DAFTAR HASIL PEMERIKSAAN FISIK BARANG PERSEDIAAN

SEMESTER I TAHUN 2023

NAMA AUDITI : PUSKESMAS CIPEUNDEUY

ALAMAT : JL. RAYA MALINGPING-SAEKTI KM.9 KP.GINTUNG DS. CIPEUNDEUY KEC. MALINGPING KAB. LEBAK
NAMA PIMPINAN AUDITI : M. ARIFUDIN, S.Sos.,M.Kes
NAMA PENGURUS BARANG : AEP SAEPULLAH,Amd.Kep
NO SK PENGURUS BARANG : 032/Kep.41-BKAD/2022
TANGGAL SK : 12 JANUARI 2022
TANGGAL CUT OFF : 31 DESEMBER 2022

penerimaan pengeluaran
SISA PER 31 SALDO (Sisa
(1 Januari s/d ( (1 Januari s/d Harga Jumlah Nilai
NO URAIAN (NAMA BARANG/ALAT) Desember per 30 Januari Keterangan
31 Januari 31 Januari Satuan (Rp) Persediaan (Rp)
2022 2023)
2023) 2023`)
1 2 3 4 5 6= (3+4-5) 7 8 = (6 x 7) 9
I ALAT TULIS KANTOR
1 Pulpen - - - - 4,000 -
2 Post It 25 X 75 2 - 2 - 16,300 -
3 Binder Clip - - - - 25,000 -
4 Amplop Putih 90 11 X 23 - - - - 575 -
5 Isi Staples No.10 - - - - 6,875 -
6 Buku Polio 100 Lembar - - - - 18,750 -
7 Stabillo All Color - - - - 18,500 -
8 Gunting Besar - - - - 18,500 -
9 Spidol Permanent hitam - - - - 10,000 -
10 Map Pocket Diamond - - - - 215,000 -
11 Lem Stik - 35 Gr - - - - 18,000 -
12 Ordner 1 - - 1 258,500.00 258,500
14 Kwitansi besar 1 - - 1 6,600.00 6,600
17 Spidol White Board - - - - 12,000.00 -
18 Stapler HD10 - - - - 25,000.00 -
19 Buku Tamu Besar - Batik - - - - 25,000.00 -
20 Cutter L500 - - - - 22,000.00 -
21 Isi Cutter besar - - - - 10,000.00 -
22 Nota 1 Play - - - - 4,200.00 -
Amplop putih 104 - Size 9.5 x 15.2 Cm 25,000.00
23 - - - - -
24 Pulpen H/B/M 0.8mm - - - - 22,000.00 -
25 Amplop Map Folio - - - - 123,000.00 -
26 Lem Stik - 35GR - - - - 18,000.00 -
27 Lakban - 1 1/2 - - - - 17,500.00 -
28 Remover - - - - - 30,000.00 -
29 Cutter A300 - - - - 10,500.00 -
30 Isi Cutter A 300 - - - - 6,500.00 -
31 Bak stempel - no.2 - - - - 18,500.00 -
32 Tinta Stempel - - - - - 12,500.00 -
33 Penggaris Besi - 30CM - - - - 18,500.00 -
34 Double Tape Busa - 1 - - - - 24,000.00 -
35 Trigonal Paper Clip - No. 1 - - - - 4,000.00 -
Amplop Coklat Folio - 80 GRSize: 240 62,500.00
36
mm x 345 mm - - - - -
Kertas -
37 Kertas F4 - - - - 50,000 -
38 Kertas A4 70 gram ( Sinar Dunia ) - - - - 40,000 -
39 Kartu Pasien 1,700 - - 1,700 300 510,000
Alat Kebersihan -
40 Sapu Lidi Tangkai - - - - 18,450 -
41 Sapu Nylon - - - - 33,800 -
42 Ember - - - - 18,450 -
43 Tempat Sampah 20 Liter - - - - 80,000 -
44 Gayung - - - - 12,300 -
45 Sikat Tangkai - - - - 55,000 -
46 Kemoceng Nylon - - - - 14,750 -
47 Sabun Cream/Cuci - - - - 10,000 -
48 Cairan Pembersih WC - - - - 24,600 -
49 Plastik Sampah Hitam 90x120 - - - - 18,450 -
50 Keset Welcome Kain Besar - - - - 61,500 -
51 Sabun Cucu Piring - - - - 8,000 -
52 Lap tangan gantung microfiber - - - - 60,000 -
53 Kop WC - - - - 18,450 -
54 Kamper Bola - - - - 18,450 -
55 Wipol - - - - 18,500 -
56 Mop Complete - - - - 67,650 -
Bahan / Alat Pakai Habis Lainnya -
57 Benda Pos (Materai) - - - - 10,000 -
58 Tinta Epson Cyan Ink - - - - 82,400 -
59 Tinta Epson Magenta Ink - - - - 110,700 -
60 Tinta Epson Yellow Ink - - - - 110,700 -
61 Tinta Epson Balck - - - - 110,700 -
62 Oksigen Besar - - - - 200,000 -
 63 Oksigen Kecil - - - - 150,000 -
JUMLAH PERSEDIAAN PAKAI
- 775,100
HABIS I
II OBAT DAN BMHP BLUD/ JKN -
64 Abocath No. 24 21 - - 21 8,514 178,794
65 Alkohol Swab (Aximed) - - 31,680 -
Blood Transfusion Set (Transufusi
66 7 - - 7 85,426
Darah) 597,982
67 Examination Gloves Size 6.0 217 - - 217 16,610 3,604,370
68 Examination Gloves Size 6.5 250 - - 250 3,256 814,000
69 Examination Gloves Size 7.0 137 - - 137 3,597 492,789
70 Foley Catheter No 10 15 - - 15 9,350 140,250
71 Foley Catheter No 18 14 - - 14 99,275 1,389,850
72 Kateter Penghisap Lendir 5 - - 5 293,150 1,465,750
73 Oxygen Canula 15 - - 15 5,720 85,800
74 Three-Way Stopcock ( Steril ) 10 - - 10 5,632 56,320
75 Umbilical Cord Clamp (Onemed) - - - - 2,750 -
76 Underpad (Cosmomed ) 260 50 210 4,620 970,200
77 Plaster - - - - 20,000 -
78 Acyclovir Tablet 400 Mg - - - - 310 -
79 Adalat Oros 30 - - 30 340,000 10,200,000
80 Adrome 700 - - 700 600 420,000
81 Alletrol Sm - - - - 11,500 -
82 Alletrol Tm - - - - 15,500 -
83 Allopurinol Tablet 100 Mg - - - - 238 -
84 Alpara - - - - 92,000 -
85 Ambroxol 30 Mg 2,400 - - 2,400 145 348,000
86 Amlodipine Tablet 10 Mg - - - - 410 -
87 Amoxycillin Sirup 125 Mg/5 Ml 1,829 - - 1,829 4,000 7,316,000
88 Amoxycillin Sirup 250 Mg/5 Ml - - - - 7,200 -
89 Amoxycillin Tablet 500 Mg 20,400 - 20,400 370 7,548,000
90 Antacida Sirup 400 Mg/5 Ml - - - - 300 -
91 Antacida Tablet - - - - 155 -
92 Anti Tetanus - - - - 200,000 -
93 Antihemoroid Suppositoria - - - - 6,200 -
94 Aqua Pro Injeksi Injeksi - - - - 12,000 -
95 Betahistine - - - - 390 -
96 Betametason Cream 1 Mg - - - - 3,200 -
97 Bioplacenton Gel 6 - - 6 24,000 144,000
98 Bisoprolol 5 Mg 150 - - 150 600 90,000
99 Bledstop ( Mhetylergometrine) 900 - - 900 1,000 900,000
100 Calsium Glukonas 10 Ml Injek 8 - 8 30,000 240,000
101 Candasartan Tab 8 Mg - - - 2,400 -
102 Captopril Tablet 25 Mg 4,100 - - 4,100 260 1,066,000
103 Cefadroxil Sirup Kering 125Mg - - - - 7,600 -
104 Cefixime - - - - 960 -
105 Cendo Lyteers Tm - - - - 28,000 -
106 Cetirizine 2,000 - - 2,000 265 530,000
107 Chlorpeniramine Maleat 4 Mg (Ctm) 6,000 - - 6,000 100 600,000
Ciprofloxacin Tablet Salut Selaput
108 - - - - 600
500 Mg -
109 Clopidogrel 75 Mg 42 - - 42 2,420 101,640
110 Cloramphenicol Salep Kulit - - - - 7,000 -
111 Cotrimoxazole Tablet 480 Mg - - - - 275 -
112 Dexamethasone Tablet 0.5 Mg 2,000 - - 2,000 100 200,000
113 Dextral Syr - - - - 9,000 -
114 Dios - - - - 4,800 -
115 Domperidone Tablet 10 Mg 6,700 - - 6,700 210 1,407,000
116 Erythromycin Capsul 500 Mg - - - - 1,252 -
117 Flukonazole 150 Mg 50 - - 50 25,200 1,260,000
118 Furosemid Tablet - - - - 206 -
119 Gentamicin 0,1 % Sk - - - - 4,200 -
120 Glibenklamid Tablet 5 Mg 900 1,000 - 1,900 192 364,800
121 Glimepiride Tablet 1 Mg - - - - 624 -
122 Glimepiride Tablet 2Mg - - - - 780 -
123 Glukosa 10% Cairan Infus 20 - - 20 10,000 200,000
124 Glukosa 5% Cairan Infus 19 - - 19 10,000 190,000
125 Griseofulvin Tablet 125 Mg - - - - 386 -
126 Guaifenesin 1,000 - 1,000 - 130 -
127 Hydrocortisone 2,5 % - - - - 5,200 -
128 Ibuprofen Sirup 100 Mg/5 Ml - - - - 6,000 -
129 Ibuprofen Sirup 200 Mg/5 Ml 22 - - 22 7,800 171,600
130 Kalsium Laktat Tablet 500 Mg - - - - 90 -
131 Ketokonazole 200 Mg 1,500 - - 1,500 460 690,000
132 Ketroprofen Supp - - - - 22,000 -
133 Laxadine Syr 5 - - 5 40,000 200,000
134 Lerzin Syr 15 - - 15 5,100 76,500
135 Loratadine 550 - - 550 354 194,700
136 Metformin Tablet 500 Mg 800 - - 800 200 160,000
137 Methylprednisolone Tablet 4 Mg 2,900 - - 2,900 293 849,700
138 Metronidazole 500 Mg - - - - 350 -
139 Mgso4 Injeksi 40% - - - - 13,000 -
140 Mhetylergometrine Injek 170 - - 170 6,000 1,020,000
141 Miconazole Salep 2% - - 5,600 -
142 Misoprostol 10 - - 10 6,280 62,800
143 Mixcrolax Supp 2 - - 2 24,500 49,000
144 Natrium Clorida 0.9% Infus 2 - - 2 9,500 19,000
145 Natrium Diklofenak Tablet 50 Mg - - - - 370 -
146 Neo K - - - - 15,000 -
147 Nifedipine Tablet 10 Mg 200 - - 200 240 48,000
148 Nystatin Drop - - - - 20,000 -
149 Nystatin Tab 100.000 Ui - - - - 1,065 -
150 Obh Syr 142 - - 142 5,200 738,400
151 Omedom Syr 140 - - 140 4,500 630,000
152 Omeprazole Capsul 20Mg - - - - 400 -
153 Oxytosine - - - - 5,000 -
154 Paracetamol 160 Mg Supp 20 - - 20 9,600 192,000
155 Paracetamol 80 Mg Supp 40 - - 40 8,000 320,000
Paracetamol Drop 100 Mg/Ml Btl
156 - - - - 11,400
@15Ml (60Mg/0,6Ml) -
157 Paracetamol Sirup 120 Mg/5 Ml 1,000 - - 1,000 2,600 2,600,000
158 Paracetamol Tablet 500 Mg 2,000 - - 2,000 210 420,000
159 Prednisone Tablet 5 Mg - - - - 185 -
160 Proris Supp 30 - - 30 7,500 225,000
161 Ranitidine 150 Mg 1,700 - - 1,700 200 340,000
162 Salbutamol Tablet 4 Mg - - - - 158 -
163 Scabimite Sk - - - - 62,500 -
164 Scopma - - - - 1,150 -
165 Simvastati Tablet 20 Mg - - - - 350 -
166 Simvastatin Tablet 10 Mg 2,100 - 300 1,800 253 455,400
167 Sodium Bicarbonat 1,000 - - 1,000 170 170,000
168 Spasminal 1,900 - - 1,900 1,070 2,033,000
169 Thiamine Tablet 50 Mg - - - - 225 -
170 Vagistin Supp 3 - - 3 14,500 43,500
171 Vitamin B Complex 8,100 - - 8,100 190 1,539,000
172 Zinc 20 Mg Sirup - - - - 6,000 -
173 Zink 20 Mg Tab 2,000 - - 2,000 380 760,000
174 Anusolsupp / Superhoid 6 - - 6 6,200 37,200
175 Chloretil/Etil Chloride - - - - 210,000 -
JUMLAH PERSEDIAAN PAKAI
- 56,966,345
HABIS OBAT BLUD II
III BERSUMBER DARI APBN - -
176 Coronavac 1 dosis - - - - 211,282 -
177 Coronavac 2 dosis - - - - 422,564 -
178 Coronavac 10 dosis - - - - 1,339,440 -
179 Moderna 14 dosis - - - - 4,298,000 -
180 Sinopharm - - - - 128,586 -
181 AstraZeneca - - - - 783,306 -
182 Pfizer - - - 2,003,742 -
183 ADS 3 cc - - - - 569 -
184 ADS 0,5 cc - - - - 1,185 -
185 ADS 0,3 cc - - - - 1,255 -
186 Alkohol Swab - - - - 95 -
187 Safety Bok - - - - 14,000 -
OBAT/ BMHP PROGRAM TB - -
188 Kategori I - 415,467 -
189 Kategori II - - - 1,199,900 -
190 Kategori Anak - - - 214,985 -
191 Reagen Zhiel Neelsen - - 214,500 -
192 Pot Dahak - - 2,850 -
193 Kombipak Kategori I - - - 359,985 -
194 Slide - - 17,604 -
195 Masker Hijab - - 15,700 -
OBAT/ BMHP PROGRAM CACING - 1,206,800
196 Albendazole Tablet 400 Mg 2,800 - - 2,800 431 1,206,800
JUMLAH PERSEDIAAN PAKAI
- 1,206,800
HABIS OBAT APBN III
OBAT BERSUMBER DARI APBD -
OBAT/BMHP PELAYANAN
-
KESEHATAN DASAR (PKD)
TABLET -
197 Allopurinol Tablet 100 Mg 2,400 - 700 1,700 105 178,500
198 Amlodipine Tablet 10 Mg - 2,000 - 2,000 99 198,000
199 Amlodipine Tablet 10 Mg - - - - 70 -
200 Amoxycillin Tablet 250 Mg - - - - 253 -
201 Amoxycillin Tablet 500 Mg 2,000 - - 2,000 201 402,000
AMBROXOL 30Mg (HOLICOS Tab) 500 1,000 1,500
202 Antacida Tablet 1,000 2,000 1,000 2,000 54 108,000
Asam Ascorbat (Vitamin C) Tablet 50
203 - - - - 105
Mg -
ALBENDAZOLE TABLET 400 MG 2,800 2,800 -
204 Asam Mefenamat 500 Mg 300 - 300 - 111 -
205 Pularex 630 Mg 600 - - 600 162 97,200
CARBAMAZEPINE TABLET 200 MG - - - -
206 Cetirizine Capsul 10 Mg 800 1,000 300 1,500 49 73,500
207 Chlorpeniramine Maleat 4 Mg (Ctm) 1,000 - - 1,000 23 23,000
208 Cotrimoxazole Tablet 480 Mg 2,800 - - 2,800 133 372,400
209 Dexamethasone Tablet 0.5 Mg 900 - - 900 75 67,500
210 OBAT FLU DAN BATUK (DEXTRAL KAPLET) 300 300 - 600 556 333,600
211 Furosemid Tablet - - - - 82 -
212 Garam Oralit 2,100 - 100 2,000 280 560,000
213 Glibenklamid Tablet 5 Mg 900 - - 900 82 73,800
Guaifenesin Tablet (Obat Batuk
214 1,000 - - 1,000 202
Ekspektoran) 202,000
215 Griseofulvin Tablet 250Mg - - - - 1,773 -
216 Kalium Diklofenak 50 Mg - - - - 706 -
217 Kalsium Glukonas - - - - 3,500 -
218 Kalsium Laktat Tablet 500 Mg - - - - 59 -
219 Metformin Tablet 500 Mg 600 - - 600 77 46,200
220 Methylprednisolone Tablet 4 Mg - - - - 102 -
221 Molagit 600 - - 600 474 284,400
222 Paracetamol Tablet 500 Mg 2,000 - - 2,000 150 300,000
223 Prednisone Tablet 5 Mg 8,600 - - 8,600 73 627,800
224 Pritagesic Capstab 1,300 - - 1,300 568 738,400
225 Pyridoxine Tablet - - - - 131 -
226 Ranitidine 150 Mg 500 - - 500 85 42,500
227 Salbutamol Tablet 4 Mg - - - - 67 -
228 Simvastatin Tablet 10 Mg 300 - - 300 68 20,400
229 Tablet Tambah Darah 102,450 - 17,450 85,000 228 19,380,000
230 Thiamine Tablet 50 Mg - - - - 91 -
231 Vitamin A 100000 Iu - - - - 248 -
232 Vitamin A 200000 Iu 1,250 - 50 1,200 539 646,800
233 Vitamin B Complex - - - - 118 -
234 Zinc Tablet 20 Mg 35,200 - - 35,200 208 7,321,600
235 Anti Influenza (Molexflu Captabs) - - - - 426 -
Anti Influenza Dan Batuk (Alpara
236 - - 620
Tablet) -
Antihemoroid & Udema (Dios Fillm
237 - - 4,180
Coated Tablet) -
Multivitamin Antioksidan (Antoksid
238 200 - - 200 773
Capsul 10 Strip @ 10 Kapsul) 154,600
Multivitamin Mineral Tablet (Livron B
239 2,200 2,800 1,600 3,400 281
Plex Tablet Salut Gula) 955,400
MULTIVITAMIN TABLET TAMBAH DARAH
240 (HEMAFORT TABLET SALUT GULA ) 4,000 - 300 3,700 846
3,130,200
Obat Gangguan Sistem Pencernaan
241 - - - - 528
(Lexacrol Tablet) -
242 Obat Hipertensi Herbal (Tensi Gard) - - 2,123 -
243 Probiotik (Probiokid) - - - - 13,640 -
244 Geriavita 1,800 - - 1,800 2,696 4,852,800
245 Orabloc 50 50 - 100 3,080 308,000
CAIRAN/SIRUP -
246 Ambroxol Holicos Syrup - - - - 9,889 -
247 Amoxycillin Sirup 125 Mg/5 Ml 500 - - 500 2,050 1,025,000
248 Antacida Sirup 400 Mg/5 Ml - - - - 1,995 -
249 Anti Influenza (Molexflu Syr) - - - - 6,510 -
250 Cairan Infus (Ringer Laktat 500Ml) 194 - - 194 7,630 1,480,220
251 Cotrimoxazole Sirup 240 Mg/5 Ml 100 - - 100 2,100 210,000
252 Dextral Syr 240 - - 240 9,570 2,296,800
253 Glukosa 5% Cairan Infus 123 - - 123 6,627 815,121
254 Natrium Clorida 0.9% Infus - - - - 6,410 -
255 Paracetamol Sirup 120 Mg/5 Ml 100 - - 100 1,160 116,000
256 Anti Diare (Neo Kaominal Suspensi) 56 - - 56 6,564 367,584
Multivitamin Sirup (Procurma Sirup
257 165 - 29 136 11,385
60 Ml) 1,548,360
258 Multivitamin Sirup (Stimuno Sirup) 110 - 10 100 28,118 2,811,800
259 Obat Batuk Herbal (Herbakof Sirup) 310 - 10 300 14,273 4,281,900
Obat Batuk Expectoran (Holidrylsirup
260 350 - 184 166 6,262
Botol 100 Ml) 1,039,492
OBAT FLU DAN BATUK (DEXTRAL SIRUP
261 BOTOL 60 ML) 240 - - 240
-
262 Obat Flu dan Batuk (Protexinal) 150 - - 150 6,262 939,300
SALEP/CREAM/TETES -
263 Betametason Cream 1 Mg - - 2,461 -
264 Chloramfenikol Tetes Mata 30 50 30 50 16,940 847,000
265 Chloramfenikol Tetes Telinga - 72 - 72 9,640 694,080
266 Cloramphenicol Salep Kulit 50 - - 50 3,242 162,100
267 Gentamicine Salep 0.1% (Sk) 24 24 24 24 3,520 84,480
268 Gentamicine Tetes 0.3% (Tm) - - 4,232 -
269 Hidrokortisone Krim 2.5% - - - - 2,325 -
270 Klorfeson Cream 143 - 59 84 8,300 697,200
271 Bevalex Cream - - - - 10,054 -
272 Salep 2-4 Kombinasi 12 24 12 24 1,410 33,840
273 Salep Antifungi DOEN 30 - 10 20 3,477 69,540
BMHP/BAHAN MEDIS HABIS PAKAI -
Blood Transfusion Set (Transufusi
273 86 - - 86 6,700
Darah) 576,200
274 Catgut Plain 3-0 75 Cm - - - - 37,203 -
275 Catgut Plain 3-0 76 Cm 34 - - 34 58,700 1,995,800
276 Cat Gut Chromic 3-0 75 Cm - - - - 37,203 -
277 Cat Gut Chromic 3-0 76 Cm 36 - - 36 58,700 2,113,200
278 Cat Gut Chromic 2-0 90 Cm - - - - 61,800 -
279 Cat Gut Chromic 3-0 90 Cm 24 - - 24 53,000 1,272,000
280 Disposible 20 Ml 29 - - 29 2,090 60,610
281 Disposible 10 Ml 28 - - 28 1,463 40,964
282 Disposible 1Ml 11,300 - - 11,300 641 7,243,300
283 Disposible 3 Ml 3,500 - - 3,500 924 3,234,000
284 Examination Gloves Size 6.5 179 - - 179 13,178 2,358,862
285 Examination Gloves Size M - - - - 40,733 -
286 Gynaecological Glove S 37 - - 37 13,178 487,586
287 Gynaecological Glove M 105 - - 105 13,178 1,383,690
288 Latex Foley Catheter - - 15,800 -
289 Infusion Set Anak (Cosmomed) 99 - - 99 4,400 435,600
290 Iv Catheter No 16 (Pen) 79 - - 79 4,700 371,300
291 Iv Catheter No 18 (Pen) - - - - 4,700 -
292 Iv Catheter No 20 (Pen) - - - - 7,100 -
293 Iv Catheter No 22 (Pen) - - - - 4,700 -
294 Iv Catheter No 24 (Pen) - - - - 4,700 -
295 Kapas Pembalut 250 G 1 - 1 12,500 12,500
296 Kasa 4 X 10 (Onemed) - - - - 590 -
297 Kasa 4X 5 (Onemed) - - - - 633 -
298 Kasa 16X16 (Onemed) - 30 30 - 3,500 -
299 Lubricating (My Jelly) 13 - - 13 44,391 577,083
300 Masker (Karet) - - - - 466 -
301 Nasal Oxygen Cannula (Cosmo Med) 182 - - 182 6,900
1,255,800
302 Nebulizer Mask (Dewasa ) 93 - - 93 14,400 1,339,200
303 Oxygen Masker (Anak)&(Dewasa) 153 - - 153 9,500 1,453,500
304 Pembalut Elastis - - - - 29,000 -
305 Suction Catheter No 8 100 - - 100 3,100 310,000
306 Test Glucose Strip (Benecheck) - - - - 137,500 -
307 Test Hemoglobin Strip - - - 400,000 -
308 Three - Way Stop Cock 88 - - 88 5,720 503,360
309 Umbilical Cord Clamp (Onemed) 150 - - 150 1,400 210,000
310 Underpad (Cosmomed ) 260 - 50 210 7,900 1,659,000
311 Urine Bag With Hanger (Cosmomed) 269 - - 269 5,500
1,479,500
INJEKSI/ SUPP -
312 Ascorin Vitamin C Injek 85 - - 85 23,000 1,955,000
313 Dexamethasone Cairan Injeksi 5 Mg - - 1,097 -
314 Diazepam Enema 10Mg/2.5Ml - - - - 18,279 -
315 Diazepam Enema 5Mg/2.5Ml 2 - - 2 12,573 25,146
Lidocain Plus Ephineprin (Pehacain
316 600 - - 600 3,080 1,848,000
Cairan Injeksi)
317 Oxytosine Injeksi 10 IU/Ml 1,395 - - 1,395 1,126 1,570,770
Phytomenadione (Vitamin K) Injeksi
318 291 - - 291 6,915 2,012,265
2 Mg/Ml
Serum Anti Bisa Ular Polivalen
319 1 - - 1 465,640 465,640
Injeksi
KEGIATAN PROGRAM -
PROGRAM IMUNISASI/VAKSIN -
320 VAKSIN UNIJEK ( HB0 ) 30 - 14 16 23,490 375,840
321 VAKSIN BCG 1,200 440 70 1,570 88,891 139,558,870
322 VAKSIN BCG - - - - 59,950 -
323 VAKSIN DPT-HB-HIB ( PENTABIO ) - 350 - 350 77,366 27,078,100
324 VAKSIN POLIO 20 300 20 300 19,540 5,862,000
325 VAKSIN POLIO - - - - 42,300 -
326 VAKSIN POLIO Injeksi ( IPV ) - 60 - 60 144,540 8,672,400
327 VAKSIN POLIO Injeksi ( IPV ) - - - - 139,000 -
VAKSIN PCV 96 24 28 92 144,540 13,297,680
328 VAKSIN MEASLES RUBELLA ( MR ) 470 250 90 630 152,600 96,138,000
329 VAKSIN MEASLES RUBELLA ( MR ) - - - - 136,200 -
330 VAKSIN DT - 50 - 50 31,273 1,563,650
331 VAKSIN DT - - - - 16,412 -
332 VAKSIN TD - 250 - 250 16,480 4,120,000
333 VAKSIN TD - - - - 16,500 -
334 AUTO DISABLE ( ADS ) 0,05 ML 60 440 60 440 1,460 642,400
335 AUTO DISABLE ( ADS ) 0,5 ML 470 330 90 710 1,190 844,900
336 AUTO DISABLE ( ADS ) 5 ML 47 44 9 82 1,460 119,720
337 VAKSIN Hbsag 2 - - 2 1,325,000 2,650,000
PROGRAM P2M - - - -
338 Yellow Tips - - 34 -
339 Vacuseara needle 3 cc - - 15,200 -
340 Vacutainer EDTA 3 cc - - 1,540 -
341 Alkohol SWAB (100 pcs) - - - - 12,000 -
Rapid Tes P2M - - - -
342 Rapid SD Hbsag (Hepattis) 150 450 - 600 4,125 2,475,000
343 Rapid SD HIV - 100 25 75 4,125 309,375
344 Rapid Syphilis (Trepocheck) 100 - - 100 9,300 930,000
PROGRAM Obat Jiwa - - -
345 Amitriptyline 25mg - - - - 167 -
346 Clobazam - - - - 776 -
347 Clozapine 25mg 90 - 40 50 1,121 56,050
348 Halloperidol 5mg 100 - - 100 -
349 Resperidon 2mg 180 - 100 80 287 22,960
350 Skizonoat 25mg/ml - 63,813 -
351 Trihexpyhenidyl 2mg 60 - - 60 91 5,460
KEGIATAN COVID 19 -
OBAT & BMHP COVID -
352 Apd ( Hazmat ) 35 - - 35 160,000 5,600,000
353 Alkohol Swab (Aximed) 56 - - 56 32,100 1,797,600
354 Hazmat Solid 3A 719 - - 719 110,520 79,463,880
355 Hansanitezer Spray ( Triton ) 351 - - 351 27,273 9,572,823
356 Disinfectan Spray ( Clitera ) 67 - - 67 146,250 9,798,750
357 Masker N95 Mask Nousmed 140 - - 140 13,636 1,909,040
358 Handscoon M ( Protos ) 30 - - 30 105,000 3,150,000
359 Kimsmed Disposible 1 Ml 11,000 - - 11,000 641 7,051,000
360 Face Sheild 24 - - 24 40,900 981,600
TEST DIAGNOSTIK COVID -
361 Rapid Test Covid Abbot - 82,973 -
362 Rapid Test Covid Viva Diag - - - - 55,000 -
363 Rapid Test Covid SD Biosensor - - - 81,907 -
ALAT DAN OBAT KONTRASEPSI
(DINAS KB)
-
364 Pil Kb 1,000 - - 1,000 1,153 1,153,000
365 Kondom 164 - - 164 7,294 1,196,216
366 Implant 60 - - 60 175,050 10,503,000
367 Kb Suntik 20 - - 20 4,800 96,000
BERSUMBER DARI BOK -
368 Masker Medis - - 60,000 -
369 Gown Disposable ( Apd ) - - - 150,000 -
370 Handsanitizer 500 Ml - - - 30,000 -
JUMLAH OBAT APBD IV 536,263,607
Jumlah OBAT 595,211,852
JUMLAH TOTAL (I+II+III+IV) - - 595,211,852

Jumlah Total Barang Persediaan Per Tanggal 30 Juni 2022 Rp 595.211.852,-

Tim Pemeriksa

Pengurus Barang 1. Aditya Suhartika, Amd.Kep (……………………)

NIP:199006062017042001

WINDA PUTRIANINGSIH
NIP. 19961107 202203 2 006 2. Eti hayati,Amd.Kep ( …………………… )
NIP :198603252017042002

Mengetahui,
Pengguna Barang
Kepala UPTD Puskesmas
3. Fatwa Firdaus,SKM ( …………………… )
NIP :19930427 202203 1 002

M. ARIFUDIN,S.Sos.,M.Kes
NIP. 19670919 198803 1 007
LAMPIRAN STOCK OPNAME BARANG PERSEDIAAN (Kertas Kerja Stok Opname)
NAMA AUDITI : PUSKESMAS CIPEUNDEUY
TAHUN ANGGARAN SO : 2022
TANGGAL PELAKSANAAN SO : 31 DESEMBER 2022

Persediaan 1 Januari s/d tgl uji petik

Sisa per 30
penerimaan Hasil Stok Opname
SISA PER 31 pengeluara Sisa per 30 2 Maret 2023 Januari
(1 Jan s/d SELISIH
NO URAIAN (NAMA BARANG/ALAT) Desember n (1 Jan s/d Januari Jumlah (tgl Nilai 2023
30 Januari STOCK
2022 30 Januari 2023 uji petik 2 Persediaan KET Jumlah Penambaha Penguranga (pemeriksaa
2023)
2023) Maret 2023) (Rp) n 2023 n 2023 n)
1 2 3 4 5 6= (3+4-5) 7 8 9 10=12-11 11 12 13 = (7-10) 14=6-10
I ALAT TULIS KANTOR - - - - - kosongkan
1 Pulpen - - - - - - baik - - - - -
2 Post It 25 X 75 2 - 2 - - - - - - - -
3 Binder Clip - - - - - - - - - - -
4 Amplop Putih 90 11 X 23 - - - - - - - - - - -
5 Isi Staples No.10 - - - - - - - - - - -
6 Buku Polio 100 Lembar - - - - - - - - - - -
7 Stabillo All Color - - - - - - - - - - -
8 Gunting Besar - - - - - - - - - - -
9 Spidol Permanent hitam - - - - - - - - - - -
10 Map Pocket Diamond - - - - - - - - - - -
11 Lem Stik - 35 Gr - - - - - - - - - - -
12 Ordner 1 - - 1 1 258,500 - - - 1 1
14 Kwitansi besar 1 - - 1 1 6,600 - - - 1 1
17 Spidol White Board - - - - - - - - - - -
18 Stapler HD10 - - - - - - - - - - -
19 Buku Tamu Besar - Batik - - - - - - - - - -
20 Cutter L500 - - - - - - - - - - -
21 Isi Cutter besar - - - - - - - - - - -
22 Nota 1 Play - - - - - - - - - - -
23 Amplop putih 104 - Size 9.5 x 15.2 Cm - - - - - - - - - - -
24 Pulpen H/B/M 0.8mm - - - - - - - - - - -
25 Amplop Map Folio - - - - - - - - - - -
26 Lem Stik - 35GR - - - - - - - - - - -
27 Lakban - 1 1/2 - - - - - - - - - - -
28 Remover - - - - - - - - - - - -
29 Cutter A300 - - - - - - - - - - -
30 Isi Cutter A 300 - - - - - - - - - - -
31 Bak stempel - no.2 - - - - - - - - - - -
32 Tinta Stempel - - - - - - - - - - - -
33 Penggaris Besi - 30CM - - - - - - - - - - -
34 Double Tape Busa - 1 - - - - - - - - - - -
35 Trigonal Paper Clip - No. 1 - - - - - - - - - - -
36 Amplop Coklat Folio - 80 GRSize: 240 mm x 345 - - - - - - - - - - -
- Kertas
37 Kertas F4 - - - - - - - - - - -
38 Kertas A4 70 gram ( Sinar Dunia ) - - - - - - - - - - -
39 Kartu Pasien 1,700 - - 1,700 300 510,000 - - - - 300 -
- Alat Kebersihan
40 Sapu Lidi Tangkai - - - - - - - - - - -
41 Sapu Nylon - - - - - - - - - - -
41 Ember - - - - - - - - - - -
43 Tempat Sampah 20 Liter - - - - - - - - - - -
42 Gayung - - - - - - - - - - -
45 Sikat Tangkai - - - - - - - - - - -
43 Kemoceng Nylon - - - - - - - - - - -
47 Sabun Cream/Cuci - - - - - - - - - - -
44 Cairan Pembersih WC - - - - - - - - - - -
49 Plastik Sampah Hitam 90x120 - - - - - - - - - - -
45 Keset Welcome Kain Besar - - - - - - - - - - -
51 Sabun Cucu Piring - - - - - - - - - - -
46 Lap tangan gantung microfiber - - - - - - - - - - -
53 Kop WC - - - - - - - - - - -
47 Kamper Bola - - - - - - - - - - -
55 Wipol - - - - - - - - - - -
48 Mop Complete - - - - - - - - - - -
- Bahan / Alat Pakai Habis Lainnya
57 Benda Pos (Materai) - - - - - - - - - - -
58 Tinta Epson Cyan Ink - - - - - - - - - - -
59 Tinta Epson Magenta Ink - - - - - - - - - - -
60 Tinta Epson Yellow Ink - - - - - - - - - - -
61 Tinta Epson Balck - - - - - - - - - - -
62 Oksigen Besar - - - - - - - - - - -
63 Oksigen Kecil - - - - - - - - - - -
- JUMLAH PERSEDIAAN PAKAI HABIS I - - - -
II OBAT DAN BMHP BLUD/ JKN
64 Abocath No. 24 21 - - 21 21 178,794 baik - - - 21 21
65 Alkohol Swab (Aximed) - - - - - - - - - - -
66 Blood Transfusion Set (Transufusi Darah) 7 - - 7 7 597,982 baik - - - 7 7
67 Examination Gloves Size 6.0 217 - - 217 217 3,604,370 baik - - - 217 217
68 Examination Gloves Size 6.5 250 - - 250 250 814,000 baik - - - 250 250
69 Examination Gloves Size 7.0 137 - - 137 137 492,789 baik - - - 137 137
70 Foley Catheter No 10 15 - - 15 15 140,250 baik - - - 15 15
71 Foley Catheter No 18 14 - - 14 14 1,389,850 baik - - - 14 14
72 Kateter Penghisap Lendir 5 - - 5 5 1,465,750 baik - - - 5 5
73 Oxygen Canula 15 - - 15 15 85,800 baik - - - 15 15
74 Three-Way Stopcock ( Steril ) 10 - - 10 10 56,320 baik - - - 10 10
75 Umbilical Cord Clamp (Onemed) - - - - - - - - - - -
76 Underpad (Cosmomed ) 260 - 50 210 210 970,200 baik - - - 210 210
77 Plaster - - - - - - - - - - -
78 Acyclovir Tablet 400 Mg - - - - - - - - - - -
79 Adalat Oros 30 - - 30 30 10,200,000 baik - - - 30 30
80 Adrome 700 - - 700 700 420,000 baik - - - 700 700
81 Alletrol Sm - - - - - - - - - - -
82 Alletrol Tm - - - - - - - - - - -
83 Allopurinol Tablet 100 Mg - - - - - - baii - - - - -
84 Alpara - - - - - - - - - - -
85 Ambroxol 30 Mg 2,400 - - 2,400 2,400 348,000 baik - - - 2,400 2,400
86 Amlodipine Tablet 10 Mg - - - - - -baik - - - - -
87 Amoxycillin Sirup 125 Mg/5 Ml 1,829 - - 1,829 1,829 7,316,000 baik - - - 1,829 1,829
88 Amoxycillin Sirup 250 Mg/5 Ml - - - - - - - - - - -
89 Amoxycillin Tablet 500 Mg 20,400 - - 20,400 20,400 7,548,000 baik - - - 20,400 20,400
90 Antacida Sirup 400 Mg/5 Ml - - - - - - - - - - -
91 Antacida Tablet - - - - - - - - - - -
92 Anti Tetanus - - - - - - - - - - -
93 Antihemoroid Suppositoria - - - - - - baik - - - - -
94 Aqua Pro Injeksi Injeksi - - - - - - baik - - - - -
95 Betahistine - - - - - - baik - - - - -
96 Betametason Cream 1 Mg - - - - - - - - - - -
97 Bioplacenton Gel 6 - - 6 6 144,000 baik - - - 6 6
98 Bisoprolol 5 Mg 150 - - 150 150 90,000 baik - - - 150 150
99 Bledstop ( Mhetylergometrine) 900 - - 900 900 900,000 baik - - - 900 900
100 Calsium Glukonas 10 Ml Injek 8 - - 8 8 240,000 baik - - - 8 8
101 Candasartan Tab 8 Mg - - - - - - baik - - - - -
102 Captopril Tablet 25 Mg 4,100 - - 4,100 4,100 1,066,000 baik - - - 4,100 4,100
103 Cefadroxil Sirup Kering 125Mg - - - - - - - - - - -
104 Cefixime - - - - - - - - - - -
105 Cendo Lyteers Tm - - - - - - - - - - -
106 Cetirizine 2,000 - - 2,000 2,000 530,000 baik - - - 2,000 2,000
107 Chlorpeniramine Maleat 4 Mg (Ctm) 6,000 - - 6,000 6,000 600,000 baik - - - 6,000 6,000
108 Ciprofloxacin Tablet Salut Selaput 500 Mg - - - - - - - - - - -
109 Clopidogrel 75 Mg 42 - - 42 42 101,640 baik - - - 42 42
110 Cloramphenicol Salep Kulit - - - - - - - - - - -
111 Cotrimoxazole Tablet 480 Mg - - - - - - - - - - -
112 Dexamethasone Tablet 0.5 Mg 2,000 - - 2,000 2,000 200,000 baik - - - 2,000 2,000
113 Dextral Syr - - - - - - baik - - - - -
114 Dios - - - - - - - - - - -
115 Domperidone Tablet 10 Mg 6,700 - - 6,700 6,700 1,407,000 baik - - - 6,700 6,700
116 Erythromycin Capsul 500 Mg - - - - - - - - - - -
117 Flukonazole 150 Mg 50 - - 50 50 1,260,000 baik - - - 50 50
118 Furosemid Tablet - - - - - - - - - - -
119 Gentamicin 0,1 % Sk - - - - - - - - - - -
120 Glibenklamid Tablet 5 Mg 900 1,000 - 1,900 1,900 364,800 baik - - - 1,900 1,900
121 Glimepiride Tablet 1 Mg - - - - - - - - - - -
122 Glimepiride Tablet 2Mg - - - - - - - - - - -
123 Glukosa 10% Cairan Infus 20 - - 20 20 200,000 baik - - - 20 20
124 Glukosa 5% Cairan Infus 19 - - 19 19 190,000 baik - - - 19 19
125 Griseofulvin Tablet 125 Mg - - - - - - baik - - - - -
126 Guaifenesin 1,000 - 1,000 - - - baik - - - - -
127 Hydrocortisone 2,5 % - - - - - - baik - - - - -
128 Ibuprofen Sirup 100 Mg/5 Ml - - - - - - - - - - -
129 Ibuprofen Sirup 200 Mg/5 Ml 22 - - 22 22 171,600 baik - - - 22 22
130 Kalsium Laktat Tablet 500 Mg - - - - - - - - - - -
131 Ketokonazole 200 Mg 1,500 - - 1,500 1,500 690,000 baik - - - 1,500 1,500
132 Ketroprofen Supp - - - - - - baik - - - - -
133 Laxadine Syr 5 - - 5 5 200,000 baik - - - 5 5
134 Lerzin Syr 15 - - 15 15 76,500 baik - - - 15 15
135 Loratadine 550 - - 550 550 194,700 baik - - - 550 550
136 Metformin Tablet 500 Mg 800 - - 800 800 160,000 baik - - - 800 800
137 Methylprednisolone Tablet 4 Mg 2,900 - - 2,900 2,900 849,700 baik - - - 2,900 2,900
138 Metronidazole 500 Mg - - - - - - baik - - - - -
139 Mgso4 Injeksi 40% - - - - - - baik - - - - -
140 Mhetylergometrine Injek 170 - - 170 170 1,020,000 baik - - - 170 170
141 Miconazole Salep 2% - - - - - - - - - - -
142 Misoprostol 10 - - 10 10 62,800 baik - - - 10 10
143 Mixcrolax Supp 2 - - 2 2 49,000 baik - - - 2 2
144 Natrium Clorida 0.9% Infus 2 - - 2 2 19,000 baik - - - 2 2
145 Natrium Diklofenak Tablet 50 Mg - - - - - - - - - - -
146 Neo K - - - - - - - - - - -
147 Nifedipine Tablet 10 Mg 200 - - 200 200 48,000 baik - - - 200 200
148 Nystatin Drop - - - - - - - - - - -
149 Nystatin Tab 100.000 Ui - - - - - - baik - - - - -
150 Obh Syr 142 - - 142 142 738,400 baik - - - 142 142
151 Omedom Syr 140 - - 140 140 630,000 baik - - - 140 140
152 Omeprazole Capsul 20Mg - - - - - - baik - - - - -
153 Oxytosine - - - - - - - - - - -
154 Paracetamol 160 Mg Supp 20 - - 20 20 192,000 - - - 20 20
155 Paracetamol 80 Mg Supp 40 - - 40 40 320,000 - - - 40 40
156 Paracetamol Drop 100 Mg/Ml Btl @15Ml (60Mg/ - - - - - - - - - - -
157 Paracetamol Sirup 120 Mg/5 Ml 1,000 - - 1,000 1,000 2,600,000 baik - - - 1,000 1,000
158 Paracetamol Tablet 500 Mg 2,000 - - 2,000 2,000 420,000 baik - - - 2,000 2,000
159 Prednisone Tablet 5 Mg - - - - - - baik - - - - -
160 Proris Supp 30 - - 30 30 225,000 baik - - - 30 30
161 Ranitidine 150 Mg 1,700 - - 1,700 1,700 340,000 baik - - - 1,700 1,700
162 Salbutamol Tablet 4 Mg - - - - - - - - - - -
163 Scabimite Sk - - - - - - - - - - -
164 Scopma - - - - - - baik - - - - -
165 Simvastati Tablet 20 Mg - - - - - - - - - - -
166 Simvastatin Tablet 10 Mg 2,100 - 300 1,800 1,800 455,400 baik - - - 1,800 1,800
167 Sodium Bicarbonat 1,000 - - 1,000 1,000 170,000 baik - - - 1,000 1,000
168 Spasminal 1,900 - - 1,900 1,900 2,033,000 baik - - - 1,900 1,900
169 Thiamine Tablet 50 Mg - - - - - - - - - - -
170 Vagistin Supp 3 - - 3 3 43,500 baik - - - 3 3
171 Vitamin B Complex 8,100 - - 8,100 8,100 1,539,000 baik - - - 8,100 8,100
172 Zinc 20 Mg Sirup - - - - - - baik - - - - -
173 Zink 20 Mg Tab 2,000 - - 2,000 2,000 760,000 baik - - - 2,000 2,000
174 Anusolsupp / Superhoid 6 - - 6 6 37,200 - - - 6 6
175 Chloretil/Etil Chloride - - - - - - - - - - -
- JUMLAH PERSEDIAAN PAKAI HABIS OBAT BLUD II - - - - - -
III BERSUMBER DARI APBN
176 Coronavac 1 dosis - - - - - - - - - - -
177 Coronavac 2 dosis - - - - - - - - - - -
178 Coronavac 10 dosis - - - - - - - - - - -
179 Moderna 14 dosis - - - - - - - - - - -
180 Sinopharm - - - - - - - - - - -
181 AstraZeneca - - - - - - - - - - -
182 Pfizer - - - - - - - - - - -
183 ADS 3 cc - - - - - - - - - - -
184 ADS 0,5 cc - - - - - - - - - - -
185 ADS 0,3 cc - - - - - - - - - - -
186 Alkohol Swab - - - - - - - - - - -
187 Safety Bok - - - - - - - - - - -
- OBAT/ BMHP PROGRAM TB
188 Kategori I - - - - - - - - - - -
189 Kategori II - - - - - - - - - - -
190 Kategori Anak - - - - - - - - - - -
191 Reagen Zhiel Neelsen - - - - - - - - - - -
192 Pot Dahak - - - - - - - - - - -
193 Kombipak Kategori I - - - - - - - - - - -
194 Slide - - - - - - - - - - -
195 Masker Hijab - - - - - - - - - - -
- OBAT/ BMHP PROGRAM CACING -
196 Albendazole Tablet 400 Mg 2,800 - - 2,800 2,800 1,206,800 - - - 2,800 2,800
- JUMLAH PERSEDIAAN PAKAI HABIS OBAT APBN III - - - - - -
- OBAT BERSUMBER DARI APBD - - - - - -
- OBAT/BMHP PELAYANAN KESEHATAN DASAR (PKD) - - - - - -
- TABLET
197 Allopurinol Tablet 100 Mg 2,400 - 700 1,700 1,700 178,500 baik - - - 1,700 1,700
198 Amlodipine Tablet 10 Mg - 2,000 - 2,000 2,000 198,000 - - - 2,000 2,000
199 Amlodipine Tablet 10 Mg - - - - - - baik - - - - -
200 Amoxycillin Tablet 250 Mg - - - - - - - - - - -
201 Amoxycillin Tablet 500 Mg 2,000 - - 2,000 2,000 402,000 baik - - - 2,000 2,000
202 Antacida Tablet 1,000 2,000 1,000 2,000 2,000 108,000 - - - 2,000 2,000
203 Asam Ascorbat (Vitamin C) Tablet 50 Mg - - - - - - - - - - -
204 Asam Mefenamat 500 Mg 300 - 300 - - - - - - - -
205 Pularex 630 Mg 600 - - 600 600 97,200 baik - - - 600 600
206 Cetirizine Capsul 10 Mg 800 1,000 300 1,500 1,500 73,500 baik - - - 1,500 1,500
207 Chlorpeniramine Maleat 4 Mg (Ctm) 1,000 - - 1,000 1,000 23,000 baik - - - 1,000 1,000
208 Cotrimoxazole Tablet 480 Mg 2,800 - - 2,800 2,800 372,400 baik - - - 2,800 2,800
209 Dexamethasone Tablet 0.5 Mg 900 - - 900 900 67,500 baik - - - 900 900
210 OBAT FLU DAN BATUK (DEXTRAL KAPLET) 300 300 - 600 600 333,600 - - - 600 600
211 Furosemid Tablet - - - - - - - - - - -
212 Garam Oralit 2,100 - 100 2,000 2,000 560,000 - - - 2,000 2,000
213 Glibenklamid Tablet 5 Mg 900 - - 900 900 73,800 baik - - - 900 900
214 Guaifenesin Tablet (Obat Batuk Ekspektoran) 1,000 - - 1,000 1,000 202,000 baik - - - 1,000 1,000
215 Griseofulvin Tablet 250Mg - - - - - - - - - - -
216 Kalium Diklofenak 50 Mg - - - - - - - - - - -
217 Kalsium Glukonas - - - - - - - - - - -
218 Kalsium Laktat Tablet 500 Mg - - - - - - - - - - -
219 Metformin Tablet 500 Mg 600 - - 600 600 46,200 baik - - - 600 600
222 Paracetamol Tablet 500 Mg 2,000 - - 2,000 2,000 300,000 baik - - - 2,000 2,000
223 Prednisone Tablet 5 Mg 8,600 - - 8,600 8,600 627,800 baik - - - 8,600 8,600
224 Pritagesic Capstab 1,300 - - 1,300 1,300 738,400 baik - - - 1,300 1,300
225 Pyridoxine Tablet - - - - - - - - - - -
226 Ranitidine 150 Mg 500 - - 500 500 42,500 baik - - - 500 500
227 Salbutamol Tablet 4 Mg - - - - - - - - - - -
228 Simvastatin Tablet 10 Mg 300 - - 300 300 20,400 baik - - - 300 300
229 Tablet Tambah Darah 102,450 - 17,450 85,000 85,000 19,380,000 baik - - - 85,000 85,000
230 Thiamine Tablet 50 Mg - - - - - - - - - - -
231 Vitamin A 100000 Iu - - - - - - baik - - - - -
232 Vitamin A 200000 Iu 1,250 - 50 1,200 1,200 646,800 baik - - - 1,200 1,200
233 Vitamin B Complex - - - - - - - - - - -
234 Zinc Tablet 20 Mg 35,200 - - 35,200 35,200 7,321,600 baik - - - 35,200 35,200
235 Anti Influenza (Molexflu Captabs) - - - - - - - - - - -
236 Anti Influenza Dan Batuk (Alpara Tablet) - - - - - - - - - - -
237 Antihemoroid & Udema (Dios Fillm Coated Tablet - - - - - - - - - - -
238 Multivitamin Antioksidan (Antoksid Capsul 10 St 200 - - 200 200 154,600 baik - - - 200 200
239 Multivitamin Mineral Tablet (Livron B Plex Tablet 2,200 2,800 1,600 3,400 3,400 955,400 baik - - - 3,400 3,400
240 MULTIVITAMIN TABLET TAMBAH DARAH (HEMAFORT TABLET 4,000SALUT GULA ) - 300 3,700 3,700 3,130,200 - - - 3,700 3,700
241 Obat Gangguan Sistem Pencernaan (Lexacrol Tabl - - - - - - - - - - -
242 Obat Hipertensi Herbal (Tensi Gard) - - - - - - - - - - -
243 Probiotik (Probiokid) - - - - - - - - - - -
244 Geriavita 1,800 - - 1,800 1,800 4,852,800 - - - 1,800 1,800
245 Orabloc 50 50 - 100 100 308,000 - - - 100 100
- CAIRAN/SIRUP
246 Ambroxol Holicos Syrup - - - - - - baik - - - - -
247 Amoxycillin Sirup 125 Mg/5 Ml 500 - - 500 500 1,025,000 - - - 500 500
248 Antacida Sirup 400 Mg/5 Ml - - - - - -baik 100 - 100 100 - 100
250 Cairan Infus (Ringer Laktat 500Ml) 194 - - 194 194 1,480,220baik 5 - 5 199 189
251 Cotrimoxazole Sirup 240 Mg/5 Ml 100 - - 100 100 210,000 baik - - - 100 100
253 Glukosa 5% Cairan Infus 123 - - 123 123 815,121 baik - - - 123 123
254 Natrium Clorida 0.9% Infus - - - - - - - - - - -
255 Paracetamol Sirup 120 Mg/5 Ml 100 - - 100 100 116,000 baik - - - 100 100
256 Anti Diare (Neo Kaominal Suspensi) 56 - - 56 56 367,584 baik - - - 56 56
257 Multivitamin Sirup (Procurma Sirup 60 Ml) 165 - 29 136 136 1,548,360 - - - 136 136
258 Multivitamin Sirup (Stimuno Sirup) 110 - 10 100 100 2,811,800 baik - - - 100 100
259 Obat Batuk Herbal (Herbakof Sirup) 310 - 10 300 300 4,281,900 baik - - - 300 300
260 Obat Batuk Expectoran (Holidrylsirup Botol 100 350 - 184 166 166 1,039,492 baik - - - 166 166
262 Obat Flu dan Batuk (Protexinal) 150 - - 150 150 939,300 - - - 150 150
- SALEP/CREAM/TETES
263 Betametason Cream 1 Mg - - - - - - - - - - -
264 Chloramfenikol Tetes Mata 30 50 30 50 50 847,000 baik - - - 50 50
266 Cloramphenicol Salep Kulit 50 - - 50 50 162,100 baik - - - 50 50
267 Gentamicine Salep 0.1% (Sk) 24 24 24 24 24 84,480 - - - 24 24
268 Gentamicine Tetes 0.3% (Tm) - - - - - - - - - - -
269 Hidrokortisone Krim 2.5% - - - - - - baik - - - - -
270 Klorfeson Cream 143 - 59 84 84 697,200 baik - - - 84 84
273 Salep Antifungi DOEN 30 - 10 20 20 69,540 - - - 20 20
- BMHP/BAHAN MEDIS HABIS PAKAI
273 Blood Transfusion Set (Transufusi Darah) 86 - - 86 86 576,200 baik - - - 86 86
274 Catgut Plain 3-0 75 Cm - - - - - - baik - - - - -
275 Catgut Plain 3-0 76 Cm 34 - - 34 34 1,995,800 baik - - - 34 34
276 Cat Gut Chromic 3-0 75 Cm - - - - - - - - - - -
277 Cat Gut Chromic 3-0 76 Cm 36 - - 36 36 2,113,200 baik - - - 36 36
278 Cat Gut Chromic 2-0 90 Cm - - - - - - - - - - -
279 Cat Gut Chromic 3-0 90 Cm 24 - - 24 24 1,272,000baik - - - 24 24
280 Disposible 20 Ml 29 - - 29 29 60,610 baik - - - 29 29
281 Disposible 10 Ml 28 - - 28 28 40,964 baik - - - 28 28
282 Disposible 1Ml 11,300 - - 11,300 11,300 7,243,300 - - - 11,300 11,300
283 Disposible 3 Ml 3,500 - - 3,500 3,500 3,234,000 baik 115 - 115 3,615 3,385
284 Examination Gloves Size 6.5 179 - - 179 179 2,358,862 baik - - - 179 179
285 Examination Gloves Size M - - - - - - baik 4 - 4 4 - 4
286 Gynaecological Glove S 37 - - 37 37 487,586 baik - - - 37 37
287 Gynaecological Glove M 105 - - 105 105 1,383,690baik - - - 105 105
288 Latex Foley Catheter - - - - - -baik - - - - -
289 Infusion Set Anak (Cosmomed) 99 - - 99 99 435,600 baik - - - 99 99
290 Iv Catheter No 16 (Pen) 79 - - 79 79 371,300 baik - - - 79 79
291 Iv Catheter No 18 (Pen) - - - - - - - - - - -
292 Iv Catheter No 20 (Pen) - - - - - - baik 5 - 5 5 - 5
293 Iv Catheter No 22 (Pen) - - - - - - baik 5 - 5 5 - 5
294 Iv Catheter No 24 (Pen) - - - - - - - - - - -
295 Kapas Pembalut 250 G 1 - - 1 1 12,500 baik - - - 1 1
296 Kasa 4 X 10 (Onemed) - - - - - - - - - - -
297 Kasa 4X 5 (Onemed) - - - - - - - - - - -
298 Kasa 16X16 (Onemed) - 30 30 - - - - - - - -
299 Lubricating (My Jelly) 13 - - 13 13 577,083 baik - - - 13 13
300 Masker (Karet) - - - - - - baik - - - - -
301 Nasal Oxygen Cannula (Cosmo Med) 182 - - 182 182 1,255,800 baik - - - 182 182
302 Nebulizer Mask (Dewasa ) 93 - - 93 93 1,339,200 baik - - - 93 93
303 Oxygen Masker (Anak)&(Dewasa) 153 - - 153 153 1,453,500 - - - 153 153
304 Pembalut Elastis - - - - - - - - - - -
305 Suction Catheter No 8 100 - - 100 100 310,000 baik - - - 100 100
306 Test Glucose Strip (Benecheck) - - - - - - baik - - - - -
307 Test Hemoglobin Strip - - - - - - - - - - -
308 Three - Way Stop Cock 88 - - 88 88 503,360 baik - - - 88 88
309 Umbilical Cord Clamp (Onemed) 150 - - 150 150 210,000 baik - - - 150 150
310 Underpad (Cosmomed ) 260 - 50 210 210 1,659,000 baik - - - 210 210
311 Urine Bag With Hanger (Cosmomed) 269 - - 269 269 1,479,500 baik - - - 269 269
- INJEKSI/ SUPP
312 Ascorin Vitamin C Injek 85 - - 85 85 1,955,000 baik - - - 85 85
313 Dexamethasone Cairan Injeksi 5 Mg - - - - - - - - - - -
314 Diazepam Enema 10Mg/2.5Ml - - - - - - baik - - - - -
315 Diazepam Enema 5Mg/2.5Ml 2 - - 2 2 25,146 baik - - - 2 2
316 Lidocain Plus Ephineprin (Pehacain Cairan Injeksi 600 - - 600 600 1,848,000 baik - - - 600 600
319 Serum Anti Bisa Ular Polivalen Injeksi 1 - - 1 1 465,640 baik - - - 1 1
- KEGIATAN PROGRAM
- PROGRAM IMUNISASI/VAKSIN
320 VAKSIN UNIJEK ( HB0 ) 30 - 14 16 16 375,840 - - - 16 16
321 VAKSIN BCG 1,200 440 70 1,570 1,570 139,558,870 - - - 1,570 1,570
322 VAKSIN BCG - - - - - - - - - - -
323 VAKSIN DPT-HB-HIB ( PENTABIO ) - 350 - 350 350 27,078,100 - - - 350 350
324 VAKSIN POLIO 20 300 20 300 300 5,862,000 - - - 300 300
325 VAKSIN POLIO - - - - - - - - - - -
326 VAKSIN POLIO Injeksi ( IPV ) - 60 - 60 60 8,672,400 - - - 60 60
327 VAKSIN POLIO Injeksi ( IPV ) - - - - - - - - - - -
328 VAKSIN MEASLES RUBELLA ( MR ) 470 250 90 630 630 96,138,000 - - - 630 630
329 VAKSIN MEASLES RUBELLA ( MR ) - - - - - - - - - - -
330 VAKSIN DT - 50 - 50 50 1,563,650 - - - 50 50
331 VAKSIN DT - - - - - - - - - - -
332 VAKSIN TD - 250 - 250 250 4,120,000 - - - 250 250
333 VAKSIN TD - - - - - - - - - - -
334 AUTO DISABLE ( ADS ) 0,05 ML 60 440 60 440 440 642,400 - - - 440 440
335 AUTO DISABLE ( ADS ) 0,5 ML 470 330 90 710 710 844,900 - - - 710 710
336 AUTO DISABLE ( ADS ) 5 ML 47 44 9 82 82 119,720 - - - 82 82
337 VAKSIN Hbsag 2 - - 2 2 2,650,000 - - - 2 2
- PROGRAM P2M
338 Yellow Tips - - - - - - - - - - -
339 Vacuseara needle 3 cc - - - - - - - - - - -
340 Vacutainer EDTA 3 cc - - - - - - - - - - -
341 Alkohol SWAB (100 pcs) - - - - - - - - - - -
- Rapid Tes P2M - - - - -
342 Rapid SD Hbsag (Hepattis) 150 450 - 600 600 2,475,000 - - - 600 600
343 Rapid SD HIV - 100 25 75 75 309,375 - - - 75 75
344 Rapid Syphilis (Trepocheck) 100 - - 100 100 930,000 - - - 100 100
- PROGRAM Obat Jiwa - - - - -
345 Amitriptyline 25mg - - - - - - - - - - -
346 Clobazam - - - - - - - - - - -
347 Clozapine 25mg 90 - 40 50 50 56,050 - - - 50 50
349 Resperidon 2mg 180 - 100 80 80 22,960 - - - 80 80
350 Skizonoat 25mg/ml - - - - - - - - - - -
351 Trihexpyhenidyl 2mg 60 - - 60 60 5,460 - - - 60 60
- KEGIATAN COVID 19
- OBAT & BMHP COVID
352 Apd ( Hazmat ) 35 - - 35 35 5,600,000 - - - 35 35
353 Alkohol Swab (Aximed) 56 - - 56 56 1,797,600 - - - 56 56
354 Hazmat Solid 3A 719 - - 719 719 79,463,880 - - - 719 719
355 Hansanitezer Spray ( Triton ) 351 - - 351 351 9,572,823 - - - 351 351
356 Disinfectan Spray ( Clitera ) 67 - - 67 67 9,798,750 - - - 67 67
357 Masker N95 Mask Nousmed 140 - - 140 140 1,909,040 - - - 140 140
358 Handscoon M ( Protos ) 30 - - 30 30 3,150,000 - - - 30 30
359 Kimsmed Disposible 1 Ml 11,000 - - 11,000 11,000 7,051,000 - - - 11,000 11,000
360 Face Sheild 24 - - 24 24 981,600 - - - 24 24
- TEST DIAGNOSTIK COVID
361 Rapid Test Covid Abbot - - - - - - - - - - -
362 Rapid Test Covid Viva Diag - - - - - - - - - - -
363 Rapid Test Covid SD Biosensor - - - - - - - - - - -
- ALAT DAN OBAT KONTRASEPSI (DINAS KB)
364 Pil Kb 1,000 - - 1,000 1,000 1,153,000 - - - 1,000 1,000
365 Kondom 164 - - 164 164 1,196,216 - - - 164 164
366 Implant 60 - - 60 60 10,503,000 - - - 60 60
367 Kb Suntik 20 - - 20 20 96,000 - - - 20 20
- BERSUMBER DARI BOK
368 Masker Medis - - - - - - - - - - -
369 Gown Disposable ( Apd ) - - - - - - - - - - -
370 Handsanitizer 500 Ml - - - - - - - - - -
JUMLAH TOTAL - 575,022,017 - -

Pihak yang diperiksa Mengetahui Pemeriksa 1 Pemeriksa 2

Kepala Puskesmas Cipeundeuy

WINDA PUTRIANINGSIH M. ARIFUDIN,S.Sos.,M.Kes Aditya Suhartika, Amd.Kep Eti hayati,Amd.Kep

NIP. 19961107 202203 2 006 NIP. 19670919 198803 1 007 NIP:199006062017042001 NIP :198603252017042002