SBBK PKM Wawondula 2023

PEMERINTAH KA BUPATEN LUWU TIMUR
DINAS KESEHATAN
Jl. Ki Hajar Dewantara No. Telp (0474) 321-489 , Fax (0474) 321489
MALILI
SBBK No. 440/ /SBBK/ I /2023
PUSKESMAS : WAWONDULA
KEMA APBD APBD PROGRA

No. NAMA SEDIAAN SAN LAMA HARGA LAMA JML HARGA BARU HARGA BARU JML HARGA M HARGA JML HARGA
1 Alat Suntik Sekali Pakai 1 ml/ 0,3 ml Set 827.95 Rp - 1,090.98 Rp - Rp -

2 Alat Suntik Sekali Pakai 2,5 ml/ 3 ml Set 803.76 Rp - 1,003.20 Rp - Rp -
3 Alat Suntik Sekali Pakai 5 ml Set 1,218.00 Rp - 200 1,103.52 Rp 220,704.00 1,460.00 Rp -
4 Alcohol Swab Lembar 126.50 Rp - 148.87 Rp - 138.00 Rp -
5 Bisturi No.11 Pcs - Rp - Rp - Rp -
6 Blood Lancet Pcs 167.51 Rp - Rp - 320.325 Rp -
7 Catgut / Benang Bedah No. 3/0 dan Set 4,114.58 Rp - 6,379.05 Rp - Rp -
8 Cuticell Classic 10 cm x 10 cm Pcs - Rp - 7,100.00 Rp - Rp -
9 Devitalisasi pasta (non arsen) Tube - Rp - Rp - Rp -
10 Disable Syringes 0,05 ml Set 1,492.00 Rp - Rp - 1,465.00 Rp -
11 Disable Syringes 0,5 ml Set 1,237.00 Rp - 1,206.00 Rp - 1,650.00 Rp -
12 Etakridin (rivanol) larutan 0,1 % Botol 4,080.00 Rp - 8,665.20 Rp - Rp -
13 Etanol 70% Botol 22,440.00 Rp - 27,595.00 Rp - Rp -
14 Fixomull Stretch 5 cm x 5 cm Rol - Rp - 20 50,200.00 Rp 1,004,000.00 Rp -
15 Folley catheter No.14 Pcs 9,269.57 Rp - Rp - Rp -
17 Folley catheter No.18 Pcs 12,156.33 Rp - 11,132.00 Rp - Rp -
18 GC Tooth Mouse Tube - Rp - Rp - Rp -
19 Glass lonomer cement (gc ix ) Set - Rp - Rp - Rp -
20 Handscoen Ginecolog Pasang 43,010.00 Rp - Rp - 43,010.00 Rp -
21 Hanscoen Pasang 8,635.00 Rp - 100 8,635.00 Rp 863,500.00 Rp -
22 Hanscoen Non Steril Pasang 2000 1,780.68 Rp 3,561,360.00 Rp - 1,575.02 Rp -
23 Infusion Set Anak Set 7,680.00 Rp - 6,072.00 Rp - Rp -
24 Infusion Set Dewasa Set 7,140.00 Rp - 7,128.00 Rp - Rp -
25 Iodine Tes Botol - Rp - Rp - 9,945.00 Rp -
26 IV Catheter No. 18 Buah 4,332.00 Rp - 7,375.00 Rp - Rp -
28 IV Catheter No. 22 Buah 12,631.00 Rp - 150 5,492.52 Rp 823,878.00 Rp -
30 IV Catheter No. 26 Buah 11,700.00 Rp - Rp - Rp -
31 Jarum jahit ( bedah ) no. 10 Set 836.17 Rp - Rp - Rp -
32 Jarum jahit ( bedah ) no. 11 Set - Rp - Rp - Rp -
37 Kalsium hidroksida pasta Tube - Rp - Rp - Rp -
38 Kapas pembalut/absorben 250 mg Gulung 14,375.00 Rp - 5 16,698.00 Rp 83,490.00 Rp -
39 Kasa kompres 40/40 steril Bungkus - Rp - Rp - Rp -
40 Kasa pembalut 2 m x 80 cm Rol - Rp - Rp - Rp -
41 Kasa pembalut hidrofil 4 m x 15 cm Rol 4,244.10 Rp - Rp - Rp -
42 Kasa Pembalut Hidrofil 4 x 10 cm Roll - Rp - Rp - Rp -
43 Kasa Pembalut Hidrofil 40 Yds x 80 c Roll 147,600.00 Rp - 5 181,907.00 Rp 909,535.00 Rp -
44 Klorfenol kamfer mentol (CHKM) Botol - Rp - Rp - Rp -
45 Larutan Benedict Botol - Rp - Rp - Rp -
46 Larutan dental mercuri Botol - Rp - Rp - Rp -
47 Larutan giemsa stain Botol - Rp - Rp - 279,820.80 Rp -
48 Larutan HCl Alkohol 3 % Botol - Rp - Rp - Rp -
49 Larutan Karbol Fuchsin 0,3% Botol - Rp - Rp - Rp -
50 Larutan Methylen Blue 0,3 % Botol - Rp - Rp - Rp -
51 Larutan Pemutih Gigi/ remover staint Botol - Rp - Rp - Rp -
52 Larutan turk Botol - Rp - Rp - Rp -
53 Leukomed IV Film 6 cm x 8 cm steril Lembar 2,461.12 Rp - Rp - Rp -
54 Lisol Botol 49,200.00 Rp - Rp - Rp -
55 Maag Slang 14 Set - Rp - 8,905.60 Rp - Rp -
56 Maag Slang 16 Set - Rp - Rp - Rp -
58 Masker Buah 2000 571.82 Rp 1,143,648.00 Rp - 20 10,533.60 Rp 210,672.00
59 Masker Fogging Buah - Rp - Rp - 9,800.00 Rp -
60 Masker Kerudung Buah 596.90 Rp - 526.24 Rp - 706.420 Rp -
61 Nasal Canula Anak Set - Rp - 6,325.00 Rp - Rp -
62 Nasal Canula Bayi Set - Rp - 6,325.00 Rp - Rp -
63 Nasal Canula Dewasa Set 6,270.00 Rp - 10 6,325.00 Rp 63,250.00 Rp -
64 Needle Carpule Pcs - Rp - Rp - Rp -
65 Onemed Gluco Protein Strip 1,191.30 Rp - 1,201.75 Rp - Rp -
66 Pembalut Gips Rol - Rp - Rp - Rp -
67 Pita LILA buah - Rp - Rp - Rp -
68 Plester 5 yard x 2 inch / 2,5 cm x 4,5 Rol 37,371.00 Rp - 27,324.00 Rp - Rp -
69 Pot Dahak Buah - Rp - Rp - 3,137.20 Rp -
70 Reagen Pemeriksaan TB Paru Paket - Rp - Rp - 274,560.00 Rp -
71 Safety Box Ktk - Rp - Rp - 23,398.00 Rp -
72 Semen seng fosfat serbuk dan cairan Botol - Rp - Rp - Rp -
73 Silk ( Benang Bedah Sutera ) No 3/0 Set 2,599.83 Rp - 72 5,313.89 Rp 382,600.01 Rp -
74 Slide Dos - Rp - Rp - 41,065.00 Rp -
75 Softpad(Underpad) 60x90 Lembar 3,018.75 Rp - Rp - Rp -
76 Spon Gelatin Pcs - Rp - Rp - Rp -
77 Tambalan Sementara Pot - Rp - Rp - Rp -
78 Temporary stopping fletcher Pasang - Rp - Rp - Rp -
79 Tes Kehamilan strip - Rp - 2,185.00 Rp - Rp -
80 Umbilical Cord Klem Pcs 50 2,052.00 Rp 102,600.00 Rp - Rp -
81 Urine bag Pcs 20 4,827.90 Rp 96,558.00 Rp - Rp -
82 Urine Rapid Test strip - Rp - Rp - Rp -
83 USG Gel 250 ml Botol 5 15,800.40 Rp 79,002.00 16,632.00 Rp - Rp -

84 Wing Needle No. 21 G Set - Rp - Rp - Rp -
88 Yodium povidon larutan 10% 60 ml Botol - Rp - 4,699.00 Rp - Rp -
89 Yodium povidon larutan 10% 300 ml Botol 19,800.00 Rp - Rp - Rp -
90 Alat Deteksi Resiko Kehamilan (ADRK Paket - Rp - Rp - 501,745.00 Rp -
91 SD HIV-1/2 3.0 (multi) (R1) test - Rp - Rp - 13,362.00 Rp -
92 Fokus Diagnostic (R2) test - Rp - Rp - 11,500.00 Rp -
93 VIKIA-HIV 1/2 (R3) test - Rp - Rp - 10,500.00 Rp -
94 RDT Malaria test - Rp - Rp - 10,488.00 Rp -
95 Laboratorium Kit Paket - Rp - Rp - 1,016,565.00 Rp -
96 Slide Box buah - Rp - Rp - 66,065.00 Rp -
97 Immerision oil Botol - Rp - Rp - 1,123,065.00 Rp -
98 Aximed nonwoven Fixation 5cm x 10 Rol - Rp - Rp - Rp -
99 Safety Box 2,5 L Ktk - Rp - Rp - 21,930.00 Rp -
100 Needle (Jarum Suntik) Buah - Rp - Rp - 3,600.00 Rp -
101 RDT Hepatitis test - Rp - Rp - 9,918.00 Rp -
102 Pot Steril Buah - Rp - Rp - 5,890.00 Rp -
103 RDT DBD (NS1) Strip - Rp - Rp - 600 61,691.93 Rp 37,015,159.80
104 ACT (Artesunate + Amodiaquin) Tablet - Rp - Rp - Rp -
105 Albendazole Tablet - Rp - Rp - 5000 366.50 Rp 1,832,500.00
106 Alopurinol tablet 100 mg Tablet 89.00 Rp - 89.00 Rp - Rp -
107 Ambroxol syrup 15 mg/ml Botol 3,630.00 Rp - 4,807.60 Rp - Rp -
108 Ambroxol tab 30 mg Tablet 123.42 Rp - 1000 147.00 Rp 147,000.00 Rp -
109 Aminofilin Injeksi 24 mg/ml - 10 ml Ampul - Rp - 2,736.00 Rp - Rp -
110 Aminofilin tablet 200 mg Tablet - Rp - 596.40 Rp - Rp -
111 Amitriptilin tab Tablet - Rp - Rp - 167.00 Rp -
112 Amlodipin 10 mg Tablet 74.00 Rp - 3000 74.00 Rp 222,000.00 Rp -
113 Amoksisilin 500 mg Tablet 231.00 Rp - 5000 231.00 Rp 1,155,000.00 Rp -
114 Amoksisilin Kapsul 250 mg Kapsul 198.00 Rp - Rp - Rp -
115 Amoksisilin sirup kering 125 mg/5 ml Botol 3,846.00 Rp - 2,068.64 Rp - Rp -
116 Ampisilin injeksi I,m/i.v 1000 mg/vial Vial - Rp - Rp - 9,834.00 Rp -
117 Antalgin (metampiron) tablet 500 mg Tablet - Rp - Rp - Rp -
118 Antalgin injeksi 250 mg/ml - 2 ml Ampul - Rp - Rp - Rp -
119 Antasida doen suspensi Botol 1,756.00 Rp - 1,756.00 Rp - Rp -
120 Antasida doen tablet kombinasi Tablet - Rp - 2000 54.49 Rp 108,980.00 Rp -
121 Antibakteri doen salep kombinasi Tube - Rp - Rp - Rp -
122 Antifungi Kombinasi Pot - Rp - 3,637.00 Rp - Rp -
123 Antihemoroid supp supp 3,260.00 Rp - 3,289.64 Rp - Rp -
124 Antimigrain doen kombinasi Tablet 199.00 Rp - 329.00 Rp - Rp -
125 Antiparkinson doen tablet kombinasi Tablet - Rp - Rp - Rp -
126 Aqua proinjeksi steril, bebas pirogen Botol 2,860.00 Rp - 2,322.00 Rp - Rp -
127 Artemeter Injeksi Ampul - Rp - Rp - Rp -
128 Artesunate Injeksi Ampul - Rp - Rp - 39,000.00 Rp -
129 Asam askorbat (vit c) tablet 250 mg Tablet - Rp - Rp - Rp -
130 Asam askorbat (vit c) tablet 50 mg Tablet 46.00 Rp - 3000 46.42 Rp 139,260.00 Rp -
131 Asam Folat tab 0,4 mg Tablet 45.00 Rp - 45.41 Rp - Rp -
132 Asam mefenamat 500 mg Tablet 117.00 Rp - 117.00 Rp - Rp -
133 Asam Traneksamat 500 mg Tablet - Rp - 277.20 Rp - Rp -
134 Asetosal tablet 100 mg Tablet - Rp - Rp - Rp -
137 Asiklovir 200 mg Tablet - Rp - Rp - Rp -
138 Asiklovir krim 5 % Tube - Rp - 4,760.00 Rp - Rp -
139 Asiklovir tab 400 mg Tablet 429.00 Rp - 1,087.80 Rp - Rp -
140 Atropin sulfat injeksi 0,25 mg/ml - 1 Ampul - Rp - Rp - Rp -
141 Atropin sulfat injeksi 0,5 mgl Ampul - Rp - Rp - Rp -
142 Atropin sulfat tetes mata 0,5 % Botol - Rp - Rp - Rp -
143 Attapulgite 600 mg Tablet - Rp - 816.52 Rp - Rp -
144 Betametason krim 0,1 % Tube 1,520.00 Rp - 200 1,533.82 Rp 306,764.00 Rp -
145 Bisakodil Suppositoria 10 mg supp - Rp - Rp - Rp -
147 Captopril 25 mg Tablet 75.00 Rp - 75.68 Rp - Rp -
148 Cetirizin tab Kapsul 132.00 Rp - 52.00 Rp - Rp -
149 Cetirizin sirup 5mg/ml Botol - Rp - 2,215.00 Rp - Rp -
150 Cimetidin Tablet - Rp - Rp - Rp -
151 Ciprofloxasin 500 mg Tablet 260.00 Rp - Rp - Rp -
152 Clobazam 10 mg Tablet - Rp - Rp - 776.00 Rp -
153 Clozapine 25 mg Tablet 473.00 Rp - Rp - 473.00 Rp -
154 Darplex (Antimalaria) Tablet 2,134.00 Rp - Rp - 1,917.00 Rp -
155 Deksametason inj Ampul 1,210.00 Rp - 968.00 Rp - Rp -
156 Deksametason tablet 0,5 mg Tablet 163.27 Rp - 10000 104.86 Rp 1,048,600.00 Rp -
157 Diazepam 5 mg Tablet 105.00 Rp - 108.96 Rp - Rp -
158 Diazepam inj 5 mg/ml - 2 ml Ampul 1,913.00 Rp - Rp - 1,545.00 Rp -
159 Diazepam Rektal 10 mg/2,5 ml Tube 21,021.00 Rp - Rp - Rp -
160 Diazepam Rektal 5 mg/2,5 ml Tube 14,459.00 Rp - 13,546.00 Rp - Rp -
161 Diazepam tablet 2 mg Tablet - Rp - Rp - Rp -
162 Dietilkarbamazin sitrat tablet 100 mg Tablet - Rp - Rp - Rp -
163 Difenhidramin hcl inj 10 mg/ml - 1 mlAmpul 825.00 Rp - 825.00 Rp - Rp -
164 Digoksin tablet 0,25 mg Tablet - Rp - Rp - Rp -
165 Diltiazem 30 mg tab Tablet 152.00 Rp - Rp - Rp -
166 Dimenhidrinat 50 mg Tablet 109.00 Rp - 109.99 Rp - Rp -
167 Doksisiklin 100 mg Tablet 289.00 Rp - Rp - Rp -
168 Domperidon suspensi 5mg/5ml Botol 2,401.00 Rp - 2,401.00 Rp - Rp -
169 Domperidon tab Tablet 75.00 Rp - 75.00 Rp - Rp -
170 Efedrin hcl tablet 25 mg Tablet - Rp - Rp - Rp -
171 Ekstrak Belladona Tablet - Rp - Rp - Rp -
172 Epinefrin(adrenalin) inj 0,1 %-1 ml Ampul 4,224.00 Rp - 13,675.20 Rp - 1,518.00 Rp -
173 Eritromisin kapsul 500 mg Kapsul 900.00 Rp - Rp - Rp -
174 Eritromisin Sirup Botol 6,390.00 Rp - 7,503.60 Rp - Rp -

175 Etil klorida semprot Botol - Rp - Rp - Rp -
176 Eugenol cairan Botol - Rp - 20,358.41 Rp - Rp -
177 Fenobarbital injeksi 50 mg/ml - 2 Ampul 1,700.00 Rp - Rp - 1,700.00 Rp -
178 Fenobarbital tablet 30 mg Tablet 177.00 Rp - Rp - Rp -
179 Fenol gliserol tetes telinga 10 % Botol 2,764.00 Rp - 3,330.00 Rp - Rp -
180 Fitomenadion injeksi 10 mg/ml - 1 mlAmpul 3,900.00 Rp - 7,435.40 Rp - Rp -
181 Fitomenadion injeksi 2 mg/ml - 1 ml (Ampul 4,236.00 Rp - 1,452.00 Rp - 1,452.00 Rp -
182 Fitomenadion tablet salut 10 mg Tablet 873.00 Rp - 781.00 Rp - Rp -
183 Fluoksetin kap 20 mg Kapsul 225.00 Rp - Rp - Rp -
184 Furosemid inj 10 mg/ml Ampul 1,555.00 Rp - 969.00 Rp - Rp -
185 Furosemid tablet 40 mg Tablet 82.00 Rp - 443.80 Rp - Rp -
186 Garam oralit untuk 200 ml air Bungkus 293.00 Rp - Rp - 500 280.00 Rp 140,000.00
187 Gemfibrozil 300 mg Kapsul - Rp - Rp - Rp -
188 Gentamisin injeksi 80 mg/2 ml Ampul 3,355.00 Rp - Rp - 4,036.00 Rp -
189 Gentamisin salep kulit Tube - Rp - 5,600.00 Rp - Rp -
190 Gentamisin sulfat tts mata 0,3 % Botol 22,300.00 Rp - Rp - Rp -
191 Gentian violet larutan 1 % Botol - Rp - Rp - Rp -
192 Glibenklamid tablet 5 mg Tablet - Rp - Rp - Rp -
193 Glimepiride 2 mg /3 mg Tablet 143.00 Rp - 123.00 Rp - Rp -
194 Gliseril guayakolat tablet 100 mg Tablet - Rp - Rp - Rp -
195 Gliserin Botol - Rp - Rp - Rp -
196 Glukosa larutan infus 10 % steril Botol - Rp - Rp - Rp -
197 Glukosa larutan infus 5 % steril Botol 6,627.00 Rp - 6,627.00 Rp - Rp -
198 Griseofulvin tablet 125 mg, micronize Tablet 300 210.00 Rp 63,000.00 Rp - Rp -
199 Glukosa kalsikus ampul - Rp - Rp - 10,351.00 Rp -
200 Haloperidol 5 mg Tablet 54.00 Rp - 54.49 Rp - 54.00 Rp -
201 Haloperidol tablet 0,5 mg Tablet 53.00 Rp - Rp - Rp -
203 Haloperidol tablet 2 mg Tablet 81.00 Rp - 81.74 Rp - Rp -
204 Haloperidol 50 mg/ml Ampul - Rp - Rp - 101,300.00 Rp -
206 Hidroklorotiazid (hct) tablet 25 mg Tablet 178.00 Rp - 200 149.35 Rp 29,870.00 Rp -
207 Hidrokortison krim 2,5 % Tube 2,325.00 Rp - 48 2,346.14 Rp 112,614.72 Rp -
208 Hyocine N Butilbromide inj. Ampul - Rp - Rp - Rp -
209 Ibuprofen Suspensi 200 mg/5ml Botol 5,411.00 Rp - 3,422.84 Rp - Rp -
210 Ibuprofen tablet 400 mg Tablet 292.82 Rp - 1000 216.95 Rp 216,950.00 Rp -
211 Isoniazid tab 100 mg Tablet - Rp - Rp - 282.00 Rp -
212 Isosorbid dinitrat tablet subling 5 mg Tablet 89.00 Rp - Rp - Rp -
213 Kalsium Laktat (Kalk) tab 500 mg Tablet 60.00 Rp - 2000 60.55 Rp 121,100.00 Rp -
214 Karbamazepin tab 200 mg Tablet 216.00 Rp - 217.96 Rp - Rp -
215 Ketokenazol krim 2% Tube - Rp - Rp - Rp -
216 Ketokenazol tab 200 mg Tablet 260.00 Rp - 260.00 Rp - Rp -
217 klindamisin kap 150 mg Kapsul - Rp - Rp - Rp -
218 Klonidin tab 0,15 mg Tablet - Rp - 147.33 Rp - Rp -
219 Kloramfenikol kapsul 250 mg Kapsul 632.50 Rp - Rp - Rp -
220 Kloramfenikol kapsul 500 mg Kapsul - Rp - Rp - Rp -
221 Kloramfenikol salep kulit 2% Tube 4,334.00 Rp - 3,794.00 Rp - Rp -
222 Kloramfenikol salep mata 1 % Tube - Rp - Rp - Rp -
223 Kloramfenikol suspensi 125 mg/ 5 ml Botol 5,352.00 Rp - Rp - Rp -
224 Kloramfenikol tetes mata 0,5 % Botol 17,820.00 Rp - 16,450.00 Rp - Rp -
225 Kloramfenikol tetes telinga 3 % Botol - Rp - Rp - Rp -
226 Klorfeniramin maleat (ctm) tablet 4 Tablet 85.80 Rp - 6000 139.36 Rp 836,163.00 Rp -
227 Klorokuin fosfat tablet 150 mg Tablet - Rp - Rp - Rp -
228 Klorpromazin hcl tablet salut 100 mg Tablet - Rp - 1,010.10 Rp - 157.00 Rp -
229 Klorpromazin hcl tablet salut 25 mg Tablet 208.00 Rp - 209.89 Rp - Rp -
230 Klorpromazin inj 25 mg/ml-1ml Ampul - Rp - Rp - Rp -
231 Klorpromazin inj 5 mg/ml Ampul - Rp - Rp - Rp -
232 Kodein hcl tablet 10 mg Tablet - Rp - 610.50 Rp - Rp -
233 Komb. Primetamin + sulfadoksin Tablet - Rp - Rp - Rp -
234 Kombinasi ipatropium bromida 0,5mgampul 4,550.00 Rp - 3,951.60 Rp - Rp -
235 Kombipak Kategori 1 Paket - Rp - Rp - 317,018.00 Rp -
236 Kotrimoksazol Adult Botol 133.00 Rp - 127.15 Rp - Rp -
237 Kotrimoksazol Suspensi Botol 2,190.00 Rp - Rp - Rp -
238 Kuinin dihidroklorida injeksi 25 % - 2 Ampul - Rp - Rp - Rp -
239 Kuinin sulfat tablet 222 mg ( 7 h2o ) Tablet - Rp - Rp - Rp -
240 Larutan mengandung Elektrolit (Na 1 Botol 10,293.00 Rp - 9,592.00 Rp - Rp -
Botol
241 Larutan mengandung Karbohidrat + Elek 11,500.00 Rp - Rp - Rp -
242 Lidokain injeksi 2 % Ampul - Rp - 899.10 Rp - Rp -
243 Lidokain kompositum injeksi Ampul 847.00 Rp - 854.70 Rp - Rp -
244 Loperamid tab 2 mg Tablet 156.20 Rp - Rp - Rp -
245 Loratidin Tablet 117.00 Rp - 2000 117.00 Rp 234,000.00 Rp -
246 Magnesium Sulfat Injeksi 20 %-25 mlAmpul 4,120.00 Rp - Rp - 4,120.00 Rp -
247 Magnesium Sulfat Injeksi 40 %-25 mlAmpul 4,700.00 Rp - 4,700.00 Rp - 4,700.00 Rp -
248 Metformin 500 mg tablet Tablet 264.00 Rp - 77.00 Rp - Rp -
249 Metilergometrin maleat injeksi 0,200 Ampul 1,069.00 Rp - Rp - 1,079.00 Rp -
250 Metilergometrin maleat tablet salut Tablet 214.00 Rp - 215.95 Rp - Rp -
251 Metilprednisolon 4 mg Tablet 216.70 Rp - 102.00 Rp - Rp -
252 Metoklopramid injeksi 5 mg/ml Ampul 1,883.00 Rp - 50 1,883.00 Rp 94,150.00 Rp -
253 Metoklopramid sirup 5 mg/ml Botol - Rp - Rp - Rp -
254 Metoklopramid tab 10 mg Tablet 66.00 Rp - 2000 66.60 Rp 133,200.00 Rp -
255 Metronidazol tablet 500 mg Tablet - Rp - Rp - Rp -
256 Metronidazole syrup Botol 3,950.00 Rp - Rp - Rp -
257 Mikonazol krim 2 % Tube 1,900.00 Rp - 1,917.27 Rp - Rp -
258 Mineral Mix Sachet - Rp - Rp - 40 3,116.00 Rp 124,640.00
259 Multivitamin Syrup Botol 17,569.20 Rp - Rp - 16,500.00 Rp -
260 N- asetil sistein kapsul 200 mg Kapsul 990.00 Rp - 319.88 Rp - Rp -
261 Natrium diklofenat 50 mg Tablet 109.00 Rp - 2000 109.00 Rp 218,000.00 Rp -
262 Natrium klorida larutan infus 0,9 % st Botol 100 6,840.00 Rp 684,000.00 6,900.00 Rp - Rp -
263 Natrium Tiroksin Tablet - Rp - Rp - Rp -
264 Nifedipin 10 mg Tablet 220.17 Rp - Rp - Rp -
265 Nistatin tab 500.000UI/g Tablet - Rp - 869.00 Rp - Rp -

266 Nistatin tablet vaginal 100.000UI/g Tablet - Rp - 550.00 Rp - Rp -
267 OAT Kategori Sisipan Paket - Rp - Rp - Rp -
268 Obat anti tuberculosis kategori anak Paket - Rp - Rp - 287,387.00 Rp -
269 Obat anti tuberculosis kategori I Paket - Rp - Rp - 478,142.00 Rp -
270 Obat anti tuberculosis kategori II Paket - Rp - Rp - 1,592,731.00 Rp -
271 Obat batuk (o.b.h ) cairan Botol - Rp - Rp - Rp -
272 Oksitetrasiklin hcl inj.I.m.50 mg/ml-1 Vial - Rp - Rp - Rp -
273 Oksitetrasiklin hcl salep 3 % Tube - Rp - Rp - Rp -
274 Oksitetrasiklin hcl salep mata Tube 3,500.00 Rp - 5,588.80 Rp - 3,500.00 Rp -
275 Oksitosin injeksi 10 iu/ml - 1 ml Ampul 1,348.00 Rp - Rp - 1,348.00 Rp -
276 Omeprazol inj 40 mg/ml Ampul - Rp - 8,247.00 Rp - Rp -
277 Omeprazol kap 20 mg Kapsul - Rp - 502.24 Rp - Rp -
278 Papaverin injeksi 40 mg/ml Ampul - Rp - Rp - Rp -
279 Papaverin tab 40 mg Tablet - Rp - Rp - Rp -
280 Parasetamol Drops Botol 5,204.00 Rp - 5,204.00 Rp - Rp -
281 Parasetamol sirup 120 mg/5 ml Botol 1,160.00 Rp - 1,170.55 Rp - Rp -
282 Parasetamol tablet 500 mg Tablet 188.76 Rp - 8000 209.79 Rp 1,678,320.00 131.00 Rp -
283 Perak Sulfadiazin 1% Tube - Rp - Rp - Rp -
284 Permetrin krim 5% Tube 11,466.00 Rp - 11,250.00 Rp - Rp -
285 Piracetam 400 mg Tablet - Rp - Rp - Rp -
286 Piridoksin Tablet 256.00 Rp - Rp - Rp -
287 Piroksikam 20 mg Tablet - Rp - Rp - Rp -
288 Polikresulen Botol - Rp - Rp - Rp -
289 Prednison tablet 5 mg Tablet 79.00 Rp - 73.66 Rp - Rp -
290 Primakuin tab 15 mg Tablet - Rp - Rp - 242.00 Rp -
291 Prokain benzil penisilin 3 juta iu/vial i Vial Rp - Rp - Rp -

- 14,500.00
292 Propitiourasil tablet 100 mg Tablet - Rp - Rp - Rp -
293 Propranolol hcl tablet 10 mg Tablet 63.00 Rp - Rp - Rp -
294 Pyrantel pamoat tablet 125 mg Tablet - Rp - Rp - Rp -
295 Pyrantel Suspensi 125 mg/5ml Botol 11,791.00 Rp - Rp - Rp -
296 Ranitidin Injeksi 25 mg/2ml Ampul - Rp - Rp - Rp -
297 Ranitidin tab 150 mg Tablet 122.00 Rp - 85.00 Rp - Rp -
298 Retinol (Vitamin A) 100.000 IU kapsulKapsul 354.00 Rp - Rp - 200 352.00 Rp 70,400.00
299 Retinol (Vitamin A) 200.000 IU kapsulKapsul 637.00 Rp - 642.79 Rp - 1900 637.00 Rp 1,210,300.00
300 Ringer laktat larutan infus steril Botol 7,703.00 Rp - 200 7,703.00 Rp 1,540,600.00 Rp -
301 Risperidone 2 mg Tablet 130.00 Rp - Rp - 287.00 Rp -
302 Salbutamol cairan ih 0,1% Ampul - Rp - 5,400.00 Rp - Rp -
303 Salbutamol inhalasi/aerosol 100mcg/dBotol 22,000.00 Rp - 22,000.00 Rp - Rp -
304 Salbutamol tablet 4 mg Tablet 67.00 Rp - Rp - Rp -
305 Salep 2-4 Pot 3,219.00 Rp - Rp - Rp -
306 Salisil bedak 2% Bungkus 1,040.00 Rp - Rp - Rp -
307 Sefadroksil kapsul 500 mg/ 250 mg Kapsul 732.00 Rp - 2000 952.15 Rp 1,904,300.00 Rp -
308 Sefadroksil syrup 250 mg/5 ml Botol 5,826.00 Rp - Rp - Rp -
309 Sefotaksim injeksi 1 g Vial - Rp - Rp - Rp -
310 Seftriakson injeksi 1 g Vial - Rp - Rp - Rp -
311 Sianokobalamin (vit b 12) inj. 500 m Ampul 1,066.00 Rp - 1,066.00 Rp - Rp -
312 Sianokobalamin tab Tablet - Rp - 44.40 Rp - Rp -
313 Simvastatin 10 mg Tablet 220.00 Rp - 73.00 Rp - Rp -
314 Streptomisin serbuk inj 1000 mg/ml Vial - Rp - Rp - Rp -
315 Sulfacetamid sodium Botol - Rp - Rp - Rp -
316 Tablet tambah darah Tablet 255.00 Rp - 257.32 Rp - 50000 255.00 Rp 12,750,000.00
317 Taburia Sach Sachet - Rp - Rp - Rp -
318 Tamiflu Kapsul - Rp - Rp - Rp -
319 Tetrakain hcl tetes mata Botol - Rp - Rp - Rp -
320 Tetrasiklinhcl kapsul 250 mg Kapsul - Rp - Rp - Rp -
321 Tetrasiklinhcl kapsul 500 mg Kapsul - Rp - 948.54 Rp - Rp -
322 Tiamin hcl ( vit b1 ) inj. Ampul - Rp - Rp - Rp -
323 Tiamin hcl mononitrat 50 mg Tablet 375.10 Rp - 300.01 Rp - Rp -
324 Tiampenikol tab 500 mg Tablet - Rp - Rp - Rp -
325 Tramadol injeksi 50 mg/ml Ampul

- Rp - Rp - Rp -
326 Triheksifenidil hidroklorida tab 2 mg Tablet 63.00 Rp - 63.57 Rp - 91.00 Rp -

327 Vitamin B-Compleks Tablet - Rp - 5000 60.55 Rp 302,750.00 Rp -
328 Zinc dispersibel tab Tablet 604.00 Rp - 329.14 Rp - 216.00 Rp -
329 Zinc Sirup 20 mg/5 ml Botol 2,489.00 Rp - Rp - Rp -
330 Vaksin Anti Influenza Vial - Rp - Rp - 82,335.00 Rp -
331 Vaksin Anti Rabies Vial - Rp - Rp - 153,000.00 Rp -
332 Vaksin HB PID Kantong 0,5 ml - Rp - Rp - 23,991.00 Rp -
333 Vaksin BCG + Pelarut Vial 1 ml - Rp - Rp - 10 61,996.00 Rp 619,960.00
334 Vaksin Polio (bOPV) Vial 1 ml - Rp - Rp - 40 19,954.00 Rp 798,160.00
335 Vaksin DPT-HB-HIB Vial 2,5 ml - Rp - Rp - 40 78,991.00 Rp 3,159,640.00
336 Vaksin IPV Vial 2,5 ml - Rp - Rp - 20 158,994.00 Rp 3,179,880.00
337 Vaksin Campak + Pelarut Vial 5 ml - Rp - Rp - 28,204.00 Rp -
338 Vaksin TD (Tetanus Difteri) Vial 5 ml - Rp - Rp - 16,995.00 Rp -
339 Vaksin DT (Difteri Tetanus) Vial 5 ml - Rp - Rp - 17,996.00 Rp -
340 Efavirenz (EFV) 600 mg Tablet - Rp - Rp - 7,625.00 Rp -
341 Lamivudine (3TC) 150 mg Tablet

- Rp - Rp - 1,794.00 Rp -
342 Nevirapine (NVP) 200 mg Tablet - Rp - Rp - 3,058.00 Rp -
343 Tenofovir (TDF) 300 mg Tablet - Rp - Rp - 9,688.00 Rp -
344 Triple FDC Dewasa (TDF300+3TC300Tablet - Rp - Rp - 6,971.00 Rp -
345 Triple FDC Ped (ZDV60+3TC30+NVP5Tablet - Rp - Rp - 1,480.30 Rp -
346 Zidovudine (ZDV) 100 mg Tablet - Rp - Rp - 1,768.00 Rp -
347 Zidovudine 300 mg + Lamivudine 15 Tablet - Rp - Rp - 4,050.00 Rp -
348 Xylocain spray/ lidokain spray oral 1 Botol - Rp - Rp - Rp -
349 Betahistin Tablet 92.00 Rp - Rp - Rp -
350 Bisakodil tab 5 mg Tablet - Rp - Rp - Rp -
351 Ketorolac Inj Ampul 923.00 Rp - 923.00 Rp - Rp -
352 Kotrimoksazol Adult forte Tablet - Rp - Rp - Rp -
353 Laktulosa syrup Botol - Rp - Rp - Rp -
354 Vaksin Meningitis Vial - Rp - Rp - 135,000.00 Rp -

355 Vaksin HBIG Vial - Rp - Rp - 3 1,325,000.00 Rp 3,975,000.00
356 Human Hexagon Spilis Test - Rp - Rp - 8,433.60 Rp -
357 RPR Focus Test - Rp - Rp - 4,360.00 Rp -
358 Micropipet 60 Pcs - Rp - Rp - 179.20 Rp -
360 Pipet TIPS Pcs - Rp - Rp - 980.00 Rp -
361 Vaksin Measles Rubella (MR) + Pelaru
Vial 5 ml - Rp - Rp - 155,813.00 Rp -
362 Multivitamin tab Tablet - Rp - Rp - 7,000.00 Rp -
363 Reagen Human Hexagon Spilis Test - Rp - Rp - 20,400.00 Rp -
364 Metronidazol 500mg/100 ml Botol - Rp - Rp - 5,885.00 Rp -
365 Serum Anti Rabies (SAR) Vial - Rp - Rp - 1,608,255.00 Rp -
366 Handrub (AntiSeptic) 5 Liter jrg - Rp - Rp - 395,000.00 Rp -
367 Albendazole Suspensi Botol Rp - Rp - 200 4,300.00 Rp 860,000.00
368 Vaksin HB Recombinan ( HB dewasa) Vial Rp - Rp - 52,050.00 Rp -
369 Larutan Methanol Botol Rp - Rp - 45,360.00 Rp -
370 Cartridge TCM-TB Test Rp - Rp - 253,400.00 Rp -
Vial
371 Vaksin Corona Vac (10 Rp - Rp - 1,339,440.00 Rp -
dosis)
372 Endo Vacutube Steril pcs Rp - Rp - 2,500.00 Rp -
373 Freezing Tubes pcs Rp - Rp - 2,500.00 Rp -
374 DBS Collection Kit pcs Rp - Rp - 19,651.00 Rp -
375 MDT MB Dewasa Tablet Rp - Rp - 40,526.00 Rp -
376 Tenofovir + Lamivudine +Dolutegra Tablet Rp - Rp - 2,609.43 Rp -
377 Abacavir 120 mg + 3TC 60 mg (FDC Tablet Rp - Rp - 1,618.27 Rp -
378 Lopinavir 40 mg + Ritonavir 10 mg ( Sachet Rp - Rp - 2,451.02 Rp -
379 Dolutegravir 50 mg Tablet Rp - Rp - 943.90 Rp -
380 MDT MB Anak Blister Rp - Rp - 25,364.00 Rp -
381 Strip Glukosa Darah Botol Rp - Rp - 130,891.24 Rp -
382 Rapid Test Anti HCV Test Rp - Rp - 11,188.00 Rp -
383 Tuberculin Test Vial Rp - Rp - 2 625,800.00 Rp 1,251,600.00
384 INH 300 mg Tablet Rp - Rp - 150.00 Rp -
385 Rifapentin 150 mg Lepasan Tablet Rp - Rp - 5,525.00 Rp -
Rifapentin 300 mg/ Isoniazid 300

386 Tablet Rp - Rp - 6,546.00 Rp -
mg (3HP/KDT)
Rifampicin 75 mg/ Isoniazid 50 mg

387 Tablet Rp - Rp - 799.00 Rp -
(3HR/KDT)
388 Vaksin PCV MDV (4 dosis) Vial Rp - Rp - 30 190,657.00 Rp 5,719,710.00
389 Kotrimoksazol 960 mg Tablet Rp - Rp - 325.00 Rp -
390 OAT KDT Harian Paket Rp - Rp - 397,612.00 Rp -
391 Herba Asimor Kapsul Rp - Rp - 240 2,750.00 Rp 660,000.00
392 Herbakof Syrup Botol Rp - Rp - 5 15,125.00 Rp 75,625.00
393 Stimuno Syrup Botol Rp - Rp - 9 48,881.00 Rp 439,929.00
Rp 5,730,168.00 Rp 14,900,578.73 Rp 74,093,175.80
JUMLAH Rp 94,723,922.53
Malili, Januari 2023

Yang Menyerahkan Yang Menerima
Melyati Suhaery, S.Si.,Apt

NIP. 19831117 201001 2 025 NIP.
Mengetahui,
Sub Koordinator Kefarmasian
Fitriani, S.Si., M.Kes

NIP. 19840807 2010 01 2 029
STOK
433 0 6,600 55
47 0 1,200 10
-119 0 300 3
1,000 0 89,300 744
0 0 0 0
-242 0 0 0
71 0 3,372 28
-13 0 0 0
0 0 0 0
200 10,400 0 87
842 16,200 46,000 518
14 0 305 3
4 0 2,618 22
-23 0 179 1
-4 525 0 4
8 321 0 3
46 0 6,417 53
0 0 0 0
0 0 0 0
-100 400 0 3
-54 0 10,450 87
-326 290,000 0 2,417
-88 0 0 0
68 0 1,475 12
0 0 0 0
64 0 650 5
248 0 3,200 27
-168 0 850 7
0 0 0 0
79 0 0 0
12 5,340 0 45
0 0 0 0
12 2,172 0 18
0 0 0 0
0 0 0 0
12 2,340 0 20
0 0 0 0
-5 0 117 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-12 0 432 4
0 0 0 0
0 0 0 0
0 0 0 0
1 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 145 1
0 0 0 0
0 0 0 0
-2,316 143,150 0 1,193
0 0 0 0
-1,000 0 227,950 1,900
19 0 0 0
-6 0 0 0
40 0 200 2
0 0 0 0
20 0 40 0
0 0 0 0
0 0 0 0
2 0 0 0
549 0 0 0
1 0 0 0
19 0 0 0
0 0 0 0
-7 0 780 7
5 0 0 0
68 10,780 0 90
0 0 0 0
0 0 0 0
0 0 0 0
38 0 8,150 68
54 2,550 0 21
0 219 0 2
0 0 0 0
STOK
-7 101 50 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
28 0 4,170 35
0 0 0 0
1 0 0 0
194 0 0 0
-300 0 0 0
16 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
600 0 0 0
100 0 0 0
0 0 0 0
-170 0 0 0
0 0 0 0
2,100 0 0 0
2,826 0 0 0
290 0 0 0
-5,205 0 0 0
0 0 60 1
0 0 800 7
170 0 0 0
-3,588 0 135,000 1,125
-3,881 0 213,200 1,777
-56 0 0 0
172 0 9,700 81
40 0 0 0
0 0 0 0
0 0 0 0
-664 0 0 0
-1,154 0 156,900 1,308
0 0 0 0
0 0 3,670 31
-14 0 0 0
381 0 2,600 22
0 0 0 0
40 0 4,000 33
0 0 0 0
0 0 0 0
0 0 0 0
-2,103 0 126,000 1,050
190 0 0 0
6,930 0 86,000 717
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 980 8
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 52,500 438
-90 0 8,375 70
0 0 0 0
0 0 0 0
1,405 0 87,000 725
-1,902 0 0 0
144 0 11,450 95
0 0 0 0
2,015 35,000 0 292
0 0 0 0
0 0 0 0
0 0 0 0
39 0 790 7
-11,365 0 214,000 1,783
245 0 11,300 94
60 440 0 4
0 0 0 0
5 0 45 0
0 0 0 0
0 0 0 0
32 0 120 1
0 0 0 0
0 1,800 0 15
10 0 0 0
377 0 0 0
0 0 0 0
-768 0 0 0
0 0 0 0
0 0 0 0
89 0 2,400 20
300 1,400 0 12
STOK
0 0 0 0
0 0 0 0
0 0 0 0
37 360 0 3
0 0 0 0
97 0 3,816 32
30 0 0 0
157 0 6,780 57
153 0 12,200 102
0 0 0 0
0 0 20 0
300 0 9,200 77
2,000 0 0 0
0 0 0 0
20 0 0 0
0 0 0 0
-2 0 0 0
0 0 0 0
0 0 0 0
404 0 25,500 213
0 0 0 0
0 0 0 0
0 0 0 0
-54 0 0 0
-600 2,700 0 23
6 0 0 0
203 0 10,100 84
227 0 0 0
92 0 0 0
200 0 200 2
5 0 0 0
0 0 0 0
-200 0 1,500 13
-47 0 2,544 21
0 0 0 0
124 0 560 5
713 0 59,000 492
0 0 0 0
100 0 0 0
1,620 0 40,500 338
88 0 3,400 28
0 0 0 0
200 0 4,600 38
0 0 0 0
0 0 1,400 12
0 0 0 0
0 0 0 0
3 0 3,288 27
0 0 0 0
9 360 0 3
0 0 0 0
0 0 0 0
-6,456 0 46,000 383
0 0 0 0
90 0 1,500 13
263 0 0 0
0 0 0 0
0 0 0 0
-570 0 0 0
0 0 0 0
97 0 1,480 12
-2 0 0 0
844 0 36,500 304
235 0 0 0
0 0 0 0
0 0 0 0
270 0 100 1
0 0 0 0
244 0 4,900 41
-204 0 5,250 44
1,532 160,700 0 1,339
-682 0 11,600 97
14 6 0 0
11 6 100 1
7,184 0 54,000 450
50 325 0 3
300 0 16,800 140
3,072 0 3,000 25
-44 0 2,670 22
0 0 0 0
-1,549 0 35,500 296
0 0 0 0
119 3,100 0 26
77 0 2,304 19
0 0 0 0
0 0 0 0
783 0 126,960 1,058
508 0 76,500 638
2 740 2,100 24
0 0 0 0
0 0 0 0
STOK
100 0 1,300 11
78 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
195 0 2,250 19
18 0 0 0
139 0 158 1
1,856 0 63,000 525
0 0 0 0
0 0 0 0
0 0 0 0
620 0 8,300 69
-11,742 0 8,500 71
0 0 0 0
17 0 185 2
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-14 0 0 0
2 0 0 0
0 0 0 0
50 1,300 0 11
0 0 0 0
0 0 0 0
0 0 0 0
-2,216 0 0 0
200 0 0 0
-6,150 0 19,050 159
-244 0 13,720 114
183 0 0 0
0 0 10 0
0 0 415 3
0 0 0 0
39 1,944 0 16
0 0 0 0
-2,073 0 61,000 508
0 0 0 0
0 0 0 0
0 0 0 0
82 0 3,000 25
5,400 0 261,000 2,175
1,038 0 0 0
0 0 0 0
0 0 0 0
-3,633 0 90,000 750
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1,400 12
0 0 0 0
-329 0 82,400 687
0 0 0 0
0 0 0 0
-94 0 9,000 75
786 0 268,000 2,233
3,093 0 4,500 38
2 0 0 0
0 0 0 0
3 0 0 0
-282 0 0 0
-145 0 0 0
-382 0 0 0
-510 0 0 0
-200 0 0 0
0 0 0 0
-215 0 0 0
-106 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
150 0 0 0
0 0 0 0
60 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
50 0 2,580 22
0 0 0 0
0 0 0 0
STOK
0 0 0 0
0 0 0 0
-29 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-638 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-2 0 0 0
50 0 0 0
0 0 0 0
-1 0 #VALUE!
0 0 0 0
0 0 #VALUE!
0 0 0 0
0 0 0
0 0 0 0
0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
68 0 0 0
0 0 0 0
4 0 0 0
100 0 0 0
0 0 0 0
180 0 0 0
0 0 0 0
-41 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
DINAS KESEHATAN
MALILI
SBBK No. 440/ /SBBK/ II /2023

1 Alat Suntik Sekali Pakai 1 ml/ 0,3 ml Set 827.95 Rp - 500 1,090.98 Rp 545,490.00 Rp -
2 Alat Suntik Sekali Pakai 2,5 ml/ 3 ml Set 803.76 Rp - 700 1,158.84 Rp 811,188.00 Rp -
3 Alat Suntik Sekali Pakai 5 ml Set 1,218.00 Rp - 1,103.52 Rp - 1,460.00 Rp -
4 Alcohol Swab Lembar 126.50 Rp - 148.87 Rp - 138.00 Rp -
6 Blood Lancet Pcs 167.51 Rp - Rp - 320.325 Rp -
7 Catgut / Benang Bedah No. 3/0 dan Set 4,114.58 Rp - 48 6,379.05 Rp 306,194.16 Rp -
8 Cuticell Classic 10 cm x 10 cm Pcs - Rp - 7,100.00 Rp - Rp -
11 Disable Syringes 0,5 ml Set 400 1,237.00 Rp 494,800.00 1,206.00 Rp - 1,650.00 Rp -
12 Etakridin (rivanol) larutan 0,1 % Botol 4,080.00 Rp - 8,665.20 Rp - Rp -
13 Etanol 70% Botol 22,440.00 Rp - 15 27,595.00 Rp 413,925.00 Rp -
14 Fixomull Stretch 5 cm x 5 cm Rol - Rp - 20 50,200.00 Rp 1,004,000.00 Rp -
16 Folley catheter No.16 Pcs 10 11,035.20 Rp 110,352.00 Rp - Rp -
17 Folley catheter No.18 Pcs 12,156.33 Rp - 11,132.00 Rp - Rp -
20 Handscoen Ginecolog Pasang 43,010.00 Rp - Rp - 43,010.00 Rp -
21 Hanscoen Pasang 8,635.00 Rp - 8,635.00 Rp - Rp -
22 Hanscoen Non Steril Pasang 5000 1,780.68 Rp 8,903,400.00 Rp - 1,575.02 Rp -
23 Infusion Set Anak Set 7,680.00 Rp - 6,072.00 Rp - Rp -
24 Infusion Set Dewasa Set 7,140.00 Rp - 200 7,128.00 Rp 1,425,600.00 Rp -
27 IV Catheter No. 20 Buah 12,631.00 Rp - 200 5,492.52 Rp 1,098,504.00 Rp -
38 Kapas pembalut/absorben 250 mg Gulung 14,375.00 Rp - 16,698.00 Rp - Rp -
43 Kasa Pembalut Hidrofil 40 Yds x 80 c Roll 147,600.00 Rp - 31 181,907.00 Rp 5,639,117.00 Rp -
55 Maag Slang 14 Set - Rp - 3 8,905.60 Rp 26,716.80 Rp -
58 Masker Buah 571.82 Rp - Rp - 10,533.60 Rp -
60 Masker Kerudung Buah 596.90 Rp - 1000 526.24 Rp 526,240.00 706.420 Rp -
61 Nasal Canula Anak Set - Rp - 6,325.00 Rp - Rp -
62 Nasal Canula Bayi Set - Rp - 6,325.00 Rp - Rp -
63 Nasal Canula Dewasa Set 6,270.00 Rp - 30 6,325.00 Rp 189,750.00 Rp -
65 Onemed Gluco Protein Strip 1,191.30 Rp - 1,201.75 Rp - Rp -
68 Plester 5 yard x 2 inch / 2,5 cm x 4,5 Rol 37,371.00 Rp - 27,324.00 Rp - Rp -
73 Silk ( Benang Bedah Sutera ) No 3/0 Set 2,599.83 Rp - 72 5,313.89 Rp 382,600.01 Rp -
74 Slide Dos - Rp - Rp - 44,500.00 Rp -
75 Softpad(Underpad) 60x90 Lembar 100 3,018.75 Rp 301,875.00 Rp - Rp -
79 Tes Kehamilan strip - Rp - 2,185.00 Rp - Rp -
81 Urine bag Pcs 4,827.90 Rp - Rp - Rp -
83 USG Gel 250 ml Botol 10 15,800.40 Rp 158,004.00 16,632.00 Rp - Rp -

88 Yodium povidon larutan 10% 60 ml Botol - Rp - 30 4,699.00 Rp 140,970.00 Rp -
91 SD HIV-1/2 3.0 (multi) (R1) test - Rp - Rp - 13,362.00 Rp -
92 Fokus Diagnostic (R2) test - Rp - Rp - 11,500.00 Rp -
94 RDT Malaria test - Rp - Rp - 25 10,488.00 Rp 262,200.00
101 RDT Hepatitis test - Rp - Rp - 200 9,918.00 Rp 1,983,600.00
103 RDT DBD (NS1) Strip - Rp - Rp - 45,224.00 Rp -
105 Albendazole Tablet - Rp - Rp - 366.50 Rp -
106 Alopurinol tablet 100 mg Tablet 89.00 Rp - 89.00 Rp - Rp -
108 Ambroxol tab 30 mg Tablet 123.42 Rp - 147.00 Rp - Rp -
109 Aminofilin Injeksi 24 mg/ml - 10 ml Ampul - Rp - 2,736.00 Rp - Rp -
110 Aminofilin tablet 200 mg Tablet - Rp - 596.40 Rp - Rp -
112 Amlodipin 10 mg Tablet 74.00 Rp - 5000 74.00 Rp 370,000.00 Rp -
113 Amoksisilin 500 mg Tablet 231.00 Rp - 8000 231.00 Rp 1,848,000.00 Rp -
114 Amoksisilin Kapsul 250 mg Kapsul 198.00 Rp - Rp - Rp -
115 Amoksisilin sirup kering 125 mg/5 ml Botol 3,846.00 Rp - 2,068.64 Rp - Rp -
119 Antasida doen suspensi Botol 1,756.00 Rp - 1,756.00 Rp - Rp -
120 Antasida doen tablet kombinasi Tablet - Rp - 3000 54.49 Rp 163,470.00 Rp -
122 Antifungi Kombinasi Pot - Rp - 3,637.00 Rp - Rp -
123 Antihemoroid supp supp 3,260.00 Rp - 3,289.64 Rp - Rp -
124 Antimigrain doen kombinasi Tablet 199.00 Rp - 329.00 Rp - Rp -
126 Aqua proinjeksi steril, bebas pirogen Botol 2,860.00 Rp - 40 2,322.00 Rp 92,880.00 Rp -
130 Asam askorbat (vit c) tablet 50 mg Tablet 46.00 Rp - 3000 46.42 Rp 139,260.00 Rp -
131 Asam Folat tab 0,4 mg Tablet 45.00 Rp - 45.41 Rp - Rp -
132 Asam mefenamat 500 mg Tablet 117.00 Rp - 117.00 Rp - Rp -
133 Asam Traneksamat 500 mg Tablet - Rp - 277.20 Rp - Rp -
138 Asiklovir krim 5 % Tube - Rp - 4,760.00 Rp - Rp -
139 Asiklovir tab 400 mg Tablet 429.00 Rp - 1,087.80 Rp - Rp -
143 Attapulgite 600 mg Tablet - Rp - 1000 816.52 Rp 816,520.00 Rp -
144 Betametason krim 0,1 % Tube 1,520.00 Rp - 1,533.82 Rp - Rp -
147 Captopril 25 mg Tablet 75.00 Rp - 75.68 Rp - Rp -
148 Cetirizin tab Kapsul 132.00 Rp - 52.00 Rp - Rp -
149 Cetirizin sirup 5mg/ml Botol - Rp - 2,215.00 Rp - Rp -
151 Ciprofloxasin 500 mg Tablet 260.00 Rp - Rp - Rp -
154 Darplex (Antimalaria) Tablet 2,134.00 Rp - Rp - 1,917.00 Rp -
155 Deksametason inj Ampul 1,210.00 Rp - 968.00 Rp - Rp -
156 Deksametason tablet 0,5 mg Tablet 163.27 Rp - 4000 104.86 Rp 419,440.00 Rp -
157 Diazepam 5 mg Tablet 105.00 Rp - 200 108.96 Rp 21,792.00 Rp -
158 Diazepam inj 5 mg/ml - 2 ml Ampul 1,913.00 Rp - Rp - 1,545.00 Rp -
160 Diazepam Rektal 5 mg/2,5 ml Tube 14,459.00 Rp - 5 13,546.00 Rp 67,730.00 Rp -
163 Difenhidramin hcl inj 10 mg/ml - 1 mlAmpul 825.00 Rp - 825.00 Rp - Rp -
166 Dimenhidrinat 50 mg Tablet 109.00 Rp - 109.99 Rp - Rp -
167 Doksisiklin 100 mg Tablet 289.00 Rp - Rp - Rp -
168 Domperidon suspensi 5mg/5ml Botol 2,401.00 Rp - 2,401.00 Rp - Rp -
169 Domperidon tab Tablet 75.00 Rp - 75.00 Rp - Rp -
172 Epinefrin(adrenalin) inj 0,1 %-1 ml Ampul 4,224.00 Rp - 13,675.20 Rp - 1,518.00 Rp -
174 Eritromisin Sirup Botol 6,390.00 Rp - 7,503.60 Rp - Rp -

176 Eugenol cairan Botol - Rp - 20,358.41 Rp - Rp -
179 Fenol gliserol tetes telinga 10 % Botol 2,764.00 Rp - 3,330.00 Rp - Rp -
180 Fitomenadion injeksi 10 mg/ml - 1 mlAmpul 3,900.00 Rp - 7,435.40 Rp - Rp -
181 Fitomenadion injeksi 2 mg/ml - 1 ml (Ampul 4,236.00 Rp - 1,452.00 Rp - 1,452.00 Rp -
182 Fitomenadion tablet salut 10 mg Tablet 873.00 Rp - 781.00 Rp - Rp -
183 Fluoksetin kap 20 mg Kapsul 225.00 Rp - Rp - Rp -
184 Furosemid inj 10 mg/ml Ampul 1,555.00 Rp - 969.00 Rp - Rp -
185 Furosemid tablet 40 mg Tablet 82.00 Rp - 443.80 Rp - Rp -
186 Garam oralit untuk 200 ml air Bungkus 293.00 Rp - Rp - 280.00 Rp -
188 Gentamisin injeksi 80 mg/2 ml Ampul 3,355.00 Rp - Rp - 4,036.00 Rp -
189 Gentamisin salep kulit Tube - Rp - 5,600.00 Rp - Rp -
190 Gentamisin sulfat tts mata 0,3 % Botol 22,300.00 Rp - Rp - Rp -
193 Glimepiride 2 mg /3 mg Tablet 143.00 Rp - 1000 123.00 Rp 123,000.00 Rp -
197 Glukosa larutan infus 5 % steril Botol 6,627.00 Rp - 6,627.00 Rp - Rp -
198 Griseofulvin tablet 125 mg, micronize Tablet 210.00 Rp - Rp - Rp -
200 Haloperidol 5 mg Tablet 54.00 Rp - 54.49 Rp - 54.00 Rp -
203 Haloperidol tablet 2 mg Tablet 81.00 Rp - 81.74 Rp - Rp -
206 Hidroklorotiazid (hct) tablet 25 mg Tablet 178.00 Rp - 149.35 Rp - Rp -
207 Hidrokortison krim 2,5 % Tube 2,325.00 Rp - 2,346.14 Rp - Rp -
209 Ibuprofen Suspensi 200 mg/5ml Botol 5,411.00 Rp - 3,422.84 Rp - Rp -
210 Ibuprofen tablet 400 mg Tablet 292.82 Rp - 2000 216.95 Rp 433,900.00 Rp -
212 Isosorbid dinitrat tablet subling 5 mg Tablet 89.00 Rp - Rp - Rp -
213 Kalsium Laktat (Kalk) tab 500 mg Tablet 60.00 Rp - 2000 60.55 Rp 121,100.00 Rp -
214 Karbamazepin tab 200 mg Tablet 216.00 Rp - 217.96 Rp - Rp -
216 Ketokenazol tab 200 mg Tablet 260.00 Rp - 260.00 Rp - Rp -
218 Klonidin tab 0,15 mg Tablet - Rp - 147.33 Rp - Rp -
219 Kloramfenikol kapsul 250 mg Kapsul 632.50 Rp - Rp - Rp -
221 Kloramfenikol salep kulit 2% Tube 4,334.00 Rp - 96 3,794.00 Rp 364,224.00 Rp -
224 Kloramfenikol tetes mata 0,5 % Botol 17,820.00 Rp - 16,450.00 Rp - Rp -
226 Klorfeniramin maleat (ctm) tablet 4 Tablet 85.80 Rp - 4000 139.36 Rp 557,442.00 Rp -
228 Klorpromazin hcl tablet salut 100 mg Tablet - Rp - 1,010.10 Rp - 157.00 Rp -
229 Klorpromazin hcl tablet salut 25 mg Tablet 208.00 Rp - 209.89 Rp - Rp -
232 Kodein hcl tablet 10 mg Tablet - Rp - 610.50 Rp - Rp -
234 Kombinasi ipatropium bromida 0,5mgampul 4,550.00 Rp - 3,951.60 Rp - Rp -
236 Kotrimoksazol Adult Botol 133.00 Rp - 127.15 Rp - Rp -
237 Kotrimoksazol Suspensi Botol 2,190.00 Rp - Rp - Rp -
Botol
242 Lidokain injeksi 2 % Ampul - Rp - 100 899.10 Rp 89,910.00 Rp -
243 Lidokain kompositum injeksi Ampul 847.00 Rp - 210 854.70 Rp 179,487.00 Rp -
244 Loperamid tab 2 mg Tablet 2000 156.20 Rp 312,400.00 Rp - Rp -
245 Loratidin Tablet 117.00 Rp - 1000 117.00 Rp 117,000.00 Rp -
247 Magnesium Sulfat Injeksi 40 %-25 mlAmpul 4,700.00 Rp - 4,700.00 Rp - 4,700.00 Rp -
248 Metformin 500 mg tablet Tablet 264.00 Rp - 77.00 Rp - Rp -
250 Metilergometrin maleat tablet salut Tablet 214.00 Rp - 215.95 Rp - Rp -
251 Metilprednisolon 4 mg Tablet 216.70 Rp - 102.00 Rp - Rp -
252 Metoklopramid injeksi 5 mg/ml Ampul 1,883.00 Rp - 20 1,883.00 Rp 37,660.00 Rp -
254 Metoklopramid tab 10 mg Tablet 66.00 Rp - 66.60 Rp - Rp -
257 Mikonazol krim 2 % Tube 1,900.00 Rp - 1,917.27 Rp - Rp -
258 Mineral Mix Sachet - Rp - Rp - 2,981.00 Rp -
259 Multivitamin Syrup Botol 17,569.20 Rp - Rp - 16,500.00 Rp -
260 N- asetil sistein kapsul 200 mg Kapsul 990.00 Rp - 2640 319.88 Rp 844,487.95 Rp -
261 Natrium diklofenat 50 mg Tablet 109.00 Rp - 2000 109.00 Rp 218,000.00 Rp -
262 Natrium klorida larutan infus 0,9 % st Botol 6,840.00 Rp - 6,900.00 Rp - Rp -
264 Nifedipin 10 mg Tablet 220.17 Rp - Rp - Rp -
265 Nistatin tab 500.000UI/g Tablet - Rp - 869.00 Rp - Rp -

266 Nistatin tablet vaginal 100.000UI/g Tablet - Rp - 550.00 Rp - Rp -
268 Obat anti tuberculosis kategori anak Paket - Rp - Rp - 250,971.00 Rp -
274 Oksitetrasiklin hcl salep mata Tube 3,500.00 Rp - 5,588.80 Rp - 3,500.00 Rp -
275 Oksitosin injeksi 10 iu/ml - 1 ml Ampul 1,348.00 Rp - Rp - 100 1,348.00 Rp 134,800.00
276 Omeprazol inj 40 mg/ml Ampul - Rp - 8,247.00 Rp - Rp -
277 Omeprazol kap 20 mg Kapsul - Rp - 502.24 Rp - Rp -
280 Parasetamol Drops Botol 5,204.00 Rp - 5,204.00 Rp - Rp -
281 Parasetamol sirup 120 mg/5 ml Botol 1,160.00 Rp - 1,170.55 Rp - Rp -
282 Parasetamol tablet 500 mg Tablet 188.76 Rp - 2000 209.79 Rp 419,580.00 131.00 Rp -
284 Permetrin krim 5% Tube 11,466.00 Rp - 11,250.00 Rp - Rp -
286 Piridoksin Tablet 256.00 Rp - Rp - Rp -
289 Prednison tablet 5 mg Tablet 79.00 Rp - 73.66 Rp - Rp -
290 Primakuin tab 15 mg Tablet - Rp - Rp - 242.00 Rp -

- 14,500.00
293 Propranolol hcl tablet 10 mg Tablet 63.00 Rp - Rp - Rp -
295 Pyrantel Suspensi 125 mg/5ml Botol 11,791.00 Rp - Rp - Rp -
296 Ranitidin Injeksi 25 mg/2ml Ampul - Rp - Rp - Rp -
297 Ranitidin tab 150 mg Tablet 122.00 Rp - 85.00 Rp - Rp -
298 Retinol (Vitamin A) 100.000 IU kapsulKapsul 354.00 Rp - Rp - 352.00 Rp -
299 Retinol (Vitamin A) 200.000 IU kapsulKapsul 637.00 Rp - 642.79 Rp - 637.00 Rp -
300 Ringer laktat larutan infus steril Botol 7,703.00 Rp - 600 7,703.00 Rp 4,621,800.00 Rp -
301 Risperidone 2 mg Tablet 130.00 Rp - Rp - 287.00 Rp -
302 Salbutamol cairan ih 0,1% Ampul - Rp - 5,400.00 Rp - Rp -
303 Salbutamol inhalasi/aerosol 100mcg/dBotol 22,000.00 Rp - 22,000.00 Rp - Rp -
305 Salep 2-4 Pot 3,219.00 Rp - Rp - Rp -
307 Sefadroksil kapsul 500 mg/ 250 mg Kapsul 732.00 Rp - 3000 952.15 Rp 2,856,450.00 Rp -
308 Sefadroksil syrup 250 mg/5 ml Botol 5,826.00 Rp - Rp - Rp -
311 Sianokobalamin (vit b 12) inj. 500 m Ampul 1,066.00 Rp - 1,066.00 Rp - Rp -
312 Sianokobalamin tab Tablet - Rp - 44.40 Rp - Rp -
313 Simvastatin 10 mg Tablet 220.00 Rp - 73.00 Rp - Rp -
316 Tablet tambah darah Tablet 255.00 Rp - 257.32 Rp - 255.00 Rp -
321 Tetrasiklinhcl kapsul 500 mg Kapsul - Rp - 948.54 Rp - Rp -
323 Tiamin hcl mononitrat 50 mg Tablet 375.10 Rp - 2000 300.01 Rp 600,012.00 Rp -

- Rp - Rp - Rp -
326 Triheksifenidil hidroklorida tab 2 mg Tablet 63.00 Rp - 200 63.57 Rp 12,714.00 91.00 Rp -
327 Vitamin B-Compleks Tablet - Rp - 6000 60.55 Rp 363,300.00 Rp -
328 Zinc dispersibel tab Tablet 604.00 Rp - 329.14 Rp - 216.00 Rp -
330 Vaksin Anti Influenza Vial - Rp - Rp - 82,335.00 Rp -
331 Vaksin Anti Rabies Vial - Rp - Rp - 153,000.00 Rp -
333 Vaksin BCG + Pelarut Vial 1 ml - Rp - Rp - 61,996.00 Rp -
334 Vaksin Polio (bOPV) Vial 1 ml - Rp - Rp - 19,954.00 Rp -
335 Vaksin DPT-HB-HIB Vial 2,5 ml - Rp - Rp - 78,991.00 Rp -
336 Vaksin IPV Vial 2,5 ml - Rp - Rp - 158,994.00 Rp -

- Rp - Rp - 1,640.00 Rp -
351 Ketorolac Inj Ampul 923.00 Rp - 923.00 Rp - Rp -
354 Vaksin Meningitis Vial - Rp - Rp - 135,000.00 Rp -

355 Vaksin HBIG Vial - Rp - Rp - 1,325,000.00 Rp -
356 Human Hexagon Spilis Test - Rp - Rp - 100 8,433.60 Rp 843,360.00
Vial 5 ml - Rp - Rp - 155,813.00 Rp -
366 Handrub (AntiSeptic) 5 Liter jrg - Rp - Rp - 7 395,000.00 Rp 2,765,000.00
367 Albendazole Suspensi Botol Rp - Rp - 4,300.00 Rp -
Vial
dosis)
376 Tenofovir + Lamivudine +Dolutegra Tablet Rp - Rp - 2,609.43 Rp -
377 Abacavir 120 mg + 3TC 60 mg (FDC Tablet Rp - Rp - 1,618.27 Rp -
378 Lopinavir 40 mg + Ritonavir 10 mg ( Sachet Rp - Rp - 2,451.02 Rp -
383 Tuberculin Test Vial Rp - Rp - 625,800.00 Rp -

386 Tablet Rp - Rp - 180 6,546.00 Rp 1,178,280.00
mg (3HP/KDT)

387 Tablet Rp - Rp - 799.00 Rp -
(3HR/KDT)
388 Vaksin PCV MDV (4 dosis) Vial Rp - Rp - 190,657.00 Rp -
391 Herba Asimor Kapsul Rp - Rp - 2,750.00 Rp -
392 Herbakof Syrup Botol Rp - Rp - 15,125.00 Rp -
393 Stimuno Syrup Botol Rp - Rp - 48,881.00 Rp -
Rp 10,486,031.00 Rp 28,409,453.92 Rp 7,167,240.00
JUMLAH Rp 46,062,724.92
Malili, Februari 2023


NIP. 19831117 201001 2 025 NIP.
Mengetahui,

NIP. 19840807 2010 01 2 029
STOK
-403 0 5,300 44
-927 0 0 0
424 0 0 0
400 0 86,300 719
0 0 0 0
0 0 0 0
-25 0 2,880 24
-18 0 0 0
0 0 0 0
200 9,600 0 80
170 11,300 46,000 478
17 0 257 2
-4 0 2,483 21
-5 0 94 1
7 504 0 4
3 264 0 2
44 0 6,382 53
0 0 0 0
0 0 0 0
0 325 0 3
66 0 9,850 82
-3,970 258,000 0 2,150
0 0 0 0
-156 0 300 3
0 0 0 0
68 0 600 5
-137 0 2,300 19
73 0 0 0
0 0 0 0
67 0 0 0
12 5,328 0 44
0 0 0 0
12 2,160 0 18
0 0 0 0
0 0 0 0
12 2,328 0 19
0 0 0 0
9 0 60 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-29 0 268 2
0 0 0 0
0 0 0 0
0 0 0 0
1 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 132 1
0 0 0 0
0 0 0 0
254 124,150 0 1,035
0 0 0 0
-650 0 198,950 1,658
-15 0 0 0
0 0 0 0
-1 0 0 0
0 0 0 0
20 0 0 0
0 0 0 0
0 0 0 0
-24 0 0 0
154 0 0 0
1 0 0 0
23 0 0 0
0 0 0 0
-12 0 288 2
5 0 0 0
-59 10,170 0 85
0 0 0 0
0 0 0 0
0 0 0 0
92 0 7,250 60
-60 2,150 0 18
16 164 0 1
0 0 0 0
STOK
-2 12 50 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
34 0 3,960 33
0 0 0 0
1 0 0 0
122 0 0 0
0 0 0 0
13 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
600 0 0 0
-113 0 0 0
0 0 0 0
460 0 0 0
0 0 0 0
-1,300 0 0 0
2,648 0 0 0
302 0 0 0
-6,376 0 0 0
0 0 60 1
0 0 400 3
170 0 0 0
-2,937 0 84,000 700
-420 0 155,000 1,292
0 0 0 0
174 0 9,700 81
40 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-2,970 0 129,000 1,075
0 0 0 0
0 0 3,600 30
0 0 0 0
147 0 2,600 22
0 0 0 0
-44 0 3,960 33
0 0 0 0
0 0 0 0
0 0 0 0
-1,918 0 87,500 729
190 0 0 0
2,888 0 59,000 492
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 740 6
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 48,500 404
45 0 7,775 65
0 0 0 0
0 0 0 0
787 0 79,000 658
-4,088 0 0 0
144 0 11,450 95
0 0 0 0
1,086 32,000 0 267
0 0 0 0
0 0 0 0
0 0 0 0
67 0 750 6
-612 0 180,000 1,500
-86 0 10,800 90
60 150 0 1
0 0 0 0
-4 0 0 0
0 0 0 0
0 0 0 0
32 0 70 1
0 0 0 0
0 1,500 0 13
1 0 0 0
518 0 0 0
0 0 0 0
-2,660 0 0 0
0 0 0 0
0 0 0 0
-107 0 2,370 20
300 1,400 0 12
STOK
0 0 0 0
0 0 0 0
0 0 0 0
39 360 0 3
0 0 0 0
94 0 3,744 31
30 0 0 0
64 0 6,330 53
166 0 12,100 101
0 0 0 0
0 0 10 0
300 0 7,800 65
2,367 0 0 0
0 0 0 0
20 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-728 0 10,500 88
0 0 0 0
0 0 0 0
0 0 0 0
-20 0 0 0
300 2,500 0 21
6 0 0 0
203 0 9,000 75
227 0 0 0
92 0 0 0
200 0 0 0
5 0 0 0
0 0 0 0
200 0 500 4
42 0 2,016 17
0 0 0 0
124 0 560 5
754 0 18,000 150
0 0 0 0
100 0 0 0
563 0 23,000 192
118 0 1,700 14
0 0 0 0
119 0 4,000 33
0 0 0 0
0 0 1,400 12
0 0 0 0
0 0 0 0
-98 0 2,688 22
0 0 0 0
101 360 0 3
0 0 0 0
0 0 0 0
-3,928 0 13,000 108
0 0 0 0
90 0 500 4
254 0 0 0
0 0 0 0
0 0 0 0
-216 0 0 0
0 0 0 0
70 0 1,120 9
0 0 0 0
1,335 0 32,000 267
235 0 0 0
0 0 0 0
0 0 0 0
305 0 60 1
0 0 0 0
-29 0 3,500 29
-130 0 3,450 29
215 148,000 0 1,233
-183 0 7,000 58
14 0 0 0
11 0 100 1
1,382 0 18,000 150
50 200 0 2
300 0 16,800 140
2,064 0 0 0
30 0 2,050 17
0 0 0 0
1,467 0 31,000 258
0 0 0 0
119 3,100 0 26
37 0 1,896 16
40 0 0 0
0 0 0 0
344 0 110,100 918
-1,980 0 54,000 450
105 0 2,100 18
0 0 0 0
0 0 0 0
STOK
82 0 1,100 9
55 0 0 0
0 0 0 0
0 0 0 0
11 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
101 0 1,900 16
-92 0 0 0
106 0 0 0
802 0 50,100 418
0 0 0 0
0 0 0 0
0 0 0 0
611 0 8,300 69
-27,580 0 0 0
0 0 0 0
19 0 75 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
14 0 0 0
2 0 0 0
0 0 0 0
95 1,300 0 11
0 0 0 0
0 0 0 0
0 0 0 0
-3,856 0 0 0
82 0 0 0
652 0 19,050 159
-959 0 10,720 89
93 0 0 0
0 0 0 0
0 0 370 3
0 0 0 0
21 1,584 0 13
0 0 0 0
-4,621 0 45,000 375
0 0 0 0
0 0 0 0
0 0 0 0
64 0 3,000 25
5,494 0 242,500 2,021
-140 0 0 0
0 0 0 0
0 0 0 0
47,921 0 90,000 750
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1,300 11
0 0 0 0
-2,010 0 69,900 583
0 0 0 0
0 0 0 0
-64 0 7,700 64
-4,800 0 210,400 1,753
2,194 0 1,700 14
2 0 0 0
0 0 0 0
-46 0 0 0
50 0 0 0
12 0 0 0
4 0 0 0
8 0 0 0
20 0 0 0
0 0 0 0
37 0 0 0
28 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
150 0 0 0
0 0 0 0
42 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
50 0 2,040 17
0 0 0 0
0 0 0 0
STOK
0 0 0 0
3 0 0 0
-96 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
14 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 0 0 0
250 0 0 0
0 0 0 0
1 0 #VALUE!
0 0 0 0
0 0 #VALUE!
0 0 0 0
0 0 0
0 0 0 0
0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
228 0 0 0
0 0 0 0
-6 0 0 0
100 0 0 0
0 0 0 0
-252 0 0 0
0 0 0 0
20 0 0 0
0 0 0 0
0 0 0 0
240 0 0 0
5 0 0 0
9 0 0 0
0 0 0 0
DINAS KESEHATAN
MALILI
SBBK No. 440/ /SBBK/ III /2023
No. NAMA SEDIAAN KEMA APBD HARGA LAMA JML HARGA APBD HARGA BARU
SAN LAMA BARU
1 Alat Suntik Sekali Pakai 1 ml/ 0,3 ml Set 827.95 Rp - 300 1,090.98
2 Alat Suntik Sekali Pakai 2,5 ml/ 3 ml Set 803.76 Rp - 200 1,158.84
3 Alat Suntik Sekali Pakai 5 ml Set 1,218.00 Rp - 1,103.52
4 Alcohol Swab Lembar 126.50 Rp - 500 148.87
5 Bisturi No.11 Pcs - Rp -
6 Blood Lancet Pcs 167.51 Rp -
7 Catgut / Benang Bedah No. 3/0 dan Set 4,114.58 Rp - 6,379.05
8 Cuticell Classic 10 cm x 10 cm Pcs - Rp - 7,100.00
9 Devitalisasi pasta (non arsen) Tube - Rp -
10 Disable Syringes 0,05 ml Set 1,492.00 Rp -
11 Disable Syringes 0,5 ml Set 300 1,237.00 Rp 371,100.00 1,206.00
12 Etakridin (rivanol) larutan 0,1 % Botol 4,080.00 Rp - 8,665.20
13 Etanol 70% Botol 22,440.00 Rp - 27,595.00
14 Fixomull Stretch 5 cm x 5 cm Rol - Rp - 18 50,200.00
15 Folley catheter No.14 Pcs 9,269.57 Rp -
17 Folley catheter No.18 Pcs 12,156.33 Rp - 11,132.00
18 GC Tooth Mouse Tube - Rp -
19 Glass lonomer cement (gc ix ) Set - Rp -
20 Handscoen Ginecolog Pasang 25 43,010.00 Rp 1,075,250.00
21 Hanscoen Pasang 8,635.00 Rp - 8,635.00
22 Hanscoen Non Steril Pasang 5000 1,780.68 Rp 8,903,400.00
23 Infusion Set Anak Set 7,680.00 Rp - 6,072.00
24 Infusion Set Dewasa Set Rp - 100 8,369.40
25 Iodine Tes Botol - Rp -
26 IV Catheter No. 18 Buah 4,332.00 Rp - 7,375.00
27 IV Catheter No. 20 Buah 12,631.00 Rp - 100 5,492.52
30 IV Catheter No. 26 Buah 11,700.00 Rp -
31 Jarum jahit ( bedah ) no. 10 Set 836.17 Rp -
32 Jarum jahit ( bedah ) no. 11 Set - Rp -
37 Kalsium hidroksida pasta Tube - Rp -
38 Kapas pembalut/absorben 250 mg Gulung 14,375.00 Rp - 2 16,698.00
39 Kasa kompres 40/40 steril Bungkus - Rp -
40 Kasa pembalut 2 m x 80 cm Rol - Rp -
41 Kasa pembalut hidrofil 4 m x 15 cm Rol 4,244.10 Rp -
42 Kasa Pembalut Hidrofil 4 x 10 cm Roll - Rp -
43 Kasa Pembalut Hidrofil 40 Yds x 80 c Roll 147,600.00 Rp - 181,907.00
44 Klorfenol kamfer mentol (CHKM) Botol - Rp -
45 Larutan Benedict Botol - Rp -
46 Larutan dental mercuri Botol - Rp -
47 Larutan giemsa stain Botol - Rp -
48 Larutan HCl Alkohol 3 % Botol - Rp -
49 Larutan Karbol Fuchsin 0,3% Botol - Rp -
50 Larutan Methylen Blue 0,3 % Botol - Rp -
51 Larutan Pemutih Gigi/ remover staint Botol - Rp -
52 Larutan turk Botol - Rp -
53 Leukomed IV Film 6 cm x 8 cm sterilLembar 2,461.12 Rp -
54 Lisol Botol 49,200.00 Rp -
55 Maag Slang 14 Set - Rp - 8,905.60
56 Maag Slang 16 Set - Rp -
KEMA APBD APBD
No. NAMA SEDIAAN SAN LAMA HARGA LAMA JML HARGA BARU HARGA BARU

58 Masker Buah 1000 571.82 Rp 571,824.00
59 Masker Fogging Buah - Rp -
60 Masker Kerudung Buah 596.90 Rp - 3000 526.24
61 Nasal Canula Anak Set - Rp - 6,325.00
62 Nasal Canula Bayi Set - Rp - 6,325.00
63 Nasal Canula Dewasa Set 6,270.00 Rp - 6,325.00
64 Needle Carpule Pcs - Rp -
65 Onemed Gluco Protein Strip 1,191.30 Rp - 1,201.75
66 Pembalut Gips Rol - Rp -
67 Pita LILA buah - Rp -
68 Plester 5 yard x 2 inch / 2,5 cm x 4,5 Rol 37,371.00 Rp - 27,324.00
69 Pot Dahak Buah - Rp -
70 Reagen Pemeriksaan TB Paru Paket - Rp -
71 Safety Box Ktk - Rp -
72 Semen seng fosfat serbuk dan cairan Botol - Rp -
73 Silk ( Benang Bedah Sutera ) No 3/0 Set 2,599.83 Rp - 5,313.89
74 Slide Dos - Rp -
75 Softpad(Underpad) 60x90 Lembar 3,018.75 Rp -
76 Spon Gelatin Pcs - Rp -
77 Tambalan Sementara Pot - Rp -
78 Temporary stopping fletcher Pasang - Rp -
79 Tes Kehamilan strip - Rp - 100 2,185.00
80 Umbilical Cord Klem Pcs 2,052.00 Rp -
81 Urine bag Pcs 4,827.90 Rp -
82 Urine Rapid Test strip - Rp -
83 USG Gel 250 ml Botol 15,800.40 Rp - 10 16,632.00
84 Wing Needle No. 21 G Set - Rp -
88 Yodium povidon larutan 10% 60 ml Botol - Rp - 30 4,699.00
89 Yodium povidon larutan 10% 300 ml Botol 19,800.00 Rp -
90 Alat Deteksi Resiko Kehamilan (ADRK Paket - Rp -
91 SD HIV-1/2 3.0 (multi) (R1) test - Rp -
92 Fokus Diagnostic (R2) test - Rp -
93 VIKIA-HIV 1/2 (R3) test - Rp -
94 RDT Malaria test - Rp -
95 Laboratorium Kit Paket - Rp -
96 Slide Box buah - Rp -
97 Immerision oil Botol - Rp -
98 Aximed nonwoven Fixation 5cm x 10 Rol - Rp -
99 Safety Box 2,5 L Ktk - Rp -
100 Needle (Jarum Suntik) Buah - Rp -
101 RDT Hepatitis test - Rp -
102 Pot Steril Buah - Rp -
103 RDT DBD (NS1) Strip - Rp -
104 ACT (Artesunate + Amodiaquin) Tablet - Rp -
105 Albendazole Tablet - Rp -
106 Alopurinol tablet 100 mg Tablet 89.00 Rp - 89.00
107 Ambroxol syrup 15 mg/ml Botol 3,630.00 Rp - 4,807.60
108 Ambroxol tab 30 mg Tablet 123.42 Rp - 147.00
109 Aminofilin Injeksi 24 mg/ml - 10 ml Ampul - Rp - 2,736.00
110 Aminofilin tablet 200 mg Tablet - Rp - 596.40
111 Amitriptilin tab Tablet - Rp -
112 Amlodipin 10 mg Tablet 74.00 Rp - 5000 74.00
113 Amoksisilin 500 mg Tablet 231.00 Rp - 231.00
114 Amoksisilin Kapsul 250 mg Kapsul 198.00 Rp -
115 Amoksisilin sirup kering 125 mg/5 ml Botol 3,846.00 Rp - 2,068.64
116 Ampisilin injeksi I,m/i.v 1000 mg/vial Vial - Rp -
117 Antalgin (metampiron) tablet 500 mg Tablet - Rp -
118 Antalgin injeksi 250 mg/ml - 2 ml Ampul - Rp -
119 Antasida doen suspensi Botol 1,756.00 Rp - 1,756.00
120 Antasida doen tablet kombinasi Tablet - Rp - 4000 54.49
121 Antibakteri doen salep kombinasi Tube - Rp -
KEMA APBD APBD
122 Antifungi Kombinasi Pot - Rp - 3,637.00

123 Antihemoroid supp supp 3,260.00 Rp - 3,289.64
124 Antimigrain doen kombinasi Tablet 199.00 Rp - 329.00
125 Antiparkinson doen tablet kombinasi Tablet - Rp -
126 Aqua proinjeksi steril, bebas pirogen Botol 2,860.00 Rp - 2,322.00
127 Artemeter Injeksi Ampul - Rp -
128 Artesunate Injeksi Ampul - Rp -
129 Asam askorbat (vit c) tablet 250 mg Tablet - Rp -
130 Asam askorbat (vit c) tablet 50 mg Tablet 46.00 Rp - 5000 46.42
131 Asam Folat tab 0,4 mg Tablet 45.00 Rp - 45.41
132 Asam mefenamat 500 mg Tablet 117.00 Rp - 117.00
133 Asam Traneksamat 500 mg Tablet - Rp - 277.20
134 Asetosal tablet 100 mg Tablet - Rp -
137 Asiklovir 200 mg Tablet - Rp -
138 Asiklovir krim 5 % Tube - Rp - 4,760.00
139 Asiklovir tab 400 mg Tablet 429.00 Rp - 1,087.80
140 Atropin sulfat injeksi 0,25 mg/ml - 1 Ampul - Rp -
141 Atropin sulfat injeksi 0,5 mgl Ampul - Rp -
142 Atropin sulfat tetes mata 0,5 % Botol - Rp -
143 Attapulgite 600 mg Tablet - Rp - 816.52
144 Betametason krim 0,1 % Tube 1,520.00 Rp - 50 1,533.82
145 Bisakodil Suppositoria 10 mg supp - Rp -
147 Captopril 25 mg Tablet 75.00 Rp - 75.68
148 Cetirizin tab Kapsul 132.00 Rp - 52.00
149 Cetirizin sirup 5mg/ml Botol - Rp - 2,215.00
150 Cimetidin Tablet - Rp -
151 Ciprofloxasin 500 mg Tablet 260.00 Rp -
152 Clobazam 10 mg Tablet - Rp -
153 Clozapine 25 mg Tablet 473.00 Rp -
154 Darplex (Antimalaria) Tablet 2,134.00 Rp -
155 Deksametason inj Ampul 1,210.00 Rp - 968.00
156 Deksametason tablet 0,5 mg Tablet 163.27 Rp - 7000 104.86
157 Diazepam 5 mg Tablet 105.00 Rp - 500 108.96
158 Diazepam inj 5 mg/ml - 2 ml Ampul 20 1,913.00 Rp 38,260.00
159 Diazepam Rektal 10 mg/2,5 ml Tube 21,021.00 Rp -
160 Diazepam Rektal 5 mg/2,5 ml Tube 14,459.00 Rp - 13,546.00
161 Diazepam tablet 2 mg Tablet - Rp -
162 Dietilkarbamazin sitrat tablet 100 mg Tablet - Rp -
163 Difenhidramin hcl inj 10 mg/ml - 1 mlAmpul 825.00 Rp - 825.00
164 Digoksin tablet 0,25 mg Tablet - Rp -
165 Diltiazem 30 mg tab Tablet 200 152.00 Rp 30,400.00
166 Dimenhidrinat 50 mg Tablet 109.00 Rp - 109.99
167 Doksisiklin 100 mg Tablet 289.00 Rp -
168 Domperidon suspensi 5mg/5ml Botol 2,401.00 Rp - 2,401.00
169 Domperidon tab Tablet 75.00 Rp - 75.00
170 Efedrin hcl tablet 25 mg Tablet - Rp -
171 Ekstrak Belladona Tablet - Rp -
172 Epinefrin(adrenalin) inj 0,1 %-1 ml Ampul 4,224.00 Rp - 30 13,675.20
173 Eritromisin kapsul 500 mg Kapsul 900.00 Rp -
174 Eritromisin Sirup Botol 6,390.00 Rp - 7,503.60
175 Etil klorida semprot Botol - Rp -
176 Eugenol cairan Botol - Rp - 20,358.41
177 Fenobarbital injeksi 50 mg/ml - 2 Ampul 1,700.00 Rp -
178 Fenobarbital tablet 30 mg Tablet 177.00 Rp -
179 Fenol gliserol tetes telinga 10 % Botol 2,764.00 Rp - 3,330.00
180 Fitomenadion injeksi 10 mg/ml - 1 mlAmpul 3,900.00 Rp - 7,435.40
181 Fitomenadion injeksi 2 mg/ml - 1 ml (Ampul 4,236.00 Rp - 1,452.00
182 Fitomenadion tablet salut 10 mg Tablet 873.00 Rp - 781.00
183 Fluoksetin kap 20 mg Kapsul 225.00 Rp -
184 Furosemid inj 10 mg/ml Ampul 1,555.00 Rp - 969.00
185 Furosemid tablet 40 mg Tablet 82.00 Rp - 300 443.80
186 Garam oralit untuk 200 ml air Bungkus 293.00 Rp -
KEMA APBD APBD
187 Gemfibrozil 300 mg Kapsul - Rp -

188 Gentamisin injeksi 80 mg/2 ml Ampul 3,355.00 Rp -
189 Gentamisin salep kulit Tube - Rp - 5,600.00
190 Gentamisin sulfat tts mata 0,3 % Botol 22,300.00 Rp -
191 Gentian violet larutan 1 % Botol - Rp -
192 Glibenklamid tablet 5 mg Tablet - Rp -
193 Glimepiride 2 mg /3 mg Tablet 143.00 Rp - 1000 123.00
194 Gliseril guayakolat tablet 100 mg Tablet - Rp -
195 Gliserin Botol - Rp -
196 Glukosa larutan infus 10 % steril Botol - Rp -
197 Glukosa larutan infus 5 % steril Botol 6,627.00 Rp - 6,627.00
198 Griseofulvin tablet 125 mg, micronizeTablet 210.00 Rp -
199 Glukosa kalsikus ampul - Rp -
200 Haloperidol 5 mg Tablet 54.00 Rp - 54.49
201 Haloperidol tablet 0,5 mg Tablet 53.00 Rp -
203 Haloperidol tablet 2 mg Tablet 81.00 Rp - 81.74
204 Haloperidol 50 mg/ml Ampul - Rp -
206 Hidroklorotiazid (hct) tablet 25 mg Tablet 178.00 Rp - 149.35
207 Hidrokortison krim 2,5 % Tube 2,325.00 Rp - 48 2,346.14
208 Hyocine N Butilbromide inj. Ampul - Rp -
209 Ibuprofen Suspensi 200 mg/5ml Botol 5,411.00 Rp - 3,422.84
210 Ibuprofen tablet 400 mg Tablet 292.82 Rp - 2000 216.95
211 Isoniazid tab 100 mg Tablet - Rp -
212 Isosorbid dinitrat tablet subling 5 mg Tablet 89.00 Rp -
213 Kalsium Laktat (Kalk) tab 500 mg Tablet 60.00 Rp - 60.55
214 Karbamazepin tab 200 mg Tablet 216.00 Rp - 217.96
215 Ketokenazol krim 2% Tube - Rp -
216 Ketokenazol tab 200 mg Tablet 260.00 Rp - 260.00
217 klindamisin kap 150 mg Kapsul - Rp -
218 Klonidin tab 0,15 mg Tablet - Rp - 147.33
219 Kloramfenikol kapsul 250 mg Kapsul 632.50 Rp -
220 Kloramfenikol kapsul 500 mg Kapsul - Rp -
221 Kloramfenikol salep kulit 2% Tube 4,334.00 Rp - 96 3,794.00
222 Kloramfenikol salep mata 1 % Tube - Rp -
223 Kloramfenikol suspensi 125 mg/ 5 ml Botol 5,352.00 Rp -
224 Kloramfenikol tetes mata 0,5 % Botol 17,820.00 Rp - 16,450.00
225 Kloramfenikol tetes telinga 3 % Botol - Rp -
226 Klorfeniramin maleat (ctm) tablet 4 Tablet 85.80 Rp - 3000 139.36
227 Klorokuin fosfat tablet 150 mg Tablet - Rp -
228 Klorpromazin hcl tablet salut 100 mg Tablet - Rp - 1,010.10
229 Klorpromazin hcl tablet salut 25 mg Tablet 208.00 Rp - 209.89
230 Klorpromazin inj 25 mg/ml-1ml Ampul - Rp -
231 Klorpromazin inj 5 mg/ml Ampul - Rp -
232 Kodein hcl tablet 10 mg Tablet - Rp - 610.50
233 Komb. Primetamin + sulfadoksin Tablet - Rp -
234 Kombinasi ipatropium bromida 0,5mgampul 4,550.00 Rp - 160 3,951.60
235 Kombipak Kategori 1 Paket - Rp -
236 Kotrimoksazol Adult Botol 133.00 Rp - 127.15
237 Kotrimoksazol Suspensi Botol 2,190.00 Rp -
238 Kuinin dihidroklorida injeksi 25 % - 2 Ampul - Rp -
239 Kuinin sulfat tablet 222 mg ( 7 h2o ) Tablet - Rp -
240 Larutan mengandung Elektrolit (Na 1 Botol 10,293.00 Rp - 9,592.00
241 Larutan mengandung Karbohidrat + Ele Botol 11,500.00 Rp -
242 Lidokain injeksi 2 % Ampul - Rp - 899.10
243 Lidokain kompositum injeksi Ampul 847.00 Rp - 150 854.70
244 Loperamid tab 2 mg Tablet 1000 156.20 Rp 156,200.00
245 Loratidin Tablet 117.00 Rp - 117.00
246 Magnesium Sulfat Injeksi 20 %-25 mlAmpul 4,120.00 Rp -
247 Magnesium Sulfat Injeksi 40 %-25 mlAmpul 4,700.00 Rp - 4,700.00
248 Metformin 500 mg tablet Tablet 264.00 Rp - 77.00
249 Metilergometrin maleat injeksi 0,200 Ampul 25 1,069.00 Rp 26,725.00
250 Metilergometrin maleat tablet salut Tablet 214.00 Rp - 215.95
251 Metilprednisolon 4 mg Tablet 216.70 Rp - 102.00
KEMA APBD APBD
252 Metoklopramid injeksi 5 mg/ml Ampul 1,883.00 Rp - 50 1,883.00

253 Metoklopramid sirup 5 mg/ml Botol - Rp -
254 Metoklopramid tab 10 mg Tablet 66.00 Rp - 1000 66.60
255 Metronidazol tablet 500 mg Tablet - Rp -
256 Metronidazole syrup Botol 3,950.00 Rp -
257 Mikonazol krim 2 % Tube 1,900.00 Rp - 1,917.27
258 Mineral Mix Sachet - Rp -
259 Multivitamin Syrup Botol 17,569.20 Rp -
260 N- asetil sistein kapsul 200 mg Kapsul 990.00 Rp - 2640 319.88
261 Natrium diklofenat 50 mg Tablet 109.00 Rp - 2000 109.00
262 Natrium klorida larutan infus 0,9 % st Botol 6,840.00 Rp - 200 6,900.00
263 Natrium Tiroksin Tablet - Rp -
264 Nifedipin 10 mg Tablet 220.17 Rp -
265 Nistatin tab 500.000UI/g Tablet - Rp - 869.00
266 Nistatin tablet vaginal 100.000UI/g Tablet - Rp - 550.00
267 OAT Kategori Sisipan Paket - Rp -
268 Obat anti tuberculosis kategori anak Paket - Rp -
269 Obat anti tuberculosis kategori I Paket - Rp -
270 Obat anti tuberculosis kategori II Paket - Rp -
271 Obat batuk (o.b.h ) cairan Botol - Rp -
272 Oksitetrasiklin hcl inj.I.m.50 mg/ml- Vial - Rp -
273 Oksitetrasiklin hcl salep 3 % Tube - Rp -
274 Oksitetrasiklin hcl salep mata Tube 3,500.00 Rp - 5,588.80
275 Oksitosin injeksi 10 iu/ml - 1 ml Ampul 1,348.00 Rp -
276 Omeprazol inj 40 mg/ml Ampul - Rp - 8,247.00
277 Omeprazol kap 20 mg Kapsul - Rp - 502.24
278 Papaverin injeksi 40 mg/ml Ampul - Rp -
279 Papaverin tab 40 mg Tablet - Rp -
280 Parasetamol Drops Botol 5,204.00 Rp - 5,204.00
281 Parasetamol sirup 120 mg/5 ml Botol 1,160.00 Rp - 1,170.55
282 Parasetamol tablet 500 mg Tablet 188.76 Rp - 209.79
283 Perak Sulfadiazin 1% Tube - Rp -
284 Permetrin krim 5% Tube 11,466.00 Rp - 11,250.00
285 Piracetam 400 mg Tablet - Rp -
286 Piridoksin Tablet 256.00 Rp -
287 Piroksikam 20 mg Tablet - Rp -
288 Polikresulen Botol - Rp -
289 Prednison tablet 5 mg Tablet 79.00 Rp - 73.66
290 Primakuin tab 15 mg Tablet - Rp -
291 Prokain benzil penisilin 3 juta iu/vial i Vial Rp -

-
292 Propitiourasil tablet 100 mg Tablet - Rp -
293 Propranolol hcl tablet 10 mg Tablet 300 63.00 Rp 18,900.00
294 Pyrantel pamoat tablet 125 mg Tablet - Rp -
295 Pyrantel Suspensi 125 mg/5ml Botol 11,791.00 Rp -
296 Ranitidin Injeksi 25 mg/2ml Ampul - Rp -
297 Ranitidin tab 150 mg Tablet 122.00 Rp - 85.00
298 Retinol (Vitamin A) 100.000 IU kapsulKapsul 354.00 Rp -
299 Retinol (Vitamin A) 200.000 IU kapsulKapsul 637.00 Rp - 642.79
300 Ringer laktat larutan infus steril Botol 7,703.00 Rp - 400 7,703.00
301 Risperidone 2 mg Tablet 130.00 Rp -
302 Salbutamol cairan ih 0,1% Ampul - Rp - 5,400.00
303 Salbutamol inhalasi/aerosol 100mcg/dBotol 22,000.00 Rp - 22,000.00
304 Salbutamol tablet 4 mg Tablet 67.00 Rp -
305 Salep 2-4 Pot 72 3,219.00 Rp 231,768.00
306 Salisil bedak 2% Bungkus 1,040.00 Rp -
307 Sefadroksil kapsul 500 mg/ 250 mg Kapsul 732.00 Rp - 3000 952.15
308 Sefadroksil syrup 250 mg/5 ml Botol 5,826.00 Rp -
309 Sefotaksim injeksi 1 g Vial - Rp -
310 Seftriakson injeksi 1 g Vial - Rp -
311 Sianokobalamin (vit b 12) inj. 500 m Ampul 1,066.00 Rp - 1,066.00
312 Sianokobalamin tab Tablet - Rp - 2000 44.40
313 Simvastatin 10 mg Tablet 220.00 Rp - 73.00
314 Streptomisin serbuk inj 1000 mg/ml Vial - Rp -
315 Sulfacetamid sodium Botol - Rp -
KEMA APBD APBD
316 Tablet tambah darah Tablet 255.00 Rp - 257.32

317 Taburia Sach Sachet - Rp -
318 Tamiflu Kapsul - Rp -
319 Tetrakain hcl tetes mata Botol - Rp -
320 Tetrasiklinhcl kapsul 250 mg Kapsul - Rp -
321 Tetrasiklinhcl kapsul 500 mg Kapsul - Rp - 948.54
322 Tiamin hcl ( vit b1 ) inj. Ampul - Rp -
323 Tiamin hcl mononitrat 50 mg Tablet 375.10 Rp - 300.01
324 Tiampenikol tab 500 mg Tablet - Rp -

- Rp -
326 Triheksifenidil hidroklorida tab 2 mg Tablet 63.00 Rp - 63.57

327 Vitamin B-Compleks Tablet - Rp - 5000 60.55
328 Zinc dispersibel tab Tablet 604.00 Rp - 329.14
329 Zinc Sirup 20 mg/5 ml Botol 2,489.00 Rp -
330 Vaksin Anti Influenza Vial - Rp -
331 Vaksin Anti Rabies Vial - Rp -
332 Vaksin HB PID Kantong 0,5 ml - Rp -
333 Vaksin BCG + Pelarut Vial 1 ml - Rp -
334 Vaksin Polio (bOPV) Vial 1 ml - Rp -
335 Vaksin DPT-HB-HIB Vial 2,5 ml - Rp -
336 Vaksin IPV Vial 2,5 ml - Rp -
337 Vaksin Campak + Pelarut Vial 5 ml - Rp -
338 Vaksin TD (Tetanus Difteri) Vial 5 ml - Rp -
339 Vaksin DT (Difteri Tetanus) Vial 5 ml - Rp -
340 Efavirenz (EFV) 600 mg Tablet - Rp -

- Rp -
342 Nevirapine (NVP) 200 mg Tablet - Rp -
343 Tenofovir (TDF) 300 mg Tablet - Rp -
344 Triple FDC Dewasa (TDF300+3TC30 Tablet - Rp -
345 Triple FDC Ped (ZDV60+3TC30+NVP5Tablet - Rp -
346 Zidovudine (ZDV) 100 mg Tablet - Rp -
347 Zidovudine 300 mg + Lamivudine 15 Tablet - Rp -
348 Xylocain spray/ lidokain spray oral 1 Botol - Rp -
349 Betahistin Tablet 92.00 Rp -
350 Bisakodil tab 5 mg Tablet - Rp -
351 Ketorolac Inj Ampul 923.00 Rp - 923.00
352 Kotrimoksazol Adult forte Tablet - Rp -
353 Laktulosa syrup Botol - Rp -
354 Vaksin Meningitis Vial - Rp -
355 Vaksin HBIG Vial - Rp -
356 Human Hexagon Spilis Test - Rp -
357 RPR Focus Test - Rp -
358 Micropipet 60 Pcs - Rp -
360 Pipet TIPS Pcs - Rp -
Vial 5 ml - Rp -
362 Multivitamin tab Tablet - Rp -
363 Reagen Human Hexagon Spilis Test - Rp -
364 Metronidazol 500mg/100 ml Botol - Rp -
365 Serum Anti Rabies (SAR) Vial - Rp -
366 Handrub (AntiSeptic) 5 Liter jrg - Rp -
367 Albendazole Suspensi Botol Rp -
368 Vaksin HB Recombinan ( HB dewasa) Vial Rp -
369 Larutan Methanol Botol Rp -
370 Cartridge TCM-TB Test Rp -
Vial
371 Vaksin Corona Vac (10 Rp -
dosis)
372 Endo Vacutube Steril pcs Rp -
373 Freezing Tubes pcs Rp -
374 DBS Collection Kit pcs Rp -
375 MDT MB Dewasa Tablet Rp -
376 Tenofovir + Lamivudine +Dolutegra Tablet Rp -
377 Abacavir 120 mg + 3TC 60 mg (FDC Tablet Rp -
378 Lopinavir 40 mg + Ritonavir 10 mg ( Sachet Rp -
KEMA APBD APBD
379 Dolutegravir 50 mg Tablet Rp -

380 MDT MB Anak Blister Rp -
381 Strip Glukosa Darah Botol Rp -
382 Rapid Test Anti HCV Test Rp -
383 Tuberculin Test Vial Rp -
384 INH 300 mg Tablet Rp -
385 Rifapentin 150 mg Lepasan Tablet Rp -

386 Tablet Rp -
mg (3HP/KDT)

387 Tablet Rp -
(3HR/KDT)
388 Vaksin PCV MDV (4 dosis) Vial Rp -
389 Kotrimoksazol 960 mg Tablet Rp -
390 OAT KDT Harian Paket Rp -
391 Herba Asimor Kapsul Rp -
392 Herbakof Syrup Botol Rp -
393 Stimuno Syrup Botol Rp -
Rp 11,423,827.00
JUMLAH
Yang Menyerahkan

NIP. 19831117 201001 2 025
Mengetahui,

NIP. 19840807 2010 01 2 029
UWU TIMUR
AN
, Fax (0474) 321489
II /2023
JML HARGA PROGRA HARGA JML HARGA STOK

M
Rp 327,294.00 Rp - -303 0 3,500 29
Rp 231,768.00 Rp - 286 0 1,200 10
Rp - 1,460.00 Rp - -86 0 0 0
Rp 74,435.00 138.00 Rp - -400 0 82,900 691
Rp - Rp - 0 0 0 0
Rp - 320.325 Rp - 0 0 0 0
Rp - Rp - 105 0 2,676 22
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 100 1,465.00 Rp 146,500.00 -400 8,000 0 67
Rp - 1,650.00 Rp - 1,590 6,800 46,000 440
Rp - Rp - 13 0 219 2
Rp - Rp - 17 0 2,435 20
Rp 903,600.00 Rp - -45 0 0 0
Rp - Rp - 14 461 0 4
Rp - Rp - 14 204 0 2
Rp - Rp - 45 0 6,352 53
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 43,010.00 Rp - 0 250 0 2
Rp - Rp - 100 0 9,500 79
Rp - 1,575.02 Rp - -140 226,500 0 1,888
Rp - Rp - 0 0 0 0
Rp 836,940.00 Rp - 27 0 2,500 21
Rp - 9,945.00 Rp - 0 0 0 0
Rp - Rp - 68 0 450 4
Rp 549,252.00 Rp - 7 0 1,700 14
Rp - Rp - 179 0 600 5
Rp - Rp - 0 0 0 0
Rp - Rp - 75 0 0 0
Rp - Rp - 12 5,328 0 44
Rp - Rp - 0 0 0 0
Rp - Rp - 12 2,160 0 18
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 12 2,328 0 19
Rp - Rp - 0 0 0 0
Rp 33,396.00 Rp - 5 0 15 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 16 0 133 1
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 279,820.80 Rp - 1 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 3 0 132 1
Rp - Rp - 0 0 0 0
PROGRA
JML HARGA M HARGA JML HARGA STOK
Rp - Rp - 0 0 0 0
Rp - 19,422.22 Rp - 190 105,650 0 880
Rp - 9,800.00 Rp - 0 0 0 0
Rp 1,578,720.00 706.420 Rp - -1,650 0 164,450 1,370
Rp - Rp - -9 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - -59 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 20 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - -5 0 0 0
Rp - 3,137.20 Rp - 410 0 0 0
Rp - 274,560.00 Rp - 1 0 0 0
Rp - 23,398.00 Rp - 23 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 82 0 60 1
Rp - 44,500.00 Rp - 5 0 0 0
Rp - Rp - 104 9,900 0 83
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 218,500.00 Rp - 39 0 6,500 54
Rp - Rp - 152 1,800 0 15
Rp - Rp - 19 149 0 1
Rp - Rp - 0 0 0 0
Rp 166,320.00 Rp - 1 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 140,970.00 Rp - 77 0 3,840 32
Rp - Rp - 0 0 0 0
Rp - 501,745.00 Rp - 1 0 0 0
Rp - 13,362.00 Rp - 144 0 0 0
Rp - 11,500.00 Rp - 0 0 0 0
Rp - 11,440.00 Rp - 12 0 0 0
Rp - 10,488.00 Rp - 25 0 0 0
Rp - 1,016,565.00 Rp - 0 0 0 0
Rp - 66,065.00 Rp - 0 0 0 0
Rp - 1,123,065.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 21,930.00 Rp - 0 0 0 0
Rp - 3,600.00 Rp - 600 0 0 0
Rp - 9,918.00 Rp - 124 0 0 0
Rp - 19,500.00 Rp - 0 0 0 0
Rp - 45,224.00 Rp - 410 0 0 0
Rp - Rp - 0 0 0 0
Rp - 366.50 Rp - -200 0 0 0
Rp - Rp - 1,533 0 0 0
Rp - Rp - 221 0 0 0
Rp - Rp - -1,340 0 0 0
Rp - Rp - 0 0 50 0
Rp - Rp - 0 0 100 1
Rp - 167.00 Rp - 170 0 0 0
Rp 370,000.00 Rp - -1,573 0 37,000 308
Rp - Rp - 6,480 0 101,000 842
Rp - Rp - 0 0 0 0
Rp - Rp - 159 0 9,100 76
Rp - 9,834.00 Rp - 40 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 217,960.00 Rp - -2,874 0 97,000 808
Rp - Rp - 0 0 0 0
PROGRA
Rp - Rp - 0 0 3,600 30
Rp - Rp - 0 0 0 0
Rp - Rp - 307 0 2,600 22
Rp - Rp - 0 0 0 0
Rp - Rp - 4 0 3,640 30
Rp - Rp - 0 0 0 0
Rp - 39,000.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 232,100.00 Rp - -3,447 0 54,000 450
Rp - Rp - 190 0 0 0
Rp - Rp - 3,562 0 32,000 267
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 610 5
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 1,000 0 45,500 379
Rp 76,691.00 Rp - 8 0 6,775 56
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 751 0 68,000 567
Rp - Rp - -690 0 0 0
Rp - Rp - 135 0 11,450 95
Rp - Rp - 0 0 0 0
Rp - Rp - 659 26,500 0 221
Rp - 776.00 Rp - 0 0 0 0
Rp - 473.00 Rp - 0 0 0 0
Rp - 1,917.00 Rp - 0 0 0 0
Rp - Rp - 61 0 650 5
Rp 734,020.00 Rp - -3,930 0 136,000 1,133
Rp 54,480.00 Rp - -92 0 8,700 73
Rp - 1,545.00 Rp - 60 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 4 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 32 0 20 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 1,300 0 11
Rp - Rp - 26 0 0 0
Rp - Rp - 518 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - -320 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 410,256.00 1,518.00 Rp - 19 0 2,220 19
Rp - Rp - 300 700 0 6
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 1,700.00 Rp - 39 300 0 3
Rp - Rp - 0 0 0 0
Rp - Rp - 96 0 3,600 30
Rp - Rp - 30 0 0 0
Rp - 1,452.00 Rp - 150 0 5,970 50
Rp - Rp - 67 0 11,100 93
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 133,140.00 Rp - 78 0 6,600 55
Rp - 500 280.00 Rp 140,000.00 1,109 0 0 0
PROGRA
Rp - Rp - 0 0 0 0
Rp - 4,036.00 Rp - 20 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 123,000.00 Rp - -30 0 1,000 8
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 300 2,500 0 21
Rp - 10,351.00 Rp - 6 0 0 0
Rp - 54.00 Rp - 194 0 8,100 68
Rp - Rp - 137 0 0 0
Rp - Rp - 92 0 0 0
Rp - Rp - 200 0 0 0
Rp - 101,300.00 Rp - 5 0 0 0
Rp - 1,190.00 Rp - 0 0 0 0
Rp - Rp - 197 0 0 0
Rp 112,614.72 Rp - -29 0 1,536 13
Rp - Rp - 0 0 0 0
Rp - Rp - 124 0 560 5
Rp 433,900.00 Rp - -368 0 0 0
Rp - 282.00 Rp - 0 0 0 0
Rp - Rp - -92 0 0 0
Rp - Rp - 2,208 0 8,000 67
Rp - Rp - 88 0 500 4
Rp - Rp - 0 0 0 0
Rp - Rp - 173 0 3,800 32
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 1,400 12
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 364,224.00 Rp - 5 0 1,704 14
Rp - Rp - 0 0 0 0
Rp - Rp - 101 360 0 3
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 418,081.50 Rp - -6,483 0 0 0
Rp - Rp - 0 0 0 0
Rp - 157.00 Rp - 66 0 0 0
Rp - Rp - 80 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 632,256.00 Rp - -130 0 720 6
Rp - 317,018.00 Rp - 0 0 0 0
Rp - Rp - 541 0 28,000 233
Rp - Rp - 220 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 257 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 244 0 2,900 24
Rp 128,205.00 Rp - 217 0 2,760 23
Rp - Rp - 1,964 143,000 0 1,192
Rp - Rp - 2,622 0 2,700 23
Rp - 4,120.00 Rp - 14 0 0 0
Rp - 4,700.00 Rp - 11 0 100 1
Rp - Rp - 2,304 0 0 0
Rp - 1,079.00 Rp - 50 0 0 0
Rp - Rp - 0 0 16,800 140
Rp - Rp - 2,644 0 0 0
PROGRA
Rp 94,150.00 Rp - -50 0 1,810 15

Rp - Rp - 0 0 0 0
Rp 66,600.00 Rp - 1,455 0 24,500 204
Rp - Rp - 0 0 0 0
Rp - Rp - 119 3,100 0 26
Rp - Rp - 16 0 1,536 13
Rp - 2,981.00 Rp - 40 0 0 0
Rp - 16,500.00 Rp - 0 0 0 0
Rp 844,487.95 Rp - 988 0 95,040 792
Rp 218,000.00 Rp - 864 0 29,500 246
Rp 1,380,000.00 Rp - 87 0 1,100 9
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 94 0 1,000 8
Rp - Rp - 64 0 0 0
Rp - Rp - 0 0 0 0
Rp - 250,971.00 Rp - 0 0 0 0
Rp - 478,142.00 Rp - 5 0 0 0
Rp - 1,592,731.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 3,500.00 Rp - 61 0 1,525 13
Rp - 1,348.00 Rp - 98 0 0 0
Rp - Rp - 2 0 0 0
Rp - Rp - 2,250 0 30,600 255
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 596 0 8,300 69
Rp - 131.00 Rp - -14,260 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 13 0 20 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 242.00 Rp - 14 0 0 0
Rp - Rp -
14,500.00 2 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - -45 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 352.00 Rp - -306 0 0 0
Rp - 637.00 Rp - -1,266 0 19,050 159
Rp 3,081,200.00 Rp - 265 0 8,000 67
Rp - 123.00 Rp - 153 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 330 3
Rp - Rp - 0 0 0 0
Rp - Rp - 43 888 0 7
Rp - Rp - 0 0 0 0
Rp 2,856,450.00 Rp - -2,085 0 33,500 279
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 55 0 2,800 23
Rp 88,800.00 Rp - 1,369 0 224,000 1,867
Rp - Rp - -961 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
PROGRA
Rp - 255.00 Rp - 17,149 0 90,000 750

Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 1,300 11
Rp - Rp - 0 0 0 0
Rp - Rp - 618 0 55,400 462
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 91.00 Rp - 240 0 5,900 49
Rp 302,750.00 Rp - -405 0 139,400 1,162
Rp - 216.00 Rp - 414 0 0 0
Rp - Rp - -4 0 0 0
Rp - 82,335.00 Rp - 0 0 0 0
Rp - 20 153,000.00 Rp 3,060,000.00 -38 0 0 0
Rp - 30 23,991.00 Rp 719,730.00 50 0 0 0
Rp - 10 61,996.00 Rp 619,960.00 8 0 0 0
Rp - 10 19,954.00 Rp 199,540.00 -26 0 0 0
Rp - 30 78,991.00 Rp 2,369,730.00 -11 0 0 0
Rp - 20 158,994.00 Rp 3,179,880.00 -19 0 0 0
Rp - 28,204.00 Rp - 0 0 0 0
Rp - 16,995.00 Rp - 49 0 0 0
Rp - 17,996.00 Rp - 28 0 0 0
Rp - 7,625.00 Rp - 0 0 0 0
Rp - 1,640.00 Rp - 0 0 0 0
Rp - 3,058.00 Rp - 0 0 0 0
Rp - 9,688.00 Rp - 0 0 0 0
Rp - 6,971.00 Rp - 60 0 0 0
Rp - 1,480.30 Rp - 0 0 0 0
Rp - 1,840.00 Rp - 54 0 0 0
Rp - 3,550.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 11 0 1,700 14
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 135,000.00 Rp - 0 0 0 0
Rp - 1,325,000.00 Rp - -6 0 0 0
Rp - 8,433.60 Rp - 58 0 0 0
Rp - 4,360.00 Rp - 0 0 0 0
Rp - 179.20 Rp - 0 0 0 0
Rp - 230.60 Rp - 0 0 0 0
Rp - 980.00 Rp - 0 0 0 0
Rp - 155,813.00 Rp - -10 0 0 0
Rp - 7,000.00 Rp - 0 0 0 0
Rp - 20,400.00 Rp - 0 0 0 0
Rp - 5,885.00 Rp - 0 0 0 0
Rp - 1,608,255.00 Rp - 0 0 0 0
Rp - 3 395,000.00 Rp 1,185,000.00 6 0 0 0
Rp - 4,300.00 Rp - 250 0 0 0
Rp - 52,050.00 Rp - 0 0 0 0
Rp - 45,360.00 Rp - 1 0 #VALUE!
Rp - 253,400.00 Rp - 0 0 0 0
Rp - 1,339,440.00 Rp - 0 0 #VALUE!
Rp - 2,500.00 Rp - 0 0 0 0
Rp - 2,500.00Rp - 0 0 0
Rp - 19,651.00Rp - 0 0 0 0
Rp - 40,526.00 Rp - 0 0 0
Rp - 2,609.43 Rp - 0 0 0 0
Rp - 1,618.27 Rp - 0 0 0 0
Rp - 2,451.02 Rp - 0 0 0 0
PROGRA
Rp - 943.90 Rp - 0 0 0 0
Rp - 25,364.00 Rp - 0 0 0 0
Rp - 130,891.24 Rp - 54 0 0 0
Rp - 11,188.00 Rp - 0 0 0 0
Rp - 625,800.00 Rp - 2 0 0 0
Rp - 309.00 Rp - 100 0 0 0
Rp - 5,525.00 Rp - 0 0 0 0
Rp - 6,546.00 Rp -
216 0 0 0
Rp - 799.00 Rp -
0 0 0 0
Rp - 20 190,657.00 Rp 3,813,140.00 30 0 0 0
Rp - 325.00 Rp - 0 0 0 0
Rp - 397,612.00 Rp - 0 0 0 0
Rp - 2,750.00 Rp - 240 0 0 0
Rp - 15,125.00 Rp - 5 0 0 0
Rp - 48,881.00 Rp - 6 0 0 0
Rp 18,434,561.17 Rp 15,433,480.00 0 0 0 0
Rp 45,291,868.17
Malili, Maret 2023

Yang Menerima
NIP.
DINAS KESEHATAN
MALILI
SBBK No. 440/ /SBBK/ IV /2023
No. NAMA SEDIAAN KEMA APBD HARGA LAMA JML HARGA APBD HARGA BARU
SAN LAMA BARU
1 Alat Suntik Sekali Pakai 1 ml/ 0,3 ml Set 827.95 Rp - 300 1,090.98
2 Alat Suntik Sekali Pakai 2,5 ml/ 3 ml Set 803.76 Rp - 1,158.84
3 Alat Suntik Sekali Pakai 5 ml Set 1,218.00 Rp - 1,103.52
4 Alcohol Swab Lembar 126.50 Rp - 148.87
5 Bisturi No.11 Pcs - Rp -
6 Blood Lancet Pcs 167.51 Rp -
7 Catgut / Benang Bedah No. 3/0 dan Set 4,114.58 Rp - 6,379.05
8 Cuticell Classic 10 cm x 10 cm Pcs - Rp - 7,100.00
9 Devitalisasi pasta (non arsen) Tube - Rp -
10 Disable Syringes 0,05 ml Set 1,492.00 Rp -
11 Disable Syringes 0,5 ml Set 1,237.00 Rp - 1,206.00
12 Etakridin (rivanol) larutan 0,1 % Botol 4,080.00 Rp - 8,665.20
13 Etanol 70% Botol 22,440.00 Rp - 27,595.00
14 Fixomull Stretch 5 cm x 5 cm Rol - Rp - 50,200.00
17 Folley catheter No.18 Pcs 12,156.33 Rp - 11,132.00
18 GC Tooth Mouse Tube - Rp -
19 Glass lonomer cement (gc ix ) Set - Rp -
20 Handscoen Ginecolog Pasang 25 43,010.00 Rp 1,075,250.00
21 Hanscoen Pasang 8,635.00 Rp - 8,635.00
22 Hanscoen Non Steril Pasang 5000 1,780.68 Rp 8,903,400.00
23 Infusion Set Anak Set 7,680.00 Rp - 6,072.00
24 Infusion Set Dewasa Set Rp - 8,369.40
25 Iodine Tes Botol - Rp -
30 IV Catheter No. 26 Buah 11,700.00 Rp -
37 Kalsium hidroksida pasta Tube - Rp -
38 Kapas pembalut/absorben 250 mg Gulung 14,375.00 Rp - 16,698.00
39 Kasa kompres 40/40 steril Bungkus - Rp -
40 Kasa pembalut 2 m x 80 cm Rol - Rp -
41 Kasa pembalut hidrofil 4 m x 15 cm Rol 4,244.10 Rp -
42 Kasa Pembalut Hidrofil 4 x 10 cm Roll - Rp -
43 Kasa Pembalut Hidrofil 40 Yds x 80 c Roll 147,600.00 Rp - 181,907.00
44 Klorfenol kamfer mentol (CHKM) Botol - Rp -
45 Larutan Benedict Botol - Rp -
46 Larutan dental mercuri Botol - Rp -
47 Larutan giemsa stain Botol - Rp -
48 Larutan HCl Alkohol 3 % Botol - Rp -
49 Larutan Karbol Fuchsin 0,3% Botol - Rp -
50 Larutan Methylen Blue 0,3 % Botol - Rp -
51 Larutan Pemutih Gigi/ remover staint Botol - Rp -
52 Larutan turk Botol - Rp -
53 Leukomed IV Film 6 cm x 8 cm sterilLembar 2,461.12 Rp -
54 Lisol Botol 49,200.00 Rp -
55 Maag Slang 14 Set - Rp - 8,905.60
KEMA APBD APBD

58 Masker Buah 1000 571.82 Rp 571,824.00
59 Masker Fogging Buah - Rp -
60 Masker Kerudung Buah 596.90 Rp - 3000 526.24
61 Nasal Canula Anak Set - Rp - 6,325.00
62 Nasal Canula Bayi Set - Rp - 6,325.00
63 Nasal Canula Dewasa Set 6,270.00 Rp - 6,325.00
64 Needle Carpule Pcs - Rp -
65 Onemed Gluco Protein Strip 1,191.30 Rp - 1,201.75
66 Pembalut Gips Rol - Rp -
67 Pita LILA buah - Rp -
68 Plester 5 yard x 2 inch / 2,5 cm x 4,5 Rol 37,371.00 Rp - 27,324.00
69 Pot Dahak Buah - Rp -
70 Reagen Pemeriksaan TB Paru Paket - Rp -
71 Safety Box Ktk - Rp -
72 Semen seng fosfat serbuk dan cairan Botol - Rp -
73 Silk ( Benang Bedah Sutera ) No 3/0 Set 2,599.83 Rp - 5,313.89
74 Slide Dos - Rp -
75 Softpad(Underpad) 60x90 Lembar 3,018.75 Rp -
76 Spon Gelatin Pcs - Rp -
77 Tambalan Sementara Pot - Rp -
78 Temporary stopping fletcher Pasang - Rp -
79 Tes Kehamilan strip - Rp - 100 2,185.00
80 Umbilical Cord Klem Pcs 2,052.00 Rp -
81 Urine bag Pcs 4,827.90 Rp -
82 Urine Rapid Test strip - Rp -
83 USG Gel 250 ml Botol 15,800.40 Rp - 16,632.00
88 Yodium povidon larutan 10% 60 ml Botol - Rp - 4,699.00
89 Yodium povidon larutan 10% 300 ml Botol 19,800.00 Rp -
90 Alat Deteksi Resiko Kehamilan (ADRK Paket - Rp -
91 SD HIV-1/2 3.0 (multi) (R1) test - Rp -
92 Fokus Diagnostic (R2) test - Rp -
93 VIKIA-HIV 1/2 (R3) test - Rp -
94 RDT Malaria test - Rp -
95 Laboratorium Kit Paket - Rp -
96 Slide Box buah - Rp -
97 Immerision oil Botol - Rp -
98 Aximed nonwoven Fixation 5cm x 10 Rol - Rp -
99 Safety Box 2,5 L Ktk - Rp -
100 Needle (Jarum Suntik) Buah - Rp -
101 RDT Hepatitis test - Rp -
102 Pot Steril Buah - Rp -
103 RDT DBD (NS1) Strip - Rp -
104 ACT (Artesunate + Amodiaquin) Tablet - Rp -
105 Albendazole Tablet - Rp -
106 Alopurinol tablet 100 mg Tablet 89.00 Rp - 89.00
107 Ambroxol syrup 15 mg/ml Botol 3,630.00 Rp - 4,807.60
108 Ambroxol tab 30 mg Tablet 123.42 Rp - 147.00
109 Aminofilin Injeksi 24 mg/ml - 10 ml Ampul - Rp - 2,736.00
110 Aminofilin tablet 200 mg Tablet - Rp - 596.40
111 Amitriptilin tab Tablet - Rp -
112 Amlodipin 10 mg Tablet 74.00 Rp - 2000 74.00
113 Amoksisilin 500 mg Tablet 231.00 Rp - 231.00
114 Amoksisilin Kapsul 250 mg Kapsul 198.00 Rp -
115 Amoksisilin sirup kering 125 mg/5 ml Botol 3,846.00 Rp - 2,068.64
116 Ampisilin injeksi I,m/i.v 1000 mg/vial Vial - Rp -
117 Antalgin (metampiron) tablet 500 mg Tablet - Rp -
118 Antalgin injeksi 250 mg/ml - 2 ml Ampul - Rp -
119 Antasida doen suspensi Botol 1,756.00 Rp - 1,756.00
120 Antasida doen tablet kombinasi Tablet - Rp - 4000 54.49
121 Antibakteri doen salep kombinasi Tube - Rp -
KEMA APBD APBD
122 Antifungi Kombinasi Pot - Rp - 3,637.00

123 Antihemoroid supp supp 3,260.00 Rp - 3,289.64
124 Antimigrain doen kombinasi Tablet 199.00 Rp - 329.00
125 Antiparkinson doen tablet kombinasi Tablet - Rp -
126 Aqua proinjeksi steril, bebas pirogen Botol 2,860.00 Rp - 2,322.00
127 Artemeter Injeksi Ampul - Rp -
128 Artesunate Injeksi Ampul - Rp -
129 Asam askorbat (vit c) tablet 250 mg Tablet - Rp -
130 Asam askorbat (vit c) tablet 50 mg Tablet 46.00 Rp - 4000 46.42
131 Asam Folat tab 0,4 mg Tablet 45.00 Rp - 45.41
132 Asam mefenamat 500 mg Tablet 117.00 Rp - 117.00
133 Asam Traneksamat 500 mg Tablet - Rp - 277.20
137 Asiklovir 200 mg Tablet - Rp -
138 Asiklovir krim 5 % Tube - Rp - 4,760.00
139 Asiklovir tab 400 mg Tablet 429.00 Rp - 1,087.80
140 Atropin sulfat injeksi 0,25 mg/ml - 1 Ampul - Rp -
141 Atropin sulfat injeksi 0,5 mgl Ampul - Rp -
142 Atropin sulfat tetes mata 0,5 % Botol - Rp -
143 Attapulgite 600 mg Tablet - Rp - 816.52
144 Betametason krim 0,1 % Tube 1,520.00 Rp - 100 1,533.82
147 Captopril 25 mg Tablet 75.00 Rp - 75.68
148 Cetirizin tab Kapsul 132.00 Rp - 52.00
149 Cetirizin sirup 5mg/ml Botol - Rp - 2,215.00
150 Cimetidin Tablet - Rp -
151 Ciprofloxasin 500 mg Tablet 1000 260.00 Rp 260,000.00
152 Clobazam 10 mg Tablet - Rp -
153 Clozapine 25 mg Tablet 473.00 Rp -
154 Darplex (Antimalaria) Tablet 2,134.00 Rp -
155 Deksametason inj Ampul 1,210.00 Rp - 968.00
156 Deksametason tablet 0,5 mg Tablet 163.27 Rp - 7000 104.86
157 Diazepam 5 mg Tablet 105.00 Rp - 300 108.96
158 Diazepam inj 5 mg/ml - 2 ml Ampul 1,913.00 Rp -
159 Diazepam Rektal 10 mg/2,5 ml Tube 21,021.00 Rp -
160 Diazepam Rektal 5 mg/2,5 ml Tube 14,459.00 Rp - 13,546.00
161 Diazepam tablet 2 mg Tablet - Rp -
162 Dietilkarbamazin sitrat tablet 100 mg Tablet - Rp -
163 Difenhidramin hcl inj 10 mg/ml - 1 mlAmpul 825.00 Rp - 825.00
164 Digoksin tablet 0,25 mg Tablet - Rp -
165 Diltiazem 30 mg tab Tablet 200 152.00 Rp 30,400.00
166 Dimenhidrinat 50 mg Tablet 109.00 Rp - 109.99
167 Doksisiklin 100 mg Tablet 289.00 Rp -
168 Domperidon suspensi 5mg/5ml Botol 2,401.00 Rp - 2,401.00
169 Domperidon tab Tablet 75.00 Rp - 75.00
170 Efedrin hcl tablet 25 mg Tablet - Rp -
171 Ekstrak Belladona Tablet - Rp -
172 Epinefrin(adrenalin) inj 0,1 %-1 ml Ampul 4,224.00 Rp - 30 13,675.20
173 Eritromisin kapsul 500 mg Kapsul 900.00 Rp -
174 Eritromisin Sirup Botol 6,390.00 Rp - 7,503.60
175 Etil klorida semprot Botol - Rp -
176 Eugenol cairan Botol - Rp - 20,358.41
177 Fenobarbital injeksi 50 mg/ml - 2 Ampul 1,700.00 Rp -
178 Fenobarbital tablet 30 mg Tablet 177.00 Rp -
179 Fenol gliserol tetes telinga 10 % Botol 2,764.00 Rp - 3,330.00
180 Fitomenadion injeksi 10 mg/ml - 1 mlAmpul 3,900.00 Rp - 7,435.40
181 Fitomenadion injeksi 2 mg/ml - 1 ml (Ampul 4,236.00 Rp - 1,452.00
182 Fitomenadion tablet salut 10 mg Tablet 873.00 Rp - 300 781.00
183 Fluoksetin kap 20 mg Kapsul 225.00 Rp -
184 Furosemid inj 10 mg/ml Ampul 1,555.00 Rp - 969.00
185 Furosemid tablet 40 mg Tablet 82.00 Rp - 300 443.80
186 Garam oralit untuk 200 ml air Bungkus 293.00 Rp -
KEMA APBD APBD
187 Gemfibrozil 300 mg Kapsul - Rp -

188 Gentamisin injeksi 80 mg/2 ml Ampul 3,355.00 Rp -
189 Gentamisin salep kulit Tube - Rp - 5,600.00
190 Gentamisin sulfat tts mata 0,3 % Botol 22,300.00 Rp -
191 Gentian violet larutan 1 % Botol - Rp -
192 Glibenklamid tablet 5 mg Tablet - Rp -
193 Glimepiride 2 mg /3 mg Tablet 143.00 Rp - 123.00
194 Gliseril guayakolat tablet 100 mg Tablet - Rp -
195 Gliserin Botol - Rp -
196 Glukosa larutan infus 10 % steril Botol - Rp -
197 Glukosa larutan infus 5 % steril Botol 6,627.00 Rp - 6,627.00
198 Griseofulvin tablet 125 mg, micronizeTablet 210.00 Rp -
199 Glukosa kalsikus ampul - Rp -
200 Haloperidol 5 mg Tablet 54.00 Rp - 54.49
203 Haloperidol tablet 2 mg Tablet 81.00 Rp - 81.74
206 Hidroklorotiazid (hct) tablet 25 mg Tablet 178.00 Rp - 149.35
207 Hidrokortison krim 2,5 % Tube 2,325.00 Rp - 48 2,346.14
208 Hyocine N Butilbromide inj. Ampul - Rp -
209 Ibuprofen Suspensi 200 mg/5ml Botol 5,411.00 Rp - 3,422.84
210 Ibuprofen tablet 400 mg Tablet 292.82 Rp - 216.95
211 Isoniazid tab 100 mg Tablet - Rp -
212 Isosorbid dinitrat tablet subling 5 mg Tablet 89.00 Rp -
213 Kalsium Laktat (Kalk) tab 500 mg Tablet 60.00 Rp - 1000 60.55
214 Karbamazepin tab 200 mg Tablet 216.00 Rp - 217.96
215 Ketokenazol krim 2% Tube - Rp -
216 Ketokenazol tab 200 mg Tablet 260.00 Rp - 260.00
217 klindamisin kap 150 mg Kapsul - Rp -
218 Klonidin tab 0,15 mg Tablet - Rp - 147.33
219 Kloramfenikol kapsul 250 mg Kapsul 632.50 Rp -
220 Kloramfenikol kapsul 500 mg Kapsul - Rp -
221 Kloramfenikol salep kulit 2% Tube 4,334.00 Rp - 96 3,794.00
222 Kloramfenikol salep mata 1 % Tube - Rp -
223 Kloramfenikol suspensi 125 mg/ 5 ml Botol 5,352.00 Rp -
224 Kloramfenikol tetes mata 0,5 % Botol 17,820.00 Rp - 16,450.00
225 Kloramfenikol tetes telinga 3 % Botol - Rp -
226 Klorfeniramin maleat (ctm) tablet 4 Tablet 85.80 Rp - 139.36
227 Klorokuin fosfat tablet 150 mg Tablet - Rp -
228 Klorpromazin hcl tablet salut 100 mg Tablet - Rp - 1,010.10
229 Klorpromazin hcl tablet salut 25 mg Tablet 208.00 Rp - 209.89
230 Klorpromazin inj 25 mg/ml-1ml Ampul - Rp -
231 Klorpromazin inj 5 mg/ml Ampul - Rp -
232 Kodein hcl tablet 10 mg Tablet - Rp - 610.50
233 Komb. Primetamin + sulfadoksin Tablet - Rp -
234 Kombinasi ipatropium bromida 0,5mgampul 4,550.00 Rp - 140 3,951.60
235 Kombipak Kategori 1 Paket - Rp -
236 Kotrimoksazol Adult Botol 133.00 Rp - 127.15
237 Kotrimoksazol Suspensi Botol 2,190.00 Rp -
238 Kuinin dihidroklorida injeksi 25 % - 2 Ampul - Rp -
239 Kuinin sulfat tablet 222 mg ( 7 h2o ) Tablet - Rp -
240 Larutan mengandung Elektrolit (Na 1 Botol 10,293.00 Rp - 9,592.00
241 Larutan mengandung Karbohidrat + Ele Botol 11,500.00 Rp -
242 Lidokain injeksi 2 % Ampul - Rp - 100 899.10
243 Lidokain kompositum injeksi Ampul 847.00 Rp - 60 854.70
244 Loperamid tab 2 mg Tablet 156.20 Rp -
245 Loratidin Tablet 117.00 Rp - 117.00
246 Magnesium Sulfat Injeksi 20 %-25 mlAmpul 4,120.00 Rp -
247 Magnesium Sulfat Injeksi 40 %-25 mlAmpul 4,700.00 Rp - 4,700.00
248 Metformin 500 mg tablet Tablet 264.00 Rp - 77.00
249 Metilergometrin maleat injeksi 0,200 Ampul 1,069.00 Rp -
250 Metilergometrin maleat tablet salut Tablet 214.00 Rp - 200 215.95
251 Metilprednisolon 4 mg Tablet 216.70 Rp - 102.00
KEMA APBD APBD
252 Metoklopramid injeksi 5 mg/ml Ampul 1,883.00 Rp - 50 1,883.00

253 Metoklopramid sirup 5 mg/ml Botol - Rp -
254 Metoklopramid tab 10 mg Tablet 66.00 Rp - 1000 66.60
255 Metronidazol tablet 500 mg Tablet - Rp -
256 Metronidazole syrup Botol 3,950.00 Rp -
257 Mikonazol krim 2 % Tube 1,900.00 Rp - 1,917.27
258 Mineral Mix Sachet - Rp -
259 Multivitamin Syrup Botol 17,569.20 Rp -
260 N- asetil sistein kapsul 200 mg Kapsul 990.00 Rp - 319.88
261 Natrium diklofenat 50 mg Tablet 109.00 Rp - 2000 109.00
262 Natrium klorida larutan infus 0,9 % st Botol 6,840.00 Rp - 100 6,900.00
263 Natrium Tiroksin Tablet - Rp -
264 Nifedipin 10 mg Tablet 220.17 Rp -
265 Nistatin tab 500.000UI/g Tablet - Rp - 869.00
266 Nistatin tablet vaginal 100.000UI/g Tablet - Rp - 550.00
267 OAT Kategori Sisipan Paket - Rp -
268 Obat anti tuberculosis kategori anak Paket - Rp -
269 Obat anti tuberculosis kategori I Paket - Rp -
270 Obat anti tuberculosis kategori II Paket - Rp -
271 Obat batuk (o.b.h ) cairan Botol - Rp -
272 Oksitetrasiklin hcl inj.I.m.50 mg/ml- Vial - Rp -
273 Oksitetrasiklin hcl salep 3 % Tube - Rp -
274 Oksitetrasiklin hcl salep mata Tube 3,500.00 Rp - 50 5,588.80
275 Oksitosin injeksi 10 iu/ml - 1 ml Ampul 1,348.00 Rp -
276 Omeprazol inj 40 mg/ml Ampul - Rp - 8,247.00
277 Omeprazol kap 20 mg Kapsul - Rp - 502.24
278 Papaverin injeksi 40 mg/ml Ampul - Rp -
279 Papaverin tab 40 mg Tablet - Rp -
280 Parasetamol Drops Botol 5,204.00 Rp - 5,204.00
281 Parasetamol sirup 120 mg/5 ml Botol 1,160.00 Rp - 1,170.55
282 Parasetamol tablet 500 mg Tablet 188.76 Rp - 209.79
283 Perak Sulfadiazin 1% Tube - Rp -
284 Permetrin krim 5% Tube 11,466.00 Rp - 11,250.00
285 Piracetam 400 mg Tablet - Rp -
286 Piridoksin Tablet 256.00 Rp -
287 Piroksikam 20 mg Tablet - Rp -
288 Polikresulen Botol - Rp -
289 Prednison tablet 5 mg Tablet 79.00 Rp - 73.66
290 Primakuin tab 15 mg Tablet - Rp -
291 Prokain benzil penisilin 3 juta iu/vial i Vial Rp -

-
292 Propitiourasil tablet 100 mg Tablet - Rp -
293 Propranolol hcl tablet 10 mg Tablet 63.00 Rp -
294 Pyrantel pamoat tablet 125 mg Tablet - Rp -
295 Pyrantel Suspensi 125 mg/5ml Botol 11,791.00 Rp -
296 Ranitidin Injeksi 25 mg/2ml Ampul - Rp -
297 Ranitidin tab 150 mg Tablet 122.00 Rp - 85.00
298 Retinol (Vitamin A) 100.000 IU kapsulKapsul 354.00 Rp -
299 Retinol (Vitamin A) 200.000 IU kapsulKapsul 637.00 Rp - 642.79
300 Ringer laktat larutan infus steril Botol 7,703.00 Rp - 400 7,703.00
301 Risperidone 2 mg Tablet 130.00 Rp -
302 Salbutamol cairan ih 0,1% Ampul - Rp - 5,400.00
303 Salbutamol inhalasi/aerosol 100mcg/dBotol 22,000.00 Rp - 22,000.00
304 Salbutamol tablet 4 mg Tablet 67.00 Rp -
305 Salep 2-4 Pot 3,219.00 Rp -
306 Salisil bedak 2% Bungkus 1,040.00 Rp -
307 Sefadroksil kapsul 500 mg/ 250 mg Kapsul 732.00 Rp - 3000 952.15
308 Sefadroksil syrup 250 mg/5 ml Botol 5,826.00 Rp -
309 Sefotaksim injeksi 1 g Vial - Rp -
310 Seftriakson injeksi 1 g Vial - Rp -
311 Sianokobalamin (vit b 12) inj. 500 m Ampul 1,066.00 Rp - 1,066.00
312 Sianokobalamin tab Tablet - Rp - 44.40
313 Simvastatin 10 mg Tablet 220.00 Rp - 73.00
314 Streptomisin serbuk inj 1000 mg/ml Vial - Rp -
315 Sulfacetamid sodium Botol - Rp -
KEMA APBD APBD
316 Tablet tambah darah Tablet 255.00 Rp - 257.32

317 Taburia Sach Sachet - Rp -
318 Tamiflu Kapsul - Rp -
319 Tetrakain hcl tetes mata Botol - Rp -
320 Tetrasiklinhcl kapsul 250 mg Kapsul - Rp -
321 Tetrasiklinhcl kapsul 500 mg Kapsul - Rp - 948.54
322 Tiamin hcl ( vit b1 ) inj. Ampul - Rp -
323 Tiamin hcl mononitrat 50 mg Tablet 375.10 Rp - 2000 300.01
324 Tiampenikol tab 500 mg Tablet - Rp -

- Rp -
326 Triheksifenidil hidroklorida tab 2 mg Tablet 63.00 Rp - 63.57

327 Vitamin B-Compleks Tablet - Rp - 5000 60.55
328 Zinc dispersibel tab Tablet 604.00 Rp - 329.14
329 Zinc Sirup 20 mg/5 ml Botol 2,489.00 Rp -
330 Vaksin Anti Influenza Vial - Rp -
331 Vaksin Anti Rabies Vial - Rp -
332 Vaksin HB PID Kantong 0,5 ml - Rp -
333 Vaksin BCG + Pelarut Vial 1 ml - Rp -
334 Vaksin Polio (bOPV) Vial 1 ml - Rp -
335 Vaksin DPT-HB-HIB Vial 2,5 ml - Rp -
336 Vaksin IPV Vial 2,5 ml - Rp -
337 Vaksin Campak + Pelarut Vial 5 ml - Rp -
338 Vaksin TD (Tetanus Difteri) Vial 5 ml - Rp -
339 Vaksin DT (Difteri Tetanus) Vial 5 ml - Rp -
340 Efavirenz (EFV) 600 mg Tablet - Rp -

- Rp -
342 Nevirapine (NVP) 200 mg Tablet - Rp -
343 Tenofovir (TDF) 300 mg Tablet - Rp -
344 Triple FDC Dewasa (TDF300+3TC30 Tablet - Rp -
345 Triple FDC Ped (ZDV60+3TC30+NVP5Tablet - Rp -
346 Zidovudine (ZDV) 100 mg Tablet - Rp -
347 Zidovudine 300 mg + Lamivudine 15 Tablet - Rp -
348 Xylocain spray/ lidokain spray oral 1 Botol - Rp -
349 Betahistin Tablet 92.00 Rp -
350 Bisakodil tab 5 mg Tablet - Rp -
351 Ketorolac Inj Ampul 923.00 Rp - 923.00
352 Kotrimoksazol Adult forte Tablet - Rp -
353 Laktulosa syrup Botol - Rp -
354 Vaksin Meningitis Vial - Rp -
355 Vaksin HBIG Vial - Rp -
356 Human Hexagon Spilis Test - Rp -
357 RPR Focus Test - Rp -
360 Pipet TIPS Pcs - Rp -
Vial 5 ml - Rp -
362 Multivitamin tab Tablet - Rp -
363 Reagen Human Hexagon Spilis Test - Rp -
364 Metronidazol 500mg/100 ml Botol - Rp -
365 Serum Anti Rabies (SAR) Vial - Rp -
366 Handrub (AntiSeptic) 5 Liter jrg - Rp -
367 Albendazole Suspensi Botol Rp -
368 Vaksin HB Recombinan ( HB dewasa) Vial Rp -
369 Larutan Methanol Botol Rp -
370 Cartridge TCM-TB Test Rp -
Vial
371 Vaksin Corona Vac (10 Rp -
dosis)
372 Endo Vacutube Steril pcs Rp -
373 Freezing Tubes pcs Rp -
374 DBS Collection Kit pcs Rp -
375 MDT MB Dewasa Tablet Rp -
376 Tenofovir + Lamivudine +Dolutegra Tablet Rp -
377 Abacavir 120 mg + 3TC 60 mg (FDC Tablet Rp -
378 Lopinavir 40 mg + Ritonavir 10 mg ( Sachet Rp -
KEMA APBD APBD
379 Dolutegravir 50 mg Tablet Rp -

380 MDT MB Anak Blister Rp -
381 Strip Glukosa Darah Botol Rp -
382 Rapid Test Anti HCV Test Rp -
383 Tuberculin Test Vial Rp -
384 INH 300 mg Tablet Rp -
385 Rifapentin 150 mg Lepasan Tablet Rp -

386 Tablet Rp -
mg (3HP/KDT)

387 Tablet Rp -
(3HR/KDT)
388 Vaksin PCV MDV (4 dosis) Vial Rp -
389 Kotrimoksazol 960 mg Tablet Rp -
390 OAT KDT Harian Paket Rp -
391 Herba Asimor Kapsul Rp -
392 Herbakof Syrup Botol Rp -
393 Stimuno Syrup Botol Rp -
Rp 10,840,874.00
JUMLAH
Yang Menyerahkan

NIP. 19831117 201001 2 025
Mengetahui,

NIP. 19840807 2010 01 2 029
UWU TIMUR
AN
, Fax (0474) 321489
V /2023
JML HARGA PROGRA HARGA JML HARGA STOK

M
Rp 327,294.00 Rp - -448 0 1,700 14
Rp - Rp - 95 0 0 0
Rp - 1,460.00 Rp - 153 0 0 0
Rp - 138.00 Rp - 900 0 80,600 672
Rp - Rp - 0 0 0 0
Rp - 320.325 Rp - 0 0 0 0
Rp - Rp - 119 0 2,316 19
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 1,465.00 Rp - 100 8,000 0 67
Rp - 1,650.00 Rp - 1,890 6,800 46,000 440
Rp - Rp - 8 0 192 2
Rp - Rp - 12 0 2,357 20
Rp - Rp - -25 0 0 0
Rp - Rp - 16 438 0 4
Rp - Rp - 11 164 0 1
Rp - Rp - 41 0 6,342 53
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 43,010.00 Rp - -20 225 0 2
Rp - Rp - -115 0 9,050 75
Rp - 1,575.02 Rp - 3,650 187,500 0 1,563
Rp - Rp - 0 0 0 0
Rp - Rp - 112 0 1,250 10
Rp - 9,945.00 Rp - 0 0 0 0
Rp - Rp - 59 0 200 2
Rp - Rp - 136 0 1,050 9
Rp - Rp - -73 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 75 0 0 0
Rp - Rp - 12 5,328 0 44
Rp - Rp - 0 0 0 0
Rp - Rp - 12 2,160 0 18
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 12 2,328 0 19
Rp - Rp - 0 0 0 0
Rp - Rp - 5 0 4 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 13 0 26 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 279,820.80 Rp - 1 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 3 0 130 1
Rp - Rp - 0 0 0 0
PROGRA
Rp - Rp - 0 0 0 0
Rp - 19,422.22 Rp - -2,960 92,650 0 772
Rp - 9,800.00 Rp - 0 0 0 0
Rp 1,578,720.00 1000 706.420 Rp 706,420.00 2,400 0 132,950 1,108
Rp - Rp - -4 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - -63 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 20 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 1 0 0 0
Rp - 3,137.20 Rp - 350 0 0 0
Rp - 187,933.00 Rp - -2 0 0 0
Rp - 5 23,398.00 Rp 116,990.00 23 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 85 0 0 0
Rp - 44,500.00 Rp - 5 0 0 0
Rp - Rp - 139 9,210 0 77
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 218,500.00 Rp - -61 0 5,850 49
Rp - Rp - 137 1,750 0 15
Rp - Rp - 7 108 0 1
Rp - Rp - 0 0 0 0
Rp - Rp - 9 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 113 0 3,780 32
Rp - Rp - 0 0 0 0
Rp - 501,745.00 Rp - 1 0 0 0
Rp - 50 13,362.00 Rp 668,100.00 -37 0 0 0
Rp - 11,500.00 Rp - 0 0 0 0
Rp - 11,440.00 Rp - 5 0 0 0
Rp - 10,488.00 Rp - 25 0 0 0
Rp - 1,016,565.00 Rp - 0 0 0 0
Rp - 66,065.00 Rp - 0 0 0 0
Rp - 1,123,065.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 21,930.00 Rp - 0 0 0 0
Rp - 3,600.00 Rp - 600 0 0 0
Rp - 50 7,120.00 Rp 356,000.00 -160 0 0 0
Rp - 19,500.00 Rp - 0 0 0 0
Rp - 45,224.00 Rp - 330 0 0 0
Rp - Rp - 0 0 0 0
Rp - 400 366.50 Rp 146,600.00 2,800 0 0 0
Rp - Rp - -412 0 0 0
Rp - Rp - 275 0 0 0
Rp - Rp - -20 0 0 0
Rp - Rp - 0 0 50 0
Rp - Rp - 0 0 0 0
Rp - 167.00 Rp - 80 0 0 0
Rp 148,000.00 Rp - -2,657 0 0 0
Rp - Rp - 4,047 0 61,000 508
Rp - Rp - 0 0 0 0
Rp - Rp - 82 0 8,500 71
Rp - 9,834.00 Rp - -80 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 217,960.00 Rp - -3,698 0 62,500 521
Rp - Rp - 0 0 0 0
PROGRA
Rp - Rp - 0 0 3,600 30
Rp - Rp - 0 0 0 0
Rp - Rp - 286 0 2,600 22
Rp - Rp - 0 0 0 0
Rp - Rp - 33 0 3,560 30
Rp - Rp - 0 0 0 0
Rp - 39,000.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 185,680.00 Rp - -6,891 0 25,000 208
Rp - Rp - 190 0 0 0
Rp - Rp - 61 0 10,000 83
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 480 4
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 1,000 0 39,500 329
Rp 153,382.00 Rp - -148 0 5,775 48
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 1,135 0 61,000 508
Rp - Rp - 80 0 0 0
Rp - Rp - 141 0 11,450 95
Rp - Rp - 0 0 0 0
Rp - Rp - -1,508 21,000 0 175
Rp - 776.00 Rp - 0 0 0 0
Rp - 473.00 Rp - 0 0 0 0
Rp - 1,917.00 Rp - 0 0 0 0
Rp - Rp - 65 0 500 4
Rp 734,020.00 Rp - -10,260 0 105,000 875
Rp 32,688.00 Rp - 768 0 7,900 66
Rp - 1,545.00 Rp - 62 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 32 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 200 1,100 0 9
Rp - Rp - -47 0 0 0
Rp - Rp - 538 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - -438 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 410,256.00 1,518.00 Rp - 29 0 2,130 18
Rp - Rp - 300 700 0 6
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 1,700.00 Rp - 39 300 0 3
Rp - Rp - 0 0 0 0
Rp - Rp - 96 0 3,528 29
Rp - Rp - -60 0 0 0
Rp - 1,452.00 Rp - 66 0 5,700 48
Rp 234,300.00 Rp - -275 0 9,400 78
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 133,140.00 Rp - 211 0 5,600 47
Rp - 500 280.00 Rp 140,000.00 -3,804 0 0 0
PROGRA
Rp - Rp - 0 0 0 0
Rp - 4,036.00 Rp - 20 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 844 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 300 2,500 0 21
Rp - 10,351.00 Rp - 6 0 0 0
Rp - 54.00 Rp - 50 0 7,100 59
Rp - Rp - 107 0 0 0
Rp - Rp - 92 0 0 0
Rp - Rp - 200 0 0 0
Rp - 101,300.00 Rp - 5 0 0 0
Rp - 1,190.00 Rp - 0 0 0 0
Rp - Rp - 196 0 0 0
Rp 112,614.72 Rp - 5 0 1,032 9
Rp - Rp - 0 0 0 0
Rp - Rp - 121 0 560 5
Rp - Rp - -422 0 0 0
Rp - 282.00 Rp - 0 0 0 0
Rp - Rp - -54 0 0 0
Rp 60,550.00 Rp - -1,153 0 1,500 13
Rp - Rp - -212 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 143 0 3,200 27
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 1,400 12
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 364,224.00 Rp - 84 0 1,008 8
Rp - Rp - 0 0 0 0
Rp - Rp - 101 360 0 3
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - -10,252 0 0 0
Rp - Rp - 0 0 0 0
Rp - 157.00 Rp - -2 0 0 0
Rp - Rp - 20 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 553,224.00 Rp - -130 0 380 3
Rp - 317,018.00 Rp - 0 0 0 0
Rp - Rp - -1,332 0 25,300 211
Rp - Rp - 230 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 309 0 0 0
Rp - Rp - 0 0 0 0
Rp 89,910.00 Rp - -5 0 2,200 18
Rp 51,282.00 Rp - 292 0 2,070 17
Rp - Rp - 713 143,000 0 1,192
Rp - Rp - -2,257 0 0 0
Rp - 6 4,120.00 Rp 24,720.00 14 0 0 0
Rp - 6 4,700.00 Rp 28,200.00 11 0 100 1
Rp - Rp - -3,982 0 0 0
Rp - 1,079.00 Rp - 75 0 0 0
Rp 43,190.00 Rp - -190 0 16,200 135
Rp - Rp - 2,956 0 0 0
PROGRA
Rp 94,150.00 Rp - 80 0 1,280 11
Rp - Rp - 0 0 0 0
Rp 66,600.00 Rp - 2,817 0 16,500 138
Rp - Rp - 0 0 0 0
Rp - Rp - 119 2,100 0 18
Rp - Rp - -8 0 1,176 10
Rp - 2,981.00 Rp - 40 0 0 0
Rp - 16,500.00 Rp - 0 0 0 0
Rp - Rp - 163 0 87,120 726
Rp 218,000.00 Rp - 2,096 0 8,500 71
Rp 690,000.00 Rp - 271 0 620 5
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 94 0 900 8
Rp - Rp - 3 0 0 0
Rp - Rp - 0 0 0 0
Rp - 250,971.00 Rp - 0 0 0 0
Rp - 478,142.00 Rp - 3 0 0 0
Rp - 1,592,731.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp 279,440.00 3,500.00 Rp - 70 0 1,325 11
Rp - 1,348.00 Rp - 72 0 0 0
Rp - Rp - 77 0 0 0
Rp - Rp - 135 0 16,800 140
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 610 0 8,300 69
Rp - 131.00 Rp - -670 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 17 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 242.00 Rp - 14 0 0 0
Rp - Rp -
14,500.00 2 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 196 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 352.00 Rp - -56 0 0 0
Rp - 637.00 Rp - 382 0 19,050 159
Rp 3,081,200.00 Rp - 68 0 4,820 40
Rp - 123.00 Rp - 153 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 305 3
Rp - Rp - 0 0 0 0
Rp - Rp - 95 336 0 3
Rp - Rp - 0 0 0 0
Rp 2,856,450.00 Rp - 492 0 23,000 192
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 44 0 2,500 21
Rp - Rp - 4,146 0 208,500 1,738
Rp - Rp - -455 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
PROGRA
Rp - 255.00 Rp - 23,031 0 90,000 750

Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 1,300 11
Rp - Rp - 0 0 0 0
Rp 600,012.00 Rp - -2,629 0 44,900 374
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 91.00 Rp - 264 0 4,900 41
Rp 302,750.00 Rp - -6,021 0 92,900 774
Rp - 216.00 Rp - 676 0 0 0
Rp - Rp - 0 0 0 0
Rp - 82,335.00 Rp - 0 0 0 0
Rp - 30 154,880.00 Rp 4,646,400.00 -52 0 0 0
Rp - 30 23,991.00 Rp 719,730.00 -88 0 0 0
Rp - 5 61,996.00 Rp 309,980.00 -29 0 0 0
Rp - 20 19,954.00 Rp 399,080.00 -32 0 0 0
Rp - 20 78,991.00 Rp 1,579,820.00 41 0 0 0
Rp - 158,994.00 Rp - -21 0 0 0
Rp - 28,204.00 Rp - 0 0 0 0
Rp - 16,995.00 Rp - 46 0 0 0
Rp - 17,996.00 Rp - 28 0 0 0
Rp - 7,100.00 Rp - 0 0 0 0
Rp - 1,640.00 Rp - 0 0 0 0
Rp - 3,058.00 Rp - 0 0 0 0
Rp - 9,688.00 Rp - 0 0 0 0
Rp - 6,971.00 Rp - 120 0 0 0
Rp - 1,480.30 Rp - 0 0 0 0
Rp - 1,840.00 Rp - 54 0 0 0
Rp - 3,550.00 Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - Rp - 7 0 1,370 11
Rp - Rp - 0 0 0 0
Rp - Rp - 0 0 0 0
Rp - 135,000.00 Rp - 0 0 0 0
Rp - 1,325,000.00 Rp - 0 0 0 0
Rp - 8,096.00 Rp - -39 0 0 0
Rp - 2,422.00 Rp - 0 0 0 0
Rp - 179.20 Rp - 0 0 0 0
Rp - 230.60 Rp - 0 0 0 0
Rp - 980.00 Rp - 0 0 0 0
Rp - 155,813.00 Rp - 6 0 0 0
Rp - 7,000.00 Rp - 0 0 0 0
Rp - 20,400.00 Rp - 0 0 0 0
Rp - 5,885.00 Rp - 0 0 0 0
Rp - 1,608,255.00 Rp - 0 0 0 0
Rp - 395,000.00 Rp - 8 0 0 0
Rp - 4,300.00 Rp - 250 0 0 0
Rp - 52,050.00 Rp - 0 0 0 0
Rp - 45,360.00 Rp - 1 0 #VALUE!
Rp - 253,400.00 Rp - 0 0 0 0
Rp - 1,339,440.00 Rp - 0 0 #VALUE!
Rp - 2,500.00 Rp - 0 0 0 0
Rp - 2,500.00Rp - 0 0 0
Rp - 26,980.00Rp - 0 0 0 0
Rp - 40,526.00 Rp - 0 0 0
Rp - 2,609.43 Rp - 0 0 0 0
Rp - 1,618.27 Rp - 0 0 0 0
Rp - 2,451.02 Rp - 0 0 0 0
PROGRA
Rp - 943.90 Rp - 0 0 0 0
Rp - 25,364.00 Rp - 0 0 0 0
Rp - 100 130,891.24 Rp 13,089,124.00 143 0 0 0
Rp - 11,188.00 Rp - 0 0 0 0
Rp - 625,800.00 Rp - 2 0 0 0
Rp - 309.00 Rp - 100 0 0 0
Rp - 5,525.00 Rp - 0 0 0 0
Rp - 6,546.00 Rp -
216 0 0 0
Rp - 799.00 Rp -
0 0 0 0
Rp - 20 190,657.00 Rp 3,813,140.00 -52 0 0 0
Rp - 325.00 Rp - 0 0 0 0
Rp - 397,612.00 Rp - 0 0 0 0
Rp - 2,750.00 Rp - -480 0 0 0
Rp - 15,125.00 Rp - 5 0 0 0
Rp - 48,881.00 Rp - -16 0 0 0
Rp 13,837,536.72 Rp 26,744,304.00 0 0 0 0
Rp 51,422,714.72
Malili, April 2023

Yang Menerima
NIP.
DINAS KESEHATAN
MALILI
SBBK No. 440/ /SBBK/ V /2023

1 Alat Suntik Sekali Pakai 1 ml/ 0,3 ml Set 500 1,090.98 Rp 545,490.00 Rp - Rp -
2 Alat Suntik Sekali Pakai 2,5 ml/ 3 ml Set 1,158.84 Rp - Rp - Rp -
3 Alat Suntik Sekali Pakai 5 ml Set 1,103.52 Rp - Rp - 1,460.00 Rp -
4 Alcohol Swab Lembar 148.87 Rp - Rp - 138.00 Rp -
6 Blood Lancet Pcs - Rp - Rp - 320.325 Rp -
7 Catgut / Benang Bedah No. 3/0 dan Set 96 6,379.05 Rp 612,388.32 Rp - Rp -
8 Cuticell Classic 10 cm x 10 cm Pcs 7,100.00 Rp - Rp - Rp -
12 Etakridin (rivanol) larutan 0,1 % Botol 8,665.20 Rp - Rp - Rp -
13 Etanol 70% Botol 27,595.00 Rp - Rp - Rp -
14 Fixomull Stretch 5 cm x 5 cm Rol 50,200.00 Rp - Rp - Rp -
20 Handscoen Ginecolog Pasang 25 43,010.00 Rp 1,075,250.00 Rp - 43,010.00 Rp -
21 Hanscoen Pasang 200 8,635.00 Rp 1,727,000.00 Rp - Rp -
22 Hanscoen Non Steril Pasang 1,780.68 Rp - Rp - 1,575.02 Rp -
23 Infusion Set Anak Set 6,072.00 Rp - Rp - Rp -
24 Infusion Set Dewasa Set 200 8,369.40 Rp 1,673,880.00 Rp - Rp -
27 IV Catheter No. 20 Buah 150 5,492.52 Rp 823,878.00 Rp - Rp -
38 Kapas pembalut/absorben 250 mg Gulung 16,698.00 Rp - Rp - Rp -
43 Kasa Pembalut Hidrofil 40 Yds x 80 c Roll 4 181,907.00 Rp 727,628.00 Rp - Rp -
55 Maag Slang 14 Set 8,905.60 Rp - Rp - Rp -
58 Masker Buah 571.82 Rp - Rp - 19,422.22 Rp -
60 Masker Kerudung Buah 526.24 Rp - Rp - 314.000 Rp -
61 Nasal Canula Anak Set 6,325.00 Rp - Rp - Rp -
62 Nasal Canula Bayi Set 6,325.00 Rp - Rp - Rp -
63 Nasal Canula Dewasa Set 6,325.00 Rp - Rp - Rp -
65 Onemed Gluco Protein Strip 1,201.75 Rp - Rp - Rp -
68 Plester 5 yard x 2 inch / 2,5 cm x 4,5 Rol 27,324.00 Rp - Rp - Rp -
73 Silk ( Benang Bedah Sutera ) No 3/0 Set 5,313.89 Rp - Rp - Rp -
74 Slide Dos - Rp - Rp - 44,500.00 Rp -
75 Softpad(Underpad) 60x90 Lembar 100 3,018.75 Rp 301,875.00 Rp - Rp -
79 Tes Kehamilan strip 100 2,185.00 Rp 218,500.00 Rp - Rp -
81 Urine bag Pcs 10 4,827.90 Rp 48,279.00 Rp - Rp -
83 USG Gel 250 ml Botol 15,800.40 Rp - Rp - Rp -

91 SD HIV-1/2 3.0 (multi) (R1) test - Rp - Rp - 150 13,362.00 Rp 2,004,300.00
92 Fokus Diagnostic (R2) test - Rp - Rp - 25 11,500.00 Rp 287,500.00
94 RDT Malaria test - Rp - Rp - 10,488.00 Rp -
101 RDT Hepatitis test - Rp - Rp - 50 7,120.00 Rp 356,000.00
103 RDT DBD (NS1) Strip - Rp - Rp - 45,224.00 Rp -
105 Albendazole Tablet - Rp - Rp - 390.00 Rp -
106 Alopurinol tablet 100 mg Tablet 89.00 Rp - Rp - Rp -
108 Ambroxol tab 30 mg Tablet 147.00 Rp - 6200 211.00 Rp 1,308,200.00 Rp -
109 Aminofilin Injeksi 24 mg/ml - 10 ml Ampul 2,736.00 Rp - Rp - Rp -
110 Aminofilin tablet 200 mg Tablet 596.40 Rp - Rp - Rp -
112 Amlodipin 10 mg Tablet 74.00 Rp - 10000 138.00 Rp 1,380,000.00 Rp -
113 Amoksisilin 500 mg Tablet 5000 231.00 Rp 1,155,000.00 Rp - Rp -
114 Amoksisilin Kapsul 250 mg Kapsul - Rp - 456.00 Rp - Rp -
115 Amoksisilin sirup kering 125 mg/5 ml Botol 200 2,068.64 Rp 413,728.00 Rp - Rp -
119 Antasida doen suspensi Botol 1,756.00 Rp - Rp - Rp -
120 Antasida doen tablet kombinasi Tablet 2000 54.49 Rp 108,980.00 Rp - Rp -
122 Antifungi Kombinasi Pot 3,637.00 Rp - Rp - Rp -
123 Antihemoroid supp supp 3,289.64 Rp - Rp - Rp -
124 Antimigrain doen kombinasi Tablet 329.00 Rp - Rp - Rp -
126 Aqua proinjeksi steril, bebas pirogen Botol 2,322.00 Rp - Rp - Rp -
130 Asam askorbat (vit c) tablet 50 mg Tablet 2500 46.42 Rp 116,050.00 Rp - Rp -
131 Asam Folat tab 0,4 mg Tablet 45.41 Rp - Rp - Rp -
132 Asam mefenamat 500 mg Tablet 117.00 Rp - 1000 226.00 Rp 226,000.00 Rp -
133 Asam Traneksamat 500 mg Tablet 277.20 Rp - Rp - Rp -
138 Asiklovir krim 5 % Tube 4,760.00 Rp - Rp - Rp -
139 Asiklovir tab 400 mg Tablet 1,087.80 Rp - Rp - Rp -
143 Attapulgite 600 mg Tablet 816.52 Rp - Rp - Rp -
144 Betametason krim 0,1 % Tube 100 1,533.82 Rp 153,382.00 Rp - Rp -
147 Captopril 25 mg Tablet 1000 75.68 Rp 75,680.00 Rp - Rp -
148 Cetirizin tab Kapsul 52.00 Rp - Rp - Rp -
149 Cetirizin sirup 5mg/ml Botol 2,215.00 Rp - Rp - Rp -
151 Ciprofloxasin 500 mg Tablet 260.00 Rp - 586.00 Rp - Rp -
154 Darplex (Antimalaria) Tablet 2,134.00 Rp - Rp - 18 1,917.00 Rp 34,506.00
155 Deksametason inj Ampul 968.00 Rp - 1,427.00 Rp - Rp -
156 Deksametason tablet 0,5 mg Tablet 7000 104.86 Rp 734,020.00 119.00 Rp - Rp -
157 Diazepam 5 mg Tablet 300 108.96 Rp 32,688.00 Rp - Rp -
158 Diazepam inj 5 mg/ml - 2 ml Ampul - Rp - Rp - 1,545.00 Rp -
159 Diazepam Rektal 10 mg/2,5 ml Tube - Rp - Rp - Rp -
163 Difenhidramin hcl inj 10 mg/ml - 1 mlAmpul 825.00 Rp - Rp - Rp -
166 Dimenhidrinat 50 mg Tablet 109.99 Rp - Rp - Rp -
167 Doksisiklin 100 mg Tablet - Rp - Rp - Rp -
168 Domperidon suspensi 5mg/5ml Botol 2,401.00 Rp - Rp - Rp -
169 Domperidon tab Tablet 75.00 Rp - Rp - Rp -
172 Epinefrin(adrenalin) inj 0,1 %-1 ml Ampul 13,675.20 Rp - Rp - 1,518.00 Rp -
174 Eritromisin Sirup Botol 7,503.60 Rp - Rp - Rp -

176 Eugenol cairan Botol 20,358.41 Rp - Rp - Rp -
179 Fenol gliserol tetes telinga 10 % Botol 3,330.00 Rp - Rp - Rp -
180 Fitomenadion injeksi 10 mg/ml - 1 mlAmpul 7,435.40 Rp - Rp - Rp -
181 Fitomenadion injeksi 2 mg/ml - 1 ml (Ampul 1,452.00 Rp - Rp - 1,452.00 Rp -
182 Fitomenadion tablet salut 10 mg Tablet 781.00 Rp - Rp - Rp -
183 Fluoksetin kap 20 mg Kapsul - Rp - Rp - Rp -
184 Furosemid inj 10 mg/ml Ampul 969.00 Rp - Rp - Rp -
185 Furosemid tablet 40 mg Tablet 443.80 Rp - Rp - Rp -
186 Garam oralit untuk 200 ml air Bungkus - Rp - Rp - 700 280.00 Rp 196,000.00
188 Gentamisin injeksi 80 mg/2 ml Ampul - Rp - Rp - 4,036.00 Rp -
189 Gentamisin salep kulit Tube 5,600.00 Rp - Rp - Rp -
190 Gentamisin sulfat tts mata 0,3 % Botol - Rp - Rp - Rp -
193 Glimepiride 2 mg /3 mg Tablet 123.00 Rp - Rp - Rp -
197 Glukosa larutan infus 5 % steril Botol 6,627.00 Rp - 60 7,685.00 Rp 461,100.00 Rp -
198 Griseofulvin tablet 125 mg, micronize Tablet 210.00 Rp - Rp - Rp -
200 Haloperidol 5 mg Tablet 54.49 Rp - Rp - 54.00 Rp -
201 Haloperidol tablet 0,5 mg Tablet - Rp - Rp - Rp -
202 Haloperidol tablet 1,5 mg Tablet - Rp - Rp - Rp -
203 Haloperidol tablet 2 mg Tablet 81.74 Rp - Rp - Rp -
206 Hidroklorotiazid (hct) tablet 25 mg Tablet 149.35 Rp - Rp - Rp -
207 Hidrokortison krim 2,5 % Tube 2,346.14 Rp - 2,800.00 Rp - Rp -
209 Ibuprofen Suspensi 200 mg/5ml Botol 3,422.84 Rp - Rp - Rp -
210 Ibuprofen tablet 400 mg Tablet 216.95 Rp - 199.00 Rp - Rp -
212 Isosorbid dinitrat tablet subling 5 mg Tablet - Rp - Rp - Rp -
213 Kalsium Laktat (Kalk) tab 500 mg Tablet 60.55 Rp - Rp - Rp -
214 Karbamazepin tab 200 mg Tablet 217.96 Rp - Rp - Rp -
216 Ketokenazol tab 200 mg Tablet 260.00 Rp - Rp - Rp -
218 Klonidin tab 0,15 mg Tablet 147.33 Rp - Rp - Rp -
219 Kloramfenikol kapsul 250 mg Kapsul - Rp - 1000 795.00 Rp 795,000.00 Rp -
221 Kloramfenikol salep kulit 2% Tube 3,794.00 Rp - Rp - Rp -
224 Kloramfenikol tetes mata 0,5 % Botol 16,450.00 Rp - Rp - Rp -
226 Klorfeniramin maleat (ctm) tablet 4 Tablet 139.36 Rp - Rp - Rp -
228 Klorpromazin hcl tablet salut 100 mg Tablet 1,010.10 Rp - Rp - 157.00 Rp -
229 Klorpromazin hcl tablet salut 25 mg Tablet 209.89 Rp - Rp - Rp -
232 Kodein hcl tablet 10 mg Tablet 610.50 Rp - Rp - Rp -
234 Kombinasi ipatropium bromida 0,5mgampul 40 3,951.60 Rp 158,064.00 Rp - Rp -
236 Kotrimoksazol Adult Botol 1000 127.15 Rp 127,150.00 Rp - Rp -
237 Kotrimoksazol Suspensi Botol - Rp - Rp - Rp -
Botol
242 Lidokain injeksi 2 % Ampul 100 899.10 Rp 89,910.00 Rp - Rp -
243 Lidokain kompositum injeksi Ampul 854.70 Rp - 1,532.00 Rp - Rp -
244 Loperamid tab 2 mg Tablet 156.20 Rp - Rp - Rp -
245 Loratidin Tablet 117.00 Rp - Rp - Rp -
246 Magnesium Sulfat Injeksi 20 %-25 mlAmpul - Rp - Rp - 4,120.00 Rp -
248 Metformin 500 mg tablet Tablet 77.00 Rp - Rp - Rp -
250 Metilergometrin maleat tablet salut Tablet 215.95 Rp - Rp - Rp -
251 Metilprednisolon 4 mg Tablet 102.00 Rp - Rp - Rp -
252 Metoklopramid injeksi 5 mg/ml Ampul 1,883.00 Rp - Rp - Rp -
254 Metoklopramid tab 10 mg Tablet 66.60 Rp - 112.00 Rp - Rp -
257 Mikonazol krim 2 % Tube 48 1,917.27 Rp 92,028.96 3,917.00 Rp - Rp -
258 Mineral Mix Sachet - Rp - Rp - 2,981.00 Rp -
259 Multivitamin Syrup Botol - Rp - 24,420.00 Rp - 30 16,500.00 Rp 495,000.00
260 N- asetil sistein kapsul 200 mg Kapsul 319.88 Rp - Rp - Rp -
261 Natrium diklofenat 50 mg Tablet 1000 109.00 Rp 109,000.00 Rp - Rp -
262 Natrium klorida larutan infus 0,9 % st Botol 40 6,900.00 Rp 276,000.00 7,672.00 Rp - Rp -
264 Nifedipin 10 mg Tablet - Rp - Rp - Rp -
265 Nistatin tab 500.000UI/g Tablet 869.00 Rp - Rp - Rp -

266 Nistatin tablet vaginal 100.000UI/g Tablet 550.00 Rp - Rp - Rp -
268 Obat anti tuberculosis kategori anak Paket - Rp - Rp - 2 314,241.00 Rp 628,482.00
274 Oksitetrasiklin hcl salep mata Tube 50 5,588.80 Rp 279,440.00 Rp - 3,500.00 Rp -
275 Oksitosin injeksi 10 iu/ml - 1 ml Ampul - Rp - Rp - 100 1,348.00 Rp 134,800.00
276 Omeprazol inj 40 mg/ml Ampul 8,247.00 Rp - Rp - Rp -
277 Omeprazol kap 20 mg Kapsul 900 502.24 Rp 452,017.80 Rp - Rp -
280 Parasetamol Drops Botol 5,204.00 Rp - Rp - Rp -
281 Parasetamol sirup 120 mg/5 ml Botol 1,170.55 Rp - Rp - Rp -
282 Parasetamol tablet 500 mg Tablet 209.79 Rp - 14000 213.00 Rp 2,982,000.00 131.00 Rp -
284 Permetrin krim 5% Tube 11,250.00 Rp - Rp - Rp -
286 Piridoksin Tablet - Rp - Rp - Rp -
289 Prednison tablet 5 mg Tablet 73.66 Rp - Rp - Rp -
290 Primakuin tab 15 mg Tablet - Rp - Rp - 20 242.00 Rp 4,840.00

- 14,500.00
293 Propranolol hcl tablet 10 mg Tablet - Rp - Rp - Rp -
295 Pyrantel Suspensi 125 mg/5ml Botol - Rp - Rp - Rp -
296 Ranitidin Injeksi 25 mg/2ml Ampul - Rp - 1,469.00 Rp - Rp -
297 Ranitidin tab 150 mg Tablet 85.00 Rp - Rp - Rp -
298 Retinol (Vitamin A) 100.000 IU kapsulKapsul - Rp - Rp - 352.00 Rp -
299 Retinol (Vitamin A) 200.000 IU kapsulKapsul 642.79 Rp - Rp - 637.00 Rp -
300 Ringer laktat larutan infus steril Botol 200 7,703.00 Rp 1,540,600.00 8,497.00 Rp - Rp -
301 Risperidone 2 mg Tablet - Rp - Rp - 100 123.00 Rp 12,300.00
302 Salbutamol cairan ih 0,1% Ampul 5,400.00 Rp - Rp - Rp -
303 Salbutamol inhalasi/aerosol 100mcg/dBotol 22,000.00 Rp - Rp - Rp -
305 Salep 2-4 Pot 3,219.00 Rp - Rp - Rp -
307 Sefadroksil kapsul 500 mg/ 250 mg Kapsul 3000 952.15 Rp 2,856,450.00 1,002.00 Rp - Rp -
308 Sefadroksil syrup 250 mg/5 ml Botol - Rp - Rp - Rp -
311 Sianokobalamin (vit b 12) inj. 500 m Ampul 1,066.00 Rp - Rp - Rp -
312 Sianokobalamin tab Tablet 44.40 Rp - Rp - Rp -
313 Simvastatin 10 mg Tablet 73.00 Rp - Rp - Rp -
316 Tablet tambah darah Tablet 257.32 Rp - Rp - 255.00 Rp -
321 Tetrasiklinhcl kapsul 500 mg Kapsul 948.54 Rp - Rp - Rp -
323 Tiamin hcl mononitrat 50 mg Tablet 2000 300.01 Rp 600,012.00 98.00 Rp - Rp -

- Rp - Rp - Rp -
326 Triheksifenidil hidroklorida tab 2 mg Tablet 300 63.57 Rp 19,071.00 Rp - 91.00 Rp -

327 Vitamin B-Compleks Tablet 5000 60.55 Rp 302,750.00 120.00 Rp - Rp -
328 Zinc dispersibel tab Tablet 329.14 Rp - Rp - 500 253.00 Rp 126,500.00
330 Vaksin Anti Influenza Vial - Rp - Rp - 12 110,778.00 Rp 1,329,336.00
331 Vaksin Anti Rabies (Verorab) Vial - Rp - Rp - 3 153,000.00 Rp 459,000.00
Vaksin Anti Rabies (Rabivax) 33 154,880.00 Rp 5,111,040.00
333 Vaksin BCG + Pelarut Vial 1 ml - Rp - Rp - 61,996.00 Rp -
334 Vaksin Polio (bOPV) Vial 1 ml - Rp - Rp - 19,954.00 Rp -
335 Vaksin DPT-HB-HIB Vial 2,5 ml - Rp - Rp - 78,991.00 Rp -
336 Vaksin IPV Vial 2,5 ml - Rp - Rp - 158,994.00 Rp -

- Rp - Rp - 1,640.00 Rp -
351 Ketorolac Inj Ampul 923.00 Rp - Rp - Rp -

354 Vaksin Meningitis Vial - Rp - Rp - 20 122,000.00 Rp 2,440,000.00
355 Vaksin HBIG Vial - Rp - Rp - 3 1,325,000.00 Rp 3,975,000.00
356 Human Hexagon Spilis Test - Rp - Rp - 25 8,096.00 Rp 202,400.00
Vial 5 ml - Rp - Rp - 155,813.00 Rp -
366 Handrub (AntiSeptic) 5 Liter jrg - Rp - Rp - 38,801.33 Rp -
367 Albendazole Suspensi Botol Rp - Rp - 4,300.00 Rp -
Vial
dosis)
376 Tenofovir + Lamivudine +Dolutegra Tablet Rp - Rp - 60 2,609.43 Rp 156,565.98
377 Abacavir 120 mg + 3TC 60 mg (FDC Tablet Rp - Rp - 120 1,618.27 Rp 194,191.92
378 Lopinavir 40 mg + Ritonavir 10 mg ( Sachet Rp - Rp - 480 2,381.91 Rp 1,143,315.84
383 Tuberculin Test Vial Rp - Rp - 625,800.00 Rp -

386 Tablet Rp - Rp - 180 6,546.00 Rp 1,178,280.00
mg (3HP/KDT)

387 Tablet Rp - Rp - 799.00 Rp -
(3HR/KDT)
388 Vaksin PCV MDV (4 dosis) Vial Rp - Rp - 190,657.00 Rp -
391 Herba Asimor Kapsul Rp - Rp - 2,750.00 Rp -
392 Herbakof Syrup Botol Rp - Rp - 15,125.00 Rp -
393 Stimuno Syrup Botol Rp - Rp - 48,881.00 Rp -
394 RDT HIV 1/2 & Sifilis Combo Test Rp - Rp - 17,497.52 Rp -
Rp 17,854,437.76 Rp 7,152,300.00 Rp 20,469,357.74
JUMLAH Rp 45,476,095.50
Malili, Mei 2023


NIP. 19831117 201001 2 025 NIP.
Mengetahui,

NIP. 19840807 2010 01 2 029
STOK
-759 500 0 4
-995 0 0 0
-163 0 0 0
900 77,900 0 649
0 0 0 0
0 0 0 0
-15 1,956 0 16
0 0 0 0
0 0 0 0
100 8,000 0 67
1,890 6,800 0 57
14 164 0 1
12 2,292 0 19
-16 0 0 0
-14 422 0 4
-28 128 0 1
39 6,322 0 53
0 0 0 0
0 0 0 0
5 200 0 2
-130 8,100 0 68
5,810 165,000 0 1,375
0 0 0 0
-119 0 0 0
0 0 0 0
59 50 0 0
-303 600 0 5
-153 0 0 0
0 0 0 0
75 0 0 0
12 5,328 0 44
0 0 0 0
12 2,160 0 18
0 0 0 0
0 0 0 0
12 2,328 0 19
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-13 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
3 125 0 1
0 0 0 0
0 0 0 0
-690 79,350 0 661
0 0 0 0
6,750 101,950 0 850
6 0 0 0
0 0 0 0
-34 0 0 0
0 0 0 0
-40 0 0 0
0 0 0 0
0 0 0 0
-2 0 0 0
-248 0 0 0
0 0 0 0
-56 0 0 0
0 0 0 0
-29 0 0 0
5 0 0 0
-61 8,870 0 74
0 0 0 0
0 0 0 0
0 0 0 0
48 5,200 0 43
42 1,550 0 13
-8 74 0 1
0 0 0 0
STOK
-4 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
43 3,730 0 31
0 0 0 0
1 0 0 0
-168 0 0 0
0 0 0 0
-1 0 0 0
16 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
600 0 0 0
-27 0 0 0
0 0 0 0
270 0 0 0
0 0 0 0
3,200 0 0 0
1,612 0 0 0
140 0 193 2
-90 0 512,000 4,267
0 30 0 0
0 0 0 0
140 0 0 0
-2,218 0 182,000 1,517
-2,142 17,000 0 142
0 0 6,500 54
23 7,400 0 62
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-869 28,000 0 233
0 0 0 0
0 3,600 0 30
0 0 0 0
300 2,600 0 22
0 0 0 0
5 3,480 0 29
0 0 0 0
0 0 0 0
0 0 0 0
194 1,000 0 8
190 0 0 0
831 0 15,300 128
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 270 0 2
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1,000 36,000 0 300
-136 4,975 0 41
0 0 0 0
0 0 0 0
-122 56,000 0 467
100 0 0 0
141 11,450 0 95
0 0 0 0
1,687 17,000 50,000 558
0 0 0 0
0 0 0 0
0 0 0 0
53 300 1,600 16
-8,128 72,500 280,000 2,938
-270 7,400 0 62
71 0 0 0
0 0 0 0
-8 0 0 0
0 0 0 0
0 0 0 0
2 0 0 0
0 0 0 0
400 1,100 0 9
11 0 0 0
-1,076 0 0 0
0 0 0 0
-348 0 0 0
0 0 0 0
0 0 0 0
63 2,100 0 18
300 700 0 6
STOK
0 0 0 0
0 0 0 0
0 0 0 0
39 300 0 3
0 0 0 0
96 3,528 0 29
0 0 0 0
122 5,610 0 47
337 8,700 0 73
0 0 0 0
0 0 0 0
604 5,200 0 43
-292 0 0 0
0 0 0 0
20 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-2,895 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 780 7
300 2,500 0 21
6 0 0 0
120 5,000 0 42
167 0 0 0
-34 0 0 0
200 0 0 0
-10 0 0 0
0 0 0 0
198 0 0 0
91 696 3,936 39
0 0 0 0
123 560 0 5
361 0 68,000 567
0 0 0 0
6 0 0 0
772 0 0 0
-56 0 0 0
0 0 0 0
142 3,200 0 27
0 0 0 0
0 1,400 0 12
0 0 19,000 158
0 0 0 0
-99 552 0 5
0 0 0 0
-16 360 0 3
0 0 0 0
0 0 0 0
-2,702 0 0 0
0 0 0 0
48 0 0 0
140 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
80 40 0 0
0 0 0 0
123 22,500 0 188
230 0 0 0
0 0 0 0
0 0 0 0
282 0 2,980 25
0 0 0 0
-17 1,800 0 15
446 1,740 5,000 56
2,358 135,000 0 1,125
-1,962 0 0 0
-22 0 0 0
-16 100 0 1
1,518 0 0 0
75 0 0 0
270 16,200 0 135
337 0 0 0
100 790 0 7
0 0 0 0
2,831 8,000 11,600 163
0 0 0 0
119 1,800 0 15
-31 840 1,000 15
40 0 0 0
0 0 6,050 50
1,982 65,340 0 545
1,822 0 0 0
14 0 6,560 55
0 0 0 0
0 0 0 0
STOK
94 900 0 8
53 0 0 0
0 0 0 0
0 0 0 0
7 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-195 1,000 0 8
-58 0 0 0
83 0 0 0
-2,475 900 0 8
0 0 0 0
0 0 0 0
0 0 0 0
610 8,300 0 69
-130 0 640,600 5,338
0 0 0 0
8 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
14 0 0 0
2 0 0 0
0 0 0 0
302 0 0 0
0 0 0 0
0 0 0 0
0 0 3,000 25
0 0 0 0
41 0 0 0
550 19,050 0 159
-130 2,040 27,020 242
-60 0 0 0
0 0 0 0
0 265 0 2
0 0 0 0
84 0 0 0
0 0 0 0
-3,224 11,500 114,000 1,046
0 0 0 0
0 0 0 0
0 0 0 0
66 2,100 0 18
1,508 196,500 0 1,638
-88 0 0 0
0 0 0 0
0 0 0 0
31,423 90,000 0 750
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 1,300 0 11
0 0 0 0
258 33,900 168,000 1,683
0 0 0 0
0 0 0 0
-417 2,000 0 17
-5,766 22,900 200,000 1,858
270 0 0 0
0 0 0 0
0 0 0 0
-51 0 0 0 3 verorab
39 0 0 0
10 0 0 0
-5 0 0 0
-72 0 0 0
-4 0 0 0
0 0 0 0
48 0 0 0
28 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
120 0 0 0
0 0 0 0
54 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
27 960 0 8
0 0 0 0
STOK
0 0 0 0
0 0 0 0
0 0 0 0
17 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-12 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 0 0 0
250 0 0 0
0 0 0 0
1 0 #VALUE!
0 0 0 0
0 0 #VALUE!
0 0 0 0
0 0 0
0 0 0 0
0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
252 0 0 0
0 0 0 0
-4 0 0 0
-200 0 0 0
0 0 0 0
-324 0 0 0
0 0 0 0
-21 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
-10 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

SBBK PKM Wawondula 2023

Diunggah oleh

Informasi Dokumen

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

SBBK PKM Wawondula 2023

Diunggah oleh

Hak Cipta:

Format Tersedia

PEMERINTAH KA BUPATEN LUWU TIMUR

KEMA APBD APBD PROGRA

1 Alat Suntik Sekali Pakai 1 ml/ 0,3 ml Set 827.95 Rp - 1,090.98 Rp - Rp -

83 USG Gel 250 ml Botol 5 15,800.40 Rp 79,002.00 16,632.00 Rp - Rp -

174 Eritromisin Sirup Botol 6,390.00 Rp - 7,503.60 Rp - Rp -

265 Nistatin tab 500.000UI/g Tablet - Rp - 869.00 Rp - Rp -

291 Prokain benzil penisilin 3 juta iu/vial i Vial Rp - Rp - Rp -

325 Tramadol injeksi 50 mg/ml Ampul

326 Triheksifenidil hidroklorida tab 2 mg Tablet 63.00 Rp - 63.57 Rp - 91.00 Rp -

341 Lamivudine (3TC) 150 mg Tablet

354 Vaksin Meningitis Vial - Rp - Rp - 135,000.00 Rp -

Rifapentin 300 mg/ Isoniazid 300

Rifampicin 75 mg/ Isoniazid 50 mg

Malili, Januari 2023

Melyati Suhaery, S.Si.,Apt

Fitriani, S.Si., M.Kes

KEMA APBD APBD PROGRA

83 USG Gel 250 ml Botol 10 15,800.40 Rp 158,004.00 16,632.00 Rp - Rp -

174 Eritromisin Sirup Botol 6,390.00 Rp - 7,503.60 Rp - Rp -

265 Nistatin tab 500.000UI/g Tablet - Rp - 869.00 Rp - Rp -

291 Prokain benzil penisilin 3 juta iu/vial i Vial Rp - Rp - Rp -

325 Tramadol injeksi 50 mg/ml Ampul

341 Lamivudine (3TC) 150 mg Tablet

354 Vaksin Meningitis Vial - Rp - Rp - 135,000.00 Rp -

Rifapentin 300 mg/ Isoniazid 300

Rifampicin 75 mg/ Isoniazid 50 mg

Malili, Februari 2023

Melyati Suhaery, S.Si.,Apt

Fitriani, S.Si., M.Kes

57 Maag Slang 18 Set - Rp -

122 Antifungi Kombinasi Pot - Rp - 3,637.00

187 Gemfibrozil 300 mg Kapsul - Rp -

252 Metoklopramid injeksi 5 mg/ml Ampul 1,883.00 Rp - 50 1,883.00

291 Prokain benzil penisilin 3 juta iu/vial i Vial Rp -

316 Tablet tambah darah Tablet 255.00 Rp - 257.32

325 Tramadol injeksi 50 mg/ml Ampul

326 Triheksifenidil hidroklorida tab 2 mg Tablet 63.00 Rp - 63.57

341 Lamivudine (3TC) 150 mg Tablet

379 Dolutegravir 50 mg Tablet Rp -

Rifapentin 300 mg/ Isoniazid 300

Rifampicin 75 mg/ Isoniazid 50 mg

Melyati Suhaery, S.Si.,Apt

Fitriani, S.Si., M.Kes

JML HARGA PROGRA HARGA JML HARGA STOK

Rp 94,150.00 Rp - -50 0 1,810 15

Rp - 255.00 Rp - 17,149 0 90,000 750

Malili, Maret 2023

57 Maag Slang 18 Set - Rp -

122 Antifungi Kombinasi Pot - Rp - 3,637.00

187 Gemfibrozil 300 mg Kapsul - Rp -

252 Metoklopramid injeksi 5 mg/ml Ampul 1,883.00 Rp - 50 1,883.00

291 Prokain benzil penisilin 3 juta iu/vial i Vial Rp -

316 Tablet tambah darah Tablet 255.00 Rp - 257.32

325 Tramadol injeksi 50 mg/ml Ampul

326 Triheksifenidil hidroklorida tab 2 mg Tablet 63.00 Rp - 63.57

341 Lamivudine (3TC) 150 mg Tablet

379 Dolutegravir 50 mg Tablet Rp -

Rifapentin 300 mg/ Isoniazid 300

Rifampicin 75 mg/ Isoniazid 50 mg

Melyati Suhaery, S.Si.,Apt

Fitriani, S.Si., M.Kes

JML HARGA PROGRA HARGA JML HARGA STOK

Rp - 255.00 Rp - 23,031 0 90,000 750