DAFTAR OBAT / BMHP RUSAK DAN ATAU KADALUWAR

PUSKESMAS TEGAL BARAT

PERIODE JANUARI 2019 - JANUARI 2023
HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
SATUAN TOTAL HARGA

AKITA / ATTAPULGITE 150 TAB Rp 145 Rp 21,750

ANTASIDA DOEN 6000 TAB Rp 54 Rp 324,000
ANTASIDA DOEN 16800 TAB Rp 54 Rp 907,200
DIAZEPAM 2 MG 56 TAB Rp 86 Rp 4,816
HALOPERIDOL INJ 5 AMPUL Rp 1,551 Rp 7,755
ALLOPURINOL 100 MG 100 TAB Rp 67 Rp 6,700
BISACODIL 5MG 1000 TAB Rp 216 Rp 216,000
CALCIUM LACTAT 16800 TAB Rp 63 Rp 1,058,400
DIGOXIN 0,5 MG 160 TAB Rp 104 Rp 16,640
GRISEOFULVIN 125 MG 500 TAB Rp 224 Rp 112,000
GRISEOFULVIN 125 MG 390 TAB Rp 224 Rp 87,360
HALOPERIDOL 5MG 200 TAB Rp 54 Rp 10,800
SIMVASTATIN 20 MG 800 TAB Rp 150 Rp 120,000
CIPROFLOXACIN 500 MG 200 TAB Rp 248 Rp 49,600
CIPROFLOXACIN 500 MG 39600 TAB Rp 248 Rp 9,820,800
CORSANEURON 200 TAB Rp 616 Rp 123,200
CORSANEURON 200 TAB Rp 616 Rp 123,200
COTRIMOXAZOLE 480 MG 2700 TAB Rp 133 Rp 359,100
DEXAMETHASONE 0,5 MG 30 TAB Rp 32 Rp 960
DIAZEPAM INJ 18 AMPUL Rp 1,735 Rp 31,230
PREDNISON 5 MG 937 TAB Rp 68 Rp 63,716
PREDNISON 5 MG 30000 TAB Rp 68 Rp 2,040,000
PREDNISON 5 MG 60 TAB Rp 68 Rp 4,080
PREDNISON 5 MG 200 TAB Rp 68 Rp 13,600
SALICYL TALK 100 PCS Rp 2,420 Rp 242,000
SALICYL TALK 100 PCS Rp 2,420 Rp 242,000
AMOXICILLIN 250 MG 5100 TAB Rp 184 Rp 938,400
AMOXICILLIN 250 MG 200 TAB Rp 184 Rp 36,800
ANTASIDA DOEN 2800 TAB Rp 54 Rp 151,200
ANTASIDA DOEN 21600 TAB Rp 54 Rp 1,166,400
 HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
TOTAL HARGA
SATUAN

ANTASIDA DOEN 7200 TAB Rp 54 Rp 388,800

ANTASIDA DOEN 600 TAB Rp 54 Rp 32,400
ANTASIDA DOEN 600 TAB Rp 54 Rp 32,400
AQUA PRO INJEKSI 12 VIAL Rp 2,650 Rp 31,800
ASETIL SISTEIN 2800 CAP Rp 373 Rp 1,044,400
ASETIL SISTEIN 2080 TAB Rp 373 Rp 775,840
ASETIL SISTEIN 2100 TAB Rp 373 Rp 783,300
ASETIL SISTEIN 80 TAB Rp 373 Rp 29,840
CALCIUM LACTAT 8900 TAB Rp 63 Rp 560,700
CALCIUM LACTAT 460 TAB Rp 63 Rp 28,980
CALCIUM LACTAT 900 TAB Rp 63 Rp 56,700
CLORAMPHENICOL SM 9 TAB Rp 2,007 Rp 18,063
DIAZEPAM INJ 27 AMPUL Rp 1,735 Rp 46,845
DOMPERIDONE 10 MG 700 TAB Rp 71 Rp 49,700
DOMPERIDONE 10 MG 170 TAB Rp 71 Rp 12,070
DOMPERIDONE 10 MG 800 TAB Rp 71 Rp 56,800
DOMPERIDONE 10 MG 700 TAB Rp 71 Rp 49,700
NISTATIN TAB VAGINAL 600 TAB Rp 560 Rp 336,000
PARACETAMOL 500 MG 3300 TAB Rp 81 Rp 267,300
PARACETAMOL 500 MG 7900 TAB Rp 81 Rp 639,900
PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800
PARACETAMOL 500 MG 930 TAB Rp 81 Rp 75,330
PARACETAMOL 500 MG 1800 TAB Rp 81 Rp 145,800
PARACETAMOL 500 MG 42 TAB Rp 81 Rp 3,402
PARACETAMOL 500 MG 120 TAB Rp 81 Rp 9,720
PHENOL GLISEROL TT 33 PFLS Rp 3,300 Rp 108,900
DEXAMETHASONE 0,5 MG 6200 TAB Rp 32 Rp 198,400
DEXAMETHASONE 0,5 MG 19800 TAB Rp 32 Rp 633,600
DIFENHIDRAMIN INJ 30 AMPUL Rp 1,095 Rp 32,850
IBUPROFEN 200 MG 200 TAB Rp 105 Rp 21,000
PARACETAMOL 500 MG 10800 TAB Rp 81 Rp 874,800
PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800
 HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
TOTAL HARGA
SATUAN

PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800

PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800
EMCITARABINE 30 TAB Rp 458 Rp 13,740
EPINEFRIN INJ 40 AMPUL Rp 1,515 Rp 60,600
FLUFENAZINE DECANOAT INJ 35 AMPUL Rp 59,800 Rp 2,093,000
LIDOCAIN INJ 210 AMPUL Rp 1,221 Rp 256,410
MUCUS EXSTRAKTOR 4 PCS Rp 8,178 Rp 32,712
TERADI/ NEW ANTIDES 5900 TAB Rp 145 Rp 855,500
ATROPIN SULFAT INJ 65 AMPUL Rp 1,639 Rp 106,535
ANTI FUNGI SK 48 TUBE Rp 4,798 Rp 230,304
CA GLUCONAS INJ 52 AMPUL Rp 5,723 Rp 297,596
HALOPERIDOL 40 TAB Rp 54 Rp 2,160
IV CATHETER NO. 22 4 PCS Rp 8,700 Rp 34,800
PYRANTEL PAMOAT 125 MG 100 TAB Rp 289 Rp 28,900
RANITIDINE INJ 10 AMPUL Rp 1,155 Rp 11,550
AZITROMICIN 500 MG 200 TAB Rp 1,136 Rp 227,200
CIPROFLOXACIN 500 MG 200 TAB Rp 248 Rp 49,600
ONE MED TEST KEHAMILAN 250 PCS Rp 1,957 Rp 489,250
BENZATIN BENZIL PENICILLIN INI 20 VIAL Rp 14,500 Rp 290,000
ELITE SEMEN 2 PCS Rp 151,000 Rp 302,000
ELITE SEMEN 2 PCS Rp 151,000 Rp 302,000
LIDOCAIN COMPOSITUM INJ 60 AMPUL Rp 803 Rp 48,180
OCHO POLIREN 5 PCS Rp 142,000 Rp 710,000
URINE GLUCOPROTEIN TEST 40 PCS Rp 1,045 Rp 41,800
GLYCERILIS GUAIACOLAT 100MG 40 TAB Rp 88 Rp 3,520
GLYCERILIS GUAIACOLAT 100MG 100 TAB Rp 88 Rp 8,800
METHYLERGOMETRIN INJ 17 AMPUL Rp 2,959 Rp 50,303
METOCLOPRAMID 74 TAB Rp 66 Rp 4,884
MgSO4 40 % 35 VIAL Rp 4,090 Rp 143,150
NISTATIN TAB VAGINAL 420 TAB Rp 560 Rp 235,200
TKF 2 PCS Rp 55,000 Rp 110,000
EPINEFRIN INJ 5 AMPUL Rp 1,515 Rp 7,575
LIDOCAIN INJ 100 AMPUL Rp 1,221 Rp 122,100
 HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
TOTAL HARGA
SATUAN

LIDOCAIN INJ 1348 AMPUL Rp 1,221 Rp 1,645,908

OXYTOCIN INJ 65 AMPUL Rp 1,126 Rp 73,190
METFORMIN 500 MG 20 TAB Rp 77 Rp 1,540
PREDNISON 5 MG 4300 TAB Rp 68 Rp 292,400
PREDNISON 5 MG 300 TAB Rp 68 Rp 20,400
PREDNISON 5 MG 600 TAB Rp 68 Rp 40,800
ANTIHEMOROID 470 SUPPO Rp 3,250 Rp 1,527,500
BETAFLU 30 TAB Rp 330 Rp 9,900
CLORAMPHENICOL SM 40 TUBE Rp 2,007 Rp 80,280
DOMPERIDONE 10 MG 160 TAB Rp 71 Rp 11,360
FE TABLET 1090 TAB Rp 354 Rp 385,860
HEMMOROGARD 240 TAB Rp 1,552 Rp 372,480
HEMMOROGARD 30 TAB Rp 1,552 Rp 46,560
LIDOCAIN COMPOSITUM INJ 166 AMPUL Rp 803 Rp 133,298
LIDOCAIN INJ 22 AMPUL Rp 1,221 Rp 26,862
METHYLERGOMETRIN 1312 TAB Rp 225 Rp 295,200
METHYLPREDNISOLON 4 MG 270 TAB Rp 102 Rp 27,540
MICONAZOLE SK 53 TUBE Rp 1,900 Rp 100,700
OXYGEN MASK DEWASA 11 TAB Rp 8,178 Rp 89,958
SALEP 2-4 12 POT Rp 2,996 Rp 35,952
SALEP 2-4 45 POT Rp 2,996 Rp 134,820
SALEP 2-4 168 POT Rp 2,996 Rp 503,328
TERADI/ NEW ANTIDES 530 TAB Rp 145 Rp 76,850
TERADI/ NEW ANTIDES 100 TAB Rp 145 Rp 14,500
VITAMIN B COMPLEK 70 TAB Rp 89 Rp 6,230
VITAMIN B COMPLEK 100 TAB Rp 89 Rp 8,900
VITAMIN B6 10 MG 200 TAB Rp 131 Rp 26,200
ALLOPURINOL 100 MG 100 TAB Rp 67 Rp 6,700
ALLOPURINOL 100 MG 140 TAB Rp 67 Rp 9,380
AMOXICILLIN 500 MG 400 TAB Rp 201 Rp 80,400
AMOXICILLIN 500 MG 300 TAB Rp 201 Rp 60,300
CTM 4 MG 59400 TAB Rp 24 Rp 1,425,600
CTM 4 MG 5855 TAB Rp 24 Rp 140,520
 HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
TOTAL HARGA
SATUAN

CTM 4 MG 19800 TAB Rp 24 Rp 475,200

CTM 4 MG 660 TAB Rp 24 Rp 15,840
CTM 4 MG 800 TAB Rp 24 Rp 19,200
CTM 4 MG 300 TAB Rp 24 Rp 7,200
DOXYCYCLINE 100 MG 20 TAB Rp 275 Rp 5,500
DOXYCYCLINE 100 MG 190 TAB Rp 275 Rp 52,250
FLUOCONAZOLE 150 MG 90 TAB Rp 18,720 Rp 1,684,800
IBUPROFEN 400 MG 40 TAB Rp 261 Rp 10,440
ISDN 5 MG 135 TAB Rp 86 Rp 11,610
LAMIVUDIN 480 TAB Rp 458 Rp 219,840
LAMIVUDIN, ZIDOVUDINE 600 TAB Rp 1,050 Rp 630,000
LORATADINE 10 MG 350 TAB Rp 131 Rp 45,850
PROPANOLOL 10 MG 260 TAB Rp 58 Rp 15,080
PROPANOLOL 10 MG 100 TAB Rp 58 Rp 5,800
SPUIT 1 ML 200 PCS Rp 1,023 Rp 204,600
TERADI/ NEW ANTIDES 370 TAB Rp 145 Rp 53,650
TETRACYCLINE 500 MG 270 TAB Rp 310 Rp 83,700
TETRACYCLINE 500 MG 2348 TAB Rp 310 Rp 727,880
TRANSFUSION BLOODADMINISTRATION 50 PCS Rp 13,976 Rp 698,800
VITAMIN B1 130 TAB Rp 91 Rp 11,830
VITAMIN B1 800 TAB Rp 91 Rp 72,800
VITAMIN K TAB 50 TAB Rp 748 Rp 37,400
VITAMIN K TAB 190 TAB Rp 748 Rp 142,120
COTRIMOXAZOLE 480 MG 520 TAB Rp 133 Rp 69,160
EPINEFRIN INJ 13 AMPUL Rp 1,515 Rp 19,695
PHENOBARBITAL 30MG 200 TAB Rp 171 Rp 34,200
COTRIMOXAZOLE 480 MG 7200 TAB Rp 133 Rp 957,600
KETOCONAZOLE 200 MG 1050 TAB Rp 252 Rp 264,600
METHYLERGOMETRIN 500 TAB Rp 225 Rp 112,500
NATRIUM DIKLOFENAK 50 MG 5250 TAB Rp 99 Rp 519,750
POVIDON IODINE 30 ML 150 FLS Rp 3,100 Rp 465,000
TERADI/ NEW ANTIDES 10200 TAB Rp 145 Rp 1,479,000
EUGENOL 16 PCS Rp 20,087 Rp 321,392
 HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
TOTAL HARGA
SATUAN

ACYCLOVIR SK 20 TUBE Rp 3,300 Rp 66,000

AMBROXOL 30 MG 300 TAB Rp 110 Rp 33,000
AMBROXOL 30 MG 13600 TAB Rp 110 Rp 1,496,000
CUTICUCELL 5 PCS Rp 5,520 Rp 27,600
DEXAMETHASONE 0,5 MG 100 TAB Rp 32 Rp 3,200
FOLLEY CATHETER NO. 16 8 PCS Rp 10,659 Rp 85,272
VITAMIN K TAB 2100 TAB Rp 748 Rp 1,570,800
CALCETIN 16 PCS Rp 102,000 Rp 1,632,000
BETAHISTINE MESILAT 6 MG 10 TAB Rp 110 Rp 1,100
IBUPROFEN 200 MG 3800 TAB Rp 105 Rp 399,000
MgSO4 20 % 12 VIAL Rp 35,280 Rp 423,360
TRIKRESOL FORMALIN 12 PCS Rp 55,000 Rp 660,000
URINE BAG 12 PCS Rp 3,100 Rp 37,200
BIODINAMICA MASTER FILL 9 PCS Rp 154,000 Rp 1,386,000
ISONIAZID 300 MG 90 TAB Rp 164 Rp 14,760
KOMBIPAK (AZITROMICIN+CEFIXIME 200 MG) 240 TAB Rp 1,136 Rp 272,640
MgSO4 20 % 6 VIAL Rp 3,580 Rp 21,480
OXYTETRACICLINE SM 75 TUBE Rp 3,500 Rp 262,500
SPIRONOLACTON 25MG 2500 TAB Rp 190 Rp 475,000
SPIRONOLACTON 25MG 200 TAB Rp 190 Rp 38,000
URINE BAG 26 PCS Rp 3,100 Rp 80,600
URINE BAG 15 PCS Rp 3,100 Rp 46,500
VITAMIN K INJ 2 MG/ML 70 AMPUL Rp 3,450 Rp 241,500
ZINC DISPERSIBLE 4 TAB Rp 440 Rp 1,760
BIOSAT ATS SERUM 16 AMPUL Rp 130,999 Rp 2,095,984
CLOPIDOGREL 75 MG 720 TAB Rp 1,404 Rp 1,010,880
COTRIMOXAZOLE 960 MG 300 TAB Rp 133 Rp 39,900
LAMIVUDINE 60 TAB Rp 458 Rp 27,480
NISTATIN TAB VAGINAL 1600 TAB Rp 560 Rp 896,000
OXYTETRACICLINE SK 28 TUBE Rp 4,400 Rp 123,200
CLORAMPHENICOL TM 10 TUBE Rp 7,260 Rp 72,600
HEMMOROGARD 60 TAB Rp 1,552 Rp 93,120
RECO TM 10 FLS Rp 6,969 Rp 69,690
 HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
TOTAL HARGA
SATUAN

SALBUTAMOL 4 MG 100 TAB Rp 63 Rp 6,300

VITAMIN K INJ 2 MG/ML 300 VIAL Rp 3,450 Rp 1,035,000
AMLODIPINE 5 MG 2100 TAB Rp 75 Rp 157,500
AMLODIPINE 5 MG 300 TAB Rp 75 Rp 22,500
CALCIUM LACTAT 4200 TAB Rp 63 Rp 264,600
CREOSOTIN 28 PCS Rp 130,000 Rp 3,640,000
DESOXIMETHASON SK 20 TUBE Rp 10,919 Rp 218,380
ERLAMYCETIN TT 13 FLS Rp 7,370 Rp 95,810
ACYCLOVIR 200 MG 100 TAB Rp 236 Rp 23,600
ALBENDAZOLE 400 TAB Rp 337 Rp 134,800
CLORAMPHENICOL 250 MG 820 TAB Rp 623 Rp 510,860
FLUFENAZINE DECANOAT INJ 5 AMPUL Rp 59,800 Rp 299,000
SPUIT 1CC 447 PCS Rp 1,023 Rp 457,281
SPUIT 5 CC 25 PCS Rp 1,045 Rp 26,125
ACYCLOVIR 400 MG 580 TAB Rp 380 Rp 220,400
ACYCLOVIR SK 25 TUBE Rp 3,300 Rp 82,500
METHYLPREDNISOLON 4 MG 100 TAB Rp 102 Rp 10,200
CHKM 6 PCS Rp 49,500 Rp 297,000
ISDN 5 MG 100 TAB Rp 86 Rp 8,600
GLASS IONOMER (MICRON) 26 PCS Rp 270,000 Rp 7,020,000
ZINC FOSFATE CEMEN 3 PCS Rp 140,000 Rp 420,000
CTM 4 MG 19800 TAB Rp 24 Rp 475,200
CTM 4 MG 27150 TAB Rp 24 Rp 651,600
EFAVIRENZ 600 MG 7 TAB Rp -
FUROSEMID 40 MG 2175 TAB Rp 82 Rp 178,350
GENTAMICIN TM 12 TUBE Rp 4,232 Rp 50,784
ASETIL SISTEIN 70 TAB Rp 373 Rp 26,110
ASETIL SISTEIN 113 TAB Rp 373 Rp 42,149
BLOOD LANCET 85000 TAB Rp 144 Rp 12,240,000
OXYTETRACICLINE SM 317 TUBE Rp 3,500 Rp 1,109,500
OXYGEN MASK DEWASA 1 PCS Rp 8,178 Rp 8,178
POLIKRESULEN 4 PCS Rp 24,200 Rp 96,800
 HARGA
NO NAMA OBAT JUMLAH SATUAN
HARGA
TOTAL HARGA
SATUAN

CLONIDIN 130 TAB Rp 174 Rp 22,620

NOVAHEKSIN 826 TAB Rp 110 Rp 90,860
PHENOL GLISEROL TT 10 PCS Rp 3,300 Rp 33,000
PHENOL GLISEROL TT 18 FLS Rp 3,300 Rp 59,400
CREOSOTIN 5 PCS Rp 130,000 Rp 650,000
COTRIMOXAZOL 480 MG 7500 TAB Rp 133 Rp 997,500
GARAM ORALIT 114 SACH Rp 280 Rp 31,920
GARAM ORALIT 1200 SACH Rp 280 Rp 336,000
PULP X 10 PCS Rp 217,000 Rp 2,170,000
KSR 500 TAB Rp 1,841 Rp 920,500
CLORPROMAZINE 100 3000 TAB Rp 157 Rp 471,000
CLOZAPINE 25 MG 1270 TAB Rp 1,121 Rp 1,423,670
IBUPROFEN 400 MG 100 TAB Rp 261 Rp 26,100
METRONIDAZOLE 500 MG 300 TAB Rp 174 Rp 52,200
HALOPERIDOL 5MG 3400 TAB Rp 54 Rp 183,600

JUMLAH TOTAL Rp 106,444,942

Mengetahui/Menyetujui,
Kepala Puskesmas Tegal Barat

dr. Bambang Kuswanto

NIP.19651107 200212 1 004
 DAFTAR OBAT / BMHP RUSAK DAN ATAU KADALUWAR
PUSKESMAS TEGAL BARAT
PERIODE JANUARI 2019 - JANUARI 2023
HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN KADALUWARSA / ED
HARGA
SATUAN TOTAL HARGA

AKITA / ATTAPULGITE 150 TAB Rp 145 Rp 21,750 1-Jan-2020

ANTASIDA DOEN 6000 TAB Rp 54 Rp 324,000 1-Jan-2020
ANTASIDA DOEN 16800 TAB Rp 54 Rp 907,200 1-Jan-2020
DIAZEPAM 2 MG 56 TAB Rp 86 Rp 4,816 1-Jan-2020
HALOPERIDOL INJ 5 AMPUL Rp 1,551 Rp 7,755 1-Jan-2020
ALLOPURINOL 100 MG 100 TAB Rp 67 Rp 6,700 1-Feb-2020
BISACODIL 5MG 1000 TAB Rp 216 Rp 216,000 1-Feb-2020
CALCIUM LACTAT 16800 TAB Rp 63 Rp 1,058,400 1-Feb-2020
DIGOXIN 0,5 MG 160 TAB Rp 104 Rp 16,640 1-Feb-2020
GRISEOFULVIN 125 MG 500 TAB Rp 224 Rp 112,000 1-Feb-2020
GRISEOFULVIN 125 MG 390 TAB Rp 224 Rp 87,360 1-Feb-2020
HALOPERIDOL 5MG 200 TAB Rp 54 Rp 10,800 1-Feb-2020
SIMVASTATIN 20 MG 800 TAB Rp 150 Rp 120,000 1-Feb-2020
CIPROFLOXACIN 500 MG 200 TAB Rp 248 Rp 49,600 1-Mar-2020
CIPROFLOXACIN 500 MG 39600 TAB Rp 248 Rp 9,820,800 1-Mar-2020
CORSANEURON 200 TAB Rp 616 Rp 123,200 1-Mar-2020
CORSANEURON 200 TAB Rp 616 Rp 123,200 1-Mar-2020
COTRIMOXAZOLE 480 MG 2700 TAB Rp 133 Rp 359,100 1-Mar-2020
DEXAMETHASONE 0,5 MG 30 TAB Rp 32 Rp 960 1-Mar-2020
DIAZEPAM INJ 18 AMPUL Rp 1,735 Rp 31,230 1-Mar-2020
PREDNISON 5 MG 937 TAB Rp 68 Rp 63,716 1-Mar-2020
PREDNISON 5 MG 30000 TAB Rp 68 Rp 2,040,000 1-Mar-2020
PREDNISON 5 MG 60 TAB Rp 68 Rp 4,080 1-Mar-2020
PREDNISON 5 MG 200 TAB Rp 68 Rp 13,600 1-Mar-2020
SALICYL TALK 100 PCS Rp 2,420 Rp 242,000 1-Mar-2020
SALICYL TALK 100 PCS Rp 2,420 Rp 242,000 1-Mar-2020
AMOXICILLIN 250 MG 5100 TAB Rp 184 Rp 938,400 1-Apr-2020
AMOXICILLIN 250 MG 200 TAB Rp 184 Rp 36,800 1-Apr-2020
ANTASIDA DOEN 2800 TAB Rp 54 Rp 151,200 1-Apr-2020
ANTASIDA DOEN 21600 TAB Rp 54 Rp 1,166,400 1-Apr-2020
 HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN
KADALUWARSA / ED
HARGA
TOTAL HARGA
SATUAN

ANTASIDA DOEN 7200 TAB Rp 54 Rp 388,800 1-Apr-2020

ANTASIDA DOEN 600 TAB Rp 54 Rp 32,400 1-Apr-2020
ANTASIDA DOEN 600 TAB Rp 54 Rp 32,400 1-Apr-2020
AQUA PRO INJEKSI 12 VIAL Rp 2,650 Rp 31,800 1-Apr-2020
ASETIL SISTEIN 2800 CAP Rp 373 Rp 1,044,400 1-Apr-2020
ASETIL SISTEIN 2080 TAB Rp 373 Rp 775,840 1-Apr-2020
ASETIL SISTEIN 2100 TAB Rp 373 Rp 783,300 1-Apr-2020
ASETIL SISTEIN 80 TAB Rp 373 Rp 29,840 1-Apr-2020
CALCIUM LACTAT 8900 TAB Rp 63 Rp 560,700 1-Apr-2020
CALCIUM LACTAT 460 TAB Rp 63 Rp 28,980 1-Apr-2020
CALCIUM LACTAT 900 TAB Rp 63 Rp 56,700 1-Apr-2020
CLORAMPHENICOL SM 9 TAB Rp 2,007 Rp 18,063 1-Apr-2020
DIAZEPAM INJ 27 AMPUL Rp 1,735 Rp 46,845 1-Apr-2020
DOMPERIDONE 10 MG 700 TAB Rp 71 Rp 49,700 1-Apr-2020
DOMPERIDONE 10 MG 170 TAB Rp 71 Rp 12,070 1-Apr-2020
DOMPERIDONE 10 MG 800 TAB Rp 71 Rp 56,800 1-Apr-2020
DOMPERIDONE 10 MG 700 TAB Rp 71 Rp 49,700 1-Apr-2020
NISTATIN TAB VAGINAL 600 TAB Rp 560 Rp 336,000 1-Apr-2020
PARACETAMOL 500 MG 3300 TAB Rp 81 Rp 267,300 1-Apr-2020
PARACETAMOL 500 MG 7900 TAB Rp 81 Rp 639,900 1-Apr-2020
PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800 1-Apr-2020
PARACETAMOL 500 MG 930 TAB Rp 81 Rp 75,330 1-Apr-2020
PARACETAMOL 500 MG 1800 TAB Rp 81 Rp 145,800 1-Apr-2020
PARACETAMOL 500 MG 42 TAB Rp 81 Rp 3,402 1-Apr-2020
PARACETAMOL 500 MG 120 TAB Rp 81 Rp 9,720 1-Apr-2020
PHENOL GLISEROL TT 33 PFLS Rp 3,300 Rp 108,900 1-Apr-2020
DEXAMETHASONE 0,5 MG 6200 TAB Rp 32 Rp 198,400 1-May-2020
DEXAMETHASONE 0,5 MG 19800 TAB Rp 32 Rp 633,600 1-May-2020
DIFENHIDRAMIN INJ 30 AMPUL Rp 1,095 Rp 32,850 1-May-2020
IBUPROFEN 200 MG 200 TAB Rp 105 Rp 21,000 1-May-2020
PARACETAMOL 500 MG 10800 TAB Rp 81 Rp 874,800 1-May-2020
PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800 1-May-2020
 HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN
KADALUWARSA / ED
HARGA
TOTAL HARGA
SATUAN

PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800 1-May-2020

PARACETAMOL 500 MG 16800 TAB Rp 81 Rp 1,360,800 1-May-2020
EMCITARABINE 30 TAB Rp 458 Rp 13,740 1-Jun-2020
EPINEFRIN INJ 40 AMPUL Rp 1,515 Rp 60,600 1-Jun-2020
FLUFENAZINE DECANOAT INJ 35 AMPUL Rp 59,800 Rp 2,093,000 1-Jun-2020
LIDOCAIN INJ 210 AMPUL Rp 1,221 Rp 256,410 1-Jun-2020
MUCUS EXSTRAKTOR 4 PCS Rp 8,178 Rp 32,712 1-Jun-2020
TERADI/ NEW ANTIDES 5900 TAB Rp 145 Rp 855,500 1-Jun-2020
ATROPIN SULFAT INJ 65 AMPUL Rp 1,639 Rp 106,535 1-Jul-2020
ANTI FUNGI SK 48 TUBE Rp 4,798 Rp 230,304 1-Aug-2020
CA GLUCONAS INJ 52 AMPUL Rp 5,723 Rp 297,596 1-Aug-2020
HALOPERIDOL 40 TAB Rp 54 Rp 2,160 1-Aug-2020
IV CATHETER NO. 22 4 PCS Rp 8,700 Rp 34,800 1-Aug-2020
PYRANTEL PAMOAT 125 MG 100 TAB Rp 289 Rp 28,900 1-Aug-2020
RANITIDINE INJ 10 AMPUL Rp 1,155 Rp 11,550 1-Aug-2020
AZITROMICIN 500 MG 200 TAB Rp 1,136 Rp 227,200 1-Sep-2020
CIPROFLOXACIN 500 MG 200 TAB Rp 248 Rp 49,600 1-Sep-2020
ONE MED TEST KEHAMILAN 250 PCS Rp 1,957 Rp 489,250 1-Sep-2020
BENZATIN BENZIL PENICILLIN INI 20 VIAL Rp 14,500 Rp 290,000 1-Oct-2020
ELITE SEMEN 2 PCS Rp 151,000 Rp 302,000 1-Oct-2020
ELITE SEMEN 2 PCS Rp 151,000 Rp 302,000 1-Oct-2020
LIDOCAIN COMPOSITUM INJ 60 AMPUL Rp 803 Rp 48,180 1-Oct-2020
OCHO POLIREN 5 PCS Rp 142,000 Rp 710,000 1-Oct-2020
URINE GLUCOPROTEIN TEST 40 PCS Rp 1,045 Rp 41,800 1-Oct-2020
GLYCERILIS GUAIACOLAT 100MG 40 TAB Rp 88 Rp 3,520 1-Nov-2020
GLYCERILIS GUAIACOLAT 100MG 100 TAB Rp 88 Rp 8,800 1-Nov-2020
METHYLERGOMETRIN INJ 17 AMPUL Rp 2,959 Rp 50,303 1-Nov-2020
METOCLOPRAMID 74 TAB Rp 66 Rp 4,884 1-Nov-2020
MgSO4 40 % 35 VIAL Rp 4,090 Rp 143,150 1-Nov-2020
NISTATIN TAB VAGINAL 420 TAB Rp 560 Rp 235,200 1-Nov-2020
TKF 2 PCS Rp 55,000 Rp 110,000 1-Nov-2020
EPINEFRIN INJ 5 AMPUL Rp 1,515 Rp 7,575 1-Dec-2020
LIDOCAIN INJ 100 AMPUL Rp 1,221 Rp 122,100 1-Dec-2020
 HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN
KADALUWARSA / ED
HARGA
TOTAL HARGA
SATUAN

LIDOCAIN INJ 1348 AMPUL Rp 1,221 Rp 1,645,908 1-Dec-2020

OXYTOCIN INJ 65 AMPUL Rp 1,126 Rp 73,190 1-Dec-2020
METFORMIN 500 MG 20 TAB Rp 77 Rp 1,540 1-Jan-2021
PREDNISON 5 MG 4300 TAB Rp 68 Rp 292,400 1-Jan-2021
PREDNISON 5 MG 300 TAB Rp 68 Rp 20,400 1-Jan-2021
PREDNISON 5 MG 600 TAB Rp 68 Rp 40,800 1-Jan-2021
ANTIHEMOROID 470 SUPPO Rp 3,250 Rp 1,527,500 1-Feb-2021
BETAFLU 30 TAB Rp 330 Rp 9,900 1-Feb-2021
CLORAMPHENICOL SM 40 TUBE Rp 2,007 Rp 80,280 1-Feb-2021
DOMPERIDONE 10 MG 160 TAB Rp 71 Rp 11,360 1-Feb-2021
FE TABLET 1090 TAB Rp 354 Rp 385,860 1-Feb-2021
HEMMOROGARD 240 TAB Rp 1,552 Rp 372,480 1-Feb-2021
HEMMOROGARD 30 TAB Rp 1,552 Rp 46,560 1-Feb-2021
LIDOCAIN COMPOSITUM INJ 166 AMPUL Rp 803 Rp 133,298 1-Feb-2021
LIDOCAIN INJ 22 AMPUL Rp 1,221 Rp 26,862 1-Feb-2021
METHYLERGOMETRIN 1312 TAB Rp 225 Rp 295,200 1-Feb-2021
METHYLPREDNISOLON 4 MG 270 TAB Rp 102 Rp 27,540 1-Feb-2021
MICONAZOLE SK 53 TUBE Rp 1,900 Rp 100,700 1-Feb-2021
OXYGEN MASK DEWASA 11 TAB Rp 8,178 Rp 89,958 1-Feb-2021
SALEP 2-4 12 POT Rp 2,996 Rp 35,952 1-Feb-2021
SALEP 2-4 45 POT Rp 2,996 Rp 134,820 1-Feb-2021
SALEP 2-4 168 POT Rp 2,996 Rp 503,328 1-Feb-2021
TERADI/ NEW ANTIDES 530 TAB Rp 145 Rp 76,850 1-Feb-2021
TERADI/ NEW ANTIDES 100 TAB Rp 145 Rp 14,500 1-Feb-2021
VITAMIN B COMPLEK 70 TAB Rp 89 Rp 6,230 1-Feb-2021
VITAMIN B COMPLEK 100 TAB Rp 89 Rp 8,900 1-Feb-2021
VITAMIN B6 10 MG 200 TAB Rp 131 Rp 26,200 1-Feb-2021
ALLOPURINOL 100 MG 100 TAB Rp 67 Rp 6,700 1-Mar-2021
ALLOPURINOL 100 MG 140 TAB Rp 67 Rp 9,380 1-Mar-2021
AMOXICILLIN 500 MG 400 TAB Rp 201 Rp 80,400 1-Mar-2021
AMOXICILLIN 500 MG 300 TAB Rp 201 Rp 60,300 1-Mar-2021
CTM 4 MG 59400 TAB Rp 24 Rp 1,425,600 1-Mar-2021
CTM 4 MG 5855 TAB Rp 24 Rp 140,520 1-Mar-2021
 HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN
KADALUWARSA / ED
HARGA
TOTAL HARGA
SATUAN

CTM 4 MG 19800 TAB Rp 24 Rp 475,200 1-Mar-2021

CTM 4 MG 660 TAB Rp 24 Rp 15,840 1-Mar-2021
CTM 4 MG 800 TAB Rp 24 Rp 19,200 1-Mar-2021
CTM 4 MG 300 TAB Rp 24 Rp 7,200 1-Mar-2021
DOXYCYCLINE 100 MG 20 TAB Rp 275 Rp 5,500 1-Mar-2021
DOXYCYCLINE 100 MG 190 TAB Rp 275 Rp 52,250 1-Mar-2021
FLUOCONAZOLE 150 MG 90 TAB Rp 18,720 Rp 1,684,800 1-Mar-2021
IBUPROFEN 400 MG 40 TAB Rp 261 Rp 10,440 1-Mar-2021
ISDN 5 MG 135 TAB Rp 86 Rp 11,610 1-Mar-2021
LAMIVUDIN 480 TAB Rp 458 Rp 219,840 1-Mar-2021
LAMIVUDIN, ZIDOVUDINE 600 TAB Rp 1,050 Rp 630,000 1-Mar-2021
LORATADINE 10 MG 350 TAB Rp 131 Rp 45,850 1-Mar-2021
PROPANOLOL 10 MG 260 TAB Rp 58 Rp 15,080 1-Mar-2021
PROPANOLOL 10 MG 100 TAB Rp 58 Rp 5,800 1-Mar-2021
SPUIT 1 ML 200 PCS Rp 1,023 Rp 204,600 1-Mar-2021
TERADI/ NEW ANTIDES 370 TAB Rp 145 Rp 53,650 1-Mar-2021
TETRACYCLINE 500 MG 270 TAB Rp 310 Rp 83,700 1-Mar-2021
TETRACYCLINE 500 MG 2348 TAB Rp 310 Rp 727,880 1-Mar-2021
TRANSFUSION BLOODADMINISTRATION 50 PCS Rp 13,976 Rp 698,800 1-Mar-2021
VITAMIN B1 130 TAB Rp 91 Rp 11,830 1-Mar-2021
VITAMIN B1 800 TAB Rp 91 Rp 72,800 1-Mar-2021
VITAMIN K TAB 50 TAB Rp 748 Rp 37,400 1-Mar-2021
VITAMIN K TAB 190 TAB Rp 748 Rp 142,120 1-Mar-2021
COTRIMOXAZOLE 480 MG 520 TAB Rp 133 Rp 69,160 1-Apr-2021
EPINEFRIN INJ 13 AMPUL Rp 1,515 Rp 19,695 1-Apr-2021
PHENOBARBITAL 30MG 200 TAB Rp 171 Rp 34,200 1-Apr-2021
COTRIMOXAZOLE 480 MG 7200 TAB Rp 133 Rp 957,600 1-May-2021
KETOCONAZOLE 200 MG 1050 TAB Rp 252 Rp 264,600 1-May-2021
METHYLERGOMETRIN 500 TAB Rp 225 Rp 112,500 1-May-2021
NATRIUM DIKLOFENAK 50 MG 5250 TAB Rp 99 Rp 519,750 1-May-2021
POVIDON IODINE 30 ML 150 FLS Rp 3,100 Rp 465,000 1-May-2021
TERADI/ NEW ANTIDES 10200 TAB Rp 145 Rp 1,479,000 1-May-2021
EUGENOL 16 PCS Rp 20,087 Rp 321,392 1-May-2021
 HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN
KADALUWARSA / ED
HARGA
TOTAL HARGA
SATUAN

ACYCLOVIR SK 20 TUBE Rp 3,300 Rp 66,000 1-Jul-2021

AMBROXOL 30 MG 300 TAB Rp 110 Rp 33,000 1-Jul-2021
AMBROXOL 30 MG 13600 TAB Rp 110 Rp 1,496,000 1-Jul-2021
CUTICUCELL 5 PCS Rp 5,520 Rp 27,600 1-Jul-2021
DEXAMETHASONE 0,5 MG 100 TAB Rp 32 Rp 3,200 1-Jul-2021
FOLLEY CATHETER NO. 16 8 PCS Rp 10,659 Rp 85,272 1-Jul-2021
VITAMIN K TAB 2100 TAB Rp 748 Rp 1,570,800 1-Jul-2021
CALCETIN 16 PCS Rp 102,000 Rp 1,632,000 1-Aug-2021
BETAHISTINE MESILAT 6 MG 10 TAB Rp 110 Rp 1,100 1-Sep-2021
IBUPROFEN 200 MG 3800 TAB Rp 105 Rp 399,000 1-Sep-2021
MgSO4 20 % 12 VIAL Rp 35,280 Rp 423,360 1-Sep-2021
TRIKRESOL FORMALIN 12 PCS Rp 55,000 Rp 660,000 1-Sep-2021
URINE BAG 12 PCS Rp 3,100 Rp 37,200 1-Sep-2021
BIODINAMICA MASTER FILL 9 PCS Rp 154,000 Rp 1,386,000 1-Sep-2021
ISONIAZID 300 MG 90 TAB Rp 164 Rp 14,760 1-Oct-2021
KOMBIPAK (AZITROMICIN+CEFIXIME 200 MG) 240 TAB Rp 1,136 Rp 272,640 1-Oct-2021
MgSO4 20 % 6 VIAL Rp 3,580 Rp 21,480 1-Oct-2021
OXYTETRACICLINE SM 75 TUBE Rp 3,500 Rp 262,500 1-Oct-2021
SPIRONOLACTON 25MG 2500 TAB Rp 190 Rp 475,000 1-Oct-2021
SPIRONOLACTON 25MG 200 TAB Rp 190 Rp 38,000 1-Oct-2021
URINE BAG 26 PCS Rp 3,100 Rp 80,600 1-Oct-2021
URINE BAG 15 PCS Rp 3,100 Rp 46,500 1-Oct-2021
VITAMIN K INJ 2 MG/ML 70 AMPUL Rp 3,450 Rp 241,500 1-Oct-2021
ZINC DISPERSIBLE 4 TAB Rp 440 Rp 1,760 1-Oct-2021
BIOSAT ATS SERUM 16 AMPUL Rp 130,999 Rp 2,095,984 1-Nov-2021
CLOPIDOGREL 75 MG 720 TAB Rp 1,404 Rp 1,010,880 1-Nov-2021
COTRIMOXAZOLE 960 MG 300 TAB Rp 133 Rp 39,900 1-Nov-2021
LAMIVUDINE 60 TAB Rp 458 Rp 27,480 1-Nov-2021
NISTATIN TAB VAGINAL 1600 TAB Rp 560 Rp 896,000 1-Nov-2021
OXYTETRACICLINE SK 28 TUBE Rp 4,400 Rp 123,200 1-Nov-2021
CLORAMPHENICOL TM 10 TUBE Rp 7,260 Rp 72,600 1-Dec-2021
HEMMOROGARD 60 TAB Rp 1,552 Rp 93,120 1-Dec-2021
RECO TM 10 FLS Rp 6,969 Rp 69,690 1-Dec-2021
 HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN
KADALUWARSA / ED
HARGA
TOTAL HARGA
SATUAN

SALBUTAMOL 4 MG 100 TAB Rp 63 Rp 6,300 1-Dec-2021

VITAMIN K INJ 2 MG/ML 300 VIAL Rp 3,450 Rp 1,035,000 1-Dec-2021
AMLODIPINE 5 MG 2100 TAB Rp 75 Rp 157,500 1-Jan-2022
AMLODIPINE 5 MG 300 TAB Rp 75 Rp 22,500 1-Jan-2022
CALCIUM LACTAT 4200 TAB Rp 63 Rp 264,600 1-Jan-2022
CREOSOTIN 28 PCS Rp 130,000 Rp 3,640,000 1-Jan-2022
DESOXIMETHASON SK 20 TUBE Rp 10,919 Rp 218,380 1-Jan-2022
ERLAMYCETIN TT 13 FLS Rp 7,370 Rp 95,810 1-Jan-2022
ACYCLOVIR 200 MG 100 TAB Rp 236 Rp 23,600 1-Feb-2022
ALBENDAZOLE 400 TAB Rp 337 Rp 134,800 1-Feb-2022
CLORAMPHENICOL 250 MG 820 TAB Rp 623 Rp 510,860 1-Feb-2022
FLUFENAZINE DECANOAT INJ 5 AMPUL Rp 59,800 Rp 299,000 1-Feb-2022
SPUIT 1CC 447 PCS Rp 1,023 Rp 457,281 1-Feb-2022
SPUIT 5 CC 25 PCS Rp 1,045 Rp 26,125 1-Feb-2022
ACYCLOVIR 400 MG 580 TAB Rp 380 Rp 220,400 1-Mar-2022
ACYCLOVIR SK 25 TUBE Rp 3,300 Rp 82,500 1-Mar-2022
METHYLPREDNISOLON 4 MG 100 TAB Rp 102 Rp 10,200 1-Mar-2022
CHKM 6 PCS Rp 49,500 Rp 297,000 1-Mar-2022
ISDN 5 MG 100 TAB Rp 86 Rp 8,600 1-Apr-2022
GLASS IONOMER (MICRON) 26 PCS Rp 270,000 Rp 7,020,000 1-Apr-2022
ZINC FOSFATE CEMEN 3 PCS Rp 140,000 Rp 420,000 1-Apr-2022
CTM 4 MG 19800 TAB Rp 24 Rp 475,200 1-May-2022
CTM 4 MG 27150 TAB Rp 24 Rp 651,600 1-May-2022
EFAVIRENZ 600 MG 7 TAB Rp - 1-May-2022
FUROSEMID 40 MG 2175 TAB Rp 82 Rp 178,350 1-May-2022
GENTAMICIN TM 12 TUBE Rp 4,232 Rp 50,784 1-May-2022
ASETIL SISTEIN 70 TAB Rp 373 Rp 26,110 1-Jun-2022
ASETIL SISTEIN 113 TAB Rp 373 Rp 42,149 1-Jun-2022
BLOOD LANCET 85000 TAB Rp 144 Rp 12,240,000 1-Jun-2022
OXYTETRACICLINE SM 317 TUBE Rp 3,500 Rp 1,109,500 1-Jun-2022
OXYGEN MASK DEWASA 1 PCS Rp 8,178 Rp 8,178 1-Jul-2022
POLIKRESULEN 4 PCS Rp 24,200 Rp 96,800 1-Jul-2022
 HARGA
TANGGAL
NO NAMA OBAT JUMLAH SATUAN
KADALUWARSA / ED
HARGA
TOTAL HARGA
SATUAN

CLONIDIN 130 TAB Rp 174 Rp 22,620 1-Aug-2022

NOVAHEKSIN 826 TAB Rp 110 Rp 90,860 1-Aug-2022
PHENOL GLISEROL TT 10 PCS Rp 3,300 Rp 33,000 1-Aug-2022
PHENOL GLISEROL TT 18 FLS Rp 3,300 Rp 59,400 1-Aug-2022
CREOSOTIN 5 PCS Rp 130,000 Rp 650,000 1-Aug-2022
COTRIMOXAZOL 480 MG 7500 TAB Rp 133 Rp 997,500 1-Sep-2022
GARAM ORALIT 114 SACH Rp 280 Rp 31,920 1-Sep-2022
GARAM ORALIT 1200 SACH Rp 280 Rp 336,000 1-Sep-2022
PULP X 10 PCS Rp 217,000 Rp 2,170,000 1-Sep-2022
KSR 500 TAB Rp 1,841 Rp 920,500 1-Oct-2022
CLORPROMAZINE 100 3000 TAB Rp 157 Rp 471,000 1-Nov-2022
CLOZAPINE 25 MG 1270 TAB Rp 1,121 Rp 1,423,670 1-Nov-2022
IBUPROFEN 400 MG 100 TAB Rp 261 Rp 26,100 1-Nov-2022
METRONIDAZOLE 500 MG 300 TAB Rp 174 Rp 52,200 1-Nov-2022
HALOPERIDOL 5MG 3400 TAB Rp 54 Rp 183,600 1-Jan-2023

JUMLAH TOTAL Rp 106,444,942

Tega
Mengetahui/Menyetujui,
Kepala Puskesmas Tegal Barat Pet

dr. Bambang Kuswanto Nurul

NIP.19651107 200212 1 004 NIP. 19
 DAFTAR OBAT / BMHP RUSAK DAN ATAU KADALUWARSA
PUSKESMAS TEGAL BARAT
PERIODE AGUSTUS 2018 - JANUARI 2023
HARGA
NO NAMA OBAT SATUAN JUMLAH JUMLAH HARGA
SATUAN

REAGEN LABORATORIUM

1 VACUM TUBE NON EDTA botol Rp 100,500 10 Rp 1,005,000

2 GIEMSA STAIN botol Rp 350,000 2 Rp 700,000

3 IMMERSION OIL botol Rp 195,000 5 Rp 975,000

4 XILOL botol Rp 100,000 3 Rp 300,000

5 ASAM ALKOHOL botol Rp 165,000 9 Rp 1,485,000

6 NACL botol Rp 60,500 1 Rp 60,500

7 STIK GENERAL ELEKTRIK tube 87 Rp -

8 SALMONELLA TYPHI H botol Rp 63,000 1 Rp 63,000

9 SALMONELLA TYPHI O botol Rp 63,000 2 Rp 126,000

10 STIK ASAM URAT (EASY TOUCH) box Rp 150,787 6 Rp 904,722

11 STIK HB (EASY TOUCH) box Rp 159,500 1 Rp 159,500

12 ANTISERA AB botol Rp 86,000 5 Rp 430,000

13 HBSAG RAPID TES (SD BIOLINE) pcs Rp 1,595 703 Rp 1,121,285

14 HBSAG RAPID TES box Rp 159,500 33 Rp 5,263,500

15 ANTISERA B botol Rp 86,000 1 Rp 86,000

16 BLOOD LANCET botol Rp 15,000 7 Rp 105,000

17 HCL 0,1 botol Rp 25,000 4 Rp 100,000

 HARGA
NO NAMA OBAT SATUAN JUMLAH JUMLAH HARGA
SATUAN

18 VACUM TUBE NON EDTA box Rp 100,500 5 Rp 502,500

TOTAL Rp 13,387,007

Mengetahui/Menyetujui,
Kepala Puskesmas Tegal Barat

dr. Bambang Kuswanto

NIP.19651107 200212 1 004
 DAFTAR OBAT / BMHP RUSAK DAN ATAU KADALUWARSA
PUSKESMAS TEGAL BARAT
PERIODE AGUSTUS 2018 - JANUARI 2023
SU
HARGA
NO NAMA OBAT SATUAN JUMLAH JUMLAH HARGA ED AP
SATUAN

REAGEN LABORATORIUM

1 VACUM TUBE NON EDTA botol Rp 100,500 10 Rp 1,005,000 Jan-20

2 GIEMSA STAIN botol Rp 350,000 2 Rp 700,000 Jun-20

3 IMMERSION OIL botol Rp 195,000 5 Rp 975,000 Jul-20

4 XILOL botol Rp 100,000 3 Rp 300,000 Jul-20

5 ASAM ALKOHOL botol Rp 165,000 9 Rp 1,485,000 Sep-20

6 NACL botol Rp 60,500 1 Rp 60,500 Sep-20

7 STIK GENERAL ELEKTRIK tube 87 Rp - Jan-21

8 SALMONELLA TYPHI H botol Rp 63,000 1 Rp 63,000 Jun-21

9 SALMONELLA TYPHI O botol Rp 63,000 2 Rp 126,000 Jun-21

10 STIK ASAM URAT (EASY TOUCH) box Rp 150,787 6 Rp 904,722 Sep-21

11 STIK HB (EASY TOUCH) box Rp 159,500 1 Rp 159,500 Sep-21

12 ANTISERA AB botol Rp 86,000 5 Rp 430,000 Oct-21

13 HBSAG RAPID TES (SD BIOLINE) pcs Rp 1,595 703 Rp 1,121,285 Oct-21

14 HBSAG RAPID TES box Rp 159,500 33 Rp 5,263,500 Nov-21

15 ANTISERA B botol Rp 86,000 1 Rp 86,000 Dec-21

16 BLOOD LANCET botol Rp 15,000 7 Rp 105,000 Dec-21

17 HCL 0,1 botol Rp 25,000 4 Rp 100,000 Dec-21

 SU
HARGA
NO NAMA OBAT SATUAN JUMLAH JUMLAH HARGA ED AP
SATUAN

18 VACUM TUBE NON EDTA box Rp 100,500 5 Rp 502,500 nnov 21

TOTAL Rp 13,387,007

Tegal,
Mengetahui/Menyetujui,
Kepala Puskesmas Tegal Barat Petug

dr. Bambang Kuswanto Nurul A

NIP.19651107 200212 1 004 NIP. 1983