Laporan Puskesmas Gunung Meriah

PELAPORAN : PUSKESMAS GUNUNG MERIAH 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH GUNUNG MERIAH TOTAL
HARGA TOTAL
NO NAMA OBAT SATUAN HARGA
SATUAN KELUAR
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL KELUAR
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER OKTOBER NOPEMBER DESEMBER
1 Acyclovir 400 mg tablet tablet 359 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 50 429000 0 0 0 50 429000

tablet 93 0 0 3,000 279000 0 2,000 186000 0 1,000 93000 0 1,000 93000 0 0 0 7000 651000
3 Allopurinol 100 mg
silva/ 2014 945 0 0 0 0 0 0 0 0 8,000 7563640 0 0 0 8000 7563640
4 Albendazole tablet 400 mg tablet 313 0 0 2,000 626000 0 1,000 313000 0 1,000 313000 0 1,000 313000 0 0 0 5000 1565000
tablet 88 0 0 3,000 264000 0 4,000 352000 0 5,000 440000 0 5,000 440000 0 0 0 17000 1496000
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
kapsul 265 0 0 5,000 1325000 0 2,500 662500 0 1,000 265000 0 3,000 795000 0 0 0 11500 3047500
6 Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 300 750000 0 150 375000 0 200 500000 0 200 500000 0 0 0 850 2125000
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 200 734000 0 0 0 200 734000
9 Antasida DOEN I Kombinasi tablet 63 0 0 3,000 0 4,000 0 5,000 315000 0 5,000 315000 0 0 0
btl 60 ml 2,065 0 0 400 826000 0 250 516250 0 300 619500 0 300 619500 0 0 0 1250 2581250
10 Antasida DOEN II Suppensi Kombinasi
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 200 1381000 0 25 172625 0 30 207150 0 50 345250 0 0 0 305 2106025
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 4,000 436000 0 3,000 327000 0 3,000 327000 0 3,000 327000 0 0 0 13000 1417000
tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 3,000 1336500 0 0 0 0 0 8000 3564000
tablet 176 0 0 800 140800 0 0 0 0 0 0 0 0 0 800 140800

13 Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 6,000 1822380 0 0 0 6000 1822380
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000 607460
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 200 975000 0 150 731250 0 150 731250 0 30 146250 0 0 0 530 2583750
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 2,000 290000 0 0 0 700 101500 0 1,000 145000 0 0 0 3700 536500
18 Cetrizin syrup botol 2,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 3,000 3168000 0 1,500 1584000 0 1,200 1267200 0 1,500 1584000 0 0 0 7200 7603200
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 200 359600 0 75 134850 0 100 179800 0 100 179800 0 0 0 475 854050
botol 11,550 0 0 0 0 0 0 300 3465000 0 0 0 0 0 300 3465000

21 Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 150 1732500 0 0 0 150 1732500
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 400 37840 0 0 0 400 37840
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 2 3643 0 0 0 2 3643
24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 200 576000 0 0 0 0 0 0 0 0 0 200 576000
tablet 64 0 0 5,000 320000 0 3,000 192000 0 5,000 320000 0 5,000 320000 0 0 0 18000 1152000
25 Deksametason tablet 0,5 mg
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Digoksin tablet 0,25 mg
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 600 1412400 0 0 0 0 0 0 0 0 0 600 1412400
29 Eritromysin kapsul 500 mg tablet 751 0 0 2,000 1502000 0 1,300 976300 0 3,000 2253000 0 2,500 1877500 0 0 0 8800 6608800
30 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tube 18,844 0 0 0 0 0 0 0 0 50 942200 0 0 0 942200
30 Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 3,000 1308000 0 0 0 0 0 0 0 0 0 3000 1308000

32 Fito Menadione tablet 10 mg
tablet/ H. baru 797 0 0 0 0 0 0 500 398495 0 500 398495 0 0 0 1000 796990
33 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 600 48600 0 1,000 81000 0 500 40500 0 0 0 4100 332100
34 Fenobarbital 30 mg tablet 180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Garam oralit 200 ml air bks 303 0 0 1,000 303000 0 0 0 0 0 0 0 0 0 1000 303000
tablet 58 0 0 4,000 232000 0 3,000 174000 0 3,000 174000 0 0 0 0 0 10000 580000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 3,000 375000 0 0 0 3000 375000

36 Glibenclamida 5 mg
silva 2015 125 0 0 0 0 0 0 0 0 12,000 1500000 0 0 0 12000 1500000
silva 2014 125 0 0 0 0 0 0 0 0 8,000 1000000 0 0 0 8000 1000000

botol 6,900 0 0 400 2760000 0 100 690000 0 100 690000 0 200 1380000 0 0 0 800 5520000
37 Glukosa 5% Larutan Infus
JKN 2019 7,363 0 0 0 0 0 0 0 0 0
38 Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0 5 37500 0 0 0 0 0 5 37500
39 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 500 86995 0 0 0 500 86995
40 Griseofulvin 125 mg Tablet tablet 240 0 0 3,000 720000 0 4,000 960000 0 3,500 840000 0 2,500 600000 0 0 0 13000 3120000
41 Haloperidol tablet 0,5 mg tablet 62 0 0 1,000 62000 0 500 31000 0 500 31000 0 400 24800 0 0 0 2400 148800
42 Hidrokortison Cream 2.5 % tube 2,650 0 0 100 265000 0 50 132500 0 100 265000 0 100 265000 0 0 0 350 927500
43 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 3,000 468000 0 0 0 500 78000 0 0 0 6500 1014000
tablet / H.Baru 437 0 0 0 0 3,600 1573200 0 3,600 1573200 0 3,000 1311000 0 0 0 10200 4457400
44 Hustab Tablet tablet 258 0 0 0 0 3,000 774000 0 0 0 0 0 0 3000 774000
tablet P 312 0 0 5,000 1560000 0 0 0 0 0 0 0 0 0 5000 1560000
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 200 2310000 0 200 2310000 0 0 0 700 8085000
JKN 11,550 0 0 0 0 0 0 0 0 0
45 Hustab syrup silva /2014 11,550 0 0 0 0 0 0 0 0 120 1386000 0 0 0 120 1386000
silva/ 2015 11,550 0 0 0 0 0 0 0 0 150 1732500 0 0 0 150 1732500
botol / bpjs 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0

47 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 2,500 232500 0 3,000 279000 0 3,500 325500 0 0 0 11000 1023000
48 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 0 0 0 0 0 0

49 Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 3,000 188970 0 0 0 188970
51 Karbamazepin tablet 200 mg tablet 230 0 0 300 69000 0 500 115000 0 400 92000 0 400 92000 0 0 0 1600 368000
52 Kaptopril 12,5 mg tablet 62 0 0 3,000 186000 0 2,000 124000 0 2,500 155000 0 2,500 155000 0 0 0 10000 620000
53 Kaptopril 25 mg tablet 715 0 0 3,000 2145000 0 2,000 1430000 0 3,000 2145000 0 4,000 2860000 0 0 0 12000 8580000
54 Klorpramazine HCl 100 mg tablet - 0 0 300 0 0 300 0 0 400 0 0 400 0 0 0 0 1400 0
55 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 10,000 430000 0 8,000 344000 0 10,000 430000 0 10,000 430000 0 0 0 38000 1634000
56 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 500 1091500 0 200 436600 0 200 436600 0 200 436600 0 0 0 1100 2401300
tablet 154 0 0 3,000 462000 0 2,000 308000 0 4,000 616000 0 4,000 616000 0 0 0 13000 2002000
57 Kotrimoksazol 480 mg komb (DW)
APBD 2019 133 0 0 0 0 0 0 0 0 0
58 Kodein HCL 10 mg tablet 575 0 0 2,000 1150000 0 1,400 805000 0 0 0 0 0 0 0 3400 1955000
ampul 1,937 0 0 500 968500 0 100 193700 0 200 387400 0 200 387400 0 0 0 1000 1937000
59 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Loperramid tablet 2 mg tablet 80 0 0 4,000 320000 0 0 0 0 0 0 0 0 0 4000 320000
61 MgSO4 20 % ampul 3,200 0 0 30 96000 0 0 0 0 0 0 0 0 0 30 96000
tablet 133 0 0 3,000 399000 0 4,000 532000 0 5,000 665000 0 5,000 665000 0 0 0 17000 2261000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Metformin tablet 500 mg
Silva 2015 106 0 0 0 0 0 0 0 0 8,000 848000 0 0 0 8000 848000
Silva 2014 106 0 0 0 0 0 0 0 0 8,000 848000 0 0 0 8000 848000
63 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 400 1073600 0 100 268400 0 0 0 0 0 0 0
64 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 3,000 486000 0 1,000 162000 0 600 97200 0 500 81000 0 0 0 5100 826200
65 Metoclorpramid HCL 10 mg tablet 123 0 0 2,000 246000 0 2,000 246000 0 2,000 246000 0 1,000 123000 0 0 0 7000 861000
tablet 133 0 0 17,000 2261000 0 7,644 1016652 0 0 0 0 0 0 0 24644 3277652

66 Metronidazol 500 mg
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Metronidazole syirup botol 3,800 0 0 500 1900000 0 100 380000 0 200 760000 0 200 760000 0 0 0 1000 3800000
68 Mikonazol Cream 2 % tube 3,410 0 0 100 341000 0 100 341000 0 50 170500 0 100 341000 0 0 0 350 1193500
tablet 107 0 0 3,000 320010 0 1,500 160005 0 0 0 0 0 0 0 4500 480015

69 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 2,500 340000 0 3,000 408000 0 0 0 5500 748000
silva 2015 136 0 0 0 0 0 0 0 0 12,000 1630800 0 0 0 12000 1630800

botol 6,410 0 0 400 2564000 0 50 320500 0 100 641000 0 100 641000 0 0 0 650 4166500
70 Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 3,000 1647000 0 500 274500 0 1,500 823500 0 1,000 549000 0 0 0 6000 3294000
71 Nistatin tablet salut 100.000 IU/g
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 2,000 1606000 0 500 401500 0 600 481800 0 250 200750 0 0 0 3350 2690050
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 300 1072500 0 0 0 0 0 300 1072500
74 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 300 539400 0 0 0 0 0 0 0 0 0 300 539400
ampul 1,900 0 0 300 570000 0 100 190000 0 300 570000 0 300 570000 0 0 0 1000 1900000
75 Oksitoksin injeksi 10 iv/ml
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 Omeprazole kapsul/kaplet 20 mg tablet 164 2,000 3,000 1,500

tablet 51 0 0 10,000 510000 0 0 0 0 0 0 0 0 0 10000 510000
tablet 178 0 0 0 0 0 0 0 0 0 0 0
77 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 2,500 411550 0 10,000 1646200 0 10,000 1646200 0 0 0 22500 3703950
silva/ 2015 165 0 0 0 0 0 0 0 0 15,000 2469300 0 0 0 15000 2469300
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 1,496 0 0 400 598400 0 300 448800 0 100 149600 0 100 149600 0 0 0 900 1346400
78 Paracetamol sirup 120 mg/5ml
botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 300 933900 0 100 311300 0 100 311300 0 0 0 900 2801700
79 Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Pirantel tablet score 125 mg tablet 308 0 0 4,000 1232000 0 400 123200 0 2,000 616000 0 2,000 616000 0 0 0 8400 2587200
81 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 7,000 868000 0 10,000 1240000 0 0 0 4,000 496000 0 0 0 21000 2604000
82 Prednison 5 mg Tablet tablet 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Propanolol HCL 10 mg tablet 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 191 0 0 0 0 0 0 3,000 571980 0 3,000 571980 0 0 0 6000 1143960
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 1600 1056000 0 0 0 1600 1056000
Silva 2014 191 0 0 0 0 0 0 0 0 2000 381320 0 0 0 2000 381320
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0
85 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 3,000 1491000 0 0 0 0 0 69 34293 0 0 0 3069 1525293
87 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 656 0 0 0 0 656 0
botol 7,150 0 0 400 2860000 0 200 1430000 0 100 715000 0 100 715000 0 0 0 800 5720000
88 Ringer Laktat laturan infus steril
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 120 832320 0 0 0 120 832320
89 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Salbutamol tablet 2 mg tablet 78 0 0 4,000 312000 0 5,000 390000 0 3000 234000 0 3,000 234000 0 0 0 15000 1170000
91 Salbutamol Cairan 0,1 % ampul 4,000 0 0 100 400000 0 0 0 0 0 0 0 0 0 100 400000
92 Salbutamol syrup botol 4,042 0 0 0 0 0 0 100 404182 0 0 0 0 0 100 404182

93 Salisil Bedak 2,5% bks 1,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 3 565989 0 5 943315 0 0 0 8 1509304

95 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 4,000 240000 0 5,000 300000 0 0 0 0 0 0 0 9000 540000
96 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 1,000 1168000 0 600 700800 0 1,000 1168000 0 500 584000 0 0 0 3100 3620800
tablet 133 0 0 1,000 133000 0 0 0 0 0 0 0 0 0 1000 133000
97 Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0 0 0 3,000 386100 0 0 0 3000 386100
tablet/ SILVA 2015 117 0 0 0 0 0 0 0 0 18,000 2106000 0 0 0 18000 2106000
98 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 500 63000 0 0 0 500 63000

tablet 880 0 0 0 0 0 0 3,000 2640000 0 3,000 2640000 0 0 0 6000 5280000
99 Siprofloksasin 500 MG
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Sanadryl Syrup botol 12,210 0 0 0 0 0 0 0 0 0 0 0 0 0 0
101 Tetrasiklin 500 mg kapsul 319 0 0 3,000 957000 0 0 0 2,000 638000 0 2,000 638000 0 0 0 7000 2233000
102 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 7,000 588000 0 5,000 420000 0 5,000 420000 0 0 0 0 0 17000 1428000
103 Vitamin B komplek Tablet tablet 121 0 0 10,000 1210000 0 6,000 726000 0 5,000 605000 0 6000 726000 0 0 0 27000 3267000
Botol 9,646 0 0 500 4823000 0 0 0 0 0 0 0 0 0 500 4823000
104 Wida Bes Asetat Ringer Infus
Botol 10,293 0 0 0 0 0 0 0 0 200 2058580 0 0 0 200 2058580
105 Zink Tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 0 0 50 314500 0 0 0 50 314500

106 Zircum syrup 20 mg/5ml
botol 3,322 0 0 0 0 50 166100 0 50 166100 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
107 Eugenol cairan botol 19,005 0 0 10 190050 0 4 76020 0 3 57015 0 2 38010 0 0 0 19 361095
BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
108 Accu Check safe T Pro Uno Dus 127,050 0 10 1270500 0 0 0 0 0 0 1 127050 0 0 0 11 1397550
109 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 10 1375000 0 0 0 0 0 0 0 10 1375000
110 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 2 737000 0 5 1842500 0 0 0 0 0 0 0 7 2579500
111 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 10 1787500 0 0 0 0 0 0 0 10 1787500
112 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 10 606364 0 5 303182 0 0 0 15 909545
113 Abbocath No.20 G buah 4,180 0 0 200 836000 0 50 209000 0 50 209000 0 50 209000 0 0 0 350 1463000
buah 4,180 0 0 200 836000 0 50 209000 0 50 209000 0 50 209000 0 0 0 350 1463000

116 Abbocath No.18 G
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 2,5 ml 23 G
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,200 950400 0 0 0 500 396000 0 500 396000 0 0 0 2200 1742400
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Alat suntik 3 ml 23 G X1
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Alat suntik 5 ML buah 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 200 43200 0 0 0 0 0 0 0 1200 259200

122 Alkohol Sweb 2 Ply
buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
123 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
124 Aseptan Gel 500 cc + Dispenser
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 12 542196 0 12 542196 0 12 542196 0 0 0 36 1626588

125 Cat Gut /benang bedah Plain no . 2/0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
126 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 12 630732 0 0 0 0 0 0 0 0 0 12 630732
127 Cat Gut /benang bedah CHROMIC no . 2/0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Cat Gut /benang bedah CHROMIC no .3/0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
129 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Etakridin (Rivanol) larutan 0,1%
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 5 143750 0 0 0 0 0 0 0 10 287500

131 Etanol 70% 1000 ml
131 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Folly Catheter 2 way no 18
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 50 192500 0 0 0 50 192500
133 Infusion Set Anak set 2,831 0 0 50 141563 0 0 0 0 0 0 0 0 0 50 141563
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 50 176000 0 50 176000 0 50 176000 0 50 176000 0 0 0 200 704000

134 Infusion Set Dewasa
set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 30 412500 0 10 137500 0 6 82500 0 5 68750 0 0 0 51 701250

135 Kapas Pembalut 250 g
buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas Pembalut 500 g buah 27,280 0 0 20 545600 0 0 0 0 0 3 81840 0 0 0 23 627440
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
137 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 20 154000 0 0 0 0 0 0 0 0 0 20 154000
138 Kasa Pembalut Hid 2 m x 80 cm steril
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Kasa Pembalut Hid 4 m x 15 cm
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 20 33000 0 0 0 0 0 0 0 0 0 20 33000

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
142 Kasa Steril 16 m x 16 cm
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
143 Kasa Steril 40 x 40 buah 1,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 5 235750 0 0 0 0 0 10 471500 0 0 0 15 707250
146 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 200 72600 0 0 0 0 0 0 0 0 0 200 72600
147 Masker Tie On buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Masker 3 Ply Earloop buah 439
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 1,000 440000 0 500 220000 0 0 0 0 0 0 0 1500 660000

151 Masker Plus 3 Ply Earloop ( Jilbab )
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0
152 My Jelly 82 gram tube - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

153 Object Glass Kotak 19,365 0 0 0 0 0 0 0 0 0 0 0 0 0 0
154 One scrub 500 cc + dispenser botol 65,341 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 13 1065421 0 0 0 0 0 0 0 0 0 13 1065421
155 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0 0 5 235000 0 5 235000 0 0 0 10 470000

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
157 Pharfix 5 cm x 5 m rol/ H. baru 16,500 0 0 0 0 0 0 0 0 5 82500 0 0 0 5 82500

rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 3 56455 0 0 0 0 0 4 75273 0 0 0 7 131727

158 Povidon Iodida 10 % 300 ml
botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 304 921673 0 0 0 0 0 0 0 0 0 304 921673
159 Povindo lodida 10% 30 ml
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0 0 0 0 400 1866400 0 0 0 400 1866400
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Sarung tangan M buah 471 0 0 0 0 0 0 500 235250 0 0 0 0 0 500 235250

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
163 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
164 Skin Celean 500 ml botol - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 Tranfusion Set buah 4,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
168 Diluen Samsung Unit 2,750,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

170 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
171 Lise Samsung Unit 3,300,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Rinse Mindrey galon 1,254,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
173 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0
174 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0
175 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0

176 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
177 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0 0 0 0 0 0 0 0 0
178 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
179 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0

180 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0
181 URID ACID (URICASE) Kit 799,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0

182 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
183 GARAM ORALIT SACHET 303 0 0 0 0 300 90900 0 0 0 200 60600 0 0 0 500 151500
184 ZINC Tablet TABLET 539 0 45 24255 0 0 0 0 0 0 0 0 0 0 45 24255

185 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 0 0 0 0 0 0 0 0 0 0 0 0 0
186 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0

188 Tuberculin PPD Vial 702,250 0 0 0 0 0 0 0 0 0 0 0 0 0 0
189 Sarung tangan tanpa tepung M buah 583 0 500 291500 0 0 0 0 0 0 0 0 0 0 500 291500
190 Lisol 100 % botol 47,150 0 1 47150 0 0 0 0 0 0 0 0 0 0 1 47150

191 Reagen Ziehl Neelsen kit 181,811 0 0 0 0 0 0 0 0 0 0 0 0 0 0
192 Masker 3 Ply Earloop Jilbab buah - 0 1,000 0 0 0 0 0 0 0 0 0 0 0 1000 0
193 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
194 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
195 Imersion Oil Botol 3,181,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 KAPAS LIDI Bungkus - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
197 ASAM CUKA botol - 0 0 2 0 0 0 0 0 0 0 0 0 0 2 0
198 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0

199 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Imunisasi 1,404 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 20 24500 0 0 0 0 0 20 24500
202 Safety Box 5 liter box - 0 0 0 0 0 0 3 0 0 0 0 0 0 3 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
204 BD Vacuntainer box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
205 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 25 0 0 0 0 0 25 0
207 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 0 0 0 0 25 364750 0 0 0 0 25 364750
208 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0

209 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0
210 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0 0 0 0 0 0 0 0 0
211 Sarung tangan L buah 499 0 0 0 0 0 0 0 0 0 0 0 0 0 0
212 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 125 0 0 0 0 0 125 0
213 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
215 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 2 704000 0 2 704000 0 0 0 5 1760000
216 Articulating Pcs 181,500 0 0 0 0 0 0 2 363000 0 2 363000 0 0 0 4 726000
217 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0 0 2 880094 0 0 0 2 880094
218 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0 0 0 2 381032 0 0 0 2 381032
220 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0 0 2 329547 0 0 0 2 329547

221 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0 0 0 0 2 93400 0 0 0 2 93400
223 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 2 369400 0 0 0 2 369400
224 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0 0 2 133400 0 0 0 2 133400

225 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 2 437400 0 0 0 2 437400
226 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0 0 2 196400 0 0 0 2 196400

OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227 OAT FDC Kategori 1 paket 327,259 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228 OAT FDC Kategori 2 paket 1,259,990 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 0 0 0 0 0 0 0 0 0 0 0

230 OAT FDC Kategori Anak paket 203,259 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

232 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 REAGEN TB PARU KIT 276,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
236 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 100 311590 0 0 0 0 100 311590
tablet 367 0 0 0 0 0 0 0 8800 3229600 0 0 0 0 8800 3229600

237 Tablet Tambah Darah
Provinsi 367 0 11,968 4392256 0 0 0 0 0 0 0 0 0 0 11968 4392256
Program Imunisasi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah/ skipa 1,240 167 207080 0 0 0 0 0 0 0 0 0 0 0 167 207080

238 Spuit 0,5 ml
buah / apbn 1,621 569 922349 0 0 0 0 0 0 0 0 0 0 0 569 922349
239 Spuit 0,5 ml ( Solosot Mini) Box 165,550 1 165550 0 0 0 0 0 0 0 0 0 0 0 1 165550
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0

240 Spuit 0,05 ml
240 Spuit 0,05 ml
APBN 1,315 0 0 0 0 0 0 0 0 0 0 0 0 0 0
241 Spuit 5 ml APBN 1,705 7 11935 0 0 0 0 0 0 0 0 0 0 0 7 11935
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
242 Safety Box Box / 5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
243 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0

244 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Primaquin TABLET 235 0 0 0 0 0 0 0 0 0 0 0 0 0 0
246 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Vaksin Rabies kur - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Alkohol Swab buah 1,985 0 0 0 0 0 0 0 1 1985 0 0 0 0 1 1985
249 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
250 Fluconazol tablet TABLET - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0 0 0 0 0 0 0 0 0
252 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0
253 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0 100 430000 0 0 0 0 100 430000
254 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 0 0 0 0 100 2233000 0 0 0 0 100 2233000
255 Rapid Test II ( FOKUS ) Test 13,615 0 0 0 0 0 0 0 0 0 0 0 0 0 0
256 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0 0 0 0 0 0 0 0
257 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 0 0 0 0 0 0 0 0 0 0 0
258 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0
259 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Yellow Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

261 Blue Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 Metilen Blue botol 94,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0
263 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
264 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0
265 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

267 Object Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 Cover Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
269 Handscoen boks - 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0
270 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
271 BCG VIAL 59,950 6 359700 6 359700 5 299750 4 239800 5 299750 5 299750 3 179850 4 239800 4 239800 0 0 0 42 2517900
272 CAMPAK VIAL 28,204 0 0 0 0 5 141020 0 0 0 0 0 0 0 5 141020
273 MR VIAL 141,648 10 1416480 10 1416480 7 991536 8 1133184 5 708240 2 283296 2 283296 0 9 1274832 0 0 0 53 7507344
274 DPT-HB-Hib VIAL 76,285 20 1525700 15 1144275 5 381425 20 1525700 20 1525700 15 1144275 15 1144275 15 1144275 15 1144275 0 0 0 140 10679900
275 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

276 HB-PID-(HB-0) VIAL 20,900 6 125400 6 125400 4 83600 5 104500 5 104500 5 104500 15 313500 5 104500 4 83600 0 0 0 55 1149500
277 POLIO (BOPV) VIAL 19,954 20 399080 15 299310 0 0 20 399080 15 299310 15 299310 10 199540 15 299310 0 0 0 110 2194940
278 POLIO (IPV) VIAL 13,976 3 41928 3 41928 2 27952 3 41928 2 27952 2 27952 2 27952 3 41928 3 41928 0 0 0 23 321448
279 Td VIAL 16,500 4 66000 5 82500 2 33000 3 49500 5 82500 4 66000 4 66000 3 49500 4 66000 0 0 0 34 561000
PELAPORAN : PUSKESMAS TIGA JUHAR 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TIGA JUHAR TOTAL
HARGA TOTAL
SATUAN KELUAR
2 Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 93 0 0 4,000 372000 0 5,000 465000 0 4,000 372000 0 4,000 372000 0 0 0 17000 1581000
silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730 0 0 0 6000 5672730
tablet 88 0 0 4,000 352000 0 5,000 440000 0 4,000 352000 0 4,000 352000 0 0 0 17000 1496000
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
kapsul 265 0 0 15,000 3975000 0 15,000 3975000 0 13,000 3445000 0 13,000 3445000 0 0 0 56000 14840000
kapsul 260 0 0 0 0 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 0 10,000 630000 0 10,000 630000 0 10,000 630000 0 10,000 630000 0 0 0 40000 2520000
btl 60 ml 2,065 0 0 400 826000 0 400 826000 0 500 1032500 0 500 1032500 0 0 0 1800 3717000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 100 690500 0 100 690500 0 50 345250 0 0 0 0 0 250 1726250
tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 4,000 1782000 0 0 0 0 0 9000 4009500
tablet 176 0 0 3,000 528000 0 0 0 0 0 0 0 0 0 3000 528000
13 Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 6,000 1822380 0 0 0 6000 1822380
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000 607460
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 3,000 435000 0 0 1,000 145000 3,000 435000 0 2,000 290000 0 0 0 9000 1305000
18 Cetrizin syrup botol 2,900 0 0 0 0 0 0 50 145000 0 100 290000 0 0 0 150 435000
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 2,000 2112000 0 2,000 2112000 0 2,000 2112000 0 0 0 8000 8448000
botol 11,550 0 0 0 0 0 0 300 3465000 0 150 1732500 0 0 0 450 5197500
21 Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100 1155000
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 500 47300 0 0 0 500 47300
tablet 64 0 0 3,000 192000 0 5,000 320000 0 5,000 320000 0 5,000 320000 0 0 0 18000 1152000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 200 1373400 0 0 0 0 0 0 0 0 0 200 1373400
tube 18,844 0 0 0 0 0 0 0 100 1884400 0 0 0

30 Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0
31 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 200 833400 0 0 0 0 0 0 0 0 0 200 833400
tablet 436 0 0 500 218000 0 0 0 0 0 0 0 0 0 500 218000
tablet/ H. baru 797 0 0 0 0 0 0 1,000 796990 0 1,000 796990 0 0 0 2000 1593980
33 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 2,000 162000 0 1,000 81000 0 1,000 81000 0 0 0 6000 486000

tablet 58 0 0 3,000 174000 0 2,000 116000 0 2,000 116000 0 0 0 0 0 7000 406000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 2,000 250000 0 0 0 2000 250000

silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000 0 0 0 9000 1125000
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000 0 0 0 6000 750000
botol 6,900 0 0 200 1380000 0 200 1380000 0 200 1380000 0 0 0 0 0 600 4140000
37 Glukosa 5% Larutan Infus
JKN 2019 7,363 0 0 0 0 0 0 0 0 0
40 Griseofulvin 125 mg Tablet tablet 240 0 0 3,000 720000 0 2,000 480000 0 0 0 1,000 240000 0 0 0 6000 1440000
41 Haloperidol tablet 0,5 mg tablet 62 0 0 500 31000 0 0 0 0 0 500 31000 0 0 0 1000 62000
43 Hidrokloratiazid 25 mg tablet 156 0 0 0 0 0 0 1,000 156000 0 2,000 312000 0 0 0 3000 468000
tablet / H.Baru 437 0 0 6,000 2622000 0 10,800 4719600 0 3,600 1573200 0 3,000 1311000 0 0 0 23400 10225800
44 Hustab Tablet tablet 258 0 0 0 2,000 516000 0 0 0 0 0 0
tablet P 312 0 1,500 468000 0 0 0 0 0 0 0 0 0 0 1500 468000
botol/ H. Baru 11,550 0 0 200 2310000 0 250 2887500 0 300 3465000 0 200 2310000 0 0 0 950 10972500
JKN 11,550 0 0 0 0 0 0 0 0 0

silva/ 2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100 1155000
botol / bpjs 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0

47 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 3,000 279000 0 2,000 186000 0 0 0 1,000 93000 0 0 0 6000 558000
48 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 0 0 0 0 0

50 Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 4,000 251960 0 0 0 251960
51 Karbamazepin tablet 200 mg tablet 230 0 0 0 0 0 0 300 69000 0 500 115000 0 0 0 800 184000
54 Klorpramazine HCl 100 mg tablet - 0 0 2,000 0 0 0 0 0 0 500 0 0 0 0 2500 0
tablet 154 0 0 5,000 770000 0 5,000 770000 0 5,000 770000 0 4,000 616000 0 0 0 19000 2926000
57 Kotrimoksazol 480 mg komb (DW)
APBD 2019 133 0 0 0 0 0 0 0 0 0
58 Kodein HCL 10 mg tablet 575 0 0 300 172500 0 0 0 0 0 0 0 0 0 300 172500
ampul 1,937 0 0 400 774800 0 300 581100 0 400 774800 0 200 387400 0 0 0 1300 2518100
59 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 133 0 0 4,000 532000 0 3,000 399000 0 3,000 399000 0 3,000 399000 0 0 0 13000 1729000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000

63 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 300 805200 0 100 268400 0 0 0 0 0 0 0 400 1073600
64 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 1,000 162000 0 1,000 162000 0 1,000 162000 0 0 0 0 0 3000 486000
tablet 133 0 0 15,000 1995000 0 15,000 1995000 0 0 0 0 0 0 0 30000 3990000
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 4,000 426680 0 4,000 426680 0 0 0 0 0 0 0 8000 853360

69 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 0 0 4,000 544000 0 0 0 4000 544000
silva 2015 136 0 0 0 0 0 0 4,000 543600 0 9,000 1223100 0 0 0 13000 1766700

botol 6,410 0 0 400 2564000 0 200 1282000 0 400 2564000 0 0 0 0 0 1000 6410000
70 Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 200 109800 0 0 0 0 0 1,000 549000 0 0 0 1200 658800

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 1,000 803000 0 0 0 0 0 1,000 803000 0 0 0 2000 1606000

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 100 179800 0 100 179800 0 100 179800 0 100 179800 0 0 0 400 719200
ampul 1,900 0 0 300 570000 0 200 380000 0 300 570000 0 200 380000 0 0 0 1000 1900000
ampul/H baru 1,199
76 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 5,000 820000 0 3,000 492000 0 3,000 492000 0 0 0 0 0 11000 1804000
tablet 51 0 0 13,000 663000 0 0 0 0 0 0 0 0 0 13000 663000
tablet 178 0 0 0 0 0 0 0 0 0 0 0
77 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 4,000 658480 1,000 164620 10,000 1646200 0 10,000 1646200 0 0 0 25000 4115500
silva/ 2015 165 0 0 0 0 0 0 0 0 15,000 2469300 0 0 0 15000 2469300
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 1,496 0 0 500 748000 0 500 748000 0 500 748000 0 400 598400 0 0 0 1900 2842400
botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 500 1556500 0 500 1556500 0 400 1245200 0 200 622600 0 0 0 1600 4980800

JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Pirantel tablet score 125 mg tablet 308 0 0 1,000 308000 0 500 154000 0 500 154000 0 2,000 616000 0 0 0 4000 1232000
81 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 7,000 868000 0 2,000 248000 0 2,000 248000 0 4,000 496000 0 0 0 15000 1860000

tablet 191 0 0 0 0 0 1,500 285990 3,000 571980 0 3,000 571980 0 0 0 #REF! 1429950
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 1500 0
84 Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 1,500 990000 0 0 0 1500 990000
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 0 0 0 2000 381320
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 50 59400 0 0 0 50 59400
86 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 500 248500 0 0 0 0 0 346 171962 0 0 0 846 420462
87 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 3,645 0 0 0 0 3645 0
botol 7,150 0 0 500 3575000 0 400 2860000 0 400 2860000 0 0 0 0 0 1300 9295000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600 0 0 0 100 693600
89 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0

90 Salbutamol tablet 2 mg tablet 78 0 0 3,000 234000 0 2,000 156000 0 0 0 2000 156000 0 0 0 7000 546000

92 Salbutamol syrup botol 4,042 0 0 0 0 0 0 50 202091 0 100 404182 0 0 0 150 606273

94 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 5 943315 0 0 0 0 0 5 943315
95 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 4,000 240000 0 3,000 180000 0 4,000 240000 0 5,000 300000 0 0 0 16000 960000
96 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 800 934400 0 600 700800 0 600 700800 0 600 700800 0 0 0 2600 3036800
tablet 133 0 0 1,000 133000 0 0 0 0 0 0 0 0 0 1000 133000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000 0 0 0 15000 1755000
tablet 289 0 0 2,000 578000 0 0 0 2,000 578000 0 0 0 0 0 4000 1156000
99 Siprofloksasin 500 MG tablet 880 0 0 0 0 1,000 880000 0 0 0 2,000 1760000 0 0 0 3000 2640000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

100 Sanadryl Syrup botol 12,210 0 0 100 1221000 0 0 0 0 0 0 0 0 0 100 1221000
101 Tetrasiklin 500 mg kapsul 319 0 0 4,000 1276000 0 0 0 0 0 2,500 797500 0 0 0 6500 2073500
102 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 7,000 588000 0 6,000 504000 0 5,000 420000 0 4,000 336000 0 0 0 22000 1848000
103 Vitamin B komplek Tablet tablet 121 0 0 10,000 1210000 0 10,000 1210000 0 10,000 1210000 0 10,000 1210000 0 0 0 40000 4840000
Botol 9,646 0 0 300 2893800 0 0 0 0 0 0 0 0 0 300 2893800

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
105 Zink Tablet Tablet 0 0 0 0 0 0 0 0 3,000 0 0 0 0 3000 0
botol 6,290 0 0 200 1258000 0 0 0 100 629000 0 100 629000 0 0 0 400 2516000
3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
107 Eugenol cairan botol 19,005 0 0 5 95025 0 0 0 0 0 0 0 0 0 5 95025
109 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 5 687500 0 0 0 5 687500 0 0 0 10 1375000
111 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 5 893750 0 0 0 5 893750 0 0 0 10 1787500
113 Abbocath No.20 G buah 4,180 0 0 100 418000 0 0 0 0 0 0 0 0 0 100 418000
buah 4,180 0 0 100 418000 0 0 0 0 0 0 0 0 0 100 418000
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,500 1188000 0 140 110880 200 158400 1,500 1188000 0 1,500 1188000 0 0 0 4840 3833280
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 0 0 0 0 500 108000 0 0 0 500 108000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 48 2168784 0 24 1084392 0 0 0 0 0 72 3253176

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 24 779784 0 12 389892 0 0 0 36 1169676
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 12 630732 0 0 0 24 1261464 0 0 0 0 0 36 1892196

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 24 1224528 0 0 0 0 0 24 1224528

buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
129 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 200 690000 0 0 0 0 0 0 0 0 0 200 690000

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 5 143750 0 0 0 0 0 0 0 10 287500

131 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Infusion Set Anak set 2,831 0 0 50 141563 0 50 141563 0 0 0 0 0 0 0 100 283126
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 200 704000 0 100 352000 0 0 0 100 352000 0 0 0 400 1408000
set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 10 137500 0 10 137500 0 0 0 10 137500 0 0 0 30 412500

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas Pembalut 500 g buah 27,280 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
137 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 1,000 825000 0 0 0 0 0 0 0 0 0 1000 825000

rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Kasa Steril 7,5 x 7,5 buah - 0 0 10 0 0 0 0 0 0 0 0 0 0 10 0

botol 47,150 0 0 0 0 5 235750 0 0 0 10 471500 0 0 0 15 707250
146 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 200 72600 0 100 36300 0 0 0 0 0 0 0 300 108900
147 Masker Tie On buah 439 0 0 0 0 0 0 500 219450 0 1,500 658350 0 0 0 2000 877800
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 100 36300 0 0 0 0 0 0 0 0 0 100 36300
149 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0 0 0 500 219450 0 0 0 500 219450
buah 440 0 0 1,000 440000 0 500 220000 0 500 220000 0 0 0 0 0 2000 880000
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777
155 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0 2 94000 10 470000 0 5 235000 0 0 0 17 799000
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
156 Pharfix 10 cm x 5 m rol/ H. baru 30,000 0 0 0 0 0 2 60000 10 300000 0 5 150000 0 0 0 17 510000
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 10 188182 0 0 0 0 0 10 188182 0 0 0 20 376364

botol / bpjs 18,818 0 1 18818 0 0 0 0 0 0 0 0 0 0 1 18818
botol 3,032 0 0 200 606364 0 0 0 0 0 0 0 0 0 200 606364

botol / bpjs 3,032 0 8 24255 0 0 0 0 0 0 0 0 0 0 8 24255
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 36,582 0 0 0 0 0 0 24 877968 0 0 0 0 0 24 877968

162 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 24 0 0 0 0 0 0 24 0
163 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

173 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0 0 0 1 1379400 0 0 0 1 1379400

174 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0 0 0 2 2758800 0 0 0 2 2758800
175 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0 0 0 1 1669800 0 0 0 1 1669800
176 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0 0 0 1 949850 0 0 0 1 949850
177 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0 0 0 1 76230 0 0 0 1 76230


Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
183 GARAM ORALIT SACHET 303 0 0 0 0 1,000 303000 0 0 0 1,000 303000 0 0 0 2000 606000
186 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
188 Tuberculin PPD Vial 702,250 2 1404500 0 0 0 0 0 0 0 0 0 0 0 2 1404500
190 Lisol 100 % botol 47,150 0 1 47150 0 0 0 0 0 0 0 0 0 0 1 47150
193 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
194 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
197 ASAM CUKA botol - 0 0 4 0 0 0 0 0 0 0 0 0 0 4 0

198 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
199 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


201 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 1,584 2615184 0 0 0 0 0 1584 2615184
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
204 BD Vacuntainer box - 200 0 0 0 0 0 0 0 0 0 0 0 0 200 0
205 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
215 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 0 0 3 1056000 0 0 0 4 1408000
216 Articulating Pcs 181,500 0 0 0 0 0 0 0 0 3 544500 0 0 0 3 544500


223 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 3 554100 0 0 0 3 554100

225 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 3 656100 0 0 0 3 656100

Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227 OAT FDC Kategori 1 paket 327,259 5 1636295 0 0 0 0 0 0 0 5 1636295 0 0 0 10 3272590
229 OAT FDC Kategori 1 Kombipak paket 302,605 6 1815630 0 0 0 0 0 0 0 0 0 0 0 6 1815630
232 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
236 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 500 1557950 0 0 0 0 500 1557950
tablet 367 0 0 0 0 0 0 0 44,100 16184700 0 0 0 0 44100 16184700

Provinsi 367 0 58,408 21435736 0 0 0 0 0 0 0 0 0 0 58408 21435736
buah/ skipa 1,240 193 239320 0 0 0 0 0 0 0 0 0 0 0 193 239320

238 Spuit 0,5 ml
buah / apbn 1,621 2471 4005491 0 0 0 0 0 0 0 0 0 0 0 2471 4005491
239 Spuit 0,5 ml ( Solosot Mini) Box 165,550 1 165550 0 0 0 0 1 165550

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
240 Spuit 0,05 ml
APBN 1,315 188 247220 0 0 0 0 0 0 0 0 0 0 0 188 247220
241 Spuit 5 ml APBN 1,705 8 13640 0 0 0 141 0 149 13640
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
242 Safety Box Box / 5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216

243 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Vaksin Rabies kur - 16 0 0 0 4 0 12 0 4 0 0 8 0 16 0 0 0 0 60 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
252 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0


257 Rapid Test Sifilis (Hexagon) Test 13,407 100 1340700 0 0 0 0 0 0 0 0 0 0 0 100 1340700

259 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

263 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
265 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0


269 Handscoen boks - 0 0 0 0 0 0 0 0 5 0 0 0 0 5 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
271 BCG VIAL 59,950 0 0 0 10 599500 10 599500 10 599500 10 599500 10 599500 5 299750 0 0 0 55 3297250
272 CAMPAK VIAL 28,204 0 15 423060 0 0 0 0 0 0 0 0 0 0 15 423060
273 MR VIAL 141,648 0 10 1416480 20 2832960 0 20 2832960 10 1416480 10 1416480 10 1416480 51 7224048 0 0 0 131 18555888
274 DPT-HB-Hib VIAL 76,285 0 30 2288550 20 1525700 20 1525700 20 1525700 20 1525700 20 1525700 20 1525700 20 1525700 0 0 0 170 12968450
275 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
276 HB-PID-(HB-0) VIAL 20,900 0 20 418000 10 209000 0 10 209000 10 209000 20 418000 0 20 418000 0 0 0 90 1881000
277 POLIO (BOPV) VIAL 19,954 0 20 399080 0 0 20 399080 20 399080 20 399080 20 399080 20 399080 0 0 0 120 2394480
278 POLIO (IPV) VIAL 13,976 0 20 279520 20 279520 0 20 279520 10 139760 7 97832 10 139760 15 209640 0 0 0 102 1425552
279 Td VIAL 16,500 0 0 0 10 165000 0 0 0 0 0 0 0 0 10 165000

PELAPORAN : PUSKESMAS SIBOLANGIT 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT SIBOLANGIT TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 3,000 279000 0 3,000 279000 0 3,000 279000 0 2,600 241800 0 0 0 11600 1078800
silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730 0 0 0 6000 5672730
4 Albendazole tablet 400 mg tablet 313 0 0 3,000 939000 0 3,000 939000 0 2,500 782500 0 0 0 0 0 8500 2660500
tablet 88 0 0 5,000 440000 0 5,000 440000 0 3,800 334400 0 1,500 132000 0 0 0 15300 1346400
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
kapsul 265 0 0 20,000 5300000 0 20,000 5300000 0 19,000 5035000 0 8,000 2120000 0 0 0 67000 17755000
kapsul 260 0 0 0 0 0 0 0 0 0
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 5,000 18350000 0 0 0 100 367000 0 0 0 5100 18717000
9 Antasida DOEN I Kombinasi tablet 63 0 0 5,000 315000 0 0 0 6,000 378000 0 5,000 315000 0 0 0 16000 1008000
btl 60 ml 2,065 0 0 300 619500 0 300 619500 0 350 722750 0 300 619500 0 0 0 1250 2581250
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 2,000 891000 0 2,000 891000 0 0 0 0 0 4000 1782000
tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 6,000 1822380 0 0 0 6000 1822380
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000 607460
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 10 29760 0 0 0 10 29760
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 0 0 0 0 50 243750 0 0 0 0 0 50 243750
17 Cetrizin tablet tablet 145 0 0 0 0 0 0 4,000 580000 0 800 116000 0 0 0 4800 696000

19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 2,000 2112000 0 2,000 2112000 0 300 316800 0 0 0 6300 6652800
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 0 0 0 0 120 215760 0 0 0 0 0 120 215760
botol 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21
Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100 1155000
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 300 28380 0 0 0 0 0 300 28380

tablet 64 0 0 5,000 320000 0 5,000 320000 0 5,400 345600 0 8,000 512000 0 0 0 23400 1497600
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 300 34320 0 0 0 0 0 300 34320
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0

27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 2,000 1502000 0 2,000 1502000 0 1,500 1126500 0 0 0 0 0 5500 4130500
tube 18,844 0 0 0 0 0 0 0 0 100 1884400 0 0 0 1884400

Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 436 0 0 100 43600 0 0 0 0 0 0 0 0 0 100 43600
tablet/ H. baru 797 0 0 0 0 0 0 100 79699 0 0 0 0 0 100 79699
32 Furosemid tablet 40 mg tablet 81 0 0 3,000 243000 0 3,000 243000 0 2,500 202500 0 400 32400 0 0 0 8900 720900
tablet 58 0 0 7,000 406000 0 7,000 406000 0 6,000 348000 0 0 0 0 0 20000 1160000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000 0 0 0 9000 1125000
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000 0 0 0 6000 750000
36 botol 6,900 0 0 200 1380000 0 200 1380000 0 180 1242000 0 0 0 0 0 580 4002000
Glukosa 5% Larutan Infus
JKN 2019 7,363 0 0 0 0 0 0 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 2,500 18750000 0 0 0 0 0 0 0 0 0 2500 18750000
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 1,000 173990 0 0 0 1000 173990
39 Griseofulvin 125 mg Tablet tablet 240 0 0 0 0 2,500 600000 0 1,600 384000 0 0 0 0 0 4100 984000
40 Haloperidol tablet 0,5 mg tablet 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 200 530000 0 200 530000 0 0 0 0 0 0 0 400 1060000
42 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 3,000 468000 0 2,000 312000 0 0 0 0 0 8000 1248000
tablet / H.Baru 437 0 0 600 262200 0 0 0 3,600 1573200 0 3,000 1311000 0 0 0 7200 3146400
43 Hustab Tablet tablet 258 0 0 0 600 154800 0 0 0 0 0 0 600 154800
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 150 1732500 0 150 1732500 0 200 2310000 0 0 0 500 5775000
JKN 11,550 0 0 0 0 0 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100 1155000

botol / bpjs 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0

46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 2,000 186000 0 1,500 139500 0 0 0 0 0 5500 511500
47 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 30 1081080 0 0 0 30 1081080

48 Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 30 932400 0 0 0 30 932400
Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 500 31495 0 0 0 31495

49 Karbamazepin tablet 200 mg tablet 230 0 0 1,000 230000 0 200 46000 0 200 46000 0 0 0 0 0 1400 322000
51 Kaptopril 25 mg tablet 715 0 0 4,000 2860000 0 4,000 2860000 0 2,200 1573000 0 0 0 0 0 10200 7293000
52 Klorpramazine HCl 100 mg tablet - 0 0 2,000 0 0 2,000 0 0 200 0 0 0 0 0 0 4200 0
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 500 1091500 0 500 1091500 0 250 545750 0 0 0 0 0 1250 2728750
55 tablet 154 0 0 8,000 1232000 0 8,000 1232000 0 2,500 385000 0 0 0 0 0 18500 2849000
Kotrimoksazol 480 mg komb (DW)
APBD 2019 133 0 0 0 0 0 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 200 115000 0 200 115000 0 0 0 0 0 0 0 400 230000
ampul 1,937 0 0 1,200 2324400 0 1,200 2324400 0 1,200 2324400 0 0 0 0 0 3600 6973200
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 4,000 532000 0 4,000 532000 0 1,200 159600 0 0 0 0 0 9200 1223600
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 600 1610400 0 0 0 0 0 0 0 0 0 600 1610400
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 1,000 162000 0 200 32400 0 600 97200 0 0 0 0 0 1800 291600
63 Metoclorpramid HCL 10 mg tablet 123 0 0 5,000 615000 0 5,000 615000 0 1,900 233700 0 0 0 0 0 11900 1463700
tablet 133 0 0 20,000 2660000 0 20,000 2660000 0 0 0 0 0 0 0 40000 5320000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 200 760000 0 400 1520000 0 0 0 300 1140000 0 0 0 900 3420000
66 Mikonazol Cream 2 % tube 3,410 0 0 0 0 0 0 100 341000 0 0 0 0 0 100 341000
tablet 107 0 0 2,800 298676 0 2,800 298676 0 0 0 0 0 0 0 5600 597352

silva 2015 136 0 0 0 0 0 0 1,600 217440 0 9,000 1223100 0 0 0 10600 1440540
botol 6,410 0 0 300 1923000 0 300 1923000 0 300 1923000 0 0 0 0 0 900 5769000
68
Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 0 0 0 0 200 109800 0 0 0 0 0 200 109800

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 100 80300 0 100 80300 0 100 80300 0 0 0 0 0 300 240900
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
71 Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 600 1140000 0 600 1140000 0 200 380000 0 0 0 0 0 1400 2660000
ampul/H baru 1,199
tablet 51 0 0 6,000 306000 0 0 0 0 0 0 0 0 0 6000 306000
tablet 178 0 0 0 0 0 0 0 0 0 0 0
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 3,000 493860 0 7,400 1218188 0 8,000 1316960 0 0 0 18400 3029008
silva/ 2015 165 0 0 0 0 0 0 0 0 15,000 2469300 0 0 0 15000 2469300
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 1,496 0 0 500 748000 0 500 748000 0 400 598400 0 600 897600 0 0 0 2000 2992000
botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 100 311300 0 100 311300 0 60 186780 0 100 311300 0 0 0 360 1120680
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0

79 Pirantel tablet score 125 mg tablet 308 0 0 1,000 308000 0 1,000 308000 0 200 61600 0 0 0 0 0 2200 677600
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 15,000 1860000 0 15,000 1860000 0 0 0 5,000 620000 0 0 0 35000 4340000

tablet 191 0 0 0 0 0 0 3,000 571980 0 2,000 381320 0 0 0 5000 953300
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 1,500 990000 0 0 0 1500 990000
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 0 0 0 2000 381320
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 2,000 994000 0 0 0 0 0 257 127729 0 0 0 2257 1121729
botol 7,150 0 0 400 2860000 0 400 2860000 0 200 1430000 0 0 0 0 0 1000 7150000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600 0 0 0 100 693600
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Salbutamol syrup botol 4,042 0 0 0 0 0 0 50 202091 0 100 404182 0 0 0 150 606273


94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 2,000 120000 0 2,000 120000 0 600 36000 0 1,000 60000 0 0 0 5600 336000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 1,000 1168000 0 1,000 1168000 0 1,200 1401600 0 500 584000 0 0 0 3700 4321600
tablet 133 0 0 1,000 133000 0 0 0 0 0 0 0 0 0 1000 133000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000 0 0 0 15000 1755000

tablet 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 0 0 1,000 880000 0 1,500 1320000 0 0 0 2500 2200000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 12,000 3828000 0 0 0 5,000 1595000 0 0 0 0 0 17000 5423000
Botol 9,646 0 0 50 482300 0 0 0 0 0 0 0 0 0 50 482300

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3,322 0 0 0 0 100 332200 0 0 0 0 0 0 0 100 332200
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 10 190050 0 10 190050 0 5 95025 0 0 0 0 0 25 475125
107 Accu Check safe T Pro Uno Dus 127,050 0 0 0 0 0 0 0 0 0 0 0 0 0 0
109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 0 0 3 1105500 0 0 0 0 0 0 0 3 1105500
112 Abbocath No.20 G buah 4,180 0 0 200 836000 0 200 836000 0 200 836000 0 0 0 0 0 600 2508000
buah 4,180 0 0 200 836000 0 200 836000 0 200 836000 0 0 0 0 0 600 2508000
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 50 227500 0 0 0 0 0 0 0 0 0 0 50 227500
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 500 396000 0 0 0 0 0 0 0 0 0 0 500 396000
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,000 792000 0 0 0 500 396000 0 1,000 792000 0 0 0 2500 1980000
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 1,000 216000 0 0 0 0 0 0 0 2000 432000

buah 197 0 0 0 0 0 0 0 0 1,000 196800 0 0 0 1000 196800
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 5 189750 0 0 0 0 0 0 0 0 0 0 5 189750
buah 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 110 410410 0 0 0 0 0 0 0 0 0 0 110 410410
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 5 143750 0 1 28750 0 0 0 0 0 11 316250

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 10 287500 0 0 0 0 0 0 0 0 0 0 10 287500
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 100 880000 0 0 0 0 0 0 0 0 0 0 100 880000
set 3,850 0 0 0 0 0 0 50 192500 0 50 192500 0 0 0 100 385000
set / bpjs 2,831 0 100 283126 0 0 0 0 0 0 0 0 0 0 100 283126
set 3,520 0 0 100 352000 0 100 352000 0 100 352000 0 100 352000 0 0 0 400 1408000
set / bpjs 3,520 0 100 352000 0 0 0 0 0 0 0 0 0 0 100 352000
buah 13,750 0 0 10 137500 0 20 275000 0 25 343750 0 0 0 0 0 55 756250

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 50 385000 0 0 0 0 0 0 0 0 0 50 385000

rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 0 0 0 0 0 0 0 0 100 165000

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 47,150 0 0 3 141450 0 0 0 0 0 0 0 0 0 3 141450
145 Lisol 100 %
botol / bpjs 47,150 0 10 471500 0 0 0 0 0 0 0 0 0 0 10 471500
buah 363 0 0 300 108900 0 100 36300 0 0 0 0 0 0 0 400 145200
146 Masker Tie On buah 439 0 0 0 0 0 0 0 0 500 219450 0 0 0 500 219450

buah / bpjs - 0 250 0 0 0 0 0 0 0 0 0 0 0 250 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 300 131670 0 0 0 0 0 300 131670
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 1,000 438900 0 500 219450 0 0 0 1500 658350
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 1,000 440000 0 1,000 440000 0 0 0 0 0 0 0 2000 880000

buah / bpjs 440 0 250 110000 0 0 0 0 0 0 0 0 0 0 250 110000
rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777
rol / bpjs 81,955 0 5 409777 0 0 0 0 0 0 0 0 0 0 5 409777

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
155 Pharfix 10 cm x 5 m rol/ H. baru 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 10 513050 0 0 0 0 0 0 0 0 0 0 10 513050
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 5 141432 0 0 0 0 0 0 0 0 0 0 5 141432

botol 18,818 0 0 0 0 0 0 0 0 10 188182 0 0 0 10 188182
botol / bpjs 18,818 0 10 188182 0 0 0 0 0 0 0 0 0 0 10 188182
botol 3,032 0 0 80 242546 0 0 0 0 0 0 0 0 0 80 242546

botol / bpjs 3,032 0 6 18191 0 0 0 0 0 0 0 0 0 0 6 18191
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Sarung tangan 7,5

buah / bpjs 6,895 0 100 689500 0 0 0 0 0 0 0 0 0 0 100 689500
160 Sarung tangan M buah 471 0 0 0 0 0 0 1,000 470500 0 0 0 0 0 1000 470500

buah 36,582 0 0 0 0 0 0 12 438984 0 24 877968 0 0 0 36 1316952
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 12 0 0 0 0 0 0 12 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 2 28943 0 0 0 0 0 0 0 0 0 0 2 28943
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 1,000 303000 0 600 181800 0 0 0 0 0 1600 484800
185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
189 Lisol 100 % botol 47,150 0 1 47150 0 0 0 0 0 0 0 0 0 0 1 47150
192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

196 ASAM CUKA botol - 0 0 2 0 0 0 0 0 0 0 0 0 0 2 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0

198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 25 0 0 0 0 25 0

OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 1 352000 0 1 352000 0 0 0 4 1408000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 2 369400 0 0 0 2 369400

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 2 437400 0 0 0 2 437400

Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 19 6217921 0 0 0 0 0 0 0 0 0 0 19 6217921
227 OAT FDC Kategori 2 paket 1,259,990 0 1 1259990 0 0 0 0 0 0 0 0 0 0 1 1259990

231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 100 311590 0 0 0 0 100 311590
tablet 367 0 0 0 0 0 0 0 32,800 12037600 0 0 0 0 32800 12037600

Provinsi 367 0 43,444 15943948 0 0 0 0 0 0 0 0 0 0 43444 15943948
buah/ skipa 1,240 143 177320 0 0 0 0 0 0 0 0 0 0 0 143 177320
237 Spuit 0,5 ml
buah / apbn 1,621 1856 3008576 0 0 0 0 0 0 0 0 0 0 0 1856 3008576
Spuit 0,5 ml ( Solosot Mini) Box 165,550 1
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 140 184100 0 0 0 0 0 0 0 0 0 0 0 140 184100
Spuit 5 ml APBN 1,705 6 10230 19 25

Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 0 0 0 0 16 0 0 0 0 0 0 0 16 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0


266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 5 299750 10 599500 5 299750 8 479600 10 599500 8 479600 7 419650 7 419650 20 1199000 0 0 0 80 4796000
269 CAMPAK VIAL 28,204 0 0 0 0 10 282040 0 0 0 0 0 0 0 10 282040
270 MR VIAL 141,648 0 25 3541200 0 20 2832960 10 1416480 20 2832960 25 3541200 10 1416480 49 6940752 0 0 0 159 22522032
271 DPT-HB-Hib VIAL 76,285 10 762850 20 1525700 20 1525700 25 1907125 20 1525700 20 1525700 25 1907125 25 1907125 30 2288550 0 0 0 195 14875575
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 10 209000 25 522500 20 418000 20 418000 20 418000 20 418000 20 418000 20 418000 30 627000 0 0 0 185 3866500
274 POLIO (BOPV) VIAL 19,954 10 199540 20 399080 0 0 20 399080 20 399080 20 399080 20 399080 15 299310 0 0 0 125 2494250
275 POLIO (IPV) VIAL 13,976 10 139760 10 139760 0 20 279520 10 139760 0 20 279520 0 30 419280 0 0 0 100 1397600
276 Td VIAL 16,500 0 10 165000 0 0 0 0 0 30 495000 0 0 0 0 40 660000

PELAPORAN : PUSKESMAS BANDAR BARU 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU BANDAR BARU
HARGA TOTAL
NO NAMA OBAT SATUAN
SATUAN KELUAR
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
1 Acyclovir 400 mg tablet tablet 359 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 93 0 0 5,000 465000 0 0 0 2,000 186000 0 1,800 167400 0 0 0 8800
silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730 0 0 0 6000
4 Albendazole tablet 400 mg tablet 313 0 0 2,000 626000 0 0 0 3,000 939000 0 2,000 626000 0 0 0 7000
tablet 88 0 2,000 176000 12,000 1056000 0 0 0 5,000 440000 0 5,000 440000 0 0 0 24000
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0
kapsul 265 0 5,000 1325000 15,000 3975000 0 0 0 15,000 3975000 0 12,000 3180000 0 0 0 47000
kapsul 260 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 200 500000 500 1250000 0 0 0 300 750000 0 200 500000 0 0 0 1200
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 200 734000 0 0 0 200
9 Antasida DOEN I Kombinasi tablet 63 0 5,000 315000 12,000 756000 0 0 0 6,000 378000 0 5,000 315000 0 0 0 28000
btl 60 ml 2,065 0 200 413000 500 1032500 0 0 0 0 0 300 619500 0 0 0 1000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 10,000 1090000 0 0 0 6,000 654000 0 5,000 545000 0 0 0 21000
tablet/ H Baru 446 0 0 0 0 0 0 4,000 1782000 2,000 891000 0 0 0 0 6000
tablet 176 0 2,000 352000 0 0 0 0 0 0 0 0 0 0 2000
13 Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 6,000 1822380 0 0 0 6000
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 100 487500 0 0 0 50 243750 0 50 243750 0 0 0 200
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 2,000 290000 0 0 0 4,000 580000 0 3,000 435000 0 0 0 9000
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 0 0 2,000 2112000 0 1,600 1689600 0 0 0 5600
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 100 179800 0 0 0 100 179800 0 100 179800 0 0 0 300
botol 11,550 0 0 0 0 0 0 100 1155000 0 0 0 0 0 100
21 Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 150 1732500 0 0 0 150
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 300 28380 0 0 0 300
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 2 3643 0 0 0 2
24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 100 288000 0 0 0 0 0 0 0 0 0 100

tablet 64 0 5,000 320000 10,000 640000 0 0 0 8,000 512000 0 6,000 384000 0 0 0 29000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 300 706200 0 0 0 400 941600 0 300 706200 0 0 0 1000
28 Eritromysin kapsul 500 mg tablet 751 0 0 1,000 751000 0 0 0 2,000 1502000 0 1,500 1126500 0 0 0 4500
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 0 0 0 0 0 0 0 0 0 0 0
tube 18,844 0 0 0 0 0 0 0 0 50 942200 0 0 0 50

Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 1,000 436000 0 0 0 0 0 0 0 0 0 1000
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 1,000 81000 0 0 0 2,000 162000 0 2,000 162000 0 0 0 5000
33 Fenobarbital 30 mg tablet 180 0 0 0 0 0 0 0 0 0 0 0 0 0

34 Garam oralit 200 ml air bks 303 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 58 0 0 3,000 174000 0 0 0 2,000 116000 0 0 0 0 0 5000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 500 62500 0 0 0 500

silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000 0 0 0 9000
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000 0 0 0 6000
36 botol 6,900 0 0 500 3450000 0 0 0 60 414000 0 60 414000 0 0 0 620

JKN 2019 7,363 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 500 86995 0 0 0 500
39 Griseofulvin 125 mg Tablet tablet 240 0 0 4,000 960000 0 0 0 2,000 480000 0 1,500 360000 0 0 0 7500
40 Haloperidol tablet 0,5 mg tablet 62 0 0 0 0 0 0 500 31000 0 400 24800 0 0 0 900
42 Hidrokloratiazid 25 mg tablet 156 0 0 0 0 0 0 3,000 468000 0 2,500 390000 0 0 0 5500
tablet / H.Baru 437 0 0 1,000 437000 0 0 0 5,000 2185000 0 400 174800 0 0 0 6400
43 Hustab Tablet tablet 258 0 0 0 0 0 0 0 0 0 0 0
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 0 0 100 1155000 0 200 2310000 0 0 0 300

JKN 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0
44 Hustab syrup silva /2014 11,550 0 0 0 0 0 0 0 0 90 1039500 0 0 0 90

silva/ 2015 11,550 0 0 0 0 0 0 0 0 150 1732500 0 0 0 150
botol / bpjs 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0

45 Isoniazid ( INH ) tablet 100 mg Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 0 0 0 0 2,000 186000 0 1,700 158100 0 0 0 3700
47 Iliadin Spray Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 50 1801800 0 0 0 50
48 Iliadin Drop Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 50 1554000 0 0 0 50

Kalsium Laktas 500 mg Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 2,000 125980 0 0 0 2000
49 Karbamazepin tablet 200 mg Karbamazepin tablet 200 mg tablet 230 0 0 0 0 0 0 0 0 500 115000 0 0 0 500
50 Kaptopril 12,5 mg Kaptopril 12,5 mg tablet 62 0 0 2,000 124000 0 0 0 3,000 186000 0 2,400 148800 0 0 0 7400
51 Kaptopril 25 mg Kaptopril 25 mg tablet 715 0 0 3,000 2145000 0 0 0 3,000 2145000 0 3,000 2145000 0 0 0 9000
52 Klorpramazine HCl 100 mg Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 0 0 500 0 0 0 0 500
53 Kloramfeniramin Maleat (CTM) 4 mg Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 5,000 215000 10,000 430000 0 0 0 5,000 215000 0 4,000 172000 0 0 0 24000
54 Kotrimoksazole Suspensi Kotrimoksazole Suspensi btl 60ml 2,183 0 0 500 1091500 0 0 0 500 1091500 0 400 873200 0 0 0 1400
55 tablet 154 0 0 5,000 770000 0 0 0 5,000 770000 0 4,000 616000 0 0 0 14000

Kotrimoksazol 480 mg komb (DW) Kotrimoksazol 480 mg komb (DW)
APBD 2019 133 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Kodein HCL 10 mg Kodein HCL 10 mg tablet 575 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 500 968500 0 0 0 100 193700 0 100 193700 0 0 0 700

57 Lidokain Injeksi Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg Loperramid tablet 2 mg tablet 80 0 0 1,000 80000 0 0 0 0 0 0 0 0 0 1000
59 MgSO4 20 % MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 133 0 0 5,000 665000 0 0 0 3,000 399000 0 2,500 332500 0 0 0 10500
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Metformin tablet 500 mg Metformin tablet 500 mg
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000

61 Metil Ergometrin Maleat injeksi Metil Ergometrin Maleat injeksi ampul 2,684 0 0 500 1342000 0 0 0 0 0 0 0 0 0 500
62 Metil Ergometrin Maleat 0,125 mg Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 0 0 0 0 500 81000 0 400 64800 0 0 0 900
63 Metoclorpramid HCL 10 mg Metoclorpramid HCL 10 mg tablet 123 0 0 5,000 615000 0 0 0 1,000 123000 0 500 61500 0 0 0 6500
tablet 133 0 0 15,000 1995000 0 0 0 0 0 0 0 0 0 15000
64 Metronidazol 500 mg Metronidazol 500 mg
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup Metronidazole syirup botol 3,800 0 0 500 1900000 0 0 0 200 760000 0 200 760000 0 0 0 900
66 Mikonazol Cream 2 % Mikonazol Cream 2 % tube 3,410 0 0 250 852500 0 0 0 100 341000 0 100 341000 0 0 0 450
tablet 107 0 0 2,000 213340 0 0 0 0 0 0 0 0 0 2000

67 Natrium Diklofenak tablet 50 mg Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 0 0 2,000 272000 0 0 0 2000
silva 2015 136 0 0 0 0 0 0 3,000 407700 0 9,000 1223100 0 0 0 12000

botol 6,410 0 0 100 641000 0 0 0 100 641000 0 0 0 0 0 200
68
Natrium Klorida larutan infus 0,9% Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 100 621800 0 0 0 100
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 0 0 0 0 1,000 549000 0 800 439200 0 0 0 1800

69 Nistatin tablet salut 100.000 IU/g Nistatin tablet salut 100.000 IU/g
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 0 0 0 0 2,000 1606000 0 1,500 1204500 0 0 0 3500

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0
71 Nifedipin 20 mg Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 200 715000 0 0 0 0 0 200
72 Oksitetrasiklin salep mata 1 % Oksitetrasiklin salep mata 1 % tube 1,798 0 0 0 0 0 0 200 359600 0 200 359600 0 0 0 400
ampul 1,900 0 0 200 380000 0 0 0 200 380000 0 200 380000 0 0 0 600

73 Oksitoksin injeksi 10 iv/ml Oksitoksin injeksi 10 iv/ml
ampul/H baru 1,199
74 Omeprazole kapsul/kaplet 20 mg Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 3,000 492000 0 0 0 2,000 328000 0 0 0 0 0 5000
tablet 51 0 5,000 255000 6,000 306000 0 0 0 0 0 0 0 0 0 11000
tablet 178 0 0 0 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 0 0 5,000 823100 0 5,000 823100 0 0 0 10000
silva/ 2015 165 0 0 0 0 0 0 0 0 13,000 2140060 0 0 0 13000
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0

76 botol 1,496 0 200 299200 500 748000 0 0 0 500 748000 0 400 598400 0 0 0 1600
Paracetamol sirup 120 mg/5ml
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 100 311300 0 0 0 100 311300 0 100 311300 0 0 0 300
78
Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg Pirantel tablet score 125 mg tablet 308 0 0 2,000 616000 0 0 0 3,000 924000 0 2,500 770000 500 154000 0 0 8000
80 Pyridoksin HCI (Vit B6) Tablet Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 10,000 1240000 0 0 0 8,000 992000 0 8,000 992000 0 0 0 26000
81 Prednison 5 mg Tablet Prednison 5 mg Tablet tablet 96 0 0 0 0 0 0 0 0 0 0 0 0 0

82 Propanolol HCL 10 mg Propanolol HCL 10 mg tablet 66 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 191 0 0 0 0 0 0 2,000 381320 0 2,000 381320 2,000 381320 0 0 6000
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 1,500 990000 1,500 990000 0 0 3000
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 2,000 381320 0 0 4000
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Ranitidin Injeksi 25 mg Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 0 50 59400 0 0 50
85 Retinol 100.000 ( Vit. A Kapsul Biru) Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 321 159537 321 159537 0 0 642
86 Retinol 200.000 ( Vit. A Kapsul Merah) Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 2,520 0 2,974 0 0 0 5494
botol 7,150 0 0 200 1430000 0 0 0 100 715000 0 200 1430000 0 0 0 500

87 Ringer Laktat laturan infus steril Ringer Laktat laturan infus steril
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600 120 832320 0 0 220
88 Salap 2-4 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0

89 Salbutamol tablet 2 mg Salbutamol tablet 2 mg tablet 78 0 0 3,000 234000 0 0 0 2,000 156000 0 3,000 234000 0 0 0 8000
90 Salbutamol Cairan 0,1 % Salbutamol Cairan 0,1 % ampul 4,000 0 0 20 80000 0 0 0 0 0 0 0 0 0 20

91 Salbutamol syrup Salbutamol syrup botol 4,042 0 0 0 0 0 0 50 202091 0 50 202091 0 0 0 100
92 Salisil Bedak 2,5% Salisil Bedak 2,5% bks 1,046 0 0 0 0 0 0 0 0 0 0 0 0 0

93 Serum ATS 1.500 IU Injeksi Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 5 943315 0 5 943315 0 0 0 10
94 Sianokobalamin (Vit B12) tablet 50 mg Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 5,000 300000 0 0 0 3,800 228000 0 3,000 180000 0 0 0 11800
95 Sianokobalamin (Vit B12) injeksi Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 0 0 600 700800 0 500 584000 0 0 0 1600
tablet 133 0 0 930 123690 0 0 0 0 0 0 0 0 0 930
96 Simvastatin tablet 10 mg Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0 0 0 2,000 257400 1,000 128700 0 0 3000
tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000 18,000 2106000 0 0 33000
97 Simvastatin tablet 20 mg Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 500 63000 200 25200 0 0 700
tablet 289 0 0 0 0 0 0 1,600 462400 0 0 0 0 0 1600
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 0 0 0 0 2,000 1760000 0 0 0 2000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0

99 Sanadryl Syrup botol 12,210 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 5,000 1595000 0 0 0 4,500 1435500 0 2,000 638000 0 0 0 11500
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 5,000 420000 0 0 0 2,000 168000 0 0 0 0 0 7000
102 Vitamin B komplek Tablet tablet 121 0 0 12,000 1452000 0 0 0 7,600 919600 0 7,000 847000 0 0 0 26600
Botol 9,646 0 0 50 482300 0 0 0 0 0 0 0 0 0 50

Botol 10,293 0 0 0 0 0 0 0 0 100 1029290 0 0 0 100
104 Zink Tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 0 0 50 314500 0 0 0 50

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0
BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0 0 0 0 0 0
111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 5 303182 0 5 303182 0 0 0 10
113 Abbocath No.22 G buah 4,180 0 0 100 418000 0 0 0 100 418000 0 100 418000 0 0 0 300
buah 4,180 0 0 0 0 0 0 100 418000 0 100 418000 0 0 0 200

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 200 910000 0 0 0 0 0 0 0 0 0 0 200
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 200 158400 0 0 0 0 0 0 0 0 0 0 200
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 200 158400 0 0 0 1,000 792000 0 500 396000 0 0 0 1700
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 197 0 0 0 0 0 0 0 0 100 19680 0 0 0 100
122 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 0 0 12 542196 0 0 0 12

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 12 389892 0 0 0 12
125 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 12 630732 0 0 0 12 630732 0 0 0 0 0 24
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 12 612264 0 0 0 0 0 12
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 7 201250 0 0 0 0 0 0 0 0 0 7
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 1 28750 0 0 0 0 0 0 0 0 0 0 1
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 100 385000 0 0 0 100
132 Infusion Set Anak set 2,831 0 0 100 283126 0 0 0 0 0 0 0 0 0 100
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 100 352000 0 0 0 50 176000 0 100 352000 0 0 0 250

set / bpjs 3,520 0 300 1056000 0 0 0 0 0 0 0 0 0 0 300
buah 13,750 0 0 20 275000 0 0 0 10 137500 0 10 137500 0 0 0 40

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 10 77000 0 0 0 0 0 0 0 0 0 10
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 50 82500 0 0 0 0 0 0 0 0 0 50
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0
142 Kasa Steril 40 x 40 buah 1,600 0 0 0 0 0 0 0 0 0 0 0 0 0

144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 3 141450 0 0 0 0 0 5 235750 0 0 0 8

145 Lisol 100 %
botol / bpjs 47,150 0 3 141450 0 0 0 0 0 0 0 0 0 0 3
buah 363 0 0 200 72600 0 0 0 0 0 0 0 0 0 200
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 500 220000 0 0 0 0 0 0 0 0 0 500

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0
151 My Jelly 82 gram tube - 0 0 0 0 0 0 0 0 0 0 0 0 0
152 Object Glass Kotak 19,365 0 0 0 0 0 0 0 0 0 0 0 0 0
153 One scrub 500 cc + dispenser botol 65,341 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 18,818 0 0 0 0 0 0 0 0 10 188182 0 0 0 10
botol / bpjs 18,818 0 2 37636 0 0 0 0 0 0 0 0 0 0 2
botol 3,032 0 0 20 60636 0 0 0 0 0 0 0 0 0 20
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0 0 0 0 400 1866400 0 0 0 400
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Sarung tangan M buah 471 0 0 0 0 0 0 500 235250 0 0 0 0 0 500
buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0
163 Skin Celean 500 ml botol - 0 0 0 0 0 0 0 0 0 0 0 0 0
164 Tranfusion Set buah 4,000 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 2 28943 0 0 0 0 0 0 0 0 0 0 2
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 0 0 0 0 0 0 0 0 0

168 Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0 0 0 0 0
170 Lise Samsung Unit 3,300,000 0 0 0 0 0 0 0 0 0 0 0 0 0
171 Rinse Mindrey galon 1,254,000 0 0 0 0 0 0 0 0 0 0 0 0 0

172 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0 0 0
173 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0 0 0
174 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0 0 0 0 0 0 0 0
175 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0 0 0 0 0 0 0 0

176 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0 0 0 0 0 0 0 0
177 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0 0 0 0 0 0 0 0 0

178 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0 0 0
179 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0 0 0
180 URID ACID (URICASE) Kit 799,700 0 0 0 0 0 0 0 0 0 0 0 0 0
181 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori 2 PAKET 1,259,990 0 0 0 0 0 0 0 0 1 1259990 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 0 0 200 60600 0 200 60600 0 0 0 400
183 ZINC Tablet TABLET 539 0 187 100793 0 0 0 0 0 0 0 0 0 0 187
184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 0 0 0 0 0 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Tuberculin PPD Vial 702,250 0 0 0 0 0 0 0 0 0 0 0 0 0
189 Lisol 100 % botol 47,150 0 1 47150 0 0 0 0 0 0 0 0 0 0 1
190 Reagen Ziehl Neelsen kit 181,811 0 0 0 0 0 0 0 0 0 0 0 0 0
191 Masker 3 Ply Earloop Jilbab buah - 0 1,000 0 0 0 0 0 0 0 0 0 0 0 1000

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1

194 Imersion Oil Botol 3,181,818 0 0 0 0 0 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0
195 KAPAS LIDI Bungkus - 0 0 1 0 0 0 0 0 0 0 0 0 0 1
196 ASAM CUKA botol - 0 0 2 0 0 0 0 0 0 0 0 0 0 2

197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Imunisasi 1,404 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 55 67375 0 0 0 0 0 55
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 1,272 2100072 0 0 0 0 0 1272
201 Safety Box 5 liter box - 0 0 0 0 0 0 13 0 0 0 0 0 0 13
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0
203 BD Vacuntainer box - 0 0 0 0 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0
206 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 0 0 0 0 0 0 0 0 0 0
207 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0 0 0 0 0 0 0
208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0 0 0 0 0 0 0

209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0 0 0 0 0 0 0 0
210 Sarung tangan L buah 499 0 0 0 0 0 0 0 0 0 0 0 0 0

211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 0 0 0 0 0 0
212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0 0 0 0 0 0 0

213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 1 352000 0 2 704000 0 0 0 4
215 Articulating Pcs 181,500 0 0 0 0 0 0 0 0 2 363000 0 0 0 2
216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0 0 2 880094 0 0 0 2
217 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0 0 0 2 381032 0 0 0 2
219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0 0 2 329547 0 0 0 2
220 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0 0 0 0 2 93400 0 0 0 2

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 2 369400 0 0 0 2
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0 0 2 133400 0 0 0 2

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 2 437400 0 0 0 2
225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0 0 2 196400 0 0 0 2
OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0
227 OAT FDC Kategori 2 paket 1,259,990 0 0 0 0 0 0 0 0 0 0 0 0 0
228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 0 0 0 0 0 0 0 0 0 0
229 OAT FDC Kategori Anak paket 203,259 0 0 0 0 0 0 0 0 0 0 0 0 0
230 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 100 311590 0 0 0 0 100
tablet 367 0 0 0 0 0 0 0 38,000 13946000 0 0 0 0 38000

Provinsi 367 0 50,152 18405784 0 0 0 0 0 0 0 0 0 0 50152
Program Imunisasi - 0 0 0 0 0 0 0 0 0 0 0 0 0
buah/ skipa 1,240 165 204600 0 0 0 0 0 0 0 0 0 0 0 165

237 Spuit 0,5 ml
buah / apbn 1,621 2170 3517570 0 0 0 0 0 0 0 0 0 0 0 2170

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 162 213030 0 0 0 0 0 0 0 0 0 0 0 162
Spuit 5 ml APBN 1,705 7 11935 31 38
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0
241 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0 0 0 0 0 0 0
242 Primaquin TABLET 235 0 0 0 0 0 0 0 0 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 0 0 0 0 0 0 0 0 0 0 0
246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 0 0 0 0 0 0 0 0 0 0 0 0

248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0 0 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0

251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 0 0 0 0 0 0 0 0 0 0

253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0 0 0 0 0 0 0

254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 0 0 0 0 0 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0 0 0 0 0 0 0
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0 0 0

258 Blue Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0 0 0
259 Metilen Blue botol 94,500 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0
263 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0 0 0 0 0 0 0

264 Object Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0 0 0
265 Cover Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 5 299750 10 599500 5 299750 5 299750 8 479600 8 479600 10 599500 5 299750 5 299750 0 0 0 61
269 CAMPAK VIAL 28,204 0 0 0 0 10 282040 5 141020 0 0 0 0 0 0 15
270 MR VIAL 141,648 0 0 10 1416480 10 1416480 10 1416480 5 708240 10 1416480 15 2124720 46 6515808 0 0 0 106
271 DPT-HB-Hib VIAL 76,285 10 762850 20 1525700 20 1525700 20 1525700 20 1525700 25 1907125 25 1907125 20 1525700 20 1525700 0 0 0 180
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 10 209000 25 522500 10 209000 20 418000 20 418000 25 522500 20 418000 20 418000 20 418000 0 0 0 170
274 POLIO (BOPV) VIAL 19,954 10 199540 20 399080 0 0 20 399080 120 2394480 20 399080 10 199540 30 598620 0 0 0 230
275 POLIO (IPV) VIAL 13,976 10 139760 10 139760 5 69880 10 139760 5 69880 5 69880 10 139760 10 139760 5 69880 0 0 0 70
276 Td VIAL 16,500 0 0 10 165000 10 165000 0 5 82500 0 5 82500 5 82500 0 0 0 35

TOTAL
HARGA
KELUAR
429000
818400
5672730
2191000
2112000
12455000
3000000
734000
1764000
2065000
1381000
2289000
2673000
352000
1822380
607460
148800
975000
1305000
290000
5913600
539400
1155000
1732500
0
0
28380
3643
288000
1856000
0
0
0
0
2354000
3379500
942200
0
0
436000
0
405000
0
0
290000
62500
1125000
750000
4278000
86995
1800000
55800
1060000
858000
2796800
3465000
0
1039500
1732500
0
0
344100
1801800
1554000
125980
115000
458800
6435000
1032000
3056200
2156000
1355900
0
80000
0
1396500
0
636000
636000
1342000
145800
799500
1995000
0
3420000
1534500
213340
272000
1630800
1282000
621800
988200
2810500
715000
719200
1140000
820000
561000
1646200
2140060
0
2393600
0
933900
0
0
2464000
3224000
0
0
1143960
1980000
762640
59400
319074
3575000
1525920
0
624000
80000
404182
0
1886630
708000
1868800
123690
386100
3861000
88200
462400
1760000
0
0
3668500
588000
3218600
482300
1029290
314500
266070
381150
2750000
7370000
3575000
606364
836000
1254000
836000
836000
0
0
910000
158400
1346400
19680
542196
389892
0
1261464
0
612264
0
0
0
0
0
201250
28750
385000
283126
880000
1056000
550000
272800
0
0
77000
0
0
0
82500
0
0
0
0
0
0
377200
141450
72600
307230
131670
219450
220000
409777
235000
0
0
150000
0
0
82500
0
188182
37636
60636
1866400
235250
0
0
28943
0
0
0
0
0
0
0
0
0
0
0
0
0
1259990
121200
100793
291500
47150
0
0
0
0
0
0
0
0
0
0
67375
2100072
0
0
0
0
0
0
0
1408000
363000
880094
381032
381032
329547
93400
93400
369400
133400
437400
196400
6217921
311590
13946000
18405784
0
204600
3517570
213030
0
83040
33216
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3656950
423060
15014688
13731300
3553000
4589420
978320
577500
PELAPORAN : PUSKESMAS PANCUR BATU 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU PANCUR BATU
HARGA TOTAL
NO NAMA OBAT SATUAN
SATUAN KELUAR
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
1 Acyclovir 400 mg tablet Acyclovir 400 mg tablet tablet 359 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Acyclovir Krim Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 100 858000 0 0 0 100
tablet 93 0 0 5,000 465000 0 5,000 465000 0 3,000 279000 0 3,000 279000 0 0 0 16000
3 Allopurinol 100 mg Allopurinol 100 mg
silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730 0 0 0 6000
4 Albendazole tablet 400 mg Albendazole tablet 400 mg tablet 313 0 0 1,000 313000 0 2,000 626000 0 0 0 0 0 0 0 3000
tablet 88 0 0 0 0 5,000 440000 0 5,000 440000 0 5,000 440000 0 0 0 15000

5 Amlodipine 5 mg Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 2,000 530000 20,000 5300000 0 20,000 5300000 0 20,000 5300000 0 25,000 6625000 0 0 0 87000
Amoksisilin 500 mg Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 0 0 0 0 300 750000 0 300 750000 0 0 0 600
8 Amoksisilin Sirup 250 mg Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 300 1101000 0 0 0 300
9 Antasida DOEN I Kombinasi Antasida DOEN I Kombinasi tablet 63 0 0 0 0 10,000 630000 0 20,000 1260000 0 15,000 945000 0 0 0 45000
btl 60 ml 2,065 0 0 400 826000 0 300 619500 0 300 619500 0 0 0 0 0 1000

10 Antasida DOEN II Suppensi Kombinasi Antasida DOEN II Suppensi Kombinasi
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN Anti Fungi DOEN pot 6,905 0 0 0 0 0 0 100 690500 0 0 0 0 0 100
12 Asam Askorbat (vit C) 50mg Asam Askorbat (vit C) 50mg tablet 109 0 0 1,000 109000 0 5,000 545000 0 5,000 545000 0 5,000 545000 0 0 0 16000
tablet/ H Baru 446 0 0 0 0 7,000 3118500 0 10,000 4455000 0 0 0 0 0 17000
tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0
13
Asam Mefenamat 500 mg Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 6,000 1822380 0 0 0 6000
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000

JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 0 0 0 0 0

15 Betametason krim 0,1% 5 gr Betametason krim 0,1% 5 gr tube 4,875 0 0 0 0 0 0 0 0 25 121875 0 0 0 25
16 Bisoprolol 5 mg Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet Cetrizin tablet tablet 145 0 1,000 145000 4,000 580000 0 0 0 4,000 580000 0 4,000 580000 0 0 0 13000
18 Cetrizin syrup Cetrizin syrup botol 2,900 0 0 0 0 0 0 200 580000 0 0 0 0 0 200

19 Cholaramfenicol Kapsul 500 mg Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 4,000 4224000 0 4,000 4224000 0 4,000 4224000 0 3,000 3168000 0 0 0 15000
20 Chloramfenicol salep mata 1 % Chloramfenicol salep mata 1 % tube 1,798 0 0 200 359600 0 0 0 100 179800 0 100 179800 0 0 0 400
botol 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100

21
Dextrofen syrup Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 1,000 94600 0 0 0 1000
23 Diazepam Injeksi Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 5 9108 0 0 0 5
24 Deksametason inj 5mg /ml-1ml Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 400 1152000 0 0 0 0 0 0 0 0 0 400
tablet 64 0 0 4,000 256000 0 10,000 640000 0 10,000 640000 0 10,000 640000 0 0 0 34000
25 Deksametason tablet 0,5 mg Deksametason tablet 0,5 mg
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Digoksin tablet 0,25 mg Digoksin tablet 0,25 mg
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0
Diphen Hidramin Inj 10 Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg Eritromysin kapsul 500 mg tablet 751 0 0 5,000 3755000 0 5,000 3755000 0 5,000 3755000 0 3,000 2253000 0 0 0 18000
29 Eritromysin syrup kering 200 mg / 5 ml Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 400 2746800 0 0 0 0 0 0 0 0 0 400
tube 18,844 0 0 0 0 0 0 0 0 150 2826600 0 0 0 150
Flucord N Cream Flucort N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 200 833400 0 0 0 0 0 0 0 0 0 200
tablet 436 0 0 2,000 872000 0 0 0 0 0 0 0 0 0 2000
31 Fito Menadione tablet 10 mg Fito Menadione tablet 10 mg
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg Furosemid tablet 40 mg tablet 81 0 0 3,000 243000 0 0 0 0 0 1,000 81000 0 0 0 4000
33 Fenobarbital 30 mg Fenobarbital 30 mg tablet 180 0 0 0 0 0 0 0 0 0 0 0 0 0

34 Garam oralit 200 ml air Garam oralit 200 ml air bks 303 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 58 0 0 3,000 174000 0 3,000 174000 0 3,000 174000 0 0 0 0 0 9000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 3,000 375000 0 0 0 3000

35 Glibenclamida 5 mg Glibenclamida 5 mg
silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000 0 0 0 9000
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000 0 0 0 6000
36 botol 6,900 0 0 200 1380000 0 0 0 0 0 0 0 0 0 200

Glukosa 5% Larutan Infus Glukosa 5% Larutan Infus
JKN 2019 7,363 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Glukosa 10% Larutan Infus Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Glimipiride 1 mg Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 1,000 173990 0 0 0 1000
39 Griseofulvin 125 mg Tablet Griseofulvin 125 mg Tablet tablet 240 0 0 0 0 1,000 240000 0 1,000 240000 0 1,000 240000 0 0 0 3000
40 Haloperidol tablet 0,5 mg Haloperidol tablet 0,5 mg tablet 62 0 0 1,000 62000 0 0 0 500 31000 0 0 0 0 0 1500
41 Hidrokortison Cream 2.5 % Hidrokortison Cream 2.5 % tube 2,650 0 0 200 530000 0 0 0 0 0 0 0 0 0 200
42 Hidrokloratiazid 25 mg Hidrokloratiazid 25 mg tablet 156 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet / H.Baru 437 0 0 3,000 1311000 0 18,000 7866000 0 10,800 4719600 0 10,000 4370000 0 0 0 41800
43 Hustab Tablet tablet 258 0 0 0 4,000 0 0 0 0 0 0 4000
tablet P 312 0 1,500 468000 0 0 0 0 0 0 0 0 0 0 1500
botol/ H. Baru 11,550 0 0 0 0 500 5775000 0 500 5775000 0 200 2310000 0 0 0 1200
JKN 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0

silva/ 2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100
botol 8,046 0 200 1609200 0 0 0 0 0 0 0 0 0 0 200

45 Isoniazid ( INH ) tablet 100 mg Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 0 0 0 0 0 0 0 0 2000
47 Iliadin Spray Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 100 3603600 0 0 0 100
48 Iliadin Drop Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 100 3108000 0 0 0 100

Kalsium Laktas 500 mg Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Karbamazepin tablet 200 mg Karbamazepin tablet 200 mg tablet 230 0 0 2,000 460000 0 0 0 500 115000 0 0 0 0 0 2500
50 Kaptopril 12,5 mg Kaptopril 12,5 mg tablet 62 0 0 3,000 186000 0 0 0 0 0 0 0 0 0 3000
51 Kaptopril 25 mg Kaptopril 25 mg tablet 715 0 0 2,000 1430000 0 5,000 3575000 0 5,000 3575000 0 5,000 3575000 0 0 0 17000
52 Klorpramazine HCl 100 mg Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 500 0 0 0 0 0 0 500
53 Kloramfeniramin Maleat (CTM) 4 mg Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 25,000 1075000 0 15,000 645000 0 15,000 645000 0 19,800 851400 0 0 0 74800
54 Kotrimoksazole Suspensi Kotrimoksazole Suspensi btl 60ml 2,183 0 0 300 654900 0 400 873200 0 500 1091500 0 300 654900 0 0 0 1500
55 tablet 154 0 0 10,000 1540000 0 7,000 1078000 0 5,000 770000 0 5,000 770000 0 0 0 27000
Kotrimoksazol 480 mg komb (DW) Kotrimoksazol 480 mg komb (DW)
APBD 2019 133 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Kodein HCL 10 mg Kodein HCL 10 mg tablet 575 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 300 581100 0 0 0 0 0 0 0 0 0 300

57 Lidokain Injeksi Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg Loperramid tablet 2 mg tablet 80 0 0 500 40000 0 0 0 0 0 0 0 0 0 500
59 MgSO4 20 % MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 133 0 0 3,000 399000 0 1,000 133000 0 1,000 133000 0 1,000 133000 0 0 0 6000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Metformin tablet 500 mg Metformin tablet 500 mg
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000

61 Metil Ergometrin Maleat injeksi Metil Ergometrin Maleat injeksi ampul 2,684 0 0 300 805200 0 0 0 0 0 0 0 0 0 300
62 Metil Ergometrin Maleat 0,125 mg Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 2,000 324000 0 0 0 0 0 0 0 0 0 2000
63 Metoclorpramid HCL 10 mg Metoclorpramid HCL 10 mg tablet 123 0 0 3,000 369000 0 2,000 246000 0 2,000 246000 0 2,000 246000 0 0 0 9000
tablet 133 0 0 15,000 1995000 0 15,000 1995000 0 0 0 0 0 0 0 30000
64 Metronidazol 500 mg Metronidazol 500 mg
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup Metronidazole syirup botol 3,800 0 0 400 1520000 0 400 1520000 0 300 1140000 0 0 0 0 0 1100
66 Mikonazol Cream 2 % Mikonazol Cream 2 % tube 3,410 0 0 0 0 100 341000 0 100 341000 0 100 341000 0 0 0 300
tablet 107 0 0 5,000 533350 0 3,000 320010 0 0 0 0 0 0 0 8000

67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 0 0 4,800 652800 0 0 0 4800
Natrium Diklofenak tablet 50 mg
silva 2015 136 0 0 0 0 0 0 4,000 543600 0 9,000 1223100 0 0 0 13000
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0
Natrium Klorida larutan infus 0,9% botol 6,410 0 0 300 1923000 0 200 1282000 0 300 1923000 0 0 0 0 0 800
68 Natrium Klorida larutan infus 0,9%
botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 1,000 549000 0 0 0 300 164700 0 1,000 549000 0 0 0 2300

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 1,000 803000 0 0 0 300 240900 0 1,000 803000 0 0 0 2300

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0
71 Nifedipin 20 mg Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % Oksitetrasiklin salep mata 1 % tube 1,798 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 300 570000 0 0 0 300 570000 0 0 0 0 0 600

73 Oksitoksin injeksi 10 iv/ml Oksitoksin injeksi 10 iv/ml
ampul/H baru 1,199
74 Omeprazole kapsul/kaplet 20 mg Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 6,000 984000 0 6,000 984000 0 6,000 984000 0 0 0 0 0 18000
tablet 51 0 5,000 255000 15,000 765000 0 0 0 0 0 0 0 0 0 20000
tablet 178 0 0 0 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 8,000 1316960 3,000 493860 15,000 2469300 0 15,000 2469300 0 0 0 41000
silva/ 2015 165 0 0 0 0 0 0 0 0 15,000 2469300 0 0 0 15000
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0

76 botol 1,496 0 0 500 748000 0 500 748000 0 600 897600 0 500 748000 0 0 0 2100
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 0 0 0 0 0 0 0 0 400
78
Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 0 0 2,000 616000 0 0 0 0 0 0 0 2000

80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 15,000 1860000 0 15,000 1860000 0 0 0 0 0 0 0 30000
81 Prednison 5 mg Tablet tablet 96 0 2,000 192000 0 0 0 0 0 0 0 0 0 0 2000

82 Propanolol HCL 10 mg tablet 66 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 191 0 0 0 0 0 0 5,000 953300 0 2,000 381320 0 0 0 7000
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 1,500 990000 0 0 0 1500
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 0 0 0 2000
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Ranitidin Injeksi 25 mg Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 100 118800 0 0 0 100
85 Retinol 100.000 ( Vit. A Kapsul Biru) Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 2,060 1023820 0 0 0 2060
86 Retinol 200.000 ( Vit. A Kapsul Merah) Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 17,236 0 0 0 0 17236
botol 7,150 0 0 500 3575000 0 600 4290000 0 500 3575000 0 500 3575000 0 0 0 2100
87 Ringer Laktat laturan infus steril Ringer Laktat laturan infus steril
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600 0 0 0 100
88 Salap 2-4 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0

89 Salbutamol tablet 2 mg Salbutamol tablet 2 mg tablet 78 0 0 5,000 390000 0 5,000 390000 0 3000 234000 0 5000 390000 0 0 0 18000
90 Salbutamol Cairan 0,1 % Salbutamol Cairan 0,1 % ampul 4,000 0 0 100 400000 0 0 0 0 0 0 0 0 0 100
91 Salbutamol syrup Salbutamol syrup botol 4,042 0 200 808364 0 0 0 0 0 0 0 0 0 0 200
92 Salisil Bedak 2,5% Salisil Bedak 2,5% bks 1,046 0 0 0 0 0 0 0 0 0 0 0 0 0

93 Serum ATS 1.500 IU Injeksi Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 10 1886630 0 5 943315 0 0 0 15
94 Sianokobalamin (Vit B12) tablet 50 mg Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 7,000 420000 0 0 0 0 0 0 0 0 0 7000
95 Sianokobalamin (Vit B12) injeksi Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 400 467200 0 1,000 1168000 0 800 934400 0 200 233600 0 0 0 2400
tablet 133 0 0 2,000 266000 0 0 0 0 0 0 0 0 0 2000
96 Simvastatin tablet 10 mg Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0 0 0 5,000 643500 0 0 0 5000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000 0 0 0 15000
97 Simvastatin tablet 20 mg Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 1,500 189000 0 0 0 1500
tablet 289 0 0 0 0 0 0 3,000 867000 0 0 0 0 0 3000
98 Siprofloksasin 500 MG tablet 880 0 0 2,000 1760000 0 3,000 2640000 0 0 0 3,000 2640000 0 0 0 8000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 2,000 638000 0 0 0 2,000 638000 0 2,000 638000 0 0 0 6000
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 15,000 1260000 0 10,000 840000 0 10,000 840000 0 0 0 0 0 35000
102 Vitamin B komplek Tablet tablet 121 0 5,000 605000 20,000 2420000 0 20,000 2420000 0 10,000 1210000 0 10,000 1210000 0 0 0 65000
Botol 9,646 0 0 400 3858400 0 0 0 0 0 0 0 0 0 400

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0
104 Zink Tablet Tablet 0 0 0 0 0 0 0 0 1,000 0 0 0 0 1000
botol 6,290 0 0 0 0 0 0 0 0 0 0 0 0 0
3,322 0 0 0 0 100 332200 0 0 0 0 0 0 0 100
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0
BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0 0 0 0 0 0
108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 5 687500 0 0 0 0 0 0 0 5
109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 0 0 5 1842500 0 0 0 0 0 0 0 5
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 5 893750 0 0 0 0 0 0 0 5
112 Abbocath No.20 G buah 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0

113 Abbocath No.22 G buah 4,180 0 0 100 418000 0 0 0 0 0 0 0 0 0 100
buah 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,000 792000 0 0 0 1,000 792000 0 1,000 792000 0 0 0 3000
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 500 108000 0 100 21600 0 0 0 500 108000 0 0 0 1100

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 12 542196 0 0 0 24 1084392 0 0 0 36

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 12 389892 0 0 0 0 0 0 0 12
125 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 24 1261464 0 0 0 24 1261464 0 0 0 0 0 48
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 112 417872 0 0 0 0 0 0 0 0 0 0 112
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 4 115000 0 0 0 0 0 0 0 0 0 4
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 100 385000 0 0 0 0 0 100 385000 0 0 0 200
132 Infusion Set Anak set 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 100 352000 0 0 0 0 0 200 704000 0 0 0 300

set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 10 137500 0 0 0 10 137500 0 20 275000 0 0 0 40

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 10 77000 0 0 0 0 0 0 0 0 0 10
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 200 420000 0 0 0 0 0 0 0 0 0 0 200
rol 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 200 330000 0 0 0 0 0 0 0 0 0 0 200
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 1,600 14080000 0 0 0 0 0 0 0 0 0 0 1600

144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 0 0 0 0 0 0 10 471500 0 0 0 10

145 Lisol 100 %
botol / bpjs 47,150 0 39 1838850 0 0 0 0 0 0 0 0 0 0 39
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Masker Tie On buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 300 108900 0 0 0 0 0 0 0 0 0 300
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 1,000 438900 0 1,000 438900 0 0 0 2000
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 1,000 440000 0 1,000 440000 0 0 0 0 0 0 0 2000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0
151 My Jelly 82 gram tube - 0 0 0 0 0 0 0 0 0 0 0 0 0
153 One scrub 500 cc + dispenser botol 65,341 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 10 819555 0 0 0 0 0 0 0 0 0 10
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 18,818 0 0 20 376364 0 0 0 0 0 0 0 0 0 20
botol / bpjs 18,818 0 25 470455 0 0 0 0 0 0 0 0 0 0 25
botol 3,032 0 0 200 606364 0 0 0 0 0 0 0 0 0 200
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0 0 0 0 1,000 4666000 0 0 0 1000
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Sarung tangan M buah 471 0 0 0 0 0 0 1,000 470500 0 0 0 0 0 1000
buah 36,582 0 0 0 0 0 0 0 0 12 438984 0 0 0 12

161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 24 0 0 0 0 0 0 24
162 Silk 3/0
buah / bpjs - 0 24 0 0 0 0 0 0 0 0 0 0 0 24
163 Skin Celean 500 ml botol - 0 0 0 0 0 0 0 0 0 0 0 0 0
164 Tranfusion Set buah 4,000 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 30 434148 0 0 0 0 0 0 0 0 0 0 30
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0

171 Rinse Mindrey galon 1,254,000 0 0 0 0 0 0 0 0 0 0 0 0 0

172 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0 0 0
173 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0 0 0
174 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0 0 0 0 0 0 0 0
175 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0 0 0 0 0 0 0 0

176 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0 0 0 0 0 0 0 0
177 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0 0 0 0 0 0 0 0 0

178 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0 0 0
179 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0 0 0
180 URID ACID (URICASE) Kit 799,700 0 0 0 0 0 0 0 0 0 0 0 0 0
181 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 0 0 1,000 303000 0 0 0 0 0 1000
183 ZINC Tablet TABLET 539 0 1,289 694771 0 0 0 0 0 0 0 0 0 0 1289
184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 0 0 0 0 0 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 0 500 1475000 0 0 0 0 0 0 0 0 500
187 Tuberculin PPD Vial 702,250 0 0 0 0 0 0 0 0 0 0 0 0 0
188 Sarung tangan tanpa tepung M buah 583 0 1,500 874500 0 0 0 0 0 0 0 0 0 0 1500
189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2
191 Masker 3 Ply Earloop Jilbab buah - 0 3,000 0 0 0 0 0 0 0 0 0 0 0 3000
192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 5 0 0 0 0 0 0 0 0 0 0 0 5
194 Imersion Oil Botol 3,181,818 0 0 0 0 0 0 0 0 0 0 0 0 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0

196 ASAM CUKA botol - 0 0 7 0 0 0 0 0 0 0 0 0 0 7
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1

198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Imunisasi 1,404 0 0 0 0 0 0 0 0 0 0 0 0 0

199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 350 428750 0 0 0 0 0 350
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 7,997 13203047 0 0 0 0 0 7997
201 Safety Box 5 liter box - 0 0 0 0 0 0 84 0 0 0 0 0 0 84
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0
203 BD Vacuntainer box - 0 0 0 0 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0
208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0 0 0 0 0 0 0 0

210 Sarung tangan L buah 499 0 0 0 0 0 0 0 0 0 0 0 0 0
211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 0 0 0 0 0 0

212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0 0 0 0 0 0 0
213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 2 704000 0 2 704000 0 2 704000 0 3 1056000 0 0 0 9

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 3 554100 0 0 0 3

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 3 656100 0 0 0 3

OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0
228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 0 0 0 0 0 0 0 0 0 0
230 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 500 1557950 0 0 0 0 500
tablet 367 0 0 0 0 0 0 0 261,200 95860400 0 0 0 0 261200

Provinsi 367 0 346,680 127231560 0 0 0 0 0 0 0 0 0 0 346680
Program Imunisasi - 0 0 0 0 0 0 0 0 0 0 0 0 0
buah/ skipa 1,240 1144 1418560 0 0 0 0 0 0 0 0 0 0 0 1144
237 Spuit 0,5 ml
buah / apbn 1,621 14570 23617970 0 0 0 0 0 0 0 0 0 0 0 14570
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 1119 1471485 0 0 0 0 0 0 0 0 0 0 0 1119
Spuit 5 ml APBN 1,705 49 83545 213 262

Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 15 249120 0 0 0 0 0 0 0 0 0 0 0 15

Box / 2,5ml 16,608 4 66432 0 0 0 0 0 0 0 0 0 0 0 4
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0
241 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0 0 0 0 0 0 0
242 Primaquin TABLET 235 0 0 0 0 0 0 0 0 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0
246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0


253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0 0 0 0 0 0 0

255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0 0 0 0 0 0 0
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0 0 0
258 Blue Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0 0 0

259 Metilen Blue botol 94,500 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0

263 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0 0 0 0 0 0 0
264 Object Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0 0 0

265 Cover Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 38 2278100 38 2278100 35 2098250 35 2098250 30 1798500 35 2098250 32 1918400 32 1918400 32 1918400 0 0 0 307
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 20 564080 10 282040 0 0 0 0 0 50
270 MR VIAL 141,648 40 5665920 40 5665920 40 5665920 40 5665920 20 2832960 20 2832960 40 5665920 20 2832960 253 35836944 0 0 0 513
271 DPT-HB-Hib VIAL 76,285 120 9154200 70 5339950 50 3814250 120 9154200 100 7628500 120 9154200 120 9154200 120 9154200 120 9154200 0 0 0 940
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 110 2299000 120 2508000 50 1045000 100 2090000 100 2090000 100 2090000 100 2090000 100 2090000 100 2090000 0 0 0 880
274 POLIO (BOPV) VIAL 19,954 120 2394480 40 798160 0 0 100 1995400 20 399080 120 2394480 120 2394480 120 2394480 0 0 0 640
275 POLIO (IPV) VIAL 13,976 40 559040 40 559040 40 559040 40 559040 30 419280 40 559040 40 559040 40 559040 40 559040 0 0 0 350
276 Td VIAL 16,500 40 660000 40 660000 40 660000 40 660000 30 495000 30 495000 30 495000 30 495000 30 495000 0 0 0 310
TOTAL
HARGA
KELUAR
858000
1488000
5672730
939000
1320000
23055000
1500000
1101000
2835000
2065000
0
690500
1744000
7573500
0
1822380
607460
0
0
121875
1885000
580000
15840000
719200
1155000
1155000
94600
9108
1152000
2176000
0
0
0
13518000
2746800
2826600
0
833400
872000
0
324000
0
0
522000
375000
1125000
750000
1380000
173990
720000
93000
530000
18266600
468000
13860000
0
1039500
1155000
1609200
0
186000
3603600
3108000
0
575000
186000
12155000
3216400
3274500
4158000
581100
0
40000
0
798000
0
636000
636000
805200
324000
1107000
3990000
0
4180000
1023000
853360
652800
1766700
0
5128000
1262700
1846900
1140000
2952000
1020000
6749420
2469300
0
3141600
0
1245200
0
0
616000
3720000
192000
0
1334620
990000
381320
118800
1023820
15015000
693600
0
1404000
400000
808364
0
2829945
420000
2803200
266000
643500
1755000
189000
867000
7040000
0
2442000
1914000
2940000
7865000
3858400
332200
190050
381150
687500
1842500
893750
1212727
0
418000
1672000
0
0
0
0
2376000
237600
1626588
389892
0
2522928
0
0
0
0
417872
0
0
115000
770000
1056000
550000
272800
0
0
77000
0
0
420000
0
330000
0
0
14080000
0
0
0
471500
1838850
108900
877800
880000
819555
705000
0
0
600000
0
0
247500
0
376364
470455
606364
4666000
470500
438984
0
0
434148
0
0
0
16500000
15400000
15400000
19800000
0
0
0
0
0
0
0
0
303000
694771
1475000
874500
94300
2181732
0
0
0
0
0
0
0
0
0
428750
13203047
0
0
0
0
0
0
3168000
544500
1320141
571548
571548
494321
140100
140100
554100
200100
656100
294600
5236144
5039960
406518
1557950
95860400
127231560
0
1418560
23617970
0
1471485
249120
66432
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18404650
1410200
72665424
71707900
18392000
12770560
4891600
5115000
PELAPORAN : PUSKESMAS KUTALIMBARU 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU KUTALIMBARU TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 1,000 93000 0 700 65100 0 700 65100 0 800 74400 0 0 0 3200 297600
silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730 0 0 0 6000 5672730
4 Albendazole tablet 400 mg tablet 313 0 0 0 0 2,000 626000 0 500 156500 0 0 0 0 0 2500 782500
tablet 88 0 0 3,000 264000 0 1,500 132000 0 1,500 132000 0 3,000 264000 0 0 0 9000 792000
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 0 15,000 3975000 0 15,000 3975000 0 14,000 3710000 0 10,000 2650000 0 0 0 54000 14310000
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0

btl 60 ml 2,065 0 0 500 1032500 0 100 206500 0 300 619500 0 200 413000 0 0 0 1100 2271500
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 0 0 0 0 48 331440 0 0 0 0 0 48 331440
tablet/ H Baru 446 0 0 0 0 7,000 3118500 0 7,000 3118500 0 0 0 0 0 14000 6237000
tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000 607460
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 50 148800 0 0 0 50 148800
17 Cetrizin tablet tablet 145 500 72500 0 0 0 0 0 500 72500 0 0 0 0 0 1000 145000
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 300 316800 0 0 0 0 0 0 0 0 0 300 316800
botol 11,550 0 0 0 0 0 0 200 2310000 0 50 577500 0 0 0 250 2887500

21
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 500 47300 0 0 0 500 47300
tablet 64 0 0 10,000 640000 0 10,000 640000 0 10,000 640000 0 5,000 320000 0 0 0 35000 2240000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tube 18,844 0 0 0 0 0 0 0 0 50 942200 0 0 0 50 942200

Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 500 218000 0 0 0 0 0 0 0 0 0 500 218000
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 500 40500 0 300 24300 0 0 0 0 0 0 0 800 64800

34 Garam oralit 200 ml air bks 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 58 0 0 3,000 174000 0 2,000 116000 0 4,000 232000 0 0 0 0 0 9000 522000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 4,000 500000 0 0 0 4000 500000

silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000 0 0 0 9000 1125000
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000 0 0 0 6000 750000
36 botol 6,900 0 0 400 2760000 0 60 414000 0 0 0 0 0 0 0 460 3174000

JKN 2019 7,363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 1,000 173990 0 0 0 1000 173990
39 Griseofulvin 125 mg Tablet tablet 240 0 0 2,000 480000 0 800 192000 0 3,000 720000 0 2,500 600000 0 0 0 8300 1992000
42 Hidrokloratiazid 25 mg tablet 156 0 0 0 0 0 0 1,000 156000 0 0 0 0 0 1000 156000
tablet / H.Baru 437 0 0 3,200 1398400 0 3,600 1573200 0 5,000 2185000 0 5,000 2185000 0 0 0 16800 7341600
43 Hustab Tablet tablet 258 0 0 0 2,000 0 0 0 0 0 0 2000 0
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 200 2310000 0 300 3465000 0 50 577500 0 0 0 550 6352500
JKN 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

silva/ 2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100 1155000
botol 8,046 0 0 50 402300 0 0 0 0 0 0 0 0 0 50 402300

45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 1,000 75000 0 0 0 0 0 0 0 1000 75000
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 2,000 125980 0 0 0 2000 125980
49 Karbamazepin tablet 200 mg tablet 230 0 0 0 0 0 0 200 46000 0 0 0 0 0 200 46000
51 Kaptopril 25 mg tablet 715 0 0 2,000 1430000 0 0 0 1,000 715000 0 1,000 715000 0 0 0 4000 2860000
52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 200 0 0 0 0 0 0 200 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 0 0 0 0 10,000 430000 0 10,000 430000 0 0 0 20000 860000
55 tablet 154 0 0 2,000 308000 0 0 0 2,000 308000 0 2,000 308000 0 0 0 6000 924000
APBD 2019 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 300 581100 0 0 0 0 0 0 0 0 0 300 581100

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 133 0 0 1,000 133000 0 0 0 0 0 0 0 0 0 1000 133000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000

62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 1,000 162000 0 0 0 0 0 0 0 0 0 1000 162000
63 Metoclorpramid HCL 10 mg tablet 123 0 0 2,000 246000 0 700 86100 0 2,500 307500 0 1,000 123000 0 0 0 6200 762600
tablet 133 0 0 10,000 1330000 0 5,000 665000 0 0 0 0 0 0 0 15000 1995000
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 300 1140000 0 0 0 400 1520000 0 0 0 0 0 700 2660000
66 Mikonazol Cream 2 % tube 3,410 0 0 200 682000 0 72 245520 0 200 682000 0 0 0 0 0 472 1609520
tablet 107 500 53335 0 3,000 320010 0 2,000 213340 0 0 0 0 0 0 0 5500 586685
silva 2015 136 0 0 0 0 0 0 2,000 271800 0 9,000 1223100 0 0 0 11000 1494900

botol 6,410 0 0 300 1923000 0 100 641000 0 20 128200 0 50 320500 0 0 0 470 3012700
68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 500 274500 0 0 0 0 0 0 0 0 0 500 274500

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 300 240900 0 0 0 0 0 0 0 0 0 300 240900

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 300 570000 0 250 475000 0 0 0 0 0 0 0 550 1045000

ampul/H baru 1,199
tablet 51 0 0 15,000 765000 0 0 0 0 0 0 0 0 0 15000 765000
tablet 178 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 5,000 823100 0 13,000 2140060 0 7,000 1152340 0 0 0 25000 4115500
silva/ 2015 165 0 0 0 0 0 0 0 0 12,000 1975440 0 0 0 12000 1975440
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0

76 botol 1,496 0 0 300 448800 0 100 149600 0 300 448800 0 200 299200 0 0 0 900 1346400
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 0 0 0 0 0 0 0 0 400 1245200

JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 2,100 646800 0 0 0 0 0 0 0 0 0 2100 646800
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 2,000 248000 0 0 0 0 0 0 0 0 0 2000 248000

tablet 191 0 0 0 0 0 0 10,000 1906600 0 5,000 953300 0 0 0 15000 2859900
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 0 0 0 2000 381320
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 1,002 497994 0 0 0 1002 497994
botol 7,150 0 0 300 2145000 0 100 715000 0 200 1430000 0 0 0 0 0 600 4290000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600 0 0 0 100 693600
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0

90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0


94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 0 0 0 0 500 30000 0 0 0 0 0 500 30000

tablet 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000 0 0 0 15000 1755000
tablet 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 1,000 880000 0 500 440000 0 1,000 880000 0 0 0 2500 2200000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 500 159500 0 0 0 0 0 0 0 0 0 500 159500

Botol 9,646 0 0 300 2893800 0 0 0 0 0 0 0 0 0 300 2893800

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 50 314500 0 0 0 0 0 50 314500

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 0 0 0 0 5 95025 0 0 0 10 190050
108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 5 687500 0 0 10 1375000 5 687500 0 0 0 20 2750000
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 5 893750 0 0 10 1787500 5 893750 0 0 0 20 3575000
buah 4,180 0 0 100 418000 0 50 209000 0 0 0 0 0 0 0 150 627000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 70 318500 0 0 0 0 0 0 0 0 0 0 70 318500
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 500 396000 0 0 0 0 0 0 0 0 0 0 500 396000
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 500 396000 0 0 0 1,000 792000 0 300 237600 0 0 0 1800 1425600
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 2,000 432000 0 500 108000 0 1,000 216000 0 0 0 0 0 3500 756000
buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0 0 0 0 10 379500
buah 45,183 0 0 0 0 12 542196 0 0 0 0 0 0 0 12 542196

buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0 0 0 12 542196
buah 32,491 0 0 0 0 12 389892 0 36 1169676 0 24 779784 0 0 0 72 2339352
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0 0 0 0 12 389892

buah 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 24 1224528 0 0 0 0 0 24 1224528
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 100 373100 0 0 0 0 0 0 0 0 0 0 100 373100
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 15 51750 0 0 0 0 0 0 0 0 0 0 15 51750
botol 28,750 0 0 5 143750 0 0 0 0 0 0 0 0 0 5 143750
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 20 575000 0 0 0 0 0 0 0 0 0 0 20 575000
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 50 192500 0 0 0 0 0 0 0 0 0 50 192500
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 50 176000 0 50 176000 0 50 176000 0 0 0 0 0 150 528000

set / bpjs 3,520 0 150 528000 0 0 0 0 0 0 0 0 0 0 150 528000
buah 13,750 0 0 10 137500 0 0 0 0 0 10 137500 0 0 0 20 275000

buah / bpjs 13,750 0 20 275000 0 0 0 0 0 0 0 0 0 0 20 275000
135 Kapas Pembalut 500 g buah 27,280 0 0 5 136400 0 0 0 0 0 0 0 0 0 5 136400

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 10 77000 0 0 0 0 0 0 0 0 0 10 77000
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 100 210000 0 0 0 0 0 0 0 0 0 0 100 210000
rol 1,650 0 0 50 82500 0 0 0 0 0 0 0 0 0 50 82500
rol / bpjs 1,650 0 100 165000 0 0 0 0 0 0 0 0 0 0 100 165000
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 50 41250 0 0 0 0 0 0 0 0 0 0 50 41250
buah 8,800 320 2816000 0 0 0 0 0 0 0 0 0 0 0 320 2816000
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 0 0 0 0 0 0 5 235750 0 0 0 5 235750

145 Lisol 100 %
botol / bpjs 47,150 0 20 943000 0 0 0 0 0 0 0 0 0 0 20 943000
buah 363 0 0 100 36300 0 100 36300 0 0 0 0 0 0 0 200 72600
146 Masker Tie On buah 439 0 0 0 0 0 0 500 219450 0 500 219450 0 0 0 1000 438900
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 500 219450 0 0 0 0 0 500 219450
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 1,000 440000 0 0 0 0 0 0 0 0 0 1000 440000

buah / bpjs 440 0 2,500 1100000 0 0 0 0 0 0 0 0 0 0 2500 1100000
rol 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 81,955 0 5 409777 0 0 0 0 0 0 0 0 0 0 5 409777

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 5 256525 0 0 0 0 0 0 0 0 0 0 5 256525
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 5 141432 0 0 0 0 0 0 0 0 0 0 5 141432

botol 18,818 0 0 10 188182 0 0 0 0 0 0 0 0 0 10 188182
botol / bpjs 18,818 0 10 188182 0 0 0 0 0 0 0 0 0 0 10 188182
botol 3,032 0 0 100 303182 0 0 0 0 0 0 0 0 0 100 303182
botol / bpjs 3,032 0 32 97018 0 0 0 0 0 0 0 0 0 0 32 97018
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 100 689500 0 0 0 0 0 0 0 0 0 0 100 689500
buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 1 14472 0 0 0 0 0 0 0 0 0 0 1 14472
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


172 DIFF Diluent 20 L galon 1,379,400 0 0 0 8 11035200 0 0 0 0 0 0 0 0 8 11035200


Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 0 0 0 0 0 0 0 0 0 0
184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 6 1815630 0 0 0 0 0 0 0 0 0 0 6 1815630
185 POT SPUTUM BUAH 2,950 0 500 1475000 0 0 0 0 0 0 0 0 0 0 500 1475000
189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300
192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0 0 0 5 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0

198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 0 0 2 704000 0 0 0 3 1056000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 2 369400 0 0 0 2 369400

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 2 437400 0 0 0 2 437400

Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 OAT FDC Kategori Anak paket 203,259 0 0 0 0 4 813036 0 0 0 0 0 0 0 4 813036
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 100 311590 0 0 0 0 100 311590
tablet 367 0 0 0 0 0 0 0 127,100 46645700 0 0 0 0 127100 46645700

Provinsi 367 0 169,348 62150716 0 0 0 0 0 0 0 0 0 0 169348 62150716
buah/ skipa 1,240 557 690680 0 0 0 0 0 0 0 0 0 0 0 557 690680
237 Spuit 0,5 ml
buah / apbn 1,621 7098 11505858 0 0 0 0 0 0 0 0 0 0 0 7098 11505858
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 545 716675 0 0 0 0 0 0 0 0 0 0 0 545 716675
Spuit 5 ml APBN 1,705 24 40920 99 123

Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 8 132864 0 0 0 0 0 0 0 0 0 0 0 8 132864

Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0

251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 0 0 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0


266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 15 899250 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 15 899250 15 899250 20 1199000 0 0 0 165 9891750
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 20 564080 20 564080 0 0 0 0 0 60 1692240
270 MR VIAL 141,648 0 0 20 2832960 10 1416480 10 1416480 20 2832960 0 10 1416480 119 16856112 0 0 0 189 26771472
271 DPT-HB-Hib VIAL 76,285 80 6102800 40 3051400 35 2669975 70 5339950 60 4577100 80 6102800 60 4577100 70 5339950 80 6102800 0 0 0 575 43863875
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 100 2090000 50 1045000 20 418000 50 1045000 70 1463000 70 1463000 70 1463000 50 1045000 50 1045000 0 0 0 530 11077000
274 POLIO (BOPV) VIAL 19,954 40 798160 40 798160 0 0 50 997700 70 1396780 50 997700 50 997700 70 1396780 0 0 0 370 7382980
275 POLIO (IPV) VIAL 13,976 20 279520 20 279520 20 279520 15 209640 15 209640 20 279520 20 279520 15 209640 20 279520 0 0 0 165 2306040
276 Td VIAL 16,500 20 330000 20 330000 20 330000 20 330000 10 165000 10 165000 20 330000 20 330000 30 495000 0 0 0 170 2805000
PELAPORAN : PUSKESMAS SUKARAYA 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA SUKARAYA TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 500 46500 0 1,000 93000 0 1,000 93000 0 0 0 0 0 2500 232500
silva/ 2014 945 0 0 0 0 0 0 0 0 8,000 7563640 0 0 0 8000 7563640
4 Albendazole tablet 400 mg tablet 313 0 0 2,000 626000 0 0 0 0 0 0 0 0 0 2000 626000
tablet 88 0 0 1,000 88000 0 1,000 88000 0 2,000 176000 0 0 0 0 0 4000 352000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 0 0 0 10,000 2650000 0 5,000 1325000 0 0 0 0 0 15000 3975000

Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 200 500000 0 0 0 100 250000 0 0 0 0 0 300 750000

9 Antasida DOEN I Kombinasi tablet 63 0 0 0 0 0 0 0 0 0 0 0 0 0 0
btl 60 ml 2,065 0 0 400 826000 0 200 413000 0 0 0 0 0 0 0 600 1239000

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 0 0 1,000 109000 0 0 0 2,000 218000 0 0 0 3000 327000
tablet/ H Baru 446 0 0 1,000 445500 0 3,000 1336500 0 3,000 1336500 0 0 0 0 0 7000 3118500
tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000 607460
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 Cetrizin tablet tablet 145 0 0 1,000 145000 0 1,500 217500 0 2,000 290000 0 0 0 0 0 4500 652500
18 Cetrizin syrup botol 2,900 0 0 0 0 0 0 100 290000 0 0 0 0 0 100 290000
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 0 0 1,000 1056000 0 0 0 0 0 0 0 1000 1056000
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 11,550 0 0 0 0 0 0 100 1155000 0 0 0 0 0 100 1155000

21
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 64 0 0 200 12800 0 5,000 320000 0 0 0 0 0 0 0 5200 332800

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0

28 Eritromysin kapsul 500 mg tablet 751 0 0 500 375500 0 1,000 751000 0 0 0 500 375500 0 0 0 2000 1502000
tube 18,844 0 0 0 0 0 0 0 0 50 942200 0 0 0 50 942200

Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 0 0 500 40500 0 0 0 0 0 0 0 500 40500

tablet 58 0 0 0 0 1,000 58000 0 0 0 0 0 0 0 1000 58000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 1,000 125000 0 0 0 1000 125000

silva 2015 125 0 0 0 0 0 0 0 0 12,000 1500000 0 0 0 12000 1500000
silva 2014 125 0 0 0 0 0 0 0 0 8,000 1000000 0 0 0 8000 1000000
36 botol 6,900 0 0 0 0 0 0 20 138000 0 0 0 0 0 20 138000

JKN 2019 7,363 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 500 120000 0 1,000 240000 0 0 0 0 0 0 0 1500 360000
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 48 127200 0 100 265000 0 100 265000 0 0 0 0 0 248 657200
42 Hidrokloratiazid 25 mg tablet 156 0 0 1,000 156000 0 0 0 0 0 0 0 0 0 1000 156000
tablet / H.Baru 437 0 0 2,000 874000 0 3,000 1311000 0 0 0 0 0 0 0 5000 2185000
43 Hustab Tablet tablet 258 0 0 0 3,000 774000 0 0 0 0 0 0 0 3000 774000
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 100 1155000 0 0 0 100 1155000 0 0 0 200 2310000

JKN 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0

silva/ 2015 11,550 0 0 0 0 0 0 0 0 150 1732500 0 0 0 150 1732500
botol 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 300 27900 0 0 0 0 0 500 46500 0 0 0 800 74400
47 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 0 0 0 0 0

49 Karbamazepin tablet 200 mg tablet 230 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Kaptopril 12,5 mg tablet 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Kaptopril 25 mg tablet 715 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 2,000 86000 0 4,000 172000 0 0 0 0 0 0 0 6000 258000
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
55 tablet 154 0 0 0 0 0 0 1,000 154000 0 1,000 154000 0 0 0 2000 308000

APBD 2019 133 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 0 0 0 0 20 38740 0 0 0 0 0 20 38740

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 133 0 0 0 0 0 0 500 66500 0 500 66500 0 0 0 1000 133000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 8,000 848000 0 0 0 8000 848000
Silva 2014 106 0 0 0 0 0 0 0 0 8,000 848000 0 0 0 8000 848000

62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 0 0 0 0 0 0 100 380000 0 0 0 100 380000
tablet 107 0 0 2,000 213340 0 2,000 213340 0 0 0 0 0 0 0 4000 426680

silva 2015 136 0 0 0 0 0 0 2,000 271800 0 12,000 1630800 0 0 0 14000 1902600

botol 6,410 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul/H baru 1,199
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 3,000 492000 0 2000 328000 0 600 98400 0 0 0 0 0 5600 918400
tablet 51 0 0 4,000 204000 0 0 0 0 0 0 0 0 0 4000 204000
tablet 178 0 0 0 0 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 2000 329240 0 4000 658480 0 5000 823100 0 0 0 11000 1810820
silva/ 2015 165 0 0 0 0 0 0 0 0 15000 2469300 0 0 0 15000 2469300
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0

76 botol 1,496 0 0 500 748000 0 0 0 0 0 0 0 0 0 500 748000
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0 20 62260 0 40 124520 0 0 0 60 186780
78
Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 0 0 0 0 0 0 500 154000 0 0 0 500 154000
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 191 0 0 0 0 0 0 2,000 381320 0 2,000 381320 0 0 0 4000 762640
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 0 0 0 2000 381320
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 321 159537 0 0 0 321 159537
botol 7,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 120 832320 0 0 0 120 832320
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0

89 Salbutamol tablet 2 mg tablet 78 0 0 300 23400 0 1,000 78000 0 0 0 0 0 0 0 1300 101400


94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 0 0 0 0 1,000 60000 0 0 0 0 0 1000 60000

95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 18,000 2106000 0 0 0 18000 2106000
tablet 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 500 440000 0 1,000 880000 0 0 0 0 0 1500 1320000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 300 95700 0 0 0 500 159500 0 0 0 0 0 800 255200
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 2,000 168000 0 2,000 168000 0 0 0 0 0 0 0 4000 336000
102 Vitamin B komplek Tablet tablet 121 0 0 2,000 242000 0 2,000 242000 0 0 0 0 0 0 0 4000 484000
Botol 9,646 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


buah 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 100 21600 0 0 0 0 0 0 0 0 100 21600

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 96 358176 0 0 0 0 0 0 0 0 0 0 96 358176
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 30 103500 0 0 0 0 0 0 0 0 0 0 30 103500
botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0

set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 13,750 0 1 13750 0 0 0 0 0 0 0 0 0 0 1 13750

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 15 450120 0 0 0 0 0 0 0 0 0 0 15 450120
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 3 141450 0 0 0 0 0 5 235750 0 0 0 8 377200

145 Lisol 100 %
botol / bpjs 47,150 0 30 1414500 0 0 0 0 0 0 0 0 0 0 30 1414500
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 500 219450 0 0 0 0 0 500 219450
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,032 0 10 30318 0 0 0 0 0 0 0 0 0 0 10 30318
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 1 47150 0 0 0 0 0 0 0 0 0 0 1 47150

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 4 0 0 0 0 0 0 0 0 0 0 4 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

206 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 50 729500 50 729500 50 729500 0 0 0 0 0 0 150 2188500



OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 0 0 0 0 1 352000 0 2 704000 0 0 0 3 1056000
222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 2 369400 0 0 0 2 369400
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 2 437400 0 0 0 2 437400
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 100 311590 0 0 0 0 100 311590
tablet 367 0 0 0 0 0 0 0 41,000 15047000 0 0 0 0 41000 15047000

Provinsi 367 0 54,280 19920760 0 0 0 0 0 0 0 0 0 0 54280 19920760
buah/ skipa 1,240 178 220720 0 0 0 0 0 0 0 0 0 0 0 178 220720
237 Spuit 0,5 ml
buah / apbn 1,621 2271 3681291 0 0 0 0 0 0 0 0 0 0 0 2271 3681291
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 174 228810 0 0 0 0 0 0 0 0 0 0 0 174 228810
Spuit 5 ml APBN 1,705 8 13640 40 48
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 100 2233000 100 2233000 100 2233000 0 0 0 0 0 0 300 6699000

254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 40 536280 40 536280 40 536280 0 0 0 0 0 0 120 1608840
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 8 479600 5 299750 10 599500 5 299750 10 599500 7 419650 8 479600 10 599500 0 0 0 0 63 3776850
269 CAMPAK VIAL 28,204 0 0 0 0 5 141020 0 0 0 0 0 0 0 5 141020
270 MR VIAL 141,648 0 0 0 0 0 0 0 0 41 5807568 0 0 0 41 5807568
271 DPT-HB-Hib VIAL 76,285 30 2288550 25 1907125 20 1525700 25 1907125 30 2288550 25 1907125 25 1907125 25 1907125 30 2288550 0 0 0 235 17926975
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 25 522500 25 522500 20 418000 20 418000 20 418000 25 522500 25 522500 25 522500 20 418000 0 0 0 205 4284500
274 POLIO (BOPV) VIAL 19,954 25 498850 20 399080 0 0 20 399080 20 399080 20 399080 20 399080 20 399080 0 0 0 145 2893330
275 POLIO (IPV) VIAL 13,976 5 69880 10 139760 5 69880 5 69880 10 139760 10 139760 8 111808 10 139760 5 69880 0 0 0 68 950368
276 Td VIAL 16,500 0 5 82500 0 5 82500 5 82500 5 82500 0 5 82500 5 82500 0 0 0 30 495000
PELAPORAN : PUSKESMAS NAMORAMBE 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE NAMORAMBE TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 5,000 465000 0 5,000 465000 0 2,500 232500 0 6,000 558000 0 0 0 18500 1720500
silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730 0 0 0 6000 5672730
tablet 88 0 0 2,000 176000 0 2,000 176000 0 1,000 88000 0 3,300 290400 0 0 0 8300 730400
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 5,000 1325000 0 10,000 2650000 0 10,000 2650000 0 10,000 2650000 0 10,000 2650000 0 0 0 45000 11925000
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0
btl 60 ml 2,065 0 0 300 619500 0 100 206500 0 300 619500 0 300 619500 0 0 0 1000 2065000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 100 690500 0 50 345250 0 50 345250 0 100 690500 0 0 0 300 2071500
12 Asam Askorbat (vit C) 50mg tablet 109 0 5,000 545000 7,000 763000 0 7,000 763000 0 5,000 545000 0 5,000 545000 0 0 0 29000 3161000
tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 5,000 2227500 0 0 0 0 0 10000 4455000
tablet 176 0 0 1,000 176000 0 0 0 0 0 0 0 0 0 1000 176000

13
silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000 607460
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 500 118450 0 0 0 500 118450
17 Cetrizin tablet tablet 145 0 0 3,000 435000 0 2,000 290000 0 500 72500 0 3,000 435000 0 0 0 8500 1232500
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 4,000 4224000 0 4,000 4224000 0 500 528000 0 2,000 2112000 0 0 0 10500 11088000
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 200 359600 0 150 269700 0 0 0 200 359600 0 0 0 550 988900
botol 11,550 0 0 0 0 0 0 300 3465000 0 200 2310000 0 0 0 500 5775000

21
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 200 18920 0 0 0 200 18920
tablet 64 0 0 5,000 320000 0 5,000 320000 0 4,000 256000 0 10,000 640000 0 0 0 24000 1536000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 200 470800 0 10 23540 0 0 0 100 235400 0 0 0 310 729740
tube 18,844 0 0 0 0 0 0 0 100 1884400 0 0 0 100 1884400

Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 2,000 872000 0 0 0 0 0 0 0 0 0 2000 872000
tablet/ H. baru 797 0 0 0 0 0 0 500 398495 0 1,000 796990 0 0 0 1500 1195485
32 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 1,000 81000 0 1,000 81000 0 500 40500 0 0 0 4500 364500

34 Garam oralit 200 ml air bks 303 0 0 500 151500 0 0 0 0 0 0 0 0 0 500 151500
tablet 58 0 4,000 232000 3,000 174000 0 3,000 174000 0 1,000 58000 0 0 0 0 0 11000 638000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 5,000 625000 0 0 0 5000 625000

silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000 0 0 0 9000 1125000
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000 0 0 0 6000 750000
36 botol 6,900 0 0 300 2070000 0 40 276000 0 100 690000 0 200 1380000 0 0 0 640 4416000
JKN 2019 7,363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 1,000 240000 0 800 192000 0 500 120000 0 5,000 1200000 0 0 0 7300 1752000
42 Hidrokloratiazid 25 mg tablet 156 0 0 2,000 312000 0 0 0 0 0 2,000 312000 0 0 0 4000 624000
tablet / H.Baru 437 0 0 0 0 7,200 3146400 0 7,200 3146400 0 3,000 1311000 0 0 0 17400 7603800
43 Hustab Tablet tablet 258 0 0 0 0 4,000 1032000 0 0 0 0 0 0 4000 1032000
tablet P 312 2,000 624000 1,000 312000 5,000 1560000 0 0 0 0 0 0 0 0 0 8000 2496000
botol/ H. Baru 11,550 0 0 0 0 200 2310000 0 300 3465000 0 200 2310000 0 0 0 700 8085000
JKN 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

silva/ 2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0 0 100 1155000
botol 8,046 200 1609200 100 804600 0 0 0 0 0 0 0 0 0 0 300 2413800

46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 1,000 93000 0 300 27900 0 2,000 186000 0 0 0 5300 492900

52 Klorpramazine HCl 100 mg tablet - 0 0 300 0 0 0 0 0 0 200 0 0 0 0 500 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 5,000 215000 7,000 301000 0 7,000 301000 0 5,000 215000 0 10,000 430000 0 0 0 34000 1462000
55 tablet 154 0 4,000 616000 6,000 924000 0 6,000 924000 0 2,000 308000 0 6,000 924000 0 0 0 24000 3696000
APBD 2019 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 400 774800 0 100 193700 0 200 387400 0 500 968500 0 0 0 1200 2324400
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 3,000 240000 2,000 160000 0 0 0 0 0 0 0 0 0 5000 400000
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 133 0 0 3,000 399000 0 2,000 266000 0 2,000 266000 0 6,000 798000 0 0 0 13000 1729000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000 0 0 0 6000 636000

62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 3,000 486000 0 3,000 486000 0 1,000 162000 0 1,000 162000 0 0 0 8000 1296000
tablet 133 0 15,000 1995000 10,000 1330000 0 10,000 1330000 0 0 0 0 0 0 0 35000 4655000
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 2,800 298676 0 3,000 320010 0 5,000 533350 0 0 0 0 0 0 0 10800 1152036
silva 2015 136 0 0 0 0 0 0 2,000 271800 0 9,000 1223100 0 0 0 11000 1494900

botol 6,410 0 0 400 2564000 0 300 1923000 0 40 256400 0 200 1282000 0 0 0 940 6025400
68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 2,000 1098000 0 500 274500 0 500 274500 0 1,000 549000 0 0 0 4000 2196000
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 2,000 1606000 0 0 0 1,000 803000 0 2,000 1606000 0 0 0 5000 4015000
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 200 359600 0 100 179800 0 100 179800 0 300 539400 0 0 0 700 1258600
ampul 1,900 0 0 300 570000 0 200 380000 0 100 190000 0 100 190000 0 0 0 700 1330000
ampul/H baru 1,199
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 2,000 328000 0 700 114800 0 1,600 262400 0 0 0 0 0 4300 705200
tablet 51 5,000 255000 5,000 255000 10,000 510000 0 0 0 0 0 0 0 0 0 20000 1020000
tablet 178 0 0 0 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 5,000 823100 1,000 164620 6,000 987720 0 10,000 1646200 0 0 0 22000 3621640
silva/ 2015 165 0 0 0 0 0 0 0 0 13,000 2140060 0 0 0 13000 2140060
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0

76 botol 1,496 0 0 400 598400 0 300 448800 0 100 149600 0 300 448800 0 0 0 1100 1645600
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 500 1556500 0 400 1245200 0 200 622600 0 160 498080 0 0 0 1260 3922380
78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 2,000 616000 0 500 154000 0 1,000 308000 0 1,500 462000 0 0 0 5000 1540000
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 4,000 496000 10,000 1240000 0 4,000 496000 0 3,000 372000 0 5,000 620000 0 0 0 26000 3224000

82 Propanolol HCL 10 mg tablet 66 0 0 1,000 66000 0 0 0 0 0 0 0 0 0 1000 66000
tablet 191 0 0 0 0 0 1,000 190660 6,000 1143960 0 3,000 571980 0 0 0 10000 1906600
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 0 0 0 2000 381320
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 1,025 509425 0 0 0 1025 509425
botol 7,150 0 0 400 2860000 0 60 429000 0 200 1430000 0 200 1430000 0 0 0 860 6149000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600 0 0 0 100 693600
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0

89 Salbutamol tablet 2 mg tablet 78 0 0 2,000 156000 0 500 39000 0 1000 78000 0 3000 234000 0 0 0 6500 507000


93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 5 943315 0 5 943315 0 0 0 10 1886630
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 2,000 120000 0 1,000 60000 0 2,000 120000 0 8,000 480000 0 0 0 13000 780000
tablet 133 0 0 2,000 266000 0 0 0 0 0 0 0 0 0 2000 266000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000 0 0 0 15000 1755000
tablet 289 0 0 600 173400 0 0 0 0 0 0 0 0 0 600 173400
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 1,000 880000 0 2,000 1760000 0 2,000 1760000 0 0 0 5000 4400000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

99 Sanadryl Syrup botol 12,210 0 60 732600 100 1221000 0 0 0 0 0 0 0 0 0 160 1953600
100 Tetrasiklin 500 mg kapsul 319 0 4,000 1276000 3,000 957000 0 0 0 3,000 957000 0 7,000 2233000 0 0 0 17000 5423000
102 Vitamin B komplek Tablet tablet 121 0 6,000 726000 10,000 1210000 0 7,000 847000 0 7,000 847000 0 8,000 968000 0 0 0 38000 4598000
Botol 9,646 0 0 400 3858400 0 0 0 0 0 0 0 0 0 400 3858400

Botol 10,293 0 0 0 0 0 0 0 0 300 3087870 0 0 0 300 3087870
104 Zink Tablet Tablet 0 0 0 0 0 0 0 0 1,000 0 0 0 0 1000 0
botol 6,290 0 0 0 0 0 0 50 314500 0 100 629000 0 0 0 150 943500

3,322 0 0 0 0 30 99660 0 0 0 0 0 0 0 30 99660
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 5 95025 0 3 57015 0 10 190050 0 0 0 23 437115
buah 4,180 0 0 100 418000 0 50 209000 0 50 209000 0 100 418000 0 0 0 300 1254000
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 100 79200 0 0 0 0 0 0 0 0 0 0 100 79200
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 500 396000 0 0 0 500 396000 0 500 396000 0 0 0 1500 1188000
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 0 0 0 0 500 108000 0 0 0 1500 324000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 16 607200 0 0 0 0 0 0 0 0 0 0 16 607200
buah 45,183 0 0 0 0 0 0 24 1084392 0 24 1084392 0 0 0 48 2168784

buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0 0 0 12 542196
buah 32,491 0 0 0 0 0 0 24 779784 0 24 779784 0 0 0 48 1559568
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0 0 0 0 12 389892
buah 52,561 0 0 0 0 0 0 24 1261464 0 0 0 0 0 24 1261464

buah / bpjs 52,561 0 12 630732 0 0 0 0 0 0 0 0 0 0 12 630732
buah 51,022 0 0 0 0 0 0 24 1224528 0 0 0 0 0 24 1224528

buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0 0 0 12 612264
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 58 216398 0 0 0 0 0 0 0 0 0 0 58 216398
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 60 207000 0 0 0 0 0 0 0 0 0 0 60 207000
botol 28,750 0 0 0 0 5 143750 0 0 0 0 0 0 0 5 143750

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 16 460000 0 0 0 0 0 0 0 0 0 0 16 460000
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 300 2640000 0 0 0 0 0 0 0 0 0 0 300 2640000
set 3,850 0 0 50 192500 0 0 0 0 0 50 192500 0 0 0 100 385000

set / bpjs 2,831 0 25 70781 0 0 0 0 0 0 0 0 0 0 25 70781

set 3,520 0 0 100 352000 0 50 176000 0 50 176000 0 100 352000 0 0 0 300 1056000
set / bpjs 3,520 0 65 228800 0 0 0 0 0 0 0 0 0 0 65 228800
buah 13,750 0 0 0 0 10 137500 0 30 412500 0 20 275000 0 0 0 60 825000

buah / bpjs 13,750 0 30 412500 0 0 0 0 0 0 0 0 0 0 30 412500
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 25 750200 0 0 0 0 0 0 0 0 0 0 25 750200
rol 7,700 0 0 10 77000 0 0 0 0 0 0 0 0 0 10 77000

rol / bpjs 7,700 0 20 154000 0 0 0 0 0 0 0 0 0 0 20 154000
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 120 252000 0 0 0 0 0 0 0 0 0 0 120 252000
rol 1,650 0 0 50 82500 0 0 0 0 0 0 0 0 0 50 82500

rol / bpjs 1,650 0 120 198000 0 0 0 0 0 0 0 0 0 0 120 198000
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 120 99000 0 0 0 0 0 0 0 0 0 0 120 99000
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 320 2816000 0 0 0 0 0 0 0 0 0 0 320 2816000

botol 47,150 0 0 5 235750 0 0 0 0 0 5 235750 0 0 0 10 471500

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 100 36300 0 100 36300 0 0 0 0 0 0 0 200 72600

buah / bpjs - 0 1,000 0 0 0 0 0 0 0 0 0 0 0 1000 0

buah 363 0 0 300 108900 0 0 0 0 0 0 0 0 0 300 108900
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 50 21945 0 1,200 526680 0 0 0 1250 548625
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0 0 0 1,200 526680 0 0 0 1200 526680
buah 440 0 0 1,000 440000 0 0 0 700 308000 0 0 0 0 0 1700 748000

buah / bpjs 440 0 1,000 440000 0 0 0 0 0 0 0 0 0 0 1000 440000
rol 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 81,955 0 9 737599 0 0 0 0 0 0 0 0 0 0 9 737599
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 7 359135 0 0 0 0 0 0 0 0 0 0 7 359135

rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 28,286 0 7 198005 0 0 0 0 0 0 0 0 0 0 7 198005
botol 18,818 0 0 10 188182 0 0 0 0 0 10 188182 0 0 0 20 376364

botol / bpjs 18,818 0 30 564545 0 0 0 0 0 0 0 0 0 0 30 564545
botol 3,032 0 0 300 909546 0 0 0 0 0 0 0 0 0 300 909546

botol / bpjs 3,032 0 30 90955 0 0 0 0 0 0 0 0 0 0 30 90955
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 100 689500 0 0 0 0 0 0 0 0 0 0 100 689500

160 Sarung tangan M buah 471 0 0 0 0 0 200 94100 500 235250 0 0 0 0 0 700 329350
buah 36,582 0 0 0 0 0 0 12 438984 0 0 0 0 0 12 438984

161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0 0 0 0 0 0 0 0 12 438984
buah - 0 0 0 0 0 0 12 0 0 11 0 0 0 0 23 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0
163 Skin Celean 500 ml botol - 0 50 0 0 0 0 0 0 0 0 0 0 0 50 0
botol 14,472 0 0 0 0 0 0 0 0 12 173659 0 0 0 12 173659

165 USG GEL
botol / bpjs 14,472 0 17 246017 0 0 0 0 0 0 0 0 0 0 17 246017
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori 2 paket 1,259,990 0 0 0 0 0 0 0 0 2 2519980 0 0 0 2 2519980
182 GARAM ORALIT SACHET 303 0 0 0 0 500 151500 0 500 151500 0 500 151500 0 0 0 1500 454500
185 POT SPUTUM BUAH 2,950 0 0 0 500 1475000 0 0 0 0 0 0 0 0 500 1475000
188 Sarung tangan tanpa tepung M buah 583 0 1,000 583000 0 0 0 0 0 0 0 0 0 0 1000 583000
189 Lisol 100 % botol 47,150 0 3 141450 0 0 0 0 0 0 0 0 0 0 3 141450

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0 0 0 5 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 1 352000 0 2 704000 0 0 0 5 1760000
215 Articulating Pcs 181,500 0 0 0 0 0 0 1 181500 0 3 544500 0 0 0 4 726000


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 3 554100 0 0 0 3 554100

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 3 656100 0 0 0 3 656100

Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 100 311590 0 0 0 0 100 311590
tablet 367 0 0 0 0 0 0 0 130,000 47710000 0 0 0 0 130000 47710000

Provinsi 367 0 172,788 63413196 0 0 0 0 0 0 0 0 0 0 172788 63413196
buah/ skipa 1,240 570 706800 0 0 0 0 0 0 0 0 0 0 0 570 706800
237 Spuit 0,5 ml
buah / apbn 1,621 7268 11781428 0 0 0 0 0 0 0 0 0 0 0 7268 11781428
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 558 733770 0 0 0 0 0 0 0 0 0 0 0 558 733770
Spuit 5 ml APBN 1,705 25 42625 98 123
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 8 132864 0 0 0 0 0 0 0 0 0 0 0 8 132864

Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 0 0 8 0 0 0 4 0 0 0 0 0 0 12 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0


266 Handscoen boks - 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 15 899250 20 1199000 20 1199000 10 599500 20 1199000 20 1199000 15 899250 20 1199000 20 1199000 0 0 0 160 9592000
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 20 564080 0 0 0 0 0 0 40 1128160
270 MR VIAL 141,648 0 0 0 20 2832960 10 1416480 20 2832960 0 128 18130944 40 5665920 0 0 0 218 30879264
271 DPT-HB-Hib VIAL 76,285 80 6102800 30 2288550 40 3051400 70 5339950 70 5339950 80 6102800 80 6102800 70 5339950 80 6102800 0 0 0 600 45771000
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 80 1672000 70 1463000 30 627000 80 1672000 70 1463000 80 1672000 80 1672000 80 1672000 90 1881000 0 0 0 660 13794000
274 POLIO (BOPV) VIAL 19,954 60 1197240 40 798160 0 0 50 997700 70 1396780 70 1396780 70 1396780 80 1596320 0 0 0 440 8779760
275 POLIO (IPV) VIAL 13,976 25 349400 20 279520 20 279520 15 209640 15 209640 20 279520 25 349400 20 279520 25 349400 0 0 0 185 2585560
276 Td VIAL 16,500 20 330000 10 165000 20 330000 20 330000 20 330000 20 330000 15 247500 15 247500 10 165000 0 0 0 150 2475000
PELAPORAN : PUSKESMAS BIRU - BIRU 3 4 5 6 8 9 10
1 2 3 4 5 6 8 9 10
BIRU - BIRU BIRU - BIRU BIRU - BIRU BIRU - BIRU BIRU - BIRU BIRU - BIRU BIRU - BIRU BIRU - BIRU BIRU - BIRU BIRU - BIRU
HARGA
NO NAMA OBAT SATUAN
SATUAN
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER OKTOBER
1 Acyclovir 400 mg tablet tablet 359 0 0 0 0 0 0 0 0 0
2 Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 50 429000
tablet 93 0 0 2,000 186000 0 3,000 279000 0 3,000 279000 0 3,000 279000

silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730
4 Albendazole tablet 400 mg tablet 313 0 0 3,000 939000 0 2,000 626000 0 2,000 626000 0 0
tablet 88 0 0 3,000 264000 0 4,000 352000 0 3,000 264000 0 264000

5 Amlodipine 5 mg 3,000
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
6 kapsul 245 0 5,000 1225000 18,000 4410000 0 15,000 3675000 0 15,000 3675000 0 3675000
15,000
Amoksisilin 500 mg
kapsul 191 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 300 750000 0 300 750000 0 300 750000 0 0
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 120 440400

9 Antasida DOEN I Kombinasi tablet 63 0 0 0 0 10,000 630000 0 10,000 630000 0 10,000 630000
btl 60 ml 2,065 0 100 206500 300 619500 0 300 619500 0 400 826000 0 400 826000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 0 0 48 331440 0 48 331440 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 3,000 327000 3,000 327000 0 8,000 872000 0 7,000 763000 0 7,000 763000
tablet/ H Baru 446 0 0 0 0 5,000 2227500 3,000 1336500 7,000 3118500 0 0

tablet 176 3,000 528000 0 0 0 0 0 0 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 6,000 1822380
silva/ 2014 304 0 0 0 0 0 0 0 0 2,500 759325
JKN 2019 444 0 0 0 0 0 0 0 0 0

14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 0
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 150 731250 0 150 731250 0 150 731250 0 25 121875
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 0

17 Cetrizin tablet tablet 145 0 0 1,000 145000 0 0 0 1,000 145000 0 1,000 145000
18 Cetrizin syrup botol 2,900 0 0 0 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 2,000 2112000 0 3,000 3168000 0 2,000 2112000
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 48 86304 0 100 179800 0 100 179800 0 100 179800
botol 11,550 0 0 0 0 0 0 250 2887500 0 0
21
Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 100 1155000
Dextrofen syrup
JKN 2019 11,550 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 500 47300
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 3 5465
24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 100 288000 0 0 0 0 0 0
tablet 64 0 2,000 128000 5,000 320000 0 5,000 320000 0 8,000 512000 0 8,000 512000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 1,000 751000 2,000 1502000 0 2,000 1502000 0 3,000 2253000 0 2,000 1502000
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 0 0 0 0 0 0 0

tube 18,844 0 0 0 0 0 0 0 0 50 942200
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 0 0 0 0 0 0 0

tablet 436 0 0 500 218000 0 0 0 0 0 0
tablet/ H. baru 797 0 0 0 0 0 0 500 398495 0 500 398495
32 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 2,000 162000 0 0 0 0

33 Fenobarbital 30 mg tablet 180 0 0 0 0 0 0 0 0 0
34 Garam oralit 200 ml air bks 303 0 0 0 0 0 0 0 0 0
tablet 58 3,000 174000 0 2,000 116000 0 2,000 116000 0 4,000 232000 0 0
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 7,000 875000

silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000
36 botol 6,900 0 0 200 1380000 0 200 1380000 0 200 1380000 0 0

JKN 2019 7,363 0 0 0 0 0 0 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0 0 0 0
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 1,000 173990

39 Griseofulvin 125 mg Tablet tablet 240 0 0 1,000 240000 0 1,000 240000 0 1,000 240000 0 1,000 240000
40 Haloperidol tablet 0,5 mg tablet 62 0 0 100 6200 0 200 12400 0 200 12400 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 150 397500 0 150 397500 0 150 397500 0 100 265000
42 Hidrokloratiazid 25 mg tablet 156 0 0 0 0 0 0 0 0 0

tablet / H.Baru 437 0 0 1,000 437000 0 3,000 1311000 0 3,600 1573200 0 0
43 Hustab Tablet tablet 258 0 0 0 3,000 774000 0 0 0
tablet P 312 0 600 187200 0 0 0 0 0 0 0

botol/ H. Baru 11,550 0 0 0 0 400 4620000 0 350 4042500 0 300 3465000
JKN 11,550 0 0 0 0 0 0 0 0 0
44 Hustab syrup
44 Hustab syrup silva /2014 11,550 0 0 0 0 0 0 0 0 90 1039500
silva/ 2015 11,550 0 0 0 0 0 0 0 0 100 1155000

botol 8,046 0 100 804600 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 1,000 75000 0 200 15000 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 1,000 93000 0 1,000 93000 0 1,000 93000 0 0
47 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 30 1081080

48 Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 30 932400
Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 4,000 251960
49 Karbamazepin tablet 200 mg tablet 230 0 0 0 0 0 0 500 115000 0 0

50 Kaptopril 12,5 mg tablet 62 0 0 2,000 124000 0 1,000 62000 0 2,000 124000 0 0
51 Kaptopril 25 mg tablet 715 0 0 3,000 2145000 0 2,500 1787500 0 5,000 3575000 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 300 0 0 1,000 0 0 500 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 3,000 129000 5,000 215000 10,000 430000 0 10,000 430000 0 12,000 516000 0 12,000 516000
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 500 1091500 0 500 1091500 0 400 873200 0 0
55 tablet 154 0 1,000 154000 3,000 462000 0 3,000 462000 0 5,000 770000 0 7,000 1078000
APBD 2019 133 0 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 200 387400 0 200 387400 0 400 774800 0 0

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 500 40000 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0
tablet 133 0 0 1,000 133000 0 1,000 133000 0 2,000 266000 0 2,000 266000
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 1,000 2684000 0 300 805200 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 1,000 162000 0 1,000 162000 0 1,500 243000 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 2,000 246000 0 1,000 123000 0 2,000 246000 0 500 61500
tablet 133 0 0 15,000 1995000 0 0 0 0 0 0
tablet 264 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 300 1140000 0 300 1140000 0 300 1140000 0 0
66 Mikonazol Cream 2 % tube 3,410 0 0 150 511500 0 0 0 200 682000 0 150 511500
tablet 107 0 2,000 213340 2,000 213340 0 1,000 106670 0 0 0 0
67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 3,000 408000 0 5,000 680000
silva 2015 136 0 0 0 0 0 0 0 0 9,000 1223100

botol 6,410 0 0 40 256400 0 100 641000 0 200 1282000 0 0
68
Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 100 621800
APBD 2019 6,840 0 0 0 0 0 0 0 0 0

tablet 549 0 0 0 0 300 164700 0 300 164700 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0
tablet 803 0 0 2,000 1606000 0 1,000 803000 0 1,000 803000 0 0
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0
71 Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 500 1787500 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 0 0 0 0 100 179800 0 100 179800

ampul 1,900 0 0 200 380000 0 200 380000 0 0 0 0
ampul/H baru 1,199
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 2,000 328000 0 2,000 328000 0 2,000 328000 0 0
tablet 51 3,000 153000 5,000 255000 0 0 0 0 0 0 0
tablet 178 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 0 8,000 1316960 8,000 1316960 0 12,000 1975440
silva/ 2015 165 0 0 0 0 0 0 0 0 13,000 2140060

JKN 2019 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 300 448800 0 400 598400 0 200 299200
77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0 300 933900 0 0
78
Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0 0 0 0 0

79 Pirantel tablet score 125 mg tablet 308 0 0 140 43120 0 1,000 308000 0 1,000 308000 0 1,000 308000
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 5,000 620000 5,000 620000 0 5,000 620000 0 5,000 620000 0 7,000 868000
81 Prednison 5 mg Tablet tablet 96 0 0 0 0 0 0 0 0 0
82 Propanolol HCL 10 mg tablet 66 0 0 0 0 0 0 0 0 0

tablet 191 0 0 0 0 0 3,000 571980 3,000 571980 0 2,000 381320
tablet 226 0 0 0 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 1,500 990000
Silva 2014 191 0 0 0 0 0 0 0 0 2,200 419452
JKN 2019 225 0 0 0 0 0 0 0 0 0
84 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 954 474138
86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 9,129 0
botol 7,150 0 0 140 1001000 0 200 1430000 0 300 2145000 0 200 1430000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 1,000 78000 1,000 78000 0 1,000 78000 0 1000 78000 0 1,000 78000
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 20 80000 0 0 0 0 0 0

91 Salbutamol syrup botol 4,042 0 0 0 0 0 0 20 80836 0 0
92 Salisil Bedak 2,5% bks 1,046 0 0 0 0 0 0 0 0 0

93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 3 565989 0 3 565989
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 4,000 240000 0 4,000 240000 0 4,000 240000 0 4,000 240000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 200 233600 500 584000 0 300 350400 0 300 350400 0 200 233600
tablet 133 0 0 0 0 0 0 0 0 0
96 Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0 0 0 3,000 386100

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000
97 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 0
tablet 289 0 1,000 289000 0 0 0 0 3,000 867000 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 2,000 1760000 0 0 0 2,000 1760000

silva/ 2018 880 0 0 0 0 0 0 0 0 0
99 Sanadryl Syrup botol 12,210 0 200 2442000 0 0 0 0 0 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 3,000 957000 0 0 0 500 159500 0 2,000 638000
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 3,300 277200 0 5,000 420000 0 8,000 672000 0 0
102 Vitamin B komplek Tablet tablet 121 0 0 10,000 1210000 0 5,000 605000 0 8,000 968000 0 8,000 968000
Botol 9,646 0 0 0 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0
104 Zink Tablet Tablet 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 50 314500 0 0

3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 5 95025 0 2 38010 0 5 95025
BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0 0
107 Accu Check safe T Pro Uno Dus 127,050 0 1 127050 0 0 0 0 0 0 1 127050
108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 5 687500 0 0 0 0
109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 0 0 10 3685000 0 0 0 0
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 5 893750 0 0 0 0

111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 10 606364 0 5 303182
112 Abbocath No.20 G buah 4,180 0 0 200 836000 0 200 836000 0 100 418000 0 0
buah 4,180 0 0 200 836000 0 100 418000 0 100 418000 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 0 0 0 0 1,500 1188000 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 0 0 0 0 0 0 0

buah 216 0 0 0 0 100 21600 0 0 0 0
buah 197 0 0 0 0 0 0 0 0 0
122 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 0 0 12 542196

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 12 389892 0 24 779784 0 0
125 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 0 0 0 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 5 143750 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 50 192500
132 Infusion Set Anak set 2,831 0 0 0 0 0 0 0 0 0

set / bpjs 2,831 0 0 0 0 0 0 0 0 0
set 3,520 0 0 0 0 50 176000 0 50 176000 0 0

set / bpjs 3,520 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 20 275000 0 20 275000 0 20 275000 0 0

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 10 77000 0 0 0 0 0 0

rol / bpjs 7,700 0 50 385000 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 20 42000 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 800 7040000 0 0 0 0 0 0 0
142 Kasa Steril 40 x 40 buah 1,600 0 0 0 0 0 0 0 0 0
144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 3 141450 0 0 0 0 0 10 471500
145 Lisol 100 %
botol / bpjs 47,150 0 5 235750 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0
146 Masker Tie On buah 439 0 0 0 0 0 0 0 0 500 219450
buah / bpjs - 0 0 0 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 1,000 438900 0 0

buah 363 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 1,000 438900 0 500 219450
buah / bpjs 363 0 0 0 0 0 0 0 0 0
149 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0 0 0 0

buah 440 0 0 0 0 100 44000 0 0 0 0
buah / bpjs 440 0 0 0 0 0 0 0 0 0
151 My Jelly 82 gram tube - 0 0 0 0 0 0 0 0 0

152 Object Glass Kotak 19,365 0 0 0 0 0 0 0 0 0
153 One scrub 500 cc + dispenser botol 65,341 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 0 0 0 0 0 0 0
154 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0 0 10 470000 0 0

rol / bpjs 81,955 0 3 245866 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0

rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0

botol 18,818 0 0 0 0 0 0 0 0 10 188182
botol / bpjs 18,818 0 4 75273 0 0 0 0 0 0 0
botol 3,032 0 0 0 0 0 0 0 0 0
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0
159 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0

160 Sarung tangan M buah 471 0 0 0 0 0 0 500 235250 0 0
buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 12 0 0 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0
163 Skin Celean 500 ml botol - 0 0 0 0 0 0 0 0 0
164 Tranfusion Set buah 4,000 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 0 0 0 0 0

168 Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0
169 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0
170 Lise Samsung Unit 3,300,000 0 0 0 0 0 0 0 0 0
171 Rinse Mindrey galon 1,254,000 0 0 0 0 0 0 0 0 0

172 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0
173 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0
174 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0 0 0 0

175 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0 0 0 0
176 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0 0 0 0

177 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0 0 0 0 0
178 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0

179 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0
180 URID ACID (URICASE) Kit 799,700 0 0 0 0 0 0 0 0 0
181 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 3,000 909000 0 1,500 454500 0 0
183 ZINC Tablet TABLET 539 0 599 322861 0 0 0 0 0 0 0

184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 0 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0
187 Tuberculin PPD Vial 702,250 0 0 0 0 3 2106750 0 0 0 0

188 Sarung tangan tanpa tepung M buah 583 0 1,000 583000 0 0 0 0 0 0 0
189 Lisol 100 % botol 47,150 0 3 141450 0 0 0 0 0 0 0
190 Reagen Ziehl Neelsen kit 181,811 0 0 0 0 0 0 0 0 0

191 Masker 3 Ply Earloop Jilbab buah - 0 1,250 0 0 0 0 0 0 0 0
192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0

194 Imersion Oil Botol 3,181,818 0 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0
195 KAPAS LIDI Bungkus - 0 0 1 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0

197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0
Program Imunisasi 1,404 0 0 0 0 0 0 0 0 0

199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 170 208250 0 0
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 3,731 6159881 0 0
201 Safety Box 5 liter box - 0 0 0 0 0 0 39 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0
203 BD Vacuntainer box - 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0

206 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 0 0 0 0 0 0
207 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0 0 0

208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0 0 0
209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0 0 0 0

210 Sarung tangan L buah 499 0 0 0 0 0 0 0 0 0
211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 125 0 0

212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0 0 0
213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 1 352000 0 2 704000

215 Articulating Pcs 181,500 0 0 0 0 0 0 0 0 2 363000
216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0 0 2 880094
217 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0 0 0 2 381032
219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0 0 2 329547
220 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0 0 0 0 2 93400

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 2 369400
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0 0 2 133400
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 2 437400

225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0 0 2 196400
OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 0 16 5236144 0 32 10472288 0 0 0 0
227 OAT FDC Kategori 2 paket 1,259,990 0 0 0 0 0 0 0 0 0
228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 0 0 0 0 0 0
229 OAT FDC Kategori Anak paket 203,259 0 0 0 0 5 1016295 0 0 0 0

230 RH ( Fase Lanjutan ) paket - 0 0 3,360 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 500 1557950 0
tablet 367 0 0 0 0 0 0 0 121,000 44407000 0

Provinsi 367 0 160,748 58994516 0 0 0 0 0 0 0
Program Imunisasi - 0 0 0 0 0 0 0 0 0
buah/ skipa 1,240 531 658440 0 0 0 0 0 0 0 0
237 Spuit 0,5 ml
buah / apbn 1,621 6763 10962823 0 0 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 520 683800 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 23 39215 87 148335
Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 7 116256 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0
241 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0 0 0

242 Primaquin TABLET 235 0 0 0 0 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 0 0 0 0 0 0 0
246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0 0 0 0

247 Fluconazol tablet TABLET - 0 0 0 0 0 0 0 0 0
248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0

251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 0 0 0 0 100 2233000 0

253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0 0 0
254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 0 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0 0 0
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0

257 Yellow Tips bungkus - 0 0 0 0 0 0 0 0 0
258 Blue Tips bungkus - 0 0 0 0 0 0 0 0 0
259 Metilen Blue botol 94,500 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0

263 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0 0 0
264 Object Glass Kotak - 0 0 0 0 0 0 0 0 0
265 Cover Glass Kotak - 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0

267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 15 899250 15 899250 15 899250 15 899250 15 899250 25 1498750 25 1498750 20 1199000 20 1199000
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 0 0 0 0

270 MR VIAL 141,648 0 0 10 1416480 20 2832960 10 1416480 30 4249440 35 4957680 30 4249440 117 16572816
271 DPT-HB-Hib VIAL 76,285 60 4577100 55 4195675 60 4577100 60 4577100 50 3814250 65 4958525 65 4958525 65 4958525 70 5339950
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 60 1254000 60 1254000 60 1254000 60 1254000 60 1254000 70 1463000 70 1463000 70 1463000 70 1463000
274 POLIO (BOPV) VIAL 19,954 65 1297010 70 1396780 0 0 50 997700 60 1197240 65 1297010 65 1297010 60 1197240
275 POLIO (IPV) VIAL 13,976 15 209640 20 279520 20 279520 20 279520 15 209640 30 419280 30 419280 20 279520 20 279520
276 Td VIAL 16,500 15 247500 15 247500 20 330000 20 330000 20 330000 20 330000 20 330000 20 330000 30 495000
11 12
11 12
BIRU - BIRU BIRU - BIRU BIRU - BIRU TOTAL

TOTAL
HARGA
KELUAR
TOTAL TOTAL TOTAL KELUAR
JUMLAH JUMLAH
HARGA HARGA HARGA
OKTOBER NOPEMBER DESEMBER
0 0 0 0 0
0 0 0 50 429000
0 0 0 11000 1023000
0 0 0 6000 5672730
0 0 0 7000 2191000
0 0 0 13000 1144000
0 0 0 0 0
0 0 0 68000 16660000
0 0 0 0 0
0 0 0 900 2250000
0 0 0 120 440400
0 0 0 30000 1890000
0 0 0 1500 3097500
0 0 0 0 0
0 0 0 96 662880
0 0 0 28000 3052000
0 0 0 15000 6682500
0 0 0 3000 528000
0 0 0 6000 1822380
0 0 0 2500 759325
0 0 0 0 0
0 0 0 0 0
0 0 0 475 2315625
0 0 0 0 0
0 0 0 3000 435000
0 0 0 0 0
0 0 0 9000 9504000
0 0 0 348 625704
0 0 0 250 2887500
0 0 0 100 1155000
0 0 0 0 0
0 0 0 0 0
0 0 0 500 47300
0 0 0 3 5465
0 0 0 100 288000
0 0 0 28000 1792000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 10000 7510000
0 0 0 0 0
0 0 0 50 942200
0 0 0 0 0
0 0 0 0 0
0 0 0 500 218000
0 0 0 1000 796990
0 0 0 4000 324000
0 0 0 0 0
0 0 0 0 0
0 0 0 11000 638000
0 0 0 7000 875000
0 0 0 9000 1125000
0 0 0 6000 750000
0 0 0 600 4140000
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 173990
0 0 0 4000 960000
0 0 0 500 31000
0 0 0 550 1457500
0 0 0 0 0
0 0 0 7600 3321200
0 0 0 3000 774000
0 0 0 600 187200
0 0 0 1050 12127500
0 0 0 0 0
0 0 0 90 1039500
0 0 0 100 1155000
0 0 0 100 804600
0 0 0 1200 90000
0 0 0 3000 279000
0 0 0 30 1081080
0 0 0 30 932400
0 0 0 251960
0 0 0 500 115000
0 0 0 5000 310000
0 0 0 10500 7507500
0 0 0 1800 0
0 0 0 52000 2236000
0 0 0 1400 3056200
0 0 0 19000 2926000
0 0 0
0 0 0 0 0
0 0 0 800 1549600
0 0 0 0 0
0 0 0 500 40000
0 0 0 0 0
0 0 0 6000 798000
0 0 0 0 0
0 0 0 6000 636000
0 0 0 6000 636000
0 0 0 1300 3489200
0 0 0 3500 567000
0 0 0 5500 676500
0 0 0 15000 1995000
0 0 0 0 0
0 0 0 900 3420000
0 0 0 500 1705000
0 0 0 5000 533350
0 0 0 8000 1088000
0 0 0 9000 1223100
0 0 0 340 2179400
0 0 0 100 621800
0 0 0 0
0 0 0 600 329400
0 0 0 0 0
0 0 0 4000 3212000
0 0 0 0 0
0 0 0 500 1787500
0 0 0 200 359600
0 0 0 400 760000
0 0 0 6000 984000
0 0 0 8000 408000
0 0 0
0 0 0 28000 4609360
0 0 0 13000 2140060
0 0 0 0
0 0 0 1400 2094400
0 0 0 0 0
0 0 0 300 933900
0 0 0 0 0
0 0 0 0
0 0 0 3140 967120
0 0 0 27000 3348000
0 0 0 0 0
0 0 0 0 0
0 0 0 8000 1525280
0 0 0 0 0
0 0 0 1500 990000
0 0 0 2200 419452
0 0 0 0
0 0 0 0 0
0 0 0 954 474138
0 0 0 9129 0
0 0 0 840 6006000
0 0 0 100 693600
0 0 0 0 0
0 0 0 5000 390000
0 0 0 20 80000
0 0 0 20 80836
0 0 0 0 0
0 0 0 6 1131978
0 0 0 16000 960000
0 0 0 1500 1752000
0 0 0 0 0
0 0 0 3000 386100
0 0 0 15000 1755000
0 0 0 0 0
0 0 0 4000 1156000
0 0 0 4000 3520000
0 0 0 0 0
0 0 0 200 2442000
0 0 0 5500 1754500
0 0 0 16300 1369200
0 0 0 31000 3751000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 314500
0 0 0 0 0
0 0 0 0 0
0 0 0 17 323085
0 0 0 0 0
0 0 0 2 254100
0 0 0 5 687500
0 0 0 10 3685000
0 0 0 5 893750
0 0 0 15 909545
0 0 0 500 2090000
0 0 0 400 1672000
0 0 0 450 1881000
0 0 0 400 1672000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1500 1188000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 21600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 12 542196
0 0 0 0 0
0 0 0 36 1169676
0 0 0 0 0
0 0 0 12 389892
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 12 612264
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 143750
0 0 0 5 143750
0 0 0 0 0
0 0 0 0 0
0 0 0 50 192500
0 0 0 0 0
0 0 0 0 0
0 0 0 100 352000
0 0 0 0 0
0 0 0 60 825000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 10 77000
0 0 0 50 385000
0 0 0 0 0
0 0 0 20 42000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 800 7040000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 13 612950
0 0 0 5 235750
0 0 0 0 0
0 0 0 500 219450
0 0 0 0 0
0 0 0 1000 438900
0 0 0 0 0
0 0 0 1500 658350
0 0 0 0 0
0 0 0 0 0
0 0 0 100 44000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 10 470000
0 0 0 3 245866
0 0 0 0 0
0 0 0 10 300000
0 0 0 0 0
0 0 0 0 0
0 0 0 10 165000
0 0 0 0 0
0 0 0 10 188182
0 0 0 4 75273
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 235250
0 0 0 0 0
0 0 0 0 0
0 0 0 12 0
0 0 0 12 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 4500 1363500
0 0 0 599 322861
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 2106750
0 0 0 1000 583000
0 0 0 3 141450
0 0 0 0 0
0 0 0 1250 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 0
0 0 0 5 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 170 208250
0 0 0 3731 6159881
0 0 0 39 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 125 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 4 1408000
0 0 0 2 363000
0 0 0 2 880094
0 0 0 2 381032
0 0 0 2 381032
0 0 0 2 329547
0 0 0 2 93400
0 0 0 2 93400
0 0 0 2 369400
0 0 0 2 133400
0 0 0 2 437400
0 0 0 2 196400
0 0 0 0 0
0 0 0 0 0
0 0 0 48 15708432
0 0 0 0 0
0 0 0 0 0
0 0 0 5 1016295
0 0 0 3360 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 1557950
0 0 0 121000 44407000
0 0 0 160748 58994516
0 0 0 0 0
0 0 0 531 658440
0 0 0 6763 10962823
0 0 0 0 0
0 0 0 520 683800
110
0 0 0 0 0
0 0 0 7 116256
0 0 0 2 33216
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 48 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 2233000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 165 9891750
0 0 0 20 564080
0 0 0 252 35695296
0 0 0 550 41956750
0 0 0 0 0
0 0 0 580 12122000
0 0 0 435 8679990
0 0 0 190 2655440
0 0 0 180 2970000
PELAPORAN : PUSKESMAS TALUN KENAS 3 4 5 6 8 9 10 11
1 2 3 4 5 6 8 9 10 11
TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS TALUN KENAS
NO NAMA OBAT SATUAN HARGA SATUAN
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER OKTOBER NOPEMBER
1 Acyclovir 400 mg tablet tablet 359 0 0 310 111290 0 0 0 0 0 0 0 0
2 Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 50 429000 0 0
tablet 93 0 0 3,000 279000 0 3,000 279000 0 3,000 279000 0 3,000 279000 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 6,000 5672730 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 3,000 939000 0 1,000 313000 0 1,000 313000 0 800 250400 0 0
tablet 88 0 0 4,000 352000 0 4,000 352000 0 2,000 176000 0 237600 0 0

5 Amlodipine 5 mg 2,700
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 191 0 4,000 764000 25,000 4775000 0 25,000 4775000 0 20,000 3820000 0 0 0 0
Amoksisilin 500 mg kapsul 245 0 0 0 0 6125000 0 0

25,000
kapsul 260 0 0 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 500 1250000 0 600 1500000 0 400 1000000 0 500 1250000 0 0
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 180 660600 0 0

9 Antasida DOEN I Kombinasi tablet 63 0 2,000 126000 10,000 630000 0 10,000 630000 0 10,000 630000 0 10,000 630000 0 0
btl 60 ml 2,065 0 0 300 619500 0 300 619500 0 300 619500 0 300 619500 0 0
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 12,000 1308000 0 12,000 1308000 0 10,000 1090000 0 12,000 1308000 0 0
tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 10,000 4455000 0 0 0 0
tablet 176 0 2,000 352000 2,000 352000 0 0 0 0 0 0 0 0

13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 6,000 1822380 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 2,500 759325 0 0

JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 50 148800 0 0

15 Betametason krim 0,1% 5 gr tube 4,875 0 0 300 1462500 0 300 1462500 0 50 243750 0 100 487500 0 0
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 300 71070 0 0
17 Cetrizin tablet tablet 145 0 0 4,000 580000 0 0 0 4,000 580000 0 3,000 435000 0 0

19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 1,000 1056000 3,000 3168000 0 3,000 3168000 0 3,000 3168000 0 1,700 1795200 0 0
botol 11,550 0 0 0 0 0 0 200 2310000 0 0 0 0

21
Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 500 47300 0 0
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 3 5465 0 0

24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 100 288000 400 1152000 0 0 0 0 0 0 0 0
tablet 64 0 0 7,000 448000 0 7,000 448000 0 6,000 384000 0 7,000 448000 0 0

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 500 53000 0 0 0 0 0 0 0 0

DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 300 706200 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 5,000 3755000 0 5,000 3755000 0 3,000 2253000 0 2,000 1502000 0 0
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 400 2746800 0 0 0 0 0 0 0 0
tube 18,844 0 0 0 0 0 0 0 100 1884400 0 0

Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 300 1250100 0 150 625050 0 0 0 0 0 0
tablet 436 0 0 2,000 872000 0 2,300 1002800 0 0 0 0 0 0
tablet/ H. baru 797 0 0 0 0 0 0 1,000 796990 0 800 637592 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 3,000 243000 0 2,000 162000 0 2,000 162000 0 2,000 162000 0 0
33 Fenobarbital 30 mg tablet 180 0 0 0 0 0 0 0 0 0 0 0

34 Garam oralit 200 ml air bks 303 0 0 700 212100 0 0 0 0 0 0 0 0
tablet 58 0 0 4,000 232000 0 4,000 232000 0 4,000 232000 0 0 0 0

tablet/ H. Baru 125 0 0 0 0 0 0 0 0 3,000 375000 0 0
silva 2015 125 0 0 0 0 0 0 0 0 9,000 1125000 0 0
silva 2014 125 0 0 0 0 0 0 0 0 6,000 750000 0 0
36 botol 6,900 0 0 500 3450000 0 200 1380000 0 200 1380000 0 60 414000 0 0

JKN 2019 7,363 0 0 0 0 0 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0 0 0 0 0 0
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 500 86995 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 3,000 720000 0 2,000 480000 0 2,000 480000 0 1,700 408000 0 0
40 Haloperidol tablet 0,5 mg tablet 62 0 0 3,000 186000 0 0 0 0 0 0 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 200 530000 0 200 530000 0 200 530000 0 200 530000 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 2,000 312000 0 2,000 312000 0 0 0 0
tablet / H.Baru 437 0 0 8,000 3496000 0 10,800 4719600 0 10,000 4370000 0 10,000 4370000 0 0
43 Hustab Tablet tablet 258 0 0 0 2,000 516000 0 0 0 0 0

tablet P 312 0 2,000 624000 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 45 519750 0 300 3465000 0 0 0 200 2310000 0 0

JKN 11,550 0 0 0 0 0 0 0 0 0
44 Hustab syrup silva /2014 11,550 0 0 0 0 0 0 300 3465000 0 90 1039500 0 0

silva/ 2015 11,550 0 0 0 0 0 0 0 0 100 1155000 0 0
botol 8,046 0 0 0 0 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 2,000 186000 0 0 0 2,000 186000 0 0
47 Iliadin Spray botol 36,036 0 0 0 0 0 0 1,000 36036000 0 0 0 0
48 Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 0 0 0
Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 5,000 314950 0 0
49 Karbamazepin tablet 200 mg tablet 230 0 0 4,000 920000 0 4,000 920000 0 0 0 500 115000 0 0
50 Kaptopril 12,5 mg tablet 62 0 0 3,000 186000 0 3,000 186000 0 0 0 2,700 167400 0 0
51 Kaptopril 25 mg tablet 715 0 0 3,000 2145000 0 3,000 2145000 0 3,000 2145000 0 3,000 2145000 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 2,000 0 0 2,000 0 0 2,000 0 0 1,000 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 10,000 430000 0 10,000 430000 0 0 0 15,000 645000 0 0
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 600 1309800 0 600 1309800 0 15,000 32745000 0 200 436600 0 0
55 tablet 154 0 0 8,000 1232000 0 8,000 1232000 0 400 61600 0 5,000 770000 0 0
APBD 2019 133 0 0 0 0 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 400 230000 0 1,500 862500 0 0 0 0 0 0
ampul 1,937 0 0 500 968500 0 500 968500 0 0 0 300 581100 0 0

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 200 2420000 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 2,000 160000 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 30 96000 0 0 0 0 0 0 0 0

tablet 133 0 0 3,000 399000 0 3,000 399000 0 3,000 399000 0 3,600 478800 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 6,000 636000 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 6,000 636000 0 0

61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 800 2147200 0 500 1342000 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 3,000 486000 0 2,000 324000 0 1,000 162000 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 3,000 369000 0 3,000 369000 0 1,000 123000 0 147600 0 0
1,200
tablet 133 0 0 20,000 2660000 0 20,000 2660000 0 0 0 0 0 0
tablet 264 0 0 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 400 1520000 0 300 1140000 0 0 0 200 760000 0 0
66 Mikonazol Cream 2 % tube 3,410 0 0 200 682000 0 200 682000 0 100 341000 0 0 0 0
tablet 107 0 0 5,000 533350 0 4,000 426680 0 0 0 0 0 0
67 Natrium Diklofenak tablet 50 mg

67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 4,000 544000 0 5,200 707200 0 0
silva 2015 136 0 0 0 0 0 0 0 0 9,000 1223100 0 0

botol 6,410 0 0 500 3205000 0 300 1923000 0 200 1282000 0 140 897400 0 0
68
Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 1,000 549000 0 500 274500 0 0 0 1,000 549000 0 0

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 2,000 1606000 0 500 401500 0 0 0 1,000 803000 0 0

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0
71 Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 200 715000 0 0 0 0

ampul 1,900 0 0 1,000 1900000 0 800 1520000 0 200 380000 0 100 190000 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 1,000 164000 6,000 984000 4,000 656000 3,000 492000
tablet 51 0 3,000 153000 15,000 765000 0 0 0 0 0 0 0 0

tablet 178 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 5,000 823100 0 10,000 1646200 0 10,000 1646200 0 0
silva/ 2015 165 0 0 0 0 0 0 0 0 13,000 2140060 0 0
JKN 2019 165 0 0 0 0
76 botol 1,496 0 0 600 897600 0 600 897600 0 600 897600 0 500 748000 0 0
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 400 1245200 0 200 622600 0 100 311300 0 0
78
Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 3,000 924000 0 2,000 616000 0 2,000 616000 0 1,000 308000 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 10,000 1240000 0 10,000 1240000 0 0 0 5,000 620000 0 0
81 Prednison 5 mg Tablet tablet 96 0 0 0 0 0 0 0 0 0 0 0
82 Propanolol HCL 10 mg tablet 66 0 0 200 13200 0 0 0 0 0 0 0 0
tablet 191 0 0 0 0 0 0 0 0 3,000 571980 0 0
tablet 226 0 0 0 0 0 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 1,500 990000 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 2,000 381320 0 0

JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0
84 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 50 59400 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 1,000 497000 0 0 0 150 74550 0 856 425432 0 0
86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 8,225 0 0 0
botol 7,150 0 0 500 3575000 0 500 3575000 0 400 2860000 0 500 3575000 0 0
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 100 693600 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 3,000 234000 0 3,000 234000 0 2000 156000 0 0 0 0
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 200 800000 0 290 1160000 0 0 0 0 0 0
91 Salbutamol syrup botol 4,042 0 0 0 0 0 0 0 0 100 404182 0 0

92 Salisil Bedak 2,5% bks 1,046 0 0 9 9414 0 0 0 0 0 0 0 0
93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 10 1886630 0 5 943315 0 0

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 5,000 300000 0 5,000 300000 0 4,000 240000 0 3,000 180000 0 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 1,000 1168000 0 500 584000 0 1,000 1168000 0 0
tablet 133 0 0 2,000 266000 0 0 0 0 0 0 0 0
96 Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0 0 0 1,000 128700 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 15,000 1755000 0 0
97 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 500 63000 0 0
tablet 289 0 0 4,000 1156000 0 0 0 0 0 0 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 3,000 2640000 0 3,000 2640000 0 3,000 2640000 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0
99 Sanadryl Syrup botol 12,210 0 100 1221000 200 2442000 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 7,000 2233000 0 0 0 5,000 1595000 0 2,000 638000 0 0
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 10,000 840000 0 6,000 504000 0 5,000 420000 0 6,000 504000 0 0
102 Vitamin B komplek Tablet tablet 121 0 0 10,000 1210000 0 10,000 1210000 0 10,000 1210000 0 11,000 1331000 0 0
Botol 9,646 0 0 600 5787600 0 160 1543360 0 0 0 0 0 0

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0
104 Zink Tablet Tablet 0 0 0 0 0 0 0 0 2,500 0 0 0

botol 6,290 0 0 200 1258000 0 0 0 50 314500 0 25 157250 0 0
3,322 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 10 190050 0 0 0 0 0 3 57015 0 0
BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0 0 0 0
107 Accu Check safe T Pro Uno Dus 127,050 0 0 0 0 0 0 0 0 2 254100 0 0

108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 5 687500 0 0 0 5 687500 0 0
109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 0 0 10 3685000 0 0 0 5 1842500 0 0
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 5 893750 0 0 0 5 893750 0 0
111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 10 606364 0 13 788273 0 0

buah 4,180 0 0 200 836000 0 200 836000 0 200 836000 0 50 209000 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,500 1188000 0 300 237600 0 500 396000 0 600 475200 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 300 247500 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 500 108000 0 500 108000 0 500 108000 0 0
buah 197 0 0 0 0 0 0 0 0 0 0 0
122 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 2 75900 0 0 0 0 0 0

botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 12 542196 0 12 542196 0 0 0 0

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 12 389892 0 12 389892 0 12 389892 0 0

125 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 12 630732 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 500 1725000 0 0 0 0 0 0 0 0

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 10 287500 0 10 287500 0 1 28750 0 0 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 100 385000 0 0 0 50 192500 0 0 0 0
132 Infusion Set Anak set 2,831 0 0 0 0 100 283126 0 0 0 0 0 0

set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 200 704000 0 200 704000 0 200 704000 0 0 0 0

set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 20 275000 0 20 275000 0 20 275000 0 0 0 0

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 5 136400 0 5 136400 0 0 0 0 0 0

buah 30,008 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 100 770000 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 1 7700 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 60 99000 0 0 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 1,000 825000 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 320 2816000 0 0 0 0 0 0 0 0 0
142 Kasa Steril 40 x 40 buah 1,600 0 0 0 0 0 0 0 0 0 0 0
143 Kasa Steril 5 x 5 buah 3,181 0 0 0 0 0 0 0 0 0 0 0

144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0 0 0 50 0 0 0
botol 47,150 0 0 5 235750 0 5 235750 0 0 0 10 471500 0 0
145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 500 181500 0 100 36300 0 0 0 0 0 0
146 Masker Tie On buah 439 0 0 0 0 0 0 100 43890 0 100 43890 0 0

buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 0 0 0 0 0

buah 363 0 0 200 72600 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 0 0 750 329175 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0
149 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0 0 0 600 263340 0 0
buah 440 0 0 1,000 440000 0 500 220000 0 500 220000 0 0 0 0
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0
151 My Jelly 82 gram tube - 0 0 0 0 0 0 0 0 0 0 0
152 Object Glass Kotak 19,365 0 0 0 0 0 0 0 0 0 0 0
153 One scrub 500 cc + dispenser botol 65,341 0 0 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 10 819555 0 0 0 0 0 0 0 0
154 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0 0 5 235000 0 0 0 0
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0

rol 28,286 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 12 225818 0 0 0 0 0 0 0 0

botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 200 606364 0 0 0 0 0 0 0 0

botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0
159 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 450 3102750 0 0 0 0 0 0 0 0 0

160 Sarung tangan M buah 471 0 0 0 0 0 0 500 235250 0 0 0 0
buah 36,582 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0
163 Skin Celean 500 ml botol - 0 0 0 0 0 0 0 0 0 0 0

164 Tranfusion Set buah 4,000 0 0 0 0 5 20000 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 0 0 0 0 0 0 0
168 Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0 0 0

169 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 0 0 0 0 0
170 Lise Samsung Unit 3,300,000 0 0 0 0 0 0 0 0 0 0 0

171 Rinse Mindrey galon 1,254,000 0 0 0 0 0 0 0 0 0 0 0
172 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0

173 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0 0
174 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0 0 0 0 0 0
175 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0 0 0 0 0 0
176 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0 0 0 0 0 0
177 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0 0 0 0 0 0 0
178 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0

179 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0 0
180 URID ACID (URICASE) Kit 799,700 0 0 0 0 0 0 0 0 0 0 0

181 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 500 151500 0 0 0 0 0 0

183 ZINC Tablet TABLET 539 0 539 290521 0 0 0 0 0 0 0 0 0
184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 0 0 0 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 500 1475000 0 0 0 0 0 0 0 0 0

187 Tuberculin PPD Vial 702,250 0 0 0 0 0 0 0 0 0 0 0
188 Sarung tangan tanpa tepung M buah 583 0 1,000 583000 0 0 0 0 0 0 0 0 0
189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0
190 Reagen Ziehl Neelsen kit 181,811 0 0 0 0 0 0 0 0 0 0 0
191 Masker 3 Ply Earloop Jilbab buah - 0 1,250 0 0 0 0 0 0 0 0 0 0
192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0
194 Imersion Oil Botol 3,181,818 0 0 0 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0
195 KAPAS LIDI Bungkus - 0 0 1 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0 0

197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0

Program Imunisasi 1,404 0 0 0 0 0 0 0 0 0 0 0
199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 15 18375 0 0 0 0
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 3,407 5624957 0 0 0 0
201 Safety Box 5 liter box - 0 0 0 0 0 0 35 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0
203 BD Vacuntainer box - 0 0 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0

206 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 0 0 0 0 0 0 0 0

207 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0 0 0 0 0
208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0 0 0 0 0

209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0 0 0 0 0 0
210 Sarung tangan L buah 499 0 0 0 0 0 0 0 0 0 0 0

211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 75 0 0 0 0
212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0 0 0 0 0
213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 0 0 0 0 0
215 Articulating Pcs 181,500 0 0 0 0 0 0 0 0 0 0 0

216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0 0 0 0 0
217 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0 0 0 0 0 0

218 1470A2 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0 0 0 0 0 0
219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0 0 0 0 0

220 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0 0 0 0 0 0 0
221 Guta Percha Point #45-80 Box 46,700 0 0 0 0 0 0 0 0 0 0 0

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0
225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 16 5236144 0 0 16 5236144 0 0 0 0 0 0
227 OAT FDC Kategori 2 paket 1,259,990 0 1 1259990 0 0 0 0 0 0 0 0 0

228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 0 0 0 0 0 0 0 0
229 OAT FDC Kategori Anak paket 203,259 0 0 0 0 0 0 0 0 0 0 0

230 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0

232 REAGEN TB PARU KIT 276,500 0 0 0 0 30 8295000 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 500 1557950 0 0 0
tablet 367 0 0 0 0 0 0 0 108,600 39856200 0 0 0

Provinsi 367 0 144,752 53123984 0 0 0 0 0 0 0 0 0
Program Imunisasi - 0 0 0 0 0 0 0 0 0 0 0
buah/ skipa 1,240 477 591480 0 0 0 0 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 6070 9839470 0 0 0 0 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 466 612790 0 0 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 21 35805 130 221650
Box 16,608 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 6 99648 0 0 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0

240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0
241 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0 0 0 0 0
242 Primaquin TABLET 235 0 0 0 0 0 0 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 4 0 20 0 20 0 8 0 8 0 8 0 8 0 20 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0

246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 0 0 0 0 0 0 0 0 0 0

248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0

250 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0 0 0 0 0
252 Rapid Test II ( FOKUS ) Test 13,615 0 0 0 0 0 0 0 0 0 0 0
253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0 0 0 0 0
254 Rapid Test Sifilis (Hexagon) Test 13,407 60 804420 0 0 0 0 0 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0 0 0 0 0

256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0

258 Blue Tips bungkus - 0 0 0 0 0 0 0 0 0 0 0
259 Metilen Blue botol 94,500 0 0 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0
263 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0 0 0 0 0

264 Object Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0
265 Cover Glass Kotak - 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 3 0 0 0 0 0 0 0 1 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 20 0 15 0 15 0 15 0 20 599500 15 0 15 1798500 15 899250 0 0 0
269 CAMPAK VIAL 28,204 564080 282040 564080 423060 10 564080 423060 30 0 0 0 0 0
270 MR VIAL 141,648 10 0 10 7082400 20 7082400 30 0 20 5665920 30 0 9915360 0 0 0 0
271 DPT-HB-Hib VIAL 76,285 70 762850 50 0 50 0 70 2288550 40 0 35 2288550 70 0 65 4958525 0 0 0

272 DT (BIAS) VIAL 17,798 1245860 1067880 1067880 1245860 1245860 622930 1067880 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 70 0 60 1045000 60 0 60 0 70 836000 65 0 60 1358500 50 1045000 0 0 0

274 POLIO (BOPV) VIAL 19,954 70 1396780 50 299310 399080 1197240 40 399080 50 1297010 65 399080 65 1297010 0 0 0
275 POLIO (IPV) VIAL 13,976 20 978320 15 139760 20 139760 20 0 20 279520 20 698800 20 279520 15 209640 0 0 0
276 Td VIAL 16,500 10 330000 10 0 10 0 20 330000 20 0 20 330000 20 0 20 330000 0 0 0

12
12
TALUN KENAS TOTAL

TOTAL
HARGA
KELUAR
TOTAL KELUAR
JUMLAH
HARGA
DESEMBER
0 310 111290
0 50 429000
0 12000 1116000
0 6000 5672730
0 5800 1815400
0 12700 1117600
0 0 0
0 74000 14134000
0 2000 5000000
0 180 660600
0 42000 2646000
0 1200 2478000
0 0 0
0 572 3949660
0 46000 5014000
0 15000 6682500
0 4000 704000
0 6000 1822380
0 2500 759325
0 0
0 50 148800
0 750 3656250
0 300 71070
0 11000 1595000
0 210 609000
0 11700 12355200
0 800 1438400
0 200 2310000
0 100 1155000
0 0
0 0 0
0 500 47300
0 3 5465
0 500 1440000
0 27000 1728000
0 0 0
0 500 53000
0 0 0
0 0
0 300 706200
0 15000 11265000
0 400 2746800
0
0
0 450 1875150
0 4300 1874800
0 1800 1434582
0 9000 729000
0 0 0
0 700 212100
0 12000 696000
0 3000 375000
0 9000 1125000
0 6000 750000
0 960 6624000
0
0 0 0
0 500 86995
0 8700 2088000
0 3000 186000
0 800 2120000
0 7000 1092000
0 38800 16955600
0 2000 516000
0 2000 624000
0 545 6294750
0
0 390 4504500
0 100 1155000
0 0 0
0 0 0
0 6000 558000
0 1000 36036000
0 0 0
0 314950
0 8500 1955000
0 8700 539400
0 12000 8580000
0 7000 0
0 35000 1505000
0 16400 35801200
0 21400 3295600
0
0 1900 1092500
0 1300 2518100
0 200 2420000
0 2000 160000
0 30 96000
0 12600 1675800
0 0 0
0 6000 636000
0 6000 636000
0 1300 3489200
0 6000 972000
0 8200 1008600
0 40000 5320000
0 0 0
0 900 3420000
0 500 1705000
0 9000 960030
0 9200 1251200
0 9000 1223100
0 1140 7307400
0 0 0
0 0
0 2500 1372500
0 0 0
0 3500 2810500
0 0 0
0 200 715000
0 1150 2067700
0 2100 3990000
0 0 0
14000 2296000
0 18000 918000
0
0 25000 4115500
0 13000 2140060
0 2300 3440800
0 0 0
0 1100 3424300
0 0 0
0 0
0 8000 2464000
0 25000 3100000
0 0 0
0 200 13200
0 3000 571980
0 0 0
0 1500 990000
0 2000 381320
0 0
0 50 59400
0 2006 996982
0 8225 0
0 1900 13585000
0 100 693600
0 0 0
0 8000 624000
0 490 1960000
0 100 404182
0 9 9414
0 15 2829945
0 17000 1020000
0 3000 3504000
0 2000 266000
0 1000 128700
0 15000 1755000
0 500 63000
0 4000 1156000
0 9000 7920000
0 0 0
0 300 3663000
0 14000 4466000
0 27000 2268000
0 41000 4961000
0 760 7330960
0 0 0
0 2500 0
0 275 1729750
0 0 0
0 0 0
0 13 247065
0 0 0
0 2 254100
0 10 1375000
0 15 5527500
0 10 1787500
0 23 1394636
0 800 3344000
0 950 3971000
0 850 3553000
0 650 2717000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 2900 2296800
0 0 0
0 0 0
0 300 247500
0 2500 540000
0 0 0
0 0 0
0 2 75900
0 0 0
0 24 1084392
0 0 0
0 36 1169676
0 0 0
0 0 0
0 12 630732
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 1725000
0 0 0
0 21 603750
0 0 0
0 0 0
0 0 0
0 150 577500
0 100 283126
0 0 0
0 600 2112000
0 0 0
0 60 825000
0 0 0
0 10 272800
0 0 0
0 0 0
0 100 770000
0 1 7700
0 0 0
0 0 0
0 160 264000
0 0 0
0 1000 825000
0 0 0
0 0 0
0 320 2816000
0 0 0
0 0 0
0 50 0
0 20 943000
0 0 0
0 600 217800
0 200 87780
0 0 0
0 0 0
0 200 72600
0 750 329175
0 0 0
0 600 263340
0 2000 880000
0 0 0
0 0 0
0 0 0
0 0 0
0 10 819555
0 5 235000
0 0 0
0 0 0
0 5 150000
0 0 0
0 0 0
0 5 82500
0 0 0
0 12 225818
0 0 0
0 200 606364
0 0 0
0 0 0
0 0 0
0 450 3102750
0 500 235250
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 5 20000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 500 151500
0 539 290521
0 0 0
0 500 1475000
0 0 0
0 0 0
0 1000 583000
0 2 94300
0 0 0
0 1250 0
0 0 0
0 1 0
0 0 0
0 0 0
0 1 0
0 5 0
0 1 0
0 0 0
0 0 0
0 15 18375
0 3407 5624957
0 35 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 75 0
0 0 0
0 0 0
0 0 0
0 1 352000
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 32 10472288
0 1 1259990
0 0 0
0 0 0
0 0 0
0 0 0
0 30 8295000
0 0 0
0 0 0
0 0 0
0 500 1557950
0 108600 39856200
0 144752 53123984
0 0 0
0 477 591480
0 6070 9839470
0 0 0
0 466 612790
151
0 0 0
0 6 99648
0 2 33216
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 96 0
0 0 0
0 5 9925
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 600 13398000
0 0 0
0 0 0
0 60 804420
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 4 0
0 0 0
0 0 0
0 0 0
0 130 3297250
0 40 2820400
0 120 29746080
0 450 10298475
0 0 7564150
0 495 4284500
0 340 6684590
0 150 2725320
0 130 1320000
PELAPORAN : PUSKESMAS BANGUN PURBA 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA BANGUN PURBA TOTAL
HARGA TOTAL
SATUAN KELUAR
2 Acyclovir Krim tube 8,580 0 0

tablet 93 0 0 2,000 186000 0 5,000 465000 0 5,000 465000 0 0 0 0 0 12000 1116000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 500 156500 0 2,000 626000 0 2,000 626000 0 0 0 0 0 4500 1408500
tablet 88 0 0 2,000 176000 0 6,500 572000 0 3,000 264000 0 0 0 0 0 11500 1012000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 0 5,000 1325000 0 6,000 1590000 0 6,000 1590000 0 0 0 0 0 17000 4505000
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0 0
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 0 5,000 315000 0 5,000 315000 0 8,000 504000 0 0 0 0 0 18000 1134000
btl 60 ml 2,065 0 0 500 1032500 0 400 826000 0 500 1032500 0 0 0 0 0 1400 2891000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 4,000 436000 0 6,500 708500 0 6,000 654000 0 0 0 0 0 16500 1798500
tablet/ H Baru 446 0 0 0 0 3,000 1336500 0 3,000 1336500 0 0 0 0 0 6000 2673000
tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 100 487500 0 150 731250 0 200 975000 0 0 0 0 0 450 2193750
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 3,000 435000 0 0 0 0 0 0 0 0 0 3000 435000
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 1,000 1056000 0 1,000 1056000 0 0 0 0 0 4000 4224000
botol 11,550 0 0 0 0 0 0 400 4620000 0 0 0 0 0 400 4620000

21
Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 0 3,000 192000 0 3,000 192000 0 3,000 192000 0 0 0 0 0 9000 576000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tube 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
Flucord N Cream
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 3,000 1308000 0 0 0 0 0 0 0 0 0 3000 1308000

tablet/ H. baru 797 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 1,000 81000 0 1,000 81000 0 0 0 0 0 0 0 2000 162000


tablet 58 0 0 3,000 174000 0 3,000 174000 0 3,000 174000 0 0 0 0 0 9000 522000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 botol 6,900 0 0 100 690000 0 100 690000 0 200 1380000 0 0 0 0 0 400 2760000
7,363 0 0 0 0 0 0 0 0 0
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 0 0 500 120000 0 0 0 0 0 0 0 500 120000
42 Hidrokloratiazid 25 mg tablet 156 0 0 2,000 312000 0 1,000 156000 0 0 0 0 0 0 0 3000 468000
tablet / H.Baru 437 0 0 3,000 1311000 0 3,600 1573200 0 3,600 1573200 0 0 0 0 0 10200 4457400
43 Hustab Tablet tablet 258 0 0 0 3,000 774000 0 0 0 0 0 0 3000 774000
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 200 2310000 0 0 0 0 0 500 5775000
JKN 11,550 0 0 0 0 0 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0 0 0 0

48 Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 0

Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0
49 Karbamazepin tablet 200 mg tablet 230 0 0 0 0 0 0 0 0 0

50 Kaptopril 12,5 mg tablet 62 0 0 1,000 62000 0 1,000 62000 0 0 0 0 0 0 0 2000 124000
51 Kaptopril 25 mg tablet 715 0 0 1,000 715000 0 1,000 715000 0 0 0 0 0 0 0 2000 1430000

53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 7,000 301000 0 8,000 344000 0 8,000 344000 0 0 0 0 0 23000 989000
55 tablet 154 0 0 2,000 308000 0 2,000 308000 0 4,000 616000 0 0 0 0 0 8000 1232000
APBD 2019 133 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 0 0 100 193700 0 500 968500 0 0 0 0 0 600 1162200

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 2,000 160000 0 0 0 0 2000 160000
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 3,000 399000 0 3,500 465500 0 4,900 651700 0 0 0 0 0 11400 1516200
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0
Silva 2014 106 0 0 0 0 0

61 Metil Ergometrin Maleat injeksi ampul 2,684 300 805200 0 0 300 805200
63 Metoclorpramid HCL 10 mg tablet 123 0 0 2,000 246000 0 0 0 1,000 123000 0 0 0 0 0 3000 369000
tablet 133 0 0 15,000 1995000 0 0 0 0 0 0 0 0 0 15000 1995000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Mikonazol Cream 2 % tube 3,410 0 0 120 409200 0 250 852500 0 0 0 0 0 0 0 370 1261700
tablet 107 0 0 3,000 320010 0 0 0 0 0 0 0 0 0 3000 320010
67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 3,500 476000 0 0 0 0 0 3500 476000
silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 6,410 0 0 200 1282000 0 200 1282000 0 200 1282000 0 0 0 0 0 600 3846000
68
Natrium Klorida larutan infus 0,9%
68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 120 215760 0 200 359600 0 0 0 0 0 0 0 320 575360
ampul 1,900 0 0 0 0 100 190000 0 200 380000 0 0 0 0 0 300 570000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 0 0 10,000 510000 0 0 0 0 0 0 0 0 0 10000 510000
tablet 178 0 0 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 2,000 329240 0 12,000 1975440 0 0 0 0 0 14000 2304680
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 400 598400 0 400 598400 0 400 598400 0 0 0 0 0 1200 1795200
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 300 933900 0 200 622600 0 400 1245200 0 0 0 0 0 900 2801700
78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 3,000 924000 0 3,500 1078000 0 0 0 0 0 0 0 6500 2002000
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 5,000 620000 0 3,500 434000 0 3,500 434000 0 0 0 0 0 12000 1488000
tablet 191 0 0 0 0 0 0 3,500 667310 3500 667310
tablet 226 0 0 0 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0
JKN 2019 225 0 0 0 0 0 0 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 0

86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 7,150 0 0 400 2860000 0 200 1430000 0 300 2145000 900 6435000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0

89 Salbutamol tablet 2 mg tablet 78 0 0 3,000 234000 0 2,500 195000 0 0 0 0 0 0 0 5500 429000

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 4,000 240000 0 4,500 270000 0 5,000 300000 0 0 0 0 0 13500 810000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 300 350400 0 800 934400 0 0 0 0 0 0 0 1100 1284800
tablet 133 0 0 0 0 0 0 0 0 0
tablet/ SILVA 2015 117 0 0 0 0 0 0 0 0 0
97 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 0 0 1,000 289000 0 500 144500 0 0 0 0 0 1500 433500

98 Siprofloksasin 500 MG tablet 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 0 0 4,000 1276000 0 0 0 0 0 0 0 4000 1276000
102 Vitamin B komplek Tablet tablet 121 0 0 10,000 1210000 0 0 0 8,000 968000 18000 2178000
Botol 9,646 0 0 200 1929200 0 0 0 0 0 0 0 0 0 200 1929200
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 50 314500 0 0 0 0 0 50 314500

botol 3,322 0 0 0 0 50 166100 0 0 0 0 0 0 0 50 166100
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 200 836000 0 100 418000 0 0 0 0 0 0 0 300 1254000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 216 0 0 3,000 648000 0 1,000 216000 0 0 0 0 0 0 0 4000 864000
buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0 0 0 0 10 379500
buah 45,183 0 0 0 0 48 2168784 0 0 0 0 0 0 0 48 2168784

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 48 1559568 0 0 48 1559568

buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 12 630732 0 0 0 12 630732 0 0 0 0 0 24 1261464

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 0 0 5 143750 0 0 0 0 0 0 0 5 143750

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 50 192500 0 0 0 0 0 0 0 0 0 50 192500

set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 100 352000 0 50 176000 0 50 176000 0 0 0 0 0 200 704000

set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 5 68750 0 5 68750 0 5 68750 0 0 0 0 0 15 206250

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 10 77000 0 0 0 0 0 0 0 0 0 10 77000
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 100 210000 0 0 0 0 0 0 0 0 0 0 100 210000
rol 1,650 0 0 10 16500 0 0 0 0 0 0 0 0 0 10 16500

rol / bpjs 1,650 0 50 82500 0 0 0 0 0 0 0 0 0 0 50 82500
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 2,880 25344000 0 0 0 0 0 0 0 0 0 0 2880 25344000
botol 47,150 0 0 5 235750 0 0 0 0 0 0 0 0 0 5 235750

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 100 36300 0 0 0 0 100 36300
146 Masker Tie On buah 439 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 1,000 438900 1000 438900
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 500 220000 0 0 0 0 0 0 0 1500 660000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0


rol 81,955 0 0 3 245866 0 0 0 0 3 245866

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 10 188182 0 0 0 0 0 0 0 0 0 10 188182

botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 300 909546 0 0 0 0 0 0 0 0 0 300 909546

botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 48 1755936 0 0 0 0 0 48 1755936

161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 48 0 0 0 0 0 0 48 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 1 2750000 0 0 0 0 0 0 0 1 2750000
168 Cleaner Samsung Unit 2,200,000 0 0 0 0 1 2200000 0 0 0 0 0 0 0 1 2200000

170 Lise Samsung Unit 3,300,000 0 0 0 0 1 3300000 0 0 1 3300000
Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 2 0 0 0 0 0 0 0 0 0 0 2 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 0 0 0 0 0 0 0
215 Articulating Pcs 181,500 0 0 0 0 0 0 0 0 0
216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0 0 0
217 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0 0 0 0
219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0 0 0
220 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0 0 0 0 0
222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 102,096 37469232 0 0 0 0 0 0 0 0 0 0 102096 37469232
buah/ skipa 1,240 337 417880 0 0 0 0 0 0 0 0 0 0 0 337 417880
237 Spuit 0,5 ml
buah / apbn 1,621 4,294 6960574 0 0 0 0 0 0 0 0 0 0 0 4294 6960574
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0

238 Spuit 0,05 ml
APBN 1,315 330 433950 0 0 0 0 0 0 0 0 0 0 0 330 433950
Spuit 5 ml APBN 1,705 15 25575 15
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 4 0 0 4 0 0 0 4 0 0 0 0 0 0 0 12 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

248 Paket Kombipak HIV paket 39,998 10 399982 0 0 0 0 0 0 0 0 0 0 0 10 399982
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0



256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 5 299750 10 599500 10 599500 10 599500 10 599500 10 599500 10 599500 0 0 0 0 0 65 3896750
269 CAMPAK VIAL 28,204 0 0 0 0 10 282040 10 282040 10 282040 0 0 0 0 0 30 846120

270 MR VIAL 141,648 0 0 0 0 0 0 0 0 0 0 0 0 0 0
271 DPT-HB-Hib VIAL 76,285 40 3051400 30 2288550 35 2669975 50 3814250 40 3051400 40 3051400 50 3814250 0 0 0 0 0 285 21741225
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 30 627000 20 418000 20 418000 50 1045000 40 836000 40 836000 40 836000 0 0 0 0 0 240 5016000
274 POLIO (BOPV) VIAL 19,954 30 598620 10 199540 0 0 30 598620 35 698390 40 798160 0 0 0 0 0 145 2893330
275 POLIO (IPV) VIAL 13,976 20 279520 10 139760 20 279520 10 139760 10 139760 15 209640 20 279520 0 0 0 0 0 105 1467480
276 Td VIAL 16,500 10 165000 0 5 82500 10 165000 0 10 165000 10 165000 0 0 0 0 0 45 742500
PELAPORAN : PUSKESMAS GALANG 3 4 5 6 8 9
1 2 3 4 5 6 8 9
GALANG GALANG GALANG GALANG GALANG GALANG GALANG GALANG GALANG

JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER
2 Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 0
tablet 93 0 0 1,000 93000 0 1,000 93000 0 3,000 279000 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 5,000 1565000 0 0 0 200 62600 0 0
tablet 88 0 0 3,000 264000 0 2,000 176000 0 4,000 352000 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 3,000 795000 5,000 1325000 0 7,000 1855000 0 10,000 2650000 0 0
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 0

9 Antasida DOEN I Kombinasi tablet 63 0 0 7,000 441000 0 5,000 315000 0 5,800 365400 0 0
btl 60 ml 2,065 0 0 500 1032500 0 0 0 200 413000 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 200 1381000 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 5,000 545000 0 3,000 327000 0 4,000 436000 0 0
tablet/ H Baru 446 0 0 1,000 445500 0 0 0 5,000 2227500 0 0

tablet 176 0 0 0 0 0 0 0 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0 0

15 Betametason krim 0,1% 5 gr tube 4,875 0 0 150 731250 0 50 243750 0 50 243750 0 0

17 Cetrizin tablet tablet 145 0 0 5,000 725000 0 0 0 3,000 435000 0 0
18 Cetrizin syrup botol 2,900 0 0 20 58000 0 0 0 50 145000 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 1,000 1056000 0 1,000 1056000 0 2,000 2112000 0 0
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 100 179800 0 0 0 50 89900 0 0

botol 11,550 0 0 0 0 0 0 200 2310000 0 0
21
Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0 0 0 0
Dextrofen syrup
JKN 2019 11,550 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 0
tablet 64 0 0 5,000 320000 0 3,000 192000 0 5,000 320000 0 0

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 100 235400 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 5,000 3755000 0 1,000 751000 0 1,500 1126500 0 0
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 100 686700 0 0 0 0 0 0

tube 18,844 0 0 0 0 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 60 250020 0 0 0 0 0 0

tablet 436 0 0 1,000 436000 0 0 0 0 0 0
tablet/ H. baru 797 0 0 0 0 0 0 1,000 796990 0 0

34 Garam oralit 200 ml air bks 303 0 0 200 60600 0 0 0 0 0 0
tablet 58 0 0 5,000 290000 0 2,000 116000 0 3,900 226200 0 0
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0
36 botol 6,900 0 0 100 690000 0 0 0 0 0 0

JKN 2019 7,363 0 0 0 0 0 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 2,000 15000000 0 0 0 0 0 0

39 Griseofulvin 125 mg Tablet tablet 240 0 0 0 0 1,000 240000 0 600 144000 0 0
40 Haloperidol tablet 0,5 mg tablet 62 0 0 0 0 0 0 0 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 50 132500 0 0 0 100 265000 0 0

tablet / H.Baru 437 0 0 1,000 437000 0 3,600 1573200 0 3,600 1573200 0 0
tablet P 312 0 300 93600 0 0 0 0 1,000 312000 0 0

botol/ H. Baru 11,550 0 0 100 1155000 0 200 2310000 0 250 2887500 0 0
JKN 11,550 0 0 0 0 0 0
44 Hustab syrup
44 Hustab syrup silva /2014 11,550 0 0 0 0 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0

botol 8,046 0 100 804600 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 500 37500 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 0 0 0 0 0 0 0
47 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 0

Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 0

50 Kaptopril 12,5 mg tablet 62 0 0 0 0 2,000 124000 0 0 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 5,000 215000 7,000 301000 0 5,000 215000 0 8,000 344000 0 0
55 tablet 154 0 0 5,000 770000 0 2,000 308000 0 3,800 585200 0 0

APBD 2019 133 0 0 0 0 0 0
ampul 1,937 0 0 500 968500 0 0 0 0 0 0

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 30 96000 0 0 0 0 0 0
tablet 133 0 0 3,000 399000 0 1,000 133000 0 1,200 159600 0 0
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 500 1342000 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 5,000 810000 0 1,000 162000 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 2,000 246000 0 0 0 2,000 246000 0 0

tablet 133 0 0 10,000 1330000 0 5,000 665000 0 0 0 0
tablet 264 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 300 1140000 0 200 760000 0 0 0 0
66 Mikonazol Cream 2 % tube 3,410 0 0 300 1023000 0 0 0 100 341000 0 0

tablet 107 0 0 3,000 320010 0 0 0 0 0 0
67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 0 0 0
silva 2015 136 0 0 0 0 0 0 0 0 0

botol 6,410 0 0 200 1282000 0 0 0 0 0 0
68
Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0
APBD 2019 6,840 0 0 0 0 0 0 0 0 0

tablet 549 0 0 1,000 549000 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0
tablet 803 0 0 2,000 1606000 0 0 0 0 0 0
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0
71 Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 500 899000 0 0 0 0 0 0

ampul 1,900 0 0 500 950000 0 0 0 0 0 0
ampul/H baru 1,199
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 2,000 328000 0 0 0 3,000 492000 0 0

tablet 51 1,000 51000 3,000 153000 5,000 255000 0 0 0 0 0 0
tablet 178 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 3,000 493860 0 5,000 823100 0 0
silva/ 2015 165 0 0 0 0 0 0 0 0 0

JKN 2019 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 50 74800 500 748000 0 0 0 300 448800 0 0

77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 300 933900 0 200 622600 0 0 0 0
78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0

79 Pirantel tablet score 125 mg tablet 308 0 0 500 154000 0 0 0 1,000 308000 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 10,000 1240000 0 3,000 372000 0 0 0 0
82 Propanolol HCL 10 mg tablet 66 0 0 200 13200 0 0 0 0 0 0

tablet 191 0 0 0 0 0 0 0 0 0
tablet 226 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 0
JKN 2019 225 0 0 0 0 0 0 0 0 0

86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 0
botol 7,150 0 0 500 3575000 0 200 1430000 0 0 0 0

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 100 255400 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 500 39000 5,000 390000 0 0 0 2,000 156000 0 0


93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 3 565989 0 0
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 15,000 900000 0 0 0 0 0 0

95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 0 0 0 0 0
tablet 133 0 0 1,000 133000 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0
tablet 289 0 0 1,000 289000 0 0 0 1,000 289000 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 0 0 0 0 0

silva/ 2018 880 0 0 0 0 0 0 0 0 0
99 Sanadryl Syrup botol 12,210 0 100 1221000 150 1831500 0 0 0 0 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 500 159500 0 0 0 0 0 0
Botol 9,646 0 0 300 2893800 0 0 0 0 0 0

Botol 10,293 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 100 629000 0 0 0 0 0 0

3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 0 0 0 0 0 0 0
107 Accu Check safe T Pro Uno Dus 127,050 0 1 127050 0 0 0 0 0 0 0


111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 0 0 0

buah 4,180 50 209000 0 50 209000 0 0 0 0 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 45 204750 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 100 79200 200 158400 500 396000 0 0 0 400 316800 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 100 82500 0 0 0 0 0 0

buah 216 0 0 500 108000 0 0 0 0 0 0
buah 197 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 24 1224528 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 100 345000 0 0 0 0 0 0

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 10 287500 0 0 0 0 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 9 258750 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 100 880000 0 0 0 0 0 0 0
set 3,850 0 0 50 192500 0 0 0 0 0 0

set / bpjs 2,831 0 150 424689 0 0 0 0 0 0 0
set 3,520 50 176000 0 50 176000 0 0 0 100 352000 0 0

set / bpjs 3,520 0 300 1056000 0 0 0 0 0 0 0
buah 13,750 0 0 10 137500 0 0 0 0 0 0
buah / bpjs 13,750 0 0 0 0 0 0 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 10 272800 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 50 385000 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 50 105000 0 0 0 0 0 0 0
rol 1,650 0 0 50 82500 0 0 0 0 0 0
rol / bpjs 1,650 0 100 165000 0 0 0 0 0 0 0
rol 825 0 0 200 165000 0 0 0 0 0 0
rol / bpjs 825 0 57 47025 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 800 7040000 0 0 0 0 0 0 0

botol 47,150 0 0 5 235750 0 0 0 0 0 0
145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0

buah / bpjs - 0 0 0 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 0 0 0
buah 363 0 0 200 72600 0 0 0 0 0 0

148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0

buah 440 0 0 0 0 0 0 0 0 0
buah / bpjs 440 0 0 0 0 0 0 0 0 0
151 My Jelly 82 gram tube - 0 3 0 0 0 0 0 0 0 0

rol 81,955 0 0 5 409777 0 0 0 0 0 0

rol / bpjs 81,955 0 5 409777 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 5 256525 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 15 424297 0 0 0 0 0 0 0

botol 18,818 0 0 10 188182 0 0 0 0 0 0
botol / bpjs 18,818 0 10 188182 0 0 0 0 0 0 0
botol 3,032 0 0 500 1515910 0 0 0 0 0 0

botol / bpjs 3,032 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0

buah / bpjs 6,895 0 0 0 0 0 0 0 0 0

160 Sarung tangan M buah 471 0 0 0 0 0 0 0 0 0
buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 48 1755936 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 500 151500 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 500 1475000 0 0 0 0 0 0

187 Tuberculin PPD Vial 702,250 0 0 0 0 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0

Program IFA - 0 0 0 0 0 0 0 0 0
195 KAPAS LIDI Bungkus - 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 0 0 0 0 0 0 0

197 CHLORIN Liter - 0 0 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0


211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 0 0

OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 0 0 0 0 0 0 0


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0

225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 0 0 0 0 16 5236144 0 0 0

227 OAT FDC Kategori 2 paket 1,259,990 0 0 0 3 3779970 0 0 0 0 0

230 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 5 150000 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 175024 64233808 0 0 0 0 0 0 0
buah/ skipa 1,240 578 716720 0 0 0 0 0 0 0 0
237 Spuit 0,5 ml
buah / apbn 1,621 7361 11932181 0 0 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 565 742975 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 25 42625
Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 8 132864 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

241 DHP Frimal TABLET 2,160 315 680400 45 97200 0 0 0 0 0 0 0
242 Primaquin TABLET 235 500 117500 100 23500 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 4 0 0 0 8 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0


249 PH Peper rol 239 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0

266 Handscoen boks - 0 0 0 0 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 30 846120 0 0 0 0
270 MR VIAL 141,648 0 10 1416480 20 2832960 30 4249440 0 30 4249440 25 3541200 0 0
271 DPT-HB-Hib VIAL 76,285 65 4958525 60 4577100 30 2288550 60 4577100 60 4577100 70 5339950 60 4577100 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 70 1463000 70 1463000 60 1254000 60 1254000 60 1254000 60 1254000 65 1358500 0 0
274 POLIO (BOPV) VIAL 19,954 40 798160 50 997700 0 0 50 997700 50 997700 50 997700 0 0
275 POLIO (IPV) VIAL 13,976 10 139760 15 209640 10 139760 20 279520 25 349400 20 279520 15 209640 0 0
276 Td VIAL 16,500 10 165000 10 165000 20 330000 30 495000 10 165000 20 330000 20 330000 0 0
10 11 12
10 11 12
GALANG GALANG GALANG TOTAL

TOTAL
HARGA
KELUAR
JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA
0 0 0 0 0
0 0 0 0 0
0 0 0 5000 465000
0 0 0 0 0
0 0 0 5200 1627600
0 0 0 9000 792000
0 0 0 0 0
0 0 0 25000 6625000
0 0 0
0 0 0 1050 2625000
0 0 0 0 0
0 0 0 17800 1121400
0 0 0 700 1445500
0 0 0 0 0
0 0 0 200 1381000
0 0 0 12000 1308000
0 0 0 6000 2673000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 250 1218750
0 0 0 0 0
0 0 0 8000 1160000
0 0 0 70 203000
0 0 0 4000 4224000
0 0 0 150 269700
0 0 0 200 2310000
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 288000
0 0 0 13000 832000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 100 235400
0 0 0 7500 5632500
0 0 0 100 686700
0 0 0
0 0 0
0 0 0 60 250020
0 0 0 1000 436000
0 0 0 1000 796990
0 0 0 3000 243000
0 0 0 0 0
0 0 0 200 60600
0 0 0 10900 632200
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 690000
0 0 0
0 0 0 2000 15000000
0 0 0 0 0
0 0 0 1600 384000
0 0 0 0 0
0 0 0 150 397500
0 0 0 0 0
0 0 0 8200 3583400
0 0 0 1000 258000
0 0 0 1300 405600
0 0 0 550 6352500
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 804600
0 0 0 500 37500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 500 115000
0 0 0 2000 124000
0 0 0 6500 4647500
0 0 0 0 0
0 0 0 25000 1075000
0 0 0 800 1746400
0 0 0 10800 1663200
0 0 0
0 0 0 0 0
0 0 0 500 968500
0 0 0 0 0
0 0 0 2000 160000
0 0 0 30 96000
0 0 0 5200 691600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 1342000
0 0 0 6000 972000
0 0 0 4000 492000
0 0 0 15000 1995000
0 0 0 0 0
0 0 0 500 1900000
0 0 0 400 1364000
0 0 0 3000 320010
0 0 0 0 0
0 0 0 0 0
0 0 0 200 1282000
0 0 0 0 0
0 0 0 0
0 0 0 1000 549000
0 0 0 0 0
0 0 0 2000 1606000
0 0 0 0 0
0 0 0 0 0
0 0 0 500 899000
0 0 0 500 950000
0 0 0 5000 820000
0 0 0 9000 459000
0 0 0
0 0 0 8000 1316960
0 0 0 0 0
0 0 0 0
0 0 0 850 1271600
0 0 0 0 0
0 0 0 500 1556500
0 0 0 0 0
0 0 0 0
0 0 0 1500 462000
0 0 0 13000 1612000
0 0 0 0 0
0 0 0 200 13200
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 700 5005000
0 0 0 0 0
0 0 0 100 255400
0 0 0 7500 585000
0 0 0 50 200000
0 0 0 50 202091
0 0 0 0 0
0 0 0 3 565989
0 0 0 15000 900000
0 0 0 500 584000
0 0 0 1000 133000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 578000
0 0 0 0 0
0 0 0 0 0
0 0 0 250 3052500
0 0 0 500 159500
0 0 0 9000 756000
0 0 0 10000 1210000
0 0 0 300 2893800
0 0 0 0 0
0 0 0 0 0
0 0 0 100 629000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 127050
0 0 0 5 687500
0 0 0 5 1842500
0 0 0 5 893750
0 0 0 0 0
0 0 0 150 627000
0 0 0 150 627000
0 0 0 150 627000
0 0 0 100 418000
0 0 0 0 0
0 0 0 0 0
0 0 0 45 204750
0 0 0 0 0
0 0 0 0 0
0 0 0 1200 950400
0 0 0 0 0
0 0 0 0 0
0 0 0 100 82500
0 0 0 500 108000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 12 542196
0 0 0 0 0
0 0 0 0 0
0 0 0 12 389892
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 24 1224528
0 0 0 0 0
0 0 0 0 0
0 0 0 100 345000
0 0 0 0 0
0 0 0 10 287500
0 0 0 9 258750
0 0 0 0 0
0 0 0 100 880000
0 0 0 50 192500
0 0 0 0 0
0 0 0 150 424689
0 0 0 200 704000
0 0 0 300 1056000
0 0 0 10 137500
0 0 0 0 0
0 0 0 10 272800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 385000
0 0 0 0 0
0 0 0 50 105000
0 0 0 50 82500
0 0 0 100 165000
0 0 0 200 165000
0 0 0 57 47025
0 0 0 0 0
0 0 0 800 7040000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 235750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 72600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 409777
0 0 0 3 141000
0 0 0 5 409777
0 0 0 0 0
0 0 0 3 90000
0 0 0 5 256525
0 0 0 0 0
0 0 0 3 49500
0 0 0 15 424297
0 0 0 10 188182
0 0 0 10 188182
0 0 0 500 1515910
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 48 1755936
0 0 0 0 0
0 0 0 12 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 151500
0 0 0 651 350889
0 0 0 0 0
0 0 0 500 1475000
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 583000
0 0 0 2 94300
0 0 0 0 0
0 0 0 1250 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 180 220500
0 0 0 3500 5778500
0 0 0 43 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 16 5236144
0 0 0 3 3779970
0 0 0 0 0
0 0 0 1 203259
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 150000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 175024 64233808
0 0 0 0 0
0 0 0 578 716720
0 0 0 7361 11932181
0 0 0 0 0
0 0 0 565 742975
25
0 0 0 0 0
0 0 0 8 132864
0 0 0 2 33216
0 0 0 0 0
0 0 0 360 777600
0 0 0 600 141000
0 0 0 0 0
0 0 0 0 0
0 0 0 12 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 4466000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 140 8393000
0 0 0 30 846120
0 0 0 115 16289520
0 0 0 405 30895425
0 0 0 0 0
0 0 0 445 9300500
0 0 0 240 4788960
0 0 0 115 1607240
0 0 0 120 1980000
PELAPORAN : PUSKESMAS PETUMBUKAN 3 4 5
1 2 3 4 5
PETUMBUKAN PETUMBUKAN PETUMBUKAN PETUMBUKAN PETUMBUKAN

TOTAL TOTAL TOTAL TOTAL TOTAL
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI
1 Acyclovir 400 mg tablet tablet 359 0 0 0 0 0

2 Acyclovir Krim tube 8,580 0 0 0 0 0
tablet 93 0 0 2,000 186000 0 2000 186000

silva/ 2014 945 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 3,000 939000 0 0
tablet 88 0 0 3,000 264000 0 3000 264000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0
6 kapsul 265 0 2000 530000 6,000 1590000 0 6000 1590000

Amoksisilin 500 mg
kapsul 260 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 500 1250000 0 150 375000
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 1000 7,000 5000
btl 60 ml 2,065 0 0 400 826000 0 150 309750

btl 60 ml 2,189 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 120 828600 0 48 331440
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 10,000 1090000 0 0
tablet/ H Baru 446 0 0 0 0 5000 2227500

tablet 176 0 1000 176000 3,000 528000 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0
JKN 2019 444 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 240 1170000 0 120 585000
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 4,000 580000 0 4000 580000
18 Cetrizin syrup botol 2,900 0 50 145000 100 290000 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 1,500 1584000 0 2000 2112000
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 120 215760 0 120 215760
botol 11,550 0 0 0 0 0
21
Dextrofen syrup silva/2015 11,550 0 0 0 0 0
JKN 2019 11,550 0 0 0 0 0
tablet 45 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0

24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 200 576000 0 0
tablet 64 0 0 10,000 640000 0 2000 128000

tablet/ H. Baru 143 0 0 0 0 0
tablet 106 0 0 500 53000 0 0

DAK 2019 114 0 0 0 0 0
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 500 1177000 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 3,000 2253000 0 0
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 300 2060100 0 0
tube 18,844 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 50 208350 0 30 125010
tablet 436 0 0 1,500 654000 0 0

tablet/ H. baru 797 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 1,000 81000 0 500 40500
33 Fenobarbital 30 mg tablet 180 0 0 0 0 0
34 Garam oralit 200 ml air bks 303 0 0 500 151500 0 0
tablet 58 0 0 5,000 290000 0 5000 290000
tablet/ H. Baru 125 0 0 0 0 0

silva 2015 125 0 0 0 0 0
silva 2014 125 0 0 0 0 0
36 botol 6,900 0 0 400 2760000 0 60 414000

JKN 2019 7,363 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 5,000 37500000 0 0

38 Glimipiride 1 mg tablet 174 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 0 0 4000 960000
40 Haloperidol tablet 0,5 mg tablet 62 0 0 1,000 62000 0 0

41 Hidrokortison Cream 2.5 % tube 2,650 0 0 120 318000 0 120 318000
42 Hidrokloratiazid 25 mg tablet 156 0 0 5,000 780000 0 0
tablet / H.Baru 437 0 0 3,000 1311000 0 5000 2185000

43 Hustab Tablet tablet 258 0 0 0
tablet P 312 0 0 0 0 0
botol/ H. Baru 11,550 0 0 100 1155000 0 100 1155000

JKN 11,550 0 0 0
44 Hustab syrup silva /2014 11,550 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0
botol 8,046 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 0 0 0

47 Iliadin Spray botol 36,036 0 0 0 0 0
48 Iliadin Drop botol 31,080 0 0 0 0 0
Kalsium Laktas 500 mg tablet 63 0 0 0 0 0
49 Karbamazepin tablet 200 mg tablet 230 0 0 500 115000 0 0
50 Kaptopril 12,5 mg tablet 62 0 0 5,000 310000 0 2000 124000
51 Kaptopril 25 mg tablet 715 0 0 3,000 2145000 0 3000 2145000

52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 7,000 301000 0 3000 129000
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 300 654900 0 0
55 tablet 154 0 0 3,000 462000 0 0

APBD 2019 133 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 200 115000 0 200 115000

ampul 1,937 0 0 500 968500 0 100 193700
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 2,000 160000 0 0
59 MgSO4 20 % ampul 3,200 0 0 20 64000 0 0
tablet 133 0 0 2,000 266000 0 3000 399000
tablet 106 0 0 0 0 0
Silva 2015 106 0 0 0 0 0
Silva 2014 106 0 0 0 0 0
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 400 1073600 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 4,000 648000 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 3,000 369000 0 0
tablet 133 0 0 15,000 1995000 0 10000 1330000

tablet 264 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 300 1140000 0 200 760000
66 Mikonazol Cream 2 % tube 3,410 0 0 120 409200 0 120 409200
tablet 107 0 0 3,000 320010 0 2000 213340
67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0
silva 2015 136 0 0 0 0 0
botol 6,410 0 0 300 1923000 0 0

68
Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0
APBD 2019 6,840 0 0 0 0 0
tablet 549 0 0 1,000 549000 0 0

tablet/ H Baru 630 0 0 0 0 0
tablet 803 0 0 2,000 1606000 0 0

tablet/ H Baru 886
71 Nifedipin 20 mg tablet 3,575 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 48 86304 0 120 215760
ampul 1,900 0 0 300 570000 0 0

ampul/H baru 1,199 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 5,000 820000 0 2000 328000
tablet 51 0 3,000 153000 5,000 255000 0 0

tablet 178 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 2000 329240
silva/ 2015 165 0 0 0 0 0

Paracetamol 500 mg (lanamol)
JKN 2019 165 0 0 0 0 0

76 botol 1,496 0 0 300 448800 0 300 448800
77 botol 1,184 0 0 0 0 0
ampul 3,113 0 0 300 933900 0 0

78
Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0

79 Pirantel tablet score 125 mg tablet 308 0 0 500 154000 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 5,000 620000 0 0
81 Prednison 5 mg Tablet tablet 96 0 0 0 0 0
82 Propanolol HCL 10 mg tablet 66 0 0 100 6600 0 0
tablet 191 0 0 0 0 0
tablet 226 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0
Silva 2014 191 0 0 0 0 0
JKN 2019 225 0 0 0 0 0
84 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0
85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0
86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0
botol 7,150 0 0 300 2145000 0 40 286000

Jkn Silva 2015 6,936 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 120 306480 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 0 0 500 39000
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 50 200000 0 0
91 Salbutamol syrup botol 4,042 0 0 0 0 0
92 Salisil Bedak 2,5% bks 1,046 0 0 0 0 0

93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 5,000 300000 0 1500 90000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 200 233600
tablet 133 0 0 2,000 266000 0 0
96 Simvastatin tablet 10 mg tablet 129 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0
97 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0
tablet 289 0 0 2,000 578000 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 2000 1760000

silva/ 2018 880 0 0 0 0 0
99 Sanadryl Syrup botol 12,210 0 0 200 2442000 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 2,000 638000 0 1000 319000
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 6,000 504000 0 4000 336000
102 Vitamin B komplek Tablet tablet 121 0 0 10,000 1210000 0 5000 605000
Botol 9,646 0 0 300 2893800 0 0

Botol 10,293 0 0 0 0 0
104 Zink Tablet Tablet 0 0 0 0 0
botol 6,290 0 0 150 943500 0 0
3,322 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 0 0 0
BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0

107 Accu Check safe T Pro Uno Dus 127,050 0 1 127050 0 0 0
108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 10 1375000
109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 0 0 15 5527500
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 10 1787500
111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0
112 Abbocath No.20 G buah 4,180 0 0 100 418000 0 100 418000
buah 4,180 0 0 100 418000 0 100 418000

buah / bpjs 4,180 0 0 0 0 0
buah 4,550 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0
buah 792 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 500 396000 0 0
buah 792 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 200 165000 0 0
buah 216 0 0 500 108000 0 0

buah 197 0 0 0 0 0
122 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0
botol 37,950 0 0 0 0 0
botol / bpjs 37,950 0 15 569250 0 0 0
buah 45,183 0 0 0 0 12 542196

buah / bpjs 45,183 0 0 0 0 0
buah 32,491 0 0 0 0 12 389892
125 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0

buah 52,561 0 0 12 630732 0 0
buah / bpjs 52,561 0 0 0 0 0
buah 51,022 0 0 0 0 0
buah / bpjs 51,022 0 12 612264 0 0 0
buah 3,731 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 18 67158 0 0 0
botol 3,450 0 0 500 1725000 0 0
botol / bpjs 3,450 0 0 0 0 0
botol 28,750 0 0 10 287500 0 10 287500

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 5 143750 0 0 0
buah 8,800 0 0 0 0 0
buah / bpjs 8,800 0 100 880000 0 0 0
set 3,850 0 0 50 192500 0 50 192500
132 Infusion Set Anak set 2,831 0 0 0 0 0
set / bpjs 2,831 0 50 141563 0 0 0
set 3,520 0 0 100 352000 0 50 176000

set / bpjs 3,520 0 50 176000 0 0 0
buah 13,750 0 0 20 275000 0 10 137500

buah / bpjs 13,750 0 10 137500 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 20 545600 0 5 136400
buah 30,008 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 5 150040 0 0 0
rol 7,700 0 0 0 0 0
rol / bpjs 7,700 0 50 385000 0 0 0
rol 2,100 0 0 0 0 0
rol / bpjs 2,100 0 100 210000 0 0 0
rol 1,650 0 0 200 330000 0 50 82500

rol / bpjs 1,650 0 100 165000 0 0 0
rol 825 0 0 200 165000 0 0

rol / bpjs 825 0 100 82500 0 0 0
buah 8,800 0 0 0 0 0
buah / bpjs 8,800 0 1,600 14080000 0 0 0
142 Kasa Steril 40 x 40 buah 1,600 0 0 0 0 0

143 Kasa Steril 5 x 5 buah 3,181 0 0 0 0 0
144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0
botol 47,150 0 0 10 471500 0 2 94300

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0
buah 363 0 0 200 72600 0 100 36300
146 Masker Tie On buah 439 0 0 0 0 0

buah / bpjs - 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0
buah 363 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0

148 Masker 3 Ply Earloop
buah / bpjs 363 0 0 0 0 0
149 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0
buah 440 0 0 1,000 440000 0 1000 440000

buah / bpjs 440 0 0 0 0 0
151 My Jelly 82 gram tube - 0 0 0 0 0

152 Object Glass Kotak 19,365 0 0 0 0 0
153 One scrub 500 cc + dispenser botol 65,341 0 0 2 130682 0 1 65341
rol 81,955 0 0 5 409777 0 0
154 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0
rol / bpjs 81,955 0 4 327822 0 0 0
rol 51,305 0 0 0 0 0
rol / bpjs 51,305 0 2 102610 0 0 0
rol 28,286 0 0 0 0 0
rol / bpjs 28,286 0 3 84859 0 0 0
botol 18,818 0 0 20 376364 0 0

botol / bpjs 18,818 0 10 188182 0 0 0
botol 3,032 0 0 50 151591 0 0

botol / bpjs 3,032 0 0 0 0 0
buah 6,895 0 0 0 0 0
159 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0
160 Sarung tangan M buah 471 0 0 0 0 0

buah 36,582 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0
buah - 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0
163 Skin Celean 500 ml botol - 0 0 0 0 0
164 Tranfusion Set buah 4,000 0 0 0 0 0

botol 14,472 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0
buah 3,300 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0
REAGENSIA - 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 0
168 Cleaner Samsung Unit 2,200,000 0 0 0 0 0
169 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 0
170 Lise Samsung Unit 3,300,000 0 0 0 0 0

171 Rinse Mindrey galon 1,254,000 0 0 0 0 0
172 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0
173 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0
174 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0
175 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0
176 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0

177 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0
178 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0
179 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0
180 URID ACID (URICASE) Kit 799,700 0 0 0 0 0
181 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0
Obat Paru - 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 0
183 ZINC Tablet TABLET 539 0 433 233387 0 0 0
184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 500 1475000 0 0
187 Tuberculin PPD Vial 702,250 0 0 0 0 0
188 Sarung tangan tanpa tepung M buah 583 0 1,000 583000 0 0 0
189 Lisol 100 % botol 47,150 0 1 47150 0 0 0
190 Reagen Ziehl Neelsen kit 181,811 0 0 0 12 2181732 0
191 Masker 3 Ply Earloop Jilbab buah - 0 1000 0 0 0 0
192 Spritus Liter 45,455 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0

194 Imersion Oil Botol 3,181,818 0 0 0 0 0
Program IFA - 0 0 0 0 0
195 KAPAS LIDI Bungkus - 0 0 0 0 0

196 ASAM CUKA botol - 0 0 0 0 0
197 CHLORIN Liter - 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0

Program Imunisasi 1,404 0 0 0 0 0
199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0

201 Safety Box 5 liter box - 0 0 0 0 0
Program HIV - 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0
203 BD Vacuntainer box - 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0

206 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 0 0
207 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0
208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0
209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0
210 Sarung tangan L buah 499 0 0 0 0 0
211 Standard Q Shyphilis Ab kit - 0 0 0 0 0

212 Alat Suntik Steril buah 1,668 0 0 0 0 0
213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 0 0 0
215 Articulating Pcs 181,500 0 0 0 0 0
216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0
217 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0
218 1470A2 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0
219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0
220 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0
221 Guta Percha Point #45-80 Box 46,700 0 0 0 0 0
222 Denpro Cal LC Dus 184,700 0 0 0 0 0
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0
225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0
OBAT PROGRAM PROVINSI - 0 0 0 0 0
Program TB Paru - 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 0 6 1963554 3 981777 0
227 OAT FDC Kategori 2 paket 1,259,990 1 1259990 0 0 2 2519980 0

228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 1 302605 0
229 OAT FDC Kategori Anak paket 203,259 0 0 0 0 0
230 RH ( Fase Lanjutan ) paket - 0 0 672 0 0 0

231 POT SPUTUM BUAH 2,950 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0
Program Gizi - 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0

tablet 367 0 0 0 0 0
Provinsi 367 0 116200 42645400 0 0 0
Program Imunisasi - 0 0 0 0 0
buah/ skipa 1,240 383 474920 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 4875 7902375 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0
238 Spuit 0,05 ml
238 Spuit 0,05 ml
APBN 1,315 374 491810 0 0 0 0
Spuit 5 ml APBN 1,705 17 28985

Box 16,608 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 5 83040 0 0 0 0
Box / 2,5ml 16,608 2 33216 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0
241 DHP Frimal TABLET 2,160 0 0 0 0 0

242 Primaquin TABLET 235 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0
Obat Rabies - 0 0 0 0 0
244 Vaksin Rabies kur - 4 0 0 0 0 4 0
OBAT APBN - 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 0 0 0
246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 0 0 0 0
248 Paket Kombipak HIV paket 39,998 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0
250 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0
251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 100 2233000 0 0 0
252 Rapid Test II ( FOKUS ) Test 13,615 0 0 0 0 0
253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0
254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0
256 Anuscopy buah - 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0
258 Blue Tips bungkus - 0 0 0 0 0

259 Metilen Blue botol 94,500 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0
263 Cotton Aplicator boks 135,000 0 0 0 0 0
264 Object Glass Kotak - 0 0 0 0 0

265 Cover Glass Kotak - 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0
268 BCG VIAL 59,950 8 479600 10 599500 12 719400 10 599500 15 899250
269 CAMPAK VIAL 28,204 0 0 0 0 10 282040
270 MR VIAL 141,648 0 0 0 0 0
271 DPT-HB-Hib VIAL 76,285 60 4577100 40 3051400 20 1525700 60 4577100 60 4577100

272 DT (BIAS) VIAL 17,798 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 40 836000 40 836000 25 522500 60 1254000 60 1254000
274 POLIO (BOPV) VIAL 19,954 40 798160 30 598620 0 0 40 798160
275 POLIO (IPV) VIAL 13,976 10 139760 15 209640 10 139760 15 209640 10 139760
276 Td VIAL 16,500 14 231000 50 825000 5 82500 5 82500 0

6 8 9 10 11 12
6 8 9 10 11 12
PETUMBUKAN PETUMBUKAN PETUMBUKAN PETUMBUKAN PETUMBUKAN PETUMBUKAN PETUMBUKAN TOTAL

TOTAL
HARGA
KELUAR
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL KELUAR
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA HARGA HARGA
JUNI JULI AGUSTUS SEPTEMBER OKTOBER NOPEMBER DESEMBER
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 1,000 93000 0 0 0 0 0 5000 465000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 3000 939000
0 2,000 176000 0 0 0 0 0 8000 704000
0 0 0 0 0 0 0 0 0
0 4,000 1060000 0 0 0 0 0 18000 4770000
0 0 0 0 0 0
0 100 250000 0 0 0 0 0 750 1875000
0 0 0 0 0 0 0 0 0
5,000
0 100 206500 0 0 0 0 0 650 1342250
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 168 1160040
0 1,500 163500 0 0 0 0 0 11500 1253500
0 3,000 1336500 0 0 0 0 0 8000 3564000

0 0 0 0 0 0 0 4000 704000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 48 234000 0 0 0 0 0 408 1989000
0 0 0 0 0 0 0 0 0
0 2,500 362500 0 0 0 0 0 10500 1522500
0 0 0 0 0 0 0 150 435000
0 0 0 0 0 0 0 3500 3696000
0 50 89900 0 0 0 0 0 290 521420
0 100 1155000 0 0 0 0 0 100 1155000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 200 576000
0 2,000 128000 0 0 0 0 0 14000 896000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 500 53000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 500 1177000
0 0 0 0 0 0 0 3000 2253000
0 0 0 0 0 0 0 300 2060100
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 80 333360
0 0 0 0 0 0 0 1500 654000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1500 121500
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 500 151500
0 2,500 145000 0 0 0 0 0 12500 725000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 460 3174000
0 0 0 0 0 0 0
0 5 37500 0 0 0 0 0 5005 37537500

0 0 0 0 0 0 0 0 0
0 500 120000 0 0 0 0 0 4500 1080000
0 0 0 0 0 0 0 1000 62000
0 0 0 0 0 0 0 240 636000
0 0 0 0 0 0 0 5000 780000
0 3,600 1573200 0 0 0 0 0 11600 5069200

0 0 0 0 0 0
0 2,000 624000 0 0 0 0 0 2000 624000
0 100 1155000 0 0 0 0 0 300 3465000

0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 500 115000
0 1,000 62000 0 0 0 0 0 8000 496000
0 500 357500 0 0 0 0 0 6500 4647500

0 0 0 0 0 0 0 0 0
0 3,000 129000 0 0 0 0 0 13000 559000
0 0 0 0 0 0 0 300 654900
0 1,000 154000 0 0 0 0 0 4000 616000
0 0 0 0 0 0
0 0 0 0 0 0 0 400 230000
0 0 0 0 0 0 0 600 1162200
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2000 160000
0 0 0 0 0 0 0 20 64000
0 0 0 0 0 0 0 5000 665000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 400 1073600
0 0 0 0 0 0 0 4000 648000
0 0 0 0 0 0 0 3000 369000
0 0 0 0 0 0 0 25000 3325000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 500 1900000
0 0 0 0 0 0 0 240 818400
0 0 0 0 0 0 0 5000 533350
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 300 1923000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1000 549000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2000 1606000
0 200 715000 0 0 0 0 0 200 715000
0 0 0 0 0 0 0 168 302064
0 0 0 0 0 0 0 300 570000
0 0 0 0 0 0 0 0 0
0 1,000 164000 0 0 0 0 0 8000 1312000
0 0 0 0 0 0 0 #REF! 408000
0 0 0 0 0 0 0
0 2,000 329240 0 0 0 0 0 7000 658480
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 200 299200 0 0 0 0 0 800 1196800
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 300 933900
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 500 154000
0 0 0 0 0 0 0 5000 620000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 6600
2,000 381320 0 0 0 0 0 0 2000 381320
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 340 2431000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 120 306480
0 0 0 0 0 0 0 500 39000
0 0 0 0 0 0 0 50 200000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 3 565989 0 0 0 0 0 3 565989
0 2,000 120000 0 0 0 0 0 8500 510000
0 0 0 0 0 0 0 700 817600
0 0 0 0 0 0 0 2000 266000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2000 578000
0 0 0 0 0 0 0 2000 1760000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 200 2442000
0 0 0 0 0 0 0 3000 957000
0 3,000 252000 0 0 0 0 0 13000 1092000
0 5,000 605000 0 0 0 0 0 20000 2420000
0 0 0 0 0 0 0 300 2893800
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 150 943500
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 127050
0 0 0 0 0 0 0 11 1375000
0 0 0 0 0 0 0 5527500
0 0 0 0 0 0 0 10 1787500
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 200 836000
0 0 0 0 0 0 0 200 836000
0 0 0 0 0 0 0 200 836000
0 0 0 0 0 0 0 200 836000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 500 396000 0 0 0 0 0 1000 792000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 200 165000
0 0 0 0 0 0 0 500 108000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 569250
0 0 0 0 0 0 0 27 542196
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 12 389892
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 12 630732
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 612264
0 0 0 0 0 0 0 #REF! 0
0 0 0 0 0 0 0 12 67158
0 0 0 0 0 0 0 500 1725000
0 0 0 0 0 0 0 18 0
0 0 0 0 0 0 0 20 575000
0 0 0 0 0 0 0 0 143750
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 5 880000
0 0 0 0 0 0 0 100 385000
0 0 0 0 0 0 0 100 0
0 0 0 0 0 0 0 0 141563
0 0 0 0 0 0 0 150 528000
0 0 0 0 0 0 0 50 176000
0 0 0 0 0 0 0 30 412500
0 0 0 0 0 0 0 50 137500
0 0 0 0 0 0 0 25 682000
0 0 0 0 0 0 0 10 0
0 0 0 0 0 0 0 0 150040
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 5 385000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 50 210000
0 0 0 0 0 0 0 250 412500
0 0 0 0 0 0 0 100 165000
0 0 0 0 0 0 0 200 165000
0 0 0 0 0 0 0 100 82500
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 14080000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1600 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 12 565800
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 300 108900
0 200 87780 0 0 0 0 0 200 87780

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 1,000 440000 0 0 0 0 0 3000 1320000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 3 196023
0 0 0 0 0 0 0 5 409777
0 5 235000 0 0 0 0 0 5 235000
0 0 0 0 0 0 0 0 327822
0 0 0 0 0 0 0 0 0
0 5 150000 0 0 0 0 0 9 150000
0 0 0 0 0 0 0 0 102610
0 0 0 0 0 0 0 0 0
0 5 82500 0 0 0 0 0 7 82500
0 0 0 0 0 0 0 0 84859
0 0 0 0 0 0 0 20 376364
0 0 0 0 0 0 0 3 188182
0 0 0 0 0 0 0 50 151591
0 0 0 0 0 0 0 10 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 300 141150 0 0 0 0 0 300 141150

0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 438984
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 12 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 233387
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 933 1475000
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 583000
0 0 0 0 0 0 0 0 47150
0 0 0 0 0 0 0 1012 2181732
0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1000 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 120 147000 0 0 0 0 0 120 147000
0 2,500 4127500 2500 4127500

0 28 0 28 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 #REF! 2945331
0 0 #REF! 3779970
0 0 3 302605
0 0 2 0
0 0 673 0
0 0 0 0
0 30 8295000 30 8295000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 42645400
0 0 0 0
0 0 116583 474920
0 0 4875 7902375
0 0 0 0
0 0 374 491810
0 0 0 0
0 0 5 83040
0 0 2 33216
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 8 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 2233000
0 0 0 0
0 0 100 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
13 779350 14 839300 62 4915900
0 0 10 282040
0 20 2832960 40 2832960
40 3051400 50 3814250 230 25174050

0 0 0 0
50 1045000 60 1254000 335 7001500
30 598620 40 798160 150 3591720
7 97832 10 139760 147 1076152
0 10 165000 59 1386000
PELAPORAN : PUSKESMAS TANJUNG MORAWA 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TANJUNG MORAWA TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 1,700 158100 0 0 0 5,000 465000 0 0 0 0 0 6700 623100
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 3,000 939000 0 0 0 2,000 626000 0 0 0 0 0 5000 1565000
tablet 88 0 0 2,400 211200 0 2,000 176000 0 0 0 0 0 0 0 4400 387200

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 0 20,000 5300000 0 20,000 5300000 0 25,000 6625000 0 0 0 0 0 65000 17225000
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0 0
btl 60 ml 2,065 0 0 400 826000 0 300 619500 0 700 1445500 0 0 0 0 0 1400 2891000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 0 0 5,000 2227500 0 0 0 0 0 5000 2227500
tablet 176 0 0 1,000 176000 0 0 0 0 0 0 0 0 0 1000 176000

13
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 2,000 290000 0 600 87000 0 3,000 435000 0 0 0 0 0 5600 812000
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 1,000 1056000 0 600 633600 0 1,000 1056000 0 0 0 0 0 2600 2745600
botol 11,550 0 0 0 0 0 0 300 3465000 0 0 0 0 0 300 3465000

21
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 0 10,000 640000 0 6,500 416000 0 8,000 512000 0 0 0 0 0 24500 1568000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tube 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
Flucord N Cream
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 400 174400 0 500 218000 0 0 0 0 0 0 0 900 392400
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 1,300 105300 0 1,000 81000 0 0 0 0 0 4300 348300

tablet 58 0 0 5,000 290000 0 3,000 174000 0 6,000 348000 0 0 0 0 0 14000 812000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

36 botol 6,900 0 0 0 0 130 897000 0 200 1380000 0 0 0 0 0 330 2277000
JKN 2019 7,363 0 0 0 0 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 3,000 720000 0 1,700 408000 0 3,500 840000 0 0 0 0 0 8200 1968000
42 Hidrokloratiazid 25 mg tablet 156 0 0 5,000 780000 0 1,000 156000 0 0 0 0 0 0 0 6000 936000
tablet / H.Baru 437 0 0 0 0 7,200 3146400 0 7,200 3146400 0 0 0 0 0 14400 6292800
43 Hustab Tablet tablet P 3,600 0 3600 0
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 50 577500 0 250 2887500 0 400 4620000 0 0 0 0 0 700 8085000
JKN 11,550 0 0 0 0 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 0 0 0 0 0

49 Karbamazepin tablet 200 mg tablet 230 0 0 500 115000 0 0 0 1,000 230000 0 0 0 0 0 1500 345000
50 Kaptopril 12,5 mg tablet 62 0 0 0 0 0 0 3,000 186000 0 0 0 0 0 3000 186000

52 Klorpramazine HCl 100 mg tablet - 0 0 2,000 0 0 0 0 0 0 0 0 0 0 2000 0

55 tablet 154 0 0 5,000 770000 0 15,000 2310000 0 5,000 770000 0 0 0 0 0 25000 3850000
APBD 2019 133 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 0 0 600 1162200 0 0 0 0 0 0 0 600 1162200

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 400 32000 0 0 0 0 0 0 0 0 0 400 32000
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 5,000 665000 0 3,600 478800 0 4,000 532000 0 0 0 0 0 12600 1675800
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 1,000 2684000 0 200 536800 0 100 268400 0 0 0 0 0 1300 3489200
tablet 133 0 0 15,000 1995000 0 10,000 1330000 0 0 0 0 0 0 0 25000 3325000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 5,600 597352 0 3,000 320010 0 0 0 0 0 0 0 8600 917362

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 6,410 0 0 200 1282000 0 240 1538400 0 300 1923000 0 0 0 0 0 740 4743400
68
Natrium Klorida larutan infus 0,9%
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 1,000
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 0 0 700 1330000 0 200 380000 0 0 0 0 0 900 1710000

ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 178 0 0 0 0 0 0 0 0 0 0 0 0 0
75
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 550 822800 0 600 897600 0 0 0 0 0 1650 2468400
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 100 311300 0 500 1556500 0 500 1556500 0 0 0 0 0 1100 3424300
78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 3,000 924000 0 1,300 400400 0 0 0 0 0 0 0 4300 1324400
82 Propanolol HCL 10 mg tablet 66 0 0 200 13200 0 0 0 0 0 0 0 0 0 200 13200

tablet 191 0 0 0 0 0 0 5,000 953300 0 0 0 0 0 5000 953300
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 1,000 497000 0 0 0 0 0 0 0 0 0 1000 497000
botol 7,150 0 0 400 2860000 0 600 4290000 0 300 2145000 0 0 0 0 0 1300 9295000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 30 76620 0 0 0 0 0 0 0 0 0 30 76620
89 Salbutamol tablet 2 mg tablet 78 0 0 2,000 156000 0 1,000 78000 0 2,000 156000 0 0 0 0 0 5000 390000
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 40 160000 0 100 400000 0 0 0 0 0 0 0 140 560000
93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 1,000 1168000 0 1,000 1168000 0 0 0 0 0 0 0 2000 2336000
tablet 133 0 0 1,000 133000 0 0 0 0 0 0 0 0 0 1000 133000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 289 0 0 800 231200 0 0 0 3,000 867000 0 0 0 0 0 3800 1098200
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 800 704000 0 0 0 0 0 0 0 800 704000

silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 1,000 319000 0 4,300 1371700 0 3,000 957000 0 0 0 0 0 8300 2647700
102 Vitamin B komplek Tablet tablet 121 0 0 15,000 1815000 0 0 0 20,000 2420000 0 0 0 0 0 35000 4235000
Botol 9,646 0 0 500 4823000 0 0 0 0 0 0 0 0 0 500 4823000
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 100 629000 0 0 0 200 1258000 0 0 0 0 0 300 1887000
3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

108 Autocheck Blood Glucose Test Strip box 137,500 0 0 3 412500 2 275000 10 1375000 0 10 1375000 0 0 0 0 0 25 3437500
110 Autocheck Urid Acid Test Strip box 178,750 0 0 3 536250 2 357500 10 1787500 0 10 1787500 0 0 0 0 0 25 4468750
111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 10 606364 0 0 0 0 0 606364

113 Abbocath No.22 G buah 4,180 0 0 200 836000 0 250 1045000 0 0
buah 4,180 0 0 200 836000 0 200 836000 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 2,000 1584000 0 0 0 0 0 0 0 0 0 0 2000 1584000
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 0 0 300 64800 0 0 0 0 0 1300 280800

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 2 75900 0 0 0 0 0 0 0 2 75900

botol / bpjs 37,950 0 44 1669800 0 0 0 0 0 0 0 0 0 0 44 1669800
buah 45,183 0 0 0 0 12 542196 0 12 542196 0 0 0 0 0 24 1084392

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 12 389892 0 12 389892 0 0 0 0 0 24 779784

buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 100 373100 0 0 0 0 0 0 0 0 0 0 100 373100
botol 3,450 0 0 100 345000 0 0 0 0 0 0 0 0 0 100 345000

botol / bpjs 3,450 0 24 82800 0 0 0 0 0 0 0 0 0 0 24 82800
botol 28,750 0 0 3 86250 0 10 287500 0 0 0 0 0 0 0 13 373750

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 30 862500 0 0 0 0 0 0 0 0 0 0 30 862500
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 200 566251 0 0 0 0 0 0 0 0 0 0 200 566251
set 3,520 0 0 100 352000 0 200 704000 0 200 704000 0 0 0 0 0 500 1760000
set / bpjs 3,520 0 400 1408000 0 0 0 0 0 0 0 0 0 0 400 1408000
buah 13,750 0 0 0 0 25 343750 0 0 0 0 0 0 0 25 343750

buah / bpjs 13,750 0 30 412500 0 0 0 0 0 0 0 0 0 0 30 412500

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 50 105000 0 0 0 0 0 0 0 0 0 0 50 105000
rol 1,650 0 0 0 0 200 330000 0 0 0 0 0 0 0 200 330000

rol / bpjs 1,650 0 250 412500 0 0 0 0 0 0 0 0 0 0 250 412500
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 100 82500 0 0 0 0 0 0 0 0 0 0 100 82500
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 1,280 11264000 0 0 0 0 0 0 0 0 0 0 1280 11264000
botol 47,150 0 0 3 141450 0 2 94300 0 0 0 0 0 0 0 5 235750

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 500 181500 0 0 0 0 0 0 0 500 181500
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 5,000 2200000 0 1,000 440000 0 300 132000 0 0 0 0 0 6300 2772000
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0


rol 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 10 188182 0 0 0 0 0 0 0 0 0 0 10 188182
botol 3,032 0 0 100 303182 0 0 0 0 0 0 0 0 0 100 303182

botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 400 2758000 0 0 0 0 0 0 0 0 0 0 400 2758000

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 20 66000 0 0 0 0 0 0 0 0 0 0 20 66000
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 2 5500000 0 0 0 2 5500000 0 0 0 0 0 4 11000000
168 Cleaner Samsung Unit 2,200,000 0 0 1 2200000 0 0 0 2 4400000 0 0 0 0 0 3 6600000

169 Hipo Cleaner Samsung Unit 2,200,000 0 0 2 4400000 0 0 0 2 4400000 0 0 0 0 0 4 8800000
170 Lise Samsung Unit 3,300,000 0 0 1 3300000 0 0 0 2 6600000 0 0 0 0 0 3 9900000

171 Rinse Mindrey galon 1,254,000 0 4 5016000 0 0 0 0 0 0 0 0 0 0 4 5016000
Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 2,000 606000 0 0 0 0 0 0 0 2000 606000
183 ZINC Tablet TABLET 539 0 1,971 1062369 0 0 0 0 0 0 0 0 0 0 1971 1062369
185 POT SPUTUM BUAH 2,950 0 500 1475000 0 500 1475000 0 0 0 0 0 0 0 0 1000 2950000

189 Lisol 100 % botol 47,150 0 3 141450 0 0 0 0 0 0 0 0 0 0 3 141450

190 Reagen Ziehl Neelsen kit 181,811 0 30 5454330 0 0 0 0 0 0 0 0 0 0 30 5454330

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 3 0 0 0 0 0 0 0 0 0 0 0 3 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 10 0 0 0 0 0 0 0 0 0 0 10 0
197 CHLORIN Liter - 0 0 2 0 0 0 0 0 0 0 0 0 0 2 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 25 0 25 0 25 0 0 0 0 0 0 0 75 0




OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 2 704000 0 0 0 2 704000 0 0 0 0 0 4 1408000


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 16 5236144 0 32 10472288 0 48 15708432 0 0 0 0 0 0 0 96 31416864
228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 4 1210420 20 6052100 0 0 0 0 0 0 0 24 7262520
229 OAT FDC Kategori Anak paket 203,259 0 10 2032590 0 15 3048885 0 0 0 0 0 0 0 0 25 5081475
230 RH ( Fase Lanjutan ) paket - 0 0 1,344 0 0 0 0 0 0 0 0 0 0 1344 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 20 5530000 0 0 0 0 0 0 0 20 5530000

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 531064 194900488 0 0 0 0 0 0 0 0 0 0 531064 194900488
buah/ skipa 1,240 1751 2171240 0 0 0 0 0 0 0 0 0 0 0 1751 2171240

237 Spuit 0,5 ml
buah / apbn 1,621 22298 36145058 0 0 0 0 0 0 0 0 0 0 0 22298 36145058

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 1713 2252595 0 0 0 0 0 0 0 0 0 0 0 1713 2252595
Spuit 5 ml APBN 1,705 76 129580 76
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 20 332160 0 0 0 0 0 0 0 0 0 0 0 20 332160
Box / 2,5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 500 11165000 500 11165000 500 11165000 0 0 0 0 0 0 1500 33495000

256 Anuscopy buah - 0 0 0 0 0 500 0 0 0 0 0 0 0 500 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 50 2997500 50 2997500 50 2997500 50 2997500 50 2997500 50 2997500 40 2398000 0 0 0 0 0 340 20383000
269 CAMPAK VIAL 28,204 0 0 0 0 50 1410200 50 1410200 0 0 0 0 0 0 100 2820400
270 MR VIAL 141,648 0 0 50 7082400 0 0 0 50 7082400 0 0 0 0 0 100 14164800
271 DPT-HB-Hib VIAL 76,285 170 12968450 80 6102800 170 12968450 170 12968450 120 9154200 170 12968450 170 12968450 0 0 0 0 0 1050 80099250
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 200 4180000 200 4180000 200 4180000 200 4180000 200 4180000 200 4180000 200 4180000 0 0 0 0 0 1400 29260000
274 POLIO (BOPV) VIAL 19,954 140 2793560 100 1995400 0 0 120 2394480 200 3990800 120 2394480 0 0 0 0 0 680 13568720
275 POLIO (IPV) VIAL 13,976 30 419280 30 419280 30 419280 50 698800 50 698800 50 698800 50 698800 0 0 0 0 0 290 4053040
276 Td VIAL 16,500 25 412500 25 412500 50 825000 30 495000 30 495000 30 495000 30 495000 0 0 0 0 0 220 3630000
PELAPORAN : PUSKESMAS DALU X 3 4 5 6
1 2 3 4 5 6
DALU X DALU X DALU X DALU X DALU X DALU X

TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA HARGA
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI JUNI
1 Acyclovir 400 mg tablet tablet 359 0 0 0 0 0 0

2 Acyclovir Krim tube 8,580 0 0 0 0 0 0
tablet 93 0 0 2,000 186000 0 0 0

silva/ 2014 945 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 0 0 0 0
tablet 88 0 0 2,000 176000 0 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0
6 kapsul 265 0 0 15,000 3975000 0 15,000 3975000 0

Amoksisilin 500 mg
kapsul 260 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 300 750000 0 0 0

8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 0 0 0 0 0
btl 60 ml 2,065 0 0 400 826000 0 200 413000 0

btl 60 ml 2,189 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 0 0 0 0

tablet/ H Baru 446 0 0 0 0 0 0
tablet 176 0 0 0 0 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0
14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0

15 Betametason krim 0,1% 5 gr tube 4,875 0 0 0 0 0 0
16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 3,000 435000 0 0 0

18 Cetrizin syrup botol 2,900 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 3,000 3168000 0 0 0
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 100 179800 0 50 89900 0
botol 11,550 0 0 0 0 0 0
21
Dextrofen syrup silva/2015 11,550 0 0 0 0 0 0
JKN 2019 11,550 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0
24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 200 576000 0 0 0
tablet 64 0 0 10,000 640000 0 10,000 640000 0
tablet/ H. Baru 143 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 2,000 1502000 0 0 0

29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 200 1373400 0 0 0
tube 18,844 0 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 200 833400 0 0 0
tablet 436 0 0 500 218000 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 0 0
33 Fenobarbital 30 mg tablet 180 0 0 0 0 0 0
34 Garam oralit 200 ml air bks 303 0 0 0 0 0 0
tablet 58 0 0 5,000 290000 0 4,000 232000 0
tablet/ H. Baru 125 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0
36 botol 6,900 0 0 100 690000 0 100 690000 0

JKN 2019 7,363 0 0 0 0
37 Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0

39 Griseofulvin 125 mg Tablet tablet 240 0 0 1,000 240000 0 0 0
40 Haloperidol tablet 0,5 mg tablet 62 0 0 0 0 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 48 127200 0 100 265000 0

42 Hidrokloratiazid 25 mg tablet 156 0 0 2,000 312000 0 0 0
tablet / H.Baru 437 0 0 3,000 1311000 0 3,600 1573200 0

43 Hustab Tablet tablet 258 0 0 0 1,000 0
tablet P 312 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 50 577500 0 200 2310000 0
JKN 11,550 0 0 0 0
44 Hustab syrup silva /2014 11,550 0 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0 0

botol 8,046 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 500 46500 0 0 0

47 Iliadin Spray botol 36,036 0 0 0 0 0 0
48 Iliadin Drop botol 31,080 0 0 0 0 0 0
Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0

49 Karbamazepin tablet 200 mg tablet 230 0 0 0 0 0 0
50 Kaptopril 12,5 mg tablet 62 0 0 3,000 186000 0 0 0
51 Kaptopril 25 mg tablet 715 0 0 3,000 2145000 0 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 15,000 645000 0 10,000 430000 0
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 200 436600 0 300 654900 0
55 tablet 154 0 0 3,000 462000 0 4,000 616000 0

APBD 2019 133 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 0 0 0 0
ampul 1,937 0 0 300 581100 0 0 0

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 2,000 160000 0 0 0

59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0
tablet 133 0 0 4,000 532000 0 0 0
tablet 106 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 0 0 30 80520 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 3,000 486000 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 1,000 123000 0 0 0
tablet 133 0 0 15,000 1995000 0 5,000 665000 0

tablet 264 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 200 760000 0 0 0
66 Mikonazol Cream 2 % tube 3,410 0 0 24 81840 0 24 81840 0
tablet 107 0 0 2,000 213340 0 2,000 213340 0
67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0
silva 2015 136 0 0 0 0 0 0
botol 6,410 0 0 200 1282000 0 100 641000 0

68
Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0
APBD 2019 6,840 0 0 0 0 0 0
tablet 549 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0
tablet 803
tablet/ H Baru 886 0 0 0 0 0 0
71 Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 0 0 0 0
ampul 1,900 0 0 0 0 0 0
ampul/H baru 1,199 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 3,000 492000 0 1500 246000 0
tablet 51 0 0 0 0 0 0
tablet 178 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 0 0
silva/ 2015 165 0 0 0 0 0 0
JKN 2019 165 0 0 0 0 0 0
76 botol 1,496 0 0 200 299200 0 300 448800 0

77 botol 1,184 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0
78
Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0
JKN 2019 3,113 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 0 0 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 5,000 620000 0 0 0

81 Prednison 5 mg Tablet tablet 96 0 0 0 0 0 0
82 Propanolol HCL 10 mg tablet 66 0 0 0 0 0 0

tablet 191 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL)
tablet 226 0 0 0 0 0 0
83
Ranitidin tablet 150 mg (HCL) Silva 2015 660 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0
JKN 2019 225 0 0 0 0 0 0
84 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0
85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0
86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0

botol 7,150 0 0 400 2860000 0 100 715000 0
Jkn Silva 2015 6,936 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 0 0 2,000 156000 0
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 0 0 0 0
91 Salbutamol syrup botol 4,042 0 0 0 0 0 0
92 Salisil Bedak 2,5% bks 1,046 0 0 0 0 0 0
93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 0 0 1,000 60000 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 500 584000 0
tablet 133 0 0 0 0 0 0
96 Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0
97 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0

tablet 289 0 0 0 0 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 0 0
silva/ 2018 880 0 0 0 0 0 0

99 Sanadryl Syrup botol 12,210 0 0 100 1221000 0 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 0 0 300 95700 0
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 10,000 840000 0 5,000 420000 0
102 Vitamin B komplek Tablet tablet 121 0 0 7,000 847000 0 10,000 1210000 0
Botol 9,646 0 0 200 1929200 0 0 0

Botol 10,293 0 0 0 0 0 0
104 Zink Tablet Tablet 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0
3,322 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 4 76020 0

BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0
107 Accu Check safe T Pro Uno Dus 127,050 0 0 0 0 0 0
108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 0 0

109 Autocheck Blood Cholesterol Test Strip box 368,500
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 0 0
111 ABN Hand Rub 500 ml Botol 60,636

113 Abbocath No.22 G buah 4,180 50
buah 4,180 100
buah / bpjs 4,180 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0
buah 792 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 0 0 0 0
buah 792 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 0 0 0 0
buah 216 0 0 0 0 0 0
buah 197 0 0 0 0 0 0
122 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0
125 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0

buah 52,561 0 0 0 0 0 0
buah / bpjs 52,561 0 36 1892196 0 0 0 0
buah 51,022 0 0 0 0 0 0
buah / bpjs 51,022 0 36 1836792 0 0 0 0
buah 3,731 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0
botol 28,750 0 0 0 0 0 0
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0
132 Infusion Set Anak set 2,831 0 0 0 0 0 0

set / bpjs 2,831 0 20 56625 0 0 0 0
set 3,520 0 0 0 0 0 0
set / bpjs 3,520 0 50 176000 0 0 0 0
buah 13,750 0 0 0 0 0 0
buah / bpjs 13,750 0 0 0 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0
rol / bpjs 7,700 0 10 77000 0 0 0 0
rol 2,100 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0
rol 1,650 0 0 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0
rol 825 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0
buah / bpjs 8,800 0 16,800 147840000 0 0 0 0
142 Kasa Steril 40 x 40 buah 1,600 0 0 0 0 0 0
143 Kasa Steril 5 x 5 buah 3,181 0 0 0 0 0 0
144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0
botol 47,150 0 0 0 0 0 0
145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0
buah 363 0 0 0 0 0 0
146 Masker Tie On buah 439 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0

buah 363 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0

149 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0
buah 440 0 0 0 0 0 0
buah / bpjs 440 0 0 0 0 0 0
151 My Jelly 82 gram tube - 0 0 0 0 0 0
152 Object Glass Kotak 19,365 0 0 0 0 0 0
153 One scrub 500 cc + dispenser botol 65,341 0 0 0 0 0 0
rol 81,955 0 0 0 0 0 0
154 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0 0

rol / bpjs 81,955 0 9 737599 0 0 0 0
rol 51,305 0 0 0 0 0 0
rol / bpjs 51,305 0 15 769575 0 0 0 0
rol 28,286 0 0 0 0 0 0
rol / bpjs 28,286 0 62 1753760 0 0 0 0
botol 18,818 0 0 0 0 0 0
botol / bpjs 18,818 0 0 0 0 0 0
botol 3,032 0 0 0 0 0 0
botol / bpjs 3,032 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0
159 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0
160 Sarung tangan M buah 471 0 0 0 0 0 0
buah 36,582 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0
buah - 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0
163 Skin Celean 500 ml botol - 0 100 0 0 0 0 0
164 Tranfusion Set buah 4,000 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 1 3300 0 0 0 0
REAGENSIA - 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 0 0
168 Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0

169 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0
170 Lise Samsung Unit 3,300,000 0 0 0 0 0 0

171 Rinse Mindrey galon 1,254,000 0 0 0 0 0 0
172 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0
173 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0
174 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0
175 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0
176 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0

177 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0 0
178 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0
179 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0

180 URID ACID (URICASE) Kit 799,700 0 0 0 0 0 0
181 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 0 0
183 ZINC Tablet TABLET 539 0 1,400 754600 0 0 0 0
184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0
187 Tuberculin PPD Vial 702,250 0 0 0 0 0 0
188 Sarung tangan tanpa tepung M buah 583 0 1,000 583000 0 0 0 0
189 Lisol 100 % botol 47,150 0 3 141450 0 0 0 0
190 Reagen Ziehl Neelsen kit 181,811 0 0 0 0 0 0

191 Masker 3 Ply Earloop Jilbab buah - 0 1,500 0 0 0 0 0
192 Spritus Liter 45,455 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0
194 Imersion Oil Botol 3,181,818 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0
195 KAPAS LIDI Bungkus - 0 0 1 0 0 0 0
196 ASAM CUKA botol - 0 0 6 0 0 0 0
197 CHLORIN Liter - 0 0 1 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0
Program Imunisasi 1,404 0 0 0 0 0 0
199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0
201 Safety Box 5 liter box - 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0
203 BD Vacuntainer box - 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0

206 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 0 0 0
207 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0

208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0
209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0

210 Sarung tangan L buah 499 0 0 0 0 0 0
211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0
212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0
213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0

215 Articulating Pcs 181,500 0 0 0 0 0 0
216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0
217 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0

218 1470A2 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0
219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0
220 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0 0

221 Guta Percha Point #45-80 Box 46,700 0 0 0 0 0 0
222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0
225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0
OBAT PROGRAM PROVINSI - 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 0 16 5236144 0 32 10472288 0
227 OAT FDC Kategori 2 paket 1,259,990 1 1259990 0 0 0 0 0

228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 0 5 1513025 0
229 OAT FDC Kategori Anak paket 203,259 0 0 0 0 0 0
230 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 60 16590000 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0
Provinsi 367 0 377812 138657004 0 0 0 0
Program Imunisasi - 0 0 0 0 0 0
buah/ skipa 1,240 1246 1545040 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 15868 25722028 0 0 0 0 0
Spuit 0,5 ml ( Solosot Mini) Box 165,550 1 165550 0
buah/ skipa 1,415 0 0 0 0 0 0

238 Spuit 0,05 ml
APBN 1,315 1219 1602985 0 0 0 0 0
Spuit 5 ml APBN 1,705 54 92070 0
Box 16,608 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 17 282336 0 0 0 0 0

Box / 2,5ml 16,608 4 66432 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0

241 DHP Frimal TABLET 2,160 0 0 0 0 0 0
242 Primaquin TABLET 235 0 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 0 0 0 0
246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 0 0 0 0 0

248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0
250 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0

251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 0 0 0
252 Rapid Test II ( FOKUS ) Test 13,615 0 0 0 0 0 0
253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0
254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0

256 Anuscopy buah - 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0 0
258 Blue Tips bungkus - 0 0 0 0 0 0
259 Metilen Blue botol 94,500 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0

263 Cotton Aplicator boks 135,000 0 0 0 0 0 0
264 Object Glass Kotak - 0 0 0 0 0 0
265 Cover Glass Kotak - 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0
268 BCG VIAL 59,950 40 2398000 40 2398000 40 2398000 40 2398000 40 2398000 40 2398000
269 CAMPAK VIAL 28,204 0 0 0 0 30 846120 30 846120
270 MR VIAL 141,648 70 9915360 70 9915360 20 2832960 50 7082400 30 4249440 30 4249440
271 DPT-HB-Hib VIAL 76,285 50 3814250 90 6865650 100 7628500 180 13731300 150 11442750 150 11442750
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 15 313500 200 4180000 100 2090000 170 3553000 170 3553000 170 3553000
274 POLIO (BOPV) VIAL 19,954 70 1396780 120 2394480 0 0 130 2594020 150 2993100
275 POLIO (IPV) VIAL 13,976 40 559040 40 559040 40 559040 40 559040 40 559040 40 559040
276 Td VIAL 16,500 0 40 660000 40 660000 20 330000 40 660000 30 495000

8 9 10 11 12
8 9 10 11 12
DALU X DALU X DALU X DALU X DALU X DALU X TOTAL

TOTAL
HARGA
KELUAR
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL KELUAR
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA HARGA
JULI AGUSTUS SEPTEMBER OKTOBER NOPEMBER DESEMBER
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 186000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 176000
0 0 0 0 0 0 0 0
5,000 1325000 0 0 0 0 0 35000 9275000
0 0 0 0 0
0 0 0 0 0 0 300 750000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 600 1239000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
5,000 2227500 0 0 0 0 0 5000 2227500
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
50 243750 0 0 0 0 0 50 243750
0 0 0 0 0 0 0 0
0 0 0 0 0 0 3000 435000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 3000 3168000
48 86304 0 0 0 0 0 198 356004
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 200 576000
0 0 0 0 0 0 20000 1280000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 1502000
0 0 0 0 0 0 200 1373400
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 200 833400
0 0 0 0 0 0 500 218000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 162000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 9000 522000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 200 1380000
0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 240000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 148 392200
0 0 0 0 0 0 2000 312000
0 0 0 0 0 0 6600 2884200
0 0 0 0 0 0 1000 0
0 0 0 0 0 0 0 0
100 1155000 0 0 0 0 0 350 4042500
0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
200 18600 0 0 0 0 0 700 65100

0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 3000 186000
0 0 0 0 0 0 3000 2145000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 25000 1075000
0 0 0 0 0 0 500 1091500
0 0 0 0 0 0 7000 1078000
0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 300 581100
0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 160000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 4000 532000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 30 80520
0 0 0 0 0 0 3000 486000
0 0 0 0 0 0 1000 123000
0 0 0 0 0 0 20000 2660000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 200 760000
50 170500 0 0 0 0 0 98 334180
0 0 0 0 0 0 4000 426680
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 300 1923000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 4500 738000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 500 748000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 5000 620000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 500 3575000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 156000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 60000
0 0 0 0 0 0 1000 1168000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 100 1221000
1,000 319000 0 0 0 0 0 1300 414700
5,000 420000 0 0 0 0 0 20000 1680000

5,000 605000 0 0 0 0 0 22000 2662000
0 0 0 0 0 0 200 1929200
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 9 171045
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 50 209000
0 0 0 0 0 0 50 209000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 36 1892196
0 0 0 0 0 0 0 0
0 0 0 0 0 0 36 1836792
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 20 56625
50 176000 0 0 0 0 0 50 176000
0 0 0 0 0 0 50 176000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 10 77000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 16800 147840000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 9 737599
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 15 769575
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 62 1753760
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 100 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 3300
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1 1379400 0 0 0 0 0 1 1379400
1 1379400 0 0 0 0 0 1 1379400
1 1669800 0 0 0 0 0 1 1669800
1 949850 0 0 0 0 0 1 949850
1 76230 0 0 0 0 0 1 76230
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1400 754600
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 583000
0 0 0 0 0 0 3 141450
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1500 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 0
0 0 0 0 0 0 6 0
0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
390 477750 0 0 0 0 0 390 477750
8,000 13208000 0 0 0 0 0 8000 13208000
92 0 0 0 0 0 0 92 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 352000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 48 15708432
0 0 0 0 0 0 1 1259990
0 0 0 0 0 0 5 1513025
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 60 16590000
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 377812 138657004
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1246 1545040
0 0 0 0 0 0 15868 25722028
0 1 165550
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1219 1602985
0 54 92070
0 0 0 0 0 0 0 0
0 0 0 0 0 0 17 282336
0 0 0 0 0 0 4 66432
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 8 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
40 2398000 0 0 0 0 0 280 16786000
30 846120 0 0 0 0 0 90 2538360
30 4249440 0 0 0 0 0 300 42494400
180 13731300 0 0 0 0 0 900 68656500
0 0 0 0 0 0 0 0
200 4180000 0 0 0 0 0 1025 21422500
170 3392180 0 0 0 0 0 640 12770560

40 559040 0 0 0 0 0 280 3913280
30 495000 0 0 0 0 0 200 3300000

PELAPORAN : PUSKESMAS PATUMBAK 3 4 5 6 8 9
1 2 3 4 5 6 8 9
PATUMBAK PATUMBAK PATUMBAK PATUMBAK PATUMBAK PATUMBAK PATUMBAK PATUMBAK PATUMBAK

tablet 93 0 0 4,000 372000 0 3,500 325500 0 0 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 0 0 2,900 907700 0 0 0 0
tablet 88 0 0 5,000 440000 0 5,300 466400 0 5,000 440000 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 0 20,000 5300000 0 20,000 5300000 0 15,000 3975000 0 0

Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0

btl 60 ml 2,065 0 0 500 1032500 0 200 413000 0 500 1032500 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 0 0 7,500 3341250 0 0

tablet 176 0 0 500 88000 0 0 0 0 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0 0


17 Cetrizin tablet tablet 145 0 0 2,000 290000 0 1,000 145000 0 4,000 580000 0 0
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 200 359600 0 200 359600 0 200 359600 0 0
botol 11,550 0 0 0 0 0 0 0 0 0
21
Dextrofen syrup
JKN 2019 11,550 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0
tablet 64 0 0 16,000 1024000 0 2,700 172800 0 9,000 576000 0 0

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0

tube 18,844 0 0 0 0 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 100 416700 0 30 125010 0 0 0 0
tablet 436 0 0 1,000 436000 0 400 174400 0 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0 300 239097 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 300 24300 0 1,600 129600 0 1,100 89100 0 0

tablet 58 0 0 6,000 348000 0 1,500 87000 0 4,400 255200 0 0
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0
36 botol 6,900 0 0 100 690000 0 40 276000 0 160 1104000 0 0

JKN 2019 7,363 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 3,000 720000 0 800 192000 0 2,600 624000 0 0
40 Haloperidol tablet 0,5 mg tablet 62 0 0 1,000 62000 0 0 0 0 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 96 254400 0 200 530000 0 200 530000 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 0 0 1,000 156000 0 0
tablet / H.Baru 437 0 0 5,000 2185000 0 5,000 2185000 0 5,000 2185000 0 0

tablet P 312 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 100 1155000 0 150 1732500 0 200 2310000 0 0

JKN 11,550 0 0 0 0 0 0

44 Hustab syrup
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 0 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 1,500 139500 0 0 0 500 46500 0 0

Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 0
49 Karbamazepin tablet 200 mg tablet 230 0 0 1,000 230000 0 0 0 0 0 0
50 Kaptopril 12,5 mg tablet 62 0 0 3,000 186000 0 0 0 1,200 74400 0 0

52 Klorpramazine HCl 100 mg tablet - 0 0 1,000 0 0 0 0 0 0 0

53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 15,000 645000 0 11,000 473000 0 11,000 473000 0 0
55 tablet 154 0 0 5,000 770000 0 7,000 1078000 0 8,500 1309000 0 0
APBD 2019 133 0 0 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 200 115000 0 0 0 0 0 0
ampul 1,937 0 0 400 774800 0 90 174330 0 400 774800 0 0

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0
tablet 133 0 0 3,000 399000 0 1,800 239400 0 2,800 372400 0 0
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 300 805200 0 100 268400 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 300 48600 0 0 0 200 32400 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 4,000 492000 0 3,000 369000 0 4,000 492000 0 0
tablet 133 0 0 15,000 1995000 0 10,000 1330000 0 0 0 0

tablet 264 0 0 0 0 0 0 0 0 0
tablet 107 0 0 3,000 320010 0 1,300 138671 0 0 0 0
67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 3,000 408000 0 0

silva 2015 136 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 400 2564000 0 100 641000 0 240 1538400 0 0

68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0
tablet 549 0 0 2,000 1098000 0 0 0 700 384300 0 0

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0
tablet 803 500 3,000
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 500 950000 0 150 285000 0 500 950000 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0
tablet 51 0 0 17,000 867000 0 0 0 0 0 0
tablet 178 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 4,000 658480 0 0 0 0
75
silva/ 2015 165 0 0 0 0 0 0 0 0 0

JKN 2019 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 400 598400 0 350 523600 0 0

77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 1,300 4046900 0 0 0 0 0 0

78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0

79 Pirantel tablet score 125 mg tablet 308 0 0 2,000 616000 0 600 184800 0 1,400 431200 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 10,000 1240000 0 5,000 620000 0 7,400 917600 0 0

tablet 191 0 0 0 0 0 0 3,000 571980 0 0
tablet 226 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 0
JKN 2019 225 0 0 0 0 0 0 0 0 0

botol 7,150 0 0 600 4290000 0 200 1430000 0 200 1430000 0 0

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 3,000 234000 0 1,100 85800 0 2100 163800 0 0
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 100 400000 0 40 160000 0 0 0 0

91 Salbutamol syrup botol 4,042 0 0 0 0 0 0 0 0 0

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 7,000 420000 0 6,000 360000 0 10,000 600000 0 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 700 817600 0 500 584000 0 800 934400 0 0
tablet 133 0 0 2,000 266000 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0
tablet 289 0 0 1,500 433500 0 0 0 4,000 1156000 0 0

98 Siprofloksasin 500 MG tablet 880 0 0 0 0 2,000 1760000 0 0 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 5,500 1754500 0 0 0 3,800 1212200 0 0
Botol 9,646 0 0 300 2893800 0 0 0 0 0 0

Botol 10,293 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 100 629000 0 0 0 100 629000 0 0
3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 6 114030 0 3 57015 0 0
108 Autocheck Blood Glucose Test Strip box 137,500 0 0 5 687500 0 5 687500 0 10 1375000 0 0
109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 5 1842500 10 10
110 Autocheck Urid Acid Test Strip box 178,750 0 0 5 893750 0 5 893750 0 10 1787500 0 0
111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 5
112 Abbocath No.20 G buah 4,180 0 0 100 418000 0 0 0 50 209000 0 0
113 Abbocath No.22 G buah 4,180 0 0 100 418000 50

buah 4,180 0 0 100 418000 50
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 1,000 792000 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 500 396000 0 500 396000 0 500 396000 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0

buah 216 0 0 1,000 216000 0 0 0 300 64800 0 0
buah 197 0 0 0 0 0 0 0 0 0

botol 37,950 0 0 0 0 2 75900 0 0 0 0
botol / bpjs 37,950 0 20 759000 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 12 630732 0 0 0 12 630732 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 400 1380000 0 0 0 0 0 0

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 18 517500 0 10 287500 0 1 28750 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 10 287500 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0
132 Infusion Set Anak set 2,831 0 0 100 283126 0 0 0 0 0 0

set / bpjs 2,831 0 200 566251 0 0 0 0 0 0 0
set 3,520 0 0 200 704000 0 150 528000 0 200 704000 0 0

set / bpjs 3,520 0 200 704000 0 0 0 0 0 0 0
buah 13,750 0 0 20 275000 0 13 178750 0 48 660000 0 0

buah / bpjs 13,750 0 10 137500 0 0 0 0 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 10 272800 0 5 136400 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 10 300080 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 20 154000 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 100 210000 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 100 165000 0 0 0 0 0 0 0
rol 825 0 0 500 412500 0 0 0 0 0 0
rol / bpjs 825 0 100 82500 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 1,600 14080000 0 0 0 0 0 0 0

botol 47,150 0 0 5 235750 0 0 0 0 0 0

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0

buah 363 0 0 100 36300 0 0 0 0 0 0

buah / bpjs 363 0 0 0 0 0 0 0 0 0

buah 440 0 0 500 220000 0 600 264000 0 0 0 0
buah / bpjs 440 0 0 0 0 0 0 0 0 0
153 One scrub 500 cc + dispenser botol 65,341 0 0 2 130682 0 0 0 0 0 0
rol 81,955 0 0 5 409777 0 0 0 0 0 0

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0

rol / bpjs 28,286 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 30 564545 0 0 0 0 0 0

botol / bpjs 18,818 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 200 606364 0 0 0 0 0 0
botol / bpjs 3,032 0 1 3032 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0
160 Sarung tangan M buah 471 0 0 0 0 0 0 2,000 941000 0 0
buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 10 144716 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 1 2750000 0 0 0 0
168 Cleaner Samsung Unit 2,200,000 0 0 0 0 1 2200000 0 0 0 0
169 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 1 2200000 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 1,200 363600 0 0 0 0

183 ZINC Tablet TABLET 539 0 1,551 835989 0 0 0 0 0 0 0
184 OAT FDC Kategori 1 Kombipak PAKET 302,605 0 4 1210420 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 500 1475000 0 500 1475000 0 0 0 0 0


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0
192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 3 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 7 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0

198 Spritus Liter - 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0




OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 1 352000 0 0


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0

Program TB Paru - 0 0 0 0 0 0 0 0 0


231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 418576 153617392 0 0 0 0 0 0 0
buah/ skipa 1,240 1379 1709960 0 0 0 0 0 0 0 0
237 Spuit 0,5 ml
buah / apbn 1,621 17566 28474486 0 0 0 0 0 0 0 0
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 1349 1773935 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 60 102300

Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 19 315552 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 4 66432 0 0 0 0 0 0 0 0

240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0

248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 4 159993 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0
251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0

266 Handscoen boks - 0 0 0 0 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0

Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 40 2398000 40 2398000 42 2517900 42 2517900 40 2398000 42 2517900 42 2517900 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 50 1410200 0 20 564080 0 0
270 MR VIAL 141,648 20 2832960 80 11331840 80 11331840 80 11331840 30 4249440 80 11331840 80 11331840 0 0
271 DPT-HB-Hib VIAL 76,285 200 15257000 140 10679900 70 5339950 200 15257000 100 7628500 165 12587025 160 12205600 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 130 2717000 180 3762000 50 1045000 180 3762000 180 3762000 200 4180000 180 3762000 0 0
274 POLIO (BOPV) VIAL 19,954 80 1596320 90 1795860 0 0 100 1995400 130 2594020 130 2594020 0 0
275 POLIO (IPV) VIAL 13,976 40 559040 50 698800 20 279520 30 419280 40 559040 50 698800 50 698800 0 0
276 Td VIAL 16,500 30 495000 0 30 495000 30 495000 30 495000 30 495000 30 495000 0 0

10 11 12
10 11 12
PATUMBAK PATUMBAK PATUMBAK TOTAL

TOTAL
HARGA
KELUAR
HARGA HARGA HARGA
0 0 0 0 0
0 0 0 0 0
0 0 0 7500 697500
0 0 0 0 0
0 0 0 2900 907700
0 0 0 15300 1346400
0 0 0 0 0
0 0 0 55000 14575000
0 0 0
0 0 0 2000 5000000
0 0 0 0 0
0 0 0 44000 2772000
0 0 0 1200 2478000
0 0 0 0 0
0 0 0 72 497160
0 0 0 26000 2834000
0 0 0 7500 3341250
0 0 0 500 88000
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 650 3168750
0 0 0 0 0
0 0 0 7000 1015000
0 0 0 0 0
0 0 0 6500 6864000
0 0 0 600 1078800
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 350 1008000
0 0 0 27700 1772800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 7800 5857800
0 0 0 250 1716750
0 0 0
0 0 0
0 0 0 130 541710
0 0 0 1400 610400
0 0 0 300 239097
0 0 0 3000 243000
0 0 0 0 0
0 0 0 0 0
0 0 0 11900 690200
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 2070000
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 6400 1536000
0 0 0 1000 62000
0 0 0 496 1314400
0 0 0 4000 624000
0 0 0 15000 6555000
0 0 0 5000 1290000
0 0 0 0 0
0 0 0 450 5197500
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 186000
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 1000 230000
0 0 0 4200 260400
0 0 0 5500 3932500
0 0 0 1000 0
0 0 0 37000 1591000
0 0 0 1400 3056200
0 0 0 20500 3157000
0 0 0
0 0 0 200 115000
0 0 0 890 1723930
0 0 0 0 0
0 0 0 1000 80000
0 0 0 0 0
0 0 0 7600 1010800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 400 1073600
0 0 0 500 81000
0 0 0 11000 1353000
0 0 0 25000 3325000
0 0 0 0 0
0 0 0 900 3420000
0 0 0 250 852500
0 0 0 4300 458681
0 0 0 3000 408000
0 0 0 0 0
0 0 0 740 4743400
0 0 0 0 0
0 0 0 0
0 0 0 2700 1482300
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 539400
0 0 0 1150 2185000
0 0 0 0 0
0 0 0 8000 1312000
0 0 0 17000 867000
0 0 0
0 0 0 4000 658480
0 0 0 0 0
0 0 0 0
0 0 0 1250 1870000
0 0 0 0 0
0 0 0 1300 4046900
0 0 0 0 0
0 0 0 0
0 0 0 4000 1232000
0 0 0 22400 2777600
0 0 0 0 0
0 0 0 0 0
0 0 0 3000 571980
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 7150000
0 0 0 0 0
0 0 0 0 0
0 0 0 6200 483600
0 0 0 140 560000
0 0 0 0 0
0 0 0 0 0
0 0 0 3 565989
0 0 0 23000 1380000
0 0 0 2000 2336000
0 0 0 2000 266000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5500 1589500
0 0 0 2000 1760000
0 0 0 0 0
0 0 0 200 2442000
0 0 0 9300 2966700
0 0 0 18000 1512000
0 0 0 21600 2613600
0 0 0 300 2893800
0 0 0 0 0
0 0 0 0 0
0 0 0 200 1258000
0 0 0 0 0
0 0 0 0 0
0 0 0 14 266070
0 0 0 0 0
0 0 0 #REF! 381150
0 0 0 21 2750000
0 0 0 20 3575000
0 0 0 150 627000
0 0 0 300 1254000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 792000
0 0 0 #REF! 1188000
0 0 0 #REF! 0
0 0 0 #REF! 0
0 0 0 #REF! 41250
0 0 0 2300 280800
0 0 0 0 0
0 0 0 0 0
0 0 0 2 75900
0 0 0 0 759000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 20 0
0 0 0 24 1261464
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 400 1380000
0 0 0 0 0
0 0 0 29 833750
0 0 0 0 287500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 283126
0 0 0 10 566251
0 0 0 550 1936000
0 0 0 0 704000
0 0 0 81 1113750
0 0 0 0 137500
0 0 0 215 409200
0 0 0 0 0
0 0 0 200 300080
0 0 0 0 0
0 0 0 10 154000
0 0 0 0 0
0 0 0 0 210000
0 0 0 10 0
0 0 0 0 165000
0 0 0 520 412500
0 0 0 0 82500
0 0 0 100 0
0 0 0 0 14080000
0 0 0 100 0
0 0 0 0 0
0 0 0 100 0
0 0 0 5 235750
0 0 0 1600 0
0 0 0 0 0
0 0 0 100 43890
0 0 0 0 0
0 0 0 0 0
0 0 0 100 36300
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1100 484000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 130682
0 0 0 5 409777
0 0 0 5 235000
0 0 0 0 0
0 0 0 0 0
0 0 0 5 150000
0 0 0 0 0
0 0 0 0 0
0 0 0 5 82500
0 0 0 0 0
0 0 0 30 564545
0 0 0 0 0
0 0 0 200 606364
0 0 0 0 3032
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 941000
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 144716
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 2750000
0 0 0 11 2200000
0 0 0 1 2200000
0 0 0 1 3300000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1200 363600
0 0 0 0 835989
0 0 0 0 1210420
0 0 0 #REF! 2950000
0 0 0 #REF! 0
0 0 0 #REF! 1404500
0 0 0 #REF! 1166000
0 0 0 #REF! 94300
0 0 0 1000 0
0 0 0 0 0
0 0 0 2 0
0 0 0 2000 0
0 0 0 2 0
0 0 0 0 0
0 0 0 1501 0
0 0 0 7 0
0 0 0 4 0
0 0 0 0 0
0 0 0 0 0
0 0 0 450 551250
0 0 0 1000 1651000
0 0 0 102 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 704000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 22253612
0 0 0 0 3779970
0 0 0 0 0
0 0 0 0 406518
0 0 0 0 0
0 0 0 68 0
0 0 0 3 0
0 0 0 0 0
0 0 0 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 153617392
0 0 0 0 0
0 0 0 1379 1709960
0 0 0 17566 28474486
0 0 0 0 0
0 0 0 419925 1773935
0 0 0 0 0
0 0 0 19 315552
0 0 0 4 66432
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 20 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 32 159993
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 206 17265600
0 0 0 70 1974280
0 0 0 290 63741600
0 0 0 695 78954975
0 0 0 0 0
0 0 0 822 22990000
0 0 0 440 10575620
0 0 0 360 3913280
0 0 0 490 2970000
PELAPORAN : PUSKESMAS DELI TUA 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA DELI TUA TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 3,000 279000 0 2,000 186000 0 2,000 186000 0 0 0 0 0 7000 651000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 2,000 626000 0 2,000 626000 0 0 0 0 0 0 0 4000 1252000
tablet 88 0 0 3,000 264000 0 0 0 500 44000 0 0 0 0 0 3500 308000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 0 12,000 3180000 0 12,000 3180000 0 10,000 2650000 0 0 0 0 0 34000 9010000
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0 0

9 Antasida DOEN I Kombinasi tablet 63 0 0 7,000 441000 0 0 0 5,000 315000 0 0 0 0 0 12000 756000
btl 60 ml 2,065 0 0 400 826000 0 300 619500 0 500 1032500 0 0 0 0 0 1200 2478000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 5,000 2227500 0 0 0 0 0 10000 4455000

tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 3,000 435000 0 0 0 1,500 217500 0 0 0 0 0 4500 652500

botol 11,550 0 0 0 0 0 0 200 2310000 0 0 0 0 0 200 2310000

21
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 64 0 0 6,000 384000 0 8,000 512000 0 6,000 384000 0 0 0 0 0 20000 1280000

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ Jkn 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0


tube 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 1,500 654000 0 0 0 0 0 0 0 0 0 1500 654000

tablet/ H. baru 797 0 0 0 0 0 0 600 478194 0 0 0 0 0 600 478194
32 Furosemid tablet 40 mg tablet 81 0 0 1,000 81000 0 2,000 162000 0 0 0 0 0 0 0 3000 243000

tablet 58 0 0 3,000 174000 0 1,000 58000 0 1,000 58000 0 0 0 0 0 5000 290000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 botol 6,900 0 0 300 2070000 0 100 690000 0 100 690000 0 0 0 0 0 500 3450000
JKN 2019 7,363 0 0 0 0 0 0 0 0 0

39 Griseofulvin 125 mg Tablet tablet 240 0 0 2,000 480000 0 500 120000 0 500 120000 0 0 0 0 0 3000 720000

42 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 0 0 1,000 156000 0 0 0 0 0 4000 624000

tablet / H.Baru 437 0 0 0 0 3,600 1573200 0 3,600 1573200 0 0 0 0 0 7200 3146400
43 Hustab Tablet tablet P 312 0 0 3,000 936000 0 0 0 0 0 0 0 0 0 936000

tablet P 258 0 0 0 0 3,000 774000 0 0 0 0 0 0 0 3000 774000
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 250 2887500 0 0 0 0 0 550 6352500

JKN 11,550 0 0 0 0 0 0 0 0 0 0

silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0

46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 500 46500 0 500 46500 0 500 46500 0 0 0 0 0 1500 139500


50 Kaptopril 12,5 mg tablet 62 0 0 1,000 62000 0 1,000 62000 0 600 37200 0 0 0 0 0 2600 161200
55 tablet 154 0 0 3,000 462000 0 2,000 308000 0 2,000 308000 0 0 0 0 0 7000 1078000
APBD 2019 133 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 300 581100 0 100 193700 0 500 968500 0 0 0 0 0 900 1743300
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 5 16000 0 0 0 0 0 0 0 0 0 5 16000
tablet 133 0 0 3,000 399000 0 0 0 2,000 266000 0 0 0 0 0 5000 665000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0

63 Metoclorpramid HCL 10 mg tablet 123 0 0 3,000 369000 0 0 0 0 0 0 0 0 0 3000 369000
tablet 133 0 0 15,000 1995000 0 0 0 0 0 0 0 0 0 15000 1995000
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 5,000 533350 0 0 0 0 0 0 0 0 0 5000 533350

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 300 1923000 0 200 1282000 0 200 1282000 0 0 0 0 0 700 4487000
68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 549 0 0 1,000 549000 0 0 0 0 0 0 0 0 0 1000 549000
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 1,000
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 300 570000 0 0 0 0 0 0 0 0 0 300 570000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 0 0 2,500 127500 0 0 0 0 0 0 0 0 0 2500 127500
tablet 178 0 0 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 0 0 8,000 1316960 0 0 0 0 0 8000 1316960
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 400 598400 0 300 448800 0 400 598400 0 0 0 0 0 1100 1645600
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 500 1556500 0 200 622600 0 300 933900 0 0 0 0 0 1000 3113000
78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0

79 Pirantel tablet score 125 mg tablet 308 0 0 1,000 308000 0 0 0 0 0 0 0 0 0 1000 308000

tablet 191 0 0 0 0 0 0 1,000 190660 0 0 0 0 0 1000 190660
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 0 0 0 0 0 0 0 0 0 0 0 0

86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 400 0 0 0 0 0 0 0 0 0 0 400 0
botol 7,150 0 0 0 0 200 1430000 0 300 2145000 0 0 0 0 0 500 3575000

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 1,000 78000 0 600 46800 0 600 46800 0 0 0 0 0 2200 171600


95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 400 467200 0 300 350400 0 200 233600 0 0 0 0 0 900 1051200
tablet 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 4,000 3520000 0 3,000 2640000 0 0 0 0 0 7000 6160000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

102 Vitamin B komplek Tablet tablet 121 0 0 10,000 1210000 0 7,000 847000 0 7,000 847000 0 0 0 0 0 24000 2904000
Botol 9,646 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 0 0 0 0 30 188700 0 0 0 0 0 30 188700
3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

107 Accu Check safe T Pro Uno Dus 115,500 0 1 115500 0 0 0 0 0 0 0 0 0 0 1 115500
127,050 0 0 0 0 0 0 1 127050 0 0 0 0 0


buah 4,180 0 0 200 836000 0 0 0 0 0 0 0 0 0 200 836000
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 200 158400 0 0 0 0 0 0 0 0 0 0 200 158400
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 216 0 0 200 43200 0 100 21600 0 0 0 0 0 0 0 300 64800
buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0 0 0 0 10 379500
buah 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 10 287500 0 0 0 0 0 0 0 15 431250
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 50 192500 0 0 0 0 0 0 0 0 0 50 192500

set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 100 352000 0 100 352000 0 0 0 0 0 0 0 200 704000

set / bpjs 3,520 0 80 281600 0 0 0 0 0 0 0 0 0 0 80 281600
buah 13,750 0 0 30 412500 0 0 0 0 0 0 0 0 0 30 412500

buah / bpjs 13,750 0 12 165000 0 0 0 0 0 0 0 0 0 0 12 165000

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 2 60016 0 0 0 0 0 0 0 0 0 0 2 60016
rol 7,700 0 0 12 92400 0 0 0 0 0 0 0 0 0 12 92400
rol / bpjs 7,700 0 50 385000 0 0 0 0 0 0 0 0 0 0 50 385000
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 0 0 0 0 0 0 0 0 100 165000

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 5 235750 0 0 0 0 0 0 0 0 0 5 235750

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 500 0 0 0 0 0 0 0 0 0 0 0 500 0

147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 1,000 438900 0 0 0 0 0 1000 438900
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 1,000 438900 0 0 0 0 0 1000 438900
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 0 0 0 0 0 0 0 0 1000 440000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0

153 One scrub 500 cc + dispenser botol 65,341 0 0 2 130682 0 0 0 0 0 0 0 0 0 2 130682
rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 5 256525 0 0 0 0 0 0 0 0 0 0 5 256525
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 10 282864 0 0 0 0 0 0 0 0 0 0 10 282864
botol 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 20 60636 0 0 0 0 0 0 0 0 0 20 60636
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 50 344750 0 0 0 0 0 0 0 0 0 0 50 344750

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 3 141450 0 0 0 0 0 0 0 0 0 0 3 141450

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 3 0 0 0 0 0 0 0 0 0 0 0 3 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0 0 0 5 0

197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Imunisasi 1,404 0 0 0 0 0 0 0
199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 300 367500

200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 6,910 11408410
201 Safety Box 5 liter box - 0 0 0 0 0 0 69 0
Program HIV - 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0

203 BD Vacuntainer box - 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0

205 Object Glass Kotak 19,365 0 0 0 0 0 0 0
206 Rapid Test II ( FOKUS ) Test 14,590 0 300 4377000 0 0 0 0 0
207 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0

208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0
209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0 0

210 Sarung tangan L buah 499 0 0 0 0 0 0 0
211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0

212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0
213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0

OBAT GIGI - 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 2 704000

215 Articulating Pcs 181,500 0 0 0 0 0 0 0
216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0

217 1470A3 Z250 XT Rest Syr 3 G La Apac Mea Dus 190,516 0 0 0 0 0 0 0

219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0
220 Guta Percha Point #15-40 Box 46,700 0 0 0 0 0 0 0

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0
225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0

OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 32 10472288 0 0 0 0 0
227 OAT FDC Kategori 2 paket 1,259,990 0 6 7559940 0 0 0 0 0
229 OAT FDC Kategori Anak paket 203,259 0 5 1016295 0 0 0 0 0

230 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 400 1180000 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 20 600000 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0
Provinsi 367 0 285964 104948788 0 0 0 0 0
Program Imunisasi - 0 0 0 0 0 0 0
buah/ skipa 1,240 943 1169320 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 12013 19473073 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 923 1213745 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 41 69905
Box 16,608 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 13 215904 0 0 0 0 0 0

Box / 2,5ml 16,608 3 49824 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0

241 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0
242 Primaquin TABLET 235 0 0 0 0 0 0 0

243 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 0 0 0 0 0
246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0 0

247 Fluconazol tablet TABLET - 0 0 0 0 0 0 0
248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0
251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 300 6699000 0 0 0 0 0

252 Rapid Test II ( FOKUS ) Test 13,615 0 0 0 0 0 0 0
253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0

254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0

256 Anuscopy buah - 0 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0 0 0

258 Blue Tips bungkus - 0 0 0 0 0 0 0
259 Metilen Blue botol 94,500 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0
263 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0

264 Object Glass Kotak - 0 0 0 0 0 0 0
265 Cover Glass Kotak - 0 0 0 0 0 0 0

266 Handscoen boks - 0 0 0 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0
268 BCG VIAL 59,950 25 1498750 20 1199000 25 1498750 25 1498750 25 1498750 22 1318900 25 1498750
269 CAMPAK VIAL 28,204 0 0 0 0 30 846120 10 282040 10 282040
270 MR VIAL 141,648 50 7082400 40 5665920 30 4249440 30 4249440 10 1416480 30 4249440 30 4249440
271 DPT-HB-Hib VIAL 76,285 120 9154200 80 6102800 50 3814250 120 9154200 80 6102800 100 7628500 120 9154200
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 120 2508000 100 2090000 50 1045000 120 2508000 120 2508000 120 2508000 120 2508000
274 POLIO (BOPV) VIAL 19,954 60 1197240 70 1396780 0 0 70 1396780 80 1596320 100 1995400
275 POLIO (IPV) VIAL 13,976 30 419280 30 419280 20 279520 20 279520 25 349400 25 349400 30 419280
276 Td VIAL 16,500 20 330000 10 165000 20 330000 20 330000 30 495000 20 330000 30 495000
PELAPORAN : PUSKESMAS MULIYOREJO 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO MULIYOREJO TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 1,000 93000 4,000 372000 0 5,000 465000 0 5,000 465000 0 0 0 0 0 15000 1395000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 88 0 1,500 132000 5,000 440000 0 4,000 352000 0 4,000 352000 0 0 0 0 0 14500 1276000
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 6,000 1590000 18,000 4770000 0 18,000 4770000 0 18,000 4770000 0 0 0 0 0 60000 15900000
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 3,000 189000 7,000 441000 0 9,000 567000 0 12,000 756000 0 0 0 0 0 31000 1953000
btl 60 ml 2,065 0 100 206500 500 1032500 0 500 1032500 0 600 1239000 0 0 0 0 0 1700 3510500
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 0 0 300 2071500 0 180 1242900 0 0 0 0 0 480 3314400
12 Asam Askorbat (vit C) 50mg tablet 109 0 2,000 218000 2,800 305200 0 4,000 436000 0 5,000 545000 0 0 0 0 0 13800 1504200
tablet/ H Baru 446 0 0 0 0 5,000 2227500 2,000 891000 6,000 2673000 0 0 0 0 0 13000 5791500
tablet 176 0 3,000 528000 1,000 176000 0 0 0 0 0 0 0 0 0 4000 704000

13
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 1,000 145000 5,000 725000 0 6,000 870000 2,000 290000 5,000 725000 0 0 0 0 0 19000 2755000
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 500 528000 1,800 1900800 0 2,000 2112000 0 2,000 2112000 0 0 0 0 0 6300 6652800
botol 11,550 0 0 0 0 0 0 500 5775000 0 0 0 0 0 500 5775000

21
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 3,000 192000 0 8,000 512000 0 8,000 512000 0 8,000 512000 0 0 0 0 0 27000 1728000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 500 53000 310 32860 0 0 0 0 0 0 0 0 0 810 85860
tablet/ Jkn 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 1,000 751000 1,000 751000 1,600 1201600 0 4,000 3004000 0 4,000 3004000 0 0 0 0 0 11600 8711600
tube 18,844 0 0 0 0 0 0 0 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 1,000 436000 0 0 0 0 0 0 0 0 0 1000 436000
tablet/ H. baru 797 0 0 0 0 0 0 3,000 2390970 0 0 0 0 0 3000 2390970
tablet 58 3,000 174000 0 4,000 232000 0 4,500 261000 0 5,000 290000 0 0 0 0 0 16500 957000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 botol 6,900 0 0 400 2760000 0 200 1380000 0 300 2070000 0 0 0 0 0 900 6210000
JKN 2019 7,363 0 0 0 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 2,000 480000 2,000 480000 5,000 1200000 0 5,000 1200000 0 5,000 1200000 0 0 0 0 0 19000 4560000
40 Haloperidol tablet 0,5 mg tablet 62 0 0 2,000 124000 0 2,500 155000 0 2,500 155000 0 0 0 0 0 7000 434000
41 Hidrokortison Cream 2.5 % tube 2,650 0 200 530000 150 397500 0 400 1060000 100 265000 400 1060000 0 0 0 0 0 1250 3312500
42 Hidrokloratiazid 25 mg tablet 156 0 0 5,000 780000 0 4,000 624000 0 3,000 468000 0 0 0 0 0 12000 1872000
tablet / H.Baru 437 0 0 0 0 10,800 4719600 0 7,500 3277500 0 0 0 0 0 18300 7997100
43 Hustab Tablet tablet P 312 3,000 936000 2,000 624000 3,000 936000 0 0 0 0 0 0 0 0 0 8000 2496000
tablet P 258 0 6,000 1548000 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 400 4620000 0 400 4620000 0 0 0 0 0 800 9240000
JKN 11,550 0 0 0 0 0 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 8,046 0 100 804600 0 0 0 0 0 0 0 0 0 0 100 804600
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 1,000 75000 0 200 15000 0 0 0 0 0 1200 90000
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 0 0 1,000 93000 0 500 46500 0 0 0 0 0 1500 139500


49 Karbamazepin tablet 200 mg tablet 230 0 0 1,000 230000 0 2,000 460000 0 2,000 460000 0 0 0 0 0 5000 1150000
50 Kaptopril 12,5 mg tablet 62 0 0 2,000 124000 0 2,500 155000 0 200 12400 0 0 0 0 0 4700 291400
51 Kaptopril 25 mg tablet 715 0 1,000 715000 3,000 2145000 0 3,000 2145000 0 4,000 2860000 0 0 0 0 0 11000 7865000
52 Klorpramazine HCl 100 mg tablet - 0 0 3,000 0 0 3,000 0 0 3,000 0 0 0 0 0 0 9000 0
55 tablet 154 0 3,000 462000 5,400 831600 0 7,500 1155000 0 8,000 1232000 0 0 0 0 0 23900 3680600
APBD 2019 133 0 0 0 0 0 0 0 0
ampul 1,937 0 0 200 387400 0 500 968500 0 600 1162200 0 0 0 0 0 1300 2518100
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 500 66500 4,000 532000 0 4,000 532000 0 3,000 399000 0 0 0 0 0 11500 1529500
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0

63 Metoclorpramid HCL 10 mg tablet 123 0 1,000 123000 2,000 246000 0 2,000 246000 2,000 246000 3,000 369000 0 0 0 0 0 10000 1230000
tablet 133 0 15,000 1995000 20,000 2660000 0 15,000 1995000 0 0 0 0 0 0 0 50000 6650000
tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 2,800 298676 9,000 960030 0 800 85336 0 0 0 0 0 0 0 12600 1344042

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 60 384600 0 70 448700 0 200 1282000 0 0 0 0 0 330 2115300

68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 300 164700 0 400 219600 0 500 274500 0 0 0 0 0 1200 658800
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 5,000 3,000 5,000
tablet/ H Baru 886 50 44295 0 0 0 0 0 0 0 0 0 0 0 50 44295

72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 200 359600 0 240 431520 0 300 539400 0 0 0 0 0 740 1330520
ampul 1,900 0 0 500 950000 0 400 760000 0 500 950000 0 0 0 0 0 1400 2660000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 1,000 164000 2,000 328000 8,000 1312000 0 3,000 492000 1,000 164000 5,000 820000 0 0 0 0 0 20000 3280000
tablet 51 5,000 255000 5,000 255000 7,000 357000 0 0 0 0 0 0 0 0 0 17000 867000
tablet 178 0 0 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 4,000 658480 3,000 493860 8,000 1316960 0 0 0 0 0 15000 2469300
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 600 897600 0 500 748000 0 0 0 0 0 1600 2393600
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 100 311300 240 747120 0 200 622600 500 1556500 500 1556500 0 0 0 0 0 1540 4794020
78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 2,000 616000 0 2,700 831600 0 1,000 308000 0 0 0 0 0 5700 1755600
tablet 191 0 0 0 0 0 2,000 381320 5,000 953300 0 0 0 0 0 7000 1334620

tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 200 1430000 0 200 1430000 0 300 2145000 0 0 0 0 0 700 5005000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0
92 Salisil Bedak 2,5% bks 1,046 0 100 104600 0 0 0 0 0 0 0 0 0 0 100 104600
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 1,000 60000 5,000 300000 0 5,000 300000 0 5,000 300000 0 0 0 0 0 16000 960000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 1,000 1168000 0 1,000 1168000 0 1,000 1168000 0 0 0 0 0 3000 3504000
tablet 133 0 2,000 266000 5,000 665000 0 0 0 0 0 0 0 0 0 7000 931000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 2,000 578000 0 0 0 0 0 0 0 0 0 0 2000 578000

silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 2,000 168000 5,000 420000 0 7,500 630000 0 7,000 588000 0 0 0 0 0 21500 1806000
102 Vitamin B komplek Tablet tablet 121 0 3,000 363000 10,000 1210000 0 14,000 1694000 0 10,000 1210000 0 0 0 0 0 37000 4477000
Botol 9,646 0 0 200 1929200 0 0 0 0 0 0 0 0 0 200 1929200

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 100 629000 0 0 0 0 0 100 629000
3,322 0 0 0 0 200 664400 0 0 0 0 0 0 0 200 664400
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
115,500 0 2 231000 0 0 0 0 0 0 0 0 0 0 2 231000
107 Accu Check safe T Pro Uno Dus
127,050 0 0 0 0 0 1 127050 0 0 0 0 0
buah 4,180 0 0 200 836000 0 100 418000 0 50 209000 0 0 0 0 0 350 1463000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 1,000 792000 1,200 950400 0 0 0 2,000 1584000 0 0 0 0 0 4200 3326400
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 2,000 432000 0 2,000 432000 0 0 0 0 0 0 0 4000 864000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0 0 0 0 10 379500
buah 45,183 0 0 0 0 48 2168784 0 48 2168784 0 0 0 0 0 96 4337568

buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0 0 0 12 542196
buah 32,491 0 0 0 0 48 1559568 0 48 1559568 0 0 0 0 0 96 3119136

buah / bpjs 32,491 0 24 779784 0 0 0 0 0 0 0 0 0 0 24 779784

buah 52,561 0 0 0 0 0 0 48 2522928 0 0 0 0 0 48 2522928
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 48 2449056 0 0 0 0 0 48 2449056

buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0 0 0 12 612264
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 110 379500 0 0 0 0 0 0 0 0 0 0 110 379500
botol 28,750 0 0 10 287500 0 10 287500 0 5 143750 0 0 0 0 0 25 718750

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 36 1035000 0 0 0 0 0 0 0 0 0 0 36 1035000
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 50 192500 0 0 0 50 192500 0 0 0 0 0 100 385000

set / bpjs 2,831 0 20 56625 0 0 0 0 0 0 0 0 0 0 20 56625
set 3,520 100 352000 0 250 880000 0 300 1056000 0 200 704000 0 0 0 0 0 850 2992000
set / bpjs 3,520 0 250 880000 0 0 0 0 0 0 0 0 0 0 250 880000
buah 13,750 0 0 40 550000 0 50 687500 0 10 137500 0 0 0 0 0 100 1375000

buah / bpjs 13,750 0 50 687500 0 0 0 0 0 0 0 0 0 0 50 687500
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 30 231000 0 0 0 0 0 0 0 0 0 30 231000
rol / bpjs 7,700 0 100 770000 0 0 0 0 0 0 0 0 0 0 100 770000
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 0 0 0 0 0 0 0 0 100 165000

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 816 7180800 0 0 0 0 0 0 0 0 0 0 816 7180800
botol 47,150 0 0 5 235750 0 0 0 0 0 0 0 0 0 5 235750

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 500 181500 0 0 0 0 0 0 0 0 0 500 181500
146 Masker Tie On buah 439 0 0 0 0 0 0 1,000 438900 0 0 0 0 0 1000 438900
buah / bpjs - 0 1,000 0 0 0 0 0 0 0 0 0 0 0 1000 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 1,000 440000 0 1,500 660000 0 0 0 0 0 0 0 2500 1100000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0


rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777

rol / bpjs 81,955 0 25 2048887 0 0 0 0 0 0 0 0 0 0 25 2048887
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 25 1282625 0 0 0 0 0 0 0 0 0 0 25 1282625
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 25 707161 0 0 0 0 0 0 0 0 0 0 25 707161
botol 18,818 0 0 6 112909 0 0 0 0 0 0 0 0 0 6 112909

botol / bpjs 18,818 0 10 188182 0 0 0 0 0 0 0 0 0 0 10 188182
botol 3,032 0 0 100 303182 0 0 0 0 0 0 0 0 0 100 303182

botol / bpjs 3,032 0 10 30318 0 0 0 0 0 0 0 0 0 0 10 30318
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 200 1379000 0 0 0 0 0 0 0 0 0 0 200 1379000

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0 0 0 0 0 0 0 0 12 438984
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 3,000 909000 0 3,000 909000 0 0 0 0 0 6000 1818000
185 POT SPUTUM BUAH 2,950 0 500 1475000 0 0 0 0 0 0 0 0 0 0 500 1475000


189 Lisol 100 % botol 47,150 0 5 235750 0 0 0 0 0 0 0 0 0 0 5 235750


192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 3 0 0 0 0 0 0 0 0 0 0 0 3 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 10 0 0 0 0 0 0 0 0 0 0 10 0
197 CHLORIN Liter - 0 0 2 0 0 0 0 0 0 0 0 0 0 2 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Imunisasi 1,404 0 0 0 0 0 0 0
199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 330 404250
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 7,257 11981307
201 Safety Box 5 liter box - 0 0 0 0 0 0 94 0
Program HIV - 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0

203 BD Vacuntainer box - 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0

205 Object Glass Kotak 19,365 0 0 0 0 0 0 0

208 Masker Plus 3 Ply Earloop buah 440 0 0 0 0 0 0 0

209 Sarung tangan tanpa tepung M buah 583 0 0 0 0 0 0 0
210 Sarung tangan L buah 499 0 0 0 0 0 0 0
211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0
212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0

213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 2 704000 0 1 352000 0 1 352000
215 Articulating Pcs 181,500 0 0 0 0 0 0 0

216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0

219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0
222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0
225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0
OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 64 20944576 0 64 20944576 0 0 0
229 OAT FDC Kategori Anak paket 203,259 0 5 1016295 0 5 1016295 0 0 0
230 RH ( Fase Lanjutan ) paket - 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0
Provinsi 367 0 640,112 234921104 0 0 0 0 0
Program Imunisasi - 0 0 0 0 0 0 0
buah/ skipa 1,240 2111 2617640 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 28886 46824206 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 2065 2715475 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 91 155155
Box 16,608 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 26 431808 0 0 0 0 0 0
Box / 2,5ml 16,608 5 83040 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0
241 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0
242 Primaquin TABLET 235 0 0 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 0 0 0 20 0 0 8 0

OBAT APBN - 0 0 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 0 0 0 0 0

246 Benzatin Phenisillin 2,4 jt vial - 0 0 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 0 0 0 0 0 0

248 Paket Kombipak HIV paket 39,998 0 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0
251 Rapid Test I ( SD HIV 1/2) Test 22,330 0 0 0 0 0 0 0

253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0
254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0

256 Anuscopy buah - 0 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0 0 0

258 Blue Tips bungkus - 0 0 0 0 0 0 0
259 Metilen Blue botol 94,500 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0
263 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0
264 Object Glass Kotak - 0 0 0 0 0 0 0
265 Cover Glass Kotak - 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0
268 BCG VIAL 59,950 50 2997500 50 2997500 50 2997500 45 2697750 45 2697750 45 2697750 50 2997500
269 CAMPAK VIAL 28,204 0 0 0 0 0 0 0
270 MR VIAL 141,648 70 9915360 50 7082400 50 7082400 50 7082400 50 7082400 60 8498880 50 7082400
271 DPT-HB-Hib VIAL 76,285 260 19834100 120 9154200 130 9917050 260 19834100 120 9154200 200 15257000 250 19071250
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 280 5852000 250 5225000 100 2090000 260 5434000 270 5643000 280 5852000 280 5852000
274 POLIO (BOPV) VIAL 19,954 160 3192640 160 3192640 0 0 120 2394480 160 3192640 160 3192640
275 POLIO (IPV) VIAL 13,976 70 978320 70 978320 50 698800 50 698800 40 559040 50 698800 60 838560
276 Td VIAL 16,500 20 330000 0 30 495000 20 330000 20 330000 20 330000 30 495000

PELAPORAN : PUSKESMAS SEI MENCIRIM 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM SEI MENCIRIM TOTAL
HARGA TOTAL
SATUAN KELUAR
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER OKTOBER NOVEMBER DESEMBER

tablet 93 0 0 300 27900 0 1,500 139500 0 1,500 139500 0 0 0 0 0 3300 306900
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 0 0 500 156500 0 0 0 0 0 0 0 500 156500
tablet 88 0 0 0 0 1,500 132000 0 2,000 176000 0 0 0 0 0 3500 308000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 kapsul 265 2,000 530000 1,000 265000 10,000 2650000 0 10,000 2650000 0 8,000 2120000 0 0 0 0 0 31000 8215000
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0

btl 60 ml 2,065 100 206500 100 206500 400 826000 0 100 206500 0 300 619500 0 0 0 0 0 1000 2065000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 4,000 1782000 0 10,000 4455000 0 0 0 0 0 14000 6237000
tablet 176 1,000 176000 3,000 528000 1,000 176000 0 0 0 0 0 0 0 0 0 5000 880000
13
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 3,000 3168000 0 0 0 0 0 0 0 0 0 3000 3168000
botol 11,550 0 0 0 0 0 0 250 2887500 0 0 0 0 0 250 2887500

21
JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 0 0 0 2,000 128000 0 2,000 128000 0 0 0 0 0 4000 256000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ Jkn 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 500 375500 2,000 1502000 5,000 3755000 0 1,500 1126500 0 3,000 2253000 0 0 0 0 0 12000 9012000
tube 18,844 0 0 0 0 0 0 0 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 3,000 1308000 0 0 0 0 0 0 0 0 0 3000 1308000
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 0 0 0 0 0 0 0 0 2000 162000

tablet 58 0 0 3,000 174000 0 2,000 116000 0 2,000 116000 0 0 0 0 0 7000 406000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 botol 6,900 0 0 300 2070000 0 0 0 0 0 0 0 0 0 300 2070000

JKN 2019 7,363 0 0 0 0 0 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 1,000 240000 0 1,000 240000 0 0 0 0 0 0 0 2000 480000
tablet / H.Baru 437 0 0 0 0 5,000 2185000 0 3,600 1573200 0 0 0 0 0 8600 3758200
43 Hustab Tablet tablet P 312 0 0 5,000 1560000 0 0 0 0 0 0 0 0 0 5000 1560000
258 0 0 0 5,000 1290000 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 150 1732500 0 250 2887500 0 0 0 0 0 400 4620000
JKN 11,550 0 0 0 0 0 0 0 0 0 0
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 8,046 100 804600 100 804600 0 0 0 0 0 0 0 0 0 0 200 1609200
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 2,000 150000 0 0 0 0 0 0 0 0 2000 150000

46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 0 0 0 0 0 0 0 0 2000 186000


50 Kaptopril 12,5 mg tablet 62 0 0 2,000 124000 0 0 0 0 0 0 0 0 0 2000 124000

51 Kaptopril 25 mg tablet 715 0 0 2,000 1430000 0 0 0 1,500 1072500 0 0 0 0 0 3500 2502500
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 5,000 215000 0 10,000 430000 0 10,000 430000 0 10,000 430000 0 0 0 0 0 35000 1505000
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 200 436600 0 0 0 0 0 0 0 0 0 200 436600
55 tablet 154 0 0 0 0 0 0 3,000 462000 0 0 0 0 0 3000 462000

APBD 2019 133 0 0 0 0 0 0 0 0 0 0 0
ampul 1,937 0 0 200 387400 0 0 0 0 0 0 0 0 0 200 387400

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 1,500 199500 0 0 0 1,000 133000 0 0 0 0 0 2500 332500
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 2,000 266000 10,000 1330000 0 0 0 0 0 0 0 0 0 12000 1596000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 3,000 320010 0 2,000 213340 0 0 0 0 0 0 0 5000 533350

67 Natrium Diklofenak tablet 50 mg
silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68
APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 200 380000 0 0 0 0 0 0 0 0 0 200 380000

ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 2,000 102000 5,000 255000 12,000 612000 0 0 0 0 0 0 0 0 0 19000 969000
tablet 178 0 0 0 0 0 0 0 0 0
75
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 100 149600 0 400 598400 0 200 299200 0 400 598400 0 0 0 0 0 1100 1645600
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 0 0 0 0 0 0 0 0 400 1245200

78
JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 0 0 1,000 308000 0 0 0 0 0 0 0 1000 308000
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 1,000 124000 7,000 868000 0 0 0 3,000 372000 0 0 0 0 0 11000 1364000
81 Prednison 5 mg Tablet tablet 96 0 3,200 307200 0 0 0 0 0 0 0 0 0 0 3200 307200
tablet 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0
JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 100 715000 0 400 2860000 0 100 715000 0 0 0 0 0 0 0 600 4290000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0

91 Salbutamol syrup botol 4,042 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 1,000 60000 0 0 0 0 0 0 0 0 0 1000 60000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 0 0 100 116800 0 0 0 0 0 0 0 100 116800
tablet 133 1,000 133000 0 1,500 199500 0 0 0 0 0 0 0 0 0 2500 332500

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 2,000 638000 1,500 478500 0 0 0 3,000 957000 0 0 0 0 0 6500 2073500
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 1,000 84000 5,000 420000 0 0 0 3,000 252000 0 0 0 0 0 9000 756000
Botol 9,646 0 0 200 1929200 0 0 0 0 0 0 0 0 0 200 1929200
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 100 629000 0 0 0 0 0 100 629000

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 0 0 50 209000 0 0 0 0 0 0 0 50 209000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 0 0 0 0 200 158400 0 0 0 0 0 200 158400
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 100 21600 0 0 0 0 0 0 0 100 21600

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 50 1897500 0 0 0 0 0 0 0 0 0 0 50 1897500
buah 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0 0 0 12 542196
buah 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0 0 0 0 12 389892
buah 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 12 630732 0 0 0 0 0 0 0 0 0 0 12 630732
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0 0 0 12 612264
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 20 69000 0 0 0 0 0 0 0 0 0 0 20 69000
botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 50 1437500 0 0 0 0 0 0 0 0 0 0 50 1437500
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0

set 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 3,520 0 200 704000 0 0 0 0 0 0 0 0 0 0 200 704000
buah 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 13,750 0 40 550000 0 0 0 0 0 0 0 0 0 0 40 550000
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 30 900240 0 0 0 0 0 0 0 0 0 0 30 900240
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 100 210000 0 0 0 0 0 0 0 0 0 0 100 210000
rol 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 20 33000 0 0 0 0 0 0 0 0 0 0 20 33000
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 100 82500 0 0 0 0 0 0 0 0 0 0 100 82500
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 5 235750 0 2 94300 0 0 0 0 0 0 0 7 330050

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 1000 440000 0 0 0 0 0 0 0 0 0 1000 440000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0


rol 81,955 0 2 163911 0 0 0 0 0 0 0 0 0 0 2 163911

rol / bpjs 81,955 0 15 1229332 0 0 0 0 0 0 0 0 0 0 15 1229332
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 14 718270 0 0 0 0 0 0 0 0 0 0 14 718270
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 15 424297 0 0 0 0 0 0 0 0 0 0 15 424297
botol 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 50 940909 0 0 0 0 0 0 0 0 0 0 50 940909
botol 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0 0 0 0 0 0 0 0 12 438984
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300

191 Masker 3 Ply Earloop Jilbab buah - 0 1250 0 0 0 0 0 0 0 0 0 0 0 1250 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 7 0 0 0 0 0 0 0 0 0 0 7 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0

206 Rapid Test II ( FOKUS ) Test 14,590 0 0 0 0 0 25 364750 0 25 364750


OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 2 704000 4 1408000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0

231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 309504 113587968 0 0 0 0 0 309504 113587968
buah/ skipa 1,240 1053 1305720 0 0 0 0 0 0 1053 1305720

237 Spuit 0,5 ml
buah / apbn 1,621 13407 21732747 0 0 0 0 0 0 13407 21732747
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 1030 1354450 0 0 0 0 0 0 1030 1354450
Spuit 5 ml APBN 1,705 45 76725 45

Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 14 232512 0 0 0 0 0 0 14 232512

Box / 2,5ml 16,608 4 66432 0 0 0 0 0 0 4 66432
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0
245 Alkohol Swab buah 1,985 0 0 5 9925 0 0 0 0 5 9925
246 Benzatin Phenisillin 2,4 jt vial - 0 0 5 0 0 0 0 0 5 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0

251 Rapid Test I ( SD HIV 1/2) Test 22,330 200 4466000 0 200 4466000 0 0 0 0 400 8932000

254 Rapid Test Sifilis (Hexagon) Test 13,407 200 2681400 0 200 2681400 0 0 0 0 400 5362800
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 1 0 0 0 0 0 1 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 2 0 0 0 0 0 2 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 15 899250 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 18 1079100 133 7973350
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 0 10 282040 30 846120

270 MR VIAL 141,648 0 0 0 0 0 0 0 0 0
271 DPT-HB-Hib VIAL 76,285 150 11442750 140 10679900 100 7628500 150 11442750 80 6102800 70 5339950 130 9917050 820 62553700
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 150 3135000 150 3135000 100 2090000 130 2717000 140 2926000 140 2926000 140 2926000 950 19855000
274 POLIO (BOPV) VIAL 19,954 80 1596320 70 1396780 0 0 80 1596320 80 1596320 100 1995400 410 8181140
275 POLIO (IPV) VIAL 13,976 50 698800 50 698800 30 419280 30 419280 25 349400 35 489160 35 489160 255 3563880
276 Td VIAL 16,500 15 247500 20 330000 15 247500 20 330000 20 330000 20 330000 15 247500 125 2062500
PELAPORAN : JANUARI 2019 1 2 3 4 5 6 8 9
1 2 3 4 5 6 8 9
SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG
tablet 93 0 0 0 0 1,000 93000 0 1,000 93000 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 500 156500 0 0 0 0 0 0
tablet 88 0 0 0 0 1,000 88000 0 1,000 88000 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
6 kapsul 265 0 2,000 530000 6,000 1590000 0 7,000 1855000 0 4,000 1060000 0 0
Amoksisilin 500 mg
kapsul 260 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 200 500000 0 0 0 100 250000 0 0

9 Antasida DOEN I Kombinasi tablet 63 0 2,000 126000 3,000 189000 0 5,000 315000 0 3,000 189000 0 0
btl 60 ml 2,065 0 0 400 826000 0 0 0 200 413000 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 3,000 327000 0 0 0 500 54500 0 0
tablet/ H Baru 446 0 0 0 0 2,000 891000 0 3,000 1336500 0 0

tablet 176 0 352000 0 0 0 0 0 0 0
13
Asam Mefenamat 500 mg silva/ 2015 304 0 2,000 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
JKN 2019 444 0 0 0 0 0 0 0 0

15 Betametason krim 0,1% 5 gr tube 4,875 0 0 0 0 0 0 0 0 0

17 Cetrizin tablet tablet 145 0 0 3,000 435000 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 0 0 500 528000 0 0
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 100 179800 0 0 0 0 0 0

botol 11,550 0 0 0 0 0 0 0 0 0
21
Dextrofen syrup
JKN 2019 11,550 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0
tablet 64 0 0 2,000 128000 0 1,000 64000 0 1,000 64000 0 0

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0
Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 1502000 500 375500 0 0 0 0 0 0
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 2,000 0 100 686700 0 0 0 0 0 0

tube 18,844 0 0 0 0 0 0 0
Flucord N Cream
JKN 2019 18,844 0 0 0 0 0 0 0
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 0 0 0 0 0 0 0

tablet 436 0 0 2,000 872000 0 0 0 0 0 0
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 300 24300 0 0 0 500 40500 0 0

tablet 58 0 0 1,000 58000 0 1,000 58000 0 1,000 58000 0 0
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0
36 botol 6,900 0 0 60 414000 0 0 0 0 0 0

JKN 2019 7,363 0 0 0 0 0 0 0

39 Griseofulvin 125 mg Tablet tablet 240 0 0 2,000 480000 0 0 0 0 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 0 0 0 0 0 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 2,000 312000 0 0 0 0 0 0

tablet / H.Baru 437 0 0 3,000 1311000 0 0 0 5,000 2185000 0 0
43 Hustab Tablet tablet 258 0 0 1,000 258000 0 0 0
tablet P 312 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 200 2310000 0 300 3465000 0 0
JKN 11,550 0 0 0 0 0 0
44 Hustab syrup
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0

botol 8,046 0 0 0 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 300 27900 0 0 0 0 0 0

Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0

50 Kaptopril 12,5 mg tablet 62 0 0 2,000 124000 0 0 0 0 0 0
51 Kaptopril 25 mg tablet 715 0 0 0 0 0 0 1,000 715000 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 100 0 0 0
55 tablet 154 0 0 4,000 616000 0 0 0 0 0 0

APBD 2019 133 0 0 0 0 0 0 0
ampul 1,937 0 0 200 387400 0 0 0 0 0 0

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 20 64000 0 0 0 0 0 0
tablet 133 0 0 500 66500 0 1,000 133000 0 2,000 266000 0 0
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0

61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 0 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 1,000 162000 0 0 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 1,000 123000 0 0 0 0 0 0

tablet 133 0 665000 0 0 0 0 0 0 0
tablet 264 0 5,000 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 300 1140000 0 0 0 0 0 0
66 Mikonazol Cream 2 % tube 3,410 0 0 200 682000 0 0 0 0 0 0

tablet 107 0 0 2,000 213340 0 1,000 106670 0 0 0 0
silva 2015 136 0 0 0 0 0 0 0 0 0

botol 6,410 0 0 40 256400 0 0 0 20 128200 0 0
68
APBD 2019 6,840 0 0 0 0 0 0 0 0

tablet 549 0 0 0 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0
tablet 803 500
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 0 0 0 0 0 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 0 1,000 164000 0 0 0 0 0 0

tablet 51 0 255000 6,000 306000 0 0 0 0 0 0
tablet 178 0 0 0 0 0 0 0
75
Paracetamol 500 mg (lanamol) tablet 165 0 5,000 0 0 0 0 0 5,000 823100 0 0
silva/ 2015 165 0 0 0 0 0 0 0 0 0

JKN 2019 165 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 200 299200 0 0 0 600 897600 0 0

77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0 0 0 0
78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 500 154000 0 0 0 0 0 0

80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 0 0 0 0 0 0 0
tablet 191 0 0 0 0 0 0 0 0 0
tablet 226 0 0 0 0 0 0 0 0 0
83
Silva 2014 191 0 0 0 0 0 0 0 0 0

JKN 2019 225 0 0 0 0 0 0 0 0

botol 7,150 0 0 100 715000 0 0 0 0 0 0

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0

89 Salbutamol tablet 2 mg tablet 78 0 0 0 0 1000 78000 0 0 0 0
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 0 0 0 0 0 0 0

93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 0 0 0

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 5,000 300000 0 0 0 0 0 0

tablet 133 0 0 500 66500 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0

tablet 289 0 0 0 0 0 0 0 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 1,000 880000 0 0 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0

99 Sanadryl Syrup botol 12,210 0 0 0 0 0 0 0 0 0
100 Tetrasiklin 500 mg kapsul 319 0 0 500 159500 0 0 0 0 0 0
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 3,000 252000 0 2,000 168000 0 0 0 0
102 Vitamin B komplek Tablet tablet 121 0 0 3,000 363000 0 5,000 605000 0 3,000 363000 0 0
Botol 9,646 0 0 100 964600 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 0 0 0 0 0 0 0
3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 0 0 0 0 0
109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 0 0 5 1842500 0 10 3685000 0 0
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 5 893750 0 10 1787500 0 0
111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 5 303182 0 0


buah 4,180 0 0 0 0 0 0 0 0 0
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 500 396000 0 0 0 200 158400 0 0

buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 0 0 0 0 0
buah 197 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 879750 0 0 0 0 0 0 0
botol 28,750 0 255 0 0 0 0 0 0 0 0
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 115000 0 0 0 0 0 0 0
buah 8,800 0 4 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0

set 3,520 0 0 50 176000 0 50 176000 0 0 0 0
set / bpjs 3,520 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 0 0 5 68750 0 0 0 0

buah / bpjs 13,750 0 137500 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 385000 0 0 0 0 0 0 0
rol 2,100 0 50 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 430500 0 0 0 0 0 0 0
rol 1,650 0 205 0 200 330000 0 0 0 0 0 0

rol / bpjs 1,650 0 165000 0 0 0 0 0 0 0
rol 825 0 100 0 0 0 0 0 0 0 0

rol / bpjs 825 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 0 0 0 0 0 0 0
145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0

buah / bpjs 363 0 0 0 0 0 0 0 0 0
buah 440 0 0 500 220000 0 0 0 850 374000 0 0

buah / bpjs 440 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 0 0 0 0 0 0 0
154 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0 0 0 0 0
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0

rol 51,305 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0

rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 282864 0 0 0 0 0 0 0
botol 18,818 0 10 0 10 188182 0 0 0 0 0 0

botol / bpjs 18,818 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 50 151591 0 0 0 0 0 0

botol / bpjs 3,032 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0

buah / bpjs 6,895 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 0 0 0 0 0
183 ZINC Tablet TABLET 539 0 384846 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 1000 94300 0 0 0 0 0 0 0

190 Reagen Ziehl Neelsen kit 181,811 0 2 0 0 0 24 4363464 0 0 0 0
191 Masker 3 Ply Earloop Jilbab buah - 0 0 0 0 0 0 0 0 0

192 Spritus Liter 45,455 0 1500 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 0 0 0 0 0 0 0 0
194 Imersion Oil Botol 3,181,818 0 1 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0

198 Spritus Liter - 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0

203 BD Vacuntainer box - 200 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 0 0 0



222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0

Program TB Paru - 0 0 0 0 0 0 0 0 0

230 RH ( Fase Lanjutan ) paket - 0 1 0 0 0 0 0 0 0 0

231 POT SPUTUM BUAH 2,950 400 1180000 0 0 0 0 0 0 0 0
232 REAGEN TB PARU KIT 276,500 0 0 0 0 20 5530000 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 70356836 0 0 0 0 0 0 0
Program Imunisasi - 0 191708 0 0 0 0 0 0 0 0
buah/ skipa 1,240 630 781200 0 0 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 8045 13040945 0 0 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 618 812670 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 27 46035
Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 9 149472 0 0 0 0 0 0 0 0

Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 0 0 0 0 0 8 0 0 0

OBAT APBN - 0 0 0 0 0 0 0 0 0


249 PH Peper rol 239 0 0 0 0 0 0 0 0 0

254 Rapid Test Sifilis (Hexagon) Test 13,407 0 0 200 2681400 0 0 0 0 0 0

256 Anuscopy buah - 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0

266 Handscoen boks - 0 0 4 0 0 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 10 599500 899250 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 0 0
269 CAMPAK VIAL 28,204 0 15 0 0 0 0 10 282040 0 0 0

270 MR VIAL 141,648 30 4249440 2832960 20 2832960 15 2124720 30 4249440 10 1416480 40 5665920 0 0
271 DPT-HB-Hib VIAL 76,285 60 4577100 20 2288550 40 3051400 80 6102800 40 3051400 80 6102800 80 6102800 0 0
272 DT (BIAS) VIAL 17,798 0 30 0 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 100 2090000 1672000 40 836000 100 2090000 80 1672000 80 1672000 80 1672000 0 0
274 POLIO (BOPV) VIAL 19,954 50 997700 80 997700 0 0 50 997700 70 1396780 70 1396780 0 0
275 POLIO (IPV) VIAL 13,976 20 279520 50 279520 20 279520 15 209640 20 279520 30 419280 20 279520 0 0
276 Td VIAL 16,500 0 20 0 20 330000 10 165000 10 165000 10 165000 0 0 0
10 11 12
10 11 12
SEI SEMAYANG SEI SEMAYANG SEI SEMAYANG TOTAL

TOTAL
HARGA
KELUAR
HARGA HARGA HARGA
OKTOBER NOVEMBER DESEMBER
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 186000
0 0 0 0 0
0 0 0 500 156500
0 0 0 2000 176000
0 0 0 0 0
0 0 0 19000 5035000
0 0 0
0 0 0 300 750000
0 0 0 0 0
0 0 0 13000 819000
0 0 0 600 1239000
0 0 0 0 0
0 0 0 100 690500
0 0 0 3500 381500
0 0 0 5000 2227500
0 0 0 2000 352000
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3000 435000
0 0 0 0 0
0 0 0 2500 2640000
0 0 0 100 179800
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 576000
0 0 0 4000 256000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 2500 1877500
0 0 0 100 686700
0 0 0
0 0 0
0 0 0 0 0
0 0 0 2000 872000
0 0 0 0 0
0 0 0 800 64800
0 0 0 0 0
0 0 0 0 0
0 0 0 3000 174000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 60 414000
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 480000
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 312000
0 0 0 8000 3496000
0 0 0
0 0 0 0 0
0 0 0 500 5775000
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 27900
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 100 23000
0 0 0 2000 124000
0 0 0 1000 715000
0 0 0 100 0
0 0 0 24000 1032000
0 0 0 400 873200
0 0 0 4000 616000
0 0 0
0 0 0 0 0
0 0 0 200 387400
0 0 0 0 0
0 0 0 0 0
0 0 0 20 64000
0 0 0 3500 465500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 162000
0 0 0 1000 123000
0 0 0 5000 665000
0 0 0 0 0
0 0 0 300 1140000
0 0 0 200 682000
0 0 0 3000 320010
0 0 0 1000 136000
0 0 0 0 0
0 0 0 60 384600
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 715000
0 0 0 300 539400
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 164000
0 0 0 11000 561000
0 0 0
0 0 0 5000 823100
0 0 0 0 0
0 0 0
0 0 0 800 1196800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 154000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 715000
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 78000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5000 300000
0 0 0 300 350400
0 0 0 500 66500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 880000
0 0 0 0 0
0 0 0 0 0
0 0 0 500 159500
0 0 0 5000 420000
0 0 0 11000 1331000
0 0 0 100 964600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 95025
0 0 0 0 0
0 0 0 2 254100
0 0 0 15 2062500
0 0 0 15 5527500
0 0 0 15 2681250
0 0 0 5 303182
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 700 554400
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 255 879750
0 0 0 0 0
0 0 0 4 115000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 141563
0 0 0 0 0
0 0 0 100 352000
0 0 0 0 0
0 0 0 5 68750
0 0 0 10 137500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 385000
0 0 0 0 0
0 0 0 205 430500
0 0 0 200 330000
0 0 0 100 165000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 87780
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1350 594000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 49500
0 0 0 10 282864
0 0 0 10 188182
0 0 0 0 0
0 0 0 50 151591
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 141150
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 714 384846
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 583000
0 0 0 2 94300
0 0 0 24 4363464
0 0 0 1500 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 0
0 0 0 5 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 245000
0 0 0 4770 7875270
0 0 0 47 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 704000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 32 10472288
0 0 0 2 2519980
0 0 0 0 0
0 0 0 4 813036
0 0 0 0 0
0 0 0 400 1180000
0 0 0 20 5530000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 191708 70356836
0 0 0 0 0
0 0 0 630 781200
0 0 0 8045 13040945
0 0 0 0 0
0 0 0 618 812670
0 0 0 0 0
0 0 0 9 149472
0 0 0 2 33216
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 8 0
0 0 0 0 0
0 0 0 2 3970
0 0 0 0 0
0 0 0 0 0
0 0 0 200 7999640
0 0 0 0 0
0 0 0 0 0
0 0 0 200 4466000
0 0 0 0 0
0 0 0 0 0
0 0 0 200 2681400
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 4 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 125 7493750
0 0 0 10 282040
0 0 0 165 23371920
0 0 0 410 31276850
0 0 0 0 0
0 0 0 560 11704000
0 0 0 290 5786660
0 0 0 145 2026520
0 0 0 50 825000
PELAPORAN : HAMPARAN PERAK 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK H.PERAK TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 5,000 465000 0 5,000 465000 0 5,000 465000 0 0 0 0 0 15000 1395000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 0 0 1,000 313000 0 1,000 313000 0 0 0 0 0 2000 626000
tablet 88 0 0 10,000 880000 0 5,000 440000 0 0 0 0 0 0 0 15000 1320000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Amoksisilin 500 mg kapsul 265 0 0 20,000 5300000 0 20,000 5300000 0 20,000 5300000 0 0 0 0 0 60000 15900000
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 0 0 300 750000 0 400 1000000 0 0 0 0 0 700 1750000
btl 60 ml 2,065 0 100 206500 500 1032500 0 500 1032500 0 500 1032500 0 0 0 0 0 1600 3304000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 1,000 445500 0 5,000 2227500 0 5,000 2227500 0 0 0 0 0 11000 4900500
tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Asam Mefenamat 500 mg
silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 0 10,000 640000 0 10,000 640000 0 10,000 640000 0 0 0 0 0 30000 1920000

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 1,000 436000 0 0 0 0 0 0 0 0 0 1000 436000

tablet/ H. baru 797 0 0 0 0 0 0 1,000 796990 0 0 0 0 0 1000 796990
tablet 58 0 0 0 0 3,000 174000 0 3,000 174000 0 0 0 0 0 6000 348000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet / H.Baru 437 0 0 3,000 1311000 0 10,800 4719600 0 10,800 4719600 0 0 0 0 0 24600 10750200
43 Hustab Tablet tablet 258 0 0 0 3,000 774000 0 0 0 0 0 0 3000 774000
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 300 3465000 0 0 0 0 0 600 6930000
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

44 Hustab syrup
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0 100 7500 0 0 0 0 0 100 7500

50 Kaptopril 12,5 mg tablet 62 0 0 2,000 124000 0 2,000 124000 0 2,000 124000 0 0 0 0 0 6000 372000
52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 2,000 0 0 0 0 0 0 2000 0

53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 5,000 215000 10,000 430000 0 20,000 860000 0 20,000 860000 0 0 0 0 0 55000 2365000
55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 0 2,000 308000 0 2,000 308000 0 4,000 616000 0 0 0 0 0 8000 1232000

ampul 1,937 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 0 0 2,000 266000 0 0 0 0 0 0 0 2000 266000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 20,000 2660000 0 10,000 1330000 0 0 0 0 0 0 0 30000 3990000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 5,600 597352 0 3,000 320010 0 0 0 0 0 0 0 8600 917362

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 5,000 2745000 0 0 0 0 0 0 0 0 0 5000 2745000

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 0 0 1,000 803000 0 0 0 0 0 0 0 1000 803000

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 200 380000 0 0 0 0 0 0 0 0 0 200 380000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 0 0 7,000 357000 0 0 0 0 0 0 0 0 0 7000 357000
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 5,000 823100 0 10,000 1646200 0 0 0 0 0 15000 2469300
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 500 748000 0 500 748000 0 0 0 0 0 1500 2244000
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 10,000 1240000 0 20,000 2480000 0 0 0 0 0 0 0 30000 3720000
tablet 191 0 0 0 0 0 0 3,000 571980 0 0 0 0 0 3000 571980
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Ranitidin tablet 150 mg (HCL)
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 500 248500 0 0 0 0 0 0 0 0 0 500 248500

botol 7,150 0 200 1430000 400 2860000 0 400 2860000 0 0 0 0 0 0 0 1000 7150000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 3,000 180000 0 2,000 120000 0 0 0 0 0 0 0 5000 300000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 1,000 1168000 0 1,000 1168000 0 0 0 0 0 0 0 2000 2336000
tablet 133 0 0 3,000 399000 0 0 0 0 0 0 0 0 0 3000 399000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 2,000 578000 0 0 0 3,000 867000 0 0 0 0 0 5000 1445000
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 2,000 1760000 0 0 0 0 0 0 0 2000 1760000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 0 0 5,000 420000 0 3,000 252000 0 0 0 0 0 8000 672000
Botol 9,646 0 0 300 2893800 0 0 0 0 0 0 0 0 0 300 2893800

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 100 629000 0 0 0 100 629000 0 0 0 0 0 200 1258000
3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


buah 4,180 0 0 200 836000 0 0 0 0 0 0 0 0 0 200 836000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 0 0 0 0 3,000 2376000 0 0 0 0 0 3000 2376000
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 2,000 432000 0 1,000 216000 0 0 0 0 0 0 0 3000 648000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 3 113850 0 0 0 0 0 0 0 0 0 0 3 113850
buah 45,183 0 0 0 0 48 2168784 0 24 1084392 0 0 0 0 0 72 3253176

buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0 0 0 12 542196
buah 32,491 0 0 12 389892 0 24 779784 0 24 779784 0 0 0 0 0 60 1949460

buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0 0 0 0 12 389892

buah 52,561 0 0 24 1261464 0 0 0 0 0 0 0 0 0 24 1261464
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0 0 0 12 612264
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 76 262200 0 0 0 0 0 0 0 0 0 76 262200

botol / bpjs 3,450 0 10 34500 0 0 0 0 0 0 0 0 0 0 10 34500
botol 28,750 0 0 10 287500 0 10 287500 0 10 287500 0 0 0 0 0 30 862500

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 15 431250 0 0 0 0 0 0 0 0 0 0 15 431250
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 50 141563 0 0 0 0 0 0 0 0 0 0 50 141563
set 3,520 0 0 200 704000 0 200 704000 0 0 0 0 0 0 0 400 1408000

set / bpjs 3,520 0 200 704000 0 0 0 0 0 0 0 0 0 0 200 704000
buah 13,750 0 0 0 0 20 275000 0 10 137500 0 0 0 0 0 30 412500

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 50 1500400 0 0 0 0 0 0 0 0 0 0 50 1500400
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 0 0 0 0 0 0 0 0 100 165000
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 100 82500 0 0 0 0 0 0 0 0 0 100 82500
rol / bpjs 825 0 150 123750 0 0 0 0 0 0 0 0 0 0 150 123750
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 5 235750 0 5 235750 0 0 0 0 0 0 0 10 471500

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 25,000 9075000 0 0 0 0 0 0 0 0 0 0 25000 9075000
buah 440 0 0 2,000 880000 0 500 220000 0 0 0 0 0 0 0 2500 1100000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 5 94091 0 0 0 0 0 0 0 0 0 5 94091

botol / bpjs 18,818 0 35 658636 0 0 0 0 0 0 0 0 0 0 35 658636
botol 3,032 0 0 100 303182 0 0 0 0 0 0 0 0 0 100 303182

botol / bpjs 3,032 0 70 212227 0 0 0 0 0 0 0 0 0 0 70 212227
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 10 68950 0 0 0 0 0 0 0 0 0 0 10 68950

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 24 877968 0 0 0 0 0 0 0 0 0 0 24 877968
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 19 274960 0 0 0 0 0 0 0 0 0 0 19 274960
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

170 Lise Samsung Unit 3,300,000 0 0 0 0 0 0 2 6600000 0 0 0 0 0 2 6600000

Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 500 151500 0 1,000 303000 0 0 0 0 0 1500 454500
185 POT SPUTUM BUAH 2,950 0 0 500 1475000 0 0 0 0 0 0 0 0 0 500 1475000

189 Lisol 100 % botol 47,150 0 5 235750 0 0 0 0 0 0 0 0 0 0 5 235750

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 9 0 0 0 0 0 0 0 0 0 0 9 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0




OBAT GIGI - 0 0 0 0 0 0 2 0 0 0 0 0 0 2 0
214 ENDO ICE Botol 352,000 0 0 2 704000 0 1 352000 0 0 0 0 0 0 0 3 1056000


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 10 29500 0 0 0 0 0 10 29500
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 454,148 166672316 0 0 0 0 0 0 0 0 0 0 454148 166672316
buah/ skipa 1,240 1494 1852560 0 0 0 0 0 0 0 0 0 0 0 1494 1852560
237 Spuit 0,5 ml
buah / apbn 1,621 19023 30836283 0 0 0 0 0 0 0 0 0 0 0 19023 30836283
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 1461 1921215 0 0 0 0 0 0 0 0 0 0 0 1461 1921215
Spuit 5 ml APBN 1,705 64 109120 64
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 20 332160 0 0 0 0 0 0 0 0 0 0 0 20 332160
Box / 2,5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0

256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 35 2098250 80 4796000 50 2997500 40 2398000 30 1798500 50 2997500 50 2997500 0 0 0 0 0 335 20083250
269 CAMPAK VIAL 28,204 0 0 0 0 30 846120 20 564080 20 564080 0 0 0 0 0 70 1974280
270 MR VIAL 141,648 40 5665920 50 7082400 80 11331840 60 8498880 20 2832960 30 4249440 30 4249440 0 0 0 0 0 310 43910880
271 DPT-HB-Hib VIAL 76,285 100 7628500 200 15257000 100 7628500 200 15257000 150 11442750 150 11442750 150 11442750 0 0 0 0 0 1050 80099250
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 180 3762000 300 6270000 100 2090000 230 4807000 150 3135000 200 4180000 200 4180000 0 0 0 0 0 1360 28424000
274 POLIO (BOPV) VIAL 19,954 120 2394480 150 2993100 0 0 120 2394480 130 2594020 130 2594020 0 0 0 0 0 650 12970100
275 POLIO (IPV) VIAL 13,976 40 559040 100 1397600 20 279520 40 559040 30 419280 40 559040 50 698800 0 0 0 0 0 320 4472320
276 Td VIAL 16,500 30 495000 50 825000 70 1155000 20 330000 40 660000 40 660000 30 495000 0 0 0 0 0 280 4620000
PELAPORAN : KOTA DATAR 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR K.DATAR TOTAL
TOTAL
NO NAMA OBAT SATUAN HARGA SATUAN HARGA
KELUAR

tablet 93 0 0 3,000 279000 0 5,000 465000 0 5,000 465000 0 0 0 0 0 13000 1209000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 3,500 1095500 0 0 0 2,000 626000 0 0 0 0 0 5500 1721500
tablet 88 0 0 8,000 704000 0 7,000 616000 0 6,000 528000 0 0 0 0 0 21000 1848000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Amoksisilin 500 mg kapsul 265 0 5,000 1325000 18,000 4770000 0 18,000 4770000 0 20,000 5300000 0 0 0 0 0 61000 16165000
btl 60 ml 2,065 0 100 206500 500 1032500 0 500 1032500 0 500 1032500 0 0 0 0 0 1600 3304000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 8,000 3564000 0 0 0 0 0 13000 5791500
tablet 176 0 5,000 880000 1,000 176000 0 0 0 0 0 0 0 0 0 6000 1056000

silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 11,550 0 0 0 0 0 0 300 3465000 0 0 0 0 0 300 3465000

21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 0 8,000 512000 0 8,000 512000 0 8,000 512000 0 0 0 0 0 24000 1536000

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 1,000 436000 0 0 0 0 0 0 0 0 0 1000 436000

tablet/ H. baru 797 0 0 0 0 0 0 1,000 796990 0 0 0 0 0 1000 796990
tablet 58 0 0 4,000 232000 0 5,000 290000 0 7,000 406000 0 0 0 0 0 16000 928000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 Glukosa 5% Larutan Infus botol 6,900 0 0 400 2760000 0 300 2070000 0 200 1380000 0 0 0 0 0 900 6210000
39 Griseofulvin 125 mg Tablet tablet 240 0 0 200 48000 0 3,000 720000 0 3,000 720000 0 0 0 0 0 6200 1488000
42 Hidrokloratiazid 25 mg tablet 156 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet / H.Baru 437 0 0 0 0 10,800 4719600 0 7,200 3146400 0 0 0 0 0 18000 7866000
43 Hustab Tablet tablet 258 0 0 0 0 2,000 516000 0 0 0 0 0 0 0 2000 516000
tablet P 312 0 0 2,000 624000 0 0 0 0 0 0 0 0 0 2000 624000
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 300 3465000 0 0 0 0 0 600 6930000
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0

44 Hustab syrup
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 100 804600 0 0 0 0 0 0 0 0 0 0 100 804600
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 1,000 75000 0 0 0 0 0 0 0 1000 75000

49 Karbamazepin tablet 200 mg tablet 230 0 0 500 115000 0 1,000 230000 0 1,000 230000 0 0 0 0 0 2500 575000
50 Kaptopril 12,5 mg tablet 62 0 0 1,000 62000 0 2,000 124000 0 2,000 124000 0 0 0 0 0 5000 310000
52 Klorpramazine HCl 100 mg tablet - 0 0 1,000 0 0 1,000 0 0 1,000 0 0 0 0 0 0 3000 0

53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 2,000 86000 10,000 430000 0 10,000 430000 0 10,000 430000 0 0 0 0 0 32000 1376000
55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 2,000 308000 8,000 1232000 0 8,000 1232000 0 8,000 1232000 0 0 0 0 0 26000 4004000

ampul 1,937 0 0 300 581100 0 500 968500 0 500 968500 0 0 0 0 0 1300 2518100
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 2,000 266000 0 2,000 266000 0 2,000 266000 0 0 0 0 0 6000 798000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 300 805200 0 300 805200 0 78 209352 0 0 0 0 0 678 1819752
tablet 133 0 0 20,000 2660000 0 25,000 3325000 0 0 0 0 0 0 0 45000 5985000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 1,000 106670 2,800 298676 0 2,000 213340 0 0 0 0 0 0 0 5800 618686

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 200 1282000 0 400 2564000 0 400 2564000 0 0 0 0 0 1000 6410000
botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 0 0 500 274500 0 0 0 0 0 0 0 500 274500

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 1,000 1,000 600

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 200 380000 0 300 570000 0 300 570000 0 0 0 0 0 800 1520000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 1,000 164000 5,000 820000 0 4,000 656000 0 5,000 820000 0 0 0 0 0 15000 2460000
tablet 51 0 5,000 255000 7,000 357000 0 0 0 0 0 0 0 0 0 12000 612000
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 700 1047200 0 600 897600 0 600 897600 0 0 0 0 0 1900 2842400
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 100 311300 0 200 622600 0 600 1867800 0 0 0 0 0 900 2801700
78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 1,000 308000 0 500 154000 0 1,000 308000 0 0 0 0 0 2500 770000
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 2,000 248000 1,000 124000 0 10,000 1240000 0 8,000 992000 0 0 0 0 0 21000 2604000
tablet 191 0 0 0 0 0 0 4,000 762640 0 0 0 0 0 4000 762640
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 7,150 0 100 715000 400 2860000 0 400 2860000 0 500 3575000 0 0 0 0 0 1400 10010000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0



95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 1,000 1168000 0 1,000 1168000 0 1,000 1168000 0 0 0 0 0 3000 3504000
tablet 133 0 0 5,000 665000 0 0 0 0 0 0 0 0 0 5000 665000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 0 0 0 0 3,000 867000 0 0 0 0 0 3000 867000
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 3,000 2640000 0 0 0 0 0 0 0 3000 2640000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Botol 9,646 0 0 200 1929200 0 0 0 0 0 0 0 0 0 200 1929200
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 100 629000 0 0 0 0 0 100 629000

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,180 0 0 200 836000 0 0 0 100 418000 0 0 0 0 0 300 1254000
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 1,000 792000 0 0 0 0 0 0 0 0 0 0 1000 792000
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 3,000 2376000 0 300 237600 0 2,200 1742400 0 0 0 0 0 5500 4356000
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 1,000 216000 0 0 0 0 0 0 0 2000 432000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 24 1084392 0 24 1084392 0 0 0 0 0 48 2168784

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 24 779784 0 24 779784 0 0 0 0 0 48 1559568
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 24 1261464 0 0 0 0 0 24 1261464

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 24 1224528 0 0 0 0 0 24 1224528

buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 10 287500 0 10 287500 0 0 0 0 0 25 718750

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 12 345000 0 0 0 0 0 0 0 0 0 0 12 345000
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Infusion Set Anak set 2,831 0 50 141563 100 283126 0 50 141563 0 0 0 0 0 0 0 200 566251
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 100 352000 150 528000 0 150 528000 0 150 528000 0 0 0 0 0 550 1936000
set / bpjs 3,520 0 100 352000 0 0 0 0 0 0 0 0 0 0 100 352000
buah 13,750 0 0 20 275000 0 20 275000 0 20 275000 0 0 0 0 0 60 825000
buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 10 272800 0 6 163680 0 0 0 0 0 0 0 16 436480
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 0 0 0 0 0 0 0 0 100 165000

rol / bpjs 1,650 0 21 34650 0 0 0 0 0 0 0 0 0 0 21 34650
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 3 141450 0 5 235750 0 0 0 0 0 0 0 8 377200

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 250 0 0 0 0 0 0 0 0 0 0 0 250 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 250 90750 0 0 0 0 0 0 0 0 0 0 250 90750
buah 440 0 0 5,000 2200000 0 1,000 440000 0 2,000 880000 0 0 0 0 0 8000 3520000
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 2 163911 0 0 0 0 0 0 0 0 0 2 163911

rol / bpjs 81,955 0 5 409777 0 0 0 0 0 0 0 0 0 0 5 409777
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 28,286 0 5 141432 0 0 0 0 0 0 0 0 0 0 5 141432
botol 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 100 303182 0 0 0 0 0 0 0 0 0 100 303182

botol / bpjs 3,032 0 50 151591 0 0 0 0 0 0 0 0 0 0 50 151591
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 36,582 0 0 0 0 0 0 24 877968 0 0 0 0 0 24 877968

161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 24 0 0 0 0 0 0 24 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0



Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 1,000 303000 0 3,000 909000 0 0 0 0 0 4000 1212000
185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300

191 Masker 3 Ply Earloop Jilbab buah - 0 1000 0 0 0 0 0 0 0 0 0 0 0 1000 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 2 0 0 0 0 0 0 0 0 0 0 0 2 0

Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0 0 0 5 0

197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0




OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 1 352000 0 0 0 0 0 3 1056000



222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 15 450000 0 0 0 0 0 0 0 15 450000
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 255176 93649592 0 0 0 0 0 0 0 0 0 0 255176 93649592
buah/ skipa 1,240 841 1042840 0 0 0 0 0 0 0 0 0 0 0 841 1042840

237 Spuit 0,5 ml
buah / apbn 1,621 10714 17367394 0 0 0 0 0 0 0 0 0 0 0 10714 17367394

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 823 1082245 0 0 0 0 0 0 0 0 0 0 0 823 1082245
Spuit 5 ml APBN 1,705 36 61380 36
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 11 182688 0 0 0 0 0 0 0 0 0 0 0 11 182688
Box / 2,5ml 16,608 3 49824 0 0 0 0 0 0 0 0 0 0 0 3 49824
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0



256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 30 1798500 30 1798500 30 1798500 30 1798500 30 1798500 25 1498750 25 1498750 0 0 0 0 0 200 11990000
269 CAMPAK VIAL 28,204 0 0 0 0 30 846120 30 846120 20 564080 0 0 0 0 0 80 2256320
270 MR VIAL 141,648 80 11331840 80 11331840 70 9915360 50 7082400 20 2832960 50 7082400 20 2832960 0 0 0 0 0 370 52409760
271 DPT-HB-Hib VIAL 76,285 80 6102800 60 4577100 50 3814250 100 7628500 80 6102800 90 6865650 100 7628500 0 0 0 0 0 560 42719600
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 100 2090000 110 2299000 50 1045000 100 2090000 110 2299000 110 2299000 110 2299000 0 0 0 0 0 690 14421000
274 POLIO (BOPV) VIAL 19,954 100 1995400 100 1995400 0 0 80 1596320 70 1396780 80 1596320 0 0 0 0 0 430 8580220
275 POLIO (IPV) VIAL 13,976 30 419280 30 419280 30 419280 30 419280 25 349400 25 349400 30 419280 0 0 0 0 0 200 2795200
276 Td VIAL 16,500 20 330000 20 330000 30 495000 20 330000 10 165000 30 495000 30 495000 0 0 0 0 0 160 2640000
PELAPORAN : LABUHAN DELI 2 3 4 5 6 8 9
1 2 3 4 5 6 8 9
L.DELI L.DELI L.DELI L.DELI L.DELI L.DELI L.DELI L.DELI L.DELI

tablet 93 0 0 400 37200 0 600 55800 0 1,500 139500 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 1,000 313000 0 0 0 2,000 626000 0 0
tablet 88 0 0 0 0 0 0 3,000 264000 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
6 Amoksisilin 500 mg kapsul 265 0 0 9,000 2385000 0 9,000 2385000 0 6,000 1590000 0 0
btl 60 ml 2,065 0 0 50 103250 0 100 206500 0 400 826000 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 3,000 327000 0 3,000 327000 0 0 0 0
tablet/ H Baru 446 0 0 0 0 1,200 534600 0 3,000 1336500 0 0

tablet 176 0 0 1,000 176000 0 0 0 0 0 0
silva/ 2015 304 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 0 0 24 117000 0 72 351000 0 0
17 Cetrizin tablet tablet 145 0 2,000 290000 0 1,500 217500 0 0 4,000 580000 0 0
18 Cetrizin syrup botol 2,900 0 60 174000 63 182700 0 0 0 50 145000 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 300 316800 0 300 316800 0 0 0 0

botol 11,550 0 0 0 0 0 0 350 4042500 0 0
21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0
24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 0 0 0 0 0 0 0

tablet 64 0 0 3,000 192000 0 3,500 224000 0 2,500 160000 0 0
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 1,200 901200 1,000 751000 2,200 1652200 0 2,500 1877500 0 0
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 120 824040 120 824040 0 0 0 0 0 0
tablet 436 0 0 100 43600 0 0 0 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0 200 159398 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 0 0 0 0 0 0 0

tablet 58 0 0 800 46400 0 1,200 69600 0 500 29000 0 0

tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0

36 Glukosa 5% Larutan Infus botol 6,900 0 0 50 345000 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 800 192000 0 800 192000 0 300 72000 0 0
40 Haloperidol tablet 0,5 mg tablet 62 0 0 0 0 0 0 100 6200 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 24 63600 48 127200 24 63600 48 127200 0 72 190800 0 0

tablet / H.Baru 437 0 0 0 0 0 0 0 0 0
43 Hustab Tablet tablet 258 0 0 0 0 2,000 516000 0 0 0 0
tablet P 312 0 3,000 936000 4,000 1248000 0 0 0 0 0 0

botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 200 2310000 0 0
silva /2014 11,550 0 0 0 0 0 0 0 0 0

44 Hustab syrup
silva/ 2015 11,550 0 0 0 0 0 0 0 0 0
botol 8,046 0 50 402300 50 402300 0 0 0 0 0 0


49 Karbamazepin tablet 200 mg tablet 230 0 0 100 23000 0 200 46000 0 200 46000 0 0
50 Kaptopril 12,5 mg tablet 62 0 0 300 18600 0 500 31000 0 700 43400 0 0
51 Kaptopril 25 mg tablet 715 0 500 357500 300 214500 0 500 357500 0 300 214500 0 0
55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 0 500 77000 0 1,000 154000 0 5,000 770000 0 0
ampul 1,937 0 0 0 0 0 0 0 0 0
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0
tablet 133 0 0 500 66500 0 0 0 500 66500 0 0

tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0

62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 0 0 0 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 400 49200 600 73800 2,000 246000 0 4,000 492000 0 0
tablet 133 0 0 10,000 1330000 0 5,000 665000 0 0 0 0
tablet 264 0 0 0 0 0 0 0 0 0
66 Mikonazol Cream 2 % tube 3,410 0 24 81840 48 163680 0 48 163680 0 72 245520 0 0

tablet 107 0 0 2,000 213340 0 2,500 266675 0 0 0 0
silva 2015 136 0 0 0 0 0 0 0 0 0

botol 6,410 0 0 0 0 0 0 0 0 0
botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0
tablet 549 0 0 100 54900 0 0 0 0 0 0

tablet/ H Baru 630
tablet 803 0 0 100 80300 0 0 0 0 0 0

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 0 0 0 0 200 380000 0 0

ampul/H baru 1,199 0 0 0 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 600 98400 900 147600 600 98400 2,000 328000 0 3,600 590400 0 0
tablet 51 0 5,000 255000 7,000 357000 0 0 0 0 0 0
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 4,000 658480 0 10,000 1646200 0 0

75 Paracetamol 500 mg (lanamol)
silva/ 2015 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 200 299200 100 149600 0 200 299200 0 300 448800 0 0
77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0 0 0 0
78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 0 1,200 369600 0 0 1,000 308000 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 3,000 372000 0 2500 310000 0 400 49600 0 0

tablet 191 0 0 0 0 0 0 4,000 762640 0 0
tablet 226 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 0 0 0 0 100 715000 0 0
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0

89 Salbutamol tablet 2 mg tablet 78 0 0 400 31200 0 300 23400 0 300 23400 0 0

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 1,200 72000 2,000 120000 0 1,700 102000 0 800 48000 0 0

tablet 133 0 300 39900 600 79800 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0
tablet 289 0 0 500 144500 0 0 0 500 144500 0 0
98 Siprofloksasin 500 MG tablet 880 0 0 0 0 500 440000 0 0 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 0 0 0 0 0 0 0
101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 0 0 0 0 0 0 0

102 Vitamin B komplek Tablet tablet 121 0 3000 363000 2,000 242000 0 2,500 302500 0 4,000 484000 0 0
Botol 9,646 0 0 50 482300 0 0 0 0 0 0

Botol 10,293 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 100 629000 0 0 0 50 314500 0 0
3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0



buah 4,180 0 0 100 418000 0 0 0 0 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 20 91000 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 50 39600 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 0 0 0 0 0
buah 197 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 16 607200 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 24 779784 0 0 0 0

buah / bpjs 32,491 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 50 172500 0 0 0 0 0 0

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 0 0 0 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0
132 Infusion Set Anak set 2,831 0 0 50 141563 0 50 141563 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0
set 3,520 0 0 50 176000 0 50 176000 0 0 0 0

set / bpjs 3,520 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 20 275000 0 0 0 0 0 0

buah / bpjs 13,750 0 4 55000 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 10 77000 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0
buah 8,800 0 372 3273600 0 0 0 0 0 0 0

buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 5 235750 2 94300 5 235750 0 0 0 0

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 500 181500 0 100 36300 0 0 0 0

buah / bpjs - 0 0 0 0 0 0 0 0 0

buah 363 0 0 200 72600 0 0 0 0 0 0

buah / bpjs 363 0 0 0 0 0 0 0 0 0
buah 440 0 0 1,000 440000 0 0 0 1,000 440000 0 0

buah / bpjs 440 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 5 409777 0 0 0 0 0 0
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 0 0 0 0 0 0 0
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0
160 Sarung tangan M buah 471 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 24 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 4 57886 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0
188 Sarung tangan tanpa tepung M buah 583 0 1000 583000 0 0 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 3 141450 0 0 0 0 0 0 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0

Program IFA - 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0

198 Spritus Liter - 0 0 0 0 0 0 0 0 0


Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 2 704000 0 0


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0

Program TB Paru - 0 0 0 0 0 0 0 0 0


231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 180700 66316900 0 0 0 0 0 0 0
buah/ skipa 1,240 533 660920 0 0 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 6795 11014695 0 0 0 0 0 0 0 0
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 522 686430 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 23 39215
Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 7 116256 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0

240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 4 0 0 4 0 4 0 0 0 0 0

OBAT APBN - 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0


266 Handscoen boks - 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0

Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 25 1498750 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 0 20 564080 0 0 0

270 MR VIAL 141,648 0 0 0 0 0 0 0 0 0
271 DPT-HB-Hib VIAL 76,285 70 5339950 60 4577100 50 3814250 80 6102800 60 4577100 80 6102800 80 6102800 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 80 1672000 80 1672000 50 1045000 80 1672000 65 1358500 80 1672000 80 1672000 0 0
274 POLIO (BOPV) VIAL 19,954 70 1396780 70 1396780 0 0 60 1197240 70 1396780 70 1396780 0 0
275 POLIO (IPV) VIAL 13,976 20 279520 30 419280 20 279520 30 419280 20 279520 30 419280 20 279520 0 0
276 Td VIAL 16,500 10 165000 7 115500 0 10 165000 5 82500 20 330000 5 82500 0 0

10 11 12
10 11 12
L.DELI L.DELI L.DELI TOTAL

TOTAL
HARGA
KELUAR
HARGA HARGA HARGA
0 0 0 0 0
0 0 0 0 0
0 0 0 2500 232500
0 0 0 0 0
0 0 0 3000 939000
0 0 0 3000 264000
0 0 0 0 0
0 0 0 24000 6360000
0 0 0 700 1750000
0 0 0 0 0
0 0 0 16000 1008000
0 0 0 550 1135750
0 0 0 0 0
0 0 0 24 165720
0 0 0 6000 654000
0 0 0 4200 1871100
0 0 0 1000 176000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 96 468000
0 0 0 0 0
0 0 0 7500 1087500
0 0 0 173 501700
0 0 0 600 633600
0 0 0 96 172608
0 0 0 350 4042500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 9000 576000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 6900 5181900
0 0 0 240 1648080
0 0 0 30 125010
0 0 0 100 43600
0 0 0 200 159398
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2500 145000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 345000
0 0 0 5 37500
0 0 0 0 0
0 0 0 1900 456000
0 0 0 100 6200
0 0 0 216 572400
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 516000
0 0 0 7000 2184000
0 0 0 500 5775000
0 0 0 0 0
0 0 0 0 0
0 0 0 100 804600
0 0 0 400 30000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 115000
0 0 0 1500 93000
0 0 0 1600 1144000
0 0 0 100 0
0 0 0 13500 580500
0 0 0 300 654900
0 0 0 6500 1001000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 133000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 268400
0 0 0 0 0
0 0 0 7000 861000
0 0 0 15000 1995000
0 0 0 0 0
0 0 0 500 1900000
0 0 0 192 654720
0 0 0 4500 480015
0 0 0 3500 476000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 54900
0 0 0 100 80300
0 0 0 0 0
0 0 0 300 1072500
0 0 0 100 179800
0 0 0 200 380000
0 0 0 0 0
0 0 0 7700 1262800
0 0 0 12000 612000
0 0 0 14000 2304680
0 0 0 0 0
0 0 0 800 1196800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2200 677600
0 0 0 5900 731600
0 0 0 0 0
0 0 0 0 0
0 0 0 4000 762640
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 715000
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 78000
0 0 0 0 0
0 0 0 50 202091
0 0 0 0 0
0 0 0 2 377326
0 0 0 5700 342000
0 0 0 100 116800
0 0 0 900 119700
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 289000
0 0 0 500 440000
0 0 0 0 0
0 0 0 250 3052500
0 0 0 0 0
0 0 0 0 0
0 0 0 11500 1391500
0 0 0 50 482300
0 0 0 0 0
0 0 0 0 0
0 0 0 150 943500
0 0 0 0 0
0 0 0 0 0
0 0 0 5 95025
0 0 0 0 0
0 0 0 1 127050
0 0 0 5 687500
0 0 0 5 1842500
0 0 0 5 893750
0 0 0 5 303182
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 418000
0 0 0 0 0
0 0 0 0 0
0 0 0 20 91000
0 0 0 0 0
0 0 0 0 0
0 0 0 50 39600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 16 607200
0 0 0 0 0
0 0 0 0 0
0 0 0 24 779784
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 172500
0 0 0 0 0
0 0 0 5 143750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 283126
0 0 0 0 0
0 0 0 100 352000
0 0 0 0 0
0 0 0 20 275000
0 0 0 4 55000
0 0 0 20 545600
0 0 0 0 0
0 0 0 0 0
0 0 0 10 77000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 372 3273600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 12 565800
0 0 0 0 0
0 0 0 600 217800
0 0 0 100 43890
0 0 0 0 0
0 0 0 0 0
0 0 0 200 72600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 880000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 409777
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 82500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 12 438984
0 0 0 24 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 4 57886
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 671 361669
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 583000
0 0 0 3 141450
0 0 0 0 0
0 0 0 1000 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 0
0 0 0 5 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 245000
0 0 0 4000 6604000
0 0 0 44 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 1056000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 32 10472288
0 0 0 0 0
0 0 0 0 0
0 0 0 2 406518
0 0 0 0 0
0 0 0 0 0
0 0 0 20 5530000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 180700 66316900
0 0 0 0 0
0 0 0 533 660920
0 0 0 6795 11014695
0 0 0 0 0
0 0 0 522 686430
23
0 0 0 0 0
0 0 0 7 116256
0 0 0 2 33216
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 12 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 2233000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 145 8692750
0 0 0 20 564080
0 0 0 0 0
0 0 0 480 36616800
0 0 0 0 0
0 0 0 515 10763500
0 0 0 340 6784360
0 0 0 170 2375920
0 0 0 57 940500
PELAPORAN : PEMATANG JOHAR 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR P.JOHAR TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 200 18600 0 2,000 186000 0 400 37200 0 0 0 0 0 2600 241800
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 88 0 0 700 61600 0 2,000 176000 0 0 0 0 0 0 0 2700 237600

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 0 2,000 126000 0 6,000 378000 0 0 0 0 0 0 0 8000 504000
btl 60 ml 2,065 0 0 150 309750 0 150 309750 0 0 0 0 0 0 0 300 619500

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 1,700 185300 0 0 0 300 32700 0 0 0 0 0 2000 218000
tablet/ H Baru 446 0 0 1,000 445500 0 0 0 2,000 891000 0 0 0 0 0 3000 1336500
tablet 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 500 72500 0 0 0 400 58000 0 0 0 0 0 900 130500
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 11,550 0 0 0 0 0 0 200 2310000 0 0 0 0 0 200 2310000

21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 500 47300 0 0 0 0 0 500 47300
tablet 64 0 0 700 44800 0 3,000 192000 0 2,300 147200 0 0 0 0 0 6000 384000

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 0 0 0 0 100 75100 0 0 0 0 0 100 75100
tablet 436 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 58 0 0 1,000 58000 0 1,000 58000 0 400 23200 0 0 0 0 0 2400 139200
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

39 Griseofulvin 125 mg Tablet tablet 240 0 0 0 0 500 120000 0 0 0 0 0 0 0 500 120000
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 0 0 50 132500 0 0 0 0 0 0 0 50 132500
tablet / H.Baru 437 0 0 500 218500 0 3,600 1573200 0 0 0 0 0 0 0 4100 1791700
tablet 258 0 0 0 0 2,000 516000 0 0 0 0 0 0 0 2000 516000

43 Hustab Tablet
tablet P 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ BPJS 312 0 2,500 780000 0 0 0 0 0 0 0 0 0 0 2500 780000
botol/ H. Baru 11,550 0 0 0 0 200 2310000 0 100 1155000 0 0 0 0 0 300 3465000
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
44 Hustab syrup silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 8,046 0 100 804600 0 0 0 0 0 0 0 0 0 0 100 804600



51 Kaptopril 25 mg tablet 715 0 0 1,000 715000 0 1,000 715000 0 300 214500 0 0 0 0 0 2300 1644500

55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 0 800 123200 0 2,000 308000 0 1,000 154000 0 0 0 0 0 3800 585200
ampul 1,937 0 0 0 0 50 96850 0 0 0 0 0 0 0 50 96850

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 600 79800 0 2,000 266000 0 400 53200 0 0 0 0 0 3000 399000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 300 48600 0 1,000 162000 0 0 0 0 0 0 0 1300 210600
63 Metoclorpramid HCL 10 mg tablet 123 0 0 600 73800 0 1,000 123000 0 900 110700 0 0 0 0 0 2500 307500
tablet 133 0 0 10,000 1330000 0 1,000 133000 0 0 0 0 0 0 0 11000 1463000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 300 1140000 0 0 0 0 0 0 0 0 0 300 1140000
66 Mikonazol Cream 2 % tube 3,410 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 107 0 0 1,600 170672 0 2,000 213340 0 0 0 0 0 0 0 3600 384012

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 0 0 100 641000 0 0 0 0 0 0 0 100 641000

botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 630
tablet 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 0 0 6,000 306000 0 0 0 0 0 0 0 0 0 6000 306000
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 300 448800 0 300 448800 0 200 299200 0 0 0 0 0 800 1196800
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 40 124520 0 0 0 0 0 0 0 0 0 40 124520

78 Pehacain Injeksi
ampul / bpjs 3,113 0 300 933900 0 0 0 0 0 0 0 0 0 0 300 933900
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 7,000 868000 0 0 0 0 0 0 0 0 0 7000 868000
tablet 191 0 0 0 0 0 0 2,000 381320 0 0 0 0 0 2000 381320
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 40 286000 0 100 715000 0 40 286000 0 0 0 0 0 180 1287000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 1,000 78000 0 500 39000 0 0 0 0 0 0 0 1500 117000

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 2,000 120000 0 1,000 60000 0 800 48000 0 0 0 0 0 3800 228000
tablet 133 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 500 144500 0 0 0 200 57800 0 0 0 0 0 700 202300
tablet 880 0 0 0 0 600 528000 0 0 0 0 0 0 0 600 528000

silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 1,000 289000 0 0 0 0 0 0 0 0 0 0 1000 289000

100 Tetrasiklin 500 mg kapsul 319 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Botol 9,646 0 0 100 964600 0 0 0 0 0 0 0 0 0 100 964600
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0 0 0 0 10 379500
buah 45,183 0 0 0 0 48 2168784 0 12 542196 0 0 0 0 0 60 2710980
buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0 0 0 12 542196
buah 32,491 0 0 0 0 48 1559568 0 0 0 0 0 0 0 48 1559568
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0 0 0 0 12 389892
buah 52,561 0 0 24 1261464 0 0 0 0 0 0 0 0 0 24 1261464

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0 0 0 12 612264
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 11 316250 0 0 0 0 0 0 0 0 0 0 11 316250
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0

set 3,520 0 0 200 704000 0 200 704000 0 0 0 0 0 0 0 400 1408000
set / bpjs 3,520 0 50 176000 0 0 0 0 0 0 0 0 0 0 50 176000
buah 13,750 0 0 0 0 0 0 15 206250 0 0 0 0 0 15 206250
buah / bpjs 13,750 0 15 206250 0 0 0 0 0 0 0 0 0 0 15 206250
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 5 38500 0 0 0 0 0 0 0 0 0 5 38500
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 50 105000 0 0 0 0 0 0 0 0 0 0 50 105000
rol 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 150 247500 0 0 0 0 0 0 0 0 0 0 150 247500
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 3 141450 0 5 235750 0 0 0 0 0 0 0 8 377200

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 100 36300 0 0 0 0 0 0 0 100 36300
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 250 90750 0 0 0 0 0 0 0 0 0 0 250 90750

buah 440 0 0 0 0 500 220000 0 350 154000 0 0 0 0 0 850 374000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0

153 One scrub 500 cc + dispenser botol 65,341 0 0 2 130682 0 1 65341 0 0 0 0 0 0 0 3 196023
rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777

rol / bpjs 81,955 0 2 163911 0 0 0 0 0 0 0 0 0 0 2 163911
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 2 102610 0 0 0 0 0 0 0 0 0 0 2 102610
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 5 94091 0 0 0 0 0 0 0 0 0 0 5 94091
botol 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,032 0 28 84891 0 0 0 0 0 0 0 0 0 0 28 84891
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 50 344750 0 0 0 0 0 0 0 0 0 0 50 344750

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0 0 0 0 0 0 0 0 12 438984
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 10 144716 0 0 0 0 0 0 0 0 0 0 10 144716
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300


192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0 0 0 5 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 0 0 0 0 0 0 2 704000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 103,644 38037348 0 0 0 0 0 0 0 0 0 0 103644 38037348
buah/ skipa 1,240 341 422840 0 0 0 0 0 0 0 0 0 0 0 341 422840

237 Spuit 0,5 ml
buah / apbn 1,621 4343 7040003 0 0 0 0 0 0 0 0 0 0 0 4343 7040003

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 333 437895 0 0 0 0 0 0 0 0 0 0 0 333 437895
Spuit 5 ml APBN 1,705 15 25575 15
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
Box / 2,5ml 16,608 4 66432 0 0 0 0 0 0 0 0 0 0 0 4 66432
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0



256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 14 839300 14 839300 14 839300 14 839300 10 599500 14 839300 10 599500 0 0 0 0 0 90 5395500
269 CAMPAK VIAL 28,204 0 0 0 0 10 282040 0 0 0 0 0 0 0 10 282040
270 MR VIAL 141,648 30 4249440 20 2832960 20 2832960 20 2832960 20 2832960 60 8498880 0 0 0 0 0 0 170 24080160
271 DPT-HB-Hib VIAL 76,285 50 3814250 20 1525700 40 3051400 40 3051400 40 3051400 60 4577100 30 2288550 0 0 0 0 0 280 21359800
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 40 836000 40 836000 40 836000 50 1045000 40 836000 50 1045000 25 522500 0 0 0 0 0 285 5956500
274 POLIO (BOPV) VIAL 19,954 40 798160 30 598620 0 0 30 598620 50 997700 40 798160 0 0 0 0 0 190 3791260
275 POLIO (IPV) VIAL 13,976 10 139760 15 209640 10 139760 0 20 279520 10 139760 0 0 0 0 0 0 65 908440
276 Td VIAL 16,500 0 10 165000 0 10 165000 0 0 0 0 0 0 0 0 20 330000

PELAPORAN : BANDAR KHALIPAH 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH B.KHALIPAH TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 2,000 186000 0 2,000 186000 0 2,000 186000 0 0 0 0 0 6000 558000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 500 156500 0 2,000 626000 0 0 0 0 0 0 0 2500 782500
tablet 88 0 0 15,000 1320000 0 0 0 0 0 0 0 0 0 15000 1320000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 700 1750000 0 0 0 0 0 0 0 0 0 700 1750000
9 Antasida DOEN I Kombinasi tablet 63 0 0 16,000 1008000 0 0 0 0 0 0 0 0 0 16000 1008000
btl 60 ml 2,065 0 0 500 1032500 0 300 619500 0 200 413000 0 0 0 0 0 1000 2065000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 0 3,000 1336500 7,000 3118500 0 0 0 0 0 10000 4455000
tablet 176 0 0 3,000 528000 0 0 0 0 0 0 0 0 0 3000 528000

silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 500 72500 2,000 290000 0 1,000 145000 0 100 14500 0 0 0 0 0 3600 522000
botol 11,550 0 0 0 0 0 0 500 5775000 0 0 0 0 0 500 5775000

21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 5,000 320000 10,000 640000 0 10,000 640000 0 15,000 960000 0 0 0 0 0 40000 2560000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 200 21200 0 0 0 0 0 0 0 0 0 200 21200

DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 5,000 3755000 0 0 0 3,000 2253000 0 0 0 0 0 8000 6008000
30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 100 416700 0 30 125010 0 0 0 0 0 0 0 130 541710
tablet 436 0 500 218000 1,000 436000 0 500 218000 0 0 0 0 0 0 0 2000 872000
tablet/ H. baru 797 0 0 0 0 0 0 1,000 796990 0 0 0 0 0 1000 796990
34 Garam oralit 200 ml air bks 303 0 0 700 212100 0 1,930 584790 0 0 0 0 0 0 0 2630 796890
tablet 58 0 0 5,000 290000 0 0 0 0 0 0 0 0 0 5000 290000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 Glukosa 5% Larutan Infus botol 6,900 0 0 400 2760000 0 0 0 100 690000 0 0 0 0 0 500 3450000
39 Griseofulvin 125 mg Tablet tablet 240 0 0 4,000 960000 0 0 0 0 0 0 0 0 0 4000 960000
40 Haloperidol tablet 0,5 mg tablet 62 0 0 2,000 124000 0 0 0 0 0 0 0 0 0 2000 124000
tablet / H.Baru 437 0 0 0 0 3,600 1573200 0 6,000 2622000 0 0 0 0 0 9600 4195200
tablet 258 0 0 0 0 5,000 1290000 0 6,000 1548000 0 0 0 0 0 11000 2838000

43 Hustab Tablet
tablet P 312 3,000 936000 0 4,000 1248000 0 0 0 0 0 0 0 0 0 7000 2184000
tablet/ bpjs 312 2,100 655200 0 0 0 0 0 0 0 0 0 0 2100 655200
botol/ H. Baru 11,550 0 0 0 0 200 2310000 0 500 5775000 0 0 0 0 0 700 8085000
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 200 1609200 0 300 2413800 0 0 0 0 0 0 0 0 0 500 4023000
botol / bpjs 8,046 650 5229900 0 0 0 0 0 0 0 0 0 0 650 5229900



51 Kaptopril 25 mg tablet 715 0 0 3,000 2145000 0 0 0 0 0 0 0 0 0 3000 2145000

53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 5000 215000 10000 430000 15,000 645000 0 10,000 430000 0 12,000 516000 0 0 0 0 0 52000 2236000
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 700 1528100 0 0 0 0 0 0 0 0 0 700 1528100

ampul 1,937 0 200 387400 1,000 1937000 0 0 0 300 581100 0 0 0 0 0 1500 2905500
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 500 40000 1,000 80000 0 0 0 0 0 0 0 0 0 1500 120000
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 2,000 266000 0 0 0 1,000 133000 0 0 0 0 0 3000 399000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 5,000 615000 0 0 0 2,000 246000 0 0 0 0 0 7000 861000
tablet 133 0 0 20,000 2660000 0 0 0 0 0 0 0 0 0 20000 2660000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 5,000 533350 5,000 533350 0 500 53335 0 0 0 0 0 0 0 10500 1120035
67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 500 3205000 0 0 0 100 641000 0 0 0 0 0 600 3846000

botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 2,000 1098000 0 0 0 0 0 0 0 0 0 2000 1098000

tablet/ H Baru 630
tablet 803 0 0 2,000 1606000 0 0 0 0 0 0 0 0 0 2000 1606000
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 300 570000 0 0 0 0 0 0 0 0 0 300 570000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 6,000 306000 15,000 765000 19,000 969000 0 0 0 0 0 0 0 0 0 40000 2040000
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 4,000 658480 5,000 823100 13,000 2140060 0 0 0 0 0 22000 3621640
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 500 748000 600 897600 0 500 748000 0 100 149600 0 0 0 0 0 1700 2543200
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 100 311300 400 1245200 0 500 1556500 0 740 2303620 0 0 0 0 0 1740 5416620
78 Pehacain Injeksi
ampul / bpjs 3,113 0 1,000 3113000 0 0 0 0 0 0 0 0 0 0 1000 3113000
79 Pirantel tablet score 125 mg tablet 308 0 0 600 184800 0 0 0 0 0 0 0 0 0 600 184800
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 6,000 744000 0 15000 1860000 0 5,000 620000 0 0 0 0 0 26000 3224000
82 Propanolol HCL 10 mg tablet 66 0 0 100 6600 0 0 0 0 0 0 0 0 0 100 6600
tablet 191 0 0 0 0 0 0 5,000 953300 0 0 0 0 0 5000 953300
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 1,200 8580000 0 0 0 100 715000 0 0 0 0 0 1300 9295000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 50 127700 0 0 0 0 0 0 0 0 0 50 127700
89 Salbutamol tablet 2 mg tablet 78 0 0 700 54600 0 1,000 78000 0 1,000 78000 0 0 0 0 0 2700 210600
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 3,000 180000 0 0 0 5,000 300000 0 0 0 0 0 8000 480000
tablet 133 0 0 2,000 266000 0 0 0 0 0 0 0 0 0 2000 266000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 3,000 867000 0 0 0 3,500 1011500 0 0 0 0 0 6500 1878500
tablet/ bpjs 289 0 4000 1156000 0 0 0 0 0 0 0 0 0 0 4000 1156000

tablet 880 0 0 0 0 2,000 1760000 0 0 0 0 0 0 0 2000 1760000
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0

99 Sanadryl Syrup botol 12,210 96 1172160 240 2930400 300 3663000 0 0 0 0 0 0 0 0 0 636 7765560
102 Vitamin B komplek Tablet tablet 121 0 12,000 1452000 20,000 2420000 0 15,000 1815000 0 20,000 2420000 0 0 0 0 0 67000 8107000
Botol 9,646 0 0 400 3858400 0 0 0 0 0 0 0 0 0 400 3858400
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 100 629000 0 0 0 100 629000 0 0 0 0 0 200 1258000

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 50 209000 100 418000 0 0 0 0 0 0 0 0 0 150 627000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,000 792000 0 500 396000 0 500 396000 0 0 0 0 0 2000 1584000
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Alat suntik 5 ML buah 825 0 0 300 247500 0 0 0 0 0 0 0 0 0 300 247500
buah 216 0 0 0 0 500 108000 0 500 108000 0 0 0 0 0 1000 216000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0 0 0 0 10 379500
buah 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 12 389892 0 0 0 0 0 0 0 0 0 12 389892
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 24 1261464 0 0 0 24 1261464 0 0 0 0 0 48 2522928

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 24 1224528 0 0 0 0 0 24 1224528

buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0 0 0 12 612264
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 300 1035000 0 0 0 0 0 0 0 0 0 300 1035000

botol / bpjs 3,450 0 2 6900 0 0 0 0 0 0 0 0 0 0 2 6900
botol 28,750 0 0 10 287500 0 0 0 2 57500 0 0 0 0 0 12 345000

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 15 431250 0 0 0 0 0 0 0 0 0 0 15 431250
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0

set 3,520 0 0 300 1056000 0 100 352000 0 100 352000 0 0 0 0 0 500 1760000
set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 14 192500 0 0 0 0 0 0 0 0 0 14 192500
buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 50 82500 0 0 0 0 0 0 0 0 0 50 82500

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 500 412500 0 0 0 0 0 0 0 0 0 500 412500

rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 5 235750 0 2 94300 0 0 0 0 0 0 0 7 330050

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 300 108900 0 0 0 0 0 0 0 0 0 300 108900
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 0 0 0 0 0 0 0 0 1000 440000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0


rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 2 102610 0 0 0 0 0 0 0 0 0 0 2 102610
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 5 141432 0 0 0 0 0 0 0 0 0 0 5 141432
botol 18,818 0 0 5 94091 0 0 0 0 0 0 0 0 0 5 94091

botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 400 1212728 0 0 0 0 0 0 0 0 0 400 1212728

botol / bpjs 3,032 0 100 303182 0 0 0 0 0 0 0 0 0 0 100 303182
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 350 2413250 0 0 0 0 0 0 0 0 0 0 350 2413250

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0 0 0 0 0 0 0 0 12 438984
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 4 57886 0 0 0 0 0 0 0 0 0 0 4 57886
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 500 1475000 0 0 0 0 0 0 0 0 0 500 1475000


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300


192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 13 0 0 0 0 0 0 0 0 0 0 13 0
197 CHLORIN Liter - 0 0 2 0 0 0 0 0 0 0 0 0 0 2 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 0 0 0 0 0 0 1 352000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 16 5236144 16 5236144 48 15708432 0 32 10472288 0 0 0 0 0 0 0 112 36653008
227 OAT FDC Kategori 2 paket 1,259,990 2 2519980 0 0 1 1259990 0 0 0 0 0 0 0 0 3 3779970

231 POT SPUTUM BUAH 2,950 400 1180000 0 0 0 0 0 0 0 0 0 0 0 400 1180000

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 820368 301075056 0 0 0 0 0 0 0 0 0 0 820368 301075056
buah/ skipa 1,240 2576 3194240 0 0 0 0 0 0 0 0 0 0 0 2576 3194240

237 Spuit 0,5 ml
buah / apbn 1,621 34446 55836966 0 0 0 0 0 0 0 0 0 0 0 34446 55836966

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 2646 3479490 0 0 0 0 0 0 0 0 0 0 0 2646 3479490
Spuit 5 ml APBN 1,705 111 189255 111
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 29 481632 0 0 0 0 0 0 0 0 0 0 0 29 481632
Box / 2,5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0



256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 90 5395500 90 5395500 90 5395500 90 5395500 90 5395500 90 5395500 80 4796000 0 0 0 0 0 620 37169000
269 CAMPAK VIAL 28,204 0 0 0 0 70 1974280 50 1410200 40 1128160 0 0 0 0 0 160 4512640
270 MR VIAL 141,648 20 2832960 80 11331840 80 11331840 90 12748320 30 4249440 50 7082400 40 5665920 0 0 0 0 0 390 55242720
271 DPT-HB-Hib VIAL 76,285 200 15257000 100 7628500 160 12205600 300 22885500 290 22122650 230 17545550 280 21359800 0 0 0 0 0 1560 119004600
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 360 7524000 360 7524000 204 4263600 360 7524000 350 7315000 350 7315000 350 7315000 0 0 0 0 0 2334 48780600
274 POLIO (BOPV) VIAL 19,954 200 3990800 50 997700 0 0 230 4589420 230 4589420 240 4788960 0 0 0 0 0 950 18956300
275 POLIO (IPV) VIAL 13,976 50 698800 40 559040 50 698800 50 698800 50 698800 50 698800 50 698800 0 0 0 0 0 340 4751840
276 Td VIAL 16,500 20 330000 30 495000 40 660000 30 495000 30 495000 30 495000 50 825000 0 0 0 0 0 230 3795000
PELAPORAN : TANJUNG REJO 2 3 4 5 6 8 9
1 2 3 4 5 6 8 9
T.REJO T.REJO T.REJO T.REJO T.REJO T.REJO T.REJO T.REJO T.REJO

tablet 93 0 0 10,000 930000 0 10,000 930000 0 10,000 930000 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 0 0 0 0 1,000 313000 0 0
tablet 88 0 0 0 0 0 0 7,000 616000 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
btl 60 ml 2,065 0 0 500 1032500 0 300 619500 0 700 1445500 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 0 0 6,000 2673000 0 0

tablet 176 0 0 1,000 176000 0 0 0 0 0 0
silva/ 2015 304 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 10,000 1450000 0 0 0 5,000 725000 0 0

18 Cetrizin syrup botol 2,900 0 0 0 0 0 0 100 290000 0 0
botol 11,550 0 0 0 0 0 0 0 0 0
21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0

tablet 64 0 0 20,000 1280000 0 20,000 1280000 0 20,000 1280000 0 0
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 500 53000 0 0 0 0 0 0

DAK 2019 114 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 300 706200 0 50 117700 0 0 0 0

tablet 436 0 0 4,000 1744000 0 0 0 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0 1,000 796990 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 0 0 1,000 81000 0 0

34 Garam oralit 200 ml air bks 303 0 0 300 90900 0 0 0 0 0 0
tablet 58 0 0 10,000 580000 0 10,000 580000 0 10,000 580000 0 0

tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0

36 Glukosa 5% Larutan Infus botol 6,900 0 0 300 2070000 0 100 690000 0 200 1380000 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 2,000 480000 0 2,000 480000 0 2,000 480000 0 0
40 Haloperidol tablet 0,5 mg tablet 62 0 0 200 12400 0 0 0 500 31000 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 48 127200 0 300 795000 0 300 795000 0 300 795000 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 1,000 156000 0 0 0 0

tablet / H.Baru 437 0 0 0 0 10,800 4719600 0 7,200 3146400 0 0
tablet 258 0 0 0 0 5,000 1290000 0 4,400 1135200 0 0

43 Hustab Tablet
tablet P 312 3,000 936000 0 6,000 1872000 0 0 0 0 0 0
tablet / BPJS 312 6,300 1965600 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 400 4620000 0 700 8085000 0 0
silva /2014 11,550 0 0 0 0 0 0 0 0 0
44 Hustab syrup silva/ 2015 11,550 0 0 0 0 0 0 0 0 0

botol 8,046 200 1609200 0 0 0 0 0 0 0 0
botol / bpjs 8,046 850 6839100 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 1,500 112500 0 1,000 75000 0 500 37500 0 0


55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 0 15,000 2310000 0 15,000 2310000 0 15,000 2310000 0 0

ampul 1,937 0 0 500 968500 0 600 1162200 0 600 1162200 0 0
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0
tablet 133 0 0 10,000 1330000 0 10,000 1330000 0 10,000 1330000 0 0
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0

62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 3,000 486000 0 0 0 0 0 0
tablet 133 0 0 20,000 2660000 0 10,000 1330000 0 0 0 0

tablet 264 0 0 0 0 0 0 0 0 0
tablet 107 0 0 15,000 1600050 0 10,000 1066700 0 0 0 0

silva 2015 136 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 500 3205000 0 200 1282000 0 300 1923000 0 0

botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0
tablet 549 0 0 1,000 549000 0 0 0 200 109800 0 0

tablet/ H Baru 630
tablet 803 0 0 1,000 803000 0 0 0 200 160600 0 0

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 300 539400 0 200 359600 0 200 359600 0 0
ampul 1,900 0 0 400 760000 0 200 380000 0 0 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0
tablet 51 5,000 255000 0 20,000 1020000 0 0 0 0 0 0

silva/ 2015 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 300 448800 0 500 748000 0 0

77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 400 1245200 0 500 1556500 0 0

78 Pehacain Injeksi
ampul / bpjs 3,113 0 500 1556500 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 2,000 616000 0 0 0 0 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 15,000 1860000 0 10000 1240000 0 10,000 1240000 0 0
tablet 191 0 0 0 0 0 0 0 0 0
tablet 226 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0

botol 7,150 0 0 500 3575000 0 200 1430000 0 300 2145000 0 0

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 10,000 780000 0 10,000 780000 0 5,000 390000 0 0


94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 10,000 600000 0 0 0 10,000 600000 0 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 400 467200 0 0 0 300 350400 0 0
tablet 133 0 0 3,000 399000 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0
tablet 289 1,000 289000 0 1,000 289000 0 0 0 4,000 1156000 0 0

tablet 880 0 0 0 0 4,000 3520000 0 0 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0
tablet / BPJS 289 0 6,000 1734000 0 0 0 0 0 0 0


Botol 9,646 0 0 400 3858400 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 84 528360 0 0 0 100 629000 0 0

3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0

108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 5 687500 0 20 2750000 0 0
buah 4,180 0 0 200 836000 0 0 0 0 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,000 792000 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 0 0 0 0 0

buah 197 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 3 113850 0 2 75900 0 0 0 0

botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 24 1084392 0 24 1084392 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 24 779784 0 24 779784 0 0

buah / bpjs 32,491 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 0 0 0 0 24 1261464 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 24 1224528 0 0
buah / bpjs 51,022 0 24 1224528 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 10 37310 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 20 69000 0 0 0 0 0 0 0
botol 28,750 0 0 10 287500 0 20 575000 0 0 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 13 373750 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 150 424689 0 0 0 0 0 0 0
set 3,520 0 0 0 0 150 528000 0 200 704000 0 0

set / bpjs 3,520 0 150 528000 150 528000 0 0 0 0 0 0
buah 13,750 0 0 5 68750 0 0 0 10 137500 0 0

buah / bpjs 13,750 0 25 343750 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 20 154000 0 0 0 0 0 0

rol / bpjs 7,700 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 0 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0
rol 825 0 0 1,000 825000 0 0 0 0 0 0

rol / bpjs 825 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 3 141450 0 5 235750 0 0 0 0

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 200 72600 0 162 58806 0 0 0 0
146 Masker Tie On

buah / bpjs - 0 0 0 0 0 0 0 0 0
buah 363 0 0 200 72600 0 0 0 0 0 0
buah / bpjs 363 0 2,500 907500 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 0 0 500 220000 0 0

buah / bpjs 440 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 0 0 0 0 0 0 0
rol / bpjs 81,955 0 5 409777 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 15 769575 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 23 650588 0 0 0 0 0 0 0
botol 18,818 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 20 376364 0 0 0 0 0 0 0
botol 3,032 0 0 300 909546 0 0 0 0 0 0
botol / bpjs 3,032 0 75 227387 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 24 877968 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 2 28943 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0




Obat Paru - 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 1,000 303000 0 0 0 0
183 ZINC Tablet TABLET 539 0 1,865 1005235 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 500 1475000 0 0 0 0 0 0


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 7 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 2 0 0 0 0 0 0 0

198 Spritus Liter - 0 0 0 0 0 0 0 0 0


Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 2 704000 0 2 704000 0 2 704000 0 0


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0

Program TB Paru - 0 0 0 0 0 0 0 0 0
227 OAT FDC Kategori 2 paket 1,259,990 3 3779970 0 3 3779970 0 0 0 0 0 0


231 POT SPUTUM BUAH 2,950 200 590000 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 502856 184548152 0 0 0 0 0 0 0
buah/ skipa 1,240 1657 2054680 0 0 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 21111 34220931 0 0 0 0 0 0 0 0
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 1622 2132930 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 72 122760

Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 22 365376 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 5 83040 0 0 0 0 0 0 0 0

240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0


260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0

266 Handscoen boks - 0 0 0 0 0 2 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0

Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 50 2997500 50 2997500 45 2697750 50 2997500 50 2997500 50 2997500 50 2997500 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 0 0 0 0 0
270 MR VIAL 141,648 0 50 7082400 70 9915360 80 11331840 70 9915360 70 9915360 60 8498880 0 0

271 DPT-HB-Hib VIAL 76,285 200 15257000 70 5339950 120 9154200 200 15257000 120 9154200 200 15257000 200 15257000 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 200 4180000 200 4180000 100 2090000 220 4598000 220 4598000 220 4598000 220 4598000 0 0
274 POLIO (BOPV) VIAL 19,954 110 2194940 120 2394480 0 0 120 2394480 140 2793560 140 2793560 0 0
275 POLIO (IPV) VIAL 13,976 20 279520 30 419280 50 698800 30 419280 50 698800 30 419280 30 419280 0 0
276 Td VIAL 16,500 20 330000 30 495000 40 660000 0 30 495000 40 660000 30 495000 0 0

10 11 12
10 11 12
T.REJO T.REJO T.REJO TOTAL

TOTAL
HARGA
KELUAR
HARGA HARGA HARGA
0 0 0 0 0
0 0 0 0 0
0 0 0 30000 2790000
0 0 0 0 0
0 0 0 1000 313000
0 0 0 7000 616000
0 0 0 0 0
0 0 0 60000 15900000
0 0 0 1600 4000000
0 0 0 0 0
0 0 0 60000 3780000
0 0 0 1500 3097500
0 0 0 0 0
0 0 0 300 2071500
0 0 0 30000 3270000
0 0 0 6000 2673000
0 0 0 1000 176000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 900 4387500
0 0 0 0 0
0 0 0 15000 2175000
0 0 0 100 290000
0 0 0 15000 15840000
0 0 0 600 1078800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 1440000
0 0 0 60000 3840000
0 0 0 0 0
0 0 0 500 53000
0 0 0 0 0
0 0 0 350 823900
0 0 0 30000 22530000
0 0 0 300 2060100
0 0 0 400 1666800
0 0 0 4000 1744000
0 0 0 1000 796990
0 0 0 3000 243000
0 0 0 0 0
0 0 0 300 90900
0 0 0 30000 1740000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 600 4140000
0 0 0 0 0
0 0 0 0 0
0 0 0 6000 1440000
0 0 0 700 43400
0 0 0 948 2512200
0 0 0 4000 624000
0 0 0 18000 7866000
0 0 0 9400 2425200
0 0 0 9000 2808000
0 0 0
0 0 0 1100 12705000
0 0 0 0 0
0 0 0 0 0
0 0 0 200 1609200
0 0 0
0 0 0 3000 225000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 230000
0 0 0 6000 372000
0 0 0 6000 4290000
0 0 0 500 0
0 0 0 40000 1720000
0 0 0 1200 2619600
0 0 0 45000 6930000
0 0 0 0 0
0 0 0 1700 3292900
0 0 0 0 0
0 0 0 2000 160000
0 0 0 0 0
0 0 0 30000 3990000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 805200
0 0 0 3000 486000
0 0 0 9000 1107000
0 0 0 30000 3990000
0 0 0 0 0
0 0 0 1200 4560000
0 0 0 900 3069000
0 0 0 25000 2666750
0 0 0 7000 952000
0 0 0 0 0
0 0 0 1000 6410000
0 0 0 0 0
0 0 0 1200 658800
0 0 0 1200 963600
0 0 0 0 0
0 0 0 0 0
0 0 0 700 1258600
0 0 0 600 1140000
0 0 0 0 0
0 0 0 30000 4920000
0 0 0 25000 1275000
0 0 0 25000 4115500
0 0 0 0 0
0 0 0 1300 1944800
0 0 0 0 0
0 0 0 1300 4046900
0 0 0 500 1556500
0 0 0 2000 616000
0 0 0 35000 4340000
0 0 0 0 0
0 0 0 500 33000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 7150000
0 0 0 0 0
0 0 0 0 0
0 0 0 25000 1950000
0 0 0 200 800000
0 0 0 0 0
0 0 0 0 0
0 0 0 5 943315
0 0 0 20000 1200000
0 0 0 700 817600
0 0 0 3000 399000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 6000 1734000
0 0 0 4000 3520000
0 0 0 0 0
0 0 0 1734000
0 0 0 300 3663000
0 0 0 8000 2552000
0 0 0 35000 2940000
0 0 0 45000 5445000
0 0 0 400 3858400
0 0 0 0 0
0 0 0 0 0
0 0 0 184 1157360
0 0 0 0 0
0 0 0 0 0
0 0 0 5 95025
0 0 0 0 0
0 0 0 3 381150
0 0 0 25 3437500
0 0 0 30 11055000
0 0 0 25 4468750
0 0 0 10 606364
0 0 0 600 2508000
0 0 0 600 2508000
0 0 0 600 2508000
0 0 0 200 836000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 792000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 216000
0 0 0 0 0
0 0 0 0 0
0 0 0 5 189750
0 0 0 10 379500
0 0 0 48 2168784
0 0 0 0 0
0 0 0 48 1559568
0 0 0 0 0
0 0 0 0 0
0 0 0 24 1261464
0 0 0 0 0
0 0 0 24 1224528
0 0 0 24 1224528
0 0 0 0 0
0 0 0 10 37310
0 0 0 0 0
0 0 0 20 69000
0 0 0 30 862500
0 0 0 13 373750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 250 707814
0 0 0 150 424689
0 0 0 350 1232000
0 0 0 300 1056000
0 0 0 15 206250
0 0 0 25 343750
0 0 0 23 627440
0 0 0 0 0
0 0 0 0 0
0 0 0 20 154000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 165000
0 0 0 0 0
0 0 0 1000 825000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 8 377200
0 0 0 0 0
0 0 0 362 131406
0 0 0 100 43890
0 0 0 0 0
0 0 0 0 0
0 0 0 200 72600
0 0 0 0 0
0 0 0 2500 907500
0 0 0 0 0
0 0 0 1500 660000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 8 376000
0 0 0 5 409777
0 0 0 0 0
0 0 0 0 0
0 0 0 15 769575
0 0 0 0 0
0 0 0 1 16500
0 0 0 23 650588
0 0 0 0 0
0 0 0 20 376364
0 0 0 300 909546
0 0 0 75 227387
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 470500
0 0 0 0 0
0 0 0 24 877968
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 28943
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 303000
0 0 0 1865 1005235
0 0 0 0 0
0 0 0 500 1475000
0 0 0 0 0
0 0 0 3 2106750
0 0 0 1000 583000
0 0 0 2 94300
0 0 0 0 0
0 0 0 1000 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 0
0 0 0 7 0
0 0 0 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 612500
0 0 0 11000 18161000
0 0 0 122 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 6 2112000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 64 20944576
0 0 0 6 7559940
0 0 0 0 0
0 0 0 4 813036
0 0 0 0 0
0 0 0 200 590000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 502856 184548152
0 0 0 0 0
0 0 0 1657 2054680
0 0 0 21111 34220931
0 0 0 0 0
0 0 0 1622 2132930
72
0 0 0 0 0
0 0 0 22 365376
0 0 0 5 83040
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 4466000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 345 20682750
0 0 0 0 0
0 0 0 400 56659200
0 0 0 1110 84676350
0 0 0 0 0
0 0 0 1380 28842000
0 0 0 630 12571020
0 0 0 240 3354240
0 0 0 190 3135000
PELAPORAN : Kenangan 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN KENANGAN TOTAL
HARGA TOTAL
SATUAN KELUAR

tablet 93 0 0 2,000 186000 0 2,500 232500 0 2,000 186000 0 0 0 0 0 6500 604500
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 500 156500 0 1,000 313000 0 0 0 0 0 0 0 1500 469500
tablet 88 0 0 4,000 352000 0 4,000 352000 0 2,300 202400 0 0 0 0 0 10300 906400

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
btl 60 ml 2,065 0 0 400 826000 0 300 619500 0 250 516250 0 0 0 0 0 950 1961750
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 200 1381000 0 50 345250 0 0 0 0 0 0 0 250 1726250
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 0 0 0 0 10,000 1090000 0 0 0 0 0 10000 1090000
tablet/ H Baru 446 0 0 0 0 0 0 5,000 2227500 0 0 0 0 0 5000 2227500
tablet 176 0 0 3,000 528000 0 0 0 0 0 0 0 0 0 3000 528000

silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 1,000 1056000 0 500 528000 0 0 0 0 0 3500 3696000
botol 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 0 6,000 384000 0 0 0 10,000 640000 0 0 0 0 0 16000 1024000

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 100 10600 0 0 0 0 0 0 0 0 0 100 10600

DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 3,000 2253000 0 1,500 1126500 0 0 0 0 0 0 0 4500 3379500
tablet 436 0 0 1,000 436000 0 300 130800 0 0 0 0 0 0 0 1300 566800

tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 200 16200 0 1,000 81000 0 0 0 0 0 0 0 1200 97200
tablet 58 0 0 3,000 174000 0 3,000 174000 0 0 0 0 0 0 0 6000 348000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 Glukosa 5% Larutan Infus botol 6,900 0 0 300 2070000 0 200 1380000 0 0 0 0 0 0 0 500 3450000
tablet / H.Baru 437 0 0 0 0 3,600 1573200 0 1,500 655500 0 0 0 0 0 5100 2228700
43 Hustab Tablet tablet 258 0 0 0 0 2,000 516000 0 5,000 1290000 0 0 0 0 0 7000 1806000
tablet P 312 0 0 3,000 936000 0 0 0 0 0 0 0 0 0 3000 936000
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 150 1732500 0 0 0 0 0 450 5197500
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 200 1609200 0 0 0 0 0 0 0 0 0 200 1609200
botol/ BPJS 8,046 0 200 1609200 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 500 37500 1,000 75000 0 0 0 0 0 0 0 1500 112500
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 1,500 139500 0 0 0 0 0 0 0 3500 325500

50 Kaptopril 12,5 mg tablet 62 0 0 3,000 186000 0 2,000 124000 0 0 0 0 0 0 0 5000 310000

ampul 1,937 0 0 600 1162200 0 300 581100 0 0 0 0 0 0 0 900 1743300

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 20 64000 0 0 0 0 0 0 0 0 0 20 64000
tablet 133 0 0 1,000 133000 0 500 66500 0 0 0 0 0 0 0 1500 199500
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 2,000 324000 0 500 81000 0 0 0 0 0 0 0 2500 405000
63 Metoclorpramid HCL 10 mg tablet 123 0 0 2,000 246000 0 1,000 123000 0 500 61500 0 0 0 0 0 3500 430500
tablet 133 0 0 15,000 1995000 0 15,000 1995000 0 0 0 0 0 0 0 30000 3990000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 3,000 320010 0 1,000 106670 0 0 0 0 0 0 0 4000 426680

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 6,410 0 0 400 2564000 0 100 641000 0 100 641000 0 0 0 0 0 600 3846000
botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 549 0 0 500 274500 0 200 109800 0 0 0 0 0 0 0 700 384300
tablet/ H Baru 630
tablet 803 0 0 1,000 803000 0 200 160600 0 0 0 0 0 0 0 1200 963600
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 300 570000 0 150 285000 0 0 0 0 0 0 0 450 855000

ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 0 5,000 255000 17,000 867000 0 0 0 0 0 0 0 0 0 22000 1122000
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 250 374000 0 250 374000 0 0 0 0 0 1000 1496000
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 300 933900 0 300 933900 0 0 0 0 0 0 0 600 1867800

78 Pehacain Injeksi
ampul / bpjs 3,113 0 140 435820 0 0 0 0 0 0 0 0 0 0 140 435820
79 Pirantel tablet score 125 mg tablet 308 0 0 400 123200 0 500 154000 0 0 0 0 0 0 0 900 277200
tablet 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 500 3575000 0 200 1430000 0 0 0 0 0 0 0 700 5005000

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 50 127700 0 0 0 0 0 0 0 0 0 50 127700


tablet 133 0 0 1,000 133000 0 0 0 0 0 0 0 0 0 1000 133000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 1,000 289000 0 0 0 0 0 0 0 0 0 1000 289000
tablet 880 0 0 0 0 1,500 1320000 0 2,000 1760000 0 0 0 0 0 3500 3080000

silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 3,000 867000 0 0 0 0 0 0 0 0 0 0 867000

100 Tetrasiklin 500 mg kapsul 319 0 0 3,000 957000 0 500 159500 0 1,300 414700 0 0 0 0 0 4800 1531200
Botol 9,646 0 0 300 2893800 0 0 0 0 0 0 0 0 0 300 2893800

Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 100 629000 0 0 0 30 188700 0 0 0 0 0 130 817700

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,180 0 0 100 418000 0 0 0 50 209000 0 0 0 0 0 150 627000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,000 216000 0 500 108000 0 500 108000 0 0 0 0 0 2000 432000
buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 12 542196 0 12 542196 0 0 0 0 0 24 1084392

buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 12 389892 0 24 779784 0 12 389892 0 0 0 0 0 48 1559568

buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 24 1261464 0 0 0 12 630732 0 0 0 0 0 36 1892196
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 12 612264 0 0 0 0 0 12 612264

buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 200 690000 0 0 0 0 0 0 0 0 0 200 690000

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 20 575000 0 5 143750 0 1 28750 0 0 0 0 0 26 747500

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,520 0 0 100 352000 0 100 352000 0 100 352000 0 0 0 0 0 300 1056000
set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 4 55000 0 0 0 4 55000 0 0 0 0 0 8 110000

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 50 385000 0 0 0 0 0 0 0 0 0 50 385000
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 50 82500 0 50 82500 0 0 0 0 0 0 0 100 165000
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 100 82500 0 0 0 0 0 0 0 0 0 100 82500
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0 50 0 0 0 0 0 0 50 0
botol 47,150 0 0 5 235750 0 2 94300 0 0 0 0 0 0 0 7 330050

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 500 181500 0 50 18150 0 0 0 0 0 0 0 550 199650
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 500 220000 0 600 264000 0 0 0 0 0 2100 924000
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 10 188182 0 0 0 0 0 0 0 0 0 10 188182

botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 100 303182 0 0 0 0 0 0 0 0 0 100 303182

botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
164 Tranfusion Set buah 4,000 0 0 0 0 2 8000 0 0 0 0 0 0 0 2 8000
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 200 60600 0 0 0 0 0 0 0 200 60600

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 7 0 0 0 0 0 0 0 0 0 0 7 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 75 0 0 0 0 0 0 0 0 0 0 75 0

206 Rapid Test II ( FOKUS ) Test 14,590 0 0 75 1094250 0 0 0 0 0 0 0 0 0 75 1094250

208 Masker Plus 3 Ply Earloop ( Jilbab ) buah 440 400 176000 0 0 0 0 0 0 0 0 0 0 0 400 176000

OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 0 0 0 0 0 0 2 704000


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 32 10472288 0 0 32 10472288 32 10472288 0 0 0 0 0 0 0 96 31416864
229 OAT FDC Kategori Anak paket 203,259 0 0 0 3 609777 3 609777 0 0 0 0 0 0 0 6 1219554
231 POT SPUTUM BUAH 2,950 400 1180000 0 0 0 0 0 0 0 0 0 0 0 400 1180000

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 492536 180760712 0 0 0 0 0 0 0 0 0 0 492536 180760712
buah/ skipa 1,240 1624 2013760 0 0 0 0 0 0 0 0 0 0 0 1624 2013760
237 Spuit 0,5 ml
buah / apbn 1,621 20680 33522280 0 0 0 0 0 0 0 0 0 0 0 20680 33522280

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 1589 2089535 0 0 0 0 0 0 0 0 0 0 0 1589 2089535
Spuit 5 ml APBN 1,705 70 119350 70
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 22 365376 0 0 0 0 0 0 0 0 0 0 0 22 365376
Box / 2,5ml 16,608 5 83040 0 0 0 0 0 0 0 0 0 0 0 5 83040
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0

256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 10 0 0 0 0 0 0 0 0 0 0 10 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 50 2997500 50 2997500 50 2997500 50 2997500 50 2997500 50 2997500 50 2997500 0 0 0 0 0 350 20982500
269 CAMPAK VIAL 28,204 0 0 0 0 30 846120 0 0 0 0 0 0 0 30 846120
270 MR VIAL 141,648 30 4249440 40 5665920 70 9915360 20 2832960 20 2832960 50 7082400 50 7082400 0 0 0 0 0 280 39661440
271 DPT-HB-Hib VIAL 76,285 200 15257000 70 5339950 120 9154200 200 15257000 125 9535625 190 14494150 180 13731300 0 0 0 0 0 1085 82769225
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 150 3135000 200 4180000 100 2090000 220 4598000 220 4598000 220 4598000 220 4598000 0 0 0 0 0 1330 27797000
274 POLIO (BOPV) VIAL 19,954 100 1995400 40 798160 0 0 125 2494250 140 2793560 140 2793560 0 0 0 0 0 545 10874930
275 POLIO (IPV) VIAL 13,976 20 279520 15 209640 10 139760 20 279520 20 279520 20 279520 20 279520 0 0 0 0 0 125 1747000
276 Td VIAL 16,500 20 330000 20 330000 10 165000 10 165000 20 330000 20 330000 20 330000 0 0 0 0 0 120 1980000
PELAPORAN : Batang Kuis 1 2 3 4 5 6 8 9
1 2 3 4 5 6 8 9
B.KUIS B.KUIS B.KUIS B.KUIS B.KUIS B.KUIS KENANGAN B.KUIS B.KUIS

tablet 93 0 3,000 279000 2,000 186000 0 3,000 279000 0 6,000 558000 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 3,000 939000 5,000 1565000 0 1,000 313000 0 0 0 0
tablet 88 0 0 15,000 1320000 0 10,000 880000 0 9,000 792000 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 200 500000 500 1250000 0 500 1250000 0 250 625000 0 0
btl 60 ml 2,065 0 100 206500 400 826000 0 200 413000 0 200 413000 0 0
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 5,000 545000 15,000 1635000 0 15,000 1635000 0 10,000 1090000 0 0
tablet/ H Baru 446 0 0 0 0 0 0 7,000 3118500 0 0

tablet 176 0 5,000 880000 2,000 352000 0 0 0 0 0 0
silva/ 2015 304 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 1,000 145000 5,000 725000 0 0 0 5,000 725000 0 0
18 Cetrizin syrup botol 2,900 0 0 20 58000 0 0 0 100 290000 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 3,000 3168000 5,000 5280000 0 2,500 2640000 0 2,000 2112000 0 0
botol 11,550 0 0 0 0 0 0 500 5775000 0 0
21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0

tablet 64 0 5,000 320000 10,000 640000 0 10,000 640000 0 9,000 576000 0 0
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0

30 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 100 416700 0 30 125010 0 0 0 0
tablet 436 0 0 1,000 436000 0 200 87200 0 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0 700 557893 0 0

34 Garam oralit 200 ml air bks 303 0 0 2,000 606000 0 0 0 0 0 0
tablet 58 0 4,000 232000 15,000 870000 0 10,000 580000 0 12,000 696000 0 0

tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0

40 Haloperidol tablet 0,5 mg tablet 62 0 0 7,000 434000 0 0 0 200 12400 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 0 0 1,300 202800 0 0

tablet / H.Baru 437 0 0 0 0 10,800 4719600 0 5,000 2185000 0 0
tablet 258 0 0 0 0 2,000 516000 0 8,500 2193000 0 0

43 Hustab Tablet
tablet P 312 3,000 936000 0 6,000 1872000 0 0 0 0 0 0
tablet/ BPJS 312 0 8,000 2496000 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 350 4042500 0 0
silva /2014 11,550 0 0 0 0 0 0 0 0 0

botol 8,046 100 804600 100 804600 200 1609200 0 0 0 0 0 0
botol/ BPJS 8,046 0 500 4023000 0 0 0 0 0 0 0

46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 2,000 186000 0 1,000 93000 0 0 0 0


53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 10000 430000 20,000 860000 0 15,000 645000 0 15,000 645000 0 0

ampul 1,937 0 0 300 581100 0 0 0 200 387400 0 0
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 1,000 80000 2,000 160000 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 20 64000 0 0 0 0 0 0
tablet 133 0 0 5,000 665000 0 2,000 266000 0 5,000 665000 0 0
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0
61 Metil Ergometrin Maleat injeksi ampul 2,684 0 0 200 536800 0 100 268400 0 30 80520 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 3,000 486000 0 1,000 162000 0 2,200 356400 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 4,000 492000 0 0 0 500 61500 0 0
tablet 133 0 15,000 1995000 10,000 1330000 0 15,000 1995000 0 0 0 0

tablet 264 0 0 0 0 0 0 0 0 0
tablet 107 0 2,800 298676 5,000 533350 0 3,000 320010 0 0 0 0

silva 2015 136 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 300 1923000 0 200 1282000 0 0 0 0

botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0
tablet 549 0 0 1,500 823500 0 0 0 0 0 0

tablet/ H Baru 630 0
tablet 803 0 0 2,000 1606000 0 0 0 0 0 0

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 300 539400 0 100 179800 0 70 125860 0 0
ampul 1,900 0 0 500 950000 0 0 0 200 380000 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 3,000 492000 8,000 1312000 0 3,000 492000 0 3,000 492000 0 0
tablet 51 4,000 204000 13,000 663000 15,000 765000 0 0 0 0 0 0

silva/ 2015 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 100 149600 700 1047200 0 500 748000 0 500 748000 0 0
77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 500 1556500 0 300 933900 0 0

78 Pehacain Injeksi
ampul / bpjs 3,113 0 580 1805540 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 4,000 1232000 0 300 92400 0 1,600 492800 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 7,000 868000 0 0 0 5,000 620000 0 0
81 Prednison 5 mg Tablet tablet 96 0 5000 480000 0 0 0 0 0 0 0
tablet 191 0 0 0 0 0 0 5,000 953300 0 0
tablet 226 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0

botol 7,150 0 200 1430000 600 4290000 0 400 2860000 0 260 1859000 0 0
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 20 51080 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 3,000 234000 0 0 0 1,400 109200 0 0
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 100 400000 0 50 200000 0 0 0 0


tablet 133 0 0 1,000 133000 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0
tablet 289 0 2000 578000 1,500 433500 0 0 0 0 0 0
tablet 880 0 0 0 0 1,500 1320000 0 3,000 2640000 0 0

silva/ 2018 880 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 1,000 289000 0 0 0 0 0 0 0
99 Sanadryl Syrup botol 12,210 100 1221000 200 2442000 200 2442000 0 0 0 0 0 0

Botol 9,646 0 0 500 4823000 0 50 482300 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 100 629000 0 0 0 40 251600 0 0

3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 4 76020 0 5 95025 0 0

107 Accu Check safe T Pro Uno Dus 127,050 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 100 418000 0 0 0 50 209000 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 0 0 1,000 792000 0 300 237600 0 300 237600 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
buah 216 0 0 1,500 324000 0 300 64800 0 500 108000 0 0

buah 197 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 2 75900 0 1 37950 0 0 0 0

botol / bpjs 37,950 0 10 379500 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 12 542196 0 12 542196 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 12 389892 0 12 389892 0 12 389892 0 0

buah / bpjs 32,491 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 12 630732 0 0 0 12 630732 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 35 130585 0 0 0 0 0 0 0
botol 3,450 0 0 200 690000 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 6 172500 0 5 143750 0 1 28750 0 0
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 10 287500 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0
132 Infusion Set Anak set 2,831 0 50 141563 100 283126 0 50 141563 0 0 0 0
set / bpjs 2,831 0 50 141563 0 0 0 0 0 0 0
set 3,520 100 352000 100 352000 100 352000 0 100 352000 0 50 176000 0 0
set / bpjs 3,520 0 100 352000 0 0 0 0 0 0 0
buah 13,750 0 0 10 137500 0 0 0 15 206250 0 0
buah / bpjs 13,750 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 10 300080 0 0 0 0 0 0 0
rol 7,700 0 0 10 77000 0 0 0 0 0 0

rol / bpjs 7,700 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 100 165000 0 0 0 0

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0
rol 825 0 0 500 412500 0 49 40425 0 0 0 0

rol / bpjs 825 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 5 235750 0 2 94300 0 0 0 0

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 200 72600 0 100 36300 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0

buah 363 0 0 200 72600 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 500 220000 0 1,500 660000 0 0

buah / bpjs 440 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 5 409777 0 0 0 0 0 0

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0

botol 18,818 0 0 20 376364 0 0 0 0 0 0
botol / bpjs 18,818 0 10 188182 0 0 0 0 0 0 0
botol 3,032 0 0 200 606364 0 0 0 0 0 0

botol / bpjs 3,032 0 20 60636 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0

buah / bpjs 6,895 0 0 0 0 0 0 0 0 0
buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0

164 Tranfusion Set buah 4,000 0 0 0 0 2 8000 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 10 144716 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0






Obat Paru - 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 500 1475000 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0

Program IFA - 0 0 0 0 0 0 0 0 0

196 ASAM CUKA botol - 0 0 8 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0


Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 1 352000 0 2 704000 0 0


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0

229 OAT FDC Kategori Anak paket 203,259 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 265324 97373908 0 0 0 0 0 0 0
buah/ skipa 1,240 875 1085000 0 0 0 0 0 0 0 0

237 Spuit 0,5 ml
237 Spuit 0,5 ml
buah / apbn 1,621 11144 18064424 0 0 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 856 1125640 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 38 64790
Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 12 199296 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 3 49824 0 0 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0


249 PH Peper rol 239 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0


266 Handscoen boks - 0 1 0 0 0 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 25 1498750 25 1498750 20 1199000 25 1498750 30 1798500 30 1798500 30 1798500 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 40 1128160 40 1128160 30 846120 0 0
270 MR VIAL 141,648 40 5665920 0 20 2832960 20 2832960 10 1416480 0 0 0 0
271 DPT-HB-Hib VIAL 76,285 90 6865650 30 2288550 60 4577100 120 9154200 75 5721375 80 6102800 100 7628500 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 100 2090000 100 2090000 75 1567500 120 2508000 100 2090000 100 2090000 120 2508000 0 0
274 POLIO (BOPV) VIAL 19,954 90 1795860 40 798160 0 0 75 1496550 80 1596320 80 1596320 0 0
275 POLIO (IPV) VIAL 13,976 30 419280 30 419280 15 209640 20 279520 30 419280 30 419280 30 419280 0 0
276 Td VIAL 16,500 0 30 495000 10 165000 20 330000 30 495000 30 495000 0 0 0

10 11 12
10 11 12
B.KUIS B.KUIS B.KUIS TOTAL

TOTAL
HARGA
KELUAR
HARGA HARGA HARGA
0 0 0 0 0
0 0 0 0 0
0 0 0 14000 1302000
0 0 0 0 0
0 0 0 9000 2817000
0 0 0 34000 2992000
0 0 0 0 0
0 0 0 50000 13250000
0 0 0 1450 3625000
0 0 0 0 0
0 0 0 53000 3339000
0 0 0 900 1858500
0 0 0 0 0
0 0 0 124 856220
0 0 0 45000 4905000
0 0 0 7000 3118500
0 0 0 7000 1232000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 675 3290625
0 0 0 0 0
0 0 0 11000 1595000
0 0 0 120 348000
0 0 0 12500 13200000
0 0 0 550 988900
0 0 0 500 5775000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 576000
0 0 0 34000 2176000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 117700
0 0 0 11500 8636500
0 0 0 120 824040
0 0 0 130 541710
0 0 0 1200 523200
0 0 0 700 557893
0 0 0 4000 324000
0 0 0 0 0
0 0 0 2000 606000
0 0 0 41000 2378000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 2070000
0 0 0 0 0
0 0 0 0 0
0 0 0 15000 3600000
0 0 0 7200 446400
0 0 0 660 1749000
0 0 0 4300 670800
0 0 0 15800 6904600
0 0 0 10500 2709000
0 0 0 9000 2808000
0 0 0 8000 2496000
0 0 0 650 7507500
0 0 0 0 0
0 0 0 0 0
0 0 0 400 3218400
0 0 0 500 4023000
0 0 0 1000 75000
0 0 0 3000 279000
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 460000
0 0 0 9300 576600
0 0 0 6600 4719000
0 0 0 300 0
0 0 0 60000 2580000
0 0 0 1200 2619600
0 0 0 16400 2525600
0 0 0 0 0
0 0 0 500 968500
0 0 0 0 0
0 0 0 3000 240000
0 0 0 20 64000
0 0 0 12000 1596000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 330 885720
0 0 0 6200 1004400
0 0 0 4500 553500
0 0 0 40000 5320000
0 0 0 0 0
0 0 0 1200 4560000
0 0 0 600 2046000
0 0 0 10800 1152036
0 0 0 0 0
0 0 0 0 0
0 0 0 500 3205000
0 0 0 0 0
0 0 0 1500 823500
0 0 0
0 0 0 2000 1606000
0 0 0 0 0
0 0 0 300 1072500
0 0 0 470 845060
0 0 0 700 1330000
0 0 0 0 0
0 0 0 17000 2788000
0 0 0 32000 1632000
0 0 0 16000 2633920
0 0 0 0 0
0 0 0 1800 2692800
0 0 0 0 0
0 0 0 1200 3735600
0 0 0 580 1805540
0 0 0 5900 1817200
0 0 0 12000 1488000
0 0 0 5000 480000
0 0 0 0 0
0 0 0 5000 953300
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1460 10439000
0 0 0 0 0
0 0 0 20 51080
0 0 0 4400 343200
0 0 0 150 600000
0 0 0 0 0
0 0 0 0 0
0 0 0 5 943315
0 0 0 10000 600000
0 0 0 1300 1518400
0 0 0 1000 133000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3500 1011500
0 0 0 4500 3960000
0 0 0 0 0
0 0 0 1000 289000
0 0 0 500 6105000
0 0 0 5300 1690700
0 0 0 34000 2856000
0 0 0 50000 6050000
0 0 0 550 5305300
0 0 0 0 0
0 0 0 0 0
0 0 0 140 880600
0 0 0 0 0
0 0 0 0 0
0 0 0 14 266070
0 0 0 0 0
0 0 0 0 0
0 0 0 10 1375000
0 0 0 15 5527500
0 0 0 10 1787500
0 0 0 0 0
0 0 0 400 1672000
0 0 0 400 1672000
0 0 0 300 1254000
0 0 0 150 627000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1600 1267200
0 0 0 0 0
0 0 0 0 0
0 0 0 300 247500
0 0 0 2300 496800
0 0 0 0 0
0 0 0 0 0
0 0 0 3 113850
0 0 0 10 379500
0 0 0 24 1084392
0 0 0 0 0
0 0 0 36 1169676
0 0 0 0 0
0 0 0 0 0
0 0 0 24 1261464
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 35 130585
0 0 0 200 690000
0 0 0 0 0
0 0 0 12 345000
0 0 0 10 287500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 566251
0 0 0 50 141563
0 0 0 450 1584000
0 0 0 100 352000
0 0 0 25 343750
0 0 0 0 0
0 0 0 7 190960
0 0 0 0 0
0 0 0 10 300080
0 0 0 10 77000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 330000
0 0 0 0 0
0 0 0 549 452925
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 7 330050
0 0 0 0 0
0 0 0 300 108900
0 0 0 250 109725
0 0 0 0 0
0 0 0 0 0
0 0 0 200 72600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3000 1320000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 196023
0 0 0 5 409777
0 0 0 5 235000
0 0 0 0 0
0 0 0 0 0
0 0 0 5 150000
0 0 0 0 0
0 0 0 0 0
0 0 0 5 82500
0 0 0 0 0
0 0 0 20 376364
0 0 0 10 188182
0 0 0 200 606364
0 0 0 20 60636
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 235250
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 8000
0 0 0 0 0
0 0 0 10 144716
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 986 531454
0 0 0 0 0
0 0 0 500 1475000
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 583000
0 0 0 2 94300
0 0 0 0 0
0 0 0 1250 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 0
0 0 0 8 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 280 343000
0 0 0 5500 9080500
0 0 0 64 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 4 1408000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 16 5236144
0 0 0 2 2519980
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 20 5530000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 265324 97373908
0 0 0 0 0
0 0 0 875 1085000
0 0 0 11144 18064424
0 0 0 0 0
0 0 0 856 1125640
38
0 0 0 0 0
0 0 0 12 199296
0 0 0 3 49824
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 3970
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 6699000
0 0 0 0 0
0 0 0 0 0
0 0 0 100 1340700
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 185 11090750
0 0 0 110 3102440
0 0 0 90 12748320
0 0 0 555 42338175
0 0 0 0 0
0 0 0 715 14943500
0 0 0 365 7283210
0 0 0 185 2585560
0 0 0 120 1980000
PELAPORAN : Pantai Labu 1 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
P.LABU P.LABU P.LABU P.LABU P.LABU P.LABU P.LABU P.LABU P.LABU P.LABU P.LABU P.LABU TOTAL
TOTAL
NO NAMA OBAT SATUAN HARGA SATUAN HARGA
KELUAR

tablet 93 0 0 8,000 744000 0 10,000 930000 0 7,000 651000 0 0 0 0 0 25000 2325000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 88 0 0 0 0 3,000 264000 0 3,000 264000 0 0 0 0 0 6000 528000

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
btl 60 ml 2,065 0 0 300 619500 0 300 619500 0 400 826000 0 0 0 0 0 1000 2065000
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 5,000 2227500 0 0 0 0 0 10000 4455000
tablet 176 0 0 1,000 176000 0 0 0 0 0 0 0 0 0 1000 176000

silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 11,550 0 0 0 0 0 300 3465000 200 2310000 0 0 0 0 0 500 5775000

21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 0 10,000 640000 0 10,000 640000 0 10,000 640000 0 0 0 0 0 30000 1920000

tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 0 0 300 706200 0 200 470800 0 200 470800 0 0 0 0 0 700 1647800
tablet 436 0 0 3,000 1308000 0 0 0 0 0 0 0 0 0 3000 1308000

tablet/ H. baru 797 0 0 0 0 0 0 300 239097 0 0 0 0 0 300 239097
tablet 58 0 0 5,000 290000 0 5,000 290000 0 5,000 290000 0 0 0 0 0 15000 870000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet / H.Baru 437 0 0 0 0 10,800 4719600 0 7,200 3146400 0 0 0 0 0 18000 7866000
tablet 258 0 0 0 0 3,000 774000 0 0 0 0 0 0 0 3000 774000

43 Hustab Tablet
tablet P 312 0 0 3,000 936000 0 0 0 0 0 0 0 0 0 3000 936000
tablet/ BPJS 312 0 6,500 2028000 0 0 0 0 0 0 0 0 0 0 6500 2028000
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 300 3465000 0 0 0 0 0 600 6930000
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ BPJS 8,046 0 850 6839100 0 0 0 0 0 0 0 0 0 0 850 6839100




ampul 1,937 0 0 600 1162200 0 500 968500 0 500 968500 0 0 0 0 0 1600 3099200
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59 MgSO4 20 % ampul 3,200 0 0 40 128000 0 0 0 0 0 0 0 0 0 40 128000
tablet 133 0 0 1,000 133000 0 1,000 133000 0 1,000 133000 0 0 0 0 0 3000 399000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 0 0 0 0 3,000 369000 0 0 0 0 0 3000 369000
tablet 133 0 0 15,000 1995000 0 0 0 0 0 0 0 0 0 15000 1995000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 5,000 533350 0 500 53335 0 0 0 0 0 0 0 5500 586685

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 300 1923000 0 300 1923000 0 400 2564000 0 0 0 0 0 1000 6410000
botol/ H. Baru 6,218
tablet 549 0 0 1,000 549000 0 1,000 549000 0 0 0 0 0 0 0 2000 1098000

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 200 359600 0 300 539400 0 200 359600 0 0 0 0 0 700 1258600
ampul 1,900 0 0 300 570000 0 300 570000 0 0 0 0 0 0 0 600 1140000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 0 0 10,000 510000 0 0 0 0 0 0 0 0 0 10000 510000
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 0 3,000 493860 5,000 823100 0 0 0 0 0 8000 1316960
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 500 748000 0 500 748000 0 0 0 0 0 1500 2244000
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 400 1245200 0 600 1867800 0 600 1867800 0 0 0 0 0 1600 4980800
78 Pehacain Injeksi
ampul / bpjs 3,113 0 20 62260 0 0 0 0 0 0 0 0 0 0 20 62260
79 Pirantel tablet score 125 mg tablet 308 0 0 2,000 616000 0 3000 924000 0 3,000 924000 0 0 0 0 0 8000 2464000
tablet 191 0 0 0 0 0 2,000 381320 1,000 190660 0 0 0 0 0 3000 571980
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 400 2860000 0 600 4290000 0 500 3575000 0 0 0 0 0 1500 10725000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 1,000 1168000 0 1,000 1168000 0 0 0 0 0 2500 2920000
tablet 133 0 0 600 79800 0 0 0 0 0 0 0 0 0 600 79800

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 0 0 0 0 1,000 289000 0 0 0 0 0 1000 289000
tablet 880 0 0 0 0 1,000 880000 0 0 0 0 0 0 0 1000 880000

silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 1,500 433500 0 0 0 0 0 0 0 0 0 0 1500 433500

Botol 9,646 0 0 300 2893800 0 0 0 0 0 0 0 0 0 300 2893800
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 0 0 0 0 200 1258000 0 0 0 0 0 200 1258000

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 300 1254000 0 0 0 0 0 0 0 0 0 300 1254000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 100 79200 0 0 0 0 0 0 0 0 0 0 100 79200
buah 216 0 0 1,000 216000 0 0 0 0 0 0 0 0 0 1000 216000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 12 542196 0 24 1084392 0 0 0 0 0 36 1626588
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 12 389892 0 24 779784 0 0 0 0 0 36 1169676
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 24 1261464 0 0 0 0 0 0 0 0 0 24 1261464

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 50 186550 0 0 0 0 0 0 0 0 0 0 50 186550
botol 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 5 17250 0 0 0 0 0 0 0 0 0 0 5 17250
botol 28,750 0 0 4 115000 0 0 0 0 0 0 0 0 0 4 115000

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 1 28750 0 0 0 0 0 0 0 0 0 0 1 28750
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 100 385000 0 0 0 0 0 100 385000

set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0

set 3,520 0 0 100 352000 0 100 352000 0 50 176000 0 0 0 0 0 250 880000
set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 20 275000 0 30 412500 0 25 343750 0 0 0 0 0 75 1031250
buah / bpjs 13,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 3 90024 0 0 0 0 0 0 0 0 0 0 3 90024
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 200 330000 0 0 0 0 0 0 0 0 0 200 330000

rol / bpjs 1,650 0 100 165000 0 0 0 0 0 0 0 0 0 0 100 165000
rol 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 5 235750 0 0 0 0 0 0 0 0 0 5 235750

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 200 72600 0 0 0 0 0 0 0 0 0 200 72600
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 2,000 877800 0 0 0 0 0 2000 877800
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 300 132000 0 0 0 0 0 0 0 1300 572000

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0


rol 81,955 0 0 5 409777 0 0 0 0 0 0 0 0 0 5 409777

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 10 188182 0 0 0 0 0 0 0 0 0 10 188182

botol / bpjs 18,818 0 1 18818 0 0 0 0 0 0 0 0 0 0 1 18818
botol 3,032 0 0 200 606364 0 0 0 0 0 0 0 0 0 200 606364

botol / bpjs 3,032 0 6 18191 0 0 0 0 0 0 0 0 0 0 6 18191
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 24 877968 0 0 0 0 0 24 877968

161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 24 0 0 0 0 0 0 24 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 1,000 303000 0 0 0 0 0 0 0 1000 303000

185 POT SPUTUM BUAH 2,950 0 0 0 500 1475000 0 0 0 0 0 0 0 0 500 1475000


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300


192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0 0 0 5 0
197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 4 1408000 0 0 0 0 0 5 1760000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 203576 74712392 0 0 0 0 0 0 0 0 0 0 203576 74712392
buah/ skipa 1,240 671 832040 0 0 0 0 0 0 0 0 0 0 0 671 832040

237 Spuit 0,5 ml
buah / apbn 1,621 8548 13856308 0 0 0 0 0 0 0 0 0 0 0 8548 13856308

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 657 863955 0 0 0 0 0 0 0 0 0 0 0 657 863955
Spuit 5 ml APBN 1,705 29 49445 29
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 9 149472 0 0 0 0 0 0 0 0 0 0 0 9 149472
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 0 4 0 4 0 4 0 0 0 0 0 0 0 0 12 0

OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0



256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 0 0 0 0 0 140 8393000
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 30 846120 10 282040 0 0 0 0 0 60 1692240
270 MR VIAL 141,648 10 1416480 20 2832960 30 4249440 50 7082400 10 1416480 0 20 2832960 0 0 0 0 0 140 19830720
271 DPT-HB-Hib VIAL 76,285 60 4577100 40 3051400 40 3051400 70 5339950 70 5339950 70 5339950 60 4577100 0 0 0 0 0 410 31276850
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 60 1254000 90 1881000 60 1254000 100 2090000 100 2090000 80 1672000 80 1672000 0 0 0 0 0 570 11913000
274 POLIO (BOPV) VIAL 19,954 70 1396780 70 1396780 0 0 50 997700 50 997700 50 997700 0 0 0 0 0 290 5786660
275 POLIO (IPV) VIAL 13,976 10 139760 30 419280 30 419280 30 419280 30 419280 20 279520 20 279520 0 0 0 0 0 170 2375920
276 Td VIAL 16,500 30 495000 40 660000 40 660000 30 495000 30 495000 20 330000 0 0 0 0 0 0 190 3135000
REKAP LAPORAN MUTASI OBAT GUDANG FARMASI DINAS KESEHATAN
SUMBER DANA APBD II , BPJS, PROGRAM APBD II, PROGRAM PROPINSI I , APBN DAN VAKSIN KABUPATEN DELI SERDANG
PELAPORAN : JANUARI 2019 1 2 3 4 5 6 8 9 10 11

1 2 3 4 5 6 8 9 10 11
K.ANYAR K.ANYAR K.ANYAR K.ANYAR K.ANYAR K.ANYAR K.ANYAR K.ANYAR K.ANYAR K.ANYAR P.LABU
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA
OBAT APBD II JANUARI FEBRUARI MARET APRIL MEI JUNI JULI AGUSTUS SEPTEMBER OKTOBER NOVEMBER
1 Acyclovir 400 mg tablet tablet 359 0 0 0 0 0 0 0 0 0 0
2 Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 0 0
tablet 93 0 0 900 83700 0 1,500 139500 0 1,000 93000 0 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 2,000 626000 0 1,000 313000 0 500 156500 0 0 0
tablet 88 0 0 5,000 440000 0 0 0 1,000 88000 0 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0
6 Amoksisilin 500 mg kapsul 265 0 0 8,000 2120000 0 8,000 2120000 0 8,000 2120000 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 0 0 0 0 0 0 0 0
8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 0 0 0 0 0 0 0 0 0
btl 60 ml 2,065 0 0 300 619500 0 0 0 300 619500 0 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 5,000 545000 0 3,000 327000 0 3,000 327000 0 0 0
tablet/ H Baru 446 0 0 0 0 4,000 1782000 0 3,000 1336500 0 0 0
tablet 176 2,000 352000 0 1,000 176000 0 0 0 0 0 0 0

silva/ 2015 304 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0

14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 0 0

16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 0 0
17 Cetrizin tablet tablet 145 0 0 0 0 1,500 217500 0 1,000 145000 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 700 739200 0 0 0 500 528000 0 0 0
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 48 86304 0 24 43152 0 48 86304 0 0 0
botol 11,550 0 0 0 0 0 0 200 2310000 0 0 0

21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0
23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 0 0
24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 100 288000 0 0 0 0 0 0 0

tablet 64 0 0 3,000 192000 0 1,000 64000 0 1,500 96000 0 0 0
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 500 53000 0 0 0 0 0 0 0

DAK 2019 114 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 2,000 1502000 0 1,000 751000 0 1,200 901200 0 0 0
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 53 363951 0 0 0 0 0 0 0

tablet 436 0 0 200 87200 0 0 0 0 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 2,000 162000 0 0 0 0 0 0 0
33 Fenobarbital 30 mg tablet 180 0 0 0 0 0 0 0 0 0 0
34 Garam oralit 200 ml air bks 303 0 0 1,000 303000 0 0 0 0 0 0 0
tablet 58 0 0 3,000 174000 0 0 0 500 29000 0 0 0
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0

silva 2015 125 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0
38 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 0 0
39 Griseofulvin 125 mg Tablet tablet 240 0 0 3,000 720000 0 0 0 0 0 0 0

40 Haloperidol tablet 0,5 mg tablet 62 0 0 500 31000 0 0 0 0 0 0 0
41 Hidrokortison Cream 2.5 % tube 2,650 0 0 0 0 0 0 24 63600 0 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 3,000 468000 0 0 0 0 0 0 0

tablet / H.Baru 437 0 0 0 0 2,000 874000 0 3,600 1573200 0 0 0
tablet 258 0 0 0 0 500 129000 0 0 0 0 0

43 Hustab Tablet
tablet P 312 0 0 500 156000 0 0 0 0 0 0 0
tablet/ BPJS 312 0 3,000 936000 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 200 2310000 0 200 2310000 0 0 0

silva /2014 11,550 0 0 0 0 0 0 0 0 0 0
44 Hustab syrup silva/ 2015 11,550 0 0 0 0 0 0 0 0 0 0
botol 8,046 50 402300 0 0 0 0 0 0 0 0 0
botol/ BPJS 8,046 0 200 1609200 0 0 0 0 0 0 0 0
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 1,000 93000 0 0 0 0 0 0 0

47 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 0 0
48 Iliadin Drop botol 31,080 0 0 0 0 0 0 0 0 0 0
49 Karbamazepin tablet 200 mg tablet 230 0 0 500 115000 0 0 0 0 0 0 0

50 Kaptopril 12,5 mg tablet 62 0 0 2,000 124000 0 0 0 1,000 62000 0 0 0
51 Kaptopril 25 mg tablet 715 500 357500 0 2,000 1430000 0 0 0 1,000 715000 0 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 500 0 0 0 0 0 0 0 0

53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 5,000 215000 0 3,000 129000 0 3,000 129000 0 0 0
55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 0 0 0 0 0 2,000 308000 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 100 57500 0 0 0 0 0 0 0
ampul 1,937 0 0 100 193700 0 0 0 0 0 0 0

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 500 40000 0 0 0 0 0 0 0
59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 2,000 266000 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 100 16200 0 0 0 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 1,000 123000 0 0 0 0 0 0 0
tablet 133 0 0 10,000 1330000 0 0 0 0 0 0 0

tablet 264 0 0 0 0 0 0 0 0 0 0
tablet 107 0 0 1,500 160005 0 0 0 0 0 0 0

67 Natrium Diklofenak tablet 50 mg tablet 136 0 0 0 0 0 0 1,000 136000 0 0 0
silva 2015 136 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0
tablet 549 100

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 1,000 803000 0 0 0 0 0 0 0
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 100 190000 0 0 0 0 0 0 0

ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0
74 Omeprazole kapsul/kaplet 20 mg tablet 164 0 1,500 246000 1,500 246000 0 2,000 328000 0 2,000 328000 0 0 0
tablet 51 2000 102000 0 5,000 255000 0 0 0 0 0 0 0

75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 0 5,000 823100 5,000 823100 0 0 0
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 500 748000 0 0 0 100 149600 0 0 0

77 botol 1,184 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0 0 0 0 0
78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 100 30800 1,000 308000 0 0 0 0 0 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 3,000 372000 0 1000 124000 0 2,500 310000 0 0 0
81 Prednison 5 mg Tablet tablet 96 0 0 0 0 0 0 0 0 0 0
tablet 191 0 0 0 0 0 1,000 190660 2,000 381320 0 0 0
tablet 226 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0
84 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 500 248500 0 0 0 0 0 0 0
86 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 0 0
botol 7,150 0 0 0 0 40 286000 0 100 715000 0 0 0

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 700 54600 0 700 54600 0 500 39000 0 0 0
91 Salbutamol syrup botol 4,042 0 0 0 0 0 0 100 404182 0 0 0
92 Salisil Bedak 2,5% bks 1,046 0 0 0 0 0 0 0 0 0 0
93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 2 377326 0 0 0
94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 2,000 120000 0 1,000 60000 0 1,000 60000 0 0 0
tablet 133 0 0 1,500 199500 0 0 0 0 0 0 0
96 Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0
97 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 0 0 0 0 0 0 0 0
tablet 880 0 0 0 0 1,000 880000 0 1,500 1320000 0 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 700 202300 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 1,000 319000 0 0 0 1,000 319000 0 0 0

101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 0 3,000 252000 0 3,000 252000 0 4,000 336000 0 0 0
102 Vitamin B komplek Tablet tablet 121 0 0 5,000 605000 0 0 0 2,000 242000 0 0 0
Botol 9,646 0 0 0 0 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0 0
104 Zink Tablet Tablet 0 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 0 0 0 0 20 125800 0 0 0
3,322 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 0 0 0 0 0 0
BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0 0 0
108 Autocheck Blood Glucose Test Strip box 137,500 0 0 0 0 5 687500 0 0 0 0 0

111 ABN Hand Rub 500 ml Botol 60,636 0 0 0 0 0 0 10 606364 0 0 0
114 Abbocath No.24 G buah 4,180 0 0 0 0 0 0 0 0 0 0
buah 4,180 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 100 79200 200 158400 300 237600 0 0 200 158400 500 396000 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 300 64800 0 100 21600 0 0 0 0 0

buah 197 0 0 0 0 0 0 0 0 0 0
122 Asepton 500 cc + dispenser botol 24,200 0 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 15 569250 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 12 542196 0 0 0

buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 12 389892 0 0 0
125 Cat Gut /benang bedah Plain no .3/0 buah/ H baru 35,740 0 0 0 0 0 0 0 0 0 0
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 0 0 0 0
buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 20 74620 0 0 0 0 0 0 0 0
botol 3,450 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,450 0 30 103500 0 0 0 0 0 0 0 0
botol 28,750 0 0 0 0 0 0 0 0 0 0
130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 10 287500 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 10 28313 0 0 0 0 0 0 0 0
set 3,520 0 0 0 0 50 176000 0 0 0 0 0

set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 0 0 0 0 8 110000 0 0 0

buah / bpjs 13,750 0 6 82500 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 10 77000 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 10 21000 0 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 0 0 0 0 0 0
rol / bpjs 1,650 0 100 165000 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 100 82500 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0
142 Kasa Steril 40 x 40 buah 1,600 0 0 0 0 0 0 0 0 0 0

144 Kasa Steril 7,5 x 7,5 buah - 0 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 3 141450 0 0 0 0 0 0 0
145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 1,250 0 0 0 0 0 0 0 0 0
147 Masker 3 Ply Tie On buah 439 0 0 0 0 0 0 0 0 0 0

buah 363 0 0 0 0 0 0 0 0 0 0
148 Masker 3 Ply Earloop buah 439 0 0 0 0 0 0 1,500 658350 0 0 0
buah / bpjs 363 0 1,000 363000 0 0 0 0 0 0 0 0

149 Masker 3 Ply Earloop With Ear Loop buah 439 0 0 0 0 0 0 0 0 0 0
buah 440 0 0 1,000 440000 0 1,000 440000 0 0 0 0 0

buah / bpjs 440 0 0 0 0 0 0 0 0 0 0
151 My Jelly 82 gram tube - 0 0 0 0 0 0 0 0 0 0
152 Object Glass Kotak 19,365 0 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 3 245866 0 0 0 0 0 0 0
154 Pharfix 15 cm x 5 m rol/ H. baru 47,000 0 0 0 0 0 0 5 235000 0 0 0
rol / bpjs 81,955 0 1 81955 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 5 256525 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 8 226292 0 0 0 0 0 0 0 0
botol 18,818 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0
159 Sarung tangan 7,5 buah/ H baru 4,666 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 200 1379000 0 0 0 0 0 0 0 0
160 Sarung tangan M buah 471 0 0 0 0 0 0 1,000 470500 0 0 0
buah 36,582 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 24 877968 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0 0
163 Skin Celean 500 ml botol - 0 0 0 0 0 0 0 0 0 0

botol 14,472 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 4 57886 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0
171 Rinse Mindrey galon 1,254,000 0 0 0 0 0 0 0 0 0 0

172 DIFF Diluent 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0
173 DIFF Rinse 20 L galon 1,379,400 0 0 0 0 0 0 0 0 0 0
174 DIFF Lyse 500 ml Botol 1,669,800 0 0 0 0 0 0 0 0 0 0

175 E-Z Cleanser 100 ml Botol 949,850 0 0 0 0 0 0 0 0 0 0
176 Probe Cleanser 17 ml Botol 76,230 0 0 0 0 0 0 0 0 0 0
177 Thermal Paper 5 cm u/ Hematologi Rol 44,000 0 0 0 0 0 0 0 0 0 0

178 ALT/GPT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0
179 AST/GOT(IFCC) Single Vial Kit 1,071,400 0 0 0 0 0 0 0 0 0 0
180 URID ACID (URICASE) Kit 799,700 0 0 0 0 0 0 0 0 0 0
181 Cholesterol CHOD-PAP Kit 664,400 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD - 0 0 0 0 0 0 0 0 0 0
Obat Paru - 0 0 0 0 0 0 0 0 0 0
182 GARAM ORALIT SACHET 303 0 0 0 0 0 0 0 0 0 0
183 ZINC Tablet TABLET 539 0 570 307230 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0
188 Sarung tangan tanpa tepung M buah 583 0 1000 583000 0 0 0 0 0 0 0 0
189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0
190 Reagen Ziehl Neelsen kit 181,811 0 0 0 0 0 0 0 0 0 0
191 Masker 3 Ply Earloop Jilbab buah - 0 1,000 0 0 0 0 0 0 0 0 0
192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0
194 Imersion Oil Botol 3,181,818 0 0 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0 0
195 KAPAS LIDI Bungkus - 0 0 1 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 5 0 0 0 0 0 0 0 0

197 CHLORIN Liter - 0 0 1 0 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0
Program Imunisasi 1,404 0 0 0 0 0 0 0 0 0 0

199 Alat suntik 0,05 ml set 1,225 0 0 0 0 0 0 150 183750 0 0 0
200 Alat suntik 0,5 ml set 1,651 0 0 0 0 0 0 3,719 6140069 0 0 0
201 Safety Box 5 liter box - 0 0 0 0 0 0 38 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0

203 BD Vacuntainer box - 0 0 0 0 0 0 0 0 0 0
204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0
207 RPR Sifilis ( FOCUS ) Test 4,300 0 0 0 0 0 0 0 0 0 0
208 Masker Plus 3 Ply Earloop ( Jilbab ) buah 440 0 0 0 0 0 0 0 0 0 0

210 Sarung tangan L buah 499 0 0 0 0 0 0 0 0 0 0
211 Standard Q Shyphilis Ab kit - 0 0 0 0 0 0 0 0 0 0

212 Alat Suntik Steril buah 1,668 0 0 0 0 0 0 0 0 0 0
213 Needle Flash Back 21 x 1 Box 85,000 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 1 352000 0 0 0
215 Articulating Pcs 181,500 0 0 0 0 0 0 2 363000 0 0 0
216 61104 Ketac Universal HM Intro Kit A3 Dus 440,047 0 0 0 0 0 0 0 0 0 0
219 Cresotin Liquid II Tehnodent Botol 164,774 0 0 0 0 0 0 0 0 0 0

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0
223 Paramono Cloofenol (CHKM) Dus 66,700 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0
225 Iodotin Tehnoden Pot 98,200 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0
228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 0 0 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0
233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0

234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0
Program Gizi - 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 152836 56090812 0 0 0 0 0 0 0 0
Program Imunisasi - 0 0 0 0 0 0 0 0 0 0
buah/ skipa 1,240 505 626200 0 0 0 0 0 0 0 0 0
237 Spuit 0,5 ml
buah / apbn 1,621 6428 10419788 0 0 0 0 0 0 0 0 0
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 494 649610 0 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 22 37510
Box 16,608 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 7 116256 0 0 0 0 0 0 0 0 0

Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0
241 DHP Frimal TABLET 2,160 0 0 0 0 0 0 0 0 0 0

242 Primaquin TABLET 235 0 0 0 0 0 0 0 0 0 0
243 RDT Malaria TABLET 5,271 0 0 0 0 0 0 0 0 0 0
Obat Rabies - 0 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 0 0 0 0 0 0 0 0 0
249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0

253 Rapid Test III ( VIKIA ) Test 19,480 0 0 0 0 0 0 0 0 0 0
255 Rapid Test Sifilis Ab Test 20,400 0 0 0 0 0 0 0 0 0 0
256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0
257 Yellow Tips bungkus - 0 0 0 0 0 0 0 0 0 0
258 Blue Tips bungkus - 0 0 0 0 0 0 0 0 0 0
259 Metilen Blue botol 94,500 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0
261 Jarum Vacutainer boks 21,500 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0
263 Cotton Aplicator boks 135,000 0 0 0 0 0 0 0 0 0 0
264 Object Glass Kotak - 0 0 0 0 0 0 0 0 0 0

265 Cover Glass Kotak - 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0
267 Disposable Needle No 18 boks 25,000 0 0 0 0 0 0 0 0 0 0

OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 13 779350 13 779350 13 779350 15 899250 15 899250 15 899250 15 899250 0 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 10 282040 10 282040 10 282040 0 0 0
270 MR VIAL 141,648 0 0 5 708240 15 2124720 8 1133184 10 1416480 10 1416480 0 0 0

271 DPT-HB-Hib VIAL 76,285 50 3814250 45 3432825 40 3051400 50 3814250 50 3814250 40 3051400 40 3051400 0 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 65 1358500 65 1358500 65 1358500 60 1254000 60 1254000 60 1254000 60 1254000 0 0 0
274 POLIO (BOPV) VIAL 19,954 40 798160 33 658482 0 0 40 798160 40 798160 40 798160 0 0 0
275 POLIO (IPV) VIAL 13,976 13 181688 10 139760 15 209640 15 209640 13 181688 12 167712 10 139760 0 0 0
276 Td VIAL 16,500 10 165000 10 165000 10 165000 10 165000 10 165000 10 165000 10 165000 0 0 0
12
12
P.LABU P.LABU TOTAL

TOTAL
HARGA
KELUAR
TOTAL TOTAL KELUAR
JUMLAH
HARGA HARGA
NOVEMBER DESEMBER
0 0 0 0
0 0 0 0
0 0 3400 316200
0 0 0 0
0 0 3500 1095500
0 0 6000 528000
0 0 0 0
0 0 24000 6360000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 600 1239000
0 0 0 0
0 0 24 165720
0 0 11000 1199000
0 0 7000 3118500
0 0 3000 528000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 96 468000
0 0 0 0
0 0 2500 362500
0 0 0 0
0 0 1200 1267200
0 0 120 215760
0 0 200 2310000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 100 288000
0 0 5500 352000
0 0 0 0
0 0 500 53000
0 0 0 0
0 0 0 0
0 0 4200 3154200
0 0 53 363951
0 0 0 0
0 0 200 87200
0 0 0 0
0 0 2000 162000
0 0 0 0
0 0 1000 303000
0 0 3500 203000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 140 966000
0 0 0 0
0 0 0 0
0 0 3000 720000
0 0 500 31000
0 0 24 63600
0 0 3000 468000
0 0 5600 2447200
0 0 500 129000
0 0 500 156000
0 0 936000
0 0 400 4620000
0 0 0 0
0 0 0 0
0 0 50 402300
0 0 200 1609200
0 0 0 0
0 0 1000 93000
0 0 0 0
0 0 0 0
0 0 500 115000
0 0 3000 186000
0 0 3500 2502500
0 0 500 0
0 0 11000 473000
0 0 250 545750
0 0 2000 308000
0 0 100 57500
0 0 100 193700
0 0 0 0
0 0 500 40000
0 0 0 0
0 0 2000 266000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 100 268400
0 0 100 16200
0 0 1000 123000
0 0 10000 1330000
0 0 0 0
0 0 230 874000
0 0 48 163680
0 0 1500 160005
0 0 1000 136000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1000 803000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 100 190000
0 0 0 0
0 0 7000 1148000
0 0 7000 357000
0 0 10000 1646200
0 0 0 0
0 0 600 897600
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1100 338800
0 0 6500 806000
0 0 0 0
0 0 0 0
0 0 3000 571980
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 500 248500
0 0 0 0
0 0 140 1001000
0 0 0 0
0 0 0 0
0 0 1900 148200
0 0 0 0
0 0 100 404182
0 0 0 0
0 0 2 377326
0 0 4000 240000
0 0 600 700800
0 0 1500 199500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 2500 2200000
0 0 0 0
0 0 700 202300
0 0 0 0
0 0 2000 638000
0 0 10000 840000
0 0 7000 847000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 20 125800
0 0 0 0
0 0 0 0
0 0 5 95025
0 0 0 0
0 0 0 0
0 0 5 687500
0 0 10 3685000
0 0 5 893750
0 0 10 606364
0 0 50 209000
0 0 50 209000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1300 1029600
0 0 0 0
0 0 0 0
0 0 0 0
0 0 400 86400
0 0 0 0
0 0 0 0
0 0 0 0
0 0 15 569250
0 0 12 542196
0 0 12 542196
0 0 12 389892
0 0 0 0
0 0 12 389892
0 0 0 0
0 0 0 0
0 0 0 0
0 0 12 612264
0 0 0 0
0 0 20 74620
0 0 0 0
0 0 30 103500
0 0 0 0
0 0 10 287500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 10 28313
0 0 50 176000
0 0 0 0
0 0 8 110000
0 0 6 82500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 10 77000
0 0 0 0
0 0 10 21000
0 0 0 0
0 0 100 165000
0 0 0 0
0 0 100 82500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 3 141450
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1250 0
0 0 0 0
0 0 0 0
0 0 1500 658350
0 0 1000 363000
0 0 0 0
0 0 2000 880000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1 65341
0 0 3 245866
0 0 5 235000
0 0 1 81955
0 0 0 0
0 0 5 150000
0 0 5 256525
0 0 0 0
0 0 10 165000
0 0 8 226292
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 200 1379000
0 0 1000 470500
0 0 0 0
0 0 24 877968
0 0 0 0
0 0 12 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 4 57886
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 570 307230
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1000 583000
0 0 2 94300
0 0 0 0
0 0 1000 0
0 0 0 0
0 0 1 0
0 0 0 0
0 0 0 0
0 0 1 0
0 0 5 0
0 0 1 0
0 0 0 0
0 0 0 0
0 0 150 183750
0 0 3719 6140069
0 0 38 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 2 704000
0 0 2 363000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 152836 56090812
0 0 0 0
0 0 505 626200
0 0 6428 10419788
0 0 0 0
0 0 494 649610
22
0 0 0 0
0 0 7 116256
0 0 2 33216
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 4 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 150 2011050
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 99 5935050
0 0 30 846120
0 0 48 6799104
0 0 315 24029775
0 0 0 0
0 0 435 9091500
0 0 193 3851122
0 0 88 1229888
0 0 70 1155000
PELAPORAN : Araskabu 1 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
A.KABU A.KABU A.KABU A.KABU A.KABU A.KABU A.KABU A.KABU A.KABU A.KABU A.KABU A.KABU TOTAL
HARGA TOTAL
SATUAN KELUAR
1 Acyclovir 400 mg tablet tablet 359 0 0 300 107700 0 0 0 0 0 0 0 0 0 300 107700

tablet 93 0 1,000 93000 5,000 465000 0 5,500 511500 0 5,500 511500 0 0 0 0 0 17000 1581000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 88 0 1,000 88000 5,000 440000 0 5,000 440000 0 6,000 528000 0 0 0 0 0 17000 1496000
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Amoksisilin 500 mg kapsul 265 3,000 795000 2,000 530000 15,000 3975000 0 16,000 4240000 0 17,000 4505000 0 0 0 0 0 53000 14045000
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 100 250000 100 250000 600 1500000 0 550 1375000 0 650 1625000 0 0 0 0 0 2000 5000000
9 Antasida DOEN I Kombinasi tablet 63 3,000 189000 2,000 126000 10,000 630000 0 8,000 504000 0 9,000 567000 0 0 0 0 0 32000 2016000
btl 60 ml 2,065 0 100 206500 500 1032500 0 500 1032500 0 600 1239000 0 0 0 0 0 1700 3510500
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ H Baru 446 0 0 0 0 0 1,000 445500 5,000 2227500 0 0 0 0 0 6000 2673000
tablet 176 2,000 352000 2,000 352000 2,000 352000 0 0 0 0 0 0 0 0 0 6000 1056000
silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 11,550 0 0 0 0 0 0 150 1732500 0 0 0 0 0 150 1732500

21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Deksametason inj 5mg /ml-1ml ampul 2,880 0 0 150 432000 0 40 115200 0 0 0 0 0 0 0 190 547200
tablet 64 1,000 64000 1,000 64000 5,000 320000 0 6,800 435200 0 7,000 448000 0 0 0 0 0 20800 1331200
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 436 0 0 1,000 436000 0 500 218000 0 0 0 0 0 0 0 1500 654000

tablet/ H. baru 797 0 0 0 0 0 0 700 557893 0 0 0 0 0 700 557893
34 Garam oralit 200 ml air bks 303 0 0 7,000 2121000 0 8,000 2424000 0 0 0 0 0 0 0 15000 4545000
tablet 58 0 0 5,000 290000 0 5,000 290000 0 5,000 290000 0 0 0 0 0 15000 870000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 0 0 3,000 468000 0 0 0 0 0 0 0 3000 468000
tablet / H.Baru 437 0 0 0 0 3,000 1311000 0 3,000 1311000 0 0 0 0 0 6000 2622000
tablet 258 0 0 0 0 4,000 1032000 0 5,000 1290000 0 0 0 0 0 9000 2322000

43 Hustab Tablet
tablet P 312 1000 312000 2000 624000 5000 1560000 0 0 0 0 0 0 0 0 0 8000 2496000
tablet/ BPJS 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 200 2310000 0 200 2310000 0 0 0 0 0 400 4620000
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 200 1609200 0 100 804600 0 0 0 0 0 0 0 0 0 300 2413800
botol/ BPJS 8,046 0 200 1609200 0 0 0 0 0 0 0 0 0 0 200 1609200
46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 0 0 1,500 139500 0 0 0 0 0 0 0 1500 139500


50 Kaptopril 12,5 mg tablet 62 0 0 3000 186000 0 3,500 217000 0 4,300 266600 0 0 0 0 0 10800 669600
51 Kaptopril 25 mg tablet 715 0 1000 715000 5000 3575000 0 5,000 3575000 0 6,000 4290000 0 0 0 0 0 17000 12155000

53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 2000 86000 2000 86000 20000 860000 0 10,000 430000 0 15,000 645000 0 0 0 0 0 49000 2107000
54 Kotrimoksazole Suspensi btl 60ml 2,183 50 109150 100 218300 500 1091500 0 500 1091500 0 600 1309800 0 0 0 0 0 1750 3820250
55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 1,000 154000 5,000 770000 0 5,000 770000 0 6,000 924000 0 0 0 0 0 17000 2618000
ampul 1,937 0 0 300 581100 0 400 774800 0 400 774800 0 0 0 0 0 1100 2130700
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 1,000 80000 500 40000 0 0 0 0 0 0 0 0 0 1500 120000

59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 2,000 266000 0 2,400 319200 0 2,500 332500 0 0 0 0 0 6900 917700
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 1,000 162000 0 800 129600 0 1,000 162000 0 0 0 0 0 2800 453600
tablet 133 0 0 15,000 1995000 0 20,000 2660000 0 0 0 0 0 0 0 35000 4655000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 107 0 1,000 106670 2,000 213340 0 500 53335 0 0 0 0 0 0 0 3500 373345

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 300 1923000 0 400 2564000 0 160 1025600 0 0 0 0 0 860 5512600
tablet 549 0 0 500 274500 0 380 208620 0 700 384300 0 0 0 0 0 1580 867420
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 1,000 803000 0 380 305140 0 900 722700 0 0 0 0 0 2280 1830840
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 1,900 0 0 600 1140000 0 700 1330000 0 800 1520000 0 0 0 0 0 2100 3990000
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 2,000 102000 2,000 102000 10,000 510000 0 0 0 0 0 0 0 0 0 14000 714000
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 3,000 493860 2,000 329240 10,000 1646200 0 0 0 0 0 15000 2469300
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 100 149600 500 748000 0 600 897600 0 600 897600 0 0 0 0 0 1800 2692800
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 100 311300 0 120 373560 0 120 373560 0 0 0 0 0 340 1058420
78 Pehacain Injeksi
ampul / bpjs 3,113 0 120 373560 0 0 0 0 0 0 0 0 0 0 120 373560
79 Pirantel tablet score 125 mg tablet 308 0 0 200 61600 0 1000 308000 0 1,500 462000 0 0 0 0 0 2700 831600
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 7000 868000 0 10000 1240000 0 10,000 1240000 0 0 0 0 0 27000 3348000
81 Prednison 5 mg Tablet tablet 96 0 1000 96000 0 0 0 0 0 0 0 0 0 0 1000 96000
tablet 191 0 0 0 0 0 2,000 381320 2,000 381320 0 0 0 0 0 4000 762640
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 500 3575000 0 240 1716000 0 400 2860000 0 0 0 0 0 1140 8151000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 50 127700 0 0 0 0 0 0 0 0 0 50 127700
90 Salbutamol Cairan 0,1 % ampul 4,000 0 0 100 400000 0 20 80000 0 0 0 0 0 0 0 120 480000
93 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 1,000 1168000 0 1,200 1401600 0 0 0 0 0 2700 3153600
tablet 133 0 0 500 66500 0 0 0 0 0 0 0 0 0 500 66500

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 500 144500 0 0 0 0 0 0 0 0 0 500 144500
tablet 880 0 0 0 0 2,000 1760000 0 2,500 2200000 0 0 0 0 0 4500 3960000

silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 500 144500 0 0 0 0 0 0 0 0 0 0 500 144500

100 Tetrasiklin 500 mg kapsul 319 0 1,000 319000 2,500 797500 0 3,000 957000 0 3,500 1116500 0 0 0 0 0 10000 3190000
Botol 9,646 0 0 300 2893800 0 0 0 0 0 0 0 0 0 300 2893800
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 100 629000 0 0 0 0 0 0 0 0 0 100 629000

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 50 209000 0 50 209000 0 50 209000 0 0 0 0 0 150 627000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Alat suntik 3 ml 24 G X1 buah 792 200 158400 300 237600 1,000 792000 0 500 396000 0 1,000 792000 0 0 0 0 0 3000 2376000
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 500 108000 0 500 108000 0 2,000 432000 0 500 108000 0 0 0 0 0 3500 756000
buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 20 759000 0 0 0 0 0 0 0 0 0 0 20 759000
buah 45,183 0 0 0 0 24 1084392 0 24 1084392 0 0 0 0 0 48 2168784
buah / bpjs 45,183 0 12 542196 0 0 0 0 0 0 0 0 0 0 12 542196
buah 32,491 0 0 12 389892 0 24 779784 0 24 779784 0 0 0 0 0 60 1949460
buah / bpjs 32,491 0 12 389892 0 0 0 0 0 0 0 0 0 0 12 389892
buah 52,561 0 0 12 630732 0 0 0 24 1261464 0 0 0 0 0 36 1892196

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 24 1224528 0 0 0 0 0 24 1224528

buah / bpjs 51,022 0 12 612264 0 0 0 0 0 0 0 0 0 0 12 612264
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 100 373100 0 0 0 0 0 0 0 0 0 0 100 373100
botol 3,450 0 0 100 345000 0 0 0 0 0 0 0 0 0 100 345000

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 5 143750 0 10 287500 0 2 57500 0 0 0 0 0 17 488750

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 20 575000 0 0 0 0 0 0 0 0 0 0 20 575000
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Infusion Set Anak set 2,831 50 141563 0 50 141563 0 50 141563 0 0 0 0 0 0 0 150 424689
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0

set 3,520 50 176000 0 100 352000 0 50 176000 0 100 352000 0 0 0 0 0 300 1056000
set / bpjs 3,520 0 200 704000 0 0 0 0 0 0 0 0 0 0 200 704000
buah 13,750 0 0 10 137500 0 10 137500 0 10 137500 0 0 0 0 0 30 412500
buah / bpjs 13,750 0 10 137500 0 0 0 0 0 0 0 0 0 0 10 137500
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 50 385000 0 0 0 0 0 0 0 0 0 50 385000
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 0 0 0 0 0 0 0 0 100 165000

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 825 0 0 200 165000 0 0 0 0 0 0 0 0 0 200 165000

rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
142 Kasa Steril 40 x 40 buah 1,600 0 0 50 80000 0 0 0 0 0 0 0 0 0 50 80000
143 Kasa Steril 5 x 5 buah 3,181 0 0 100 318100 0 0 0 0 0 0 0 0 0 100 318100
botol 47,150 0 0 8 377200 0 3 141450 0 0 0 0 0 0 0 11 518650

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 100 36300 0 0 0 0 0 0 0 0 0 100 36300
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 100 36300 0 100 36300 0 0 0 0 0 0 0 200 72600
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 500 220000 0 600 264000 0 700 308000 0 0 0 0 0 1800 792000
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0


rol 81,955 0 0 4 327822 0 0 0 0 0 0 0 0 0 4 327822

rol / bpjs 81,955 0 6 491733 0 0 0 0 0 0 0 0 0 0 6 491733
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 6 307830 0 0 0 0 0 0 0 0 0 0 6 307830
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 10 282864 0 0 0 0 0 0 0 0 0 0 10 282864
botol 18,818 0 0 10 188182 0 0 0 0 0 0 0 0 0 10 188182

botol / bpjs 18,818 0 20 376364 0 0 0 0 0 0 0 0 0 0 20 376364
botol 3,032 0 0 50 151591 0 0 0 0 0 0 0 0 0 50 151591

botol / bpjs 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 24 877968 0 0 0 0 0 24 877968

161 Silk 2/0
buah / bpjs 36,582 0 24 877968 0 0 0 0 0 0 0 0 0 0 24 877968
buah - 0 0 0 0 0 0 24 0 0 0 0 0 0 24 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Diluen Samsung Unit 2,750,000 0 0 0 0 0 0 2 5500000 0 0 0 0 0 2 5500000

169 Hipo Cleaner Samsung Unit 2,200,000 0 0 0 0 0 0 1 2200000 0 0 0 0 0 1 2200000
170 Lise Samsung Unit 3,300,000 0 0 0 0 0 0 2 6600000 0 0 0 0 0 2 6600000
Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300


192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 3 1056000 0 0 0 0 0 4 1408000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

231 POT SPUTUM BUAH 2,950 400 1180000 0 0 0 0 0 0 0 0 0 0 0 400 1180000

233 Kaca Slide Box 30,000 0 0 20 600000 0 0 0 0 0 0 0 0 0 20 600000
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 95944 35211448 0 0 0 0 0 0 0 0 0 0 95944 35211448
buah/ skipa 1,240 313 388120 0 0 0 0 0 0 0 0 0 0 0 313 388120

237 Spuit 0,5 ml
buah / apbn 1,621 3983 6456443 0 0 0 0 0 0 0 0 0 0 0 3983 6456443

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 306 402390 0 0 0 0 0 0 0 0 0 0 0 306 402390
Spuit 5 ml APBN 1,705 13 22165 13
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 4 66432 0 0 0 0 0 0 0 0 0 0 0 4 66432
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0



256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 10 599500 10 599500 10 599500 10 599500 10 599500 10 599500 10 599500 0 0 0 0 0 70 4196500
269 CAMPAK VIAL 28,204 0 0 0 0 0 0 0 0 0 0 0 0 0 0
270 MR VIAL 141,648 0 10 1416480 10 1416480 10 1416480 10 1416480 10 1416480 10 1416480 0 0 0 0 0 60 8498880
271 DPT-HB-Hib VIAL 76,285 40 3051400 30 2288550 30 2288550 40 3051400 40 3051400 40 3051400 40 3051400 0 0 0 0 0 260 19834100
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 40 836000 30 627000 30 627000 40 836000 40 836000 30 627000 40 836000 0 0 0 0 0 250 5225000
274 POLIO (BOPV) VIAL 19,954 40 798160 40 798160 0 0 35 698390 40 798160 35 698390 0 0 0 0 0 190 3791260
275 POLIO (IPV) VIAL 13,976 10 139760 10 139760 10 139760 10 139760 7 97832 10 139760 10 139760 0 0 0 0 0 67 936392
276 Td VIAL 16,500 0 0 0 0 0 0 5 82500 0 0 0 0 0 5 82500

PELAPORAN : Lubuk Pakam 1 2 3 4 5 6 8 9
1 2 3 4 5 6 8 9
LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM
tablet 93 0 0 2,000 186000 0 2,500 232500 0 3,000 279000 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 5,000 1565000 0 4,000 1252000 0 1,800 563400 0 0
tablet 88 0 0 5,000 440000 0 0 0 5,000 440000 0 0

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 50 125000 500 1250000 0 400 1000000 0 500 1250000 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 0 10,000 630000 0 0 0 10,000 630000 0 0
btl 60 ml 2,065 0 0 700 1445500 0 500 1032500 0 500 1032500 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 15,000 1635000 0 0 0 10,000 1090000 0 0
tablet/ H Baru 446 0 0 0 0 0 0 5,000 2227500 0 0

tablet 176 0 0 1,000 176000 0 0 0 0 0 0
silva/ 2015 304 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
20 Chloramfenicol salep mata 1 % tube 1,798 0 0 200 359600 0 0 0 72 129456 0 0

botol 11,550 0 0 0 0 0 0 200 2310000 0 0
21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0

tablet 64 0 0 5,000 320000 0 0 0 10,000 640000 0 0
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 100 10600 0 0 0 0 0 0

DAK 2019 114 0 0 0 0 0 0 0 0 0

tablet 436 0 0 1,000 436000 0 1,000 436000 0 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0 100 79699 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 6,000 486000 0 8,000 648000 0 6,000 486000 0 0

34 Garam oralit 200 ml air bks 303 0 0 1,000 303000 0 2,500 757500 0 0 0 0
tablet 58 0 300 17400 15,000 870000 0 0 0 9,000 522000 0 0

tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0

36 Glukosa 5% Larutan Infus botol 6,900 0 0 200 1380000 0 250 1725000 0 200 1380000 0 0
40 Haloperidol tablet 0,5 mg tablet 62 0 0 0 0 0 0 5,200 322400 0 0
42 Hidrokloratiazid 25 mg tablet 156 0 0 10,000 1560000 0 7,000 1092000 0 7,000 1092000 0 0

tablet / H.Baru 437 0 0 0 0 0 0 5,000 2185000 0 0
tablet 258 0 0 0 0 1,000 258000 0 0 0 0

43 Hustab Tablet
tablet P 312 0 0 1,000 312000 0 0 0 0 0 0
tablet/ BPJS 312 0 500 156000 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 500 5775000 0 300 3465000 0 0
silva /2014 11,550 0 0 0 0 0 0 0 0 0

botol 8,046 0 0 100 804600 0 0 0 0 0 0
botol/ BPJS 8,046 0 700 5632200 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 1000 75000 200 15000 0 380 28500 0 400 30000 0 0


52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 2,000 0 0 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 1500 64500 10,000 430000 0 0 0 10,000 430000 0 0
54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 1,500 3274500 0 1,000 2183000 0 1,300 2837900 0 0

ampul 1,937 0 0 1,000 1937000 0 500 968500 0 250 484250 0 0
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0
58 Loperramid tablet 2 mg tablet 80 0 0 700 56000 0 2,800 224000 0 0 0 0

59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0
tablet 133 0 300 39900 5,000 665000 0 0 0 5,000 665000 0 0
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0
62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 0 0 0 0 2,000 324000 0 0
tablet 133 0 0 15,000 1995000 0 15,000 1995000 0 0 0 0

tablet 264 0 0 0 0 0 0 0 0 0
tablet 107 0 0 0 0 500 53335 0 0 0 0

silva 2015 136 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 500 3205000 0 0 0 120 769200 0 0

tablet 549 0 0 2,000 1098000 0 0 0 1,800 988200 0 0

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0
tablet 803 0 0 2,000 1606000 0 0 0 1,500 1204500 0 0

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0
72 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 1,000 1798000 0 0 0 0 0 0

ampul 1,900 0 0 300 570000 0 500 950000 0 600 1140000 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0
tablet 51 0 0 7,000 357000 0 0 0 0 0 0

silva/ 2015 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 1,000 1496000 0 100 149600 0 400 598400 0 0

77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 200 622600 0 600 1867800 0 0

78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0
79 Pirantel tablet score 125 mg tablet 308 0 0 0 0 0 0 0 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 0 0 0 0 12,000 1488000 0 0

tablet 191 0 0 0 0 0 0 3,000 571980 0 0
tablet 226 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0

botol 7,150 0 0 0 0 200 1430000 0 200 1430000 0 0

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 10 25540 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 0 0 0 0 5,000 390000 0 0

tablet 133 0 0 1,500 199500 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0
tablet 289 0 0 700 202300 0 0 0 0 0 0

tablet 880 0 0 0 0 500 440000 0 900 792000 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 1,400 404600 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 3,000 957000 0 3,000 957000 0 3,900 1244100 0 0
Botol 9,646 0 0 200 1929200 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 50 314500 0 0 0 50 314500 0 0

3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0
106 Eugenol cairan botol 19,005 0 0 5 95025 0 0 0 8 152040 0 0

109 Autocheck Blood Cholesterol Test Strip box 368,500 0 0 0 0 5 1842500 4 1474000 5 1842500 0 0
110 Autocheck Urid Acid Test Strip box 178,750 0 0 0 0 5 893750 2 357500 5 893750 0 0
buah 4,180 0 0 100 418000 0 100 418000 0 50 209000 0 0

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 10 7920 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
buah 216 0 0 500 108000 0 500 108000 0 600 129600 0 0

buah 197 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 1 37950 0 0 0 0 0 0

botol / bpjs 37,950 0 32 1214400 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 12 542196 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 12 389892 0 0
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 12 630732 0 0

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 12 612264 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 100 345000 0 0 0 0 0 0
botol / bpjs 3,450 0 2 6900 0 0 0 0 0 0 0
botol 28,750 0 0 6 172500 0 0 0 1 28750 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 2 57500 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 5 14156 0 0 0 0 0 0 0
set 3,520 0 0 150 528000 0 50 176000 0 100 352000 0 0

set / bpjs 3,520 0 10 35200 0 0 0 0 0 0 0
buah 13,750 0 0 20 275000 0 0 0 30 412500 0 0
buah / bpjs 13,750 0 60 825000 0 0 0 0 0 0 0

buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 10 77000 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 100 165000 0 50 82500 0 0 0 0

rol / bpjs 1,650 0 0 0 0 0 0 0 0 0
rol 825 0 0 100 82500 0 0 0 0 0 0

rol / bpjs 825 0 210 173250 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 6 282900 0 2 94300 0 0 0 0

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 50 18150 0 0 0 0
146 Masker Tie On buah 439 0 0 0 0 0 0 1,000 438900 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0

buah / bpjs 363 0 0 0 0 0 0 0 0 0

buah 440 0 0 200 88000 0 200 88000 0 500 220000 0 0

buah / bpjs 440 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 4 327822 0 0 0 0 0 0

rol / bpjs 81,955 0 3 245866 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0

rol / bpjs 51,305 0 3 153915 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0

rol / bpjs 28,286 0 3 84859 0 0 0 0 0 0 0
botol 18,818 0 0 5 94091 0 0 0 0 0 0

botol / bpjs 18,818 0 22 414000 0 0 0 0 0 0 0
botol 3,032 0 0 50 151591 0 0 0 0 0 0
botol / bpjs 3,032 0 2 6064 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0

buah / bpjs 6,895 0 0 0 0 0 0 0 0 0
buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0





Obat Paru - 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 500 1475000 500 1475000 0 0 0 0 0

189 Lisol 100 % botol 47,150 0 3 141450 0 0 0 0 0 0 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0

193 Lampu Bunsen Pcs - 0 3 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0


Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0


OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 2 704000 0 0


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0

Program TB Paru - 0 0 0 0 0 0 0 0 0

228 OAT FDC Kategori 1 Kombipak paket 302,605 0 0 0 3 907815 0 0 0 0 0
231 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 0 0 0 15 450000 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 299092 109766764 0 0 0 0 0 0 0
buah/ skipa 1,240 956 1185440 0 0 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 12180 19743780 0 0 0 0 0 0 0 0

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 936 1230840 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 40 68200

Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 13 215904 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 3 49824 0 0 0 0 0 0 0 0
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0


Obat Rabies - 0 0 0 0 0 0 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0
247 Fluconazol tablet TABLET - 0 40 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0

260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0


266 Handscoen boks - 0 3 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 35 2098250 32 1918400 30 1798500 30 1798500 30 1798500 35 2098250 35 2098250 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 10 282040 10 282040 0 0
270 MR VIAL 141,648 35 4957680 35 4957680 30 4249440 30 4249440 20 2832960 30 4249440 25 3541200 0 0
271 DPT-HB-Hib VIAL 76,285 100 7628500 30 2288550 50 3814250 120 9154200 80 6102800 100 7628500 120 9154200 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 120 2508000 120 2508000 60 1254000 130 2717000 130 2717000 130 2717000 130 2717000 0 0
274 POLIO (BOPV) VIAL 19,954 100 1995400 40 798160 0 0 70 1396780 85 1696090 85 1696090 0 0
275 POLIO (IPV) VIAL 13,976 30 419280 30 419280 30 419280 20 279520 30 419280 35 489160 30 419280 0 0
276 Td VIAL 16,500 30 495000 30 495000 30 495000 30 495000 30 495000 35 577500 30 495000 0 0
10 11 12
10 11 12
LUBUK PAKAM LUBUK PAKAM LUBUK PAKAM TOTAL

TOTAL
HARGA
KELUAR
HARGA HARGA HARGA
0 0 0 0 0
0 0 0 0 0
0 0 0 7500 697500
0 0 0 0 0
0 0 0 10800 3380400
0 0 0 10000 880000
0 0 0 0 0
0 0 0 40000 10600000
0 0 0 1450 3625000
0 0 0 0 0
0 0 0 20000 1260000
0 0 0 1700 3510500
0 0 0 0 0
0 0 0 200 1381000
0 0 0 25000 2725000
0 0 0 5000 2227500
0 0 0 1000 176000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 2437500
0 0 0 0 0
0 0 0 21900 3175500
0 0 0 50 145000
0 0 0 8500 8976000
0 0 0 272 489056
0 0 0 200 2310000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 288000
0 0 0 15000 960000
0 0 0 0 0
0 0 0 100 10600
0 0 0 0 0
0 0 0 200 470800
0 0 0 11500 8636500
0 0 0 100 686700
0 0 0 50 208350
0 0 0 2000 872000
0 0 0 100 79699
0 0 0 20000 1620000
0 0 0 0 0
0 0 0 3500 1060500
0 0 0 24300 1409400
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 650 4485000
0 0 0 0 0
0 0 0 0 0
0 0 0 20000 4800000
0 0 0 5200 322400
0 0 0 1000 2650000
0 0 0 24000 3744000
0 0 0 5000 2185000
0 0 0 1000 258000
0 0 0 1000 312000
0 0 0 500 156000
0 0 0 800 9240000
0 0 0 0 0
0 0 0 0 0
0 0 0 100 804600
0 0 0 700 5632200
0 0 0 1980 148500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 24900 1543800
0 0 0 26000 18590000
0 0 0 2000 0
0 0 0 21500 924500
0 0 0 3800 8295400
0 0 0 31000 4774000
0 0 0 0 0
0 0 0 1750 3389750
0 0 0 0 0
0 0 0 3500 280000
0 0 0 0 0
0 0 0 10300 1369900
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 1342000
0 0 0 2000 324000
0 0 0 13600 1672800
0 0 0 30000 3990000
0 0 0 0 0
0 0 0 2300 8740000
0 0 0 250 852500
0 0 0 500 53335
0 0 0 3000 408000
0 0 0 0 0
0 0 0 620 3974200
0 0 0 3800 2086200
0 0 0 0 0
0 0 0 3500 2810500
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 1798000
0 0 0 1400 2660000
0 0 0 0 0
0 0 0 8600 1410400
0 0 0 7000 357000
0 0 0 17000 2798540
0 0 0 0 0
0 0 0 1500 2244000
0 0 0 0 0
0 0 0 800 2490400
0 0 0 0 0
0 0 0 0 0
0 0 0 12000 1488000
0 0 0 0 0
0 0 0 100 6600
0 0 0 3000 571980
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 400 2860000
0 0 0 0 0
0 0 0 10 25540
0 0 0 5000 390000
0 0 0 0 0
0 0 0 0 0
0 0 0 10 10460
0 0 0 5 943315
0 0 0 14500 870000
0 0 0 1700 1985600
0 0 0 1500 199500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 700 202300
0 0 0 1400 1232000
0 0 0 0 0
0 0 0 1400 404600
0 0 0 100 1221000
0 0 0 9900 3158100
0 0 0 32000 2688000
0 0 0 50000 6050000
0 0 0 200 1929200
0 0 0 0 0
0 0 0 0 0
0 0 0 100 629000
0 0 0 0 0
0 0 0 0 0
0 0 0 13 247065
0 0 0 0 0
0 0 0 0 0
0 0 0 12 1650000
0 0 0 14 5159000
0 0 0 12 2145000
0 0 0 10 606364
0 0 0 250 1045000
0 0 0 250 1045000
0 0 0 250 1045000
0 0 0 250 1045000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 10 7920
0 0 0 1000 792000
0 0 0 0 0
0 0 0 0 0
0 0 0 100 82500
0 0 0 1600 345600
0 0 0 0 0
0 0 0 0 0
0 0 0 1 37950
0 0 0 32 1214400
0 0 0 12 542196
0 0 0 0 0
0 0 0 12 389892
0 0 0 0 0
0 0 0 0 0
0 0 0 12 630732
0 0 0 0 0
0 0 0 12 612264
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 345000
0 0 0 2 6900
0 0 0 7 201250
0 0 0 2 57500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 283126
0 0 0 5 14156
0 0 0 300 1056000
0 0 0 10 35200
0 0 0 50 687500
0 0 0 60 825000
0 0 0 9 245520
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 10 77000
0 0 0 0 0
0 0 0 0 0
0 0 0 150 247500
0 0 0 0 0
0 0 0 100 82500
0 0 0 210 173250
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 8 377200
0 0 0 0 0
0 0 0 50 18150
0 0 0 1000 438900
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 900 396000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 4 327822
0 0 0 5 235000
0 0 0 3 245866
0 0 0 0 0
0 0 0 0 0
0 0 0 3 153915
0 0 0 0 0
0 0 0 3 49500
0 0 0 3 84859
0 0 0 5 94091
0 0 0 22 414000
0 0 0 50 151591
0 0 0 2 6064
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1000 470500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 5500000
0 0 0 3 6600000
0 0 0 1 2200000
0 0 0 2 6600000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1081 582659
0 0 0 0 0
0 0 0 1000 2950000
0 0 0 0 0
0 0 0 2 1404500
0 0 0 1000 583000
0 0 0 3 141450
0 0 0 0 0
0 0 0 3000 0
0 0 0 0 0
0 0 0 3 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 300 367500
0 0 0 7029 11604879
0 0 0 71 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 1056000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 64 20944576
0 0 0 4 5039960
0 0 0 3 907815
0 0 0 7 1422813
0 0 0 0 0
0 0 0 0 0
0 0 0 20 5530000
0 0 0 15 450000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 299092 109766764
0 0 0 0 0
0 0 0 956 1185440
0 0 0 12180 19743780
0 0 0 0 0
0 0 0 936 1230840
40
0 0 0 0 0
0 0 0 13 215904
0 0 0 3 49824
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 16 0
0 0 0 0 0
0 0 0 0 0
0 0 0 10 0
0 0 0 40 0
0 0 0 50 1999910
0 0 0 0 0
0 0 0 0 0
0 0 0 300 6699000
0 0 0 0 0
0 0 0 0 0
0 0 0 200 2681400
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 227 13608650
0 0 0 40 1128160
0 0 0 205 29037840
0 0 0 600 45771000
0 0 0 0 0
0 0 0 820 17138000
0 0 0 380 7582520
0 0 0 205 2865080
0 0 0 215 3547500
PELAPORAN : Pagar Jati 1 2 3 4 5 6 8 9
1 2 3 4 5 6 8 9
P.JATI P.JATI P.JATI P.JATI P.JATI P.JATI P.JATI P.JATI P.JATI

1 Acyclovir 400 mg tablet tablet 359 0 0 200 71800 0 0 0 0 0 0
tablet 93 0 0 0 0 1,000 93000 0 0 0 0

silva/ 2014 945 0 0 0 0 0 0 0 0 0
4 Albendazole tablet 400 mg tablet 313 0 0 1,000 313000 0 500 156500 0 0 0 0
tablet 88 0 0 0 0 0 0 0 0 0
5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0
7 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 0 0 300 750000 0 0 0 0 0 0
btl 60 ml 2,065 0 0 400 826000 0 200 413000 0 200 413000 0 0

btl 60 ml 2,189 0 0 0 0 0 0 0 0 0
11 Anti Fungi DOEN pot 6,905 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 3,000 327000 0 0 0 3,300 359700 0 0
tablet/ H Baru 446 0 0 0 0 0 0 0 0 0

tablet 176 0 0 0 0 0 0 0 0 0
silva/ 2015 304 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0
15 Betametason krim 0,1% 5 gr tube 4,875 0 0 0 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 200 211200 0 0 0 0 0 0

botol 11,550 0 0 0 0 0 0 0 0 0
21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0

tablet 64 0 0 0 0 500 32000 0 500 32000 0 0
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 1,000 751000 0 1,000 751000 0 700 525700 0 0
29 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 0 0 0 0 0 0 0 0 0

tablet 436 0 0 500 218000 0 500 218000 0 0 0 0

tablet/ H. baru 797 0 0 0 0 0 0 200 159398 0 0
32 Furosemid tablet 40 mg tablet 81 0 0 1,000 81000 0 0 0 0 0 0

34 Garam oralit 200 ml air bks 303 0 0 200 60600 0 500 151500 0 0 0 0
tablet 58 0 0 200 11600 0 500 29000 0 1,300 75400 0 0

tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0

39 Griseofulvin 125 mg Tablet tablet 240 0 0 300 72000 0 500 120000 0 400 96000 0 0

tablet / H.Baru 437 0 0 0 0 0 0 0 0 0
tablet 258 0 0 0 0 3,000 774000 0 1,700 438600 0 0

43 Hustab Tablet
tablet P 312 2000 624000 0 2,000 624000 0 0 0 0 0 0
tablet/ BPJS 312 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 150 1732500 400 4620000 200 2310000 0 0
silva /2014 11,550 0 0 0 0 0 0 0 0 0

botol 8,046 200 1609200 0 150 1206900 0 0 0 0 0 0
botol/ BPJS 8,046 0 200 1609200 0 0 0 0 0 0 0
45 Isoniazid ( INH ) tablet 100 mg tablet 75 0 1,000 75000 0 0 0 0 0 0 0

46 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 0 0 0 0 200 18600 0 0 0 0


50 Kaptopril 12,5 mg tablet 62 0 0 0 0 0 0 0 0 0
51 Kaptopril 25 mg tablet 715 0 0 0 0 500 357500 0 0 0 0
52 Klorpramazine HCl 100 mg tablet - 0 0 0 0 0 0 0 0 0
53 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 0 0 15,000 645000 0 0 0 5,000 215000 0 0

54 Kotrimoksazole Suspensi btl 60ml 2,183 0 0 200 436600 0 0 0 0 0 0
55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 0 0 0 0 0 0 0 0
56 Kodein HCL 10 mg tablet 575 0 0 200 115000 0 0 0 0 0 0

ampul 1,937 0 0 0 0 0 0 0 0 0
57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0

59 MgSO4 20 % ampul 3,200 0 0 0 0 25 80000 0 0 0 0
tablet 133 0 0 0 0 500 66500 0 400 53200 0 0
tablet 106 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0

62 Metil Ergometrin Maleat 0,125 mg tablet 162 0 0 0 0 200 32400 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 0 0 0 0 0 0 0
tablet 133 0 0 10,000 1330000 0 0 0 0 0 0

tablet 264 0 0 0 0 0 0 0 0 0
65 Metronidazole syirup botol 3,800 0 0 250 950000 0 0 0 0 0 0
tablet 107 0 0 300 32001 0 0 0 0 0 0

silva 2015 136 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 0 0 0 0 20 128200 0 0

tablet 549 0 0 0 0 0 0 0 0 0
tablet/ H Baru 630 0 0 0 0 0 0 0 0 0
tablet 803 0 0 0 0 200 160600 0 0 0 0

tablet/ H Baru 886 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 0 0 0 0 0 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0
tablet 51 3,000 153000 0 9,000 459000 0 0 0 0 0 0
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 1,500 246930 3,000 493860 5,000 823100 0 0
silva/ 2015 165 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 300 448800 0 300 448800 0 200 299200 0 0

77 botol 1,184 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 0 0 0 0 0 0 0
78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0
80 Pyridoksin HCI (Vit B6) Tablet tablet 124 0 0 2,500 310000 0 0 0 4,400 545600 0 0
tablet 191 0 0 0 0 0 0 0 0 0
tablet 226 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0

85 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 0 0 500 248500 0 0 0 0 0 0
botol 7,150 0 0 100 715000 0 0 0 0 0 0

Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 300 23400 0 500 39000 0 0 0 0


94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 3,000 180000 0 5,000 300000 0 0 0 0
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 0 0 100 116800 0 100 116800 0 0
tablet 133 0 0 1,500 199500 0 0 0 0 0 0

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0
tablet 289 1000 289000 0 1,000 289000 0 0 0 0 0 0

tablet 880 0 0 0 0 500 440000 0 600 528000 0 0
silva/ 2018 880 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 0 0 0 0 0 0 0 0

100 Tetrasiklin 500 mg kapsul 319 0 0 0 0 500 159500 0 200 63800 0 0

Botol 9,646 0 0 100 964600 0 0 0 0 0 0
Botol 10,293 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 100 629000 0 0 0 50 314500 0 0

3,322 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0



buah 4,180 0 0 0 0 0 0 0 0 0
buah / bpjs 4,180 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 0 0 0 0 0
buah 197 0 0 0 0 0 0 0 0 0
botol 37,950 0 0 1 37950 0 0 0 0 0 0

botol / bpjs 37,950 0 0 0 0 0 0 0 0 0
buah 45,183 0 0 0 0 0 0 12 542196 0 0
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 0 0 12 389892 0 0

buah / bpjs 32,491 0 0 0 0 0 0 0 0 0

buah 52,561 0 0 0 0 0 0 0 0 0
buah / bpjs 52,561 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 12 612264 0 0
buah / bpjs 51,022 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 92 343252 0 0 0 0 0 0 0
botol 3,450 0 0 100 345000 0 0 0 0 0 0
botol / bpjs 3,450 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 0 0 0 0 1 28750 0 0

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0
set 3,850 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0
set 3,520 0 0 100 352000 0 50 176000 0 0 0 0

set / bpjs 3,520 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 10 137500 0 10 137500 0 10 137500 0 0

buah / bpjs 13,750 0 0 0 0 0 0 0 0 0
135 Kapas Pembalut 500 g buah 27,280 0 0 0 0 0 0 0 0 0
buah 30,008 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 150 315000 0 0 0 0 0 0

rol / bpjs 2,100 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 50 82500 0 0 0 0
rol / bpjs 1,650 0 0 0 0 0 0 0 0 0
rol 825 0 0 0 0 0 0 0 0 0
rol / bpjs 825 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0

botol 47,150 0 0 5 235750 0 2 94300 0 0 0 0

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0
146 Masker Tie On

buah / bpjs - 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0

buah 440 0 0 0 0 2,000 880000 0 0 0 0

buah / bpjs 440 0 0 0 0 0 0 0 0 0
rol 81,955 0 0 0 0 0 0 0 0 0
rol / bpjs 81,955 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 0 0 0 0 0 0 0 0
botol 18,818 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 0 0 0 0 0 0 0 0
botol 3,032 0 0 50 151591 0 0 0 0 0 0
botol / bpjs 3,032 0 0 0 0 0 0 0 0 0
buah 6,895 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 0 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 0 0 0 0 0 0 0 0
botol 14,472 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0
166 Urine Bag
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0




Obat Paru - 0 0 0 0 0 0 0 0 0
185 POT SPUTUM BUAH 2,950 0 0 0 0 0 0 0 0 0


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0
190 Reagen Ziehl Neelsen kit 181,811 10 1818110 0 0 0 0 0 0 0 0

192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 1 0 0 0 0 0 0 0 0
Program IFA - 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 0 0 0 0 0 0 0

198 Spritus Liter - 0 0 0 0 0 0 0 0 0


Program HIV - 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 1 28750 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 25 0 0 0 0 0 0 0


212 Alat Suntik Steril buah 1,668 0 0 100 166800 0 0 0 0 0 0

OBAT GIGI - 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 0 1 352000 0 0 0 0 0 0


222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0

224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0

Program TB Paru - 0 0 0 0 0 0 0 0 0
226 OAT FDC Kategori 1 paket 327,259 0 0 0 0 0 0 0 0 0


231 POT SPUTUM BUAH 2,950 200 590000 0 0 0 0 0 0 0 0

233 Kaca Slide Box 30,000 10 300000 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0
tablet 367 0 0 0 0 0 0 0 0 0
Provinsi 367 0 92636 33997412 0 0 0 0 0 0 0
buah/ skipa 1,240 304 376960 0 0 0 0 0 0 0 0

237 Spuit 0,5 ml
buah / apbn 1,621 3873 6278133 0 0 0 0 0 0 0 0
buah/ skipa 1,415 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 297 390555 0 0 0 0 0 0 0 0
Spuit 5 ml APBN 1,705 13 22165

Box 16,608 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 4 66432 0 0 0 0 0 0 0 0
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0

240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0

Obat Rabies - 0 0 0 0 0 0 0 0 0
244 Vaksin Rabies kur - 0 8 0 4 0 0 8 0 0 8 0 0 0
OBAT APBN - 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0


256 Anuscopy buah - 0 0 0 0 0 0 0 0 0


260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0

262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0

266 Handscoen boks - 2 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0

Obat Vaccine - 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 10 599500 10 599500 10 599500 0 10 599500 10 599500 10 599500 0 0
269 CAMPAK VIAL 28,204 0 0 0 0 10 282040 10 282040 10 282040 0 0
270 MR VIAL 141,648 10 1416480 10 1416480 10 1416480 10 1416480 10 1416480 10 1416480 10 1416480 0 0
271 DPT-HB-Hib VIAL 76,285 22 1678270 40 3051400 30 2288550 10 762850 30 2288550 30 2288550 40 3051400 0 0
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0
273 HB-PID-(HB-0) VIAL 20,900 50 1045000 40 836000 30 627000 30 627000 30 627000 30 627000 40 836000 0 0
274 POLIO (BOPV) VIAL 19,954 30 598620 20 399080 0 0 30 598620 30 598620 40 798160 0 0
275 POLIO (IPV) VIAL 13,976 10 139760 10 139760 10 139760 10 139760 10 139760 10 139760 10 139760 0 0
276 Td VIAL 16,500 10 165000 10 165000 10 165000 10 165000 10 165000 10 165000 0 0 0

10 11 12
10 11 12
P.JATI P.JATI P.JATI TOTAL

TOTAL
HARGA
KELUAR
HARGA HARGA HARGA
0 0 0 200 71800
0 0 0 0 0
0 0 0 1000 93000
0 0 0 0 0
0 0 0 1500 469500
0 0 0 0 0
0 0 0 0 0
0 0 0 26000 6890000
0 0 0 300 750000
0 0 0 0 0
0 0 0 8200 516600
0 0 0 800 1652000
0 0 0 0 0
0 0 0 0 0
0 0 0 6300 686700
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 4000 580000
0 0 0 50 145000
0 0 0 200 211200
0 0 0 192 345216
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 288000
0 0 0 1000 64000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 235400
0 0 0 2700 2027700
0 0 0 0 0
0 0 0 30 125010
0 0 0 1000 436000
0 0 0 200 159398
0 0 0 1000 81000
0 0 0 0 0
0 0 0 700 212100
0 0 0 2000 116000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 690000
0 0 0 0 0
0 0 0 0 0
0 0 0 1200 288000
0 0 0 0 0
0 0 0 144 381600
0 0 0 0 0
0 0 0 0 0
0 0 0 4700 1212600
0 0 0 4000 1248000
0 0 0 0 0
0 0 0 750 8662500
0 0 0 0 0
0 0 0 0 0
0 0 0 350 2816100
0 0 0 200 1609200
0 0 0 1000 75000
0 0 0 200 18600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 357500
0 0 0 0 0
0 0 0 20000 860000
0 0 0 200 436600
0 0 0 0 0
0 0 0 200 115000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 25 80000
0 0 0 900 119700
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 30 80520
0 0 0 200 32400
0 0 0 0 0
0 0 0 10000 1330000
0 0 0 0 0
0 0 0 250 950000
0 0 0 96 327360
0 0 0 300 32001
0 0 0 2000 272000
0 0 0 0 0
0 0 0 20 128200
0 0 0 0 0
0 0 0 0 0
0 0 0 200 160600
0 0 0 0 0
0 0 0 0 0
0 0 0 100 179800
0 0 0 0 0
0 0 0 0 0
0 0 0 6300 1033200
0 0 0 12000 612000
0 0 0 9500 1563890
0 0 0 0 0
0 0 0 800 1196800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 6900 855600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 500 248500
0 0 0 0 0
0 0 0 100 715000
0 0 0 0 0
0 0 0 0 0
0 0 0 800 62400
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 5 943315
0 0 0 8000 480000
0 0 0 200 233600
0 0 0 1500 199500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 578000
0 0 0 1100 968000
0 0 0 0 0
0 0 0 0 0
0 0 0 248 3028080
0 0 0 700 223300
0 0 0 9000 756000
0 0 0 13900 1681900
0 0 0 100 964600
0 0 0 0 0
0 0 0 0 0
0 0 0 150 943500
0 0 0 0 0
0 0 0 0 0
0 0 0 5 95025
0 0 0 0 0
0 0 0 0 0
0 0 0 10 1375000
0 0 0 15 5527500
0 0 0 10 1787500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 600 475200
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 1 37950
0 0 0 0 0
0 0 0 12 542196
0 0 0 0 0
0 0 0 12 389892
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 12 612264
0 0 0 0 0
0 0 0 0 0
0 0 0 92 343252
0 0 0 100 345000
0 0 0 0 0
0 0 0 1 28750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 150 528000
0 0 0 0 0
0 0 0 30 412500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 150 315000
0 0 0 0 0
0 0 0 50 82500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 7 330050
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2000 880000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 3 141000
0 0 0 0 0
0 0 0 0 0
0 0 0 3 90000
0 0 0 0 0
0 0 0 0 0
0 0 0 3 49500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 50 151591
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 47050
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 345 185955
0 0 0 4 1210420
0 0 0 0 0
0 0 0 0 0
0 0 0 2 1404500
0 0 0 1000 583000
0 0 0 2 94300
0 0 0 10 1818110
0 0 0 1750 0
0 0 0 0 0
0 0 0 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 122500
0 0 0 2000 3302000
0 0 0 25 0
0 0 0 0 0
0 0 0 1 28750
0 0 0 0 0
0 0 0 25 0
0 0 0 0 0
0 0 0 75 1094250
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 100 166800
0 0 0 0 0
0 0 0 0 0
0 0 0 1 352000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 2519980
0 0 0 0 0
0 0 0 5 1016295
0 0 0 672 0
0 0 0 200 590000
0 0 0 0 0
0 0 0 10 300000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 92636 33997412
0 0 0 0 0
0 0 0 304 376960
0 0 0 3873 6278133
0 0 0 0 0
0 0 0 297 390555
13
0 0 0 0 0
0 0 0 4 66432
0 0 0 2 33216
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 28 0
0 0 0 0 0
0 0 0 2 3970
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 4466000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 60 3597000
0 0 0 30 846120
0 0 0 70 9915360
0 0 0 202 15409570
0 0 0 0 0
0 0 0 250 5225000
0 0 0 150 2993100
0 0 0 70 978320
0 0 0 60 990000
PELAPORAN : Pagar Merbau 1 2 3 4 5 6 8 9 10 11 12
1 2 3 4 5 6 8 9 10 11 12
P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU P.MERBAU TOTAL
HARGA TOTAL
SATUAN KELUAR
1 Acyclovir 400 mg tablet tablet 359 0 0 200 71800 0 0 0 0 0 0 0 0 0 200 71800

tablet 93 0 0 4,000 372000 0 4,000 372000 0 4,000 372000 0 0 0 0 0 12000 1116000
silva/ 2014 945 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 88 0 0 0 0 0 0 400 35200 0 0 0 0 0 400 35200

5 Amlodipine 5 mg
tablet/ H Baru 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Antasida DOEN I Kombinasi tablet 63 0 0 0 0 5,000 315000 0 5,000 315000 0 0 0 0 0 10000 630000
btl 60 ml 2,065 0 0 300 619500 0 200 413000 0 200 413000 0 0 0 0 0 700 1445500
btl 60 ml 2,189 0 0 0 0 0 0 0 0 0 0 0 0 0 0
12 Asam Askorbat (vit C) 50mg tablet 109 0 0 0 0 5,000 545000 0 2,500 272500 0 0 0 0 0 7500 817500
tablet/ H Baru 446 0 0 0 0 0 2,000 891000 5,000 2227500 0 0 0 0 0 7000 3118500
tablet 176 3,000 528000 0 4,000 704000 0 0 0 0 0 0 0 0 0 7000 1232000

silva/ 2015 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva/ 2014 304 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Cholaramfenicol Kapsul 500 mg kapsul 1,056 0 0 2,000 2112000 0 0 0 2,000 2112000 0 0 0 0 0 4000 4224000
botol 11,550 0 0 0 0 0 0 300 3465000 0 0 0 0 0 300 3465000

21 Dextrofen syrup
silva/2015 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Diazepam 2 mg
tablet 95 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 64 0 5,000 320000 5,000 320000 0 5,000 320000 0 7,000 448000 0 0 0 0 0 22000 1408000
tablet/ H. Baru 143 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DAK 2019 114 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Eritromysin kapsul 500 mg tablet 751 0 0 0 0 1,000 751000 0 2,000 1502000 0 0 0 0 0 3000 2253000
tablet 436 0 0 2,000 872000 0 0 0 0 0 0 0 0 0 2000 872000

tablet/ H. baru 797 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 58 0 3,000 174000 7,000 406000 0 2,000 116000 0 2,000 116000 0 0 0 0 0 14000 812000
tablet/ H. Baru 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2015 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0
silva 2014 125 0 0 0 0 0 0 0 0 0 0 0 0 0 0

39 Griseofulvin 125 mg Tablet tablet 240 0 0 5,000 1200000 0 1,000 240000 0 0 0 0 0 0 0 6000 1440000
tablet / H.Baru 437 0 0 0 0 3,600 1573200 0 0 0 0 0 0 0 3600 1573200
tablet 258 0 0 0 0 1,000 258000 0 1,000 258000 0 0 0 0 0 2000 516000

43 Hustab Tablet
tablet P 312 0 1,500 468000 4,000 1248000 0 0 0 0 0 0 0 0 0 5500 1716000
tablet/ BPJS 312 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol/ H. Baru 11,550 0 0 0 0 300 3465000 0 300 3465000 0 0 0 0 0 600 6930000
silva /2014 11,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 8,046 0 200 1609200 50 402300 0 0 0 0 0 0 0 0 0 250 2011500
botol/ BPJS 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0


50 Kaptopril 12,5 mg tablet 62 0 0 0 0 2,000 124000 0 2,000 124000 0 0 0 0 0 4000 248000

51 Kaptopril 25 mg tablet 715 0 0 5,000 3575000 0 0 0 0 0 0 0 0 0 5000 3575000

55 Kotrimoksazol 480 mg komb (DW) tablet 154 0 0 0 0 3,000 462000 0 2,000 308000 0 0 0 0 0 5000 770000
ampul 1,937 0 0 200 387400 0 0 0 0 0 0 0 0 0 200 387400

57 Lidokain Injeksi
ampul/H baru 12,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59 MgSO4 20 % ampul 3,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 133 0 0 5,000 665000 0 2,000 266000 0 0 0 0 0 0 0 7000 931000
tablet 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 106 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Metoclorpramid HCL 10 mg tablet 123 0 0 2,000 246000 0 0 0 0 0 0 0 0 0 2000 246000
tablet 133 0 0 10,000 1330000 0 10,000 1330000 0 0 0 0 0 0 0 20000 2660000

tablet 264 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Mikonazol Cream 2 % tube 3,410 0 0 150 511500 0 0 0 0 0 0 0 0 0 150 511500

tablet 107 0 2,800 298676 5,000 533350 0 2,000 213340 0 0 0 0 0 0 0 9800 1045366

silva 2015 136 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,410 0 0 200 1282000 0 100 641000 0 0 0 0 0 0 0 300 1923000

tablet 549 0 0 200 109800 0 0 0 0 0 0 0 0 0 200 109800

tablet/ H Baru 630 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 803 0 0 500 401500 0 0 0 0 0 0 0 0 0 500 401500
tablet/ H Baru 886 0 0 0 0 0 0 0 0 0 0 0 0 0 0

ampul 1,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul/H baru 1,199 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 51 4000 204000 5,000 255000 11,000 561000 0 0 0 0 0 0 0 0 0 20000 1020000
75 Paracetamol 500 mg (lanamol) tablet 165 0 0 0 0 3,000 493860 3,000 493860 7000 1152340 0 0 0 0 0 13000 2140060
silva/ 2015 165 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 botol 1,496 0 0 600 897600 0 500 748000 0 300 448800 0 0 0 0 0 1400 2094400
77 botol 1,184 0 0 0 0 0 0 0 0 0 0 0 0 0 0
ampul 3,113 0 0 200 622600 0 0 0 0 0 0 0 0 0 200 622600

78 Pehacain Injeksi
ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Prednison 5 mg Tablet tablet 96 0 3000 288000 0 0 0 0 0 0 0 0 0 0 3000 288000
tablet 191 0 0 0 0 0 0 5000 953300 0 0 0 0 0 5000 953300
tablet 226 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2015 660 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Silva 2014 191 0 0 0 0 0 0 0 0 0 0 0 0 0 0


botol 7,150 0 0 600 4290000 0 0 0 0 0 0 0 0 0 600 4290000
Jkn Silva 2015 6,936 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Salap 2-4 pot 2,554 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Salbutamol tablet 2 mg tablet 78 0 0 0 0 0 0 3000 234000 0 0 0 0 0 3000 234000

94 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 0 0 5,000 300000 0 2,000 120000 0 2000 120000 0 0 0 0 0 9000 540000
95 Sianokobalamin (Vit B12) injeksi ampul 1,168 0 0 500 584000 0 500 584000 0 0 0 0 0 0 0 1000 1168000
tablet 133 0 2000 266000 3,000 399000 0 0 0 0 0 0 0 0 0 5000 665000

tablet/ SILVA
2015
117 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 289 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet 880 0 0 0 0 3,000 2640000 0 2000 1760000 0 0 0 0 0 5000 4400000

silva/ 2018 880 0 0 0 0 0 0 0 0 0 0 0 0 0 0
tablet/ BPJS 289 0 2300 664700 0 0 0 0 0 0 0 0 0 0 2300 664700

100 Tetrasiklin 500 mg kapsul 319 0 0 2,000 638000 0 0 0 0 0 0 0 0 0 2000 638000

101 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 0 5000 420000 2,000 168000 0 2,000 168000 0 3000 252000 0 0 0 0 0 12000 1008000
102 Vitamin B komplek Tablet tablet 121 0 5000 605000 10,000 1210000 0 2,000 242000 0 5000 605000 0 0 0 0 0 22000 2662000
Botol 9,646 0 0 200 1929200 0 0 0 0 0 0 0 0 0 200 1929200
Botol 10,293 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 6,290 0 0 50 314500 0 0 0 200 1258000 0 0 0 0 0 250 1572500

3,322 0 0 0 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 50 209000 0 0 0 0 0 0 0 0 0 50 209000

buah / bpjs 4,180 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 4,550 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 792 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 216 0 0 0 0 1,000 216000 0 500 108000 0 0 0 0 0 1500 324000

buah 197 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 37,950 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 37,950 0 30 1138500 0 0 0 0 0 0 0 0 0 0 30 1138500
buah 45,183 0 0 0 0 0 0 12 542196 0 0 0 0 0 12 542196
buah / bpjs 45,183 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 32,491 0 0 0 0 24 779784 0 0 0 0 0 0 0 24 779784
buah / bpjs 32,491 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 52,561 0 0 0 0 0 0 12 630732 0 0 0 0 0 12 630732

buah / bpjs 52,561 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 51,022 0 0 0 0 0 0 12 612264 0 0 0 0 0 12 612264

buah / bpjs 51,022 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Dermafix S IV
buah / bpjs 3,731 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 3,450 0 0 100 345000 0 0 0 0 0 0 0 0 0 100 345000

botol / bpjs 3,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 28,750 0 0 0 0 0 0 1 28750 0 0 0 0 0 1 28750

130 Etanol 70% 1000 ml
botol / bpjs 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 500 4400000 0 0 0 0 0 0 0 0 0 0 500 4400000
set 3,850 0 0 0 0 0 0 0 0 0 0 0 0 0 0
set / bpjs 2,831 0 0 0 0 0 0 0 0 0 0 0 0 0 0

set 3,520 0 0 50 176000 0 50 176000 0 100 352000 0 0 0 0 0 200 704000
set / bpjs 3,520 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 13,750 0 0 0 0 0 0 20 275000 0 0 0 0 0 20 275000
buah / bpjs 13,750 0 2 27500 0 0 0 0 0 0 0 0 0 0 2 27500
buah 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kapas 500 g
buah / bpjs 30,008 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 7,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 2,100 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 1,650 0 0 0 0 100 165000 0 0 0 0 0 0 0 100 165000

rol / bpjs 1,650 0 10 16500 0 0 0 0 0 0 0 0 0 0 10 16500
rol 825 0 0 200 165000 0 0 0 0 0 0 0 0 0 200 165000

rol / bpjs 825 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 8,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol 47,150 0 0 0 0 2 94300 0 0 0 0 0 0 0 2 94300

145 Lisol 100 %
botol / bpjs 47,150 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 363 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 440 0 0 1,000 440000 0 500 220000 0 2,000 880000 0 0 0 0 0 3500 1540000
buah / bpjs 440 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0

rol / bpjs 81,955 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 51,305 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol 28,286 0 0 0 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 28,286 0 30 848593 0 0 0 0 0 0 0 0 0 0 30 848593
botol 18,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 18,818 0 10 188182 0 0 0 0 0 0 0 0 0 0 10 188182
botol 3,032 0 0 0 0 0 0 0 0 0 0 0 0 0 0
botol / bpjs 3,032 0 76 230418 0 0 0 0 0 0 0 0 0 0 76 230418
buah 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah / bpjs 6,895 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 36,582 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Silk 2/0
buah / bpjs 36,582 0 12 438984 0 0 0 0 0 0 0 0 0 0 12 438984
buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Silk 3/0
buah / bpjs - 0 12 0 0 0 0 0 0 0 0 0 0 0 12 0
botol 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 USG GEL
botol / bpjs 14,472 0 0 0 0 0 0 0 0 0 0 0 0 0 0
buah 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Urine Bag
buah / bpjs 3,300 0 0 0 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Obat Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

185 POT SPUTUM BUAH 2,950 0 0 0 0 500 1475000 0 0 0 0 0 0 0 500 1475000


189 Lisol 100 % botol 47,150 0 2 94300 0 0 0 0 0 0 0 0 0 0 2 94300


192 Spritus Liter 45,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Lampu Bunsen Pcs - 0 2 0 0 0 0 0 0 0 0 0 0 0 2 0
Program IFA - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 ASAM CUKA botol - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
197 CHLORIN Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
198 Spritus Liter - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program HIV - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Alkohol 70 % botol 28,750 0 0 0 0 0 0 0 0 0 0 0 0 0 0

204 Vikia HIV 1/2 box - 0 0 0 0 0 0 0 0 0 0 0 0 0 0



OBAT GIGI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 ENDO ICE Botol 352,000 0 2 704000 0 0 0 0 0 0 0 0 0 0 2 704000

222 Denpro Cal LC Dus 184,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 PULP - X Dus 218,700 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

231 POT SPUTUM BUAH 2,950 400 1180000 0 0 0 0 0 0 0 0 0 0 0 400 1180000

233 Kaca Slide Box 30,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 Lancet Box 1,190,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Program Gizi - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Mineral Mix Pcs 3,116 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 367 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Provinsi 367 0 176536 64788712 0 0 0 0 0 0 0 0 0 0 176536 64788712
buah/ skipa 1,240 574 711760 0 0 0 0 0 0 0 0 0 0 0 574 711760

237 Spuit 0,5 ml
buah / apbn 1,621 7313 11854373 0 0 0 0 0 0 0 0 0 0 0 7313 11854373

buah/ skipa 1,415 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Spuit 0,05 ml
APBN 1,315 562 739030 0 0 0 0 0 0 0 0 0 0 0 562 739030
Spuit 5 ml APBN 1,705 25 42625 25
Box 16,608 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239 Safety Box Box / 5ml 16,608 8 132864 0 0 0 0 0 0 0 0 0 0 0 8 132864
Box / 2,5ml 16,608 2 33216 0 0 0 0 0 0 0 0 0 0 0 2 33216
240 RCW Unit 2,266,454 0 0 0 0 0 0 0 0 0 0 0 0 0 0


Obat Rabies - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

249 PH Peper rol 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0



256 Anuscopy buah - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
260 Lens Paper boks 90,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
262 KOH 10 % boks 50,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
266 Handscoen boks - 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0 0 0 0 0 0 0
268 BCG VIAL 59,950 18 1079100 20 1199000 20 1199000 20 1199000 20 1199000 20 1199000 15 899250 0 0 0 0 0 133 7973350
269 CAMPAK VIAL 28,204 0 0 0 0 20 564080 0 0 0 0 0 0 0 20 564080
270 MR VIAL 141,648 0 20 2832960 20 2832960 30 4249440 10 1416480 10 1416480 30 4249440 0 0 0 0 0 120 16997760
271 DPT-HB-Hib VIAL 76,285 70 5339950 40 3051400 45 3432825 70 5339950 60 4577100 70 5339950 65 4958525 0 0 0 0 0 420 32039700
272 DT (BIAS) VIAL 17,798 0 0 0 0 0 0 0 0 0 0 0 0 0 0

273 HB-PID-(HB-0) VIAL 20,900 80 1672000 80 1672000 50 1045000 75 1567500 80 1672000 80 1672000 80 1672000 0 0 0 0 0 525 10972500
274 POLIO (BOPV) VIAL 19,954 60 1197240 40 798160 0 0 50 997700 50 997700 50 997700 0 0 0 0 0 250 4988500
275 POLIO (IPV) VIAL 13,976 10 139760 30 419280 20 279520 20 279520 20 279520 20 279520 20 279520 0 0 0 0 0 140 1956640
276 Td VIAL 16,500 10 165000 0 20 330000 10 165000 20 330000 0 0 0 0 0 0 0 60 990000

REKAP LAPORAN MUTASI OBAT GUDANG FARMASI DINAS KESEHATAN
SUMBER DANA APBD II , BPJS, PROGRAM APBD II, PROGRAM PROPINSI I , APBN DAN VAKSIN KABUPATEN DELI SERDANG
PELAPORAN : JANUARI 2019 1 2 3 4 5 6

1 2 3 4 5 6
GUNUNG MERIAH TIGA JUHAR SIBOLANGIT BANDAR BARU KUTALIMBARU PANCUR BATU SUKA RAYA
MASUK
NO NAMA OBAT SATUAN HARGA SATUAN STOK AWAL SISA NO
BARANG
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH JUMLAH
HARGA HARGA HARGA HARGA HARGA HARGA HARGA
OBAT APBD II
1 Acyclovir 400 mg tablet tablet 359 1,010 1010 0 0 0 0 0 0 0 1
2 Allopurinol 100 mg tablet 93 676,500 676500 0 0 0 0 0 0 0 2

3 Albendazole tablet 400 mg tablet 313 248,470 248470 0 0 0 0 0 0 0 3
4 Amlodipine 5 mg tablet 88 761,560 761560 0 0 0 0 0 0 0 4
5 Amoksisilin 500 mg kapsul 265 2,719,100 2711100 0 0 0 0 0 0 0 5
6 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 2,500 90,550 90550 0 0 0 0 0 0 0 6
7 Antasida DOEN I Kombinasi tablet 63 1,371,400 1369400 0 0 0 0 0 0 0 7
8 Antasida DOEN II Suppensi Kombinasi btl 60 ml 2,065 78,690 78590 0 0 0 0 0 0 0 8
9 Anti Fungi DOEN pot 6,905 8,917 8917 0 0 0 0 0 0 0 9
10 Asam Askorbat (vit C) 50mg tablet 109 1,175,500 1175500 0 0 0 0 0 0 0 10
11 Asam Mefenamat 500 mg tablet 176 73,300 66300 0 0 0 0 0 0 0 11

12 Betametason krim 0,1% 5 gr tube 4,875 14,584 14584 0 0 0 0 0 0 0 12
13 Cetrizin tablet tablet 145 480,500 480000 0 0 0 0 500 72500 0 0 13

15 Cholaramfenicol Kapsul 500 mg kapsul 1,056 261,800 261800 0 0 0 0 0 0 0 15
16 Chloramfenicol salep mata 1 % tube 1,798 10,807 10807 0 0 0 0 0 0 0 16
17 Diazepam 2 mg tablet 45 70,650 70650 0 0 0 0 0 0 0 17
18 Deksametason inj 5mg /ml-1ml ampul 2,880 6,440 6440 0 0 0 0 0 0 0 18
19 Deksametason tablet 0,5 mg tablet 64 1,319,500 1316500 0 0 0 0 0 0 0 19
20 Digoksin tablet 0,25 mg tablet 106 3,210 3210 0 0 0 0 0 0 0 20
21 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 2,354 11,230 11230 0 0 0 0 0 0 0 21
22 Eritromysin kapsul 500 mg tablet 751 366,600 365100 0 0 0 0 0 0 0 22
23 Eritromysin syrup kering 200 mg / 5 ml botol 6,867 4,603 4603 0 0 0 0 0 0 0 23
24 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 2,715 2715 0 0 0 0 0 0 0 24
25 Fito Menadione tablet 10 mg tablet 436 50,000 50000 0 0 0 0 0 0 0 25
26 Furosemid tablet 40 mg tablet 81 372,100 372100 0 0 0 0 0 0 0 26
27 Garam oralit 200 ml air bks 303 39,630 39630 0 0 0 0 0 0 0 27
28 Glibenclamida 5 mg tablet 58 744,502 741502 0 0 0 0 0 0 0 28

29 Glukosa 5% Larutan Infus botol 6,900 16,890 16890 0 0 0 0 0 0 0 29
30 Griseofulvin 125 mg Tablet tablet 240 375,900 373900 0 0 0 0 0 0 0 30

31 Haloperidol tablet 0,5 mg tablet 62 97,300 97300 0 0 0 0 0 0 0 31
32 Hidrokortison Cream 2.5 % tube 2,650 28,586 28538 0 0 0 0 0 0 0 32
33 Hidrokloratiazid 25 mg tablet 156 470,280 470280 0 0 0 0 0 0 0 33
tablet P 312 262,500 246500 0 0 0 0 0 0 0

34 Hustab Tablet 34
tablet / bpjs 312 28,900 28900 0 0 0 0 0 0 0
botol 8,046 4,245 3195 0 0 0 0 0 0 0

35 Hustab syrup 35
botol / bpjs 8,046 4,450 4450 0 0 0 0 0 0 0
36 Isoniazid ( INH ) tablet 100 mg tablet 75 17,800 17800 0 0 0 0 0 0 0 36
37 Isosorbit Dinitrat tablet sublingual 5 mg tablet 93 239,380 239380 0 0 0 0 0 0 0 37
38 Karbamazepin tablet 200 mg tablet 230 98,200 98200 0 0 0 0 0 0 0 38
39 Kaptopril 12,5 mg tablet 62 479,900 479900 0 0 0 0 0 0 0 39

40 Kaptopril 25 mg tablet 715 486,930 486430 0 0 0 0 0 0 0 40
41 Klorpramazine HCl 100 mg tablet 106,000 106000 0 0 0 0 0 0 0 41
42 Kloramfeniramin Maleat (CTM) 4 mg tablet 43 1,585,727 1574727 0 0 0 0 0 0 0 42

43 Kotrimoksazole Suspensi btl 60ml 2,183 92,464 92414 0 0 0 0 0 0 0 43
44 Kotrimoksazol 480 mg komb (DW) tablet 154 765,500 765500 0 0 0 0 0 0 0 44
45 Kodein HCL 10 mg tablet 575 8,400 8400 0 0 0 0 0 0 0 45

46 Lidokain Injeksi ampul 1,937 53,882 53882 0 0 0 0 0 0 0 46
47 Loperramid tablet 2 mg tablet 80 51,100 51100 0 0 0 0 0 0 0 47
48 MgSO4 20 % ampul 3,200 240 240 0 0 0 0 0 0 0 48
49 Metformin tablet 500 mg tablet 133 336,600 336600 0 0 0 0 0 0 0 49

50 Metil Ergometrin Maleat injeksi ampul 2,684 14,968 14968 0 0 0 0 0 0 0 50
51 Metil Ergometrin Maleat 0,125 mg tablet 162 232,300 232300 0 0 0 0 0 0 0 51
52 Metoclorpramid HCL 10 mg tablet 123 232,400 232400 0 0 0 0 0 0 0 52

53 Metronidazol 500 mg tablet 133 801,644 801644 0 0 0 0 0 0 0 53
54 Metronidazole syirup botol 3,800 49,842 49842 0 0 0 0 0 0 0 54
55 Mikonazol Cream 2 % tube 3,410 13,833 13833 0 0 0 0 0 0 0 55

56 Natrium Diklofenak tablet 50 mg tablet 107 211,800 208500 0 0 0 0 500 53335 0 0 56
57 Natrium Klorida larutan infus 0,9% botol 6,410 20,887 20887 0 0 0 0 0 0 0 57
58 Nistatin tablet salut 100.000 IU/g tablet 549 102,540 102540 0 0 0 0 0 0 0 58
59 Nistatin tablet salut 500.000 IU/g tablet 803 97,400 97400 0 0 0 0 0 0 0 59

60 Oksitetrasiklin salep mata 1 % tube 1,798 46,370 46370 0 0 0 0 0 0 0 60
61 Oksitoksin injeksi 10 iv/ml ampul 1,900 30,637 30637 0 0 0 0 0 0 0 61
62 Omeprazole kapsul/kaplet 20 mg tablet 164 324,640 323640 0 0 0 0 0 0 0 62

63 Paracetamol 500 mg (lanamol) tablet 51 451,500 412500 0 0 0 0 0 0 0 63
64 Paracetamol sirup 120 mg/5ml botol 1,496 103,150 103050 0 0 0 0 0 0 0 64

ampul 3,113 19,210 19210 0 0 0 0 0 0 0
65 Pehacain Injeksi 65
ampul / bpjs 3,113 2,660 2660 0 0 0 0 0 0 0
66 Pirantel tablet score 125 mg tablet 308 155,500 155500 0 0 0 0 0 0 0 66
67 Pyridoksin HCI (Vit B6) Tablet tablet 124 1,677,000 1677000 0 0 0 0 0 0 0 67
68 Prednison 5 mg Tablet tablet 96 14,200 14200 0 0 0 0 0 0 0 68
69 Propanolol HCL 10 mg tablet 66 2,400 2400 0 0 0 0 0 0 0 69

70 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 497 19,150 19150 0 0 0 0 0 0 0 70
71 Ringer Laktat laturan infus steril botol 7,150 28,287 28187 0 0 0 0 0 0 0 71
72 Salap 2-4 pot 2,554 430 430 0 0 0 0 0 0 0 72

73 Salbutamol tablet 2 mg tablet 78 443,000 443000 0 0 0 0 0 0 0 73
74 Salbutamol Cairan 0,1 % ampul 4,000 2,450 2450 0 0 0 0 0 0 0 74
76 Sianokobalamin (Vit B12) tablet 50 mg tablet 60 606,500 606500 0 0 0 0 0 0 0 76
77 Sianokobalamin (Vit B12) injeksi ampul 1,168 285,850 285850 0 0 0 0 0 0 0 77
78 Simvastatin tablet 10 mg tablet 133 55,430 54430 0 0 0 0 0 0 0 78

tablet 289 32,600 31600 0 0 0 0 0 0 0
79 Siprofloksasin 500 MG 79
tablet / bpjs 289 21,400 21400 0 0 0 0 0 0 0
80 Sanadryl Syrup botol 12,210 5,340 4900 0 0 0 0 0 0 0 80

81 Tetrasiklin 500 mg kapsul 319 112,900 112900 0 0 0 0 0 0 0 81
82 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 84 658,700 658700 0 0 0 0 0 0 0 82
83 Vitamin B komplek Tablet tablet 121 2,205,000 2205000 0 0 0 0 0 0 0 83
84 Wida Bes Asetat Ringer Infus Botol 9,646 8,460 8460 0 0 0 0 0 0 0 84

85 Zircum syrup 20 mg/5ml botol 6,290 1,734 1734 0 0 0 0 0 0 0 85
OBAT GIGI - 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0
88 Abbocath No.20 G buah 4,180 25,000 24800 0 0 0 0 0 0 0 88

buah 4,180 25,000 24950 0 0 0 0 0 0 0

91 Abbocath No.18 G 91
buah / bpjs 4,180 - 0 0 0 0 0 0 0 0
buah 4,550 385 385 0 0 0 0 0 0 0
92 Abbocath No.26 G 92
buah / bpjs 4,550 - 0 0 0 0 0 0 0 0
buah 792 - 0 0 0 0 0 0 0 0
93 Alat suntik 2,5 ml 23 G 93
buah / bpjs 792 5,510 5510 0 0 0 0 0 0 0
94 Alat suntik 3 ml 24 G X1 buah 792 26,390 25990 0 0 0 0 0 0 0 94
buah 792 - 0 0 0 0 0 0 0 0
95 Alat suntik 3 ml 23 G X1 95
95 Alat suntik 3 ml 23 G X1 95
buah / bpjs 792 100 100 0 0 0 0 0 0 0
96 Alat suntik 5 ML buah 825 1,450 1450 0 0 0 0 0 0 0 96

97 Alkohol Sweb 2 Ply buah 216 51,400 50900 0 0 0 0 0 0 0 97
98 Asepton 500 cc + dispenser botol 24,200 - 0 0 0 0 0 0 0 0 98
botol 37,950 16 16 0 0 0 0 0 0 0
99 Aseptan Gel 500 cc + Dispenser 99
botol / bpjs 37,950 346 346 0 0 0 0 0 0 0
buah 45,183 - 0 0 0 0 0 0 0 0
100 Cat Gut /benang bedah Plain no . 2/0 100
buah / bpjs 45,183 108 108 0 0 0 0 0 0 0
buah 32,491 60 60 0 0 0 0 0 0 0
101 Cat Gut /benang bedah Plain no .3/0 101
buah / bpjs 32,491 132 132 0 0 0 0 0 0 0
buah 52,561 252 252 0 0 0 0 0 0 0

102 Cat Gut /benang bedah CHROMIC no . 2/0 102
buah / bpjs 52,561 60 60 0 0 0 0 0 0 0
buah 51,022 - 0 0 0 0 0 0 0 0
103 Cat Gut /benang bedah CHROMIC no .3/0 103
buah / bpjs 51,022 204 204 0 0 0 0 0 0 0
buah 3,731 - 0 0 0 0 0 0 0 0
104 Dermafix S IV 104
buah / bpjs 3,731 901 901 0 0 0 0 0 0 0
botol 3,450 3,026 3026 0 0 0 0 0 0 0
105 Etakridin (Rivanol) larutan 0,1% 105
botol / bpjs 3,450 583 583 0 0 0 0 0 0 0
botol 28,750 387 387 0 0 0 0 0 0 0

106 Etanol 70% 1000 ml 106
botol / bpjs 28,750 305 305 0 0 0 0 0 0 0
buah 8,800 - 0 0 0 0 0 0 0 0
107 Folly Catheter 2 way no 18 107
buah / bpjs 8,800 1,100 1100 0 0 0 0 0 0 0
set 2,831 3,000 2950 0 0 0 0 0 0 0

108 Infusion Set Anak 108
set / bpjs 2,831 1,030 1030 0 0 0 0 0 0 0
set 3,520 10,000 9700 0 0 0 0 0 0 0

109 Infusion Set Dewasa 109
set / bpjs 3,520 2,955 2955 0 0 0 0 0 0 0
buah 13,750 1,688 1688 0 0 0 0 0 0 0
110 Kapas Pembalut 250 g 110
buah / bpjs 13,750 335 335 0 0 0 0 0 0 0

buah 30,008 - 0 0 0 0 0 0 0 0
112 Kapas 500 g 112
buah / bpjs 30,008 150 150 0 0 0 0 0 0 0
rol 7,700 417 417 0 0 0 0 0 0 0

113 Kasa Pembalut Hid 2 m x 80 cm steril 113
rol / bpjs 7,700 421 421 0 0 0 0 0 0 0
rol 2,100 150 150 0 0 0 0 0 0 0
114 Kasa Pembalut Hid 4 m x 15 cm 114
rol / bpjs 2,100 1,205 1205 0 0 0 0 0 0 0
rol 1,650 2,590 2590 0 0 0 0 0 0 0

115 Kasa Pembalut Hid 4 m x 10 cm 115
rol / bpjs 1,650 1,521 1521 0 0 0 0 0 0 0
rol 825 5,649 5649 0 0 0 0 0 0 0

rol / bpjs 825 1,087 1087 0 0 0 0 0 0 0
buah 8,800 692 672 0 0 0 0 20 176000 0 0

117 Kasa Steril 16 m x 16 cm 117
buah / bpjs 8,800 28,816 28816 0 0 0 0 0 0 0
botol 47,150 199 199 0 0 0 0 0 0 0

120 Lisol 100 % 120
botol / bpjs 47,150 107 107 0 0 0 0 0 0 0
buah 363 6,062 6062 0 0 0 0 0 0 0

121 Masker Tie On 121
buah / bpjs 4,250 4250 0 0 0 0 0 0 0
buah 363 2,000 2000 0 0 0 0 0 0 0
122 Masker 3 Ply Earloop 122
buah / bpjs 363 29,000 29000 0 0 0 0 0 0 0
buah 440 64,000 64000 0 0 0 0 0 0 0

123 Masker Plus 3 Ply Earloop ( Jilbab ) 123
buah / bpjs 440 3,750 3750 0 0 0 0 0 0 0
124 My Jelly 82 gram tube 3 3 0 0 0 0 0 0 0 124
126 One scrub 500 cc + dispenser botol 65,341 24 24 0 0 0 0 0 0 0 126

rol 81,955 129 129 0 0 0 0 0 0 0
127 Pharfix 15 cm x 5 m 127
rol / bpjs 81,955 104 104 0 0 0 0 0 0 0
rol 51,305 - 0 0 0 0 0 0 0 0
rol / bpjs 51,305 126 126 0 0 0 0 0 0 0
rol 28,286 - 0 0 0 0 0 0 0 0
rol / bpjs 28,286 241 241 0 0 0 0 0 0 0
botol 18,818 226 226 0 0 0 0 0 0 0

130 Povidon Iodida 10 % 300 ml 130
botol / bpjs 18,818 295 295 0 0 0 0 0 0 0
botol 3,032 4,474 4474 0 0 0 0 0 0 0

131 Povindo lodida 10% 30 ml 131
botol / bpjs 3,032 524 524 0 0 0 0 0 0 0
buah 6,895 - 0 0 0 0 0 0 0 0
132 Sarung tangan 7,5 132
buah / bpjs 6,895 2,010 2010 0 0 0 0 0 0 0
buah 36,582 - 0 0 0 0 0 0 0 0
133 Silk 2/0 133
buah / bpjs 36,582 240 240 0 0 0 0 0 0 0
buah - 0 0 0 0 0 0 0 0
134 Silk 3/0 134
buah / bpjs 120 120 0 0 0 0 0 0 0
135 Skin Celean 500 ml botol 340 340 0 0 0 0 0 0 0 135

botol 14,472 - 0 0 0 0 0 0 0 0
137 USG GEL 137
botol / bpjs 14,472 135 135 0 0 0 0 0 0 0
buah 3,300 - 0 0 0 0 0 0 0 0
138 Urine Bag 138
buah / bpjs 3,300 1 1 0 0 0 0 0 0 0
REAGENSIA - 0 0 0 0 0 0 0 0

143 Rinse Mindrey galon 1,254,000 2 2 0 0 0 0 0 0 0 143

OBAT PROGRAM APBD - 0 0 0 0 0 0 0 0
Obat Paru - 0 0 0 0 0 0 0 0
144 GARAM ORALIT SACHET 303 74,340 74340 0 0 0 0 0 0 0 144

145 ZINC Tablet TABLET 539 31,400 31400 0 0 0 0 0 0 0 145
147 POT SPUTUM BUAH 2,950 28,500 28500 0 0 0 0 0 0 0 147
148 Object Glass Kotak 19,365 2,000 2000 0 0 0 0 0 0 0 148

149 Tuberculin PPD Vial 702,250 100 89 0 2 1404500 0 0 0 0 0 149
150 Sarung tangan tanpa tepung M buah 583 34,200 34200 0 0 0 0 0 0 0 150
151 Lisol 100 % botol 47,150 75 75 0 0 0 0 0 0 0 151

152 Reagen Ziehl Neelsen kit 242 208 0 0 0 0 0 0 0 152
153 Masker 3 Ply Earloop Jilbab buah 49,900 49900 0 0 0 0 0 0 0 153
154 Spritus Liter 20 20 0 0 0 0 0 0 0 154

155 Lampu Bunsen Pcs 50 50 0 0 0 0 0 0 0 155
156 Imersion Oil Botol 2 2 0 0 0 0 0 0 0 156
Program IFA - 0 0 0 0 0 0 0 0
157 KAPAS LIDI Bungkus 40 40 0 0 0 0 0 0 0 157

158 ASAM CUKA botol 190 190 0 0 0 0 0 0 0 158
159 CHLORIN Liter 38 38 0 0 0 0 0 0 0 159
160 Spritus Liter 230 230 0 0 0 0 0 0 0 160

Program Imunisasi 1,404 - 0 0 0 0 0 0 0 0
161 Alat suntik 0,05 ml set 1,225 8,711 8711 0 0 0 0 0 0 0 161
162 Alat suntik 0,5 ml set 1,651 189,314 189314 0 0 0 0 0 0 0 162

163 Safety Box 5 liter box 2,060 2060 0 0 0 0 0 0 0 163
Program HIV - 0 0 0 0 0 0 0 0
164 BD Vacuntainer box 2,600 2600 0 0 0 0 0 0 0 164
165 Vikia HIV 1/2 box 350 350 0 0 0 0 0 0 0 165


169 Masker Plus 3 Ply Earloop ( Jilbab ) buah 440 400 400 0 0 0 0 0 0 0 169
170 Sarung tangan tanpa tepung M buah 583 1,000 1000 0 0 0 0 0 0 0 170
171 Standard Q Shyphilis Ab kit 675 675 0 0 0 0 0 0 0 171
OBAT GIGI - 0 0 0 0 0 0 0 0
172 ENDO ICE BOTOL 352,000 50 50 0 0 0 0 0 0 0 172
OBAT PROGRAM PROVINSI - 0 0 0 0 0 0 0 0
Program TB Paru - 0 0 0 0 0 0 0 0
173 OAT FDC Kategori 1 paket 327,259 2,711 2395 0 5 1636295 0 0 0 0 16 5236144 173
175 OAT FDC Kategori 1 Kombipak paket 302,605 6 0 0 6 1815630 0 0 0 0 0 175
176 RH ( Fase Lanjutan ) paket 16,800 16800 0 0 0 0 0 0 0 176

177 POT SPUTUM BUAH 2,950 4,400 1400 0 0 0 0 0 0 0 177
178 REAGEN TB PARU KIT 276,500 1,700 1700 0 0 0 0 0 0 0 178
179 Kaca Slide Box 30,000 955 930 0 0 0 0 0 0 0 179
180 Lancet Box 1,190,000 3 3 0 0 0 0 0 0 0 180

Program Gizi - 0 0 0 0 0 0 0 0
tablet 367 - 0 0 0 0 0 0 0 0
181 Tablet Tambah Darah 181
Provinsi 367 8,456,000 8456000 0 0 0 0 0 0 0
Program Imunisasi - 0 0 0 0 0 0 0 0
buah/ skipa 1,240 27,800 27800 0 0 0 0 0 0 0

182 Spuit 0,5 ml 182
buah / apbn 1,621 354,300 354300 0 0 0 0 0 0 0
BUAH 1,315 - 0 0 0 0 0 0 0 0
183 Spuit 0,05 ml 183
APBN 1,315 27,200 27200 0 0 0 0 0 0 0
Box 16,608 - 0 0 0 0 0 0 0 0
184 Safety Box Box / 5ml 16,608 375 375 0 0 0 0 0 0 0 184

Box / 2,5ml 16,608 100 100 0 0 0 0 0 0 0
185 RCW Unit 2,266,454 14 14 0 0 0 0 0 0 0 185
Obat Rabies - 0 0 0 0 0 0 0 0
186 Vaksin Rabies kur 64 20 0 16 0 0 0 0 0 0 186
OBAT APBN - 0 0 0 0 0 0 0 0

188 Benzatin Phenisillin 2,4 jt vial 27 27 0 0 0 0 0 0 0 188
189 Fluconazol tablet TABLET 27 27 0 0 0 0 0 0 0 189
191 PH Peper rol 239 19 19 0 0 0 0 0 0 0 191

192 RPR Sifilis ( FOCUS ) Test 4,300 11,000 11000 0 0 0 0 0 0 0 192
193 Rapid Test I ( SD HIV 1/2) Test 22,330 1,400 1000 0 0 0 0 0 0 0 193
194 Rapid Test Sifilis Test 13,407 3,210 3150 0 0 0 0 0 0 0 194

195 Anuscopy buah 4 4 0 0 0 0 0 0 0 195
196 Yellow Tips bungkus 8 8 0 0 0 0 0 0 0 196

197 Blue Tips bungkus 5 5 0 0 0 0 0 0 0 197
198 Metilen Blue botol 94,500 5 5 0 0 0 0 0 0 0 198

199 Lens Paper boks 90,000 5 5 0 0 0 0 0 0 0 199
200 Jarum Vacutainer boks 21,500 1 1 0 0 0 0 0 0 0 200
201 KOH 10 % boks 50,000 1 1 0 0 0 0 0 0 0 201
202 Cotton Aplicator boks 135,000 8 8 0 0 0 0 0 0 0 202

203 Object Glass Kotak 5 5 0 0 0 0 0 0 0 203
204 Cover Glass Kotak 18 18 0 0 0 0 0 0 0 204
205 Handscoen boks 131 127 0 0 0 0 0 0 0 205

206 Disposable Needle No 18 boks 25,000 10 10 0 0 0 0 0 0 0 206
OBAT APBN PUSAT - 0 0 0 0 0 0 0 0
Obat Vaccine - 0 0 0 0 0 0 0 0
207 BCG VIAL 59,950 999 999 0 0 0 0 0 0 0 207

208 MR VIAL 141,648 2,263 1678 0 0 0 10 1416480 0 40 5665920 0 208
209 DPT-HB-Hib VIAL 76,285 3000 272 0 0 10 762850 23 1754555 80 6102800 120 9154200 30 2288550 209
210 DT (BIAS) VIAL 17,798 117 117 0 0 0 0 0 0 0 210

211 HB-PID-(HB-0) VIAL 20,900 1,750 3600 2165 0 0 10 209000 20 418000 100 2090000 110 2299000 25 522500 211
212 POLIO (BOPV) VIAL 19,954 1,778 1778 0 0 0 0 0 0 0 212
213 POLIO (IPV) VIAL 13,976 670 800 725 0 0 10 139760 10 139760 20 279520 40 559040 5 69880 213
218 Td VIAL 16,500 155 500 211 0 0 0 5 82500 20 330000 40 660000 0 218
0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0
244 Sarung tangan 7,5 244
buah / bpjs 0 0 0 0 0 0 0 0
245 Sarung tangan gynecolog 7,5 buah 0 0 0 0 0 0 0 0 245
246 Sarung tangan tanpa tepung M buah 0 0 0 0 0 0 0 0 246

247 Sarung tangan tanpa tepung S buah 0 0 0 0 0 0 0 0 247
248 Sarung tangan/hancun buah 0 0 0 0 0 0 0 0 248
buah 0 0 0 0 0 0 0 0
249 Silk 2/0 249
buah / bpjs 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0
250 Silk 3/0 250
buah / bpjs 0 0 0 0 0 0 0 0
251 Suction Catether No 8 buah 0 0 0 0 0 0 0 0 251

252 Suction Catether No 16 buah 0 0 0 0 0 0 0 0 252
253 Softpad ( Underpad ) 60x90cm Bag buah 0 0 0 0 0 0 0 0 253

254 Stimulen Collagen Gel tube 0 0 0 0 0 0 0 0 254
255 Stimulen Collagen Lotion botol 0 0 0 0 0 0 0 0 255

256 Skin Celean 500 ml botol 0 0 0 0 0 0 0 0 256
257 Tranfusion Set buah 0 0 0 0 0 0 0 0 257
258 Tree Way Stop Cock Kotak 0 0 0 0 0 0 0 0 258
259 Tes Hamil buah 0 0 0 0 0 0 0 0 259

botol 0 0 0 0 0 0 0 0
260 USG GEL 260
botol bpjs 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0
261 Urine Bag 261
buah / bpjs 0 0 0 0 0 0 0 0
262 Urobag 2000 Steril T Valve buah 0 0 0 0 0 0 0 0 262
263 Wall Bracket Hand Wash Plastik buah 0 0 0 0 0 0 0 0 263
264 Wing Needle 19G buah 0 0 0 0 0 0 0 0 264


269 WIN FLON 18 G buah 0 0 0 0 0 0 0 0 269
270 WIN FLON 20 G buah 0 0 0 0 0 0 0 0 270

271 WIN FLON 22 G buah 0 0 0 0 0 0 0 0 271
272 WIN FLON 24 G buah 0 0 0 0 0 0 0 0 272
273 WIN FLON 26 G buah 0 0 0 0 0 0 0 0 273
REAGENSIA 0 0 0 0 0 0 0 0
274 Diluen Samsung Unit 0 0 0 0 0 0 0 0 274
275 Cleaner Samsung Unit 0 0 0 0 0 0 0 0 275
276 Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0 276

277 Lise Samsung Unit 0 0 0 0 0 0 0 0 277
278 Rinse Mindrey galon 0 0 0 0 0 0 0 0 278
279 Probe Cleanser Mindrey botol 0 0 0 0 0 0 0 0 279

280 Diluen Mindrey galon 0 0 0 0 0 0 0 0 280
281 Calibration Serum kit 0 0 0 0 0 0 0 0 281
282 QC Serum kit 0 0 0 0 0 0 0 0 282
283 Billirubin kit 0 0 0 0 0 0 0 0 283

284 AST kit 0 0 0 0 0 0 0 0 284
285 ALT kit 0 0 0 0 0 0 0 0 285
286 Creatine kit 0 0 0 0 0 0 0 0 286

287 Ureum Nitrogen kit 0 0 0 0 0 0 0 0 287
288 Detecto HB S Antigen buah 0 0 0 0 0 0 0 0 288

289 Gluco Protein Tes Urine buah 0 0 0 0 0 0 0 0 289
290 Hcl 0,1 N 100 ml botol 0 0 0 0 0 0 0 0 290

291 Resecker botol 0 0 0 0 0 0 0 0 291
292 Widal Set Incl Control set 0 0 0 0 0 0 0 0 292
293 Ziehl Neelsen Set 5 x100 ml set 0 0 0 0 0 0 0 0 293
OBAT PROGRAM APBD 0 0 0 0 0 0 0 0

Obat Paru 0 0 0 0 0 0 0 0
294 GARAM ORALIT SACHET 0 0 0 0 0 0 0 0 294
295 OAT KAT I PAKET 0 0 0 0 0 0 0 0 295

296 OAT KAT II PAKET 0 0 0 0 0 0 0 0 296
297 OAT KAT ANAK PAKET 0 0 0 0 0 0 0 0 297
298 ZINC Tablet TABLET 0 0 0 0 0 0 0 0 298
299 OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 0 0 299

300 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 300
301 Object Glass Kotak 0 0 0 0 0 0 0 0 301

303 Etanol 70% 1000 ml botol 0 0 0 0 0 0 0 0 303
304 Lisol 100 % botol 0 0 0 0 0 0 0 0 304
305 Reagen Ziehl Neelsen kit 0 0 0 0 0 0 0 0 305

306 Kaca Slide Box 0 0 0 0 0 0 0 0 306
307 Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0 307
308 Spritus Liter 0 0 0 0 0 0 0 0 308
309 Lampu Bunsen Pcs 0 0 0 0 0 0 0 0 309

310 Imersion Oil Botol 0 0 0 0 0 0 0 0 310
Program IFA 0 0 0 0 0 0 0 0
311 KAPAS LIDI Bungkus 0 0 0 0 0 0 0 0 311

312 ASAM CUKA botol 0 0 0 0 0 0 0 0 312
313 CHLORIN Liter 0 0 0 0 0 0 0 0 313
314 Spritus Liter 0 0 0 0 0 0 0 0 314

Program Imunisasi 0 0 0 0 0 0 0 0
315 Alat suntik 0,05 ml set 0 0 0 0 0 0 0 0 315
316 Alat suntik 0,5 ml set 0 0 0 0 0 0 0 0 316
317 Alat suntik 5 ml set 0 0 0 0 0 0 0 0 317

318 Safety Box 5 liter box 0 0 0 0 0 0 0 0 318
Program HIV 0 0 0 0 0 0 0 0
319 Rapid Test I ( SD HIV 1/2) Test 0 0 0 0 0 0 0 0 319

320 Fokus Anti HIV 1/2 Cassete Test 0 0 0 0 0 0 0 0 320
321 BD Vacuntainer box 0 0 0 0 0 0 0 0 321

322 Vikia HIV 1/2 box 0 0 0 0 0 0 0 0 322

324 Rapid Test II ( FOKUS ) Test 0 0 0 0 0 0 0 0 324
325 RPR Sifilis ( FOCUS ) Test 0 0 0 0 0 0 0 0 325
326 Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0 326

328 Handscoen boks 0 0 0 0 0 0 0 0 328
329 Standard Q Shyphilis Ab kit 0 0 0 0 0 0 0 0 329
OBAT GIGI 0 0 0 0 0 0 0 0
330 Articulating paper PART DC Kotak 0 0 0 0 0 0 0 0 330
331 ENDO ICE BOTOL 0 0 0 0 0 0 0 0 331
332 FUJI IX ART 1-1 BOTOL 0 0 0 0 0 0 0 0 332
333 GUTTA PERCHA DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 333

334 PAPER POINT DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 334
335 CAL LC DENPRO PCS 0 0 0 0 0 0 0 0 335
336 CHKM(paraformal dehide 20 mg) PCS 0 0 0 0 0 0 0 0 336

337 Syiring Refil +shade A3-LA/APAC (Resin komposit) SET 0 0 0 0 0 0 0 0 337
338 PULP X (DEVITALIZER) 5g Denpro PCS 0 0 0 0 0 0 0 0 338
339 Iodotin technodent PCS 0 0 0 0 0 0 0 0 339

OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0
Program TB Paru 0 0 0 0 0 0 0 0
340 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0 0 340
341 OAT FDC Kategori 1 paket 0 0 0 0 0 0 0 0 341

342 OAT FDC Kategori 2 paket 0 0 0 0 0 0 0 0 342
343 OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0 343
344 OAT FDC Kategori Anak paket 0 0 0 0 0 0 0 0 344

345 RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0 345
346 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 346
347 REAGEN TB PARU KIT 0 0 0 0 0 0 0 0 347

348 Kaca Slide Box 0 0 0 0 0 0 0 0 348
349 Human Hexagon Sypilis KIT 0 0 0 0 0 0 0 0 349
350 Alkohol Sweb Box 0 0 0 0 0 0 0 0 350
351 Lancet Box 0 0 0 0 0 0 0 0 351

352 Sarung Tangan Karet Pasang 0 0 0 0 0 0 0 0 352
353 Safety Box Box 0 0 0 0 0 0 0 0 353
354 Mikroskop dan kotak Unit 0 0 0 0 0 0 0 0 354

Program Gizi 0 0 0 0 0 0 0 0
Kabsul 0 0 0 0 0 0 0 0
355 VIT A 100.000 UI BIRU 355
355 VIT A 100.000 UI BIRU 355
Kabsul/ provinsi 0 0 0 0 0 0 0 0
Kabsul 0 0 0 0 0 0 0 0
356 VIT A 200.000 UI MERAH 356
Kabsul/ provinsi 0 0 0 0 0 0 0 0
357 Nifas Merah tablet 0 0 0 0 0 0 0 0 357
358 Mineral Mix Kotak 0 0 0 0 0 0 0 0 358
359 ZINC Tablet tablet 0 0 0 0 0 0 0 0 359

tablet 0 0 0 0 0 0 0 0
360 Tablet Tambah Darah 360
tablet/ provinsi 0 0 0 0 0 0 0 0
361 PMT Balita (MP ASI) Kotak 0 0 0 0 0 0 0 0 361

362 PMT Anak Sekolah Kotak 0 0 0 0 0 0 0 0 362
363 PMT Bumil Kek Kotak 0 0 0 0 0 0 0 0 363
Program Kesehatan Ibu 0 0 0 0 0 0 0 0
364 Gentamicin Injeksi 40 mg/ml ampul 0 0 0 0 0 0 0 0 364
365 Oxytocin injeksi ampul 0 0 0 0 0 0 0 0 365
366 Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0 366
367 Fito Medanion (Vit K1) 10mg/ml-1ml injeksi ampul 0 0 0 0 0 0 0 0 367
Program Kesehatan Anak 0 0 0 0 0 0 0 0
368 Levotiroksin 100 mg tablet 0 0 0 0 0 0 0 0 368

369 Fenobarbital Injeksi 50 mg/ml ampul 0 0 0 0 0 0 0 0 369
Program Imunisasi 0 0 0 0 0 0 0 0
Buah/ Skipa 0 0 0 0 0 0 0 0
370 Spuit 0,5 ml 370
buah/ Apbn 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0
371 Spuit 0,05 ml 371
BUAH 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0
372 Spuit 5 ml 372
BUAH 0 0 0 0 0 0 0 0
373 Kipi Kit BUAH 0 0 0 0 0 0 0 0 373
374 vaccine carrer BUAH 0 0 0 0 0 0 0 0 374

375 Spuit 0,5 ml BUAH 0 0 0 0 0 0 0 0 375
Box 0 0 0 0 0 0 0 0
376 Safety Box Box / 5ml 0 0 0 0 0 0 0 0 376

Box / 2,5ml 0 0 0 0 0 0 0 0
377 RCW Unit 0 0 0 0 0 0 0 0 377
Obat Flu Burung 0 0 0 0 0 0 0 0

378 Oseltamivir Kapsul 0 0 0 0 0 0 0 0 378
Obat Rabies 0 0 0 0 0 0 0 0
379 Vaksin Rabies kur 0 0 0 0 0 0 0 0 379

OBAT APBN 0 0 0 0 0 0 0 0
380 Acyclovir 400 mg tablet 0 0 0 0 0 0 0 0 380

381 Alkohol Swab buah 0 0 0 0 0 0 0 0 381
382 Benzatin Phenisillin 2,4 jt vial 0 0 0 0 0 0 0 0 382
383 Clindamicin 150 mg tablet 0 0 0 0 0 0 0 0 383
384 Fluconazol tablet tablet 0 0 0 0 0 0 0 0 384

385 Kondom Laki-laki pcs 0 0 0 0 0 0 0 0 385
386 Mikropipet Variabel buah 0 0 0 0 0 0 0 0 386
387 Paket Kombipak HIV paket 0 0 0 0 0 0 0 0 387

388 PH Peper rol 0 0 0 0 0 0 0 0 388
389 RPR Sifilis Test 0 0 0 0 0 0 0 0 389
390 RPR Sifilis ( FOCUS ) Test 0 0 0 0 0 0 0 0 390
391 Rapid Test I ( SD HIV 1/2) Test 0 0 0 0 0 0 0 0 391

392 Rapid Test II ( Intec) Test 0 0 0 0 0 0 0 0 392
393 Rapid Test II ( FOKUS ) Test 0 0 0 0 0 0 0 0 393
394 Rapid Test III ( Oncoprobe) Test 0 0 0 0 0 0 0 0 394

395 Rapid Test Sifilis Test 0 0 0 0 0 0 0 0 395
396 Rotator buah 0 0 0 0 0 0 0 0 396
397 Tabung Vacutainer pack 0 0 0 0 0 0 0 0 397

398 Vikia HIV 1/2 buah 0 0 0 0 0 0 0 0 398
399 Anuscopy buah 0 0 0 0 0 0 0 0 399
400 LUBRICANT 82 mg buah 0 0 0 0 0 0 0 0 400
401 Yellow Tips bungkus 0 0 0 0 0 0 0 0 401

402 Blue Tips bungkus 0 0 0 0 0 0 0 0 402
403 Plesterin Bulat boks 0 0 0 0 0 0 0 0 403
404 Metilen Blue botol 0 0 0 0 0 0 0 0 404

405 Lens Paper boks 0 0 0 0 0 0 0 0 405
406 Jarum Vacutainer boks 0 0 0 0 0 0 0 0 406
407 KOH 10 % boks 0 0 0 0 0 0 0 0 407

408 Cotton Aplicator boks 0 0 0 0 0 0 0 0 408
410 Cover Glass Kotak 0 0 0 0 0 0 0 0 410
411 Handscoen boks 0 0 0 0 0 0 0 0 411

412 Disposable Needle No 18 boks 0 0 0 0 0 0 0 0 412
413 Reagen CD4 Test 0 0 0 0 0 0 0 0 413
OBAT APBN PUSAT 0 0 0 0 0 0 0 0

Obat Vaccine 0 0 0 0 0 0 0 0
414 BCG VIAL 0 0 0 0 0 0 0 0 414

415 Campak VIAL 0 0 0 0 0 0 0 0 415
416 MR VIAL 0 0 0 0 0 0 0 0 416

417 DPT-HB-Hib VIAL 0 0 0 0 0 0 0 0 417
418 DT (BIAS) VIAL 0 0 0 0 0 0 0 0 418
419 HB-PID-(HB-0) VIAL 0 0 0 0 0 0 0 0 419
420 POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0 420

421 POLIO (IPV) VIAL 0 0 0 0 0 0 0 0 421
422 Td VIAL 0 0 0 0 0 0 0 0 422
TOTAL
8 9 10 11 12 13 14 15 17 18
8 9 10 11 12 13 14 15 17 18
NAMO RAMBE BIRU-BIRU TALUN KENAS BANGUN PURBA GALANG PETUMBUKAN TANJUNG MORAWA DALU X PATUMBAK DELI TUA MULIYOREJO
NAMA OBAT SATUAN
TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL TOTAL
HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA HARGA
OBAT APBD II
Acyclovir 400 mg tablet tablet 0 0 0 0 0 0 0 0 0 0 0
Allopurinol 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Albendazole tablet 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Amlodipine 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Amoksisilin 500 mg kapsul 5,000 1325000 0 0 0 0 0 0 0 0 0 0
Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 0 0 0 0 0 0 0 0 0 0 0
Antasida DOEN I Kombinasi tablet 0 0 0 0 0 0 0 0 0 0 0
Antasida DOEN II Suppensi Kombinasi btl 60 ml 0 0 0 0 0 0 0 0 0 0 0
Anti Fungi DOEN pot 0 0 0 0 0 0 0 0 0 0 0
Asam Askorbat (vit C) 50mg tablet 0 0 0 0 0 0 0 0 0 0 0
Asam Mefenamat 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Betametason krim 0,1% 5 gr tube 0 0 0 0 0 0 0 0 0 0 0
Cetrizin tablet tablet 0 0 0 0 0 0 0 0 0 0 0
Cetrizin syrup botol 0 0 0 0 0 0 0 0 0 0 0

Cholaramfenicol Kapsul 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
Chloramfenicol salep mata 1 % tube 0 0 0 0 0 0 0 0 0 0 0
Diazepam 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Deksametason inj 5mg /ml-1ml ampul 0 0 0 0 0 0 0 0 0 0 0
Deksametason tablet 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 3,000 192000
Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai
ampul 0 0 0 0 0 0 0 0 0 0 0
HCL)
Eritromysin kapsul 500 mg tablet 0 0 0 0 0 0 0 0 0 0 1,000 751000
Eritromysin syrup kering 200 mg / 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 0 0 0 0 0 0 0 0 0 0 0

Fito Menadione tablet 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Furosemid tablet 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Garam oralit 200 ml air bks 0 0 0 0 0 0 0 0 0 0 0
Glibenclamida 5 mg tablet 0 0 0 0 0 0 0 0 0 0 3,000 174000

Glukosa 5% Larutan Infus botol 0 0 0 0 0 0 0 0 0 0 0
Griseofulvin 125 mg Tablet tablet 0 0 0 0 0 0 0 0 0 0 2,000 480000

Haloperidol tablet 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Hidrokortison Cream 2.5 % tube 0 0 0 0 0 0 0 0 0 0 0
Hidrokloratiazid 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
tablet P 2,000 624000 0 0 0 0 0 0 0 0 0 3,000 936000

Hustab Tablet
tablet / bpjs 0 0 0 0 0 0 0 0 0 0 0
botol 200 1609200 0 0 0 0 0 0 0 0 0 0

Hustab syrup
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
Isoniazid ( INH ) tablet 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Isosorbit Dinitrat tablet sublingual 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Karbamazepin tablet 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Kaptopril 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Kaptopril 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Klorpramazine HCl 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Kloramfeniramin Maleat (CTM) 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Kotrimoksazole Suspensi btl 60ml 0 0 0 0 0 0 0 0 0 0 0
Kotrimoksazol 480 mg komb (DW) tablet 0 0 0 0 0 0 0 0 0 0 0
Kodein HCL 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Lidokain Injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
Loperramid tablet 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
MgSO4 20 % ampul 0 0 0 0 0 0 0 0 0 0 0
Metformin tablet 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
Metil Ergometrin Maleat 0,125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Metoclorpramid HCL 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Metronidazol 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Metronidazole syirup botol 0 0 0 0 0 0 0 0 0 0 0
Mikonazol Cream 2 % tube 0 0 0 0 0 0 0 0 0 0 0

Natrium Diklofenak tablet 50 mg tablet 2,800 298676 0 0 0 0 0 0 0 0 0 0
Natrium Klorida larutan infus 0,9% botol 0 0 0 0 0 0 0 0 0 0 0
Nistatin tablet salut 100.000 IU/g tablet 0 0 0 0 0 0 0 0 0 0 0
Nistatin tablet salut 500.000 IU/g tablet 0 0 0 0 0 0 0 0 0 0 0

Oksitetrasiklin salep mata 1 % tube 0 0 0 0 0 0 0 0 0 0 0
Oksitoksin injeksi 10 iv/ml ampul 0 0 0 0 0 0 0 0 0 0 0
Omeprazole kapsul/kaplet 20 mg tablet 0 0 0 0 0 0 0 0 0 0 1,000 164000

Paracetamol 500 mg (lanamol) tablet 5,000 255000 0 0 0 1,000 51000 0 0 0 0 0 5,000 255000
Paracetamol sirup 120 mg/5ml botol 0 0 0 0 0 0 0 0 0 0 0

ampul 0 0 0 0 0 0 0 0 0 0 0
Pehacain Injeksi
ampul / bpjs 0 0 0 0 0 0 0 0 0 0 0
Pirantel tablet score 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Pyridoksin HCI (Vit B6) Tablet tablet 0 0 0 0 0 0 0 0 0 0 0
Prednison 5 mg Tablet tablet 0 0 0 0 0 0 0 0 0 0 0
Propanolol HCL 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 0 0 0 0 0 0 0 0 0 0 0
Ringer Laktat laturan infus steril botol 0 0 0 0 0 0 0 0 0 0 0
Salap 2-4 pot 0 0 0 0 0 0 0 0 0 0 0

Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Salbutamol Cairan 0,1 % ampul 0 0 0 0 0 0 0 0 0 0 0
Salisil Bedak 2,5% bks 0 0 0 0 0 0 0 0 0 0 0
Sianokobalamin (Vit B12) tablet 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Sianokobalamin (Vit B12) injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
Simvastatin tablet 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0

tablet 0 0 0 0 0 0 0 0 0 0 0
Siprofloksasin 500 MG
tablet / bpjs 0 0 0 0 0 0 0 0 0 0 0
Sanadryl Syrup botol 0 0 0 0 0 0 0 0 0 0 96 1172160

Tetrasiklin 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
Tiamin HCI (Vit B1.) Tablet 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Vitamin B komplek Tablet tablet 0 0 0 0 0 0 0 0 0 0 0
Wida Bes Asetat Ringer Infus Botol 0 0 0 0 0 0 0 0 0 0 0

Zircum syrup 20 mg/5ml botol 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI 0 0 0 0 0 0 0 0 0 0 0
Eugenol cairan botol 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI 0 0 0 0 0 0 0 0 0 0 0
Accu Check safe T Pro Uno Dus 0 0 0 0 0 0 0 0 0 0 0
Abbocath No.20 G buah 0 0 0 0 50 209000 0 0 0 0 0 50 209000

Abbocath No.22 G buah 0 0 0 0 50 209000 0 0 0 0 0 0
Abbocath No.24 G buah 0 0 0 0 50 209000 0 0 0 0 0 0
buah 0 0 0 0 50 209000 0 0 0 0 0 0
Abbocath No.18 G
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Abbocath No.26 G
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Alat suntik 2,5 ml 23 G
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Alat suntik 3 ml 24 G X1 buah 0 0 0 0 100 79200 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Alat suntik 3 ml 23 G X1
Alat suntik 3 ml 23 G X1
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Alat suntik 5 ML buah 0 0 0 0 0 0 0 0 0 0 0

Alkohol Sweb 2 Ply buah 0 0 0 0 0 0 0 0 0 0 0
Asepton 500 cc + dispenser botol 0 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0 0
Aseptan Gel 500 cc + Dispenser
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Cat Gut /benang bedah Plain no . 2/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Cat Gut /benang bedah Plain no .3/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Cat Gut /benang bedah CHROMIC no . 2/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Cat Gut /benang bedah CHROMIC no .3/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Dermafix S IV
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0 0
Etakridin (Rivanol) larutan 0,1%
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0 0
Etanol 70% 1000 ml
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Folly Catheter 2 way no 18
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
set 0 0 0 0 0 0 0 0 0 0 0
Infusion Set Anak
set / bpjs 0 0 0 0 0 0 0 0 0 0 0
set 0 0 0 0 50 176000 0 0 0 0 0 100 352000

Infusion Set Dewasa
set / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Kapas Pembalut 250 g
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Kapas Pembalut 500 g buah 0 0 0 0 0 0 0 0 0 0 0

buah 0 0 0 0 0 0 0 0 0 0 0
Kapas 500 g
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0 0
Kasa Pembalut Hid 2 m x 80 cm steril
rol / bpjs 0 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0 0
Kasa Pembalut Hid 4 m x 15 cm
rol / bpjs 0 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0 0
Kasa Pembalut Hid 4 m x 10 cm
rol / bpjs 0 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0 0
rol / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Kasa Steril 16 m x 16 cm
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Kasa Steril 40 x 40 buah 0 0 0 0 0 0 0 0 0 0 0
Kasa Steril 5 x 5 buah 0 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0 0
Lisol 100 %
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Masker Tie On
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Masker 3 Ply Earloop
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Masker Plus 3 Ply Earloop ( Jilbab )
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
My Jelly 82 gram tube 0 0 0 0 0 0 0 0 0 0 0
Object Glass Kotak 0 0 0 0 0 0 0 0 0 0 0
One scrub 500 cc + dispenser botol 0 0 0 0 0 0 0 0 0 0 0

rol 0 0 0 0 0 0 0 0 0 0 0
Pharfix 15 cm x 5 m
rol / bpjs 0 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0 0
Pharfix 10 cm x 5 m
rol / bpjs 0 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0 0
Pharfix 5 cm x 5 m
rol / bpjs 0 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0 0
Povidon Iodida 10 % 300 ml
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0 0
Povindo lodida 10% 30 ml
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Sarung tangan 7,5
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Silk 2/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Silk 3/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Skin Celean 500 ml botol 0 0 0 0 0 0 0 0 0 0 0

Tranfusion Set buah 0 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0 0
USG GEL
botol / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Urine Bag
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA 0 0 0 0 0 0 0 0 0 0 0
Diluen Samsung Unit 0 0 0 0 0 0 0 0 0 0 0

Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0 0
Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0 0
Lise Samsung Unit 0 0 0 0 0 0 0 0 0 0 0
Rinse Mindrey galon 0 0 0 0 0 0 0 0 0 0 0

OBAT PROGRAM APBD 0 0 0 0 0 0 0 0 0 0 0
Obat Paru 0 0 0 0 0 0 0 0 0 0 0
GARAM ORALIT SACHET 0 0 0 0 0 0 0 0 0 0 0

ZINC Tablet TABLET 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 0 0 0 0 0
POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0 0 0

Tuberculin PPD Vial 0 0 0 0 0 0 7 4915750 0 0 0 0
Sarung tangan tanpa tepung M buah 0 0 0 0 0 0 0 0 0 0 0
Lisol 100 % botol 0 0 0 0 0 0 0 0 0 0 0

Reagen Ziehl Neelsen kit 0 0 0 0 0 0 0 0 0 0 0
Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0 0 0 0
Spritus Liter 0 0 0 0 0 0 0 0 0 0 0
Lampu Bunsen Pcs 0 0 0 0 0 0 0 0 0 0 0
Imersion Oil Botol 0 0 0 0 0 0 0 0 0 0 0
Program IFA 0 0 0 0 0 0 0 0 0 0 0
KAPAS LIDI Bungkus 0 0 0 0 0 0 0 0 0 0 0

ASAM CUKA botol 0 0 0 0 0 0 0 0 0 0 0
CHLORIN Liter 0 0 0 0 0 0 0 0 0 0 0
Spritus Liter 0 0 0 0 0 0 0 0 0 0 0
Program Imunisasi 0 0 0 0 0 0 0 0 0 0 0
Alat suntik 0,05 ml set 0 0 0 0 0 0 0 0 0 0 0

Safety Box 5 liter box 0 0 0 0 0 0 0 0 0 0 0
Program HIV 0 0 0 0 0 0 0 0 0 0 0
BD Vacuntainer box 0 0 0 0 0 0 0 0 0 0 0
Vikia HIV 1/2 box 0 0 0 0 0 0 0 0 0 0 0

Rapid Test II ( FOKUS ) Test 0 0 0 0 0 0 0 0 0 0 0
RPR Sifilis ( FOCUS ) Test 0 0 0 0 0 0 0 0 0 0 0

Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0 0 0 0

Standard Q Shyphilis Ab kit 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI 0 0 0 0 0 0 0 0 0 0 0
ENDO ICE BOTOL 0 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori 1 paket 0 0 0 16 5236144 0 0 16 5236144 0 0 0 0

OAT FDC Kategori 2 paket 0 0 0 0 0 1 1259990 0 1 1259990 0 0 0
OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0 0 0 0
RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0 0 0 0

POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0 0 0
REAGEN TB PARU KIT 0 0 0 0 0 0 0 0 0 0 0
Kaca Slide Box 0 0 0 0 5 150000 0 0 0 0 0 0
Lancet Box 0 0 0 0 0 0 0 0 0 0 0
Program Gizi 0 0 0 0 0 0 0 0 0 0 0
tablet 0 0 0 0 0 0 0 0 0 0 0
Tablet Tambah Darah
Provinsi 0 0 0 0 0 0 0 0 0 0 0
buah/ skipa 0 0 0 0 0 0 0 0 0 0 0
Spuit 0,5 ml
buah / apbn 0 0 0 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0 0 0 0
Spuit 0,05 ml
APBN 0 0 0 0 0 0 0 0 0 0 0
Box 0 0 0 0 0 0 0 0 0 0 0
Safety Box Box / 5ml 0 0 0 0 0 0 0 0 0 0 0

Box / 2,5ml 0 0 0 0 0 0 0 0 0 0 0
RCW Unit 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies 0 0 0 0 0 0 0 0 0 0 0
Vaksin Rabies kur 0 8 0 4 0 0 0 8 0 0 0 4 0 0 0
OBAT APBN 0 0 0 0 0 0 0 0 0 0 0
Alkohol Swab buah 0 0 3 5955 0 0 0 0 0 0 0 0

Benzatin Phenisillin 2,4 jt vial 0 0 0 0 0 0 0 0 0 0 0
Fluconazol tablet TABLET 0 0 0 0 0 0 0 0 0 0 0
Paket Kombipak HIV paket 0 0 0 10 399982 0 0 0 0 0 0 0
PH Peper rol 0 0 0 0 0 0 0 0 0 0 0
Rapid Test I ( SD HIV 1/2) Test 0 0 300 6699000 100 2233000 0 0 0 0 0 0 0
Rapid Test Sifilis Test 0 0 60 804420 0 0 0 0 0 0 0 0

Anuscopy buah 0 0 0 0 0 0 0 0 0 0 0
Yellow Tips bungkus 0 0 0 0 0 0 0 0 0 0 0

Blue Tips bungkus 0 0 0 0 0 0 0 0 0 0 0
Metilen Blue botol 0 0 0 0 0 0 0 0 0 0 0

Lens Paper boks 0 0 0 0 0 0 0 0 0 0 0
Jarum Vacutainer boks 0 0 0 0 0 0 0 0 0 0 0
KOH 10 % boks 0 0 0 0 0 0 0 0 0 0 0
Cotton Aplicator boks 0 0 0 0 0 0 0 0 0 0 0

Cover Glass Kotak 0 0 0 0 0 0 0 0 0 0 0
Handscoen boks 0 0 3 0 1 0 0 0 0 0 0 0 0
Disposable Needle No 18 boks 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT 0 0 0 0 0 0 0 0 0 0 0
Obat Vaccine 0 0 0 0 0 0 0 0 0 0 0
BCG VIAL 0 0 0 0 0 0 0 0 0 0 0
MR VIAL 0 0 10 1416480 0 0 0 0 70 9915360 20 2832960 50 7082400 70 9915360
DPT-HB-Hib VIAL 80 6102800 60 4577100 70 5339950 40 3051400 65 4958525 60 4577100 170 12968450 50 3814250 200 15257000 120 9154200 260 19834100
DT (BIAS) VIAL 0 0 0 0 0 0 0 0 0 0 0
HB-PID-(HB-0) VIAL 80 1672000 60 1254000 70 1463000 30 627000 70 1463000 40 836000 200 4180000 15 313500 130 2717000 120 2508000 280 5852000
POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0 0 0 0
POLIO (IPV) VIAL 25 349400 15 209640 20 279520 20 279520 10 139760 10 139760 30 419280 40 559040 40 559040 30 419280 70 978320
Td VIAL 20 330000 15 247500 10 165000 10 165000 10 165000 14 231000 25 412500 0 30 495000 20 330000 20 330000
0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Sarung tangan 7,5
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Sarung tangan gynecolog 7,5 buah 0 0 0 0 0 0 0 0 0 0 0

Sarung tangan tanpa tepung S buah 0 0 0 0 0 0 0 0 0 0 0
Sarung tangan/hancun buah 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Silk 2/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Silk 3/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Suction Catether No 8 buah 0 0 0 0 0 0 0 0 0 0 0

Suction Catether No 16 buah 0 0 0 0 0 0 0 0 0 0 0
Softpad ( Underpad ) 60x90cm Bag buah 0 0 0 0 0 0 0 0 0 0 0

Stimulen Collagen Gel tube 0 0 0 0 0 0 0 0 0 0 0
Stimulen Collagen Lotion botol 0 0 0 0 0 0 0 0 0 0 0

Skin Celean 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
Tranfusion Set buah 0 0 0 0 0 0 0 0 0 0 0
Tree Way Stop Cock Kotak 0 0 0 0 0 0 0 0 0 0 0
Tes Hamil buah 0 0 0 0 0 0 0 0 0 0 0

botol 0 0 0 0 0 0 0 0 0 0 0
USG GEL
botol bpjs 0 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0 0
Urine Bag
buah / bpjs 0 0 0 0 0 0 0 0 0 0 0
Urobag 2000 Steril T Valve buah 0 0 0 0 0 0 0 0 0 0 0
Wall Bracket Hand Wash Plastik buah 0 0 0 0 0 0 0 0 0 0 0
Wing Needle 19G buah 0 0 0 0 0 0 0 0 0 0 0


WIN FLON 18 G buah 0 0 0 0 0 0 0 0 0 0 0
WIN FLON 20 G buah 0 0 0 0 0 0 0 0 0 0 0

WIN FLON 22 G buah 0 0 0 0 0 0 0 0 0 0 0
WIN FLON 24 G buah 0 0 0 0 0 0 0 0 0 0 0
WIN FLON 26 G buah 0 0 0 0 0 0 0 0 0 0 0
REAGENSIA 0 0 0 0 0 0 0 0 0 0 0
Diluen Samsung Unit 0 0 0 0 0 0 0 0 0 0 0
Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0 0
Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0 0

Lise Samsung Unit 0 0 0 0 0 0 0 0 0 0 0
Rinse Mindrey galon 0 0 0 0 0 0 0 0 0 0 0
Probe Cleanser Mindrey botol 0 0 0 0 0 0 0 0 0 0 0

Diluen Mindrey galon 0 0 0 0 0 0 0 0 0 0 0
Calibration Serum kit 0 0 0 0 0 0 0 0 0 0 0
QC Serum kit 0 0 0 0 0 0 0 0 0 0 0
Billirubin kit 0 0 0 0 0 0 0 0 0 0 0
AST kit 0 0 0 0 0 0 0 0 0 0 0
ALT kit 0 0 0 0 0 0 0 0 0 0 0
Creatine kit 0 0 0 0 0 0 0 0 0 0 0
Ureum Nitrogen kit 0 0 0 0 0 0 0 0 0 0 0
Detecto HB S Antigen buah 0 0 0 0 0 0 0 0 0 0 0

Gluco Protein Tes Urine buah 0 0 0 0 0 0 0 0 0 0 0
Hcl 0,1 N 100 ml botol 0 0 0 0 0 0 0 0 0 0 0

Resecker botol 0 0 0 0 0 0 0 0 0 0 0
Widal Set Incl Control set 0 0 0 0 0 0 0 0 0 0 0
Ziehl Neelsen Set 5 x100 ml set 0 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD 0 0 0 0 0 0 0 0 0 0 0

Obat Paru 0 0 0 0 0 0 0 0 0 0 0
GARAM ORALIT SACHET 0 0 0 0 0 0 0 0 0 0 0
OAT KAT I PAKET 0 0 0 0 0 0 0 0 0 0 0

OAT KAT II PAKET 0 0 0 0 0 0 0 0 0 0 0
OAT KAT ANAK PAKET 0 0 0 0 0 0 0 0 0 0 0
ZINC Tablet TABLET 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 0 0 0 0 0

POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0 0 0

Etanol 70% 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
Lisol 100 % botol 0 0 0 0 0 0 0 0 0 0 0
Reagen Ziehl Neelsen kit 0 0 0 0 0 0 0 0 0 0 0

Kaca Slide Box 0 0 0 0 0 0 0 0 0 0 0
Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0 0 0 0
Spritus Liter 0 0 0 0 0 0 0 0 0 0 0
Lampu Bunsen Pcs 0 0 0 0 0 0 0 0 0 0 0

Imersion Oil Botol 0 0 0 0 0 0 0 0 0 0 0
Program IFA 0 0 0 0 0 0 0 0 0 0 0
KAPAS LIDI Bungkus 0 0 0 0 0 0 0 0 0 0 0

ASAM CUKA botol 0 0 0 0 0 0 0 0 0 0 0
CHLORIN Liter 0 0 0 0 0 0 0 0 0 0 0
Spritus Liter 0 0 0 0 0 0 0 0 0 0 0
Alat suntik 5 ml set 0 0 0 0 0 0 0 0 0 0 0

Safety Box 5 liter box 0 0 0 0 0 0 0 0 0 0 0
Program HIV 0 0 0 0 0 0 0 0 0 0 0
Rapid Test I ( SD HIV 1/2) Test 0 0 0 0 0 0 0 0 0 0 0

Fokus Anti HIV 1/2 Cassete Test 0 0 0 0 0 0 0 0 0 0 0
BD Vacuntainer box 0 0 0 0 0 0 0 0 0 0 0
Vikia HIV 1/2 box 0 0 0 0 0 0 0 0 0 0 0

Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0 0 0 0

Handscoen boks 0 0 0 0 0 0 0 0 0 0 0
Standard Q Shyphilis Ab kit 0 0 0 0 0 0 0 0 0 0 0
OBAT GIGI 0 0 0 0 0 0 0 0 0 0 0
Articulating paper PART DC Kotak 0 0 0 0 0 0 0 0 0 0 0
ENDO ICE BOTOL 0 0 0 0 0 0 0 0 0 0 0
FUJI IX ART 1-1 BOTOL 0 0 0 0 0 0 0 0 0 0 0
GUTTA PERCHA DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 0 0 0

PAPER POINT DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 0 0 0
CAL LC DENPRO PCS 0 0 0 0 0 0 0 0 0 0 0
CHKM(paraformal dehide 20 mg) PCS 0 0 0 0 0 0 0 0 0 0 0

Syiring Refil +shade A3-LA/APAC (Resin komp SET 0 0 0 0 0 0 0 0 0 0 0
PULP X (DEVITALIZER) 5g Denpro PCS 0 0 0 0 0 0 0 0 0 0 0
Iodotin technodent PCS 0 0 0 0 0 0 0 0 0 0 0

OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0 0 0 0
Program TB Paru 0 0 0 0 0 0 0 0 0 0 0
Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori 1 paket 0 0 0 0 0 0 0 0 0 0 0

OAT FDC Kategori 2 paket 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0 0 0 0
OAT FDC Kategori Anak paket 0 0 0 0 0 0 0 0 0 0 0

RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0 0 0 0
POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0 0 0
REAGEN TB PARU KIT 0 0 0 0 0 0 0 0 0 0 0

Kaca Slide Box 0 0 0 0 0 0 0 0 0 0 0
Human Hexagon Sypilis KIT 0 0 0 0 0 0 0 0 0 0 0
Alkohol Sweb Box 0 0 0 0 0 0 0 0 0 0 0
Lancet Box 0 0 0 0 0 0 0 0 0 0 0
Sarung Tangan Karet Pasang 0 0 0 0 0 0 0 0 0 0 0
Safety Box Box 0 0 0 0 0 0 0 0 0 0 0
Mikroskop dan kotak Unit 0 0 0 0 0 0 0 0 0 0 0

Program Gizi 0 0 0 0 0 0 0 0 0 0 0
Kabsul 0 0 0 0 0 0 0 0 0 0 0
VIT A 100.000 UI BIRU
VIT A 100.000 UI BIRU Kabsul/
0 0 0 0 0 0 0 0 0 0 0
provinsi
Kabsul 0 0 0 0 0 0 0 0 0 0 0
VIT A 200.000 UI MERAH Kabsul/
0 0 0 0 0 0 0 0 0 0 0
provinsi
Nifas Merah tablet 0 0 0 0 0 0 0 0 0 0 0
Mineral Mix Kotak 0 0 0 0 0 0 0 0 0 0 0
ZINC Tablet tablet 0 0 0 0 0 0 0 0 0 0 0

tablet 0 0 0 0 0 0 0 0 0 0 0
Tablet Tambah Darah tablet/
0 0 0 0 0 0 0 0 0 0 0
provinsi
PMT Balita (MP ASI) Kotak 0 0 0 0 0 0 0 0 0 0 0
PMT Anak Sekolah Kotak 0 0 0 0 0 0 0 0 0 0 0
PMT Bumil Kek Kotak 0 0 0 0 0 0 0 0 0 0 0
Program Kesehatan Ibu 0 0 0 0 0 0 0 0 0 0 0
Gentamicin Injeksi 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
Oxytocin injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
Fito Medanion (Vit K1) 10mg/ml-1ml injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
Program Kesehatan Anak 0 0 0 0 0 0 0 0 0 0 0
Levotiroksin 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Fenobarbital Injeksi 50 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
Buah/ Skipa 0 0 0 0 0 0 0 0 0 0 0
Spuit 0,5 ml
buah/ Apbn 0 0 0 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0 0 0 0
Spuit 0,05 ml
BUAH 0 0 0 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0 0 0 0
Spuit 5 ml
BUAH 0 0 0 0 0 0 0 0 0 0 0
Kipi Kit BUAH 0 0 0 0 0 0 0 0 0 0 0
vaccine carrer BUAH 0 0 0 0 0 0 0 0 0 0 0

Spuit 0,5 ml BUAH 0 0 0 0 0 0 0 0 0 0 0
Box 0 0 0 0 0 0 0 0 0 0 0
Safety Box Box / 5ml 0 0 0 0 0 0 0 0 0 0 0

Box / 2,5ml 0 0 0 0 0 0 0 0 0 0 0
RCW Unit 0 0 0 0 0 0 0 0 0 0 0
Obat Flu Burung 0 0 0 0 0 0 0 0 0 0 0

Oseltamivir Kapsul 0 0 0 0 0 0 0 0 0 0 0
Obat Rabies 0 0 0 0 0 0 0 0 0 0 0
Vaksin Rabies kur 0 0 0 0 0 0 0 0 0 0 0

OBAT APBN 0 0 0 0 0 0 0 0 0 0 0
Acyclovir 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0

Alkohol Swab buah 0 0 0 0 0 0 0 0 0 0 0
Benzatin Phenisillin 2,4 jt vial 0 0 0 0 0 0 0 0 0 0 0
Clindamicin 150 mg tablet 0 0 0 0 0 0 0 0 0 0 0
Fluconazol tablet tablet 0 0 0 0 0 0 0 0 0 0 0

Kondom Laki-laki pcs 0 0 0 0 0 0 0 0 0 0 0
Mikropipet Variabel buah 0 0 0 0 0 0 0 0 0 0 0
Paket Kombipak HIV paket 0 0 0 0 0 0 0 0 0 0 0

PH Peper rol 0 0 0 0 0 0 0 0 0 0 0
RPR Sifilis Test 0 0 0 0 0 0 0 0 0 0 0
Rapid Test I ( SD HIV 1/2) Test 0 0 0 0 0 0 0 0 0 0 0

Rapid Test II ( Intec) Test 0 0 0 0 0 0 0 0 0 0 0
Rapid Test III ( Oncoprobe) Test 0 0 0 0 0 0 0 0 0 0 0

Rapid Test Sifilis Test 0 0 0 0 0 0 0 0 0 0 0
Rotator buah 0 0 0 0 0 0 0 0 0 0 0
Tabung Vacutainer pack 0 0 0 0 0 0 0 0 0 0 0

Vikia HIV 1/2 buah 0 0 0 0 0 0 0 0 0 0 0
Anuscopy buah 0 0 0 0 0 0 0 0 0 0 0
LUBRICANT 82 mg buah 0 0 0 0 0 0 0 0 0 0 0
Yellow Tips bungkus 0 0 0 0 0 0 0 0 0 0 0

Blue Tips bungkus 0 0 0 0 0 0 0 0 0 0 0
Plesterin Bulat boks 0 0 0 0 0 0 0 0 0 0 0
Metilen Blue botol 0 0 0 0 0 0 0 0 0 0 0

Lens Paper boks 0 0 0 0 0 0 0 0 0 0 0
Jarum Vacutainer boks 0 0 0 0 0 0 0 0 0 0 0
KOH 10 % boks 0 0 0 0 0 0 0 0 0 0 0
Cotton Aplicator boks 0 0 0 0 0 0 0 0 0 0 0
Cover Glass Kotak 0 0 0 0 0 0 0 0 0 0 0
Handscoen boks 0 0 0 0 0 0 0 0 0 0 0
Disposable Needle No 18 boks 0 0 0 0 0 0 0 0 0 0 0
Reagen CD4 Test 0 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT 0 0 0 0 0 0 0 0 0 0 0

Obat Vaccine 0 0 0 0 0 0 0 0 0 0 0
BCG VIAL 0 0 0 0 0 0 0 0 0 0 0
Campak VIAL 0 0 0 0 0 0 0 0 0 0 0
MR VIAL 0 0 0 0 0 0 0 0 0 0 0
DPT-HB-Hib VIAL 0 0 0 0 0 0 0 0 0 0 0
DT (BIAS) VIAL 0 0 0 0 0 0 0 0 0 0 0
HB-PID-(HB-0) VIAL 0 0 0 0 0 0 0 0 0 0 0
POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0 0 0 0

POLIO (IPV) VIAL 0 0 0 0 0 0 0 0 0 0 0
Td VIAL 0 0 0 0 0 0 0 0 0 0 0
19 21 22 23 25 26 27 28
19 20 21 22 23 25 26 27 28
SEI MENCIRIM SEI SEMAYANG H PERAK K. DATAR L DELI P JOHAR B KHALIPAH T. REJO KENANGAN B. KUIS
NO NAMA OBAT SATUAN
OBAT APBD II
2 Allopurinol 100 mg tablet 0 0 0 0 0 0 0 0 0 0

3 Albendazole tablet 400 mg tablet 0 0 0 0 0 0 0 0 0 0
4 Amlodipine 5 mg tablet 0 0 0 0 0 0 0 0 0 0
5 Amoksisilin 500 mg kapsul 2,000 530000 0 0 0 0 0 0 0 0 0
6 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 0 0 0 0 0 0 0 0 0 0
7 Antasida DOEN I Kombinasi tablet 0 0 0 0 0 0 0 0 0 0
8 Antasida DOEN II Suppensi Kombinasi btl 60 ml 100 206500 0 0 0 0 0 0 0 0 0
9 Anti Fungi DOEN pot 0 0 0 0 0 0 0 0 0 0
10 Asam Askorbat (vit C) 50mg tablet 0 0 0 0 0 0 0 0 0 0
11 Asam Mefenamat 500 mg tablet 1,000 176000 0 0 0 0 0 0 0 0 0

12 Betametason krim 0,1% 5 gr tube 0 0 0 0 0 0 0 0 0 0
13 Cetrizin tablet tablet 0 0 0 0 0 0 0 0 0 0
14 Cetrizin syrup botol 0 0 0 0 0 0 0 0 0 0

15 Cholaramfenicol Kapsul 500 mg kapsul 0 0 0 0 0 0 0 0 0 0
16 Chloramfenicol salep mata 1 % tube 0 0 0 0 0 0 0 0 0 0
17 Diazepam 2 mg tablet 0 0 0 0 0 0 0 0 0 0
18 Deksametason inj 5mg /ml-1ml ampul 0 0 0 0 0 0 0 0 0 0
19 Deksametason tablet 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0
20 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0
21 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 0 0 0 0 0 0 0 0 0 0

22 Eritromysin kapsul 500 mg tablet 500 375500 0 0 0 0 0 0 0 0 0
23 Eritromysin syrup kering 200 mg / 5 ml botol 0 0 0 0 0 0 0 0 0 0
24 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 0 0 0 0 0 0 0 0 0 0

25 Fito Menadione tablet 10 mg tablet 0 0 0 0 0 0 0 0 0 0
26 Furosemid tablet 40 mg tablet 0 0 0 0 0 0 0 0 0 0
28 Glibenclamida 5 mg tablet 0 0 0 0 0 0 0 0 0 0
29 Glukosa 5% Larutan Infus botol 0 0 0 0 0 0 0 0 0 0
30 Griseofulvin 125 mg Tablet tablet 0 0 0 0 0 0 0 0 0 0

32 Hidrokortison Cream 2.5 % tube 0 0 0 0 0 0 0 48 127200 0 0
tablet P 0 0 0 0 0 0 3,000 936000 3,000 936000 0 3,000 936000

34 Hustab Tablet
tablet / bpjs 0 0 0 0 0 0 0 0 0 0
botol 100 804600 0 0 0 0 0 200 1609200 200 1609200 0 100 804600

35 Hustab syrup
botol / bpjs 0 0 0 0 0 0 0 0 0 0
39 Kaptopril 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0

40 Kaptopril 25 mg tablet 0 0 0 0 0 0 0 0 0 0
41 Klorpramazine HCl 100 mg tablet 0 0 0 0 0 0 0 0 0 0
42 Kloramfeniramin Maleat (CTM) 4 mg tablet 5,000 215000 0 0 0 0 0 5,000 215000 0 0 0

43 Kotrimoksazole Suspensi btl 60ml 0 0 0 0 0 0 0 0 0 0
44 Kotrimoksazol 480 mg komb (DW) tablet 0 0 0 0 0 0 0 0 0 0

46 Lidokain Injeksi ampul 0 0 0 0 0 0 0 0 0 0
48 MgSO4 20 % ampul 0 0 0 0 0 0 0 0 0 0
49 Metformin tablet 500 mg tablet 0 0 0 0 0 0 0 0 0 0

50 Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0 0 0
51 Metil Ergometrin Maleat 0,125 mg tablet 0 0 0 0 0 0 0 0 0 0
52 Metoclorpramid HCL 10 mg tablet 0 0 0 0 0 0 0 0 0 0

53 Metronidazol 500 mg tablet 0 0 0 0 0 0 0 0 0 0
54 Metronidazole syirup botol 0 0 0 0 0 0 0 0 0 0
55 Mikonazol Cream 2 % tube 0 0 0 0 0 0 0 0 0 0

57 Natrium Klorida larutan infus 0,9% botol 0 0 0 0 0 0 0 0 0 0
58 Nistatin tablet salut 100.000 IU/g tablet 0 0 0 0 0 0 0 0 0 0
59 Nistatin tablet salut 500.000 IU/g tablet 0 0 0 0 0 0 0 0 0 0

60 Oksitetrasiklin salep mata 1 % tube 0 0 0 0 0 0 0 0 0 0
61 Oksitoksin injeksi 10 iv/ml ampul 0 0 0 0 0 0 0 0 0 0
62 Omeprazole kapsul/kaplet 20 mg tablet 0 0 0 0 0 0 0 0 0 0

63 Paracetamol 500 mg (lanamol) tablet 2,000 102000 0 0 0 0 0 6000 306000 5000 255000 0 4000 204000
64 Paracetamol sirup 120 mg/5ml botol 100 149600 0 0 0 0 0 0 0 0 0

ampul 0 0 0 0 0 0 0 0 0 0
65 Pehacain Injeksi
ampul / bpjs 0 0 0 0 0 0 0 0 0 0
67 Pyridoksin HCI (Vit B6) Tablet tablet 0 0 0 0 0 0 0 0 0 0

71 Ringer Laktat laturan infus steril botol 100 715000 0 0 0 0 0 0 0 0 0
72 Salap 2-4 pot 0 0 0 0 0 0 0 0 0 0

73 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 0 0 0 0
74 Salbutamol Cairan 0,1 % ampul 0 0 0 0 0 0 0 0 0 0
75 Salisil Bedak 2,5% bks 0 0 0 0 0 0 0 0 0 0
76 Sianokobalamin (Vit B12) tablet 50 mg tablet 0 0 0 0 0 0 0 0 0 0
77 Sianokobalamin (Vit B12) injeksi ampul 0 0 0 0 0 0 0 0 0 0
78 Simvastatin tablet 10 mg tablet 1,000 133000 0 0 0 0 0 0 0 0 0

tablet 0 0 0 0 0 0 0 1,000 289000 0 0
tablet / bpjs 0 0 0 0 0 0 0 0 0 0
80 Sanadryl Syrup botol 0 0 0 0 0 0 96 1172160 0 0 100 1221000

81 Tetrasiklin 500 mg kapsul 0 0 0 0 0 0 0 0 0 0
82 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 0 0 0 0 0 0 0 0 0 0
83 Vitamin B komplek Tablet tablet 0 0 0 0 0 0 0 0 0 0
84 Wida Bes Asetat Ringer Infus Botol 0 0 0 0 0 0 0 0 0 0

85 Zircum syrup 20 mg/5ml botol 0 0 0 0 0 0 0 0 0 0
OBAT GIGI 0 0 0 0 0 0 0 0 0 0
86 Eugenol cairan botol 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI 0 0 0 0 0 0 0 0 0 0
87 Accu Check safe T Pro Uno Dus 0 0 0 0 0 0 0 0 0 0
88 Abbocath No.20 G buah 50 209000 0 0 0 0 0 0 0 0 0

buah 0 0 0 0 0 0 0 0 0 0
91 Abbocath No.18 G
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
92 Abbocath No.26 G
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
94 Alat suntik 3 ml 24 G X1 buah 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0

97 Alkohol Sweb 2 Ply buah 0 0 0 0 0 0 0 0 0 0
98 Asepton 500 cc + dispenser botol 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0
botol / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
101 Cat Gut /benang bedah Plain no .3/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
104 Dermafix S IV
buah / bpjs 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0
botol / bpjs 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0
106 Etanol 70% 1000 ml
botol / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
set 0 0 0 0 0 0 0 0 0 0
108 Infusion Set Anak
set / bpjs 0 0 0 0 0 0 0 0 0 0
set 0 0 0 0 0 0 0 0 0 100 352000

set / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
111 Kapas Pembalut 500 g buah 0 0 0 0 0 0 0 0 0 0

buah 0 0 0 0 0 0 0 0 0 0
112 Kapas 500 g
buah / bpjs 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0
rol / bpjs 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0
rol / bpjs 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0
rol / bpjs 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0
rol / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
118 Kasa Steril 40 x 40 buah 0 0 0 0 0 0 0 0 0 0
119 Kasa Steril 5 x 5 buah 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0
120 Lisol 100 %
botol / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
121 Masker Tie On
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
124 My Jelly 82 gram tube 0 0 0 0 0 0 0 0 0 0
126 One scrub 500 cc + dispenser botol 0 0 0 0 0 0 0 0 0 0

rol 0 0 0 0 0 0 0 0 0 0
127 Pharfix 15 cm x 5 m
rol / bpjs 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0
rol / bpjs 0 0 0 0 0 0 0 0 0 0
rol 0 0 0 0 0 0 0 0 0 0
rol / bpjs 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0
botol / bpjs 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0
botol / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
133 Silk 2/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
134 Silk 3/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0

136 Tranfusion Set buah 0 0 0 0 0 0 0 0 0 0
botol 0 0 0 0 0 0 0 0 0 0
137 USG GEL
botol / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
138 Urine Bag
buah / bpjs 0 0 0 0 0 0 0 0 0 0
REAGENSIA 0 0 0 0 0 0 0 0 0 0
139 Diluen Samsung Unit 0 0 0 0 0 0 0 0 0 0

140 Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0
141 Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0
142 Lise Samsung Unit 0 0 0 0 0 0 0 0 0 0
143 Rinse Mindrey galon 0 0 0 0 0 0 0 0 0 0

OBAT PROGRAM APBD 0 0 0 0 0 0 0 0 0 0
Obat Paru 0 0 0 0 0 0 0 0 0 0

146 OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 20 6052100 0 0 0
147 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0 0

149 Tuberculin PPD Vial 0 0 0 0 0 0 0 0 0 0
151 Lisol 100 % botol 0 0 0 0 0 0 0 0 0 0

153 Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0 0 0
154 Spritus Liter 0 0 0 0 0 0 0 0 0 0

155 Lampu Bunsen Pcs 0 0 0 0 0 0 0 0 0 0
Program IFA 0 0 0 0 0 0 0 0 0 0

158 ASAM CUKA botol 0 0 0 0 0 0 0 0 0 0
159 CHLORIN Liter 0 0 0 0 0 0 0 0 0 0
160 Spritus Liter 0 0 0 0 0 0 0 0 0 0

Program Imunisasi 0 0 0 0 0 0 0 0 0 0
161 Alat suntik 0,05 ml set 0 0 0 0 0 0 0 0 0 0

163 Safety Box 5 liter box 0 0 0 0 0 0 0 0 0 0
Program HIV 0 0 0 0 0 0 0 0 0 0
164 BD Vacuntainer box 0 0 0 0 0 0 0 0 0 0
165 Vikia HIV 1/2 box 0 0 0 0 0 0 0 0 0 0

167 Rapid Test II ( FOKUS ) Test 0 0 0 0 0 0 0 0 0 0
168 RPR Sifilis ( FOCUS ) Test 0 0 0 0 0 0 0 0 0 0

169 Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0 0 0

OBAT GIGI 0 0 0 0 0 0 0 0 0 0
172 ENDO ICE BOTOL 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0 0 0
Program TB Paru 0 0 0 0 0 0 0 0 0 0
173 OAT FDC Kategori 1 paket 0 32 10472288 0 0 0 0 16 5236144 32 10472288 32 10472288 0

174 OAT FDC Kategori 2 paket 0 2 2519980 0 0 0 0 2 2519980 3 3779970 0 0
175 OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0 0 0
176 RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0 0 0

177 POT SPUTUM BUAH 0 400 1180000 0 0 0 0 400 1180000 200 590000 0 0
178 REAGEN TB PARU KIT 0 0 0 0 0 0 0 0 0 0
179 Kaca Slide Box 0 0 0 0 0 0 0 0 0 0
180 Lancet Box 0 0 0 0 0 0 0 0 0 0

Program Gizi 0 0 0 0 0 0 0 0 0 0
tablet 0 0 0 0 0 0 0 0 0 0
Provinsi 0 0 0 0 0 0 0 0 0 0
buah/ skipa 0 0 0 0 0 0 0 0 0 0
182 Spuit 0,5 ml
buah / apbn 0 0 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0 0 0
183 Spuit 0,05 ml
APBN 0 0 0 0 0 0 0 0 0 0
Box 0 0 0 0 0 0 0 0 0 0
184 Safety Box Box / 5ml 0 0 0 0 0 0 0 0 0 0

Box / 2,5ml 0 0 0 0 0 0 0 0 0 0
185 RCW Unit 0 0 0 0 0 0 0 0 0 0
Obat Rabies 0 0 0 0 0 0 0 0 0 0
186 Vaksin Rabies kur 0 0 0 0 0 0 0 0 0 0
OBAT APBN 0 0 0 0 0 0 0 0 0 0
187 Alkohol Swab buah 0 0 0 0 0 0 0 0 0 0

189 Fluconazol tablet TABLET 0 0 0 0 0 0 0 0 0 0
190 Paket Kombipak HIV paket 0 0 0 0 0 0 0 0 0 0
191 PH Peper rol 0 0 0 0 0 0 0 0 0 0

193 Rapid Test I ( SD HIV 1/2) Test 0 0 0 0 0 0 0 0 0 0
194 Rapid Test Sifilis Test 0 0 0 0 0 0 0 0 0 0

195 Anuscopy buah 0 0 0 0 0 0 0 0 0 0

198 Metilen Blue botol 0 0 0 0 0 0 0 0 0 0

199 Lens Paper boks 0 0 0 0 0 0 0 0 0 0
200 Jarum Vacutainer boks 0 0 0 0 0 0 0 0 0 0
201 KOH 10 % boks 0 0 0 0 0 0 0 0 0 0
202 Cotton Aplicator boks 0 0 0 0 0 0 0 0 0 0

205 Handscoen boks 0 0 0 0 0 0 0 0 0 0

206 Disposable Needle No 18 boks 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT 0 0 0 0 0 0 0 0 0 0
Obat Vaccine 0 0 0 0 0 0 0 0 0 0
207 BCG VIAL 0 0 0 0 0 0 0 0 0 0

208 MR VIAL 0 30 4249440 40 5665920 80 11331840 0 30 4249440 20 2832960 0 30 4249440 40 5665920
209 DPT-HB-Hib VIAL 150 11442750 60 4577100 0 0 70 5339950 50 3814250 200 15257000 200 15257000 200 15257000 90 6865650
210 DT (BIAS) VIAL 0 0 0 0 0 0 0 0 0 0

211 HB-PID-(HB-0) VIAL 150 3135000 100 2090000 180 3762000 100 2090000 80 1672000 40 836000 360 7524000 200 4180000 150 3135000 100 2090000
212 POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0 0 0
213 POLIO (IPV) VIAL 50 698800 20 279520 40 559040 30 419280 20 279520 10 139760 50 698800 20 279520 20 279520 30 419280
218 Td VIAL 15 247500 0 30 495000 20 330000 10 165000 0 20 330000 20 330000 20 330000 0
0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
245 Sarung tangan gynecolog 7,5 buah 0 0 0 0 0 0 0 0 0 0

247 Sarung tangan tanpa tepung S buah 0 0 0 0 0 0 0 0 0 0
248 Sarung tangan/hancun buah 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
249 Silk 2/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
250 Silk 3/0
buah / bpjs 0 0 0 0 0 0 0 0 0 0
251 Suction Catether No 8 buah 0 0 0 0 0 0 0 0 0 0

252 Suction Catether No 16 buah 0 0 0 0 0 0 0 0 0 0
253 Softpad ( Underpad ) 60x90cm Bag buah 0 0 0 0 0 0 0 0 0 0

254 Stimulen Collagen Gel tube 0 0 0 0 0 0 0 0 0 0
255 Stimulen Collagen Lotion botol 0 0 0 0 0 0 0 0 0 0

257 Tranfusion Set buah 0 0 0 0 0 0 0 0 0 0
258 Tree Way Stop Cock Kotak 0 0 0 0 0 0 0 0 0 0
259 Tes Hamil buah 0 0 0 0 0 0 0 0 0 0

botol 0 0 0 0 0 0 0 0 0 0
260 USG GEL
botol bpjs 0 0 0 0 0 0 0 0 0 0
buah 0 0 0 0 0 0 0 0 0 0
261 Urine Bag
buah / bpjs 0 0 0 0 0 0 0 0 0 0
262 Urobag 2000 Steril T Valve buah 0 0 0 0 0 0 0 0 0 0
263 Wall Bracket Hand Wash Plastik buah 0 0 0 0 0 0 0 0 0 0
264 Wing Needle 19G buah 0 0 0 0 0 0 0 0 0 0


269 WIN FLON 18 G buah 0 0 0 0 0 0 0 0 0 0
270 WIN FLON 20 G buah 0 0 0 0 0 0 0 0 0 0

271 WIN FLON 22 G buah 0 0 0 0 0 0 0 0 0 0
272 WIN FLON 24 G buah 0 0 0 0 0 0 0 0 0 0
273 WIN FLON 26 G buah 0 0 0 0 0 0 0 0 0 0
REAGENSIA 0 0 0 0 0 0 0 0 0 0
274 Diluen Samsung Unit 0 0 0 0 0 0 0 0 0 0
275 Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0
276 Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0 0

277 Lise Samsung Unit 0 0 0 0 0 0 0 0 0 0
278 Rinse Mindrey galon 0 0 0 0 0 0 0 0 0 0
279 Probe Cleanser Mindrey botol 0 0 0 0 0 0 0 0 0 0

280 Diluen Mindrey galon 0 0 0 0 0 0 0 0 0 0
281 Calibration Serum kit 0 0 0 0 0 0 0 0 0 0
282 QC Serum kit 0 0 0 0 0 0 0 0 0 0
283 Billirubin kit 0 0 0 0 0 0 0 0 0 0

284 AST kit 0 0 0 0 0 0 0 0 0 0
285 ALT kit 0 0 0 0 0 0 0 0 0 0
286 Creatine kit 0 0 0 0 0 0 0 0 0 0

287 Ureum Nitrogen kit 0 0 0 0 0 0 0 0 0 0
288 Detecto HB S Antigen buah 0 0 0 0 0 0 0 0 0 0

289 Gluco Protein Tes Urine buah 0 0 0 0 0 0 0 0 0 0
290 Hcl 0,1 N 100 ml botol 0 0 0 0 0 0 0 0 0 0

291 Resecker botol 0 0 0 0 0 0 0 0 0 0
292 Widal Set Incl Control set 0 0 0 0 0 0 0 0 0 0
293 Ziehl Neelsen Set 5 x100 ml set 0 0 0 0 0 0 0 0 0 0
OBAT PROGRAM APBD 0 0 0 0 0 0 0 0 0 0

Obat Paru 0 0 0 0 0 0 0 0 0 0
295 OAT KAT I PAKET 0 0 0 0 0 0 0 0 0 0

296 OAT KAT II PAKET 0 0 0 0 0 0 0 0 0 0
297 OAT KAT ANAK PAKET 0 0 0 0 0 0 0 0 0 0
299 OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 0 0 0 0

300 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0 0

303 Etanol 70% 1000 ml botol 0 0 0 0 0 0 0 0 0 0
304 Lisol 100 % botol 0 0 0 0 0 0 0 0 0 0

306 Kaca Slide Box 0 0 0 0 0 0 0 0 0 0
307 Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0 0 0
308 Spritus Liter 0 0 0 0 0 0 0 0 0 0
309 Lampu Bunsen Pcs 0 0 0 0 0 0 0 0 0 0

Program IFA 0 0 0 0 0 0 0 0 0 0

312 ASAM CUKA botol 0 0 0 0 0 0 0 0 0 0
313 CHLORIN Liter 0 0 0 0 0 0 0 0 0 0
314 Spritus Liter 0 0 0 0 0 0 0 0 0 0

317 Alat suntik 5 ml set 0 0 0 0 0 0 0 0 0 0

318 Safety Box 5 liter box 0 0 0 0 0 0 0 0 0 0
Program HIV 0 0 0 0 0 0 0 0 0 0

320 Fokus Anti HIV 1/2 Cassete Test 0 0 0 0 0 0 0 0 0 0
321 BD Vacuntainer box 0 0 0 0 0 0 0 0 0 0

322 Vikia HIV 1/2 box 0 0 0 0 0 0 0 0 0 0

326 Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0 0 0

328 Handscoen boks 0 0 0 0 0 0 0 0 0 0
OBAT GIGI 0 0 0 0 0 0 0 0 0 0
330 Articulating paper PART DC Kotak 0 0 0 0 0 0 0 0 0 0
331 ENDO ICE BOTOL 0 0 0 0 0 0 0 0 0 0
332 FUJI IX ART 1-1 BOTOL 0 0 0 0 0 0 0 0 0 0
333 GUTTA PERCHA DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 0 0

334 PAPER POINT DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 0 0
335 CAL LC DENPRO PCS 0 0 0 0 0 0 0 0 0 0
336 CHKM(paraformal dehide 20 mg) PCS 0 0 0 0 0 0 0 0 0 0

337 Syiring Refil +shade A3-LA/APAC (Resin komposit) SET 0 0 0 0 0 0 0 0 0 0
338 PULP X (DEVITALIZER) 5g Denpro PCS 0 0 0 0 0 0 0 0 0 0
339 Iodotin technodent PCS 0 0 0 0 0 0 0 0 0 0

OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0 0 0
Program TB Paru 0 0 0 0 0 0 0 0 0 0
340 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0 0 0 0
341 OAT FDC Kategori 1 paket 0 0 0 0 0 0 0 0 0 0

342 OAT FDC Kategori 2 paket 0 0 0 0 0 0 0 0 0 0
343 OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0 0 0
344 OAT FDC Kategori Anak paket 0 0 0 0 0 0 0 0 0 0

345 RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0 0 0
346 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0 0
347 REAGEN TB PARU KIT 0 0 0 0 0 0 0 0 0 0

348 Kaca Slide Box 0 0 0 0 0 0 0 0 0 0
349 Human Hexagon Sypilis KIT 0 0 0 0 0 0 0 0 0 0
350 Alkohol Sweb Box 0 0 0 0 0 0 0 0 0 0
351 Lancet Box 0 0 0 0 0 0 0 0 0 0

352 Sarung Tangan Karet Pasang 0 0 0 0 0 0 0 0 0 0
353 Safety Box Box 0 0 0 0 0 0 0 0 0 0
354 Mikroskop dan kotak Unit 0 0 0 0 0 0 0 0 0 0

Program Gizi 0 0 0 0 0 0 0 0 0 0
Kabsul 0 0 0 0 0 0 0 0 0 0
355 VIT A 100.000 UI BIRU
355 VIT A 100.000 UI BIRU Kabsul/
0 0 0 0 0 0 0 0 0 0
provinsi
Kabsul 0 0 0 0 0 0 0 0 0 0
356 VIT A 200.000 UI MERAH Kabsul/
0 0 0 0 0 0 0 0 0 0
provinsi
357 Nifas Merah tablet 0 0 0 0 0 0 0 0 0 0
358 Mineral Mix Kotak 0 0 0 0 0 0 0 0 0 0
359 ZINC Tablet tablet 0 0 0 0 0 0 0 0 0 0

tablet 0 0 0 0 0 0 0 0 0 0
360 Tablet Tambah Darah tablet/
0 0 0 0 0 0 0 0 0 0
provinsi
361 PMT Balita (MP ASI) Kotak 0 0 0 0 0 0 0 0 0 0
362 PMT Anak Sekolah Kotak 0 0 0 0 0 0 0 0 0 0
363 PMT Bumil Kek Kotak 0 0 0 0 0 0 0 0 0 0
Program Kesehatan Ibu 0 0 0 0 0 0 0 0 0 0
364 Gentamicin Injeksi 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0
365 Oxytocin injeksi ampul 0 0 0 0 0 0 0 0 0 0
366 Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0 0 0
367 Fito Medanion (Vit K1) 10mg/ml-1ml injeksi ampul 0 0 0 0 0 0 0 0 0 0
Program Kesehatan Anak 0 0 0 0 0 0 0 0 0 0
368 Levotiroksin 100 mg tablet 0 0 0 0 0 0 0 0 0 0

369 Fenobarbital Injeksi 50 mg/ml ampul 0 0 0 0 0 0 0 0 0 0
Buah/ Skipa 0 0 0 0 0 0 0 0 0 0
370 Spuit 0,5 ml
buah/ Apbn 0 0 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0 0 0
371 Spuit 0,05 ml
BUAH 0 0 0 0 0 0 0 0 0 0
BUAH 0 0 0 0 0 0 0 0 0 0
372 Spuit 5 ml
BUAH 0 0 0 0 0 0 0 0 0 0
373 Kipi Kit BUAH 0 0 0 0 0 0 0 0 0 0
374 vaccine carrer BUAH 0 0 0 0 0 0 0 0 0 0

375 Spuit 0,5 ml BUAH 0 0 0 0 0 0 0 0 0 0
Box 0 0 0 0 0 0 0 0 0 0
376 Safety Box Box / 5ml 0 0 0 0 0 0 0 0 0 0

Box / 2,5ml 0 0 0 0 0 0 0 0 0 0
377 RCW Unit 0 0 0 0 0 0 0 0 0 0
Obat Flu Burung 0 0 0 0 0 0 0 0 0 0

378 Oseltamivir Kapsul 0 0 0 0 0 0 0 0 0 0
Obat Rabies 0 0 0 0 0 0 0 0 0 0
379 Vaksin Rabies kur 0 0 0 0 0 0 0 0 0 0

OBAT APBN 0 0 0 0 0 0 0 0 0 0
380 Acyclovir 400 mg tablet 0 0 0 0 0 0 0 0 0 0

381 Alkohol Swab buah 0 0 0 0 0 0 0 0 0 0
383 Clindamicin 150 mg tablet 0 0 0 0 0 0 0 0 0 0
384 Fluconazol tablet tablet 0 0 0 0 0 0 0 0 0 0

385 Kondom Laki-laki pcs 0 0 0 0 0 0 0 0 0 0
386 Mikropipet Variabel buah 0 0 0 0 0 0 0 0 0 0
387 Paket Kombipak HIV paket 0 0 0 0 0 0 0 0 0 0

388 PH Peper rol 0 0 0 0 0 0 0 0 0 0
389 RPR Sifilis Test 0 0 0 0 0 0 0 0 0 0

392 Rapid Test II ( Intec) Test 0 0 0 0 0 0 0 0 0 0
394 Rapid Test III ( Oncoprobe) Test 0 0 0 0 0 0 0 0 0 0

395 Rapid Test Sifilis Test 0 0 0 0 0 0 0 0 0 0
396 Rotator buah 0 0 0 0 0 0 0 0 0 0
397 Tabung Vacutainer pack 0 0 0 0 0 0 0 0 0 0

398 Vikia HIV 1/2 buah 0 0 0 0 0 0 0 0 0 0
399 Anuscopy buah 0 0 0 0 0 0 0 0 0 0
400 LUBRICANT 82 mg buah 0 0 0 0 0 0 0 0 0 0

403 Plesterin Bulat boks 0 0 0 0 0 0 0 0 0 0
404 Metilen Blue botol 0 0 0 0 0 0 0 0 0 0

405 Lens Paper boks 0 0 0 0 0 0 0 0 0 0
406 Jarum Vacutainer boks 0 0 0 0 0 0 0 0 0 0
407 KOH 10 % boks 0 0 0 0 0 0 0 0 0 0

408 Cotton Aplicator boks 0 0 0 0 0 0 0 0 0 0
411 Handscoen boks 0 0 0 0 0 0 0 0 0 0

412 Disposable Needle No 18 boks 0 0 0 0 0 0 0 0 0 0
413 Reagen CD4 Test 0 0 0 0 0 0 0 0 0 0
OBAT APBN PUSAT 0 0 0 0 0 0 0 0 0 0

Obat Vaccine 0 0 0 0 0 0 0 0 0 0
414 BCG VIAL 0 0 0 0 0 0 0 0 0 0

415 Campak VIAL 0 0 0 0 0 0 0 0 0 0
416 MR VIAL 0 0 0 0 0 0 0 0 0 0
417 DPT-HB-Hib VIAL 0 0 0 0 0 0 0 0 0 0
418 DT (BIAS) VIAL 0 0 0 0 0 0 0 0 0 0
419 HB-PID-(HB-0) VIAL 0 0 0 0 0 0 0 0 0 0
420 POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0 0 0

421 POLIO (IPV) VIAL 0 0 0 0 0 0 0 0 0 0
422 Td VIAL 0 0 0 0 0 0 0 0 0 0
29 30 31 32 33 34
29 30 31 32 33 34
P LABU K ANYAR ARAS KABU LUBUK PAKAM PAGAR JATI P. Merbau RSU DELI SERDANG RSU CITRA MEDIKA KLINIK Dhea RSU MITRA MEDIKA
NO NAMA OBAT SATUAN
OBAT APBD II
0 1 Acyclovir 400 mg tablet tablet 0 0 0 0 0 0 0 0 0
0 2 Allopurinol 100 mg tablet 0 0 0 0 0 0 0 0 0

0 3 Albendazole tablet 400 mg tablet 0 0 0 0 0 0 0 0 0
0 4 Amlodipine 5 mg tablet 0 0 0 0 0 0 0 0 0
0 5 Amoksisilin 500 mg kapsul 0 1,000 265000 0 0 0 0 0 0 0
0 6 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 0 0 0 0 0 0 0 0 0
0 7 Antasida DOEN I Kombinasi tablet 0 2,000 126000 0 0 0 0 0 0 0
0 8 Antasida DOEN II Suppensi Kombinasi btl 60 ml 0 0 0 0 0 0 0 0 0
0 9 Anti Fungi DOEN pot 0 0 0 0 0 0 0 0 0
0 10 Asam Askorbat (vit C) 50mg tablet 0 0 0 0 0 0 0 0 0
0 11 Asam Mefenamat 500 mg tablet 2,000 352000 1,000 176000 0 0 3,000 528000 0 0 0 0
0 12 Betametason krim 0,1% 5 gr tube 0 0 0 0 0 0 0 0 0
0 13 Cetrizin tablet tablet 0 0 0 0 0 0 0 0 0
0 14 Cetrizin syrup botol 0 0 0 0 0 0 0 0 0

0 15 Cholaramfenicol Kapsul 500 mg kapsul 0 0 0 0 0 0 0 0 0
0 16 Chloramfenicol salep mata 1 % tube 0 0 0 0 0 0 0 0 0
0 17 Diazepam 2 mg tablet 0 0 0 0 0 0 0 0 0
0 18 Deksametason inj 5mg /ml-1ml ampul 0 0 0 0 0 0 0 0 0
0 19 Deksametason tablet 0,5 mg tablet 0 0 0 0 0 0 0 0 0
0 20 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0 0 0 0
0 21 Efinefrin (Adrelanin) Injkesi 0,1 % (sebagai HCL) ampul 0 0 0 0 0 0 0 0 0

0 22 Eritromysin kapsul 500 mg tablet 0 0 0 0 0 0 0 0 0
0 23 Eritromysin syrup kering 200 mg / 5 ml botol 0 0 0 0 0 0 0 0 0
0 24 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 0 0 0 0 0 0 0 0 0

0 25 Fito Menadione tablet 10 mg tablet 0 0 0 0 0 0 0 0 0
0 26 Furosemid tablet 40 mg tablet 0 0 0 0 0 0 0 0 0
0 27 Garam oralit 200 ml air bks 0 0 0 0 0 0 0 0 0
0 28 Glibenclamida 5 mg tablet 0 0 0 0 0 0 0 0 0
0 29 Glukosa 5% Larutan Infus botol 0 0 0 0 0 0 0 0 0
0 30 Griseofulvin 125 mg Tablet tablet 0 0 0 0 0 0 0 0 0

0 31 Haloperidol tablet 0,5 mg tablet 0 0 0 0 0 0 0 0 0
0 32 Hidrokortison Cream 2.5 % tube 0 0 0 0 0 0 0 0 0
0 33 Hidrokloratiazid 25 mg tablet 0 0 0 0 0 0 0 0 0
0 tablet P 0 0 0 2,000 624000 0 0 0 0 0

34 Hustab Tablet
0 tablet / bpjs 0 0 0 0 0 0 0 0 0
0 botol 50 402300 100 804600 0 100 804600 0 0 0 0 0

35 Hustab syrup
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 36 Isoniazid ( INH ) tablet 100 mg tablet 0 0 0 0 0 0 0 0 0
0 37 Isosorbit Dinitrat tablet sublingual 5 mg tablet 0 0 0 0 0 0 0 0 0
0 38 Karbamazepin tablet 200 mg tablet 0 0 0 0 0 0 0 0 0
0 39 Kaptopril 12,5 mg tablet 0 0 0 0 0 0 0 0 0

0 40 Kaptopril 25 mg tablet 500 357500 0 0 0 0 0 0 0 0
0 41 Klorpramazine HCl 100 mg tablet 0 0 0 0 0 0 0 0 0
0 42 Kloramfeniramin Maleat (CTM) 4 mg tablet 0 1,000 43000 0 0 0 0 0 0 0

0 43 Kotrimoksazole Suspensi btl 60ml 0 50 109150 0 0 0 0 0 0 0
0 44 Kotrimoksazol 480 mg komb (DW) tablet 0 0 0 0 0 0 0 0 0
0 45 Kodein HCL 10 mg tablet 0 0 0 0 0 0 0 0 0

0 46 Lidokain Injeksi ampul 0 0 0 0 0 0 0 0 0
0 47 Loperramid tablet 2 mg tablet 0 0 0 0 0 0 0 0 0
0 48 MgSO4 20 % ampul 0 0 0 0 0 0 0 0 0
0 49 Metformin tablet 500 mg tablet 0 0 0 0 0 0 0 0 0

0 50 Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0 0
0 51 Metil Ergometrin Maleat 0,125 mg tablet 0 0 0 0 0 0 0 0 0
0 52 Metoclorpramid HCL 10 mg tablet 0 0 0 0 0 0 0 0 0

0 53 Metronidazol 500 mg tablet 0 0 0 0 0 0 0 0 0
0 54 Metronidazole syirup botol 0 0 0 0 0 0 0 0 0
0 55 Mikonazol Cream 2 % tube 0 0 0 0 0 0 0 0 0

0 56 Natrium Diklofenak tablet 50 mg tablet 0 0 0 0 0 0 0 0 0
0 57 Natrium Klorida larutan infus 0,9% botol 0 0 0 0 0 0 0 0 0
0 58 Nistatin tablet salut 100.000 IU/g tablet 0 0 0 0 0 0 0 0 0
0 59 Nistatin tablet salut 500.000 IU/g tablet 0 0 0 0 0 0 0 0 0

0 60 Oksitetrasiklin salep mata 1 % tube 0 0 0 0 0 0 0 0 0
0 61 Oksitoksin injeksi 10 iv/ml ampul 0 0 0 0 0 0 0 0 0
0 62 Omeprazole kapsul/kaplet 20 mg tablet 0 0 0 0 0 0 0 0 0

0 63 Paracetamol 500 mg (lanamol) tablet 2000 102000 2000 102000 0 3000 153000 4000 204000 0 0 0 0
0 64 Paracetamol sirup 120 mg/5ml botol 0 0 0 0 0 0 0 0 0

0 ampul 0 0 0 0 0 0 0 0 0
65 Pehacain Injeksi
0 ampul / bpjs 0 0 0 0 0 0 0 0 0
0 66 Pirantel tablet score 125 mg tablet 0 0 0 0 0 0 0 0 0
0 67 Pyridoksin HCI (Vit B6) Tablet tablet 0 0 0 0 0 0 0 0 0
0 68 Prednison 5 mg Tablet tablet 0 0 0 0 0 0 0 0 0
0 69 Propanolol HCL 10 mg tablet 0 0 0 0 0 0 0 0 0

0 70 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 0 0 0 0 0 0 0 0 0
0 71 Ringer Laktat laturan infus steril botol 0 0 0 0 0 0 0 0 0
0 72 Salap 2-4 pot 0 0 0 0 0 0 0 0 0

0 73 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 0 0 0
0 74 Salbutamol Cairan 0,1 % ampul 0 0 0 0 0 0 0 0 0
0 75 Salisil Bedak 2,5% bks 0 0 0 0 0 0 0 0 0
0 76 Sianokobalamin (Vit B12) tablet 50 mg tablet 0 0 0 0 0 0 0 0 0
0 77 Sianokobalamin (Vit B12) injeksi ampul 0 0 0 0 0 0 0 0 0
0 78 Simvastatin tablet 10 mg tablet 0 0 0 0 0 0 0 0 0

0 tablet 0 0 0 0 0 0 0 0 0
0 tablet / bpjs 0 0 0 0 0 0 0 0 0
0 80 Sanadryl Syrup botol 0 100 1221000 0 48 586080 0 0 0 0 0

0 81 Tetrasiklin 500 mg kapsul 0 0 0 0 0 0 0 0 0
0 82 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 0 0 0 0 0 0 0 0 0
0 83 Vitamin B komplek Tablet tablet 0 0 0 0 0 0 0 0 0
0 84 Wida Bes Asetat Ringer Infus Botol 0 0 0 0 0 0 0 0 0

0 85 Zircum syrup 20 mg/5ml botol 0 0 0 0 0 0 0 0 0
0 OBAT GIGI 0 0 0 0 0 0 0 0 0
0 86 Eugenol cairan botol 0 0 0 0 0 0 0 0 0

0 BAHAN MEDIS HABIS PAKAI 0 0 0 0 0 0 0 0 0
0 87 Accu Check safe T Pro Uno Dus 0 0 0 0 0 0 0 0 0
0 88 Abbocath No.20 G buah 0 50 209000 0 0 0 0 0 0 0

0 buah 0 0 0 0 0 0 0 0 0
91 Abbocath No.18 G
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
92 Abbocath No.26 G
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 94 Alat suntik 3 ml 24 G X1 buah 100 79200 200 158400 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 96 Alat suntik 5 ML buah 0 0 0 0 0 0 0 0 0

0 97 Alkohol Sweb 2 Ply buah 0 500 108000 0 0 0 0 0 0 0
0 98 Asepton 500 cc + dispenser botol 0 0 0 0 0 0 0 0 0
0 botol 0 0 0 0 0 0 0 0 0
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
101 Cat Gut /benang bedah Plain no .3/0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
104 Dermafix S IV
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 botol 0 0 0 0 0 0 0 0 0
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 botol 0 0 0 0 0 0 0 0 0
106 Etanol 70% 1000 ml
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 set 0 50 141563 0 0 0 0 0 0 0
0 set / bpjs 0 0 0 0 0 0 0 0 0
0 set 0 50 176000 0 0 0 0 0 0 0
0 set / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 111 Kapas Pembalut 500 g buah 0 0 0 0 0 0 0 0 0

0 buah 0 0 0 0 0 0 0 0 0
112 Kapas 500 g
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 rol 0 0 0 0 0 0 0 0 0
0 rol / bpjs 0 0 0 0 0 0 0 0 0
0 rol 0 0 0 0 0 0 0 0 0
0 rol / bpjs 0 0 0 0 0 0 0 0 0
0 rol 0 0 0 0 0 0 0 0 0
0 rol / bpjs 0 0 0 0 0 0 0 0 0
0 rol 0 0 0 0 0 0 0 0 0
0 rol / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 118 Kasa Steril 40 x 40 buah 0 0 0 0 0 0 0 0 0
0 119 Kasa Steril 5 x 5 buah 0 0 0 0 0 0 0 0 0
0 botol 0 0 0 0 0 0 0 0 0
120 Lisol 100 %
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
121 Masker Tie On
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 124 My Jelly 82 gram tube 0 0 0 0 0 0 0 0 0
0 125 Object Glass Kotak 0 0 0 0 0 0 0 0 0
0 126 One scrub 500 cc + dispenser botol 0 0 0 0 0 0 0 0 0

0 rol 0 0 0 0 0 0 0 0 0
0 rol / bpjs 0 0 0 0 0 0 0 0 0
0 rol 0 0 0 0 0 0 0 0 0
0 rol / bpjs 0 0 0 0 0 0 0 0 0
0 rol 0 0 0 0 0 0 0 0 0
0 rol / bpjs 0 0 0 0 0 0 0 0 0
0 botol 0 0 0 0 0 0 0 0 0
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 botol 0 0 0 0 0 0 0 0 0
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
133 Silk 2/0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
134 Silk 3/0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 135 Skin Celean 500 ml botol 0 0 0 0 0 0 0 0 0

0 136 Tranfusion Set buah 0 0 0 0 0 0 0 0 0
0 botol 0 0 0 0 0 0 0 0 0
137 USG GEL
0 botol / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
138 Urine Bag
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 REAGENSIA 0 0 0 0 0 0 0 0 0
0 139 Diluen Samsung Unit 0 0 0 0 0 0 0 0 0

0 140 Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0
0 141 Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0
0 142 Lise Samsung Unit 0 0 0 0 0 0 0 0 0
0 143 Rinse Mindrey galon 0 0 0 0 0 0 0 0 0

0 OBAT PROGRAM APBD 0 0 0 0 0 0 0 0 0
0 Obat Paru 0 0 0 0 0 0 0 0 0
0 144 GARAM ORALIT SACHET 0 0 0 0 0 0 0 0 0

0 145 ZINC Tablet TABLET 0 0 0 0 0 0 0 0 0
0 146 OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 0 0 0
0 147 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0

0 149 Tuberculin PPD Vial 0 2 1404500 0 0 0 0 0 0 0
0 150 Sarung tangan tanpa tepung M buah 0 0 0 0 0 0 0 0 0
0 151 Lisol 100 % botol 0 0 0 0 0 0 0 0 0

0 152 Reagen Ziehl Neelsen kit 0 0 0 0 0 0 0 0 0
0 153 Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0 0
0 154 Spritus Liter 0 0 0 0 0 0 0 0 0

0 155 Lampu Bunsen Pcs 0 0 0 0 0 0 0 0 0
0 156 Imersion Oil Botol 0 0 0 0 0 0 0 0 0
0 Program IFA 0 0 0 0 0 0 0 0 0
0 157 KAPAS LIDI Bungkus 0 0 0 0 0 0 0 0 0

0 158 ASAM CUKA botol 0 0 0 0 0 0 0 0 0
0 159 CHLORIN Liter 0 0 0 0 0 0 0 0 0
0 160 Spritus Liter 0 0 0 0 0 0 0 0 0

0 Program Imunisasi 0 0 0 0 0 0 0 0 0
0 161 Alat suntik 0,05 ml set 0 0 0 0 0 0 0 0 0

0 163 Safety Box 5 liter box 0 0 0 0 0 0 0 0 0
0 Program HIV 0 0 0 0 0 0 0 0 0
0 164 BD Vacuntainer box 0 0 0 0 0 0 0 0 0
0 165 Vikia HIV 1/2 box 0 0 0 0 0 0 0 0 0

0 167 Rapid Test II ( FOKUS ) Test 0 0 0 0 0 0 0 0 0
0 168 RPR Sifilis ( FOCUS ) Test 0 0 0 0 0 0 0 0 0

0 169 Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0 0

0 171 Standard Q Shyphilis Ab kit 0 0 0 0 0 0 0 0 0
0 OBAT GIGI 0 0 0 0 0 0 0 0 0
0 172 ENDO ICE BOTOL 0 0 0 0 0 0 0 0 0
0 OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0 0
0 Program TB Paru 0 0 0 0 0 0 0 0 0
10 3272590 173 OAT FDC Kategori 1 paket 0 0 0 0 10 3272590 0 0 0 0

1 1259990 174 OAT FDC Kategori 2 paket 0 0 0 0 0 0 0 0 0
0 175 OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0 0
0 176 RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0 0

0 177 POT SPUTUM BUAH 0 400 1180000 0 0 400 1180000 0 0 0 0
0 178 REAGEN TB PARU KIT 0 0 0 0 0 0 0 0 0
0 179 Kaca Slide Box 0 0 0 0 0 0 0 0 0
0 180 Lancet Box 0 0 0 0 0 0 0 0 0

0 Program Gizi 0 0 0 0 0 0 0 0 0
0 tablet 0 0 0 0 0 0 0 0 0
0 Provinsi 0 0 0 0 0 0 0 0 0
0 buah/ skipa 0 0 0 0 0 0 0 0 0
182 Spuit 0,5 ml
0 buah / apbn 0 0 0 0 0 0 0 0 0
0 BUAH 0 0 0 0 0 0 0 0 0
183 Spuit 0,05 ml
0 APBN 0 0 0 0 0 0 0 0 0
0 Box 0 0 0 0 0 0 0 0 0
0 184 Safety Box Box / 5ml 0 0 0 0 0 0 0 0 0

0 Box / 2,5ml 0 0 0 0 0 0 0 0 0
0 185 RCW Unit 0 0 0 0 0 0 0 0 0
0 Obat Rabies 0 0 0 0 0 0 0 0 0
0 186 Vaksin Rabies kur 4 0 0 0 0 0 0 0 0 0
0 OBAT APBN 0 0 0 0 0 0 0 0 0
0 187 Alkohol Swab buah 0 0 0 0 0 0 0 0 0

0 188 Benzatin Phenisillin 2,4 jt vial 0 0 0 0 0 0 0 0 0
0 189 Fluconazol tablet TABLET 0 0 0 0 0 0 0 0 0
0 190 Paket Kombipak HIV paket 0 0 0 0 0 0 0 0 0
0 191 PH Peper rol 0 0 0 0 0 0 0 0 0

0 193 Rapid Test I ( SD HIV 1/2) Test 0 0 0 0 0 0 0 0 0
0 194 Rapid Test Sifilis Test 0 0 0 0 0 0 0 0 0

0 195 Anuscopy buah 0 0 0 0 0 0 0 0 0
0 196 Yellow Tips bungkus 0 0 0 0 0 0 0 0 0

0 197 Blue Tips bungkus 0 0 0 0 0 0 0 0 0
0 198 Metilen Blue botol 0 0 0 0 0 0 0 0 0

0 199 Lens Paper boks 0 0 0 0 0 0 0 0 0
0 200 Jarum Vacutainer boks 0 0 0 0 0 0 0 0 0
0 201 KOH 10 % boks 0 0 0 0 0 0 0 0 0
0 202 Cotton Aplicator boks 0 0 0 0 0 0 0 0 0

0 204 Cover Glass Kotak 0 0 0 0 0 0 0 0 0
0 205 Handscoen boks 0 0 0 0 0 0 0 0 0

0 206 Disposable Needle No 18 boks 0 0 0 0 0 0 0 0 0
0 OBAT APBN PUSAT 0 0 0 0 0 0 0 0 0
0 Obat Vaccine 0 0 0 0 0 0 0 0 0
0 207 BCG VIAL 0 0 0 0 0 0 0 0 0

10 1416480 208 MR VIAL 0 0 35 4957680 0 0 0 0 0 0
60 4577100 209 DPT-HB-Hib VIAL 0 40 3051400 100 7628500 0 70 5339950 0 0 0 0
0 210 DT (BIAS) VIAL 0 0 0 0 0 0 0 0 0

60 1254000 211 HB-PID-(HB-0) VIAL 65 1358500 40 836000 120 2508000 0 80 1672000 0 0 0 0
0 212 POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0 0
10 139760 213 POLIO (IPV) VIAL 0 10 139760 30 419280 0 10 139760 0 0 0 0

30 495000 218 Td VIAL 0 0 30 495000 0 10 165000 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 245 Sarung tangan gynecolog 7,5 buah 0 0 0 0 0 0 0 0 0

0 247 Sarung tangan tanpa tepung S buah 0 0 0 0 0 0 0 0 0
0 248 Sarung tangan/hancun buah 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
249 Silk 2/0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
250 Silk 3/0
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 251 Suction Catether No 8 buah 0 0 0 0 0 0 0 0 0

0 252 Suction Catether No 16 buah 0 0 0 0 0 0 0 0 0
0 253 Softpad ( Underpad ) 60x90cm Bag buah 0 0 0 0 0 0 0 0 0

0 254 Stimulen Collagen Gel tube 0 0 0 0 0 0 0 0 0
0 255 Stimulen Collagen Lotion botol 0 0 0 0 0 0 0 0 0

0 256 Skin Celean 500 ml botol 0 0 0 0 0 0 0 0 0
0 257 Tranfusion Set buah 0 0 0 0 0 0 0 0 0
0 258 Tree Way Stop Cock Kotak 0 0 0 0 0 0 0 0 0
0 259 Tes Hamil buah 0 0 0 0 0 0 0 0 0

0 botol 0 0 0 0 0 0 0 0 0
260 USG GEL
0 botol bpjs 0 0 0 0 0 0 0 0 0
0 buah 0 0 0 0 0 0 0 0 0
261 Urine Bag
0 buah / bpjs 0 0 0 0 0 0 0 0 0
0 262 Urobag 2000 Steril T Valve buah 0 0 0 0 0 0 0 0 0
0 263 Wall Bracket Hand Wash Plastik buah 0 0 0 0 0 0 0 0 0
0 264 Wing Needle 19G buah 0 0 0 0 0 0 0 0 0


0 269 WIN FLON 18 G buah 0 0 0 0 0 0 0 0 0
0 270 WIN FLON 20 G buah 0 0 0 0 0 0 0 0 0

0 271 WIN FLON 22 G buah 0 0 0 0 0 0 0 0 0
0 272 WIN FLON 24 G buah 0 0 0 0 0 0 0 0 0
0 273 WIN FLON 26 G buah 0 0 0 0 0 0 0 0 0
0 REAGENSIA 0 0 0 0 0 0 0 0 0
0 274 Diluen Samsung Unit 0 0 0 0 0 0 0 0 0
0 275 Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0
0 276 Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0 0

0 277 Lise Samsung Unit 0 0 0 0 0 0 0 0 0
0 278 Rinse Mindrey galon 0 0 0 0 0 0 0 0 0
0 279 Probe Cleanser Mindrey botol 0 0 0 0 0 0 0 0 0

0 280 Diluen Mindrey galon 0 0 0 0 0 0 0 0 0
0 281 Calibration Serum kit 0 0 0 0 0 0 0 0 0
0 282 QC Serum kit 0 0 0 0 0 0 0 0 0
0 283 Billirubin kit 0 0 0 0 0 0 0 0 0

0 284 AST kit 0 0 0 0 0 0 0 0 0
0 285 ALT kit 0 0 0 0 0 0 0 0 0
0 286 Creatine kit 0 0 0 0 0 0 0 0 0

0 287 Ureum Nitrogen kit 0 0 0 0 0 0 0 0 0
0 288 Detecto HB S Antigen buah 0 0 0 0 0 0 0 0 0

0 289 Gluco Protein Tes Urine buah 0 0 0 0 0 0 0 0 0
0 290 Hcl 0,1 N 100 ml botol 0 0 0 0 0 0 0 0 0

0 291 Resecker botol 0 0 0 0 0 0 0 0 0
0 292 Widal Set Incl Control set 0 0 0 0 0 0 0 0 0
0 293 Ziehl Neelsen Set 5 x100 ml set 0 0 0 0 0 0 0 0 0
0 OBAT PROGRAM APBD 0 0 0 0 0 0 0 0 0

0 Obat Paru 0 0 0 0 0 0 0 0 0
0 294 GARAM ORALIT SACHET 0 0 0 0 0 0 0 0 0
0 295 OAT KAT I PAKET 0 0 0 0 0 0 0 0 0

0 296 OAT KAT II PAKET 0 0 0 0 0 0 0 0 0
0 297 OAT KAT ANAK PAKET 0 0 0 0 0 0 0 0 0
0 298 ZINC Tablet TABLET 0 0 0 0 0 0 0 0 0
0 299 OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 0 0 0

0 300 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0

0 303 Etanol 70% 1000 ml botol 0 0 0 0 0 0 0 0 0
0 304 Lisol 100 % botol 0 0 0 0 0 0 0 0 0
0 305 Reagen Ziehl Neelsen kit 0 0 0 0 0 0 0 0 0

0 306 Kaca Slide Box 0 0 0 0 0 0 0 0 0
0 307 Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0 0
0 308 Spritus Liter 0 0 0 0 0 0 0 0 0
0 309 Lampu Bunsen Pcs 0 0 0 0 0 0 0 0 0

0 310 Imersion Oil Botol 0 0 0 0 0 0 0 0 0
0 Program IFA 0 0 0 0 0 0 0 0 0
0 311 KAPAS LIDI Bungkus 0 0 0 0 0 0 0 0 0

0 312 ASAM CUKA botol 0 0 0 0 0 0 0 0 0
0 313 CHLORIN Liter 0 0 0 0 0 0 0 0 0
0 314 Spritus Liter 0 0 0 0 0 0 0 0 0

0 317 Alat suntik 5 ml set 0 0 0 0 0 0 0 0 0

0 318 Safety Box 5 liter box 0 0 0 0 0 0 0 0 0
0 Program HIV 0 0 0 0 0 0 0 0 0

0 320 Fokus Anti HIV 1/2 Cassete Test 0 0 0 0 0 0 0 0 0
0 321 BD Vacuntainer box 0 0 0 0 0 0 0 0 0

0 322 Vikia HIV 1/2 box 0 0 0 0 0 0 0 0 0

0 326 Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0 0

0 328 Handscoen boks 0 0 0 0 0 0 0 0 0
0 329 Standard Q Shyphilis Ab kit 0 0 0 0 0 0 0 0 0
0 OBAT GIGI 0 0 0 0 0 0 0 0 0
0 330 Articulating paper PART DC Kotak 0 0 0 0 0 0 0 0 0
0 331 ENDO ICE BOTOL 0 0 0 0 0 0 0 0 0
0 332 FUJI IX ART 1-1 BOTOL 0 0 0 0 0 0 0 0 0
0 333 GUTTA PERCHA DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 0

0 334 PAPER POINT DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0 0
0 335 CAL LC DENPRO PCS 0 0 0 0 0 0 0 0 0
0 336 CHKM(paraformal dehide 20 mg) PCS 0 0 0 0 0 0 0 0 0

0 337 Syiring Refil +shade A3-LA/APAC (Resin komposit) SET 0 0 0 0 0 0 0 0 0
0 338 PULP X (DEVITALIZER) 5g Denpro PCS 0 0 0 0 0 0 0 0 0
0 339 Iodotin technodent PCS 0 0 0 0 0 0 0 0 0

0 OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0 0
0 Program TB Paru 0 0 0 0 0 0 0 0 0
0 340 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0 0 0
0 341 OAT FDC Kategori 1 paket 0 0 0 0 0 0 0 0 0

0 342 OAT FDC Kategori 2 paket 0 0 0 0 0 0 0 0 0
0 343 OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0 0
0 344 OAT FDC Kategori Anak paket 0 0 0 0 0 0 0 0 0

0 345 RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0 0
0 346 POT SPUTUM BUAH 0 0 0 0 0 0 0 0 0
0 347 REAGEN TB PARU KIT 0 0 0 0 0 0 0 0 0

0 348 Kaca Slide Box 0 0 0 0 0 0 0 0 0
0 349 Human Hexagon Sypilis KIT 0 0 0 0 0 0 0 0 0
0 350 Alkohol Sweb Box 0 0 0 0 0 0 0 0 0
0 351 Lancet Box 0 0 0 0 0 0 0 0 0

0 352 Sarung Tangan Karet Pasang 0 0 0 0 0 0 0 0 0
0 353 Safety Box Box 0 0 0 0 0 0 0 0 0
0 354 Mikroskop dan kotak Unit 0 0 0 0 0 0 0 0 0

0 Program Gizi 0 0 0 0 0 0 0 0 0
0 Kabsul 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
provinsi
0 Kabsul 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
provinsi
0 357 Nifas Merah tablet 0 0 0 0 0 0 0 0 0
0 358 Mineral Mix Kotak 0 0 0 0 0 0 0 0 0
0 359 ZINC Tablet tablet 0 0 0 0 0 0 0 0 0

0 tablet 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
provinsi
0 361 PMT Balita (MP ASI) Kotak 0 0 0 0 0 0 0 0 0
0 362 PMT Anak Sekolah Kotak 0 0 0 0 0 0 0 0 0
0 363 PMT Bumil Kek Kotak 0 0 0 0 0 0 0 0 0
0 Program Kesehatan Ibu 0 0 0 0 0 0 0 0 0
0 364 Gentamicin Injeksi 40 mg/ml ampul 0 0 0 0 0 0 0 0 0
0 365 Oxytocin injeksi ampul 0 0 0 0 0 0 0 0 0
0 366 Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0 0
0 367 Fito Medanion (Vit K1) 10mg/ml-1ml injeksi ampul 0 0 0 0 0 0 0 0 0
0 Program Kesehatan Anak 0 0 0 0 0 0 0 0 0
0 368 Levotiroksin 100 mg tablet 0 0 0 0 0 0 0 0 0

0 369 Fenobarbital Injeksi 50 mg/ml ampul 0 0 0 0 0 0 0 0 0
0 Buah/ Skipa 0 0 0 0 0 0 0 0 0
370 Spuit 0,5 ml
0 buah/ Apbn 0 0 0 0 0 0 0 0 0
0 BUAH 0 0 0 0 0 0 0 0 0
371 Spuit 0,05 ml
0 BUAH 0 0 0 0 0 0 0 0 0
0 BUAH 0 0 0 0 0 0 0 0 0
372 Spuit 5 ml
0 BUAH 0 0 0 0 0 0 0 0 0
0 373 Kipi Kit BUAH 0 0 0 0 0 0 0 0 0
0 374 vaccine carrer BUAH 0 0 0 0 0 0 0 0 0

0 375 Spuit 0,5 ml BUAH 0 0 0 0 0 0 0 0 0
0 Box 0 0 0 0 0 0 0 0 0
0 376 Safety Box Box / 5ml 0 0 0 0 0 0 0 0 0

0 Box / 2,5ml 0 0 0 0 0 0 0 0 0
0 377 RCW Unit 0 0 0 0 0 0 0 0 0
0 Obat Flu Burung 0 0 0 0 0 0 0 0 0

0 378 Oseltamivir Kapsul 0 0 0 0 0 0 0 0 0
0 Obat Rabies 0 0 0 0 0 0 0 0 0
0 379 Vaksin Rabies kur 0 0 0 0 0 0 0 0 0

0 OBAT APBN 0 0 0 0 0 0 0 0 0
0 380 Acyclovir 400 mg tablet 0 0 0 0 0 0 0 0 0

0 381 Alkohol Swab buah 0 0 0 0 0 0 0 0 0
0 382 Benzatin Phenisillin 2,4 jt vial 0 0 0 0 0 0 0 0 0
0 383 Clindamicin 150 mg tablet 0 0 0 0 0 0 0 0 0
0 384 Fluconazol tablet tablet 0 0 0 0 0 0 0 0 0

0 385 Kondom Laki-laki pcs 0 0 0 0 0 0 0 0 0
0 386 Mikropipet Variabel buah 0 0 0 0 0 0 0 0 0
0 387 Paket Kombipak HIV paket 0 0 0 0 0 0 0 0 0

0 388 PH Peper rol 0 0 0 0 0 0 0 0 0
0 389 RPR Sifilis Test 0 0 0 0 0 0 0 0 0

0 392 Rapid Test II ( Intec) Test 0 0 0 0 0 0 0 0 0
0 394 Rapid Test III ( Oncoprobe) Test 0 0 0 0 0 0 0 0 0

0 395 Rapid Test Sifilis Test 0 0 0 0 0 0 0 0 0
0 396 Rotator buah 0 0 0 0 0 0 0 0 0
0 397 Tabung Vacutainer pack 0 0 0 0 0 0 0 0 0

0 398 Vikia HIV 1/2 buah 0 0 0 0 0 0 0 0 0
0 399 Anuscopy buah 0 0 0 0 0 0 0 0 0
0 400 LUBRICANT 82 mg buah 0 0 0 0 0 0 0 0 0
0 401 Yellow Tips bungkus 0 0 0 0 0 0 0 0 0

0 402 Blue Tips bungkus 0 0 0 0 0 0 0 0 0
0 403 Plesterin Bulat boks 0 0 0 0 0 0 0 0 0
0 404 Metilen Blue botol 0 0 0 0 0 0 0 0 0

0 405 Lens Paper boks 0 0 0 0 0 0 0 0 0
0 406 Jarum Vacutainer boks 0 0 0 0 0 0 0 0 0
0 407 KOH 10 % boks 0 0 0 0 0 0 0 0 0

0 408 Cotton Aplicator boks 0 0 0 0 0 0 0 0 0
0 410 Cover Glass Kotak 0 0 0 0 0 0 0 0 0
0 411 Handscoen boks 0 0 0 0 0 0 0 0 0

0 412 Disposable Needle No 18 boks 0 0 0 0 0 0 0 0 0
0 413 Reagen CD4 Test 0 0 0 0 0 0 0 0 0
0 OBAT APBN PUSAT 0 0 0 0 0 0 0 0 0

0 Obat Vaccine 0 0 0 0 0 0 0 0 0
0 414 BCG VIAL 0 0 0 0 0 0 0 0 0

0 415 Campak VIAL 0 0 0 0 0 0 0 0 0
0 416 MR VIAL 0 0 0 0 0 0 0 0 0
0 417 DPT-HB-Hib VIAL 0 0 0 0 0 0 0 0 0
0 418 DT (BIAS) VIAL 0 0 0 0 0 0 0 0 0
0 419 HB-PID-(HB-0) VIAL 0 0 0 0 0 0 0 0 0
0 420 POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0 0

0 421 POLIO (IPV) VIAL 0 0 0 0 0 0 0 0 0
0 422 Td VIAL 0 0 0 0 0 0 0 0 0
RSU GRAND MED RSU SARI MUTIARA LAPAS LUBUK PAKAM Rutan Pancur Batu KLINIK TIARA RSU SEMBIRING KLINIK PRATAMA Dhilon Medical Centre RSU Full Bethesda Klinik Sejati Balai POM
NO NAMA OBAT SATUAN
OBAT APBD II
0 0 1 Acyclovir 400 mg tablet tablet 0 0 0 0 0 0 0 0
0 0 2 Allopurinol 100 mg tablet 0 0 0 0 0 0 0 0

0 0 3 Albendazole tablet 400 mg tablet 0 0 0 0 0 0 0 0
0 0 4 Amlodipine 5 mg tablet 0 0 0 0 0 0 0 0
0 0 5 Amoksisilin 500 mg kapsul 0 0 0 0 0 0 0 0
0 0 6 Amoksisilin Sirup kering 125 mg/5ml btl 60 ml 0 0 0 0 0 0 0 0
0 0 7 Antasida DOEN I Kombinasi tablet 0 0 0 0 0 0 0 0

Antasida DOEN II Suppensi
0 0 8 btl 60 ml 0 0 0 0 0 0 0 0
Kombinasi
0 0 9 Anti Fungi DOEN pot 0 0 0 0 0 0 0 0
0 0 10 Asam Askorbat (vit C) 50mg tablet 0 0 0 0 0 0 0 0
0 0 11 Asam Mefenamat 500 mg tablet 0 0 0 0 0 0 0 0

0 0 12 Betametason krim 0,1% 5 gr tube 0 0 0 0 0 0 0 0
0 0 13 Cetrizin tablet tablet 0 0 0 0 0 0 0 0
0 0 14 Cetrizin syrup botol 0 0 0 0 0 0 0 0

0 0 15 Cholaramfenicol Kapsul 500 mg kapsul 0 0 0 0 0 0 0 0
0 0 16 Chloramfenicol salep mata 1 % tube 0 0 0 0 0 0 0 0
0 0 17 Diazepam 2 mg tablet 0 0 0 0 0 0 0 0
0 0 18 Deksametason inj 5mg /ml-1ml ampul 0 0 0 0 0 0 0 0
0 0 19 Deksametason tablet 0,5 mg tablet 0 0 0 0 0 0 0 0
0 0 20 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0 0 0

Efinefrin (Adrelanin) Injkesi 0,1 %
0 0 21 ampul 0 0 0 0 0 0 0 0
(sebagai HCL)
0 0 22 Eritromysin kapsul 500 mg tablet 0 0 0 0 0 0 0 0
Eritromysin syrup kering 200 mg / 5
0 0 23 botol 0 0 0 0 0 0 0 0
ml
Fito Menadione (Vit K1) 10mg/ml-
0 0 24 ampul 0 0 0 0 0 0 0 0
1ml injeksi
0 0 25 Fito Menadione tablet 10 mg tablet 0 0 0 0 0 0 0 0
0 0 26 Furosemid tablet 40 mg tablet 0 0 0 0 0 0 0 0
0 0 27 Garam oralit 200 ml air bks 0 0 0 0 0 0 0 0
0 0 28 Glibenclamida 5 mg tablet 0 0 0 0 0 0 0 0
0 0 29 Glukosa 5% Larutan Infus botol 0 0 0 0 0 0 0 0
0 0 30 Griseofulvin 125 mg Tablet tablet 0 0 0 0 0 0 0 0

0 0 31 Haloperidol tablet 0,5 mg tablet 0 0 0 0 0 0 0 0
0 0 32 Hidrokortison Cream 2.5 % tube 0 0 0 0 0 0 0 0
0 0 33 Hidrokloratiazid 25 mg tablet 0 0 0 0 0 0 0 0
0 0 tablet P 0 0 0 0 0 0 0 0
34 Hustab Tablet
0 0 tablet / bpjs 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
35 Hustab syrup
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 36 Isoniazid ( INH ) tablet 100 mg tablet 0 0 0 0 0 0 0 0
Isosorbit Dinitrat tablet sublingual 5
0 0 37 tablet 0 0 0 0 0 0 0 0
mg
0 0 38 Karbamazepin tablet 200 mg tablet 0 0 0 0 0 0 0 0
0 0 39 Kaptopril 12,5 mg tablet 0 0 0 0 0 0 0 0

0 0 40 Kaptopril 25 mg tablet 0 0 0 0 0 0 0 0
0 0 41 Klorpramazine HCl 100 mg tablet 0 0 0 0 0 0 0 0
0 0 42 Kloramfeniramin Maleat (CTM) 4 mg tablet 0 0 0 0 0 0 0 0

0 0 43 Kotrimoksazole Suspensi btl 60ml 0 0 0 0 0 0 0 0
0 0 44 Kotrimoksazol 480 mg komb (DW) tablet 0 0 0 0 0 0 0 0
0 0 45 Kodein HCL 10 mg tablet 0 0 0 0 0 0 0 0

0 0 46 Lidokain Injeksi ampul 0 0 0 0 0 0 0 0
0 0 47 Loperramid tablet 2 mg tablet 0 0 0 0 0 0 0 0
0 0 48 MgSO4 20 % ampul 0 0 0 0 0 0 0 0
0 0 49 Metformin tablet 500 mg tablet 0 0 0 0 0 0 0 0

0 0 50 Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0
0 0 51 Metil Ergometrin Maleat 0,125 mg tablet 0 0 0 0 0 0 0 0
0 0 52 Metoclorpramid HCL 10 mg tablet 0 0 0 0 0 0 0 0

0 0 53 Metronidazol 500 mg tablet 0 0 0 0 0 0 0 0
0 0 54 Metronidazole syirup botol 0 0 0 0 0 0 0 0
0 0 55 Mikonazol Cream 2 % tube 0 0 0 0 0 0 0 0

0 0 56 Natrium Diklofenak tablet 50 mg tablet 0 0 0 0 0 0 0 0
0 0 57 Natrium Klorida larutan infus 0,9% botol 0 0 0 0 0 0 0 0
0 0 58 Nistatin tablet salut 100.000 IU/g tablet 0 0 0 0 0 0 0 0
0 0 59 Nistatin tablet salut 500.000 IU/g tablet 0 0 0 0 0 0 0 0

0 0 60 Oksitetrasiklin salep mata 1 % tube 0 0 0 0 0 0 0 0
0 0 61 Oksitoksin injeksi 10 iv/ml ampul 0 0 0 0 0 0 0 0
0 0 62 Omeprazole kapsul/kaplet 20 mg tablet 0 0 0 0 0 0 0 0

0 0 63 Paracetamol 500 mg (lanamol) tablet 0 0 0 0 0 0 0 0
0 0 64 Paracetamol sirup 120 mg/5ml botol 0 0 0 0 0 0 0 0

0 0 ampul 0 0 0 0 0 0 0 0
65 Pehacain Injeksi
0 0 ampul / bpjs 0 0 0 0 0 0 0 0
0 0 66 Pirantel tablet score 125 mg tablet 0 0 0 0 0 0 0 0
0 0 67 Pyridoksin HCI (Vit B6) Tablet tablet 0 0 0 0 0 0 0 0
0 0 68 Prednison 5 mg Tablet tablet 0 0 0 0 0 0 0 0
0 0 69 Propanolol HCL 10 mg tablet 0 0 0 0 0 0 0 0

0 0 70 Retinol 100.000 ( Vit. A Kapsul Biru) kapsul 0 0 0 0 0 0 0 0
0 0 71 Ringer Laktat laturan infus steril botol 0 0 0 0 0 0 0 0
0 0 72 Salap 2-4 pot 0 0 0 0 0 0 0 0

0 0 73 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 0 0
0 0 74 Salbutamol Cairan 0,1 % ampul 0 0 0 0 0 0 0 0
0 0 75 Salisil Bedak 2,5% bks 0 0 0 0 0 0 0 0

Sianokobalamin (Vit B12) tablet 50
0 0 76 tablet 0 0 0 0 0 0 0 0
mg
0 0 77 Sianokobalamin (Vit B12) injeksi ampul 0 0 0 0 0 0 0 0
0 0 78 Simvastatin tablet 10 mg tablet 0 0 0 0 0 0 0 0

0 0 tablet 0 0 0 0 0 0 0 0
0 0 tablet / bpjs 0 0 0 0 0 0 0 0
0 0 80 Sanadryl Syrup botol 0 0 0 0 0 0 0 0

0 0 81 Tetrasiklin 500 mg kapsul 0 0 0 0 0 0 0 0
0 0 82 Tiamin HCI (Vit B1.) Tablet 50 mg tablet 0 0 0 0 0 0 0 0
0 0 83 Vitamin B komplek Tablet tablet 0 0 0 0 0 0 0 0
0 0 84 Wida Bes Asetat Ringer Infus Botol 0 0 0 0 0 0 0 0

0 0 85 Zircum syrup 20 mg/5ml botol 0 0 0 0 0 0 0 0
0 0 OBAT GIGI 0 0 0 0 0 0 0 0
0 0 86 Eugenol cairan botol 0 0 0 0 0 0 0 0

0 0 BAHAN MEDIS HABIS PAKAI 0 0 0 0 0 0 0 0
0 0 87 Accu Check safe T Pro Uno Dus 0 0 0 0 0 0 0 0
0 0 88 Abbocath No.20 G buah 0 0 0 0 0 0 0 0

0 0 buah 0 0 0 0 0 0 0 0
91 Abbocath No.18 G
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
92 Abbocath No.26 G
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 94 Alat suntik 3 ml 24 G X1 buah 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 96 Alat suntik 5 ML buah 0 0 0 0 0 0 0 0

0 0 97 Alkohol Sweb 2 Ply buah 0 0 0 0 0 0 0 0
0 0 98 Asepton 500 cc + dispenser botol 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 Cat Gut /benang bedah Plain no . buah 0 0 0 0 0 0 0 0
100
0 0 2/0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 Cat Gut /benang bedah Plain buah 0 0 0 0 0 0 0 0

101
0 0 no .3/0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 Cat Gut /benang bedah CHROMIC buah 0 0 0 0 0 0 0 0

102
0 0 no . 2/0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 Cat Gut /benang bedah CHROMIC buah 0 0 0 0 0 0 0 0

103
0 0 no .3/0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
104 Dermafix S IV
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
106 Etanol 70% 1000 ml
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 set 0 0 0 0 0 0 0 0
0 0 set / bpjs 0 0 0 0 0 0 0 0
0 0 set 0 0 0 0 0 0 0 0
0 0 set / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 111 Kapas Pembalut 500 g buah 0 0 0 0 0 0 0 0

0 0 buah 0 0 0 0 0 0 0 0
112 Kapas 500 g
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 Kasa Pembalut Hid 2 m x 80 cm rol 0 0 0 0 0 0 0 0

113
0 0 steril rol / bpjs 0 0 0 0 0 0 0 0
0 0 rol 0 0 0 0 0 0 0 0
0 0 rol / bpjs 0 0 0 0 0 0 0 0
0 0 rol 0 0 0 0 0 0 0 0
0 0 rol / bpjs 0 0 0 0 0 0 0 0
0 0 rol 0 0 0 0 0 0 0 0
0 0 rol / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 118 Kasa Steril 40 x 40 buah 0 0 0 0 0 0 0 0
0 0 119 Kasa Steril 5 x 5 buah 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
120 Lisol 100 %
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
121 Masker Tie On
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 124 My Jelly 82 gram tube 0 0 0 0 0 0 0 0
0 0 125 Object Glass Kotak 0 0 0 0 0 0 0 0
0 0 126 One scrub 500 cc + dispenser botol 0 0 0 0 0 0 0 0

0 0 rol 0 0 0 0 0 0 0 0
0 0 rol / bpjs 0 0 0 0 0 0 0 0
0 0 rol 0 0 0 0 0 0 0 0
0 0 rol / bpjs 0 0 0 0 0 0 0 0
0 0 rol 0 0 0 0 0 0 0 0
0 0 rol / bpjs 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
133 Silk 2/0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
134 Silk 3/0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 135 Skin Celean 500 ml botol 0 0 0 0 0 0 0 0

0 0 136 Tranfusion Set buah 0 0 0 0 0 0 0 0
0 0 botol 0 0 0 0 0 0 0 0
137 USG GEL
0 0 botol / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
138 Urine Bag
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 REAGENSIA 0 0 0 0 0 0 0 0
0 0 139 Diluen Samsung Unit 0 0 0 0 0 0 0 0

0 0 140 Cleaner Samsung Unit 0 0 0 0 0 0 0 0
0 0 141 Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0
0 0 142 Lise Samsung Unit 0 0 0 0 0 0 0 0
0 0 143 Rinse Mindrey galon 0 0 0 0 0 0 0 0

0 0 OBAT PROGRAM APBD 0 0 0 0 0 0 0 0
0 0 Obat Paru 0 0 0 0 0 0 0 0
0 0 144 GARAM ORALIT SACHET 0 0 0 0 0 0 0 0

0 0 145 ZINC Tablet TABLET 0 0 0 0 0 0 0 0
0 0 146 OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 10 3026050 0
0 0 147 POT SPUTUM BUAH 0 0 0 0 0 0 0 0

0 0 149 Tuberculin PPD Vial 0 0 0 0 0 0 0 0
0 0 150 Sarung tangan tanpa tepung M buah 0 0 0 0 0 0 0 0
0 0 151 Lisol 100 % botol 0 0 0 0 0 0 0 0

10 0 0 152 Reagen Ziehl Neelsen kit 0 0 0 12 0 0 0 0 0
0 0 153 Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0
0 0 154 Spritus Liter 0 0 0 0 0 0 0 0

0 0 155 Lampu Bunsen Pcs 0 0 0 0 0 0 0 0
0 0 156 Imersion Oil Botol 0 0 0 0 0 0 0 0
0 0 Program IFA 0 0 0 0 0 0 0 0
0 0 157 KAPAS LIDI Bungkus 0 0 0 0 0 0 0 0

0 0 158 ASAM CUKA botol 0 0 0 0 0 0 0 0
0 0 159 CHLORIN Liter 0 0 0 0 0 0 0 0
0 0 160 Spritus Liter 0 0 0 0 0 0 0 0

0 0 Program Imunisasi 0 0 0 0 0 0 0 0
0 0 161 Alat suntik 0,05 ml set 0 0 0 0 0 0 0 0

0 0 163 Safety Box 5 liter box 0 0 0 0 0 0 0 0
0 0 Program HIV 0 0 0 0 0 0 0 0
0 0 164 BD Vacuntainer box 0 0 0 0 0 0 0 0
0 0 165 Vikia HIV 1/2 box 0 0 0 0 0 0 0 0

0 0 167 Rapid Test II ( FOKUS ) Test 0 0 0 0 0 0 0 0
0 0 168 RPR Sifilis ( FOCUS ) Test 0 0 0 0 0 0 0 0

0 0 169 Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0

0 0 171 Standard Q Shyphilis Ab kit 0 0 0 0 0 0 0 0
0 0 OBAT GIGI 0 0 0 0 0 0 0 0
0 0 172 ENDO ICE BOTOL 0 0 0 0 0 0 0 0
0 0 OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0
0 0 Program TB Paru 0 0 0 0 0 0 0 0
48 15708432 0 173 OAT FDC Kategori 1 paket 0 0 0 50 16362950 1 327259 0 32 10472288 0

8 10079920 0 174 OAT FDC Kategori 2 paket 0 0 0 0 0 0 0 0
0 0 175 OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0
0 0 176 RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0

600 1770000 0 177 POT SPUTUM BUAH 0 0 0 200 590000 0 0 200 590000 0
0 0 178 REAGEN TB PARU KIT 0 0 0 0 0 0 0 0
0 0 179 Kaca Slide Box 0 0 0 10 300000 0 0 10 300000 0
0 0 180 Lancet Box 0 0 0 0 0 0 0 0

0 0 Program Gizi 0 0 0 0 0 0 0 0
0 0 tablet 0 0 0 0 0 0 0 0
0 0 Provinsi 0 0 0 0 0 0 0 0
0 0 buah/ skipa 0 0 0 0 0 0 0 0
182 Spuit 0,5 ml
0 0 buah / apbn 0 0 0 0 0 0 0 0
0 0 BUAH 0 0 0 0 0 0 0 0
183 Spuit 0,05 ml
0 0 APBN 0 0 0 0 0 0 0 0
0 0 Box 0 0 0 0 0 0 0 0
0 0 184 Safety Box Box / 5ml 0 0 0 0 0 0 0 0

0 0 Box / 2,5ml 0 0 0 0 0 0 0 0
0 0 185 RCW Unit 0 0 0 0 0 0 0 0
0 0 Obat Rabies 0 0 0 0 0 0 0 0
0 0 186 Vaksin Rabies kur 0 0 0 0 0 0 0 0
0 0 OBAT APBN 0 0 0 0 0 0 0 0
0 0 187 Alkohol Swab buah 0 0 0 0 0 0 0 0

0 0 188 Benzatin Phenisillin 2,4 jt vial 0 0 0 0 0 0 0 0
0 0 189 Fluconazol tablet TABLET 0 0 0 0 0 0 0 0
0 0 190 Paket Kombipak HIV paket 0 0 0 0 0 0 0 0
0 0 191 PH Peper rol 0 0 0 0 0 0 0 0

0 0 193 Rapid Test I ( SD HIV 1/2) Test 0 0 0 0 0 0 0 0
0 0 194 Rapid Test Sifilis Test 0 0 0 0 0 0 0 0

0 0 195 Anuscopy buah 0 0 0 0 0 0 0 0
0 0 196 Yellow Tips bungkus 0 0 0 0 0 0 0 0

0 0 197 Blue Tips bungkus 0 0 0 0 0 0 0 0
0 0 198 Metilen Blue botol 0 0 0 0 0 0 0 0

0 0 199 Lens Paper boks 0 0 0 0 0 0 0 0
0 0 200 Jarum Vacutainer boks 0 0 0 0 0 0 0 0
0 0 201 KOH 10 % boks 0 0 0 0 0 0 0 0
0 0 202 Cotton Aplicator boks 0 0 0 0 0 0 0 0

0 0 204 Cover Glass Kotak 0 0 0 0 0 0 0 0
0 0 205 Handscoen boks 0 0 0 0 0 0 0 0

0 0 206 Disposable Needle No 18 boks 0 0 0 0 0 0 0 0
0 0 OBAT APBN PUSAT 0 0 0 0 0 0 0 0
0 0 Obat Vaccine 0 0 0 0 0 0 0 0
0 0 207 BCG VIAL 0 0 0 0 0 0 0 0

0 0 208 MR VIAL 0 0 0 0 0 0 0 0
0 0 209 DT (BIAS) VIAL 0 0 0 0 0 0 0 0
0 0 210 DT (BIAS) VIAL 0 0 0 0 0 0 0 0

0 0 211 HB-PID-(HB-0) VIAL 0 0 0 0 0 0 0 0
0 0 212 POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0
0 0 213 POLIO (IPV) VIAL 0 0 0 0 0 0 0 0

0 0 218 Td VIAL 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 245 Sarung tangan gynecolog 7,5 buah 0 0 0 0 0 0 0 0

0 0 247 Sarung tangan tanpa tepung S buah 0 0 0 0 0 0 0 0
0 0 248 Sarung tangan/hancun buah 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
249 Silk 2/0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
250 Silk 3/0
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 251 Suction Catether No 8 buah 0 0 0 0 0 0 0 0

0 0 252 Suction Catether No 16 buah 0 0 0 0 0 0 0 0
0 0 253 Softpad ( Underpad ) 60x90cm Bag buah 0 0 0 0 0 0 0 0

0 0 254 Stimulen Collagen Gel tube 0 0 0 0 0 0 0 0
0 0 255 Stimulen Collagen Lotion botol 0 0 0 0 0 0 0 0

0 0 256 Skin Celean 500 ml botol 0 0 0 0 0 0 0 0
0 0 257 Tranfusion Set buah 0 0 0 0 0 0 0 0
0 0 258 Tree Way Stop Cock Kotak 0 0 0 0 0 0 0 0
0 0 259 Tes Hamil buah 0 0 0 0 0 0 0 0

0 0 botol 0 0 0 0 0 0 0 0
260 USG GEL
0 0 botol bpjs 0 0 0 0 0 0 0 0
0 0 buah 0 0 0 0 0 0 0 0
261 Urine Bag
0 0 buah / bpjs 0 0 0 0 0 0 0 0
0 0 262 Urobag 2000 Steril T Valve buah 0 0 0 0 0 0 0 0
0 0 263 Wall Bracket Hand Wash Plastik buah 0 0 0 0 0 0 0 0
0 0 264 Wing Needle 19G buah 0 0 0 0 0 0 0 0


0 0 269 WIN FLON 18 G buah 0 0 0 0 0 0 0 0
0 0 270 WIN FLON 20 G buah 0 0 0 0 0 0 0 0

0 0 271 WIN FLON 22 G buah 0 0 0 0 0 0 0 0
0 0 272 WIN FLON 24 G buah 0 0 0 0 0 0 0 0
0 0 273 WIN FLON 26 G buah 0 0 0 0 0 0 0 0
0 0 REAGENSIA 0 0 0 0 0 0 0 0
0 0 274 Diluen Samsung Unit 0 0 0 0 0 0 0 0
0 0 275 Cleaner Samsung Unit 0 0 0 0 0 0 0 0
0 0 276 Hipo Cleaner Samsung Unit 0 0 0 0 0 0 0 0

0 0 277 Lise Samsung Unit 0 0 0 0 0 0 0 0
0 0 278 Rinse Mindrey galon 0 0 0 0 0 0 0 0
0 0 279 Probe Cleanser Mindrey botol 0 0 0 0 0 0 0 0

0 0 280 Diluen Mindrey galon 0 0 0 0 0 0 0 0
0 0 281 Calibration Serum kit 0 0 0 0 0 0 0 0
0 0 282 QC Serum kit 0 0 0 0 0 0 0 0
0 0 283 Billirubin kit 0 0 0 0 0 0 0 0

0 0 284 AST kit 0 0 0 0 0 0 0 0
0 0 285 ALT kit 0 0 0 0 0 0 0 0
0 0 286 Creatine kit 0 0 0 0 0 0 0 0

0 0 287 Ureum Nitrogen kit 0 0 0 0 0 0 0 0
0 0 288 Detecto HB S Antigen buah 0 0 0 0 0 0 0 0

0 0 289 Gluco Protein Tes Urine buah 0 0 0 0 0 0 0 0
0 0 290 Hcl 0,1 N 100 ml botol 0 0 0 0 0 0 0 0

0 0 291 Resecker botol 0 0 0 0 0 0 0 0
0 0 292 Widal Set Incl Control set 0 0 0 0 0 0 0 0
0 0 293 Ziehl Neelsen Set 5 x100 ml set 0 0 0 0 0 0 0 0
0 0 OBAT PROGRAM APBD 0 0 0 0 0 0 0 0

0 0 Obat Paru 0 0 0 0 0 0 0 0
0 0 294 GARAM ORALIT SACHET 0 0 0 0 0 0 0 0
0 0 295 OAT KAT I PAKET 0 0 0 0 0 0 0 0

0 0 296 OAT KAT II PAKET 0 0 0 0 0 0 0 0
0 0 297 OAT KAT ANAK PAKET 0 0 0 0 0 0 0 0
0 0 298 ZINC Tablet TABLET 0 0 0 0 0 0 0 0
0 0 299 OAT FDC Kategori 1 Kombipak PAKET 0 0 0 0 0 0 0 0

0 0 300 POT SPUTUM BUAH 0 0 0 0 0 0 0 0

0 0 303 Etanol 70% 1000 ml botol 0 0 0 0 0 0 0 0
0 0 304 Lisol 100 % botol 0 0 0 0 0 0 0 0
0 0 305 Reagen Ziehl Neelsen kit 0 0 0 0 0 0 0 0

0 0 306 Kaca Slide Box 0 0 0 0 0 0 0 0
0 0 307 Masker 3 Ply Earloop Jilbab buah 0 0 0 0 0 0 0 0
0 0 308 Spritus Liter 0 0 0 0 0 0 0 0
0 0 309 Lampu Bunsen Pcs 0 0 0 0 0 0 0 0

0 0 310 Imersion Oil Botol 0 0 0 0 0 0 0 0
0 0 Program IFA 0 0 0 0 0 0 0 0
0 0 311 KAPAS LIDI Bungkus 0 0 0 0 0 0 0 0

0 0 312 ASAM CUKA botol 0 0 0 0 0 0 0 0
0 0 313 CHLORIN Liter 0 0 0 0 0 0 0 0
0 0 314 Spritus Liter 0 0 0 0 0 0 0 0

0 0 317 Alat suntik 5 ml set 0 0 0 0 0 0 0 0

0 0 318 Safety Box 5 liter box 0 0 0 0 0 0 0 0
0 0 Program HIV 0 0 0 0 0 0 0 0

0 0 320 Fokus Anti HIV 1/2 Cassete Test 0 0 0 0 0 0 0 0
0 0 321 BD Vacuntainer box 0 0 0 0 0 0 0 0

0 0 322 Vikia HIV 1/2 box 0 0 0 0 0 0 0 0

0 0 326 Masker Plus 3 Ply Earloop ( Jilbab ) buah 0 0 0 0 0 0 0 0

0 0 328 Handscoen boks 0 0 0 0 0 0 0 0
0 0 329 Standard Q Shyphilis Ab kit 0 0 0 0 0 0 0 0
0 0 OBAT GIGI 0 0 0 0 0 0 0 0
0 0 330 Articulating paper PART DC Kotak 0 0 0 0 0 0 0 0
0 0 331 ENDO ICE BOTOL 0 0 0 0 0 0 0 0
0 0 332 FUJI IX ART 1-1 BOTOL 0 0 0 0 0 0 0 0
0 0 333 GUTTA PERCHA DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0

0 0 334 PAPER POINT DENTPLUS 15-40 PCS 0 0 0 0 0 0 0 0
0 0 335 CAL LC DENPRO PCS 0 0 0 0 0 0 0 0
0 0 336 CHKM(paraformal dehide 20 mg) PCS 0 0 0 0 0 0 0 0

0 0 337 Syiring Refil +shade A3-LA/APAC (Re SET 0 0 0 0 0 0 0 0
0 0 338 PULP X (DEVITALIZER) 5g Denpro PCS 0 0 0 0 0 0 0 0
0 0 339 Iodotin technodent PCS 0 0 0 0 0 0 0 0

0 0 OBAT PROGRAM PROVINSI 0 0 0 0 0 0 0 0
0 0 Program TB Paru 0 0 0 0 0 0 0 0
0 0 340 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0 0
0 0 341 OAT FDC Kategori 1 paket 0 0 0 0 0 0 0 0

0 0 342 OAT FDC Kategori 2 paket 0 0 0 0 0 0 0 0
0 0 343 OAT FDC Kategori 1 Kombipak paket 0 0 0 0 0 0 0 0
0 0 344 OAT FDC Kategori Anak paket 0 0 0 0 0 0 0 0

0 0 345 RH ( Fase Lanjutan ) paket 0 0 0 0 0 0 0 0
0 0 346 POT SPUTUM BUAH 0 0 0 0 0 0 0 0
0 0 347 REAGEN TB PARU KIT 0 0 0 0 0 0 0 0

0 0 348 Kaca Slide Box 0 0 0 0 0 0 0 0
0 0 349 Human Hexagon Sypilis KIT 0 0 0 0 0 0 0 0
0 0 350 Alkohol Sweb Box 0 0 0 0 0 0 0 0
0 0 351 Lancet Box 0 0 0 0 0 0 0 0

0 0 352 Sarung Tangan Karet Pasang 0 0 0 0 0 0 0 0
0 0 353 Safety Box Box 0 0 0 0 0 0 0 0
0 0 354 Mikroskop dan kotak Unit 0 0 0 0 0 0 0 0

0 0 Program Gizi 0 0 0 0 0 0 0 0
0 0 Kabsul 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
provinsi
0 0 Kabsul 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
provinsi
0 0 357 Nifas Merah tablet 0 0 0 0 0 0 0 0
0 0 358 Mineral Mix Kotak 0 0 0 0 0 0 0 0
0 0 359 ZINC Tablet tablet 0 0 0 0 0 0 0 0

0 0 tablet 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
provinsi
0 0 361 PMT Balita (MP ASI) Kotak 0 0 0 0 0 0 0 0
0 0 362 PMT Anak Sekolah Kotak 0 0 0 0 0 0 0 0
0 0 363 PMT Bumil Kek Kotak 0 0 0 0 0 0 0 0
0 0 Program Kesehatan Ibu 0 0 0 0 0 0 0 0
0 0 364 Gentamicin Injeksi 40 mg/ml ampul 0 0 0 0 0 0 0 0
0 0 365 Oxytocin injeksi ampul 0 0 0 0 0 0 0 0
0 0 366 Metil Ergometrin Maleat injeksi ampul 0 0 0 0 0 0 0 0
Fito Medanion (Vit K1) 10mg/ml-1ml

0 0 367 ampul 0 0 0 0 0 0 0 0
injeksi
0 0 Program Kesehatan Anak 0 0 0 0 0 0 0 0
0 0 368 Levotiroksin 100 mg tablet 0 0 0 0 0 0 0 0

0 0 369 Fenobarbital Injeksi 50 mg/ml ampul 0 0 0 0 0 0 0 0
0 0 Buah/ Skipa 0 0 0 0 0 0 0 0
370 Spuit 0,5 ml
0 0 buah/ Apbn 0 0 0 0 0 0 0 0
0 0 BUAH 0 0 0 0 0 0 0 0
371 Spuit 0,05 ml
0 0 BUAH 0 0 0 0 0 0 0 0
0 0 BUAH 0 0 0 0 0 0 0 0
372 Spuit 5 ml
0 0 BUAH 0 0 0 0 0 0 0 0
0 0 373 Kipi Kit BUAH 0 0 0 0 0 0 0 0
0 0 374 vaccine carrer BUAH 0 0 0 0 0 0 0 0

0 0 375 Spuit 0,5 ml BUAH 0 0 0 0 0 0 0 0
0 0 Box 0 0 0 0 0 0 0 0
0 0 376 Safety Box Box / 5ml 0 0 0 0 0 0 0 0

0 0 Box / 2,5ml 0 0 0 0 0 0 0 0
0 0 377 RCW Unit 0 0 0 0 0 0 0 0
0 0 Obat Flu Burung 0 0 0 0 0 0 0 0

0 0 378 Oseltamivir Kapsul 0 0 0 0 0 0 0 0
0 0 Obat Rabies 0 0 0 0 0 0 0 0
0 0 379 Vaksin Rabies kur 0 0 0 0 0 0 0 0

0 0 OBAT APBN 0 0 0 0 0 0 0 0
0 0 380 Acyclovir 400 mg tablet 0 0 0 0 0 0 0 0

0 0 381 Alkohol Swab buah 0 0 0 0 0 0 0 0
0 0 382 Benzatin Phenisillin 2,4 jt vial 0 0 0 0 0 0 0 0
0 0 383 Clindamicin 150 mg tablet 0 0 0 0 0 0 0 0
0 0 384 Fluconazol tablet tablet 0 0 0 0 0 0 0 0

0 0 385 Kondom Laki-laki pcs 0 0 0 0 0 0 0 0
0 0 386 Mikropipet Variabel buah 0 0 0 0 0 0 0 0
0 0 387 Paket Kombipak HIV paket 0 0 0 0 0 0 0 0

0 0 388 PH Peper rol 0 0 0 0 0 0 0 0
0 0 389 RPR Sifilis Test 0 0 0 0 0 0 0 0

0 0 392 Rapid Test II ( Intec) Test 0 0 0 0 0 0 0 0
0 0 394 Rapid Test III ( Oncoprobe) Test 0 0 0 0 0 0 0 0

0 0 395 Rapid Test Sifilis Test 0 0 0 0 0 0 0 0
0 0 396 Rotator buah 0 0 0 0 0 0 0 0
0 0 397 Tabung Vacutainer pack 0 0 0 0 0 0 0 0

0 0 398 Vikia HIV 1/2 buah 0 0 0 0 0 0 0 0
0 0 399 Anuscopy buah 0 0 0 0 0 0 0 0
0 0 400 LUBRICANT 82 mg buah 0 0 0 0 0 0 0 0
0 0 401 Yellow Tips bungkus 0 0 0 0 0 0 0 0

0 0 402 Blue Tips bungkus 0 0 0 0 0 0 0 0
0 0 403 Plesterin Bulat boks 0 0 0 0 0 0 0 0
0 0 404 Metilen Blue botol 0 0 0 0 0 0 0 0

0 0 405 Lens Paper boks 0 0 0 0 0 0 0 0
0 0 406 Jarum Vacutainer boks 0 0 0 0 0 0 0 0
0 0 407 KOH 10 % boks 0 0 0 0 0 0 0 0

0 0 408 Cotton Aplicator boks 0 0 0 0 0 0 0 0
0 0 410 Cover Glass Kotak 0 0 0 0 0 0 0 0
0 0 411 Handscoen boks 0 0 0 0 0 0 0 0

0 0 412 Disposable Needle No 18 boks 0 0 0 0 0 0 0 0
0 0 413 Reagen CD4 Test 0 0 0 0 0 0 0 0
0 0 OBAT APBN PUSAT 0 0 0 0 0 0 0 0

0 0 Obat Vaccine 0 0 0 0 0 0 0 0
0 0 414 BCG VIAL 0 0 0 0 0 0 0 0

0 0 415 Campak VIAL 0 0 0 0 0 0 0 0
0 0 416 MR VIAL 0 0 0 0 0 0 0 0
0 0 417 DPT-HB-Hib VIAL 0 0 0 0 0 0 0 0
0 0 418 DT (BIAS) VIAL 0 0 0 0 0 0 0 0
0 0 419 HB-PID-(HB-0) VIAL 0 0 0 0 0 0 0 0
0 0 420 POLIO (BOPV) VIAL 0 0 0 0 0 0 0 0

0 0 421 POLIO (IPV) VIAL 0 0 0 0 0 0 0 0
0 0 422 Td VIAL 0 0 0 0 0 0 0 0
Balai POM RSU PATAR ASIH Baksos IDI Deli Serdang ED TOTAL
TOTAL
HARGA SISA STOK
KELUAR
TOTAL TOTAL TOTAL TOTAL KELUAR
HARGA HARGA HARGA HARGA
0 0 0 0 0 0 1010
0 0 0 0 0 0 676500
0 0 0 0 0 0 248470
0 0 0 0 0 0 761560
0 0 0 0 8000 2120000 2711100
0 0 0 0 0 0 90550
0 0 0 0 2000 126000 1369400
0 0 0 0 100 206500 78590
0 0 0 0 0 0 8917
0 0 0 0 0 0 1175500
0 0 0 0 7000 1232000 66300

0 0 0 0 0 0 14584
0 0 0 0 500 72500 480000
0 0 0 0 0 0 491
0 0 0 0 0 0 261800
0 0 0 0 0 0 10807
0 0 0 0 0 0 70650
0 0 0 0 0 0 6440
0 0 0 0 3000 192000 1316500
0 0 0 0 0 0 3210
0 0 0 0 0 0 11230
0 0 0 0 1500 1126500 365100
0 0 0 0 0 0 4603
0 0 0 0 0 0 2715
0 0 0 0 0 0 50000
0 0 0 0 0 0 372100
0 0 0 0 0 0 39630
0 0 0 0 3000 174000 741502

0 0 0 0 0 0 16890
0 0 0 0 2000 480000 373900

0 0 0 0 0 0 97300
0 0 0 0 48 127200 28538
0 0 0 0 0 0 470280
0 0 0 0 16000 4992000 246500

0 0 0 0 0 0 28900
0 0 0 0 1050 8448300 3195
0 0 0 0 0 0 4450
0 0 0 0 0 0 17800
0 0 0 0 0 0 239380
0 0 0 0 0 0 98200
0 0 0 0 0 0 479900
0 0 0 0 500 357500 486430
0 0 0 0 0 0 106000
0 0 0 0 11000 473000 1574727

0 0 0 0 50 109150 92414
0 0 0 0 0 0 765500
0 0 0 0 0 0 8400
0 0 0 0 0 0 53882
0 0 0 0 0 0 51100
0 0 0 0 0 0 240
0 0 0 0 0 0 336600
0 0 0 0 0 0 14968
0 0 0 0 0 0 232300
0 0 0 0 0 0 232400
0 0 0 0 0 0 801644
0 0 0 0 0 0 49842
0 0 0 0 0 0 13833
0 0 0 0 3300 352011 208500
0 0 0 0 0 0 20887
0 0 0 0 0 0 102540
0 0 0 0 0 0 97400
0 0 0 0 0 0 46370
0 0 0 0 0 0 30637
0 0 0 0 1000 164000 323640

0 0 0 0 39000 1989000 412500
0 0 0 0 100 149600 103050

0 0 0 0 0 0 19210
0 0 0 0 0 0 2660
0 0 0 0 0 0 155500
0 0 0 0 0 0 1677000
0 0 0 0 0 0 14200
0 0 0 0 0 0 2400
0 0 0 0 0 0 19150
0 0 0 0 100 715000 28187
0 0 0 0 0 0 430
0 0 0 0 0 0 443000
0 0 0 0 0 0 2450
0 0 0 0 0 0 339
0 0 0 0 0 0 606500
0 0 0 0 0 0 285850
0 0 0 0 1000 133000 54430

0 0 0 0 1000 289000 31600
0 0 0 0 0 0 21400
0 0 0 0 440 5372400 4900

0 0 0 0 0 0 112900
0 0 0 0 0 0 658700
0 0 0 0 0 0 2205000
0 0 0 0 0 0 8460
0 0 0 0 0 0 1734
0 0 0 0 0 0 0
0 0 0 0 0 0 629
0 0 0 0 0 0 0
0 0 0 0 0 0 30
0 0 0 0 200 836000 24800

0 0 0 0 150 627000 24850
0 0 0 0 150 627000 24850
0 0 0 0 50 209000 24950
0 0 0 0 0 0 0
0 0 0 0 0 0 385
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 5510
0 0 0 0 400 316800 25990
0 0 0 0 0 0 0
0 0 0 0 0 0 100
0 0 0 0 0 0 1450
0 0 0 0 500 108000 50900
0 0 0 0 0 0 0
0 0 0 0 0 0 16
0 0 0 0 0 0 346
0 0 0 0 0 0 0
0 0 0 0 0 0 108
0 0 0 0 0 0 60
0 0 0 0 0 0 132
0 0 0 0 0 0 252
0 0 0 0 0 0 60
0 0 0 0 0 0 0
0 0 0 0 0 0 204
0 0 0 0 0 0 0
0 0 0 0 0 0 901
0 0 0 0 0 0 3026
0 0 0 0 0 0 583
0 0 0 0 0 0 387
0 0 0 0 0 0 305
0 0 0 0 0 0 0
0 0 0 0 0 0 1100
0 0 0 0 50 141563 2950
0 0 0 0 0 0 1030
0 0 0 0 300 1056000 9700
0 0 0 0 0 0 2955
0 0 0 0 0 0 1688
0 0 0 0 0 0 335
0 0 0 0 0 0 210
0 0 0 0 0 0 0
0 0 0 0 0 0 150
0 0 0 0 0 0 417
0 0 0 0 0 0 421
0 0 0 0 0 0 150
0 0 0 0 0 0 1205
0 0 0 0 0 0 2590
0 0 0 0 0 0 1521
0 0 0 0 0 0 5649
0 0 0 0 0 0 1087
0 0 0 0 20 176000 672
0 0 0 0 0 0 28816
0 0 0 0 0 0 50
0 0 0 0 0 0 100
0 0 0 0 0 0 199
0 0 0 0 0 0 107
0 0 0 0 0 0 6062
0 0 0 0 0 0 4250
0 0 0 0 0 0 2000
0 0 0 0 0 0 29000
0 0 0 0 0 0 64000
0 0 0 0 0 0 3750
0 0 0 0 0 0 3
0 0 0 0 0 0 13
0 0 0 0 0 0 24
0 0 0 0 0 0 129
0 0 0 0 0 0 104
0 0 0 0 0 0 0
0 0 0 0 0 0 126
0 0 0 0 0 0 0
0 0 0 0 0 0 241
0 0 0 0 0 0 226
0 0 0 0 0 0 295
0 0 0 0 0 0 4474
0 0 0 0 0 0 524
0 0 0 0 0 0 0
0 0 0 0 0 0 2010
0 0 0 0 0 0 0
0 0 0 0 0 0 240
0 0 0 0 0 0 0
0 0 0 0 0 0 120
0 0 0 0 0 0 340
0 0 0 0 0 0 9
0 0 0 0 0 0 0
0 0 0 0 0 0 135
0 0 0 0 0 0 0
0 0 0 0 0 0 1
0 0 0 0 0 0 0
0 0 0 0 0 0 2
0 0 0 0 0 0 1
0 0 0 0 0 0 2
0 0 0 0 0 0 1
0 0 0 0 0 0 2
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 74340
0 0 0 0 0 0 31400
0 0 0 0 30 9078150 17
0 0 0 0 0 0 28500
0 0 0 0 0 0 2000
0 0 0 0 11 7724750 89
0 0 0 0 0 0 34200
0 0 0 0 0 0 75
0 12 0 0 0 34 0 208
0 0 0 0 0 0 49900
0 0 0 0 0 0 20
0 0 0 0 0 0 50
0 0 0 0 0 0 2
0 0 0 0 0 0 0
0 0 0 0 0 0 40
0 0 0 0 0 0 190
0 0 0 0 0 0 38
0 0 0 0 0 0 230
0 0 0 0 0 0 0
0 0 0 0 0 0 8711
0 0 0 0 0 0 189314
0 0 0 0 0 0 2060
0 0 0 0 0 0 0
0 0 0 0 0 0 2600
0 0 0 0 0 0 350
0 0 0 0 0 0 50
0 0 0 0 0 0 375
0 0 0 0 0 0 200
0 0 0 0 0 0 400
0 0 0 0 0 0 1000
0 0 0 0 0 0 675
0 0 0 0 0 0 0
0 0 0 0 0 0 50
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 316 103413844 2395

0 0 0 0 18 22679820 0
0 0 0 0 6 1815630 0
0 0 0 0 0 0 16800
0 200 590000 0 0 3000 8850000 1400
0 0 0 0 0 0 1700
0 0 0 0 25 750000 930
0 0 0 0 0 0 3
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 8456000
0 0 0 0 0 0 0
0 0 0 0 0 0 27800
0 0 0 0 0 0 354300
0 0 0 0 0 0 0
0 0 0 0 0 0 27200
0 0 0 0 0 0 0
0 0 0 0 0 0 375
0 0 0 0 0 0 100
0 0 0 0 0 0 14
0 0 0 0 0 0 0
0 0 0 0 44 0 20
0 0 0 0 0 0 0
0 0 0 0 3 5955 28
0 0 0 0 0 0 27
0 0 0 0 0 0 27
0 0 0 0 10 399982 280
0 0 0 0 0 0 19
0 0 0 0 0 0 11000
0 0 0 0 400 8932000 1000
0 0 0 0 60 804420 3150
0 0 0 0 0 0 4
0 0 0 0 0 0 8
0 0 0 0 0 0 5
0 0 0 0 0 0 5
0 0 0 0 0 0 5
0 0 0 0 0 0 1
0 0 0 0 0 0 1
0 0 0 0 0 0 8
0 0 0 0 0 0 5
0 0 0 0 0 0 18
0 0 0 0 4 0 127
0 0 0 0 0 0 10
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 999
0 0 0 0 585 82864080 1678
0 0 0 0 2728 208105480 272
0 0 0 0 0 0 117
0 0 0 0 3185 66566500 2165
0 0 0 0 0 0 1778
0 0 0 0 745 10412120 725

0 0 0 0 444 7326000 211
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
Lubuk Pakam, JANUARI 2019
Ka. Instalasi Farmasi

Kabupaten Deli Serdang
Hedni Febrianty Sembiring, S.Farm, Apt

NIP : 198202032000122003

Laporan Puskesmas Gunung Meriah

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PELAPORAN : PUSKESMAS GUNUNG MERIAH 3 4 5 6 8 9 10 11 12

2 Acyclovir Krim tube 8,580 0 0 0 0 0 0 0 0 50 429000 0 0 0 50 429000

8 Amoksisilin Sirup 250 mg btl 60 ml 3,670 0 0 0 0 0 0 0 0 200 734000 0 0 0 200 734000

tablet/ H Baru 446 0 0 0 0 5,000 2227500 0 3,000 1336500 0 0 0 0 0 8000 3564000

tablet 176 0 0 800 140800 0 0 0 0 0 0 0 0 0 800 140800

silva/ 2014 304 0 0 0 0 0 0 0 0 2,000 607460 0 0 0 2000 607460

JKN 2019 444 0 0 0 0 0 0 0 0 0 0 0

14 Aminophyline Injeksi 24 mg/ml Ampul 2,976 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 Bisoprolol 5 mg tablet 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 11,550 0 0 0 0 0 0 300 3465000 0 0 0 0 0 300 3465000

JKN 2019 11,550 0 0 0 0 0 0 0 0 0 0 0

23 Diazepam Injeksi Ampul 1,822 0 0 0 0 0 0 0 0 2 3643 0 0 0 2 3643

27 Diphen Hidramin Inj 10 Ampul 1,228 0 0 0 0 0 0 0 0 0 0 0 0 0

31 Fito Menadione (Vit K1) 10mg/ml-1ml injeksi ampul 4,167 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 436 0 0 3,000 1308000 0 0 0 0 0 0 0 0 0 3000 1308000

tablet 58 0 0 4,000 232000 0 3,000 174000 0 3,000 174000 0 0 0 0 0 10000 580000

tablet/ H. Baru 125 0 0 0 0 0 0 0 0 3,000 375000 0 0 0 3000 375000

silva 2014 125 0 0 0 0 0 0 0 0 8,000 1000000 0 0 0 8000 1000000

38 Glukosa 10% Larutan Infus botol 7,500 0 0 0 0 0 0 5 37500 0 0 0 0 0 5 37500

39 Glimipiride 1 mg tablet 174 0 0 0 0 0 0 0 0 500 86995 0 0 0 500 86995

44 Hustab Tablet tablet 258 0 0 0 0 3,000 774000 0 0 0 0 0 0 3000 774000

tablet P 312 0 0 5,000 1560000 0 0 0 0 0 0 0 0 0 5000 1560000

silva/ 2015 11,550 0 0 0 0 0 0 0 0 150 1732500 0 0 0 150 1732500

botol / bpjs 8,046 0 0 0 0 0 0 0 0 0 0 0 0 0 0

46 Isoniazid ( INH ) tablet 100 mg tablet 75 0 0 0 0 0 0 0 0 0 0 0 0 0 0

48 Iliadin Spray botol 36,036 0 0 0 0 0 0 0 0 0 0 0 0 0 0

50 Kalsium Laktas 500 mg tablet 63 0 0 0 0 0 0 0 0 3,000 188970 0 0 0 188970

60 Loperramid tablet 2 mg tablet 80 0 0 4,000 320000 0 0 0 0 0 0 0 0 0 4000 320000

61 MgSO4 20 % ampul 3,200 0 0 30 96000 0 0 0 0 0 0 0 0 0 30 96000

Silva 2014 106 0 0 0 0 0 0 0 0 8,000 848000 0 0 0 8000 848000

tablet 133 0 0 17,000 2261000 0 7,644 1016652 0 0 0 0 0 0 0 24644 3277652

tablet 107 0 0 3,000 320010 0 1,500 160005 0 0 0 0 0 0 0 4500 480015

silva 2015 136 0 0 0 0 0 0 0 0 12,000 1630800 0 0 0 12000 1630800

70 Natrium Klorida larutan infus 0,9% botol/ H. Baru 6,218 0 0 0 0 0 0 0 0 0 0 0 0 0 0

APBD 2019 6,840 0 0 0 0 0 0 0 0 0 0 0 0 0

73 Nifedipin 20 mg tablet 3,575 0 0 0 0 0 0 300 1072500 0 0 0 0 0 300 1072500

74 Oksitetrasiklin salep mata 1 % tube 1,798 0 0 300 539400 0 0 0 0 0 0 0 0 0 300 539400

76 Omeprazole kapsul/kaplet 20 mg tablet 164 2,000 3,000 1,500

silva/ 2015 165 0 0 0 0 0 0 0 0 15,000 2469300 0 0 0 15000 2469300

JKN 2019 165 0 0 0 0 0 0 0 0 0 0 0 0 0

79 Pehacain Injeksi ampul / bpjs 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0 0

JKN 2019 3,113 0 0 0 0 0 0 0 0 0 0 0 0 0

82 Prednison 5 mg Tablet tablet 96 0 0 0 0 0 0 0 0 0 0 0 0 0 0

83 Propanolol HCL 10 mg tablet 66 0 0 0 0 0 0 0 0 0 0 0 0 0 0

tablet 191 0 0 0 0 0 0 3,000 571980 0 3,000 571980 0 0 0 6000 1143960

Silva 2014 191 0 0 0 0 0 0 0 0 2000 381320 0 0 0 2000 381320

JKN 2019 225 0 0 0 0 0 0 0 0 0 0 0

85 Ranitidin Injeksi 25 mg Ampul 1,188 0 0 0 0 0 0 0 0 0 0 0 0 0 0

87 Retinol 200.000 ( Vit. A Kapsul Merah) kapsul - 0 0 0 0 0 0 0 0 656 0 0 0 0 656 0

91 Salbutamol Cairan 0,1 % ampul 4,000 0 0 100 400000 0 0 0 0 0 0 0 0 0 100 400000

92 Salbutamol syrup botol 4,042 0 0 0 0 0 0 100 404182 0 0 0 0 0 100 404182

94 Serum ATS 1.500 IU Injeksi ampul 188,663 0 0 0 0 0 0 3 565989 0 5 943315 0 0 0 8 1509304

tablet 133 0 0 1,000 133000 0 0 0 0 0 0 0 0 0 1000 133000

97 Simvastatin tablet 10 mg tablet 129 0 0 0 0 0 0 0 0 3,000 386100 0 0 0 3000 386100

tablet/ SILVA 2015 117 0 0 0 0 0 0 0 0 18,000 2106000 0 0 0 18000 2106000

98 Simvastatin tablet 20 mg tablet 126 0 0 0 0 0 0 0 0 500 63000 0 0 0 500 63000

100 Sanadryl Syrup botol 12,210 0 0 0 0 0 0 0 0 0 0 0 0 0 0

105 Zink Tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0

botol 6,290 0 0 0 0 0 0 0 0 50 314500 0 0 0 50 314500

BAHAN MEDIS HABIS PAKAI - 0 0 0 0 0 0 0 0 0 0 0 0 0 0

buah 4,180 0 0 200 836000 0 50 209000 0 50 209000 0 50 209000 0 0 0 350 1463000

buah 216 0 0 1,000 216000 0 200 43200 0 0 0 0 0 0 0 1200 259200