200.00 190 Rp 988,000.00 Rp -
130 GRISEOFULVIN 125 MG, MICRONIZE TAB Rp 210.00 328 Rp 68,880.00 Rp -
131 Haloperidol tablet 0,5 mg TAB Rp 59.00 0 Rp - Rp -
Rp 55.00 1481 Rp 81,455.00 Rp -
132 Haloperidol tablet 5 mg TAB Rp 75.00 0 Rp - Rp -
133 Haloperidol 5 mg/ml Injeksi AMP Rp 6,250.00 0 Rp - Rp -
134 Haldol Decanoat 50 mg/ml inj AMP Rp 83,333.00 Rp - Rp -
136 HIDROKHLOROTIAZID TABLET 25 MG TAB Rp 24.64 Rp - Rp -
138 HIDROKORTISON KREM 2,5 % TUBE Rp 2,708.33 Rp - Rp -
141 HIDROKORTISON KREM 2,5 % TUBE Rp 2,475.00 44 Rp 108,900.00 Rp -
142 IBUPROFEN TABLET 200 MG TAB Rp - Rp -
143 IBUPROFEN TABLET 400 MG TAB Rp 205.04 Rp - Rp -
HARGA SATUAN
No. SATUAN
146 IBUPROFEN TABLET 400 MG TAB Rp 31,650.00 Rp - Rp -
147 ISOSORBID DINITRAT TABLET SUBLINGAL 5 TAB Rp 89.00 Rp - Rp -
148 ISOSORBID DINITRAT TABLET SUBLINGAL 5 TAB Rp 88.00 477 Rp 41,976.00 Rp -
149 KALSIUM GLUKONAT INJ TAB Rp 9,955.00 Rp - Rp -
150 KALSIUM LAKTAT TAB 500 MG TAB Rp 52.00 Rp - Rp -
152 KALSIUM LAKTAT TAB 500 MG TAB Rp 59.00 7108 Rp 419,372.00 Rp -
153 Ketokonazol tablet 200 mg TAB Rp 270.00 275 Rp 74,250.00 Rp -
154 KETOPROFEN SUPPO SUP Rp 2,380.00 9 Rp 21,420.00 Rp -
155 KHLORAMFENIKOL KAPSUL 250 MG KAP Rp 227.00 Rp - Rp -
157 KHLORAMFENIKOL 1% SALEP MATA TUBE Rp 1,798.00 Rp - Rp -
158 KHLORAMFENIKOL 1% SALEP MATA TUBE Rp 1,881.00 94 Rp 176,814.00 Rp -
159 KHLORAMFENIKOL TT 3% BTL Rp 7,150.00 1 Rp 7,150.00 Rp -
160 KHLORAMFENIKOL TT 3% BTL Rp 2,310.00 Rp - Rp -
162 KHLORAMFENIKOL TETES MATA Rp 6,380.00 Rp - Rp -
165 KHLORAMFENIKOL SYRUP Rp 5,500.00 Rp - Rp -
168 Kloramfenikol kapsul 250 mg Rp 249.00 Rp - Rp -
169 KLORAMFENIKOL INJEKSI Rp 10,175.00 136 Rp 1,383,800.00 Rp -
170 KLORAMFENIKOL INJEKSI Rp 9,900.04 Rp - Rp -
171 KLORAMFENIKOL SK Rp 3,038.00 43 Rp 130,634.00 Rp -
172 KHLORFENIRAMIN MALEAT (CTM TAB) TAB Rp 24.00 Rp - Rp -
174 KHLORFENIRAMIN MALEAT (CTM TAB) TAB Rp 22.00 11018 Rp 242,396.00 Rp -
176 Klorpromazin HCl tablet salut 100 mg TAB Rp 147.00 127 Rp 18,669.00 Rp -
177 Klorpromazin HCl tablet salut 100 mg TAB Rp 162.00 Rp - Rp -
178 KHLORPROMAZIN HCL TABLET 25 MG TAB Rp 60.50 Rp - Rp -
181 KODEIN HCL TABLET 10 MG TAB Rp 550.00 Rp - Rp -
182 KODEIN HCL TABLET 10 MG TAB Rp 571.00 130 Rp 74,230.00 Rp -
183 KOTRIMOKSAZOL SUSPENSI BTL Rp 3,500.00 Rp - Rp -
185 KOTRIMOKSAZOL SUSPENSI BTL Rp 2,167.00 101 Rp 218,867.00 Rp -
186 KOTRIMOKSAZOL ADULT TABLET TAB Rp 100.00 Rp - Rp -
189 KOTRIMOKSAZOL ADULT TABLET TAB Rp 138.00 3159 Rp 435,942.00 Rp -
190 KOMBIVENT TAB Rp 4,550.00 21 Rp 95,550.00 Rp -
191 Larutan elektrolit D5-1/4ns Rp 7,700.00 140 Rp 1,078,000.00 Rp -
192 Larutan elektrolit D5-1/2ns Rp 9,400.00 80 Rp 752,000.00 Rp -
193 LIDOKAIN COMP INJ-2 ML AMP Rp 1,136.67 Rp - Rp -
195 LIDOKAIN COMP INJ-2 ML AMP Rp 1,845.00 126 Rp 232,470.00 Rp -
196 LORATADIN TAB Rp 123.00 920 Rp 113,160.00 Rp -
HARGA SATUAN
No. SATUAN
197 Magnesium Sulfat injeksi (iv) 40 % - 25 ml BTL Rp 2,629.00 Rp - Rp -
198 Mikonazole krim/salep 2 % (Nitrat) BTL Rp 3,250.00 26 Rp 84,500.00 Rp -
199 Mikonazole krim/salep 2 % (Nitrat) Rp 3,414.00 Rp - Rp -
200 Metamizole injeksi 500 mg/ 1 ml AMP Rp 7,150.00 Rp - Rp -
202 Metformin HCl tablet 500 mg TAB Rp 100.00 1299 Rp 129,900.00 Rp -
203 Metformin HCl tablet 500 mg TAB Rp 96.00 Rp - Rp -
204 METILERGOMETRINMALEAT TAB 0,125 MG TAB Rp 275.00 80 Rp 22,000.00 Rp -
205 METILERGOMETRINMALEAT INJ TAB Rp 2,684.00 36 Rp 96,624.00 Rp -
206 METRONIDAZOL TABLET 500 MG TAB Rp 133.00 Rp - Rp -
208 METOKLOPROPAMIDE TABLET TAB Rp 99.00 Rp - Rp -
209 Monochlorkamfer mentol ( CHKM ) BTL Rp 60,500.00 Rp - Rp -
210 NA CL LAR INFUS 0,9 % STERIL BTL Rp 4,700.00 Rp - Rp -
211 Natrium Diklofenak tablet 50 mg BTL Rp 176.00 Rp - Rp -
213 Natrium Klorida larutan infus 0,9 % steril BTL Rp 6,410.00 12 Rp 76,920.00 Rp -
214 NIFEDIPIN TAB Rp 104.00 Rp - Rp -
216 NISTATIN TAB VAGINAL 100.000IU TAB Rp - Rp -
217 NISTATIN TAB SALUT 500.000IU TAB Rp - Rp -
218 OAT KATEGORI III PKT Rp - Rp -
220 OAT SISIPAN PKT Rp - Rp -
221 OBH BTL Rp 1,430.00 Rp - Rp -
222 OBH BTL Rp 1,258.95 Rp - Rp -
223 OBH BTL Rp 2,310.00 Rp - Rp -
224 OBH BTL Rp 2,970.00 Rp - Rp -
225 OKSITOSIN TUBE Rp 1,900.00 91 Rp 172,899.73 Rp -
226 OKSITETRASIKLIN HCL SALEP 3% TUBE Rp 1,650.97 Rp - Rp -
228 Omeprazol kapsul 20 mg Rp 160.00 Rp - Rp -
229 Omeprazol injeksi 40 mg/ 10 ml Rp 36,000.00 Rp - Rp -
230 PARASETAMOL SIRUP 120 MG/5ML BTL Rp 1,074.00 Rp - Rp -
231 PARASETAMOL SIRUP 120 MG/5ML BTL Rp 1,010.00 227 Rp 229,270.00 Rp -
232 PARASETAMOL TABLET 500 MG TAB Rp 53.00 31746 Rp 1,682,538.00 Rp -
233 PARASETAMOL TABLET 500 MG TAB Rp 56.00 Rp - Rp -
Rp 49.00 Rp -
234 PIRANTEL PAMOAT TAB 125 MG BASA TAB Rp - Rp -
235 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 123.00 Rp - Rp -
237 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 118.00 6113 Rp 721,334.00 Rp -
238 POLIKRESULEN BTL Rp - Rp -
239 PREDNISON TABLET 5 MG TAB Rp 40.00 Rp - Rp -
240 PREDNISON TABLET 5 MG TAB Rp 96.00 6123 Rp 587,808.00 Rp -
243 PPC INJEKSI 3 JUTA IU VIAL Rp - Rp -
244 PTU TABLET 100 MG TAB Rp 309.00 Rp - Rp -
245 PROPRANOLOL HCL TABLET 40 MG TAB Rp 83.00 Rp - Rp -
247 PROPRANOLOL HCL TABLET 10 MG TAB Rp 82.50 569 Rp 46,942.50 Rp -
HARGA SATUAN
No. SATUAN
248 Ranitidin tablet 150 mg Rp 120.00 Rp - Rp -
249 Ranitidin injeksi 25 mg / 2 ml Rp 1,140.00 Rp - Rp -
250 RETINOL KAPSUL LUNAK 200.000IU KAP Rp 519.20 500 Rp 259,600.00 Rp -
251 RETINOL KAPSUL LUNAK 200.000IU KAP Rp 505.00 Rp - Rp -
252 RETINOL KAPSUL LUNAK 100.000IU KAP Rp 284.00 Rp - Rp -
Rp 288.00 150 Rp 43,200.00 Rp -
253 RINGER LAKTAT LAR INFUS STERIL BTL Rp 7,150.00 396 Rp 2,831,400.00 300 Rp 2,145,000.00
254 RINGER LAKTAT LAR INFUS STERIL BTL Rp 5,200.00 Rp - Rp -
256 RISPERIDON BTL Rp 347.00 375 Rp 130,125.00 Rp -
257 Asering Laruran Infus BTL Rp 15,899.40 Rp - Rp -
259 SALBUTAMOL TABLET 2 MG TAB Rp 66.00 1264 Rp 83,424.00 Rp -
260 SALBUTAMOL TABLET 2 MG TAB Rp 59.00 Rp - Rp -
262 SALEP 2,4 KOMBINASI POT Rp 826.00 Rp - Rp -
263 SALEP 2,4 KOMBINASI POT Rp 2,000.00 Rp - Rp -
264 SALEP 2,4 KOMBINASI POT Rp 2,620.00 30 Rp 78,600.00 Rp -
266 SALISIL BEDAK 2% KTK Rp 1,450.00 2 Rp 2,900.00 Rp -
267 SALISIL BEDAK 2% KTK Rp 1,430.00 Rp - Rp -
269 SILK NO3/0 SAK Rp - Rp -
270 SILK NO3/1 SAK Rp 6,386.11 Rp - Rp -
271 Serum Anti Bisa Ular Polivalen injeksi 5 ml VIAL Rp 473,000.00 Rp - Rp -
272 SATS 1.500 IU/AMPUL AMP Rp 130,999.00 6 Rp 785,994.00 10 Rp 1,309,990.00
273 SIANOKOBALAMIN INJ 500 MCG/ML, 1ML AMP Rp 916.00 Rp - Rp -
274 SIANOKOBALAMIN INJ 500 MCG/ML, 1ML AMP Rp 1,078.00 9 Rp 9,702.00 Rp -
275 Simvastatin tablet 10 mg TAB Rp 110.00 0 Rp - Rp -
276 Sefadroxil kapsul 500 mg TAB Rp 509.00 Rp - Rp -
277 ZINC TAB TAB Rp 475.00 Rp - Rp -
278 ZINC TAB TAB Rp - Rp - Rp -
280 ZINC TAB TAB Rp 474.00 1602 Rp 759,348.00 Rp -
281 SULFASETAMID T.M 15% BTL Rp 3,446.00 Rp - Rp -
283 TABLET TAMBAH DARAH KOMBINASI TAB Rp 354.00 95200 Rp 33,700,800.00 Rp -
286 TETRASIKLINA KAPSUL 500MG KAP Rp 310.00 70 Rp 21,700.00 Rp -
287 TIAMIN HCL MONOHIDRAT TABLET 50 MG TAB Rp 86.00 Rp - Rp -
Tiamfenikol kapsul 500 mg TAB Rp 739.20 Rp -
288 Tiamfenikol kapsul 500 mg TAB Rp 495.00 2210 Rp 1,093,950.00 Rp -
289 Tiamin (Viamin B1) tablet 50 mg TAB Rp 86.00 7587 Rp 652,482.00 Rp -
290 Tiamin (Vitamin B1) tablet 100 mg TAB Rp 62.70 Rp - Rp -
291 TRIHEKSIFINIDIL 2 MG TAB Rp 88.00 Rp - Rp -
292 TRIHEKSIFINIDIL 2 MG TAB Rp 80.00 623 Rp 49,840.00 Rp -
294 VIT B KOMPLEKS TABLET TAB Rp 115.00 7537 Rp 866,755.00 Rp -
295 VIT B KOMPLEKS TABLET TAB Rp 83.00 Rp - Rp -
296 VENTOLIN INHALER(Salbutamol CFC 200 dos TAB Rp 63,750.00 Rp - Rp -
297 YODIUM POVIDON LAR 10%, 30ML BTL Rp - Rp -
HARGA SATUAN
No. SATUAN
298 YODIUM POVIDON LAR 10%, 300ML BTL Rp 17,996.00 Rp - Rp -
299 Povidon Iodida 10 %, 300 ml BTL Rp 14,499.10 Rp - Rp -
300 MINERAL MIX SAK Rp 2,541.00 Rp - Rp -
301 OAT kat 1 Rp 288,199.00 Rp - Rp -
302 FDC Kit KAT 1 Rp 359,985.00 3 Rp 1,079,955.00 Rp -
303 FDC Kit KAT 2 Rp 1,297,894.00 Rp - 1 Rp 1,297,894.00
304 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
305 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
JUMLAH TOTAL OBAT Rp 103,932,852.82 Rp 5,457,184.00
OBAT GIGI
1 ETIL KHLORIDA SEMPROT BTL Rp 104,500.00 Rp - Rp -
4 Glass Ionomer Cement ART BTL Rp 521,235.00 Rp - Rp -
JUMLAH TOTAL OBAT GIGI Rp - Rp -
REAGEN LABORATORIUM
1 Reagen Hepatitis B (HBSAg dan Dropper) Rp 9,870.00 Rp - Rp -
2 Reagen HIV R1 (Standart Diagnostic) Rp 14,340.00 Rp - Rp -
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
3 Reagen HIV R2 Rp 14,470.00 23 Rp 332,810.00 Rp -
5 HUMAN HEXAGON SIPHILYS Rp 26,671.00 17 Rp 453,407.00 Rp -
6 Reagen Hepatitis B Rp 9,870.00 Rp - Rp -
7 Rp 9,850.00 151 Rp 1,487,350.00 Rp -
10 Reagen Urine Stik 10 Parameter Rp 2,200.00 Rp - Rp -
11 REAGEN GOLONGAN DARAH A Rp 104,500.00 Rp - Rp -
12 REAGEN GOLONGAN DARAH B Rp 104,500.00 Rp - Rp -
JUMLAH TOTAL REAGEN LABORATORIUM Rp 4,513,372.00 Rp -
BAHAN MEDIS HABIS PAKAI
1 ALAT SUNTIK SEKALI PAKAI 1 ML SET Rp 748.00 Rp - Rp -
2 ALAT SUNTIK SEKALI PAKAI 1 ML SET Rp 990.00 322 Rp 318,780.00 Rp -
3 ALAT SUNTIK SEKALI PAKAI 1 ML SET Rp 1,078.00 Rp - Rp -
4 ALAT SUNTIK SEKALI PAKAI 2.5 ML SET Rp 957.00 Rp - Rp -
11 CAT GUT / BENANG BEDAH NO 2/0-3/0 (PLAIN, KHROM SAK Rp 24,062.50 Rp - Rp -
14 INFUSION SET ANAK BTL Rp 4,032.60 Rp - Rp -
15 INFUSION SET DEWASA BTL Rp 7,321.00 Rp - Rp -
17 JARUM JAHID (BEDAH) NO 9 S/D 14 BIJI Rp - Rp -
18 KAPAS PEMBALUT / ABSORBEN 250 MG BKS Rp 12,500.00 Rp - Rp -
20 KASA PEMBALUT 2MX80CM ROL Rp 7,700.00 Rp - Rp -
HARGA SATUAN
No. SATUAN
25 KASA PEMBALUT 4MX3CM ROL Rp 660.00 Rp - Rp -
Rp 770.00 Rp - Rp -
26 KASA PEMBALUT 16MX16CM ROL Rp 362.50 544 Rp 197,200.00 Rp -
27 PLESTER 5X2 INCHI ROL Rp 23,540.00 Rp - Rp -
29 IV CATETER NO. 20 BIJI Rp 7,700.00 Rp - Rp -
35 FOLEY CATETER NO.18 BIJI Rp 8,360.00 Rp - Rp -
37 Urine Bag Steril 2 Lt Rp 3,960.00 Rp - Rp -
39 MASKER BIJI Rp 990.00 Rp - Rp -
40 KI 0.5 ml Rp 2,398.00 Rp - Rp -
41 KI 5 ml Rp 2,508.00 Rp - Rp -
42 Safety Box 2,5 L Rp 18,480.00 Rp - Rp -
43 Hands shoen No. 7 BIJI Rp 4,180.00 Rp - Rp -
44 Hands shoen No. 7 Non steril BIJI Rp 325.00 Rp - Rp -
JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 515,980.00 Rp -

TOTAL 108,962,204.82 5,457,184.00
Mengetahui Jombang, 30 Januari 2019

Plt.Kepala Puskesmas Pulorejo Pengurus Barang Pembantu
Puskesmas Pulorejo
DIDIK RIJADI, SKM, M.Kes MEIN YULIANA

NIP. 196303031989031014 NIP. 197503122009012002
KOREKSI TOTAL HARGA :
Stok awal Rp 108,962,204.82

Penerimaan Rp 5,457,184.00
HARGA SATUAN
No. SATUAN
Pemakaian Rp 35,882,072.72
Stok akhir Rp 78,537,316.10
N
MUTASI KURANG TAHUN 2019 STOK AKHIR TAHUN 2019
JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

373 Rp 141,740.00 321 Rp 121,980.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
30 Rp 10,320.00 750 Rp 258,000.00
0 Rp - Rp -
676 Rp 60,840.00 1529 Rp 137,610.00
0 Rp - Rp -
0 Rp - Rp -
165 Rp 18,513.00 618 Rp 69,339.60
0 Rp - Rp -
0 Rp - 23 Rp 76,935.00
0 Rp - 0 Rp -
0 Rp - Rp -
230 Rp 38,410.00 870 Rp 145,290.00
3021 Rp 211,470.00 4222 Rp 295,540.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
4612 Rp 249,048.00 15795 Rp 852,930.00
15 Rp 29,925.00 30 Rp 59,850.00
0 Rp - Rp -
0 Rp - Rp -
18 Rp 54,810.00 53 Rp 161,385.00
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
9 Rp 24,750.00 143 Rp 393,250.00
0 Rp - Rp -
0 Rp - Rp -
1366 Rp 143,430.00 4588 Rp 481,740.00

0 Rp - 0 Rp -
5095 Rp 524,785.00 5016 Rp 516,648.00
0 Rp - Rp -
904 Rp 122,944.00 2018 Rp 274,448.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
23 Rp 77,050.00 74 Rp 247,900.00
0 Rp - Rp -
7 Rp 3,465.00 54 Rp 26,730.00
0 Rp - Rp -
0 Rp - Rp -
773 Rp 64,932.00 4229 Rp 355,236.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
150 Rp 164,550.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
673 Rp 21,536.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
225 Rp 10,125.00 Rp -
0 Rp - Rp -
30 Rp 32,850.00 Rp -
36 Rp 37,800.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
58 Rp 5,626.00 37 Rp 3,589.00
0 Rp - Rp -
221 Rp 23,205.00 1469 Rp 154,245.00
0 Rp - Rp -
1354 Rp 115,090.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
2629 Rp 1,971,750.00 260 Rp 195,000.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
9 Rp 39,600.00 539 Rp 2,371,600.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 3 Rp 54,300.00
77 Rp 11,858.00 408 Rp 62,832.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
90 Rp 63,900.00 1041 Rp 739,110.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
14 Rp 837,200.00 Rp -
783 Rp 61,074.00 1381 Rp 107,718.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
416 Rp 119,808.00 942 Rp 271,296.00
0 Rp - Rp -
136 Rp 462,264.00 1 Rp 3,399.00
0 Rp - Rp -
0 Rp - Rp -
755 Rp 89,845.00 3251 Rp 386,869.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 190 Rp 988,000.00
80 Rp 16,800.00 248 Rp 52,080.00
0 Rp - 0 Rp -
279 Rp 15,345.00 1202 Rp 66,110.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 39,600.00 28 Rp 69,300.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
121 Rp 10,648.00 356 Rp 31,328.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1633 Rp 96,347.00 5475 Rp 323,025.00
35 Rp 9,450.00 240 Rp 64,800.00
4 Rp 9,520.00 5 Rp 11,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
25 Rp 47,025.00 69 Rp 129,789.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
31 Rp 315,425.00 105 Rp 1,068,375.00
0 Rp - Rp -
9 Rp 27,342.00 34 Rp 103,292.00
0 Rp - Rp -
0 Rp - Rp -
5019 Rp 110,418.00 5999 Rp 131,978.00
0 Rp - Rp -
115 Rp 16,905.00 12 Rp 1,764.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
50 Rp 28,550.00 80 Rp 45,680.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1947 Rp 268,686.00 1212 Rp 167,256.00
15 Rp 68,250.00 6 Rp 27,300.00
0 Rp - 140 Rp 1,078,000.00
0 Rp - 80 Rp 752,000.00
0 Rp - Rp -
0 Rp - Rp -
16 Rp 29,520.00 110 Rp 202,950.00
40 Rp 4,920.00 880 Rp 108,240.00

0 Rp - Rp -
5 Rp 16,250.00 21 Rp 68,250.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
334 Rp 33,400.00 965 Rp 96,500.00
0 Rp - Rp -
20 Rp 5,500.00 60 Rp 16,500.00
0 Rp - 36 Rp 96,624.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 12 Rp 76,920.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
143 Rp 144,430.00 84 Rp 84,840.00
11191 Rp 593,123.00 20555 Rp 1,089,415.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
2067 Rp 243,906.00 4046 Rp 477,428.00
0 Rp - Rp -
0 Rp - Rp -
3853 Rp 369,888.00 2270 Rp 217,920.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 569 Rp 46,942.50

0 Rp - Rp -
0 Rp - Rp -
0 Rp - 500 Rp 259,600.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 150 Rp 43,200.00
506 Rp 3,617,900.00 190 Rp 1,358,500.00
0 Rp - Rp -
0 Rp - Rp -
55 Rp 19,085.00 320 Rp 111,040.00
0 Rp - Rp -
0 Rp - Rp -
167 Rp 11,022.00 1097 Rp 72,402.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
5 Rp 13,100.00 25 Rp 65,500.00
0 Rp - Rp -
0 Rp - 2 Rp 2,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
7 Rp 916,993.00 9 Rp 1,178,991.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
374 Rp 177,276.00 1228 Rp 582,072.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 95200 Rp 33,700,800.00
23547 Rp 8,359,185.00 Rp -
11231 Rp 3,975,774.00 50369 Rp 17,830,626.00
56 Rp 17,360.00 14 Rp 4,340.00
0 Rp - Rp -
0 Rp - Rp -
1109 Rp 548,955.00 1101 Rp 544,995.00
3513 Rp 302,118.00 4074 Rp 350,364.00
0 Rp - Rp -
0 Rp - Rp -
185 Rp 14,800.00 438 Rp 35,040.00
0 Rp - Rp -
4599 Rp 528,885.00 2938 Rp 337,870.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp -
3 Rp 1,079,955.00 Rp -
1 Rp 1,297,894.00 Rp -
0 Rp - 7 Rp 315,854.00
0 Rp - 2 Rp 71,204.00
Rp 35,765,662.72 Rp 73,624,374.10 73,624,374.10 Rp 103,932,452.82
30,308,078.72
0 Rp - Rp - Rp 100.00
0 Rp - Rp - 303,080.79
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 152 Rp 2,180,288.00
0 Rp - 23 Rp 332,810.00
0 Rp - 3 Rp 59,517.00
0 Rp - 17 Rp 453,407.00
0 Rp - Rp -
0 Rp - 151 Rp 1,487,350.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp 4,513,372.00 Rp 4,513,372.00
0 Rp - Rp -
59 Rp 58,410.00 263 Rp 260,370.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
160 Rp 58,000.00 384 Rp 139,200.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 116,410.00 Rp 399,570.00
35,882,072.72 78,537,316.10 78,537,316.10
Pengelola Obat
Puskesmas Pulorejo
BOBY DARYONO, S.Farm., Apt.

NIP.198209032010011012
DARI UPTD INSTALASI FARMASI KABUPATEN
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
1 ACYCLOVIR TAB Rp 380.00 694 Rp 263,720.00 1000 Rp 380,000.00
8 ALLOPURINOL TABLET 100 MG TAB Rp 90.00 2205 Rp 198,450.00 1000 Rp 90,000.00
11 AMINOFILIN TAB 200 MG TAB Rp 112.20 783 Rp 87,852.60 200 Rp 22,440.00
Rp 167.00 100 Rp 16,700.00 1000 Rp 167,000.00
16 AMLODIPIN TAB TAB Rp 70.00 7243 Rp 507,010.00 7200 Rp 504,000.00
33 Antasida DOEN suspensi Rp 1,995.00 45 Rp 89,775.00 100 Rp 199,500.00
35 ANTI HAEMORHOID SUPPOSITORIA SUP Rp 3,167.00 Rp - 20 Rp 63,340.00
42 ASAM ASKORBAT (VIT C) TAB 50 MG TAB Rp 105.00 5954 Rp 625,170.00 7000 Rp 735,000.00
HARGA SATUAN
No. SATUAN
44 ASAM MEFENAMAT TAB 500 MG Rp 103.00 10111 Rp 1,041,433.00 19200 Rp 1,977,600.00
46 Atapulgit tablet 600 mg Rp 136.00 2922 Rp 397,392.00 2000 Rp 272,000.00
55 CAPTOPRIL Rp 75.00 Rp - 1600 Rp 120,000.00
70 DEKSAMETASON TABLET 0.5 MG TAB Rp 32.00 673 Rp 21,536.00 2100 Rp 67,200.00
77 DIAZEPAM TABLET 2 MG TAB Rp 86.00 Rp - 1700 Rp 146,200.00
82 DIGOKSIN TABLET 0.25 MG TAB Rp 104.00 Rp - 200 Rp 20,800.00
Rp 105.00 1690 Rp 177,450.00 Rp -
87 Domperidon tablet 10 mg TAB Rp 85.00 1354 Rp 115,090.00 5000 Rp 425,000.00
89 EPINEFRIN HCL/BITARTAT (ADRENALIN) INJ 0,1%-1ML AMP Rp 1,408.00 Rp - 2 Rp 2,816.00
92 Erytromycin kaplet 500 mg Rp 730.00 Rp - 2000 Rp 1,460,000.00
HARGA SATUAN
No. SATUAN
95 ETANOL 70% BTL Rp 4,400.00 548 Rp 2,411,200.00 500 Rp 2,200,000.00
104 Fitomenadion (Vit.K1) injeksi 2 mg/ml -1 m AMP Rp 3,682.00 Rp - 60 Rp 220,920.00
110 (SIKZONOATE Inj) Rp 59,800.00 14 Rp 837,200.00 30 Rp 1,794,000.00
112 FUROSEMID TABLET 40 MG TAB Rp 77.00 Rp - 2000 Rp 154,000.00
116 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 288.00 1358 Rp 391,104.00 2400 Rp 691,200.00
119 Gentamisin injeksi 40 mg/ml (sbg Sulfat) TAB Rp 3,083.00 Rp - 100 Rp 308,300.00
121 GLIBENKLAMID TABLET 5 MG TAB Rp 119.00 4006 Rp 476,714.00 1500 Rp 178,500.00
130 GRISEOFULVIN 125 MG, MICRONIZE TAB Rp 210.00 328 Rp 68,880.00 200 Rp 42,000.00
Rp 55.00 1481 Rp 81,455.00 Rp -
141 HIDROKORTISON KREM 2,5 % TUBE Rp 2,475.00 44 Rp 108,900.00 48 Rp 118,800.00
142 INH TAB Rp 145.00 Rp - 600 Rp 87,000.00
HARGA SATUAN
No. SATUAN
147 ISOSORBID DINITRAT TABLET SUBLINGAL 5 TAB Rp 89.00 Rp - 200 Rp 17,800.00
152 KALSIUM LAKTAT TAB 500 MG TAB Rp 59.00 7108 Rp 419,372.00 2000 Rp 118,000.00
154 KETOPROFEN SUPPO SUP Rp 2,380.00 9 Rp 21,420.00 10 Rp 23,800.00
155 KHLORAMFENIKOL KAPSUL 250 MG KAP Rp 495.00 Rp - 6500 Rp 3,217,500.00
158 KHLORAMFENIKOL 1% SALEP MATA TUBE Rp 1,881.00 94 Rp 176,814.00 48 Rp 90,288.00
174 KHLORFENIRAMIN MALEAT (CTM TAB) TAB Rp 22.00 11018 Rp 242,396.00 19800 Rp 435,600.00
176 Klorpromazin HCl tablet salut 100 mg TAB Rp 147.00 127 Rp 18,669.00 2000 Rp 294,000.00
182 KODEIN HCL TABLET 10 MG TAB Rp 571.00 130 Rp 74,230.00 200 Rp 114,200.00
190 KOMBIVENT TAB Rp 4,550.00 21 Rp 95,550.00 40 Rp 182,000.00
194 LIDOKAIN COMP INJ-2 ML AMP Rp 1,145.00 Rp - 60 Rp 68,700.00
HARGA SATUAN
No. SATUAN
199 Mikonazole krim/salep 2 % (Nitrat) Rp 3,414.00 Rp - 24 Rp 81,936.00
203 Metformin HCl tablet 500 mg TAB Rp 96.00 Rp - 800 Rp 76,800.00
204 METILERGOMETRINMALEAT TAB 0,125 MG TAB Rp 275.00 80 Rp 22,000.00 100 Rp 27,500.00
221 OBH BTL Rp 1,430.00 Rp - Rp -
222 OBH BTL Rp 1,258.95 Rp - Rp -
223 OBH BTL Rp 2,310.00 Rp - Rp -
224 OBH BTL Rp 2,970.00 Rp - Rp -
226 OKSITOSIN TUBE Rp 1,900.00 Rp - 100 Rp 190,000.00
231 PARASETAMOL SIRUP 120 MG/5ML BTL Rp 1,010.00 227 Rp 229,270.00 300 Rp 303,000.00
232 PARASETAMOL TABLET 500 MG TAB Rp 53.00 31746 Rp 1,682,538.00 16500 Rp 874,500.00
Rp 49.00 Rp -
235 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 123.00 Rp - 7000 Rp 861,000.00
240 PREDNISON TABLET 5 MG TAB Rp 96.00 6123 Rp 587,808.00 2000 Rp 192,000.00
241 PREDNISON TABLET 5 MG TAB Rp 68.00 Rp - 10000 Rp 680,000.00
HARGA SATUAN
No. SATUAN
251 RETINOL KAPSUL LUNAK 200.000IU KAP Rp 517.00 Rp - 4000 Rp 2,068,000.00
252 RETINOL KAPSUL LUNAK 100.000IU KAP Rp 284.00 Rp - 500 Rp 142,000.00
Rp 288.00 150 Rp 43,200.00 Rp -
260 SALBUTAMOL TABLET 2 MG TAB Rp 63.00 Rp - 300 Rp 18,900.00
264 SALEP 2,4 KOMBINASI POT Rp 2,620.00 30 Rp 78,600.00 24 Rp 62,880.00
279 ZINC TAB TAB Rp 524.00 Rp - 1000 Rp 524,000.00
287 TIAMIN HCL MONOHIDRAT TABLET 50 MG TAB Rp 85.00 Rp - 9000 Rp 765,000.00
293 TRIHEKSIFINIDIL 2 MG TAB Rp 85.00 Rp - 400 Rp 34,000.00
295 VIT B KOMPLEKS TABLET TAB Rp 83.00 Rp - 10000 Rp 830,000.00
HARGA SATUAN
No. SATUAN
301 OAT kat 1 Rp 389,344.00 Rp - 16 Rp 6,229,504.00
304 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
305 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
REAGEN LABORATORIUM
1 Reagen Hepatitis B (HBSAg dan Dropper) Rp 9,870.00 Rp - Rp -
2 Reagen HIV R1 (Standart Diagnostic) Rp 14,340.00 Rp - Rp -
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
6 Reagen Hepatitis B Rp 9,870.00 Rp - Rp -
7 Rp 9,850.00 151 Rp 1,487,350.00 Rp -
JUMLAH TOTAL REAGEN LABORATORIUM Rp 4,513,372.00 Rp -
1 ALAT SUNTIK SEKALI PAKAI 1 ML SET Rp 1,539.60 Rp - 1000 Rp 1,539,604.00
HARGA SATUAN
No. SATUAN
Rp 770.00 Rp - Rp -
40 KI 0.5 ml Rp 2,398.00 Rp - Rp -
41 KI 5 ml Rp 2,508.00 Rp - Rp -
JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 515,980.00 Rp 1,539,604.00

TOTAL 108,962,204.82 50,683,726.00
Mengetahui Jombang, 28 FEBRUARI 2019

Puskesmas Pulorejo

NIP. 196303031989031014 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

HARGA SATUAN
No. SATUAN
EN

425 Rp 161,500.00 1269 Rp 482,220.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
40 Rp 13,760.00 740 Rp 254,560.00
0 Rp - Rp -
1036 Rp 93,240.00 2169 Rp 195,210.00
0 Rp - Rp -
0 Rp - Rp -
272 Rp 30,518.40 711 Rp 79,774.20
0 Rp - Rp -
1 Rp 3,345.00 22 Rp 73,590.00
0 Rp - 0 Rp -
0 Rp - Rp -
410 Rp 68,470.00 690 Rp 115,230.00
5777 Rp 404,390.00 8666 Rp 606,620.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
9607 Rp 518,778.00 10800 Rp 583,200.00
38 Rp 75,810.00 107 Rp 213,465.00
0 Rp - Rp -
20 Rp 63,340.00 Rp -
14 Rp 42,630.00 57 Rp 173,565.00
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
27 Rp 74,250.00 125 Rp 343,750.00
0 Rp - Rp -
0 Rp - Rp -
3691 Rp 387,555.00 9263 Rp 972,615.00

0 Rp - 0 Rp -
10451 Rp 1,076,453.00 18860 Rp 1,942,580.00
0 Rp - Rp -
1527 Rp 207,672.00 3395 Rp 461,720.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
39 Rp 130,650.00 58 Rp 194,300.00
0 Rp - Rp -
17 Rp 8,415.00 44 Rp 21,780.00
0 Rp - Rp -
0 Rp - 1600 Rp 120,000.00
1531 Rp 128,604.00 3471 Rp 291,564.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
158 Rp 173,326.00 352 Rp 386,144.00
0 Rp - Rp -
0 Rp - Rp -
789 Rp 25,248.00 1984 Rp 63,488.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
36 Rp 3,096.00 1664 Rp 143,104.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
51 Rp 55,845.00 249 Rp 272,655.00
36 Rp 37,800.00 Rp -
0 Rp - 200 Rp 20,800.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
398 Rp 41,790.00 1292 Rp 135,660.00
0 Rp - Rp -
1948 Rp 165,580.00 4406 Rp 374,510.00
0 Rp - Rp -
2 Rp 2,816.00 Rp -
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
761 Rp 555,530.00 1239 Rp 904,470.00
0 Rp - Rp -

0 Rp - Rp -
18 Rp 79,200.00 1030 Rp 4,532,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 3 Rp 54,300.00
287 Rp 44,198.00 198 Rp 30,492.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 60 Rp 220,920.00
0 Rp - Rp -
0 Rp - Rp -
180 Rp 127,800.00 951 Rp 675,210.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
14 Rp 837,200.00 30 Rp 1,794,000.00
1611 Rp 125,658.00 553 Rp 43,134.00
0 Rp - 2000 Rp 154,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
828 Rp 238,464.00 2930 Rp 843,840.00
0 Rp - Rp -
185 Rp 628,815.00 2 Rp 6,798.00
0 Rp - 100 Rp 308,300.00
0 Rp - Rp -
1475 Rp 175,525.00 4031 Rp 479,689.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 190 Rp 988,000.00
180 Rp 37,800.00 348 Rp 73,080.00
0 Rp - 0 Rp -
429 Rp 23,595.00 1052 Rp 57,860.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
37 Rp 91,575.00 55 Rp 136,125.00
0 Rp - 600 Rp 87,000.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - 200 Rp 17,800.00
188 Rp 16,544.00 289 Rp 25,432.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3290 Rp 194,110.00 5818 Rp 343,262.00
35 Rp 9,450.00 240 Rp 64,800.00
4 Rp 9,520.00 15 Rp 35,700.00
983 Rp 486,585.00 5517 Rp 2,730,915.00
0 Rp - Rp -
0 Rp - Rp -
45 Rp 84,645.00 97 Rp 182,457.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
107 Rp 1,088,725.00 29 Rp 295,075.00
0 Rp - Rp -
19 Rp 57,722.00 24 Rp 72,912.00
0 Rp - Rp -
0 Rp - Rp -
10987 Rp 241,714.00 19831 Rp 436,282.00
0 Rp - Rp -
115 Rp 16,905.00 2012 Rp 295,764.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
60 Rp 34,260.00 270 Rp 154,170.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
9 Rp 40,950.00 52 Rp 236,600.00
0 Rp - 140 Rp 1,078,000.00
0 Rp - 80 Rp 752,000.00
0 Rp - Rp -
0 Rp - 60 Rp 68,700.00
32 Rp 59,040.00 94 Rp 173,430.00
750 Rp 92,250.00 170 Rp 20,910.00

0 Rp - Rp -
8 Rp 26,000.00 18 Rp 58,500.00
0 Rp - 24 Rp 81,936.00
0 Rp - Rp -
0 Rp - Rp -
584 Rp 58,400.00 715 Rp 71,500.00
0 Rp - 800 Rp 76,800.00
40 Rp 11,000.00 140 Rp 38,500.00
0 Rp - 36 Rp 96,624.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 12 Rp 76,920.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
0 Rp - 100 Rp 190,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
226 Rp 228,260.00 301 Rp 304,010.00
24509 Rp 1,298,977.00 23737 Rp 1,258,061.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 7000 Rp 861,000.00
0 Rp - Rp -
4834 Rp 570,412.00 1279 Rp 150,922.00
0 Rp - Rp -
0 Rp - Rp -
7957 Rp 763,872.00 166 Rp 15,936.00
0 Rp - 10000 Rp 680,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 569 Rp 46,942.50

0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
3500 Rp 1,809,500.00 500 Rp 258,500.00
350 Rp 99,400.00 150 Rp 42,600.00
150 Rp 43,200.00 Rp -
881 Rp 6,299,150.00 1315 Rp 9,402,250.00
0 Rp - Rp -
0 Rp - Rp -
205 Rp 71,135.00 170 Rp 58,990.00
0 Rp - Rp -
0 Rp - Rp -
297 Rp 19,602.00 967 Rp 63,822.00
0 Rp - 300 Rp 18,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
12 Rp 31,440.00 42 Rp 110,040.00
0 Rp - Rp -
0 Rp - 2 Rp 2,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
8 Rp 1,047,992.00 8 Rp 1,047,992.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 1000 Rp 524,000.00
813 Rp 385,362.00 789 Rp 373,986.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 95200 Rp 33,700,800.00
23547 Rp 8,359,185.00 Rp -
23115 Rp 8,182,710.00 38485 Rp 13,623,690.00
70 Rp 21,700.00 Rp -
0 Rp - 9000 Rp 765,000.00
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7181 Rp 617,566.00 406 Rp 34,916.00
0 Rp - Rp -
0 Rp - Rp -
295 Rp 23,600.00 328 Rp 26,240.00
0 Rp - 400 Rp 34,000.00
7537 Rp 866,755.00 Rp -
727 Rp 60,341.00 9273 Rp 769,659.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 6,229,504.00
3 Rp 1,079,955.00 Rp -
2 Rp 2,595,788.00 Rp -
7 Rp 315,854.00 Rp -
2 Rp 71,204.00 Rp -
Rp 61,075,707.12 Rp 92,001,267.70 92,001,267.70 Rp 103,932,452.82
11,931,185.12
0 Rp - Rp - Rp 100.00
0 Rp - Rp - 119,311.85
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
126 Rp 1,807,344.00 26 Rp 372,944.00
0 Rp - 23 Rp 332,810.00
0 Rp - 3 Rp 59,517.00
0 Rp - 17 Rp 453,407.00
0 Rp - Rp -
120 Rp 1,182,000.00 31 Rp 305,350.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 2,989,344.00 Rp 1,524,028.00 Rp 4,513,372.00
0 Rp - 1000 Rp 1,539,604.00
111 Rp 109,890.00 211 Rp 208,890.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
240 Rp 87,000.00 304 Rp 110,200.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 196,890.00 Rp 1,858,694.00
64,261,941.12 95,383,989.70 95,383,989.70
Pengelola Obat
Puskesmas Pulorejo

NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
Rp 167.00 100 Rp 16,700.00 1000 Rp 167,000.00
21 AMOKSISILIN KAPSUL 500 MG KAP Rp 233.00 Rp - 60000 Rp 13,980,000.00
42 ASAM ASKORBAT (VIT C) TAB 50 MG TAB Rp 105.00 5954 Rp 625,170.00 7000 Rp 735,000.00
HARGA SATUAN
No. SATUAN
Rp 105.00 1690 Rp 177,450.00 Rp -
HARGA SATUAN
No. SATUAN
116 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 288.00 1358 Rp 391,104.00 2400 Rp 691,200.00
Rp 55.00 1481 Rp 81,455.00 Rp -
142 INH TAB Rp 145.00 Rp - 600 Rp 87,000.00
HARGA SATUAN
No. SATUAN
HARGA SATUAN
No. SATUAN
221 OBH BTL Rp 1,430.00 Rp - Rp -
222 OBH BTL Rp 1,258.95 Rp - Rp -
223 OBH BTL Rp 2,310.00 Rp - Rp -
224 OBH BTL Rp 2,970.00 Rp - Rp -
Rp 49.00 Rp -
235 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 123.00 Rp - 7000 Rp 861,000.00
HARGA SATUAN
No. SATUAN
Rp 288.00 150 Rp 43,200.00 Rp -
279 ZINC TAB TAB Rp 524.00 Rp - 1000 Rp 524,000.00
295 VIT B KOMPLEKS TABLET TAB Rp 83.00 Rp - 10000 Rp 830,000.00
HARGA SATUAN
No. SATUAN
301 OAT kat 1 Rp 389,344.00 Rp - 16 Rp 6,229,504.00
304 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
Rp 31,570.00 Rp - 24 Rp 757,680.00
305 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
REAGEN LABORATORIUM
1 Reagen Hepatitis B (HBSAg dan Dropper) Rp 10,547.00 Rp - 200 Rp 2,109,400.00
2 Reagen HIV R1 (Standart Diagnostic) Rp 11,975.00 Rp - 200 Rp 2,395,000.00
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 19,480.00 Rp - 5 Rp 97,400.00
6 Standard Q Rp 20,400.00 Rp - 200 Rp 4,080,000.00
7 Reagen Hepatitis B Rp 9,850.00 151 Rp 1,487,350.00 Rp -
JUMLAH TOTAL REAGEN LABORATORIUM Rp 4,513,372.00 Rp 8,681,800.00
HARGA SATUAN
No. SATUAN
Rp 770.00 Rp - Rp -
40 KI 0.5 ml Rp 2,398.00 Rp - Rp -
41 KI 5 ml Rp 2,508.00 Rp - Rp -

TOTAL 108,962,204.82 75,401,100.00
Mengetahui Jombang, 30 MARET 2019

Puskesmas Pulorejo

NIP. 196303031989031014 NIP. 197503122009012002

HARGA SATUAN
No. SATUAN
Stok awal Rp 108,962,204.82

Stok akhir Rp 101,969,259.90
EN

555 Rp 210,900.00 1139 Rp 432,820.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
54 Rp 18,576.00 726 Rp 249,744.00
0 Rp - Rp -
1302 Rp 117,180.00 1903 Rp 171,270.00
0 Rp - Rp -
0 Rp - Rp -
406 Rp 45,553.20 577 Rp 64,739.40
0 Rp - Rp -
2 Rp 6,690.00 21 Rp 70,245.00
0 Rp - 0 Rp -
0 Rp - Rp -
595 Rp 99,365.00 505 Rp 84,335.00
8070 Rp 564,900.00 6373 Rp 446,110.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
12756 Rp 2,972,148.00 47244 Rp 11,007,852.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
13153 Rp 710,262.00 7254 Rp 391,716.00
137 Rp 273,315.00 8 Rp 15,960.00
0 Rp - Rp -
20 Rp 63,340.00 Rp -
14 Rp 42,630.00 57 Rp 173,565.00
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
32 Rp 88,000.00 120 Rp 330,000.00
0 Rp - Rp -
0 Rp - Rp -
6123 Rp 642,915.00 6831 Rp 717,255.00

0 Rp - 0 Rp -
15926 Rp 1,640,378.00 13385 Rp 1,378,655.00
0 Rp - Rp -
2012 Rp 273,632.00 2910 Rp 395,760.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
61 Rp 204,350.00 36 Rp 120,600.00
0 Rp - Rp -
23 Rp 11,385.00 38 Rp 18,810.00
0 Rp - Rp -
0 Rp - 1600 Rp 120,000.00
2798 Rp 235,032.00 2204 Rp 185,136.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
251 Rp 275,347.00 259 Rp 284,123.00
0 Rp - Rp -
0 Rp - Rp -
2301 Rp 73,632.00 472 Rp 15,104.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
91 Rp 7,826.00 1609 Rp 138,374.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
106 Rp 116,070.00 194 Rp 212,430.00
36 Rp 37,800.00 Rp -
92 Rp 9,568.00 108 Rp 11,232.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
752 Rp 78,960.00 938 Rp 98,490.00
0 Rp - Rp -
2628 Rp 223,380.00 3726 Rp 316,710.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
1887 Rp 1,377,510.00 113 Rp 82,490.00
0 Rp - Rp -

0 Rp - Rp -
21 Rp 92,400.00 1027 Rp 4,518,800.00
0 Rp - Rp -
0 Rp - Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 60 Rp 220,920.00
0 Rp - Rp -
0 Rp - Rp -
251 Rp 178,210.00 880 Rp 624,800.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
14 Rp 837,200.00 30 Rp 1,794,000.00
2164 Rp 168,792.00 Rp -
451 Rp 34,727.00 1549 Rp 119,273.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1077 Rp 310,176.00 2681 Rp 772,128.00
0 Rp - Rp -
187 Rp 635,613.00 Rp -
100 Rp 308,300.00 Rp -
0 Rp - Rp -
2040 Rp 242,760.00 3466 Rp 412,454.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 190 Rp 988,000.00
180 Rp 37,800.00 348 Rp 73,080.00
0 Rp - 0 Rp -
592 Rp 32,560.00 889 Rp 48,895.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
45 Rp 111,375.00 47 Rp 116,325.00
0 Rp - 600 Rp 87,000.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - 200 Rp 17,800.00
244 Rp 21,472.00 233 Rp 20,504.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
5133 Rp 302,847.00 3975 Rp 234,525.00
65 Rp 17,550.00 210 Rp 56,700.00
7 Rp 16,660.00 12 Rp 28,560.00
2898 Rp 1,434,510.00 3602 Rp 1,782,990.00
0 Rp - Rp -
0 Rp - Rp -
61 Rp 114,741.00 81 Rp 152,361.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
25 Rp 75,950.00 18 Rp 54,684.00
0 Rp - Rp -
0 Rp - Rp -
17460 Rp 384,120.00 13358 Rp 293,876.00
0 Rp - Rp -
140 Rp 20,580.00 1987 Rp 292,089.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
105 Rp 59,955.00 225 Rp 128,475.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
18 Rp 81,900.00 43 Rp 195,650.00
0 Rp - 140 Rp 1,078,000.00
0 Rp - 80 Rp 752,000.00
0 Rp - Rp -
0 Rp - 60 Rp 68,700.00
75 Rp 138,375.00 51 Rp 94,095.00
880 Rp 108,240.00 40 Rp 4,920.00

0 Rp - Rp -
14 Rp 45,500.00 12 Rp 39,000.00
0 Rp - 24 Rp 81,936.00
0 Rp - Rp -
0 Rp - Rp -
819 Rp 81,900.00 480 Rp 48,000.00
0 Rp - 800 Rp 76,800.00
90 Rp 24,750.00 90 Rp 24,750.00
0 Rp - 36 Rp 96,624.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 12 Rp 76,920.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
0 Rp - 100 Rp 190,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
323 Rp 326,230.00 204 Rp 206,040.00
36363 Rp 1,927,239.00 11883 Rp 629,799.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
902 Rp 110,946.00 6098 Rp 750,054.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
3224 Rp 219,232.00 6776 Rp 460,768.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 569 Rp 46,942.50

0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
3500 Rp 1,809,500.00 500 Rp 258,500.00
350 Rp 99,400.00 150 Rp 42,600.00
150 Rp 43,200.00 Rp -
1303 Rp 9,316,450.00 893 Rp 6,384,950.00
0 Rp - Rp -
0 Rp - Rp -
348 Rp 120,756.00 27 Rp 9,369.00
0 Rp - Rp -
0 Rp - Rp -
469 Rp 30,954.00 795 Rp 52,470.00
0 Rp - 300 Rp 18,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
21 Rp 55,020.00 33 Rp 86,460.00
0 Rp - Rp -
0 Rp - 2 Rp 2,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
10 Rp 1,309,990.00 6 Rp 785,994.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 1000 Rp 524,000.00
1078 Rp 510,972.00 524 Rp 248,376.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 95200 Rp 33,700,800.00
23547 Rp 8,359,185.00 Rp -
28799 Rp 10,194,846.00 32801 Rp 11,611,554.00
70 Rp 21,700.00 Rp -
3721 Rp 316,285.00 5279 Rp 448,715.00
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
455 Rp 36,400.00 168 Rp 13,440.00
0 Rp - 400 Rp 34,000.00
7537 Rp 866,755.00 Rp -
4543 Rp 377,069.00 5457 Rp 452,931.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 6,229,504.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
2 Rp 71,204.00 Rp -
Rp 78,901,210.92 Rp 90,211,337.90 90,211,337.90 Rp 103,932,452.82
13,721,114.92
0 Rp - Rp - Rp 100.00
0 Rp - Rp - 137,211.15
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp -
0 Rp - 200 Rp 2,109,400.00
0 Rp - 200 Rp 2,395,000.00
126 Rp 1,807,344.00 26 Rp 372,944.00
0 Rp - 23 Rp 332,810.00
0 Rp - 3 Rp 59,517.00
5 Rp 97,400.00 Rp -
0 Rp - 17 Rp 453,407.00
0 Rp - 200 Rp 4,080,000.00
120 Rp 1,182,000.00 31 Rp 305,350.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 3,086,744.00 Rp 10,108,428.00 Rp 4,513,372.00
0 Rp - 1000 Rp 1,539,604.00
211 Rp 208,890.00 111 Rp 109,890.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
544 Rp 197,200.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 406,090.00 Rp 1,649,494.00
82,394,044.92 101,969,259.90
Pengelola Obat
Puskesmas Pulorejo

NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
12 AMINOFILIN TAB 200 MG TAB Rp 91.00 Rp - 1000 Rp 91,000.00
Rp 167.00 100 Rp 16,700.00 1000 Rp 167,000.00
24 AMPICILIN INJ Rp 8,237.00 Rp - 2000 Rp 16,474,000.00
42 ASAM ASKORBAT (VIT C) TAB 50 MG TAB Rp 105.00 5954 Rp 625,170.00 14000 Rp 1,470,000.00
HARGA SATUAN
No. SATUAN
51 BETAMETASON CREAM 0,1 % TUB Rp 3,350.00 97 Rp 324,950.00 100 Rp 335,000.00
52 Bisacodyl tablet 5 mg TAB Rp 594.00 Rp - 100 Rp 59,400.00
Rp 105.00 1690 Rp 177,450.00 500 Rp 52,500.00
HARGA SATUAN
No. SATUAN
116 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 288.00 1358 Rp 391,104.00 4800 Rp 1,382,400.00
Rp 55.00 1481 Rp 81,455.00 Rp -
142 INH TAB Rp 145.00 Rp - 600 Rp 87,000.00
HARGA SATUAN
No. SATUAN
167 KHLORAMFENIKOL SYRUP Rp 4,700.00 Rp - 50 Rp 235,000.00
Kloramfenikol kapsul 250 mg Rp 495.00 Rp - 2700 Rp 1,336,500.00
171 KLORAMFENIKOL SK Rp 3,038.00 43 Rp 130,634.00 24 Rp 72,912.00
HARGA SATUAN
No. SATUAN
196 LORATADIN TAB Rp 123.00 920 Rp 113,160.00 400 Rp 49,200.00
197 Magnesium Sulfat injeksi (iv) 40 % - 25 ml BTL Rp 3,796.00 Rp - 12 Rp 45,552.00
198 Magnesium Sulfat injeksi (iv) 20 % - 25 ml Rp 3,328.00 Rp - 12 Rp 39,936.00
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
231 PARASETAMOL SIRUP 120 MG/5ML BTL Rp 1,107.00 Rp - 200 Rp 221,400.00
235 Rp 49.00 Rp -
237 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 123.00 Rp - 9700 Rp 1,193,100.00
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 Rp -
278 Simvastatin tablet 10 mg TAB Rp 110.00 0 Rp - 8400 Rp 924,000.00
282 ZINC TAB TAB Rp 524.00 Rp - 5800 Rp 3,039,200.00
291 Tiamfenikol kapsul 500 mg TAB Rp 739.20 Rp -
294 Tiamin (Vitamin B1) tablet 100 mg TAB Rp 85.00 Rp - 8000 Rp 680,000.00
299 VIT B KOMPLEKS TABLET TAB Rp 83.00 Rp - 20000 Rp 1,660,000.00
HARGA SATUAN
No. SATUAN
305 OAT kat 1 Rp 389,344.00 Rp - 16 Rp 6,229,504.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
REAGEN LABORATORIUM
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 19,480.00 Rp - 5 Rp 97,400.00

TOTAL 108,962,204.82 110,181,595.00
Mengetahui Jombang, 30 April 2019

Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN

NIP. 196303031989031014 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

Stok akhir Rp 121,302,827.10
EN

689 Rp 261,820.00 1005 Rp 381,900.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
60 Rp 20,640.00 720 Rp 247,680.00
0 Rp - Rp -
1588 Rp 142,920.00 1617 Rp 145,530.00
0 Rp - Rp -
0 Rp - Rp -
580 Rp 65,076.00 403 Rp 45,216.60
0 Rp - 1000 Rp 91,000.00
2 Rp 6,690.00 21 Rp 70,245.00
0 Rp - 0 Rp -
0 Rp - Rp -
690 Rp 115,230.00 410 Rp 68,470.00
10735 Rp 751,450.00 6708 Rp 469,560.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
7753 Rp 1,806,449.00 52247 Rp 12,173,551.00
0 Rp - Rp -
0 Rp - 0 Rp -
6 Rp 49,422.00 1994 Rp 16,424,578.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16212 Rp 875,448.00 4195 Rp 226,530.00
140 Rp 279,300.00 5 Rp 9,975.00
0 Rp - Rp -
0 Rp - 20 Rp 63,340.00
34 Rp 103,530.00 37 Rp 112,665.00
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
32 Rp 88,000.00 120 Rp 330,000.00
0 Rp - Rp -
0 Rp - Rp -
7610 Rp 799,050.00 12344 Rp 1,296,120.00

0 Rp - 0 Rp -
21627 Rp 2,227,581.00 17284 Rp 1,780,252.00
0 Rp - Rp -
2378 Rp 323,408.00 3044 Rp 413,984.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
75 Rp 251,250.00 122 Rp 408,700.00
0 Rp - 100 Rp 59,400.00
23 Rp 11,385.00 38 Rp 18,810.00
0 Rp - Rp -
0 Rp - 2000 Rp 150,000.00
3921 Rp 329,364.00 1081 Rp 90,804.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
356 Rp 390,532.00 304 Rp 333,488.00
0 Rp - Rp -
0 Rp - Rp -
10532 Rp 337,024.00 2241 Rp 71,712.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
155 Rp 13,330.00 1545 Rp 132,870.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
145 Rp 158,775.00 245 Rp 268,275.00
36 Rp 37,800.00 Rp -
176 Rp 18,304.00 524 Rp 54,496.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
1043 Rp 109,515.00 1147 Rp 120,435.00
0 Rp - Rp -
3391 Rp 288,235.00 3963 Rp 336,855.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
224 Rp 985,600.00 1124 Rp 4,945,600.00
0 Rp - Rp -
0 Rp - Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 150 Rp 552,300.00
0 Rp - Rp -
0 Rp - Rp -
321 Rp 227,910.00 810 Rp 575,100.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
21 Rp 1,255,800.00 23 Rp 1,375,400.00
2164 Rp 168,792.00 Rp -
1387 Rp 106,799.00 5613 Rp 432,201.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1312 Rp 377,856.00 4846 Rp 1,395,648.00
0 Rp - Rp -
187 Rp 635,613.00 Rp -
195 Rp 601,185.00 Rp -
0 Rp - Rp -
2572 Rp 306,068.00 2934 Rp 349,146.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
190 Rp 988,000.00 0 Rp -
200 Rp 42,000.00 328 Rp 68,880.00
0 Rp - 0 Rp -
890 Rp 48,950.00 591 Rp 32,505.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
58 Rp 143,550.00 34 Rp 84,150.00
0 Rp - 600 Rp 87,000.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - 200 Rp 17,800.00
297 Rp 26,136.00 180 Rp 15,840.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
7137 Rp 421,083.00 6471 Rp 381,789.00
75 Rp 20,250.00 200 Rp 54,000.00
7 Rp 16,660.00 12 Rp 28,560.00
1564 Rp 774,180.00 4936 Rp 2,443,320.00
0 Rp - Rp -
0 Rp - Rp -
77 Rp 144,837.00 65 Rp 122,265.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 50 Rp 235,000.00
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
49 Rp 148,862.00 18 Rp 54,684.00
0 Rp - Rp -
0 Rp - Rp -
22514 Rp 495,308.00 17304 Rp 380,688.00
0 Rp - Rp -
412 Rp 60,564.00 1715 Rp 252,105.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
288 Rp 164,448.00 42 Rp 23,982.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
21 Rp 95,550.00 140 Rp 637,000.00
10 Rp 77,000.00 130 Rp 1,001,000.00
10 Rp 94,000.00 70 Rp 658,000.00
0 Rp - Rp -
0 Rp - 150 Rp 171,750.00
125 Rp 230,625.00 1 Rp 1,845.00

880 Rp 108,240.00 440 Rp 54,120.00
0 Rp - 12 Rp 45,552.00
0 Rp - 12 Rp 39,936.00
14 Rp 45,500.00 12 Rp 39,000.00
0 Rp - 24 Rp 81,936.00
0 Rp - Rp -
0 Rp - Rp -
979 Rp 97,900.00 320 Rp 32,000.00
0 Rp - 800 Rp 76,800.00
120 Rp 33,000.00 260 Rp 71,500.00
0 Rp - 36 Rp 96,624.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
2 Rp 12,820.00 10 Rp 64,100.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
0 Rp - 100 Rp 190,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 200 Rp 221,400.00
493 Rp 497,930.00 34 Rp 34,340.00
46009 Rp 2,438,477.00 2237 Rp 118,561.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
2982 Rp 366,786.00 6718 Rp 826,314.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
6099 Rp 414,732.00 3901 Rp 265,268.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - 569 Rp 46,942.50
0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
3500 Rp 1,809,500.00 500 Rp 258,500.00
350 Rp 99,400.00 150 Rp 42,600.00
150 Rp 43,200.00 Rp -
1836 Rp 13,127,400.00 860 Rp 6,149,000.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
659 Rp 43,494.00 605 Rp 39,930.00
0 Rp - 300 Rp 18,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
27 Rp 70,740.00 51 Rp 133,620.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 2,095,984.00 0 Rp -
0 Rp - Rp -
9 Rp 9,702.00 Rp -
8400 Rp 924,000.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 5800 Rp 3,039,200.00
1518 Rp 719,532.00 84 Rp 39,816.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 95200 Rp 33,700,800.00
23547 Rp 8,359,185.00 Rp -
35955 Rp 12,728,070.00 25645 Rp 9,078,330.00
70 Rp 21,700.00 Rp -
0 Rp - 9000 Rp 765,000.00
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
0 Rp - Rp -
615 Rp 49,200.00 8 Rp 640.00
0 Rp - 400 Rp 34,000.00
7537 Rp 866,755.00 Rp -
8670 Rp 719,610.00 11330 Rp 940,390.00

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 6,229,504.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
2 Rp 71,204.00 Rp -
Rp 94,331,308.72 Rp 109,561,735.10 109,561,735.10 Rp 103,932,452.82
(5,629,282.28)
0 Rp - Rp - Rp 100.00
0 Rp - Rp - (56,292.82)
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp -
0 Rp - 200 Rp 2,109,400.00
0 Rp - 200 Rp 2,395,000.00
126 Rp 1,807,344.00 26 Rp 372,944.00
0 Rp - 23 Rp 332,810.00
0 Rp - 3 Rp 59,517.00
5 Rp 97,400.00 Rp -
0 Rp - 17 Rp 453,407.00
0 Rp - 200 Rp 4,080,000.00
120 Rp 1,182,000.00 31 Rp 305,350.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 3,086,744.00 Rp 10,108,428.00 Rp 4,513,372.00
0 Rp - 1000 Rp 1,539,604.00
228 Rp 225,720.00 94 Rp 93,060.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
544 Rp 197,200.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 422,920.00 Rp 1,632,664.00
97,840,972.72 121,302,827.10
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
Rp 167.00 100 Rp 16,700.00 1000 Rp 167,000.00
32 ANTASID TAB, MGOH3 + ALOH3 AA200MG TAB Rp 54.00 20407 Rp 1,101,978.00 16800 Rp 907,200.00
HARGA SATUAN
No. SATUAN
Rp 105.00 1690 Rp 177,450.00 500 Rp 52,500.00
HARGA SATUAN
No. SATUAN
Rp 55.00 1481 Rp 81,455.00 Rp -
142 INH TAB Rp 145.00 Rp - 600 Rp 87,000.00
HARGA SATUAN
No. SATUAN
HARGA SATUAN
No. SATUAN
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
233 PARASETAMOL TABLET 500 MG TAB Rp 53.00 31746 Rp 1,682,538.00 33000 Rp 1,749,000.00
235 Rp 49.00 Rp -
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 Rp -
HARGA SATUAN
No. SATUAN
305 OAT kat 1 Rp 389,344.00 Rp - 16 Rp 6,229,504.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
REAGEN LABORATORIUM
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 19,480.00 Rp - 5 Rp 97,400.00
26 KASA PEMBALUT 16MX16CM ROL Rp 362.50 544 Rp 197,200.00 320 Rp 116,000.00
44 Urin bag BIJI Rp 3,000.00 Rp - 20 Rp 60,000.00

TOTAL 108,962,204.82 112,421,295.00
Mengetahui Jombang, 30 Mei 2019

Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN

NIP. 196303031989031014 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

Stok akhir Rp 113,986,160.10
EN

809 Rp 307,420.00 885 Rp 336,300.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
64 Rp 22,016.00 716 Rp 246,304.00
0 Rp - Rp -
1913 Rp 172,170.00 1292 Rp 116,280.00
0 Rp - Rp -
0 Rp - Rp -
735 Rp 82,467.00 248 Rp 27,825.60
0 Rp - 1000 Rp 91,000.00
2 Rp 6,690.00 21 Rp 70,245.00
0 Rp - 0 Rp -
0 Rp - Rp -
805 Rp 134,435.00 295 Rp 49,265.00
12943 Rp 906,010.00 4500 Rp 315,000.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
11826 Rp 2,755,458.00 48174 Rp 11,224,542.00
0 Rp - Rp -
0 Rp - 0 Rp -
22 Rp 181,214.00 1978 Rp 16,292,786.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
19006 Rp 1,026,324.00 18201 Rp 982,854.00
74 Rp 147,630.00 71 Rp 141,645.00
0 Rp - Rp -
0 Rp - 20 Rp 63,340.00
67 Rp 204,015.00 4 Rp 12,180.00
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
41 Rp 112,750.00 111 Rp 305,250.00
0 Rp - Rp -
0 Rp - Rp -
8909 Rp 935,445.00 11045 Rp 1,159,725.00

0 Rp - 0 Rp -
25860 Rp 2,663,580.00 13051 Rp 1,344,253.00
0 Rp - Rp -
2900 Rp 394,400.00 2522 Rp 342,992.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
87 Rp 291,450.00 110 Rp 368,500.00
0 Rp - 100 Rp 59,400.00
37 Rp 18,315.00 24 Rp 11,880.00
0 Rp - Rp -
567 Rp 42,525.00 1433 Rp 107,475.00
5002 Rp 420,168.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
399 Rp 437,703.00 261 Rp 286,317.00
0 Rp - Rp -
0 Rp - Rp -
3977 Rp 127,264.00 8796 Rp 281,472.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
274 Rp 23,564.00 1426 Rp 122,636.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
173 Rp 189,435.00 217 Rp 237,615.00
36 Rp 37,800.00 Rp -
196 Rp 20,384.00 504 Rp 52,416.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
1704 Rp 178,920.00 486 Rp 51,030.00
0 Rp - Rp -
3849 Rp 327,165.00 3505 Rp 297,925.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
234 Rp 1,029,600.00 1114 Rp 4,901,600.00
0 Rp - Rp -
0 Rp - Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 150 Rp 552,300.00
0 Rp - Rp -
0 Rp - Rp -
474 Rp 336,540.00 657 Rp 466,470.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
28 Rp 1,674,400.00 16 Rp 956,800.00
2164 Rp 168,792.00 Rp -
2296 Rp 176,792.00 4704 Rp 362,208.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1295 Rp 372,960.00 4863 Rp 1,400,544.00
0 Rp - Rp -
155 Rp 526,845.00 32 Rp 108,768.00
195 Rp 601,185.00 Rp -
0 Rp - Rp -
3102 Rp 369,138.00 2404 Rp 286,076.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
190 Rp 988,000.00 0 Rp -
200 Rp 42,000.00 328 Rp 68,880.00
0 Rp - 0 Rp -
1040 Rp 57,200.00 441 Rp 24,255.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
70 Rp 173,250.00 22 Rp 54,450.00
0 Rp - 600 Rp 87,000.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - 200 Rp 17,800.00
327 Rp 28,776.00 150 Rp 13,200.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
8757 Rp 516,663.00 4851 Rp 286,209.00
85 Rp 22,950.00 190 Rp 51,300.00
7 Rp 16,660.00 12 Rp 28,560.00
2402 Rp 1,188,990.00 4098 Rp 2,028,510.00
0 Rp - Rp -
0 Rp - Rp -
96 Rp 180,576.00 46 Rp 86,526.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1 Rp 4,700.00 49 Rp 230,300.00
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
47 Rp 142,786.00 20 Rp 60,760.00
0 Rp - Rp -
0 Rp - Rp -
27018 Rp 594,396.00 12800 Rp 281,600.00
0 Rp - Rp -
824 Rp 121,128.00 1303 Rp 191,541.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
388 Rp 221,548.00 242 Rp 138,182.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
27 Rp 122,850.00 134 Rp 609,700.00
10 Rp 77,000.00 130 Rp 1,001,000.00
10 Rp 94,000.00 70 Rp 658,000.00
0 Rp - Rp -
13 Rp 14,885.00 137 Rp 156,865.00
126 Rp 232,470.00 0 Rp -

880 Rp 108,240.00 440 Rp 54,120.00
12 Rp 45,552.00 0 Rp -
12 Rp 39,936.00 0 Rp -
19 Rp 61,750.00 7 Rp 22,750.00
0 Rp - 24 Rp 81,936.00
0 Rp - Rp -
0 Rp - Rp -
1159 Rp 115,900.00 140 Rp 14,000.00
0 Rp - 800 Rp 76,800.00
170 Rp 46,750.00 210 Rp 57,750.00
0 Rp - 36 Rp 96,624.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
2 Rp 12,820.00 10 Rp 64,100.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
18 Rp 34,200.00 82 Rp 155,800.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
44 Rp 48,708.00 256 Rp 283,392.00
527 Rp 532,270.00 0 Rp -
52071 Rp 2,759,763.00 12675 Rp 671,775.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
4584 Rp 563,832.00 5116 Rp 629,268.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
8070 Rp 548,760.00 1930 Rp 131,240.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - 569 Rp 46,942.50
0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
3500 Rp 1,809,500.00 500 Rp 258,500.00
350 Rp 99,400.00 150 Rp 42,600.00
150 Rp 43,200.00 Rp -
1940 Rp 13,871,000.00 756 Rp 5,405,400.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
746 Rp 49,236.00 518 Rp 34,188.00
0 Rp - 300 Rp 18,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
40 Rp 104,800.00 38 Rp 99,560.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 2,095,984.00 0 Rp -
0 Rp - Rp -
9 Rp 9,702.00 Rp -
125 Rp 13,750.00 8275 Rp 910,250.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
72 Rp 37,728.00 5728 Rp 3,001,472.00
1602 Rp 759,348.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 95200 Rp 33,700,800.00
23547 Rp 8,359,185.00 Rp -
48368 Rp 17,122,272.00 13232 Rp 4,684,128.00
70 Rp 21,700.00 Rp -
1877 Rp 159,545.00 7123 Rp 605,455.00
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
0 Rp - Rp -
623 Rp 49,840.00 0 Rp -
227 Rp 19,295.00 173 Rp 14,705.00
7537 Rp 866,755.00 Rp -
11520 Rp 956,160.00 8480 Rp 703,840.00

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 6,229,504.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
2 Rp 71,204.00 Rp -
Rp 103,739,975.72 Rp 102,216,768.10
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp -
0 Rp - 200 Rp 2,109,400.00
0 Rp - 200 Rp 2,395,000.00
126 Rp 1,807,344.00 26 Rp 372,944.00
0 Rp - 23 Rp 332,810.00
0 Rp - 3 Rp 59,517.00
5 Rp 97,400.00 Rp -
0 Rp - 17 Rp 453,407.00
0 Rp - 200 Rp 4,080,000.00
120 Rp 1,182,000.00 31 Rp 305,350.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 3,086,744.00 Rp 10,108,428.00
0 Rp - 1000 Rp 1,539,604.00
258 Rp 255,420.00 64 Rp 63,360.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
704 Rp 255,200.00 160 Rp 58,000.00
0 Rp - Rp -
20 Rp 60,000.00 Rp -
0 Rp - Rp -
Rp 570,620.00 Rp 1,660,964.00
107,397,339.72 113,986,160.10
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
Rp 167.00 100 Rp 16,700.00 1200 Rp 200,400.00
32 ANTASID TAB, MGOH3 + ALOH3 AA200MG TAB Rp 54.00 20407 Rp 1,101,978.00 33600 Rp 1,814,400.00
HARGA SATUAN
No. SATUAN
Rp 105.00 1690 Rp 177,450.00 1500 Rp 157,500.00
HARGA SATUAN
No. SATUAN
107 FITOMENADION TAB SALUT 10 MG TAB Rp 710.00 1131 Rp 803,010.00 200 Rp 142,000.00
Rp 55.00 1481 Rp 81,455.00 300 Rp 16,500.00
142 INH TAB Rp 145.00 Rp - 600 Rp 87,000.00
HARGA SATUAN
No. SATUAN
HARGA SATUAN
No. SATUAN
212 Natrium Diklofenak tablet 50 mg BTL Rp 115.00 Rp - 2800 Rp 322,000.00
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
235 Rp 49.00 Rp -
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 Rp -
HARGA SATUAN
No. SATUAN
305 OAT kat 1 Rp 389,344.00 Rp - 16 Rp 6,229,504.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
REAGEN LABORATORIUM
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 19,480.00 Rp - 5 Rp 97,400.00
6 Rp 20,400.00 Rp - 300 Rp 6,120,000.00
7 Reagen Hepatitis B Rp 9,850.00 151 Rp 1,487,350.00 100 Rp 985,000.00

TOTAL 108,962,204.82 126,040,173.00
Mengetahui Jombang, 30 Juni 2019

Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN

NIP. 196303031989031014 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

Stok akhir Rp 105,764,466.90
EN

1007 Rp 382,660.00 687 Rp 261,060.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
72 Rp 24,768.00 708 Rp 243,552.00
0 Rp - Rp -
2169 Rp 195,210.00 1036 Rp 93,240.00
0 Rp - Rp -
0 Rp - Rp -
861 Rp 96,604.20 122 Rp 13,688.40
0 Rp - 1000 Rp 91,000.00
2 Rp 6,690.00 21 Rp 70,245.00
0 Rp - 0 Rp -
0 Rp - Rp -
855 Rp 142,785.00 445 Rp 74,315.00
14415 Rp 1,009,050.00 5128 Rp 358,960.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
15127 Rp 3,524,591.00 44873 Rp 10,455,409.00
0 Rp - Rp -
0 Rp - 0 Rp -
43 Rp 354,191.00 1957 Rp 16,119,809.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
20727 Rp 1,119,258.00 33280 Rp 1,797,120.00
92 Rp 183,540.00 53 Rp 105,735.00
0 Rp - Rp -
0 Rp - 60 Rp 190,020.00
70 Rp 213,150.00 1 Rp 3,045.00
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
49 Rp 134,750.00 103 Rp 283,250.00
0 Rp - Rp -
0 Rp - Rp -
10321 Rp 1,083,705.00 11633 Rp 1,221,465.00

0 Rp - 0 Rp -
32913 Rp 3,390,039.00 9498 Rp 978,294.00
0 Rp - Rp -
3559 Rp 484,024.00 2463 Rp 334,968.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
95 Rp 318,250.00 102 Rp 341,700.00
0 Rp - 100 Rp 59,400.00
47 Rp 23,265.00 14 Rp 6,930.00
0 Rp - Rp -
1439 Rp 107,925.00 2561 Rp 192,075.00
5002 Rp 420,168.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
439 Rp 481,583.00 271 Rp 297,287.00
0 Rp - Rp -
0 Rp - Rp -
5119 Rp 163,808.00 17654 Rp 564,928.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
386 Rp 33,196.00 1314 Rp 113,004.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
217 Rp 237,615.00 233 Rp 255,135.00
36 Rp 37,800.00 Rp -
206 Rp 21,424.00 494 Rp 51,376.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
1962 Rp 206,010.00 1228 Rp 128,940.00
0 Rp - Rp -
4335 Rp 368,475.00 3019 Rp 256,615.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
238 Rp 1,047,200.00 1110 Rp 4,884,000.00
0 Rp - Rp -
0 Rp - Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 150 Rp 552,300.00
0 Rp - Rp -
0 Rp - Rp -
597 Rp 423,870.00 734 Rp 521,140.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
28 Rp 1,674,400.00 16 Rp 956,800.00
2164 Rp 168,792.00 Rp -
3059 Rp 235,543.00 3941 Rp 303,457.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1624 Rp 467,712.00 4534 Rp 1,305,792.00
0 Rp - Rp -
186 Rp 632,214.00 1 Rp 3,399.00
195 Rp 601,185.00 Rp -
0 Rp - Rp -
3602 Rp 428,638.00 1904 Rp 226,576.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
190 Rp 988,000.00 Rp -
220 Rp 46,200.00 508 Rp 106,680.00
0 Rp - Rp -
1165 Rp 64,075.00 616 Rp 33,880.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
79 Rp 195,525.00 13 Rp 32,175.00
0 Rp - 600 Rp 87,000.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - 200 Rp 17,800.00
402 Rp 35,376.00 75 Rp 6,600.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
10394 Rp 613,246.00 8214 Rp 484,626.00
205 Rp 55,350.00 70 Rp 18,900.00
7 Rp 16,660.00 12 Rp 28,560.00
3259 Rp 1,613,205.00 3241 Rp 1,604,295.00
0 Rp - Rp -
0 Rp - Rp -
115 Rp 216,315.00 99 Rp 186,219.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
2 Rp 9,400.00 48 Rp 225,600.00
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
50 Rp 151,900.00 17 Rp 51,646.00
0 Rp - Rp -
0 Rp - Rp -
30536 Rp 671,792.00 13282 Rp 292,204.00
0 Rp - Rp -
1099 Rp 161,553.00 1028 Rp 151,116.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
452 Rp 258,092.00 178 Rp 101,638.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
31 Rp 141,050.00 130 Rp 591,500.00
10 Rp 77,000.00 130 Rp 1,001,000.00
10 Rp 94,000.00 70 Rp 658,000.00
0 Rp - Rp -
43 Rp 49,235.00 137 Rp 156,865.00
126 Rp 232,470.00 0 Rp -

940 Rp 115,620.00 380 Rp 46,740.00
12 Rp 45,552.00 24 Rp 91,104.00
12 Rp 39,936.00 24 Rp 79,872.00
26 Rp 84,500.00 Rp -
1 Rp 3,414.00 23 Rp 78,522.00
0 Rp - Rp -
0 Rp - Rp -
1249 Rp 124,900.00 50 Rp 5,000.00
0 Rp - 1800 Rp 172,800.00
220 Rp 60,500.00 160 Rp 44,000.00
0 Rp - 36 Rp 96,624.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 2800 Rp 322,000.00
0 Rp - Rp -
2 Rp 12,820.00 10 Rp 64,100.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
30 Rp 57,000.00 70 Rp 133,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
106 Rp 117,342.00 294 Rp 325,458.00
527 Rp 532,270.00 0 Rp -
57732 Rp 3,059,796.00 23514 Rp 1,246,242.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
5919 Rp 728,037.00 10781 Rp 1,326,063.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
9669 Rp 657,492.00 331 Rp 22,508.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - 569 Rp 46,942.50
0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
3500 Rp 1,809,500.00 500 Rp 258,500.00
350 Rp 99,400.00 150 Rp 42,600.00
150 Rp 43,200.00 Rp -
2162 Rp 15,458,300.00 534 Rp 3,818,100.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
826 Rp 54,516.00 438 Rp 28,908.00
0 Rp - 300 Rp 18,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
49 Rp 128,380.00 29 Rp 75,980.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 2,095,984.00 10 Rp 1,309,990.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
295 Rp 32,450.00 8105 Rp 891,550.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
402 Rp 210,648.00 5398 Rp 2,828,552.00
1602 Rp 759,348.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
2978 Rp 1,054,212.00 92222 Rp 32,646,588.00
23547 Rp 8,359,185.00 Rp -
61600 Rp 21,806,400.00 Rp -
70 Rp 21,700.00 Rp -
4159 Rp 353,515.00 4841 Rp 411,485.00
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
0 Rp - Rp -
623 Rp 49,840.00 0 Rp -
377 Rp 32,045.00 523 Rp 44,455.00
7537 Rp 866,755.00 Rp -
13760 Rp 1,142,080.00 16240 Rp 1,347,920.00

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 6,229,504.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
2 Rp 71,204.00 Rp -
Rp 116,270,168.92 Rp 97,619,452.90
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp -
115 Rp 1,212,905.00 85 Rp 896,495.00

227 Rp 2,718,325.00 173 Rp 2,071,675.00
152 Rp 2,180,288.00 Rp -
1 Rp 14,470.00 22 Rp 318,340.00
3 Rp 59,517.00 Rp -
0 Rp - 5 Rp 97,400.00
17 Rp 453,407.00 Rp -
158 Rp 3,223,200.00 142 Rp 2,896,800.00
251 Rp 2,472,350.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 12,334,462.00 Rp 6,280,710.00
0 Rp - 1000 Rp 1,539,604.00
292 Rp 289,080.00 30 Rp 29,700.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
784 Rp 284,200.00 400 Rp 145,000.00
0 Rp - Rp -
20 Rp 60,000.00 50 Rp 150,000.00
0 Rp - Rp -
Rp 633,280.00 Rp 1,864,304.00
129,237,910.92 105,764,466.90
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
Rp 167.00 100 Rp 16,700.00 1200 Rp 200,400.00
HARGA SATUAN
No. SATUAN
Rp 105.00 1690 Rp 177,450.00 1500 Rp 157,500.00
HARGA SATUAN
No. SATUAN
Rp 55.00 1481 Rp 81,455.00 300 Rp 16,500.00
142 INH TAB Rp 145.00 Rp - 600 Rp 87,000.00
HARGA SATUAN
No. SATUAN
HARGA SATUAN
No. SATUAN
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
235 Rp 49.00 Rp -
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 Rp -
HARGA SATUAN
No. SATUAN
305 OAT kat 1 Rp 389,344.00 Rp - 16 Rp 6,229,504.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
REAGEN LABORATORIUM
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 19,480.00 Rp - 5 Rp 97,400.00
6 Rp 20,400.00 Rp - 300 Rp 6,120,000.00

TOTAL 108,962,204.82 128,435,173.00
Mengetahui Jombang, 30 Juli 2019

Kepala Puskesmas Pulorejo Pengurus Barang Pembantu
Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN
dr. RITA ANDAYANI MEIN YULIANA

NIP. 1977050920110120003 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

EN

1146 Rp 435,480.00 548 Rp 208,240.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
780 Rp 268,320.00 0 Rp -
0 Rp - Rp -
2561 Rp 230,490.00 644 Rp 57,960.00
0 Rp - Rp -
0 Rp - Rp -
961 Rp 107,824.20 22 Rp 2,468.40
0 Rp - 1000 Rp 91,000.00
2 Rp 6,690.00 21 Rp 70,245.00
0 Rp - 0 Rp -
0 Rp - Rp -
915 Rp 152,805.00 385 Rp 64,295.00
16956 Rp 1,186,920.00 2587 Rp 181,090.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
19132 Rp 4,457,756.00 40868 Rp 9,522,244.00
0 Rp - Rp -
0 Rp - 0 Rp -
101 Rp 831,937.00 1899 Rp 15,642,063.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
23489 Rp 1,268,406.00 30518 Rp 1,647,972.00
111 Rp 221,445.00 34 Rp 67,830.00
0 Rp - Rp -
32 Rp 101,344.00 28 Rp 88,676.00
71 Rp 216,195.00 0 Rp -
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
56 Rp 154,000.00 96 Rp 264,000.00
0 Rp - Rp -
0 Rp - Rp -
11900 Rp 1,249,500.00 10054 Rp 1,055,670.00

0 Rp - 0 Rp -
38507 Rp 3,966,221.00 3904 Rp 402,112.00
0 Rp - Rp -
4365 Rp 593,640.00 1657 Rp 225,352.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
110 Rp 368,500.00 87 Rp 291,450.00
0 Rp - 100 Rp 59,400.00
47 Rp 23,265.00 14 Rp 6,930.00
0 Rp - Rp -
2080 Rp 156,000.00 1920 Rp 144,000.00
5002 Rp 420,168.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
477 Rp 523,269.00 233 Rp 255,601.00
0 Rp - Rp -
0 Rp - Rp -
7946 Rp 254,272.00 14827 Rp 474,464.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
576 Rp 49,536.00 1124 Rp 96,664.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
242 Rp 264,990.00 208 Rp 227,760.00
36 Rp 37,800.00 Rp -
294 Rp 30,576.00 406 Rp 42,224.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
2754 Rp 289,170.00 436 Rp 45,780.00
0 Rp - Rp -
4784 Rp 406,640.00 2570 Rp 218,450.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
361 Rp 1,588,400.00 987 Rp 4,342,800.00
0 Rp - Rp -
0 Rp - Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 150 Rp 552,300.00
0 Rp - Rp -
0 Rp - Rp -
897 Rp 636,870.00 434 Rp 308,140.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
44 Rp 2,631,200.00 0 Rp -
2164 Rp 168,792.00 Rp -
4007 Rp 308,539.00 2993 Rp 230,461.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
5555 Rp 1,599,840.00 603 Rp 173,664.00
0 Rp - Rp -
187 Rp 635,613.00 0 Rp -
195 Rp 601,185.00 Rp -
0 Rp - Rp -
4187 Rp 498,253.00 1319 Rp 156,961.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
190 Rp 988,000.00 Rp -
440 Rp 92,400.00 288 Rp 60,480.00
0 Rp - Rp -
1350 Rp 74,250.00 431 Rp 23,705.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
87 Rp 215,325.00 5 Rp 12,375.00
100 Rp 14,500.00 500 Rp 72,500.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
42 Rp 3,738.00 158 Rp 14,062.00
477 Rp 41,976.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
12866 Rp 759,094.00 5742 Rp 338,778.00
225 Rp 60,750.00 50 Rp 13,500.00
7 Rp 16,660.00 12 Rp 28,560.00
4263 Rp 2,110,185.00 2237 Rp 1,107,315.00
0 Rp - Rp -
0 Rp - Rp -
140 Rp 263,340.00 74 Rp 139,194.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
6 Rp 28,200.00 44 Rp 206,800.00
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
52 Rp 157,976.00 15 Rp 45,570.00
0 Rp - Rp -
0 Rp - Rp -
34483 Rp 758,626.00 9335 Rp 205,370.00
0 Rp - Rp -
1577 Rp 231,819.00 550 Rp 80,850.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
630 Rp 359,730.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
32 Rp 145,600.00 129 Rp 586,950.00
10 Rp 77,000.00 130 Rp 1,001,000.00
80 Rp 752,000.00 0 Rp -
0 Rp - Rp -
118 Rp 135,110.00 62 Rp 70,990.00
126 Rp 232,470.00 0 Rp -

1180 Rp 145,140.00 140 Rp 17,220.00
12 Rp 45,552.00 24 Rp 91,104.00
12 Rp 39,936.00 24 Rp 79,872.00
26 Rp 84,500.00 Rp -
10 Rp 34,140.00 14 Rp 47,796.00
0 Rp - Rp -
0 Rp - Rp -
1299 Rp 129,900.00 0 Rp -
130 Rp 12,480.00 1670 Rp 160,320.00
250 Rp 68,750.00 130 Rp 35,750.00
0 Rp - 36 Rp 96,624.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
600 Rp 69,000.00 2200 Rp 253,000.00
0 Rp - Rp -
7 Rp 44,870.00 5 Rp 32,050.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
38 Rp 72,200.00 62 Rp 117,800.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
171 Rp 189,297.00 229 Rp 253,503.00
527 Rp 532,270.00 0 Rp -
65161 Rp 3,453,533.00 16085 Rp 852,505.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
7490 Rp 921,270.00 9210 Rp 1,132,830.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
9930 Rp 675,240.00 70 Rp 4,760.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
62 Rp 5,115.00 507 Rp 41,827.50
0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
3500 Rp 1,809,500.00 500 Rp 258,500.00
350 Rp 99,400.00 150 Rp 42,600.00
150 Rp 43,200.00 Rp -
2425 Rp 17,338,750.00 271 Rp 1,937,650.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
974 Rp 64,284.00 290 Rp 19,140.00
0 Rp - 300 Rp 18,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
52 Rp 136,240.00 26 Rp 68,120.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
23 Rp 3,012,977.00 3 Rp 392,997.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
786 Rp 86,460.00 7614 Rp 837,540.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
727 Rp 380,948.00 5073 Rp 2,658,252.00
1602 Rp 759,348.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
8578 Rp 3,036,612.00 86622 Rp 30,664,188.00
23547 Rp 8,359,185.00 Rp -
61600 Rp 21,806,400.00 Rp -
70 Rp 21,700.00 Rp -
7175 Rp 609,875.00 1825 Rp 155,125.00
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
0 Rp - Rp -
623 Rp 49,840.00 0 Rp -
685 Rp 58,225.00 215 Rp 18,275.00
7537 Rp 866,755.00 Rp -
16454 Rp 1,365,682.00 13546 Rp 1,124,318.00

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
16 Rp 6,229,504.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
2 Rp 71,204.00 Rp -
Rp 131,008,173.92 Rp 82,881,447.90
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp - Rp -
115 Rp 1,212,905.00 85 Rp 896,495.00

227 Rp 2,718,325.00 373 Rp 4,466,675.00
152 Rp 2,180,288.00 Rp -
1 Rp 14,470.00 22 Rp 318,340.00
3 Rp 59,517.00 Rp -
0 Rp - 5 Rp 97,400.00
17 Rp 453,407.00 Rp -
158 Rp 3,223,200.00 142 Rp 2,896,800.00
251 Rp 2,472,350.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 12,334,462.00 Rp 8,675,710.00
3 Rp 4,618.81 997 Rp 1,534,985.19

322 Rp 318,780.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
944 Rp 342,200.00 240 Rp 87,000.00
0 Rp - Rp -
20 Rp 60,000.00 50 Rp 150,000.00
0 Rp - Rp -
Rp 725,598.81 Rp 1,771,985.19
144,068,234.73 93,329,143.09
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
5 Albendazol tablet 400 mg Rp 404.00 Rp - 7560 Rp 3,054,240.00
Rp 167.00 100 Rp 16,700.00 1200 Rp 200,400.00
16 AMLODIPIN TAB TAB Rp 70.00 7243 Rp 507,010.00 17400 Rp 1,218,000.00
HARGA SATUAN
No. SATUAN
43 Asam Asetil salisilat 80 mg (asetosal ) Rp 99.00 0 Rp - 2000 Rp 198,000.00
Rp 105.00 1690 Rp 177,450.00 3500 Rp 367,500.00
86 Domperidon tablet 10 mg TAB Rp 91.00 Rp - 500 Rp 45,500.00
HARGA SATUAN
No. SATUAN
97 EUGENOL CAIRAN BTL Rp 18,824.00 0 Rp - 1 Rp 18,824.00
115 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 257.00 Rp - 1800 Rp 462,600.00
Rp 55.00 1481 Rp 81,455.00 800 Rp 44,000.00
134 Haldol Decanoat 50 mg/ml inj AMP Rp 101,300.00 Rp - 20 Rp 2,026,000.00
142 INH TAB Rp 145.00 Rp - 600 Rp 87,000.00
HARGA SATUAN
No. SATUAN
149 KALSIUM GLUKONAT INJ TAB Rp 9,955.00 Rp - 24 Rp 238,920.00
HARGA SATUAN
No. SATUAN
Rp 210.00 Rp - 100 Rp 21,000.00
Rp 2,959.00 Rp - 100 Rp 295,900.00
211 NA CL LAR INFUS 0,9 % STERIL BTL Rp 6,410.00 Rp - 100 Rp 641,000.00
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
228 OKSITETRASIKLIN HCL SALEP MATA 3% TUBE Rp 2,500.00 Rp - 100 Rp 250,000.00
229 Omeprazol kapsul 20 mg Rp 139.00 Rp - 1500 Rp 208,500.00
235 Rp 49.00 Rp -
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 2250 Rp 648,000.00
Rp 91.00 Rp - 12000 Rp 1,092,000.00
HARGA SATUAN
No. SATUAN
305 OAT kat 1 Rp 389,344.00 Rp - 26 Rp 10,122,944.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
Rp 41,784.00 Rp - 6 Rp 250,704.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
1 EUGENOL CAIRAN BTL Rp 18,824.00 Rp - Rp -
2 ETIL KHLORIDA SEMPROT BTL Rp 444,027.00 Rp - 2 Rp 888,054.00
3 CHKM BTL Rp 66,200.00 Rp - 1 Rp 66,200.00
JUMLAH TOTAL OBAT GIGI Rp - Rp 954,254.00
REAGEN LABORATORIUM
Rp 9,850.00 Rp - 200 Rp 1,970,000.00
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 13,235.00 Rp - 10 Rp 132,350.00
Rp 19,480.00 Rp - 5 Rp 97,400.00
Rp 20,400.00 Rp - 300 Rp 6,120,000.00
Rp 9,611.00 Rp - 200 Rp 1,922,200.00

TOTAL 108,962,204.82 163,113,033.00
Mengetahui Jombang, 30 Agustus 2019

Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN

NIP. 1977050920110120003 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

Stok akhir Rp 100,861,894.57
EN

1216 Rp 462,080.00 478 Rp 181,640.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
7560 Rp 3,054,240.00 Rp -
780 Rp 268,320.00 0 Rp -
0 Rp - Rp -
3027 Rp 272,430.00 1178 Rp 106,020.00
0 Rp - Rp -
0 Rp - 2400 Rp 213,600.00
983 Rp 110,292.60 0 Rp -
820 Rp 74,620.00 180 Rp 16,380.00
23 Rp 76,935.00 0 Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
955 Rp 159,485.00 345 Rp 57,615.00
19037 Rp 1,332,590.00 5606 Rp 392,420.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
23405 Rp 5,453,365.00 36595 Rp 8,526,635.00
0 Rp - Rp -
0 Rp - 0 Rp -
147 Rp 1,210,839.00 1853 Rp 15,263,161.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
26293 Rp 1,419,822.00 27714 Rp 1,496,556.00
128 Rp 255,360.00 17 Rp 33,915.00
0 Rp - Rp -
36 Rp 114,012.00 124 Rp 392,708.00
71 Rp 216,195.00 0 Rp -
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
68 Rp 187,000.00 84 Rp 231,000.00
0 Rp - Rp -
0 Rp - Rp -
13782 Rp 1,447,110.00 11172 Rp 1,173,060.00

2000 Rp 198,000.00 0 Rp -
43231 Rp 4,452,793.00 28780 Rp 2,964,340.00
0 Rp - Rp -
5179 Rp 704,344.00 3343 Rp 454,648.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
118 Rp 395,300.00 179 Rp 599,650.00
0 Rp - 100 Rp 59,400.00
57 Rp 28,215.00 4 Rp 1,980.00
1500 Rp 102,000.00 Rp -
1104 Rp 82,800.00 2896 Rp 217,200.00
5002 Rp 420,168.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
505 Rp 553,985.00 255 Rp 279,735.00
0 Rp - Rp -
0 Rp - Rp -
11326 Rp 362,432.00 16447 Rp 526,304.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
666 Rp 57,276.00 1034 Rp 88,924.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
251 Rp 274,845.00 229 Rp 250,755.00
36 Rp 37,800.00 Rp -
447 Rp 46,488.00 253 Rp 26,312.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
3186 Rp 334,530.00 2004 Rp 210,420.00
500 Rp 45,500.00 Rp -
4869 Rp 413,865.00 2485 Rp 211,225.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
721 Rp 3,172,400.00 627 Rp 2,758,800.00
0 Rp - Rp -
1 Rp 18,824.00 Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 180 Rp 662,760.00
0 Rp - Rp -
0 Rp - Rp -
977 Rp 693,670.00 1054 Rp 748,340.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
44 Rp 2,631,200.00 0 Rp -
2164 Rp 168,792.00 Rp -
4832 Rp 372,064.00 2168 Rp 166,936.00
0 Rp - Rp -
0 Rp - Rp -
1800 Rp 462,600.00 Rp -
4148 Rp 1,194,624.00 2010 Rp 578,880.00
0 Rp - Rp -
187 Rp 635,613.00 0 Rp -
195 Rp 601,185.00 Rp -
0 Rp - Rp -
4971 Rp 591,549.00 1535 Rp 182,665.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
190 Rp 988,000.00 Rp -
490 Rp 102,900.00 838 Rp 175,980.00
0 Rp - Rp -
1500 Rp 82,500.00 781 Rp 42,955.00
0 Rp - Rp -
0 Rp - Rp -
20 Rp 2,026,000.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
92 Rp 227,700.00 0 Rp -
100 Rp 14,500.00 500 Rp 72,500.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
198 Rp 17,622.00 502 Rp 44,678.00
477 Rp 41,976.00 Rp -
24 Rp 238,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
14669 Rp 865,471.00 8439 Rp 497,901.00
235 Rp 63,450.00 40 Rp 10,800.00
7 Rp 16,660.00 12 Rp 28,560.00
5133 Rp 2,540,835.00 1367 Rp 676,665.00
0 Rp - Rp -
0 Rp - Rp -
157 Rp 295,317.00 57 Rp 107,217.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
5 Rp 23,500.00 45 Rp 211,500.00
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
56 Rp 170,128.00 35 Rp 106,330.00
0 Rp - Rp -
0 Rp - Rp -
38698 Rp 851,356.00 11620 Rp 255,640.00
0 Rp - Rp -
1955 Rp 287,385.00 1372 Rp 201,684.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1130 Rp 645,230.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
161 Rp 732,550.00 0 Rp -
10 Rp 77,000.00 130 Rp 1,001,000.00
80 Rp 752,000.00 0 Rp -
0 Rp - Rp -
130 Rp 148,850.00 260 Rp 297,700.00
126 Rp 232,470.00 0 Rp -

1270 Rp 156,210.00 750 Rp 92,250.00
12 Rp 45,552.00 24 Rp 91,104.00
12 Rp 39,936.00 24 Rp 79,872.00
26 Rp 84,500.00 Rp -
10 Rp 34,140.00 38 Rp 129,732.00
0 Rp - Rp -
0 Rp - Rp -
1299 Rp 129,900.00 0 Rp -
425 Rp 40,800.00 1375 Rp 132,000.00
190 Rp 52,250.00 190 Rp 52,250.00
100 Rp 21,000.00 Rp -
0 Rp - 36 Rp 96,624.00
0 Rp - 100 Rp 295,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 100 Rp 641,000.00
920 Rp 105,800.00 1880 Rp 216,200.00
0 Rp - Rp -
12 Rp 76,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
100 Rp 190,000.00 0 Rp -
100 Rp 250,000.00 Rp -
0 Rp - 1500 Rp 208,500.00
0 Rp - Rp -
247 Rp 273,429.00 253 Rp 280,071.00
527 Rp 532,270.00 0 Rp -
72716 Rp 3,853,948.00 16530 Rp 876,090.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
9046 Rp 1,112,658.00 10154 Rp 1,248,942.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
10000 Rp 680,000.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
122 Rp 10,065.00 447 Rp 36,877.50

0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
5550 Rp 2,869,350.00 850 Rp 439,450.00
500 Rp 142,000.00 0 Rp -
2400 Rp 691,200.00 Rp -
2693 Rp 19,254,950.00 603 Rp 4,311,450.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
1220 Rp 80,520.00 44 Rp 2,904.00
0 Rp - 800 Rp 50,400.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
58 Rp 151,960.00 44 Rp 115,280.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
25 Rp 3,274,975.00 11 Rp 1,440,989.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
1275 Rp 140,250.00 7125 Rp 783,750.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1343 Rp 703,732.00 5457 Rp 2,859,468.00
1602 Rp 759,348.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
19272 Rp 6,822,288.00 75928 Rp 26,878,512.00
23547 Rp 8,359,185.00 Rp -
61600 Rp 21,806,400.00 Rp -
70 Rp 21,700.00 Rp -
9000 Rp 765,000.00 0 Rp -
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
1394 Rp 126,854.00 10606 Rp 965,146.00
0 Rp - Rp -
623 Rp 49,840.00 0 Rp -
952 Rp 80,920.00 948 Rp 80,580.00
7537 Rp 866,755.00 Rp -
18858 Rp 1,565,214.00 11142 Rp 924,786.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

26 Rp 10,122,944.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
6 Rp 250,704.00
2 Rp 71,204.00 Rp -
Rp 157,094,840.32 Rp 86,377,837.50
0 Rp - Rp -
2 Rp 888,054.00 Rp -
1 Rp 66,200.00 Rp -
0 Rp - Rp -
Rp 954,254.00 Rp -
115 Rp 1,212,905.00 85 Rp 896,495.00

0 Rp - 200 Rp 1,970,000.00
227 Rp 2,718,325.00 373 Rp 4,466,675.00
152 Rp 2,180,288.00 Rp -
1 Rp 14,470.00 22 Rp 318,340.00
0 Rp - 10 Rp 132,350.00
3 Rp 59,517.00 Rp -
0 Rp - 5 Rp 97,400.00
17 Rp 453,407.00 Rp -
158 Rp 3,223,200.00 142 Rp 2,896,800.00
0 Rp - 200 Rp 1,922,200.00
251 Rp 2,472,350.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 12,334,462.00 Rp 12,700,260.00
33 Rp 50,806.93 967 Rp 1,488,797.07

322 Rp 318,780.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1104 Rp 400,200.00 400 Rp 145,000.00
0 Rp - Rp -
20 Rp 60,000.00 50 Rp 150,000.00
0 Rp - Rp -
Rp 829,786.93 Rp 1,783,797.07
171,213,343.25 100,861,894.57
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
Rp 167.00 100 Rp 16,700.00 1200 Rp 200,400.00
HARGA SATUAN
No. SATUAN
Rp 105.00 1690 Rp 177,450.00 3500 Rp 367,500.00
HARGA SATUAN
No. SATUAN
Rp 55.00 1481 Rp 81,455.00 800 Rp 44,000.00
142 INH TAB Rp 145.00 Rp - 1200 Rp 174,000.00
HARGA SATUAN
No. SATUAN
HARGA SATUAN
No. SATUAN
Rp 210.00 Rp - 100 Rp 21,000.00
Rp 2,959.00 Rp - 100 Rp 295,900.00
211 NA CL LAR INFUS 0,9 % STERIL BTL Rp 6,410.00 Rp - 100 Rp 641,000.00
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
235 Rp 49.00 Rp -
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 2250 Rp 648,000.00
Rp 91.00 Rp - 12000 Rp 1,092,000.00
HARGA SATUAN
No. SATUAN
305 OAT kat 1 Rp 389,344.00 Rp - 26 Rp 10,122,944.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
Rp 41,784.00 Rp - 6 Rp 250,704.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
3 CHKM BTL Rp 66,200.00 Rp - 1 Rp 66,200.00
REAGEN LABORATORIUM
Rp 9,850.00 Rp - 200 Rp 1,970,000.00
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 13,235.00 Rp - 10 Rp 132,350.00
Rp 19,480.00 Rp - 5 Rp 97,400.00
Rp 20,400.00 Rp - 300 Rp 6,120,000.00
Rp 9,611.00 Rp - 200 Rp 1,922,200.00

TOTAL 108,962,204.82 164,213,033.00
Mengetahui Jombang, 30 September 2019

Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN

NIP. 1977050920110120003 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

EN

1370 Rp 520,600.00 324 Rp 123,120.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
7560 Rp 3,054,240.00 Rp -
780 Rp 268,320.00 0 Rp -
0 Rp - Rp -
3243 Rp 291,870.00 962 Rp 86,580.00
0 Rp - Rp -
0 Rp - 2400 Rp 213,600.00
983 Rp 110,292.60 0 Rp -
915 Rp 83,265.00 85 Rp 7,735.00
23 Rp 76,935.00 0 Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
990 Rp 165,330.00 310 Rp 51,770.00
20820 Rp 1,457,400.00 3823 Rp 267,610.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
27495 Rp 6,406,335.00 32505 Rp 7,573,665.00
0 Rp - Rp -
0 Rp - 0 Rp -
203 Rp 1,672,111.00 1797 Rp 14,801,889.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
29019 Rp 1,567,026.00 24988 Rp 1,349,352.00
141 Rp 281,295.00 4 Rp 7,980.00
0 Rp - Rp -
40 Rp 126,680.00 120 Rp 380,040.00
71 Rp 216,195.00 0 Rp -
0 Rp - Rp -
0 Rp - 10 Rp 198,000.00
88 Rp 242,000.00 64 Rp 176,000.00
0 Rp - Rp -
0 Rp - Rp -
15637 Rp 1,641,885.00 9317 Rp 978,285.00

2000 Rp 198,000.00 0 Rp -
48624 Rp 5,008,272.00 23387 Rp 2,408,861.00
0 Rp - Rp -
5617 Rp 763,912.00 2905 Rp 395,080.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
121 Rp 405,350.00 176 Rp 589,600.00
6 Rp 3,564.00 94 Rp 55,836.00
61 Rp 30,195.00 0 Rp -
1500 Rp 102,000.00 Rp -
1693 Rp 126,975.00 2307 Rp 173,025.00
5002 Rp 420,168.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
508 Rp 557,276.00 252 Rp 276,444.00
0 Rp - Rp -
0 Rp - Rp -
14487 Rp 463,584.00 13286 Rp 425,152.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
735 Rp 63,210.00 965 Rp 82,990.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
265 Rp 290,175.00 215 Rp 235,425.00
36 Rp 37,800.00 Rp -
585 Rp 60,840.00 115 Rp 11,960.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
3647 Rp 382,935.00 1543 Rp 162,015.00
500 Rp 45,500.00 Rp -
5363 Rp 455,855.00 1991 Rp 169,235.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
1081 Rp 4,756,400.00 267 Rp 1,174,800.00
0 Rp - Rp -
1 Rp 18,824.00 Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 180 Rp 662,760.00
0 Rp - Rp -
0 Rp - Rp -
1045 Rp 741,950.00 986 Rp 700,060.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
44 Rp 2,631,200.00 0 Rp -
2164 Rp 168,792.00 Rp -
5690 Rp 438,130.00 1310 Rp 100,870.00
0 Rp - Rp -
0 Rp - Rp -
1800 Rp 462,600.00 Rp -
4488 Rp 1,292,544.00 1670 Rp 480,960.00
0 Rp - Rp -
187 Rp 635,613.00 0 Rp -
195 Rp 601,185.00 Rp -
0 Rp - Rp -
5631 Rp 670,089.00 875 Rp 104,125.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
190 Rp 988,000.00 Rp -
490 Rp 102,900.00 838 Rp 175,980.00
0 Rp - Rp -
1555 Rp 85,525.00 726 Rp 39,930.00
0 Rp - Rp -
0 Rp - Rp -
30 Rp 3,039,000.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
92 Rp 227,700.00 0 Rp -
600 Rp 87,000.00 600 Rp 87,000.00
0 Rp - Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
213 Rp 18,957.00 487 Rp 43,343.00
477 Rp 41,976.00 Rp -
24 Rp 238,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
16993 Rp 1,002,587.00 6115 Rp 360,785.00
255 Rp 68,850.00 20 Rp 5,400.00
7 Rp 16,660.00 12 Rp 28,560.00
6300 Rp 3,118,500.00 200 Rp 99,000.00
0 Rp - Rp -
0 Rp - Rp -
186 Rp 349,866.00 28 Rp 52,668.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
11 Rp 51,700.00 39 Rp 183,300.00
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
60 Rp 182,280.00 31 Rp 94,178.00
0 Rp - Rp -
0 Rp - Rp -
41351 Rp 909,722.00 8967 Rp 197,274.00
0 Rp - Rp -
2305 Rp 338,835.00 1022 Rp 150,234.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1130 Rp 645,230.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
161 Rp 732,550.00 0 Rp -
10 Rp 77,000.00 130 Rp 1,001,000.00
80 Rp 752,000.00 0 Rp -
0 Rp - Rp -
157 Rp 179,765.00 233 Rp 266,785.00
126 Rp 232,470.00 0 Rp -

1300 Rp 159,900.00 720 Rp 88,560.00
12 Rp 45,552.00 24 Rp 91,104.00
12 Rp 39,936.00 24 Rp 79,872.00
26 Rp 84,500.00 Rp -
10 Rp 34,140.00 38 Rp 129,732.00
0 Rp - Rp -
0 Rp - Rp -
1299 Rp 129,900.00 0 Rp -
695 Rp 66,720.00 1105 Rp 106,080.00
350 Rp 96,250.00 30 Rp 8,250.00
100 Rp 21,000.00 Rp -
0 Rp - 36 Rp 96,624.00
0 Rp - 100 Rp 295,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 100 Rp 641,000.00
1680 Rp 193,200.00 1120 Rp 128,800.00
0 Rp - Rp -
12 Rp 76,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
100 Rp 190,000.00 0 Rp -
0 Rp - 100 Rp 250,000.00
130 Rp 18,070.00 1370 Rp 190,430.00
0 Rp - Rp -
316 Rp 349,812.00 184 Rp 203,688.00
527 Rp 532,270.00 0 Rp -
79903 Rp 4,234,859.00 9343 Rp 495,179.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
10824 Rp 1,331,352.00 8376 Rp 1,030,248.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
10000 Rp 680,000.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
169 Rp 13,942.50 400 Rp 33,000.00

0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
5550 Rp 2,869,350.00 850 Rp 439,450.00
500 Rp 142,000.00 0 Rp -
2400 Rp 691,200.00 Rp -
2871 Rp 20,527,650.00 425 Rp 3,038,750.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
1264 Rp 83,424.00 Rp -
203 Rp 12,789.00 597 Rp 37,611.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
67 Rp 175,540.00 35 Rp 91,700.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
27 Rp 3,536,973.00 9 Rp 1,178,991.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
1587 Rp 174,570.00 6813 Rp 749,430.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1682 Rp 881,368.00 5118 Rp 2,681,832.00
1602 Rp 759,348.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
40027 Rp 14,169,558.00 55173 Rp 19,531,242.00
23547 Rp 8,359,185.00 Rp -
61600 Rp 21,806,400.00 Rp -
70 Rp 21,700.00 Rp -
9000 Rp 765,000.00 0 Rp -
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
4161 Rp 378,651.00 7839 Rp 713,349.00
0 Rp - Rp -
623 Rp 49,840.00 0 Rp -
1038 Rp 88,230.00 862 Rp 73,270.00
7537 Rp 866,755.00 Rp -
21814 Rp 1,810,562.00 8186 Rp 679,438.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

26 Rp 10,122,944.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
6 Rp 250,704.00
2 Rp 71,204.00 Rp -
Rp 174,234,270.82 Rp 70,338,407.00
0 Rp - Rp -
2 Rp 888,054.00 Rp -
1 Rp 66,200.00 Rp -
0 Rp - Rp -
Rp 954,254.00 Rp -
115 Rp 1,212,905.00 85 Rp 896,495.00

0 Rp - 200 Rp 1,970,000.00
227 Rp 2,718,325.00 373 Rp 4,466,675.00
152 Rp 2,180,288.00 Rp -
1 Rp 14,470.00 22 Rp 318,340.00
0 Rp - 10 Rp 132,350.00
3 Rp 59,517.00 Rp -
0 Rp - 5 Rp 97,400.00
17 Rp 453,407.00 Rp -
158 Rp 3,223,200.00 142 Rp 2,896,800.00
0 Rp - 200 Rp 1,922,200.00
251 Rp 2,472,350.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 12,334,462.00 Rp 12,700,260.00
65 Rp 100,074.26 935 Rp 1,439,529.74

322 Rp 318,780.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1104 Rp 400,200.00 400 Rp 145,000.00
0 Rp - Rp -
20 Rp 60,000.00 50 Rp 150,000.00
0 Rp - Rp -
Rp 879,054.26 Rp 1,734,529.74
188,402,041.08 84,773,196.74
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
Rp 167.00 100 Rp 16,700.00 1200 Rp 200,400.00
Rp 2,129.00 Rp - 100 Rp 212,900.00
HARGA SATUAN
No. SATUAN
48 ASEIL SISTEIN TAB Rp 373.00 Rp - 11200 Rp 4,177,600.00
51 BETAMETASON CREAM 0,1 % TUB Rp 3,350.00 97 Rp 324,950.00 300 Rp 1,005,000.00
70 DEKSAMETASON TABLET 0.5 MG TAB Rp 32.00 673 Rp 21,536.00 31600 Rp 1,011,200.00
Rp 105.00 1690 Rp 177,450.00 3500 Rp 367,500.00
HARGA SATUAN
No. SATUAN
93 ETAKRIDIN LAR 0,1% BTL Rp 770.00 Rp - 5000 Rp 3,850,000.00
100 FANITOIN NATRIUM 100 MG KAP Rp 158.00 Rp - 2000 Rp 316,000.00
128 GLUKOSE LAR INFUS 5 % STERIL BTL Rp 6,900.00 Rp - 200 Rp 1,380,000.00
Rp 55.00 1481 Rp 81,455.00 800 Rp 44,000.00
142 INH TAB Rp 145.00 Rp - 1200 Rp 174,000.00
HARGA SATUAN
No. SATUAN
152 KALSIUM LAKTAT TAB 500 MG TAB Rp 59.00 7108 Rp 419,372.00 19000 Rp 1,121,000.00
175 KHLORFENIRAMIN MALEAT (CTM TAB) TAB Rp 23.00 Rp - 3200 Rp 73,600.00
HARGA SATUAN
No. SATUAN
Rp 210.00 Rp - 500 Rp 105,000.00
Rp 2,959.00 Rp - 100 Rp 295,900.00
211 NA CL LAR INFUS 0,9 % STERIL BTL Rp 6,410.00 Rp - 200 Rp 1,282,000.00
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
235 Rp 49.00 Rp -
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 2250 Rp 648,000.00
Rp 91.00 Rp - 14000 Rp 1,274,000.00
Rp 89.00 Rp - 3500 Rp 311,500.00
HARGA SATUAN
No. SATUAN
305 OAT kat 1 Rp 389,344.00 Rp - 26 Rp 10,122,944.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
Rp 41,784.00 Rp - 6 Rp 250,704.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
3 CHKM BTL Rp 66,200.00 Rp - 1 Rp 66,200.00
REAGEN LABORATORIUM
Rp 9,850.00 Rp - 200 Rp 1,970,000.00
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 13,235.00 Rp - 10 Rp 132,350.00
Rp 19,480.00 Rp - 5 Rp 97,400.00
Rp 20,400.00 Rp - 300 Rp 6,120,000.00
Rp 9,611.00 Rp - 200 Rp 1,922,200.00

TOTAL 108,962,204.82 185,191,595.00
Mengetahui Jombang, 30 oktober 2019

Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN

NIP. 1977050920110120003 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

EN

1645 Rp 625,100.00 549 Rp 208,620.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
7560 Rp 3,054,240.00 Rp -
780 Rp 268,320.00 0 Rp -
0 Rp - Rp -
3576 Rp 321,840.00 629 Rp 56,610.00
0 Rp - Rp -
1 Rp 89.00 3399 Rp 302,511.00
983 Rp 110,292.60 0 Rp -
1000 Rp 91,000.00 0 Rp -
23 Rp 76,935.00 0 Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
1091 Rp 182,197.00 209 Rp 34,903.00
23438 Rp 1,640,660.00 1205 Rp 84,350.00
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
31916 Rp 7,436,428.00 28084 Rp 6,543,572.00
0 Rp - Rp -
0 Rp - 0 Rp -
258 Rp 2,125,146.00 1742 Rp 14,348,854.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
32557 Rp 1,758,078.00 21450 Rp 1,158,300.00
145 Rp 289,275.00 0 Rp -
0 Rp - 100 Rp 212,900.00
0 Rp - Rp -
46 Rp 145,682.00 114 Rp 361,038.00
71 Rp 216,195.00 0 Rp -
0 Rp - Rp -
2 Rp 39,600.00 8 Rp 158,400.00
114 Rp 313,500.00 38 Rp 104,500.00
0 Rp - Rp -
0 Rp - Rp -

17252 Rp 1,811,460.00 11702 Rp 1,228,710.00
2000 Rp 198,000.00 0 Rp -
54256 Rp 5,588,368.00 17755 Rp 1,828,765.00
0 Rp - Rp -
6406 Rp 871,216.00 3116 Rp 423,776.00
0 Rp - Rp -
122 Rp 45,506.00 11078 Rp 4,132,094.00
0 Rp - Rp -
0 Rp - Rp -
127 Rp 425,450.00 270 Rp 904,500.00
26 Rp 15,444.00 74 Rp 43,956.00
61 Rp 30,195.00 0 Rp -
1500 Rp 102,000.00 Rp -
2553 Rp 191,475.00 1447 Rp 108,525.00
5002 Rp 420,168.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
512 Rp 561,664.00 248 Rp 272,056.00
0 Rp - Rp -
0 Rp - Rp -
18363 Rp 587,616.00 13910 Rp 445,120.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
853 Rp 73,358.00 847 Rp 72,842.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
274 Rp 300,030.00 206 Rp 225,570.00
36 Rp 37,800.00 Rp -
635 Rp 66,040.00 565 Rp 58,760.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
4177 Rp 438,585.00 1013 Rp 106,365.00
1700 Rp 154,700.00 Rp -
4731 Rp 402,135.00 2623 Rp 222,955.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -

5000 Rp 3,850,000.00 Rp -
0 Rp - Rp -
1088 Rp 4,787,200.00 260 Rp 1,144,000.00
0 Rp - Rp -
1 Rp 18,824.00 Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
0 Rp - 2000 Rp 316,000.00
0 Rp - Rp -
4 Rp 14,728.00 176 Rp 648,032.00
0 Rp - Rp -
0 Rp - Rp -
1065 Rp 756,150.00 966 Rp 685,860.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
44 Rp 2,631,200.00 0 Rp -
2164 Rp 168,792.00 Rp -
6662 Rp 512,974.00 5338 Rp 411,026.00
0 Rp - Rp -
0 Rp - Rp -
1800 Rp 462,600.00 Rp -
4938 Rp 1,422,144.00 1220 Rp 351,360.00
0 Rp - Rp -
187 Rp 635,613.00 0 Rp -
195 Rp 601,185.00 Rp -
0 Rp - Rp -
6302 Rp 749,938.00 2204 Rp 262,276.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 200 Rp 1,380,000.00
190 Rp 988,000.00 Rp -
532 Rp 111,720.00 796 Rp 167,160.00
0 Rp - Rp -
1891 Rp 104,005.00 390 Rp 21,450.00
0 Rp - Rp -
0 Rp - Rp -
30 Rp 3,039,000.00 30 Rp 3,039,000.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
92 Rp 227,700.00 0 Rp -
600 Rp 87,000.00 600 Rp 87,000.00
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
293 Rp 26,077.00 707 Rp 62,923.00
477 Rp 41,976.00 Rp -
24 Rp 238,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
17976 Rp 1,060,584.00 8132 Rp 479,788.00
275 Rp 74,250.00 0 Rp -
7 Rp 16,660.00 12 Rp 28,560.00
6500 Rp 3,217,500.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
218 Rp 410,058.00 116 Rp 218,196.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
36 Rp 169,200.00 14 Rp 65,800.00
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
62 Rp 188,356.00 53 Rp 161,014.00
0 Rp - Rp -
0 Rp - Rp -
42267 Rp 929,874.00 8051 Rp 177,122.00
3200 Rp 73,600.00 Rp -
2710 Rp 398,370.00 1217 Rp 178,899.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
933 Rp 532,743.00 197 Rp 112,487.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
161 Rp 732,550.00 0 Rp -
10 Rp 77,000.00 130 Rp 1,001,000.00
10 Rp 94,000.00 70 Rp 658,000.00
0 Rp - Rp -
169 Rp 193,505.00 251 Rp 287,395.00

126 Rp 232,470.00 0 Rp -
1300 Rp 159,900.00 720 Rp 88,560.00
12 Rp 45,552.00 24 Rp 91,104.00
12 Rp 39,936.00 24 Rp 79,872.00
26 Rp 84,500.00 Rp -
16 Rp 54,624.00 32 Rp 109,248.00
0 Rp - Rp -
0 Rp - Rp -
1299 Rp 129,900.00 0 Rp -
1110 Rp 106,560.00 990 Rp 95,040.00
380 Rp 104,500.00 0 Rp -
110 Rp 23,100.00 390 Rp 81,900.00
0 Rp - 36 Rp 96,624.00
0 Rp - 100 Rp 295,900.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
10 Rp 64,100.00 190 Rp 1,217,900.00
2907 Rp 334,305.00 893 Rp 102,695.00
0 Rp - Rp -
12 Rp 76,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
100 Rp 190,000.00 0 Rp -
30 Rp 75,000.00 70 Rp 175,000.00
512 Rp 71,168.00 988 Rp 137,332.00
0 Rp - Rp -
395 Rp 437,265.00 205 Rp 226,935.00
527 Rp 532,270.00 0 Rp -
86016 Rp 4,558,848.00 24730 Rp 1,310,690.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
13280 Rp 1,633,440.00 8920 Rp 1,097,160.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
10000 Rp 680,000.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

194 Rp 16,005.00 375 Rp 30,937.50
0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
5550 Rp 2,869,350.00 850 Rp 439,450.00
500 Rp 142,000.00 0 Rp -
2400 Rp 691,200.00 Rp -
3105 Rp 22,200,750.00 491 Rp 3,510,650.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
1264 Rp 83,424.00 Rp -
421 Rp 26,523.00 379 Rp 23,877.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
78 Rp 204,360.00 48 Rp 125,760.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
27 Rp 3,536,973.00 9 Rp 1,178,991.00
0 Rp - Rp -
9 Rp 9,702.00 Rp -
2016 Rp 221,760.00 6384 Rp 702,240.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1946 Rp 1,019,704.00 4854 Rp 2,543,496.00
1602 Rp 759,348.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
70210 Rp 24,854,340.00 24990 Rp 8,846,460.00
23547 Rp 8,359,185.00 Rp -
61600 Rp 21,806,400.00 Rp -
70 Rp 21,700.00 Rp -
9000 Rp 765,000.00 0 Rp -
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
8725 Rp 793,975.00 5275 Rp 480,025.00
0 Rp - Rp -
623 Rp 49,840.00 0 Rp -
1328 Rp 112,880.00 772 Rp 65,620.00
7537 Rp 866,755.00 Rp -
21831 Rp 1,811,973.00 8169 Rp 678,027.00
3500 Rp 311,500.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
26 Rp 10,122,944.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
6 Rp 250,704.00
2 Rp 71,204.00 Rp -
Rp 196,082,230.32 Rp 69,469,009.50
0 Rp - Rp -
2 Rp 888,054.00 Rp -
1 Rp 66,200.00 Rp -
0 Rp - Rp -
Rp 954,254.00 Rp -
115 Rp 1,212,905.00 85 Rp 896,495.00

0 Rp - 200 Rp 1,970,000.00
227 Rp 2,718,325.00 373 Rp 4,466,675.00
152 Rp 2,180,288.00 Rp -
1 Rp 14,470.00 22 Rp 318,340.00
0 Rp - 10 Rp 132,350.00
3 Rp 59,517.00 Rp -
0 Rp - 5 Rp 97,400.00
17 Rp 453,407.00 Rp -
158 Rp 3,223,200.00 142 Rp 2,896,800.00
0 Rp - 200 Rp 1,922,200.00
251 Rp 2,472,350.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 12,334,462.00 Rp 12,700,260.00
112 Rp 172,435.65 888 Rp 1,367,168.35

322 Rp 318,780.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
1264 Rp 458,200.00 240 Rp 87,000.00
0 Rp - Rp -
20 Rp 60,000.00 50 Rp 150,000.00
0 Rp - Rp -
Rp 1,009,415.65 Rp 1,604,168.35
210,380,361.97 83,773,437.85
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019

HARGA SATUAN
No. SATUAN
OBAT
Rp 167.00 100 Rp 16,700.00 1200 Rp 200,400.00
Rp 2,129.00 Rp - 100 Rp 212,900.00
HARGA SATUAN
No. SATUAN
48 ASEIL SISTEIN TAB Rp 373.00 Rp - 11200 Rp 4,177,600.00
51 BETAMETASON CREAM 0,1 % TUB Rp 3,350.00 97 Rp 324,950.00 300 Rp 1,005,000.00
70 DEKSAMETASON TABLET 0.5 MG TAB Rp 32.00 673 Rp 21,536.00 31600 Rp 1,011,200.00
Rp 105.00 1690 Rp 177,450.00 3500 Rp 367,500.00
HARGA SATUAN
No. SATUAN
93 BTL Rp 770.00 Rp - 5000 Rp 3,850,000.00
100 FANITOIN NATRIUM 100 MG KAP Rp 158.00 Rp - 2000 Rp 316,000.00
128 GLUKOSE LAR INFUS 5 % STERIL BTL Rp 6,900.00 Rp - 200 Rp 1,380,000.00
Rp 55.00 1481 Rp 81,455.00 800 Rp 44,000.00
142 INH TAB Rp 145.00 Rp - 1200 Rp 174,000.00
HARGA SATUAN
No. SATUAN
152 KALSIUM LAKTAT TAB 500 MG TAB Rp 59.00 7108 Rp 419,372.00 19000 Rp 1,121,000.00
175 KHLORFENIRAMIN MALEAT (CTM TAB) TAB Rp 23.00 Rp - 3200 Rp 73,600.00
HARGA SATUAN
No. SATUAN
Rp 210.00 Rp - 500 Rp 105,000.00
Rp 2,959.00 Rp - 100 Rp 295,900.00
211 NA CL LAR INFUS 0,9 % STERIL BTL Rp 6,410.00 Rp - 200 Rp 1,282,000.00
222 OBH BTL Rp 1,430.00 Rp - Rp -
223 OBH BTL Rp 1,258.95 Rp - Rp -
224 OBH BTL Rp 2,310.00 Rp - Rp -
225 OBH BTL Rp 2,970.00 Rp - Rp -
235 Rp 49.00 Rp -
HARGA SATUAN
No. SATUAN
255 Rp 288.00 150 Rp 43,200.00 2250 Rp 648,000.00
286 TABLET TAMBAH DARAH KOMBINASI TAB Rp 354.00 95200 Rp 33,700,800.00 16800 Rp 5,947,200.00
Rp 91.00 Rp - 14000 Rp 1,274,000.00
Rp 89.00 Rp - 3500 Rp 311,500.00
HARGA SATUAN
No. SATUAN
304 MINERAL MIX SAK Rp 3,115.92 Rp - 2400 Rp 7,478,207.97
305 OAT kat 1 Rp 389,344.00 Rp - 46 Rp 17,909,824.00
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp -
309 Rp 31,570.00 Rp - 24 Rp 757,680.00
Rp 41,784.00 Rp - 6 Rp 250,704.00
MB anak Rp 28,354.00 Rp - 6 Rp 170,124.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp -
OBAT GIGI
3 CHKM BTL Rp 66,200.00 Rp - 1 Rp 66,200.00
REAGEN LABORATORIUM
Rp 9,850.00 Rp - 200 Rp 1,970,000.00
Rp 14,344.00 152 Rp 2,180,288.00 Rp -
Rp 13,235.00 Rp - 10 Rp 132,350.00
Rp 19,480.00 Rp - 5 Rp 97,400.00
Rp 20,400.00 Rp - 300 Rp 6,120,000.00
Rp 9,611.00 Rp - 200 Rp 1,922,200.00

TOTAL 108,962,204.82 213,473,406.97
Mengetahui Jombang, 25 November 2019

Puskesmas Pulorejo
HARGA SATUAN
No. SATUAN

NIP. 1977050920110120003 NIP. 197503122009012002
Stok awal Rp 108,962,204.82

EN

1867 Rp 709,460.00 327 Rp 124,260.00

0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
7560 Rp 3,054,240.00 Rp -
780 Rp 268,320.00 0 Rp -
0 Rp - Rp -
3755 Rp 337,950.00 450 Rp 40,500.00
0 Rp - Rp -
188 Rp 16,732.00 3212 Rp 285,868.00
983 Rp 110,292.60 0 Rp -
1000 Rp 91,000.00 0 Rp -
23 Rp 76,935.00 0 Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
1136 Rp 189,712.00 164 Rp 27,388.00
24643 Rp 1,725,010.00 0 Rp -
0 Rp - Rp -
0 Rp - 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
36599 Rp 8,527,567.00 23401 Rp 5,452,433.00
0 Rp - Rp -
0 Rp - 0 Rp -
336 Rp 2,767,632.00 1664 Rp 13,706,368.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
35667 Rp 1,926,018.00 18340 Rp 990,360.00
145 Rp 289,275.00 0 Rp -
23 Rp 48,967.00 77 Rp 163,933.00
0 Rp - Rp -
52 Rp 164,684.00 108 Rp 342,036.00
71 Rp 216,195.00 0 Rp -
0 Rp - Rp -
2 Rp 39,600.00 8 Rp 158,400.00
139 Rp 382,250.00 13 Rp 35,750.00
0 Rp - Rp -
0 Rp - Rp -

18694 Rp 1,962,870.00 10260 Rp 1,077,300.00
210 Rp 20,790.00 1790 Rp 177,210.00
59773 Rp 6,156,619.00 12238 Rp 1,260,514.00
0 Rp - Rp -
6973 Rp 948,328.00 2549 Rp 346,664.00
0 Rp - Rp -
1495 Rp 557,635.00 9705 Rp 3,619,965.00
0 Rp - Rp -
0 Rp - Rp -
141 Rp 472,350.00 256 Rp 857,600.00
26 Rp 15,444.00 74 Rp 43,956.00
61 Rp 30,195.00 0 Rp -
1500 Rp 102,000.00 Rp -
2999 Rp 224,925.00 1001 Rp 75,075.00
5002 Rp 420,168.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
89 Rp 135,102.00 Rp -
520 Rp 570,440.00 240 Rp 263,280.00
0 Rp - Rp -
0 Rp - Rp -
21604 Rp 691,328.00 10669 Rp 341,408.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - 10 Rp 41,800.00
0 Rp - Rp -
0 Rp - Rp -
979 Rp 84,194.00 721 Rp 62,006.00
225 Rp 10,125.00 Rp -
0 Rp - Rp -
290 Rp 317,550.00 190 Rp 208,050.00
36 Rp 37,800.00 Rp -
735 Rp 76,440.00 465 Rp 48,360.00
0 Rp - Rp -
95 Rp 9,215.00 Rp -
0 Rp - Rp -
4669 Rp 490,245.00 521 Rp 54,705.00
1700 Rp 154,700.00 Rp -
5425 Rp 461,125.00 1929 Rp 163,965.00
0 Rp - Rp -
0 Rp - 2 Rp 2,816.00
0 Rp - Rp -
2889 Rp 2,166,750.00 Rp -
2000 Rp 1,460,000.00 Rp -

428 Rp 329,560.00 4572 Rp 3,520,440.00
0 Rp - Rp -
1348 Rp 5,931,200.00 0 Rp -
0 Rp - Rp -
1 Rp 18,824.00 Rp -
3 Rp 54,300.00 0 Rp -
485 Rp 74,690.00 0 Rp -
30 Rp 4,740.00 1970 Rp 311,260.00
0 Rp - Rp -
158 Rp 581,756.00 22 Rp 81,004.00
0 Rp - Rp -
0 Rp - Rp -
1302 Rp 924,420.00 729 Rp 517,590.00
0 Rp - Rp -
100 Rp 5,975,878.99 Rp -
44 Rp 2,631,200.00 0 Rp -
2164 Rp 168,792.00 Rp -
7896 Rp 607,992.00 4104 Rp 316,008.00
0 Rp - Rp -
0 Rp - Rp -
1800 Rp 462,600.00 Rp -
5221 Rp 1,503,648.00 937 Rp 269,856.00
0 Rp - Rp -
187 Rp 635,613.00 0 Rp -
195 Rp 601,185.00 Rp -
0 Rp - Rp -
7193 Rp 855,967.00 1313 Rp 156,247.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
10 Rp 69,000.00 190 Rp 1,311,000.00
190 Rp 988,000.00 Rp -
626 Rp 131,460.00 702 Rp 147,420.00
0 Rp - Rp -
2191 Rp 120,505.00 90 Rp 4,950.00
0 Rp - Rp -
0 Rp - Rp -
38 Rp 3,849,400.00 22 Rp 2,228,600.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
92 Rp 227,700.00 0 Rp -
600 Rp 87,000.00 600 Rp 87,000.00
0 Rp - Rp -

0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
373 Rp 33,197.00 627 Rp 55,803.00
477 Rp 41,976.00 Rp -
24 Rp 238,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
19248 Rp 1,135,632.00 6860 Rp 404,740.00
275 Rp 74,250.00 0 Rp -
7 Rp 16,660.00 12 Rp 28,560.00
6500 Rp 3,217,500.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
234 Rp 440,154.00 100 Rp 188,100.00
1 Rp 7,150.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
50 Rp 235,000.00 0 Rp -
0 Rp - Rp -
2700 Rp 1,336,500.00 Rp -
136 Rp 1,383,800.00 0 Rp -
0 Rp - Rp -
62 Rp 188,356.00 53 Rp 161,014.00
0 Rp - Rp -
0 Rp - Rp -
45834 Rp 1,008,348.00 4484 Rp 98,648.00
3200 Rp 73,600.00 Rp -
3266 Rp 480,102.00 661 Rp 97,167.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
999 Rp 570,429.00 131 Rp 74,801.00
0 Rp - Rp -
0 Rp - Rp -
101 Rp 218,867.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
3159 Rp 435,942.00 Rp -
161 Rp 732,550.00 0 Rp -
10 Rp 77,000.00 130 Rp 1,001,000.00
10 Rp 94,000.00 70 Rp 658,000.00
0 Rp - Rp -
207 Rp 237,015.00 213 Rp 243,885.00

126 Rp 232,470.00 0 Rp -
1300 Rp 159,900.00 720 Rp 88,560.00
36 Rp 136,656.00 0 Rp -
36 Rp 119,808.00 0 Rp -
26 Rp 84,500.00 Rp -
26 Rp 88,764.00 22 Rp 75,108.00
0 Rp - Rp -
0 Rp - Rp -
1299 Rp 129,900.00 0 Rp -
1625 Rp 156,000.00 475 Rp 45,600.00
380 Rp 104,500.00 0 Rp -
160 Rp 33,600.00 340 Rp 71,400.00
36 Rp 96,624.00 Rp -
10 Rp 29,590.00 90 Rp 266,310.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
27 Rp 173,070.00 173 Rp 1,108,930.00
3800 Rp 437,000.00 0 Rp -
0 Rp - Rp -
12 Rp 76,920.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
91 Rp 172,899.73 Rp -
100 Rp 190,000.00 0 Rp -
33 Rp 82,500.00 67 Rp 167,500.00
862 Rp 119,818.00 638 Rp 88,682.00
0 Rp - Rp -
487 Rp 539,109.00 113 Rp 125,091.00
527 Rp 532,270.00 0 Rp -
92909 Rp 4,924,177.00 17837 Rp 945,361.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
15209 Rp 1,870,707.00 6991 Rp 859,893.00
0 Rp - Rp -
6113 Rp 721,334.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
8123 Rp 779,808.00 Rp -
10000 Rp 680,000.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -

204 Rp 16,830.00 365 Rp 30,112.50
0 Rp - Rp -
0 Rp - Rp -
500 Rp 259,600.00 Rp -
5600 Rp 2,895,200.00 800 Rp 413,600.00
500 Rp 142,000.00 0 Rp -
2400 Rp 691,200.00 Rp -
3381 Rp 24,174,150.00 215 Rp 1,537,250.00
0 Rp - Rp -
0 Rp - Rp -
375 Rp 130,125.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
1264 Rp 83,424.00 Rp -
800 Rp 50,400.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
84 Rp 220,080.00 42 Rp 110,040.00
0 Rp - Rp -
2 Rp 2,900.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
36 Rp 4,715,964.00 Rp -
0 Rp - Rp -
9 Rp 9,702.00 Rp -
2172 Rp 238,920.00 6228 Rp 685,080.00
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
2202 Rp 1,153,848.00 4598 Rp 2,409,352.00
1602 Rp 759,348.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
76955 Rp 27,242,070.00 35045 Rp 12,405,930.00
23547 Rp 8,359,185.00 Rp -
61600 Rp 21,806,400.00 Rp -
70 Rp 21,700.00 Rp -
9000 Rp 765,000.00 0 Rp -
0 Rp - Rp -
2210 Rp 1,093,950.00 Rp -
7587 Rp 652,482.00 Rp -
8000 Rp 680,000.00 Rp -
12958 Rp 1,179,178.00 1042 Rp 94,822.00
0 Rp - Rp -
623 Rp 49,840.00 Rp -
1668 Rp 141,780.00 432 Rp 36,720.00
7537 Rp 866,755.00 Rp -
25360 Rp 2,104,880.00 4640 Rp 385,120.00
3500 Rp 311,500.00 Rp -
0 Rp - Rp -

0 Rp - Rp -
2400 Rp 7,478,207.97 Rp -
46 Rp 17,909,824.00
3 Rp 1,079,955.00 Rp -
3 Rp 3,893,682.00 Rp -
7 Rp 315,854.00 Rp -
24 Rp 757,680.00 Rp -
6 Rp 250,704.00
6 Rp 170,124.00
2 Rp 71,204.00 Rp -
Rp 223,048,127.29 Rp 63,885,524.50
0 Rp - Rp -
1 Rp 444,027.00 1 Rp 444,027.00
0 Rp - 1 Rp 66,200.00
0 Rp - Rp -
Rp 444,027.00 Rp 510,227.00
214 Rp 2,257,058.00 186 Rp 1,961,742.00

200 Rp 1,970,000.00 0 Rp -
610 Rp 7,304,750.00 390 Rp 4,670,250.00
152 Rp 2,180,288.00 Rp -
23 Rp 332,810.00 Rp -
0 Rp - 10 Rp 132,350.00
3 Rp 59,517.00 Rp -
5 Rp 97,400.00 Rp -
17 Rp 453,407.00 Rp -
300 Rp 6,120,000.00 Rp -
188 Rp 1,806,868.00 12 Rp 115,332.00
251 Rp 2,472,350.00 Rp -
0 Rp - Rp -
0 Rp - Rp -
0 Rp - Rp -
Rp 25,054,448.00 Rp 6,879,674.00
58 Rp 89,297.03 942 Rp 1,450,306.97

322 Rp 318,780.00 0 Rp -
0 Rp - Rp -
0 Rp - Rp -
1344 Rp 487,200.00 160 Rp 58,000.00
20 Rp 60,000.00 50 Rp 150,000.00
0 Rp - Rp -
Rp 955,277.03 Rp 1,658,306.97
249,501,879.32 72,933,732.47
Pengelola Obat
Puskesmas Pulorejo


NIP.198209032010011012
PUSKESMAS PULOREJO
TAHUN 2019
NAMA OBAT STOK AWAL 2019 MUTASI TAMBAH TAHUN 2019 MUTASI KURANG TAHUN 2019
HARGA SATUAN
No. (Rp)
JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA
TOTAL (Rp) TOTAL (Rp) TOTAL (Rp)
OBAT
1 ACYCLOVIR TAB Rp 380.00 694 Rp 263,720.00 2100 Rp 798,000.00 2059 Rp 782,420.00
2 ACYCLOVIR TAB Rp 349.00 0 Rp - Rp - 0 Rp -
3 ACYCLOVIR SALEP Rp 3,000.00 Rp - Rp - 0 Rp -
4 ACYCLOVIR SALEP Rp 2,152.00 Rp - Rp - 0 Rp -
5 Albendazol tablet 400 mg Rp 404.00 Rp - 7560 Rp 3,054,240.00 7560 Rp 3,054,240.00
6 Albendazol tablet 400 mg Rp 344.00 780 Rp 268,320.00 Rp - 780 Rp 268,320.00
7 ALLOPURINOL TABLET 100 MG Rp 132.00 Rp - Rp - 0 Rp -
8 ALLOPURINOL TABLET 100 MG Rp 90.00 2205 Rp 198,450.00 4000 Rp 360,000.00 3784 Rp 340,560.00
9 ALLOPURINOL TABLET 100 MG Rp 86.00 Rp - Rp - 0 Rp -
10 AMINOFILIN TAB 200 MG Rp 89.00 Rp - 3400 Rp 302,600.00 400 Rp 35,600.00
11 AMINOFILIN TAB 200 MG Rp 112.20 783 Rp 87,852.60 200 Rp 22,440.00 983 Rp 110,292.60
12 AMINOFILIN TAB 200 MG Rp 91.00 Rp - 1000 Rp 91,000.00 1000 Rp 91,000.00
13 AMINOFILIN INJ 24 MG/ML, 10 ML Rp 3,345.00 23 Rp 76,935.00 Rp - 23 Rp 76,935.00
14 AMINOFILIN INJ 24 MG/ML, 10 ML Rp 3,822.00 0 Rp - Rp - 0 Rp -
15 Amitriptilin HCl tablet salut 25 mg Rp 112.00 Rp - 500 Rp 56,000.00 500 Rp 56,000.00
Rp 167.00 100 Rp 16,700.00 1200 Rp 200,400.00 766 Rp 127,922.00
16 AMLODIPIN TAB Rp 70.00 7243 Rp 507,010.00 17400 Rp 1,218,000.00 24643 Rp 1,725,010.00
17 AMLODIPIN TAB Rp 105.00 Rp - Rp - 0 Rp -
18 AMOKSISILIN SIRUP 125 MG/ML Rp 2,090.00 0 Rp - Rp - 0 Rp -
19 Amoksisilin FORTE sirup kering 250 mg/ Rp 4,070.00 Rp - Rp - 0 Rp -
20 AMOKSISILIN SIRUP 125 MG/ML Rp 2,445.00 Rp - Rp - 0 Rp -
21 AMOKSISILIN KAPSUL 500 MG Rp 233.00 Rp - 60000 Rp 13,980,000.00 42489 Rp 9,899,937.00
22 AMOKSISILIN KAPSUL 500 MG Rp 232.00 Rp - Rp - 0 Rp -
23 AMOKSISILIN KAPSUL 500 MG Rp 261.00 0 Rp - Rp - 0 Rp -
24 AMPICILIN INJ Rp 8,237.00 Rp - 2000 Rp 16,474,000.00 487 Rp 4,011,419.00
25 AMPICILIN INJ Rp 4,000.00 Rp - Rp - 0 Rp -
28 ANTALGIN TABLET 500 MG Rp 67.00 Rp - Rp - 0 Rp -
29 ANTALGIN TABLET 500 MG Rp 145.00 Rp - Rp - 0 Rp -
30 ANTASID TAB, MGOH3 + ALOH3 AA200 Rp 30.53 Rp - Rp - 0 Rp -
31 ANTASID TAB, MGOH3 + ALOH3 AA200 Rp 62.00 Rp - Rp - 0 Rp -
32 ANTASID TAB, MGOH3 + ALOH3 AA200 Rp 54.00 20407 Rp 1,101,978.00 39600 Rp 2,138,400.00 39677 Rp 2,142,558.00
33 Antasida DOEN suspensi Rp 1,995.00 45 Rp 89,775.00 100 Rp 199,500.00 145 Rp 289,275.00
Rp 2,129.00 Rp - 200 Rp 425,800.00 54 Rp 114,966.00
34 ANTI FUNGI Rp 2,025.00 Rp - Rp - 0 Rp -
35 ANTI HAEMORHOID SUPPOSITORIA Rp 3,167.00 Rp - 190 Rp 601,730.00 60 Rp 190,020.00
36 Anti Hemoroid DOEN Kombinasi Rp 3,045.00 71 Rp 216,195.00 Rp - 71 Rp 216,195.00
37 Aqua pro Injeksi steril 25 ml/ OTSU SWI 25 ml Rp 2,860.00 Rp - 84 Rp 240,240.00 7 Rp 20,020.00
38 Aquadest 500 ml Rp 19,800.00 10 Rp 198,000.00 Rp - 4 Rp 79,200.00
39 AQUA PRO INJEKSI STERIL, BEBAS PIROGEN 2 Rp 2,750.00 152 Rp 418,000.00 Rp - 152 Rp 418,000.00
40 ASAM ASKORBAT (VIT C) TAB 100 MG Rp 51.00 Rp - Rp - 0 Rp -
41 ASAM ASKORBAT (VIT C) TAB 50 MG Rp 104.00 Rp - Rp - 0 Rp -
42 ASAM ASKORBAT (VIT C) TAB 50 MG Rp 105.00 5954 Rp 625,170.00 28000 Rp 2,940,000.00 20183 Rp 2,119,215.00
43 Asam Asetil salisilat 80 mg (asetosal ) Rp 99.00 0 Rp - 2000 Rp 198,000.00 461 Rp 45,639.00
44 ASAM MEFENAMAT TAB 500 MG Rp 103.00 10111 Rp 1,041,433.00 77900 Rp 8,023,700.00 66263 Rp 6,825,089.00
45 ASAM MEFENAMAT TAB 500 MG Rp 106.00 Rp - Rp - 0 Rp -
46 Atapulgit tablet 600 mg Rp 136.00 2922 Rp 397,392.00 7200 Rp 979,200.00 8068 Rp 1,097,248.00
47 Atapulgit tablet 600 mg Rp 145.00 Rp - Rp - 0 Rp -
48 ASEIL SISTEIN Rp 373.00 Rp - 11200 Rp 4,177,600.00 3750 Rp 1,398,750.00
49 BECARBON Rp 121.00 Rp - Rp - 0 Rp -
50 BETAMETASON CREAM 0,1 % Rp 3,388.00 Rp - Rp - 0 Rp -
51 BETAMETASON CREAM 0,1 % Rp 3,350.00 97 Rp 324,950.00 325 Rp 1,088,750.00 158 Rp 529,300.00
52 Bisacodyl tablet 5 mg Rp 594.00 Rp - 100 Rp 59,400.00 74 Rp 43,956.00
HARGA SATUAN
No. (Rp)
53 Bisacodyl tablet 5 mg Rp 495.00 61 Rp 30,195.00 Rp - 61 Rp 30,195.00
54 CAPTOPRIL Rp 68.00 Rp - 1500 Rp 102,000.00 1500 Rp 102,000.00
55 CAPTOPRIL Rp 75.00 Rp - 4000 Rp 300,000.00 3614 Rp 271,050.00
56 CAPTOPRIL 25 mg Rp 84.00 5002 Rp 420,168.00 Rp - 5002 Rp 420,168.00
57 CAPTOPRIL tablet 50 mg Rp 140.00 Rp - Rp - 0 Rp -
58 CIMETIDIN Rp 114.90 Rp - Rp - 0 Rp -
59 CIMETIDIN Rp 110.84 Rp - Rp - 0 Rp -
60 CIPROFLOXACIN 500 MG Rp 284.00 Rp - Rp - 0 Rp -
64 CEFOTAXIM INJ 1000 MG Rp 6,800.00 Rp - Rp - 0 Rp -
65 DEKSAMETASON INJ 5 MG/ML-1 ML Rp 143.89 Rp - Rp - 0 Rp -
66 DEKSAMETASON INJ 5 MG/ML-1 ML Rp 1,518.00 89 Rp 135,102.00 Rp - 89 Rp 135,102.00
67 DEKSAMETASON INJ 5 MG/ML-1 ML Rp 1,097.00 Rp - 760 Rp 833,720.00 536 Rp 587,992.00
68 DEKSAMETASON TABLET 0.5 MG Rp 69.00 Rp - Rp - 0 Rp -
69 DEKSAMETASON TABLET 0.5 MG Rp 44.00 Rp - Rp - 0 Rp -
70 DEKSAMETASON TABLET 0.5 MG Rp 32.00 673 Rp 21,536.00 39600 Rp 1,267,200.00 25418 Rp 813,376.00
71 DEKTROMERFAN HBR SIRUP 10MG/ML Rp 2,864.40 Rp - Rp - 0 Rp -
72 DEKTROMERFAN HBR TAB 15 MG Rp 68.98 Rp - Rp - 0 Rp -
73 DEKTROMERFAN HBR TAB 15 MG Rp 90.00 Rp - Rp - 0 Rp -
74 DIAZEPAM INJ 5 MG/ML-2 ML Rp 4,180.00 10 Rp 41,800.00 Rp - 0 Rp -
75 DIAZEPAM INJ 5 MG/ML-2 ML Rp 2,365.00 Rp - Rp - 0 Rp -
76 DIAZEPAM TABLET 2 MG Rp 19.80 Rp - Rp - 0 Rp -
77 DIAZEPAM TABLET 2 MG Rp 86.00 Rp - 1700 Rp 146,200.00 1172 Rp 100,792.00
78 DIAZEPAM TABLET 2 MG Rp 45.00 225 Rp 10,125.00 Rp - 225 Rp 10,125.00
79 DIFENHIDRAMIN INJ 10MG/ML-1 ML Rp 60.00 Rp - Rp - 0 Rp -
80 DIFENHIDRAMIN INJ 10MG/ML-1 ML Rp 1,095.00 Rp - 480 Rp 525,600.00 303 Rp 331,785.00
81 DIFENHIDRAMIN INJ 10MG/ML-1 ML Rp 1,050.00 36 Rp 37,800.00 Rp - 36 Rp 37,800.00
82 DIGOKSIN TABLET 0.25 MG Rp 104.00 Rp - 1200 Rp 124,800.00 841 Rp 87,464.00
83 DIGOKSIN TABLET 0.25 MG Rp 105.00 Rp - Rp - 0 Rp -
84 DIGOKSIN TABLET 0.25 MG Rp 97.00 95 Rp 9,215.00 Rp - 95 Rp 9,215.00
85 Dimenhidrinat tablet 50 mg Rp 99.00 Rp - Rp - 0 Rp -
Rp 105.00 1690 Rp 177,450.00 5500 Rp 577,500.00 5209 Rp 546,945.00
86 Domperidon tablet 10 mg Rp 91.00 Rp - 1700 Rp 154,700.00 1700 Rp 154,700.00
87 Domperidon tablet 10 mg Rp 85.00 1354 Rp 115,090.00 6000 Rp 510,000.00 6499 Rp 552,415.00
88 EKSTRAK BELLADON TABLET 10 MG Rp 26.40 Rp - Rp - 0 Rp -
89 EPINEFRIN HCL/BITARTAT (ADRENALIN) INJ 0,1%- Rp 1,408.00 Rp - 2 Rp 2,816.00 0 Rp -
90 ERGOTAMIN CAFEIN Rp 135.00 Rp - Rp - 0 Rp -
91 Erytromycin kaplet 500 mg Rp 750.00 2889 Rp 2,166,750.00 Rp - 2889 Rp 2,166,750.00
92 Erytromycin kaplet 500 mg Rp 730.00 Rp - 2000 Rp 1,460,000.00 2000 Rp 1,460,000.00
93 Rp 770.00 Rp - 5000 Rp 3,850,000.00 1160 Rp 893,200.00
94 ETANOL 70% Rp 15,400.00 Rp - Rp - 0 Rp -
95 ETANOL 70% Rp 4,400.00 548 Rp 2,411,200.00 800 Rp 3,520,000.00 1348 Rp 5,931,200.00
96 ETANOL 70% Rp 2,500.00 Rp - Rp - 0 Rp -
97 EUGENOL CAIRAN Rp 18,824.00 0 Rp - 1 Rp 18,824.00 1 Rp 18,824.00
98 EUGENOL CAIRAN Rp 18,100.00 3 Rp 54,300.00 Rp - 3 Rp 54,300.00
99 FANITOIN NATRIUM 100 MG Rp 154.00 485 Rp 74,690.00 Rp - 485 Rp 74,690.00
100 FANITOIN NATRIUM 100 MG Rp 158.00 Rp - 2000 Rp 316,000.00 140 Rp 22,120.00
101 FENOBARBITAL TABLET 30 MG Rp 31.00 Rp - Rp - 0 Rp -
104 Fitomenadion (Vit.K1) injeksi 2 mg/ml - Rp 3,682.00 Rp - 270 Rp 994,140.00 180 Rp 662,760.00
105 Fitomenadion (Vit.K1) injeksi 2 mg/ml - Rp 3,550.00 0 Rp - Rp - 0 Rp -
106 FITOMENADION TAB SALUT 10 MG Rp 680.61 Rp - Rp - 0 Rp -
107 FITOMENADION TAB SALUT 10 MG Rp 710.00 1131 Rp 803,010.00 1400 Rp 994,000.00 1424 Rp 1,011,040.00
108 FITOMENADION TAB SALUT 10 MG Rp 630.00 Rp - Rp - 0 Rp -
109 (SIKZONOATE Inj) Rp 59,758.79 100 Rp 5,975,878.99 Rp - 100 Rp 5,975,878.99
110 (SIKZONOATE Inj) Rp 59,800.00 14 Rp 837,200.00 30 Rp 1,794,000.00 44 Rp 2,631,200.00
111 FUROSEMID TABLET 40 MG Rp 78.00 2164 Rp 168,792.00 Rp - 2164 Rp 168,792.00
112 FUROSEMID TABLET 40 MG Rp 77.00 Rp - 12000 Rp 924,000.00 9137 Rp 703,549.00
113 GARAM ORALIT UNTUK 200 ML AIR Rp - Rp - 0 Rp -
HARGA SATUAN
No. (Rp)
114 GARAM ORALIT UNTUK 200 ML AIR Rp 292.00 Rp - Rp - 0 Rp -
115 GARAM ORALIT UNTUK 200 ML AIR Rp 257.00 Rp - 3600 Rp 925,200.00 3600 Rp 925,200.00
116 GARAM ORALIT UNTUK 200 ML AIR Rp 288.00 1358 Rp 391,104.00 4800 Rp 1,382,400.00 3979 Rp 1,145,952.00
117 GENTIAN VIOLET 1 % Rp 990.90 Rp - Rp - 0 Rp -
118 Rp
Gentamisin injeksi 40 mg/ml (sbg Sulfat) 3,399.00 37 Rp 125,763.00 150 Rp 509,850.00 187 Rp 635,613.00
119 Rp
Gentamisin injeksi 40 mg/ml (sbg Sulfat) 3,083.00 Rp - 195 Rp 601,185.00 195 Rp 601,185.00
120 GLIBENKLAMID TABLET 5 MG Rp 80.30 0 Rp - Rp - 0 Rp -
121 GLIBENKLAMID TABLET 5 MG Rp 119.00 4006 Rp 476,714.00 6500 Rp 773,500.00 7963 Rp 947,597.00
122 GLIMEPIRID 2 Rp 207.00 Rp - Rp - 0 Rp -
123 GLISERI GUAYAKOLAT TABLET 100 MG Rp 27.90 Rp - Rp - 0 Rp -
127 Gliserin 100 ml Rp 6,600.00 Rp - Rp - 0 Rp -
128 GLUKOSE LAR INFUS 5 % STERIL Rp 6,900.00 Rp - 200 Rp 1,380,000.00 30 Rp 207,000.00
129 GLUKOSE LAR INFUS 5 % STERIL Rp 5,200.00 190 Rp 988,000.00 Rp - 190 Rp 988,000.00
130 GRISEOFULVIN 125 MG, MICRONIZE Rp 210.00 328 Rp 68,880.00 1500 Rp 315,000.00 688 Rp 144,480.00
131 Haloperidol tablet 0,5 mg Rp 59.00 0 Rp - Rp - 0 Rp -
Rp 55.00 1481 Rp 81,455.00 1800 Rp 99,000.00 2311 Rp 127,105.00
132 Haloperidol tablet 5 mg Rp 75.00 0 Rp - Rp - 0 Rp -
133 Haloperidol 5 mg/ml Injeksi Rp 6,250.00 0 Rp - Rp - 0 Rp -
134 Haldol Decanoat 50 mg/ml inj Rp 101,300.00 Rp - 80 Rp 8,104,000.00 46 Rp 4,659,800.00
135 Haldol Decanoat 50 mg/ml inj Rp 97,491.45 Rp - Rp - 0 Rp -
136 HIDROKHLOROTIAZID TABLET 25 MG Rp 24.64 Rp - Rp - 0 Rp -
137 HIDROKHLOROTIAZID TABLET 25 MG Rp 36.30 Rp - Rp - 0 Rp -
138 HIDROKORTISON KREM 2,5 % Rp 2,708.33 Rp - Rp - 0 Rp -
141 HIDROKORTISON KREM 2,5 % Rp 2,475.00 44 Rp 108,900.00 48 Rp 118,800.00 92 Rp 227,700.00
142 INH Rp 145.00 Rp - 1200 Rp 174,000.00 1200 Rp 174,000.00
143 IBUPROFEN TABLET 400 MG Rp 205.04 Rp - Rp - 0 Rp -
146 IBUPROFEN TABLET 400 MG Rp 31,650.00 Rp - Rp - 0 Rp -
147 ISOSORBID DINITRAT TABLET SUBLINGA Rp 89.00 Rp - 1000 Rp 89,000.00 420 Rp 37,380.00
148 ISOSORBID DINITRAT TABLET SUBLINGA Rp 88.00 477 Rp 41,976.00 Rp - 477 Rp 41,976.00
149 KALSIUM GLUKONAT INJ Rp 9,955.00 Rp - 24 Rp 238,920.00 0 Rp -
150 KALSIUM LAKTAT TAB 500 MG Rp 52.00 Rp - Rp - 0 Rp -
151 KALSIUM LAKTAT TAB 500 MG Rp 63.00 Rp - Rp - 0 Rp -
152 KALSIUM LAKTAT TAB 500 MG Rp 59.00 7108 Rp 419,372.00 19000 Rp 1,121,000.00 21140 Rp 1,247,260.00
153 Ketokonazol tablet 200 mg Rp 270.00 275 Rp 74,250.00 Rp - 275 Rp 74,250.00
154 KETOPROFEN SUPPO Rp 2,380.00 9 Rp 21,420.00 10 Rp 23,800.00 7 Rp 16,660.00
155 KHLORAMFENIKOL KAPSUL 250 MG Rp 495.00 Rp - 6500 Rp 3,217,500.00 6500 Rp 3,217,500.00
156 KHLORAMFENIKOL KAPSUL 250 MG Rp 249.00 Rp - Rp - 0 Rp -
157 KHLORAMFENIKOL 1% SALEP MATA Rp 1,798.00 Rp - Rp - 0 Rp -
158 KHLORAMFENIKOL 1% SALEP MATA Rp 1,881.00 94 Rp 176,814.00 240 Rp 451,440.00 251 Rp 472,131.00
159 KHLORAMFENIKOL TT 3% Rp 7,150.00 1 Rp 7,150.00 Rp - 1 Rp 7,150.00
160 KHLORAMFENIKOL TT 3% Rp 2,310.00 Rp - Rp - 0 Rp -
161 KHLORAMFENIKOL TT 3% Rp 1,815.00 Rp - Rp - 0 Rp -
162 KHLORAMFENIKOL TETES MATA Rp 6,380.00 Rp - Rp - 0 Rp -
165 KHLORAMFENIKOL SYRUP Rp 5,500.00 Rp - Rp - 0 Rp -
166 KHLORAMFENIKOL SYRUP Rp 5,015.00 Rp - 100 Rp 501,500.00 5 Rp 25,075.00
167 KHLORAMFENIKOL SYRUP Rp 4,700.00 Rp - 50 Rp 235,000.00 50 Rp 235,000.00
168 Kloramfenikol kapsul 250 mg Rp 249.00 Rp - Rp - 0 Rp -
Kloramfenikol kapsul 250 mg Rp 495.00 Rp - 2700 Rp 1,336,500.00 2700 Rp 1,336,500.00
169 KLORAMFENIKOL INJEKSI Rp 10,175.00 136 Rp 1,383,800.00 Rp - 136 Rp 1,383,800.00
170 KLORAMFENIKOL INJEKSI Rp 9,900.04 Rp - Rp - 0 Rp -
171 KLORAMFENIKOL SK Rp 3,038.00 43 Rp 130,634.00 72 Rp 218,736.00 63 Rp 191,394.00
172 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 24.00 Rp - Rp - 0 Rp -
173 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 42.00 Rp - Rp - 0 Rp -
HARGA SATUAN
No. (Rp)
174 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 22.00 11018 Rp 242,396.00 39300 Rp 864,600.00 40596 Rp 893,112.00
175 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 23.00 Rp - 13200 Rp 303,600.00 13200 Rp 303,600.00
176 Klorpromazin HCl tablet salut 100 mg Rp 147.00 127 Rp 18,669.00 4800 Rp 705,600.00 3761 Rp 552,867.00
177 Klorpromazin HCl tablet salut 100 mg Rp 162.00 Rp - Rp - 0 Rp -
178 KHLORPROMAZIN HCL TABLET 25 MG Rp 60.50 Rp - Rp - 0 Rp -
181 KODEIN HCL TABLET 10 MG Rp 550.00 Rp - Rp - 0 Rp -
182 KODEIN HCL TABLET 10 MG Rp 571.00 130 Rp 74,230.00 1300 Rp 742,300.00 1119 Rp 638,949.00
183 KOTRIMOKSAZOL SUSPENSI Rp 3,500.00 Rp - Rp - 0 Rp -
184 KOTRIMOKSAZOL SUSPENSI Rp 2,574.00 Rp - Rp - 0 Rp -
185 KOTRIMOKSAZOL SUSPENSI Rp 2,167.00 101 Rp 218,867.00 Rp - 101 Rp 218,867.00
186 KOTRIMOKSAZOL ADULT TABLET Rp 100.00 Rp - Rp - 0 Rp -
189 KOTRIMOKSAZOL ADULT TABLET Rp 138.00 3159 Rp 435,942.00 Rp - 3159 Rp 435,942.00
190 KOMBIVENT Rp 4,550.00 21 Rp 95,550.00 140 Rp 637,000.00 161 Rp 732,550.00
191 Larutan elektrolit D5-1/4ns Rp 7,700.00 140 Rp 1,078,000.00 Rp - 140 Rp 1,078,000.00
192 Larutan elektrolit D5-1/2ns Rp 9,400.00 80 Rp 752,000.00 Rp - 80 Rp 752,000.00
193 LIDOKAIN COMP INJ-2 ML Rp 1,136.67 Rp - Rp - 0 Rp -
194 LIDOKAIN COMP INJ-2 ML Rp 1,145.00 Rp - 420 Rp 480,900.00 263 Rp 301,135.00
195 LIDOKAIN COMP INJ-2 ML Rp 1,845.00 126 Rp 232,470.00 Rp - 126 Rp 232,470.00
196 LORATADIN Rp 123.00 920 Rp 113,160.00 1100 Rp 135,300.00 1620 Rp 199,260.00
197 Magnesium Sulfat injeksi (iv) 40 % - 25 Rp 3,796.00 Rp - 41 Rp 155,636.00 36 Rp 136,656.00
198 Magnesium Sulfat injeksi (iv) 20 % - 25 Rp 3,328.00 Rp - 36 Rp 119,808.00 36 Rp 119,808.00
199 Mikonazole krim/salep 2 % (Nitrat) Rp 3,250.00 26 Rp 84,500.00 Rp - 26 Rp 84,500.00
200 Mikonazole krim/salep 2 % (Nitrat) Rp 3,414.00 Rp - 96 Rp 327,744.00 34 Rp 116,076.00
201 Metamizole injeksi 500 mg/ 1 ml Rp 7,150.00 Rp - Rp - 0 Rp -
202 Metamizole injeksi 500 mg/ 1 ml Rp 6,600.00 Rp - Rp - 0 Rp -
203 Metformin HCl tablet 500 mg Rp 100.00 1299 Rp 129,900.00 Rp - 1299 Rp 129,900.00
204 Metformin HCl tablet 500 mg Rp 96.00 Rp - 4100 Rp 393,600.00 1940 Rp 186,240.00
205 METILERGOMETRINMALEAT TAB 0,125 Rp 275.00 80 Rp 22,000.00 300 Rp 82,500.00 380 Rp 104,500.00
Rp 210.00 Rp - 500 Rp 105,000.00 160 Rp 33,600.00
206 METILERGOMETRINMALEAT INJ Rp 2,684.00 36 Rp 96,624.00 Rp - 36 Rp 96,624.00
Rp 2,959.00 Rp - 100 Rp 295,900.00 10 Rp 29,590.00
207 METRONIDAZOL TABLET 500 MG Rp 133.00 Rp - Rp - 0 Rp -
208 METRONIDAZOL TABLET 250 MG Rp 110.00 Rp - Rp - 0 Rp -
209 METOKLOPROPAMIDE TABLET Rp 99.00 Rp - Rp - 0 Rp -
210 Monochlorkamfer mentol ( CHKM ) Rp 60,500.00 Rp - Rp - 0 Rp -
211 NA CL LAR INFUS 0,9 % STERIL Rp 6,410.00 Rp - 200 Rp 1,282,000.00 113 Rp 724,330.00
212 Natrium Diklofenak tablet 50 mg Rp 115.00 Rp - 6800 Rp 782,000.00 3800 Rp 437,000.00
213 Natrium Diklofenak tablet 50 mg Rp 159.00 Rp - Rp - 0 Rp -
214 Natrium Klorida larutan infus 0,9 % steril Rp 6,410.00 12 Rp 76,920.00 Rp - 12 Rp 76,920.00
215 NIFEDIPIN Rp 104.00 Rp - Rp - 0 Rp -
216 NIFEDIPIN Rp 110.00 Rp - Rp - 0 Rp -
221 OAT SISIPAN Rp - Rp - 0 Rp -
222 OBH Rp 1,430.00 Rp - Rp - 0 Rp -
223 OBH Rp 1,258.95 Rp - Rp - 0 Rp -
224 OBH Rp 2,310.00 Rp - Rp - 0 Rp -
225 OBH Rp 2,970.00 Rp - Rp - 0 Rp -
226 OKSITOSIN Rp 1,900.00 91 Rp 172,899.73 Rp - 91 Rp 172,899.73
227 OKSITOSIN Rp 1,900.00 Rp - 100 Rp 190,000.00 100 Rp 190,000.00
228 OKSITETRASIKLIN HCL SALEP MATA 3% Rp 2,500.00 Rp - 100 Rp 250,000.00 34 Rp 85,000.00
229 Omeprazol kapsul 20 mg Rp 139.00 Rp - 2100 Rp 291,900.00 1405 Rp 195,295.00
230 Omeprazol injeksi 40 mg/ 10 ml Rp 36,000.00 Rp - Rp - 0 Rp -
231 PARASETAMOL SIRUP 120 MG/5ML Rp 1,107.00 Rp - 700 Rp 774,900.00 607 Rp 671,949.00
232 PARASETAMOL SIRUP 120 MG/5ML Rp 1,010.00 227 Rp 229,270.00 300 Rp 303,000.00 527 Rp 532,270.00
233 PARASETAMOL TABLET 500 MG Rp 53.00 31746 Rp 1,682,538.00 89000 Rp 4,717,000.00 102133 Rp 5,413,049.00
234 PARASETAMOL TABLET 500 MG Rp 56.00 Rp - Rp - 0 Rp -
235 Rp 49.00 Rp - 0 Rp -
236 PIRANTEL PAMOAT TAB 125 MG BASA Rp - Rp - 0 Rp -
237 PIRIDOKSIN HCL TABLET 10 MG Rp 123.00 Rp - 27200 Rp 3,345,600.00 18812 Rp 2,313,876.00
HARGA SATUAN
No. (Rp)
238 PIRIDOKSIN HCL TABLET 10 MG Rp 27.50 Rp - Rp - 0 Rp -
239 PIRIDOKSIN HCL TABLET 10 MG Rp 118.00 6113 Rp 721,334.00 Rp - 6113 Rp 721,334.00
240 POLIKRESULEN Rp - Rp - 0 Rp -
241 PREDNISON TABLET 5 MG Rp 40.00 Rp - Rp - 0 Rp -
242 PREDNISON TABLET 5 MG Rp 96.00 6123 Rp 587,808.00 2000 Rp 192,000.00 8123 Rp 779,808.00
243 PREDNISON TABLET 5 MG Rp 68.00 Rp - 10000 Rp 680,000.00 10000 Rp 680,000.00
244 PREDNISON TABLET 5 MG Rp 82.50 Rp - Rp - 0 Rp -
245 PPC INJEKSI 3 JUTA IU Rp - Rp - 0 Rp -
246 POVIDON IODINE Rp 18,000.00 Rp - 10 Rp 180,000.00 0 Rp -
247 PROPRANOLOL HCL TABLET 40 MG Rp 83.00 Rp - Rp - 0 Rp -
248 PROPRANOLOL HCL TABLET 10 MG Rp 65.00 Rp - Rp - 0 Rp -
249 PROPRANOLOL HCL TABLET 10 MG Rp 82.50 569 Rp 46,942.50 Rp - 214 Rp 17,655.00
250 Ranitidin tablet 150 mg Rp 120.00 Rp - Rp - 0 Rp -
251 Ranitidin injeksi 25 mg / 2 ml Rp 1,140.00 Rp - Rp - 0 Rp -
252 RETINOL KAPSUL LUNAK 200.000IU Rp 519.20 500 Rp 259,600.00 Rp - 500 Rp 259,600.00
253 RETINOL KAPSUL LUNAK 200.000IU Rp 517.00 Rp - 6400 Rp 3,308,800.00 5600 Rp 2,895,200.00
254 RETINOL KAPSUL LUNAK 100.000IU Rp 284.00 Rp - 500 Rp 142,000.00 500 Rp 142,000.00
255 Rp 288.00 150 Rp 43,200.00 2250 Rp 648,000.00 2400 Rp 691,200.00
256 RINGER LAKTAT LAR INFUS STERIL Rp 7,150.00 396 Rp 2,831,400.00 3800 Rp 27,170,000.00 3636 Rp 25,997,400.00
257 RINGER LAKTAT LAR INFUS STERIL Rp 5,200.00 Rp - Rp - 0 Rp -
258 RINGER LAKTAT LAR INFUS STERIL Rp 5,189.80 Rp - Rp - 0 Rp -
259 RISPERIDON Rp 347.00 375 Rp 130,125.00 Rp - 375 Rp 130,125.00
260 Asering Laruran Infus Rp 15,899.40 Rp - Rp - 0 Rp -
261 Asering Laruran Infus Rp 9,000.00 Rp - Rp - 0 Rp -
262 SALBUTAMOL TABLET 2 MG Rp 66.00 1264 Rp 83,424.00 Rp - 1264 Rp 83,424.00
263 SALBUTAMOL TABLET 2 MG Rp 63.00 Rp - 2000 Rp 126,000.00 498 Rp 31,374.00
264 SALBUTAMOL TABLET 4 MG Rp 89.00 Rp - Rp - 0 Rp -
265 SALEP 2,4 KOMBINASI Rp 826.00 Rp - Rp - 0 Rp -
266 SALEP 2,4 KOMBINASI Rp 2,000.00 Rp - Rp - 0 Rp -
267 SALEP 2,4 KOMBINASI Rp 2,620.00 30 Rp 78,600.00 96 Rp 251,520.00 88 Rp 230,560.00
268 SALEP 2,4 KOMBINASI Rp 2,310.00 Rp - Rp - 0 Rp -
269 SALISIL BEDAK 2% Rp 1,450.00 2 Rp 2,900.00 Rp - 2 Rp 2,900.00
270 SALISIL BEDAK 2% Rp 1,430.00 Rp - Rp - 0 Rp -
273 SILK NO3/1 Rp 6,386.11 Rp - Rp - 0 Rp -
274 Serum Anti Bisa Ular Polivalen injeksi 5 mRp 473,000.00 Rp - Rp - 0 Rp -
275 SATS 1.500 IU/AMPUL Rp 130,999.00 6 Rp 785,994.00 30 Rp 3,929,970.00 36 Rp 4,715,964.00
276 SIANOKOBALAMIN INJ 500 MCG/ML, 1M Rp 916.00 Rp - Rp - 0 Rp -
277 SIANOKOBALAMIN INJ 500 MCG/ML, 1M Rp 1,078.00 9 Rp 9,702.00 Rp - 9 Rp 9,702.00
278 Simvastatin tablet 10 mg Rp 110.00 0 Rp - 8400 Rp 924,000.00 2412 Rp 265,320.00
279 Sefadroxil kapsul 500 mg Rp 509.00 Rp - Rp - 0 Rp -
280 ZINC TAB Rp 475.00 Rp - Rp - 0 Rp -
281 ZINC TAB Rp - Rp - Rp - 0 Rp -
282 ZINC TAB Rp 524.00 Rp - 6800 Rp 3,563,200.00 2898 Rp 1,518,552.00
283 ZINC TAB Rp 474.00 1602 Rp 759,348.00 Rp - 1602 Rp 759,348.00
284 SULFASETAMID T.M 15% Rp 3,446.00 Rp - Rp - 0 Rp -
285 SULFASETAMID T.M 15% Rp 3,226.00 Rp - Rp - 0 Rp -
286 TABLET TAMBAH DARAH KOMBINASI Rp 354.00 95200 Rp 33,700,800.00 16800 Rp 5,947,200.00 83913 Rp 29,705,202.00
287 TABLET TAMBAH DARAH KOMBINASI Rp 355.00 23547 Rp 8,359,185.00 Rp - 23547 Rp 8,359,185.00
288 TABLET TAMBAH DARAH KOMBINASI Rp 354.00 61600 Rp 21,806,400.00 Rp - 61600 Rp 21,806,400.00
289 TETRASIKLINA KAPSUL 500MG Rp 310.00 70 Rp 21,700.00 Rp - 70 Rp 21,700.00
290 TIAMIN HCL MONOHIDRAT TABLET 50 Rp 85.00 Rp - 9000 Rp 765,000.00 9000 Rp 765,000.00
291 Tiamfenikol kapsul 500 mg Rp 739.20 Rp - 0 Rp -
292 Tiamfenikol kapsul 500 mg Rp 495.00 2210 Rp 1,093,950.00 Rp - 2210 Rp 1,093,950.00
293 Tiamin (Viamin B1) tablet 50 mg Rp 86.00 7587 Rp 652,482.00 Rp - 7587 Rp 652,482.00
294 Tiamin (Vitamin B1) tablet 100 mg Rp 85.00 Rp - 8000 Rp 680,000.00 8000 Rp 680,000.00
Rp 91.00 Rp - 14000 Rp 1,274,000.00 13706 Rp 1,247,246.00
295 TRIHEKSIFINIDIL 2 MG Rp 88.00 Rp - Rp - 0 Rp -
296 TRIHEKSIFINIDIL 2 MG Rp 80.00 623 Rp 49,840.00 Rp - 623 Rp 49,840.00
297 TRIHEKSIFINIDIL 2 MG Rp 85.00 Rp - 3100 Rp 263,500.00 1938 Rp 164,730.00
298 VIT B KOMPLEKS TABLET Rp 115.00 7537 Rp 866,755.00 Rp - 7537 Rp 866,755.00
299 VIT B KOMPLEKS TABLET Rp 83.00 Rp - 30000 Rp 2,490,000.00 29309 Rp 2,432,647.00
Rp 89.00 Rp - 3500 Rp 311,500.00 3500 Rp 311,500.00
HARGA SATUAN
No. (Rp)
300 VENTOLIN INHALER(Salbutamol CFC 200 Rp 63,750.00 Rp - Rp - 0 Rp -
301 YODIUM POVIDON LAR 10%, 30ML Rp - Rp - 0 Rp -
304 MINERAL MIX Rp 3,115.92 Rp - 2400 Rp 7,478,207.97 810 Rp 2,523,895.19
305 OAT kat 1 Rp 389,344.00 Rp - 50 Rp 19,467,200.00 26 Rp 10,122,944.00
306 FDC Kit KAT 1 Rp 359,985.00 3 Rp 1,079,955.00 Rp - 3 Rp 1,079,955.00
307 FDC Kit KAT 2 Rp 1,297,894.00 Rp - 3 Rp 3,893,682.00 3 Rp 3,893,682.00
Nevirapine (NVP) 200 mg Rp 2,940.00 Rp - 180 Rp 529,200.00 0 Rp -
Efavirenz (EFV) 600 mg Rp 6,375.00 Rp - 90 Rp 573,750.00 0 Rp -
Tenofovir 300mg (TDF) + Lamivudin
(3TC) 300 + Efaviren 600 (Triple FDC)
Dewasa Rp 2,638.47 Rp - 90 Rp 237,462.00 0 Rp -
Zidofudine (ZDV) 300mg + Lamivudine
(3TC) 150mg Rp 3,700.00 Rp - 180 Rp 666,000.00 0 Rp -
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 Rp - 7 Rp 315,854.00
309 Rp 31,570.00 Rp - 24 Rp 757,680.00 24 Rp 757,680.00
Rp 41,784.00 Rp - 6 Rp 250,704.00 6 Rp 250,704.00
MB anak Rp 28,354.00 Rp - 6 Rp 170,124.00 6 Rp 170,124.00
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 Rp - 2 Rp 71,204.00
JUMLAH TOTAL OBAT Rp 103,932,852.82 Rp 202,017,418.97 Rp 226,607,202.51
OBAT GIGI
1 EUGENOL CAIRAN Rp 18,824.00 Rp - Rp - 0 Rp -
2 Glass Ionomer Cement ART Rp 444,027.00 Rp - 2 Rp 888,054.00 1 Rp 444,027.00
3 CHKM Rp 66,200.00 Rp - 1 Rp 66,200.00 0 Rp -
4 Rp 521,235.00 Rp - Rp - 0 Rp -
JUMLAH TOTAL OBAT GIGI Rp - Rp 954,254.00 Rp 444,027.00
REAGEN LABORATORIUM
1 Rp
Reagen Hepatitis B (HBSAg dan Dropper)10,547.00 Rp - 600 Rp 6,328,200.00 266 Rp 2,805,502.00
Rp 9,850.00 Rp - 200 Rp 1,970,000.00 200 Rp 1,970,000.00
2 Reagen HIV R1 (Standart Diagnostic) Rp 11,975.00 Rp - 1200 Rp 14,370,000.00 663 Rp 7,939,425.00
Rp 14,344.00 152 Rp 2,180,288.00 Rp - 152 Rp 2,180,288.00
3 Reagen HIV R2 Rp 14,470.00 23 Rp 332,810.00 Rp - 23 Rp 332,810.00
Rp 13,235.00 Rp - 10 Rp 132,350.00 0 Rp -
4 Reagen HIV R3 Rp 19,839.00 3 Rp 59,517.00 Rp - 3 Rp 59,517.00
Rp 19,480.00 Rp - 5 Rp 97,400.00 5 Rp 97,400.00
5 HUMAN HEXAGON SIPHILYS Rp 26,671.00 17 Rp 453,407.00 Rp - 17 Rp 453,407.00
Rp 20,400.00 Rp - 300 Rp 6,120,000.00 300 Rp 6,120,000.00
Rp 9,611.00 Rp - 200 Rp 1,922,200.00 200 Rp 1,922,200.00
7 Reagen Hepatitis B Rp 9,850.00 151 Rp 1,487,350.00 100 Rp 985,000.00 251 Rp 2,472,350.00
10 Reagen Urine Stik 10 Parameter Rp 2,200.00 Rp - Rp - 0 Rp -
11 REAGEN GOLONGAN DARAH A Rp 104,500.00 Rp - Rp - 0 Rp -
12 REAGEN GOLONGAN DARAH B Rp 104,500.00 Rp - Rp - 0 Rp -
JUMLAH TOTAL REAGEN LABORATORIUM Rp 4,513,372.00 Rp 31,925,150.00 Rp 26,352,899.00
1 ALAT SUNTIK SEKALI PAKAI 1 ML Rp 1,539.60 Rp - 1000 Rp 1,539,604.00 100 Rp 153,960.40
2 ALAT SUNTIK SEKALI PAKAI 1 ML Rp 990.00 322 Rp 318,780.00 Rp - 322 Rp 318,780.00
4 ALAT SUNTIK SEKALI PAKAI 2.5 ML Rp 957.00 Rp - Rp - 0 Rp -
25 KASA PEMBALUT 4MX3CM Rp 660.00 Rp - Rp - 0 Rp -
26 KASA PEMBALUT 16MX16CM Rp 362.50 544 Rp 197,200.00 960 Rp 348,000.00 1504 Rp 545,200.00
44 Urin bag Rp 3,000.00 Rp - 70 Rp 210,000.00 30 Rp 90,000.00
45 Hands shoen No. 7 Rp 4,612.48 Rp - Rp - 0 Rp -
JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 515,980.00 Rp 2,097,604.00 Rp 1,107,940.40

TOTAL Rp 108,962,204.82 Rp 236,994,426.97 Rp 254,512,068.91
Mengetahui Jombang, Desember 2019

Kepala Puskesmas Pulorejo Pengurus Barang Pembantu Pemeriksa 1
Puskesmas Pulorejo
HARGA SATUAN
No. (Rp)
dr. RITA ANDAYANI MEIN YULIANA Taufik Akbar Solikin, ST

NIP. 1977050920110120003 NIP. 197503122009012002 NIP.197901272011011002
N
STOK AKHIR TAHUN 2019 Nilai selisih

SELISIH SALDO VS
Keterangan
CEK FISIK
JUMLAH JUMLAH HARGA
(Rp)
TOTAL (Rp)
735 Rp 279,300.00
0 Rp -
Rp -
Rp -
Rp -
0 Rp -
Rp -
2421 Rp 217,890.00
Rp -
3000 Rp 267,000.00
0 Rp -
0 Rp -
0 Rp -
0 Rp -
Rp -
534 Rp 89,178.00
0 Rp -
Rp -
0 Rp -
Rp -
Rp -
17511 Rp 4,080,063.00
Rp -
0 Rp -
1513 Rp 12,462,581.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
20330 Rp 1,097,820.00
0 Rp -
146 Rp 310,834.00
Rp -
130 Rp 411,710.00
0 Rp -
77 Rp 220,220.00
6 Rp 118,800.00
Rp -
Rp -
Rp -
13771 Rp 1,445,955.00
1539 Rp 152,361.00
21748 Rp 2,240,044.00
Rp -
2054 Rp 279,344.00
Rp -
7450 Rp 2,778,850.00
Rp -
Rp -
264 Rp 884,400.00
26 Rp 15,444.00
SELISIH SALDO VS
Keterangan
CEK FISIK
JUMLAH JUMLAH HARGA
(Rp)
TOTAL (Rp)
0 Rp -
Rp -
386 Rp 28,950.00
0 Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
224 Rp 245,728.00
Rp -
Rp -
14855 Rp 475,360.00
Rp -
Rp -
Rp -
10 Rp 41,800.00
Rp -
Rp -
528 Rp 45,408.00
Rp -
Rp -
177 Rp 193,815.00
Rp -
359 Rp 37,336.00
Rp -
Rp -
Rp -
1981 Rp 208,005.00
Rp -
855 Rp 72,675.00
Rp -
2 Rp 2,816.00
Rp -
Rp -
Rp -
3840 Rp 2,956,800.00
Rp -
0 Rp -
Rp -
Rp -
0 Rp -
0 Rp -
1860 Rp 293,880.00
Rp -
90 Rp 331,380.00
Rp -
Rp -
1107 Rp 785,970.00
Rp -
Rp -
0 Rp -
Rp -
2863 Rp 220,451.00
Rp -
SELISIH SALDO VS
Keterangan
CEK FISIK
JUMLAH JUMLAH HARGA
(Rp)
TOTAL (Rp)
Rp -
Rp -
2179 Rp 627,552.00
Rp -
0 Rp -
Rp -
Rp -
2543 Rp 302,617.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
170 Rp 1,173,000.00
Rp -
1140 Rp 239,400.00
Rp -
970 Rp 53,350.00
Rp -
Rp -
34 Rp 3,444,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
0 Rp -
0 Rp -
Rp -
Rp -
Rp -
Rp -
580 Rp 51,620.00
Rp -
24 Rp 238,920.00
Rp -
Rp -
4968 Rp 293,112.00
0 Rp -
12 Rp 28,560.00
0 Rp -
Rp -
Rp -
83 Rp 156,123.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
95 Rp 476,425.00
0 Rp -
Rp -
Rp -
0 Rp -
Rp -
52 Rp 157,976.00
Rp -
Rp -
SELISIH SALDO VS
Keterangan
CEK FISIK
JUMLAH JUMLAH HARGA
(Rp)
TOTAL (Rp)
9722 Rp 213,884.00
Rp -
1166 Rp 171,402.00
Rp -
Rp -
Rp -
Rp -
Rp -
311 Rp 177,581.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
0 Rp -
0 Rp -
0 Rp -
Rp -
157 Rp 179,765.00
0 Rp -
400 Rp 49,200.00
5 Rp 18,980.00
0 Rp -
Rp -
62 Rp 211,668.00
Rp -
Rp -
0 Rp -
2160 Rp 207,360.00
0 Rp -
340 Rp 71,400.00
Rp -
90 Rp 266,310.00
Rp -
Rp -
Rp -
Rp -
87 Rp 557,670.00
3000 Rp 345,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
0 Rp -
66 Rp 165,000.00
695 Rp 96,605.00
Rp -
93 Rp 102,951.00
0 Rp -
18613 Rp 986,489.00
Rp -
Rp -
Rp -
8388 Rp 1,031,724.00
SELISIH SALDO VS
Keterangan
CEK FISIK
JUMLAH JUMLAH HARGA
(Rp)
TOTAL (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
10 Rp 180,000.00
Rp -
Rp -
355 Rp 29,287.50
Rp -
Rp -
Rp -
800 Rp 413,600.00
0 Rp -
Rp -
560 Rp 4,004,000.00
Rp -
Rp -
0 Rp -
Rp -
Rp -
Rp -
1502 Rp 94,626.00
Rp -
Rp -
Rp -
38 Rp 99,560.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
5988 Rp 658,680.00
Rp -
Rp -
Rp -
3902 Rp 2,044,648.00
0 Rp -
Rp -
Rp -
28087 Rp 9,942,798.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
294 Rp 26,754.00
Rp -
Rp -
1162 Rp 98,770.00
Rp -
691 Rp 57,353.00
Rp -
SELISIH SALDO VS
Keterangan
CEK FISIK
JUMLAH JUMLAH HARGA
(Rp)
TOTAL (Rp)
Rp -
Rp -
1590 Rp 4,954,312.78
24 Rp 9,344,256.00
Rp -
Rp -
180 Rp 529,200.00
90 Rp 573,750.00
90 Rp 237,462.00
180 Rp 666,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 79,343,069.28
Rp -
1 Rp 444,027.00
1 Rp 66,200.00
Rp -
Rp 510,227.00
334 Rp 3,522,698.00
0 Rp -
537 Rp 6,430,575.00
Rp -
Rp -
10 Rp 132,350.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 10,085,623.00
900 Rp 1,385,643.60
0 Rp -
Rp -
Rp -
0 Rp -
40 Rp 120,000.00
Rp -
Rp 1,505,643.60
Rp 91,444,562.88
Pemeriksa 2 Pemeriksa 3
SELISIH SALDO VS
Keterangan
CEK FISIK
JUMLAH JUMLAH HARGA
(Rp)
TOTAL (Rp)
Rangga Kusuma, SAB Ike Rochmaniar, SE

NIP. 19880130 201101 1 003 NIP. 19800202 201001 2 026
Pemeriksa 4 Pemeriksa 5
Anis Zul Hulaifah, S.STP Dra. Wahyu Ratna Sulistijani

NIP. 19820830 200012 2 001 NIP. 19620814 198903 2 009
PUSKESMAS PULOREJO
TAHUN 2019
rata rata
NAMA OBAT MUTASI KURANG TAHUN 2019
HARGA SATUAN
No. (Rp)
Keterangan
JUMLAH JUMLAH HARGA
TOTAL (Rp)
OBAT
1 ACYCLOVIR TAB Rp 380.00 2059 Rp 782,420.00 172
2 ACYCLOVIR TAB Rp 349.00 0 Rp - 0
3 ACYCLOVIR SALEP Rp 3,000.00 0 Rp - 0
4 ACYCLOVIR SALEP Rp 2,152.00 0 Rp - 0
5 Albendazol tablet 400 mg Rp 404.00 7560 Rp 3,054,240.00 630
6 Albendazol tablet 400 mg Rp 344.00 780 Rp 268,320.00 65
7 ALLOPURINOL TABLET 100 MG Rp 132.00 0 Rp - 0
8 ALLOPURINOL TABLET 100 MG Rp 90.00 3784 Rp 340,560.00 315
9 ALLOPURINOL TABLET 100 MG Rp 86.00 0 Rp - 0
10 AMINOFILIN TAB 200 MG Rp 89.00 400 Rp 35,600.00 33
13 AMINOFILIN INJ 24 MG/ML, 10 ML Rp 3,345.00 23 Rp 76,935.00 2
14 AMINOFILIN INJ 24 MG/ML, 10 ML Rp 3,822.00 0 Rp - 0
15 Amitriptilin HCl tablet salut 25 mg Rp 112.00 500 Rp 56,000.00 42
Rp 167.00 766 Rp 127,922.00 64
16 AMLODIPIN TAB Rp 70.00 24643 Rp 1,725,010.00 2,054
17 AMLODIPIN TAB Rp 105.00 0 Rp - 0
18 AMOKSISILIN SIRUP 125 MG/ML Rp 2,090.00 0 Rp - 0
19 Amoksisilin FORTE sirup kering 250 mg/ Rp 4,070.00 0 Rp - 0
20 AMOKSISILIN SIRUP 125 MG/ML Rp 2,445.00 0 Rp - 0
21 AMOKSISILIN KAPSUL 500 MG Rp 233.00 42489 Rp 9,899,937.00 3,541
22 AMOKSISILIN KAPSUL 500 MG Rp 232.00 0 Rp - 0
23 AMOKSISILIN KAPSUL 500 MG Rp 261.00 0 Rp - 0
24 AMPICILIN INJ Rp 8,237.00 487 Rp 4,011,419.00 41
25 AMPICILIN INJ Rp 4,000.00 0 Rp - 0
28 ANTALGIN TABLET 500 MG Rp 67.00 0 Rp - 0
29 ANTALGIN TABLET 500 MG Rp 145.00 0 Rp - 0
30 ANTASID TAB, MGOH3 + ALOH3 AA200 Rp 30.53 0 Rp - 0
31 ANTASID TAB, MGOH3 + ALOH3 AA200 Rp 62.00 0 Rp - 0
32 ANTASID TAB, MGOH3 + ALOH3 AA200 Rp 54.00 39677 Rp 2,142,558.00 3,306
33 Antasida DOEN suspensi Rp 1,995.00 145 Rp 289,275.00 12
Rp 2,129.00 54 Rp 114,966.00 5
34 ANTI FUNGI Rp 2,025.00 0 Rp - 0
35 ANTI HAEMORHOID SUPPOSITORIA Rp 3,167.00 60 Rp 190,020.00 5
36 Anti Hemoroid DOEN Kombinasi Rp 3,045.00 71 Rp 216,195.00 6
37 Aqua pro Injeksi steril 25 ml/ OTSU SWI 25 ml Rp 2,860.00 7 Rp 20,020.00 1
38 Aquadest 500 ml Rp 19,800.00 4 Rp 79,200.00 0
39 AQUA PRO INJEKSI STERIL, BEBAS PIROGEN 2 Rp 2,750.00 152 Rp 418,000.00 13
40 ASAM ASKORBAT (VIT C) TAB 100 MG Rp 51.00 0 Rp - 0
41 ASAM ASKORBAT (VIT C) TAB 50 MG Rp 104.00 0 Rp - 0
42 ASAM ASKORBAT (VIT C) TAB 50 MG Rp 105.00 20183 Rp 2,119,215.00 1,682
43 Asam Asetil salisilat 80 mg (asetosal ) Rp 99.00 461 Rp 45,639.00 154
44 ASAM MEFENAMAT TAB 500 MG Rp 103.00 66263 Rp 6,825,089.00 5,522
45 ASAM MEFENAMAT TAB 500 MG Rp 106.00 0 Rp - 0
46 Atapulgit tablet 600 mg Rp 136.00 8068 Rp 1,097,248.00 672
47 Atapulgit tablet 600 mg Rp 145.00 0 Rp - 0
48 ASEIL SISTEIN Rp 373.00 3750 Rp 1,398,750.00 313
49 BECARBON Rp 121.00 0 Rp - 0
50 BETAMETASON CREAM 0,1 % Rp 3,388.00 0 Rp - 0
51 BETAMETASON CREAM 0,1 % Rp 3,350.00 158 Rp 529,300.00 13
52 Bisacodyl tablet 5 mg Rp 594.00 74 Rp 43,956.00 6
53 Bisacodyl tablet 5 mg Rp 495.00 61 Rp 30,195.00 5
54 CAPTOPRIL Rp 68.00 1500 Rp 102,000.00 125
55 CAPTOPRIL Rp 75.00 3614 Rp 271,050.00 301
56 CAPTOPRIL 25 mg Rp 84.00 5002 Rp 420,168.00 417
57 CAPTOPRIL tablet 50 mg Rp 140.00 0 Rp - 0
58 CIMETIDIN Rp 114.90 0 Rp - 0
59 CIMETIDIN Rp 110.84 0 Rp - 0
rata rata
HARGA SATUAN
No. (Rp)
Keterangan
JUMLAH JUMLAH HARGA
TOTAL (Rp)
60 CIPROFLOXACIN 500 MG Rp 284.00 0 Rp - 0
64 CEFOTAXIM INJ 1000 MG Rp 6,800.00 0 Rp - 0
65 DEKSAMETASON INJ 5 MG/ML-1 ML Rp 143.89 0 Rp - 0
66 DEKSAMETASON INJ 5 MG/ML-1 ML Rp 1,518.00 89 Rp 135,102.00 7
67 DEKSAMETASON INJ 5 MG/ML-1 ML Rp 1,097.00 536 Rp 587,992.00 45
68 DEKSAMETASON TABLET 0.5 MG Rp 69.00 0 Rp - 0
69 DEKSAMETASON TABLET 0.5 MG Rp 44.00 0 Rp - 0
70 DEKSAMETASON TABLET 0.5 MG Rp 32.00 25418 Rp 813,376.00 2,118
71 DEKTROMERFAN HBR SIRUP 10MG/ML Rp 2,864.40 0 Rp - 0
72 DEKTROMERFAN HBR TAB 15 MG Rp 68.98 0 Rp - 0
73 DEKTROMERFAN HBR TAB 15 MG Rp 90.00 0 Rp - 0
74 DIAZEPAM INJ 5 MG/ML-2 ML Rp 4,180.00 0 Rp - 0
75 DIAZEPAM INJ 5 MG/ML-2 ML Rp 2,365.00 0 Rp - 0
76 DIAZEPAM TABLET 2 MG Rp 19.80 0 Rp - 0
77 DIAZEPAM TABLET 2 MG Rp 86.00 1172 Rp 100,792.00 98
78 DIAZEPAM TABLET 2 MG Rp 45.00 225 Rp 10,125.00 19
79 DIFENHIDRAMIN INJ 10MG/ML-1 ML Rp 60.00 0 Rp - 0
80 DIFENHIDRAMIN INJ 10MG/ML-1 ML Rp 1,095.00 303 Rp 331,785.00 25
81 DIFENHIDRAMIN INJ 10MG/ML-1 ML Rp 1,050.00 36 Rp 37,800.00 3
82 DIGOKSIN TABLET 0.25 MG Rp 104.00 841 Rp 87,464.00 70
83 DIGOKSIN TABLET 0.25 MG Rp 105.00 0 Rp - 0
84 DIGOKSIN TABLET 0.25 MG Rp 97.00 95 Rp 9,215.00 8
85 Dimenhidrinat tablet 50 mg Rp 99.00 0 Rp - 0
Rp 105.00 5209 Rp 546,945.00 434
86 Domperidon tablet 10 mg Rp 91.00 1700 Rp 154,700.00 142
87 Domperidon tablet 10 mg Rp 85.00 6499 Rp 552,415.00 542
88 EKSTRAK BELLADON TABLET 10 MG Rp 26.40 0 Rp - 0
89 EPINEFRIN HCL/BITARTAT (ADRENALIN) INJ 0,1%- Rp 1,408.00 0 Rp - 0
90 ERGOTAMIN CAFEIN Rp 135.00 0 Rp - 0
91 Erytromycin kaplet 500 mg Rp 750.00 2889 Rp 2,166,750.00 241
92 Erytromycin kaplet 500 mg Rp 730.00 2000 Rp 1,460,000.00 167
93 Rp 770.00 1160 Rp 893,200.00 97
94 ETANOL 70% Rp 15,400.00 0 Rp - 0
95 ETANOL 70% Rp 4,400.00 1348 Rp 5,931,200.00 112
96 ETANOL 70% Rp 2,500.00 0 Rp - 0
97 EUGENOL CAIRAN Rp 18,824.00 1 Rp 18,824.00 0
98 EUGENOL CAIRAN Rp 18,100.00 3 Rp 54,300.00 0
99 FANITOIN NATRIUM 100 MG Rp 154.00 485 Rp 74,690.00 40
100 FANITOIN NATRIUM 100 MG Rp 158.00 140 Rp 22,120.00 12
101 FENOBARBITAL TABLET 30 MG Rp 31.00 0 Rp - 0
104 Fitomenadion (Vit.K1) injeksi 2 mg/ml - Rp 3,682.00 180 Rp 662,760.00 15
105 Fitomenadion (Vit.K1) injeksi 2 mg/ml - Rp 3,550.00 0 Rp - 0
106 FITOMENADION TAB SALUT 10 MG Rp 680.61 0 Rp - 0
107 FITOMENADION TAB SALUT 10 MG Rp 710.00 1424 Rp 1,011,040.00 119
108 FITOMENADION TAB SALUT 10 MG Rp 630.00 0 Rp - 0
109 (SIKZONOATE Inj) Rp 59,758.79 100 Rp 5,975,878.99 8
110 (SIKZONOATE Inj) Rp 59,800.00 44 Rp 2,631,200.00 4
111 FUROSEMID TABLET 40 MG Rp 78.00 2164 Rp 168,792.00 180
112 FUROSEMID TABLET 40 MG Rp 77.00 9137 Rp 703,549.00 761
113 GARAM ORALIT UNTUK 200 ML AIR 0 Rp - 0
114 GARAM ORALIT UNTUK 200 ML AIR Rp 292.00 0 Rp - 0
115 GARAM ORALIT UNTUK 200 ML AIR Rp 257.00 3600 Rp 925,200.00 300
116 GARAM ORALIT UNTUK 200 ML AIR Rp 288.00 3979 Rp 1,145,952.00 332
117 GENTIAN VIOLET 1 % Rp 990.90 0 Rp - 0
118 Gentamisin injeksi 40 mg/ml (sbg Sulfat) Rp 3,399.00 187 Rp 635,613.00 16
119 Gentamisin injeksi 40 mg/ml (sbg Sulfat) Rp 3,083.00 195 Rp 601,185.00 16
120 GLIBENKLAMID TABLET 5 MG Rp 80.30 0 Rp - 0
121 GLIBENKLAMID TABLET 5 MG Rp 119.00 7963 Rp 947,597.00 664
122 GLIMEPIRID 2 Rp 207.00 0 Rp - 0
123 GLISERI GUAYAKOLAT TABLET 100 MG Rp 27.90 0 Rp - 0
127 Gliserin 100 ml Rp 6,600.00 0 Rp - 0
rata rata
HARGA SATUAN
No. (Rp)
Keterangan
JUMLAH JUMLAH HARGA
TOTAL (Rp)
128 GLUKOSE LAR INFUS 5 % STERIL Rp 6,900.00 30 Rp 207,000.00 3
129 GLUKOSE LAR INFUS 5 % STERIL Rp 5,200.00 190 Rp 988,000.00 16
130 GRISEOFULVIN 125 MG, MICRONIZE Rp 210.00 688 Rp 144,480.00 57
131 Haloperidol tablet 0,5 mg Rp 59.00 0 Rp - 0
Rp 55.00 2311 Rp 127,105.00 193
132 Haloperidol tablet 5 mg Rp 75.00 0 Rp - 0
133 Haloperidol 5 mg/ml Injeksi Rp 6,250.00 0 Rp - 0
134 Haldol Decanoat 50 mg/ml inj Rp 101,300.00 46 Rp 4,659,800.00 4
135 Haldol Decanoat 50 mg/ml inj Rp 97,491.45 0 Rp - 0
136 HIDROKHLOROTIAZID TABLET 25 MG Rp 24.64 0 Rp - 0
137 HIDROKHLOROTIAZID TABLET 25 MG Rp 36.30 0 Rp - 0
138 HIDROKORTISON KREM 2,5 % Rp 2,708.33 0 Rp - 0
141 HIDROKORTISON KREM 2,5 % Rp 2,475.00 92 Rp 227,700.00 8
142 INH Rp 145.00 1200 Rp 174,000.00 100
143 IBUPROFEN TABLET 400 MG Rp 205.04 0 Rp - 0
146 IBUPROFEN TABLET 400 MG Rp 31,650.00 0 Rp - 0
147 ISOSORBID DINITRAT TABLET SUBLINGA Rp 89.00 420 Rp 37,380.00 35
148 ISOSORBID DINITRAT TABLET SUBLINGA Rp 88.00 477 Rp 41,976.00 40
149 KALSIUM GLUKONAT INJ Rp 9,955.00 0 Rp - 0
150 KALSIUM LAKTAT TAB 500 MG Rp 52.00 0 Rp - 0
151 KALSIUM LAKTAT TAB 500 MG Rp 63.00 0 Rp - 0
152 KALSIUM LAKTAT TAB 500 MG Rp 59.00 21140 Rp 1,247,260.00 1,762
153 Ketokonazol tablet 200 mg Rp 270.00 275 Rp 74,250.00 23
154 KETOPROFEN SUPPO Rp 2,380.00 7 Rp 16,660.00 1
155 KHLORAMFENIKOL KAPSUL 250 MG Rp 495.00 6500 Rp 3,217,500.00 542
156 KHLORAMFENIKOL KAPSUL 250 MG Rp 249.00 0 Rp - 0
157 KHLORAMFENIKOL 1% SALEP MATA Rp 1,798.00 0 Rp - 0
158 KHLORAMFENIKOL 1% SALEP MATA Rp 1,881.00 251 Rp 472,131.00 21
159 KHLORAMFENIKOL TT 3% Rp 7,150.00 1 Rp 7,150.00 0
160 KHLORAMFENIKOL TT 3% Rp 2,310.00 0 Rp - 0
161 KHLORAMFENIKOL TT 3% Rp 1,815.00 0 Rp - 0
162 KHLORAMFENIKOL TETES MATA Rp 6,380.00 0 Rp - 0
165 KHLORAMFENIKOL SYRUP Rp 5,500.00 0 Rp - 0
166 KHLORAMFENIKOL SYRUP Rp 5,015.00 5 Rp 25,075.00 0
167 KHLORAMFENIKOL SYRUP Rp 4,700.00 50 Rp 235,000.00 4
168 Kloramfenikol kapsul 250 mg Rp 249.00 0 Rp - 0
Kloramfenikol kapsul 250 mg Rp 495.00 2700 Rp 1,336,500.00 225
169 KLORAMFENIKOL INJEKSI Rp 10,175.00 136 Rp 1,383,800.00 11
170 KLORAMFENIKOL INJEKSI Rp 9,900.04 0 Rp - 0
171 KLORAMFENIKOL SK Rp 3,038.00 63 Rp 191,394.00 5
172 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 24.00 0 Rp - 0
173 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 42.00 0 Rp - 0
174 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 22.00 40596 Rp 893,112.00 3,383
175 KHLORFENIRAMIN MALEAT (CTM TAB) Rp 23.00 13200 Rp 303,600.00 1,100
176 Klorpromazin HCl tablet salut 100 mg Rp 147.00 3761 Rp 552,867.00 313
177 Klorpromazin HCl tablet salut 100 mg Rp 162.00 0 Rp - 0
178 KHLORPROMAZIN HCL TABLET 25 MG Rp 60.50 0 Rp - 0
181 KODEIN HCL TABLET 10 MG Rp 550.00 0 Rp - 0
182 KODEIN HCL TABLET 10 MG Rp 571.00 1119 Rp 638,949.00 93
183 KOTRIMOKSAZOL SUSPENSI Rp 3,500.00 0 Rp - 0
184 KOTRIMOKSAZOL SUSPENSI Rp 2,574.00 0 Rp - 0
185 KOTRIMOKSAZOL SUSPENSI Rp 2,167.00 101 Rp 218,867.00 8
186 KOTRIMOKSAZOL ADULT TABLET Rp 100.00 0 Rp - 0
189 KOTRIMOKSAZOL ADULT TABLET Rp 138.00 3159 Rp 435,942.00 263
190 KOMBIVENT Rp 4,550.00 161 Rp 732,550.00 13
191 Larutan elektrolit D5-1/4ns Rp 7,700.00 140 Rp 1,078,000.00 12
192 Larutan elektrolit D5-1/2ns Rp 9,400.00 80 Rp 752,000.00 7
193 LIDOKAIN COMP INJ-2 ML Rp 1,136.67 0 Rp - 0
194 LIDOKAIN COMP INJ-2 ML Rp 1,145.00 263 Rp 301,135.00 22
rata rata
HARGA SATUAN
No. (Rp)
Keterangan
JUMLAH JUMLAH HARGA
TOTAL (Rp)
195 LIDOKAIN COMP INJ-2 ML Rp 1,845.00 126 Rp 232,470.00 11
196 LORATADIN Rp 123.00 1620 Rp 199,260.00 135
197 Magnesium Sulfat injeksi (iv) 40 % - 25 Rp 3,796.00 36 Rp 136,656.00 3
198 Magnesium Sulfat injeksi (iv) 20 % - 25 Rp 3,328.00 36 Rp 119,808.00 3
199 Mikonazole krim/salep 2 % (Nitrat) Rp 3,250.00 26 Rp 84,500.00 2
200 Mikonazole krim/salep 2 % (Nitrat) Rp 3,414.00 34 Rp 116,076.00 3
201 Metamizole injeksi 500 mg/ 1 ml Rp 7,150.00 0 Rp - 0
202 Metamizole injeksi 500 mg/ 1 ml Rp 6,600.00 0 Rp - 0
203 Metformin HCl tablet 500 mg Rp 100.00 1299 Rp 129,900.00 108
204 Metformin HCl tablet 500 mg Rp 96.00 1940 Rp 186,240.00 162
205 METILERGOMETRINMALEAT TAB 0,125 Rp 275.00 380 Rp 104,500.00 32
Rp 210.00 160 Rp 33,600.00 13
206 METILERGOMETRINMALEAT INJ Rp 2,684.00 36 Rp 96,624.00 3
Rp 2,959.00 10 Rp 29,590.00 1
207 METRONIDAZOL TABLET 500 MG Rp 133.00 0 Rp - 0
208 METRONIDAZOL TABLET 250 MG Rp 110.00 0 Rp - 0
209 METOKLOPROPAMIDE TABLET Rp 99.00 0 Rp - 0
210 Monochlorkamfer mentol ( CHKM ) Rp 60,500.00 0 Rp - 0
211 NA CL LAR INFUS 0,9 % STERIL Rp 6,410.00 113 Rp 724,330.00 9
212 Natrium Diklofenak tablet 50 mg Rp 115.00 3800 Rp 437,000.00 317
213 Natrium Diklofenak tablet 50 mg Rp 159.00 0 Rp - 0
214 Natrium Klorida larutan infus 0,9 % steril Rp 6,410.00 12 Rp 76,920.00 1
225 OBH Rp 2,970.00 0 Rp - 0
226 OKSITOSIN Rp 1,900.00 91 Rp 172,899.73 8
227 OKSITOSIN Rp 1,900.00 100 Rp 190,000.00 8
228 OKSITETRASIKLIN HCL SALEP MATA 3% Rp 2,500.00 34 Rp 85,000.00 3
229 Omeprazol kapsul 20 mg Rp 139.00 1405 Rp 195,295.00 117
230 Omeprazol injeksi 40 mg/ 10 ml Rp 36,000.00 0 Rp - 0
231 PARASETAMOL SIRUP 120 MG/5ML Rp 1,107.00 607 Rp 671,949.00 51
232 PARASETAMOL SIRUP 120 MG/5ML Rp 1,010.00 527 Rp 532,270.00 44
233 PARASETAMOL TABLET 500 MG Rp 53.00 102133 Rp 5,413,049.00 8,511
234 PARASETAMOL TABLET 500 MG Rp 56.00 0 Rp - 0
235 Rp 49.00 0 Rp - 0
236 PIRANTEL PAMOAT TAB 125 MG BASA 0 Rp - 0
237 PIRIDOKSIN HCL TABLET 10 MG Rp 123.00 18812 Rp 2,313,876.00 1,568
238 PIRIDOKSIN HCL TABLET 10 MG Rp 27.50 0 Rp - 0
239 PIRIDOKSIN HCL TABLET 10 MG Rp 118.00 6113 Rp 721,334.00 509
240 POLIKRESULEN 0 Rp - 0
241 PREDNISON TABLET 5 MG Rp 40.00 0 Rp - 0
242 PREDNISON TABLET 5 MG Rp 96.00 8123 Rp 779,808.00 677
243 PREDNISON TABLET 5 MG Rp 68.00 10000 Rp 680,000.00 833
248 PROPRANOLOL HCL TABLET 10 MG Rp 65.00 0 Rp - 0
249 PROPRANOLOL HCL TABLET 10 MG Rp 82.50 214 Rp 17,655.00 18
250 Ranitidin tablet 150 mg Rp 120.00 0 Rp - 0
251 Ranitidin injeksi 25 mg / 2 ml Rp 1,140.00 0 Rp - 0
252 RETINOL KAPSUL LUNAK 200.000IU Rp 519.20 500 Rp 259,600.00 42
253 RETINOL KAPSUL LUNAK 200.000IU Rp 517.00 5600 Rp 2,895,200.00 467
254 RETINOL KAPSUL LUNAK 100.000IU Rp 284.00 500 Rp 142,000.00 42
255 Rp 288.00 2400 Rp 691,200.00 200
256 RINGER LAKTAT LAR INFUS STERIL Rp 7,150.00 3636 Rp 25,997,400.00 303
257 RINGER LAKTAT LAR INFUS STERIL Rp 5,200.00 0 Rp - 0
258 RINGER LAKTAT LAR INFUS STERIL Rp 5,189.80 0 Rp - 0
259 RISPERIDON Rp 347.00 375 Rp 130,125.00 31
260 Asering Laruran Infus Rp 15,899.40 0 Rp - 0
261 Asering Laruran Infus Rp 9,000.00 0 Rp - 0
262 SALBUTAMOL TABLET 2 MG Rp 66.00 1264 Rp 83,424.00 105
263 SALBUTAMOL TABLET 2 MG Rp 63.00 498 Rp 31,374.00 42
264 SALBUTAMOL TABLET 4 MG Rp 89.00 0 Rp - 0
265 SALEP 2,4 KOMBINASI Rp 826.00 0 Rp - 0
266 SALEP 2,4 KOMBINASI Rp 2,000.00 0 Rp - 0
267 SALEP 2,4 KOMBINASI Rp 2,620.00 88 Rp 230,560.00 7
275 SATS 1.500 IU/AMPUL Rp 130,999.00 36 Rp 4,715,964.00 3
276 SIANOKOBALAMIN INJ 500 MCG/ML, 1M Rp 916.00 0 Rp - 0
277 SIANOKOBALAMIN INJ 500 MCG/ML, 1M Rp 1,078.00 9 Rp 9,702.00 1
278 Simvastatin tablet 10 mg Rp 110.00 2412 Rp 265,320.00 201
279 Sefadroxil kapsul 500 mg Rp 509.00 0 Rp - 0
280 ZINC TAB Rp 475.00 0 Rp - 0
281 ZINC TAB Rp - 0 Rp - 0
282 ZINC TAB Rp 524.00 2898 Rp 1,518,552.00 242
rata rata
HARGA SATUAN
No. (Rp)
Keterangan
JUMLAH JUMLAH HARGA
TOTAL (Rp)
283 ZINC TAB Rp 474.00 1602 Rp 759,348.00 134
284 SULFASETAMID T.M 15% Rp 3,446.00 0 Rp - 0
285 SULFASETAMID T.M 15% Rp 3,226.00 0 Rp - 0
286 TABLET TAMBAH DARAH KOMBINASI Rp 354.00 83913 Rp 29,705,202.00 6,993
289 TETRASIKLINA KAPSUL 500MG Rp 310.00 70 Rp 21,700.00 6
290 TIAMIN HCL MONOHIDRAT TABLET 50 Rp 85.00 9000 Rp 765,000.00 750
291 Tiamfenikol kapsul 500 mg Rp 739.20 0 Rp - 0
292 Tiamfenikol kapsul 500 mg Rp 495.00 2210 Rp 1,093,950.00 184
293 Tiamin (Viamin B1) tablet 50 mg Rp 86.00 7587 Rp 652,482.00 632
294 Tiamin (Vitamin B1) tablet 100 mg Rp 85.00 8000 Rp 680,000.00 667
Rp 91.00 13706 Rp 1,247,246.00 1,142
295 TRIHEKSIFINIDIL 2 MG Rp 88.00 0 Rp - 0
296 TRIHEKSIFINIDIL 2 MG Rp 80.00 623 Rp 49,840.00 52
297 TRIHEKSIFINIDIL 2 MG Rp 85.00 1938 Rp 164,730.00 162
298 VIT B KOMPLEKS TABLET Rp 115.00 7537 Rp 866,755.00 628
299 VIT B KOMPLEKS TABLET Rp 83.00 29309 Rp 2,432,647.00 2,442
Rp 89.00 3500 Rp 311,500.00 292
300 VENTOLIN INHALER(Salbutamol CFC 200 Rp 63,750.00 0 Rp - 0
301 YODIUM POVIDON LAR 10%, 30ML 0 Rp - 0
304 MINERAL MIX Rp 3,115.92 810 Rp 2,523,895.19 68
305 OAT kat 1 Rp 389,344.00 26 Rp 10,122,944.00 2
306 FDC Kit KAT 1 Rp 359,985.00 3 Rp 1,079,955.00 0
307 FDC Kit KAT 2 Rp 1,297,894.00 3 Rp 3,893,682.00 0
Nevirapine (NVP) 200 mg Rp 2,940.00 0 Rp - 0
Efavirenz (EFV) 600 mg Rp 6,375.00 0 Rp - 0
Tenofovir 300mg (TDF) + Lamivudin
(3TC) 300 + Efaviren 600 (Triple FDC)
Dewasa Rp 2,638.47 0 Rp - 0
(3TC) 150mg Rp 3,700.00 0 Rp - 0
308 MB DEWASA Rp 45,122.00 7 Rp 315,854.00 1
309 Rp 31,570.00 24 Rp 757,680.00 2
Rp 41,784.00 6 Rp 250,704.00 1
MB anak Rp 28,354.00 6 Rp 170,124.00 1
310 PB DEWASA Rp 35,602.00 2 Rp 71,204.00 0
JUMLAH TOTAL OBAT Rp 226,604,302.51
OBAT GIGI
1 EUGENOL CAIRAN Rp 18,824.00 0 Rp -
2 Glass Ionomer Cement ART Rp 444,027.00 1 Rp 444,027.00
3 CHKM Rp 66,200.00 0 Rp -
4 Rp 521,235.00 0 Rp -
JUMLAH TOTAL OBAT GIGI Rp 444,027.00
REAGEN LABORATORIUM
1 Rp
Reagen Hepatitis B (HBSAg dan Dropper)10,547.00 266 Rp 2,805,502.00
Rp 9,850.00 200 Rp 1,970,000.00
2 Reagen HIV R1 (Standart Diagnostic) Rp 11,975.00 663 Rp 7,939,425.00
Rp 14,344.00 152 Rp 2,180,288.00
3 Reagen HIV R2 Rp 14,470.00 23 Rp 332,810.00
Rp 13,235.00 0 Rp -
4 Reagen HIV R3 Rp 19,839.00 3 Rp 59,517.00
Rp 19,480.00 5 Rp 97,400.00
5 HUMAN HEXAGON SIPHILYS Rp 26,671.00 17 Rp 453,407.00
Rp 20,400.00 300 Rp 6,120,000.00
Rp 9,611.00 200 Rp 1,922,200.00
7 Reagen Hepatitis B Rp 9,850.00 251 Rp 2,472,350.00
10 Reagen Urine Stik 10 Parameter Rp 2,200.00 0 Rp -
11 REAGEN GOLONGAN DARAH A Rp 104,500.00 0 Rp -
12 REAGEN GOLONGAN DARAH B Rp 104,500.00 0 Rp -
JUMLAH TOTAL REAGEN LABORATORIUM Rp 26,352,899.00
1 ALAT SUNTIK SEKALI PAKAI 1 ML Rp 1,539.60 100 Rp 153,960.40
2 ALAT SUNTIK SEKALI PAKAI 1 ML Rp 990.00 322 Rp 318,780.00
4 ALAT SUNTIK SEKALI PAKAI 2.5 ML Rp 957.00 0 Rp -
25 KASA PEMBALUT 4MX3CM Rp 660.00 0 Rp -
26 KASA PEMBALUT 16MX16CM Rp 362.50 1504 Rp 545,200.00
44 Urin bag Rp 3,000.00 30 Rp 90,000.00
45 Hands shoen No. 7 Rp 4,612.48 0 Rp -
rata rata
HARGA SATUAN
No. (Rp)
Keterangan
JUMLAH JUMLAH HARGA
TOTAL (Rp)
JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 1,107,940.40

TOTAL Rp 254,509,168.91
Mengetahui
Kepala Puskesmas Pulorejo Pemeriksa 1
dr. RITA ANDAYANI Taufik Akbar Solikin, ST

NIP. 1977050920110120003 NIP.197901272011011002
HASIL STOCK OPNAME
SALDO AWAL 1 PENGURANGAN SALDO AKHIR 31

NO URAIAN PENAMBAHAN 2019 Nilai Persediaan
JANUARI 2019 2019 DESEMBER 2019 Jumlah
(Rp)
1 2 3 4 5 6=(3+4-5) 7 8
OBAT
1 ACYCLOVIR TAB 694 2,100 2,059 735 735 Rp 279,300.00
ACYCLOVIR TAB 0 0 0 0 Rp -
2 ACYCLOVIR SALEP 0 0 Rp -
ACYCLOVIR SALEP 0 0 Rp -
3 Albendazol tablet 400 mg 7,560 7,560 0 Rp -
Albendazol tablet 400 mg 780 780 0 0 Rp -
4 ALLOPURINOL TABLET 100 MG 0 0 Rp -
ALLOPURINOL TABLET 100 MG 2,205 4,000 3,784 2,421 2,421 Rp 217,890.00
ALLOPURINOL TABLET 100 MG 0 0 Rp -
5 AMINOFILIN TAB 200 MG 3,400 400 3,000 3,000 Rp 267,000.00
AMINOFILIN TAB 200 MG 783 200 983 0 0 Rp -
AMINOFILIN TAB 200 MG 1,000 1,000 0 0 Rp -
6 AMINOFILIN INJ 24 MG/ML, 10 ML 23 23 0 0 Rp -
AMINOFILIN INJ 24 MG/ML, 10 ML 0 0 0 0 Rp -
7 Amitriptilin HCl tablet salut 25 mg 500 500 0 Rp -
100 1,200 766 534 534 Rp 89,178.00
8 AMLODIPIN TAB 7,243 17,400 24,643 0 0 Rp -
AMLODIPIN TAB 0 0 Rp -
9 AMOKSISILIN SIRUP 125 MG/ML 0 0 0 0 Rp -
10 Amoksisilin FORTE sirup kering 250 mg/5ml 0 0 Rp -
AMOKSISILIN SIRUP 125 MG/ML 0 0 Rp -
11 AMOKSISILIN KAPSUL 500 MG 60,000 42,489 17,511 17,511 Rp 4,080,063.00
AMOKSISILIN KAPSUL 500 MG 0 0 Rp -
AMOKSISILIN KAPSUL 500 MG 0 0 0 0 Rp -
12 AMPICILIN INJ 2,000 487 1,513 1,513 Rp 12,462,581.00
AMPICILIN INJ 0 0 Rp -
13 ANTALGIN TABLET 500 MG 0 0 Rp -
ANTALGIN TABLET 500 MG 0 0 Rp -
14 ANTASID TAB, MGOH3 + ALOH3 AA200MG 0 0 Rp -
ANTASID TAB, MGOH3 + ALOH3 AA200MG 0 0 Rp -
ANTASID TAB, MGOH3 + ALOH3 AA200MG 20,407 39,600 39,677 20,330 20,330 Rp 1,097,820.00
15 Antasida DOEN suspensi 45 100 145 0 0 Rp -
200 54 146 146 Rp 310,834.00
16 ANTI FUNGI 0 0 Rp -
17 ANTI HAEMORHOID SUPPOSITORIA 190 60 130 130 Rp 411,710.00
Anti Hemoroid DOEN Kombinasi 71 71 0 0 Rp -
18 Aqua pro Injeksi steril 25 ml/ OTSU SWI 25 ml 84 7 77 77 Rp 220,220.00
19 Aquadest 500 ml 10 4 6 6 Rp 118,800.00
AQUA PRO INJEKSI STERIL, BEBAS PIROGEN 20 ML 152 152 0 Rp -
20 ASAM ASKORBAT (VIT C) TAB 100 MG 0 0 Rp -
ASAM ASKORBAT (VIT C) TAB 50 MG 0 0 Rp -
ASAM ASKORBAT (VIT C) TAB 50 MG 5,954 28,000 20,183 13,771 13,771 Rp 1,445,955.00
21 Asam Asetil salisilat 80 mg (asetosal ) 0 2,000 461 1,539 1,539 Rp 152,361.00
22 ASAM MEFENAMAT TAB 500 MG 10,111 77,900 66,263 21,748 21,748 Rp 2,240,044.00
ASAM MEFENAMAT TAB 500 MG 0 0 Rp -
23 Atapulgit tablet 600 mg 2,922 7,200 8,068 2,054 2,054 Rp 279,344.00
Atapulgit tablet 600 mg 0 0 Rp -
24 ASEIL SISTEIN 11,200 3,750 7,450 7,450 Rp 2,778,850.00
25 BECARBON 0 0 Rp -
26 BETAMETASON CREAM 0,1 % 0 0 Rp -
BETAMETASON CREAM 0,1 % 97 325 158 264 264 Rp 884,400.00
27 Bisacodyl tablet 5 mg 100 74 26 26 Rp 15,444.00
Bisacodyl tablet 5 mg 61 61 0 0 Rp -
28 CAPTOPRIL 1,500 1,500 0 Rp -
CAPTOPRIL 4,000 3,614 386 386 Rp 28,950.00
CAPTOPRIL 25 mg 5,002 5,002 0 0 Rp -
CAPTOPRIL tablet 50 mg 0 0 Rp -
29 CIMETIDIN 0 0 Rp -
CIMETIDIN 0 0 Rp -
30 CIPROFLOXACIN 500 MG 0 0 Rp -
CIPROFLOXACIN 500 MG 0 0 Rp -
31 CEFOTAXIM INJ 1000 MG 0 0 Rp -
32 DEKSAMETASON INJ 5 MG/ML-1 ML 0 0 Rp -
DEKSAMETASON INJ 5 MG/ML-1 ML 89 89 0 Rp -
DEKSAMETASON INJ 5 MG/ML-1 ML 760 536 224 224 Rp 245,728.00
33 DEKSAMETASON TABLET 0.5 MG 0 0 Rp -
DEKSAMETASON TABLET 0.5 MG 0 0 Rp -
DEKSAMETASON TABLET 0.5 MG 673 39,600 25,418 14,855 14,855 Rp 475,360.00
34 DEKTROMERFAN HBR SIRUP 10MG/ML 0 0 Rp -
DEKTROMERFAN HBR TAB 15 MG 0 0 Rp -
DEKTROMERFAN HBR TAB 15 MG 0 0 Rp -
35 DIAZEPAM INJ 5 MG/ML-2 ML 10 0 10 10 Rp 41,800.00
DIAZEPAM INJ 5 MG/ML-2 ML 0 0 Rp -
36 DIAZEPAM TABLET 2 MG 0 0 Rp -
DIAZEPAM TABLET 2 MG 1,700 1,172 528 528 Rp 45,408.00
DIAZEPAM TABLET 2 MG 225 225 0 Rp -
37 DIFENHIDRAMIN INJ 10MG/ML-1 ML 0 0 Rp -
DIFENHIDRAMIN INJ 10MG/ML-1 ML 480 303 177 177 Rp 193,815.00
DIFENHIDRAMIN INJ 10MG/ML-1 ML 36 36 0 Rp -
38 DIGOKSIN TABLET 0.25 MG 1,200 841 359 359 Rp 37,336.00
DIGOKSIN TABLET 0.25 MG 0 0 Rp -
DIGOKSIN TABLET 0.25 MG 95 95 0 Rp -
39 Dimenhidrinat tablet 50 mg 0 0 Rp -
1,690 5,500 5,209 1,981 1,981 Rp 208,005.00
40 Domperidon tablet 10 mg 1,700 1,700 0 Rp -
Domperidon tablet 10 mg 1,354 6,000 6,499 855 855 Rp 72,675.00
41 EKSTRAK BELLADON TABLET 10 MG 0 0 Rp -
42 EPINEFRIN HCL/BITARTAT (ADRENALIN) INJ 0,1%-1ML 2 0 2 2 Rp 2,816.00
43 ERGOTAMIN CAFEIN 0 0 Rp -
44 Erytromycin kaplet 500 mg 2,889 2,889 0 Rp -
Erytromycin kaplet 500 mg 2,000 2,000 0 Rp -
5,000 1,160 3,840 3,840 Rp 2,956,800.00
45 ETANOL 70% 0 0 Rp -
ETANOL 70% 548 800 1,348 0 0 Rp -
ETANOL 70% 0 0 Rp -
46 EUGENOL CAIRAN 0 1 1 0 Rp -
EUGENOL CAIRAN 3 3 0 0 Rp -
47 FANITOIN NATRIUM 100 MG 485 485 0 0 Rp -
FANITOIN NATRIUM 100 MG 2,000 140 1,860 1,860 Rp 293,880.00
48 FENOBARBITAL TABLET 30 MG 0 0 Rp -
49 Fitomenadion (Vit.K1) injeksi 2 mg/ml -1 ml 270 180 90 90 Rp 331,380.00
Fitomenadion (Vit.K1) injeksi 2 mg/ml -1 ml 0 0 0 Rp -
50 FITOMENADION TAB SALUT 10 MG 0 0 Rp -
FITOMENADION TAB SALUT 10 MG 1,131 1,400 1,424 1,107 1,107 Rp 785,970.00
FITOMENADION TAB SALUT 10 MG 0 0 Rp -
51 (SIKZONOATE Inj) 100 100 0 Rp -
(SIKZONOATE Inj) 14 30 44 0 0 Rp -
52 FUROSEMID TABLET 40 MG 2,164 2,164 0 Rp -
FUROSEMID TABLET 40 MG 12,000 9,137 2,863 2,863 Rp 220,451.00
53 GARAM ORALIT UNTUK 200 ML AIR 0 0 Rp -
GARAM ORALIT UNTUK 200 ML AIR 0 0 Rp -
GARAM ORALIT UNTUK 200 ML AIR 3,600 3,600 0 Rp -
GARAM ORALIT UNTUK 200 ML AIR 1,358 4,800 3,979 2,179 2,179 Rp 627,552.00
54 GENTIAN VIOLET 1 % 0 0 Rp -
55 Gentamisin injeksi 40 mg/ml (sbg Sulfat) 37 150 187 0 0 Rp -
Gentamisin injeksi 40 mg/ml (sbg Sulfat) 195 195 0 Rp -
56 GLIBENKLAMID TABLET 5 MG 0 0 0 Rp -
GLIBENKLAMID TABLET 5 MG 4,006 6,500 7,963 2,543 2,543 Rp 302,617.00
57 GLIMEPIRID 2 0 0 Rp -
58 GLISERI GUAYAKOLAT TABLET 100 MG 0 0 Rp -
GLISERI GUAYAKOLAT TABLET 100 MG 0 0 Rp -
59 Gliserin 100 ml 0 0 Rp -
60 GLUKOSE LAR INFUS 5 % STERIL 200 30 170 170 Rp 1,173,000.00
GLUKOSE LAR INFUS 5 % STERIL 190 190 0 Rp -
61 GRISEOFULVIN 125 MG, MICRONIZE 328 1,500 688 1,140 1,140 Rp 239,400.00
62 Haloperidol tablet 0,5 mg 0 0 0 Rp -
1,481 1,800 2,311 970 970 Rp 53,350.00
Haloperidol tablet 5 mg 0 0 0 Rp -
63 Haloperidol 5 mg/ml Injeksi 0 0 0 Rp -
64 Haldol Decanoat 50 mg/ml inj 80 46 34 34 Rp 3,444,200.00
Haldol Decanoat 50 mg/ml inj 0 0 Rp -
65 HIDROKHLOROTIAZID TABLET 25 MG 0 0 Rp -
HIDROKHLOROTIAZID TABLET 25 MG 0 0 Rp -
66 HIDROKORTISON KREM 2,5 % 0 0 Rp -
HIDROKORTISON KREM 2,5 % 0 0 Rp -
HIDROKORTISON KREM 2,5 % 0 0 Rp -
HIDROKORTISON KREM 2,5 % 44 48 92 0 0 Rp -
67 INH 1,200 1,200 0 0 Rp -
68 IBUPROFEN TABLET 400 MG 0 0 Rp -
IBUPROFEN TABLET 400 MG 0 0 Rp -
69 ISOSORBID DINITRAT TABLET SUBLINGAL 5 MG 1,000 420 580 580 Rp 51,620.00
ISOSORBID DINITRAT TABLET SUBLINGAL 5 MG 477 477 0 Rp -
70 KALSIUM GLUKONAT INJ 24 0 24 24 Rp 238,920.00
71 KALSIUM LAKTAT TAB 500 MG 0 0 Rp -
KALSIUM LAKTAT TAB 500 MG 0 0 Rp -
KALSIUM LAKTAT TAB 500 MG 7,108 19,000 21,140 4,968 4,968 Rp 293,112.00
72 Ketokonazol tablet 200 mg 275 275 0 0 Rp -
73 KETOPROFEN SUPPO 9 10 7 12 12 Rp 28,560.00
74 KHLORAMFENIKOL KAPSUL 250 MG 6,500 6,500 0 0 Rp -
KHLORAMFENIKOL KAPSUL 250 MG 0 0 Rp -
75 KHLORAMFENIKOL 1% SALEP MATA 0 0 Rp -
KHLORAMFENIKOL 1% SALEP MATA 94 240 251 83 83 Rp 156,123.00
76 KHLORAMFENIKOL TT 3% 1 1 0 Rp -
KHLORAMFENIKOL TT 3% 0 0 Rp -
KHLORAMFENIKOL TT 3% 0 0 Rp -
77 KHLORAMFENIKOL TETES MATA 0 0 Rp -
KHLORAMFENIKOL TETES MATA 0 0 Rp -
KHLORAMFENIKOL TETES MATA 0 0 Rp -
78 KHLORAMFENIKOL SYRUP 0 0 Rp -
KHLORAMFENIKOL SYRUP 100 5 95 95 Rp 476,425.00
KHLORAMFENIKOL SYRUP 50 50 0 0 Rp -
Kloramfenikol kapsul 250 mg 0 0 Rp -
Kloramfenikol kapsul 250 mg 2,700 2,700 0 Rp -
79 KLORAMFENIKOL INJEKSI 136 136 0 0 Rp -
KLORAMFENIKOL INJEKSI 0 0 Rp -
80 KLORAMFENIKOL SK 43 72 63 52 52 Rp 157,976.00
81 KHLORFENIRAMIN MALEAT (CTM TAB) 0 0 Rp -
KHLORFENIRAMIN MALEAT (CTM TAB) 0 0 Rp -
KHLORFENIRAMIN MALEAT (CTM TAB) 11,018 39,300 40,596 9,722 9,722 Rp 213,884.00
KHLORFENIRAMIN MALEAT (CTM TAB) 13,200 13,200 0 Rp -
82 Klorpromazin HCl tablet salut 100 mg 127 4,800 3,761 1,166 1,166 Rp 171,402.00
Klorpromazin HCl tablet salut 100 mg 0 0 Rp -
KHLORPROMAZIN HCL TABLET 25 MG 0 0 Rp -
83 KODEIN HCL TABLET 10 MG 0 0 Rp -
KODEIN HCL TABLET 10 MG 130 1,300 1,119 311 331 Rp 177,581.00
84 KOTRIMOKSAZOL SUSPENSI 0 0 Rp -
KOTRIMOKSAZOL SUSPENSI 0 0 Rp -
KOTRIMOKSAZOL SUSPENSI 101 101 0 Rp -
85 KOTRIMOKSAZOL ADULT TABLET 0 0 Rp -
KOTRIMOKSAZOL ADULT TABLET 0 0 Rp -
KOTRIMOKSAZOL ADULT TABLET 0 0 Rp -
KOTRIMOKSAZOL ADULT TABLET 3,159 3,159 0 Rp -
86 KOMBIVENT 21 140 161 0 0 Rp -
Larutan elektrolit D5-1/4ns 140 140 0 0 Rp -
Larutan elektrolit D5-1/2ns 80 80 0 0 Rp -
87 LIDOKAIN COMP INJ-2 ML 0 0 Rp -
LIDOKAIN COMP INJ-2 ML 420 263 157 157 Rp 179,765.00
LIDOKAIN COMP INJ-2 ML 126 126 0 0 Rp -
88 LORATADIN 920 1,100 1,620 400 400 Rp 49,200.00
89 Magnesium Sulfat injeksi (iv) 40 % - 25 ml 41 36 5 5 Rp 18,980.00
90 Magnesium Sulfat injeksi (iv) 20 % - 25 ml 36 36 0 0 Rp -
91 Mikonazole krim/salep 2 % (Nitrat) 26 26 0 Rp -
Mikonazole krim/salep 2 % (Nitrat) 96 34 62 62 Rp 211,668.00
92 Metamizole injeksi 500 mg/ 1 ml 0 0 Rp -
Metamizole injeksi 500 mg/ 1 ml 0 0 Rp -
93 Metformin HCl tablet 500 mg 1,299 1,299 0 0 Rp -
Metformin HCl tablet 500 mg 4,100 1,940 2,160 2,160 Rp 207,360.00
94 METILERGOMETRINMALEAT TAB 0,125 MG 80 300 380 0 0 Rp -
500 160 340 340 Rp 71,400.00
95 METILERGOMETRINMALEAT INJ 36 36 0 Rp -
100 10 90 90 Rp 266,310.00
96 METRONIDAZOL TABLET 500 MG 0 0 Rp -
METRONIDAZOL TABLET 250 MG 0 0 Rp -
97 METOKLOPROPAMIDE TABLET 0 0 Rp -
Monochlorkamfer mentol ( CHKM ) 0 0 Rp -
98 NA CL LAR INFUS 0,9 % STERIL 200 113 87 87 Rp 557,670.00
99 Natrium Diklofenak tablet 50 mg 6,800 3,800 3,000 3,000 Rp 345,000.00
Natrium Diklofenak tablet 50 mg 0 0 Rp -
Natrium Klorida larutan infus 0,9 % steril 12 12 0 Rp -
100 NIFEDIPIN 0 0 Rp -
NIFEDIPIN 0 0 Rp -
OAT SISIPAN 0 0 Rp -
101 OBH 0 0 Rp -
OBH 0 0 Rp -
OBH 0 0 Rp -
OBH 0 0 Rp -
102 OKSITOSIN 91 91 0 Rp -
OKSITOSIN 100 100 0 0 Rp -
103 OKSITETRASIKLIN HCL SALEP MATA 3% 100 34 66 66 Rp 165,000.00
104 Omeprazol kapsul 20 mg 2,100 1,405 695 695 Rp 96,605.00
Omeprazol injeksi 40 mg/ 10 ml 0 0 Rp -
105 PARASETAMOL SIRUP 120 MG/5ML 700 607 93 93 Rp 102,951.00
PARASETAMOL SIRUP 120 MG/5ML 227 300 527 0 0 Rp -
106 PARASETAMOL TABLET 500 MG 31,746 89,000 102,133 18,613 18,613 Rp 986,489.00
PARASETAMOL TABLET 500 MG 0 0 Rp -
0 0 Rp -
107 PIRANTEL PAMOAT TAB 125 MG BASA 0 0 Rp -
108 PIRIDOKSIN HCL TABLET 10 MG 27,200 18,812 8,388 8,388 Rp 1,031,724.00
PIRIDOKSIN HCL TABLET 10 MG 0 0 Rp -
PIRIDOKSIN HCL TABLET 10 MG 6,113 6,113 0 Rp -
POLIKRESULEN 0 0 Rp -
109 PREDNISON TABLET 5 MG 0 0 Rp -
PREDNISON TABLET 5 MG 6,123 2,000 8,123 0 Rp -
PREDNISON TABLET 5 MG 10,000 10,000 0 Rp -
PREDNISON TABLET 5 MG 0 0 Rp -
PPC INJEKSI 3 JUTA IU 0 0 Rp -
110 POVIDON IODINE 10 0 10 10 Rp 180,000.00
111 PROPRANOLOL HCL TABLET 40 MG 0 0 Rp -
PROPRANOLOL HCL TABLET 10 MG 0 0 Rp -
PROPRANOLOL HCL TABLET 10 MG 569 214 355 355 Rp 29,287.50
112 Ranitidin tablet 150 mg 0 0 Rp -
Ranitidin injeksi 25 mg / 2 ml 0 0 Rp -
113 RETINOL KAPSUL LUNAK 200.000IU 500 500 0 Rp -
RETINOL KAPSUL LUNAK 200.000IU 6,400 5,600 800 800 Rp 413,600.00
114 RETINOL KAPSUL LUNAK 100.000IU 500 500 0 0 Rp -
150 2,250 2,400 0 Rp -
115 RINGER LAKTAT LAR INFUS STERIL 396 3,800 3,636 560 560 Rp 4,004,000.00
RINGER LAKTAT LAR INFUS STERIL 0 0 Rp -
RINGER LAKTAT LAR INFUS STERIL 0 0 Rp -
116 RISPERIDON 375 375 0 0 Rp -
117 Asering Laruran Infus 0 0 Rp -
Asering Laruran Infus 0 0 Rp -
118 SALBUTAMOL TABLET 2 MG 1,264 1,264 0 Rp -
SALBUTAMOL TABLET 2 MG 2,000 498 1,502 1,502 Rp 94,626.00
SALBUTAMOL TABLET 4 MG 0 0 Rp -
119 SALEP 2,4 KOMBINASI 0 0 Rp -
SALEP 2,4 KOMBINASI 0 0 Rp -
SALEP 2,4 KOMBINASI 30 96 88 38 38 Rp 99,560.00
SALEP 2,4 KOMBINASI 0 0 Rp -
120 SALISIL BEDAK 2% 2 2 0 Rp -
SALISIL BEDAK 2% 0 0 Rp -
SILK NO3/1 0 0 Rp -
121 Serum Anti Bisa Ular Polivalen injeksi 5 ml 0 0 Rp -
122 SATS 1.500 IU/AMPUL 6 30 36 0 Rp -
123 SIANOKOBALAMIN INJ 500 MCG/ML, 1ML 0 0 Rp -
SIANOKOBALAMIN INJ 500 MCG/ML, 1ML 9 9 0 Rp -
124 Simvastatin tablet 10 mg 0 8,400 2,412 5,988 5,988 Rp 658,680.00
125 Sefadroxil kapsul 500 mg 0 0 Rp -
126 ZINC TAB 0 0 Rp -
ZINC TAB 0 0 Rp -
ZINC TAB 6,800 2,898 3,902 3,902 Rp 2,044,648.00
ZINC TAB 1,602 1,602 0 0 Rp -
127 SULFASETAMID T.M 15% 0 0 Rp -
SULFASETAMID T.M 15% 0 0 Rp -
128 TABLET TAMBAH DARAH KOMBINASI 95,200 16,800 83,913 28,087 28,087 Rp 9,942,798.00
TABLET TAMBAH DARAH KOMBINASI 23,547 23,547 0 Rp -
TABLET TAMBAH DARAH KOMBINASI 61,600 61,600 0 Rp -
129 TETRASIKLINA KAPSUL 500MG 70 70 0 Rp -
130 TIAMIN HCL MONOHIDRAT TABLET 50 MG 9,000 9,000 0 Rp -
131 Tiamfenikol kapsul 500 mg 0 0 Rp -
Tiamfenikol kapsul 500 mg 2,210 2,210 0 Rp -
132 Tiamin (Viamin B1) tablet 50 mg 7,587 7,587 0 Rp -
Tiamin (Vitamin B1) tablet 100 mg 8,000 8,000 0 Rp -
14,000 13,706 294 294 Rp 26,754.00
133 TRIHEKSIFINIDIL 2 MG 0 0 Rp -
TRIHEKSIFINIDIL 2 MG 623 623 0 Rp -
TRIHEKSIFINIDIL 2 MG 3,100 1,938 1,162 1,162 Rp 98,770.00
134 VIT B KOMPLEKS TABLET 7,537 7,537 0 Rp -
VIT B KOMPLEKS TABLET 30,000 29,309 691 691 Rp 57,353.00
3,500 3,500 0 Rp -
VENTOLIN INHALER(Salbutamol CFC 200 dosis) 0 0 Rp -
135 YODIUM POVIDON LAR 10%, 30ML 0 0 Rp -
136 MINERAL MIX 2,400 810 1,590 1,590 Rp 4,954,312.78
137 OAT kat 1 50 26 24 24 Rp 9,344,256.00
FDC Kit KAT 1 3 3 0 Rp -
FDC Kit KAT 2 3 3 0 Rp -
138 Nevirapine (NVP) 200 mg 180 0 180 180 Rp 529,200.00
139 Efavirenz (EFV) 600 mg 90 0 90 90 Rp 573,750.00
140 Tenofovir 300mg (TDF) + Lamivudin (3TC) 300 +
Efaviren 600 (Triple FDC) Dewasa 90 0 90 90 Rp 237,462.00
141 Zidofudine (ZDV) 300mg + Lamivudine (3TC)
150mg 180 0 180 180 Rp 666,000.00
142 MB DEWASA 7 7 0 Rp -
24 24 0 Rp -
6 6 0 Rp -
143 MB anak 6 6 0 Rp -
144 PB DEWASA 2 2 0 Rp -
OBAT GIGI
EUGENOL CAIRAN 0 0 0 Rp -
Glass Ionomer Cement ART 2 1 1 1 Rp 444,027.00
CHKM 1 0 1 1 Rp 66,200.00
ETIL KHLORIDA SEMPROT 0 0 0 Rp -
REAGEN LAB
1 Reagen Hepatitis B (HBSAg dan Dropper) 600 266 334 334 Rp 3,522,698.00
200 200 0 0 Rp -
2 Reagen HIV R1 (Standart Diagnostic) 1200 663 537 537 Rp 6,430,575.00
152 152 0 Rp -
3 Reagen HIV R2 23 23 0 Rp -
10 0 10 10 Rp 132,350.00
4 Reagen HIV R3 3 3 0 Rp -
5 5 0 Rp -
5 HUMAN HEXAGON SIPHILYS 17 17 0 Rp -
300 300 0 Rp -
200 200 0 Rp -
6 Reagen Hepatitis B 151 100 251 0 Rp -
JUMLAH TOTAL REAGEN LAB Rp 10,085,623.00
1 ALAT SUNTIK SEKALI PAKAI 1 ML 1000 100 900 900 Rp 1,385,643.60
2 ALAT SUNTIK SEKALI PAKAI 1 ML 322 322 0 0 Rp -
3 ALAT SUNTIK SEKALI PAKAI 2.5 ML 0 0 Rp -
4 KASA PEMBALUT 4MX3CM 0 0 Rp -
5 KASA PEMBALUT 16MX16CM 544 960 1,504 0 0 Rp -
6 Urin bag 70 30 40 40 Rp 120,000.00
7 Hands shoen No. 7 0 0 Rp -
TOTAL SELURUHNYA Rp 91,444,562.88
STOCK OPNAME Nilai selisih
SELISIH SALDO
Keterangan
Keterangan VS CEK FISIK (Rp)
9 10=(7-6) 11
PUSKESMAS PULOREJO
TAHUN 2019
NAMA OBAT STOK AKHIR TAHUN 2019

HARGA SATUAN
No. SATUAN
(Rp) JUMLAH JUMLAH HARGA
TOTAL (Rp)
OBAT
1 ACYCLOVIR TAB Rp 380.00 735 Rp 279,300.00
2 ACYCLOVIR TAB Rp 349.00 0 Rp -
3 ACYCLOVIR SALEP Rp 3,000.00 Rp -
4 ACYCLOVIR SALEP Rp 2,152.00 Rp -
5 Albendazol tablet 400 mg Rp 404.00 Rp -
6 Albendazol tablet 400 mg Rp 344.00 0 Rp -
7 ALLOPURINOL TABLET 100 MG TAB Rp 132.00 Rp -
8 ALLOPURINOL TABLET 100 MG TAB Rp 90.00 2421 Rp 217,890.00
9 ALLOPURINOL TABLET 100 MG TAB Rp 86.00 Rp -
10 AMINOFILIN TAB 200 MG TAB Rp 89.00 3000 Rp 267,000.00
11 AMINOFILIN TAB 200 MG TAB Rp 112.20 0 Rp -
12 AMINOFILIN TAB 200 MG TAB Rp 91.00 0 Rp -
13 AMINOFILIN INJ 24 MG/ML, 10 ML TAB Rp 3,345.00 0 Rp -
14 AMINOFILIN INJ 24 MG/ML, 10 ML AMP Rp 3,822.00 0 Rp -
15 Amitriptilin HCl tablet salut 25 mg AMP Rp 112.00 Rp -
Rp 167.00 534 Rp 89,178.00
16 AMLODIPIN TAB TAB Rp 70.00 0 Rp -
17 AMLODIPIN TAB TAB Rp 105.00 Rp -
18 AMOKSISILIN SIRUP 125 MG/ML BTL Rp 2,090.00 0 Rp -
19 Amoksisilin FORTE sirup kering 250 mg/5ml BTL Rp 4,070.00 Rp -
20 AMOKSISILIN SIRUP 125 MG/ML BTL Rp 2,445.00 Rp -
21 AMOKSISILIN KAPSUL 500 MG KAP Rp 233.00 17511 Rp 4,080,063.00
22 AMOKSISILIN KAPSUL 500 MG KAP Rp 232.00 Rp -
23 AMOKSISILIN KAPSUL 500 MG KAP Rp 261.00 0 Rp -
24 AMPICILIN INJ Rp 8,237.00 1513 Rp 12,462,581.00
25 AMPICILIN INJ Rp 4,000.00 Rp -
28 ANTALGIN TABLET 500 MG TAB Rp 67.00 Rp -
29 ANTALGIN TABLET 500 MG TAB Rp 145.00 Rp -
30 ANTASID TAB, MGOH3 + ALOH3 AA200MG TAB Rp 30.53 Rp -
31 ANTASID TAB, MGOH3 + ALOH3 AA200MG TAB Rp 62.00 Rp -
32 ANTASID TAB, MGOH3 + ALOH3 AA200MG TAB Rp 54.00 20330 Rp 1,097,820.00
33 Antasida DOEN suspensi Rp 1,995.00 0 Rp -
Rp 2,129.00 146 Rp 310,834.00
34 ANTI FUNGI Rp 2,025.00 Rp -
35 ANTI HAEMORHOID SUPPOSITORIA SUP Rp 3,167.00 130 Rp 411,710.00
36 Anti Hemoroid DOEN Kombinasi sup Rp 3,045.00 0 Rp -
37 Aqua pro Injeksi steril 25 ml/ OTSU SWI 25 ml AMP Rp 2,860.00 77 Rp 220,220.00
38 Aquadest 500 ml BTL Rp 19,800.00 6 Rp 118,800.00
39 AQUA PRO INJEKSI STERIL, BEBAS PIROGEN 20 M AMP Rp 2,750.00 Rp -
HARGA SATUAN
No. SATUAN
TOTAL (Rp)
40 ASAM ASKORBAT (VIT C) TAB 100 MG TAB Rp 51.00 Rp -
41 ASAM ASKORBAT (VIT C) TAB 50 MG TAB Rp 104.00 Rp -
42 ASAM ASKORBAT (VIT C) TAB 50 MG TAB Rp 105.00 13771 Rp 1,445,955.00
43 Asam Asetil salisilat 80 mg (asetosal ) Rp 99.00 1539 Rp 152,361.00
44 ASAM MEFENAMAT TAB 500 MG Rp 103.00 21748 Rp 2,240,044.00
45 ASAM MEFENAMAT TAB 500 MG Rp 106.00 Rp -
46 Atapulgit tablet 600 mg Rp 136.00 2054 Rp 279,344.00
47 Atapulgit tablet 600 mg AMP Rp 145.00 Rp -
48 ASEIL SISTEIN TAB Rp 373.00 7450 Rp 2,778,850.00
49 BECARBON TAB Rp 121.00 Rp -
50 BETAMETASON CREAM 0,1 % TUB Rp 3,388.00 Rp -
51 BETAMETASON CREAM 0,1 % TUB Rp 3,350.00 264 Rp 884,400.00
52 Bisacodyl tablet 5 mg TAB Rp 594.00 26 Rp 15,444.00
53 Bisacodyl tablet 5 mg TAB Rp 495.00 0 Rp -
54 CAPTOPRIL Rp 68.00 Rp -
55 CAPTOPRIL Rp 75.00 386 Rp 28,950.00
56 CAPTOPRIL 25 mg Rp 84.00 0 Rp -
57 CAPTOPRIL tablet 50 mg Rp 140.00 Rp -
58 CIMETIDIN Rp 114.90 Rp -
59 CIMETIDIN Rp 110.84 Rp -
60 CIPROFLOXACIN 500 MG Rp 284.00 Rp -
64 CEFOTAXIM INJ 1000 MG Rp 6,800.00 Rp -
65 DEKSAMETASON INJ 5 MG/ML-1 ML AMP Rp 143.89 Rp -
66 DEKSAMETASON INJ 5 MG/ML-1 ML AMP Rp 1,518.00 Rp -
67 DEKSAMETASON INJ 5 MG/ML-1 ML AMP Rp 1,097.00 224 Rp 245,728.00
68 DEKSAMETASON TABLET 0.5 MG TAB Rp 69.00 Rp -
69 DEKSAMETASON TABLET 0.5 MG TAB Rp 44.00 Rp -
70 DEKSAMETASON TABLET 0.5 MG TAB Rp 32.00 14855 Rp 475,360.00
71 DEKTROMERFAN HBR SIRUP 10MG/ML BTL Rp 2,864.40 Rp -
72 DEKTROMERFAN HBR TAB 15 MG TAB Rp 68.98 Rp -
73 DEKTROMERFAN HBR TAB 15 MG TAB Rp 90.00 Rp -
74 DIAZEPAM INJ 5 MG/ML-2 ML AMP Rp 4,180.00 10 Rp 41,800.00
75 DIAZEPAM INJ 5 MG/ML-2 ML AMP Rp 2,365.00 Rp -
76 DIAZEPAM TABLET 2 MG TAB Rp 19.80 Rp -
77 DIAZEPAM TABLET 2 MG TAB Rp 86.00 528 Rp 45,408.00
78 DIAZEPAM TABLET 2 MG TAB Rp 45.00 Rp -
79 DIFENHIDRAMIN INJ 10MG/ML-1 ML AMP Rp 60.00 Rp -
80 DIFENHIDRAMIN INJ 10MG/ML-1 ML AMP Rp 1,095.00 177 Rp 193,815.00
81 DIFENHIDRAMIN INJ 10MG/ML-1 ML AMP Rp 1,050.00 Rp -
82 DIGOKSIN TABLET 0.25 MG TAB Rp 104.00 359 Rp 37,336.00
83 DIGOKSIN TABLET 0.25 MG TAB Rp 105.00 Rp -
84 DIGOKSIN TABLET 0.25 MG TAB Rp 97.00 Rp -
85 Dimenhidrinat tablet 50 mg TAB Rp 99.00 Rp -
Rp 105.00 1981 Rp 208,005.00
86 Domperidon tablet 10 mg TAB Rp 91.00 Rp -
87 Domperidon tablet 10 mg TAB Rp 85.00 855 Rp 72,675.00
HARGA SATUAN
No. SATUAN
TOTAL (Rp)
88 EKSTRAK BELLADON TABLET 10 MG TAB Rp 26.40 Rp -
89 EPINEFRIN HCL/BITARTAT (ADRENALIN) INJ 0,1%-1ML AMP Rp 1,408.00 2 Rp 2,816.00
90 ERGOTAMIN CAFEIN Rp 135.00 Rp -
91 Erytromycin kaplet 500 mg Rp 750.00 Rp -
92 Erytromycin kaplet 500 mg Rp 730.00 Rp -
93 BTL Rp 770.00 3840 Rp 2,956,800.00
94 ETANOL 70% BTL Rp 15,400.00 Rp -
95 ETANOL 70% BTL Rp 4,400.00 0 Rp -
96 ETANOL 70% BTL Rp 2,500.00 Rp -
97 EUGENOL CAIRAN BTL Rp 18,824.00 Rp -
98 EUGENOL CAIRAN BTL Rp 18,100.00 0 Rp -
99 FANITOIN NATRIUM 100 MG KAP Rp 154.00 0 Rp -
100 FANITOIN NATRIUM 100 MG KAP Rp 158.00 1860 Rp 293,880.00
101 FENOBARBITAL TABLET 30 MG TAB Rp 31.00 Rp -
104 Fitomenadion (Vit.K1) injeksi 2 mg/ml -1 m AMP Rp 3,682.00 90 Rp 331,380.00
105 Fitomenadion (Vit.K1) injeksi 2 mg/ml -1 m AMP Rp 3,550.00 Rp -
106 FITOMENADION TAB SALUT 10 MG TAB Rp 680.61 Rp -
107 FITOMENADION TAB SALUT 10 MG TAB Rp 710.00 1107 Rp 785,970.00
108 FITOMENADION TAB SALUT 10 MG TAB Rp 630.00 Rp -
109 (SIKZONOATE Inj) Rp 59,758.79 Rp -
110 (SIKZONOATE Inj) Rp 59,800.00 0 Rp -
111 FUROSEMID TABLET 40 MG TAB Rp 78.00 Rp -
112 FUROSEMID TABLET 40 MG TAB Rp 77.00 2863 Rp 220,451.00
113 GARAM ORALIT UNTUK 200 ML AIR SAK Rp -
114 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 292.00 Rp -
115 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 257.00 Rp -
116 GARAM ORALIT UNTUK 200 ML AIR SAK Rp 288.00 2179 Rp 627,552.00
117 GENTIAN VIOLET 1 % BTL Rp 990.90 Rp -
118 Gentamisin injeksi 40 mg/ml (sbg Sulfat) AMP Rp 3,399.00 0 Rp -
119 Gentamisin injeksi 40 mg/ml (sbg Sulfat) TAB Rp 3,083.00 Rp -
120 GLIBENKLAMID TABLET 5 MG TAB Rp 80.30 Rp -
121 GLIBENKLAMID TABLET 5 MG TAB Rp 119.00 2543 Rp 302,617.00
122 GLIMEPIRID 2 TAB Rp 207.00 Rp -
123 GLISERI GUAYAKOLAT TABLET 100 MG TAB Rp 27.90 Rp -
127 Gliserin 100 ml TAB Rp 6,600.00 Rp -
128 GLUKOSE LAR INFUS 5 % STERIL BTL Rp 6,900.00 170 Rp 1,173,000.00
129 GLUKOSE LAR INFUS 5 % STERIL BTL Rp 5,200.00 Rp -
130 GRISEOFULVIN 125 MG, MICRONIZE TAB Rp 210.00 1140 Rp 239,400.00
131 Haloperidol tablet 0,5 mg TAB Rp 59.00 Rp -
Rp 55.00 970 Rp 53,350.00
132 Haloperidol tablet 5 mg TAB Rp 75.00 Rp -
133 Haloperidol 5 mg/ml Injeksi AMP Rp 6,250.00 Rp -
134 Haldol Decanoat 50 mg/ml inj AMP Rp 101,300.00 34 Rp 3,444,200.00
135 Haldol Decanoat 50 mg/ml inj AMP Rp 97,491.45 Rp -
HARGA SATUAN
No. SATUAN
TOTAL (Rp)
136 HIDROKHLOROTIAZID TABLET 25 MG TAB Rp 24.64 Rp -
137 HIDROKHLOROTIAZID TABLET 25 MG TAB Rp 36.30 Rp -
138 HIDROKORTISON KREM 2,5 % TUBE Rp 2,708.33 Rp -
141 HIDROKORTISON KREM 2,5 % TUBE Rp 2,475.00 0 Rp -
142 INH TAB Rp 145.00 0 Rp -
143 IBUPROFEN TABLET 400 MG TAB Rp 205.04 Rp -
146 IBUPROFEN TABLET 400 MG TAB Rp 31,650.00 Rp -
147 ISOSORBID DINITRAT TABLET SUBLINGAL 5 TAB Rp 89.00 580 Rp 51,620.00
148 ISOSORBID DINITRAT TABLET SUBLINGAL 5 TAB Rp 88.00 Rp -
149 KALSIUM GLUKONAT INJ TAB Rp 9,955.00 24 Rp 238,920.00
150 KALSIUM LAKTAT TAB 500 MG TAB Rp 52.00 Rp -
151 KALSIUM LAKTAT TAB 500 MG TAB Rp 63.00 Rp -
152 KALSIUM LAKTAT TAB 500 MG TAB Rp 59.00 4968 Rp 293,112.00
153 Ketokonazol tablet 200 mg TAB Rp 270.00 0 Rp -
154 KETOPROFEN SUPPO SUP Rp 2,380.00 12 Rp 28,560.00
155 KHLORAMFENIKOL KAPSUL 250 MG KAP Rp 495.00 0 Rp -
156 KHLORAMFENIKOL KAPSUL 250 MG KAP Rp 249.00 Rp -
157 KHLORAMFENIKOL 1% SALEP MATA TUBE Rp 1,798.00 Rp -
158 KHLORAMFENIKOL 1% SALEP MATA TUBE Rp 1,881.00 83 Rp 156,123.00
159 KHLORAMFENIKOL TT 3% BTL Rp 7,150.00 Rp -
162 KHLORAMFENIKOL TETES MATA Rp 6,380.00 Rp -
165 KHLORAMFENIKOL SYRUP Rp 5,500.00 Rp -
166 KHLORAMFENIKOL SYRUP Rp 5,015.00 95 Rp 476,425.00
167 KHLORAMFENIKOL SYRUP Rp 4,700.00 0 Rp -
168 Kloramfenikol kapsul 250 mg Rp 249.00 Rp -
Kloramfenikol kapsul 250 mg Rp 495.00 Rp -
169 KLORAMFENIKOL INJEKSI Rp 10,175.00 0 Rp -
170 KLORAMFENIKOL INJEKSI Rp 9,900.04 Rp -
171 KLORAMFENIKOL SK Rp 3,038.00 52 Rp 157,976.00
172 KHLORFENIRAMIN MALEAT (CTM TAB) TAB Rp 24.00 Rp -
174 KHLORFENIRAMIN MALEAT (CTM TAB) TAB Rp 22.00 9722 Rp 213,884.00
176 Klorpromazin HCl tablet salut 100 mg TAB Rp 147.00 1166 Rp 171,402.00
177 Klorpromazin HCl tablet salut 100 mg TAB Rp 162.00 Rp -
178 KHLORPROMAZIN HCL TABLET 25 MG TAB Rp 60.50 Rp -
181 KODEIN HCL TABLET 10 MG TAB Rp 550.00 Rp -
182 KODEIN HCL TABLET 10 MG TAB Rp 571.00 311 Rp 177,581.00
183 KOTRIMOKSAZOL SUSPENSI BTL Rp 3,500.00 Rp -
HARGA SATUAN
No. SATUAN
TOTAL (Rp)
186 KOTRIMOKSAZOL ADULT TABLET TAB Rp 100.00 Rp -
190 KOMBIVENT TAB Rp 4,550.00 0 Rp -
191 Larutan elektrolit D5-1/4ns Rp 7,700.00 0 Rp -
192 Larutan elektrolit D5-1/2ns Rp 9,400.00 0 Rp -
193 LIDOKAIN COMP INJ-2 ML AMP Rp 1,136.67 Rp -
194 LIDOKAIN COMP INJ-2 ML AMP Rp 1,145.00 157 Rp 179,765.00
195 LIDOKAIN COMP INJ-2 ML AMP Rp 1,845.00 0 Rp -
196 LORATADIN TAB Rp 123.00 400 Rp 49,200.00
197 Magnesium Sulfat injeksi (iv) 40 % - 25 ml BTL Rp 3,796.00 5 Rp 18,980.00
198 Magnesium Sulfat injeksi (iv) 20 % - 25 ml Rp 3,328.00 0 Rp -
199 Mikonazole krim/salep 2 % (Nitrat) BTL Rp 3,250.00 Rp -
200 Mikonazole krim/salep 2 % (Nitrat) Rp 3,414.00 62 Rp 211,668.00
201 Metamizole injeksi 500 mg/ 1 ml AMP Rp 7,150.00 Rp -
202 Metamizole injeksi 500 mg/ 1 ml AMP Rp 6,600.00 Rp -
203 Metformin HCl tablet 500 mg TAB Rp 100.00 0 Rp -
204 Metformin HCl tablet 500 mg TAB Rp 96.00 2160 Rp 207,360.00
205 METILERGOMETRINMALEAT TAB 0,125 MG TAB Rp 275.00 0 Rp -
Rp 210.00 340 Rp 71,400.00
206 METILERGOMETRINMALEAT INJ TAB Rp 2,684.00 Rp -
Rp 2,959.00 90 Rp 266,310.00
207 METRONIDAZOL TABLET 500 MG TAB Rp 133.00 Rp -
208 METRONIDAZOL TABLET 250 MG TAB Rp 110.00 Rp -
209 METOKLOPROPAMIDE TABLET TAB Rp 99.00 Rp -
210 Monochlorkamfer mentol ( CHKM ) BTL Rp 60,500.00 Rp -
211 NA CL LAR INFUS 0,9 % STERIL BTL Rp 6,410.00 87 Rp 557,670.00
212 Natrium Diklofenak tablet 50 mg BTL Rp 115.00 3000 Rp 345,000.00
213 Natrium Diklofenak tablet 50 mg BTL Rp 159.00 Rp -
214 Natrium Klorida larutan infus 0,9 % steril BTL Rp 6,410.00 Rp -
215 NIFEDIPIN TAB Rp 104.00 Rp -
216 NIFEDIPIN TAB Rp 110.00 Rp -
221 OAT SISIPAN PKT Rp -
222 OBH BTL Rp 1,430.00 Rp -
223 OBH BTL Rp 1,258.95 Rp -
224 OBH BTL Rp 2,310.00 Rp -
225 OBH BTL Rp 2,970.00 Rp -
226 OKSITOSIN TUBE Rp 1,900.00 Rp -
227 OKSITOSIN TUBE Rp 1,900.00 0 Rp -
228 OKSITETRASIKLIN HCL SALEP MATA 3% TUBE Rp 2,500.00 66 Rp 165,000.00
229 Omeprazol kapsul 20 mg Rp 139.00 695 Rp 96,605.00
230 Omeprazol injeksi 40 mg/ 10 ml Rp 36,000.00 Rp -
231 PARASETAMOL SIRUP 120 MG/5ML BTL Rp 1,107.00 93 Rp 102,951.00
232 PARASETAMOL SIRUP 120 MG/5ML BTL Rp 1,010.00 0 Rp -
233 PARASETAMOL TABLET 500 MG TAB Rp 53.00 18613 Rp 986,489.00
234 PARASETAMOL TABLET 500 MG TAB Rp 56.00 Rp -
HARGA SATUAN
No. SATUAN
TOTAL (Rp)
235 Rp 49.00 Rp -
236 PIRANTEL PAMOAT TAB 125 MG BASA TAB Rp -
237 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 123.00 8388 Rp 1,031,724.00
238 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 27.50 Rp -
239 PIRIDOKSIN HCL TABLET 10 MG TAB Rp 118.00 Rp -
240 POLIKRESULEN BTL Rp -
241 PREDNISON TABLET 5 MG TAB Rp 40.00 Rp -
245 PPC INJEKSI 3 JUTA IU VIAL Rp -
246 POVIDON IODINE TAB Rp 18,000.00 10 Rp 180,000.00
247 PROPRANOLOL HCL TABLET 40 MG TAB Rp 83.00 Rp -
248 PROPRANOLOL HCL TABLET 10 MG TAB Rp 65.00 Rp -
249 PROPRANOLOL HCL TABLET 10 MG TAB Rp 82.50 355 Rp 29,287.50
250 Ranitidin tablet 150 mg Rp 120.00 Rp -
251 Ranitidin injeksi 25 mg / 2 ml Rp 1,140.00 Rp -
252 RETINOL KAPSUL LUNAK 200.000IU KAP Rp 519.20 Rp -
253 RETINOL KAPSUL LUNAK 200.000IU KAP Rp 517.00 800 Rp 413,600.00
254 RETINOL KAPSUL LUNAK 100.000IU KAP Rp 284.00 0 Rp -
255 Rp 288.00 Rp -
256 RINGER LAKTAT LAR INFUS STERIL BTL Rp 7,150.00 560 Rp 4,004,000.00
257 RINGER LAKTAT LAR INFUS STERIL BTL Rp 5,200.00 Rp -
258 RINGER LAKTAT LAR INFUS STERIL BTL Rp 5,189.80 Rp -
259 RISPERIDON BTL Rp 347.00 0 Rp -
260 Asering Laruran Infus BTL Rp 15,899.40 Rp -
261 Asering Laruran Infus BTL Rp 9,000.00 Rp -
262 SALBUTAMOL TABLET 2 MG TAB Rp 66.00 Rp -
263 SALBUTAMOL TABLET 2 MG TAB Rp 63.00 1502 Rp 94,626.00
264 SALBUTAMOL TABLET 4 MG TAB Rp 89.00 Rp -
265 SALEP 2,4 KOMBINASI POT Rp 826.00 Rp -
266 SALEP 2,4 KOMBINASI POT Rp 2,000.00 Rp -
267 SALEP 2,4 KOMBINASI POT Rp 2,620.00 38 Rp 99,560.00
268 SALEP 2,4 KOMBINASI POT Rp 2,310.00 Rp -
269 SALISIL BEDAK 2% KTK Rp 1,450.00 Rp -
270 SALISIL BEDAK 2% KTK Rp 1,430.00 Rp -
273 SILK NO3/1 SAK Rp 6,386.11 Rp -
274 Serum Anti Bisa Ular Polivalen injeksi 5 ml VIAL Rp 473,000.00 Rp -
275 SATS 1.500 IU/AMPUL AMP Rp 130,999.00 Rp -
276 SIANOKOBALAMIN INJ 500 MCG/ML, 1ML AMP Rp 916.00 Rp -
277 SIANOKOBALAMIN INJ 500 MCG/ML, 1ML AMP Rp 1,078.00 Rp -
278 Simvastatin tablet 10 mg TAB Rp 110.00 5988 Rp 658,680.00
279 Sefadroxil kapsul 500 mg TAB Rp 509.00 Rp -
280 ZINC TAB TAB Rp 475.00 Rp -
281 ZINC TAB TAB Rp - Rp -
282 ZINC TAB TAB Rp 524.00 3902 Rp 2,044,648.00
283 ZINC TAB TAB Rp 474.00 0 Rp -
284 SULFASETAMID T.M 15% BTL Rp 3,446.00 Rp -
285 SULFASETAMID T.M 15% BTL Rp 3,226.00 Rp -
HARGA SATUAN
No. SATUAN
TOTAL (Rp)
286 TABLET TAMBAH DARAH KOMBINASI TAB Rp 354.00 28087 Rp 9,942,798.00
287 TABLET TAMBAH DARAH KOMBINASI TAB Rp 355.00 Rp -
288 TABLET TAMBAH DARAH KOMBINASI TAB Rp 354.00 Rp -
289 TETRASIKLINA KAPSUL 500MG KAP Rp 310.00 Rp -
290 TIAMIN HCL MONOHIDRAT TABLET 50 MG TAB Rp 85.00 Rp -
293 Tiamin (Viamin B1) tablet 50 mg TAB Rp 86.00 Rp -
294 Tiamin (Vitamin B1) tablet 100 mg TAB Rp 85.00 Rp -
Rp 91.00 294 Rp 26,754.00
295 TRIHEKSIFINIDIL 2 MG TAB Rp 88.00 Rp -
296 TRIHEKSIFINIDIL 2 MG TAB Rp 80.00 Rp -
297 TRIHEKSIFINIDIL 2 MG TAB Rp 85.00 1162 Rp 98,770.00
298 VIT B KOMPLEKS TABLET TAB Rp 115.00 Rp -
299 VIT B KOMPLEKS TABLET TAB Rp 83.00 691 Rp 57,353.00
Rp 89.00 Rp -
300 VENTOLIN INHALER(Salbutamol CFC 200 dos TAB Rp 63,750.00 Rp -
301 YODIUM POVIDON LAR 10%, 30ML BTL Rp -
304 MINERAL MIX SAK Rp 3,115.92 1590 Rp 4,954,312.78
305 OAT kat 1 Rp 389,344.00 24 Rp 9,344,256.00
306 FDC Kit KAT 1 Rp 359,985.00 Rp -
307 FDC Kit KAT 2 Rp 1,297,894.00 Rp -
Nevirapine (NVP) 200 mg Rp 2,940.00 180 Rp 529,200.00
Efavirenz (EFV) 600 mg Rp 6,375.00 90 Rp 573,750.00
Tenofovir 300mg (TDF) + Lamivudin (3TC)

300 + Efaviren 600 (Triple FDC) Dewasa Rp 2,638.47 90 Rp 237,462.00
(3TC) 150mg Rp 3,700.00 180 Rp 666,000.00
308 MB DEWASA Rp 45,122.00 Rp -
309 Rp 31,570.00 Rp -
Rp 41,784.00 Rp -
MB anak Rp 28,354.00 Rp -
310 PB DEWASA Rp 35,602.00 Rp -
OBAT GIGI
1 EUGENOL CAIRAN BTL Rp 18,824.00 Rp -
2 Glass Ionomer Cement ART BTL Rp 444,027.00 1 Rp 444,027.00
3 CHKM BTL Rp 66,200.00 1 Rp 66,200.00
4 BTL Rp 521,235.00 Rp -
REAGEN LABORATORIUM
1 Reagen Hepatitis B (HBSAg dan Dropper) Rp 10,547.00 334 Rp 3,522,698.00
Rp 9,850.00 0 Rp -
2 Reagen HIV R1 (Standart Diagnostic) Rp 11,975.00 537 Rp 6,430,575.00
Rp 14,344.00 Rp -
3 Reagen HIV R2 Rp 14,470.00 Rp -
Rp 13,235.00 10 Rp 132,350.00
4 Reagen HIV R3 Rp 19,839.00 Rp -
HARGA SATUAN
No. SATUAN
TOTAL (Rp)
Rp 19,480.00 Rp -
5 HUMAN HEXAGON SIPHILYS Rp 26,671.00 Rp -
Rp 20,400.00 Rp -
Rp 9,611.00 Rp -
7 Reagen Hepatitis B Rp 9,850.00 Rp -
10 Reagen Urine Stik 10 Parameter Rp 2,200.00 Rp -
11 REAGEN GOLONGAN DARAH A Rp 104,500.00 Rp -
12 REAGEN GOLONGAN DARAH B Rp 104,500.00 Rp -
JUMLAH TOTAL REAGEN LABORATORIUM Rp 10,085,623.00
1 ALAT SUNTIK SEKALI PAKAI 1 ML SET Rp 1,539.60 900 Rp 1,385,643.60
2 ALAT SUNTIK SEKALI PAKAI 1 ML SET Rp 990.00 0 Rp -
4 ALAT SUNTIK SEKALI PAKAI 2.5 ML SET Rp 957.00 Rp -
25 KASA PEMBALUT 4MX3CM ROL Rp 660.00 Rp -
26 KASA PEMBALUT 16MX16CM ROL Rp 362.50 0 Rp -
44 Urin bag BIJI Rp 3,000.00 40 Rp 120,000.00
45 Hands shoen No. 7 BIJI Rp 4,612.48 Rp -

TOTAL Rp 91,444,562.88
Mengetahui Pengelola Obat

Kepala Puskesmas Pulorejo Puskesmas Pulor
dr. RITA ANDAYANI BOBY DARYONO, S

NIP. 1977050920110120003 NIP.19820903201

Mutasi GFK 2019 - KRM Ifk

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DAFTAR PERSEDIAAN OBAT

DARI UPTD GUDANG FARMASI KABUPATEN

NAMA OBAT STOK AWAL 2019 MUTASI TAMBAH TAHUN 2019

JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 515,980.00 Rp -

Mengetahui Jombang, 30 Januari 2019

DIDIK RIJADI, SKM, M.Kes MEIN YULIANA

KOREKSI TOTAL HARGA :

Stok awal Rp 108,962,204.82

MUTASI KURANG TAHUN 2019 STOK AKHIR TAHUN 2019

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

373 Rp 141,740.00 321 Rp 121,980.00

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

BOBY DARYONO, S.Farm., Apt.

NAMA OBAT STOK AWAL 2019 MUTASI TAMBAH TAHUN 2019

JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 515,980.00 Rp 1,539,604.00

Mengetahui Jombang, 28 FEBRUARI 2019

DIDIK RIJADI, SKM, M.Kes MEIN YULIANA

KOREKSI TOTAL HARGA :

Stok awal Rp 108,962,204.82

MUTASI KURANG TAHUN 2019 STOK AKHIR TAHUN 2019

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

425 Rp 161,500.00 1269 Rp 482,220.00

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

BOBY DARYONO, S.Farm., Apt.

NAMA OBAT STOK AWAL 2019 MUTASI TAMBAH TAHUN 2019

JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 515,980.00 Rp 1,539,604.00

Mengetahui Jombang, 30 MARET 2019

DIDIK RIJADI, SKM, M.Kes MEIN YULIANA

KOREKSI TOTAL HARGA :

Stok awal Rp 108,962,204.82

MUTASI KURANG TAHUN 2019 STOK AKHIR TAHUN 2019

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

555 Rp 210,900.00 1139 Rp 432,820.00

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

BOBY DARYONO, S.Farm., Apt.

NAMA OBAT STOK AWAL 2019 MUTASI TAMBAH TAHUN 2019

JUMLAH TOTAL BAHAN MEDIS HABIS PAKAI Rp 515,980.00 Rp 1,539,604.00

Mengetahui Jombang, 30 April 2019

DIDIK RIJADI, SKM, M.Kes MEIN YULIANA

KOREKSI TOTAL HARGA :

Stok awal Rp 108,962,204.82

MUTASI KURANG TAHUN 2019 STOK AKHIR TAHUN 2019

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA

689 Rp 261,820.00 1005 Rp 381,900.00

JUMLAH JUMLAH HARGA JUMLAH JUMLAH HARGA