Aset Apbd 2022 PKM Perawatan Lasung

LAPORAN PENERIMAAN DAN PENGELUARAN OBAT APBD
BULAN JANUARI 2022

Puskesmas : Perawatan Lasung
KAB. / KOTA : Tanah Bumbu
PROVINSI : Kalimantan Selatan
Stock Awal PENERIMAAN PENGELUARAN Stock Akhir
IFK Realisasi
NO Banyaknya KET
Nama Obat Harga satuan Total Harga Berita acara Jumlah Total harga
Jumlah TOTAL Harga Jumlah Total harga
Jumlah Satuan no tgl

1 2 3 4 5 6 7 8 9 10 19 20 25 26 27
BMHP Program HIV
1 Safety box 51 IDR Rp 16,666.00 Rp 849,966.00 Rp - 0 Rp - 51 Rp 849,966.00
2 Plesterin Bulat non woven 3 Kotak Rp 40,187.50 Rp 120,562.50 Rp - 0 Rp - 3 Rp 120,562.50
3 Vacum Tube sterile, plastic, K3 EDTA 1880 Pcs Rp 1,160.00 Rp 2,180,800.00 Rp - 280 Rp 324,800.00 1600 Rp 1,856,000.00
4 surgical Gloves no. 7, 5 100 Pcs Rp 13,178.00 Rp 1,317,800.00 Rp - 0 Rp - 100 Rp 1,317,800.00
5 surgical Gloves no. 8 100 Pcs Rp 13,178.00 Rp 1,317,800.00 Rp - 0 Rp - 100 Rp 1,317,800.00
6 Vacutainer Needle 550 Pcs Rp 132.00 Rp 72,600.00 Rp - 0 Rp - 550 Rp 72,600.00
BMHP Program TB
1 Larutan Zhihi Neeisen 13 Paket Rp 3,566,706.00 Rp - 2 Rp 548,724.00 11 Rp 3,017,982.00

Rp 274,362.00
2 Sputum Pot 0 Biji Rp - Rp - 0 Rp - 0 Rp -

Rp 3,137.00
2 Object Glass Frosted 7105 9 box @ 72 pcs Rp 214,740.72 Rp - 0 Rp - 9 Rp 214,740.72

Rp 23,860.08
DAU 2021
Btl isi @ 30
1 Multivitamin Ibu Hamil OMEGA 3 0
kapsul
Rp 45,000.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP 0
2 Disposable syringe 1 cc 100 Pcs Rp 1,361.00 Rp 136,100 Rp - 0 Rp - 100 Rp 136,100
3 Sarung Tangan Uk. S 800 Pcs Rp 1,712.53 Rp 1,370,024 Rp - 200 Rp 342,506 600 Rp 1,027,518
4 Sarung Tangan Uk. M 400 Pcs Rp 1,710.13 Rp 684,052 Rp - 100 Rp 171,013 300 Rp 513,039
P 21
1 Acyclovir Cream 46 Tube Rp 4,400.00 Rp 202,400 Rp - 4 Rp 17,600 42 Rp 184,800
2 Bedak Salisil 30 Wadah Rp 7,700.00 Rp 231,000 1/19/2022 12 Rp 92,400 10 Rp 77,000 32 Rp 246,400
3 Bicombin inj 137 Ampul Rp 6,600.00 Rp 904,200 Rp - 61 Rp 402,600 76 Rp 501,600
4 Cefadroxil 500 mg 3750 Kap Rp 880.00 Rp 3,300,000 Rp - 182 Rp 160,160 3568 Rp 3,139,840
5 Digoxin 0,5 mg 500 Tab Rp 198.00 Rp 99,000 Rp - 0 Rp - 500 Rp 99,000
6 Eflin 500 Tab Rp 1,413.50 Rp 706,750 Rp - 0 Rp - 500 Rp 706,750
7 Furosemid 800 Tab Rp 275.00 Rp 220,000 Rp - 180 Rp 49,500 620 Rp 170,500
8 Ibuprofen 200mg 1390 Tab Rp 275.00 Rp 382,250 1/19/2022 2000 Rp 550,000 240 Rp 66,000 3150 Rp 866,250
9 Kloramfenikol 250 mg 400 Kap Rp 770.00 Rp 308,000 Rp - 0 Rp - 400 Rp 308,000
10 Lexartans (as. Traneksamat) 100 Tab Rp 1,650.00 Rp 165,000 Rp - 80 Rp 132,000 20 Rp 33,000
11 Meloxicam 7,5 mg 2230 Tab Rp 385.00 Rp 858,550 Rp - 280 Rp 107,800 1950 Rp 750,750
12 Novastan syr 100 Btl Rp 11,000.00 Rp 1,100,000 Rp - 6 Rp 66,000 94 Rp 1,034,000
13 Nifedipine 1600 Tab Rp 220.00 Rp 352,000 1/19/2022 2000 Rp 440,000 130 Rp 28,600 3470 Rp 763,400
14 Oxytetracycline Salep Kulit 3% 159 Tube Rp 4,950.00 Rp 787,050 Rp - 24 Rp 118,800 135 Rp 668,250
15 OBH Plus 142 Btl Rp 12,100.00 Rp 1,718,200 1/19/2022 48 Rp 580,800 6 Rp 72,600 184 Rp 2,226,400
16 Paracetamol 500 mg 110 tab Rp 275.00 Rp 30,250 1/19/2022 6000 Rp 1,650,000 950 Rp 261,250 5160 Rp 1,419,000
17 Reco Salep Mata ( Chloamphenicol) 200 Tube Rp 6,600.00 Rp 1,320,000 Rp - 0 Rp - 200 Rp 1,320,000
18 Reco Tetes Telinga (Chloramphenicol) 188 Btl Rp 11,000.00 Rp 2,068,000 Rp - 18 Rp 198,000 170 Rp 1,870,000
19 Skincol Gel 10 Tube Rp 148,500.00 Rp 1,485,000 Rp - 1 Rp 148,500 9 Rp 1,336,500

DAK 2021
Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg
1
(hexapram Jaya )
3454 Tab Rp 231.00 Rp 797,874 Rp - 1130 Rp 261,030 2324 Rp 536,844
2 Amoksisilin sirup kering 125mg/5ml 220 Btl Rp 2,050.00 Rp 451,000 Rp - 1 Rp 2,050 219 Rp 448,950
3 Allupurinol 100 mg 1280 Tab Rp 89.00 Rp 113,920 Rp - 100 Rp 8,900 1180 Rp 105,020
5 Asam Mefenamat 4230 tab Rp 117.00 Rp 494,910 Rp - 840 Rp 98,280 3390 Rp 396,630
6 Amlodipine 5 mg 1300 Tab Rp 55.00 Rp 71,500 1/19/2022 500 Rp 27,500 300 Rp 16,500 1500 Rp 82,500
8 Ampisillin serbuk injeksi i.v 1000 mg/ Vial 90 Vial Rp 9,900.00 Rp 891,000 Rp - 0 Rp - 90 Rp 891,000
9 Antihemeroid kombinasi 92 Suppo Rp 3,260.00 Rp 299,920 Rp - 11 Rp 35,860 81 Rp 264,060
Antifungi DOEN kombinasi: Asam Benzoat 3% + Asam
10
Salisilat 6%
47 Botol Rp 3,637.00 Rp 170,939 Rp - 0 Rp - 47 Rp 170,939
11 Antasida Doen I Tablet Kunyah 2460 Tab Rp 54.00 Rp 132,840 Rp - 1180 Rp 63,720 1280 Rp 69,120
12 Antasida Doen suspensi 172 Botol Rp 1,756.00 Rp 302,032 1/19/2022 300 Rp 526,800 91 Rp 159,796 381 Rp 669,036
13 Asam askorbat / Vit C 50 mg 1980 Tab Rp 46.00 Rp 91,080 Rp - 250 Rp 11,500 1730 Rp 79,580
14 Asam Traneksamat injeksi 40 amp Rp 1,820.00 Rp 72,800 Rp - 14 Rp 25,480 26 Rp 47,320
15 Asam folat tab 1 mg 2670 pcs Rp 61.00 Rp 162,870 Rp - 880 Rp 53,680 1790 Rp 109,190
16 Asetosal 80 mg 250 Tab Rp 89.00 Rp 22,250 Rp - 130 Rp 11,570 120 Rp 10,680
17 Betahistine 6 mg 540 Tab Rp 92.00 Rp 49,680 Rp - 320 Rp 29,440 220 Rp 20,240
18 Betamethason cream 99 Tab Rp 1,540.00 Rp 152,460 Rp - 10 Rp 15,400 89 Rp 137,060
19 Captopril 12,5 mg 2300 tab Rp 68.00 Rp 156,400 Rp - 360 Rp 24,480 1940 Rp 131,920
20 Cetrizine syr 46 Botol Rp 2,215.00 Rp 101,890 Rp - 19 Rp 42,085 27 Rp 59,805
21 Cefotaxim Injeksi 33 Vial Rp 3,050.00 Rp 100,650 1/19/2022 100 Rp 305,000 109 Rp 332,450 24 Rp 73,200
22 Diazepam inj 5 mg / 2 ml 10 Ampul Rp 1,545.00 Rp 15,450 Rp - 2 Rp 3,090 8 Rp 12,360
23 Dexamethasone injeksi 179 Ampul Rp 968.00 Rp 173,272 1/19/2022 200 Rp 193,600 166 Rp 160,688 213 Rp 206,184
24 Doksisiklin 500 Tab Rp 289.00 Rp 144,500 Rp - 0 Rp - 500 Rp 144,500
25 Domperidone syr 140 Botol Rp 2,401.00 Rp 336,140 Rp - 10 Rp 24,010 130 Rp 312,130
26 Eritromisin sirup 200 mg 100 Botol Rp 7,436.00 Rp 743,600 Rp - 0 Rp - 100 Rp 743,600
27 Furosemid Injeksi i.v./i.m 10mg/ml 60 Ampul Rp 969.00 Rp 58,140 Rp - 44 Rp 42,636 16 Rp 15,504
28 Glukosa Infus D5% 80 btl Rp 7,363.00 Rp 589,040 Rp - 0 Rp - 80 Rp 589,040
29 Glibenklamide 5 mg 470 Tab Rp 87.00 Rp 40,890 1/19/2022 300 Rp 26,100 270 Rp 23,490 500 Rp 43,500
30 Haloperidole 5 mg 200 Tab Rp 54.00 Rp 10,800 Rp - 0 Rp - 200 Rp 10,800
31 Hyoscine N butylbromide 390 Tab Rp 1,050.00 Rp 409,500 Rp - 10 Rp 10,500 380 Rp 399,000
Karbogliserin tetes telinga 10% (phenol gliserol tts.
32
Telinga)
17 Botol Rp 3,300.00 Rp 56,100 Rp - 4 Rp 13,200 13 Rp 42,900
33 Kalsium laktat (Kalk) 500 mg 1030 Tab Rp 60.00 Rp 61,800 1/19/2022 2000 Rp 120,000 1030 Rp 61,800 2000 Rp 120,000
34 Ketorolac inj 30Mg/MI 20 Ampul Rp 923.00 Rp 18,460 1/19/2022 50 Rp 46,150 1 Rp 923 69 Rp 63,687
35 Isosorbid Dinitrat tablet sublingual 5mg 195 Tab Rp 99.00 Rp 19,305 Rp - 30 Rp 2,970 165 Rp 16,335
36 Ibuprofen Syr 100mg/5ml 174 Btl Rp 2,339.00 Rp 406,986 Rp - 0 Rp - 174 Rp 406,986
37 Ketokonazole Cream 216 Tube Rp 2,399.00 Rp 518,184 Rp - 13 Rp 31,187 203 Rp 486,997
38 Ketokonazole tablet 200mg 540 Tab Rp 260.00 Rp 140,400 Rp - 50 Rp 13,000 490 Rp 127,400
39 Kloramfenikol Suspensi 125 mg/ 5ml 99 Btl Rp 5,352.00 Rp 529,848 Rp - 0 Rp - 99 Rp 529,848
40 Lansoprazole 30 mg 1930 kap Rp 278.00 Rp 536,540 1/19/2022 2000 Rp 556,000 600 Rp 166,800 3330 Rp 925,740
41 Lidocain inj 2 % (HCL) 199 Ampul Rp 891.00 Rp 177,309 Rp - 44 Rp 39,204 155 Rp 138,105
42 Loratadine 370 kap Rp 117.00 Rp 43,290 Rp - 10 Rp 1,170 360 Rp 42,120
43 Metformin HCL 500 mg 6880 tab Rp 77.00 Rp 529,760 Rp - 1110 Rp 85,470 5770 Rp 444,290
44 Metilprednisolon tablat 4 mg 2190 tab Rp 102.00 Rp 223,380 1/19/2022 2000 Rp 204,000 1070 Rp 109,140 3120 Rp 318,240
45 Metoklopramid inj 159 Ampul Rp 1,983.00 Rp 315,297 Rp - 71 Rp 140,793 88 Rp 174,504
46 Methamizole Na Inj 100 Ampul Rp 3,045.00 Rp 304,500 Rp - 100 Rp 304,500 0 Rp -
47 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp - Rp - 0 Rp - 0 Rp -
48 Mikonazole kream 170 Tube Rp 1,900.00 Rp 323,000 Rp - 6 Rp 11,400 164 Rp 311,600
49 Nistatin drop 32 Btl Rp 11,750.00 Rp 376,000 Rp - 0 Rp - 32 Rp 376,000
50 Natrium Diklofenak 25 mg 2770 tab Rp 109.00 Rp 301,930 Rp - 630 Rp 68,670 2140 Rp 233,260
51 N-Asetilsistein 600 Tab Rp 317.00 Rp 190,200 Rp - 30 Rp 9,510 570 Rp 180,690
52 Natrium Chloride 0,9 % ( NACL 0,9 %) 100 btl Rp 6,900.00 Rp 690,000 1/19/2022 100 Rp 690,000 60 Rp 414,000 140 Rp 966,000
53 Oxytocin injeksi 100 Ampul Rp 1,248.00 Rp 124,800 Rp - 0 Rp - 100 Rp 124,800
54 Parasetamol syr 260 btl Rp 1,160.00 Rp 301,600 Rp - 71 Rp 82,360 189 Rp 219,240
55 Phytomenadion inj 2mg/ml 90 Ampul Rp 3,900.00 Rp 351,000 Rp - 0 Rp - 90 Rp 351,000
56 Permetrin cream 17 Tube Rp 11,466.00 Rp 194,922 1/19/2022 5 Rp 57,330 22 Rp 252,252 0 Rp -
57 Ranitidin tablet 150 mg 2600 tab Rp 85.00 Rp 221,000 Rp - 30 Rp 2,550 2570 Rp 218,450
58 Ranitidin injeksi 0 Ampul Rp 858.00 Rp - Rp - 0 Rp - 0 Rp -
59 Salbutamol 4 mg 0 Tab Rp 67.00 Rp - Rp - 0 Rp - 0 Rp -
60 Salep 2-4 16 Pot Rp 1,475.00 Rp 23,600 Rp - 0 Rp - 16 Rp 23,600
61 Simvastatin 10 mg 1800 tab Rp 73.00 Rp 131,400 Rp - 0 Rp - 1800 Rp 131,400
62 Simvastatin 20 mg 1340 tab Rp 73.00 Rp 97,820 Rp - 660 Rp 48,180 680 Rp 49,640
63 Siprofloksasin 500 mg 1180 Tab Rp 260.00 Rp 306,800 Rp - 370 Rp 96,200 810 Rp 210,600
64 Sianocbalamin (B12) 700 Tab Rp 44.00 Rp 30,800 1/19/2022 1000 Rp 44,000 170 Rp 7,480 1530 Rp 67,320
65 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 240 Ampul Rp 1,066.00 Rp 255,840 Rp - 16 Rp 17,056 224 Rp 238,784
66 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00 Rp 1,034,264 Rp - 0 Rp - 2 Rp 1,034,264
67 VAR 2 Vial Rp 153,000.00 Rp 306,000 Rp - 0 Rp - 2 Rp 306,000
68 Vit. B.Complex 230 Tab Rp 60 Rp 13,800 1/19/2022 4000 Rp 240,000 390 Rp 23,400 3840 Rp 230,400
69 Zink 20 mg tab 70 Tab Rp 253.00 Rp 17,710 Rp - 30 Rp 7,590 40 Rp 10,120.00
70 Zink syr 0 Btl Rp 2,489.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
71 Disposable syringe 3 cc 1400 Pcs Rp 818.00 Rp 1,145,200 Rp - 200 Rp 163,600 1200 Rp 981,600.00
72 Disposable syringe 10 cc 200 Pcs Rp 1,100.00 Rp 220,000 Rp - 0 Rp - 200 Rp 220,000.00
73 Folly Catheter 18 20 pcs Rp 11,132.00 Rp 222,640 Rp - 0 Rp - 20 Rp 222,640.00
74 Handscoond steril no 6,5 450 Pasang Rp 13,563.00 Rp 6,103,350 Rp - 1 Rp 13,563 449 Rp 6,089,787.00
75 Handscoond steril no 7 996 Pasang Rp 13,563.00 Rp 13,508,748 Rp - 106 Rp 1,437,678 890 Rp 12,071,070.00
77 Hand Sanitizer / Handrub 500 ml 40 Btl Rp 68,200.00 Rp 2,728,000.00 Rp - 3 Rp 204,600.00 37 Rp 2,523,400.00
78 Handscrub 1 Btl Rp 115,800.00 Rp 115,800.00 Rp - 0 Rp - 1 Rp 115,800.00
79 Infus Set Dewasa 125 pcs Rp 7,128.00 Rp 891,000 Rp - 125 Rp 891,000 0 Rp -
80 IV.Chateter No.18 G 100 pcs Rp 25,487.00 Rp 2,548,700 1/19/2022 100 Rp 2,548,700 0 Rp - 200 Rp 5,097,400.00
81 Scalpet Blades no.10 0 Pcs Rp 618.70 Rp - Rp - 0 Rp - 0 Rp -
82 Scalpet Blades no.15 100 Pcs Rp 618.71 Rp 61,871 Rp - 0 Rp - 100 Rp 61,871.29
83 Surgical mask earloop 3ply / Masker 0 Box Rp 1,373.14 Rp - Rp - 0 Rp - 0 Rp -
84 Under Pad Steril 200 pcs Rp 37,875.00 Rp 7,575,000 Rp - 0 Rp - 200 Rp 7,575,000.00
DAK 2020
1 CTM 4 mg 1340 tab Rp 26.00 Rp 34,840 Rp - 710 Rp 18,460 630 Rp 16,380
2 Cetrizine 10 mg 640 tab Rp 104.00 Rp 66,560 1/19/2022 1000 Rp 104,000 360 Rp 37,440 1280 Rp 133,120
3 Gentamicine tetes mata 12 Botol Rp 4,885.00 Rp 58,620 Rp - 12 Rp 58,620 0 Rp -
4 Kodein 10 mg 244 Tab Rp 657.00 Rp 160,308 Rp - 60 Rp 39,420 184 Rp 120,888
5 Metilprednisolon tablat 4 mg 0 tab Rp 148.00 Rp - Rp - 0 Rp - 0 Rp -
6 Paracetamol Drop 364 Botol Rp 7,646.00 Rp 2,783,144 Rp - 2 Rp 15,292 362 Rp 2,767,852
BMHP
7 Catgut chromic 3/0 +jarum Bulat (*optime*) 0 Pcs Rp 55,000.00 Rp - 1/19/2022 36 Rp 1,980,000 0 Rp - 36 Rp 1,980,000
8 Catgut chromic 3/0 +jarum Segitiga (*optime*) 0 Pcs Rp 62,000.00 Rp - Rp - 0 Rp - 0 Rp -
9 Catgut chromic 2/0 +jarum Bulat (*optime-R*) 42 Pcs Rp 44,000.00 Rp 1,848,000 Rp - 0 Rp - 42 Rp 1,848,000
10 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 36 Pcs Rp 71,000.00 Rp 2,556,000 Rp - 36 Rp 2,556,000 0 Rp -
11 Handscoond steril no 8 146 Pasang Rp 13,178.00 Rp 1,923,988 Rp - 3 Rp 39,534 143 Rp 1,884,454
12 Kasa 16x16 85 pcs Rp 7,897.31 Rp 671,271 Rp - 0 Rp - 85 Rp 671,271
13 Silk 2/0 + jarum 1/2 25 mm 75 cm 36 Pcs Rp 32,500.00 Rp 1,170,000 Rp - 0 Rp - 36 Rp 1,170,000
14 Umbilical Cord Klem 100 Pcs Rp 1,495.00 Rp 149,500 Rp - 0 Rp - 100 Rp 149,500
DAU 2020
1 Aqua pro injeksi 20 ml 190 ampul Rp 2,860.00 Rp 543,400 Rp - 84 Rp 240,240 106 Rp 303,160
2 Hyoscine N butylbromide 10 mg inj 56 Ampul Rp 9,900.00 Rp 554,400 Rp - 4 Rp 39,600 52 Rp 514,800
3 Natrium Chloride 0,9 % ( NACL 0,9 %) 100 btl Rp 6,840.00 Rp 684,000 Rp - 100 Rp 684,000 0 Rp -
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00 Rp 161,260 Rp - 0 Rp - 220 Rp 161,260
5 Ringer Laktat (RL) 180 btl Rp 7,150.00 Rp 1,287,000 1/19/2022 100 Rp 715,000 80 Rp 572,000 200 Rp 1,430,000
P 2020
1 Ambroxol sirup 15 mg/5 ml 141 Btl Rp 3,250.01 Rp 458,251 Rp - 27 Rp 87,750 114 Rp 370,501
2 Ambroxol Tablet 30 mg 590 Tab Rp 110.00 Rp 64,900 Rp - 50 Rp 5,500 540 Rp 59,400
3 Bisakodil Suppo 18 Suppo Rp 23,475.00 Rp 422,550 Rp - 12 Rp 281,700 6 Rp 140,850
4 Bisakodil ( LAXANA) 40 Tab Rp 367.00 Rp 14,680 Rp - 6 Rp 2,202 34 Rp 12,478
5 Guaiafenesin (GG) 100 mg 190 tab Rp 175.00 Rp 33,250 Rp - 190 Rp 33,250 0 Rp -
Kombinasi Tetes Mata (Deksametason, Neomisin

6 Sulfat, Polimiksin B Sulfat ) ALLETROL 19 Botol Rp 14,900.00 Rp 283,100 Rp - 5 Rp 74,500 14 Rp 208,600
COMPOSITUM
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 67 Botol Rp 12,900.00 Rp 864,300 1/19/2022 100 Rp 1,290,000 71 Rp 915,900 96 Rp 1,238,400
Obat flu kombinasi ( pseudoephedrin Hcl, Tripolidin
8
Hcl ) FLUTROP
420 tab Rp 600.00 Rp 252,000 Rp - 90 Rp 54,000 330 Rp 198,000
9 Salbutamol nebulizer / Ventolin Nebulizer 50 Flash Rp 10,000.00 Rp 500,000 1/19/2022 60 Rp 600,000 7 Rp 70,000 103 Rp 1,030,000
10 Hemafort 0 Tab Rp 820.00 Rp - 1/19/2022 5000 Rp 4,100,000 330 Rp 270,600 4670 Rp 3,829,400
DAK 2019
1 Acyclovir 400 mg 310 Tab Rp 425.00 Rp 131,750 Rp - 0 Rp - 310 Rp 131,750
2 Alprazolam 0,5 mg 365 tab Rp 88.00 Rp 32,120 Rp - 60 Rp 5,280 305 Rp 26,840
3 Cefadroxil sirup kering 125mg/5ml 116 btl Rp 4,360.00 Rp 505,760 Rp - 75 Rp 327,000 41 Rp 178,760
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 8 Tube Rp 14,459.00 Rp 115,672 Rp - 0 Rp - 8 Rp 115,672
5 Kotrimoxazole syr 111 btl Rp 2,052.00 Rp 227,772 Rp - 18 Rp 36,936 93 Rp 190,836
6 Metoklopramide 10 mg 140 tab Rp 83.00 Rp 11,620 Rp - 40 Rp 3,320 100 Rp 8,300
7 Oxtretrasiklin Salep Mata 96 tube Rp 2,600.00 Rp 249,600 Rp - 19 Rp 49,400 77 Rp 200,200
8 Pirantel 125 mg 53 tab Rp 331.00 Rp 17,543 Rp - 0 Rp - 53 Rp 17,543
BMHP
9 Alat Suntik 5 ml 1800 pcs Rp 1,600 Rp 2,880,000 Rp - 0 Rp - 1800 Rp 2,880,000
10 Folly Catheter 14 10 pcs Rp 11,891.00 Rp 118,910 Rp - 0 Rp - 10 Rp 118,910
PENUNJANG 2019
1 Gentamicin salep kulit 85 tube Rp 2,640.00 Rp 224,400 Rp - 45 Rp 118,800 40 Rp 105,600
2 Loperamide 860 Tab Rp 198.00 Rp 170,280 Rp - 0 Rp - 860 Rp 170,280
3 Multivitamin syr anak ( Becefort ) 278 Botol Rp 17,365.70 Rp 4,827,665 Rp - 40 Rp 694,628 238 Rp 4,133,037
Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep
4
Sirup)
298 btl Rp 3,850.00 Rp 1,147,300 Rp - 4 Rp 15,400 294 Rp 1,131,900
BG 2019 0
1 Pehacain 100 Ampul Rp 3,113.0495 Rp 311,305 Rp - 80 Rp 249,044 20 Rp 62,261
DAK 2018
1 Diazepam 5 mg 223.5 Tab Rp 109.00 Rp 24,362 Rp - 104 Rp 11,336.00 119.5 Rp 13,025.50
2 HCT 25 mg 190 tab Rp 178.00 Rp 33,820 Rp - 160 Rp 28,480 30 Rp 5,340.00
3 Nistatin 100.000 IU 73 tab Rp 645.00 Rp 47,085 Rp - 73 Rp 47,085 0 Rp -
BMHP
4 Blood Lancet 800 Pcs Rp 167.509 Rp 134,007 Rp - 400 Rp 67,004 400 Rp 67,004
5 Plaster ( Hifafix ) 16 Roll Rp 29,642.86 Rp 474,286 Rp - 10 Rp 296,429 6 Rp 177,857
DAU 2017
BMHP Rp - Rp -
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 36 Pcs Rp 46,187.44 Rp 1,662,748 Rp - 0 Rp - 36 Rp 1,662,748
DAK 2017 Rp - Rp -
1 Diltiazem 30 mg 440 tab Rp 128.00 Rp 56,320 Rp - 0 Rp - 440 Rp 56,320
BMHP
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 25 Bks Rp 14,375.00 Rp 359,375 Rp - 0 Rp - 25 Rp 359,375
2 Kasa 4mx5cm 300 Roll Rp 862.50 Rp 258,750 Rp - 100 Rp 86,250 200 Rp 172,500
APBD 2016 Rp -
BMHP 2016 Rp -
1 Infus set anak (Aximed) 150 pcs Rp 6,222.00 Rp 933,300 Rp - 0 Rp - 150 Rp 933,300
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 18 roll/bungkus Rp 11,914 Rp 214,452 Rp - 0 Rp - 18 Rp 214,452
TOTAL 85,606.50 Rp 116,694,033.34 30,111 Rp 17,768,780.00 20,300 Rp 18,155,200.43 95,417.50 Rp 116,307,612.91
Mengetahui Binawara, 31 Januari 2022

Kepala Puskesmas Perawatan Lasung Pengelola Obat Puskesmas
Rosyidah, A.Md.Keb Summi Ariyani, A.Md. Far

NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011
BULAN FEBRUARI 2022
IFK Realisasi
NO Banyaknya KET
1 2 3 4 5 6 7 8 9 10 19 20 25 26 27
BMHP Program HIV
3 Vacum Tube sterile, plastic, K3 EDTA 1600 Pcs Rp 1,160.00 Rp 1,856,000.00 Rp - 0 Rp - 1600 Rp 1,856,000.00
4 surgical Gloves no. 7, 5 100 Pcs Rp 13,178.00 Rp 1,317,800.00 Rp - 100 Rp 1,317,800.00 0 Rp -
5 surgical Gloves no. 8 100 Pcs Rp 13,178.00 Rp 1,317,800.00 Rp - 0 Rp - 100 Rp 1,317,800.00
BMHP Program TB
1 Larutan Zhihi Neeisen 11 Paket Rp 3,017,982.00 Rp - 0 Rp - 11 Rp 3,017,982.00

Rp 274,362.00
2 Sputum Pot 0 Biji Rp - Rp - 0 Rp - 0 Rp -

Rp 3,137.00
3 Object Glass Frosted 7105 9 box @ 72 pcs Rp 214,740.72 Rp - 0 Rp - 9 Rp 214,740.72

Rp 23,860.08
DAU 2021
Btl isi @ 30
kapsul
Rp 45,000.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
2 Disposable syringe 1 cc 100 Pcs Rp 1,361.00 Rp 136,100 Rp - 100 Rp 136,100 0 Rp -
3 Sarung Tangan Uk. S 600 Pcs Rp 1,712.53 Rp 1,027,518 Rp - 600 Rp 1,027,518 0 Rp -
4 Sarung Tangan Uk. M 300 Pcs Rp 1,710.13 Rp 513,039 Rp - 300 Rp 513,039 0 Rp -
P 21
1 Acyclovir Cream 42 Tube Rp 4,400.00 Rp 184,800 2/9/2022 50 Rp 220,000 3 Rp 13,200 89 Rp 391,600
2 Bedak Salisil 32 Wadah Rp 7,700.00 Rp 246,400 Rp - 25 Rp 192,500 7 Rp 53,900
3 Bicombin inj 76 Ampul Rp 6,600.00 Rp 501,600 2/9/2022 100 Rp 660,000 42 Rp 277,200 134 Rp 884,400
5 Digoxin 0,5 mg 500 Tab Rp 198.00 Rp 99,000 Rp - 20 Rp 3,960 480 Rp 95,040
8 Ibuprofen 200mg 3150 Tab Rp 275.00 Rp 866,250 Rp - 1760 Rp 484,000 1390 Rp 382,250
10 Lexartans (as. Traneksamat) 20 Tab Rp 1,650.00 Rp 33,000 Rp - 20 Rp 33,000 0 Rp -
12 Novastan syr 94 Btl Rp 11,000.00 Rp 1,034,000 Rp - 8 Rp 88,000 86 Rp 946,000
13 Nifedipine 3470 Tab Rp 220.00 Rp 763,400 Rp - 740 Rp 162,800 2730 Rp 600,600
15 OBH Plus 184 Btl Rp 12,100.00 Rp 2,226,400 Rp - 93 Rp 1,125,300 91 Rp 1,101,100
16 Paracetamol 500 mg 5160 tab Rp 275.00 Rp 1,419,000 2/9/2022 2000 Rp 550,000 4200 Rp 1,155,000 2960 Rp 814,000
17 Reco Salep Mata ( Chloamphenicol) 200 Tube Rp 6,600.00 Rp 1,320,000 Rp - 0 Rp - 200 Rp 1,320,000
19 Skincol Gel 9 Tube Rp 148,500.00 Rp 1,336,500 Rp - 0 Rp - 9 Rp 1,336,500
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 2324 Tab Rp 231.00 Rp 536,844 2/9/2022 2000 Rp 462,000 2240 Rp 517,440 2084 Rp 481,404
7 Amlodipine 10 mg 1820 Tab Rp 74.00 Rp 134,680 Rp - 1500 Rp 111,000 320 Rp 23,680
Antifungi DOEN kombinasi: Asam Benzoat 3% + Asam Salisilat
10
6%
11 Antasida Doen I Tablet Kunyah 1280 Tab Rp 54.00 Rp 69,120 2/9/2022 2000 Rp 108,000 1410 Rp 76,140 1870 Rp 100,980
12 Antasida Doen suspensi 381 Botol Rp 1,756.00 Rp 669,036 Rp - 310 Rp 544,360 71 Rp 124,676
14 Asam Traneksamat injeksi 26 amp Rp 1,820.00 Rp 47,320 2/9/2022 30 Rp 54,600 47 Rp 85,540 9 Rp 16,380
15 Asam folat tab 1 mg 1790 pcs Rp 61.00 Rp 109,190 2/9/2022 2000 Rp 122,000 1020 Rp 62,220 2770 Rp 168,970
16 Asetosal 80 mg 120 Tab Rp 89.00 Rp 10,680 2/9/2022 300 Rp 26,700 10 Rp 890 410 Rp 36,490
17 Betahistine 6 mg 220 Tab Rp 92.00 Rp 20,240 Rp - 90 Rp 8,280 130 Rp 11,960
18 Betamethason cream 89 Tab Rp 1,540.00 Rp 137,060 Rp - 64 Rp 98,560 25 Rp 38,500
19 Bisakodil Suppo 0 Suppo Rp 5,085.00 Rp - 2/9/2022 30 Rp 152,550 0 Rp - 30 Rp 152,550
20 Captopril 12,5 mg 1940 tab Rp 68.00 Rp 131,920 2/9/2022 2000 Rp 136,000 1970 Rp 133,960 1970 Rp 133,960
21 Cetrizine syr 27 Botol Rp 2,215.00 Rp 59,805 2/21/2022 100 Rp 221,500 13 Rp 28,795 114 Rp 252,510
22 Cefotaxim Injeksi 24 Vial Rp 3,050.00 Rp 73,200 2/9/2022 100 Rp 305,000 25 Rp 76,250 99 Rp 301,950
23 Diazepam inj 5 mg / 2 ml 8 Ampul Rp 1,545.00 Rp 12,360 Rp - 0 Rp - 8 Rp 12,360
24 Dexamethasone injeksi 213 Ampul Rp 968.00 Rp 206,184 Rp - 137 Rp 132,616 76 Rp 73,568
28 Furosemid Injeksi i.v./i.m 10mg/ml 16 Ampul Rp 969.00 Rp 15,504 2/21/2022 100 Rp 96,900 0 Rp - 116 Rp 112,404
30 Glibenklamide 5 mg 500 Tab Rp 87.00 Rp 43,500 Rp - 310 Rp 26,970 190 Rp 16,530
31 Haloperidole 5 mg 200 Tab Rp 54.00 Rp 10,800 Rp - 0 Rp - 200 Rp 10,800
33 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 13 Botol Rp 3,300.00 Rp 42,900 Rp - 5 Rp 16,500 8 Rp 26,400
35 Ketorolac inj 30Mg/MI 69 Ampul Rp 923.00 Rp 63,687 Rp - 33 Rp 30,459 36 Rp 33,228
36 Isosorbid Dinitrat tablet sublingual 5mg 165 Tab Rp 99.00 Rp 16,335 Rp - 10 Rp 990 155 Rp 15,345
37 Ibuprofen Syr 100mg/5ml 174 Btl Rp 2,339.00 Rp 406,986 Rp - 10 Rp 23,390 164 Rp 383,596
41 Lansoprazole 30 mg 3330 kap Rp 278.00 Rp 925,740 2/9/2022 2000 Rp 556,000 1570 Rp 436,460 3760 Rp 1,045,280
42 Lidocain inj 2 % (HCL) 155 Ampul Rp 891.00 Rp 138,105 Rp - 0 Rp - 155 Rp 138,105
45 Metilprednisolon tablat 4 mg 3120 tab Rp 102.00 Rp 318,240 Rp - 1480 Rp 150,960 1640 Rp 167,280
47 Methamizole Na Inj 0 Ampul Rp 3,045.00 Rp - Rp - 0 Rp - 0 Rp -
50 Nistatin drop 32 Btl Rp 11,750.00 Rp 376,000 Rp - 1 Rp 11,750 31 Rp 364,250
51 Nistatin Ovula 100.000 IU 0 tab Rp 550.00 Rp - 2/9/2022 100 Rp 55,000 0 Rp - 100 Rp 55,000.00
52 Natrium Diklofenak 25 mg 2140 tab Rp 109.00 Rp 233,260 2/9/2022 1000 Rp 109,000 2260 Rp 246,340 880 Rp 95,920
54 Natrium Chloride 0,9 % ( NACL 0,9 %) 140 btl Rp 6,900.00 Rp 966,000 Rp - 120 Rp 828,000 20 Rp 138,000
56 Parasetamol syr 189 btl Rp 1,160.00 Rp 219,240 2/21/2022 100 Rp 116,000 131 Rp 151,960 158 Rp 183,280
57 Phytomenadion inj 2mg/ml 90 Ampul Rp 3,900.00 Rp 351,000 Rp - 62 Rp 241,800 28 Rp 109,200
58 Permetrin cream 0 Tube Rp 11,466.00 Rp - Rp - 0 Rp - 0 Rp -
62 Salep 2-4 16 Pot Rp 1,475.00 Rp 23,600 Rp - 5 Rp 7,375 11 Rp 16,225
64 Simvastatin 20 mg 680 tab Rp 73.00 Rp 49,640 2/9/2022 1000 Rp 73,000 600 Rp 43,800 1080 Rp 78,840
65 Siprofloksasin 500 mg 810 Tab Rp 260.00 Rp 210,600 2/9/2022 500 Rp 130,000 710 Rp 184,600 600 Rp 156,000
66 Sianocbalamin (B12) 1530 Tab Rp 44.00 Rp 67,320 Rp - 1030 Rp 45,320 500 Rp 22,000
67 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 224 Ampul Rp 1,066.00 Rp 238,784 Rp - 9 Rp 9,594 215 Rp 229,190
69 VAR 2 Vial Rp 153,000.00 Rp 306,000 Rp - 2 Rp 306,000 0 Rp -
71 Zink 20 mg tab 40 Tab Rp 253.00 Rp 10,120 Rp - 40 Rp 10,120 Rp -
BMHP
73 Catgut chromic 3/0 +jarum Bulat (*optime*) 0 Pcs Rp 68,090.00 Rp - 2/21/2022 36 Rp 2,451,240 0 Rp - 36 Rp 2,451,240
74 Disposable syringe 3 cc 1200 Pcs Rp 818.00 Rp 981,600 Rp - 534 Rp 436,812 666 Rp 544,788.00
76 Folly Catheter 18 20 pcs Rp 11,132.00 Rp 222,640 Rp - 10 Rp 111,320 10 Rp 111,320.00
78 Handscoond steril no 7 890 Pasang Rp 13,563.00 Rp 12,071,070 Rp - 60 Rp 813,780 830 Rp 11,257,290.00
80 Hand Sanitizer / Handrub 500 ml 37 Btl Rp 68,200.00 Rp 2,523,400.00 Rp - 18 Rp 1,227,600.00 19 Rp 1,295,800.00
82 Infus Set Dewasa 0 pcs Rp 7,128.00 Rp - 2/21/2022 200 Rp 1,425,600 40 Rp 285,120 160 Rp 1,140,480.00
83 IV.Chateter No.18 G 200 pcs Rp 25,487.00 Rp 5,097,400 Rp - 50 Rp 1,274,350 150 Rp 3,823,050.00
84 Scalpet Blades no.10 0 Pcs Rp 618.70 Rp - 2/21/2022 100 Rp 61,870 0 Rp - 100 Rp 61,869.50
85 Scalpet Blades no.11 0 Pcs Rp 618.68 Rp - 2/21/2022 100 Rp 61,868 0 Rp - 100 Rp 61,868.40
86 Scalpet Blades no.15 100 Pcs Rp 618.71 Rp 61,871 Rp - 20 Rp 12,374 80 Rp 49,497.03
88 Under Pad Steril 200 pcs Rp 37,875.00 Rp 7,575,000 Rp - 100 Rp 3,787,500 100 Rp 3,787,500.00
DAK 2020
1 CTM 4 mg 630 tab Rp 26.00 Rp 16,380 Rp - 630 Rp 16,380 0 Rp -
2 Cetrizine 10 mg 1280 tab Rp 104.00 Rp 133,120 Rp - 860 Rp 89,440 420 Rp 43,680
3 Domperidone syr 0 Botol Rp 2,862.00 Rp - Rp - 0 Rp - 0 Rp -
6 Paracetamol Drop 362 Botol Rp 7,646.00 Rp 2,767,852 Rp - 17 Rp 129,982 345 Rp 2,637,870
BMHP
7 Catgut chromic 3/0 +jarum Bulat (*optime*) 36 Pcs Rp 55,000.00 Rp 1,980,000 Rp - 0 Rp - 36 Rp 1,980,000
10 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00 Rp - Rp - 0 Rp - 0 Rp -
12 Kasa 16x16 85 pcs Rp 7,897.31 Rp 671,271 Rp - 0 Rp - 85 Rp 671,271
13 Silk 2/0 + jarum 1/2 25 mm 75 cm 36 Pcs Rp 32,500.00 Rp 1,170,000 Rp - 0 Rp - 36 Rp 1,170,000
14 Umbilical Cord Klem 100 Pcs Rp 1,495.00 Rp 149,500 Rp - 100 Rp 149,500 0 Rp -
DAU 2020
1 Aqua pro injeksi 20 ml 106 ampul Rp 2,860.00 Rp 303,160 Rp - 0 Rp - 106 Rp 303,160
2 Hyoscine N butylbromide 10 mg inj 52 Ampul Rp 9,900.00 Rp 514,800 Rp - 17 Rp 168,300 35 Rp 346,500
4 Ringer Laktat (RL) 200 btl Rp 7,150.00 Rp 1,430,000 2/21/2022 100 Rp 715,000 160 Rp 1,144,000 140 Rp 1,001,000
P 2020
4 Bisakodil ( LAXANA) 34 Tab Rp 367.00 Rp 12,478 Rp - 0 Rp - 34 Rp 12,478
Kombinasi Tetes Mata (Deksametason, Neomisin Sulfat,
5
Polimiksin B Sulfat ) ALLETROL COMPOSITUM
14 Botol Rp 14,900.00 Rp 208,600 Rp - 14 Rp 208,600 0 Rp -
6 Obat batuk pilek anak kombinasi GG ( Dextrofen) 96 Botol Rp 12,900.00 Rp 1,238,400 2/21/2022 100 Rp 1,290,000 49 Rp 632,100 147 Rp 1,896,300
Obat flu kombinasi ( pseudoephedrin Hcl, Tripolidin Hcl )
7
FLUTROP
330 tab Rp 600.00 Rp 198,000 Rp - 130 Rp 78,000 200 Rp 120,000
8 Salbutamol nebulizer / Ventolin Nebulizer 103 Flash Rp 10,000.00 Rp 1,030,000 Rp - 43 Rp 430,000 60 Rp 600,000
9 Hemafort 4670 Tab Rp 820.00 Rp 3,829,400 Rp - 4670 Rp 3,829,400 0 Rp -
DAK 2019
1 Acyclovir 400 mg 310 Tab Rp 425.00 Rp 131,750 Rp - 175 Rp 74,375 135 Rp 57,375
2 Alprazolam 0,5 mg 305 tab Rp 88.00 Rp 26,840 Rp - 305 Rp 26,840 0 Rp -
3 Cefadroxil sirup kering 125mg/5ml 41 btl Rp 4,360.00 Rp 178,760 2/21/2022 100 Rp 436,000 64 Rp 279,040 77 Rp 335,720
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 8 Tube Rp 14,459.00 Rp 115,672 Rp - 3 Rp 43,377 5 Rp 72,295
7 Oxtretrasiklin Salep Mata 77 tube Rp 2,600.00 Rp 200,200 Rp - 73 Rp 189,800 4 Rp 10,400
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
11 Folly Catheter 14 10 pcs Rp 11,891.00 Rp 118,910 Rp - 10 Rp 118,910 0 Rp -
12 Folly Catheter 16 10 pcs Rp 11,891.00 Rp 118,910 Rp - 10 Rp 118,910 0 Rp -
13 Infus Set Dewasa 0 pcs Rp 6,842.00 Rp - Rp - 0 Rp - 0 Rp -
PENUNJANG 2019
1 Gentamicin salep kulit 40 tube Rp 2,640.00 Rp 105,600 2/9/2022 100 Rp 264,000 26 Rp 68,640 114 Rp 300,960
2 Loperamide 860 Tab Rp 198.00 Rp 170,280 Rp - 200 Rp 39,600 660 Rp 130,680
3 Multivitamin syr anak ( Becefort ) 238 Botol Rp 17,365.70 Rp 4,133,037 Rp - 101 Rp 1,753,936 137 Rp 2,379,101
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 294 btl Rp 3,850.00 Rp 1,131,900 Rp - 12 Rp 46,200 282 Rp 1,085,700
BG 2019
1 Pehacain 20 Ampul Rp 3,113.0495 Rp 62,261 2/9/2022 100 Rp 311,305 0 Rp - 120 Rp 373,566
DAK 2018
1 Diazepam 5 mg 119.5 Tab Rp 109.00 Rp 13,026 Rp - 120 Rp 13,025.50 0 Rp -
2 HCT 25 mg 30 tab Rp 178.00 Rp 5,340 Rp - 30 Rp 5,340 0 Rp -
3 Nistatin 100.000 IU 0 tab Rp 645.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
4 Blood Lancet 400 Pcs Rp 167.509 Rp 67,004 Rp - 0 Rp - 400 Rp 67,004
5 Plaster ( Hifafix ) 6 Roll Rp 29,642.86 Rp 177,857 Rp - 6 Rp 177,857 0 Rp -
DAU 2017
BMHP
DAK 2017 Rp - 0 Rp -
1 Diltiazem 30 mg 440 tab Rp 128.00 Rp 56,320 Rp - 440 Rp 56,320 0 Rp -
BMHP
3 Kasa 4mx5cm 200 Roll Rp 862.50 Rp 172,500 Rp - 100 Rp 86,250 100 Rp 86,250
APBD 2016
BMHP 2016
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 18 roll/bungkus Rp 11,914 Rp 214,452 Rp - 2 Rp 23,828 16 Rp 190,624
TOTAL 95,417.50 Rp 116,307,612.91 19,546.00 Rp 11,356,632.85 52,812.50 Rp 34,053,126.18 62,151.00 Rp 93,611,119.58
Mengetahui Binawara, 26 Februari 2022


NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011
BULAN MARET 2022
IFK Realisasi
NO Banyaknya KET
1 2 3 4 5 6 7 8 9 10 19 20 25 26 27
BMHP Program HIV
1 Safety box 51 IDR Rp 16,666.00 Rp 849,966.00 Rp - 26 Rp 433,316.00 25 Rp 416,650.00
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Rp - 0 Rp - 0 Rp -
5 surgical Gloves no. 8 100 Pcs Rp 13,178.00 Rp 1,317,800.00 Rp - 100 Rp 1,317,800.00 0 Rp -
BMHP Program TB
1 Larutan Zhihi Neeisen 11 Paket Rp 274,362.00 Rp 3,017,982.00 Rp - 0 Rp - 11 Rp 3,017,982.00
2 Sputum Pot 0 Biji Rp 3,137.00 Rp - Rp - 0 Rp - 0 Rp -
3 Object Glass Frosted 7105 9 box @ 72 pcs Rp 23,860.08 Rp 214,740.72 Rp - 0 Rp - 9 Rp 214,740.72
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00 Rp - 3/21/2022 2 Rp 712,800 2 Rp 712,800 0 Rp -
2 Cairan bonding 0 Pot Rp 391,500.00 Rp - 3/21/2022 2 Rp 783,000 2 Rp 783,000 0 Rp -
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00 Rp - 3/21/2022 5 Rp 337,500 5 Rp 337,500 0 Rp -
DAU 2021
Btl isi @ 30
kapsul
Rp 45,000.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
2 Disposable syringe 1 cc 0 Pcs Rp 1,361.00 Rp - Rp - 0 Rp - 0 Rp -
3 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53 Rp - Rp - 0 Rp - 0 Rp -
4 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13 Rp - Rp - 0 Rp - 0 Rp -
P 21
1 Acyclovir Cream 89 Tube Rp 4,400.00 Rp 391,600 3/21/2022 50 Rp 220,000 0 Rp - 139 Rp 611,600
2 Bedak Salisil 7 Wadah Rp 7,700.00 Rp 53,900 Rp - 7 Rp 53,900 0 Rp -
3 Bicombin inj 134 Ampul Rp 6,600.00 Rp 884,400 3/21/2022 100 Rp 660,000 48 Rp 316,800 186 Rp 1,227,600
4 Cefadroxil 500 mg 2884 Kap Rp 880.00 Rp 2,537,920 3/21/2022 1000 Rp 880,000 614 Rp 540,320 3270 Rp 2,877,600
8 Guaiafenesin (GG) 100 mg 0 tab Rp 147.99 Rp - 3/21/2022 2000 Rp 295,980 0 Rp - 2000 Rp 295,980
10 Kloramfenikol 250 mg 400 Kap Rp 770.00 Rp 308,000 Rp - 20 Rp 15,400 380 Rp 292,600
11 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00 Rp - Rp - 0 Rp - 0 Rp -
13 Novastan syr 86 Btl Rp 11,000.00 Rp 946,000 Rp - 4 Rp 44,000 82 Rp 902,000
16 OBH Plus 91 Btl Rp 12,100.00 Rp 1,101,100 Rp - 15 Rp 181,500 76 Rp 919,600
17 Paracetamol 500 mg 2960 tab Rp 275.00 Rp 814,000 3/21/2022 7000 Rp 1,925,000 1740 Rp 478,500 8220 Rp 2,260,500
18 Reco Salep Mata ( Chloamphenicol) 200 Tube Rp 6,600.00 Rp 1,320,000 Rp - 35 Rp 231,000 165 Rp 1,089,000
20 Skincol Gel 9 Tube Rp 148,500.00 Rp 1,336,500 Rp - 0 Rp - 9 Rp 1,336,500
DAK 2021
Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram
1 2084 Tab Rp 231.00 Rp 481,404 3/21/2022 8000 Rp 1,848,000 980 Rp 226,380 9104 Rp 2,103,024
Jaya )
2 Amoksisilin sirup kering 125mg/5ml 187 Btl Rp 2,050.00 Rp 383,350 3/21/2022 300 Rp 615,000 1 Rp 2,050 486 Rp 996,300
3 Allupurinol 100 mg 630 Tab Rp 89.00 Rp 56,070 3/21/2022 2000 Rp 178,000 30 Rp 2,670 2600 Rp 231,400
4 Allupurinol 300 mg 1160 Tab Rp 200.00 Rp 232,000 3/21/2022 1000 Rp 200,000 180 Rp 36,000 1980 Rp 396,000
5 Asam Mefenamat 780 tab Rp 117.00 Rp 91,260 3/21/2022 5000 Rp 585,000 750 Rp 87,750 5030 Rp 588,510
6 Amlodipine 5 mg 80 Tab Rp 55.00 Rp 4,400 3/21/2022 Rp - 60 Rp 3,300 20 Rp 1,100
7 Amlodipine 10 mg 320 Tab Rp 74.00 Rp 23,680 Rp - 210 Rp 15,540 110 Rp 8,140
Antifungi DOEN kombinasi: Asam Benzoat 3% + Asam
10
Salisilat 6%
12 Antasida Doen suspensi 71 Botol Rp 1,756.00 Rp 124,676 3/21/2022 800 Rp 1,404,800 180 Rp 316,080 691 Rp 1,213,396
14 Asam Traneksamat injeksi 9 amp Rp 1,820.00 Rp 16,380 3/21/2022 30 Rp 54,600 5 Rp 9,100 34 Rp 61,880
15 Asam folat tab 1 mg 2770 pcs Rp 61.00 Rp 168,970 3/21/2022 3000 Rp 183,000 840 Rp 51,240 4930 Rp 300,730
16 Asetosal 80 mg 410 Tab Rp 89.00 Rp 36,490 3/21/2022 100 Rp 8,900 130 Rp 11,570 380 Rp 33,820
17 Betahistine 6 mg 130 Tab Rp 92.00 Rp 11,960 Rp - 130 Rp 11,960 0 Rp -
18 Betamethason cream 25 Tab Rp 1,540.00 Rp 38,500 Rp - 25 Rp 38,500 0 Rp -
19 Bisakodil Suppo 30 Suppo Rp 5,085.00 Rp 152,550 3/21/2022 30 Rp 152,550 4 Rp 20,340 56 Rp 284,760
20 Captopril 12,5 mg 1970 tab Rp 68.00 Rp 133,960 3/21/2022 3400 Rp 231,200 360 Rp 24,480 5010 Rp 340,680
22 Cefotaxim Injeksi 99 Vial Rp 3,050.00 Rp 301,950 Rp - 95 Rp 289,750 4 Rp 12,200
23 Diazepam inj 5 mg / 2 ml 8 Ampul Rp 1,545.00 Rp 12,360 Rp - 0 Rp - 8 Rp 12,360
24 Dexamethasone injeksi 76 Ampul Rp 968.00 Rp 73,568 3/21/2022 300 Rp 290,400 39 Rp 37,752 337 Rp 326,216
26 Domperidone syr 93 Botol Rp 2,401.00 Rp 223,293 3/21/2022 300 Rp 720,300 23 Rp 55,223 370 Rp 888,370
28 Epinephrine 0 Ampul Rp 1,740.00 Rp - 3/21/2022 6 Rp 10,440 0 Rp - 6 Rp 10,440
30 Glukosa Infus D5% 80 btl Rp 7,363.00 Rp 589,040 Rp - 1 Rp 7,363 79 Rp 581,677
31 Glibenklamide 5 mg 190 Tab Rp 87.00 Rp 16,530 Rp - 150 Rp 13,050 40 Rp 3,480
32 Haloperidole 5 mg 200 Tab Rp 54.00 Rp 10,800 Rp - 65 Rp 3,510 135 Rp 7,290
34 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 8 Botol Rp 3,300.00 Rp 26,400 Rp - 8 Rp 26,400 0 Rp -
36 Kalsium Glukonat inj 10 % 0 Ampul Rp 6,199.00 Rp - 3/21/2022 24 Rp 148,776 0 Rp - 24 Rp 148,776
37 Ketorolac inj 30Mg/MI 36 Ampul Rp 923.00 Rp 33,228 3/21/2022 120 Rp 110,760 14 Rp 12,922 142 Rp 131,066
38 Karbamazepin 200mg 0 tab Rp 216.00 Rp - 3/21/2022 100 Rp 21,600 0 Rp - 100 Rp 21,600
44 Kodein 10 mg 0 Tab Rp 605.00 Rp - 3/21/2022 100 Rp 60,500 0 Rp - 100 Rp 60,500
45 Lansoprazole 30 mg 3760 kap Rp 278.00 Rp 1,045,280 3/21/2022 2400 Rp 667,200 680 Rp 189,040 5480 Rp 1,523,440
46 Lidocain inj 2 % (HCL) 155 Ampul Rp 891.00 Rp 138,105 3/21/2022 100 Rp 89,100 0 Rp - 255 Rp 227,205
47 Loratadine 150 kap Rp 117.00 Rp 17,550 3/21/2022 1000 Rp 117,000 10 Rp 1,170 1140 Rp 133,380
48 Metformin HCL 500 mg 3050 tab Rp 77.00 Rp 234,850 3/21/2022 6000 Rp 462,000 770 Rp 59,290 8280 Rp 637,560
50 Metoklopramid 10 mg 0 tab Rp 66.00 Rp - 3/21/2022 100 Rp 6,600 0 Rp - 100 Rp 6,600.00
51 Metoklopramid inj 12 Ampul Rp 1,983.00 Rp 23,796 3/21/2022 300 Rp 594,900 121 Rp 239,943 191 Rp 378,753
54 Mikonazole kream 96 Tube Rp 1,900.00 Rp 182,400 3/21/2022 96 Rp 182,400 8 Rp 15,200 184 Rp 349,600
56 Nistatin Ovula 100.000 IU 100 tab Rp 550.00 Rp 55,000 Rp - 0 Rp - 100 Rp 55,000.00
59 Natrium Chloride 0,9 % ( NACL 0,9 %) 20 btl Rp 6,900.00 Rp 138,000 3/21/2022 200 Rp 1,380,000 60 Rp 414,000 160 Rp 1,104,000
61 Parasetamol syr 158 btl Rp 1,160.00 Rp 183,280 3/21/2022 200 Rp 232,000 62 Rp 71,920 296 Rp 343,360
62 Phytomenadion inj 2mg/ml 28 Ampul Rp 3,900.00 Rp 109,200 3/21/2022 30 Rp 117,000 0 Rp - 58 Rp 226,200
64 Ranitidin tablet 150 mg 2260 tab Rp 85.00 Rp 192,100 Rp - 10 Rp 850 2250 Rp 191,250
68 Simvastatin 10 mg 1100 tab Rp 73.00 Rp 80,300 3/21/2022 2000 Rp 146,000 0 Rp - 3100 Rp 226,300
69 Simvastatin 20 mg 1080 tab Rp 73.00 Rp 78,840 3/21/2022 2000 Rp 146,000 320 Rp 23,360 2760 Rp 201,480
70 Siprofloksasin 500 mg 600 Tab Rp 260.00 Rp 156,000 3/21/2022 1000 Rp 260,000 40 Rp 10,400 1560 Rp 405,600
72 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 215 Ampul Rp 1,066.00 Rp 229,190 Rp - 0 Rp - 215 Rp 229,190
74 VAR 0 Vial Rp 153,000.00 Rp - Rp - 0 Rp - 0 Rp -
76 Zink 20 mg tab Tab Rp 253.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
78 Catgut chromic 3/0 +jarum Bulat (*optime*) 36 Pcs Rp 68,090.00 Rp 2,451,240 3/21/2022 36 Rp 2,451,240 0 Rp - 72 Rp 4,902,480
79 Disposable syringe 3 cc 666 Pcs Rp 818.00 Rp 544,788 3/21/2022 1000 Rp 818,000 266 Rp 217,588 1400 Rp 1,145,200.00
83 Handscoond steril no 7 830 Pasang Rp 13,563.00 Rp 11,257,290 Rp - 13 Rp 176,319 817 Rp 11,080,971.00
85 Hand Sanitizer / Handrub 500 ml 19 Btl Rp 68,200.00 Rp 1,295,800.00 Rp - 0 Rp - 19 Rp 1,295,800.00
87 Infus Set Dewasa 160 pcs Rp 7,128.00 Rp 1,140,480 3/21/2022 100 Rp 712,800 140 Rp 997,920 120 Rp 855,360.00
88 IV.Chateter No.18 G 150 pcs Rp 25,487.00 Rp 3,823,050 Rp - 50 Rp 1,274,350 100 Rp 2,548,700.00
90 Scalpet Blades no.11 100 Pcs Rp 618.68 Rp 61,868 Rp - 1 Rp 619 99 Rp 61,249.72
93 Under Pad Steril 100 pcs Rp 37,875.00 Rp 3,787,500 3/21/2022 100 Rp 3,787,500 0 Rp - 200 Rp 7,575,000.00
DAK 2020 0
1 Acyclovir 400 mg 0 Tab Rp 454.00 Rp - 3/21/2022 500 Rp 227,000 0 Rp - 500 Rp 227,000
2 Betahistine 6 mg 0 Tab Rp 119.00 Rp - Rp - 0 Rp - 0 Rp -
3 CTM 4 mg 0 tab Rp 26.00 Rp - Rp - 0 Rp - 0 Rp -
4 Cetrizine 10 mg 420 tab Rp 104.00 Rp 43,680 Rp - 280 Rp 29,120 140 Rp 14,560
6 Gentamicine tetes mata 0 Botol Rp 4,885.00 Rp - Rp - 0 Rp - 0 Rp -
7 Kodein 10 mg 154 Tab Rp 657.00 Rp 101,178 Rp - 0 Rp - 154 Rp 101,178
8 Lansoprazole 30 mg 0 kap Rp 352.00 Rp - Rp - 0 Rp - 0 Rp -
10 Paracetamol Drop 345 Botol Rp 7,646.00 Rp 2,637,870 Rp - 345 Rp 2,637,870 0 Rp -

BMHP
11 Catgut chromic 3/0 +jarum Bulat (*optime*) 36 Pcs Rp 55,000.00 Rp 1,980,000 Rp - 36 Rp 1,980,000 0 Rp -
12 Catgut chromic 3/0 +jarum Segitiga (*optime*) Pcs Rp 62,000.00 Rp - Rp - 0 Rp - 0 Rp -
15 Feeding Tube 14 0 pcs Rp 8,407.00 Rp - 3/21/2022 10 Rp 84,070 10 Rp 84,070 0 Rp -
16 Feeding Tube 16 0 pcs Rp 8,407.00 Rp - 3/21/2022 10 Rp 84,070 10 Rp 84,070 0 Rp -
18 IV.Chateter No.20 G 0 pcs Rp 23,100.00 Rp - Rp - 0 Rp - 0 Rp -
20 Kasa 16x16 85 pcs Rp 7,897.31 Rp 671,271 Rp - 85 Rp 671,271 0 Rp -
21 Silk 2/0 + jarum 1/2 25 mm 75 cm 36 Pcs Rp 32,500.00 Rp 1,170,000 Rp - 36 Rp 1,170,000 0 Rp -
22 Umbilical Cord Klem 0 Pcs Rp 1,495.00 Rp - Rp - 0 Rp - 0 Rp -
DAU 2020
2 Hyoscine N butylbromide 10 mg inj 35 Ampul Rp 9,900.00 Rp 346,500 Rp - 35 Rp 346,500 0 Rp -
3 Natrium Chloride 0,9 % ( NACL 0,9 %) 0 btl Rp 6,840.00 Rp - Rp - 0 Rp - 0 Rp -
5 Ringer Laktat (RL) 140 btl Rp 7,150.00 Rp 1,001,000 3/21/2022 300 Rp 2,145,000 180 Rp 1,287,000 260 Rp 1,859,000
P 2020 0
3 Bisakodil Suppo 1 Suppo Rp 23,475.00 Rp 23,475 Rp - 1 Rp 23,475 0 Rp -
5 Guaiafenesin (GG) 100 mg 0 tab Rp 175.00 Rp - Rp - 0 Rp - 0 Rp -
6
0 Botol Rp 14,900.00 Rp - Rp - 0 Rp - 0 Rp -
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 147 Botol Rp 12,900.00 Rp 1,896,300 3/21/2022 200 Rp 2,580,000 69 Rp 890,100 278 Rp 3,586,200
8
FLUTROP
200 tab Rp 600.00 Rp 120,000 Rp - 60 Rp 36,000 140 Rp 84,000
9 Salbutamol nebulizer / Ventolin Nebulizer 60 Flash Rp 10,000.00 Rp 600,000 Rp - 26 Rp 260,000 34 Rp 340,000

10 Hemafort 0 Tab Rp 820.00 Rp - Rp - 0 Rp - 0 Rp -
DAK 2019
2 Alprazolam 0,5 mg 0 tab Rp 88.00 Rp - Rp - 0 Rp - 0 Rp -
3 Cefadroxil sirup kering 125mg/5ml 77 btl Rp 4,360.00 Rp 335,720 3/21/2022 200 Rp 872,000 47 Rp 204,920 230 Rp 1,002,800
7 Oxtretrasiklin Salep Mata 4 tube Rp 2,600.00 Rp 10,400 Rp - 4 Rp 10,400 0 Rp -
BMHP
11 Folly Catheter 14 0 pcs Rp 11,891.00 Rp - 3/21/2022 20 Rp 237,820 0 Rp - 20 Rp 237,820
12 Folly Catheter 16 0 pcs Rp 11,891.00 Rp - 3/21/2022 20 Rp 237,820 0 Rp - 20 Rp 237,820
14 urine bag 0 pcs Rp 1,848.00 Rp - 3/21/2022 50 Rp 92,400 0 Rp - 50 Rp 92,400
PENUNJANG 2019
1 Gentamicin salep kulit 114 tube Rp 2,640.00 Rp 300,960 3/21/2022 100 Rp 264,000 53 Rp 139,920 161 Rp 425,040
2 Loperamide 660 Tab Rp 198.00 Rp 130,680 Rp - 10 Rp 1,980 650 Rp 128,700
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 282 btl Rp 3,850.00 Rp 1,085,700 Rp - 10 Rp 38,500 272 Rp 1,047,200
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00 Rp - 3/21/2022 1 Rp 242,000 1 Rp 242,000 0 Rp -
2 Cotton roll medium 0 Pack Rp 85,800.00 Rp - 3/21/2022 10 Rp 858,000 10 Rp 858,000 0 Rp -
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp - 3/21/2022 1 Rp 97,500 1 Rp 97,500 0 Rp -
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00 Rp - Rp - 0 Rp - 0 Rp -
2 HCT 25 mg 0 tab Rp 178.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86 Rp - Rp - 0 Rp - 0 Rp -
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 0 pcs Rp 22,000.00 Rp - 3/21/2022 100 Rp 2,200,000.00 0 Rp - 100 Rp 2,200,000
DAU 2017
BMHP
DAK 2017
1 Diltiazem 30 mg 0 tab Rp 128.00 Rp - Rp - 0 Rp - 0
BMHP
3 Kasa 4mx5cm 100 Roll Rp 862.50 Rp 86,250 Rp - 100 Rp 86,250 0 Rp -
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 150 pcs Rp 6,222.00 Rp 933,300 Rp - 100 Rp 622,200 50 Rp 311,100
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 16 roll/bungkus Rp 11,914 Rp 190,624 Rp - 0 Rp - 16 Rp 190,624
TOTAL 62,151.00 Rp 93,611,119.58 58,953.00 Rp 35,389,526.00 16,439.00 Rp 24,395,983.90 104,665.00 Rp 104,604,661.67
Mengetahui Binawara, 31 Maret 2022


NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011
TOTAL 104,665.00 Rp 104,604,661.67
Mengetahui
Kepala Puskesmas Perawatan Lasung
Rosyidah, A.Md.Keb
NIP. 19701001 199102 2 002

BULAN APRIL 2022
IFK Realisasi
NO Banyaknya KET
1 2 3 4 5 6 7 8 9 10 19 20 25 26 27
BMHP Program HIV
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Rp - 0 Rp - 0 Rp -
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP Program TB
1 Larutan Zhihi Neeisen 11 Paket Rp 274,362.00 Rp 3,017,982.00 Rp - 0 Rp - 11 Rp 3,017,982.00
2 Sputum Pot 0 Biji Rp 3,137.00 Rp - Rp - 0 Rp - 0 Rp -
box @ 72
3 Object Glass Frosted 7105 9
pcs
Rp 214,740.72 Rp - 2 Rp 47,720.16 7 Rp 167,020.56
Rp 23,860.08
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00 Rp - Rp - 0 Rp - 0 Rp -
2 Cairan bonding 0 Pot Rp 391,500.00 Rp - Rp - 0 Rp - 0 Rp -
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00 Rp - Rp - 0 Rp - 0 Rp -
DAU 2021
Btl isi @ 30
kapsul
Rp 45,000.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
2 Disposable syringe 1 cc 0 Pcs Rp 1,361.00 Rp - Rp - 0 Rp - 0 Rp -
3 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53 Rp - Rp - 0 Rp - 0 Rp -
4 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13 Rp - Rp - 0 Rp - 0 Rp -
P 21
1 Acyclovir Cream 139 Tube Rp 4,400.00 Rp 611,600 Rp - 8 Rp 35,200 131 Rp 576,400
2 Bedak Salisil 0 Wadah Rp 7,700.00 Rp - Rp - 0 Rp - 0 Rp -
3 Bicombin inj 186 Ampul Rp 6,600.00 Rp 1,227,600 Rp - 76 Rp 501,600 110 Rp 726,000
8 Guaiafenesin (GG) 100 mg 2000 tab Rp 147.99 Rp 295,980 Rp - 400 Rp 59,196 1600 Rp 236,784
11 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00 Rp - Rp - 0 Rp - 0 Rp -
13 Novastan syr 82 Btl Rp 11,000.00 Rp 902,000 Rp - 2 Rp 22,000 80 Rp 880,000
16 OBH Plus 76 Btl Rp 12,100.00 Rp 919,600 Rp - 55 Rp 665,500 21 Rp 254,100
B/
442/792-
SPB/
17 Paracetamol 500 mg 8220 tab Rp 275.00 Rp 2,260,500 4/26/2022 5000 Rp 1,375,000 7640 Rp 2,101,000 5580 Rp 1,534,500
UPTD-
IFK/IV-
2022
18 Reco Salep Mata ( Chloamphenicol) 165 Tube Rp 6,600.00 Rp 1,089,000 Rp - 14 Rp 92,400 151 Rp 996,600
20 Skincol Gel 9 Tube Rp 148,500.00 Rp 1,336,500 Rp - 4 Rp 594,000 5 Rp 742,500
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 9104 Tab Rp 231.00 Rp 2,103,024 Rp - 2550 Rp 589,050 6554 Rp 1,513,974
6 Amlodipine 5 mg 20 Tab Rp 55.00 Rp 1,100 Rp - 20 Rp 1,100 0 Rp -
7 Amlodipine 10 mg 110 Tab Rp 74.00 Rp 8,140 Rp - 110 Rp 8,140 0 Rp -
10
6%
44 Botol Rp 3,637.00 Rp 160,028 Rp - 0 Rp - 44 Rp 160,028
12 Antasida Doen suspensi 691 Botol Rp 1,756.00 Rp 1,213,396 Rp - 616 Rp 1,081,696 75 Rp 131,700
14 Asam Traneksamat injeksi 34 amp Rp 1,820.00 Rp 61,880 Rp - 34 Rp 61,880 0 Rp -
15 Asam folat tab 1 mg 4930 pcs Rp 61.00 Rp 300,730 Rp - 1670 Rp 101,870 3260 Rp 198,860
16 Asetosal 80 mg 380 Tab Rp 89.00 Rp 33,820 Rp - 10 Rp 890 370 Rp 32,930
18 Betamethason cream 0 Tab Rp 1,540.00 Rp - Rp - 0 Rp - 0 Rp -
20 Captopril 12,5 mg 5010 tab Rp 68.00 Rp 340,680 Rp - 4860 Rp 330,480 150 Rp 10,200
22 Cefotaxim Injeksi 4 Vial Rp 3,050.00 Rp 12,200 Rp - 4 Rp 12,200 0 Rp -
23 Diazepam inj 5 mg / 2 ml 8 Ampul Rp 1,545.00 Rp 12,360 Rp - 4 Rp 6,180 4 Rp 6,180
24 Dexamethasone injeksi 337 Ampul Rp 968.00 Rp 326,216 Rp - 23 Rp 22,264 314 Rp 303,952
28 Epinephrine 6 Ampul Rp 1,740.00 Rp 10,440 Rp - 0 Rp - 6 Rp 10,440
31 Glibenklamide 5 mg 40 Tab Rp 87.00 Rp 3,480 Rp - 40 Rp 3,480 0 Rp -
32 Haloperidole 5 mg 135 Tab Rp 54.00 Rp 7,290 Rp - 25 Rp 1,350 110 Rp 5,940
34 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00 Rp - Rp - 0 Rp - 0 Rp -
35 Kalsium laktat (Kalk) 500 mg 1580 Tab Rp 60.00 Rp 94,800 Rp - 1500 Rp 90,000 80 Rp 4,800
36 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00 Rp 148,776 Rp - 0 Rp - 24 Rp 148,776
37 Ketorolac inj 30Mg/MI 142 Ampul Rp 923.00 Rp 131,066 Rp - 88 Rp 81,224 54 Rp 49,842
38 Karbamazepin 200mg 100 tab Rp 216.00 Rp 21,600 Rp - 30 Rp 6,480 70 Rp 15,120
44 Kodein 10 mg 100 Tab Rp 605.00 Rp 60,500 Rp - 0 Rp - 100 Rp 60,500
45 Lansoprazole 30 mg 5480 kap Rp 278.00 Rp 1,523,440 Rp - 2830 Rp 786,740 2650 Rp 736,700
46 Lidocain inj 2 % (HCL) 255 Ampul Rp 891.00 Rp 227,205 Rp - 100 Rp 89,100 155 Rp 138,105
B/
442/792-
SPB/
50 Metilprednisolon tablat 8 mg 0 tab Rp 237.00 Rp -
UPTD-
4/26/2022 500 Rp 118,500 0 Rp - 500 Rp 118,500
IFK/IV-
2022
51 Metoklopramid 10 mg 100 tab Rp 66.00 Rp 6,600 Rp - 0 Rp - 100 Rp 6,600.00
B/
442/792-
SPB/
55 MGSO4 20 % 0 Ampul Rp 4,120.00 Rp -
UPTD-
4/26/2022 50 Rp 206,000 24 Rp 98,880 26 Rp 107,120
IFK/IV-
2022

58 Nistatin Ovula 100.000 IU 100 tab Rp 550.00 Rp 55,000 Rp - 0 Rp - 100 Rp 55,000.00
B/
442/792-
SPB/
61 Natrium Chloride 0,9 % ( NACL 0,9 %) 160 btl Rp 6,900.00 Rp 1,104,000
UPTD-
4/26/2022 100 Rp 690,000 120 Rp 828,000 140 Rp 966,000
IFK/IV-
2022
62 Oxytocin injeksi 100 Ampul Rp 1,248.00 Rp 124,800 Rp - 100 Rp 124,800.00 0 Rp -

63 Parasetamol syr 296 btl Rp 1,160.00 Rp 343,360 Rp - 194 Rp 225,040 102 Rp 118,320
64 Phytomenadion inj 2mg/ml 58 Ampul Rp 3,900.00 Rp 226,200 Rp - 0 Rp - 58 Rp 226,200
72 Siprofloksasin 500 mg 1560 Tab Rp 260.00 Rp 405,600 Rp - 280 Rp 72,800 1280 Rp 332,800
74 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 215 Ampul Rp 1,066.00 Rp 229,190 Rp - 0 Rp - 215 Rp 229,190
B/
442/792-
SPB/
76 Tablet tambah darah 0 tab Rp 255.00 Rp -
UPTD-
4/26/2022 11200 Rp 2,856,000 0 Rp - 11200 Rp 2,856,000
IFK/IV-
2022
B/
442/792-
SPB/
77 USG GEL 0 Btl Rp 18,858.33 Rp -
UPTD-
4/26/2022 5 Rp 94,292 3 Rp 56,575 2 Rp 37,717
IFK/IV-
2022
78 VAR 0 Vial Rp 153,000.00 Rp - Rp - 0 Rp - 0 Rp -

79 Vit. B.Complex 5890 Tab Rp 60 Rp 353,400 Rp - 3360 Rp 201,600 2530 Rp 151,800
80 Zink 20 mg tab 0 Tab Rp 253.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
82 Catgut chromic 3/0 +jarum Bulat (*optime*) 72 Pcs Rp 68,090.00 Rp 4,902,480 Rp - 0 Rp - 72 Rp 4,902,480
83 Disposable syringe 3 cc 1400 Pcs Rp 818.00 Rp 1,145,200 Rp - 200 Rp 163,600 1200 Rp 981,600.00
87 Handscoond steril no 7 817 Pasang Rp 13,563.00 Rp 11,080,971 Rp - 412 Rp 5,587,956 405 Rp 5,493,015.00
88 Handscoond steril no 7,5 222 Pasang Rp 13,563.00 Rp 3,010,986 Rp - 212 Rp 2,875,356 10 Rp 135,630.00
89 Hand Sanitizer / Handrub 500 ml 19 Btl Rp 68,200.00 Rp 1,295,800.00 Rp - 0 Rp - 19 Rp 1,295,800.00
92 IV.Chateter No.18 G 100 pcs Rp 25,487.00 Rp 2,548,700 Rp - 100 Rp 2,548,700 0 Rp -
B/
442/792-
SPB/
93 Kasa 4 x 10 0 pcs Rp 2,176.72 Rp -
UPTD-
4/26/2022 500 Rp 1,088,362 500 Rp 1,088,362 0 Rp -
IFK/IV-
2022
B/
442/792-
SPB/
94 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp -
UPTD-
4/26/2022 500 Rp 544,835 500 Rp 544,835 0 Rp -
IFK/IV-
2022

99 Under Pad Steril 200 pcs Rp 37,875.00 Rp 7,575,000 Rp - 100 Rp 3,787,500 100 Rp 3,787,500.00
DAK 2020
3 CTM 4 mg 0 tab Rp 26.00 Rp - Rp - 0 Rp - 0 Rp -
5 Cetrizine 10 mg 140 tab Rp 104.00 Rp 14,560 Rp - 140 Rp 14,560 0 Rp -
6 Gentamicine tetes mata 0 Botol Rp 26.00 Rp - Rp - 0 Rp - 0 Rp -
8 Lansoprazole 30 mg 0 kap Rp 352.00 Rp - Rp - 0 Rp - 0 Rp -
10 Paracetamol Drop 0 Botol Rp 7,646.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
11 Catgut chromic 3/0 +jarum Bulat (*optime*) 0 Pcs Rp 55,000.00 Rp - Rp - 0 Rp - 0 Rp -
15 Feeding Tube 14 0 pcs Rp 8,407.00 Rp - Rp - 0 Rp - 0 Rp -
16 Feeding Tube 16 0 pcs Rp 8,407.00 Rp - Rp - 0 Rp - 0 Rp -
17 Handscoond steril no 8 99 Pasang Rp 13,178.00 Rp 1,304,622 Rp - 50 Rp 658,900 49 Rp 645,722
20 Kasa 16x16 0 pcs Rp 7,897.31 Rp - Rp - 0 Rp - 0 Rp -
21 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00 Rp - Rp - 0 Rp - 0 Rp -
22 Umbilical Cord Klem 0 Pcs Rp 1,495.00 Rp - Rp - 0 Rp - 0 Rp -
DAU 2020
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00 Rp - Rp - 0 Rp - 0 Rp -
3 Natrium Chloride 0,9 % ( NACL 0,9 %) 0 btl Rp 6,840.00 Rp - Rp - 0 Rp - 0 Rp -
B/
442/792-
SPB/
5 Ringer Laktat (RL) 260 btl Rp 7,150.00 Rp 1,859,000 4/26/2022 100 Rp 715,000 300 Rp 2,145,000 60 Rp 429,000
UPTD-
IFK/IV-
2022
P 2020
1 Ambroxol sirup 15 mg/5 ml 45 Btl Rp 3,250.01 Rp 146,250 Rp - 45 Rp 146,250 0 Rp -
2 Ambroxol Tablet 30 mg 30 Tab Rp 110.00 Rp 3,300 Rp - 30 Rp 3,300 0 Rp -
3 Bisakodil Suppo 0 Suppo Rp 23,475.00 Rp - Rp - 0 Rp - 0 Rp -
5 Guaiafenesin (GG) 100 mg 0 tab Rp 175.00 Rp - Rp - 0 Rp - 0 Rp -
6
0 Botol Rp 14,900.00 Rp - Rp - 0 Rp - 0 Rp -
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 278 Botol Rp 12,900.00 Rp 3,586,200 Rp - 119 Rp 1,535,100 159 Rp 2,051,100
8
FLUTROP
140 tab Rp 600.00 Rp 84,000 Rp - 110 Rp 66,000 30 Rp 18,000
9 Salbutamol nebulizer / Ventolin Nebulizer 34 Flash Rp 10,000.00 Rp 340,000 Rp - 34 Rp 340,000 0 Rp -

10 Hemafort 0 Tab Rp 820.00 Rp - Rp - 0 Rp - 0 Rp -
DAK 2019
1 Acyclovir 400 mg 25 Tab Rp 425.00 Rp 10,625 Rp - 25 Rp 10,625 0 Rp -
2 Alprazolam 0,5 mg 0 tab Rp 88.00 Rp - Rp - 0 Rp - 0 Rp -
3 Cefadroxil sirup kering 125mg/5ml 230 btl Rp 4,360.00 Rp 1,002,800 Rp - 28 Rp 122,080 202 Rp 880,720
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00 Rp - Rp - 0 Rp - 0 Rp -
8 Pirantel 125 mg 53 tab Rp 331.00 Rp 17,543 Rp - 0 Rp - 53 Rp 17,543 exp 2480
BMHP
10 Alat Suntik 5 ml 1800 pcs Rp 1,600 Rp 2,880,000 Rp - 503 Rp 804,800 1297 Rp 2,075,200
14 urine bag 50 pcs Rp 1,848.00 Rp 92,400 Rp - 50 Rp 92,400 0 Rp -
PENUNJANG 2019
1 Gentamicin salep kulit 161 tube Rp 2,640.00 Rp 425,040 Rp - 107 Rp 282,480 54 Rp 142,560
2 Loperamide 650 Tab Rp 198.00 Rp 128,700 Rp - 0 Rp - 650 Rp 128,700
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 272 btl Rp 3,850.00 Rp 1,047,200 Rp - 83 Rp 319,550 189 Rp 727,650
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00 Rp - Rp - 0 Rp - 0 Rp -
2 Cotton roll medium 0 Pack Rp 85,800.00 Rp - Rp - 0 Rp - 0 Rp -
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp - Rp - 0 Rp - 0 Rp -

DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00 Rp - Rp - 0 Rp - 0 Rp -
2 HCT 25 mg 0 tab Rp 178.00 Rp - Rp - 0 Rp - 0 Rp -
BMHP
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86 Rp - Rp - 0 Rp - 0 Rp -
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 100 pcs Rp 22,000.00 Rp 2,200,000 Rp - 0 Rp - 100 Rp 2,200,000
DAU 2017
BMHP
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 36 Pcs Rp 46,187.44 Rp 1,662,748 Rp - 5 Rp 230,937 31 Rp 1,431,811
DAK 2017
BMHP
2 Kasa 4mx5cm 0 Roll Rp 862.50 Rp - Rp - 0 Rp - 0 Rp -
APBD 2016
BMHP 2016
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 16 roll/bungkus Rp 11,914 Rp 190,624 Rp - 1 Rp 11,914 15 Rp 178,710
TOTAL 104,665.00 Rp 104,604,661.67 17,955.00 Rp 7,687,989.15 49,970.00 Rp 37,487,829.41 72,650.00 Rp 74,804,821.42
Mengetahui Binawara, 28 April2022

NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011
BULAN MEI 2022
IFK Realisasi
NO Banyaknya Jumlah
Nama Obat Harga satuan Total Harga Berita acara Jumlah
Jumlah TOTAL Harga Total harga
1 2 3 4 5 6 7 8 9 10 19 20 25
BMHP Program HIV
1 Safety box 25 IDR Rp 16,666.00 Rp 416,650.00 Rp - 0 Rp - 25
2 Plesterin Bulat non woven 3 Kotak Rp 40,187.50 Rp 120,562.50 Rp - 0 Rp - 3
3 Vacum Tube sterile, plastic, K3 EDTA 1600 Pcs Rp 1,160.00 Rp 1,856,000.00 Rp - 0 Rp - 1600
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Rp - 0 Rp - 0
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00 Rp - Rp - 0 Rp - 0
6 Vacutainer Needle 550 Pcs Rp 132.00 Rp 72,600.00 Rp - 0 Rp - 550
BMHP Program TB
1 Larutan Zhihi Neeisen 11 Paket Rp 274,362.00 Rp 3,017,982.00 Rp - 0 Rp - 11
2 Sputum Pot 0 Biji Rp 3,137.00 Rp - Rp - 0 Rp - 0
3 Object Glass Frosted 7105 7 box @ 72 pcs Rp 23,860.08 Rp 167,020.56 Rp - 0 Rp - 7
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00 Rp - Rp - 0 Rp - 0
2 Cairan bonding 0 Pot Rp 391,500.00 Rp - Rp - 0 Rp - 0
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00 Rp - Rp - 0 Rp - 0
DAU 2021
Btl isi @ 30
kapsul
Rp 45,000.00 Rp - Rp - 0 Rp - 0
BMHP 0
3 Disposable syringe 1 cc 0 Pcs Rp 1,361.00 Rp - Rp - 0 Rp - 0
4 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53 Rp - Rp - 0 Rp - 0
5 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13 Rp - Rp - 0 Rp - 0
P 21
1 Acyclovir Cream 131 Tube Rp 4,400.00 Rp 576,400 Rp - 4 Rp 17,600 127
2 Bedak Salisil 0 Wadah Rp 7,700.00 Rp - Rp - 0 Rp - 0
3 Bicombin inj 110 Ampul Rp 6,600.00 Rp 726,000 Rp - 7 Rp 46,200 103
4 Cefadroxil 500 mg 2960 Kap Rp 880.00 Rp 2,604,800 Rp - 300 Rp 264,000 2660
5 Digoxin 0,5 mg 480 Tab Rp 198.00 Rp 95,040 Rp - 0 Rp - 480
6 Eflin 500 Tab Rp 1,413.50 Rp 706,750 Rp - 40 Rp 56,540 460
7 Furosemid 136 Tab Rp 275.00 Rp 37,400 Rp - 61 Rp 16,775 75
B/
442/86
9/
8 Guaiafenesin (GG) 100 mg 1600 tab Rp 147.99 Rp 236,784 UPTD-
5/27/2022 1000 Rp 147,990 0 Rp - 2600
IFK/V/
2022
9 Ibuprofen 200mg 110 Tab Rp 275.00 Rp 30,250 Rp - 80 Rp 22,000 30
10 Kloramfenikol 250 mg 380 Kap Rp 770.00 Rp 292,600 Rp - 0 Rp - 380
11 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00 Rp - Rp - 0 Rp - 0
12 Meloxicam 7,5 mg 640 Tab Rp 385.00 Rp 246,400 Rp - 220 Rp 84,700 420
13 Novastan syr 80 Btl Rp 11,000.00 Rp 880,000 Rp - 0 Rp - 80
14 Nifedipine 2580 Tab Rp 220.00 Rp 567,600 Rp - 30 Rp 6,600 2550
15 Oxytetracycline Salep Kulit 3% 69 Tube Rp 4,950.00 Rp 341,550 Rp - 4 Rp 19,800 65
16 OBH Plus 21 Btl Rp 12,100.00 Rp 254,100 Rp - 11 Rp 133,100 10
B/
442/86
9/
17 Paracetamol 500 mg 5580 tab Rp 275.00 Rp 1,534,500 UPTD-
5/27/2022 4000 Rp 1,100,000 1420 Rp 390,500 8160
IFK/V/
2022
B/
442/86
9/
18 Pehavral 0 tab Rp 1,045.00 Rp - UPTD-
5/27/2022 3600 Rp 3,762,000 0 Rp - 3600
IFK/V/
2022
19 Reco Salep Mata ( Chloamphenicol) 151 Tube Rp 6,600.00 Rp 996,600 Rp - 31 Rp 204,600 120
20 Reco Tetes Telinga (Chloramphenicol) 117 Btl Rp 11,000.00 Rp 1,287,000 Rp - 8 Rp 88,000 109
21 Skincol Gel 5 Tube Rp 148,500.00 Rp 742,500 Rp - 3 Rp 445,500 2
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 6554 Tab Rp 231.00 Rp 1,513,974 Rp - 1010 Rp 233,310 5544
2 Amoksisilin sirup kering 125mg/5ml 454 Btl Rp 2,050.00 Rp 930,700 Rp - 29 Rp 59,450 425
B/
442/86
9/
3 Allupurinol 100 mg 1160 Tab Rp 89.00 Rp 103,240 UPTD- 5/27/2022 2000 Rp 178,000 50 Rp 4,450 3110
IFK/V/
2022
B/
442/86
9/
4 Allupurinol 300 mg 1620 Tab Rp 200.00 Rp 324,000 UPTD- 5/27/2022 1000 Rp 200,000 90 Rp 18,000 2530
IFK/V/
2022
B/
442/86
9/
5 Asam Mefenamat 1590 tab Rp 117.00 Rp 186,030 UPTD- 5/27/2022 2000 Rp 234,000 840 Rp 98,280 2750
IFK/V/
2022
6 Amlodipine 5 mg 0 Tab Rp 55.00 Rp - Rp - 0 Rp - 0
8 Ampisillin serbuk injeksi i.v 1000 mg/ Vial 90 Vial Rp 9,900.00 Rp 891,000 Rp - 2 Rp 19,800 88
9 Antihemeroid kombinasi 52 Suppo Rp 3,260.00 Rp 169,520 Rp - 0 Rp - 52
10 Antifungi DOEN kombinasi: Asam Benzoat 3% + Asam Salisilat 6% 44 Botol Rp 3,637.00 Rp 160,028 Rp - 0 Rp - 44
11 Antasida Doen I Tablet Kunyah 50 Tab Rp 54.00 Rp 2,700 Rp - 50 Rp 2,700 0

B/
442/86
9/
12 Antasida Doen suspensi 75 Botol Rp 1,756.00 Rp 131,700 UPTD-
5/27/2022 600 Rp 1,053,600 41 Rp 71,996 634
IFK/V/
2022
B/
442/86
9/
13 Asam askorbat / Vit C 50 mg 50 Tab Rp 46.00 Rp 2,300 UPTD-
5/27/2022 3000 Rp 138,000 50 Rp 2,300 3000
IFK/V/
2022
B/
442/86
9/
14 Asam Traneksamat injeksi 0 amp Rp 1,820.00 Rp - UPTD-
5/27/2022 100 Rp 182,000 0 Rp - 100
IFK/V/
2022
B/
442/86
9/
15 Asam folat tab 1 mg 3260 pcs Rp 61.00 Rp 198,860 UPTD-
5/27/2022 3000 Rp 183,000 610 Rp 37,210 5650
IFK/V/
2022
16 Asetosal 80 mg 370 Tab Rp 89.00 Rp 32,930 Rp - 30 Rp 2,670 340
17 Betahistine 6 mg 0 Tab Rp 92.00 Rp - Rp - 0 Rp - 0
18 Betamethason cream 0 Tab Rp 1,540.00 Rp - Rp - 0 Rp - 0
19 Bisakodil Suppo 52 Suppo Rp 5,085.00 Rp 264,420 Rp - 22 Rp 111,870 30
20 Captopril 12,5 mg 150 tab Rp 68.00 Rp 10,200 Rp - 150 Rp 10,200 0
B/
442/86
9/
21 Cetrizine syr 13 Botol Rp 2,215.00 Rp 28,795 UPTD- 5/27/2022 400 Rp 886,000 34 Rp 75,310 379
IFK/V/
2022
22 Cefotaxim Injeksi 0 Vial Rp 3,050.00 Rp - Rp - 0 Rp - 0
23 Diazepam inj 5 mg / 2 ml 4 Ampul Rp 1,545.00 Rp 6,180 Rp - 2 Rp 3,090 2
24 Dexamethasone injeksi 314 Ampul Rp 968.00 Rp 303,952 Rp - 110 Rp 106,480 204
25 Doksisiklin 500 Tab Rp 289.00 Rp 144,500 Rp - 0 Rp - 500
26 Domperidone syr 349 Botol Rp 2,401.00 Rp 837,949 Rp - 17 Rp 40,817 332
27 Eritromisin sirup 200 mg 100 Botol Rp 7,436.00 Rp 743,600 Rp - 1 Rp 7,436 99
28 Epinephrine 6 Ampul Rp 1,740.00 Rp 10,440 Rp - 0 Rp - 6
29 Furosemid Injeksi i.v./i.m 10mg/ml 108 Ampul Rp 969.00 Rp 104,652 Rp - 5 Rp 4,845 103
30 Glukosa Infus D5% 79 btl Rp 7,363.00 Rp 581,677 Rp - 0 Rp - 79
31 Glibenklamide 5 mg 0 Tab Rp 87.00 Rp - Rp - 0 Rp - 0
32 Haloperidole 5 mg 110 Tab Rp 54.00 Rp 5,940 Rp - 0 Rp - 110
33 Hyoscine N butylbromide 260 Tab Rp 1,050.00 Rp 273,000 Rp - 0 Rp - 260
34 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00 Rp - Rp - 0 Rp - 0
35 Kalsium laktat (Kalk) 500 mg 80 Tab Rp 60.00 Rp 4,800 Rp - 10 Rp 600 70
36 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00 Rp 148,776 Rp - 0 Rp - 24
B/
442/86
9/
37 Ketorolac inj 30Mg/MI 54 Ampul Rp 923.00 Rp 49,842 UPTD- 5/27/2022 200 Rp 184,600 53 Rp 48,919 201
IFK/V/
2022
38 Karbamazepin 200mg 70 tab Rp 216.00 Rp 15,120 Rp - 30 Rp 6,480 40
39 Isosorbid Dinitrat tablet sublingual 5mg 95 Tab Rp 99.00 Rp 9,405 Rp - 20 Rp 1,980 75
40 Ibuprofen Syr 100mg/5ml 96 Btl Rp 2,339.00 Rp 224,544 Rp - 8 Rp 18,712 88
41 Ketokonazole Cream 89 Tube Rp 2,399.00 Rp 213,511 Rp - 6 Rp 14,394 83
42 Ketokonazole tablet 200mg 100 Tab Rp 260.00 Rp 26,000 Rp - 50 Rp 13,000 50
43 Kloramfenikol Suspensi 125 mg/ 5ml 99 Btl Rp 5,352.00 Rp 529,848 Rp - 0 Rp - 99
44 Kodein 10 mg 100 Tab Rp 605.00 Rp 60,500 Rp - 0 Rp - 100
45 Lansoprazole 30 mg 2650 kap Rp 278.00 Rp 736,700 B/ Rp - 180 Rp 50,040 2470
442/86
Lidokain comp (Lidokain injeksi 2% (HCI) + 9/
46
epinefrin) 0 Ampul Rp 847.00 Rp - UPTD- 5/27/2022 60 Rp 50,820 0 Rp - 60
IFK/V/
47 Lidocain inj 2 % (HCL) 155 Ampul Rp 891.00 Rp 138,105 2022 Rp - 55 Rp 49,005 100
B/
442/86
9/
48 Loratadine 1040 kap Rp 117.00 Rp 121,680 UPTD- 5/27/2022 3000 Rp 351,000 330 Rp 38,610 3710
IFK/V/
2022
B/
442/86
9/
49 Metformin HCL 500 mg 2900 tab Rp 77.00 Rp 223,300 UPTD- 5/27/2022 6000 Rp 462,000 1170 Rp 90,090 7730
IFK/V/
2022
50 Metilprednisolon tablat 4 mg 160 tab Rp 102.00 Rp 16,320 Rp - 160 Rp 16,320
51 Metilprednisolon tablat 8 mg 500 tab Rp 237.00 Rp 118,500 Rp - 260 Rp 61,620 240
52 Metoklopramid 10 mg 100 tab Rp 66.00 Rp 6,600 Rp - 10 Rp 660 90
B/
442/86
9/
53 Metoklopramid inj 96 Ampul Rp 1,983.00 Rp 190,368 UPTD- 5/27/2022 300 Rp 594,900 4 Rp 7,932 392
IFK/V/
2022
54 Methamizole Na Inj 0 Ampul Rp 3,045.00 Rp - Rp - 0 Rp - 0
B/
442/86
9/
55 Metronidazol sirup 0 Btl Rp 3,765.00 Rp - UPTD- 5/27/2022 100 Rp 376,500 0 Rp - 100
IFK/V/
2022
56 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp - Rp - 0 Rp - 0
B/
442/86
9/
57 MGSO4 20 % 26 Ampul Rp 4,120.00 Rp 107,120 UPTD- 5/27/2022 24 Rp 98,880 0 Rp - 50
IFK/V/
2022
58 Mikonazole kream 163 Tube Rp 1,900.00 Rp 309,700 Rp - 5 Rp 9,500 158
59 Nistatin drop 26 Btl Rp 11,750.00 Rp 305,500 Rp - 4 Rp 47,000 22
60 Nistatin Ovula 100.000 IU 100 tab Rp 550.00 Rp 55,000 Rp - 4 Rp 2,200 96
61 Natrium Diklofenak 25 mg 30 tab Rp 109.00 Rp 3,270 Rp - 30 Rp 3,270 0
62 N-Asetilsistein 500 Tab Rp 317.00 Rp 158,500 Rp - 110 Rp 34,870 390
B/
442/86
9/
63 Natrium Chloride 0,9 % ( NACL 0,9 %) 140 btl Rp 6,900.00 Rp 966,000 UPTD- 5/27/2022 140 Rp 966,000 44 Rp 303,600 236
IFK/V/
2022
64 Oxytocin injeksi 0 Ampul Rp 1,248.00 Rp - Rp - 0 Rp - 0
B/
442/86
9/
65 Omeprazole 20 mg 0 Kap Rp 129.00 Rp - UPTD- 5/27/2022 4000 Rp 516,000 0 Rp - 4000
IFK/V/
2022
66 Parasetamol syr 102 btl Rp 1,160.00 Rp 118,320 Rp - 49 Rp 56,840 53
B/
442/86
9/
67 Phytomenadion inj 2mg/ml 58 Ampul Rp 3,900.00 Rp 226,200 UPTD- 5/27/2022 60 Rp 234,000 0 Rp - 118
IFK/V/
2022
B/
442/86
9/
68 Phytomenadion 10 mg 0 Tab Rp 781.00 Rp - UPTD- 5/27/2022 200 Rp 156,200 0 Rp - 200
IFK/V/
2022
69 Permetrin cream 0 Tube Rp 11,466.00 Rp - Rp - 0 Rp - 0
70 Ranitidin tablet 150 mg 1750 tab Rp 85.00 Rp 148,750 Rp - 180 Rp 15,300 1570
71 Ranitidin injeksi 0 Ampul Rp 858.00 Rp - Rp - 0 Rp - 0
72 Salbutamol 4 mg 0 Tab Rp 67.00 Rp - Rp - 0 Rp - 0
73 Salep 2-4 11 Pot Rp 1,475.00 Rp 16,225 Rp - 1 Rp 1,475 10
B/
442/86
9/
74 Simvastatin 10 mg 1200 tab Rp 73.00 Rp 87,600 UPTD- 5/27/2022 2000 Rp 146,000 0 Rp - 3200
IFK/V/
2022
B/
442/86
9/
75 Simvastatin 20 mg 2610 tab Rp 73.00 Rp 190,530 UPTD- 5/27/2022 1000 Rp 73,000 270 Rp 19,710 3340
IFK/V/
2022
76 Siprofloksasin 500 mg 1280 Tab Rp 260.00 Rp 332,800 Rp - 430 Rp 111,800 850
77 Sianocbalamin (B12) 60 Tab Rp 44.00 Rp 2,640 Rp - 60 Rp 2,640 0
78 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 215 Ampul Rp 1,066.00 Rp 229,190 Rp - 0 Rp - 215
79 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00 Rp 1,034,264 Rp - 0 Rp - 2
80 Tablet tambah darah 11200 tab Rp 255.00 Rp 2,856,000 Rp - 2560 Rp 652,800 8640
B/
442/86
9/
81 USG GEL 2 Btl Rp 18,858.33 Rp 37,717 UPTD-
5/27/2022 2 Rp 37,717 0 Rp - 4
IFK/V/
2022
82 VAR 0 Vial Rp 153,000.00 Rp - Rp - 0 Rp - 0
B/
442/86
9/
83 Vit. B.Complex 2530 Tab Rp 60 Rp 151,800 UPTD- 5/27/2022 4000 Rp 240,000 550 Rp 33,000 5980
IFK/V/
2022
84 Zink 20 mg tab 0 Tab Rp 253.00 Rp - Rp - 0 Rp - 0
85 Zink syr 0 Btl Rp 2,489.00 Rp - Rp - 0 Rp - 0
BMHP
86 Catgut chromic 3/0 +jarum Bulat (*optime*) 72 Pcs Rp 68,090.00 Rp 4,902,480 Rp - 0 Rp - 72
B/
442/86
9/
87 Disposable syringe 3 cc 1200 Pcs Rp 818.00 Rp 981,600 UPTD- 5/27/2022 500 Rp 409,000 700 Rp 572,600 1000
IFK/V/
2022
88 Disposable syringe 10 cc 200 Pcs Rp 1,100.00 Rp 220,000 Rp - 100 Rp 110,000 100
B/
442/86
9/
89 Folly Catheter 18 10 pcs Rp 11,132.00 Rp 111,320 UPTD- 5/27/2022 20 Rp 222,640 10 Rp 111,320 20
IFK/V/
2022
B/
442/86
9/
90 Handscoond steril no 6 0 Pasang Rp 13,563.00 Rp - UPTD- 5/27/2022 200 Rp 2,712,600 100 Rp 1,356,300 100
IFK/V/
2022
91 Handscoond steril no 6,5 389 Pasang Rp 13,563.00 Rp 5,276,007 Rp - 3 Rp 40,689 386
92 Handscoond steril no 7 405 Pasang Rp 13,563.00 Rp 5,493,015 Rp - 5 Rp 67,815 400
93 Handscoond steril no 7,5 10 Pasang Rp 13,563.00 Rp 135,630 Rp - 10 Rp 135,630 0
94 Hand Sanitizer / Handrub 500 ml 19 Btl Rp 68,200.00 Rp 1,295,800.00 Rp - 9 Rp 613,800.00 10
B/
442/86
9/
95 Handscrub 1 Btl Rp 115,800.00 Rp 115,800.00 UPTD- 5/27/2022 10 Rp 1,158,000.00 0 Rp - 11
IFK/V/
2022
96 Infus Set Dewasa 0 pcs Rp 7,128.00 Rp - Rp - 0 Rp - 0
97 IV.Chateter No.18 G 0 pcs Rp 25,487.00 Rp - Rp - 0 Rp - 0
B/
442/86
9/
98 Kasa 4 x 10 0 pcs Rp 2,176.72 Rp - UPTD- 5/27/2022 300 Rp 653,017 0 Rp - 300
IFK/V/
2022
99 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp - Rp - 0 Rp - 0
100 Scalpet Blades no.10 100 Pcs Rp 618.70 Rp 61,870 Rp - 0 Rp - 100
B/
442/86
9/
103 Surgical mask earloop 3ply / Masker 0 Box Rp 1,373.14 Rp - UPTD- 5/27/2022 20000 Rp 27,462,800 4000 Rp 5,492,560 16000
IFK/V/
2022
B/
442/86
9/
104 Under Pad Steril 100 pcs Rp 37,875.00 Rp 3,787,500 UPTD- 5/27/2022 200 Rp 7,575,000 100 Rp 3,787,500 200
IFK/V/
2022
DAK 2020
B/
442/86
9/
1 Acyclovir 400 mg 235 Tab Rp 454.00 Rp 106,690 UPTD- 5/27/2022 1000 Rp 454,000 115 Rp 52,210 1120
IFK/V/
2022
3 CTM 4 mg 0 tab Rp 26.00 Rp - Rp - 0 Rp - 0
4 Cetrizine 10 mg 0 tab Rp 104.00 Rp - Rp - 0 Rp - 0
5 Domperidone syr 0 Botol Rp 2,862.00 Rp - Rp - 0 Rp - 0
B/
442/86
9/
6 0 tab Rp 212.00 Rp - UPTD- 5/27/2022 500 Rp 106,000 0 Rp - 500
IFK/V/
Anti migren kombinasi ( ERGOTAMIN ) 2022
7 Gentamicine tetes mata 0 Botol Rp 26.00 Rp - Rp - 0 Rp - 0
8 Kodein 10 mg 134 Tab Rp 657.00 Rp 88,038 Rp - 35 Rp 22,995 99
9 Lansoprazole 30 mg 0 kap Rp 352.00 Rp - Rp - 0 Rp - 0
10 Metilprednisolon tablat 4 mg 0 tab Rp 148.00 Rp - Rp - 0 Rp - 0
11 Paracetamol Drop 0 Botol Rp 7,646.00 Rp - Rp - 0 Rp - 0
BMHP
12 Catgut chromic 3/0 +jarum Bulat (*optime*) 0 Pcs Rp 55,000.00 Rp - Rp - 0 Rp - 0
13 Catgut chromic 3/0 +jarum Segitiga (*optime*) 0 Pcs Rp 62,000.00 Rp - Rp - 0 Rp - 0
14 Catgut chromic 2/0 +jarum Bulat (*optime-R*) 42 Pcs Rp 44,000.00 Rp 1,848,000 Rp - 0 Rp - 42
15 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00 Rp - Rp - 0 Rp - 0

16 Feeding Tube 14 0 pcs Rp 8,407.00 Rp - Rp - 0 Rp - 0
18 Handscoond steril no 8 49 Pasang Rp 13,178.00 Rp 645,722 Rp - 0 Rp - 49
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp - Rp - 0 Rp - 0
22 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00 Rp - Rp - 0 Rp - 0
23 Umbilical Cord Klem 0 Pcs Rp 1,495.00 Rp - Rp - 0 Rp - 0
DAU 2020
1 Aqua pro injeksi 20 ml 18 ampul Rp 2,860.00 Rp 51,480 Rp - 0 Rp - 18
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00 Rp - Rp - 0 Rp - 0
3 Natrium Chloride 0,9 % ( NACL 0,9 %) 0 btl Rp 6,840.00 Rp - Rp - 0 Rp - 0
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00 Rp 161,260 Rp - 0 Rp - 220
B/
442/86
9/
5 Ringer Laktat (RL) 60 btl Rp 7,150.00 Rp 429,000 UPTD- 5/27/2022 400 Rp 2,860,000 16 Rp 114,400 444
IFK/V/
2022
P 2020
1 Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01 Rp - Rp - 0 Rp - 0
2 Ambroxol Tablet 30 mg 0 Tab Rp 110.00 Rp - Rp - 0 Rp - 0
3 Bisakodil Suppo 0 Suppo Rp 23,475.00 Rp - Rp - 0 Rp - 0
4 Bisakodil ( LAXANA) 14 Tab Rp 367.00 Rp 5,138 Rp - 12 Rp 4,404 2
5 Guaiafenesin (GG) 100 mg 0 tab Rp 175.00 Rp - Rp - 0 Rp - 0
6
0 Botol Rp 14,900.00 Rp - Rp - 0 Rp - 0
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 159 Botol Rp 2,051,100 Rp - 49 Rp 632,100 110
Rp 12,900.00
8
FLUTROP
30 tab Rp 600.00 Rp 18,000 Rp - 30 Rp 18,000 0
9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00 Rp - Rp - 0 Rp - 0

B/
442/86
9/
10 Hemafort 0 Tab Rp 820.00 Rp - UPTD- 5/27/2022 3600 Rp 2,952,000 0 Rp - 3600
IFK/V/
2022
DAK 2019
1 Acyclovir 400 mg 0 Tab Rp 425.00 Rp - Rp - 0 Rp - 0
2 Alprazolam 0,5 mg 0 tab Rp 88.00 Rp - Rp - 0 Rp - 0
3 Cefadroxil sirup kering 125mg/5ml 202 btl Rp 4,360.00 Rp 880,720 Rp - 202 Rp 880,720 0
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 5 Tube Rp 14,459.00 Rp 72,295 Rp - 5 Rp 72,295 0
5 Kotrimoxazole syr 47 btl Rp 2,052.00 Rp 96,444 Rp - 47 Rp 96,444 0
6 Metoklopramide 10 mg 20 tab Rp 83.00 Rp 1,660 Rp - 20 Rp 1,660 0
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00 Rp - Rp - 0 Rp - 0
8 Pirantel 125 mg 53 tab Rp 331.00 Rp 17,543 Rp - 0 Rp - 53
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00 Rp - Rp - 0 Rp - 0
BMHP
10 Alat Suntik 5 ml 1297 pcs Rp 1,600 Rp 2,075,200 Rp - 0 Rp - 1297
B/
442/86
9/
IFK/V/
2022
B/
442/86
9/
IFK/V/
2022
B/
442/86
9/
14 urine bag 0 pcs Rp 1,848.00 Rp - UPTD- 5/27/2022 100 Rp 184,800 100 Rp 184,800 0
IFK/V/
2022
PENUNJANG 2019
1 Gentamicin salep kulit 54 tube Rp 2,640.00 Rp 142,560 Rp - 27 Rp 71,280 27
2 Loperamide 650 Tab Rp 198.00 Rp 128,700 Rp - 10 Rp 1,980 640
3 Multivitamin syr anak ( Becefort ) 93 Botol Rp 17,365.70 Rp 1,615,010 Rp - 93 Rp 1,615,010 0
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 189 btl Rp 3,850.00 Rp 727,650 Rp - 1 Rp 3,850 188
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00 Rp - Rp - 0 Rp - 0
2 Cotton roll medium 0 Pack Rp 85,800.00 Rp - Rp - 0 Rp - 0
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp - Rp - 0 Rp - 0
4 Pehacain 60 Ampul Rp 3,113.0495 Rp 186,783 Rp - 60 Rp 186,783 0
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00 Rp - Rp - 0 Rp - 0
2 HCT 25 mg 0 tab Rp 178.00 Rp - Rp - 0 Rp - 0
3 Nistatin 100.000 IU 0 tab Rp 645.00 Rp - Rp - 0 Rp - 0
BMHP
4 Blood Lancet 400 Pcs Rp 167.509 Rp 67,004 Rp - 0 Rp - 400
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86 Rp - Rp - 0 Rp - 0
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 100 pcs Rp 22,000.00 Rp 2,200,000 Rp - 100 Rp 2,200,000 0
DAU 2017
BMHP
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 31 Pcs Rp 46,187.44 Rp 1,431,811 Rp - 0 Rp - 31
DAK 2017
BMHP
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 25 Bks Rp 14,375.00 Rp 359,375 Rp - 0 Rp - 25
2 Kasa 4mx5cm 0 Roll Rp 862.50 Rp - Rp - 0 Rp - 0
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 50 pcs Rp 6,222.00 Rp 311,100 Rp - 0 Rp - 50
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 15 roll/bungkus Rp 11,914 Rp 178,710 Rp - 3 Rp 35,742 12
TOTAL 72,650.00 Rp 74,804,821.42 68,656.00 Rp 59,777,703.91 17,987.00 Rp 23,139,203.07 123,319.00
Mengetahui Binawara, 31 Mei 2022


NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011
Stock Akhir
KET
Total harga
26 27
Rp 416,650.00
Rp 120,562.50
Rp 1,856,000.00
Rp -
Rp -
Rp 72,600.00
Rp 3,017,982.00
Rp -
Rp 167,020.56
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 558,800
Rp -
Rp 679,800
Rp 2,340,800
Rp 95,040
Rp 650,210
Rp 20,625
Rp 384,774
Rp 8,250
Rp 292,600
Rp -
Rp 161,700
Rp 880,000
Rp 561,000
Rp 321,750
Rp 121,000
Rp 2,244,000
Rp 3,762,000
Rp 792,000
Rp 1,199,000
Rp 297,000
Rp 1,280,664
Rp 871,250
Rp 276,790
Rp 506,000
Rp 321,750
Rp -
Rp -
Rp 871,200
Rp 169,520
Rp 160,028
Rp -
Rp 1,113,304
Rp 138,000
Rp 182,000
Rp 344,650
Rp 30,260
Rp -
Rp -
Rp 152,550
Rp -
Rp 839,485
Rp -
Rp 3,090
Rp 197,472
Rp 144,500
Rp 797,132
Rp 736,164
Rp 10,440
Rp 99,807
Rp 581,677
Rp -
Rp 5,940
Rp 273,000
Rp -
Rp 4,200
Rp 148,776
Rp 185,523
Rp 8,640
Rp 7,425
Rp 205,832
Rp 199,117
Rp 13,000
Rp 529,848
Rp 60,500
Rp 686,660
Rp 50,820
Rp 89,100
Rp 434,070
Rp 595,210
Rp -
Rp 56,880
Rp 5,940.00
Rp 777,336
Rp -
Rp 376,500
Rp -
Rp 206,000
Rp 300,200
Rp 258,500
Rp 52,800.00
Rp -
Rp 123,630
Rp 1,628,400
Rp -
Rp 516,000
Rp 61,480
Rp 460,200
Rp 156,200
Rp -
Rp 133,450
Rp -
Rp -
Rp 14,750
Rp 233,600
Rp 243,820
Rp 221,000
Rp -
Rp 229,190
Rp 1,034,264
Rp 2,203,200
Rp 75,433
Rp -
Rp 358,800
Rp -
Rp -
Rp 4,902,480
Rp 818,000.00
Rp 110,000.00
Rp 222,640.00
Rp 1,356,300.00
Rp 5,235,318.00
Rp 5,425,200.00
Rp -
Rp 682,000.00
Rp 1,273,800.00
Rp -
Rp -
Rp 653,017
Rp -
Rp 61,869.50
Rp 61,249.72
Rp 49,497.03
Rp 21,970,240.00
Rp 7,575,000.00
Rp 508,480
Rp -
Rp -
Rp -
Rp -
Rp 106,000
Rp -
Rp 65,043
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,848,000
Rp -
Rp -
Rp -
Rp 645,722
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 51,480
Rp -
Rp -
Rp 161,260
Rp 3,174,600
Rp -
Rp -
Rp -
Rp 734
Rp -
Rp -
Rp 1,419,000
Rp -
Rp -
Rp 2,952,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 17,543
Rp -
Rp 2,075,200
Rp 356,730
Rp 356,730
Rp -
Rp -
Rp 71,280
Rp 126,720
Rp -
Rp 723,800
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 67,004
Rp -
Rp -
Rp 1,431,811
Rp 359,375
Rp -
Rp 311,100
Rp 142,968
Rp 111,443,322.26
la Obat Puskesmas
890825 201101 2 011

BULAN JUNI 2022
IFK Realisasi
NO Banyaknya Jumlah
Nama Obat Harga satuan Total Harga Berita acara Jumlah
Jumlah TOTAL Harga Total harga
1 2 3 4 5 6 7 8 9 10 19 20 25
BMHP Program HIV
1 Safety box 25 IDR Rp 16,666.00 Rp 416,650.00 Rp - 0 Rp - 25
2 Plesterin Bulat non woven 3 Kotak Rp 40,187.50 Rp 120,562.50 Rp - 0 Rp - 3
3 Vacum Tube sterile, plastic, K3 EDTA 1600 Pcs Rp 1,160.00 Rp 1,856,000.00 Rp - 0 Rp - 1600
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Rp - 0 Rp - 0
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00 Rp - Rp - 0 Rp - 0
6 Vacutainer Needle 550 Pcs Rp 132.00 Rp 72,600.00 Rp - 0 Rp - 550
BMHP Program TB
1 Larutan Zhihi Neeisen 11 Paket Rp 274,362.00 Rp 3,017,982.00 Rp - 5 Rp 1,371,810.00 6
2 Sputum Pot 0 Biji Rp 3,137.00 Rp - Rp - 0 Rp - 0
3 Object Glass Frosted 7105 7 box @ 72 pcs Rp 23,860.08 Rp 167,020.56 Rp - 3 Rp 71,580.24 4
DAK 22
B/
442/102
8-
2 IV.Chateter No.18 G 0 pcs Rp - SPB/ 6/16/2022 50 Rp 1,320,900 50 Rp 1,320,900 0
UPTD-
IFK/VI-
Rp 26,418.00 2022
B/
442/102
8-
UPTD-
IFK/VI-
Rp 26,418.00 2022
B/
442/102
8-
UPTD-
IFK/VI-
Rp 26,418.00 2022
B/
442/102
8-
UPTD-
IFK/VI-
Rp 26,418.00 2022
B/
442/102
8-
UPTD-
IFK/VI-
Rp 27,639.00 2022
B/
442/102
8-
1 Plaster Putih 5 x 5 ( Farmafix ) 0 pcs Rp 8,731.00 Rp - SPB/ 6/16/2022 10 Rp 87,310 10 Rp 87,310 0
UPTD-
IFK/VI-
2022
1 Bahan tambal sinar 0 Syringe Rp 356,400.00 Rp - Rp - 0 Rp - 0
2 Cairan bonding 0 Pot Rp 391,500.00 Rp - Rp - 0 Rp - 0
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00 Rp - Rp - 0 Rp - 0
DAU 2021
Btl isi @ 30
kapsul
Rp 45,000.00 Rp - Rp - 0 Rp - 0
BMHP 0
3 Disposable syringe 1 cc 0 Pcs Rp 1,361.00 Rp - Rp - 0 Rp - 0
4 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53 Rp - Rp - 0 Rp - 0
5 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13 Rp - Rp - 0 Rp - 0
P 21
1 Acyclovir Cream 127 Tube Rp 4,400.00 Rp 558,800 Rp - 2 Rp 8,800 125
2 Bedak Salisil 0 Wadah Rp 7,700.00 Rp - Rp - 0 Rp - 0
3 Bicombin inj 103 Ampul Rp 6,600.00 Rp 679,800 Rp - 14 Rp 92,400 89
4 Cefadroxil 500 mg 2660 Kap Rp 880.00 Rp 2,340,800 Rp - 230 Rp 202,400 2430
5 Digoxin 0,5 mg 480 Tab Rp 198.00 Rp 95,040 Rp - 0 Rp - 480
B/
442/102
8-
6 Diazepam larutan rektal 5mg/2,5ml 0 Suppo Rp 30,800.00 Rp - SPB/ 6/16/2022 10 Rp 308,000 0 Rp - 10
UPTD-
IFK/VI-
2022
7 Eflin 460 Tab Rp 1,413.50 Rp 650,210 Rp - 50 Rp 70,675 410

8 Furosemid 75 Tab Rp 275.00 Rp 20,625 Rp - 75 Rp 20,625 0
9 Guaiafenesin (GG) 100 mg 2600 tab Rp 147.99 Rp 384,774 Rp - 700 Rp 103,593 1900
10 Ibuprofen 200mg 30 Tab Rp 275.00 Rp 8,250 Rp - 30 Rp 8,250 0
11 Kloramfenikol 250 mg 380 Kap Rp 770.00 Rp 292,600 Rp - 170 Rp 130,900 210
12 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00 Rp - Rp - 0 Rp - 0
13 Meloxicam 7,5 mg 420 Tab Rp 385.00 Rp 161,700 Rp - 130 Rp 50,050 290
14 Novastan syr 80 Btl Rp 11,000.00 Rp 880,000 Rp - 0 Rp - 80
15 Nifedipine 2550 Tab Rp 220.00 Rp 561,000 Rp - 920 Rp 202,400 1630
16 Oxytetracycline Salep Kulit 3% 65 Tube Rp 4,950.00 Rp 321,750 Rp - 12 Rp 59,400 53
17 OBH Plus 10 Btl Rp 12,100.00 Rp 121,000 Rp - 10 Rp 121,000 0
B/
442/102
8-
18 Paracetamol 500 mg 8160 tab Rp 275.00 Rp 2,244,000 SPB/ 6/16/2022 3000 Rp 825,000 1610 Rp 442,750 9550
UPTD-
IFK/VI-
2022
19 Pehavral 3600 tab Rp 1,045.00 Rp 3,762,000 Rp - 254 Rp 265,430 3346

20 Reco Salep Mata ( Chloamphenicol) 120 Tube Rp 6,600.00 Rp 792,000 Rp - 2 Rp 13,200 118
21 Reco Tetes Telinga (Chloramphenicol) 109 Btl Rp 11,000.00 Rp 1,199,000 Rp - 8 Rp 88,000 101
22 Skincol Gel 2 Tube Rp 148,500.00 Rp 297,000 Rp - 0 Rp - 2
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 5544 Tab Rp 231.00 Rp 1,280,664 Rp - 330 Rp 76,230 5214
2 Amoksisilin sirup kering 125mg/5ml 425 Btl Rp 2,050.00 Rp 871,250 Rp - 31 Rp 63,550 394
B/
442/102
8-
3 Amox icillin Drop 0 Btl Rp 11,750.00 Rp - SPB/ 6/16/2022 140 Rp 1,645,000 0 Rp - 140
UPTD-
IFK/VI-
2022
4 Allupurinol 100 mg 3110 Tab Rp 89.00 Rp 276,790 Rp - 50 Rp 4,450 3060
5 Allupurinol 300 mg 2530 Tab Rp 200.00 Rp 506,000 Rp - 110 Rp 22,000 2420
B/
442/102
8-
6 Asam Mefenamat 2750 tab Rp 117.00 Rp 321,750 SPB/ 6/16/2022 3000 Rp 351,000 660 Rp 77,220 5090
UPTD-
IFK/VI-
2022
9 Ampisillin serbuk injeksi i.v 1000 mg/ Vial 88 Vial Rp 9,900.00 Rp 871,200 Rp - 0 Rp - 88
10 Antihemeroid kombinasi 52 Suppo Rp 3,260.00 Rp 169,520 Rp - 6 Rp 19,560 46
11 Antifungi DOEN kombinasi: Asam Benzoat 3% + Asam Salisilat 6% 44 Botol Rp 3,637.00 Rp 160,028 Rp - 0 Rp - 44
12 Antasida Doen I Tablet Kunyah 0 Tab Rp 54.00 Rp - Rp - 0 Rp - 0
B/
442/102
8-
13 Antasida Doen suspensi 634 Botol Rp 1,756.00 Rp 1,113,304 SPB/ 6/16/2022 100 Rp 175,600 235 Rp 412,660 499
UPTD-
IFK/VI-
2022
14 Asam askorbat / Vit C 50 mg 3000 Tab Rp 46.00 Rp 138,000 Rp - 70 Rp 3,220 2930
15 Asam Traneksamat injeksi 100 amp Rp 1,820.00 Rp 182,000 Rp - 46 Rp 83,720 54
16 Asam folat tab 1 mg 5650 pcs Rp 61.00 Rp 344,650 Rp - 820 Rp 50,020 4830
17 Asetosal 80 mg 340 Tab Rp 89.00 Rp 30,260 Rp - 60 Rp 5,340 280
19 Betamethason cream 0 Tab Rp 1,540.00 Rp - Rp - 0 Rp - 0
20 Bisakodil Suppo 30 Suppo Rp 5,085.00 Rp 152,550 Rp - 5 Rp 25,425 25
21 Captopril 12,5 mg 0 tab Rp 68.00 Rp - Rp - 0 Rp - 0
B/
442/102
8-
22 Cetrizine syr 379 Botol Rp 2,215.00 Rp 839,485 SPB/ 6/16/2022 200 Rp 443,000 18 Rp 39,870 561
UPTD-
IFK/VI-
2022
23 Cefotaxim Injeksi 0 Vial Rp 3,050.00 Rp - Rp - 0 Rp - 0
24 Diazepam inj 5 mg / 2 ml 2 Ampul Rp 1,545.00 Rp 3,090 Rp - 0 Rp - 2
25 Dexamethasone injeksi 204 Ampul Rp 968.00 Rp 197,472 Rp - 18 Rp 17,424 186
26 Doksisiklin 500 Tab Rp 289.00 Rp 144,500 Rp - 0 Rp - 500
27 Domperidone syr 332 Botol Rp 2,401.00 Rp 797,132 Rp - 38 Rp 91,238 294
28 Eritromisin sirup 200 mg 99 Botol Rp 7,436.00 Rp 736,164 Rp - 5 Rp 37,180 94
29 Epinephrine 6 Ampul Rp 1,740.00 Rp 10,440 Rp - 0 Rp - 6
30 Furosemid Injeksi i.v./i.m 10mg/ml 103 Ampul Rp 969.00 Rp 99,807 Rp - 26 Rp 25,194 77
31 Glukosa Infus D5% 79 btl Rp 7,363.00 Rp 581,677 Rp - 0 Rp - 79
32 Glibenklamide 5 mg 0 Tab Rp 87.00 Rp - Rp - 0 Rp - 0
33 Haloperidole 5 mg 110 Tab Rp 54.00 Rp 5,940 Rp - 0 Rp - 110
34 Hyoscine N butylbromide 260 Tab Rp 1,050.00 Rp 273,000 Rp - 0 Rp - 260
35 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00 Rp - Rp - 0 Rp - 0
36 Kalsium laktat (Kalk) 500 mg 70 Tab Rp 60.00 Rp 4,200 Rp - 70 Rp 4,200 0

37 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00 Rp 148,776 Rp - 0 Rp - 24
38 Ketorolac inj 30Mg/MI 201 Ampul Rp 923.00 Rp 185,523 Rp - 8 Rp 7,384 193
39 Karbamazepin 200mg 40 tab Rp 216.00 Rp 8,640 Rp - 30 Rp 6,480 10
40 Isosorbid Dinitrat tablet sublingual 5mg 75 Tab Rp 99.00 Rp 7,425 Rp - 10 Rp 990 65
41 Ibuprofen Syr 100mg/5ml 88 Btl Rp 2,339.00 Rp 205,832 Rp - 8 Rp 18,712 80
42 Ketokonazole Cream 83 Tube Rp 2,399.00 Rp 199,117 Rp - 5 Rp 11,995 78
43 Ketokonazole tablet 200mg 50 Tab Rp 260.00 Rp 13,000 Rp - 30 Rp 7,800 20
44 Kloramfenikol Suspensi 125 mg/ 5ml 99 Btl Rp 5,352.00 Rp 529,848 Rp - 1 Rp 5,352 98
45 Kodein 10 mg 100 Tab Rp 605.00 Rp 60,500 Rp - 0 Rp - 100
46 Lansoprazole 30 mg 2470 kap Rp 278.00 Rp 686,660 Rp - 470 Rp 130,660 2000
Lidokain comp (Lidokain injeksi 2% (HCI) +
47 epinefrin) 60 Ampul Rp 847.00 Rp 50,820 Rp - 60 Rp 50,820 0
48 Lidocain inj 2 % (HCL) 100 Ampul Rp 891.00 Rp 89,100 Rp - 3 Rp 2,673 97

B/
442/102
8-
49 Loratadine 3710 kap Rp 117.00 Rp 434,070 SPB/ 6/16/2022 1000 Rp 117,000 220 Rp 25,740 4490
UPTD-
IFK/VI-
2022
B/
442/102
8-
50 Metformin HCL 500 mg 7730 tab Rp 77.00 Rp 595,210 SPB/ 6/16/2022 3000 Rp 231,000 1190 Rp 91,630 9540
UPTD-
IFK/VI-
2022
51 Metilprednisolon tablat 4 mg tab Rp 102.00 Rp - Rp - 0 Rp - 0
B/
442/102
8-
52 Metilprednisolon tablat 8 mg 240 tab Rp 237.00 Rp 56,880 SPB/ 6/16/2022 200 Rp 47,400 310 Rp 73,470 130
UPTD-
IFK/VI-
2022
53 Metoklopramid 10 mg 90 tab Rp 66.00 Rp 5,940 Rp - 0 Rp - 90
B/
442/102
8-
54 Metoklopramid inj 392 Ampul Rp 1,983.00 Rp 777,336 SPB/ 6/16/2022 300 Rp 594,900 40 Rp 79,320 652
UPTD-
IFK/VI-
2022
55 Methamizole Na Inj 0 Ampul Rp 3,045.00 Rp - Rp - 0 Rp - 0

56 Metronidazol sirup 100 Btl Rp 3,765.00 Rp 376,500 Rp - 0 Rp - 100
57 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp - Rp - 0 Rp - 0
58 MGSO4 20 % 50 Ampul Rp 4,120.00 Rp 206,000 Rp - 0 Rp - 50
59 Mikonazole kream 158 Tube Rp 1,900.00 Rp 300,200 Rp - 10 Rp 19,000 148
60 Nistatin drop 22 Btl Rp 11,750.00 Rp 258,500 Rp - 7 Rp 82,250 15
61 Nistatin Ovula 100.000 IU 96 tab Rp 550.00 Rp 52,800 Rp - 0 Rp - 96
62 Natrium Diklofenak 25 mg 0 tab Rp 109.00 Rp - Rp - 0 Rp - 0
63 N-Asetilsistein 390 Tab Rp 317.00 Rp 123,630 Rp - 70 Rp 22,190 320
64 Natrium Chloride 0,9 % ( NACL 0,9 %) 236 btl Rp 6,900.00 Rp 1,628,400 Rp - 80 Rp 552,000 156
65 Oxytocin injeksi 0 Ampul Rp 1,248.00 Rp - Rp - 0 Rp - 0
B/
442/102
8-
66 Omeprazole 20 mg 4000 Kap Rp 129.00 Rp 516,000 SPB/ 6/16/2022 2000 Rp 258,000 630 Rp 81,270.00 5370
UPTD-
IFK/VI-
2022
67 Parasetamol syr 53 btl Rp 1,160.00 Rp 61,480 Rp - 35 Rp 40,600 18
68 Phytomenadion inj 2mg/ml 118 Ampul Rp 3,900.00 Rp 460,200 Rp - 0 Rp - 118
69 Phytomenadion 10 mg 200 Tab Rp 781.00 Rp 156,200 Rp - 0 Rp - 200
70 Permetrin cream 0 Tube Rp 11,466.00 Rp - Rp - 0 Rp - 0
71 Ranitidin tablet 150 mg 1570 tab Rp 85.00 Rp 133,450 Rp - 270 Rp 22,950 1300
72 Ranitidin injeksi 0 Ampul Rp 858.00 Rp - Rp - 0 Rp - 0
73 Salbutamol 4 mg 0 Tab Rp 67.00 Rp - Rp - 0 Rp - 0
74 Salep 2-4 10 Pot Rp 1,475.00 Rp 14,750 Rp - 0 Rp - 10
75 Simvastatin 10 mg 3200 tab Rp 73.00 Rp 233,600 Rp - 0 Rp - 3200
B/
442/102
8-
76 Simvastatin 20 mg 3340 tab Rp 73.00 Rp 243,820 SPB/ 6/16/2022 1000 Rp 73,000 350 Rp 25,550 3990
UPTD-
IFK/VI-
2022
77 Siprofloksasin 500 mg 850 Tab Rp 260.00 Rp 221,000 Rp - 500 Rp 130,000 350
78 Sianocbalamin (B12) 0 Tab Rp 44.00 Rp - Rp - 0 Rp - 0
79 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 215 Ampul Rp 1,066.00 Rp 229,190 Rp - 0 Rp - 215
80 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00 Rp 1,034,264 Rp - 0 Rp - 2
81 Tablet tambah darah 8640 tab Rp 255.00 Rp 2,203,200 Rp - 1600 Rp 408,000 7040
82 USG GEL 4 Btl Rp 18,858.33 Rp 75,433 Rp - 0 Rp - 4
83 VAR 0 Vial Rp 153,000.00 Rp - Rp - 0 Rp - 0
84 Vit. B.Complex 5980 Tab Rp 60 Rp 358,800 Rp - 700 Rp 42,000 5280
85 Zink 20 mg tab 0 Tab Rp 253.00 Rp - Rp - 0 Rp - 0
86 Zink syr 0 Btl Rp 2,489.00 Rp - Rp - 0 Rp - 0
BMHP
87 Catgut chromic 3/0 +jarum Bulat (*optime*) 72 Pcs Rp 68,090.00 Rp 4,902,480 Rp - 0 Rp - 72
88 Disposable syringe 3 cc 1000 Pcs Rp 818.00 Rp 818,000 Rp - 0 Rp - 1000
B/
442/102
8-
89 Disposable syringe 10 cc 100 Pcs Rp 1,100.00 Rp 110,000 SPB/ 6/16/2022 200 Rp 220,000 0 Rp - 300
UPTD-
IFK/VI-
2022
90 Folly Catheter 18 20 pcs Rp 11,132.00 Rp 222,640 Rp - 0 Rp - 20
91 Handscoond steril no 6 100 Pasang Rp 13,563.00 Rp 1,356,300 Rp - 0 Rp - 100
92 Handscoond steril no 6,5 386 Pasang Rp 13,563.00 Rp 5,235,318 Rp - 4 Rp 54,252 382
93 Handscoond steril no 7 400 Pasang Rp 13,563.00 Rp 5,425,200 Rp - 22 Rp 298,386 378
94 Handscoond steril no 7,5 0 Pasang Rp 13,563.00 Rp - Rp - 0 Rp - 0
95 Hand Sanitizer / Handrub 500 ml 10 Btl Rp 68,200.00 Rp 682,000.00 Rp - 10 Rp 682,000.00 0
96 Handscrub 11 Btl Rp 115,800.00 Rp 1,273,800.00 Rp - 11 Rp 1,273,800.00 0
99 Kasa 4 x 10 300 pcs Rp 2,176.72 Rp 653,017 Rp - 0 Rp - 300
100 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp - Rp - 0 Rp - 0
101 Scalpet Blades no.10 100 Pcs Rp 618.70 Rp 61,870 Rp - 100 Rp 61,870 0
B/
442/102
8-
104 Surgical mask earloop 3ply / Masker 16000 Box Rp 1,373.14 Rp 21,970,240 SPB/ 6/16/2022 4000 Rp 5,492,560 8350 Rp 11,465,719 11650
UPTD-
IFK/VI-
2022
105 Under Pad Steril 200 pcs Rp 37,875.00 Rp 7,575,000 Rp - 0 Rp - 200
DAK 2020
1 Acyclovir 400 mg 1120 Tab Rp 454.00 Rp 508,480 Rp - 0 Rp - 1120
3 CTM 4 mg 0 tab Rp 26.00 Rp - Rp - 0 Rp - 0
4 Cetrizine 10 mg 0 tab Rp 104.00 Rp - Rp - 0 Rp - 0
5 Domperidone syr 0 Botol Rp 2,862.00 Rp - Rp - 0 Rp - 0
6 Anti migren kombinasi ( ERGOTAMIN ) 500 tab Rp 212.00 Rp 106,000 Rp - 81 Rp 17,172 419
7 Gentamicine tetes mata 0 Botol Rp 26.00 Rp - Rp - 0 Rp - 0
8 Kodein 10 mg 99 Tab Rp 657.00 Rp 65,043 Rp - 20 Rp 13,140 79
9 Lansoprazole 30 mg 0 kap Rp 352.00 Rp - Rp - 0 Rp - 0
10 Metilprednisolon tablat 4 mg 0 tab Rp 148.00 Rp - Rp - 0 Rp - 0
11 Paracetamol Drop 0 Botol Rp 7,646.00 Rp - Rp - 0 Rp - 0
BMHP
12 Catgut chromic 3/0 +jarum Bulat (*optime*) 0 Pcs Rp 55,000.00 Rp - Rp - 0 Rp - 0
13 Catgut chromic 3/0 +jarum Segitiga (*optime*) 0 Pcs Rp 62,000.00 Rp - Rp - 0 Rp - 0
14 Catgut chromic 2/0 +jarum Bulat (*optime-R*) 42 Pcs Rp 44,000.00 Rp 1,848,000 Rp - 0 Rp - 42
15 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00 Rp - Rp - 0 Rp - 0
18 Handscoond steril no 8 49 Pasang Rp 13,178.00 Rp 645,722 Rp - 0 Rp - 49
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp - Rp - 0 Rp - 0
22 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00 Rp - Rp - 0 Rp - 0
23 Umbilical Cord Klem 0 Pcs Rp 1,495.00 Rp - Rp - 0 Rp - 0
DAU 2020
1 Aqua pro injeksi 20 ml 18 ampul Rp 2,860.00 Rp 51,480 Rp - 18 Rp 51,480 0
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00 Rp - Rp - 0 Rp - 0
3 Natrium Chloride 0,9 % ( NACL 0,9 %) 0 btl Rp 6,840.00 Rp - Rp - 0 Rp - 0
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00 Rp 161,260 Rp - 0 Rp - 220
5 Ringer Laktat (RL) 444 btl Rp 7,150.00 Rp 3,174,600 Rp - 144 Rp 1,029,600 300
P 2020
1 Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01 Rp - Rp - 0 Rp - 0
2 Ambroxol Tablet 30 mg 0 Tab Rp 110.00 Rp - Rp - 0 Rp - 0
3 Bisakodil Suppo 0 Suppo Rp 23,475.00 Rp - Rp - 0 Rp - 0
4 Bisakodil ( LAXANA) 2 Tab Rp 367.00 Rp 734 Rp - 2 Rp 734 0
5 Guaiafenesin (GG) 100 mg 0 tab Rp 175.00 Rp - Rp - 0 Rp - 0

6
0 Botol Rp 14,900.00 Rp - Rp - 0 Rp - 0
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 110 Botol Rp 1,419,000 Rp - 71 Rp 915,900 39
Rp 12,900.00
8
FLUTROP
0 tab Rp 600.00 Rp - Rp - 0 Rp - 0
9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00 Rp - Rp - 0 Rp - 0

10 Hemafort 3600 Tab Rp 820.00 Rp 2,952,000 Rp - 3000 Rp 2,460,000 600
DAK 2019
1 Acyclovir 400 mg 0 Tab Rp 425.00 Rp - Rp - 0 Rp - 0
2 Alprazolam 0,5 mg 0 tab Rp 88.00 Rp - Rp - 0 Rp - 0
3 Cefadroxil sirup kering 125mg/5ml 0 btl Rp 4,360.00 Rp - Rp - 0 Rp - 0
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 0 Tube Rp 14,459.00 Rp - Rp - 0 Rp - 0
5 Kotrimoxazole syr 0 btl Rp 2,052.00 Rp - Rp - 0 Rp - 0
6 Metoklopramide 10 mg 0 tab Rp 83.00 Rp - Rp - 0 Rp - 0
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00 Rp - Rp - 0 Rp - 0
8 Pirantel 125 mg 53 tab Rp 331.00 Rp 17,543 Rp - 0 Rp - 53
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00 Rp - Rp - 0 Rp - 0
BMHP
10 Alat Suntik 5 ml 1297 pcs Rp 1,600 Rp 2,075,200 Rp - 0 Rp - 1297
14 urine bag 0 pcs Rp 1,848.00 Rp - Rp - 0 Rp - 0
PENUNJANG 2019
1 Gentamicin salep kulit 27 tube Rp 2,640.00 Rp 71,280 Rp - 16 Rp 42,240 11
2 Loperamide 640 Tab Rp 198.00 Rp 126,720 Rp - 10 Rp 1,980 630
3 Multivitamin syr anak ( Becefort ) 0 Botol Rp 17,365.70 Rp - Rp - 0 Rp -
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 188 btl Rp 3,850.00 Rp 723,800 Rp - 0 Rp - 188
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00 Rp - Rp - 0 Rp - 0
2 Cotton roll medium 0 Pack Rp 85,800.00 Rp - Rp - 0 Rp - 0
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp - Rp - 0 Rp - 0
4 Pehacain 0 Ampul Rp 3,113.0495 Rp - Rp - 0 Rp - 0
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00 Rp - Rp - 0 Rp - 0
2 HCT 25 mg 0 tab Rp 178.00 Rp - Rp - 0 Rp - 0
3 Nistatin 100.000 IU 0 tab Rp 645.00 Rp - Rp - 0 Rp - 0
BMHP
4 Blood Lancet 400 Pcs Rp 167.509 Rp 67,004 Rp - 0 Rp - 400
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86 Rp - Rp - 0 Rp - 0
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 0 pcs Rp 22,000.00 Rp - Rp - 0 Rp - 0
DAU 2017
BMHP
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 31 Pcs Rp 46,187.44 Rp 1,431,811 Rp - 0 Rp - 31
DAK 2017
BMHP
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 25 Bks Rp 14,375.00 Rp 359,375 Rp - 0 Rp - 25
2 Kasa 4mx5cm 0 Roll Rp 862.50 Rp - Rp - 0 Rp - 0
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 50 pcs Rp 6,222.00 Rp 311,100 Rp - 0 Rp - 50
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 12 roll/bungkus Rp 11,914 Rp 142,968 Rp - 0 Rp - 12
TOTAL 123,319.00 Rp 111,443,322.26 18,410.00 Rp 17,534,320.00 25,579.00 Rp 31,441,732.74 116,150.00
Mengetahui Binawara, 30 Juni 2022


NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011
Stock Akhir
KET
Total harga
26 27
Rp 416,650.00
Rp 120,562.50
Rp 1,856,000.00
Rp -
Rp -
Rp 72,600.00
Rp 1,646,172.00
Rp -
Rp 95,440.32
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 550,000
Rp -
Rp 587,400
Rp 2,138,400
Rp 95,040
Rp 308,000
Rp 579,535
Rp -
Rp 281,181
Rp -
Rp 161,700
Rp -
Rp 111,650
Rp 880,000
Rp 358,600
Rp 262,350
Rp -
Rp 2,626,250
Rp 3,496,570
Rp 778,800
Rp 1,111,000
Rp 297,000
Rp 1,204,434
Rp 807,700
Rp 1,645,000
Rp 272,340
Rp 484,000
Rp 595,530
Rp -
Rp -
Rp 871,200
Rp 149,960
Rp 160,028
Rp -
Rp 876,244
Rp 134,780
Rp 98,280
Rp 294,630
Rp 24,920
Rp -
Rp -
Rp 127,125
Rp -
Rp 1,242,615
Rp -
Rp 3,090
Rp 180,048
Rp 144,500
Rp 705,894
Rp 698,984
Rp 10,440
Rp 74,613
Rp 581,677
Rp -
Rp 5,940
Rp 273,000
Rp -
Rp -
Rp 148,776
Rp 178,139
Rp 2,160
Rp 6,435
Rp 187,120
Rp 187,122
Rp 5,200
Rp 524,496
Rp 60,500
Rp 556,000
Rp -
Rp 86,427
Rp 525,330
Rp 734,580
Rp -
Rp 30,810
Rp 5,940.00
Rp 1,292,916
Rp -
Rp 376,500
Rp -
Rp 206,000
Rp 281,200
Rp 176,250
Rp 52,800.00
Rp -
Rp 101,440
Rp 1,076,400
Rp -
Rp 692,730
Rp 20,880
Rp 460,200
Rp 156,200
Rp -
Rp 110,500
Rp -
Rp -
Rp 14,750
Rp 233,600
Rp 291,270
Rp 91,000
Rp -
Rp 229,190
Rp 1,034,264
Rp 1,795,200
Rp 75,433
Rp -
Rp 316,800
Rp -
Rp -
Rp 4,902,480
Rp 818,000.00
Rp 330,000.00
Rp 222,640.00
Rp 1,356,300.00
Rp 5,181,066.00
Rp 5,126,814.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 653,017
Rp -
Rp -
Rp 61,249.72
Rp 49,497.03
Rp 15,997,081.00
Rp 7,575,000.00
Rp 508,480
Rp -
Rp -
Rp -
Rp -
Rp 88,828
Rp -
Rp 51,903
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,848,000
Rp -
Rp -
Rp -
Rp 645,722
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 161,260
Rp 2,145,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 503,100
Rp -
Rp -
Rp 492,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 17,543
Rp -
Rp 2,075,200
Rp 356,730
Rp 356,730
Rp -
Rp -
Rp 29,040
Rp 124,740
Rp -
Rp 723,800
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 67,004
Rp -
Rp -
Rp 1,431,811
Rp 359,375
Rp -
Rp 311,100
Rp 142,968
Rp 97,535,909.52
gelola Obat Puskesmas
mi Ariyani, A.Md. Far

19890825 201101 2 011
PEMERINTAH KABUPATEN TANAH BUMBU
DINAS KESEHATAN
PUSKESMAS PERAWATAN LASUNG
Alamat : Jalan Pemerintahan No.2 Desa Binawara,Kecamatan Kusan Hulu, Kabupaten Tanah Bumbu Prop Kalimantan Selatan, KP
72272
Website http://dinkes.tanahbumbukab.go.id email lasungmedical@gmail.com
BERITA ACARA PEMERIKSAAN STOCK OPNAME

ALKES / BMHP DAN OBAT APBD ( DAERAH ) 2022
NO: B/440/ 617 /PKM.Lsg.TU.4/VI/2022
Pada Hari Kamis Tanggal Tiga Puluh Bulan Juni Tahun Dua Ribu Dua Puluh Dua, yang bertanda tangan
dibawah ini :
Nama : Summi Ariyani, A.Md. Far

NIP : 19890825 201101 2 011
Jabatan : Asisten Apoteker Mahir / Pelaksana Lanjutan
Dengan ini menyatakan telah melakukan pemeriksaan dengan teliti terhadap barang - barang persediaan
obat yaitu :
Stock Akhir
Banyaknya Ket
No Nama Obat
Harga satuan Total Harga
Jumlah Satuan Sumber
1 2 3 4 5 6 7
BMHP Program HIV
1 Safety box 25 IDR Rp 416,650.00 Dinkes Aset

Rp 16,666.00 ( BPBD )
2 Plesterin Bulat non woven 3 Kotak Rp 120,562.50 Dinkes Aset

Rp 40,187.50 ( BPBD )
Vacum Tube sterile, plastic, K3 Dinkes Aset
3
EDTA 1600 Pcs Rp 1,856,000.00
Rp 1,160.00 ( BPBD )
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Dinkes Aset

( BPBD )
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00 Rp - Dinkes Aset

( BPBD )
6 Vacutainer Needle 550 Pcs Rp 132.00 Rp 72,600.00 Dinkes Aset

( BPBD )
BMHP Program TB
1 Larutan Zhihi Neeisen 6 Paket Rp 1,646,172.00 Dinkes Aset

Rp 274,362.00 ( BPBD )
2 Sputum Pot 0 Biji Rp - Dinkes Aset

Rp 3,137.00 ( BPBD )
box @ Dinkes Aset
3 Object Glass Frosted 7105 4 72 pcs
Rp 95,440.32
Rp 23,860.08 ( BPBD )
DAK 22
2 IV.Chateter No.18 G 0 pcs ### Rp -
1 Plaster Putih 5 x 5 ( Farmafix ) 0 pcs Rp 8,731.00 Rp -
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00 Rp -
2 Cairan bonding 0 Pot Rp 391,500.00 Rp -
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00 Rp -
DAU 2021
Btl isi @
1 Multivitamin Ibu Hamil OMEGA 3 0 30 Rp 45,000.00 Rp -
kapsul
BMHP
3 Disposable syringe 1 cc 0 Pcs Rp 1,361.00 Rp -
4 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53 Rp -
5 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13 Rp -
P 21
1 Acyclovir Cream 125 Tube Rp 4,400.00 Rp 550,000 gudang IFK

2 Bedak Salisil 0 Wadah Rp 7,700.00 Rp - gudang IFK
3 Bicombin inj 89 Ampul Rp 6,600.00 Rp 587,400 gudang IFK
4 Cefadroxil 500 mg 2430 Kap Rp 880.00 Rp 2,138,400 gudang IFK
5 Digoxin 0,5 mg 480 Tab Rp 198.00 Rp 95,040 gudang IFK
6 Diazepam larutan rektal 5mg/2,5ml 10 Suppo Rp 30,800.00 Rp 308,000 gudang IFK
7 Eflin 410 Tab Rp 1,413.50 Rp 579,535 gudang IFK
8 Furosemid 0 Tab Rp 275.00 Rp - gudang IFK
9 Guaiafenesin (GG) 100 mg 1900 tab Rp 147.99 Rp 281,181 gudang IFK
10 Ibuprofen 200mg 0 Tab Rp 275.00 Rp - gudang IFK
11 Kloramfenikol 250 mg 210 Kap Rp 770.00 Rp 161,700 gudang IFK
12 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00 Rp - gudang IFK
13 Meloxicam 7,5 mg 290 Tab Rp 385.00 Rp 111,650 gudang IFK
14 Novastan syr 80 Btl Rp 11,000.00 Rp 880,000 gudang IFK
15 Nifedipine 1630 Tab Rp 220.00 Rp 358,600 gudang IFK
16 Oxytetracycline Salep Kulit 3% 53 Tube Rp 4,950.00 Rp 262,350 gudang IFK
17 OBH Plus 0 Btl Rp 12,100.00 Rp - gudang IFK
18 Paracetamol 500 mg 9550 tab Rp 275.00 Rp 2,626,250 gudang IFK
19 Pehavral 3346 tab Rp 1,045.00 Rp 3,496,570 gudang IFK
20 Reco Salep Mata ( Chloamphenicol) 118 Tube Rp 6,600.00 Rp 778,800 gudang IFK
Reco Tetes Telinga
21
(Chloramphenicol) 101 Btl Rp 11,000.00 Rp 1,111,000 gudang IFK
22 Skincol Gel 2 Tube Rp 148,500.00 Rp 297,000 gudang IFK

DAK 2021
Amoxicillin Trihydrate / Pehamoxiil

1
Forte 500 mg (hexapram Jaya ) 5214 Tab Rp 231.00 Rp 1,204,434 gudang IFK
2 Amoksisilin sirup kering 125mg/5ml 394 Btl Rp 2,050.00 Rp 807,700 gudang IFK
3 Amox icillin Drop 140 Btl Rp 11,750.00 Rp 1,645,000 gudang IFK

4 Allupurinol 100 mg 3060 Tab Rp 89.00 Rp 272,340 gudang IFK
6 Asam Mefenamat 5090 tab Rp 117.00 Rp 595,530 gudang IFK
7 Amlodipine 5 mg 0 Tab Rp 55.00 Rp - gudang IFK
Ampisillin serbuk injeksi i.v 1000
9
mg/ Vial 88 Vial Rp 9,900.00 Rp 871,200 gudang IFK
10 Antihemeroid kombinasi 46 Suppo Rp 3,260.00 Rp 149,960 gudang IFK

Antifungi DOEN kombinasi: Asam
11
Benzoat 3% + Asam Salisilat 6% 44 Botol Rp 3,637.00 Rp 160,028 gudang IFK
12 Antasida Doen I Tablet Kunyah 0 Tab Rp 54.00 Rp - gudang IFK

13 Antasida Doen suspensi 499 Botol Rp 1,756.00 Rp 876,244 gudang IFK
14 Asam askorbat / Vit C 50 mg 2930 Tab Rp 46.00 Rp 134,780 gudang IFK
15 Asam Traneksamat injeksi 54 amp Rp 1,820.00 Rp 98,280 gudang IFK
16 Asam folat tab 1 mg 4830 pcs Rp 61.00 Rp 294,630 gudang IFK
17 Asetosal 80 mg 280 Tab Rp 89.00 Rp 24,920 gudang IFK
18 Betahistine 6 mg 0 Tab Rp 92.00 Rp - gudang IFK
19 Betamethason cream 0 Tab Rp 1,540.00 Rp - gudang IFK
20 Bisakodil Suppo 25 Suppo Rp 5,085.00 Rp 127,125 gudang IFK
21 Captopril 12,5 mg 0 tab Rp 68.00 Rp - gudang IFK
22 Cetrizine syr 561 Botol Rp 2,215.00 Rp 1,242,615 gudang IFK
23 Cefotaxim Injeksi 0 Vial Rp 3,050.00 Rp - gudang IFK
24 Diazepam inj 5 mg / 2 ml 2 Ampul Rp 1,545.00 Rp 3,090 gudang IFK
25 Dexamethasone injeksi 186 Ampul Rp 968.00 Rp 180,048 gudang IFK
26 Doksisiklin 500 Tab Rp 289.00 Rp 144,500 gudang IFK
27 Domperidone syr 294 Botol Rp 2,401.00 Rp 705,894 gudang IFK
28 Eritromisin sirup 200 mg 94 Botol Rp 7,436.00 Rp 698,984 gudang IFK
29 Epinephrine 6 Ampul Rp 1,740.00 Rp 10,440 gudang IFK
30 Furosemid Injeksi i.v./i.m 10mg/ml 77 Ampul Rp 969.00 Rp 74,613 gudang IFK
31 Glukosa Infus D5% 79 btl Rp 7,363.00 Rp 581,677 gudang IFK
32 Glibenklamide 5 mg 0 Tab Rp 87.00 Rp - gudang IFK
33 Haloperidole 5 mg 110 Tab Rp 54.00 Rp 5,940 gudang IFK
34 Hyoscine N butylbromide 260 Tab Rp 1,050.00 Rp 273,000 gudang IFK
Karbogliserin tetes telinga 10%
35
(phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00 Rp - gudang IFK
36 Kalsium laktat (Kalk) 500 mg 0 Tab Rp 60.00 Rp - gudang IFK
37 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00 Rp 148,776 gudang IFK
38 Ketorolac inj 30Mg/MI 193 Ampul Rp 923.00 Rp 178,139 gudang IFK
39 Karbamazepin 200mg 10 tab Rp 216.00 Rp 2,160 gudang IFK
Isosorbid Dinitrat tablet sublingual
40
5mg
65 Tab Rp 99.00 Rp 6,435 gudang IFK
41 Ibuprofen Syr 100mg/5ml 80 Btl Rp 2,339.00 Rp 187,120 gudang IFK

42 Ketokonazole Cream 78 Tube Rp 2,399.00 Rp 187,122 gudang IFK
43 Ketokonazole tablet 200mg 20 Tab Rp 260.00 Rp 5,200 gudang IFK
Kloramfenikol Suspensi 125 mg/
44
5ml
98 Btl Rp 5,352.00 Rp 524,496 gudang IFK
45 Kodein 10 mg 100 Tab Rp 605.00 Rp 60,500 gudang IFK

46 Lansoprazole 30 mg 2000 kap Rp 278.00 Rp 556,000 gudang IFK
Lidokain comp (Lidokain injeksi 2%
47
(HCI) + epinefrin) 0 Ampul Rp 847.00 Rp - gudang IFK
48 Lidocain inj 2 % (HCL) 97 Ampul Rp 891.00 Rp 86,427 gudang IFK
49 Loratadine 4490 kap Rp 117.00 Rp 525,330 gudang IFK
50 Metformin HCL 500 mg 9540 tab Rp 77.00 Rp 734,580 gudang IFK
51 Metilprednisolon tablat 4 mg 0 tab Rp 102.00 Rp - gudang IFK
52 Metilprednisolon tablat 8 mg 130 tab Rp 237.00 Rp 30,810 gudang IFK
53 Metoklopramid 10 mg 90 tab Rp 66.00 Rp 5,940 gudang IFK
54 Metoklopramid inj 652 Ampul Rp 1,983.00 Rp 1,292,916 gudang IFK
55 Methamizole Na Inj 0 Ampul Rp 3,045.00 Rp - gudang IFK
56 Metronidazol sirup 100 Btl Rp 3,765.00 Rp 376,500 gudang IFK
57 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp - gudang IFK
58 MGSO4 20 % 50 Ampul Rp 4,120.00 Rp 206,000 gudang IFK
59 Mikonazole kream 148 Tube Rp 1,900.00 Rp 281,200 gudang IFK
60 Nistatin drop 15 Btl Rp 11,750.00 Rp 176,250 gudang IFK
61 Nistatin Ovula 100.000 IU 96 tab Rp 550.00 Rp 52,800 gudang IFK
62 Natrium Diklofenak 25 mg 0 tab Rp 109.00 Rp - gudang IFK
63 N-Asetilsistein 320 Tab Rp 317.00 Rp 101,440 gudang IFK
Natrium Chloride 0,9 % ( NACL 0,9
64
%) 156 btl Rp 6,900.00 Rp 1,076,400 gudang IFK
65 Oxytocin injeksi 0 Ampul Rp 1,248.00 Rp - gudang IFK

66 Omeprazole 20 mg 5370 Kap Rp 129.00 Rp 692,730 gudang IFK
67 Parasetamol syr 18 btl Rp 1,160.00 Rp 20,880 gudang IFK
68 Phytomenadion inj 2mg/ml 118 Ampul Rp 3,900.00 Rp 460,200 gudang IFK
69 Phytomenadion 10 mg 200 Tab Rp 781.00 Rp 156,200 gudang IFK
70 Permetrin cream 0 Tube Rp 11,466.00 Rp - gudang IFK
71 Ranitidin tablet 150 mg 1300 tab Rp 85.00 Rp 110,500 gudang IFK
72 Ranitidin injeksi 0 Ampul Rp 858.00 Rp - gudang IFK
73 Salbutamol 4 mg 0 Tab Rp 67.00 Rp - gudang IFK
74 Salep 2-4 10 Pot Rp 1,475.00 Rp 14,750 gudang IFK
75 Simvastatin 10 mg 3200 tab Rp 73.00 Rp 233,600 gudang IFK
77 Siprofloksasin 500 mg 350 Tab Rp 260.00 Rp 91,000 gudang IFK
78 Sianocbalamin (B12) 0 Tab Rp 44.00 Rp - gudang IFK
Sianocobalamin ( Vitamin B12)
79
Injeksi 500 mcg 215 Ampul Rp 1,066.00 Rp 229,190 gudang IFK
80 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00 Rp 1,034,264 gudang IFK
81 Tablet tambah darah 7040 tab Rp 255.00 Rp 1,795,200 gudang IFK
82 USG GEL 4 Btl Rp 18,858.33 Rp 75,433 gudang IFK
83 VAR 0 Vial Rp 153,000.00 Rp - gudang IFK
84 Vit. B.Complex 5280 Tab Rp 60.00 Rp 316,800 gudang IFK
85 Zink 20 mg tab 0 Tab Rp 253.00 Rp - gudang IFK
86 Zink syr 0 Btl Rp 2,489.00 Rp - gudang IFK
BMHP
Catgut chromic 3/0 +jarum Bulat
87
(*optime*)
72 Pcs Rp 68,090.00 Rp 4,902,480 gudang IFK
88 Disposable syringe 3 cc 1000 Pcs Rp 818.00 Rp 818,000 gudang IFK
89 Disposable syringe 10 cc 300 Pcs Rp 1,100.00 Rp 330,000 gudang IFK
90 Folly Catheter 18 20 pcs Rp 11,132.00 Rp 222,640 gudang IFK
91 Handscoond steril no 6 100 Pasang Rp 13,563.00 Rp 1,356,300 gudang IFK
92 Handscoond steril no 6,5 382 Pasang Rp 13,563.00 Rp 5,181,066 gudang IFK
94 Handscoond steril no 7,5 0 Pasang Rp 13,563.00 Rp - gudang IFK
95 Hand Sanitizer / Handrub 500 ml 0 Btl Rp 68,200.00 Rp - gudang IFK
96 Handscrub 0 Btl Rp 115,800.00 Rp - gudang IFK
97 Infus Set Dewasa 0 pcs Rp 7,128.00 Rp - gudang IFK
98 IV.Chateter No.18 G 0 pcs Rp 25,487.00 Rp - gudang IFK
99 Kasa 4 x 10 300 pcs Rp 2,176.72 Rp 653,017 gudang IFK
100 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp - gudang IFK
101 Scalpet Blades no.10 0 Pcs Rp 618.70 Rp - gudang IFK
102 Scalpet Blades no.11 99 Pcs Rp 618.68 Rp 61,250 gudang IFK
Surgical mask earloop 3ply /
104
Masker
11650 Box Rp 1,373.14 Rp 15,997,081 gudang IFK
105 Under Pad Steril 200 pcs Rp 37,875.00 Rp 7,575,000 gudang IFK
DAK 2020
1 Acyclovir 400 mg 1120 Tab Rp 454.00 Rp 508,480 gudang IFK

3 CTM 4 mg 0 tab Rp 26.00 Rp - gudang IFK
4 Cetrizine 10 mg 0 tab Rp 104.00 Rp - gudang IFK
5 Domperidone syr 0 Botol Rp 2,862.00 Rp - gudang IFK
6 Anti migren kombinasi 419 tab Rp 212.00 Rp 88,828 gudang IFK
( ERGOTAMIN )
7 Gentamicine tetes mata 0 Botol Rp 26.00 Rp - gudang IFK
8 Kodein 10 mg 79 Tab Rp 657.00 Rp 51,903 gudang IFK
9 Lansoprazole 30 mg 0 kap Rp 352.00 Rp - gudang IFK
11 Paracetamol Drop 0 Botol Rp 7,646.00 Rp - gudang IFK
BMHP
12
(*optime*) 0 Pcs Rp 55,000.00 Rp - gudang IFK
Catgut chromic 3/0 +jarum Segitiga
13
(*optime*) 0 Pcs Rp 62,000.00 Rp - gudang IFK
14
(*optime-R*) 42 Pcs Rp 44,000.00 Rp 1,848,000 gudang IFK
Catgut plain 3/0 + jarum Segitiga
15
(*Advantime*) 0 Pcs Rp 71,000.00 Rp - gudang IFK
16 Feeding Tube 14 0 pcs Rp 8,407.00 Rp - gudang IFK
18 Handscoond steril no 8 49 Pasang Rp 13,178.00 Rp 645,722 gudang IFK
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp - gudang IFK
22 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00 Rp - gudang IFK
23 Umbilical Cord Klem 0 Pcs Rp 1,495.00 Rp - gudang IFK
DAU 2020
1 Aqua pro injeksi 20 ml 0 ampul Rp 2,860.00 Rp - gudang IFK
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00 Rp - gudang IFK

3
%) 0 btl Rp 6,840.00 Rp - gudang IFK
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00 Rp 161,260 gudang IFK

5 Ringer Laktat (RL) 300 btl Rp 7,150.00 Rp 2,145,000 gudang IFK
P 2020
1 Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01 Rp - gudang IFK

2 Ambroxol Tablet 30 mg 0 Tab Rp 110.00 Rp - gudang IFK
3 Bisakodil Suppo 0 Suppo Rp 23,475.00 Rp - gudang IFK
4 Bisakodil ( LAXANA) 0 Tab Rp 367.00 Rp - gudang IFK
5 Guaiafenesin (GG) 100 mg 0 tab Rp 175.00 Rp - gudang IFK
Kombinasi Tetes Mata
(Deksametason, Neomisin Sulfat,
6
Polimiksin B Sulfat ) ALLETROL
0 Botol Rp 14,900.00 Rp - gudang IFK
COMPOSITUM
Obat batuk pilek anak kombinasi

7
GG ( Dextrofen) 39 Botol Rp 503,100 gudang IFK
Rp 12,900.00
Obat flu kombinasi

8 ( pseudoephedrin Hcl, Tripolidin 0 tab Rp 600.00 Rp - gudang IFK
Hcl ) FLUTROP
Salbutamol nebulizer / Ventolin

9
Nebulizer 0 Flash Rp 10,000.00 Rp - gudang IFK
10 Hemafort 600 Tab Rp 820.00 Rp 492,000 gudang IFK
DAK 2019
1 Acyclovir 400 mg 0 Tab Rp 425.00 Rp - gudang IFK

2 Alprazolam 0,5 mg 0 tab Rp 88.00 Rp - gudang IFK
3 Cefadroxil sirup kering 125mg/5ml 0 btl Rp 4,360.00 Rp - gudang IFK
Diazepam 5 mg / 2,5 ml
4
( STESOLID ) Rektal 0 Tube Rp 14,459.00 Rp - gudang IFK
5 Kotrimoxazole syr 0 btl Rp 2,052.00 Rp - gudang IFK
6 Metoklopramide 10 mg 0 tab Rp 83.00 Rp - gudang IFK
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00 Rp - gudang IFK
8 Pirantel 125 mg 53 tab Rp 331.00 Rp 17,543 gudang IFK
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00 Rp - gudang IFK
BMHP
10 Alat Suntik 5 ml 1297 pcs Rp 1,600 Rp 2,075,200 gudang IFK

14 urine bag 0 pcs Rp 1,848.00 Rp - gudang IFK
PENUNJANG 2019
1 Gentamicin salep kulit 11 tube Rp 2,640.00 Rp 29,040 gudang IFK

2 Loperamide 630 Tab Rp 198.00 Rp 124,740 gudang IFK
3 Multivitamin syr anak ( Becefort ) Botol Rp - gudang IFK

Rp 17,365.70
Anti diare kombinasi (Kaolin Pektin)

4
sirup (Guanistrep Sirup)
188 btl Rp 3,850.00 Rp 723,800 gudang IFK
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00 Rp - gudang IFK

2 Cotton roll medium 0 Pack Rp 85,800.00 Rp - gudang IFK
Botol 10
3 Eugenol 0 ml
Rp 97,500.00 Rp - gudang IFK
4 Pehacain 0 Ampul Rp 3,113.0495 Rp - gudang IFK
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00 Rp - gudang IFK

2 HCT 25 mg 0 tab Rp 178.00 Rp - gudang IFK
3 Nistatin 100.000 IU 0 tab Rp 645.00 Rp - gudang IFK
BMHP
4 Blood Lancet 400 Pcs Rp 167.509 Rp 67,004 gudang IFK

5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86 Rp - gudang IFK
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 0 pcs Rp 22,000.00 Rp - gudang IFK

DAU 2017
BMHP
Silk 3/0 + jarum 1/2 GT 35 mm
1
( Sole) 31 Pcs Rp 46,187.44 Rp 1,431,811 gudang IFK
DAK 2017
1 Diltiazem 30 mg 0 tab Rp 128.00 Rp - gudang IFK

BMHP
KAPAS PEMBALUT / ABSORBEN
1
250 GRAM 25 Bks Rp 14,375.00 Rp 359,375 gudang IFK
2 Kasa 4mx5cm 0 Roll Rp 862.50 Rp - gudang IFK
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 50 pcs Rp 6,222.00 Rp 311,100 gudang IFK

DAU 2009
KAPAS PEMBALUT / ABSORBEN roll/

1
250 GRAM
12 bungkus
Rp 11,914 Rp 142,968 gudang IFK
TOTAL 116,150.00 Rp 97,535,909.52
Mengetahui Binawara, 30 Juni 2022

NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011

Ket
Tanggal
Penerimaan
8 9
3/21/2022
3/21/2022
3/21/2022
LAPORAN PENER

Stock Awal
NO Banyaknya
Nama Obat Harga satuan
Jumlah Satuan
1 2 3 4 5
BMHP Program HIV
1 Safety box 25 IDR Rp 16,666.00
2 Plesterin Bulat non woven 3 Kotak Rp 40,187.50
3 Vacum Tube sterile, plastic, K3 EDTA 1600 Pcs Rp 1,160.00
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00
6 Vacutainer Needle 550 Pcs Rp 132.00
BMHP Program TB
1 Larutan Zhihi Neeisen 6 Paket Rp 274,362.00
2 Sputum Pot 0 Biji Rp 3,137.00
3 Object Glass Frosted 7105 4 box @ 72 pcs Rp 23,860.08
DAK 22
1 Amlodipine 10 mg 0 Tab
Rp 74.67
2 Asam Traneksamat 500 mg 0 Tab
Rp 1,927.00
3 Antasida syr 0 Btl Rp 1,756.00
4 Cetrizine 10 mg 0 tab
Rp 52.47
5 Glimepirid 2 mg 0 Tab
Rp 123.00
6 Ketokonazol 200mg 0 Tab
Rp 260.00
7 Lansoprazole 30 mg 0 Kap
Rp 278.00
8 Metformin HCL 500 mg 0 tab
Rp 77.00
9 Metilprednisolon tablat 4 mg 0 tab
Rp 102.00
10 Omeprazole inj 0 Ampl
Rp 5,346.00
11 Paracetamol Drop 0 Drop
Rp 5,204.00
12 Povidon iodida 10 % 30 ml 0 Btl Rp 4,182.00
15 Vitamin B1 0 tab
Rp 173.00
BMHP
16 Alkohol 70% 100 mL 0 Btl Rp 3,256.00

17 Alkohol 70% 1000 mL 0 Btl Rp 23,595.00
19 Infuset Dewasa ( Troge Hamburg ) 0 pcs
Rp 26,062.00
20 IV.Chateter No.18 G 0 pcs
Rp 26,418.00
Rp 26,418.00
Rp 26,418.00
Rp 26,418.00
Rp 27,639.00
25 Kasa 40x80 0 pcs Rp 91,045.00
26 Plaster Putih 5 x 5 ( Farmafix ) 0 pcs
Rp 32,190.00
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00
2 Cairan bonding 0 Pot Rp 391,500.00
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00
DAU 2021
Btl isi @ 30
1 Multivitamin Ibu Hamil OMEGA 3 0 Rp 45,000.00
kapsul
BMHP
3 Disposable syringe 1 cc 0 Pcs Rp 1,361.00
4 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53
5 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13
P 21
1 Acyclovir Cream 125 Tube Rp 4,400.00
2 Bedak Salisil 0 Wadah Rp 7,700.00
3 Bicombin inj 89 Ampul Rp 6,600.00
4 Cefadroxil 500 mg 2430 Kap Rp 880.00
5 Digoxin 0,5 mg 480 Tab Rp 198.00
6 Diazepam larutan rektal 5mg/2,5ml 10 Suppo Rp 30,800.00
7 Eflin 410 Tab Rp 1,413.50
8 Furosemid 0 Tab Rp 275.00
9 Guaiafenesin (GG) 100 mg 1900 tab Rp 147.99
10 Ibuprofen 200mg 0 Tab Rp 275.00

11 Kloramfenikol 250 mg 210 Kap Rp 770.00
12 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00
13 Meloxicam 7,5 mg 290 Tab Rp 385.00
14 Novastan syr 80 Btl Rp 11,000.00
15 Nifedipine 1630 Tab Rp 220.00
16 Oxytetracycline Salep Kulit 3% 53 Tube Rp 4,950.00
17 OBH Plus 0 Btl Rp 12,100.00
18 Paracetamol 500 mg 9550 tab Rp 275.00
19 Pehavral 3346 tab Rp 1,045.00

20 Reco Salep Mata ( Chloamphenicol) 118 Tube Rp 6,600.00
21 Reco Tetes Telinga (Chloramphenicol) 101 Btl Rp 11,000.00
22 Skincol Gel 2 Tube Rp 148,500.00
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 5214 Tab Rp 231.00
2 Amoksisilin sirup kering 125mg/5ml 394 Btl Rp 2,050.00

3 Amox icillin Drop 140 Btl Rp 11,750.00
4 Allupurinol 100 mg 3060 Tab Rp 89.00
6 Asam Mefenamat 5090 tab Rp 117.00
7 Amlodipine 5 mg 0 Tab Rp 55.00
9 Ampisillin serbuk injeksi i.v 1000 mg/ Vial 88 Vial Rp 9,900.00
10 Antihemeroid kombinasi 46 Suppo Rp 3,260.00
11 44 Botol Rp 3,637.00
6%
12 Antasida Doen I Tablet Kunyah 0 Tab Rp 54.00
13 Antasida Doen suspensi 499 Botol Rp 1,756.00
14 Asam askorbat / Vit C 50 mg 2930 Tab Rp 46.00
15 Asam Traneksamat injeksi 54 amp Rp 1,820.00
16 Asam folat tab 1 mg 4830 pcs Rp 61.00
17 Asetosal 80 mg 280 Tab Rp 89.00
18 Betahistine 6 mg 0 Tab Rp 92.00
19 Betamethason cream 0 Tab Rp 1,540.00
20 Bisakodil Suppo 25 Suppo Rp 5,085.00
21 Captopril 12,5 mg 0 tab Rp 68.00
22 Cetrizine syr 561 Botol Rp 2,215.00
23 Cefotaxim Injeksi 0 Vial Rp 3,050.00
24 Diazepam inj 5 mg / 2 ml 2 Ampul Rp 1,545.00
25 Dexamethasone injeksi 186 Ampul Rp 968.00
25 Dextrosa 10 % 0 Botol Rp 7,200.00
26 Doksisiklin 500 Tab Rp 289.00

27 Domperidone syr 294 Botol Rp 2,401.00
28 Eritromisin sirup 200 mg 94 Botol Rp 7,436.00
29 Epinephrine 6 Ampul Rp 1,740.00
30 Furosemid Injeksi i.v./i.m 10mg/ml 77 Ampul Rp 969.00
31 Glukosa Infus D5% 79 btl Rp 7,363.00
32 Glibenklamide 5 mg 0 Tab Rp 87.00
33 Haloperidole 5 mg 110 Tab Rp 54.00
34 Hyoscine N butylbromide 260 Tab Rp 1,050.00
35 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00
36 Kalsium laktat (Kalk) 500 mg 0 Tab Rp 60.00

37 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00
38 Ketorolac inj 30Mg/MI 193 Ampul Rp 923.00
39 Karbamazepin 200mg 10 tab Rp 216.00
39 KAEN 3B 0 tab Rp 11,500.00
40 Isosorbid Dinitrat tablet sublingual 5mg 65 Tab Rp 99.00
41 Ibuprofen Syr 100mg/5ml 80 Btl Rp 2,339.00

42 Ketokonazole Cream 78 Tube Rp 2,399.00
43 Ketokonazole tablet 200mg 20 Tab Rp 260.00
44 Kloramfenikol Suspensi 125 mg/ 5ml 98 Btl Rp 5,352.00
45 Kodein 10 mg 100 Tab Rp 605.00
46 Lansoprazole 30 mg 2000 kap Rp 278.00
47 Lidokain comp (Lidokain injeksi 2% (HCI) + epinefrin) 0 Ampul Rp 847.00
48 Lidocain inj 2 % (HCL) 97 Ampul Rp 891.00

49 Loratadine 4490 kap Rp 117.00
50 Metformin HCL 500 mg 9540 tab Rp 77.00

51 Metilprednisolon tablat 4 mg 0 tab Rp 102.00
53 Metoklopramid 10 mg 90 tab Rp 66.00
54 Metoklopramid inj 652 Ampul Rp 1,983.00
55 Methamizole Na Inj 0 Ampul Rp 3,045.00

56 Metronidazol sirup 100 Btl Rp 3,765.00
57 MGSO4 40 % 0 Ampul Rp 4,700.00
58 MGSO4 20 % 50 Ampul Rp 4,120.00
59 Mikonazole kream 148 Tube Rp 1,900.00
60 Nistatin drop 15 Btl Rp 11,750.00

61 Nistatin Ovula 100.000 IU 96 tab Rp 550.00
62 Natrium Diklofenak 25 mg 0 tab Rp 109.00
63 N-Asetilsistein 320 Tab Rp 317.00
64 Natrium Chloride 0,9 % ( NACL 0,9 %) 156 btl Rp 6,900.00
65 Oxytocin injeksi 0 Ampul Rp 1,248.00
66 Omeprazole 20 mg 5370 Kap Rp 129.00
67 Parasetamol syr 18 btl Rp 1,160.00

68 Phytomenadion inj 2mg/ml 118 Ampul Rp 3,900.00
69 Phytomenadion 10 mg 200 Tab Rp 781.00
70 Permetrin cream 0 Tube Rp 11,466.00
71 Ranitidin tablet 150 mg 1300 tab Rp 85.00
72 Ranitidin injeksi 0 Ampul Rp 858.00
73 Salbutamol 4 mg 0 Tab Rp 67.00
74 Salep 2-4 10 Pot Rp 1,475.00
75 Simvastatin 10 mg 3200 tab Rp 73.00
77 Siprofloksasin 500 mg 350 Tab Rp 260.00
78 Sianocbalamin (B12) 0 Tab Rp 44.00
79 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 215 Ampul Rp 1,066.00
80 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00
81 Tablet tambah darah 7040 tab Rp 255.00
82 USG GEL 4 Btl Rp 18,858.33
83 VAR 0 Vial Rp 153,000.00
84 Vit. B.Complex 5280 Tab Rp 60
85 Zink 20 mg tab 0 Tab Rp 253.00
86 Zink syr 0 Btl Rp 2,489.00
BMHP
87 Catgut chromic 3/0 +jarum Bulat (*optime*) 72 Pcs Rp 68,090.00
88 Disposable syringe 3 cc 1000 Pcs Rp 818.00
90 Folly Catheter 18 20 pcs Rp 11,132.00
91 Handscoond steril no 6 100 Pasang Rp 13,563.00
92 Handscoond steril no 6,5 382 Pasang Rp 13,563.00
95 Hand Sanitizer / Handrub 500 ml 0 Btl Rp 68,200.00
96 Handscrub 0 Btl Rp 115,800.00
97 Infus Set Dewasa 0 pcs Rp 7,128.00
98 IV.Chateter No.18 G 0 pcs Rp 25,487.00
99 Kasa 4 x 10 300 pcs Rp 2,176.72
100 Kasa 4 x 5 0 pcs Rp 1,089.67
101 Scalpet Blades no.10 0 Pcs Rp 618.70

104 Surgical mask earloop 3ply / Masker 11650 Box Rp 1,373.14
105 Under Pad Steril 200 pcs Rp 37,875.00
DAK 2020
1 Acyclovir 400 mg 1120 Tab Rp 454.00
3 CTM 4 mg 0 tab Rp 26.00
4 Cetrizine 10 mg 0 tab Rp 104.00
6 Anti migren kombinasi ( ERGOTAMIN ) 419 tab Rp 212.00
7 Gentamicine tetes mata 0 Botol Rp 26.00
8 Kodein 10 mg 79 Tab Rp 657.00
11 Paracetamol Drop 0 Botol Rp 7,646.00
BMHP
13 Catgut chromic 3/0 +jarum Segitiga (*optime*) 0 Pcs Rp 62,000.00
14 Catgut chromic 2/0 +jarum Bulat (*optime-R*) 42 Pcs Rp 44,000.00
15 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00
16 Feeding Tube 14 0 pcs Rp 8,407.00
21 Kasa 16x16 0 pcs Rp 7,897.31
22 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00
23 Umbilical Cord Klem 0 Pcs Rp 1,495.00
DAU 2020
1 Aqua pro injeksi 20 ml 0 ampul Rp 2,860.00
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00
5 Ringer Laktat (RL) 300 btl Rp 7,150.00
P 2020
1 Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01
2 Ambroxol Tablet 30 mg 0 Tab Rp 110.00
4 Bisakodil ( LAXANA) 0 Tab Rp 367.00
6 0 Botol Rp 14,900.00
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 39 Botol
Rp 12,900.00
8 0 tab Rp 600.00
FLUTROP
9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00
10 Hemafort 600 Tab Rp 820.00
DAK 2019
2 Alprazolam 0,5 mg 0 tab Rp 88.00
3 Cefadroxil sirup kering 125mg/5ml 0 btl Rp 4,360.00
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 0 Tube Rp 14,459.00
5 Kotrimoxazole syr 0 btl Rp 2,052.00
6 Metoklopramide 10 mg 0 tab Rp 83.00
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00
8 Pirantel 125 mg 53 tab Rp 331.00
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00
BMHP
10 Alat Suntik 5 ml 1297 pcs Rp 1,600
14 urine bag 0 pcs Rp 1,848.00
PENUNJANG 2019
1 Gentamicin salep kulit 11 tube Rp 2,640.00
2 Loperamide 630 Tab Rp 198.00
3 Multivitamin syr anak ( Becefort ) Botol Rp 17,365.70
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 188 btl Rp 3,850.00
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00
2 Cotton roll medium 0 Pack Rp 85,800.00
3 Eugenol 0 Botol 10 ml Rp 97,500.00
4 Pehacain 0 Ampul Rp 3,113.0495
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00
2 HCT 25 mg 0 tab Rp 178.00
3 Nistatin 100.000 IU 0 tab Rp 645.00
BMHP
4 Blood Lancet 400 Pcs Rp 167.509
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 0 pcs Rp 22,000.00
DAU 2017
BMHP
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 31 Pcs Rp 46,187.44
DAK 2017
1 Diltiazem 30 mg 0 tab Rp 128.00
BMHP
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 25 Bks Rp 14,375.00
2 Kasa 4mx5cm 0 Roll Rp 862.50
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 50 pcs Rp 6,222.00
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 12 roll/bungkus Rp 11,914
TOTAL 116,150.00
Mengetahui
Rosyidah, A.Md.Keb
NIP. 19701001 199102 2 002
BULAN JULI 2022
PENERIMAAN PENGELUARAN
IFK Realisasi
Jumlah
Total Harga Berita acara
Jumlah TOTAL Harga
no tgl
6 7 8 9 10 11
Rp 416,650.00 Rp - 0
Rp 120,562.50 Rp - 0
Rp 1,856,000.00 Rp - 300
Rp - Rp - 0
Rp - Rp - 0
Rp 72,600.00 Rp - 0
Rp 1,646,172.00 Rp - 2
Rp - Rp - 0
Rp 95,440.32 Rp - 4
B/
442/120
7/
Rp - 7/15/2022 3000 Rp 224,010 410
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 500 Rp 963,500 110
UPTD-
IFK/
VII/2022
B/
442/124
7/
Rp - 7/25/2022 300 Rp 526,800 0
UPTD-
IFK/
VII/2022
B/
442/120
7/
Rp - 7/15/2022 3000 Rp 157,410 200
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 1000 Rp 123,000 20
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 200 Rp 52,000 20
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 2000 Rp 556,000 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 3000 Rp 231,000 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 2000 Rp 204,000 380
UPTD-
IFK/
VII/2022
B/
442/124
7/
Rp - 7/25/2022 200 Rp 1,069,200 0
UPTD-
IFK/
VII/2022
B/
442/124
7/
Rp - 7/25/2022 192 Rp 999,168 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 20 Rp 83,640 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 20 Rp 133,660 3
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 10 Rp 231,320 2
UPTD-
IFK/
VII/2022
B/
442/124
7/
Rp - 7/25/2022 3000 Rp 519,000 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 20 Rp 65,120 4
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 10 Rp 235,950 3
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 300 Rp 7,818,600 60
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 100 Rp 2,641,800 50
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 100 Rp 2,641,800 50
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 100 Rp 2,641,800 50
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 100 Rp 2,641,800 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 100 Rp 2,763,900 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 10 Rp 910,450 10
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp - 7/20/2022 10 Rp 321,900 6
UPTD-
IFK/
VII/2022
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 550,000 Rp - 5
Rp - Rp - 0
Rp 587,400 Rp - 53
Rp 2,138,400 Rp - 450
Rp 95,040 Rp - 0
Rp 308,000 Rp - 0
Rp 579,535 Rp - 130
Rp - Rp - 0
B/
442/116
6/
Rp 281,181 7/20/2022 500 Rp 73,995 920
UPTD-
IFK/
VII/2022
Rp - Rp - 0
Rp 161,700 Rp - 0
Rp - Rp - 0
Rp 111,650 Rp - 290
Rp 880,000 Rp - 2
Rp 358,600 Rp - 140
B/
442/116
6/
Rp 262,350 7/20/2022 100 Rp 495,000 15
UPTD-
IFK/
VII/2022
Rp - Rp - 0
B/
442/116
6/
Rp 2,626,250 7/20/2022 3000 Rp 825,000 7150
UPTD-
IFK/
VII/2022
Rp 3,496,570 Rp - 376
Rp 778,800 Rp - 22
Rp 1,111,000 Rp - 2
Rp 297,000 Rp - 0
Rp 1,204,434 Rp - 2640
Rp 807,700 Rp - 40
Rp 1,645,000 Rp - 0
Rp 272,340 Rp - 1740
Rp 484,000 Rp - 600
Rp 595,530 Rp - 1780
Rp - Rp - 0
Rp - Rp - 0
Rp 871,200 Rp - 0
Rp 149,960 Rp - 16
Rp 160,028 Rp - 0
Rp - Rp - 0
Rp 876,244 Rp - 179
Rp 134,780 Rp - 920
Rp 98,280 Rp - 22
Rp 294,630 Rp - 880
Rp 24,920 Rp - 50
Rp - Rp - 0
Rp - Rp - 0
Rp 127,125 Rp - 0
Rp - Rp - 0
Rp 1,242,615 Rp - 247
Rp - Rp - 0
Rp 3,090 Rp - 0
Rp 180,048 Rp - 21
B/
442/123
5/
Rp - 7/21/2022 20 Rp 144,000 0
UPTD-
IFK/
VII/2022
Rp 144,500 Rp - 0
Rp 705,894 Rp - 56
Rp 698,984 Rp - 4
Rp 10,440 Rp - 0
Rp 74,613 Rp - 4
Rp 581,677 Rp - 0
Rp - Rp - 0
Rp 5,940 Rp - 20
Rp 273,000 Rp - 80
Rp - Rp - 0
Rp - Rp - 0
Rp 148,776 Rp - 0
Rp 178,139 Rp - 67
Rp 2,160 Rp - 0
B/
442/123
5/
Rp - 7/21/2022 20 Rp 230,000 0
UPTD-
IFK/
VII/2022
B/
442/116
6/
Rp 6,435 7/20/2022 100 Rp 9,900 55
UPTD-
IFK/
VII/2022
Rp 187,120 Rp - 5
Rp 187,122 Rp - 32
Rp 5,200 Rp - 20
Rp 524,496 Rp - 10
Rp 60,500 Rp - 0
Rp 556,000 Rp - 1600
B/
442/116
6/
Rp - 7/20/2022 150 Rp 127,050 60
UPTD-
IFK/
VII/2022
Rp 86,427 Rp - 5
B/
442/116
6/
Rp 525,330 7/20/2022 1000 Rp 117,000 690
UPTD-
IFK/
VII/2022
Rp 734,580 Rp - 5270
Rp - Rp - 0
Rp 30,810 Rp - 130
Rp 5,940 Rp - 20
B/
442/116
6/
Rp 1,292,916 7/20/2022 300 Rp 594,900 153
UPTD-
IFK/
VII/2022
Rp - Rp - 0
Rp 376,500 Rp - 4
Rp - Rp - 0
Rp 206,000 Rp - 0
B/
442/116
6/
Rp 281,200 7/20/2022 192 Rp 364,800 39
UPTD-
IFK/
VII/2022
Rp 176,250 Rp - 2
Rp 52,800 Rp - 0
Rp - Rp - 0
Rp 101,440 Rp - 120
B/
442/116
6/
UPTD-
IFK/
VII/2022
20/07/2022 ,
Rp 1,076,400 , 100 Rp 690,000 25
21/07/2022
B/442/1
235-
SPB/UP
TD-
IFK/VII-
2022
Rp - Rp - 0
B/
442/116
6/
Rp 692,730 7/20/2022 2000 Rp 258,000 610
UPTD-
IFK/
VII/2022
Rp 20,880 Rp - 18
Rp 460,200 Rp - 0
Rp 156,200 Rp - 30
Rp - Rp - 0
Rp 110,500 Rp - 300
Rp - Rp - 0
Rp - Rp - 0
Rp 14,750 Rp - 0
Rp 233,600 Rp - 1300
Rp 291,270 Rp - 710
Rp 91,000 Rp - 260
Rp - Rp - 0
Rp 229,190 Rp - 2
Rp 1,034,264 Rp - 0
Rp 1,795,200 Rp - 2650
Rp 75,433 Rp - 1
Rp - Rp - 0
Rp 316,800 Rp - 2490
Rp - Rp - 0
Rp - Rp - 0
0
Rp 4,902,480 Rp - 0
Rp 818,000 Rp - 160
Rp 330,000 Rp - 5
Rp 222,640 Rp - 0
Rp 1,356,300 Rp - 0
Rp 5,181,066 Rp - 101
Rp 5,126,814 Rp - 128
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 653,017 Rp - 60
Rp - Rp - 0
B/
442/116
6/
Rp - 7/20/2022 100 Rp 61,870 0
UPTD-
IFK/
VII/2022
Rp 61,250 Rp - 1
Rp 49,497 Rp - 1
Rp 15,997,081 Rp - 6600
B/
442/116
6/
Rp 7,575,000 7/20/2022 200 Rp 7,575,000 200
UPTD-
IFK/
VII/2022
Rp 508,480 Rp - 115
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 88,828 Rp - 40
Rp - Rp - 0
Rp 51,903 Rp - 60
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 1,848,000 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 645,722 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 161,260 Rp - 0
B/
442/116
6/
Rp 2,145,000 7/20/2022 60 Rp 429,000 142
UPTD-
IFK/
VII/2022
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
B/
442/116
6/
Rp 503,100 7/20/2022 100 Rp 1,290,000 67
UPTD-
IFK/
VII/2022
Rp - Rp - 0
Rp - Rp - 0
Rp 492,000 Rp - 600
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 17,543 Rp - 0
Rp - Rp - 0
Rp 2,075,200 Rp - 15
Rp 356,730 Rp - 0
Rp 356,730 Rp - 0
Rp - Rp - 0
B/
442/116
6/
Rp - 7/20/2022 100 Rp 184,800 25
UPTD-
IFK/
VII/2022
Rp 29,040 Rp - 11
Rp 124,740 Rp - 110
Rp - Rp - 0
Rp 723,800 Rp - 70
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 67,004 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 1,431,811 Rp - 0
Rp - Rp - 0
Rp 359,375 Rp - 0
Rp - Rp - 0
Rp 311,100 Rp - 0
Rp 142,968 Rp - 1
Rp 97,535,909.52 27,334.00 Rp 42,227,142.50 45,728.00
PENGELUARAN Stock Akhir
Realisasi
KET
Jumlah Total harga
Total harga
12 15 16 17
Rp - 25 Rp 416,650.00
Rp - 3 Rp 120,562.50
Rp 348,000.00 1300 Rp 1,508,000.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 550 Rp 72,600.00
Rp 548,724.00 4 Rp 1,097,448.00
Rp - 0 Rp -
Rp 95,440.32 0 Rp -
Rp 30,615 2590 Rp 193,395
Rp 211,970 390 Rp 751,530
Rp - 300 Rp 526,800
Rp 10,494 2800 Rp 146,916
Rp 2,460 980 Rp 120,540
Rp 5,200 180 Rp 46,800

Rp - 2000 Rp 556,000
Rp - 3000 Rp 231,000
Rp 38,760 1620 Rp 165,240
Rp - 200 Rp 1,069,200
Rp - 192 Rp 999,168
Rp - 20 Rp 83,640
Rp 20,049 17 Rp 113,611
Rp 46,264 8 Rp 185,056
Rp - 3000 Rp 519,000
Rp 13,024 16 Rp 52,096.00
Rp 70,785 7 Rp 165,165.00
Rp 1,563,720 240 Rp 6,254,880.00
Rp 1,320,900 50 Rp 1,320,900.00
Rp 1,320,900 50 Rp 1,320,900.00
Rp 1,320,900 50 Rp 1,320,900.00
Rp - 100 Rp 2,641,800.00
Rp - 100 Rp 2,763,900.00
Rp 910,450 0 Rp -
Rp 193,140 4 Rp 128,760.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 22,000 120 Rp 528,000

Rp - 0 Rp -
Rp 349,800 36 Rp 237,600
Rp 396,000 1980 Rp 1,742,400
Rp - 480 Rp 95,040
Rp - 10 Rp 308,000
Rp 183,755 280 Rp 395,780
Rp - 0 Rp -
Rp 136,151 1480 Rp 219,025
Rp - 0 Rp -
Rp - 210 Rp 161,700
Rp - 0 Rp -
Rp 111,650 0 Rp -
Rp 22,000 78 Rp 858,000
Rp 30,800 1490 Rp 327,800
Rp 74,250 138 Rp 683,100
Rp - 0 Rp -
Rp 1,966,250 5400 Rp 1,485,000
Rp 392,920 2970 Rp 3,103,650

Rp 145,200 96 Rp 633,600
Rp 22,000 99 Rp 1,089,000
Rp - 2 Rp 297,000
Rp 609,840 2574 Rp 594,594
Rp 82,000 354 Rp 725,700

Rp - 140 Rp 1,645,000
Rp 154,860 1320 Rp 117,480
Rp 120,000 1820 Rp 364,000
Rp 208,260 3310 Rp 387,270
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 88 Rp 871,200
Rp 52,160 30 Rp 97,800
Rp - 44 Rp 160,028
Rp - 0 Rp -
Rp 314,324 320 Rp 561,920
Rp 42,320 2010 Rp 92,460
Rp 40,040 32 Rp 58,240
Rp 53,680 3950 Rp 240,950
Rp 4,450 230 Rp 20,470
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 25 Rp 127,125
Rp - 0 Rp -
Rp 547,105 314 Rp 695,510
Rp - 0 Rp -
Rp - 2 Rp 3,090
Rp 20,328 165 Rp 159,720
Rp - 20 Rp 144,000
Rp - 500 Rp 144,500
Rp 134,456 238 Rp 571,438
Rp 29,744 90 Rp 669,240
Rp - 6 Rp 10,440
Rp 3,876 73 Rp 70,737
Rp - 79 Rp 581,677
Rp - 0 Rp -
Rp 1,080 90 Rp 4,860
Rp 84,000 180 Rp 189,000
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 24 Rp 148,776
Rp 61,841 126 Rp 116,298
Rp - 10 Rp 2,160
Rp - 20 Rp 230,000
Rp 5,445 110 Rp 10,890
Rp 11,695 75 Rp 175,425
Rp 76,768 46 Rp 110,354
Rp 5,200 0 Rp -
Rp 53,520 88 Rp 470,976
Rp - 100 Rp 60,500
Rp 444,800 400 Rp 111,200
Rp 50,820 90 Rp 76,230
Rp 4,455 92 Rp 81,972
Rp 80,730 4800 Rp 561,600
Rp 405,790 4270 Rp 328,790

Rp - 0 Rp -
Rp 30,810 0 Rp -
Rp 1,320 70 Rp 4,620.00
Rp 303,399 799 Rp 1,584,417
Rp - 0 Rp -
Rp 15,060 96 Rp 361,440
Rp - 0 Rp -
Rp - 50 Rp 206,000
Rp 74,100 301 Rp 571,900
Rp 23,500 13 Rp 152,750
Rp - 96 Rp 52,800.00
Rp - 0 Rp -
Rp 38,040 200 Rp 63,400
Rp 172,500 231 Rp 1,593,900
Rp - Rp -
Rp 78,690.00 6760 Rp 872,040
Rp 20,880 Rp -
Rp - 118 Rp 460,200
Rp 23,430 170 Rp 132,770
Rp - Rp -
Rp 25,500 1000 Rp 85,000
Rp - Rp -
Rp - Rp -
Rp - 10 Rp 14,750
Rp 94,900 1900 Rp 138,700
Rp 51,830 3280 Rp 239,440
Rp 67,600 90 Rp 23,400
Rp - 0 Rp -
Rp 2,132 213 Rp 227,058
Rp - 2 Rp 1,034,264
Rp 675,750 4390 Rp 1,119,450
Rp 18,858 3 Rp 56,575
Rp - 0 Rp -
Rp 149,400 2790 Rp 167,400
Rp - 0 Rp -
Rp - 0 Rp -
0
Rp - 72 Rp 4,902,480
Rp 130,880 840 Rp 687,120.00
Rp 5,500 295 Rp 324,500.00
Rp - 20 Rp 222,640.00
Rp - 100 Rp 1,356,300.00
Rp 1,369,863 281 Rp 3,811,203.00
Rp 1,736,064 250 Rp 3,390,750.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 130,603 240 Rp 522,414
Rp - 0 Rp -
Rp - 100 Rp 61,869.50
Rp 619 98 Rp 60,631.03
Rp 619 79 Rp 48,878.32
Rp 9,062,724 5050 Rp 6,934,357.00
Rp 7,575,000 200 Rp 7,575,000.00
Rp 52,210 1005 Rp 456,270

Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 8,480 379 Rp 80,348
Rp - 0 Rp -
Rp 39,420 19 Rp 12,483
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 42 Rp 1,848,000
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 49 Rp 645,722
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 220 Rp 161,260
Rp 1,015,300 218 Rp 1,558,700
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 864,300 72 Rp 928,800
Rp - 0 Rp -
Rp - 0 Rp -
Rp 492,000 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 53 Rp 17,543
Rp - 0 Rp -
Rp 24,000 1282 Rp 2,051,200

Rp - 30 Rp 356,730
Rp - 30 Rp 356,730
Rp - Rp -
Rp 46,200 75 Rp 138,600
Rp 29,040 0 Rp -
Rp 21,780 520 Rp 102,960
Rp - 0 Rp -
Rp 269,500 118 Rp 454,300
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - Rp -
Rp - 400 Rp 67,004
Rp - 0 Rp -
Rp - 0 Rp - Mar-21
Rp - 31 Rp 1,431,811
Rp - 0
Rp - 25 Rp 359,375 retur ruang RGD

Rp - 0 Rp -
Rp - 50 Rp 311,100
Rp 11,914 11 Rp 131,054
Rp 40,381,873.00 97,756.00 Rp 99,381,179.02
Binawara, 30 Juli 2022

Pengelola Obat Puskesmas
Summi Ariyani, A.Md. Far

NIP. 19890825 201101 2 011
LAPORAN PENER

Stock Awal
NO Banyaknya
Nama Obat Harga satuan
Jumlah Satuan
1 2 3 4 5
BMHP Program HIV
2 Plesterin Bulat non woven 3 Kotak Rp 40,187.50
3 Vacum Tube sterile, plastic, K3 EDTA 1300 Pcs Rp 1,160.00
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00
6 Vacutainer Needle 550 Pcs Rp 132.00
BMHP Program TB
1 Larutan Zhihi Neeisen 4 Paket Rp 274,362.00
2 Sputum Pot 0 Biji Rp 3,137.00
3 Object Glass Frosted 7105 0 box @ 72 pcs Rp 23,860.08
DAK 22
Rp 74.67
Rp 55.00
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 0 Tab
Rp 231.00
2 Asam Traneksamat 500 mg 390 Tab Rp 1,927.00
3 Antasida syr 300 Btl Rp 1,756.00
3 Anti Hemoroid komb. Supp 0 Suppo
Rp 3,260.00
4 Cetrizine 10 mg 2800 tab
Rp 52.47
4 Ciprofloxacin 500 mg 0 tab
Rp 260.00
5 Glimepirid 2 mg 980 Tab
Rp 123.00
6 Ketokonazol 200mg 180 Tab Rp 260.00
7 Lansoprazole 30 mg 2000 Kap Rp 278.00
10 Omeprazole inj 200 Ampl Rp 5,346.00
11 Paracetamol Drop 192 Drop Rp 5,204.00
11 Scabimite cream 0 Tube
Rp 11,466.00
72 Rivanol 0 Btl Rp 7,221.00
72 Ringer Laktat (RL) 0 Btl
Rp 7,703.00
26 USG GEL 0 pcs Rp 16,632.00
15 Vitamin B1 3000 tab Rp 173.00

BMHP
16 Alkohol 70% 100 mL 16 Btl Rp 3,256.00
17 Alkohol 70% 1000 mL 7 Btl Rp 23,595.00
19 Handscoon non steril L 0 pcs
Rp 1,252.08
20 Handscoon non steril M 0 pcs
Rp 1,252.08
19 Infuset Dewasa ( Troge Hamburg ) 240 pcs Rp 26,062.00
Rp 26,418.00
Rp 26,418.00
Rp 27,639.00
25 Kasa 40x80 0 pcs Rp 91,045.00
26 Plaster Putih 5 x 5 ( Farmafix ) 4 pcs
Rp 32,190.00
26 Plester Putih 5x2 0 pcs Rp 21,638.40

17 Rivanol 0 Btl Rp 7,221.00
26 Umbilical Cord Klem 0 pcs Rp 2,070.00
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00
2 Cairan bonding 0 Pot Rp 391,500.00
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00
DAU 2021
Btl isi @ 30
1 Multivitamin Ibu Hamil OMEGA 3 0 Rp 45,000.00
kapsul
BMHP
4 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53
5 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13
P 21
1 Acyclovir Cream 120 Tube Rp 4,400.00
2 Bedak Salisil 0 Wadah Rp 7,700.00
3 Bicombin inj 36 Ampul Rp 6,600.00
4 Cefadroxil 500 mg 1980 Kap Rp 880.00
5 Digoxin 0,5 mg 480 Tab Rp 198.00
6 Diazepam larutan rektal 5mg/2,5ml 10 Suppo Rp 30,800.00
7 Eflin 280 Tab Rp 1,413.50
8 Furosemid 0 Tab Rp 275.00
10 Ibuprofen 200mg 0 Tab Rp 275.00

11 Kloramfenikol 250 mg 210 Kap Rp 770.00
12 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00
13 Meloxicam 7,5 mg 0 Tab Rp 385.00
14 Novastan syr 78 Btl Rp 11,000.00
15 Nifedipine 1490 Tab Rp 220.00
15 Neo Diaform 0 Tab Rp 286.00
16 Oxytetracycline Salep Kulit 3% 138 Tube Rp 4,950.00
17 OBH Plus 0 Btl Rp 12,100.00

18 Paracetamol 500 mg 5400 tab Rp 275.00
19 Pehavral 2970 tab Rp 1,045.00
20 Reco Salep Mata ( Chloamphenicol) 96 Tube Rp 6,600.00

21 Reco Tetes Telinga (Chloramphenicol) 99 Btl Rp 11,000.00
22 Skincol Gel 2 Tube Rp 148,500.00
22 Visoprin 0 Btl Rp 72,600.00
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 2574 Tab Rp 231.00
2 Amoksisilin sirup kering 125mg/5ml 354 Btl Rp 2,050.00

3 Amox icillin Drop 140 Btl Rp 11,750.00
6 Asam Mefenamat 3310 tab Rp 117.00

9 Ampisillin serbuk injeksi i.v 1000 mg/ Vial 88 Vial Rp 9,900.00
10 Antihemeroid kombinasi 30 Suppo Rp 3,260.00
11 44 Botol Rp 3,637.00
6%
12 Antasida Doen I Tablet Kunyah 0 Tab Rp 54.00
13 Antasida Doen suspensi 320 Botol Rp 1,756.00
14 Asam askorbat / Vit C 50 mg 2010 Tab Rp 46.00
15 Asam Traneksamat injeksi 32 amp Rp 1,820.00
16 Asam folat tab 1 mg 3950 pcs Rp 61.00
17 Asetosal 80 mg 230 Tab Rp 89.00
19 Betamethason cream 0 Tab Rp 1,540.00
21 Captopril 12,5 mg 0 tab Rp 68.00

22 Cetrizine syr 314 Botol Rp 2,215.00
23 Cefotaxim Injeksi 0 Vial Rp 3,050.00
24 Diazepam inj 5 mg / 2 ml 2 Ampul Rp 1,545.00
25 Dexamethasone injeksi 165 Ampul Rp 968.00
25 Dextrosa 10 % 20 Botol Rp 7,200.00

26 Doksisiklin 500 Tab Rp 289.00
28 Eritromisin sirup 200 mg 90 Botol Rp 7,436.00
29 Epinephrine 6 Ampul Rp 1,740.00
30 Furosemid Injeksi i.v./i.m 10mg/ml 73 Ampul Rp 969.00
31 Glukosa Infus D5% 79 btl Rp 7,363.00
32 Glibenklamide 5 mg 0 Tab Rp 87.00
33 Haloperidole 5 mg 90 Tab Rp 54.00
34 Hyoscine N butylbromide 180 Tab Rp 1,050.00
35 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00
36 Kalsium laktat (Kalk) 500 mg 0 Tab Rp 60.00

37 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00
38 Ketorolac inj 30Mg/MI 126 Ampul Rp 923.00
39 Karbamazepin 200mg 10 tab Rp 216.00
39 KAEN 3B 20 tab Rp 11,500.00
40 Isosorbid Dinitrat tablet sublingual 5mg 110 Tab Rp 99.00
41 Ibuprofen Syr 100mg/5ml 75 Btl Rp 2,339.00

42 Ketokonazole Cream 46 Tube Rp 2,399.00
43 Ketokonazole tablet 200mg 0 Tab Rp 260.00
44 Kloramfenikol Suspensi 125 mg/ 5ml 88 Btl Rp 5,352.00
45 Kodein 10 mg 100 Tab Rp 605.00
47 Lidokain comp (Lidokain injeksi 2% (HCI) + epinefrin) 90 Ampul Rp 847.00
48 Lidocain inj 2 % (HCL) 92 Ampul Rp 891.00

49 Loratadine 4800 kap Rp 117.00

53 Metoklopramid 10 mg 70 tab Rp 66.00
54 Metoklopramid inj 799 Ampul Rp 1,983.00
55 Methamizole Na Inj 0 Ampul Rp 3,045.00
56 Metronidazol sirup 96 Btl Rp 3,765.00
57 MGSO4 40 % 0 Ampul Rp 4,700.00
58 MGSO4 20 % 50 Ampul Rp 4,120.00
59 Mikonazole kream 301 Tube Rp 1,900.00
60 Nistatin drop 13 Btl Rp 11,750.00

61 Nistatin Ovula 100.000 IU 96 tab Rp 550.00
62 Natrium Diklofenak 25 mg 0 tab Rp 109.00
63 N-Asetilsistein 200 Tab Rp 317.00
65 Oxytocin injeksi Ampul Rp 1,248.00

66 Omeprazole 20 mg 6760 Kap Rp 129.00
67 Parasetamol syr btl Rp 1,160.00
68 Phytomenadion inj 2mg/ml 118 Ampul Rp 3,900.00
69 Phytomenadion 10 mg 170 Tab Rp 781.00
70 Permetrin cream Tube Rp 11,466.00
71 Ranitidin tablet 150 mg 1000 tab Rp 85.00
72 Ranitidin injeksi Ampul Rp 858.00
73 Salbutamol 4 mg Tab Rp 67.00
74 Salep 2-4 10 Pot Rp 1,475.00
77 Siprofloksasin 500 mg 90 Tab Rp 260.00

78 Sianocbalamin (B12) 0 Tab Rp 44.00
79 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 213 Ampul Rp 1,066.00
80 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00
81 Tablet tambah darah 4390 tab Rp 255.00
82 USG GEL 3 Btl Rp 18,858.33
83 VAR 0 Vial Rp 153,000.00
84 Vit. B.Complex 2790 Tab Rp 60
85 Zink 20 mg tab 0 Tab Rp 253.00
86 Zink syr 0 Btl Rp 2,489.00
BMHP 0
88 Disposable syringe 3 cc 840 Pcs Rp 818.00
95 Hand Sanitizer / Handrub 500 ml 0 Btl Rp 68,200.00
96 Handscrub 0 Btl Rp 115,800.00
99 Kasa 4 x 10 240 pcs Rp 2,176.72

100 Kasa 4 x 5 0 pcs Rp 1,089.67
104 Surgical mask earloop 3ply / Masker 5050 Box Rp 1,373.14
105 Under Pad Steril 200 pcs Rp 37,875.00
DAK 2020
3 CTM 4 mg 0 tab Rp 26.00
4 Cetrizine 10 mg 0 tab Rp 104.00
6 Anti migren kombinasi ( ERGOTAMIN ) 379 tab Rp 212.00
7 Gentamicine tetes mata 0 Botol Rp 26.00
8 Kodein 10 mg 19 Tab Rp 657.00
11 Paracetamol Drop 0 Botol Rp 7,646.00
BMHP
13 Catgut chromic 3/0 +jarum Segitiga (*optime*) 0 Pcs Rp 62,000.00
14 Catgut chromic 2/0 +jarum Bulat (*optime-R*) 42 Pcs Rp 44,000.00
15 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00
21 Kasa 16x16 0 pcs Rp 7,897.31
22 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00
23 Umbilical Cord Klem 0 Pcs Rp 1,495.00
DAU 2020
1 Aqua pro injeksi 20 ml 0 ampul Rp 2,860.00
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00
5 Ringer Laktat (RL) 218 btl Rp 7,150.00
P 2020
1 Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01
2 Ambroxol Tablet 30 mg 0 Tab Rp 110.00
4 Bisakodil ( LAXANA) 0 Tab Rp 367.00
6 0 Botol Rp 14,900.00
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 72 Botol

Rp 12,900.00
8 0 tab Rp 600.00
FLUTROP
9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00
10 Hemafort 0 Tab Rp 820.00
DAK 2019
2 Alprazolam 0,5 mg 0 tab Rp 88.00
3 Cefadroxil sirup kering 125mg/5ml 0 btl Rp 4,360.00
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 0 Tube Rp 14,459.00
5 Kotrimoxazole syr 0 btl Rp 2,052.00
6 Metoklopramide 10 mg 0 tab Rp 83.00
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00
8 Pirantel 125 mg 53 tab Rp 331.00
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00
BMHP
10 Alat Suntik 5 ml 1282 pcs Rp 1,600
13 Infus Set Dewasa pcs Rp 6,842.00
14 urine bag 75 pcs Rp 1,848.00
PENUNJANG 2019
1 Gentamicin salep kulit 0 tube Rp 2,640.00
2 Loperamide 520 Tab Rp 198.00
3 Multivitamin syr anak ( Becefort ) 0 Botol Rp 17,365.70
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 118 btl Rp 3,850.00
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00
2 Cotton roll medium 0 Pack Rp 85,800.00
3 Eugenol 0 Botol 10 ml Rp 97,500.00
4 Pehacain 0 Ampul Rp 3,113.0495
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00
2 HCT 25 mg 0 tab Rp 178.00
3 Nistatin 100.000 IU tab Rp 645.00
BMHP
4 Blood Lancet 400 Pcs Rp 167.509
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 0 pcs Rp 22,000.00
DAU 2017
BMHP
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 31 Pcs Rp 46,187.44
DAK 2017
1 Diltiazem 30 mg 0 tab Rp 128.00
BMHP
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 25 Bks Rp 14,375.00
2 Kasa 4mx5cm 0 Roll Rp 862.50
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 50 pcs Rp 6,222.00
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 11 roll/bungkus Rp 11,914
TOTAL 97,756.00
Mengetahui
Rosyidah, A.Md.Keb
NIP. 19701001 199102 2 002
BULAN AGUSTUS 2022
PENERIMAAN PENGELUARAN
IFK Realisasi
Jumlah
Total Harga Berita acara
Jumlah TOTAL Harga
no tgl
6 7 8 9 10 11
Rp 416,650.00 Rp - 0
Rp 120,562.50 Rp - 0
Rp 1,508,000.00 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 72,600.00 Rp - 0
Rp 1,097,448.00 Rp - 4
Rp - Rp - 0
Rp - Rp - 0
B/
442/136
1/
UPTD-
IFK/
VIII/ 02/08/2022 ,
Rp 193,395 5000 Rp 373,350 3900
2022 , 15/08/2022
B/442/1
368/UP
TD-
IFK/VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 2000 Rp 110,000 200
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 2000 Rp 462,000 0
IFK/
VIII/
2022
Rp 751,530 Rp - 10
Rp 526,800 Rp - 48
B/
442/136
8/
Rp - UPTD- 8/15/2022 20 Rp 65,200 0
IFK/
VIII/
2022
B/
442/136
1/
Rp 146,916 UPTD- 8/2/2022 2000 Rp 104,940 410
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 500 Rp 130,000 220
IFK/
VIII/
2022
B/
442/136
1/
UPTD-
IFK/
VIII/ 02/08/2022 ,
Rp 120,540 1000 Rp 123,000 770
2022 , 15/08/2022
B/442/1
368/UP
TD-
IFK/VIII/
2022
Rp 46,800 200 Rp 52,000 20

Rp 556,000 500 Rp 139,000 1030
Rp 231,000 3000 Rp 231,000 0
Rp 165,240 Rp - 720
Rp 1,069,200 Rp - 68
Rp 999,168 Rp - 112
B/
442/136
8/
Rp - UPTD- 8/15/2022 20 Rp 229,320 2
IFK/
VIII/
2022
Rp 83,640 Rp - 4
Rp 113,611 Rp - 0
Rp 185,056 Rp - 0
B/
442/136
8/
Rp - UPTD- 8/15/2022 10 Rp 72,210 5
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 100 Rp 770,300 100
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 5 Rp 83,160 0
IFK/
VIII/
2022
Rp 519,000 Rp - 800
B/
442/136
8/
Rp 52,096 UPTD- 8/15/2022 24 Rp 78,144 2
IFK/
VIII/
2022
B/
442/136
8/
Rp 165,165 UPTD- 8/15/2022 5 Rp 117,975 1
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 1000 Rp 1,252,080 0
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 1000 Rp 1,252,080 0
IFK/
VIII/
2022
Rp 6,254,880 Rp - 180
Rp 1,320,900 Rp - 0
B/
442/136
8/
Rp 1,320,900 UPTD- 8/15/2022 50 Rp 1,320,900 50
IFK/
VIII/
2022
Rp 1,320,900 Rp - 50
B/
442/136
8/
Rp 2,641,800 UPTD- 8/15/2022 50 Rp 1,320,900 0
IFK/
VIII/
2022
B/
442/136
8/
Rp 2,763,900 UPTD- 8/15/2022 50 Rp 1,381,950 50
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 10 Rp 910,450 0
IFK/
VIII/
2022
B/
442/136
8/
Rp 128,760 UPTD- 8/15/2022 10 Rp 321,900 10
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 10 Rp 216,384 0
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 10 Rp 72,210 5
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 200 Rp 414,000 50
IFK/
VIII/
2022
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 528,000 Rp - 28
Rp - Rp - 0
Rp 237,600 Rp - 36
Rp 1,742,400 Rp - 630
Rp 95,040 Rp - 0
Rp 308,000 Rp - 0
Rp 395,780 Rp - 200
Rp - Rp - 0
B/
442/136
8/
Rp 219,025 UPTD- 8/15/2022 1000 Rp 147,990 1940
IFK/
VIII/
2022
Rp - Rp - 0
Rp 161,700 Rp - 40
Rp - Rp - 0
Rp - Rp - 0
Rp 858,000 Rp - 1
Rp 327,800 Rp - 1380
B/
442/136
1/
Rp - UPTD- 8/2/2022 2000 Rp 572,000 0
IFK/
VIII/
2022
B/
442/136
1/
Rp 683,100 UPTD- 8/2/2022 50 Rp 247,500 64
IFK/
VIII/
2022
Rp - Rp - 0
B/
442/136
1/
Rp 1,485,000 UPTD- 8/2/2022 2000 Rp 550,000 5350
IFK/
VIII/
2022
B/
442/136
8/
Rp 3,103,650 UPTD- 8/15/2022 2000 Rp 2,090,000 370
IFK/
VIII/
2022
Rp 633,600 Rp - 45
Rp 1,089,000 Rp - 10
Rp 297,000 Rp - 0
B/
442/136
1/
Rp - UPTD- 8/2/2022 50 Rp 3,630,000 0
IFK/
VIII/
2022
Rp 594,594 Rp - 1864
Rp 725,700 Rp - 70
Rp 1,645,000 Rp - 5
B/
442/136
8/
Rp 117,480 UPTD- 8/15/2022 1000 Rp 89,000 1040
IFK/
VIII/
2022
B/
442/136
8/
Rp 364,000 UPTD- 8/15/2022 1000 Rp 200,000 420
IFK/
VIII/
2022
Rp 387,270 Rp - 1490
Rp - Rp - 0
Rp - Rp - 0
Rp 871,200 Rp - 9
Rp 97,800 Rp - 18
Rp 160,028 Rp - 2
Rp - Rp - 0
Rp 561,920 Rp - 320
Rp 92,460 Rp - 1410
Rp 58,240 Rp - 8
Rp 240,950 Rp - 870
Rp 20,470 Rp - 20
Rp - Rp - 0
Rp - Rp - 0
B/
442/136
8/
Rp 127,125 UPTD- 8/15/2022 24 Rp 122,040 0
IFK/
VIII/
2022
Rp - Rp - 0
Rp 695,510 Rp - 111
Rp - Rp - 0
Rp 3,090 Rp - 2
B/
442/136
8/
Rp 159,720 UPTD- 8/15/2022 100 Rp 96,800 159
IFK/
VIII/
2022
Rp 144,000 Rp - 0
Rp 144,500 Rp - 0
Rp 571,438 Rp - 67
Rp 669,240 Rp - 11
Rp 10,440 10 Rp 17,400 10
Rp 70,737 Rp - 3
Rp 581,677 Rp - 0
Rp - Rp - 0
Rp 4,860 Rp - 70
Rp 189,000 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 148,776 Rp - 0
Rp 116,298 Rp - 79
Rp 2,160 Rp - 10
Rp 230,000 Rp - 0
B/
442/136
8/
Rp 10,890 UPTD- 8/15/2022 100 Rp 9,900 60
IFK/
VIII/
2022
Rp 175,425 Rp - 7
Rp 110,354 Rp - 21
Rp - Rp - 0
Rp 470,976 Rp - 17
Rp 60,500 Rp - 71
Rp 111,200 Rp - 400
B/
442/136
8/
Rp 76,230 UPTD- 8/15/2022 90 Rp 76,230 0
IFK/
VIII/
2022
Rp 81,972 Rp - 0
Rp 561,600 Rp - 530
B/
442/136
8/
Rp 328,790 UPTD- 8/15/2022 3000 Rp 231,000 5540
IFK/
VIII/
2022
B/
442/136
8/
Rp - UPTD- 8/15/2022 500 Rp 51,000 500
IFK/
VIII/
2022
Rp - Rp - 0
Rp 4,620 Rp - 0
Rp 1,584,417 Rp - 42
Rp - Rp - 0
Rp 361,440 Rp - 23
Rp - Rp - 0
Rp 206,000 Rp - 0
B/
442/136
1/
Rp 571,900 UPTD- 8/2/2022 192 Rp 364,800 178
IFK/
VIII/
2022
Rp 152,750 Rp - 10
Rp 52,800 Rp - 0
Rp - Rp - 0
Rp 63,400 Rp - 190
B/
442/136
8/
Rp 1,593,900 UPTD- 8/15/2022 100 Rp 690,000 11
IFK/
VIII/
2022
Rp - Rp - 0
Rp 872,040 Rp - 250
Rp - Rp - 0
Rp 460,200 Rp - 30
Rp 132,770 Rp - 10
Rp - Rp - 0
Rp 85,000 Rp - 360
Rp - Rp - 0
Rp - Rp - 0
Rp 14,750 Rp - 2
Rp 138,700 Rp - 900
B/
442/136
8/
Rp 239,440 UPTD- 8/15/2022 2000 Rp 146,000 400
IFK/
VIII/
2022
Rp 23,400 Rp - 90
Rp - Rp - 0
Rp 227,058 Rp - 0
Rp 1,034,264 Rp - 0
Rp 1,119,450 Rp - 4350
Rp 56,575 Rp - 0
Rp - Rp - 0
Rp 167,400 Rp - 2150
Rp - Rp - 0
Rp - Rp - 0
0
Rp 4,902,480 Rp - 0
Rp 687,120 Rp - 440
Rp 324,500 Rp - 0
Rp 222,640 Rp - 10
Rp 1,356,300 Rp - 0
Rp 3,811,203 Rp - 0
Rp 3,390,750 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
B/
442/136
8/
Rp - UPTD- 8/15/2022 50 Rp 1,274,350 0
IFK/
VIII/
2022
Rp 522,414 Rp - 0
Rp - Rp - 0
Rp 61,870 Rp - 0
Rp 60,631 Rp - 0
Rp 48,878 Rp - 0
Rp 6,934,357 Rp - 1000
Rp 7,575,000 Rp - 0
Rp 456,270 Rp - 395
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 80,348 Rp - 20
Rp - Rp - 0
Rp 12,483 Rp - 19
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 1,848,000 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 645,722 Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 161,260 Rp - 0
Rp 1,558,700 Rp - 218
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 928,800 Rp - 72
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 17,543 Rp - 4
Rp - Rp - 0
Rp 2,051,200 Rp - 200
Rp 356,730 Rp - 0
Rp 356,730 Rp - 10
Rp - Rp - 0
Rp 138,600 Rp - 0
Rp - Rp - 0
Rp 102,960 Rp - 0
Rp - Rp - 0
Rp 454,300 Rp - 41
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp - Rp - 0
Rp 67,004 Rp - 400
Rp - Rp - 0
Rp - Rp - 0
Rp 1,431,811 Rp - 0
Rp - Rp - 0
Rp 359,375 Rp - 0
Rp - Rp - 0
Rp 311,100 Rp - 0
Rp 131,054 Rp - 0
Rp 99,381,179.02 34,040.00 Rp 22,210,463.00 45,954.00
Realisasi
KET
Jumlah Total harga
Total harga
12 15 16 17
Rp - 25 Rp 416,650.00
Rp - 3 Rp 120,562.50
Rp - 1300 Rp 1,508,000.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 550 Rp 72,600.00
Rp 1,097,448.00 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 291,213 3690 Rp 275,532
Rp 11,000 1800 Rp 99,000
Rp - 2000 Rp 462,000
Rp 19,270 380 Rp 732,260

Rp 84,288 252 Rp 442,512
Rp - 20 Rp 65,200
Rp 21,513 4390 Rp 230,343
Rp 57,200 280 Rp 72,800
Rp 94,710 1210 Rp 148,830
Rp 5,200 360 Rp 93,600

Rp 286,340 1470 Rp 408,660
Rp - 6000 Rp 462,000
Rp 73,440 900 Rp 91,800
Rp 363,528 132 Rp 705,672
Rp 582,848 80 Rp 416,320
Rp 22,932 18 Rp 206,388
Rp 16,728 16 Rp 66,912
Rp - 17 Rp 113,611
Rp - 8 Rp 185,056
Rp 36,105 5 Rp 36,105
Rp 770,300 0 Rp -
Rp - 5 Rp 83,160.00
Rp 138,400 2200 Rp 380,600

Rp 6,512 38 Rp 123,728.00
Rp 23,595 11 Rp 259,545.00
Rp - 1000 Rp 1,252,080.00
Rp - 1000 Rp 1,252,080.00
Rp 4,691,160 60 Rp 1,563,720.00
Rp - 50 Rp 1,320,900.00
Rp 1,320,900 50 Rp 1,320,900.00
Rp 1,320,900 0 Rp -
Rp - 150 Rp 3,962,700.00
Rp 1,381,950 100 Rp 2,763,900.00
Rp - 10 Rp 910,450
Rp 321,900 4 Rp 128,760.00
Rp - 10 Rp 216,384.00
Rp 36,105 5 Rp 36,105.00
Rp 103,500 150 Rp 310,500.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 123,200 92 Rp 404,800
Rp - 0 Rp -
Rp 237,600 0 Rp -
Rp 554,400 1350 Rp 1,188,000
Rp - 480 Rp 95,040
Rp - 10 Rp 308,000
Rp 282,700 80 Rp 113,080
Rp - 0 Rp -
Rp 287,101 540 Rp 79,915
Rp - 0 Rp -
Rp 30,800 170 Rp 130,900
Rp - 0 Rp -
Rp - 0 Rp -
Rp 11,000 77 Rp 847,000
Rp 303,600 110 Rp 24,200
Rp - 2000 Rp 572,000
Rp 316,800 124 Rp 613,800
Rp - 0 Rp -
Rp 1,471,250 2050 Rp 563,750
Rp 386,650 4600 Rp 4,807,000
Rp 297,000 51 Rp 336,600
Rp 110,000 89 Rp 979,000
Rp - 2 Rp 297,000
Rp - 50 Rp 3,630,000
Rp 430,584 710 Rp 164,010
Rp 143,500 284 Rp 582,200

Rp 58,750 135 Rp 1,586,250
Rp 92,560 1280 Rp 113,920
Rp 84,000 2400 Rp 480,000
Rp 174,330 1820 Rp 212,940

Rp - 0 Rp -
Rp - 0 Rp -
Rp 89,100 79 Rp 782,100
Rp 58,680 12 Rp 39,120
Rp 7,274 42 Rp 152,754
Rp - 0 Rp - cek penerimaan
Rp 561,920 0 Rp -
Rp 64,860 600 Rp 27,600
Rp 14,560 24 Rp 43,680
Rp 53,070 3080 Rp 187,880
Rp 1,780 210 Rp 18,690
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 49 Rp 249,165
Rp - 0 Rp -
Rp 245,865 203 Rp 449,645
Rp - 0 Rp -
Rp 3,090 0 Rp -
Rp 153,912 106 Rp 102,608
Rp - 20 Rp 144,000
Rp - 500 Rp 144,500
Rp 160,867 171 Rp 410,571
Rp 81,796 79 Rp 587,444
Rp 17,400 6 Rp 10,440
Rp 2,907 70 Rp 67,830
Rp - 79 Rp 581,677
Rp - 0 Rp -
Rp 3,780 20 Rp 1,080
Rp - 180 Rp 189,000
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 24 Rp 148,776
Rp 72,917 47 Rp 43,381
Rp 2,160 0 Rp -
Rp - 20 Rp 230,000
Rp 5,940 150 Rp 14,850
Rp 16,373 68 Rp 159,052
Rp 50,379 25 Rp 59,975
Rp - 0 Rp -
Rp 90,984 71 Rp 379,992
Rp 42,955 29 Rp 17,545
Rp 111,200 0 Rp -
Rp - 180 Rp 152,460
Rp - 92 Rp 81,972
Rp 62,010 4270 Rp 499,590
Rp 426,580 1730 Rp 133,210
Rp 51,000 0 Rp -
Rp - 0 Rp -
Rp - 70 Rp 4,620.00
Rp 83,286 757 Rp 1,501,131
Rp - 0 Rp -
Rp 86,595 73 Rp 274,845
Rp - 0 Rp -
Rp - 50 Rp 206,000
Rp 338,200 315 Rp 598,500
Rp 117,500 3 Rp 35,250
Rp - 96 Rp 52,800.00
Rp - Rp -
Rp 60,230 10 Rp 3,170
Rp 75,900 320 Rp 2,208,000
Rp - 0 Rp -
Rp 32,250.00 6510 Rp 839,790
Rp - 0 Rp -
Rp 117,000 88 Rp 343,200
Rp 7,810 160 Rp 124,960
Rp - 0 Rp -
Rp 30,600 640 Rp 54,400
Rp - 0 Rp -
Rp - 0 Rp -
Rp 2,950 8 Rp 11,800
Rp 65,700 1000 Rp 73,000
Rp 29,200 4880 Rp 356,240
Rp 23,400 0 Rp -
Rp - 0 Rp -
Rp - 213 Rp 227,058
Rp - 2 Rp 1,034,264
Rp 1,109,250 40 Rp 10,200
Rp - 3 Rp 56,575
Rp - 0 Rp -
Rp 129,000 640 Rp 38,400
Rp - 0 Rp -
Rp - 0 Rp -
0
Rp - 72 Rp 4,902,480
Rp 359,920 400 Rp 327,200.00
Rp - 295 Rp 324,500.00
Rp 111,320 10 Rp 111,320.00
Rp - 100 Rp 1,356,300.00
Rp - 281 Rp 3,811,203.00
Rp - 250 Rp 3,390,750.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 50 Rp 1,274,350.00
Rp - 240 Rp 522,414
Rp - 0 Rp -
Rp - 100 Rp 61,869.50
Rp - 98 Rp 60,631.03
Rp - 79 Rp 48,878.32
Rp 1,373,140 4050 Rp 5,561,217.00
Rp - 200 Rp 7,575,000.00
Rp 179,330 610 Rp 276,940

Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 4,240 359 Rp 76,108
Rp - 0 Rp -
Rp 12,483 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 42 Rp 1,848,000
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 49 Rp 645,722
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 220 Rp 161,260
Rp 1,558,700 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 928,800 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 1,324 49 Rp 16,219
Rp - 0 Rp -
Rp 320,000 1082 Rp 1,731,200

Rp - 30 Rp 356,730
Rp 118,910 20 Rp 237,820
Rp - 0 Rp -
Rp - 75 Rp 138,600
Rp - 0 Rp -
Rp - 520 Rp 102,960
Rp - 0 Rp -
Rp 157,850 77 Rp 296,450
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 67,004 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp - Mar-21
Rp - 31 Rp 1,431,811
Rp - 0
Rp - 25 Rp 359,375 retur ruang RGD

Rp - 0 Rp -
Rp - 50 Rp 311,100
Rp - 11 Rp 131,054
Rp 28,530,059.90 85,842.00 Rp 93,061,582.12
Binawara, 31 Agustus 2022


NIP. 19890825 201101 2 011
BULAN SEPTEMBER 2022
Stock Awal PENERIMAAN PENGELUARAN
IFK Realisasi
NO Banyaknya Jumlah
Nama Obat Harga satuan Total Harga Berita acara
Jumlah TOTAL Harga
1 2 3 4 5 6 7 8 9 10 11
BMHP Program HIV
1 Safety box 25 IDR Rp 16,666.00 Rp 416,650.00 Rp - 0
2 Plesterin Bulat non woven 3 Kotak Rp 40,187.50 Rp 120,562.50 Rp - 0
3 Vacum Tube sterile, plastic, K3 EDTA 1300 Pcs Rp 1,160.00 Rp 1,508,000.00 Rp - 0
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Rp - 0
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00 Rp - Rp - 0
6 Vacutainer Needle 550 Pcs Rp 132.00 Rp 72,600.00 Rp - 0
BMHP Program TB
1 Larutan Zhihi Neeisen 0 Paket Rp 274,362.00 Rp - Rp - 0
2 Sputum Pot 0 Biji Rp 3,137.00 Rp - Rp - 0
3 Object Glass Frosted 7105 0 box @ 72 pcs Rp 23,860.08 Rp - Rp - 0
DAK 22
B/442/1488/
1 Allupurinol 100 mg 0 Tab Rp - UPTD-IFK/IX/ 9/14/2022 1000 Rp 89,000 0
Rp 89.00 2022
B/442/1488/
2 Amlodipine 10 mg 3690 Tab Rp 275,532 UPTD-IFK/IX/ 9/14/2022 3000 Rp 224,010 1640
Rp 74.67 2022
B/442/1488/
3 Amlodipine 5 mg 1800 Tab Rp 99,000 UPTD-IFK/IX/ 9/14/2022 1000 Rp 55,000 2190
Rp 55.00 2022
4 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 2000 Tab Rp 462,000 Rp - 0
Rp 231.00
5 Asam Traneksamat 500 mg 380 Tab Rp 1,927.00 Rp 732,260 Rp - 90
B/442/1488/
6 Asam folat tab 1 mg 0 Tab Rp - UPTD-IFK/IX/ 9/14/2022 1000 Rp 61,000 0
Rp 61.00 2022
B/442/1488/
7 Antasida syr 252 Btl Rp 1,756.00 Rp 442,512 UPTD-IFK/IX/ 9/14/2022 300 Rp 526,800 276
2022
B/442/1488/
8 Antasida Doen I Tablet Kunyah 0 tab Rp - UPTD-IFK/IX/ 9/14/2022 4000 Rp 216,000 1960
Rp 54.00 2022
B/442/1488/
9 Anti Hemoroid komb. Supp 20 Suppo Rp 65,200 UPTD-IFK/IX/ 9/14/2022 20 Rp 65,200 22
Rp 3,260.00 2022
10 Cetrizine 10 mg 4390 tab Rp 52.47 Rp 230,343 Rp - 1990
B/442/1488/
11 Ciprofloxacin 500 mg 280 tab Rp 72,800 UPTD-IFK/IX/ 9/14/2022 500 Rp 130,000 510
Rp 260.00 2022
B/442/1488/
12 Dimenhidrinat 50 mg 0 tab Rp - UPTD-IFK/IX/ 9/14/2022 1000 Rp 109,000 10
Rp 109.00 2022
B/442/1488/
13 Fenol gliserol TT 10 % 0 Btl Rp - UPTD-IFK/IX/ 9/14/2022 96 Rp 316,800 50
Rp 3,300.00 2022
B/442/1488/
14 Glimepirid 2 mg 1210 Tab Rp 148,830 UPTD-IFK/IX/ 9/14/2022 500 Rp 61,500 270
Rp 123.00 2022
B/442/1488/
15 Hidrokortisone cream 0 Tube Rp - UPTD-IFK/IX/ 9/14/2022 96 Rp 223,200 80
Rp 2,325.00 2022
B/442/1488/
16 Ibuprofen 400mg 0 Tab Rp - UPTD-IFK/IX/ 9/14/2022 3000 Rp 630,000 2035
Rp 210.00 2022
17 Ketokonazol 200mg 360 Tab Rp 260.00 Rp 93,600 Rp - 116
18 Lansoprazole 30 mg 1470 Kap Rp 278.00 Rp 408,660 Rp - 800
B/442/1488/
19 Metformin HCL 500 mg 6000 tab Rp 462,000 UPTD-IFK/IX/ 9/14/2022 3000 Rp 231,000 400
Rp 77.00 2022
20 Metilprednisolon tablat 4 mg 900 tab Rp 102.00 Rp 91,800 Rp - 900
B/442/1488/
21 Novatusin syr 0 Btl Rp - UPTD-IFK/IX/ 9/14/2022 120 Rp 984,000 63
Rp 8,200.00 2022
B/442/1488/
22 Omeprazole inj 132 Ampl Rp 705,672 UPTD-IFK/IX/ 9/14/2022 100 Rp 534,600 88
Rp 5,346.00 2022
23 Paracetamol Drop 80 Drop Rp 5,204.00 Rp 416,320 Rp - 46
B/442/1488/
24 Paracetamol syr 0 Btl Rp - UPTD-IFK/IX/ 9/14/2022 400 Rp 464,000 174
Rp 1,160.00 2022
25 Scabimite cream 18 Tube Rp 11,466.00 Rp 206,388 Rp - 10
26 Povidon iodida 10 % 30 ml 16 Btl Rp 4,182.00 Rp 66,912 Rp - 0
B/442/1488/
29 Rivanol 5 Btl Rp 7,221.00 Rp 36,105 UPTD-IFK/IX/ 9/14/2022 10 Rp 72,210 0
2022
B/442/1488/
30 Ringer Laktat (RL) 0 Btl Rp - UPTD-IFK/IX/ 9/14/2022 400 Rp 3,081,200 220
Rp 7,703.00 2022
B/442/1488/
31 Salbutamol 2 mg 0 Tab Rp - UPTD-IFK/IX/ 9/14/2022 1000 Rp 51,000 550
Rp 51.00 2022
B/442/1488/
32 Salbutamol 4 mg 0 Tab Rp - UPTD-IFK/IX/ 9/14/2022 1000 Rp 67,000 70
Rp 67.00 2022
33 USG GEL 5 pcs Rp 16,632.00 Rp 83,160 Rp - 0
34 Vitamin B1 2200 tab Rp 173.00 Rp 380,600 Rp - 400
B/442/1488/
35 Vitamin B6 0 tab Rp - UPTD-IFK/IX/ 9/14/2022 4000 Rp 288,000 140
Rp 72.00 2022
B/442/1488/
36 Vitamin B12 0 tab Rp - UPTD-IFK/IX/ 9/14/2022 1000 Rp 44,000 80
Rp 44.00 2022
BMHP
37 Alkohol 70% 100 mL 38 Btl Rp 3,256.00 Rp 123,728 Rp - 2
38 Alkohol 70% 1000 mL 11 Btl Rp 23,595.00 Rp 259,545 Rp - 0
B/442/1488/
39 Disposable syringe 1 cc 0 pcs Rp 1,045.00 Rp - UPTD-IFK/IX/ 9/14/2022 1000 Rp 1,045,000 300
2022
41 Handscoon non steril L 1000 pcs Rp 1,252.08 Rp 1,252,080 Rp - 100
42 Handscoon non steril M 1000 pcs Rp 1,252.08 Rp 1,252,080 Rp - 0
43 Infuset Dewasa ( Troge Hamburg ) 60 pcs Rp 26,062.00 Rp 1,563,720 Rp - 30
B/442/1488/
44 IV.Chateter No.18 G 50 pcs Rp 1,320,900 UPTD-IFK/IX/ 9/14/2022 100 Rp 2,641,800 50
Rp 26,418.00 2022
45 IV.Chateter No.20 G 50 pcs Rp 26,418.00 Rp 1,320,900 Rp - 50
46 IV.Chateter No.22 G 0 pcs Rp 26,418.00 Rp - Rp - 0
B/442/1488/
48 IV.Chateter No.26 G 100 pcs Rp 2,763,900 UPTD-IFK/IX/ 9/14/2022 100 Rp 2,763,900 0
Rp 27,639.00 2022
B/442/1488/
49 Kasa 16 x 16 0 pcs Rp 3,541.00 Rp - UPTD-IFK/IX/ 9/14/2022 100 Rp 354,100 1
2022
50 Kasa 40x80 10 pcs Rp 91,045.00 Rp 910,450 Rp - 0
B/442/1488/
51 Plaster Putih 5 x 5 ( Farmafix ) 4 pcs Rp 128,760 UPTD-IFK/IX/ 9/14/2022 10 Rp 321,900 5
Rp 32,190.00 2022
B/442/1488/
52 Plester Putih 5x2 10 pcs Rp 21,638.40 Rp 216,384 UPTD-IFK/IX/ 9/14/2022 10 Rp 216,384 8
2022
B/442/1488/
53 Rivanol 5 Btl Rp 7,221.00 Rp 36,105 UPTD-IFK/IX/ 9/14/2022 10 Rp 72,210 0
2022
54 Umbilical Cord Klem 150 pcs Rp 2,070.00 Rp 310,500 Rp - 0
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00 Rp - Rp - 0
2 Cairan bonding 0 Pot Rp 391,500.00 Rp - Rp - 0
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00 Rp - Rp - 0
DAU 2021
Btl isi @ 30
1 Multivitamin Ibu Hamil OMEGA 3 0 Rp 45,000.00 Rp - Rp - 0
kapsul
BMHP
2 Disposable syringe 1 cc 0 Pcs Rp 1,361.00 Rp - Rp - 0
3 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53 Rp - Rp - 0
4 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13 Rp - Rp - 0
P 21
1 Acyclovir Cream 92 Tube Rp 4,400.00 Rp 404,800 Rp - 27
2 Bedak Salisil 0 Wadah Rp 7,700.00 Rp - Rp - 0
3 Bicombin inj 0 Ampul Rp 6,600.00 Rp - Rp - 0
4 Cefadroxil 500 mg 1350 Kap Rp 880.00 Rp 1,188,000 Rp - 560
5 Digoxin 0,5 mg 480 Tab Rp 198.00 Rp 95,040 Rp - 0
6 Diazepam larutan rektal 5mg/2,5ml 10 Suppo Rp 30,800.00 Rp 308,000 Rp - 4
7 Eflin 80 Tab Rp 1,413.50 Rp 113,080 Rp - 80
8 Furosemid 0 Tab Rp 275.00 Rp - Rp - 0
9 Guaiafenesin (GG) 100 mg 540 tab Rp 147.99 Rp 79,915 Rp - 540
10 Ibuprofen 200mg 0 Tab Rp 275.00 Rp - Rp - 0
11 Kloramfenikol 250 mg 170 Kap Rp 770.00 Rp 130,900 Rp - 80
12 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00 Rp - Rp - 0
13 Meloxicam 7,5 mg 0 Tab Rp 385.00 Rp - Rp - 0
14 Novastan syr 77 Btl Rp 11,000.00 Rp 847,000 Rp - 0
15 Nifedipine 110 Tab Rp 220.00 Rp 24,200 Rp - 90
16 Neo Diaform 2000 Tab Rp 286.00 Rp 572,000 Rp - 0
17 Oxytetracycline Salep Kulit 3% 124 Tube Rp 4,950.00 Rp 613,800 Rp - 29
18 OBH Plus 0 Btl Rp 12,100.00 Rp - Rp - 0
B/442/1488/
19 Paracetamol 500 mg 2050 tab Rp 275.00 Rp 563,750 UPTD-IFK/IX/ 9/14/2022 5000 Rp 1,375,000 4160
2022
B/442/1488/
20 Pehavral 4600 tab Rp 1,045.00 Rp 4,807,000 UPTD-IFK/IX/ 9/14/2022 1000 Rp 1,045,000 860
2022
21 Reco Salep Mata ( Chloamphenicol) 51 Tube Rp 6,600.00 Rp 336,600 Rp - 13
22 Reco Tetes Telinga (Chloramphenicol) 89 Btl Rp 11,000.00 Rp 979,000 Rp - 1
23 Skincol Gel 2 Tube Rp 148,500.00 Rp 297,000 Rp - 1
24 Visoprin 50 Btl Rp 72,600.00 Rp 3,630,000 Rp - 0
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 710 Tab Rp 231.00 Rp 164,010 Rp - 375
2 Amoksisilin sirup kering 125mg/5ml 284 Btl Rp 2,050.00 Rp 582,200 Rp - 42

3 Amox icillin Drop 135 Btl Rp 11,750.00 Rp 1,586,250 Rp - 5
4 Allupurinol 100 mg 1280 Tab Rp 89.00 Rp 113,920 Rp - 180
B/442/1488/
5 Allupurinol 300 mg 2400 Tab Rp 200.00 Rp 480,000 UPTD-IFK/IX/ 9/14/2022 1000 Rp 200,000 360
2022
6 Asam Mefenamat 1820 tab Rp 117.00 Rp 212,940 Rp - 1260
7 Amlodipine 5 mg 0 Tab Rp 55.00 Rp - Rp - 0
8 Amlodipine 10 mg 0 Tab Rp 74.00 Rp - Rp - 0
9 Ampisillin serbuk injeksi i.v 1000 mg/ Vial 79 Vial Rp 9,900.00 Rp 782,100 Rp - 3
10 Antihemeroid kombinasi 12 Suppo Rp 3,260.00 Rp 39,120 Rp - 12
11 42 Botol Rp 3,637.00 Rp 152,754 Rp - 5
6%
12 Antasida Doen I Tablet Kunyah 0 Tab Rp 54.00 Rp - Rp - 0
13 Antasida Doen suspensi 0 Botol Rp 1,756.00 Rp - Rp - 0
B/442/1488/
14 Asam askorbat / Vit C 50 mg 600 Tab Rp 46.00 Rp 27,600 UPTD-IFK/IX/ 9/14/2022 3000 Rp 138,000 490
2022
15 Asam Traneksamat injeksi 24 amp Rp 1,820.00 Rp 43,680 Rp - 12
16 Asam folat tab 1 mg 3080 pcs Rp 61.00 Rp 187,880 Rp - 900
17 Asetosal 80 mg 210 Tab Rp 89.00 Rp 18,690 Rp - 10
18 Betahistine 6 mg 0 Tab Rp 92.00 Rp - Rp - 0
19 Betamethason cream 0 Tab Rp 1,540.00 Rp - Rp - 0
20 Bisakodil Suppo 49 Suppo Rp 5,085.00 Rp 249,165 Rp - 0
B/442/1488/
21 Bisakodil 5 mg 0 Tab Rp 5,085.00 Rp - UPTD-IFK/IX/ 9/14/2022 300 Rp 1,525,500 0
2022
22 Captopril 12,5 mg 0 tab Rp 68.00 Rp - Rp - 0
23 Cetrizine syr 203 Botol Rp 2,215.00 Rp 449,645 Rp - 75
24 Cefotaxim Injeksi 0 Vial Rp 3,050.00 Rp - Rp - 0
25 Diazepam inj 5 mg / 2 ml 0 Ampul Rp 1,545.00 Rp - Rp - 0
B/442/1488/
26 Dexamethasone injeksi 106 Ampul Rp 968.00 Rp 102,608 UPTD-IFK/IX/ 9/14/2022 100 Rp 96,800 31
2022
27 Dextrosa 10 % 20 Botol Rp 7,200.00 Rp 144,000 Rp - 20
28 Doksisiklin 500 Tab Rp 289.00 Rp 144,500 Rp - 0
29 Domperidone syr 171 Botol Rp 2,401.00 Rp 410,571 Rp - 40
30 Eritromisin sirup 200 mg 79 Botol Rp 7,436.00 Rp 587,444 Rp - 25
31 Epinephrine 6 Ampul Rp 1,740.00 Rp 10,440 Rp - 0
32 Furosemid Injeksi i.v./i.m 10mg/ml 70 Ampul Rp 969.00 Rp 67,830 Rp - 1
33 Glukosa Infus D5% 79 btl Rp 7,363.00 Rp 581,677 Rp - 0
34 Glibenklamide 5 mg 0 Tab Rp 87.00 Rp - Rp - 0
35 Haloperidole 5 mg 20 Tab Rp 54.00 Rp 1,080 Rp - 20
36 Hyoscine N butylbromide 180 Tab Rp 1,050.00 Rp 189,000 Rp - 30
37 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00 Rp - Rp - 0
38 Kalsium laktat (Kalk) 500 mg 0 Tab Rp 60.00 Rp - Rp - 0
39 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00 Rp 148,776 Rp - 0
B/442/1488/
40 Ketorolac inj 30Mg/MI 47 Ampul Rp 923.00 Rp 43,381 UPTD-IFK/IX/ 9/14/2022 100 Rp 92,300 77
2022
41 Karbamazepin 200mg 0 tab Rp 216.00 Rp - Rp - 0
42 KAEN 3B 20 tab Rp 11,500.00 Rp 230,000 Rp - 20
B/442/1488/
43 Isosorbid Dinitrat tablet sublingual 5mg 150 Tab Rp 99.00 Rp 14,850 UPTD-IFK/IX/ 9/14/2022 100 Rp 9,900 60
2022
44 Ibuprofen Syr 100mg/5ml 68 Btl Rp 2,339.00 Rp 159,052 Rp - 18
45 Ketokonazole Cream 25 Tube Rp 2,399.00 Rp 59,975 Rp - 4
46 Ketokonazole tablet 200mg 0 Tab Rp 260.00 Rp - Rp - 0
47 Kloramfenikol Suspensi 125 mg/ 5ml 71 Btl Rp 5,352.00 Rp 379,992 Rp - 5
48 Kodein 10 mg 29 Tab Rp 605.00 Rp 17,545 Rp - 29
49 Lansoprazole 30 mg 0 kap Rp 278.00 Rp - Rp - 0
50 Lidokain comp (Lidokain injeksi 2% (HCI) + epinefrin) 180 Ampul Rp 847.00 Rp 152,460 Rp - 30
51 Lidocain inj 2 % (HCL) 92 Ampul Rp 891.00 Rp 81,972 Rp - 92
52 Loratadine 4270 kap Rp 117.00 Rp 499,590 Rp - 590
53 Metformin HCL 500 mg 1730 tab Rp 77.00 Rp 133,210 Rp - 1480
54 Metilprednisolon tablat 4 mg 0 tab Rp 102.00 Rp - Rp - 0
56 Metoklopramid 10 mg 70 tab Rp 66.00 Rp 4,620 Rp - 10
57 Metoklopramid inj 757 Ampul Rp 1,983.00 Rp 1,501,131 Rp - 25
58 Methamizole Na Inj 0 Ampul Rp 3,045.00 Rp - Rp - 0
59 Metronidazol sirup 73 Btl Rp 3,765.00 Rp 274,845 Rp - 6
60 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp - Rp - 0
61 MGSO4 20 % 50 Ampul Rp 4,120.00 Rp 206,000 Rp - 0
62 Mikonazole kream 315 Tube Rp 1,900.00 Rp 598,500 Rp - 23
B/442/1488/
63 Nistatin drop 3 Btl Rp 11,750.00 Rp 35,250 UPTD-IFK/IX/ 9/14/2022 20 Rp 235,000 9
2022
64 Nistatin Ovula 100.000 IU 96 tab Rp 550.00 Rp 52,800 Rp - 1
65 Natrium Diklofenak 25 mg tab Rp 109.00 Rp - Rp - 0
66 N-Asetilsistein 10 Tab Rp 317.00 Rp 3,170 Rp - 10
67 Natrium Chloride 0,9 % ( NACL 0,9 %) 320 btl Rp 6,900.00 Rp 2,208,000 Rp - 100
68 Oxytocin injeksi 0 Ampul Rp 1,248.00 Rp - Rp - 0
69 Omeprazole 20 mg 6510 Kap Rp 129.00 Rp 839,790 Rp - 170
70 Parasetamol syr 0 btl Rp 1,160.00 Rp - Rp - 0
71 Phytomenadion inj 2mg/ml 88 Ampul Rp 3,900.00 Rp 343,200 Rp - 4
72 Phytomenadion 10 mg 160 Tab Rp 781.00 Rp 124,960 Rp - 0
73 Permetrin cream 0 Tube Rp 11,466.00 Rp - Rp - 0
74 Ranitidin tablet 150 mg 640 tab Rp 85.00 Rp 54,400 Rp - 50
75 Ranitidin injeksi 0 Ampul Rp 858.00 Rp - Rp - 0
76 Salbutamol 4 mg 0 Tab Rp 67.00 Rp - Rp - 0
77 Salep 2-4 8 Pot Rp 1,475.00 Rp 11,800 Rp - 0
78 Simvastatin 10 mg 1000 tab Rp 73.00 Rp 73,000 Rp - 500
B/442/1488/
79 Simvastatin 20 mg 4880 tab Rp 73.00 Rp 356,240 UPTD-IFK/IX/ 9/14/2022 2000 Rp 146,000 220
2022
80 Siprofloksasin 500 mg 0 Tab Rp 260.00 Rp - Rp - 0
81 Sianocbalamin (B12) 0 Tab Rp 44.00 Rp - Rp - 0
82 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 213 Ampul Rp 1,066.00 Rp 227,058 Rp - 115
83 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00 Rp 1,034,264 Rp - 0
84 Tablet tambah darah 40 tab Rp 255.00 Rp 10,200 Rp - 40
85 USG GEL 3 Btl Rp 18,858.33 Rp 56,575 Rp - 0
86 VAR 0 Vial Rp 153,000.00 Rp - Rp - 0
B/442/1488/
87 Vit. B.Complex 640 Tab Rp 60 Rp 38,400 UPTD-IFK/IX/ 9/14/2022 3000 Rp 180,000 1310
2022
88 Zink 20 mg tab 0 Tab Rp 253.00 Rp - Rp - 0
89 Zink syr 0 Btl Rp 2,489.00 Rp - Rp - 0
BMHP 0 0
90 Catgut chromic 3/0 +jarum Bulat (*optime*) 72 Pcs Rp 68,090.00 Rp 4,902,480 Rp - 36
B/442/1488/
91 Disposable syringe 3 cc 400 Pcs Rp 818.00 Rp 327,200 UPTD-IFK/IX/ 9/14/2022 1000 Rp 818,000 300
2022
92 Disposable syringe 10 cc 295 Pcs Rp 1,100.00 Rp 324,500 Rp - 95
93 Folly Catheter 18 10 pcs Rp 11,132.00 Rp 111,320 Rp - 0
94 Handscoond steril no 6 100 Pasang Rp 13,563.00 Rp 1,356,300 Rp - 0
95 Handscoond steril no 6,5 281 Pasang Rp 13,563.00 Rp 3,811,203 Rp - 0
96 Handscoond steril no 7 250 Pasang Rp 13,563.00 Rp 3,390,750 Rp - 50
97 Handscoond steril no 7,5 0 Pasang Rp 13,563.00 Rp - Rp - 0
98 Hand Sanitizer / Handrub 500 ml 0 Btl Rp 68,200.00 Rp - Rp - 0
99 Handscrub 0 Btl Rp 115,800.00 Rp - Rp - 0
100 Infus Set Dewasa 0 pcs Rp 7,128.00 Rp - Rp - 0
102 Kasa 4 x 10 240 pcs Rp 2,176.72 Rp 522,414 Rp - 10
103 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp - Rp - 0
104 Scalpet Blades no.10 100 Pcs Rp 618.70 Rp 61,870 Rp - 0
107 Surgical mask earloop 3ply / Masker 4050 Box Rp 1,373.14 Rp 5,561,217 Rp - 350
108 Under Pad Steril 200 pcs Rp 37,875.00 Rp 7,575,000 Rp - 0
DAK 2020
1 Acyclovir 400 mg 610 Tab Rp 454.00 Rp 276,940 Rp - 195
2 Betahistine 6 mg 0 Tab Rp 119.00 Rp - Rp - 0
3 CTM 4 mg 0 tab Rp 26.00 Rp - Rp - 0
4 Cetrizine 10 mg 0 tab Rp 104.00 Rp - Rp - 0
5 Domperidone syr 0 Botol Rp 2,862.00 Rp - Rp - 0
6 Anti migren kombinasi ( ERGOTAMIN ) 359 tab Rp 212.00 Rp 76,108 Rp - 20
7 Gentamicine tetes mata 0 Botol Rp 26.00 Rp - Rp - 0
8 Kodein 10 mg 0 Tab Rp 657.00 Rp - Rp - 0
9 Lansoprazole 30 mg 0 kap Rp 352.00 Rp - Rp - 0
11 Paracetamol Drop 0 Botol Rp 7,646.00 Rp - Rp - 0
BMHP
12 Catgut chromic 3/0 +jarum Bulat (*optime*) 0 Pcs Rp 55,000.00 Rp - Rp - 0
13 Catgut chromic 3/0 +jarum Segitiga (*optime*) 0 Pcs Rp 62,000.00 Rp - Rp - 0
14 Catgut chromic 2/0 +jarum Bulat (*optime-R*) 42 Pcs Rp 44,000.00 Rp 1,848,000 Rp - 0
15 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00 Rp - Rp - 0
16 Feeding Tube 14 0 pcs Rp 8,407.00 Rp - Rp - 0
17 Feeding Tube 16 0 pcs Rp 8,407.00 Rp - Rp - 0
18 Handscoond steril no 8 49 Pasang Rp 13,178.00 Rp 645,722 Rp - 0
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp - Rp - 0
22 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00 Rp - Rp - 0
23 Umbilical Cord Klem 0 Pcs Rp 1,495.00 Rp - Rp - 0
DAU 2020
1 Aqua pro injeksi 20 ml 0 ampul Rp 2,860.00 Rp - Rp - 0
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00 Rp - Rp - 0
3 Natrium Chloride 0,9 % ( NACL 0,9 %) 0 btl Rp 6,840.00 Rp - Rp - 0
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00 Rp 161,260 Rp - 0
5 Ringer Laktat (RL) 0 btl Rp 7,150.00 Rp - Rp - 0
P 2020
1 Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01 Rp - Rp - 0
2 Ambroxol Tablet 30 mg 0 Tab Rp 110.00 Rp - Rp - 0
3 Bisakodil Suppo 0 Suppo Rp 23,475.00 Rp - Rp - 0
4 Bisakodil ( LAXANA) 0 Tab Rp 367.00 Rp - Rp - 0
5 Guaiafenesin (GG) 100 mg 0 tab Rp 175.00 Rp - Rp - 0
6 0 Botol Rp 14,900.00 Rp - Rp - 0
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 0 Botol Rp 12,900.00 Rp - Rp - 0
8 0 tab Rp 600.00 Rp - Rp - 0
FLUTROP
9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00 Rp - Rp - 0
10 Hemafort 0 Tab Rp 820.00 Rp - Rp - 0
DAK 2019
1 Acyclovir 400 mg 0 Tab Rp 425.00 Rp - Rp - 0
2 Alprazolam 0,5 mg 0 tab Rp 88.00 Rp - Rp - 0
3 Cefadroxil sirup kering 125mg/5ml 0 btl Rp 4,360.00 Rp - Rp - 0
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 0 Tube Rp 14,459.00 Rp - Rp - 0
5 Kotrimoxazole syr 0 btl Rp 2,052.00 Rp - Rp - 0
6 Metoklopramide 10 mg 0 tab Rp 83.00 Rp - Rp - 0
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00 Rp - Rp - 0
8 Pirantel 125 mg 49 tab Rp 331.00 Rp 16,219 Rp - 8
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00 Rp - Rp - 0
BMHP
10 Alat Suntik 5 ml 1082 pcs Rp 1,600 Rp 1,731,200 Rp - 82
13 Infus Set Dewasa 0 pcs Rp 6,842.00 Rp - Rp - 0
14 urine bag 75 pcs Rp 1,848.00 Rp 138,600 Rp - 0
PENUNJANG 2019
1 Gentamicin salep kulit 0 tube Rp 2,640.00 Rp - Rp - 0
2 Loperamide 520 Tab Rp 198.00 Rp 102,960 Rp - 0
3 Multivitamin syr anak ( Becefort ) 0 Botol Rp 17,365.70 Rp - Rp - 0
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 77 btl Rp 3,850.00 Rp 296,450 Rp - 25
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00 Rp - Rp - 0
2 Cotton roll medium 0 Pack Rp 85,800.00 Rp - Rp - 0
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp - Rp - 0
4 Pehacain 0 Ampul Rp 3,113.0495 Rp - Rp - 0
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00 Rp - Rp - 0
2 HCT 25 mg 0 tab Rp 178.00 Rp - Rp - 0
3 Nistatin 100.000 IU 0 tab Rp 645.00 Rp - Rp - 0
BMHP
4 Blood Lancet 0 Pcs Rp 167.509 Rp - Rp - 0
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86 Rp - Rp - 0
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 0 pcs Rp 22,000.00 Rp - Rp - 0
DAU 2017
BMHP
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 31 Pcs Rp 46,187.44 Rp 1,431,811 Rp - 31
DAK 2017
1 Diltiazem 30 mg 0 tab Rp 128.00 Rp - Rp - 0
BMHP
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 25 Bks Rp 14,375.00 Rp 359,375 Rp - 0
2 Kasa 4mx5cm 0 Roll Rp 862.50 Rp - Rp - 0
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 50 pcs Rp 6,222.00 Rp 311,100 Rp - 0
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 11 roll/bungkus Rp 11,914 Rp 131,054 Rp - 3
TOTAL 85,842.00 Rp 93,061,582.12 44,492.00 Rp 21,801,314.00 32,391.00
Mengetahui
Rosyidah, A.Md.Keb
NIP. 19701001 199102 2 002
Realisasi
KET
Jumlah Total harga
Total harga
12 15 16 17
Rp - 25 Rp 416,650.00
Rp - 3 Rp 120,562.50
Rp - 1300 Rp 1,508,000.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 550 Rp 72,600.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 1000 Rp 89,000
Rp 122,459 5050 Rp 377,084
Rp 120,450 610 Rp 33,550
Rp - 2000 Rp 462,000
Rp 173,430 290 Rp 558,830

Rp - 1000 Rp 61,000
Rp 484,656 276 Rp 484,656
Rp 105,840 2040 Rp 110,160
Rp 71,720 18 Rp 58,680
Rp 104,415 2400 Rp 125,928
Rp 132,600 270 Rp 70,200
Rp 1,090 990 Rp 107,910
Rp 165,000 46 Rp 151,800
Rp 33,210 1440 Rp 177,120
Rp 186,000 16 Rp 37,200
Rp 427,350 965 Rp 202,650
Rp 30,160 244 Rp 63,440

Rp 222,400 670 Rp 186,260
Rp 30,800 8600 Rp 662,200

Rp 91,800 0 Rp -
Rp 516,600 57 Rp 467,400
Rp 470,448 144 Rp 769,824
Rp 239,384 34 Rp 176,936
Rp 201,840 226 Rp 262,160
Rp 114,660 8 Rp 91,728
Rp - 16 Rp 66,912
Rp 6,683 16 Rp 106,928
Rp - 8 Rp 185,056
Rp - 15 Rp 108,315
Rp 1,694,660 180 Rp 1,386,540
Rp 28,050 450 Rp 22,950
Rp 4,690 930 Rp 62,310
Rp - 5 Rp 83,160.00
Rp 69,200 1800 Rp 311,400
Rp 10,080 3860 Rp 277,920
Rp 3,520 920 Rp 40,480

Rp 6,512 36 Rp 117,216.00
Rp - 11 Rp 259,545.00
Rp 313,500 700 Rp 731,500.00
Rp 125,208 900 Rp 1,126,872.00

Rp - 1000 Rp 1,252,080.00
Rp 781,860 30 Rp 781,860.00
Rp 1,320,900 100 Rp 2,641,800.00
Rp 1,320,900 0 Rp -
Rp - 0 Rp -
Rp 2,641,800 50 Rp 1,320,900.00
Rp - 200 Rp 5,527,800.00
Rp 3,541 99 Rp 350,559
Rp - 10 Rp 910,450
Rp 160,950 9 Rp 289,710.00
Rp 173,107 12 Rp 259,660.80
Rp - 15 Rp 108,315.00
Rp - 150 Rp 310,500.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 118,800 65 Rp 286,000
Rp - 0 Rp -
Rp - 0 Rp -
Rp 492,800 790 Rp 695,200
Rp - 480 Rp 95,040
Rp 123,200 6 Rp 184,800
Rp 113,080 0 Rp -
Rp - 0 Rp -
Rp 79,915 0 Rp -
Rp - 0 Rp -
Rp 61,600 90 Rp 69,300
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 77 Rp 847,000
Rp 19,800 20 Rp 4,400
Rp - 2000 Rp 572,000
Rp 143,550 95 Rp 470,250
Rp - 0 Rp -
Rp 1,144,000 2890 Rp 794,750
Rp 898,700 4740 Rp 4,953,300
Rp 85,800 38 Rp 250,800
Rp 11,000 88 Rp 968,000
Rp 148,500 1 Rp 148,500
Rp - 50 Rp 3,630,000
Rp 86,625 335 Rp 77,385
Rp 86,100 242 Rp 496,100

Rp 58,750 130 Rp 1,527,500
Rp 16,020 1100 Rp 97,900
Rp 72,000 3040 Rp 608,000
Rp 147,420 560 Rp 65,520

Rp - 0 Rp -
Rp - 0 Rp -
Rp 29,700 76 Rp 752,400
Rp 39,120 0 Rp -
Rp 18,185 37 Rp 134,569
Rp - 0 Rp -
Rp - 0 Rp -
Rp 22,540 3110 Rp 143,060
Rp 21,840 12 Rp 21,840
Rp 54,900 2180 Rp 132,980
Rp 890 200 Rp 17,800
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 49 Rp 249,165
Rp - 300 Rp 1,525,500
Rp - 0 Rp -
Rp 166,125 128 Rp 283,520
Rp - 0 Rp -
Rp - 0 Rp -
Rp 30,008 175 Rp 169,400
Rp 144,000 0 Rp -
Rp - 500 Rp 144,500
Rp 96,040 131 Rp 314,531
Rp 185,900 54 Rp 401,544
Rp - 6 Rp 10,440
Rp 969 69 Rp 66,861
Rp - 79 Rp 581,677
Rp - 0 Rp -
Rp 1,080 0 Rp -
Rp 31,500 150 Rp 157,500
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 24 Rp 148,776
Rp 71,071 70 Rp 64,610
Rp - 0 Rp -
Rp 230,000 0 Rp -
Rp 5,940 190 Rp 18,810
Rp 42,102 50 Rp 116,950
Rp 9,596 21 Rp 50,379
Rp - 0 Rp -
Rp 26,760 66 Rp 353,232
Rp 17,545 0 Rp -
Rp - 0 Rp -
Rp 25,410 150 Rp 127,050
Rp 81,972 0 Rp -
Rp 69,030 3680 Rp 430,560
Rp 113,960 250 Rp 19,250
Rp - 0 Rp -
Rp - 0 Rp -
Rp 660 60 Rp 3,960.00
Rp 49,575 732 Rp 1,451,556
Rp - 0 Rp -
Rp 22,590 67 Rp 252,255
Rp - 0 Rp -
Rp - 50 Rp 206,000
Rp 43,700 292 Rp 554,800
Rp 105,750 14 Rp 164,500
Rp 550 95 Rp 52,250.00
Rp - 0 Rp -
Rp 3,170 0 Rp -
Rp 690,000 220 Rp 1,518,000
Rp - 0 Rp -
Rp 21,930.00 6340 Rp 817,860
Rp - 0 Rp -
Rp 15,600 84 Rp 327,600
Rp - 160 Rp 124,960
Rp - 0 Rp -
Rp 4,250 590 Rp 50,150
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 8 Rp 11,800
Rp 36,500 500 Rp 36,500
Rp 16,060 6660 Rp 486,180
Rp - 0 Rp -
Rp - 0 Rp -
Rp 122,590 98 Rp 104,468
Rp - 2 Rp 1,034,264
Rp 10,200 0 Rp -
Rp - 3 Rp 56,575
Rp - 0 Rp -
Rp 78,600 2330 Rp 139,800
Rp - 0 Rp -
Rp - 0 Rp -
0
Rp 2,451,240 36 Rp 2,451,240
Rp 245,400 1100 Rp 899,800.00
Rp 104,500 200 Rp 220,000.00

Rp - 10 Rp 111,320.00
Rp - 100 Rp 1,356,300.00
Rp - 281 Rp 3,811,203.00
Rp 678,150 200 Rp 2,712,600.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 50 Rp 1,274,350.00
Rp 21,767 230 Rp 500,647
Rp - 0 Rp -
Rp - 100 Rp 61,869.50
Rp - 98 Rp 60,631.03
Rp - 79 Rp 48,878.32
Rp 480,599 3700 Rp 5,080,618.00
Rp - 200 Rp 7,575,000.00
Rp 88,530 415 Rp 188,410

Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 4,240 339 Rp 71,868
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 42 Rp 1,848,000
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 49 Rp 645,722
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 220 Rp 161,260
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 2,648 41 Rp 13,571
Rp - 0 Rp -
Rp 131,200 1000 Rp 1,600,000

Rp 118,910 20 Rp 237,820
Rp 118,910 10 Rp 118,910
Rp - 0 Rp -
Rp - 75 Rp 138,600
Rp - 0 Rp -
Rp - 520 Rp 102,960
Rp - 0 Rp -
Rp 96,250 52 Rp 200,200
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 1,431,811 0 Rp -
Rp - 0
Rp - 25 Rp 359,375
Rp - 0 Rp -
Rp - 50 Rp 311,100
Rp 35,742 8 Rp 95,312
Rp 25,386,937.92 97,943.00 Rp 89,475,958.20
Binawara, 30 September 2022


NIP. 19890825 201101 2 011
PEMERINTAH KABUPATEN TANAH BUMBU
DINAS KESEHATAN
Alamat : Jalan Pemerintahan No.2 Desa Binawara,Kecamatan Kusan Hulu, Kabupaten Tanah Bumbu Prop Kalimantan Selatan, KP 72272
Website http://dinkes.tanahbumbukab.go.id email lasungmedical@gmail.com
BERITA ACARA PEMERIKSAAN STOCK OPNAME
ALKES / BMHP DAN OBAT APBD ( DAERAH ) 2022

NO: B/440/ /PKM.Lsg.TU.4/IX/2022
Pada Hari Jum'at Tanggal Tiga Puluh Bulan September Tahun Dua Ribu Dua Puluh Dua, yang bertanda tangan dibawah ini :
Nama : Summi Ariyani, A.Md. Far
NIP : 19890825 201101 2 011
Jabatan : Asisten Apoteker Mahir / Pelaksana Lanjutan
Dengan ini menyatakan telah melakukan pemeriksaan dengan teliti terhadap barang - barang persediaan obat yaitu :
Stock Akhir
Banyaknya Ket
No Nama Obat
Harga satuan Total Harga
Jumlah Satuan Sumber Tanggal Penerimaan
1 2 3 4 5 6 7 8 9
BMHP Program HIV
1 Safety box 25 IDR Rp 16,666.00 Rp 416,650.00 Dinkes Aset ( BPBD )
2 Plesterin Bulat non woven 3 Kotak Rp 40,187.50 Rp 120,562.50 Dinkes Aset ( BPBD )
3 Vacum Tube sterile, plastic, K3 EDTA 1300 Pcs Rp 1,160.00 Rp 1,508,000.00 Dinkes Aset ( BPBD )
4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Dinkes Aset ( BPBD )
5 surgical Gloves no. 8 0 Pcs Rp 13,178.00 Rp - Dinkes Aset ( BPBD )
6 Vacutainer Needle 550 Pcs Rp 132.00 Rp 72,600.00 Dinkes Aset ( BPBD )
BMHP Program TB
1 Larutan Zhihi Neeisen 0 Paket Rp 274,362.00 Rp - Dinkes Aset ( BPBD )
2 Sputum Pot 0 Biji Rp 3,137.00 Rp - Dinkes Aset ( BPBD )
3 Object Glass Frosted 7105 0 box @ 72 pcs Rp 23,860.08 Rp - Dinkes Aset ( BPBD )
DAK 22
2 Amlodipine 10 mg 5050 Tab Rp 74.67 Rp 377,084 gudang IFK
3 Amlodipine 5 mg 610 Tab Rp 55.00 Rp 33,550 gudang IFK
4 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 2000 Tab Rp 231.00 Rp 462,000 gudang IFK
5 Asam Traneksamat 500 mg 290 Tab Rp 1,927.00 Rp 558,830 gudang IFK
6 Asam folat tab 1 mg 1000 Tab Rp 61.00 Rp 61,000 gudang IFK
7 Antasida syr 276 Btl Rp 1,756.00 Rp 484,656 gudang IFK
8 Antasida Doen I Tablet Kunyah 2040 tab Rp 54.00 Rp 110,160 gudang IFK
9 Anti Hemoroid komb. Supp 18 Suppo Rp 3,260.00 Rp 58,680 gudang IFK
10 Cetrizine 10 mg 2400 tab Rp 52.47 Rp 125,928 gudang IFK
11 Ciprofloxacin 500 mg 270 tab Rp 260.00 Rp 70,200 gudang IFK
12 Dimenhidrinat 50 mg 990 tab Rp 109.00 Rp 107,910 gudang IFK
13 Fenol gliserol TT 10 % 46 Btl Rp 3,300.00 Rp 151,800 gudang IFK
14 Glimepirid 2 mg 1440 Tab Rp 123.00 Rp 177,120 gudang IFK
15 Hidrokortisone cream 16 Tube Rp 2,325.00 Rp 37,200 gudang IFK
16 Ibuprofen 400mg 965 Tab Rp 210.00 Rp 202,650 gudang IFK
17 Ketokonazol 200mg 244 Tab Rp 260.00 Rp 63,440 gudang IFK
18 Lansoprazole 30 mg 670 Kap Rp 278.00 Rp 186,260 gudang IFK
21 Novatusin syr 57 Btl Rp 8,200.00 Rp 467,400 gudang IFK
22 Omeprazole inj 144 Ampl Rp 5,346.00 Rp 769,824 gudang IFK
23 Paracetamol Drop 34 Drop Rp 5,204.00 Rp 176,936 gudang IFK
24 Paracetamol syr 226 Btl Rp 1,160.00 Rp 262,160 gudang IFK
25 Scabimite cream 8 Tube Rp 11,466.00 Rp 91,728 gudang IFK
26 Povidon iodida 10 % 30 ml 16 Btl Rp 4,182.00 Rp 66,912 gudang IFK
29 Rivanol 15 Btl Rp 7,221.00 Rp 108,315 gudang IFK
30 Ringer Laktat (RL) 180 Btl Rp 7,703.00 Rp 1,386,540 gudang IFK
31 Salbutamol 2 mg 450 Tab Rp 51.00 Rp 22,950 gudang IFK
32 Salbutamol 4 mg 930 Tab Rp 67.00 Rp 62,310 gudang IFK
33 USG GEL 5 pcs Rp 16,632.00 Rp 83,160 gudang IFK
34 Vitamin B1 1800 tab Rp 173.00 Rp 311,400 gudang IFK
BMHP
37 Alkohol 70% 100 mL 36 Btl Rp 3,256.00 Rp 117,216 gudang IFK
38 Alkohol 70% 1000 mL 11 Btl Rp 23,595.00 Rp 259,545 gudang IFK
39 Disposable syringe 1 cc 700 pcs Rp 1,045.00 Rp 731,500 gudang IFK
41 Handscoon non steril L 900 pcs Rp 1,252.08 Rp 1,126,872 gudang IFK
42 Handscoon non steril M 1000 pcs Rp 1,252.08 Rp 1,252,080 gudang IFK
43 Infuset Dewasa ( Troge Hamburg ) 30 pcs Rp 26,062.00 Rp 781,860 gudang IFK
44 IV.Chateter No.18 G 100 pcs Rp 26,418.00 Rp 2,641,800 gudang IFK
50 Kasa 40x80 10 pcs Rp 91,045.00 Rp 910,450 gudang IFK
51 Plaster Putih 5 x 5 ( Farmafix ) 9 pcs Rp 32,190.00 Rp 289,710 gudang IFK
52 Plester Putih 5x2 12 pcs Rp 21,638.40 Rp 259,661 gudang IFK
53 Rivanol 15 Btl Rp 7,221.00 Rp 108,315 gudang IFK
54 Umbilical Cord Klem 150 pcs Rp 2,070.00 Rp 310,500 gudang IFK
BG 2021
1 Bahan tambal sinar 0 Syringe Rp 356,400.00 Rp - gudang IFK
2 Cairan bonding 0 Pot Rp 391,500.00 Rp - gudang IFK
3 Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00 Rp - gudang IFK
DAU 2021
Btl isi @ 30
1 Multivitamin Ibu Hamil OMEGA 3 0 Rp 45,000.00 Rp - gudang IFK
kapsul
BMHP
2 Disposable syringe 1 cc 0 Pcs Rp 1,361.00 Rp - gudang IFK
3 Sarung Tangan Uk. S 0 Pcs Rp 1,712.53 Rp - gudang IFK
4 Sarung Tangan Uk. M 0 Pcs Rp 1,710.13 Rp - gudang IFK
P 21
1 Acyclovir Cream 65 Tube Rp 4,400.00 Rp 286,000 gudang IFK
2 Bedak Salisil 0 Wadah Rp 7,700.00 Rp - gudang IFK
3 Bicombin inj 0 Ampul Rp 6,600.00 Rp - gudang IFK
4 Cefadroxil 500 mg 790 Kap Rp 880.00 Rp 695,200 gudang IFK
5 Digoxin 0,5 mg 480 Tab Rp 198.00 Rp 95,040 gudang IFK
6 Diazepam larutan rektal 5mg/2,5ml 6 Suppo Rp 30,800.00 Rp 184,800 gudang IFK
7 Eflin 0 Tab Rp 1,413.50 Rp - gudang IFK
8 Furosemid 0 Tab Rp 275.00 Rp - gudang IFK
10 Ibuprofen 200mg 0 Tab Rp 275.00 Rp - gudang IFK
11 Kloramfenikol 250 mg 90 Kap Rp 770.00 Rp 69,300 gudang IFK
12 Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00 Rp - gudang IFK
13 Meloxicam 7,5 mg 0 Tab Rp 385.00 Rp - gudang IFK
14 Novastan syr 77 Btl Rp 11,000.00 Rp 847,000 gudang IFK
15 Nifedipine 20 Tab Rp 220.00 Rp 4,400 gudang IFK
16 Neo Diaform 2000 Tab Rp 286.00 Rp 572,000 gudang IFK
17 Oxytetracycline Salep Kulit 3% 95 Tube Rp 4,950.00 Rp 470,250 gudang IFK
18 OBH Plus 0 Btl Rp 12,100.00 Rp - gudang IFK
19 Paracetamol 500 mg 2890 tab Rp 275.00 Rp 794,750 gudang IFK
20 Pehavral 4740 tab Rp 1,045.00 Rp 4,953,300 gudang IFK
21 Reco Salep Mata ( Chloamphenicol) 38 Tube Rp 6,600.00 Rp 250,800 gudang IFK
22 Reco Tetes Telinga (Chloramphenicol) 88 Btl Rp 11,000.00 Rp 968,000 gudang IFK
23 Skincol Gel 1 Tube Rp 148,500.00 Rp 148,500 gudang IFK
24 Visoprin 50 Btl Rp 72,600.00 Rp 3,630,000 gudang IFK
DAK 2021
1 Amoxicillin Trihydrate / Pehamoxiil Forte 500 mg (hexapram Jaya ) 335 Tab Rp 231.00 Rp 77,385 gudang IFK
2 Amoksisilin sirup kering 125mg/5ml 242 Btl Rp 2,050.00 Rp 496,100 gudang IFK
3 Amox icillin Drop 130 Btl Rp 11,750.00 Rp 1,527,500 gudang IFK
6 Asam Mefenamat 560 tab Rp 117.00 Rp 65,520 gudang IFK
9 Ampisillin serbuk injeksi i.v 1000 mg/ Vial 76 Vial Rp 9,900.00 Rp 752,400 gudang IFK
10 Antihemeroid kombinasi 0 Suppo Rp 3,260.00 Rp - gudang IFK
11 Antifungi DOEN kombinasi: Asam Benzoat 3% + Asam Salisilat 6% 37 Botol Rp 3,637.00 Rp 134,569 gudang IFK
12 Antasida Doen I Tablet Kunyah 0 Tab Rp 54.00 Rp - gudang IFK
13 Antasida Doen suspensi 0 Botol Rp 1,756.00 Rp - gudang IFK
14 Asam askorbat / Vit C 50 mg 3110 Tab Rp 46.00 Rp 143,060 gudang IFK
15 Asam Traneksamat injeksi 12 amp Rp 1,820.00 Rp 21,840 gudang IFK
16 Asam folat tab 1 mg 2180 pcs Rp 61.00 Rp 132,980 gudang IFK
17 Asetosal 80 mg 200 Tab Rp 89.00 Rp 17,800 gudang IFK
19 Betamethason cream 0 Tab Rp 1,540.00 Rp - gudang IFK
20 Bisakodil Suppo 49 Suppo Rp 5,085.00 Rp 249,165 gudang IFK
21 Bisakodil 5 mg 300 Tab Rp 5,085.00 Rp 1,525,500 gudang IFK
22 Captopril 12,5 mg 0 tab Rp 68.00 Rp - gudang IFK
23 Cetrizine syr 128 Botol Rp 2,215.00 Rp 283,520 gudang IFK
24 Cefotaxim Injeksi 0 Vial Rp 3,050.00 Rp - gudang IFK
25 Diazepam inj 5 mg / 2 ml 0 Ampul Rp 1,545.00 Rp - gudang IFK
26 Dexamethasone injeksi 175 Ampul Rp 968.00 Rp 169,400 gudang IFK
27 Dextrosa 10 % 0 Botol Rp 7,200.00 Rp - gudang IFK
28 Doksisiklin 500 Tab Rp 289.00 Rp 144,500 gudang IFK
29 Domperidone syr 131 Botol Rp 2,401.00 Rp 314,531 gudang IFK
30 Eritromisin sirup 200 mg 54 Botol Rp 7,436.00 Rp 401,544 gudang IFK
31 Epinephrine 6 Ampul Rp 1,740.00 Rp 10,440 gudang IFK
32 Furosemid Injeksi i.v./i.m 10mg/ml 69 Ampul Rp 969.00 Rp 66,861 gudang IFK
33 Glukosa Infus D5% 79 btl Rp 7,363.00 Rp 581,677 gudang IFK
34 Glibenklamide 5 mg 0 Tab Rp 87.00 Rp - gudang IFK
35 Haloperidole 5 mg 0 Tab Rp 54.00 Rp - gudang IFK
36 Hyoscine N butylbromide 150 Tab Rp 1,050.00 Rp 157,500 gudang IFK
37 Karbogliserin tetes telinga 10% (phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00 Rp - gudang IFK
38 Kalsium laktat (Kalk) 500 mg 0 Tab Rp 60.00 Rp - gudang IFK
39 Kalsium Glukonat inj 10 % 24 Ampul Rp 6,199.00 Rp 148,776 gudang IFK
40 Ketorolac inj 30Mg/MI 70 Ampul Rp 923.00 Rp 64,610 gudang IFK
41 Karbamazepin 200mg 0 tab Rp 216.00 Rp - gudang IFK
42 KAEN 3B 0 tab Rp 11,500.00 Rp - gudang IFK
43 Isosorbid Dinitrat tablet sublingual 5mg 190 Tab Rp 99.00 Rp 18,810 gudang IFK
44 Ibuprofen Syr 100mg/5ml 50 Btl Rp 2,339.00 Rp 116,950 gudang IFK
45 Ketokonazole Cream 21 Tube Rp 2,399.00 Rp 50,379 gudang IFK
46 Ketokonazole tablet 200mg 0 Tab Rp 260.00 Rp - gudang IFK
47 Kloramfenikol Suspensi 125 mg/ 5ml 66 Btl Rp 5,352.00 Rp 353,232 gudang IFK
48 Kodein 10 mg 0 Tab Rp 605.00 Rp - gudang IFK
50 Lidokain comp (Lidokain injeksi 2% (HCI) + epinefrin) 150 Ampul Rp 847.00 Rp 127,050 gudang IFK
51 Lidocain inj 2 % (HCL) 0 Ampul Rp 891.00 Rp - gudang IFK
52 Loratadine 3680 kap Rp 117.00 Rp 430,560 gudang IFK
56 Metoklopramid 10 mg 60 tab Rp 66.00 Rp 3,960 gudang IFK
57 Metoklopramid inj 732 Ampul Rp 1,983.00 Rp 1,451,556 gudang IFK
58 Methamizole Na Inj 0 Ampul Rp 3,045.00 Rp - gudang IFK
59 Metronidazol sirup 67 Btl Rp 3,765.00 Rp 252,255 gudang IFK
60 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp - gudang IFK
61 MGSO4 20 % 50 Ampul Rp 4,120.00 Rp 206,000 gudang IFK
62 Mikonazole kream 292 Tube Rp 1,900.00 Rp 554,800 gudang IFK
63 Nistatin drop 14 Btl Rp 11,750.00 Rp 164,500 gudang IFK
64 Nistatin Ovula 100.000 IU 95 tab Rp 550.00 Rp 52,250 gudang IFK
65 Natrium Diklofenak 25 mg 0 tab Rp 109.00 Rp - gudang IFK
66 N-Asetilsistein 0 Tab Rp 317.00 Rp - gudang IFK
67 Natrium Chloride 0,9 % ( NACL 0,9 %) 220 btl Rp 6,900.00 Rp 1,518,000 gudang IFK
68 Oxytocin injeksi 0 Ampul Rp 1,248.00 Rp - gudang IFK
69 Omeprazole 20 mg 6340 Kap Rp 129.00 Rp 817,860 gudang IFK
70 Parasetamol syr 0 btl Rp 1,160.00 Rp - gudang IFK
71 Phytomenadion inj 2mg/ml 84 Ampul Rp 3,900.00 Rp 327,600 gudang IFK
72 Phytomenadion 10 mg 160 Tab Rp 781.00 Rp 124,960 gudang IFK
73 Permetrin cream 0 Tube Rp 11,466.00 Rp - gudang IFK
74 Ranitidin tablet 150 mg 590 tab Rp 85.00 Rp 50,150 gudang IFK
75 Ranitidin injeksi 0 Ampul Rp 858.00 Rp - gudang IFK
76 Salbutamol 4 mg 0 Tab Rp 67.00 Rp - gudang IFK
77 Salep 2-4 8 Pot Rp 1,475.00 Rp 11,800 gudang IFK
80 Siprofloksasin 500 mg 0 Tab Rp 260.00 Rp - gudang IFK
81 Sianocbalamin (B12) 0 Tab Rp 44.00 Rp - gudang IFK
82 Sianocobalamin ( Vitamin B12) Injeksi 500 mcg 98 Ampul Rp 1,066.00 Rp 104,468 gudang IFK
83 SABU ( Serum Anti Bisa Ular) 2 Vial Rp 517,132.00 Rp 1,034,264 gudang IFK
84 Tablet tambah darah 0 tab Rp 255.00 Rp - gudang IFK
85 USG GEL 3 Btl Rp 18,858.33 Rp 56,575 gudang IFK
86 VAR 0 Vial Rp 153,000.00 Rp - gudang IFK
87 Vit. B.Complex 2330 Tab Rp 60 Rp 139,800 gudang IFK
88 Zink 20 mg tab 0 Tab Rp 253.00 Rp - gudang IFK
89 Zink syr 0 Btl Rp 2,489.00 Rp - gudang IFK
BMHP 0
90 Catgut chromic 3/0 +jarum Bulat (*optime*) 36 Pcs Rp 68,090.00 Rp 2,451,240 gudang IFK
91 Disposable syringe 3 cc 1100 Pcs Rp 818.00 Rp 899,800 gudang IFK
92 Disposable syringe 10 cc 200 Pcs Rp 1,100.00 Rp 220,000 gudang IFK
95 Handscoond steril no 6,5 281 Pasang Rp 13,563.00 Rp 3,811,203 gudang IFK
97 Handscoond steril no 7,5 0 Pasang Rp 13,563.00 Rp - gudang IFK
98 Hand Sanitizer / Handrub 500 ml 0 Btl Rp 68,200.00 Rp - gudang IFK
99 Handscrub 0 Btl Rp 115,800.00 Rp - gudang IFK
103 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp - gudang IFK
107 Surgical mask earloop 3ply / Masker 3700 Box Rp 1,373.14 Rp 5,080,618 gudang IFK
108 Under Pad Steril 200 pcs Rp 37,875.00 Rp 7,575,000 gudang IFK
DAK 2020
1 Acyclovir 400 mg 415 Tab Rp 454.00 Rp 188,410 gudang IFK
3 CTM 4 mg 0 tab Rp 26.00 Rp - gudang IFK
4 Cetrizine 10 mg 0 tab Rp 104.00 Rp - gudang IFK
5 Domperidone syr 0 Botol Rp 2,862.00 Rp - gudang IFK
6 Anti migren kombinasi ( ERGOTAMIN ) 339 tab Rp 212.00 Rp 71,868 gudang IFK
7 Gentamicine tetes mata 0 Botol Rp 26.00 Rp - gudang IFK
8 Kodein 10 mg 0 Tab Rp 657.00 Rp - gudang IFK
11 Paracetamol Drop 0 Botol Rp 7,646.00 Rp - gudang IFK
BMHP
12 Catgut chromic 3/0 +jarum Bulat (*optime*) 0 Pcs Rp 55,000.00 Rp - gudang IFK
13 Catgut chromic 3/0 +jarum Segitiga (*optime*) 0 Pcs Rp 62,000.00 Rp - gudang IFK
14 Catgut chromic 2/0 +jarum Bulat (*optime-R*) 42 Pcs Rp 44,000.00 Rp 1,848,000 gudang IFK
15 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00 Rp - gudang IFK
18 Handscoond steril no 8 49 Pasang Rp 13,178.00 Rp 645,722 gudang IFK
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp - gudang IFK
22 Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00 Rp - gudang IFK
23 Umbilical Cord Klem 0 Pcs Rp 1,495.00 Rp - gudang IFK
DAU 2020
1 Aqua pro injeksi 20 ml 0 ampul Rp 2,860.00 Rp - gudang IFK
2 Hyoscine N butylbromide 10 mg inj 0 Ampul Rp 9,900.00 Rp - gudang IFK
3 Natrium Chloride 0,9 % ( NACL 0,9 %) 0 btl Rp 6,840.00 Rp - gudang IFK
4 Propylthiouracyl 100 mg tablet 220 Tab Rp 733.00 Rp 161,260 gudang IFK
5 Ringer Laktat (RL) 0 btl Rp 7,150.00 Rp - gudang IFK
P 2020
1 Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01 Rp - gudang IFK
2 Ambroxol Tablet 30 mg 0 Tab Rp 110.00 Rp - gudang IFK
3 Bisakodil Suppo 0 Suppo Rp 23,475.00 Rp - gudang IFK
4 Bisakodil ( LAXANA) 0 Tab Rp 367.00 Rp - gudang IFK
Kombinasi Tetes Mata (Deksametason, Neomisin Sulfat, Polimiksin B
6 0 Botol Rp 14,900.00 Rp - gudang IFK
Sulfat ) ALLETROL COMPOSITUM
7 Obat batuk pilek anak kombinasi GG ( Dextrofen) 0 Botol Rp 12,900.00 Rp - gudang IFK
8 Obat flu kombinasi ( pseudoephedrin Hcl, Tripolidin Hcl ) FLUTROP 0 tab Rp 600.00 Rp - gudang IFK
9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00 Rp - gudang IFK
10 Hemafort 0 Tab Rp 820.00 Rp - gudang IFK
DAK 2019
1 Acyclovir 400 mg 0 Tab Rp 425.00 Rp - gudang IFK
2 Alprazolam 0,5 mg 0 tab Rp 88.00 Rp - gudang IFK
3 Cefadroxil sirup kering 125mg/5ml 0 btl Rp 4,360.00 Rp - gudang IFK
4 Diazepam 5 mg / 2,5 ml ( STESOLID ) Rektal 0 Tube Rp 14,459.00 Rp - gudang IFK
5 Kotrimoxazole syr 0 btl Rp 2,052.00 Rp - gudang IFK
6 Metoklopramide 10 mg 0 tab Rp 83.00 Rp - gudang IFK
7 Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00 Rp - gudang IFK
8 Pirantel 125 mg 41 tab Rp 331.00 Rp 13,571 gudang IFK
9 Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00 Rp -
BMHP gudang IFK
10 Alat Suntik 5 ml 1000 pcs Rp 1,600 Rp 1,600,000 gudang IFK
14 urine bag 75 pcs Rp 1,848.00 Rp 138,600
PENUNJANG 2019 gudang IFK
1 Gentamicin salep kulit 0 tube Rp 2,640.00 Rp - gudang IFK
2 Loperamide 520 Tab Rp 198.00 Rp 102,960 gudang IFK
3 Multivitamin syr anak ( Becefort ) 0 Botol Rp 17,365.70 Rp - gudang IFK
4 Anti diare kombinasi (Kaolin Pektin) sirup (Guanistrep Sirup) 52 btl Rp 3,850.00 Rp 200,200 gudang IFK
BG 2019
1 Articulating Paper 0 Pcs Rp 242,000.00 Rp - gudang IFK
2 Cotton roll medium 0 Pack Rp 85,800.00 Rp - gudang IFK
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp - gudang IFK
4 Pehacain 0 Ampul Rp 3,113.0495 Rp - gudang IFK
DAK 2018
1 Diazepam 5 mg 0 Tab Rp 109.00 Rp - gudang IFK
2 HCT 25 mg 0 tab Rp 178.00 Rp - gudang IFK
3 Nistatin 100.000 IU 0 tab Rp 645.00 Rp - gudang IFK
BMHP
4 Blood Lancet 0 Pcs Rp 167.509 Rp - gudang IFK
5 Plaster ( Hifafix ) 0 Roll Rp 29,642.86 Rp - gudang IFK
Penunjang 2017
BMHP
1 Jarum Jahit Segitiga 0 pcs Rp 22,000.00 Rp - gudang IFK
DAU 2017
BMHP
1 Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 0 Pcs Rp 46,187.44 Rp - gudang IFK
DAK 2017
1 Diltiazem 30 mg 0 tab Rp 128.00 Rp - gudang IFK
BMHP
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 25 Bks Rp 14,375.00 Rp 359,375 gudang IFK
2 Kasa 4mx5cm 0 Roll Rp 862.50 Rp - gudang IFK
APBD 2016
BMHP 2016
1 Infus set anak (Aximed) 50 pcs Rp 6,222.00 Rp 311,100 gudang IFK
DAU 2009
1 KAPAS PEMBALUT / ABSORBEN 250 GRAM 8 roll/bungkus Rp 11,914 Rp 95,312 gudang IFK
TOTAL 97,943.00 Rp 89,475,958.20
Mengetahui Binawara, 30 September 2022


NIP. 19701001 199102 2 002 NIP. 19890825 201101 2 011
: PUSKESMAS PERAWATAN LASUNG
Kuasa Pengguna Barang
pengguna barang :
Kode Rekening :
Stok Awal
Nama
No Jumlah Satuan Harga Satuan No Penyedia
Obat
Total harga
1 2
BMHP
Program HIV
1 Safety box 25 IDR Rp 16,666.00 Rp 416,650.00
Plesterin
2 Bulat non 3 Kotak Rp 40,187.50 Rp 120,562.50
woven
Vacum Tube
3 sterile, 1300 Pcs Rp 1,160.00 Rp 1,508,000.00
plastic, K3
EDTA
surgical
4 Gloves no. 7, 0 Pcs Rp 13,178.00 Rp -
5
surgical
5 Gloves no. 8 0 Pcs Rp 13,178.00 Rp -
6 Vacutainer 550 Pcs Rp 132.00 Rp 72,600.00

Needle
BMHP
Program TB
1 Larutan Zhihi 0 Paket Rp 274,362.00 Rp -

Neeisen
2 Sputum Pot 0 Biji Rp 3,137.00 Rp -

3 Object Glass 0 box @ 72 pcs Rp 23,860.08 Rp -
Frosted 7105
DAK 22
Allupurinol
1
100 mg
1000 Tab Rp 89.00 Rp 89,000
Amlodipine
2
10 mg
5050 Tab Rp 74.67 Rp 377,084
Amlodipine 5
3 mg 610 Tab Rp 55.00 Rp 33,550 IFK
Amoxicillin
Trihydrate /
Pehamoxiil
4
Forte 500 mg
2000 Tab Rp 231.00 Rp 462,000 IFK
(hexapram
Jaya )
Ambroxol
5 sirup 15 0 Btl Rp 4,800.00 Rp - IFK
mg/5 ml
Asam
6 Traneksamat 290 Tab Rp 1,927.00 Rp 558,830
500 mg
Asam folat
7
tab 1 mg
1000 Tab Rp 61.00 Rp 61,000 IFK
Asam
8
Mefenamat
0 tab Rp 117.00 Rp - IFK
9 Antasida syr 276 Btl Rp 1,756.00 Rp 484,656 IFK
Antasida
10 Doen I Tablet 2040 tab Rp 54.00 Rp 110,160 IFK
Kunyah
Anti
11 Hemoroid 18 Suppo Rp 3,260.00 Rp 58,680 IFK
komb. Supp
Captopril 25
12
mg
Cetrizine 10
13
mg
2400 tab Rp 52.47 Rp 125,928
Ciprofloxacin
14
500 mg
270 tab Rp 260.00 Rp 70,200 IFK
Dexamethas
15 one 0,5mg 0 Tablet Rp 106.00 Rp - IFK
Dimenhidrin
16 at 50 mg 990 tab Rp 109.00 Rp 107,910
Fenol gliserol
17 TT 10 % 46 Btl Rp 3,300.00 Rp 151,800 IFK
Glimepirid 2
18
mg
1440 Tab Rp 123.00 Rp 177,120
Hidrokortiso
19
ne cream
16 Tube Rp 2,325.00 Rp 37,200 IFK
Haloperidole
20
5 mg
0 Tab Rp 54.00 Rp - IFK
Ibuprofen
21
400mg
965 Tab Rp 210.00 Rp 202,650 IFK
22 Kalk 0 Tablet Rp 60.00 Rp - IFK
Ketokonazol
23
200mg
244 Tab Rp 260.00 Rp 63,440
Klorfeniram
24 in maleat 0 Tab Rp 86.00 Rp - IFK
(CTM) 4 mg
Kodein 10
25
mg
Lansoprazole
26
30 mg
670 Kap Rp 278.00 Rp 186,260
Metformin
27
HCL 500 mg
8600 tab Rp 77.00 Rp 662,200
Metilprednis
28 olon tablat 4 0 tab Rp 102.00 Rp -
mg
Metronidazo
29
l 500mg
Multivitami
n sirup
30
anak
0 Btl Rp 7,400.00 Rp - IFK
(Novakid)
Novatusin
31
syr
57 Btl Rp 8,200.00 Rp 467,400
N-
32 Asetilsistein 0 Kapsule Rp 319.87 Rp - IFK
200mg
Natrium
33 Diklofenak 0 Tablet Rp 109.00 Rp - IFK
50 mg
Omeprazole
34 inj 144 Ampl Rp 5,346.00 Rp 769,824 IFK
Paracetamol
35
Drop
34 Drop Rp 5,204.00 Rp 176,936
Paracetamol
36
syr
226 Btl Rp 1,160.00 Rp 262,160 IFK
Paracetam
37
ol 500 mg
Scabimite
38
cream
8 Tube Rp 11,466.00 Rp 91,728 IFK
Povidon
39 iodida 10 % 16 Btl Rp 4,182.00 Rp 66,912
30 ml
Povidon
40 iodida 10 % 16 Btl Rp 6,683.00 Rp 106,928
60 ml
Povidon
41 iodida 10 % 8 Btl Rp 23,132.00 Rp 185,056
300 ml
42 Rivanol 15 Btl Rp 7,221.00 Rp 108,315
Ringer Laktat
43
(RL)
180 Btl Rp 7,703.00 Rp 1,386,540 IFK
Salbutamol 2
44 mg 450 Tab Rp 51.00 Rp 22,950 IFK
Salbutamol 4
45 mg 930 Tab Rp 67.00 Rp 62,310 IFK
Salbutamol
46 inhaler 0 Ampul Rp 22,200.00 Rp - IFK
48 USG GEL 5 pcs Rp 16,632.00 Rp 83,160

49 Vitamin B1 1800 tab Rp 173.00 Rp 311,400
BMHP
52 Alkohol 70% 36 Btl Rp 3,256.00 Rp 117,216

100 mL
53 Alkohol 70% 11 Btl Rp 23,595.00 Rp 259,545

1000 mL
Disposable
54
syringe 1 cc
700 pcs Rp 1,045.00 Rp 731,500 IFK
Disposable
55 syringe 3 cc 0 pcs Rp 825.00 Rp - IFK
Handscoon
56
non steril L
900 pcs Rp 1,252.08 Rp 1,126,872
Handscoon
57
non steril M
1000 pcs Rp 1,252.08 Rp 1,252,080
Handscoon
58
non steril S
0 pcs Rp 1,252.08 Rp - IFK
Infuset
Dewasa
59
( Troge
30 pcs Rp 26,062.00 Rp 781,860
Hamburg )
IV.Chateter
60
No.18 G
100 pcs Rp 26,418.00 Rp 2,641,800
IV.Chateter
61
No.20 G
0 pcs Rp 26,418.00 Rp -
IV.Chateter
62
No.22 G
0 pcs Rp 26,418.00 Rp -
IV.Chateter
63
No.24 G
50 pcs Rp 26,418.00 Rp 1,320,900
IV.Chateter
64
No.26 G
200 pcs Rp 27,639.00 Rp 5,527,800
65 Kasa 16 x 16 99 pcs Rp 3,541.00 Rp 350,559
66 Kasa 40x80 10 pcs Rp 91,045.00 Rp 910,450
Plaster Putih
67 5x5 9 pcs Rp 32,190.00 Rp 289,710 IFK
( Farmafix )
Plester Putih
68
5x2
12 pcs Rp 21,638.40 Rp 259,661 IFK
69 Rivanol 15 Btl Rp 7,221.00 Rp 108,315

Umbilical
70
Cord Klem
150 pcs Rp 2,070.00 Rp 310,500
BG 2021
Bahan
1 0 Syringe Rp 356,400.00 Rp -
tambal sinar
2 Cairan 0 Pot Rp 391,500.00 Rp -

bonding
Cairan etsa /
3 Etching 0 Pcs Rp 67,500.00 Rp -
liquid
DAU 2021
Multivitamin
Btl isi @ 30
1 Ibu Hamil 0 Rp 45,000.00 Rp -
kapsul
OMEGA 3
BMHP
2 Disposable 0 Pcs Rp 1,361.00 Rp -

syringe 1 cc
3 Sarung 0 Pcs Rp 1,712.53 Rp -

Tangan Uk. S
Sarung
4 Tangan Uk. 0 Pcs Rp 1,710.13 Rp -
M
P 21
Acyclovir
1 65 Tube Rp 4,400.00 Rp 286,000
Cream
2 Bedak Salisil 0 Wadah Rp 7,700.00 Rp -
3 Bicombin inj 0 Ampul Rp 6,600.00 Rp -
Cefadroxil
4 790 Kap Rp 880.00 Rp 695,200
500 mg
5 CPZ 100mg 0 tab Rp 495.00 Rp - IFK
Digoxin 0,5
6 480 Tab Rp 198.00 Rp 95,040
mg
Diazepam
larutan
7 rektal 6 Suppo Rp 30,800.00 Rp 184,800
5mg/2,5ml
8 Eflin 0 Tab Rp 1,413.50 Rp -
9 Furosemid 0 Tab Rp 275.00 Rp -

10 Guaiafenesin 0 tab Rp 147.99 Rp -
(GG) 100 mg
Ibuprofen
11 0 Tab Rp 275.00 Rp -
200mg
12 Kloramfenik 90 Kap Rp 770.00 Rp 69,300

ol 250 mg
Lexartans
(as.
13 0 Tab Rp 1,650.00 Rp -
Traneksamat
)
Meloxicam
14 0 Tab Rp 385.00 Rp -
7,5 mg
15 Novastan syr 77 Btl Rp 11,000.00 Rp 847,000
16 Nifedipine 20 Tab Rp 220.00 Rp 4,400
17 Neo Diaform 2000 Tab Rp 286.00 Rp 572,000
Oxytetracycli
18 ne Salep 95 Tube Rp 4,950.00 Rp 470,250
Kulit 3%
19 OBH Plus 0 Btl Rp 12,100.00 Rp -

Paracetamol
20 2890 tab Rp 275.00 Rp 794,750
500 mg
21 Pehavral 4740 tab Rp 1,045.00 Rp 4,953,300
Reco Salep
Mata
22 38 Tube Rp 6,600.00 Rp 250,800
( Chloamphe
nicol)
Reco Tetes
Telinga
23 (Chloramphe 88 Btl Rp 11,000.00 Rp 968,000
nicol)
24 Skincol Gel 1 Tube Rp 148,500.00 Rp 148,500
25 Visoprin 50 Btl Rp 72,600.00 Rp 3,630,000
DAK 2021
Amoxicillin
Trihydrate /
1 Pehamoxiil 335 Tab Rp 231.00 Rp 77,385
Forte 500 mg
(hexapram
Jaya )
Amoksisilin
2 sirup kering 242 Btl Rp 2,050.00 Rp 496,100
125mg/5ml
3 Amox icillin 130 Btl Rp 11,750.00 Rp 1,527,500

Drop
4 Allupurinol 1100 Tab Rp 89.00 Rp 97,900

100 mg

300 mg
Asam
6 Mefenamat 560 tab Rp 117.00 Rp 65,520
Amlodipine 5
7 0 Tab Rp 55.00 Rp -
mg
Amlodipine
8 10 mg 0 Tab Rp 74.00 Rp -
Ampisillin
serbuk
9 injeksi i.v 76 Vial Rp 9,900.00 Rp 752,400
1000 mg/
Vial
Antihemeroi
10 0 Suppo Rp 3,260.00 Rp -
d kombinasi
Antifungi
DOEN
kombinasi:
11 Asam 37 Botol Rp 3,637.00 Rp 134,569
Benzoat 3%
+ Asam
Salisilat 6%
Antasida
12 Doen I Tablet 0 Tab Rp 54.00 Rp -
Kunyah
Antasida
13 Doen 0 Botol Rp 1,756.00 Rp -
suspensi
Asam
14 askorbat / 3110 Tab Rp 46.00 Rp 143,060
Vit C 50 mg
Asam
15 Traneksamat 12 amp Rp 1,820.00 Rp 21,840
injeksi
Asam folat
16 2180 pcs Rp 61.00 Rp 132,980
tab 1 mg
Asetosal 80
17
mg
200 Tab Rp 89.00 Rp 17,800 IFK
Aqua pro
18
injeksi 25 ml
0 Tab Rp 2,650.00 Rp - IFK
Betahistine 6
19 mg 0 Tab Rp 92.00 Rp -
20 Betamethaso 0 Tab Rp 1,540.00 Rp -

n cream
Bisakodil
21 49 Suppo Rp 5,085.00 Rp 249,165
Suppo
22 Bisakodil 5 300 Tab Rp 5,085.00 Rp 1,525,500

mg
23 Captopril 0 tab Rp 68.00 Rp -

12,5 mg
24 Cetrizine syr 128 Botol Rp 2,215.00 Rp 283,520
Cefotaxim
25 0 Vial Rp 3,050.00 Rp -
Injeksi
26 Diazepam inj 0 Ampul Rp 1,545.00 Rp -

5 mg / 2 ml
Dexamethas
27
one injeksi
175 Ampul Rp 968.00 Rp 169,400 IFK
Dextrosa 10
28 0 Botol Rp 7,200.00 Rp -
%
29 Doksisiklin 500 Tab Rp 289.00 Rp 144,500
30 Domperidon 131 Botol Rp 2,401.00 Rp 314,531

e syr
Eritromisin
31 sirup 200 mg 54 Botol Rp 7,436.00 Rp 401,544
32 Epinephrine 6 Ampul Rp 1,740.00 Rp 10,440
Furosemid
Injeksi
33 i.v./i.m 69 Ampul Rp 969.00 Rp 66,861
10mg/ml
34 Glukosa 79 btl Rp 7,363.00 Rp 581,677

Infus D5%
35 Glibenklamid 0 Tab Rp 87.00 Rp -

e 5 mg
36 Haloperidole 0 Tab Rp 54.00 Rp -

5 mg
Hyoscine N
37 butylbromid 150 Tab Rp 1,050.00 Rp 157,500
e
Karbogliserin
tetes telinga
38 10% (phenol 0 Botol Rp 3,300.00 Rp -
gliserol tts.
Telinga)
Kalsium
39 laktat (Kalk) 0 Tab Rp 60.00 Rp -
500 mg
Kalsium
40 Glukonat inj 24 Ampul Rp 6,199.00 Rp 148,776
10 %
Ketorolac inj
41
30Mg/MI
70 Ampul Rp 923.00 Rp 64,610 IFK
42 Karbamazepi 0 tab Rp 216.00 Rp -

n 200mg
43 KAEN 3B 0 tab Rp 11,500.00 Rp - IFK
Isosorbid
Dinitrat
44 tablet 190 Tab Rp 99.00 Rp 18,810
sublingual
5mg
Ibuprofen
45 Syr 50 Btl Rp 2,339.00 Rp 116,950
100mg/5ml
Ketokonazol
46 21 Tube Rp 2,399.00 Rp 50,379
e Cream
Ketokonazol
47 e tablet 0 Tab Rp 260.00 Rp -
200mg
Kloramfenik
48 ol Suspensi 66 Btl Rp 5,352.00 Rp 353,232
125 mg/ 5ml
Kodein 10
49 0 Tab Rp 605.00 Rp -
mg
50 Lansoprazole 0 kap Rp 278.00 Rp -

30 mg
Lidokain
comp
51 (Lidokain 150 Ampul Rp 847.00 Rp 127,050
injeksi 2%
(HCI) +
epinefrin)
52 Lidocain inj 2 0 Ampul Rp 891.00 Rp -
% (HCL)
53 Loratadine 3680 kap Rp 117.00 Rp 430,560
54 Metformin 250 tab Rp 77.00 Rp 19,250

HCL 500 mg
Metilprednis
mg
Metilprednis
mg
Metoklopra
57
mid 10 mg
60 tab Rp 66.00 Rp 3,960 IFK
58 Metoklopra 732 Ampul Rp 1,983.00 Rp 1,451,556

mid inj
Methamizole
59 0 Ampul Rp 3,045.00 Rp -
Na Inj
Metronidazo
60 l sirup 67 Btl Rp 3,765.00 Rp 252,255
61 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp -
62 MGSO4 20 % 50 Ampul Rp 4,120.00 Rp 206,000
Mikonazole
63 292 Tube Rp 1,900.00 Rp 554,800
kream
64 Nistatin drop 14 Btl Rp 11,750.00 Rp 164,500
Nistatin
65 Ovula 95 tab Rp 550.00 Rp 52,250
100.000 IU
Natrium
66 Diklofenak 0 tab Rp 109.00 Rp -
25 mg
67 N- 0 Tab Rp 317.00 Rp -
Asetilsistein
Natrium
Chloride 0,9
68
% ( NACL 0,9
220 btl Rp 6,900.00 Rp 1,518,000 IFK
%)
69 Oxytocin 0 Ampul Rp 1,248.00 Rp -

injeksi
Omeprazole
70
20 mg
6340 Kap Rp 129.00 Rp 817,860 IFK
Parasetamol
71 syr 0 btl Rp 1,160.00 Rp -
Phytomenadi
72 on inj 84 Ampul Rp 3,900.00 Rp 327,600
2mg/ml
73 Phytomenadi 160 Tab Rp 781.00 Rp 124,960

on 10 mg
Permetrin
74 0 Tube Rp 11,466.00 Rp -
cream
Ranitidin
75 tablet 150 590 tab Rp 85.00 Rp 50,150
mg
76 Ranitidin 0 Ampul Rp 858.00 Rp -

injeksi
77 Salbutamol 4 0 Tab Rp 67.00 Rp -

mg
Salbutamol
nebulizer
78
(Salbutamo
0 Btl Rp 5,400.00 Rp - IFK
l Sulfate )
79 Salep 2-4 8 Pot Rp 1,475.00 Rp 11,800
80 Simvastatin 500 tab Rp 73.00 Rp 36,500

10 mg
Simvastatin
81 6660 tab Rp 73.00 Rp 486,180
20 mg
82 Siprofloksasi 0 Tab Rp 260.00 Rp -

n 500 mg
83 Sianocbalami 0 Tab Rp 44.00 Rp -

n (B12)
Sianocobala
min
84 ( Vitamin 98 Ampul Rp 1,066.00 Rp 104,468 IFK
B12) Injeksi
500 mcg
SABU
85 ( Serum Anti 2 Vial Rp 517,132.00 Rp 1,034,264
Bisa Ular)
Tablet
86 tambah 0 tab Rp 255.00 Rp -
darah
87 USG GEL 3 Btl Rp 18,858.33 Rp 56,575
88 VAR 0 Vial Rp 153,000.00 Rp -
Vit.
89
B.Complex
2330 Tab Rp 60 Rp 139,800 IFK
90 Zink 20 mg 0 Tab Rp 253.00 Rp -

tab
91 Zink syr 0 Btl Rp 2,489.00 Rp -
BMHP 0
Catgut
92 chromic 3/0 36 Pcs Rp 68,090.00 Rp 2,451,240
+jarum Bulat
(*optime*)
93 Disposable 1100 Pcs Rp 818.00 Rp 899,800

syringe 3 cc
94 Disposable 200 Pcs Rp 1,100.00 Rp 220,000

syringe 10 cc
95 Folly 10 pcs Rp 11,132.00 Rp 111,320

Catheter 18
96 Handscoond 100 Pasang Rp 13,563.00 Rp 1,356,300

steril no 6

steril no 6,5

steril no 7
99 Handscoond 0 Pasang Rp 13,563.00 Rp -

steril no 7,5
Hand
100 Sanitizer / 0 Btl Rp 68,200.00 Rp -
Handrub 500
ml
101 Handscrub 0 Btl Rp 115,800.00 Rp -
Infus Set
102 0 pcs Rp 7,128.00 Rp -
Dewasa
IV.Chateter
103 No.18 G 50 pcs Rp 25,487.00 Rp 1,274,350
104 Kasa 4 x 10 230 pcs Rp 2,176.72 Rp 500,647
105 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp -
Scalpet
106
Blades no.10
100 Pcs Rp 618.70 Rp 61,870 IFK
107 Scalpet 98 Pcs Rp 618.68 Rp 60,631

Blades no.11
Scalpet
108 Blades no.15 79 Pcs Rp 618.71 Rp 48,878
Surgical
mask
109 earloop 3700 Box Rp 1,373.14 Rp 5,080,618
3ply /
Masker
Under Pad
110 200 pcs Rp 37,875.00 Rp 7,575,000
Steril
DAK 2020
1 Acyclovir 415 Tab Rp 454.00 Rp 188,410

400 mg
2 Betahistine 6 0 Tab Rp 119.00 Rp -

mg
3 CTM 4 mg 0 tab Rp 26.00 Rp -
Cetrizine 10
4 0 tab Rp 104.00 Rp -
mg
5 Domperidon 0 Botol Rp 2,862.00 Rp -

e syr
6 Anti migren 339 tab Rp 212.00 Rp 71,868

kombinasi
( ERGOTAMI
N)
Gentamicine
7 0 Botol Rp 26.00 Rp -
tetes mata
Kodein 10
8 0 Tab Rp 657.00 Rp -
mg

30 mg
Metilprednis
mg
11 Paracetamol 0 Botol Rp 7,646.00 Rp -

Drop
BMHP
Catgut
chromic 3/0
12 0 Pcs Rp 55,000.00 Rp -
+jarum Bulat
(*optime*)
Catgut
chromic 3/0
13 +jarum 0 Pcs Rp 62,000.00 Rp -
Segitiga
(*optime*)
Catgut
chromic 2/0
14 +jarum Bulat 42 Pcs Rp 44,000.00 Rp 1,848,000
(*optime-
R*)
Catgut plain
3/0 + jarum
15 Segitiga 0 Pcs Rp 71,000.00 Rp -
(*Advantime
*)
Feeding
16 0 pcs Rp 8,407.00 Rp -
Tube 14
17 Feeding 0 pcs Rp 8,407.00 Rp -

Tube 16
Handscoond
18 49 Pasang Rp 13,178.00 Rp 645,722
steril no 8
19 IV.Chateter 0 pcs Rp 23,100.00 Rp -

No.20 G
IV.Chateter
20 0 pcs Rp 23,100.00 Rp -
No.22 G
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp -
Silk 2/0 +
22 jarum 1/2 25 0 Pcs Rp 32,500.00 Rp -
mm 75 cm
Umbilical
23 0 Pcs Rp 1,495.00 Rp -
Cord Klem
DAU 2020
Aqua pro
1 0 ampul Rp 2,860.00 Rp -
injeksi 20 ml
Hyoscine N
2 butylbromid 0 Ampul Rp 9,900.00 Rp -
e 10 mg inj
Natrium
Chloride 0,9
3 % ( NACL 0,9 0 btl Rp 6,840.00 Rp -
%)
Propylthiour
4 acyl 100 mg 220 Tab Rp 733.00 Rp 161,260
tablet
Ringer Laktat
5 0 btl Rp 7,150.00 Rp -
(RL)
P 2020
Ambroxol
1 sirup 15 0 Btl Rp 3,250.01 Rp -
mg/5 ml
Ambroxol
2 0 Tab Rp 110.00 Rp -
Tablet 30 mg
3 Bisakodil 0 Suppo Rp 23,475.00 Rp -

Suppo
4 Bisakodil 0 Tab Rp 367.00 Rp -

( LAXANA)
Guaiafenesin
5 0 tab Rp 175.00 Rp -
(GG) 100 mg
Kombinasi
Tetes Mata
(Deksametas
on, Neomisin
6 Sulfat, 0 Botol Rp 14,900.00 Rp -
Polimiksin B
Sulfat )
ALLETROL
COMPOSITU
M
Obat batuk
pilek anak
7 kombinasi 0 Botol Rp 12,900.00 Rp -
GG
( Dextrofen)
Obat flu
kombinasi
( pseudoeph
8 0 tab Rp 600.00 Rp -
edrin Hcl,
Tripolidin Hcl
) FLUTROP
Salbutamol
9 nebulizer / 0 Flash Rp 10,000.00 Rp -
Ventolin
Nebulizer
10 Hemafort 0 Tab Rp 820.00 Rp -

DAK 2019
1 Acyclovir 0 Tab Rp 425.00 Rp -

400 mg
Alprazolam
2 0 tab Rp 88.00 Rp -
0,5 mg
Cefadroxil
3 sirup kering 0 btl Rp 4,360.00 Rp -
125mg/5ml
Diazepam 5
4 mg / 2,5 ml 0 Tube Rp 14,459.00 Rp -
( STESOLID )
Rektal
5 Kotrimoxazol 0 btl Rp 2,052.00 Rp -

e syr
6 Metoklopra 0 tab Rp 83.00 Rp -

mide 10 mg
7 Oxtretrasikli 0 tube Rp 2,600.00 Rp -
n Salep Mata
Pirantel 125
8 41 tab Rp 331.00 Rp 13,571
mg
Piridoksin
9 HCL ( Vit. B 6 0 tab Rp 141.00 Rp -
) 10 mg
BMHP
10 Alat Suntik 5 1000 pcs Rp 1,600 Rp 1,600,000

ml
11 Folly 20 pcs Rp 11,891.00 Rp 237,820

Catheter 14
12 Folly 10 pcs Rp 11,891.00 Rp 118,910

Catheter 16
Infus Set
13 0 pcs Rp 6,842.00 Rp -
Dewasa
PENUNJANG
2019
Gentamicin
1 0 tube Rp 2,640.00 Rp -
salep kulit
2 Loperamide 520 Tab Rp 198.00 Rp 102,960
Multivitamin
3 syr anak 0 Botol Rp 17,365.70 Rp -
( Becefort )
Anti diare
kombinasi
(Kaolin
4 52 btl Rp 3,850.00 Rp 200,200
Pektin) sirup
(Guanistrep
Sirup)
BG 2019
1 Articulating 0 Pcs Rp 242,000.00 Rp -

Paper
Cotton roll
2 0 Pack Rp 85,800.00 Rp -
medium
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp -
4 Pehacain 0 Ampul Rp 3,113.0495 Rp -

DAK 2018
1 Diazepam 5 0 Tab Rp 109.00 Rp -

mg
2 HCT 25 mg 0 tab Rp 178.00 Rp -
3 Nistatin 0 tab Rp 645.00 Rp -

100.000 IU
BMHP
4 Blood Lancet 0 Pcs Rp 167.509 Rp -
5 Plaster 0 Roll Rp 29,642.86 Rp -

( Hifafix )
Penunjang
2017
BMHP
Jarum Jahit
1 0 pcs Rp 22,000.00 Rp -
Segitiga
DAU 2017
BMHP
Silk 3/0 +
jarum 1/2 GT
1 0 Pcs Rp 46,187.44 Rp -
35 mm
( Sole)
DAK 2017
1 Diltiazem 30 0 tab Rp 128.00 Rp -

mg
BMHP
KAPAS
1 PEMBALUT / 25 Bks Rp 14,375.00 Rp 359,375
ABSORBEN
250 GRAM
Kasa
2 0 Roll Rp 862.50 Rp -
4mx5cm
APBD 2016
BMHP 2016
Infus set
1 anak 50 pcs Rp 6,222.00 Rp 311,100
(Aximed)
DAU 2009
KAPAS
PEMBALUT /
1 8 roll/bungkus Rp 11,914 Rp 95,312
ABSORBEN
250 GRAM
97,943.00 Rp 89,475,958.20
PENERIMAAN
LPLPO, BON
Dokumen Spesifikasi Barang

Kode Barang Nama Barang
Tanggal Nomor Nama NUSP
3 4 5 6 7 8
BMHP Program HIV
Safety box
Plesterin Bulat non

woven
Vacum Tube sterile,

plastic, K3 EDTA
surgical Gloves no. 7, 5
surgical Gloves no. 8
Vacutainer Needle
BMHP Program TB
Larutan Zhihi Neeisen
Sputum Pot
Object Glass Frosted
7105
DAK 22
Allupurinol 100 mg
Amlodipine 10 mg
B/442/1582/UPTD-
10/17/2022 IFK/X/2022 LPLPO Amlodipine 5 mg
B/442/1582/UPTD- Amoxicillin Trihydrate /

10/17/2022 IFK/X/2022 LPLPO Pehamoxiil Forte 500 mg
(hexapram Jaya )
B/442/1582/UPTD- Ambroxol sirup 15 mg/5

10/17/2022 LPLPO
IFK/X/2022 ml
Asam Traneksamat 500

mg
B/442/1582/UPTD-
10/17/2022 LPLPO Asam folat tab 1 mg
IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Asam Mefenamat
IFK/X/2022
B/442/1582/UPTD- LPLPO , Surat

17/10/2022 , IFK/X/2022 , Penyerahan Antasida syr
21/10/2022 B/442/1626-SPB/UPT Barang ( SPB )
D-IFK/X/2022
10/17/2022 B/442/1582/UPTD- LPLPO Antasida Doen I Tablet

IFK/X/2022 Kunyah
10/17/2022 B/442/1582/UPTD- LPLPO Anti Hemoroid komb.

IFK/X/2022 Supp
B/442/1582/UPTD-
10/17/2022 LPLPO Captopril 25 mg
IFK/X/2022
Cetrizine 10 mg
B/442/1582/UPTD-
10/17/2022 LPLPO Ciprofloxacin 500 mg
IFK/X/2022
Surat
B/442/1626/UPTD- Penyerahan
10/21/2022 Dexamethasone 0,5mg
IFK/X/2022 Barang ( SPB
)
Dimenhidrinat 50 mg
B/442/1582/UPTD-
10/17/2022 LPLPO Fenol gliserol TT 10 %
IFK/X/2022
Glimepirid 2 mg
10/17/2022 B/442/1582/UPTD- LPLPO Hidrokortisone cream

IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Haloperidole 5 mg
IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Ibuprofen 400mg
IFK/X/2022
Surat
10/21/2022 IFK/X/2022 Barang ( SPB
Kalk
)
Ketokonazol 200mg
B/442/1582/UPTD- Klorfeniramin maleat

10/17/2022 LPLPO
IFK/X/2022 (CTM) 4 mg
B/442/1582/UPTD-
10/17/2022 LPLPO Kodein 10 mg
IFK/X/2022
Lansoprazole 30 mg
Metformin HCL 500 mg
Metilprednisolon tablat
4 mg
B/442/1582/UPTD-
10/17/2022 LPLPO Metronidazol 500mg
IFK/X/2022
LPLPO ,
B/442/1582/UPTD- Surat
17/10/2022 , IFK/X/2022 , Multivitamin sirup
Penyerahan
21/10/2022 B/442/1626-SPB/UP Barang ( SPB anak (Novakid)
TD-IFK/X/2022
)
Novatusin syr
Surat
10/21/2022 N-Asetilsistein 200mg
)
Surat
B/442/1626/UPTD- Penyerahan Natrium Diklofenak 50
10/21/2022
IFK/X/2022 Barang ( SPB mg
)
B/442/1582/UPTD-
10/17/2022 LPLPO Omeprazole inj
IFK/X/2022
Paracetamol Drop
10/17/2022 B/442/1582/UPTD- LPLPO Paracetamol syr

IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Paracetamol 500 mg
IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Scabimite cream
IFK/X/2022
Povidon iodida 10 % 30
ml
ml

ml
Rivanol
10/17/2022 B/442/1582/UPTD- LPLPO Ringer Laktat (RL)

IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Salbutamol 2 mg
IFK/X/2022
B/442/1582/UPTD-
IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Salbutamol inhaler
IFK/X/2022
USG GEL
Vitamin B1
Vitamin B6
Vitamin B12
BMHP
Alkohol 70% 100 mL
Alkohol 70% 1000 mL
B/442/1582/UPTD-
10/17/2022 LPLPO Disposable syringe 1 cc
IFK/X/2022
B/442/1582/UPTD-
10/17/2022 IFK/X/2022 LPLPO Disposable syringe 3 cc
Handscoon non steril L
Handscoon non steril M
B/442/1582/UPTD-
10/17/2022 LPLPO Handscoon non steril S
IFK/X/2022
Infuset Dewasa ( Troge

Hamburg )
IV.Chateter No.18 G
IV.Chateter No.20 G
IV.Chateter No.22 G
IV.Chateter No.24 G
IV.Chateter No.26 G
Kasa 16 x 16
Kasa 40x80
B/442/1582/UPTD- Plaster Putih 5 x 5

10/17/2022 IFK/X/2022 LPLPO ( Farmafix )
B/442/1582/UPTD-
10/17/2022 LPLPO Plester Putih 5x2
IFK/X/2022
Rivanol
Umbilical Cord Klem
BG 2021
Bahan tambal sinar
Cairan bonding
Cairan etsa / Etching

liquid
DAU 2021
Multivitamin Ibu Hamil

OMEGA 3
BMHP
Disposable syringe 1 cc
Sarung Tangan Uk. S
Sarung Tangan Uk. M
P 21
Acyclovir Cream
Bedak Salisil
Bicombin inj
Cefadroxil 500 mg
B/442/1582/UPTD-
10/17/2022 LPLPO CPZ 100mg
IFK/X/2022
Digoxin 0,5 mg
Diazepam larutan rektal

5mg/2,5ml
Eflin
Furosemid
Guaiafenesin (GG) 100
mg
Ibuprofen 200mg
Kloramfenikol 250 mg
Lexartans (as.
Traneksamat)
Meloxicam 7,5 mg
Novastan syr
Nifedipine
Neo Diaform
Oxytetracycline Salep
Kulit 3%
OBH Plus
Paracetamol 500 mg
Pehavral
Reco Salep Mata

( Chloamphenicol)
Reco Tetes Telinga

(Chloramphenicol)
Skincol Gel
Visoprin
DAK 2021
Amoxicillin Trihydrate /
Pehamoxiil Forte 500 mg
(hexapram Jaya )
Amoksisilin sirup kering
125mg/5ml
Amox icillin Drop
Allupurinol 100 mg
Allupurinol 300 mg
Asam Mefenamat
Amlodipine 5 mg
Amlodipine 10 mg
Ampisillin serbuk injeksi

i.v 1000 mg/ Vial
Antihemeroid kombinasi
Antifungi DOEN
kombinasi: Asam
Benzoat 3% + Asam
Salisilat 6%
Antasida Doen I Tablet

Kunyah
Antasida Doen suspensi
Asam askorbat / Vit C 50

mg
Asam Traneksamat
injeksi
Asam folat tab 1 mg
B/442/1582/UPTD-
10/17/2022 LPLPO Asetosal 80 mg
IFK/X/2022
B/442/1582/UPTD-
10/17/2022 LPLPO Aqua pro injeksi 25 ml
IFK/X/2022
Betahistine 6 mg
Betamethason cream
Bisakodil Suppo
Bisakodil 5 mg
Captopril 12,5 mg
Cetrizine syr
Cefotaxim Injeksi
Diazepam inj 5 mg / 2 ml
10/17/2022 B/442/1582/UPTD- LPLPO Dexamethasone injeksi

IFK/X/2022
Dextrosa 10 %
Doksisiklin
Domperidone syr
Eritromisin sirup 200 mg
Epinephrine
Furosemid Injeksi
i.v./i.m 10mg/ml
Glukosa Infus D5%
Glibenklamide 5 mg
Haloperidole 5 mg
Hyoscine N
butylbromide
Karbogliserin tetes
telinga 10% (phenol
gliserol tts. Telinga)
Kalsium laktat (Kalk) 500

mg
Kalsium Glukonat inj 10

%
B/442/1582/UPTD-
10/17/2022 LPLPO Ketorolac inj 30Mg/MI
IFK/X/2022
Karbamazepin 200mg
B/442/1582/UPTD-
10/17/2022 LPLPO KAEN 3B
IFK/X/2022
Isosorbid Dinitrat tablet

sublingual 5mg
Ibuprofen Syr
100mg/5ml
Ketokonazole Cream
Ketokonazole tablet
200mg
Kloramfenikol Suspensi
125 mg/ 5ml
Kodein 10 mg
Lansoprazole 30 mg
Lidokain comp (Lidokain

injeksi 2% (HCI) +
epinefrin)
Lidocain inj 2 % (HCL)
Loratadine
4 mg
8 mg
10/17/2022 B/442/1582/UPTD- LPLPO Metoklopramid 10 mg

IFK/X/2022
Metoklopramid inj
Methamizole Na Inj
Metronidazol sirup
MGSO4 40 %
MGSO4 20 %
Mikonazole kream
Nistatin drop
Nistatin Ovula 100.000

IU
Natrium Diklofenak 25
mg
N-Asetilsistein
10/17/2022 B/442/1582/UPTD- LPLPO Natrium Chloride 0,9 % (

IFK/X/2022 NACL 0,9 %)
Oxytocin injeksi
Surat
10/21/2022 Omeprazole 20 mg
)
Parasetamol syr
Phytomenadion inj
2mg/ml
Phytomenadion 10 mg
Permetrin cream
Ranitidin tablet 150 mg
Ranitidin injeksi
Salbutamol 4 mg
10/17/2022 B/442/1582/UPTD- LPLPO Salbutamol nebulizer

IFK/X/2022 (Salbutamol Sulfate )
Salep 2-4
Simvastatin 10 mg
Simvastatin 20 mg
Siprofloksasin 500 mg
Sianocbalamin (B12)
Sianocobalamin
10/17/2022 B/442/1582/UPTD- LPLPO ( Vitamin B12) Injeksi
IFK/X/2022 500 mcg
SABU ( Serum Anti Bisa

Ular)
Tablet tambah darah
USG GEL
VAR
B/442/1582/UPTD-
10/17/2022 LPLPO Vit. B.Complex
IFK/X/2022
Zink 20 mg tab
Zink syr
BMHP
Catgut chromic 3/0
+jarum Bulat (*optime*)
Folly Catheter 18
Handscoond steril no 6
Handscoond steril no 6,5
Hand Sanitizer /
Handrub 500 ml
Handscrub
Infus Set Dewasa
IV.Chateter No.18 G
Kasa 4 x 10
Kasa 4 x 5
10/17/2022 B/442/1582/UPTD- LPLPO Scalpet Blades no.10

IFK/X/2022
Scalpet Blades no.11
Surgical mask earloop

3ply / Masker
Under Pad Steril
DAK 2020
Acyclovir 400 mg
Betahistine 6 mg
CTM 4 mg
Cetrizine 10 mg
Domperidone syr
Anti migren kombinasi

( ERGOTAMIN )
Gentamicine tetes mata
Kodein 10 mg
Lansoprazole 30 mg
4 mg
Paracetamol Drop
BMHP
Catgut chromic 3/0

Catgut chromic 3/0

+jarum Segitiga
(*optime*)
Catgut chromic 2/0

+jarum Bulat (*optime-
R*)
Catgut plain 3/0 + jarum

Segitiga (*Advantime*)
Feeding Tube 14
Feeding Tube 16
IV.Chateter No.20 G
IV.Chateter No.22 G
Kasa 16x16
Silk 2/0 + jarum 1/2 25

mm 75 cm
Umbilical Cord Klem
DAU 2020
Aqua pro injeksi 20 ml
Hyoscine N
butylbromide 10 mg inj
Natrium Chloride 0,9 % (

NACL 0,9 %)
Propylthiouracyl 100 mg
tablet
Ringer Laktat (RL)
P 2020
Ambroxol sirup 15 mg/5

ml
Ambroxol Tablet 30 mg
Bisakodil Suppo
Bisakodil ( LAXANA)

mg
(Deksametason,
Neomisin Sulfat,
Polimiksin B Sulfat )
ALLETROL
COMPOSITUM
Obat batuk pilek anak

kombinasi GG
( Dextrofen)
Obat flu kombinasi

( pseudoephedrin Hcl,
Tripolidin Hcl ) FLUTROP
Salbutamol nebulizer /
Ventolin Nebulizer
Hemafort
DAK 2019
Acyclovir 400 mg
Alprazolam 0,5 mg
Cefadroxil sirup kering

125mg/5ml
( STESOLID ) Rektal
Kotrimoxazole syr
Metoklopramide 10 mg
Oxtretrasiklin Salep
Mata
Pirantel 125 mg
Piridoksin HCL ( Vit. B 6 )

10 mg
BMHP
Alat Suntik 5 ml
Folly Catheter 14
Folly Catheter 16
Infus Set Dewasa
urine bag
PENUNJANG 2019
Gentamicin salep kulit
Loperamide
Multivitamin syr anak

( Becefort )
Anti diare kombinasi

(Kaolin Pektin) sirup
(Guanistrep Sirup)
BG 2019
Articulating Paper
Cotton roll medium
Eugenol
Pehacain
DAK 2018
Diazepam 5 mg
HCT 25 mg
Nistatin 100.000 IU
BMHP
Blood Lancet
Plaster ( Hifafix )
Penunjang 2017
BMHP
Jarum Jahit Segitiga
DAU 2017
BMHP
Silk 3/0 + jarum 1/2 GT

35 mm ( Sole)
DAK 2017
Diltiazem 30 mg
berita acara BMHP
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
Kasa 4mx5cm
APBD 2016
BMHP 2016
Infus set anak (Aximed)
DAU 2009
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
BUKU PENERIMAAN DAN PENGELUARAN PER
TAHUN 202
PENERIMAAN
LPLPO, BON
Spesifikasi Barang Harga Satuan Nilai Total

Jumlah Satuan Barang
Spesifikasi Nama Barang (Rp) (Rp)
9 10 11 12 13
BMHP Program HIV
Safety box IDR Rp 16,666.00 Rp -
Plesterin Bulat non woven Kotak Rp 40,187.50 Rp -
Vacum Tube sterile, plastic, K3 Pcs Rp 1,160.00 Rp -

EDTA
surgical Gloves no. 7, 5 Pcs Rp 13,178.00 Rp -
surgical Gloves no. 8 Pcs Rp 13,178.00 Rp -
Vacutainer Needle Pcs Rp 132.00 Rp -
BMHP Program TB
Larutan Zhihi Neeisen Paket Rp 274,362.00 Rp -
Sputum Pot Biji Rp 3,137.00 Rp -

Object Glass Frosted 7105 box @ 72 pcs Rp 23,860.08 Rp -
DAK 22
Allupurinol 100 mg Tab Rp 89.00 Rp -
Amlodipine 10 mg Tab Rp 74.67 Rp -
Amlodipine 5 mg 2000 Tab Rp 55.00 Rp 110,000.00
Pehamoxiil Forte 500 mg 3000 Tab Rp 231.00 Rp 693,000.00
(hexapram Jaya )
Ambroxol sirup 15 mg/5 ml 300 Btl Rp 4,800.00 Rp 1,440,000.00
Asam Traneksamat 500 mg Tab Rp 1,927.00 Rp -
Asam folat tab 1 mg 1000 Tab Rp 61.00 Rp 61,000.00
Asam Mefenamat 2000 tab Rp 117.00 Rp 234,000.00
Antasida syr 500 Btl Rp 1,756.00 Rp 878,000.00
Antasida Doen I Tablet Kunyah 1000 tab Rp 54.00 Rp 54,000.00
Anti Hemoroid komb. Supp 50 Suppo Rp 3,260.00 Rp 163,000.00
Captopril 25 mg 500 tab Rp 72.00 Rp 36,000.00
Cetrizine 10 mg tab Rp 52.47 Rp -

Ciprofloxacin 500 mg 1000 tab Rp 260.00 Rp 260,000.00
Dexamethasone 0,5mg 3000 Tablet Rp 106.00 Rp 318,000.00
Dimenhidrinat 50 mg tab Rp 109.00 Rp -
Fenol gliserol TT 10 % 96 Btl Rp 3,300.00 Rp 316,800.00
Glimepirid 2 mg Tab Rp 123.00 Rp -
Hidrokortisone cream 96 Tube Rp 2,325.00 Rp 223,200.00
Haloperidole 5 mg 200 Tab Rp 54.00 Rp 10,800.00
Ibuprofen 400mg 3000 Tab Rp 210.00 Rp 630,000.00
Kalk 5000 Tablet Rp 60.00 Rp 300,000.00
Ketokonazol 200mg Tab Rp 260.00 Rp -
Klorfeniramin maleat (CTM) 4

mg
1000 Tab Rp 86.00 Rp 86,000.00
Kodein 10 mg 300 Tab Rp 605.00 Rp 181,500.00
Lansoprazole 30 mg Kap Rp 278.00 Rp -
Metformin HCL 500 mg tab Rp 77.00 Rp -
Metilprednisolon tablat 4 mg tab Rp 102.00 Rp -
Metronidazol 500mg 1000 tab Rp 317.00 Rp 317,000.00

Multivitamin sirup anak
(Novakid)
600 Btl Rp 7,400.00 Rp 4,440,000.00
Novatusin syr Btl Rp 8,200.00 Rp -
N-Asetilsistein 200mg 1080 Kapsule Rp 319.87 Rp 345,459.60
Natrium Diklofenak 50 mg 3000 Tablet Rp 109.00 Rp 327,000.00
Omeprazole inj 100 Ampl Rp 5,346.00 Rp 534,600.00
Paracetamol Drop Drop Rp 5,204.00 Rp -
Paracetamol syr 200 Btl Rp 1,160.00 Rp 232,000.00
Paracetamol 500 mg 5000 Tab Rp 257.00 Rp 1,285,000.00
Scabimite cream 10 Tube Rp 11,466.00 Rp 114,660.00
Povidon iodida 10 % 30 ml Btl Rp 4,182.00 Rp -
Rivanol Btl Rp 7,221.00 Rp -
Ringer Laktat (RL) 300 Btl Rp 7,703.00 Rp 2,310,900.00
Salbutamol 2 mg 1000 Tab Rp 51.00 Rp 51,000.00
Salbutamol 4 mg 1000 Tab Rp 67.00 Rp 67,000.00
Salbutamol inhaler 10 Ampul Rp 22,200.00 Rp 222,000.00
USG GEL pcs Rp 16,632.00 Rp -

Vitamin B1 tab Rp 173.00 Rp -
BMHP
Alkohol 70% 100 mL Btl Rp 3,256.00 Rp -
Disposable syringe 1 cc 500 pcs Rp 1,045.00 Rp 522,500.00
Disposable syringe 3 cc 500 pcs Rp 825.00 Rp 412,500.00
Handscoon non steril L pcs Rp 1,252.08 Rp -
Handscoon non steril M pcs Rp 1,252.08 Rp -
Handscoon non steril S 1000 pcs Rp 1,252.08 Rp 1,252,080.00
Infuset Dewasa ( Troge Hamburg ) pcs Rp 26,062.00 Rp -
IV.Chateter No.18 G pcs Rp 26,418.00 Rp -
Kasa 16 x 16 pcs Rp 3,541.00 Rp -
Kasa 40x80 pcs Rp 91,045.00 Rp -
Plaster Putih 5 x 5 ( Farmafix ) 10 pcs Rp 32,190.00 Rp 321,900.00

Plester Putih 5x2 10 pcs Rp 21,638.40 Rp 216,384.00
Umbilical Cord Klem pcs Rp 2,070.00 Rp -
BG 2021
Bahan tambal sinar Syringe Rp 356,400.00 Rp -
Cairan bonding Pot Rp 391,500.00 Rp -
Cairan etsa / Etching liquid Pcs Rp 67,500.00 Rp -
DAU 2021
Multivitamin Ibu Hamil OMEGA 3 Btl isi @ 30 kapsul Rp 45,000.00 Rp -
BMHP
Disposable syringe 1 cc Pcs Rp 1,361.00 Rp -
Sarung Tangan Uk. S Pcs Rp 1,712.53 Rp -
Sarung Tangan Uk. M Pcs Rp 1,710.13 Rp -
P 21
Acyclovir Cream Tube Rp 4,400.00 Rp -
Bedak Salisil Wadah Rp 7,700.00 Rp -
Bicombin inj Ampul Rp 6,600.00 Rp -
Cefadroxil 500 mg Kap Rp 880.00 Rp -
CPZ 100mg 200 tab Rp 495.00 Rp 99,000.00
Digoxin 0,5 mg Tab Rp 198.00 Rp -

5mg/2,5ml Suppo Rp 30,800.00 Rp -
Eflin Tab Rp 1,413.50 Rp -
Furosemid Tab Rp 275.00 Rp -

Guaiafenesin (GG) 100 mg tab Rp 147.99 Rp -
Ibuprofen 200mg Tab Rp 275.00 Rp -
Kloramfenikol 250 mg Kap Rp 770.00 Rp -
Lexartans (as. Traneksamat) Tab Rp 1,650.00 Rp -
Meloxicam 7,5 mg Tab Rp 385.00 Rp -
Novastan syr Btl Rp 11,000.00 Rp -
Nifedipine Tab Rp 220.00 Rp -
Neo Diaform Tab Rp 286.00 Rp -
Oxytetracycline Salep Kulit 3% Tube Rp 4,950.00 Rp -
OBH Plus Btl Rp 12,100.00 Rp -
Paracetamol 500 mg tab Rp 275.00 Rp -
Pehavral tab Rp 1,045.00 Rp -
Reco Salep Mata

Tube Rp 6,600.00 Rp -
( Chloamphenicol)
Reco Tetes Telinga

(Chloramphenicol) Btl Rp 11,000.00 Rp -
Skincol Gel Tube Rp 148,500.00 Rp -
Visoprin Btl Rp 72,600.00 Rp -
DAK 2021
Pehamoxiil Forte 500 mg Tab Rp 231.00 Rp -
(hexapram Jaya )
Btl Rp 2,050.00 Rp -
125mg/5ml
Amox icillin Drop Btl Rp 11,750.00 Rp -
Asam Mefenamat tab Rp 117.00 Rp -

Vial Rp 9,900.00 Rp -
mg/ Vial
Antihemeroid kombinasi Suppo Rp 3,260.00 Rp -

Botol Rp 3,637.00 Rp -
Benzoat 3% + Asam Salisilat 6%
Antasida Doen I Tablet Kunyah Tab Rp 54.00 Rp -
Antasida Doen suspensi Botol Rp 1,756.00 Rp -
Asam askorbat / Vit C 50 mg Tab Rp 46.00 Rp -
Asam Traneksamat injeksi amp Rp 1,820.00 Rp -
Asam folat tab 1 mg pcs Rp 61.00 Rp -
Asetosal 80 mg 100 Tab Rp 89.00 Rp 8,900.00

Aqua pro injeksi 25 ml 240 Tab Rp 2,650.00 Rp 636,000.00
Betahistine 6 mg Tab Rp 92.00 Rp -
Betamethason cream Tab Rp 1,540.00 Rp -
Bisakodil Suppo Suppo Rp 5,085.00 Rp -
Bisakodil 5 mg Tab Rp 5,085.00 Rp -
Captopril 12,5 mg tab Rp 68.00 Rp -
Cetrizine syr Botol Rp 2,215.00 Rp -
Cefotaxim Injeksi Vial Rp 3,050.00 Rp -
Diazepam inj 5 mg / 2 ml Ampul Rp 1,545.00 Rp -
Dexamethasone injeksi 100 Ampul Rp 968.00 Rp 96,800.00
Dextrosa 10 % Botol Rp 7,200.00 Rp -
Doksisiklin Tab Rp 289.00 Rp -
Domperidone syr Botol Rp 2,401.00 Rp -
Eritromisin sirup 200 mg Botol Rp 7,436.00 Rp -
Epinephrine Ampul Rp 1,740.00 Rp -
Furosemid Injeksi i.v./i.m

10mg/ml Ampul Rp 969.00 Rp -
Glukosa Infus D5% btl Rp 7,363.00 Rp -
Glibenklamide 5 mg Tab Rp 87.00 Rp -
Haloperidole 5 mg Tab Rp 54.00 Rp -
Hyoscine N butylbromide Tab Rp 1,050.00 Rp -

(phenol gliserol tts. Telinga)
Kalsium laktat (Kalk) 500 mg Tab Rp 60.00 Rp -
Kalsium Glukonat inj 10 % Ampul Rp 6,199.00 Rp -
Ketorolac inj 30Mg/MI 100 Ampul Rp 923.00 Rp 92,300.00
Karbamazepin 200mg tab Rp 216.00 Rp -
KAEN 3B 40 tab Rp 11,500.00 Rp 460,000.00
Isosorbid Dinitrat tablet Tab Rp 99.00 Rp -

sublingual 5mg
Ibuprofen Syr 100mg/5ml Btl Rp 2,339.00 Rp -
Ketokonazole Cream Tube Rp 2,399.00 Rp -
Ketokonazole tablet 200mg Tab Rp 260.00 Rp -

5ml Btl Rp 5,352.00 Rp -
Kodein 10 mg Tab Rp 605.00 Rp -
Lansoprazole 30 mg kap Rp 278.00 Rp -
Lidokain comp (Lidokain injeksi Ampul Rp 847.00 Rp -

2% (HCI) + epinefrin)
Lidocain inj 2 % (HCL) Ampul Rp 891.00 Rp -
Loratadine kap Rp 117.00 Rp -
Metoklopramid 10 mg 100 tab Rp 66.00 Rp 6,600.00
Metoklopramid inj Ampul Rp 1,983.00 Rp -
Methamizole Na Inj Ampul Rp 3,045.00 Rp -
Metronidazol sirup Btl Rp 3,765.00 Rp -
MGSO4 40 % Ampul Rp 4,700.00 Rp -
MGSO4 20 % Ampul Rp 4,120.00 Rp -
Mikonazole kream Tube Rp 1,900.00 Rp -
Nistatin drop Btl Rp 11,750.00 Rp -
Nistatin Ovula 100.000 IU tab Rp 550.00 Rp -
Natrium Diklofenak 25 mg tab Rp 109.00 Rp -
N-Asetilsistein Tab Rp 317.00 Rp -

%) 100 btl Rp 6,900.00 Rp 690,000.00
Oxytocin injeksi Ampul Rp 1,248.00 Rp -
Omeprazole 20 mg 2000 Kap Rp 129.00 Rp 258,000.00
Parasetamol syr btl Rp 1,160.00 Rp -

Phytomenadion inj 2mg/ml Ampul Rp 3,900.00 Rp -
Phytomenadion 10 mg Tab Rp 781.00 Rp -
Permetrin cream Tube Rp 11,466.00 Rp -
Ranitidin tablet 150 mg tab Rp 85.00 Rp -
Ranitidin injeksi Ampul Rp 858.00 Rp -
Salbutamol 4 mg Tab Rp 67.00 Rp -
Salbutamol nebulizer
(Salbutamol Sulfate ) 100 Btl Rp 5,400.00 Rp 540,000.00
Salep 2-4 Pot Rp 1,475.00 Rp -
Simvastatin 10 mg tab Rp 73.00 Rp -
Siprofloksasin 500 mg Tab Rp 260.00 Rp -
Sianocbalamin (B12) Tab Rp 44.00 Rp -

Injeksi 500 mcg 100 Ampul Rp 1,066.00 Rp 106,600.00
SABU ( Serum Anti Bisa Ular) Vial Rp 517,132.00 Rp -
Tablet tambah darah tab Rp 255.00 Rp -
USG GEL Btl Rp 18,858.33 Rp -

VAR Vial Rp 153,000.00 Rp -
Vit. B.Complex 1000 Tab Rp 60 Rp 60,000.00
Zink 20 mg tab Tab Rp 253.00 Rp -
Zink syr Btl Rp 2,489.00 Rp -

BMHP
Catgut chromic 3/0 +jarum Bulat Pcs Rp 68,090.00 Rp -
(*optime*)
Disposable syringe 3 cc Pcs Rp 818.00 Rp -
Folly Catheter 18 pcs Rp 11,132.00 Rp -
Handscoond steril no 6 Pasang Rp 13,563.00 Rp -
Handscoond steril no 6,5 Pasang Rp 13,563.00 Rp -
Hand Sanitizer / Handrub 500 ml Btl Rp 68,200.00 Rp -
Handscrub Btl Rp 115,800.00 Rp -
Infus Set Dewasa pcs Rp 7,128.00 Rp -
Kasa 4 x 10 pcs Rp 2,176.72 Rp -
Kasa 4 x 5 pcs Rp 1,089.67 Rp -
Scalpet Blades no.10 100 Pcs Rp 618.70 Rp 61,869.50
Scalpet Blades no.11 Pcs Rp 618.68 Rp -
Surgical mask earloop 3ply / Box Rp 1,373.14 Rp -

Masker
Under Pad Steril pcs Rp 37,875.00 Rp -
DAK 2020
Acyclovir 400 mg Tab Rp 454.00 Rp -
CTM 4 mg tab Rp 26.00 Rp -
tab Rp 212.00 Rp -

( ERGOTAMIN )
Gentamicine tetes mata Botol Rp 26.00 Rp -
Paracetamol Drop Botol Rp 7,646.00 Rp -
BMHP

Pcs Rp 55,000.00 Rp -
(*optime*)
Catgut chromic 3/0 +jarum

Pcs Rp 62,000.00 Rp -
Segitiga (*optime*)

Pcs Rp 44,000.00 Rp -
(*optime-R*)

Pcs Rp 71,000.00 Rp -
(*Advantime*)
Feeding Tube 14 pcs Rp 8,407.00 Rp -
Kasa 16x16 pcs Rp 7,897.31 Rp -
Silk 2/0 + jarum 1/2 25 mm 75 cm Pcs Rp 32,500.00 Rp -
Umbilical Cord Klem Pcs Rp 1,495.00 Rp -
DAU 2020
Aqua pro injeksi 20 ml ampul Rp 2,860.00 Rp -
Hyoscine N butylbromide 10 mg
Ampul Rp 9,900.00 Rp -
inj

%) btl Rp 6,840.00 Rp -
Propylthiouracyl 100 mg tablet Tab Rp 733.00 Rp -
Ringer Laktat (RL) btl Rp 7,150.00 Rp -
P 2020
Ambroxol sirup 15 mg/5 ml Btl Rp 3,250.01 Rp -
Ambroxol Tablet 30 mg Tab Rp 110.00 Rp -
Bisakodil ( LAXANA) Tab Rp 367.00 Rp -

(Deksametason, Neomisin Sulfat, Botol Rp 14,900.00 Rp -
COMPOSITUM
Obat batuk pilek anak kombinasi Botol Rp 12,900.00 Rp -

GG ( Dextrofen)
Obat flu kombinasi

( pseudoephedrin Hcl, Tripolidin tab Rp 600.00 Rp -
Hcl ) FLUTROP
Salbutamol nebulizer / Ventolin Flash Rp 10,000.00 Rp -

Nebulizer
Hemafort Tab Rp 820.00 Rp -

DAK 2019
Alprazolam 0,5 mg tab Rp 88.00 Rp -

125mg/5ml btl Rp 4,360.00 Rp -
Diazepam 5 mg / 2,5 ml Tube Rp 14,459.00 Rp -

( STESOLID ) Rektal
Kotrimoxazole syr btl Rp 2,052.00 Rp -
Metoklopramide 10 mg tab Rp 83.00 Rp -

Oxtretrasiklin Salep Mata tube Rp 2,600.00 Rp -
Pirantel 125 mg tab Rp 331.00 Rp -
Piridoksin HCL ( Vit. B 6 ) 10 mg tab Rp 141.00 Rp -
BMHP
Alat Suntik 5 ml pcs Rp 1,600 Rp -
Infus Set Dewasa pcs Rp 6,842.00
urine bag pcs Rp 1,848.00 Rp -
PENUNJANG 2019
Gentamicin salep kulit tube Rp 2,640.00 Rp -
Loperamide Tab Rp 198.00 Rp -
Multivitamin syr anak ( Becefort ) Botol Rp 17,365.70 Rp -
Anti diare kombinasi (Kaolin

btl Rp 3,850.00 Rp -
Pektin) sirup (Guanistrep Sirup)
BG 2019
Articulating Paper Pcs Rp 242,000.00 Rp -
Cotton roll medium Pack Rp 85,800.00 Rp -
Eugenol Botol 10 ml Rp 97,500.00 Rp -
Pehacain Ampul Rp 3,113.0495 Rp -

DAK 2018
Diazepam 5 mg Tab Rp 109.00 Rp -
HCT 25 mg tab Rp 178.00 Rp -
Nistatin 100.000 IU tab Rp 645.00 Rp -
BMHP
Blood Lancet Pcs Rp 167.509 Rp -
Plaster ( Hifafix ) Roll Rp 29,642.86 Rp -
Penunjang 2017
BMHP
Jarum Jahit Segitiga pcs Rp 22,000.00 Rp -
DAU 2017
BMHP

Pcs Rp 46,187.44 Rp -
( Sole)
DAK 2017
Diltiazem 30 mg tab Rp 128.00 Rp -
BMHP
KAPAS PEMBALUT / ABSORBEN Bks Rp 14,375.00 Rp -

250 GRAM
Kasa 4mx5cm Roll Rp 862.50 Rp -
APBD 2016
BMHP 2016
Infus set anak (Aximed) pcs Rp 6,222.00 Rp -
DAU 2009

roll/bungkus Rp 11,914 Rp -
250 GRAM
43642 Rp22,083,353.10
DAN PENGELUARAN PERSEDIAAN ( ASET OBAT DROPPING )
TAHUN 2022
PE
PUSKESMAS ( RGD, RPP, LAB, RKGM, Poli Umum, Promkes, Pendaftaran , TU ,
Dokumen
Keterangan No Pengguna Kode Barang Nama Barang
Tanggal Nomor Nama
14 15 16 17 18 19 20 21
BMHP Program HIV

Saldo 2021
Safety box
Plesterin Bulat non

woven
Vacum Tube sterile,

plastic, K3 EDTA
Vacutainer Needle
BMHP Program TB
Sputum Pot
7105
DAK 22
Allupurinol 100 mg
Amlodipine 10 mg
Amlodipine 5 mg
(hexapram Jaya )

ml

mg
Asam folat tab 1 mg
Asam Mefenamat
Antasida syr

Kunyah
Anti Hemoroid komb.

Supp
Captopril 25 mg
Cetrizine 10 mg
Ciprofloxacin 500 mg
Dexamethasone 0,5mg
Dimenhidrinat 50 mg
Fenol gliserol TT 10 %
Glimepirid 2 mg
Hidrokortisone cream
Haloperidole 5 mg
Ibuprofen 400mg
Kalk
Ketokonazol 200mg
Klorfeniramin maleat
(CTM) 4 mg
Kodein 10 mg
Lansoprazole 30 mg
4 mg
Metronidazol 500mg
Multivitamin sirup
anak (Novakid)
Novatusin syr
N-Asetilsistein 200mg
mg
Omeprazole inj
Paracetamol Drop
Paracetamol syr
Paracetamol 500 mg
Scabimite cream
ml
ml

ml
Rivanol
Ringer Laktat (RL)
Salbutamol 2 mg
Salbutamol 4 mg
Salbutamol inhaler
USG GEL
Vitamin B1
Vitamin B6
Vitamin B12
BMHP
Alkohol 70% 100 mL
Alkohol 70% 1000 mL
Handscoon non steril S

Hamburg )
IV.Chateter No.18 G
IV.Chateter No.20 G
IV.Chateter No.22 G
IV.Chateter No.24 G
IV.Chateter No.26 G
Kasa 16 x 16
Kasa 40x80
Plaster Putih 5 x 5
( Farmafix )
Plester Putih 5x2
Rivanol
Umbilical Cord Klem
BG 2021
Bahan tambal sinar
Cairan bonding

liquid
DAU 2021

OMEGA 3
BMHP
Sarung Tangan Uk. S
Sarung Tangan Uk. M
P 21
Acyclovir Cream
Bedak Salisil
Bicombin inj
Cefadroxil 500 mg
CPZ 100mg
Digoxin 0,5 mg

5mg/2,5ml
Eflin
Furosemid
mg
Ibuprofen 200mg
Lexartans (as.
Traneksamat)
Meloxicam 7,5 mg
Novastan syr
Nifedipine
Neo Diaform
Kulit 3%
OBH Plus
Paracetamol 500 mg
Pehavral
Reco Salep Mata

( Chloamphenicol)
Reco Tetes Telinga

(Chloramphenicol)
Skincol Gel
Visoprin
DAK 2021
(hexapram Jaya )
125mg/5ml
Amox icillin Drop
Allupurinol 100 mg
Allupurinol 300 mg
Asam Mefenamat
Amlodipine 5 mg
Amlodipine 10 mg

i.v 1000 mg/ Vial
Antifungi DOEN
kombinasi: Asam
Benzoat 3% + Asam
Salisilat 6%

Kunyah

mg
Asam Traneksamat
injeksi
Asam folat tab 1 mg
Asetosal 80 mg
Betahistine 6 mg
Betamethason cream
Bisakodil Suppo
Bisakodil 5 mg
Captopril 12,5 mg
Cetrizine syr
Cefotaxim Injeksi
Dexamethasone injeksi
Dextrosa 10 %
Doksisiklin
Domperidone syr
Epinephrine
Furosemid Injeksi
i.v./i.m 10mg/ml
Glukosa Infus D5%
Glibenklamide 5 mg
Haloperidole 5 mg
Hyoscine N
butylbromide
Karbogliserin tetes
telinga 10% (phenol

mg

%
Ketorolac inj 30Mg/MI
Karbamazepin 200mg
KAEN 3B

sublingual 5mg
Ibuprofen Syr
100mg/5ml
Ketokonazole Cream
Ketokonazole tablet
200mg
125 mg/ 5ml
Kodein 10 mg
Lansoprazole 30 mg

injeksi 2% (HCI) +
epinefrin)
Loratadine
4 mg
8 mg
Metoklopramid 10 mg
Metoklopramid inj
Methamizole Na Inj
Metronidazol sirup
MGSO4 40 %
MGSO4 20 %
Mikonazole kream
Nistatin drop

IU
mg
N-Asetilsistein

NACL 0,9 %)
Oxytocin injeksi
Omeprazole 20 mg
Parasetamol syr
Phytomenadion inj
2mg/ml
Phytomenadion 10 mg
Permetrin cream
Ranitidin injeksi
Salbutamol 4 mg
(Salbutamol Sulfate )
Salep 2-4
Simvastatin 10 mg
Simvastatin 20 mg
Sianocbalamin (B12)
Sianocobalamin
( Vitamin B12) Injeksi
500 mcg

Ular)
Tablet tambah darah
USG GEL
VAR
Vit. B.Complex
Zink 20 mg tab
Zink syr
BMHP
Catgut chromic 3/0
Folly Catheter 18
Hand Sanitizer /
Handrub 500 ml
Handscrub
Infus Set Dewasa
IV.Chateter No.18 G
Kasa 4 x 10
Kasa 4 x 5

3ply / Masker
Under Pad Steril
DAK 2020
Acyclovir 400 mg
Betahistine 6 mg
CTM 4 mg
Cetrizine 10 mg
Domperidone syr

( ERGOTAMIN )
Kodein 10 mg
Lansoprazole 30 mg
4 mg
Paracetamol Drop
BMHP
Catgut chromic 3/0

Catgut chromic 3/0

+jarum Segitiga
(*optime*)
Catgut chromic 2/0

R*)

Feeding Tube 14
Feeding Tube 16
IV.Chateter No.20 G
IV.Chateter No.22 G
Kasa 16x16
Silk 2/0 + jarum 1/2 25

mm 75 cm
Umbilical Cord Klem
DAU 2020
Hyoscine N

NACL 0,9 %)
tablet
Ringer Laktat (RL)
P 2020

ml
Bisakodil Suppo
Bisakodil ( LAXANA)

mg
(Deksametason,
Neomisin Sulfat,
ALLETROL
COMPOSITUM

kombinasi GG
( Dextrofen)
Obat flu kombinasi

Ventolin Nebulizer
Hemafort
DAK 2019
Acyclovir 400 mg
Alprazolam 0,5 mg

125mg/5ml
( STESOLID ) Rektal
Kotrimoxazole syr
Mata
Pirantel 125 mg

10 mg
BMHP
Alat Suntik 5 ml
Folly Catheter 14
Folly Catheter 16
Infus Set Dewasa
urine bag
PENUNJANG 2019
Loperamide

( Becefort )

(Guanistrep Sirup)
BG 2019
Articulating Paper
Cotton roll medium
Eugenol
Pehacain
DAK 2018
Diazepam 5 mg
HCT 25 mg
Nistatin 100.000 IU
BMHP
Blood Lancet
Plaster ( Hifafix )
Penunjang 2017
BMHP
DAU 2017
BMHP

35 mm ( Sole)
DAK 2017
Diltiazem 30 mg
BMHP
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
Kasa 4mx5cm
APBD 2016
BMHP 2016

Pembelian Nota Dinas
DAU 2009
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
PENGELUARAN
mkes, Pendaftaran , TU , Posko ) , DESA ( Pelayanan Poskesdes, Lansia, Imunisasi, Bumil, Posyandu Balita, Posko )
Spesifikasi Barang Jumlah Satuan Barang Harga Satuan
NUSP Spesifikasi Nama Barang (Rp)
22 23 24 25 26
BMHP Program HIV
Safety box 0 IDR Rp 16,666.00
Plesterin Bulat non woven 0 Kotak Rp 40,187.50
Vacum Tube sterile, plastic, K3

EDTA 0 Pcs Rp 1,160.00
surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00
surgical Gloves no. 8 0 Pcs Rp 13,178.00
Vacutainer Needle 0 Pcs Rp 132.00
BMHP Program TB
Larutan Zhihi Neeisen 0 Paket Rp 274,362.00
Sputum Pot 0 Biji Rp 3,137.00

Object Glass Frosted 7105 0 box @ 72 pcs Rp 23,860.08
DAK 22
Allupurinol 100 mg 0 Tab Rp 89.00
Amlodipine 10 mg 790 Tab Rp 74.67
Pehamoxiil Forte 500 mg 0 Tab Rp 231.00
(hexapram Jaya )
Ambroxol sirup 15 mg/5 ml 183 Btl Rp 4,800.00
Asam Traneksamat 500 mg 160 Tab Rp 1,927.00
Asam folat tab 1 mg 0 Tab Rp 61.00
Asam Mefenamat 0 tab Rp 117.00
Antasida syr 271 Btl Rp 1,756.00
Antasida Doen I Tablet Kunyah 570 tab Rp 54.00
Anti Hemoroid komb. Supp 6 Suppo Rp 3,260.00
Captopril 25 mg 160 tab Rp 72.00
Cetrizine 10 mg 840 tab Rp 52.47

Ciprofloxacin 500 mg 340 tab Rp 260.00
Dexamethasone 0,5mg 490 Tablet Rp 106.00
Dimenhidrinat 50 mg 20 tab Rp 109.00
Fenol gliserol TT 10 % 23 Btl Rp 3,300.00
Glimepirid 2 mg 500 Tab Rp 123.00
Hidrokortisone cream 38 Tube Rp 2,325.00
Haloperidole 5 mg 0 Tab Rp 54.00
Ibuprofen 400mg 1215 Tab Rp 210.00
Kalk 20 Tablet Rp 60.00
Ketokonazol 200mg 130 Tab Rp 260.00
Klorfeniramin maleat (CTM) 4

mg 485 Tab Rp 86.00
Kodein 10 mg 70 Tab Rp 605.00
Lansoprazole 30 mg 670 Kap Rp 278.00
Metformin HCL 500 mg 2780 tab Rp 77.00
Metilprednisolon tablat 4 mg 0 tab Rp 102.00
Metronidazol 500mg 500 tab Rp 317.00

(Novakid) 99 Btl Rp 7,400.00
Novatusin syr 57 Btl Rp 8,200.00
N-Asetilsistein 200mg 240 Kapsule Rp 319.87
Natrium Diklofenak 50 mg 10 Tablet Rp 109.00
Omeprazole inj 75 Ampl Rp 5,346.00
Paracetamol Drop 15 Drop Rp 5,204.00
Paracetamol syr 91 Btl Rp 1,160.00
Paracetamol 500 mg 1750 Tab Rp 257.00
Scabimite cream 8 Tube Rp 11,466.00
Povidon iodida 10 % 30 ml 6 Btl Rp 4,182.00
Rivanol 0 Btl Rp 7,221.00
Ringer Laktat (RL) 220 Btl Rp 7,703.00
Salbutamol 2 mg 1140 Tab Rp 51.00
Salbutamol inhaler 0 Ampul Rp 22,200.00
USG GEL 0 pcs Rp 16,632.00

Vitamin B1 130 tab Rp 173.00
BMHP
Alkohol 70% 100 mL 1 Btl Rp 3,256.00
Alkohol 70% 1000 mL 4 Btl Rp 23,595.00
Disposable syringe 1 cc 0 pcs Rp 1,045.00
Disposable syringe 3 cc 0 pcs Rp 825.00
Handscoon non steril L 0 pcs Rp 1,252.08
Handscoon non steril M 0 pcs Rp 1,252.08
Handscoon non steril S 0 pcs Rp 1,252.08
Infuset Dewasa ( Troge Hamburg ) 30 pcs Rp 26,062.00
IV.Chateter No.18 G 0 pcs Rp 26,418.00
Kasa 16 x 16 49 pcs Rp 3,541.00
Kasa 40x80 3 pcs Rp 91,045.00
Plaster Putih 5 x 5 ( Farmafix ) 3 pcs Rp 32,190.00

Plester Putih 5x2 2 pcs Rp 21,638.40
Rivanol 0 Btl Rp 7,221.00
Umbilical Cord Klem 0 pcs Rp 2,070.00

BG 2021
Bahan tambal sinar 0 Syringe Rp 356,400.00
Cairan bonding 0 Pot Rp 391,500.00
Cairan etsa / Etching liquid 0 Pcs Rp 67,500.00
DAU 2021
Multivitamin Ibu Hamil OMEGA 3 0 Btl isi @ 30 kapsul Rp 45,000.00
BMHP
Disposable syringe 1 cc 0 Pcs Rp 1,361.00
Sarung Tangan Uk. S 0 Pcs Rp 1,712.53
Sarung Tangan Uk. M 0 Pcs Rp 1,710.13
P 21
Acyclovir Cream 8 Tube Rp 4,400.00
Bedak Salisil 0 Wadah Rp 7,700.00
Bicombin inj 0 Ampul Rp 6,600.00
Cefadroxil 500 mg 510 Kap Rp 880.00
CPZ 100mg 0 tab Rp 495.00
Digoxin 0,5 mg 0 Tab Rp 198.00

5mg/2,5ml 6 Suppo Rp 30,800.00
Eflin 0 Tab Rp 1,413.50
Furosemid 0 Tab Rp 275.00

Guaiafenesin (GG) 100 mg 0 tab Rp 147.99
Ibuprofen 200mg 0 Tab Rp 275.00
Kloramfenikol 250 mg 40 Kap Rp 770.00
Lexartans (as. Traneksamat) 0 Tab Rp 1,650.00
Meloxicam 7,5 mg 0 Tab Rp 385.00
Novastan syr 3 Btl Rp 11,000.00
Nifedipine 20 Tab Rp 220.00
Neo Diaform 320 Tab Rp 286.00
Oxytetracycline Salep Kulit 3% 32 Tube Rp 4,950.00
OBH Plus 0 Btl Rp 12,100.00
Paracetamol 500 mg 2890 tab Rp 275.00
Pehavral 670 tab Rp 1,045.00
Reco Salep Mata

( Chloamphenicol) 30 Tube Rp 6,600.00
Reco Tetes Telinga

(Chloramphenicol) 16 Btl Rp 11,000.00
Skincol Gel 0 Tube Rp 148,500.00
Visoprin 0 Btl Rp 72,600.00
DAK 2021
Pehamoxiil Forte 500 mg 335 Tab Rp 231.00
(hexapram Jaya )
125mg/5ml 96 Btl Rp 2,050.00
Amox icillin Drop 10 Btl Rp 11,750.00
Asam Mefenamat 510 tab Rp 117.00

mg/ Vial 0 Vial Rp 9,900.00
Antihemeroid kombinasi 0 Suppo Rp 3,260.00

Benzoat 3% + Asam Salisilat 6% 0 Botol Rp 3,637.00
Antasida Doen I Tablet Kunyah 0 Tab Rp 54.00
Antasida Doen suspensi 0 Botol Rp 1,756.00
Asam askorbat / Vit C 50 mg 600 Tab Rp 46.00
Asam Traneksamat injeksi 12 amp Rp 1,820.00
Asam folat tab 1 mg 270 pcs Rp 61.00
Asetosal 80 mg 110 Tab Rp 89.00

Aqua pro injeksi 25 ml 130 Tab Rp 2,650.00
Betahistine 6 mg 0 Tab Rp 92.00
Betamethason cream 0 Tab Rp 1,540.00
Bisakodil Suppo 10 Suppo Rp 5,085.00
Bisakodil 5 mg 4 Tab Rp 5,085.00
Captopril 12,5 mg 0 tab Rp 68.00
Cetrizine syr 32 Botol Rp 2,215.00
Cefotaxim Injeksi 0 Vial Rp 3,050.00
Diazepam inj 5 mg / 2 ml 0 Ampul Rp 1,545.00
Dexamethasone injeksi 132 Ampul Rp 968.00
Dextrosa 10 % 0 Botol Rp 7,200.00
Doksisiklin 10 Tab Rp 289.00
Domperidone syr 40 Botol Rp 2,401.00
Eritromisin sirup 200 mg 13 Botol Rp 7,436.00
Epinephrine 0 Ampul Rp 1,740.00

10mg/ml 27 Ampul Rp 969.00
Glukosa Infus D5% 19 btl Rp 7,363.00
Glibenklamide 5 mg 0 Tab Rp 87.00
Haloperidole 5 mg 0 Tab Rp 54.00
Hyoscine N butylbromide 50 Tab Rp 1,050.00

(phenol gliserol tts. Telinga) 0 Botol Rp 3,300.00
Kalsium laktat (Kalk) 500 mg 0 Tab Rp 60.00
Kalsium Glukonat inj 10 % 0 Ampul Rp 6,199.00
Ketorolac inj 30Mg/MI 53 Ampul Rp 923.00
Karbamazepin 200mg 0 tab Rp 216.00
KAEN 3B 40 tab Rp 11,500.00

sublingual 5mg 30 Tab Rp 99.00
Ibuprofen Syr 100mg/5ml 9 Btl Rp 2,339.00
Ketokonazole Cream 14 Tube Rp 2,399.00
Ketokonazole tablet 200mg 0 Tab Rp 260.00

5ml 1 Btl Rp 5,352.00
Lansoprazole 30 mg 0 kap Rp 278.00
Lidokain comp (Lidokain injeksi

2% (HCI) + epinefrin) 90 Ampul Rp 847.00
Lidocain inj 2 % (HCL) 0 Ampul Rp 891.00
Loratadine 350 kap Rp 117.00
Metformin HCL 500 mg 250 tab Rp 77.00
Metoklopramid 10 mg 10 tab Rp 66.00
Metoklopramid inj 18 Ampul Rp 1,983.00
Methamizole Na Inj 0 Ampul Rp 3,045.00
Metronidazol sirup 15 Btl Rp 3,765.00
MGSO4 40 % 0 Ampul Rp 4,700.00
MGSO4 20 % 0 Ampul Rp 4,120.00
Mikonazole kream 64 Tube Rp 1,900.00
Nistatin drop 3 Btl Rp 11,750.00
Nistatin Ovula 100.000 IU 0 tab Rp 550.00
Natrium Diklofenak 25 mg 0 tab Rp 109.00
N-Asetilsistein 0 Tab Rp 317.00

%) 85 btl Rp 6,900.00
Oxytocin injeksi 0 Ampul Rp 1,248.00
Omeprazole 20 mg 420 Kap Rp 129.00
Parasetamol syr 0 btl Rp 1,160.00

Phytomenadion inj 2mg/ml 30 Ampul Rp 3,900.00
Phytomenadion 10 mg 0 Tab Rp 781.00
Permetrin cream 0 Tube Rp 11,466.00
Ranitidin tablet 150 mg 270 tab Rp 85.00
Ranitidin injeksi 0 Ampul Rp 858.00
(Salbutamol Sulfate ) 13 Btl Rp 5,400.00
Salep 2-4 0 Pot Rp 1,475.00
Simvastatin 10 mg 300 tab Rp 73.00
Simvastatin 20 mg 460 tab Rp 73.00
Siprofloksasin 500 mg 0 Tab Rp 260.00
Sianocbalamin (B12) 0 Tab Rp 44.00

Injeksi 500 mcg 11 Ampul Rp 1,066.00
SABU ( Serum Anti Bisa Ular) 0 Vial Rp 517,132.00
Tablet tambah darah 0 tab Rp 255.00
USG GEL 0 Btl Rp 18,858.33

VAR 0 Vial Rp 153,000.00
Vit. B.Complex 2040 Tab Rp 60
Zink 20 mg tab 0 Tab Rp 253.00
Zink syr 0 Btl Rp 2,489.00

BMHP
(*optime*) 0 Pcs Rp 68,090.00
Disposable syringe 3 cc 400 Pcs Rp 818.00
Disposable syringe 10 cc 100 Pcs Rp 1,100.00
Folly Catheter 18 0 pcs Rp 11,132.00
Handscoond steril no 6 0 Pasang Rp 13,563.00
Handscoond steril no 6,5 0 Pasang Rp 13,563.00
Handscoond steril no 7,5 0 Pasang Rp 13,563.00
Hand Sanitizer / Handrub 500 ml 0 Btl Rp 68,200.00
Handscrub 0 Btl Rp 115,800.00
Infus Set Dewasa 0 pcs Rp 7,128.00
Kasa 4 x 10 0 pcs Rp 2,176.72
Kasa 4 x 5 0 pcs Rp 1,089.67
Scalpet Blades no.10 0 Pcs Rp 618.70

Masker 600 Box Rp 1,373.14
Under Pad Steril 0 pcs Rp 37,875.00
DAK 2020
Acyclovir 400 mg 285 Tab Rp 454.00
Betahistine 6 mg 0 Tab Rp 119.00
CTM 4 mg 0 tab Rp 26.00
Cetrizine 10 mg 0 tab Rp 104.00
Domperidone syr 0 Botol Rp 2,862.00
0 tab Rp 212.00

( ERGOTAMIN )
Gentamicine tetes mata 0 Botol Rp 26.00
Lansoprazole 30 mg 0 kap Rp 352.00
Paracetamol Drop 0 Botol Rp 7,646.00
BMHP

(*optime*) 0 Pcs Rp 55,000.00

Segitiga (*optime*) 0 Pcs Rp 62,000.00

(*optime-R*) 0 Pcs Rp 44,000.00

(*Advantime*) 0 Pcs Rp 71,000.00
Feeding Tube 14 0 pcs Rp 8,407.00
Feeding Tube 16 0 pcs Rp 8,407.00
Kasa 16x16 0 pcs Rp 7,897.31
Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs Rp 32,500.00
Umbilical Cord Klem 0 Pcs Rp 1,495.00
DAU 2020
Aqua pro injeksi 20 ml 0 ampul Rp 2,860.00
inj 0 Ampul Rp 9,900.00

%) 0 btl Rp 6,840.00
Propylthiouracyl 100 mg tablet 0 Tab Rp 733.00
Ringer Laktat (RL) 0 btl Rp 7,150.00
P 2020
Ambroxol sirup 15 mg/5 ml 0 Btl Rp 3,250.01
Ambroxol Tablet 30 mg 0 Tab Rp 110.00
Bisakodil Suppo 0 Suppo Rp 23,475.00
Bisakodil ( LAXANA) 0 Tab Rp 367.00
Guaiafenesin (GG) 100 mg 0 tab Rp 175.00

Polimiksin B Sulfat ) ALLETROL 0 Botol Rp 14,900.00
COMPOSITUM

GG ( Dextrofen) 0 Botol Rp 12,900.00
Obat flu kombinasi

( pseudoephedrin Hcl, Tripolidin 0 tab Rp 600.00
Hcl ) FLUTROP

Nebulizer 0 Flash Rp 10,000.00
Hemafort 0 Tab Rp 820.00

DAK 2019
Acyclovir 400 mg 0 Tab Rp 425.00
Alprazolam 0,5 mg 0 tab Rp 88.00

125mg/5ml 0 btl Rp 4,360.00
( STESOLID ) Rektal 0 Tube Rp 14,459.00
Kotrimoxazole syr 0 btl Rp 2,052.00
Metoklopramide 10 mg 0 tab Rp 83.00

Oxtretrasiklin Salep Mata 0 tube Rp 2,600.00
Pirantel 125 mg 0 tab Rp 331.00
Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab Rp 141.00
BMHP
Alat Suntik 5 ml 100 pcs Rp 1,600
Infus Set Dewasa 0 pcs Rp 6,842.00
urine bag 0 pcs Rp 1,848.00
PENUNJANG 2019
Gentamicin salep kulit 0 tube Rp 2,640.00
Loperamide 0 Tab Rp 198.00
Multivitamin syr anak ( Becefort ) 0 Botol Rp 17,365.70

Pektin) sirup (Guanistrep Sirup) 27 btl Rp 3,850.00
BG 2019
Articulating Paper 0 Pcs Rp 242,000.00
Cotton roll medium 0 Pack Rp 85,800.00
Eugenol 0 Botol 10 ml Rp 97,500.00
Pehacain 0 Ampul Rp 3,113.0495

DAK 2018
Diazepam 5 mg 0 Tab Rp 109.00
HCT 25 mg 0 tab Rp 178.00
Nistatin 100.000 IU 0 tab Rp 645.00
BMHP
Blood Lancet 0 Pcs Rp 167.509
Plaster ( Hifafix ) 0 Roll Rp 29,642.86
Penunjang 2017
BMHP
Jarum Jahit Segitiga 0 pcs Rp 22,000.00
DAU 2017
BMHP

( Sole) 0 Pcs Rp 46,187.44
DAK 2017
Diltiazem 30 mg 0 tab Rp 128.00
BMHP

250 GRAM 0 Bks Rp 14,375.00
Kasa 4mx5cm 0 Roll Rp 862.50
APBD 2016
BMHP 2016
Infus set anak (Aximed) 0 pcs Rp 6,222.00
DAU 2009

250 GRAM 4 roll/bungkus Rp 11,914
29,952.00
Nilai Saldo Awal

Nilai Total Penerimaan
Nilai Total Pengeluaran
Saldo/Sisa
Jumlah Stick Awal

Total Penerimaan
Total Pengeluaaran
Stock Akhir
Sisa Stok
u Balita, Posko )
Nilai Total
Keterangan Jumlah Total Harga
(Rp)
27 28
Saldo 2021
Rp - 25 Rp 416,650.00
Rp - 3 Rp 120,562.50
Rp - 1300 Rp 1,508,000.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 550 Rp 72,600.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 1000 Rp 89,000.00
Rp 58,989.30 4260 Rp 318,094.20
Rp 75,350.00 1240 Rp 68,200.00
Rp - 5000 Rp 1,155,000.00
Rp 878,400.00 117 Rp 561,600.00
Rp 308,320.00 130 Rp 250,510.00
Rp - 2000 Rp 122,000.00
Rp - 2000 Rp 234,000.00
Rp 475,876.00 505 Rp 886,780.00
Rp 30,780.00 2470 Rp 133,380.00
Rp 19,560.00 62 Rp 202,120.00
Rp 11,520.00 340 Rp 24,480.00
Rp 44,074.80 1560 Rp 81,853.20

Rp 88,400.00 930 Rp 241,800.00
Rp 51,940.00 2510 Rp 266,060.00
Rp 2,180.00 970 Rp 105,730.00
Rp 75,900.00 119 Rp 392,700.00
Rp 61,500.00 940 Rp 115,620.00
Rp 88,350.00 74 Rp 172,050.00
Rp - 200 Rp 10,800.00
Rp 255,150.00 2750 Rp 577,500.00
Rp 1,200.00 4980 Rp 298,800.00
Rp 33,800.00 114 Rp 29,640.00
Rp 41,710.00 515 Rp 44,290.00
Rp 42,350.00 230 Rp 139,150.00
Rp 186,260.00 0 Rp -
Rp 214,060.00 5820 Rp 448,140.00
Rp - 0 Rp -
Rp 158,500.00 500 Rp 158,500.00

Rp 732,600.00 501 Rp 3,707,400.00
Rp 467,400.00 0 Rp -
Rp 76,768.80 840 Rp 268,690.80
Rp 1,090.00 2990 Rp 325,910.00
Rp 400,950.00 169 Rp 903,474.00
Rp 78,060.00 19 Rp 98,876.00
Rp 105,560.00 335 Rp 388,600.00
Rp 449,750.00 3250 Rp 835,250.00
Rp 91,728.00 10 Rp 114,660.00
Rp 25,092.00 10 Rp 41,820.00
Rp - 16 Rp 106,928.00
Rp 23,132.00 7 Rp 161,924.00
Rp - 15 Rp 108,315.00
Rp 1,694,660.00 260 Rp 2,002,780.00
Rp 58,140.00 310 Rp 15,810.00
Rp 9,380.00 1790 Rp 119,930.00
Rp - 10 Rp 222,000.00
Rp - 5 Rp 83,160.00
Rp 22,490.00 1670 Rp 288,910.00
Rp 8,640.00 3740 Rp 269,280.00
Rp 22,000.00 420 Rp 18,480.00
Rp 3,256.00 35 Rp 113,960.00
Rp 94,380.00 7 Rp 165,165.00
Rp - 1200 Rp 1,254,000.00
Rp - 500 Rp 412,500.00
Rp - 900 Rp 1,126,872.00
Rp - 1000 Rp 1,252,080.00
Rp - 1000 Rp 1,252,080.00
Rp 781,860.00 0 Rp -
Rp - 100 Rp 2,641,800.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 1,320,900.00 0 Rp -
Rp 1,381,950.00 150 Rp 4,145,850.00
Rp 173,509.00 50 Rp 177,050.00
Rp 273,135.00 7 Rp 637,315.00
Rp 96,570.00 16 Rp 515,040.00
Rp 43,276.80 20 Rp 432,768.00
Rp - 15 Rp 108,315.00
Rp - 150 Rp 310,500.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 35,200.00 57 Rp 250,800.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 448,800.00 280 Rp 246,400.00
Rp - 200 Rp 99,000.00
Rp - 480 Rp 95,040.00
Rp 184,800.00 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 30,800.00 50 Rp 38,500.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 33,000.00 74 Rp 814,000.00
Rp 4,400.00 0 Rp -
Rp 91,520.00 1680 Rp 480,480.00
Rp 158,400.00 63 Rp 311,850.00
Rp - 0 Rp -
Rp 794,750.00 0 Rp -
Rp 700,150.00 4070 Rp 4,253,150.00
Rp 198,000.00 8 Rp 52,800.00
Rp 176,000.00 72 Rp 792,000.00
Rp - 1 Rp 148,500.00
Rp - 50 Rp 3,630,000.00
Rp 77,385.00 0 Rp -
Rp 196,800.00 146 Rp 299,300.00
Rp 117,500.00 120 Rp 1,410,000.00
Rp 12,460.00 960 Rp 85,440.00
Rp 28,000.00 2900 Rp 580,000.00
Rp 59,670.00 50 Rp 5,850.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 76 Rp 752,400.00
Rp - 0 Rp -
Rp - 37 Rp 134,569.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 27,600.00 2510 Rp 115,460.00
Rp 21,840.00 Rp -
Rp 16,470.00 1910 Rp 116,510.00
Rp 9,790.00 190 Rp 16,910.00

Rp 344,500.00 110 Rp 291,500.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 50,850.00 39 Rp 198,315.00
Rp 20,340.00 296 Rp 1,505,160.00
Rp - 0 Rp -
Rp 70,880.00 96 Rp 212,640.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 127,776.00 143 Rp 138,424.00
Rp - 0 Rp -
Rp 2,890.00 490 Rp 141,610.00
Rp 96,040.00 91 Rp 218,491.00
Rp 96,668.00 41 Rp 304,876.00
Rp - 6 Rp 10,440.00
Rp 26,163.00 42 Rp 40,698.00
Rp 139,897.00 60 Rp 441,780.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 52,500.00 100 Rp 105,000.00

Rp - 0 Rp -
Rp - 0 Rp -
Rp - 24 Rp 148,776.00
Rp 48,919.00 117 Rp 107,991.00
Rp - 0 Rp -
Rp 460,000.00 0 Rp -
Rp 2,970.00 160 Rp 15,840.00
Rp 21,051.00 41 Rp 95,899.00
Rp 33,586.00 7 Rp 16,793.00
Rp - 0 Rp -
Rp 5,352.00 65 Rp 347,880.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 76,230.00 60 Rp 50,820.00
Rp - 0 Rp -
Rp 40,950.00 3330 Rp 389,610.00
Rp 19,250.00 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 660.00 150 Rp 9,900.00
Rp 35,694.00 714 Rp 1,415,862.00
Rp - 0 Rp -
Rp 56,475.00 52 Rp 195,780.00
Rp - 0 Rp -
Rp - 50 Rp 206,000.00
Rp 121,600.00 228 Rp 433,200.00
Rp 35,250.00 11 Rp 129,250.00
Rp - 95 Rp 52,250.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 586,500.00 235 Rp 1,621,500.00
Rp - 0 Rp -
Rp 54,180.00 7920 Rp 1,021,680.00
Rp - 0 Rp -
Rp 117,000.00 54 Rp 210,600.00
Rp - 160 Rp 124,960.00
Rp - 0 Rp -
Rp 22,950.00 320 Rp 27,200.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 70,200.00 87 Rp 469,800.00
Rp - 8 Rp 11,800.00
Rp 21,900.00 200 Rp 14,600.00
Rp 33,580.00 6200 Rp 452,600.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp 11,726.00 187 Rp 199,342.00
Rp - 2 Rp 1,034,264.00
Rp - 0 Rp -
Rp - 3 Rp 56,575.00
Rp - 0 Rp -
Rp 122,400.00 1290 Rp 77,400.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 36 Rp 2,451,240.00
Rp 327,200.00 700 Rp 572,600.00
Rp 110,000.00 100 Rp 110,000.00
Rp - 10 Rp 111,320.00
Rp - 100 Rp 1,356,300.00
Rp - 281 Rp 3,811,203.00
Rp 2,034,450.00 50 Rp 678,150.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp 1,274,350.00 0 Rp -
Rp - 230 Rp 500,646.55
Rp - 0 Rp -
Rp - 200 Rp 123,739.00
Rp - 98 Rp 60,631.03
Rp - 79 Rp 48,878.32
Rp 823,884.00 3100 Rp 4,256,734.00

Rp - 200 Rp 7,575,000.00
Rp 129,390.00 130 Rp 59,020.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 339 Rp 71,868.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 42 Rp 1,848,000.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 49 Rp 645,722.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 220 Rp 161,260.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 41 Rp 13,571.00
Rp - 0 Rp -
Rp 160,000.00 900 Rp 1,440,000.00
Rp - 20 Rp 237,820.00
Rp - 10 Rp 118,910.00
Rp - 0 Rp -
Rp - 75 Rp 138,600.00
Rp - 0 Rp -
Rp - 520 Rp 102,960.00
Rp - 0 Rp -
Rp 103,950.00 25 Rp 96,250.00
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
Rp - 0 Rp -
0 Rp -
0 Rp -
Rp - 25 Rp 359,375.00
Rp - 0 Rp -
Rp - 50 Rp 311,100.00
Rp 47,656.00 4 Rp 47,656.00
Rp 23,101,589.70 111,633.00 Rp 88,457,721.60
Rp 89,475,958.20
Rp 22,083,353.10
Rp 23,101,589.70
Rp 88,457,721.60
97,943.00
43,642.00
29,952.00
111633.00
Kuasa Pengguna Barang : PUSKESMAS PERAWATAN LASUNG
pengguna barang :
Kode Rekening :
Stok Awal
Nama No Penyedia
No Obat Jumlah Satuan Harga Satuan Total harga
1 2
BMHP
Program HIV

Rp 16,666.00
Plesterin
2 Bulat non 3 Kotak Rp 120,562.50
woven Rp 40,187.50
Vacum Tube
sterile,
3
plastic, K3 1300 Pcs Rp 1,508,000.00
EDTA
Rp 1,160.00
surgical
4 Gloves no. 7, 0 Pcs Rp 13,178.00 Rp -
5
surgical
5 Gloves no. 8 0 Pcs Rp 13,178.00 Rp -
Vacutainer
6
Needle 550 Pcs Rp 132.00 Rp 72,600.00
BMHP
Program TB
Larutan Zhihi
1
Neeisen 0 Paket Rp -
Rp 274,362.00
2 Sputum Pot 0 Biji Rp -

Rp 3,137.00
Object Glass
3
Frosted 7105 0 box @ 72 pcs Rp -
Rp 23,860.08
DAK 22
Allupurinol
1
100 mg 1000 Tab
Rp 89.00
Rp 89,000
Amlodipine
2
10 mg 4260 Tab Rp 318,094 IFK
Rp 74.67
Amlodipine 5
3
mg 1240 Tab Rp 68,200 IFK
Rp 55.00
Amoxicillin
Trihydrate /
Pehamoxiil
4
Forte 500 mg 5000 Tab Rp 1,155,000 IFK
(hexapram
Jaya )
Rp 231.00
Ambroxol
5 sirup 15 117 Btl Rp 561,600 IFK
mg/5 ml Rp 4,800.00
Asam
6 Traneksamat 130 Tab Rp 250,510
500 mg
Rp 1,927.00
Asam
7 Traneksamat 0 Ampul Rp - IFK
injeksi
Rp 1,837.00
Asam folat
8
tab 1 mg 2000 Tab Rp 122,000 IFK
Rp 61.00
Asam
9
Mefenamat 2000 tab Rp 234,000 IFK
Rp 117.00
10 Antasida syr 505 Btl Rp 1,756.00 Rp 886,780
Antasida
11 Doen I Tablet 2470 tab Rp 133,380 IFK
Kunyah
Rp 54.00
Anti
12 Hemoroid 62 Suppo Rp 202,120 IFK
komb. Supp
Rp 3,260.00
Betahistine 6
13
mg 0 tab Rp - IFK
Rp 93.00
Captopril 25
14 340 tab Rp 24,480
mg Rp 72.00
Cetrizine 10
15
mg 1560 tab Rp 81,853 IFK
Rp 52.47
Ciprofloxacin
16 500 mg 930 tab Rp 241,800
Rp 260.00
Dexamethas
17 one 0,5mg 2510 Tablet Rp 266,060 IFK
Rp 106.00
Dimenhidrin
18 at 50 mg 970 tab Rp 105,730
Rp 109.00
Domperidon
19 e 10 mg 0 Tablet Rp - IFK
Rp 75.68
Esomeprazol
20
e injeksi 0 Vial Rp - IFK
Rp 8,247.00
Fenol gliserol
21 TT 10 % 119 Btl Rp 392,700 IFK
Rp 3,300.00
Glimepirid 2
22 mg 940 Tab
Rp 123.00
Rp 115,620
Hidrokortiso
23
ne cream 74 Tube Rp 172,050
Rp 2,325.00
Haloperidole
24
5 mg 200 Tab
Rp 54.00
Rp 10,800
Ibuprofen
25
400mg 2750 Tab Rp 577,500 IFK
Rp 210.00
Isosorbid
Dinitrat
26 tablet 0 Tab Rp - IFK
sublingual
5mg
Rp 99.90
27 Kalk 4980 Tablet Rp 298,800 IFK
Rp 60.00
Ketokonazol
28
200mg 114 Tab Rp 29,640 IFK
Rp 260.00
Ketokonazol
29 e cream 0 Tube Rp - IFK
Rp 2,399.00
Klorfeniram
30 in maleat 515 Tab Rp 44,290 IFK
(CTM) 4 mg
Rp 86.00
Kodein 10
31
mg 230 Tab Rp 139,150 IFK
Rp 605.00
Lansoprazole
32
30 mg 0 Kap
Rp 278.00
Rp -
Metformin
33
HCL 500 mg 5820 tab Rp 448,140 IFK
Rp 77.00
Metilprednis
34 olon tablat 4 0 tab Rp -
mg
Rp 102.00
Metronidazo
35 l 500mg 500 tab Rp 158,500 IFK
Rp 317.00
Metoklopra
36
mide 10 mg 0 tab Rp - IFK
Rp 66.00
Multivitami
n sirup
37
anak 501 Btl Rp 3,707,400
(Novakid) Rp 7,400.00
Novatusin
38
syr 0 Btl
Rp 8,200.00
Rp -
N-
39 Asetilsistein 840 Kapsule Rp 268,691 IFK
200mg Rp 319.87
Natrium
40 Diklofenak 2990 Tablet Rp 325,910 IFK
50 mg Rp 109.00
Omeprazole
41 inj 169 Ampl Rp 903,474 IFK
Rp 5,346.00
Paracetamol
42
Drop 19 Drop
Rp 5,204.00
Rp 98,876
Paracetamol
43
syr 335 Btl
Rp 1,160.00
Rp 388,600
Paracetam
44
ol 500 mg 3250 Tab Rp 835,250 IFK
Rp 257.00
Ranitidine
45 injeksi 0 Ampul Rp - IFK
Rp 858.00
Scabimite
46 cream 10 Tube Rp 114,660 IFK
Rp 11,466.00
Povidon
47 iodida 10 % 10 Btl Rp 4,182.00 Rp 41,820
30 ml
Povidon
48 iodida 10 % 16 Btl Rp 6,683.00 Rp 106,928
60 ml
Povidon
49 iodida 10 % 7 Btl Rp 23,132.00 Rp 161,924
300 ml
Prednison 5
50
mg 0 tab Rp - IFK
Rp 73.00
51 Rivanol 15 Btl Rp 7,221.00 Rp 108,315
Ringer Laktat
52
(RL) 260 Btl Rp 2,002,780 IFK
Rp 7,703.00
Salbutamol 2
53 mg 310 Tab
Rp 51.00
Rp 15,810
Salbutamol 4
54
mg 1790 Tab Rp 119,930 IFK
Rp 67.00
Salbutamol
55
inhaler 10 Btl
Rp 22,200.00
Rp 222,000
Sefadroksil
56
500mg 0 Kap Rp 1,036.00 Rp - IFK
Simvastatin
57
10 mg 0 Kap Rp - IFK
Rp 73.00
Simvastatin
58
20 mg 0 Kap Rp - IFK
Rp 150.00
60 USG GEL 5 pcs Rp 16,632.00 Rp 83,160 IFK
61 Vitamin B1 1670 tab Rp 288,910

Rp 173.00
62 Vitamin B6 3740 tab Rp 269,280 IFK

Rp 72.00
63 Vitamin B12 420 tab Rp 18,480 IFK

Rp 44.00
BMHP
Alkohol 70%
64 100 mL 35 Btl Rp 3,256.00 Rp 113,960
Alkohol 70%
65
1000 mL 7 Btl Rp 23,595.00 Rp 165,165 IFK
Disposable
66 syringe 1 cc 1200 pcs Rp 1,045.00 Rp 1,254,000 IFK
Disposable
67 syringe 3 cc 500 pcs Rp 825.00 Rp 412,500
Disposable
68
syringe 5 cc 0 pcs Rp 955.00 Rp - IFK
Disposable
69
syringe 10 cc 0 pcs Rp 1,110.00 Rp - IFK
Handscoon
70
non steril L 900 pcs Rp 1,126,872 IFK
Rp 1,252.08
Handscoon
71
non steril M 1000 pcs Rp 1,252,080 IFK
Rp 1,252.08
Handscoon
72
non steril S 1000 pcs Rp 1,252,080 IFK
Rp 1,252.08
Infuset
Dewasa
73 ( Troge 0 pcs Rp -
Hamburg ) Rp 26,062.00
IV.Chateter
74 No.18 G 100 pcs
Rp 26,418.00
Rp 2,641,800
IV.Chateter
75
No.20 G 0 pcs
Rp 26,418.00
Rp -
IV.Chateter
76
No.22 G 0 pcs
Rp 26,418.00
Rp -
IV.Chateter
77
No.24 G 0 pcs
Rp 26,418.00
Rp -
IV.Chateter
78
No.26 G 150 pcs
Rp 27,639.00
Rp 4,145,850
79 Kasa 16 x 16 50 pcs Rp 3,541.00 Rp 177,050 IFK
80 Kasa 40x80 7 pcs Rp 91,045.00 Rp 637,315 IFK
Plester Putih
81 5x10 0 pcs Rp - IFK
Rp 61,605.00
Plaster Putih
82 5x5 16 pcs Rp 515,040 IFK
( Farmafix )
Rp 32,190.00
Plester Putih
83
5x2 20 pcs Rp 21,638.40 Rp 432,768 IFK
84 Rivanol 15 Btl Rp 7,221.00 Rp 108,315

Umbilical
85
Cord Klem 150 pcs Rp 2,070.00 Rp 310,500
BG 2021
Bahan
1
tambal sinar 0 Syringe Rp 356,400.00 Rp -
Cairan
2
bonding 0 Pot Rp 391,500.00 Rp - IFK
Cairan etsa /
3 Etching 0 Pcs Rp 67,500.00 Rp -
liquid
DAU 2021
Multivitamin Btl isi @ 30

1 Ibu Hamil 0 kapsul
Rp 45,000.00 Rp -
OMEGA 3
BMHP
Disposable
2
syringe 1 cc 0 Pcs Rp 1,361.00 Rp -
Sarung
3
Tangan Uk. S 0 Pcs Rp 1,712.53 Rp -
Sarung
4 Tangan Uk. 0 Pcs Rp 1,710.13 Rp -
M
P 21
Acyclovir
1
Cream 57 Tube Rp 4,400.00 Rp 250,800
Cefadroxil
4
500 mg 280 Kap Rp 880.00 Rp 246,400
Klorpromaz
5 in 100 mg 200 Kap Rp 495.00 Rp 99,000
(CPZ )
Digoxin 0,5
6
mg 480 Tab Rp 198.00 Rp 95,040
Diazepam
larutan
7
rektal 0 Suppo Rp 30,800.00 Rp -
5mg/2,5ml
Guaiafenesin
10
(GG) 100 mg 0 tab Rp 147.99 Rp -
Ibuprofen
11
200mg 0 Tab Rp 275.00 Rp -
Kloramfenik
12
ol 250 mg 50 Kap Rp 770.00 Rp 38,500
Lexartans
(as.
13
Traneksamat 0 Tab Rp 1,650.00 Rp -
)
Meloxicam
14
7,5 mg 0 Tab Rp 385.00 Rp -
16 Nifedipine 0 Tab Rp 220.00 Rp -

Oxytetracycli
18 ne Salep 63 Tube Rp 4,950.00 Rp 311,850
Kulit 3%

Paracetamol
20
500 mg 0 tab Rp 275.00 Rp -
Reco Salep
Mata
22 ( Chloamphe 8 Tube Rp 6,600.00 Rp 52,800
nicol)
Reco Tetes
Telinga
23 (Chloramphe 72 Btl Rp 11,000.00 Rp 792,000
nicol)
Tramadol inj
25
50 mg/ml 0 Ampul Rp 11,000.00 Rp - IFK
DAK 2021
Amoxicillin
Trihydrate /
Pehamoxiil
1
Forte 500 mg 0 Tab Rp 231.00 Rp -
(hexapram
Jaya )
Amoksisilin
125mg/5ml
Amox icillin
3
Drop 120 Btl Rp 11,750.00 Rp 1,410,000
Allupurinol
4
100 mg 960 Tab Rp 89.00 Rp 85,440
Allupurinol
5
300 mg 2900 Tab Rp 200.00 Rp 580,000
Asam
6 Mefenamat 50 tab Rp 117.00 Rp 5,850
Amlodipine 5
7
mg 0 Tab Rp 55.00 Rp -
Amlodipine
8
10 mg 0 Tab Rp 74.00 Rp -
Ampisillin
serbuk
9 injeksi i.v 76 Vial Rp 9,900.00 Rp 752,400
1000 mg/
Vial
Antihemeroi
10 d kombinasi 0 Suppo Rp 3,260.00 Rp -
Antifungi
DOEN
kombinasi:
11 Asam 37 Botol Rp 3,637.00 Rp 134,569
Benzoat 3%
+ Asam
Salisilat 6%
Antasida
12 Doen I Tablet 0 Tab Rp 54.00 Rp -
Kunyah
Antasida
13 Doen 0 Botol Rp 1,756.00 Rp -
suspensi
Asam
14 askorbat / 2510 Tab Rp 46.00 Rp 115,460
Vit C 50 mg
Asam
15 Traneksamat amp Rp 1,820.00 Rp -
injeksi
Asam folat
16
tab 1 mg 1910 pcs Rp 61.00 Rp 116,510
Asetosal 80
17
mg 190 Tab Rp 89.00 Rp 16,910 IFK
Aqua pro
18 injeksi 25 ml 110 Tab Rp 2,650.00 Rp 291,500 IFK
Betahistine 6
19
mg 0 Tab Rp 92.00 Rp -
Betamethaso
20
n cream 0 Tab Rp 1,540.00 Rp -
Bisakodil
21
Suppo 39 Suppo Rp 5,085.00 Rp 198,315
Bisakodil 5
22
mg 296 Tab Rp 5,085.00 Rp 1,505,160
Captopril
23
12,5 mg 0 tab Rp 68.00 Rp -

Cefotaxim
25
Injeksi 0 Vial Rp 3,050.00 Rp -
Diazepam inj
26
5 mg / 2 ml 0 Ampul Rp 1,545.00 Rp -
Dexamethas
27
one injeksi 143 Ampul Rp 968.00 Rp 138,424 IFK
Dextrosa 10
28
% 0 Botol Rp 7,200.00 Rp -
Domperidon
30
e syr 91 Botol Rp 2,401.00 Rp 218,491
Eritromisin
31 sirup 200 mg 41 Botol Rp 7,436.00 Rp 304,876
Furosemid
Injeksi
33
i.v./i.m 42 Ampul Rp 969.00 Rp 40,698
10mg/ml
Glukosa
34
Infus D5% 60 btl Rp 7,363.00 Rp 441,780
Glibenklamid
35
e 5 mg 0 Tab Rp 87.00 Rp -
Haloperidole
36
5 mg 0 Tab Rp 54.00 Rp -
Hyoscine N
37 butylbromid 100 Tab Rp 1,050.00 Rp 105,000
e
Karbogliserin
tetes telinga
gliserol tts.
Telinga)
Kalsium
39 laktat (Kalk) 0 Tab Rp 60.00 Rp -
500 mg
Kalsium
10 %
Ketorolac inj
41
30Mg/MI 117 Ampul Rp 923.00 Rp 107,991 IFK
Karbamazepi
42
n 200mg 0 tab Rp 216.00 Rp -
43 KAEN 3B 0 tab Rp 11,500.00 Rp - IFK
Isosorbid
Dinitrat
44 tablet 160 Tab Rp 99.00 Rp 15,840
sublingual
5mg
Ibuprofen
45 Syr 41 Btl Rp 2,339.00 Rp 95,899
100mg/5ml
Ketokonazol
46
e Cream 7 Tube Rp 2,399.00 Rp 16,793
Ketokonazol
47 e tablet 0 Tab Rp 260.00 Rp -
200mg
Kloramfenik
48 ol Suspensi 65 Btl Rp 5,352.00 Rp 347,880
125 mg/ 5ml
Kodein 10
49
mg 0 Tab Rp 605.00 Rp -
Lansoprazole
50
30 mg 0 kap Rp 278.00 Rp -
Lidokain
comp
(Lidokain
51 injeksi 2% 60 Ampul Rp 847.00 Rp 50,820 IFK
(HCI) +
epinefrin)
Lidocain inj 2
52 % (HCL) 0 Ampul Rp 891.00 Rp -
Metformin
54
HCL 500 mg 0 tab Rp 77.00 Rp -
Metilprednis
mg
Metilprednis
mg
Metoklopra
57
mid 10 mg 150 tab Rp 66.00 Rp 9,900
58 Metoklopra 714 Ampul Rp 1,983.00 Rp 1,415,862

mid inj
59 Methamizole 0 Ampul Rp 3,045.00 Rp -

Na Inj
Metronidazo
60 52 Btl Rp 3,765.00 Rp 195,780
l sirup
61 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp -
62 MGSO4 20 % 50 Ampul Rp 4,120.00 Rp 206,000
Mikonazole
63 228 Tube Rp 1,900.00 Rp 433,200
kream
Nistatin
65 Ovula 95 tab Rp 550.00 Rp 52,250
100.000 IU
Natrium
66 Diklofenak 0 tab Rp 109.00 Rp -
25 mg
N-
67 0 Tab Rp 317.00 Rp -
Asetilsistein
Natrium
Chloride 0,9
68
% ( NACL 0,9
235 btl Rp 6,900.00 Rp 1,621,500 IFK
%)
Oxytocin
69 0 Ampul Rp 1,248.00 Rp -
injeksi
Omeprazole
70 20 mg 7920 Kap Rp 129.00 Rp 1,021,680
Parasetamol
71 0 btl Rp 1,160.00 Rp -
syr
Phytomenadi
72 on inj 54 Ampul Rp 3,900.00 Rp 210,600 IFK
2mg/ml
Phytomenadi
73 160 Tab Rp 781.00 Rp 124,960
on 10 mg
Permetrin
74 0 Tube Rp 11,466.00 Rp -
cream
Ranitidin
75 tablet 150 320 tab Rp 85.00 Rp 27,200
mg
76 Ranitidin 0 Ampul Rp 858.00 Rp -

injeksi
Salbutamol 4
77 0 Tab Rp 67.00 Rp -
mg
Salbutamol
nebulizer
78
(Salbutamo 87 Ampul Rp 5,400.00 Rp 469,800
l Sulfate )
79 Salep 2-4 8 Pot Rp 1,475.00 Rp 11,800
80 Simvastatin 200 tab Rp 73.00 Rp 14,600

10 mg
Simvastatin
81 6200 tab Rp 73.00 Rp 452,600
20 mg
82 Siprofloksasi 0 Tab Rp 260.00 Rp -

n 500 mg
83 Sianocbalami 0 Tab Rp 44.00 Rp -

n (B12)
Sianocobala
min
84 ( Vitamin 187 Ampul Rp 1,066.00 Rp 199,342 IFK
B12) Injeksi
500 mcg
SABU
85 ( Serum Anti 2 Vial Rp 517,132.00 Rp 1,034,264
Bisa Ular)
Tablet
86 tambah 0 tab Rp 255.00 Rp -
darah
87 USG GEL 3 Btl Rp 18,858.33 Rp 56,575
88 VAR 0 Vial Rp 153,000.00 Rp -
Vit.
89
B.Complex
1290 Tab Rp 60 Rp 77,400 IFK
90 Zink 20 mg 0 Tab Rp 253.00 Rp -

tab
BMHP
Catgut
chromic 3/0
91 36 Pcs Rp 68,090.00 Rp 2,451,240
+jarum Bulat
(*optime*)
Disposable
92
syringe 3 cc
700 Pcs Rp 818.00 Rp 572,600 IFK
Disposable
93 100 Pcs Rp 1,100.00 Rp 110,000
syringe 10 cc
Folly
94 10 pcs Rp 11,132.00 Rp 111,320
Catheter 18
Handscoond
95 100 Pasang Rp 13,563.00 Rp 1,356,300
steril no 6
Handscoond
96 281 Pasang Rp 13,563.00 Rp 3,811,203
steril no 6,5
Handscoond
97 steril no 7 50 Pasang Rp 13,563.00 Rp 678,150
Handscoond
98 steril no 7,5 0 Pasang Rp 13,563.00 Rp -
Hand
99 Sanitizer / 0 Btl Rp 68,200.00 Rp -
Handrub 500
ml
Infus Set
101 0 pcs Rp 7,128.00 Rp -
Dewasa
IV.Chateter
102 No.18 G 0 pcs Rp 25,487.00 Rp -
103 Kasa 4 x 10 230 pcs Rp 2,176.72 Rp 500,647
104 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp -
105 Scalpet 200 Pcs Rp 618.70 Rp 123,739

Blades no.10
106 Scalpet 98 Pcs Rp 618.68 Rp 60,631

Blades no.11
Scalpet
107 Blades no.15 79 Pcs Rp 618.71 Rp 48,878
Surgical
mask
108 earloop 3100 Box Rp 1,373.14 Rp 4,256,734
3ply /
Masker
109 Under Pad 200 pcs Rp 37,875.00 Rp 7,575,000

Steril
DAK 2020
1 Acyclovir 130 Tab Rp 454.00 Rp 59,020

400 mg
Betahistine 6
2 0 Tab Rp 119.00 Rp -
mg
Cetrizine 10
4 0 tab Rp 104.00 Rp -
mg
5 Domperidon 0 Botol Rp 2,862.00 Rp -

e syr
6 Anti migren 339 tab Rp 212.00 Rp 71,868

kombinasi
( ERGOTAMI
N)
7 Gentamicine 0 Botol Rp 26.00 Rp -

tetes mata
8 Kodein 10 0 Tab Rp 657.00 Rp -

mg

30 mg
Metilprednis
mg

Drop
BMHP
Catgut
12 chromic 3/0 0 Pcs Rp 55,000.00 Rp -
+jarum Bulat
(*optime*)
Catgut
chromic 3/0
13 +jarum 0 Pcs Rp 62,000.00 Rp -
Segitiga
(*optime*)
Catgut
chromic 2/0
14 +jarum Bulat 42 Pcs Rp 44,000.00 Rp 1,848,000
(*optime-
R*)
Catgut plain
3/0 + jarum
(*Advantime
*)
Feeding
16 0 pcs Rp 8,407.00 Rp -
Tube 14
Feeding
17 0 pcs Rp 8,407.00 Rp -
Tube 16
Handscoond
18 49 Pasang Rp 13,178.00 Rp 645,722
steril no 8
IV.Chateter
19 No.20 G 0 pcs Rp 23,100.00 Rp -
20 IV.Chateter 0 pcs Rp 23,100.00 Rp -

No.22 G
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp -
Silk 2/0 +
22 jarum 1/2 25 0 Pcs Rp 32,500.00 Rp -
mm 75 cm
23 Umbilical 0 Pcs Rp -
Cord Klem Rp 1,495.00
DAU 2020
Aqua pro
1 0 ampul Rp 2,860.00 Rp -
injeksi 20 ml
Hyoscine N
2 butylbromid 0 Ampul Rp 9,900.00 Rp -
e 10 mg inj
Natrium
3 Chloride 0,9 0 btl Rp 6,840.00 Rp -
% ( NACL 0,9
%)
Propylthiour
4 acyl 100 mg 220 Tab Rp 733.00 Rp 161,260
tablet
5 Ringer Laktat 0 btl Rp 7,150.00 Rp -

(RL)
P 2020
Ambroxol
1 sirup 15 0 Btl Rp 3,250.01 Rp -
mg/5 ml
Ambroxol
2 0 Tab Rp 110.00 Rp -
Tablet 30 mg
Bisakodil
3 0 Suppo Rp 23,475.00 Rp -
Suppo
4 Bisakodil 0 Tab Rp 367.00 Rp -

( LAXANA)
Guaiafenesin
5 0 tab Rp 175.00 Rp -
(GG) 100 mg
Kombinasi
Tetes Mata
(Deksametas
on, Neomisin
Sulfat,
6 0 Botol Rp 14,900.00 Rp -
Polimiksin B
Sulfat )
ALLETROL
COMPOSITU
M
Obat batuk
pilek anak
7 kombinasi 0 Botol Rp -
GG
( Dextrofen)
Rp 12,900.00
Obat flu
kombinasi
8 ( pseudoeph 0 tab Rp 600.00 Rp -
edrin Hcl,
Tripolidin Hcl
) FLUTROP
Salbutamol
nebulizer /
9 0 Flash Rp 10,000.00 Rp -
Ventolin
Nebulizer
DAK 2019
1 Acyclovir 0 Tab Rp 425.00 Rp -

400 mg
Alprazolam
2 0 tab Rp 88.00 Rp -
0,5 mg
Cefadroxil
125mg/5ml
Diazepam 5
mg / 2,5 ml
4 0 Tube Rp 14,459.00 Rp -
( STESOLID )
Rektal
5 Kotrimoxazol 0 btl Rp 2,052.00 Rp -

e syr
Metoklopra
6 0 tab Rp 83.00 Rp -
mide 10 mg
Oxtretrasikli
7 0 tube Rp 2,600.00 Rp -
n Salep Mata
8 Pirantel 125 41 tab Rp 331.00 Rp 13,571

mg
Piridoksin
9 HCL ( Vit. B 6 0 tab Rp 141.00 Rp -
) 10 mg
BMHP
10 Alat Suntik 5 900 pcs Rp 1,600 Rp 1,440,000

ml
11 Folly 20 pcs Rp 11,891.00 Rp 237,820

Catheter 14
12 Folly 10 pcs Rp 11,891.00 Rp 118,910

Catheter 16
Infus Set
13 0 pcs Rp 6,842.00 Rp -
Dewasa
PENUNJANG
2019
Gentamicin
1 salep kulit 0 tube Rp 2,640.00 Rp -
Multivitamin
3 syr anak 0 Botol Rp -
( Becefort )
Rp 17,365.70
Anti diare
kombinasi
4 (Kaolin 25 btl Rp 3,850.00 Rp 96,250
Pektin) sirup
(Guanistrep
Sirup)
BG 2019
Articulating
1
Paper
0 Pcs Rp 242,000.00 Rp - IFK
Cotton roll
2
medium
0 Pack Rp 85,800.00 Rp - IFK
3 Eugenol 0 Pot Rp 97,500.00 Rp - IFK

DAK 2018
Diazepam 5
1 0 Tab Rp 109.00 Rp -
mg
2 HCT 25 mg 0 tab Rp 178.00 Rp -
3 Nistatin 0 tab Rp 645.00 Rp -

100.000 IU
BMHP
Plaster
5 0 Roll Rp 29,642.86 Rp -
( Hifafix )
Penunjang
2017
BMHP
Jarum Jahit
1 Segitiga 0 pcs Rp 22,000.00 Rp -
DAU 2017
BMHP
Silk 3/0 +
1 jarum 1/2 GT 0 Pcs Rp 46,187.44 Rp -
35 mm
( Sole)
DAK 2017
1 Diltiazem 30 0 tab Rp 128.00 Rp -

mg
BMHP
KAPAS
ABSORBEN
250 GRAM
Kasa
2 0 Roll Rp 862.50 Rp -
4mx5cm
APBD 2016
BMHP 2016
Infus set
1 anak 50 pcs Rp 6,222.00 Rp 311,100
(Aximed)
DAU 2009
KAPAS
PEMBALUT /
1 4 roll/bungkus Rp 11,914 Rp 47,656
ABSORBEN
250 GRAM
111,633.00 Rp 88,457,721.60
PENERIMAAN
LPLPO, BON
Dokumen Spesifikasi Barang

Tanggal Nomor Nama NUSP
3 4 5 6 7 8
BMHP Program HIV
Safety box
Plesterin Bulat non

woven
Vacum Tube sterile,

plastic, K3 EDTA
Vacutainer Needle
BMHP Program TB
Sputum Pot
7105
DAK 22
Allupurinol 100 mg
11/16/2022 B/442/1692/UPTD- LPLPO Amlodipine 10 mg

IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Amlodipine 5 mg
IFK/XI/2022
B/442/1692/UPTD- Amoxicillin Trihydrate /

11/16/2022 LPLPO Pehamoxiil Forte 500 mg
IFK/XI/2022 (hexapram Jaya )
B/442/1692/UPTD- Ambroxol sirup 15 mg/5

11/16/2022 LPLPO
IFK/XI/2022 ml

mg
B/442/1582/UPTD- Asam Traneksamat

11/15/2022 SPB
IFK/XI/2022 injeksi
B/442/1692/UPTD-
11/16/2022 LPLPO Asam folat tab 1 mg
IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Asam Mefenamat
IFK/XI/2022
Antasida syr
11/16/2022 B/442/1692/UPTD- LPLPO Antasida Doen I Tablet

IFK/XI/2022 Kunyah
11/16/2022 B/442/1692/UPTD- LPLPO Anti Hemoroid komb.

IFK/XI/2022 Supp
B/442/1582/UPTD-
11/15/2022 SPB Betahistine 6 mg
IFK/XI/2022
Captopril 25 mg
B/442/1692/UPTD-
11/16/2022 LPLPO Cetrizine 10 mg
IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Dexamethasone 0,5mg
IFK/XI/2022
Dimenhidrinat 50 mg
B/442/1692/UPTD-
11/16/2022 LPLPO Domperidone 10 mg
IFK/XI/2022
B/442/1582/UPTD- Asam Traneksamat
11/15/2022 SPB
IFK/XI/2022 injeksi
B/442/1692/UPTD-
11/16/2022 LPLPO Fenol gliserol TT 10 %
IFK/XI/2022
Glimepirid 2 mg
Haloperidole 5 mg
B/442/1692/UPTD-
11/16/2022 LPLPO Ibuprofen 400mg
IFK/XI/2022
11/16/2022 B/442/1692/UPTD- LPLPO Isosorbid Dinitrat tablet

IFK/XI/2022 sublingual 5mg
B/442/1692/UPTD-
11/16/2022 LPLPO Kalk
IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Ketokonazol 200mg
IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Ketokonazole cream
IFK/XI/2022
B/442/1692/UPTD- Klorfeniramin maleat

11/16/2022 LPLPO
IFK/XI/2022 (CTM) 4 mg
B/442/1692/UPTD-
11/16/2022 LPLPO Kodein 10 mg
IFK/XI/2022
Lansoprazole 30 mg
B/442/1692/UPTD-
11/16/2022 LPLPO Metformin HCL 500 mg
IFK/XI/2022
4 mg
B/442/1692/UPTD-
11/16/2022 IFK/XI/2022 LPLPO Metronidazol 500mg
B/442/1692/UPTD-
11/16/2022 LPLPO Metoklopramide 10 mg
IFK/XI/2022
Multivitamin sirup
anak (Novakid)
Novatusin syr
B/442/1692/UPTD-
11/16/2022 LPLPO N-Asetilsistein 200mg
IFK/XI/2022
B/442/1692/UPTD- Natrium Diklofenak 50

11/16/2022 LPLPO
IFK/XI/2022 mg
B/442/1692/UPTD-
11/16/2022 LPLPO Omeprazole inj
IFK/XI/2022
Paracetamol Drop
Paracetamol syr
B/442/1692/UPTD-
11/16/2022 LPLPO Paracetamol 500 mg
IFK/XI/2022
B/442/1582/UPTD-
11/15/2022 IFK/XI/2022 SPB Ranitidine injeksi
B/442/1692/UPTD-
11/16/2022 LPLPO Scabimite cream
IFK/XI/2022
ml
ml

ml
B/442/1692/UPTD-
11/16/2022 LPLPO Prednison 5 mg
IFK/XI/2022
Rivanol
B/442/1692/UPTD-
11/16/2022 LPLPO Ringer Laktat (RL)
IFK/XI/2022
Salbutamol 2 mg
B/442/1692/UPTD-
IFK/XI/2022
Salbutamol inhaler
11/16/2022 B/442/1692/UPTD- LPLPO Sefadroksil 500mg

IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Simvastatin 10 mg
IFK/XI/2022
11/16/2022 B/442/1692/UPTD- LPLPO Simvastatin 20 mg

IFK/XI/2022
11/16/2022 B/442/1692/UPTD- LPLPO USG GEL

IFK/XI/2022
Vitamin B1
11/16/2022 B/442/1692/UPTD- LPLPO Vitamin B6

IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Vitamin B12
IFK/XI/2022
BMHP
Alkohol 70% 100 mL
B/442/1692/UPTD-
11/16/2022 LPLPO Alkohol 70% 1000 mL
IFK/XI/2022
B/442/1692/UPTD-
IFK/XI/2022
B/442/1692/UPTD-
IFK/XI/2022
B/442/1692/UPTD-
IFK/XI/2022
11/16/2022 B/442/1692/UPTD- LPLPO Handscoon non steril L

IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Handscoon non steril M
IFK/XI/2022
11/16/2022 B/442/1692/UPTD- LPLPO Handscoon non steril S

IFK/XI/2022

Hamburg )
IV.Chateter No.18 G
IV.Chateter No.20 G
IV.Chateter No.22 G
IV.Chateter No.24 G
IV.Chateter No.26 G
B/442/1692/UPTD-
11/16/2022 LPLPO Kasa 16 x 16
IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Kasa 40x80
IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 IFK/XI/2022 LPLPO Plester Putih 5x10
B/442/1692/UPTD-
IFK/XI/2022
B/442/1692/UPTD-
IFK/XI/2022
Rivanol
Umbilical Cord Klem
BG 2021
Bahan tambal sinar
B/442/1692/UPTD-
11/16/2022 LPLPO Cairan bonding
IFK/XI/2022

liquid
DAU 2021

OMEGA 3
BMHP
Sarung Tangan Uk. S
Sarung Tangan Uk. M
P 21
Acyclovir Cream
Bedak Salisil
Bicombin inj
Cefadroxil 500 mg
Klorpromazin 100 mg
(CPZ )
Digoxin 0,5 mg

5mg/2,5ml
Eflin
Furosemid

mg
Ibuprofen 200mg
Lexartans (as.
Traneksamat)
Meloxicam 7,5 mg
Novastan syr
Nifedipine
Neo Diaform
Kulit 3%
OBH Plus
Paracetamol 500 mg
Pehavral
Reco Salep Mata

( Chloamphenicol)
Reco Tetes Telinga

(Chloramphenicol)
Skincol Gel
B/442/1692/UPTD-
11/16/2022 LPLPO Tramadol inj 50 mg/ml
IFK/XI/2022
Visoprin
DAK 2021
(hexapram Jaya )

125mg/5ml
Amox icillin Drop
Allupurinol 100 mg
Allupurinol 300 mg
Asam Mefenamat
Amlodipine 5 mg
Amlodipine 10 mg

i.v 1000 mg/ Vial
Antifungi DOEN
kombinasi: Asam
Benzoat 3% + Asam
Salisilat 6%

Kunyah

mg
Asam Traneksamat
injeksi
Asam folat tab 1 mg
B/442/1692/UPTD-
11/16/2022 IFK/XI/2022 LPLPO Asetosal 80 mg
B/442/1692/UPTD-
11/16/2022 LPLPO Aqua pro injeksi 25 ml
IFK/XI/2022
Betahistine 6 mg
Betamethason cream
Bisakodil Suppo
Bisakodil 5 mg
Captopril 12,5 mg
Cetrizine syr
Cefotaxim Injeksi
11/16/2022 B/442/1692/UPTD- LPLPO Dexamethasone injeksi

IFK/XI/2022
Dextrosa 10 %
Doksisiklin
Domperidone syr
Epinephrine
Furosemid Injeksi
i.v./i.m 10mg/ml
Glukosa Infus D5%
Glibenklamide 5 mg
Haloperidole 5 mg
Hyoscine N
butylbromide
Karbogliserin tetes
telinga 10% (phenol

mg

%
B/442/1692/UPTD-
11/16/2022 LPLPO Ketorolac inj 30Mg/MI
IFK/XI/2022
Karbamazepin 200mg
B/442/1692/UPTD-
11/16/2022 LPLPO KAEN 3B
IFK/XI/2022

sublingual 5mg
Ibuprofen Syr
100mg/5ml
Ketokonazole Cream
Ketokonazole tablet
200mg
125 mg/ 5ml
Kodein 10 mg
Lansoprazole 30 mg
B/442/1692/UPTD- Lidokain comp (Lidokain

11/16/2022 LPLPO injeksi 2% (HCI) +
IFK/XI/2022 epinefrin)
Loratadine
4 mg
8 mg
Metoklopramid 10 mg
Metoklopramid inj
Methamizole Na Inj
Metronidazol sirup
MGSO4 40 %
MGSO4 20 %
Mikonazole kream
Nistatin drop

IU
mg
N-Asetilsistein
B/442/1692/UPTD- Natrium Chloride 0,9 %

11/16/2022 LPLPO
IFK/XI/2022 ( NACL 0,9 %)
Oxytocin injeksi
Omeprazole 20 mg
Parasetamol syr
B/442/1692/UPTD- Phytomenadion inj

11/16/2022 LPLPO
IFK/XI/2022 2mg/ml
Phytomenadion 10 mg
Permetrin cream
Ranitidin injeksi
Salbutamol 4 mg
Salep 2-4
Simvastatin 10 mg
Simvastatin 20 mg
Sianocbalamin (B12)
B/442/1692/UPTD- Sianocobalamin
11/16/2022 LPLPO ( Vitamin B12) Injeksi
IFK/XI/2022 500 mcg

Ular)
Tablet tambah darah
USG GEL
VAR
11/16/2022 B/442/1692/UPTD- LPLPO Vit. B.Complex

IFK/XI/2022
Zink 20 mg tab
Zink syr
BMHP
Catgut chromic 3/0

B/442/1692/UPTD-
11/16/2022 IFK/XI/2022 LPLPO Disposable syringe 3 cc
Folly Catheter 18

Hand Sanitizer /
Handrub 500 ml
Handscrub
Infus Set Dewasa
IV.Chateter No.18 G
Kasa 4 x 10
Kasa 4 x 5

3ply / Masker
Under Pad Steril
DAK 2020
Acyclovir 400 mg
Betahistine 6 mg
CTM 4 mg
Cetrizine 10 mg
Domperidone syr

( ERGOTAMIN )
Kodein 10 mg
Lansoprazole 30 mg
4 mg
Paracetamol Drop
BMHP
Catgut chromic 3/0

Catgut chromic 3/0

+jarum Segitiga
(*optime*)
Catgut chromic 2/0

R*)

Feeding Tube 14
Feeding Tube 16
IV.Chateter No.20 G
IV.Chateter No.22 G
Kasa 16x16
Silk 2/0 + jarum 1/2 25

mm 75 cm
Umbilical Cord Klem
DAU 2020

Hyoscine N
Natrium Chloride 0,9 %

( NACL 0,9 %)
tablet
Ringer Laktat (RL)
P 2020

ml
Bisakodil Suppo
Bisakodil ( LAXANA)

mg

(Deksametason,
Neomisin Sulfat,
ALLETROL
COMPOSITUM

kombinasi GG
( Dextrofen)
Obat flu kombinasi
Ventolin Nebulizer
Hemafort
DAK 2019
Acyclovir 400 mg
Alprazolam 0,5 mg

125mg/5ml
Diazepam 5 mg / 2,5 ml (
STESOLID ) Rektal
Kotrimoxazole syr
Mata
Pirantel 125 mg

10 mg
BMHP
Alat Suntik 5 ml
Folly Catheter 14
Folly Catheter 16
Infus Set Dewasa
urine bag
PENUNJANG 2019
Loperamide

( Becefort )

(Guanistrep Sirup)
BG 2019
B/442/1692/UPTD-
11/16/2022 LPLPO Articulating Paper
IFK/XI/2022
11/16/2022 B/442/1692/UPTD- LPLPO Cotton roll medium

IFK/XI/2022
B/442/1692/UPTD-
11/16/2022 LPLPO Eugenol
IFK/XI/2022
Pehacain
DAK 2018
Diazepam 5 mg
HCT 25 mg
Nistatin 100.000 IU
BMHP
Blood Lancet
Plaster ( Hifafix )
Penunjang 2017
BMHP
DAU 2017
BMHP
35 mm ( Sole)
DAK 2017
Diltiazem 30 mg
BMHP
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
Kasa 4mx5cm
APBD 2016
BMHP 2016
DAU 2009
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
BUKU PENERIMAAN DAN PENGELUARAN PE
TAHUN 20
PENERIMAAN
LPLPO, BON
Spesifikasi Barang Harga Satuan Nilai Total

Spesifikasi Nama Barang (Rp) (Rp)
9 10 11 12 13
BMHP Program HIV
Safety box IDR Rp -

Rp 16,666.00
Plesterin Bulat non woven Kotak Rp -

Rp 40,187.50
Vacum Tube sterile, plastic, K3 Pcs Rp -

EDTA
Rp 1,160.00
surgical Gloves no. 7, 5 Pcs Rp 13,178.00 Rp -
surgical Gloves no. 8 Pcs Rp 13,178.00 Rp -
Vacutainer Needle Pcs Rp 132.00 Rp -
BMHP Program TB
Larutan Zhihi Neeisen Paket Rp -

Rp 274,362.00
Sputum Pot Biji Rp -

Rp 3,137.00
Object Glass Frosted 7105 box @ 72 pcs Rp -
Rp 23,860.08
DAK 22
Allupurinol 100 mg Tab Rp -

Rp 89.00
Amlodipine 10 mg 2000 Tab Rp 149,340.00
Rp 74.67
Amlodipine 5 mg 3000 Tab Rp 165,000.00
Rp 55.00
Pehamoxiil Forte 500 mg 4000 Tab Rp 924,000.00
(hexapram Jaya )
Rp 231.00
Ambroxol sirup 15 mg/5 ml 300 Btl Rp 1,440,000.00
Rp 4,800.00
Asam Traneksamat 500 mg Tab Rp -

Rp 1,927.00
Asam Traneksamat injeksi 20 Ampul Rp 36,740.00

Rp 1,837.00
Asam folat tab 1 mg 4000 Tab Rp 244,000.00

Rp 61.00
Asam Mefenamat 2000 tab Rp 234,000.00

Rp 117.00
Antasida syr Btl Rp 1,756.00 Rp -
Antasida Doen I Tablet Kunyah 5000 tab Rp 270,000.00

Rp 54.00
Anti Hemoroid komb. Supp 50 Suppo Rp 163,000.00

Rp 3,260.00
Betahistine 6 mg 4000 tab Rp 372,000.00
Rp 93.00
Captopril 25 mg tab Rp -
Rp 72.00
Cetrizine 10 mg 4000 tab Rp 209,880.00
Rp 52.47
Ciprofloxacin 500 mg tab Rp -

Rp 260.00
Dexamethasone 0,5mg 5000 Tablet Rp 530,000.00

Rp 106.00
Dimenhidrinat 50 mg tab Rp -
Rp 109.00
Domperidone 10 mg 1000 Tablet Rp 75,680.00
Rp 75.68
Asam Traneksamat injeksi 5 Vial Rp 41,235.00

Rp 8,247.00
Fenol gliserol TT 10 % 96 Btl Rp 316,800.00

Rp 3,300.00
Glimepirid 2 mg Tab Rp -
Rp 123.00
Hidrokortisone cream Tube Rp -

Rp 2,325.00
Haloperidole 5 mg Tab Rp -
Rp 54.00
Ibuprofen 400mg 4000 Tab Rp 840,000.00
Rp 210.00

sublingual 5mg 200 Tab Rp 19,980.00
Rp 99.90
Kalk 3000 Tablet Rp 180,000.00
Rp 60.00
Ketokonazol 200mg 300 Tab Rp 78,000.00
Rp 260.00
Ketokonazole cream 50 Tube Rp 119,950.00

Rp 2,399.00
Klorfeniramin maleat (CTM) 4 3000 Tab Rp 258,000.00

mg
Rp 86.00
Kodein 10 mg 200 Tab Rp 121,000.00
Rp 605.00
Lansoprazole 30 mg Kap Rp -
Rp 278.00
Metformin HCL 500 mg 8000 tab Rp 616,000.00
Rp 77.00
Metilprednisolon tablat 4 mg tab Rp -

Rp 102.00
Metronidazol 500mg 2000 tab Rp 634,000.00

Rp 317.00
Metoklopramide 10 mg 500 tab Rp 33,000.00

Rp 66.00
Multivitamin sirup anak Btl Rp -

(Novakid)
Rp 7,400.00
Novatusin syr Btl Rp -
Rp 8,200.00
N-Asetilsistein 200mg 300 Kapsule Rp 95,961.00

Rp 319.87
Natrium Diklofenak 50 mg 3000 Tablet Rp 327,000.00

Rp 109.00
Omeprazole inj 150 Ampl Rp 801,900.00
Rp 5,346.00
Paracetamol Drop Drop Rp -
Rp 5,204.00
Paracetamol syr Btl Rp -
Rp 1,160.00
Paracetamol 500 mg 9000 Tab Rp 2,313,000.00
Rp 257.00
Ranitidine injeksi 150 Ampul Rp 128,700.00
Rp 858.00
Scabimite cream 30 Tube Rp 343,980.00
Rp 11,466.00
Prednison 5 mg 2000 tab Rp 146,000.00

Rp 73.00
Ringer Laktat (RL) 520 Btl Rp 4,005,560.00
Rp 7,703.00
Salbutamol 2 mg Tab Rp -
Rp 51.00
Salbutamol 4 mg 3000 Tab Rp 201,000.00
Rp 67.00
Salbutamol inhaler Btl Rp -
Rp 22,200.00
Sefadroksil 500mg 1000 Kap Rp 1,036.00 Rp 1,036,000.00
Simvastatin 10 mg 2000 Kap Rp 146,000.00

Rp 73.00
Simvastatin 20 mg 2000 Kap Rp 300,000.00
Rp 150.00
USG GEL 10 pcs Rp 16,632.00 Rp 166,320.00
Vitamin B1 tab Rp -
Rp 173.00
Vitamin B6 3000 tab Rp 216,000.00

Rp 72.00
Vitamin B12 2000 tab Rp 88,000.00

Rp 44.00
BMHP
Alkohol 70% 1000 mL 5 Btl Rp 23,595.00 Rp 117,975.00
Disposable syringe 3 cc pcs Rp 825.00 Rp -
Disposable syringe 5 cc 500 pcs Rp 955.00 Rp 477,500.00
Handscoon non steril L 2000 pcs Rp 2,504,160.00

Rp 1,252.08
Handscoon non steril M 2000 pcs Rp 2,504,160.00
Rp 1,252.08
Handscoon non steril S 2000 pcs Rp 2,504,160.00

Rp 1,252.08
Infuset Dewasa ( Troge Hamburg ) pcs Rp -

Rp 26,062.00
IV.Chateter No.18 G pcs Rp -
Rp 26,418.00
Rp 26,418.00
Rp 26,418.00
Rp 26,418.00
Rp 27,639.00
Kasa 16 x 16 50 pcs Rp 3,541.00 Rp 177,050.00
Kasa 40x80 20 pcs Rp 91,045.00 Rp 1,820,900.00

Rp 61,605.00

Rp 32,190.00
Plester Putih 5x2 19 pcs Rp 21,638.40 Rp 411,129.60
Umbilical Cord Klem pcs Rp 2,070.00 Rp -
BG 2021
Bahan tambal sinar Syringe Rp 356,400.00 Rp -
Cairan bonding 1 Pot Rp 391,500.00 Rp 391,500.00
Cairan etsa / Etching liquid Pcs Rp 67,500.00 Rp -
DAU 2021
Multivitamin Ibu Hamil OMEGA 3 Btl isi @ 30 kapsul Rp 45,000.00 Rp -

BMHP
Sarung Tangan Uk. S Pcs Rp 1,712.53 Rp -
Sarung Tangan Uk. M Pcs Rp 1,710.13 Rp -
P 21
Acyclovir Cream Tube Rp 4,400.00 Rp -
Bedak Salisil Wadah Rp 7,700.00 Rp -
Bicombin inj Ampul Rp 6,600.00 Rp -
Cefadroxil 500 mg Kap Rp 880.00 Rp -
Klorpromazin 100 mg (CPZ ) Kap Rp 495.00 Rp -
Digoxin 0,5 mg Tab Rp 198.00 Rp -

Suppo Rp 30,800.00 Rp -
5mg/2,5ml
Eflin Tab Rp 1,413.50 Rp -
Furosemid Tab Rp 275.00 Rp -
Ibuprofen 200mg Tab Rp 275.00 Rp -
Kloramfenikol 250 mg Kap Rp 770.00 Rp -
Lexartans (as. Traneksamat) Tab Rp 1,650.00 Rp -
Meloxicam 7,5 mg Tab Rp 385.00 Rp -
Novastan syr Btl Rp 11,000.00 Rp -
Nifedipine Tab Rp 220.00 Rp -
Neo Diaform Tab Rp 286.00 Rp -

Oxytetracycline Salep Kulit 3% Tube Rp 4,950.00 Rp -
OBH Plus Btl Rp 12,100.00 Rp -
Paracetamol 500 mg tab Rp 275.00 Rp -
Pehavral tab Rp 1,045.00 Rp -
Reco Salep Mata

( Chloamphenicol) Tube Rp 6,600.00 Rp -
Reco Tetes Telinga

(Chloramphenicol) Btl Rp 11,000.00 Rp -
Skincol Gel Tube Rp 148,500.00 Rp -
Tramadol inj 50 mg/ml 65 Ampul Rp 11,000.00 Rp 715,000.00
Visoprin Btl Rp 72,600.00 Rp -
DAK 2021
Pehamoxiil Forte 500 mg Tab Rp 231.00 Rp -
(hexapram Jaya )
Amoksisilin sirup kering Btl Rp 2,050.00 Rp -

125mg/5ml
Amox icillin Drop Btl Rp 11,750.00 Rp -
Asam Mefenamat tab Rp 117.00 Rp -

Ampisillin serbuk injeksi i.v 1000 Vial Rp 9,900.00 Rp -

mg/ Vial
Antihemeroid kombinasi Suppo Rp 3,260.00 Rp -

Benzoat 3% + Asam Salisilat 6% Botol Rp 3,637.00 Rp -
Antasida Doen I Tablet Kunyah Tab Rp 54.00 Rp -
Antasida Doen suspensi Botol Rp 1,756.00 Rp -
Asam askorbat / Vit C 50 mg Tab Rp 46.00 Rp -
Asam Traneksamat injeksi amp Rp 1,820.00 Rp -
Asam folat tab 1 mg pcs Rp 61.00 Rp -
Asetosal 80 mg 200 Tab Rp 89.00 Rp 17,800.00
Aqua pro injeksi 25 ml 240 Tab Rp 2,650.00 Rp 636,000.00
Betamethason cream Tab Rp 1,540.00 Rp -
Bisakodil 5 mg Tab Rp 5,085.00 Rp -
Captopril 12,5 mg tab Rp 68.00 Rp -
Cetrizine syr Botol Rp 2,215.00 Rp -

Cefotaxim Injeksi Vial Rp 3,050.00 Rp -
Diazepam inj 5 mg / 2 ml Ampul Rp 1,545.00 Rp -
Dexamethasone injeksi 200 Ampul Rp 968.00 Rp 193,600.00
Dextrosa 10 % Botol Rp 7,200.00 Rp -
Doksisiklin Tab Rp 289.00 Rp -
Eritromisin sirup 200 mg Botol Rp 7,436.00 Rp -
Epinephrine Ampul Rp 1,740.00 Rp -
Furosemid Injeksi i.v./i.m Ampul Rp 969.00 Rp -

10mg/ml
Glukosa Infus D5% btl Rp 7,363.00 Rp -
Glibenklamide 5 mg Tab Rp 87.00 Rp -
Haloperidole 5 mg Tab Rp 54.00 Rp -
Hyoscine N butylbromide Tab Rp 1,050.00 Rp -

Kalsium laktat (Kalk) 500 mg Tab Rp 60.00 Rp -
Kalsium Glukonat inj 10 % Ampul Rp 6,199.00 Rp -
Ketorolac inj 30Mg/MI 150 Ampul Rp 923.00 Rp 138,450.00
Karbamazepin 200mg tab Rp 216.00 Rp -

KAEN 3B 20 tab Rp 11,500.00 Rp 230,000.00

Tab Rp 99.00 Rp -
sublingual 5mg
Ibuprofen Syr 100mg/5ml Btl Rp 2,339.00 Rp -
Ketokonazole Cream Tube Rp 2,399.00 Rp -
Ketokonazole tablet 200mg Tab Rp 260.00 Rp -

Btl Rp 5,352.00 Rp -
5ml
Lidokain comp (Lidokain injeksi

2% (HCI) + epinefrin) 210 Ampul Rp 847.00 Rp 177,870.00
Lidocain inj 2 % (HCL) Ampul Rp 891.00 Rp -
Loratadine kap Rp 117.00 Rp -
Metoklopramid 10 mg tab Rp 66.00 Rp -
Metoklopramid inj Ampul Rp 1,983.00 Rp -
Methamizole Na Inj Ampul Rp 3,045.00 Rp -

Metronidazol sirup Btl Rp 3,765.00 Rp -
MGSO4 40 % Ampul Rp 4,700.00 Rp -
MGSO4 20 % Ampul Rp 4,120.00 Rp -
Mikonazole kream Tube Rp 1,900.00 Rp -
Nistatin drop Btl Rp 11,750.00 Rp -
Nistatin Ovula 100.000 IU tab Rp 550.00 Rp -
Natrium Diklofenak 25 mg tab Rp 109.00 Rp -
N-Asetilsistein Tab Rp 317.00 Rp -

%) 180 btl Rp 6,900.00 Rp 1,242,000.00
Oxytocin injeksi Ampul Rp 1,248.00 Rp -
Omeprazole 20 mg Kap Rp 129.00 Rp -
Parasetamol syr btl Rp 1,160.00 Rp -
Phytomenadion inj 2mg/ml 60 Ampul Rp 3,900.00 Rp 234,000.00
Phytomenadion 10 mg Tab Rp 781.00 Rp -
Permetrin cream Tube Rp 11,466.00 Rp -
Ranitidin tablet 150 mg tab Rp 85.00 Rp -
Ranitidin injeksi Ampul Rp 858.00 Rp -
Salbutamol 4 mg Tab Rp 67.00 Rp -
Salbutamol nebulizer Ampul Rp 5,400.00 Rp -

Salep 2-4 Pot Rp 1,475.00 Rp -

Siprofloksasin 500 mg Tab Rp 260.00 Rp -
Sianocbalamin (B12) Tab Rp 44.00 Rp -

Injeksi 500 mcg 100 Ampul Rp 1,066.00 Rp 106,600.00
SABU ( Serum Anti Bisa Ular) Vial Rp 517,132.00 Rp -
Tablet tambah darah tab Rp 255.00 Rp -
USG GEL Btl Rp 18,858.33 Rp -

VAR Vial Rp 153,000.00 Rp -
Vit. B.Complex 3900 Tab Rp 60 Rp 234,000.00
Zink 20 mg tab Tab Rp 253.00 Rp -
Zink syr Btl Rp 2,489.00 Rp -

BMHP

Pcs Rp 68,090.00 Rp -
(*optime*)
Disposable syringe 3 cc 2000 Pcs Rp 818.00 Rp 1,636,000.00

Hand Sanitizer / Handrub 500 ml Btl Rp 68,200.00 Rp -
Handscrub Btl Rp 115,800.00 Rp -
Infus Set Dewasa pcs Rp 7,128.00 Rp -
Kasa 4 x 10 pcs Rp 2,176.72 Rp -
Kasa 4 x 5 pcs Rp 1,089.67 Rp -

Box Rp 1,373.14 Rp -
Masker
Under Pad Steril pcs Rp 37,875.00 Rp -
DAK 2020
CTM 4 mg tab Rp 26.00 Rp -
tab Rp 212.00 Rp -

( ERGOTAMIN )
Gentamicine tetes mata Botol Rp 26.00 Rp -

Paracetamol Drop Botol Rp 7,646.00 Rp -
BMHP
Catgut chromic 3/0 +jarum Bulat Pcs Rp 55,000.00 Rp -

(*optime*)
Catgut chromic 3/0 +jarum Pcs Rp 62,000.00 Rp -

Segitiga (*optime*)

Pcs Rp 44,000.00 Rp -
(*optime-R*)

Pcs Rp 71,000.00 Rp -
(*Advantime*)
Kasa 16x16 pcs Rp 7,897.31 Rp -
Silk 2/0 + jarum 1/2 25 mm 75 cm Pcs Rp 32,500.00 Rp -
Umbilical Cord Klem Pcs Rp -

Rp 1,495.00
DAU 2020
Aqua pro injeksi 20 ml ampul Rp 2,860.00 Rp -

Ampul Rp 9,900.00 Rp -
inj
Natrium Chloride 0,9 % ( NACL 0,9 btl Rp 6,840.00 Rp -

%)
Propylthiouracyl 100 mg tablet Tab Rp 733.00 Rp -
Ringer Laktat (RL) btl Rp 7,150.00 Rp -
P 2020
Ambroxol sirup 15 mg/5 ml Btl Rp 3,250.01 Rp -
Ambroxol Tablet 30 mg Tab Rp 110.00 Rp -
Bisakodil ( LAXANA) Tab Rp 367.00 Rp -

Botol Rp 14,900.00 Rp -
COMPOSITUM
Obat batuk pilek anak kombinasi Botol Rp -

GG ( Dextrofen)
Rp 12,900.00
Obat flu kombinasi
( pseudoephedrin Hcl, Tripolidin tab Rp 600.00 Rp -
Hcl ) FLUTROP

Flash Rp 10,000.00 Rp -
Nebulizer
Hemafort Tab Rp 820.00 Rp -
DAK 2019
Alprazolam 0,5 mg tab Rp 88.00 Rp -

btl Rp 4,360.00 Rp -
125mg/5ml
Tube Rp 14,459.00 Rp -
( STESOLID ) Rektal
Kotrimoxazole syr btl Rp 2,052.00 Rp -
Metoklopramide 10 mg tab Rp 83.00 Rp -
Oxtretrasiklin Salep Mata tube Rp 2,600.00 Rp -
Pirantel 125 mg tab Rp 331.00 Rp -
Piridoksin HCL ( Vit. B 6 ) 10 mg tab Rp 141.00 Rp -
BMHP
Alat Suntik 5 ml pcs Rp 1,600 Rp -

urine bag pcs Rp 1,848.00 Rp -
PENUNJANG 2019
Gentamicin salep kulit tube Rp 2,640.00 Rp -
Loperamide Tab Rp 198.00 Rp -
Multivitamin syr anak ( Becefort ) Botol Rp -
Rp 17,365.70
Anti diare kombinasi (Kaolin btl Rp 3,850.00 Rp -

Pektin) sirup (Guanistrep Sirup)
BG 2019
Articulating Paper 1 Pcs Rp 242,000.00 Rp 242,000.00
Cotton roll medium 1 Pack Rp 85,800.00 Rp 85,800.00
Eugenol 1 Pot Rp 97,500.00 Rp 97,500.00
Pehacain Ampul Rp 3,113.0495 Rp -

DAK 2018
Diazepam 5 mg Tab Rp 109.00 Rp -
HCT 25 mg tab Rp 178.00 Rp -
Nistatin 100.000 IU tab Rp 645.00 Rp -
BMHP
Blood Lancet Pcs Rp 167.509 Rp -
Plaster ( Hifafix ) Roll Rp 29,642.86 Rp -
Penunjang 2017
BMHP
Jarum Jahit Segitiga pcs Rp 22,000.00 Rp -
DAU 2017
BMHP
Silk 3/0 + jarum 1/2 GT 35 mm Pcs Rp 46,187.44 Rp -
( Sole)
DAK 2017
Diltiazem 30 mg tab Rp 128.00 Rp -
BMHP
KAPAS PEMBALUT / ABSORBEN Bks Rp 14,375.00 Rp -

250 GRAM
Kasa 4mx5cm Roll Rp 862.50 Rp -
APBD 2016
BMHP 2016
Infus set anak (Aximed) pcs Rp 6,222.00 Rp -
DAU 2009

roll/bungkus Rp 11,914 Rp -
250 GRAM
98524 Rp 36,964,630.60
AN PENGELUARAN PERSEDIAAN ( ASET OBAT DROPPING )
TAHUN 2022
PUSKESMAS ( RGD, RPP, LAB, RKGM, Poli Umum, Promkes, Pendaftaran , TU

Dokumen
Keterangan No Pengguna Kode Barang
Nomor Nama
Tanggal
14 15 16 17 18 19 20
Saldo 2021
PENGELUARAN
GM, Poli Umum, Promkes, Pendaftaran , TU , Posko ) , DESA ( Pelayanan Poskesdes, Lansia, Imunisasi, Bumil, Posyandu Balita, Posko )
Spesifikasi Barang Jumlah Satuan Barang
Nama Barang
NUSP Spesifikasi Nama Barang
21 22 23 24 25
BMHP Program HIV BMHP Program HIV
Safety box Safety box 0 IDR
Plesterin Bulat non

woven Plesterin Bulat non woven 0 Kotak
Vacum Tube sterile, Vacum Tube sterile, plastic, K3

plastic, K3 EDTA EDTA 400 Pcs
surgical Gloves no. 7, 5 surgical Gloves no. 7, 5 0 Pcs
surgical Gloves no. 8 surgical Gloves no. 8 0 Pcs
Vacutainer Needle Vacutainer Needle 150 Pcs
BMHP Program TB BMHP Program TB
Larutan Zhihi Neeisen Larutan Zhihi Neeisen 0 Paket
Sputum Pot Sputum Pot 0 Biji

7105
Object Glass Frosted 7105 0 box @ 72 pcs
DAK 22 DAK 22
Allupurinol 100 mg Allupurinol 100 mg 0 Tab
Amlodipine 10 mg Amlodipine 10 mg 1880 Tab
Amoxicillin Trihydrate / Amoxicillin Trihydrate /

Pehamoxiil Forte 500 mg Pehamoxiil Forte 500 mg 2300 Tab
(hexapram Jaya ) (hexapram Jaya )

ml
Ambroxol sirup 15 mg/5 ml 81 Btl

mg
Asam Traneksamat 500 mg 90 Tab
Asam Traneksamat
injeksi
Asam Traneksamat injeksi 20 Ampul
Asam folat tab 1 mg Asam folat tab 1 mg 0 Tab
Asam Mefenamat Asam Mefenamat 400 tab
Antasida syr Antasida syr 505 Btl

Kunyah Antasida Doen I Tablet Kunyah 5740 tab
Anti Hemoroid komb.

Supp Anti Hemoroid komb. Supp 16 Suppo
Betahistine 6 mg Betahistine 6 mg 1930 tab

Captopril 25 mg Captopril 25 mg 340 tab
Cetrizine 10 mg Cetrizine 10 mg 1110 tab
Ciprofloxacin 500 mg Ciprofloxacin 500 mg 370 tab
Dexamethasone 0,5mg Dexamethasone 0,5mg 3270 Tablet
Dimenhidrinat 50 mg Dimenhidrinat 50 mg 90 tab
Domperidone 10 mg Domperidone 10 mg 590 Tablet
Asam Traneksamat
injeksi
Asam Traneksamat injeksi 5 Vial
Fenol gliserol TT 10 % Fenol gliserol TT 10 % 20 Btl
Glimepirid 2 mg Glimepirid 2 mg 410 Tab
Hidrokortisone cream Hidrokortisone cream 19 Tube
Haloperidole 5 mg Haloperidole 5 mg 10 Tab
Ibuprofen 400mg Ibuprofen 400mg 2080 Tab
Isosorbid Dinitrat tablet Isosorbid Dinitrat tablet

sublingual 5mg sublingual 5mg 0 Tab
Kalk Kalk 4120 Tablet
Ketokonazol 200mg Ketokonazol 200mg 24 Tab
Ketokonazole cream Ketokonazole cream 0 Tube
Klorfeniramin maleat Klorfeniramin maleat (CTM) 4

(CTM) 4 mg mg 3365 Tab
Kodein 10 mg Kodein 10 mg 20 Tab
Lansoprazole 30 mg Lansoprazole 30 mg 0 Kap

Metformin HCL 500 mg Metformin HCL 500 mg 5040 tab
4 mg
Metilprednisolon tablat 4 mg 0 tab
Metronidazol 500mg Metronidazol 500mg 70 tab
Metoklopramide 10 mg Metoklopramide 10 mg 100 tab
Multivitamin sirup Multivitamin sirup anak

anak (Novakid) (Novakid) 16 Btl
Novatusin syr Novatusin syr 0 Btl
N-Asetilsistein 200mg N-Asetilsistein 200mg 740 Kapsule
mg Natrium Diklofenak 50 mg 820 Tablet
Omeprazole inj Omeprazole inj 32 Ampl
Paracetamol Drop Paracetamol Drop 19 Drop
Paracetamol syr Paracetamol syr 77 Btl
Paracetamol 500 mg Paracetamol 500 mg 6770 Tab
Ranitidine injeksi Ranitidine injeksi 50 Ampul
Scabimite cream Scabimite cream 9 Tube
ml
Povidon iodida 10 % 30 ml 0 Btl
ml

ml
Prednison 5 mg Prednison 5 mg 240 tab
Rivanol Rivanol 0 Btl

Ringer Laktat (RL) Ringer Laktat (RL) 240 Btl
Salbutamol 2 mg Salbutamol 2 mg 300 Tab
Salbutamol inhaler Salbutamol inhaler 0 Btl
Sefadroksil 500mg Sefadroksil 500mg 200 Kap
Simvastatin 10 mg Simvastatin 10 mg 0 Kap
Simvastatin 20 mg Simvastatin 20 mg 0 Kap
USG GEL USG GEL 0 pcs
Vitamin B1 Vitamin B1 200 tab
BMHP BMHP
Alkohol 70% 100 mL Alkohol 70% 100 mL 0 Btl
Alkohol 70% 1000 mL Alkohol 70% 1000 mL 4 Btl
Disposable syringe 1 cc Disposable syringe 1 cc 1000 pcs
Handscoon non steril L Handscoon non steril L 1200 pcs

Handscoon non steril M Handscoon non steril M 1100 pcs
Handscoon non steril S Handscoon non steril S 2100 pcs

Hamburg ) Infuset Dewasa ( Troge Hamburg ) 0 pcs
IV.Chateter No.18 G IV.Chateter No.18 G 0 pcs
Kasa 16 x 16 Kasa 16 x 16 50 pcs
Kasa 40x80 Kasa 40x80 17 pcs
Plester Putih 5x10 Plester Putih 5x10 0 pcs
Rivanol Rivanol 15 Btl
Umbilical Cord Klem Umbilical Cord Klem 0 pcs
BG 2021 BG 2021
Bahan tambal sinar Bahan tambal sinar 0 Syringe
Cairan bonding Cairan bonding 1 Pot

liquid
Cairan etsa / Etching liquid 0 Pcs
DAU 2021 DAU 2021

OMEGA 3
Multivitamin Ibu Hamil OMEGA 3 0 Btl isi @ 30 kapsul
BMHP BMHP
Disposable syringe 1 cc Disposable syringe 1 cc 0 Pcs
Sarung Tangan Uk. S Sarung Tangan Uk. S 0 Pcs
Sarung Tangan Uk. M Sarung Tangan Uk. M 0 Pcs
P 21 P 21
Acyclovir Cream Acyclovir Cream 7 Tube
Bedak Salisil Bedak Salisil 0 Wadah
Bicombin inj Bicombin inj 0 Ampul
Cefadroxil 500 mg Cefadroxil 500 mg 160 Kap
Klorpromazin 100 mg
(CPZ )
Klorpromazin 100 mg (CPZ ) 0 Kap
Digoxin 0,5 mg Digoxin 0,5 mg 80 Tab
Diazepam larutan rektal Diazepam larutan rektal

5mg/2,5ml 5mg/2,5ml 0 Suppo
Eflin Eflin 0 Tab
Furosemid Furosemid 0 Tab

mg
Guaiafenesin (GG) 100 mg 0 tab
Ibuprofen 200mg Ibuprofen 200mg 0 Tab
Kloramfenikol 250 mg Kloramfenikol 250 mg 50 Kap
Lexartans (as.
Traneksamat)
Lexartans (as. Traneksamat) 0 Tab
Meloxicam 7,5 mg Meloxicam 7,5 mg 0 Tab
Novastan syr Novastan syr 2 Btl
Nifedipine Nifedipine 0 Tab
Neo Diaform Neo Diaform 180 Tab

Kulit 3%
Oxytetracycline Salep Kulit 3% 62 Tube
OBH Plus OBH Plus 0 Btl
Paracetamol 500 mg Paracetamol 500 mg 0 tab
Pehavral Pehavral 640 tab
Reco Salep Mata Reco Salep Mata

( Chloamphenicol) ( Chloamphenicol) 8 Tube
Reco Tetes Telinga Reco Tetes Telinga

(Chloramphenicol) (Chloramphenicol) 2 Btl
Skincol Gel Skincol Gel 0 Tube
Tramadol inj 50 mg/ml Tramadol inj 50 mg/ml 0 Ampul
Visoprin Visoprin 0 Btl
DAK 2021 DAK 2021
Amoxicillin Trihydrate / Amoxicillin Trihydrate /

Pehamoxiil Forte 500 mg Pehamoxiil Forte 500 mg 0 Tab
(hexapram Jaya ) (hexapram Jaya )
Amoksisilin sirup kering Amoksisilin sirup kering

125mg/5ml 125mg/5ml 44 Btl
Amox icillin Drop Amox icillin Drop 3 Btl
Asam Mefenamat Asam Mefenamat 50 tab

Ampisillin serbuk injeksi Ampisillin serbuk injeksi i.v 1000

i.v 1000 mg/ Vial mg/ Vial 0 Vial
Antihemeroid kombinasi Antihemeroid kombinasi 0 Suppo
Antifungi DOEN
kombinasi: Asam Antifungi DOEN kombinasi: Asam
Benzoat 3% + Asam Benzoat 3% + Asam Salisilat 6% 2 Botol
Salisilat 6%

Kunyah Antasida Doen I Tablet Kunyah 0 Tab
Antasida Doen suspensi Antasida Doen suspensi 0 Botol

mg
Asam askorbat / Vit C 50 mg 680 Tab
Asam Traneksamat
injeksi
Asam Traneksamat injeksi 0 amp
Asam folat tab 1 mg Asam folat tab 1 mg 1370 pcs
Asetosal 80 mg Asetosal 80 mg 160 Tab
Aqua pro injeksi 25 ml Aqua pro injeksi 25 ml 110 Tab
Betahistine 6 mg Betahistine 6 mg 0 Tab
Betamethason cream Betamethason cream 0 Tab
Bisakodil Suppo Bisakodil Suppo 3 Suppo
Bisakodil 5 mg Bisakodil 5 mg 12 Tab
Captopril 12,5 mg Captopril 12,5 mg 0 tab
Cetrizine syr Cetrizine syr 16 Botol

Cefotaxim Injeksi Cefotaxim Injeksi 0 Vial
Diazepam inj 5 mg / 2 ml Diazepam inj 5 mg / 2 ml 0 Ampul
Dexamethasone injeksi Dexamethasone injeksi 143 Ampul
Dextrosa 10 % Dextrosa 10 % 0 Botol
Doksisiklin Doksisiklin 20 Tab
Domperidone syr Domperidone syr 91 Botol
Eritromisin sirup 200 mg Eritromisin sirup 200 mg 13 Botol
Epinephrine Epinephrine 0 Ampul
Furosemid Injeksi Furosemid Injeksi i.v./i.m

i.v./i.m 10mg/ml 10mg/ml 0 Ampul
Glukosa Infus D5% Glukosa Infus D5% 0 btl
Glibenklamide 5 mg Glibenklamide 5 mg 0 Tab
Haloperidole 5 mg Haloperidole 5 mg 0 Tab
Hyoscine N
butylbromide
Hyoscine N butylbromide 0 Tab
Karbogliserin tetes Karbogliserin tetes telinga 10%

telinga 10% (phenol
(phenol gliserol tts. Telinga) 0 Botol

mg
Kalsium laktat (Kalk) 500 mg 0 Tab

%
Kalsium Glukonat inj 10 % 0 Ampul
Ketorolac inj 30Mg/MI Ketorolac inj 30Mg/MI 5 Ampul
Karbamazepin 200mg Karbamazepin 200mg 0 tab

KAEN 3B KAEN 3B 20 tab
Isosorbid Dinitrat tablet Isosorbid Dinitrat tablet

sublingual 5mg sublingual 5mg 20 Tab
Ibuprofen Syr
100mg/5ml
Ibuprofen Syr 100mg/5ml 41 Btl
Ketokonazole Cream Ketokonazole Cream 0 Tube
Ketokonazole tablet
200mg
Ketokonazole tablet 200mg 0 Tab
Kloramfenikol Suspensi Kloramfenikol Suspensi 125 mg/

125 mg/ 5ml 5ml 1 Btl
Lansoprazole 30 mg Lansoprazole 30 mg 0 kap
Lidokain comp (Lidokain Lidokain comp (Lidokain injeksi

injeksi 2% (HCI) + 2% (HCI) + epinefrin) 30 Ampul
epinefrin)
Lidocain inj 2 % (HCL) Lidocain inj 2 % (HCL) 0 Ampul
Loratadine Loratadine 30 kap
Metformin HCL 500 mg Metformin HCL 500 mg 0 tab
4 mg Metilprednisolon tablat 4 mg 0 tab
8 mg
Metoklopramid 10 mg Metoklopramid 10 mg 60 tab
Metoklopramid inj Metoklopramid inj 103 Ampul
Methamizole Na Inj Methamizole Na Inj 0 Ampul

Metronidazol sirup Metronidazol sirup 1 Btl
MGSO4 40 % MGSO4 40 % 0 Ampul
MGSO4 20 % MGSO4 20 % 0 Ampul
Mikonazole kream Mikonazole kream 103 Tube
Nistatin drop Nistatin drop 2 Btl

IU
Nistatin Ovula 100.000 IU 0 tab
mg
Natrium Diklofenak 25 mg 0 tab
N-Asetilsistein N-Asetilsistein 0 Tab
Natrium Chloride 0,9 % Natrium Chloride 0,9 % ( NACL 0,9

( NACL 0,9 %) %) 118 btl
Oxytocin injeksi Oxytocin injeksi 0 Ampul
Omeprazole 20 mg Omeprazole 20 mg 1440 Kap
Parasetamol syr Parasetamol syr 0 btl
Phytomenadion inj
2mg/ml
Phytomenadion inj 2mg/ml 3 Ampul
Phytomenadion 10 mg Phytomenadion 10 mg 20 Tab
Permetrin cream Permetrin cream 0 Tube
Ranitidin tablet 150 mg Ranitidin tablet 150 mg 180 tab
Ranitidin injeksi Ranitidin injeksi 0 Ampul
Salbutamol nebulizer Salbutamol nebulizer

(Salbutamol Sulfate ) (Salbutamol Sulfate ) 31 Ampul
Salep 2-4 Salep 2-4 5 Pot
Simvastatin 10 mg Simvastatin 10 mg 200 tab

Simvastatin 20 mg Simvastatin 20 mg 1270 tab
Siprofloksasin 500 mg Siprofloksasin 500 mg 0 Tab
Sianocbalamin (B12) Sianocbalamin (B12) 0 Tab
Sianocobalamin
( Vitamin B12) Injeksi
Injeksi 500 mcg 0 Ampul
500 mcg

Ular)
SABU ( Serum Anti Bisa Ular) 0 Vial
Tablet tambah darah Tablet tambah darah 0 tab
USG GEL USG GEL 3 Btl

VAR VAR 0 Vial
Vit. B.Complex Vit. B.Complex 2690 Tab
Zink 20 mg tab Zink 20 mg tab 0 Tab
Zink syr Zink syr 0 Btl

BMHP BMHP
Catgut chromic 3/0 Catgut chromic 3/0 +jarum Bulat

+jarum Bulat (*optime*) (*optime*) 36 Pcs
Folly Catheter 18 Folly Catheter 18 0 pcs
Handscoond steril no 6 Handscoond steril no 6 0 Pasang
Handscoond steril no 6,5 Handscoond steril no 6,5 50 Pasang
Handscoond steril no 7,5 Handscoond steril no 7,5 0 Pasang

Hand Sanitizer /
Handrub 500 ml
Hand Sanitizer / Handrub 500 ml 0 Btl
Handscrub Handscrub 0 Btl
Infus Set Dewasa Infus Set Dewasa 0 pcs
Scalpet Blades no.10 Scalpet Blades no.10 100 Pcs
Surgical mask earloop Surgical mask earloop 3ply /

3ply / Masker Masker 800 Box
Under Pad Steril Under Pad Steril 200 pcs
DAK 2020 DAK 2020
Acyclovir 400 mg Acyclovir 400 mg 130 Tab
Betahistine 6 mg Betahistine 6 mg 0 Tab
CTM 4 mg CTM 4 mg 0 tab
Cetrizine 10 mg Cetrizine 10 mg 0 tab
Domperidone syr Domperidone syr 0 Botol
10 tab
Anti migren kombinasi Anti migren kombinasi

( ERGOTAMIN ) ( ERGOTAMIN )
Gentamicine tetes mata Gentamicine tetes mata 0 Botol
Lansoprazole 30 mg Lansoprazole 30 mg 0 kap

4 mg
Paracetamol Drop Paracetamol Drop 0 Botol
BMHP BMHP
Catgut chromic 3/0 Catgut chromic 3/0 +jarum Bulat

+jarum Bulat (*optime*) (*optime*) 0 Pcs
Catgut chromic 3/0

+jarum Segitiga
Segitiga (*optime*) 0 Pcs
(*optime*)
Catgut chromic 2/0

(*optime-R*) 42 Pcs
R*)
Catgut plain 3/0 + jarum Catgut plain 3/0 + jarum Segitiga

Segitiga (*Advantime*) (*Advantime*) 0 Pcs
Feeding Tube 14 Feeding Tube 14 0 pcs
Feeding Tube 16 Feeding Tube 16 0 pcs
Kasa 16x16 Kasa 16x16 0 pcs
Silk 2/0 + jarum 1/2 25

mm 75 cm
Silk 2/0 + jarum 1/2 25 mm 75 cm 0 Pcs
Umbilical Cord Klem Umbilical Cord Klem 0 Pcs
DAU 2020 DAU 2020
Aqua pro injeksi 20 ml Aqua pro injeksi 20 ml 0 ampul

Hyoscine N Hyoscine N butylbromide 10 mg
butylbromide 10 mg inj inj 0 Ampul
Natrium Chloride 0,9 % Natrium Chloride 0,9 % ( NACL 0,9

( NACL 0,9 %) %) 0 btl
tablet
Propylthiouracyl 100 mg tablet 0 Tab
Ringer Laktat (RL) Ringer Laktat (RL) 0 btl
P 2020 P 2020

ml
Ambroxol sirup 15 mg/5 ml 0 Btl
Ambroxol Tablet 30 mg Ambroxol Tablet 30 mg 0 Tab
Bisakodil Suppo Bisakodil Suppo 0 Suppo
Bisakodil ( LAXANA) Bisakodil ( LAXANA) 0 Tab

mg
Guaiafenesin (GG) 100 mg 0 tab

(Deksametason, Kombinasi Tetes Mata
Neomisin Sulfat, (Deksametason, Neomisin Sulfat,
Polimiksin B Sulfat ) Polimiksin B Sulfat ) ALLETROL 0 Botol
ALLETROL COMPOSITUM
COMPOSITUM

kombinasi GG
GG ( Dextrofen) 0 Botol
( Dextrofen)
Obat flu kombinasi Obat flu kombinasi
( pseudoephedrin Hcl, ( pseudoephedrin Hcl, Tripolidin 0 tab
Tripolidin Hcl ) FLUTROP Hcl ) FLUTROP
Salbutamol nebulizer / Salbutamol nebulizer / Ventolin

Ventolin Nebulizer Nebulizer 0 Flash
Hemafort Hemafort 0 Tab
DAK 2019 DAK 2019
Acyclovir 400 mg Acyclovir 400 mg 0 Tab
Alprazolam 0,5 mg Alprazolam 0,5 mg 0 tab
Cefadroxil sirup kering Cefadroxil sirup kering

125mg/5ml 125mg/5ml 0 btl
Diazepam 5 mg / 2,5 ml ( Diazepam 5 mg / 2,5 ml

STESOLID ) Rektal ( STESOLID ) Rektal 0 Tube
Kotrimoxazole syr Kotrimoxazole syr 0 btl
Metoklopramide 10 mg Metoklopramide 10 mg 0 tab
Mata
Oxtretrasiklin Salep Mata 0 tube
Pirantel 125 mg Pirantel 125 mg 12 tab

10 mg
Piridoksin HCL ( Vit. B 6 ) 10 mg 0 tab
BMHP BMHP
Alat Suntik 5 ml Alat Suntik 5 ml 0 pcs

Infus Set Dewasa Infus Set Dewasa 0 pcs
urine bag urine bag 25 pcs
PENUNJANG 2019 PENUNJANG 2019
Gentamicin salep kulit Gentamicin salep kulit 0 tube
Loperamide Loperamide 20 Tab

( Becefort ) Multivitamin syr anak ( Becefort ) 0 Botol

Pektin) sirup (Guanistrep Sirup) 9 btl
(Guanistrep Sirup)
BG 2019 BG 2019
Articulating Paper Articulating Paper 1 Pcs
Cotton roll medium Cotton roll medium 1 Pack
Eugenol Eugenol 1 Pot
Pehacain Pehacain 0 Ampul

DAK 2018 DAK 2018
Diazepam 5 mg Diazepam 5 mg 0 Tab
HCT 25 mg HCT 25 mg 0 tab
Nistatin 100.000 IU Nistatin 100.000 IU 0 tab
BMHP BMHP
Blood Lancet Blood Lancet 0 Pcs
Plaster ( Hifafix ) Plaster ( Hifafix ) 0 Roll
Penunjang 2017 Penunjang 2017
BMHP BMHP
Jarum Jahit Segitiga Jarum Jahit Segitiga 0 pcs
DAU 2017 DAU 2017

BMHP BMHP
Silk 3/0 + jarum 1/2 GT Silk 3/0 + jarum 1/2 GT 35 mm
35 mm ( Sole) ( Sole) 0 Pcs
DAK 2017 DAK 2017
Diltiazem 30 mg Diltiazem 30 mg 0 tab
BMHP BMHP
KAPAS PEMBALUT / KAPAS PEMBALUT / ABSORBEN

ABSORBEN 250 GRAM 250 GRAM 0 Bks
Kasa 4mx5cm Kasa 4mx5cm 0 Roll
APBD 2016 APBD 2016
BMHP 2016 BMHP 2016
Infus set anak (Aximed) Infus set anak (Aximed) 0 pcs
DAU 2009 DAU 2009
KAPAS PEMBALUT / KAPAS PEMBALUT / ABSORBEN

ABSORBEN 250 GRAM 250 GRAM 4 roll/bungkus
68,408.00
Nilai Saldo Awal

Nilai Total Penerimaan
Nilai Total Pengeluaran
Saldo/Sisa
Jumlah Stick Awal

Total Penerimaan
Total Pengeluaaran
Stock Akhir
asi, Bumil, Posyandu Balita, Posko ) Sisa Stok
Harga Satuan Nilai Total
Keterangan Jumlah Total Harga
(Rp) (Rp)
26 27 28
Saldo 2021
Rp - 25 Rp 416,650.00
Rp 16,666.00
Rp - 3 Rp 120,562.50
Rp 40,187.50
Rp 464,000.00 900 Rp 1,044,000.00
Rp 1,160.00
Rp 13,178.00 Rp - 0 Rp -
Rp 13,178.00 Rp - 0 Rp -
Rp 132.00 Rp 19,800.00 400 Rp 52,800.00
Rp - 0 Rp -
Rp 274,362.00
Rp - 0 Rp -
Rp 3,137.00
Rp - 0 Rp -
Rp 23,860.08
Rp 89.00
Rp - 1000 Rp 89,000.00
Rp 140,379.60 4380 Rp 327,054.60

Rp 74.67
Rp 191,950.00 750 Rp 41,250.00
Rp 55.00
Rp 531,300.00 6700 Rp 1,547,700.00
Rp 231.00
Rp 388,800.00 336 Rp 1,612,800.00
Rp 4,800.00
Rp 173,430.00 40 Rp 77,080.00
Rp 1,927.00
Rp 36,740.00 0 Rp -
Rp 1,837.00
Rp - 6000 Rp 366,000.00
Rp 61.00
Rp 46,800.00 3600 Rp 421,200.00

Rp 117.00
Rp 1,756.00 Rp 886,780.00 0 Rp -
Rp 309,960.00 1730 Rp 93,420.00

Rp 54.00
Rp 52,160.00 96 Rp 312,960.00
Rp 3,260.00
Rp 179,490.00 2070 Rp 192,510.00
Rp 93.00
Rp 24,480.00 0 Rp -
Rp 72.00
Rp 58,241.70 4450 Rp 233,491.50
Rp 52.47
Rp 96,200.00 560 Rp 145,600.00

Rp 260.00
Rp 346,620.00 4240 Rp 449,440.00

Rp 106.00
Rp 9,810.00 880 Rp 95,920.00

Rp 109.00
Rp 44,651.20 410 Rp 31,028.80
Rp 75.68
Rp 41,235.00 0 Rp -
Rp 8,247.00
Rp 66,000.00 195 Rp 643,500.00

Rp 3,300.00
Rp 123.00
Rp 50,430.00 530 Rp 65,190.00
Rp 44,175.00 55 Rp 127,875.00
Rp 2,325.00
Rp 54.00
Rp 540.00 190 Rp 10,260.00
Rp 436,800.00 4670 Rp 980,700.00

Rp 210.00
Rp - 200 Rp 19,980.00
Rp 99.90
Rp 247,200.00 3860 Rp 231,600.00
Rp 60.00
Rp 6,240.00 390 Rp 101,400.00
Rp 260.00
Rp - 50 Rp 119,950.00
Rp 2,399.00
Rp 289,390.00 150 Rp 12,900.00
Rp 86.00
Rp 12,100.00 410 Rp 248,050.00
Rp 605.00
Rp 278.00
Rp - 0 Rp -
Rp 388,080.00 8780 Rp 676,060.00
Rp 77.00
Rp - 0 Rp -
Rp 102.00
Rp 22,190.00 2430 Rp 770,310.00

Rp 317.00
Rp 6,600.00 400 Rp 26,400.00

Rp 66.00
Rp 118,400.00 485 Rp 3,589,000.00
Rp 7,400.00
Rp 8,200.00
Rp - 0 Rp -
Rp 236,703.80 400 Rp 127,948.00

Rp 319.87
Rp 89,380.00 5170 Rp 563,530.00

Rp 109.00
Rp 171,072.00 287 Rp 1,534,302.00
Rp 5,346.00
Rp 5,204.00
Rp 98,876.00 0 Rp -
Rp 1,160.00
Rp 89,320.00 258 Rp 299,280.00
Rp 1,739,890.00 5480 Rp 1,408,360.00
Rp 257.00
Rp 42,900.00 100 Rp 85,800.00
Rp 858.00
Rp 103,194.00 31 Rp 355,446.00
Rp 11,466.00
Rp 4,182.00 Rp - 10 Rp 41,820.00
Rp 6,683.00 Rp 33,415.00 11 Rp 73,513.00
Rp 23,132.00 Rp 23,132.00 6 Rp 138,792.00
Rp 17,520.00 1760 Rp 128,480.00

Rp 73.00
Rp 7,221.00 Rp - 15 Rp 108,315.00
Rp 1,848,720.00 540 Rp 4,159,620.00
Rp 7,703.00
Rp 51.00
Rp 15,300.00 10 Rp 510.00
Rp 34,840.00 4270 Rp 286,090.00

Rp 67.00
Rp 22,200.00
Rp - 10 Rp 222,000.00
Rp 1,036.00 Rp 207,200.00 800 Rp 828,800.00
Rp - 2000 Rp 146,000.00
Rp 73.00
Rp - 2000 Rp 300,000.00
Rp 150.00
Rp 16,632.00 Rp - 15 Rp 249,480.00
Rp 34,600.00 1470 Rp 254,310.00

Rp 173.00
Rp 59,040.00 5920 Rp 426,240.00

Rp 72.00
Rp 8,800.00 2220 Rp 97,680.00

Rp 44.00
Rp 3,256.00 Rp - 35 Rp 113,960.00
Rp 23,595.00 Rp 94,380.00 8 Rp 188,760.00
Rp 1,045.00 Rp 1,045,000.00 700 Rp 731,500.00
Rp 825.00 Rp - 500 Rp 412,500.00
Rp 955.00 Rp - 500 Rp 477,500.00
Rp 1,110.00 Rp - 200 Rp 222,000.00
Rp 1,502,496.00 1700 Rp 2,128,536.00

Rp 1,252.08
Rp 1,377,288.00 1900 Rp 2,378,952.00
Rp 1,252.08
Rp 2,629,368.00 900 Rp 1,126,872.00

Rp 1,252.08
Rp - 0 Rp -
Rp 26,062.00
Rp 26,418.00
Rp - 100 Rp 2,641,800.00
Rp 26,418.00
Rp - 0 Rp -
Rp 26,418.00
Rp - 0 Rp -
Rp 26,418.00
Rp - 0 Rp -
Rp 27,639.00
Rp - 150 Rp 4,145,850.00
Rp 3,541.00 Rp 177,050.00 50 Rp 177,050.00
Rp 91,045.00 Rp 1,547,765.00 10 Rp 910,450.00
Rp - 10 Rp 616,050.00
Rp 61,605.00
Rp 321,900.00 16 Rp 515,040.00
Rp 32,190.00
Rp 21,638.40 Rp 216,384.00 29 Rp 627,513.60
Rp 7,221.00 Rp 108,315.00 Rp -
Rp 2,070.00 Rp - 150 Rp 310,500.00
Rp 356,400.00 Rp - 0 Rp -
Rp 391,500.00 Rp 391,500.00 0 Rp -
Rp 67,500.00 Rp - 0 Rp -
Rp 45,000.00 Rp - 0 Rp -
Rp 1,361.00 Rp - 0 Rp -
Rp 1,712.53 Rp - 0 Rp -
Rp 1,710.13 Rp - 0 Rp -
Rp 4,400.00 Rp 30,800.00 50 Rp 220,000.00
Rp 7,700.00 Rp - 0 Rp -
Rp 6,600.00 Rp - 0 Rp -
Rp 880.00 Rp 140,800.00 120 Rp 105,600.00
Rp 495.00 Rp - 200 Rp 99,000.00
Rp 198.00 Rp 15,840.00 400 Rp 79,200.00
Rp 30,800.00 Rp - 0 Rp -
Rp 1,413.50 Rp - 0 Rp -
Rp 275.00 Rp - 0 Rp -
Rp 147.99 Rp - 0 Rp -
Rp 275.00 Rp - 0 Rp -
Rp 770.00 Rp 38,500.00 0 Rp -
Rp 1,650.00 Rp - 0 Rp -
Rp 385.00 Rp - 0 Rp -
Rp 11,000.00 Rp 22,000.00 72 Rp 792,000.00
Rp 220.00 Rp - 0 Rp -
Rp 286.00 Rp 51,480.00 1500 Rp 429,000.00

Rp 4,950.00 Rp 306,900.00 1 Rp 4,950.00
Rp 12,100.00 Rp - 0 Rp -
Rp 275.00 Rp - 0 Rp -
Rp 1,045.00 Rp 668,800.00 3430 Rp 3,584,350.00
Rp 6,600.00 Rp 52,800.00 0 Rp -
Rp 11,000.00 Rp 22,000.00 70 Rp 770,000.00
Rp 148,500.00 Rp - 1 Rp 148,500.00
Rp 11,000.00 Rp - 65 Rp 715,000.00
Rp 72,600.00 Rp - 50 Rp 3,630,000.00
Rp 231.00 Rp - 0 Rp -
Rp 2,050.00 Rp 90,200.00 102 Rp 209,100.00
Rp 11,750.00 Rp 35,250.00 117 Rp 1,374,750.00
Rp 89.00 Rp 49,840.00 400 Rp 35,600.00
Rp 200.00 Rp 56,000.00 2620 Rp 524,000.00
Rp 117.00 Rp 5,850.00 0 Rp -
Rp 55.00 Rp - 0 Rp -
Rp 74.00 Rp - 0 Rp -
Rp 9,900.00 Rp - 76 Rp 752,400.00
Rp 3,260.00 Rp - 0 Rp -
Rp 3,637.00 Rp 7,274.00 35 Rp 127,295.00
Rp 54.00 Rp - 0 Rp -
Rp 1,756.00 Rp - 0 Rp -
Rp 46.00 Rp 31,280.00 1830 Rp 84,180.00
Rp 1,820.00 Rp - 0 Rp -
Rp 61.00 Rp 83,570.00 540 Rp 32,940.00
Rp 89.00 Rp 14,240.00 230 Rp 20,470.00
Rp 2,650.00 Rp 291,500.00 240 Rp 636,000.00
Rp 92.00 Rp - 0 Rp -
Rp 1,540.00 Rp - 0 Rp -
Rp 5,085.00 Rp 15,255.00 36 Rp 183,060.00
Rp 5,085.00 Rp 61,020.00 284 Rp 1,444,140.00
Rp 68.00 Rp - 0 Rp -
Rp 2,215.00 Rp 35,440.00 80 Rp 177,200.00

Rp 3,050.00 Rp - 0 Rp -
Rp 1,545.00 Rp - 0 Rp -
Rp 968.00 Rp 138,424.00 200 Rp 193,600.00
Rp 7,200.00 Rp - 0 Rp -
Rp 289.00 Rp 5,780.00 470 Rp 135,830.00
Rp 2,401.00 Rp 218,491.00 0 Rp -
Rp 7,436.00 Rp 96,668.00 28 Rp 208,208.00
Rp 1,740.00 Rp - 6 Rp 10,440.00
Rp 969.00 Rp - 42 Rp 40,698.00
Rp 7,363.00 Rp - 60 Rp 441,780.00
Rp 87.00 Rp - 0 Rp -
Rp 54.00 Rp - 0 Rp -
Rp 1,050.00 Rp - 100 Rp 105,000.00
Rp 3,300.00 Rp - 0 Rp -
Rp 60.00 Rp - 0 Rp -
Rp 6,199.00 Rp - 24 Rp 148,776.00
Rp 923.00 Rp 4,615.00 262 Rp 241,826.00
Rp 216.00 Rp - 0 Rp -
Rp 11,500.00 Rp 230,000.00 0 Rp -
Rp 99.00 Rp 1,980.00 140 Rp 13,860.00
Rp 2,339.00 Rp 95,899.00 0 Rp -
Rp 2,399.00 Rp - 7 Rp 16,793.00
Rp 260.00 Rp - 0 Rp -
Rp 5,352.00 Rp 5,352.00 64 Rp 342,528.00
Rp 605.00 Rp - 0 Rp -
Rp 278.00 Rp - 0 Rp -
Rp 847.00 Rp 25,410.00 240 Rp 203,280.00
Rp 891.00 Rp - 0 Rp -
Rp 117.00 Rp 3,510.00 3300 Rp 386,100.00
Rp 77.00 Rp - 0 Rp -
Rp 102.00 Rp - 0 Rp -
Rp 237.00 Rp - 0 Rp -
Rp 66.00 Rp 3,960.00 90 Rp 5,940.00
Rp 1,983.00 Rp 204,249.00 611 Rp 1,211,613.00
Rp 3,045.00 Rp - 0 Rp -
Rp 3,765.00 Rp 3,765.00 51 Rp 192,015.00
Rp 4,700.00 Rp - 0 Rp -
Rp 4,120.00 Rp - 50 Rp 206,000.00
Rp 1,900.00 Rp 195,700.00 125 Rp 237,500.00
Rp 11,750.00 Rp 23,500.00 9 Rp 105,750.00
Rp 550.00 Rp - 95 Rp 52,250.00
Rp 109.00 Rp - 0 Rp -
Rp 317.00 Rp - 0 Rp -
Rp 6,900.00 Rp 814,200.00 297 Rp 2,049,300.00
Rp 1,248.00 Rp - 0 Rp -
Rp 129.00 Rp 185,760.00 6480 Rp 835,920.00
Rp 1,160.00 Rp - 0 Rp -
Rp 3,900.00 Rp 11,700.00 111 Rp 432,900.00
Rp 781.00 Rp 15,620.00 140 Rp 109,340.00
Rp 11,466.00 Rp - 0 Rp -
Rp 85.00 Rp 15,300.00 140 Rp 11,900.00
Rp 858.00 Rp - 0 Rp -
Rp 67.00 Rp - 0 Rp -
Rp 5,400.00 Rp 167,400.00 56 Rp 302,400.00
Rp 1,475.00 Rp 7,375.00 3 Rp 4,425.00
Rp 73.00 Rp 14,600.00 0 Rp -
Rp 73.00 Rp 92,710.00 4930 Rp 359,890.00
Rp 260.00 Rp - 0 Rp -
Rp 44.00 Rp - 0 Rp -
Rp 1,066.00 Rp - 287 Rp 305,942.00
Rp 517,132.00 Rp - 2 Rp 1,034,264.00
Rp 255.00 Rp - 0 Rp -
Rp 18,858.33 Rp 56,575.00 0 Rp -
Rp 153,000.00 Rp - 0 Rp -
Rp 60 Rp 161,400.00 2500 Rp 150,000.00
Rp 253.00 Rp - 0 Rp -
Rp 2,489.00 Rp - 0 Rp -
Rp 68,090.00 Rp 2,451,240.00 0 Rp -
Rp 818.00 Rp 654,400.00 1900 Rp 1,554,200.00
Rp 1,100.00 Rp 11,000.00 90 Rp 99,000.00
Rp 11,132.00 Rp - 10 Rp 111,320.00
Rp 13,563.00 Rp - 100 Rp 1,356,300.00
Rp 13,563.00 Rp 678,150.00 231 Rp 3,133,053.00
Rp 13,563.00 Rp 67,815.00 45 Rp 610,335.00
Rp 13,563.00 Rp - 0 Rp -
Rp 68,200.00 Rp - 0 Rp -
Rp 115,800.00 Rp - 0 Rp -
Rp 7,128.00 Rp - 0 Rp -
Rp 25,487.00 Rp - 0 Rp -
Rp 2,176.72 Rp 43,534.48 210 Rp 457,112.07
Rp 1,089.67 Rp - 0 Rp -
Rp 618.70 Rp 61,869.50 100 Rp 61,869.50
Rp 618.68 Rp 60,631.03 0 Rp -
Rp 618.71 Rp 48,878.32 0 Rp -
Rp 1,373.14 Rp 1,098,512.00 2300 Rp 3,158,222.00
Rp 37,875.00 Rp 7,575,000.00 0 Rp -
Rp 454.00 Rp 59,020.00 0 Rp -
Rp 119.00 Rp - 0 Rp -
Rp 26.00 Rp - 0 Rp -
Rp 104.00 Rp - 0 Rp -
Rp 2,862.00 Rp - 0 Rp -
Rp 212.00 Rp 2,120.00 329 Rp 69,748.00
Rp 26.00 Rp - 0 Rp -
Rp 657.00 Rp - 0 Rp -
Rp 352.00 Rp - 0 Rp -
Rp 148.00 Rp - 0 Rp -
Rp 7,646.00 Rp - 0 Rp -
Rp 55,000.00 Rp - 0 Rp -
Rp 62,000.00 Rp - 0 Rp -
Rp 44,000.00 Rp 1,848,000.00 0 Rp -
Rp 71,000.00 Rp - 0 Rp -
Rp 8,407.00 Rp - 0 Rp -
Rp 8,407.00 Rp - 0 Rp -
Rp 13,178.00 Rp - 49 Rp 645,722.00
Rp 23,100.00 Rp - 0 Rp -
Rp 23,100.00 Rp - 0 Rp -
Rp 7,897.31 Rp - 0 Rp -
Rp 32,500.00 Rp - 0 Rp -
Rp - 0 Rp -
Rp 1,495.00
Rp 2,860.00 Rp - 0 Rp -
Rp 9,900.00 Rp - 0 Rp -
Rp 6,840.00 Rp - 0 Rp -
Rp 733.00 Rp - 220 Rp 161,260.00
Rp 7,150.00 Rp - 0 Rp -
Rp 3,250.01 Rp - 0 Rp -
Rp 110.00 Rp - 0 Rp -
Rp 23,475.00 Rp - 0 Rp -
Rp 367.00 Rp - 0 Rp -
Rp 175.00 Rp - 0 Rp -
Rp 14,900.00 Rp - 0 Rp -
Rp - 0 Rp -
Rp 12,900.00
Rp 600.00 Rp - 0 Rp -
Rp 10,000.00 Rp - 0 Rp -
Rp 820.00 Rp - 0 Rp -
Rp 425.00 Rp - 0 Rp -
Rp 88.00 Rp - 0 Rp -
Rp 4,360.00 Rp - 0 Rp -
Rp 14,459.00 Rp - 0 Rp -
Rp 2,052.00 Rp - 0 Rp -
Rp 83.00 Rp - 0 Rp -
Rp 2,600.00 Rp - 0 Rp -
Rp 331.00 Rp 3,972.00 29 Rp 9,599.00
Rp 141.00 Rp - 0 Rp -
Rp 1,600 Rp - 900 Rp 1,440,000.00
Rp 11,891.00 Rp 118,910.00 10 Rp 118,910.00
Rp 11,891.00 Rp - 10 Rp 118,910.00
Rp 6,842.00 Rp - 0 Rp -
Rp 1,848.00 Rp 46,200.00 50 Rp 92,400.00
Rp 2,640.00 Rp - 0 Rp -
Rp 198.00 Rp 3,960.00 500 Rp 99,000.00
Rp - 0 Rp -
Rp 17,365.70
Rp 3,850.00 Rp 34,650.00 16 Rp 61,600.00
Rp 242,000.00 Rp 242,000.00 0 Rp -
Rp 85,800.00 Rp 85,800.00 0 Rp -
Rp 97,500.00 Rp 97,500.00 0 Rp -
Rp 3,113.0495 Rp - 0 Rp -
Rp 109.00 Rp - 0 Rp -
Rp 178.00 Rp - 0 Rp -
Rp 645.00 Rp - 0 Rp -
Rp 167.509 Rp - 0 Rp -
Rp 29,642.86 Rp - 0 Rp -
Rp 22,000.00 Rp - 0 Rp -
Rp 46,187.44 0 Rp -
Rp 128.00 0 Rp -
Rp 14,375.00 Rp - 25 Rp 359,375.00
Rp 862.50 Rp - 0 Rp -
Rp 6,222.00 Rp - 50 Rp 311,100.00
Rp 11,914 Rp 47,656.00 0 Rp -
Rp 40,263,721.63 141,749.00 Rp 85,158,630.57
Rp 88,457,721.60
Total Penerimaan Rp 36,964,630.60
Total Pengeluaran Rp 40,263,721.63
/Sisa Rp 85,158,630.57
ah Stick Awal 111,633.00

Penerimaan 98,524.00
Pengeluaaran 68,408.00
141749.00
Kuasa Pengguna Barang : PUSKESMAS PERAWATAN LASUNG
pengguna barang :
Kode Rekening :
Stok Awal
No
No Nama Obat Jumlah Satuan Harga Satuan Total harga
1
BMHP
Program HIV

Rp 16,666.00
2 Plesterin Bulat 3 Kotak Rp 120,562.50

non woven
Rp 40,187.50
Vacum Tube
3 sterile, plastic, 900 Pcs Rp 1,044,000.00
K3 EDTA
Rp 1,160.00
surgical Gloves
4 no. 7, 5 0 Pcs Rp 13,178.00 Rp -
5 surgical Gloves 0 Pcs Rp 13,178.00 Rp -

no. 8
Vacutainer
6 400 Pcs Rp 132.00 Rp 52,800.00
Needle
BMHP
Program TB
1 Larutan Zhihi 0 Paket Rp -

Neeisen
Rp 274,362.00
2 Sputum Pot 0 Biji Rp -

Rp 3,137.00
3 Object Glass 0 box @ 72 pcs Rp -

Frosted 7105
Rp 23,860.08
DAK 22
1 Allupurinol 1000 Tab Rp 89,000

100 mg Rp 89.00
2 Amlodipine 10 4380 Tab Rp 327,055

mg Rp 74.67
3 Amlodipine 5 750 Tab Rp 41,250

mg Rp 55.00
Amoxicillin
Trihydrate /
Pehamoxiil
4 Forte 500 mg 6700 Tab Rp 1,547,700
(hexapram
Jaya )
Rp 231.00
Ambroxol
5 sirup 15 mg/5 336 Btl Rp 1,612,800
ml Rp 4,800.00
Asam
6 Traneksamat 40 Tab Rp 77,080
500 mg Rp 1,927.00
Asam
7 Traneksamat 0 Ampul Rp -
injeksi Rp 1,837.00
Asam folat tab

8 6000 Tab Rp 366,000
1 mg
Rp 61.00
Asam
9 Mefenamat 3600 tab Rp 421,200
Rp 117.00
10 Antasida syr 0 Btl Rp 1,756.00 Rp -
Antasida Doen
11 I Tablet 1730 tab Rp 93,420
Kunyah
Rp 54.00
12 Anti Hemoroid 96 Suppo Rp 312,960

komb. Supp
Rp 3,260.00
Betahistine 6
13 mg 2070 tab Rp 192,510
Rp 93.00
14 Captopril 25 0 tab Rp -
mg Rp 72.00
15 Cetrizine 10 4450 tab Rp 233,492

mg Rp 52.47
16 Ciprofloxacin 560 tab Rp 145,600

500 mg
Rp 260.00
17 Dexamethaso 4240 Tablet Rp 449,440

ne 0,5mg Rp 106.00
Dimenhidrinat
18 880 tab Rp 95,920
50 mg Rp 109.00
19 Domperidone 410 Tablet Rp 31,029

10 mg Rp 75.68
Esomeprazole
20 injeksi 0 Vial Rp -
Rp 8,247.00
21 Fenol gliserol 195 Btl Rp 643,500

TT 10 %
Rp 3,300.00
22 Glimepirid 2 530 Tab Rp 65,190

mg Rp 123.00
Hidrokortisone
23 55 Tube Rp 127,875
cream
Rp 2,325.00
Haloperidole 5
24 mg 190 Tab Rp 10,260
Rp 54.00
25 Ibuprofen 4670 Tab Rp 980,700

400mg Rp 210.00
Isosorbid
Dinitrat tablet
26 200 Tab Rp 19,980
sublingual
5mg
Rp 99.90
27 Kalk 3860 Tablet Rp 60.00 Rp 231,600
Ketokonazol
28 390 Tab Rp 101,400
200mg Rp 260.00
Ketokonazole
29 cream 50 Tube Rp 119,950
Rp 2,399.00
Klorfeniramin
30 maleat (CTM) 150 Tab Rp 12,900
4 mg Rp 86.00
31 Kodein 10 mg 410 Tab Rp 248,050

Rp 605.00
Lansoprazole
32 0 Kap Rp -
30 mg Rp 278.00
Metformin
33 HCL 500 mg 8780 tab Rp 676,060
Rp 77.00
Metilprednisol
34 on tablat 4 mg 0 tab Rp -
Rp 102.00
35 Metronidazol 2430 tab Rp 770,310

500mg
Rp 317.00
Metokloprami
36 400 tab Rp 26,400
de 10 mg Rp 66.00
Multivitamin
37 sirup anak 485 Btl Rp 3,589,000
(Novakid) Rp 7,400.00
38 Novatusin syr 0 Btl Rp -

Rp 8,200.00
N-Asetilsistein
39 400 Kapsule Rp 127,948
200mg
Rp 319.87
Natrium
40 Diklofenak 50 5170 Tablet Rp 563,530
mg Rp 109.00
Omeprazole
41 inj 287 Vial Rp 1,534,302
Rp 5,346.00
42 Paracetamol 0 Drop Rp -
Drop Rp 5,204.00
43 Paracetamol 258 Btl Rp 299,280

syr Rp 1,160.00
44 Paracetamol 5480 Tab Rp 1,408,360

500 mg
Rp 257.00
Ranitidine
45 injeksi 100 Ampul Rp 85,800
Rp 858.00
46 Scabimite 31 Tube Rp 355,446

cream Rp 11,466.00
Povidon iodida
47 10 % 30 ml 10 Btl Rp 4,182.00 Rp 41,820
48 Povidon iodida 11 Btl Rp 6,683.00 Rp 73,513

10 % 60 ml
Povidon iodida
49 6 Btl Rp 23,132.00 Rp 138,792
10 % 300 ml
50 Prednison 5 1760 tab Rp 128,480

mg Rp 73.00
51 Rivanol 15 Btl Rp 7,221.00 Rp 108,315
Ringer Laktat
52 540 Btl Rp 4,159,620
(RL)
Rp 7,703.00
Salbutamol 2
53 mg 10 Tab Rp 510
Rp 51.00
Salbutamol 4
54 mg 4270 Tab Rp 286,090
Rp 67.00
Salbutamol
55 inheler 10 Btl Rp 222,000
(Salbutamol
Sulfate )
Rp 22,200.00
56 Sefadroksil 800 Kap Rp 1,036.00 Rp 828,800

500mg
Simvastatin 10
57 2000 Kap Rp 146,000
mg Rp 73.00
Simvastatin 20
58 2000 Kap Rp 300,000
mg Rp 150.00
60 USG GEL 15 pcs Rp 16,632.00 Rp 249,480
61 Vitamin B1 1470 tab Rp 254,310

Rp 173.00
62 Vitamin B6 5920 tab Rp 426,240

Rp 72.00
63 Vitamin B12 2220 tab Rp 97,680

Rp 44.00
BMHP
Alkohol 70%
64 100 mL 35 Btl Rp 3,256.00 Rp 113,960
Alkohol 70%
65 1000 mL 8 Btl Rp 23,595.00 Rp 188,760
66 Disposable 700 pcs Rp 1,045.00 Rp 731,500

syringe 1 cc
67 Disposable 500 pcs Rp 825.00 Rp 412,500

syringe 3 cc
68 Disposable 500 pcs Rp 955.00 Rp 477,500

syringe 5 cc
Disposable
69 200 pcs Rp 1,110.00 Rp 222,000
syringe 10 cc
Handscoon
70 non steril L 1700 pcs Rp 2,128,536
Rp 1,252.08
71 Handscoon 1900 pcs Rp 2,378,952
non steril M
Rp 1,252.08
Handscoon
72 non steril S 900 pcs Rp 1,126,872
Rp 1,252.08
Infuset
Dewasa
73 0 pcs Rp -
( Troge
Hamburg )
Rp 26,062.00
IV.Chateter
74 No.18 G 100 pcs Rp 2,641,800
Rp 26,418.00
IV.Chateter
75 No.20 G 0 pcs Rp -
Rp 26,418.00
IV.Chateter
76 0 pcs Rp -
No.22 G Rp 26,418.00
77 IV.Chateter 0 pcs Rp -
No.24 G Rp 26,418.00
78 IV.Chateter 150 pcs Rp 4,145,850

No.26 G Rp 27,639.00
79 Kasa 16 x 16 50 pcs Rp 3,541.00 Rp 177,050
80 Kasa 40x80 10 pcs Rp 91,045.00 Rp 910,450
Plester Putih
81 5x10 10 pcs Rp 616,050
Rp 61,605.00
82 Plaster Putih 5 16 pcs Rp 515,040

x 5 ( Farmafix )
Rp 32,190.00
83 Plester Putih 29 pcs Rp 21,638.40 Rp 627,514

5x2
84 Rivanol Btl Rp 7,221.00 Rp -
Umbilical Cord
85 Klem 150 pcs Rp 2,070.00 Rp 310,500
BG 2021
Bahan tambal
1 0 Syringe Rp 356,400.00 Rp -
sinar
2 Cairan 0 Pot Rp 391,500.00 Rp -

bonding
Cairan etsa /
3 Etching liquid 0 Pcs Rp 67,500.00 Rp -
DAU 2021
Multivitamin Btl isi @ 30

1 Ibu Hamil 0 kapsul Rp 45,000.00 Rp -
OMEGA 3
BMHP
Disposable
2 syringe 1 cc 0 Pcs Rp 1,361.00 Rp -
3 Sarung Tangan 0 Pcs Rp 1,712.53 Rp -

Uk. S
4 Sarung Tangan 0 Pcs Rp 1,710.13 Rp -

Uk. M
P 21
1 Acyclovir 50 Tube Rp 4,400.00 Rp 220,000
Cream
Cefadroxil 500
4 mg 120 Kap Rp 880.00 Rp 105,600
5 Klorpromazin 200 Kap Rp 495.00 Rp 99,000

100 mg (CPZ )
6 Digoxin 0,5 mg 400 Tab Rp 198.00 Rp 79,200
Diazepam
7 larutan rektal 0 Suppo Rp 30,800.00 Rp -
5mg/2,5ml


(GG) 100 mg
Ibuprofen
11 0 Tab Rp 275.00 Rp -
200mg
12 Kloramfenikol 0 Kap Rp 770.00 Rp -

250 mg
Lexartans (as.
13 0 Tab Rp 1,650.00 Rp -
Traneksamat)
Meloxicam 7,5
14 0 Tab Rp 385.00 Rp -
mg
16 Nifedipine 0 Tab Rp 220.00 Rp -
Oxytetracyclin
18 e Salep Kulit 1 Tube Rp 4,950.00 Rp 4,950
3%
20 Paracetamol 0 tab Rp 275.00 Rp -

500 mg
Reco Salep
22 Mata 0 Tube Rp 6,600.00 Rp -
( Chloampheni
col)
Reco Tetes
23 Telinga 70 Btl Rp 11,000.00 Rp 770,000
(Chlorampheni
col)
25 Tramadol inj 65 Ampul Rp 11,000.00 Rp 715,000

50 mg/ml

DAK 2021
Amoxicillin
Trihydrate /
1 Pehamoxiil 0 Tab Rp 231.00 Rp -
Forte 500 mg
(hexapram
Jaya )
Amoksisilin
125mg/5ml
3 Amox icillin 117 Btl Rp 11,750.00 Rp 1,374,750

Drop

100 mg
Allupurinol
5 300 mg 2620 Tab Rp 200.00 Rp 524,000
6 Asam 0 tab Rp 117.00 Rp -

Mefenamat
Amlodipine 5
7 0 Tab Rp 55.00 Rp -
mg
8 Amlodipine 10 0 Tab Rp 74.00 Rp -

mg
Ampisillin
serbuk injeksi
9 76 Vial Rp 9,900.00 Rp 752,400
i.v 1000 mg/
Vial
Antihemeroid
10 0 Suppo Rp 3,260.00 Rp -
kombinasi
Antifungi
DOEN
kombinasi:
11 Asam Benzoat 35 Botol Rp 3,637.00 Rp 127,295
3% + Asam
Salisilat 6%
Antasida Doen
12 I Tablet 0 Tab Rp 54.00 Rp -
Kunyah
13 Antasida Doen 0 Botol Rp 1,756.00 Rp -

suspensi
Asam askorbat
14 1830 Tab Rp 46.00 Rp 84,180
/ Vit C 50 mg
Asam
15 Traneksamat 0 amp Rp 1,820.00 Rp -
injeksi
Asam folat tab

16 1 mg 540 pcs Rp 61.00 Rp 32,940
17 Asetosal 80 230 Tab Rp 89.00 Rp 20,470

mg
Aqua pro
18 injeksi 25 ml 240 Tab Rp 2,650.00 Rp 636,000
Betahistine 6
19 mg 0 Tab Rp 92.00 Rp -
Betamethason
20 0 Tab Rp 1,540.00 Rp -
cream
21 Bisakodil 36 Suppo Rp 5,085.00 Rp 183,060
Suppo
22 Bisakodil 5 mg 284 Tab Rp 5,085.00 Rp 1,444,140
23 Captopril 12,5 0 tab Rp 68.00 Rp -

mg
Cefotaxim
25 Injeksi 0 Vial Rp 3,050.00 Rp -
Diazepam inj 5
26 mg / 2 ml 0 Ampul Rp 1,545.00 Rp -
Dexamethaso
27 ne injeksi 200 Ampul Rp 968.00 Rp 193,600
28 Dextrosa 10 % 0 Botol Rp 7,200.00 Rp -

Domperidone
30 syr 0 Botol Rp 2,401.00 Rp -
Eritromisin
31 28 Botol Rp 7,436.00 Rp 208,208
sirup 200 mg
Furosemid
33 Injeksi i.v./i.m 42 Ampul Rp 969.00 Rp 40,698
10mg/ml
Glukosa Infus
34 60 btl Rp 7,363.00 Rp 441,780
D5%
Glibenklamide
35 0 Tab Rp 87.00 Rp -
5 mg
Haloperidole 5
36 mg 0 Tab Rp 54.00 Rp -
Hyoscine N
37 100 Tab Rp 1,050.00 Rp 105,000
butylbromide
Karbogliserin
tetes telinga
gliserol tts.
Telinga)
39 Kalsium laktat 0 Tab Rp 60.00 Rp -

(Kalk) 500 mg
Kalsium
10 %
Ketorolac inj
41 30Mg/MI 262 Ampul Rp 923.00 Rp 241,826
Karbamazepin
42 200mg 0 tab Rp 216.00 Rp -
43 KAEN 3B 0 tab Rp 11,500.00 Rp -

Isosorbid
44 Dinitrat tablet 140 Tab Rp 99.00 Rp 13,860
sublingual
5mg
45 Ibuprofen Syr 0 Btl Rp 2,339.00 Rp -

100mg/5ml
46 Ketokonazole 7 Tube Rp 2,399.00 Rp 16,793

Cream
47 Ketokonazole 0 Tab Rp 260.00 Rp -

tablet 200mg
Kloramfenikol
48 Suspensi 125 64 Btl Rp 5,352.00 Rp 342,528
mg/ 5ml
49 Kodein 10 mg 0 Tab Rp 605.00 Rp -
Lansoprazole
50 30 mg 0 kap Rp 278.00 Rp -
Lidokain comp
(Lidokain
51 injeksi 2% 240 Ampul Rp 847.00 Rp 203,280
(HCI) +
epinefrin)
Lidocain inj 2
52 % (HCL) 0 Ampul Rp 891.00 Rp -

Metformin
54 0 tab Rp 77.00 Rp -
HCL 500 mg
Metilprednisol
55 0 tab Rp 102.00 Rp -
on tablat 4 mg
Metilprednisol
56 on tablat 8 mg 0 tab Rp 237.00 Rp -
Metokloprami
57 90 tab Rp 66.00 Rp 5,940
d 10 mg
Metokloprami
58 d inj 611 Ampul Rp 1,983.00 Rp 1,211,613
Methamizole
59 Na Inj 0 Ampul Rp 3,045.00 Rp -
Metronidazol
60 sirup 51 Btl Rp 3,765.00 Rp 192,015
61 MGSO4 40 % 0 Ampul Rp 4,700.00 Rp -
62 MGSO4 20 % 50 Ampul Rp 4,120.00 Rp 206,000
63 Mikonazole 125 Tube Rp 1,900.00 Rp 237,500

kream
65 Nistatin Ovula 95 tab Rp 550.00 Rp 52,250

100.000 IU
Natrium
66 Diklofenak 25 0 tab Rp 109.00 Rp -
mg
67 N-Asetilsistein 0 Tab Rp 317.00 Rp -
Natrium
68 Chloride 0,9 % 297 btl Rp 6,900.00 Rp 2,049,300
( NACL 0,9 %)
Oxytocin
69 injeksi 0 Ampul Rp 1,248.00 Rp -
70 Omeprazole 6480 Kap Rp 129.00 Rp 835,920

20 mg
Parasetamol
71 syr 0 btl Rp 1,160.00 Rp -
72 Phytomenadio 111 Ampul Rp 3,900.00 Rp 432,900

n inj 2mg/ml
73 Phytomenadio 140 Tab Rp 781.00 Rp 109,340

n 10 mg
Permetrin
74 cream 0 Tube Rp 11,466.00 Rp -
75 Ranitidin 140 tab Rp 85.00 Rp 11,900

tablet 150 mg
Ranitidin
76 injeksi 0 Ampul Rp 858.00 Rp -
Salbutamol 4
77 mg 0 Tab Rp 67.00 Rp -
Salbutamol
nebulizer /
78 56 Ampul Rp 5,400.00 Rp 302,400
Ventolin
Nebulizer
79 Salep 2-4 3 Pot Rp 1,475.00 Rp 4,425

Simvastatin 10
80 0 tab Rp 73.00 Rp -
mg
Simvastatin 20
81 4930 tab Rp 73.00 Rp 359,890
mg
Siprofloksasin
82 0 Tab Rp 260.00 Rp -
500 mg
Sianocbalamin
83 (B12) 0 Tab Rp 44.00 Rp -
Sianocobalami
n ( Vitamin
84 B12) Injeksi 287 Ampul Rp 1,066.00 Rp 305,942
500 mcg
85 SABU ( Serum 2 Vial Rp 517,132.00 Rp 1,034,264

Anti Bisa Ular)
86 Tablet tambah 0 tab Rp 255.00 Rp -

darah
87 USG GEL 0 Btl Rp 18,858.33 Rp -

88 VAR 0 Vial Rp 153,000.00 Rp -
89 Vit. B.Complex 2500 Tab Rp 60 Rp 150,000
90 Zink 20 mg tab 0 Tab Rp 253.00 Rp -

BMHP
Catgut
92 chromic 3/0 0 Pcs Rp 68,090.00 Rp -
+jarum Bulat
(*optime*)
93 Disposable 1900 Pcs Rp 818.00 Rp 1,554,200
syringe 3 cc
94 Disposable 90 Pcs Rp 1,100.00 Rp 99,000

syringe 10 cc
Folly Catheter
95 18 10 pcs Rp 11,132.00 Rp 111,320

steril no 6

steril no 6,5
98 Handscoond 45 Pasang Rp 13,563.00 Rp 610,335

steril no 7
Handscoond
99 0 Pasang Rp 13,563.00 Rp -
steril no 7,5
Hand Sanitizer
100 / Handrub 500 0 Btl Rp 68,200.00 Rp -
ml

Infus Set
102 0 pcs Rp 7,128.00 Rp -
Dewasa
IV.Chateter
103 0 pcs Rp 25,487.00 Rp -
No.18 G
104 Kasa 4 x 10 210 pcs Rp 2,176.72 Rp 457,112
105 Kasa 4 x 5 0 pcs Rp 1,089.67 Rp -
Scalpet Blades
106 no.10 100 Pcs Rp 618.70 Rp 61,870
Scalpet Blades
107 no.11 0 Pcs Rp 618.68 Rp -
Scalpet Blades
108 no.15 0 Pcs Rp 618.71 Rp -
Surgical mask
109 earloop 3ply / 2300 Box Rp 1,373.14 Rp 3,158,222
Masker
Under Pad
110 Steril 0 pcs Rp 37,875.00 Rp -
DAK 2020
Acyclovir 400
1 mg 0 Tab Rp 454.00 Rp -
Betahistine 6
2 mg 0 Tab Rp 119.00 Rp -
4 Cetrizine 10 0 tab Rp 104.00 Rp -

mg
Domperidone
5 syr 0 Botol Rp 2,862.00 Rp -
Anti migren
6 kombinasi 329 tab Rp 212.00 Rp 69,748
( ERGOTAMIN
)
7 Gentamicine 0 Botol Rp 26.00 Rp -

tetes mata
8 Kodein 10 mg 0 Tab Rp 657.00 Rp -
Lansoprazole
9 0 kap Rp 352.00 Rp -
30 mg
Metilprednisol
10 on tablat 4 mg 0 tab Rp 148.00 Rp -

Drop
BMHP
Catgut
chromic 3/0
12 +jarum Bulat 0 Pcs Rp 55,000.00 Rp -
(*optime*)
Catgut
chromic 3/0
13 +jarum 0 Pcs Rp 62,000.00 Rp -
Segitiga
(*optime*)
Catgut
chromic 2/0
14 0 Pcs Rp 44,000.00 Rp -
+jarum Bulat
(*optime-R*)
Catgut plain
3/0 + jarum
(*Advantime*)
Feeding Tube
16 0 pcs Rp 8,407.00 Rp -
14
Feeding Tube
17 16 0 pcs Rp 8,407.00 Rp -
18 Handscoond 49 Pasang Rp 13,178.00 Rp 645,722

steril no 8
IV.Chateter
19 0 pcs Rp 23,100.00 Rp -
No.20 G
IV.Chateter
20 0 pcs Rp 23,100.00 Rp -
No.22 G
21 Kasa 16x16 0 pcs Rp 7,897.31 Rp -
Silk 2/0 +
22 jarum 1/2 25 0 Pcs Rp 32,500.00 Rp -
mm 75 cm
23 Umbilical Cord 0 Pcs Rp -

Klem Rp 1,495.00
DAU 2020
Aqua pro
1 injeksi 20 ml 0 ampul Rp 2,860.00 Rp -
Hyoscine N
2 butylbromide 0 Ampul Rp 9,900.00 Rp -
10 mg inj
Natrium
3 Chloride 0,9 % 0 btl Rp 6,840.00 Rp -
( NACL 0,9 %)
Propylthiourac
4 yl 100 mg 220 Tab Rp 733.00 Rp 161,260
tablet
5 Ringer Laktat 0 btl Rp 7,150.00 Rp -
(RL)
P 2020
Ambroxol
1 sirup 15 mg/5 0 Btl Rp 3,250.01 Rp -
ml
Ambroxol
2 0 Tab Rp 110.00 Rp -
Tablet 30 mg
3 Bisakodil 0 Suppo Rp 23,475.00 Rp -

Suppo
Bisakodil
4 ( LAXANA) 0 Tab Rp 367.00 Rp -

(GG) 100 mg
Kombinasi
Tetes Mata
(Deksametaso
n, Neomisin
6 Sulfat, 0 Botol Rp 14,900.00 Rp -
Polimiksin B
Sulfat )
ALLETROL
COMPOSITUM
Obat batuk
7 pilek anak 0 Botol Rp -
kombinasi GG
( Dextrofen)
Rp 12,900.00
Obat flu
kombinasi
8 ( pseudoephed 0 tab Rp 600.00 Rp -
rin Hcl,
Tripolidin Hcl )
FLUTROP
Salbutamol
nebulizer /
9 Ventolin 0 Flash Rp 10,000.00 Rp -
Nebulizer
DAK 2019
1 Acyclovir 400 0 Tab Rp 425.00 Rp -

mg
2 Alprazolam 0,5 0 tab Rp 88.00 Rp -

mg
Cefadroxil
125mg/5ml
Diazepam 5
mg / 2,5 ml
4 0 Tube Rp 14,459.00 Rp -
( STESOLID )
Rektal
5 Kotrimoxazole 0 btl Rp 2,052.00 Rp -

syr
Metokloprami
6 0 tab Rp 83.00 Rp -
de 10 mg
7 Oxtretrasiklin 0 tube Rp 2,600.00 Rp -

Salep Mata
8 Pirantel 125 29 tab Rp 331.00 Rp 9,599
mg
Piridoksin HCL
9 ( Vit. B 6 ) 10 0 tab Rp 141.00 Rp -
mg
BMHP
Alat Suntik 5
10 ml 900 pcs Rp 1,600 Rp 1,440,000
Folly Catheter
11 14 10 pcs Rp 11,891.00 Rp 118,910
Folly Catheter
12 16 10 pcs Rp 11,891.00 Rp 118,910
13 Infus Set 0 pcs Rp 6,842.00 Rp -

Dewasa
PENUNJANG
2019
Gentamicin
1 0 tube Rp 2,640.00 Rp -
salep kulit
Multivitamin
3 syr anak 0 Botol Rp -
( Becefort ) Rp 17,365.70
Anti diare
kombinasi
(Kaolin Pektin)
4 sirup 16 btl Rp 3,850.00 Rp 61,600
(Guanistrep
Sirup)
BG 2019
Articulating
1 0 Pcs Rp 242,000.00 Rp -
Paper
Cotton roll
2 medium 0 Pack Rp 85,800.00 Rp -
3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp -

DAK 2018
Diazepam 5
1 mg 0 Tab Rp 109.00 Rp -
2 HCT 25 mg 0 tab Rp 178.00 Rp -

Nistatin
3 100.000 IU 0 tab Rp 645.00 Rp -
BMHP
5 Plaster 0 Roll Rp 29,642.86 Rp -

( Hifafix )
Penunjang
2017
BMHP
1 Jarum Jahit 0 pcs Rp 22,000.00 Rp -

Segitiga
DAU 2017
BMHP
Silk 3/0 +
1 jarum 1/2 GT 0 Pcs Rp 46,187.44 Rp -
35 mm ( Sole)
DAK 2017
Diltiazem 30
1 mg 0 tab Rp 128.00 Rp -
BMHP
KAPAS
ABSORBEN
250 GRAM
2 Kasa 4mx5cm 0 Roll Rp 862.50 Rp -
APBD 2016
BMHP 2016
1 Infus set anak 50 pcs Rp 6,222.00 Rp 311,100

(Aximed)
DAU 2009
KAPAS
PEMBALUT /
1 ABSORBEN 0 roll/bungkus Rp 11,914 Rp -
250 GRAM
141,749.00 Rp 85,158,630.57
PENERIMAAN
LPLPO, BON
Dokumen
Penyedia Kode Barang Nama Barang
Tanggal Nomor Nama
2 3 4 5 6 7
BMHP Program HIV
Safety box
Plesterin Bulat non woven
Vacum Tube sterile, plastic,

K3 EDTA
Vacutainer Needle
BMHP Program TB
Sputum Pot
Object Glass Frosted 7105
DAK 22
Allupurinol 100 mg
Amlodipine 10 mg
Amlodipine 5 mg
(hexapram Jaya )
Ambroxol sirup 15 mg/5 ml
Asam Traneksamat 500 mg
IFK 12/7/2022 B/442/1800-SPB/UPTD- SPB Asam Traneksamat injeksi

IFK/XII-2022
Asam folat tab 1 mg
Asam Mefenamat
Antasida syr
B/442/1800-SPB/UPTD- Antasida Doen I Tablet

IFK 12/7/2022 SPB
IFK/XII-2022 Kunyah
Anti Hemoroid komb. Supp
Betahistine 6 mg
Captopril 25 mg
Cetrizine 10 mg
Dexamethasone 0,5mg
Dimenhidrinat 50 mg
IFK 12/7/2022 B/442/1800-SPB/UPTD- SPB Domperidone 10 mg

IFK/XII-2022
B/442/1800-SPB/UPTD-
IFK 12/7/2022 IFK/XII-2022 SPB Esomeprazole injeksi
Fenol gliserol TT 10 %
Glimepirid 2 mg
Haloperidole 5 mg
Ibuprofen 400mg

sublingual 5mg
Kalk
Ketokonazol 200mg
Ketokonazole cream
IFK 12/7/2022 B/442/1800-SPB/UPTD- SPB Klorfeniramin maleat (CTM)

IFK/XII-2022 4 mg
Kodein 10 mg
Lansoprazole 30 mg
Metilprednisolon tablat 4
mg
Metronidazol 500mg

(Novakid)
Novatusin syr
N-Asetilsistein 200mg
Natrium Diklofenak 50 mg
IFK 12/7/2022 IFK/XII-2022 SPB Omeprazole inj
Paracetamol Drop
Paracetamol syr
Paracetamol 500 mg
IFK 12/7/2022 IFK/XII-2022 SPB Ranitidine injeksi
Scabimite cream
Povidon iodida 10 % 30 ml
Prednison 5 mg
Rivanol
Ringer Laktat (RL)
Salbutamol 2 mg
Salbutamol 4 mg
Salbutamol inheler
Sefadroksil 500mg
Simvastatin 10 mg
Simvastatin 20 mg
USG GEL
Vitamin B1
Vitamin B6
Vitamin B12
BMHP
Alkohol 70% 100 mL
Alkohol 70% 1000 mL

Handscoon non steril S

Hamburg )
IV.Chateter No.18 G
IV.Chateter No.20 G
IV.Chateter No.22 G
IV.Chateter No.24 G
IV.Chateter No.26 G
Kasa 16 x 16
Kasa 40x80
Plester Putih 5x10
Plester Putih 5x5
Plester Putih 5x2
Rivanol
Umbilical Cord Klem
BG 2021
Bahan tambal sinar
Cairan bonding
Cairan etsa / Etching liquid
DAU 2021

OMEGA 3
BMHP
Sarung Tangan Uk. S
Sarung Tangan Uk. M
P 21
Acyclovir Cream
Bedak Salisil
Bicombin inj
Cefadroxil 500 mg
Klorpromazin 100 mg (CPZ )
Digoxin 0,5 mg

5mg/2,5ml
Eflin
Furosemid
Guaiafenesin (GG) 100 mg
Ibuprofen 200mg
Lexartans (as. Traneksamat)
Meloxicam 7,5 mg
Novastan syr
Nifedipine
Neo Diaform
Oxytetracycline Salep Kulit

3%
OBH Plus
Paracetamol 500 mg
Pehavral
Reco Salep Mata

( Chloamphenicol)
Reco Tetes Telinga

(Chloramphenicol)
Skincol Gel
Tramadol inj 50 mg/ml
Visoprin
DAK 2021
(hexapram Jaya )

125mg/5ml
Amox icillin Drop
Allupurinol 100 mg
Allupurinol 300 mg
Asam Mefenamat
Amlodipine 5 mg
Amlodipine 10 mg
Ampisillin serbuk injeksi i.v

1000 mg/ Vial
Antifungi DOEN kombinasi:

Asam Benzoat 3% + Asam
Salisilat 6%

Kunyah
Asam askorbat / Vit C 50 mg
Asam Traneksamat injeksi
Asam folat tab 1 mg
Asetosal 80 mg
Betahistine 6 mg
Betamethason cream
Bisakodil Suppo
Bisakodil 5 mg
Captopril 12,5 mg
Cetrizine syr
Cefotaxim Injeksi
Dexamethasone injeksi
Dextrosa 10 %
Doksisiklin
Domperidone syr
Epinephrine

10mg/ml
Glukosa Infus D5%
Glibenklamide 5 mg
Haloperidole 5 mg
Hyoscine N butylbromide
Karbogliserin tetes telinga

10% (phenol gliserol tts.
Telinga)
Kalsium laktat (Kalk) 500 mg
Kalsium Glukonat inj 10 %
Ketorolac inj 30Mg/MI
Karbamazepin 200mg
KAEN 3B
sublingual 5mg
Ibuprofen Syr 100mg/5ml
Ketokonazole Cream
Ketokonazole tablet 200mg
Kloramfenikol Suspensi 125

mg/ 5ml
Kodein 10 mg
Lansoprazole 30 mg

injeksi 2% (HCI) + epinefrin)
Loratadine
mg
mg
Metoklopramid 10 mg
Metoklopramid inj
Methamizole Na Inj
Metronidazol sirup
MGSO4 40 %
MGSO4 20 %
Mikonazole kream
Nistatin drop
Nistatin Ovula 100.000 IU
Natrium Diklofenak 25 mg
N-Asetilsistein

( NACL 0,9 %)
Oxytocin injeksi
Omeprazole 20 mg
Parasetamol syr
Phytomenadion inj 2mg/ml
Phytomenadion 10 mg
Permetrin cream
Ranitidin injeksi
Salbutamol 4 mg
Ventolin Nebulizer
Salep 2-4
Simvastatin 10 mg
Simvastatin 20 mg
Sianocbalamin (B12)
Sianocobalamin ( Vitamin
B12) Injeksi 500 mcg

Ular)
Tablet tambah darah
USG GEL
VAR
IFK 12/7/2022 IFK/XII-2022 SPB Vit. B.Complex
Zink 20 mg tab
Zink syr
BMHP

Bulat (*optime*)
Folly Catheter 18
Hand Sanitizer / Handrub

500 ml
Handscrub
Infus Set Dewasa
IV.Chateter No.18 G
Kasa 4 x 10
Kasa 4 x 5

Masker
Under Pad Steril
DAK 2020
Acyclovir 400 mg
Betahistine 6 mg
CTM 4 mg
Cetrizine 10 mg
Domperidone syr

( ERGOTAMIN )

Kodein 10 mg
Lansoprazole 30 mg
mg
Paracetamol Drop
BMHP

Bulat (*optime*)

Segitiga (*optime*)

Bulat (*optime-R*)

Feeding Tube 14
Feeding Tube 16
IV.Chateter No.20 G
IV.Chateter No.22 G
Kasa 16x16
Silk 2/0 + jarum 1/2 25 mm

75 cm
Umbilical Cord Klem
DAU 2020
Hyoscine N butylbromide 10
mg inj

( NACL 0,9 %)
tablet
Ringer Laktat (RL)
P 2020
Ambroxol sirup 15 mg/5 ml
Bisakodil Suppo
Bisakodil ( LAXANA)
Guaiafenesin (GG) 100 mg

(Deksametason, Neomisin
Sulfat, Polimiksin B Sulfat )
ALLETROL COMPOSITUM

kombinasi GG ( Dextrofen)
Obat flu kombinasi

Ventolin Nebulizer
Hemafort
DAK 2019
Acyclovir 400 mg
Alprazolam 0,5 mg

125mg/5ml
( STESOLID ) Rektal
Kotrimoxazole syr
Oxtretrasiklin Salep Mata

Pirantel 125 mg
Piridoksin HCL ( Vit. B 6 ) 10

mg
BMHP
Alat Suntik 5 ml
Folly Catheter 14
Folly Catheter 16
Infus Set Dewasa
urine bag
PENUNJANG 2019
Loperamide

( Becefort )

Pektin) sirup (Guanistrep
Sirup)
BG 2019
Articulating Paper
Cotton roll medium
Eugenol
Pehacain
DAK 2018
Diazepam 5 mg
HCT 25 mg
Nistatin 100.000 IU
BMHP
Blood Lancet
Plaster ( Hifafix )
Penunjang 2017
BMHP
DAU 2017
BMHP
Silk 3/0 + jarum 1/2 GT 35

mm ( Sole)
DAK 2017
Diltiazem 30 mg
BMHP
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
Kasa 4mx5cm
APBD 2016
BMHP 2016
DAU 2009
KAPAS PEMBALUT /
ABSORBEN 250 GRAM
BUKU PENERIMAAN DAN
PENERIMAAN
LPLPO, BON
Spesifikasi Barang Harga Satuan

NUSP Spesifikasi Nama Barang (Rp)
8 9 10 11 12
BMHP Program HIV
Safety box IDR

Rp 16,666.00
Plesterin Bulat non woven Kotak

Rp 40,187.50
Vacum Tube sterile, plastic, K3 EDTA Pcs
Rp 1,160.00
surgical Gloves no. 7, 5 Pcs Rp 13,178.00
surgical Gloves no. 8 Pcs Rp 13,178.00
Vacutainer Needle Pcs Rp 132.00
BMHP Program TB
Larutan Zhihi Neeisen Paket

Rp 274,362.00
Sputum Pot Biji

Rp 3,137.00
Object Glass Frosted 7105 box @ 72 pcs
Rp 23,860.08
DAK 22
Allupurinol 100 mg Tab

Rp 89.00
Amlodipine 10 mg Tab
Rp 74.67
Amlodipine 5 mg Tab
Rp 55.00
Forte 500 mg (hexapram Jaya ) Tab
Rp 231.00
Ambroxol sirup 15 mg/5 ml Btl

Rp 4,800.00
Asam Traneksamat 500 mg Tab

Rp 1,927.00
Asam Traneksamat injeksi 100 Ampul

Rp 1,837.00
Asam folat tab 1 mg Tab
Rp 61.00
Asam Mefenamat tab
Rp 117.00
Antasida syr Btl Rp 1,756.00
Antasida Doen I Tablet Kunyah 5000 tab
Rp 54.00
Anti Hemoroid komb. Supp Suppo

Rp 3,260.00
Betahistine 6 mg tab
Rp 93.00
Captopril 25 mg tab
Rp 72.00
Cetrizine 10 mg tab
Rp 52.47
Ciprofloxacin 500 mg tab
Rp 260.00
Dexamethasone 0,5mg Tablet

Rp 106.00
Dimenhidrinat 50 mg tab
Rp 109.00
Domperidone 10 mg 3000 Tablet

Rp 75.68
Esomeprazole injeksi 10 Vial

Rp 8,247.00
Fenol gliserol TT 10 % Btl

Rp 3,300.00
Glimepirid 2 mg Tab
Rp 123.00
Hidrokortisone cream Tube
Rp 2,325.00
Haloperidole 5 mg Tab
Rp 54.00
Ibuprofen 400mg Tab

Rp 210.00
Isosorbid Dinitrat tablet sublingual

Tab
5mg
Rp 99.90
Kalk Tablet Rp 60.00
Ketokonazol 200mg Tab

Rp 260.00
Ketokonazole cream Tube

Rp 2,399.00
Klorfeniramin maleat (CTM) 4 mg 3000 Tab

Rp 86.00
Kodein 10 mg Tab
Rp 605.00
Lansoprazole 30 mg Kap
Rp 278.00
Metformin HCL 500 mg tab

Rp 77.00
Metilprednisolon tablat 4 mg tab

Rp 102.00
Metronidazol 500mg tab

Rp 317.00
Metoklopramide 10 mg tab
Rp 66.00
Multivitamin sirup anak (Novakid) Btl

Rp 7,400.00
Novatusin syr Btl

Rp 8,200.00
N-Asetilsistein 200mg Kapsule

Rp 319.87
Natrium Diklofenak 50 mg Tablet

Rp 109.00
Omeprazole inj 150 Vial

Rp 5,346.00
Paracetamol Drop Drop

Rp 5,204.00
Paracetamol syr Btl

Rp 1,160.00
Paracetamol 500 mg Tab
Rp 257.00
Ranitidine injeksi 150 Ampul

Rp 858.00
Scabimite cream Tube

Rp 11,466.00
Povidon iodida 10 % 30 ml Btl Rp 4,182.00
Prednison 5 mg tab
Rp 73.00
Rivanol Btl Rp 7,221.00
Ringer Laktat (RL) Btl
Rp 7,703.00
Salbutamol 2 mg Tab
Rp 51.00
Salbutamol 4 mg Tab
Rp 67.00
Salbutamol inheler (Salbutamol Sulfate Btl

)
Rp 22,200.00
Sefadroksil 500mg Kap Rp 1,036.00
Simvastatin 10 mg Kap
Rp 73.00
Simvastatin 20 mg Kap
Rp 150.00
USG GEL pcs Rp 16,632.00
Vitamin B1 tab
Rp 173.00
Vitamin B6 tab
Rp 72.00
Vitamin B12 tab

Rp 44.00
BMHP
Alkohol 70% 100 mL Btl Rp 3,256.00
Alkohol 70% 1000 mL Btl Rp 23,595.00
Disposable syringe 1 cc pcs Rp 1,045.00
Disposable syringe 3 cc pcs Rp 825.00
Disposable syringe 5 cc pcs Rp 955.00
Disposable syringe 10 cc pcs Rp 1,110.00
Handscoon non steril L pcs
Rp 1,252.08
Handscoon non steril M pcs
Rp 1,252.08
Handscoon non steril S pcs
Rp 1,252.08
Infuset Dewasa ( Troge Hamburg ) pcs
Rp 26,062.00
IV.Chateter No.18 G pcs

Rp 26,418.00

Rp 26,418.00

Rp 26,418.00

Rp 26,418.00

Rp 27,639.00
Kasa 16 x 16 pcs Rp 3,541.00
Kasa 40x80 pcs Rp 91,045.00
Plester Putih 5x10 pcs

Rp 61,605.00
Plester Putih 5x5 pcs

Rp 32,190.00
Plester Putih 5x2 pcs Rp 21,638.40
Rivanol Btl Rp 7,221.00
Umbilical Cord Klem pcs Rp 2,070.00
BG 2021
Bahan tambal sinar Syringe Rp 356,400.00
Cairan bonding Pot Rp 391,500.00
Cairan etsa / Etching liquid Pcs Rp 67,500.00
DAU 2021
Multivitamin Ibu Hamil OMEGA 3 Btl isi @ 30 kapsul Rp 45,000.00
BMHP
Disposable syringe 1 cc Pcs Rp 1,361.00
Sarung Tangan Uk. S Pcs Rp 1,712.53
Sarung Tangan Uk. M Pcs Rp 1,710.13
P 21
Acyclovir Cream Tube Rp 4,400.00
Bedak Salisil Wadah Rp 7,700.00
Bicombin inj Ampul Rp 6,600.00
Cefadroxil 500 mg Kap Rp 880.00
Klorpromazin 100 mg (CPZ ) Kap Rp 495.00
Digoxin 0,5 mg Tab Rp 198.00
Diazepam larutan rektal 5mg/2,5ml Suppo Rp 30,800.00
Eflin Tab Rp 1,413.50

Furosemid Tab Rp 275.00
Guaiafenesin (GG) 100 mg tab Rp 147.99
Ibuprofen 200mg Tab Rp 275.00
Kloramfenikol 250 mg Kap Rp 770.00
Lexartans (as. Traneksamat) Tab Rp 1,650.00
Meloxicam 7,5 mg Tab Rp 385.00
Novastan syr Btl Rp 11,000.00
Nifedipine Tab Rp 220.00
Neo Diaform Tab Rp 286.00
Oxytetracycline Salep Kulit 3% Tube Rp 4,950.00
OBH Plus Btl Rp 12,100.00
Paracetamol 500 mg tab Rp 275.00
Pehavral tab Rp 1,045.00
Reco Salep Mata ( Chloamphenicol) Tube Rp 6,600.00
Reco Tetes Telinga (Chloramphenicol) Btl Rp 11,000.00
Skincol Gel Tube Rp 148,500.00
Tramadol inj 50 mg/ml Ampul Rp 11,000.00
Visoprin Btl Rp 72,600.00

DAK 2021
Amoxicillin Trihydrate / Pehamoxiil Tab Rp 231.00

Forte 500 mg (hexapram Jaya )
Amoksisilin sirup kering 125mg/5ml Btl Rp 2,050.00
Amox icillin Drop Btl Rp 11,750.00
Allupurinol 100 mg Tab Rp 89.00
Allupurinol 300 mg Tab Rp 200.00
Asam Mefenamat tab Rp 117.00
Amlodipine 5 mg Tab Rp 55.00
Amlodipine 10 mg Tab Rp 74.00
Ampisillin serbuk injeksi i.v 1000 mg/

Vial Rp 9,900.00
Vial
Antihemeroid kombinasi Suppo Rp 3,260.00

Benzoat 3% + Asam Salisilat 6% Botol Rp 3,637.00
Antasida Doen I Tablet Kunyah Tab Rp 54.00
Antasida Doen suspensi Botol Rp 1,756.00
Asam askorbat / Vit C 50 mg Tab Rp 46.00
Asam Traneksamat injeksi amp Rp 1,820.00
Asam folat tab 1 mg pcs Rp 61.00
Asetosal 80 mg Tab Rp 89.00
Aqua pro injeksi 25 ml Tab Rp 2,650.00
Betahistine 6 mg Tab Rp 92.00
Betamethason cream Tab Rp 1,540.00

Bisakodil Suppo Suppo Rp 5,085.00
Bisakodil 5 mg Tab Rp 5,085.00
Captopril 12,5 mg tab Rp 68.00
Cetrizine syr Botol Rp 2,215.00
Cefotaxim Injeksi Vial Rp 3,050.00
Diazepam inj 5 mg / 2 ml Ampul Rp 1,545.00
Dexamethasone injeksi Ampul Rp 968.00
Dextrosa 10 % Botol Rp 7,200.00
Doksisiklin Tab Rp 289.00
Domperidone syr Botol Rp 2,401.00
Eritromisin sirup 200 mg Botol Rp 7,436.00
Epinephrine Ampul Rp 1,740.00
Furosemid Injeksi i.v./i.m 10mg/ml Ampul Rp 969.00
Glukosa Infus D5% btl Rp 7,363.00
Glibenklamide 5 mg Tab Rp 87.00
Haloperidole 5 mg Tab Rp 54.00
Hyoscine N butylbromide Tab Rp 1,050.00

Botol Rp 3,300.00
Kalsium laktat (Kalk) 500 mg Tab Rp 60.00
Kalsium Glukonat inj 10 % Ampul Rp 6,199.00
Ketorolac inj 30Mg/MI Ampul Rp 923.00
Karbamazepin 200mg tab Rp 216.00
KAEN 3B tab Rp 11,500.00

Isosorbid Dinitrat tablet sublingual Tab Rp 99.00
5mg
Ibuprofen Syr 100mg/5ml Btl Rp 2,339.00
Ketokonazole Cream Tube Rp 2,399.00
Ketokonazole tablet 200mg Tab Rp 260.00
Kloramfenikol Suspensi 125 mg/ 5ml Btl Rp 5,352.00
Kodein 10 mg Tab Rp 605.00
Lansoprazole 30 mg kap Rp 278.00
Lidokain comp (Lidokain injeksi 2%

Ampul Rp 847.00
(HCI) + epinefrin)
Lidocain inj 2 % (HCL) Ampul Rp 891.00
Loratadine kap Rp 117.00
Metformin HCL 500 mg tab Rp 77.00
Metilprednisolon tablat 4 mg tab Rp 102.00
Metoklopramid 10 mg tab Rp 66.00
Metoklopramid inj Ampul Rp 1,983.00
Methamizole Na Inj Ampul Rp 3,045.00
Metronidazol sirup Btl Rp 3,765.00
MGSO4 40 % Ampul Rp 4,700.00
MGSO4 20 % Ampul Rp 4,120.00
Mikonazole kream Tube Rp 1,900.00
Nistatin drop Btl Rp 11,750.00
Nistatin Ovula 100.000 IU tab Rp 550.00
Natrium Diklofenak 25 mg tab Rp 109.00

N-Asetilsistein Tab Rp 317.00
Natrium Chloride 0,9 % ( NACL 0,9 %) btl Rp 6,900.00
Oxytocin injeksi Ampul Rp 1,248.00
Omeprazole 20 mg Kap Rp 129.00
Parasetamol syr btl Rp 1,160.00
Phytomenadion inj 2mg/ml Ampul Rp 3,900.00
Phytomenadion 10 mg Tab Rp 781.00
Permetrin cream Tube Rp 11,466.00
Ranitidin tablet 150 mg tab Rp 85.00
Ranitidin injeksi Ampul Rp 858.00
Salbutamol 4 mg Tab Rp 67.00

Ampul Rp 5,400.00
Nebulizer
Salep 2-4 Pot Rp 1,475.00
Simvastatin 10 mg tab Rp 73.00
Simvastatin 20 mg tab Rp 73.00
Siprofloksasin 500 mg Tab Rp 260.00
Sianocbalamin (B12) Tab Rp 44.00
Sianocobalamin ( Vitamin B12) Injeksi

500 mcg Ampul Rp 1,066.00
SABU ( Serum Anti Bisa Ular) Vial Rp 517,132.00
Tablet tambah darah tab Rp 255.00
USG GEL Btl Rp 18,858.33

VAR Vial Rp 153,000.00
Vit. B.Complex 3000 Tab Rp 60
Zink 20 mg tab Tab Rp 253.00
Zink syr Btl Rp 2,489.00

BMHP
Catgut chromic 3/0 +jarum Bulat Pcs Rp 68,090.00

(*optime*)
Disposable syringe 3 cc Pcs Rp 818.00
Disposable syringe 10 cc Pcs Rp 1,100.00
Folly Catheter 18 pcs Rp 11,132.00
Handscoond steril no 6 Pasang Rp 13,563.00
Handscoond steril no 6,5 Pasang Rp 13,563.00
Handscoond steril no 7,5 Pasang Rp 13,563.00
Hand Sanitizer / Handrub 500 ml Btl Rp 68,200.00
Handscrub Btl Rp 115,800.00
IV.Chateter No.18 G pcs Rp 25,487.00
Kasa 4 x 10 pcs Rp 2,176.72

Kasa 4 x 5 pcs Rp 1,089.67
Scalpet Blades no.10 Pcs Rp 618.70
Surgical mask earloop 3ply / Masker Box Rp 1,373.14
Under Pad Steril pcs Rp 37,875.00
DAK 2020
Acyclovir 400 mg Tab Rp 454.00
Betahistine 6 mg Tab Rp 119.00
CTM 4 mg tab Rp 26.00
Cetrizine 10 mg tab Rp 104.00
Domperidone syr Botol Rp 2,862.00
tab Rp 212.00
Anti migren kombinasi ( ERGOTAMIN )
Gentamicine tetes mata Botol Rp 26.00

Kodein 10 mg Tab Rp 657.00
Lansoprazole 30 mg kap Rp 352.00
Paracetamol Drop Botol Rp 7,646.00
BMHP

(*optime*) Pcs Rp 55,000.00
Catgut chromic 3/0 +jarum Segitiga Pcs Rp 62,000.00

(*optime*)

Pcs Rp 44,000.00
(*optime-R*)

(*Advantime*) Pcs Rp 71,000.00
Feeding Tube 14 pcs Rp 8,407.00
Feeding Tube 16 pcs Rp 8,407.00
Kasa 16x16 pcs Rp 7,897.31
Silk 2/0 + jarum 1/2 25 mm 75 cm Pcs Rp 32,500.00
Umbilical Cord Klem Pcs

Rp 1,495.00
DAU 2020
Aqua pro injeksi 20 ml ampul Rp 2,860.00
Hyoscine N butylbromide 10 mg inj Ampul Rp 9,900.00
Natrium Chloride 0,9 % ( NACL 0,9 %) btl Rp 6,840.00
Propylthiouracyl 100 mg tablet Tab Rp 733.00

Ringer Laktat (RL) btl Rp 7,150.00
P 2020
Ambroxol sirup 15 mg/5 ml Btl Rp 3,250.01
Ambroxol Tablet 30 mg Tab Rp 110.00
Bisakodil Suppo Suppo Rp 23,475.00
Bisakodil ( LAXANA) Tab Rp 367.00
Guaiafenesin (GG) 100 mg tab Rp 175.00
Kombinasi Tetes Mata (Deksametason,

Neomisin Sulfat, Polimiksin B Sulfat ) Botol Rp 14,900.00
ALLETROL COMPOSITUM
Obat batuk pilek anak kombinasi GG Botol

( Dextrofen)
Rp 12,900.00
Obat flu kombinasi ( pseudoephedrin tab Rp 600.00

Hcl, Tripolidin Hcl ) FLUTROP

Nebulizer Flash Rp 10,000.00
Hemafort Tab Rp 820.00
DAK 2019
Acyclovir 400 mg Tab Rp 425.00
Alprazolam 0,5 mg tab Rp 88.00
Cefadroxil sirup kering 125mg/5ml btl Rp 4,360.00
Diazepam 5 mg / 2,5 ml ( STESOLID )

Tube Rp 14,459.00
Rektal
Kotrimoxazole syr btl Rp 2,052.00
Metoklopramide 10 mg tab Rp 83.00
Oxtretrasiklin Salep Mata tube Rp 2,600.00

Pirantel 125 mg tab Rp 331.00
Piridoksin HCL ( Vit. B 6 ) 10 mg tab Rp 141.00
BMHP
Alat Suntik 5 ml pcs Rp 1,600
urine bag pcs Rp 1,848.00
PENUNJANG 2019
Gentamicin salep kulit tube Rp 2,640.00
Loperamide Tab Rp 198.00
Multivitamin syr anak ( Becefort ) Botol

Rp 17,365.70

sirup (Guanistrep Sirup) btl Rp 3,850.00
BG 2019
Articulating Paper Pcs Rp 242,000.00
Cotton roll medium Pack Rp 85,800.00
Eugenol Botol 10 ml Rp 97,500.00

Pehacain Ampul Rp 3,113.0495
DAK 2018
Diazepam 5 mg Tab Rp 109.00
HCT 25 mg tab Rp 178.00
Nistatin 100.000 IU tab Rp 645.00
BMHP
Blood Lancet Pcs Rp 167.509
Plaster ( Hifafix ) Roll Rp 29,642.86
Penunjang 2017
BMHP
Jarum Jahit Segitiga pcs Rp 22,000.00
DAU 2017
BMHP
Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) Pcs Rp 46,187.44
DAK 2017
Diltiazem 30 mg tab Rp 128.00
BMHP
KAPAS PEMBALUT / ABSORBEN 250 Bks Rp 14,375.00
GRAM
Kasa 4mx5cm Roll Rp 862.50
APBD 2016
BMHP 2016
Infus set anak (Aximed) pcs Rp 6,222.00
DAU 2009
KAPAS PEMBALUT / ABSORBEN 250

GRAM roll/bungkus Rp 11,914
14410
BUKU PENERIMAAN DAN PENGELUARAN PERSEDIAAN ( ASET OBAT DROPPING )
TAHUN 2022
PUSKESMAS ( RGD, RPP, LAB, RKGM,

Nilai Total Dokumen
Keterangan No Pengguna
(Rp) Tanggal Nomor Nama
13 14 15 16 17 18 19
Saldo 2021
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 183,700.00
Rp -
Rp -
Rp -
Rp 270,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 227,040.00
Rp 82,470.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 258,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 801,900.00
Rp -
Rp -
Rp -
Rp 128,700.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 180,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Pembelian Nota Dinas
Rp -
Rp 2,131,810.00
PENGELUARAN
PUSKESMAS ( RGD, RPP, LAB, RKGM, Poli Umum, Promkes, Pendaftaran , TU , Posko ) , DESA ( Pelayanan Poskesdes, Lansia, Imunisasi, Bumil, Posyandu Balita, Posko )
Spesifikasi Barang Jumlah
NUSP Spesifikasi Nama Barang
20 21 22 23 24
BMHP Program HIV BMHP Program HIV
Safety box Safety box 0
Plesterin Bulat non woven Plesterin Bulat non woven 0
Vacum Tube sterile, plastic, Vacum Tube sterile, plastic, K3 EDTA 0

K3 EDTA
surgical Gloves no. 7, 5 surgical Gloves no. 7, 5 0
surgical Gloves no. 8 surgical Gloves no. 8 0
Vacutainer Needle Vacutainer Needle 0
BMHP Program TB BMHP Program TB
Larutan Zhihi Neeisen Larutan Zhihi Neeisen 0
Sputum Pot Sputum Pot 0
Object Glass Frosted 7105 Object Glass Frosted 7105 0
DAK 22 DAK 22
Allupurinol 100 mg Allupurinol 100 mg 0
Amlodipine 10 mg Amlodipine 10 mg 1020

Pehamoxiil Forte 500 mg Forte 500 mg (hexapram Jaya ) 300
(hexapram Jaya )
Ambroxol sirup 15 mg/5 ml Ambroxol sirup 15 mg/5 ml 109
Asam Traneksamat 500 mg Asam Traneksamat 500 mg 40
Asam Traneksamat injeksi Asam Traneksamat injeksi 30
Asam folat tab 1 mg Asam folat tab 1 mg 0
Asam Mefenamat Asam Mefenamat 420
Antasida syr Antasida syr 0

Antasida Doen I Tablet Kunyah 1150
Kunyah
Anti Hemoroid komb. Supp Anti Hemoroid komb. Supp 0
Betahistine 6 mg Betahistine 6 mg 1650
Captopril 25 mg Captopril 25 mg 0
Cetrizine 10 mg Cetrizine 10 mg 410
Ciprofloxacin 500 mg Ciprofloxacin 500 mg 400
Dexamethasone 0,5mg Dexamethasone 0,5mg 790
Dimenhidrinat 50 mg Dimenhidrinat 50 mg 0
Domperidone 10 mg Domperidone 10 mg 210
Esomeprazole injeksi Esomeprazole injeksi 10
Fenol gliserol TT 10 % Fenol gliserol TT 10 % 4
Glimepirid 2 mg Glimepirid 2 mg 380

Hidrokortisone cream Hidrokortisone cream 31
Haloperidole 5 mg Haloperidole 5 mg 0
Ibuprofen 400mg Ibuprofen 400mg 790
Isosorbid Dinitrat tablet Isosorbid Dinitrat tablet sublingual

0
sublingual 5mg 5mg
Kalk Kalk 1740
Ketokonazol 200mg Ketokonazol 200mg 10
Ketokonazole cream Ketokonazole cream 0
Klorfeniramin maleat (CTM) Klorfeniramin maleat (CTM) 4 mg 170

4 mg
Kodein 10 mg Kodein 10 mg 60
Lansoprazole 30 mg Lansoprazole 30 mg 0
Metformin HCL 500 mg Metformin HCL 500 mg 1820
mg Metilprednisolon tablat 4 mg 0
Metronidazol 500mg Metronidazol 500mg 100
Metoklopramide 10 mg Metoklopramide 10 mg 100
Multivitamin sirup anak Multivitamin sirup anak (Novakid) 1

(Novakid)
Novatusin syr Novatusin syr 0
N-Asetilsistein 200mg N-Asetilsistein 200mg 340
Natrium Diklofenak 50 mg Natrium Diklofenak 50 mg 250
Omeprazole inj Omeprazole inj 37
Paracetamol Drop Paracetamol Drop 0
Paracetamol syr Paracetamol syr 93
Paracetamol 500 mg Paracetamol 500 mg 2400
Ranitidine injeksi Ranitidine injeksi 100
Scabimite cream Scabimite cream 22

Povidon iodida 10 % 30 ml Povidon iodida 10 % 30 ml 1
Prednison 5 mg Prednison 5 mg 160
Rivanol Rivanol 10
Ringer Laktat (RL) Ringer Laktat (RL) 220
Salbutamol 2 mg Salbutamol 2 mg 0
Salbutamol inheler Salbutamol nebulizer (Salbutamol 0

(Salbutamol Sulfate ) Sulfate )
Sefadroksil 500mg Sefadroksil 500mg 30
Simvastatin 10 mg Simvastatin 10 mg 50
USG GEL USG GEL 5
Vitamin B1 Vitamin B1 0
BMHP BMHP
Alkohol 70% 100 mL Alkohol 70% 100 mL 0
Alkohol 70% 1000 mL Alkohol 70% 1000 mL 0
Disposable syringe 1 cc Disposable syringe 1 cc 200
Handscoon non steril L Handscoon non steril L 200

Handscoon non steril M Handscoon non steril M 200
Handscoon non steril S Handscoon non steril S 400

Infuset Dewasa ( Troge Hamburg ) 0
Hamburg )
IV.Chateter No.18 G IV.Chateter No.18 G 100
Kasa 16 x 16 Kasa 16 x 16 50
Kasa 40x80 Kasa 40x80 10
Plester Putih 5x10 Plester Putih 5x10 5
Rivanol Rivanol 0
Umbilical Cord Klem Umbilical Cord Klem 100
BG 2021 BG 2021
Bahan tambal sinar Bahan tambal sinar 0
Cairan bonding Cairan bonding 0
Cairan etsa / Etching liquid Cairan etsa / Etching liquid 0
DAU 2021 DAU 2021

OMEGA 3 Multivitamin Ibu Hamil OMEGA 3 0
BMHP BMHP
Sarung Tangan Uk. S Sarung Tangan Uk. S 0
Sarung Tangan Uk. M Sarung Tangan Uk. M 0
P 21 P 21
Acyclovir Cream Acyclovir Cream 4
Bedak Salisil Bedak Salisil 0
Bicombin inj Bicombin inj 0
Cefadroxil 500 mg Cefadroxil 500 mg 120
Klorpromazin 100 mg (CPZ ) Klorpromazin 100 mg (CPZ ) 0
Digoxin 0,5 mg Digoxin 0,5 mg 0
Diazepam larutan rektal Diazepam larutan rektal 5mg/2,5ml 0

5mg/2,5ml
Eflin Eflin 0
Furosemid Furosemid 0
Guaiafenesin (GG) 100 mg Guaiafenesin (GG) 100 mg 0
Ibuprofen 200mg Ibuprofen 200mg 0
Kloramfenikol 250 mg Kloramfenikol 250 mg 0
Lexartans (as. Traneksamat) Lexartans (as. Traneksamat) 0
Meloxicam 7,5 mg Meloxicam 7,5 mg 0
Novastan syr Novastan syr 60
Nifedipine Nifedipine 0
Neo Diaform Neo Diaform 1420
Oxytetracycline Salep Kulit

Oxytetracycline Salep Kulit 3% 1
3%
OBH Plus OBH Plus 0
Paracetamol 500 mg Paracetamol 500 mg 0
Pehavral Pehavral 120
Reco Salep Mata Reco Salep Mata ( Chloamphenicol) 0

( Chloamphenicol)
Reco Tetes Telinga Reco Tetes Telinga (Chloramphenicol) 5

(Chloramphenicol)
Skincol Gel Skincol Gel 0
Tramadol inj 50 mg/ml Tramadol inj 50 mg/ml 25
Visoprin Visoprin 0
DAK 2021 DAK 2021
Pehamoxiil Forte 500 mg Amoxicillin Trihydrate / Pehamoxiil 0
(hexapram Jaya ) Forte 500 mg (hexapram Jaya )
Amoksisilin sirup kering Amoksisilin sirup kering 125mg/5ml 48

125mg/5ml
Amox icillin Drop Amox icillin Drop 5
Asam Mefenamat Asam Mefenamat 0
Ampisillin serbuk injeksi i.v Ampisillin serbuk injeksi i.v 1000 mg/
0
1000 mg/ Vial Vial
Antihemeroid kombinasi Antihemeroid kombinasi 0
Antifungi DOEN kombinasi:

Asam Benzoat 3% + Asam Benzoat 3% + Asam Salisilat 6% 10
Salisilat 6%

Antasida Doen I Tablet Kunyah 0
Kunyah
Antasida Doen suspensi Antasida Doen suspensi 0
Asam askorbat / Vit C 50 mg Asam askorbat / Vit C 50 mg 30
Asam Traneksamat injeksi Asam Traneksamat injeksi 0
Asam folat tab 1 mg Asam folat tab 1 mg 490
Asetosal 80 mg Asetosal 80 mg 70
Aqua pro injeksi 25 ml Aqua pro injeksi 25 ml 120
Betamethason cream Betamethason cream 0

Bisakodil Suppo Bisakodil Suppo 4
Bisakodil 5 mg Bisakodil 5 mg 220
Captopril 12,5 mg Captopril 12,5 mg 0
Cetrizine syr Cetrizine syr 80
Cefotaxim Injeksi Cefotaxim Injeksi 0
Diazepam inj 5 mg / 2 ml Diazepam inj 5 mg / 2 ml 0
Dexamethasone injeksi Dexamethasone injeksi 11
Dextrosa 10 % Dextrosa 10 % 0
Doksisiklin Doksisiklin 10
Domperidone syr Domperidone syr 0
Eritromisin sirup 200 mg Eritromisin sirup 200 mg 18
Epinephrine Epinephrine 0

Furosemid Injeksi i.v./i.m 10mg/ml 3
10mg/ml
Glukosa Infus D5% Glukosa Infus D5% 0
Glibenklamide 5 mg Glibenklamide 5 mg 0
Haloperidole 5 mg Haloperidole 5 mg 0
Hyoscine N butylbromide Hyoscine N butylbromide 0
Karbogliserin tetes telinga

10% (phenol gliserol tts. 0
Telinga) (phenol gliserol tts. Telinga)
Kalsium laktat (Kalk) 500 mg Kalsium laktat (Kalk) 500 mg 0
Kalsium Glukonat inj 10 % Kalsium Glukonat inj 10 % 0
Ketorolac inj 30Mg/MI Ketorolac inj 30Mg/MI 62
Karbamazepin 200mg Karbamazepin 200mg 0
KAEN 3B KAEN 3B 0
Isosorbid Dinitrat tablet Isosorbid Dinitrat tablet sublingual 10
sublingual 5mg 5mg
Ibuprofen Syr 100mg/5ml Ibuprofen Syr 100mg/5ml 0
Ketokonazole Cream Ketokonazole Cream 0
Ketokonazole tablet 200mg Ketokonazole tablet 200mg 0
Kloramfenikol Suspensi 125

mg/ 5ml Kloramfenikol Suspensi 125 mg/ 5ml 3
Lidokain comp (Lidokain Lidokain comp (Lidokain injeksi 2%

60
injeksi 2% (HCI) + epinefrin) (HCI) + epinefrin)
Lidocain inj 2 % (HCL) Lidocain inj 2 % (HCL) 0
Loratadine Loratadine 70
Metformin HCL 500 mg Metformin HCL 500 mg 0
Metilprednisolon tablat 4 mg 0
mg
Metoklopramid 10 mg Metoklopramid 10 mg 0
Metoklopramid inj Metoklopramid inj 0
Methamizole Na Inj Methamizole Na Inj 0
Metronidazol sirup Metronidazol sirup 1
MGSO4 40 % MGSO4 40 % 0
MGSO4 20 % MGSO4 20 % 0
Mikonazole kream Mikonazole kream 2
Nistatin drop Nistatin drop 3
Nistatin Ovula 100.000 IU Nistatin Ovula 100.000 IU 7
Natrium Diklofenak 25 mg Natrium Diklofenak 25 mg 0

N-Asetilsistein N-Asetilsistein 0
Natrium Chloride 0,9 % Natrium Chloride 0,9 % ( NACL 0,9 %) 41

( NACL 0,9 %)
Oxytocin injeksi Oxytocin injeksi 0
Omeprazole 20 mg Omeprazole 20 mg 1320
Parasetamol syr Parasetamol syr 0
Phytomenadion inj 2mg/ml Phytomenadion inj 2mg/ml 21
Phytomenadion 10 mg Phytomenadion 10 mg 10
Permetrin cream Permetrin cream 0
Ranitidin tablet 150 mg Ranitidin tablet 150 mg 140
Ranitidin injeksi Ranitidin injeksi 0
Salbutamol inhaler 56
Ventolin Nebulizer
Salep 2-4 Salep 2-4 0
Siprofloksasin 500 mg Siprofloksasin 500 mg 0
Sianocbalamin (B12) Sianocbalamin (B12) 0
Sianocobalamin ( Vitamin Sianocobalamin ( Vitamin B12) Injeksi

B12) Injeksi 500 mcg 500 mcg 0
SABU ( Serum Anti Bisa SABU ( Serum Anti Bisa Ular) 0

Ular)
Tablet tambah darah Tablet tambah darah 0
USG GEL USG GEL 0

VAR VAR 0
Vit. B.Complex Vit. B.Complex 725
Zink 20 mg tab Zink 20 mg tab 0
Zink syr Zink syr 0

BMHP BMHP
Catgut chromic 3/0 +jarum Catgut chromic 3/0 +jarum Bulat 0

Bulat (*optime*) (*optime*)
Folly Catheter 18 Folly Catheter 18 0
Handscoond steril no 6 Handscoond steril no 6 100
Handscoond steril no 6,5 Handscoond steril no 6,5 2
Handscoond steril no 7,5 Handscoond steril no 7,5 0
Hand Sanitizer / Handrub

500 ml Hand Sanitizer / Handrub 500 ml 0
Handscrub Handscrub 0
Infus Set Dewasa Infus Set Dewasa 0
Kasa 4 x 10 Kasa 4 x 10 210

Kasa 4 x 5 Kasa 4 x 5 0
Scalpet Blades no.10 Scalpet Blades no.10 100

Masker Surgical mask earloop 3ply / Masker 2300
Under Pad Steril Under Pad Steril 0
DAK 2020 DAK 2020
Acyclovir 400 mg Acyclovir 400 mg 0
CTM 4 mg CTM 4 mg 0
Cetrizine 10 mg Cetrizine 10 mg 0
Domperidone syr Domperidone syr 0
10
( ERGOTAMIN ) Anti migren kombinasi ( ERGOTAMIN )
Gentamicine tetes mata Gentamicine tetes mata 0

Paracetamol Drop Paracetamol Drop 0
BMHP BMHP
Catgut chromic 3/0 +jarum Catgut chromic 3/0 +jarum Bulat

Bulat (*optime*) (*optime*) 0
Catgut chromic 3/0 +jarum Catgut chromic 3/0 +jarum Segitiga 0

Segitiga (*optime*) (*optime*)
Catgut chromic 2/0 +jarum Catgut chromic 2/0 +jarum Bulat

0
Bulat (*optime-R*) (*optime-R*)
Catgut plain 3/0 + jarum Catgut plain 3/0 + jarum Segitiga

Segitiga (*Advantime*) (*Advantime*) 0
Feeding Tube 14 Feeding Tube 14 0
Feeding Tube 16 Feeding Tube 16 0
Kasa 16x16 Kasa 16x16 0
Silk 2/0 + jarum 1/2 25 mm

Silk 2/0 + jarum 1/2 25 mm 75 cm 0
75 cm
Umbilical Cord Klem Umbilical Cord Klem 0
DAU 2020 DAU 2020
Aqua pro injeksi 20 ml Aqua pro injeksi 20 ml 0
Hyoscine N butylbromide 10
mg inj Hyoscine N butylbromide 10 mg inj 0

( NACL 0,9 %) Natrium Chloride 0,9 % ( NACL 0,9 %) 0
Propylthiouracyl 100 mg tablet 0
tablet
Ringer Laktat (RL) Ringer Laktat (RL) 0
P 2020 P 2020
Ambroxol sirup 15 mg/5 ml Ambroxol sirup 15 mg/5 ml 0
Ambroxol Tablet 30 mg Ambroxol Tablet 30 mg 0
Bisakodil Suppo Bisakodil Suppo 0
Bisakodil ( LAXANA) Bisakodil ( LAXANA) 0
Guaiafenesin (GG) 100 mg Guaiafenesin (GG) 100 mg 0
Kombinasi Tetes Mata Kombinasi Tetes Mata (Deksametason,

(Deksametason, Neomisin Neomisin Sulfat, Polimiksin B Sulfat ) 0
Sulfat, Polimiksin B Sulfat )
ALLETROL COMPOSITUM
ALLETROL COMPOSITUM
Obat batuk pilek anak Obat batuk pilek anak kombinasi GG 0

kombinasi GG ( Dextrofen) ( Dextrofen)
Obat flu kombinasi

( pseudoephedrin Hcl, Obat flu kombinasi ( pseudoephedrin 0
Tripolidin Hcl ) FLUTROP Hcl, Tripolidin Hcl ) FLUTROP
Salbutamol nebulizer / Salbutamol nebulizer / Ventolin

Ventolin Nebulizer Nebulizer 0
Hemafort Hemafort 0
DAK 2019 DAK 2019
Acyclovir 400 mg Acyclovir 400 mg 0
Alprazolam 0,5 mg Alprazolam 0,5 mg 0

125mg/5ml Cefadroxil sirup kering 125mg/5ml 0
Diazepam 5 mg / 2,5 ml Diazepam 5 mg / 2,5 ml ( STESOLID )

0
( STESOLID ) Rektal Rektal
Kotrimoxazole syr Kotrimoxazole syr 0
Metoklopramide 10 mg Metoklopramide 10 mg 0
Oxtretrasiklin Salep Mata Oxtretrasiklin Salep Mata 0

Pirantel 125 mg Pirantel 125 mg 8
Piridoksin HCL ( Vit. B 6 ) 10 Piridoksin HCL ( Vit. B 6 ) 10 mg 0

mg
BMHP BMHP
Alat Suntik 5 ml Alat Suntik 5 ml 0
Infus Set Dewasa Infus Set Dewasa 0
urine bag urine bag 50
PENUNJANG 2019 PENUNJANG 2019
Gentamicin salep kulit Gentamicin salep kulit 0
Loperamide Loperamide 10

( Becefort ) Multivitamin syr anak ( Becefort ) 0

Pektin) sirup (Guanistrep sirup (Guanistrep Sirup) 2
Sirup)
BG 2019 BG 2019
Articulating Paper Articulating Paper 0
Cotton roll medium Cotton roll medium 0
Eugenol Eugenol 0
Pehacain Pehacain 0
DAK 2018 DAK 2018
Diazepam 5 mg Diazepam 5 mg 0
HCT 25 mg HCT 25 mg 0
Nistatin 100.000 IU Nistatin 100.000 IU 0
BMHP BMHP
Blood Lancet Blood Lancet 0
Plaster ( Hifafix ) Plaster ( Hifafix ) 0
Penunjang 2017 Penunjang 2017
BMHP BMHP
Jarum Jahit Segitiga Jarum Jahit Segitiga 0
DAU 2017 DAU 2017

BMHP BMHP
Silk 3/0 + jarum 1/2 GT 35

mm ( Sole) Silk 3/0 + jarum 1/2 GT 35 mm ( Sole) 0
DAK 2017 DAK 2017
Diltiazem 30 mg Diltiazem 30 mg 0
BMHP BMHP
KAPAS PEMBALUT / KAPAS PEMBALUT / ABSORBEN 250 0
ABSORBEN 250 GRAM GRAM
Kasa 4mx5cm Kasa 4mx5cm 0
APBD 2016 APBD 2016

BMHP 2016 BMHP 2016
Infus set anak (Aximed) Infus set anak (Aximed) 50
DAU 2009 DAU 2009
KAPAS PEMBALUT / KAPAS PEMBALUT / ABSORBEN 250

ABSORBEN 250 GRAM GRAM 0
38,202.00
unisasi, Bumil, Posyandu Balita, Posko ) Sisa Stok
Satuan Barang Harga Satuan Nilai Total
Keterangan Jumlah
(Rp) (Rp)
25 26 27 28
Saldo 2021
IDR Rp - 25
Rp 16,666.00
Kotak Rp - 3
Rp 40,187.50
Pcs Rp - 900
Rp 1,160.00
Pcs Rp 13,178.00 Rp - 0
Pcs Rp 13,178.00 Rp - 0
Pcs Rp 132.00 Rp - 400
Paket Rp - 0
Rp 274,362.00
Biji Rp - 0
Rp 3,137.00
box @ 72 pcs Rp - 0
Rp 23,860.08
Tab Rp - 1000
Rp 89.00
Tab Rp 76,163.40 3360

Rp 74.67
Tab Rp 6,600.00 630

Rp 55.00
Tab Rp 69,300.00 6400
Rp 231.00
Btl Rp 523,200.00 227

Rp 4,800.00
Tab Rp 77,080.00 0
Rp 1,927.00
Ampul Rp 55,110.00 70
Rp 1,837.00
Tab Rp - 6000
Rp 61.00
tab Rp 49,140.00 3180
Rp 117.00
Btl Rp 1,756.00 Rp - 0
tab Rp 62,100.00 5580
Rp 54.00
Suppo Rp - 96
Rp 3,260.00
tab Rp 153,450.00 420

Rp 93.00
tab Rp - 0
Rp 72.00
tab Rp 21,512.70 4040

Rp 52.47
tab Rp 104,000.00 160
Rp 260.00
Tablet Rp 83,740.00 3450

Rp 106.00
tab Rp - 880
Rp 109.00
Tablet Rp 15,892.80 3200

Rp 75.68
Vial Rp 82,470.00 0
Rp 8,247.00
Btl Rp 13,200.00 191

Rp 3,300.00
Tab Rp 46,740.00 150

Rp 123.00
Tube Rp 72,075.00 24
Rp 2,325.00
Tab Rp - 190
Rp 54.00
Tab Rp 165,900.00 3880

Rp 210.00
Tab Rp - 200
Rp 99.90
Tablet Rp 60.00 Rp 104,400.00 2120
Tab Rp 2,600.00 380

Rp 260.00
Tube Rp - 50
Rp 2,399.00
Tab Rp 14,620.00 2980

Rp 86.00
Tab Rp 36,300.00 350

Rp 605.00
Kap Rp - 0
Rp 278.00
tab Rp 140,140.00 6960

Rp 77.00
tab Rp - 0
Rp 102.00
tab Rp 31,700.00 2330

Rp 317.00
tab Rp 6,600.00 300

Rp 66.00
Btl Rp 7,400.00 484

Rp 7,400.00
Btl Rp - 0
Rp 8,200.00
Kapsule Rp 108,755.80 60
Rp 319.87
Tablet Rp 27,250.00 4920

Rp 109.00
Vial Rp 197,802.00 400

Rp 5,346.00
Drop Rp - 0
Rp 5,204.00
Btl Rp 107,880.00 165

Rp 1,160.00
Tab Rp 616,800.00 3080
Rp 257.00
Ampul Rp 85,800.00 150

Rp 858.00
Tube Rp 252,252.00 9
Rp 11,466.00
Btl Rp 4,182.00 Rp 4,182.00 9
Btl Rp 6,683.00 Rp - 11
Btl Rp 23,132.00 Rp - 6
tab Rp 11,680.00 1600

Rp 73.00
Btl Rp 7,221.00 Rp 72,210.00 5
Btl Rp 1,694,660.00 320
Rp 7,703.00
Tab Rp - 10
Rp 51.00
Tab Rp 12,730.00 4080

Rp 67.00
Btl Rp - 10
Rp 22,200.00
Kap Rp 1,036.00 Rp 31,080.00 770
Kap Rp 3,650.00 1950

Rp 73.00
Kap Rp 300,000.00 0
Rp 150.00
pcs Rp 16,632.00 Rp 83,160.00 10
tab Rp - 1470
Rp 173.00
tab Rp 390,960.00 490

Rp 72.00
tab Rp 2,640.00 2160

Rp 44.00
Btl Rp 3,256.00 Rp - 35
Btl Rp 23,595.00 Rp - 8
pcs Rp 1,045.00 Rp 209,000.00 500
pcs Rp 825.00 Rp - 500
pcs Rp 955.00 Rp - 500
pcs Rp 1,110.00 Rp - 200
pcs Rp 250,416.00 1500
Rp 1,252.08
pcs Rp 250,416.00 1700
Rp 1,252.08
pcs Rp 500,832.00 500
Rp 1,252.08
pcs Rp - 0
Rp 26,062.00
pcs Rp 2,641,800.00 0
Rp 26,418.00
pcs Rp - 0
Rp 26,418.00
pcs Rp - 0
Rp 26,418.00
pcs Rp - 0
Rp 26,418.00
pcs Rp 4,145,850.00 0
Rp 27,639.00
pcs Rp 3,541.00 Rp 177,050.00 0
pcs Rp 91,045.00 Rp 910,450.00 0
pcs Rp 308,025.00 5
Rp 61,605.00
pcs Rp - 16
Rp 32,190.00
pcs Rp 21,638.40 Rp - 29
Btl Rp 7,221.00 Rp - 0
pcs Rp 2,070.00 Rp 207,000.00 50
Syringe Rp 356,400.00 Rp - 0
Pot Rp 391,500.00 Rp - 0
Pcs Rp 67,500.00 Rp - 0
Btl isi @ 30 kapsul Rp 45,000.00 Rp - 0
Pcs Rp 1,361.00 Rp - 0
Pcs Rp 1,712.53 Rp - 0
Pcs Rp 1,710.13 Rp - 0
Tube Rp 4,400.00 Rp 17,600.00 46
Wadah Rp 7,700.00 Rp - 0
Ampul Rp 6,600.00 Rp - 0
Kap Rp 880.00 Rp 105,600.00 0
Kap Rp 495.00 Rp - 200
Tab Rp 198.00 Rp - 400
Suppo Rp 30,800.00 Rp - 0
Tab Rp 1,413.50 Rp - 0
Tab Rp 275.00 Rp - 0
tab Rp 147.99 Rp - 0
Tab Rp 275.00 Rp - 0
Kap Rp 770.00 Rp - 0
Tab Rp 1,650.00 Rp - 0
Tab Rp 385.00 Rp - 0
Btl Rp 11,000.00 Rp 660,000.00 12
Tab Rp 220.00 Rp -
Tab Rp 286.00 Rp 406,120.00 80
Tube Rp 4,950.00 Rp 4,950.00 0
Btl Rp 12,100.00 Rp - 0
tab Rp 275.00 Rp - 0
tab Rp 1,045.00 Rp 125,400.00 3310
Tube Rp 6,600.00 Rp - 0
Btl Rp 11,000.00 Rp 55,000.00 65
Tube Rp 148,500.00 Rp - 1
Ampul Rp 11,000.00 Rp 275,000.00 40
Btl Rp 72,600.00 Rp - 50
Tab Rp 231.00 Rp - 0
Btl Rp 2,050.00 Rp 98,400.00 54
Btl Rp 11,750.00 Rp 58,750.00 112
Tab Rp 89.00 Rp - 400
Tab Rp 200.00 Rp 22,000.00 2510
tab Rp 117.00 Rp - 0
Tab Rp 55.00 Rp - 0
Tab Rp 74.00 Rp - 0
Vial Rp 9,900.00 Rp - 76
Suppo Rp 3,260.00 Rp - 0
Botol Rp 3,637.00 Rp 36,370.00 25
Tab Rp 54.00 Rp - 0
Botol Rp 1,756.00 Rp - 0
Tab Rp 46.00 Rp 1,380.00 1800
amp Rp 1,820.00 Rp - 0
pcs Rp 61.00 Rp 29,890.00 50
Tab Rp 89.00 Rp 6,230.00 160
Tab Rp 2,650.00 Rp 318,000.00 120
Tab Rp 92.00 Rp - 0
Tab Rp 1,540.00 Rp - 0
Suppo Rp 5,085.00 Rp 20,340.00 32
Tab Rp 5,085.00 Rp 1,118,700.00 64
tab Rp 68.00 Rp - 0
Botol Rp 2,215.00 Rp 177,200.00 0
Vial Rp 3,050.00 Rp - 0
Ampul Rp 1,545.00 Rp - 0
Ampul Rp 968.00 Rp 10,648.00 189
Botol Rp 7,200.00 Rp - 0
Tab Rp 289.00 Rp 2,890.00 460
Botol Rp 2,401.00 Rp - 0
Botol Rp 7,436.00 Rp 133,848.00 10
Ampul Rp 1,740.00 Rp - 6
Ampul Rp 969.00 Rp 2,907.00 39
btl Rp 7,363.00 Rp - 60
Tab Rp 87.00 Rp - 0
Tab Rp 54.00 Rp - 0
Tab Rp 1,050.00 Rp - 100
Botol Rp 3,300.00 Rp - 0
Tab Rp 60.00 Rp - 0
Ampul Rp 6,199.00 Rp - 24
Ampul Rp 923.00 Rp 57,226.00 200
tab Rp 216.00 Rp - 0
tab Rp 11,500.00 Rp - 0
Tab Rp 99.00 Rp 990.00 130
Btl Rp 2,339.00 Rp - 0
Tube Rp 2,399.00 Rp - 7
Tab Rp 260.00 Rp - 0
Btl Rp 5,352.00 Rp 16,056.00 61
Tab Rp 605.00 Rp - 0
kap Rp 278.00 Rp - 0
Ampul Rp 847.00 Rp 50,820.00 180
Ampul Rp 891.00 Rp - 0
kap Rp 117.00 Rp 8,190.00 3230
tab Rp 77.00 Rp - 0
tab Rp 102.00 Rp - 0
tab Rp 237.00 Rp - 0
tab Rp 66.00 Rp - 90
Ampul Rp 1,983.00 Rp - 611
Ampul Rp 3,045.00 Rp - 0
Btl Rp 3,765.00 Rp 3,765.00 50
Ampul Rp 4,700.00 Rp - 0
Ampul Rp 4,120.00 Rp - 50
Tube Rp 1,900.00 Rp 3,800.00 123
Btl Rp 11,750.00 Rp 35,250.00 6
tab Rp 550.00 Rp 3,850.00 88
tab Rp 109.00 Rp - 0
Tab Rp 317.00 Rp - 0
btl Rp 6,900.00 Rp 282,900.00 256
Ampul Rp 1,248.00 Rp - 0
Kap Rp 129.00 Rp 170,280.00 5160
btl Rp 1,160.00 Rp -
Ampul Rp 3,900.00 Rp 81,900.00 90
Tab Rp 781.00 Rp 7,810.00 130
Tube Rp 11,466.00 Rp - 0
tab Rp 85.00 Rp 11,900.00 0
Ampul Rp 858.00 Rp - 0
Tab Rp 67.00 Rp - 0
Ampul Rp 5,400.00 Rp 302,400.00 0
Pot Rp 1,475.00 Rp - 3
tab Rp 73.00 Rp - 0
tab Rp 73.00 Rp 359,890.00 0
Tab Rp 260.00 Rp - 0
Tab Rp 44.00 Rp - 0
Ampul Rp 1,066.00 Rp - 287
Vial Rp 517,132.00 Rp - 2
tab Rp 255.00 Rp - 0
Btl Rp 18,858.33 Rp - 0
Vial Rp 153,000.00 Rp - 0
Tab Rp 60 Rp 43,500.00 4775
Tab Rp 253.00 Rp - 0
Btl Rp 2,489.00 Rp - 0
Pcs Rp 68,090.00 Rp - 0
Pcs Rp 818.00 Rp 163,600.00 1700
Pcs Rp 1,100.00 Rp - 90
pcs Rp 11,132.00 Rp - 10
Pasang Rp 13,563.00 Rp 1,356,300.00 0
Pasang Rp 13,563.00 Rp 27,126.00 229
Pasang Rp 13,563.00 Rp 135,630.00 35
Pasang Rp 13,563.00 Rp - 0
Btl Rp 68,200.00 Rp - 0
Btl Rp 115,800.00 Rp - 0
pcs Rp 7,128.00 Rp - 0
pcs Rp 25,487.00 Rp - 0
pcs Rp 2,176.72 Rp 457,112.07 0

pcs Rp 1,089.67 Rp - 0
Pcs Rp 618.70 Rp 61,869.50 0
Pcs Rp 618.68 Rp - 0
Pcs Rp 618.71 Rp - 0
Box Rp 1,373.14 Rp 3,158,222.00
pcs Rp 37,875.00 Rp - 0
Tab Rp 454.00 Rp - 0
Tab Rp 119.00 Rp - 0
tab Rp 26.00 Rp - 0
tab Rp 104.00 Rp - 0
Botol Rp 2,862.00 Rp - 0
tab Rp 212.00 Rp 2,120.00 319
Botol Rp 26.00 Rp - 0
Tab Rp 657.00 Rp - 0
kap Rp 352.00 Rp - 0
tab Rp 148.00 Rp - 0
Botol Rp 7,646.00 Rp - 0
Pcs Rp 55,000.00 Rp - 0
Pcs Rp 62,000.00 Rp - 0
Pcs Rp 44,000.00 Rp - 0
Pcs Rp 71,000.00 Rp - 0
pcs Rp 8,407.00 Rp - 0
pcs Rp 8,407.00 Rp - 0
Pasang Rp 13,178.00 Rp 92,246.00 42
pcs Rp 23,100.00 Rp - 0
pcs Rp 23,100.00 Rp - 0
pcs Rp 7,897.31 Rp - 0
Pcs Rp 32,500.00 Rp - 0
Pcs Rp - 0
Rp 1,495.00
ampul Rp 2,860.00 Rp - 0
Ampul Rp 9,900.00 Rp - 0
btl Rp 6,840.00 Rp - 0
Tab Rp 733.00 Rp - 220

btl Rp 7,150.00 Rp - 0
Btl Rp 3,250.01 Rp - 0
Tab Rp 110.00 Rp - 0
Suppo Rp 23,475.00 Rp - 0
Tab Rp 367.00 Rp - 0
tab Rp 175.00 Rp - 0
Botol Rp 14,900.00 Rp - 0
Botol Rp - 0
Rp 12,900.00
tab Rp 600.00 Rp - 0
Flash Rp 10,000.00 Rp - 0
Tab Rp 820.00 Rp - 0
Tab Rp 425.00 Rp - 0
tab Rp 88.00 Rp - 0
btl Rp 4,360.00 Rp - 0
Tube Rp 14,459.00 Rp - 0
btl Rp 2,052.00 Rp - 0
tab Rp 83.00 Rp - 0
tube Rp 2,600.00 Rp - 0
tab Rp 331.00 Rp 2,648.00 21
tab Rp 141.00 Rp -
pcs Rp 1,600 Rp - 900
pcs Rp 11,891.00 Rp 118,910.00 0
pcs Rp 11,891.00 Rp 118,910.00 0
pcs Rp 6,842.00 Rp - 0
pcs Rp 1,848.00 Rp 92,400.00 0
tube Rp 2,640.00 Rp - 0
Tab Rp 198.00 Rp 1,980.00 490
Botol Rp -
Rp 17,365.70
btl Rp 3,850.00 Rp 7,700.00 14
Pcs Rp 242,000.00 Rp - 0
Pack Rp 85,800.00 Rp - 0
Botol 10 ml Rp 97,500.00 Rp - 0
Ampul Rp 3,113.0495 Rp - 0
Tab Rp 109.00 Rp - 0
tab Rp 178.00 Rp - 0
tab Rp 645.00 Rp - 0
Pcs Rp 167.509 Rp - 0
Roll Rp 29,642.86 Rp - 0
pcs Rp 22,000.00 Rp - 0
Pcs Rp 46,187.44 0
tab Rp 128.00 0
Bks Rp 14,375.00 Rp - 25
Roll Rp 862.50 Rp - 0
pcs Rp 6,222.00 Rp 311,100.00 0
roll/bungkus Rp 11,914 Rp - 0
Rp 26,861,388.27 117,957.00
Nilai Saldo Awal Rp 85,158,630.57

Nilai Total Penerimaan Rp 2,131,810
Nilai Total Pengeluaran Rp 26,861,388
Saldo/Sisa Rp 60,429,052.30
Jumlah Stick Awal 141,749.00

Total Penerimaan 14,410.00
Total Pengeluaaran 38,202.00
Stock Akhir 117957.00
Sisa Stok
Total Harga
Rp 416,650.00
Rp 120,562.50
Rp 1,044,000.00
Rp -
Rp -
Rp 52,800.00
Rp -
Rp -
Rp -
Rp 89,000.00
Rp 250,891.20
Rp 34,650.00
Rp 1,478,400.00
Rp 1,089,600.00
Rp -
Rp 128,590.00
Rp 366,000.00
Rp 372,060.00
Rp -
Rp 301,320.00
Rp 312,960.00
Rp 39,060.00
Rp -
Rp 211,978.80
Rp 41,600.00
Rp 365,700.00
Rp 95,920.00
Rp 242,176.00
Rp -
Rp 630,300.00
Rp 18,450.00
Rp 55,800.00
Rp 10,260.00
Rp 814,800.00
Rp 19,980.00
Rp 127,200.00
Rp 98,800.00
Rp 119,950.00
Rp 256,280.00
Rp 211,750.00
Rp -
Rp 535,920.00
Rp -
Rp 738,610.00
Rp 19,800.00
Rp 3,581,600.00
Rp -
Rp 19,192.20
Rp 536,280.00
Rp 2,138,400.00
Rp -
Rp 191,400.00
Rp 791,560.00
Rp 128,700.00
Rp 103,194.00
Rp 37,638.00
Rp 73,513.00
Rp 138,792.00
Rp 116,800.00
Rp 36,105.00
Rp 2,464,960.00
Rp 510.00
Rp 273,360.00
Rp 222,000.00
Rp 797,720.00
Rp 142,350.00
Rp -
Rp 166,320.00
Rp 254,310.00
Rp 35,280.00
Rp 95,040.00
Rp 113,960.00
Rp 188,760.00
Rp 522,500.00
Rp 412,500.00
Rp 477,500.00
Rp 222,000.00
Rp 1,878,120.00
Rp 2,128,536.00
Rp 626,040.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 308,025.00
Rp 515,040.00
Rp 627,513.60
Rp -
Rp 103,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 202,400.00
Rp -
Rp -
Rp -
Rp 99,000.00
Rp 79,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 132,000.00
Rp -
Rp 22,880.00
Rp -
Rp -
Rp -
Rp 3,458,950.00
Rp -
Rp 715,000.00
Rp 148,500.00
Rp 440,000.00
Rp 3,630,000.00
Rp -
Rp 110,700.00
Rp 1,316,000.00
Rp 35,600.00
Rp 502,000.00
Rp -
Rp -
Rp -
Rp 752,400.00
Rp -
Rp 90,925.00
Rp -
Rp -
Rp 82,800.00
Rp -
Rp 3,050.00
Rp 14,240.00
Rp 318,000.00
Rp -
Rp -
Rp 162,720.00
Rp 325,440.00
Rp -
Rp -
Rp -
Rp -
Rp 182,952.00
Rp -
Rp 132,940.00
Rp -
Rp 74,360.00
Rp 10,440.00
Rp 37,791.00
Rp 441,780.00
Rp -
Rp -
Rp 105,000.00
Rp -
Rp -
Rp 148,776.00
Rp 184,600.00
Rp -
Rp -
Rp 12,870.00
Rp -
Rp 16,793.00
Rp -
Rp 326,472.00
Rp -
Rp -
Rp 152,460.00
Rp -
Rp 377,910.00
Rp -
Rp -
Rp -
Rp 5,940.00
Rp 1,211,613.00
Rp -
Rp 188,250.00
Rp -
Rp 206,000.00
Rp 233,700.00
Rp 70,500.00
Rp 48,400.00
Rp -
Rp -
Rp 1,766,400.00
Rp -
Rp 665,640.00
Rp -
Rp 351,000.00
Rp 101,530.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 4,425.00
Rp -
Rp -
Rp -
Rp -
Rp 305,942.00
Rp 1,034,264.00
Rp -
Rp -
Rp -
Rp 286,500.00
Rp -
Rp -
Rp -
Rp 1,390,600.00
Rp 99,000.00
Rp 111,320.00
Rp -
Rp 3,105,927.00
Rp 474,705.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 67,628.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 553,476.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 161,260.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 6,951.00
Rp -
Rp 1,440,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 97,020.00
Rp -
Rp 53,900.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 359,375.00
Rp -
Rp -
Rp -
Rp 60,429,052.30
Penerimaan Pengeluaran
Bulan EXP
Jmlah Uang Jumlah Uang
Januari 30111 17768780.00 20300 18155200.43
Februari 19546 11356632.85 52812.50 34053126.1771
Maret 58953 35389526.00 16439 24395983.90
April 17955 7687989.14993 49970 37487829.4055
Mei 68656 59777703.908 17987 23139203.07
Juni 18410 17534320.00 25579 31441732.74
Juli 27334 42227142.50 45728 40381873.00
Agustus 34040 22210463.00 45954 28530059.90
September 44492 21801314.00 32391 25386937.92
Oktober 43642 22083353.10 29,952.00 23101589.70
November 98524 36964630.60 68,408.00 40263721.6305
Desember 14410 2131810.00 38,202.00 26861388.269
total 476073 296933665.11 443722.50 353198646.14
476073 296933665.11 443722.50 353198646.14

6656.5 9587048.51
437066.00 343611597.63

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LAPORAN PENERIMAAN DAN PENGELUARAN OBAT APBD

BULAN JANUARI 2022

Jumlah Satuan no tgl

1 Larutan Zhihi Neeisen 13 Paket Rp 3,566,706.00 Rp - 2 Rp 548,724.00 11 Rp 3,017,982.00

2 Sputum Pot 0 Biji Rp - Rp - 0 Rp - 0 Rp -

2 Object Glass Frosted 7105 9 box @ 72 pcs Rp 214,740.72 Rp - 0 Rp - 9 Rp 214,740.72

19 Skincol Gel 10 Tube Rp 148,500.00 Rp 1,485,000 Rp - 1 Rp 148,500 9 Rp 1,336,500

Kombinasi Tetes Mata (Deksametason, Neomisin

Mengetahui Binawara, 31 Januari 2022

Rosyidah, A.Md.Keb Summi Ariyani, A.Md. Far

1 Larutan Zhihi Neeisen 11 Paket Rp 3,017,982.00 Rp - 0 Rp - 11 Rp 3,017,982.00

2 Sputum Pot 0 Biji Rp - Rp - 0 Rp - 0 Rp -

3 Object Glass Frosted 7105 9 box @ 72 pcs Rp 214,740.72 Rp - 0 Rp - 9 Rp 214,740.72

Mengetahui Binawara, 26 Februari 2022

Rosyidah, A.Md.Keb Summi Ariyani, A.Md. Far

10 Paracetamol Drop 345 Botol Rp 7,646.00 Rp 2,637,870 Rp - 345 Rp 2,637,870 0 Rp -

9 Salbutamol nebulizer / Ventolin Nebulizer 60 Flash Rp 10,000.00 Rp 600,000 Rp - 26 Rp 260,000 34 Rp 340,000

Mengetahui Binawara, 31 Maret 2022

Rosyidah, A.Md.Keb Summi Ariyani, A.Md. Far

Kepala Puskesmas Perawatan Lasung

NIP. 19701001 199102 2 002

56 Mikonazole kream 184 Tube Rp 1,900.00 Rp 349,600 Rp - 21 Rp 39,900 163 Rp 309,700

62 Oxytocin injeksi 100 Ampul Rp 1,248.00 Rp 124,800 Rp - 100 Rp 124,800.00 0 Rp -

78 VAR 0 Vial Rp 153,000.00 Rp - Rp - 0 Rp - 0 Rp -

95 Scalpet Blades no.10 100 Pcs Rp 618.70 Rp 61,870 Rp - 0 Rp - 100 Rp 61,869.50

9 Salbutamol nebulizer / Ventolin Nebulizer 34 Flash Rp 10,000.00 Rp 340,000 Rp - 34 Rp 340,000 0 Rp -

3 Eugenol 0 Botol 10 ml Rp 97,500.00 Rp - Rp - 0 Rp - 0 Rp -

4 Pehacain 80 Ampul Rp 3,113.0495 Rp 249,044 Rp - 20 Rp 62,261 60 Rp 186,783

TOTAL 104,665.00 Rp 104,604,661.67 17,955.00 Rp 7,687,989.15 49,970.00 Rp 37,487,829.41 72,650.00 Rp 74,804,821.42

Mengetahui Binawara, 28 April2022

11 Antasida Doen I Tablet Kunyah 50 Tab Rp 54.00 Rp 2,700 Rp - 50 Rp 2,700 0

15 Catgut plain 3/0 + jarum Segitiga (*Advantime*) 0 Pcs Rp 71,000.00 Rp - Rp - 0 Rp - 0

9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00 Rp - Rp - 0 Rp - 0

TOTAL 72,650.00 Rp 74,804,821.42 68,656.00 Rp 59,777,703.91 17,987.00 Rp 23,139,203.07 123,319.00

Mengetahui Binawara, 31 Mei 2022

Rosyidah, A.Md.Keb Summi Ariyani, A.Md. Far

890825 201101 2 011

7 Eflin 460 Tab Rp 1,413.50 Rp 650,210 Rp - 50 Rp 70,675 410

19 Pehavral 3600 tab Rp 1,045.00 Rp 3,762,000 Rp - 254 Rp 265,430 3346

36 Kalsium laktat (Kalk) 500 mg 70 Tab Rp 60.00 Rp 4,200 Rp - 70 Rp 4,200 0

48 Lidocain inj 2 % (HCL) 100 Ampul Rp 891.00 Rp 89,100 Rp - 3 Rp 2,673 97

55 Methamizole Na Inj 0 Ampul Rp 3,045.00 Rp - Rp - 0 Rp - 0

Kombinasi Tetes Mata (Deksametason, Neomisin Sulfat,

9 Salbutamol nebulizer / Ventolin Nebulizer 0 Flash Rp 10,000.00 Rp - Rp - 0 Rp - 0

Mengetahui Binawara, 30 Juni 2022

Rosyidah, A.Md.Keb Summi Ariyani, A.Md. Far

gelola Obat Puskesmas

mi Ariyani, A.Md. Far

Website http://dinkes.tanahbumbukab.go.id email lasungmedical@gmail.com

BERITA ACARA PEMERIKSAAN STOCK OPNAME

PUSKESMAS PERAWATAN LASUNG

Nama : Summi Ariyani, A.Md. Far

Jumlah Satuan Sumber

1 Safety box 25 IDR Rp 416,650.00 Dinkes Aset

2 Plesterin Bulat non woven 3 Kotak Rp 120,562.50 Dinkes Aset

4 surgical Gloves no. 7, 5 0 Pcs Rp 13,178.00 Rp - Dinkes Aset

5 surgical Gloves no. 8 0 Pcs Rp 13,178.00 Rp - Dinkes Aset

6 Vacutainer Needle 550 Pcs Rp 132.00 Rp 72,600.00 Dinkes Aset

1 Larutan Zhihi Neeisen 6 Paket Rp 1,646,172.00 Dinkes Aset

2 Sputum Pot 0 Biji Rp - Dinkes Aset

2 IV.Chateter No.18 G 0 pcs ### Rp -

3 IV.Chateter No.20 G 0 pcs ### Rp -

4 IV.Chateter No.22 G 0 pcs ### Rp -

15 Catgut plain 3/0 + jarum Segitiga (Advantime) 0 Pcs Rp 71,000.00 Rp - Rp - 0 Rp - 0