Laporan Bulanan JKN 2020

LAPORAN PENERIMAAN DAN PEMAKAIAN OBAT DAN BMHP JKN
UPT PUSKESMAS DTP MENES
BULAN : DESEMBER
TAHUN : 2019
NO. NAMA BARANG SATUAN STOK AWAL PENERIMAAN PERSEDIAAN
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE
2 AMOXYCILLIN 125MG/5ML SYRUP BOTOL
3 BEDAK SALICIL ADINDA SACHET
4 BIOPLACENTON JELLY TUBE
5 CLOPIDOGREL 75MG TABLET
6 EPINEFRIN INJEKSI AMPUL
7 FITOMENADION INJEKSI AMPUL
8 FUROSEMIDE INJ AMPUL
9 GUAIFENISIN 100MG TABLET
10 IBUPROFEN 400MG TABLET
11 METRONIDAZOLE 500MG TABLET
12 NACL PIGGY BAG 100ML FLS
13 NIFEDIPINE 10MG TABLET
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL
2 BLOOD TRANSFUSION SET BUAH
3 CANULA OXYGEN ANAK BUAH
4 CANULA OXYGEN DEWASA BUAH
5 HAND SANITIZER ANVIS GALON/5L
6 HANDSCOON NON STERIL M BOX
7 HANDSCOON NON STERIL S BOX
8 JELLY USG BOTOL
9 KASA STERIL KOTAK
10 KERTAS EKG PAK
11 KERTAS USG ROLL
12 KLIP PLASTIK KECIL 10X7 PAK
13 KLIP PLASTIK KECIL 15X10 PAK
14 KLIP PLASTIK SEDANG 13X8,7 PAK
15 LANCET BOX
16 MUCUS EXTRACTOR BUAH
17 NEEDLE TERUMO NO. 23 BOX/100
18 NEEDLE TERUMO NO. 24 BOX/100
19 POVIDON IODINE 1000ML BOTOL
20 SPUIT DISP 10ML BUAH
21 SPUIT DISP 20ML BUAH
22 STIK EASY TOUCH ASAM URAT POT
23 STIK EASY TOUCH GLUKOSA POT
24 STIK EASY TOUCH HB POT
25 STIK EASY TOUCH KOLESTEROL POT
26 STIK NESCO ASAM URAT POT
27 STIK NESCO GLUKOSA POT
28 STIK NESCO KOLESTEROL POT
29 VERBAN 10CM ROLL
30 WING NEEDLE TERUMO 25 BUAH
MHP JKN
PERMAKAIAN STOK AKHIR KET.
25
20
58
103
60
23900
800
400
300
6
70
82
54
19
12
50
0
110
6
20
5
4
50
50
48
BULAN : JANUARI
TAHUN : 2020
STOK AWAL PENERIMAAN

NO. NAMA BARANG SATUAN Harga per Unit Jumlah Harga per Unit
Unit Unit
(Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE 25 6,600 165,000 -
2 AMOXYCILLIN 125MG/5ML SYRUP BOTOL 20 6,600 132,000 -
3 BEDAK SALICIL ADINDA SACHET 58 4,400 255,200 -
4 BIOPLACENTON JELLY TUBE - - - -
5 CLOPIDOGREL 75MG TABLET - - - -
6 EPINEFRIN INJEKSI AMPUL 103 9,350 963,050 -
7 FITOMENADION INJEKSI AMPUL 60 8,800 528,000 -
8 FUROSEMIDE INJ AMPUL - - - -
9 GUAIFENISIN 100MG TABLET 23,900 132 3,159,341 -
10 IBUPROFEN 400MG TABLET 800 385 308,000 -
11 METRONIDAZOLE 500MG TABLET 400 385 154,000 -
12 NACL PIGGY BAG 100ML FLS - - - -
13 NIFEDIPINE 10MG TABLET 300 220 66,000 -
5,730,591
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 6 40,000 240,000
2 BLOOD TRANSFUSION SET BUAH 70 17,000 1,190,000
3 CANULA OXYGEN ANAK BUAH 82 17,500 1,435,000
4 CANULA OXYGEN DEWASA BUAH 54 17,500 945,000
5 HAND SANITIZER ANVIS GALON/5L - -
6 HANDSCOON NON STERIL M BOX 19 50,000 950,000
7 HANDSCOON NON STERIL S BOX 12 50,000 600,000
8 JELLY USG BOTOL - -
9 KASA STERIL KOTAK - -
10 KERTAS EKG PAK - -
11 KERTAS USG ROLL - -
12 KLIP PLASTIK KECIL 10X7 PAK 50 7,500 375,000
13 KLIP PLASTIK KECIL 15X10 PAK - -
14 KLIP PLASTIK SEDANG 13X8,7 PAK 110 9,500 1,045,000
15 LANCET BOX 6 30,000 180,000
16 MUCUS EXTRACTOR BUAH 20 25,000 500,000
17 NEEDLE TERUMO NO. 23 BOX/100 5 99,550 497,750
18 NEEDLE TERUMO NO. 24 BOX/100 4 99,550 398,200
19 POVIDON IODINE 1000ML BOTOL - -
20 SPUIT DISP 10ML BUAH - -
21 SPUIT DISP 20ML BUAH 50 2,800 140,000
22 STIK EASY TOUCH ASAM URAT POT - -
23 STIK EASY TOUCH GLUKOSA POT - -
24 STIK EASY TOUCH HB POT - -
25 STIK EASY TOUCH KOLESTEROL POT - -
26 STIK NESCO ASAM URAT POT - -
27 STIK NESCO GLUKOSA POT - -
28 STIK NESCO KOLESTEROL POT - -
29 VERBAN 10CM ROLL 50 2,500 125,000
30 WING NEEDLE TERUMO 25 BUAH 48 14,685 704,880
9,325,830
PORAN PENERIMAAN DAN PEMAKAIAN OBAT DAN BMHP JKN
PENERIMAAN PERMAKAIAN STOK AKHIR

Jumlah Harga per Unit Jumlah Harga per Unit Jumlah
Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.) (Rp.)
- - - 25 6,600 165,000
- - - 20 6,600 132,000
- 34 4,400 149,600 24 4,400 105,600
- - - - -
- - - - -
- - - 103 9,350 963,050
- - - 60 8,800 528,000
- - - - -
- 1,300 132 171,847 22,600 132 2,987,494
- 500 385 192,500 300 385 115,500
- - - 400 385 154,000
- - - - -
- - - 300 220 66,000
- 513,947 5,216,644
- 1 40,000 40,000 5 40,000 200,000

- 30 17,000 510,000 40 17,000 680,000
- 10 17,500 175,000 72 17,500 1,260,000
- 10 17,500 175,000 44 17,500 770,000
- - - - -
- 15 50,000 750,000 4 50,000 200,000
- 6 50,000 300,000 6 50,000 300,000
- - - - -
- - - - -
- - - - -
- - - - -
- 40 7,500 300,000 10 7,500 75,000
- - - - -
- 34 9,500 323,000 76 9,500 722,000
- - - 6 30,000 180,000
- 5 25,000 125,000 15 25,000 375,000
- - - 5 99,550 497,750
- - - 4 99,550 398,200
- - - - -
- - - - -
- - - 50 2,800 140,000
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
- - - 50 2,500 125,000
- - - 48 14,685 704,880
- 2,698,000 6,627,830
KET.
5,216,644
6,627,830
BULAN : FEBRUARI
TAHUN : 2020

NO. NAMA BARANG SATUAN Harga per Unit Jumlah Harga per Unit Jumlah
Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE 25 6,600 165,000 - -
2 AMOXYCILLIN 125MG/5ML SYRUP BOTOL 20 6,600 132,000 - -
3 BEDAK SALICIL ADINDA SACHET 24 4,400 105,600 - -
4 BIOPLACENTON JELLY TUBE - - - - -
5 CLOPIDOGREL 75MG TABLET - - - - -
6 EPINEFRIN INJEKSI AMPUL 103 9,350 963,050 - -
7 FITOMENADION INJEKSI AMPUL 60 8,800 528,000 - -
8 FUROSEMIDE INJ AMPUL - - - - -
9 GUAIFENISIN 100MG TABLET 22,600 132.19 2,987,494 - -
10 IBUPROFEN 400MG TABLET 300 385 115,500 - -
11 METRONIDAZOLE 500MG TABLET 400 385 154,000 - -
12 NACL PIGGY BAG 100ML FLS - - - - -
13 NIFEDIPINE 10MG TABLET 300 220 66,000 - -
5,216,644 -
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 5 40,000 200,000 -
2 BLOOD TRANSFUSION SET BUAH 40 17,000 680,000 -
3 CANULA OXYGEN ANAK BUAH 72 17,500 1,260,000 -
4 CANULA OXYGEN DEWASA BUAH 44 17,500 770,000 -
5 HAND SANITIZER ANVIS GALON/5L - - -
6 HANDSCOON NON STERIL M BOX 4 50,000 200,000 -
7 HANDSCOON NON STERIL S BOX 6 50,000 300,000 -
8 JELLY USG BOTOL - - -
9 KASA STERIL KOTAK - - -
10 KERTAS EKG PAK - - -
11 KERTAS USG ROLL - - -
12 KLIP PLASTIK KECIL 10X7 PAK 10 7,500 75,000 -
13 KLIP PLASTIK KECIL 15X10 PAK - - -
14 KLIP PLASTIK SEDANG 13X8,7 PAK 76 9,500 722,000 -
15 LANCET BOX 6 30,000 180,000 -
16 MUCUS EXTRACTOR BUAH 15 25,000 375,000 -
17 NEEDLE TERUMO NO. 23 BOX/100 5 99,550 497,750 -
19 POVIDON IODINE 1000ML BOTOL - - -
20 SPUIT DISP 10ML BUAH - - -
21 SPUIT DISP 20ML BUAH 50 2,800 140,000 -
22 STIK EASY TOUCH ASAM URAT POT - - -
23 STIK EASY TOUCH GLUKOSA POT - - -
24 STIK EASY TOUCH HB POT - - -
25 STIK EASY TOUCH KOLESTEROL POT - - -
26 STIK NESCO ASAM URAT POT - - -
27 STIK NESCO GLUKOSA POT - - -
28 STIK NESCO KOLESTEROL POT - - -
29 VERBAN 10CM ROLL 50 2,500 125,000 -
30 WING NEEDLE TERUMO 25 BUAH 48 14,685 704,880 -
6,627,830 -
RAN PENERIMAAN DAN PEMAKAIAN OBAT DAN BMHP JKN
PERMAKAIAN STOK AKHIR

Harga per Unit Jumlah Harga per Unit Jumlah
Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
25 6,600 165,000 - -
20 6,600 132,000 - -
13 4,400 57,200 11 4,400 48,400
- - - -
- - - -
15 9,350 140,250 88 9,350 822,800
- - 60 8,800 528,000
- - - -
2,400 132.19 317,256 20,200 132.19 2,670,238
300 385 115,500 - -
400 385 154,000 - -
- - - -
- - 300 220 66,000
1,081,206 4,135,438
3 40,000 120,000 2 40,000 80,000

10 17,000 170,000 30 17,000 510,000
- 72 17,500 1,260,000
- 44 17,500 770,000
- - -
4 50,000 200,000 - -
6 50,000 300,000 - -
- - -
- - -
- - -
- - -
10 7,500 75,000 - -
- - -
66 9,500 627,000 10 9,500 95,000
- 6 30,000 180,000
- 15 25,000 375,000
- 5 99,550 497,750
- 4 99,550 398,200
- - -
- - -
- 50 2,800 140,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 50 2,500 125,000
- 48 14,685 704,880
1,492,000 5,135,830
KET.
4,135,438
5,135,830
BULAN : MARET
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE - - 50 3,988 199,400
2 AMOXYCILLIN 125MG/5ML SYRUP BOTOL - - - -
3 BEDAK SALICIL ADINDA SACHET 11 4,400 48,400 - -
4 BIOPLACENTON JELLY TUBE - - 30 20,570 617,100
5 CLOPIDOGREL 75MG TABLET - - 30 6,086.67 182,600
6 DEXTROSE 40% BOTOL - - 5 22,000.00 110,000
7 EPINEFRIN INJEKSI AMPUL 88 9,350 822,800 - -
8 FITOMENADION INJEKSI AMPUL 60 8,800 528,000 - -
9 FUROSEMIDE INJ AMPUL - - 25 3,542 88,550
10 GUAIFENISIN 100MG TABLET 20,200 132.19 2,670,238 - -
11 IBUPROFEN 400MG TABLET - - 1,500 528 792,000
12 METRONIDAZOLE 500MG TABLET - - 1,500 264 396,000
13 NACL PIGGY BAG 100ML FLS - - 50 24,200 1,210,000
14 NIFEDIPINE 10MG TABLET 300 220 66,000 - -
15 PARACETAMOL 500MG TABLET 60,000 160 9,600,000
4,135,438 13,195,650
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 2 40,000 80,000 -
2 BLOOD TRANSFUSION SET BUAH 30 17,000 510,000 -
3 BLOOD TRANSFUSION SET (REMEDI) BUAH - - 150 10,560 1,584,000
7 HANDSCOON NON STERIL M BOX - - -
8 HANDSCOON NON STERIL S BOX - - -
9 JELLY USG BOTOL - - 15 38,674.97 580,125
10 KASA GULUNG 4M ROLL - - 100 1,575.002 157,500
12 KERTAS EKG MAC 600 PAK - - 5 147,500.10 737,501
13 KERTAS USG SONY ROLL - - 5 277,500.08 1,387,500
14 KLIP PLASTIK KECIL 10X7 PAK - - 300 7,499.998 2,249,999
16 KLIP PLASTIK SEDANG 13X8,7 PAK 10 9,500 95,000 300 9,500.00 2,850,000
17 LANCET BOX 6 30,000 180,000 -
19 MUCUS EXTRACTOR BUAH - 30 9,800.01 294,000
22 POVIDON IODINE 1000ML BOTOL - - 5 105,000.06 525,000
23 SPUIT DISP 10ML ONEMED BUAH - - 100 1,505.262 150,526
27 STIK EASY TOUCH HB POT - - 20 169,374.975 3,387,500
28 STIK EASY TOUCH KOLESTEROL POT - - 30 206,550 6,196,500
32 VERBAN 10CM ROLL 50 2,500 125,000 -
5,135,830 20,100,151
AN PENERIMAAN DAN PEMAKAIAN OBAT DAN BMHP JKN

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
- 50 3,988 199,400
- - -
- 11 4,400 48,400
- 30 20,570 617,100
- 30 6,086.67 182,600
- 5 22,000.00 110,000
- 88 9,350 822,800
30 8,800 264,000 30 8,800 264,000
- 25 3,542 88,550
- 20,200 132.19 2,670,238
- 1,500 528 792,000
- 1,500 264 396,000
- 50 24,200 1,210,000
- 300 220 66,000
- 60,000 160 9,600,000
264,000 17,067,088
2 40,000 80,000 - -
30 17,000 510,000 - -
- 150 10,560 1,584,000
14 17,500 245,000 58 17,500 1,015,000
15 17,500 262,500 29 17,500 507,500
- - -
- - -
- - -
- 15 38,674.97 580,125
- 100 1,575.002 157,500
- - -
1 147,500.10 147,500 4 147,500.1 590,000
- 5 277,500.08 1,387,500
- 300 7,499.998 2,249,999
- - -
10 9,500 95,000 300 9,500 2,850,000
- 6 30,000 180,000
15 25,000 375,000 - -
- 30 9,800.01 294,000
- 5 99,550 497,750
- 4 99,550 398,200
- 5 105,000.06 525,000
20 1,505.262 30,105 80 1,505.262 120,421
- 50 2,800 140,000
- - -
- - -
- 20 169,375.0 3,387,500
- 30 206,550 6,196,500
- - -
- - -
- - -
50 2,500 125,000 - -
- 48 14,685 704,880
1,870,105 23,365,876.01
KET.
17,067,088
23,365,876.01
BULAN : APRIL
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
2 AMOXYCILLIN 125MG/5ML SYRUP BOTOL - - 1,000 5,200.25 5,200,250
3 BEDAK SALICIL ADINDA SACHET 11 4,400 48,400 -
4 BIOPLACENTON JELLY TUBE 30 20,570 617,100 -
5 CLOPIDOGREL 75MG TABLET 30 6,086.67 182,600 -
6 DEXTROSE 40% BOTOL 5 22,000 110,000 -
7 EPINEFRIN INJEKSI AMPUL 88 9,350 822,800 -
8 FITOMENADION INJEKSI AMPUL 30 8,800 264,000 -
9 FUROSEMIDE INJ AMPUL 25 3,542 88,550 -
10 GUAIFENISIN 100MG TABLET 20,200 132.19 2,670,238 -
11 IBUPROFEN 400MG TABLET 1,500 528 792,000 -
12 METRONIDAZOLE 500MG TABLET 1,500 264 396,000 -
13 NACL PIGGY BAG 100ML FLS 50 24,200 1,210,000 -
14 NIFEDIPINE 10MG TABLET 300 220 66,000 -
15 PARACETAMOL 500MG TABLET 60,000 160 9,600,000 -
17,067,088 5,200,250
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL - - 20 75,250.01 1,505,000.2
2 BISTURI NO.23 B BRAUN bUAH - - 200 3,867.5 773,500.2
3 BLOOD TRANSFUSION SET BUAH - - -
4 BLOOD TRANSFUSION SET (REMEDI) BUAH 150 10,560 1,584,000 -
7 CANULA OXYGEN DEWASA BUAH - - 100 7,135.997 713,599.7
11 JELLY USG BOTOL 15 38,674.97 580,125 -
12 KASA GULUNG 4M X 10CM ROLL 100 1,575.002 157,500 -
13 KASA GULUNG 4M X 10CM ROLL - -
15 KERTAS EKG MAC 600 PAK 4 147,500.1 590,000 -
16 KERTAS USG SONY ROLL 5 277,500.1 1,387,500 -
17 KLIP PLASTIK KECIL 10X7 PAK 300 7,499.998 2,249,999.4 -
19 KLIP PLASTIK SEDANG 13X8,7 PAK 300 9,500 2,850,000 -
20 LANCET BOX 6 30,000 180,000 -
21 MUCUS EXTRACTOR BUAH - - -
22 MUCUS EXTRACTOR BUAH 30 9,800.01 294,000.3 -
25 PLESTER BESAR KAIN COKLAT 7,5CM ROLL - - 15 57,586.98 863,804.7
26 POVIDON IODINE 1000ML BOTOL 5 105,000.06 525,000.3 -
27 SARUNG TANGAN STERIL NO. 6,5 PASANG - - 300 6,622 1,986,600.0
28 SARUNG TANGAN STERIL NO. 7 PASANG - - 100 6,622 662,200.0
29 SPUIT DISP 10ML ONEMED BUAH 80 1,505.262 120,421 -
30 SPUIT DISP 10ML REMEDI BUAH - - 100 3,010.513 301,051.3
34 STIK EASY TOUCH HB POT 20 169,375 3,387,500 -
35 STIK EASY TOUCH KOLESTEROL POT 30 206,550 6,196,500 -
39 VERBAN 10CM ROLL - - 500 1,354.9998 677,499.9
41 UNDERPAD PAK - - 60 45,140.004 2,708,400.2
23,365,876.01 10,191,656.24

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
25 3,988 99,700 25 3,988 99,700

- 1,000 5,200.25 5,200,250
11 4,400 48,400 - -
4 20,570 82,280 26 20,570 534,820
- 30 6,086.67 182,600
3 22,000 66,000 2 22,000.00 44,000
28 9,350 261,800 60 9,350 561,000
30 8,800 264,000 - -
5 3,542 17,710 20 3,542 70,840
8,000 132.19 1,057,520 12,200 132.19 1,612,718
200 528 105,600 1,300 528 686,400
200 264 52,800 1,300 264 343,200
10 24,200 242,000 40 24,200 968,000
100 220 22,000 200 220 44,000
8,400 160 1,344,000 51,600 160 8,256,000
3,663,810 18,603,528.10
- 20 75,250.01 1,505,000.2
200 3,867.5 773,500.2
- - -
30 10,560 316,800 120 10,560 1,267,200
- 58 17,500 1,015,000
- 29 17,500 507,500
100 7,135.997 713,599.7
- - -
- - -
- - -
- 15 38,674.97 580,124.55
- 100 1,575.002 157,500.2
- - -
- - -
- 4 147,500.1 590,000.4
- 5 277,500 1,387,500.4
60 7,500 450,000 240 7,500 1,799,999.52
- - -
50 9,500 475,000 250 9,500 2,375,000
- 6 30,000 180,000
- - -
10 9,800 98,000 20 9,800 196,000
- 5 99,550 497,750
- 4 99,550 398,200
- 15 57,586.98 863,804.7
1 105,000.06 105,000 4 105,000.06 420,000.24
- 300 6,622 1,986,600
- 100 6,622 662,200
27 1,505.26 40,642 53 1,505.26 79,778.886
- 100 3,010.513 301,051.3
- 50 2,800 140,000
- - -
- - -
- 20 169,375 3,387,500
- 30 206,550 6,196,500
- - -
- - -
- - -
- 500 1,354.9998 677,499.9
- 48 14,685 704,880
60 45,140.004 2,708,400.2
1,485,442.11 32,072,090.14
KET.
18,603,528.10
32,072,090.14
BULAN : MEI
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE 25 3,988.00 99,700.00 -
2 AMOXYCILLIN 125MG/5ML SYRUP BOTOL 1,000 5,200.25 5,200,250.00 -
3 BEDAK SALICIL 60G KF POT - - 60 6,426.20 385,572.00
4 BIOPLACENTON JELLY TUBE 26 20,570.00 534,820.00 -
5 CLOPIDOGREL 75MG TABLET 30 6,086.67 182,600.10 -
6 COTRIMOKSAZOL 480MG TABLET - 1,000 231.00 231,000.00
7 DEXTROSE 40% BOTOL 2 22,000.00 44,000.00 -
8 EPINEFRIN INJEKSI AMPUL 60 9,350.00 561,000.00 -
9 FITOMENADION INJEKSI AMPUL - - 180 4,437.98 798,836.40
10 FUROSEMIDE INJ AMPUL 20 3,542.00 70,840.00 -
11 GENTAMYSIN CR KF TUBE - 500 2,937.00 1,468,500.00
12 GUAIFENISIN 100MG TABLET 12,200 132.19 1,612,718.00 -
13 IBUPROFEN 400MG TABLET 1,300 528.00 686,400.00 -
14 KETOROLAC INJEKSI AMPUL - 480 1,667.50 800,400.00
15 METRONIDAZOLE 500MG TABLET 1,300 264.00 343,200.00 -
16 NACL PIGGY BAG 100ML FLS 40 24,200.00 968,000.00 -
17 NIFEDIPINE 10MG TABLET 200 220.00 44,000.00 -
18 PARACETAMOL 500MG TABLET 51,600 160.00 8,256,000.00 -
18,603,528.10 3,684,308.40
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 20 75,250.01 1,505,000.2 -
2 BISTURI NO.23 B BRAUN bUAH 200 3,867.50 773,500.2 -
4 BLOOD TRANSFUSION SET (REMEDI) BUAH 120 10,560 1,267,200.0 -
5 CANULA OXYGEN ANAK BUAH 58 17,500 1,015,000.0 -
6 CANULA OXYGEN DEWASA BUAH 29 17,500 507,500.0 -
7 CANULA OXYGEN DEWASA BUAH 100 7,135.997 713,599.7 -
11 JELLY USG BOTOL 15 38,674.97 580,124.55 -
12 KASA GULUNG 4M X 10CM ROLL 100 1,575.002 157,500.2 -
15 KERTAS EKG MAC 600 PAK 4 147,500.1 590,000.4 -
16 KERTAS USG SONY ROLL 5 277,500 1,387,500.4 -
19 KLIP PLASTIK SEDANG 13X8,7 PAK 250 9,500 2,375,000.0 -
20 LANCET BOX 6 30,000 180,000.0 -
22 MUCUS EXTRACTOR BUAH 20 9,800.01 196,000.2 -
23 NEEDLE TERUMO NO. 23 BOX/100 5 99,550 497,750.0 -
24 NEEDLE TERUMO NO. 24 BOX/100 4 99,550 398,200.0 -
25 PLESTER BESAR KAIN COKLAT 7,5CM ROLL 15 57,586.98 863,804.7 -
27 SARUNG TANGAN STERIL NO. 6,5 PASANG 300 6,622 1,986,600.0 -
28 SARUNG TANGAN STERIL NO. 7 PASANG 100 6,622 662,200.0 -
29 SPUIT DISP 10ML ONEMED BUAH 53 1,505.262 79,778.9 -
30 SPUIT DISP 10ML REMEDI BUAH 100 3,010.513 301,051.3 -
31 SPUIT DISP 20ML BUAH 50 2,800 140,000.0 -
34 STIK EASY TOUCH HB POT 20 169,375 3,387,499.5 -
35 STIK EASY TOUCH KOLESTEROL POT 30 206,550 6,196,500.0 -
39 VERBAN 10CM ROLL 500 1,354.9998 677,499.9 -
40 WING NEEDLE TERUMO 25 BUAH 48 14,685 704,880.0 -
41 UNDERPAD PAK 60 45,140.004 2,708,400.2 -
32,072,090.14 -

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
- 25 3,988.00 99,700.00
148 5,200.25 769,637.00 852 5,200.25 4,430,613.00
2 6,426.20 12,852.40 58 6,426.20 372,719.60
3 20,570.00 61,710.00 23 20,570.00 473,110.00
- 30 6,086.67 182,600.10
200 231.00 46,200.00 800 231.00 184,800.00
- 2 22,000.00 44,000.00
- 60 9,350.00 561,000.00
- 180 4,437.98 798,836.40
- 20 3,542.00 70,840.00
20 2,937.00 58,740.00 480 2,937.00 1,409,760.00
700 132.19 92,533.00 11,500 132.19 1,520,185.00
100 528.00 52,800.00 1,200 528.00 633,600.00
120 1,667.50 200,100.00 360 1,667.50 600,300.00
300 264.00 79,200.00 1,000 264.00 264,000.00
- 40 24,200.00 968,000.00
100 220.00 22,000.00 100 220.00 22,000.00
3,800 160.00 608,000.00 47,800 160.00 7,648,000.00
2,003,772.40 20,284,064.10
1 75,250.01 75,250.01 19 75,250.01 1,429,750.19

20 3,867.50 77,350.02 180 3,867.501 696,150.18
- - -
20 10,560.00 211,200.00 100 10,560.00 1,056,000.00
- 58 17,500.00 1,015,000.00
10 17,500.00 175,000.00 19 17,500.00 332,500.00
- 100 7,136.00 713,599.70
- - -
- - -
- - -
2 38,674.97 77,349.94 13 38,674.97 502,774.61
- 100 1,575.00 157,500.20
- - -
- - -
- 4 147,500.10 590,000.40
- 5 277,500.08 1,387,500.40
- 240 7,499.998 1,799,999.52
- - -
- 250 9,500.00 2,375,000.00
- 6 30,000.00 180,000.00
- - -
10 9,800.01 98,000.10 10 9,800.01 98,000.10
- 5 99,550.00 497,750.00
- 4 99,550.00 398,200.00
2 57,586.98 115,173.96 13 57,586.98 748,630.74
1 105,000.06 105,000.06 3 105,000.06 315,000.18
- 300 6,622.00 1,986,600.00
- 100 6,622.00 662,200.00
10 1,505.26 15,052.62 43 1,505.26 64,726.27
- 100 3,010.51 301,051.30
- 50 2,800.00 140,000.00
- - -
- - -
- 20 169,374.98 3,387,499.50
- 30 206,550.00 6,196,500.00
- - -
- - -
- - -
150 1,355.00 203,249.97 350 1,355.00 474,249.93
- 48 14,685.00 704,880.00
4 45,140.00 180,560.02 56 45,140.00 2,527,840.22
1,333,186.70 30,738,903.44
KET.
20,284,064.10
30,738,903.44
BULAN : JUNI
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE 25 3,988.00 99,700.00 -
2 AMOXYCILLIN 125MG/5ML SYRUP BOTOL 852 5,200.25 4,430,613.00 -
3 BEDAK SALICIL 60G KF POT 58 6,426.20 372,719.60 -
6 COTRIMOKSAZOL 480MG TABLET 800 231.00 184,800.00 -
7 DEXTROSE 40% BOTOL 2 22,000.00 44,000.00 -
9 FITOMENADION INJEKSI AMPUL 180 4,437.98 798,836.40 -
11 GENTAMYSIN CR KF TUBE 480 2,937.00 1,409,760.00 -
14 KETOROLAC INJEKSI AMPUL 360 1,667.50 600,300.00 -
15 METRONIDAZOLE 500MG TABLET 1,000 264.00 264,000.00 -
20,284,064.10 -
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 19 75,250.01 1,429,750.19 -
2 BISTURI NO.23 B BRAUN bUAH 180 3,867.501 696,150.18 -
11 JELLY USG BOTOL 13 38,674.97 502,774.61 -
12 KASA GULUNG 4M X 10CM ROLL 100 1,575.002 157,500.2 -
16 KERTAS USG SONY ROLL 5 277,500.08 1,387,500.4 -
20 LANCET BOX 6 30,000 180,000 -
28 SARUNG TANGAN STERIL NO. 6,5 PASANG 300 6,622 1,986,600 -
29 SARUNG TANGAN STERIL NO. 7 PASANG 100 6,622 662,200 -
31 SPUIT DISP 10ML REMEDI BUAH 100 3,010.51 301,051 -
40 VERBAN 10CM ROLL 350 1,354.9998 474,250 -
42 UNDERPAD PAK 56 45,140.00 2,527,840 -
30,738,903.44 -

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
7 3,988.00 27,916.00 18 3,988.00 71,784.00

132 5,200.25 686,433.00 720 5,200.25 3,744,180.00
10 6,426.20 64,262.00 48 6,426.20 308,457.60
1 20,570.00 20,570.00 22 20,570.00 452,540.00
- 30 6,086.67 182,600.10
400 231.00 92,400.00 400 231.00 92,400.00
- 2 22,000.00 44,000.00
- 60 9,350.00 561,000.00
60 4,437.98 266,278.80 120 4,437.98 532,557.60
- 20 3,542.00 70,840.00
40 2,937.00 117,480.00 440 2,937.00 1,292,280.00
1,100 132.19 145,409.00 10,400 132.19 1,374,776.00
200 528.00 105,600.00 1,000 528.00 528,000.00
108 1,667.50 180,090.00 252 1,667.50 420,210.00
600 264.00 158,400.00 400 264.00 105,600.00
- 40 24,200.00 968,000.00
- 100 220.00 22,000.00
8,500 160.00 1,360,000.00 39,300 160.00 6,288,000.00
3,224,838.80 17,059,225.30
2 75,250.01 150,500.02 17 75,250.01 1,279,250.17

- 180 3,867.50 696,150.18
- - -
- 100 10,560.00 1,056,000.00
10 17,500.00 175,000.00 48 17,500.00 840,000.00
10 17,500.00 175,000.00 9 17,500.00 157,500.00
- 100 7,136.00 713,599.70
- - -
- - -
- - -
4 38,674.97 154,699.88 9 38,674.97 348,074.73
100 1,575.00 157,500.20 - 1,575.00 -
- - -
- - -
- 4 147,500.10 590,000.40
- 5 277,500.08 1,387,500.40
40 7,499.998 299,999.92 200 7,499.998 1,499,999.60
- - -
20 9,500.00 190,000.00 230 9,500.00 2,185,000.00
2 30,000.00 60,000.00 4 30,000.00 120,000.00
- - -
10 9,800.00 98,000.00 - 9,800.00 -
- 5 99,550.00 497,750.00
- 4 99,550.00 398,200.00
3 57,586.98 172,760.94 10 57,586.98 575,869.80
- 3 105,000.06 315,000.18
100 6,622.00 662,200.00 200 6,622.00 1,324,400.00
- 100 6,622.00 662,200.00
30 1,505.26 45,157.86 13 1,505.26 19,568.41
- 100 3,010.51 301,051.30
- 50 2,800.00 140,000.00
- - -
- - -
4 169,374.98 677,499.92 16 169,374.98 2,709,999.68
4 206,550.00 826,200.00 26 206,550.00 5,370,300.00
- - -
- - -
- - -
- 350 1,354.9998 474,249.93
- 48 14,685.00 704,880.00
4 45,140.00 180,560.02 52 45,140.00 2,347,280.21
4,025,078.76 26,713,824.68
KET.
APOTIK UGD posbindu poned aw

7
116 16
10
1
400
60
30 10
1000 100
200
108
400 200
6800 1100 200 300 100

17,059,225.30
UGD bp gigi poned

1 1
10
10
1 2
10
10
100
30
1
4
26,713,824.68
BULAN : JULI
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
2 ACYCLOVIR CR KF TUBE - - - 250 3,304.29 826,072.50
3 AMOXYCILLIN 125MG/5ML SYRUP BOTOL 720 5,200.25 3,744,180 -
5 BIOPLACENTON JELLY TUBE 22 20,570 452,540 -
6 CEFADROXIL 500MG HEXA BOX/100 - - 20 58,002.30 1,160,046.00
7 CEFIXIME 100MG HEXA BOX/50 - - 30 41,248.3 1,237,449.00
8 CEFOTAXIME 1G HEXA BOX/2 - 250 13,000.24 3,250,060.00
9 CEFTRIAXONE 1G HEXA BOX/3 - 100 14,000.8 1,400,080.00
10 CHLORAMPHENICOL 250MG KAPSUL - - - 2,000 627 1,254,000.00
11 CIPROFLOXACIN 500MG TABLET - - - 1,000 276.32 276,320.00
13 COTRIMOKSAZOL 480MG TABLET 400 231 92,400.00 -
14 DEXTROSE 40% BOTOL 2 22,000 44,000.00 -
15 DIKLOFENAK POTASSIUM BOX/100 - - 5 46,200 231,000.00
16 EPINEFRIN INJEKSI AMPUL 60 9,350 561,000.00 -
17 ERLAMICETIN TT 10ML BOTOL - - 200 11,330 2,266,000.00
18 ERLAMICETIN TM 0,5% 10ML BOTOL - - 100 11,330 1,133,000.00
19 FITOMENADION INJEKSI AMPUL 120 4,437.98 532,557.60 450 4,437.98 1,997,091.00
20 FUROSEMIDE INJ AMPUL 20 3,542 70,840.00 -
21 GENTAMYSIN CR KF TUBE 440 2,937 1,292,280.00 -
22 GOM BOTOL - - 72 3,960 285,120.00
24 IBUPROFEN 400MG TABLET 1,000 528 528,000.00 -
25 ICHTIOL SALEP POT - - 48 10,500 504,000.00
26 KETOROLAC INJEKSI AMPUL 252 1,667.5 420,210.00 960 1,667.5 1,600,800.00
27 LEXIGO TABLET BOX - - - 10 14,000 140,000.00
28 METRONIDAZOLE 500MG TABLET 400 264 105,600.00 -
29 METRONIDAZOLE 500MG BOX/100 - 60 28,153.125 1,689,187.50
30 MISOPROSTOL 200Mcg TABLET - - 30 5,500 165,000.00
31 NACL PIGGY BAG 100ML FLS 40 24,200 968,000.00 -
32 NATRIUM BIKARBONAT 500MG POT/100 - - 3 15,000 45,000.00
33 NIFEDIPINE 10MG TABLET 100 220 22,000.00 -
34 OMEPRAZOLE KAPSUL BOX/200 - - 20 57,164.8 1,143,296.00
35 ONDANSETRON INJ 4MG/2ML BOX/5 - - 200 19,599.25 3,919,850.00
36 ORABLOC INJEKSI BOX/50 - - 3 770,000 2,310,000.00
38 TABLET TAMBAH DARAH NEO TABLET - - - 5,000 495 2,475,000.00
17,059,225.30 29,308,372.00
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 17 75,250.01 1,279,250.17 -
2 BISTURI NO.23 B BRAUN bUAH 180 3,867.50 696,150 -
3 BLOOD TRANSFUSION SET (ONEMED) BUAH - - 200 10,560 2,112,000
5 CANULA OXYGEN ANAK BUAH 48 17,500 840,000 -
11 HCG TES STRIP PAK - - 4 96,000.025 384,000.1
12 JELLY USG BOTOL 9 38,674.97 348,074.73 -
13 KAPSUL KOSONG NO.0 PAK - - 1 50,000.5 50,000.5
14 KARTU GOLONGAN DARAH PAK - - 5 38,674.9 193,374.5
15 KASA GULUNG 4M X 10CM ROLL - - -
19 KERTAS USG SONY ROLL 5 277,500 1,387,500.4 -
23 LANCET BOX 4 30,000 120,000 -
24 MUCUS EXTRACTOR BUAH - - 160 11,287.49875 1,805,999.8
30 SARUNG TANGAN STERIL NO. 6,5 PASANG 200 6,622 1,324,400 -
32 SENDOK PUYER SET - - 2 55,000 110,000
34 SPUIT DISP 10ML REMEDI BUAH 100 3,010.51 301,051.3 -
37 STIK EASY TOUCH GLUKOSA POT - - 10 108,749.96 1,087,499.6
38 STIK EASY TOUCH HB POT 16 169,374.98 2,709,999.68 -
40 STIK NESCO ASAM URAT POT - - 10 121,550 1,215,500
43 VERBAN 10CM ROLL 350 1,354.9998 474,249.93 -
45 UNDERPAD PAK 52 45,140.00 2,347,280 -
46 URINE TEST GLUKO PROTEIN BOTOL 5 22,088.00 110,440
26,713,824.68 7,068,814.50
OBAT DAN BMHP JKN
NES

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
18 3,988 71,784 - -
- 250 3,304.29 826,072.5
120 5,200.25 624,030 600 5,200.25 3,120,150
6 6,426.2 38,557.2 42 6,426.2 269,900.4
3 20,570 61,710 19 20,570 390,830.00
1 58,002.30 58,002.30 19 58,002.30 1,102,043.70
- 30 41,248.30 1,237,449.00
- 250 13,000.24 3,250,060.00
- 100 14,000.8 1,400,080.00
100 627.00 62,700.00 1,900 627 1,191,300.00
200 276.32 55,264.00 800 276.32 221,056.00
- 30 6,086.67 182,600.10
400 231.00 92,400.00 - -
- 2 22,000 44,000.00
- 5 46,200 231,000.00
- 60 9,350 561,000.00
2 11,330 22,660.00 198 11,330 2,243,340.00
2 11,330 22,660.00 98 11,330 1,110,340.00
30 4,437.98 133,139.40 540 4,437.98 2,396,509.20
- 20 3,542 70,840.00
30 2,937 88,110.00 410 2,937 1,204,170.00
- 72 3,960 285,120.00
900 132.19 118,971.00 9,500 132.19 1,255,805.00
300 528 158,400.00 700 528 369,600.00
- 48 10,500 504,000.00
216 1,667.5 360,180.00 996 1,667.5 1,660,830.00
1 14,000 14,000.00 9 14,000 126,000.00
400 264 105,600.00 - -
- 60 28,153.125 1,689,187.50
- 30 5,500 165,000.00
- 40 24,200 968,000.00
1 15,000 15,000.00 2 15,000 30,000.00
- 100 220 22,000.00
2 57,164.8 114,329.60 18 57,164.80 1,028,966.40
- 200 19,599.25 3,919,850.00
1 770,000 770,000.00 2 770,000.00 1,540,000.00
7,400 160 1,184,000.00 31,900 160.00 5,104,000.00
200 495 99,000.00 4,800 495.00 2,376,000.00
4,270,497.50 42,097,099.80
1 75,250.01 75,250.01 16 75,250.01 1,204,000.16

- 180 3,867.50 696,150.18
- 200 10,560.00 2,112,000.00
30 10,560.00 316,800.00 70 10,560.00 739,200.00
10 17,500.00 175,000.00 38 17,500.00 665,000.00
9 17,500.00 157,500.00 - 17,500.00 -
- 100 7,136.00 713,599.70
- - -
- - -
- - -
- 4 96,000.025 384,000.10
1 38,674.97 38,674.97 8 38,674.97 309,399.76
- 1 50,000.5 50,000.5
- 5 38,674.9 193,374.5
- - -
- - -
- - -
- 4 147,500.10 590,000.40
- 5 277,500.08 1,387,500.40
30 7,500.00 224,999.94 170 7,500.00 1,274,999.66
- - -
10 9,500.00 95,000.00 220 9,500.00 2,090,000.00
- 4 30,000.00 120,000.00
- 160 11,287.49875 1,805,999.80
- - -
- 5 99,550.00 497,750.00
- 4 99,550.00 398,200.00
3 57,586.98 172,760.94 7 57,586.98 403,108.86
1 105,000.06 105,000.06 2 105,000.06 210,000.12
50 6,622.00 331,100.00 150 6,622.00 993,300.00
- 100 6,622.00 662,200.00
2 55,000.00 110,000.00 - -
- 13 1,505.26 19,568.41
- 100 3,010.51 301,051.30
- 50 2,800.00 140,000.00
- - -
- 10 108,749.96 1,087,499.60
3 169,374.98 508,124.94 13 169,374.98 2,201,874.74
3 206,550.00 619,650.00 23 206,550.00 4,750,650.00
- 10 121,550.00 1,215,500.00
- - -
- - -
50 1,355.00 67,749.99 300 1,355.00 406,499.94
- 48 14,685.00 704,880.00
4 45,140.00 180,560.02 48 45,140.00 2,166,720.19
- 5 22,088.00 110,440.00
3,178,170.87 30,604,468.32
KET.
APOTIK UGD posbindu poned aw GIGI

18
105 5 10
6
1 2
1
100
100
400
2
2
30
25 5
500 300 100

300
204 12
1
200 200
1
6200 900 300
200
42,097,099.80
Apotik UGD bp gigi poned

1
10
9
10
10 10
100
30,604,468.32
BULAN : AGUSTUS
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE - - -
2 ACYCLOVIR CR KF TUBE 250 3,304.29 826,072.50 -
6 CEFADROXIL 500MG HEXA BOX/100 19 58,002.30 1,102,043.70 -
7 CEFIXIME 100MG HEXA BOX/50 30 41,248.30 1,237,449.00 -
8 CEFOTAXIME 1G HEXA BOX/2 250 13,000.24 3,250,060.00 -
9 CEFTRIAXONE 1G HEXA BOX/3 100 14,000.80 1,400,080.00 -
10 CHLORAMPHENICOL 250MG KAPSUL 1,900 627.00 1,191,300.00 -
11 CIPROFLOXACIN 500MG TABLET 800 276.32 221,056.00 -
13 COTRIMOKSAZOL 480MG TABLET - - -
14 DEXTROSE 40% BOTOL 2 22,000.00 44,000.00 -
15 DIKLOFENAK POTASSIUM BOX/100 5 46,200.00 231,000.00 -
17 ERLAMICETIN TT 10ML BOTOL 198 11,330.00 2,243,340.00 -
18 ERLAMICETIN TM 0,5% 10ML BOTOL 98 11,330.00 1,110,340.00 -
19 FITOMENADION INJEKSI AMPUL 540 4,437.98 2,396,509.20 -
22 GOM BOTOL 72 3,960.00 285,120.00 -
24 IBUPROFEN 400MG TABLET 700 528.00 369,600.00 -
25 ICHTIOL SALEP POT 48 10,500.00 504,000.00 -
26 KETOROLAC INJEKSI AMPUL 996 1,667.50 1,660,830.00 -
27 LEXIGO TABLET BOX 9 14,000.00 126,000.00 -
28 METRONIDAZOLE 500MG TABLET - - -
29 METRONIDAZOLE 500MG BOX/100 60 28,153.13 1,689,187.50 -
30 MISOPROSTOL 200Mcg TABLET 30 5,500.00 165,000.00 -
32 NATRIUM BIKARBONAT 500MG POT/100 2 15,000.00 30,000.00 -
34 OMEPRAZOLE KAPSUL BOX/200 18 57,164.80 1,028,966.40 -
35 ONDANSETRON INJ 4MG/2ML BOX/5 200 19,599.25 3,919,850.00 -
36 ORABLOC INJEKSI BOX/50 2 770,000.00 1,540,000.00 -
38 TABLET TAMBAH DARAH NEO TABLET 4,800 495.00 2,376,000.00 -
42,097,099.80 -
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 16 75,250.01 1,204,000 -
3 BLOOD TRANSFUSION SET (ONEMED) BUAH 200 10,560.0 2,112,000 -
4 BLOOD TRANSFUSION SET (REMEDI) BUAH 70 10,560.0 739,200 -
5 CANULA OXYGEN ANAK BUAH 38 17,500.0 665,000 -
6 CANULA OXYGEN DEWASA BUAH - 17,500.0 - -
7 CANULA OXYGEN DEWASA BUAH 100 7,136.0 713,600 -
11 HCG TES STRIP PAK 4 96,000.025 384,000 -
12 JELLY USG BOTOL 8 38,674.97 309,400 -
13 KAPSUL KOSONG NO.0 PAK 1 50,000.5 50,001
14 KARTU GOLONGAN DARAH PAK 5 38,674.9 193,375 -
22 KLIP PLASTIK SEDANG 13X8,7 PAK 220 9,500.0 2,090,000 -
23 LANCET BOX 4 30,000.0 120,000 -
24 MASKER HIJAB BOX/50 40 138,380.0 5,535,200
25 MASKER TALI BOX/50 40 138,380.0 5,535,200
26 MUCUS EXTRACTOR BUAH 160 11,287.49875 1,806,000 -
28 NEEDLE TERUMO NO. 23 BOX/100 5 99,550.0 497,750 -
30 PLESTER BESAR KAIN COKLAT 7,5CM ROLL 7 57,586.98 403,109 -
31 POVIDON IODINE 1000ML BOTOL 2 105,000.1 210,000 -
32 SARUNG TANGAN STERIL NO. 6,5 PASANG 150 6,622.0 993,300 -
33 SARUNG TANGAN STERIL NO. 7 PASANG 100 6,622.0 662,200 -
34 SENDOK PUYER SET - - -
37 SPUIT DISP 20ML BUAH 50 2,800.0 140,000 -
39 STIK EASY TOUCH GLUKOSA POT 10 108,749.96 1,087,500 -
40 STIK EASY TOUCH HB POT 13 169,374.9800 2,201,875 -
41 STIK EASY TOUCH KOLESTEROL POT 23 206,550.0 4,750,650 -
42 STIK NESCO ASAM URAT POT 10 121,550.0 1,215,500 -
44 STIK NESCO KOLESTEROL POT - -
45 VERBAN 10CM ROLL 300 1,355.0 406,500 -
46 WING NEEDLE TERUMO 25 BUAH 48 14,685.0 704,880 -
47 UNDERPAD PAK 48 45,140.00 2,166,720 -
48 URINE TEST GLUKO PROTEIN BOTOL 5.00 22,088.00 110,440
30,604,468.32 11,070,400

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
- - -
10 3,304.29 33,042.90 240 3,304.29 793,029.60
120 5,200.25 624,030.00 480 5,200.25 2,496,120.00
8 6,426.20 51,409.60 34 6,426.20 218,490.80
3 20,570.00 61,710.00 16 20,570.00 329,120.00
1 58,002.30 58,002.30 18 58,002.30 1,044,041.40
2 41,248.30 82,496.60 28 41,248.30 1,154,952.40
30 13,000.24 390,007.20 220 13,000.24 2,860,052.80
41 14,000.80 574,032.80 59 14,000.80 826,047.20
- 1,900 627.00 1,191,300.00
300 276.32 82,896.00 500 276.32 138,160.00
- 30 6,086.67 182,600.10
- - -
- 2 22,000.00 44,000.00
- 5 46,200.00 231,000.00
- 60 9,350.00 561,000.00
5 11,330.00 56,650.00 193 11,330.00 2,186,690.00
1 11,330.00 11,330.00 97 11,330.00 1,099,010.00
30 4,437.98 133,139.40 510 4,437.98 2,263,369.80
- 20 3,542.00 70,840.00
50 2,937.00 146,850.00 360 2,937.00 1,057,320.00
7 3,960.00 27,720.00 65 3,960.00 257,400.00
1,000 132.19 132,190.00 8,500 132.19 1,123,615.00
400 528.00 211,200.00 300 528.00 158,400.00
2 10,500.00 21,000.00 46 10,500.00 483,000.00
60 1,667.50 100,050.00 936 1,667.50 1,560,780.00
1 14,000.00 14,000.00 8 14,000.00 112,000.00
- - -
7 28,153.125 197,071.88 53 28,153.125 1,492,115.63
10 5,500.00 55,000.00 20 5,500.00 110,000.00
- 40 24,200.00 968,000.00
- 2 15,000.00 30,000.00
- 100 220.00 22,000.00
3 57,164.80 171,494.40 15 57,164.80 857,472.00
35 19,599.25 685,973.75 165 19,599.25 3,233,876.25
770,000.00 - 2 770,000.00 1,540,000.00
11,600 160.00 1,856,000.00 20,300 160.00 3,248,000.00
3,400 495.00 1,683,000.00 1,400 495.00 693,000.00
7,460,296.83 34,636,802.98
- 16 75,250.01 1,204,000.16
- 180 3,867.50 696,150.18
- 200 10,560.00 2,112,000.00
20 10,560.00 211,200.00 50 10,560.00 528,000.00
- 38 17,500.00 665,000.00
- - 17,500.00 -
- 100 7,136.00 713,599.70
- - -
- - -
- - -
1 96,000.03 96,000.03 3 96,000.03 288,000.08
3 38,674.97 116,024.91 5 38,674.97 193,374.85
1 50,000.50 50,000.50 - 50,000.50 -
2 38,674.90 77,349.80 3 38,674.90 116,024.70
- - -
- - -
- -
- 4 147,500.10 590,000.40
- 5 277,500.08 1,387,500.40
20 7,500.00 149,999.96 150 7,500.00 1,124,999.70
- - -
- 220 9,500.00 2,090,000.00
- 4 30,000.00 120,000.00
4 138,380.00 553,520.00 36 138,380.00 4,981,680.00
15 138,380.00 2,075,700.00 25 138,380.00 3,459,500.00
- 160 11,287.49875 1,805,999.80
- - -
- 5 99,550.00 497,750.00
1 99,550.00 99,550.00 3 99,550.00 298,650.00
1 57,586.98 57,586.98 6 57,586.98 345,521.88
1 105,000.06 105,000.06 1 105,000.06 105,000.06
100 6,622.00 662,200.00 50 6,622.00 331,100.00
- 100 6,622.00 662,200.00
- - -
- 13 1,505.26 19,568.41
- 100 3,010.51 301,051.30
- 50 2,800.00 140,000.00
- - -
1 108,749.96 108,749.96 9 108,749.96 978,749.64
1 169,374.98 169,374.98 12 169,374.98 2,032,499.76
3 206,550.00 619,650.00 20 206,550.00 4,131,000.00
1 121,550.00 121,550.00 9 121,550.00 1,093,950.00
- - -
- -
100 1,355.00 135,499.98 200 1,355.00 270,999.96
- 48 14,685.00 704,880.00
4 45,140.00 180,560.02 44 45,140.00 1,986,160.18
5 22,088.00 110,440.00
5,589,517.17 36,085,351.15
KET.
APOTIK UGD posbindu poned aw GIGI kd pyg
10
95 25
8 1
1 2 .
1
2
30
31
300
5
1
30
50
7
700 200 100 100
400
2
60 12
1
4 3
10
3
35
1
300 10300 1500 300 200 100
460 2840 100
34,636,802.98
Apotik UGD bp gigi poned kia lab
20
2 1
20
13
1
250 50
1
50
1
3
50
4
5.00
36,085,351.15
BULAN : SEPTEMBER
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
1 ACYCLOVIR CR TUBE - - -
6 CEFADROXIL 500MG HEXA BOX/100 18 58,002.300 1,044,041.40 -
7 CEFIXIME 100MG HEXA BOX/50 28 41,248.300 1,154,952.40 -
9 CEFTRIAXONE 1G HEXA BOX/2 59 14,000.800 826,047.20 -
11 CIPROFLOXACIN 500MG TABLET 500 276.320 138,160.00 -
14 DEXTROSE 40% BOTOL 2 22,000.000 44,000.00 -
22 GOM BOTOL 65 3,960.000 257,400.00 -
34 OMEPRAZOLE KAPSUL BOX/200 15 57,164.800 857,472.00 -
38 TABLET TAMBAH DARAH NEO TABLET 1,400 495.000 693,000.00 -
34,636,802.98 -
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 16 75,250.01 1,204,000.16 -
3 BLOOD TRANSFUSION SET (ONEMED) BUAH 200 10,560 2,112,000 -
4 BLOOD TRANSFUSION SET (REMEDI) BUAH 50 10,560 528,000 -
6 CANULA OXYGEN DEWASA BUAH - 17,500 - -
11 HCG TES STRIP PAK 3 96,000.03 288,000.08 -
12 IV CATETHER NO.26 BUAH - - 200 4,370 874,000
13 JELLY USG BOTOL 5 38,674.97 193,374.85 -
14 KAPSUL KOSONG NO.0 PAK - - -
24 LANCET BOX 4 30,000 120,000 -
25 MASKER HIJAB BOX/50 36 138,380 4,981,680 -
26 MASKER TALI BOX/50 25 138,380 3,459,500 -
32 POVIDON IODINE 1000ML BOTOL 1 105,000 105,000 -
33 SARUNG TANGAN STERIL NO. 6,5 PASANG 50 6,622 331,100 -
40 STIK EASY TOUCH GLUKOSA POT 9 108,749.96 978,750 -
43 STIK NESCO ASAM URAT POT 9 121,550 1,093,950 -
46 VERBAN 10CM ROLL 200 1,355 271,000 -
47 WING NEEDLE TERUMO 25 BUAH 48 14,685.00 704,880 -
48 UNDERPAD PAK 44 45,140.00 1,986,160 -
49 URINE TEST GLUKO PROTEIN BOTOL 5 22,088.00 110,440 -
36,085,351.15 874,000.00

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
- - -
25 3,304.29 82,607.25 215 3,304.29 710,422.35
180 5,200.25 936,045.00 300 5,200.25 1,560,075.00
4 6,426.20 25,704.80 30 6,426.20 192,786.00
- 16 20,570.00 329,120.00
2 58,002.30 116,004.60 16 58,002.30 928,036.80
4 41,248.30 164,993.20 24 41,248.30 989,959.20
20 13,000.24 260,004.80 200 13,000.24 2,600,048.00
- - 59 14,000.80 826,047.20
- 1,900 627.00 1,191,300.00
500 276.32 138,160.00 - -
10 6,086.67 60,866.70 20 6,086.67 121,733.40
- - -
- 2 22,000.00 44,000.00
- 5 46,200.00 231,000.00
- 60 9,350.00 561,000.00
7 11,330.00 79,310.00 186 11,330.00 2,107,380.00
- 97 11,330.00 1,099,010.00
60 4,437.98 266,278.80 450 4,437.98 1,997,091.00
- 20 3,542.00 70,840.00
60 2,937.00 176,220.00 300 2,937.00 881,100.00
8 3,960.00 31,680.00 57 3,960.00 225,720.00
- 8,500 132.19 1,123,615.00
200 528.00 105,600.00 100 528.00 52,800.00
- 46 10,500.00 483,000.00
72 1,667.50 120,060.00 864 1,667.50 1,440,720.00
- 8 14,000.00 112,000.00
- - -
4 28,153.13 112,612.50 49 28,153.125 1,379,503.13
10 5,500.00 55,000.00 10 5,500.00 55,000.00
5 24,200.00 121,000.00 35 24,200.00 847,000.00
- 2 15,000.00 30,000.00
- 100 220.00 22,000.00
4 57,164.80 228,659.20 11 57,164.80 628,812.80
36 19,599.25 705,573.00 129 19,599.25 2,528,303.25
- 2 770,000.00 1,540,000.00
3,400 160.00 544,000.00 16,900 160.00 2,704,000.00
800 495.00 396,000.00 600 495.00 297,000.00
4,726,379.85 29,910,423.13
- 16 75,250.01 1,204,000.16
26 3,867.50 100,555.03 154 3,867.50 595,595.15
- 200 10,560.00 2,112,000.00
20 10,560.00 211,200.00 30 10,560.00 316,800.00
5 17,500.00 87,500.00 33 17,500.00 577,500.00
- - 17,500.00 -
30 7,136.00 214,079.91 70 7,136.00 499,519.79
- - -
- - -
- - -
- 3 96,000.03 288,000.08
20 4,370.00 87,400.00 180 4,370.00 786,600.00
- 5 38,674.97 193,374.85
- - -
- 3 38,674.90 116,024.70
- - -
- - -
- - -
- 4 147,500.10 590,000.40
- 5 277,500.08 1,387,500.40
30 7,500.00 224,999.94 120 7,500.00 899,999.76
- - -
40 9,500.00 380,000.00 180 9,500.00 1,710,000.00
1 30,000.00 30,000.00 3 30,000.00 90,000.00
6 138,380.00 830,280.00 30 138,380.00 4,151,400.00
20 138,380.00 2,767,600.00 5 138,380.00 691,900.00
10 11,287.50 112,874.99 150 11,287.50 1,693,124.81
- - -
- 5 99,550.00 497,750.00
- 3 99,550.00 298,650.00
4 57,586.98 230,347.92 2 57,586.98 115,173.96
- 1 105,000.06 105,000.06
- 50 6,622.00 331,100.00
- 100 6,622.00 662,200.00
- - -
13 1,505.26 19,568.41 - 1,505.26 -
19 3,010.51 57,199.75 81 3,010.51 243,851.55
- 50 2,800.00 140,000.00
- - -
1 108,749.96 108,749.96 8 108,749.96 869,999.68
2 169,374.98 338,749.96 10 169,374.98 1,693,749.80
4 206,550.00 826,200.00 16 206,550.00 3,304,800.00
- 9 121,550.00 1,093,950.00
- - -
- - -
100 1,355.00 135,499.98 100 1,355.00 135,499.98
- 48 14,685.00 704,880.00
4 45,140.00 180,560.02 40 45,140.00 1,805,600.16
- 5 22,088.00 110,440.00
6,943,365.85 30,015,985.29
KET.
25
170 10
4
2
4
20
500
7
3
60
55 5
8
500
300
72
300 100
10
5
4
36
9600 900 400 200

800
29,910,423.13
APOTIK PONED UGD
20
5
20
10
30
27
50 250
200
50
50
4 4
30,015,985.29
BULAN : OKTOBER
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
2 AMBROXOL SYRUP BOTOL - - 450 5,500 2,475,000
4 AQUA PRO INJEKSI 200 6,600.000 1,320,000
7 CEFADROXIL 500MG HEXA BOX/100 16 58,002.300 928,036.80 -
8 CEFIXIME 100MG HEXA BOX/50 24 41,248.300 989,959.20 -
12 CIPROFLOXACIN 500MG TABLET - - 2,000 319.980 639,960.00
15 DEXTROSE 40% BOTOL 2 22,000.000 44,000.00 -
22 GENTAMYSIN CR KF TUBE 300 2,937.000 881,100.00 -
23 GOM BOTOL 57 3,960.000 225,720.00 -
26 IBUPROFEN 400MG TABLET - - 2,500 374.000 935,000.00
32 MISOPROSTOL 200Mcg TABLET 10 5,500.000 55,000.00 60 5,500.000 330,000.00
36 OMEPRAZOLE KAPSUL BOX/200 11 57,164.800 628,812.80 11 57,164.800 628,812.80
40 RANITIDIN TAB HEXA BOX/100 100 15,400.000 1,540,000.00
41 TABLET TAMBAH DARAH NEO TABLET 600 495.000 297,000.00 -
29,910,423.13 7,868,772.80
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 16 75,250 1,204,000 -
2 BISTURI NO.23 B BRAUN BUAH 154 3,867.50 595,595 -
3 BLOOD TRANSFUSION SET (ONEMED) BUAH 200 10,560 2,112,000 -
6 CANULA OXYGEN DEWASA BUAH - 17,500 - -
11 HCG TES STRIP PAK 3 96,000.03 288,000
12 IV CATETHER NO.26 BUAH 180 4,370.00 786,600 -
13 JELLY USG BOTOL 5 38,674.97 193,375 -
14 KAPSUL KOSONG NO.0 PAK - -
19 KERTAS EKG MAC 600 PAK 4 147,500 590,000 -
20 KERTAS USG SONY ROLL 5 277,500 1,387,500 -
21 KLIP PLASTIK KECIL 10X7 PAK 120 7,499.998 900,000 -
23 KLIP PLASTIK SEDANG 13X8,7 PAK 180 9,500 1,710,000
24 LANCET BOX 3 30,000 90,000
25 MASKER HIJAB BOX/50 30 138,380 4,151,400 -
26 MASKER TALI BOX/50 5 138,380 691,900 -
33 SARUNG TANGAN STERIL NO. 6,5 PASANG 50 6,622.00 331,100 -
36 SPUIT DISP 10ML ONEMED BUAH - - -
40 STIK EASY TOUCH GLUKOSA POT 8 108,749.96 870,000 -
41 STIK EASY TOUCH HB POT 10 169,374.98 1,693,749.8 -
46 VERBAN 10CM ROLL 100 1,355 135,500 -
48 UNDERPAD PAK 40 45,140 1,805,600 -
30,015,985.29 -

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
5 3,304.29 16,521.45 210 3,304.29 693,900.90

- 450 5,500.00 2,475,000.00
55 5,200.25 286,013.75 245 5,200.25 1,274,061.25
10 6,600.00 66,000.00 190 6,600.00 1,254,000.00
6 6,426.20 38,557.20 24 6,426.20 154,228.80
2 20,570.00 41,140.00 14 20,570.00 287,980.00
1 58,002.30 58,002.30 15 58,002.30 870,034.50
4 41,248.30 164,993.20 20 41,248.30 824,966.00
19 13,000.24 247,004.56 181 13,000.24 2,353,043.44
- 59 14,000.80 826,047.20
- 1,900 627.00 1,191,300.00
200 319.98 63,996.00 1,800 319.98 575,964.00
- 20 6,086.67 121,733.40
- - -
2 22,000.00 44,000.00 - -
- 5 46,200.00 231,000.00
- 60 9,350.00 561,000.00
9 11,330.00 101,970.00 177 11,330.00 2,005,410.00
6 11,330.00 67,980.00 91 11,330.00 1,031,030.00
- 450 4,437.98 1,997,091.00
- 20 3,542.00 70,840.00
45 2,937.00 132,165.00 255 2,937.00 748,935.00
- 57 3,960.00 225,720.00
- 8,500 132.19 1,123,615.00
100 528.00 52,800.00 - -
- 2,500 374.00 935,000.00
- 46 10,500.00 483,000.00
48 1,667.50 80,040.00 816 1,667.50 1,360,680.00
2 14,000.00 28,000.00 6 14,000.00 84,000.00
- - -
4 28,153.13 112,612.50 45 28,153.125 1,266,890.63
- 70 5,500.00 385,000.00
- 35 24,200.00 847,000.00
- 2 15,000.00 30,000.00
- 100 220.00 22,000.00
4 57,164.80 228,659.20 18 57,164.80 1,028,966.40
27 19,599.25 529,179.75 102 19,599.25 1,999,123.50
- 2 770,000.00 1,540,000.00
6,000 160.00 960,000.00 10,900 160.00 1,744,000.00
2 15,400.00 30,800.00 98 15,400.00 1,509,200.00
600 495.00 297,000.00 - -
3,647,434.91 34,131,761.02
1 75,250.01 75,250.01 15 75,250.01 1,128,750.15

- 154 3,867.50 595,595.15
- 200 10,560.00 2,112,000.00
20 10,560.00 211,200.00 10 10,560.00 105,600.00
- 33 17,500.00 577,500.00
- - -
- 70 7,136.00 499,519.79
- - -
- - -
- - -
3 96,000.03 288,000.08
20 4,370.00 87,400.00 160 4,370.00 699,200.00
- 5 38,674.97 193,374.85
- - -
- 3 38,674.90 116,024.70
- - -
- - -
1 147,500.10 147,500.10 3 147,500.10 442,500.30

- 5 277,500.08 1,387,500.40
10 7,500.00 74,999.98 110 7,500.00 824,999.78
- - -
- 180 9,500.00 1,710,000.00
- 3 30,000.00 90,000.00
25 138,380.00 3,459,500.00 5 138,380.00 691,900.00
5 138,380.00 691,900.00 - -
10 11,287.50 112,874.99 140 11,287.50 1,580,249.83
- - -
- 5 99,550.00 497,750.00
1 99,550.00 99,550.00 2 99,550.00 199,100.00
2 57,586.98 115,173.96 - -
- 1 105,000.06 105,000.06
- 50 6,622.00 331,100.00
- 100 6,622.00 662,200.00
- - -
- - -
36 3,010.51 108,378.47 45 3,010.51 135,473.09
- 50 2,800.00 140,000.00
- - -
- 8 108,749.96 869,999.68
1 169,374.98 169,374.98 9 169,374.98 1,524,374.82
- 16 206,550.00 3,304,800.00
- 9 121,550.00 1,093,950.00
- - -
- - -
50 1,355.00 67,749.99 50 1,355.00 67,749.99
- 48 14,685.00 704,880.00
3 45,140.00 135,420.01 37 45,140.00 1,670,180.15
- 5 22,088.00 110,440.00
5,556,272.49 24,459,712.81
KET.
132 16
1
4
30
200
5
2
11
2
500
48
2
3 1
3
150
4200 1300 300

1
34,131,761.02
APOTIK PONED UGD GIGI
20
350
200 50
10
50
3 4
24,459,712.81
BULAN : NOVEMBER
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
2 AMBROXOL SYRUP BOTOL 450 5,500.000 2,475,000.00 -
4 AQUA PRO INJEKSI VIAL 190 6,600 1,254,000.00 -
6 BIOPLACENTON JELLY TUBE 14 20,570 287,980.00 -
12 CIPROFLOXACIN 500MG TABLET 1,800 319.980 575,964.00 -
15 DEXTROSE 40% BOTOL - - -
22 GENTAMYSIN CR KF TUBE 255 2,937.000 748,935.00 -
23 GOM BOTOL 57 3,960.000 225,720.00 -
25 IBUPROFEN 400MG TABLET - - -
36 OMEPRAZOLE KAPSUL BOX/200 18 57,164.800 1,028,966.40 -
40 RANITIDIN TAB HEXA BOX/100 98 15,400.000 1,509,200.00 -
41 TABLET TAMBAH DARAH NEO TABLET - - -
34,131,761.02 -
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 15 75,250.01 1,128,750.15 -
2 BISTURI NO.23 B BRAUN BUAH 154 3,867.5 595,595.15 -
6 CANULA OXYGEN DEWASA BUAH - - -
11 HCG TES STRIP PAK 3 96,000.03 288,000 -
12 IV CATETHER NO.26 BUAH 160 4,370 699,200
13 JELLY USG BOTOL 5 38,674.97 193,375 -
15 KARTU GOLONGAN DARAH PAK 3 38,674.9 116,025
19 KERTAS EKG MAC 600 PAK 3 147,500.1 442,500.3
21 KLIP PLASTIK KECIL 10X7 PAK 110 7,499.998 824,999.78 -
24 LANCET BOX 3 30,000 90,000
25 MASKER HIJAB BOX/50 5 138,380 691,900
26 MASKER TALI BOX/50 - - -
27 MUCUS EXTRACTOR BUAH 140 11,287 1,580,250 -
31 PLESTER BESAR KAIN COKLAT 7,5CM ROLL - - -
40 STIK EASY TOUCH GLUKOSA POT 8 108,750 870,000 -
42 STIK EASY TOUCH KOLESTEROL POT 16 206,550 3,304,800
46 VERBAN 10CM ROLL 50 1,355 67,750 -
48 UNDERPAD PAK 37 45,140 1,670,180
24,459,712.81 -

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
- 210 3,304.29 693,900.90

27 5,500.00 148,500.00 423 5,500.00 2,326,500.00
104 5,200.25 540,826.00 141 5,200.25 733,235.25
30 6,600.00 198,000.00 160 6,600.00 1,056,000.00
2 6,426.20 12,852.40 22 6,426.20 141,376.40
6 20,570.00 123,420.00 8 20,570.00 164,560.00
4 58,002.28 232,009.12 11 58,002.30 638,025.30
7 41,248.30 288,738.10 13 41,248.30 536,227.90
25 13,000.24 325,006.00 156 13,000.24 2,028,037.44
- 59 14,000.80 826,047.20
- 1,900 627.00 1,191,300.00
200 319.98 63,996.00 1,600 319.98 511,968.00
- 20 6,086.67 121,733.40
- - -
- - -
- 5 46,200.00 231,000.00
3 9,350.00 28,050.00 57 9,350.00 532,950.00
10 11,330.00 113,300.00 167 11,330.00 1,892,110.00
2 11,330.00 22,660.00 89 11,330.00 1,008,370.00
60 4,437.98 266,278.80 390 4,437.98 1,730,812.20
5 3,542.00 17,710.00 15 3,542.00 53,130.00
35 2,937.00 102,795.00 220 2,937.00 646,140.00
4 3,960.00 15,840.00 53 3,960.00 209,880.00
- 8,500 132.19 1,123,615.00
- - -
500 374.00 187,000.00 2,000 374.00 748,000.00
2 10,500.00 21,000.00 44 10,500.00 462,000.00
216 1,667.50 360,180.00 600 1,667.50 1,000,500.00
4 14,000.00 56,000.00 2 14,000.00 28,000.00
- - -
2 28,153.13 56,306.25 43 28,153.125 1,210,584.38
10 5,500.00 55,000.00 60 5,500.00 330,000.00
- 35 24,200.00 847,000.00
- 2 15,000.00 30,000.00
- 100 220.00 22,000.00
4 57,164.80 228,659.20 14 57,164.80 800,307.20
59 19,599.25 1,156,355.75 43 19,599.25 842,767.75
- 2 770,000.00 1,540,000.00
8,800 160.00 1,408,000.00 2,100 160.00 336,000.00
9 15,400.00 138,600.00 89 15,400.00 1,370,600.00
- - -
6,167,082.62 27,964,678.32
4 75,250.01 301,000.04 11 75,250 827,750.11

- 154 3,867.50 595,595.15
- 200 10,560.00 2,112,000.00
- 10 10,560.00 105,600.00
25 17,500.00 437,500.00 8 17,500.00 140,000.00
- - -
10 7,136.00 71,359.97 60 7,136.00 428,159.82
- - -
- - -
- - -
- 3 96,000.03 288,000.08
1 4,370.00 4,370.00 159 4,370.00 694,830.00
3 38,674.97 116,024.91 2 38,674.97 77,349.94
- - -
- 3 38,674.90 116,024.70
- - -
- - -
- - -
- 3 147,500.10 442,500.30
- 5 277,500.08 1,387,500.40
20 7,500.00 149,999.96 90 7,500.00 674,999.82
- - -
10 9,500.00 95,000.00 170 9,500.00 1,615,000.00
- 3 30,000.00 90,000.00
5 138,380.00 691,900.00 - -
- - -
20 11,287.50 225,749.98 120 11,287.50 1,354,499.85
- - -
- 5 99,550.00 497,750.00
- 2 99,550.00 199,100.00
- - -
1 105,000.06 105,000.06 - -
- 50 6,622.00 331,100.00
- 100 6,622.00 662,200.00
- - -
- - -
45 3,010.51 135,473.09 - -
- 50 2,800.00 140,000.00
- - -
2 108,749.96 217,499.92 6 108,749.96 652,499.76
3 169,374.98 508,124.94 6 169,374.98 1,016,249.88
3 206,550.00 619,650.00 13 206,550.00 2,685,150.00
- 9 121,550.00 1,093,950.00
- - -
- - -
- 50 1,355.00 67,749.99
- 48 14,685.00 704,880.00
4 45,140.00 180,560.02 33 45,140.00 1,489,620.13
- 5 22,088.00 110,440.00
3,859,212.88 20,600,499.93
KET.
27
89 15
30
2
6
4
25
100
216
59
8400 400
27,964,678.40
APOTIK PONED UGD GIGI kia
4
25
10
1
2 1
1 3 1
20
45
50
20,600,499.93
BULAN : DESEMBER
TAHUN : 2020

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
I. OBAT-OBATAN
2 AMBROXOL SYRUP BOTOL 423 5,500 2,326,500.00 -
3 AMOXYCILLIN 125MG/5ML SYRUP BOTOL 141 5,200.25 733,235.25 -
4 AQUA PRO INJEKSI 160 6,600 1,056,000.00 -
6 BIOPLACENTON JELLY TUBE 8 20,570 164,560.00 -
11 CHLORAMPHENICOL 250MG KAPSUL 1,900 627 1,191,300.00 -
12 CIPROFLOXACIN 500MG TABLET 1,600 319.98 511,968.00 -
15 DEXTROSE 40% BOTOL - - -
16 DIKLOFENAK POTASSIUM BOX/100 5 46,200 231,000.00 -
17 EPINEFRIN INJEKSI AMPUL 57 9,350 532,950.00 -
18 ERLAMICETIN TT 10ML BOTOL 167 11,330 1,892,110.00 -
19 ERLAMICETIN TM 0,5% 10ML BOTOL 89 11,330 1,008,370.00 -
21 FUROSEMIDE INJ AMPUL 15 3,542 53,130.00 -
22 GENTAMYSIN CR KF TUBE 220 2,937 646,140.00 -
23 GOM BOTOL 53 3,960 209,880.00 -
25 IBUPROFEN 400MG TABLET - - -
26 IBUPROFEN 400MG TABLET 2,000 374 748,000.00 -
27 ICHTIOL SALEP POT 44 10,500 462,000.00 -
29 LEXIGO TABLET BOX 2 14,000 28,000.00 -
32 MISOPROSTOL 200Mcg TABLET 60 5,500 330,000.00 -
33 NACL PIGGY BAG 100ML FLS 35 24,200 847,000.00 -
34 NATRIUM BIKARBONAT 500MG POT/100 2 15,000 30,000.00 -
35 NIFEDIPINE 10MG TABLET 100 220 22,000.00 -
36 OMEPRAZOLE KAPSUL BOX/200 14 57,164.8 800,307.20 -
37 ONDANSETRON INJ 4MG/2ML BOX/5 43 19,599.25 842,767.75 -
38 ORABLOC INJEKSI BOX/50 2 770,000 1,540,000.00 -
39 PARACETAMOL 500MG TABLET 2,100 160 336,000.00 -
40 RANITIDIN TAB HEXA BOX/100 89 15,400 1,370,600.00 -
41 TABLET TAMBAH DARAH NEO TABLET - - -
27,964,678.32 -
II. BMHP
1 ALKOHOL 70% 1000ML BOTOL 11 75,250.01 827,750.11 -
2 BISTURI NO.23 B BRAUN BUAH 154 3,867.5 595,595.15 -
6 CANULA OXYGEN DEWASA BUAH - - -
11 HCG TES STRIP PAK 3 96,000.03 288,000 -
12 IV CATETHER NO.26 BUAH 159 4,370 694,830
13 JELLY USG BOTOL 2 38,674.97 77,350 -
15 KARTU GOLONGAN DARAH PAK 3 38,674.9 116,025
19 KERTAS EKG MAC 600 PAK 3 147,500.1 442,500.3
21 KLIP PLASTIK KECIL 10X7 PAK 90 7,499.998 674,999.82 -
24 LANCET BOX 3 30,000 90,000
25 MASKER HIJAB BOX/50 - -
26 MASKER TALI BOX/50 - - -
27 MUCUS EXTRACTOR BUAH 120 11,287 1,354,500 -
31 PLESTER BESAR KAIN COKLAT 7,5CM ROLL - - -
32 POVIDON IODINE 1000ML BOTOL - - -
37 SPUIT DISP 10ML REMEDI BUAH - - -
40 STIK EASY TOUCH GLUKOSA POT 6 108,750 652,500 -
42 STIK EASY TOUCH KOLESTEROL POT 13 206,550 2,685,150
46 VERBAN 10CM ROLL 50 1,355 67,750 -
48 UNDERPAD PAK 33 45,140 1,489,620
20,600,499.93 -

Unit Unit
(Rp.) (Rp.) (Rp.) (Rp.)
- 210 3,304.29 693,900.90

39 5,500 214,500.00 384 5,500 2,112,000.00
91 5,200.25 473,222.75 50 5,200.25 260,012.50
16 6,600 105,600.00 144 6,600 950,400.00
10 6,426.2 64,262.00 12 6,426.2 77,114.40
- 8 20,570 164,560.00
2 58,002.28 116,004.56 9 58,002.3 522,020.70
9 41,248.3 371,234.70 4 41,248.3 164,993.20
54 13,000.24 702,012.96 102 13,000.24 1,326,024.48
- 59 14,000.8 826,047.20
30 627 18,810.00 1,870 627 1,172,490.00
250 319.98 79,995.00 1,350 319.98 431,973.00
- 20 6,086.67 121,733.40
- - -
- - -
1 46,200 46,200.00 4 46,200 184,800.00
- 57 9,350 532,950.00
8 11,330 90,640.00 159 11,330 1,801,470.00
- 89 11,330 1,008,370.00
- 390 4,437.98 1,730,812.20
- 15 3,542 53,130.00
31 2,937 91,047.00 189 2,937 555,093.00
4 3,960 15,840.00 49 3,960 194,040.00
460 132.19 60,807.40 8,040 132.19 1,062,807.60
- - -
460 374 172,040.00 1,540 374 575,960.00
- 44 10,500 462,000.00
96 1,667.5 160,080.00 504 1,667.5 840,420.00
2 14,000 28,000.00 - -
- - -
5 28,153.13 140,765.63 38 28,153.125 1,069,818.75
5,500 - 60 5,500 330,000.00
3 24,200 72,600.00 32 24,200 774,400.00
- 2 15,000 30,000.00
- 100 220 22,000.00
1 57,164.8 57,164.80 13 57,164.8 743,142.40
38 19,599.25 744,771.50 5 19,599.25 97,996.25
- 2 770,000 1,540,000.00
2,100 160 336,000.00 - -
4 15,400 61,600.00 85 15,400 1,309,000.00
- - -
4,223,198.30 23,741,480.02
1 75,250 75,250.01 10 75,250 752,500.10

30 3,867.50 116,025.03 124 3,867.50 479,570.12
10 10,560 105,600.00 190 10,560.00 2,006,400.00
10 10,560 105,600.00 - -
8 17,500 140,000.00 - -
- - -
- 60 7,136.00 428,159.82
- - -
- - -
- - -
1 96,000.03 96,000.03 2 96,000.03 192,000.05
19 4,370 83,030.00 140 4,370.00 611,800.00
- 2 38,674.97 77,349.94
- - -
- 3 38,674.90 116,024.70
- - -
- - -
- - -
1 147,500.10 147,500.10 2 147,500.1 295,000.20
277,500.08 - 5 277,500.08 1,387,500.40
10 7,500.00 74,999.98 80 7,500 599,999.84
- - -
31 9,500.00 294,500.00 139 9,500 1,320,500.00
1 30,000.00 30,000.00 2 30,000 60,000.00
- - -
- - -
- 120 11,287.5 1,354,499.85
- - -
- 5 99,550 497,750.00
1 99,550.00 99,550.00 1 99,550 99,550.00
- - -
- - -
50 6,622.00 331,100.00 - -
- 100 6,622 662,200.00
- - -
- - -
- - -
- 50 2,800 140,000.00
- - -
2 108,749.96 217,499.92 4 108,749.96 434,999.84
4 169,374.98 677,499.92 2 169,374.98 338,749.96
2 206,550.00 413,100.00 11 206,550.00 2,272,050.00
1 121,550.00 121,550.00 8 121,550.00 972,400.00
- - -
- - -
- 50 1,355.00 67,749.99
- 48 14,685.00 704,880.00
4 45,140.00 180,560.02 29 45,140.00 1,309,060.12
1 22,088.00 22,088.00 4 22,088.00 88,352.00
3,331,453.00 17,269,046.93
KET.
APOTIK UGD KD PYG poned aw GIGI kd pyg
39
86 5
16
10
2
9
54
30
250
25 5 5
4
460
410 50
96
4.5 0.5
1
38
1800 300 100

4
23,741,480.02
APOTIK PONED UGD GIGI kia
1
30
10
10
8
1
19
350
50
50
2
4
2
1
50
4
1
17,269,046.93

Laporan Bulanan JKN 2020

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LAPORAN PENERIMAAN DAN PEMAKAIAN OBAT DAN BMHP JKN

UPT PUSKESMAS DTP MENES

NO. NAMA BARANG SATUAN STOK AWAL PENERIMAAN PERSEDIAAN

PERMAKAIAN STOK AKHIR KET.

STOK AWAL PENERIMAAN

PENERIMAAN PERMAKAIAN STOK AKHIR

- 1 40,000 40,000 5 40,000 200,000

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

3 40,000 120,000 2 40,000 80,000

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

25 3,988 99,700 25 3,988 99,700

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

1 75,250.01 75,250.01 19 75,250.01 1,429,750.19

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

7 3,988.00 27,916.00 18 3,988.00 71,784.00

2 75,250.01 150,500.02 17 75,250.01 1,279,250.17

APOTIK UGD posbindu poned aw

6800 1100 200 300 100

UGD bp gigi poned

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

1 75,250.01 75,250.01 16 75,250.01 1,204,000.16

APOTIK UGD posbindu poned aw GIGI

500 300 100

Apotik UGD bp gigi poned

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

APOTIK UGD posbindu poned aw GIGI kd pyg

Apotik UGD bp gigi poned kia lab

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

APOTIK UGD posbindu poned aw GIGI kd pyg

9600 900 400 200

APOTIK PONED UGD

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

5 3,304.29 16,521.45 210 3,304.29 693,900.90

1 75,250.01 75,250.01 15 75,250.01 1,128,750.15

1 147,500.10 147,500.10 3 147,500.10 442,500.30

APOTIK UGD posbindu poned aw GIGI kd pyg

4200 1300 300

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

- 210 3,304.29 693,900.90

4 75,250.01 301,000.04 11 75,250 827,750.11

APOTIK UGD posbindu poned aw GIGI kd pyg

STOK AWAL PENERIMAAN

PERMAKAIAN STOK AKHIR

- 210 3,304.29 693,900.90

1 75,250 75,250.01 10 75,250 752,500.10

APOTIK UGD KD PYG poned aw GIGI kd pyg

1800 300 100

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