Belanja UPT Puskesmas Sekeloa

URAIAN DAN SPESIFIKASI KUANTITAS HARGA

NO. JUMLAH HARGA (RP)
PEKERJAAN VOL. 1 Vol box SATUAN SATUAN (Rp)
1 Acyclovir 400 mg 500 Tablet 567.57 283,785.00
2 Ciprofloksasin 500 mg 1000 Tablet 468.47 468,470.00
3 N-Asetil Sistein 200 mg 5000 Kapsul 665.77 3,328,850.00
4 Betahistine 300 Tablet 387.39 116,217.00
5 Natrium Diklofenak 1000 Tablet 198.20 198,200.00
6 Hiosin Butilbromida 100 Tablet 1,225.23 122,523.00
7 Kloramfenikol Tetes Mata 50 Botol 9,009.02 450,451.00
8 Permetrin Krim 50 Tube 28,828.22 1,441,411.00
9 Glibenklamid 5 mg 500 Tablet 324.32 162,160.00
10 Deksametason Injeksi 20 Ampul 3,603.60 72,072.00
11 Loratadin 300 Tablet 324.32 97,296.00
12 Ibuprofen 400 mg 2000 Tablet 324.33 648,660.00
Jumlah Sebelum Pajak 7,390,095.0
PPN 11 % 812,910.0
Total HPS 8,203,005.0
Pembulatan 8,203,005.0

URAIAN DAN SPESIFIKASI KUANTITAS HARGA

NO. JUMLAH HARGA (RP)
PEKERJAAN VOL. 1 Vol box SATUAN SATUAN (Rp)
1 Acyclovir 400 mg 500 Tablet 567.57 283,785.00
2 Ciprofloksasin 500 mg 1000 Tablet 468.47 468,470.00
3 N-Asetil Sistein 200 mg 5000 Kapsul 665.77 3,328,850.00
4 Betahistine 300 Tablet 387.39 116,217.00
5 Natrium Diklofenak 1000 Tablet 198.20 198,200.00
6 Hiosin Butilbromida 100 Tablet 1,225.23 122,523.00
7 Kloramfenikol Tetes Mata 50 Botol 9,009.02 450,451.00
8 Permetrin Krim 50 Tube 28,828.22 1,441,411.00
9 Glibenklamid 5 mg 500 Tablet 324.32 162,160.00
10 Deksametason Injeksi 20 Ampul 3,603.60 72,072.00
11 Loratadin 300 Tablet 324.32 97,296.00
12 Ibuprofen 400 mg 2000 Tablet 324.33 648,660.00
Jumlah Sebelum Pajak 7,390,095.0
PPN 11 % 812,910.0
PPh 22 1,5% 110,852.0
Total HPS 8,203,005.0
Pembulatan 8,203,005.0

URAIAN DAN SPESIFIKASI KUANTITAS HARGA

NO. JUMLAH HARGA (RP)
PEKERJAAN VOL. 1 Vol box SATUAN SATUAN (Rp)
1 Acyclovir 400 mg 500 Tablet 630.00 315,001.35
2 Ciprofloksasin 500 mg 1000 Tablet 520.00 520,001.25
3 N-Asetil Sistein 200 mg 5000 Kapsul 739.00 3,695,023.50
4 Betahistine 300 Tablet 430.00 129,000.87
5 Natrium Diklofenak 1000 Tablet 220.00 220,002.00
6 Hiosin Butilbromida 100 Tablet 1,360.01 136,000.53
7 Kloramfenikol Tetes Mata 50 Botol 10,000.01 500,000.61
8 Permetrin Krim 50 Tube 31,999.32 1,599,966.21
9 Glibenklamid 5 mg 500 Tablet 360.00 179,997.60
10 Deksametason Injeksi 20 Ampul 4,000.00 79,999.92
11 Loratadin 300 Tablet 360.00 107,998.56
12 Ibuprofen 400 mg 2000 Tablet 360.01 720,012.60
Jumlah Sebelum Pajak 8,203,005.0000
8,203,004.5500
 £ 812,910.45

110,851.43

7,279,243.0

520.0017 519.9567
520001.7 0.045

satuan total

62.43 630.00 315,001.35

520,001.70 51.53 520.00 520,001.70
0.45 73.23 739.00 3,695,023.50
520,001.25 42.61 430.00 129,000.87
520.001250 21.80 220.00 220,002.00
134.78 1,360.01 136,000.53
990.99 10,000.01 500,000.61
3,171.10 31,999.32 1,599,966.21
35.68 360.00 179,997.60
396.40 4,000.00 79,999.92
35.68 360.00 107,998.56
35.68 360.01 720,012.60
50,978.35 8,203,005.45
Belanja UPT Puskesmas Sekeloa

URAIAN DAN SPESIFIKASI KUANTITAS HARGA

NO. JUMLAH HARGA (RP)
PEKERJAAN VOL. 1 Vol box SATUAN SATUAN (Rp)
1 Acyclovir 400 mg 500 Tablet 567.57 283,783.78
2 Ciprofloksasin 500 mg 1000 Tablet 468.47 468,468.47
3 N-Asetil Sistein 200 mg 5000 Kapsul 665.77 3,328,828.83
4 Betahistine 300 Tablet 387.39 116,216.22
5 Natrium Diklofenak 1000 Tablet 198.20 198,198.20
6 Hiosin Butilbromida 100 Tablet 1,225.23 122,522.52
7 Kloramfenikol Tetes Mata 50 Botol 9,009.01 450,450.45
8 Permetrin Krim 50 Tube 28,828.83 1,441,441.44
9 Glibenklamid 5 mg 500 Tablet 324.32 162,162.16
10 Deksametason Injeksi 20 Ampul 3,603.60 72,072.07
11 Difenhidramin Injeksi 20 Vial 3,603.60 72,072.07
12 Loratadin 300 Tablet 324.32 97,297.30
Jumlah Sebelum Pajak 6,813,513.51
PPN 11 % 749,486.49
Total HPS 7,563,000.00
Pembulatan 7,563,000.00
Belanja UPT Puskesmas Sekeloa

Belanja Bahan-Bahan Lainnya (BMHP) UPT Puskesmas Sekeloa

URAIAN DAN SPESIFIKASI KUANTITAS HARGA SATUAN
NO. (Rp)
HARGA SATUAN (Rp)
PEKERJAAN VOL. 1 Vol box SATUAN
Belanja Bahan-Bahan Lainnya
SEBELUM PAJAK SESUDAH PAJAK
(BMHP)
procleanser hematoanalizer 6 botol 146,000.0 162,060.0
Plester kertas Hypoallergenic, 1.25 c 50 Roll 25,000.0 27,750.0
betadine 10 Botol 1L 125,000.0 138,750.0
spuit 1 cc @100 buah 2 Box 480,000.0 532,800.0
Blood Lancet @ 200 4 Box 30,000.0 33,300.0
Kassa Steril 80 buah 5,000.0 5,550.0
Strip Cholesterol 19 Tube 334,000.0 370,740.0
Anasthetik Khusus Citoject 1 Kaleng -
Zinc Fosfat Cement (Liquid) 1 Fless -
Zinc Fosfat Cement (Powder) 1 Fless -
Strip asam urat 8 box 150,000.0 166,500.0
pot urine 50 buah 6,000.0 6,660.0
reagen golongan darah 1 set 540,000.0 599,400.0
tabung EDTA @100 2 dus 270,000.0 299,700.0
pp test one med 2 box 145,000.0 160,950.0
verify urine 3 parameter 1 botol 156,000.0 173,160.0
Aquabidest 10 liter 45,000.0 49,950.0
Kantong plastik ziplock kecil 30 pack 4,500.0 4,995.0
bisturi 10 buah 108,500.0 120,435.0
Chlorin 90% 2 kg 107,000.0 118,770.0
kantong plastik ukuran A4 - A5 @100 6 pack 37,000.0 41,070.0
cut gut 10 buah -
silk 10 buah -
infus set anak 2 buah -
infus set dewasa 2 buah -
kresek putih obat 20 pack 18,500.0 20,535.0
Jumlah Sebelum Pajak 3,033,075.0

URAIAN DAN SPESIFIKASI KUANTITAS HARGA SATUAN

NO.
PEKERJAAN VOL. 1 Vol box SATUAN (Rp)
Belanja Bahan-Bahan Lainnya
(BMHP)
1 procleanser hematoanalizer 6 botol 100,000.00
2 Plester kertas Hypoallergenic, 1.25 c 50 Roll 20,400.00
3 betadine 10 Botol 1L 146,500.00
4 spuit 1 cc @100 buah 2 Box 263,800.00
5 Blood Lancet @ 200 4 Box 131,900.00
6 Kassa Steril 80 buah 13,750.00
7 Strip Cholesterol 19 Tube 250,000.00
8 Anasthetik Khusus Citoject 1 Kaleng 1,144,000.00
9 Zinc Fosfat Cement (Liquid) 1 Fless 482,800.00
10 Zinc Fosfat Cement (Powder) 1 Fless 490,200.00
11 Strip asam urat 8 box 90,000.00
12 pot urine 50 buah 4,000.00
13 reagen golongan darah 1 set 300,000.00
14 tabung EDTA @100 2 dus 83,100.00
15 pp test one med 2 box 100,000.00
16 verify urine 3 parameter 1 botol 160,000.00
17 Aquabidest 10 liter 10,000.00
18 Kantong plastik ziplock kecil 30 pack 10,000.00
19 bisturi 10 buah 4,180.00
20 Chlorin 90% 2 kg 80,000.00
21 kantong plastik ukuran A4 - A5 @100 6 pack 30,000.00
22 cut gut 10 buah 16,500.00
23 silk 10 buah 7,700.00
24 infus set anak 2 buah 5,500.00
25 infus set dewasa 2 buah 8,800.00
26 kresek putih obat 20 pack 5,500.00
Jumlah Sebelum Pajak

URAIAN DAN SPESIFIKASI KUANTITAS HARGA SATUAN

NO. (Rp)
JUMLAH HARGA (RP)
PEKERJAAN VOL. 1 Vol box SATUAN
1 procleanser hematoanalizer 6 botol 90,090.09 540,540.54
2 Plester kertas Hypoallergenic, 1.25 c 50 Roll 18,378.38 918,918.92
3 betadine 10 Botol 1L 131,981.98 1,319,819.82
4 spuit 1 cc @100 buah 2 Box 237,657.66 475,315.32
5 Blood Lancet @ 200 4 Box 118,828.83 475,315.32
6 Kassa Steril 80 buah 12,387.39 990,990.99
7 Strip Cholesterol 19 Tube 225,225.23 4,279,279.28
8 Anasthetik Khusus Citoject 1 Kaleng 1,030,630.63 1,030,630.63
9 Zinc Fosfat Cement (Liquid) 1 Fless 434,954.95 434,954.95
10 Zinc Fosfat Cement (Powder) 1 Fless 441,621.62 441,621.62
11 Strip asam urat 8 box 81,081.08 648,648.65
12 pot urine 50 buah 3,603.60 180,180.18
13 reagen golongan darah 1 set 270,270.27 270,270.27
14 tabung EDTA @100 2 dus 74,864.86 149,729.73
15 pp test one med 2 box 90,090.09 180,180.18
16 verify urine 3 parameter 1 botol 144,144.14 144,144.14
17 Aquabidest 10 liter 9,009.01 90,090.09
18 Kantong plastik ziplock kecil 30 pack 9,009.01 270,270.27
19 bisturi 10 buah 3,765.77 37,657.66
20 Chlorin 90% 2 kg 72,072.07 144,144.14
21 kantong plastik ukuran A4 - A5 @100 6 pack 27,027.03 162,162.16
22 cut gut 10 buah 14,864.86 148,648.65
23 silk 10 buah 6,936.94 69,369.37
24 infus set anak 2 buah 4,954.95 9,909.91
25 infus set dewasa 2 buah 7,927.93 15,855.86
26 kresek putih obat 20 pack 4,954.95 99,099.10
Jumlah Sebelum Pajak 13,527,747.75
PPN 11 % 1,488,052.25
Total HPS 15,015,800.00
Pembulatan 15,015,800.00

URAIAN DAN SPESIFIKASI KUANTITAS HARGA SATUAN

NO.
PEKERJAAN VOL. 1 Vol box SATUAN (Rp)
1 Scrub 50 Buah 270,270
Jumlah Sebelum Pajak
PPN 11 %
Total HPS
Pembulatan
 NILAI KUITANSI NILAI DPP
NILAI DPP 100 111 300,000 270,270
PPN 11 100 270,270 29,729.73
PPH 22 1.5 100 270,270 4,054.05
JUMLAH PAJAK 300,000
JUMLAH SETELAH PAJAK
JUMLAH HARGA (RP)

11%
972,360.0 100,000.0 16,060.0
1,387,500.0 20,400.0 2,750.0
1,387,500.0 146,500.0 13,750.0
1,065,600.0 263,800.0 52,800.0
133,200.0 131,900.0 3,300.0
444,000.0 13,750.0 550.0
7,044,060.0 250,000.0 36,740.0
- 1,144,000.0 -
- 482,800.0 -
- 490,200.0 -
1,332,000.0 90,000.0 16,500.0
333,000.0 4,000.0 660.0
599,400.0 300,000.0 59,400.0
599,400.0 83,100.0 29,700.0
321,900.0 100,000.0 15,950.0
173,160.0 160,000.0 17,160.0
499,500.0 10,000.0 4,950.0
149,850.0 10,000.0 495.0
1,204,350.0 4,180.0 11,935.0
237,540.0 80,000.0 11,770.0
246,420.0 30,000.0 4,070.0
- 16,500.0 -
- 7,700.0 -
- 5,500.0 -
- 8,800.0 -
410,700.0 5,500.0 2,035.0
18,541,440.0

JUMLAH HARGA (RP)

SEBELUM PAJAK
600,000.0 90,090.09 540,540.54
1,020,000.0 18,378.38 918,918.92
1,465,000.0 131,981.98 1,319,819.82
527,600.0 237,657.66 475,315.32
527,600.0 118,828.83 475,315.32
1,100,000.0 12,387.39 990,990.99
4,750,000.0 225,225.23 4,279,279.28
1,144,000.0 1,030,630.63 1,030,630.63
482,800.0 434,954.95 434,954.95
490,200.0 441,621.62 441,621.62
720,000.0 81,081.08 648,648.65
200,000.0 3,603.60 180,180.18
 300,000.0 270,270.27 270,270.27
166,200.0 74,864.86 149,729.73
200,000.0 90,090.09 180,180.18
160,000.0 144,144.14 144,144.14
100,000.0 9,009.01 90,090.09
300,000.0 9,009.01 270,270.27
41,800.0 3,765.77 37,657.66
160,000.0 72,072.07 144,144.14
180,000.0 27,027.03 162,162.16
165,000.0 14,864.86 148,648.65
77,000.0 6,936.94 69,369.37
11,000.0 4,954.95 9,909.91
17,600.0 7,927.93 15,855.86
110,000.0 270270.27027 4,954.95 99,099.10
15,015,800.0 - 13,527,747.75
PPN 1,488,052.25
PPH 202,916.22
TOTAL 15,015,800.00

JUMLAH HARGA (RP)

13,513,500.00
13,513,500.00
1,486,485.00
14,999,985.00
14,999,985.00
540540
Belanja UPT Puskesmas Sekeloa

Belanja Bahan-Bahan Lainnya (BMHP) UPT Puskesmas Sekeloa

URAIAN DAN SPESIFIKASI KUANTITAS HARGA SATUAN HARGA SATUAN
NO. (Rp) (Rp)
JUMLAH HARGA (RP)
PEKERJAAN VOL. 1 Vol box SATUAN
Belanja Bahan-Bahan Lainnya
SEBELUM PAJAK SESUDAH PAJAK
(BMHP)
1 Acyclovir 400 mg 500 Tablet 630 315,000.0
2 Ciprofloksasin 500 mg 1000 Tablet 520 520,000.0
3 N-Asetil Sistein 200 mg 5000 Kapsul 739 3,695,000.0
4 Betahistine 300 Tablet 430 129,000.0
5 Natrium Diklofenak 1000 Tablet 220 220,000.0
6 Hiosin Butilbromida 100 Tablet 1,360 136,000.0
7 Kloramfenikol Tetes Mata 50 Botol 10,000 500,000.0
8 Permetrin Krim 50 Tube 32,000 1,600,000.0
9 Glibenklamid 5 mg 500 Tablet 360 180,000.0
10 Deksametason Injeksi 20 Ampul 4,000 80,000.0
11 Difenhidramin Injeksi 20 Vial 4,000 80,000.0
12 Loratadin 300 Tablet 360 108,000.0
Jumlah Sebelum Pajak 54,619.0 7,563,000.0

URAIAN DAN SPESIFIKASI KUANTITAS HARGA SATUAN

NO. JUMLAH HARGA (RP)
PEKERJAAN VOL. 1 Vol box SATUAN (Rp)
1 Acyclovir 400 mg 500 Tablet 567.57 283,783.78
2 Ciprofloksasin 500 mg 1000 Tablet 468.47 468,468.47
3 N-Asetil Sistein 200 mg 5000 Kapsul 665.77 3,328,828.83
4 Betahistine 300 Tablet 387.39 116,216.22
5 Natrium Diklofenak 1000 Tablet 198.20 198,198.20
6 Hiosin Butilbromida 100 Tablet 1,225.23 122,522.52
7 Kloramfenikol Tetes Mata 50 Botol 9,009.01 450,450.45
8 Permetrin Krim 50 Tube 28,828.83 1,441,441.44
9 Glibenklamid 5 mg 500 Tablet 324.32 162,162.16
10 Deksametason Injeksi 20 Ampul 3,603.60 72,072.07
11 Difenhidramin Injeksi 20 Vial 3,603.60 72,072.07
12 Loratadin 300 Tablet 324.32 97,297.30
Jumlah Sebelum Pajak 6,813,513.51
PPN 11 % 749,486.49
PPh 22 1,5% 102,203.00
Total HPS 7,563,000.00
Pembulatan 7,563,000.00
 11%
100,000.0 -
20,400.0 -
146,500.0 -
263,800.0 -
131,900.0 -
13,750.0 -
250,000.0 -
1,144,000.0 -
482,800.0 -
490,200.0 -
90,000.0 -
4,000.0 -

102,202.70
No Nama Obat Satuan Jumlah Keterangan Kategori Harga
1 Acyclovir 400 mg Tablet 500 ACC Dinas Fornas 2021 630
2 Ciprofloksasin 500 mg Tablet 1000 ACC Dinas Fornas 2021 520
3 N-Asetil Sistein 200 mg Kapsul 5000 ACC Dinas Fornas 2021 739
4 Betahistine Tablet 300 ACC Dinas Fornas 2021 430
5 Natrium Diklofenak Tablet 1000 ACC Dinas Fornas 2021 220
6 Hiosin Butilbromida Tablet 100 ACC Dinas Fornas 2021 1,360
7 Kloramfenikol Tetes Mata Botol 50 ACC Dinas Fornas 2021 10,000
8 Permetrin Krim Tube 50 ACC Dinas Fornas 2021 32,000
9 Glibenklamid 5 mg Tablet 500 ACC Dinas Fornas 2021 360
10 Deksametason Injeksi Ampul 20 ACC Dinas Fornas 2021 4,000
11 Difenhidramin Injeksi Vial 20 ACC Dinas Fornas 2021 4,000
12 Loratadin Tablet 300 ACC Dinas Fornas 2021 360
13 Ephineprin inj Ampul 20 ACC Dinas Fornas 2021 4,000
Total Harga
Jumlah
315,000
520,000
3,695,000
129,000
220,000
136,000
500,000
1,600,000
180,000
80,000
80,000
108,000
80,000
7,643,000