Urusan Pemerintahan :
Bidang Pemerintahan :
Unit Organisasi :
Sub Unit Organisasi :
5 BELANJA 0.00
…………………………………….
Pembina
NIP. …………………………………….
Lampiran 2
NERACA
PEMERINTAH KABUPATEN KLATEN
Per 31 Desember 2022 dan 2021
(Dalam Rupiah)
Urusan Pemerintahan :
Unit Organisasi :
Sub Unit Organisasi :
ASET
ASET LANCAR
Kas di Bendahara Penerimaan 0.00 0.00
Kas di Bendahara Pengeluaran 0.00 0.00
Kas di BLUD 0.00 0.00
Kas Lainnya 0.00 0.00
Setara Kas 0.00 0.00
Investasi Jangka Pendek 0.00 0.00
Piutang Pendapatan 0.00 0.00
Piutang Lainnya 0.00 0.00
Penyisihan Piutang 0.00 0.00
Beban Dibayar Dimuka 0.00 0.00
Persediaan 0.00 0.00
ASET TETAP
Tanah 0.00 0.00
Peralatan dan Mesin 0.00 0.00
Gedung dan Bangunan 0.00 0.00
Jalan, Irigasi, dan Jaringan 0.00 0.00
Aset Tetap Lainnya 0.00 0.00
Konstruksi Dalam Pengerjaan 0.00 0.00
Akumulasi Penyusutan 0.00 0.00
DANA CADANGAN
Dana Cadangan 0.00 0.00
ASET LAINNYA
Tagihan Jangka Panjang 0.00 0.00
Kemitraan dengan Pihak Ketiga 0.00 0.00
Aset Tidak Berwujud 0.00 0.00
Aset Lain-lain 0.00 0.00
KEWAJIBAN
KEWAJIBAN JANGKA PENDEK
Utang Perhitungan Pihak Ketiga (PFK) 0.00 0.00
Utang Bunga 0.00 0.00
Bagian Lancar Utang Jangka Panjang 0.00 0.00
Pendapatan Diterima Dimuka 0.00 0.00
Utang Belanja 0.00 0.00
Utang Jangka Pendek Lainnya 0.00 0.00
Kewajiban Untuk Dikonsolidasikan 0.00 0.00
JUMLAH KEWAJIBAN JANGKA PENDEK 0.00 0.00
EKUITAS
EKUITAS 0.00 0.00
…………………………………….
Pembina
NIP. …………………………………….
Lampiran 3
PEMERINTAH KABUPATEN KLATEN
LAPORAN OPERASIONAL
UNTUK TAHUN YANG BERAKHIR SAMPAI DENGAN 31 DESEMBER 2022 DAN 2021
Urusan Pemerintahan :
Bidang Pemerintahan :
Unit Organisasi :
Sub Unit Organisasi :
8.2.1 Pendapatan Transfer Pemerintah Pusat -LO 0.00 0.00 0.00 0.00
8.2.2 Pendapatan Transfer Pemerintah Pusat - Lainnya - LO 0.00 0.00 0.00 0.00
8.2.3 Pendapatan Transfer Pemerintah Daerah Lainnya - LO 0.00 0.00 0.00 0.00
8.2.4 Bantuan Keuangan - LO 0.00 0.00 0.00 0.00
8.3 LAIN-LAIN PENDAPATAN DAERAH YANG SAH - LO 0.00 0.00 0.00 0.00
8.4.1 Surplus Penjualan Aset Non Lancar - LO 0.00 0.00 0.00 0.00
8.4.2 Surplus Penyelesaian Kewajiban Jangka Panjang - LO 0.00 0.00 0.00 0.00
8.4.3 Surplus dari Kegiatan Non Operasional Lainnya - LO 0.00 0.00 0.00 0.00
9.2.1 Beban Transfer Bagi Hasil Pajak Daerah 0.00 0.00 0.00 0.00
9.2.2 Beban Transfer Bagi Hasil Pendapatan Lainnya 0.00 0.00 0.00 0.00
9.2.3 Beban Transfer Bantuan Keuangan ke Pemerintah Daerah Lainnya 0.00 0.00 0.00 0.00
9.2.4 Beban Transfer Bantuan Keuangan ke Desa 0.00 0.00 0.00 0.00
9.2.5 Beban Transfer Bantuan Keuangan Lainnya 0.00 0.00 0.00 0.00
9.2.6 Beban Transfer Dana Otonomi Khusus 0.00 0.00 0.00 0.00
9.3.1 Defisit Penjualan Aset Non Lancar - LO 0.00 0.00 0.00 0.00
9.3.2 Defisit Penyelesaian Kewajiban Jangka Panjang - LO 0.00 0.00 0.00 0.00
9.3.3 Defisit dari Kegiatan Non Operasional Lainnya - LO 0.00 0.00 0.00 0.00
SURPLUS/DEFISIT-LO
Pembina
NIP. …………………………………………………
Lampiran 4
PEMERINTAH KABUPATEN KLATEN
LAPORAN PERUBAHAN EKUITAS
UNTUK PERIODE YANG BERAKHIR SAMPAI DENGAN 31 DESEMBER 2022 DAN 2021
(Dalam Rupiah)
Urusan Pemerintahan :
Unit Organisasi :
Sub Unit Organisasi :
……………………………………
Pembina
NIP. ……………………………………..
Lampiran 5
KABUPATEN KLATEN
CATATAN ATAS LAPORAN KEUANGAN
SKPD ………………………………….
PENDAHULUAN
Bab I Pendahuluan
1.1 Maksud dan tujuan penyusunan laporan keuangan SKPD
1.2 Landasan hukum penyusunan laporan keuangan SKPD
1.3 Sistematika penulisan catatan atas laporan keuangan SKPD
Bab II Ekonomi makro, kebijakan keuangan dan pencapaian target kinerja APBD SKPD
2.1 Ekonomi Makro
2.2 Kebijakan Keuangan
2.3 Indikator pencapaian target kinerja APBD
Ka. OPD
Selaku Pengguna Anggaran,
……………………………….
Pembina
NIP. ……………………………….
LAMPIRAN BERITA ACARA PEMERIKSAAN FISIK PERSEDIAAN PER 31 DESEMBER 2022
OPD PUSKESMAS TRUCUK II
No Kode Barang Nama Barang Satuan Saldo Awal Penambahan Pengurangan Saldo Akhir
(1) (2) (3) (4) (5) (6) (7) (8 = 5+6-7)
1.1.7.01.01 Bahan
Bahan Bangunan
1.1.7.01.01.01
Dan Konstruksi
1.1.7.01.01.01.020 Karung
1 1.1.7.01.01.001.0003 Karung Plastik Lembar 0 100 0 100
1.1.7.01.01.02 Bahan Kimia
1.1.7.01.01.02.002 Bahan Kimia Cair
2 1.1.7.01.01.002.0023 Alkohol Swabs Buah 0 110 110 0
Isi Tabung
1.1.7.01.01.09 Pemadam
Kebakaran
Isi Tabung
Pemadam
1.1.7.01.01.09.001
Kebakaran 3 Kg
Abc Powder
Refilling Tabung
3 1.1.7.01.01.009.0007 Apar ABC Powder Tabung 0 6 6 0
3,5 Kg
1.1.7.01.01.10 Isi Tabung Gas
Isi Tabung Gas
1.1.7.01.01.10.001
Oksigen
Isi Ulang Gas
4 1.1.7.01.01.010.0004 Tabung 0 6 6 0
Oksigen 5 m3
Alat/Bahan Untuk
1.1.7.01.03
Kegiatan Kantor
1.1.7.01.03.01 Alat Tulis Kantor
1.1.7.01.03.01.001 Alat Tulis
Bollpoint Standar
5 1.1.7.01.03.001.0017 Buah 250 250 428 72
AE7
Bollpoint Standar
6 1.1.7.01.03.001.0021 Biji 31 0 31 0
TECNO
7 1.1.7.01.03.001.0155 Gunting Tanaman Buah 2 0 2 0
8 1.1.7.01.03.001.0163 Isi Bollpoint Pentel Buah 0 36 36 0
Pembolong Kertas
9 1.1.7.01.03.001.0215 Buah 5 5 0 10
40 x 1
Pembolong Kertas
10 1.1.7.01.03.001.0219 Buah 1 0 0 1
Jumbo
11 1.1.7.01.03.001.0223 Pensil 2B Biji 12 0 0 12
12 1.1.7.01.03.001.0223 Pensil 2B Buah 5 0 5 0
Spidol Besar
13 1.1.7.01.03.001.0255 Buah 0 24 23 1
Permanen
Spidol Besar
14 1.1.7.01.03.001.0255 Buah 7 0 7 0
Permanen
AC02 ACYCLOFIR TABLET 400 MG Tablet DAK 0 405.00 0.00 0 405.00 0.00 0 405.00 0.00 0 405.00 0.00 0
AC03 ACYCLOVIR KRIM 5% Tube DAK 2 0 3,613.50 0.00 0 3,613.50 0.00 0 3,613.50 0.00 0 3,613.50 0.00 0
AD08 ADS 0.5 ML BLUD 0 1,870.00 0.00 0 1,870.00 0.00 0 1,870.00 0.00 0 1,870.00 0.00 0
AL02 ALAT SUNTIK SEKALI PAKAI 1 ML Set HIBAH 0 1,100.00 0.00 0 1,100.00 0.00 0 1,100.00 0.00 0 1,100.00 0.00 0
AL02 ALAT SUNTIK SEKALI PAKAI 1 ML Set DAK 0 830.00 0.00 0 830.00 0.00 0 830.00 0.00 0 830.00 0.00 0
AL04 ALAT SUNTIK SEKALI PAKAI 3 ML Set BLUD 0 1,380.00 0.00 0 1,380.00 0.00 0 1,380.00 0.00 0 1,380.00 0.00 0
AL04 ALAT SUNTIK SEKALI PAKAI 3 ML Set DAK 0 887.78 0.00 0 887.78 0.00 0 887.78 0.00 0 887.78 0.00 0
AL05 ALAT SUNTIK SEKALI PAKAI 5 ML Set DAK 0 928.00 0.00 0 928.00 0.00 0 928.00 0.00 0 928.00 0.00 0
AL06 ALBENDAZOLE TABLET 400 MG Tablet HIBAH 0 366.00 0.00 0 366.00 0.00 0 366.00 0.00 0 366.00 0.00 0
AL06 ALBENDAZOLE TABLET 400 MG Tablet PROGRAM 0 367.00 0.00 0 367.00 0.00 0 367.00 0.00 0 367.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji Hibah 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 95.00 0.00 0 95.00 0.00 0 95.00 0.00 0 95.00 0.00 0
AL35 ALKOHOL SWAB Biji PROGRAM IMUNISASI 0 97.00 0.00 0 97.00 0.00 0 97.00 0.00 0 97.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji DAK 0 112.99 0.00 0 112.99 0.00 0 112.99 0.00 0 112.99 0.00 0
AL35 ALKOHOL SWAB Biji PROGRAM IMUNISASI 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji PROGRAM IMUNISASI 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0
AL35 ALKOHOL SWAB Biji PROGRAM IMUNISASI 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji PROGRAM IMUNISASI 0 95.00 0.00 0 95.00 0.00 0 95.00 0.00 0 95.00 0.00 0
AL35 ALKOHOL SWAB Biji PROGRAM IMUNISASI 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji HIBAH 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0 88.00 0.00 0
AL35 ALKOHOL SWAB Biji PROGRAM IMUNISASI 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0 79.00 0.00 0
AL35 ALKOHOL SWAB Biji REFOCUSING 0 83.80 0.00 0 83.80 0.00 0 83.80 0.00 0 83.80 0.00 0
AL35 ALKOHOL SWAB Biji DAK 0 110.00 0.00 0 110.00 0.00 0 110.00 0.00 0 110.00 0.00 0
AL07 ALOPURINOL TABLET 100 MG Tablet DAK 0 87.00 0.00 0 87.00 0.00 0 87.00 0.00 0 87.00 0.00 0
AL07 ALOPURINOL TABLET 100 MG Tablet DAK 0 105.00 0.00 0 105.00 0.00 0 105.00 0.00 0 105.00 0.00 0
AL09 ALPRAZOLAM TABLET 1 MG Tablet DAK 0 128.00 0.00 0 128.00 0.00 0 128.00 0.00 0 128.00 0.00 45
AM02 AMBROXOL TABLET 30 MG Tablet Bantuan Tidak Te 0 244.20 0.00 0 244.20 0.00 0 244.20 0.00 0 244.20 0.00 0
AM02 AMBROXOL TABLET 30 MG Tablet BTT 0 192.50 0.00 0 192.50 0.00 0 192.50 0.00 0 192.50 0.00 0
AM02 AMBROXOL TABLET 30 MG Tablet BTT 0 244.20 0.00 0 244.20 0.00 0 244.20 0.00 0 244.20 0.00 0
AM04 AMINOFILIN TABLET 200 MG Tablet DAK 0 95.00 0.00 0 95.00 0.00 0 95.00 0.00 0 95.00 0.00 192
AM06 AMITRIPTILIN HCl TABLET SALUT 25 MG Tablet DAK 0 167.00 0.00 0 167.00 0.00 0 167.00 0.00 0 167.00 0.00 0
AM07 AMLODIPIN TABLET 5 MG Tablet Dana Alokasi Khu 0 53.48 0.00 0 53.48 0.00 0 53.48 0.00 0 53.48 0.00 0
AM07 AMLODIPIN TABLET 5 MG Tablet BLUD 0 201.82 0.00 0 201.82 0.00 0 201.82 0.00 0 201.82 0.00 0
AM07 AMLODIPIN TABLET 5 MG Tablet DAK 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0
AM07 AMLODIPIN TABLET 5 MG Tablet BLUD 0 53.00 0.00 0 53.00 0.00 0 53.00 0.00 0 53.00 0.00 0
AM08 AMOKSISILIN KAPLET 500 MG Kaplet Dana Alokasi Khu 0 201.00 0.00 0 201.00 0.00 0 201.00 0.00 0 201.00 0.00 0
AM08 AMOKSISILIN KAPLET 500 MG Kaplet DAK 0 249.00 0.00 0 249.00 0.00 0 249.00 0.00 0 249.00 0.00 0
AM08 AMOKSISILIN KAPLET 500 MG Kaplet DAK 0 201.00 0.00 0 201.00 0.00 0 201.00 0.00 0 201.00 0.00 0
AM08 AMOKSISILIN KAPLET 500 MG Kaplet DAK 0 201.00 0.00 0 201.00 0.00 0 201.00 0.00 0 201.00 0.00 0
AM10 AMOKSISILIN SIRUP KERING 125 MG/5 ML Botol DAK 2 0 6,858.00 0.00 0 6,858.00 0.00 0 6,858.00 0.00 0 6,858.00 0.00 0
AM10 AMOKSISILIN SIRUP KERING 125 MG/5 ML Botol DAK 0 7,557.00 0.00 0 7,557.00 0.00 0 7,557.00 0.00 0 7,557.00 0.00 0
AM10 AMOKSISILIN SIRUP KERING 125 MG/5 ML Botol DAK 2 0 9,999.00 0.00 0 9,999.00 0.00 0 9,999.00 0.00 0 9,999.00 0.00 0
AN04 ANTASIDA DOEN I TABLET KUNYAH, kombinasi :Aluminium Hidroksida 200 mg + Magnesium Hidroksida 200 mg Tablet Hibah 0 54.00 0.00 0 54.00 0.00 0 54.00 0.00 0 54.00 0.00 0
AN04 ANTASIDA DOEN I TABLET KUNYAH, kombinasi :Aluminium Hidroksida 200 mg + Magnesium Hidroksida 200 mg Tablet DAK 0 58.00 0.00 0 58.00 0.00 0 58.00 0.00 0 58.00 0.00 0
AN04 ANTASIDA DOEN I TABLET KUNYAH, kombinasi :Aluminium Hidroksida 200 mg + Magnesium Hidroksida 200 mg Tablet DAK 0 54.00 0.00 0 54.00 0.00 0 54.00 0.00 0 54.00 0.00 0
AN07 ANTIBAKTERI DOEN SLP. kombinasi : Basitrasin 500 IU/g + polimiksin 10.000 IU/g Tube BTT 20 0 5,060.00 0.00 0 5,060.00 0.00 0 5,060.00 0.00 0 5,060.00 0.00 0
AN08 ANTIDIARE SIRUP (KAOLIN 986 MG + PECTIN 40 MG) Botol BTT 0 6,820.00 0.00 0 6,820.00 0.00 0 6,820.00 0.00 0 6,820.00 0.00 0
AN08 ANTIDIARE SIRUP (KAOLIN 986 MG + PECTIN 40 MG) Botol BTT 20 0 6,820.00 0.00 0 6,820.00 0.00 0 6,820.00 0.00 0 6,820.00 0.00 0
AN09 ANTIDIARE TABLET (ATTAPULGIT 600 MG) Tablet BLUD 0 162.00 0.00 0 162.00 0.00 0 162.00 0.00 0 162.00 0.00 3,799
AN10 ANTIFUNGI DOEN Kombinasi : Asam Benzoat 6% + Asam Salisilat 3% Tube DAK 0 4,798.00 0.00 0 4,798.00 0.00 0 4,798.00 0.00 0 4,798.00 0.00 0
AN11 ANTIHEMOROID DOEN SUPPOSITORIA, kombinasi : Bismut Subgalat 150 mg + Heksaklorofen 250 mg Biji DAK 0 3,250.00 0.00 0 3,250.00 0.00 0 3,250.00 0.00 0 3,250.00 0.00 0
AN11 ANTIHEMOROID DOEN SUPPOSITORIA, kombinasi : Bismut Subgalat 150 mg + Heksaklorofen 250 mg Biji BLUD 0 3,279.50 0.00 0 3,279.50 0.00 0 3,279.50 0.00 0 3,279.50 0.00 0
AN12 ANTIMIGREN : Ergotamin tartrat 1 mg + Kofein 50 mg Tablet DAK 0 185.00 0.00 0 185.00 0.00 0 185.00 0.00 0 185.00 0.00 0
AN25 ANTISEPTIC HANDRUB 500 ML DAK 0 34,091.80 0.00 0 34,091.80 0.00 0 34,091.80 0.00 0 34,091.80 0.00 0
AN25 ANTISEPTIC HANDRUB 500 ML DAK 0 69,700.00 0.00 0 69,700.00 0.00 0 69,700.00 0.00 0 69,700.00 0.00 0
AN25 ANTISEPTIC HANDRUB 500 ML DAU 0 45,000.00 0.00 0 45,000.00 0.00 0 45,000.00 0.00 0 45,000.00 0.00 0
AN25 ANTISEPTIC HANDRUB 500 ML BTT 0 55,000.00 0.00 0 55,000.00 0.00 0 55,000.00 0.00 0 55,000.00 0.00 8
AN25 ANTISEPTIC HANDRUB 500 ML BTT 0 55,272.00 0.00 0 55,272.00 0.00 0 55,272.00 0.00 0 55,272.00 0.00 20
AN25 ANTISEPTIC HANDRUB 500 ML BTT 0 42,000.00 0.00 0 42,000.00 0.00 0 42,000.00 0.00 0 42,000.00 0.00 0
AN25 ANTISEPTIC HANDRUB 500 ML DID 0 65,340.00 0.00 0 65,340.00 0.00 0 65,340.00 0.00 0 65,340.00 0.00 0
AN14 ANTITUSIF KAPLET : KOMB.DEXTROMETORFAN 15 MG + GG 100 MG + CTM 2 MG Kaplet BTT 0 1,204.50 0.00 0 1,204.50 0.00 0 1,204.50 0.00 0 1,204.50 0.00 0
AP01 APD : Baju Coverall Biji BANTUAN COVID 19 0 175,000.00 0.00 0 175,000.00 0.00 0 175,000.00 0.00 0 175,000.00 0.00 0
AP01 APD : Baju Coverall Biji REFOCUSING 0 175,000.00 0.00 0 175,000.00 0.00 0 175,000.00 0.00 0 175,000.00 0.00 0
AP01 APD : Baju Coverall Biji BLUD 0 110,000.00 0.00 0 110,000.00 0.00 0 110,000.00 0.00 0 110,000.00 0.00 0
AP02 APD : FACE SHIELD BTT 0 185,000.00 0.00 0 185,000.00 0.00 0 185,000.00 0.00 0 185,000.00 0.00 0
Tablet_x0
AP02 APD : FACE SHIELD 00D_ BANTUAN COVID 19 0 10,000.00 0.00 0 10,000.00 0.00 0 10,000.00 0.00 0 10,000.00 0.00 0
AS29 ASAM ASETILSALISILAT 80MG BLUD 0 89.81 0.00 0 89.81 0.00 0 89.81 0.00 0 89.81 0.00 0
AS03 ASAM ASKORBAT (Vitamin C) TABLET 50 MG Tablet BUFFER STOK 0 105.00 0.00 0 105.00 0.00 0 105.00 0.00 0 105.00 0.00 0
AS03 ASAM ASKORBAT (Vitamin C) TABLET 50 MG Tablet Dana Alokasi Khu 0 42.00 0.00 0 42.00 0.00 0 42.00 0.00 0 42.00 0.00 0
AS03 ASAM ASKORBAT (Vitamin C) TABLET 50 MG Tablet DAK 0 42.00 0.00 0 42.00 0.00 0 42.00 0.00 0 42.00 0.00 0
AS07 ASAM ASKORBAT TABLET 500 MG Tablet BANTUAN COVID 19 0 750.00 0.00 0 750.00 0.00 0 750.00 0.00 0 750.00 0.00 0
AS07 ASAM ASKORBAT TABLET 500 MG Tablet REFOCUSING 0 594.00 0.00 0 594.00 0.00 0 594.00 0.00 0 594.00 0.00 0
AS07 ASAM ASKORBAT TABLET 500 MG Tablet BANTUAN COVID 19 0 750.00 0.00 0 750.00 0.00 0 750.00 0.00 0 750.00 0.00 0
AS11 ASAM MEFENAMAT KAPLET 500 MG Kaplet DAK 0 111.00 0.00 0 111.00 0.00 0 111.00 0.00 0 111.00 0.00 0
AU08 AUTO LANCET 100 Pcs BLUD 0 60,500.00 0.00 0 60,500.00 0.00 0 60,500.00 0.00 0 60,500.00 0.00 0
AC04 Acetylcysteine kapsul 200mg Kapsul BANTUAN COVID 19 0 373.00 0.00 0 373.00 0.00 0 373.00 0.00 0 373.00 0.00 0
AL16 Alopurinol 300 mg tab Tablet BLUD 0 780.00 0.00 0 780.00 0.00 0 780.00 0.00 0 780.00 0.00 0
AM16 Amlodipin 10 mg tab Tablet BLUD 0 336.03 0.00 0 336.03 0.00 0 336.03 0.00 0 336.03 0.00 0
AS14 Asam Folat 400 mcg tab Tablet BLUD 0 42.00 0.00 0 42.00 0.00 0 42.00 0.00 0 42.00 0.00 0
AZ01 Azithromycin 500 mg tab Tablet BANTUAN COVID 19 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00 0.00 0
AZ01 Azithromycin 500 mg tab Tablet BANTUAN COVID 19 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00 0.00 0
AZ01 Azithromycin 500 mg tab Tablet BANTUAN COVID 19 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00 0.00 0
AZ01 Azithromycin 500 mg tab Tablet BTT 0 1,343.65 0.00 0 1,343.65 0.00 0 1,343.65 0.00 0 1,343.65 0.00 0
BE05 BETAHISTIN MESILAT TABLET 6 MG Tablet BLUD 0 1,300.00 0.00 0 1,300.00 0.00 0 1,300.00 0.00 0 1,300.00 0.00 0
BE05 BETAHISTIN MESILAT TABLET 6 MG Tablet DAK 0 110.00 0.00 0 110.00 0.00 0 110.00 0.00 0 110.00 0.00 0
BE06 BETAMETASON KRIM 0,1 % Tube BLUD 0 5,000.00 0.00 0 5,000.00 0.00 0 5,000.00 0.00 0 5,000.00 0.00 0
BE06 BETAMETASON KRIM 0,1 % Tube DAK 0 1,430.00 0.00 0 1,430.00 0.00 0 1,430.00 0.00 0 1,430.00 0.00 0
BI15 Bisturi Pcs BLUD 0 330,000.00 0.00 0 330,000.00 0.00 0 330,000.00 0.00 0 330,000.00 0.00 0
BI15 Bisturi Pcs BLUD 0 280,000.00 0.00 0 280,000.00 0.00 0 280,000.00 0.00 0 280,000.00 0.00 0
BL06 BloodLancet DAK 0 173.23 0.00 0 173.23 0.00 0 173.23 0.00 0 173.23 0.00 0
BL06 BloodLancet DAK 0 143.77 0.00 0 143.77 0.00 0 143.77 0.00 0 143.77 0.00 0
CE01 CETIRIZINA KAPSUL 10 MG Kapsul DAK 0 90.00 0.00 0 90.00 0.00 0 90.00 0.00 0 90.00 0.00 0
CI04 CIPROFLOKSASIN TABLET 500 MG Tablet BLUD 0 1,000.00 0.00 0 1,000.00 0.00 0 1,000.00 0.00 0 1,000.00 0.00 0
Botol_x00
CI04 CIPROFLOKSASIN TABLET 500 MG Tablet
0D_ DAK 0 757.00 0.00 0 757.00 0.00 0 757.00 0.00 0 757.00 0.00 1,611
CU08 CUKA BLUD 0 3,500.00 0.00 0 3,500.00 0.00 0 3,500.00 0.00 0 3,500.00 0.00 0
CL03 Clindamycin 150 mg tab Tablet BLUD 0 759.00 0.00 0 759.00 0.00 0 759.00 0.00 0 759.00 0.00 2,872
CO26 Combo stik (3 parameter) Kit BLUD 0 184,800.00 0.00 0 184,800.00 0.00 0 184,800.00 0.00 0 184,800.00 0.00 0
CO26 Combo stik (3 parameter) Kit BLUD 0 148,000.00 0.00 0 148,000.00 0.00 0 148,000.00 0.00 0 148,000.00 0.00 0
DE36 DECK GLASS 22X22 BLUD 0 34,000.00 0.00 0 34,000.00 0.00 0 34,000.00 0.00 0 34,000.00 0.00 0
DE01 DEKSAMETASON INJEKSI I.V 5 MG/ML 1 ML Ampul REFOCUSING 0 924.00 0.00 0 924.00 0.00 0 924.00 0.00 0 924.00 0.00 0
DE02 DEKSAMETASON TABLET 0,5 MG Tablet Dana Alokasi Khu 0 99.10 0.00 0 99.10 0.00 0 99.10 0.00 0 99.10 0.00 0
DE02 DEKSAMETASON TABLET 0,5 MG Tablet DAK 0 199.10 0.00 0 199.10 0.00 0 199.10 0.00 0 199.10 0.00 0
DE02 DEKSAMETASON TABLET 0,5 MG Tablet DAK 2 0 199.10 0.00 0 199.10 0.00 0 199.10 0.00 0 199.10 0.00 0
DE35 DESINFEKTAN 5 LITER Pcs BTT 0 415,000.00 0.00 0 415,000.00 0.00 0 415,000.00 0.00 0 415,000.00 0.00 0
DI02 DIAZEPAM RECTAL TUBE 5 MG Suppo DAK 0 12,573.00 0.00 0 12,573.00 0.00 0 12,573.00 0.00 5 12,573.00 62,865.00 0
DI06 DIFENHIDRAMIN INJEKSI I.M 10 MG/ML (HCL) Ampul Dana Alokasi Khu 0 788.00 0.00 0 788.00 0.00 0 788.00 0.00 0 788.00 0.00 0
DI06 DIFENHIDRAMIN INJEKSI I.M 10 MG/ML (HCL) Ampul STOK OP 0 1,176.00 0.00 0 1,176.00 0.00 0 1,176.00 0.00 0 1,176.00 0.00 0
DI07 DIGOKSIN TABLET 0,25 MG Tablet DAK 2 0 181.50 0.00 0 181.50 0.00 0 181.50 0.00 0 181.50 0.00 0
DO03 DOMPERIDONE TABLET 10 MG Tablet DAK 0 71.00 0.00 0 71.00 0.00 0 71.00 0.00 0 71.00 0.00 0
EK09 EKSTRAK IMUNOMODULATOR KAPSUL Kapsul Bantuan Tidak Te 0 1,763.00 0.00 0 1,763.00 0.00 0 1,763.00 0.00 0 1,763.00 0.00 0
EK09 EKSTRAK IMUNOMODULATOR KAPSUL Kapsul REFOCUSING 0 1,763.00 0.00 0 1,763.00 0.00 0 1,763.00 0.00 0 1,763.00 0.00 0
EK14 EKSTRAK PLASENTA + NEOMISIN 5 G GEL Tube DAK 0 15,730.00 0.00 0 15,730.00 0.00 0 15,730.00 0.00 0 15,730.00 0.00 0
EK14 EKSTRAK PLASENTA + NEOMISIN 5 G GEL Tube DAK 2 0 15,730.00 0.00 0 15,730.00 0.00 0 15,730.00 0.00 0 15,730.00 0.00 0
EK14 EKSTRAK PLASENTA + NEOMISIN 5 G GEL Tube BTT 20 0 11,550.00 0.00 0 11,550.00 0.00 0 11,550.00 0.00 0 11,550.00 0.00 0
EP02 EPINEFRIN (Adrenalin) INJEKSI 0,1 % - 1 (sebagai HCL) Ampul REFOCUSING 0 1,515.00 0.00 0 1,515.00 0.00 0 1,515.00 0.00 0 1,515.00 0.00 0
EP02 EPINEFRIN (Adrenalin) INJEKSI 0,1 % - 1 (sebagai HCL) Ampul DAK 0 6,072.00 0.00 0 6,072.00 0.00 0 6,072.00 0.00 0 6,072.00 0.00 0
ET01 ETAKRIDIN LARUTAN 0,1 % Botol DAK 0 3,400.00 0.00 0 3,400.00 0.00 0 3,400.00 0.00 0 3,400.00 0.00 5
ET05 ETANOL 70 % 1000 ML Botol BTT 0 37,000.00 0.00 0 37,000.00 0.00 0 37,000.00 0.00 0 37,000.00 0.00 0
FE08 FENOL GLISEROL TETES TELINGA 10 % Botol DAK 0 2,997.50 0.00 0 2,997.50 0.00 0 2,997.50 0.00 0 2,997.50 0.00 0
FI01 FITOMENADION (VIT.K1) INJEKSI 10 MG/ML Ampul HIBAH 0 1,386.00 0.00 0 1,386.00 0.00 0 1,386.00 0.00 0 1,386.00 0.00 0
FI02 FITOMENADION (VIT.K1) TABLET SALUT GULA 10 MG Tablet BLUD 0 800.00 0.00 0 800.00 0.00 0 800.00 0.00 0 800.00 0.00 0
FI02 FITOMENADION (VIT.K1) TABLET SALUT GULA 10 MG Tablet BLUD 0 758.00 0.00 0 758.00 0.00 0 758.00 0.00 0 758.00 0.00 1,135
FI06 FIXOMULL STRETCH 5 CM X 5 CM Pcs DAK 0 42,800.00 0.00 0 42,800.00 0.00 0 42,800.00 0.00 0 42,800.00 0.00 0
FR01 FRAMYCETIN SULFAT B.P 1% 10 CM X 10 CM Lembar Dana Alokasi Khu 0 12,210.00 0.00 0 12,210.00 0.00 0 12,210.00 0.00 0 12,210.00 0.00 0
FU02 FUROSEMID TABLET 40 MG Tablet BLUD 0 245.00 0.00 0 245.00 0.00 0 245.00 0.00 0 245.00 0.00 0
FU02 FUROSEMID TABLET 40 MG Tablet Dana Alokasi Khu 0 186.00 0.00 0 186.00 0.00 0 186.00 0.00 0 186.00 0.00 0
FU02 FUROSEMID TABLET 40 MG Tablet DAK 0 82.00 0.00 0 82.00 0.00 0 82.00 0.00 0 82.00 0.00 0
FA07 Favipiravir 200 Mg Tablet BTT 0 19,841.00 0.00 0 19,841.00 0.00 0 19,841.00 0.00 0 19,841.00 0.00 0
FA07 Favipiravir 200 Mg Tablet BANTUAN COVID 19 0 14,850.00 0.00 0 14,850.00 0.00 0 14,850.00 0.00 0 14,850.00 0.00 0
FA07 Favipiravir 200 Mg Tablet BANTUAN COVID 19 0 14,850.00 0.00 0 14,850.00 0.00 0 14,850.00 0.00 0 14,850.00 0.00 0
GA02 GARAM ORALIT I SERBUK KOMBINASI : Natrium 0,70 g ,Kalium klorida 0,30 g, Tribatrium Sitrat dihidrat 0,58 g Saset PROGRAM 0 274.00 0.00 0 274.00 0.00 0 274.00 0.00 0 274.00 0.00 0
GA02 GARAM ORALIT I SERBUK KOMBINASI : Natrium 0,70 g ,Kalium klorida 0,30 g, Tribatrium Sitrat dihidrat 0,58 g Saset DAK 0 280.00 0.00 0 280.00 0.00 0 280.00 0.00 0 280.00 0.00 0
GA02 GARAM ORALIT I SERBUK KOMBINASI : Natrium 0,70 g ,Kalium klorida 0,30 g, Tribatrium Sitrat dihidrat 0,58 g Saset BTT 0 379.50 0.00 0 379.50 0.00 0 379.50 0.00 0 379.50 0.00 0
GA02 GARAM ORALIT I SERBUK KOMBINASI : Natrium 0,70 g ,Kalium klorida 0,30 g, Tribatrium Sitrat dihidrat 0,58 g Saset BTT 20 0 379.50 0.00 0 379.50 0.00 0 379.50 0.00 0 379.50 0.00 0
GE05 GENTAMICIN TETES MATA Botol BLUD 0 11,500.00 0.00 0 11,500.00 0.00 0 11,500.00 0.00 0 11,500.00 0.00 0
GE05 GENTAMICIN TETES MATA Botol BLUD 0 4,232.00 0.00 0 4,232.00 0.00 0 4,232.00 0.00 0 4,232.00 0.00 46
GE06 GENTIAN VIOLET LARUTAN 1 % Botol DAK 0 2,700.00 0.00 0 2,700.00 0.00 0 2,700.00 0.00 0 2,700.00 0.00 18
GI07 GIEMSA 100 ML BLUD 0 649,000.00 0.00 0 649,000.00 0.00 0 649,000.00 0.00 0 649,000.00 0.00 0
GL02 GLIBENKLAMIDA TABLET 5 MG Tablet DAK 0 97.00 0.00 0 97.00 0.00 0 97.00 0.00 0 97.00 0.00 0
GL25 GLIMEPIRIDE 3 MG TAB Pcs BLUD 0 143.00 0.00 0 143.00 0.00 0 143.00 0.00 0 143.00 0.00 0
GL03 GLIMEPIRIDE TABLET 1 MG Tablet DAK 0 174.00 0.00 0 174.00 0.00 0 174.00 0.00 0 174.00 0.00 45
GL03 GLIMEPIRIDE TABLET 1 MG Tablet Dana Alokasi Khu 0 844.00 0.00 0 844.00 0.00 0 844.00 0.00 0 844.00 0.00 0
GL03 GLIMEPIRIDE TABLET 1 MG Tablet DAK 0 174.00 0.00 0 174.00 0.00 0 174.00 0.00 0 174.00 0.00 0
GL04 GLISERIL GUAIAKOLAT TABLET 100 MG Tablet DAK 0 122.00 0.00 0 122.00 0.00 0 122.00 0.00 0 122.00 0.00 0
GL04 GLISERIL GUAIAKOLAT TABLET 100 MG Tablet DAK 2 0 122.00 0.00 0 122.00 0.00 0 122.00 0.00 0 122.00 0.00 0
GL04 GLISERIL GUAIAKOLAT TABLET 100 MG Tablet DAK 2 0 258.50 0.00 0 258.50 0.00 0 258.50 0.00 0 258.50 0.00 0
GL27 GLUKOSA TEST DAK 0 3,375.72 0.00 0 3,375.72 0.00 0 3,375.72 0.00 0 3,375.72 0.00 0
GL27 GLUKOSA TEST DAK 0 3,200.00 0.00 0 3,200.00 0.00 0 3,200.00 0.00 0 3,200.00 0.00 0
GE11 Gentamicin salep mata Tube BLUD 0 8,000.00 0.00 0 8,000.00 0.00 0 8,000.00 0.00 0 8,000.00 0.00 0
GL10 Glimepiride 2 mg tab Tablet BLUD 0 300.00 0.00 0 300.00 0.00 0 300.00 0.00 0 300.00 0.00 0
GL10 Glimepiride 2 mg tab Tablet BLUD 0 123.00 0.00 0 123.00 0.00 0 123.00 0.00 0 123.00 0.00 0
HA04 HALOPERIDOL TABLET 1,5 MG Tablet DAK 0 59.00 0.00 0 59.00 0.00 0 59.00 0.00 0 59.00 0.00 100
HI01 HIDROKLOROTIAZIDA TABLET 25 MG Tablet BLUD 0 149.35 0.00 0 149.35 0.00 0 149.35 0.00 0 149.35 0.00 0
HI02 HIDROKORTISON KRIM 2,5% Tube DAK 0 2,475.00 0.00 0 2,475.00 0.00 0 2,475.00 0.00 0 2,475.00 0.00 0
HI02 HIDROKORTISON KRIM 2,5% Tube Dana Alokasi Khu 0 2,346.14 0.00 0 2,346.14 0.00 0 2,346.14 0.00 0 2,346.14 0.00 0
HI02 HIDROKORTISON KRIM 2,5% Tube DAK 0 2,325.00 0.00 0 2,325.00 0.00 0 2,325.00 0.00 0 2,325.00 0.00 0
HY11 HYPAFIX 5 X 1 Pcs BLUD 0 28,500.00 0.00 0 28,500.00 0.00 0 28,500.00 0.00 0 28,500.00 0.00 0
HY11 HYPAFIX 5 X 1 Pcs BLUD 0 33,000.00 0.00 0 33,000.00 0.00 0 33,000.00 0.00 0 33,000.00 0.00 0
IV03 I.V CATHETER NO.26 Set DAK 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0
IV05 I.V.CATHETER NO.20 Biji DAK 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0
IV06 I.V.CATHETER NO.22 Set DAK 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0
IV08 I.V.CATHETER NO.24 Set DAK 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0 11,000.00 0.00 0
IB03 IBUPROFEN TABLET 400 MG Tablet Dana Alokasi Khu 0 190.00 0.00 0 190.00 0.00 0 190.00 0.00 0 190.00 0.00 0
IB03 IBUPROFEN TABLET 400 MG Tablet DAK 0 302.50 0.00 0 302.50 0.00 0 302.50 0.00 0 302.50 0.00 0
IB03 IBUPROFEN TABLET 400 MG Tablet DAK 0 190.00 0.00 0 190.00 0.00 0 190.00 0.00 0 190.00 0.00 0
IB03 IBUPROFEN TABLET 400 MG Tablet DAK 2 0 302.50 0.00 0 302.50 0.00 0 302.50 0.00 0 302.50 0.00 0
IC01 ICHTYOL SALEP Pot BLUD 0 12,200.00 0.00 0 12,200.00 0.00 2 12,200.00 24,400.00 0 12,200.00 0.00 0
IN01 INFUSION SET ANAK Set DAK 0 7,920.00 0.00 0 7,920.00 0.00 0 7,920.00 0.00 0 7,920.00 0.00 0
IN02 INFUSION SET DEWASA Set DAK 0 5,817.00 0.00 0 5,817.00 0.00 0 5,817.00 0.00 0 5,817.00 0.00 0
IO01 IODIUM TEST Botol BLUD 0 64,000.00 0.00 0 64,000.00 0.00 0 64,000.00 0.00 0 64,000.00 0.00 0
IS01 ISONIAZID (INH) TABLET 100 MG Tablet PROGRAM 0 231.00 0.00 0 231.00 0.00 0 231.00 0.00 0 231.00 0.00 0
JE01 JELLY USG Botol BLUD 0 220,000.00 0.00 0 220,000.00 0.00 0 220,000.00 0.00 0 220,000.00 0.00 0
KA10 KALSIUM LAKTAT (Kalk) TABLET 500 MG Tablet DAK 0 60.00 0.00 0 60.00 0.00 0 60.00 0.00 0 60.00 0.00 0
KA10 KALSIUM LAKTAT (Kalk) TABLET 500 MG Tablet BLUD 0 60.00 0.00 0 60.00 0.00 0 60.00 0.00 0 60.00 0.00 0
KA10 KALSIUM LAKTAT (Kalk) TABLET 500 MG Tablet BLUD 0 60.55 0.00 0 60.55 0.00 0 60.55 0.00 0 60.55 0.00 0
KA90 KAPAS LIDI Set BLUD 0 49,000.00 0.00 0 49,000.00 0.00 0 49,000.00 0.00 0 49,000.00 0.00 0
KA16 KAPAS PEMBALUT/ABSORBEN 250 G Rol DAK 0 13,400.00 0.00 0 13,400.00 0.00 0 13,400.00 0.00 0 13,400.00 0.00 0
KA16 KAPAS PEMBALUT/ABSORBEN 250 G Rol DAK 0 13,400.00 0.00 0 13,400.00 0.00 0 13,400.00 0.00 0 13,400.00 0.00 0
KA18 KAPTOPRIL TABLET 12,5 MG Tablet Dana Alokasi Khu 0 66.00 0.00 0 66.00 0.00 0 66.00 0.00 0 66.00 0.00 0
KA18 KAPTOPRIL TABLET 12,5 MG Tablet DAK 0 65.00 0.00 0 65.00 0.00 0 65.00 0.00 0 65.00 0.00 0
KA18 KAPTOPRIL TABLET 12,5 MG Tablet BLUD 0 65.00 0.00 0 65.00 0.00 0 65.00 0.00 0 65.00 0.00 0
KA19 KAPTOPRIL TABLET 25 MG Tablet BLUD 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0
KA19 KAPTOPRIL TABLET 25 MG Tablet BLUD 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0
KA19 KAPTOPRIL TABLET 25 MG Tablet BLUD 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0
KA19 KAPTOPRIL TABLET 25 MG Tablet BLUD 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0 75.00 0.00 0
KA22 KASA KOMPRES 40 X 40 STERIL Rol DAK 0 1,618.00 0.00 0 1,618.00 0.00 0 1,618.00 0.00 0 1,618.00 0.00 0
KA24 KASA PEMBALUT HIDROFIL 16 X 16 Rol DAK 0 5,950.00 0.00 0 5,950.00 0.00 0 5,950.00 0.00 0 5,950.00 0.00 0
KA25 KASA PEMBALUT HIDROFIL 4 M X 3 CM Rol BUFFER STOK 0 594.00 0.00 0 594.00 0.00 0 594.00 0.00 0 594.00 0.00 0
KA28 KASA PEMBALUT HIDROFIL 4 M X 5 M Rol DAK 0 303.49 0.00 0 303.49 0.00 0 303.49 0.00 0 303.49 0.00 225
KA70 KASSA HYDROFIL 40 YARD X 80 CM Pcs BLUD 0 132,000.00 0.00 0 132,000.00 0.00 0 132,000.00 0.00 0 132,000.00 0.00 0
KA70 KASSA HYDROFIL 40 YARD X 80 CM Pcs BLUD 0 100,000.00 0.00 0 100,000.00 0.00 0 100,000.00 0.00 0 100,000.00 0.00 0
KE03 KETOKONAZOL TABLET 200 MG Tablet BLUD 0 252.00 0.00 0 252.00 0.00 0 252.00 0.00 0 252.00 0.00 0
KL04 KLORAMFENIKOL TETES MATA 0,5 % Botol Dana Alokasi Khu 0 9,324.00 0.00 0 9,324.00 0.00 0 9,324.00 0.00 0 9,324.00 0.00 0
KL04 KLORAMFENIKOL TETES MATA 0,5 % Botol BTT 0 12,600.00 0.00 0 12,600.00 0.00 0 12,600.00 0.00 0 12,600.00 0.00 0
KL04 KLORAMFENIKOL TETES MATA 0,5 % Botol DAK 2 0 7,260.00 0.00 0 7,260.00 0.00 0 7,260.00 0.00 0 7,260.00 0.00 0
KL10 KLORAMPENIKOL SALEP MATA 1% Tube DAK 0 2,007.00 0.00 0 2,007.00 0.00 0 2,007.00 0.00 0 2,007.00 0.00 0
KL13 KLORFENERAMIN MALEAT (CTM) TABLET 4 MG Tablet BLUD 0 63.00 0.00 0 63.00 0.00 0 63.00 0.00 0 63.00 0.00 0
KL13 KLORFENERAMIN MALEAT (CTM) TABLET 4 MG Tablet Dana Alokasi Khu 0 90.00 0.00 0 90.00 0.00 0 90.00 0.00 0 90.00 0.00 0
KL13 KLORFENERAMIN MALEAT (CTM) TABLET 4 MG Tablet DAK 0 22.00 0.00 0 22.00 0.00 0 22.00 0.00 0 22.00 0.00 0
KL13 KLORFENERAMIN MALEAT (CTM) TABLET 4 MG Tablet BLUD 0 51.00 0.00 0 51.00 0.00 0 51.00 0.00 0 51.00 0.00 0
KL13 KLORFENERAMIN MALEAT (CTM) TABLET 4 MG Tablet DAK 2 0 166.00 0.00 0 166.00 0.00 0 166.00 0.00 0 166.00 0.00 0
KL15 KLOROKUIN TABLET 150 MG Tablet BANTUAN COVI 0 850.00 0.00 0 850.00 0.00 0 850.00 0.00 0 850.00 0.00 0
KO21 KOTRIMOSAZOL DOEN I (dewasa) KOMBINASI : Sulfametoksazol 400 mg, Trimetoprim 80 mg Tablet Dana Alokasi Khu 0 126.00 0.00 0 126.00 0.00 0 126.00 0.00 0 126.00 0.00 0
KO21 KOTRIMOSAZOL DOEN I (dewasa) KOMBINASI : Sulfametoksazol 400 mg, Trimetoprim 80 mg Tablet BUFFER STOK 0 133.00 0.00 0 133.00 0.00 0 133.00 0.00 0 133.00 0.00 0
KO21 KOTRIMOSAZOL DOEN I (dewasa) KOMBINASI : Sulfametoksazol 400 mg, Trimetoprim 80 mg Tablet BUFFER STOK 0 133.00 0.00 0 133.00 0.00 0 133.00 0.00 0 133.00 0.00 0
KO23 KOTRIMOSAZOL SUSPENSI KOMBINASI :Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml Botol DAK 0 2,100.00 0.00 0 2,100.00 0.00 0 2,100.00 0.00 0 2,100.00 0.00 0
KO23 KOTRIMOSAZOL SUSPENSI KOMBINASI :Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml Botol DAK 0 2,190.00 0.00 0 2,190.00 0.00 0 2,190.00 0.00 0 2,190.00 0.00 0
KA49 Kaca Slide Frosted HIBAH 0 15,350.00 0.00 0 15,350.00 0.00 0 15,350.00 0.00 0 15,350.00 0.00 0
KA49 Kaca Slide Frosted PROGRAM TB 0 21,747.00 0.00 0 21,747.00 0.00 0 21,747.00 0.00 0 21,747.00 0.00 0
KA43 Kacamata Google Pcs BTT 0 80,000.00 0.00 0 80,000.00 0.00 0 80,000.00 0.00 0 80,000.00 0.00 0
KA43 Kacamata Google Pcs DID 0 24,200.00 0.00 0 24,200.00 0.00 0 24,200.00 0.00 0 24,200.00 0.00 0
KA43 Kacamata Google Pcs BTT 0 60,000.00 0.00 0 60,000.00 0.00 0 60,000.00 0.00 0 60,000.00 0.00 0
KE30 Kertas Golongan darah Pcs BLUD 0 52,000.00 0.00 0 52,000.00 0.00 0 52,000.00 0.00 0 52,000.00 0.00 0
KE30 Kertas Golongan darah Pcs BLUD 0 39,820.00 0.00 0 39,820.00 0.00 0 39,820.00 0.00 0 39,820.00 0.00 0
KO28 Kompolax emulsi Botol BLUD 0 5,367.00 0.00 0 5,367.00 0.00 0 5,367.00 0.00 0 5,367.00 0.00 59
LE01 LEVERTRAN SALEP Pot BLUD 0 4,000.00 0.00 0 4,000.00 0.00 0 4,000.00 0.00 19 4,000.00 76,000.00 0
LI02 LIDOKAIN INJEKSI 2 % (HCL) + EPINEFRIN 1:80.000 - 2 ML Ampul DAK 2 0 3,600.00 0.00 0 3,600.00 0.00 0 3,600.00 0.00 0 3,600.00 0.00 0
LI02 LIDOKAIN INJEKSI 2 % (HCL) + EPINEFRIN 1:80.000 - 2 ML Ampul DAK 0 3,600.00 0.00 0 3,600.00 0.00 0 3,600.00 0.00 0 3,600.00 0.00 0
LI03 LIDOKAIN INJEKSI 2% (HCl) Ampul BLUD 0 847.00 0.00 0 847.00 0.00 0 847.00 0.00 0 847.00 0.00 0
LI05 LISOL MENGANDUNG KRESOL TERSABUN 50 % Botol DAK 0 40,700.00 0.00 0 40,700.00 0.00 0 40,700.00 0.00 0 40,700.00 0.00 0
LO01 LOPERAMID HCL TABLET 2 MG Tablet BTT 0 211.20 0.00 0 211.20 0.00 0 211.20 0.00 0 211.20 0.00 0
LO01 LOPERAMID HCL TABLET 2 MG Tablet
Botol_x00 BTT 20 0 211.20 0.00 0 211.20 0.00 0 211.20 0.00 0 211.20 0.00 0
0D_
LU03 LUGOL BLUD 0 135,300.00 0.00 0 135,300.00 0.00 0 135,300.00 0.00 0 135,300.00 0.00 0
MA01 MAGNESIUM SULFAT INJEKSI (I.V) 20 % - 25 ML Vial HIBAH 0 3,254.00 0.00 0 3,254.00 0.00 0 3,254.00 0.00 0 3,254.00 0.00 0
MA02 MAGNESIUM SULFAT INJEKSI (I.V) 40 % - 25 ML Vial HIBAH 0 3,718.00 0.00 0 3,718.00 0.00 0 3,718.00 0.00 0 3,718.00 0.00 0
MA04 MASKER DISPOSIBEL Biji REFOCUSING 0 880.00 0.00 0 880.00 0.00 0 880.00 0.00 0 880.00 0.00 0
MA04 MASKER DISPOSIBEL Biji BTT 0 1,400.00 0.00 0 1,400.00 0.00 0 1,400.00 0.00 0 1,400.00 0.00 0
Lampiran 6b
LAPORAN PERSEDIAAN OBAT TAHUN 2022
Harga 2020 Total Harga Jumlah Harga 2021 Total Harga Jumlah Harga 2022 Total Harga Jumlah Harga 2016 Total Harga Jumlah Harga 2017
405.00 0.00 293 405.00 118,665.00 200 405.00 81,000.00 0 405.00 0.00 0 405.00
3,613.50 0.00 0 3,613.50 0.00 250 3,613.50 903,375.00 0 3,613.50 0.00 0 3,613.50
1,870.00 0.00 0 1,870.00 0.00 500 1,870.00 935,000.00 0 1,870.00 0.00 0 1,870.00
1,100.00 0.00 0 1,100.00 0.00 39 1,100.00 42,900.00 0 1,100.00 0.00 0 1,100.00
830.00 0.00 0 830.00 0.00 200 830.00 166,000.00 0 830.00 0.00 0 830.00
1,380.00 0.00 0 1,380.00 0.00 2,500 1,380.00 3,450,000.00 0 1,380.00 0.00 0 1,380.00
887.78 0.00 0 887.78 0.00 500 887.78 443,890.00 0 887.78 0.00 0 887.78
928.00 0.00 0 928.00 0.00 600 928.00 556,800.00 0 928.00 0.00 0 928.00
366.00 0.00 0 366.00 0.00 7,500 366.00 2,745,000.00 0 366.00 0.00 0 366.00
367.00 0.00 0 367.00 0.00 8,100 367.00 2,972,700.00 0 367.00 0.00 0 367.00
79.00 0.00 0 79.00 0.00 100 79.00 7,900.00 0 79.00 0.00 0 79.00
79.00 0.00 0 79.00 0.00 100 79.00 7,900.00 0 79.00 0.00 0 79.00
79.00 0.00 0 79.00 0.00 700 79.00 55,300.00 0 79.00 0.00 0 79.00
95.00 0.00 0 95.00 0.00 39 95.00 3,705.00 0 95.00 0.00 0 95.00
97.00 0.00 196 97.00 19,012.00 0 97.00 0.00 0 97.00 0.00 0 97.00
79.00 0.00 0 79.00 0.00 200 79.00 15,800.00 0 79.00 0.00 0 79.00
79.00 0.00 0 79.00 0.00 360 79.00 28,440.00 0 79.00 0.00 0 79.00
79.00 0.00 0 79.00 0.00 600 79.00 47,400.00 0 79.00 0.00 0 79.00
112.99 0.00 0 112.99 0.00 900 112.99 101,694.92 0 112.99 0.00 0 112.99
79.00 0.00 0 79.00 0.00 900 79.00 71,100.00 0 79.00 0.00 0 79.00
79.00 0.00 0 79.00 0.00 1,200 79.00 94,800.00 0 79.00 0.00 0 79.00
79.00 0.00 0 79.00 0.00 1,050 79.00 82,950.00 0 79.00 0.00 0 79.00
79.00 0.00 0 79.00 0.00 1,100 79.00 86,900.00 0 79.00 0.00 0 79.00
88.00 0.00 0 88.00 0.00 1,200 88.00 105,600.00 0 88.00 0.00 0 88.00
88.00 0.00 0 88.00 0.00 1,210 88.00 106,480.00 0 88.00 0.00 0 88.00
88.00 0.00 0 88.00 0.00 1,280 88.00 112,640.00 0 88.00 0.00 0 88.00
79.00 0.00 1,402 79.00 110,758.00 0 79.00 0.00 0 79.00 0.00 0 79.00
95.00 0.00 2,350 95.00 223,250.00 0 95.00 0.00 0 95.00 0.00 0 95.00
79.00 0.00 0 79.00 0.00 2,850 79.00 225,150.00 0 79.00 0.00 0 79.00
88.00 0.00 0 88.00 0.00 4,140 88.00 364,320.00 0 88.00 0.00 0 88.00
79.00 0.00 2,140 79.00 169,060.00 3,320 79.00 262,280.00 0 79.00 0.00 0 79.00
83.80 0.00 8,712 83.80 730,065.60 0 83.80 0.00 0 83.80 0.00 0 83.80
110.00 0.00 0 110.00 0.00 14,200 110.00 1,562,000.00 0 110.00 0.00 0 110.00
87.00 0.00 0 87.00 0.00 500 87.00 43,500.00 0 87.00 0.00 0 87.00
105.00 0.00 600 105.00 63,000.00 0 105.00 0.00 0 105.00 0.00 0 105.00
128.00 5,760.00 0 128.00 0.00 0 128.00 0.00 0 128.00 0.00 0 128.00
244.20 0.00 0 244.20 0.00 6,000 244.20 1,465,200.00 0 244.20 0.00 0 244.20
192.50 0.00 1,873 192.50 360,552.50 0 192.50 0.00 0 192.50 0.00 0 192.50
244.20 0.00 0 244.20 0.00 14,000 244.20 3,418,800.00 0 244.20 0.00 0 244.20
95.00 18,240.00 0 95.00 0.00 300 95.00 28,500.00 0 95.00 0.00 0 95.00
167.00 0.00 0 167.00 0.00 300 167.00 50,100.00 0 167.00 0.00 0 167.00
53.48 0.00 0 53.48 0.00 2,100 53.48 112,308.00 0 53.48 0.00 0 53.48
201.82 0.00 0 201.82 0.00 19,800 201.82 3,995,970.00 0 201.82 0.00 0 201.82
75.00 0.00 2,272 75.00 170,400.00 0 75.00 0.00 0 75.00 0.00 0 75.00
53.00 0.00 0 53.00 0.00 15,000 53.00 795,000.00 0 53.00 0.00 0 53.00
201.00 0.00 0 201.00 0.00 8,000 201.00 1,608,000.00 0 201.00 0.00 0 201.00
249.00 0.00 3,924 249.00 977,076.00 0 249.00 0.00 0 249.00 0.00 0 249.00
201.00 0.00 0 201.00 0.00 8,000 201.00 1,608,000.00 0 201.00 0.00 0 201.00
201.00 0.00 0 201.00 0.00 27,000 201.00 5,427,000.00 0 201.00 0.00 0 201.00
6,858.00 0.00 0 6,858.00 0.00 180 6,858.00 1,234,440.00 0 6,858.00 0.00 0 6,858.00
7,557.00 0.00 110 7,557.00 831,270.00 0 7,557.00 0.00 0 7,557.00 0.00 0 7,557.00
9,999.00 0.00 0 9,999.00 0.00 200 9,999.00 1,999,800.00 0 9,999.00 0.00 0 9,999.00
54.00 0.00 0 54.00 0.00 2,000 54.00 108,000.00 0 54.00 0.00 0 54.00
58.00 0.00 5,044 58.00 292,552.00 5,000 58.00 290,000.00 0 58.00 0.00 0 58.00
54.00 0.00 0 54.00 0.00 20,000 54.00 1,080,000.00 0 54.00 0.00 0 54.00
5,060.00 0.00 0 5,060.00 0.00 100 5,060.00 506,000.00 0 5,060.00 0.00 0 5,060.00
6,820.00 0.00 6 6,820.00 40,920.00 0 6,820.00 0.00 0 6,820.00 0.00 0 6,820.00
6,820.00 0.00 0 6,820.00 0.00 20 6,820.00 136,400.00 0 6,820.00 0.00 0 6,820.00
162.00 615,438.00 0 162.00 0.00 0 162.00 0.00 0 162.00 0.00 0 162.00
4,798.00 0.00 45 4,798.00 215,910.00 286 4,798.00 1,372,228.00 0 4,798.00 0.00 0 4,798.00
3,250.00 0.00 0 3,250.00 0.00 60 3,250.00 195,000.00 0 3,250.00 0.00 0 3,250.00
3,279.50 0.00 0 3,279.50 0.00 100 3,279.50 327,949.50 0 3,279.50 0.00 0 3,279.50
185.00 0.00 0 185.00 0.00 200 185.00 37,000.00 0 185.00 0.00 0 185.00
34,091.80 0.00 0 34,091.80 0.00 10 34,091.80 340,918.00 0 34,091.80 0.00 0 34,091.80
69,700.00 0.00 0 69,700.00 0.00 30 69,700.00 2,091,000.00 0 69,700.00 0.00 0 69,700.00
45,000.00 0.00 0 45,000.00 0.00 54 45,000.00 2,430,000.00 0 45,000.00 0.00 0 45,000.00
55,000.00 440,000.00 0 55,000.00 0.00 0 55,000.00 0.00 0 55,000.00 0.00 0 55,000.00
55,272.00 1,105,440.00 0 55,272.00 0.00 0 55,272.00 0.00 0 55,272.00 0.00 0 55,272.00
42,000.00 0.00 48 42,000.00 2,016,000.00 0 42,000.00 0.00 0 42,000.00 0.00 0 42,000.00
65,340.00 0.00 100 65,340.00 6,534,000.00 0 65,340.00 0.00 0 65,340.00 0.00 0 65,340.00
1,204.50 0.00 75 1,204.50 90,337.50 0 1,204.50 0.00 0 1,204.50 0.00 0 1,204.50
175,000.00 0.00 100 175,000.00 17,500,000.00 0 175,000.00 0.00 0 175,000.00 0.00 0 175,000.00
175,000.00 0.00 100 175,000.00 17,500,000.00 0 175,000.00 0.00 0 175,000.00 0.00 0 175,000.00
110,000.00 0.00 70 110,000.00 7,700,000.00 0 110,000.00 0.00 0 110,000.00 0.00 0 110,000.00
185,000.00 0.00 5 185,000.00 925,000.00 0 185,000.00 0.00 0 185,000.00 0.00 0 185,000.00
10,000.00 0.00 25 10,000.00 250,000.00 0 10,000.00 0.00 0 10,000.00 0.00 0 10,000.00
89.81 0.00 0 89.81 0.00 200 89.81 17,962.00 0 89.81 0.00 0 89.81
105.00 0.00 749 105.00 78,645.00 0 105.00 0.00 0 105.00 0.00 0 105.00
42.00 0.00 0 42.00 0.00 7,000 42.00 294,000.00 0 42.00 0.00 0 42.00
42.00 0.00 0 42.00 0.00 28,000 42.00 1,176,000.00 0 42.00 0.00 0 42.00
750.00 0.00 200 750.00 150,000.00 0 750.00 0.00 0 750.00 0.00 0 750.00
594.00 0.00 0 594.00 0.00 600 594.00 356,400.00 0 594.00 0.00 0 594.00
750.00 0.00 1,910 750.00 1,432,500.00 0 750.00 0.00 0 750.00 0.00 0 750.00
111.00 0.00 6,277 111.00 696,747.00 21,000 111.00 2,331,000.00 0 111.00 0.00 0 111.00
60,500.00 0.00 11 60,500.00 665,500.00 0 60,500.00 0.00 0 60,500.00 0.00 0 60,500.00
373.00 0.00 15 373.00 5,595.00 0 373.00 0.00 0 373.00 0.00 0 373.00
780.00 0.00 0 780.00 0.00 1,000 780.00 780,000.00 0 780.00 0.00 0 780.00
336.03 0.00 0 336.03 0.00 29,700 336.03 9,979,992.00 0 336.03 0.00 0 336.03
42.00 0.00 0 42.00 0.00 10,000 42.00 420,000.00 0 42.00 0.00 0 42.00
1,250.00 0.00 20 1,250.00 25,000.00 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00
1,250.00 0.00 21 1,250.00 26,250.00 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00
1,250.00 0.00 40 1,250.00 50,000.00 0 1,250.00 0.00 0 1,250.00 0.00 0 1,250.00
1,343.65 0.00 0 1,343.65 0.00 40 1,343.65 53,746.00 0 1,343.65 0.00 0 1,343.65
1,300.00 0.00 0 1,300.00 0.00 900 1,300.00 1,170,000.00 0 1,300.00 0.00 0 1,300.00
110.00 0.00 3,161 110.00 347,710.00 0 110.00 0.00 0 110.00 0.00 0 110.00
5,000.00 0.00 0 5,000.00 0.00 96 5,000.00 480,000.00 0 5,000.00 0.00 0 5,000.00
1,430.00 0.00 0 1,430.00 0.00 50 1,430.00 71,500.00 0 1,430.00 0.00 0 1,430.00
330,000.00 0.00 3 330,000.00 990,000.00 0 330,000.00 0.00 0 330,000.00 0.00 0 330,000.00
280,000.00 0.00 0 280,000.00 0.00 3 280,000.00 840,000.00 0 280,000.00 0.00 0 280,000.00
173.23 0.00 0 173.23 0.00 600 173.23 103,938.30 0 173.23 0.00 0 173.23
143.77 0.00 0 143.77 0.00 14,200 143.77 2,041,534.00 0 143.77 0.00 0 143.77
90.00 0.00 605 90.00 54,450.00 0 90.00 0.00 0 90.00 0.00 0 90.00
1,000.00 0.00 0 1,000.00 0.00 500 1,000.00 500,000.00 0 1,000.00 0.00 0 1,000.00
757.00 1,219,527.00 0 757.00 0.00 0 757.00 0.00 0 757.00 0.00 0 757.00
3,500.00 0.00 0 3,500.00 0.00 5 3,500.00 17,500.00 0 3,500.00 0.00 0 3,500.00
759.00 2,179,848.00 0 759.00 0.00 0 759.00 0.00 0 759.00 0.00 0 759.00
184,800.00 0.00 4 184,800.00 739,200.00 0 184,800.00 0.00 0 184,800.00 0.00 0 184,800.00
148,000.00 0.00 0 148,000.00 0.00 6 148,000.00 888,000.00 0 148,000.00 0.00 0 148,000.00
34,000.00 0.00 0 34,000.00 0.00 4 34,000.00 136,000.00 0 34,000.00 0.00 0 34,000.00
924.00 0.00 5 924.00 4,620.00 0 924.00 0.00 0 924.00 0.00 0 924.00
99.10 0.00 0 99.10 0.00 1,000 99.10 99,100.50 0 99.10 0.00 0 99.10
199.10 0.00 1,804 199.10 359,176.40 0 199.10 0.00 0 199.10 0.00 0 199.10
199.10 0.00 0 199.10 0.00 5,000 199.10 995,500.00 0 199.10 0.00 0 199.10
415,000.00 0.00 0 415,000.00 0.00 5 415,000.00 2,075,000.00 0 415,000.00 0.00 0 415,000.00
12,573.00 0.00 0 12,573.00 0.00 0 12,573.00 0.00 0 12,573.00 0.00 0 12,573.00
788.00 0.00 0 788.00 0.00 5 788.00 3,940.00 0 788.00 0.00 0 788.00
1,176.00 0.00 9 1,176.00 10,584.00 0 1,176.00 0.00 0 1,176.00 0.00 0 1,176.00
181.50 0.00 0 181.50 0.00 100 181.50 18,150.00 0 181.50 0.00 0 181.50
71.00 0.00 980 71.00 69,580.00 6,000 71.00 426,000.00 0 71.00 0.00 0 71.00
1,763.00 0.00 0 1,763.00 0.00 120 1,763.00 211,560.00 0 1,763.00 0.00 0 1,763.00
1,763.00 0.00 300 1,763.00 528,900.00 900 1,763.00 1,586,700.00 0 1,763.00 0.00 0 1,763.00
15,730.00 0.00 1 15,730.00 15,730.00 0 15,730.00 0.00 0 15,730.00 0.00 0 15,730.00
15,730.00 0.00 0 15,730.00 0.00 50 15,730.00 786,500.00 0 15,730.00 0.00 0 15,730.00
11,550.00 0.00 0 11,550.00 0.00 100 11,550.00 1,155,000.00 0 11,550.00 0.00 0 11,550.00
1,515.00 0.00 0 1,515.00 0.00 10 1,515.00 15,150.00 0 1,515.00 0.00 0 1,515.00
6,072.00 0.00 8 6,072.00 48,576.00 0 6,072.00 0.00 0 6,072.00 0.00 0 6,072.00
3,400.00 17,000.00 72 3,400.00 244,800.00 24 3,400.00 81,600.00 0 3,400.00 0.00 0 3,400.00
37,000.00 0.00 0 37,000.00 0.00 10 37,000.00 370,000.00 0 37,000.00 0.00 0 37,000.00
2,997.50 0.00 20 2,997.50 59,950.00 0 2,997.50 0.00 0 2,997.50 0.00 0 2,997.50
1,386.00 0.00 0 1,386.00 0.00 285 1,386.00 395,010.00 0 1,386.00 0.00 0 1,386.00
800.00 0.00 0 800.00 0.00 500 800.00 400,000.00 0 800.00 0.00 0 800.00
758.00 860,330.00 0 758.00 0.00 0 758.00 0.00 0 758.00 0.00 0 758.00
42,800.00 0.00 16 42,800.00 684,800.00 0 42,800.00 0.00 0 42,800.00 0.00 0 42,800.00
12,210.00 0.00 0 12,210.00 0.00 10 12,210.00 122,100.00 0 12,210.00 0.00 0 12,210.00
245.00 0.00 0 245.00 0.00 1,000 245.00 245,000.00 0 245.00 0.00 0 245.00
186.00 0.00 0 186.00 0.00 100 186.00 18,600.00 0 186.00 0.00 0 186.00
82.00 0.00 165 82.00 13,530.00 0 82.00 0.00 0 82.00 0.00 0 82.00
19,841.00 0.00 100 19,841.00 1,984,100.00 0 19,841.00 0.00 0 19,841.00 0.00 0 19,841.00
14,850.00 0.00 114 14,850.00 1,692,900.00 0 14,850.00 0.00 0 14,850.00 0.00 0 14,850.00
14,850.00 0.00 200 14,850.00 2,970,000.00 0 14,850.00 0.00 0 14,850.00 0.00 0 14,850.00
274.00 0.00 0 274.00 0.00 600 274.00 164,400.00 0 274.00 0.00 0 274.00
280.00 0.00 0 280.00 0.00 1,400 280.00 392,000.00 0 280.00 0.00 0 280.00
379.50 0.00 880 379.50 333,960.00 0 379.50 0.00 0 379.50 0.00 0 379.50
379.50 0.00 0 379.50 0.00 3,200 379.50 1,214,400.00 0 379.50 0.00 0 379.50
11,500.00 0.00 0 11,500.00 0.00 145 11,500.00 1,667,500.00 0 11,500.00 0.00 0 11,500.00
4,232.00 194,672.00 0 4,232.00 0.00 0 4,232.00 0.00 0 4,232.00 0.00 0 4,232.00
2,700.00 48,600.00 24 2,700.00 64,800.00 0 2,700.00 0.00 0 2,700.00 0.00 0 2,700.00
649,000.00 0.00 1 649,000.00 649,000.00 0 649,000.00 0.00 0 649,000.00 0.00 0 649,000.00
97.00 0.00 820 97.00 79,540.00 0 97.00 0.00 0 97.00 0.00 0 97.00
143.00 0.00 1,175 143.00 168,025.00 0 143.00 0.00 0 143.00 0.00 0 143.00
174.00 7,830.00 0 174.00 0.00 0 174.00 0.00 0 174.00 0.00 0 174.00
844.00 0.00 0 844.00 0.00 500 844.00 422,000.00 0 844.00 0.00 0 844.00
174.00 0.00 1,000 174.00 174,000.00 4,000 174.00 696,000.00 0 174.00 0.00 0 174.00
122.00 0.00 2,970 122.00 362,340.00 0 122.00 0.00 0 122.00 0.00 0 122.00
122.00 0.00 0 122.00 0.00 5,000 122.00 610,000.00 0 122.00 0.00 0 122.00
258.50 0.00 0 258.50 0.00 20,000 258.50 5,170,000.00 0 258.50 0.00 0 258.50
3,375.72 0.00 0 3,375.72 0.00 600 3,375.72 2,025,432.00 0 3,375.72 0.00 0 3,375.72
3,200.00 0.00 0 3,200.00 0.00 14,200 3,200.00 45,440,000.00 0 3,200.00 0.00 0 3,200.00
8,000.00 0.00 0 8,000.00 0.00 50 8,000.00 400,000.00 0 8,000.00 0.00 0 8,000.00
300.00 0.00 0 300.00 0.00 12,000 300.00 3,600,000.00 0 300.00 0.00 0 300.00
123.00 0.00 0 123.00 0.00 3,000 123.00 369,000.00 0 123.00 0.00 0 123.00
59.00 5,900.00 0 59.00 0.00 0 59.00 0.00 0 59.00 0.00 0 59.00
149.35 0.00 0 149.35 0.00 6,500 149.35 970,778.00 0 149.35 0.00 0 149.35
2,475.00 0.00 5 2,475.00 12,375.00 0 2,475.00 0.00 0 2,475.00 0.00 0 2,475.00
2,346.14 0.00 0 2,346.14 0.00 48 2,346.14 112,614.72 0 2,346.14 0.00 0 2,346.14
2,325.00 0.00 0 2,325.00 0.00 336 2,325.00 781,200.00 0 2,325.00 0.00 0 2,325.00
28,500.00 0.00 0 28,500.00 0.00 20 28,500.00 570,000.00 0 28,500.00 0.00 0 28,500.00
33,000.00 0.00 16 33,000.00 528,000.00 0 33,000.00 0.00 0 33,000.00 0.00 0 33,000.00
11,000.00 0.00 0 11,000.00 0.00 20 11,000.00 220,000.00 0 11,000.00 0.00 0 11,000.00
11,000.00 0.00 0 11,000.00 0.00 20 11,000.00 220,000.00 0 11,000.00 0.00 0 11,000.00
11,000.00 0.00 0 11,000.00 0.00 20 11,000.00 220,000.00 0 11,000.00 0.00 0 11,000.00
11,000.00 0.00 0 11,000.00 0.00 20 11,000.00 220,000.00 0 11,000.00 0.00 0 11,000.00
190.00 0.00 0 190.00 0.00 5,000 190.00 950,000.00 0 190.00 0.00 0 190.00
302.50 0.00 1,573 302.50 475,832.50 0 302.50 0.00 0 302.50 0.00 0 302.50
190.00 0.00 0 190.00 0.00 2,000 190.00 380,000.00 0 190.00 0.00 0 190.00
302.50 0.00 0 302.50 0.00 13,000 302.50 3,932,500.00 0 302.50 0.00 0 302.50
12,200.00 0.00 0 12,200.00 0.00 0 12,200.00 0.00 0 12,200.00 0.00 0 12,200.00
7,920.00 0.00 0 7,920.00 0.00 100 7,920.00 792,000.00 0 7,920.00 0.00 0 7,920.00
5,817.00 0.00 0 5,817.00 0.00 100 5,817.00 581,700.00 0 5,817.00 0.00 0 5,817.00
64,000.00 0.00 0 64,000.00 0.00 6 64,000.00 384,000.00 0 64,000.00 0.00 0 64,000.00
231.00 0.00 300 231.00 69,300.00 0 231.00 0.00 0 231.00 0.00 0 231.00
220,000.00 0.00 4 220,000.00 880,000.00 0 220,000.00 0.00 0 220,000.00 0.00 0 220,000.00
60.00 0.00 0 60.00 0.00 16,800 60.00 1,008,000.00 0 60.00 0.00 0 60.00
60.00 0.00 15,300 60.00 918,000.00 0 60.00 0.00 0 60.00 0.00 0 60.00
60.55 0.00 0 60.55 0.00 20,000 60.55 1,211,000.00 0 60.55 0.00 0 60.55
49,000.00 0.00 0 49,000.00 0.00 20 49,000.00 980,000.00 0 49,000.00 0.00 0 49,000.00
13,400.00 0.00 13 13,400.00 174,200.00 0 13,400.00 0.00 0 13,400.00 0.00 0 13,400.00
13,400.00 0.00 10 13,400.00 134,000.00 3 13,400.00 40,200.00 0 13,400.00 0.00 0 13,400.00
66.00 0.00 0 66.00 0.00 1,000 66.00 66,000.00 0 66.00 0.00 0 66.00
65.00 0.00 0 65.00 0.00 4,000 65.00 260,000.00 0 65.00 0.00 0 65.00
65.00 0.00 8,630 65.00 560,950.00 0 65.00 0.00 0 65.00 0.00 0 65.00
75.00 0.00 1,000 75.00 75,000.00 0 75.00 0.00 0 75.00 0.00 0 75.00
75.00 0.00 1,000 75.00 75,000.00 0 75.00 0.00 0 75.00 0.00 0 75.00
75.00 0.00 3,000 75.00 225,000.00 0 75.00 0.00 0 75.00 0.00 0 75.00
75.00 0.00 4,560 75.00 342,000.00 0 75.00 0.00 0 75.00 0.00 0 75.00
1,618.00 0.00 30 1,618.00 48,540.00 0 1,618.00 0.00 0 1,618.00 0.00 0 1,618.00
5,950.00 0.00 0 5,950.00 0.00 20 5,950.00 119,000.00 0 5,950.00 0.00 0 5,950.00
594.00 0.00 25 594.00 14,850.00 25 594.00 14,850.00 0 594.00 0.00 0 594.00
303.49 68,285.25 0 303.49 0.00 0 303.49 0.00 0 303.49 0.00 0 303.49
132,000.00 0.00 8 132,000.00 1,056,000.00 0 132,000.00 0.00 0 132,000.00 0.00 0 132,000.00
100,000.00 0.00 0 100,000.00 0.00 8 100,000.00 800,000.00 0 100,000.00 0.00 0 100,000.00
252.00 0.00 0 252.00 0.00 500 252.00 126,000.00 0 252.00 0.00 0 252.00
9,324.00 0.00 0 9,324.00 0.00 50 9,324.00 466,200.00 0 9,324.00 0.00 0 9,324.00
12,600.00 0.00 20 12,600.00 252,000.00 0 12,600.00 0.00 0 12,600.00 0.00 0 12,600.00
7,260.00 0.00 0 7,260.00 0.00 175 7,260.00 1,270,500.00 0 7,260.00 0.00 0 7,260.00
2,007.00 0.00 121 2,007.00 242,847.00 0 2,007.00 0.00 0 2,007.00 0.00 0 2,007.00
63.00 0.00 0 63.00 0.00 4,100 63.00 258,300.00 0 63.00 0.00 0 63.00
90.00 0.00 0 90.00 0.00 5,000 90.00 450,000.00 0 90.00 0.00 0 90.00
22.00 0.00 4,368 22.00 96,096.00 3,000 22.00 66,000.00 0 22.00 0.00 0 22.00
51.00 0.00 0 51.00 0.00 15,900 51.00 810,900.00 0 51.00 0.00 0 51.00
166.00 0.00 0 166.00 0.00 19,800 166.00 3,286,800.00 0 166.00 0.00 0 166.00
850.00 0.00 0 850.00 0.00 100 850.00 85,000.00 0 850.00 0.00 0 850.00
126.00 0.00 0 126.00 0.00 1,000 126.00 126,000.00 0 126.00 0.00 0 126.00
133.00 0.00 0 133.00 0.00 3,000 133.00 399,000.00 0 133.00 0.00 0 133.00
133.00 0.00 2,860 133.00 380,380.00 1,000 133.00 133,000.00 0 133.00 0.00 0 133.00
2,100.00 0.00 0 2,100.00 0.00 100 2,100.00 210,000.00 0 2,100.00 0.00 0 2,100.00
2,190.00 0.00 96 2,190.00 210,240.00 100 2,190.00 219,000.00 0 2,190.00 0.00 0 2,190.00
15,350.00 0.00 0 15,350.00 0.00 2 15,350.00 30,700.00 0 15,350.00 0.00 0 15,350.00
21,747.00 0.00 2 21,747.00 43,494.00 0 21,747.00 0.00 0 21,747.00 0.00 0 21,747.00
80,000.00 0.00 3 80,000.00 240,000.00 0 80,000.00 0.00 0 80,000.00 0.00 0 80,000.00
24,200.00 0.00 6 24,200.00 145,200.00 0 24,200.00 0.00 0 24,200.00 0.00 0 24,200.00
60,000.00 0.00 10 60,000.00 600,000.00 0 60,000.00 0.00 0 60,000.00 0.00 0 60,000.00
52,000.00 0.00 0 52,000.00 0.00 5 52,000.00 260,000.00 0 52,000.00 0.00 0 52,000.00
39,820.00 0.00 4 39,820.00 159,280.00 0 39,820.00 0.00 0 39,820.00 0.00 0 39,820.00
5,367.00 316,653.00 0 5,367.00 0.00 0 5,367.00 0.00 0 5,367.00 0.00 0 5,367.00
4,000.00 0.00 0 4,000.00 0.00 0 4,000.00 0.00 0 4,000.00 0.00 0 4,000.00
3,600.00 0.00 0 3,600.00 0.00 20 3,600.00 72,000.00 0 3,600.00 0.00 0 3,600.00
3,600.00 0.00 40 3,600.00 144,000.00 0 3,600.00 0.00 0 3,600.00 0.00 0 3,600.00
847.00 0.00 94 847.00 79,618.00 0 847.00 0.00 0 847.00 0.00 0 847.00
40,700.00 0.00 3 40,700.00 122,100.00 0 40,700.00 0.00 0 40,700.00 0.00 0 40,700.00
211.20 0.00 90 211.20 19,008.00 0 211.20 0.00 0 211.20 0.00 0 211.20
211.20 0.00 0 211.20 0.00 1,000 211.20 211,200.00 0 211.20 0.00 0 211.20
Laporan Keuangan SKPD Kecamatan Prambanan yang terdiri dari (a) Laporan Realisasi Angaran;
(b) Neraca; (c)Laporan Operasional ; (d) Laporan Perubahan Ekuitas; (e) Catatan Atas Laporan
Keuangan Tahun Anggaran 2022 Sebagaimana terlampir adalah tanggung jawab kami.
Laporan Keuangan tersebut telah disusun berdasarkan sistem pengendalian intern yang memadai, dan
isinya telah menyajikan informasi pelaksanaan anggaran, posisi keuangan dan catatan atas laporan
keuangan secara layak sesuai dengan standar akuntansi pemerintahan
…………………………………
Pembina
NIP. ………………………………….
Lampiran 8
PEMERINTAH KABUPATEN KLATEN
DAFTAR BOT ( Built Operate Transfer )
PER 31 DESEMBER 2022
Dinas/Kantor/Badan:
No Sumber Dana Lokasi Penggunaan Luas ( M ) Tahun Perolehan Nilai ( Rp ) Keterangan
1 2 3 4 5 6 7 8
…………………………………………………………
PEMBINA
NIP. …………………………………………………………..
PEMERINTAH KABUPATEN KLATEN
DAFTAR PIUTANG
PER 31 DESEMBER 2022
Dinas/Kantor/Badan:
……………………………………
PEMBINA
NIP. ……………………………………
PEMERINTAH KABUPATEN KLATEN
PENYISIHAN PIUTANG TAK TERTAGIH
PER 31 DESEMBER 2022
SKPD :
PENYISIHAN PIUTAN
Lancar Kurang Lancar
NO. Jenis Piutang Jumlah (Rp) Tanggal SKRD
0-6 bulan > 6 bln - 1 tahun
0.5% 10%
1 2 3 4 5 6
1
2
3
4
5
6
7
TOTAL - - -
Keterangan :
* Perhitungan penyisihan piutang berpedoman pada
Peraturan Bupati Nomor 40 Tahun 2021 Tentang
Perubahan Ketiga Lampiran Peraturan Bupati Klaten Nomor 25 Tahun 2017
Tentang Kebijakan Akuntansi Pemerintah Kabupaten Klaten
Cara Pengisian :
1 Kolom 1 diisi dengan nomor urut
2 Kolom 2 diisi dengan jenis piutang retribusi atau pajak
3 Kolom 3 diisi dengan jumlah rupiah piutang pendapatan
4 Kolom 4 diisi dengan tanggal diterbitkannya SKRD atau SKPD
5 Kolom 5 diisi dengan penyisihan piutang kategori lancar (kolom 3 dikalikan dengan besaran presentase penyisihan piutang kategori lancar)
6 Kolom 5 diisi dengan penyisihan piutang kategori kurang lancar (kolom 3 dikalikan dengan besaran presentase penyisihan piutang kategori kurang lanc
7 Kolom 5 diisi dengan penyisihan piutang kategori diragukan (kolom 3 dikalikan dengan besaran presentase penyisihan piutang kategori diragukan)
8 Kolom 5 diisi dengan penyisihan piutang kategori macet (kolom 3 dikalikan dengan besaran presentase penyisihan piutang kategori macet)
9 Kolom 9 diisi dengaan total penyisihan piutang (penjumlahan kolom 5,6,7 dan 8)
Lampiran 9b
PENYISIHAN PIUTANG *
Diragukan Macet
Total
> 1 - 3 tahun > 3 tahun (Rp)
50% 100%
7 8 9 = 5+7+8+9
- - -
……………………………….
PEMBINA
NIP. ……………………………
kategori lancar)
piutang kategori kurang lancar)
tang kategori diragukan)
kategori macet)
PEMERINTAH KABUPATEN KLATEN
DAFTAR PIUTANG REKLASIFIKASI DANA BERGULIR
PER 31 DESEMBER 2022
Dinas/Kantor/Badan:
1
2
3
4
5
6
7
8
9
10
11
12
13
Lampiran 10a
ATEN
NA BERGULIR
………………………………..
PEMBINA
NIP. ……………………………..
Lampiran 10b
PEMERINTAH KABUPATEN KLATEN
PENYISIHAN PIUTANG TAK TERTAGIH REKLASIFIKASI DANA BERGULIR
PER 31 DESEMBER 2022
SKPD :
Jumlah
…………………………………..
PEMBINA
NIP. …………………………………
Lampiran 11
PEMERINTAH KABUPATEN KLATEN
DAFTAR BEBAN DIBAYAR DIMUKA
PER 31 DESEMBER 2022
SKPD ………………………….
TOTAL - -
Ka. OPD
…………………………………………..
Pembina
NIP…………………………………….
Lampiran 12
PEMERINTAH KABUPATEN KLATEN
DAFTAR UTANG BEBAN
PER 31 DESEMBER 2022
SKPD ………..
JUMLAH -
Catatan: Utang Beban adalah semua beban yang masih harus dibayar di tahun anggaran
Berikutnya.
Klaten, 31 Januari 2023
Ka. OPD
………………………………………
Pembina
NIP………………………………..
PEMERINTAH KABUPATEN KLATEN
LAPORAN REALISASI KEGIATAN DANA DEKONSENTRASI / TUGAS PEMBANTUAN
SAMPAI DENGAN 31 DESEMBER 2022
SKPD:
URAIAN ANGGARAN
NOMOR
2022
1 2 3
SURPLUS / (DEFISIT )
SISA LEBIH PEMBIAYAAN ANGGARAN ( SILPA )
*
Lampiran 13
KLATEN
ENTRASI / TUGAS PEMBANTUAN
MBER 2022
……………………………………….
PEMBINA
NIP. ………………………………………
PEMERINTAH KABUPATEN KLATEN
DAFTAR TPTGR
PERIODE JANUARI S/D DESEMBER 2022
1 2 3 4 5
Jumlah
Lampiran 14
ATEN
R 2022
………………………………..
PEMBINA
NIP. ……………………………
PEMERINTAH KABUPATEN KLATEN
DAFTAR PENYERTAAN MODAL (INVESTASI) DAERAH
PER 31 DESEMBER 2022
No Tahun Nama Dasar Hukum Bentuk Jumlah Jumlah Penyertaan Jumlah modal
Penyertaan Badan/Lemba Penyertaan Penyertaan Penyertaan Modal yang Modal tahun yang telah
Modal ga/Pihak Modal Modal telah ini disertakan
Ketiga (Investasi) Daerah disertakan sampai
daerah sampai dengan akhir
dengan tahun ini
awal tahun
1 2 3 4 5 6 7 8 9 = (7+8)
Lampiran 15
AH
………………………………………………..
PEMBINA
NIP. ………………………………………………
Lampiran 16
PEMERINTAH KABUPATEN KLATEN
DINAS PEMBERDAYAAN MASYARAKAT DAN DESA
Alamat : JL.TERATAI No.2 KP.PONDOK, KLATEN.
TELP. (0272) 321647
KODE
URAIAN ANGGARAN (Rp.) REALISASI (Rp.) LEBIH/ KURANG (Rp.) KET.
REKENING
1 2 3 4 5 6
1 PENDAPATAN
1 1 Pendapatan Asli Desa 0.00 0.00 0.00
1 2 Pendapatan Transfer 0.00 0.00 0.00
1 3 Pendapatan Lain lain 0.00 0.00 0.00
JUMLAH PENDAPATAN 0.00 0.00 0.00
0.00
2 BELANJA 0.00
Bidang Penyelenggaraan
2 1 0.00 0.00 0.00
Pemerintahan Desa
Bidang Pelaksanaan Pembangunan
2 2 0.00 0.00 0.00
Desa
2 3 Bidang Pembinaan Kemasyarakatan 0.00 0.00 0.00
2 4 Bidang Pemberdayaan Masyarakat 0.00 0.00 0.00
2 5 Bidang Tak Terduga 0.00 0.00 0.00
JUMLAH BELANJA 0.00 0.00 0.00
0.00
SURPLUS / DEFISIT 0.00 0.00 0.00
0.00
3 PEMBIAYAAN 0.00
3 1 Penerimaan Pembiayaan 0.00 0.00 0.00
3 2 Pengeluaran Pembiayaan 0.00 0.00 0.00
- Pembiayaan Netto (PENERIMAAN
PEMBIAYAAN –PENGELUARAN 0.00 0.00 0.00
PEMBIAYAAN )
- SILPA tahun berjalan (SELISIH
ANTARA PEMBIAYAAN NETTO 0.00 0.00 0.00
DENGAN HASIL SURPLUS/DEFISIT)
………………………………………………..
PEMBINA
NIP. ………………………………………………
Lampiran 17
REKAPITULASI LAPORAN REALISASI PELAKSANAAN ANGGARAN DAN BELANJA DESA
KABUPATEN KLATEN
TAHUN ANGGARAN 2022
31-Jan-23
KEPALA DINAS PEMBERDAYAAN MASYARAKAT
DAN DESA KABUPATEN KLATEN
DATA BERMASALAH
ASET DESA
A.Aset Lancar B. Aset Tidak Lancar Kewajiban Jangka Jumlah Kekayaan
No Nama Desa
4. Aset Tidak Jumlah Aset Tidak Jumlah Aset Desa Pendek Bersih
1. Kas Desa 2. Piutang 3. Persediaan Jumlah Aset Lancar 1. Investasi Permanen 2. Aset Tetap 3. Dana Cadangan
lancar Lainnya lancar
1 2 3 4 5 6 (3+4+5) 7 8 9 10 11 (7+8+9+10) 12 (6+11) 13 14 (12-13)
1 KECAMATAN PRAMBANAN
DESA SENGON 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA CUCUKAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA KOTESAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA PERENG 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA KEBONDALEM KIDUL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA TLOGO 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA TAJI 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA SANGGRAHAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA GENENG 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA KEMUDO 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA BUGISAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA KOKOSAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA KEBONDALEM LOR 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA BRAJAN 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA RANDUSARI 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
DESA JOHO 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
2 Dst….
JUMLAH 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
………………………………………………..
PEMBINA
NIP. ………………………………………………
DAFTAR PENGAMPU