Rekap Pembayaran

No Nama PKM NILAI HNA PPN TOTAL
1 PUSKESMAS CIAWIGEBANG 12,428,182 1,242,818 13,671,000

2 PUSKESMAS CIBEUREUM 4,386,727 438,673 4,825,400
3 PUSKESMAS CIBINGBIN 25,826,364 2,582,636 28,409,000
4 PUSKESMAS CIDAHU 12,184,727 1,218,473 13,403,200
5 PUSKESMAS CIGANDAMEKAR 4,243,545 424,355 4,667,900
6 PUSKESMAS CIHAUR 4,180,000 418,000 4,598,000
7 PUSKESMAS CILEBAK 1,019,273 101,927 1,121,200
8 PUSKESMAS CILIMUS 7,227,091 722,709 7,949,800
9 PUSKESMAS CIMAHI 3,722,727 372,273 4,095,000
10 PUSKESMAS CINIRU 1,981,273 198,127 2,179,400
11 PUSKESMAS CIPICUNG - - -
12 PUSKESMAS CIWARU 4,923,636 492,364 5,416,000
13 PUSKESMAS DARMA 23,581,545 2,358,155 25,939,700
14 PUSKESMAS GARAWANGI 10,250,000 1,025,000 11,275,000
15 PUSKESMAS HANTARA 2,668,545 266,855 2,935,400
16 PUSKESMAS JALAKSANA 2,629,709 262,971 2,892,680
17 PUSKESMAS JAPARA 2,358,909 235,891 2,594,800
18 PUSKESMAS KADUGEDE 5,610,909 561,091 6,172,000
19 PUSKESMAS KALIMANGGIS 4,809,091 480,909 5,290,000
20 PUSKESMAS KARANGKANCANA 5,451,636 545,164 5,996,800
21 PUSKESMAS KRAMATMULYA 9,503,636 950,364 10,454,000
22 PUSKESMAS KUNINGAN - - -
23 PUSKESMAS LAMEPAYUNG 5,381,818 538,182 5,920,000
24 PUSKESMAS LINGGARJATI 2,173,491 217,349 2,390,840
25 PUSKESMAS LURAGUNG 11,280,909 1,128,091 12,409,000
26 PUSKESMAS MALEBER 630,000 63,000 693,000
27 PUSKESMAS MANDIRANCAN 3,309,273 330,927 3,640,200
28 PUSKESMAS MANGGARI 572,727 57,273 630,000
29 PUSKESMAS MEKARWANGI 3,156,873 315,687 3,472,560
30 PUSKESMAS NUSAHERANG - - -
31 PUSKESMAS PANCALANG 4,248,909 424,891 4,673,800
32 PUSKESMAS PASAWAHAN 2,129,818 212,982 2,342,800
33 PUSKESMAS SELAJAMBE 2,267,636 226,764 2,494,400
34 PUSKESMAS SINDANGAGUNG 2,233,636 223,364 2,457,000
35 PUSKESMAS SUBANG 1,236,727 123,673 1,360,400
36 PUSKESMAS SUKAMULYA 4,305,818 430,582 4,736,400
37 PUSKESMAS WINDUSENGKAHAN 3,916,000 391,600 4,307,600
TOTAL PAKET 195,831,164 19,583,116 215,414,280
NO NAMA BARANG SATUAN QTY HARGA
1 AXIMED IV-CATH NP PEN TYPE, 18 PC 2,470 6,300
5 AKSAMED ALCOHOL SWAB 2 PLY @100 DUS 100 PC 2,050 11,455
6 BAYMED MASKER EAR LOOP @50 PCS DUS 50 PC 2,034 44,655
JUMLAH
PPN
TOTAL
NO ID PAKET PRINCIPAL TOTAL

1 AK1-P2112-102995 BIOAXION 115,504,200
2 AK1-P2111-74770 LIKUID 99,910,080
215,414,280
JUMLAH
15,561,000
27,846,000
25,515,000
12,600,000
23,481,818
90,827,345
195,831,164
19,583,116
215,414,280
LAMPIRAN KONTRAK/ SURAT PERINTAH KERJA :
Nomor : 442/ /KPA PUSKESMAS/2021
Tanggal : Desember 2021
DAFTAR PESANAN PENGADAAN OBAT/ BMHP KAPITASI DI 37 PUSKESMAS MURNI
Hb Hemoglobin Test Strips

No Nama PKM JUMLAH HARGA
QTY Harga
1 PUSKESMAS CIAWIGEBANG 38 401,682 15,263,916
2 PUSKESMAS CIBEUREUM 3 401,682 1,205,046
3 PUSKESMAS CIBINGBIN - 401,682 -
4 PUSKESMAS CIDAHU 15 401,682 6,025,230
5 PUSKESMAS CIGANDAMEKAR 10 401,682 4,016,820
6 PUSKESMAS CIHAUR - 401,682 -
7 PUSKESMAS CILEBAK - 401,682 -
8 PUSKESMAS CILIMUS 12 401,682 4,820,184
9 PUSKESMAS CIMAHI 9 401,682 3,615,138
10 PUSKESMAS CINIRU 4 401,682 1,606,728
11 PUSKESMAS CIPICUNG - 401,682 -
12 PUSKESMAS CIWARU 1 401,682 401,682
13 PUSKESMAS DARMA - 401,682 -
14 PUSKESMAS GARAWANGI - 401,682 -
15 PUSKESMAS HANTARA - 401,682 -
16 PUSKESMAS JALAKSANA 1 401,682 401,682
17 PUSKESMAS JAPARA 5 401,682 2,008,410
18 PUSKESMAS KADUGEDE 10 401,682 4,016,820
19 PUSKESMAS KALIMANGGIS 5 401,682 2,008,410
20 PUSKESMAS KARANGKANCANA 10 401,682 4,016,820
21 PUSKESMAS KRAMATMULYA - 401,682 -
22 PUSKESMAS KUNINGAN 10 401,682 4,016,820
23 PUSKESMAS LAMEPAYUNG 22 401,682 8,837,004
24 PUSKESMAS LINGGARJATI - 401,682 -
25 PUSKESMAS LURAGUNG - 401,682 -
26 PUSKESMAS MALEBER - 401,682 -
27 PUSKESMAS MANDIRANCAN 4 401,682 1,606,728
28 PUSKESMAS MANGGARI 10 401,682 4,016,820
29 PUSKESMAS MEKARWANGI 12 401,682 4,820,184
30 PUSKESMAS NUSAHERANG 6 401,682 2,410,092
31 PUSKESMAS PANCALANG - 401,682 -
32 PUSKESMAS PASAWAHAN - 401,682 -
33 PUSKESMAS SELAJAMBE 15 401,682 6,025,230
34 PUSKESMAS SINDANGAGUNG 2 401,682 803,364
35 PUSKESMAS SUBANG - 401,682 -
36 PUSKESMAS SUKAMULYA 4 401,682 1,606,728
37 PUSKESMAS WINDUSENGKAHAN 4 401,682 1,606,728
TOTAL PAKET 212 85,156,584 85,156,584
TERBILANG :
Untuk dan atas nama Pemda Kab. Kuningan

KPA Selaku PEJABAT PEMBUAT KOMITMEN
Dinas Kesehatan,
H. SAEPUDIN, S.AP, S.Kep, Ners, M.Mkes

NIP : 196805281989031006
JAMINAN KESEHATAN NASIONAL (JKN MURNI)
UPTD PUSKESMAS DINAS KESEHATAN
TAHUN 2021
NO NAMA OBAT SATUAN HARGA CIAWI CIBEUREUM CIBINGBIN CIDAHU CIGANDAME CIHA CILEBAK CILIMUS CIMAHI CINIRU CIPICUNG CIWARU
SATUAN KAR UR
1 Stik Pemeriksaan Gula Darah Box/50 160,000 0 - 0 - 0 - 60 9,600,000 0 - 0 0 0 - 0 0 - 0 3
2 Stik Pemeriksaan Kolesterol Box/20 250,000 35 8,750,000 5 1,250,000 20 5,000,000 8 2,000,000 0 - 0 0 50 12,500,000 0 5 1,250,000 0 3
3 Stik Pemeriksaan Asam Urat Box/50 150,000 30 4,500,000 5 750,000 10 1,500,000 4 600,000 5 750,000 0 0 8 1,200,000 0 3 450,000 0 4
JUMLAH TOTAL 13,250,000 2,000,000 6,500,000 12,200,000 750,000 13,700,000 1,700,000
5
CIWARU DARMA GARAW HANTARA JALAKSAN JAPARA KADUGEDE KALIMANGGIS KARANGKANCA KRAMAT KUNINGAN LAMEPAYUNG LINGGARJATI LURAGUNG MALEBER MANDIRANCA MANGGARI
ANGI A NA MULYA N
480,000 0 0 0 0 0 - 0 0 - 0 - 0 0 - 0 - 0 0 - 0 - 0 - 0
750,000 0 0 0 0 20 5,000,000 0 10 2,500,000 25 6,250,000 0 50 12,500,000 60 15,000,000 0 5 1,250,000 5 1,250,000 3 750,000 7
600,000 0 0 0 0 10 1,500,000 0 10 1,500,000 10 1,500,000 0 20 3,000,000 25 3,750,000 0 3 450,000 3 450,000 2 300,000 3
1,830,000 6,500,000 4,000,000 7,750,000 15,500,000 18,750,000 1,700,000 1,700,000 1,050,000
6
MANGGARI MEKARWANGI NUSAHERANG PANCALANG PASAWAHAN SELAJAMBE SINDANG SUBANG SUKAMULYA WINDUSENGKA TOTAL QTY
TOTAL HARGA
TOTAL
AGUNG HAN KEBUTUHAN
- 0 - 0 - 0 - 0 - 0 - 0 0 12 1,920,000 0 - 75 12,000,000 12,000,075

1,750,000 25 6,250,000 0 - 3 750,000 20 5,000,000 0 - 0 0 30 7,500,000 8 2,000,000 397 99,250,000 97,250,397
450,000 4 600,000 10 1,500,000 5 750,000 20 3,000,000 4 600,000 0 0 12 1,800,000 10 1,500,000 220 33,000,000 31,500,220
2,200,000 6,850,000 1,500,000 1,500,000 8,000,000 600,000 11,220,000 3,500,000 144,250,000
7
8
9
LAMPIRAN HARGA PERKIRAAN SENDIRI
Nomor : 442/ /KPA PUSKESMAS/2021
10
REKAP PEMBAYARAN PUSKESMAS JKN
KABUPATEN KUNINGAN
TAHUN 2021
NO NAMA PUSKESMAS ITEM QTY HARGA SATUAN Sub Total TOTAL PPN PPH
Pharmafix 5 x 500 - 31,900 -
Sarung Tangan Steril No 6 500 8,635 4,317,500
1 CIAWIGEBANG 12,952,500 1,177,500 176,625
Sarung Tangan Steril No 7,5 500 8,635 4,317,500
2 CIBEUREUM 3,454,000 314,000 47,100
Pharmafix 5 x 500 50 31,900 1,595,000

3 CIBINGBIN 8,934,750 812,250 121,838
Pharmafix 5 x 500 40 31,900 1,276,000

4 CIDAHU Sarung Tangan Steril No 7 800 8,635 6,908,000 15,092,000 1,372,000 205,800
Pharmafix 5 x 500 4 31,900 127,600
Sarung Tangan Steril No 6 100 8,635 863,500
5 CIGANDAMEKAR 2,718,100 247,100 37,065
Sarung Tangan Steril No 7,5 100 8,635 863,500

6 CIHAUR 5,181,000 471,000 70,650

7 CILEBAK 1,727,000 -
Pharmafix 5 x 500 40 31,900 1,276,000

8 CILIMUS Sarung Tangan Steril No 7 300 8,635 2,590,500 5,593,500 508,500 76,275
Pharmafix 5 x 500 15 31,900 478,500
9 CIMAHI Sarung Tangan Steril No 6 600 8,635 5,181,000 9,113,500 828,500 124,275
Pharmafix 5 x 500 30 31,900 957,000
10 CIWARU 4,411,000 401,000 60,150
Pharmafix 5 x 500 54 31,900 1,722,600

11 DARMA 14,243,350 1,294,850 194,228

12 GARAWANGI Sarung Tangan Steril No 7 850 8,635 7,339,750 16,406,500 1,491,500 223,725
Pharmafix 5 x 500 10 31,900 319,000
13 HANTARA Sarung Tangan Steril No 7 400 8,635 3,454,000 5,500,000 500,000 75,000
14 JALAKSANA Pharmafix 5 x 500 4 31,900 127,600 127,600

15 KALIMANGGIS 1,727,000
16 KARANGKANCANA Sarung Tangan Steril No 7 100 8,635 863,500
1,727,000
17 KRAMAT MULYA Sarung Tangan Steril No 7 450 8,635 3,885,750
7,771,500 706,500 105,975
18 KUNINGAN Pharmafix 5 x 500 15 31,900 478,500 478,500

19 LAMEPAYUNG 8,635,000 785,000 117,750
20 LINGGAJATI Sarung Tangan Steril No 7 50 8,635 431,750 431,750
Pharmafix 5 x 500 40 31,900 1,276,000

21 LURAGUNG 9,911,000 901,000 135,150
22 MALEBER Pharmafix 5 x 500 20 31,900 638,000 638,000
Pharmafix 5 x 500 15 31,900 478,500

23 MANDIRANCAN 2,205,500 200,500 30,075
23 MANDIRANCAN 2,205,500 200,500 30,075

24 MEKARWANGI 1,727,000 -
25 PANCALANG 2,590,500 235,500 35,325
Pharmafix 5 x 500 20 31,900 638,000

26 PASAWAHAN Sarung Tangan Steril No 7 200 8,635 1,727,000 4,092,000 372,000 55,800
27 SINDANG AGUNG Pharmafix 5 x 500 14 31,900 446,600 446,600
Pharmafix 5 x 500 10 31,900 319,000

28 SUBANG Sarung Tangan Steril No 7 200 8,635 1,727,000 3,773,000 343,000 51,450
Pharmafix 5 x 500 6 31,900 191,400
29 SUKAMULYA Sarung Tangan Steril No 7 400 8,635 3,454,000 7,099,400 645,400 96,810

30 WINDUSENGKAHAN 6,908,000 628,000 94,200
TOTAL 165,616,550
REKAPAN PEMBAYARAN PKM DAERAH KUNINGAN
PERIODE : DESEMBER 2021
PT. ALPHATIRTA MEDICA
NO NAMA PUSKESMAS JUMLAH PPN PPH

1 PKM CIAWI GEBANG Rp 30,036,874 Rp 2,730,625 Rp 409,594
2 PKM CIBEUREUM Rp 3,789,352 Rp 344,487 Rp 51,673
3 PKM CIBINGBING Rp 22,777,214 Rp 2,070,656 Rp 310,598
4 PKM CIDAHU Rp 17,336,926 Rp 1,576,084 Rp 236,413
5 PKM CIGANDAMEKAR Rp 10,009,523 Rp 909,957 Rp 136,493
6 PKM CIHAUR Rp 807,602 Rp 73,418 Rp -
7 PKM CILEBAK Rp 1,006,928 Rp 91,539 Rp -
8 PKM CILIMUS Rp 12,866,321 Rp 1,169,666 Rp 175,450
9 PKM CIMAHI Rp 15,640,848 Rp 1,421,895 Rp 213,284
10 PKM CINIRU Rp 7,096,576 Rp 645,143 Rp 96,771
11 PKM CIWARU Rp 8,774,891 Rp 797,717 Rp 119,658
12 PKM DARMA Rp 14,111,329 Rp 1,282,848 Rp 192,427
13 PKM GARAWANGI Rp 1,814,448 Rp 164,950 Rp -
14 PKM HANTARA Rp 8,352,055 Rp 759,278 Rp 113,892
15 PKM JALAKSANA Rp 2,561,827 Rp 232,893 Rp 34,934
16 PKM JAPARA Rp 6,333,864 Rp 575,806 Rp 86,371
17 PKM KADUGEDE Rp 16,632,028 Rp 1,512,003 Rp 226,800
18 PKM KALIMANGGIS Rp 8,859,489 Rp 805,408 Rp 120,811
19 PKM KARANGKANCANA Rp 7,551,097 Rp 686,463 Rp 102,970
20 PKM KRAMATMULYA Rp 6,526,995 Rp 593,363 Rp 89,004
21 PKM KUNINGAN Rp 3,394,931 Rp 308,630 Rp 46,295
22 PKM LAMEPAYUNG Rp 10,681,924 Rp 971,084 Rp 145,663
23 PKM LINGGARJATI Rp 2,357,423 Rp 214,311 Rp 32,147
24 PKM LURAGUNG Rp 14,950,497 Rp 1,359,136 Rp 203,870
25 PKM MALEBER Rp 3,994,210 Rp 363,110 Rp 54,467
26 PKM MANDIRANCAN Rp 13,326,275 Rp 1,211,480 Rp 181,722
27 PKM MANGGARI Rp 5,656,348 Rp 514,213 Rp 77,132
28 PKM MEKARWANGI Rp 2,717,028 Rp 247,003 Rp 37,050
29 PKM NUSAHERANG Rp 5,833,602 Rp 530,327 Rp 79,549
30 PKM PANCALANG Rp 3,732,114 Rp 339,283 Rp 50,892
31 PKM PASAWAHAN Rp 3,867,148 Rp 351,559 Rp 52,734
32 PKM SELAJAMBE Rp 10,233,088 Rp 930,281 Rp 139,542
33 PKM SINDANGAGUNG Rp 11,308,973 Rp 1,028,088 Rp 154,213
34 PKM SUBANG Rp 4,193,776 Rp 381,252 Rp 57,188
35 PKM SUKAMULYA Rp 20,238,171 Rp 1,839,834 Rp 275,975
36 PKM WINDU SENGKAHAN Rp 7,037,007 Rp 639,728 Rp 95,959
TOTAL Rp 326,408,702 Rp 29,673,518 Rp 3,625,930
#REF!
N
KETERANGAN LUNAS
12/19/2019
Friday, December 20, 2019 RIKA
Friday, December 20, 2019 5000
Friday, December 20, 2019 Rp 15,520,929
Friday, December 20, 2019
Friday, December 20, 2019 08156456771 SUNARTO
Friday, December 20, 2019
12/23/2019
12/23/2019 Rp 14,002,168
12/23/2019 3500
12/23/2019 Rp 7,854,016
12/23/2019
12/26/2019
12/26/2019
12/26/2019
12/26/2019
12/26/2019 087828596600 IDA
12/26/2019
12/26/2019 Rp 6,758,164
12/27/2019
12/27/2019
12/31/2019
12/30/2019 Rp 2,107,465
12/31/2019 Rp 13,383,990
12/26/2019 28660
12/27/2019 Rp 5,061,503 085224277290
12/30/2019 63105
081911420278
12/26/2019 66491
DATA REKAPAN DARI PENYEDIA
PT. Kimia PT. Rajawali PT. Merapi PT. Mitra PT. Millenium
PT. Alphatirta PT. Karima PT. Muara
NO PUSKESMAS Farma TD Nusindo Cab. Utama Bahagia Citra Pharmacon JUMLAH HARGA
Medica Farma Sakti
Cab. Cirebon Cirebon Pharma, Medika International
1 PUSKESMAS CIAWIGEBANG 30,036,874 13,671,000 13,250,000 15,263,916 12,952,500 85,174,290
2 PUSKESMAS CIBEUREUM 3,789,352 4,825,400 2,000,000 1,205,046 3,454,000 15,273,798
3 PUSKESMAS CIBINGBIN 22,777,214 28,409,000 6,500,000 - 8,934,750 66,620,964
4 PUSKESMAS CIDAHU 17,336,926 13,403,200 12,200,000 6,025,230 15,092,000 64,057,356
5 PUSKESMAS CIGANDAMEKAR 10,009,523 4,667,900 750,000 4,016,820 2,718,100 22,162,343
6 PUSKESMAS CIHAUR 807,602 4,598,000 - 5,181,000 10,586,602
7 PUSKESMAS CILEBAK 1,006,928 1,121,200 - 1,727,000 3,855,128
8 PUSKESMAS CILIMUS 12,866,321 7,949,800 13,700,000 4,820,184 5,593,500 44,929,805
9 PUSKESMAS CIMAHI 15,640,848 4,095,000 3,615,138 9,113,500 32,464,486
10 PUSKESMAS CINIRU 7,096,576 2,179,400 1,700,000 1,606,728 12,582,704
11 PUSKESMAS CIPICUNG - - -
12 PUSKESMAS CIWARU 8,774,891 5,416,000 1,830,000 401,682 4,411,000 20,833,573
13 PUSKESMAS DARMA 14,111,329 25,939,700 - 14,243,350 54,294,379
14 PUSKESMAS GARAWANGI 1,814,448 11,275,000 - 16,406,500 29,495,948
15 PUSKESMAS HANTARA 8,352,055 2,935,400 - 5,500,000 16,787,455
16 PUSKESMAS JALAKSANA 2,561,827 2,892,680 401,682 127,600 5,983,789
17 PUSKESMAS JAPARA 6,333,864 2,594,800 6,500,000 2,008,410 17,437,074
18 PUSKESMAS KADUGEDE 16,632,028 6,172,000 4,016,820 26,820,848
19 PUSKESMAS KALIMANGGIS 8,859,489 5,290,000 4,000,000 2,008,410 1,727,000 21,884,899
20 PUSKESMAS KARANGKANCANA 7,551,097 5,996,800 7,750,000 4,016,820 1,727,000 27,041,717
21 PUSKESMAS KRAMATMULYA 6,526,995 10,454,000 - 7,771,500 24,752,495
22 PUSKESMAS KUNINGAN 3,394,931 - 15,500,000 4,016,820 478,500 23,390,251
23 PUSKESMAS LAMEPAYUNG 10,681,924 5,920,000 18,750,000 8,837,004 8,635,000 52,823,928
24 PUSKESMAS LINGGARJATI 2,357,423 2,390,840 - 431,750 5,180,013
25 PUSKESMAS LURAGUNG 14,950,497 12,409,000 1,700,000 - 9,911,000 38,970,497
26 PUSKESMAS MALEBER 3,994,210 693,000 1,700,000 - 638,000 7,025,210
27 PUSKESMAS MANDIRANCAN 13,326,275 3,640,200 1,050,000 1,606,728 2,205,500 21,828,703
28 PUSKESMAS MANGGARI 5,656,348 630,000 2,200,000 4,016,820 12,503,168
29 PUSKESMAS MEKARWANGI 2,717,028 3,472,560 6,850,000 4,820,184 1,727,000 19,586,772
30 PUSKESMAS NUSAHERANG 5,833,602 - 1,500,000 2,410,092 9,743,694
31 PUSKESMAS PANCALANG 3,732,114 4,673,800 1,500,000 - 2,590,500 12,496,414
PT. Kimia PT. Rajawali PT. Merapi PT. Mitra PT. Millenium
PT. Alphatirta PT. Karima PT. Muara
NO PUSKESMAS
Farma
Farma TD Nusindo Cab. Utama Bahagia Citra Pharmacon JUMLAH HARGA
Medica Sakti
Cab. Cirebon Cirebon Pharma, Medika International
32 PUSKESMAS PASAWAHAN 3,867,148 2,342,800 8,000,000 - 4,092,000 18,301,948
33 PUSKESMAS SELAJAMBE 10,233,088 2,494,400 600,000 6,025,230 19,352,718
34 PUSKESMAS SINDANGAGUNG 11,308,973 2,457,000 803,364 446,600 15,015,937
35 PUSKESMAS SUBANG 4,193,776 1,360,400 - 3,773,000 9,327,176
36 PUSKESMAS SUKAMULYA 20,238,171 4,736,400 11,220,000 1,606,728 7,099,400 44,900,699
37 PUSKESMAS WINDUSENGKAHAN 7,037,007 4,307,600 3,500,000 1,606,728 6,908,000 23,359,335
TOTAL PAKET 326,408,702 - 215,414,280 - 144,250,000 - 85,156,584 165,616,550 936,846,116
SUB JUMLAH : 936,846,116
TERBILANG : Satu Milyar Tiga Ratus Dua Juta Lima Ratus Tuhug Puluh Lima Ribu Dua Ratus Tujuh Puluh Rupiah

Dinas Kesehatan,

NIP : 19680528 198903 1 006
DATA REKAPAN DARI PENYEDIA
LELANG
PT. Kimia PT. Rajawali PT. Millenium PT. Merapi PT. Penta PT. ENSEVAL
PT.Indofarma PT. TEMPO
NO PUSKESMAS PT. Holi Farma Farma TD Nusindo Cab. Pharmacon Utama Valen PUTERA
Cab. Cirebon Global Medika CAB.CIREBON
Cirebon International Pharma, Cirebon MEGATRADING
Semarang
1 PUSKESMAS CIAWIGEBANG 1,040,000 1,150,000 88,995,500
2 PUSKESMAS CIBEUREUM - 9,385,200
3 PUSKESMAS CIBINGBIN 340,000 - 53,740,500
4 PUSKESMAS CIDAHU 870,984 230,000 903,980 36,742,200
5 PUSKESMAS CIGANDAMEKAR 1,039,960 1,150,000 451,990 40,145,600
6 PUSKESMAS CIHAUR 2,671,936 575,000 903,980 34,281,500
7 PUSKESMAS CILEBAK 567,968 575,000 903,980 2,200,000
8 PUSKESMAS CILIMUS 2,828,904 1,150,000 1,355,970 25,344,000
9 PUSKESMAS CIMAHI 864,900 1,150,000 1,355,970 17,341,500
10 PUSKESMAS CINIRU 431,968 - 903,980 15,518,250
11 PUSKESMAS CIPICUNG 1,040,000 - 41,976,000
12 PUSKESMAS CIWARU 3,137,232 575,000 2,259,950 13,666,400
13 PUSKESMAS DARMA 3,182,848 805,000 451,990 42,870,300
14 PUSKESMAS GARAWANGI 535,968 1,150,000 23,358,500
15 PUSKESMAS HANTARA 298,000 839,500 10,997,250
16 PUSKESMAS JALAKSANA 1,109,976 230,000 43,197,000
17 PUSKESMAS JAPARA 153,000 - 6,691,300
18 PUSKESMAS KADUGEDE 1,236,000 - 451,990 -
19 PUSKESMAS KALIMANGGIS - 20,397,850
20 PUSKESMAS KARANGKANCANA 1,863,936 1,150,000 1,355,970 32,730,500
21 PUSKESMAS KRAMATMULYA 899,960 575,000 71,472,500
22 PUSKESMAS KUNINGAN 1,307,920 - 19,162,000
23 PUSKESMAS LAMEPAYUNG - 56,622,500
24 PUSKESMAS LINGGARJATI 597,000 - 5,291,000
25 PUSKESMAS LURAGUNG 1,520,000 - 46,431,000
26 PUSKESMAS MALEBER 602,960 287,500 677,985 115,273,400
27 PUSKESMAS MANDIRANCAN 153,000 - 39,407,500
28 PUSKESMAS MANGGARI 1,015,952 - 677,985 18,161,000
29 PUSKESMAS MEKARWANGI 963,960 575,000 1,084,776 13,048,200
30 PUSKESMAS NUSAHERANG 153,000 1,150,000 1,355,970 31,064,000
31 PUSKESMAS PANCALANG 279,960 115,000 29,585,600
LELANG
PT. Kimia PT. Rajawali PT. Millenium PT. Merapi PT. Penta PT. ENSEVAL
PT.Indofarma PT. TEMPO
NO PUSKESMAS PT. Holi Farma Farma TD Nusindo Cab. Pharmacon Utama Valen PUTERA
Cab. Cirebon Global Medika CAB.CIREBON
Cirebon International Pharma, Cirebon MEGATRADING
Semarang
32 PUSKESMAS PASAWAHAN 2,632,832 - 22,091,300
33 PUSKESMAS SELAJAMBE - 18,177,500
34 PUSKESMAS SINDANGAGUNG 1,432,936 1,150,000 1,355,970 31,480,900
35 PUSKESMAS SUBANG 1,137,968 1,150,000 451,990 4,974,750
36 PUSKESMAS SUKAMULYA 1,108,104 575,000 451,990 60,244,800
37 PUSKESMAS WINDUSENGKAHAN 230,000 14,155,900
TOTAL PAKET 37,019,132 - - 16,537,000 - 17,356,416 1,156,223,200
SUB JUMLAH :
TERBILANG :

Dinas Kesehatan,

NIP : 19680528 198903 1 006
REKAPAN DARI PENYEDIA
PT. ANUGERAH PT ANTAR PT. ANUGERAH PT.

PHARMINDO MITRA ARGON INDOFARMA JUMLAH HARGA
LESTARI SEMBADA MEDICA CAB. TEGAL
91,185,500
9,385,200
54,080,500
38,747,164
42,787,550
38,432,416
4,246,948
30,678,874
20,712,370
16,854,198
43,016,000
19,638,582
47,310,138
25,044,468
12,134,750
44,536,976
6,844,300
1,687,990
20,397,850
37,100,406
72,947,460
20,469,920
56,622,500
5,888,000
47,951,000
116,841,845
39,560,500
19,854,937
15,671,936
33,722,970
29,980,560
PT. ANUGERAH PT ANTAR PT. ANUGERAH PT.
PHARMINDO MITRA ARGON INDOFARMA JUMLAH HARGA
LESTARI SEMBADA MEDICA CAB. TEGAL
24,724,132
18,177,500
35,419,806
7,714,708
62,379,894
14,385,900
- - 1,227,135,748
1,227,135,748
REKAP FIX FAKTUR PUSKESMAS DINAS KESEHATAN KABUPATEN KUNINGAN TAHUN 2021 (32 P
NO NAMA OBAT SATUAN CIAWI CIBINGBIN CIDAHU
1 Haloperidol Tablet 0,5 mg Tablet - - - - 3,000
2 Haloperidol Tablet 1,5 mg Tablet - - - - 6,000
3 Prednison Tablet 5 mg Tablet - - 5,000 340,000 -
4 Salep 2-4 Kombinasi : Pot - - - - 48
5 Zinc Tablet 20 mg Tablet 5,000 1,040,000 - - 1,500
6 Propanolol HCl Tablet 10 mg Tablet - - - - -
JUMLAH TOTAL 1,040,000 340,000

NINGAN TAHUN 2021 (32 PUSKESMAS)
CIDAHU CIGANDAMEKAR CIHAUR CILEBAK CILIMUS CIMAHI
141,000 - - 10,000 470,000 - - - - 700
306,000 - - 10,000 510,000 - - 3,000 153,000 -
- 2,000 136,000 3,000 204,000 2,000 136,000 5,000 340,000 -
111,984 120 279,960 192 447,936 96 223,968 288 671,904 -
312,000 3,000 624,000 5,000 1,040,000 1,000 208,000 8,000 1,664,000 4,000
- - - - - - - - - -
870,984 1,039,960 2,671,936 567,968 2,828,904

CIMAHI CINIRU CIPICUNG CIWARU DARMA
32,900 - - - - 300 14,100 11,000 517,000
- - - - - 300 15,300 10,800 550,800
- - - - - 7,000 476,000 - -
- 96 223,968 - - 504 1,175,832 456 1,063,848
832,000 1,000 208,000 5,000 1,040,000 7,000 1,456,000 5,000 1,040,000
- - - - - - - 200 11,200
864,900 431,968 1,040,000 3,137,232 3,182,848

GARAWANGI HANTARA JALAKSANA JAPARA KADUGEDE
- - 2,000 94,000 5,000 235,000 - - 2,000 94,000
- - 4,000 204,000 1,000 51,000 3,000 153,000 2,000 102,000
- - - - 2,000 136,000 - - - -
96 223,968 - - 72 167,976 - - - -
1,500 312,000 - - 2,500 520,000 - - 5,000 1,040,000
- - - - - - - - - -
535,968 298,000 1,109,976 153,000 1,236,000

KARANGKANCANA KRAMATMULYA KUNINGAN LINGGARJATI LURAGUNG
3,000 141,000 - - 1,000 47,000 500 23,500 -
5,000 255,000 - - 3,000 153,000 500 25,500 -
5,000 340,000 3,000 204,000 5,000 340,000 5,000 340,000 4,000
192 447,936 120 279,960 240 559,920 - - -
3,000 624,000 2,000 416,000 1,000 208,000 1,000 208,000 6,000
1,000 56,000 - - - - - - -
1,863,936 899,960 1,307,920 597,000

LURAGUNG MALEBER MANDIRANCAN MANGGARI MEKARWANGI NUSAHERANG
- 500 23,500 - - - - 1,000 47,000 -
- 500 25,500 3,000 153,000 - - 3,000 153,000 3,000
272,000 2,500 170,000 - - 10,000 680,000 1,000 68,000 -
- 120 279,960 - - 144 335,952 120 279,960 -
1,248,000 500 104,000 - - - - 2,000 416,000 -
- - - - - - - - - -
1,520,000 602,960 153,000 1,015,952 963,960

NUSAHERANG PANCALANG PASAWAHAN SINDANGAGUNG SUBANG SUKAMULYA
- - - 2,000 94,000 - - 3,000 141,000 1,200
153,000 - - 5,000 255,000 3,000 153,000 3,000 153,000 5,000
- - - 1,000 68,000 - - 3,000 204,000 -
- 120 279,960 504 1,175,832 192 447,936 96 223,968 288
- - - 5,000 1,040,000 4,000 832,000 2,000 416,000 600
- - - - - - - - - -
153,000 279,960 2,632,832 1,432,936 1,137,968

HARGA
SUKAMULYA TOTAL
SATUAN
56,400 46,200 2,171,400
255,000 74,100 3,779,100
- 65,500 4,454,000
671,904 4,104 9,574,632
124,800 81,600 16,972,800
- 1,200 67,200
1,108,104 37,019,132
REKAP PEMBAYARAN PUSKESMAS JKN
KABUPATEN KUNINGAN
TAHUN 2021
NO NAMA PUSKESMAS ITEM QTY HARGA SATUAN JUMLAH PPN PPH
1 CIAWIGEBANG Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
2 CIBEUREUM Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
3 CIBINGBIN Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
4 CIDAHU Nytatin Suspensi 100.000 IU/ml 20 11,500 230,000 - -
5 CIGANDAMEKAR Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
6 CIHAUR Nytatin Suspensi 100.000 IU/ml 50 11,500 575,000 - -
7 CILEBAK Nytatin Suspensi 100.000 IU/ml 50 11,500 575,000 - -
8 CILIMUS Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
9 CIMAHI Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
10 CINIRU Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
11 CIPICUNG Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
12 CIWARU Nytatin Suspensi 100.000 IU/ml 50 11,500 575,000 - -
13 DARMA Nytatin Suspensi 100.000 IU/ml 70 11,500 805,000 - -
14 GARAWANGI Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
15 HANTARA Nytatin Suspensi 100.000 IU/ml 73 11,500 839,500 - -
16 JALAKSANA Nytatin Suspensi 100.000 IU/ml 20 11,500 230,000 - -
17 JAPARA Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
18 KADUGEDE Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
19 KALIMANGGIS Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
20 KARANGKANCANA Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
21 KRAMATMULYA Nytatin Suspensi 100.000 IU/ml 50 11,500 575,000 - -
22 KUNINGAN Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
23 LAMEPAYUNG Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
24 LINGGARJATI Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
25 LURAGUNG Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
26 MALEBER Nytatin Suspensi 100.000 IU/ml 25 11,500 287,500 - -
27 MANDIRANCAN Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
28 MANGGARI Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
29 MEKARWANGI Nytatin Suspensi 100.000 IU/ml 50 11,500 575,000 - -
30 NUSAHERANG Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
31 PANCALANG Nytatin Suspensi 100.000 IU/ml 10 11,500 115,000 - -
32 PASAWAHAN Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
33 SELAJAMBE Nytatin Suspensi 100.000 IU/ml - 11,500 - - -
34 SINDANG AGUNG Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
35 SUBANG Nytatin Suspensi 100.000 IU/ml 100 11,500 1,150,000 - -
36 SUKAMULYA Nytatin Suspensi 100.000 IU/ml 50 11,500 575,000 - -
37 WINDUSENGKAHAN Nytatin Suspensi 100.000 IU/ml 20 11,500 230,000 - -
TOTAL 1,438 16,537,000 -
NO PUSKESMAS PPN PPH Total Kontrak
1 PUSKESMAS CIAWIGEBANG 8,090,500 1,213,575 88,995,500.00
2 PUSKESMAS CIBEUREUM 853,200 127,980 9,385,200.00
3 PUSKESMAS CIBINGBIN 4,885,500 732,825 53,740,500.00
4 PUSKESMAS CIDAHU 3,340,200 501,030 36,742,200.00
5 PUSKESMAS CIGANDAMEKAR 3,649,600 547,440 40,145,600.00
6 PUSKESMAS CIHAUR 3,116,500 467,475 34,281,500.00
7 PUSKESMAS CILEBAK 200,000 30,000 2,200,000.00
8 PUSKESMAS CILIMUS 2,304,000 345,600 25,344,000.00
9 PUSKESMAS CIMAHI 1,576,500 236,475 17,341,500.00
10 PUSKESMAS CINIRU 1,410,750 211,613 15,518,250.00
11 PUSKESMAS CIPICUNG 3,816,000 572,400 41,976,000.00
12 PUSKESMAS CIWARU 1,242,400 186,360 13,666,400.00
13 PUSKESMAS DARMA 3,897,300 584,595 42,870,300.00
14 PUSKESMAS GARAWANGI 2,123,500 318,525 23,358,500.00
15 PUSKESMAS HANTARA 999,750 149,963 10,997,250.00
16 PUSKESMAS JALAKSANA 3,927,000 589,050 43,197,000.00
17 PUSKESMAS JAPARA 608,300 91,245 6,691,300.00
18 PUSKESMAS KADUGEDE - - -
19 PUSKESMAS KALIMANGGIS 1,854,350 278,153 20,397,850.00
20 PUSKESMAS KARANGKANCANA 2,975,500 446,325 32,730,500.00
21 PUSKESMAS KRAMATMULYA 6,497,500 974,625 71,472,500.00
22 PUSKESMAS KUNINGAN 1,742,000 261,300 19,162,000.00
23 PUSKESMAS LAMEPAYUNG 5,147,500 772,125 56,622,500.00
24 PUSKESMAS LINGGARJATI 481,000 72,150 5,291,000.00
25 PUSKESMAS LURAGUNG 4,221,000 633,150 46,431,000.00
26 PUSKESMAS MALEBER 10,479,400 1,571,910 115,273,400.00
27 PUSKESMAS MANDIRANCAN 3,582,500 537,375 39,407,500.00
28 PUSKESMAS MANGGARI 1,651,000 247,650 18,161,000.00
29 PUSKESMAS MEKARWANGI 1,186,200 177,930 13,048,200.00
30 PUSKESMAS NUSAHERANG 2,824,000 423,600 31,064,000.00
31 PUSKESMAS PANCALANG 2,689,600 403,440 29,585,600.00
32 PUSKESMAS PASAWAHAN 2,008,300 301,245 22,091,300.00
33 PUSKESMAS SELAJAMBE 1,652,500 247,875 18,177,500.00
34 PUSKESMAS SINDANGAGUNG 2,861,900 429,285 31,480,900.00
35 PUSKESMAS SUBANG 452,250 67,838 4,974,750.00
36 PUSKESMAS SUKAMULYA 5,476,800 821,520 60,244,800.00
37 PUSKESMAS WINDUSENGKAHAN 1,286,900 193,035 14,155,900.00
TOTAL PAKET 105,111,200 15,766,680 1,156,223,200.00
AR_DATE CUST_SHIP_ID CUST_SHIP_NAME
8-Dec-21 446933 UPTD PUSKESMAS CIDAHU
8-Dec-21 446935 UPTD PUSKESMAS CIGANDAMEKAR
8-Dec-21 446937 UPTD PUSKESMAS CIHAUR
8-Dec-21 446939 UPTD PUSKESMAS CILEBAK
8-Dec-21 446941 UPTD PUSKESMAS CILIMUS
8-Dec-21 446948 UPTD PUSKESMAS CIMAHI
8-Dec-21 446951 UPTD PUSKESMAS CINIRU
8-Dec-21 446955 UPTD PUSKESMAS CIWARU
8-Dec-21 446953 UPTD PUSKESMAS DARMA
8-Dec-21 446957 UPTD PUSKESMAS KADUGEDE
8-Dec-21 446960 UPTD PUSKESMAS KARANGKANCANA
8-Dec-21 446965 UPTD PUSKESMAS MALEBER
8-Dec-21 446967 UPTD PUSKESMAS MANGGARI
8-Dec-21 446970 UPTD PUSKESMAS MEKARWANGI
8-Dec-21 446973 UPTD PUSKESMAS NUSAHERANG
8-Dec-21 446524 UPTD PUSKESMAS SINDANGAGUNG
8-Dec-21 446976 UPTD PUSKESMAS SUBANG
8-Dec-21 446978 UPTD PUSKESMAS SUKAMULYA
SHIP_ADDRESS SHIP_CITY
JL. RAYA CIDAHU NO. 63 KEC CIDAHU KAB KUNINGAN
JL. DESA BABAKANJATI KEC CIGANDAMEKAR KAB KUNINGAN
JL. RAYA CIHAUR NO. 10 DESA CIHAUR KEC CIAWIGEBANG KAB KUNINGAN
DESA CILEBAK KEC CILEBAK KAB KUNINGAN
JL. RAYA CILIMUS NO. 172 DS BOJONG KEC CILIMUS KAB KUNINGAN
DESA CIMAHI KEC CIMAHI KAB KUNINGAN
JL. RAYA CINIRU NO. 57 DESA CINIRU KEC CINIRU KAB KUNINGAN
JL. 11 APRIL NO. 479 DESA CIMARA KEC CIWARU KAB KUNINGAN
JL. RAYA DARMA NO. 01 KEC DARMA KAB KUNINGAN
JL. BARU LINGKAR BAYUNING KEC KADUGEDE KAB KUNINGAN
JL. 11 APRIL NO. 40 DESA KARANGKENCANA KEC KARANGKENCANA KAB KUNINGAN
JL. MALEBER NO. 575 KEC MALEBER KAB KUNINGAN
JL. RAYA KOREAK KEC LEBAKWANGI KAB KUNINGAN
JL. RAYA MEKARWANGI NO. 274 KEC LEBAKWANGI KAB KUNINGAN
JL. RAYA CIKADU NO. 5 KEC NUSAHERANG KAB KUNINGAN
UPTD PUSKESMAS SINDANGAGUNG KEC SINDANGAGUNG KAB. KUNINGAN
JL. H OTTO ISKANDARDINATA NO. 12 KEC SUBANG KAB KUNINGAN
JL. RAYA SUTAN SHAHRIR NO. 597 KEL SUKAMULYA KAB KUNINGAN
NO_FAKTUR PROD_ID PROD_NAME
400108210030245 037-004-0261 GENTAMICIN SULFATE TETES MATA 0.3% @5ML (E-KATALOG) R1
PROD_UOM_ID GS_QTY UNIT_LIST_PRICE HNA HNA + PPN
BTP 200 4,109.00 821,800.00 903,980.00
BTP 100 4,109.00 410,900.00 451,990.00
BTP 200 4,109.00 821,800.00 903,980.00
BTP 200 4,109.00 821,800.00 903,980.00
BTP 300 4,109.00 1,232,700.00 1,355,970.00
BTP 300 4,109.00 1,232,700.00 1,355,970.00
BTP 200 4,109.00 821,800.00 903,980.00
BTP 500 4,109.00 2,054,500.00 2,259,950.00
BTP 100 4,109.00 410,900.00 451,990.00
BTP 100 4,109.00 410,900.00 451,990.00
BTP 300 4,109.00 1,232,700.00 1,355,970.00
BTP 150 4,109.00 616,350.00 677,985.00
BTP 150 4,109.00 616,350.00 677,985.00
BTP 240 4,109.00 986,160.00 1,084,776.00
BTP 300 4,109.00 1,232,700.00 1,355,970.00
BTP 300 4,109.00 1,232,700.00 1,355,970.00
BTP 100 4,109.00 410,900.00 451,990.00
BTP 100 4,109.00 410,900.00 451,990.00
15,778,560.00 17,356,416.00

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No Nama PKM NILAI HNA PPN TOTAL

1 PUSKESMAS CIAWIGEBANG 12,428,182 1,242,818 13,671,000

NO ID PAKET PRINCIPAL TOTAL

Hb Hemoglobin Test Strips

TOTAL PAKET 212 85,156,584 85,156,584

Untuk dan atas nama Pemda Kab. Kuningan

H. SAEPUDIN, S.AP, S.Kep, Ners, M.Mkes

1 Stik Pemeriksaan Gula Darah Box/50 160,000 0 - 0 - 0 - 60 9,600,000 0 - 0 0 0 - 0 0 - 0 3

JUMLAH TOTAL 13,250,000 2,000,000 6,500,000 12,200,000 750,000 13,700,000 1,700,000

1,830,000 6,500,000 4,000,000 7,750,000 15,500,000 18,750,000 1,700,000 1,700,000 1,050,000

- 0 - 0 - 0 - 0 - 0 - 0 0 12 1,920,000 0 - 75 12,000,000 12,000,075

2,200,000 6,850,000 1,500,000 1,500,000 8,000,000 600,000 11,220,000 3,500,000 144,250,000

Pharmafix 5 x 500 50 31,900 1,595,000

Pharmafix 5 x 500 40 31,900 1,276,000

Sarung Tangan Steril No 7 300 8,635 2,590,500

Sarung Tangan Steril No 7 100 8,635 863,500

Pharmafix 5 x 500 40 31,900 1,276,000

Pharmafix 5 x 500 54 31,900 1,722,600

Sarung Tangan Steril No 6 200 8,635 1,727,000

Sarung Tangan Steril No 6 100 8,635 863,500

Sarung Tangan Steril No 7 500 8,635 4,317,500

Pharmafix 5 x 500 40 31,900 1,276,000

Pharmafix 5 x 500 15 31,900 478,500

Sarung Tangan Steril No 7 100 8,635 863,500

Pharmafix 5 x 500 20 31,900 638,000

Pharmafix 5 x 500 10 31,900 319,000

Sarung Tangan Steril No 6 300 8,635 2,590,500

NO NAMA PUSKESMAS JUMLAH PPN PPH

TOTAL PAKET 326,408,702 - 215,414,280 - 144,250,000 - 85,156,584 165,616,550 936,846,116

SUB JUMLAH : 936,846,116

Untuk dan atas nama Pemda Kab. Kuningan

H. SAEPUDIN, S.AP, S.Kep, Ners, M.Mkes

TOTAL PAKET 37,019,132 - - 16,537,000 - 17,356,416 1,156,223,200

Untuk dan atas nama Pemda Kab. Kuningan

H. SAEPUDIN, S.AP, S.Kep, Ners, M.Mkes

PT. ANUGERAH PT ANTAR PT. ANUGERAH PT.

NO NAMA OBAT SATUAN CIAWI CIBINGBIN CIDAHU

1 Haloperidol Tablet 0,5 mg Tablet - - - - 3,000

2 Haloperidol Tablet 1,5 mg Tablet - - - - 6,000

3 Prednison Tablet 5 mg Tablet - - 5,000 340,000 -

4 Salep 2-4 Kombinasi : Pot - - - - 48

5 Zinc Tablet 20 mg Tablet 5,000 1,040,000 - - 1,500

6 Propanolol HCl Tablet 10 mg Tablet - - - - -

JUMLAH TOTAL 1,040,000 340,000

CIDAHU CIGANDAMEKAR CIHAUR CILEBAK CILIMUS CIMAHI

141,000 - - 10,000 470,000 - - - - 700

306,000 - - 10,000 510,000 - - 3,000 153,000 -

- 2,000 136,000 3,000 204,000 2,000 136,000 5,000 340,000 -

111,984 120 279,960 192 447,936 96 223,968 288 671,904 -

870,984 1,039,960 2,671,936 567,968 2,828,904

32,900 - - - - 300 14,100 11,000 517,000

- - - - - 300 15,300 10,800 550,800

- 96 223,968 - - 504 1,175,832 456 1,063,848

832,000 1,000 208,000 5,000 1,040,000 7,000 1,456,000 5,000 1,040,000

864,900 431,968 1,040,000 3,137,232 3,182,848

- - 2,000 94,000 5,000 235,000 - - 2,000 94,000

- - 4,000 204,000 1,000 51,000 3,000 153,000 2,000 102,000

1,500 312,000 - - 2,500 520,000 - - 5,000 1,040,000

535,968 298,000 1,109,976 153,000 1,236,000

3,000 141,000 - - 1,000 47,000 500 23,500 -

5,000 255,000 - - 3,000 153,000 500 25,500 -

5,000 340,000 3,000 204,000 5,000 340,000 5,000 340,000 4,000

192 447,936 120 279,960 240 559,920 - - -