.

( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN :
KABUPATEN : LUMAJANG PERMINTAAN BULAN :
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN HARGA

NO Kode Obat NAMA OBAT KEMASAN
STOK AWAL PENERIMAAN PERSEDIAAN SISA STOK NO BATCH SUMBER ANGGARAN
RAWAT INAP RAWAT JALAN JUMLAH SATUAN

UNIT UNIT UNIT UNIT UNIT RP

Acetosal/Acetylsalicylic Acid Tablet 80 mg - - - -
1 A001 (MINIASPI) Tablet DAK 18/Okt.19 99.000
Acetosal/Acetylsalicylic Acid Tablet 80 mg - 129 4 115 119 10
2 A002 (MINIASPI) Tablet 129 DAK 19/Sept.21 105.000
Acetosal/Acetylsalicylic Acid Tablet 80 mg - - - -
3 A003 (MINIASPI) Tablet A00172 DAK 20/ Jan 22 105.000
4 A004 - - - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial 80 - 80 35 35 45 DAK 19/Feb.22 2,860.000
- - - - -
6 A006 Air Untuk Injeksi Vial @25 ml Vial 85L49B,A DAK 20/ 16 - Des 22 2,860.000
7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - - - - DAK 18/Apr.20 10,500.000
8 A008 Alopurinol Tablet 100 mg Tablet 917 - 917 333 333 584 2006-04- DAK 19/Mei 23 104.000
9 A009 Alopurinol Tablet 100 mg - - - - - 106 DAK 20 L 220.000
10 A010 Ambroxol Tablet 30 mg Tablet 961 - 961 107 65 172 789 DAK 19/Juni 21 93.500
11 A011 - - - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule 012390,0124 DAK 17/AGSTS-20 2,998.000
- - - - -
13 A013 - - - - - 10,112099,1
14 A014 Amlodipin Tablet 10 Mg Tablet 751 - 751 14 323 337 414 12089,11240 Dak 19/Okt. 20 93.000
15 A015 Amlodipin Tablet 10 Mg Tablet - - - - - 0 Dak 20/Okt 21 99.000
16 A016 - - - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet - - - - - DAK 17/NOV-21 190.000
18 A018 Amoksisilin Kaplet 500 mg Tablet - - - - - DAK 18/Okt.20 233.000
19 A019 Amoksisilin Kaplet 500 mg Tablet 90 - 90 90 90 - CAMXAOO1 DAK 19/Feb 21 233.000
20 A020 Amoksisilin Kaplet 500 mg Tablet - - - - - 696, B90368 DAK 20/ April 22 249.000
21 A021 - - - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 216 - 216 61 87 148 68 DAK 19/Agst.22 3,025.000
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml - - - - - B00024 DAK 20 L 3,025.000
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - - - 2003-03- DAK 19/JULI 21 4,400.000
25 A025 Amoxiclav
Amoksisilin625 mgKering
Syrup (Amoksisilin
250mg500
/ 5 mg, Clavulanat
ml (Novapharin) Botol - - - - - 193 DAK 20/ Mart 22 3,628.000
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat
125 mg) / CLABAT,CAPSINAT Tablet - - - - - DAK 18L/Mar.20 10,246.500
27 A027 125 mg) / CLABAT,CAPSINAT Tablet - - - - - AC4310B PRBG 20 9,900.000
28 A028 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial 577 - 577 186 186 391 DAK 17/MAR-20 8,500.000
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial - - - - - 26,436,043 DAK 20 / Mei-23 8,237.000
30 A030 - - - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol 87 - 87 7 7 80 DAK 19/Sept. 23 4,950.000
32 A032 - - - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 47 - 47 22 22 44 3 DAK 17/APR-19 440.000
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - - - DAK 18L/Agst.20 220.000
35 A035 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 6014 - 6,014 1,266 3,302 4,568 1,446 DAK 19/Mei 21 165.000
 Antacida tablet kunyah DOEN, kombinasi :
Alumunium Hidroksida 200 mg + Magnesium A0078, PRSpesifik 20 non
36 A036 Hidroksida 200 mg Tablet - - - - - A0054 covid-19/ 58.000
37 A037 - - - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - - - DAK 18/Apr-22 3,035.000
39 A039 Antifungi Doen Salep, Kombinasi : Asam Benzoat - - - - -
40 A040 Antihemoroid Kombinasi
6%+Asam Salisilat : Bismut
3% (Marin ) Suppgalat 150 mg Pot - - - - - DAK 19/ Juni 23 4,496.000
41 A041 Heksaklorofen 2,5 mg Lidokain 10 mg Seng Oksida - - - - -
42 A042 120 mg Supp 570 - 570 50 50 520 Buffer
DAK Prop.20 -
16/APR-20 3,045.000
43 A043 Antihemoroid
Asam Ascorbat Tablet
500 mg (Extrak Graptophili
(Vitamin C) Folium 80% Tablet - - - - - Covid-19 198.000
44 A044 Antihemoroid Tablet) HEMOROGARD
Citrus Bio 20% (Extrak Graptophili Folium 80% Citrus Bio Tablet - - - - - DAK 18L/Jan.21 1,485.000
45 A045 20% ) HEMOROGARD Tablet - - - - - PRSpesifik L 20/ 1,551.000
46 A046 Asam Ascorbat 50 mg (Vitamin C) Tablet 2805 - 2,805 216 1,110 1,326 1,479 DAK 19/Sept.21 105.000
47 A047 Asam Folat 1 mg
Ascorbat 50Beta Caroten 10000
mg (Vitamin C) Multi Mineral/ Tablet - - - - - G90168BI DAK 20/Juni 22 105.000
48 A048 FOLAMIL (Dexa Medica) Tablet - - - - - DAK 17/Jan-21 1,050.000
49 A049 Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - - - DAK 17/AGSTS-20 67.000
50 A050 Asam Folat Tablet 1 mg Tablet - - - - - 20TB016 DAK 20/Feb 22 75.000
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - - - DAK 19/MAR-22 103.000
52 A052 Asam Mefenamat 500 mg - - - - - A93276 DAK 20 L 253.000
53 A053 - - - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 20 - 20 3 7 10 10 DAK 19/Feb.22 2,076.000
55 A055 - - - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 316 - 316 16 48 64 252 DAK 19/Feb.22 1,584.000
57 A057 - - - - -
58 A058 Asiklovir 5% 5gr Cream Tube 150 - 150 - - 150 DAK 18L/Apr.22 2,915.000
59 A059 Asiklovir 5% 5gr Cream Tube - - - - - DAK 19/Juni 22 2,750.000
60 A060 - - - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - - - DAK 18/Mei.22 380.000
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 281 - 281 41 34 75 206 DAK 19/Des.22 380.000
63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - - - DAK 20/Des 23 405.000
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - - - Dak 19/Feb 21 1,639.000
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - - - 96191034ZA DAK 20/31-Okt 21 1,639.000
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet 669 - 669 283 300 583 86 DAK 18/Apr 23 136.000
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet 2000 - 2,000 - - 2,000 TD0071, DAK 20 23
DAK 19/Apr /Nov22, Mart 152.000
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - - - TC0031 23 145.000
69 A069 Betahistin Mesylat 6 mg Tablet 99 - 99 42 42 57 PRSpesifik
DAK 19/Jan 2021 Non 110.000
70 A070 Betahistin Mesylat 6 mg Tube
Tablet@ 10 - - - - - Covid-19/ 110.000
71 A071 Betametason Dipropionat Krim 0,1% Tube @ 10
gram 83 - 83 11 15 26 57 DAK 18/Feb.20 3,350.000
72 A072 Betametason Dipropionat Krim 0,1% gram 108 - 108 11 11 97 DAK 19/Feb.20 3,350.000
73 A073 Betametason Dipropionat Krim 0,1% Tube @ 10 gram - - - - - 110,009 DAK 20/Okt 21 3,350.000
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) Tablet - - - - - DAK 17/JUL-19 300.000
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - - - - 20,030,177 DAK 20/Feb 24 5,900.000
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - - - DAK 19/ 626.000
77 A077 Bricasma Respules
Benzatin Benzil Terbutalin
Penisilin 2,4 jt Cairan IH 2,5 mg/ml - - - - - DAK 20 L 18,150.000
78 A078 Bricasma Respules
(Astra Zeneca ) II Terbutalin Cairan IH 2,5 mg/ml Biji - - - - - DAK 19/Agst. 20 7,602.000
79 A079 (Astra Zeneca ) I Biji - - - - - DAK 19/Apr.20 7,124.000
80 A080 Budesonid Formoterol Inhaler 160/4,5 - - - - -
81 A081 Calcium Plus Vit(Astra
mcg/Symbicort D3 (Coral
Zeneca)calcium 500 mg,Naturan pcs - - - - - DAK 19/Jan 21 149,266.000
82 A082 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 - - - - -
83 A083 MCG,mG 100 mg,Zink 5 mg Boron 1 mg)/ CAL - 95 Tablet - - - - - DAK 19/Mei 24 5,280.000
84 A084 Cefadroksil Kapsul 500 mg Tablet 938 - 938 165 753 918 20 DAK 19/Juni 24 660.000
85 A085 Cefadroksil Kapsul 500 mg Tablet - - - - - KCFDC1181 PRBG 20/ 671.000
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - - - - DAK 17/MAR-19 4,282.000
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 76 - 76 2 - 2 74 DAK 19/Mar.21 11,000.000
88 A088 Curcumin Plus
Citicolin 250 mgCynarin,Sylimarin,Kapsul/
/ 2 ml Inj Ampule - - - - - PRSpesifik L 20/ 10,098.000
89 A089 HEPAGARD (Phapros) Tablet - - - - - DAK 19/Okt.21 2,805.000
90 A090 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 137 - 137 25 25 112 F9M342, DAK
DAK 20/ Des 21, Feb
19/Apr.21 1,097.000
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - - - FOB420 22 1,097.000
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet 3939 - 3,939 47 576 623 3,316 2007-04- DAK 19/Juni 21 60.500
93 A093 Deksamethason Tab 0,5 mg - - - - - 150 DAK 20 L 66.000
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube 6 - 6 - - 6 DAK 18/Nov 19 10,400.000
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - - - DAK 18L/Agst.20 9,900.000
 96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 232 - 232 20 57 77 155 DAK 19/Juni 22 1,095.000
97 A097 - - - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 368 - 368 51 51 317 DAK 17/APR-21 104.000
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - - - DAK 19/Nov.20 104.000
100 A100 Digoksin Tab 0,25 mg Tablet - - - - - DAK 20/ 104.000
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet - - - - - DAK 19/Nov.20 105.000
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet 484 - 484 169 257 426 58 DAK 19/Mar.24 112.000
103 A103 - - - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol 98 - 98 19 17 36 62 200229186;2 DAK 19/JULI21 4,400.000
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - - - 00230186 DAK 20/Feb 22 2,700.000
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet 445 - 445 143 19 162 283 2003-19- DAK 19/Juni 21 165.000
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - - - 149 DAK 20/Mart 23 91.000
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - - - DAK 18/Des 20 1,408.000
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 30 - 30 2 - 2 28 9619KO436 DAK
DAK GD 20 / 30-Aprl
19/Nov.20 1,408.000
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - - - A 21 1,408.000
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - - TO5068AJ2 Buffer Prop 19/Mei 20 730.000
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - - 0 DAK 20/ Mei 21 770.000
113 A113 Ethambutol 250 mg Tablet - - - - - DAK 19/Des.23 391.000
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - - - DAK 17/SEPT-20 4,167.000
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 3 - 3 - - 3 Buffer
DAK Prop.19/
17/AGS-19Feb 3,550.000
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 428 - 428 69 69 359 7805502;364 20
DAK 20 /31-Des 3,682.000
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - - - 78008 21;Jan 22 3,682.000
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet 26 - 26 26 26 - DAK 17/Apr.19 691.000
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 334 - 334 62 62 272 DAK 18/Apr.21 710.000
120 A120 - - - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule 26 - 26 24 2 26 - DAK 18/Des.19 1,333.000
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - - - 4,200,246 DAK Farmasi/Jan-22 1,333.000
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - - - DAK 19/Jan 22 82.000
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - - - F91445B DAK 20/Mei 22 82.000
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - - - DAK 18/Mei 21 4,232.000
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 95 - 95 13 30 43 52 DAK 19/Sept.22 4,232.000
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - - - 0025002 DAK 20/Feb 23 4,232.000
128 A128 Gentamycin Krim 1 % mg/ ml Tube 68 - 68 12 37 49 19 DAK 19/Juni 22 2,750.000
129 A129 Gentian Violet 1% 10 ml Botol - - - - - DAK 20 L 4,400.000
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 134 - 134 1 20 21 113 DAK 17/DES-20 2,900.000
131 A131 Glibenklamid Tablet 5 mg Tablet 5830 - 5,830 37 971 1,008 4,822 19GDI208; DAK 19/Feb 24 119.000
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - - - 20GD1008 DAK 20/ Feb 22 119.000
133 A133 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin SO4400Mg,
mg (Novapharin ) Tablet 6927 - 6,927 572 1,740 2,312 4,615 DAU
DAK PR23BG COVID
19/Mei 77.000
134 A134 MSM
Gliseril200 Mg, VitC75Mg,
Guaikoulat Selenium
Tablet 100 mg 15mg, Zink 5 Tablet - - - - - 20/ Agsts 21 99.000
135 A135 mg, Mn50mcg, Mg Gliserofosfat 10 mg Tablet 541 - 541 181 181 360 DAK 19/Mei 22 7,865.000
136 A136 Glukosa Larutan 40% Steril ( Outsuka ) Botol 10 - 10 1 - 1 9 DAK 19/Mei 21 10,010.000
137 A137 Glukosa Larutan 40% Steril botol - - - - - PRSpesifik L 20/ 10,010.000
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - - - DAK 17/FEB-20 6,900.000
139 A139 Glukosa Larutan Infus 5% @500ml Botol - - - - - DAK 20/ 7,363.000
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - - - APBD II - 15 132.000
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1871 - 1,871 320 320 1,551 2005-08- DAK 16/OKT-21 149.000
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - - - 155 DAK 20 L 88.000
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - - - DAK 18/Agst.21 2,787.000
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 92 - 92 57 57 35 DAK 19/Mei 23 2,475.000
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - - - F90871T DAK 20/ Juni 23
012650,0126 2,475.000
146 A146 Hyoscine N- Butylbromide
Human Tetanus 20 mg
Imunoglobulin InjInj/
250GITAS
UI (Tetagam) Preflied - - - - - DAK 19/Jan 21 176,800.000
147 A147 (Interbat) Ampule 10 60,021510,0 DAK 19/Mei 21 8,800.000
- 10 - - 10
148 A148 - - - - - 12680,09093 DAK 20 L
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo YangFarma )
Menyerahkan, Botol - - - - - 9,011860,12 DAK 19 4,665.000
150 A150 Ibuprofen Susp 200 mg/5KEPALA INSTALASI
ml (Indo FARMASI
Farma ) KABUPATEN Botol - - - - - 2159 DAK 20/ Des 21 4,665.000
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 6418 - 6,418 1,356 4,760 6,116 302 DAK 19/JULI21 264.000
152 A152 Isoniazid
IbuprofenTablet
Tablet100
400mg
mg+ Piridoxin HCl 10 mg Tablet - - - - - 023703 DAK 20 L 330.000
153 A153 (Phapros) Tablet - - - - - DAK 18L/Mar.20 660.000
154 A154 Isoniazid Tablet 100 mg tablet - - - - - B00058B DAK 20 L 187.000
155 A155 Isosorbid Dinitrat Tab Sublingual 5 MUSYAROFAH,
Dra. TRI mg (Yarindo) Apt Tablet 300 - 300 - - 300 DAK 17/MAR-21 90.000
NIP. 19630411 199203 2 005
 Dra. TRI MUSYAROFAH, Apt
156 A156 NIP. 19630411
Isosorbid Dinitrat Tab Sublingual 5 mg 199203 2 005
(Yarindo) Tablet 24 89.000
- 24 - - 24 DAK 18/Jan.22
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - - - DAK 19/Mart.23 121.000
158 A158 - - - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - - - DAK 18/Nov.20 9,644.000
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - - - DAK 18/Jan.21 10,696.000
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 40 - 40 40 - 40 - DAK 19/Jan.22 10,696.000
162 A162 Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium - - - - -
163 A163 (Guardian Pharmatama) Tablet - - - - - DAK 19/Juli 21 770.000
164 A164 - - - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100 - - 100 DAK 18/Mar.21 1,755.000
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 3803 - 3,803 1,462 1,462 2,341 DAK 19/Mei 21 187.000
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - - - A92438, DAK
DAK 20/ Sept 22, Jan
19/ Agst.22 63.000
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - - - A00249 23 63.000
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet 9412 - 9,412 76 2,023 2,099 7,313 DAK 19/Mei 24 94.600
170 A170 Kaptopril Tab 25 mg TAblet - - - - - DAK 20 L 99.000
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube 26 - 26 6 6 20 DAK 19/Mei23 5,610.000
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube - - - - - F90835T DAK 20/ Juni 23 2,518.000
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 400 - 400 - - 400 DAK 19/Juli21 396.000
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - - - DAK 19/Jun 21 288.000
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - - - ### DAK 20/Jan 22 288.000
176 A176 Ketorolak Inj 30 mg/ml Ampule - - - - - DAK 19/Des.20 1,089.000
177 A177 - - - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 137 - 137 8 8 129 DAK 17/SEPT-20 1,810.000
179 A179 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe - - - - -
180 A180 Kloramfenikol Tetes Telinga :Kloramfenicol
Farma) Vial - - - - - DAK 17/FEB-20 10,500.000
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol
10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube 34 - 34 15 15 19 DAK 18L/Mei.20 17,968.500
182 A182 10%,Lidocain,Proplylenglycol / COLME (Interbat) Tube 58 - 58 14 14 44 DAK 19/Mart21 35,200.000
183 A183 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo - - - - -
184 A184 Klorfeniramina
Farmasi ) Maleat (CTM) Tab 4 mg (Imfarmindo Tablet 30 - 30 30 30 - DAK 18/Mei.22 22.000
185 A185 Klorfeniramina
Farmasi ) Maleat (CTM) Tab 4 mg Tablet 8058 - 8,058 534 1,812 2,346 5,712 DAK 19/Mar.22 77.000
186 A186 (Novapharin ) Tablet - - - - - ### DAK 20/Feb 22 23.000
187 A187 Kotrimoksasol Forte / Infantrim
Kolkisin Tab 500Mcg/ ForteLaboratoris
L-Cisin ( Lapi Tab 960 mg ) Tablet - - - - - DAK 17/MEI 20 2,750.000
188 A188 Kotrimoksasol
( Molex Ayus ) Forte / Fasiprim Forte Tab 960 mg Tablet - - - - - DAK 18L/Mei.23 495.000
189 A189 Kotrimoksazol
( Ifars ) Kombinasi Tiap 5ml Suspensi : Tablet 1300 A91390, DAK 19/Juni 23 440.000
- 1,300 198 326 524 776
190 A190 Kotrimoksazol
Sulfametoksazol Kombinasi
Kotrimoksasol Forte 200mg +Tiap
/ Fasiprim 5ml Suspensi
Trimetropin
Forte Tab mg :(mg
40 960 Holi Tablet - - - - - A91181, DAU PR BG 20/ 319.000
191 A191 Krim
Farma Analgesik
Sulfametoksazol
) (setiap
200mggram mengandung
+ Trimetropin : Metyl
40 mg ( Holi Botol - - - - - A91196, DAK 19/JUN 20 2,052.000
192 A192 Krim
Farma Jelly
Salisilat Luka
) 102 mg,Bakar:
EugenolTiap Gram
13,6 mg;Mengandung
Methol 53,4 mg, Botol - - - - - A93137 DAK 20/ Mei 22 2,190.000
193 A193 Krim JellyExtract
Placenta
Vinishing Luka Bakar:
Cream 100 Tiap Gram Mengandung
ad 1mg,Neomycin
gr/ MOLAKRIM Sulfat 5 mg / Tube 17 - 17 5 5 12 DAK 17/JUNI 21 13,970.000
194 A194 Placenta
CENTABIO Extract 100Farma)
(Sanbe mg,Neomycin Sulfat 5 mg / Tube 5 - 5 2 2 3 PRSpesifik
DAK 19/Apr.21 Dokter 22,550.000
195 A195 Lactobasilus
CENTABIO (Sanbe Rhamnosus
Farma) R 11 2M + Laciophillus R- Tube - - - - - AE9548 Muter 20 23,100.000
196 A196 Lactobasilus
52 /Lacidofil, Rhamnosus R 11
Probiotik (Dexa 2M + Laciophillus
Medica, Sanbe) R- Tablet - - - - - DAK 18L/Nov.20 3,811.500
197 A197 52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet 84 - 84 13 13 71 DAK 19/Mei 21 6,600.000
198 A198 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain - - - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain
Comp. Injeksi) Ampule 3 - 3 3 3 - DAK 17/JUN 21 1,937.000
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain
Comp. Injeksi) Ampule 327 - 327 17 101 118 209 26815013; DAK 19/ Feb 21 2,178.000
201 A201 Comp. Injeksi) Ampule - - - - - 26815014 DAK 20/ Mei 21;Mei22 1,222.000
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 294 - 294 20 20 274 DAK 19/Juni 21 99.000
203 A203 Loperamid Tablet 2 mg Tablet - - - - - DAK 20 L 330.000
204 A204 Loratadin Tablet 10 mg Tablet 200 - 200 10 10 190 TLNTA9032 DAK 19/Nov.21 123.000
205 A205 Lutein
Loratadin6mg,Bellberry
Tablet 10 mg: Mirtl Fructus Ext 80mg Kaps Tablet - - - - - 2 DAK 20/Okt 23 131.000
206 A206 Lutein
Suplemen 6mg,Bellberry : Mirtl Fructus
Mata/ OCUGARD Ext 80mg Kaps
(Phapros) Tablet 580 - 580 40 40 540 DAK 18L/Sept.20 4,680.500
207 A207 Suplemen Mata/ OCUGARD (Phapros) Tablet - - - - - DAK 19/Jan 22 4,730.000
208 A208 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - - - DAK 19/ 550.000
209 A209 Metamizol Sodium Inj 500 mg/ml (Santagesik/ - - - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/
Antrain/ Norages) Ampul - - - - - DAK 18L/Apr.20 4,950.000
211 A211 Antrain/ Norages) Tablet 1683 - 1,683 413 13 426 1,257 DAK 19/Apr 21 5,500.000
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) - - - - - HTMFNA018
AC3417 PRSpesifik L 20/ 3,707.000
213 A213 Metformin HCl Tablet 500 mg Tablet 1846 - 1,846 1 339 340 1,506 41;HTMFNA DAK 19/Des.20 96.000
214 A214 Metformin HCl Tablet 500 mg Tablet - - - - - 01840 DAK20/28 Feb22 ; 102.000
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 480 - 480 20 20 460 DAK 19/Agst. 21 143.000
216 A216 - - - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet 473 - 473 48 64 112 361 DAK 17/APR 22 87.000
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - - - DAK 18/Nov.20 80.000
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - - - G71186B DAK 20 / Juni 22 121.000
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet 70 - 70 50 50 20 DAK19/JULI23 192.500
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet - - - - - 2006-02-03 DAK 20 L 275.000
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - - - DAK 19/Nov 20 8,110.000
223 A223 Multi Vit, VitE Infus
Metronidasol 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit Botol
500mg/100ml - - - - - DAK 20/ 8,110.000
224 A224 C 250 mg,
Minyak Zink
Kayu 20 mg,
Putih 60 mlBeta Caroten 10000 IU, Botol 4 - 4 4 4 - DAK 18L/Okt.20 14,318.700
225 A225 Selenium 30 mcg (LICOXY) Kapsul - - - - - DAK 19/Feb 21 5,500.000
226 A226 Multivitamin +B1Pelancar
100,B6 200,B12 500Mcg Inj
Asi (NULACVIT) Tablet 900 - 900 - - 900 DAK 18L/Des.20 2,090.000
227 A227 Multivitamin
(Biocombin) B1 100,B6 200,B12 500Mcg Inj
/ MERSIBION Ampule 8 - 8 8 8 - DAK 17/AGSTS 19 5,000.000
228 A228 (BIOCOMBIN) Ampule 151 - 151 7 52 59 92 PRSpesifik
DAK 19/FEBDokter 21 4,400.000
229 A229 Multivitamin Curcuma
Multivitamin Vitamin/ Syr:L-Lysyin
C 750 mgSuplemen
,Asam Folat+ Mineral / Vitner tablet
(BECEFORT) - - - - - Muter 20 1,265.000
230 A230 Multivitamin Curcuma
200mg,Betacaroten
-Z ( Molex Ayus ) 1000 Syr:L-Lysyin
IU vit B1 3 mg, B12 Tablet - - - - - DAK 17/APR 20 990.000
231 A231 Multivitamin
Curcuminoid Neurotopic
200mg,Betacaroten
2ml / 1000Plus
LYTACUR ATP
IU vit B1Tablet:B1
(Dexa mg, B12100,B6 Botol
3 Medika) 82 - 82 20 40 60 22 PRSpesifik
DAK 19/Apr.21 Dokter 13,200.000
Multivitamin Tab
200,B12 200Mcg,Vit Tambah Darah
E 30mg, ATP : per Tablet
232 A232 Curcuminoid 2ml / LYTACUR (Dexa20mg / Bio ATP Botol
Medika) - - - - - 4300426 Muter 20 13,167.000
233 A233 Mengandung
Multivitamin : Femofomarrat
(Phapros) Neurotopic Tablet300mg Mgso4200,B12 Tablet
: B1 100,B6 2,332.000
- - - - - 012390; DAK 18L/Des.19
234 A234 0,4mg,Cuso4
Multivitamin 0,4 mg,VitTablet
Neurotopic
200 mg/ MOLANEURON C(Molex
100mg: B1 ,Asam
100,B6
Ayus) Folat 2
200,B12 Tablet 1534 - 1,534 249 611 860 674 528.000
Mg,Vit B MOLANEURON
12 15Mcg,Faktor(Molex Intirinsik 25mg / 012410; DAK 18L/Okt.21
235 A235 200 mg/ Ayus) tablet - - - - - MI3CU003 PRSpesifik L 20/ 594.000
236 A236 HEMAFORT ( Phapros ) Tablet 112099; DAK 17/FEB 21 835.000
- - - - -
237 A237 Natrium Diklofenak Tab 50 mg (Phapros ) I Tablet - - - - - 112099; DAK 19/OKT20 115.000
238 A238 Natrium Diklofenak Tab 50 mg (Phapros ) II Tablet 2674 - 2,674 16 588 604 2,070 112089; DAK 19/Des 20 123.000
239 A239 Natrium Diklofenak
Klorida Larutan
Tab 50infus
mg0,9%
(Phapros ) Tablet - - - - - 112400 DAK20/ 123.000
240 A240 Natrium Klorida Larutan
@500ml(Widatra ) infus 0,9% Botol 40 - 40 9 9 31 DAK 17/JUN 21 6,410.000
241 A241 @500ml(Widatra ) Botol - - - - - DAK 18/Feb.22 6,410.000
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 1052 - 1,052 98 82 180 872 PRSpesifik
DAK19/Jan 22 20 Non 132.000
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - - - Covid-19/ Okt 21 3,948.000
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol 19 - 19 5 9 14 5 DAK 18L/Des.20 23,141.800
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 24 - 24 - - 24 DAK 19/Juli 21 19,800.000
246 A246 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 Ml
100.000 Vitetrifolia
IU/G (Phapros Fill) 1 Tablet 75 560.000
- 75 25 25 50 DAK 18/Agst.20
247 A247 Gr,Zingiber Officinalerhiz 0,25Mg,Abrusprecatorius
Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - - - DAK 19/Juli 23 560.000
248 A248 Fol 0,25Vaginal
Nistatin Mg , Phaleria Macrocarpa
Tab 100.000 Fruct 0,20) Mg / Tablet
IU/G (Phapros - - - - - 26,372,008 DAK20/Sep 23 598.000
249 A249 OBH
Obat Plus Syr
Kumur
HERBAKOF : Per Medica
(Dexa 5 ml Megnandung
+Hyaulorinic Acid
) 1% @ 200ml Difenhidramin Botol - - - - - DAK 19/Apr 21 12,100.000
250 A250 12,5mg,Amonium
SANORINE Chlorida 135 mg,Kalium Pcs 3 - 3 3 3 - DAK 19/Mart.21 24,860.000
251 A251 Obat Kumur +Hyaulorinic
Sulfoguaiakolat 30 mg,NaAcid Sitrat1%50@ mg200ml
/ SANADRYL Botol 75 - 75 26 26 49 PRSpesifik
DAK 19/ Agst. 21 Dokter 9,955.000
252 A252 SANORINE Botol - - - - - AE7930 Muter 20 25,597.000
253 A253 Parasetamol Komb Tablet
Omeprazole Kapsul 20 mgAntitusif : Parasetamol Tablet 1157 160.000
- 1,157 329 595 924 233 DAK 16/AGSTS 20
254 A254 500mg,Phenylpropanolamine
Ondansetron HCl Inj 2 mg/ 1mlHCl chlorpheniramine
( Dexa ) Ampule 112 - 112 98 2 100 12 DAK 19/Juli 21 1,070.000
255 A255 Parasetamol
maleate
Ondansetron Komb
HCl InjTablet
,dextromethorpan2 mg/Batuk
Hbr/ Berdahak:Paraset
1ml (ALPARA
Dexa ) ( Molex Ampule - - - - - DAK 20 1,124.000
256 A256 Parasetamol
400Mg,Bromheksin
Ayus ) Komb Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ Tablet 816 - 816 204 606 810 6 DAK 19/Mei 22 715.000
257 A257 Parasetamol
400Mg,Bromheksin
HUSTAB (Phapros)Komb Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ Tablet - - - - - DAK 18L/Jul.20 432.300
258 A258 Parasetamol
400Mg,Bromheksin
HUSTAB (Phapros)Komb Tablet Flu: Parasetamol
80Mg,Difenhidramin HCl 25Mg/ Tablet 2681 - 2,681 118 739 857 1,824 PRSpesifik Dokter
DAK19/ 437.800
259 A259 500Mg,Pseudofedrin
HUSTAB (Phapros) 30Mg, / COLPICA (Tropika Tablet - - - - - Muter 20 418.000
260 A260 Parasetamol Komb Tablet Flu: Parasetamol
Mas) Tablet - - - - - DAK 19/JUNI22 357.500
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 100 30Mg,
mg Tripolidin 2,5 mg / NOZA - - - - - 51D0124 PRSpesifik L 20/ 495.000
262 A262 (Phapros) Tablet - - - - - DAK 18L/Sept.22 789.800
263 A263 Parasetamol Syrup 120 mg/5ml (Mersi Farma) Botol 23 - 23 12 11 23 - DAK 19 1,181.000
264 A264 Parasetamol Syrup 120 mg/5ml Botol - - - - - A93631 DAK 20/ Des 22 1,181.000
265 A265 Parasetamol tablet 500 mg Tablet 1768 - 1,768 575 1,163 1,738 30 DAK 19/Des 20 53.000
266 A266 Parasetamol tablet 500 mg Tablet - - - - - Hibah RSUD Pasirian 56.000
267 A267 Perak Sulfadiazin
Parasetamol tabletKrim
500 1%
mg / Sulfadiazine Silver Tablet - - - - - Buffer Prop 20/ 53.000
268 A268 (Darya Varia L) Tube 10 - 10 1 1 9 DAK 17/JUN 20 20,700.000
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 36 - 36 3 13 16 20 DAK 19/Feb 21 11,825.000
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - - - HI9008 DAK 20/Agust 22 11,825.000
271 A271 Piracetam 800 mg Tablet Tablet 280 - 280 24 - 24 256 DAK19/Apr 21 963.600
272 A272 Parasetamol tablet 500 mg Tablet - - - - - A00198 DAK 20 L 115.500
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule 39 - 39 9 - 9 30 DAK 19/Juli 21 4,400.000
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - - - 19TK019 DAK 20 L 132.000
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 4491 - 4,491 187 578 765 3,726 DAK 19/Sept.21 123.000
276 A276 Probiotik Sachet (Probiokid) - - - - - PRSpesifik L 20/ 6,600.000
277 A277 Polikresulen (Albotyl,Apetil) Botol - - - - - DAK 17/AGSTS 20 41,500.000
278 A278 Prednison Tab 5 mg Tablet - - - - - Buffer Prop 19/Agus.20 68.000
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 5070 - 5,070 792 792 4,278 DAK 19/Jan.21 73.000
280 A280 Pseudofedrin
Prednison Tab60mg,Tripolidin
5 mg 2,5mg (Eflin Tablet - - - - - 1,004,004 DAK 20/ 73.000
281 A281 +Tremenza) Tablet - - - - - DAK 17/JUL 19 1,000.000
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 63 - 63 63 - 63 - DAK 19/Nov 20 1,155.000
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - - - PR BG 20/ 1,188.000
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet - - - - - DAK 19/ 220.000
285 A285 - - - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - - - 50A93A/50A DAK 19/Feb22 9,646.000
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - - - 94A DAK 20/24-Jan-2023 9,646.000
288 A288 Ringer Laktat cairan infus ( OTSUKA)
OTSUKA/ WIDATRA) @ Botol
@ 500 ml RL 1949 - 1,949 1,080 36 1,116 833 DAK 18L/Apr.23 7,150.000
289 A289 Ringer
500 ml Laktat
RL cairan infus ( OTSUKA/ WIDATRA) @ Botol - - - - - DAK 19/Juli 23 7,150.000
290 A290 Salbutamol
500 ml RL SO4 3,01 mg + Ipratonium Brom 0,52 mg Botol - - - - - 400,202 DAK 20/06-Jan-2025 7,630.000
291 A291 Nebulizer (COMBIVENT) I dan II Nebule 284 - 284 41 78 119 165 DAK 19/Jan 21 4,550.000
292 A292 - - - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet 573 - 573 95 298 393 180 DAK 19/Nov.22 70.000
294 A294 Salep 2-4 Kombinasi
Salbutamol Tab 4 mg:(Pristasma)
Asam Salisilat 2%+ Belerang Tablet - - - - - DAK 20 L 165.000
295 A295 Salep
Endap2-4 4%Kombinasi
(Marin ) : Asam Salisilat 2%+ Belerang Pot 109 - 109 1 31 32 77 DAK 18/Juni 22 2,620.000
296 A296 Endap 4% (Marin ) Pot - - - - - 4,005,004 DAK 20/ 2,796.000
297 A297 Salisil Bedak Serbuk 2% (Kimia Farma) Pcs 10 - 10 10 10 - DAK 18/Des.22 6,006.000
298 A298 Salisil Bedak Serbuk 2% Pcs 56 - 56 7 17 24 32 PRSpesifik
DAK 19/Okt.21 Dokter 5,170.000
299 A299 Salisil Bedak Serbuk 2% Pcs - - - - - 91182 Muter 20 2,200.000
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - 1 - - 1 DAK 19/Agst.20 479,996.000
301 A301 Serum Anti Bisa
Tetanus
Ular (A.B.U
A.T.SI )inj
inj(i.m./i.v)
1500 IU/ml im
BIOSAVE Vial - - - - - 4700219 DAK 20/30-Agust-21 512,204.000
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im
BIOSAT Ampul 5 - 5 5 5 - DAK 19/Sept. 20 130,999.000
303 A303 BIOSAT Ampul - - - - - 4201519 DAK 20/30-Nov-21 130,999.000
304 A304 Setirizin Tab 10 mg (Futamed) Tablet 110 - 110 30 30 80 DAK 18/Apr.20 90.000
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - - - - DAK 19/Mei 21 90.000
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 862 - 862 20 154 174 688 DAK 19/Juni 20 110.000
307 A307 Simvastatin Tablet 10 mg Tablet - - - - - DAK 20/ 117.000
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet 2216 - 2,216 146 2,027 2,173 43 DAK 18/Mar.20 265.000
309 A309 - - - - -
310 A310 Tetes mata
Sukralfat setiap
Susp ml mengandung
500mg/5ml @100 mlPolietilen
(Mepro) glikol Botol - - - - - DAK 19/ 6,789.000
311 A311 400 1% gliserin
Sukralfat 0.25% Hidroksipropil
Susp 500mg/5ml metil selulosa
@100 ml (Mepro) Botol - - - - - EOB819 DAK 20/Feb 22 6,789.000
312 A312 0,2% VISINE Botol - - - - - DAK 19/ 13,607.000
313 A313 Tetrasiklin HCl Kapsul 500 mg Tablet - - - - - Retur PKM/ 310.000
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - - - - Buffer Prop 19/Agus.21 86.000
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 4671 - 4,671 122 712 834 3,837 200213158;2 DAK 19/Juli 23 132.000
316 A316 Thiamin/
Vitamin BVitamin
Komplek B1Plus
50 mg (Novapharin
Ekstrak )
Hati (Substansi Hati Tablet - - - - - 00214158 DAK 20/Feb 22 91.000
317 A317 Thiamphenicol
Kering 100 mg, /Vit
Thiamfilex
B1 HCl Kapsul
0,25 mg 500
B2 mg 0,25 mg,
HCl Tablet - - - - - DAK 19/Juli 23 935.000
318 A318 Thiamphenicol/ Thiamfilex
Thiamphenicol Kapsul 500 mg Susp 125 mg/5 ml (Ifars) Tablet - - - - - DAK 20 L 935.000
319 A319 B6 HCl 0,25 mg,Thiamfilex
Thiamphenicol/
(DIONICOL) B12 0,5 mg, Vit.125
Susp C 12,5
mg/5mg,ml (Molex Botol 58 7,150.000
- 58 1 7 8 50 DAK19/Juli 23
320 A320 Calcium
Ayus) Pantetonat 1,5 mg, Nikotinamida 10 mg, Kapsul - - - - - DAK 17/Mei 21 7,150.000
321 A321 Asam
VitaminFolat 0,5 mg, FE (II) Glikonat 7,5 mg, CuSO4
B Komplek Tablet - - - - - DAK 20 89.000
322 A322 0,65 mg) LIVRPON B-PLEX Tablet - - - - - DAK 18L/Sept.20 239.800
OBAT GOLONGAN PSIKOTROPIKA - - - - -
323 A323 Alprazolam 0,5 mg (Mersi Farma) Tablet - - - - - DAK 17/AGST. 18 108.000
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - DAK 17/FEB 21 1,045.000
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - Buffer
Buffer PropProp 20/ /Des
17/Jul.21 967.000
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - 51B0211 22 776.006
327 A327 - - - - -
328 A328 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg - - - - -
329 A329 Diazepam
(Actavis ) Enema 5 mg/2,5 ml Stesolid 5 mg Pcs 1 - 1 - - 1 DAK 18/Feb.20 12,573.000
330 A330 Diazepam
(Actavis ) Enema 5 mg/2,5 ml Stesolid 5 mg Pcs 2 - 2 2 2 - DAK 19/Mar.22 12,573.000
331 A331 (Actavis ) Pcs - - - - - DAK 20/ 12,573.000
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - - - Buffer
Buffer PropProp 20/
19/ Agsts 20 Agsts 1,735.000
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule 4 - 4 4 4 - F8H513 20 1,735.000
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE - - - - - AB31415 DAK 20 L 19,789.000
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet 126 - 126 14 14 112 PRSpesifik
DAK 18L/Mei.20 20 non 396.000
336 A336 Diazepam Tablet 5 mg Tablet - - - - - covid-19/ 114.000
337 A337 Fenobarbital Tablet 30 mg Tablet - - - - - DAK 17/NOV-19 171.000
338 A338 Fenobarbital Tablet 30 mg Tablet - - - - - Buffer Prop 19/ Jun 23 171.000
339 A339 Fenobarbital Tablet 30 mg tablet - - - - - Buffer Prop 20/ 171.000
340 A340 Kodein Tablet 10 mg Tablet - - - - - DAK 16/APR 19 550.000
341 A341 - - - - -
342 A342 Metamizol
Lorazepam500
Tabmg + Diazepam
2 mg 2 mg /
(Mersi Farma) Tablet - - - - - DAK 17/JUN 20 779.000
343 A343 PRONEURON (Meprofarm) Tablet - - - - - DAK 19/Feb. 23 1,320.000
344 A344 - - - - -
345 A345 - - - - -
346 A346 - - - - - Buffer Prop. 20/ Mei
347 A347 Primaquin 15 mg tablet tablet - - - - - 16306002 21 278.300
348 A348 - - - - -
OBAT - OBAT PROGRAM - - - - -
OBAT PROGRAM KECACINGAN - - - - -
349 A349 Albendazol Tablet 400 mg Tablet 266 - 266 - - 266 Buffer Prop 19/Feb 22 404.000
350 A350 Albendazol Tablet 400 mg Tablet - - - - - Buffer Prop 20/nov 21 431.000
OBAT PROGRAM DIARE - - - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - - - - Buffer Prop 18/Jul.23 257.000
352 A352 Garam Oralit (Kimia Farma) Tablet 3369 - 3,369 18 376 394 2,975 Buffer
Buffer PropProp 20/
19 Juli 23 April 257.000
353 A353 Garam Oralit (Kimia Farma) sachet - - - - - 24 274.000
354 A354 Garam Oralit (Kimia Farma) sachet - - - - - DAK 19/Agst.22 274.000
355 A355 Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ - - - - -
356 A356 Zinc Sulphate
Combined Sirup 10 mg/ml (Zincpro Sirup/
imperial) Botol 95 - 95 17 17 78 DAK 19 /Nov 20 6,281.000
357 A357 Combiphar) Botol - - - - - DAK 18L/Sept.20 9,900.000
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - - - - Buff Prop 19 /Mei 20 524.000
359 A359 Zinc Dispersible 20 mg tablet tablet - - - - - Buff Prop 20/ Sept.22 524.000
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - - - 26496034; DAK 18/Mart 20 524.000
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 5340 - 5,340 85 677 762 4,578 26496040; DAK
DAK 20/Mei
19/Jan 21 21;Agust 524.000
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - - - 26496056 22 524.000
363 A363 - - - - - H2MAD0005
Hepatitis B Imunoglobulin
OBAT PROGRAM inj 220 IU/ml (Hb Ig)
HEPATITIS - - - - -
Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) 3,
364 A364 (Hyperhep) Pcs - - - - - DAK 19/Agus.20 ###
365 A365 Hepatitis
(Hyperhep)B Imunoglobulin inj 220 IU/ml (Hb Ig) Pcs H2MADOOO Buffer Prop 19/ Agsts. 19 ###
- - - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig)
(Hyperhep) Pcs 1 1 - - 1 23, Hibah Jember
H2MAD0005 ###
367 A367 Hepatitis
(Hyperhep)B Imunoglobulin inj 220 IU/ml (Hb Ig) Pcs - - - - - H2MADOOO DAK 20/Maret
3 Buffer Prop 20/ ###
368 A368 (Hyperhep) Pcs - - - - - 93 22,SEP 21 ###
OBAT PROGRAM TB PARU - - - - -
369 A369 OAT FDC Kategori Anak Kit - - - - - Buffer Prop19/Juni 20 232,518.000
370 A370 OAT FDC Kategori Anak Kit - - - - - Buffer
Buffer PropProp 20/
19/Jun 21 Mei 248,120.000
371 A371 OAT FDC Kategori Anak Kit - - - - - 26480019 21 248,120.000
372 A372 OAT FDC Kategori I - IIII Kit - - - - - Buffer
Buffer PropProp 20/ Agsts
19/Juli21 389,344.000
373 A373 OAT FDC Kategori I - IIII Kit - - - - - 22 415,469.000
374 A374 OAT FDC Kategori II Kit - - - - - DAU/ DAK 19/Juni 22 ###
375 A375 OAT FDC Kategori II Kit - - - - - Buffer
Buffer PropProp 20/
19/Jan 22 Agsts ###
376 A376 OAT FDC Kategori II Kit - - - - - 22 ###
377 A377 OAT FDC Kombipak Kategori I Kit - - - - - BUFF. PROP19/Agst 22 317,018.000
378 A378 - - - - - Buffer Prop 20/ Juni
379 A379 Isoniazid 100 mg tablet tablet - - - - - A904236 22 282.000
OBAT POGRAM KUSTA - - - - -
380 A380 MDT MB Anak Blister - - - - - Buffer
Buffer PropProp
19/Juni 20/Juni
21 28,354.000
381 A381 MDT MB Anak Blister - - - - - BHR9581 21 28,354.000
382 A382 MDT MB Dewasa Blister - - - - - Buffer Prop 19/ Okt.21 40,913.489
383 A383 MDT MB Dewasa Blister - - - - - Buffer
Buffer PropProp 20/
19/ Okt.21 41,784.000
384 A384 MDT MB Dewasa Blister - - - - - BH29323 Okt.21 41,784.000
385 A385 MDT PB Anak Blister - - - - - Buffer Prop 17/Mei 19 8,891.000
386 A386 MDT PB Anak Blister - - - - - Buffer
Buffer PropProp Nov20/
18/Agst.20 13,300.000
387 A387 MDT PB Anak Blister - - - - - Buffer Prop 20/ Nov
22 11,738.000
388 A388 MDT MB Dewasa Blister - - - - - 22 36,579.000
 Buffer Prop 20/ Nov
389 A389 MDT PB Dewasa Blister - - - - - 22 15,014.000
OBAT PROGRAM GIZI - - - - -
390 A390 Mineral Mix Kombinasi sachet - - - - - Buffer Prop 19/Sept 20 2,920.000
391 A391 Mineral Mix Kombinasi sachet - - - - - Buffer Prop 20/ 2,920.000
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - - - F81659W DAK 19/Agust.21 517.000
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 3,350 3,350 - - 3,350 DAK 20
D90543W Buffer Penugasan/
Prop 20/Apr.22 517.000
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) - - - - - Jan 23 552.000
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul 350 350 - - 350 K73129W/ PRSpesifik
J72852W Buffer Prop 18/Okt.2020 Non 284.000
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - - - - - G71672W Covid-19/ Okt 21 307.000
A397 Tablet
RetinolTambah DarahIU
Vit A 100.000 /Komb
(Biru)Ferro Fumarat 60 Mg Kapsul - - - - - DAU Penugasan 20 307.000
398 A398 Tablet Tambah
+As.Folat 0,4 MgDarah /Komb Ferro Fumarat 60 Tablet
Tab (Phapros) 2090 53,000 55,090 90 2,000 2,090 53,000 Buffer
Buffer PropProp 20/Agst
19/Juli 20 354.000
399 A399 Tablet Tambah
Mg +As.Folat Darah
0,4 /Komb
Mg Tab Ferro Fumarat 60 Tablet
(Phapros) - - - - - H90282BB 21 354.000
400 A400 Mg +As.Folat 0,4 Mg Tab (Phapros) tablet - - - - - DAK Penugasan 354.000
401 A401 - - - - -
402 A402 - - - - -
OBAT PROGRAM KESGA - - - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule - - - - - Buffer Prop 18/Agst.20 9,955.000
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 3 - 3 1 1 2 DAK 19/Mar 20 3,796.000
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - - - 78J49A DAK GD 20/09-Okt/21 3,796.000
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - - - 9619K0384A DAK GD 20/09-Okt/21 10,351.000
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 52 - 52 33 33 19 DAK 19/ Des 20 2,959.000
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - - - Buffer Prop 19/Jul.19 2,684.000
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - - - 961910329A Buffer
DAK 20 Propinsi 20
/30-Sept-21 2,959.000
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - - - - G81999W /Juli 21 2,500.000
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 760 - 760 130 130 630 DAK 18/Apr.22 210.000
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule 65 - 65 10 10 55 9619KO418 Buffer Prop.19/Sept.19 1,900.000
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - - - A DAK
DAKGD 20 /20/
31 31-Okt
-Okt 22 1,199.000
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - - - 9620G0207 21
96191034ZA 1,639.000
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - - - A PR BG 20/ Juli 23 1,199.000
OBAT PROGRAM JIWA - - - - -
416 A416 Amitriptilin 25 mg Tablet - - - - - DAK 18/Apr.21 167.000
417 A417 Amitriptilin 25 mg Tablet - - - - - Buffer Prop 18/Mei 21 167.000
418 A418 Amitriptilin 25 mg Tablet - - - - - Buffer
DAK 19/ JanProp
Feb.
23 20/ 167.000
419 A419 Amitriptilin 25 mg Tablet 175 - 175 - - 175 19AI1002 23 167.000
420 A420 Amitriptilin 25 mg Tablet - - - - - 2GAT1002 DAK 20/ 167.000
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - - - - PRSpesifik
DAK 19 20 non 1,121.000
422 A422 Clozapine 100 mg Tablet - - - - - covid-19/ 3,288.000
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - DAK 20/ 1,200.000
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - DAK 17/NOV 20 1,750.000
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - Hibah Penyedia/NOV 20 1,750.000
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - - - Buffer
DAK Prop
19/ Juni 21 20/ 183.000
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - - - Buffer Prop. 20/
Agst.22 63,986.000
428 A428 Flufenazin sikzonoate inj 5 ml vial - - - - - 9EAO5251 agst.22 63,813.000
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - - - - DAK 17/JUN 20 57,500.000
430 A430 Haloperidol 5 mg tablet Tablet - - - - - Buffer
DAK 19/AprProp.
22 20/ 60.000
431 A431 Haloperidol 5 mg tablet Tablet 400 - 400 - - 400 A92470 Agst.22 60.000
432 A432 Haloperidol 5 mg tablet Tablet - - - - - DAK 20/ 60.000
433 A433 - - - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - - - - Buffer Prop 19 5,000.000
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - - - DAK 20 L 13,200.000
436 A436 Haloperidol/ Lodomer drops 2 mg Botol - - - - - DAK 19/Jan 22 19,955.000
437 A437 Karbamazepin Tablet 200 mg Tablet - - - - - A93050, DAK
DAK 20/22Nov 22, Des
19/Juni 245.000
438 A438 Karbamazepin Tablet 200 mg Tablet - - - - - A93254 22 245.000
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - - - Buffer Prop 19/ Feb 21 1,243.000
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - - - 16329001-1 DAK 20/ 1,326.000
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet 377 - 377 298 298 79 Buffer
DAK Prop
19/Sept. 22 20/ Sept. 158.000
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - - - 92514 22 157.000
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - - - DAK 20 L 253.000
444 A444 - - - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - - - DAK 19/ 287.000
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - - - Buffer Prop 19/ Apr 22 287.000
447 A447 Risperidon Tab 2 mg Tablet 340 - 340 340 340 - 50H0259 Buffer Prop 20/ Juli 22 287.000
448 A448 Risperidon Tab 2 mg Tablet - - - - - DAK 20/ 287.000
449 A449 - - - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - - - DAK 19/Juni 23 287.000
451 A451 - - - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - - - - Buffer
Buffer PropProp
19/ Mei20/
22 Juni 91.000
453 A453 Triheksifenidil Tablet 2 mg Tablet 725 - 725 345 345 380 A91464 22 91.000
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - - - DAK 20 L 440.000
455 A455 - - - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - - - 9EA06323 PR BG 20/ Nov.22 63,986.000
457 A457 - - - - -
PROGRAM IMUNISASI (VAKSIN) - - - - -
458 A458 BCG vial 10 10 - - 10 Buffer Prop/ Jan 21 56,360.000
459 A459 PELARUT BCG ampul 10 10 - - 10 Buffer Prop/ Juli 22 0.000
460 A460 BCG vial - - - - - Buffer Prop/ Juli 21 60,140.000
461 A461 BCG vial - - - - - Buffer Prop/ Sept.21 66,154.000
462 A462 CAMPAK 10ds (MR) vial 50 50 - - 50 Buffer Prop/ Mar.20 141,648.000
463 A463 PELARUT CAMPAK ampul 50 50 - - 50 Buffer Prop/ Mar.23 0.000
464 A464 CAMPAK 10ds (MR) vial - - - - - Buffer Prop/ Jul.23 151,150.000
465 A465 CAMPAK 10ds (MR) vial - - - - - Buffer Prop/ Agust.21 166,265.000
466 A466 DPT HB - Hib/ PENTABIO vial 80 80 - - 80 Buffer Prop/ Juli 20 76,620.000
467 A467 DPT HB - Hib/ PENTABIO vial - - - - - Buffer Prop/ Des 20 84,282.000
468 A468 DT vial - - - - - Buffer Prop/ Apr. 22 17,450.000
469 A469 - - - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 50 50 - - 50 Buffer Prop/ Mar.21 23,270.000
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - - - Buffer Prop/ Agust 21 25,597.000
472 A472 POLIO bOPV 10 ds vial 50 50 - - 50 Buffer Prop/Juli 21 18,140.000
473 A473 DROPPER POLIO dropper 50 50 - - 50 Buffer
Buffer Prop
Prop/20/Agust- 0.000
474 A474 POLIO bOPV 10 ds vial - - - - - Buffer Prop 20/Sept-
21 19,470.270
475 A475 POLIO bOPV 10 ds vial - - - - - 21 19,954.000
476 A476 Td vial - - - - - Buffer Prop/ Mei.21 15,450.000
477 A477 - - - - - Buffer Prop 20/ Sep.
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - - - Buffer Prop 20/ Oct.
21 21,810.000
479 A479 POLIO bOPV 10 ds vial - - - - - 21 19,350.000
480 A480 Vaksin Meningtis vial - - - - - Buffer Prop 20/ Agust 135,000.000
481 A481 CAMPAK 10ds (MR) BIAS vial - - - - - Buffer Prop 20/ Okt
21 151,150.000
482 A482 PELARUT CAMPAK BIAS ampul - - - - - Buffer Prop 20/
23 0.000
483 A483 POLIO bOPV 10 ds vial - - - - - Buffer Prop 20/
Okt.21 21,285.000
484 A484 IPV vial - - - - - Buffer Prop.20 -
Nov.21 144,540.000
485 A485 VTM Include Dacron (Biofarma) pcs - - - - - V- 0800420 Buffer Prop.20/ April
Covid-19 50,000.000
486 A486 Vaksin Rabies (Verorab) vial - - - - - 21 165,000.000
487 A487 - - - - -
488 A488 - - - - -
489 A489 - - - - -
OBAT PROGRAM HIV/ AIDS - - - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - - - Buffer Prop. 19/ 34,354.100
491 A491 - - - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 300 - 300 - - 300 Buffer Prop 19/Sept. 20 164.000
493 A493 - - - - -
494 A494 Lamivudine 150 mg Tablet - - - - - Buffer
Buffer PropProp
19/Agst.20 90,000.000
495 A495 Lamivudine 150 mg Tablet - - - - - 20/Agust.20 90,000.000
496 A496 Nevirapine 200 mg Tablet - - - - - Buffer
Buffer PropProp
19/Mei 20/
23 Nov 183,480.000
497 A497 Nevirapine 200 mg Tablet - - - - - 22 176,400.000
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - - - Buffer Prop 19/Nov.20 77.000
499 A499 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple - - - - -
500 A500 Tenofovir 300
FDC) Triple +Lamivudin
FDC Dewasa 300+ Efaviren 600 (Triple Tablet - - - - - Buffer
Buffer PropProp 20/ Jan
19/Jan 21 79,154.000
501 A501 FDC) Triple FDC Dewasa Tablet - - - - - 21 79,154.000
502 A502 Tenofovir 300 mg Tablet - - - - - Buffer
Buffer PropProp
19/Feb 20/Juni
20 303,750.000
503 A503 Tenofovir 300 mg Tablet - - - - - 21 252,720.000
504 A504 Zidofudine 100 mg (ZDV) Tablet - - - - - Buffer Prop 19/Juli 21 106,080.000
505 A505 Zidofudine 100 mg (ZDV) Tablet - - - - - Buffer Prop 20/ 106,080.000
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - Buffer
Buffer PropProp
19/Nov20/20 Mei 222,000.000
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - Hibah Sidoarjo/ Apr
22 222,000.000
508 A508 Efavirenz 600 mg tablet tablet - - - - - Buffer Prop 20/ juni
20 198,900.000
509 A509 Efavirenz 600 mg tablet tablet - - - - - Buffer Prop 20/ April
20 198,900.000
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - Buffer Prop 20/ Des
21 230,880.000
511 A511 Tenofovir 300 +Lamivudin
Abacavir (ABC) 300mg 300+ Efaviren 600 (Triple Tablet - - - - - Buffer Prop 20/ Agust
21 133,137.000
512 A512 FDC) Triple FDC Dewasa Tablet - - - - - 21 84,050.000
513 A513 - - - - - Buffer Prop 20/ Nov.
514 A514 MB Anak blister - - - - - 22 22,794.000
515 A515 - - - - -
516 A516 - - - - -
517 A517 - - - - -
518 A518 - - - - -
519 A519 - - - - -
520 A520 - - - - -
521 A521 - - - - -
522 A522 - - - - -
523 A523 - - - - -
524 A524 - - - - -
525 A525 - - - - -
526 A526 - - - - -
527 A527 - - - - -
528 A528 - - - - -
529 A529 - - - - -
Alat
BMHP Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx - - - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx Pcs
1/2 (Nipro) - - - - - DAK 17/AGST 21 990.000
531 A531 1/2 (Nipro) Pcs 444 - 444 33 147 180 264 DAK 19/AGST 23 1,023.000
532 A532 - - - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 1347 - 1,347 124 769 893 454 DAK 19/Okt 23 924.000
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - - - - - 19lL0605J; DAK
PR19/Agst.
Spesifik
23 20 non 1,138.000
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - - - 20CO505J covid-19/1 Okt 24 924.000
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - - - DAU
DAK ID22NON COVID-
18/Mei 979.000
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - - - 10,112,019 19/1 Okt 24 739.200
538 A538 Catgut Chromic
Alat Suntik 3/0
Sekali 75C 10
Pakai + Jarum1/2 22M Demetech
ml (NIPRO) Pcs - - - - - DAU
DAK ID 20 non covid-
19/Feb24 1,463.000
539 A539 I Box@12pcs - - - - - 19 32,522.000
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs 6 - 6 - - 6 DAK 18/Nov.21 2,541.000
541 A541 Alkohol 70% Medika (Kimia Farma) - - - - - BTT ke 2 20 23,951.000
542 A542 Alkohol 70% (Medika) Btl 1000 ml 16 - 16 1 5 6 10 DAK 19/Jan.23 19,885.446
543 A543 Alkohol Swab 2 - ply (one med) - - - - - DAU ID 20 - Covid-19 120.000
544 A544 Alkohol Swab 2 - ply (one med) Pcs 400 - 400 400 400 - DAK 19/ Jan 24 127.260
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - - - - - DAK 19/Mar.24 212,784.000
546 A546 Cat GutSorb
Askina Chromic Demetech
10X 10 3/0 75c+
Cm (B-Braun ) jarum 1/2 22 M Pcs - - - - - DAK 17/DES 21 70,000.000
547 A547 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech
II Pcs - - - - - DAK 19/Juli 24 22,725.000
548 A548 C
I atgut Chromic 3/0 75C + Jarum1/2 22M Demetech Pcs 109 - 109 5 22 27 82 DAU
DAK ID 2320 non covid-
19/Juni 22,500.000
549 A549 Cat
I Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M - - - - - 19 32,522.000
550 A550 Cat Gut Plain/ Phsda
(Demetech) No. 3.0 70 C+ Jarum 1/2 25 M Pcs - - - - - DAU
DAK 19 ID 20 non covid- 24,583.333
551 A551 Dual Enzymatic
(Demetech) Detergen Galon 5 liter
/ Phsda - - - - - 19 34,300.000
552 A552 (STERYZIME) Pcs - - - - - DAK 19/Jan 22 712,800.000
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs 9 - 9 - - 9 DAK 18L/Jul.23 348,480.000
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 300 - 300 - - 300 DAK 18/Sept.20 2,222.000
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - - - DAK 19/ Sept. 20 1,540.000
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - - - - DAK 18/Mar.22 37,440.000
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 46 - 46 3 1 4 42 DAK 19/Agst.22 13,050.000
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs - - - - - DAU ID 20 - Covid-19 9,680.000
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - - - DAK 18 20,970.000
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs - - - - - DAK 19/sept.23 13,607.000
561 A561 Mantel Gown (Bisa Dicuci) biji - - - - - PR BG 20 Covid-19 180,000.000
562 A562 I.V Catheter No. 18 (JELCO) Pcs 129 - 129 20 13 33 96 DAK 18/Jul.22 8,900.000
 PRSpesifik 20 non
563 A563 I.V Catheter No. 18 (NIPRO) Pcs - - - - - 20A2705J covid-19/ Des 24 5,500.000
564 A564 I.V Catheter No. 20 JELCO Pcs - - - - - DAK 18/Okt.21 8,900.000
565 A565 I.V Catheter No. 20 TERUMO Pcs 147 - 147 50 4 54 93 3907416;390 DAU
DAK ID 20
19/Okt.21 non covid- 6,270.000
566 A566 I.V Catheter No. 20 JELCO Pcs - - - - - 3768 19 8,700.000
567 A567 I.V Catheter No. 22 NIPRO Pcs 156 - 156 50 9 59 97 PRSpesifik
DAK 19/Agst. 23 20 non 5,500.000
568 A568 I.V Catheter No. 22 NIPRO Pcs - - - - - 20A3006J covid-19/ Des 24 5,500.000
569 A569 I.V Catheter No. 24 TERUMO Pcs 135 - 135 39 - 39 96 DAK 19/Okt.21 6,270.000
570 A570 I.V Catheter No. 24 TERUMO - - - - - DAU ID Non Covid 6,270.000
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs 112 - 112 63 8 71 41 DAK 20/Juni
DAK 16/JUL 21 22 7,920.000
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - - - - 8,400.000
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 203 - 203 108 68 176 27 DAK 20/Agst.22
DAK 19/Jan 24 6,199.900
574 A574 Kantong Plastik
Infusion Set Bio Hazart
Dewasa (Bahan
20 Drops/ Plastik PE,
(OTSUKA) Pcs - - - - - 8,400.000
575 A575 Panjang 80 Cm, Lebar 60 Cm, Tebal 0,33 Mm) Pcs - - - - - DAK 18L 1,760.000
576 A576 Kapas Pembalut Hydrofil 250 gr Pcs 1 - 1 1 1 - DAK 18 13,400.000
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 14 - 14 6 6 8 DAK 19 13,400.000
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) - - - - - DAU ID 20 - Covid-19 12,500.000
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs 7 - 7 2 2 5 DAK 18/Nov.21 2,300.000
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 3 - 3 1 1 2 DAK 19/Okt.22 136,500.000
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) - - - - - DAU ID 20 Non Covid 136,500.000
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs 9 - 9 9 9 - DAK 18/Okt.22 8,000.000
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 68 - 68 42 42 26 DAK 19/Sept.21 5,950.000
584 A584 Kasa Hidrofil
Pembalut Hidrofil
Steril 16 cmDRC
X 163mcmX(One
15 cm (HM
Med) - - - - - DAU ID 20 - Covid-19 8,000.000
585 A585 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya
HUSADA) Pcs 222 - 222 38 38 184 DAK 18 1,430.000
586 A586 Husada) Pcs - - - - - DAK 19/Feb 22 2,240.000
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) - - - - - DAU ID 20 - Covid-19 2,100.000
588 A588 Masker Ear Loop (Masker) Pcs 602 - 602 150 145 295 307 DAK 19/Sept 23 427.850
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - - - Dak 19/Sept 20 390.860
590 A590 Masker General Care (MARCOTILA) Pcs - - - - - BTT 20 Covid-19 2,060.000
591 A591 - - - - -
592 A592 Masker N95 Disposibel Pcs 35 - 35 - - 35 APBD II-14/Sep-19 17,500.000
593 A593 Masker N95 Disposibel (One Med) Pcs - - - - - DAK 18/Okt.22 6,512.000
594 A594 Masker Tali Pcs - - - - - Buffer Prop. 19 339.900
595 A595 Masker Tali Pcs - - - - - DAU
Buffer20 PR 20
Prop. 339.900
596 A596 Masker Elastic Pcs - - - - - MKNWOD13 Spesifik/Des 25 2,200.000
597 A597 Nebulizer Aerosol
Media Sample with Mask dan Tubing Adult
Container Pcs - - - - - DAK 19 2,309.375
598 A598 Nebulizer Aerosol with Mask dan Tubing Child
(Remedi) Pcs - - - - - DAK 18/Agst.22 10,857.000
599 A599 (Remedi) Pcs - - - - - DAK 18/Nov.21 10,856.250
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - - - - DAK 19/Nov 22 65,340.000
601 A601 Nurse Cup (Tutup Kepala) Pcs 90 - 90 - - 90 DAK 16 333.900
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - - - DAK 16/MEI 21 11,615.000
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - - - DAK 16/MEI 21 6,600.000
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - - - - DAK 18/Jan. 23 154.000
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 26 - 26 1 3 4 22 DAU
DAK 20 ID
19/Jan.22 NON 7,700.000
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - - - - 2,003,208 COVID-19/ Mart 23 7,769.000
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs - - - - - DAU
DAK ID2220 NON
19/Jan 18,000.000
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) - - - - - 93117409 COVID-19 12,675.000
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs 14 - 14 7 7 7 DAK 19/Feb 22 3,700.000
610 A610 - - - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - - - DAK 17/SEPT 19 286,000.000
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - - - DAK 19/Okt 20 726.953
613 A613 - - - - - 214094814L
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair 500 - 500 500 - 500 - PZA;214088 DAK
DAU 2023(ID) NON
19/Juli 542.520
615 A615 Sarung Tangan Non
SterilSteril
Gynecolog No 7M(ONE
No S Dan MED)
(Win Glove) Pair - - - - - 241LPZA COVID-19/Jan 25 496.650
616 A616 (Pasang) Pair 33 203089694 DAK
DAU ID 20 non covid- 19,360.000
- 33 19 19 14 19/Jan.24
617 A617 Sarung Tangan size
SterilMNo
dan7 Dan 7,5 (Medic
L (Exam Glove)dent) PAir - - - - - SPZA; 19 470.530
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove)
(Pasang) Pair 600 - 600 - - 600 203089694 DAK
DAU 2023(ID) NON
19/Nov 3,773.000
619 A619 (Pasang) Pair - - - - - SPZA COVID-19/ Nov 24 4,134.900
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 72 - 72 10 16 26 46 DAK 19/Mar 23 20,586.000
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - - - DAK 19/Nov 23 15,150.000
622 A622 - - - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - - - DAK 19/ Sept. 21 87,120.000
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - - - - DAK 19/Des 21 752,400.000
625 A625 Underpad 90x 0 cm cosmo I Pcs - - - - - DAK 19 8,295.000
626 A626 Underpad 90x 0 cm cosmo II Pcs - - - - - DAK 19 8,031.579
627 A627 - - - - -
628 A628 Urine Bag Sterile Standard Pcs 21 - 21 1 - 1 20 DAK 19/Jan 24 5,368.000
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs - - - - - DAK 19/Juli 23 5,785.000
630 A630 - - - - - UCC DAU ID 20 NON
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - - - 190451AX COVID-19/ April 24 2,887.500
Accu - Check Performa Blood Glukose Meter Test
REAGEN - - - - -
632 A632 (ROCHE) Pcs - - - - - DAK 17 453,802.994
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - - - DAK 19/Mei.20 4,200.000
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 1000 - 1,000 - - 1,000 DAU
DAK ID 20
19/Nov.22 - Covid- 635.250
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - - - 478,664 19/ Juni 21 4,000.000
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - - - - DAK 19 59,000.000
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - - - DAK 19/Des 20 45,000.000
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - - - - DAK 19/Nov 20 45,000.000
639 A639 - - - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - - - DAK 19/Juli 20 546,400.000
641 A641 Cholesterol Test Strip (Human Humasens Plus) - - - - - DAU ID 20 Non Covid 544,150.000
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - - - DAK 19 0.000
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - - - DAK 19 223,949.367
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - - - - DAK 19/Sept 20 254,300.000
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - - - - DAK 19/Juni 21 252,800.000
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs - - - - - DAK 19/ Jan 21 401,666.666
647 A647 Hemoglobin Strip 50 test mission (Acon) - - - - - DAU ID 20 - Covid-19 405,000.000
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - - - DAK 17/APR 22 10,560.000
649 A649 - - - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - - - - DAK 19/Nov 20 10,837.000
651 A651 - - - - -
652 A652 TPHA (Fokus) Test - - - - - DAK 19/Mar21 19,225.000
653 A653 - - - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - - - DAK 19/Mei 20 552,800.000
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) - - - - - DAU ID 20 Non Covid 552,800.000
BMHP (PROGRAM) PROPINSI - - - - -
PROGRAM MALARIA - - - - -
656 A656 RDT Malaria Test - - - - - Buffer Prop.19/Mei 21 16,400.000
PROGRAM SYPHILIS - - - - -
657 A657 RPR Syphilis Pcs - - - - - Buffer Prop 18/Jul.20 4,120.000
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - - - - Buffer Prop 18/Jul.21 4,120.000
659 A659 Syphilis 3.0 06FK10 SD Bioline Test - - - - - DAK 20/Okt 21 15,500.000
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS)
Test - - - - - Buffer Prop 19/ Juni 21 9,738.000
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - 0 - - Buffer Prop 19/ Juli 21 9,611.000
662 A662 - - - - -
663 A663 Tuberkulin Vial - - - - - Buffer Prop 20/
18 Apr 625,900.000
664 A664 RDT Lepto (Uji Leptospira IgM) test - - - - - Buffer Prop 20/ Apr
300,119 21 22,176.000
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarahtest - - - - - 21 66,876.000
666 A666 - - - - -
667 A667 - - - - -
Rapid
PROGRAM Test Anti Hepatitis C (HCV)
HEPATITIS - - - - -
668 A668 Test - - - - - Buffer Prop 19/Sept. 20 13,252.000
669 A669 Reagen HBsAg Strip SD Test - - - - - Buffer Prop 19/Mar 21 10,865.800
670 A670 Reagen HBsAg Strip SD Test - - - - - Buffer Prop 20/ Maret 8,053.000
671 A671 Reagen HBsAg Strip SD Test - - - - - C20019 22 8,110.000
672 A672 - - - - -
673 A673 - - - - -
674 A674 - - - - -
675 A675 - - - - -
PROGRAM TB PARU - - - - -
676 A676 Box Slide Pcs - - - - - Buffer Prop 17 36,000.000
677 A677 Box Slide Pcs - - - - - Buffer Prop 19 77,690.000
678 A678 Catridge Genexpart Test - - - - - Buffer
Buffer Prop.20/ Okt
Prop.19/Agst.21 825,000.000
679 A679 Catridge Genexpart Test - - - - - 1000174387 21 224,254.000
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - - - DAK 20 259,175.000
681 A681 Oil Emersi Botol - - - - - BUFF. PROP 17/JUN 12 70,000.000
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - - - - Buffer Prop 18 4,952.830
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - - - - Buffer Prop 19 4,952.830
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - - - - Buffer Prop 19 2,728.000
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - - - - Buffer
Buffer PropProp
19 20/ Des 5,890.000
686 A686 Reagen Control CD4 - - - - - Buffer Prop 20/ Des
20 660,000.000
687 A687 Reagen Control CD4 - - - - - 21 158,400.000
688 A688 Reagen Zeil Nelseen Kit - - - - - BUFF. PROP 17/NOV 17 276,600.000
689 A689 Reagen Zeil Nelseen Kit - - - - - BUFF. PROP 17/NOV 18 276,500.000
690 A690 Reagen Zeil Nelseen Kit - - - - - DAKProp
Buffer 2019Des.19
Penugasan 257,644.000
691 A691 Reagen Zeil Nelseen Kit - - - - - TB 228,800.000
692 A692 Slide Pcs - - - - - DAKProp
Buffer 2019Penugasan 20,747.000
693 A693 Slide/ Object Glass Pcs - - - - - TB 20,748.000
694 A694 Stereofoam pcs - - - - - Buffer Prop. 19 6,700.000
695 A695 Masker N 95 TB pcs - - - - - Buffer Prop. 20 19,835.000
696 A696 Masker Tali Bedah TB pcs - - - - - Buffer Prop. 20 386.100
OBAT PROGRAM IMUNISASI - - - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - - - Buffer Prop 18/Feb.23 1,590.000
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - Buffer Prop 18/Mar.23 1,550.000
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - Buffer Prop 19/Okt.21 1,463.000
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - Buffer Prop 20/ Okt 1,518.000
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - 19,119 24 1,190.000
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - - - Buffer Prop 19/Apr.23 1,185.000
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - - - Buffer Prop 19/Feb 24 1,463.000
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - - - Buffer Prop 19/Agst 24 1,190.000
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - Buffer Prop 19/Mar.23 1,077.000
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - Buffer
Buffer PropProp
19/Juni 20/Juni
24 1,081.820
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - 24
708 A708 - - - - -
709 A709 - - - - -
710 A710 - - - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 500 - 500 11 11 22 478 Buffer Prop 19/Okt. 23 1,583.000
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - - - Buffer Prop 19/Feb.24 1,439.000
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - - - Buffer Prop 20/Feb.24 1,439.000
714 A714 - - - - -
715 A715 Safety Box 5 L Pcs - - - - - Buffer Prop 19 22,433.000
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - - - Buffer Prop 20 1,460.000
717 A717 - - - - -
718 A718 - - - - -
719 A719 - - - - -
720 A720 - - - - -
Diagnostar
PROGRAMDS HIV/HIV 1/2 One Step Rapid Test
AIDS - - - - -
721 A721 Diagnostar DS Tahap
(GCHIV-402A) HIV 1/2I One Step Rapid Test Test - - - - - Buffer Prop 19 14,712.500
722 A722 KHB DiagnostikReagen
(GCHIV-402A) Kit For HIV
R3 (1+2) Antibody (Colloidal - - - - - Buffer Prop 20/ 19,480.000
723 A723 KHB
Gold)Diagnostik
Tahap I Kit For HIV (1+2) Antibody (Colloidal Test - - - - - Buffer Prop 19/ Juli 21 13,750.000
724 A724 KHB
Gold)Diagnostik Kit For HIV (1+2) Antibody (Colloidal
(Reagen R2) - - - - - Buffer Prop 20/ 13,235.000
725 A725 KHB
Gold)Diagnostik
Tahap I Kit For HIV (1+2) Antibody (Colloidal Test - - - - - Buffer Prop 19/Feb 21 12,500.000
726 A726 Gold) V2 Tahap I - - - - - Buffer Prop 20/Mar 21 13,750.000
727 A727 Kondom Pcs - - - - - Buffer
Buffer PropProp 20/ Feb
19/Mar.20 358.000
728 A728 DBS Collection/ Lasec Pcs - - - - - 9516-1 21 121,750.000
729 A729 Lubricant Pcs - - - - - Buffer Prop 19/Nov.21 486.000
730 A730 Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV - - - - -
731 A731 AIDS) Tahap I Test - - - - - Buffer Prop 19/ Apr 20 11,975.000
732 A732 Rapid HIV 1/2 3.0 SD Bioline test - - - - - DAK 20/ Agst 21 28,666.670
733 A733 Reagen HIV (FOKUS) R 2 Test - - - - - Buffer
Buffer PropProp 20/ Mei
18/Agst.20 13,235.000
734 A734 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Test - - - - - ### 2021 12,500.000
735 A735 Reagen HIV (SD) R 1 Test - - - - - Buffer Prop 18/Okt.20 11,975.000
736 A736 Reagen HIV (SD) R 1 Test - - - - - Buffer Prop 19/Nov.20 11,975.000
737 A737 - - - - -
738 A738 Reagen HIV (VIKIA) R 3 Test - - - - - Buffer Prop 18/Jun.20 19,480.000
739 A739 - - - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - - - - Buffer Prop 19/Agst. 20 13,235.000
741 A741 - - - - -
742 A742 Reagen HIV R3 (VIKIA) Test - - - - - Buffer Prop 19/Juni 20 19,480.000
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - - - Buffer Prop 20 juli 21 13,353.000
744 A744 Sarung Tangan Non Steril Pair - - - - - Buffer Prop. 18/Okt.21 800.000
745 A745 - - - - - Buffer Prop.20 -
746 A746 APD Set (Cover All, Face Shield, Handscoen, MaskerPaket - - - - - Buffer Prop.20 -
Covid-19 323,500.000
747 A747 VTM Include Swab Test - - - - - Buffer Prop.20 -
Covid-19 53,000.000
748 A748 Masker Bedah 3 ply Pcs - - - - - Covid-19 386.100
749 A749 - - - - -
750 A750 - - - - -
751 A751 - - - - -
752 A752 - - - - -
753 A753 - - - - -
754 A754 - - - - -
755 A755 - - - - -
756 A756 - - - - -
757 A757 - - - - -
758 A758 - - - - -
759 A759 - - - - -
760 A760 - - - - -
761 A761 - - - - -
762 A762 - - - - -
763 A763 - - - - -
764 A764 - - - - -
OKSIGEN MEDICAL - - - - -
765 A765 Oksigen 3 m3 Tampon - - - - - DAK 19 38,500.000
766 A766 Oksigen 6 m3 Tampon - - - - - DAK 19 71,500.000
767 A767 Oksigen 1 m3 Tampon - - - - - DAK 20 38,500.000
768 A768 Oksigen 6 m3 Tampon - - - - - DAK 20 71,500.000
769 A769 Nurse Cup (Tutup Kepala) One Med - - - - - DAU ID 20 - Covid-19 333.900
770 A770 - - - - -
771 A771 - - - - - Retur PKM Candipuro,
772 A772
Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - - - Sumbersari 473.000
TAMBAHAN IFK - - - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - - - RETUR
RETUR PASIRIAN 110.000
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - RETUR
ROGOTRUNAN
RETUR PASIRIAN 1,750.000
3 T003 Thiamphenicol
Ranitidin Tablet/ 150 Thiamfilex
mg Kapsul 500 mg Tablet - - - - - RETUR
ROGOTRUNAN 98.000
4 T004 Tablet - - - - - ROGOTRUNAN 783.000
5 T005 Dehydro
Thiamphenicol ArtemisinSyr.40 mg + Piperakuin 320 mg - - - - - Buffer Prop 20/ Apr 7,150.000
6 T006 (DHP) tablet tablet - - - - - 190,431 21 2,134.000
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - - - RETUR
Retur Pronojiwo 6,199.900
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - - - - RETUR
ROGOTRUNAN 1155.000
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - - - RETUR
ROGOTRUNAN 80.000
10 T010 Ketokonazole 200 mg Tablet - - - - - RETUR
ROGOTRUNAN 396.000
11 T011 Kotrimoksazol Forte Tablet - - - - - RETUR
ROGOTRUNAN 500.000
12 T012 Infusion set anak Pcs - - - - - RETUR
ROGOTRUNAN 7,920.000
13 T013 Alat Suntik 10 cc Pcs - - - - - RETUR
ROGOTRUNAN 1,302.000
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - - RETUR
ROGOTRUNAN 1,890.000
15 T015 Natrium
Omeprazole Klorida Larutan
Kapsul 20 mginfus 0,9% @500ml (MJB Tablet - - - - - E202B32/E2 YOSOWILANGUN 160.000
16 T016 KF ) Botol - - - - - 02B31 DAK 20 /22 Feb 23 6,840.000
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - - - - 19RBSG78 DAK 20 /01 Sep 21 90.000
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - - - DAU
RETURPRTEKUNG
BG COVID 265.000
19 T019 Oseltamivir 75 mg Kapsul - - - - - F202C03, 20/
200Y2001 DAU PRSpesifik
Jan 22 20 14,300.000
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol - - - - - F202C02 Non Covid-19/ Mar 23 7,630.000
 RETUR
21 T021 Amitriptilin 25 mg Tablet - - - - - RETUR
ROGOTRUNAN 167.000
22 T022 Hepatitis
I.V Catheter No.B24Imunoglobulin
TERUMO inj 220 IU/ml (Hb Ig) pcs - - - - - Buffer Prop 20/ Mar
ROGOTRUNAN 8,355.000
23 T023 (Hyperhep) - - - - - 22 ###
24 T024 RDT COVID - 19 - - - - - Buffer Prop 20/ Agst 0.000
25 T025 Oseltamivir 75 mg - - - - - Buffer Prop 20/ Feb
20 12,969.000
26 T026 Katrid
Klorokuin XPert 150Xpress SARS-CoV-2. Sample
mg tablet - - - - - Buffer Prop 20/ Apr
25 1,506.000
27 T027 Katrid
CollectionXPert KitXpress SARS-CoV-2. Sample
(For Viruses) - - - - - Buffer Prop 20/ Apr
21 410,777.000
28 T028 Collection Kit (For Viruses) - - - - - Buffer Prop 20/ Mar
21 343,687.000
29 T029 Masker N95 (Particulate Respirator) - - - - - Buffer Prop 20/
25 32,493.000
30 T030 Hazmat/ APD/ Hazmat PPK - - - - - DAK 20 Penugasan
Bantuan Kemenkes 0.000
31 T031 Medical Sample Container Pcs - - - - - DAK 20 Penugasan
TB 2,254.320
32 T032 Cepheid Pcs - - - - - TB 259,175.000
33 T033 Natrium Klorida Larutan infus 0,9% @100ml - - - - - DAK 20 Penugasan 15,180.000
34 T034 Tambah Darah drop (Ferriz Drop) pcs - - - - - 0B1051 DAK 20 Penugasan 31,680.000
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs - - - - - 0A1015 DAK 20 Penugasan 31,405.000
36 T036 Ringer
Gentamycin LaktatKrimcairan
1 %infus
mg/(mlOTSUKA/
GentalexWIDATRA) @ Tube - - - - - G01CU016 PRBG 20 3,300.000
37 T037 500 ml RL Botol - - - - - PRSpesifik 20
Dokter 7,630.000
38 T038 Parasetamol
Obat Batuk Sirup Komb Tablet Antitusif : Parasetamol
/ INADRYL Botol - - - - - S040J002 PRSpesifik
Muter 20 Dokter 14,300.000
39 T039 500mg,Phenylpropanolamine
Obat Batuk Expektoran Sirup HCl chlorpheniramine Botol - - - - - AF9823 PRSpesifik
Muter 20 Dokter 8,426.000
40 T040 Parasetamol Komb Tablet Flu:
maleate, dextromethorpan Hbr Parasetamol 500 mg, Tablet - - - - - A068D264 PRSpesifik
Muter 20 Dokter 627.000
41 T041 Kombinasi Influenza Tablet - - - - - BTT 20
Muter 20KE 2 COVID - 792.000
42 T042 Masker Bedah /Bima Sakti pCS - - - - - BTT 20 KE 2 COVID -
19 1,700.000
43 T043 Masker Bedah /Rania pCS - - - - - BTT 20 KE 2 COVID -
19 1,700.000
44 T044 Masker N 95 Bima Sakti PCS - - - - - BTT 20 KE 2 COVID -
19 55,000.000
45 T045 Sarung tangan panjang steril / meditouche perpasang - - - - - BTT 20 KE 2 COVID -
19 58,500.000
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ RanniPCS - - - - - 19 850.000
47 T047 Albendazol Suspensi 200mg/ 5 ml botol - - - - - RETUR
PROP 20 4,000.000
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - - - - PRSpesifik 20 Non
ROGOTRUNAN 8,355.000
49 T049 OAT FDC Kategori Anak - - - - - BTT 20 KE 2 COVID -
Covid 248,120.000
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF - - - - - BTT 20 KE 2 COVID -
19 186,000.000
51 T051 Apron Lengan Panjang Putih (Rannia) - - - - - 19 6,500.000
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - - - DAK 20/2024 Juli 11,250.000
53 T053 - - - - -
54 T054 - - - - -
55 T055 - - - - -
56 T056 - - - - -
57 T057 - - - - -
58 T058 - - - - -
59 T059 - - - - - DAU 20 PRSpesifik
60 T060 APD Set (Rannia) - - - - - DAU 20 PRSpesifik
Covid-19 20 236,500.000
61 T061 Cover All Disposible
Re Use (Baju bisasekali
(Baju di pakai lagi (Rannia)
pakai) /dicuci) - - - - - DAU 20 PRSpesifik
Covid-19 20 99,000.000
62 T062 Baju APD Reusable (Bisa bisa dipakai lagi/dicuci)
Rannia - - - - - DAU 20 PRSpesifik
Covid-19 20 203,500.000
63 T063 (Usaha Karya Mitra Bersama) - - - - - DAU 20 PRSpesifik
Covid-19 20 275,000.000
64 T064 Helm visor (Usaha Karya Mitra Bersama) - - - - - Covid-19/20 132,000.000
65 T065 Shoe CoverGoggle
Kaca mata (sepatu(Usaha
) / (Usaha Karya
Karya Mitra
Mitra Bersama) - - - - - DAU 20 PRSpesifik 49,500.000
66 T066 Jerigen
Bersama)Putih ukuran 20 liter 1 (Usaha Karya - - - - - Covid-19/20 5,500.000
67 T067 Mitra Bersama) - - - - - DAU 20 PRSpesifik 66,000.000
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs - - - - - BUFFER PROPINSI
Covid-19/20 1,023.000
69 T069 Masker N95 Covid 19 Pcs - - - - - BUFFER PROPINSI
20 21,736.000
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - - - - BUFFER PROPINSI
20 386.100
71 T071 Masker Eaerlop Hijab Pcs - - - - - DAU 20 PRSpesifik
20 340.280
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter - - - - - DAU 20 PRSpesifik
Covid-19 20 560,000.000
73 T073 Hand Sanitzer 1 Botol = 20 Liter - - - - - DAU 20 PRSpesifik
Covid-19 20 ###
74 T074 Cover All Disposable
MC Bleach solida
Liquid 20 Liter size XL, XXL
(RAJAWALI) Botol = 20 Liter - - - - - DAU 20 PRSpesifik
Covid-19/Des 25 575,000.000
75 T075 (RAJAWALI) Pcs - - - - - DAU20
Covid-19/Des 26 156,000.000
76 T076 Mantel
KIT A1 Gown
Operasi APD 1 (Usaha
Steril Karya Mitra
(RAJAWALI) Pcs - - - - - DAU PR Spesifik
KITS113 PRSpesifik/Des25 53,636.000
77 T077 Bersama) Pcs - - - - - DAU PRSpesifik
Covid-19/20 220,000.000
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair - - - - - DAU PRS 20 Covid-
Covid-19 148,500.000
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - - - - DAU PRSpesifik
19/20 7,000.000
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - - - Covid-19/20 2,200.000
 Jerigen Putih ukuran 20 liter 2 (Usaha Karya DAU ID COVID-19
81 T081 Mitra Bersama) Botol - - - - - DAU ID COVID-19
20/ 60,000.000
82 T082 Rapid
MaskerTest VivaDiag
Face/ MaskerCovid-19 IgM/ IgG2)(COBRA pcs
Bedah (COBRA - - - - - AEE200305 20/
DAU ID COVID-19 6,269.000
83 T083 2) box @40 test - - - - - DAU
7 20/ ID21
Mar COVID-19 197,000.000
84 T084 Masker KN95 (Farmahusada) Box @50 pcs - - - - - DAU ID COVID-19
20/ 75,000.000
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - - - DAU ID COVID-19
20/ 8,500.000
86 T086 Rapid Test VivaDiag
SARS COV Covid-19 IgM/ IgG
2 (Farmahusada) Test - - - - - DAU ID COVID-19
20/ 220,000.000
87 T087 (Indofarma) test - DAU
E2003097 20/ ID21
Mar COVID-19 220,000.000
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - DAU ID COVID-19
20/ 75,000.000
89 T089 APRON (Atmosfer) pcs - DAU ID COVID-19
20/ 5,000.000
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - DAU ID COVID-19
20/ 200,000.000
91 T091 Virus
Hand Transport
Sanitzer 2 Media Corich (VTM)/ Setia liter - DAU ID COVID-19
20/ 56,000.000
92 T092 Andalan Sukses pcs - DAU ID COVID-19
20/ 80,000.000
93 T093 Virus
MantelTransport
Gown APD Media Corich Karya
2 (Usaha (VTM)/Mitra
Sekarguna
Bersama) pcs - 20/ 200,000.000
94 T094 Virus
Medika Transport
1 Media Corich (VTM)/ Sekarguna pcs - BTT 20 COVID-19 138,364.000
95 T095 Medika 2 pcs - DAU PRSpesifik
BTT 20 COVID-19 137,364.000
96 T096 Face Shield (COBRA) - DAU PRSpesifik
Covid-19 45,100.000
97 T097 Jirigen Putih 20 Liter (Usaha Karya) - DAU PRSpesifik
Covid-19 66,000.000
98 T098 Kit Steril (Rajawali) - Covid-19 53,636.000
99 T099 Alkohol II @20 Liter - DAU ID Covid-19 20 450,000.000
100 T100 Cover All (Rajawali) - DAU ID Covid-19/20 718,500.000
101 T101 Face Shield (ATMOSFER) - DAU ID Covid-19/20 69,000.000
102 T102 Jirigen Putih 20 Liter (Usaha Karya) - DAU ID Covid-19/20 60,000.000
103 T103 Masker Earloop (KasaHusada) - DAU ID Covid-19/20 6,000.000
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) - DAU ID Covid-19/20 522,728.000
105 T105 Rapid Test Covid-19 (Rajawali) - DAU ID Covid-19/20 180,000.000
106 T106 Rapid Test Covid-19 (Dakonan) - DAU ID Covid-19/20 220,000.000
107 T107 Alkohol Swab (BTT) - BTT 20 COVID-19 109.090
108 T108 Antiseptic Gel 500 - 28052086 BTT 20 COVID-19 24,091.000
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) - BTT 20 COVID-19 1,150.000
110 T110 Kaca mata Goggle (HASTEN) - BTT 20 COVID-19 47,500.000
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) - BTT 20 COVID-19 200,000.000
112 T112 Masker Bedah Hijau @50pcs - BTT 20 COVID-19 2,816.000
113 T113 Masker N95 3M 8210 (Hazten) - BTT 20 COVID-19 150,000.000
114 T114 Nurse Cap Green om 100bh - - - - - BTT 20 COVID-19 303.550
115 T115 Parafilm (Anugerah Sentosa Abadi) - - - - - BTT 20 COVID-19 891,275.000
116 T116 Rapid Test (1.000) Widhi Dharma Adi - - - - - BTT 20 COVID-19 160,500.000
117 T117 Sarung tangan Safeglove Exam M 100bh - - - - - BTT 20 COVID-19 585.000
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 - - - - - BTT 20 COVID-19 5,300.000
119 T119 Sterlisasi Swab stik (5box/ VTM) - - - - - BTT 20 COVID-19 5,500.000
120 T120 Stereofoam (Anugerah Sentosa Abadi) - - - - - BTT 20 COVID-19 60,500.000
121 T121 Universal Transport Media (UTM) Goongdong - - - - - BTT 20 COVID-19 80,000.000
122 T122 Vakutainer tube tertutup
Universal Transport Media(VTM)
(UTM)Anugerah
SekargunaSentosa - - - - - BTT 20 COVID-19 136,564.000
123 T123 Abadi - - - - - DAU ID COVID-19
BTT 20 20 non covid- 1,265.000
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) - DAU ID 20 non covid-
19 8,400.000
125 T125 Infusion Set Anak 60 Drops /(Otsuka) - BTT ke 2 20 COVID-
19 8,400.000
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) - BTT ke 2 20 COVID-
2020051401 19 98,000.000
127 T127 Rapid Test Lecurate (Bima Sakti) - BTT ke 2 20 COVID-
2OCG2519X 20 90,000.000
128 T128 Rapid Test ZYBIO (Farma Husada) - 21 97,500.000
129 T129 Alkohol 96 % Liter - - - - - DAU 20 22,500.000
130 T130 - - - - -
- - - - -
TAMBAHAN PUSKESMAS - - - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 9 - 9 9 9 - 7,199.885
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - 3 3 3 - 1,945.000
3 TP003 Asiklovir
Budesonid 5%Formoterol
5gr CreamInhaler 160/4,5 mcg/Symbicort Tube 44 - 44 15 15 29 2,950.000
4 TP004 pcs 4 - 4 4 4 - 139,880.000
5 TP005 (Astra Zeneca) - - - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 14 - 14 14 14 - 1,097.000
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 608 - 608 - - 608 77.000
8 TP008 Gentamycin Krim 1 % mg/ ml Tube 10 - 10 10 10 - 3,217.500
 9 TP009 - - - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 3 - 3 1 1 2 15,572.700
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 20 - 20 10 10 10 270.000
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet 5 - 5 5 5 - 600.000
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 344 - 344 10 10 334 1,106.000
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 293 - 293 293 293 - 45.000
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet 50 - 50 50 50 - 36.000
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul 330 - 330 330 330 - 783.000
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs 55 - 55 2 2 53 1,302.000
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 13 - 13 2 2 11 74,250.000
19 TP019 Hand Sanitizer 450 ml (Meditol) 13 - 13 2 2 11 43,186.000
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 39 - 39 39 - 39 - 7,920.000
21 TP021 I.V Catheter No. 18 (JELCO) Pcs 1 - 1 1 - 1 - 8,750.000
22 TP022 I.V Catheter No. 22 NIPRO Pcs 4 - 4 4 - 4 - 7,018.000
23 TP023 I.V Catheter No. 24 TERUMO Pcs 9 - 9 9 - 9 - 8,355.000
24 TP024 Materniti Napkin Slim L 1 - 1 1 1 - 20,328.000
25 TP025
Sarung Tangan
Plester Roll KainSteril
2.5 cmNox74.5
Dancm7,5( Leukoplast
(Medic dent)
1622H) Roll 11 - 11 6 5 11 - 12,076.000
26 TP026 (Pasang) Pair 5 - 5 5 5 - 6,595.000
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1 - - 1 1,098,900.000
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 2 - 2 - - 2 712,800.000
29 TP029 Haloperidol 5 mg tablet Tablet 148 - 148 130 130 18 56.000
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 82 - 82 52 30 82 - 1,640.000
31 TP031 Fixomull Strech 5 cm X 5 m Pcs 17 - 17 11 11 6 42,800.000
32 TP032 Umbilical crd clamp 233 - 233 9 9 224 2,750.000
33 TP033 - - - -
34 TP034 - - - -
35 TP035 - - - -
36 TP036 - - - -
37 TP037 - - - -
38 TP038 - - - -
39 TP039 - - - -
40 TP040 - - - -
41 TP041 - - - -
42 TP042 - - - -
43 TP043 - - - -
44 TP044 - - - -
45 TP045 - - - -
46 TP046 - - - -
47 TP047 - - - -
48 TP048 - - - -
49 TP049 - - - -
50 TP050 - - - -
51 TP051 - - - -
52 TP052 - - - -
53 TP053 - - - -
54 TP054 - - - -
55 TP055 - - - -
56 TP056 - - - -
57 TP057 - - - -
58 TP058 - - - -
59 TP059 - - - -
60 TP060 - - - -
- - - -
TOTAL - - - -

UMUM
BPJS
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep )

UMUM
BPJS
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

JUMLAH SETORAN RESTRIBUSI

 BULAN
TAHUN

STOK NILAI
NILAI PERSEDIAAN PERMINTAAN PEMBERIAN Ket
OPTIMUM PENERIMAAN

0.000 0.000

1,050.000 0.000

0.000 0.000
0.000 0.000
128,700.000 0.000
0.000 0.000
0.000 0.000
60,736.000 0.000
0.000 0.000
73,771.500 0.000
0.000 0.000
0.000 0.000
0.000 0.000
38,502.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
205,700.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
3,323,500.000 0.000
0.000 0.000
0.000 0.000
396,000.000 0.000
0.000 0.000
1,320.000 0.000
0.000 0.000
238,590.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,583,400.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
155,295.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
20,760.000 0.000
0.000 0.000
399,168.000 0.000
0.000 0.000
437,250.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
78,280.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
11,696.000 0.000
304,000.000 0.000
0.000 0.000
6,270.000 0.000
0.000 0.000
190,950.000 0.000
324,950.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
13,200.000 0.000
0.000 0.000
0.000 0.000
814,000.000 0.000
0.000 0.000
0.000 0.000
122,864.000 0.000
0.000 0.000
200,618.000 0.000
0.000 0.000
62,400.000 0.000
0.000 0.000
 169,725.000 0.000
0.000 0.000
32,968.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
6,496.000 0.000
0.000 0.000
272,800.000 0.000
0.000 0.000
46,695.000 0.000
0.000 0.000
0.000 0.000
39,424.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
10,650.000 0.000
1,321,838.000 0.000
0.000 0.000
0.000 0.000
193,120.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
220,064.000 0.000
0.000 0.000
52,250.000 0.000
0.000 0.000
327,700.000 0.000
573,818.000 0.000
0.000 0.000
355,355.000 0.000
0.000 0.000
2,831,400.000 0.000
90,090.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
231,099.000 0.000
0.000 0.000
0.000 0.000
86,625.000 0.000
0.000 0.000
0.000 0.000
88,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
79,728.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
27,000.000 0.000
 2,136.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
175,500.000 0.000
437,767.000 0.000
0.000 0.000
0.000 0.000
691,809.800 0.000
0.000 0.000
112,200.000 0.000
0.000 0.000
158,400.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
233,490.000 0.000
0.000 0.000
0.000 0.000
341,401.500 0.000
1,548,800.000 0.000
0.000 0.000
0.000 0.000
439,824.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
341,440.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
167,640.000 0.000
67,650.000 0.000
0.000 0.000
0.000 0.000
468,600.000 0.000
0.000 0.000
0.000 0.000
455,202.000 0.000
0.000 0.000
27,126.000 0.000
0.000 0.000
23,370.000 0.000
0.000 0.000
2,527,470.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
6,913,500.000 0.000
0.000 0.000
144,576.000 0.000
0.000 0.000
65,780.000 0.000
 0.000 0.000
31,407.000 0.000
0.000 0.000
0.000 0.000
3,850.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,881,000.000 0.000
0.000 0.000
404,800.000 0.000
0.000 0.000
0.000 0.000
290,400.000 0.000
0.000 0.000
0.000 0.000
355,872.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
254,610.000 0.000
0.000 0.000
198,710.000 0.000
0.000 0.000
115,104.000 0.000
0.000 0.000
115,709.000 0.000
475,200.000 0.000
28,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
487,795.000 0.000
0.000 0.000
37,280.000 0.000
12,840.000 0.000
0.000 0.000
4,290.000 0.000
0.000 0.000
798,547.200 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,590.000 0.000
0.000 0.000
0.000 0.000
186,300.000 0.000
236,500.000 0.000
0.000 0.000
246,681.600 0.000
0.000 0.000
132,000.000 0.000
0.000 0.000
458,298.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
312,294.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000 BUFFER P 257
0.000 0.000 BUFFER P 257
0.000 0.000
0.000 0.000
0.000 0.000
5,955,950.000 0.000
0.000 0.000
0.000 0.000
750,750.000 0.000
0.000 0.000
12,600.000 0.000
0.000 0.000
201,740.000 0.000
0.000 0.000
0.000 0.000
165,440.000 0.000
0.000 0.000
479,996.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
7,200.000 0.000
0.000 0.000
75,680.000 0.000
0.000 0.000
11,395.000 0.000 BUFFER P 2728
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
506,484.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
357,500.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
12,573.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 44,352.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
107,464.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
764,575.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
489,918.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
2,398,872.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,325,000.000 1 1,325,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,731,950.000 3,350 1,731,950.000
0.000 0.000
99,400.000 350 99,400.000
0.000 0.000
0.000 0.000
18,762,000.000 53,000 18,762,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
7,592.000 0.000
0.000 0.000
0.000 0.000
56,221.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
132,300.000 0.000
104,500.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
29,225.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
24,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
12,482.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
34,580.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
563,600.000 10 563,600.000
0.000 10 0.000
0.000 0.000
0.000 0.000
7,082,400.000 50 7,082,400.000
0.000 50 0.000
0.000 0.000
0.000 0.000
6,129,600.000 80 6,129,600.000
0.000 0.000
0.000 0.000
0.000 0.000
1,163,500.000 50 1,163,500.000
0.000 0.000
907,000.000 50 907,000.000
0.000 50 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
49,200.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
270,072.000 0.000
0.000 0.000
419,496.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
15,246.000 0.000
0.000 0.000
198,854.460 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,845,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
3,136,320.000 0.000
666,600.000 0.000
0.000 0.000
0.000 0.000
548,100.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
854,400.000 0.000
 0.000 0.000
0.000 0.000
583,110.000 0.000
0.000 0.000
533,500.000 0.000
0.000 0.000
601,920.000 0.000
0.000 0.000
324,720.000 0.000
0.000 0.000
167,397.300 0.000
0.000 0.000
0.000 0.000
0.000 0.000
107,200.000 0.000
0.000 0.000
11,500.000 0.000
273,000.000 0.000
0.000 0.000
0.000 0.000
154,700.000 0.000
0.000 0.000
263,120.000 0.000
0.000 0.000
0.000 0.000
131,349.950 0.000
0.000 0.000
0.000 0.000
0.000 0.000
612,500.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
30,051.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
169,400.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
25,900.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
271,040.000 0.000
0.000 0.000
2,263,800.000 0.000
0.000 0.000
946,956.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
107,360.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
635,250.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
756,674.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
85,550.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
46,816.000 0.000
0.000 0.000
 0.000 0.000
31,145.400 0.000
2,700.000 0.000
0.000 0.000
369,404.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
69,006.000 0.000
816,750.000 0.000
475,046.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,098,900.000 0.000
1,425,600.000 0.000
1,008.000 0.000
0.000 0.000
256,800.000 0.000
616,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
111,438,876.710 37,764,450.000

JUMLAH LBR RESEP JUMLAH TOTAL R

Rawat Jalan Rawat Inap Generik Paten

 JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

Rawat Jalan Rawat Inap antibiotik injeksi

 LAPORAN PEMAKAIAN DAN LEMBA
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN

UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - 0

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 10 100 110
100
3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -
-
4 A004 0 0 - - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial 45 - 45 12 -
6 A006 Air Untuk Injeksi Vial @25 ml Vial - - -
-
7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - - -
8 A008 Alopurinol Tablet 100 mg Tablet 584 - 584 4 54
9 A009 Alopurinol Tablet 100 mg 0 - - - -
10 A010 Ambroxol Tablet 30 mg Tablet 789 - 789 106 78
11 A011 0 0 - - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - - -
13 A013 0 0 - - - -
14 A014 Amlodipin Tablet 10 Mg Tablet 414 - 414 100 248
15 A015 Amlodipin Tablet 10 Mg Tablet - - - -
16 A016 0 0 - - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet - - - -
18 A018 Amoksisilin Kaplet 500 mg Tablet - - - -
19 A019 Amoksisilin Kaplet 500 mg Tablet - - - -
20 A020 Amoksisilin Kaplet 500 mg Tablet - - - -
21 A021 0 0 - - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 68 - 68 25 13
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - -
25 A025 Amoksisilin Syrup -
Amoxiclav 625 mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - -
-
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - -
27 A027 CLABAT,CAPSINAT Tablet - - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial 391 - 391 62 -
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial - - - -
30 A030 0 0 - - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol 80 - 80 56 24
32 A032 0 0 - - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 3 - 3 3
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
35 A035 Antacida + Simeticon 128 1,228
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet 1,446 - 1,446
-
36 A036 Tablet - - -
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - - -
40 A040 Pot - - - -
41 A041 Salisilat 3% (Marin )
0Antihemoroid 0 - - - -
Kombinasi : Bismut Suppgalat 150 mg 40
42 A042 Supp 520 - 520
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio -
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - -
45 A045 20% ) HEMOROGARD Tablet - - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet 1,479 - 1,479 132 859
47 A047 Asam -
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet - - -
-
48 A048 Tablet - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - -
50 A050 Asam Folat Tablet 1 mg Tablet - - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - -
52 A052 Asam Mefenamat 500 mg 0 - - - -
53 A053 0 0 - - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 10 - 10 -
55 A055 0 0 - - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 252 - 252 8
57 A057 0 0 - - - -
58 A058 Asiklovir 5% 5gr Cream Tube 150 - 150 -
59 A059 Asiklovir 5% 5gr Cream Tube - - - -
60 A060 0 0 - - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 206 - 206 22 6
 63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - -
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet 86 - 86 86
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet 2,000 - 2,000 102 160
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - -
69 A069 Betahistin Mesylat 6 mg Tablet 57 - 57 18
70 A070 Betahistin Mesylat 6 mg Tablet - - - -
Tube @ 10 36
71 A071 Betametason Dipropionat Krim 0,1% Tube 57 - 57
72 A072 Betametason Dipropionat Krim 0,1% gram @ 10 97 - 97 8 19
Tube
gram @ 10 -
73 A073 Betametason Dipropionat Krim 0,1% - - -
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - -
77 A077 Benzatin -
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - -
-
78 A078 Bricasma Biji - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - - -
80 A080 Zeneca
0Budesonid )I 0 - - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra -
81 A081 pcs - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - - -
84 A084 Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet 20 - 20 15 5
85 A085 Cefadroksil Kapsul 500 mg Tablet - - - -
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 74 - 74 1 -
88 A088 Citicolin -
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - - -
-
89 A089 Tablet - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 112 - 112 1 39
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - -
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet 3,316 - 3,316 35 724
93 A093 Deksamethason Tab 0,5 mg 0 - - - -
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube 6 - 6 -
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 155 - 155 6 44
97 A097 0 0 - - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 317 - 317 10
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - -
100 A100 Digoksin Tab 0,25 mg Tablet - - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet - - - -
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet 58 - 58 8 -
103 A103 0 0 - - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol 62 - 62 16 5
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet 283 - 283 29 4
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 28 - 28 2
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - -
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
113 A113 Ethambutol 250 mg Tablet - - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 3 - 3 -
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 359 - 359 1 77
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 272 - 272 40
120 A120 0 0 - - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 52 - 52 15
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
128 A128 Gentamycin Krim 1 % mg/ ml Tube 19 - 19 1 9
129 A129 Gentian Violet 1% 10 ml Botol - - - -
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 113 - 113 1 33
131 A131 Glibenklamid Tablet 5 mg Tablet 4,822 - 4,822 40 660
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet 4,615 - 4,615 564 1,472
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet - - - -
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 360 - 360 120
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 9 - 9 -
137 A137 Glukosa Larutan 40% Steril botol - - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - -
139 A139 Glukosa Larutan Infus 5% @500ml Botol - - - -
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - -
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,551 - 1,551 166
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 35 - 35 3 29
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10 -
148 A148 0 0 - - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 302 - 302 72 190
152 A152 Ibuprofen Tablet 400 mg Tablet - - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - -
154 A154 Isoniazid Tablet 100 mg tablet - - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 300 - 300 9
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 24 - 24 -
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
158 A158 0 0 - - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol - - - -
162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - - -
163 A163 Tablet - - - -
164 A164 Pharmatama)
0 0 - - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100 -
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 2,341 - 2,341 968
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - -
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet 7,313 - 7,313 38 1,549
170 A170 Kaptopril Tab 25 mg TAblet - - - -
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube 20 - 20 2 3
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube - - - -
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 400 - 400 -
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - -
176 A176 Ketorolak Inj 30 mg/ml Ampule - - - -
177 A177 0 0 - - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 129 - 129 1 9
179 A179 0 0 - - - -
180 A180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma) Vial - - - -
Kloramfenikol Tetes Telinga :Kloramfenicol 17
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube 19 - 19
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube 44 - 44 1 16
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 5,712 - 5,712 381 1,935
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 776 - 776 91 542
190 A190 Kotrimoksasol -
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg - - -
-
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol - - - -
193 A193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma ) 1
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract 12 - 12
-
194 A194 MOLAKRIM
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 3 - 3
195 A195 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma) -
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- - -
-
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - -
197 A197 Probiotik (Dexa Medica, Sanbe) Tablet 71 - 71 10
198 A198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 209 - 209 26 67
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 274 - 274 12
203 A203 Loperamid Tablet 2 mg Tablet - - - -
204 A204 Loratadin Tablet 10 mg Tablet 190 - 190 -
205 A205 Loratadin -
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - -
120
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet 540 - 540
207 A207 Mata/ OCUGARD (Phapros) Tablet - - - -
208 A208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - - -
209 A209 0 0 - - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 1,257 - 1,257 361 19
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - - -
213 A213 Metformin HCl Tablet 500 mg Tablet 1,506 - 1,506 2 341
214 A214 Metformin HCl Tablet 500 mg Tablet - - - -
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 460 - 460 -
216 A216 0 0 - - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet 361 - 361 160 40
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet 20 - 20 20
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet - - - -
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - -
223 A223 Metronidasol Infus 500mg/100ml Botol - - - -
224 A224 Minyak -
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - -
-
225 A225 Kapsul - - -
226 A226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 900 - 900 -
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / -
227 A227 Ampule - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule 92 - 92 6 46
229 A229 Multivitamin -
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - -
-
230 A230 Tablet - - -
Ayus )
 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU 8 14
231 A231 Multivitamin Curcuma Syr:L-Lysyin 1000 IU Botol 22 - 22
232 A232 vit B1 3 mg, B12 Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) Botol - - - -
Multivitamin Neurotopic
vit B1 3 mg, B12 Plus ATP
Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet -
233 A233 Multivitamin - - -
234 A234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) Tablet 674 - 674 176 204
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 A235 tablet - - - -
Femofomarrat
MOLANEURON 300mg
(MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C -
236 A236 Tablet - - -
237 A237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 2,070 - 2,070 13 418
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - -
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 31 - 31 -
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - -
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 872 - 872 49 34
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol 5 - 5 -
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 24 - 24 -
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 50 - 50 -
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
248 A248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet - - - -
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol 49 - 49 5 11
252 A252 Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - - -
253 A253 Omeprazole Kapsul 20 mg Tablet 233 - 233 70 112
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 12 - 12 12 -
255 A255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - - -
256 A256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet 6 - 6 6 -
257 A257 Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - - -
258 A258 Parasetamol Komb
400Mg,Bromheksin
(Phapros) Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet 1,824 - 1,824 78 614
259 A259 400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol HCl 25Mg/ HUSTAB Tablet - - - -
Parasetamol -
260 A260 (Phapros) Tablet - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 30Mg,
100 mg / COLPICA (Tropika Mas) 0 - - - -
Parasetamol Komb Tablet Flu: Parasetamol -
262 A262 Tablet - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - - -
264 A264 Parasetamol Syrup 120 mg/5ml Botol - - - -
265 A265 Parasetamol tablet 500 mg Tablet 30 5,000 5,030 1,330 2,879
266 A266 Parasetamol tablet 500 mg Tablet - - - -
267 A267 Parasetamol tablet 500 mg Tablet - - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 9 - 9 1
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 20 - 20 2 8
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - -
271 A271 Piracetam 800 mg Tablet Tablet 256 - 256 10 16
272 A272 Parasetamol tablet 500 mg Tablet - - - -
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule 30 - 30 5 -
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 3,726 - 3,726 130 940
276 A276 Probiotik Sachet (Probiokid) 0 - - - -
277 A277 Polikresulen (Albotyl,Apetil) Botol - - - -
278 A278 Prednison Tab 5 mg Tablet - - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 4,278 - 4,278 640 1,004
280 A280 Prednison Tab 5 mg Tablet - - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - -
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - -
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet - - - -
285 A285 0 0 - - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol 833 - 833 650 34
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - 2,000 2,000 -
290 A290 Ringer Laktat cairan -
Salbutamol SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - -
45 18
291 A291 Nebule 165 - 165
292 A292 (COMBIVENT)
0 I dan II 0 - - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet 180 - 180 98 82
294 A294 Salbutamol Tab 4 mg:(Pristasma) Tablet - - - -
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% 17
295 A295 Salep Pot 77 - 77
296 A296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - - -
298 A298 Salisil Bedak Serbuk 2% Pcs 32 - 32 2 19
299 A299 Salisil Bedak Serbuk 2% Pcs - - - -
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - 1 -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - -
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - -
304 A304 Setirizin Tab 10 mg (Futamed) Tablet 80 - 80 7
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 688 - 688 2 296
307 A307 Simvastatin Tablet 10 mg Tablet - - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet 43 - 43 34 9
309 A309 0 0 - - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - -
311 A311 Sukralfat Susp 500mg/5ml @100 mlPolietilen
(Mepro) glikol 400 1% Botol - - - -
Tetes mata setiap ml mengandung -
312 A312 Botol - - -
313 A313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - - -
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 3,837 - 3,837 106 743
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - - -
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - -
318 A318 Thiamphenicol Kapsul 500 mg Tablet - - - -
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 50 - 50 7
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - - -
321 A321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek - - - -
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - - -
323 A323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
327 A327 0 0 - - - -
328 A328 0 0 - - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 1 - 1 1 -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - -
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet 112 - 112 -
336 A336 Diazepam Tablet 5 mg Tablet - - - -
337 A337 Fenobarbital Tablet 30 mg Tablet - - - -
338 A338 Fenobarbital Tablet 30 mg Tablet - - - -
339 A339 Fenobarbital Tablet 30 mg tablet - - - -
340 A340 Kodein Tablet 10 mg Tablet - - - -
341 A341 0 0 - - - -
342 A342 Lorazepam Tab 2 mg (Mersi Farma) Tablet - - - -
Metamizol 500 mg + Diazepam 2 mg / PRONEURON -
343 A343 Tablet - - -
344 A344 (Meprofarm)
0 0 - - - -
345 A345 0 0 - - - -
346 A346 0 0 - - - -
347 A347 Primaquin 15 mg tablet tablet - - - -
348 A348 0 0 - - - -
OBAT - OBAT PROGRAM 0 - - - -
OBAT PROGRAM KECACINGAN 0 - - - -
349 A349 Albendazol Tablet 400 mg Tablet 266 - 266 -
350 A350 Albendazol Tablet 400 mg Tablet - - - -
OBAT PROGRAM DIARE 0 - - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - - -
352 A352 Garam Oralit (Kimia Farma) Tablet 2,975 - 2,975 7 523
353 A353 Garam Oralit (Kimia Farma) sachet - - - -
354 A354 Garam Oralit (Kimia Farma) sachet - - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - - -
356 A356 Botol 78 - 78 2 5
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - - -
359 A359 Zinc Dispersible 20 mg tablet tablet - - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 4,578 - 4,578 52 643
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
363 A363 0 0 - - - -
OBAT PROGRAM HEPATITIS 0 - - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 1 - 1 -
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
OBAT PROGRAM TB PARU 0 - - - -
369 A369 OAT FDC Kategori Anak Kit - - - -
370 A370 OAT FDC Kategori Anak Kit - 1 1 1
371 A371 OAT FDC Kategori Anak Kit - - - -
372 A372 OAT FDC Kategori I - IIII Kit - - - -
373 A373 OAT FDC Kategori I - IIII Kit - - - -
374 A374 OAT FDC Kategori II Kit - - - -
375 A375 OAT FDC Kategori II Kit - - - -
376 A376 OAT FDC Kategori II Kit - - - -
377 A377 OAT FDC Kombipak Kategori I Kit - - - -
378 A378 0 0 - - - -
379 A379 Isoniazid 100 mg tablet tablet - - - -
OBAT POGRAM KUSTA 0 - - - -
380 A380 MDT MB Anak Blister - - - -
381 A381 MDT MB Anak Blister - - - -
382 A382 MDT MB Dewasa Blister - - - -
383 A383 MDT MB Dewasa Blister - - - -
384 A384 MDT MB Dewasa Blister - 24 24 24
385 A385 MDT PB Anak Blister - - - -
386 A386 MDT PB Anak Blister - - - -
387 A387 MDT PB Anak Blister - - - -
388 A388 MDT MB Dewasa Blister - - - -
389 A389 MDT PB Dewasa Blister - - - -
OBAT PROGRAM GIZI 0 - - - -
390 A390 Mineral Mix Kombinasi sachet - - - -
391 A391 Mineral Mix Kombinasi sachet - - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 3,350 - 3,350 -
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - -
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul 350 - 350 -
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
397 A397 Retinol Vit A 100.000 -
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul - - -
22 3,610
398 A398 Tablet Tablet 53,000 - 53,000
399 A399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Tablet - - - -
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros) -
400 A400 tablet - - -
401 A401 0,4
0 Mg Tab (Phapros) 0 - - - -
402 A402 0 0 - - - -
OBAT PROGRAM KESGA 0 - - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule - - - -
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 2 - 2 -
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - -
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 19 - 19 9
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 630 - 630 210
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule 55 - 55 23
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
OBAT PROGRAM JIWA 0 - - - -
416 A416 Amitriptilin 25 mg Tablet - - - -
417 A417 Amitriptilin 25 mg Tablet - - - -
418 A418 Amitriptilin 25 mg Tablet - - - -
419 A419 Amitriptilin 25 mg Tablet 175 - 175 10
420 A420 Amitriptilin 25 mg Tablet - - - -
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - - -
422 A422 Clozapine 100 mg Tablet - - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - -
428 A428 Flufenazin sikzonoate inj 5 ml vial - - - -
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - - -
430 A430 Haloperidol 5 mg tablet Tablet - - - -
431 A431 Haloperidol 5 mg tablet Tablet 400 - 400 132
432 A432 Haloperidol 5 mg tablet Tablet - - - -
433 A433 0 0 - - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - -
436 A436 Haloperidol/ Lodomer drops 2 mg Botol - - - -
437 A437 Karbamazepin Tablet 200 mg Tablet - - - -
438 A438 Karbamazepin Tablet 200 mg Tablet - - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet 79 - 79 79
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
444 A444 0 0 - - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - -
447 A447 Risperidon Tab 2 mg Tablet - - - -
448 A448 Risperidon Tab 2 mg Tablet - - - -
449 A449 0 0 - - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - -
451 A451 0 0 - - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - - -
453 A453 Triheksifenidil Tablet 2 mg Tablet 380 - 380 371
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - -
455 A455 0 0 - - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - -
457 A457 0 0 - - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - - -
458 A458 BCG vial 10 20 30 20
459 A459 PELARUT BCG ampul 10 20 30 20
460 A460 BCG vial - - - -
461 A461 BCG vial - - - -
462 A462 CAMPAK 10ds (MR) vial 50 50 100 50
463 A463 PELARUT CAMPAK ampul 50 50 100 50
464 A464 CAMPAK 10ds (MR) vial - - - -
465 A465 CAMPAK 10ds (MR) vial - - - -
466 A466 DPT HB - Hib/ PENTABIO vial 80 50 130 50
467 A467 DPT HB - Hib/ PENTABIO vial - - - -
468 A468 DT vial - - - -
469 A469 0 0 - - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 50 50 100 16
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - -
472 A472 POLIO bOPV 10 ds vial 50 50 100 50
473 A473 DROPPER POLIO dropper 50 50 100 50
474 A474 POLIO bOPV 10 ds vial - - - -
475 A475 POLIO bOPV 10 ds vial - - - -
476 A476 Td vial - - - -
477 A477 0 0 - - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - -
479 A479 POLIO bOPV 10 ds vial - - - -
480 A480 Vaksin Meningtis vial - - - -
481 A481 CAMPAK 10ds (MR) BIAS vial - - - -
482 A482 PELARUT CAMPAK BIAS ampul - - - -
483 A483 POLIO bOPV 10 ds vial - - - -
484 A484 IPV vial - - - -
485 A485 VTM Include Dacron (Biofarma) pcs - - - -
486 A486 Vaksin Rabies (Verorab) vial - - - -
487 A487 0 0 - - - -
488 A488 0 0 - - - -
489 A489 0 0 - - - -
OBAT PROGRAM HIV/ AIDS 0 - - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - -
491 A491 0 0 - - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 300 - 300 30
493 A493 0 0 - - - -
494 A494 Lamivudine 150 mg Tablet - - - -
495 A495 Lamivudine 150 mg Tablet - - - -
496 A496 Nevirapine 200 mg Tablet - - - -
497 A497 Nevirapine 200 mg Tablet - - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - - -
500 A500 Tablet - - - -
Tenofovir
FDC Dewasa300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple -
501 A501 Tablet - - -
502 A502 FDC Dewasa
Tenofovir 300 mg Tablet - - - -
503 A503 Tenofovir 300 mg Tablet - - - -
504 A504 Zidofudine 100 mg (ZDV) Tablet - - - -
505 A505 Zidofudine 100 mg (ZDV) Tablet - - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
508 A508 Efavirenz 600 mg tablet tablet - - - -
509 A509 Efavirenz 600 mg tablet tablet - - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
511 A511 Abacavir -
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - -
-
512 A512 Tablet - - -
FDC Dewasa
513 A513 0 0 - - - -
514 A514 MB Anak blister - - - -
515 A515 0 0 - - - -
516 A516 0 0 - - - -
517 A517 0 0 - - - -
518 A518 0 0 - - - -
519 A519 0 0 - - - -
520 A520 0 0 - - - -
521 A521 0 0 - - - -
522 A522 0 0 - - - -
523 A523 0 0 - - - -
524 A524 0 0 - - - -
525 A525 0 0 - - - -
526 A526 0 0 - - - -
527 A527 0 0 - - - -
528 A528 0 0 - - - -
529 A529 0 0 - - - -
BMHP 0 - - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 264 - 264 20 56
532 A532 0 0 - - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 454 2,000 2,454 111 491
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - - - -
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - -
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - -
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs 6 - 6 3
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - - -
542 A542 Alkohol 70% (Medika) Btl 1000 ml 10 - 10 2 6
543 A543 Alkohol Swab 2 - ply (one med) 0 - - - -
544 A544 Alkohol Swab 2 - ply (one med) Pcs - - - -
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - - - -
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs - - - -
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs 82 - 82 9 28
549 A549 Catgut -
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - -
-
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Pcs - - -
551 A551 Phsda 0 - - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs 9 - 9 -
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 300 - 300 -
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 42 - 42 3 1
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs - - - -
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs - - - -
561 A561 Mantel Gown (Bisa Dicuci) biji - - - -
562 A562 I.V Catheter No. 18 (JELCO) Pcs 96 - 96 16 11
563 A563 I.V Catheter No. 18 (NIPRO) Pcs - - - -
564 A564 I.V Catheter No. 20 JELCO Pcs - - - -
565 A565 I.V Catheter No. 20 TERUMO Pcs 93 - 93 42 -
566 A566 I.V Catheter No. 20 JELCO Pcs - - - -
567 A567 I.V Catheter No. 22 NIPRO Pcs 97 - 97 49 -
568 A568 I.V Catheter No. 22 NIPRO Pcs - - - -
569 A569 I.V Catheter No. 24 TERUMO Pcs 96 - 96 38 -
570 A570 I.V Catheter No. 24 TERUMO 0 - - - -
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs 41 - 41 27 1
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - - -
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 27 - 27 27
574 A574 Infusion -
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs - 500 500
-
575 A575 Pcs - - -
576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 8 - 8 2 5
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - -
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs 5 - 5 5
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 2 - 2 2
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - -
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 26 - 26 16
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs 184 - 184 22 55
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs - - - -
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - -
588 A588 Masker Ear Loop (Masker) Pcs 307 - 307 150 120
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - -
590 A590 Masker General Care (MARCOTILA) Pcs - - - -
591 A591 0 0 - - - -
592 A592 Masker N95 Disposibel Pcs 35 - 35 35
593 A593 Masker N95 Disposibel (One Med) Pcs - - - -
594 A594 Masker Tali Pcs - - - -
595 A595 Masker Tali Pcs - - - -
596 A596 Masker Elastic Pcs - - - -
597 A597 Media Sample Container Pcs - - - -
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - - -
601 A601 Nurse Cup (Tutup Kepala) Pcs 90 - 90 10
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - -
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 22 - 22 10 9
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Mengetahui Pcs - - - -
607 A607 Povidon Iodine 10% (300 ml) ( One Med)Plt.KABUPATEN
KEPALA DINAS KESEHATAN
LUMAJANG Pcs - - - -
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - -
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs 7 - 7 6
610 A610 0 0 - - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) dr.BAYU WIBOWO IGN Pair - - - -
NIP. 19630724 198910 1 002
613 A613 0 0 - - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - - - -
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair 14 - 14 9
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir - - - -
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 600 - 600 50
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 46 - 46 10 6
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - -
622 A622 0 0 - - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - - -
625 A625 Underpad 90x 0 cm cosmo I Pcs - - - -
626 A626 Underpad 90x 0 cm cosmo II Pcs - - - -
627 A627 0 0 - - - -
628 A628 Urine Bag Sterile Standard Pcs 20 - 20 2 -
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs - - - -
630 A630 0 0 - - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - -
REAGEN 0 - - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 1,000 - 1,000 200
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - -
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - -
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - - -
639 A639 0 0 - - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - -
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - - -
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs - 6 6 6
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - -
649 A649 0 0 - - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - - -
651 A651 0 0 - - - -
652 A652 TPHA (Fokus) Test - - - -
653 A653 0 0 - - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - -
BMHP (PROGRAM) PROPINSI 0 - - - -
PROGRAM MALARIA 0 - - - -
656 A656 RDT Malaria Test - - - -
PROGRAM SYPHILIS 0 - - - -
657 A657 RPR Syphilis Pcs - - - -
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline Test - - - -
Test 200
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - 200 200
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
662 A662 0 0 - - - -
663 A663 Tuberkulin Vial - - - -
664 A664 RDT Lepto (Uji Leptospira IgM) test - - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - -
666 A666 0 0 - - - -
667 A667 0 0 - - - -
PROGRAM HEPATITIS 0 - - - -
Rapid Test Anti Hepatitis C (HCV) -
668 A668 Test - - -
669 A669 Reagen HBsAg Strip SD Test - 200 200 200
670 A670 Reagen HBsAg Strip SD Test - - - -
671 A671 Reagen HBsAg Strip SD Test - - - -
672 A672 0 0 - - - -
673 A673 0 0 - - - -
674 A674 0 0 - - - -
675 A675 0 0 - - - -
PROGRAM TB PARU 0 - - - -
676 A676 Box Slide Pcs - - - -
677 A677 Box Slide Pcs - - - -
678 A678 Catridge Genexpart Test - - - -
679 A679 Catridge Genexpart Test - - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - -
681 A681 Oil Emersi Botol - - - -
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - - -
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - - -
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - 200 200 200
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - - -
686 A686 Reagen Control CD4 0 - - - -
687 A687 Reagen Control CD4 0 - - - -
688 A688 Reagen Zeil Nelseen Kit - 5 5 5
689 A689 Reagen Zeil Nelseen Kit - - - -
690 A690 Reagen Zeil Nelseen Kit - 5 5 5
691 A691 Reagen Zeil Nelseen Kit - - - -
692 A692 Slide Pcs - - - -
693 A693 Slide/ Object Glass Pcs - - - -
694 A694 Stereofoam pcs - - - -
695 A695 Masker N 95 TB pcs - - - -
696 A696 Masker Tali Bedah TB pcs - - - -
OBAT PROGRAM IMUNISASI 0 - - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - 500 500 500
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - -
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
708 A708 0 0 - - - -
709 A709 0 0 - - - -
710 A710 0 0 - - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 478 - 478 1 42
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
714 A714 0 0 - - - -
715 A715 Safety Box 5 L Pcs - - - -
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
717 A717 0 0 - - - -
718 A718 0 0 - - - -
719 A719 0 0 - - - -
720 A720 0 0 - - - -
PROGRAM HIV/ AIDS 0 - - - -
Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) -
721 A721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test - - -
722 A722 Tahap I 0 - - - -
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold) -
723 A723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - -
724 A724 Tahap I 0 - - - -
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold) -
725 A725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test - - -
726 A726 Tahap I 0 - - - -
727 A727 Tahap
Kondom I Pcs - 288 288 288
728 A728 DBS Collection/ Lasec Pcs - - - -
729 A729 Lubricant Pcs - 20 20 20
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - - -
731 A731 Test - 200 200 200
732 A732 IRapid HIV 1/2 3.0 SD Bioline test - - - -
733 A733 Reagen HIV (FOKUS) -
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - -
-
734 A734 Test - - -
735 A735 Tahap
ReagenI HIV (SD) R 1 Test - - - -
736 A736 Reagen HIV (SD) R 1 Test - - - -
737 A737 0 0 - - - -
738 A738 Reagen HIV (VIKIA) R 3 Test - - - -
739 A739 0 0 - - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - - -
741 A741 0 0 - - - -
742 A742 Reagen HIV R3 (VIKIA) Test - - - -
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - -
744 A744 Sarung Tangan Non Steril Pair - - - -
745 A745 0 0 - - - -
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - -
747 A747 VTM Include Swab Test - - - -
748 A748 Masker Bedah 3 ply Pcs - - - -
749 A749 0 0 - - - -
750 A750 0 0 - - - -
751 A751 0 0 - - - -
752 A752 0 0 - - - -
753 A753 0 0 - - - -
754 A754 0 0 - - - -
755 A755 0 0 - - - -
756 A756 0 0 - - - -
757 A757 0 0 - - - -
758 A758 0 0 - - - -
759 A759 0 0 - - - -
760 A760 0 0 - - - -
761 A761 0 0 - - - -
762 A762 0 0 - - - -
763 A763 0 0 - - - -
764 A764 0 0 - - - -
OKSIGEN MEDICAL 0 - - - -
765 A765 Oksigen 3 m3 Tampon - - - -
766 A766 Oksigen 6 m3 Tampon - - - -
767 A767 Oksigen 1 m3 Tampon - - - -
768 A768 Oksigen 6 m3 Tampon - - - -
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - - -
770 A770 0 0 - - - -
771 A771 0 0 - - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - -
TAMBAHAN IFK 0 - - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
3 T003 Ranitidin Tablet/ 150 mg Kapsul 500 mg Tablet - - - -
Thiamphenicol Thiamfilex -
4 T004 Tablet - - -
5 T005 Thiamphenicol Syr. 0 - - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - - -
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - -
10 T010 Ketokonazole 200 mg Tablet - - - -
11 T011 Kotrimoksazol Forte Tablet - - - -
12 T012 Infusion set anak Pcs - - - -
13 T013 Alat Suntik 10 cc Pcs - - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
15 T015 Omeprazole Kapsul 20 mg Tablet - - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - - - -
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
19 T019 Oseltamivir 75 mg Kapsul - - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol - - - -
21 T021 Amitriptilin 25 mg Tablet - - - -
22 T022 I.V Catheter No. 24 TERUMO pcs - - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - - -
24 T024 RDT COVID - 19 0 - - - -
25 T025 Oseltamivir 75 mg 0 - - - -
26 T026 Klorokuin -
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - -
-
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - -
28 T028 Viruses) 0 - - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) 0 - - - -
30 T030 Hazmat/ APD/ Hazmat PPK 0 - - - -
31 T031 Medical Sample Container Pcs - - - -
32 T032 Cepheid Pcs - - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - - -
34 T034 Tambah Darah drop (Ferriz Drop) pcs - - - -
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs - - - -
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
38 T038 Obat Batuk Sirup / INADRYL Botol - - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - - -
40 T040 500mg,Phenylpropanolamine -
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - -
-
41 T041 dextromethorpan Hbr Tablet - - -
42 T042 Influenza
Masker Bedah /Bima Sakti pCS - - - -
43 T043 Masker Bedah /Rania pCS - - - -
44 T044 Masker N 95 Bima Sakti PCS - - - -
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 - - - -
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - -
47 T047 Albendazol Suspensi 200mg/ 5 ml botol - - - -
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - - -
49 T049 OAT FDC Kategori Anak 0 - - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - -
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - -
53 T053 0 0 - - - -
54 T054 0 0 - - - -
55 T055 0 0 - - - -
56 T056 0 0 - - - -
57 T057 0 0 - - - -
58 T058 0 0 - - - -
59 T059 0 0 - - - -
60 T060 APD Set (Rannia) 0 - - - -
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 - - - -
62 T062 Cover -
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia - - -
-
63 T063 0 - - -
64 T064 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - - -
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs - - - -
69 T069 Masker N95 Covid 19 Pcs - - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - - -
71 T071 Masker Eaerlop Hijab Pcs - - - -
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter - - - -
73 T073 Hand Sanitzer 1 Botol = 20 Liter - - - -
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - - -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs - - - -
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - - -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair - - - -
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - - -
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs - - - -
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - -
84 T084 Masker KN95 (Farmahusada) Box @50 pcs - - - -
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - -
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test - - - -
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - -
89 T089 APRON (Atmosfer) pcs - - -
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - -
91 T091 Hand Sanitzer 2 liter - - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs - - - -
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - -
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - -
96 T096 Face Shield (COBRA) 0 - - - -
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
98 T098 Kit Steril (Rajawali) 0 - - - -
99 T099 Alkohol II @20 Liter 0 - - - -
100 T100 Cover All (Rajawali) 0 - - - -
101 T101 Face Shield (ATMOSFER) 0 - - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
103 T103 Masker Earloop (KasaHusada) 0 - - - -
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - -
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - - -
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - - -
107 T107 Alkohol Swab (BTT) 0 - - - -
108 T108 Antiseptic Gel 500 0 - - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - - - -
110 T110 Kaca mata Goggle (HASTEN) 0 - - - -
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - -
112 T112 Masker Bedah Hijau @50pcs 0 - - - -
113 T113 Masker N95 3M 8210 (Hazten) 0 - - - -
114 T114 Nurse Cap Green om 100bh 0 - - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - - -
117 T117 Sarung tangan Safeglove Exam M 100bh 0 - - - -
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - - -
121 T121 Universal Transport Media (UTM) Goongdong 0 - - - -
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - -
127 T127 Rapid Test Lecurate (Bima Sakti) 0 - - - -
128 T128 Rapid Test ZYBIO (Farma Husada) 0 - - - -
129 T129 Alkohol 96 % Liter - - - -
130 T130 0 0 - - - -
0 0 - - - -
TAMBAHAN PUSKESMAS 0 - - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - - -
3 TP003 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube 29 - 29 2 2
4 TP004 pcs - - - -
5 TP005 Zeneca)
0 0 - - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 608 - 608 29
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - - -
9 TP009 0 0 - - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 2 - 2 -
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 10 - 10 -
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 334 - 334 -
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs 53 - 53 -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 11 - 11 2
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 11 - 11 11
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - - -
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - - -
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - - -
24 TP024 Materniti Napkin Slim L 0 - - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1 -
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 2 - 2 -
29 TP029 Haloperidol 5 mg tablet Tablet 18 - 18 18
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - -
31 TP031 Fixomull Strech 5 cm X 5 m Pcs 6 - 6 4 2
32 TP032 Umbilical crd clamp 0 224 - 224 71
33 TP033 0 0 - - -
34 TP034 0 0 - - -
35 TP035 0 0 - - -
36 TP036 0 0 - - -
37 TP037 0 0 - - -
38 TP038 0 0 - - -
39 TP039 0 0 - - -
40 TP040 0 0 - - -
41 TP041 0 0 - - -
42 TP042 0 0 - - -
43 TP043 0 0 - - -
44 TP044 0 0 - - -
45 TP045 0 0 - - -
46 TP046 0 0 - - -
47 TP047 0 0 - - -
48 TP048 0 0 - - -
49 TP049 0 0 - - -
50 TP050 0 0 - - -
51 TP051 0 0 - - -
52 TP052 0 0 - - -
53 TP053 0 0 - - -
54 TP054 0 0 - - -
55 TP055 0 0 - - -
56 TP056 0 0 - - -
57 TP057 0 0 - - -
58 TP058 0 0 - - -
59 TP059 0 0 - - -
60 TP060 0 0 - - -

TOTAL - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

TERTULIS 2 KALI
N LEMBAR PERMINTAAN OBAT
PLPO )

:PEBRUARI BULAN :PEBRUARI

: TAHUN :2019

AN SUMBER HARGA NILAI STOK

SISA STOK NO BATCH PERMINTAAN PEMBERIAN NILAI PENERIMAAN
JUMLAH ANGGARAN SATUAN PERSEDIAAN OPTIMUM

UNIT UNIT RP

- - DAK 18/Okt.19 99.000 0.000 0.000

100 10 A92535 DAK 19/Sept.21 105.000 1,050.000 10,500.000
100
- - DAK 20/ Jan 22 105.000 0.000 0.000
- - - 0.000 0.000 0.000
12 33 DAK 19/Feb.22 2,860.000 94,380.000 0.000
DAK 20/ 16 -
- - 2,860.000 0.000 0.000
Des 22
- - DAK 18/Apr.20 10,500.000 0.000 0.000
58 526 DAK 19/Mei 23 104.000 54,704.000 0.000
- - DAK 20 L 220.000 0.000 0.000
184 605 DAK 19/Juni 21 93.500 56,567.500 0.000
- - DAK 17/AGSTS- - 0.000 0.000 0.000
- - 2,998.000 0.000 0.000
- - 20 - 0.000 0.000 0.000
348 66 Dak 19/Okt. 20 93.000 6,138.000 0.000
- - Dak 20/Okt 21 99.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 17/NOV-21 190.000 0.000 0.000
- - DAK 18/Okt.20 233.000 0.000 0.000
- - DAK 19/Feb 21 233.000 0.000 0.000
- - DAK 20/ April 22 249.000 0.000 0.000
 - - - 0.000 0.000 0.000
38 30 DAK 19/Agst.22 3,025.000 90,750.000 0.000
- - DAK 20 L 3,025.000 0.000 0.000
- - DAK 19/JULI 21 4,400.000 0.000 0.000
- - DAK 20/ Mart 22 3,628.000 0.000 0.000
- - DAK 18L/Mar.20 10,246.500 0.000 0.000
- - PRBG 20 9,900.000 0.000 0.000
62 329 DAK 17/MAR-20 8,500.000 2,796,500.000 0.000
- - DAK 20 / Mei-23 8,237.000 0.000 0.000
- - - 0.000 0.000 0.000
80 - DAK 19/Sept. 23 4,950.000 0.000 0.000
- - - 0.000 0.000 0.000
3 - DAK 17/APR-19 440.000 0.000 0.000
- - DAK 18L/Agst.20 220.000 0.000 0.000
1,356 90 DAK 19/Mei20
PRSpesifik 21 165.000 14,850.000 0.000
- - 58.000 0.000 0.000
- - non covid-19/ - 0.000 0.000 0.000
- - DAK 18/Apr-22 3,035.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/ Juni 23 4,496.000 0.000 0.000
- - - 0.000 0.000 0.000
40 480 DAK
Buffer Prop.20 - 3,045.000
16/APR-20 1,461,600.000 0.000
- - 198.000 0.000 0.000
- - Covid-19
DAK 18L/Jan.21 1,485.000 0.000 0.000
- - PRSpesifik L 20/ 1,551.000 0.000 0.000
991 488 DAK 19/Sept.21 105.000 51,240.000 0.000
- - DAK 20/Juni 22 105.000 0.000 0.000
- - DAK
DAK 17/Jan-21
17/AGSTS- 1,050.000 0.000 0.000
- - 67.000 0.000 0.000
- - 20
DAK 20/Feb 22 75.000 0.000 0.000
- - DAK 19/MAR-22 103.000 0.000 0.000
- - DAK 20 L 253.000 0.000 0.000
- - 0 0.000 0.000 0.000
- 10 DAK 19/Feb.22 2,076.000 20,760.000 0.000
- - 0 0.000 0.000 0.000
8 244 DAK 19/Feb.22 1,584.000 386,496.000 0.000
- - 0 0.000 0.000 0.000
- 150 DAK 18L/Apr.22 2,915.000 437,250.000 0.000
- - DAK 19/Juni 22 2,750.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 18/Mei.22 380.000 0.000 0.000
28 178 DAK 19/Des.22 380.000 67,640.000 0.000
 - - DAK 20/Des 23 405.000 0.000 0.000
- - Dak
DAK19/Feb 21
20/31-Okt 1,639.000 0.000 0.000
- - 1,639.000 0.000 0.000
86 - 21
DAK 18/Apr 23 136.000 0.000 0.000
262 1,738 DAK20
DAK 19/Apr 23
/Nov22, 152.000 264,176.000 0.000
- - 145.000 0.000 0.000
18 39 Mart
DAK 23
PRSpesifik 20 110.000
19/Jan 21 4,290.000 0.000
- - 110.000 0.000 0.000
36 21 Non
DAK Covid-19/
18/Feb.20 3,350.000 70,350.000 0.000
27 70 DAK 19/Feb.20 3,350.000 234,500.000 0.000
- - DAK 20/Okt 21 3,350.000 0.000 0.000
- - DAK 17/JUL-19 300.000 0.000 0.000
- - DAK 20/Feb 24 5,900.000 0.000 0.000
- - DAK 19/ 626.000 0.000 0.000
- - DAK 20 L 18,150.000 0.000 0.000
- - DAK 19/Agst. 20 7,602.000 0.000 0.000
- - DAK 19/Apr.20 7,124.000 0.000 0.000
- - 0 0.000 0.000 0.000
- - DAK 19/Jan 21 149,266.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/Mei 24 5,280.000 0.000 0.000
20 - DAK 19/Juni 24 660.000 0.000 0.000
- - PRBG 20/ 671.000 0.000 0.000
- - DAK 17/MAR-19 4,282.000 0.000 0.000
1 73 DAK 19/Mar.21 11,000.000 803,000.000 0.000
- - PRSpesifik L 20/ 10,098.000 0.000 0.000
- - DAK 19/Okt.21 2,805.000 0.000 0.000
40 72 DAK
DAK 19/Apr.21
20/ Des 21, 1,097.000 78,984.000 0.000
- - 1,097.000 0.000 0.000
759 2,557 Feb
DAK2219/Juni 21 60.500 154,698.500 0.000
- - DAK 20 L 66.000 0.000 0.000
- 6 DAK 18/Nov 19 10,400.000 62,400.000 0.000
- - DAK 18L/Agst.20 9,900.000 0.000 0.000
50 105 DAK 19/Juni 22 1,095.000 114,975.000 0.000
- - - 0.000 0.000 0.000
10 307 DAK 17/APR-21 104.000 31,928.000 0.000
- - DAK 19/Nov.20 104.000 0.000 0.000
- - DAK 20/ 104.000 0.000 0.000
- - DAK 19/Nov.20 105.000 0.000 0.000
8 50 DAK 19/Mar.24 112.000 5,600.000 0.000
- - - 0.000 0.000 0.000
21 41 DAK 19/JULI21 4,400.000 180,400.000 0.000
 - - DAK 20/Feb 22 2,700.000 0.000 0.000
33 250 DAK 19/Juni 21 165.000 41,250.000 0.000
- - DAK 20/Mart 23 91.000 0.000 0.000
- - DAK 18/Des 20 1,408.000 0.000 0.000
2 26 DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 36,608.000 0.000
- - Buffer 1,408.000 0.000 0.000
- - Aprl 21 Prop 730.000 0.000 0.000
- - 19/Mei
DAK 20/ 20Mei 21 770.000 0.000 0.000
- - DAK
DAK 19/Des.23
17/SEPT- 391.000 0.000 0.000
- - 4,167.000 0.000 0.000
- 3 20
DAK
Buffer17/AGS-19
Prop.19/ 3,550.000 10,650.000 0.000
78 281 3,682.000 1,034,642.000 0.000
- - Feb 20 /31-Des
DAK 20
3,682.000 0.000 0.000
- - 21;Jan 22
DAK 17/Apr.19 691.000 0.000 0.000
40 232 DAK 18/Apr.21 710.000 164,720.000 0.000
- - - 0.000 0.000 0.000
- - DAK
DAK 18/Des.19 1,333.000 0.000 0.000
- - 1,333.000 0.000 0.000
- - Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.000 0.000
- - DAK 20/Mei 22 82.000 0.000 0.000
- - DAK 18/Mei 21 4,232.000 0.000 0.000
15 37 DAK 19/Sept.22 4,232.000 156,584.000 0.000
- - DAK 20/Feb 23 4,232.000 0.000 0.000
10 9 DAK 19/Juni 22 2,750.000 24,750.000 0.000
- - DAK 20 L 4,400.000 0.000 0.000
34 79 DAK 17/DES-20 2,900.000 229,100.000 0.000
700 4,122 DAK 19/Feb 24 119.000 490,518.000 0.000
- - DAK 20/ Feb 22 119.000 0.000 0.000
2,036 2,579 DAU 19/Mei
DAK PR BG 23 77.000 198,583.000 0.000
- - COVID 20/ Agsts 99.000 0.000 0.000
120 240 DAK 19/Mei 22
21 7,865.000 1,887,600.000 0.000
- 9 DAK 19/Mei 21 10,010.000 90,090.000 0.000
- - PRSpesifik L 20/ 10,010.000 0.000 0.000
- - DAK 17/FEB-20 6,900.000 0.000 0.000
- - DAK 20/ 7,363.000 0.000 0.000
- - APBD II - 15 132.000 0.000 0.000
166 1,385 DAK 16/OKT-21 149.000 206,365.000 0.000
- - DAK 20 L 88.000 0.000 0.000
- - DAK 18/Agst.21 2,787.000 0.000 0.000
32 3 DAK 19/Mei 23 2,475.000 7,425.000 0.000
- - DAK 20/ Juni 23 2,475.000 0.000 0.000
- - DAK 19/Jan 21 176,800.000 0.000 0.000
 - 10 DAK 19/Mei 21 8,800.000 88,000.000 0.000
- - DAK 20 L 0.000 0.000 0.000
- - DAK 19 4,665.000 0.000 0.000
- - DAK 20/ Des 21 4,665.000 0.000 0.000
262 40 DAK 19/JULI21 264.000 10,560.000 0.000
- - DAK 20 L 330.000 0.000 0.000
- - DAK 18L/Mar.20 660.000 0.000 0.000
- - DAK 20 L 187.000 0.000 0.000
9 291 DAK 17/MAR-21 90.000 26,190.000 0.000
- 24 DAK 18/Jan.22 89.000 2,136.000 0.000
- - DAK 19/Mart.23 121.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 18/Nov.20 9,644.000 0.000 0.000
- - DAK 18/Jan.21 10,696.000 0.000 0.000
- - DAK 19/Jan.22 10,696.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/Juli 21 770.000 0.000 0.000
- - - 0.000 0.000 0.000
- 100 DAK 18/Mar.21 1,755.000 175,500.000 0.000
968 1,373 DAK 19/Mei 21 187.000 256,751.000 0.000
- - DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 0.000 0.000
- - 63.000 0.000 0.000
1,587 5,726 Jan
DAK2319/Mei 24 94.600 541,679.600 0.000
- - DAK 20 L 99.000 0.000 0.000
5 15 DAK 19/Mei23 5,610.000 84,150.000 0.000
- - DAK 20/ Juni 23 2,518.000 0.000 0.000
- 400 DAK 19/Juli21 396.000 158,400.000 0.000
- - DAK 19/Jun 21 288.000 0.000 0.000
- - DAK 20/Jan 22 288.000 0.000 0.000
- - DAK 19/Des.20 1,089.000 0.000 0.000
- - DAK 17/SEPT-- 0.000 0.000 0.000
10 119 1,810.000 215,390.000 0.000
- - 20 - 0.000 0.000 0.000
- - DAK 17/FEB-20 10,500.000 0.000 0.000
17 2 DAK 18L/Mei.20 17,968.500 35,937.000 0.000
17 27 DAK 19/Mart21 35,200.000 950,400.000 0.000
- - - 0.000 0.000 0.000
- - DAK 18/Mei.22 22.000 0.000 0.000
2,316 3,396 DAK 19/Mar.22 77.000 261,492.000 0.000
- - DAK 20/Feb 22 23.000 0.000 0.000
- - DAK 17/MEI 20 2,750.000 0.000 0.000
- - DAK 18L/Mei.23 495.000 0.000 0.000
633 143 DAK 19/Juni 23 440.000 62,920.000 0.000
- - DAU PR BG 20/ 319.000 0.000 0.000
- - DAK 19/JUN 20 2,052.000 0.000 0.000
- - DAK 20/ Mei 22 2,190.000 0.000 0.000
1 11 DAK 17/JUNI 21 13,970.000 153,670.000 0.000
- 3 DAK 19/Apr.21 22,550.000
PRSpesifik 67,650.000 0.000
- - 23,100.000 0.000 0.000
- - Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.000 0.000
10 61 DAK 19/Mei 21 6,600.000 402,600.000 0.000
- - - 0.000 0.000 0.000
- - DAK 17/JUN 21 1,937.000 0.000 0.000
93 116 DAK20/
DAK 19/Mei
Feb 21 2,178.000 252,648.000 0.000
- - 1,222.000 0.000 0.000
12 262 21;Mei22
DAK 19/Juni 21 99.000 25,938.000 0.000
- - DAK 20 L 330.000 0.000 0.000
- 190 DAK 19/Nov.21 123.000 23,370.000 0.000
- - DAK 20/Okt 23 131.000 0.000 0.000
120 420 DAK 18L/Sept.20 4,680.500 1,965,810.000 0.000
- - DAK 19/Jan 22 4,730.000 0.000 0.000
- - DAK 19/ 550.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 18L/Apr.20 4,950.000 0.000 0.000
380 877 DAK 19/Apr 21 5,500.000 4,823,500.000 0.000
- - PRSpesifik L 20/ 3,707.000 0.000 0.000
343 1,163 DAK 19/Des.20
DAK20/28 Feb22 96.000 111,648.000 0.000
- - 102.000 0.000 0.000
- 460 ;DAK 19/Agst. 21 143.000 65,780.000 0.000
- - - 0.000 0.000 0.000
200 161 DAK 17/APR 22 87.000 14,007.000 0.000
- - DAK 18/Nov.20 80.000 0.000 0.000
- - DAK 20 / Juni 22 121.000 0.000 0.000
20 - DAK19/JULI23 192.500 0.000 0.000
- - DAK 20 L 275.000 0.000 0.000
- - DAK 19/Nov 20 8,110.000 0.000 0.000
- - DAK 20/ 8,110.000 0.000 0.000
- - DAK 18L/Okt.20 14,318.700 0.000 0.000
- - DAK 19/Feb 21 5,500.000 0.000 0.000
- 900 DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 1,881,000.000 0.000
- - 5,000.000 0.000 0.000
52 40 19
DAK 19/FEB 21 4,400.000 176,000.000 0.000
PRSpesifik
- - 1,265.000 0.000 0.000
- - Dokter Muter 20
DAK 17/APR 20 990.000 0.000 0.000
 22 - DAK 19/Apr.21 13,200.000
PRSpesifik 0.000 0.000
- - 13,167.000 0.000 0.000
- - Dokter Muter 20 2,332.000
DAK 18L/Des.19 0.000 0.000
380 294 DAK 18L/Okt.21 528.000 155,232.000 0.000
- - PRSpesifik L 20/ 594.000 0.000 0.000
- - DAK 17/FEB 21 835.000 0.000 0.000
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12 - 20
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DAK 18/Mart 20 524.000 0.000 0.000
695 3,883 DAK
DAK 19/Jan
20/Mei 21 524.000 2,034,692.000 0.000
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Buffer Prop 19/ 1,325,000.000
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17/Mei 19
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210 420 20
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DAU 19/Agst.22
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24
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DAU 19/Okt.22
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DAU 19/Sept.21
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DAK 19/Sept 23 427.850 15,830.450 0.000
- - Dak 19/Sept 20 390.860 0.000 0.000
- - BTT 20 Covid-19 2,060.000 0.000 0.000
- - - 0.000
APBD II-14/Sep- 0.000 0.000
35 - 17,500.000 0.000 0.000
- - 19
DAK 18/Okt.22 6,512.000 0.000 0.000
- - Buffer Prop. 19 339.900 0.000 0.000
- - Buffer Prop. 20 339.900 0.000 0.000
 DAU 20 PR
- - 2,200.000 0.000 0.000
- - Spesifik/Des
DAK 19 25 2,309.375 0.000 0.000
- - DAK 18/Agst.22 10,857.000 0.000 0.000
- - DAK 18/Nov.21 10,856.250 0.000 0.000
- - DAK 19/Nov 22 65,340.000 0.000 0.000
10 80 DAK 16 333.900 26,712.000 0.000
- - DAK 16/MEI 21 11,615.000 0.000 0.000
- - DAK 16/MEI 21 6,600.000 0.000 0.000
- - DAK 18/Jan. 23 154.000 0.000 0.000
19 3 DAU 19/Jan.22
DAK 20 ID NON 7,700.000 23,100.000 0.000
- - COVID-19/ Mart 7,769.000 0.000 0.000
- - DAK
DAU 19/Jan
23 22
ID 20 NON 18,000.000 0.000 0.000
- - 12,675.000 0.000 0.000
6 1 COVID-19
DAK 19/Feb 22 3,700.000 3,700.000 0.000
- - DAK 17/SEPT- 0.000 0.000 0.000
- - 286,000.000 0.000 0.000
- - 19
DAK 19/Okt 20 726.953 0.000 0.000
- - - 0.000 0.000 0.000
- - DAU 19/Juli
DAK 20 (ID) 23 542.520 0.000 0.000
- - NON 496.650 0.000 0.000
9 5 DAK
DAU ID 20 non 19,360.000
19/Jan.24
COVID-19/Jan 25 96,800.000 0.000
- - 470.530 0.000 0.000
50 550 covid-19
DAU 19/Nov
DAK 20 (ID) 23 3,773.000 2,075,150.000 0.000
- - NON COVID-19/ 4,134.900 0.000 0.000
16 30 DAK2419/Mar 23 20,586.000
Nov 617,580.000 0.000
- - DAK 19/Nov 23 15,150.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/ Sept. 21 87,120.000 0.000 0.000
- - DAK 19/Des 21 752,400.000 0.000 0.000
- - DAK 19 8,295.000 0.000 0.000
- - DAK 19 8,031.579 0.000 0.000
- - - 0.000 0.000 0.000
2 18 DAK 19/Jan 24 5,368.000 96,624.000 0.000
- - DAK 19/Juli 23 5,785.000 0.000 0.000
- - DAU ID 20 NON - 0.000 0.000 0.000
- - COVID-19/ April 2,887.500 0.000 0.000
- - 24 - 0.000 0.000 0.000
- - DAK 17 453,802.994 0.000 0.000
- - DAK 19/Mei.20 4,200.000 0.000 0.000
200 800 DAK
DAU 19/Nov.22
ID 20 - 635.250 508,200.000 0.000
- - 4,000.000 0.000 0.000
- - Covid-19/
DAK 19 Juni 21 59,000.000 0.000 0.000
 - - DAK 19/Des 20 45,000.000 0.000 0.000
- - DAK 19/Nov 20 45,000.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/Juli
DAU ID 20 Non 20 546,400.000 0.000 0.000
- - 544,150.000 0.000 0.000
- - Covid
DAK 19 0.000 0.000 0.000
- - DAK 19 223,949.367 0.000 0.000
- - DAK 19/Sept 20 254,300.000 0.000 0.000
- - DAK 19/Juni 21 252,800.000 0.000 0.000
6 - HB9030025 DAK 6
DAU 19/ Jan- 21
ID 20 401,666.666 0.000 2,409,999.996
- - 405,000.000 0.000 0.000
- - Covid-19
DAK 17/APR 22 10,560.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/Nov 20 10,837.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/Mar21 19,225.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19/Mei
DAU ID 20 Non 20 552,800.000 0.000 0.000
- - 552,800.000 0.000 0.000
- - Covid - 0.000 0.000 0.000
- - Buffer - 0.000 0.000 0.000
- - 16,400.000 0.000 0.000
- - Prop.19/Mei 21- 0.000 0.000 0.000
Buffer Prop
- - Buffer Prop 4,120.000 0.000 0.000
- - 18/Jul.20 4,120.000 0.000 0.000
- - 18/Jul.21
DAK
Buffer20/Okt 21
Prop 19/ 15,500.000 0.000
200
0.000
200 - F19014 Buffer Prop 19/ 9,738.000 0.000 1,947,600.000
- - Juni 21 9,611.000 0.000 0.000
- - Juli 21 - 0.000 0.000 0.000
- - Buffer Prop 18
Buffer Prop 20/ 625,900.000 0.000 0.000
- - Buffer 22,176.000 0.000 0.000
- - Apr 21 Prop 20/ 66,876.000 0.000 0.000
- - Apr 21 - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - Buffer Prop - 0.000 0.000 0.000
- - Buffer Prop 13,252.000 0.000 0.000
200 - OIME005A 19/Sept. 20 10,865.800 0.000 200 2,173,160.000
- - 19/Mar
Buffer 21 20/
Prop 8,053.000 0.000 0.000
Buffer Prop 20/
- - 8,110.000 0.000 0.000
- - Maret 22 - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
 - - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - Buffer Prop 17 36,000.000 0.000 0.000
- - Buffer
Buffer Prop 19 77,690.000 0.000 0.000
- - Buffer Prop.20/ 825,000.000 0.000 0.000
- - Prop.19/Agst.21 224,254.000 0.000 0.000
- - Okt
DAK 21
BUFF.20PROP 259,175.000 0.000 0.000
- - 70,000.000 0.000 0.000
- - 17/JUN 12 18
Buffer Prop 4,952.830 0.000 0.000
- - Buffer Prop 19 4,952.830 0.000 0.000
200 - Buffer Prop 19 2,728.000 0.000 200 545,600.000
- - Buffer Prop 20/
Buffer Prop 19 5,890.000 0.000 0.000
- - Buffer 660,000.000 0.000 0.000
- - Des 20 Prop 20/ 158,400.000 0.000 0.000
5 - Des 21 PROP
BUFF.
276,600.000 0.000 5 1,383,000.000
BUFF. PROP
17/NOV 17
- - Buffer Prop 276,500.000 0.000 0.000
5 - 17/NOV 18 257,644.000 0.000 5 1,288,220.000
DAK 20
19Des.19
- - 228,800.000 0.000 0.000
- - Penugasan
Buffer TB
DAK 20Prop 19 20,747.000 0.000 0.000
- - 20,748.000 0.000 0.000
- - Penugasan
Buffer Prop.TB
19 6,700.000 0.000 0.000
- - Buffer Prop. 20 19,835.000 0.000 0.000
- - Buffer Prop. 20 386.100 0.000 0.000
- - Buffer Prop - 0.000 0.000 0.000
- - Buffer Prop 1,590.000 0.000 0.000
- - 18/Feb.23 1,550.000 0.000 0.000
Buffer Prop
18/Mar.23 500
500 - 1,463.000 0.000 731,500.000
- - 19/Okt.21
Buffer Prop 20/
20/ 1,518.000 0.000 0.000
Buffer Prop
- - Buffer 1,190.000 0.000 0.000
- - Okt 24 Prop 1,185.000 0.000 0.000
Buffer Prop
19/Apr.23
- - 1,463.000 0.000 0.000
- - 19/Feb Prop
Buffer 24 1,190.000 0.000 0.000
Buffer Prop
19/Agst 24
- - Buffer Prop 1,077.000 0.000 0.000
- - 19/Mar.23 1,081.820 0.000 0.000
Buffer Prop
19/Juni 24
- - 0.000 0.000 0.000
- - 20/Juni 24 - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - Buffer Prop - 0.000 0.000 0.000
43 435 Buffer Prop 1,583.000 688,605.000 0.000
- - 19/Okt. 23 1,439.000 0.000 0.000
Buffer Prop
19/Feb.24
- - 1,439.000 0.000 0.000
- - 20/Feb.24 - 0.000 0.000 0.000
 - - Buffer Prop 19 22,433.000 0.000 0.000
- - Buffer Prop 20 1,460.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - Buffer Prop 19 14,712.500 0.000 0.000
- - Buffer Prop 19/
Buffer Prop 20/ 19,480.000 0.000 0.000
- - 13,750.000 0.000 0.000
- - Juli 21 Prop 20/
Buffer 13,235.000 0.000 0.000
Buffer Prop
- - Buffer Prop 12,500.000 0.000 0.000
- - 19/Feb 21 13,750.000 0.000 0.000
Buffer Prop
20/Mar 21 288
288 - Buffer Prop 20/ 358.000 0.000 103,104.000
- - 19/Mar.20 121,750.000 0.000 0.000
Buffer
Feb 21 Prop 20
20 - 486.000 0.000 9,720.000
- - 19/Nov.21
Buffer Prop 19/- 0.000 0.000
200
0.000
200 - 03ADE011A 11,975.000 0.000 2,395,000.000
- - Apr
DAK 20 Agst 21
Buffer20/
Prop 28,666.670 0.000 0.000
- - Buffer Prop 20/ 13,235.000 0.000 0.000
- - 18/Agst.20 12,500.000 0.000 0.000
Buffer
Mei Prop
2021
- - Buffer Prop 11,975.000 0.000 0.000
- - 18/Okt.20 11,975.000 0.000 0.000
- - 19/Nov.20
Buffer Prop - 0.000 0.000 0.000
- - 19,480.000 0.000 0.000
- - 18/Jun.20
Buffer Prop - 0.000 0.000 0.000
- - 13,235.000 0.000 0.000
- - 19/Agst. 20 - 0.000 0.000 0.000
Buffer Prop
- - Buffer Prop 19,480.000 0.000 0.000
- - 19/Juni 20 20 13,353.000 0.000 0.000
Buffer
juli 21 Prop.
- - 800.000 0.000 0.000
- - 18/Okt.21
Buffer Prop.20- - 0.000 0.000 0.000
- - Buffer Prop.20 - 323,500.000 0.000 0.000
- - Covid-19 53,000.000 0.000 0.000
Buffer Prop.20 -
Covid-19
- - 386.100 0.000 0.000
- - Covid-19 - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAK 19 38,500.000 0.000 0.000
- - DAK 19 71,500.000 0.000 0.000
- - DAK 20 38,500.000 0.000 0.000
- - DAK
DAU 20
ID 20 - 71,500.000 0.000 0.000
- - 333.900 0.000 0.000
- - Covid-19 - 0.000 0.000 0.000
- - Retur PKM - 0.000 0.000 0.000
- - Candipuro, 473.000 0.000 0.000
- - Sumbersari
RETUR - 0.000 0.000 0.000
- - RETUR 110.000 0.000 0.000
- - PASIRIAN
RETUR 1,750.000 0.000 0.000
- - PASIRIAN
RETUR
ROGOTRUNAN 98.000 0.000 0.000
- - RETUR
ROGOTRUNAN 783.000 0.000 0.000
- - ROGOTRUNAN
Buffer Prop 20/ 7,150.000 0.000 0.000
- - 2,134.000 0.000 0.000
- - Apr 21 Pronojiwo
Retur 6,199.900 0.000 0.000
RETUR
- - RETUR 1,155.000 0.000 0.000
- - ROGOTRUNAN 80.000 0.000 0.000
RETUR
ROGOTRUNAN
- - RETUR 396.000 0.000 0.000
- - ROGOTRUNAN 500.000 0.000 0.000
RETUR
ROGOTRUNAN
- - RETUR 7,920.000 0.000 0.000
- - ROGOTRUNAN 1,302.000 0.000 0.000
RETUR
ROGOTRUNAN
RETUR
- - 1,890.000 0.000 0.000
- - ROGOTRUNAN
YOSOWILANGU 160.000 0.000 0.000
DAK 20 /22 Feb
- - N
DAK 20 /01 Sep 6,840.000 0.000 0.000
- - 23 90.000 0.000 0.000
RETUR
21
DAU PR BG
- - 265.000 0.000 0.000
- - TEKUNG
DAU PRSpesifik
COVID 20/ Jan 14,300.000 0.000 0.000
- - 20
RETURCovid-19/
22 Non 7,630.000 0.000 0.000
- - Mar 23
RETUR 167.000 0.000 0.000
- - ROGOTRUNAN 8,355.000 0.000 0.000
Buffer Prop 20/
ROGOTRUNAN
- - 1,457,500.000 0.000 0.000
Mar 22
- - Buffer Prop 20/
Buffer Prop 20/ 0.000 0.000 0.000
- - Buffer 12,969.000 0.000 0.000
- - Agst 20Prop 20/ 1,506.000 0.000 0.000
Buffer
Feb 25 Prop 20/ 410,777.000
- - Buffer 0.000 0.000
- - Apr 21 Prop 20/ 343,687.000 0.000 0.000
Buffer
Apr 21 Prop
Buffer Prop 20/
20/ 32,493.000
- - 0.000 0.000
- - Mar 25
Bantuan 0.000 0.000 0.000
DAK 20
- - DAK 20 TB 2,254.320
Kemenkes 0.000 0.000
- - Penugasan
DAK 20 TB 259,175.000
Penugasan
0.000 0.000
- - DAK 20 15,180.000 0.000 0.000
- - Penugasan 31,680.000 0.000 0.000
DAK 20
Penugasan
- - 31,405.000 0.000 0.000
- - Penugasan
PRBG 20 3,300.000 0.000 0.000
- - PRSpesifik
PRSpesifik 20 7,630.000 0.000 0.000
- - PRSpesifik 14,300.000 0.000 0.000
- - Dokter Muter 20 8,426.000 0.000 0.000
PRSpesifik
Dokter Muter 20 627.000
- - PRSpesifik 0.000 0.000
- - Dokter Muter 20 792.000 0.000 0.000
BTT 20Muter
Dokter KE 2 20
- - BTT 20-19
KE 2 1,700.000 0.000 0.000
- - COVID 1,700.000 0.000 0.000
BTT 20-19
COVID KE 2
- - BTT 20-19
KE 2 55,000.000 0.000 0.000
- - COVID 58,500.000 0.000 0.000
BTT 20-19
COVID KE 2
- - 850.000 0.000 0.000
- - COVID
PROP -19
20 4,000.000 0.000 0.000
RETUR
- - PRSpesifik 20 8,355.000 0.000 0.000
- - ROGOTRUNAN 248,120.000 0.000 0.000
BTTCovid
Non 20 KE 2
- - BTT 20-19
KE 2 186,000.000 0.000 0.000
- - COVID 6,500.000 0.000 0.000
- - COVID -19 Juli 11,250.000
DAK 20/2024 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - DAU 20 - 0.000 0.000 0.000
- - DAU 20
PRSpesifik 236,500.000 0.000 0.000
- - DAU 20 20
PRSpesifik
Covid-19 99,000.000 0.000 0.000
- - DAU 20 20
PRSpesifik
Covid-19 203,500.000 0.000 0.000
- - DAU 20 20
PRSpesifik
Covid-19 275,000.000 0.000 0.000
- - PRSpesifik
Covid-19
DAU 20 20 132,000.000 0.000 0.000
- - Covid-19/20 49,500.000 0.000 0.000
PRSpesifik
 DAU 20
- - PRSpesifik
DAU 5,500.000 0.000 0.000
- - DAU 2020
Covid-19/20 66,000.000 0.000 0.000
- - PRSpesifik
PRSpesifik 1,023.000 0.000 0.000
BUFFER
- - Covid-19/20
BUFFER 20 21,736.000 0.000 0.000
- - PROPINSI 386.100 0.000 0.000
BUFFER
PROPINSI
DAU 20 20
- - 340.280 0.000 0.000
- - PROPINSI
DAU 20 20
PRSpesifik 560,000.000 0.000 0.000
- - DAU 20
PRSpesifik
Covid-19 20 1,252,000.000 0.000 0.000
- - DAU 20
PRSpesifik
Covid-19 20 575,000.000 0.000 0.000
- - DAU20
PRSpesifik
Covid-19/Des 25 156,000.000 0.000 0.000
- - PRSpesifik/Des2
Covid-19/Des 26 53,636.000
DAU PR Spesifik 0.000 0.000
- - DAU PRSpesifik 220,000.000
5Covid-19/20 0.000 0.000
- - DAU PRS 20 148,500.000 0.000 0.000
- - Covid-19 0.000
DAU PRSpesifik 7,000.000
Covid-19/20
0.000
- - DAU ID COVID- 2,200.000 0.000 0.000
- - Covid-19/20 60,000.000 0.000 0.000
DAU
19 20/ID COVID- 6,269.000
- - DAU 0.000 0.000
- - 19 20/ID COVID- 197,000.000 0.000 0.000
DAU
19 20/ID COVID-
Mar 21
- - DAU 75,000.000 0.000 0.000
- - 19 20/ID COVID- 8,500.000 0.000 0.000
DAU
19 20/ID COVID- 220,000.000
- - DAU 0.000 0.000
- - 19 20/ID COVID- 220,000.000 0.000 0.000
DAU
19 20/ID COVID-
Mar 21
- - DAU 75,000.000 0.000 0.000
- - 19 20/ID COVID- 5,000.000 0.000 0.000
DAU
19 20/ID COVID- 200,000.000
- - DAU 0.000 0.000
- - 19 20/ID COVID- 56,000.000 0.000 0.000
DAU
19 20/ID COVID- 80,000.000
- - 0.000 0.000
- - 19 20/ID COVID- 200,000.000
DAU
0.000 0.000
BTT
19 20/20 COVID- 138,364.000
- - 0.000 0.000
- - 19 20 COVID- 137,364.000
BTT
0.000 0.000
DAU PRSpesifik
19
- - DAU PRSpesifik 45,100.000 0.000 0.000
- - Covid-19 0.000
DAU PRSpesifik 66,000.000
Covid-19
0.000
- - DAU ID Covid-19 53,636.000 0.000 0.000
- - Covid-19 0.000
DAU ID Covid- 450,000.000
20
0.000
- - DAU ID Covid- 718,500.000 0.000 0.000
- - 19/20 0.000
DAU ID Covid- 69,000.000
19/20
0.000
- - DAU ID Covid- 60,000.000 0.000 0.000
- - 19/20 0.000
DAU ID Covid- 6,000.000
19/20
0.000
- - DAU ID Covid- 522,728.000 0.000 0.000
- - 19/20 0.000
DAU ID Covid- 180,000.000
19/20
0.000
- - BTT 20 COVID- 220,000.000 0.000 0.000
- - 19/20 109.090 0.000 0.000
19
 BTT 20 COVID-
- - BTT 20 COVID- 24,091.000 0.000 0.000
- - 19 1,150.000 0.000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 47,500.000 0.000 0.000
- - 19 200,000.000 0.000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 2,816.000 0.000 0.000
- - 19 150,000.000 0.000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 303.550 0.000 0.000
- - 19 891,275.000 0.000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 160,500.000 0.000 0.000
- - 19 585.000 0.000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 5,300.000 0.000 0.000
- - 19 5,500.000 0.000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 60,500.000 0.000 0.000
- - 19 80,000.000 0.000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 136,564.000 0.000 0.000
- - 19 1,265.000 0.000 0.000
DAU ID 20 non
19
- - DAU ID 20 non 8,400.000 0.000 0.000
- - covid-19 8,400.000 0.000 0.000
BTT ke 2 20
covid-19
- - BTT ke 2 20 98,000.000 0.000 0.000
- - COVID-19 90,000.000 0.000 0.000
BTT ke 2 20
COVID-20
- - 97,500.000 0.000 0.000
- - COVID-21
DAU 20 22,500.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 7,199.885 0.000 0.000
- - - 1,945.000 0.000 0.000
4 25 - 2,950.000 73,750.000 0.000
- - - 139,880.000 0.000 0.000
- - - 0.000 0.000 0.000
- - - 1,097.000 0.000 0.000
29 579 - 77.000 44,583.000 0.000
- - - 3,217.500 0.000 0.000
- - - 0.000 0.000 0.000
- 2 - 15,572.700 31,145.400 0.000
- 10 - 270.000 2,700.000 0.000
- - - 600.000 0.000 0.000
- 334 - 1,106.000 369,404.000 0.000
- - - 45.000 0.000 0.000
- - - 36.000 0.000 0.000
- - - 783.000 0.000 0.000
- 53 - 1,302.000 69,006.000 0.000
 2 9 - 74,250.000 668,250.000 0.000
11 - - 43,186.000 0.000 0.000
- - - 7,920.000 0.000 0.000
- - - 8,750.000 0.000 0.000
- - - 7,018.000 0.000 0.000
- - - 8,355.000 0.000 0.000
- - - 20,328.000 0.000 0.000
- - - 12,076.000 0.000 0.000
- - - 6,595.000 0.000 0.000
- 1 - 1,098,900.000 1,098,900.000 0.000
- 2 - 712,800.000 1,425,600.000 0.000
18 - - 56.000 0.000 0.000
- - - 1,640.000 0.000 0.000
6 - - 42,800.000 0.000 0.000
71 153 - 2,750.000 420,750.000 0.000
- - - 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
 - 0.000 0.000 0.000
- 0.000 0.000 0.000
- - 108,035,629.94 48,972,439.996

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Generik Paten

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
Ket
BUFFER P 257

BUFFER P 2728
foley 16=50
foley 18=50
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN : MARET
KABUPATEN : LUMAJANG PERMINTAAN BULAN :
PROPINSI : JAWA TIMUR

PEMAKAIAN HARGA
Kode SATUAN SISA SUMBER
NO NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN RAWAT RAWAT NO BATCH
Obat KEMASAN JUMLAH STOK ANGGARAN SATUAN
INAP JALAN

UNIT UNIT UNIT UNIT UNIT RP

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - 0 - - DAK 18/Okt.19 99.000
2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 10 - 10 10 - 10 - DAK 19/Sept.21 105.000
3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - - - - DAK 20/ Jan 22 105.000
4 A004 0 0 - - - - - - - 0.000
5 A005 Air Untuk Injeksi Vial @25 ml Vial 33 - 33 12 12 21 DAK 19/Feb.22 2,860.000
DAK 20/ 16 - Des
6 A006 Air Untuk Injeksi Vial @25 ml Vial - - -
-
- -
22
2,860.000

7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - - - - - DAK 18/Apr.20 10,500.000
8 A008 Alopurinol Tablet 100 mg Tablet 526 - 526 1 108 109 417 DAK 19/Mei 23 104.000
9 A009 Alopurinol Tablet 100 mg 0 - - - - - - DAK 20 L 220.000
10 A010 Ambroxol Tablet 30 mg Tablet 605 - 605 8 276 284 321 DAK 19/Juni 21 93.500
11 A011 0 0 - - - - - -
DAK 17/AGSTS-
- 0.000
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - - - - -
20
2,998.000
13 A013 0 0 - - - - - - - 0.000
14 A014 Amlodipin Tablet 10 Mg Tablet 66 - 66 6 60 66 - Dak 19/Okt. 20 93.000
15 A015 Amlodipin Tablet 10 Mg Tablet - - - - - - Dak 20/Okt 21 99.000
16 A016 0 0 - - - - - - - 0.000
17 A017 Amoksisilin Kaplet 500 mg Tablet - - - - - - DAK 17/NOV-21 190.000
18 A018 Amoksisilin Kaplet 500 mg Tablet - - - - - - DAK 18/Okt.20 233.000
19 A019 Amoksisilin Kaplet 500 mg Tablet - - - - - - DAK 19/Feb 21 233.000
20 A020 Amoksisilin Kaplet 500 mg Tablet - - - - - - DAK 20/ April 22 249.000
21 A021 0 0 - - - - - - - 0.000
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 30 - 30 29 29 1 DAK 19/Agst.22 3,025.000
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - - - - DAK 20 L 3,025.000
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - - - - DAK 19/JULI 21 4,400.000
25 A025 Amoksisilin Syrup Kering 250mg / 5 ml (Novapharin)
Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) /
Botol - - - - - - DAK 20/ Mart 22 3,628.000
26 A026
CLABAT,CAPSINAT
Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) /
Tablet - - - - - - DAK 18L/Mar.20 10,246.500
27 A027
CLABAT,CAPSINAT
Tablet - - - - - - PRBG 20 9,900.000
28 A028 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial 329 - 329 126 189 315 14 DAK 17/MAR-20 8,500.000
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial - - - - - - DAK 20 / Mei-23 8,237.000
30 A030 0 0 - - - - - - - 0.000
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol - - - - - - DAK 19/Sept. 23 4,950.000
32 A032 0 0 - - - - - - - 0.000
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - - - - DAK 17/APR-19 440.000
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - - - - DAK 18L/Agst.20 220.000
35 A035 Antacida + Simeticon Tablet Kunyah (MAGTEN)
Antacida tablet kunyah DOEN, kombinasi : Alumunium
Tablet 90 3,000 3,090 1,060 1,060 2,030 DAK 19/Mei 21
PRSpesifik 20
165.000
36 A036
Hidroksida 200 mg + Magnesium Hidroksida 200 mg
Tablet - - - - - -
non covid-19/
58.000
37 A037 0 0 - - - - - - - 0.000
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - - - - DAK 18/Apr-22 3,035.000
39 A039 0
Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam
0 - - - - - - - 0.000
40 A040
Salisilat 3% (Marin )
Pot - - - - - - DAK 19/ Juni 23 4,496.000
41 A041 0
Antihemoroid Kombinasi : Bismut Suppgalat 150 mg
0 - - - - - - - 0.000
42 A042
Heksaklorofen 2,5 mg Lidokain 10 mg Seng Oksida 120 mg
Supp 480 - 480 60 60 420 DAK 16/APR-20
Buffer Prop.20 -
3,045.000
43 A043 Asam Ascorbat 500 mg (Vitamin C)
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
Tablet - - - - - -
Covid-19
198.000
44 A044
20% ) HEMOROGARD
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
Tablet - - - - - - DAK 18L/Jan.21 1,485.000
45 A045
20% ) HEMOROGARD
Tablet - - - - - - PRSpesifik L 20/ 1,551.000
46 A046 Asam Ascorbat 50 mg (Vitamin C) Tablet 488 - 488 13 293 306 182 DAK 19/Sept.21 105.000
47 A047 Asam Ascorbat 50 mg (Vitamin C)
Asam Folat 1 mg Beta Caroten 10000 Multi Mineral/ FOLAMIL
Tablet - - - - - - DAK 20/Juni 22 105.000
48 A048
(Dexa Medica)
Tablet - - - - - - DAK 17/Jan-21
DAK 17/AGSTS-
1,050.000
49 A049 Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - - - -
20
67.000
50 A050 Asam Folat Tablet 1 mg Tablet - - - - - - DAK 20/Feb 22 75.000
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - - - - DAK 19/MAR-22 103.000
52 A052 Asam Mefenamat 500 mg 0 - - - - - - DAK 20 L 253.000
53 A053 0 0 - - - - - - 0 0.000
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 10 - 10 1 - 1 9 DAK 19/Feb.22 2,076.000
55 A055 0 0 - - - - - - 0 0.000
56 A056 Asam Tranexamat Tablet 500 mg Tablet 244 - 244 38 42 80 164 DAK 19/Feb.22 1,584.000
57 A057 0 0 - - - - - - 0 0.000
58 A058 Asiklovir 5% 5gr Cream Tube 150 - 150 - - 150 DAK 18L/Apr.22 2,915.000
59 A059 Asiklovir 5% 5gr Cream Tube - - - - - - DAK 19/Juni 22 2,750.000
60 A060 0 0 - - - - - - - 0.000
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - - - - DAK 18/Mei.22 380.000
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 178 - 178 6 6 172 DAK 19/Des.22 380.000
63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - - - - DAK 20/Des 23 405.000
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - - - - Dak 19/Feb 21
DAK 20/31-Okt
1,639.000
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - - - -
21
1,639.000
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - - - - DAK 18/Apr 23 136.000
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet 1,738 - 1,738 955 955 783 DAK 19/Apr 23
DAK 20 /Nov22,
152.000
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - - - -
Mart 23
145.000
69 A069 Betahistin Mesylat 6 mg Tablet 39 - 39 39 39 - DAK 19/Jan 21
PRSpesifik 20
110.000
70 A070 Betahistin Mesylat 6 mg Tablet
Tube @ 10
- - - - - -
Non Covid-19/
110.000
71 A071 Betametason Dipropionat Krim 0,1%
gram
Tube @ 10
21 - 21 5 5 16 DAK 18/Feb.20 3,350.000
72 A072 Betametason Dipropionat Krim 0,1%
gram
Tube @ 10
70 - 70 44 44 26 DAK 19/Feb.20 3,350.000
73 A073 Betametason Dipropionat Krim 0,1%
gram
- - - - - - DAK 20/Okt 21 3,350.000
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) Tablet - - - - - - DAK 17/JUL-19 300.000
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - - - - - DAK 20/Feb 24 5,900.000
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - - - - DAK 19/ 626.000
77 A077 Benzatin Benzil Penisilin 2,4 jt
Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra
0 - - - - - - DAK 20 L 18,150.000
78 A078
Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra
Bricasma
Biji - - - - - - DAK 19/Agst. 20 7,602.000
79 A079
Zeneca ) I
Biji - - - - - - DAK 19/Apr.20 7,124.000
80 A080 0
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
0 - - - - - - 0 0.000
81 A081
Zeneca)
pcs - - - - - - DAK 19/Jan 21 149,266.000
82 A082 0
Calcium Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - - - - - - 0.000
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - - - - - DAK 19/Mei 24 5,280.000
84 A084 mg,Zink 5 mg
Cefadroksil Boron500
Kapsul 1 mg)/
mg CAL - 95 Tablet - - - - - - DAK 19/Juni 24 660.000
85 A085 Cefadroksil Kapsul 500 mg Tablet - - - - - - PRBG 20/ 671.000
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - - - - - DAK 17/MAR-19 4,282.000
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 73 - 73 - - 73 DAK 19/Mar.21 11,000.000
88 A088 Citicolin 250 mg / 2 ml Inj Ampule - - - - - - PRSpesifik L 20/ 10,098.000
89 A089 Curcumin Plus Cynarin,Sylimarin,Kapsul/ HEPAGARD (Phapros) Tablet - - - - - - DAK 19/Okt.21 2,805.000
90 A090 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 72 - 72 17 17 55 DAK 19/Apr.21
DAK 20/ Des 21,
1,097.000
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - - - -
Feb 22
1,097.000
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet 2,557 - 2,557 51 546 597 1,960 DAK 19/Juni 21 60.500
93 A093 Deksamethason Tab 0,5 mg 0 - - - - - - DAK 20 L 66.000
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube 6 - 6 3 3 3 DAK 18/Nov 19 10,400.000
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - - - - DAK 18L/Agst.20 9,900.000
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 105 - 105 15 35 50 55 DAK 19/Juni 22 1,095.000
 97 A097 0 0 - - - - - - - 0.000
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 307 - 307 92 92 215 DAK 17/APR-21 104.000
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - - - - DAK 19/Nov.20 104.000
100 A100 Digoksin Tab 0,25 mg Tablet - - - - - - DAK 20/ 104.000
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet - - - - - - DAK 19/Nov.20 105.000
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet 50 - 50 - - 50 DAK 19/Mar.24 112.000
103 A103 0 0 - - - - - - - 0.000
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol 41 - 41 11 23 34 7 DAK 19/JULI21 4,400.000
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - - - - DAK 20/Feb 22 2,700.000
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet 250 500 750 98 199 297 453 DAK 19/Juni 21 165.000
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - - - - DAK 20/Mart 23 91.000
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - - - - DAK 18/Des 20 1,408.000
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 26 - 26 - - 26 DAK 19/Nov.20
DAK GD 20 / 30-
1,408.000
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - - - -
Aprl 21 Prop
Buffer
1,408.000
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - - -
19/Mei 20
730.000
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - - - DAK 20/ Mei 21 770.000
113 A113 Ethambutol 250 mg Tablet - - - - - - DAK 19/Des.23 391.000
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - - - - DAK 17/SEPT-20 4,167.000
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 3 - 3 - - 3 DAK 17/AGS-19
Buffer Prop.19/
3,550.000
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 281 - 281 134 134 147
Feb
DAK2020 /31-Des
3,682.000
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - - - -
21;Jan 22
3,682.000
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - - - - - DAK 17/Apr.19 691.000
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 232 - 232 10 10 222 DAK 18/Apr.21 710.000
120 A120 0 0 - - - - - - - 0.000
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - - - - DAK 18/Des.19
DAK
1,333.000
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - - - -
Farmasi/Jan-22
1,333.000
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - - - - DAK 19/Jan 22 82.000
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - - - - DAK 20/Mei 22 82.000
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - - - - DAK 18/Mei 21 4,232.000
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 37 - 37 1 31 32 5 DAK 19/Sept.22 4,232.000
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - - - - DAK 20/Feb 23 4,232.000
128 A128 Gentamycin Krim 1 % mg/ ml Tube 9 - 9 3 - 3 6 DAK 19/Juni 22 2,750.000
129 A129 Gentian Violet 1% 10 ml Botol - - - - - - DAK 20 L 4,400.000
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 79 - 79 2 10 12 67 DAK 17/DES-20 2,900.000
131 A131 Glibenklamid Tablet 5 mg Tablet 4,122 - 4,122 14 669 683 3,439 DAK 19/Feb 24 119.000
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - - - - DAK 20/ Feb 22 119.000
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet 2,579 - 2,579 479 1,510 1,989 590 DAK 19/Mei
DAU PR BG 23 77.000
134 A134 Gliseril Guaikoulat
Glucosamin HCL 500Tablet
Mg, 100 mg SO4400Mg, MSM 200 Mg,
Konrdoitin Tablet - - - - - - COVID 20/ Agsts 99.000
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 240 - 240 101 101 139 21
DAK 19/Mei 22 7,865.000
136 A136 Gliserofosfat 10 mg
Glukosa Larutan 40% Steril ( Outsuka ) Botol 9 - 9 - - 9 DAK 19/Mei 21 10,010.000
137 A137 Glukosa Larutan 40% Steril botol - - - - - - PRSpesifik L 20/ 10,010.000
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - - - - DAK 17/FEB-20 6,900.000
139 A139 Glukosa Larutan Infus 5% @500ml Botol - - - - - - DAK 20/ 7,363.000
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - - - - APBD II - 15 132.000
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,385 - 1,385 115 115 1,270 DAK 16/OKT-21 149.000
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - - - - DAK 20 L 88.000
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - - - - DAK 18/Agst.21 2,787.000
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 3 - 3 - - 3 DAK 19/Mei 23 2,475.000
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - - - - DAK 20/ Juni 23 2,475.000
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - - - - DAK 19/Jan 21 176,800.000
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10 - - 10 DAK 19/Mei 21 8,800.000
148 A148 0 0 - - - - - - DAK 20 L 0.000
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - - - - DAK 19 4,665.000
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - - - - DAK 20/ Des 21 4,665.000
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 40 - 40 20 20 20 DAK 19/JULI21 264.000
152 A152 Ibuprofen Tablet 400 mg Tablet - - - - - - DAK 20 L 330.000
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - - - - DAK 18L/Mar.20 660.000
154 A154 Isoniazid Tablet 100 mg tablet - - - - - - DAK 20 L 187.000
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 291 - 291 23 23 268 DAK 17/MAR-21 90.000
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 24 - 24 2 - 2 22 DAK 18/Jan.22 89.000
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - - - - DAK 19/Mart.23 121.000
158 A158 0 0 - - - - - - - 0.000
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - - - - DAK 18/Nov.20 9,644.000
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - - - - DAK 18/Jan.21 10,696.000
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol - - - - - - DAK 19/Jan.22 10,696.000
162 A162 0
Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian
0 - - - - - - - 0.000
163 A163
Pharmatama)
Tablet - - - - - - DAK 19/Juli 21 770.000
164 A164 0 0 - - - - - - - 0.000
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100 - - 100 DAK 18/Mar.21 1,755.000
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 1,373 - 1,373 933 933 440 DAK 19/Mei 21 187.000
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - - - - DAK 19/ Agst.22
DAK 20/ Sept 22,
63.000
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - - - -
Jan 23
63.000
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet 5,726 - 5,726 1,239 1,239 4,487 DAK 19/Mei 24 94.600
170 A170 Kaptopril Tab 25 mg TAblet - - - - - - DAK 20 L 99.000
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube 15 - 15 1 7 8 7 DAK 19/Mei23 5,610.000
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube - - - - - - DAK 20/ Juni 23 2,518.000
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 400 - 400 - - 400 DAK 19/Juli21 396.000
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - - - - DAK 19/Jun 21 288.000
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - - - - DAK 20/Jan 22 288.000
176 A176 Ketorolak Inj 30 mg/ml Ampule - - - - - - DAK 19/Des.20 1,089.000
177 A177 0 0 - - - - - - - 0.000
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 119 - 119 11 11 108 DAK 17/SEPT-20 1,810.000
179 A179 0 0 - - - - - - - 0.000
180 A180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma)
Kloramfenikol Tetes Telinga :Kloramfenicol
Vial - - - - - - DAK 17/FEB-20 10,500.000
181 A181
10%,Lidocain,Proplylenglycol
Kloramfenikol /Colme (Interbat)
Tetes Telinga : Kloramfenicol
Tube 2 - 2 1 1 1 DAK 18L/Mei.20 17,968.500
182 A182
10%,Lidocain,Proplylenglycol / COLME (Interbat)
Tube 27 - 27 3 16 19 8 DAK 19/Mart21 35,200.000
183 A183 0 0 - - - - - - - 0.000
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - - - - - DAK 18/Mei.22 22.000
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 3,396 - 3,396 21 1,211 1,232 2,164 DAK 19/Mar.22 77.000
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - - - - DAK 20/Feb 22 23.000
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - - - - DAK 17/MEI 20 2,750.000
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - - - - DAK 18L/Mei.23 495.000
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 143 - 143 2 141 143 - DAK 19/Juni 23 440.000
190 A190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol
Tablet - - - - - - DAU PR BG 20/ 319.000
191 A191
200mg + Trimetropin
Kotrimoksazol 40 mg
Kombinasi ( Holi
Tiap 5mlFarma ) : Sulfametoksazol
Suspensi
Botol - - - - - - DAK 19/JUN 20 2,052.000
192 A192 Krim
200mgAnalgesik (setiap40gram
+ Trimetropin mg (mengandung
Holi Farma ) : Metyl Salisilat 102
Botol - - - - - - DAK 20/ Mei 22 2,190.000
193 A193 mg, Eugenol 13,6 mg; Methol 53,4 mg, Vinishing Cream ad 1 gr/
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract
Tube 11 - 11 6 6 5 DAK 17/JUNI 21 13,970.000
194 A194 MOLAKRIM
100 mg,Neomycin
Krim Sulfat
Jelly Luka Bakar: 5 mg
Tiap Gram/ CENTABIO
Mengandung(Sanbe Farma)
Placenta Extract
Tube 3 - 3 3 3 - DAK 19/Apr.21
PRSpesifik
22,550.000
195 A195
100 mg,Neomycin
Lactobasilus Sulfat 5Rmg
Rhamnosus 11 /2MCENTABIO (Sanbe
+ Laciophillus Farma)
R-52 /Lacidofil,
Tube - - - - - -
Dokter Muter 20
23,100.000
196 A196
Probiotik (Dexa
Lactobasilus Medica, Sanbe)
Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil,
Tablet - - - - - - DAK 18L/Nov.20 3,811.500
197 A197
Probiotik (Dexa Medica, Sanbe)
Tablet 61 - 61 - - 61 DAK 19/Mei 21 6,600.000
198 A198 0 0 - - - - - - - 0.000
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - - - - DAK 17/JUN 21 1,937.000
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 116 - 116 1 84 85 31 DAK 19/ Feb 21
DAK 20/ Mei
2,178.000
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - - - -
21;Mei22
1,222.000
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 262 - 262 18 18 244 DAK 19/Juni 21 99.000
203 A203 Loperamid Tablet 2 mg Tablet - - - - - - DAK 20 L 330.000
204 A204 Loratadin Tablet 10 mg Tablet 190 - 190 10 10 180 DAK 19/Nov.21 123.000
205 A205 Loratadin Tablet 10 mg
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen
Tablet - - - - - - DAK 20/Okt 23 131.000
206 A206
Mata/ OCUGARD
Lutein 6mg,Bellberry(Phapros)
: Mirtl Fructus Ext 80mg Kaps Suplemen
Tablet 420 - 420 60 60 360 DAK 18L/Sept.20 4,680.500
207 A207
Mata/ OCUGARD (Phapros)
Tablet - - - - - - DAK 19/Jan 22 4,730.000
208 A208 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - - - - DAK 19/ 550.000
209 A209 0 0 - - - - - - - 0.000
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - - - - DAK 18L/Apr.20 4,950.000
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 877 - 877 357 - 357 520 DAK 19/Apr 21 5,500.000
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - - - - - PRSpesifik L 20/ 3,707.000
213 A213 Metformin HCl Tablet 500 mg Tablet 1,163 - 1,163 11 238 249 914 DAK 19/Des.20 96.000
DAK20/28
214 A214 Metformin HCl Tablet 500 mg Tablet - - - - - -
Feb22 ;
102.000
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 460 - 460 110 110 350 DAK 19/Agst. 21 143.000
216 A216 0 0 - - - - - - - 0.000
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet 161 - 161 22 131 153 8 DAK 17/APR 22 87.000
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - - - - DAK 18/Nov.20 80.000
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - - - - DAK 20 / Juni 22 121.000
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet - - - - - - DAK19/JULI23 192.500
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet - - - - - - DAK 20 L 275.000
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - - - - DAK 19/Nov 20 8,110.000
223 A223 Metronidasol Infus 500mg/100ml Botol - - - - - - DAK 20/ 8,110.000
224 A224 Minyak Kayu Putih 60 ml
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg,
Botol - - - - - - DAK 18L/Okt.20 14,318.700
225 A225
Zink 20 mg, Beta Caroten 10000 IU, Selenium 30 mcg (LICOXY)
Kapsul - - - - - - DAK 19/Feb 21 5,500.000
226 A226 Multivitamin + Pelancar Asi (NULACVIT)
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
Tablet 900 - 900 90 90 810 DAK 18L/Des.20 2,090.000
DAK 17/AGSTS
227 A227
MERSIBION
Ampule - - - - - -
19
5,000.000
228 A228 Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule 40 - 40 18 15 33 7 DAK 19/FEB 21 4,400.000
PRSpesifik
229 A229 Multivitamin Vitamin/ Suplemen (BECEFORT)
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex
tablet - - - - - -
Dokter Muter 20
1,265.000
230 A230
Ayus )
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU
Tablet - - - - - - DAK 17/APR 20 990.000
231 A231
vit B1 3 mg, B12
Multivitamin CurcumaCurcuminoid 2ml /200mg,Betacaroten
Syr:L-Lysyin LYTACUR (Dexa Medika) 1000 IU
Botol - 192 192 96 96 96 DAK 19/Apr.21 13,200.000
PRSpesifik
232 A232
vit B1 3 mg, B12
Multivitamin Curcuminoid
Neurotopic 2mlTablet:B1
Plus ATP / LYTACUR (Dexa200,B12
100,B6 Medika)
Botol - - - - - -
Dokter Muter 20
13,167.000
233 A233
200Mcg,Vit
MultivitaminENeurotopic
30mg, ATPTablet
20mg: B1
/ Bio100,B6
ATP (Phapros)
200,B12 200 mg/
Tablet - - - - - - DAK 18L/Des.19 2,332.000
234 A234
MOLANEURON (Molex
Neurotopic Ayus)
Tablet 294 - 294 29 265 294 - DAK 18L/Okt.21 528.000
Multivitamin Tab TambahTablet
Darah: B1
: per100,B6
Tablet200,B12 200 mg/
Mengandung :
235 A235
MOLANEURON
Femofomarrat 300mg (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C
tablet - - - - - - PRSpesifik L 20/ 594.000
236 A236
100mg ,Asam Folat 2 Mg,Vit B 12 15Mcg,Faktor Intirinsik 25mg /
Tablet - - - - - - DAK 17/FEB 21 835.000
237 A237 Natrium
HEMAFORT Diklofenak Tab)50 mg (Phapros ) I
( Phapros Tablet - - - - - - DAK 19/OKT20 115.000
238 A238 Natrium Diklofenak Tab 50 mg (Phapros ) II Tablet 1,639 - 1,639 443 443 1,196 DAK 19/Des 20 123.000
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - - - - DAK20/ 123.000
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 31 - 31 4 4 27 DAK 17/JUN 21 6,410.000
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - - - - DAK 18/Feb.22 6,410.000
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 789 - 789 156 172 328 461 DAK19/Jan 20
PRSpesifik 22 132.000
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - - - - Non Covid-19/ Okt 3,948.000
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol 5 - 5 3 - 3 2 21
DAK 18L/Des.20 23,141.800
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 24 - 24 4 4 20 DAK 19/Juli 21 19,800.000
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 50 - 50 9 9 41 DAK 18/Agst.20 560.000
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - - - - DAK 19/Juli 23 560.000
248 A248 Nistatin Vaginal
Obat Batuk HerbalTab: Tiap
100.000
15 MlIU/G (Phapros
Vitetrifolia Fill)1 Gr,Zingiber Tablet - - - - - - DAK20/Sep 23 598.000
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - - - - - DAK 19/Apr 21 12,100.000
250 A250 Macrocarpa
Obat Plus
OBH Kumur SyrFruct
: Per0,20
5 mlMg
+Hyaulorinic / HERBAKOF
Acid 1% @ 200ml
Megnandung (Dexa Medica )
SANORINE
Difenhidramin Pcs - - - - - - DAK 19/Mart.21 24,860.000
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol 33 - 33 4 29 33 - DAK 19/ Agst. 21 9,955.000
PRSpesifik
252 A252 mg,Na Sitrat +Hyaulorinic
Obat Kumur 50 mg / SANADRYLAcid 1% @ 200ml SANORINE Botol - - - - - -
Dokter Muter 20
DAK 16/AGSTS
25,597.000
253 A253 Omeprazole Kapsul 20 mg Tablet 51 600 651 51 51 600
20
160.000
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule - - - - - - DAK 19/Juli 21 1,070.000
255 A255 Ondansetron
Parasetamol Komb HCl InjTablet
2 mg/Antitusif
1ml ( Dexa )
: Parasetamol Ampule - - - - - - DAK 20 1,124.000
256 A256 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Batuk HClBerdahak:Paraset
chlorpheniramine Tablet - - - - - - DAK 19/Mei 22 715.000
257 A257 maleate ,dextromethorpan
400Mg,Bromheksin
Parasetamol Hbr/ ALPARA
80Mg,Difenhidramin
Komb Tablet Batuk ( Molex
HCl
Berdahak:Paraset Ayus
25Mg/ )
HUSTAB Tablet - - - - - - DAK 18L/Jul.20 432.300
258 A258 (Phapros) Komb Tablet
400Mg,Bromheksin
Parasetamol 80Mg,Difenhidramin HCl 25Mg/ HUSTAB
Batuk Berdahak:Paraset Tablet 1,132 - 1,132 694 694 438 DAK19/
PRSpesifik
437.800
259 A259 (Phapros)
400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB
Parasetamol
Tablet - - - - - -
Dokter Muter 20
418.000
260 A260 (Phapros) Komb Tablet Flu: Parasetamol Tablet - - - - - - DAK 19/JUNI22 357.500
500Mg,Pseudofedrin 30Mg, / COLPICA (Tropika Mas)
261 A261 Propiltiourasil/ PTU 100 mg
Parasetamol Komb Tablet Flu: Parasetamol
0 - - - - - - PRSpesifik L 20/ 495.000
262 A262
500Mg,Pseudofedrin 30Mg, Tripolidin 2,5 mg / NOZA (Phapros)
Tablet - - - - - - DAK 18L/Sept.22 789.800
263 A263 Parasetamol Syrup 120 mg/5ml (Mersi Farma) Botol - - - - - - DAK 19 1,181.000
264 A264 Parasetamol Syrup 120 mg/5ml Botol - - - - - - DAK 20/ Des 22 1,181.000
265 A265 Parasetamol tablet 500 mg Tablet 821 - 821 551 551 270 DAK 19/Des 20 53.000
Hibah RSUD
266 A266 Parasetamol tablet 500 mg Tablet - 5,000 5,000 614 2,532 3,146 1,854
Pasirian
56.000
267 A267 Parasetamol tablet 500 mg Tablet - - - - - - Buffer Prop 20/ 53.000
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 8 - 8 3 3 5 DAK 17/JUN 20 20,700.000
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 10 - 10 1 7 8 2 DAK 19/Feb 21 11,825.000
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - - - - DAK 20/Agust 22 11,825.000
271 A271 Piracetam 800 mg Tablet Tablet 230 - 230 22 22 208 DAK19/Apr 21 963.600
272 A272 Parasetamol tablet 500 mg Tablet - - - - - - DAK 20 L 115.500
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule 25 - 25 6 3 9 16 DAK 19/Juli 21 4,400.000
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - - - - DAK 20 L 132.000
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 2,656 - 2,656 2 1,016 1,018 1,638 DAK 19/Sept.21 123.000
276 A276 Probiotik Sachet (Probiokid) 0 - - - - - - PRSpesifik L 20/
DAK 17/AGSTS
6,600.000
277 A277 Polikresulen (Albotyl,Apetil) Botol - - - - - -
20
Buffer Prop
41,500.000
278 A278 Prednison Tab 5 mg Tablet - - - - - -
19/Agus.20
68.000
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 2,634 - 2,634 998 845 1,843 791 DAK 19/Jan.21 73.000
280 A280 Prednison Tab 5 mg Tablet - - - - - - DAK 20/ 73.000
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - - - - DAK 17/JUL 19 1,000.000
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - - - - DAK 19/Nov 20 1,155.000
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - - - - PR BG 20/ 1,188.000
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet - 1,500 1,500 - - 1,500 DAK 19/ 220.000
285 A285 0 0 - - - - - - - 0.000
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - - - - DAK 19/Feb22
DAK 20/24-Jan-
9,646.000
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - - - -
2023
9,646.000
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol 149 - 149 118 10 128 21 DAK 18L/Apr.23 7,150.000
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 2,000 - 2,000 82 82 1,918 DAK 19/Juli 23
DAK 20/06-Jan-
7,150.000
290 A290 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL
Salbutamol SO4 3,01 mg + Ipratonium Brom 0,52 mg Nebulizer
Botol - - - - - -
2025
7,630.000
291 A291
(COMBIVENT) I dan II
Nebule 102 - 102 33 37 70 32 DAK 19/Jan 21 4,550.000
292 A292 0 0 - - - - - - - 0.000
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - - - - - DAK 19/Nov.22 70.000
294 A294 Salbutamol Tab 4 mg (Pristasma)
Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4%
Tablet - - - - - - DAK 20 L 165.000
295 A295
(Marin ) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4%
Salep 2-4
Pot 60 - 60 2 30 32 28 DAK 18/Juni 22 2,620.000
296 A296
(Marin )
Pot - - - - - - DAK 20/ 2,796.000
297 A297 Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - - - - - DAK 18/Des.22 6,006.000
298 A298 Salisil Bedak Serbuk 2% Pcs 11 - 11 4 4 7 DAK 14/MEI 19
PRSpesifik
5,170.000
299 A299 Salisil Bedak Serbuk 2% Pcs - - - - - -
Dokter Muter 20
2,200.000
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - 1 1 1 - DAK 19/Agst.20
DAK 20/30-
479,996.000
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - - - -
Agust-21
512,204.000
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - - - - DAK 19/Sept. 20
DAK 20/30-Nov-
130,999.000
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - - - -
21
130,999.000
304 A304 Setirizin Tab 10 mg (Futamed) Tablet 73 - 73 4 4 69 DAK 18/Apr.20 90.000
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - - - - - DAK 19/Mei 21 90.000
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 390 - 390 336 336 54 DAK 19/Juni 20 110.000
307 A307 Simvastatin Tablet 10 mg Tablet - - - - - - DAK 20/ 117.000
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - 5,000 5,000 - 5,000 DAK 18/Mar.20 265.000
309 A309 0 0 - - - - - - - 0.000
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - - - - DAK 19/ 6,789.000
311 A311 Sukralfat Susp 500mg/5ml @100 ml (Mepro)
Tetes mata setiap ml mengandung Polietilen glikol 400 1%
Botol - - - - - - DAK 20/Feb 22 6,789.000
312 A312
gliserin 0.25% Hidroksipropil metil selulosa 0,2% VISINE
Botol - - - - - - DAK 19/ 13,607.000
313 A313 Tetrasiklin HCl Kapsul 500 mg Tablet - - - - - - Retur PKM/
Buffer Prop
310.000
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - - - - -
19/Agus.21
86.000
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 2,988 - 2,988 42 686 728 2,260 DAK 19/Juli 23 132.000
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - - - - - DAK 20/Feb 22 91.000
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - - - - DAK 19/Juli 23 935.000
318 A318 Thiamphenicol Kapsul 500 mg Tablet - - - - - - DAK 20 L 935.000
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 43 - 43 7 7 36 DAK19/Juli 23 7,150.000
320 A320 Thiamphenicol/
Vitamin B KomplekThiamfilex Susp 125
Plus Ekstrak Hati mg/5 ml (Molex
(Substansi Hati Ayus)
Kering 100 Kapsul - - - - - - DAK 17/Mei 21 7,150.000
321 A321 Vitamin
mg, B Komplek
Vit B1 HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet - - - - - - DAK 20 89.000
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - - - - - DAK 18L/Sept.20 239.800
Nikotinamida
OBAT GOLONGAN 10 mg,PSIKOTROPIKA
Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0 - - - - - -
DAK 17/AGST.
- 0.000
323 A323 CuSO4 0,650,5
Alprazolam mg)mgLIVRPON B-PLEX
(Mersi Farma) Tablet - - - - - - 108.000
18
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - - DAK 17/FEB 21
Buffer Prop
1,045.000
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - -
17/Jul.21
Buffer Prop
967.000
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - -
20/ /Des 22
776.006
327 A327 0 0 - - - - - - - 0.000
328 A328 0 0 - - - - - - - 0.000
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - - - - DAK 18/Feb.20 12,573.000
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - - - - DAK 19/Mar.22 12,573.000
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - - - - DAK 20/
Buffer Prop 19/
12,573.000
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - - - -
Agsts
Buffer20
Prop 20/
1,735.000
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - - - -
Agsts 20
1,735.000
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - - - - DAK 20 L 19,789.000
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet 112 - 112 25 25 87 DAK 18L/Mei.20
PRSpesifik 20
396.000
336 A336 Diazepam Tablet 5 mg Tablet - - - - - -
non covid-19/
114.000
337 A337 Fenobarbital Tablet 30 mg Tablet - - - - - - DAK 17/NOV-19
Buffer Prop 19/
171.000
338 A338 Fenobarbital Tablet 30 mg Tablet - - - - - -
Jun 23
171.000
339 A339 Fenobarbital Tablet 30 mg tablet - - - - - - Buffer Prop 20/ 171.000
340 A340 Kodein Tablet 10 mg Tablet - - - - - - DAK 16/APR 19 550.000
341 A341 0 0 - - - - - - - 0.000
342 A342 Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON
Tablet - - - - - - DAK 17/JUN 20 779.000
343 A343
(Meprofarm)
Tablet - - - - - - DAK 19/Feb. 23 1,320.000
344 A344 0 0 - - - - - - - 0.000
345 A345 0 0 - - - - - - - 0.000
346 A346 0 0 - - - - - -
Buffer Prop. 20/
- 0.000
347 A347 Primaquin 15 mg tablet tablet - - - - - -
Mei 21
278.300
348 A348 0 0 - - - - - - - 0.000
OBAT - OBAT PROGRAM 0 - - - - - - - 0.000
OBAT PROGRAM KECACINGAN 0 - - - - - -
Buffer Prop
- 0.000
349 A349 Albendazol Tablet 400 mg Tablet 266 - 266 1 1 265
19/Feb 22
Buffer Prop
404.000
350 A350 Albendazol Tablet 400 mg Tablet - - - - - -
20/nov 21
431.000
OBAT PROGRAM DIARE 0 - - - - - -
Buffer Prop
- 0.000
351 A351 Garam Oralit (Kimia Farma) Tablet - - - - - -
18/Jul.23
Buffer Prop 19
257.000
352 A352 Garam Oralit (Kimia Farma) Tablet 2,445 - 2,445 384 384 2,061
Juli 23 Prop 20/
Buffer
257.000
353 A353 Garam Oralit (Kimia Farma) sachet - - - - - -
April 24
274.000
354 A354 Garam Oralit (Kimia Farma) sachet - - - - - - DAK 19/Agst.22 274.000
355 A355 0
Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined
0 - - - - - - - 0.000
356 A356
imperial)
Botol 71 - 71 1 13 14 57 DAK 19 /Nov 20 6,281.000
357 A357 Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - - - - DAK 18L/Sept.20
Buff Prop 19 /Mei
9,900.000
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - - - - -
20
Buff Prop 20/
524.000
359 A359 Zinc Dispersible 20 mg tablet tablet - - - - - -
Sept.22
524.000
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - - - - DAK 18/Mart 20 524.000
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 3,883 - 3,883 560 432 992 2,891 DAK 19/Jan 21
DAK 20/Mei
524.000
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - - - -
21;Agust 22
524.000
363 A363 0 0 - - - - - - - 0.000
OBAT PROGRAM HEPATITIS 0 - - - - - - - 0.000
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - - - DAK 19/Agus.20
Buffer Prop 19/
1,325,000.000
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - - -
Agsts. 19
1,325,000.000
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 1 - 1 - - 1 Hibah Jember 1,325,000.000
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - - - Buffer Prop 20/
DAK 20/Maret
1,325,000.000
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - - -
22,SEP 21
1,325,000.000
OBAT PROGRAM TB PARU 0 - - - - - -
Buffer
- 0.000
369 A369 OAT FDC Kategori Anak Kit - - - - - -
Prop19/Juni
Buffer Prop 20
232,518.000
370 A370 OAT FDC Kategori Anak Kit - - - - - -
19/Jun 21 20/
Buffer Prop
248,120.000
371 A371 OAT FDC Kategori Anak Kit - - - - - -
Mei 21 Prop
Buffer
248,120.000
372 A372 OAT FDC Kategori I - IIII Kit - 10 10 10 10 -
19/Juli21
Buffer Prop 20/
389,344.000
373 A373 OAT FDC Kategori I - IIII Kit - - - - - -
Agsts
DAU/ 22
DAK
415,469.000
374 A374 OAT FDC Kategori II Kit - - - - - -
19/Juni 22
Buffer Prop
1,384,983.000
375 A375 OAT FDC Kategori II Kit - - - - - -
19/Jan 22 20/
Buffer Prop
1,384,983.000
376 A376 OAT FDC Kategori II Kit - - - - - -
Agsts
BUFF.22
1,384,983.000
377 A377 OAT FDC Kombipak Kategori I Kit - - - - - -
PROP19/Agst 22
317,018.000
378 A378 0 0 - - - - - -
Buffer Prop 20/
- 0.000
379 A379 Isoniazid 100 mg tablet tablet - - - - - -
Juni 22
282.000
OBAT POGRAM KUSTA 0 - - - - - - - 0.000
 Buffer Prop
380 A380 MDT MB Anak Blister - - - - - -
19/Juni 21
Buffer Prop
28,354.000
381 A381 MDT MB Anak Blister - - - - - -
20/Juni 21 19/
Buffer Prop
28,354.000
382 A382 MDT MB Dewasa Blister - - - - - -
Okt.21
Buffer Prop 19/
40,913.489
383 A383 MDT MB Dewasa Blister - - - - - -
Okt.21
Buffer Prop 20/
41,784.000
384 A384 MDT MB Dewasa Blister - - - - - -
Okt.21
Buffer Prop
41,784.000
385 A385 MDT PB Anak Blister - - - - - -
17/Mei 19
Buffer Prop
8,891.000
386 A386 MDT PB Anak Blister - - - - - -
18/Agst.20
Buffer Prop 20/
13,300.000
387 A387 MDT PB Anak Blister - - - - - -
Nov 22 Prop 20/
Buffer
11,738.000
388 A388 MDT MB Dewasa Blister - - - - - -
Nov 22 Prop 20/
Buffer
36,579.000
389 A389 MDT PB Dewasa Blister - - - - - -
Nov 22
15,014.000
OBAT PROGRAM GIZI 0 - - - - - -
Buffer Prop
- 0.000
390 A390 Mineral Mix Kombinasi sachet - - - - - -
19/Sept 20
2,920.000
391 A391 Mineral Mix Kombinasi sachet - - - - - - Buffer Prop 20/ 2,920.000
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - - - - DAK 19/Agust.21 517.000
Buffer Prop
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 3,350 - 3,350 - - 3,350 DAK 20
20/Apr.22
517.000
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - - - - Penugasan/ Jan 552.000
Buffer Prop
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul 350 - 350 - - 350 23
PRSpesifik
18/Okt. 20 20
284.000
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - - - - - - Non Covid-19/ Okt 307.000
DAU Penugasan
397 A397 Retinol Vit A 100.000 IU (Biru)
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4
Kapsul - - - - - - 21
20
Buffer Prop
307.000
398 A398
Mg TabTambah
Tablet (Phapros)
Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4
Tablet 49,368 - 49,368 5,900 5,900 43,468
19/Juli
Buffer 20
Prop
354.000
399 A399
Mg Tab (Phapros)
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4
Tablet - - - - - -
20/Agst 21
354.000
400 A400
Mg Tab (Phapros)
tablet - - - - - - DAK Penugasan 354.000
401 A401 0 0 - - - - - - - 0.000
402 A402 0 0 - - - - - - - 0.000
OBAT PROGRAM KESGA 0 - - - - - -
Buffer Prop
- 0.000
403 A403 Calcii Gluconas Inj (Ethica) Ampule - - - - - -
18/Agst.20
9,955.000
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 2 - 2 - - 2 DAK 19/Mar 20 3,796.000
DAK GD 20/09-
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - - - -
Okt/21
DAK GD 20/09-
3,796.000
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - - - -
Okt/21
10,351.000
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 10 - 10 3 3 7 DAK 19/ Des 20 2,959.000
Buffer Prop
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - - - -
19/Jul.19
DAK 20 /30-Sept-
2,684.000
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - - - -
21
Buffer Propinsi 20
2,959.000
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - - - - -
/Juli 21
2,500.000
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 420 - 420 40 40 380 DAK 18/Apr.22 210.000
Buffer
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule 32 - 32 27 27 5
Prop.19/Sept.19
DAK 20 / 31 -Okt
1,900.000
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - - - -
22
DAK GD 20/ 31-
1,199.000
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - - - -
Okt 21
1,639.000
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - - - - PR BG 20/ Juli 23 1,199.000
OBAT PROGRAM JIWA 0 - - - - - - - 0.000
416 A416 Amitriptilin 25 mg Tablet - - - - - - DAK 18/Apr.21 167.000
Buffer Prop
417 A417 Amitriptilin 25 mg Tablet - - - - - -
18/Mei 21
167.000
418 A418 Amitriptilin 25 mg Tablet - - - - - - DAK 19/ Jan 23 167.000
Buffer Prop 20/
419 A419 Amitriptilin 25 mg Tablet 165 - 165 5 5 160
Feb. 23
167.000
420 A420 Amitriptilin 25 mg Tablet - - - - - - DAK 20/ 167.000
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - - - - - DAK 19
PRSpesifik 20
1,121.000
422 A422 Clozapine 100 mg Tablet - - - - - -
non covid-19/
3,288.000
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - - DAK 20/ 1,200.000
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - - DAK 17/NOV 20 1,750.000
Hibah
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - -
Penyedia/NOV 20
1,750.000
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - - - - DAK 19/ Juni 21 183.000
Buffer Prop 20/
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - - - -
Agst.22
Buffer Prop. 20/
63,986.000
428 A428 Flufenazin sikzonoate inj 5 ml vial - - - - - -
agst.22
63,813.000
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - - - - - DAK 17/JUN 20 57,500.000
430 A430 Haloperidol 5 mg tablet Tablet - - - - - - DAK 19/Apr 22 60.000
Buffer Prop. 20/
431 A431 Haloperidol 5 mg tablet Tablet 268 - 268 181 181 87
Agst.22
60.000
432 A432 Haloperidol 5 mg tablet Tablet - - - - - - DAK 20/ 60.000
433 A433 0 0 - - - - - - - 0.000
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - - - - - Buffer Prop 19 5,000.000
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - - - - DAK 20 L 13,200.000
436 A436 Haloperidol/ Lodomer drops 2 mg Botol - - - - - - DAK 19/Jan 22 19,955.000
437 A437 Karbamazepin Tablet 200 mg Tablet - - - - - - DAK 19/Juni 22
DAK 20/ Nov 22,
245.000
438 A438 Karbamazepin Tablet 200 mg Tablet - - - - - -
Des 22 Prop 19/
Buffer
245.000
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - - - -
Feb 21
1,243.000
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - - - - DAK 20/ 1,326.000
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - - - - - DAK 19/Sept. 22
Buffer Prop 20/
158.000
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - - - -
Sept. 22
157.000
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - - - - DAK 20 L 253.000
444 A444 0 0 - - - - - - - 0.000
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - - - - DAK 19/
Buffer Prop 19/
287.000
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - - - -
Apr 22 Prop 20/
Buffer
287.000
447 A447 Risperidon Tab 2 mg Tablet - 500 500 150 150 350
Juli 22
287.000
448 A448 Risperidon Tab 2 mg Tablet - - - - - - DAK 20/ 287.000
449 A449 0 0 - - - - - - - 0.000
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - - - - DAK 19/Juni 23 287.000
451 A451 0 0 - - - - - -
Buffer Prop 19/
- 0.000
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - 1,000 1,000 139 139 861
Mei 22 Prop 20/
Buffer
91.000
453 A453 Triheksifenidil Tablet 2 mg Tablet 9 - 9 9 9 -
Juni 22
91.000
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - - - - DAK 20 L 440.000
455 A455 0 0 - - - - - -
PR BG 20/
- 0.000
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - - - -
Nov.22
63,986.000
457 A457 0 0 - - - - - - - 0.000
PROGRAM IMUNISASI (VAKSIN) 0 - - - - - -
Buffer Prop/ Jan
- 0.000
458 A458 BCG vial 10 30 40 29 29 11 0378G181
21
Buffer Prop/ Juli
56,360.000
459 A459 PELARUT BCG ampul 10 30 40 29 29 11 0708S4025E
22
Buffer Prop/ Juli
0.000
460 A460 BCG vial - - - - - -
21
Buffer Prop/
60,140.000
461 A461 BCG vial - - - - - -
Sept.21
Buffer Prop/
66,154.000
462 A462 CAMPAK 10ds (MR) vial 50 20 70 21 21 49 0128W0820Z
Mar.20
Buffer Prop/
141,648.000
463 A463 PELARUT CAMPAK ampul 50 20 70 21 21 49 0688S41352
Mar.23
Buffer Prop/
0.000
464 A464 CAMPAK 10ds (MR) vial - - - - - -
Jul.23
Buffer Prop/
151,150.000
465 A465 CAMPAK 10ds (MR) vial - - - - - -
Agust.21
Buffer Prop/ Juli
166,265.000
466 A466 DPT HB - Hib/ PENTABIO vial 80 50 130 14 14 116 5044118
20
Buffer Prop/ Des
76,620.000
467 A467 DPT HB - Hib/ PENTABIO vial - - - - - -
20
Buffer Prop/ Apr.
84,282.000
468 A468 DT vial - - - - - -
22
17,450.000
469 A469 0 0 - - - - - -
Buffer Prop/
- 0.000
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 84 - 84 34 34 50
Mar.21
Buffer Prop/
23,270.000
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - - - -
Agust
Buffer21Prop/Juli
25,597.000
472 A472 POLIO bOPV 10 ds vial 50 - 50 12 12 38 2054519
21
18,140.000
473 A473 DROPPER POLIO dropper 50 30 80 12 12 68 10109119 Buffer Prop/
Buffer Prop
0.000
474 A474 POLIO bOPV 10 ds vial - 30 30 - - 30
20/Agust-21
Buffer Prop
19,470.270
475 A475 POLIO bOPV 10 ds vial - - - - - -
20/Sept-21
Buffer Prop/
19,954.000
476 A476 Td vial - - - - - -
Mei.21
15,450.000
477 A477 0 0 - - - - - -
Buffer Prop 20/
- 0.000
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - - - -
Sep.
Buffer21Prop 20/
21,810.000
479 A479 POLIO bOPV 10 ds vial - - - - - -
Oct. 21
19,350.000
480 A480 Vaksin Meningtis vial - - - - - - Buffer Prop 20/
Buffer Prop 20/
135,000.000
481 A481 CAMPAK 10ds (MR) BIAS vial - - - - - -
Agust
Buffer21Prop 20/
151,150.000
482 A482 PELARUT CAMPAK BIAS ampul - - - - - -
Okt 23 Prop 20/
Buffer
0.000
483 A483 POLIO bOPV 10 ds vial - - - - - -
Okt.21
Buffer Prop 20/
21,285.000
484 A484 IPV vial - - - - - -
Nov.21
Buffer Prop.20 -
144,540.000
485 A485 VTM Include Dacron (Biofarma) pcs - - - - - -
Covid-19
Buffer Prop.20/
50,000.000
486 A486 Vaksin Rabies (Verorab) vial - - - - - -
April 21
165,000.000
487 A487 0 0 - - - - - - - 0.000
488 A488 0 0 - - - - - - - 0.000
489 A489 0 0 - - - - - - - 0.000
OBAT PROGRAM HIV/ AIDS 0 - - - - - - - 0.000
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - - - - Buffer Prop. 19/ 34,354.100
491 A491 0 0 - - - - - -
Buffer Prop
- 0.000
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 270 - 270 - - 270
19/Sept. 20
164.000
493 A493 0 0 - - - - - -
Buffer Prop
- 0.000
494 A494 Lamivudine 150 mg Tablet - - - - - -
19/Agst.20
Buffer Prop
90,000.000
495 A495 Lamivudine 150 mg Tablet - - - - - -
20/Agust.20
Buffer Prop
90,000.000
496 A496 Nevirapine 200 mg Tablet - - - - - -
19/Mei 23 20/
Buffer Prop
183,480.000
497 A497 Nevirapine 200 mg Tablet - - - - - -
Nov 22
Buffer Prop
176,400.000
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - - - -
19/Nov.20
77.000
499 A499 0
Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple
0 - - - - - -
Buffer Prop
- 0.000
500 A500
FDC Dewasa
Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple
Tablet - - - - - -
19/Jan 21 20/
Buffer Prop
79,154.000
501 A501
FDC Dewasa
Tablet - - - - - -
Jan 21 Prop
Buffer
79,154.000
502 A502 Tenofovir 300 mg Tablet - - - - - -
19/Feb 20
Buffer Prop
303,750.000
503 A503 Tenofovir 300 mg Tablet - - - - - -
20/Juni 21
Buffer Prop
252,720.000
504 A504 Zidofudine 100 mg (ZDV) Tablet - - - - - -
19/Juli 21
106,080.000
505 A505 Zidofudine 100 mg (ZDV) Tablet - - - - - - Buffer Prop 20/ 106,080.000
Buffer Prop
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - -
19/Nov 20 20/
Buffer Prop
222,000.000
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - -
Mei 22 Sidoarjo/
Hibah
222,000.000
508 A508 Efavirenz 600 mg tablet tablet - - - - - -
Apr 20 Prop 20/
Buffer
198,900.000
509 A509 Efavirenz 600 mg tablet tablet - - - - - -
juni 20 Prop 20/
Buffer
198,900.000
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - -
April
Buffer21Prop 20/
230,880.000
511 A511 Abacavir (ABC) 300mg
Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple
Tablet - - - - - -
Des 21
Buffer Prop 20/
133,137.000
512 A512
FDC Dewasa
Tablet - - - - - -
Agust 21
84,050.000
513 A513 0 0 - - - - - -
Buffer Prop 20/
- 0.000
514 A514 MB Anak blister - - - - - -
Nov. 22
22,794.000
515 A515 0 0 - - - - - - - 0.000
516 A516 0 0 - - - - - - - 0.000
517 A517 0 0 - - - - - - - 0.000
518 A518 0 0 - - - - - - - 0.000
519 A519 0 0 - - - - - - - 0.000
520 A520 0 0 - - - - - - - 0.000
521 A521 0 0 - - - - - - - 0.000
522 A522 0 0 - - - - - - - 0.000
523 A523 0 0 - - - - - - - 0.000
524 A524 0 0 - - - - - - - 0.000
525 A525 0 0 - - - - - - - 0.000
526 A526 0 0 - - - - - - - 0.000
527 A527 0 0 - - - - - - - 0.000
528 A528 0 0 - - - - - - - 0.000
529 A529 0 0 - - - - - - - 0.000
BMHP 0 - - - - - - - 0.000
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - - - - DAK 17/AGST 21 990.000
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 188 - 188 16 57 73 115 DAK 19/AGST 23 1,023.000
532 A532 0 0 - - - - - - - 0.000
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 1,852 - 1,852 300 621 921 931 DAK 19/Okt 23 924.000
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - - - - - - DAKSpesifik
PR 19/Agst.2023 1,138.000
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - - - - non covid-19/1 924.000
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - - - - Okt
DAK2418/Mei
DAU ID NON22 979.000
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - - - - COVID-19/1 Okt 739.200
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - - - - 24
DAK 19/Feb24 1,463.000
DAU ID 20 non
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - - - -
covid-19
32,522.000
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs 3 - 3 - - 3 DAK 18/Nov.21 2,541.000
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - - - - - BTT ke 2 20 23,951.000
542 A542 Alkohol 70% (Medika) Btl 1000 ml 2 - 2 1 1 1 DAK 19/Jan.23 19,885.446
DAU ID 20 -
543 A543 Alkohol Swab 2 - ply (one med) 0 - - - - - -
Covid-19
120.000
544 A544 Alkohol Swab 2 - ply (one med) Pcs - - - - - - DAK 19/ Jan 24 127.260
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - 1 1 1 1 - DAK 19/Mar.24 212,784.000
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - - - - DAK 17/DES 21 70,000.000
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs - - - - - - DAK 19/Juli 24 22,725.000
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs 45 - 45 6 11 17 28 DAK 19/Juni 23
DAU ID 20 non
22,500.000
549 A549 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I 0 - - - - - -
covid-19
32,522.000
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda Pcs - - - - - - DAK 19
DAU ID 20 non
24,583.333
551 A551 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda 0 - - - - - -
covid-19
34,300.000
552 A552 Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - - - - DAK 19/Jan 22 712,800.000
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs 9 - 9 - - 9 DAK 18L/Jul.23 348,480.000
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 300 - 300 30 - 30 270 DAK 18/Sept.20 2,222.000
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - - - - DAK 19/ Sept. 20 1,540.000
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - - - - - DAK 18/Mar.22 37,440.000
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 38 - 38 4 3 7 31 DAK 19/Agst.22
DAU ID 20 -
13,050.000
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs - - - - - -
Covid-19
9,680.000
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - - - - DAK 18 20,970.000
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs - - - - - - DAK 19/sept.23
PR BG 20 Covid-
13,607.000
561 A561 Mantel Gown (Bisa Dicuci) biji - - - - - -
19
180,000.000
562 A562 I.V Catheter No. 18 (JELCO) Pcs 69 - 69 10 1 11 58 DAK 18/Jul.22
PRSpesifik 20 8,900.000
563 A563 I.V Catheter No. 18 (NIPRO) Pcs - - - - - - non covid-19/ Des 5,500.000
564 A564 I.V Catheter No. 20 JELCO Pcs - - - - - - 24
DAK 18/Okt.21 8,900.000
565 A565 I.V Catheter No. 20 TERUMO Pcs 51 - 51 42 - 42 9 DAK 19/Okt.21
DAU ID 20 non
6,270.000
566 A566 I.V Catheter No. 20 JELCO Pcs - - - - - -
covid-19
8,700.000
567 A567 I.V Catheter No. 22 NIPRO Pcs 48 - 48 43 - 43 5 DAK 19/Agst.
PRSpesifik 20 23 5,500.000
568 A568 I.V Catheter No. 22 NIPRO Pcs - - - - - - non covid-19/ Des 5,500.000
569 A569 I.V Catheter No. 24 TERUMO Pcs 58 - 58 51 2 53 5 24
DAK 19/Okt.21
DAU ID Non
6,270.000
570 A570 I.V Catheter No. 24 TERUMO 0 - - - - - -
Covid
6,270.000
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs 13 - 13 9 - 9 4 DAK 16/JUL 21
DAK 20/Juni 22
7,920.000
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - - - - - 8,400.000
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - - - DAK 19/Jan 24
DAK 20/Agst.22
6,199.900
574 A574 Infusion Set Dewasa 20 Drops/ (OTSUKA)
Kantong Plastik Bio Hazart (Bahan Plastik PE, Panjang 80 Cm,
Pcs 500 - 500 - - 500 8,400.000
575 A575
Lebar 60 Cm, Tebal 0,33 Mm)
Pcs - - - - - - DAK 18L 1,760.000
576 A576 Kapas Pembalut Hydrofil 250 gr Pcs - - - - - - DAK 18 13,400.000
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 1 - 1 - - 1 DAK 19
DAU ID 20 -
13,400.000
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - - - -
Covid-19
12,500.000
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - - - - - DAK 18/Nov.21 2,300.000
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs - - - - - - DAK 19/Okt.22
DAU ID 20 Non
136,500.000
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - - - -
Covid
136,500.000
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - - - - - DAK 18/Okt.22 8,000.000
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 10 - 10 2 2 8 DAK 19/Sept.21
DAU ID 20 -
5,950.000
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - - - -
Covid-19
8,000.000
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs 107 - 107 11 11 96 DAK 18 1,430.000
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs - - - - - - DAK 19/Feb 22
DAU ID 20 -
2,240.000
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - - - -
Covid-19
2,100.000
588 A588 Masker Ear Loop (Masker) Pcs 37 - 37 20 20 17 DAK 19/Sept 23 427.850
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - - - - Dak 19/Sept 20 390.860
590 A590 Masker General Care (MARCOTILA) Pcs - - - - - - BTT 20 Covid-19 2,060.000
591 A591 0 0 - - - - - -
APBD II-14/Sep-
- 0.000
592 A592 Masker N95 Disposibel Pcs - - - - - -
19
17,500.000
593 A593 Masker N95 Disposibel (One Med) Pcs - - - - - - DAK 18/Okt.22 6,512.000
594 A594 Masker Tali Pcs - - - - - - Buffer Prop. 19 339.900
595 A595 Masker Tali Pcs - - - - - - Buffer Prop. 20
DAU 20 PR
339.900
596 A596 Masker Elastic Pcs - - - - - -
Spesifik/Des 25
2,200.000
597 A597 Media Sample Container Pcs - - - - - - DAK 19 2,309.375
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - - - - DAK 18/Agst.22 10,857.000
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - - - - DAK 18/Nov.21 10,856.250
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - - - - - DAK 19/Nov 22 65,340.000
601 A601 Nurse Cup (Tutup Kepala) Pcs 80 - 80 20 20 60 DAK 16 333.900
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - - - - DAK 16/MEI 21 11,615.000
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - - - - DAK 16/MEI 21 6,600.000
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - - - - - DAK 18/Jan. 23 154.000
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 3 - 3 1 1 2 DAK 19/Jan.22 7,700.000
 DAU 20 ID NON
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - - - - - COVID-19/ Mart 7,769.000
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs - - - - - - 23
DAK 19/Jan 22 18,000.000
DAU ID 20 NON
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - - - -
COVID-19
12,675.000
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs 1 - 1 1 1 - DAK 19/Feb 22 3,700.000
610 A610 0 0 - - - - - - - 0.000
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - - - - DAK 17/SEPT 19 286,000.000
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - - - - DAK 19/Okt 20 726.953
613 A613 0 0 - - - - - - - 0.000
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - - - - - - DAK 19/Juli 23 542.520
DAU 20 (ID) NON
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - - - -
COVID-19/Jan 25
496.650
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair 5 - 5 - - 5 DAK 19/Jan.24 19,360.000
DAU ID 20 non
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir - - - - - -
covid-19
470.530
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 550 - 550 50 50 500 DAK 19/Nov
DAU 23 3,773.000
20 (ID) NON
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - - - - COVID-19/ Nov 4,134.900
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 30 - 30 12 13 25 5 24
DAK 19/Mar 23 20,586.000
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - - - - DAK 19/Nov 23 15,150.000
622 A622 0 0 - - - - - - - 0.000
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - - - - DAK 19/ Sept. 21 87,120.000
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - 2 2 - - 2 DAK 19/Des 21 752,400.000
625 A625 Underpad 90x 0 cm cosmo I Pcs - - - - - - DAK 19 8,295.000
626 A626 Underpad 90x 0 cm cosmo II Pcs - - - - - - DAK 19 8,031.579
627 A627 0 0 - - - - - - - 0.000
628 A628 Urine Bag Sterile Standard Pcs 18 - 18 6 6 12 6 DAK 19/Jan 24 5,368.000
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs - - - - - - DAK 19/Juli 23 5,785.000
630 A630 0 0 - - - - - - DAU ID 20 NON- 0.000
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - - - - COVID-19/ April 2,887.500
REAGEN 0 - - - - - - 24 - 0.000
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - - - - DAK 17 453,802.994
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - - - - DAK 19/Mei.20 4,200.000
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 800 - 800 - - 800 DAK 19/Nov.22 635.250
DAU ID 20 -
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - - - -
Covid-19/ Juni 21
4,000.000
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - - - - - DAK 19 59,000.000
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - - - - DAK 19/Des 20 45,000.000
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - - - - - DAK 19/Nov 20 45,000.000
639 A639 0 0 - - - - - - - 0.000
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - - - - DAK 19/Juli 20 546,400.000
DAU ID 20 Non
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - - - - -
Covid
544,150.000
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - - - - DAK 19 0.000
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - - - - DAK 19 223,949.367
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - - - - - DAK 19/Sept 20 254,300.000
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - - - - - DAK 19/Juni 21 252,800.000
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs - - - - - - DAK 19/ Jan 21 401,666.666
DAU ID 20 -
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - - - - -
Covid-19
405,000.000
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - - - - DAK 17/APR 22 10,560.000
649 A649 0 0 - - - - - - - 0.000
650 A650 Reagen HBsAg Strip (FOKUS) Test - - - - - - DAK 19/Nov 20 10,837.000
651 A651 0 0 - - - - - - - 0.000
652 A652 TPHA (Fokus) Test - - - - - - DAK 19/Mar21 19,225.000
653 A653 0 0 - - - - - - - 0.000
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - - - - DAK 19/Mei 20 552,800.000
DAU ID 20 Non
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - - - -
Covid
552,800.000
BMHP (PROGRAM) PROPINSI 0 - - - - - - - 0.000
PROGRAM MALARIA 0 - - - - - -
Buffer
- 0.000
656 A656 RDT Malaria Test - - - - - -
Prop.19/Mei 21
16,400.000
PROGRAM SYPHILIS 0 - - - - - -
Buffer Prop
- 0.000
657 A657 RPR Syphilis Pcs - - - - - -
18/Jul.20
Buffer Prop
4,120.000
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - - - - -
18/Jul.21
4,120.000
659 A659 Syphilis 3.0 06FK10 SD Bioline Test - - - - - - DAK 20/Okt 21 15,500.000
 Test Buffer Prop 19/
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS)
Test
- - - - - -
Juni 21Prop 19/
Buffer
9,738.000
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - - - -
Juli 21
9,611.000
662 A662 0 0 - - - - - - - 0.000
663 A663 Tuberkulin Vial - - - - - - Buffer Prop 18
Buffer Prop 20/
625,900.000
664 A664 RDT Lepto (Uji Leptospira IgM) test - - - - - -
Apr 21 Prop 20/
Buffer
22,176.000
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - - - -
Apr 21
66,876.000
666 A666 0 0 - - - - - - - 0.000
667 A667 0 0 - - - - - - - 0.000
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV)
0 - - - - - -
Buffer Prop
- 0.000
668 A668 Test - - - - - -
19/Sept. 20
Buffer Prop
13,252.000
669 A669 Reagen HBsAg Strip SD Test - - - - - -
19/Mar 21
10,865.800
670 A670 Reagen HBsAg Strip SD Test - - - - - - Buffer Prop 20/
Buffer Prop 20/
8,053.000
671 A671 Reagen HBsAg Strip SD Test - - - - - -
Maret 22
8,110.000
672 A672 0 0 - - - - - - - 0.000
673 A673 0 0 - - - - - - - 0.000
674 A674 0 0 - - - - - - - 0.000
675 A675 0 0 - - - - - - - 0.000
PROGRAM TB PARU 0 - - - - - - - 0.000
676 A676 Box Slide Pcs - - - - - - Buffer Prop 17 36,000.000
677 A677 Box Slide Pcs - - - - - - Buffer Prop 19
Buffer
77,690.000
678 A678 Catridge Genexpart Test - - - - - -
Prop.19/Agst.21
Buffer Prop.20/
825,000.000
679 A679 Catridge Genexpart Test - - - - - -
Okt 21
224,254.000
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - - - - DAK 20
BUFF. PROP
259,175.000
681 A681 Oil Emersi Botol - - - - - -
17/JUN 12
70,000.000
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - - - - - Buffer Prop 18 4,952.830
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - - - - - Buffer Prop 19 4,952.830
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - - - - - Buffer Prop 19 2,728.000
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - - - - - Buffer Prop 19
Buffer Prop 20/
5,890.000
686 A686 Reagen Control CD4 0 - - - - - -
Des 20 Prop 20/
Buffer
660,000.000
687 A687 Reagen Control CD4 0 - - - - - -
Des
BUFF.21 PROP
158,400.000
688 A688 Reagen Zeil Nelseen Kit - - - - - -
17/NOV 17
BUFF. PROP
276,600.000
689 A689 Reagen Zeil Nelseen Kit - - - - - -
17/NOV 18
Buffer Prop
276,500.000
690 A690 Reagen Zeil Nelseen Kit - - - - - -
19Des.19
DAK 20
257,644.000
691 A691 Reagen Zeil Nelseen Kit - - - - - -
Penugasan TB
228,800.000
692 A692 Slide Pcs - - - - - - Buffer Prop 19
DAK 20
20,747.000
693 A693 Slide/ Object Glass Pcs - - - - - -
Penugasan TB
20,748.000
694 A694 Stereofoam pcs - - - - - - Buffer Prop. 19 6,700.000
695 A695 Masker N 95 TB pcs - - - - - - Buffer Prop. 20 19,835.000
696 A696 Masker Tali Bedah TB pcs - - - - - - Buffer Prop. 20 386.100
OBAT PROGRAM IMUNISASI 0 - - - - - -
Buffer Prop
- 0.000
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - - - -
18/Feb.23
Buffer Prop
1,590.000
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - -
18/Mar.23
Buffer Prop
1,550.000
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - -
19/Okt.21
1,463.000
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - - Buffer Prop 20/
Buffer Prop 20/
1,518.000
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - -
Okt 24 Prop
Buffer
1,190.000
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - - - -
19/Apr.23
Buffer Prop
1,185.000
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - - - -
19/Feb 24
Buffer Prop
1,463.000
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - - - -
19/Agst 24
Buffer Prop
1,190.000
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - -
19/Mar.23
Buffer Prop
1,077.000
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - -
19/Juni 24
Buffer Prop
1,081.820
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - -
20/Juni 24
0.000
708 A708 0 0 - - - - - - - 0.000
709 A709 0 0 - - - - - - - 0.000
710 A710 0 0 - - - - - -
Buffer Prop
- 0.000
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 435 - 435 3 4 7 428
19/Okt. 23
Buffer Prop
1,583.000
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - - - -
19/Feb.24
Buffer Prop
1,439.000
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - - - -
20/Feb.24
1,439.000
714 A714 0 0 - - - - - - - 0.000
715 A715 Safety Box 5 L Pcs - - - - - - Buffer Prop 19 22,433.000
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - - - - Buffer Prop 20 1,460.000
717 A717 0 0 - - - - - - - 0.000
718 A718 0 0 - - - - - - - 0.000
719 A719 0 0 - - - - - - - 0.000
720 A720 0 0 - - - - - - - 0.000
PROGRAM HIV/ AIDS
Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A)
0 - - - - - - - 0.000
721 A721
Tahap I DS HIV 1/2 One Step Rapid Test (GCHIV-402A)
Diagnostar
Test - - - - - - Buffer Prop 19 14,712.500
722 A722
Reagen
KHB R3
Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold)
0 - - - - - - Buffer Prop 20/
Buffer Prop 19/
19,480.000
723 A723
TahapDiagnostik
KHB I Kit For HIV (1+2) Antibody (Colloidal Gold)
Test - - - - - -
Juli 21
13,750.000
724 A724
(Reagen
KHB R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
Diagnostik
0 - - - - - - Buffer Prop 20/
Buffer Prop
13,235.000
725 A725
Tahap I
KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2
Test - - - - - -
19/Feb 21
Buffer Prop
12,500.000
726 A726
Tahap I
0 - - - - - -
20/Mar 21
Buffer Prop
13,750.000
727 A727 Kondom Pcs - 144 144 - - 144
19/Mar.20
Buffer Prop 20/
358.000
728 A728 DBS Collection/ Lasec Pcs - - - - - -
Feb 21 Prop
Buffer
121,750.000
729 A729 Lubricant Pcs - 20 20 - - 20
19/Nov.21
486.000
730 A730 0
Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap
0 - - - - - -
Buffer Prop 19/
- 0.000
731 A731
I
Test - - - - - -
Apr 20
11,975.000
732 A732 Rapid HIV 1/2 3.0 SD Bioline test - - - - - - DAK 20/ Agst 21
Buffer Prop
28,666.670
733 A733 Reagen HIV (FOKUS) R 2
KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2
Test - - - - - -
18/Agst.20
Buffer Prop 20/
13,235.000
734 A734
Tahap I
Test - - - - - -
Mei 2021
Buffer Prop
12,500.000
735 A735 Reagen HIV (SD) R 1 Test - - - - - -
18/Okt.20
Buffer Prop
11,975.000
736 A736 Reagen HIV (SD) R 1 Test - - - - - -
19/Nov.20
11,975.000
737 A737 0 0 - - - - - -
Buffer Prop
- 0.000
738 A738 Reagen HIV (VIKIA) R 3 Test - - - - - -
18/Jun.20
19,480.000
739 A739 0 0 - - - - - -
Buffer Prop
- 0.000
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - - - - -
19/Agst. 20
13,235.000
741 A741 0 0 - - - - - -
Buffer Prop
- 0.000
742 A742 Reagen HIV R3 (VIKIA) Test - - - - - -
19/Juni 20 20
Buffer Prop
19,480.000
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - - - -
juli 21 Prop.
Buffer
13,353.000
744 A744 Sarung Tangan Non Steril Pair - - - - - -
18/Okt.21
800.000
745 A745 0 0 - - - - - -
Buffer Prop.20 -
- 0.000
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - - - -
Covid-19
Buffer Prop.20 -
323,500.000
747 A747 VTM Include Swab Test - - - - - -
Covid-19
Buffer Prop.20 -
53,000.000
748 A748 Masker Bedah 3 ply Pcs - - - - - -
Covid-19
386.100
749 A749 0 0 - - - - - - - 0.000
750 A750 0 0 - - - - - - - 0.000
751 A751 0 0 - - - - - - - 0.000
752 A752 0 0 - - - - - - - 0.000
753 A753 0 0 - - - - - - - 0.000
754 A754 0 0 - - - - - - - 0.000
755 A755 0 0 - - - - - - - 0.000
756 A756 0 0 - - - - - - - 0.000
757 A757 0 0 - - - - - - - 0.000
758 A758 0 0 - - - - - - - 0.000
759 A759 0 0 - - - - - - - 0.000
760 A760 0 0 - - - - - - - 0.000
761 A761 0 0 - - - - - - - 0.000
762 A762 0 0 - - - - - - - 0.000
763 A763 0 0 - - - - - - - 0.000
764 A764 0 0 - - - - - - - 0.000
OKSIGEN MEDICAL 0 - - - - - - - 0.000
765 A765 Oksigen 3 m3 Tampon - - - - - - DAK 19 38,500.000
766 A766 Oksigen 6 m3 Tampon - - - - - - DAK 19 71,500.000
767 A767 Oksigen 1 m3 Tampon - - - - - - DAK 20 38,500.000
768 A768 Oksigen 6 m3 Tampon - - - - - - DAK 20
DAU ID 20 -
71,500.000
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - - - - -
Covid-19
333.900
770 A770 0 0 - - - - - - - 0.000
771 A771 0 0 - - - - - - Retur PKM - 0.000
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - - - - Candipuro, 473.000
TAMBAHAN IFK 0 - - - - - - Sumbersari
RETUR
- 0.000
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - - - -
PASIRIAN
RETUR
110.000
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - - RETUR
PASIRIAN
1,750.000
3 T003 Ranitidin Tablet 150 mg
Thiamphenicol / Thiamfilex Kapsul 500 mg
Tablet - - - - - - ROGOTRUNAN
RETUR 98.000
4 T004 Tablet - - - - - - ROGOTRUNAN
RETUR 783.000
5 T005 Thiamphenicol Syr. 0 - - - - - - ROGOTRUNAN 7,150.000
Buffer Prop 20/
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - - - -
Apr 21
2,134.000
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - - - - Retur Pronojiwo 6,199.900
RETUR
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - - - - -
ROGOTRUNAN
RETUR
1,155.000
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - - - -
ROGOTRUNAN
RETUR
80.000
10 T010 Ketokonazole 200 mg Tablet - - - - - -
ROGOTRUNAN
RETUR
396.000
11 T011 Kotrimoksazol Forte Tablet - - - - - -
ROGOTRUNAN
RETUR
500.000
12 T012 Infusion set anak Pcs - 50 50 - - 50
ROGOTRUNAN
RETUR
7,920.000
13 T013 Alat Suntik 10 cc Pcs - - - - - -
ROGOTRUNAN
RETUR
1,302.000
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - - - RETUR
ROGOTRUNAN
1,890.000
15 T015 Omeprazole Kapsul 20 mg Tablet - - - - - - YOSOWILANGU 160.000
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - - - - - - NDAK 20 /22 Feb 6,840.000
23
DAK 20 /01 Sep
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - - - - -
21
90.000
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - - - - RETUR TEKUNG 265.000
DAU PR BG
19 T019 Oseltamivir 75 mg Kapsul - - - - - - DAU PRSpesifik
COVID 20/ Jan 22
14,300.000
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol - - - - - - 20 Non Covid-19/ 7,630.000
RETUR
21 T021 Amitriptilin 25 mg Tablet - - - - - - Mar 23
ROGOTRUNAN
RETUR
167.000
22 T022 I.V Catheter No. 24 TERUMO pcs - - - - - -
ROGOTRUNAN
Buffer Prop 20/
8,355.000
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - - - - -
Mar 22
1,457,500.000
24 T024 RDT COVID - 19 0 - - - - - - Buffer Prop 20/ 0.000
Buffer Prop 20/
25 T025 Oseltamivir 75 mg 0 - - - - - -
Agst 20Prop 20/
Buffer
12,969.000
26 T026 Klorokuin 150 mg tablet
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For
0 - - - - - -
Feb 25 Prop 20/
Buffer
1,506.000
27 T027
Viruses)
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For
0 - - - - - -
Apr 21
Buffer Prop 20/
410,777.000
28 T028
Viruses)
0 - - - - - -
Apr 21 Prop 20/
Buffer
343,687.000
29 T029 Masker N95 (Particulate Respirator) 0 - - - - - - Buffer
Mar 25 Prop 20/
32,493.000
30 T030 Hazmat/ APD/ Hazmat PPK 0 - - - - - - Bantuan
DAK 20
0.000
31 T031 Medical Sample Container Pcs - - - - - - Kemenkes
Penugasan
DAK 20 TB
2,254.320
32 T032 Cepheid Pcs - - - - - -
Penugasan
DAK 20 TB
259,175.000
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - - - - -
Penugasan
DAK 20
15,180.000
34 T034 Tambah Darah drop (Ferriz Drop) pcs - - - - - -
Penugasan
DAK 20
31,680.000
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs - - - - - -
Penugasan
31,405.000
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - - - - PRBG 20 3,300.000
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - - - - PRSpesifik 20
PRSpesifik
7,630.000
38 T038 Obat Batuk Sirup / INADRYL Botol - - - - - -
Dokter Muter
PRSpesifik 20
14,300.000
39 T039 Parasetamol
Obat Batuk Expektoran Sirup
Komb Tablet Antitusif : Parasetamol Botol - - - - - -
Dokter Muter 20
PRSpesifik
8,426.000
40 T040 500mg,Phenylpropanolamine HCl chlorpheniramine maleate,
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi
Tablet - - - - - -
Dokter Muter 20
PRSpesifik
627.000
41 T041 dextromethorpan Hbr
Influenza
Tablet - - - - - -
Dokter
BTT 20Muter
KE 2 20
792.000
42 T042 Masker Bedah /Bima Sakti pCS - - - - - -
COVID
BTT 20-19
KE 2
1,700.000
43 T043 Masker Bedah /Rania pCS - - - - - -
COVID -19
BTT 20 KE 2
1,700.000
44 T044 Masker N 95 Bima Sakti PCS - - - - - -
COVID
BTT 20-19
KE 2
55,000.000
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 - - - - - -
COVID -19
BTT 20 KE 2
58,500.000
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - - - -
COVID -19
850.000
47 T047 Albendazol Suspensi 200mg/ 5 ml botol - - - - - - PROP 20
RETUR
4,000.000
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - - - - -
ROGOTRUNAN
PRSpesifik 20
8,355.000
49 T049 OAT FDC Kategori Anak 0 - - - - - -
Non
BTTCovid
20 KE 2
248,120.000
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - - - -
COVID
BTT 20-19
KE 2
186,000.000
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - - - - -
COVID -19
6,500.000
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - - - - DAK 20/2024 Juli 11,250.000
53 T053 0 0 - - - - - - - 0.000
54 T054 0 0 - - - - - - - 0.000
55 T055 0 0 - - - - - - - 0.000
 56 T056 0 0 - - - - - - - 0.000
57 T057 0 0 - - - - - - - 0.000
58 T058 0 0 - - - - - - - 0.000
59 T059 0 0 - - - - - - DAU 20 - 0.000
60 T060 APD Set (Rannia) 0 - - - - - - PRSpesifik
DAU 20 Covid- 236,500.000
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 - - - - - - 19 20 20 Covid-
PRSpesifik
DAU 99,000.000
62 T062 Cover All Re Use (Baju bisa di pakai lagi /dicuci) Rannia
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya
0 - - - - - - 19 20 20 Covid-
PRSpesifik
DAU 203,500.000
63 T063
Mitra Bersama)
0 - - - - - - 19 20 20 Covid-
PRSpesifik
DAU 275,000.000
64 T064 Helm visor (Usaha Karya Mitra Bersama) 0 - - - - - - 19 20
PRSpesifik
DAU 20
Covid- 132,000.000
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - - - - 19/20
DAU 20
PRSpesifik
49,500.000
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - - - - PRSpesifik Covid-
DAU 20
5,500.000
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0
box @100
- - - - - - 19/20
DAU 20
PRSpesifik
66,000.000
68 T068 Sarung tangan non steril M,L (COBRA)
pcs
- - - - - - PRSpesifik Covid-
BUFFER
1,023.000
69 T069 Masker N95 Covid 19 Pcs - - - - - - 19/20
PROPINSI
BUFFER 20
21,736.000
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - - - - -
PROPINSI
BUFFER 20
386.100
71 T071 Masker Eaerlop Hijab Pcs
Botol = 20
- - - - - - DAU 20 20
PROPINSI
340.280
72 T072 Etanol 96 % (Alkohol 1)
Liter = 20
Botol
- - - - - - PRSpesifik
DAU 20 Covid- 560,000.000
73 T073 Hand Sanitzer 1
Liter = 20
Botol
- - - - - - 19 20 20 Covid-
PRSpesifik
DAU 1,252,000.000
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI)
Liter
- - - - - - 19 20 20 Covid-
PRSpesifik
DAU 575,000.000
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs - - - - - - 19/Des 25 Covid-
PRSpesifik
DAU2026
156,000.000
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - - - - - 19/Des
PRSpesifik/Des25
DAU PR Spesifik
53,636.000
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - - - - -
Covid-19/20
DAU PRSpesifik
220,000.000
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair - - - - - -
Covid-19
DAU PRS 20
148,500.000
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - - - - -
Covid-19/20
DAU PRSpesifik
7,000.000
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - - - -
Covid-19/20
DAU ID COVID-
2,200.000
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - - - -
19
DAU20/ID COVID-
60,000.000
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs - - - - - -
19
DAU20/ID COVID-
6,269.000
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - - - -
19
DAU20/IDMar 21
COVID-
197,000.000
84 T084 Masker KN95 (Farmahusada) Box @50 pcs - - - - - -
19
DAU20/ID COVID-
75,000.000
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - - - -
19
DAU20/ID COVID-
8,500.000
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test - - 220,000.000
19
DAU20/ID COVID-
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - - - -
19
DAU20/IDMar 21
COVID-
220,000.000
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - - - - -
19
DAU20/ID COVID-
75,000.000
89 T089 APRON (Atmosfer) pcs - - - - - 5,000.000
19
DAU20/ID COVID-
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - - - 200,000.000
19
DAU20/ID COVID-
91 T091 Hand Sanitzer 2 liter - - - - - 56,000.000
19
DAU20/ID COVID-
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - - - 80,000.000
19
DAU20/ID COVID-
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs - - - - - -
19
BTT20/20 COVID-
200,000.000
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - - - -
19
BTT 20 COVID-
138,364.000
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - - - -
19
DAU PRSpesifik
137,364.000
96 T096 Face Shield (COBRA) 0 - - - - - -
Covid-19
DAU PRSpesifik
45,100.000
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - - - -
Covid-19
DAU PRSpesifik
66,000.000
98 T098 Kit Steril (Rajawali) 0 - - - - - -
Covid-19
DAU ID Covid-19
53,636.000
99 T099 Alkohol II @20 Liter 0 - - - - - -
20
DAU ID Covid-
450,000.000
100 T100 Cover All (Rajawali) 0 - - - - - -
19/20
DAU ID Covid-
718,500.000
101 T101 Face Shield (ATMOSFER) 0 - - - - - -
19/20
DAU ID Covid-
69,000.000
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - - - -
19/20
DAU ID Covid-
60,000.000
103 T103 Masker Earloop (KasaHusada) 0 - - - - - -
19/20
DAU ID Covid-
6,000.000
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - - - -
19/20
DAU ID Covid-
522,728.000
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - - - - -
19/20
DAU ID Covid-
180,000.000
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - - - - -
19/20
BTT 20 COVID-
220,000.000
107 T107 Alkohol Swab (BTT) 0 - - - - - -
19
BTT 20 COVID-
109.090
108 T108 Antiseptic Gel 500 0 - - - - - -
19
BTT 20 COVID-
24,091.000
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - - - - - -
19
BTT 20 COVID-
1,150.000
110 T110 Kaca mata Goggle (HASTEN) 0 - - - - - -
19
BTT 20 COVID-
47,500.000
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - - - -
19
BTT 20 COVID-
200,000.000
112 T112 Masker Bedah Hijau @50pcs 0 - - - - - -
19
BTT 20 COVID-
2,816.000
113 T113 Masker N95 3M 8210 (Hazten) 0 - - - - - -
19
150,000.000
 BTT 20 COVID-
114 T114 Nurse Cap Green om 100bh 0 - - - - - -
19
BTT 20 COVID-
303.550
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - - - - -
19
BTT 20 COVID-
891,275.000
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - - - - -
19
BTT 20 COVID-
160,500.000
117 T117 Sarung tangan Safeglove Exam M 100bh 0 - - - - - -
19
BTT 20 COVID-
585.000
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - 0 - -
19
BTT 20 COVID-
5,300.000
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - - 0 - -
19
BTT 20 COVID-
5,500.000
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - - - - -
19
BTT 20 COVID-
60,500.000
121 T121 Universal Transport Media (UTM) Goongdong 0 - - - - - -
19
BTT 20 COVID-
80,000.000
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - - - - -
19
BTT 20 COVID-
136,564.000
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - - - -
19
DAU ID 20 non
1,265.000
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - - - -
covid-19
DAU ID 20 non
8,400.000
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - - - - - covid-19
BTT ke 2 20
8,400.000
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - - - - COVID-19
BTT ke 2 20
98,000.000
127 T127 Rapid Test Lecurate (Bima Sakti) 0 - - - - - - COVID-20
BTT ke 2 20
90,000.000
128 T128 Rapid Test ZYBIO (Farma Husada) 0 - - - - - - COVID-21
97,500.000
129 T129 Alkohol 96 % Liter - - - - - - DAU 20 22,500.000
130 T130 0 0 - - - - - - - 0.000
0 0 - - - - - - - 0.000
TAMBAHAN PUSKESMAS 0 - - - - - - - 0.000
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - - - - - - 7,199.885
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - - - - - - 1,945.000
3 TP003 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
Tube 25 - 25 1 11 12 13 - 2,950.000
4 TP004
Zeneca)
pcs - - - - - - - 139,880.000
5 TP005 0 0 - - - - - - - 0.000
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - - - - - 1,097.000
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 579 - 579 - - 579 - 77.000
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - - - - - - 3,217.500
9 TP009 0 0 - - - - - - - 0.000
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 2 - 2 1 - 1 1 - 15,572.700
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 10 - 10 - - 10 - 270.000
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - - - - - 600.000
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 334 - 334 10 10 324 - 1,106.000
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - - - - - 45.000
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - - - - - - 36.000
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - - - - - - 783.000
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs 53 - 53 53 - 53 - - 1,302.000
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 9 - 9 - - 9 - 74,250.000
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 - - - - - - - 43,186.000
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - - - - - 7,920.000
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - - - - - - 8,750.000
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - - - - - - 7,018.000
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - - - - - - 8,355.000
24 TP024 Materniti Napkin Slim L 0 - - - - - - - 20,328.000
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - - - - - - 12,076.000
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - - - - - - 6,595.000
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1 - - 1 - 1,098,900.000
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 2 - 2 - - 2 - 712,800.000
29 TP029 Haloperidol 5 mg tablet Tablet - - - - - - - 56.000
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - - - - - 1,640.000
31 TP031 Fixomull Strech 5 cm X 5 m Pcs - - - - - - - 42,800.000
32 TP032 Umbilical crd clamp 0 153 - 153 27 27 126 - 2,750.000
33 TP033 0 0 - - - - 0.000
34 TP034 0 0 - - - - 0.000
35 TP035 0 0 - - - - 0.000
36 TP036 0 0 - - - - 0.000
37 TP037 0 0 - - - - 0.000
38 TP038 0 0 - - - - 0.000
39 TP039 0 0 - - - - 0.000
40 TP040 0 0 - - - - 0.000
41 TP041 0 0 - - - - 0.000
42 TP042 0 0 - - - - 0.000
43 TP043 0 0 - - - - 0.000
44 TP044 0 0 - - - - 0.000
45 TP045 0 0 - - - - 0.000
46 TP046 0 0 - - - - 0.000
47 TP047 0 0 - - - - 0.000
48 TP048 0 0 - - - - 0.000
49 TP049 0 0 - - - - 0.000
50 TP050 0 0 - - - - 0.000
51 TP051 0 0 - - - - 0.000
52 TP052 0 0 - - - - 0.000
53 TP053 0 0 - - - - 0.000
54 TP054 0 0 - - - - 0.000
55 TP055 0 0 - - - - 0.000
56 TP056 0 0 - - - - 0.000
57 TP057 0 0 - - - - 0.000
58 TP058 0 0 - - - - 0.000
59 TP059 0 0 - - - - 0.000
60 TP060 0 0 - - - - 0.000

TOTAL - - -

UMUM
BPJS
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

UMUM
BPJS
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Yang Menyerahkan,
TERTULIS 2 KALI KEPALA INSTALASI FARMASI KABUPATEN YANG MEMINTA / MELAPOR
KEPALA PUSKESMAS

Dra. TRI MUSYAROFAH, Apt ......................................................

NIP. 19630411 199203 2 005
 BULAN : MARET
TAHUN : 2019

NILAI STOK
PERSEDIAAN OPTIMUM
PERMINTAAN PEMBERIAN NILAI PENERIMAAN Ket

0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
60,060.000 0.000

0.000 0.000

0.000 0.000
43,368.000 0.000
0.000 0.000
30,013.500 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
3,025.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
119,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
334,950.000 3,000 495,000.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
1,278,900.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
19,110.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
18,684.000 0.000
0.000 0.000
259,776.000 0.000
0.000 0.000
437,250.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
65,360.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
119,016.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
53,600.000 0.000
87,100.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
803,000.000 0.000
0.000 0.000
0.000 0.000
60,335.000 0.000
0.000 0.000
118,580.000 0.000
0.000 0.000
31,200.000 0.000
0.000 0.000
60,225.000 0.000
 0.000 0.000
22,360.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
5,600.000 0.000
0.000 0.000
30,800.000 0.000
0.000 0.000
74,745.000 500 82,500.000
0.000 0.000
0.000 0.000
36,608.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
10,650.000 0.000
541,254.000 0.000
0.000 0.000
0.000 0.000
157,620.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
21,160.000 0.000
0.000 0.000
16,500.000 0.000
0.000 0.000
194,300.000 0.000
409,241.000 0.000
0.000 0.000
45,430.000 0.000
0.000 0.000
1,093,235.000 0.000
90,090.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
189,230.000 0.000
0.000 0.000
0.000 0.000
7,425.000 0.000
0.000 0.000
0.000 0.000
88,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
5,280.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 24,120.000 0.000
1,958.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
175,500.000 0.000
82,280.000 0.000
0.000 0.000
0.000 0.000
424,470.200 0.000
0.000 0.000
39,270.000 0.000
0.000 0.000
158,400.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
195,480.000 0.000
0.000 0.000
0.000 0.000
17,968.500 0.000
281,600.000 0.000
0.000 0.000
0.000 0.000
166,628.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
69,850.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
402,600.000 0.000
0.000 0.000
0.000 0.000
67,518.000 0.000
0.000 0.000
24,156.000 0.000
0.000 0.000
22,140.000 0.000
0.000 0.000
1,684,980.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
2,860,000.000 0.000
0.000 0.000
 87,744.000 0.000
0.000 0.000
50,050.000 0.000
0.000 0.000
696.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,692,900.000 0.000
0.000 0.000
30,800.000 0.000
0.000 0.000
0.000 0.000
1,267,200.000 192 2,534,400.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
147,108.000 0.000
0.000 0.000
173,070.000 0.000
0.000 0.000
60,852.000 0.000
0.000 0.000
46,283.600 0.000
396,000.000 0.000
22,960.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
96,000.000 600 96,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
191,756.400 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
14,310.000 0.000
103,824.000 5,000 280,000.000
0.000 0.000
103,500.000 0.000
23,650.000 0.000
0.000 0.000
 200,428.800 0.000
0.000 0.000
70,400.000 0.000
0.000 0.000
201,474.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
57,743.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
330,000.000 1,500 330,000.000
0.000 0.000
0.000 0.000
0.000 0.000
150,150.000 0.000
13,713,700.000 0.000
0.000 0.000
145,600.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
73,360.000 0.000
0.000 0.000
0.000 0.000
36,190.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
6,210.000 0.000
0.000 0.000
5,940.000 0.000
0.000 0.000
1,325,000.000 5,000 1,325,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
298,320.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
257,400.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
34,452.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
107,060.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
529,677.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
358,017.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,514,884.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,325,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 10 3,893,440.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,731,950.000 0.000
0.000 0.000
99,400.000 0.000
0.000 0.000
0.000 0.000
15,387,672.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
7,592.000 0.000
0.000 0.000
0.000 0.000
20,713.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
79,800.000 0.000
9,500.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
26,720.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
5,220.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
100,450.000 500 143,500.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
78,351.000 1,000 91,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
619,960.000 30 1,690,800.000
0.000 30 0.000
0.000 0.000
0.000 0.000
6,940,752.000 20 2,832,960.000
0.000 20 0.000
0.000 0.000
0.000 0.000
8,887,920.000 50 3,831,000.000
0.000 0.000
0.000 - 0.000
0.000 0.000
1,163,500.000 - 0.000
0.000 0.000
689,320.000 0.000
0.000 30 0.000
584,108.100 30 584,108.100
0.000 0.000
0.000 - 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
44,280.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
117,645.000 0.000
0.000 0.000
860,244.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
7,623.000 0.000
0.000 0.000
19,885.446 0.000
0.000 0.000
0.000 0.000
0.000 1 212,784.000
0.000 0.000
0.000 0.000
 630,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
3,136,320.000 0.000
599,940.000 0.000
0.000 0.000
0.000 0.000
404,550.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
516,200.000 0.000
0.000 0.000
0.000 0.000
56,430.000 0.000
0.000 0.000
27,500.000 0.000
0.000 0.000
31,350.000 0.000
0.000 0.000
31,680.000 0.000
0.000 0.000
0.000 0.000
4,200,000.000 0.000
0.000 0.000
0.000 0.000
13,400.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
47,600.000 0.000
0.000 0.000
137,280.000 0.000
0.000 0.000
0.000 0.000
7,273.450 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
20,034.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
15,400.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
96,800.000 0.000
0.000 0.000
1,886,500.000 0.000
0.000 0.000
102,930.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,504,800.000 2 1,504,800.000
0.000 0.000
0.000 0.000
0.000 0.000
32,208.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
508,200.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
677,524.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
51,552.000 144 51,552.000
0.000 0.000
9,720.000 20 9,720.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
396,000.000 50 396,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
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0.000 0.000
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0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
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0.000 0.000
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0.000 0.000
0.000 0.000
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0.000 0.000
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0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
38,350.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
44,583.000 0.000
0.000 0.000
0.000 0.000
15,572.700 0.000
2,700.000 0.000
0.000 0.000
358,344.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
668,250.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,098,900.000 0.000
1,425,600.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
346,500.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
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0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000
95,613,305.696 20,384,564.100

JUMLAH LBR RESEP JUMLAH TOTAL R

Rawat Jalan Rawat Inap Generik Paten

JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

Rawat Jalan Rawat Inap antibiotik injeksi

BUFFER P 257

BUFFER P 2728
Pelaporan : Persentase Puskesmas denga
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Albendazol /Pira Tablet 1
2 Alopurinol Tablet 1
3 Amlodipin/Kapto Tablet 1
4 Amoksisilin 500 Tablet 0
5 Amoksisilin sirup Botol 1
6 Antasida tablet k Tablet/Botol 1
7 Asam Askorbat (V Tablet 1
8 Asiklovir Tablet 1
9 Betametason sal Tube 1
10 Deksametason tabTablet/Vial/Ampul 1
11 Diazepam injeksi Ampul 0
12 Diazepam Tablet 1
13 Dihidroartemsin Tablet 1
14 Difenhidramin In Ampul 1
15 Epinefrin (Adrena Ampul 1
16 Fitomenadion (Vi Ampul 1
17 Furosemid 40 mg/ Tablet 0
18 Garam Oralit ser Kantong 1
19 Glibenklamid/Me Tablet 1
20 Hidrokortison kr Tube 1
21 Kotrimoksazol (d Tablet/Botol 1
22 Lidokain inj Vial 1
23 Magnesium Sulfat Vial 1
24 Metilergometrin Ampul 1
25 Natrium Diklofen Tablet 1
26 OAT FDC Kat 1 Paket 1
27 Oksitosin injeksi Ampul 1
28 Parasetamol siru Botol 0
29 Parasetamol 500 Tablet 1
30 Prednison 5 mg Tablet 1
31 Ranitidin 150 mg Tablet 1
32 Retinol 100.000/ Kapsul 1
33 Salbutamol Tablet 1
34 Salep Mata/Tetes Tube 1
35 Simvastatin Tablet 1
36 Siprofloksasin Tablet 1
37 Tablet Tambah D Tablet 1
38 Triheksifenidil Tablet 1
39 Vitamin B6 (Pirid Tablet 1
40 Zinc 20 mg Tablet 1
JUMLAH ITEM OBAT INDIKATOR 36
Pelaporan : Persentase Puskesmas deng
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Vaksin Hepatitis Vial 1
2 Vaksin BCG Ampul 1
3 Vaksin DPT-HB-H Vial 1
4 Vaksin Polio Vial 1
5 Vaksin Campak/V Vial/Ampul 1
JUMLAH ITEM OBAT INDIKATOR 5
 ( LPLPO )
KODE PUSKESMAS
PUSKESMAS
KECAMATAN PELAPORAN BULAN
KABUPATEN PERMINTAAN BULAN
PROPINSI

PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
RAWAT INAP RAWAT JALAN JUMLAH

UNIT UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) - - - -

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) - - - -
3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) - - - -
4 A004 0 - - - -
5 A005 Air Untuk Injeksi Vial @25 ml 21 - 21 -
6 A006 Air Untuk Injeksi Vial @25 ml - - - -
7 A007 Air Untuk Irigasi Infus 1000 ml - - - -
8 A008 Alopurinol Tablet 100 mg 417 - 417 133 133
9 A009 Alopurinol Tablet 100 mg - - - -
10 A010 Ambroxol Tablet 30 mg 321 - 321 180 141 321
11 A011 0 - - - -
12 A012 Aminofilin Injeksi 24 mg/ml - - - -
13 A013 0 - - - -
14 A014 Amlodipin Tablet 10 Mg - - - -
15 A015 Amlodipin Tablet 10 Mg - - - -
16 A016 0 - - - -
17 A017 Amoksisilin Kaplet 500 mg - - - -
18 A018 Amoksisilin Kaplet 500 mg - - - -
19 A019 Amoksisilin Kaplet 500 mg - - - -
20 A020 Amoksisilin Kaplet 500 mg - - - -
21 A021 0 - - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml 1 - 1 1 1
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml - - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml - - - -
25 A025 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / - - - -
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / - - - -
27 A027 CLABAT,CAPSINAT - - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 14 - 14 14 14
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial - - - -
30 A030 0 - - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) - - - -
32 A032 0 - - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) - - - -
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) - - - -
35 A035 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium 2,030 - 2,030 811 719 1,530
36 A036 - - - -
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg - - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) - - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam - - - -
40 A040 - - - -
41 A041 Salisilat 3% (Marin )
0Antihemoroid - - - -
Kombinasi : Bismut Suppgalat 150 mg
42 A042 420 - 420 60 60
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmgLidokain 10C)mg Seng Oksida 120 mg
(Vitamin - - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio - - - -
45 A045 20% ) HEMOROGARD - - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) 182 - 182 182 182
47 A047 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL - - - -
48 A048 - - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) - - - -
50 A050 Asam Folat Tablet 1 mg - - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) - - - -
52 A052 Asam Mefenamat 500 mg - - - -
53 A053 0 - - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi 9 - 9 1 1
55 A055 0 - - - -
56 A056 Asam Tranexamat Tablet 500 mg 164 - 164 9 69 78
57 A057 0 - - - -
58 A058 Asiklovir 5% 5gr Cream 150 - 150 6 12 18
59 A059 Asiklovir 5% 5gr Cream - - - -
60 A060 0 - - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) - - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) 172 - 172 18 124 142
63 A063 Asiklovir Tab 400 mg ( Phapros ) - - - -
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml - - - -
 65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) - - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides - - - -
67 A067 Attapulgite Active 630 mg Tab/ PULAREX 783 - 783 89 201 290
68 A068 Attapulgite Active 630 mg Tab/ New Antides - - - -
69 A069 Betahistin Mesylat 6 mg - - - -
70 A070 Betahistin Mesylat 6 mg - - - -
71 A071 Betametason Dipropionat Krim 0,1% 16 - 16 4 12 16
72 A072 Betametason Dipropionat Krim 0,1% 26 - 26 26 26
73 A073 Betametason Dipropionat Krim 0,1% - - - -
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) - - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) - - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 - - - -
77 A077 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin - - - -
78 A078 Bricasma - - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra - - - -
80 A080 Zeneca )I
0Budesonid - - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 A081 - - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan - - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 - - - -
84 A084 Cefadroksil
mg,Zink Kapsul
5 mg Boron500 mg CAL - 95
1 mg)/ - - - -
85 A085 Cefadroksil Kapsul 500 mg - - - -
86 A086 Cefotaxime serbuk injeksi 1.000 mg - - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) 73 - 73 1 2
88 A088 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD - - - -
89 A089 - - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) 55 - 55 -
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) - - - -
92 A092 Deksamethason Tab 0,5 mg (Promed ) 1,960 - 1,960 93 638 731
93 A093 Deksamethason Tab 0,5 mg - - - -
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) 3 - 3 2 2
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) - - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) 55 - 55 7 34 41
97 A097 0 - - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) 215 - 215 39 39
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) - - - -
100 A100 Digoksin Tab 0,25 mg - - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma - - - -
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II 50 - 50 50 50
103 A103 0 - - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) 7 - 7 7 7
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) - - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) 453 - 453 103 54 157
107 A107 Domperidon Tab 10 mg (Novapharin ) - - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% - - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) 26 - 26 -
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) - - - -
111 A111 Eritrosmisin Stearate Kaplet 500 mg - - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg - - - -
113 A113 Ethambutol 250 mg - - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) - - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) 3 - 3 3 3
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) 147 - 147 147 147
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) - - - -
118 A118 Fitomenadion Tabet 10 mg (Phapros ) - - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) 222 - 222 92 92
120 A120 0 - - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) - - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) - - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) - - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) - - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) - - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) 5 - 5 5 5
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) - - - -
128 A128 Gentamycin Krim 1 % mg/ ml 6 - 6 6 6
129 A129 Gentian Violet 1% 10 ml - - - -
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) 67 - 67 27 27
131 A131 Glibenklamid Tablet 5 mg 3,439 - 3,439 30 584 614
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) - - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) 590 - 590 590 590
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, - - - -
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg 139 - 139 13 13
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg 9 - 9 -
137 A137 Glukosa Larutan 40% Steril - - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) - - - -
139 A139 Glukosa Larutan Infus 5% @500ml - - - -
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg - - - -
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg 1,270 - 1,270 -
142 A142 Gliseril Guaikoulat Tablet 100 mg - - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) - - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) 3 - 3 3 3
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) - - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) - - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) 10 - 10 -
148 A148 0 - - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) - - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) - - - -
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) 20 - 20 20 20
152 A152 Ibuprofen Tablet 400 mg - - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) - - - -
154 A154 Isoniazid Tablet 100 mg - - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) 268 - 268 13 13
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) 22 - 22 22 22
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) - - - -
158 A158 0 - - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) - - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) - - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) - - - -
162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian - - - -
163 A163 - - - -
164 A164 Pharmatama)
0 - - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) 100 - 100 -
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) 440 - 440 440 440
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) - - - -
168 A168 Kalsium Laktat (Kalk) Tab 500 mg - - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) 4,487 - 4,487 106 2,175 2,281
170 A170 Kaptopril Tab 25 mg - - - -
171 A171 Ketokonazol Krim 2 % @ 10 gr 7 7 2 2
172 A172 Ketokonazol Krim 2 % @ 10 gr - - - -
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I 400 - 400 30 30
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II - - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) - - - -
176 A176 Ketorolak Inj 30 mg/ml - - - -
177 A177 0 - - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) 108 - 108 1 16 17
179 A179 0 - - - -
180 A180 Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol - - - -
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol 1 - 1 1 1
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) 8 - 8 8 8
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) - - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) - - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) 2,164 - 2,164 415 1,349 1,764
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) - - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) - - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) - - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) - - - -
190 A190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg - - - -
 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol - - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 - - - -
193 A193 200mg
mg, + Trimetropin 40 mg ( Holi Farma )
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placentaad
Eugenol 13,6 mg; Methol 53,4 mg, Vinishing Cream 1 gr/
Extract 5 - 5 3 3
194 A194 MOLAKRIM
Krimmg,Neomycin
Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract - - - -
195 A195 100 Sulfat 5 mg / CENTABIO (Sanbe Farma) - - - -
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil,
Farma)
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, - - - -
197 A197 Probiotik (Dexa Medica, Sanbe) 61 - 61 2 2
198 A198 Probiotik
0 (Dexa Medica, Sanbe) - - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) - - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) 31 - 31 4 27 31
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) - - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) 244 - 244 44 44
203 A203 Loperamid Tablet 2 mg - - - -
204 A204 Loratadin Tablet 10 mg 180 - 180 34 34
205 A205 Loratadin Tablet 10 mg
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen - - - -
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen 360 - 360 -
207 A207 Mata/ OCUGARD (Phapros) - 180 180 -
208 A208 Mata/ OCUGARD (Phapros)
Meloxicam Tab 15 mg (Bernofarm ) - - - -
209 A209 0 - - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) - - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) 520 - 520 43 210 253
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) - - - -
213 A213 Metformin HCl Tablet 500 mg 914 - 914 134 280 414
214 A214 Metformin HCl Tablet 500 mg - - - -
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) 350 - 350 41 41
216 A216 0 - - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) 8 - 8 8 8
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) - - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) - - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) - - - -
221 A221 Metronidasol 500 mg tablet (Novagyl) - - - -
222 A222 Metronidasol Infus 500mg/100ml - - - -
223 A223 Metronidasol Infus 500mg/100ml - - - -
224 A224 Minyak
Multi Vit,Kayu
VitE Putih
50 mg,60Lutein
ml 3 mg, Lycopen 8 mg, Vit C 250 mg, - - - -
225 A225 - 120 120 -
226 A226 Zink 20 mg, Beta
Multivitamin Caroten
+ Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY)
(NULACVIT) 810 90 900 30 30
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 A227 - - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) 7 - 7 2 2
229 A229 Multivitamin
Multivitamin CVitamin/
750 mgSuplemen (BECEFORT)
,Asam Folat+ Mineral / Vitner -Z ( Molex - - - -
230 A230 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU - - - -
231 A231 Ayus ) 96 - 96 20 30 50
Multivitamin Curcuma
vit B1 3 mg, B12 Syr:L-Lysyin
Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) 1000 IU
232 A232 - - - -
vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
 Multivitamin Neurotopic Plus ATP Tablet:B1 100,B6 200,B12
233 A233 Multivitamin - - - -
234 A234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) - - - -
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 A235 Femofomarrat 300mg - - - -
236 A236 MOLANEURON (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C - - - -
237 A237 100mg ,Asam Folat 2 Mg,Vit
Natrium Diklofenak Tab 50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / - - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II 1,196 - 1,196 297 297
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) - - - -
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) 27 - 27 27 27
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) - - - -
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) 461 - 461 127 46 173
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) - - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) 2 - 2 2 2
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) 20 - 20 5 4 9
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) 41 - 41 3 3
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) - - - -
248 A248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber - - - -
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria - - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) - - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 - - - -
252 A252 Obat Kumur
mg,Na Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL - - - -
253 A253 Omeprazole Kapsul 20 mg 600 - 600 -
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) - - - -
255 A255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) - - - -
256 A256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine - - - -
257 A257 Parasetamol Komb Tablet
400Mg,Bromheksin
maleate ,dextromethorpan Batuk Berdahak:Paraset
80Mg,Difenhidramin
Hbr/ ALPARA HCl 25Mg/
( Molex AyusHUSTAB
) - - - -
258 A258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB 438 - 438 438 438
259 A259 400Mg,Bromheksin
(Phapros) Komb Tablet
Parasetamol 80Mg,Difenhidramin
Flu: Parasetamol HCl 25Mg/ HUSTAB - - - -
260 A260 (Phapros) - - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ 30Mg,
PTU Tablet
100 / COLPICA (Tropika Mas)
mgFlu: - - - -
Parasetamol Komb Parasetamol
262 A262 - - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros)
Farma) - - - -
264 A264 Parasetamol Syrup 120 mg/5ml - - - -
265 A265 Parasetamol tablet 500 mg 270 - 270 198 198
266 A266 Parasetamol tablet 500 mg 1,854 - 1,854 650 1,204 1,854
267 A267 Parasetamol tablet 500 mg - - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) 5 - 5 -
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) 2 - 2 -
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) - - - -
271 A271 Piracetam 800 mg Tablet 208 - 208 20 96 116
272 A272 Parasetamol tablet 500 mg - - - -
273 A273 Piracetam Injeksi 1gr/ 5ml 16 - 16 3 4 7
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg - - - -
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg 1,638 - 1,638 129 817 946
276 A276 Probiotik Sachet (Probiokid) - - - -
277 A277 Polikresulen (Albotyl,Apetil) - - - -
278 A278 Prednison Tab 5 mg - - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) 791 - 791 791 791
280 A280 Prednison Tab 5 mg - - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) - - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) - - - -
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) - - - -
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) 1,500 - 1,500 302 302
285 A285 0 - - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING - - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING - - - -
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL 21 - 21 21 21
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL 1,918 - 1,918 1,318 1,318
290 A290 Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer - - - -
291 A291 32 - 32 23 9 32
292 A292 (COMBIVENT)
0 I dan II - - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) - - - -
294 A294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% - - - -
295 A295 Salep 28 - 28 10 15 25
296 A296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% - - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) - - - -
298 A298 Salisil Bedak Serbuk 2% 7 - 7 7 7
299 A299 Salisil Bedak Serbuk 2% - - - -
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE - - - -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE - - - -
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT - - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT - - - -
304 A304 Setirizin Tab 10 mg (Futamed) 69 - 69 27 27
305 A305 Setirizin Tab 10 mg (Futamed) - - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) 54 - 54 19 4 23
307 A307 Simvastatin Tablet 10 mg - - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) 5,000 - 5,000 -
309 A309 0 - - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) - - - -
311 A311 Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% - - - -
312 A312 - - - -
313 A313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE - - - -
314 A314 Thiamin/ Vitamin B1 50 mg - - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) 2,260 - 2,260 246 1,162 1,408
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) - - - -
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg - - - -
318 A318 Thiamphenicol Kapsul 500 mg - - - -
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) 36 - 36 4 4
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 - - - -
321 A321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12
B Komplek - - - -
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, - - - -
OBAT GOLONGAN
Nikotinamida 10 mg,PSIKOTROPIKA
Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, - - - -
323 A323 Alprazolam
CuSO4 0,65 mg)mgLIVRPON
0,5 (Mersi Farma)
B-PLEX - - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) - - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) - - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) - - - -
327 A327 0 - - - -
328 A328 0 - - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) - - - -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) - - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) - - - -
332 A332 Diazepam Injeksi 5 mg / ml-2 ml - - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml - - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE - - - -
335 A335 Diazepam Tablet 5 mg (VALISANBE) 87 - 87 47 47
336 A336 Diazepam Tablet 5 mg - - - -
337 A337 Fenobarbital Tablet 30 mg - - - -
338 A338 Fenobarbital Tablet 30 mg - - - -
339 A339 Fenobarbital Tablet 30 mg - - - -
340 A340 Kodein Tablet 10 mg - - - -
341 A341 0 - - - -
342 A342 Lorazepam
Metamizol 500Tabmg
2 mg (Mersi Farma)
+ Diazepam 2 mg / PRONEURON - - - -
343 A343 - - - -
344 A344 (Meprofarm)
0 - - - -
345 A345 0 - - - -
346 A346 0 - - - -
347 A347 Primaquin 15 mg tablet - - - -
348 A348 0 - - - -
OBAT - OBAT PROGRAM - - - -
OBAT PROGRAM KECACINGAN - - - -
349 A349 Albendazol Tablet 400 mg 265 - 265 2 2
350 A350 Albendazol Tablet 400 mg - - - -
OBAT PROGRAM DIARE - - - -
351 A351 Garam Oralit (Kimia Farma) - - - -
352 A352 Garam Oralit (Kimia Farma) 2,061 - 2,061 30 894 924
353 A353 Garam Oralit (Kimia Farma) - - - -
354 A354 Garam Oralit (Kimia Farma) - - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined - - - -
356 A356 57 - 57 1 5 6
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) - - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg - 500 500 -
359 A359 Zinc Dispersible 20 mg tablet - - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) - - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) 2,891 5,000 7,891 50 1,192 1,242
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) - - - -
363 A363 0 - - - -
OBAT PROGRAM HEPATITIS - - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 1 - 1 1 1
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - - - -
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - - - -
OBAT PROGRAM TB PARU - - - -
369 A369 OAT FDC Kategori Anak - - - -
370 A370 OAT FDC Kategori Anak - - - -
371 A371 OAT FDC Kategori Anak - - - -
372 A372 OAT FDC Kategori I - IIII - - - -
373 A373 OAT FDC Kategori I - IIII - - - -
374 A374 OAT FDC Kategori II - 1 1 1 1
375 A375 OAT FDC Kategori II - - - -
376 A376 OAT FDC Kategori II - - - -
377 A377 OAT FDC Kombipak Kategori I - - - -
378 A378 0 - - - -
379 A379 Isoniazid 100 mg tablet - - - -
OBAT POGRAM KUSTA - - - -
380 A380 MDT MB Anak - - - -
381 A381 MDT MB Anak - - - -
382 A382 MDT MB Dewasa - - - -
383 A383 MDT MB Dewasa - - - -
384 A384 MDT MB Dewasa - - - -
385 A385 MDT PB Anak - - - -
386 A386 MDT PB Anak - - - -
387 A387 MDT PB Anak - - - -
388 A388 MDT MB Dewasa - - - -
389 A389 MDT PB Dewasa - - - -
OBAT PROGRAM GIZI - - - -
390 A390 Mineral Mix Kombinasi - - - -
391 A391 Mineral Mix Kombinasi - - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) - - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 3,350 - 3,350 3,225 3,225
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) - - - -
395 A395 Retinol Vit A 100.000 IU (Biru) 350 - 350 350 350
396 A396 Retinol Vit A 100.000 IU (Biru) - - - -
397 A397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb - - - -
398 A398 Tablet 43,468 5,000 48,468 26,268 26,268
399 A399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) - - - -
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros)
400 A400 - - - -
401 A401 0,4
0 Mg Tab (Phapros) - - - -
402 A402 0 - - - -
OBAT PROGRAM KESGA - - - -
403 A403 Calcii Gluconas Inj (Ethica) - - - -
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka 2 - 2 -
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka - - - -
406 A406 Calcii Gluconas Inj 10% (Ethica) - - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) 7 - 7 7 7
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) - - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) - - - -
410 A410 Oksitetrasiklin 1 % Salep Mata - - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg 380 - 380 200 200
412 A412 Oksitosin Inj 10 UI/ml (Ethica) 5 - 5 5 5
413 A413 Oksitosin Inj 10 UI/ml (Ethica) - - - -
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) - - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) - - - -
OBAT PROGRAM JIWA - - - -
416 A416 Amitriptilin 25 mg - - - -
417 A417 Amitriptilin 25 mg - - - -
418 A418 Amitriptilin 25 mg - - - -
419 A419 Amitriptilin 25 mg 160 - 160 -
420 A420 Amitriptilin 25 mg - - - -
421 A421 Clozapine 25mg (OGB Dexa) - - - -
422 A422 Clozapine 100 mg - - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) - - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) - - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) - - - -
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) - - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml - - - -
428 A428 Flufenazin sikzonoate inj 5 ml - - - -
429 A429 Flufenazin sikzonoate inj 5 ml - - - -
430 A430 Haloperidol 5 mg tablet - - - -
431 A431 Haloperidol 5 mg tablet 87 - 87 65 65
432 A432 Haloperidol 5 mg tablet - - - -
433 A433 0 - - - -
434 A434 Haloperidol Injeksi 5 mg/ml - - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) - - - -
436 A436 Haloperidol/ Lodomer drops 2 mg - - - -
437 A437 Karbamazepin Tablet 200 mg - - - -
438 A438 Karbamazepin Tablet 200 mg - - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) - - - -
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) - - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) - - - -
442 A442 Klorpromazin Tab Salut 100 mg (HCl) - - - -
443 A443 Klorpromazin Tab Salut 100 mg (HCl) - - - -
444 A444 0 - - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) - - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) - - - -
447 A447 Risperidon Tab 2 mg 350 - 350 317 317
448 A448 Risperidon Tab 2 mg - - - -
449 A449 0 - - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi - - - -
451 A451 0 - - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) 861 - 861 368 368
453 A453 Triheksifenidil Tablet 2 mg - - - -
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) - - - -
455 A455 0 - - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml - - - -
457 A457 0 - - - -
PROGRAM IMUNISASI (VAKSIN) - - - -
458 A458 BCG 11 30 41 32 32
459 A459 PELARUT BCG 11 30 41 32 32
460 A460 BCG - - - -
461 A461 BCG - - - -
462 A462 CAMPAK 10ds (MR) 49 - 49 -
463 A463 PELARUT CAMPAK 49 20 69 -
464 A464 CAMPAK 10ds (MR) - 50 50 18 18
465 A465 CAMPAK 10ds (MR) - - - -
466 A466 DPT HB - Hib/ PENTABIO 116 50 166 84 84
467 A467 DPT HB - Hib/ PENTABIO - - - -
468 A468 DT - - - -
469 A469 0 - - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B 50 - 50 -
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B - - - -
472 A472 POLIO bOPV 10 ds 38 - 38 68 68
473 A473 DROPPER POLIO 68 30 98 85 85
474 A474 POLIO bOPV 10 ds 30 30 60 17 17
475 A475 POLIO bOPV 10 ds - - - -
476 A476 Td - 10 10 1 1
477 A477 0 - - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B - - - -
479 A479 POLIO bOPV 10 ds - - - -
480 A480 Vaksin Meningtis - - - -
481 A481 CAMPAK 10ds (MR) BIAS - - - -
482 A482 PELARUT CAMPAK BIAS - - - -
483 A483 POLIO bOPV 10 ds - - - -
484 A484 IPV - - - -
485 A485 VTM Include Dacron (Biofarma) - - - -
486 A486 Vaksin Rabies (Verorab) - - - -
487 A487 0 - - - -
488 A488 0 - - - -
489 A489 0 - - - -
OBAT PROGRAM HIV/ AIDS - - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg - - - -
491 A491 0 - - - -
492 A492 Isoniazid (INH) Tablet 300 mg 270 - 270 -
493 A493 0 - - - -
494 A494 Lamivudine 150 mg - - - -
495 A495 Lamivudine 150 mg - - - -
496 A496 Nevirapine 200 mg - - - -
497 A497 Nevirapine 200 mg - - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg - - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple - - - -
500 A500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple - - - -
501 A501 FDC Dewasa - - - -
502 A502 FDC Dewasa
Tenofovir 300 mg - - - -
503 A503 Tenofovir 300 mg - - - -
504 A504 Zidofudine 100 mg (ZDV) - - - -
505 A505 Zidofudine 100 mg (ZDV) - - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg - - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg - - - -
508 A508 Efavirenz 600 mg tablet - - - -
509 A509 Efavirenz 600 mg tablet - - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg - - - -
511 A511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin - - - -
512 A512 - - - -
513 A513 FDC
0 Dewasa - - - -
514 A514 MB Anak - - - -
515 A515 0 - - - -
516 A516 0 - - - -
517 A517 0 - - - -
518 A518 0 - - - -
519 A519 0 - - - -
520 A520 0 - - - -
521 A521 0 - - - -
522 A522 0 - - - -
523 A523 0 - - - -
524 A524 0 - - - -
525 A525 0 - - - -
526 A526 0 - - - -
527 A527 0 - - - -
528 A528 0 - - - -
529 A529 0 - - - -
BMHP - - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) - - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) 115 - 115 43 28 71
532 A532 0 - - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) 931 - 931 123 658 781
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) - - - -
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) - - - -
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) - - - -
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) - - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) - - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I - - - -
540 A540 Alat Suntik Sekali Pakai 20 ml 3 - 3 3 3
541 A541 Alkohol 70% Medika (Kimia Farma) - - - -
542 A542 Alkohol 70% (Medika) 1 - 1 1 1
543 A543 Alkohol Swab 2 - ply (one med) - - - -
544 A544 Alkohol Swab 2 - ply (one med) - - - -
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) - - - -
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) - - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II - - - -
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I 28 - 28 9 15 24
549 A549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) - - - -
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / - - - -
551 A551 Phsda - - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) - - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) 9 - 9 9 9
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care 270 - 270 240 240
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care - - - -
556 A556 Fixomull Strech 5 cm X 5 m - - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) 31 - 31 2 5 7
558 A558 Foley Catheter 2 Way Ch 16,18 - - - -
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) - - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) - - - -
561 A561 Mantel Gown (Bisa Dicuci) - - - -
562 A562 I.V Catheter No. 18 (JELCO) 58 - 58 25 33 58
563 A563 I.V Catheter No. 18 (NIPRO) - - - -
564 A564 I.V Catheter No. 20 JELCO - - - -
565 A565 I.V Catheter No. 20 TERUMO 9 - 9 5 5
566 A566 I.V Catheter No. 20 JELCO - - - -
567 A567 I.V Catheter No. 22 NIPRO 5 - 5 3 1 4
568 A568 I.V Catheter No. 22 NIPRO - - - -
569 A569 I.V Catheter No. 24 TERUMO 5 - 5 3 2 5
570 A570 I.V Catheter No. 24 TERUMO - - - -
571 A571 Infusion Set Anak 60 Drops /(Otsuka) 4 - 4 -
572 A572 Infusion Set Anak 60 Drops /(Otsuka) - - - -
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) - - - -
574 A574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, 500 - 500 -
575 A575 - - - -
576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr - - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) 1 - 1 1 1
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) - - - -
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm - - - -
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) - - - -
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) - - - -
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) - - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) 8 - 8 8 8
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) - - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) 96 - 96 96 96
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) - - - -
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) - - - -
588 A588 Masker Ear Loop (Masker) 17 - 17 17 17
589 A589 Masker Ear Loop Jilbab (Golden Gloves) - - - -
590 A590 Masker General Care (MARCOTILA) - - - -
591 A591 0 - - - -
592 A592 Masker N95 Disposibel - - - -
593 A593 Masker N95 Disposibel (One Med) - 15 15 15 15
594 A594 Masker Tali - - - -
595 A595 Masker Tali - - - -
596 A596 Masker Elastic - - - -
597 A597 Media Sample Container - - - -
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) - - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) - - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) - - - -
601 A601 Nurse Cup (Tutup Kepala) 60 100 160 60 60
602 A602 Oxygen Mask Elongated Adult (Remedi) - - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) - - - -
604 A604 Plesterin Bulat Non Woven (One Med) - - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) 2 - 2 2 2
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) - - - -
607 A607 Povidon Iodine 10% (300 ml) ( One Med) - - - -
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) - - - -
609 A609 Povidon Iodine 10% (60 ml) ( One Med) - - - -
610 A610 0 - - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) - - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) - - - -
613 A613 0 - - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) - 1,500 1,500 -
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) - - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) 5 - 5 5 5
617 A617 Sarung Tangan size M dan L (Exam Glove) - - - -
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) 500 - 500 -
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) - - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech 5 - 5 3 2 5
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech - - - -
622 A622 0 - - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) - - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) 2 - 2 1 1
625 A625 Underpad 90x 0 cm cosmo I - - - -
626 A626 Underpad 90x 0 cm cosmo II - - - -
627 A627 0 - - - -
628 A628 Urine Bag Sterile Standard 6 - 6 4 2 6
629 A629 Urine Bag Sterile Standard (AXIMED) - - - -
630 A630 0 - - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) - - - -
REAGEN - - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) - - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) - - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) 800 - 800 -
635 A635 Accu- Check Performa Tes Strip ( Roche ) - - - -
636 A636 Antimonoclonal A (Anti A) 10 ml - - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml - - - -
638 A638 Antimonoclonal B (Anti B) 10 ml - - - -
639 A639 0 - - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) - - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) - - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) - - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 - - - -
644 A644 Glucose Test Strip (Human Humasens plus) - - - -
645 A645 Glucose Test Strip (Human Humasens plus) II - - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) - - - -
647 A647 Hemoglobin Strip 50 test mission (Acon) - - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml - - - -
649 A649 0 - - - -
650 A650 Reagen HBsAg Strip (FOKUS) - - - -
651 A651 0 - - - -
652 A652 TPHA (Fokus) - - - -
653 A653 0 - - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) - - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) - - - -
BMHP (PROGRAM) PROPINSI - - - -
PROGRAM MALARIA - - - -
656 A656 RDT Malaria - - - -
PROGRAM SYPHILIS - - - -
657 A657 RPR Syphilis - - - -
658 A658 RPR Syphilis tahap II (FOKUS) - - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline - - - -
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
662 A662 0 - - - -
663 A663 Tuberkulin - - - -
664 A664 RDT Lepto (Uji Leptospira IgM) - - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) - - - -
666 A666 0 - - - -
667 A667 0 - - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) - - - -
668 A668 - - - -
669 A669 Reagen HBsAg Strip SD - - - -
670 A670 Reagen HBsAg Strip SD - - - -
671 A671 Reagen HBsAg Strip SD - - - -
672 A672 0 - - - -
673 A673 0 - - - -
674 A674 0 - - - -
675 A675 0 - - - -
PROGRAM TB PARU - - - -
676 A676 Box Slide - - - -
677 A677 Box Slide - - - -
678 A678 Catridge Genexpart - - - -
679 A679 Catridge Genexpart - - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) - - - -
681 A681 Oil Emersi - - - -
682 A682 Pot Spuntum/Pot Dahak Steril - - - -
683 A683 Pot Spuntum/Pot Dahak Steril - - - -
684 A684 Pot Spuntum/Pot Dahak Steril - - - -
685 A685 Pot Spuntum/Pot Dahak Steril - - - -
686 A686 Reagen Control CD4 - - - -
687 A687 Reagen Control CD4 - - - -
688 A688 Reagen Zeil Nelseen - - - -
689 A689 Reagen Zeil Nelseen - - - -
690 A690 Reagen Zeil Nelseen - - - -
691 A691 Reagen Zeil Nelseen - - - -
692 A692 Slide - - - -
693 A693 Slide/ Object Glass - - - -
694 A694 Stereofoam - - - -
695 A695 Masker N 95 TB - - - -
696 A696 Masker Tali Bedah TB - - - -
OBAT PROGRAM IMUNISASI - - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml - - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - - - -
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT - - - -
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT - - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT - - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA - - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA - - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA - - - -
708 A708 0 - - - -
709 A709 0 - - - -
710 A710 0 - - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) 428 - 428 19 9 28
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject - - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject - - - -
714 A714 0 - - - -
715 A715 Safety Box 5 L - - - -
716 A716 Alat Suntik Sekali Pakai 0,05 ml - - - -
717 A717 0 - - - -
718 A718 0 - - - -
719 A719 0 - - - -
720 A720 0 - - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) - - - -
721 A721 Diagnostar - - - -
722 A722 Tahap I DS HIV 1/2 One Step Rapid Test (GCHIV-402A) - - - -
KHB
Reagen Diagnostik
R3 Kit For HIV (1+2) Antibody (Colloidal Gold)
723 A723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) - - - -
724 A724 Tahap I - - - -
KHB
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
Diagnostik
725 A725 KHB - - - -
726 A726 TahapDiagnostik
I Kit For HIV (1+2) Antibody (Colloidal Gold) V2
- - - -
727 A727 Tahap
Kondom I 144 - 144 144 144
728 A728 DBS Collection/ Lasec - - - -
729 A729 Lubricant 20 - 20 20 20
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap - - - -
731 A731 - - - -
732 A732 IRapid HIV 1/2 3.0 SD Bioline - - - -
733 A733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 - - - -
734 A734 - - - -
735 A735 Tahap
ReagenI HIV (SD) R 1 - - - -
736 A736 Reagen HIV (SD) R 1 - - - -
737 A737 0 - - - -
738 A738 Reagen HIV (VIKIA) R 3 - - - -
739 A739 0 - - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS - - - -
741 A741 0 - - - -
742 A742 Reagen HIV R3 (VIKIA) - - - -
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR - - - -
744 A744 Sarung Tangan Non Steril - - - -
745 A745 0 - - - -
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) - - - -
747 A747 VTM Include Swab - - - -
748 A748 Masker Bedah 3 ply - - - -
749 A749 0 - - - -
750 A750 0 - - - -
751 A751 0 - - - -
752 A752 0 - - - -
753 A753 0 - - - -
754 A754 0 - - - -
755 A755 0 - - - -
756 A756 0 - - - -
757 A757 0 - - - -
758 A758 0 - - - -
759 A759 0 - - - -
760 A760 0 - - - -
761 A761 0 - - - -
762 A762 0 - - - -
763 A763 0 - - - -
764 A764 0 - - - -
OKSIGEN MEDICAL - - - -
765 A765 Oksigen 3 m3 - - - -
766 A766 Oksigen 6 m3 - - - -
767 A767 Oksigen 1 m3 - - - -
768 A768 Oksigen 6 m3 - - - -
769 A769 Nurse Cup (Tutup Kepala) One Med - - - -
770 A770 0 - - - -
771 A771 0 - - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) - - - -
TAMBAHAN IFK - - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) - - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) - - - -
3 T003 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex - - - -
4 T004 - - - -
5 T005 Thiamphenicol Syr. - - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet - - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) - - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml - - - -
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg - - - -
10 T010 Ketokonazole 200 mg - - - -
11 T011 Kotrimoksazol Forte - - - -
12 T012 Infusion set anak 50 - 50 -
13 T013 Alat Suntik 10 cc - - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg - - - -
15 T015 Omeprazole Kapsul 20 mg - - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) - - - -
17 T017 Setirizin Tab 10 mg (Futamed) - - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) - - - -
19 T019 Oseltamivir 75 mg - - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL - - - -
21 T021 Amitriptilin 25 mg - - - -
22 T022 I.V Catheter No. 24 TERUMO - - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - - - -
24 T024 RDT COVID - 19 - - - -
25 T025 Oseltamivir 75 mg - - - -
26 T026 Klorokuin 150Xpress
Katrid XPert mg tablet
SARS-CoV-2. Sample Collection Kit (For - - - -
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For - - - -
28 T028 Viruses) - - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) - - - -
30 T030 Hazmat/ APD/ Hazmat PPK - - - -
31 T031 Medical Sample Container - - - -
32 T032 Cepheid - - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml - - - -
34 T034 Tambah Darah drop (Ferriz Drop) - - - -
35 T035 Tambah Darah Sirup (Ferriz Sirup) - - - -
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex - - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL - - - -
38 T038 Obat Batuk Sirup / INADRYL - - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup - - - -
40 T040 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu:HCl chlorpheniramine
Parasetamol 500 mg,maleate,
Kombinasi - - - -
41 T041 dextromethorpan Hbr - - - -
42 T042 Influenza
Masker Bedah /Bima Sakti - - - -
43 T043 Masker Bedah /Rania - - - -
44 T044 Masker N 95 Bima Sakti - - - -
45 T045 Sarung tangan panjang steril / meditouche perpasang - - - -
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) - - - -
47 T047 Albendazol Suspensi 200mg/ 5 ml - - - -
48 T048 I.V Catheter No. 24 (BRAUN) - - - -
49 T049 OAT FDC Kategori Anak - - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF - - - -
51 T051 Apron Lengan Panjang Putih (Rannia) - - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) - - - -
53 T053 0 - - - -
54 T054 0 - - - -
55 T055 0 - - - -
56 T056 0 - - - -
57 T057 0 - - - -
58 T058 0 - - - -
59 T059 0 - - - -
60 T060 APD Set (Rannia) - 5 5 -
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) - 5 5 -
62 T062 Cover All Re
Baju APD Use (Baju
Reusable bisa
(Bisa di pakai
bisa dipakailagi /dicuci) Rannia
lagi/dicuci) (Usaha Karya - - - -
63 T063 - 5 5 -
64 T064 Mitra Bersama)
Helm visor (Usaha Karya Mitra Bersama) - - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) - - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) - - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) - - - -
68 T068 Sarung tangan non steril M,L (COBRA) - - - -
69 T069 Masker N95 Covid 19 - - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 - - - -
71 T071 Masker Eaerlop Hijab - 2,000 2,000 -
72 T072 Etanol 96 % (Alkohol 1) - 1 1 -
73 T073 Hand Sanitzer 1 - 1 1 -
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) - 1 1 -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) - 20 20 -
76 T076 KIT A1 Operasi Steril (RAJAWALI) - - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) - 5 5 -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) - 3 3 -
79 T079 Masker Face/ Masker Bedah (COBRA 1) - - - -
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) - - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) - -
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) - - - -
84 T084 Masker KN95 (Farmahusada) - - - -
85 T085 Masker Bedah (Sensi/ Farmahusada) - - - -
86 T086 Rapid Test SARS COV 2 (Farmahusada) - - - -
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) - - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) - - - -
89 T089 APRON (Atmosfer) - - - -
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) - - - -
91 T091 Hand Sanitzer 2 - - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses - - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) - - - -
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 - - - -
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 - - - -
96 T096 Face Shield (COBRA) - - - -
97 T097 Jirigen Putih 20 Liter (Usaha Karya) - - - -
98 T098 Kit Steril (Rajawali) - - - -
99 T099 Alkohol II @20 Liter - - - -
100 T100 Cover All (Rajawali) - - - -
101 T101 Face Shield (ATMOSFER) - - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) - - - -
103 T103 Masker Earloop (KasaHusada) - - - -
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) - - - -
105 T105 Rapid Test Covid-19 (Rajawali) - - - -
106 T106 Rapid Test Covid-19 (Dakonan) - - - -
107 T107 Alkohol Swab (BTT) - - - -
108 T108 Antiseptic Gel 500 - - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) - - - -
110 T110 Kaca mata Goggle (HASTEN) - - - -
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) - - - -
112 T112 Masker Bedah Hijau @50pcs - - - -
113 T113 Masker N95 3M 8210 (Hazten) - - - -
114 T114 Nurse Cap Green om 100bh - - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) - - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi - - - -
117 T117 Sarung tangan Safeglove Exam M 100bh - - - -
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 - - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) - - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) - - - -
121 T121 Universal Transport Media (UTM) Goongdong - - - -
122 T122 Universal Transport Media (UTM) Sekarguna - - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi - - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) - - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) - - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) - - - -
127 T127 Rapid Test Lecurate (Bima Sakti) - - - -
128 T128 Rapid Test ZYBIO (Farma Husada) - - - -
129 T129 Alkohol 96 % - - - -
130 T130 0 - - - -
0 - - - -
TAMBAHAN PUSKESMAS - - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) - - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi - - - -
3 TP003 Asiklovir
Budesonid 5%Formoterol
5gr CreamInhaler 160/4,5 mcg/Symbicort (Astra 13 - 13 13 13
4 TP004 - - - -
5 TP005 Zeneca)
0 - - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) - - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) 579 - 579 27 27
8 TP008 Gentamycin Krim 1 % mg/ ml - - - -
9 TP009 0 - - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) 1 - 1 1 1
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I 10 - 10 10 10
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) - - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON 324 - 324 24 24
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg - - - -
15 TP015 Thiamin/ Vitamin B1 50 mg - - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg - - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) - - - -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 9 - 9 1 2 3
19 TP019 Hand Sanitizer 450 ml (Meditol) - - - -
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) - - - -
21 TP021 I.V Catheter No. 18 (JELCO) - - - -
22 TP022 I.V Catheter No. 22 NIPRO - - - -
23 TP023 I.V Catheter No. 24 TERUMO - - - -
24 TP024 Materniti Napkin Slim L - - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) - - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) - - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) 1 - 1 1 1
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 2 - 2 1 1
29 TP029 Haloperidol 5 mg tablet - - - -
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) - - - -
31 TP031 Fixomull Strech 5 cm X 5 m - - - -
32 TP032 Umbilical crd clamp 126 - 126 -
33 TP033 0 - - -
34 TP034 0 - - -
35 TP035 0 - - -
36 TP036 0 - - -
37 TP037 0 - - -
38 TP038 0 - - -
39 TP039 0 - - -
40 TP040 0 - - -
41 TP041 0 - - -
42 TP042 0 - - -
43 TP043 0 - - -
44 TP044 0 - - -
45 TP045 0 - - -
46 TP046 0 - - -
47 TP047 0 - - -
48 TP048 0 - - -
49 TP049 0 - - -
50 TP050 0 - - -
51 TP051 0 - - -
52 TP052 0 - - -
53 TP053 0 - - -
54 TP054 0 - - -
55 TP055 0 - - -
56 TP056 0 - - -
57 TP057 0 - - -
58 TP058 0 - - -
59 TP059 0 - - -
60 TP060 0 - - -
0 - - -
 TOTAL - - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

JUMLAH SETORAN RESTRIBUSI

Mengetahui Yang Menyerahkan,

Plt. KEPALA DINAS KESEHATAN KEPALA INSTALASI FARMASI KABUPATEN
KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN Dra. TRI MUSYAROFAH, Apt

NIP. 19630724 198910 1 002 NIP. 19630411 199203 2 005
LPO )

: APRIL 2020 BULAN

: TAHUN

SUMBER HARGA STOK NILAI

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN Ket
ANGGARAN SATUAN OPTIMUM PENERIMAAN

UNIT RP

- DAK 18/Okt.19 99.000 0.000 0.000

- DAK 19/Sept.21 105.000 0.000 0.000
- DAK 20/ Jan 22 105.000 0.000 600 0.000
- - 0.000 0.000 0.000
21 DAK 19/Feb.22 2,860.000 60,060.000 120 0.000
DAK 20/ 16 - Des
- 2,860.000 0.000 0.000
22
- DAK 18/Apr.20 10,500.000 0.000 0.000
284 DAK 19/Mei 23 104.000 29,536.000 0.000
- DAK 20 L 220.000 0.000 0.000
- DAK 19/Juni 21 93.500 0.000 600 0.000
- - 0.000 0.000 0.000
- DAK 17/AGSTS-20 2,998.000 0.000 0.000
- - 0.000 0.000 0.000
- Dak 19/Okt. 20 93.000 0.000 0.000
- Dak 20/Okt 21 99.000 0.000 5,000 0.000
- - 0.000 0.000 0.000
- DAK 17/NOV-21 190.000 0.000 0.000
- DAK 18/Okt.20 233.000 0.000 0.000
- DAK 19/Feb 21 233.000 0.000 0.000
- DAK 20/ April 22 249.000 0.000 30,000 0.000
- - 0.000 0.000 0.000
- DAK 19/Agst.22 3,025.000 0.000 300 0.000
 - DAK 20 L 3,025.000 0.000 0.000
- DAK 19/JULI 21 4,400.000 0.000 0.000
- DAK 20/ Mart 22 3,628.000 0.000 200 0.000
- DAK 18L/Mar.20 10,246.500 0.000 0.000
- PRBG 20 9,900.000 0.000 0.000
- DAK 17/MAR-20 8,500.000 0.000 0.000
- DAK 20 / Mei-23 8,237.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 19/Sept. 23 4,950.000 0.000 300 0.000
- - 0.000 0.000 0.000
- DAK 17/APR-19 440.000 0.000 0.000
- DAK 18L/Agst.20 220.000 0.000 0.000
500 DAK 19/Mei20
PRSpesifik 21non 165.000 82,500.000 30,000 0.000
- 58.000 0.000 0.000
- covid-19/ - 0.000 0.000 0.000
- DAK 18/Apr-22 3,035.000 0.000 50 0.000
- - 0.000 0.000 0.000
- DAK 19/ Juni 23 4,496.000 0.000 30 0.000
- - 0.000 0.000 0.000
360 DAK
Buffer Prop.20 - 3,045.000
16/APR-20 1,096,200.000 0.000
- 198.000 0.000 0.000
- Covid-19
DAK 18L/Jan.21 1,485.000 0.000 300 0.000
- PRSpesifik L 20/ 1,551.000 0.000 0.000
- DAK 19/Sept.21 105.000 0.000 12,000 0.000
- DAK 20/Juni 22 105.000 0.000 0.000
- DAK 17/Jan-21 1,050.000 0.000 10,000 0.000
- DAK 17/AGSTS-20 67.000 0.000 0.000
- DAK 20/Feb 22 75.000 0.000 10,000 0.000
- DAK 19/MAR-22 103.000 0.000 10,000 0.000
- DAK 20 L 253.000 0.000 0.000
- 0 0.000 0.000 0.000
8 DAK 19/Feb.22 2,076.000 16,608.000 10 0.000
- 0 0.000 0.000 0.000
86 DAK 19/Feb.22 1,584.000 136,224.000 200 0.000
- 0 0.000 0.000 0.000
132 DAK 18L/Apr.22 2,915.000 384,780.000 0.000
- DAK 19/Juni 22 2,750.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 18/Mei.22 380.000 0.000 0.000
30 DAK 19/Des.22 380.000 11,400.000 0.000
- DAK 20/Des 23 405.000 0.000 200 0.000
- Dak 19/Feb 21 1,639.000 0.000 0.000
 - DAK 20/31-Okt 21 1,639.000 0.000 25 0.000
- DAK 18/Apr 23 136.000 0.000 0.000
493 DAK 19/Apr 23
DAK 20 /Nov22, 152.000 74,936.000 7,500 0.000
- 145.000 0.000 0.000
- Mart
DAK 23
PRSpesifik 20 Non 110.000
19/Jan 21 0.000 0.000
- 110.000 0.000 3,000 0.000
- Covid-19/
DAK 18/Feb.20 3,350.000 0.000 0.000
- DAK 19/Feb.20 3,350.000 0.000 0.000
- DAK 20/Okt 21 3,350.000 0.000 500 0.000
- DAK 17/JUL-19 300.000 0.000 0.000
- DAK 20/Feb 24 5,900.000 0.000 50 0.000
- DAK 19/ 626.000 0.000 0.000
- DAK 20 L 18,150.000 0.000 0.000
- DAK 19/Agst. 20 7,602.000 0.000 0.000
- DAK 19/Apr.20 7,124.000 0.000 0.000
- 0 0.000 0.000 0.000
- DAK 19/Jan 21 149,266.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 19/Mei 24 5,280.000 0.000 5,000 0.000
- DAK 19/Juni 24 660.000 0.000 500 0.000
- PRBG 20/ 671.000 0.000 0.000
- DAK 17/MAR-19 4,282.000 0.000 0.000
73 DAK 19/Mar.21 11,000.000 803,000.000 0.000
- PRSpesifik L 20/ 10,098.000 0.000 0.000
- DAK 19/Okt.21 2,805.000 0.000 0.000
55 DAK
DAK 20/ Des 21, 1,097.000
19/Apr.21 60,335.000 100 0.000
- 1,097.000 0.000 0.000
1,229 Feb
DAK2219/Juni 21 60.500 74,354.500 5,000 0.000
- DAK 20 L 66.000 0.000 0.000
1 DAK 18/Nov 19 10,400.000 10,400.000 0.000
- DAK 18L/Agst.20 9,900.000 0.000 0.000
14 DAK 19/Juni 22 1,095.000 15,330.000 400 0.000
- - 0.000 0.000 0.000
176 DAK 17/APR-21 104.000 18,304.000 0.000
- DAK 19/Nov.20 104.000 0.000 0.000
- DAK 20/ 104.000 0.000 0.000
- DAK 19/Nov.20 105.000 0.000 0.000
- DAK 19/Mar.24 112.000 0.000 1,500 0.000
- - 0.000 0.000 0.000
- DAK 19/JULI21 4,400.000 0.000 0.000
- DAK 20/Feb 22 2,700.000 0.000 100 0.000
296 DAK 19/Juni 21 165.000 48,840.000 500 0.000
 - DAK 20/Mart 23 91.000 0.000 0.000
- DAK 18/Des 20 1,408.000 0.000 0.000
26 DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 36,608.000 0.000
- Buffer 1,408.000 0.000 50 0.000
- Aprl 21 Prop 19/Mei 730.000 0.000 0.000
- 20
DAK 20/ Mei 21 770.000 0.000 100 0.000
- DAK 19/Des.23 391.000 0.000 0.000
- DAK 17/SEPT-20 4,167.000 0.000 0.000
- DAK
Buffer17/AGS-19
Prop.19/ 3,550.000 0.000 0.000
- 3,682.000 0.000 0.000
- Feb 20 /31-Des
DAK 20
3,682.000 0.000 60 0.000
- 21;Jan 22
DAK 17/Apr.19 691.000 0.000 0.000
130 DAK 18/Apr.21 710.000 92,300.000 1,000 0.000
- - 0.000 0.000 0.000
- DAK 18/Des.19
DAK Farmasi/Jan- 1,333.000 0.000 0.000
- 1,333.000 0.000 0.000
- 22
DAK 19/Jan 22 82.000 0.000 0.000
- DAK 20/Mei 22 82.000 0.000 0.000
- DAK 18/Mei 21 4,232.000 0.000 400 0.000
- DAK 19/Sept.22 4,232.000 0.000 0.000
- DAK 20/Feb 23 4,232.000 0.000 0.000
- DAK 19/Juni 22 2,750.000 0.000 500 0.000
- DAK 20 L 4,400.000 0.000 0.000
40 DAK 17/DES-20 2,900.000 116,000.000 200 0.000
2,825 DAK 19/Feb 24 119.000 336,175.000 1,000 0.000
- DAK 20/ Feb 22 119.000 0.000 0.000
- DAU 19/Mei
DAK PR BG 23 77.000 0.000 20,000 0.000
- COVID 20/ Agsts 99.000 0.000 0.000
126 DAK 19/Mei 22
21 7,865.000 990,990.000 0.000
9 DAK 19/Mei 21 10,010.000 90,090.000 12 0.000
- PRSpesifik L 20/ 10,010.000 0.000 0.000
- DAK 17/FEB-20 6,900.000 0.000 40 0.000
- DAK 20/ 7,363.000 0.000 0.000
- APBD II - 15 132.000 0.000 0.000
1,270 DAK 16/OKT-21 149.000 189,230.000 300 0.000
- DAK 20 L 88.000 0.000 0.000
- DAK 18/Agst.21 2,787.000 0.000 100 0.000
- DAK 19/Mei 23 2,475.000 0.000 500 0.000
- DAK 20/ Juni 23 2,475.000 0.000 0.000
- DAK 19/Jan 21 176,800.000 0.000 30 0.000
10 DAK 19/Mei 21 8,800.000 88,000.000 0.000
- DAK 20 L 0.000 0.000 0.000
 - DAK 19 4,665.000 0.000 0.000
- DAK 20/ Des 21 4,665.000 0.000 50 0.000
- DAK 19/JULI21 264.000 0.000 12,000 0.000
- DAK 20 L 330.000 0.000 0.000
- DAK 18L/Mar.20 660.000 0.000 0.000
- DAK 20 L 187.000 0.000 0.000
255 DAK 17/MAR-21 90.000 22,950.000 0.000
- DAK 18/Jan.22 89.000 0.000 0.000
- DAK 19/Mart.23 121.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 18/Nov.20 9,644.000 0.000 20 0.000
- DAK 18/Jan.21 10,696.000 0.000 0.000
- DAK 19/Jan.22 10,696.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 19/Juli 21 770.000 0.000 0.000
- - 0.000 0.000 0.000
100 DAK 18/Mar.21 1,755.000 175,500.000 0.000
- DAK 19/Mei 21 187.000 0.000 12,000 0.000
- DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 0.000 12,000 0.000
- 63.000 0.000 0.000
2,206 Jan 23
DAK 19/Mei 24 94.600 208,687.600 10,000 0.000
- DAK 20 L 99.000 0.000 0.000
5 DAK 19/Mei23 5,610.000 28,050.000 50 0.000
- DAK 20/ Juni 23 2,518.000 0.000 0.000
370 DAK 19/Juli21 396.000 146,520.000 0.000
- DAK 19/Jun 21 288.000 0.000 0.000
- DAK 20/Jan 22 288.000 0.000 0.000
- DAK 19/Des.20 1,089.000 0.000 0.000
- - 0.000 0.000 0.000
91 DAK 17/SEPT-20 1,810.000 164,710.000 50 0.000
- - 0.000 0.000 0.000
- DAK 17/FEB-20 10,500.000 0.000 0.000
- DAK 18L/Mei.20 17,968.500 0.000 0.000
- DAK 19/Mart21 35,200.000 0.000 100 0.000
- - 0.000 0.000 0.000
- DAK 18/Mei.22 22.000 0.000 0.000
400 DAK 19/Mar.22 77.000 30,800.000 12,000 0.000
- DAK 20/Feb 22 23.000 0.000 0.000
- DAK 17/MEI 20 2,750.000 0.000 0.000
- DAK 18L/Mei.23 495.000 0.000 5,000 0.000
- DAK 19/Juni 23 440.000 0.000 0.000
- DAU PR BG 20/ 319.000 0.000 0.000
 - DAK 19/JUN 20 2,052.000 0.000 0.000
- DAK 20/ Mei 22 2,190.000 0.000 0.000
2 DAK 17/JUNI 21 13,970.000 27,940.000 50 0.000
- DAK 19/Apr.21
PRSpesifik Dokter 22,550.000 0.000 50 0.000
- 23,100.000 0.000 0.000
- Muter 20
DAK 18L/Nov.20 3,811.500 0.000 60 0.000
59 DAK 19/Mei 21 6,600.000 389,400.000 0.000
- - 0.000 0.000 0.000
- DAK 17/JUN 21 1,937.000 0.000 1,200 0.000
- DAK20/
DAK 19/Mei
Feb 21 2,178.000 0.000 0.000
- 1,222.000 0.000 0.000
200 21;Mei22
DAK 19/Juni 21 99.000 19,800.000 0.000
- DAK 20 L 330.000 0.000 0.000
146 DAK 19/Nov.21 123.000 17,958.000 0.000
- DAK 20/Okt 23 131.000 0.000 0.000
360 DAK 18L/Sept.20 4,680.500 1,684,980.000 0.000
180 DAK 19/Jan 22 4,730.000 851,400.000 180 851,400.000
- DAK 19/ 550.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 18L/Apr.20 4,950.000 0.000 0.000
267 DAK 19/Apr 21 5,500.000 1,468,500.000 3,000 0.000
- PRSpesifik L 20/ 3,707.000 0.000 0.000
500 DAK 19/Des.20 96.000 48,000.000 0.000
- DAK20/28 Feb22 ; 102.000 0.000 0.000
309 DAK 19/Agst. 21 143.000 44,187.000 300 0.000
- - 0.000 0.000 0.000
- DAK 17/APR 22 87.000 0.000 700 0.000
- DAK 18/Nov.20 80.000 0.000 0.000
- DAK 20 / Juni 22 121.000 0.000 0.000
- DAK19/JULI23 192.500 0.000 6,000 0.000
- DAK 20 L 275.000 0.000 0.000
- DAK 19/Nov 20 8,110.000 0.000 0.000
- DAK 20/ 8,110.000 0.000 0.000
- DAK 18L/Okt.20 14,318.700 0.000 12 0.000
120 DAK 19/Feb 21 5,500.000 660,000.000 120 660,000.000
870 DAK 18L/Des.20 2,090.000 1,818,300.000 90 188,100.000
- DAK 17/AGSTS 19 5,000.000 0.000 0.000
5 DAK 19/FEBDokter
PRSpesifik 21 4,400.000 22,000.000 400 0.000
- 1,265.000 0.000 0.000
- Muter 20
DAK 17/APR 20 990.000 0.000 0.000
46 DAK 19/Apr.21
PRSpesifik Dokter 13,200.000 607,200.000 192 0.000
- 13,167.000 0.000 0.000
Muter 20
 - DAK 18L/Des.19 2,332.000 0.000 0.000
- DAK 18L/Okt.21 528.000 0.000 3,000 0.000
- PRSpesifik L 20/ 594.000 0.000 0.000
- DAK 17/FEB 21 835.000 0.000 0.000
- DAK 19/OKT20 115.000 0.000 0.000
899 DAK 19/Des 20 123.000 110,577.000 3,000 0.000
- DAK20/ 123.000 0.000 0.000
- DAK 17/JUN 21 6,410.000 0.000 60 0.000
- DAK 18/Feb.22 6,410.000 0.000 0.000
288 DAK19/Jan
PRSpesifik 20 Non 132.000
22 38,016.000 300 0.000
- 3,948.000 0.000 0.000
- Covid-19/ Okt 21 23,141.800
DAK 18L/Des.20 0.000 0.000
11 DAK 19/Juli 21 19,800.000 217,800.000 0.000
38 DAK 18/Agst.20 560.000 21,280.000 0.000
- DAK 19/Juli 23 560.000 0.000 0.000
- DAK20/Sep 23 598.000 0.000 0.000
- DAK 19/Apr 21 12,100.000 0.000 100 0.000
- DAK 19/Mart.21 24,860.000 0.000 50 0.000
- DAK 19/ Agst.
PRSpesifik 21 9,955.000
Dokter 0.000 100 0.000
- 25,597.000 0.000
600 Muter 20
DAK 16/AGSTS 20 160.000 96,000.000 5,000 0.000
- DAK 19/Juli 21 1,070.000 0.000 1,500 0.000
- DAK 20 1,124.000 0.000 0.000
- DAK 19/Mei 22 715.000 0.000 5,000 0.000
- DAK 18L/Jul.20 432.300 0.000 0.000
- DAK19/
PRSpesifik Dokter 437.800 0.000 0.000
- 418.000 0.000 0.000
- Muter 20
DAK 19/JUNI22 357.500 0.000 5,000 0.000
- PRSpesifik L 20/ 495.000 0.000 0.000
- DAK 18L/Sept.22 789.800 0.000 100 0.000
- DAK 19 1,181.000 0.000 0.000
- DAK 20/ Des 22 1,181.000 0.000 600 0.000
72 DAK
Hibah19/Des
RSUD 20 53.000 3,816.000 30,000 0.000
- 56.000 0.000 0.000
- Pasirian
Buffer Prop 20/ 53.000 0.000 0.000
5 DAK 17/JUN 20 20,700.000 103,500.000 0.000
2 DAK 19/Feb 21 11,825.000 23,650.000 50 0.000
- DAK 20/Agust 22 11,825.000 0.000 0.000
92 DAK19/Apr 21 963.600 88,651.200 100 0.000
- DAK 20 L 115.500 0.000 0.000
9 DAK 19/Juli 21 4,400.000 39,600.000 30 0.000
- DAK 20 L 132.000 0.000 0.000
 692 DAK 19/Sept.21 123.000 85,116.000 8,000 0.000
- PRSpesifik L 20/ 6,600.000 0.000 0.000
- DAK
Buffer17/AGSTS
Prop 20 41,500.000 0.000 0.000
- 68.000 0.000 0.000
- 19/Agus.20
DAK 19/Jan.21 73.000 0.000 7,000 0.000
- DAK 20/ 73.000 0.000 0.000
- DAK 17/JUL 19 1,000.000 0.000 0.000
- DAK 19/Nov 20 1,155.000 0.000 1,500 0.000
- PR BG 20/ 1,188.000 0.000 0.000
1,198 DAK 19/ 220.000 263,560.000 5,000 0.000
- - 0.000 0.000 0.000
- DAK
DAK 19/Feb22
20/24-Jan- 9,646.000 0.000 0.000
- 9,646.000 0.000 0.000
- 2023
DAK 18L/Apr.23 7,150.000 0.000 0.000
600 DAK
DAK 19/Juli 23
20/06-Jan- 7,150.000 4,290,000.000 0.000
- 7,630.000 0.000 0.000
- 2025
DAK 19/Jan 21 4,550.000 0.000 300 0.000
- - 0.000 0.000 0.000
- DAK 19/Nov.22 70.000 0.000 3,000 0.000
- DAK 20 L 165.000 0.000 0.000
3 DAK 18/Juni 22 2,620.000 7,860.000 240 0.000
- DAK 20/ 2,796.000 0.000 0.000
- DAK 18/Des.22 6,006.000 0.000 240 0.000
- DAK
PRSpesifik Dokter 5,170.000
14/MEI 19 0.000 0.000
- 2,200.000 0.000 0.000
- Muter
DAK 20
DAK 20/30-Agust- 479,996.000
19/Agst.20 0.000 6 0.000
- 512,204.000 0.000 0.000
- 21
DAK 19/Sept. 20 130,999.000 0.000 0.000
- DAK 20/30-Nov-21 130,999.000 0.000 30 0.000
42 DAK 18/Apr.20 90.000 3,780.000 0.000
- DAK 19/Mei 21 90.000 0.000 120 0.000
31 DAK 19/Juni 20 110.000 3,410.000 3,000 0.000
- DAK 20/ 117.000 0.000 0.000
5,000 DAK 18/Mar.20 265.000 1,325,000.000 0.000
- - 0.000 0.000 0.000
- DAK 19/ 6,789.000 0.000 0.000
- DAK 20/Feb 22 6,789.000 0.000 20 0.000
- DAK 19/ 13,607.000 0.000 0.000
- Retur PKM/
Buffer Prop 310.000 0.000 0.000
- 86.000 0.000 0.000
852 19/Agus.21
DAK 19/Juli 23 132.000 112,464.000 3,000 0.000
- DAK 20/Feb 22 91.000 0.000 0.000
 - DAK 19/Juli 23 935.000 0.000 4,500 0.000
- DAK 20 L 935.000 0.000 0.000
32 DAK19/Juli 23 7,150.000 228,800.000 0.000
- DAK 17/Mei 21 7,150.000 0.000 0.000
- DAK 20 89.000 0.000 8,000 0.000
- DAK 18L/Sept.20 239.800 0.000 1,000 0.000
- - 0.000 0.000 0.000
- DAK 17/AGST. 18 108.000 0.000 0.000
- DAK
Buffer17/FEB
Prop 21 1,045.000 0.000 0.000
- Buffer Prop 20/ 967.000 0.000 0.000
- 17/Jul.21 776.006 0.000 0.000
- /Des 22 - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 18/Feb.20 12,573.000 0.000 0.000
- DAK 19/Mar.22 12,573.000 0.000 20 0.000
- DAK
Buffer20/
Prop 19/ 12,573.000 0.000 0.000
- Buffer20
Prop 20/ 1,735.000 0.000 0.000
- Agsts 1,735.000 0.000 5 0.000
- Agsts 20
DAK 20 L 19,789.000 0.000 0.000
40 DAK 18L/Mei.20
PRSpesifik 20 non 396.000 15,840.000 0.000
- 114.000 0.000 100 0.000
- covid-19/
DAK 17/NOV-19 171.000 0.000 0.000
Buffer Prop 19/
- 171.000 0.000 0.000
- Jun 23 Prop 20/
Buffer 171.000 0.000 0.000
- DAK 16/APR 19 550.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 17/JUN 20 779.000 0.000 0.000
- DAK 19/Feb. 23 1,320.000 0.000 0.000
- - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- Buffer Prop. 20/ - 0.000 0.000 0.000
- 278.300 0.000 0.000
- Mei 21 - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- - 0.000
Buffer Prop 19/Feb 0.000 0.000
263 Buffer Prop 20/nov 404.000 106,252.000 0.000
- 22 431.000 0.000 0.000
- 21 - 0.000 0.000 0.000
Buffer Prop
- Buffer Prop 19 Juli 257.000 0.000 0.000
1,137 18/Jul.23 257.000 292,209.000 5,000 0.000
Buffer Prop 20/
23
- 274.000 0.000 0.000
- April
DAK2419/Agst.22 274.000 0.000 0.000
 - - 0.000 0.000 0.000
51 DAK 19 /Nov 20 6,281.000 320,331.000 0.000
- DAK 18L/Sept.20
Buff Prop 19 /Mei 9,900.000 0.000 0.000
500 Buff Prop 20/ 524.000 262,000.000 500 262,000.000
- 20 524.000 0.000 0.000
- Sept.22
DAK 18/Mart 20 524.000 0.000 0.000
6,649 DAK
DAK 19/Jan
20/Mei 21 524.000 3,484,076.000 5,000 2,620,000.000
- 524.000 0.000 0.000
- 21;Agust 22 - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 19/Agus.20
Buffer Prop 19/ 1,325,000.000 0.000 0.000
- 1,325,000.000 0.000 0.000
- Agsts.
Hibah 19
Jember 1,325,000.000 0.000 0.000
- Buffer Prop
DAK 20/Maret20/ 1,325,000.000 0.000 0.000
- 1,325,000.000 0.000 0.000
- 22,SEP 21
Buffer Prop19/Juni 0.000
- 0.000 0.000
- Buffer Prop 19/Jun 232,518.000 0.000 0.000
- 20 248,120.000 0.000 0.000
Buffer Prop 20/
21
- Buffer 248,120.000 0.000 0.000
- Mei 21 Prop 389,344.000 0.000 0.000
Buffer Prop 20/
19/Juli21
- DAU/ 22DAK 19/Juni 415,469.000 0.000 0.000
- Agsts
Buffer Prop 19/Jan 1,384,983.000
22
0.000 1 1,384,983.000
- Buffer Prop 20/ 1,384,983.000 0.000 0.000
- 22 1,384,983.000 0.000 0.000
BUFF.22
Agsts
- 317,018.000 0.000 0.000
- PROP19/Agst 22 - 0.000 0.000 0.000
Buffer Prop 20/
- 282.000 0.000 0.000
- Juni 22
Buffer Prop 19/Juni 0.000
- 0.000 0.000
- Buffer Prop 20/Juni 28,354.000 0.000 0.000
- 21 28,354.000 0.000 0.000
Buffer Prop 19/
21
- Buffer Prop 19/ 40,913.489 0.000 0.000
- Okt.21 41,784.000 0.000 0.000
Buffer Prop 20/
Okt.21
- Buffer Prop 17/Mei 41,784.000 0.000 0.000
- Okt.21 8,891.000 0.000 0.000
Buffer Prop
19
- Buffer Prop 20/ 13,300.000 0.000 0.000
- 18/Agst.20 11,738.000 0.000 0.000
Buffer
Nov 22 Prop 20/
- Buffer 36,579.000 0.000 0.000
- Nov 22 Prop 20/ 15,014.000 0.000 0.000
- Nov 22 - 0.000 0.000 0.000
Buffer Prop
- 2,920.000 0.000 0.000
- 19/Sept 20 20/
Buffer Prop 2,920.000 0.000 0.000
- DAK 19/Agust.21 517.000 0.000 0.000
 Buffer Prop
125 DAK 20 517.000 64,625.000 0.000
- 20/Apr.22 552.000 0.000 0.000
Buffer Prop 18/Okt.
Penugasan/ Jan 23 284.000
- PRSpesifik 20 Non 0.000 0.000
- 20 307.000 0.000 0.000
DAU Penugasan
Covid-19/ Okt 21 307.000
- Buffer Prop 19/Juli 0.000 0.000
22,200 20 354.000 7,858,800.000 5,000 1,770,000.000
Buffer Prop
20
- 354.000 0.000 0.000
- 20/Agst 21
DAK Penugasan 354.000 0.000 0.000
- - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- Buffer Prop - 0.000 0.000 0.000
- 9,955.000 0.000 0.000
2 18/Agst.20
DAK
DAK GD 20/09- 3,796.000
19/Mar 20 7,592.000 0.000
- DAK GD 20/09- 3,796.000 0.000 60 0.000
- Okt/21 10,351.000 0.000 0.000
- Okt/21
DAK 19/ Des 20 2,959.000 0.000 200 0.000
Buffer Prop
- DAK 20 /30-Sept- 2,684.000 0.000 0.000
- 19/Jul.19 2,959.000 0.000 0.000
Buffer Propinsi
21
- 2,500.000 0.000 0.000
180 20 /Juli18/Apr.22
DAK 21 210.000 37,800.000 1,200 0.000
Buffer
- DAK 20 / 31 -Okt 1,900.000 0.000 0.000
- Prop.19/Sept.19
DAK GD 20/ 31- 1,199.000
22
0.000 300 0.000
- 1,639.000 0.000 50 0.000
- Okt
PR 21
BG 20/ Juli 23 1,199.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK
Buffer Prop 18/Mei 167.000
18/Apr.21 0.000 0.000
- 167.000 0.000 0.000
- 21
DAK 19/ Jan 23 167.000 0.000 0.000
Buffer Prop 20/
160 167.000 26,720.000 0.000
- Feb.
DAK23 20/ 167.000 0.000 0.000
- DAK
PRSpesifik 20 non 1,121.000
19 0.000 0.000
- 3,288.000 0.000 0.000
- covid-19/
DAK 20/ 1,200.000 0.000 0.000
- DAK
Hibah 17/NOV 20 1,750.000 0.000 0.000
- 1,750.000 0.000 0.000
- Penyedia/NOV
DAK 19/ Juni 2120 183.000 0.000 0.000
Buffer Prop 20/
- Buffer Prop. 20/ 63,986.000 0.000 0.000
- Agst.22 63,813.000 0.000 0.000
- agst.22
DAK 17/JUN 20 57,500.000 0.000 0.000
- DAK
Buffer19/Apr
Prop. 22
20/ 60.000 0.000 0.000
22 60.000 1,320.000 5,000 0.000
- Agst.22
DAK 20/ 60.000 0.000 0.000
 - - 0.000 0.000 0.000
- Buffer Prop 19 5,000.000 0.000 5 0.000
- DAK 20 L 13,200.000 0.000 0.000
- DAK 19/Jan 22 19,955.000 0.000 0.000
- DAK
DAK 20/ Nov 22, 245.000
19/Juni 22 0.000 0.000
- Buffer 245.000 0.000 0.000
- Des 22 Prop 19/ 1,243.000 0.000 5 0.000
- Feb
DAK2120/ 1,326.000 0.000 0.000
- DAK 19/Sept.
Buffer Prop 20/22 158.000 0.000 5,000 0.000
- 157.000 0.000 0.000
- Sept.
DAK 2220 L 253.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK
Buffer19/
Prop 19/ Apr 287.000 0.000 0.000
- Buffer Prop 20/ Juli 287.000 0.000 0.000
33 22 287.000 9,471.000 5,000 0.000
- 22
DAK 20/ 287.000 0.000 0.000
- - 0.000 0.000 0.000
- DAK 19/Juni 23 287.000 0.000 0.000
- Buffer Prop 19/ - 0.000 0.000 0.000
493 Buffer 91.000 44,863.000 7,000 0.000
- Mei 22 Prop 20/ 91.000 0.000 0.000
- Juni
DAK22 20 L 440.000 0.000 0.000
- - 0.000 0.000 0.000
- PR BG 20/ Nov.22 63,986.000 0.000 0.000
- - 0.000 0.000 0.000
- Buffer Prop/ Jan - 0.000 0.000 0.000
9 0378G181 56,360.000 507,240.000 30 30 1,690,800.000
9 0708S4025E 21Buffer Prop/ Juli 22 0.000 0.000 30 30 0.000
- Buffer
Buffer Prop/
Prop/ Juli 21 60,140.000 0.000 - 0.000
- Buffer Prop/ 66,154.000 0.000 - 0.000
49 0182W0820Z Sept.21
Buffer Prop/ 141,648.000 6,940,752.000 - 0.000
69 0688S1424 Mar.20 0.000 0.000 50 20 0.000
32 0128M427 Mar.23
Buffer Prop/
Buffer Prop/ Jul.23 151,150.000 4,836,800.000 50 50 7,557,500.000
- 166,265.000 0.000 - 0.000
82 5044118 Agust.21
Buffer
Buffer Prop/ Des 76,620.000
Prop/ Juli 20 6,282,840.000 50 50 3,831,000.000
- Buffer Prop/ Apr. 84,282.000 0.000 - 0.000
- - 20 17,450.000 0.000 - 0.000
- 22 - 0.000 0.000 - 0.000
Buffer Prop/
50 - Buffer Prop/ Agust 23,270.000 1,163,500.000 - 0.000
- Mar.21 25,597.000 0.000 - 0.000
(30) 2053419 21
Buffer Prop/Juli 21 18,140.000 -544,200.000 - 0.000
13 10100916 Buffer Prop/ 0.000 0.000 30 30 0.000
 Buffer Prop
43 2054519 Buffer Prop 19,470.270 837,221.610 30 30 584,108.100
- 20/Agust-21 19,954.000 0.000 - 0.000
Buffer Prop/
9 041338 20/Sept-21 15,450.000 139,050.000 10 10 154,500.000
- Mei.21 - 0.000 0.000 0.000
Buffer Prop 20/
- Buffer21Prop 20/ 21,810.000 0.000 0.000
- Sep. 19,350.000 0.000 0.000
- Oct. 21Prop 20/
Buffer 135,000.000 0.000 0.000
Buffer Prop 20/
- Buffer21Prop 20/ Okt 151,150.000 0.000 0.000
- Agust 0.000 0.000 0.000
Buffer Prop 20/
23
- Buffer Prop 20/ 21,285.000 0.000 0.000
- Okt.21
Buffer Prop.20 - 144,540.000
Nov.21
0.000 0.000
- Buffer Prop.20/ 50,000.000 0.000 0.000
- Covid-19 165,000.000 0.000 0.000
- April 21 - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- Buffer Prop. 19/ 34,354.100 0.000 0.000
- Buffer Prop - 0.000 0.000 0.000
270 164.000 44,280.000 0.000
- 19/Sept. 20 - 0.000 0.000 0.000
Buffer Prop
- Buffer Prop 90,000.000 0.000 0.000
- 19/Agst.20
Buffer Prop 19/Mei 90,000.000
20/Agust.20
0.000 0.000
- Buffer Prop 20/ 183,480.000 0.000 0.000
- 23 176,400.000 0.000 0.000
Buffer
Nov 22 Prop
- 77.000 0.000 0.000
- 19/Nov.20
Buffer Prop 19/Jan 0.000
- 0.000 0.000
- Buffer Prop 20/ 79,154.000 0.000 0.000
- 21 79,154.000 0.000 0.000
Buffer
Jan 21 Prop 19/Feb 303,750.000
- Buffer Prop 20/Juni 0.000 0.000
- 20
Buffer Prop 19/Juli 252,720.000
21
0.000 0.000
- 106,080.000 0.000 0.000
- 21
Buffer
Buffer Prop 19/Nov 106,080.000
Prop 20/ 0.000 0.000
- Buffer Prop 20/ 222,000.000 0.000 0.000
- 20 222,000.000 0.000 0.000
Hibah
Mei 22 Sidoarjo/
- Buffer 198,900.000 0.000 0.000
- Apr 20 Prop 20/ juni 198,900.000 0.000 0.000
Buffer Prop 20/
20
- Buffer21Prop 20/ 230,880.000 0.000 0.000
- April 133,137.000 0.000 0.000
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- BTT 20 COVID-19 2,816.000 0.000 0.000
- BTT 20 COVID-19 150,000.000 0.000 0.000
- BTT 20 COVID-19 303.550 0.000 0.000
- BTT 20 COVID-19 891,275.000 0.000 0.000
- BTT 20 COVID-19 160,500.000 0.000 0.000
- BTT 20 COVID-19 585.000 0.000 0.000
- BTT 20 COVID-19 5,300.000 0.000 0.000
- BTT 20 COVID-19 5,500.000 0.000 0.000
- BTT 20 COVID-19 60,500.000 0.000 0.000
- BTT 20 COVID-19 80,000.000 0.000 0.000
- BTT 20 COVID-19 136,564.000 0.000 0.000
- BTT
DAU 20
ID COVID-19
20 non 1,265.000 0.000 0.000
- 8,400.000 0.000 0.000
- covid-19 20 non
DAU ID
8,400.000 0.000 0.000
BTT ke 2 20
covid-19
- BTT ke 2 20 98,000.000 0.000 0.000
- COVID-19 90,000.000 0.000 0.000
BTT ke 2 20
COVID-20
- 97,500.000 0.000 0.000
- COVID-21
DAU 20 22,500.000 0.000 0.000
- - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- - 0.000 0.000 0.000
- - 7,199.885 0.000 1,000 0.000
- - 1,945.000 0.000 10 0.000
- - 2,950.000 0.000 0.000
- - 139,880.000 0.000 0.000
- - 0.000 0.000 0.000
- - 1,097.000 0.000 100 0.000
552 - 77.000 42,504.000 0.000
- - 3,217.500 0.000 500 0.000
- - 0.000 0.000 0.000
- - 15,572.700 0.000 0.000
- - 270.000 0.000 0.000
- - 600.000 0.000 0.000
300 - 1,106.000 331,800.000 0.000
- - 45.000 0.000 8,000 0.000
- - 36.000 0.000 3,000 0.000
- - 783.000 0.000 4,500 0.000
- - 1,302.000 0.000 100 0.000
6 - 74,250.000 445,500.000 0.000
- - 43,186.000 0.000 20 0.000
 - - 7,920.000 0.000 0.000
- - 8,750.000 0.000 0.000
- - 7,018.000 0.000 0.000
- - 8,355.000 0.000 0.000
- - 20,328.000 0.000 50 0.000
- - 12,076.000 0.000 200 0.000
- - 6,595.000 0.000 0.000
- - 1,098,900.000 0.000 0.000
1 - 712,800.000 712,800.000 0.000
- - 56.000 0.000 0.000
- - 1,640.000 0.000 0.000
- - 42,800.000 0.000 0.000
126 - 2,750.000 346,500.000 100 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
- 0.000 0.000 0.000
0 0 0.000 0.000
 - 75,705,211.910 33,284,801.100

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Generik Paten

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
180

120
90
BUFFER P 257

BUFFER P 2728
 500

5,000

1
5,000
30
30

50
10

30
30
50
20
15
 100

1,500
Pelaporan : Persentase Puskesmas deng
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Vaksin Hepatitis Vial 1
2 Vaksin BCG Ampul 1
3 Vaksin DPT-HB-H Vial 1
4 Vaksin Polio Vial 1
5 Vaksin Campak/V Vial/Ampul 1
JUMLAH ITEM OBAT INDIKATOR 5
Pelaporan : Persentase Puskesmas denga
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Albendazol /Pira Tablet 1
2 Alopurinol Tablet 1
3 Amlodipin/Kapto Tablet 0
4 Amoksisilin 500 Tablet 0
5 Amoksisilin sirup Botol 1
6 Antasida tablet k Tablet/Botol 1
7 Asam Askorbat (V Tablet 1
8 Asiklovir Tablet 1
9 Betametason sal Tube 1
10 Deksametason tabTablet/Vial/Ampul 1
11 Diazepam injeksi Ampul 0
12 Diazepam Tablet 1
13 Dihidroartemsin Tablet 1
14 Difenhidramin In Ampul 1
15 Epinefrin (Adrena Ampul 1
16 Fitomenadion (Vi Ampul 1
17 Furosemid 40 mg/ Tablet 0
18 Garam Oralit ser Kantong 1
19 Glibenklamid/Me Tablet 1
20 Hidrokortison kr Tube 1
21 Kotrimoksazol (d Tablet/Botol 0
22 Lidokain inj Vial 1
23 Magnesium Sulfat Vial 1
24 Metilergometrin Ampul 1
25 Natrium Diklofen Tablet 1
26 OAT FDC Kat 1 Paket 0
27 Oksitosin injeksi Ampul 1
28 Parasetamol siru Botol 0
29 Parasetamol 500 Tablet 1
30 Prednison 5 mg Tablet 1
31 Ranitidin 150 mg Tablet 1
32 Retinol 100.000/ Kapsul 1
33 Salbutamol Tablet 1
34 Salep Mata/Tetes Tube 1
35 Simvastatin Tablet 1
36 Siprofloksasin Tablet 1
37 Tablet Tambah D Tablet 1
38 Triheksifenidil Tablet 1
39 Vitamin B6 (Pirid Tablet 1
40 Zinc 20 mg Tablet 1
JUMLAH ITEM OBAT INDIKATOR 33
 REKAP LAPORAN PERSEDIAAN BAHAN OBAT - OBATAN (ASET) TR
PUSKESMAS .......................... TAHUN 2020
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN :
KAB / KODYA : LUMAJANG
PROPINSI : JAWA TIMUR

PENERIMAAN
NO NAMA OBAT SATUAN KEMASAN STOK AWAL Jan Feb Mar

1 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 0 - - -

2 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 129 - 100 -
3 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 0 - - -
4 0 0 0 - - -
5 Air Untuk Injeksi Vial @25 ml Vial 80 - - -
6 Air Untuk Injeksi Vial @25 ml Vial 0 - - -
7 Air Untuk Irigasi Infus 1000 ml Botol 0 - - -
8 Alopurinol Tablet 100 mg Tablet 917 - - -
9 Alopurinol Tablet 100 mg 0 0 - - -
10 Ambroxol Tablet 30 mg Tablet 961 - - -
11 0 0 0 - - -
12 Aminofilin Injeksi 24 mg/ml Ampule 0 - - -
13 0 0 0 - - -
14 Amlodipin Tablet 10 Mg Tablet 751 - - -
15 Amlodipin Tablet 10 Mg Tablet 0 - - -
16 0 0 0 - - -
17 Amoksisilin Kaplet 500 mg Tablet 0 - - -
18 Amoksisilin Kaplet 500 mg Tablet 0 - - -
19 Amoksisilin Kaplet 500 mg Tablet 90 - - -
20 Amoksisilin Kaplet 500 mg Tablet 0 - - -
21 0 0 0 - - -
22 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 216 - - -
23 Amoksisilin Syrup Kering 125 mg / 5 ml 0 0 - - -
24 Amoksisilin Syrup Kering 250mg / 5 ml Botol 0 - - -
25 Amoksisilin Syrup Kering 250mg / 5 ml (Novapharin) Botol 0 - - -
26 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet 0 - - -
27 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet 0 - - -
28 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial 577 - - -
29 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 0 - - -
30 0 0 0 - - -
31 Antacida + Simeticon Suspensi (NOVAMAG) Botol 87 - - -
32 0 0 0 - - -
33 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 47 - - -
34 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 0 - - -
35 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 6014 - - 3,000
36 Antacida tablet kunyah DOEN, kombinasi : Alumunium Hidroksida 200 mg + Magnesium Hidroksida 200 mg Tablet 0 - - -
37 0 0 0 - - -
38 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube 0 - - -
39 0 0 0 - - -
40 Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam Salisilat 3% (Marin ) Pot 0 - - -
41 0 0 0 - - -
42 Supp
Antihemoroid Kombinasi : Bismut Suppgalat 150 mg Heksaklorofen 2,5 mg Lidokain 10 mg Seng Oksida 120 mg
570 - - -
43 Asam Ascorbat 500 mg (Vitamin C) Tablet 0 - - -
44 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet 0 - - -
45 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet 0 - - -
46 Asam Ascorbat 50 mg (Vitamin C) Tablet 2805 - - -
47 Asam Ascorbat 50 mg (Vitamin C) Tablet 0 - - -
48 Asam Folat 1 mg Beta Caroten 10000 Multi Mineral/ FOLAMIL (Dexa Medica) Tablet 0 - - -
49 Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet 0 - - -
50 Asam Folat Tablet 1 mg Tablet 0 - - -
51 Asam Mefenamat 500 mg ( Mersi ) Tablet 0 - - -
52 Asam Mefenamat 500 mg 0 0 - - -
53 0 0 0 - - -
54 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 20 - - -
55 0 0 0 - - -
56 Asam Tranexamat Tablet 500 mg Tablet 316 - - -
57 0 0 0 - - -
58 Asiklovir 5% 5gr Cream Tube 150 - - -
59 Asiklovir 5% 5gr Cream Tube 0 - - -
60 0 0 0 - - -
61 Asiklovir Tab 400 mg ( Phapros ) Tablet 0 - - -
62 Asiklovir Tab 400 mg ( Phapros ) Tablet 281 - - -
63 Asiklovir Tab 400 mg ( Phapros ) Tablet 0 - - -
64 Atropin Sulfat Injeksi 0,25 mg/ml Ampule 0 - - -
65 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule 0 - - -
66 Attapulgite Active 630 mg Tab/ New Antides Tablet 669 - - -
67 Attapulgite Active 630 mg Tab/ PULAREX Tablet 2000 - - -
68 Attapulgite Active 630 mg Tab/ New Antides Tablet 0 - - -
69 Betahistin Mesylat 6 mg Tablet 99 - - -
70 Betahistin Mesylat 6 mg Tablet 0 - - -
71 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 83 - - -
72 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 108 - - -
73 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 0 - - -
74 Bisakodil Tablet 5 mg (Etercon Pharma ) Tablet 0 - - -
75 Bisakodil Sup 10 mg (Dulcolax) Supp 0 - - -
76 Bisoprolol 2,5 mg/concor 2,5 Tablet 0 - - -
77 Benzatin Benzil Penisilin 2,4 jt 0 0 - - -
78 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) II Biji 0 - - -
79 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) I Biji 0 - - -
80 0 0 0 - - -
81 Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs 0 - - -
82 0 0 0 - - -
83 Tablet
Calcium Plus Vit D3 (Coral calcium 500 mg,Naturan Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 mg,Zink 5 mg Boron 1 mg)/ CAL - 95
0 - - -
84 Cefadroksil Kapsul 500 mg Tablet 938 - - -
85 Cefadroksil Kapsul 500 mg Tablet 0 - - -
86 Cefotaxime serbuk injeksi 1.000 mg Vial 0 - - -
87 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 76 - - -
88 Citicolin 250 mg / 2 ml Inj Ampule 0 - - -
89 Curcumin Plus Cynarin,Sylimarin,Kapsul/ HEPAGARD (Phapros) Tablet 0 - - -
90 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 137 - - -
91 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 0 - - -
92 Deksamethason Tab 0,5 mg (Promed ) Tablet 3939 - - -
93 Deksamethason Tab 0,5 mg 0 0 - - -
94 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube 6 - - -
95 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol 0 - - -
96 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 232 - - -
97 0 0 0 - - -
98 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 368 - - -
99 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 0 - - -
100 Digoksin Tab 0,25 mg Tablet 0 - - -
101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 0 - - -
102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet 484 - - -
103 0 0 0 - - -
104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol 98 - - -
105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol 0 - - -
106 Domperidon Tab 10 mg (Novapharin ) Tablet 445 - - 500
107 Domperidon Tab 10 mg (Novapharin ) Tablet 0 - - -
108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule 0 - - -
109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 30 - - -
110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 0 - - -
111 Eritrosmisin Stearate Kaplet 500 mg Tablet 0 - - -
112 Eritrosmisin Stearate Kaplet 500 mg Tablet 0 - - -
113 Ethambutol 250 mg Tablet 0 - - -
114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule 0 - - -
115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 3 - - -
116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 428 - - -
117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 0 - - -
118 Fitomenadion Tabet 10 mg (Phapros ) Tablet 26 - - -
119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 334 - - -
120 0 0 0 - - -
121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule 26 - - -
122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule 0 - - -
123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 0 - - -
124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 0 - - -
125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 0 - - -
126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 95 - - -
127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 0 - - -
128 Gentamycin Krim 1 % mg/ ml Tube 68 - - -
129 Gentian Violet 1% 10 ml Botol 0 - - -
130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 134 - - -
131 Glibenklamid Tablet 5 mg Tablet 5830 - - -
132 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet 0 - - -
133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet 6927 - - -
134 Gliseril Guaikoulat Tablet 100 mg Tablet 0 - - -
135 Tablet
Glucosamin HCL 500 Mg, Konrdoitin SO4400Mg, MSM 200 Mg, VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Gliserofosfat 10 mg
541 - - -
136 Glukosa Larutan 40% Steril ( Outsuka ) Botol 10 - - -
137 Glukosa Larutan 40% Steril botol 0 - - -
138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol 0 - - -
139 Glukosa Larutan Infus 5% @500ml Botol 0 - - -
140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 0 - - -
141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1871 - - -
142 Gliseril Guaikoulat Tablet 100 mg Tablet 0 - - -
143 Hidrokortison Krim 1 % (Kimia Farma ) Tube 0 - - -
144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 92 - - -
145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 0 - - -
146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied 0 - - -
147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - - -
148 0 0 0 - - -
149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 0 - - -
150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 0 - - -
151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 6418 - - -
152 Ibuprofen Tablet 400 mg Tablet 0 - - -
153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet 0 - - -
154 Isoniazid Tablet 100 mg tablet 0 - - -
155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 300 - - -
156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 24 - - -
157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 0 - - -
158 0 0 0 - - -
159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol 0 - - -
160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol 0 - - -
161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 40 - - -
162 0 0 0 - - -
163 Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian Pharmatama) Tablet 0 - - -
164 0 0 0 - - -
165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - - -
166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 3803 - - -
167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet 0 - - -
168 Kalsium Laktat (Kalk) Tab 500 mg Tablet 0 - - -
169 Kaptopril Tab 25 mg ( Phapros ) Tablet 9412 - - -
170 Kaptopril Tab 25 mg TAblet 0 - - -
171 Ketokonazol Krim 2 % @ 10 gr Tube 26 - - -
172 Ketokonazol Krim 2 % @ 10 gr Tube 0 - - -
173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 400 - - -
174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet 0 - - -
175 Ketokonazol Tablet 200 mg (Novapharin) Tablet 0 - - -
176 Ketorolak Inj 30 mg/ml Ampule 0 - - -
177 0 0 0 - - -
178 Kloramfenikol 1% Salep Mata (KF) Tube 137 - - -
179 0 0 0 - - -
180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma) Vial 0 - - -
181 Kloramfenikol Tetes Telinga :Kloramfenicol 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube 34 - - -
182 Kloramfenikol Tetes Telinga : Kloramfenicol 10%,Lidocain,Proplylenglycol / COLME (Interbat) Tube 58 - - -
183 0 0 0 - - -
184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 30 - - -
185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 8058 - - -
186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet 0 - - -
187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet 0 - - -
188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet 0 - - -
189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1300 - - -
190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg Tablet 0 - - -
191 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol 0 - - -
192 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol 0 - - -
193 Tube
Krim Analgesik (setiap gram mengandung : Metyl Salisilat 102 mg, Eugenol 13,6 mg; Methol 53,4 mg, Vinishing Cream ad 1 gr/ MOLAKRIM
17 - - -
194 Tube
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
5 - - -
195 Tube
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
0 - - -
196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet 0 - - -
197 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet 84 - - -
198 0 0 0 - - -
199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 3 - - -
200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 327 - - -
201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 0 - - -
202 Loperamid Tablet 2 mg ( Ifars) Tablet 294 - - -
203 Loperamid Tablet 2 mg Tablet 0 - - -
204 Loratadin Tablet 10 mg Tablet 200 - - -
205 Loratadin Tablet 10 mg Tablet 0 - - -
206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet 580 - - -
207 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet 0 - - -
208 Meloxicam Tab 15 mg (Bernofarm ) Tablet 0 - - -
209 0 0 0 - - -
210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul 0 - - -
211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 1683 - - -
212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 0 - - -
213 Metformin HCl Tablet 500 mg Tablet 1846 - - -
214 Metformin HCl Tablet 500 mg Tablet 0 - - -
215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 480 - - -
216 0 0 0 - - -
217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet 473 - - -
218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet 0 - - -
219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet 0 - - -
220 Metronidasol 500 mg tablet (Novapharin) Tablet 70 - - -
221 Metronidasol 500 mg tablet (Novagyl) Tablet 0 - - -
222 Metronidasol Infus 500mg/100ml Btl= 100 ml 0 - - -
223 Metronidasol Infus 500mg/100ml Botol 0 - - -
224 Minyak Kayu Putih 60 ml Botol 4 - - -
225 Kapsul
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Zink 20 mg, Beta Caroten 10000 IU, Selenium 30 mcg (LICOXY)
0 - - -
226 Multivitamin + Pelancar Asi (NULACVIT) Tablet 900 - - -
227 Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / MERSIBION Ampule 8 - - -
228 Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule 151 - - -
229 Multivitamin Vitamin/ Suplemen (BECEFORT) tablet 0 - - -
230 Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex Ayus ) Tablet 0 - - -
231 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
82 - - 192
232 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
0 - - -
233 Multivitamin Neurotopic Plus ATP Tablet:B1 100,B6 200,B12 200Mcg,Vit E 30mg, ATP 20mg / Bio ATP (Phapros) Tablet 0 - - -
234 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) Tablet 1534 - - -
235 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) tablet 0 - - -
236 Tablet
Multivitamin Tab Tambah Darah : per Tablet Mengandung : Femofomarrat 300mg Mgso4 0,4mg,Cuso4 0,4 mg,Vit C 100mg ,Asam Folat 2 Mg,Vit B 12 15Mcg,Faktor Intirinsik 25mg / HEMAFORT ( Phapros )
0 - - -
237 Natrium Diklofenak Tab 50 mg (Phapros ) I Tablet 0 - - -
238 Natrium Diklofenak Tab 50 mg (Phapros ) II Tablet 2674 - - -
239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet 0 - - -
240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 40 - - -
241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 0 - - -
242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 1052 - - -
243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet 0 - - -
244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol 19 - - -
245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 24 - - -
246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 75 - - -
247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 0 - - -
248 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 0 - - -
249 Botol
Obat Batuk Herbal : Tiap 15 Ml Vitetrifolia Fill 1 Gr,Zingiber Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Macrocarpa Fruct 0,20 Mg / HERBAKOF (Dexa Medica )
0 - - -
250 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Pcs 3 - - -
251 Botol
OBH Plus Syr : Per 5 ml Megnandung Difenhidramin 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 mg,Na Sitrat 50 mg / SANADRYL
75 - - -
252 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Botol 0 - - -
253 Omeprazole Kapsul 20 mg Tablet 1157 - - 600
254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 112 - - -
255 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 0 - - -
256 Tablet
Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus )
816 - - -
257 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet 0 - - -
258 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet 2681 - - -
259 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet 0 - - -
260 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, / COLPICA (Tropika Mas) Tablet 0 - - -
261 Propiltiourasil/ PTU 100 mg 0 0 - - -
262 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, Tripolidin 2,5 mg / NOZA (Phapros) Tablet 0 - - -
263 Parasetamol Syrup 120 mg/5ml (Mersi Farma) Botol 23 - - -
264 Parasetamol Syrup 120 mg/5ml Botol 0 - - -
265 Parasetamol tablet 500 mg Tablet 1768 - 5,000 -
266 Parasetamol tablet 500 mg Tablet 0 - - 5,000
267 Parasetamol tablet 500 mg Tablet 0 - - -
268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 10 - - -
269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 36 - - -
270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 0 - - -
271 Piracetam 800 mg Tablet Tablet 280 - - -
272 Parasetamol tablet 500 mg Tablet 0 - - -
273 Piracetam Injeksi 1gr/ 5ml Ampule 39 - - -
274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 0 - - -
275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 4491 - - -
276 Probiotik Sachet (Probiokid) 0 0 - - -
277 Polikresulen (Albotyl,Apetil) Botol 0 - - -
278 Prednison Tab 5 mg Tablet 0 - - -
279 Prednison Tab 5 mg (Holi Pharma) Tablet 5070 - - -
280 Prednison Tab 5 mg Tablet 0 - - -
281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet 0 - - -
282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 63 - - -
283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 0 - - -
284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 0 - - 1,500
285 0 0 0 - - -
286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol 0 - - -
287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol 0 - - -
288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol 1949 - - -
289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 0 - 2,000 -
290 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 0 - - -
291 Salbutamol SO4 3,01 mg + Ipratonium Brom 0,52 mg Nebulizer (COMBIVENT) I dan II Nebule 284 - - -
292 0 0 0 - - -
293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet 573 - - -
294 Salbutamol Tab 4 mg (Pristasma) Tablet 0 - - -
295 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot 109 - - -
296 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot 0 - - -
297 Salisil Bedak Serbuk 2% (Kimia Farma) Pcs 10 - - -
298 Salisil Bedak Serbuk 2% Pcs 56 - - -
299 Salisil Bedak Serbuk 2% Pcs 0 - - -
300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - - -
301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 0 - - -
302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 5 - - -
303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 0 - - -
304 Setirizin Tab 10 mg (Futamed) Tablet 110 - - -
305 Setirizin Tab 10 mg (Futamed) Tablet 0 - - -
306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 862 - - -
307 Simvastatin Tablet 10 mg Tablet 0 - - -
308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet 2216 - - 5,000
309 0 0 0 - - -
310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol 0 - - -
311 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol 0 - - -
312 Botol
Tetes mata setiap ml mengandung Polietilen glikol 400 1% gliserin 0.25% Hidroksipropil metil selulosa 0,2% VISINE 0 - - -
313 Tetrasiklin HCl Kapsul 500 mg Tablet 0 - - -
314 Thiamin/ Vitamin B1 50 mg Tablet 0 - - -
315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 4671 - - -
316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 0 - - -
317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet 0 - - -
318 Thiamphenicol Kapsul 500 mg Tablet 0 - - -
319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 58 - - -
320 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Molex Ayus) Kapsul 0 - - -
321 Vitamin B Komplek Tablet 0 - - -
322 Tablet
Vitamin B Komplek Plus Ekstrak Hati (Substansi Hati Kering 100 mg, Vit B1 HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, CuSO4 0,65 mg) LIVRPON B-PLEX
0 - - -
0 OBAT GOLONGAN PSIKOTROPIKA 0 0 - - -
323 Alprazolam 0,5 mg (Mersi Farma) Tablet 0 - - -
324 Clobazam Tab 10 mg (Meprofarm) Tablet 0 - - -
325 Clobazam Tab 10 mg (Meprofarm) Tablet 0 - - -
326 Clobazam Tab 10 mg (Meprofarm) Tablet 0 - - -
327 0 0 0 - - -
328 0 0 0 - - -
329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 1 - - -
330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 2 - - -
331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 0 - - -
332 Diazepam Injeksi 5 mg / ml-2 ml Ampule 0 - - -
333 Diazepam Injeksi 5 mg / ml-2 ml Ampule 4 - - -
334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 0 - - -
335 Diazepam Tablet 5 mg (VALISANBE) Tablet 126 - - -
336 Diazepam Tablet 5 mg Tablet 0 - - -
337 Fenobarbital Tablet 30 mg Tablet 0 - - -
338 Fenobarbital Tablet 30 mg Tablet 0 - - -
339 Fenobarbital Tablet 30 mg tablet 0 - - -
340 Kodein Tablet 10 mg Tablet 0 - - -
341 0 0 0 - - -
342 Lorazepam Tab 2 mg (Mersi Farma) Tablet 0 - - -
343 Metamizol 500 mg + Diazepam 2 mg / PRONEURON (Meprofarm) Tablet 0 - - -
344 0 0 0 - - -
345 0 0 0 - - -
346 0 0 0 - - -
347 Primaquin 15 mg tablet tablet 0 - - -
348 0 0 0 - - -
0 OBAT - OBAT PROGRAM 0 0 - - -
0 OBAT PROGRAM KECACINGAN 0 0 - - -
349 Albendazol Tablet 400 mg Tablet 266 - - -
350 Albendazol Tablet 400 mg Tablet 0 - - -
0 OBAT PROGRAM DIARE 0 0 - - -
351 Garam Oralit (Kimia Farma) Tablet 0 - - -
352 Garam Oralit (Kimia Farma) Tablet 3369 - - -
353 Garam Oralit (Kimia Farma) sachet 0 - - -
354 Garam Oralit (Kimia Farma) sachet 0 - - -
355 0 0 0 - - -
356 Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined imperial) Botol 95 - - -
357 Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol 0 - - -
358 Zinc Sulphate Tablet Dispersible 20 mg Tablet 0 - - -
359 Zinc Dispersible 20 mg tablet tablet 0 - - -
360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 0 - - -
361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 5340 - - -
362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 0 - - -
363 0 0 0 - - -
0 OBAT PROGRAM HEPATITIS 0 0 - - -
364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 0 - - -
365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 0 - - -
366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 0 1 - -
367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 0 - - -
368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 0 - - -
0 OBAT PROGRAM TB PARU 0 0 - - -
369 OAT FDC Kategori Anak Kit 0 - - -
370 OAT FDC Kategori Anak Kit 0 - 1 -
371 OAT FDC Kategori Anak Kit 0 - - -
372 OAT FDC Kategori I - IIII Kit 0 - - 10
373 OAT FDC Kategori I - IIII Kit 0 - - -
374 OAT FDC Kategori II Kit 0 - - -
375 OAT FDC Kategori II Kit 0 - - -
376 OAT FDC Kategori II Kit 0 - - -
377 OAT FDC Kombipak Kategori I Kit 0 - - -
378 0 0 0 - - -
379 Isoniazid 100 mg tablet tablet 0 - - -
0 OBAT POGRAM KUSTA 0 0 - - -
380 MDT MB Anak Blister 0 - - -
381 MDT MB Anak Blister 0 - - -
382 MDT MB Dewasa Blister 0 - - -
383 MDT MB Dewasa Blister 0 - - -
384 MDT MB Dewasa Blister 0 - 24 -
385 MDT PB Anak Blister 0 - - -
386 MDT PB Anak Blister 0 - - -
387 MDT PB Anak Blister 0 - - -
388 MDT MB Dewasa Blister 0 - - -
389 MDT PB Dewasa Blister 0 - - -
0 OBAT PROGRAM GIZI 0 0 - - -
390 Mineral Mix Kombinasi sachet 0 - - -
391 Mineral Mix Kombinasi sachet 0 - - -
392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 0 - - -
393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 0 3,350 - -
394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 0 - - -
395 Retinol Vit A 100.000 IU (Biru) Kapsul 0 350 - -
396 Retinol Vit A 100.000 IU (Biru) Kapsul 0 - - -
Retinol Vit A 100.000 IU (Biru) Kapsul 0 - - -
398 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet 2090 53,000 - -
399 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet 0 - - -
400 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) tablet 0 - - -
401 0 0 0 - - -
402 0 0 0 - - -
0 OBAT PROGRAM KESGA 0 0 - - -
403 Calcii Gluconas Inj (Ethica) Ampule 0 - - -
404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 3 - - -
405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial 0 - - -
406 Calcii Gluconas Inj 10% (Ethica) Ampule 0 - - -
407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 52 - - -
408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 0 - - -
409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 0 - - -
410 Oksitetrasiklin 1 % Salep Mata Tablet 0 - - -
411 Metilergometrin Maleat Tablet 0,125 mg Tablet 760 - - -
412 Oksitosin Inj 10 UI/ml (Ethica) Ampule 65 - - -
413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 0 - - -
414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule 0 - - -
415 Oksitosin Inj 10 UI/ml (Ethica) Ampule 0 - - -
0 OBAT PROGRAM JIWA 0 0 - - -
416 Amitriptilin 25 mg Tablet 0 - - -
417 Amitriptilin 25 mg Tablet 0 - - -
418 Amitriptilin 25 mg Tablet 0 - - -
419 Amitriptilin 25 mg Tablet 175 - - -
420 Amitriptilin 25 mg Tablet 0 - - -
421 Clozapine 25mg (OGB Dexa) Tablet 0 - - -
422 Clozapine 100 mg Tablet 0 - - -
423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet 0 - - -
424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet 0 - - -
425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet 0 - - -
426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul 0 - - -
427 Flufenazin sikzonoate inj 25 mg/ ml Ampul 0 - - -
428 Flufenazin sikzonoate inj 5 ml vial 0 - - -
429 Flufenazin sikzonoate inj 5 ml Vial 0 - - -
430 Haloperidol 5 mg tablet Tablet 0 - - -
431 Haloperidol 5 mg tablet Tablet 400 - - -
432 Haloperidol 5 mg tablet Tablet 0 - - -
433 0 0 0 - - -
434 Haloperidol Injeksi 5 mg/ml ampule 0 - - -
435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule 0 - - -
436 Haloperidol/ Lodomer drops 2 mg Botol 0 - - -
437 Karbamazepin Tablet 200 mg Tablet 0 - - -
438 Karbamazepin Tablet 200 mg Tablet 0 - - -
439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 0 - - -
440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 0 - - -
441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet 377 - - -
442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 0 - - -
443 Klorpromazin Tab Salut 100 mg (HCl) Tablet 0 - - -
444 0 0 0 - - -
445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet 0 - - -
446 Risperidon Tab 2 mg (OGB Dexa) Tablet 0 - - -
447 Risperidon Tab 2 mg Tablet 340 - - 500
448 Risperidon Tab 2 mg Tablet 0 - - -
449 0 0 0 - - -
450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet 0 - - -
451 0 0 0 - - -
452 Triheksifenidil Tablet 2 mg (Mersi) Tablet 0 - - 1,000
453 Triheksifenidil Tablet 2 mg Tablet 725 - - -
454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet 0 - - -
455 0 0 0 - - -
456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul 0 - - -
457 0 0 0 - - -
0 PROGRAM IMUNISASI (VAKSIN) 0 0 - - -
458 BCG vial 0 10 20 30
459 PELARUT BCG ampul 0 10 20 30
460 BCG vial 0 - - -
461 BCG vial 0 - - -
462 CAMPAK 10ds (MR) vial 0 50 50 20
463 PELARUT CAMPAK ampul 0 50 50 20
464 CAMPAK 10ds (MR) vial 0 - - -
465 CAMPAK 10ds (MR) vial 0 - - -
466 DPT HB - Hib/ PENTABIO vial 0 80 50 50
467 DPT HB - Hib/ PENTABIO vial 0 - - -
468 DT vial 0 - - -
469 0 0 0 - - -
470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 0 50 50 -
471 HB UNIJECT/ HB - ADS / HEPATITIS B vial 0 - - -
472 POLIO bOPV 10 ds vial 0 50 50 -
473 DROPPER POLIO dropper 0 50 50 30
474 POLIO bOPV 10 ds vial 0 - - 30
475 POLIO bOPV 10 ds vial 0 - - -
476 Td vial 0 - - -
477 0 0 0 - - -
478 HB UNIJECT/ HB - ADS / HEPATITIS B vial 0 - - -
479 POLIO bOPV 10 ds vial 0 - - -
480 Vaksin Meningtis vial 0 - - -
481 CAMPAK 10ds (MR) BIAS vial 0 - - -
482 PELARUT CAMPAK BIAS ampul 0 - - -
483 POLIO bOPV 10 ds vial 0 - - -
484 IPV vial 0 - - -
485 VTM Include Dacron (Biofarma) pcs 0 - - -
486 Vaksin Rabies (Verorab) vial 0 - - -
487 0 0 0 - - -
488 0 0 0 - - -
489 0 0 0 - - -
0 OBAT PROGRAM HIV/ AIDS 0 0 - - -
490 Azitromicyn 500 mg + Cefixime 200 mg Tablet 0 - - -
491 0 0 0 - - -
492 Isoniazid (INH) Tablet 300 mg Tablet 300 - - -
493 0 0 0 - - -
494 Lamivudine 150 mg Tablet 0 - - -
495 Lamivudine 150 mg Tablet 0 - - -
496 Nevirapine 200 mg Tablet 0 - - -
497 Nevirapine 200 mg Tablet 0 - - -
498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet 0 - - -
499 0 0 0 - - -
500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet 0 - - -
501 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet 0 - - -
502 Tenofovir 300 mg Tablet 0 - - -
503 Tenofovir 300 mg Tablet 0 - - -
504 Zidofudine 100 mg (ZDV) Tablet 0 - - -
505 Zidofudine 100 mg (ZDV) Tablet 0 - - -
506 Zidofudine 300 mg + Lamifudine 150 mg Tablet 0 - - -
507 Zidofudine 300 mg + Lamifudine 150 mg Tablet 0 - - -
508 Efavirenz 600 mg tablet tablet 0 - - -
509 Efavirenz 600 mg tablet tablet 0 - - -
510 Zidofudine 300 mg + Lamifudine 150 mg Tablet 0 - - -
511 Abacavir (ABC) 300mg Tablet 0 - - -
512 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet 0 - - -
513 0 0 0 - - -
514 MB Anak blister 0 - - -
515 0 0 0 - - -
516 0 0 0 - - -
517 0 0 0 - - -
518 0 0 0 - - -
519 0 0 0 - - -
520 0 0 0 - - -
521 0 0 0 - - -
522 0 0 0 - - -
523 0 0 0 - - -
524 0 0 0 - - -
525 0 0 0 - - -
526 0 0 0 - - -
527 0 0 0 - - -
528 0 0 0 - - -
529 0 0 0 - - -
0 BMHP 0 0 - - -
530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 0 - - -
531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 444 - - -
532 0 0 0 - - -
533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 1347 - 2,000 -
534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs 0 - - -
535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 0 - - -
536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 0 - - -
537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs 0 - - -
538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs 0 - - -
539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs 0 - - -
540 Alat Suntik Sekali Pakai 20 ml Pcs 6 - - -
541 Alkohol 70% Medika (Kimia Farma) 0 0 - - -
542 Alkohol 70% (Medika) Btl 1000 ml 16 - - -
543 Alkohol Swab 2 - ply (one med) 0 0 - - -
544 Alkohol Swab 2 - ply (one med) Pcs 400 - - -
545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol 0 - - 1
546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs 0 - - -
547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 0 - - -
548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs 109 - - -
549 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I 0 0 - - -
550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda Pcs 0 - - -
551 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda 0 0 - - -
552 Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs 0 - - -
553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs 9 - - -
554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 300 - - -
555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 0 - - -
556 Fixomull Strech 5 cm X 5 m Pcs 0 - - -
557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 46 - - -
558 Foley Catheter 2 Way Ch 16,18 Pcs 0 - - -
559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs 0 - - -
560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 0 - - -
561 Mantel Gown (Bisa Dicuci) biji 0 - - -
562 I.V Catheter No. 18 (JELCO) Pcs 129 - - -
563 I.V Catheter No. 18 (NIPRO) Pcs 0 - - -
564 I.V Catheter No. 20 JELCO Pcs 0 - - -
565 I.V Catheter No. 20 TERUMO Pcs 147 - - -
566 I.V Catheter No. 20 JELCO Pcs 0 - - -
567 I.V Catheter No. 22 NIPRO Pcs 156 - - -
568 I.V Catheter No. 22 NIPRO Pcs 0 - - -
569 I.V Catheter No. 24 TERUMO Pcs 135 - - -
570 I.V Catheter No. 24 TERUMO 0 0 - - -
571 Infusion Set Anak 60 Drops /(Otsuka) Pcs 112 - - -
572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 0 - - -
573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 203 - - -
574 Infusion Set Dewasa 20 Drops/ (OTSUKA) Pcs 0 - 500 -
575 Kantong Plastik Bio Hazart (Bahan Plastik PE, Panjang 80 Cm, Lebar 60 Cm, Tebal 0,33 Mm) Pcs 0 - - -
576 Kapas Pembalut Hydrofil 250 gr Pcs 1 - - -
577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 14 - - -
578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 0 - - -
579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs 7 - - -
580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 3 - - -
581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 0 - - -
582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs 9 - - -
583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 68 - - -
584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 0 - - -
585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs 222 - - -
586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 0 - - -
587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 0 - - -
588 Masker Ear Loop (Masker) Pcs 602 - - -
589 Masker Ear Loop Jilbab (Golden Gloves) Pcs 0 - - -
590 Masker General Care (MARCOTILA) Pcs 0 - - -
591 0 0 0 - - -
592 Masker N95 Disposibel Pcs 35 - - -
593 Masker N95 Disposibel (One Med) Pcs 0 - - -
594 Masker Tali Pcs 0 - - -
595 Masker Tali Pcs 0 - - -
596 Masker Elastic Pcs 0 - - -
597 Media Sample Container Pcs 0 - - -
598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs 0 - - -
599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs 0 - - -
600 Norinse Antimicrobial 500 ml (Viorex) Pcs 0 - - -
601 Nurse Cup (Tutup Kepala) Pcs 90 - - -
602 Oxygen Mask Elongated Adult (Remedi) Pcs 0 - - -
603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs 0 - - -
604 Plesterin Bulat Non Woven (One Med) Pcs 0 - - -
605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 26 - - -
606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 0 - - -
607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 0 - - -
608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 0 - - -
609 Povidon Iodine 10% (60 ml) ( One Med) Pcs 14 - - -
610 0 0 0 - - -
611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube 0 - - -
612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair 0 - - -
613 0 0 0 - - -
614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair 500 - - -
615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair 0 - - -
616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair 33 - - -
617 Sarung Tangan size M dan L (Exam Glove) PAir 0 - - -
618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 600 - - -
619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair 0 - - -
620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 72 - - -
621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs 0 - - -
622 0 0 0 - - -
623 Surface Disinfectant 500 ml (Stericide ) Pcs 0 - - -
624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 0 - - 2
625 Underpad 90x 0 cm cosmo I Pcs 0 - - -
626 Underpad 90x 0 cm cosmo II Pcs 0 - - -
627 0 0 0 - - -
628 Urine Bag Sterile Standard Pcs 21 - - -
629 Urine Bag Sterile Standard (AXIMED) Pcs 0 - - -
630 0 0 0 - - -
631 Umbilical Cord Clamp ( Hospitech ) Pcs 0 - - -
0 REAGEN 0 0 - - -
632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs 0 - - -
633 Accu- Check Performa Tes Strip ( Roche ) pcs 0 - - -
634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 1000 - - -
635 Accu- Check Performa Tes Strip ( Roche ) Pcs 0 - - -
636 Antimonoclonal A (Anti A) 10 ml Btl 0 - - -
637 Antimonoclonal AB (Anti AB) 10 ml Btl 0 - - -
638 Antimonoclonal B (Anti B) 10 ml Btl 0 - - -
639 0 0 0 - - -
640 Cholesterol Test Strip (Human Humasens Plus) Tes 0 - - -
641 Cholesterol Test Strip (Human Humasens Plus) 0 0 - - -
642 Family DR HB Hemoglobin Test Meter (Alat) Pcs 0 - - -
643 Family DR HB Hemoglobin Test Trip MHS 2 Tes 0 - - -
644 Glucose Test Strip (Human Humasens plus) Tes 0 - - -
645 Glucose Test Strip (Human Humasens plus) II Tes 0 - - -
646 Hemoglobin Strip 50 test mission (Acon) Pcs 0 - 6 -
647 Hemoglobin Strip 50 test mission (Acon) 0 0 - - -
648 Reagen Hb (HCl 0,1 N) 100ml Btl 0 - - -
649 0 0 0 - - -
650 Reagen HBsAg Strip (FOKUS) Test 0 - - -
651 0 0 0 - - -
652 TPHA (Fokus) Test 0 - - -
653 0 0 0 - - -
654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes 0 - - -
655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 0 - - -
0 BMHP (PROGRAM) PROPINSI 0 0 - - -
0 PROGRAM MALARIA 0 0 - - -
656 RDT Malaria Test 0 - - -
0 PROGRAM SYPHILIS 0 0 - - -
657 RPR Syphilis Pcs 0 - - -
658 RPR Syphilis tahap II (FOKUS) Pcs 0 - - -
659 Syphilis 3.0 06FK10 SD Bioline Test 0 - - -
Test
660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) 0 - 200 -
Test
661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) 0 - - -
662 0 0 0 - - -
663 Tuberkulin Vial 0 - - -
664 RDT Lepto (Uji Leptospira IgM) test 0 - - -
665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test 0 - - -
666 0 0 0 - - -
667 0 0 0 - - -
0 PROGRAM HEPATITIS 0 0 - - -
Rapid Test Anti Hepatitis C (HCV)
668 Test 0 - - -
669 Reagen HBsAg Strip SD Test 0 - 200 -
670 Reagen HBsAg Strip SD Test 0 - - -
671 Reagen HBsAg Strip SD Test 0 - - -
672 0 0 0 - - -
673 0 0 0 - - -
674 0 0 0 - - -
675 0 0 0 - - -
0 PROGRAM TB PARU 0 0 - - -
676 Box Slide Pcs 0 - - -
677 Box Slide Pcs 0 - - -
678 Catridge Genexpart Test 0 - - -
679 Catridge Genexpart Test 0 - - -
680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test 0 - - -
681 Oil Emersi Botol 0 - - -
682 Pot Spuntum/Pot Dahak Steril Pcs 0 - - -
683 Pot Spuntum/Pot Dahak Steril Pcs 0 - - -
684 Pot Spuntum/Pot Dahak Steril Pcs 0 - 200 -
685 Pot Spuntum/Pot Dahak Steril Pcs 0 - - -
686 Reagen Control CD4 0 0 - - -
687 Reagen Control CD4 0 0 - - -
688 Reagen Zeil Nelseen Kit 0 - 5 -
689 Reagen Zeil Nelseen Kit 0 - - -
690 Reagen Zeil Nelseen Kit 0 - 5 -
691 Reagen Zeil Nelseen Kit 0 - - -
692 Slide Pcs 0 - - -
693 Slide/ Object Glass Pcs 0 - - -
694 Stereofoam pcs 0 - - -
695 Masker N 95 TB pcs 0 - - -
696 Masker Tali Bedah TB pcs 0 - - -
0 OBAT PROGRAM IMUNISASI 0 0 - - -
697 Alat Suntik Sekali Pakai 0,05 ml Pcs 0 - - -
698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs 0 - - -
699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs 0 - 500 -
700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs 0 - - -
701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs 0 - - -
702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs 0 - - -
703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs 0 - - -
704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs 0 - - -
705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs 0 - - -
706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs 0 - - -
707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs 0 - - -
708 0 0 0 - - -
709 0 0 0 - - -
710 0 0 0 - - -
711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 500 - - -
712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs 0 - - -
713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs 0 - - -
714 0 0 0 - - -
715 Safety Box 5 L Pcs 0 - - -
716 Alat Suntik Sekali Pakai 0,05 ml Pcs 0 - - -
717 0 0 0 - - -
718 0 0 0 - - -
719 0 0 0 - - -
720 0 0 0 - - -
0 PROGRAM HIV/ AIDS 0 0 - - -
721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Tahap I Test 0 - - -
722 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Reagen R3 0 0 - - -
723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test 0 - - -
724 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) (Reagen R2) 0 0 - - -
725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test 0 - - -
726 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I 0 0 - - -
727 Kondom Pcs 0 - 288 144
728 DBS Collection/ Lasec Pcs 0 - - -
729 Lubricant Pcs 0 - 20 20
730 0 0 0 - - -
731 Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap I Test 0 - 200 -
732 Rapid HIV 1/2 3.0 SD Bioline test 0 - - -
733 Reagen HIV (FOKUS) R 2 Test 0 - - -
734 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I Test 0 - - -
735 Reagen HIV (SD) R 1 Test 0 - - -
736 Reagen HIV (SD) R 1 Test 0 - - -
737 0 0 0 - - -
738 Reagen HIV (VIKIA) R 3 Test 0 - - -
739 0 0 0 - - -
740 Reagen HIV R2 (Rapid Test) FOKUS Test 0 - - -
741 0 0 0 - - -
742 Reagen HIV R3 (VIKIA) Test 0 - - -
743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test 0 - - -
744 Sarung Tangan Non Steril Pair 0 - - -
745 0 0 0 - - -
746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket 0 - - -
747 VTM Include Swab Test 0 - - -
748 Masker Bedah 3 ply Pcs 0 - - -
749 0 0 0 - - -
750 0 0 0 - - -
751 0 0 0 - - -
752 0 0 0 - - -
753 0 0 0 - - -
754 0 0 0 - - -
755 0 0 0 - - -
756 0 0 0 - - -
757 0 0 0 - - -
758 0 0 0 - - -
759 0 0 0 - - -
760 0 0 0 - - -
761 0 0 0 - - -
762 0 0 0 - - -
763 0 0 0 - - -
764 0 0 0 - - -
0 OKSIGEN MEDICAL 0 0 - - -
765 Oksigen 3 m3 Tampon 0 - - -
766 Oksigen 6 m3 Tampon 0 - - -
767 Oksigen 1 m3 Tampon 0 - - -
768 Oksigen 6 m3 Tampon 0 - - -
769 Nurse Cup (Tutup Kepala) One Med 0 0 - - -
770 0 0 0 - - -
771 0 0 0 - - -
772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet 0 - - -
0 TAMBAHAN IFK 0 0 - - -
1 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 0 - - -
2 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet 0 - - -
3 Ranitidin Tablet 150 mg Tablet 0 - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg
4 Tablet 0 - - -
5 Thiamphenicol Syr. 0 0 - - -
6 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet 0 - - -
7 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 0 - - -
8 Ranitidin Injeksi 25 mg/ 2 ml Ampule 0 - - -
9 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet 0 - - -
10 Ketokonazole 200 mg Tablet 0 - - -
11 Kotrimoksazol Forte Tablet 0 - - -
12 Infusion set anak Pcs 0 - - 50
13 Alat Suntik 10 cc Pcs 0 - - -
14 Eritrosmisin Stearate Kaplet 500 mg Tablet 0 - - -
15 Omeprazole Kapsul 20 mg Tablet 0 - - -
16 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol 0 - - -
17 Setirizin Tab 10 mg (Futamed) Tablet 0 - - -
18 Siprofloksasin Tablet 500 mg (Novapharin) Tablet 0 - - -
19 Oseltamivir 75 mg Kapsul 0 - - -
20 Ringer Laktat cairan infus @ 500 ml RL Botol 0 - - -
21 Amitriptilin 25 mg Tablet 0 - - -
22 I.V Catheter No. 24 TERUMO pcs 0 - - -
23 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 0 - - -
24 RDT COVID - 19 0 0 - - -
25 Oseltamivir 75 mg 0 0 - - -
26 Klorokuin 150 mg tablet 0 0 - - -
27 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 0 - - -
28 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 0 - - -
29 Masker N95 (Particulate Respirator) 0 0 - - -
30 Hazmat/ APD/ Hazmat PPK 0 0 - - -
31 Medical Sample Container Pcs 0 - - -
32 Cepheid Pcs 0 - - -
33 Natrium Klorida Larutan infus 0,9% @100ml 0 0 - - -
34 Tambah Darah drop (Ferriz Drop) pcs 0 - - -
35 Tambah Darah Sirup (Ferriz Sirup) pcs 0 - - -
36 Gentamycin Krim 1 % mg/ ml Gentalex Tube 0 - - -
37 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 0 - - -
38 Obat Batuk Sirup / INADRYL Botol 0 - - -
39 Obat Batuk Expektoran Sirup Botol 0 - - -
40 Tablet
Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate, dextromethorpan Hbr
0 - - -
41 Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Influenza Tablet 0 - - -
42 Masker Bedah /Bima Sakti pCS 0 - - -
43 Masker Bedah /Rania pCS 0 - - -
44 Masker N 95 Bima Sakti PCS 0 - - -
45 Sarung tangan panjang steril / meditouche perpasang 0 0 - - -
46 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS 0 - - -
47 Albendazol Suspensi 200mg/ 5 ml botol 0 - - -
48 I.V Catheter No. 24 (BRAUN) pcs 0 - - -
49 OAT FDC Kategori Anak 0 0 - - -
50 Handsanitizer Medicare 0,5% (5 liter) KF 0 0 - - -
51 Apron Lengan Panjang Putih (Rannia) 0 0 - - -
52 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 0 - - -
53 0 0 0 - - -
54 0 0 0 - - -
55 0 0 0 - - -
56 0 0 0 - - -
57 0 0 0 - - -
58 0 0 0 - - -
59 0 0 0 - - -
60 APD Set (Rannia) 0 0 - - -
61 Cover All Disposible (Baju sekali pakai) (Rannia) 0 0 - - -
62 Cover All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 0 0 - - -
63 Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya Mitra Bersama) 0 0 - - -
64 Helm visor (Usaha Karya Mitra Bersama) 0 0 - - -
65 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 0 - - -
Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 0 - - -
Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 0 - - -
Sarung tangan non steril M,L (COBRA) box @100 pcs 0 - - -
Masker N95 Covid 19 Pcs 0 - - -
Masker Tali Bedah 3 ply Covid 19 Pcs 0 - - -
Masker Eaerlop Hijab Pcs 0 - - -
Etanol 96 % (Alkohol 1) Botol = 20 Liter 0 - - -
Hand Sanitzer 1 Botol = 20 Liter 0 - - -
MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter 0 - - -
Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs 0 - - -
KIT A1 Operasi Steril (RAJAWALI) Pcs 0 - - -
Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs 0 - - -
Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 0 - - -
Masker Face/ Masker Bedah (COBRA 1) pcs 0 - - -
Masker Elastis Hijau 3 ply (RAJAWALI) Pcs 0 - - -
Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - -
Masker Face/ Masker Bedah (COBRA 2) pcs - - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - -
Masker KN95 (Farmahusada) Box @50 pcs - - - -
Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - -
Rapid Test SARS COV 2 (Farmahusada) Test - - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - -
Masker KN95 (Anugrah Sentosa Abadi) pcs - - - -
APRON (Atmosfer) pcs - - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - -
Hand Sanitzer 2 liter - - - -
Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - -
Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs - - - -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - -
Face Shield (COBRA) 0 - - - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Kit Steril (Rajawali) 0 - - - -
Alkohol II @20 Liter 0 - - - -
Cover All (Rajawali) 0 - - - -
Face Shield (ATMOSFER) 0 - - - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Masker Earloop (KasaHusada) 0 - - - -
MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - -
Rapid Test Covid-19 (Rajawali) 0 - - - -
Rapid Test Covid-19 (Dakonan) 0 - - - -
Alkohol Swab (BTT) 0 - - - -
Antiseptic Gel 500 0 - - - -
Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - - - -
Kaca mata Goggle (HASTEN) 0 - - - -
Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - -
Masker Bedah Hijau @50pcs 0 - - - -
Masker N95 3M 8210 (Hazten) 0 - - - -
Nurse Cap Green om 100bh 0 - - - -
Parafilm (Anugerah Sentosa Abadi) 0 - - - -
Rapid Test (1.000) Widhi Dharma Adi 0 - - - -
Sarung tangan Safeglove Exam M 100bh 0 - - - -
Sarung tangan Safeglove Surgical size 7 dan 7,5 0 0 - - -
Sterlisasi Swab stik (5box/ VTM) 0 0 - - -
Stereofoam (Anugerah Sentosa Abadi) 0 - - - -
Universal Transport Media (UTM) Goongdong 0 - - - -
Universal Transport Media (UTM) Sekarguna 0 - - - -
Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 0 - - -
Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 0 - - -
Infusion Set Anak 60 Drops /(Otsuka) 0 - - - -
Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - -
Rapid Test Lecurate (Bima Sakti) 0 - - - -
Rapid Test ZYBIO (Farma Husada) 0 0 - - -
Alkohol 96 % Liter - - - -
0 0 - - - -
0 0 - - - -
TAMBAHAN PUSKESMAS 0 - - - -
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 9 - - -
Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - - -
Asiklovir 5% 5gr Cream Tube 44 - - -
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs 4 - - -
0 0 - - - -
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 14 - - -
Furosemide Tablet 40 mg (Kimia Farma ) Tablet 608 - - -
Gentamycin Krim 1 % mg/ ml Tube 10 - - -
0 0 - - - -
Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 3 - - -
Ketokonazol Tablet 200 mg (Novapharin) I Tablet 20 - - -
Meloxicam Tab 15 mg (Bernofarm ) Tablet 5 - - -
Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 344 - - -
Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 293 - - -
Thiamin/ Vitamin B1 50 mg Tablet 50 - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul 330 - - -
Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs 55 - - -
Antimicrobial Liquid Soap 500 ml (Viorex) 0 13 - - -
Hand Sanitizer 450 ml (Meditol) 0 13 - - -
Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 39 - - -
I.V Catheter No. 18 (JELCO) Pcs 1 - - -
I.V Catheter No. 22 NIPRO Pcs 4 - - -
I.V Catheter No. 24 TERUMO Pcs 9 - - -
Materniti Napkin Slim L 0 1 - - -
Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll 11 - - -
Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 5 - - -
Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - - -
Sterizyme Dual Enymatic Detergent 5 Ltr 0 2 - - -
Haloperidol 5 mg tablet Tablet 148 - - -
Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 82 - - -
Fixomull Strech 5 cm X 5 m Pcs 17 - - -
Umbilical crd clamp 0 233 - - -
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 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0
TOTAL

Mengetahui,
KEPALA PUSKESMAS

.....................................................
OBAT - OBATAN (ASET) TRIWULAN I
........ TAHUN 2020

PEMAKAIAN
SISA
TOTAL PENERIMAAN Jan Feb Mar TOTAL PEMAKAIAN SISA STOK Ket Harga
MARET

- - - - - - - 1 99.000
100 119 100 10 229 - - 1 105.000
- - - - - - - 1 105.000
- - - - - - - 1 0.000
- 35 12 12 59 21 21 1 2,860.000
- - - - - - - 1 2,860.000
- - - - - - - 1 10,500.000
- 333 58 109 500 417 417 1 104.000
- - - - - - - 1 220.000
- 172 184 284 640 321 321 1 93.500
- - - - - - - 1 0.000
- - - - - - - 1 2,998.000
- - - - - - - 1 0.000
- 337 348 66 751 - - 1 93.000
- - - - - - - 1 99.000
- - - - - - - 1 0.000
- - - - - - - 1 190.000
- - - - - - - 1 233.000
- 90 - - 90 - - 1 233.000
- - - - - - - 1 249.000
- - - - - - - 1 0.000
- 148 38 29 215 1 1 1 3,025.000
- - - - - - - 1 3,025.000
- - - - - - - 1 4,400.000
- - - - - - - 1 3,628.000
- - - - - - - 1 10,246.500
- - - - - - - 1 9,900.000
- 186 62 315 563 14 14 1 8,500.000
- - - - - - - 1 8,237.000
- - - - - - - 1 0.000
- 7 80 - 87 - - 1 4,950.000
- - - - - - - 1 0.000
- 44 3 - 47 - - 1 440.000
- - - - - - - 1 220.000
3,000 4,568 1,356 1,060 6,984 2,030 2,030 1 165.000
- - - - - - - 1 58.000
- - - - - - - 1 0.000
- - - - - - - 1 3,035.000
- - - - - - - 1 0.000
- - - - - - - 1 4,496.000
- - - - - - - 1 0.000
- 50 40 60 150 420 420 1 3,045.000
- - - - - - - 1 198.000
- - - - - - - 1 1,485.000
- - - - - - - 1 1,551.000
- 1,326 991 306 2,623 182 182 1 105.000
- - - - - - - 1 105.000
- - - - - - - 1 1,050.000
- - - - - - - 1 67.000
- - - - - - - 1 75.000
- - - - - - - 1 103.000
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.....................................................
Nilai Penerimaan Nilai Pemakaian Nilai Persediaan

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0 0 0 0
0 0 0 0
0 1283276 1514884 2798160
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1325000 0 1325000 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
248120 248120 0 0
0 0 0 0
3893440 3893440 0 0
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1002816 1002816 0 0
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1731950 0 1731950 0
0 0 0 0
 99400 0 99400 0
0 0 0 0
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18762000 4114188 15387672 739860
0 0 0 0
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0 0 0 0
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0 3796 7592 11388
0 0 0 0
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0 133155 20713 153868
0 0 0 0
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0 79800 79800 159600
0 114000 9500 123500
0 0 0 0
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0 2505 26720 29225
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 0 0 0 0
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0 59566 0 59566
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143500 140630 100450 97580
0 0 0 0
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91000 12649 78351 0
0 65975 0 65975
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3381600 2761640 619960 0
0 0 0 0
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16997760 10057008 6940752 0
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13791600 4903680 8887920 0
0 0 0 0
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0 0 0 0
2327000 1163500 1163500 0
0 0 0 0
1814000 1124680 689320 0
0 0 0 0
584108.1 0 584108.1 0
0 0 0 0
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0 4920 44280 49200
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 0 0 0 0
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0 0 0 0
0 336567 117645 454212
0 0 0 0
1848000 2232384 860244 1244628
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 7623 7623 15246
0 0 0 0
0 298281.69 19885.446 318167.136
0 0 0 0
0 50904 0 50904
212784 212784 0 0
0 0 0 0
0 0 0 0
0 1822500 630000 2452500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 3136320 3136320
0 66660 599940 666600
0 0 0 0
0 0 0 0
0 195750 404550 600300
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 631900 516200 1148100
0 0 0 0
0 0 0 0
0 865260 56430 921690
0 0 0 0
0 830500 27500 858000
0 0 0 0
0 815100 31350 846450
0 0 0 0
0 855360 31680 887040
0 0 0 0
0 1258579.7 0 1258579.7
4200000 0 4200000 0
0 0 0 0
0 13400 0 13400
0 174200 13400 187600
0 0 0 0
0 16100 0 16100
0 409500 0 409500
0 0 0 0
0 72000 0 72000
0 357000 47600 404600
0 0 0 0
0 180180 137280 317460
0 0 0 0
0 0 0 0
0 250292.25 7273.45 257565.7
0 0 0 0
0 0 0 0
0 0 0 0
0 612500 0 612500
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 10017 20034 30051
0 0 0 0
0 0 0 0
0 0 0 0
0 184800 15400 200200
0 0 0 0
0 0 0 0
0 0 0 0
0 51800 0 51800
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 271260 0 271260
0 0 0 0
0 542080 96800 638880
0 0 0 0
0 377300 1886500 2263800
0 0 0 0
 0 1379262 102930 1482192
0 0 0 0
0 0 0 0
0 0 0 0
1504800 0 1504800 0
0 0 0 0
0 0 0 0
0 0 0 0
0 80520 32208 112728
0 0 0 0
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0 0 0 0
0 0 0 0
0 127050 508200 635250
0 0 0 0
0 0 0 0
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2409999.996 2409999.996 0 0
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1947600 1947600 0 0
0 0 0 0
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0 0 0 0
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0 0 0 0
2173160 2173160 0 0
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545600 545600 0 0
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0 0 0 0
1383000 1383000 0 0
0 0 0 0
1288220 1288220 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
0 0 0 0
731500 731500 0 0
0 0 0 0
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 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 113976 677524 791500
0 0 0 0
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0 0 0 0
154656 103104 51552 0
0 0 0 0
19440 9720 9720 0
0 0 0 0
2395000 2395000 0 0
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396000 0 396000 0
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0 64798.965 0
0 5835 0
0 91450 38350
0 559520 0
0 0 0
0 15358 0
0 2233 44583
0 32175 0
0 0 0
0 31145.4 15572.7
0 2700 2700
0 3000 0
0 22120 358344
0 13185 0
0 1800 0
0 258390 0
0 71610 0
0 297000 668250
0 561418 0
0 308880 0
0 8750 0
0 28072 0
0 75195 0 75195
0 20328 0 20328
0 132836 0 132836
0 32975 0 32975
0 0 1098900 1098900
 0 0 1425600 1425600
0 8288 0 8288
0 134480 0 134480
0 727600 0 727600
0 294250 346500 640750
0 0 0
0 0 0
0 0 0
0 0 0
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0
107,121,454.096 124,752,956.001 95,613,305.696 109,737,567.536

PETUGAS
PENGELOLA KEFARMASIAN

.....................................................
 ( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN :
KABUPATEN : LUMAJANG PERMINTAAN BULAN :
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN SUMBER

NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN SISA STOK NO BATCH
KEMASAN RAWAT INAP RAWAT JALAN JUMLAH ANGGARAN

UNIT UNIT UNIT UNIT UNIT

Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - - - DAK 18/Okt.19

Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - 500 500 50 450 DAK 19/Sept.21
50
Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - - - DAK 20/ Jan 22
0 0 - - - - - -
Air Untuk Injeksi Vial @25 ml Vial 21 - 21 21 21 - DAK 19/Feb.22
DAK 20/ 16 -
Air Untuk Injeksi Vial @25 ml Vial - 240 240 60 180
60 Des 22
Air Untuk Irigasi Infus 1000 ml Botol - - - - - DAK 18/Apr.20
Alopurinol Tablet 100 mg Tablet 284 800 1,084 134 134 950 DAK 19/Mei 23
Alopurinol Tablet 100 mg 0 - - - - - DAK 20 L
Ambroxol Tablet 30 mg Tablet - 2,000 2,000 - 2,000 DAK 19/Juni 21
0 0 - - - - - DAK 17/AGSTS- -
Aminofilin Injeksi 24 mg/ml Ampule - - - - -
0 0 - - - - - 20 -
Amlodipin Tablet 10 Mg Tablet - - - - - Dak 19/Okt. 20
Amlodipin Tablet 10 Mg Tablet - 3,000 3,000 12 12 2,988 Dak 20/Okt 21
0 0 - - - - - -
Amoksisilin Kaplet 500 mg Tablet - 35,000 35,000 320 792 1,112 33,888 DAK 17/NOV-21
Amoksisilin Kaplet 500 mg Tablet - - - - - DAK 18/Okt.20
Amoksisilin Kaplet 500 mg Tablet - - - - - DAK 19/Feb 21
Amoksisilin Kaplet 500 mg Tablet - - - - - DAK 20/ April 22
0 0 - - - - - -
Amoksisilin Syrup Kering 125 mg / 5 ml Botol - 300 300 - 300 DAK 19/Agst.22
Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - - - DAK 20 L
Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - - - DAK 19/JULI 21
Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - - - - DAK 20/ Mart 22
Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - - - - DAK 18L/Mar.20
CLABAT,CAPSINAT Tablet - - - - - PRBG 20
CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - - - - DAK 17/MAR-20
Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial - - - - - DAK 20 / Mei-23
0 0 - - - - - -
Antacida + Simeticon Suspensi (NOVAMAG) Botol - 50 50 - 50 DAK 19/Sept. 23
0 0 - - - - - -
Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - - - DAK 17/APR-19
Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - - - DAK 18L/Agst.20
Antacida + Simeticon 700 1,026
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet 500 8,000 8,500 1,726 6,774 DAK 19/Mei20
PRSpesifik 21
Tablet - - - - -
Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - - - - non covid-19/ -
Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - - - DAK 18/Apr-22
0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - - - - -
Pot - 24 24 - 24 DAK 19/ Juni 23
Salisilat 3% (Marin )
0Antihemoroid 0 - - - - - -
Kombinasi : Bismut Suppgalat 150 mg 140
Supp 360 - 360 140 220 DAK 16/APR-20
Buffer Prop.20 -
Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Covid-19
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - - - - DAK 18L/Jan.21
20% ) HEMOROGARD Tablet - - - - - PRSpesifik L 20/
20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet - 5,000 5,000 139 139 4,861 DAK 19/Sept.21
Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet - - - - - DAK 20/Juni 22
Tablet - - - - - DAK
DAK 17/Jan-21
17/AGSTS-
(Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - - -
Asam Folat Tablet 1 mg Tablet - - - - - 20
DAK 20/Feb 22
Asam Mefenamat 500 mg ( Mersi ) Tablet - - - - - DAK 19/MAR-22
Asam Mefenamat 500 mg 0 - - - - - DAK 20 L
0 0 - - - - - 0
Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 8 - 8 1 1 7 DAK 19/Feb.22
0 0 - - - - - 0
Asam Tranexamat Tablet 500 mg Tablet 86 200 286 - 286 DAK 19/Feb.22
0 0 - - - - - 0
Asiklovir 5% 5gr Cream Tube 132 - 132 2 2 130 DAK 18L/Apr.22
Asiklovir 5% 5gr Cream Tube - - - - - DAK 19/Juni 22
0 0 - - - - - -
Asiklovir Tab 400 mg ( Phapros ) Tablet - - - - - DAK 18/Mei.22
Asiklovir Tab 400 mg ( Phapros ) Tablet 30 300 330 23 47 70 260 DAK 19/Des.22
Asiklovir Tab 400 mg ( Phapros ) Tablet - - - - - DAK 20/Des 23
Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - - - Dak
DAK19/Feb 21
20/31-Okt
Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - - -
Attapulgite Active 630 mg Tab/ New Antides Tablet - - - - - 21
DAK 18/Apr 23
Attapulgite Active 630 mg Tab/ PULAREX Tablet 493 - 493 156 152 308 185 DAK20
19/Apr 23
DAK /Nov22,
Attapulgite Active 630 mg Tab/ New Antides Tablet - 2,000 2,000 - 2,000
Betahistin Mesylat 6 mg Tablet - - - - - Mart
DAK 23
19/Jan 20
21
PRSpesifik
Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - - - -
Betametason Dipropionat Krim 0,1% - - - - - Non
DAK Covid-19/
18/Feb.20
Tube
gram @ 10
Betametason Dipropionat Krim 0,1% Tube - - - - - DAK 19/Feb.20
Betametason Dipropionat Krim 0,1% gram @ 10 - 300 300 6 39 45 255 DAK 20/Okt 21
Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - - - - DAK 17/JUL-19
Bisakodil Sup 10 mg (Dulcolax) Supp - - - - - DAK 20/Feb 24
Bisoprolol 2,5 mg/concor 2,5 Tablet - - - - - DAK 19/
Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - - - - DAK 20 L
Bricasma Biji - - - - - DAK 19/Agst. 20
Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - - - - DAK 19/Apr.20
Zeneca
0Budesonid )I 0 - - - - - 0
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
pcs - - - - - DAK 19/Jan 21
Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - - - - -
Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - - - - DAK 19/Mei 24
Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet - 1,000 1,000 - 1,000 DAK 19/Juni 24
Cefadroksil Kapsul 500 mg Tablet - - - - - PRBG 20/
Cefotaxime serbuk injeksi 1.000 mg Vial - - - - - DAK 17/MAR-19
Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 73 - 73 5 5 68 DAK 19/Mar.21
Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - - - - - PRSpesifik L 20/
Tablet - - - - - DAK 19/Okt.21
(Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 55 - 55 12 2 14 41 DAK
DAK 19/Apr.21
20/ Des 21,
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - 200 200 - 200
Deksamethason Tab 0,5 mg (Promed ) Tablet 1,229 1,000 2,229 145 421 566 1,663 Feb
DAK2219/Juni 21
Deksamethason Tab 0,5 mg 0 - - - - - DAK 20 L
Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube 1 - 1 1 1 - DAK 18/Nov 19
Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - - - DAK 18L/Agst.20
Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 14 300 314 8 27 35 279 DAK 19/Juni 22
0 0 - - - - - -
Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 176 - 176 15 15 161 DAK 17/APR-21
Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - - - DAK 19/Nov.20
Digoksin Tab 0,25 mg Tablet - - - - - DAK 20/
Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet - 1,500 1,500 30 30 1,470 DAK 19/Nov.20
Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - - - - DAK 19/Mar.24
0 0 - - - - - -
Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - - - DAK 19/JULI21
Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - - - DAK 20/Feb 22
Domperidon Tab 10 mg (Novapharin ) Tablet 296 - 296 92 84 176 120 DAK 19/Juni 21
Domperidon Tab 10 mg (Novapharin ) Tablet - - - - - DAK 20/Mart 23
Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - - - DAK 18/Des 20
Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 26 30 56 31 31 25 DAK
DAK 19/Nov.20
GD 20 / 30-
Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - - - Buffer
Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - - Aprl 21 Prop
Eritrosmisin Stearate Kaplet 500 mg Tablet - 200 200 - 200 19/Mei
DAK 20/ 20Mei 21
Ethambutol 250 mg Tablet - - - - - DAK
DAK 19/Des.23
17/SEPT-
Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - - -
Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - - - 20
DAK
120 Buffer17/AGS-19
Prop.19/
Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - 120 120 120 -
Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - 120 120 27 27 93 Feb 20 /31-Des
DAK 20
Fitomenadion Tabet 10 mg (Phapros ) Tablet - - - - - 21;Jan 22
DAK 17/Apr.19
Fitomenadion Tabet 10 mg (Phapros ) Tablet 130 - 130 15 15 115 DAK 18/Apr.21
0 0 - - - - - -
Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - - - DAK
DAK 18/Des.19
Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - - -
Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - - - Farmasi/Jan-22
DAK 19/Jan 22
Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - - - DAK 20/Mei 22
Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - - - DAK 18/Mei 21
Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - - - DAK 19/Sept.22
Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - 192 192 80 80 112 DAK 20/Feb 23
Gentamycin Krim 1 % mg/ ml Tube - - - - - DAK 19/Juni 22
Gentian Violet 1% 10 ml Botol - - - - - DAK 20 L
Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 40 24 64 8 8 56 DAK 17/DES-20
Glibenklamid Tablet 5 mg Tablet 2,825 3,000 5,825 14 280 294 5,531 DAK 19/Feb 24
Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - - - DAK 20/ Feb 22
Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - - - - - DAU 19/Mei
DAK PR BG 23
Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet - 7,800 7,800 54 931 985 6,815 COVID 20/ Agsts
VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 126 - 126 6 6 120 DAK 19/Mei 22
21
Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 9 5 14 - 14 DAK 19/Mei 21
Glukosa Larutan 40% Steril botol - - - - - PRSpesifik L 20/
Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - - - DAK 17/FEB-20
Glukosa Larutan Infus 5% @500ml Botol - - - - - DAK 20/
Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - - - APBD II - 15
Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,270 1,000 2,270 903 903 1,367 DAK 16/OKT-21
Gliseril Guaikoulat Tablet 100 mg Tablet - - - - - DAK 20 L
Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - - - DAK 18/Agst.21
Hidrokortison Krim 2,5 % (Kimia Farma) Tube - 120 120 - 120 DAK 19/Mei 23
Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - - - DAK 20/ Juni 23
Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - - - DAK 19/Jan 21
Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10 - 10 DAK 19/Mei 21
0 0 - - - - - DAK 20 L
Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - - - DAK 19
Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - 216 216 28 28 188 DAK 20/ Des 21
Ibuprofen Tablet 400 mg (Novapharin ) Tablet - 8,000 8,000 100 100 7,900 DAK 19/JULI21
Ibuprofen Tablet 400 mg Tablet - - - - - DAK 20 L
Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - - - DAK 18L/Mar.20
Isoniazid Tablet 100 mg tablet - - - - - DAK 20 L
Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 255 - 255 - 255 DAK 17/MAR-21
Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - - - DAK 18/Jan.22
Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - - - DAK 19/Mart.23
0 0 - - - - - -
KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - - - DAK 18/Nov.20
KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - - - DAK 18/Jan.21
KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol - - - - - DAK 19/Jan.22
0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - - - - -
Tablet - - - - - DAK 19/Juli 21
Pharmatama)
0 0 - - - - - -
Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100 - 100 DAK 18/Mar.21
Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet - 8,000 8,000 1,540 1,540 6,460 DAK 19/Mei 21
Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - - - DAK
DAK 19/ Agst.22
20/ Sept 22,
Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - - -
Kaptopril Tab 25 mg ( Phapros ) Tablet 2,206 3,000 5,206 - 5,206 Jan 23
DAK 19/Mei 24
Kaptopril Tab 25 mg TAblet - - - - - DAK 20 L
Ketokonazol Krim 2 % @ 10 gr Tube 5 - 5 1 4 5 - DAK 19/Mei23
Ketokonazol Krim 2 % @ 10 gr Tube - 50 50 4 4 46 DAK 20/ Juni 23
Ketokonazol Tablet 200 mg (Novapharin) I Tablet 370 - 370 - 370 DAK 19/Juli21
Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - - - DAK 19/Jun 21
Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - - - DAK 20/Jan 22
Ketorolak Inj 30 mg/ml Ampule - - - - - DAK 19/Des.20
0 0 - - - - - DAK 17/SEPT--
Kloramfenikol 1% Salep Mata (KF) Tube 91 240 331 2 69 71 260
0 0 - - - - - 20 -
Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol Vial - - - - - DAK 17/FEB-20
Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - - - - DAK 18L/Mei.20
10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - - - - DAK 19/Mart21
10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - - - - -
Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - - - - DAK 18/Mei.22
Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 400 10,000 10,400 300 2,530 2,830 7,570 DAK 19/Mar.22
Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - - - DAK 20/Feb 22
Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - - - DAK 17/MEI 20
Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - - - DAK 18L/Mei.23
Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet - 2,000 2,000 6 56 62 1,938 DAK 19/Juni 23
Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg - - - - - DAU PR BG 20/
Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - - - - DAK 19/JUN 20
200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol - 200 200 - 200 DAK 20/ Mei 22
200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma ) 2
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract 2 12 14 2 12 DAK 17/JUNI 21
MOLAKRIM
Krim Jelly Luka Bakar:
100 mg,Neomycin SulfatTiap Gram
5 mg Mengandung
/ CENTABIO Placenta
(Sanbe Farma) Extract Tube - 20 20 - 20 DAK 19/Apr.21
PRSpesifik
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- - - - -
Dokter Muter 20
Lactobasilus
Probiotik (DexaRhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet
Medica, Sanbe)
- - -
10
- - DAK 18L/Nov.20
Tablet 59 - 59 10 49 DAK 19/Mei 21
Probiotik
0 (Dexa Medica, Sanbe) 0 - - - - - -
Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - - - DAK 17/JUN 21
Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - 450 450 37 33 70 380 DAK20/
19/Mei
Feb 21
DAK
Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - - -
Loperamid Tablet 2 mg ( Ifars) Tablet 200 - 200 - 200 21;Mei22
DAK 19/Juni 21
Loperamid Tablet 2 mg Tablet - - - - - DAK 20 L
Loratadin Tablet 10 mg Tablet 146 - 146 - 146 DAK 19/Nov.21
Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - - - - DAK 20/Okt 23
Lutein 6mg,Bellberry
Mata/ OCUGARD : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
(Phapros)
360 - 360 - 360 DAK 18L/Sept.20
Tablet 180 - 180 - 180 DAK 19/Jan 22
Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - - - - DAK 19/
0 0 - - - - - -
Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - - - DAK 18L/Apr.20
Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 267 100 367 290 290 77 DAK 19/Apr 21
Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - - - - PRSpesifik L 20/
Metformin HCl Tablet 500 mg Tablet 500 - 500 6 21 27 473 DAK 19/Des.20
DAK20/28 Feb22
Metformin HCl Tablet 500 mg Tablet - 2,000 2,000 - 2,000
Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 309 - 309 109 109 200 ;DAK 19/Agst. 21
0 0 - - - - - -
Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - - - DAK 17/APR 22
Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - - - DAK 18/Nov.20
Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - - - DAK 20 / Juni 22
Metronidasol 500 mg tablet (Novapharin) Tablet - - - - - DAK19/JULI23
Metronidasol 500 mg tablet (Novagyl) Tablet - - - - - DAK 20 L
Metronidasol Infus 500mg/100ml Btl= 100 ml - - - - - DAK 19/Nov 20
Metronidasol Infus 500mg/100ml Botol - - - - - DAK 20/
Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - - - - DAK 18L/Okt.20
Kapsul 120 - 120 120 120 - DAK 19/Feb 21
Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 870 - 870 - 870 DAK
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / DAK 18L/Des.20
17/AGSTS
Ampule - - - - -
MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule 5 - 5 2 3 5 - 19
DAK 19/FEB 21
PRSpesifik
Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - - - -
Tablet - - - - - Dokter Muter 20
DAK 17/APR 20
Ayus )
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU 23 9
Multivitamin Curcuma
vit B1 3 mg, B12 Syr:L-Lysyin
Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) 1000 IU Botol 46 48 94 32 62 DAK 19/Apr.21
PRSpesifik
Multivitamin Neurotopic Plus ATP Botol - - - - -
vit B1 3 mg, B12 Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet - - - - - Dokter Muter 20
DAK 18L/Des.19
Multivitamin
200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros)
Multivitamin Tab TambahTablet
Neurotopic Darah: B1: per Tablet200,B12
100,B6 Mengandung200 mg/: Tablet - - - - - DAK 18L/Okt.21
MOLANEURON (Molex Ayus) tablet - - - - - PRSpesifik L 20/
Femofomarrat
MOLANEURON 300mg
(MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C Tablet - 3,600 3,600 - 3,600 DAK 17/FEB 21
100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - - - - DAK 19/OKT20
HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 899 - 899 28 211 239 660 DAK 19/Des 20
Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - - - DAK20/
Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - - - DAK 17/JUN 21
Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - - - DAK 18/Feb.22
Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 288 - 288 78 140 218 70 PRSpesifik 20
DAK19/Jan 22
Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - - - Non Covid-19/
Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - - - - DAK2118L/Des.20
Okt
Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 11 - 11 - 11 DAK 19/Juli 21
Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 38 - 38 1 10 11 27 DAK 18/Agst.20
Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - - - DAK 19/Juli 23
Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet - - - - - DAK20/Sep 23
Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - - - - DAK 19/Apr 21
OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - - - - DAK 19/Mart.21
12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - - - - DAK 19/ Agst. 21
PRSpesifik
Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - - - - DAK 16/AGSTS
Omeprazole Kapsul 20 mg Tablet 600 - 600 134 466 600 - Dokter Muter 20
Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule - 500 500 - 500 20
DAK 19/Juli 21
Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - - - - DAK 20
Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet - - - - - DAK 19/Mei 22
Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - - - - DAK 18L/Jul.20
Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - - - - DAK19/
PRSpesifik
400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol
Parasetamol HCl 25Mg/ HUSTAB Tablet - - - - -
Tablet - - - - - Dokter Muter 20
DAK 19/JUNI22
(Phapros)
500Mg,Pseudofedrin 30Mg, / COLPICA (Tropika Mas)
Propiltiourasil/ PTU 100 mg
Parasetamol Komb Tablet Flu: Parasetamol 0 - - - - - PRSpesifik L 20/
Tablet - - - - - DAK 18L/Sept.22
500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - - - - DAK 19
Parasetamol Syrup 120 mg/5ml Botol - 300 300 - 300 DAK 20/ Des 22
Parasetamol tablet 500 mg Tablet 72 1,000 1,072 72 72 1,000 DAK
Hibah19/Des
RSUD 20
Parasetamol tablet 500 mg Tablet - - - - -
Parasetamol tablet 500 mg Tablet - - - - - Pasirian
Buffer Prop 20/
Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 5 30 35 1 1 34 DAK 17/JUN 20
Permetrin crem 5% @10 mg (Scabimite crem ) Tube 2 90 92 3 3 89 DAK 19/Feb 21
Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - - - DAK 20/Agust 22
Piracetam 800 mg Tablet Tablet 92 - 92 10 20 30 62 DAK19/Apr 21
Parasetamol tablet 500 mg Tablet - - - - - DAK 20 L
Piracetam Injeksi 1gr/ 5ml Ampule 9 20 29 10 10 19 DAK 19/Juli 21
Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - - - DAK 20 L
Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 692 3,000 3,692 608 608 3,084 DAK 19/Sept.21
Probiotik Sachet (Probiokid) 0 - - - - PRSpesifik
DAK 17/AGSTSL 20/
Polikresulen (Albotyl,Apetil) Botol - - - - - Buffer Prop
Prednison Tab 5 mg Tablet - - - - - 20
Prednison Tab 5 mg (Holi Pharma) Tablet - 4,000 4,000 18 788 806 3,194 19/Agus.20
DAK 19/Jan.21
Prednison Tab 5 mg Tablet - - - - - DAK 20/
Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - - - DAK 17/JUL 19
Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - 600 600 - 600 DAK 19/Nov 20
Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - - - PR BG 20/
Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 1,198 1,000 2,198 52 310 362 1,836 DAK 19/
0 0 - - - - - -
Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - - - DAK 19/Feb22
DAK 20/24-Jan-
Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - - -
Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - - - - 2023
DAK 18L/Apr.23
Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 600 - 600 280 280 320 DAK
DAK 19/Juli 23
20/06-Jan-
Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - - - -
Nebule - 300 300 15 15 285 2025
DAK 19/Jan 21
(COMBIVENT)
0 I dan II 0 - - - - - -
Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - - - - DAK 19/Nov.22
Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet - - - - - DAK 20 L
Pot 3 72 75 4 7 11 64 DAK 18/Juni 22
Salep
(Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - - - - DAK 20/
(Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - - - - DAK 18/Des.22
Salisil Bedak Serbuk 2% Pcs - - - - - DAK 14/MEI 19
PRSpesifik
Salisil Bedak Serbuk 2% Pcs - - - - -
Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - - - Dokter
DAK Muter 20
DAK 19/Agst.20
20/30-
Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - 2 2 - 2
Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - - - Agust-21
DAK
DAK 19/Sept. 20
20/30-Nov-
Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - 50 50 - 50
Setirizin Tab 10 mg (Futamed) Tablet 42 - 42 22 22 20 21
DAK 18/Apr.20
Setirizin Tab 10 mg (Futamed) Tablet - - - - - DAK 19/Mei 21
Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 31 1,200 1,231 53 53 1,178 DAK 19/Juni 20
Simvastatin Tablet 10 mg Tablet - - - - - DAK 20/
Siprofloksasin Tablet 500 mg (Novapharin) Tablet 5,000 - 5,000 129 4,871 5,000 - DAK 18/Mar.20
0 0 - - - - - -
Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - - - DAK 19/
Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% Botol - 25 25 - 25 DAK 20/Feb 22
Botol - - - - - DAK 19/
gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - - - - Retur
Buffer PKM/
Prop
Thiamin/ Vitamin B1 50 mg Tablet - - - - -
19/Agus.21
Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 852 - 852 74 778 852 - DAK 19/Juli 23
Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - 1,000 1,000 72 72 928 DAK 20/Feb 22
Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - - - DAK 19/Juli 23
Thiamphenicol Kapsul 500 mg Tablet - - - - - DAK 20 L
Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 32 - 32 3 3 29 DAK19/Juli 23
Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - - - - DAK 17/Mei 21
mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek - - - - - DAK 20
0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - - - - DAK 18L/Sept.20
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - - - - DAK 17/AGST.-
Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - - - -
Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - 18
DAK
Buffer17/FEB
Prop 21
Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - Buffer Prop
Clobazam Tab 10 mg (Meprofarm) Tablet - - - - - 17/Jul.21
0 0 - - - - - 20/ /Des 22 -
0 0 - - - - - -
Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - - - DAK 18/Feb.20
Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - - - DAK 19/Mar.22
Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - - - DAK
Buffer20/
Prop 19/
Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - - - Buffer20
Prop 20/
Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - - - Agsts
Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - - - Agsts 20
DAK 20 L
Diazepam Tablet 5 mg (VALISANBE) Tablet 40 - 40 9 9 31 DAK 18L/Mei.20
PRSpesifik 20
Diazepam Tablet 5 mg Tablet - - - - -
Fenobarbital Tablet 30 mg Tablet - - - - - non
DAK covid-19/
Buffer17/NOV-19
Prop 19/
Fenobarbital Tablet 30 mg Tablet - - - - -
Fenobarbital Tablet 30 mg tablet - - - - - Jun 23
Buffer Prop 20/
Kodein Tablet 10 mg Tablet - - - - - DAK 16/APR 19
0 0 - - - - - -
Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON Tablet - - - - - DAK 17/JUN 20
Tablet - - - - - DAK 19/Feb. 23
(Meprofarm)
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
Buffer Prop. 20/
Primaquin 15 mg tablet tablet - - - - -
0 0 - - - - - Mei 21 -
OBAT - OBAT PROGRAM 0 - - - - - -
OBAT PROGRAM KECACINGAN 0 - - - - - Buffer Prop -
Albendazol Tablet 400 mg Tablet 263 - 263 1 1 262 Buffer Prop
19/Feb 22
Albendazol Tablet 400 mg Tablet - - - - -
OBAT PROGRAM DIARE 0 - - - - - 20/nov 21
Buffer Prop -
Garam Oralit (Kimia Farma) Tablet - - - - - Buffer Prop 19
Garam Oralit (Kimia Farma) Tablet 1,137 1,000 2,137 41 1,201 1,242 895 18/Jul.23
Juli 23
 Buffer Prop 20/
Garam Oralit (Kimia Farma) sachet - - - - -
Garam Oralit (Kimia Farma) sachet - - - - - April
DAK24 19/Agst.22
0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - - - - -
Botol 51 - 51 1 1 50 DAK 19 /Nov 20
imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - - - DAK 18L/Sept.20
34 466 Buff Prop 19 /Mei
Zinc Sulphate Tablet Dispersible 20 mg Tablet 500 - 500 500 - Buff Prop 20/
Zinc Dispersible 20 mg tablet tablet - - - - - 20
Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - - - Sept.22
DAK 18/Mart 20
Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 6,649 - 6,649 1,450 1,450 5,199 DAK
DAK 19/Jan
20/Mei 21
Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - - -
0 0 - - - - - 21;Agust 22 -
OBAT PROGRAM HEPATITIS 0 - - - - - -
Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - - DAK 19/Agus.20
Buffer Prop 19/
Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - -
Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - - Agsts.
Hibah 19
Jember
Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - - - Buffer Prop 20/
DAK 20/Maret
Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - 1 1 1 1 -
OBAT PROGRAM TB PARU 0 - - - - - 22,SEP 21 -
Buffer
OAT FDC Kategori Anak Kit - - - - - Buffer Prop 20
OAT FDC Kategori Anak Kit - - - - - Prop19/Juni
Buffer Prop
19/Jun 21 20/
OAT FDC Kategori Anak Kit - - - - - Buffer
OAT FDC Kategori I - IIII Kit - - - - - Mei 21 Prop
Buffer Prop 20/
19/Juli21
OAT FDC Kategori I - IIII Kit - - - - - DAU/ 22DAK
OAT FDC Kategori II Kit - 1 1 1 1 - Agsts
Buffer Prop
19/Juni 22
OAT FDC Kategori II Kit - - - - - Buffer Prop
OAT FDC Kategori II Kit - - - - - 19/Jan 22 20/
BUFF.22
Agsts
OAT FDC Kombipak Kategori I Kit - - - - -
0 0 - - - - - PROP19/Agst 22
Buffer Prop 20/-
Isoniazid 100 mg tablet tablet - - - - -
OBAT POGRAM KUSTA 0 - - - - - Juni 22
Buffer Prop -
MDT MB Anak Blister - - - - - Buffer Prop
MDT MB Anak Blister - - - - - 19/Juni 21
Buffer Prop
20/Juni 21 19/
MDT MB Dewasa Blister - - - - - Buffer Prop 19/
MDT MB Dewasa Blister - - - - - Okt.21
Buffer
Okt.21 Prop 20/
MDT MB Dewasa Blister - - - - - Buffer Prop
MDT PB Anak Blister - - - - - Okt.21
Buffer Prop
17/Mei 19
MDT PB Anak Blister - - - - - Buffer Prop 20/
MDT PB Anak Blister - - - - - 18/Agst.20
Buffer
Nov 22 Prop 20/
MDT MB Dewasa Blister - - - - - Buffer
MDT PB Dewasa Blister - - - - - Nov 22 Prop 20/
OBAT PROGRAM GIZI 0 - - - - - Nov 22
Buffer Prop -
Mineral Mix Kombinasi sachet - - - - -
19/Sept 20
Mineral Mix Kombinasi sachet - - - - - Buffer Prop 20/
Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - - - DAK
Buffer19/Agust.21
Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 125 - 125 55 55 70 DAK 20Prop
Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - - - 20/Apr.22
Penugasan/ Jan
Buffer Prop 20
PRSpesifik
Retinol Vit A 100.000 IU (Biru) Kapsul - - - - - 23
Retinol Vit A 100.000 IU (Biru) Kapsul - - - - - 18/Okt.
Non 20
DAUCovid-19/
Penugasan
Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul - - - - - Okt 21 Prop
Buffer
Tablet 22,200 - 22,200 22,200 22,200 - 20
Tablet
0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Buffer Prop
19/Juli 20
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat Tablet - - - - -
0,4 Mg Tab (Phapros) tablet - - - - - 20/Agst 21
DAK Penugasan
0,4
0 Mg Tab (Phapros) 0 - - - - - -
0 0 - - - - - -
OBAT PROGRAM KESGA 0 - - - - - Buffer Prop -
Calcii Gluconas Inj (Ethica) Ampule - 10 10 - 10
Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 2 - 2 - 2 18/Agst.20
DAK
DAK 19/Mar 20
GD 20/09-
Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - - - DAK GD 20/09-
Calcii Gluconas Inj 10% (Ethica) Ampule - - - - - Okt/21
Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - - - Okt/21
DAK
50 Buffer19/ Des 20
Prop
Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - 50 50 50 - DAK 20 /30-
Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - 50 50 - 50 19/Jul.19
Buffer Propinsi
Sept-21
Oksitetrasiklin 1 % Salep Mata Tablet - - - - -
Metilergometrin Maleat Tablet 0,125 mg Tablet 180 500 680 50 50 630 20
DAK/Juli 21
Buffer18/Apr.22
Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - - - DAK 20 / 31 -
Oksitosin Inj 10 UI/ml (Ethica) Ampule - 200 200 28 28 172 Prop.19/Sept.19
DAK22GD 20/ 31-
Okt
Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - - - PR 21BG 20/ Juli
Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - - - Okt
OBAT PROGRAM JIWA 0 - - - - - 23 -
Amitriptilin 25 mg Tablet - - - - - DAK 18/Apr.21
Buffer Prop
Amitriptilin 25 mg Tablet - - - - -
Amitriptilin 25 mg Tablet - - - - - 18/Mei
DAK 21Jan 23
Buffer19/
Prop 20/
Amitriptilin 25 mg Tablet 160 - 160 - 160
Amitriptilin 25 mg Tablet - - - - - Feb.
DAK23 20/
Clozapine 25mg (OGB Dexa) Tablet - - - - - DAK 19 20
PRSpesifik
Clozapine 100 mg Tablet - - - - -
Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - non
DAKcovid-19/
20/
Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - Hibah17/NOV 20
DAK
Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - Penyedia/NOV
Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - - - DAK
Buffer19/
20 Juni20/
Prop 21
Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - - - Buffer Prop. 20/
Flufenazin sikzonoate inj 5 ml vial - - - - - Agst.22
Flufenazin sikzonoate inj 5 ml Vial - - - - - agst.22
DAK 17/JUN 20
Haloperidol 5 mg tablet Tablet - - - - - DAK 19/Apr 22
 77 Buffer Prop. 20/
Haloperidol 5 mg tablet Tablet 22 3,000 3,022 77 2,945
Haloperidol 5 mg tablet Tablet - - - - - Agst.22
DAK 20/
0 0 - - - - - -
Haloperidol Injeksi 5 mg/ml ampule - - - - - Buffer Prop 19
Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - - - DAK 20 L
Haloperidol/ Lodomer drops 2 mg Botol - - - - - DAK 19/Jan 22
Karbamazepin Tablet 200 mg Tablet - - - - - DAK
DAK 19/Juni
20/ Nov 22
22,
Karbamazepin Tablet 200 mg Tablet - - - - - Buffer Prop 19/
Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - 3 3 - 3 Des 22
Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - - - Feb
DAK2120/
Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - - - - DAK
Buffer19/Sept.
Prop 20/22
Klorpromazin Tab Salut 100 mg (HCl) Tablet - 3,000 3,000 43 43 2,957
Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - - - Sept.
DAK 2220 L
0 0 - - - - - -
Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - - - DAK 19/
Buffer Prop 19/
Risperidon Tab 2 mg (OGB Dexa) Tablet - - - - - Buffer
Risperidon Tab 2 mg Tablet 33 1,000 1,033 119 119 914 Apr 22 Prop 20/
Risperidon Tab 2 mg Tablet - - - - - Juli 22
DAK 20/
0 0 - - - - - -
Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - - - DAK 19/Juni 23
0 0 - - - - - Buffer Prop 19/-
Triheksifenidil Tablet 2 mg (Mersi) Tablet 493 - 493 372 372 121 Buffer
Mei 22 Prop 20/
Triheksifenidil Tablet 2 mg Tablet - 3,000 3,000 - 3,000
Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - - - Juni
DAK22 20 L
0 0 - - - - - PR BG 20/ -
Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - - -
0 0 - - - - - Nov.22 -
PROGRAM IMUNISASI (VAKSIN) 0 - - - - - -
Buffer Prop/ Jan
BCG vial 9 30 39 - 39 0378G182 Buffer Prop/ Juli
PELARUT BCG ampul 9 30 39 - 39 0709S4016 21Buffer Prop/ Juli
BCG vial - - - - - 22
Buffer Prop/
21
BCG vial - - - - - Buffer Prop/
CAMPAK 10ds (MR) vial 49 - 49 - 49 Sept.21
Buffer Prop/
Mar.20
PELARUT CAMPAK ampul 69 20 89 - 89 Buffer Prop/
CAMPAK 10ds (MR) vial 32 20 52 - 52 Mar.23
Buffer Prop/
Jul.23
CAMPAK 10ds (MR) vial - - - - - Buffer Prop/ Juli
DPT HB - Hib/ PENTABIO vial 82 - 82 - 82 Agust.21
Buffer Prop/ Des
20
DPT HB - Hib/ PENTABIO vial - - - - - Buffer Prop/ Apr.
DT vial - - - - - 20
0 0 - - - - - 22
Buffer Prop/ -
HB UNIJECT/ HB - ADS / HEPATITIS B vial 50 - 50 - 50 - Buffer Prop/
HB UNIJECT/ HB - ADS / HEPATITIS B vial - 60 60 - 60 3652319 Mar.21
Agust 21
 Buffer Prop/Juli
POLIO bOPV 10 ds vial (30) 50 20 - 20 2054519
DROPPER POLIO dropper 13 50 63 - 63 21
10100916 Buffer Prop/
Buffer Prop
POLIO bOPV 10 ds vial 43 - 43 - 43 - Buffer Prop
POLIO bOPV 10 ds vial - - - - - - 20/Agust-21
Buffer Prop/
Td vial 9 - 9 - 9 - 20/Sept-21
0 0 - - - - - Mei.21
Buffer Prop 20/-
HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - - - Buffer21Prop 20/
POLIO bOPV 10 ds vial - - - - - Sep.
Vaksin Meningtis vial - - - - - Oct. 21Prop 20/
Buffer
Buffer Prop 20/
CAMPAK 10ds (MR) BIAS vial - - - - -
PELARUT CAMPAK BIAS ampul - - - - - Agust 21 20/
Buffer Prop
Buffer
Okt 23 Prop 20/
POLIO bOPV 10 ds vial - - - - -
IPV vial - - - - - Okt.21 Prop 20/
Buffer
Buffer Prop.20 -
Nov.21
VTM Include Dacron (Biofarma) pcs - - - - - Buffer Prop.20/
Vaksin Rabies (Verorab) vial - - - - - Covid-19
0 0 - - - - - April 21 -
0 0 - - - - - -
0 0 - - - - - -
OBAT PROGRAM HIV/ AIDS 0 - - - - - -
Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - - - Buffer Prop. 19/
0 0 - - - - - Buffer Prop -
Isoniazid (INH) Tablet 300 mg Tablet 270 - 270 10 10 260
0 0 - - - - - 19/Sept. 20 -
Buffer Prop
Lamivudine 150 mg Tablet - - - - - Buffer Prop
Lamivudine 150 mg Tablet - - - - - 19/Agst.20
Buffer Prop
20/Agust.20
Nevirapine 200 mg Tablet - - - - - Buffer Prop
Nevirapine 200 mg Tablet - - - - - 19/Mei 23 20/
Buffer
Nov 22 Prop
Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - - -
0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - - - - 19/Nov.20
Buffer Prop -
Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - - - - Buffer Prop
FDC Dewasa Tablet - - - - - 19/Jan 21 20/
FDC Dewasa Buffer
Jan 21 Prop
Tenofovir 300 mg Tablet - - - - - Buffer Prop
Tenofovir 300 mg Tablet - - - - - 19/Feb 20
Buffer Prop
20/Juni 21
Zidofudine 100 mg (ZDV) Tablet - - - - -
Zidofudine 100 mg (ZDV) Tablet - - - - - 19/Juli
Buffer 21
Prop 20/
Buffer Prop
Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - Buffer Prop
Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - 19/Nov 20 20/
Hibah
Mei 22 Sidoarjo/
Efavirenz 600 mg tablet tablet - - - - - Buffer
Efavirenz 600 mg tablet tablet - - - - - Apr 20 Prop 20/
Buffer
juni 20 Prop 20/
Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - - - Buffer21Prop 20/
Abacavir April
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - - - - Buffer
Des 21 Prop 20/
Tablet - - - - -
FDC Dewasa Agust 21
0 0 - - - - - Buffer Prop 20/-
MB Anak blister - - - - -
0 0 - - - - - Nov. 22 -
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 - - - - - -
BMHP 0 - - - - - DAK 17/AGST-
Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - - - DAK 19/AGST
Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 44 - 44 30 30 14 21
0 0 - - - - - 23 -
Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 150 - 150 150 150 - DAK 19/Okt 23
Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - 3,000 3,000 427 38 465 2,535 PR Spesifik
DAK 19/Agst.2023
Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - - - non covid-19/1
Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - 1,000 1,000 - 1,000 DAU2418/Mei
DAK
Okt ID NON22
Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - - - COVID-19/1 Okt
Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - - - DAK
DAU 19/Feb24
24 ID 20 non
Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - - -
Alat Suntik Sekali Pakai 20 ml Pcs - - - - - covid-19
DAK 18/Nov.21
Alkohol 70% Medika (Kimia Farma) 0 - - - - - BTT ke 2 20
Alkohol 70% (Medika) Btl 1000 ml - - - - - DAK
DAU 19/Jan.23
ID 20 -
Alkohol Swab 2 - ply (one med) 0 - - - - -
Alkohol Swab 2 - ply (one med) Pcs - 500 500 - 500 Covid-19
DAK 19/ Jan 24
Antiseptic Hand Scrub 0,5 % (Medicare) Botol - - - - - DAK 19/Mar.24
Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - - - DAK 17/DES 21
Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs - 120 120 - 120 DAK 19/Juli 24
Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs 4 - 4 4 4 - DAK
DAU 19/Juni
ID 20 non23
Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - - - -
Pcs - - - - - covid-19
DAK
Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) /
Phsda DAU 19
ID 20 non
0 - - - - -
Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - - - covid-19
DAK 19/Jan 22
Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - - - - DAK 18L/Jul.23
Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 30 - 30 30 30 - DAK 18/Sept.20
Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - - DAK 19/ Sept. 20
Fixomull Strech 5 cm X 5 m Pcs - - - - - DAK 18/Mar.22
Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 24 10 34 4 7 11 23 DAK
DAU 19/Agst.22
ID 20 -
Foley Catheter 2 Way Ch 16,18 Pcs - - - - -
Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - - - Covid-19
DAK 18
I.V Cannula No. 26 G Polywin (Polymed) Pcs - 5 5 - 5 DAK
PR BG19/sept.23
20 Covid-
Mantel Gown (Bisa Dicuci) biji - - - - -
I.V Catheter No. 18 (JELCO) Pcs - - - - - 19
PRSpesifik
DAK 20
18/Jul.22
I.V Catheter No. 18 (NIPRO) Pcs - 100 100 27 27 73 non covid-19/
I.V Catheter No. 20 JELCO Pcs - - - - - DAK2418/Okt.21
Des
I.V Catheter No. 20 TERUMO Pcs 4 200 204 54 54 150 DAK
DAU 19/Okt.21
ID 20 non
I.V Catheter No. 20 JELCO Pcs - - - - -
I.V Catheter No. 22 NIPRO Pcs 1 - 1 1 1 - covid-19
PRSpesifik
DAK 2023
19/Agst.
I.V Catheter No. 22 NIPRO Pcs - 300 300 51 51 249 non covid-19/
I.V Catheter No. 24 TERUMO Pcs - 200 200 49 49 151 DAK
DAU2419/Okt.21
Des ID Non
I.V Catheter No. 24 TERUMO 0 - - - - -
Infusion Set Anak 60 Drops /(Otsuka) Pcs 4 - 4 4 4 - Covid
DAK
DAK 16/JUL
20/Juni 21
22
Infusion Set Anak 60 Drops /(Otsuka) Pcs - 100 100 - 100
Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - - - DAK
DAK 19/Jan 24
20/Agst.22
Infusion 500
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 500 400 900 500 400
Pcs - - - - - DAK 18L
Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - - - - DAK 18
Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs - 10 10 - 10 DAK
DAU 19
ID 20 -
Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - - -
Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - - - - Covid-19
DAK 18/Nov.21
Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs - 10 10 2 2 8 DAK
DAU 19/Okt.22
ID 20 Non
Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - - -
Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - - - - Covid
DAK 18/Okt.22
Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - 50 50 - 50 DAK
DAU 19/Sept.21
ID 20 -
Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - - -
Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - - - - Covid-19
DAK 18
Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs - 100 100 10 10 90 DAK
DAU 19/Feb
ID 20 - 22
Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - - -
Masker Ear Loop (Masker) Pcs - - - - - Covid-19
DAK 19/Sept 23
Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - - - Dak 19/Sept 20
Masker General Care (MARCOTILA) Pcs - - - - - BTT 20 Covid-19
0 0 - - - - - -
APBD II-14/Sep-
Masker N95 Disposibel Pcs - - - - -
Masker N95 Disposibel (One Med) Pcs - - - - - 19
DAK 18/Okt.22
Masker Tali Pcs - - - - - Buffer Prop. 19
Masker Tali Pcs - - - - - Buffer Prop. 20
 DAU 20 PR
Masker Elastic Pcs - - - - -
Media Sample Container Pcs - 200 200 80 80 120 Spesifik/Des
DAK 19 25
Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - - - DAK 18/Agst.22
Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - - - DAK 18/Nov.21
Norinse Antimicrobial 500 ml (Viorex) Pcs - - - - - DAK 19/Nov 22
Nurse Cup (Tutup Kepala) Pcs 100 - 100 50 50 50 DAK 16
Oxygen Mask Elongated Adult (Remedi) Pcs - - - - - DAK 16/MEI 21
Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - - - DAK 16/MEI 21
Plesterin Bulat Non Woven (One Med) Pcs - - - - - DAK 18/Jan. 23
Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - 54 54 31 31 23 DAU 19/Jan.22
DAK 20 ID NON
Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - 54 54 - 54 COVID-19/ Mart
Povidon Iodine 10% (300 ml) ( One Med) Pcs - 10 10 1 1 9 DAK
DAU 19/Jan
23 22
ID 20 NON
Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - - -
Povidon Iodine 10% (60 ml) ( One Med) Pcs - - - - - COVID-19
DAK 19/Feb 22
0 0 - - - - - DAK 17/SEPT-
Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - - -
Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - - - 19
DAK 19/Okt 20
0 0 - - - - - -
Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair 1,500 - 1,500 1,400 1,400 100 DAU 19/Juli
DAK 20 (ID) 23
Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - - - NON
Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - - - - DAK
DAU 19/Jan.24
COVID-19/Jan
ID 20 non25
Sarung Tangan size M dan L (Exam Glove) PAir - - - - -
Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 500 - 500 200 200 300 covid-19
DAU 19/Nov
DAK 20 (ID) 23
Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - - - NON COVID-19/
Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs - 60 60 12 12 48 DAK2419/Mar 23
Nov
Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - - - DAK 19/Nov 23
0 0 - - - - - -
Surface Disinfectant 500 ml (Stericide ) Pcs - - - - - DAK 19/ Sept. 21
Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1 - 1 DAK 19/Des 21
Underpad 90x 0 cm cosmo I Pcs - 30 30 5 5 25 DAK 19
Underpad 90x 0 cm cosmo II Pcs - - - - - DAK 19
0 0 - - - - - -
Urine Bag Sterile Standard Pcs - 20 20 7 7 13 DAK 19/Jan 24
Urine Bag Sterile Standard (AXIMED) Pcs - - - - - DAK 19/Juli 23
0 0 - - - - - DAU ID 20 NON -
Umbilical Cord Clamp ( Hospitech ) Pcs - - - - - COVID-19/ April
REAGEN 0 - - - - - 24 -
Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - - - DAK 17
Accu- Check Performa Tes Strip ( Roche ) pcs - - - - - DAK 19/Mei.20
Accu- Check Safe-T-Pro Uno (Roche) Pcs 800 - 800 200 200 600 DAK
DAU 19/Nov.22
ID 20 -
Accu- Check Performa Tes Strip ( Roche ) Pcs - - - - -
Antimonoclonal A (Anti A) 10 ml Btl - - - - - Covid-19/
DAK 19 Juni 21
Antimonoclonal AB (Anti AB) 10 ml Btl - - - - - DAK 19/Des 20
Antimonoclonal B (Anti B) 10 ml Btl - - - - - DAK 19/Nov 20
0 0 - - - - - -
Cholesterol Test Strip (Human Humasens Plus) Tes - - - - - DAK 19/Juli
DAU ID 20 Non 20
Cholesterol Test Strip (Human Humasens Plus) 0 - - - - -
Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - - - Covid
DAK 19
Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - - - DAK 19
Glucose Test Strip (Human Humasens plus) Tes - - - - - DAK 19/Sept 20
Glucose Test Strip (Human Humasens plus) II Tes - - - - - DAK 19/Juni 21
Hemoglobin Strip 50 test mission (Acon) Pcs - 2 2 1 1 1 DAK
DAU 19/ Jan- 21
ID 20
Hemoglobin Strip 50 test mission (Acon) 0 - - - - -
Reagen Hb (HCl 0,1 N) 100ml Btl - - - - - Covid-19
DAK 17/APR 22
0 0 - - - - - -
Reagen HBsAg Strip (FOKUS) Test - - - - - DAK 19/Nov 20
0 0 - - - - - -
TPHA (Fokus) Test - - - - - DAK 19/Mar21
0 0 - - - - - -
Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - - - DAK 19/Mei
DAU ID 20 Non 20
Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - - -
BMHP (PROGRAM) PROPINSI 0 - - - - - Covid -
PROGRAM MALARIA 0 - - - - - Buffer -
RDT Malaria Test - - - - -
PROGRAM SYPHILIS 0 - - - - - Prop.19/Mei 21-
Buffer Prop
RPR Syphilis Pcs - - - - - Buffer Prop
RPR Syphilis tahap II (FOKUS) Pcs - - - - - 18/Jul.20
Syphilis 3.0 06FK10 SD Bioline Test - - - - - 18/Jul.21
DAK
Test Buffer20/Okt 21
Prop 19/
Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - - - - Buffer
Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - - - Juni 21Prop 19/
0 0 - - - - - Juli 21 -
Tuberkulin Vial - - - - - Buffer Prop 18
Buffer Prop 20/
RDT Lepto (Uji Leptospira IgM) test - - - - - Buffer
RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - - - Apr 21 Prop 20/
0 0 - - - - - Apr 21 -
0 0 - - - - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - - - - Buffer Prop -
Test - - - - - Buffer Prop
Reagen HBsAg Strip SD Test - - - - - 19/Sept. 20
Reagen HBsAg Strip SD Test - - - - - 19/Mar
Buffer 21
Prop 20/
20/
Buffer Prop
Reagen HBsAg Strip SD Test - - - - -
0 0 - - - - - Maret 22 -
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
PROGRAM TB PARU 0 - - - - - -
Box Slide Pcs - - - - - Buffer Prop 17
Box Slide Pcs - - - - - Buffer
Buffer Prop 19
Catridge Genexpart Test - - - - - Buffer Prop.20/
Catridge Genexpart Test - - - - - Prop.19/Agst.21
Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - - - Okt
DAK 21
BUFF.20PROP
Oil Emersi Botol - - - - -
Pot Spuntum/Pot Dahak Steril Pcs - - - - - 17/JUN 12 18
Buffer Prop
Pot Spuntum/Pot Dahak Steril Pcs - - - - - Buffer Prop 19
Pot Spuntum/Pot Dahak Steril Pcs - - - - - Buffer Prop 19
Pot Spuntum/Pot Dahak Steril Pcs - - - - - Buffer Prop 20/
Buffer Prop 19
Reagen Control CD4 0 - - - - - Buffer
Reagen Control CD4 0 - - - - - Des 20 Prop 20/
Reagen Zeil Nelseen Kit - - - - - Des 21 PROP
BUFF.
BUFF. PROP
17/NOV 17
Reagen Zeil Nelseen Kit - - - - - Buffer Prop
Reagen Zeil Nelseen Kit - - - - - 17/NOV 18
DAK 20
19Des.19
Reagen Zeil Nelseen Kit - - - - -
Slide Pcs - - - - - Penugasan
Buffer TB
DAK 20Prop 19
Slide/ Object Glass Pcs - - - - -
Stereofoam pcs - - - - - Penugasan
Buffer Prop.TB
19
Masker N 95 TB pcs - - - - - Buffer Prop. 20
Masker Tali Bedah TB pcs - - - - - Buffer Prop. 20
OBAT PROGRAM IMUNISASI 0 - - - - - Buffer Prop -
Alat Suntik Sekali Pakai 0,05 ml Pcs - - - - - Buffer Prop
Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - 18/Feb.23
Buffer Prop
18/Mar.23
Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - -
Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - 19/Okt.21
Buffer Prop 20/
20/
Buffer Prop
Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - - - Buffer
Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - - - Okt 24 Prop
Buffer Prop
19/Apr.23
Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - - -
Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - - - 19/Feb Prop
Buffer 24
Buffer Prop
19/Agst 24
Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - Buffer Prop
Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - - 19/Mar.23
Buffer Prop
19/Juni 24
Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - - -
0 0 - - - - - 20/Juni 24 -
0 0 - - - - - -
0 0 - - - - - Buffer Prop -
Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 400 - 400 114 114 286 Buffer Prop
19/Okt. 23
Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - - - Buffer Prop
Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - - - 19/Feb.24
0 0 - - - - - 20/Feb.24 -
Safety Box 5 L Pcs - - - - - Buffer Prop 19
Alat Suntik Sekali Pakai 0,05 ml Pcs - - - - - Buffer Prop 20
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - - - - -
Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test - - - - - Buffer Prop 19
Tahap I 0 - - - - - Buffer Prop 19/
20/
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold) Buffer Prop
KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - - - -
Tahap I 0 - - - - - Juli 21 Prop 20/
Buffer
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold) Buffer Prop
KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test - - - - - Buffer Prop
Tahap I 0 - - - - - 19/Feb 21
Tahap I Buffer Prop
20/Mar 21
Kondom Pcs - - - - - Buffer Prop 20/
DBS Collection/ Lasec Pcs - - - - - 19/Mar.20
Buffer
Feb 21 Prop
Lubricant Pcs - - - - -
0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - - - - 19/Nov.21
Buffer Prop 19/-
Test - - - - -
IRapid HIV 1/2 3.0 SD Bioline test - - - - - Apr
DAK 20 Agst 21
Buffer20/
Prop
Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - - - - Buffer Prop 20/
Test - - - - - 18/Agst.20
Tahap Buffer Prop
ReagenI HIV (SD) R 1 Test - - - - - Mei 2021
Buffer Prop
Reagen HIV (SD) R 1 Test - - - - - 18/Okt.20
0 0 - - - - - 19/Nov.20
Buffer Prop -
Reagen HIV (VIKIA) R 3 Test - - - - -
0 0 - - - - - 18/Jun.20
Buffer Prop -
Reagen HIV R2 (Rapid Test) FOKUS Test - - - - -
0 0 - - - - - 19/Agst. 20 -
Buffer Prop
Reagen HIV R3 (VIKIA) Test - - - - - Buffer Prop
Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - - - 19/Juni 20 20
Buffer
juli 21 Prop.
Sarung Tangan Non Steril Pair - - - - -
0 0 - - - - - 18/Okt.21
Buffer Prop.20- -
APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - - - Buffer Prop.20 -
VTM Include Swab Test - - - - - Covid-19
Buffer Prop.20 -
Covid-19
Masker Bedah 3 ply Pcs - - - - -
0 0 - - - - - Covid-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 - - - - - -
0 0Mengetahui - - - - - -
0 Plt. KEPALA
0 DINAS KESEHATAN - - - - - -
KABUPATEN LUMAJANG
0 0 - - - - - -
OKSIGEN MEDICAL 0 - - - - - -
Oksigen 3 m3 Tampon - - - - - DAK 19
Oksigen 6 m3 Tampon - - - - - DAK 19
Oksigen 1 m3 Tampon
dr.BAYU WIBOWO IGN - - - - - DAK 20
Oksigen 6 m3 NIP. 19630724
Tampon 198910 1 002 - - - - - DAK
DAU 20
ID 20 -
Nurse Cup (Tutup Kepala) One Med 0 - - - - -
0 0 - - - - - Covid-19 -
0 0 - - - - - Retur PKM -
Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - - - Candipuro,
TAMBAHAN IFK 0 - - - - - Sumbersari
RETUR -
Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - - - RETUR
Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - - - PASIRIAN
RETUR
Ranitidin Tablet/ 150 mg Kapsul 500 mg Tablet - - - - - PASIRIAN
RETUR
ROGOTRUNAN
Thiamphenicol Thiamfilex RETUR
Tablet - - - - - ROGOTRUNAN
Thiamphenicol Syr. 0 - - - - - ROGOTRUNAN
Buffer Prop 20/
Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - - -
Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - - - Apr 21 Pronojiwo
Retur
RETUR
Ranitidin Injeksi 25 mg/ 2 ml Ampule - - - - - RETUR
Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - - - ROGOTRUNAN
RETUR
ROGOTRUNAN
Ketokonazole 200 mg Tablet - - - - - RETUR
Kotrimoksazol Forte Tablet - - - - - ROGOTRUNAN
RETUR
ROGOTRUNAN
Infusion set anak Pcs 50 - 50 - 50 RETUR
Alat Suntik 10 cc Pcs - - - - - ROGOTRUNAN
RETUR
ROGOTRUNAN
RETUR
Eritrosmisin Stearate Kaplet 500 mg Tablet - - - - -
Omeprazole Kapsul 20 mg Tablet - - - - - ROGOTRUNAN
YOSOWILANGU
DAK 20 /22 Feb
Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - - - - - N
DAK 20 /01 Sep
Setirizin Tab 10 mg (Futamed) Tablet - - - - - 23
RETUR
21
DAU PR BG
Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - - -
Oseltamivir 75 mg Kapsul - - - - - TEKUNG
DAU PRSpesifik
COVID 20/ Jan
Ringer Laktat cairan infus @ 500 ml RL Botol - - - - - 20
RETURCovid-19/
22 Non
Amitriptilin 25 mg Tablet - - - - - Mar 23
RETUR
I.V Catheter No. 24 TERUMO pcs - - - - - ROGOTRUNAN
Buffer Prop 20/
ROGOTRUNAN
Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - - - -
Mar 22
RDT COVID - 19 0 - - - - - Buffer Prop 20/
Buffer Prop 20/
Oseltamivir 75 mg 0 - - - - - Buffer
Klorokuin Agst 20Prop 20/
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - - - - Buffer
Feb 25 Prop 20/
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
Viruses)
- - - - - Buffer
Apr 21 Prop 20/
0 - - - - - Buffer
Viruses)
Masker N95 (Particulate Respirator) 0 - - - - - Apr 21 Prop
Buffer Prop 20/
20/
Hazmat/ APD/ Hazmat PPK 0 - - - - - Mar 25
Bantuan
DAK 20
Medical Sample Container Pcs - - - - - Kemenkes
DAK 20 TB
Cepheid Pcs - - - - - Penugasan
DAK 20 TB
Penugasan
Natrium Klorida Larutan infus 0,9% @100ml 0 - - - - - DAK 20
Tambah Darah drop (Ferriz Drop) pcs - - - - - Penugasan
DAK 20
Penugasan
Tambah Darah Sirup (Ferriz Sirup) pcs - - - - -
Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - - - Penugasan
PRBG 20
Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - - - PRSpesifik
PRSpesifik 20
Obat Batuk Sirup / INADRYL Botol - - - - - PRSpesifik
Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - - - - Dokter Muter 20
PRSpesifik
Dokter Muter 20
500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - - - - PRSpesifik
Tablet - - - - - Dokter Muter 20
dextromethorpan
Influenza Hbr BTT 20Muter
Dokter KE 2 20
Masker Bedah /Bima Sakti pCS - - - - - BTT 20-19
KE 2
Masker Bedah /Rania pCS - - - - - COVID
BTT 20-19
COVID KE 2
Masker N 95 Bima Sakti PCS - - - - - BTT 20-19
KE 2
Sarung tangan panjang steril / meditouche perpasang 0 - - - - - COVID
BTT 20-19
COVID KE 2
Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - - -
Albendazol Suspensi 200mg/ 5 ml botol - - - - - COVID
PROP -19
RETUR20
I.V Catheter No. 24 (BRAUN) pcs - - - - - PRSpesifik 20
OAT FDC Kategori Anak 0 - - - - - ROGOTRUNAN
BTTCovid
Non 20 KE 2
Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - - - BTT 20-19
KE 2
Apron Lengan Panjang Putih (Rannia) 0 - - - - - COVID
Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - - - COVID -19 Juli
DAK 20/2024
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - -
0 0 - - - - - DAU 20 -
APD Set (Rannia) 0 5 - 5 - 5 DAU 20
PRSpesifik
Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5 - 5 DAU 20 20
PRSpesifik
Covid-19
Cover 3 DAU 20 20
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia - 7 7
10
3 4 PRSpesifik
Covid-19
DAU 20 20
0 5 5 10 10 - PRSpesifik
Covid-19
Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - - - - PRSpesifik
Covid-19
DAU 20 20
Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - - - Covid-19/20
PRSpesifik
 DAU 20
Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - - - PRSpesifik
DAU
Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - - - - DAU 2020
Covid-19/20
Sarung tangan non steril M,L (COBRA) box @100 pcs - 1,900 1,900 - 1,900 PRSpesifik
PRSpesifik
BUFFER
Masker N95 Covid 19 Pcs - - - - - Covid-19/20
BUFFER 20
Masker Tali Bedah 3 ply Covid 19 Pcs - - - - - PROPINSI
BUFFER
PROPINSI
DAU 20 20
Masker Eaerlop Hijab Pcs 2,000 - 2,000 - 2,000
Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - 1 - 1 PROPINSI
DAU 20 20
PRSpesifik
Hand Sanitzer 1 Botol = 20 Liter 1 1 2 - 2 DAU 20 20
PRSpesifik
Covid-19
MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter 1 - 1 1 1 - DAU 20 20
PRSpesifik
Covid-19
Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs 20 - 20 20 20 - DAU20
PRSpesifik
Covid-19/Des 25
KIT A1 Operasi Steril (RAJAWALI) Pcs - - - - - PRSpesifik/Des2
Covid-19/Des 26
DAU PR Spesifik
Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs 5 - 5 5 5 - 5Covid-19/20
1 DAU PRSpesifik
Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 3 - 3 1 2 DAU PRS 20
Masker Face/ Masker Bedah (COBRA 1) pcs - 1,200 1,200 1,000 1,000 200 Covid-19
DAU PRSpesifik
Covid-19/20
Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - - - DAU ID COVID-
Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - - - Covid-19/20
DAU
19 20/ID COVID-
Masker Face/ Masker Bedah (COBRA 2) pcs - - - - - DAU
Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - - - 19 20/ID COVID-
DAU
19 20/ID COVID-
Mar 21
Masker KN95 (Farmahusada) Box @50 pcs - 40 40 20 20 20 DAU
Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - - - 19 20/ID COVID-
DAU
19 20/ID COVID-
Rapid Test SARS COV 2 (Farmahusada) Test - 25 25 4 4 21 DAU
Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - - - 19 20/ID COVID-
DAU
19 20/ID COVID-
Mar 21
Masker KN95 (Anugrah Sentosa Abadi) pcs - - - - - DAU
APRON (Atmosfer) pcs - 200 200 50 50 150 19 20/ID COVID-
DAU
19 20/ID COVID-
Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - - - DAU
Hand Sanitzer 2 liter - - - - - 19 20/ID COVID-
DAU
19 20/ID COVID-
Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - - -
Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs - 49 49 15 15 34 19 20/ID COVID-
DAU
BTT
19 20/20 COVID-
Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - - -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - - - 19 20 COVID-
BTT
DAU PRSpesifik
19
Face Shield (COBRA) 0 - - - - - DAU PRSpesifik
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - - - Covid-19
DAU PRSpesifik
Covid-19
Kit Steril (Rajawali) 0 - - - - - DAU ID Covid-19
Alkohol II @20 Liter 0 - - - - - Covid-19
DAU ID Covid-
20
Cover All (Rajawali) 0 - - - - - DAU ID Covid-
Face Shield (ATMOSFER) 0 - - - - - 19/20
DAU ID Covid-
19/20
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - - - DAU ID Covid-
Masker Earloop (KasaHusada) 0 - - - - - 19/20
DAU ID Covid-
19/20
MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - - - DAU ID Covid-
Rapid Test Covid-19 (Rajawali) 0 - - - - - 19/20
DAU ID Covid-
19/20
Rapid Test Covid-19 (Dakonan) 0 - - - - - BTT 20 COVID-
Alkohol Swab (BTT) 0 - - - - - 19/20
19
 BTT 20 COVID-
Antiseptic Gel 500 0 - - - - - BTT 20 COVID-
Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - - - - - 19
BTT 20 COVID-
19
Kaca mata Goggle (HASTEN) 0 - - - - - BTT 20 COVID-
Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - - - 19
BTT 20 COVID-
19
Masker Bedah Hijau @50pcs 0 - - - - - BTT 20 COVID-
Masker N95 3M 8210 (Hazten) 0 - - - - - 19
BTT 20 COVID-
19
Nurse Cap Green om 100bh 0 - - - - - BTT 20 COVID-
Parafilm (Anugerah Sentosa Abadi) 0 - - - - - 19
BTT 20 COVID-
19
Rapid Test (1.000) Widhi Dharma Adi 0 - - - - - BTT 20 COVID-
Sarung tangan Safeglove Exam M 100bh 0 - - - - - 19
BTT 20 COVID-
19
Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - - - BTT 20 COVID-
Sterlisasi Swab stik (5box/ VTM) 0 - - - - - 19
BTT 20 COVID-
19
Stereofoam (Anugerah Sentosa Abadi) 0 - - - - - BTT 20 COVID-
Universal Transport Media (UTM) Goongdong 0 - - - - - 19
BTT 20 COVID-
19
Universal Transport Media (UTM) Sekarguna 0 - - - - - BTT 20 COVID-
Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - - - 19
DAU ID 20 non
19
Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - - - DAU ID 20 non
Infusion Set Anak 60 Drops /(Otsuka) 0 - - - - - covid-19
BTT ke 2 20
covid-19
Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - - - BTT ke 2 20
Rapid Test Lecurate (Bima Sakti) 0 - - - - - COVID-19
BTT ke 2 20
COVID-20
Rapid Test ZYBIO (Farma Husada) 0 - - - - -
Alkohol 96 % Liter - - - - - COVID-21
DAU 20
0 0 - - - - - -
0 0 - - - - - -
TAMBAHAN PUSKESMAS 0 - - - - - -
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - - - - -
Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - - - - -
Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube - - - - - -
pcs - - - - - -
Zeneca)
0 0 - - - - - -
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - - - -
Furosemide Tablet 40 mg (Kimia Farma ) Tablet 552 - 552 - 552 -
Gentamycin Krim 1 % mg/ ml Tube - - - - - -
0 0 - - - - - -
Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - - - - -
Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - - - - -
Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - - - -
Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 300 - 300 - 300 -
Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - - - -
Thiamin/ Vitamin B1 50 mg Tablet - - - - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - - - - -
Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - - - -
Antimicrobial Liquid Soap 500 ml (Viorex) 0 6 - 6 2 2 4 -
Hand Sanitizer 450 ml (Meditol) 0 - - - - - -
Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - - - -
I.V Catheter No. 18 (JELCO) Pcs - - - - - -
I.V Catheter No. 22 NIPRO Pcs - - - - - -
I.V Catheter No. 24 TERUMO Pcs - - - - - -
Materniti Napkin Slim L 0 - - - - - -
Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - - - - -
Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - - - - -
Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - - - - -
Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1 - 1 -
Haloperidol 5 mg tablet Tablet - - - - - -
Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - - - -
Fixomull Strech 5 cm X 5 m Pcs - - - - - -
Umbilical crd clamp 0 126 - 126 - 126 -
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 - - - -
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
TOTAL - - - -

UMUM
BPJS
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

UMUM
BPJS
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

TERTULIS 2 KALI
 BULAN : MEI
TAHUN :

HARGA STOK NILAI

NILAI PERSEDIAAN PERMINTAAN PEMBERIAN Ket
SATUAN OPTIMUM PENERIMAAN

RP

99.000 0.000 - 0.000

105.000 47,250.000 143 1,000 500 52,500.000

105.000 0.000 - 0.000

0.000 0.000 - 0.000
2,860.000 0.000 28 100 0.000
2,860.000 514,800.000 - 240 686,400.000
10,500.000 0.000 - 0.000
104.000 98,800.000 319 1,000 800 83,200.000
220.000 0.000 - 0.000
93.500 187,000.000 850 1,000 2,000 187,000.000
0.000 0.000 - 0.000
2,998.000 0.000 - 0.000
0.000 0.000 - 0.000
93.000 0.000 530 1,200 0.000
99.000 295,812.000 - 3,000 297,000.000
0.000 0.000 - 0.000
190.000 6,438,720.000 - 35,000 35,000 6,650,000.000
233.000 0.000 - 0.000
233.000 0.000 - 0.000
249.000 0.000 - 0.000
0.000 0.000 - 0.000
3,025.000 907,500.000 81 300 300 907,500.000
3,025.000 0.000 - 0.000
4,400.000 0.000 - 100 0.000
3,628.000 0.000 - 0.000
10,246.500 0.000 - 0.000
9,900.000 0.000 - 0.000
8,500.000 0.000 412 1,000 - 0.000
8,237.000 0.000 - 0.000
0.000 0.000 - 0.000
4,950.000 247,500.000 107 100 50 247,500.000
0.000 0.000 - 0.000
440.000 0.000 4 0.000
220.000 0.000 - 0.000
165.000 1,117,710.000 4,398 8,000 8,000 1,320,000.000
58.000 0.000 - 0.000
0.000 0.000 - 0.000
3,035.000 0.000 - 50 - 0.000
0.000 0.000 - 0.000
4,496.000 107,904.000 - 25 24 107,904.000
0.000 0.000 - 0.000
3,045.000 669,900.000 173 0.000
198.000 0.000 - 0.000
1,485.000 0.000 - 200 - 0.000
1,551.000 0.000 - 0.000
105.000 510,405.000 1,809 5,000 5,000 525,000.000
105.000 0.000 - 0.000
1,050.000 0.000 - 0.000
67.000 0.000 - 0.000
75.000 0.000 - 0.000
103.000 0.000 - 6,000 - 0.000
253.000 0.000 - 0.000
0.000 0.000 - 0.000
2,076.000 14,532.000 2 0.000
0.000 0.000 - 0.000
1,584.000 453,024.000 169 200 200 316,800.000
0.000 0.000 - 0.000
2,915.000 378,950.000 18 0.000
2,750.000 0.000 - 0.000
0.000 0.000 - 0.000
380.000 0.000 - 0.000
380.000 98,800.000 185 300 300 114,000.000
405.000 0.000 - 0.000
1,639.000 0.000 - 0.000
1,639.000 0.000 - 0.000
136.000 0.000 115 0.000
152.000 28,120.000 1,594 2,000 0.000
145.000 290,000.000 - 2,000 290,000.000
110.000 0.000 63 500 - 0.000
110.000 0.000 - 0.000
3,350.000 0.000 69 0.000
3,350.000 0.000 106 300 0.000
3,350.000 854,250.000 - 300 1,005,000.000
300.000 0.000 - 0.000
5,900.000 0.000 - 0.000
626.000 0.000 - 0.000
18,150.000 0.000 - 0.000
7,602.000 0.000 - 0.000
7,124.000 0.000 - 0.000
0.000 0.000 - 0.000
149,266.000 0.000 - 0.000
0.000 0.000 - 0.000
5,280.000 0.000 - 0.000
660.000 660,000.000 27 1,000 1,000 660,000.000
671.000 0.000 - 0.000
4,282.000 0.000 - 0.000
11,000.000 748,000.000 1 0.000
10,098.000 0.000 - 0.000
2,805.000 0.000 - 0.000
1,097.000 44,977.000 70 200 0.000
1,097.000 219,400.000 - 200 219,400.000
60.500 100,611.500 2,340 5,000 1,000 60,500.000
66.000 0.000 - 0.000
10,400.000 0.000 5 0.000
9,900.000 0.000 - 48 - 0.000
1,095.000 305,505.000 158 300 300 328,500.000
0.000 0.000 - 0.000
104.000 16,744.000 144 0.000
104.000 0.000 - 0.000
104.000 0.000 - 0.000
105.000 154,350.000 - 1,500 157,500.000
112.000 0.000 61 1,500 0.000
0.000 0.000 - 0.000
4,400.000 0.000 69 0.000
2,700.000 0.000 - 0.000
165.000 19,800.000 498 0.000
91.000 0.000 - 0.000
1,408.000 0.000 - 0.000
1,408.000 35,200.000 3 30 30 42,240.000
1,408.000 0.000 - 0.000
730.000 0.000 - 500 0.000
770.000 154,000.000 - 200 154,000.000
391.000 0.000 - 0.000
4,167.000 0.000 - 0.000
3,550.000 0.000 3 0.000
3,682.000 0.000 385 120 120 441,840.000
3,682.000 342,426.000 - 120 441,840.000
691.000 0.000 - 0.000
710.000 81,650.000 155 0.000
0.000 0.000 - 0.000
1,333.000 0.000 - 25 0.000
1,333.000 0.000 - 0.000
82.000 0.000 - 0.000
82.000 0.000 - 0.000
4,232.000 0.000 - 0.000
4,232.000 0.000 57 240 0.000
4,232.000 473,984.000 - 192 812,544.000
2,750.000 0.000 22 144 - 0.000
4,400.000 0.000 - 0.000
2,900.000 162,400.000 84 24 24 69,600.000
119.000 658,189.000 2,230 2,000 3,000 357,000.000
119.000 0.000 - 0.000
77.000 0.000 5,294 10,000 - 0.000
99.000 674,685.000 - 7,800 772,200.000
7,865.000 943,800.000 274 0.000
10,010.000 140,140.000 - 5 5 50,050.000
10,010.000 0.000 - 0.000
6,900.000 0.000 - 40 - 0.000
7,363.000 0.000 - 0.000
132.000 0.000 - 0.000
149.000 203,683.000 336 1,000 1,000 149,000.000
88.000 0.000 - 0.000
2,787.000 0.000 - 0.000
2,475.000 297,000.000 46 240 120 297,000.000
2,475.000 0.000 - 0.000
176,800.000 0.000 - 50 - 0.000
8,800.000 88,000.000 - 0.000
0.000 0.000 - 0.000
4,665.000 0.000 - 200 0.000
4,665.000 877,020.000 - 216 1,007,640.000
264.000 2,085,600.000 389 6,000 8,000 2,112,000.000
330.000 0.000 - 0.000
660.000 0.000 - 0.000
187.000 0.000 - 0.000
90.000 22,950.000 48 0.000
89.000 0.000 24 0.000
121.000 0.000 - 0.000
0.000 0.000 - 0.000
9,644.000 0.000 - 20 0.000
10,696.000 0.000 - 40 0.000
10,696.000 0.000 - 40 0.000
0.000 0.000 - 0.000
770.000 0.000 - 0.000
0.000 0.000 - 0.000
1,755.000 175,500.000 - 0.000
187.000 1,208,020.000 2,664 2,000 8,000 1,496,000.000
63.000 0.000 - 6,000 - 0.000
63.000 0.000 - 0.000
94.600 492,487.600 5,636 2,000 3,000 283,800.000
99.000 0.000 - 0.000
5,610.000 0.000 17 50 0.000
2,518.000 115,828.000 - 50 125,900.000
396.000 146,520.000 30 0.000
288.000 0.000 - 0.000
288.000 0.000 - 0.000
1,089.000 0.000 - 0.000
0.000 0.000 - 0.000
1,810.000 470,600.000 41 240 434,400.000
0.000 0.000 - 0.000
10,500.000 0.000 - 0.000
17,968.500 0.000 25 0.000
35,200.000 0.000 50 120 - 0.000
0.000 0.000 - 0.000
22.000 0.000 - 0.000
77.000 582,890.000 6,084 10,000 10,000 770,000.000
23.000 0.000 - 0.000
2,750.000 0.000 - 300 - 0.000
495.000 0.000 - 2,000 0.000
440.000 852,720.000 987 2,000 880,000.000
319.000 0.000 - 0.000
2,052.000 0.000 - 200 0.000
2,190.000 438,000.000 - 200 438,000.000
13,970.000 167,640.000 10 24 12 167,640.000
22,550.000 451,000.000 3 30 20 451,000.000
23,100.000 0.000 - 0.000
3,811.500 0.000 - 0.000
6,600.000 323,400.000 15 0.000
0.000 0.000 - 0.000
1,937.000 0.000 - 0.000
2,178.000 827,640.000 240 450 450 980,100.000
1,222.000 0.000 - 0.000
99.000 19,800.000 78 0.000
330.000 0.000 - 0.000
123.000 17,958.000 44 0.000
131.000 0.000 - 0.000
4,680.500 1,684,980.000 220 0.000
4,730.000 851,400.000 - 0.000
550.000 0.000 - 0.000
0.000 0.000 - 0.000
4,950.000 0.000 - 0.000
5,500.000 423,500.000 1,117 1,000 100 550,000.000
3,707.000 0.000 - 0.000
96.000 45,408.000 1,120 1,000 0.000
102.000 204,000.000 - 2,000 204,000.000
143.000 28,600.000 151 0.000
0.000 0.000 - 0.000
87.000 0.000 428 0.000
80.000 0.000 - 0.000
121.000 0.000 - 0.000
192.500 0.000 27 3,000 - 0.000
275.000 0.000 - 0.000
8,110.000 0.000 - 0.000
8,110.000 0.000 - 0.000
14,318.700 0.000 - 36 - 0.000
5,500.000 0.000 - 500 - 0.000
2,090.000 1,818,300.000 120 0.000
5,000.000 0.000 - 0.000
4,400.000 0.000 104 300 - 0.000
1,265.000 0.000 - 0.000
990.000 0.000 - 1,000 - 0.000
13,200.000 818,400.000 175 144 48 633,600.000
13,167.000 0.000 - 0.000
2,332.000 0.000 - 0.000
528.000 0.000 801 2,000 - 0.000
594.000 0.000 - 0.000
835.000 3,006,000.000 - 1,000 3,600 3,006,000.000
115.000 0.000 - 0.000
123.000 81,180.000 1,315 0.000
123.000 0.000 - 0.000
6,410.000 0.000 31 0.000
6,410.000 0.000 - 0.000
132.000 9,240.000 612 1,000 0.000
3,948.000 0.000 - 0.000
23,141.800 0.000 5 0.000
19,800.000 217,800.000 13 30 - 0.000
560.000 15,120.000 12 0.000
560.000 0.000 - 0.000
598.000 0.000 - 0.000
12,100.000 0.000 - 50 - 0.000
24,860.000 0.000 - 10 - 0.000
9,955.000 0.000 54 100 - 0.000
25,597.000 0.000 -
160.000 0.000 294 0.000
1,070.000 535,000.000 16 500 500 535,000.000
1,124.000 0.000 - 0.000
715.000 0.000 8 3,000 - 0.000
432.300 0.000 - 0.000
437.800 0.000 2,055 6,000 - 0.000
418.000 0.000 - 0.000
357.500 0.000 - 0.000
495.000 0.000 - 0.000
789.800 0.000 - 0.000
1,181.000 0.000 - 300 0.000
1,181.000 354,300.000 - 300 354,300.000
53.000 53,000.000 6,361 1,000 53,000.000
56.000 0.000 5,000 30,000 0.000
53.000 0.000 - 0.000
20,700.000 703,800.000 4 5 30 621,000.000
11,825.000 1,052,425.000 21 120 90 1,064,250.000
11,825.000 0.000 - 0.000
963.600 59,743.200 173 0.000
115.500 0.000 - 0.000
4,400.000 83,600.000 23 20 20 88,000.000
132.000 0.000 - 0.000
123.000 379,332.000 3,391 2,000 3,000 369,000.000
6,600.000 0.000 - 0.000
41,500.000 0.000 - 0.000
68.000 0.000 - 0.000
73.000 233,162.000 4,826 8,000 4,000 292,000.000
73.000 0.000 - 0.000
1,000.000 0.000 - 300 - 0.000
1,155.000 693,000.000 - 600 600 693,000.000
1,188.000 0.000 - 0.000
220.000 403,920.000 302 1,000 1,000 220,000.000
0.000 0.000 - 0.000
9,646.000 0.000 - 0.000
9,646.000 0.000 - 0.000
7,150.000 0.000 1,061 0.000
7,150.000 2,288,000.000 1,400 0.000
7,630.000 0.000 - 0.000
4,550.000 1,296,750.000 186 300 300 1,365,000.000
0.000 0.000 - 0.000
70.000 0.000 240 3,000 - 0.000
165.000 0.000 - 0.000
2,620.000 167,680.000 80 72 72 188,640.000
2,796.000 0.000 - 0.000
6,006.000 0.000 - 0.000
5,170.000 0.000 39 200 - 0.000
2,200.000 0.000 - 0.000
479,996.000 0.000 1 2 0.000
512,204.000 1,024,408.000 - 2 1,024,408.000
130,999.000 0.000 - 50 0.000
130,999.000 6,549,950.000 - 50 6,549,950.000
90.000 1,800.000 40 0.000
90.000 0.000 - 0.000
110.000 129,580.000 756 3,000 1,200 132,000.000
117.000 0.000 - 0.000
265.000 0.000 57 0.000
0.000 0.000 - 0.000
6,789.000 0.000 - 30 0.000
6,789.000 169,725.000 - 25 169,725.000
13,607.000 0.000 - 0.000
310.000 0.000 - 0.000
86.000 0.000 - 0.000
132.000 0.000 3,268 1,000 0.000
91.000 84,448.000 - 1,000 91,000.000
935.000 0.000 - 2,000 - 0.000
935.000 0.000 - 0.000
7,150.000 207,350.000 20 0.000
7,150.000 0.000 - 0.000
89.000 0.000 - 0.000
239.800 0.000 - 1,000 - 0.000
0.000 0.000 - 0.000
108.000 0.000 - 0.000
1,045.000 0.000 - 0.000
967.000 0.000 - 0.000
776.006 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
12,573.000 0.000 1 0.000
12,573.000 0.000 - 10 - 0.000
12,573.000 0.000 - 0.000
1,735.000 0.000 - 0.000
1,735.000 0.000 - 10 - 0.000
19,789.000 0.000 - 0.000
396.000 12,276.000 72 0.000
114.000 0.000 - 0.000
171.000 0.000 - 0.000
171.000 0.000 - 0.000
171.000 0.000 - 0.000
550.000 0.000 - 0.000
0.000 0.000 - 0.000
779.000 0.000 - 0.000
1,320.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
278.300 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
404.000 105,848.000 3 0.000
431.000 0.000 - 0.000
0.000 0.000 - 0.000
257.000 0.000 - 0.000
257.000 230,015.000 2,015 1,000 1,000 257,000.000
274.000 0.000 - 0.000
274.000 0.000 - 0.000
0.000 0.000 - 0.000
6,281.000 314,050.000 29 0.000
9,900.000 0.000 - 0.000
524.000 0.000 - 0.000
524.000 0.000 - 0.000
524.000 0.000 - 0.000
524.000 2,724,276.000 3,161 0.000
524.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
1,325,000.000 0.000 - 0.000
1,325,000.000 0.000 - 0.000
1,325,000.000 0.000 1 0.000
1,325,000.000 0.000 - 0.000
1,325,000.000 0.000 - 1 1,325,000.000
0.000 0.000 - 0.000
232,518.000 0.000 - 0.000
248,120.000 0.000 1 0.000
248,120.000 0.000 - 0.000
389,344.000 0.000 10 0.000
415,469.000 0.000 - 0.000
1,384,983.000 0.000 1 1 1,384,983.000
1,384,983.000 0.000 - 0.000
1,384,983.000 0.000 - 0.000
317,018.000 0.000 - 0.000
0.000 0.000 - 0.000
282.000 0.000 - 0.000
0.000 0.000 - 0.000
28,354.000 0.000 - 0.000
28,354.000 0.000 - 0.000
40,913.489 0.000 - 0.000
41,784.000 0.000 - 0.000
41,784.000 0.000 32 0.000
8,891.000 0.000 - 0.000
13,300.000 0.000 - 0.000
11,738.000 0.000 - 0.000
36,579.000 0.000 - 0.000
15,014.000 0.000 - 0.000
0.000 0.000 - 0.000
2,920.000 0.000 - 0.000
2,920.000 0.000 - 0.000
517.000 0.000 - 0.000
517.000 36,190.000 3,225 0.000
552.000 0.000 - 0.000
284.000 0.000 350 0.000
307.000 0.000 - 0.000
307.000 0.000 - 0.000
354.000 0.000 37,011 0.000
354.000 0.000 - 0.000
354.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
9,955.000 99,550.000 - 5 10 99,550.000
3,796.000 7,592.000 - 0.000
3,796.000 0.000 - 0.000
10,351.000 0.000 - 0.000
2,959.000 0.000 22 50 0.000
2,684.000 0.000 - 50 134,200.000
2,959.000 147,950.000 - 50 147,950.000
2,500.000 0.000 - 0.000
210.000 132,300.000 520 500 500 105,000.000
1,900.000 0.000 63 200 - 0.000
1,199.000 206,228.000 - 200 239,800.000
1,639.000 0.000 - 0.000
1,199.000 0.000 - 0.000
0.000 0.000 - 0.000
167.000 0.000 - 0.000
167.000 0.000 - 0.000
167.000 0.000 - 0.000
167.000 26,720.000 18 0.000
167.000 0.000 - 0.000
1,121.000 0.000 - 0.000
3,288.000 0.000 - 0.000
1,200.000 0.000 - 0.000
1,750.000 0.000 - 0.000
1,750.000 0.000 - 0.000
183.000 0.000 - 0.000
63,986.000 0.000 - 0.000
63,813.000 0.000 - 0.000
57,500.000 0.000 - 10 0.000
60.000 0.000 - 0.000
60.000 176,700.000 422 2,000 3,000 180,000.000
60.000 0.000 - 0.000
0.000 0.000 - 0.000
5,000.000 0.000 - 3 0.000
13,200.000 0.000 - 0.000
19,955.000 0.000 - 0.000
245.000 0.000 - 0.000
245.000 0.000 - 0.000
1,243.000 3,729.000 - 3 3 3,729.000
1,326.000 0.000 - 0.000
158.000 0.000 105 0.000
157.000 464,249.000 - 2,000 3,000 471,000.000
253.000 0.000 - 0.000
0.000 0.000 - 0.000
287.000 0.000 - 0.000
287.000 0.000 - 0.000
287.000 262,318.000 467 2,000 1,000 287,000.000
287.000 0.000 - 0.000
0.000 0.000 - 0.000
287.000 0.000 - 0.000
0.000 0.000 - 0.000
91.000 11,011.000 507 2,000 0.000
91.000 273,000.000 504 3,000 273,000.000
440.000 0.000 - 0.000
0.000 0.000 - 0.000
63,986.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
56,360.000 2,198,040.000 88 30 30 1,690,800.000
0.000 0.000 88 30 30 0.000
60,140.000 0.000 - 0.000
66,154.000 0.000 - 0.000
141,648.000 6,940,752.000 88 - - 0.000
0.000 0.000 88 20 20 0.000
151,150.000 7,859,800.000 18 20 20 3,023,000.000
166,265.000 0.000 - 0.000
76,620.000 6,282,840.000 165 - - 0.000
84,282.000 0.000 - - - 0.000
17,450.000 0.000 - - - 0.000
0.000 0.000 - 0.000
23,270.000 1,163,500.000 55 - - 0.000
25,597.000 1,535,820.000 - 60 60 1,535,820.000
18,140.000 362,800.000 147 50 50 907,000.000
0.000 0.000 164 50 50 0.000
19,470.270 837,221.610 17 - - 0.000
19,954.000 0.000 - - - 0.000
15,450.000 139,050.000 1 - - 0.000
0.000 0.000 - 0.000
21,810.000 0.000 - 0.000
19,350.000 0.000 - 0.000
135,000.000 0.000 - 0.000
151,150.000 0.000 - 0.000
0.000 0.000 - 0.000
21,285.000 0.000 - 0.000
144,540.000 0.000 - 0.000
50,000.000 0.000 - 0.000
165,000.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
34,354.100 0.000 - 0.000
0.000 0.000 - 0.000
164.000 42,640.000 40 0.000
0.000 0.000 - 0.000
90,000.000 0.000 - 0.000
90,000.000 0.000 - 0.000
183,480.000 0.000 - 0.000
176,400.000 0.000 - 0.000
77.000 0.000 - 0.000
0.000 0.000 - 0.000
79,154.000 0.000 - 0.000
79,154.000 0.000 - 0.000
303,750.000 0.000 - 0.000
252,720.000 0.000 - 0.000
106,080.000 0.000 - 0.000
106,080.000 0.000 - 0.000
222,000.000 0.000 - 0.000
222,000.000 0.000 - 0.000
198,900.000 0.000 - 0.000
198,900.000 0.000 - 0.000
230,880.000 0.000 - 0.000
133,137.000 0.000 - 0.000
84,050.000 0.000 - 0.000
0.000 0.000 - 0.000
22,794.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
990.000 0.000 - 0.000
1,023.000 14,322.000 245 500 0 0.000
0.000 0.000 - 0.000
924.000 0.000 2,505 3,000 0.000
1,138.000 2,884,830.000 - 3,000 3,414,000.000 sudah
924.000 0.000 - 0.000
979.000 979,000.000 - 1,000 979,000.000 sudah
739.200 0.000 - 0.000
1,463.000 0.000 - 0.000
32,522.000 0.000 - 0.000
2,541.000 0.000 7 0.000
23,951.000 0.000 - 0.000
19,885.446 0.000 13 20 - 0.000
120.000 0.000 - 0.000
127.260 63,630.000 - 1,000 500 63,630.000
212,784.000 0.000 1 20 - 0.000
70,000.000 0.000 - 0.000 sudah
22,725.000 2,727,000.000 - 120 2,727,000.000
22,500.000 0.000 90 120 0.000 60
32,522.000 0.000 - 0.000
24,583.333 0.000 - 0.000
34,300.000 0.000 - 0.000
712,800.000 0.000 - 0.000
348,480.000 0.000 9 0.000
2,222.000 0.000 270 0.000
1,540.000 0.000 - 0.000
37,440.000 0.000 - 30 - 0.000
13,050.000 300,150.000 19 30 10 130,500.000
9,680.000 0.000 - 0.000
20,970.000 0.000 - 0.000
13,607.000 68,035.000 - 20 5 68,035.000
180,000.000 0.000 - 0.000
8,900.000 0.000 105 100 0.000
5,500.000 401,500.000 - 100 550,000.000 sudah
8,900.000 0.000 - 0.000
6,270.000 940,500.000 103 100 200 1,254,000.000 sudah
8,700.000 0.000 - 0.000
5,500.000 0.000 112 100 0.000
5,500.000 1,369,500.000 - 300 1,650,000.000 sudah
6,270.000 946,770.000 109 100 200 1,254,000.000 sudah
6,270.000 0.000 - 0.000
7,920.000 0.000 46 100 0.000
8,400.000 840,000.000 - 100 840,000.000
6,199.900 0.000 36 600 0.000
8,400.000 3,360,000.000 - 400 3,360,000.000
1,760.000 0.000 - 0.000
13,400.000 0.000 - 3,000 0.000
13,400.000 134,000.000 10 10 134,000.000
12,500.000 0.000 - 0.000
2,300.000 0.000 7 200 0.000
136,500.000 1,092,000.000 3 15 10 1,365,000.000
136,500.000 0.000 - 0.000
8,000.000 0.000 - 0.000
5,950.000 297,500.000 31 200 50 297,500.000
8,000.000 0.000 - 0.000
1,430.000 0.000 210 0.000
2,240.000 201,600.000 - 100 224,000.000
2,100.000 0.000 - 0.000
427.850 0.000 397 2,000 - 0.000
390.860 0.000 - 0.000
2,060.000 0.000 - 0.000
0.000 0.000 - 0.000
17,500.000 0.000 47 50 - 0.000
6,512.000 0.000 15 0.000
339.900 0.000 - 0.000
339.900 0.000 - 0.000
2,200.000 0.000 - 0.000
2,309.375 277,125.000 - 200 461,875.000
10,857.000 0.000 - 0.000
10,856.250 0.000 - 0.000
65,340.000 0.000 - 0.000
333.900 16,695.000 93 0.000
11,615.000 0.000 - 0.000
6,600.000 0.000 - 0.000
154.000 0.000 - 0.000 sudah
7,700.000 177,100.000 28 100 54 415,800.000
7,769.000 419,526.000 - 54 419,526.000 54
18,000.000 162,000.000 - 25 10 180,000.000
12,675.000 0.000 - 0.000
3,700.000 0.000 9 0.000
0.000 0.000 - 0.000
286,000.000 0.000 - 2 - 0.000
726.953 0.000 - 0.000
0.000 0.000 - 0.000
542.520 54,252.000 - 0.000
496.650 0.000 - 0.000
19,360.000 0.000 17 0.000
470.530 0.000 - 0.000
3,773.000 1,131,900.000 117 0.000
4,134.900 0.000 - 0.000
20,586.000 988,128.000 51 120 60 1,235,160.000
15,150.000 0.000 - 0.000
0.000 0.000 - 0.000
87,120.000 0.000 - 0.000
752,400.000 752,400.000 1 0.000
8,295.000 207,375.000 - 30 248,850.000
8,031.579 0.000 - 0.000
0.000 0.000 - 0.000
5,368.000 69,784.000 21 20 20 107,360.000
5,785.000 0.000 - 0.000
0.000 0.000 - 0.000
2,887.500 0.000 - 0.000
0.000 0.000 - 0.000
453,802.994 0.000 - 0.000
4,200.000 0.000 - 0.000
635.250 381,150.000 267 0.000
4,000.000 0.000 - 0.000
59,000.000 0.000 - 0.000
45,000.000 0.000 - 0.000
45,000.000 0.000 - 0.000
0.000 0.000 - 0.000
546,400.000 0.000 - 0.000
544,150.000 0.000 - 0.000
0.000 0.000 - 0.000
223,949.367 0.000 - 0.000
254,300.000 0.000 - 0.000
252,800.000 0.000 - 0.000
401,666.666 401,666.666 8 2 803,333.332
405,000.000 0.000 - 0.000
10,560.000 0.000 - 0.000
0.000 0.000 - 0.000
10,837.000 0.000 - 0.000
0.000 0.000 - 0.000
19,225.000 0.000 - 0.000
0.000 0.000 - 0.000
552,800.000 0.000 - 100 0.000
552,800.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
16,400.000 0.000 - 0.000
0.000 0.000 - 0.000
4,120.000 0.000 - 0.000
4,120.000 0.000 - 0.000
15,500.000 0.000 - 0.000
9,738.000 0.000 267 0.000
9,611.000 0.000 - 0.000
0.000 0.000 - 0.000
625,900.000 0.000 - 0.000
22,176.000 0.000 - 0.000
66,876.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
13,252.000 0.000 - 0.000
10,865.800 0.000 267 0.000
8,053.000 0.000 - 0.000
8,110.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
36,000.000 0.000 - 0.000
77,690.000 0.000 - 0.000
825,000.000 0.000 - 0.000
224,254.000 0.000 - 0.000
259,175.000 0.000 - 0.000
70,000.000 0.000 - 0.000
4,952.830 0.000 - 200 - 0.000
4,952.830 0.000 - 0.000
2,728.000 0.000 267 0.000
5,890.000 0.000 - 0.000
660,000.000 0.000 - 0.000
158,400.000 0.000 - 0.000
276,600.000 0.000 7 0.000
276,500.000 0.000 - 0.000
257,644.000 0.000 7 0.000
228,800.000 0.000 - 0.000
20,747.000 0.000 - 0.000
20,748.000 0.000 - 0.000
6,700.000 0.000 - 0.000
19,835.000 0.000 - 0.000
386.100 0.000 - 0.000
0.000 0.000 - 0.000
1,590.000 0.000 - 0.000
1,550.000 0.000 - 0.000
1,463.000 0.000 667 0.000
1,518.000 0.000 - 0.000
1,190.000 0.000 - 0.000
1,185.000 0.000 - 0.000
1,463.000 0.000 - 0.000
1,190.000 0.000 - 0.000
1,077.000 0.000 - 0.000
1,081.820 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
1,583.000 452,738.000 92 0.000
1,439.000 0.000 - 0.000
1,439.000 0.000 - 0.000
0.000 0.000 - 0.000
22,433.000 0.000 - 0.000
1,460.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
14,712.500 0.000 - 0.000
19,480.000 0.000 - 0.000
13,750.000 0.000 - 0.000
13,235.000 0.000 - 0.000
12,500.000 0.000 - 0.000
13,750.000 0.000 - 0.000
358.000 0.000 528 0.000
121,750.000 0.000 - 0.000
486.000 0.000 47 0.000
0.000 0.000 - 0.000
11,975.000 0.000 267 0.000
28,666.670 0.000 - 0.000
13,235.000 0.000 - 0.000
12,500.000 0.000 - 0.000
11,975.000 0.000 - 0.000
11,975.000 0.000 - 0.000
0.000 0.000 - 0.000
19,480.000 0.000 - 0.000
0.000 0.000 - 0.000
13,235.000 0.000 - 0.000
0.000 0.000 - 0.000
19,480.000 0.000 - 0.000
13,353.000 0.000 - 0.000
800.000 0.000 - 0.000
0.000 0.000 - 0.000
323,500.000 0.000 - 0.000
53,000.000 0.000 - 0.000
386.100 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
38,500.000 0.000 - 0.000
71,500.000 0.000 - 0.000
38,500.000 0.000 - 0.000
71,500.000 0.000 - 0.000
333.900 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
473.000 0.000 - 0.000
0.000 0.000 - 0.000
110.000 0.000 - 0.000
1,750.000 0.000 - 0.000
98.000 0.000 - 0.000
783.000 0.000 - 0.000
7,150.000 0.000 - 0.000
2,134.000 0.000 - 0.000
6,199.900 0.000 - 0.000
1,155.000 0.000 - 0.000
80.000 0.000 - 0.000
396.000 0.000 - 0.000
500.000 0.000 - 0.000
7,920.000 396,000.000 - 0.000
1,302.000 0.000 - 0.000
1,890.000 0.000 - 0.000
160.000 0.000 - 0.000
6,840.000 0.000 - 0.000
90.000 0.000 - 0.000
265.000 0.000 - 0.000
14,300.000 0.000 - 0.000
7,630.000 0.000 - 0.000
167.000 0.000 - 0.000
8,355.000 0.000 - 0.000
1,457,500.000 0.000 - 0.000
0.000 0.000 - 0.000
12,969.000 0.000 - 0.000
1,506.000 0.000 - 0.000
410,777.000 0.000 - 0.000
343,687.000 0.000 - 0.000
32,493.000 0.000 - 0.000
0.000 0.000 - 0.000
2,254.320 0.000 - 0.000
259,175.000 0.000 - 0.000
15,180.000 0.000 - 0.000
31,680.000 0.000 - 0.000
31,405.000 0.000 - 0.000
3,300.000 0.000 - 0.000
7,630.000 0.000 - 0.000
14,300.000 0.000 - 0.000
8,426.000 0.000 - 0.000
627.000 0.000 - 0.000
792.000 0.000 - 0.000
1,700.000 0.000 - 0.000
1,700.000 0.000 - 0.000
55,000.000 0.000 - 0.000
58,500.000 0.000 - 0.000
850.000 0.000 - 0.000
4,000.000 0.000 - 0.000
8,355.000 0.000 - 0.000
248,120.000 0.000 - 0.000
186,000.000 0.000 - 0.000
6,500.000 0.000 - 0.000
11,250.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
236,500.000 1,182,500.000 - 0.000
99,000.000 495,000.000 - 0.000
203,500.000 814,000.000 - 7 1,424,500.000
275,000.000 0.000 - 5 1,375,000.000
132,000.000 0.000 - 0.000
49,500.000 0.000 - 0.000
5,500.000 0.000 - 0.000
66,000.000 0.000 - 0.000
1,023.000 1,943,700.000 - 1,900 1,943,700.000
21,736.000 0.000 - 0.000
386.100 0.000 - 0.000
340.280 680,560.000 - 0.000
560,000.000 560,000.000 - 0.000
1,252,000.000 2,504,000.000 - 1 1,252,000.000
575,000.000 0.000 - 0.000
156,000.000 0.000 - 0.000
53,636.000 0.000 - 0.000
220,000.000 0.000 - 0.000
148,500.000 297,000.000 - 0.000
7,000.000 1,400,000.000 - 1,200 8,400,000.000
2,200.000 0.000 - 0.000
60,000.000 0.000 - 0.000
6,269.000 0.000 - 0.000
197,000.000 0.000 - 0.000
75,000.000 1,500,000.000 - 40 3,000,000.000
8,500.000 0.000 - 0.000
220,000.000 4,620,000.000 - 25 5,500,000.000
220,000.000 0.000 - 0.000
75,000.000 0.000 - 0.000
5,000.000 750,000.000 - 200 1,000,000.000
200,000.000 0.000 - 0.000
56,000.000 0.000 - 0.000
80,000.000 0.000 - 0.000
200,000.000 6,800,000.000 - 49 9,800,000.000
138,364.000 0.000 - 0.000
137,364.000 0.000 - 0.000
45,100.000 0.000 - 0.000
66,000.000 0.000 - 0.000
53,636.000 0.000 - 0.000
450,000.000 0.000 - 0.000
718,500.000 0.000 - 0.000
69,000.000 0.000 - 0.000
60,000.000 0.000 - 0.000
6,000.000 0.000 - 0.000
522,728.000 0.000 - 0.000
180,000.000 0.000 - 0.000
220,000.000 0.000 - 0.000
109.090 0.000 - 0.000
24,091.000 0.000 - 0.000
1,150.000 0.000 - 0.000
47,500.000 0.000 - 0.000
200,000.000 0.000 - 0.000
2,816.000 0.000 - 0.000
150,000.000 0.000 - 0.000
303.550 0.000 - 0.000
891,275.000 0.000 - 0.000
160,500.000 0.000 - 0.000
585.000 0.000 - 0.000
5,300.000 0.000 - 0.000
5,500.000 0.000 - 0.000
60,500.000 0.000 - 0.000
80,000.000 0.000 - 0.000
136,564.000 0.000 - 0.000
1,265.000 0.000 - 0.000
8,400.000 0.000 - 0.000
8,400.000 0.000 - 0.000
98,000.000 0.000 - 0.000
90,000.000 0.000 - 0.000
97,500.000 0.000 - 0.000
22,500.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
7,199.885 0.000 - 0.000
1,945.000 0.000 - 0.000
2,950.000 0.000 30 0.000
139,880.000 0.000 - 0.000
0.000 0.000 - 0.000
1,097.000 0.000 - 0.000
77.000 42,504.000 66 0.000
3,217.500 0.000 - 0.000
0.000 0.000 - 0.000
15,572.700 0.000 2 0.000
270.000 0.000 10 0.000
600.000 0.000 - 0.000
1,106.000 331,800.000 34 0.000
45.000 0.000 - 0.000
36.000 0.000 - 0.000
783.000 0.000 - 0.000
1,302.000 0.000 53 0.000
74,250.000 297,000.000 6 0.000
43,186.000 0.000 15 0.000
7,920.000 0.000 - 0.000
8,750.000 0.000 - 0.000
7,018.000 0.000 - 0.000
8,355.000 0.000 - 0.000
20,328.000 0.000 - 0.000
12,076.000 0.000 - 0.000
6,595.000 0.000 - 0.000
1,098,900.000 0.000 1 0.000
712,800.000 712,800.000 1 0.000
56.000 0.000 24 0.000
1,640.000 0.000 - 0.000
42,800.000 0.000 8 0.000
2,750.000 346,500.000 122 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0.000 0.000 - 0.000
0 0.000 0.000
135,118,002.576 113,095,972.332

JUMLAH LBR RESEP JUMLAH TOTAL R

Rawat Jalan Rawat Inap Generik Paten

JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

Rawat Jalan Rawat Inap antibiotik injeksi

BUFFER P 257

BUFFER P 2728
Pelaporan : Persentase Puskesmas denga
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Albendazol /Pira Tablet 1
2 Alopurinol Tablet 1
3 Amlodipin/Kapto Tablet 1
4 Amoksisilin 500 Tablet 1
5 Amoksisilin sirup Botol 1
6 Antasida tablet k Tablet/Botol 1
7 Asam Askorbat (V Tablet 1
8 Asiklovir Tablet 1
9 Betametason sal Tube 0
10 Deksametason tabTablet/Vial/Ampul 0
11 Diazepam injeksi Ampul 1
12 Diazepam Tablet 1
13 Dihidroartemsin Tablet 1
14 Difenhidramin In Ampul 1
15 Epinefrin (Adrena Ampul 1
16 Fitomenadion (Vi Ampul 0
17 Furosemid 40 mg/ Tablet 1
18 Garam Oralit ser Kantong 1
19 Glibenklamid/Me Tablet 1
20 Hidrokortison kr Tube 0
21 Kotrimoksazol (d Tablet/Botol 0
22 Lidokain inj Vial 0
23 Magnesium Sulfat Vial 0
24 Metilergometrin Ampul 0
25 Natrium Diklofen Tablet 1
26 OAT FDC Kat 1 Paket 1
27 Oksitosin injeksi Ampul 1
28 Parasetamol siru Botol 1
29 Parasetamol 500 Tablet 1
30 Prednison 5 mg Tablet 1
31 Ranitidin 150 mg Tablet 1
32 Retinol 100.000/ Kapsul 0
33 Salbutamol Tablet 1
34 Salep Mata/Tetes Tube 1
35 Simvastatin Tablet 1
36 Siprofloksasin Tablet 1
37 Tablet Tambah D Tablet 1
38 Triheksifenidil Tablet 1
39 Vitamin B6 (Pirid Tablet 1
40 Zinc 20 mg Tablet 1
JUMLAH ITEM OBAT INDIKATOR 31
Pelaporan : Persentase Puskesmas deng
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Vaksin Hepatitis Vial 1
2 Vaksin BCG Ampul 1
3 Vaksin DPT-HB-H Vial 1
4 Vaksin Polio Vial 1
5 Vaksin Campak/V Vial/Ampul 1
JUMLAH ITEM OBAT INDIKATOR 5
 LAPORAN PEMAKAIAN DAN LEMBAR PE
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
NO NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN JUMLAH

UNIT UNIT UNIT UNIT

1 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -

2 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 450 - 450 445
1 444

3 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -

4 0 0 - - - -
5 Air Untuk Injeksi Vial @25 ml Vial - - - -
6 Air Untuk Injeksi Vial @25 ml Vial 180 - 180 -
7 Air Untuk Irigasi Infus 1000 ml Botol - - - -
8 Alopurinol Tablet 100 mg Tablet 950 - 950 -
9 Alopurinol Tablet 100 mg 0 - - - -
10 Ambroxol Tablet 30 mg Tablet 2,000 - 2,000 -
11 0 0 - - - -
12 Aminofilin Injeksi 24 mg/ml Ampule - - - -
13 0 0 - - - -
14 Amlodipin Tablet 10 Mg Tablet - - - -
15 Amlodipin Tablet 10 Mg Tablet 2,988 - 2,988 22 242 264
16 0 0 - - - -
17 Amoksisilin Kaplet 500 mg Tablet 33,888 - 33,888 432 3,448 3,880
18 Amoksisilin Kaplet 500 mg Tablet - - - -
19 Amoksisilin Kaplet 500 mg Tablet - - - -
20 Amoksisilin Kaplet 500 mg Tablet - - - -
21 0 0 - - - -
22 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 300 - 300 2 34 36
23 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - -
24 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - -
25 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - - -
26 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - - -
27 CLABAT,CAPSINAT Tablet - - - -
28 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - - -
29 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial - 300 300 9 9
30 0 0 - - - -
31 Antacida + Simeticon Suspensi (NOVAMAG) Botol 50 - 50 -
32 0 0 - - - -
33 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
34 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
35 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet 6,774 - 6,774 689 2,849 3,538
36 Tablet - - - -
37 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - - -
38 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - -
39 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - - -
40 Pot 24 - 24 -
41 Salisilat 3% (Marin )
0Antihemoroid 0 - - - -
Kombinasi : Bismut Suppgalat 150 mg
42 Supp 220 - 220 220 220
43 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - - -
45 20% ) HEMOROGARD Tablet - - - -
46 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet 4,861 - 4,861 64 1,829 1,893
47 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet - - - -
48 Tablet - - - -
49 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - -
50 Asam Folat Tablet 1 mg Tablet - - - -
51 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - -
52 Asam Mefenamat 500 mg 0 - - - -
53 0 0 - - - -
54 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 7 - 7 4 4
55 0 0 - - - -
56 Asam Tranexamat Tablet 500 mg Tablet 286 - 286 - 60 60
57 0 0 - - - -
58 Asiklovir 5% 5gr Cream Tube 130 - 130 3 2 5
59 Asiklovir 5% 5gr Cream Tube - - - -
60 0 0 - - - -
61 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
62 Asiklovir Tab 400 mg ( Phapros ) Tablet 260 - 260 60 60
 63 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
64 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - -
65 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
66 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - -
67 Attapulgite Active 630 mg Tab/ PULAREX Tablet 185 - 185 74 111 185
68 Attapulgite Active 630 mg Tab/ New Antides Tablet 2,000 - 2,000 325 325
69 Betahistin Mesylat 6 mg Tablet - - - -
70 Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - - -
71 Betametason Dipropionat Krim 0,1% Tube - - - -
72 Betametason Dipropionat Krim 0,1% gram @ 10 - - - -
Tube
gram @ 10
73 Betametason Dipropionat Krim 0,1% 255 - 255 8 44 52
74 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - - -
75 Bisakodil Sup 10 mg (Dulcolax) Supp - - - -
76 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - -
77 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - - -
78 Bricasma Biji - - - -
79 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - - -
80 Zeneca
0Budesonid )I 0 - - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 pcs - - - -
82 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - - -
83 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - - -
84 Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet 1,000 - 1,000 170 170
85 Cefadroksil Kapsul 500 mg Tablet - - - -
86 Cefotaxime serbuk injeksi 1.000 mg Vial - - - -
87 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 68 - 68 6 6
88 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - - - -
89 Tablet - - - -
90 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 41 - 41 3 21 24
91 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 200 - 200 -
92 Deksamethason Tab 0,5 mg (Promed ) Tablet 1,663 - 1,663 49 535 584
93 Deksamethason Tab 0,5 mg 0 - - - -
94 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - - -
95 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - -
96 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 279 - 279 1 23 24
97 0 0 - - - -
98 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 161 - 161 -
99 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - -
100 Digoksin Tab 0,25 mg Tablet - - - -
101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 1,470 - 1,470 -
102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - - -
103 0 0 - - - -
104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
106 Domperidon Tab 10 mg (Novapharin ) Tablet 120 - 120 -
107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - -
108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - -
109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 25 - 25 -
110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - -
111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
112 Eritrosmisin Stearate Kaplet 500 mg Tablet 200 - 200 -
113 Ethambutol 250 mg Tablet - - - -
114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - -
115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 93 - 93 -
118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - - -
119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 115 - 115 -
120 0 0 - - - -
121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 112 - 112 -
128 Gentamycin Krim 1 % mg/ ml Tube - - - -
129 Gentian Violet 1% 10 ml Botol - - - -
130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 56 - 56 -
131 Glibenklamid Tablet 5 mg Tablet 5,531 - 5,531 -
132 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - -
133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - - - -
134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet 6,815 - 6,815 -
135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 120 - 120 -
136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 14 - 14 -
137 Glukosa Larutan 40% Steril botol - - - -
138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - -
139 Glukosa Larutan Infus 5% @500ml Botol - 40 40 -
140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - -
141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,367 - 1,367 -
142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - -
143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - -
144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 120 - 120 -
145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - -
146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - -
147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10 -
148 0 0 - - - -
149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 188 - 188 -
151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 7,900 - 7,900 -
152 Ibuprofen Tablet 400 mg Tablet - - - -
153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - -
154 Isoniazid Tablet 100 mg tablet - - - -
155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 255 - 255 -
156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
158 0 0 - - - -
159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - -
160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - -
161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol - - - -
162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - - -
163 Tablet - - - -
164 Pharmatama)
0 0 - - - -
165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100 -
166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 6,460 - 6,460 -
167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - -
168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - -
169 Kaptopril Tab 25 mg ( Phapros ) Tablet 5,206 - 5,206 -
170 Kaptopril Tab 25 mg TAblet - - - -
171 Ketokonazol Krim 2 % @ 10 gr Tube - - - -
172 Ketokonazol Krim 2 % @ 10 gr Tube 46 - 46 -
173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 370 - 370 -
174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - -
175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - -
176 Ketorolak Inj 30 mg/ml Ampule - - - -
177 0 0 - - - -
178 Kloramfenikol 1% Salep Mata (KF) Tube 260 - 260 -
179 0 0 - - - -
180 Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol Vial - - - -
181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - - -
182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - - -
183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - - -
184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - - -
185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 7,570 - 7,570 -
186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - -
187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - -
188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - -
189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,938 - 1,938 -
190 Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg - - - -
191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - - -
192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol 200 - 200 -
193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma )
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract 12 - 12 -
194 MOLAKRIM
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 20 - 20 -
195 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- - - -
196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - - -
197 Probiotik (Dexa Medica, Sanbe) Tablet 49 - 49 -
198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - - -
199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 380 - 380 -
201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
202 Loperamid Tablet 2 mg ( Ifars) Tablet 200 - 200 -
203 Loperamid Tablet 2 mg Tablet - - - -
204 Loratadin Tablet 10 mg Tablet 146 - 146 -
205 Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - - -
206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet 360 - 360 -
207 Mata/ OCUGARD (Phapros) Tablet 180 - 180 -
208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - - -
209 0 0 - - - -
210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - -
211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 77 - 77 -
212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - - -
213 Metformin HCl Tablet 500 mg Tablet 473 - 473 -
214 Metformin HCl Tablet 500 mg Tablet 2,000 - 2,000 -
215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 200 - 200 -
216 0 0 - - - -
217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - -
220 Metronidasol 500 mg tablet (Novapharin) Tablet - - - -
221 Metronidasol 500 mg tablet (Novagyl) Tablet - - - -
222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - -
223 Metronidasol Infus 500mg/100ml Botol - - - -
224 Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - - -
225 Kapsul - - - -
226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 870 - 870 -
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 Ampule - - - -
228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - - -
229 Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - - -
230 Tablet - - - -
Ayus )
 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU
231 Multivitamin Curcuma Syr:L-Lysyin 1000 IU Botol 62 - 62 -
232 vit B1 3 mg, B12 Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) Botol - - - -
Multivitamin Neurotopic
vit B1 3 mg, B12 Plus ATP
Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet
233 Multivitamin - - - -
234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) Tablet - - - -
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 Femofomarrat 300mg tablet - - - -
236 MOLANEURON (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C Tablet 3,600 21,700 25,300 -
237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - - -
238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 660 - 660 -
239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - -
240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - -
241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - -
242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 70 - 70 -
243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - -
244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - - -
245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 11 - 11 -
246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 27 - 27 -
247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet - - - -
249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - - -
250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - - -
251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - - -
252 Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - - -
253 Omeprazole Kapsul 20 mg Tablet - - - -
254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 500 - 500 -
255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - - -
256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet - - - -
257 Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - - -
258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - - -
259 400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol
Parasetamol HCl 25Mg/ HUSTAB Tablet - - - -
260 (Phapros) Tablet - - - -
261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 30Mg,
100 mg / COLPICA (Tropika Mas) 0 - - - -
Parasetamol Komb Tablet Flu: Parasetamol
262 Tablet - - - -
263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - - -
264 Parasetamol Syrup 120 mg/5ml Botol 300 - 300 -
265 Parasetamol tablet 500 mg Tablet 1,000 - 1,000 -
266 Parasetamol tablet 500 mg Tablet - - - -
267 Parasetamol tablet 500 mg Tablet - - - -
268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 34 - 34 -
269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 89 - 89 -
270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - -
271 Piracetam 800 mg Tablet Tablet 62 - 62 -
272 Parasetamol tablet 500 mg Tablet - - - -
273 Piracetam Injeksi 1gr/ 5ml Ampule 19 - 19 -
274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 3,084 - 3,084 -
276 Probiotik Sachet (Probiokid) 0 - - - -
277 Polikresulen (Albotyl,Apetil) Botol - - - -
278 Prednison Tab 5 mg Tablet - - - -
279 Prednison Tab 5 mg (Holi Pharma) Tablet 3,194 - 3,194 -
280 Prednison Tab 5 mg Tablet - - - -
281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - -
282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 600 - 600 -
283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - -
284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 1,836 - 1,836 -
285 0 0 - - - -
286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - - -
289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 320 - 320 -
290 Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - - -
291 Nebule 285 - 285 -
292 (COMBIVENT)
0 I dan II 0 - - - -
293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - - -
294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet - - - -
295 Salep Pot 64 - 64 -
296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - - -
297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - - -
298 Salisil Bedak Serbuk 2% Pcs - - - -
299 Salisil Bedak Serbuk 2% Pcs - - - -
300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - -
301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 2 - 2 -
302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - -
303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 50 - 50 -
304 Setirizin Tab 10 mg (Futamed) Tablet 20 - 20 -
305 Setirizin Tab 10 mg (Futamed) Tablet - - - -
306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 1,178 - 1,178 -
307 Simvastatin Tablet 10 mg Tablet - - - -
308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
309 0 0 - - - -
310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - -
311 Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% Botol 25 - 25 -
312 Botol - - - -
313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - - -
314 Thiamin/ Vitamin B1 50 mg Tablet - - - -
315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - - -
316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 928 - 928 -
317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - -
318 Thiamphenicol Kapsul 500 mg Tablet - - - -
319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 29 - 29 -
320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - - -
321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek - - - -
322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - - -
323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - - -
324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
327 0 0 - - - -
328 0 0 - - - -
329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - -
335 Diazepam Tablet 5 mg (VALISANBE) Tablet 31 - 31 -
336 Diazepam Tablet 5 mg Tablet - - - -
337 Fenobarbital Tablet 30 mg Tablet - - - -
338 Fenobarbital Tablet 30 mg Tablet - - - -
339 Fenobarbital Tablet 30 mg tablet - - - -
340 Kodein Tablet 10 mg Tablet - - - -
341 0 0 - - - -
342 Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON Tablet - - - -
343 Tablet - - - -
344 (Meprofarm)
0 0 - - - -
345 0 0 - - - -
346 0 0 - - - -
347 Primaquin 15 mg tablet tablet - - - -
348 0 0 - - - -
OBAT - OBAT PROGRAM 0 - - - -
OBAT PROGRAM KECACINGAN 0 - - - -
349 Albendazol Tablet 400 mg Tablet 262 - 262 -
350 Albendazol Tablet 400 mg Tablet - - - -
OBAT PROGRAM DIARE 0 - - - -
351 Garam Oralit (Kimia Farma) Tablet - - - -
352 Garam Oralit (Kimia Farma) Tablet 895 - 895 -
353 Garam Oralit (Kimia Farma) sachet - - - -
354 Garam Oralit (Kimia Farma) sachet - - - -
355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - - -
356 Botol 50 - 50 -
357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - -
358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - - -
359 Zinc Dispersible 20 mg tablet tablet - - - -
360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 5,199 - 5,199 -
362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
363 0 0 - - - -
OBAT PROGRAM HEPATITIS 0 - - - -
364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
OBAT PROGRAM TB PARU 0 - - - -
369 OAT FDC Kategori Anak Kit - - - -
370 OAT FDC Kategori Anak Kit - - - -
371 OAT FDC Kategori Anak Kit - - - -
372 OAT FDC Kategori I - IIII Kit - - - -
373 OAT FDC Kategori I - IIII Kit - - - -
374 OAT FDC Kategori II Kit - - - -
375 OAT FDC Kategori II Kit - - - -
376 OAT FDC Kategori II Kit - - - -
377 OAT FDC Kombipak Kategori I Kit - - - -
378 0 0 - - - -
379 Isoniazid 100 mg tablet tablet - - - -
OBAT POGRAM KUSTA 0 - - - -
380 MDT MB Anak Blister - - - -
381 MDT MB Anak Blister - - - -
382 MDT MB Dewasa Blister - - - -
383 MDT MB Dewasa Blister - - - -
384 MDT MB Dewasa Blister - - - -
385 MDT PB Anak Blister - - - -
386 MDT PB Anak Blister - - - -
387 MDT PB Anak Blister - - - -
388 MDT MB Dewasa Blister - - - -
389 MDT PB Dewasa Blister - - - -
OBAT PROGRAM GIZI 0 - - - -
390 Mineral Mix Kombinasi sachet - - - -
391 Mineral Mix Kombinasi sachet - - - -
392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - -
393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 70 - 70 -
394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - -
395 Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
396 Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul - - - -
398 Tablet Tablet - - - -
399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Tablet - - - -
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros)
400 tablet - - - -
401 0,4
0 Mg Tab (Phapros) 0 - - - -
402 0 0 - - - -
OBAT PROGRAM KESGA 0 - - - -
403 Calcii Gluconas Inj (Ethica) Ampule 10 - 10 -
404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 2 - 2 -
405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - -
406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - -
407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 50 - 50 -
410 Oksitetrasiklin 1 % Salep Mata Tablet - - - -
411 Metilergometrin Maleat Tablet 0,125 mg Tablet 630 - 630 -
412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 172 - 172 -
414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
OBAT PROGRAM JIWA 0 - - - -
416 Amitriptilin 25 mg Tablet - - - -
417 Amitriptilin 25 mg Tablet - - - -
418 Amitriptilin 25 mg Tablet - - - -
419 Amitriptilin 25 mg Tablet 160 - 160 -
420 Amitriptilin 25 mg Tablet - - - -
421 Clozapine 25mg (OGB Dexa) Tablet - - - -
422 Clozapine 100 mg Tablet - - - -
423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - -
427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - -
428 Flufenazin sikzonoate inj 5 ml vial - - - -
429 Flufenazin sikzonoate inj 5 ml Vial - - - -
430 Haloperidol 5 mg tablet Tablet - - - -
431 Haloperidol 5 mg tablet Tablet 2,945 - 2,945 -
432 Haloperidol 5 mg tablet Tablet - - - -
433 0 0 - - - -
434 Haloperidol Injeksi 5 mg/ml ampule - - - -
435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - -
436 Haloperidol/ Lodomer drops 2 mg Botol - - - -
437 Karbamazepin Tablet 200 mg Tablet - - - -
438 Karbamazepin Tablet 200 mg Tablet - - - -
439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - 3 -
440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - - -
442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 2,957 - 2,957 -
443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
444 0 0 - - - -
445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - -
446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - -
447 Risperidon Tab 2 mg Tablet 914 - 914 -
448 Risperidon Tab 2 mg Tablet - - - -
449 0 0 - - - -
450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - -
451 0 0 - - - -
452 Triheksifenidil Tablet 2 mg (Mersi) Tablet 121 - 121 -
453 Triheksifenidil Tablet 2 mg Tablet 3,000 - 3,000 -
454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - -
455 0 0 - - - -
456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - -
457 0 0 - - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - - -
458 BCG vial 39 10 49 -
459 PELARUT BCG ampul 39 10 49 -
460 BCG vial - - - -
461 BCG vial - - - -
462 CAMPAK 10ds (MR) vial 49 - 49 -
463 PELARUT CAMPAK ampul 89 - 89 -
464 CAMPAK 10ds (MR) vial 52 - 52 -
465 CAMPAK 10ds (MR) vial - - - -
466 DPT HB - Hib/ PENTABIO vial 82 20 102 -
467 DPT HB - Hib/ PENTABIO vial - - - -
468 DT vial - - - -
469 0 0 - - - -
470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 50 - 50 -
471 HB UNIJECT/ HB - ADS / HEPATITIS B vial 60 30 90 -
472 POLIO bOPV 10 ds vial 20 30 50 -
473 DROPPER POLIO dropper 63 30 93 -
474 POLIO bOPV 10 ds vial 43 - 43 -
475 POLIO bOPV 10 ds vial - - - -
476 Td vial 9 - 9 -
477 0 0 - - - -
478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - -
479 POLIO bOPV 10 ds vial - - - -
480 Vaksin Meningtis vial - - - -
481 CAMPAK 10ds (MR) BIAS vial - - - -
482 PELARUT CAMPAK BIAS ampul - - - -
483 POLIO bOPV 10 ds vial - - - -
484 IPV vial - - - -
485 VTM Include Dacron (Biofarma) pcs - - - -
486 Vaksin Rabies (Verorab) vial - - - -
487 0 0 - - - -
488 0 0 - - - -
489 0 0 - - - -
OBAT PROGRAM HIV/ AIDS 0 - - - -
490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - -
491 0 0 - - - -
492 Isoniazid (INH) Tablet 300 mg Tablet 260 - 260 -
493 0 0 - - - -
494 Lamivudine 150 mg Tablet - - - -
495 Lamivudine 150 mg Tablet - - - -
496 Nevirapine 200 mg Tablet - - - -
497 Nevirapine 200 mg Tablet - - - -
498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - -
499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - - -
500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - - -
501 FDC Dewasa Tablet - - - -
502 FDC Dewasa
Tenofovir 300 mg Tablet - - - -
503 Tenofovir 300 mg Tablet - - - -
504 Zidofudine 100 mg (ZDV) Tablet - - - -
505 Zidofudine 100 mg (ZDV) Tablet - - - -
506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
508 Efavirenz 600 mg tablet tablet - - - -
509 Efavirenz 600 mg tablet tablet - - - -
510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - - -
512 Tablet - - - -
FDC Dewasa
513 0 0 - - - -
514 MB Anak blister - - - -
515 0 0 - - - -
516 0 0 - - - -
517 0 0 - - - -
518 0 0 - - - -
519 0 0 - - - -
520 0 0 - - - -
521 0 0 - - - -
522 0 0 - - - -
523 0 0 - - - -
524 0 0 - - - -
525 0 0 - - - -
526 0 0 - - - -
527 0 0 - - - -
528 0 0 - - - -
529 0 0 - - - -
BMHP 0 - - - -
530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - -
531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 14 - 14 -
532 0 0 - - - -
533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs 2,535 - 2,535 -
535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 1,000 - 1,000 -
537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - -
538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - -
540 Alat Suntik Sekali Pakai 20 ml Pcs - - - -
541 Alkohol 70% Medika (Kimia Farma) 0 - - - -
542 Alkohol 70% (Medika) Btl 1000 ml - - - -
543 Alkohol Swab 2 - ply (one med) 0 - - - -
544 Alkohol Swab 2 - ply (one med) Pcs 500 - 500 -
545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - - - -
546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - -
547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 120 - 120 -
548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - - -
549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - - -
550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Pcs - - - -
551 Phsda 0 - - - -
552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - -
553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - - -
554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
556 Fixomull Strech 5 cm X 5 m Pcs - - - -
557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 23 - 23 -
558 Foley Catheter 2 Way Ch 16,18 Pcs - - - -
559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - -
560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - 5 -
561 Mantel Gown (Bisa Dicuci) biji - - - -
562 I.V Catheter No. 18 (JELCO) Pcs - - - -
563 I.V Catheter No. 18 (NIPRO) Pcs 73 - 73 -
564 I.V Catheter No. 20 JELCO Pcs - - - -
565 I.V Catheter No. 20 TERUMO Pcs 150 - 150 -
566 I.V Catheter No. 20 JELCO Pcs - - - -
567 I.V Catheter No. 22 NIPRO Pcs - - - -
568 I.V Catheter No. 22 NIPRO Pcs 249 - 249 -
569 I.V Catheter No. 24 TERUMO Pcs 151 - 151 -
570 I.V Catheter No. 24 TERUMO 0 - - - -
571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - - -
572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 100 - 100 -
573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 400 - 400 -
575 Pcs - - - -
576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - - -
577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 10 - 10 -
578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - -
579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - - -
580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 8 - 8 -
581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - -
582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - - -
583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 50 - 50 -
584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - -
585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - - -
586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 90 - 90 -
587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - -
588 Masker Ear Loop (Masker) Pcs - - - -
589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - -
590 Masker General Care (MARCOTILA) Pcs - - - -
591 0 0 - - - -
592 Masker N95 Disposibel Pcs - - - -
593 Masker N95 Disposibel (One Med) Pcs - - - -
594 Masker Tali Pcs - - - -
595 Masker Tali Pcs - - - -
596 Masker Elastic Pcs - - - -
597 Media Sample Container Pcs 120 - 120 -
598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - -
599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - -
600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - - -
601 Nurse Cup (Tutup Kepala) Pcs 50 - 50 -
602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - -
603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - -
604 Plesterin Bulat Non Woven (One Med) Pcs - - - -
605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 23 - 23 -
606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 54 - 54 -
607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 9 - 9 -
608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - -
609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - - -
610 0 0 - - - -
611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - -
612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - -
613 0 0 - - - -
614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair 100 - 100 -
615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - -
616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - - -
617 Sarung Tangan size M dan L (Exam Glove) PAir - - - -
618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 300 - 300 -
619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - -
620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 48 - 48 -
621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - -
622 0 0 - - - -
623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - -
624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1 -
625 Underpad 90x 0 cm cosmo I Pcs 25 - 25 -
626 Underpad 90x 0 cm cosmo II Pcs - - - -
627 0 0 - - - -
628 Urine Bag Sterile Standard Pcs 13 - 13 -
629 Urine Bag Sterile Standard (AXIMED) Pcs - - - -
630 0 0 - - - -
631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - -
REAGEN 0 - - - -
632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - -
633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - -
634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 600 - 600 -
635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - -
636 Antimonoclonal A (Anti A) 10 ml Btl - - - -
637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - -
638 Antimonoclonal B (Anti B) 10 ml Btl - - - -
639 0 0 - - - -
640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - -
641 Cholesterol Test Strip (Human Humasens Plus) 0 - - - -
642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - -
643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - -
644 Glucose Test Strip (Human Humasens plus) Tes - - - -
645 Glucose Test Strip (Human Humasens plus) II Tes - - - -
646 Hemoglobin Strip 50 test mission (Acon) Pcs 1 - 1 -
647 Hemoglobin Strip 50 test mission (Acon) 0 - - - -
648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - -
649 0 0 - - - -
650 Reagen HBsAg Strip (FOKUS) Test - - - -
651 0 0 - - - -
652 TPHA (Fokus) Test - - - -
653 0 0 - - - -
654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - -
655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - -
BMHP (PROGRAM) PROPINSI 0 - - - -
PROGRAM MALARIA 0 - - - -
656 RDT Malaria Test - - - -
PROGRAM SYPHILIS 0 - - - -
657 RPR Syphilis Pcs - 100 100 -
658 RPR Syphilis tahap II (FOKUS) Pcs - - - -
659 Syphilis 3.0 06FK10 SD Bioline Test
Test - 300 300 -
660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - - -
661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
662 0 0 - - - -
663 Tuberkulin Vial - - - -
664 RDT Lepto (Uji Leptospira IgM) test - - - -
665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - -
666 0 0 - - - -
667 0 0 - - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - - -
668 Test - - - -
669 Reagen HBsAg Strip SD Test - - - -
670 Reagen HBsAg Strip SD Test - 350 350 -
671 Reagen HBsAg Strip SD Test - - - -
672 0 0 - - - -
673 0 0 - - - -
674 0 0 - - - -
675 0 0 - - - -
PROGRAM TB PARU 0 - - - -
676 Box Slide Pcs - - - -
677 Box Slide Pcs - - - -
678 Catridge Genexpart Test - - - -
679 Catridge Genexpart Test - - - -
680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - -
681 Oil Emersi Botol - - - -
682 Pot Spuntum/Pot Dahak Steril Pcs - - - -
683 Pot Spuntum/Pot Dahak Steril Pcs - - - -
684 Pot Spuntum/Pot Dahak Steril Pcs - - - -
685 Pot Spuntum/Pot Dahak Steril Pcs - - - -
686 Reagen Control CD4 0 - - - -
687 Reagen Control CD4 0 - - - -
688 Reagen Zeil Nelseen Kit - - - -
689 Reagen Zeil Nelseen Kit - - - -
690 Reagen Zeil Nelseen Kit - - - -
691 Reagen Zeil Nelseen Kit - - - -
692 Slide Pcs - - - -
693 Slide/ Object Glass Pcs - - - -
694 Stereofoam pcs - - - -
695 Masker N 95 TB pcs - - - -
696 Masker Tali Bedah TB pcs - - - -
OBAT PROGRAM IMUNISASI 0 - - - -
697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - -
703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
708 0 0 - - - -
709 0 0 - - - -
710 0 0 - - - -
711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 286 - 286 -
712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
714 0 0 - - - -
715 Safety Box 5 L Pcs - - - -
716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
717 0 0 - - - -
718 0 0 - - - -
719 0 0 - - - -
720 0 0 - - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - - -
721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test - 50 50 -
722 Tahap I 0 - - - -
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold)
723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - - -
724 Tahap I 0 - - - -
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test - 50 50 -
726 Tahap I 0 - - - -
727 Tahap
Kondom I Pcs - - - -
728 DBS Collection/ Lasec Pcs - - - -
729 Lubricant Pcs - - - -
730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - - -
731 Test - 900 900 -
732 IRapid HIV 1/2 3.0 SD Bioline test - - - -
733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - - -
734 Test - - - -
735 Tahap
ReagenI HIV (SD) R 1 Test - - - -
736 Reagen HIV (SD) R 1 Test - - - -
737 0 0 - - - -
738 Reagen HIV (VIKIA) R 3 Test - - - -
739 0 0 - - - -
740 Reagen HIV R2 (Rapid Test) FOKUS Test - - - -
741 0 0 - - - -
742 Reagen HIV R3 (VIKIA) Test - - - -
743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - -
744 Sarung Tangan Non Steril Pair - - - -
745 0 0 - - - -
746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - -
747 VTM Include Swab Test - - - -
748 Masker Bedah 3 ply Pcs - - - -
749 0 0 - - - -
750 0 0 - - - -
751 0 0 - - - -
752 0 0 - - - -
753 0 0 - - - -
754 0 0 - - - -
755 0 0 - - - -
756 0 0 - - - -
757 0 0 - - - -
758 0 0 - - - -
759 0 0 - - - -
760 0 0 - - - -
761 0 0 - - - -
762 0 0 - - - -
763 0 0 - - - -
764 0 0 - - - -
OKSIGEN MEDICAL 0 - - - -
765 Oksigen 3 m3 Tampon - - - -
766 Oksigen 6 m3 Tampon - - - -
767 Oksigen 1 m3 Tampon - - - -
768 Oksigen 6 m3 Tampon - - - -
769 Nurse Cup (Tutup Kepala) One Med 0 - - - -
770 0 0 - - - -
771 0 0 - - - -
772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - -
TAMBAHAN IFK 0 - - - -
1 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - -
2 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
3 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex Tablet - - - -
4 Tablet - - - -
5 Thiamphenicol Syr. 0 - - - -
6 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - -
7 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
8 Ranitidin Injeksi 25 mg/ 2 ml Ampule - 300 300 -
9 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - -
10 Ketokonazole 200 mg Tablet - - - -
11 Kotrimoksazol Forte Tablet - - - -
12 Infusion set anak Pcs 50 - 50 -
13 Alat Suntik 10 cc Pcs - - - -
14 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
15 Omeprazole Kapsul 20 mg Tablet - - - -
16 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - - - -
17 Setirizin Tab 10 mg (Futamed) Tablet - - - -
18 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
19 Oseltamivir 75 mg Kapsul - - - -
20 Ringer Laktat cairan infus @ 500 ml RL Botol - - - -
21 Amitriptilin 25 mg Tablet - - - -
22 I.V Catheter No. 24 TERUMO pcs - - - -
23 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - 1 1 -
24 RDT COVID - 19 0 - - - -
25 Oseltamivir 75 mg 0 - - - -
26 Klorokuin
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - - -
27 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - - -
28 Viruses) 0 - - - -
29 Viruses)
Masker N95 (Particulate Respirator) 0 - - - -
30 Hazmat/ APD/ Hazmat PPK 0 - - - -
31 Medical Sample Container Pcs - - - -
32 Cepheid Pcs - - - -
33 Natrium Klorida Larutan infus 0,9% @100ml 0 - - - -
34 Tambah Darah drop (Ferriz Drop) pcs - - - -
35 Tambah Darah Sirup (Ferriz Sirup) pcs - - - -
36 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - -
37 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
38 Obat Batuk Sirup / INADRYL Botol - - - -
39 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - - -
40 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - - -
41 dextromethorpan Hbr Tablet - - - -
42 Influenza
Masker Bedah /Bima Sakti pCS - - - -
43 Masker Bedah /Rania pCS - - - -
44 Masker N 95 Bima Sakti PCS - - - -
45 Sarung tangan panjang steril / meditouche perpasang 0 - - - -
46 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - -
47 Albendazol Suspensi 200mg/ 5 ml botol - - - -
48 I.V Catheter No. 24 (BRAUN) pcs - - - -
49 OAT FDC Kategori Anak 0 - - - -
50 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - -
51 Apron Lengan Panjang Putih (Rannia) 0 - - - -
52 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - -
53 0 0 - - - -
54 0 0 - - - -
55 0 0 - - - -
56 0 0 - - - -
57 0 0 - - - -
58 0 0 - - - -
59 0 0 - - - -
60 APD Set (Rannia) 0 5 - 5 -
61 Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5 -
62 Cover
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 4 - 4 -
63 0 - - - -
64 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - - -
65 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - -
66 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - -
67 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - - -
68 Sarung tangan non steril M,L (COBRA) box @100 pcs 1,900 3,000 4,900 -
69 Masker N95 Covid 19 Pcs - - - -
70 Masker Tali Bedah 3 ply Covid 19 Pcs - - - -
71 Masker Eaerlop Hijab Pcs 2,000 - 2,000 -
72 Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - 1 -
73 Hand Sanitzer 1 Botol = 20 Liter 2 - 2 -
74 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - - -
75 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs - - - -
76 KIT A1 Operasi Steril (RAJAWALI) Pcs - - - -
77 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - - -
78 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - 2 -
79 Masker Face/ Masker Bedah (COBRA 1) pcs 200 - 200 -
80 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - -
81 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - -
82 Masker Face/ Masker Bedah (COBRA 2) pcs - 1,200 1,200 -
83 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - -
84 Masker KN95 (Farmahusada) Box @50 pcs 20 - 20 -
85 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - -
86 Rapid Test SARS COV 2 (Farmahusada) Test 21 - 21 -
87 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - -
88 Masker KN95 (Anugrah Sentosa Abadi) pcs - - - -
89 APRON (Atmosfer) pcs 150 - 150 -
90 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - -
91 Hand Sanitzer 2 liter - - - -
92 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - -
93 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 34 - 34 -
94 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - -
95 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - -
96 Face Shield (COBRA) 0 - - - -
97 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
98 Kit Steril (Rajawali) 0 - - - -
99 Alkohol II @20 Liter 0 - - - -
100 Cover All (Rajawali) 0 - - - -
101 Face Shield (ATMOSFER) 0 - - - -
102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
103 Masker Earloop (KasaHusada) 0 - - - -
104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - -
105 Rapid Test Covid-19 (Rajawali) 0 - - - -
106 Rapid Test Covid-19 (Dakonan) 0 - - - -
107 Alkohol Swab (BTT) 0 - - - -
108 Antiseptic Gel 500 0 - - - -
109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - 5,400 5,400 -
110 Kaca mata Goggle (HASTEN) 0 - - - -
111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - -
112 Masker Bedah Hijau @50pcs 0 - - - -
113 Masker N95 3M 8210 (Hazten) 0 - - - -
114 Nurse Cap Green om 100bh 0 - - - -
115 Parafilm (Anugerah Sentosa Abadi) 0 - - - -
116 Rapid Test (1.000) Widhi Dharma Adi 0 - - - -
117 Sarung tangan Safeglove Exam M 100bh 0 - - - -
118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - -
119 Sterlisasi Swab stik (5box/ VTM) 0 - - - -
120 Stereofoam (Anugerah Sentosa Abadi) 0 - - - -
121 Universal Transport Media (UTM) Goongdong 0 - - - -
122 Universal Transport Media (UTM) Sekarguna 0 - - - -
123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - -
124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - -
125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - - -
126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - -
127 Rapid Test Lecurate (Bima Sakti) 0 - - - -
128 Rapid Test ZYBIO (Farma Husada) 0 - - - -
129 Alkohol 96 % Liter - - - -
130 0 0 - - - -
0 0 - - - -
TAMBAHAN PUSKESMAS 0 - - - -
1 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - - -
2 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - - -
3 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube - - - -
4 pcs - - - -
5 Zeneca)
0 0 - - - -
6 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - -
7 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 552 - 552 -
8 Gentamycin Krim 1 % mg/ ml Tube - - - -
9 0 0 - - - -
10 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - - -
11 Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - - -
12 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
13 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 300 - 300 -
14 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
15 Thiamin/ Vitamin B1 50 mg Tablet - - - -
16 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - - -
17 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
18 Antimicrobial Liquid Soap 500 ml (Viorex) 0 4 - 4 -
19 Hand Sanitizer 450 ml (Meditol) 0 - - - -
20 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
21 I.V Catheter No. 18 (JELCO) Pcs - - - -
22 I.V Catheter No. 22 NIPRO Pcs - - - -
23 I.V Catheter No. 24 TERUMO Pcs - - - -
24 Materniti Napkin Slim L 0 - - - -
25 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - - -
26 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - - -
27 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - - -
28 Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1 -
29 Haloperidol 5 mg tablet Tablet - - - -
30 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - -
31 Fixomull Strech 5 cm X 5 m Pcs - - - -
32 Umbilical crd clamp 0 126 - 126 -
33 0 0 - - -
34 0 0 - - -
35 0 0 - - -
36 0 0 - - -
37 0 0 - - -
38 0 0 - - -
39 0 0 - - -
40 0 0 - - -
41 0 0 - - -
42 0 0 - - -
43 0 0 - - -
44 0 0 - - -
45 0 0 - - -
46 0 0 - - -
47 0 0 - - -
48 0 0 - - -
49 0 0 - - -
50 0 0 - - -
51 0 0 - - -
52 0 0 - - -
53 0 0 - - -
54 0 0 - - -
55 0 0 - - -
56 0 0 - - -
57 0 0 - - -
58 0 0 - - -
59 0 0 - - -
60 0 0 - - -
0 0 - - -
TOTAL - - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Mengetahui Yang Menyerahkan,
Plt. KEPALA DINAS KESEHATAN TERTULIS 2 KALI KEPALA INSTALASI FARMASI KABUPATEN
KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN Dra. TRI MUSYAROFAH, Apt

NIP. 19630724 198910 1 002 NIP. 19630411 199203 2 005
AR PERMINTAAN OBAT

: BULAN
: TAHUN

SUMBER HARGA STOK NILAI

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN Ket
ANGGARAN SATUAN OPTIMUM PENERIMAAN

UNIT RP

- DAK 18/Okt.19 99.000 0.00 0.000

5 DAK 19/Sept.21 105.000 525.00 0.000

- DAK 20/ Jan 22 105.000 0.00 0.000

- - 0.000 0.00 0.000
- DAK 19/Feb.22 2,860.000 0.00 0.000
DAK 20/ 16 -
180 2,860.000 514,800.00 0.000
Des 22
- DAK 18/Apr.20 10,500.000 0.00 0.000
950 DAK 19/Mei 23 104.000 98,800.00 0.000
- DAK 20 L 220.000 0.00 0.000
2,000 DAK 19/Juni 21 93.500 187,000.00 0.000
- DAK 17/AGSTS- - 0.000 0.00 0.000
- 2,998.000 0.00 0.000
- 20 - 0.000 0.00 0.000
- Dak 19/Okt. 20 93.000 0.00 0.000
2,724 Dak 20/Okt 21 99.000 269,676.00 0.000
- - 0.000 0.00 0.000
30,008 DAK 17/NOV-21 190.000 5,701,520.00 0.000
- DAK 18/Okt.20 233.000 0.00 0.000
- DAK 19/Feb 21 233.000 0.00 0.000
- DAK 20/ April 22 249.000 0.00 0.000
 - - 0.000 0.00 0.000
264 DAK 19/Agst.22 3,025.000 798,600.00 0.000
- DAK 20 L 3,025.000 0.00 0.000
- DAK 19/JULI 21 4,400.000 0.00 0.000
- DAK 20/ Mart 22 3,628.000 0.00 0.000
- DAK 18L/Mar.20 10,246.500 0.00 0.000
- PRBG 20 9,900.000 0.00 0.000
- DAK 17/MAR-20 8,500.000 0.00 0.000
291 DAK 20 / Mei-23 8,237.000 2,396,967.00 300 2,471,100.000
- - 0.000 0.00 0.000
50 DAK 19/Sept. 23 4,950.000 247,500.00 0.000
- - 0.000 0.00 0.000
- DAK 17/APR-19 440.000 0.00 0.000
- DAK 18L/Agst.20 220.000 0.00 0.000
3,236 DAK 19/Mei20
PRSpesifik 21 165.000 533,940.00 0.000
- 58.000 0.00 0.000
- non covid-19/ - 0.000 0.00 0.000
- DAK 18/Apr-22 3,035.000 0.00 0.000
- - 0.000 0.00 0.000
24 DAK 19/ Juni 23 4,496.000 107,904.00 0.000
- - 0.000 0.00 0.000
- DAK
Buffer Prop.20 - 3,045.000
16/APR-20 0.00 0.000
- 198.000 0.00 0.000
- Covid-19
DAK 18L/Jan.21 1,485.000 0.00 0.000
- PRSpesifik L 20/ 1,551.000 0.00 0.000
2,968 DAK 19/Sept.21 105.000 311,640.00 0.000
- DAK 20/Juni 22 105.000 0.00 0.000
- DAK
DAK 17/Jan-21
17/AGSTS- 1,050.000 0.00 0.000
- 67.000 0.00 0.000
- 20
DAK 20/Feb 22 75.000 0.00 0.000
- DAK 19/MAR-22 103.000 0.00 0.000
- DAK 20 L 253.000 0.00 0.000
- 0 0.000 0.00 0.000
3 DAK 19/Feb.22 2,076.000 6,228.00 0.000
- 0 0.000 0.00 0.000
226 DAK 19/Feb.22 1,584.000 357,984.00 0.000
- 0 0.000 0.00 0.000
125 DAK 18L/Apr.22 2,915.000 364,375.00 0.000
- DAK 19/Juni 22 2,750.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 18/Mei.22 380.000 0.00 0.000
200 DAK 19/Des.22 380.000 76,000.00 0.000
 - DAK 20/Des 23 405.000 0.00 0.000
- Dak
DAK19/Feb 21
20/31-Okt 1,639.000 0.00 0.000
- 1,639.000 0.00 0.000
- 21
DAK 18/Apr 23 136.000 0.00 0.000
- DAK20
DAK 19/Apr 23
/Nov22, 152.000 0.00 0.000
1,675 145.000 242,875.00 0.000
- Mart
DAK 23
PRSpesifik 20 110.000
19/Jan 21 0.00 0.000
- 110.000 0.00 0.000
- Non
DAK Covid-19/
18/Feb.20 3,350.000 0.00 0.000
- DAK 19/Feb.20 3,350.000 0.00 0.000
203 DAK 20/Okt 21 3,350.000 680,050.00 0.000
- DAK 17/JUL-19 300.000 0.00 0.000
- DAK 20/Feb 24 5,900.000 0.00 0.000
- DAK 19/ 626.000 0.00 0.000
- DAK 20 L 18,150.000 0.00 0.000
- DAK 19/Agst. 20 7,602.000 0.00 0.000
- DAK 19/Apr.20 7,124.000 0.00 0.000
- 0 0.000 0.00 0.000
- DAK 19/Jan 21 149,266.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 19/Mei 24 5,280.000 0.00 0.000
830 DAK 19/Juni 24 660.000 547,800.00 0.000
- PRBG 20/ 671.000 0.00 0.000
- DAK 17/MAR-19 4,282.000 0.00 0.000
62 DAK 19/Mar.21 11,000.000 682,000.00 0.000
- PRSpesifik L 20/ 10,098.000 0.00 0.000
- DAK 19/Okt.21 2,805.000 0.00 0.000
17 DAK
DAK 19/Apr.21
20/ Des 21, 1,097.000 18,649.00 0.000
200 1,097.000 219,400.00 0.000
1,079 Feb
DAK2219/Juni 21 60.500 65,279.50 0.000
- DAK 20 L 66.000 0.00 0.000
- DAK 18/Nov 19 10,400.000 0.00 0.000
- DAK 18L/Agst.20 9,900.000 0.00 0.000
255 DAK 19/Juni 22 1,095.000 279,225.00 0.000
- - 0.000 0.00 0.000
161 DAK 17/APR-21 104.000 16,744.00 0.000
- DAK 19/Nov.20 104.000 0.00 0.000
- DAK 20/ 104.000 0.00 0.000
1,470 DAK 19/Nov.20 105.000 154,350.00 0.000
- DAK 19/Mar.24 112.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 19/JULI21 4,400.000 0.00 0.000
 - DAK 20/Feb 22 2,700.000 0.00 0.000
120 DAK 19/Juni 21 165.000 19,800.00 0.000
- DAK 20/Mart 23 91.000 0.00 0.000
- DAK 18/Des 20 1,408.000 0.00 0.000
25 DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 35,200.00 0.000
- Buffer 1,408.000 0.00 0.000
- Aprl 21 Prop 730.000 0.00 0.000
200 19/Mei
DAK 20/ 20Mei 21 770.000 154,000.00 0.000
- DAK
DAK 19/Des.23
17/SEPT- 391.000 0.00 0.000
- 4,167.000 0.00 0.000
- 20
DAK
Buffer17/AGS-19
Prop.19/ 3,550.000 0.00 0.000
- 3,682.000 0.00 0.000
93 Feb 20 /31-Des
DAK 20
3,682.000 342,426.00 0.000
- 21;Jan 22
DAK 17/Apr.19 691.000 0.00 0.000
115 DAK 18/Apr.21 710.000 81,650.00 0.000
- DAK 17/ JAN-20 0.000 0.00 0.000
- DAK
DAK 18/Des.19 1,333.000 0.00 0.000
- 1,333.000 0.00 0.000
- Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.00 0.000
- DAK 20/Mei 22 82.000 0.00 0.000
- DAK 18/Mei 21 4,232.000 0.00 0.000
- DAK 19/Sept.22 4,232.000 0.00 0.000
112 DAK 20/Feb 23 4,232.000 473,984.00 0.000
- DAK 19/Juni 22 2,750.000 0.00 0.000
- DAK 20 L 4,400.000 0.00 0.000
56 DAK 17/DES-20 2,900.000 162,400.00 0.000
5,531 DAK 19/Feb 24 119.000 658,189.00 0.000
- DAK 20/ Feb 22 119.000 0.00 0.000
- DAU 19/Mei
DAK PR BG 23 77.000 0.00 0.000
6,815 COVID 20/ Agsts 99.000 674,685.00 0.000
120 DAK 19/Mei 22
21 7,865.000 943,800.00 0.000
14 DAK 19/Mei 21 10,010.000 140,140.00 0.000
- PRSpesifik L 20/ 10,010.000 0.00 0.000
- DAK 17/FEB-20 6,900.000 0.00 0.000
40 DAK 20/ 7,363.000 294,520.00 40 294,520.000
- APBD II - 15 132.000 0.00 0.000
1,367 DAK 16/OKT-21 149.000 203,683.00 0.000
- DAK 20 L 88.000 0.00 0.000
- DAK 18/Agst.21 2,787.000 0.00 0.000
120 DAK 19/Mei 23 2,475.000 297,000.00 0.000
- DAK 20/ Juni 23 2,475.000 0.00 0.000
- DAK 19/Jan 21 176,800.000 0.00 0.000
 10 DAK 19/Mei 21 8,800.000 88,000.00 0.000
- DAK 20 L 0.000 0.00 0.000
- DAK 19 4,665.000 0.00 0.000
188 DAK 20/ Des 21 4,665.000 877,020.00 0.000
7,900 DAK 19/JULI21 264.000 2,085,600.00 0.000
- DAK 20 L 330.000 0.00 0.000
- DAK 18L/Mar.20 660.000 0.00 0.000
- DAK 20 L 187.000 0.00 0.000
255 DAK 17/MAR-21 90.000 22,950.00 0.000
- DAK 18/Jan.22 89.000 0.00 0.000
- DAK 19/Mart.23 121.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 18/Nov.20 9,644.000 0.00 0.000
- DAK 18/Jan.21 10,696.000 0.00 0.000
- DAK 19/Jan.22 10,696.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 19/Juli 21 770.000 0.00 0.000
- - 0.000 0.00 0.000
100 DAK 18/Mar.21 1,755.000 175,500.00 0.000
6,460 DAK 19/Mei 21 187.000 1,208,020.00 0.000
- DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 0.00 0.000
- 63.000 0.00 0.000
5,206 Jan
DAK2319/Mei 24 94.600 492,487.60 0.000
- DAK 20 L 99.000 0.00 0.000
- DAK 19/Mei23 5,610.000 0.00 0.000
46 DAK 20/ Juni 23 2,518.000 115,828.00 0.000
370 DAK 19/Juli21 396.000 146,520.00 0.000
- DAK 19/Jun 21 288.000 0.00 0.000
- DAK 20/Jan 22 288.000 0.00 0.000
- DAK 19/Des.20 1,089.000 0.00 0.000
- DAK 17/SEPT-- 0.000 0.00 0.000
260 1,810.000 470,600.00 0.000
- 20 - 0.000 0.00 0.000
- DAK 17/FEB-20 10,500.000 0.00 0.000
- DAK 18L/Mei.20 17,968.500 0.00 0.000
- DAK 19/Mart21 35,200.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 18/Mei.22 22.000 0.00 0.000
7,570 DAK 19/Mar.22 77.000 582,890.00 0.000
- DAK 20/Feb 22 23.000 0.00 0.000
- DAK 17/MEI 20 2,750.000 0.00 0.000
- DAK 18L/Mei.23 495.000 0.00 0.000
1,938 DAK 19/Juni 23 440.000 852,720.00 0.000
- DAU PR BG 20/ 319.000 0.00 0.000
- DAK 19/JUN 20 2,052.000 0.00 0.000
200 DAK 20/ Mei 22 2,190.000 438,000.00 0.000
12 DAK 17/JUNI 21 13,970.000 167,640.00 0.000
20 DAK 19/Apr.21 22,550.000
PRSpesifik 451,000.00 0.000
- 23,100.000 0.00 0.000
- Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.00 0.000
49 DAK 19/Mei 21 6,600.000 323,400.00 0.000
- - 0.000 0.00 0.000
- DAK 17/JUN 21 1,937.000 0.00 0.000
380 DAK20/
DAK 19/Mei
Feb 21 2,178.000 827,640.00 0.000
- 1,222.000 0.00 0.000
200 21;Mei22
DAK 19/Juni 21 99.000 19,800.00 0.000
- DAK 20 L 330.000 0.00 0.000
146 DAK 19/Nov.21 123.000 17,958.00 0.000
- DAK 20/Okt 23 131.000 0.00 0.000
360 DAK 18L/Sept.20 4,680.500 1,684,980.00 0.000
180 DAK 19/Jan 22 4,730.000 851,400.00 0.000
- DAK 19/ 550.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 18L/Apr.20 4,950.000 0.00 0.000
77 DAK 19/Apr 21 5,500.000 423,500.00 0.000
- PRSpesifik L 20/ 3,707.000 0.00 0.000
473 DAK 19/Des.20
DAK20/28 Feb22 96.000 45,408.00 0.000
2,000 102.000 204,000.00 0.000
200 ;DAK 19/Agst. 21 143.000 28,600.00 0.000
- - 0.000 0.00 0.000
- DAK 17/APR 22 87.000 0.00 0.000
- DAK 18/Nov.20 80.000 0.00 0.000
- DAK 20 / Juni 22 121.000 0.00 0.000
- DAK19/JULI23 192.500 0.00 0.000
- DAK 20 L 275.000 0.00 0.000
- DAK 19/Nov 20 8,110.000 0.00 0.000
- DAK 20/ 8,110.000 0.00 0.000
- DAK 18L/Okt.20 14,318.700 0.00 0.000
- DAK 19/Feb 21 5,500.000 0.00 0.000
870 DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 1,818,300.00 0.000
- 5,000.000 0.00 0.000
- 19
DAK 19/FEB 21 4,400.000 0.00 0.000
PRSpesifik
- 1,265.000 0.00 0.000
- Dokter Muter 20
DAK 17/APR 20 990.000 0.00 0.000
 62 DAK 19/Apr.21 13,200.000
PRSpesifik 818,400.00 0.000
- 13,167.000 0.00 0.000
- Dokter Muter 20 2,332.000
DAK 18L/Des.19 0.00 0.000
- DAK 18L/Okt.21 528.000 0.00 0.000
- PRSpesifik L 20/ 594.000 0.00 0.000
25,300 DAK 17/FEB 21 835.000 21,125,500.00 21,700 18,119,500.000
- DAK 19/OKT20 115.000 0.00 0.000
660 DAK 19/Des 20 123.000 81,180.00 0.000
- DAK20/ 123.000 0.00 0.000
- DAK 17/JUN 21 6,410.000 0.00 0.000
- DAK 18/Feb.22 6,410.000 0.00 0.000
70 PRSpesifik 20
DAK19/Jan 22 132.000 9,240.00 0.000
- Non Covid-19/ 3,948.000 0.00 0.000
- DAK2118L/Des.20 23,141.800
Okt 0.00 0.000
11 DAK 19/Juli 21 19,800.000 217,800.00 0.000
27 DAK 18/Agst.20 560.000 15,120.00 0.000
- DAK 19/Juli 23 560.000 0.00 0.000
- DAK20/Sep 23 598.000 0.00 0.000
- DAK 19/Apr 21 12,100.000 0.00 0.000
- DAK 19/Mart.21 24,860.000 0.00 0.000
- DAK 19/ Agst. 21 9,955.000
PRSpesifik 0.00 0.000
- DAK 16/AGSTS 25,597.000 0.00 0.000
- Dokter Muter 20 160.000 0.00 0.000
500 20
DAK 19/Juli 21 1,070.000 535,000.00 0.000
- DAK 20 1,124.000 0.00 0.000
- DAK 19/Mei 22 715.000 0.00 0.000
- DAK 18L/Jul.20 432.300 0.00 0.000
- DAK19/
PRSpesifik 437.800 0.00 0.000
- 418.000 0.00 0.000
- Dokter Muter 20 357.500
DAK 19/JUNI22 0.00 0.000
- PRSpesifik L 20/ 495.000 0.00 0.000
- DAK 18L/Sept.22 789.800 0.00 0.000
- DAK 19 1,181.000 0.00 0.000
300 DAK 20/ Des 22 1,181.000 354,300.00 0.000
1,000 DAK
Hibah19/Des
RSUD 20 53.000 53,000.00 0.000
- 56.000 0.00 0.000
- Pasirian
Buffer Prop 20/ 53.000 0.00 0.000
34 DAK 17/JUN 20 20,700.000 703,800.00 0.000
89 DAK 19/Feb 21 11,825.000 1,052,425.00 0.000
- DAK 20/Agust 22 11,825.000 0.00 0.000
62 DAK19/Apr 21 963.600 59,743.20 0.000
- DAK 20 L 115.500 0.00 0.000
 19 DAK 19/Juli 21 4,400.000 83,600.00 0.000
- DAK 20 L 132.000 0.00 0.000
3,084 DAK 19/Sept.21 123.000 379,332.00 0.000
- PRSpesifik
DAK 17/AGSTSL 20/ 6,600.000 0.00 0.000
- Buffer Prop 41,500.000 0.00 0.000
- 20 68.000 0.00 0.000
3,194 19/Agus.20
DAK 19/Jan.21 73.000 233,162.00 0.000
APBD II-16/JUL-
- 73.000 0.00 0.000
- 20
DAK 17/JUL 19 1,000.000 0.00 0.000
600 DAK 19/Nov 20 1,155.000 693,000.00 0.000
- PR BG 20/ 1,188.000 0.00 0.000
1,836 DAK 19/ 220.000 403,920.00 0.000
- - 0.000 0.00 0.000
- DAK 19/Feb22
DAK 20/24-Jan- 9,646.000 0.00 0.000
- 9,646.000 0.00 0.000
- 2023
DAK 18L/Apr.23 7,150.000 0.00 0.000
320 DAK
DAK 19/Juli 23
20/06-Jan- 7,150.000 2,288,000.00 0.000
- 7,630.000 0.00 0.000
285 2025
DAK 19/Jan 21 4,550.000 1,296,750.00 0.000
- - 0.000 0.00 0.000
- DAK 19/Nov.22 70.000 0.00 0.000
- DAK 20 L 165.000 0.00 0.000
64 DAK 18/Juni 22 2,620.000 167,680.00 0.000
- DAK 20/ 2,796.000 0.00 0.000
- DAK 18/Des.22 6,006.000 0.00 0.000
- DAK 14/MEI 19
PRSpesifik 5,170.000 0.00 0.000
- 2,200.000 0.00 0.000
- Dokter
DAK Muter 20
DAK 19/Agst.20
20/30- 479,996.000 0.00 0.000
2 512,204.000 1,024,408.00 0.000
- Agust-21
DAK
DAK 19/Sept. 20
20/30-Nov- 130,999.000 0.00 0.000
50 130,999.000 6,549,950.00 0.000
20 21
DAK 18/Apr.20 90.000 1,800.00 0.000
- DAK 19/Mei 21 90.000 0.00 0.000
1,178 DAK 19/Juni 20 110.000 129,580.00 0.000
- DAK 20/ 117.000 0.00 0.000
- DAK 18/Mar.20 265.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 19/ 6,789.000 0.00 0.000
25 DAK 20/Feb 22 6,789.000 169,725.00 0.000
- DAK 18L/DES19 13,607.000 0.00 0.000
- Retur
Buffer PKM/
Prop 310.000 0.00 0.000
- 86.000 0.00 0.000
19/Agus.21
 - DAK 19/Juli 23 132.000 0.00 0.000
928 DAK 20/Feb 22 91.000 84,448.00 0.000
- DAK 19/Juli 23 935.000 0.00 0.000
- DAK 20 L 935.000 0.00 0.000
29 DAK19/Juli 23 7,150.000 207,350.00 0.000
- DAK 17/Mei 21 7,150.000 0.00 0.000
- DAK 20 89.000 0.00 0.000
- DAK 18L/Sept.20 239.800 0.00 0.000
- DAK 17/AGST.- 0.000 0.00 0.000
- 108.000 0.00 0.000
- 18
DAK 17/FEB 21 1,045.000 0.00 0.000
Buffer Prop
- Buffer Prop 967.000 0.00 0.000
- 17/Jul.21 776.006 0.00 0.000
- 20/ /Des 22 - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 18/Feb.20 12,573.000 0.00 0.000
- DAK 19/Mar.22 12,573.000 0.00 0.000
- DAK
Buffer20/
Prop 19/ 12,573.000 0.00 0.000
- Prop 20/ 1,735.000
Buffer20 0.00 0.000
- Agsts 1,735.000 0.00 0.000
- Agsts
DAK 2020 L 19,789.000 0.00 0.000
31 DAK
PRSpesifik 20 396.000
18L/Mei.20 12,276.00 0.000
- 114.000 0.00 0.000
- non
DAK covid-19/
Buffer Prop 19/ 171.000
17/NOV-19 0.00 0.000
- 171.000 0.00 0.000
- Jun 23 Prop 20/ 171.000
Buffer 0.00 0.000
- DAK 16/APR 19 550.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 17/JUN 20 779.000 0.00 0.000
- DAK 19/Feb. 23 1,320.000 0.00 0.000
- - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- - 0.000
Buffer Prop. 20/ 0.00 0.000
- 278.300 0.00 0.000
- Mei 21 - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- Buffer Prop - 0.000 0.00 0.000
262 Buffer Prop 404.000 105,848.00 0.000
- 19/Feb 22 431.000 0.00 0.000
- 20/nov 21 - 0.000 0.00 0.000
Buffer Prop
- Buffer Prop 19 257.000 0.00 0.000
895 18/Jul.23 257.000 230,015.00 0.000
Juli 23
 Buffer Prop 20/
- 274.000 0.00 0.000
- April
DAK24 19/Agst.22 274.000 0.00 0.000
- - 0.000 0.00 0.000
50 DAK 19 /Nov 20 6,281.000 314,050.00 0.000
- DAK 18L/Sept.20
Buff Prop 19 /Mei 9,900.000 0.00 0.000
- Buff Prop 20/ 524.000 0.00 0.000
- 20 524.000 0.00 0.000
- Sept.22
DAK 18/Mart 20 524.000 0.00 0.000
5,199 DAK
DAK 19/Jan
20/Mei 21 524.000 2,724,276.00 0.000
- 524.000 0.00 0.000
- 21;Agust 22 - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK
Buffer Prop 19/ 1,325,000.000
19/Agus.20 0.00 0.000
- 1,325,000.000 0.00 0.000
- Agsts.
Hibah 19
Jember 1,325,000.000 0.00 0.000
- Buffer Prop 20/ 1,325,000.000
DAK 20/Maret 0.00 0.000
- 1,325,000.000 0.00 0.000
- 22,SEP 21 - 0.000 0.00 0.000
Buffer
- Buffer Prop 20 232,518.000 0.00 0.000
- Prop19/Juni 248,120.000 0.00 0.000
Buffer Prop
19/Jun 21 20/ 248,120.000
- Buffer 0.00 0.000
- Mei 21 Prop
Buffer Prop 20/ 389,344.000
19/Juli21
0.00 0.000
- DAU/ 22DAK 415,469.000 0.00 0.000
- Agsts 1,384,983.000 0.00 0.000
Buffer Prop
19/Juni 22
- Buffer Prop 1,384,983.000 0.00 0.000
- 19/Jan 22 20/ 1,384,983.000 0.00 0.000
BUFF.22
Agsts
- 317,018.000 0.00 0.000
- PROP19/Agst 22
Buffer Prop 20/ 0.000
- 0.00 0.000
- 282.000 0.00 0.000
- Juni 22 - 0.000 0.00 0.000
Buffer Prop
- Buffer Prop 28,354.000 0.00 0.000
- 19/Juni 21 28,354.000 0.00 0.000
Buffer Prop
20/Juni 21 19/ 40,913.489
- Buffer Prop 19/ 0.00 0.000
- Okt.21
Buffer Prop 20/ 41,784.000
Okt.21
0.00 0.000
- Buffer Prop 41,784.000 0.00 0.000
- Okt.21 8,891.000 0.00 0.000
Buffer Prop
17/Mei 19
- 13,300.000 0.00 0.000
- 18/Agst.20
DAK
Buffer Prop 20/ 11,738.000
17/Agus.20 0.00 0.000
- Buffer 36,579.000 0.00 0.000
- Nov 22 Prop 20/ 15,014.000 0.00 0.000
- Nov 22
Buffer Prop - 0.000 0.00 0.000
- 2,920.000 0.00 0.000
19/Sept 20
 - Buffer Prop 20/ 2,920.000 0.00 0.000
- DAK
Buffer19/Agust.21 517.000 0.00 0.000
70 DAK 20Prop 517.000 36,190.00 0.000
- 20/Apr.22
Penugasan/
Buffer Prop 20 552.000
PRSpesifik
Jan 0.00 0.000
- 23 284.000 0.00 0.000
- 18/Okt.
Non 20
DAU Penugasan 307.000
Covid-19/ 0.00 0.000
- Okt 21 Prop
Buffer 307.000 0.00 0.000
- 20 354.000 0.00 0.000
Buffer 20
19/Juli Prop
- 354.000 0.00 0.000
- 20/Agst 21
DAK Penugasan 354.000 0.00 0.000
- - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- Buffer Prop - 0.000 0.00 0.000
10 9,955.000 99,550.00 0.000
2 18/Agst.20
DAK
DAK GD 20/09- 3,796.000
19/Mar 20 7,592.00 0.000
- DAK GD 20/09- 3,796.000 0.00 0.000
- Okt/21 10,351.000 0.00 0.000
- Okt/21
DAK 19/ Des 20 2,959.000 0.00 0.000
Buffer Prop
- DAK 20 /30- 2,684.000 0.00 0.000
50 19/Jul.19
Buffer Propinsi 2,959.000
Sept-21
147,950.00 0.000
- 2,500.000 0.00 0.000
630 20
DAK/Juli18/Apr.22
21 210.000 132,300.00 0.000
Buffer
- DAK 20 / 31 - 1,900.000 0.00 0.000
172 Prop.19/Sept.19
DAK22GD 20/ 31- 1,199.000
Okt
206,228.00 0.000
- PR 21BG 20/ Juli 1,639.000 0.00 0.000
- Okt 1,199.000 0.00 0.000
- 23 - 0.000 0.00 0.000
- DAK
Buffer18/Apr.21
Prop 167.000 0.00 0.000
- 167.000 0.00 0.000
- 18/Mei
DAK 19/21Jan 23 167.000 0.00 0.000
Buffer Prop 20/
160 167.000 26,720.00 0.000
- Feb.
DAK23 20/ 167.000 0.00 0.000
- DAK
PRSpesifik 20 1,121.000
19 0.00 0.000
- 3,288.000 0.00 0.000
- non
DAKcovid-19/
20/ 1,200.000 0.00 0.000
- Hibah17/NOV 20 1,750.000
DAK 0.00 0.000
- Penyedia/NOV 1,750.000 0.00 0.000
- DAK
Buffer19/
20 Juni20/
Prop 21 183.000 0.00 0.000
- Buffer Prop. 20/ 63,986.000 0.00 0.000
- Agst.22 63,813.000 0.00 0.000
- agst.22
DAK 17/JUN 20 57,500.000 0.00 0.000
- DAK 19/Apr 22 60.000 0.00 0.000
 Buffer Prop. 20/
2,945 60.000 176,700.00 0.000
- Agst.22
DAK 20/ 60.000 0.00 0.000
- - 0.000 0.00 0.000
- Buffer Prop 19 5,000.000 0.00 0.000
- DAK 20 L 13,200.000 0.00 0.000
- DAK 19/Jan 22 19,955.000 0.00 0.000
- DAK
DAK 19/Juni
20/ Nov 22
22, 245.000 0.00 0.000
- Buffer Prop 19/ 245.000 0.00 0.000
3 Des 22 1,243.000 3,729.00 0.000
- Feb
DAK2120/ 1,326.000 0.00 0.000
- DAK
Buffer19/Sept.
Prop 20/22 158.000 0.00 0.000
2,957 157.000 464,249.00 0.000
- Sept.
DAK 2220 L 253.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 19/
Buffer Prop 19/ 287.000 0.00 0.000
- Buffer 287.000 0.00 0.000
914 Apr 22 Prop 20/ 287.000 262,318.00 0.000
- Juli 22
DAK 20/ 287.000 0.00 0.000
- - 0.000 0.00 0.000
- DAK 19/Juni 23 287.000 0.00 0.000
- Buffer Prop 19/- 0.000 0.00 0.000
121 Buffer 91.000 11,011.00 0.000
3,000 Mei 22 Prop 20/ 91.000 273,000.00 0.000
- Juni
DAK22 20 L 440.000 0.00 0.000
- PR BG 20/ - 0.000 0.00 0.000
- 63,986.000 0.00 0.000
- Nov.22 - 0.000 0.00 0.000
- -
Buffer Prop/ Jan 0.000 0.00 0.000
49 Buffer Prop/ Juli 56,360.000 2,761,640.00 10 563,600.000
49 21 0.000 0.00 10 0.000
Buffer Prop/ Juli
22
- Buffer Prop/ 60,140.000 0.00 0.000
- 21 66,154.000 0.00 0.000
Buffer Prop/
Sept.21
49 Buffer Prop/ 141,648.000 6,940,752.00 0.000
89 Mar.20 0.000 0.00 0.000
Buffer Prop/
Mar.23
52 Buffer Prop/ 151,150.000 7,859,800.00 0.000
- Jul.23 166,265.000 0.00 0.000
Buffer Prop/ Juli
Agust.21
102 Buffer Prop/ Des 76,620.000 7,815,240.00 20 1,532,400.000
- 20 84,282.000 0.00 0.000
Buffer Prop/ Apr.
20
- 17,450.000 0.00 0.000
- 22
Buffer Prop/ - 0.000 0.00 0.000
50 Buffer Prop/ 23,270.000 1,163,500.00 0.000
90 Mar.21 25,597.000 2,303,730.00 30 767,910.000
Agust 21
 Buffer Prop/Juli
50 18,140.000 907,000.00 30 544,200.000
93 21
Buffer Prop/ 0.000 0.00 30 0.000
Buffer Prop
43 Buffer Prop 19,470.270 837,221.61 0.000
- 20/Agust-21 19,954.000 0.00 0.000
Buffer Prop/
20/Sept-21
9 15,450.000 139,050.00 0.000
- Mei.21
Buffer Prop 20/- 0.000 0.00 0.000
- Buffer21Prop 20/ 21,810.000 0.00 0.000
- Sep. 19,350.000 0.00 0.000
- Oct. 21Prop 20/
Buffer 135,000.000 0.00 0.000
Buffer Prop 20/
- 151,150.000 0.00 0.000
- Agust 21 20/
Buffer Prop
0.000 0.00 0.000
Buffer
Okt 23 Prop 20/
- 21,285.000 0.00 0.000
- Okt.21 Prop 20/
Buffer
144,540.000 0.00 0.000
Buffer Prop.20 -
Nov.21
- Buffer Prop.20/ 50,000.000 0.00 0.000
- Covid-19 165,000.000 0.00 0.000
- April 21 - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- - 0.000 0.00 0.000
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DAU 19
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DAU 19/Agst.22
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24
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16/JUL 21 0.00 0.000
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DAK 20/Agst.22 6,199.900
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DAU ID 20 - 13,400.000 134,000.00 0.000
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- Covid-19
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DAU 19/Okt.22
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DAU 19/Sept.21
ID 20 - 5,950.000 297,500.00 0.000
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- Covid-19
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DAU ID 20 - 22 2,240.000 201,600.00 0.000
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DAK 18/Okt.22 6,512.000 0.00 0.000
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DAU 19/Jan
23 22
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DAU 19/Nov.22
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DAU 19/ Jan- 21
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18/Mar.23
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RETUR
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DAU PR BG
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Buffer Prop 20/
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DAK 20 TB 259,175.000
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DAK 20
Penugasan
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PRSpesifik
Dokter Muter 20 627.000
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5 DAU 20 20
PRSpesifik
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4 DAU 20 20
PRSpesifik
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PRSpesifik
Covid-19 275,000.000 0.00 0.000
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Covid-19
DAU 20 20 132,000.000 0.00 0.000
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DAU 5,500.000 0.00 0.000
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PROPINSI
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DAU 20 20
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PRSpesifik
Covid-19 20 1,252,000.000 2,504,000.00 0.000
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PRSpesifik
Covid-19 20 575,000.000 0.00 0.000
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DAU PRSpesifik 7,000.000
Covid-19/20
1,400,000.00 0.000
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DAU
19 20/ID COVID-
Mar 21
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DAU
19 20/ID COVID- 220,000.000
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DAU
19 20/ID COVID-
Mar 21
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150 19 20/ID COVID- 5,000.000 750,000.00 0.000
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19 20/ID COVID- 200,000.000
- DAU 0.00 0.000
- 19 20/ID COVID- 56,000.000 0.00 0.000
DAU
19 20/ID COVID- 80,000.000
- 0.00 0.000
34 19 20/ID COVID- 200,000.000
DAU
6,800,000.00 0.000
BTT
19 20/20 COVID- 138,364.000
- 0.00 0.000
- 19 20 COVID- 137,364.000
BTT
0.00 0.000
DAU PRSpesifik
19
- DAU PRSpesifik 45,100.000 0.00 0.000
- Covid-19
DAU PRSpesifik 66,000.000
Covid-19
0.00 0.000
- DAU ID Covid-19 53,636.000 0.00 0.000
- Covid-19
DAU ID Covid- 450,000.000
20
0.00 0.000
- DAU ID Covid- 718,500.000 0.00 0.000
- 19/20
DAU ID Covid- 69,000.000
19/20
0.00 0.000
- DAU ID Covid- 60,000.000 0.00 0.000
- 19/20
DAU ID Covid- 6,000.000
19/20
0.00 0.000
- DAU ID Covid- 522,728.000 0.00 0.000
- 19/20
DAU ID Covid- 180,000.000
19/20
0.00 0.000
- BTT 20 COVID- 220,000.000 0.00 0.000
- 19/20 109.090 0.00 0.000
19
 BTT 20 COVID-
- BTT 20 COVID- 24,091.000 0.00 0.000
5,400 19 1,150.000 6,210,000.00 5,400 6,210,000.000
BTT 20 COVID-
19
- BTT 20 COVID- 47,500.000 0.00 0.000
- 19 200,000.000 0.00 0.000
BTT 20 COVID-
19
- BTT 20 COVID- 2,816.000 0.00 0.000
- 19 150,000.000 0.00 0.000
BTT 20 COVID-
19
- BTT 20 COVID- 303.550 0.00 0.000
- 19 891,275.000 0.00 0.000
BTT 20 COVID-
19
- BTT 20 COVID- 160,500.000 0.00 0.000
- 19 585.000 0.00 0.000
BTT 20 COVID-
19
- BTT 20 COVID- 5,300.000 0.00 0.000
- 19 5,500.000 0.00 0.000
BTT 20 COVID-
19
- BTT 20 COVID- 60,500.000 0.00 0.000
- 19 80,000.000 0.00 0.000
BTT 20 COVID-
19
- BTT 20 COVID- 136,564.000 0.00 0.000
- 19 1,265.000 0.00 0.000
DAU ID 20 non
19
- DAU ID 20 non 8,400.000 0.00 0.000
- covid-19 8,400.000 0.00 0.000
BTT ke 2 20
covid-19
- BTT ke 2 20 98,000.000 0.00 0.000
- COVID-19 90,000.000 0.00 0.000
BTT ke 2 20
COVID-20
- 97,500.000 0.00 0.000
- COVID-21
DAU 20 22,500.000 0.00 0.000
- - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- - 0.000 0.00 0.000
- - 7,199.885 0.00 0.000
- - 1,945.000 0.00 0.000
- - 2,950.000 0.00 0.000
- - 139,880.000 0.00 0.000
- - 0.000 0.00 0.000
- - 1,097.000 0.00 0.000
552 - 77.000 42,504.00 0.000
- - 3,217.500 0.00 0.000
- - 0.000 0.00 0.000
- - 15,572.700 0.00 0.000
- - 270.000 0.00 0.000
- - 600.000 0.00 0.000
300 - 1,106.000 331,800.00 0.000
- - 45.000 0.00 0.000
- - 36.000 0.00 0.000
- - 783.000 0.00 0.000
- - 1,302.000 0.00 0.000
 4 - 74,250.000 297,000.00 0.000
- - 43,186.000 0.00 0.000
- - 7,920.000 0.00 0.000
- - 8,750.000 0.00 0.000
- - 7,018.000 0.00 0.000
- - 8,355.000 0.00 0.000
- - 20,328.000 0.00 0.000
- - 12,076.000 0.00 0.000
- - 6,595.000 0.00 0.000
- - 1,098,900.000 0.00 0.000
1 - 712,800.000 712,800.00 0.000
- - 56.000 0.00 0.000
- - 1,640.000 0.00 0.000
- - 42,800.000 0.00 0.000
126 - 2,750.000 346,500.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
 - 0.000 0.00 0.000
0 0 0.00 0.000
- 194,933,874.58 62,917,705.000

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Generik Paten Rawat Inap Generik Paten

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
BUFFER P 257

BUFFER P 2728
Pelaporan : Persentase Puskesmas denga
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Albendazol /Pira Tablet 262 1
2 Alopurinol Tablet 36,876 1
3 Amlodipin/Kapto Tablet 33,888 1
4 Amoksisilin 500 Tablet 33,888 1
5 Amoksisilin sirup Botol 300 1
6 Antasida tablet k Tablet/Botol 6,774 1
7 Asam Askorbat (V Tablet 6,774 1
8 Asiklovir Tablet 6,774 1
9 Betametason sal Tube - 0
10 Deksametason tabTablet/Vial/Ampul - 0
11 Diazepam injeksi Ampul 24 1
12 Diazepam Tablet 24 1
13 Dihidroartemsin Tablet 244 1
14 Difenhidramin In Ampul 220 1
15 Epinefrin (Adrena Ampul 220 1
16 Fitomenadion (Vi Ampul - 0
17 Furosemid 40 mg/ Tablet 4,861 1
18 Garam Oralit ser Kantong 4,861 1
19 Glibenklamid/Me Tablet 4,861 1
20 Hidrokortison kr Tube - 0
21 Kotrimoksazol (d Tablet/Botol - 0
22 Lidokain inj Vial - 0
23 Magnesium Sulfat Vial - 0
24 Metilergometrin Ampul - 0
25 Natrium Diklofen Tablet 7 1
26 OAT FDC Kat 1 Paket 7 1
27 Oksitosin injeksi Ampul 293 1
28 Parasetamol siru Botol 286 1
29 Parasetamol 500 Tablet 416 1
30 Prednison 5 mg Tablet 130 1
31 Ranitidin 150 mg Tablet 130 1
32 Retinol 100.000/ Kapsul - 0
33 Salbutamol Tablet 3,121 1
34 Salep Mata/Tetes Tube 260 1
35 Simvastatin Tablet 1,178 1
36 Siprofloksasin Tablet - 0
37 Tablet Tambah D Tablet - 0
38 Triheksifenidil Tablet 3,121 1
39 Vitamin B6 (Pirid Tablet 3,084 1
40 Zinc 20 mg Tablet 5,199 1
JUMLAH ITEM OBAT INDIKATOR 29
Pelaporan : Persentase Puskesmas deng
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Vaksin Hepatitis Vial 50 1
2 Vaksin BCG Ampul 49 1
3 Vaksin DPT-HB-H Vial 102 1
4 Vaksin Polio Vial 50 1
5 Vaksin Campak/V Vial/Ampul 49 1
JUMLAH ITEM OBAT INDIKATOR 5
 REKAP LAPORAN PERSEDIAAN BAHAN OBAT - OBATAN (ASET) TRIW
PUSKESMAS .......................... TAHUN 2020
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN :
KAB / KODYA : LUMAJANG
PROPINSI : JAWA TIMUR

PENERIMAAN
NO NAMA OBAT SATUAN KEMASAN STOK AWAL April Mei Juni

1 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -

2 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - 500 -
3 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -
4 0 0 - - - -
5 Air Untuk Injeksi Vial @25 ml Vial 21 - - -
6 Air Untuk Injeksi Vial @25 ml Vial - - 240 -
7 Air Untuk Irigasi Infus 1000 ml Botol - - - -
8 Alopurinol Tablet 100 mg Tablet 417 - 800 -
9 Alopurinol Tablet 100 mg 0 - - - -
10 Ambroxol Tablet 30 mg Tablet 321 - 2,000 -
11 0 0 - - - -
12 Aminofilin Injeksi 24 mg/ml Ampule - - - -
13 0 0 - - - -
14 Amlodipin Tablet 10 Mg Tablet - - - -
15 Amlodipin Tablet 10 Mg Tablet - - 3,000 -
16 0 0 - - - -
17 Amoksisilin Kaplet 500 mg Tablet - - 35,000 -
18 Amoksisilin Kaplet 500 mg Tablet - - - -
19 Amoksisilin Kaplet 500 mg Tablet - - - -
20 Amoksisilin Kaplet 500 mg Tablet - - - -
21 0 0 - - - -
22 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 1 - 300 -
23 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - -
24 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - -
25 Amoksisilin Syrup Kering 250mg / 5 ml (Novapharin) Botol - - - -
26 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet - - - -
27 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet - - - -
28 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial 14 - - -
29 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial - - - 300
30 0 0 - - - -
31 Antacida + Simeticon Suspensi (NOVAMAG) Botol - - 50 -
32 0 0 - - - -
33 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
34 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
35 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 2,030 - 8,000 -
36 Antacida tablet kunyah DOEN, kombinasi : Alumunium Hidroksida 200 mg + Magnesium Hidroksida 200 mg Tablet - - - -
37 0 0 - - - -
38 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - -
39 0 0 - - - -
40 Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam Salisilat 3% (Marin ) Pot - - 24 -
41 0 0 - - - -
42 Supp
Antihemoroid Kombinasi : Bismut Suppgalat 150 mg Heksaklorofen 2,5 mg Lidokain 10 mg Seng Oksida 120 mg
420 - - -
43 Asam Ascorbat 500 mg (Vitamin C) Tablet - - - -
44 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet - - - -
45 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet - - - -
46 Asam Ascorbat 50 mg (Vitamin C) Tablet 182 - 5,000 -
47 Asam Ascorbat 50 mg (Vitamin C) Tablet - - - -
48 Asam Folat 1 mg Beta Caroten 10000 Multi Mineral/ FOLAMIL (Dexa Medica) Tablet - - - -
49 Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - -
50 Asam Folat Tablet 1 mg Tablet - - - -
51 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - -
52 Asam Mefenamat 500 mg 0 - - - -
53 0 0 - - - -
54 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 9 - - -
55 0 0 - - - -
56 Asam Tranexamat Tablet 500 mg Tablet 164 - 200 -
57 0 0 - - - -
58 Asiklovir 5% 5gr Cream Tube 150 - - -
59 Asiklovir 5% 5gr Cream Tube - - - -
60 0 0 - - - -
61 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
62 Asiklovir Tab 400 mg ( Phapros ) Tablet 172 - 300 -
63 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
64 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - -
65 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
66 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - -
67 Attapulgite Active 630 mg Tab/ PULAREX Tablet 783 - - -
68 Attapulgite Active 630 mg Tab/ New Antides Tablet - - 2,000 -
69 Betahistin Mesylat 6 mg Tablet - - - -
70 Betahistin Mesylat 6 mg Tablet - - - -
71 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 16 - - -
72 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 26 - - -
73 Betametason Dipropionat Krim 0,1% Tube @ 10 gram - - 300 -
74 Bisakodil Tablet 5 mg (Etercon Pharma ) Tablet - - - -
75 Bisakodil Sup 10 mg (Dulcolax) Supp - - - -
76 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - -
77 Benzatin Benzil Penisilin 2,4 jt 0 - - - -
78 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) II Biji - - - -
79 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) I Biji - - - -
80 0 0 - - - -
81 Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs - - - -
82 0 0 - - - -
83 Calcium Plus Vit D3 (Coral calcium 500 mg,Naturan Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 mg,Zink 5 mg Boron 1 mg)/ CAL - 95
Tablet - - - -
84 Cefadroksil Kapsul 500 mg Tablet - - 1,000 -
85 Cefadroksil Kapsul 500 mg Tablet - - - -
86 Cefotaxime serbuk injeksi 1.000 mg Vial - - - -
87 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 73 - - -
88 Citicolin 250 mg / 2 ml Inj Ampule - - - -
89 Curcumin Plus Cynarin,Sylimarin,Kapsul/ HEPAGARD (Phapros) Tablet - - - -
90 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 55 - - -
91 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - 200 -
92 Deksamethason Tab 0,5 mg (Promed ) Tablet 1,960 - 1,000 -
93 Deksamethason Tab 0,5 mg 0 - - - -
94 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube 3 - - -
95 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - -
96 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 55 - 300 -
97 0 0 - - - -
98 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 215 - - -
99 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - -
100 Digoksin Tab 0,25 mg Tablet - - - -
101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet - - 1,500 -
102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet 50 - - -
103 0 0 - - - -
104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol 7 - - -
105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
106 Domperidon Tab 10 mg (Novapharin ) Tablet 453 - - -
107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - -
108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - -
109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 26 - 30 -
110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - -
111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
112 Eritrosmisin Stearate Kaplet 500 mg Tablet - - 200 -
113 Ethambutol 250 mg Tablet - - - -
114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - -
115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 3 - - -
116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 147 - 120 -
117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - 120 -
118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - - -
119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 222 - - -
120 0 0 - - - -
121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 5 - - -
127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - 192 -
128 Gentamycin Krim 1 % mg/ ml Tube 6 - - -
129 Gentian Violet 1% 10 ml Botol - - - -
130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 67 - 24 -
131 Glibenklamid Tablet 5 mg Tablet 3,439 - 3,000 -
132 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - -
133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet 590 - - -
134 Gliseril Guaikoulat Tablet 100 mg Tablet - - 7,800 -
135 Glucosamin HCL 500 Mg, Konrdoitin SO4400Mg, MSM 200 Mg, VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Gliserofosfat 10 mg Tablet 139 - - -
136 Glukosa Larutan 40% Steril ( Outsuka ) Botol 9 - 5 -
137 Glukosa Larutan 40% Steril botol - - - -
138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - -
139 Glukosa Larutan Infus 5% @500ml Botol - - - 40
140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - -
141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,270 - 1,000 -
142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - -
143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - -
144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 3 - 120 -
145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - -
146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - -
147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - - -
148 0 0 - - - -
149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - 216 -
151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 20 - 8,000 -
152 Ibuprofen Tablet 400 mg Tablet - - - -
153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - -
154 Isoniazid Tablet 100 mg tablet - - - -
155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 268 - - -
156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 22 - - -
157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
158 0 0 - - - -
159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - -
160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - -
161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol - - - -
162 0 0 - - - -
163 Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian Pharmatama) Tablet - - - -
164 0 0 - - - -
165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - - -
166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 440 - 8,000 -
167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - -
168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - -
169 Kaptopril Tab 25 mg ( Phapros ) Tablet 4,487 - 3,000 -
170 Kaptopril Tab 25 mg TAblet - - - -
171 Ketokonazol Krim 2 % @ 10 gr Tube 7 - - -
172 Ketokonazol Krim 2 % @ 10 gr Tube - - 50 -
173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 400 - - -
174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - -
175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - -
176 Ketorolak Inj 30 mg/ml Ampule - - - -
177 0 0 - - - -
178 Kloramfenikol 1% Salep Mata (KF) Tube 108 - 240 -
179 0 0 - - - -
180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma) Vial - - - -
181 Kloramfenikol Tetes Telinga :Kloramfenicol 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube 1 - - -
182 Kloramfenikol Tetes Telinga : Kloramfenicol 10%,Lidocain,Proplylenglycol / COLME (Interbat) Tube 8 - - -
183 0 0 - - - -
184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - - -
185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 2,164 - 10,000 -
186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - -
187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - -
188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - -
189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet - - 2,000 -
190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg Tablet - - - -
191 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol - - - -
192 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol - - 200 -
193 Krim Analgesik (setiap gram mengandung : Metyl Salisilat 102 mg, Eugenol 13,6 mg; Methol 53,4 mg, Vinishing Cream ad 1 gr/ MOLAKRIM Tube 5 - 12 -
194 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma) Tube - - 20 -
195 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma) Tube - - - -
196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet - - - -
197 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet 61 - - -
198 0 0 - - - -
199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 31 - 450 -
201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
202 Loperamid Tablet 2 mg ( Ifars) Tablet 244 - - -
203 Loperamid Tablet 2 mg Tablet - - - -
204 Loratadin Tablet 10 mg Tablet 180 - - -
205 Loratadin Tablet 10 mg Tablet - - - -
206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet 360 - - -
207 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet - 180 - -
208 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
209 0 0 - - - -
210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - -
211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 520 - 100 -
212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - - -
213 Metformin HCl Tablet 500 mg Tablet 914 - - -
214 Metformin HCl Tablet 500 mg Tablet - - 2,000 -
215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 350 - - -
216 0 0 - - - -
217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet 8 - - -
218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - -
220 Metronidasol 500 mg tablet (Novapharin) Tablet - - - -
221 Metronidasol 500 mg tablet (Novagyl) Tablet - - - -
222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - -
223 Metronidasol Infus 500mg/100ml Botol - - - -
224 Minyak Kayu Putih 60 ml Botol - - - -
225 Kapsul
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Zink 20 mg, Beta Caroten 10000 IU, Selenium 30 mcg (LICOXY)
- 120 - -
226 Multivitamin + Pelancar Asi (NULACVIT) Tablet 810 90 - -
227 Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / MERSIBION Ampule - - - -
228 Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule 7 - - -
229 Multivitamin Vitamin/ Suplemen (BECEFORT) tablet - - - -
230 Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex Ayus ) Tablet - - - -
231 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
96 - 48 -
232 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
- - - -
233 Multivitamin Neurotopic Plus ATP Tablet:B1 100,B6 200,B12 200Mcg,Vit E 30mg, ATP 20mg / Bio ATP (Phapros) Tablet - - - -
234 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) Tablet - - - -
235 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) tablet - - - -
236 Tablet
Multivitamin Tab Tambah Darah : per Tablet Mengandung : Femofomarrat 300mg Mgso4 0,4mg,Cuso4 0,4 mg,Vit C 100mg ,Asam Folat 2 Mg,Vit B 12 15Mcg,Faktor Intirinsik 25mg / HEMAFORT ( Phapros )
- - 3,600 21,700
237 Natrium Diklofenak Tab 50 mg (Phapros ) I Tablet - - - -
238 Natrium Diklofenak Tab 50 mg (Phapros ) II Tablet 1,196 - - -
239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - -
240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 27 - - -
241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - -
242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 461 - - -
243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - -
244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol 2 - - -
245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 20 - - -
246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 41 - - -
247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
248 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
249 Botol
Obat Batuk Herbal : Tiap 15 Ml Vitetrifolia Fill 1 Gr,Zingiber Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Macrocarpa Fruct 0,20 Mg / HERBAKOF (Dexa Medica )
- - - -
250 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Pcs - - - -
251 Botol
OBH Plus Syr : Per 5 ml Megnandung Difenhidramin 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 mg,Na Sitrat 50 mg / SANADRYL
- - - -
252 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Botol - - - -
253 Omeprazole Kapsul 20 mg Tablet 600 - - -
254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule - - 500 -
255 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule - - - -
256 Tablet
Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus )
- - - -
257 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet - - - -
258 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet 438 - - -
259 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet - - - -
260 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, / COLPICA (Tropika Mas) Tablet - - - -
261 Propiltiourasil/ PTU 100 mg 0 - - - -
262 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, Tripolidin 2,5 mg / NOZA (Phapros) Tablet - - - -
263 Parasetamol Syrup 120 mg/5ml (Mersi Farma) Botol - - - -
264 Parasetamol Syrup 120 mg/5ml Botol - - 300 -
265 Parasetamol tablet 500 mg Tablet 270 - 1,000 -
266 Parasetamol tablet 500 mg Tablet 1,854 - - -
267 Parasetamol tablet 500 mg Tablet - - - -
268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 5 - 30 -
269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 2 - 90 -
270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - -
271 Piracetam 800 mg Tablet Tablet 208 - - -
272 Parasetamol tablet 500 mg Tablet - - - -
273 Piracetam Injeksi 1gr/ 5ml Ampule 16 - 20 -
274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 1,638 - 3,000 -
276 Probiotik Sachet (Probiokid) 0 - - - -
277 Polikresulen (Albotyl,Apetil) Botol - - - -
278 Prednison Tab 5 mg Tablet - - - -
279 Prednison Tab 5 mg (Holi Pharma) Tablet 791 - 4,000 -
280 Prednison Tab 5 mg Tablet - - - -
281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - -
282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - 600 -
283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - -
284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 1,500 - 1,000 -
285 0 0 - - - -
286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol 21 - - -
289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 1,918 - - -
290 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
291 Salbutamol SO4 3,01 mg + Ipratonium Brom 0,52 mg Nebulizer (COMBIVENT) I dan II Nebule 32 - 300 -
292 0 0 - - - -
293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - - -
294 Salbutamol Tab 4 mg (Pristasma) Tablet - - - -
295 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot 28 - 72 -
296 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot - - - -
297 Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - - -
298 Salisil Bedak Serbuk 2% Pcs 7 - - -
299 Salisil Bedak Serbuk 2% Pcs - - - -
300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - -
301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - 2 -
302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - -
303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - 50 -
304 Setirizin Tab 10 mg (Futamed) Tablet 69 - - -
305 Setirizin Tab 10 mg (Futamed) Tablet - - - -
306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 54 - 1,200 -
307 Simvastatin Tablet 10 mg Tablet - - - -
308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet 5,000 - - -
309 0 0 - - - -
310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - -
311 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - 25 -
312 Tetes mata setiap ml mengandung Polietilen glikol 400 1% gliserin 0.25% Hidroksipropil metil selulosa 0,2% VISINE Botol - - - -
313 Tetrasiklin HCl Kapsul 500 mg Tablet - - - -
314 Thiamin/ Vitamin B1 50 mg Tablet - - - -
315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 2,260 - - -
316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - 1,000 -
317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - -
318 Thiamphenicol Kapsul 500 mg Tablet - - - -
319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 36 - - -
320 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Molex Ayus) Kapsul - - - -
321 Vitamin B Komplek Tablet - - - -
322 Vitamin B Komplek Plus Ekstrak Hati (Substansi Hati Kering 100 mg, Vit B1 HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, CuSO4 0,65 mg) LIVRPON B-PLEX
Tablet - - - -
0 OBAT GOLONGAN PSIKOTROPIKA 0 - - - -
323 Alprazolam 0,5 mg (Mersi Farma) Tablet - - - -
324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
327 0 0 - - - -
328 0 0 - - - -
329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - -
335 Diazepam Tablet 5 mg (VALISANBE) Tablet 87 - - -
336 Diazepam Tablet 5 mg Tablet - - - -
337 Fenobarbital Tablet 30 mg Tablet - - - -
338 Fenobarbital Tablet 30 mg Tablet - - - -
339 Fenobarbital Tablet 30 mg tablet - - - -
340 Kodein Tablet 10 mg Tablet - - - -
341 0 0 - - - -
342 Lorazepam Tab 2 mg (Mersi Farma) Tablet - - - -
343 Metamizol 500 mg + Diazepam 2 mg / PRONEURON (Meprofarm) Tablet - - - -
344 0 0 - - - -
345 0 0 - - - -
346 0 0 - - - -
347 Primaquin 15 mg tablet tablet - - - -
348 0 0 - - - -
0 OBAT - OBAT PROGRAM 0 - - - -
0 OBAT PROGRAM KECACINGAN 0 - - - -
349 Albendazol Tablet 400 mg Tablet 265 - - -
350 Albendazol Tablet 400 mg Tablet - - - -
0 OBAT PROGRAM DIARE 0 - - - -
351 Garam Oralit (Kimia Farma) Tablet - - - -
352 Garam Oralit (Kimia Farma) Tablet 2,061 - 1,000 -
353 Garam Oralit (Kimia Farma) sachet - - - -
354 Garam Oralit (Kimia Farma) sachet - - - -
355 0 0 - - - -
356 Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined imperial) Botol 57 - - -
357 Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - -
358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - 500 - -
359 Zinc Dispersible 20 mg tablet tablet - - - -
360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 2,891 5,000 - -
362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
363 0 0 - - - -
0 OBAT PROGRAM HEPATITIS 0 - - - -
364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs 1 - - -
367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - 1 -
0 OBAT PROGRAM TB PARU 0 - - - -
369 OAT FDC Kategori Anak Kit - - - -
370 OAT FDC Kategori Anak Kit - - - -
371 OAT FDC Kategori Anak Kit - - - -
372 OAT FDC Kategori I - IIII Kit - - - -
373 OAT FDC Kategori I - IIII Kit - - - -
374 OAT FDC Kategori II Kit - 1 1 -
375 OAT FDC Kategori II Kit - - - -
376 OAT FDC Kategori II Kit - - - -
377 OAT FDC Kombipak Kategori I Kit - - - -
378 0 0 - - - -
379 Isoniazid 100 mg tablet tablet - - - -
0 OBAT POGRAM KUSTA 0 - - - -
380 MDT MB Anak Blister - - - -
381 MDT MB Anak Blister - - - -
382 MDT MB Dewasa Blister - - - -
383 MDT MB Dewasa Blister - - - -
384 MDT MB Dewasa Blister - - - -
385 MDT PB Anak Blister - - - -
386 MDT PB Anak Blister - - - -
387 MDT PB Anak Blister - - - -
388 MDT MB Dewasa Blister - - - -
389 MDT PB Dewasa Blister - - - -
0 OBAT PROGRAM GIZI 0 - - - -
390 Mineral Mix Kombinasi sachet - - - -
391 Mineral Mix Kombinasi sachet - - - -
392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - -
393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 3,350 - - -
394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - -
395 Retinol Vit A 100.000 IU (Biru) Kapsul 350 - - -
396 Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
398 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet 43,468 5,000 - -
399 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet - - - -
400 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) tablet - - - -
401 0 0 - - - -
402 0 0 - - - -
0 OBAT PROGRAM KESGA 0 - - - -
403 Calcii Gluconas Inj (Ethica) Ampule - - 10 -
404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 2 - - -
405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - -
406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - -
407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 7 - - -
408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - 50 -
409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - 50 -
410 Oksitetrasiklin 1 % Salep Mata Tablet - - - -
411 Metilergometrin Maleat Tablet 0,125 mg Tablet 380 - 500 -
412 Oksitosin Inj 10 UI/ml (Ethica) Ampule 5 - - -
413 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - 200 -
414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
0 OBAT PROGRAM JIWA 0 - - - -
416 Amitriptilin 25 mg Tablet - - - -
417 Amitriptilin 25 mg Tablet - - - -
418 Amitriptilin 25 mg Tablet - - - -
419 Amitriptilin 25 mg Tablet 160 - - -
420 Amitriptilin 25 mg Tablet - - - -
421 Clozapine 25mg (OGB Dexa) Tablet - - - -
422 Clozapine 100 mg Tablet - - - -
423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - -
427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - -
428 Flufenazin sikzonoate inj 5 ml vial - - - -
429 Flufenazin sikzonoate inj 5 ml Vial - - - -
430 Haloperidol 5 mg tablet Tablet - - - -
431 Haloperidol 5 mg tablet Tablet 87 - 3,000 -
432 Haloperidol 5 mg tablet Tablet - - - -
433 0 0 - - - -
434 Haloperidol Injeksi 5 mg/ml ampule - - - -
435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - -
436 Haloperidol/ Lodomer drops 2 mg Botol - - - -
437 Karbamazepin Tablet 200 mg Tablet - - - -
438 Karbamazepin Tablet 200 mg Tablet - - - -
439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - 3 -
440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - - -
442 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - 3,000 -
443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
444 0 0 - - - -
445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - -
446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - -
447 Risperidon Tab 2 mg Tablet 350 - 1,000 -
448 Risperidon Tab 2 mg Tablet - - - -
449 0 0 - - - -
450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - -
451 0 0 - - - -
452 Triheksifenidil Tablet 2 mg (Mersi) Tablet 861 - - -
453 Triheksifenidil Tablet 2 mg Tablet - - 3,000 -
454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - -
455 0 0 - - - -
456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - -
457 0 0 - - - -
0 PROGRAM IMUNISASI (VAKSIN) 0 - - - -
458 BCG vial 11 30 30 10
459 PELARUT BCG ampul 11 30 30 10
460 BCG vial - - - -
461 BCG vial - - - -
462 CAMPAK 10ds (MR) vial 49 - - -
463 PELARUT CAMPAK ampul 49 20 20 -
464 CAMPAK 10ds (MR) vial - 50 20 -
465 CAMPAK 10ds (MR) vial - - - -
466 DPT HB - Hib/ PENTABIO vial 116 50 - 20
467 DPT HB - Hib/ PENTABIO vial - - - -
468 DT vial - - - -
469 0 0 - - - -
470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 50 - - -
471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - 60 30
472 POLIO bOPV 10 ds vial 38 - 50 30
473 DROPPER POLIO dropper 68 30 50 30
474 POLIO bOPV 10 ds vial 30 30 - -
475 POLIO bOPV 10 ds vial - - - -
476 Td vial - 10 - -
477 0 0 - - - -
478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - -
479 POLIO bOPV 10 ds vial - - - -
480 Vaksin Meningtis vial - - - -
481 CAMPAK 10ds (MR) BIAS vial - - - -
482 PELARUT CAMPAK BIAS ampul - - - -
483 POLIO bOPV 10 ds vial - - - -
484 IPV vial - - - -
485 VTM Include Dacron (Biofarma) pcs - - - -
486 Vaksin Rabies (Verorab) vial - - - -
487 0 0 - - - -
488 0 0 - - - -
489 0 0 - - - -
0 OBAT PROGRAM HIV/ AIDS 0 - - - -
490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - -
491 0 0 - - - -
492 Isoniazid (INH) Tablet 300 mg Tablet 270 - - -
493 0 0 - - - -
494 Lamivudine 150 mg Tablet - - - -
495 Lamivudine 150 mg Tablet - - - -
496 Nevirapine 200 mg Tablet - - - -
497 Nevirapine 200 mg Tablet - - - -
498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - -
499 0 0 - - - -
500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
501 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
502 Tenofovir 300 mg Tablet - - - -
503 Tenofovir 300 mg Tablet - - - -
504 Zidofudine 100 mg (ZDV) Tablet - - - -
505 Zidofudine 100 mg (ZDV) Tablet - - - -
506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
508 Efavirenz 600 mg tablet tablet - - - -
509 Efavirenz 600 mg tablet tablet - - - -
510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
511 Abacavir (ABC) 300mg Tablet - - - -
512 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
513 0 0 - - - -
514 MB Anak blister - - - -
515 0 0 - - - -
516 0 0 - - - -
517 0 0 - - - -
518 0 0 - - - -
519 0 0 - - - -
520 0 0 - - - -
521 0 0 - - - -
522 0 0 - - - -
523 0 0 - - - -
524 0 0 - - - -
525 0 0 - - - -
526 0 0 - - - -
527 0 0 - - - -
528 0 0 - - - -
529 0 0 - - - -
0 BMHP 0 - - - -
530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - -
531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 115 - - -
532 0 0 - - - -
533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 931 - - -
534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - - 3,000 -
535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - 1,000 -
537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - -
538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - -
540 Alat Suntik Sekali Pakai 20 ml Pcs 3 - - -
541 Alkohol 70% Medika (Kimia Farma) 0 - - - -
542 Alkohol 70% (Medika) Btl 1000 ml 1 - - -
543 Alkohol Swab 2 - ply (one med) 0 - - - -
544 Alkohol Swab 2 - ply (one med) Pcs - - 500 -
545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - - - -
546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - -
547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs - - 120 -
548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs 28 - - -
549 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I 0 - - - -
550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda Pcs - - - -
551 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda 0 - - - -
552 Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - -
553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs 9 - - -
554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 270 - - -
555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
556 Fixomull Strech 5 cm X 5 m Pcs - - - -
557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 31 - 10 -
558 Foley Catheter 2 Way Ch 16,18 Pcs - - - -
559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - -
560 I.V Cannula No. 26 G Polywin (Polymed) Pcs - - 5 -
561 Mantel Gown (Bisa Dicuci) biji - - - -
562 I.V Catheter No. 18 (JELCO) Pcs 58 - - -
563 I.V Catheter No. 18 (NIPRO) Pcs - - 100 -
564 I.V Catheter No. 20 JELCO Pcs - - - -
565 I.V Catheter No. 20 TERUMO Pcs 9 - 200 -
566 I.V Catheter No. 20 JELCO Pcs - - - -
567 I.V Catheter No. 22 NIPRO Pcs 5 - - -
568 I.V Catheter No. 22 NIPRO Pcs - - 300 -
569 I.V Catheter No. 24 TERUMO Pcs 5 - 200 -
570 I.V Catheter No. 24 TERUMO 0 - - - -
571 Infusion Set Anak 60 Drops /(Otsuka) Pcs 4 - - -
572 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - 100 -
573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
574 Infusion Set Dewasa 20 Drops/ (OTSUKA) Pcs 500 - 400 -
575 Kantong Plastik Bio Hazart (Bahan Plastik PE, Panjang 80 Cm, Lebar 60 Cm, Tebal 0,33 Mm) Pcs - - - -
576 Kapas Pembalut Hydrofil 250 gr Pcs - - - -
577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 1 - 10 -
578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - -
579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - - -
580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs - - 10 -
581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - -
582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - - -
583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 8 - 50 -
584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - -
585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs 96 - - -
586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs - - 100 -
587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - -
588 Masker Ear Loop (Masker) Pcs 17 - - -
589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - -
590 Masker General Care (MARCOTILA) Pcs - - - -
591 0 0 - - - -
592 Masker N95 Disposibel Pcs - - - -
593 Masker N95 Disposibel (One Med) Pcs - 15 - -
594 Masker Tali Pcs - - - -
595 Masker Tali Pcs - - - -
596 Masker Elastic Pcs - - - -
597 Media Sample Container Pcs - - 200 -
598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - -
599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - -
600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - - -
601 Nurse Cup (Tutup Kepala) Pcs 60 100 - -
602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - -
603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - -
604 Plesterin Bulat Non Woven (One Med) Pcs - - - -
605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 2 - 54 -
606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - 54 -
607 Povidon Iodine 10% (300 ml) ( One Med) Pcs - - 10 -
608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - -
609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - - -
610 0 0 - - - -
611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - -
612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - -
613 0 0 - - - -
614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - 1,500 - -
615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - -
616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair 5 - - -
617 Sarung Tangan size M dan L (Exam Glove) PAir - - - -
618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 500 - - -
619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - -
620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 5 - 60 -
621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - -
622 0 0 - - - -
623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - -
624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 2 - - -
625 Underpad 90x 0 cm cosmo I Pcs - - 30 -
626 Underpad 90x 0 cm cosmo II Pcs - - - -
627 0 0 - - - -
628 Urine Bag Sterile Standard Pcs 6 - 20 -
629 Urine Bag Sterile Standard (AXIMED) Pcs - - - -
630 0 0 - - - -
631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - -
0 REAGEN 0 - - - -
632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - -
633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - -
634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 800 - - -
635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - -
636 Antimonoclonal A (Anti A) 10 ml Btl - - - -
637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - -
638 Antimonoclonal B (Anti B) 10 ml Btl - - - -
639 0 0 - - - -
640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - -
641 Cholesterol Test Strip (Human Humasens Plus) 0 - - - -
642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - -
643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - -
644 Glucose Test Strip (Human Humasens plus) Tes - - - -
645 Glucose Test Strip (Human Humasens plus) II Tes - - - -
646 Hemoglobin Strip 50 test mission (Acon) Pcs - - 2 -
647 Hemoglobin Strip 50 test mission (Acon) 0 - - - -
648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - -
649 0 0 - - - -
650 Reagen HBsAg Strip (FOKUS) Test - - - -
651 0 0 - - - -
652 TPHA (Fokus) Test - - - -
653 0 0 - - - -
654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - -
655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - -
0 BMHP (PROGRAM) PROPINSI 0 - - - -
0 PROGRAM MALARIA 0 - - - -
656 RDT Malaria Test - - - -
0 PROGRAM SYPHILIS 0 - - - -
657 RPR Syphilis Pcs - - - 100
658 RPR Syphilis tahap II (FOKUS) Pcs - - - -
659 Syphilis 3.0 06FK10 SD Bioline Test - - - 300
Test
660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
Test
661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
662 0 0 - - - -
663 Tuberkulin Vial - - - -
664 RDT Lepto (Uji Leptospira IgM) test - - - -
665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - -
666 0 0 - - - -
667 0 0 - - - -
0 PROGRAM HEPATITIS 0 - - - -
Rapid Test Anti Hepatitis C (HCV)
668 Test - - - -
669 Reagen HBsAg Strip SD Test - - - -
670 Reagen HBsAg Strip SD Test - - - 350
671 Reagen HBsAg Strip SD Test - - - -
672 0 0 - - - -
673 0 0 - - - -
674 0 0 - - - -
675 0 0 - - - -
0 PROGRAM TB PARU 0 - - - -
676 Box Slide Pcs - - - -
677 Box Slide Pcs - - - -
678 Catridge Genexpart Test - - - -
679 Catridge Genexpart Test - - - -
680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - -
681 Oil Emersi Botol - - - -
682 Pot Spuntum/Pot Dahak Steril Pcs - - - -
683 Pot Spuntum/Pot Dahak Steril Pcs - - - -
684 Pot Spuntum/Pot Dahak Steril Pcs - - - -
685 Pot Spuntum/Pot Dahak Steril Pcs - - - -
686 Reagen Control CD4 0 - - - -
687 Reagen Control CD4 0 - - - -
688 Reagen Zeil Nelseen Kit - - - -
689 Reagen Zeil Nelseen Kit - - - -
690 Reagen Zeil Nelseen Kit - - - -
691 Reagen Zeil Nelseen Kit - - - -
692 Slide Pcs - - - -
693 Slide/ Object Glass Pcs - - - -
694 Stereofoam pcs - - - -
695 Masker N 95 TB pcs - - - -
696 Masker Tali Bedah TB pcs - - - -
0 OBAT PROGRAM IMUNISASI 0 - - - -
697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - -
703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
708 0 0 - - - -
709 0 0 - - - -
710 0 0 - - - -
711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 428 - - -
712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
714 0 0 - - - -
715 Safety Box 5 L Pcs - - - -
716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
717 0 0 - - - -
718 0 0 - - - -
719 0 0 - - - -
720 0 0 - - - -
0 PROGRAM HIV/ AIDS 0 - - - -
721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Tahap I Test - - - 50
722 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Reagen R3 0 - - - -
723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test - - - -
724 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) (Reagen R2) 0 - - - -
725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test - - - 50
726 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I 0 - - - -
727 Kondom Pcs 144 - - -
728 DBS Collection/ Lasec Pcs - - - -
729 Lubricant Pcs 20 - - -
730 0 0 - - - -
731 Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap I Test - - - 900
732 Rapid HIV 1/2 3.0 SD Bioline test - - - -
733 Reagen HIV (FOKUS) R 2 Test - - - -
734 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I Test - - - -
735 Reagen HIV (SD) R 1 Test - - - -
736 Reagen HIV (SD) R 1 Test - - - -
737 0 0 - - - -
738 Reagen HIV (VIKIA) R 3 Test - - - -
739 0 0 - - - -
740 Reagen HIV R2 (Rapid Test) FOKUS Test - - - -
741 0 0 - - - -
742 Reagen HIV R3 (VIKIA) Test - - - -
743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - -
744 Sarung Tangan Non Steril Pair - - - -
745 0 0 - - - -
746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - -
747 VTM Include Swab Test - - - -
748 Masker Bedah 3 ply Pcs - - - -
749 0 0 - - - -
750 0 0 - - - -
751 0 0 - - - -
752 0 0 - - - -
753 0 0 - - - -
754 0 0 - - - -
755 0 0 - - - -
756 0 0 - - - -
757 0 0 - - - -
758 0 0 - - - -
759 0 0 - - - -
760 0 0 - - - -
761 0 0 - - - -
762 0 0 - - - -
763 0 0 - - - -
764 0 0 - - - -
0 OKSIGEN MEDICAL 0 - - - -
765 Oksigen 3 m3 Tampon - - - -
766 Oksigen 6 m3 Tampon - - - -
767 Oksigen 1 m3 Tampon - - - -
768 Oksigen 6 m3 Tampon - - - -
769 Nurse Cup (Tutup Kepala) One Med 0 - - - -
770 0 0 - - - -
771 0 0 - - - -
772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - -
0 TAMBAHAN IFK 0 - - - -
1 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - -
2 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
3 Ranitidin Tablet 150 mg Tablet - - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg
4 Tablet - - - -
5 Thiamphenicol Syr. 0 - - - -
6 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - -
7 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
8 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - - 300
9 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - -
10 Ketokonazole 200 mg Tablet - - - -
11 Kotrimoksazol Forte Tablet - - - -
12 Infusion set anak Pcs 50 - - -
13 Alat Suntik 10 cc Pcs - - - -
14 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
15 Omeprazole Kapsul 20 mg Tablet - - - -
16 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - - - -
17 Setirizin Tab 10 mg (Futamed) Tablet - - - -
18 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
19 Oseltamivir 75 mg Kapsul - - - -
20 Ringer Laktat cairan infus @ 500 ml RL Botol - - - -
21 Amitriptilin 25 mg Tablet - - - -
22 I.V Catheter No. 24 TERUMO pcs - - - -
23 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - - 1
24 RDT COVID - 19 0 - - - -
25 Oseltamivir 75 mg 0 - - - -
26 Klorokuin 150 mg tablet 0 - - - -
27 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 - - - -
28 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 - - - -
29 Masker N95 (Particulate Respirator) 0 - - - -
30 Hazmat/ APD/ Hazmat PPK 0 - - - -
31 Medical Sample Container Pcs - - - -
32 Cepheid Pcs - - - -
33 Natrium Klorida Larutan infus 0,9% @100ml 0 - - - -
34 Tambah Darah drop (Ferriz Drop) pcs - - - -
35 Tambah Darah Sirup (Ferriz Sirup) pcs - - - -
36 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - -
37 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
38 Obat Batuk Sirup / INADRYL Botol - - - -
39 Obat Batuk Expektoran Sirup Botol - - - -
40 Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate, dextromethorpan Hbr
Tablet - - - -
41 Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Influenza Tablet - - - -
42 Masker Bedah /Bima Sakti pCS - - - -
43 Masker Bedah /Rania pCS - - - -
44 Masker N 95 Bima Sakti PCS - - - -
45 Sarung tangan panjang steril / meditouche perpasang 0 - - - -
46 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - -
47 Albendazol Suspensi 200mg/ 5 ml botol - - - -
48 I.V Catheter No. 24 (BRAUN) pcs - - - -
49 OAT FDC Kategori Anak 0 - - - -
50 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - -
51 Apron Lengan Panjang Putih (Rannia) 0 - - - -
Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
APD Set (Rannia) 0 - 5 - -
Cover All Disposible (Baju sekali pakai) (Rannia) 0 - 5 - -
Cover All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 0 - - 7 -
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya Mitra Bersama) 0 - 5 5 -
Helm visor (Usaha Karya Mitra Bersama) 0 - - - -
Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - -
Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - -
Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - - -
Sarung tangan non steril M,L (COBRA) box @100 pcs - - 1,900 3,000
Masker N95 Covid 19 Pcs - - - -
Masker Tali Bedah 3 ply Covid 19 Pcs - - - -
Masker Eaerlop Hijab Pcs - 2,000 - -
Etanol 96 % (Alkohol 1) Botol = 20 Liter - 1 - -
Hand Sanitzer 1 Botol = 20 Liter - 1 1 -
MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - 1 - -
Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs - 20 - -
KIT A1 Operasi Steril (RAJAWALI) Pcs - - - -
Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - 5 - -
Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair - 3 - -
Masker Face/ Masker Bedah (COBRA 1) pcs - - 1,200 -
Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - -
Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - -
Masker Face/ Masker Bedah (COBRA 2) pcs - - - 1,200
Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - -
Masker KN95 (Farmahusada) Box @50 pcs - - 40 -
Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - -
Rapid Test SARS COV 2 (Farmahusada) Test - - 25 -
Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - -
Masker KN95 (Anugrah Sentosa Abadi) pcs - - - -
APRON (Atmosfer) pcs - - 200 -
Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - -
Hand Sanitzer 2 liter - - - -
Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - -
Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs - - 49 -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - -
Face Shield (COBRA) 0 - - - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Kit Steril (Rajawali) 0 - - - -
Alkohol II @20 Liter 0 - - - -
Cover All (Rajawali) 0 - - - -
Face Shield (ATMOSFER) 0 - - - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Masker Earloop (KasaHusada) 0 - - - -
MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - -
Rapid Test Covid-19 (Rajawali) 0 - - - -
Rapid Test Covid-19 (Dakonan) 0 - - - -
Alkohol Swab (BTT) 0 - - - -
Antiseptic Gel 500 0 - - - -
Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - - - 5,400
Kaca mata Goggle (HASTEN) 0 - - - -
Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - -
Masker Bedah Hijau @50pcs 0 - - - -
Masker N95 3M 8210 (Hazten) 0 - - - -
Nurse Cap Green om 100bh 0 - - - -
Parafilm (Anugerah Sentosa Abadi) 0 - - - -
Rapid Test (1.000) Widhi Dharma Adi 0 - - - -
Sarung tangan Safeglove Exam M 100bh 0 - - - -
Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - -
Sterlisasi Swab stik (5box/ VTM) 0 - - - -
Stereofoam (Anugerah Sentosa Abadi) 0 - - - -
Universal Transport Media (UTM) Goongdong 0 - - - -
Universal Transport Media (UTM) Sekarguna 0 - - - -
Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - -
Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - -
Infusion Set Anak 60 Drops /(Otsuka) 0 - - - -
Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - -
Rapid Test Lecurate (Bima Sakti) 0 - - - -
Rapid Test ZYBIO (Farma Husada) 0 - - - -
Alkohol 96 % Liter - - - -
0 0 - - - -
0 0 - - - -
TAMBAHAN PUSKESMAS 0 - - - -
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - - -
Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - - -
Asiklovir 5% 5gr Cream Tube 13 - - -
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs - - - -
0 0 - - - -
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - -
Furosemide Tablet 40 mg (Kimia Farma ) Tablet 579 - - -
Gentamycin Krim 1 % mg/ ml Tube - - - -
0 0 - - - -
Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 1 - - -
Ketokonazol Tablet 200 mg (Novapharin) I Tablet 10 - - -
Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 324 - - -
Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
Thiamin/ Vitamin B1 50 mg Tablet - - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - - -
Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
Antimicrobial Liquid Soap 500 ml (Viorex) 0 9 - - -
Hand Sanitizer 450 ml (Meditol) 0 - - - -
Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
I.V Catheter No. 18 (JELCO) Pcs - - - -
I.V Catheter No. 22 NIPRO Pcs - - - -
I.V Catheter No. 24 TERUMO Pcs - - - -
Materniti Napkin Slim L 0 - - - -
Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - - -
Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - - -
Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - - -
Sterizyme Dual Enymatic Detergent 5 Ltr 0 2 - - -
Haloperidol 5 mg tablet Tablet - - - -
Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - -
Fixomull Strech 5 cm X 5 m Pcs - - - -
Umbilical crd clamp 0 126 - - -
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 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -

TOTAL

Mengetahui,
KEPALA PUSKESMAS

.....................................................
AT - OBATAN (ASET) TRIWULAN 2
..... TAHUN 2020

PEMAKAIAN
SISA
TOTAL PENERIMAAN April Mei Juni TOTAL PEMAKAIAN SISA STOK Ket Harga
JUNI

- - - - - - - 1 99.000
500 - 50 445 495 5 5 1 105.000
- - - - - - - 1 105.000
- - - - - - - 1 0.000
- - 21 - 21 - - 1 2,860.000
240 - 60 - 60 180 180 1 2,860.000
- - - - - - - 1 10,500.000
800 133 134 - 267 950 950 1 104.000
- - - - - - - 1 220.000
2,000 321 - - 321 2,000 2,000 1 93.500
- - - - - - - 1 0.000
- - - - - - - 1 2,998.000
- - - - - - - 1 0.000
- - - - - - - 1 93.000
3,000 - 12 264 276 2,724 2,724 1 99.000
- - - - - - - 1 0.000
35,000 - 1,112 3,880 4,992 30,008 30,008 1 190.000
- - - - - - - 1 233.000
- - - - - - - 1 233.000
- - - - - - - 1 249.000
- - - - - - - 1 0.000
300 1 - 36 37 264 264 1 3,025.000
- - - - - - - 1 3,025.000
- - - - - - - 1 4,400.000
- - - - - - - 1 3,628.000
- - - - - - - 1 10,246.500
- - - - - - - 1 9,900.000
- 14 - - 14 - - 1 8,500.000
300 - - 9 9 291 291 1 8,237.000
- - - - - - - 1 0.000
50 - - - - 50 50 1 4,950.000
- - - - - - - 1 0.000
- - - - - - - 1 440.000
- - - - - - - 1 220.000
8,000 1,530 1,726 3,538 6,794 3,236 3,236 1 165.000
- - - - - - - 1 58.000
- - - - - - - 1 0.000
- - - - - - - 1 3,035.000
- - - - - - - 1 0.000
24 - - - - 24 24 1 4,496.000
- - - - - - - 1 0.000
- 60 140 220 420 - - 1 3,045.000
- - - - - - - 1 198.000
- - - - - - - 1 1,485.000
- - - - - - - 1 1,551.000
5,000 182 139 1,893 2,214 2,968 2,968 1 105.000
- - - - - - - 1 105.000
- - - - - - - 1 1,050.000
- - - - - - - 1 67.000
- - - - - - - 1 75.000
- - - - - - - 1 103.000
- - - - - - - 1 253.000
- - - - - - - 1 0.000
- 1 1 4 6 3 3 1 2,076.000
- - - - - - - 1 0.000
200 78 - 60 138 226 226 1 1,584.000
- - - - - - - 1 0.000
- 18 2 5 25 125 125 1 2,915.000
- - - - - - - 1 2,750.000
- - - - - - - 1 0.000
- - - - - - - 1 380.000
300 142 70 60 272 200 200 1 380.000
- - - - - - - 1 405.000
- - - - - - - 1 1,639.000
- - - - - - - 1 1,639.000
- - - - - - - 1 136.000
- 290 308 185 783 - - 1 152.000
2,000 - - 325 325 1,675 1,675 1 145.000
- - - - - - - 1 110.000
- - - - - - - 1 110.000
- 16 - - 16 - - 1 3,350.000
- 26 - - 26 - - 1 3,350.000
300 - 45 52 97 203 203 1 3,350.000
- - - - - - - 1 300.000
- - - - - - - 1 5,900.000
- - - - - - - 1 626.000
- - - - - - - 1 18,150.000
- - - - - - - 1 7,602.000
- - - - - - - 1 7,124.000
- - - - - - - 1 0.000
 - - - - - - - 1 149,266.000
- - - - - - - 1 0.000
- - - - - - - 1 5,280.000
1,000 - - 170 170 830 830 1 660.000
- - - - - - - 1 671.000
- - - - - - - 1 4,282.000
- - 5 6 11 62 62 1 11,000.000
- - - - - - - 1 10,098.000
- - - - - - - 1 2,805.000
- - 14 24 38 17 17 1 1,097.000
200 - - - - 200 200 1 1,097.000
1,000 731 566 584 1,881 1,079 1,079 1 60.500
- - - - - - - 1 66.000
- 2 1 - 3 - - 1 10,400.000
- - - - - - - 1 9,900.000
300 41 35 24 100 255 255 1 1,095.000
- - - - - - - 1 0.000
- 39 15 - 54 161 161 1 104.000
- - - - - - - 1 104.000
- - - - - - - 1 104.000
1,500 - 30 - 30 1,470 1,470 1 105.000
- 50 - - 50 - - 1 112.000
- - - - - - - 1 0.000
- 7 - - 7 - - 1 4,400.000
- - - - - - - 1 2,700.000
- 157 176 - 333 120 120 1 165.000
- - - - - - - 1 91.000
- - - - - - - 1 1,408.000
30 - 31 - 31 25 25 1 1,408.000
- - - - - - - 1 1,408.000
- - - - - - - 1 730.000
200 - - - - 200 200 1 770.000
- - - - - - - 1 391.000
- - - - - - - 1 4,167.000
- 3 - - 3 - - 1 3,550.000
120 147 120 - 267 - - 1 3,682.000
120 - 27 - 27 93 93 1 3,682.000
- - - - - - - 1 691.000
- 92 15 - 107 115 115 1 710.000
- - - - - - - 1 0.000
- - - - - - - 1 1,333.000
- - - - - - - 1 1,333.000
- - - - - - - 1 82.000
- - - - - - - 1 82.000
- - - - - - - 1 4,232.000
- 5 - - 5 - - 1 4,232.000
 192 - 80 - 80 112 112 1 4,232.000
- 6 - - 6 - - 1 2,750.000
- - - - - - - 1 4,400.000
24 27 8 - 35 56 56 1 2,900.000
3,000 614 294 - 908 5,531 5,531 1 119.000
- - - - - - - 1 119.000
- 590 - - 590 - - 1 77.000
7,800 - 985 - 985 6,815 6,815 1 99.000
- 13 6 - 19 120 120 1 7,865.000
5 - - - - 14 14 1 10,010.000
- - - - - - - 1 10,010.000
- - - - - - - 1 6,900.000
40 - - - - 40 40 1 7,363.000
- - - - - - - 1 132.000
1,000 - 903 - 903 1,367 1,367 1 149.000
- - - - - - - 1 88.000
- - - - - - - 1 2,787.000
120 3 - - 3 120 120 1 2,475.000
- - - - - - - 1 2,475.000
- - - - - - - 1 176,800.000
- - - - - 10 10 1 8,800.000
- - - - - - - 1 0.000
- - - - - - - 1 4,665.000
216 - 28 - 28 188 188 1 4,665.000
8,000 20 100 - 120 7,900 7,900 1 264.000
- - - - - - - 1 330.000
- - - - - - - 1 660.000
- - - - - - - 1 187.000
- 13 - - 13 255 255 1 90.000
- 22 - - 22 - - 1 89.000
- - - - - - - 1 121.000
- - - - - - - 1 0.000
- - - - - - - 1 9,644.000
- - - - - - - 1 10,696.000
- - - - - - - 1 10,696.000
- - - - - - - 1 0.000
- - - - - - - 1 770.000
- - - - - - - 1 0.000
- - - - - 100 100 1 1,755.000
8,000 440 1,540 - 1,980 6,460 6,460 1 187.000
- - - - - - - 1 63.000
- - - - - - - 1 63.000
3,000 2,281 - - 2,281 5,206 5,206 1 94.600
- - - - - - - 1 99.000
- 2 5 - 7 - - 1 5,610.000
50 - 4 - 4 46 46 1 2,518.000
 - 30 - - 30 370 370 1 396.000
- - - - - - - 1 288.000
- - - - - - - 1 288.000
- - - - - - - 1 1,089.000
- - - - - - - 1 0.000
240 17 71 - 88 260 260 1 1,810.000
- - - - - - - 1 0.000
- - - - - - - 1 10,500.000
- 1 - - 1 - - 1 17,968.500
- 8 - - 8 - - 1 35,200.000
- - - - - - - 1 0.000
- - - - - - - 1 22.000
10,000 1,764 2,830 - 4,594 7,570 7,570 1 77.000
- - - - - - - 1 23.000
- - - - - - - 1 2,750.000
- - - - - - - 1 495.000
2,000 - 62 - 62 1,938 1,938 1 440.000
- - - - - - - 1 319.000
- - - - - - - 1 2,052.000
200 - - - - 200 200 1 2,190.000
12 3 2 - 5 12 12 1 13,970.000
20 - - - - 20 20 1 22,550.000
- - - - - - - 1 23,100.000
- - - - - - - 1 3,811.500
- 2 10 - 12 49 49 1 6,600.000
- - - - - - - 1 0.000
- - - - - - - 1 1,937.000
450 31 70 - 101 380 380 1 2,178.000
- - - - - - - 1 1,222.000
- 44 - - 44 200 200 1 99.000
- - - - - - - 1 330.000
- 34 - - 34 146 146 1 123.000
- - - - - - - 1 131.000
- - - - - 360 360 1 4,680.500
180 - - - - 180 180 1 4,730.000
- - - - - - - 1 550.000
- - - - - - - 1 0.000
- - - - - - - 1 4,950.000
100 253 290 - 543 77 77 1 5,500.000
- - - - - - - 1 3,707.000
- 414 27 - 441 473 473 1 96.000
2,000 - - - - 2,000 2,000 1 102.000
- 41 109 - 150 200 200 1 143.000
- - - - - - - 1 0.000
- 8 - - 8 - - 1 87.000
- - - - - - - 1 80.000
 - - - - - - - 1 121.000
- - - - - - - 1 192.500
- - - - - - - 1 275.000
- - - - - - - 1 8,110.000
- - - - - - - 1 8,110.000
- - - - - - - 1 14,318.700
120 - 120 - 120 - - 1 5,500.000
90 30 - - 30 870 870 1 2,090.000
- - - - - - - 1 5,000.000
- 2 5 - 7 - - 1 4,400.000
- - - - - - - 1 1,265.000
- - - - - - - 1 990.000
48 50 32 - 82 62 62 1 13,200.000
- - - - - - - 1 13,167.000
- - - - - - - 1 2,332.000
- - - - - - - 1 528.000
- - - - - - - 1 594.000
25,300 - - - - 25,300 25,300 1 835.000
- - - - - - - 1 115.000
- 297 239 - 536 660 660 1 123.000
- - - - - - - 1 123.000
- 27 - - 27 - - 1 6,410.000
- - - - - - - 1 6,410.000
- 173 218 - 391 70 70 1 132.000
- - - - - - - 1 3,948.000
- 2 - - 2 - - 1 23,141.800
- 9 - - 9 11 11 1 19,800.000
- 3 11 - 14 27 27 1 560.000
- - - - - - - 1 560.000
- - - - - - - 1 598.000
- - - - - - - 1 12,100.000
- - - - - - - 1 24,860.000
- - - - - - - 1 9,955.000
- - - - - - - 1 25,597.000
- - 600 - 600 - - 1 160.000
500 - - - - 500 500 1 1,070.000
- - - - - - - 1 1,124.000
- - - - - - - 1 715.000
- - - - - - - 1 432.300
- 438 - - 438 - - 1 437.800
- - - - - - - 1 418.000
- - - - - - - 1 357.500
- - - - - - - 1 495.000
- - - - - - - 1 789.800
- - - - - - - 1 1,181.000
300 - - - - 300 300 1 1,181.000
1,000 198 72 - 270 1,000 1,000 1 53.000
- 1,854 - - 1,854 - - 1 56.000
- - - - - - - 1 53.000
30 - 1 - 1 34 34 1 20,700.000
90 - 3 - 3 89 89 1 11,825.000
- - - - - - - 1 11,825.000
- 116 30 - 146 62 62 1 963.600
- - - - - - - 1 115.500
20 7 10 - 17 19 19 1 4,400.000
- - - - - - - 1 132.000
3,000 946 608 - 1,554 3,084 3,084 1 123.000
- - - - - - - 1 6,600.000
- - - - - - - 1 41,500.000
- - - - - - - 1 68.000
4,000 791 806 - 1,597 3,194 3,194 1 73.000
- - - - - - - 1 73.000
- - - - - - - 1 1,000.000
600 - - - - 600 600 1 1,155.000
- - - - - - - 1 1,188.000
1,000 302 362 - 664 1,836 1,836 1 220.000
- - - - - - - 1 0.000
- - - - - - - 1 9,646.000
- - - - - - - 1 9,646.000
- 21 - - 21 - - 1 7,150.000
- 1,318 280 - 1,598 320 320 1 7,150.000
- - - - - - - 1 7,630.000
300 32 15 - 47 285 285 1 4,550.000
- - - - - - - 1 0.000
- - - - - - - 1 70.000
- - - - - - - 1 165.000
72 25 11 - 36 64 64 1 2,620.000
- - - - - - - 1 2,796.000
- - - - - - - 1 6,006.000
- 7 - - 7 - - 1 5,170.000
- - - - - - - 1 2,200.000
- - - - - - - 1 479,996.000
2 - - - - 2 2 1 512,204.000
- - - - - - - 1 130,999.000
50 - - - - 50 50 1 130,999.000
- 27 22 - 49 20 20 1 90.000
- - - - - - - 1 90.000
1,200 23 53 - 76 1,178 1,178 1 110.000
- - - - - - - 1 117.000
- - 5,000 - 5,000 - - 1 265.000
- - - - - - - 1 0.000
- - - - - - - 1 6,789.000
 25 - - - - 25 25 1 6,789.000
- - - - - - - 1 13,607.000
- - - - - - - 1 310.000
- - - - - - - 1 86.000
- 1,408 852 - 2,260 - - 1 132.000
1,000 - 72 - 72 928 928 1 91.000
- - - - - - - 1 935.000
- - - - - - - 1 935.000
- 4 3 - 7 29 29 1 7,150.000
- - - - - - - 1 7,150.000
- - - - - - - 1 89.000
- - - - - - - 1 239.800
- - - - - - - 1 0.000
- - - - - - - 1 108.000
- - - - - - - 1 1,045.000
- - - - - - - 1 967.000
- - - - - - - 1 776.006
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 12,573.000
- - - - - - - 1 12,573.000
- - - - - - - 1 12,573.000
- - - - - - - 1 1,735.000
- - - - - - - 1 1,735.000
- - - - - - - 1 19,789.000
- - - 87 31 - 396.000
- - - - - - - 1 114.000
- - - - - - - 1 171.000
- - - - - - - 1 171.000
- - - - - - - 1 171.000
- - - - - - - 1 550.000
- - - - - - - 1 0.000
- - - - - - - 1 779.000
- - - - - - - 1 1,320.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 278.300
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- 2 1 - 3 262 262 1 404.000
- - - - - - - 1 431.000
- - - - - - - 1 0.000
- - - - - - - 1 257.000
1,000 924 1,242 - 2,166 895 895 1 257.000
 - - - - - - - 1 274.000
- - - - - - - 1 274.000
- - - - - - - 1 0.000
- 6 1 - 7 50 50 1 6,281.000
- - - - - - - 1 9,900.000
500 - 500 - 500 - - 1 524.000
- - - - - - - 1 524.000
- - - - - - - 1 524.000
5,000 1,242 1,450 - 2,692 5,199 5,199 1 524.000
- - - - - - - 1 524.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 1,325,000.000
- - - - - - - 1 1,325,000.000
- 1 - - 1 - - 1 1,325,000.000
- - - - - - - 1 1,325,000.000
1 - 1 - 1 - - 1 1,325,000.000
- - - - - - - 1 0.000
- - - - - - - 1 232,518.000
- - - - - - - 1 248,120.000
- - - - - - - 1 248,120.000
- - - - - - - 1 389,344.000
- - - - - - - 1 415,469.000
2 1 1 - 2 - - 1 1,384,983.000
- - - - - - - 1 1,384,983.000
- - - - - - - 1 1,384,983.000
- - - - - - - 1 317,018.000
- - - - - - - 1 0.000
- - - - - - - 1 282.000
- - - - - - - 1 0.000
- - - - - - - 1 28,354.000
- - - - - - - 1 28,354.000
- - - - - - - 1 40,913.489
- - - - - - - 1 41,784.000
- - - - - - - 1 41,784.000
- - - - - - - 1 8,891.000
- - - - - - - 1 13,300.000
- - - - - - - 1 11,738.000
- - - - - - - 1 36,579.000
- - - - - - - 1 15,014.000
- - - - - - - 1 0.000
- - - - - - - 1 2,920.000
- - - - - - - 1 2,920.000
- - - - - - - 1 517.000
- 3,225 55 - 3,280 70 70 1 517.000
- - - - - - - 1 552.000
 - 350 - - 350 - - 1 284.000
- - - - - - - 1 307.000
- - - - - - - 1 307.000
5,000 26,268 22,200 - 48,468 - - 1 354.000
- - - - - - - 1 354.000
- - - - - - - 1 354.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
10 - - - - 10 10 1 9,955.000
- - - - - 2 2 1 3,796.000
- - - - - - - 1 3,796.000
- - - - - - - 1 10,351.000
- 7 - - 7 - - 1 2,959.000
50 - 50 - 50 - - 1 2,684.000
50 - - - - 50 50 1 2,959.000
- - - - - - - 1 2,500.000
500 200 50 - 250 630 630 1 210.000
- 5 - - 5 - - 1 1,900.000
200 - 28 - 28 172 172 1 1,199.000
- - - - - - - 1 1,639.000
- - - - - - - 1 1,199.000
- - - - - - - 1 0.000
- - - - - - - 1 167.000
- - - - - - - 1 167.000
- - - - - - - 1 167.000
- - - - - 160 160 1 167.000
- - - - - - - 1 167.000
- - - - - - - 1 1,121.000
- - - - - - - 1 3,288.000
- - - - - - - 1 1,200.000
- - - - - - - 1 1,750.000
- - - - - - - 1 1,750.000
- - - - - - - 1 183.000
- - - - - - - 1 63,986.000
- - - - - - - 1 63,813.000
- - - - - - - 1 57,500.000
- - - - - - - 1 60.000
3,000 65 77 - 142 2,945 2,945 1 60.000
- - - - - - - 1 60.000
- - - - - - - 1 0.000
- - - - - - - 1 5,000.000
- - - - - - - 1 13,200.000
- - - - - - - 1 19,955.000
- - - - - - - 1 245.000
- - - - - - - 1 245.000
 3 - - - - 3 3 1 1,243.000
- - - - - - - 1 1,326.000
- - - - - - - 1 158.000
3,000 - 43 - 43 2,957 2,957 1 157.000
- - - - - - - 1 253.000
- - - - - - - 1 0.000
- - - - - - - 1 287.000
- - - - - - - 1 287.000
1,000 317 119 - 436 914 914 1 287.000
- - - - - - - 1 287.000
- - - - - - - 1 0.000
- - - - - - - 1 287.000
- - - - - - - 1 0.000
- 368 372 - 740 121 121 1 91.000
3,000 - - - - 3,000 3,000 1 91.000
- - - - - - - 1 440.000
- - - - - - - 1 0.000
- - - - - - - 1 63,986.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
70 32 - - 32 49 49 1 56,360.000
70 32 - - 32 49 49 1 0.000
- - - - - - - 1 60,140.000
- - - - - - - 1 66,154.000
- - - - - 49 49 1 141,648.000
40 - - - - 89 89 1 0.000
70 18 - - 18 52 52 1 151,150.000
- - - - - - - 1 166,265.000
70 84 - - 84 102 102 1 76,620.000
- - - - - - - 1 84,282.000
- - - - - - - 1 17,450.000
- - - - - - - 1 0.000
- - - - - 50 50 1 23,270.000
90 - - - - 90 90 1 25,597.000
80 68 - - 68 50 50 1 18,140.000
110 85 - - 85 93 93 1 0.000
30 17 - - 17 43 43 1 19,470.270
- - - - - - - 1 19,954.000
10 1 - - 1 9 9 1 15,450.000
- - - - - - - 1 0.000
- - - - - - - 1 21,810.000
- - - - - - - 1 19,350.000
- - - - - - - 1 135,000.000
- - - - - - - 1 151,150.000
- - - - - - - 1 0.000
- - - - - - - 1 21,285.000
- - - - - - - 1 144,540.000
- - - - - - - 1 50,000.000
- - - - - - - 1 165,000.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 34,354.100
- - - - - - - 1 0.000
- - 10 - 10 260 260 1 164.000
- - - - - - - 1 0.000
- - - - - - - 1 90,000.000
- - - - - - - 1 90,000.000
- - - - - - - 1 183,480.000
- - - - - - - 1 176,400.000
- - - - - - - 1 77.000
- - - - - - - 1 0.000
- - - - - - - 1 79,154.000
- - - - - - - 1 79,154.000
- - - - - - - 1 303,750.000
- - - - - - - 1 252,720.000
- - - - - - - 1 106,080.000
- - - - - - - 1 106,080.000
- - - - - - - 1 222,000.000
- - - - - - - 1 222,000.000
- - - - - - - 1 198,900.000
- - - - - - - 1 198,900.000
- - - - - - - 1 230,880.000
- - - - - - - 1 133,137.000
- - - - - - - 1 84,050.000
- - - - - - - 1 0.000
- - - - - - - 1 22,794.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
 - - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 990.000
- 71 30 - 101 14 14 1 1,023.000
- - - - - - - 1 0.000
- 781 150 - 931 - - 1 924.000
3,000 - 465 - 465 2,535 2,535 1 1,138.000
- - - - - - - 1 924.000
1,000 - - - - 1,000 1,000 1 979.000
- - - - - - - 1 739.200
- - - - - - - 1 1,463.000
- - - - - - - 1 32,522.000
- 3 - - 3 - - 1 2,541.000
- - - - - - - 1 23,951.000
- 1 - - 1 - - 1 19,885.446
- - - - - - - 1 120.000
500 - - - - 500 500 1 127.260
- - - - - - - 1 212,784.000
- - - - - - - 1 70,000.000
120 - - - - 120 120 1 22,725.000
- 24 4 - 28 - - 1 22,500.000
- - - - - - - 1 32,522.000
- - - - - - - 1 24,583.333
- - - - - - - 1 34,300.000
- - - - - - - 1 712,800.000
- 9 - - 9 - - 1 348,480.000
- 240 30 - 270 - - 1 2,222.000
- - - - - - - 1 1,540.000
- - - - - - - 1 37,440.000
10 7 11 - 18 23 23 1 13,050.000
- - - - - - - 1 9,680.000
- - - - - - - 1 20,970.000
5 - - - - 5 5 1 13,607.000
- - - - - - - 1 180,000.000
- 58 - - 58 - - 1 8,900.000
100 - 27 - 27 73 73 1 5,500.000
- - - - - - - 1 8,900.000
200 5 54 - 59 150 150 1 6,270.000
- - - - - - - 1 8,700.000
- 4 1 - 5 - - 1 5,500.000
300 - 51 - 51 249 249 1 5,500.000
200 5 49 - 54 151 151 1 6,270.000
- - - - - - - 1 6,270.000
- - 4 - 4 - - 1 7,920.000
100 - - - - 100 100 1 8,400.000
- - - - - - - 1 6,199.900
 400 - 500 - 500 400 400 1 8,400.000
- - - - - - - 1 1,760.000
- - - - - - - 1 13,400.000
10 1 - - 1 10 10 1 13,400.000
- - - - - - - 1 12,500.000
- - - - - - - 1 2,300.000
10 - 2 - 2 8 8 1 136,500.000
- - - - - - - 1 136,500.000
- - - - - - - 1 8,000.000
50 8 - - 8 50 50 1 5,950.000
- - - - - - - 1 8,000.000
- 96 - - 96 - - 1 1,430.000
100 - 10 - 10 90 90 1 2,240.000
- - - - - - - 1 2,100.000
- 17 - - 17 - - 1 427.850
- - - - - - - 1 390.860
- - - - - - - 1 2,060.000
- - - - - - - 1 0.000
- - - - - - - 1 17,500.000
15 15 - - 15 - - 1 6,512.000
- - - - - - - 1 339.900
- - - - - - - 1 339.900
- - - - - - - 1 2,200.000
200 - 80 - 80 120 120 1 2,309.375
- - - - - - - 1 10,857.000
- - - - - - - 1 10,856.250
- - - - - - - 1 65,340.000
100 60 50 - 110 50 50 1 333.900
- - - - - - - 1 11,615.000
- - - - - - - 1 6,600.000
- - - - - - - 1 154.000
54 2 31 - 33 23 23 1 7,700.000
54 - - - - 54 54 1 7,769.000
10 - 1 - 1 9 9 1 18,000.000
- - - - - - - 1 12,675.000
- - - - - - - 1 3,700.000
- - - - - - - 1 0.000
- - - - - - - 1 286,000.000
- - - - - - - 1 726.953
- - - - - - - 1 0.000
1,500 - 1,400 - 1,400 100 100 1 542.520
- - - - - - - 1 496.650
- 5 - - 5 - - 1 19,360.000
- - - - - - - 1 470.530
- - 200 - 200 300 300 1 3,773.000
- - - - - - - 1 4,134.900
 60 5 12 - 17 48 48 1 20,586.000
- - - - - - - 1 15,150.000
- - - - - - - 1 0.000
- - - - - - - 1 87,120.000
- 1 - - 1 1 1 1 752,400.000
30 - 5 - 5 25 25 1 8,295.000
- - - - - - - 1 8,031.579
- - - - - - - 1 0.000
20 6 7 - 13 13 13 1 5,368.000
- - - - - - - 1 5,785.000
- - - - - - - 1 0.000
- - - - - - - 1 2,887.500
- - - - - - - 1 0.000
- - - - - - - 1 453,802.994
- - - - - - - 1 4,200.000
- - 200 - 200 600 600 1 635.250
- - - - - - - 1 4,000.000
- - - - - - - 1 59,000.000
- - - - - - - 1 45,000.000
- - - - - - - 1 45,000.000
- - - - - - - 1 0.000
- - - - - - - 1 546,400.000
- - - - - - - 1 544,150.000
- - - - - - - 1 0.000
- - - - - - - 1 223,949.367
- - - - - - - 1 254,300.000
- - - - - - - 1 252,800.000
2 - 1 - 1 1 1 1 401,666.666
- - - - - - - 1 405,000.000
- - - - - - - 1 10,560.000
- - - - - - - 1 0.000
- - - - - - - 1 10,837.000
- - - - - - - 1 0.000
- - - - - - - 1 19,225.000
- - - - - - - 1 0.000
- - - - - - - 1 552,800.000
- - - - - - - 1 552,800.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 16,400.000
- - - - - - - 1 0.000
100 - - - - 100 100 1 4,120.000
- - - - - - - 1 4,120.000
300 - - - - 300 300 1 15,500.000
- - - - - - - 1 9,738.000
- - - - - - - 1 9,611.000
 - - - - - - - 1 0.000
- - - - - - - 1 625,900.000
- - - - - - - 1 22,176.000
- - - - - - - 1 66,876.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 13,252.000
- - - - - - - 1 10,865.800
350 - - - - 350 350 1 8,053.000
- - - - - - - 1 8,110.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 36,000.000
- - - - - - - 1 77,690.000
- - - - - - - 1 825,000.000
- - - - - - - 1 224,254.000
- - - - - - - 1 259,175.000
- - - - - - - 1 70,000.000
- - - - - - - 1 4,952.830
- - - - - - - 1 4,952.830
- - - - - - - 1 2,728.000
- - - - - - - 1 5,890.000
- - - - - - - 1 660,000.000
- - - - - - - 1 158,400.000
- - - - - - - 1 276,600.000
- - - - - - - 1 276,500.000
- - - - - - - 1 257,644.000
- - - - - - - 1 228,800.000
- - - - - - - 1 20,747.000
- - - - - - - 1 20,748.000
- - - - - - - 1 6,700.000
- - - - - - - 1 19,835.000
- - - - - - - 1 386.100
- - - - - - - 1 0.000
- - - - - - - 1 1,590.000
- - - - - - - 1 1,550.000
- - - - - - - 1 1,463.000
- - - - - - - 1 1,518.000
- - - - - - - 1 1,190.000
- - - - - - - 1 1,185.000
- - - - - - - 1 1,463.000
- - - - - - - 1 1,190.000
 - - - - - - - 1 1,077.000
- - - - - - - 1 1,081.820
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- 28 114 - 142 286 286 1 1,583.000
- - - - - - - 1 1,439.000
- - - - - - - 1 1,439.000
- - - - - - - 1 0.000
- - - - - - - 1 22,433.000
- - - - - - - 1 1,460.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
50 - - - - 50 50 1 14,712.500
- - - - - - - 1 19,480.000
- - - - - - - 1 13,750.000
- - - - - - - 1 13,235.000
50 - - - - 50 50 1 12,500.000
- - - - - - - 1 13,750.000
- 144 - - 144 - - 1 358.000
- - - - - - - 1 121,750.000
- 20 - - 20 - - 1 486.000
- - - - - - - 1 0.000
900 - - - - 900 900 1 11,975.000
- - - - - - - 1 28,666.670
- - - - - - - 1 13,235.000
- - - - - - - 1 12,500.000
- - - - - - - 1 11,975.000
- - - - - - - 1 11,975.000
- - - - - - - 1 0.000
- - - - - - - 1 19,480.000
- - - - - - - 1 0.000
- - - - - - - 1 13,235.000
- - - - - - - 1 0.000
- - - - - - - 1 19,480.000
- - - - - - - 1 13,353.000
- - - - - - - 1 800.000
- - - - - - - 1 0.000
- - - - - - - 1 323,500.000
- - - - - - - 1 53,000.000
- - - - - - - 1 386.100
- - - - - - - 1 0.000
 - - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 38,500.000
- - - - - - - 1 71,500.000
- - - - - - - 1 38,500.000
- - - - - - - 1 71,500.000
- - - - - - - 1 333.900
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 473.000
- - - - - - - 1 0.000
- - - - - - - 1 110.000
- - - - - - - 1 1,750.000
- - - - - - - 1 98.000
- - - - - - - 1 783.000
- - - - - - - 1 7,150.000
- - - - - - - 1 2,134.000
- - - - - - - 1 6,199.900
300 - - - - 300 300 1 1,155.000
- - - - - - - 1 80.000
- - - - - - - 1 396.000
- - - - - - - 1 500.000
- - - - - 50 50 1 7,920.000
- - - - - - - 1 1,302.000
- - - - - - - 1 1,890.000
- - - - - - - 1 160.000
- - - - - - - 1 6,840.000
- - - - - - - 1 90.000
- - - - - - - 1 265.000
- - - - - - - 1 14,300.000
- - - - - - - 1 7,630.000
- - - - - - - 1 167.000
 - - - - - - - 1 8,355.000
1 - - - - 1 1 1 1,457,500.000
- - - - - - - 1 0.000
- - - - - - - 1 12,969.000
- - - - - - - 1 1,506.000
- - - - - - - 1 410,777.000
- - - - - - - 1 343,687.000
- - - - - - - 1 32,493.000
- - - - - - - 1 0.000
- - - - - - - 1 2,254.320
- - - - - - - 1 259,175.000
- - - - - - - 1 15,180.000
- - - - - - - 1 31,680.000
- - - - - - - 1 31,405.000
- - - - - - - 1 3,300.000
- - - - - - - 1 7,630.000
- - - - - - - 1 14,300.000
- - - - - - - 1 8,426.000
- - - - - - - 1 627.000
- - - - - - - 1 792.000
- - - - - - - 1 1,700.000
- - - - - - - 1 1,700.000
- - - - - - - 1 55,000.000
- - - - - - - 1 58,500.000
- - - - - - - 1 850.000
- - - - - - - 1 4,000.000
- - - - - - - 1 8,355.000
- - - - - - - 1 248,120.000
- - - - - - - 1 186,000.000
- - - - - - - 1 6,500.000
- - - - - - - 1 11,250.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
5 - - - - 5 5 1 236,500.000
5 - - - - 5 5 1 99,000.000
7 - 3 - 3 4 4 1 203,500.000
10 - 10 - 10 - - 1 275,000.000
- - - - - - - 1 132,000.000
- - - - - - - 1 49,500.000
- - - - - - - 1 5,500.000
- - - - - - - 1 66,000.000
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- - - - - - - 1 21,736.000
- - - - - - - 1 386.100
2,000 - - - - 2,000 2,000 1 340.280
1 - - - - 1 1 1 560,000.000
2 - - - - 2 2 1 1,252,000.000
1 - 1 - 1 - - 1 575,000.000
20 - 20 - 20 - - 1 156,000.000
- - - - - - - 1 53,636.000
5 - 5 - 5 - - 1 220,000.000
3 - 1 - 1 2 2 1 148,500.000
1,200 - 1,000 - 1,000 200 200 1 7,000.000
- - - - - - - 1 2,200.000
- - - - - - - 1 60,000.000
1,200 - - - - 1,200 1,200 1 6,269.000
- - - - - - - 1 197,000.000
40 - 20 - 20 20 20 1 75,000.000
- - - - - - - 1 8,500.000
25 - 4 - 4 21 21 1 220,000.000
- - - - - - - 1 220,000.000
- - - - - - - 1 75,000.000
200 - 50 - 50 150 150 1 5,000.000
- - - - - - - 1 200,000.000
- - - - - - - 1 56,000.000
- - - - - - - 1 80,000.000
49 - 15 - 15 34 34 1 200,000.000
- - - - - - - 1 138,364.000
- - - - - - - 1 137,364.000
- - - - - - - 1 45,100.000
- - - - - - - 1 66,000.000
- - - - - - - 1 53,636.000
- - - - - - - 1 450,000.000
- - - - - - - 1 718,500.000
- - - - - - - 1 69,000.000
- - - - - - - 1 60,000.000
- - - - - - - 1 6,000.000
- - - - - - - 1 522,728.000
- - - - - - - 1 180,000.000
- - - - - - - 1 220,000.000
- - - - - - - 1 109.090
- - - - - - - 1 24,091.000
5,400 - - - - 5,400 5,400 1 1,150.000
- - - - - - - 1 47,500.000
- - - - - - - 1 200,000.000
- - - - - - - 1 2,816.000
- - - - - - - 1 150,000.000
- - - - - - - 1 303.550
- - - - - - - 1 891,275.000
- - - - - - - 1 160,500.000
- - - - - - - 1 585.000
- - - - - - - 1 5,300.000
- - - - - - - 1 5,500.000
- - - - - - - 1 60,500.000
- - - - - - - 1 80,000.000
- - - - - - - 1 136,564.000
- - - - - - - 1 1,265.000
- - - - - - - 1 8,400.000
- - - - - - - 1 8,400.000
- - - - - - - 1 98,000.000
- - - - - - - 1 90,000.000
- - - - - - - 1 97,500.000
- - - - - - - 1 22,500.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 7,199.885
- - - - - - - 1 1,945.000
- 13 - - 13 - - 1 2,950.000
- - - - - - - 1 139,880.000
- - - - - - - 1 0.000
- - - - - - - 1 1,097.000
- 27 - - 27 552 552 1 77.000
- - - - - - - 1 3,217.500
- - - - - - - 1 0.000
- 1 - - 1 - - 1 15,572.700
- 10 - - 10 - - 1 270.000
- - - - - - - 1 600.000
- 24 - - 24 300 300 1 1,106.000
- - - - - - - 1 45.000
- - - - - - - 1 36.000
- - - - - - - 1 783.000
- - - - - - - 1 1,302.000
- 3 2 - 5 4 4 1 74,250.000
- - - - - - - 1 43,186.000
- - - - - - - 1 7,920.000
- - - - - - - 1 8,750.000
- - - - - - - 1 7,018.000
- - - - - - - 1 8,355.000
- - - - - - - 1 20,328.000
- - - - - - - 1 12,076.000
- - - - - - - 1 6,595.000
- 1 - - 1 - - 1 1,098,900.000
- 1 - - 1 1 1 1 712,800.000
- - - - - - - 1 56.000
- - - - - - - 1 1,640.000
- - - - - - - 1 42,800.000
- - - - - 126 126 1 2,750.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
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- - - - - - - 1 0.000
- - - - - - - 1 0.000
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- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
- - - - - - - 1 0.000
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- - - - - - - 1 0.000
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- - - - - - - 1 0.000
- - - - - - - 1 0.000
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- - - - - - - 1 0.000
- - - - - - - 1 0.000

PENGELOLA KEFARMASIAN

...................................................
Nilai Penerimaan Nilai Pemakaian Nilai Persediaan

0.000 0.000 0.000

52,500.000 51,975.000 525.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 60,060.000 0.000
686,400.000 171,600.000 514,800.000
0.000 0.000 0.000
83,200.000 27,768.000 98,800.000
0.000 0.000 0.000
187,000.000 30,013.500 187,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
297,000.000 27,324.000 269,676.000
0.000 0.000 0.000
6,650,000.000 948,480.000 5,701,520.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
907,500.000 111,925.000 798,600.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 119,000.000 0.000
2,471,100.000 74,133.000 2,396,967.000
0.000 0.000 0.000
247,500.000 0.000 247,500.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
1,320,000.000 1,121,010.000 533,940.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
107,904.000 0.000 107,904.000
0.000 0.000 0.000
0.000 1,278,900.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
525,000.000 232,470.000 311,640.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 12,456.000 6,228.000
0.000 0.000 0.000
316,800.000 218,592.000 357,984.000
0.000 0.000 0.000
0.000 72,875.000 364,375.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
114,000.000 103,360.000 76,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 119,016.000 0.000
290,000.000 47,125.000 242,875.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 53,600.000 0.000
0.000 87,100.000 0.000
1,005,000.000 324,950.000 680,050.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
 0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
660,000.000 112,200.000 547,800.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 121,000.000 682,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 41,686.000 18,649.000
219,400.000 0.000 219,400.000
60,500.000 113,800.500 65,279.500
0.000 0.000 0.000
0.000 31,200.000 0.000
0.000 0.000 0.000
328,500.000 109,500.000 279,225.000
0.000 0.000 0.000
0.000 5,616.000 16,744.000
0.000 0.000 0.000
0.000 0.000 0.000
157,500.000 3,150.000 154,350.000
0.000 5,600.000 0.000
0.000 0.000 0.000
0.000 30,800.000 0.000
0.000 0.000 0.000
0.000 54,945.000 19,800.000
0.000 0.000 0.000
0.000 0.000 0.000
42,240.000 43,648.000 35,200.000
0.000 0.000 0.000
0.000 0.000 0.000
154,000.000 0.000 154,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 10,650.000 0.000
441,840.000 983,094.000 0.000
441,840.000 99,414.000 342,426.000
0.000 0.000 0.000
0.000 75,970.000 81,650.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 21,160.000 0.000
 812,544.000 338,560.000 473,984.000
0.000 16,500.000 0.000
0.000 0.000 0.000
69,600.000 101,500.000 162,400.000
357,000.000 108,052.000 658,189.000
0.000 0.000 0.000
0.000 45,430.000 0.000
772,200.000 97,515.000 674,685.000
0.000 149,435.000 943,800.000
50,050.000 0.000 140,140.000
0.000 0.000 0.000
0.000 0.000 0.000
294,520.000 0.000 294,520.000
0.000 0.000 0.000
149,000.000 134,547.000 203,683.000
0.000 0.000 0.000
0.000 0.000 0.000
297,000.000 7,425.000 297,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 88,000.000
0.000 0.000 0.000
0.000 0.000 0.000
1,007,640.000 130,620.000 877,020.000
2,112,000.000 31,680.000 2,085,600.000
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1,457,500.000 0.000 1,457,500.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
1,182,500.000 0.000 1,182,500.000
495,000.000 0.000 495,000.000
1,424,500.000 610,500.000 814,000.000
2,750,000.000 2,750,000.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
5,012,700.000 0.000 5,012,700.000
0.000 0.000 0.000
0.000 0.000 0.000
680,560.000 0.000 680,560.000
560,000.000 0.000 560,000.000
2,504,000.000 0.000 2,504,000.000
575,000.000 575,000.000 0.000
3,120,000.000 3,120,000.000 0.000
0.000 0.000 0.000
1,100,000.000 1,100,000.000 0.000
445,500.000 148,500.000 297,000.000
8,400,000.000 7,000,000.000 1,400,000.000
0.000 0.000 0.000
0.000 0.000 0.000
7,522,800.000 0.000 7,522,800.000
0.000 0.000 0.000
3,000,000.000 1,500,000.000 1,500,000.000
0.000 0.000 0.000
5,500,000.000 880,000.000 4,620,000.000
0.000 0.000 0.000
0.000 0.000 0.000
1,000,000.000 250,000.000 750,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
9,800,000.000 3,000,000.000 6,800,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
6,210,000.000 0.000 6,210,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 38,350.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 2,079.000 42,504.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 15,572.700 0.000
0.000 2,700.000 0.000
0.000 0.000 0.000
0.000 26,544.000 331,800.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 371,250.000 297,000.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 1,098,900.000 0.000
 0.000 712,800.000 712,800.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 346,500.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000

209,298,478.432 109,955,733.552 194,956,050.576

PETUGAS
PENGELOLA KEFARMASIAN

.....................................................
 LAPORAN PEMAKAIAN DAN LEMBAR PERM
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN JUMLAH

UNIT UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 5 - 5 5
5

3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -

4 A004 0 0 - - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial - - - -
6 A006 Air Untuk Injeksi Vial @25 ml Vial 180 - 180 33
33
7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - - -
8 A008 Alopurinol Tablet 100 mg Tablet 950 - 950 6 37 43
9 A009 Alopurinol Tablet 100 mg 0 - - - -
10 A010 Ambroxol Tablet 30 mg Tablet 2,000 - 2,000 21 21
11 A011 0 0 - - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - - -
13 A013 0 0 - - - -
14 A014 Amlodipin Tablet 10 Mg Tablet - - - -
15 A015 Amlodipin Tablet 10 Mg Tablet 2,724 - 2,724 52 639 691
16 A016 0 0 - - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet 30,008 - 30,008 90 5,431 5,521
18 A018 Amoksisilin Kaplet 500 mg Tablet - - - -
19 A019 Amoksisilin Kaplet 500 mg Tablet - - - -
20 A020 Amoksisilin Kaplet 500 mg Tablet - - - -
21 A021 0 0 - - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 264 - 264 3 75 78
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - -
25 A025 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - - -
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - - -
27 A027 CLABAT,CAPSINAT Tablet - - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - - -
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 291 - 291 23 23
30 A030 0 0 - - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol 50 - 50 -
32 A032 0 0 - - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
35 A035 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet 3,236 - 3,236 450 2,459 2,909
36 A036 Tablet - - - -
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - - -
40 A040 Pot 24 - 24 -
41 A041 Salisilat 3% (Marin )
0Antihemoroid 0 - - - -
Kombinasi : Bismut Suppgalat 150 mg
42 A042 Supp - - - -
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - - -
45 A045 20% ) HEMOROGARD Tablet - - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet 2,968 - 2,968 10 1,205 1,215
47 A047 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet - - - -
48 A048 Tablet - - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - -
50 A050 Asam Folat Tablet 1 mg Tablet - - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - -
52 A052 Asam Mefenamat 500 mg 0 - - - -
53 A053 0 0 - - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - 3 -
55 A055 0 0 - - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 226 - 226 - 37 37
57 A057 0 0 - - - -
58 A058 Asiklovir 5% 5gr Cream Tube 125 - 125 3 6 9
59 A059 Asiklovir 5% 5gr Cream Tube - - - -
60 A060 0 0 - - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 200 - 200 -
63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - -
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - -
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet - - - -
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet 1,675 - 1,675 -
69 A069 Betahistin Mesylat 6 mg Tablet - - - -
70 A070 Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - - -
71 A071 Betametason Dipropionat Krim 0,1% Tube @ 10 - - - -
72 A072 Betametason Dipropionat Krim 0,1% gram - - - -
Tube @ 10
gram
73 A073 Betametason Dipropionat Krim 0,1% 203 - 203 2 84 86
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - -
77 A077 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - - -
78 A078 Bricasma Biji - - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - - -
80 A080 Zeneca )I
0Budesonid 0 - - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 A081 pcs - - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - - -
84 A084 Cefadroksil
mg,Zink Kapsul
5 mg Boron500 mg CAL - 95
1 mg)/ Tablet 830 - 830 - 425 425
85 A085 Cefadroksil Kapsul 500 mg Tablet - - - -
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 62 - 62 8 8
88 A088 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - - - -
89 A089 Tablet - - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 17 - 17 17 17
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 200 - 200 2 24 26
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet 1,079 - 1,079 6 755 761
93 A093 Deksamethason Tab 0,5 mg 0 - - - -
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - - -
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 255 - 255 78 78
97 A097 0 0 - - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 161 - 161 119 119
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - -
100 A100 Digoksin Tab 0,25 mg Tablet - - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 1,470 - 1,470 52 607 659
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - - -
103 A103 0 0 - - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet 120 - 120 120 120
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 25 - 25 15 15
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - -
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet 200 - 200 -
113 A113 Ethambutol 250 mg Tablet - - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 93 - 93 3 36 39
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 115 - 115 52 52
120 A120 0 0 - - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 112 - 112 -
128 A128 Gentamycin Krim 1 % mg/ ml Tube - - - -
129 A129 Gentian Violet 1% 10 ml Botol - - - -
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 56 - 56 33 33
131 A131 Glibenklamid Tablet 5 mg Tablet 5,531 - 5,531 12 964 976
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - - - -
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet 6,815 - 6,815 84 2,176 2,260
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 120 - 120 12 12
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 14 - 14 -
137 A137 Glukosa Larutan 40% Steril botol - - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - -
139 A139 Glukosa Larutan Infus 5% @500ml Botol 40 - 40 12 12
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - -
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,367 - 1,367 240 240
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 120 - 120 68 68
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10 -
148 A148 0 0 - - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 188 - 188 -
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 7,900 - 7,900 7,336 7,336
152 A152 Ibuprofen Tablet 400 mg Tablet - - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - -
154 A154 Isoniazid Tablet 100 mg tablet - - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 255 - 255 3 34 37
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
158 A158 0 0 - - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol - 100 100 8 8
162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - - -
163 A163 Tablet - - - -
164 A164 Pharmatama)
0 0 - - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100 -
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 6,460 - 6,460 30 2,887 2,917
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - -
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet 5,206 - 5,206 12 3,711 3,723
170 A170 Kaptopril Tab 25 mg TAblet - - - -
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube - - - -
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube 46 - 46 17 17
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 370 - 370 10 10
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - -
176 A176 Ketorolak Inj 30 mg/ml Ampule - - - -
177 A177 0 0 - - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 260 - 260 94 94
179 A179 0 0 - - - -
180 A180 Kloramfenikol Inj 1G/5 ml / Colcancetine
Kloramfenikol Tetes Telinga :Kloramfenicol Inj (Sanbe Farma) Vial - - - -
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - - -
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - - -
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 7,570 - 7,570 60 2,157 2,217
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,938 - 1,938 10 370 380
190 A190 Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg - - - -
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol 200 - 200 60 60
193 A193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma )
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract 12 - 12 12 12
194 A194 MOLAKRIM
Krimmg,Neomycin
Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 20 - 20 6 6
195 A195 100 Sulfat 5 mg / CENTABIO (Sanbe Farma)
Lactobasilus Rhamnosus
100 mg,Neomycin Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- - - -
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - - -
197 A197 Probiotik (Dexa Medica, Sanbe) Tablet 49 - 49 45 45
198 A198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 380 - 380 302 302
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 200 - 200 6 42 48
203 A203 Loperamid Tablet 2 mg Tablet - - - -
204 A204 Loratadin Tablet 10 mg Tablet 146 - 146 14 14
205 A205 Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - - -
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet 360 - 360 -
207 A207 Mata/ OCUGARD (Phapros) Tablet 180 - 180 -
208 A208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - - -
209 A209 0 0 - - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 77 50 127 127 127
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - - -
213 A213 Metformin HCl Tablet 500 mg Tablet 473 - 473 12 350 362
214 A214 Metformin HCl Tablet 500 mg Tablet 2,000 - 2,000 -
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 200 - 200 17 17
216 A216 0 0 - - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet - - - -
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet - - - -
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - -
223 A223 Metronidasol Infus 500mg/100ml Botol - - - -
224 A224 Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - - -
225 A225 Kapsul - - - -
226 A226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar 10000
Asi IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 870 - 870 480 480
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 A227 Ampule - - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - - -
229 A229 Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - - -
230 A230 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU Tablet - - - -
231 A231 Ayus )
Multivitamin Curcuma
vit B1 3 mg, B12 Syr:L-Lysyin
Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika)1000 IU Botol 62 - 62 4 54 58
232 A232 Multivitamin Neurotopic Plus ATP Botol - - - -
233 A233 vit B1 3 mg, B12 Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet - - - -
Multivitamin
200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1
/ Bio100,B6 200,B12 200 mg/
ATP (Phapros)
234 A234 Multivitamin Tab Tambah
Neurotopic Darah
Tablet : :
B1 per Tablet
100,B6 Mengandung
200,B12 200 mg/: Tablet - - - -
235 A235 MOLANEURON (Molex Ayus) tablet - - - -
Femofomarrat
MOLANEURON 300mg
(MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C
236 A236 Tablet 25,300 - 25,300 8 21,594 21,602
237 A237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mgB (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 660 - 660 390 390
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - -
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - -
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - 139 139 36 36
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 70 - 70 12 58 70
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - - -
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 11 - 11 -
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 27 - 27 7 7
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
248 A248 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
 Obat Batuk Herbal : Tiap 15 Ml Vitetrifolia Fill 1 Gr,Zingiber
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid Difenhidramin
1% @ 200ml
/ HERBAKOF SANORINE
(Dexa Medica ) Pcs - - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - - -
252 A252 Obat Kumur
mg,Na Sitrat +Hyaulorinic
50 mg / SANADRYLAcid 1% @ 200ml SANORINE Botol - - - -
253 A253 Omeprazole Kapsul 20 mg Tablet - - - -
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 500 - 500 164 164
255 A255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif : Parasetamol
1ml ( Dexa ) Ampule - - - -
256 A256 Parasetamol Komb Tablet Batuk Berdahak:Paraset
500mg,Phenylpropanolamine HCl chlorpheniramine Tablet - - - -
257 A257 Parasetamol Komb Tablet
400Mg,Bromheksin
maleate ,dextromethorpan Batuk Berdahak:Paraset
80Mg,Difenhidramin
Hbr/ ALPARA HCl 25Mg/
( Molex HUSTAB
Ayus ) Tablet - - - -
258 A258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - - -
259 A259 400Mg,Bromheksin
(Phapros)
Parasetamol Komb Tablet 80Mg,Difenhidramin
Flu: ParasetamolHCl 25Mg/ HUSTAB Tablet - - - -
260 A260 (Phapros) Tablet - - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ 30Mg,
PTU Tablet
100 / COLPICA (Tropika Mas)
mgFlu: 0 - - - -
Parasetamol Komb Parasetamol
262 A262 Tablet - - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 mg/5ml (Mersi2,5
30Mg, Tripolidin mg / NOZA (Phapros)
Farma) Botol - - - -
264 A264 Parasetamol Syrup 120 mg/5ml Botol 300 - 300 15 178 193
265 A265 Parasetamol tablet 500 mg Tablet 1,000 - 1,000 270 730 1,000
266 A266 Parasetamol tablet 500 mg Tablet - - - -
267 A267 Parasetamol tablet 500 mg Tablet - - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 34 - 34 2 2
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 89 - 89 33 33
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - -
271 A271 Piracetam 800 mg Tablet Tablet 62 - 62 12 38 50
272 A272 Parasetamol tablet 500 mg Tablet - - - -
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule 19 - 19 19 19
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 3,084 - 3,084 18 933 951
276 A276 Probiotik Sachet (Probiokid) 0 - - - -
277 A277 Polikresulen (Albotyl,Apetil) Botol - - - -
278 A278 Prednison Tab 5 mg Tablet - - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 3,194 - 3,194 48 2,365 2,413
280 A280 Prednison Tab 5 mg Tablet - - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 600 - 600 81 81
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - -
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 1,836 - 1,836 60 1,185 1,245
285 A285 0 0 - - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - 100 100 8 8
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - - -
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 320 - 320 320 320
290 A290 Ringer Laktat
Salbutamol SO4cairan
3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @
mg500 ml RL
Nebulizer Botol - - - -
291 A291 Nebule 285 - 285 47 47
292 A292 (COMBIVENT)
0 I dan II 0 - - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - - -
294 A294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet - - - -
295 A295 Salep Pot 64 - 64 48 48
296 A296 (Marin2-4) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - - -
298 A298 Salisil Bedak Serbuk 2% Pcs - - - -
299 A299 Salisil Bedak Serbuk 2% Pcs - - - -
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 2 - 2 1 1
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 50 - 50 34 34
304 A304 Setirizin Tab 10 mg (Futamed) Tablet 20 - 20 4 4
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 1,178 - 1,178 12 332 344
307 A307 Simvastatin Tablet 10 mg Tablet - - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
309 A309 0 0 - - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - -
311 A311 Sukralfat Susp 500mg/5ml @100 ml (Mepro)
Tetes mata setiap ml mengandung Polietilen glikol 400 1% Botol 25 - 25 2 2
312 A312 Botol - - - -
313 A313 gliserin
Tetrasiklin0.25%
HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - - -
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - - -
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 928 - 928 838 838
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - -
318 A318 Thiamphenicol Kapsul 500 mg Tablet - - - -
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 29 - 29 11 11
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - - -
321 A321 mg, Vit B1 HCl
Vitamin B Komplek 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet - - - -
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - - -
323 A323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
327 A327 0 0 - - - -
328 A328 0 0 - - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - 3 3 -
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - -
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet 31 - 31 31 31
336 A336 Diazepam Tablet 5 mg Tablet - - - -
337 A337 Fenobarbital Tablet 30 mg Tablet - - - -
338 A338 Fenobarbital Tablet 30 mg Tablet - - - -
339 A339 Fenobarbital Tablet 30 mg tablet - - - -
340 A340 Kodein Tablet 10 mg Tablet - - - -
341 A341 0 0 - - - -
342 A342 Lorazepam
Metamizol 500 Tabmg
2 mg (Mersi Farma)
+ Diazepam 2 mg / PRONEURON Tablet - - - -
343 A343 Tablet - - - -
344 A344 (Meprofarm)
0 0 - - - -
345 A345 0 0 - - - -
346 A346 0 0 - - - -
347 A347 Primaquin 15 mg tablet tablet - - - -
348 A348 0 0 - - - -
OBAT - OBAT PROGRAM 0 - - - -
OBAT PROGRAM KECACINGAN 0 - - - -
349 A349 Albendazol Tablet 400 mg Tablet 262 - 262 -
350 A350 Albendazol Tablet 400 mg Tablet - 2,820 2,820 -
OBAT PROGRAM DIARE 0 - - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - - -
352 A352 Garam Oralit (Kimia Farma) Tablet 895 - 895 48 48
353 A353 Garam Oralit (Kimia Farma) sachet - - - -
354 A354 Garam Oralit (Kimia Farma) sachet - - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - - -
356 A356 Botol 50 - 50 5 5
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - - -
359 A359 Zinc Dispersible 20 mg tablet tablet - - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 5,199 - 5,199 20 2,549 2,569
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
363 A363 0 0 - - - -
OBAT PROGRAM HEPATITIS 0 - - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
OBAT PROGRAM TB PARU 0 - - - -
369 A369 OAT FDC Kategori Anak Kit - - - -
370 A370 OAT FDC Kategori Anak Kit - - - -
371 A371 OAT FDC Kategori Anak Kit - - - -
372 A372 OAT FDC Kategori I - IIII Kit - - - -
373 A373 OAT FDC Kategori I - IIII Kit - - - -
374 A374 OAT FDC Kategori II Kit - - - -
375 A375 OAT FDC Kategori II Kit - - - -
376 A376 OAT FDC Kategori II Kit - - - -
377 A377 OAT FDC Kombipak Kategori I Kit - - - -
378 A378 0 0 - - - -
379 A379 Isoniazid 100 mg tablet tablet - - - -
OBAT POGRAM KUSTA 0 - - - -
380 A380 MDT MB Anak Blister - - - -
381 A381 MDT MB Anak Blister - - - -
382 A382 MDT MB Dewasa Blister - - - -
383 A383 MDT MB Dewasa Blister - - - -
384 A384 MDT MB Dewasa Blister - - - -
385 A385 MDT PB Anak Blister - - - -
386 A386 MDT PB Anak Blister - - - -
387 A387 MDT PB Anak Blister - - - -
388 A388 MDT MB Dewasa Blister - - - -
389 A389 MDT PB Dewasa Blister - - - -
OBAT PROGRAM GIZI 0 - - - -
390 A390 Mineral Mix Kombinasi sachet - - - -
391 A391 Mineral Mix Kombinasi sachet - - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 70 3,400 3,470 -
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - -
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - 50 50 -
397 A397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul - 300 300 -
398 A398 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat Tablet - - - -
399 A399 0,4 Mg Tab (Phapros)
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat Tablet - 46,700 46,700 -
400 A400 0,4 Mg Tab (Phapros) tablet - - - -
401 A401 0,4
0 Mg Tab (Phapros) 0 - - - -
402 A402 0 0 - - - -
OBAT PROGRAM KESGA 0 - - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule 10 - 10 5 5
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 2 - 2 2 2
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - -
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 50 - 50 23 23
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 630 - 630 20 20
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 172 - 172 112 112
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
OBAT PROGRAM JIWA 0 - - - -
416 A416 Amitriptilin 25 mg Tablet - - - -
417 A417 Amitriptilin 25 mg Tablet - - - -
418 A418 Amitriptilin 25 mg Tablet - - - -
419 A419 Amitriptilin 25 mg Tablet 160 - 160 -
420 A420 Amitriptilin 25 mg Tablet - - - -
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - - -
422 A422 Clozapine 100 mg Tablet - - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - -
428 A428 Flufenazin sikzonoate inj 5 ml vial - - - -
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - - -
430 A430 Haloperidol 5 mg tablet Tablet - - - -
431 A431 Haloperidol 5 mg tablet Tablet 2,945 - 2,945 468 468
432 A432 Haloperidol 5 mg tablet Tablet - - - -
433 A433 0 0 - - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - -
436 A436 Haloperidol/ Lodomer drops 2 mg Botol - - - -
437 A437 Karbamazepin Tablet 200 mg Tablet - - - -
438 A438 Karbamazepin Tablet 200 mg Tablet - - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - 3 -
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - - -
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 2,957 - 2,957 828 828
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
444 A444 0 0 - - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - -
447 A447 Risperidon Tab 2 mg Tablet 914 - 914 240 240
448 A448 Risperidon Tab 2 mg Tablet - - - -
449 A449 0 0 - - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - -
451 A451 0 0 - - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet 121 - 121 121 121
453 A453 Triheksifenidil Tablet 2 mg Tablet 3,000 - 3,000 1,176 1,176
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - -
455 A455 0 0 - - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - -
457 A457 0 0 - - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - - -
458 A458 BCG vial 49 20 69 58 58
459 A459 PELARUT BCG ampul 49 20 69 58 58
460 A460 BCG vial - - - -
461 A461 BCG vial - - - -
462 A462 CAMPAK 10ds (MR) vial 49 - 49 49 49
463 A463 PELARUT CAMPAK ampul 89 20 109 -
464 A464 CAMPAK 10ds (MR) vial 52 20 72 65 65
465 A465 CAMPAK 10ds (MR) vial - - - -
466 A466 DPT HB - Hib/ PENTABIO vial 102 15 117 117 117
467 A467 DPT HB - Hib/ PENTABIO vial - 45 45 45 45
468 A468 DT vial - - - -
469 A469 0 0 - - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 50 - 50 50 50
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial 90 - 90 90 90
472 A472 POLIO bOPV 10 ds vial 50 - 50 32 32
473 A473 DROPPER POLIO dropper 93 50 143 -
474 A474 POLIO bOPV 10 ds vial 43 - 43 43 43
475 A475 POLIO bOPV 10 ds vial - 50 50 50 50
476 A476 Td vial 9 10 19 14 14
477 A477 0 0 - - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - 50 50 7 7
479 A479 POLIO bOPV 10 ds vial - - - -
480 A480 Vaksin Meningtis vial - - - -
481 A481 CAMPAK 10ds (MR) BIAS vial - - - -
482 A482 PELARUT CAMPAK BIAS ampul - - - -
483 A483 POLIO bOPV 10 ds vial - - - -
484 A484 IPV vial - - - -
485 A485 VTM Include Dacron (Biofarma) pcs - - - -
486 A486 Vaksin Rabies (Verorab) vial - - - -
487 A487 0 0 - - - -
488 A488 0 0 - - - -
489 A489 0 0 - - - -
OBAT PROGRAM HIV/ AIDS 0 - - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - -
491 A491 0 0 - - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 260 - 260 58 58
493 A493 0 0 - - - -
494 A494 Lamivudine 150 mg Tablet - - - -
495 A495 Lamivudine 150 mg Tablet - - - -
496 A496 Nevirapine 200 mg Tablet - - - -
497 A497 Nevirapine 200 mg Tablet - - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - - -
500 A500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - - -
501 A501 FDC Dewasa Tablet - - - -
502 A502 FDC Dewasa
Tenofovir 300 mg Tablet - - - -
503 A503 Tenofovir 300 mg Tablet - - - -
504 A504 Zidofudine 100 mg (ZDV) Tablet - - - -
505 A505 Zidofudine 100 mg (ZDV) Tablet - - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
508 A508 Efavirenz 600 mg tablet tablet - - - -
509 A509 Efavirenz 600 mg tablet tablet - - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
511 A511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - - -
512 A512 Tablet - - - -
513 A513 FDC
0 Dewasa 0 - - - -
514 A514 MB Anak blister - - - -
515 A515 0 0 - - - -
516 A516 0 0 - - - -
517 A517 0 0 - - - -
518 A518 0 0 - - - -
519 A519 0 0 - - - -
520 A520 0 0 - - - -
521 A521 0 0 - - - -
522 A522 0 0 - - - -
523 A523 0 0 - - - -
524 A524 0 0 - - - -
525 A525 0 0 - - - -
526 A526 0 0 - - - -
527 A527 0 0 - - - -
528 A528 0 0 - - - -
529 A529 0 0 - - - -
BMHP 0 - - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 14 - 14 14 14
532 A532 0 0 - - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs 2,535 - 2,535 1,552 10 1,562
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 1,000 - 1,000 -
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - -
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs - - - -
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - - -
542 A542 Alkohol 70% (Medika) Btl 1000 ml - - - -
543 A543 Alkohol Swab 2 - ply (one med) 0 - - - -
544 A544 Alkohol Swab 2 - ply (one med) Pcs 500 - 500 200 200
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - 2 2 1 1
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 120 - 120 62 62
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - - -
549 A549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25 Demetech I /
M (Demetech) 0 - - - -
550 A550 Pcs - - - -
Phsda
 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) /
551 A551 0 - - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - - -
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 23 - 23 11 5 16
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs - - - -
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - 5 -
561 A561 Mantel Gown (Bisa Dicuci) biji - - - -
562 A562 I.V Catheter No. 18 (JELCO) Pcs - - - -
563 A563 I.V Catheter No. 18 (NIPRO) Pcs 73 - 73 35 35
564 A564 I.V Catheter No. 20 JELCO Pcs - - - -
565 A565 I.V Catheter No. 20 TERUMO Pcs 150 - 150 86 86
566 A566 I.V Catheter No. 20 JELCO Pcs - - - -
567 A567 I.V Catheter No. 22 NIPRO Pcs - - - -
568 A568 I.V Catheter No. 22 NIPRO Pcs 249 - 249 215 215
569 A569 I.V Catheter No. 24 TERUMO Pcs 151 - 151 46 46
570 A570 I.V Catheter No. 24 TERUMO 0 - - - -
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - - -
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 100 - 100 38 38
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
574 A574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 400 - 400 165 165
575 A575 Pcs - - - -
576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 10 - 10 1 1
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - -
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - - -
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 8 - 8 3 1 4
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - -
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 50 - 50 2 2
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - - -
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 90 - 90 42 42
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - -
588 A588 Masker Ear Loop (Masker) Pcs - - - -
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - -
590 A590 Masker General Care (MARCOTILA) Pcs - - - -
591 A591 0 0 - - - -
592 A592 Masker N95 Disposibel Pcs - - - -
593 A593 Masker N95 Disposibel (One Med) Pcs - - - -
594 A594 Masker Tali Pcs - - - -
595 A595 Masker Tali Pcs - - - -
596 A596 Masker Elastic Pcs - - - -
597 A597 Media Sample Container Pcs 120 1,000 1,120 -
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - - -
601 A601 Nurse Cup (Tutup Kepala) Pcs 50 - 50 50 50
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - -
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 23 - 23 23 23
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 54 54 108 3 47 50
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 9 - 9 1 3 4
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - -
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - - -
610 A610 0 0 - - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - -
613 A613 0 0 - - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair 100 - 100 100 100
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - - -
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir - - - -
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 300 - 300 24 24
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 48 - 48 29 29
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - -
622 A622 0 0 - - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1 -
625 A625 Underpad 90x 0 cm cosmo I Pcs 25 - 25 8 8
626 A626 Underpad 90x 0 cm cosmo II Pcs - - - -
627 A627 0 0 - - - -
628 A628 Urine Bag Sterile Standard Pcs 13 - 13 6 6
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs - - - -
630 A630 0 0 - - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - -
REAGEN 0 - - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 600 - 600 200 200
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - -
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - -
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - - -
639 A639 0 0 - - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - -
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - - -
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs 1 - 1 1 1
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - -
649 A649 0 0 - - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - - -
651 A651 0 0 - - - -
652 A652 TPHA (Fokus) Test - - - -
653 A653 0 0 - - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - -
BMHP (PROGRAM) PROPINSI 0 - - - -
PROGRAM MALARIA 0 - - - -
656 A656 RDT Malaria Test - - - -
PROGRAM SYPHILIS 0 - - - -
657 A657 RPR Syphilis Pcs 100 - 100 -
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline Test
Test 300 - 300 -
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - - -
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
662 A662 0 0 - - - -
663 A663 Tuberkulin Vial - - - -
664 A664 RDT Lepto (Uji Leptospira IgM) test - - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - -
666 A666 0 0 - - - -
667 A667 0 0 - - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - - -
668 A668 Test - - - -
669 A669 Reagen HBsAg Strip SD Test - - - -
670 A670 Reagen HBsAg Strip SD Test 350 - 350 -
671 A671 Reagen HBsAg Strip SD Test - - - -
672 A672 0 0 - - - -
673 A673 0 0 - - - -
674 A674 0 0 - - - -
675 A675 0 0 - - - -
PROGRAM TB PARU 0 - - - -
676 A676 Box Slide Pcs - - - -
677 A677 Box Slide Pcs - - - -
678 A678 Catridge Genexpart Test - - - -
679 A679 Catridge Genexpart Test - - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - -
681 A681 Oil Emersi Botol - - - -
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - - -
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - - -
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - - -
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - - -
686 A686 Reagen Control CD4 0 - - - -
687 A687 Reagen Control CD4 0 - - - -
688 A688 Reagen Zeil Nelseen Kit - - - -
689 A689 Reagen Zeil Nelseen Kit - - - -
690 A690 Reagen Zeil Nelseen Kit - - - -
691 A691 Reagen Zeil Nelseen Kit - - - -
692 A692 Slide Pcs - 10 10 1 1
693 A693 Slide/ Object Glass Pcs - - - -
694 A694 Stereofoam pcs - - - -
695 A695 Masker N 95 TB pcs - - - -
696 A696 Masker Tali Bedah TB pcs - - - -
OBAT PROGRAM IMUNISASI 0 - - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - -
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
708 A708 0 0 - - - -
709 A709 0 0 - - - -
710 A710 0 0 - - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 286 - 286 141 141
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
714 A714 0 0 - - - -
715 A715 Safety Box 5 L Pcs - - - -
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
717 A717 0 0 - - - -
718 A718 0 0 - - - -
719 A719 0 0 - - - -
720 A720 0 0 - - - -
PROGRAM
Diagnostar DSHIV/HIV
AIDS
1/2 One Step Rapid Test (GCHIV-402A) 0 - - - -
721 A721 Diagnostar Test 50 - 50 -
722 A722 Tahap I DS HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - - -
Reagen R3
 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold)
723 A723 KHB Test - - - -
724 A724 TahapDiagnostik
I Kit For HIV (1+2) Antibody (Colloidal Gold)
0 - - - -
KHB
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
Diagnostik
725 A725 KHB Test 50 - 50 -
726 A726 TahapDiagnostik
I Kit For HIV (1+2) Antibody (Colloidal Gold) V2
0 - - - -
727 A727 Tahap
Kondom I Pcs - - - -
728 A728 DBS Collection/ Lasec Pcs - - - -
729 A729 Lubricant Pcs - - - -
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - - -
731 A731 Test 900 - 900 81 81
732 A732 IRapid HIV 1/2 3.0 SD Bioline test - - - -
733 A733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - - -
734 A734 Test - - - -
735 Tahap
ReagenI HIV (SD) R 1
A735 Test - - - -
736 A736
Reagen HIV (SD) R 1 Test - - - -
737 A737
0 0 - - - -
738 A738
Reagen HIV (VIKIA) R 3 Test - - - -
739 A739
0 0 - - - -
740 A740
Reagen HIV R2 (Rapid Test) FOKUS Test - - - -
741 A741
0 0 - - - -
742 A742
Reagen HIV R3 (VIKIA) Test - - - -
743 A743
Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - -
744 A744
Sarung Tangan Non Steril Pair - - - -
745 A745
0 0 - - - -
746 A746
APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - -
747 A747
VTM Include Swab Test - - - -
748 A748
Masker Bedah 3 ply Pcs - - - -
749 A749
0 0 - - - -
750 A750
0 0 - - - -
751 A751
0 0 - - - -
752 A752
0 0 - - - -
753 A753
0 0 - - - -
754 A754
0 0 - - - -
755 A755
0 0 - - - -
756 A756
0 0 - - - -
757 A757
0 0 - - - -
758 A758
0 0 - - - -
759 A759
0 0 - - - -
760 A760
0 0 - - - -
761 A761
0 0 - - - -
762 A762
0 0 - - - -
763 A763
0 0 - - - -
764 A764
0 0 - - - -
OKSIGEN MEDICAL 0 - - - -
765 A765 Oksigen 3 m3 Tampon - - - -
766 A766 Oksigen 6 m3 Tampon - - - -
767 A767 Oksigen 1 m3 Tampon - - - -
768 A768 Oksigen 6 m3 Tampon - - - -
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - - -
770 A770 0 0 - - - -
771 A771 0 0 - - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - -
TAMBAHAN IFK 0 - - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
3 T003 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex Tablet - - - -
4 T004 Tablet - - - -
5 T005 Thiamphenicol Syr. 0 - - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule 300 - 300 300 300
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - -
10 T010 Ketokonazole 200 mg Tablet - - - -
11 T011 Kotrimoksazol Forte Tablet - - - -
12 T012 Infusion set anak Pcs 50 - 50 -
13 T013 Alat Suntik 10 cc Pcs - - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
15 T015 Omeprazole Kapsul 20 mg Tablet - - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - 360 360 -
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
19 T019 Oseltamivir 75 mg Kapsul - - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol - 1,500 1,500 180 180
21 T021 Amitriptilin 25 mg Tablet - - - -
22 T022 I.V Catheter No. 24 TERUMO pcs - - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 1 - 1 1 1
24 T024 RDT COVID - 19 0 - - - -
25 T025 Oseltamivir 75 mg 0 - - - -
26 T026 Klorokuin
Katrid XPert150Xpress
mg tablet
SARS-CoV-2. Sample Collection Kit (For 0 - - - -
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - - -
28 T028 Viruses) 0 - - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) 0 - - - -
30 T030 Hazmat/ APD/ Hazmat PPK 0 - 30 30 -
31 T031 Medical Sample Container Pcs - - - -
32 T032 Cepheid Pcs - - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - - -
34 T034 Tambah Darah drop (Ferriz Drop) pcs - - - -
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs - - - -
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
38 T038 Obat Batuk Sirup / INADRYL Botol - - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - - -
40 T040 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - - -
41 T041 dextromethorpan Hbr Tablet - - - -
42 T042 Influenza
Masker Bedah /Bima Sakti pCS - - - -
43 T043 Masker Bedah /Rania pCS - - - -
44 T044 Masker N 95 Bima Sakti PCS - - - -
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 - - - -
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - -
47 T047 Albendazol Suspensi 200mg/ 5 ml botol - - - -
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - - -
49 T049 OAT FDC Kategori Anak 0 - - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - -
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - -
53 T053 0 0 - - - -
54 T054 0 0 - - - -
55 T055 0 0 - - - -
56 T056 0 0 - - - -
57 T057 0 0 - - - -
58 T058 0 0 - - - -
59 T059 0 0 - - - -
60 T060 APD Set (Rannia) 0 5 3 8 -
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5 -
62 T062 Cover
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 4 - 4 -
63 T063 0 - - - -
64 T064 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - - -
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs 4,900 - 4,900 2,900 2,900
69 T069 Masker N95 Covid 19 Pcs - - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - - -
71 T071 Masker Eaerlop Hijab Pcs 2,000 - 2,000 200 200
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - 1 -
73 T073 Hand Sanitzer 1 Botol = 20 Liter 2 - 2 1 1
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - - -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs - 9 9 -
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - - -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - 2 -
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs 200 - 200 200 200
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs 1,200 - 1,200 1,200 1,200
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - -
 84 T084 Masker KN95 (Farmahusada) Box @50 pcs 20 - 20 -
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - 1,200 1,200 1,200 1,200
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test 21 - 21 -
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - - -
89 T089 APRON (Atmosfer) pcs 150 - 150 50 50
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - -
91 T091 Hand Sanitzer 2 liter - - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 34 4 38 -
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - -
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - -
96 T096 Face Shield (COBRA) 0 - 7 7 -
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
98 T098 Kit Steril (Rajawali) 0 - - - -
99 T099 Alkohol II @20 Liter 0 - - - -
100 T100 Cover All (Rajawali) 0 - 4 4 -
101 T101 Face Shield (ATMOSFER) 0 - - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
103 T103 Masker Earloop (KasaHusada) 0 - - - -
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - -
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - - -
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - - -
107 T107 Alkohol Swab (BTT) 0 - - - -
108 T108 Antiseptic Gel 500 0 - - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 5,400 - 5,400 1,260 1,260
110 T110 Kaca mata Goggle (HASTEN) 0 - 5 5 -
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - -
112 T112 Masker Bedah Hijau @50pcs 0 - - - -
113 T113 Masker N95 3M 8210 (Hazten) 0 - 10 10 -
114 T114 Nurse Cap Green om 100bh 0 - - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - - -
117 T117 Sarung tangan Safeglove Exam M 100bh 0 - 3,000 3,000 3,000 3,000
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - - -
121 T121 Universal Transport Media (UTM) Goongdong 0 - - - -
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - -
127 T127 Rapid Test Lecurate (Bima Sakti) 0 - - - -
128 T128 Rapid Test ZYBIO (Farma Husada) 0 - - - -
129 T129 Alkohol 96 % Liter - - - -
130 T130 0 0 - - - -
0 0 - - - -
TAMBAHAN PUSKESMAS 0 - - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - - -
3 TP003 Asiklovir
Budesonid 5%Formoterol
5gr CreamInhaler 160/4,5 mcg/Symbicort (Astra Tube - - - -
4 TP004 pcs - - - -
5 TP005 Zeneca)
0 0 - - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 552 - 552 3 144 147
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - - -
9 TP009 0 0 - - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - - -
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - - -
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 300 - 300 52 52
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 4 - 4 2 2
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 - - - -
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - - -
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - - -
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - - -
24 TP024 Materniti Napkin Slim L 0 - - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - - -
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1 -
29 TP029 Haloperidol 5 mg tablet Tablet - - - -
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - -
31 TP031 Fixomull Strech 5 cm X 5 m Pcs - - - -
32 TP032 Umbilical crd clamp 0 126 - 126 -
33 TP033 0 0 - - -
34 TP034 0 0 - - -
35 TP035 0 0 - - -
36 TP036 0 0 - - -
37 TP037 0 0 - - -
38 TP038 0 0 - - -
39 TP039 0 0 - - -
40 TP040 0 0 - - -
41 TP041 0 0 - - -
42 TP042 0 0 - - -
43 TP043 0 0 - - -
44 TP044 0 0 - - -
45 TP045 0 0 - - -
46 TP046 0 0 - - -
47 TP047 0 0 - - -
48 TP048 0 0 - - -
49 TP049 0 0 - - -
50 TP050 0 0 - - -
51 TP051 0 0 - - -
52 TP052 0 0 - - -
53 TP053 0 0 - - -
54 TP054 0 0 - - -
55 TP055 0 0 - - -
56 TP056 0 0 - - -
57 TP057 0 0 - - -
58 TP058 0 0 - - -
59 TP059 0 0 - - -
60 TP060 0 0 - - -
0 0 - - -
TOTAL - - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Mengetahui Yang Menyerahkan,
Plt. KEPALA DINAS KESEHATAN TERTULIS 2 KALI KEPALA INSTALASI FARMASI KABUPATEN
KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN Dra. TRI MUSYAROFAH, Apt

NIP. 19630724 198910 1 002 NIP. 19630411 199203 2 005
 KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN Dra. TRI MUSYAROFAH, Apt

NIP. 19630724 198910 1 002 NIP. 19630411 199203 2 005
AR PERMINTAAN OBAT

: BULAN : JULI
: TAHUN : 2019

SUMBER HARGA STOK

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN NILAI PENERIMAAN Ket
ANGGARAN SATUAN OPTIMUM

UNIT RP

- DAK 18/Okt.19 99.000 0.00 0.000 113

- DAK 19/Sept.21 105.000 0.00 0.000

0

- DAK 20/ Jan 22 105.000 0.00 0.000

500
- - 0.000 0.00 0.000 0
- DAK 19/Feb.22 2,860.000 0.00 0.000 76
DAK 20/ 16 -
147 2,860.000 420,420.00 0.000
Des 22 600
- DAK 18/Apr.20 10,500.000 0.00 0.000 0
907 DAK 19/Mei 23 104.000 94,328.00 0.000 0
- DAK 20 L 220.000 0.00 0.000 1444
1,979 DAK 19/Juni 21 93.500 185,036.50 0.000 0
- DAK 17/AGSTS- - 0.000 0.00 0.000 70
- 2,998.000 0.00 0.000 0
- 20 - 0.000 0.00 0.000 0
- Dak 19/Okt. 20 93.000 0.00 0.000 0
2,033 Dak 20/Okt 21 99.000 201,267.00 0.000 31
- - 0.000 0.00 0.000 0
24,487 DAK 17/NOV-21 190.000 4,652,530.00 0.000 0
- DAK 18/Okt.20 233.000 0.00 0.000 0
- DAK 19/Feb 21 233.000 0.00 0.000 2260
- DAK 20/ April 22 249.000 0.00 0.000 0
- - 0.000 0.00 0.000 4816
186 DAK 19/Agst.22 3,025.000 562,650.00 0.000 0
- DAK 20 L 3,025.000 0.00 0.000 3457
 - DAK 19/JULI 21 4,400.000 0.00 0.000 0
- DAK 20/ Mart 22 3,628.000 0.00 0.000 0
- DAK 18L/Mar.20 10,246.500 0.00 0.000 0
- PRBG 20 9,900.000 0.00 0.000 0
- DAK 17/MAR-20 8,500.000 0.00 0.000 0
268 DAK 20 / Mei-23 8,237.000 2,207,516.00 0.000 0
- - 0.000 0.00 0.000 0
50 DAK 19/Sept. 23 4,950.000 247,500.00 0.000 0
- - 0.000 0.00 0.000 50
- DAK 17/APR-19 440.000 0.00 0.000 752
- DAK 18L/Agst.20 220.000 0.00 0.000 0
327 DAK 19/Mei20
PRSpesifik 21 165.000 53,955.00 0.000 0
- 58.000 0.00 0.000 4
- non covid-19/ - 0.000 0.00 0.000 82
- DAK 18/Apr-22 3,035.000 0.00 0.000 0
- - 0.000 0.00 0.000 0
24 DAK 17/ Mei-21 4,496.000 107,904.00 0.000 0
- - 0.000 0.00 0.000 3973
- Buffer Prop.20 - 3,045.000
DAK 16/APR-20 0.00 0.000 0
- 198.000 0.00 0.000 33
- Covid-19
DAK 18L/Jan.21 1,485.000 0.00 0.000 88
- PRSpesifik L 20/ 1,551.000 0.00 0.000 6
1,753 DAK 19/Sept.21 105.000 184,065.00 0.000 54
- DAK 20/Juni 22 105.000 0.00 0.000 0
- DAK 17/Jan-21
DAK 17/AGSTS- 1,050.000 0.00 0.000 100
- 67.000 0.00 0.000 0
- 20
DAK 20/Feb 22 75.000 0.00 0.000 36
- DAK 19/MAR-22 103.000 0.00 0.000 0
- DAK 20 L 253.000 0.00 0.000 0
- 0 0.000 0.00 0.000 1464
3 DAK 19/Feb.22 2,076.000 6,228.00 0.000 4908
- 0 0.000 0.00 0.000 0
189 DAK 19/Feb.22 1,584.000 299,376.00 0.000 0
- 0 0.000 0.00 0.000 0
116 DAK 18L/Apr.22 2,915.000 338,140.00 0.000 0
- DAK 19/Juni 22 2,750.000 0.00 0.000 2253
- - 0.000 0.00 0.000 0
DAK 18/Mei.22 380.000 0.00 0.000 0
200 DAK 19/Des.22 380.000 76,000.00 0.000 0
- DAK 20/Des 23 405.000 0.00 0.000 0
- Dak 19/Feb
DAK 21 1,639.000
20/31-Okt 0.00 0.000 773
- 1,639.000 0.00 0.000 0
- 21
DAK 18/Apr 23 136.000 0.00 0.000 0
- DAK20
DAK 19/Apr 23 152.000
/Nov22, 0.00 0.000 95
1,675 145.000 242,875.00 0.000 0
Mart 23
 - DAK 19/Jan 20
PRSpesifik 21 110.000 0.00 0.000 0
- 110.000 0.00 0.000 0
- Non
DAK Covid-19/
18/Feb.20 3,350.000 0.00 0.000 464
- DAK 19/Feb.20 3,350.000 0.00 0.000 0
117 DAK 20/Okt 21 3,350.000 391,950.00 0.000 0
- DAK 17/JUL-19 300.000 0.00 0.000 0
- DAK 20/Feb 24 5,900.000 0.00 0.000 0
- DAK 19/ 626.000 0.00 0.000 254
- DAK 20 L 18,150.000 0.00 0.000 500
- DAK 19/Agst. 20 7,602.000 0.00 0.000 0
- DAK 19/Apr.20 7,124.000 0.00 0.000 187
- 0 0.000 0.00 0.000 500
- DAK 19/Jan 21 149,266.000 0.00 0.000 7
- - 0.000 0.00 0.000 63
- DAK 19/Mei 24 5,280.000 0.00 0.000 0
405 DAK 19/Juni 24 660.000 267,300.00 0.000 0
- PRBG 20/ 671.000 0.00 0.000 12
- DAK 17/MAR-19 4,282.000 0.00 0.000 0
54 DAK 19/Mar.21 11,000.000 594,000.00 0.000 0
- PRSpesifik L 20/ 10,098.000 0.00 0.000 0
- DAK 19/Okt.21 2,805.000 0.00 0.000 0
- DAK 19/Apr.21
DAK 20/ Des 21, 1,097.000 0.00 0.000 0
174 1,097.000 190,878.00 0.000 398
318 Feb
DAK2219/Juni 21 60.500 19,239.00 0.000 813
- DAK 20 L 66.000 0.00 0.000 0
- DAK 18/Nov 19 10,400.000 0.00 0.000 0
- DAK 18L/Agst.20 9,900.000 0.00 0.000 0
177 DAK 19/Juni 22 1,095.000 193,815.00 0.000 0
- - 0.000 0.00 0.000 0
42 DAK 17/APR-21 104.000 4,368.00 0.000 2534
- DAK 19/Nov.20 104.000 0.00 0.000 0
- DAK 20/ 104.000 0.00 0.000 0
811 DAK 19/Nov.20 105.000 85,155.00 0.000 0
- DAK 19/Mar.24 112.000 0.00 0.000 3
- - 0.000 0.00 0.000 0
- DAK 19/JULI21 4,400.000 0.00 0.000 0
- DAK 20/Feb 22 2,700.000 0.00 0.000 0
- DAK 19/Juni 21 165.000 0.00 0.000 1200
- DAK 20/Mart 23 91.000 0.00 0.000 0
- DAK 18/Des 20 1,408.000 0.00 0.000 0
10 DAK 19/Nov.20
DAK GD 20 / 30- 1,408.000 14,080.00 0.000 0
- Buffer 1,408.000 0.00 0.000 169
- Aprl 21 Prop 730.000 0.00 0.000 0
200 19/Mei
DAK 20/20Mei 21 770.000 154,000.00 0.000 0
- DAK 19/Des.23 391.000 0.00 0.000 0
 DAK 17/SEPT-
- 4,167.000 0.00 0.000 0
- 20
DAK 17/AGS-19 3,550.000 0.00 0.000 0
Buffer Prop.19/
- DAK2020 /31-Des 3,682.000 0.00 0.000 0
54 Feb 3,682.000 198,828.00 0.000 48
- 21;Jan 22
DAK 17/Apr.19 691.000 0.00 0.000 0
63 DAK 18/Apr.21 710.000 44,730.00 0.000 0
- DAK 17/ JAN-20 0.000 0.00 0.000 4
- DAK 18/Des.19
DAK 1,333.000 0.00 0.000 15
- 1,333.000 0.00 0.000 0
- Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.00 0.000 0
- DAK 20/Mei 22 82.000 0.00 0.000 0
- DAK 18/Mei 21 4,232.000 0.00 0.000 95
- DAK 19/Sept.22 4,232.000 0.00 0.000 0
112 DAK 20/Feb 23 4,232.000 473,984.00 0.000 0
- DAK 19/Juni 22 2,750.000 0.00 0.000 670
- DAK 20 L 4,400.000 0.00 0.000 0
23 DAK 17/DES-20 2,900.000 66,700.00 0.000 0
4,555 DAK 19/Feb 24 119.000 542,045.00 0.000 802
- DAK 20/ Feb 22 119.000 0.00 0.000 0
- DAU PR BG 23
DAK 19/Mei 77.000 0.00 0.000 0
4,555 COVID 20/ Agsts 99.000 450,945.00 0.000 1141
108 DAK 19/Mei 22
21 7,865.000 849,420.00 0.000 0
14 DAK 19/Mei 21 10,010.000 140,140.00 0.000 45
- PRSpesifik L 20/ 10,010.000 0.00 0.000 0
- DAK 17/FEB-20 6,900.000 0.00 0.000 1313
28 DAK 20/ 7,363.000 206,164.00 0.000 0
- APBD II - 15 132.000 0.00 0.000 0
1,127 DAK 16/OKT-21 149.000 167,923.00 0.000 9
- DAK 20 L 88.000 0.00 0.000 34
- DAK 18/Agst.21 2,787.000 0.00 0.000 0
52 DAK 19/Mei 23 2,475.000 128,700.00 0.000 0
- DAK 20/ Juni 23 2,475.000 0.00 0.000 0
- DAK 19/Jan 21 176,800.000 0.00 0.000 0
10 DAK 19/Mei 21 8,800.000 88,000.00 0.000 0
- DAK 20 L 0.000 0.00 0.000 89
- DAK 19 4,665.000 0.00 0.000 0
188 DAK 20/ Des 21 4,665.000 877,020.00 0.000 0
564 DAK 19/JULI21 264.000 148,896.00 0.000 849
- DAK 20 L 330.000 0.00 0.000 0
- DAK 18L/Mar.20 660.000 0.00 0.000 0
- DAK 20 L 187.000 0.00 0.000 0
218 DAK 17/MAR-21 90.000 19,620.00 0.000 19
- DAK 18/Jan.22 89.000 0.00 0.000 0
- DAK 19/Mart.23 121.000 0.00 0.000 0
- - 0.000 0.00 0.000 810
 - DAK 18/Nov.20 9,644.000 0.00 0.000 0
- DAK 18/Jan.21 10,696.000 0.00 0.000 0
92 DAK 19/Jan.22 10,696.000 984,032.00 100 1,069,600.000 0
- - 0.000 0.00 0.000 0
- DAK 19/Juli 21 770.000 0.00 0.000 113
- - 0.000 0.00 0.000 0
100 DAK 18/Mar.21 1,755.000 175,500.00 0.000 2
3,543 DAK 19/Mei 21 187.000 662,541.00 0.000 74
- DAK 19/
DAK Agst.22
20/ Sept 22, 63.000 0.00 0.000 0
- 63.000 0.00 0.000 11
1,483 Jan
DAK2319/Mei 24 94.600 140,291.80 0.000 91
- DAK 20 L 99.000 0.00 0.000 568
- DAK 19/Mei23 5,610.000 0.00 0.000 2000
29 DAK 20/ Juni 23 2,518.000 73,022.00 0.000 2000
360 DAK 19/Juli21 396.000 142,560.00 0.000 0
- DAK 19/Jun 21 288.000 0.00 0.000 713
- DAK 20/Jan 22 288.000 0.00 0.000 0
- DAK 19/Des.20 1,089.000 0.00 0.000 0
- DAK 17/SEPT-- 0.000 0.00 0.000 76
166 1,810.000 300,460.00 0.000 0
- 20 - 0.000 0.00 0.000 12
- DAK 17/FEB-20 10,500.000 0.00 0.000 0
- DAK 18L/Mei.20 17,968.500 0.00 0.000 0
- DAK 19/Mart21 35,200.000 0.00 0.000 138
- - 0.000 0.00 0.000 0
- DAK 18/Mei.22 22.000 0.00 0.000 152
5,353 DAK 19/Mar.22 77.000 412,181.00 0.000 0
- DAK 20/Feb 22 23.000 0.00 0.000 0
- DAK 17/MEI 20 2,750.000 0.00 0.000 0
- DAK 18L/Mei.23 495.000 0.00 0.000 0
1,558 DAK 19/Juni 23 440.000 685,520.00 0.000 0
- DAU PR BG 20/ 319.000 0.00 0.000 0
- DAK 19/JUN 20 2,052.000 0.00 0.000 0
140 DAK 20/ Mei 22 2,190.000 306,600.00 0.000 0
- DAK 17/JUNI 21 13,970.000 0.00 0.000 0
14 DAK 19/Apr.21 22,550.000
PRSpesifik 315,700.00 0.000 64
- 23,100.000 0.00 0.000 0
- Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.00 0.000 0
4 DAK 19/Mei 21 6,600.000 26,400.00 0.000 0
- - 0.000 0.00 0.000 529
- DAK 17/JUN 21 1,937.000 0.00 0.000 0
78 DAK20/
DAK 19/Mei
Feb 21 2,178.000 169,884.00 0.000 0
- 1,222.000 0.00 0.000 225
152 21;Mei22
DAK 19/Juni 21 99.000 15,048.00 0.000 0
- DAK 20 L 330.000 0.00 0.000 300
 132 DAK 19/Nov.21 123.000 16,236.00 0.000 0
- DAK 20/Okt 23 131.000 0.00 0.000 0
360 DAK 18L/Sept.20 4,680.500 1,684,980.00 0.000 0
180 DAK 19/Jan 22 4,730.000 851,400.00 0.000 0
- DAK 19/ 550.000 0.00 0.000 0
- - 0.000 0.00 0.000 0
- DAK 18L/Apr.20 4,950.000 0.00 0.000 0
- DAK 19/Apr 21 5,500.000 0.00 50 275,000.000 0
- PRSpesifik L 20/ 3,707.000 0.00 0.000 0
111 DAK 19/Des.20
DAK20/28 Feb22 96.000 10,656.00 0.000 0
2,000 102.000 204,000.00 0.000 520
183 ;DAK 19/Agst. 21 143.000 26,169.00 0.000 0
- - 0.000 0.00 0.000 0
- DAK 17/APR 22 87.000 0.00 0.000 2498
- DAK 18/Nov.20 80.000 0.00 0.000 0
- DAK 20 / Juni 22 121.000 0.00 0.000 0
- DAK19/JULI23 192.500 0.00 0.000 266
- DAK 20 L 275.000 0.00 0.000 0
- DAK 19/Nov 20 8,110.000 0.00 0.000 339
- DAK 20/ 8,110.000 0.00 0.000 356
- DAK 18L/Okt.20 14,318.700 0.00 0.000 0
- DAK 19/Feb 21 5,500.000 0.00 0.000 40
390 DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 815,100.00 0.000 0
- 5,000.000 0.00 0.000 0
- 19
DAK 19/FEB 21 4,400.000 0.00 0.000 0
PRSpesifik
- 1,265.000 0.00 0.000 250
- Dokter Muter 20
DAK 17/APR 20 990.000 0.00 0.000 0
4 DAK 19/Apr.21 13,200.000
PRSpesifik 52,800.00 0.000 5
- 13,167.000 0.00 0.000 0
- Dokter Muter 20 2,332.000
DAK 18L/Des.19 0.00 0.000 0
- DAK 18L/Okt.21 528.000 0.00 0.000 0
- PRSpesifik L 20/ 594.000 0.00 0.000 0
3,698 DAK 17/FEB 21 835.000 3,087,830.00 0.000 46
- DAK 19/OKT20 115.000 0.00 0.000 0
270 DAK 19/Des 20 123.000 33,210.00 0.000 0
- DAK20/ 123.000 0.00 0.000 0
- DAK 17/JUN 21 6,410.000 0.00 0.000 0
103 DAK 18/Feb.22 6,410.000 660,230.00 139 890,990.000 47
- PRSpesifik
DAK19/Jan 20
22 132.000 0.00 0.000 0
- Non Covid-19/ 3,948.000 0.00 0.000 5400
- DAK2118L/Des.20 23,141.800
Okt 0.00 0.000 0
11 DAK 19/Juli 21 19,800.000 217,800.00 0.000 0
20 DAK 18/Agst.20 560.000 11,200.00 0.000 0
- DAK 19/Juli 23 560.000 0.00 0.000 0
- DAK20/Sep 23 598.000 0.00 0.000 144
 - DAK 19/Apr 21 12,100.000 0.00 0.000 1697
- DAK 19/Mart.21 24,860.000 0.00 0.000 0
- DAK 19/ Agst. 21 9,955.000
PRSpesifik 0.00 0.000 0
- DAK 16/AGSTS 25,597.000 0.00 7
- Dokter Muter 20 160.000 0.00 0.000 24
336 20
DAK 19/Juli 21 1,070.000 359,520.00 0.000 0
- DAK 20 1,124.000 0.00 0.000 0
- DAK 19/Mei 22 715.000 0.00 0.000 14
- DAK 18L/Jul.20 432.300 0.00 0.000 0
- DAK19/
PRSpesifik 437.800 0.00 0.000 0
- 418.000 0.00 0.000 0
- Dokter Muter 20 357.500
DAK 19/JUNI22 0.00 0.000 61
- PRSpesifik L 20/ 495.000 0.00 0.000 0
- DAK 18L/Sept.22 789.800 0.00 0.000 14
- DAK 19 1,181.000 0.00 0.000 383
107 DAK 20/ Des 22 1,181.000 126,367.00 0.000 0
- DAK 19/Des
Hibah RSUD 20 53.000 0.00 0.000 20
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- Pasirian
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DAK 23 7,150.000
20/06-Jan- 0.00 0.000 0
- 7,630.000 0.00 0.000 90
238 2025
DAK 19/Jan 21 4,550.000 1,082,900.00 0.000 0
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DAK Muter 20 479,996.000
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DAK 20/30-
1 512,204.000 512,204.00 0.000 26
- Agust-21
DAK
DAK 20/30-Nov- 130,999.000
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16 130,999.000 2,095,984.00 0.000 28
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DAK 18/Apr.20 90.000 1,440.00 0.000 0
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DAK 19/Juli 23 132.000 0.00 0.000 0
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DAK 17/FEB 21 1,045.000 0.00 0.000 23
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3 DAK 20/
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DAK 18L/Mei.20 0.00 0.000 377
- 114.000 0.00 0.000 16
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DAK24 19/Agst.22 274.000 0.00 0.000 0
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45 DAK 19 /Nov 20 6,281.000 282,645.00 0.000 0
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Buff Prop 19 /Mei 9,900.000 0.00 0.000 0
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DAK 18/Mart 20 524.000 0.00 0.000 0
2,630 DAK 19/Jan
DAK 20/Mei 21 524.000 1,378,120.00 0.000 0
- 524.000 0.00 0.000 0
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- - 0.000 0.00 0.000 438
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DAK 19/Agus.20 0.00 0.000 3831
- 1,325,000.000 0.00 0.000 0
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Hibah 19
Jember 1,325,000.000 0.00 0.000 0
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- 1,325,000.000 0.00 0.000 0
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Buffer Prop
19/Jun 21 20/ 248,120.000
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Buffer Prop 20/ 389,344.000
19/Juli21
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19/Juni 22
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20/Juni 21 19/ 40,913.489
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Buffer Prop 20/ 41,784.000
Okt.21
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17/Mei 19
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DAK
Buffer Prop 20/ 11,738.000
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Buffer Prop - 0.000 0.00 0.000 0
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Buffer19/Agust.21 517.000 0.00 0.000 228
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300 Okt 21 Prop
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Buffer 20
19/Juli Prop
46,700 354.000 16,531,800.00 46,700 16,531,800.000 0
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5 9,955.000 49,775.00 0.000 179
- 18/Agst.20
DAK GD 20/09- 3,796.000
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DAK 19/ Des 20 2,959.000 0.00 0.000 4
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27 19/Jul.19
Buffer Propinsi 2,959.000
Sept-21
79,893.00 0.000 0
- 2,500.000 0.00 0.000 0
610 20 /Juli18/Apr.22
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60 Prop.19/Sept.19
DAK22GD 20/ 31- 1,199.000
Okt
71,940.00 0.000 0
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- Okt 1,199.000 0.00 0.000 2699
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Buffer Prop 167.000 0.00 0.000 1231
- 167.000 0.00 0.000 0
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DAK 19/ 21Jan 23 167.000 0.00 0.000 0
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20
Buffer Juni20/21 183.000
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2,477 60.000 148,620.00 0.000 0
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DAK 20/ Nov 22
22, 245.000 0.00 0.000 871
- Buffer 245.000 0.00 0.000 271
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DAK2120/ 1,326.000 0.00 0.000 0
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Buffer Prop 20/ 158.000
19/Sept. 22 0.00 0.000 48
2,129 157.000 334,253.00 0.000 0
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DAK 22
20 L 253.000 0.00 0.000 0
- - 0.000 0.00 0.000 2496
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DAK2220/ 287.000 0.00 0.000 0
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11 0709S4016 21
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21
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 Buffer Prop/
109 0688S1424 Buffer Prop/ 0.000 0.00 20 0.000 0
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0128M429 Buffer Prop/ 151,150.000 1,058,050.00 20 3,023,000.000 129
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Buffer Prop/ Des 76,620.000 0.00 15 1,149,300.000 645
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5040719 Buffer Prop/ Apr. 84,282.000 0.00 45 3,792,690.000 0
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- 22
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Agust Prop/Juli
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143 21
10115419 Buffer
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DAKSpesifik
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24
DAU ID 20 non 1,463.000 0.00 0.000 1000
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DAU ID 20 - 19,885.446 0.00 0.000 0
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DAU ID 20 non23 22,500.000 0.00 0.000 0
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DAU ID 20 - 13,050.000 91,350.00 0.000 0
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- 180,000.000 0.00 0.000 800
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PRSpesifik 20 8,900.000
DAK 18/Jul.22 0.00 0.000 0
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DAK 19/Okt.21 401,280.00 0.000 50
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- covid-19
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105 DAK
Des 19/Okt.21
24
DAU ID Non 6,270.000 658,350.00 0.000 0
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- Covid
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DAK 16/JUL 21 0.00 0.000 0
62 8,400.000 520,800.00 0.000 0
- DAK 20/Agst.22 6,199.900
DAK 19/Jan 24 0.00 0.000 200
235 8,400.000 1,974,000.00 0.000 7000
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9 DAK 19
DAU ID 20 - 13,400.000 120,600.00 0.000 200
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- Covid-19
DAK 18/Nov.21 2,300.000 0.00 0.000 223
4 DAK 19/Okt.22
DAU ID 20 Non 136,500.000 546,000.00 0.000 0
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- Covid
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48 DAK 19/Sept.21
DAU ID 20 - 5,950.000 285,600.00 0.000 0
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- Covid-19
DAK 18 1,430.000 0.00 0.000 0
48 DAK 19/Feb
DAU ID 20 - 22 2,240.000 107,520.00 0.000 0
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- Covid-19
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DAK 18/Okt.22 6,512.000 0.00 0.000 20
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1,120 Spesifik/Des
DAK 19 25 2,309.375 2,586,500.00 1,000 2,309,375.000 87
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- DAK 19/Nov 22 65,340.000 0.00 0.000 20
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- DAU 20 ID NON
DAK 19/Jan.22 7,700.000 0.00 0.000 0
58 COVID-19/ Mart 7,769.000 450,602.00 54 419,526.000 0
5 DAK 19/Jan
23
DAU 22
ID 20 NON 18,000.000 90,000.00 0.000 0
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- COVID-19
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- 286,000.000 0.00 0.000 10
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DAK 19/Okt 20 726.953 0.00 0.000 0
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DAK 19/Juli 0.00 0.000 0
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DAK 19/Jan.24
COVID-19/Jan 25 0.00 0.000 0
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276 covid-19
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- - 0.000 0.00 0.000 200

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- - 1,097.000 0.00 0.000
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126 - 2,750.000 346,500.00 0.000
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- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
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- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
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- 0.000 0.00 0.000
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0 0 0.00 0.000
- 143,840,877.50 71,250,308.000

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Generik Paten

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
 KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
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FALSE
FALSE
FALSE
FALSE
FALSE
TRUE
TRUE
FALSE
FALSE
FALSE
TRUE
TRUE
FALSE
TRUE
FALSE
FALSE
TRUE
TRUE
TRUE
FALSE
TRUE
TRUE
FALSE
TRUE
FALSE
TRUE
TRUE
FALSE
FALSE
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FALSE
FALSE
FALSE
FALSE
TRUE
FALSE
FALSE
TRUE
TRUE
TRUE
TRUE
TRUE
FALSE
FALSE
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TRUE
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TRUE
TRUE
FALSE
TRUE
FALSE
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TRUE
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TRUE
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TRUE
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TRUE
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TRUE
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FALSE
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TRUE
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TRUE
TRUE
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TRUE
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TRUE
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FALSE
TRUE
TRUE
FALSE
TRUE
FALSE
FALSE
TRUE BUFFER P 257
FALSE
FALSE
TRUE
FALSE
TRUE
TRUE
FALSE
FALSE
TRUE
TRUE
 TRUE
FALSE
FALSE
TRUE
TRUE
TRUE
TRUE
FALSE
TRUE
FALSE
FALSE
TRUE
FALSE
TRUE
FALSE BUFFER P 2728
TRUE
TRUE
FALSE
FALSE
TRUE
TRUE
TRUE
FALSE
FALSE
TRUE
FALSE
TRUE
FALSE
FALSE
TRUE
TRUE
FALSE
TRUE
FALSE
TRUE
TRUE
TRUE
TRUE
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TRUE
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TRUE
 TRUE
TRUE
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 TRUE
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FALSE
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FALSE
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 TRUE
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FALSE
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 TRUE
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 TRUE
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 TRUE
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 TRUE
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TRUE
Pelaporan : Persentase Puskesmas denga
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Albendazol /Pira Tablet 262 1
2 Alopurinol Tablet 32,732 1
3 Amlodipin/Kapto Tablet 30,008 1
4 Amoksisilin 500 Tablet 30,008 1
5 Amoksisilin sirup Botol 264 1
6 Antasida tablet k Tablet/Botol 3,236 1
7 Asam Askorbat (V Tablet 3,236 1
8 Asiklovir Tablet 3,236 1
9 Betametason sal Tube - 0
10 Deksametason tabTablet/Vial/Ampul - 0
11 Diazepam injeksi Ampul 24 1
12 Diazepam Tablet 24 1
13 Dihidroartemsin Tablet 24 1
14 Difenhidramin In Ampul - 0
15 Epinefrin (Adrena Ampul - 0
16 Fitomenadion (Vi Ampul - 0
17 Furosemid 40 mg/ Tablet 2,968 1
18 Garam Oralit ser Kantong 2,968 1
19 Glibenklamid/Me Tablet 2,968 1
20 Hidrokortison kr Tube - 0
21 Kotrimoksazol (d Tablet/Botol - 0
22 Lidokain inj Vial - 0
23 Magnesium Sulfat Vial - 0
24 Metilergometrin Ampul - 0
25 Natrium Diklofen Tablet 3 1
26 OAT FDC Kat 1 Paket 3 1
27 Oksitosin injeksi Ampul 229 1
28 Parasetamol siru Botol 226 1
29 Parasetamol 500 Tablet 351 1
30 Prednison 5 mg Tablet 125 1
31 Ranitidin 150 mg Tablet 125 1
32 Retinol 100.000/ Kapsul - 0
33 Salbutamol Tablet 3,121 1
34 Salep Mata/Tetes Tube 260 1
35 Simvastatin Tablet 1,178 1
36 Siprofloksasin Tablet - 0
37 Tablet Tambah D Tablet - 0
38 Triheksifenidil Tablet 3,121 1
39 Vitamin B6 (Pirid Tablet 3,084 1
40 Zinc 20 mg Tablet 5,199 1
JUMLAH ITEM OBAT INDIKATOR 27
Pelaporan : Persentase Puskesmas deng
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Vaksin Hepatitis Vial 50 1
2 Vaksin BCG Ampul 69 1
3 Vaksin DPT-HB-H Vial 117 1
4 Vaksin Polio Vial 50 1
5 Vaksin Campak/V Vial/Ampul 49 1
JUMLAH ITEM OBAT INDIKATOR 5
 LAPORAN PEMAKAIAN DAN LEMBAR
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN

UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

4 A004 0 0 - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial - - -
6 A006 Air Untuk Injeksi Vial @25 ml Vial 147 - 147
16

7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - -

8 A008 Alopurinol Tablet 100 mg Tablet 907 - 907 12 57
9 A009 Alopurinol Tablet 100 mg 0 - - -
10 A010 Ambroxol Tablet 30 mg Tablet 1,979 - 1,979 10
11 A011 0 0 - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - -
13 A013 0 0 - - -
14 A014 Amlodipin Tablet 10 Mg Tablet - - -
15 A015 Amlodipin Tablet 10 Mg Tablet 2,033 - 2,033 40 223
16 A016 0 0 - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet 24,487 - 24,487 320 2,508
18 A018 Amoksisilin Kaplet 500 mg Tablet - - -
19 A019 Amoksisilin Kaplet 500 mg Tablet - - -
20 A020 Amoksisilin Kaplet 500 mg Tablet - - -
21 A021 0 0 - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 186 - 186 4 32
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - -
25 A025 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - -
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - -
27 A027 CLABAT,CAPSINAT Tablet - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - -
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 268 - 268 65

30 A030 0 0 - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol 50 - 50 18 32
32 A032 0 0 - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
35 A035 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet 327 - 327 120 157
36 A036 Tablet - - -
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - -
40 A040 Pot 24 - 24
41 A041 Salisilat 3% (Marin )
0Antihemoroid 0 - - -
Kombinasi : Bismut Suppgalat 150 mg
42 A042 Supp - - -
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - -
45 A045 20% ) HEMOROGARD Tablet - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet 1,753 - 1,753 236
47 A047 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet - - -
48 A048 Tablet - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - -
50 A050 Asam Folat Tablet 1 mg Tablet - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - -
52 A052 Asam Mefenamat 500 mg 0 - - -
53 A053 0 0 - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - 3
55 A055 0 0 - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 189 - 189 7 18
57 A057 0 0 - - -
58 A058 Asiklovir 5% 5gr Cream Tube 116 - 116 4
59 A059 Asiklovir 5% 5gr Cream Tube - - -
60 A060 0 0 - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 200 - 200 54
 63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - -
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet - - -
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet - - -
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet 1,675 - 1,675
69 A069 Betahistin Mesylat 6 mg Tablet - - -
70 A070 Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - -
71 A071 Betametason Dipropionat Krim 0,1% Tube - - -
72 A072 Betametason Dipropionat Krim 0,1% gram @ 10 - - -
Tube
gram @ 10
73 A073 Betametason Dipropionat Krim 0,1% 117 - 117 17
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - -
77 A077 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - -
78 A078 Bricasma Biji - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - -
80 A080 Zeneca
0Budesonid )I 0 - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 A081 pcs - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - -
84 A084 Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet 405 - 405 220
85 A085 Cefadroksil Kapsul 500 mg Tablet - - -
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 54 - 54
88 A088 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - - -
89 A089 Tablet - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 174 - 174 12
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet 318 - 318 216
93 A093 Deksamethason Tab 0,5 mg 0 - - -
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - -
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 177 - 177 21
97 A097 0 0 - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 42 - 42 4 38
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - -
100 A100 Digoksin Tab 0,25 mg Tablet - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 811 - 811 60 238
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - -
103 A103 0 0 - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet - - -
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 10 - 10 4
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - -
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet 200 - 200 40
113 A113 Ethambutol 250 mg Tablet - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 54 - 54 1
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 63 - 63
120 A120 0 0 - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 112 - 112
128 A128 Gentamycin Krim 1 % mg/ ml Tube - - -
129 A129 Gentian Violet 1% 10 ml Botol - - -
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 23 - 23 2
131 A131 Glibenklamid Tablet 5 mg Tablet 4,555 - 4,555 20 399
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - - -
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet 4,555 - 4,555 30 915
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 108 - 108
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 14 - 14
137 A137 Glukosa Larutan 40% Steril botol - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - -
139 A139 Glukosa Larutan Infus 5% @500ml Botol 28 - 28 28

140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - -

141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,127 - 1,127 91
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 52 - 52 12
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10
148 A148 0 0 - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 188 - 188 23
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 564 - 564 503
152 A152 Ibuprofen Tablet 400 mg Tablet - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - -
154 A154 Isoniazid Tablet 100 mg tablet - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 218 - 218 10 17
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
158 A158 0 0 - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 92 - 92 10

162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - -

163 A163 Tablet - - -
164 A164 Pharmatama)
0 0 - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 3,543 - 3,543 20 596
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - -
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet 1,483 - 1,483 266
170 A170 Kaptopril Tab 25 mg TAblet - - -
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube - - -
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube 29 - 29 3
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 360 - 360
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - -
176 A176 Ketorolak Inj 30 mg/ml Ampule - - -
177 A177 0 0 - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 166 - 166 15
179 A179 0 0 - - -
180 A180 Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol Vial - - -
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - -
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - -
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 5,353 - 5,353 172
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,558 - 1,558 10 170
190 A190 Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg - - -
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol 140 - 140 5
193 A193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma )
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract - - -
194 A194 MOLAKRIM
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 14 - 14 1
195 A195 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- - -
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - -
197 A197 Probiotik (Dexa Medica, Sanbe) Tablet 4 - 4 4
198 A198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 78 - 78 41
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 152 - 152 18
203 A203 Loperamid Tablet 2 mg Tablet - - -
204 A204 Loratadin Tablet 10 mg Tablet 132 - 132
205 A205 Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - -
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet 360 - 360
207 A207 Mata/ OCUGARD (Phapros) Tablet 180 - 180
208 A208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - -
209 A209 0 0 - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet - - -
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - 500 500 164

213 A213 Metformin HCl Tablet 500 mg Tablet 111 - 111 111
214 A214 Metformin HCl Tablet 500 mg Tablet 2,000 - 2,000 155
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 183 - 183 20
216 A216 0 0 - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet - - -
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet - 300 300 86
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - -
223 A223 Metronidasol Infus 500mg/100ml Botol - - -
224 A224 Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - -
225 A225 Kapsul - - -
226 A226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 390 - 390 30
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 A227 Ampule - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - -
229 A229 Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - -
230 A230 Tablet - - -
Ayus )
 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU
231 A231 Multivitamin Curcuma Syr:L-Lysyin 1000 IU Botol 4 - 4 3
2ml /200mg,Betacaroten
1

232 A232 vit B1 3 mg, B12 Curcuminoid LYTACUR (Dexa Medika) Botol - - -
Multivitamin Neurotopic
vit B1 3 mg, B12 Plus ATP
Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet
233 A233 Multivitamin - - -
234 A234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) Tablet - - -
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 A235 Femofomarrat 300mg tablet - - -
236 A236 MOLANEURON (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C Tablet 3,698 - 3,698 40 500
237 A237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 270 - 270 163
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - -
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - -
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 103 - 103 58

242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet - - -

243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - -
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 11 - 11 11
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 20 - 20
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - -
248 A248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet - - -
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - -
252 A252 Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - -
253 A253 Omeprazole Kapsul 20 mg Tablet - - -
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 336 - 336 54

255 A255 Parasetamol

Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - -
256 A256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet - - -
257 A257 Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - -
258 A258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - -
259 A259 400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol
Parasetamol HCl 25Mg/ HUSTAB Tablet - - -
260 A260 (Phapros) Tablet - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 30Mg,
100 mg / COLPICA (Tropika Mas) 0 - - -
Parasetamol Komb Tablet Flu: Parasetamol
262 A262 Tablet - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - -
264 A264 Parasetamol Syrup 120 mg/5ml Botol 107 - 107 59
265 A265 Parasetamol tablet 500 mg Tablet - - -
266 A266 Parasetamol tablet 500 mg Tablet - - -
267 A267 Parasetamol tablet 500 mg Tablet - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 32 - 32
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 56 - 56 7
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - -
271 A271 Piracetam 800 mg Tablet Tablet 12 - 12 12
272 A272 Parasetamol tablet 500 mg Tablet - 7,000 7,000 132 1,148
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule - - -
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - -
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 2,133 - 2,133 21 366
276 A276 Probiotik Sachet (Probiokid) 0 - - -
277 A277 Polikresulen (Albotyl,Apetil) Botol - - -
278 A278 Prednison Tab 5 mg Tablet - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 781 - 781 287
280 A280 Prednison Tab 5 mg Tablet - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 519 - 519 87

283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - -

284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 591 - 591 60 286
285 A285 0 0 - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol 92 - 92 92

288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - -

289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
290 A290 Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - -
291 A291 Nebule 238 - 238 4 10
292 A292 (COMBIVENT)
0 I dan II 0 - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - -
294 A294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet - 500 500 12 82
295 A295 Salep Pot 16 - 16 6
296 A296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - -
298 A298 Salisil Bedak Serbuk 2% Pcs - - -
299 A299 Salisil Bedak Serbuk 2% Pcs - - -
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - 1
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 16 - 16 5
304 A304 Setirizin Tab 10 mg (Futamed) Tablet 16 - 16 4
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 834 - 834 134
307 A307 Simvastatin Tablet 10 mg Tablet - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
309 A309 0 0 - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - -
311 A311 Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% Botol 23 - 23
312 A312 Botol - - -
313 A313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - -
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - -
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 90 - 90 72
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - -
318 A318 Thiamphenicol Kapsul 500 mg Tablet - - -
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 18 - 18 6
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - -
321 A321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek - 3,000 3,000 72 667
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - -
323 A323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
327 A327 0 0 - - -
328 A328 0 0 - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 3 - 3
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - -
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet - - -
336 A336 Diazepam Tablet 5 mg Tablet - - -
337 A337 Fenobarbital Tablet 30 mg Tablet - - -
338 A338 Fenobarbital Tablet 30 mg Tablet - - -
339 A339 Fenobarbital Tablet 30 mg tablet - - -
340 A340 Kodein Tablet 10 mg Tablet - - -
341 A341 0 0 - - -
342 A342 Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON Tablet - - -
343 A343 Tablet - - -
344 A344 (Meprofarm)
0 0 - - -
345 A345 0 0 - - -
346 A346 0 0 - - -
347 A347 Primaquin 15 mg tablet tablet - - -
348 A348 0 0 - - -
OBAT - OBAT PROGRAM 0 - - -
OBAT PROGRAM KECACINGAN 0 - - -
349 A349 Albendazol Tablet 400 mg Tablet 262 - 262 262
350 A350 Albendazol Tablet 400 mg Tablet 2,820 - 2,820 2,628
OBAT PROGRAM DIARE 0 - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - -
352 A352 Garam Oralit (Kimia Farma) Tablet 847 - 847
353 A353 Garam Oralit (Kimia Farma) sachet - - -
354 A354 Garam Oralit (Kimia Farma) sachet - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - -
356 A356 Botol 45 - 45 2
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - -
359 A359 Zinc Dispersible 20 mg tablet tablet - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 2,630 - 2,630
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
363 A363 0 0 - - -
OBAT PROGRAM HEPATITIS 0 - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - 2 2 2
OBAT PROGRAM TB PARU 0 - - -
369 A369 OAT FDC Kategori Anak Kit - - -
370 A370 OAT FDC Kategori Anak Kit - - -
371 A371 OAT FDC Kategori Anak Kit - - -
372 A372 OAT FDC Kategori I - IIII Kit - - -
373 A373 OAT FDC Kategori I - IIII Kit - - -
374 A374 OAT FDC Kategori II Kit - - -
375 A375 OAT FDC Kategori II Kit - - -
376 A376 OAT FDC Kategori II Kit - - -
377 A377 OAT FDC Kombipak Kategori I Kit - - -
378 A378 0 0 - - -
379 A379 Isoniazid 100 mg tablet tablet - - -
OBAT POGRAM KUSTA 0 - - -
380 A380 MDT MB Anak Blister - - -
381 A381 MDT MB Anak Blister - - -
382 A382 MDT MB Dewasa Blister - - -
383 A383 MDT MB Dewasa Blister - - -
384 A384 MDT MB Dewasa Blister - - -
385 A385 MDT PB Anak Blister - - -
386 A386 MDT PB Anak Blister - - -
387 A387 MDT PB Anak Blister - - -
388 A388 MDT MB Dewasa Blister - - -
389 A389 MDT PB Dewasa Blister - - -
OBAT PROGRAM GIZI 0 - - -
390 A390 Mineral Mix Kombinasi sachet - - -
391 A391 Mineral Mix Kombinasi sachet - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 3,470 - 3,470 3,170
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - -
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul 50 - 50 50
397 A397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul 300 - 300 294
398 A398 Tablet Tablet - - -
399 A399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Tablet 46,700 - 46,700 2,500
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros)
400 A400 tablet - - -
401 A401 0,4
0 Mg Tab (Phapros) 0 - - -
402 A402 0 0 - - -
OBAT PROGRAM KESGA 0 - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule 5 - 5 5
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial - - -
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - -
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 27 - 27 15
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 610 - 610
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 60 - 60 20
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
OBAT PROGRAM JIWA 0 - - -
416 A416 Amitriptilin 25 mg Tablet - - -
417 A417 Amitriptilin 25 mg Tablet - - -
418 A418 Amitriptilin 25 mg Tablet - - -
419 A419 Amitriptilin 25 mg Tablet 160 - 160
420 A420 Amitriptilin 25 mg Tablet - - -
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - -
422 A422 Clozapine 100 mg Tablet - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - -
428 A428 Flufenazin sikzonoate inj 5 ml vial - 10 10 1
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - -
430 A430 Haloperidol 5 mg tablet Tablet - - -
431 A431 Haloperidol 5 mg tablet Tablet 2,477 - 2,477 190
432 A432 Haloperidol 5 mg tablet Tablet - - -
433 A433 0 0 - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - -
436 A436 Haloperidol/ Lodomer drops 2 mg Botol - - -
437 A437 Karbamazepin Tablet 200 mg Tablet - - -
438 A438 Karbamazepin Tablet 200 mg Tablet - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - 3
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - -
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 2,129 - 2,129 240
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - -
444 A444 0 0 - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - -
447 A447 Risperidon Tab 2 mg Tablet 674 800 1,474 977
448 A448 Risperidon Tab 2 mg Tablet - - -
449 A449 0 0 - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - -
451 A451 0 0 - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - -
453 A453 Triheksifenidil Tablet 2 mg Tablet 1,824 - 1,824 412
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - -
455 A455 0 0 - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - -
457 A457 0 0 - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - -
458 A458 BCG vial 11 30 41 5
459 A459 PELARUT BCG ampul 11 30 41 5
460 A460 BCG vial - - -
461 A461 BCG vial - - -
462 A462 CAMPAK 10ds (MR) vial - - -
463 A463 PELARUT CAMPAK ampul 109 30 139
464 A464 CAMPAK 10ds (MR) vial 7 30 37 16
465 A465 CAMPAK 10ds (MR) vial - - -
466 A466 DPT HB - Hib/ PENTABIO vial - - -
467 A467 DPT HB - Hib/ PENTABIO vial - 60 60 60
468 A468 DT vial - - -
469 A469 0 0 - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial - 20 20 20
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - -
472 A472 POLIO bOPV 10 ds vial 18 - 18 18
473 A473 DROPPER POLIO dropper 143 50 193
474 A474 POLIO bOPV 10 ds vial - - -
475 A475 POLIO bOPV 10 ds vial - - -
476 A476 Td vial 5 10 15
477 A477 0 0 - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial 43 30 73 6
479 A479 POLIO bOPV 10 ds vial - 50 50 5
480 A480 Vaksin Meningtis vial - - -
481 A481 CAMPAK 10ds (MR) BIAS vial - 90 90 90
482 A482 PELARUT CAMPAK BIAS ampul - 90 90 90
483 A483 POLIO bOPV 10 ds vial - - -
484 A484 IPV vial - - -
485 A485 VTM Include Dacron (Biofarma) pcs - - -
486 A486 Vaksin Rabies (Verorab) vial - - -
487 A487 0 0 - - -
488 A488 0 0 - - -
489 A489 0 0 - - -
OBAT PROGRAM HIV/ AIDS 0 - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - -
491 A491 0 0 - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 202 - 202 11
493 A493 0 0 - - -
494 A494 Lamivudine 150 mg Tablet - - -
495 A495 Lamivudine 150 mg Tablet - - -
496 A496 Nevirapine 200 mg Tablet - - -
497 A497 Nevirapine 200 mg Tablet - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - -
500 A500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - -
501 A501 FDC Dewasa Tablet - - -
502 A502 FDC Dewasa
Tenofovir 300 mg Tablet - - -
503 A503 Tenofovir 300 mg Tablet - - -
504 A504 Zidofudine 100 mg (ZDV) Tablet - - -
505 A505 Zidofudine 100 mg (ZDV) Tablet - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
508 A508 Efavirenz 600 mg tablet tablet - - -
509 A509 Efavirenz 600 mg tablet tablet - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
511 A511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - -
512 A512 Tablet - - -
FDC Dewasa
513 A513 0 0 - - -
514 A514 MB Anak blister - - -
515 A515 0 0 - - -
516 A516 0 0 - - -
517 A517 0 0 - - -
518 A518 0 0 - - -
519 A519 0 0 - - -
520 A520 0 0 - - -
521 A521 0 0 - - -
522 A522 0 0 - - -
523 A523 0 0 - - -
524 A524 0 0 - - -
525 A525 0 0 - - -
526 A526 0 0 - - -
527 A527 0 0 - - -
528 A528 0 0 - - -
529 A529 0 0 - - -
BMHP 0 - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
532 A532 0 0 - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - -
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs 973 - 973 200
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - -
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 1,000 100 1,100
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - -
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs - - -
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - -
542 A542 Alkohol 70% (Medika) Btl 1000 ml - - -
543 A543 Alkohol Swab 2 - ply (one med) 0 - - -
544 A544 Alkohol Swab 2 - ply (one med) Pcs 300 - 300 100
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol 1 1 2
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 58 - 58 58
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - -
549 A549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - -
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Pcs - - -
551 A551 Phsda 0 - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - -
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 7 - 7 7
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs - - -
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - 5
561 A561 Mantel Gown (Bisa Dicuci) biji - - -
562 A562 I.V Catheter No. 18 (JELCO) Pcs - - -
563 A563 I.V Catheter No. 18 (NIPRO) Pcs 38 - 38 29

564 A564 I.V Catheter No. 20 JELCO Pcs - - -

565 A565 I.V Catheter No. 20 TERUMO Pcs 64 - 64 64

566 A566 I.V Catheter No. 20 JELCO Pcs - - -

567 A567 I.V Catheter No. 22 NIPRO Pcs - - -
568 A568 I.V Catheter No. 22 NIPRO Pcs 34 - 34 33

569 A569 I.V Catheter No. 24 TERUMO Pcs 105 - 105 28

570 A570 I.V Catheter No. 24 TERUMO 0 - - -

571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - -
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 62 - 62 3

573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -

574 A574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 235 - 235 76

575 A575 Pcs - - -

576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 9 5 14 2

578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - -

579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - -
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 4 - 4 4

581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - -

582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 48 - 48
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - -
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 48 - 48 48

587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - -

588 A588 Masker Ear Loop (Masker) Pcs - - -
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - -
590 A590 Masker General Care (MARCOTILA) Pcs - - -
591 A591 0 0 - - -
592 A592 Masker N95 Disposibel Pcs - - -
593 A593 Masker N95 Disposibel (One Med) Pcs - - -
594 A594 Masker Tali Pcs - - -
595 A595 Masker Tali Pcs - - -
596 A596 Masker Elastic Pcs - - -
597 A597 Media Sample Container Pcs 1,120 - 1,120 785
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs - 13 13 1

601 A601 Nurse Cup (Tutup Kepala) Pcs - - -

602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - -
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - -
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 58 - 58
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 5 - 5 1

608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - -

609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - -
610 A610 0 0 - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - -
613 A613 0 0 - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - - -
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - -
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir - 300 300
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 276 - 276
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 19 - 19 19
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - -
622 A622 0 0 - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1
625 A625 Underpad 90x 0 cm cosmo I Pcs 17 - 17 17

626 A626 Underpad 90x 0 cm cosmo II Pcs - - -

627 A627 0 0 - - -
628 A628 Urine Bag Sterile Standard Pcs 7 - 7 7

629 A629 Urine Bag Sterile Standard (AXIMED) Pcs - - -

630 A630 0 0 - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs - - -
REAGEN 0 - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 400 - 400
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - -
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - -
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - -
639 A639 0 0 - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - -
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - -
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs - - -
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - -
649 A649 0 0 - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - -
651 A651 0 0 - - -
652 A652 TPHA (Fokus) Test - - -
653 A653 0 0 - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - -
BMHP (PROGRAM) PROPINSI 0 - - -
PROGRAM MALARIA 0 - - -
656 A656 RDT Malaria Test - - -
PROGRAM SYPHILIS 0 - - -
657 A657 RPR Syphilis Pcs 100 - 100
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline Test
Test 300 - 300
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - -
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - -
662 A662 0 0 - - -
663 A663 Tuberkulin Vial - - -
664 A664 RDT Lepto (Uji Leptospira IgM) test - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - -
666 A666 0 0 - - -
667 A667 0 0 - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - -
668 A668 Test - - -
669 A669 Reagen HBsAg Strip SD Test - - -
670 A670 Reagen HBsAg Strip SD Test 350 - 350
671 A671 Reagen HBsAg Strip SD Test - - -
672 A672 0 0 - - -
673 A673 0 0 - - -
674 A674 0 0 - - -
675 A675 0 0 - - -
PROGRAM TB PARU 0 - - -
676 A676 Box Slide Pcs - - -
677 A677 Box Slide Pcs - - -
678 A678 Catridge Genexpart Test - - -
679 A679 Catridge Genexpart Test - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - -
681 A681 Oil Emersi Botol - - -
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - -
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - -
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - -
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - -
686 A686 Reagen Control CD4 0 - - -
687 A687 Reagen Control CD4 0 - - -
688 A688 Reagen Zeil Nelseen Kit - - -
689 A689 Reagen Zeil Nelseen Kit - - -
690 A690 Reagen Zeil Nelseen Kit - - -
691 A691 Reagen Zeil Nelseen Kit - - -
692 A692 Slide Pcs 9 - 9
693 A693 Slide/ Object Glass Pcs - - -
694 A694 Stereofoam pcs - - -
695 A695 Masker N 95 TB pcs - 30 30 7

696 A696 Masker Tali Bedah TB pcs - - -

OBAT PROGRAM IMUNISASI 0 - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - 800 800
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
708 A708 0 0 - - -
709 A709 0 0 - - -
710 A710 0 0 - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 145 - 145
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
714 A714 0 0 - - -
715 A715 Safety Box 5 L Pcs - 25 25
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
717 A717 0 0 - - -
718 A718 0 0 - - -
719 A719 0 0 - - -
720 A720 0 0 - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - -
721 A721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test 50 - 50
722 A722 Tahap I 0 - - -
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold)
723 A723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - -
724 A724 Tahap I 0 - - -
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
725 A725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test 50 - 50
726 A726 Tahap I 0 - - -
727 A727 Tahap
Kondom I Pcs - - -
728 A728 DBS Collection/ Lasec Pcs - - -
729 A729 Lubricant Pcs - - -
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - -
731 A731 Test 819 - 819
732 A732 IRapid HIV 1/2 3.0 SD Bioline test - - -
733 A733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - -
734 A734 Test - - -
735 A735 Tahap
ReagenI HIV (SD) R 1 Test - - -
736 A736 Reagen HIV (SD) R 1 Test - - -
737 A737 0 0 - - -
738 A738 Reagen HIV (VIKIA) R 3 Test - - -
739 A739 0 0 - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - -
741 A741 0 0 - - -
742 A742 Reagen HIV R3 (VIKIA) Test - - -
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - -
744 A744 Sarung Tangan Non Steril Pair - - -
745 A745 0 0 - - -
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - -
747 A747 VTM Include Swab Test - - -
748 A748 Masker Bedah 3 ply Pcs - - -
749 A749 0 0 - - -
750 A750 0 0 - - -
751 A751 0 0 - - -
752 A752 0 0 - - -
753 A753 0 0 - - -
754 A754 0 0 - - -
755 A755 0 0 - - -
756 A756 0 0 - - -
757 A757 0 0 - - -
758 A758 0 0 - - -
759 A759 0 0 - - -
760 A760 0 0 - - -
761 A761 0 0 - - -
762 A762 0 0 - - -
763 A763 0 0 - - -
764 A764 0 0 - - -
OKSIGEN MEDICAL 0 - - -
765 A765 Oksigen 3 m3 Tampon - - -
766 A766 Oksigen 6 m3 Tampon - - -
767 A767 Oksigen 1 m3 Tampon - - -
768 A768 Oksigen 6 m3 Tampon - - -
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - -
770 A770 0 0 - - -
771 A771 0 0 - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - -
TAMBAHAN IFK 0 - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
3 T003 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex Tablet - - -
4 T004 Tablet - - -
5 T005 Thiamphenicol Syr. 0 - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - -
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - -
10 T010 Ketokonazole 200 mg Tablet - - -
11 T011 Kotrimoksazol Forte Tablet - - -
12 T012 Infusion set anak Pcs 50 - 50
13 T013 Alat Suntik 10 cc Pcs - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
15 T015 Omeprazole Kapsul 20 mg Tablet - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol 360 - 360
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
19 T019 Oseltamivir 75 mg Kapsul - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol 1,320 - 1,320 228
21 T021 Amitriptilin 25 mg Tablet - - -
22 T022 I.V Catheter No. 24 TERUMO pcs - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - -
24 T024 RDT COVID - 19 0 - - -
25 T025 Oseltamivir 75 mg 0 - - -
26 T026 Klorokuin
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - -
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - -
28 T028 Viruses) 0 - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) 0 - - -
30 T030 Hazmat/ APD/ Hazmat PPK 0 30 - 30
31 T031 Medical Sample Container Pcs - - -
32 T032 Cepheid Pcs - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - -
34 T034 Tambah Darah drop (Ferriz Drop) pcs - 200 200
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs - 200 200 1
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
38 T038 Obat Batuk Sirup / INADRYL Botol - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - -
40 T040 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - -
41 T041 dextromethorpan Hbr Tablet - - -
42 T042 Influenza
Masker Bedah /Bima Sakti pCS - - -
43 T043 Masker Bedah /Rania pCS - - -
44 T044 Masker N 95 Bima Sakti PCS - - -
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 - - -
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - -
47 T047 Albendazol Suspensi 200mg/ 5 ml botol - 300 300
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - -
49 T049 OAT FDC Kategori Anak 0 - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - -
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - -
53 T053 0 0 - - -
54 T054 0 0 - - -
55 T055 0 0 - - -
56 T056 0 0 - - -
57 T057 0 0 - - -
58 T058 0 0 - - -
59 T059 0 0 - - -
60 T060 APD Set (Rannia) 0 8 - 8
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5
62 T062 Cover
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 4 - 4
63 T063 0 - - -
64 T064 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - -
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs 2,000 - 2,000
69 T069 Masker N95 Covid 19 Pcs - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - -
71 T071 Masker Eaerlop Hijab Pcs 1,800 - 1,800
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - 1
73 T073 Hand Sanitzer 1 Botol = 20 Liter 1 - 1
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs 9 - 9
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - 2
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - -
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs - - -
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - -
84 T084 Masker KN95 (Farmahusada) Box @50 pcs 20 - 20
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - -
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test 21 - 21
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - -
89 T089 APRON (Atmosfer) pcs 100 - 100
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - -
91 T091 Hand Sanitzer 2 liter - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 38 30 68
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - -
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - -
96 T096 Face Shield (COBRA) 0 7 - 7
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
98 T098 Kit Steril (Rajawali) 0 - - -
99 T099 Alkohol II @20 Liter 0 - - -
100 T100 Cover All (Rajawali) 0 4 - 4
101 T101 Face Shield (ATMOSFER) 0 - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
103 T103 Masker Earloop (KasaHusada) 0 - 1,700 1,700
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - -
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - -
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - -
107 T107 Alkohol Swab (BTT) 0 - - -
108 T108 Antiseptic Gel 500 0 - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 4,140 - 4,140
110 T110 Kaca mata Goggle (HASTEN) 0 5 - 5
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - -
112 T112 Masker Bedah Hijau @50pcs 0 - - -
113 T113 Masker N95 3M 8210 (Hazten) 0 10 - 10
114 T114 Nurse Cap Green om 100bh 0 - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - -
117 T117 Sarung tangan Safeglove Exam M 100bh 0 - 3,000 3,000
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - -
121 T121 Universal Transport Media (UTM) Goongdong 0 - - -
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - -
127 T127 Rapid Test Lecurate (Bima Sakti) 0 - - -
128 T128 Rapid Test ZYBIO (Farma Husada) 0 - - -
129 T129 Alkohol 96 % Liter - 20 20
130 T130 0 0 - - -
0 0 - - -
TAMBAHAN PUSKESMAS 0 - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - -
3 TP003 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube - - -
4 TP004 pcs - - -
5 TP005 Zeneca)
0 0 - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 405 - 405 61
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - -
9 TP009 0 0 - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - -
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - -
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 248 - 248 10
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - -
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 2 - 2 2
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 - - -
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - -
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - -
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - -
24 TP024 Materniti Napkin Slim L 0 - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - -
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1
29 TP029 Haloperidol 5 mg tablet Tablet - - -
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - -
31 TP031 Fixomull Strech 5 cm X 5 m Pcs - - -
32 TP032 Umbilical crd clamp 0 126 - 126
33 TP033 0 0 - - -
34 TP034 0 0 - - -
35 TP035 0 0 - - -
36 TP036 0 0 - - -
37 TP037 0 0 - - -
38 TP038 0 0 - - -
39 TP039 0 0 - - -
40 TP040 0 0 - - -
41 TP041 0 0 - - -
42 TP042 0 0 - - -
43 TP043 0 0 - - -
44 TP044 0 0 - - -
45 TP045 0 0 - - -
46 TP046 0 0 - - -
47 TP047 0 0 - - -
48 TP048 0 0 - - -
49 TP049 0 0 - - -
50 TP050 0 0 - - -
51 TP051 0 0 - - -
52 TP052 0 0 - - -
53 TP053 0 0 - - -
54 TP054 0 0 - - -
55 TP055 0 0 - - -
56 TP056 0 0 - - -
57 TP057 0 0 - - -
58 TP058 0 0 - - -
59 TP059 0 0 - - -
60 TP060 0 0 - - -
0 0 - - -
TOTAL - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Mengetahui Yang Menyerahkan,
Plt. KEPALA DINAS KESEHATAN TERTULIS 2 KALI KEPALA INSTALASI FARMASI KABUPATEN
KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN Dra. TRI MUSYAROFAH, Apt

NIP. 19630724 198910 1 002 NIP. 19630411 199203 2 005
 LEMBAR PERMINTAAN OBAT
PLPO )

: BULAN : AGUSTUS
: TAHUN : 2019

AN SUMBER HARGA STOK NILAI

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN
JUMLAH ANGGARAN SATUAN OPTIMUM PENERIMAAN

UNIT UNIT RP

- - DAK 18/Okt.19 99.000 0.00 0.000

- - DAK 19/Sept.21 105.000 0.00 0.000

- - DAK 20/ Jan 22 105.000 0.00 0.000

- - - 0.000 0.00 0.000
- - DAK 19/Feb.22 2,860.000 0.00 0.000
DAK 20/ 16 -
16 131 2,860.000 374,660.00 0.000
Des 22
- - DAK 18/Apr.20 10,500.000 0.00 0.000
69 838 DAK 19/Mei 23 104.000 87,152.00 0.000
- - DAK 20 L 220.000 0.00 0.000
10 1,969 DAK 19/Juni 21 93.500 184,101.50 0.000
- - DAK 17/AGSTS- - 0.000 0.00 0.000
- - 2,998.000 0.00 0.000
- - 20 - 0.000 0.00 0.000
- - Dak 19/Okt. 20 93.000 0.00 0.000
263 1,770 Dak 20/Okt 21 99.000 175,230.00 0.000
- - - 0.000 0.00 0.000
2,828 21,659 DAK 17/NOV-21 190.000 4,115,210.00 0.000
- - DAK 18/Okt.20 233.000 0.00 0.000
- - DAK 19/Feb 21 233.000 0.00 0.000
- - DAK 20/ April 22 249.000 0.00 0.000
 - - - 0.000 0.00 0.000
36 150 DAK 19/Agst.22 3,025.000 453,750.00 0.000
- - DAK 20 L 3,025.000 0.00 0.000
- - DAK 19/JULI 21 4,400.000 0.00 0.000
- - DAK 20/ Mart 22 3,628.000 0.00 0.000
- - DAK 18L/Mar.20 10,246.500 0.00 0.000
- - PRBG 20 9,900.000 0.00 0.000
- - DAK 17/MAR-20 8,500.000 0.00 0.000
65 203 DAK 20 / Mei-23 8,237.000 1,672,111.00 0.000
- - - 0.000 0.00 0.000
50 - DAK 19/Sept. 23 4,950.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR-19 440.000 0.00 0.000
- - DAK 18L/Agst.20 220.000 0.00 0.000
277 50 DAK 19/Mei20
PRSpesifik 21 165.000 8,250.00 0.000
- - 58.000 0.00 0.000
- - non covid-19/ - 0.000 0.00 0.000
- - DAK 18/Apr-22 3,035.000 0.00 0.000
- - - 0.000 0.00 0.000
- 24 DAK 17/ Mei-21 4,496.000 107,904.00 0.000
- - - 0.000 0.00 0.000
- - DAK
Buffer Prop.20 - 3,045.000
16/APR-20 0.00 0.000
- - 198.000 0.00 0.000
- - Covid-19
DAK 18L/Jan.21 1,485.000 0.00 0.000
- - PRSpesifik L 20/ 1,551.000 0.00 0.000
236 1,517 DAK 19/Sept.21 105.000 159,285.00 0.000
- - DAK 20/Juni 22 105.000 0.00 0.000
- - DAK
DAK 17/Jan-21
17/AGSTS- 1,050.000 0.00 0.000
- - 67.000 0.00 0.000
- - 20
DAK 20/Feb 22 75.000 0.00 0.000
- - DAK 19/MAR-22 103.000 0.00 0.000
- - DAK 20 L 253.000 0.00 0.000
- - 0 0.000 0.00 0.000
- 3 DAK 19/Feb.22 2,076.000 6,228.00 0.000
- - 0 0.000 0.00 0.000
25 164 DAK 19/Feb.22 1,584.000 259,776.00 0.000
- - 0 0.000 0.00 0.000
4 112 DAK 18L/Apr.22 2,915.000 326,480.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 380.000 0.00 0.000
54 146 DAK 19/Des.22 380.000 55,480.00 0.000
 - - DAK 20/Des 23 405.000 0.00 0.000
- - Dak
DAK19/Feb 21
20/31-Okt 1,639.000 0.00 0.000
- - 1,639.000 0.00 0.000
- - 21
DAK 18/Apr 23 136.000 0.00 0.000
- - DAK20
DAK 19/Apr 23
/Nov22, 152.000 0.00 0.000
- 1,675 145.000 242,875.00 0.000
- - Mart
DAK 23
PRSpesifik 20 110.000
19/Jan 21 0.00 0.000
- - 110.000 0.00 0.000
- - Non
DAK Covid-19/
18/Feb.20 3,350.000 0.00 0.000
- - DAK 19/Feb.20 3,350.000 0.00 0.000
17 100 DAK 20/Okt 21 3,350.000 335,000.00 0.000
- - DAK 17/JUL-19 300.000 0.00 0.000
- - DAK 20/Feb 24 5,900.000 0.00 0.000
- - DAK 19/ 626.000 0.00 0.000
- - DAK 20 L 18,150.000 0.00 0.000
- - DAK 19/Agst. 20 7,602.000 0.00 0.000
- - DAK 19/Apr.20 7,124.000 0.00 0.000
- - 0 0.000 0.00 0.000
- - DAK 19/Jan 21 149,266.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Mei 24 5,280.000 0.00 0.000
220 185 DAK 19/Juni 24 660.000 122,100.00 0.000
- - PRBG 20/ 671.000 0.00 0.000
- - DAK 17/MAR-19 4,282.000 0.00 0.000
- 54 DAK 19/Mar.21 11,000.000 594,000.00 0.000
- - PRSpesifik L 20/ 10,098.000 0.00 0.000
- - DAK 19/Okt.21 2,805.000 0.00 0.000
- - DAK
DAK 19/Apr.21
20/ Des 21, 1,097.000 0.00 0.000
12 162 1,097.000 177,714.00 0.000
216 102 Feb
DAK2219/Juni 21 60.500 6,171.00 0.000
- - DAK 20 L 66.000 0.00 0.000
- - DAK 18/Nov 19 10,400.000 0.00 0.000
- - DAK 18L/Agst.20 9,900.000 0.00 0.000
21 156 DAK 19/Juni 22 1,095.000 170,820.00 0.000
- - - 0.000 0.00 0.000
42 - DAK 17/APR-21 104.000 0.00 0.000
- - DAK 19/Nov.20 104.000 0.00 0.000
- - DAK 20/ 104.000 0.00 0.000
298 513 DAK 19/Nov.20 105.000 53,865.00 0.000
- - DAK 19/Mar.24 112.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/JULI21 4,400.000 0.00 0.000
 - - DAK 20/Feb 22 2,700.000 0.00 0.000
- - DAK 19/Juni 21 165.000 0.00 0.000
- - DAK 20/Mart 23 91.000 0.00 0.000
- - DAK 18/Des 20 1,408.000 0.00 0.000
4 6 DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 8,448.00 0.000
- - Buffer 1,408.000 0.00 0.000
- - Aprl 21 Prop 730.000 0.00 0.000
40 160 19/Mei
DAK 20/ 20Mei 21 770.000 123,200.00 0.000
- - DAK
DAK 19/Des.23
17/SEPT- 391.000 0.00 0.000
- - 4,167.000 0.00 0.000
- - 20
DAK
Buffer17/AGS-19
Prop.19/ 3,550.000 0.00 0.000
- - 3,682.000 0.00 0.000
1 53 Feb 20 /31-Des
DAK 20
3,682.000 195,146.00 0.000
- - 21;Jan 22
DAK 17/Apr.19 691.000 0.00 0.000
- 63 DAK 18/Apr.21 710.000 44,730.00 0.000
- - DAK 17/ JAN-20 0.000 0.00 0.000
- - DAK
DAK 18/Des.19 1,333.000 0.00 0.000
- - 1,333.000 0.00 0.000
- - Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.00 0.000
- - DAK 20/Mei 22 82.000 0.00 0.000
- - DAK 18/Mei 21 4,232.000 0.00 0.000
- - DAK 19/Sept.22 4,232.000 0.00 0.000
- 112 DAK 20/Feb 23 4,232.000 473,984.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
- - DAK 20 L 4,400.000 0.00 0.000
2 21 DAK 17/DES-20 2,900.000 60,900.00 0.000
419 4,136 DAK 19/Feb 24 119.000 492,184.00 0.000
- - DAK 20/ Feb 22 119.000 0.00 0.000
- - DAU 19/Mei
DAK PR BG 23 77.000 0.00 0.000
945 3,610 COVID 20/ Agsts 99.000 357,390.00 0.000
- 108 DAK 19/Mei 22
21 7,865.000 849,420.00 0.000
- 14 DAK 19/Mei 21 10,010.000 140,140.00 0.000
- - PRSpesifik L 20/ 10,010.000 0.00 0.000
- - DAK 17/FEB-20 6,900.000 0.00 0.000
28 - DAK 20/ 7,363.000 0.00 0.000
- - APBD II - 15 132.000 0.00 0.000
91 1,036 DAK 16/OKT-21 149.000 154,364.00 0.000
- - DAK 20 L 88.000 0.00 0.000
- - DAK 18/Agst.21 2,787.000 0.00 0.000
12 40 DAK 19/Mei 23 2,475.000 99,000.00 0.000
- - DAK 20/ Juni 23 2,475.000 0.00 0.000
- - DAK 19/Jan 21 176,800.000 0.00 0.000
 - 10 DAK 19/Mei 21 8,800.000 88,000.00 0.000
- - DAK 20 L 0.000 0.00 0.000
- - DAK 19 4,665.000 0.00 0.000
23 165 DAK 20/ Des 21 4,665.000 769,725.00 0.000
503 61 DAK 19/JULI21 264.000 16,104.00 0.000
- - DAK 20 L 330.000 0.00 0.000
- - DAK 18L/Mar.20 660.000 0.00 0.000
- - DAK 20 L 187.000 0.00 0.000
27 191 DAK 17/MAR-21 90.000 17,190.00 0.000
- - DAK 18/Jan.22 89.000 0.00 0.000
- - DAK 19/Mart.23 121.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Nov.20 9,644.000 0.00 0.000
- - DAK 18/Jan.21 10,696.000 0.00 0.000
10 82 DAK 19/Jan.22 10,696.000 877,072.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Juli 21 770.000 0.00 0.000
- - - 0.000 0.00 0.000
- 100 DAK 18/Mar.21 1,755.000 175,500.00 0.000
616 2,927 DAK 19/Mei 21 187.000 547,349.00 0.000
- - DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 0.00 0.000
- - 63.000 0.00 0.000
266 1,217 Jan
DAK2319/Mei 24 94.600 115,128.20 0.000
- - DAK 20 L 99.000 0.00 0.000
- - DAK 19/Mei23 5,610.000 0.00 0.000
3 26 DAK 20/ Juni 23 2,518.000 65,468.00 0.000
- 360 DAK 19/Juli21 396.000 142,560.00 0.000
- - DAK 19/Jun 21 288.000 0.00 0.000
- - DAK 20/Jan 22 288.000 0.00 0.000
- - DAK 19/Des.20 1,089.000 0.00 0.000
- - DAK 17/SEPT-- 0.000 0.00 0.000
15 151 1,810.000 273,310.00 0.000
- - 20 - 0.000 0.00 0.000
- - DAK 17/FEB-20 10,500.000 0.00 0.000
- - DAK 18L/Mei.20 17,968.500 0.00 0.000
- - DAK 19/Mart21 35,200.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 22.000 0.00 0.000
172 5,181 DAK 19/Mar.22 77.000 398,937.00 0.000
- - DAK 20/Feb 22 23.000 0.00 0.000
- - DAK 17/MEI 20 2,750.000 0.00 0.000
- - DAK 18L/Mei.23 495.000 0.00 0.000
180 1,378 DAK 19/Juni 23 440.000 606,320.00 0.000
- - DAU PR BG 20/ 319.000 0.00 0.000
- - DAK 19/JUN 20 2,052.000 0.00 0.000
5 135 DAK 20/ Mei 22 2,190.000 295,650.00 0.000
- - DAK 17/JUNI 21 13,970.000 0.00 0.000
1 13 DAK 19/Apr.21 22,550.000
PRSpesifik 293,150.00 0.000
- - 23,100.000 0.00 0.000
- - Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.00 0.000
4 - DAK 19/Mei 21 6,600.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/JUN 21 1,937.000 0.00 0.000
41 37 DAK20/
DAK 19/Mei
Feb 21 2,178.000 80,586.00 0.000
- - 1,222.000 0.00 0.000
18 134 21;Mei22
DAK 19/Juni 21 99.000 13,266.00 0.000
- - DAK 20 L 330.000 0.00 0.000
- 132 DAK 19/Nov.21 123.000 16,236.00 0.000
- - DAK 20/Okt 23 131.000 0.00 0.000
- 360 DAK 18L/Sept.20 4,680.500 1,684,980.00 0.000
- 180 DAK 19/Jan 22 4,730.000 851,400.00 0.000
- - DAK 19/ 550.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18L/Apr.20 4,950.000 0.00 0.000
- - DAK 19/Apr 21 5,500.000 0.00 0.000
164 336 PRSpesifik L 20/ 3,707.000 1,245,552.00 500 1,853,500.000
111 - DAK 19/Des.20
DAK20/28 Feb22 96.000 0.00 0.000
155 1,845 102.000 188,190.00 0.000
20 163 ;DAK 19/Agst. 21 143.000 23,309.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR 22 87.000 0.00 0.000
- - DAK 18/Nov.20 80.000 0.00 0.000
- - DAK 20 / Juni 22 121.000 0.00 0.000
- - DAK19/JULI23 192.500 0.00 0.000
86 214 DAK 20 L 275.000 58,850.00 300 82,500.000
- - DAK 19/Nov 20 8,110.000 0.00 0.000
- - DAK 20/ 8,110.000 0.00 0.000
- - DAK 18L/Okt.20 14,318.700 0.00 0.000
- - DAK 19/Feb 21 5,500.000 0.00 0.000
30 360 DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 752,400.00 0.000
- - 5,000.000 0.00 0.000
- - 19
DAK 19/FEB 21 4,400.000 0.00 0.000
PRSpesifik
- - 1,265.000 0.00 0.000
- - Dokter Muter 20
DAK 17/APR 20 990.000 0.00 0.000
 4 - DAK 19/Apr.21 13,200.000
PRSpesifik 0.00 0.000
- - 13,167.000 0.00 0.000
- - Dokter Muter 20 2,332.000
DAK 18L/Des.19 0.00 0.000
- - DAK 18L/Okt.21 528.000 0.00 0.000
- - PRSpesifik L 20/ 594.000 0.00 0.000
540 3,158 DAK 17/FEB 21 835.000 2,636,930.00 0.000
- - DAK 19/OKT20 115.000 0.00 0.000
163 107 DAK 19/Des 20 123.000 13,161.00 0.000
- - DAK20/ 123.000 0.00 0.000
- - DAK 17/JUN 21 6,410.000 0.00 0.000
58 45 DAK 18/Feb.22 6,410.000 288,450.00 0.000
- - PRSpesifik 20
DAK19/Jan 22 132.000 0.00 0.000
- - Non Covid-19/ 3,948.000 0.00 0.000
- - DAK2118L/Des.20 23,141.800
Okt 0.00 0.000
11 - DAK 19/Juli 21 19,800.000 0.00 0.000
- 20 DAK 18/Agst.20 560.000 11,200.00 0.000
- - DAK 19/Juli 23 560.000 0.00 0.000
- - DAK20/Sep 23 598.000 0.00 0.000
- - DAK 19/Apr 21 12,100.000 0.00 0.000
- - DAK 19/Mart.21 24,860.000 0.00 0.000
- - DAK 19/ Agst. 21 9,955.000
PRSpesifik 0.00 0.000
- - DAK 16/AGSTS 25,597.000 0.00
- - Dokter Muter 20 160.000 0.00 0.000
54 282 20
DAK 19/Juli 21 1,070.000 301,740.00 0.000
- - DAK 20 1,124.000 0.00 0.000
- - DAK 19/Mei 22 715.000 0.00 0.000
- - DAK 18L/Jul.20 432.300 0.00 0.000
- - DAK19/
PRSpesifik 437.800 0.00 0.000
- - 418.000 0.00 0.000
- - Dokter Muter 20 357.500
DAK 19/JUNI22 0.00 0.000
- - PRSpesifik L 20/ 495.000 0.00 0.000
- - DAK 18L/Sept.22 789.800 0.00 0.000
- - DAK 19 1,181.000 0.00 0.000
59 48 DAK 20/ Des 22 1,181.000 56,688.00 0.000
- - DAK
Hibah19/Des
RSUD 20 53.000 0.00 0.000
- - 56.000 0.00 0.000
- - Pasirian
Buffer Prop 20/ 53.000 0.00 0.000
- 32 DAK 17/JUN 20 20,700.000 662,400.00 0.000
7 49 DAK 19/Feb 21 11,825.000 579,425.00 0.000
- - DAK 20/Agust 22 11,825.000 0.00 0.000
12 - DAK19/Apr 21 963.600 0.00 0.000
1,280 5,720 DAK 20 L 115.500 660,660.00 7,000 808,500.000
 - - DAK 19/Juli 21 4,400.000 0.00 0.000
- - DAK 20 L 132.000 0.00 0.000
387 1,746 DAK 19/Sept.21 123.000 214,758.00 0.000
- - PRSpesifik
DAK 17/AGSTSL 20/ 6,600.000 0.00 0.000
- - Buffer Prop 41,500.000 0.00 0.000
- - 20 68.000 0.00 0.000
287 494 19/Agus.20
DAK 19/Jan.21 73.000 36,062.00 0.000
APBD II-16/JUL-
- - 73.000 0.00 0.000
- - 20
DAK 17/JUL 19 1,000.000 0.00 0.000
87 432 DAK 19/Nov 20 1,155.000 498,960.00 0.000
- - PR BG 20/ 1,188.000 0.00 0.000
346 245 DAK 19/ 220.000 53,900.00 0.000
- - - 0.000 0.00 0.000
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RETUR
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21
DAU PR BG
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DAK 20 TB 259,175.000
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COVID KE 2
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- - - 0.000 0.00 0.000
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- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
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- 5 DAU 20 20
PRSpesifik
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PRSpesifik
Covid-19 203,500.000 814,000.00 0.000
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PRSpesifik
Covid-19 275,000.000 0.00 0.000
- - PRSpesifik
Covid-19
DAU 20 20 132,000.000 0.00 0.000
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PRSpesifik
 DAU 20
- - PRSpesifik
DAU 5,500.000 0.00 0.000
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- 2,000 PRSpesifik
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BUFFER
PROPINSI
DAU 20 20
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- 1 PROPINSI
DAU 20 20
PRSpesifik 560,000.000 560,000.00 0.000
- 1 DAU 20
PRSpesifik
Covid-19 20 1,252,000.000 1,252,000.00 0.000
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PRSpesifik
Covid-19 20 575,000.000 0.00 0.000
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PRSpesifik
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DAU
19 20/ID COVID- 6,269.000
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DAU
19 20/ID COVID-
Mar 21
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DAU
19 20/ID COVID- 220,000.000
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DAU
19 20/ID COVID-
Mar 21
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DAU
19 20/ID COVID- 200,000.000
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DAU
19 20/ID COVID- 80,000.000
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DAU
13,600,000.00 30 6,000,000.000
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BTT
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DAU PRSpesifik
19
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20
0.00 0.000
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19/20
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19/20
0.00 0.000
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19
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19
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19
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COVID-20
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- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
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10 238 - 1,106.000 263,228.00 0.000
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- - - 1,098,900.000 0.00 0.000
- 1 - 712,800.000 712,800.00 0.000
- - - 56.000 0.00 0.000
- - - 1,640.000 0.00 0.000
- - - 42,800.000 0.00 0.000
- 126 - 2,750.000 346,500.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
 - 0.000 0.00 0.000
0 0 0.00 0.000
- - 167,996,680.33 69,433,288.000

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Generik Paten

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
Ket

93 FALSE
TRUE
0

FALSE
500

0 TRUE
22 FALSE
FALSE
936

0 TRUE
0 FALSE
1189 FALSE
0 FALSE
70 FALSE
0 TRUE
984 FALSE
0 TRUE
31 FALSE
0 TRUE
0 FALSE
0 TRUE
2036 FALSE
0 TRUE
 2174 FALSE
0 FALSE
sudah 2156 FALSE
11765 FALSE
6000 0 TRUE
0 TRUE
0 TRUE
sudah 49 FALSE
0 FALSE
0 TRUE
0 TRUE
50 FALSE
1989 FALSE
0 TRUE
0 FALSE
4 FALSE
71 FALSE
40 FALSE
0 TRUE
5000 FALSE
2865 FALSE
0 TRUE
28 FALSE
69 FALSE
6 FALSE
52 FALSE
0 TRUE
192 FALSE
0 TRUE
84 FALSE
0 TRUE
0 TRUE
556 FALSE
7646 FALSE
200 FALSE
0 FALSE
0 TRUE
0 FALSE
4180 FALSE
0 TRUE
0 TRUE
10 FALSE
 0 TRUE
728 FALSE
200 FALSE
0 TRUE
84 FALSE
0 FALSE
0 TRUE
0 TRUE
395 FALSE
0 TRUE
400 FALSE
0 TRUE
5 FALSE
100 FALSE
470 FALSE
300 FALSE
187 FALSE
500 FALSE
5 FALSE
50 FALSE
50 FALSE
0 FALSE
12 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
767 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
2221 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
 0 TRUE
474 FALSE
0 TRUE
0 TRUE
0 FALSE
377 FALSE
0 TRUE
0 FALSE
0 TRUE
2000 FALSE
0 TRUE
0 TRUE
46 FALSE
0 TRUE
0 FALSE
4 FALSE
15 FALSE
0 TRUE
0 TRUE
0 TRUE
90 FALSE
0 TRUE
0 FALSE
576 FALSE
0 TRUE
0 FALSE
756 FALSE
0 TRUE
0 TRUE
766 FALSE
0 FALSE
44 FALSE
0 TRUE
1313 FALSE
0 TRUE
0 TRUE
9 FALSE
32 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
 0 FALSE
82 FALSE
0 TRUE
0 FALSE
799 FALSE
1000 FALSE
0 TRUE
0 TRUE
6 FALSE
0 TRUE
0 TRUE
804 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
154 FALSE
0 TRUE
2 FALSE
134 FALSE
0 TRUE
10 FALSE
80 FALSE
416 FALSE
2000 FALSE
3000 FALSE
0 FALSE
205 FALSE
sudah 4930 FALSE
0 TRUE
76 FALSE
0 FALSE
12 FALSE
0 TRUE
0 TRUE
138 FALSE
500 FALSE
149 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
 0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
64 FALSE
100 FALSE
0 TRUE
sudah 5000 FALSE
500 FALSE
0 TRUE
0 FALSE
225 FALSE
0 FALSE
300 FALSE
0 FALSE
0 TRUE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
428 FALSE
0 FALSE
0 TRUE
sudah 1590 FALSE
4000 FALSE
2000 0 TRUE
245 FALSE
0 FALSE
89 FALSE
128 FALSE
0 TRUE
36 FALSE
0 FALSE
0 TRUE
0 TRUE
210 FALSE
0 TRUE
 4 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
85 FALSE
0 TRUE
0 FALSE
49 FALSE
0 TRUE
47 FALSE
0 TRUE
3828 FALSE
6000 FALSE
0 TRUE
0 FALSE
0 TRUE
138 FALSE
1254 FALSE
500 FALSE
0 TRUE
103 FALSE
24 FALSE
0 FALSE
0 TRUE
13 FALSE
0 TRUE
0 TRUE
0 TRUE
51 FALSE
0 TRUE
14 FALSE
285 FALSE
0 FALSE
19 FALSE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
408 FALSE
0 TRUE
0 FALSE
 0 TRUE
0 TRUE
0 FALSE
107 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
1835 FALSE
0 FALSE
0 TRUE BUFFER P 257
3 FALSE
712 FALSE
0 TRUE
72 FALSE
0 TRUE
0 TRUE
74 FALSE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
sudah 0 TRUE
700 FALSE
500 0 TRUE
0 TRUE
0 TRUE
14 FALSE
0 TRUE
26 FALSE
0 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE BUFFER P 2728
0 TRUE
0 TRUE
0 FALSE
348 FALSE
0 TRUE
0 TRUE
 0 TRUE
100 FALSE
6384 FALSE
0 TRUE
0 FALSE
0 TRUE
600 FALSE
898 FALSE
0 TRUE
0 TRUE
23 FALSE
0 TRUE
31 FALSE
60 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
717 FALSE
0 TRUE
0 TRUE
359 FALSE
11 FALSE
0 TRUE
0 TRUE
0 TRUE
2 FALSE
96 FALSE
0 TRUE
10 FALSE
0 TRUE
0 TRUE
161 FALSE
0 TRUE
36 FALSE
70 FALSE
0 TRUE
2775 FALSE
50 FALSE
1216 FALSE
0 TRUE
55 FALSE
 0 TRUE
0 TRUE
725 FALSE
0 FALSE
0 TRUE
10650 FALSE
0 TRUE
0 TRUE
3 FALSE
0 TRUE
0 TRUE
228 FALSE
6530 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
17 FALSE
0 TRUE
42 FALSE
0 TRUE
60 FALSE
0 TRUE
0 TRUE
0 TRUE
192 FALSE
0 TRUE
0 TRUE
2710 FALSE
3000 FALSE
0 TRUE
0 TRUE
0 TRUE
1161 FALSE
4432 FALSE
314 FALSE
0 TRUE
926 FALSE
0 TRUE
1755 FALSE
0 TRUE
1100 FALSE
 0 TRUE
220 FALSE
0 FALSE
13 FALSE
299 FALSE
0 TRUE
0 FALSE
499 FALSE
0 FALSE
1624 FALSE
1000 FALSE
12 FALSE
0 TRUE
171 FALSE
0 TRUE
0 TRUE
0 TRUE
4 FALSE
0 TRUE
0 FALSE
0 TRUE
0 FALSE
680 FALSE
0 FALSE
0 TRUE
2535 FALSE
0 TRUE
703 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
279 FALSE
0 TRUE
0 TRUE
42 FALSE
1948 FALSE
0 TRUE
3682 FALSE
0 TRUE
164 FALSE
 0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
548 FALSE
249 FALSE
0 FALSE
0 TRUE
39 FALSE
0 FALSE
0 TRUE
1737 FALSE
3000 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
600 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
912 FALSE
0 TRUE
107 FALSE
0 FALSE
4925 FALSE
5000 FALSE
0 TRUE
0 FALSE
625 FALSE
0 TRUE
641 FALSE
0 TRUE
122 FALSE
0 TRUE
0 TRUE
14 FALSE
 20 FALSE
0 FALSE
0 TRUE
20 FALSE
0 FALSE
1 FALSE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
60 FALSE
192 FALSE
106 FALSE
96 FALSE
0 TRUE
0 TRUE
50 FALSE
0 TRUE
5 FALSE
142 FALSE
0 TRUE
0 TRUE
20 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
8 FALSE
420 FALSE
0 TRUE
0 TRUE
686 FALSE
100 FALSE
0 TRUE
156 FALSE
0 TRUE
0 TRUE
 0 TRUE
6 FALSE
209 FALSE
0 TRUE
100 FALSE
0 TRUE
315 FALSE
0 TRUE
5 FALSE
150 FALSE
0 TRUE
1 FALSE
0 TRUE
40 FALSE
15 FALSE
100 FALSE
0 TRUE
11 FALSE
10 FALSE
131 FALSE
100 FALSE
0 TRUE
0 FALSE
461 FALSE
500 FALSE
1446 FALSE
1000 FALSE
0 TRUE
TRUE
20 FALSE
0 TRUE
0 TRUE
0 FALSE
10 FALSE
10 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
 0 TRUE
0 TRUE
52 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
800 FALSE
0 TRUE
7 FALSE
0 TRUE
50 FALSE
59 FALSE
0 TRUE
0 FALSE
0 FALSE
3 FALSE
0 TRUE
0 FALSE
200 FALSE
8641 FALSE
0 TRUE
0 TRUE
400 FALSE
35 FALSE
124 FALSE
0 TRUE
260 FALSE
0 TRUE
0 FALSE
sudah 120 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
2 FALSE
0 TRUE
1 FALSE
0 TRUE
20 FALSE
0 TRUE
0 TRUE
 1 FALSE
98 FALSE
0 TRUE
0 TRUE
20 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
10 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
348 FALSE
1518 FALSE
0 TRUE
7 FALSE
20 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
 0 TRUE
0 TRUE
0 TRUE
170 FALSE
0 TRUE
0 TRUE
5 FALSE
126 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
555 FALSE
0 TRUE
0 TRUE
0 TRUE
968 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
2909 FALSE
0 TRUE
0 TRUE
0 TRUE
2063 FALSE
0 TRUE
6000 FALSE
0 TRUE
0 TRUE
 0 TRUE
0 TRUE
500 FALSE
0 TRUE
3138 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
14 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
 0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
12 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
9 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
6200 FALSE
sudah 5000 FALSE
0 TRUE
0 TRUE
1594 FALSE
sudah 1500 FALSE
97 FALSE
sudah 450 FALSE
0 TRUE
 0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
4 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
34559 FALSE
0 FALSE
0 TRUE
TRUE
290 FALSE
 0 TRUE
290 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
15 FALSE
0 TRUE
20 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
25 FALSE
0 TRUE
0 TRUE
6 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
5 FALSE
14 FALSE
0 FALSE
0 FALSE
121 FALSE
0 TRUE
540 FALSE
0 TRUE
0 TRUE
FALSE
0 TRUE
22 FALSE
55 FALSE
0 FALSE
0 FALSE
0 TRUE
0 FALSE
3 FALSE
0 TRUE
6 FALSE
0 TRUE
92 FALSE
TRUE
TRUE
TRUE
FALSE
TRUE
FALSE
TRUE
TRUE
FALSE
TRUE
TRUE
TRUE
FALSE
TRUE
TRUE
FALSE
TRUE
TRUE
TRUE
FALSE
TRUE
TRUE
FALSE
TRUE
TRUE
TRUE
TRUE
 TRUE
FALSE
FALSE
TRUE
TRUE
FALSE
0 TRUE
0 TRUE
3 FALSE
2 FALSE
0 TRUE
sudah 200 0 TRUE
211 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
4 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
sudah 120 284 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
TRUE
TRUE
FALSE
TRUE
TRUE
TRUE
TRUE
TRUE
FALSE
TRUE
TRUE
sudah TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
TRUE
Pelaporan : Persentase Puskesmas denga
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Albendazol /Pira Tablet 262 1
2 Alopurinol Tablet 26,520 1
3 Amlodipin/Kapto Tablet 24,487 1
4 Amoksisilin 500 Tablet 24,487 1
5 Amoksisilin sirup Botol 186 1
6 Antasida tablet k Tablet/Botol 327 1
7 Asam Askorbat (V Tablet 327 1
8 Asiklovir Tablet 327 1
9 Betametason sal Tube - 0
10 Deksametason tabTablet/Vial/Ampul - 0
11 Diazepam injeksi Ampul 24 1
12 Diazepam Tablet 24 1
13 Dihidroartemsin Tablet 24 1
14 Difenhidramin In Ampul - 0
15 Epinefrin (Adrena Ampul - 0
16 Fitomenadion (Vi Ampul - 0
17 Furosemid 40 mg/ Tablet 1,753 1
18 Garam Oralit ser Kantong 1,753 1
19 Glibenklamid/Me Tablet 1,753 1
20 Hidrokortison kr Tube - 0
21 Kotrimoksazol (d Tablet/Botol - 0
22 Lidokain inj Vial - 0
23 Magnesium Sulfat Vial - 0
24 Metilergometrin Ampul - 0
25 Natrium Diklofen Tablet 3 1
26 OAT FDC Kat 1 Paket 3 1
27 Oksitosin injeksi Ampul 192 1
28 Parasetamol siru Botol 189 1
29 Parasetamol 500 Tablet 305 1
30 Prednison 5 mg Tablet 116 1
31 Ranitidin 150 mg Tablet 116 1
32 Retinol 100.000/ Kapsul - 0
33 Salbutamol Tablet 1,824 1
34 Salep Mata/Tetes Tube 166 1
35 Simvastatin Tablet 834 1
36 Siprofloksasin Tablet - 0
37 Tablet Tambah D Tablet - 0
38 Triheksifenidil Tablet 1,824 1
39 Vitamin B6 (Pirid Tablet 2,133 1
40 Zinc 20 mg Tablet 2,630 1
JUMLAH ITEM OBAT INDIKATOR 27
Pelaporan : Persentase Puskesmas deng
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Vaksin Hepatitis Vial 20 1
2 Vaksin BCG Ampul 41 1
3 Vaksin DPT-HB-H Vial - 0
4 Vaksin Polio Vial 18 1
5 Vaksin Campak/V Vial/Ampul - 0
JUMLAH ITEM OBAT INDIKATOR 3
 ( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN

UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - 300 300

4 A004 0 0 - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial - - -
6 A006 Air Untuk Injeksi Vial @25 ml Vial 131 - 131
7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - -
8 A008 Alopurinol Tablet 100 mg Tablet 838 - 838
9 A009 Alopurinol Tablet 100 mg 0 - - -
10 A010 Ambroxol Tablet 30 mg Tablet 1,969 - 1,969
11 A011 0 0 - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - -
13 A013 0 0 - - -
14 A014 Amlodipin Tablet 10 Mg Tablet - - -
15 A015 Amlodipin Tablet 10 Mg Tablet 1,770 1,200 2,970
16 A016 0 0 - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet 21,659 - 21,659
18 A018 Amoksisilin Kaplet 500 mg Tablet - - -
19 A019 Amoksisilin Kaplet 500 mg Tablet - - -
20 A020 Amoksisilin Kaplet 500 mg Tablet - - -
21 A021 0 0 - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 150 - 150
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - -
25 A025 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - -
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - -
27 A027 CLABAT,CAPSINAT Tablet - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - -
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 203 - 203
30 A030 0 0 - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol - - -
32 A032 0 0 - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
35 A035 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet 50 - 50
36 A036 Tablet - 10,000 10,000
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - -
40 A040 Pot 24 - 24
41 A041 Salisilat 3% (Marin )
0Antihemoroid 0 - - -
Kombinasi : Bismut Suppgalat 150 mg
42 A042 Supp - 30 30
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - -
45 A045 20% ) HEMOROGARD Tablet - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet 1,517 - 1,517
47 A047 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet - 4,000 4,000
48 A048 Tablet - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - -
50 A050 Asam Folat Tablet 1 mg Tablet - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - -
52 A052 Asam Mefenamat 500 mg 0 - - -
53 A053 0 0 - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - 3
55 A055 0 0 - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 164 - 164
57 A057 0 0 - - -
58 A058 Asiklovir 5% 5gr Cream Tube 112 - 112
59 A059 Asiklovir 5% 5gr Cream Tube - - -
60 A060 0 0 - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 146 - 146
 63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - -
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet - - -
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet - - -
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet 1,675 - 1,675
69 A069 Betahistin Mesylat 6 mg Tablet - - -
70 A070 Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - -
71 A071 Betametason Dipropionat Krim 0,1% Tube - - -
72 A072 Betametason Dipropionat Krim 0,1% gram @ 10 - - -
Tube
gram @ 10
73 A073 Betametason Dipropionat Krim 0,1% 100 150 250
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - -
77 A077 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - -
78 A078 Bricasma Biji - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - -
80 A080 Zeneca
0Budesonid )I 0 - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 A081 pcs - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - -
84 A084 Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet 185 - 185
85 A085 Cefadroksil Kapsul 500 mg Tablet - 1,500 1,500
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 54 - 54
88 A088 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - - -
89 A089 Tablet - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 162 - 162
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet 102 - 102
93 A093 Deksamethason Tab 0,5 mg 0 - 2,000 2,000
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - -
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 156 180 336
97 A097 0 0 - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - -
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - 200 200
100 A100 Digoksin Tab 0,25 mg Tablet - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 513 1,000 1,513
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - -
103 A103 0 0 - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet - 500 500
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 6 - 6
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - 100 100
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet 160 100 260
113 A113 Ethambutol 250 mg Tablet - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 53 150 203
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 63 - 63
120 A120 0 0 - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 112 - 112
128 A128 Gentamycin Krim 1 % mg/ ml Tube - - -
129 A129 Gentian Violet 1% 10 ml Botol - 24 24
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 21 - 21
131 A131 Glibenklamid Tablet 5 mg Tablet 4,136 - 4,136
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - - -
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet 3,610 - 3,610
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 108 - 108
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 14 - 14
137 A137 Glukosa Larutan 40% Steril botol - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - -
139 A139 Glukosa Larutan Infus 5% @500ml Botol - - -
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - -
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,036 - 1,036
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 40 120 160
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10
148 A148 0 0 - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 165 216 381
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 61 12,000 12,061
152 A152 Ibuprofen Tablet 400 mg Tablet - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - -
154 A154 Isoniazid Tablet 100 mg tablet - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 191 - 191
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
158 A158 0 0 - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 82 100 182
162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - -
163 A163 Tablet - - -
164 A164 Pharmatama)
0 0 - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 2,927 - 2,927
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - 5,000 5,000
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet 1,217 - 1,217
170 A170 Kaptopril Tab 25 mg TAblet - 3,000 3,000
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube - - -
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube 26 - 26
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 360 - 360
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - -
176 A176 Ketorolak Inj 30 mg/ml Ampule - - -
177 A177 0 0 - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 151 - 151
179 A179 0 0 - - -
180 A180 Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol Vial - - -
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - -
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - -
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 5,181 - 5,181
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,378 - 1,378
190 A190 Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg - 3,000 3,000
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol 135 - 135
193 A193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma )
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract - 24 24
194 A194 MOLAKRIM
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 13 - 13
195 A195 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- - -
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - -
197 A197 Probiotik (Dexa Medica, Sanbe) Tablet - - -
198 A198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 37 510 547
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 134 - 134
203 A203 Loperamid Tablet 2 mg Tablet - - -
204 A204 Loratadin Tablet 10 mg Tablet 132 - 132
205 A205 Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - -
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet 360 - 360
207 A207 Mata/ OCUGARD (Phapros) Tablet 180 - 180
208 A208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - -
209 A209 0 0 - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet - - -
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 336 1,000 1,336
213 A213 Metformin HCl Tablet 500 mg Tablet - - -
214 A214 Metformin HCl Tablet 500 mg Tablet 1,845 - 1,845
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 163 - 163
216 A216 0 0 - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet - - -
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet 214 2,000 2,214
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - -
223 A223 Metronidasol Infus 500mg/100ml Botol - - -
224 A224 Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - -
225 A225 Kapsul - - -
226 A226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 360 - 360
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 A227 Ampule - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - -
229 A229 Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - -
230 A230 Tablet - - -
Ayus )
 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU
231 A231 Multivitamin Curcuma Syr:L-Lysyin 1000 IU Botol - - -
232 A232 vit B1 3 mg, B12 Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) Botol - 192 192
Multivitamin Neurotopic
vit B1 3 mg, B12 Plus ATP
Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet
233 A233 Multivitamin - - -
234 A234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) Tablet - - -
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 A235 Femofomarrat 300mg tablet - - -
236 A236 MOLANEURON (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C Tablet 3,158 - 3,158
237 A237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 107 - 107
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - 1,000 1,000
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - -
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 45 - 45
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet - - -
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - -
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol - - -
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 20 - 20
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - -
248 A248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet - 100 100
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - -
252 A252 Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - -
253 A253 Omeprazole Kapsul 20 mg Tablet - - -
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 282 200 482
255 A255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - -
256 A256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet - - -
257 A257 Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - -
258 A258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - -
259 A259 400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol
Parasetamol HCl 25Mg/ HUSTAB Tablet - - -
260 A260 (Phapros) Tablet - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 30Mg,
100 mg / COLPICA (Tropika Mas) 0 - - -
Parasetamol Komb Tablet Flu: Parasetamol
262 A262 Tablet - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - -
264 A264 Parasetamol Syrup 120 mg/5ml Botol 48 300 348
265 A265 Parasetamol tablet 500 mg Tablet - - -
266 A266 Parasetamol tablet 500 mg Tablet - - -
267 A267 Parasetamol tablet 500 mg Tablet - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 32 - 32
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 49 - 49
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - -
271 A271 Piracetam 800 mg Tablet Tablet - - -
272 A272 Parasetamol tablet 500 mg Tablet 5,720 15,000 20,720
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule - - -
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - 2,000 2,000
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 1,746 - 1,746
276 A276 Probiotik Sachet (Probiokid) 0 - - -
277 A277 Polikresulen (Albotyl,Apetil) Botol - - -
278 A278 Prednison Tab 5 mg Tablet - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 494 4,000 4,494
280 A280 Prednison Tab 5 mg Tablet - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 432 - 432
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - -
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 245 2,000 2,245
285 A285 0 0 - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - 300 300
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - -
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
290 A290 Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - -
291 A291 Nebule 224 - 224
292 A292 (COMBIVENT)
0 I dan II 0 - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - -
294 A294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet 406 1,000 1,406
295 A295 Salep Pot 10 120 130
296 A296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - -
298 A298 Salisil Bedak Serbuk 2% Pcs - - -
299 A299 Salisil Bedak Serbuk 2% Pcs - 60 60
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 1 2
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 11 60 71
304 A304 Setirizin Tab 10 mg (Futamed) Tablet 12 - 12
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 700 - 700
307 A307 Simvastatin Tablet 10 mg Tablet - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
309 A309 0 0 - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - -
311 A311 Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% Botol 23 - 23
312 A312 Botol - - -
313 A313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - -
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - -
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 18 2,500 2,518
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - -
318 A318 Thiamphenicol Kapsul 500 mg Tablet - 1,000 1,000
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 12 - 12
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - -
321 A321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek 2,261 3,000 5,261
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - -
323 A323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
327 A327 0 0 - - -
328 A328 0 0 - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 3 - 3
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - 3 3
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet - 300 300
336 A336 Diazepam Tablet 5 mg Tablet - - -
337 A337 Fenobarbital Tablet 30 mg Tablet - - -
338 A338 Fenobarbital Tablet 30 mg Tablet - - -
339 A339 Fenobarbital Tablet 30 mg tablet - - -
340 A340 Kodein Tablet 10 mg Tablet - - -
341 A341 0 0 - - -
342 A342 Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON Tablet - - -
343 A343 Tablet - - -
344 A344 (Meprofarm)
0 0 - - -
345 A345 0 0 - - -
346 A346 0 0 - - -
347 A347 Primaquin 15 mg tablet tablet - - -
348 A348 0 0 - - -
OBAT - OBAT PROGRAM 0 - - -
OBAT PROGRAM KECACINGAN 0 - - -
349 A349 Albendazol Tablet 400 mg Tablet - - -
350 A350 Albendazol Tablet 400 mg Tablet 192 - 192
OBAT PROGRAM DIARE 0 - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - -
352 A352 Garam Oralit (Kimia Farma) Tablet 847 700 1,547
353 A353 Garam Oralit (Kimia Farma) sachet - - -
354 A354 Garam Oralit (Kimia Farma) sachet - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - -
356 A356 Botol 43 - 43
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - -
359 A359 Zinc Dispersible 20 mg tablet tablet - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 2,630 - 2,630
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
363 A363 0 0 - - -
OBAT PROGRAM HEPATITIS 0 - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
OBAT PROGRAM TB PARU 0 - - -
369 A369 OAT FDC Kategori Anak Kit - - -
370 A370 OAT FDC Kategori Anak Kit - - -
371 A371 OAT FDC Kategori Anak Kit - - -
372 A372 OAT FDC Kategori I - IIII Kit - - -
373 A373 OAT FDC Kategori I - IIII Kit - 11 11
374 A374 OAT FDC Kategori II Kit - - -
375 A375 OAT FDC Kategori II Kit - - -
376 A376 OAT FDC Kategori II Kit - 1 1
377 A377 OAT FDC Kombipak Kategori I Kit - - -
378 A378 0 0 - - -
379 A379 Isoniazid 100 mg tablet tablet - - -
OBAT POGRAM KUSTA 0 - - -
380 A380 MDT MB Anak Blister - - -
381 A381 MDT MB Anak Blister - - -
382 A382 MDT MB Dewasa Blister - - -
383 A383 MDT MB Dewasa Blister - - -
384 A384 MDT MB Dewasa Blister - - -
385 A385 MDT PB Anak Blister - - -
386 A386 MDT PB Anak Blister - - -
387 A387 MDT PB Anak Blister - - -
388 A388 MDT MB Dewasa Blister - 24 24
389 A389 MDT PB Dewasa Blister - - -
OBAT PROGRAM GIZI 0 - - -
390 A390 Mineral Mix Kombinasi sachet - - -
391 A391 Mineral Mix Kombinasi sachet - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 300 - 300
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - -
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
397 A397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul 6 - 6
398 A398 Tablet Tablet - - -
399 A399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Tablet 44,200 - 44,200
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros)
400 A400 tablet - - -
401 A401 0,4
0 Mg Tab (Phapros) 0 - - -
402 A402 0 0 - - -
OBAT PROGRAM KESGA 0 - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule - - -
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial - - -
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - 18 18
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - 100 100
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 12 - 12
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 610 - 610
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 40 200 240
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
OBAT PROGRAM JIWA 0 - - -
416 A416 Amitriptilin 25 mg Tablet - - -
417 A417 Amitriptilin 25 mg Tablet - - -
418 A418 Amitriptilin 25 mg Tablet - - -
419 A419 Amitriptilin 25 mg Tablet 160 - 160
420 A420 Amitriptilin 25 mg Tablet - - -
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - -
422 A422 Clozapine 100 mg Tablet - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - 300 300
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - -
428 A428 Flufenazin sikzonoate inj 5 ml vial 9 - 9
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - -
430 A430 Haloperidol 5 mg tablet Tablet - - -
431 A431 Haloperidol 5 mg tablet Tablet 2,287 - 2,287
432 A432 Haloperidol 5 mg tablet Tablet - - -
433 A433 0 0 - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - -
436 A436 Haloperidol/ Lodomer drops 2 mg Botol - 10 10
437 A437 Karbamazepin Tablet 200 mg Tablet - - -
438 A438 Karbamazepin Tablet 200 mg Tablet - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - 3
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - -
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 1,889 - 1,889
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - -
444 A444 0 0 - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - -
447 A447 Risperidon Tab 2 mg Tablet 497 - 497
448 A448 Risperidon Tab 2 mg Tablet - 1,000 1,000
449 A449 0 0 - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - -
451 A451 0 0 - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - -
453 A453 Triheksifenidil Tablet 2 mg Tablet 1,412 - 1,412
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - -
455 A455 0 0 - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - -
457 A457 0 0 - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - -
458 A458 BCG vial 36 - 36
459 A459 PELARUT BCG ampul 36 - 36
460 A460 BCG vial - - -
461 A461 BCG vial - - -
462 A462 CAMPAK 10ds (MR) vial - - -
463 A463 PELARUT CAMPAK ampul 139 10 149
464 A464 CAMPAK 10ds (MR) vial 21 10 31
465 A465 CAMPAK 10ds (MR) vial - - -
466 A466 DPT HB - Hib/ PENTABIO vial - - -
467 A467 DPT HB - Hib/ PENTABIO vial - 70 70
468 A468 DT vial - - -
469 A469 0 0 - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - -
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - -
472 A472 POLIO bOPV 10 ds vial - - -
473 A473 DROPPER POLIO dropper 193 10 203
474 A474 POLIO bOPV 10 ds vial - - -
475 A475 POLIO bOPV 10 ds vial - - -
476 A476 Td vial 15 - 15
477 A477 0 0 - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial 67 - 67
479 A479 POLIO bOPV 10 ds vial 45 10 55
480 A480 Vaksin Meningtis vial - - -
481 A481 CAMPAK 10ds (MR) BIAS vial - - -
482 A482 PELARUT CAMPAK BIAS ampul - - -
483 A483 POLIO bOPV 10 ds vial - - -
484 A484 IPV vial - - -
485 A485 VTM Include Dacron (Biofarma) pcs - - -
486 A486 Vaksin Rabies (Verorab) vial - - -
487 A487 0 0 - - -
488 A488 0 0 - - -
489 A489 0 0 - - -
OBAT PROGRAM HIV/ AIDS 0 - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - -
491 A491 0 0 - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 191 - 191
493 A493 0 0 - - -
494 A494 Lamivudine 150 mg Tablet - - -
495 A495 Lamivudine 150 mg Tablet - - -
496 A496 Nevirapine 200 mg Tablet - - -
497 A497 Nevirapine 200 mg Tablet - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - -
500 A500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - -
501 A501 FDC Dewasa Tablet - - -
502 A502 FDC Dewasa
Tenofovir 300 mg Tablet - - -
503 A503 Tenofovir 300 mg Tablet - - -
504 A504 Zidofudine 100 mg (ZDV) Tablet - - -
505 A505 Zidofudine 100 mg (ZDV) Tablet - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
508 A508 Efavirenz 600 mg tablet tablet - - -
509 A509 Efavirenz 600 mg tablet tablet - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
511 A511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - -
512 A512 Tablet - - -
FDC Dewasa
513 A513 0 0 - - -
514 A514 MB Anak blister - - -
515 A515 0 0 - - -
516 A516 0 0 - - -
517 A517 0 0 - - -
518 A518 0 0 - - -
519 A519 0 0 - - -
520 A520 0 0 - - -
521 A521 0 0 - - -
522 A522 0 0 - - -
523 A523 0 0 - - -
524 A524 0 0 - - -
525 A525 0 0 - - -
526 A526 0 0 - - -
527 A527 0 0 - - -
528 A528 0 0 - - -
529 A529 0 0 - - -
BMHP 0 - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
532 A532 0 0 - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - -
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs 773 - 773
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - 1,500 1,500
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 1,100 - 1,100
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - -
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs - 50 50
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - -
542 A542 Alkohol 70% (Medika) Btl 1000 ml - - -
543 A543 Alkohol Swab 2 - ply (one med) 0 - - -
544 A544 Alkohol Swab 2 - ply (one med) Pcs 200 300 500
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol 2 - 2
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs - 60 60
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - -
549 A549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - -
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Pcs - - -
551 A551 Phsda 0 - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - -
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs - - -
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs - 40 40
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - 5
561 A561 Mantel Gown (Bisa Dicuci) biji - - -
562 A562 I.V Catheter No. 18 (JELCO) Pcs - - -
563 A563 I.V Catheter No. 18 (NIPRO) Pcs 9 100 109
564 A564 I.V Catheter No. 20 JELCO Pcs - - -
565 A565 I.V Catheter No. 20 TERUMO Pcs - - -
566 A566 I.V Catheter No. 20 JELCO Pcs - 200 200
567 A567 I.V Catheter No. 22 NIPRO Pcs - - -
568 A568 I.V Catheter No. 22 NIPRO Pcs 1 200 201
569 A569 I.V Catheter No. 24 TERUMO Pcs 77 - 77
570 A570 I.V Catheter No. 24 TERUMO 0 - 100 100
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - -
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 59 - 59
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
574 A574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 159 300 459
575 A575 Pcs - - -
576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 12 15 27
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - -
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - -
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs - 10 10
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - -
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 48 - 48
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - -
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs - 100 100
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - -
588 A588 Masker Ear Loop (Masker) Pcs - - -
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - -
590 A590 Masker General Care (MARCOTILA) Pcs - - -
591 A591 0 0 - - -
592 A592 Masker N95 Disposibel Pcs - - -
593 A593 Masker N95 Disposibel (One Med) Pcs - - -
594 A594 Masker Tali Pcs - - -
595 A595 Masker Tali Pcs - - -
596 A596 Masker Elastic Pcs - - -
597 A597 Media Sample Container Pcs 335 - 335
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs 12 - 12
601 A601 Nurse Cup (Tutup Kepala) Pcs - - -
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - -
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - -
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 58 54 112
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 4 5 9
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - 50 50
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - -
610 A610 0 0 - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - -
613 A613 0 0 - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - - -
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - -
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir 300 - 300
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 276 - 276
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs - 60 60
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - -
622 A622 0 0 - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1
625 A625 Underpad 90x 0 cm cosmo I Pcs - 30 30
626 A626 Underpad 90x 0 cm cosmo II Pcs - - -
627 A627 0 0 - - -
628 A628 Urine Bag Sterile Standard Pcs - - -
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs - 60 60
630 A630 0 0 - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs - 200 200
REAGEN 0 - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 400 - 400
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - -
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - -
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - -
639 A639 0 0 - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - -
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - -
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs - 10 10
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - -
649 A649 0 0 - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - -
651 A651 0 0 - - -
652 A652 TPHA (Fokus) Test - - -
653 A653 0 0 - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - -
BMHP (PROGRAM) PROPINSI 0 - - -
PROGRAM MALARIA 0 - - -
656 A656 RDT Malaria Test - - -
PROGRAM SYPHILIS 0 - - -
657 A657 RPR Syphilis Pcs 100 - 100
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline Test
Test 300 - 300
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - -
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - -
662 A662 0 0 - - -
663 A663 Tuberkulin Vial - - -
664 A664 RDT Lepto (Uji Leptospira IgM) test - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - -
666 A666 0 0 - - -
667 A667 0 0 - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - -
668 A668 Test - - -
669 A669 Reagen HBsAg Strip SD Test - - -
670 A670 Reagen HBsAg Strip SD Test 350 - 350
671 A671 Reagen HBsAg Strip SD Test - - -
672 A672 0 0 - - -
673 A673 0 0 - - -
674 A674 0 0 - - -
675 A675 0 0 - - -
PROGRAM TB PARU 0 - - -
676 A676 Box Slide Pcs - - -
677 A677 Box Slide Pcs - - -
678 A678 Catridge Genexpart Test - - -
679 A679 Catridge Genexpart Test - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - -
681 A681 Oil Emersi Botol - - -
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - -
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - -
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - -
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - -
686 A686 Reagen Control CD4 0 - - -
687 A687 Reagen Control CD4 0 - - -
688 A688 Reagen Zeil Nelseen Kit - - -
689 A689 Reagen Zeil Nelseen Kit - - -
690 A690 Reagen Zeil Nelseen Kit - - -
691 A691 Reagen Zeil Nelseen Kit - - -
692 A692 Slide Pcs 9 - 9
693 A693 Slide/ Object Glass Pcs - - -
694 A694 Stereofoam pcs - - -
695 A695 Masker N 95 TB pcs 23 - 23
696 A696 Masker Tali Bedah TB pcs - - -
OBAT PROGRAM IMUNISASI 0 - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - 500 500
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs 800 - 800
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
708 A708 0 0 - - -
709 A709 0 0 - - -
710 A710 0 0 - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 145 - 145
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
714 A714 0 0 - - -
715 A715 Safety Box 5 L Pcs 25 - 25
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
717 A717 0 0 - - -
718 A718 0 0 - - -
719 A719 0 0 - - -
720 A720 0 0 - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - -
721 A721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test 50 - 50
722 A722 Tahap I 0 - - -
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold)
723 A723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - -
724 A724 Tahap I 0 - - -
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
725 A725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test 50 - 50
726 A726 Tahap I 0 - - -
727 A727 Tahap
Kondom I Pcs - - -
728 A728 DBS Collection/ Lasec Pcs - - -
729 A729 Lubricant Pcs - - -
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - -
731 A731 Test 819 - 819
732 A732 IRapid HIV 1/2 3.0 SD Bioline test - - -
733 A733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - -
734 A734 Test - - -
735 A735 Tahap
ReagenI HIV (SD) R 1 Test - - -
736 A736 Reagen HIV (SD) R 1 Test - - -
737 A737 0 0 - - -
738 A738 Reagen HIV (VIKIA) R 3 Test - - -
739 A739 0 0 - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - -
741 A741 0 0 - - -
742 A742 Reagen HIV R3 (VIKIA) Test - - -
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - -
744 A744 Sarung Tangan Non Steril Pair - - -
745 A745 0 0 - - -
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - -
747 A747 VTM Include Swab Test - - -
748 A748 Masker Bedah 3 ply Pcs - - -
749 A749 0 0 - - -
750 A750 0 0 - - -
751 A751 0 0 - - -
752 A752 0 0 - - -
753 A753 0 0 - - -
754 A754 0 0 - - -
755 A755 0 0 - - -
756 A756 0 0 - - -
757 A757 0 0 - - -
758 A758 0 0 - - -
759 A759 0 0 - - -
760 A760 0 0 - - -
761 A761 0 0 - - -
762 A762 0 0 - - -
763 A763 0 0 - - -
764 A764 0 0 - - -
OKSIGEN MEDICAL 0 - - -
765 A765 Oksigen 3 m3 Tampon - - -
766 A766 Oksigen 6 m3 Tampon - - -
767 A767 Oksigen 1 m3 Tampon - - -
768 A768 Oksigen 6 m3 Tampon - - -
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - -
770 A770 0 0 - - -
771 A771 0 0 - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - -
TAMBAHAN IFK 0 - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
3 T003 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex Tablet - - -
4 T004 Tablet - - -
5 T005 Thiamphenicol Syr. 0 - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - -
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - -
10 T010 Ketokonazole 200 mg Tablet - - -
11 T011 Kotrimoksazol Forte Tablet - - -
12 T012 Infusion set anak Pcs 50 - 50
13 T013 Alat Suntik 10 cc Pcs - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
15 T015 Omeprazole Kapsul 20 mg Tablet - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol 360 - 360
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
19 T019 Oseltamivir 75 mg Kapsul - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol 1,092 - 1,092
21 T021 Amitriptilin 25 mg Tablet - - -
22 T022 I.V Catheter No. 24 TERUMO pcs - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - -
24 T024 RDT COVID - 19 0 - - -
25 T025 Oseltamivir 75 mg 0 - - -
26 T026 Klorokuin
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - -
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - -
28 T028 Viruses) 0 - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) 0 - - -
30 T030 Hazmat/ APD/ Hazmat PPK 0 30 - 30
31 T031 Medical Sample Container Pcs - - -
32 T032 Cepheid Pcs - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - -
34 T034 Tambah Darah drop (Ferriz Drop) pcs 200 - 200
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs 199 - 199
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
38 T038 Obat Batuk Sirup / INADRYL Botol - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - -
40 T040 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - -
41 T041 dextromethorpan Hbr Tablet - - -
42 T042 Influenza
Masker Bedah /Bima Sakti pCS - - -
43 T043 Masker Bedah /Rania pCS - - -
44 T044 Masker N 95 Bima Sakti PCS - - -
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 - 25 25
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - 6,000 6,000
47 T047 Albendazol Suspensi 200mg/ 5 ml botol 300 - 300
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - -
49 T049 OAT FDC Kategori Anak 0 - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - -
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - -
53 T053 0 0 - - -
54 T054 0 0 - - -
55 T055 0 0 - - -
56 T056 0 0 - - -
57 T057 0 0 - - -
58 T058 0 0 - - -
59 T059 0 0 - - -
60 T060 APD Set (Rannia) 0 8 - 8
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5
62 T062 Cover
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 4 - 4
63 T063 0 - - -
64 T064 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - -
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs 2,000 - 2,000
69 T069 Masker N95 Covid 19 Pcs - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - -
71 T071 Masker Eaerlop Hijab Pcs 1,800 - 1,800
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - 1
73 T073 Hand Sanitzer 1 Botol = 20 Liter 1 - 1
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs 9 - 9
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - 2
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - -
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs - - -
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - -
84 T084 Masker KN95 (Farmahusada) Box @50 pcs 20 - 20
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - -
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test 21 - 21
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - -
89 T089 APRON (Atmosfer) pcs 100 - 100
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - -
91 T091 Hand Sanitzer 2 liter - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 68 - 68
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - -
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - -
96 T096 Face Shield (COBRA) 0 7 - 7
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
98 T098 Kit Steril (Rajawali) 0 - - -
99 T099 Alkohol II @20 Liter 0 - - -
100 T100 Cover All (Rajawali) 0 4 - 4
101 T101 Face Shield (ATMOSFER) 0 - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
103 T103 Masker Earloop (KasaHusada) 0 1,700 3,400 5,100
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - -
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - -
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - -
107 T107 Alkohol Swab (BTT) 0 - - -
108 T108 Antiseptic Gel 500 0 - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 4,140 - 4,140
110 T110 Kaca mata Goggle (HASTEN) 0 5 - 5
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - -
112 T112 Masker Bedah Hijau @50pcs 0 - - -
113 T113 Masker N95 3M 8210 (Hazten) 0 10 - 10
114 T114 Nurse Cap Green om 100bh 0 - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - -
117 T117 Sarung tangan Safeglove Exam M 100bh 0 3,000 - 3,000
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - -
121 T121 Universal Transport Media (UTM) Goongdong 0 - - -
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - -
127 T127 Rapid Test Lecurate (Bima Sakti) 0 - 20 20
128 T128 Rapid Test ZYBIO (Farma Husada) 0 - - -
129 T129 Alkohol 96 % Liter 20 - 20
130 T130 0 0 - - -
0 0 - - -
TAMBAHAN PUSKESMAS 0 - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - -
3 TP003 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube - - -
4 TP004 pcs - - -
5 TP005 Zeneca)
0 0 - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 344 - 344
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - -
9 TP009 0 0 - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - -
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - -
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 238 - 238
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - -
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 - - -
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 - - -
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - -
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - -
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - -
24 TP024 Materniti Napkin Slim L 0 - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - -
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1
29 TP029 Haloperidol 5 mg tablet Tablet - - -
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - -
31 TP031 Fixomull Strech 5 cm X 5 m Pcs - - -
32 TP032 Umbilical crd clamp 0 126 - 126
33 TP033 0 0 - - -
34 TP034 0 0 - - -
35 TP035 0 0 - - -
36 TP036 0 0 - - -
37 TP037 0 0 - - -
38 TP038 0 0 - - -
39 TP039 0 0 - - -
40 TP040 0 0 - - -
41 TP041 0 0 - - -
42 TP042 0 0 - - -
43 TP043 0 0 - - -
44 TP044 0 0 - - -
45 TP045 0 0 - - -
46 TP046 0 0 - - -
47 TP047 0 0 - - -
48 TP048 0 0 - - -
49 TP049 0 0 - - -
50 TP050 0 0 - - -
51 TP051 0 0 - - -
52 TP052 0 0 - - -
53 TP053 0 0 - - -
54 TP054 0 0 - - -
55 TP055 0 0 - - -
56 TP056 0 0 - - -
57 TP057 0 0 - - -
58 TP058 0 0 - - -
59 TP059 0 0 - - -
60 TP060 0 0 - - -
0 0 - - -
TOTAL - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep ) Rawat Jalan Rawat Inap Rawat Jalan

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Mengetahui Yang Menyerahkan,
Plt. KEPALA DINAS KESEHATAN TERTULIS 2 KALI KEPALA INSTALASI FARMASI KABUPATEN
KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN Dra. TRI MUSYAROFAH, Apt

NIP. 19630724 198910 1 002 NIP. 19630411 199203 2 005
PLPO )

: BULAN
: TAHUN

AN SUMBER HARGA STOK NILAI

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN
JUMLAH ANGGARAN SATUAN OPTIMUM PENERIMAAN

UNIT UNIT RP

- - DAK 18/Okt.19 99.000 0.00 - 0.000

- - DAK 19/Sept.21 105.000 0.00 598 3,000 0.000

- 300 DAK 20/ Jan 22 105.000 31,500.00 - 300 31,500.000

- - - 0.000 0.00 - 0.000
- - DAK 19/Feb.22 2,860.000 0.00 - 0.000
DAK 20/ 16 -
- 131 2,860.000 374,660.00 49 0.000
Des 22
- - DAK 18/Apr.20 10,500.000 0.00 - 0.000
- 838 DAK 19/Mei 23 104.000 87,152.00 112 0.000
- - DAK 20 L 220.000 0.00 - 0.000
- 1,969 DAK 19/Juni 21 93.500 184,101.50 31 0.000
- - DAK 17/AGSTS- - 0.000 0.00 - 0.000
- - 2,998.000 0.00 - 0.000
- - 20 - 0.000 0.00 - 0.000
- - Dak 19/Okt. 20 93.000 0.00 - 0.000
- 2,970 Dak 20/Okt 21 99.000 294,030.00 1,306 1,000 1,200 118,800.000
- - - 0.000 0.00 - 0.000
- 21,659 DAK 17/NOV-21 190.000 4,115,210.00 13,522 0.000
- - DAK 18/Okt.20 233.000 0.00 - 0.000
- - DAK 19/Feb 21 233.000 0.00 - 0.000
- - DAK 20/ April 22 249.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- 150 DAK 19/Agst.22 3,025.000 453,750.00 162 0.000
- - DAK 20 L 3,025.000 0.00 - 0.000
- - DAK 19/JULI 21 4,400.000 0.00 - 0.000
- - DAK 20/ Mart 22 3,628.000 0.00 - 0.000
- - DAK 18L/Mar.20 10,246.500 0.00 - 0.000
- - PRBG 20 9,900.000 0.00 - 0.000
- - DAK 17/MAR-20 8,500.000 0.00 - 0.000
- 203 DAK 20 / Mei-23 8,237.000 1,672,111.00 100 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19/Sept. 23 4,950.000 0.00 50 300 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 17/APR-19 440.000 0.00 - 0.000
- - DAK 18L/Agst.20 220.000 0.00 - 0.000
- 50 DAK 19/Mei20
PRSpesifik 21 165.000 8,250.00 7,903 16,000 0.000
- 10,000 58.000 580,000.00 - 10,000 580,000.000
- - non covid-19/ - 0.000 0.00 - 0.000
- - DAK 18/Apr-22 3,035.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- 24 DAK 17/ Mei-21 4,496.000 107,904.00 - 0.000
- - - 0.000 0.00 - 0.000
- 30 DAK
Buffer Prop.20 - 3,045.000
16/APR-20 91,350.00 293 50 30 91,350.000
- - 198.000 0.00 - 0.000
- - Covid-19
DAK 18L/Jan.21 1,485.000 0.00 - 0.000
- - PRSpesifik L 20/ 1,551.000 0.00 - 0.000
- 1,517 DAK 19/Sept.21 105.000 159,285.00 3,975 4,000 0.000
- 4,000 DAK 20/Juni 22 105.000 420,000.00 - 4,000 420,000.000
- - DAK
DAK 17/Jan-21
17/AGSTS- 1,050.000 0.00 - 0.000
- - 67.000 0.00 - 0.000
- - 20
DAK 20/Feb 22 75.000 0.00 - 0.000
- - DAK 19/MAR-22 103.000 0.00 - 0.000
- - DAK 20 L 253.000 0.00 - 0.000
- - 0 0.000 0.00 - 0.000
- 3 DAK 19/Feb.22 2,076.000 6,228.00 5 0.000
- - 0 0.000 0.00 - 0.000
- 164 DAK 19/Feb.22 1,584.000 259,776.00 142 100 - 0.000
- - 0 0.000 0.00 - 0.000
- 112 DAK 18L/Apr.22 2,915.000 326,480.00 20 0.000
- - DAK 19/Juni 22 2,750.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 18/Mei.22 380.000 0.00 - 0.000
- 146 DAK 19/Des.22 380.000 55,480.00 134 0.000
- - DAK 20/Des 23 405.000 0.00 - 0.000
- - Dak
DAK19/Feb 21
20/31-Okt 1,639.000 0.00 - 0.000
- - 1,639.000 0.00 - 0.000
- - 21
DAK 18/Apr 23 136.000 0.00 - 0.000
- - DAK20
DAK 19/Apr 23
/Nov22, 152.000 0.00 247 0.000
- 1,675 145.000 242,875.00 433 0.000
- - Mart
DAK 23 -
PRSpesifik 20 110.000
19/Jan 21 0.00 0.000
- - 110.000 0.00 - 0.000
- - Non
DAK Covid-19/
18/Feb.20 3,350.000 0.00 - 0.000
- - DAK 19/Feb.20 3,350.000 0.00 - 0.000
- 250 DAK 20/Okt 21 3,350.000 837,500.00 172 200 150 502,500.000
- - DAK 17/JUL-19 300.000 0.00 - 0.000
- - DAK 20/Feb 24 5,900.000 0.00 - 0.000
- - DAK 19/ 626.000 0.00 - 0.000
- - DAK 20 L 18,150.000 0.00 - 0.000
- - DAK 19/Agst. 20 7,602.000 0.00 - 0.000
- - DAK 19/Apr.20 7,124.000 0.00 - 0.000
- - 0 0.000 0.00 - 0.000
- - DAK 19/Jan 21 149,266.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19/Mei 24 5,280.000 0.00 - 0.000
- 185 DAK 19/Juni 24 660.000 122,100.00 872 2,000 0.000
- 1,500 PRBG 20/ 671.000 1,006,500.00 - 1,500 1,006,500.000
- - DAK 17/MAR-19 4,282.000 0.00 - 0.000
- 54 DAK 19/Mar.21 11,000.000 594,000.00 16 0.000
- - PRSpesifik L 20/ 10,098.000 0.00 - 0.000
- - DAK 19/Okt.21 2,805.000 0.00 - 0.000
- - DAK
DAK 19/Apr.21
20/ Des 21, 1,097.000 0.00 49 0.000
- 162 1,097.000 177,714.00 38 0.000
- 102 Feb
DAK2219/Juni 21 60.500 6,171.00 1,756 6,000 0.000
- 2,000 DAK 20 L 66.000 132,000.00 - 2,000 132,000.000
- - DAK 18/Nov 19 10,400.000 0.00 - 0.000
- - DAK 18L/Agst.20 9,900.000 0.00 - 0.000
- 336 DAK 19/Juni 22 1,095.000 367,920.00 131 200 180 197,100.000
- - - 0.000 0.00 - 0.000
- - DAK 17/APR-21 104.000 0.00 161 200 0.000
- 200 DAK 19/Nov.20 104.000 20,800.00 - 200 20,800.000
- - DAK 20/ 104.000 0.00 - 0.000
- 1,513 DAK 19/Nov.20 105.000 158,865.00 957 1,000 1,000 105,000.000
- - DAK 19/Mar.24 112.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19/JULI21 4,400.000 0.00 - 0.000
- - DAK 20/Feb 22 2,700.000 0.00 - 0.000
- 500 DAK 19/Juni 21 165.000 82,500.00 120 500 500 82,500.000
- - DAK 20/Mart 23 91.000 0.00 - 0.000
- - DAK 18/Des 20 1,408.000 0.00 - 0.000
- 6 DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 8,448.00 19 100 0.000
- 100 Buffer 1,408.000 140,800.00 - 100 140,800.000
- - Aprl 21 Prop 730.000 0.00 - 0.000
- 260 19/Mei
DAK 20/ 20Mei 21 770.000 200,200.00 40 100 100 77,000.000
- - DAK
DAK 19/Des.23
17/SEPT- 391.000 0.00 - 0.000
- - 4,167.000 0.00 - 0.000
- - 20
DAK -
Buffer17/AGS-19
Prop.19/ 3,550.000 0.00 0.000
- - 3,682.000 0.00 - 0.000
- 203 Feb 20 /31-Des
DAK 20
3,682.000 747,446.00 40 150 150 552,300.000
- - 21;Jan 22
DAK 17/Apr.19 691.000 0.00 - 0.000
- 63 DAK 18/Apr.21 710.000 44,730.00 52 200 - 0.000
- - DAK 17/ JAN-20 0.000 0.00 - 0.000
- - DAK
DAK 18/Des.19 1,333.000 0.00 - 0.000
- - 1,333.000 0.00 - 0.000
- - Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.00 - 0.000
- - DAK 20/Mei 22 82.000 0.00 - 0.000
- - DAK 18/Mei 21 4,232.000 0.00 - 0.000
- - DAK 19/Sept.22 4,232.000 0.00 - 0.000
- 112 DAK 20/Feb 23 4,232.000 473,984.00 - 0.000
- - DAK 19/Juni 22 2,750.000 0.00 - 0.000
- 24 DAK 20 L 4,400.000 105,600.00 - 24 105,600.000
- 21 DAK 17/DES-20 2,900.000 60,900.00 35 200 0.000
- 4,136 DAK 19/Feb 24 119.000 492,184.00 1,395 0.000
- - DAK 20/ Feb 22 119.000 0.00 - 0.000
- - DAU 19/Mei
DAK PR BG 23 77.000 0.00 - 0.000
- 3,610 COVID 20/ Agsts 99.000 357,390.00 3,205 3,000 - 0.000
- 108 DAK 19/Mei 22
21 7,865.000 849,420.00 12 0.000
- 14 DAK 19/Mei 21 10,010.000 140,140.00 - 0.000
- - PRSpesifik L 20/ 10,010.000 0.00 - 0.000
- - DAK 17/FEB-20 6,900.000 0.00 - 0.000
- - DAK 20/ 7,363.000 0.00 40 0.000
- - APBD II - 15 132.000 0.00 - 0.000
- 1,036 DAK 16/OKT-21 149.000 154,364.00 331 0.000
- - DAK 20 L 88.000 0.00 - 0.000
- - DAK 18/Agst.21 2,787.000 0.00 - 0.000
- 160 DAK 19/Mei 23 2,475.000 396,000.00 80 200 120 297,000.000
- - DAK 20/ Juni 23 2,475.000 0.00 - 0.000
- - DAK 19/Jan 21 176,800.000 0.00 - 0.000
- 10 DAK 19/Mei 21 8,800.000 88,000.00 - 0.000
- - DAK 20 L 0.000 0.00 - 0.000
- - DAK 19 4,665.000 0.00 - 0.000
- 381 DAK 20/ Des 21 4,665.000 1,777,365.00 23 200 216 1,007,640.000
- 12,061 DAK 19/JULI21 264.000 3,184,104.00 7,839 12,000 12,000 3,168,000.000
- - DAK 20 L 330.000 0.00 - 0.000
- - DAK 18L/Mar.20 660.000 0.00 - 0.000
- - DAK 20 L 187.000 0.00 - 0.000
- 191 DAK 17/MAR-21 90.000 17,190.00 64 0.000
- - DAK 18/Jan.22 89.000 0.00 - 0.000
- - DAK 19/Mart.23 121.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 18/Nov.20 9,644.000 0.00 - 0.000
- - DAK 18/Jan.21 10,696.000 0.00 - 0.000
- 182 DAK 19/Jan.22 10,696.000 1,946,672.00 18 100 1,069,600.000
- - - 0.000 0.00 - 0.000
- - DAK 19/Juli 21 770.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- 100 DAK 18/Mar.21 1,755.000 175,500.00 - 0.000
- 2,927 DAK 19/Mei 21 187.000 547,349.00 3,533 5,000 0.000
- 5,000 DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 315,000.00 - 5,000 315,000.000
- - 63.000 0.00 - 0.000
- 1,217 Jan
DAK2319/Mei 24 94.600 115,128.20 3,989 3,000 0.000
- 3,000 DAK 20 L 99.000 297,000.00 - 3,000 297,000.000
- - DAK 19/Mei23 5,610.000 0.00 - 0.000
- 26 DAK 20/ Juni 23 2,518.000 65,468.00 20 0.000
- 360 DAK 19/Juli21 396.000 142,560.00 10 0.000
- - DAK 19/Jun 21 288.000 0.00 - 0.000
- - DAK 20/Jan 22 288.000 0.00 - 0.000
- - DAK 19/Des.20 1,089.000 0.00 - 0.000
- - DAK 17/SEPT-- 0.000 0.00 - 0.000
- 151 1,810.000 273,310.00 109 0.000
- - 20 - 0.000 0.00 - 0.000
- - DAK 17/FEB-20 10,500.000 0.00 - 0.000
- - DAK 18L/Mei.20 17,968.500 0.00 - 0.000
- - DAK 19/Mart21 35,200.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 18/Mei.22 22.000 0.00 - 0.000
- 5,181 DAK 19/Mar.22 77.000 398,937.00 2,389 0.000
- - DAK 20/Feb 22 23.000 0.00 - 0.000
- - DAK 17/MEI 20 2,750.000 0.00 - 0.000
- - DAK 18L/Mei.23 495.000 0.00 - 0.000
- 1,378 DAK 19/Juni 23 440.000 606,320.00 560 3,000 0.000
- 3,000 DAU PR BG 20/ 319.000 957,000.00 - 3,000 957,000.000
- - DAK 19/JUN 20 2,052.000 0.00 - 0.000
- 135 DAK 20/ Mei 22 2,190.000 295,650.00 65 0.000
- 24 DAK 17/JUNI 21 13,970.000 335,280.00 12 36 24 335,280.000
- 13 DAK 19/Apr.21 22,550.000
PRSpesifik 293,150.00 7 0.000
- - 23,100.000 0.00 - 0.000
- - Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.00 - 0.000
- - DAK 19/Mei 21 6,600.000 0.00 49 60 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 17/JUN 21 1,937.000 0.00 - 0.000
- 547 DAK20/
DAK 19/Mei
Feb 21 2,178.000 1,191,366.00 343 500 510 1,110,780.000
- - 1,222.000 0.00 - 0.000
- 134 21;Mei22
DAK 19/Juni 21 99.000 13,266.00 66 0.000
- - DAK 20 L 330.000 0.00 - 0.000
- 132 DAK 19/Nov.21 123.000 16,236.00 14 0.000
- - DAK 20/Okt 23 131.000 0.00 - 0.000
- 360 DAK 18L/Sept.20 4,680.500 1,684,980.00 - 0.000
- 180 DAK 19/Jan 22 4,730.000 851,400.00 - 0.000
- - DAK 19/ 550.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 18L/Apr.20 4,950.000 0.00 - 0.000
- - DAK 19/Apr 21 5,500.000 0.00 127 0.000
- 1,336 PRSpesifik L 20/ 3,707.000 4,952,552.00 164 1,000 1,000 3,707,000.000
- - DAK 19/Des.20
DAK20/28 Feb22 96.000 0.00 473 0.000
- 1,845 102.000 188,190.00 155 0.000
- 163 ;DAK 19/Agst. 21 143.000 23,309.00 37 0.000
- - - 0.000 0.00 - 0.000
- - DAK 17/APR 22 87.000 0.00 - 0.000
- - DAK 18/Nov.20 80.000 0.00 - 0.000
- - DAK 20 / Juni 22 121.000 0.00 - 0.000
- - DAK19/JULI23 192.500 0.00 - 0.000
- 2,214 DAK 20 L 275.000 608,850.00 86 4,000 2,000 550,000.000
- - DAK 19/Nov 20 8,110.000 0.00 - 0.000
- - DAK 20/ 8,110.000 0.00 - 0.000
- - DAK 18L/Okt.20 14,318.700 0.00 - 0.000
- - DAK 19/Feb 21 5,500.000 0.00 - 0.000
- 360 DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 752,400.00 510 0.000
- - 5,000.000 0.00 - 0.000
- - 19
DAK 19/FEB 21 4,400.000 0.00 - 0.000
PRSpesifik
- - 1,265.000 0.00 - 0.000
- - Dokter Muter 20
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19/sept.23 68,035.00 - 0.000
- - 180,000.000 0.00 - 0.000
- - 19
PRSpesifik
DAK 20 8,900.000
18/Jul.22 0.00 - 0.000
- 109 non covid-19/ 5,500.000 599,500.00 64 100 100 550,000.000
- - DAK
Des 2418/Okt.21 8,900.000 0.00 - 0.000
- - DAK
DAU ID 20 non 6,270.000
19/Okt.21 0.00 150 200 0.000
- 200 8,700.000 1,740,000.00 - 200 1,740,000.000
- - covid-19
PRSpesifik
DAK 2023 5,500.000
19/Agst. 0.00 - 0.000
- 201 non covid-19/ 5,500.000 1,105,500.00 248 200 200 1,100,000.000
- 77 DAK
Des 19/Okt.21
24
DAU ID Non 6,270.000 482,790.00 74 100 0.000
- 100 6,270.000 627,000.00 - 100 627,000.000
- - Covid
DAK -
DAK 20/Juni 22 7,920.000
16/JUL 21 0.00 0.000
- 59 8,400.000 495,600.00 41 0.000
- - DAK
DAK 20/Agst.22 6,199.900
19/Jan 24 0.00 - 0.000
- 459 8,400.000 3,855,600.00 241 300 300 2,520,000.000
- - DAK 18L 1,760.000 0.00 - 0.000
- - DAK 18 13,400.000 0.00 - 0.000
- 27 DAK 19
DAU ID 20 - 13,400.000 361,800.00 3 20 15 201,000.000
- - 12,500.000 0.00 - 0.000
- - Covid-19
DAK 18/Nov.21 2,300.000 0.00 - 0.000
- 10 DAK
DAU 19/Okt.22
ID 20 Non 136,500.000 1,365,000.00 8 10 10 1,365,000.000
- - 136,500.000 0.00 - 0.000
- - Covid
DAK 18/Okt.22 8,000.000 0.00 - 0.000
- 48 DAK
DAU 19/Sept.21
ID 20 - 5,950.000 285,600.00 2 60 0.000
- - 8,000.000 0.00 - 0.000
- - Covid-19
DAK 18 1,430.000 0.00 - 0.000
- 100 DAK 19/Feb
DAU ID 20 - 22 2,240.000 224,000.00 90 100 100 224,000.000
- - 2,100.000 0.00 - 0.000
- - Covid-19
DAK 19/Sept 23 427.850 0.00 - 0.000
- - Dak 19/Sept 20 390.860 0.00 - 0.000
- - BTT 20 Covid-19 2,060.000 0.00 - 0.000
- - - 0.000
APBD II-14/Sep- 0.00 - 0.000
- - 17,500.000 0.00 - 0.000
- - 19
DAK 18/Okt.22 6,512.000 0.00 - 0.000
- - Buffer Prop. 19 339.900 0.00 - 0.000
- - Buffer Prop. 20 339.900 0.00 - 0.000
 DAU 20 PR
- - 2,200.000 0.00 - 0.000
- 335 Spesifik/Des
DAK 19 25 2,309.375 773,640.63 785 2,000 0.000
- - DAK 18/Agst.22 10,857.000 0.00 - 0.000
- - DAK 18/Nov.21 10,856.250 0.00 - 0.000
- 12 DAK 19/Nov 22 65,340.000 784,080.00 1 0.000
- - DAK 16 333.900 0.00 50 0.000
- - DAK 16/MEI 21 11,615.000 0.00 - 0.000
- - DAK 16/MEI 21 6,600.000 0.00 - 0.000
- - DAK 18/Jan. 23 154.000 0.00 - 0.000
- - DAU 19/Jan.22
DAK 20 ID NON 7,700.000 0.00 23 0.000
- 112 COVID-19/ Mart 7,769.000 870,128.00 50 50 54 419,526.000
- 9 DAK
DAU 19/Jan
23 22
ID 20 NON 18,000.000 162,000.00 5 20 5 90,000.000
- 50 12,675.000 633,750.00 - 50 633,750.000
- - COVID-19
DAK 19/Feb 22 3,700.000 0.00 - 0.000
- - DAK 17/SEPT- 0.000 0.00 - 0.000
- - 286,000.000 0.00 - 0.000
- - 19
DAK 19/Okt 20 726.953 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAU 19/Juli
DAK 20 (ID) 23 542.520 0.00 100 0.000
- - NON 496.650 0.00 - 0.000
- - DAK
DAU ID 20 non 19,360.000
19/Jan.24
COVID-19/Jan 25 0.00 - 0.000
- 300 470.530 141,159.00 - 0.000
- 276 covid-19
DAU 19/Nov
DAK 20 (ID) 23 3,773.000 1,041,348.00 24 0.000
- - NON COVID-19/ 4,134.900 0.00 - 0.000
- 60 DAK2419/Mar 23 20,586.000
Nov 1,235,160.00 48 60 60 1,235,160.000
- - DAK 19/Nov 23 15,150.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19/ Sept. 21 87,120.000 0.00 - 0.000
- 1 DAK 19/Des 21 752,400.000 752,400.00 - 0.000
- 30 DAK 19 8,295.000 248,850.00 25 200 30 248,850.000
- - DAK 19 8,031.579 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19/Jan 24 5,368.000 0.00 13 60 0.000
- 60 DAK 19/Juli 23 5,785.000 347,100.00 - 60 347,100.000
- - DAU ID 20 NON - 0.000 0.00 - 0.000
- 200 COVID-19/ April 2,887.500 577,500.00 - 200 200 577,500.000
- - 24 - 0.000 0.00 - 0.000
- - DAK 17 453,802.994 0.00 - 0.000
- - DAK 19/Mei.20 4,200.000 0.00 - 0.000
- 400 DAK
DAU 19/Nov.22
ID 20 - 635.250 254,100.00 200 0.000
- - 4,000.000 0.00 - 0.000
- - Covid-19/
DAK 19 Juni 21 59,000.000 0.00 - 0.000
- - DAK 19/Des 20 45,000.000 0.00 - 0.000
- - DAK 19/Nov 20 45,000.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK
DAU ID 20 Non 546,400.000
17/MEI 2020 0.00 - 0.000
- - 544,150.000 0.00 - 0.000
- - Covid
DAK 19 0.000 0.00 - 0.000
- - DAK 19 223,949.367 0.00 - 0.000
- - DAK 19/Sept 20 254,300.000 0.00 - 0.000
- - DAK 19/Juni 21 252,800.000 0.00 - 0.000
- 10 DAK
DAU 19/ Jan- 21 401,666.666
ID 20 4,016,666.66 1 300 10 4,016,666.660
- - 405,000.000 0.00 - 0.000
- - Covid-19
DAK 17/APR 22 10,560.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19/Nov 20 10,837.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19/Mar21 19,225.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK
DAU ID 20 Non 552,800.000
19/Mei 20 0.00 - 0.000
- - 552,800.000 0.00 - 0.000
- - Covid - 0.000 0.00 - 0.000
- - Buffer - 0.000 0.00 - 0.000
- - 16,400.000 0.00 - 0.000
- - Prop.19/Mei 21- 0.000 0.00 - 0.000
Buffer Prop
- 100 Buffer Prop 4,120.000 412,000.00 - 0.000
- - 18/Jul.20 4,120.000 0.00 - 0.000
- 300 18/Jul.21
DAK -
Buffer Prop 19/ 15,500.000
20/Okt 21 4,650,000.00 0.000
- - Buffer 9,738.000 0.00 - 0.000
- - Juni 21Prop 19/ 9,611.000 0.00 - 0.000
- - Juli 21 - 0.000 0.00 - 0.000
- - Buffer
Buffer Prop 20/ 625,900.000
Prop 18 0.00 - 0.000
- - Buffer 22,176.000 0.00 - 0.000
- - Apr 21 Prop 20/ 66,876.000 0.00 - 0.000
- - Apr 21 - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - Buffer Prop - 0.000 0.00 - 0.000
- - Buffer Prop 13,252.000 0.00 - 0.000
- - 19/Sept. 20 10,865.800 0.00 - 0.000
- 350 19/Mar
Buffer 21 20/ 8,053.000
Prop 2,818,550.00 - 0.000
Buffer Prop 20/
- - 8,110.000 0.00 - 0.000
- - Maret 22 - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - Buffer Prop 17 36,000.000 0.00 - 0.000
- - Buffer
Buffer Prop 19 77,690.000 0.00 - 0.000
- - Buffer Prop.20/ 825,000.000 0.00 - 0.000
- - Prop.19/Agst.21 224,254.000 0.00 - 0.000
- - Okt
DAK 21 -
BUFF.20PROP 259,175.000 0.00 0.000
- - 70,000.000 0.00 - 0.000
- - 17/JUN 12 18
Buffer Prop 4,952.830 0.00 - 0.000
- - Buffer Prop 19 4,952.830 0.00 - 0.000
- - Buffer Prop 19 2,728.000 0.00 - 0.000
- - Buffer Prop 20/
Buffer Prop 19 5,890.000 0.00 - 0.000
- - Buffer 660,000.000 0.00 - 0.000
- - Des 20 Prop 20/ 158,400.000 0.00 - 0.000
- - Des 21 PROP
BUFF.
276,600.000 0.00 - 0.000
BUFF. PROP
17/NOV 17
- - Buffer Prop 276,500.000 0.00 - 0.000
- - 17/NOV 18 257,644.000 0.00 - 0.000
DAK 20
19Des.19
- - 228,800.000 0.00 - 0.000
- 9 Penugasan
Buffer TB 1
DAK 20Prop 19 20,747.000 186,723.00 0.000
- - 20,748.000 0.00 - 0.000
- - Penugasan
Buffer Prop.TB
19 6,700.000 0.00 - 0.000
- 23 Buffer Prop. 20 19,835.000 456,205.00 7 0.000
- - Buffer Prop. 20 386.100 0.00 - 0.000
- - Buffer Prop - 0.000 0.00 - 0.000
- - Buffer Prop 1,590.000 0.00 - 500 0.000
- - 18/Feb.23 1,550.000 0.00 - 0.000
Buffer Prop
18/Mar.23
- 500 1,463.000 731,500.00 - 500 731,500.000
- - 19/Okt.21
Buffer Prop 20/
20/ 1,518.000 0.00 - 0.000
Buffer Prop
- - Buffer 1,190.000 0.00 - 0.000
- 800 Okt 24 Prop 1,185.000 948,000.00 - 0.000
Buffer Prop
19/Apr.23
- - 1,463.000 0.00 - 0.000
- - 19/Feb Prop
Buffer 24 1,190.000 0.00 - 0.000
Buffer Prop
19/Agst 24
- - Buffer Prop 1,077.000 0.00 - 0.000
- - 19/Mar.23 1,081.820 0.00 - 0.000
Buffer Prop
19/Juni 24
- - 0.000 0.00 - 0.000
- - 20/Juni 24 - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - Buffer Prop - 0.000 0.00 - 0.000
- 145 Buffer Prop 1,583.000 229,535.00 141 0.000
- - 19/Okt. 23 1,439.000 0.00 - 0.000
Buffer Prop
19/Feb.24
- - 1,439.000 0.00 - 0.000
- - 20/Feb.24 - 0.000 0.00 - 0.000
- 25 Buffer Prop 19 22,433.000 560,825.00 - 0.000
- - Buffer Prop 20 1,460.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- 50 Buffer Prop 19 14,712.500 735,625.00 - 0.000
- - Buffer Prop 19/
Buffer Prop 20/ 19,480.000 0.00 - 0.000
- - 13,750.000 0.00 - 0.000
- - Juli 21 Prop 20/
Buffer 13,235.000 0.00 - 0.000
Buffer Prop
- 50 Buffer Prop 12,500.000 625,000.00 - 0.000
- - 19/Feb 21 13,750.000 0.00 - 0.000
Buffer Prop
20/Mar 21
- - Buffer Prop 20/ 358.000 0.00 - 0.000
- - 19/Mar.20 121,750.000 0.00 - 0.000
Buffer
Feb 21 Prop
- - 486.000 0.00 - 0.000
- - 19/Nov.21 -
Buffer Prop 19/- 0.000 0.00 0.000
- 819 11,975.000 9,807,525.00 81 0.000
- - Apr
DAK 20 Agst 21 -
Buffer20/
Prop 28,666.670 0.00 0.000
- - Buffer Prop 20/ 13,235.000 0.00 - 0.000
- - 18/Agst.20 12,500.000 0.00 - 0.000
- - Mei 2021
0Buffer 11,975.000 0.00 - 0.000
Prop
- - 11,975.000 0.00 - 0.000
- - 19/Nov.20 -
Buffer Prop - 0.000 0.00 0.000
- - 19,480.000 0.00 - 0.000
- - 18/Jun.20 -
Buffer Prop - 0.000 0.00 0.000
- - 13,235.000 0.00 - 0.000
- - 19/Agst. 20 - 0.000 0.00 - 0.000
Buffer Prop
- - Buffer Prop 19,480.000 0.00 - 0.000
- - 19/Juni 20 20 13,353.000 0.00 - 0.000
Buffer
juli 21 Prop.
- - 800.000 0.00 - 0.000
- - 18/Okt.21 -
Buffer Prop.20- - 0.000 0.00 0.000
- - Buffer Prop.20 - 323,500.000 0.00 - 0.000
- - Covid-19 53,000.000 0.00 - 0.000
Buffer Prop.20 -
Covid-19
- - 386.100 0.00 - 0.000
- - Covid-19 - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAK 19 38,500.000 0.00 - 0.000
- - DAK 19 71,500.000 0.00 - 0.000
- - DAK 20 38,500.000 0.00 - 0.000
- - DAK
DAU 20
ID 20 - 71,500.000 0.00 - 0.000
- - 333.900 0.00 - 0.000
- - Covid-19 - 0.000 0.00 - 0.000
- - Retur PKM - 0.000 0.00 - 0.000
- - Candipuro, 473.000 0.00 - 0.000
- - Sumbersari
RETUR - 0.000 0.00 - 0.000
- - RETUR 110.000 0.00 - 0.000
- - PASIRIAN
RETUR 1,750.000 0.00 - 0.000
- - PASIRIAN
RETUR
ROGOTRUNAN 98.000 0.00 - 0.000
- - RETUR
ROGOTRUNAN 783.000 0.00 - 0.000
- - ROGOTRUNAN
Buffer Prop 20/ 7,150.000 0.00 - 0.000
- - 2,134.000 0.00 - 0.000
- - Apr 21 Pronojiwo
Retur 6,199.900 0.00 - 0.000
RETUR
- - RETUR 1,155.000 0.00 300 0.000
- - ROGOTRUNAN 80.000 0.00 - 0.000
RETUR
ROGOTRUNAN
- - RETUR 396.000 0.00 - 0.000
- - ROGOTRUNAN 500.000 0.00 - 0.000
RETUR
ROGOTRUNAN
- 50 RETUR 7,920.000 396,000.00 - 0.000
- - ROGOTRUNAN 1,302.000 0.00 - 0.000
RETUR
ROGOTRUNAN
RETUR
- - 1,890.000 0.00 - 0.000
- - ROGOTRUNAN
YOSOWILANGU 160.000 0.00 - 0.000
DAK 20 /22 Feb
- 360 N
DAK 20 /01 Sep 6,840.000 2,462,400.00 - 0.000
- - 23 90.000 0.00 - 0.000
RETUR
21
DAU PR BG
- - 265.000 0.00 - 0.000
- - TEKUNG
DAU PRSpesifik
COVID 20/ Jan 14,300.000 0.00 - 0.000
- 1,092 20
RETURCovid-19/
22 Non 7,630.000 8,331,960.00 408 0.000
- - Mar 23
RETUR 167.000 0.00 - 0.000
- - ROGOTRUNAN 8,355.000 0.00 - 0.000
Buffer Prop 20/
ROGOTRUNAN
- - 1,457,500.000 0.00 1 0.000
Mar 22
- - Buffer Prop 20/
Buffer Prop 20/ 0.000 0.00 - 0.000
- - Buffer 12,969.000 0.00 - 0.000
- - Agst 20Prop 20/ 1,506.000 0.00 - 0.000
Buffer
Feb 25 Prop 20/ 410,777.000
- - Buffer 0.00 - 0.000
- - Apr 21 Prop 20/ 343,687.000 0.00 - 0.000
Buffer
Apr 21 Prop
Buffer Prop 20/
20/ 32,493.000
- - 0.00 - 0.000
- 30 Mar 25
Bantuan 0.000 0.00 - 0.000
DAK 20
- - DAK 20 TB 2,254.320
Kemenkes 0.00 - 0.000
- - Penugasan -
DAK 20 TB 259,175.000
Penugasan
0.00 0.000
- - DAK 20 15,180.000 0.00 - 0.000
- 200 Penugasan 31,680.000 6,336,000.00 - 0.000
DAK 20
Penugasan
- 199 31,405.000 6,249,595.00 1 0.000
- - Penugasan
PRBG 20 3,300.000 0.00 - 0.000
- - PRSpesifik
PRSpesifik 20 7,630.000 0.00 - 0.000
- - PRSpesifik 14,300.000 0.00 - 0.000
- - Dokter Muter 20 8,426.000 0.00 - 0.000
PRSpesifik
Dokter Muter 20 627.000
- - PRSpesifik 0.00 - 0.000
- - Dokter Muter 20 792.000 0.00 - 0.000
BTT 20Muter
Dokter KE 2 20
- - BTT 20-19
KE 2 1,700.000 0.00 - 0.000
- - COVID 1,700.000 0.00 - 0.000
BTT 20-19
COVID KE 2
- - BTT 20-19
KE 2 55,000.000 0.00 - 0.000
- 25 COVID 58,500.000 1,462,500.00 - 25 1,462,500.000
BTT 20-19
COVID KE 2
- 6,000 850.000 5,100,000.00 - 6,000 5,100,000.000
- 300 COVID
PROP -19
20 4,000.000 1,200,000.00 - 0.000
RETUR
- - PRSpesifik 20 8,355.000 0.00 - 0.000
- - ROGOTRUNAN 248,120.000 0.00 - 0.000
BTTCovid
Non 20 KE 2
- - BTT 20-19
KE 2 186,000.000 0.00 - 0.000
- - COVID 6,500.000 0.00 - 0.000
- - COVID -19 Juli 11,250.000
DAK 20/2024 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - DAU 20 - 0.000 0.00 - 0.000
- 8 DAU 20
PRSpesifik 236,500.000 1,892,000.00 - 0.000
- 5 DAU 20 20
PRSpesifik
Covid-19 99,000.000 495,000.00 - 0.000
- 4 DAU 20 20
PRSpesifik
Covid-19 203,500.000 814,000.00 - 0.000
- - DAU 20 20
PRSpesifik
Covid-19 275,000.000 0.00 - 0.000
- - PRSpesifik
Covid-19
DAU 20 20 132,000.000 0.00 - 0.000
- - Covid-19/20 49,500.000 0.00 - 0.000
PRSpesifik
 DAU 20
- - PRSpesifik
DAU 5,500.000 0.00 - 0.000
- - DAU 2020
Covid-19/20 66,000.000 0.00 - 0.000
- 2,000 PRSpesifik
PRSpesifik 1,023.000 2,046,000.00 2,900 0.000
BUFFER
- - Covid-19/20
BUFFER 20 21,736.000 0.00 - 0.000
- - PROPINSI 386.100 0.00 - 0.000
BUFFER
PROPINSI
DAU 20 20
- 1,800 340.280 612,504.00 200 0.000
- 1 PROPINSI
DAU 20 20
PRSpesifik 560,000.000 560,000.00 - 0.000
- 1 DAU 20
PRSpesifik
Covid-19 20 1,252,000.000 1,252,000.00 1 0.000
- - DAU 20
PRSpesifik
Covid-19 20 575,000.000 0.00 - 0.000
- 9 DAU20
PRSpesifik
Covid-19/Des 25 156,000.000 1,404,000.00 - 0.000
- - PRSpesifik/Des2
Covid-19/Des 26 53,636.000
DAU PR Spesifik 0.00 - 0.000
- - DAU PRSpesifik 220,000.000
5Covid-19/20 0.00 - 0.000
- 2 DAU PRS 20 148,500.000 297,000.00 - 0.000
- - Covid-19 200
DAU PRSpesifik 7,000.000
Covid-19/20
0.00 0.000
- - DAU ID COVID- 2,200.000 0.00 - 0.000
- - Covid-19/20 60,000.000 0.00 - 0.000
DAU
19 20/ID COVID- 6,269.000
- - DAU 0.00 1,200 0.000
- - 19 20/ID COVID- 197,000.000 0.00 - 0.000
DAU
19 20/ID COVID-
Mar 21
- 20 DAU 75,000.000 1,500,000.00 - 0.000
- - 19 20/ID COVID- 8,500.000 0.00 1,200 0.000
DAU
19 20/ID COVID- 220,000.000
- 21 DAU 4,620,000.00 - 0.000
- - 19 20/ID COVID- 220,000.000 0.00 - 0.000
DAU
19 20/ID COVID-
Mar 21
- - DAU 75,000.000 0.00 - 0.000
- 100 19 20/ID COVID- 5,000.000 500,000.00 50 0.000
DAU
19 20/ID COVID- 200,000.000
- - DAU 0.00 - 0.000
- - 19 20/ID COVID- 56,000.000 0.00 - 0.000
DAU
19 20/ID COVID- 80,000.000
- - 0.00 - 0.000
- 68 19 20/ID COVID- 200,000.000
DAU
13,600,000.00 - 0.000
BTT
19 20/20 COVID- 138,364.000
- - 0.00 - 0.000
- - 19 20 COVID- 137,364.000
BTT
0.00 - 0.000
DAU PRSpesifik
19
- 7 DAU PRSpesifik 45,100.000 315,700.00 - 0.000
- - Covid-19 -
DAU PRSpesifik 66,000.000
Covid-19
0.00 0.000
- - DAU ID Covid-19 53,636.000 0.00 - 0.000
- - Covid-19 -
DAU ID Covid- 450,000.000
20
0.00 0.000
- 4 DAU ID Covid- 718,500.000 2,874,000.00 - 0.000
- - 19/20 -
DAU ID Covid- 69,000.000
19/20
0.00 0.000
- - DAU ID Covid- 60,000.000 0.00 - 0.000
- 5,100 19/20 -
DAU ID Covid- 6,000.000 30,600,000.00 20,400,000.000
3,400
- - 19/20 -
DAU ID Covid- 522,728.000
19/20
0.00 0.000
- - DAU ID Covid- 180,000.000 0.00 - 0.000
- - 19/20 -
BTT 20 COVID- 220,000.000
19/20
0.00 0.000
- - 109.090 0.00 - 0.000
19
 BTT 20 COVID-
- - BTT 20 COVID- 24,091.000 0.00 - 0.000
- 4,140 19 1,150.000 4,761,000.00 1,260 0.000
BTT 20 COVID-
19
- 5 BTT 20 COVID- 47,500.000 237,500.00 - 0.000
- - 19 200,000.000 0.00 - 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 2,816.000 0.00 - 0.000
- 10 19 150,000.000 1,500,000.00 - 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 303.550 0.00 - 0.000
- - 19 891,275.000 0.00 - 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 160,500.000 0.00 - 0.000
- 3,000 19 585.000 1,755,000.00 3,000 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 5,300.000 0.00 - 0.000
- - 19 5,500.000 0.00 - 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 60,500.000 0.00 - 0.000
- - 19 80,000.000 0.00 - 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 136,564.000 0.00 - 0.000
- - 19 1,265.000 0.00 - 0.000
DAU ID 20 non
19
- - DAU ID 20 non 8,400.000 0.00 - 0.000
- - covid-19 8,400.000 0.00 - 0.000
BTT ke 2 20
covid-19
- - BTT ke 2 20 98,000.000 0.00 - 0.000
- 20 COVID-19 90,000.000 1,800,000.00 - 20 1,800,000.000
BTT ke 2 20
COVID-20
- - 97,500.000 0.00 - 0.000
- 20 COVID-21
DAU 20 22,500.000 450,000.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 7,199.885 0.00 - 0.000
- - - 1,945.000 0.00 - 0.000
- - - 2,950.000 0.00 - 0.000
- - - 139,880.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 1,097.000 0.00 - 0.000
- 344 - 77.000 26,488.00 208 0.000
- - - 3,217.500 0.00 - 300 0.000
- - - 0.000 0.00 - 0.000
- - - 15,572.700 0.00 - 0.000
- - - 270.000 0.00 - 0.000
- - - 600.000 0.00 - 0.000
- 238 - 1,106.000 263,228.00 62 0.000
- - - 45.000 0.00 - 0.000
- - - 36.000 0.00 - 0.000
- - - 783.000 0.00 - 0.000
- - - 1,302.000 0.00 - 0.000
- - - 74,250.000 0.00 4 0.000
- - - 43,186.000 0.00 - 0.000
- - - 7,920.000 0.00 - 0.000
- - - 8,750.000 0.00 - 0.000
- - - 7,018.000 0.00 - 0.000
- - - 8,355.000 0.00 - 0.000
- - - 20,328.000 0.00 - 0.000
- - - 12,076.000 0.00 - 0.000
- - - 6,595.000 0.00 - 0.000
- - - 1,098,900.000 0.00 - 0.000
- 1 - 712,800.000 712,800.00 - 0.000
- - - 56.000 0.00 - 0.000
- - - 1,640.000 0.00 - 0.000
- - - 42,800.000 0.00 - 0.000
- 126 - 2,750.000 346,500.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- - - 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
- 0.000 0.00 - 0.000
 - 0.000 0.00 - 0.000
0 0 0.00 0.000
- - 269,392,141.99 101,395,461.660

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap Generik Paten

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
Ket
sudah
 BUFFER P 257

sudah

BUFFER P 2728
sudah
sudah
sudah

sudah

sudah
sudah
sudah

sudah

sudah
sudah

sudah
sudah
Pelaporan : Persentase Puskesmas denga
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Albendazol /Pira Tablet - 0
2 Alopurinol Tablet 24,629 1
3 Amlodipin/Kapto Tablet 21,659 1
4 Amoksisilin 500 Tablet 21,659 1
5 Amoksisilin sirup Botol 150 1
6 Antasida tablet k Tablet/Botol 50 1
7 Asam Askorbat (V Tablet 10,050 1
8 Asiklovir Tablet 10,050 1
9 Betametason sal Tube 10,000 1
10 Deksametason tabTablet/Vial/Ampul - 0
11 Diazepam injeksi Ampul 24 1
12 Diazepam Tablet 24 1
13 Dihidroartemsin Tablet 54 1
14 Difenhidramin In Ampul 30 1
15 Epinefrin (Adrena Ampul 30 1
16 Fitomenadion (Vi Ampul - 0
17 Furosemid 40 mg/ Tablet 1,517 1
18 Garam Oralit ser Kantong 5,517 1
19 Glibenklamid/Me Tablet 5,517 1
20 Hidrokortison kr Tube 4,000 1
21 Kotrimoksazol (d Tablet/Botol - 0
22 Lidokain inj Vial - 0
23 Magnesium Sulfat Vial - 0
24 Metilergometrin Ampul - 0
25 Natrium Diklofen Tablet 3 1
26 OAT FDC Kat 1 Paket 3 1
27 Oksitosin injeksi Ampul 167 1
28 Parasetamol siru Botol 164 1
29 Parasetamol 500 Tablet 276 1
30 Prednison 5 mg Tablet 112 1
31 Ranitidin 150 mg Tablet 112 1
32 Retinol 100.000/ Kapsul - 0
33 Salbutamol Tablet 1,412 1
34 Salep Mata/Tetes Tube 151 1
35 Simvastatin Tablet 700 1
36 Siprofloksasin Tablet - 0
37 Tablet Tambah D Tablet - 0
38 Triheksifenidil Tablet 1,412 1
39 Vitamin B6 (Pirid Tablet 1,746 1
40 Zinc 20 mg Tablet 2,630 1
JUMLAH ITEM OBAT INDIKATOR 30
Pelaporan : Persentase Puskesmas deng
Puskesmas :
Bulan :
Tahun :

NO. NAMA OBAT SATUAN KETERSEDIAAN

1 Vaksin Hepatitis Vial - 0
2 Vaksin BCG Ampul 36 1
3 Vaksin DPT-HB-H Vial - 0
4 Vaksin Polio Vial - 0
5 Vaksin Campak/V Vial/Ampul - 0
JUMLAH ITEM OBAT INDIKATOR 1
 REKAP LAPORAN PERSEDIAAN BAHAN OBAT - OBATAN (ASET) TRIW
PUSKESMAS .......................... TAHUN 2020
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN :
KAB / KODYA : LUMAJANG
PROPINSI : JAWA TIMUR

PENERIMAAN

NO NAMA OBAT SATUAN KEMASAN STOK AWAL Juli Agust Sept

1 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -

2 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 5 - - -
3 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - 300
4 0 0 - - - -
5 Air Untuk Injeksi Vial @25 ml Vial - - - -
6 Air Untuk Injeksi Vial @25 ml Vial 180 - - -
7 Air Untuk Irigasi Infus 1000 ml Botol - - - -
8 Alopurinol Tablet 100 mg Tablet 950 - - -
9 Alopurinol Tablet 100 mg 0 - - - -
10 Ambroxol Tablet 30 mg Tablet 2,000 - - -
11 0 0 - - - -
12 Aminofilin Injeksi 24 mg/ml Ampule - - - -
13 0 0 - - - -
14 Amlodipin Tablet 10 Mg Tablet - - - -
15 Amlodipin Tablet 10 Mg Tablet 2,724 - - 1,200
16 0 0 - - - -
17 Amoksisilin Kaplet 500 mg Tablet 30,008 - - -
18 Amoksisilin Kaplet 500 mg Tablet - - - -
19 Amoksisilin Kaplet 500 mg Tablet - - - -
20 Amoksisilin Kaplet 500 mg Tablet - - - -
21 0 0 - - - -
22 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 264 - - -
23 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - -
24 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - -
25 Amoksisilin Syrup Kering 250mg / 5 ml (Novapharin) Botol - - - -
26 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet - - - -
27 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet - - - -
28 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - - -
29 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 291 - - -
30 0 0 - - - -
31 Antacida + Simeticon Suspensi (NOVAMAG) Botol 50 - - -
32 0 0 - - - -
33 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
34 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
35 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 3,236 - - -
36 Antacida tablet kunyah DOEN, kombinasi : Alumunium Hidroksida 200 mg + Magnesium Hidroksida 200 mg Tablet - - - 10,000
37 0 0 - - - -
38 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - -
39 0 0 - - - -
40 Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam Salisilat 3% (Marin ) Pot 24 - - -
41 0 0 - - - -
42 Supp
Antihemoroid Kombinasi : Bismut Suppgalat 150 mg Heksaklorofen 2,5 mg Lidokain 10 mg Seng Oksida 120 mg
- - - 30
43 Asam Ascorbat 500 mg (Vitamin C) Tablet - - - -
44 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet - - - -
45 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet - - - -
46 Asam Ascorbat 50 mg (Vitamin C) Tablet 2,968 - - -
47 Asam Ascorbat 50 mg (Vitamin C) Tablet - - - 4,000
48 Asam Folat 1 mg Beta Caroten 10000 Multi Mineral/ FOLAMIL (Dexa Medica) Tablet - - - -
49 Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - -
50 Asam Folat Tablet 1 mg Tablet - - - -
51 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - -
52 Asam Mefenamat 500 mg 0 - - - -
53 0 0 - - - -
54 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - - -
55 0 0 - - - -
56 Asam Tranexamat Tablet 500 mg Tablet 226 - - -
57 0 0 - - - -
58 Asiklovir 5% 5gr Cream Tube 125 - - -
59 Asiklovir 5% 5gr Cream Tube - - - -
60 0 0 - - - -
61 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
62 Asiklovir Tab 400 mg ( Phapros ) Tablet 200 - - -
63 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
64 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - -
65 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
66 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - -
67 Attapulgite Active 630 mg Tab/ PULAREX Tablet - - - -
68 Attapulgite Active 630 mg Tab/ New Antides Tablet 1,675 - - -
69 Betahistin Mesylat 6 mg Tablet - - - -
70 Betahistin Mesylat 6 mg Tablet - - - -
71 Betametason Dipropionat Krim 0,1% Tube @ 10 gram - - - -
72 Betametason Dipropionat Krim 0,1% Tube @ 10 gram - - - -
73 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 203 - - 150
74 Bisakodil Tablet 5 mg (Etercon Pharma ) Tablet - - - -
75 Bisakodil Sup 10 mg (Dulcolax) Supp - - - -
76 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - -
77 Benzatin Benzil Penisilin 2,4 jt 0 - - - -
78 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) II Biji - - - -
79 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) I Biji - - - -
80 0 0 - - - -
81 Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs - - - -
82 0 0 - - - -
83 Calcium Plus Vit D3 (Coral calcium 500 mg,Naturan Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 mg,Zink 5 mg Boron 1 mg)/ CAL - 95
Tablet - - - -
84 Cefadroksil Kapsul 500 mg Tablet 830 - - -
85 Cefadroksil Kapsul 500 mg Tablet - - - 1,500
86 Cefotaxime serbuk injeksi 1.000 mg Vial - - - -
87 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 62 - - -
88 Citicolin 250 mg / 2 ml Inj Ampule - - - -
89 Curcumin Plus Cynarin,Sylimarin,Kapsul/ HEPAGARD (Phapros) Tablet - - - -
90 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 17 - - -
91 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 200 - - -
92 Deksamethason Tab 0,5 mg (Promed ) Tablet 1,079 - - -
93 Deksamethason Tab 0,5 mg 0 - - - 2,000
94 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - - -
95 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - -
96 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 255 - - 180
97 0 0 - - - -
98 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 161 - - -
99 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - 200
100 Digoksin Tab 0,25 mg Tablet - - - -
101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 1,470 - - 1,000
102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - - -
103 0 0 - - - -
104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
106 Domperidon Tab 10 mg (Novapharin ) Tablet 120 - - 500
107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - -
108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - -
109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 25 - - -
110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - 100
111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
112 Eritrosmisin Stearate Kaplet 500 mg Tablet 200 - - 100
113 Ethambutol 250 mg Tablet - - - -
114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - -
115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 93 - - 150
118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - - -
119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 115 - - -
120 0 0 - - - -
121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 112 - - -
128 Gentamycin Krim 1 % mg/ ml Tube - - - -
129 Gentian Violet 1% 10 ml Botol - - - 24
130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 56 - - -
131 Glibenklamid Tablet 5 mg Tablet 5,531 - - -
132 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - -
133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - - - -
134 Gliseril Guaikoulat Tablet 100 mg Tablet 6,815 - - -
135 Glucosamin HCL 500 Mg, Konrdoitin SO4400Mg, MSM 200 Mg, VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Gliserofosfat 10 mg Tablet 120 - - -
136 Glukosa Larutan 40% Steril ( Outsuka ) Botol 14 - - -
137 Glukosa Larutan 40% Steril botol - - - -
138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - -
139 Glukosa Larutan Infus 5% @500ml Botol 40 - - -
140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - -
141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,367 - - -
142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - -
143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - -
144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 120 - - 120
145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - -
146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - -
147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - - -
148 0 0 - - - -
149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 188 - - 216
151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 7,900 - - 12,000
152 Ibuprofen Tablet 400 mg Tablet - - - -
153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - -
154 Isoniazid Tablet 100 mg tablet - - - -
155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 255 - - -
156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
158 0 0 - - - -
159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - -
160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - -
161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol - 100 - 100
162 0 0 - - - -
163 Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian Pharmatama) Tablet - - - -
164 0 0 - - - -
165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - - -
166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 6,460 - - -
167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - 5,000
168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - -
169 Kaptopril Tab 25 mg ( Phapros ) Tablet 5,206 - - -
170 Kaptopril Tab 25 mg TAblet - - - 3,000
171 Ketokonazol Krim 2 % @ 10 gr Tube - - - -
172 Ketokonazol Krim 2 % @ 10 gr Tube 46 - - -
173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 370 - - -
174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - -
175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - -
176 Ketorolak Inj 30 mg/ml Ampule - - - -
177 0 0 - - - -
178 Kloramfenikol 1% Salep Mata (KF) Tube 260 - - -
179 0 0 - - - -
180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma) Vial - - - -
181 Kloramfenikol Tetes Telinga :Kloramfenicol 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - - -
182 Kloramfenikol Tetes Telinga : Kloramfenicol 10%,Lidocain,Proplylenglycol / COLME (Interbat) Tube - - - -
183 0 0 - - - -
184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - - -
185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 7,570 - - -
186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - -
187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - -
188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - -
189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,938 - - -
190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg Tablet - - - 3,000
191 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol - - - -
192 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol 200 - - -
193 Krim Analgesik (setiap gram mengandung : Metyl Salisilat 102 mg, Eugenol 13,6 mg; Methol 53,4 mg, Vinishing Cream ad 1 gr/ MOLAKRIM Tube 12 - - 24
194 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma) Tube 20 - - -
195 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma) Tube - - - -
196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet - - - -
197 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet 49 - - -
198 0 0 - - - -
199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 380 - - 510
201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
202 Loperamid Tablet 2 mg ( Ifars) Tablet 200 - - -
203 Loperamid Tablet 2 mg Tablet - - - -
204 Loratadin Tablet 10 mg Tablet 146 - - -
205 Loratadin Tablet 10 mg Tablet - - - -
206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet 360 - - -
207 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet 180 - - -
208 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
209 0 0 - - - -
210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - -
211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 77 50 - -
212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - 500 1,000
213 Metformin HCl Tablet 500 mg Tablet 473 - - -
214 Metformin HCl Tablet 500 mg Tablet 2,000 - - -
215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 200 - - -
216 0 0 - - - -
217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - -
220 Metronidasol 500 mg tablet (Novapharin) Tablet - - - -
221 Metronidasol 500 mg tablet (Novagyl) Tablet - - 300 2,000
222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - -
223 Metronidasol Infus 500mg/100ml Botol - - - -
224 Minyak Kayu Putih 60 ml Botol - - - -
225 Kapsul
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Zink 20 mg, Beta Caroten 10000 IU, Selenium 30 mcg (LICOXY)
- - - -
226 Multivitamin + Pelancar Asi (NULACVIT) Tablet 870 - - -
227 Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / MERSIBION Ampule - - - -
228 Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - - -
229 Multivitamin Vitamin/ Suplemen (BECEFORT) tablet - - - -
230 Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex Ayus ) Tablet - - - -
231 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
62 - - -
232 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
- - - 192
233 Multivitamin Neurotopic Plus ATP Tablet:B1 100,B6 200,B12 200Mcg,Vit E 30mg, ATP 20mg / Bio ATP (Phapros) Tablet - - - -
234 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) Tablet - - - -
235 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) tablet - - - -
236 Tablet
Multivitamin Tab Tambah Darah : per Tablet Mengandung : Femofomarrat 300mg Mgso4 0,4mg,Cuso4 0,4 mg,Vit C 100mg ,Asam Folat 2 Mg,Vit B 12 15Mcg,Faktor Intirinsik 25mg / HEMAFORT ( Phapros )
25,300 - - -
237 Natrium Diklofenak Tab 50 mg (Phapros ) I Tablet - - - -
238 Natrium Diklofenak Tab 50 mg (Phapros ) II Tablet 660 - - -
239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - 1,000
240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - -
241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - 139 - -
242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 70 - - -
243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - -
244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - - -
245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 11 - - -
246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 27 - - -
247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
248 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - 100
249 Botol
Obat Batuk Herbal : Tiap 15 Ml Vitetrifolia Fill 1 Gr,Zingiber Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Macrocarpa Fruct 0,20 Mg / HERBAKOF (Dexa Medica )
- - - -
250 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Pcs - - - -
251 Botol
OBH Plus Syr : Per 5 ml Megnandung Difenhidramin 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 mg,Na Sitrat 50 mg / SANADRYL
- - - -
252 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Botol - - - -
253 Omeprazole Kapsul 20 mg Tablet - - - -
254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 500 - - 200
255 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule - - - -
256 Tablet
Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus )
- - - -
257 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet - - - -
258 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet - - - -
259 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet - - - -
260 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, / COLPICA (Tropika Mas) Tablet - - - -
261 Propiltiourasil/ PTU 100 mg 0 - - - -
262 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, Tripolidin 2,5 mg / NOZA (Phapros) Tablet - - - -
263 Parasetamol Syrup 120 mg/5ml (Mersi Farma) Botol - - - -
264 Parasetamol Syrup 120 mg/5ml Botol 300 - - 300
265 Parasetamol tablet 500 mg Tablet 1,000 - - -
266 Parasetamol tablet 500 mg Tablet - - - -
267 Parasetamol tablet 500 mg Tablet - - - -
268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 34 - - -
269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 89 - - -
270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - -
271 Piracetam 800 mg Tablet Tablet 62 - - -
272 Parasetamol tablet 500 mg Tablet - - 7,000 15,000
273 Piracetam Injeksi 1gr/ 5ml Ampule 19 - - -
274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - 2,000
275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 3,084 - - -
276 Probiotik Sachet (Probiokid) 0 - - - -
277 Polikresulen (Albotyl,Apetil) Botol - - - -
278 Prednison Tab 5 mg Tablet - - - -
279 Prednison Tab 5 mg (Holi Pharma) Tablet 3,194 - - 4,000
280 Prednison Tab 5 mg Tablet - - - -
281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - -
282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 600 - - -
283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - -
284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 1,836 - - 2,000
285 0 0 - - - -
286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - 100 - 300
288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - - -
289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol 320 - - -
290 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
291 Salbutamol SO4 3,01 mg + Ipratonium Brom 0,52 mg Nebulizer (COMBIVENT) I dan II Nebule 285 - - -
292 0 0 - - - -
293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - - -
294 Salbutamol Tab 4 mg (Pristasma) Tablet - - 500 1,000
295 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot 64 - - 120
296 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot - - - -
297 Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - - -
298 Salisil Bedak Serbuk 2% Pcs - - - -
299 Salisil Bedak Serbuk 2% Pcs - - - 60
300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - -
301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 2 - - 1
302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - -
303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 50 - - 60
304 Setirizin Tab 10 mg (Futamed) Tablet 20 - - -
305 Setirizin Tab 10 mg (Futamed) Tablet - - - -
306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 1,178 - - -
307 Simvastatin Tablet 10 mg Tablet - - - -
308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
309 0 0 - - - -
310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - -
311 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol 25 - - -
312 Tetes mata setiap ml mengandung Polietilen glikol 400 1% gliserin 0.25% Hidroksipropil metil selulosa 0,2% VISINE Botol - - - -
313 Tetrasiklin HCl Kapsul 500 mg Tablet - - - -
314 Thiamin/ Vitamin B1 50 mg Tablet - - - -
315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - - -
316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 928 - - 2,500
317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - -
318 Thiamphenicol Kapsul 500 mg Tablet - - - 1,000
319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 29 - - -
320 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Molex Ayus) Kapsul - - - -
321 Vitamin B Komplek Tablet - - 3,000 3,000
322 Vitamin B Komplek Plus Ekstrak Hati (Substansi Hati Kering 100 mg, Vit B1 HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, CuSO4 0,65 mg) LIVRPON B-PLEX
Tablet - - - -
0 OBAT GOLONGAN PSIKOTROPIKA 0 - - - -
323 Alprazolam 0,5 mg (Mersi Farma) Tablet - - - -
324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
327 0 0 - - - -
328 0 0 - - - -
329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - 3 - -
332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - 3
335 Diazepam Tablet 5 mg (VALISANBE) Tablet 87 - - 300
336 Diazepam Tablet 5 mg Tablet - - - -
337 Fenobarbital Tablet 30 mg Tablet - - - -
338 Fenobarbital Tablet 30 mg Tablet - - - -
339 Fenobarbital Tablet 30 mg tablet - - - -
340 Kodein Tablet 10 mg Tablet - - - -
341 0 0 - - - -
342 Lorazepam Tab 2 mg (Mersi Farma) Tablet - - - -
343 Metamizol 500 mg + Diazepam 2 mg / PRONEURON (Meprofarm) Tablet - - - -
344 0 0 - - - -
345 0 0 - - - -
346 0 0 - - - -
347 Primaquin 15 mg tablet tablet - - - -
348 0 0 - - - -
0 OBAT - OBAT PROGRAM 0 - - - -
0 OBAT PROGRAM KECACINGAN 0 - - - -
349 Albendazol Tablet 400 mg Tablet 262 - - -
350 Albendazol Tablet 400 mg Tablet - 2,820 - -
0 OBAT PROGRAM DIARE 0 - - - -
351 Garam Oralit (Kimia Farma) Tablet - - - -
352 Garam Oralit (Kimia Farma) Tablet 895 - - 700
353 Garam Oralit (Kimia Farma) sachet - - - -
354 Garam Oralit (Kimia Farma) sachet - - - -
355 0 0 - - - -
356 Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined imperial) Botol 50 - - -
357 Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - -
358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - - -
359 Zinc Dispersible 20 mg tablet tablet - - - -
360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 5,199 - - -
362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
363 0 0 - - - -
0 OBAT PROGRAM HEPATITIS 0 - - - -
364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - 2 -
0 OBAT PROGRAM TB PARU 0 - - - -
369 OAT FDC Kategori Anak Kit - - - -
370 OAT FDC Kategori Anak Kit - - - -
371 OAT FDC Kategori Anak Kit - - - -
372 OAT FDC Kategori I - IIII Kit - - - -
373 OAT FDC Kategori I - IIII Kit - - - 11
374 OAT FDC Kategori II Kit - - - -
375 OAT FDC Kategori II Kit - - - -
376 OAT FDC Kategori II Kit - - - 1
377 OAT FDC Kombipak Kategori I Kit - - - -
378 0 0 - - - -
379 Isoniazid 100 mg tablet tablet - - - -
0 OBAT POGRAM KUSTA 0 - - - -
380 MDT MB Anak Blister - - - -
381 MDT MB Anak Blister - - - -
382 MDT MB Dewasa Blister - - - -
383 MDT MB Dewasa Blister - - - -
384 MDT MB Dewasa Blister - - - -
385 MDT PB Anak Blister - - - -
386 MDT PB Anak Blister - - - -
387 MDT PB Anak Blister - - - -
388 MDT MB Dewasa Blister - - - 24
389 MDT PB Dewasa Blister - - - -
0 OBAT PROGRAM GIZI 0 - - - -
390 Mineral Mix Kombinasi sachet - - - -
391 Mineral Mix Kombinasi sachet - - - -
392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - -
393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 70 3,400 - -
394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - -
395 Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
396 Retinol Vit A 100.000 IU (Biru) Kapsul - 50 - -
Retinol Vit A 100.000 IU (Biru) Kapsul - 300 - -
398 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet - - - -
399 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet - 46,700 - -
400 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) tablet - - - -
401 0 0 - - - -
402 0 0 - - - -
0 OBAT PROGRAM KESGA 0 - - - -
403 Calcii Gluconas Inj (Ethica) Ampule 10 - - -
404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 2 - - -
405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - 18
406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - -
407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - 100
408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 50 - - -
410 Oksitetrasiklin 1 % Salep Mata Tablet - - - -
411 Metilergometrin Maleat Tablet 0,125 mg Tablet 630 - - -
412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 172 - - 200
414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
0 OBAT PROGRAM JIWA 0 - - - -
416 Amitriptilin 25 mg Tablet - - - -
417 Amitriptilin 25 mg Tablet - - - -
418 Amitriptilin 25 mg Tablet - - - -
419 Amitriptilin 25 mg Tablet 160 - - -
420 Amitriptilin 25 mg Tablet - - - -
421 Clozapine 25mg (OGB Dexa) Tablet - - - -
422 Clozapine 100 mg Tablet - - - -
423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - 300
426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - -
427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - -
428 Flufenazin sikzonoate inj 5 ml vial - - 10 -
429 Flufenazin sikzonoate inj 5 ml Vial - - - -
430 Haloperidol 5 mg tablet Tablet - - - -
431 Haloperidol 5 mg tablet Tablet 2,945 - - -
432 Haloperidol 5 mg tablet Tablet - - - -
433 0 0 - - - -
434 Haloperidol Injeksi 5 mg/ml ampule - - - -
435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - -
436 Haloperidol/ Lodomer drops 2 mg Botol - - - 10
437 Karbamazepin Tablet 200 mg Tablet - - - -
438 Karbamazepin Tablet 200 mg Tablet - - - -
439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - - -
440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - - -
442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 2,957 - - -
443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
444 0 0 - - - -
445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - -
446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - -
447 Risperidon Tab 2 mg Tablet 914 - 800 -
448 Risperidon Tab 2 mg Tablet - - - 1,000
449 0 0 - - - -
450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - -
451 0 0 - - - -
452 Triheksifenidil Tablet 2 mg (Mersi) Tablet 121 - - -
453 Triheksifenidil Tablet 2 mg Tablet 3,000 - - -
454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - -
455 0 0 - - - -
456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - -
457 0 0 - - - -
0 PROGRAM IMUNISASI (VAKSIN) 0 - - - -
458 BCG vial 49 20 30 -
459 PELARUT BCG ampul 49 20 30 -
460 BCG vial - - - -
461 BCG vial - - - -
462 CAMPAK 10ds (MR) vial 49 - - -
463 PELARUT CAMPAK ampul 89 20 30 10
464 CAMPAK 10ds (MR) vial 52 20 30 10
465 CAMPAK 10ds (MR) vial - - - -
466 DPT HB - Hib/ PENTABIO vial 102 15 - -
467 DPT HB - Hib/ PENTABIO vial - 45 60 70
468 DT vial - - - -
469 0 0 - - - -
470 HB UNIJECT/ HB - ADS / HEPATITIS B vial 50 - 20 -
471 HB UNIJECT/ HB - ADS / HEPATITIS B vial 90 - - -
472 POLIO bOPV 10 ds vial 50 - - -
473 DROPPER POLIO dropper 93 50 50 10
474 POLIO bOPV 10 ds vial 43 - - -
475 POLIO bOPV 10 ds vial - 50 - -
476 Td vial 9 10 10 -
477 0 0 - - - -
478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - 50 30 -
479 POLIO bOPV 10 ds vial - - 50 10
480 Vaksin Meningtis vial - - - -
481 CAMPAK 10ds (MR) BIAS vial - - 90 -
482 PELARUT CAMPAK BIAS ampul - - 90 -
483 POLIO bOPV 10 ds vial - - - -
484 IPV vial - - - -
485 VTM Include Dacron (Biofarma) pcs - - - -
486 Vaksin Rabies (Verorab) vial - - - -
487 0 0 - - - -
488 0 0 - - - -
489 0 0 - - - -
0 OBAT PROGRAM HIV/ AIDS 0 - - - -
490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - -
491 0 0 - - - -
492 Isoniazid (INH) Tablet 300 mg Tablet 260 - - -
493 0 0 - - - -
494 Lamivudine 150 mg Tablet - - - -
495 Lamivudine 150 mg Tablet - - - -
496 Nevirapine 200 mg Tablet - - - -
497 Nevirapine 200 mg Tablet - - - -
498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - -
499 0 0 - - - -
500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
501 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
502 Tenofovir 300 mg Tablet - - - -
503 Tenofovir 300 mg Tablet - - - -
504 Zidofudine 100 mg (ZDV) Tablet - - - -
505 Zidofudine 100 mg (ZDV) Tablet - - - -
506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
508 Efavirenz 600 mg tablet tablet - - - -
509 Efavirenz 600 mg tablet tablet - - - -
510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
511 Abacavir (ABC) 300mg Tablet - - - -
512 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
513 0 0 - - - -
514 MB Anak blister - - - -
515 0 0 - - - -
516 0 0 - - - -
517 0 0 - - - -
518 0 0 - - - -
519 0 0 - - - -
520 0 0 - - - -
521 0 0 - - - -
522 0 0 - - - -
523 0 0 - - - -
524 0 0 - - - -
525 0 0 - - - -
526 0 0 - - - -
527 0 0 - - - -
528 0 0 - - - -
529 0 0 - - - -
0 BMHP 0 - - - -
530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - -
531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 14 - - -
532 0 0 - - - -
533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs 2,535 - - -
535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - 1,500
536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 1,000 - 100 -
537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - -
538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - -
540 Alat Suntik Sekali Pakai 20 ml Pcs - - - 50
541 Alkohol 70% Medika (Kimia Farma) 0 - - - -
542 Alkohol 70% (Medika) Btl 1000 ml - - - -
543 Alkohol Swab 2 - ply (one med) 0 - - - -
544 Alkohol Swab 2 - ply (one med) Pcs 500 - - 300
545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - 2 1 -
546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - -
547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 120 - - 60
548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - - -
549 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I 0 - - - -
550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda Pcs - - - -
551 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda 0 - - - -
552 Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - -
553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - - -
554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
556 Fixomull Strech 5 cm X 5 m Pcs - - - -
557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 23 - - -
558 Foley Catheter 2 Way Ch 16,18 Pcs - - - 40
559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - -
560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - - -
561 Mantel Gown (Bisa Dicuci) biji - - - -
562 I.V Catheter No. 18 (JELCO) Pcs - - - -
563 I.V Catheter No. 18 (NIPRO) Pcs 73 - - 100
564 I.V Catheter No. 20 JELCO Pcs - - - -
565 I.V Catheter No. 20 TERUMO Pcs 150 - - -
566 I.V Catheter No. 20 JELCO Pcs - - - 200
567 I.V Catheter No. 22 NIPRO Pcs - - - -
568 I.V Catheter No. 22 NIPRO Pcs 249 - - 200
569 I.V Catheter No. 24 TERUMO Pcs 151 - - -
570 I.V Catheter No. 24 TERUMO 0 - - - 100
571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - - -
572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 100 - - -
573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
574 Infusion Set Dewasa 20 Drops/ (OTSUKA) Pcs 400 - - 300
575 Kantong Plastik Bio Hazart (Bahan Plastik PE, Panjang 80 Cm, Lebar 60 Cm, Tebal 0,33 Mm) Pcs - - - -
576 Kapas Pembalut Hydrofil 250 gr Pcs - - - -
577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 10 - 5 15
578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - -
579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - - -
580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 8 - - 10
581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - -
582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - - -
583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 50 - - -
584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - -
585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - - -
586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 90 - - 100
587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - -
588 Masker Ear Loop (Masker) Pcs - - - -
589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - -
590 Masker General Care (MARCOTILA) Pcs - - - -
591 0 0 - - - -
592 Masker N95 Disposibel Pcs - - - -
593 Masker N95 Disposibel (One Med) Pcs - - - -
594 Masker Tali Pcs - - - -
595 Masker Tali Pcs - - - -
596 Masker Elastic Pcs - - - -
597 Media Sample Container Pcs 120 1,000 - -
598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - -
599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - -
600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - 13 -
601 Nurse Cup (Tutup Kepala) Pcs 50 - - -
602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - -
603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - -
604 Plesterin Bulat Non Woven (One Med) Pcs - - - -
605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 23 - - -
606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 54 54 - 54
607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 9 - - 5
608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - 50
609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - - -
610 0 0 - - - -
611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - -
612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - -
613 0 0 - - - -
614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair 100 - - -
615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - -
616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - - -
617 Sarung Tangan size M dan L (Exam Glove) PAir - - 300 -
618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 300 - - -
619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - -
620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 48 - - 60
621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - -
622 0 0 - - - -
623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - -
624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - - -
625 Underpad 90x 0 cm cosmo I Pcs 25 - - 30
626 Underpad 90x 0 cm cosmo II Pcs - - - -
627 0 0 - - - -
628 Urine Bag Sterile Standard Pcs 13 - - -
629 Urine Bag Sterile Standard (AXIMED) Pcs - - - 60
630 0 0 - - - -
631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - 200
0 REAGEN 0 - - - -
632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - -
633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - -
634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 600 - - -
635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - -
636 Antimonoclonal A (Anti A) 10 ml Btl - - - -
637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - -
638 Antimonoclonal B (Anti B) 10 ml Btl - - - -
639 0 0 - - - -
640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - -
641 Cholesterol Test Strip (Human Humasens Plus) 0 - - - -
642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - -
643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - -
644 Glucose Test Strip (Human Humasens plus) Tes - - - -
645 Glucose Test Strip (Human Humasens plus) II Tes - - - -
646 Hemoglobin Strip 50 test mission (Acon) Pcs 1 - - 10
647 Hemoglobin Strip 50 test mission (Acon) 0 - - - -
648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - -
649 0 0 - - - -
650 Reagen HBsAg Strip (FOKUS) Test - - - -
651 0 0 - - - -
652 TPHA (Fokus) Test - - - -
653 0 0 - - - -
654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - -
655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - -
0 BMHP (PROGRAM) PROPINSI 0 - - - -
0 PROGRAM MALARIA 0 - - - -
656 RDT Malaria Test - - - -
0 PROGRAM SYPHILIS 0 - - - -
657 RPR Syphilis Pcs 100 - - -
658 RPR Syphilis tahap II (FOKUS) Pcs - - - -
659 Syphilis 3.0 06FK10 SD Bioline Test 300 - - -
Test
660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
 Test
661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
662 0 0 - - - -
663 Tuberkulin Vial - - - -
664 RDT Lepto (Uji Leptospira IgM) test - - - -
665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - -
666 0 0 - - - -
667 0 0 - - - -
0 PROGRAM HEPATITIS 0 - - - -
Rapid Test Anti Hepatitis C (HCV)
668 Test - - - -
669 Reagen HBsAg Strip SD Test - - - -
670 Reagen HBsAg Strip SD Test 350 - - -
671 Reagen HBsAg Strip SD Test - - - -
672 0 0 - - - -
673 0 0 - - - -
674 0 0 - - - -
675 0 0 - - - -
0 PROGRAM TB PARU 0 - - - -
676 Box Slide Pcs - - - -
677 Box Slide Pcs - - - -
678 Catridge Genexpart Test - - - -
679 Catridge Genexpart Test - - - -
680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - -
681 Oil Emersi Botol - - - -
682 Pot Spuntum/Pot Dahak Steril Pcs - - - -
683 Pot Spuntum/Pot Dahak Steril Pcs - - - -
684 Pot Spuntum/Pot Dahak Steril Pcs - - - -
685 Pot Spuntum/Pot Dahak Steril Pcs - - - -
686 Reagen Control CD4 0 - - - -
687 Reagen Control CD4 0 - - - -
688 Reagen Zeil Nelseen Kit - - - -
689 Reagen Zeil Nelseen Kit - - - -
690 Reagen Zeil Nelseen Kit - - - -
691 Reagen Zeil Nelseen Kit - - - -
692 Slide Pcs - 10 - -
693 Slide/ Object Glass Pcs - - - -
694 Stereofoam pcs - - - -
695 Masker N 95 TB pcs - - 30 -
696 Masker Tali Bedah TB pcs - - - -
0 OBAT PROGRAM IMUNISASI 0 - - - -
697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - 500
700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - 800 -
703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
708 0 0 - - - -
709 0 0 - - - -
710 0 0 - - - -
711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 286 - - -
712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
714 0 0 - - - -
715 Safety Box 5 L Pcs - - 25 -
716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
717 0 0 - - - -
718 0 0 - - - -
719 0 0 - - - -
720 0 0 - - - -
0 PROGRAM HIV/ AIDS 0 - - - -
721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Tahap I Test 50 - - -
722 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Reagen R3 0 - - - -
723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test - - - -
724 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) (Reagen R2) 0 - - - -
725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test 50 - - -
726 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I 0 - - - -
727 Kondom Pcs - - - -
728 DBS Collection/ Lasec Pcs - - - -
729 Lubricant Pcs - - - -
730 0 0 - - - -
731 Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap I Test 900 - - -
732 Rapid HIV 1/2 3.0 SD Bioline test - - - -
733 Reagen HIV (FOKUS) R 2 Test - - - -
734 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I Test - - - -
735 Reagen HIV (SD) R 1 Test - - - -
736 Reagen HIV (SD) R 1 Test - - - -
737 0 0 - - - -
738 Reagen HIV (VIKIA) R 3 Test - - - -
739 0 0 - - - -
740 Reagen HIV R2 (Rapid Test) FOKUS Test - - - -
741 0 0 - - - -
742 Reagen HIV R3 (VIKIA) Test - - - -
743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - -
744 Sarung Tangan Non Steril Pair - - - -
745 0 0 - - - -
746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - -
747 VTM Include Swab Test - - - -
748 Masker Bedah 3 ply Pcs - - - -
749 0 0 - - - -
750 0 0 - - - -
751 0 0 - - - -
752 0 0 - - - -
753 0 0 - - - -
754 0 0 - - - -
755 0 0 - - - -
756 0 0 - - - -
757 0 0 - - - -
758 0 0 - - - -
759 0 0 - - - -
760 0 0 - - - -
761 0 0 - - - -
762 0 0 - - - -
763 0 0 - - - -
764 0 0 - - - -
0 OKSIGEN MEDICAL 0 - - - -
765 Oksigen 3 m3 Tampon - - - -
766 Oksigen 6 m3 Tampon - - - -
767 Oksigen 1 m3 Tampon - - - -
768 Oksigen 6 m3 Tampon - - - -
769 Nurse Cup (Tutup Kepala) One Med 0 - - - -
770 0 0 - - - -
771 0 0 - - - -
772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - -
0 TAMBAHAN IFK 0 - - - -
1 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - -
2 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
3 Ranitidin Tablet 150 mg Tablet - - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg
4 Tablet - - - -
5 Thiamphenicol Syr. 0 - - - -
6 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - -
7 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
8 Ranitidin Injeksi 25 mg/ 2 ml Ampule 300 - - -
9 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - -
10 Ketokonazole 200 mg Tablet - - - -
11 Kotrimoksazol Forte Tablet - - - -
12 Infusion set anak Pcs 50 - - -
13 Alat Suntik 10 cc Pcs - - - -
14 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
15 Omeprazole Kapsul 20 mg Tablet - - - -
16 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - 360 - -
17 Setirizin Tab 10 mg (Futamed) Tablet - - - -
18 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
19 Oseltamivir 75 mg Kapsul - - - -
20 Ringer Laktat cairan infus @ 500 ml RL Botol - 1,500 - -
21 Amitriptilin 25 mg Tablet - - - -
22 I.V Catheter No. 24 TERUMO pcs - - - -
23 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 1 - - -
24 RDT COVID - 19 0 - - - -
25 Oseltamivir 75 mg 0 - - - -
26 Klorokuin 150 mg tablet 0 - - - -
27 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 - - - -
28 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 - - - -
29 Masker N95 (Particulate Respirator) 0 - - - -
30 Hazmat/ APD/ Hazmat PPK 0 - 30 - -
31 Medical Sample Container Pcs - - - -
32 Cepheid Pcs - - - -
33 Natrium Klorida Larutan infus 0,9% @100ml 0 - - - -
34 Tambah Darah drop (Ferriz Drop) pcs - - 200 -
35 Tambah Darah Sirup (Ferriz Sirup) pcs - - 200 -
36 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - -
37 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
38 Obat Batuk Sirup / INADRYL Botol - - - -
39 Obat Batuk Expektoran Sirup Botol - - - -
40 Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate, dextromethorpan Hbr
Tablet - - - -
41 Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Influenza Tablet - - - -
42 Masker Bedah /Bima Sakti pCS - - - -
43 Masker Bedah /Rania pCS - - - -
44 Masker N 95 Bima Sakti PCS - - - -
45 Sarung tangan panjang steril / meditouche perpasang 0 - - - 25
46 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - 6,000
47 Albendazol Suspensi 200mg/ 5 ml botol - - 300 -
48 I.V Catheter No. 24 (BRAUN) pcs - - - -
49 OAT FDC Kategori Anak 0 - - - -
50 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - -
51 Apron Lengan Panjang Putih (Rannia) 0 - - - -
Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
APD Set (Rannia) 0 5 3 - -
Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - - -
Cover All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 0 4 - - -
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya Mitra Bersama) 0 - - - -
Helm visor (Usaha Karya Mitra Bersama) 0 - - - -
Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - -
Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - -
Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - - -
Sarung tangan non steril M,L (COBRA) box @100 pcs 4,900 - - -
Masker N95 Covid 19 Pcs - - - -
Masker Tali Bedah 3 ply Covid 19 Pcs - - - -
Masker Eaerlop Hijab Pcs 2,000 - - -
Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - - -
Hand Sanitzer 1 Botol = 20 Liter 2 - - -
MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - - -
Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs - 9 - -
KIT A1 Operasi Steril (RAJAWALI) Pcs - - - -
Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - - -
Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - - -
Masker Face/ Masker Bedah (COBRA 1) pcs 200 - - -
Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - -
Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - -
Masker Face/ Masker Bedah (COBRA 2) pcs 1,200 - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - -
Masker KN95 (Farmahusada) Box @50 pcs 20 - - -
Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - 1,200 - -
Rapid Test SARS COV 2 (Farmahusada) Test 21 - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - -
Masker KN95 (Anugrah Sentosa Abadi) pcs - - - -
APRON (Atmosfer) pcs 150 - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - -
Hand Sanitzer 2 liter - - - -
Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - -
Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 34 4 30 -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - -
Face Shield (COBRA) 0 - 7 - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Kit Steril (Rajawali) 0 - - - -
Alkohol II @20 Liter 0 - - - -
Cover All (Rajawali) 0 - 4 - -
Face Shield (ATMOSFER) 0 - - - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Masker Earloop (KasaHusada) 0 - - 1,700 3,400
MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - -
Rapid Test Covid-19 (Rajawali) 0 - - - -
Rapid Test Covid-19 (Dakonan) 0 - - - -
Alkohol Swab (BTT) 0 - - - -
Antiseptic Gel 500 0 - - - -
Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 5,400 - - -
Kaca mata Goggle (HASTEN) 0 - 5 - -
Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - -
Masker Bedah Hijau @50pcs 0 - - - -
Masker N95 3M 8210 (Hazten) 0 - 10 - -
Nurse Cap Green om 100bh 0 - - - -
Parafilm (Anugerah Sentosa Abadi) 0 - - - -
Rapid Test (1.000) Widhi Dharma Adi 0 - - - -
Sarung tangan Safeglove Exam M 100bh 0 - 3,000 3,000 -
Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - -
Sterlisasi Swab stik (5box/ VTM) 0 - - - -
Stereofoam (Anugerah Sentosa Abadi) 0 - - - -
Universal Transport Media (UTM) Goongdong 0 - - - -
Universal Transport Media (UTM) Sekarguna 0 - - - -
Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - -
Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - -
Infusion Set Anak 60 Drops /(Otsuka) 0 - - - -
Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - -
Rapid Test Lecurate (Bima Sakti) 0 - - - 20
Rapid Test ZYBIO (Farma Husada) 0 - - - -
Alkohol 96 % Liter - - 20 -
0 0 - - - -
0 0 - - - -
TAMBAHAN PUSKESMAS 0 - - - -
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - - -
Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - - -
Asiklovir 5% 5gr Cream Tube - - - -
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs - - - -
0 0 - - - -
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - -
Furosemide Tablet 40 mg (Kimia Farma ) Tablet 552 - - -
Gentamycin Krim 1 % mg/ ml Tube - - - -
0 0 - - - -
Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - - -
Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - - -
Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 300 - - -
Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
Thiamin/ Vitamin B1 50 mg Tablet - - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - - -
Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
Antimicrobial Liquid Soap 500 ml (Viorex) 0 4 - - -
Hand Sanitizer 450 ml (Meditol) 0 - - - -
Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
I.V Catheter No. 18 (JELCO) Pcs - - - -
I.V Catheter No. 22 NIPRO Pcs - - - -
I.V Catheter No. 24 TERUMO Pcs - - - -
Materniti Napkin Slim L 0 - - - -
Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - - -
Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - - -
Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - - -
Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - - -
Haloperidol 5 mg tablet Tablet - - - -
Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - -
Fixomull Strech 5 cm X 5 m Pcs - - - -
Umbilical crd clamp 0 126 - - -
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 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -

TOTAL

Mengetahui,
KEPALA PUSKESMAS
.....................................................
AT - OBATAN (ASET) TRIWULAN 3
..... TAHUN 2020

PEMAKAIAN
TOTAL TOTAL SISA SISA
PENERIMAAN
Juli Agust Sept
PEMAKAIAN STOK
Ket Harga Nilai Penerimaan
SEPT

- - - - - - - 1 99.000 0.000
- 5 - - 5 - - 1 105.000 0.000
300 - - - - 300 300 1 105.000 31,500.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 2,860.000 0.000
- 33 16 - 49 131 131 1 2,860.000 0.000
- - - - - - - 1 10,500.000 0.000
- 43 69 - 112 838 838 1 104.000 0.000
- - - - - - - 1 220.000 0.000
- 21 10 - 31 1,969 1,969 1 93.500 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 2,998.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 93.000 0.000
1,200 691 263 - 954 2,970 2,970 1 99.000 118,800.000
- - - - - - - 1 0.000 0.000
- 5,521 2,828 - 8,349 21,659 21,659 1 190.000 0.000
- - - - - - - 1 233.000 0.000
- - - - - - - 1 233.000 0.000
- - - - - - - 1 249.000 0.000
- - - - - - - 1 0.000 0.000
- 78 36 - 114 150 150 1 3,025.000 0.000
- - - - - - - 1 3,025.000 0.000
- - - - - - - 1 4,400.000 0.000
- - - - - - - 1 3,628.000 0.000
- - - - - - - 1 10,246.500 0.000
- - - - - - - 1 9,900.000 0.000
- - - - - - - 1 8,500.000 0.000
- 23 65 - 88 203 203 1 8,237.000 0.000
- - - - - - - 1 0.000 0.000
- - 50 - 50 - - 1 4,950.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 440.000 0.000
 - - - - - - - 1 220.000 0.000
- 2,909 277 - 3,186 50 50 1 165.000 0.000
10,000 - - - - 10,000 10,000 1 58.000 580,000.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 3,035.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - 24 24 1 4,496.000 0.000
- - - - - - - 1 0.000 0.000
30 - - - - 30 30 1 3,045.000 91,350.000
- - - - - - - 1 198.000 0.000
- - - - - - - 1 1,485.000 0.000
- - - - - - - 1 1,551.000 0.000
- 1,215 236 - 1,451 1,517 1,517 1 105.000 0.000
4,000 - - - - 4,000 4,000 1 105.000 420,000.000
- - - - - - - 1 1,050.000 0.000
- - - - - - - 1 67.000 0.000
- - - - - - - 1 75.000 0.000
- - - - - - - 1 103.000 0.000
- - - - - - - 1 253.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - 3 3 1 2,076.000 0.000
- - - - - - - 1 0.000 0.000
- 37 25 - 62 164 164 1 1,584.000 0.000
- - - - - - - 1 0.000 0.000
- 9 4 - 13 112 112 1 2,915.000 0.000
- - - - - - - 1 2,750.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 380.000 0.000
- - 54 - 54 146 146 1 380.000 0.000
- - - - - - - 1 405.000 0.000
- - - - - - - 1 1,639.000 0.000
- - - - - - - 1 1,639.000 0.000
- - - - - - - 1 136.000 0.000
- - - - - - - 1 152.000 0.000
- - - - - 1,675 1,675 1 145.000 0.000
- - - - - - - 1 110.000 0.000
- - - - - - - 1 110.000 0.000
- - - - - - - 1 3,350.000 0.000
- - - - - - - 1 3,350.000 0.000
150 86 17 - 103 250 250 1 3,350.000 502,500.000
- - - - - - - 1 300.000 0.000
- - - - - - - 1 5,900.000 0.000
- - - - - - - 1 626.000 0.000
- - - - - - - 1 18,150.000 0.000
- - - - - - - 1 7,602.000 0.000
- - - - - - - 1 7,124.000 0.000
 - - - - - - - 1 0.000 0.000
- - - - - - - 1 149,266.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 5,280.000 0.000
- 425 220 - 645 185 185 1 660.000 0.000
1,500 - - - - 1,500 1,500 1 671.000 1,006,500.000
- - - - - - - 1 4,282.000 0.000
- 8 - - 8 54 54 1 11,000.000 0.000
- - - - - - - 1 10,098.000 0.000
- - - - - - - 1 2,805.000 0.000
- 17 - - 17 - - 1 1,097.000 0.000
- 26 12 - 38 162 162 1 1,097.000 0.000
- 761 216 - 977 102 102 1 60.500 0.000
2,000 - - - - 2,000 2,000 1 66.000 132,000.000
- - - - - - - 1 10,400.000 0.000
- - - - - - - 1 9,900.000 0.000
180 78 21 - 99 336 336 1 1,095.000 197,100.000
- - - - - - - 1 0.000 0.000
- 119 42 - 161 - - 1 104.000 0.000
200 - - - - 200 200 1 104.000 20,800.000
- - - - - - - 1 104.000 0.000
1,000 659 298 - 957 1,513 1,513 1 105.000 105,000.000
- - - - - - - 1 112.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 4,400.000 0.000
- - - - - - - 1 2,700.000 0.000
500 120 - - 120 500 500 1 165.000 82,500.000
- - - - - - - 1 91.000 0.000
- - - - - - - 1 1,408.000 0.000
- 15 4 - 19 6 6 1 1,408.000 0.000
100 - - - - 100 100 1 1,408.000 140,800.000
- - - - - - - 1 730.000 0.000
100 - 40 - 40 260 260 1 770.000 77,000.000
- - - - - - - 1 391.000 0.000
- - - - - - - 1 4,167.000 0.000
- - - - - - - 1 3,550.000 0.000
- - - - - - - 1 3,682.000 0.000
150 39 1 - 40 203 203 1 3,682.000 552,300.000
- - - - - - - 1 691.000 0.000
- 52 - - 52 63 63 1 710.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 1,333.000 0.000
- - - - - - - 1 1,333.000 0.000
- - - - - - - 1 82.000 0.000
- - - - - - - 1 82.000 0.000
- - - - - - - 1 4,232.000 0.000
 - - - - - - - 1 4,232.000 0.000
- - - - - 112 112 1 4,232.000 0.000
- - - - - - - 1 2,750.000 0.000
24 - - - - 24 24 1 4,400.000 105,600.000
- 33 2 - 35 21 21 1 2,900.000 0.000
- 976 419 - 1,395 4,136 4,136 1 119.000 0.000
- - - - - - - 1 119.000 0.000
- - - - - - - 1 77.000 0.000
- 2,260 945 - 3,205 3,610 3,610 1 99.000 0.000
- 12 - - 12 108 108 1 7,865.000 0.000
- - - - - 14 14 1 10,010.000 0.000
- - - - - - - 1 10,010.000 0.000
- - - - - - - 1 6,900.000 0.000
- 12 28 - 40 - - 1 7,363.000 0.000
- - - - - - - 1 132.000 0.000
- 240 91 - 331 1,036 1,036 1 149.000 0.000
- - - - - - - 1 88.000 0.000
- - - - - - - 1 2,787.000 0.000
120 68 12 - 80 160 160 1 2,475.000 297,000.000
- - - - - - - 1 2,475.000 0.000
- - - - - - - 1 176,800.000 0.000
- - - - - 10 10 1 8,800.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 4,665.000 0.000
216 - 23 - 23 381 381 1 4,665.000 1,007,640.000
12,000 7,336 503 - 7,839 12,061 12,061 1 264.000 3,168,000.000
- - - - - - - 1 330.000 0.000
- - - - - - - 1 660.000 0.000
- - - - - - - 1 187.000 0.000
- 37 27 - 64 191 191 1 90.000 0.000
- - - - - - - 1 89.000 0.000
- - - - - - - 1 121.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 9,644.000 0.000
- - - - - - - 1 10,696.000 0.000
200 8 10 - 18 182 182 1 10,696.000 2,139,200.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 770.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - 100 100 1 1,755.000 0.000
- 2,917 616 - 3,533 2,927 2,927 1 187.000 0.000
5,000 - - - - 5,000 5,000 1 63.000 315,000.000
- - - - - - - 1 63.000 0.000
- 3,723 266 - 3,989 1,217 1,217 1 94.600 0.000
3,000 - - - - 3,000 3,000 1 99.000 297,000.000
- - - - - - - 1 5,610.000 0.000
 - 17 3 - 20 26 26 1 2,518.000 0.000
- 10 - - 10 360 360 1 396.000 0.000
- - - - - - - 1 288.000 0.000
- - - - - - - 1 288.000 0.000
- - - - - - - 1 1,089.000 0.000
- - - - - - - 1 0.000 0.000
- 94 15 - 109 151 151 1 1,810.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 10,500.000 0.000
- - - - - - - 1 17,968.500 0.000
- - - - - - - 1 35,200.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 22.000 0.000
- 2,217 172 - 2,389 5,181 5,181 1 77.000 0.000
- - - - - - - 1 23.000 0.000
- - - - - - - 1 2,750.000 0.000
- - - - - - - 1 495.000 0.000
- 380 180 - 560 1,378 1,378 1 440.000 0.000
3,000 - - - - 3,000 3,000 1 319.000 957,000.000
- - - - - - - 1 2,052.000 0.000
- 60 5 - 65 135 135 1 2,190.000 0.000
24 12 - - 12 24 24 1 13,970.000 335,280.000
- 6 1 - 7 13 13 1 22,550.000 0.000
- - - - - - - 1 23,100.000 0.000
- - - - - - - 1 3,811.500 0.000
- 45 4 - 49 - - 1 6,600.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 1,937.000 0.000
510 302 41 - 343 547 547 1 2,178.000 1,110,780.000
- - - - - - - 1 1,222.000 0.000
- 48 18 - 66 134 134 1 99.000 0.000
- - - - - - - 1 330.000 0.000
- 14 - - 14 132 132 1 123.000 0.000
- - - - - - - 1 131.000 0.000
- - - - - 360 360 1 4,680.500 0.000
- - - - - 180 180 1 4,730.000 0.000
- - - - - - - 1 550.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 4,950.000 0.000
50 127 - - 127 - - 1 5,500.000 275,000.000
1,500 - 164 - 164 1,336 1,336 1 3,707.000 5,560,500.000
- 362 111 - 473 - - 1 96.000 0.000
- - 155 - 155 1,845 1,845 1 102.000 0.000
- 17 20 - 37 163 163 1 143.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 87.000 0.000
 - - - - - - - 1 80.000 0.000
- - - - - - - 1 121.000 0.000
- - - - - - - 1 192.500 0.000
2,300 - 86 - 86 2,214 2,214 1 275.000 632,500.000
- - - - - - - 1 8,110.000 0.000
- - - - - - - 1 8,110.000 0.000
- - - - - - - 1 14,318.700 0.000
- - - - - - - 1 5,500.000 0.000
- 480 30 - 510 360 360 1 2,090.000 0.000
- - - - - - - 1 5,000.000 0.000
- - - - - - - 1 4,400.000 0.000
- - - - - - - 1 1,265.000 0.000
- - - - - - - 1 990.000 0.000
- 58 4 - 62 - - 1 13,200.000 0.000
192 - - - - 192 192 1 13,167.000 2,528,064.000
- - - - - - - 1 2,332.000 0.000
- - - - - - - 1 528.000 0.000
- - - - - - - 1 594.000 0.000
- 21,602 540 - 22,142 3,158 3,158 1 835.000 0.000
- - - - - - - 1 115.000 0.000
- 390 163 - 553 107 107 1 123.000 0.000
1,000 - - - - 1,000 1,000 1 123.000 123,000.000
- - - - - - - 1 6,410.000 0.000
139 36 58 - 94 45 45 1 6,410.000 890,990.000
- 70 - - 70 - - 1 132.000 0.000
- - - - - - - 1 3,948.000 0.000
- - - - - - - 1 23,141.800 0.000
- - 11 - 11 - - 1 19,800.000 0.000
- 7 - - 7 20 20 1 560.000 0.000
- - - - - - - 1 560.000 0.000
100 - - - - 100 100 1 598.000 59,800.000
- - - - - - - 1 12,100.000 0.000
- - - - - - - 1 24,860.000 0.000
- - - - - - - 1 9,955.000 0.000
- - - - - - - 1 25,597.000 0.000
- - - - - - - 1 160.000 0.000
200 164 54 - 218 482 482 1 1,070.000 214,000.000
- - - - - - - 1 1,124.000 0.000
- - - - - - - 1 715.000 0.000
- - - - - - - 1 432.300 0.000
- - - - - - - 1 437.800 0.000
- - - - - - - 1 418.000 0.000
- - - - - - - 1 357.500 0.000
- - - - - - - 1 495.000 0.000
- - - - - - - 1 789.800 0.000
- - - - - - - 1 1,181.000 0.000
 300 193 59 - 252 348 348 1 1,181.000 354,300.000
- 1,000 - - 1,000 - - 1 53.000 0.000
- - - - - - - 1 56.000 0.000
- - - - - - - 1 53.000 0.000
- 2 - - 2 32 32 1 20,700.000 0.000
- 33 7 - 40 49 49 1 11,825.000 0.000
- - - - - - - 1 11,825.000 0.000
- 50 12 - 62 - - 1 963.600 0.000
22,000 - 1,280 - 1,280 20,720 20,720 1 115.500 2,541,000.000
- 19 - - 19 - - 1 4,400.000 0.000
2,000 - - - - 2,000 2,000 1 132.000 264,000.000
- 951 387 - 1,338 1,746 1,746 1 123.000 0.000
- - - - - - - 1 6,600.000 0.000
- - - - - - - 1 41,500.000 0.000
- - - - - - - 1 68.000 0.000
4,000 2,413 287 - 2,700 4,494 4,494 1 73.000 292,000.000
- - - - - - - 1 73.000 0.000
- - - - - - - 1 1,000.000 0.000
- 81 87 - 168 432 432 1 1,155.000 0.000
- - - - - - - 1 1,188.000 0.000
2,000 1,245 346 - 1,591 2,245 2,245 1 220.000 440,000.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 9,646.000 0.000
400 8 92 - 100 300 300 1 9,646.000 3,858,400.000
- - - - - - - 1 7,150.000 0.000
- 320 - - 320 - - 1 7,150.000 0.000
- - - - - - - 1 7,630.000 0.000
- 47 14 - 61 224 224 1 4,550.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 70.000 0.000
1,500 - 94 - 94 1,406 1,406 1 165.000 247,500.000
120 48 6 - 54 130 130 1 2,620.000 314,400.000
- - - - - - - 1 2,796.000 0.000
- - - - - - - 1 6,006.000 0.000
- - - - - - - 1 5,170.000 0.000
60 - - - - 60 60 1 2,200.000 132,000.000
- - - - - - - 1 479,996.000 0.000
1 1 - - 1 2 2 1 512,204.000 512,204.000
- - - - - - - 1 130,999.000 0.000
60 34 5 - 39 71 71 1 130,999.000 7,859,940.000
- 4 4 - 8 12 12 1 90.000 0.000
- - - - - - - 1 90.000 0.000
- 344 134 - 478 700 700 1 110.000 0.000
- - - - - - - 1 117.000 0.000
- - - - - - - 1 265.000 0.000
- - - - - - - 1 0.000 0.000
 - - - - - - - 1 6,789.000 0.000
- 2 - - 2 23 23 1 6,789.000 0.000
- - - - - - - 1 13,607.000 0.000
- - - - - - - 1 310.000 0.000
- - - - - - - 1 86.000 0.000
- - - - - - - 1 132.000 0.000
2,500 838 72 - 910 2,518 2,518 1 91.000 227,500.000
- - - - - - - 1 935.000 0.000
1,000 - - - - 1,000 1,000 1 935.000 935,000.000
- 11 6 - 17 12 12 1 7,150.000 0.000
- - - - - - - 1 7,150.000 0.000
6,000 - 739 - 739 5,261 5,261 1 89.000 534,000.000
- - - - - - - 1 239.800 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 108.000 0.000
- - - - - - - 1 1,045.000 0.000
- - - - - - - 1 967.000 0.000
- - - - - - - 1 776.006 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 12,573.000 0.000
- - - - - - - 1 12,573.000 0.000
3 - - - - 3 3 1 12,573.000 37,719.000
- - - - - - - 1 1,735.000 0.000
- - - - - - - 1 1,735.000 0.000
3 - - - - 3 3 1 19,789.000 59,367.000
300 31 - - 31 356 300 - 396.000 118,800.000
- - - - - - - 1 114.000 0.000
- - - - - - - 1 171.000 0.000
- - - - - - - 1 171.000 0.000
- - - - - - - 1 171.000 0.000
- - - - - - - 1 550.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 779.000 0.000
- - - - - - - 1 1,320.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 278.300 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - 262 - 262 - - 1 404.000 0.000
2,820 - 2,628 - 2,628 192 192 1 431.000 1,215,420.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 257.000 0.000
 700 48 - - 48 1,547 1,547 1 257.000 179,900.000
- - - - - - - 1 274.000 0.000
- - - - - - - 1 274.000 0.000
- - - - - - - 1 0.000 0.000
- 5 2 - 7 43 43 1 6,281.000 0.000
- - - - - - - 1 9,900.000 0.000
- - - - - - - 1 524.000 0.000
- - - - - - - 1 524.000 0.000
- - - - - - - 1 524.000 0.000
- 2,569 - - 2,569 2,630 2,630 1 524.000 0.000
- - - - - - - 1 524.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 1,325,000.000 0.000
- - - - - - - 1 1,325,000.000 0.000
- - - - - - - 1 1,325,000.000 0.000
- - - - - - - 1 1,325,000.000 0.000
2 - 2 - 2 - - 1 1,325,000.000 2,650,000.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 232,518.000 0.000
- - - - - - - 1 248,120.000 0.000
- - - - - - - 1 248,120.000 0.000
- - - - - - - 1 389,344.000 0.000
11 - - - - 11 11 1 415,469.000 4,570,159.000
- - - - - - - 1 1,384,983.000 0.000
- - - - - - - 1 1,384,983.000 0.000
1 - - - - 1 1 1 1,384,983.000 1,384,983.000
- - - - - - - 1 317,018.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 282.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 28,354.000 0.000
- - - - - - - 1 28,354.000 0.000
- - - - - - - 1 40,913.489 0.000
- - - - - - - 1 41,784.000 0.000
- - - - - - - 1 41,784.000 0.000
- - - - - - - 1 8,891.000 0.000
- - - - - - - 1 13,300.000 0.000
- - - - - - - 1 11,738.000 0.000
24 - - - - 24 24 1 36,579.000 877,896.000
- - - - - - - 1 15,014.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 2,920.000 0.000
- - - - - - - 1 2,920.000 0.000
- - - - - - - 1 517.000 0.000
3,400 - 3,170 - 3,170 300 300 1 517.000 1,757,800.000
 - - - - - - - 1 552.000 0.000
- - - - - - - 1 284.000 0.000
50 - 50 - 50 - - 1 307.000 15,350.000
300 - 294 - 294 6 6 1 307.000 92,100.000
- - - - - - - 1 354.000 0.000
46,700 - 2,500 - 2,500 44,200 44,200 1 354.000 16,531,800.000
- - - - - - - 1 354.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- 5 5 - 10 - - 1 9,955.000 0.000
- 2 - - 2 - - 1 3,796.000 0.000
18 - - - - 18 18 1 3,796.000 68,328.000
- - - - - - - 1 10,351.000 0.000
100 - - - - 100 100 1 2,959.000 295,900.000
- - - - - - - 1 2,684.000 0.000
- 23 15 - 38 12 12 1 2,959.000 0.000
- - - - - - - 1 2,500.000 0.000
- 20 - - 20 610 610 1 210.000 0.000
- - - - - - - 1 1,900.000 0.000
200 112 20 - 132 240 240 1 1,199.000 239,800.000
- - - - - - - 1 1,639.000 0.000
- - - - - - - 1 1,199.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 167.000 0.000
- - - - - - - 1 167.000 0.000
- - - - - - - 1 167.000 0.000
- - - - - 160 160 1 167.000 0.000
- - - - - - - 1 167.000 0.000
- - - - - - - 1 1,121.000 0.000
- - - - - - - 1 3,288.000 0.000
- - - - - - - 1 1,200.000 0.000
- - - - - - - 1 1,750.000 0.000
300 - - - - 300 300 1 1,750.000 525,000.000
- - - - - - - 1 183.000 0.000
- - - - - - - 1 63,986.000 0.000
10 - 1 - 1 9 9 1 63,813.000 638,130.000
- - - - - - - 1 57,500.000 0.000
- - - - - - - 1 60.000 0.000
- 468 190 - 658 2,287 2,287 1 60.000 0.000
- - - - - - - 1 60.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 5,000.000 0.000
- - - - - - - 1 13,200.000 0.000
10 - - - - 10 10 1 19,955.000 199,550.000
- - - - - - - 1 245.000 0.000
 - - - - - - - 1 245.000 0.000
- - - - - 3 3 1 1,243.000 0.000
- - - - - - - 1 1,326.000 0.000
- - - - - - - 1 158.000 0.000
- 828 240 - 1,068 1,889 1,889 1 157.000 0.000
- - - - - - - 1 253.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 287.000 0.000
- - - - - - - 1 287.000 0.000
800 240 977 - 1,217 497 497 1 287.000 229,600.000
1,000 - - - - 1,000 1,000 1 287.000 287,000.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 287.000 0.000
- - - - - - - 1 0.000 0.000
- 121 - - 121 - - 1 91.000 0.000
- 1,176 412 - 1,588 1,412 1,412 1 91.000 0.000
- - - - - - - 1 440.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 63,986.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
50 58 5 - 63 36 36 1 56,360.000 2,818,000.000
50 58 5 - 63 36 36 1 0.000 0.000
- - - - - - - 1 60,140.000 0.000
- - - - - - - 1 66,154.000 0.000
- 49 - - 49 - - 1 141,648.000 0.000
60 - - - - 149 149 1 0.000 0.000
60 65 16 - 81 31 31 1 151,150.000 9,069,000.000
- - - - - - - 1 166,265.000 0.000
15 117 - - 117 - - 1 76,620.000 1,149,300.000
175 45 60 - 105 70 70 1 84,282.000 14,749,350.000
- - - - - - - 1 17,450.000 0.000
- - - - - - - 1 0.000 0.000
20 50 20 - 70 - - 1 23,270.000 465,400.000
- 90 - - 90 - - 1 25,597.000 0.000
- 32 18 - 50 - - 1 18,140.000 0.000
110 - - - - 203 203 1 0.000 0.000
- 43 - - 43 - - 1 19,470.270 0.000
50 50 - - 50 - - 1 19,954.000 997,700.000
20 14 - - 14 15 15 1 15,450.000 309,000.000
- - - - - - - 1 0.000 0.000
80 7 6 - 13 67 67 1 21,810.000 1,744,800.000
60 - 5 - 5 55 55 1 19,350.000 1,161,000.000
- - - - - - - 1 135,000.000 0.000
90 - 90 - 90 - - 1 151,150.000 13,603,500.000
90 - 90 - 90 - - 1 0.000 0.000
- - - - - - - 1 21,285.000 0.000
- - - - - - - 1 144,540.000 0.000
- - - - - - - 1 50,000.000 0.000
- - - - - - - 1 165,000.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 34,354.100 0.000
- - - - - - - 1 0.000 0.000
- 58 11 - 69 191 191 1 164.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 90,000.000 0.000
- - - - - - - 1 90,000.000 0.000
- - - - - - - 1 183,480.000 0.000
- - - - - - - 1 176,400.000 0.000
- - - - - - - 1 77.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 79,154.000 0.000
- - - - - - - 1 79,154.000 0.000
- - - - - - - 1 303,750.000 0.000
- - - - - - - 1 252,720.000 0.000
- - - - - - - 1 106,080.000 0.000
- - - - - - - 1 106,080.000 0.000
- - - - - - - 1 222,000.000 0.000
- - - - - - - 1 222,000.000 0.000
- - - - - - - 1 198,900.000 0.000
- - - - - - - 1 198,900.000 0.000
- - - - - - - 1 230,880.000 0.000
- - - - - - - 1 133,137.000 0.000
- - - - - - - 1 84,050.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 22,794.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
 - - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 990.000 0.000
- 14 - - 14 - - 1 1,023.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 924.000 0.000
- 1,562 200 - 1,762 773 773 1 1,138.000 0.000
1,500 - - - - 1,500 1,500 1 924.000 1,386,000.000
100 - - - - 1,100 1,100 1 979.000 97,900.000
- - - - - - - 1 739.200 0.000
- - - - - - - 1 1,463.000 0.000
- - - - - - - 1 32,522.000 0.000
50 - - - - 50 50 1 2,541.000 127,050.000
- - - - - - - 1 23,951.000 0.000
- - - - - - - 1 19,885.446 0.000
- - - - - - - 1 120.000 0.000
300 200 100 - 300 500 500 1 127.260 38,178.000
3 1 - - 1 2 2 1 212,784.000 638,352.000
- - - - - - - 1 70,000.000 0.000
60 62 58 - 120 60 60 1 22,725.000 1,363,500.000
- - - - - - - 1 22,500.000 0.000
- - - - - - - 1 32,522.000 0.000
- - - - - - - 1 24,583.333 0.000
- - - - - - - 1 34,300.000 0.000
- - - - - - - 1 712,800.000 0.000
- - - - - - - 1 348,480.000 0.000
- - - - - - - 1 2,222.000 0.000
- - - - - - - 1 1,540.000 0.000
- - - - - - - 1 37,440.000 0.000
- 16 7 - 23 - - 1 13,050.000 0.000
40 - - - - 40 40 1 9,680.000 387,200.000
- - - - - - - 1 20,970.000 0.000
- - - - - 5 5 1 13,607.000 0.000
- - - - - - - 1 180,000.000 0.000
- - - - - - - 1 8,900.000 0.000
100 35 29 - 64 109 109 1 5,500.000 550,000.000
- - - - - - - 1 8,900.000 0.000
- 86 64 - 150 - - 1 6,270.000 0.000
200 - - - - 200 200 1 8,700.000 1,740,000.000
- - - - - - - 1 5,500.000 0.000
200 215 33 - 248 201 201 1 5,500.000 1,100,000.000
- 46 28 - 74 77 77 1 6,270.000 0.000
100 - - - - 100 100 1 6,270.000 627,000.000
- - - - - - - 1 7,920.000 0.000
- 38 3 - 41 59 59 1 8,400.000 0.000
 - - - - - - - 1 6,199.900 0.000
300 165 76 - 241 459 459 1 8,400.000 2,520,000.000
- - - - - - - 1 1,760.000 0.000
- - - - - - - 1 13,400.000 0.000
20 1 2 - 3 27 27 1 13,400.000 268,000.000
- - - - - - - 1 12,500.000 0.000
- - - - - - - 1 2,300.000 0.000
10 4 4 - 8 10 10 1 136,500.000 1,365,000.000
- - - - - - - 1 136,500.000 0.000
- - - - - - - 1 8,000.000 0.000
- 2 - - 2 48 48 1 5,950.000 0.000
- - - - - - - 1 8,000.000 0.000
- - - - - - - 1 1,430.000 0.000
100 42 48 - 90 100 100 1 2,240.000 224,000.000
- - - - - - - 1 2,100.000 0.000
- - - - - - - 1 427.850 0.000
- - - - - - - 1 390.860 0.000
- - - - - - - 1 2,060.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 17,500.000 0.000
- - - - - - - 1 6,512.000 0.000
- - - - - - - 1 339.900 0.000
- - - - - - - 1 339.900 0.000
- - - - - - - 1 2,200.000 0.000
1,000 - 785 - 785 335 335 1 2,309.375 2,309,375.000
- - - - - - - 1 10,857.000 0.000
- - - - - - - 1 10,856.250 0.000
13 - 1 - 1 12 12 1 65,340.000 849,420.000
- 50 - - 50 - - 1 333.900 0.000
- - - - - - - 1 11,615.000 0.000
- - - - - - - 1 6,600.000 0.000
- - - - - - - 1 154.000 0.000
- 23 - - 23 - - 1 7,700.000 0.000
108 50 - - 50 112 112 1 7,769.000 839,052.000
5 4 1 - 5 9 9 1 18,000.000 90,000.000
50 - - - - 50 50 1 12,675.000 633,750.000
- - - - - - - 1 3,700.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 286,000.000 0.000
- - - - - - - 1 726.953 0.000
- - - - - - - 1 0.000 0.000
- 100 - - 100 - - 1 542.520 0.000
- - - - - - - 1 496.650 0.000
- - - - - - - 1 19,360.000 0.000
300 - - - - 300 300 1 470.530 141,159.000
- 24 - - 24 276 276 1 3,773.000 0.000
 - - - - - - - 1 4,134.900 0.000
60 29 19 - 48 60 60 1 20,586.000 1,235,160.000
- - - - - - - 1 15,150.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 87,120.000 0.000
- - - - - 1 1 1 752,400.000 0.000
30 8 17 - 25 30 30 1 8,295.000 248,850.000
- - - - - - - 1 8,031.579 0.000
- - - - - - - 1 0.000 0.000
- 6 7 - 13 - - 1 5,368.000 0.000
60 - - - - 60 60 1 5,785.000 347,100.000
- - - - - - - 1 0.000 0.000
200 - - - - 200 200 1 2,887.500 577,500.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 453,802.994 0.000
- - - - - - - 1 4,200.000 0.000
- 200 - - 200 400 400 1 635.250 0.000
- - - - - - - 1 4,000.000 0.000
- - - - - - - 1 59,000.000 0.000
- - - - - - - 1 45,000.000 0.000
- - - - - - - 1 45,000.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 546,400.000 0.000
- - - - - - - 1 544,150.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 223,949.367 0.000
- - - - - - - 1 254,300.000 0.000
- - - - - - - 1 252,800.000 0.000
10 1 - - 1 10 10 1 401,666.666 4,016,666.660
- - - - - - - 1 405,000.000 0.000
- - - - - - - 1 10,560.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 10,837.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 19,225.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 552,800.000 0.000
- - - - - - - 1 552,800.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 16,400.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - 100 100 1 4,120.000 0.000
- - - - - - - 1 4,120.000 0.000
- - - - - 300 300 1 15,500.000 0.000
- - - - - - - 1 9,738.000 0.000
 - - - - - - - 1 9,611.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 625,900.000 0.000
- - - - - - - 1 22,176.000 0.000
- - - - - - - 1 66,876.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 13,252.000 0.000
- - - - - - - 1 10,865.800 0.000
- - - - - 350 350 1 8,053.000 0.000
- - - - - - - 1 8,110.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 36,000.000 0.000
- - - - - - - 1 77,690.000 0.000
- - - - - - - 1 825,000.000 0.000
- - - - - - - 1 224,254.000 0.000
- - - - - - - 1 259,175.000 0.000
- - - - - - - 1 70,000.000 0.000
- - - - - - - 1 4,952.830 0.000
- - - - - - - 1 4,952.830 0.000
- - - - - - - 1 2,728.000 0.000
- - - - - - - 1 5,890.000 0.000
- - - - - - - 1 660,000.000 0.000
- - - - - - - 1 158,400.000 0.000
- - - - - - - 1 276,600.000 0.000
- - - - - - - 1 276,500.000 0.000
- - - - - - - 1 257,644.000 0.000
- - - - - - - 1 228,800.000 0.000
10 1 - - 1 9 9 1 20,747.000 207,470.000
- - - - - - - 1 20,748.000 0.000
- - - - - - - 1 6,700.000 0.000
30 - 7 - 7 23 23 1 19,835.000 595,050.000
- - - - - - - 1 386.100 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 1,590.000 0.000
- - - - - - - 1 1,550.000 0.000
500 - - - - 500 500 1 1,463.000 731,500.000
- - - - - - - 1 1,518.000 0.000
- - - - - - - 1 1,190.000 0.000
800 - - - - 800 800 1 1,185.000 948,000.000
- - - - - - - 1 1,463.000 0.000
 - - - - - - - 1 1,190.000 0.000
- - - - - - - 1 1,077.000 0.000
- - - - - - - 1 1,081.820 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- 141 - - 141 145 145 1 1,583.000 0.000
- - - - - - - 1 1,439.000 0.000
- - - - - - - 1 1,439.000 0.000
- - - - - - - 1 0.000 0.000
25 - - - - 25 25 1 22,433.000 560,825.000
- - - - - - - 1 1,460.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - 50 50 1 14,712.500 0.000
- - - - - - - 1 19,480.000 0.000
- - - - - - - 1 13,750.000 0.000
- - - - - - - 1 13,235.000 0.000
- - - - - 50 50 1 12,500.000 0.000
- - - - - - - 1 13,750.000 0.000
- - - - - - - 1 358.000 0.000
- - - - - - - 1 121,750.000 0.000
- - - - - - - 1 486.000 0.000
- - - - - - - 1 0.000 0.000
- 81 - - 81 819 819 1 11,975.000 0.000
- - - - - - - 1 28,666.670 0.000
- - - - - - - 1 13,235.000 0.000
- - - - - - - 1 12,500.000 0.000
- - - - - - - 1 11,975.000 0.000
- - - - - - - 1 11,975.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 19,480.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 13,235.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 19,480.000 0.000
- - - - - - - 1 13,353.000 0.000
- - - - - - - 1 800.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 323,500.000 0.000
- - - - - - - 1 53,000.000 0.000
- - - - - - - 1 386.100 0.000
 - - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 38,500.000 0.000
- - - - - - - 1 71,500.000 0.000
- - - - - - - 1 38,500.000 0.000
- - - - - - - 1 71,500.000 0.000
- - - - - - - 1 333.900 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 473.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 110.000 0.000
- - - - - - - 1 1,750.000 0.000
- - - - - - - 1 98.000 0.000
- - - - - - - 1 783.000 0.000
- - - - - - - 1 7,150.000 0.000
- - - - - - - 1 2,134.000 0.000
- - - - - - - 1 6,199.900 0.000
- 300 - - 300 - - 1 1,155.000 0.000
- - - - - - - 1 80.000 0.000
- - - - - - - 1 396.000 0.000
- - - - - - - 1 500.000 0.000
- - - - - 50 50 1 7,920.000 0.000
- - - - - - - 1 1,302.000 0.000
- - - - - - - 1 1,890.000 0.000
- - - - - - - 1 160.000 0.000
360 - - - - 360 360 1 6,840.000 2,462,400.000
- - - - - - - 1 90.000 0.000
- - - - - - - 1 265.000 0.000
- - - - - - - 1 14,300.000 0.000
1,500 180 228 - 408 1,092 1,092 1 7,630.000 11,445,000.000
 - - - - - - - 1 167.000 0.000
- - - - - - - 1 8,355.000 0.000
- 1 - - 1 - - 1 1,457,500.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 12,969.000 0.000
- - - - - - - 1 1,506.000 0.000
- - - - - - - 1 410,777.000 0.000
- - - - - - - 1 343,687.000 0.000
- - - - - - - 1 32,493.000 0.000
30 - - - - 30 30 1 0.000 0.000
- - - - - - - 1 2,254.320 0.000
- - - - - - - 1 259,175.000 0.000
- - - - - - - 1 15,180.000 0.000
200 - - - - 200 200 1 31,680.000 6,336,000.000
200 - 1 - 1 199 199 1 31,405.000 6,281,000.000
- - - - - - - 1 3,300.000 0.000
- - - - - - - 1 7,630.000 0.000
- - - - - - - 1 14,300.000 0.000
- - - - - - - 1 8,426.000 0.000
- - - - - - - 1 627.000 0.000
- - - - - - - 1 792.000 0.000
- - - - - - - 1 1,700.000 0.000
- - - - - - - 1 1,700.000 0.000
- - - - - - - 1 55,000.000 0.000
25 - - - - 25 25 1 58,500.000 1,462,500.000
6,000 - - - - 6,000 6,000 1 850.000 5,100,000.000
300 - - - - 300 300 1 4,000.000 1,200,000.000
- - - - - - - 1 8,355.000 0.000
- - - - - - - 1 248,120.000 0.000
- - - - - - - 1 186,000.000 0.000
- - - - - - - 1 6,500.000 0.000
- - - - - - - 1 11,250.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
- - - - - - - 1 0.000 0.000
3 - - - - 8 8 1 236,500.000 709,500.000
- - - - - 5 5 1 99,000.000 0.000
- - - - - 4 4 1 203,500.000 0.000
- - - - - - - 1 275,000.000 0.000
- - - - - - - 1 132,000.000 0.000
- - - - - - - 1 49,500.000 0.000
- - - - - - - 1 5,500.000 0.000
 - - - - - - - 1 66,000.000 0.000
- 2,900 - - 2,900 2,000 2,000 1 1,023.000 0.000
- - - - - - - 1 21,736.000 0.000
- - - - - - - 1 386.100 0.000
- 200 - - 200 1,800 1,800 1 340.280 0.000
- - - - - 1 1 1 560,000.000 0.000
- 1 - - 1 1 1 1 1,252,000.000 0.000
- - - - - - - 1 575,000.000 0.000
9 - - - - 9 9 1 156,000.000 1,404,000.000
- - - - - - - 1 53,636.000 0.000
- - - - - - - 1 220,000.000 0.000
- - - - - 2 2 1 148,500.000 0.000
- 200 - - 200 - - 1 7,000.000 0.000
- - - - - - - 1 2,200.000 0.000
- - - - - - - 1 60,000.000 0.000
- 1,200 - - 1,200 - - 1 6,269.000 0.000
- - - - - - - 1 197,000.000 0.000
- - - - - 20 20 1 75,000.000 0.000
1,200 1,200 - - 1,200 - - 1 8,500.000 10,200,000.000
- - - - - 21 21 1 220,000.000 0.000
- - - - - - - 1 220,000.000 0.000
- - - - - - - 1 75,000.000 0.000
- 50 - - 50 100 100 1 5,000.000 0.000
- - - - - - - 1 200,000.000 0.000
- - - - - - - 1 56,000.000 0.000
- - - - - - - 1 80,000.000 0.000
34 - - - - 68 68 1 200,000.000 6,800,000.000
- - - - - - - 1 138,364.000 0.000
- - - - - - - 1 137,364.000 0.000
7 - - - - 7 7 1 45,100.000 315,700.000
- - - - - - - 1 66,000.000 0.000
- - - - - - - 1 53,636.000 0.000
- - - - - - - 1 450,000.000 0.000
4 - - - - 4 4 1 718,500.000 2,874,000.000
- - - - - - - 1 69,000.000 0.000
- - - - - - - 1 60,000.000 0.000
5,100 - - - - 5,100 5,100 1 6,000.000 30,600,000.000
- - - - - - - 1 522,728.000 0.000
- - - - - - - 1 180,000.000 0.000
- - - - - - - 1 220,000.000 0.000
- - - - - - - 1 109.090 0.000
- - - - - - - 1 24,091.000 0.000
- 1,260 - - 1,260 4,140 4,140 1 1,150.000 0.000
5 - - - - 5 5 1 47,500.000 237,500.000
- - - - - - - 1 200,000.000 0.000
- - - - - - - 1 2,816.000 0.000
 10 - - - - 10 10 1 150,000.000 1,500,000.000
- - - - - - - 1 303.550 0.000
- - - - - - - 1 891,275.000 0.000
- - - - - - - 1 160,500.000 0.000
6,000 3,000 - - 3,000 3,000 3,000 1 585.000 3,510,000.000
- - - - - - - 1 5,300.000 0.000
- - - - - - - 1 5,500.000 0.000
- - - - - - - 1 60,500.000 0.000
- - - - - - - 1 80,000.000 0.000
- - - - - - - 1 136,564.000 0.000
- - - - - - - 1 1,265.000 0.000
- - - - - - - 1 8,400.000 0.000
- - - - - - - 1 8,400.000 0.000
- - - - - - - 1 98,000.000 0.000
20 - - - - 20 20 1 90,000.000 1,800,000.000
- - - - - - - 1 97,500.000 0.000
20 - - - - 20 20 1 22,500.000 450,000.000
- - - - - - - 1 0.000 0.000
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242,079,057.660

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0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
346,500.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 396,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 2,462,400.000
0.000 0.000
0.000 0.000
0.000 0.000
3,113,040.000 8,331,960.000
 0.000 0.000
0.000 0.000
1,457,500.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 6,336,000.000
31,405.000 6,249,595.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 1,462,500.000
0.000 5,100,000.000
0.000 1,200,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 1,892,000.000
0.000 495,000.000
0.000 814,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
2,966,700.000 2,046,000.000
0.000 0.000
0.000 0.000
68,056.000 612,504.000
0.000 560,000.000
1,252,000.000 1,252,000.000
0.000 0.000
0.000 1,404,000.000
0.000 0.000
0.000 0.000
0.000 297,000.000
1,400,000.000 0.000
0.000 0.000
0.000 0.000
7,522,800.000 0.000
0.000 0.000
0.000 1,500,000.000
10,200,000.000 0.000
0.000 4,620,000.000
0.000 0.000
0.000 0.000
250,000.000 500,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 13,600,000.000
0.000 0.000
0.000 0.000
0.000 315,700.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 2,874,000.000
0.000 0.000
0.000 0.000
0.000 30,600,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
1,449,000.000 4,761,000.000
0.000 237,500.000
0.000 0.000
0.000 0.000
 0.000 1,500,000.000
0.000 0.000
0.000 0.000
0.000 0.000
1,755,000.000 1,755,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 1,800,000.000
0.000 0.000
0.000 450,000.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
16,016.000 26,488.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
68,572.000 263,228.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
297,000.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
 0.000 0.000
0.000 712,800.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 346,500.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000

167,620,790.251 269,414,317.985

KEFARMASIAN
.............................
 LAPORAN PEMAKAIAN DAN LEMBAR
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN

UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 300 - 300

240
4 A004 0 0 - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial - - -
6 A006 Air Untuk Injeksi Vial @25 ml Vial 131 - 131
7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - -
8 A008 Alopurinol Tablet 100 mg Tablet 838 - 838 12 98
9 A009 Alopurinol Tablet 100 mg 0 - - -
10 A010 Ambroxol Tablet 30 mg Tablet 1,969 - 1,969
11 A011 0 0 - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - -
13 A013 0 0 - - -
14 A014 Amlodipin Tablet 10 Mg Tablet - - -
15 A015 Amlodipin Tablet 10 Mg Tablet 2,970 - 2,970 46 664
16 A016 0 0 - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet 21,659 - 21,659 715 3,495
18 A018 Amoksisilin Kaplet 500 mg Tablet - - -
19 A019 Amoksisilin Kaplet 500 mg Tablet - - -
20 A020 Amoksisilin Kaplet 500 mg Tablet - - -
21 A021 0 0 - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 150 - 150 12 34
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - -
25 A025 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - -
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - -
27 A027 CLABAT,CAPSINAT Tablet - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - -
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 203 - 203 48
30 A030 0 0 - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol - - -
32 A032 0 0 - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
35 A035 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet 50 - 50 50
36 A036 Tablet 10,000 - 10,000 826 1,654
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - -
40 A040 Pot 24 - 24
41 A041 Salisilat 3% (Marin )
0Antihemoroid 0 - - -
Kombinasi : Bismut Suppgalat 150 mg
42 A042 Supp 30 - 30 15
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - -
45 A045 20% ) HEMOROGARD Tablet - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet 1,517 - 1,517 248 1,269
47 A047 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet 4,000 - 4,000 130
48 A048 Tablet - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - -
50 A050 Asam Folat Tablet 1 mg Tablet - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - -
52 A052 Asam Mefenamat 500 mg 0 - - -
53 A053 0 0 - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - 3
55 A055 0 0 - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 164 - 164 18
57 A057 0 0 - - -
58 A058 Asiklovir 5% 5gr Cream Tube 112 - 112 3 8
59 A059 Asiklovir 5% 5gr Cream Tube - - -
60 A060 0 0 - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 146 - 146 10 30
 63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - -
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet - - -
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet - - -
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet 1,675 - 1,675 10 112
69 A069 Betahistin Mesylat 6 mg Tablet - - -
70 A070 Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - -
71 A071 Betametason Dipropionat Krim 0,1% Tube - - -
72 A072 Betametason Dipropionat Krim 0,1% gram @ 10 - - -
Tube
gram @ 10
73 A073 Betametason Dipropionat Krim 0,1% 250 - 250 24 48
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - -
77 A077 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - -
78 A078 Bricasma Biji - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - -
80 A080 Zeneca
0Budesonid )I 0 - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 A081 pcs - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - -
84 A084 Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet 185 - 185 40 145
85 A085 Cefadroksil Kapsul 500 mg Tablet 1,500 - 1,500 51
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 54 - 54 4
88 A088 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - - -
89 A089 Tablet - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 162 - 162 36
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet 102 - 102 12 90
93 A093 Deksamethason Tab 0,5 mg 0 2,000 - 2,000 456
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - -
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 336 - 336 8 84
97 A097 0 0 - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - -
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 200 - 200 5 25
100 A100 Digoksin Tab 0,25 mg Tablet - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 1,513 - 1,513 106 214
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - -
103 A103 0 0 - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet 500 - 500 68 118
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 6 - 6 4
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 100 - 100
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet 260 - 260 70
113 A113 Ethambutol 250 mg Tablet - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 203 - 203 2 22
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 63 - 63 32
120 A120 0 0 - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 112 - 112 6 26
128 A128 Gentamycin Krim 1 % mg/ ml Tube - - -
129 A129 Gentian Violet 1% 10 ml Botol 24 - 24
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 21 - 21 4 14
131 A131 Glibenklamid Tablet 5 mg Tablet 4,136 - 4,136 20 915
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - - -
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet 3,610 - 3,610 365 1,079
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet 108 - 108 108
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 14 - 14
137 A137 Glukosa Larutan 40% Steril botol - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - -
139 A139 Glukosa Larutan Infus 5% @500ml Botol - - -
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - -
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,036 - 1,036 20 210
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 160 - 160 12 44
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10
148 A148 0 0 - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 381 - 381 4 80
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 12,061 - 12,061 1,215 2,131
152 A152 Ibuprofen Tablet 400 mg Tablet - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - -
154 A154 Isoniazid Tablet 100 mg tablet - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 191 - 191
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
158 A158 0 0 - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 182 - 182
162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - -
163 A163 Tablet - - -
164 A164 Pharmatama)
0 0 - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 2,927 - 2,927 2,363
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet 5,000 - 5,000
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet 1,217 - 1,217 30 1,187
170 A170 Kaptopril Tab 25 mg TAblet 3,000 - 3,000 220
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube - - -
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube 26 - 26 2 6
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 360 - 360
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - -
176 A176 Ketorolak Inj 30 mg/ml Ampule - - -
177 A177 0 0 - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 151 - 151 105
179 A179 0 0 - - -
180 A180 Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol Vial - - -
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - -
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - -
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 5,181 - 5,181 325 1,421
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,378 - 1,378
190 A190 Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg 3,000 - 3,000 180 468
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol 135 - 135 3 18
193 A193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma )
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract 24 - 24 4
194 A194 MOLAKRIM
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 13 - 13 7
195 A195 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- - -
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - -
197 A197 Probiotik (Dexa Medica, Sanbe) Tablet - - -
198 A198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 547 - 547 5 107
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 134 - 134 12 54
203 A203 Loperamid Tablet 2 mg Tablet - - -
204 A204 Loratadin Tablet 10 mg Tablet 132 - 132 6
205 A205 Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - -
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet 360 - 360 360
207 A207 Mata/ OCUGARD (Phapros) Tablet 180 - 180 180
208 A208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - -
209 A209 0 0 - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet - - -
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 1,336 - 1,336 323
213 A213 Metformin HCl Tablet 500 mg Tablet - - -
214 A214 Metformin HCl Tablet 500 mg Tablet 1,845 - 1,845 10 295
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 163 - 163 8 88
216 A216 0 0 - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet - - -
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet 2,214 - 2,214 110 414
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - -
223 A223 Metronidasol Infus 500mg/100ml Botol - - -
224 A224 Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - -
225 A225 Kapsul - - -
226 A226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 360 - 360 240
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 A227 Ampule - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - -
229 A229 Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - -
230 A230 Tablet - - -
Ayus )
 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU
231 A231 Multivitamin Curcuma Syr:L-Lysyin 1000 IU Botol - - -
232 A232 vit B1 3 mg, B12 Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) Botol 192 - 192 13 31
Multivitamin Neurotopic
vit B1 3 mg, B12 Plus ATP
Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet
233 A233 Multivitamin - - -
234 A234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) Tablet - - -
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 A235 Femofomarrat 300mg tablet - - -
236 A236 MOLANEURON (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C Tablet 3,158 - 3,158 3,158
237 A237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 107 - 107 84
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet 1,000 - 1,000
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - -
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 45 - 45
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet - - -
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - -
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol - - -
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 20 - 20
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - -
248 A248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet 100 - 100
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - -
252 A252 Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - -
253 A253 Omeprazole Kapsul 20 mg Tablet - - -
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 482 - 482 15
255 A255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - -
256 A256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet - - -
257 A257 Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - -
258 A258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - -
259 A259 400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol
Parasetamol HCl 25Mg/ HUSTAB Tablet - - -
260 A260 (Phapros) Tablet - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 30Mg,
100 mg / COLPICA (Tropika Mas) 0 - - -
Parasetamol Komb Tablet Flu: Parasetamol
262 A262 Tablet - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - -
264 A264 Parasetamol Syrup 120 mg/5ml Botol 348 - 348 21 104
265 A265 Parasetamol tablet 500 mg Tablet - - -
266 A266 Parasetamol tablet 500 mg Tablet - - -
267 A267 Parasetamol tablet 500 mg Tablet - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 32 - 32 15
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 49 - 49 3 18
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - -
271 A271 Piracetam 800 mg Tablet Tablet - - -
272 A272 Parasetamol tablet 500 mg Tablet 20,720 - 20,720 1,286 3,152
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule - - -
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 2,000 - 2,000 36 1,066
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 1,746 - 1,746
276 A276 Probiotik Sachet (Probiokid) 0 - - -
277 A277 Polikresulen (Albotyl,Apetil) Botol - - -
278 A278 Prednison Tab 5 mg Tablet - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 4,494 - 4,494 460 1,120
280 A280 Prednison Tab 5 mg Tablet - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 432 - 432 243
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - -
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 2,245 - 2,245 212 394
285 A285 0 0 - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol 300 - 300
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - -
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
290 A290 Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - -
291 A291 Nebule 224 - 224 2 26
292 A292 (COMBIVENT)
0 I dan II 0 - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - -
294 A294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet 1,406 - 1,406 48 156
295 A295 Salep Pot 130 - 130 3 19
296 A296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - -
298 A298 Salisil Bedak Serbuk 2% Pcs - - -
299 A299 Salisil Bedak Serbuk 2% Pcs 60 - 60 25
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 2 - 2 1
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 71 - 71 23
304 A304 Setirizin Tab 10 mg (Futamed) Tablet 12 - 12 12
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 700 - 700 30 174
307 A307 Simvastatin Tablet 10 mg Tablet - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
309 A309 0 0 - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - -
311 A311 Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% Botol 23 - 23 4
312 A312 Botol - - -
313 A313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - -
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - -
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 2,518 - 2,518 42 636
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - -
318 A318 Thiamphenicol Kapsul 500 mg Tablet 1,000 - 1,000 20 82
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 12 - 12
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - -
321 A321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek 5,261 - 5,261 430 1,274
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - -
323 A323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
327 A327 0 0 - - -
328 A328 0 0 - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 3 - 3 3
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 3 - 3
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet 300 - 300 24
336 A336 Diazepam Tablet 5 mg Tablet - - -
337 A337 Fenobarbital Tablet 30 mg Tablet - - -
338 A338 Fenobarbital Tablet 30 mg Tablet - - -
339 A339 Fenobarbital Tablet 30 mg tablet - - -
340 A340 Kodein Tablet 10 mg Tablet - - -
341 A341 0 0 - - -
342 A342 Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON Tablet - - -
343 A343 Tablet - - -
344 A344 (Meprofarm)
0 0 - - -
345 A345 0 0 - - -
346 A346 0 0 - - -
347 A347 Primaquin 15 mg tablet tablet - - -
348 A348 0 0 - - -
OBAT - OBAT PROGRAM 0 - - -
OBAT PROGRAM KECACINGAN 0 - - -
349 A349 Albendazol Tablet 400 mg Tablet - - -
350 A350 Albendazol Tablet 400 mg Tablet 192 - 192
OBAT PROGRAM DIARE 0 - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - -
352 A352 Garam Oralit (Kimia Farma) Tablet 1,547 - 1,547 52 203
353 A353 Garam Oralit (Kimia Farma) sachet - - -
354 A354 Garam Oralit (Kimia Farma) sachet - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - -
356 A356 Botol 43 - 43 2 4
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - -
359 A359 Zinc Dispersible 20 mg tablet tablet - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 2,630 - 2,630 20 40
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
363 A363 0 0 - - -
OBAT PROGRAM HEPATITIS 0 - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
OBAT PROGRAM TB PARU 0 - - -
369 A369 OAT FDC Kategori Anak Kit - - -
370 A370 OAT FDC Kategori Anak Kit - - -
371 A371 OAT FDC Kategori Anak Kit - - -
372 A372 OAT FDC Kategori I - IIII Kit - - -
373 A373 OAT FDC Kategori I - IIII Kit 11 - 11 5
374 A374 OAT FDC Kategori II Kit - - -
375 A375 OAT FDC Kategori II Kit - - -
376 A376 OAT FDC Kategori II Kit 1 - 1 1
377 A377 OAT FDC Kombipak Kategori I Kit - - -
378 A378 0 0 - - -
379 A379 Isoniazid 100 mg tablet tablet - - -
OBAT POGRAM KUSTA 0 - - -
380 A380 MDT MB Anak Blister - - -
381 A381 MDT MB Anak Blister - - -
382 A382 MDT MB Dewasa Blister - - -
383 A383 MDT MB Dewasa Blister - - -
384 A384 MDT MB Dewasa Blister - - -
385 A385 MDT PB Anak Blister - - -
386 A386 MDT PB Anak Blister - - -
387 A387 MDT PB Anak Blister - - -
388 A388 MDT MB Dewasa Blister 24 - 24 6
389 A389 MDT PB Dewasa Blister - - -
OBAT PROGRAM GIZI 0 - - -
390 A390 Mineral Mix Kombinasi sachet - - -
391 A391 Mineral Mix Kombinasi sachet - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 300 - 300 94
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - -
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
397 A397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul 6 - 6
398 A398 Tablet Tablet - - -
399 A399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Tablet 44,200 - 44,200 30 6,690
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros)
400 A400 tablet - - -
401 A401 0,4
0 Mg Tab (Phapros) 0 - - -
402 A402 0 0 - - -
OBAT PROGRAM KESGA 0 - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule - - -
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial - - -
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial 18 - 18 2
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 100 - 100
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 12 - 12 12
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 610 - 610 150
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 240 - 240 62
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
OBAT PROGRAM JIWA 0 - - -
416 A416 Amitriptilin 25 mg Tablet - - -
417 A417 Amitriptilin 25 mg Tablet - - -
418 A418 Amitriptilin 25 mg Tablet - - -
419 A419 Amitriptilin 25 mg Tablet 160 - 160 6
420 A420 Amitriptilin 25 mg Tablet - - -
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - -
422 A422 Clozapine 100 mg Tablet - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet 300 - 300 120
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - -
428 A428 Flufenazin sikzonoate inj 5 ml vial 9 - 9
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - -
430 A430 Haloperidol 5 mg tablet Tablet - - -
431 A431 Haloperidol 5 mg tablet Tablet 2,287 - 2,287 285
432 A432 Haloperidol 5 mg tablet Tablet - - -
433 A433 0 0 - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - -
436 A436 Haloperidol/ Lodomer drops 2 mg Botol 10 - 10 2
437 A437 Karbamazepin Tablet 200 mg Tablet - - -
438 A438 Karbamazepin Tablet 200 mg Tablet - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - 3
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - -
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 1,889 - 1,889 320
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - -
444 A444 0 0 - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - -
447 A447 Risperidon Tab 2 mg Tablet 497 - 497 425
448 A448 Risperidon Tab 2 mg Tablet 1,000 - 1,000
449 A449 0 0 - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - -
451 A451 0 0 - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - -
453 A453 Triheksifenidil Tablet 2 mg Tablet 1,412 - 1,412 615
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - -
455 A455 0 0 - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - -
457 A457 0 0 - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - -
458 A458 BCG vial 36 - 36 18
459 A459 PELARUT BCG ampul 36 - 36 18
460 A460 BCG vial - - -
461 A461 BCG vial - - -
462 A462 CAMPAK 10ds (MR) vial - - -
463 A463 PELARUT CAMPAK ampul 149 - 149 75
464 A464 CAMPAK 10ds (MR) vial 31 - 31 21
465 A465 CAMPAK 10ds (MR) vial - - -
466 A466 DPT HB - Hib/ PENTABIO vial - - -
467 A467 DPT HB - Hib/ PENTABIO vial 70 - 70 55
468 A468 DT vial - 90 90 42
469 A469 0 0 - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - -
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - -
472 A472 POLIO bOPV 10 ds vial - - -
473 A473 DROPPER POLIO dropper 203 - 203 110
474 A474 POLIO bOPV 10 ds vial - - -
475 A475 POLIO bOPV 10 ds vial - - -
476 A476 Td vial 15 160 175 85
477 A477 0 0 - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial 67 - 67 30
479 A479 POLIO bOPV 10 ds vial 55 - 55 55
480 A480 Vaksin Meningtis vial - - -
481 A481 CAMPAK 10ds (MR) BIAS vial - - -
482 A482 PELARUT CAMPAK BIAS ampul - - -
483 A483 POLIO bOPV 10 ds vial - - -
484 A484 IPV vial - 80 80 60
485 A485 VTM Include Dacron (Biofarma) pcs - - -
486 A486 Vaksin Rabies (Verorab) vial - - -
487 A487 0 0 - - -
488 A488 0 0 - - -
489 A489 0 0 - - -
OBAT PROGRAM HIV/ AIDS 0 - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - -
491 A491 0 0 - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 191 - 191 125
493 A493 0 0 - - -
494 A494 Lamivudine 150 mg Tablet - - -
495 A495 Lamivudine 150 mg Tablet - - -
496 A496 Nevirapine 200 mg Tablet - - -
497 A497 Nevirapine 200 mg Tablet - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - -
500 A500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - -
501 A501 FDC Dewasa Tablet - - -
502 A502 FDC Dewasa
Tenofovir 300 mg Tablet - - -
503 A503 Tenofovir 300 mg Tablet - - -
504 A504 Zidofudine 100 mg (ZDV) Tablet - - -
505 A505 Zidofudine 100 mg (ZDV) Tablet - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
508 A508 Efavirenz 600 mg tablet tablet - - -
509 A509 Efavirenz 600 mg tablet tablet - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
511 A511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - -
512 A512 Tablet - - -
FDC Dewasa
513 A513 0 0 - - -
514 A514 MB Anak blister - - -
515 A515 0 0 - - -
516 A516 0 0 - - -
517 A517 0 0 - - -
518 A518 0 0 - - -
519 A519 0 0 - - -
520 A520 0 0 - - -
521 A521 0 0 - - -
522 A522 0 0 - - -
523 A523 0 0 - - -
524 A524 0 0 - - -
525 A525 0 0 - - -
526 A526 0 0 - - -
527 A527 0 0 - - -
528 A528 0 0 - - -
529 A529 0 0 - - -
BMHP 0 - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
532 A532 0 0 - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - -
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs 773 - 773 564 209
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 1,500 - 1,500 85
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 1,100 - 1,100 55
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - -
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs 50 - 50 4
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - -
542 A542 Alkohol 70% (Medika) Btl 1000 ml - - -
543 A543 Alkohol Swab 2 - ply (one med) 0 - - -
544 A544 Alkohol Swab 2 - ply (one med) Pcs 500 - 500 300
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol 2 - 2 1
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 60 - 60 18
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - -
549 A549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - -
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Pcs - - -
551 A551 Phsda 0 - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - -
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs - - -
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs 40 - 40 8 4
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - 5
561 A561 Mantel Gown (Bisa Dicuci) biji - - -
562 A562 I.V Catheter No. 18 (JELCO) Pcs - - -
563 A563 I.V Catheter No. 18 (NIPRO) Pcs 109 - 109 28
564 A564 I.V Catheter No. 20 JELCO Pcs - - -
565 A565 I.V Catheter No. 20 TERUMO Pcs - - -
566 A566 I.V Catheter No. 20 JELCO Pcs 200 - 200 72
567 A567 I.V Catheter No. 22 NIPRO Pcs - - -
568 A568 I.V Catheter No. 22 NIPRO Pcs 201 - 201 65
569 A569 I.V Catheter No. 24 TERUMO Pcs 77 - 77 28
570 A570 I.V Catheter No. 24 TERUMO 0 100 - 100
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - -
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 59 - 59
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
574 A574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 459 - 459 128
575 A575 Pcs - - -
576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 27 2 29 1 6
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - -
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - -
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 10 - 10 2 1
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - -
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 48 - 48 6
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - -
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 100 - 100 30
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - -
588 A588 Masker Ear Loop (Masker) Pcs - - -
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - -
590 A590 Masker General Care (MARCOTILA) Pcs - - -
591 A591 0 0 - - -
592 A592 Masker N95 Disposibel Pcs - - -
593 A593 Masker N95 Disposibel (One Med) Pcs - - -
594 A594 Masker Tali Pcs - - -
595 A595 Masker Tali Pcs - - -
596 A596 Masker Elastic Pcs - - -
597 A597 Media Sample Container Pcs 335 - 335 148
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs 12 - 12 1
601 A601 Nurse Cup (Tutup Kepala) Pcs - - -
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - -
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - -
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 112 - 112 39 3
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 9 - 9 1 1
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 50 - 50 9 3
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - -
610 A610 0 0 - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - -
613 A613 0 0 - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - - -
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - -
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir 300 - 300 300
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 276 - 276 3
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 60 - 60 37
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - -
622 A622 0 0 - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1
625 A625 Underpad 90x 0 cm cosmo I Pcs 30 - 30
626 A626 Underpad 90x 0 cm cosmo II Pcs - - -
627 A627 0 0 - - -
628 A628 Urine Bag Sterile Standard Pcs - - -
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs 60 - 60 2 5
630 A630 0 0 - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs 200 - 200 25
REAGEN 0 - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 400 - 400
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - -
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - -
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - -
639 A639 0 0 - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - -
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - -
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs 10 - 10 2
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - -
649 A649 0 0 - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - -
651 A651 0 0 - - -
652 A652 TPHA (Fokus) Test - - -
653 A653 0 0 - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - -
BMHP (PROGRAM) PROPINSI 0 - - -
PROGRAM MALARIA 0 - - -
656 A656 RDT Malaria Test - - -
PROGRAM SYPHILIS 0 - - -
657 A657 RPR Syphilis Pcs 100 - 100 30
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline Test
Test 300 - 300 216
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - -
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - -
662 A662 0 0 - - -
663 A663 Tuberkulin Vial - - -
664 A664 RDT Lepto (Uji Leptospira IgM) test - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - -
666 A666 0 0 - - -
667 A667 0 0 - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - -
668 A668 Test - - -
669 A669 Reagen HBsAg Strip SD Test - - -
670 A670 Reagen HBsAg Strip SD Test 350 - 350 166
671 A671 Reagen HBsAg Strip SD Test - - -
672 A672 0 0 - - -
673 A673 0 0 - - -
674 A674 0 0 - - -
675 A675 0 0 - - -
PROGRAM TB PARU 0 - - -
676 A676 Box Slide Pcs - - -
677 A677 Box Slide Pcs - - -
678 A678 Catridge Genexpart Test - - -
679 A679 Catridge Genexpart Test - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - -
681 A681 Oil Emersi Botol - - -
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - -
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - -
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - -
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - -
686 A686 Reagen Control CD4 0 - - -
687 A687 Reagen Control CD4 0 - - -
688 A688 Reagen Zeil Nelseen Kit - - -
689 A689 Reagen Zeil Nelseen Kit - - -
690 A690 Reagen Zeil Nelseen Kit - - -
691 A691 Reagen Zeil Nelseen Kit - - -
692 A692 Slide Pcs 9 - 9 2
693 A693 Slide/ Object Glass Pcs - - -
694 A694 Stereofoam pcs - - -
695 A695 Masker N 95 TB pcs 23 - 23
696 A696 Masker Tali Bedah TB pcs - - -
OBAT PROGRAM IMUNISASI 0 - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs 500 - 500 105
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs 800 1,900 2,700 1,100
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
708 A708 0 0 - - -
709 A709 0 0 - - -
710 A710 0 0 - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 145 - 145
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
714 A714 0 0 - - -
715 A715 Safety Box 5 L Pcs 25 50 75 10
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
717 A717 0 0 - - -
718 A718 0 0 - - -
719 A719 0 0 - - -
720 A720 0 0 - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - -
721 A721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test 50 - 50
722 A722 Tahap I 0 - - -
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold)
723 A723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - -
724 A724 Tahap I 0 - - -
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
725 A725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test 50 - 50
726 A726 Tahap I 0 - - -
727 A727 Tahap
Kondom I Pcs - - -
728 A728 DBS Collection/ Lasec Pcs - - -
729 A729 Lubricant Pcs - - -
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - -
731 A731 Test 819 - 819 145
732 A732 IRapid HIV 1/2 3.0 SD Bioline test - - -
733 A733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - -
734 A734 Test - - -
735 A735 Tahap
ReagenI HIV (SD) R 1 Test - - -
736 A736 Reagen HIV (SD) R 1 Test - - -
737 A737 0 0 - - -
738 A738 Reagen HIV (VIKIA) R 3 Test - - -
739 A739 0 0 - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - -
741 A741 0 0 - - -
742 A742 Reagen HIV R3 (VIKIA) Test - - -
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - -
744 A744 Sarung Tangan Non Steril Pair - - -
745 A745 0 0 - - -
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - -
747 A747 VTM Include Swab Test - - -
748 A748 Masker Bedah 3 ply Pcs - - -
749 A749 0 0 - - -
750 A750 0 0 - - -
751 A751 0 0 - - -
752 A752 0 0 - - -
753 A753 0 0 - - -
754 A754 0 0 - - -
755 A755 0 0 - - -
756 A756 0 0 - - -
757 A757 0 0 - - -
758 A758 0 0 - - -
759 A759 0 0 - - -
760 A760 0 0 - - -
761 A761 0 0 - - -
762 A762 0 0 - - -
763 A763 0 0 - - -
764 A764 0 0 - - -
OKSIGEN MEDICAL 0 - - -
765 A765 Oksigen 3 m3 Tampon - - -
766 A766 Oksigen 6 m3 Tampon - - -
767 A767 Oksigen 1 m3 Tampon - - -
768 A768 Oksigen 6 m3 Tampon - - -
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - -
770 A770 0 0 - - -
771 A771 0 0 - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - -
TAMBAHAN IFK 0 - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
3 T003 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex Tablet - - -
4 T004 Tablet - - -
5 T005 Thiamphenicol Syr. 0 - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - -
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - -
10 T010 Ketokonazole 200 mg Tablet - - -
11 T011 Kotrimoksazol Forte Tablet - - -
12 T012 Infusion set anak Pcs 50 - 50 30
13 T013 Alat Suntik 10 cc Pcs - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
15 T015 Omeprazole Kapsul 20 mg Tablet - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol 360 - 360 8 44
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
19 T019 Oseltamivir 75 mg Kapsul - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol 1,092 - 1,092 449
21 T021 Amitriptilin 25 mg Tablet - - -
22 T022 I.V Catheter No. 24 TERUMO pcs - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - -
24 T024 RDT COVID - 19 0 - - -
25 T025 Oseltamivir 75 mg 0 - - -
26 T026 Klorokuin
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - -
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - -
28 T028 Viruses) 0 - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) 0 - - -
30 T030 Hazmat/ APD/ Hazmat PPK 0 30 - 30
31 T031 Medical Sample Container Pcs - - -
32 T032 Cepheid Pcs - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - -
34 T034 Tambah Darah drop (Ferriz Drop) pcs 200 - 200
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs 199 - 199 3
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
38 T038 Obat Batuk Sirup / INADRYL Botol - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - -
40 T040 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - -
41 T041 dextromethorpan Hbr Tablet - - -
42 T042 Influenza
Masker Bedah /Bima Sakti pCS - - -
43 T043 Masker Bedah /Rania pCS - - -
44 T044 Masker N 95 Bima Sakti PCS - - -
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 25 - 25 9
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS 6,000 - 6,000 2,900 600
47 T047 Albendazol Suspensi 200mg/ 5 ml botol 300 - 300
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - -
49 T049 OAT FDC Kategori Anak 0 - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - -
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - -
53 T053 0 0 - - -
54 T054 0 0 - - -
55 T055 0 0 - - -
56 T056 0 0 - - -
57 T057 0 0 - - -
58 T058 0 0 - - -
59 T059 0 0 - - -
60 T060 APD Set (Rannia) 0 8 - 8
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5
62 T062 Cover
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 4 - 4
63 T063 0 - - -
64 T064 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - -
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs 2,000 - 2,000
69 T069 Masker N95 Covid 19 Pcs - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - -
71 T071 Masker Eaerlop Hijab Pcs 1,800 - 1,800
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - 1
73 T073 Hand Sanitzer 1 Botol = 20 Liter 1 - 1
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs 9 - 9
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - 2
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - -
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs - - -
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - -
84 T084 Masker KN95 (Farmahusada) Box @50 pcs 20 - 20 5
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - -
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test 21 - 21 12
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - -
89 T089 APRON (Atmosfer) pcs 100 - 100
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - -
91 T091 Hand Sanitzer 2 liter - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 68 - 68 10
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - -
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - -
96 T096 Face Shield (COBRA) 0 7 - 7
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
98 T098 Kit Steril (Rajawali) 0 - - -
99 T099 Alkohol II @20 Liter 0 - - -
100 T100 Cover All (Rajawali) 0 4 - 4
101 T101 Face Shield (ATMOSFER) 0 - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
103 T103 Masker Earloop (KasaHusada) 0 5,100 - 5,100
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - -
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - -
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - -
107 T107 Alkohol Swab (BTT) 0 - - -
108 T108 Antiseptic Gel 500 0 - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 4,140 - 4,140
110 T110 Kaca mata Goggle (HASTEN) 0 5 - 5 1
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - -
112 T112 Masker Bedah Hijau @50pcs 0 - - -
113 T113 Masker N95 3M 8210 (Hazten) 0 10 - 10 6
114 T114 Nurse Cap Green om 100bh 0 - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - -
117 T117 Sarung tangan Safeglove Exam M 100bh 0 3,000 - 3,000 2,000
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - -
121 T121 Universal Transport Media (UTM) Goongdong 0 - - -
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - -
127 T127 Rapid Test Lecurate (Bima Sakti) 0 20 - 20
128 T128 Rapid Test ZYBIO (Farma Husada) 0 - 50 50
129 T129 Alkohol 96 % Liter 20 - 20 3 6
130 T130 0 0 - - -
0 0 - - -
TAMBAHAN PUSKESMAS 0 - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - -
3 TP003 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube - - -
4 TP004 pcs - - -
5 TP005 Zeneca)
0 0 - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 344 - 344 30
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - -
9 TP009 0 0 - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - -
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - -
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 238 - 238 24
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - -
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 - - -
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 - - -
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - -
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - -
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - -
24 TP024 Materniti Napkin Slim L 0 - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - -
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1
29 TP029 Haloperidol 5 mg tablet Tablet - - -
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - -
31 TP031 Fixomull Strech 5 cm X 5 m Pcs - - -
32 TP032 Umbilical crd clamp 0 126 - 126
33 TP033 0 0 - - -
34 TP034 0 0 - - -
35 TP035 0 0 - - -
36 TP036 0 0 - - -
37 TP037 0 0 - - -
38 TP038 0 0 - - -
39 TP039 0 0 - - -
40 TP040 0 0 - - -
41 TP041 0 0 - - -
42 TP042 0 0 - - -
43 TP043 0 0 - - -
44 TP044 0 0 - - -
45 TP045 0 0 - - -
46 TP046 0 0 - - -
47 TP047 0 0 - - -
48 TP048 0 0 - - -
49 TP049 0 0 - - -
50 TP050 0 0 - - -
51 TP051 0 0 - - -
52 TP052 0 0 - - -
53 TP053 0 0 - - -
54 TP054 0 0 - - -
55 TP055 0 0 - - -
56 TP056 0 0 - - -
57 TP057 0 0 - - -
58 TP058 0 0 - - -
59 TP059 0 0 - - -
60 TP060 0 0 - - -
0 0 - - -
TOTAL - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep )

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Mengetahui Yang Menyerahkan,
Plt. KEPALA DINAS KESEHATAN TERTULIS 2 KALI KEPALA INSTALASI FARMASI KABUPATEN
KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN Dra. TRI MUSYAROFAH, Apt

NIP. 19630724 198910 1 002 NIP. 19630411 199203 2 005
LEMBAR PERMINTAAN OBAT
LPO )

: BULAN
: TAHUN

AN SUMBER HARGA STOK NILAI

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN Ket
JUMLAH ANGGARAN SATUAN OPTIMUM PENERIMAAN

UNIT UNIT RP

- - DAK 18/Okt.19 99.000 0.00 0.000

- - DAK 19/Sept.21 105.000 0.00 0.000

240 60 DAK 20/ Jan 22 105.000 6,300.00 0.000

- - - 0.000 0.00 0.000
- - DAK 19/Feb.22 2,860.000 0.00 0.000
DAK 20/ 16 -
- 131 2,860.000 374,660.00 0.000
Des 22
- - DAK 18/Apr.20 10,500.000 0.00 0.000
110 728 DAK 19/Mei 23 104.000 75,712.00 0.000
- - DAK 20 L 220.000 0.00 0.000
- 1,969 DAK 19/Juni 21 93.500 184,101.50 0.000
- - DAK 17/AGSTS- - 0.000 0.00 0.000
- - 2,998.000 0.00 0.000
- - 20 - 0.000 0.00 0.000
- - Dak 19/Okt. 20 93.000 0.00 0.000
710 2,260 Dak 20/Okt 21 99.000 223,740.00 0.000
- - - 0.000 0.00 0.000
4,210 17,449 DAK 17/NOV-21 190.000 3,315,310.00 0.000
- - DAK 18/Okt.20 233.000 0.00 0.000
- - DAK 19/Feb 21 233.000 0.00 0.000
- - DAK 20/ April 22 249.000 0.00 0.000
 - - - 0.000 0.00 0.000
46 104 DAK 19/Agst.22 3,025.000 314,600.00 0.000
- - DAK 20 L 3,025.000 0.00 0.000
- - DAK 19/JULI 21 4,400.000 0.00 0.000
- - DAK 20/ Mart 22 3,628.000 0.00 0.000
- - DAK 18L/Mar.20 10,246.500 0.00 0.000
- - PRBG 20 9,900.000 0.00 0.000
- - DAK 17/MAR-20 8,500.000 0.00 0.000
48 155 DAK 20 / Mei-23 8,237.000 1,276,735.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Sept. 23 4,950.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR-19 440.000 0.00 0.000
- - DAK 18L/Agst.20 220.000 0.00 0.000
50 - DAK 19/Mei20
PRSpesifik 21 165.000 0.00 0.000
2,480 7,520 58.000 436,160.00 0.000
- - non covid-19/ - 0.000 0.00 0.000
- - DAK 18/Apr-22 3,035.000 0.00 0.000
- - - 0.000 0.00 0.000
- 24 DAK 17/ Mei-21 4,496.000 107,904.00 0.000
- - - 0.000 0.00 0.000
15 15 DAK
Buffer Prop.20 - 3,045.000
16/APR-20 45,675.00 0.000
- - 198.000 0.00 0.000
- - Covid-19
DAK 18L/Jan.21 1,485.000 0.00 0.000
- - PRSpesifik L 20/ 1,551.000 0.00 0.000
1,517 - DAK 19/Sept.21 105.000 0.00 0.000
130 3,870 DAK 20/Juni 22 105.000 406,350.00 0.000
- - DAK
DAK 17/Jan-21
17/AGSTS- 1,050.000 0.00 0.000
- - 67.000 0.00 0.000
- - 20
DAK 20/Feb 22 75.000 0.00 0.000
- - DAK 19/MAR-22 103.000 0.00 0.000
- - DAK 20 L 253.000 0.00 0.000
- - 0 0.000 0.00 0.000
- 3 DAK 19/Feb.22 2,076.000 6,228.00 0.000
- - 0 0.000 0.00 0.000
18 146 DAK 19/Feb.22 1,584.000 231,264.00 0.000
- - 0 0.000 0.00 0.000
11 101 DAK 18L/Apr.22 2,915.000 294,415.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 380.000 0.00 0.000
40 106 DAK 19/Des.22 380.000 40,280.00 0.000
 - - DAK 20/Des 23 405.000 0.00 0.000
- - Dak
DAK19/Feb 21
20/31-Okt 1,639.000 0.00 0.000
- - 1,639.000 0.00 0.000
- - 21
DAK 18/Apr 23 136.000 0.00 0.000
- - DAK20
DAK 19/Apr 23
/Nov22, 152.000 0.00 0.000
122 1,553 145.000 225,185.00 0.000
- - Mart
DAK 23
PRSpesifik 20 110.000
19/Jan 21 0.00 0.000
- - 110.000 0.00 0.000
- - Non
DAK Covid-19/
18/Feb.20 3,350.000 0.00 0.000
- - DAK 19/Feb.20 3,350.000 0.00 0.000
72 178 DAK 20/Okt 21 3,350.000 596,300.00 0.000
- - DAK 17/JUL-19 300.000 0.00 0.000
- - DAK 20/Feb 24 5,900.000 0.00 0.000
- - DAK 19/ 626.000 0.00 0.000
- - DAK 20 L 18,150.000 0.00 0.000
- - DAK 19/Agst. 20 7,602.000 0.00 0.000
- - DAK 19/Apr.20 7,124.000 0.00 0.000
- - 0 0.000 0.00 0.000
- - DAK 19/Jan 21 149,266.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Mei 24 5,280.000 0.00 0.000
185 - DAK 19/Juni 24 660.000 0.00 0.000
51 1,449 PRBG 20/ 671.000 972,279.00 0.000
- - DAK 17/MAR-19 4,282.000 0.00 0.000
4 50 DAK 19/Mar.21 11,000.000 550,000.00 0.000
- - PRSpesifik L 20/ 10,098.000 0.00 0.000
- - DAK 19/Okt.21 2,805.000 0.00 0.000
- - DAK
DAK 19/Apr.21
20/ Des 21, 1,097.000 0.00 0.000
36 126 1,097.000 138,222.00 0.000
102 - Feb
DAK2219/Juni 21 60.500 0.00 0.000
456 1,544 DAK 20 L 66.000 101,904.00 0.000
- - DAK 18/Nov 19 10,400.000 0.00 0.000
- - DAK 18L/Agst.20 9,900.000 0.00 0.000
92 244 DAK 19/Juni 22 1,095.000 267,180.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR-21 104.000 0.00 0.000
30 170 DAK 19/Nov.20 104.000 17,680.00 0.000
- - DAK 20/ 104.000 0.00 0.000
320 1,193 DAK 19/Nov.20 105.000 125,265.00 0.000
- - DAK 19/Mar.24 112.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/JULI21 4,400.000 0.00 0.000
 - - DAK 20/Feb 22 2,700.000 0.00 0.000
186 314 DAK 19/Juni 21 165.000 51,810.00 0.000
- - DAK 20/Mart 23 91.000 0.00 0.000
- - DAK 18/Des 20 1,408.000 0.00 0.000
4 2 DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 2,816.00 0.000
- 100 Buffer 1,408.000 140,800.00 0.000
- - Aprl 21 Prop 730.000 0.00 0.000
70 190 19/Mei
DAK 20/ 20Mei 21 770.000 146,300.00 0.000
- - DAK
DAK 19/Des.23
17/SEPT- 391.000 0.00 0.000
- - 4,167.000 0.00 0.000
- - 20
DAK
Buffer17/AGS-19
Prop.19/ 3,550.000 0.00 0.000
- - 3,682.000 0.00 0.000
24 179 Feb 20 /31-Des
DAK 20
3,682.000 659,078.00 0.000
- - 21;Jan 22
DAK 17/Apr.19 691.000 0.00 0.000
32 31 DAK 18/Apr.21 710.000 22,010.00 0.000
- - DAK 17/ JAN-20 0.000 0.00 0.000
- - DAK
DAK 18/Des.19 1,333.000 0.00 0.000
- - 1,333.000 0.00 0.000
- - Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.00 0.000
- - DAK 20/Mei 22 82.000 0.00 0.000
- - DAK 18/Mei 21 4,232.000 0.00 0.000
- - DAK 19/Sept.22 4,232.000 0.00 0.000
32 80 DAK 20/Feb 23 4,232.000 338,560.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
- 24 DAK 20 L 4,400.000 105,600.00 0.000
18 3 DAK 17/DES-20 2,900.000 8,700.00 0.000
935 3,201 DAK 19/Feb 24 119.000 380,919.00 0.000
- - DAK 20/ Feb 22 119.000 0.00 0.000
- - DAU 19/Mei
DAK PR BG 23 77.000 0.00 0.000
1,444 2,166 COVID 20/ Agsts 99.000 214,434.00 0.000
108 - DAK 19/Mei 22
21 7,865.000 0.00 0.000
- 14 DAK 19/Mei 21 10,010.000 140,140.00 0.000
- - PRSpesifik L 20/ 10,010.000 0.00 0.000
- - DAK 17/FEB-20 6,900.000 0.00 0.000
- - DAK 20/ 7,363.000 0.00 0.000
- - APBD II - 15 132.000 0.00 0.000
230 806 DAK 16/OKT-21 149.000 120,094.00 0.000
- - DAK 20 L 88.000 0.00 0.000
- - DAK 18/Agst.21 2,787.000 0.00 0.000
56 104 DAK 19/Mei 23 2,475.000 257,400.00 0.000
- - DAK 20/ Juni 23 2,475.000 0.00 0.000
- - DAK 19/Jan 21 176,800.000 0.00 0.000
 - 10 DAK 19/Mei 21 8,800.000 88,000.00 0.000
- - DAK 20 L 0.000 0.00 0.000
- - DAK 19 4,665.000 0.00 0.000
84 297 DAK 20/ Des 21 4,665.000 1,385,505.00 0.000
3,346 8,715 DAK 19/JULI21 264.000 2,300,760.00 0.000
- - DAK 20 L 330.000 0.00 0.000
- - DAK 18L/Mar.20 660.000 0.00 0.000
- - DAK 20 L 187.000 0.00 0.000
- 191 DAK 17/MAR-21 90.000 17,190.00 0.000
- - DAK 18/Jan.22 89.000 0.00 0.000
- - DAK 19/Mart.23 121.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Nov.20 9,644.000 0.00 0.000
- - DAK 18/Jan.21 10,696.000 0.00 0.000
- 182 DAK 19/Jan.22 10,696.000 1,946,672.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Juli 21 770.000 0.00 0.000
- - - 0.000 0.00 0.000
- 100 DAK 18/Mar.21 1,755.000 175,500.00 0.000
2,363 564 DAK 19/Mei 21 187.000 105,468.00 0.000
- 5,000 DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 315,000.00 0.000
- - 63.000 0.00 0.000
1,217 - Jan
DAK2319/Mei 24 94.600 0.00 0.000
220 2,780 DAK 20 L 99.000 275,220.00 0.000
- - DAK 19/Mei23 5,610.000 0.00 0.000
8 18 DAK 20/ Juni 23 2,518.000 45,324.00 0.000
- 360 DAK 19/Juli21 396.000 142,560.00 0.000
- - DAK 19/Jun 21 288.000 0.00 0.000
- - DAK 20/Jan 22 288.000 0.00 0.000
- - DAK 19/Des.20 1,089.000 0.00 0.000
- - DAK 17/SEPT-- 0.000 0.00 0.000
105 46 1,810.000 83,260.00 0.000
- - 20 - 0.000 0.00 0.000
- - DAK 17/FEB-20 10,500.000 0.00 0.000
- - DAK 18L/Mei.20 17,968.500 0.00 0.000
- - DAK 19/Mart21 35,200.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 22.000 0.00 0.000
1,746 3,435 DAK 19/Mar.22 77.000 264,495.00 0.000
- - DAK 20/Feb 22 23.000 0.00 0.000
- - DAK 17/MEI 20 2,750.000 0.00 0.000
- - DAK 18L/Mei.23 495.000 0.00 0.000
 - 1,378 DAK 19/Juni 23 440.000 606,320.00 0.000
648 2,352 DAU PR BG 20/ 319.000 750,288.00 0.000
- - DAK 19/JUN 20 2,052.000 0.00 0.000
21 114 DAK 20/ Mei 22 2,190.000 249,660.00 0.000
4 20 DAK 17/JUNI 21 13,970.000 279,400.00 0.000
7 6 DAK 19/Apr.21 22,550.000
PRSpesifik 135,300.00 0.000
- - 23,100.000 0.00 0.000
- - Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.00 0.000
- - DAK 19/Mei 21 6,600.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/JUN 21 1,937.000 0.00 0.000
112 435 DAK20/
DAK 19/Mei
Feb 21 2,178.000 947,430.00 0.000
- - 1,222.000 0.00 0.000
66 68 21;Mei22
DAK 19/Juni 21 99.000 6,732.00 0.000
- - DAK 20 L 330.000 0.00 0.000
6 126 DAK 19/Nov.21 123.000 15,498.00 0.000
- - DAK 20/Okt 23 131.000 0.00 0.000
360 - DAK 18L/Sept.20 4,680.500 0.00 0.000
180 - DAK 19/Jan 22 4,730.000 0.00 0.000
- - DAK 19/ 550.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18L/Apr.20 4,950.000 0.00 0.000
- - DAK 19/Apr 21 5,500.000 0.00 0.000
323 1,013 PRSpesifik L 20/ 3,707.000 3,755,191.00 0.000
- - DAK 19/Des.20
DAK20/28 Feb22 96.000 0.00 0.000
305 1,540 102.000 157,080.00 0.000
96 67 ;DAK 19/Agst. 21 143.000 9,581.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR 22 87.000 0.00 0.000
- - DAK 18/Nov.20 80.000 0.00 0.000
- - DAK 20 / Juni 22 121.000 0.00 0.000
- - DAK19/JULI23 192.500 0.00 0.000
524 1,690 DAK 20 L 275.000 464,750.00 0.000
- - DAK 19/Nov 20 8,110.000 0.00 0.000
- - DAK 20/ 8,110.000 0.00 0.000
- - DAK 18L/Okt.20 14,318.700 0.00 0.000
- - DAK 19/Feb 21 5,500.000 0.00 0.000
240 120 DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 250,800.00 0.000
- - 5,000.000 0.00 0.000
- - 19
DAK 19/FEB 21 4,400.000 0.00 0.000
PRSpesifik
- - 1,265.000 0.00 0.000
- - Dokter Muter 20
DAK 17/APR 20 990.000 0.00 0.000
 - - DAK 19/Apr.21 13,200.000
PRSpesifik 0.00 0.000
44 148 13,167.000 1,948,716.00 0.000
- - Dokter Muter 20 2,332.000
DAK 18L/Des.19 0.00 0.000
- - DAK 18L/Okt.21 528.000 0.00 0.000
- - PRSpesifik L 20/ 594.000 0.00 0.000
3,158 - DAK 17/FEB 21 835.000 0.00 0.000
- - DAK 19/OKT20 115.000 0.00 0.000
84 23 DAK 19/Des 20 123.000 2,829.00 0.000
- 1,000 DAK20/ 123.000 123,000.00 0.000
- - DAK 17/JUN 21 6,410.000 0.00 0.000
- 45 DAK 18/Feb.22 6,410.000 288,450.00 0.000
- - PRSpesifik 20
DAK19/Jan 22 132.000 0.00 0.000
- - Non Covid-19/ 3,948.000 0.00 0.000
- - DAK2118L/Des.20 23,141.800
Okt 0.00 0.000
- - DAK 19/Juli 21 19,800.000 0.00 0.000
- 20 DAK 18/Agst.20 560.000 11,200.00 0.000
- - DAK 19/Juli 23 560.000 0.00 0.000
- 100 DAK20/Sep 23 598.000 59,800.00 0.000
- - DAK 19/Apr 21 12,100.000 0.00 0.000
- - DAK 19/Mart.21 24,860.000 0.00 0.000
- - DAK 19/ Agst. 21 9,955.000
PRSpesifik 0.00 0.000
- - DAK 16/AGSTS 25,597.000 0.00
- - Dokter Muter 20 160.000 0.00 0.000
15 467 20
DAK 19/Juli 21 1,070.000 499,690.00 0.000
- - DAK 20 1,124.000 0.00 0.000
- - DAK 19/Mei 22 715.000 0.00 0.000
- - DAK 18L/Jul.20 432.300 0.00 0.000
- - DAK19/
PRSpesifik 437.800 0.00 0.000
- - 418.000 0.00 0.000
- - Dokter Muter 20 357.500
DAK 19/JUNI22 0.00 0.000
- - PRSpesifik L 20/ 495.000 0.00 0.000
- - DAK 18L/Sept.22 789.800 0.00 0.000
- - DAK 19 1,181.000 0.00 0.000
125 223 DAK 20/ Des 22 1,181.000 263,363.00 0.000
- - DAK
Hibah19/Des
RSUD 20 53.000 0.00 0.000
- - 56.000 0.00 0.000
- - Pasirian
Buffer Prop 20/ 53.000 0.00 0.000
15 17 DAK 17/JUN 20 20,700.000 351,900.00 0.000
21 28 DAK 19/Feb 21 11,825.000 331,100.00 0.000
- - DAK 20/Agust 22 11,825.000 0.00 0.000
- - DAK19/Apr 21 963.600 0.00 0.000
4,438 16,282 DAK 20 L 115.500 1,880,571.00 0.000
 - - DAK 19/Juli 21 4,400.000 0.00 0.000
1,102 898 DAK 20 L 132.000 118,536.00 0.000
- 1,746 DAK 19/Sept.21 123.000 214,758.00 0.000
- - PRSpesifik
DAK 17/AGSTSL 20/ 6,600.000 0.00 0.000
- - Buffer Prop 41,500.000 0.00 0.000
- - 20 68.000 0.00 0.000
1,580 2,914 19/Agus.20
DAK 19/Jan.21 73.000 212,722.00 0.000
APBD II-16/JUL-
- - 73.000 0.00 0.000
- - 20
DAK 17/JUL 19 1,000.000 0.00 0.000
243 189 DAK 19/Nov 20 1,155.000 218,295.00 0.000
- - PR BG 20/ 1,188.000 0.00 0.000
606 1,639 DAK 19/ 220.000 360,580.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Feb22
DAK 20/24-Jan- 9,646.000 0.00 0.000
- 300 9,646.000 2,893,800.00 0.000
- - 2023
DAK 18L/Apr.23 7,150.000 0.00 0.000
- - DAK
DAK 19/Juli 23
20/06-Jan- 7,150.000 0.00 0.000
- - 7,630.000 0.00 0.000
28 196 2025
DAK 19/Jan 21 4,550.000 891,800.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Nov.22 70.000 0.00 0.000
204 1,202 DAK 20 L 165.000 198,330.00 0.000
22 108 DAK 18/Juni 22 2,620.000 282,960.00 0.000
- - DAK 20/ 2,796.000 0.00 0.000
- - DAK 18/Des.22 6,006.000 0.00 0.000
- - DAK 14/MEI 19
PRSpesifik 5,170.000 0.00 0.000
25 35 2,200.000 77,000.00 0.000
- - Dokter
DAK Muter 20
DAK 19/Agst.20
20/30- 479,996.000 0.00 0.000
1 1 512,204.000 512,204.00 0.000
- - Agust-21
DAK
DAK 19/Sept. 20
20/30-Nov- 130,999.000 0.00 0.000
23 48 130,999.000 6,287,952.00 0.000
12 - 21
DAK 18/Apr.20 90.000 0.00 0.000
- - DAK 19/Mei 21 90.000 0.00 0.000
204 496 DAK 19/Juni 20 110.000 54,560.00 0.000
- - DAK 20/ 117.000 0.00 0.000
- - DAK 18/Mar.20 265.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/ 6,789.000 0.00 0.000
4 19 DAK 20/Feb 22 6,789.000 128,991.00 0.000
- - DAK 18L/DES19 13,607.000 0.00 0.000
- - Retur
Buffer PKM/
Prop 310.000 0.00 0.000
- - 86.000 0.00 0.000
19/Agus.21
 - - DAK 19/Juli 23 132.000 0.00 0.000
678 1,840 DAK 20/Feb 22 91.000 167,440.00 0.000
- - DAK 19/Juli 23 935.000 0.00 0.000
102 898 DAK 20 L 935.000 839,630.00 0.000
- 12 DAK19/Juli 23 7,150.000 85,800.00 0.000
- - DAK 17/Mei 21 7,150.000 0.00 0.000
1,704 3,557 DAK 20 89.000 316,573.00 0.000
- - DAK 18L/Sept.20 239.800 0.00 0.000
- - DAK 17/AGST.- 0.000 0.00 0.000
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- - Buffer Prop.20/ 825,000.000 0.00 0.000
- - Prop.19/Agst.21 224,254.000 0.00 0.000
- - Okt
DAK 21
BUFF.20PROP 259,175.000 0.00 0.000
- - 70,000.000 0.00 0.000
- - 17/JUN 12 18
Buffer Prop 4,952.830 0.00 0.000
- - Buffer Prop 19 4,952.830 0.00 0.000
- - Buffer Prop 19 2,728.000 0.00 0.000
- - Buffer Prop 20/
Buffer Prop 19 5,890.000 0.00 0.000
- - Buffer 660,000.000 0.00 0.000
- - Des 20 Prop 20/ 158,400.000 0.00 0.000
- - Des 21 PROP
BUFF.
276,600.000 0.00 0.000
BUFF. PROP
17/NOV 17
- - Buffer Prop 276,500.000 0.00 0.000
- - 17/NOV 18 257,644.000 0.00 0.000
DAK 20
19Des.19
- - 228,800.000 0.00 0.000
2 7 Penugasan
Buffer TB
DAK 20Prop 19 20,747.000 145,229.00 0.000
- - 20,748.000 0.00 0.000
- - Penugasan
Buffer Prop.TB
19 6,700.000 0.00 0.000
- 23 Buffer Prop. 20 19,835.000 456,205.00 0.000
- - Buffer Prop. 20 386.100 0.00 0.000
- - Buffer Prop - 0.000 0.00 0.000
- - Buffer Prop 1,590.000 0.00 0.000
- - 18/Feb.23 1,550.000 0.00 0.000
Buffer Prop
18/Mar.23
105 395 1,463.000 577,885.00 0.000
- - 19/Okt.21
Buffer Prop 20/
20/ 1,518.000 0.00 0.000
Buffer Prop
- - Buffer 1,190.000 0.00 0.000
1,100 1,600 Okt 24 Prop 1,185.000 1,896,000.00 1,900 2,251,500.000
Buffer Prop
19/Apr.23
- - 1,463.000 0.00 0.000
- - 19/Feb Prop
Buffer 24 1,190.000 0.00 0.000
Buffer Prop
19/Agst 24
- - Buffer Prop 1,077.000 0.00 0.000
- - 19/Mar.23 1,081.820 0.00 0.000
Buffer Prop
19/Juni 24
- - 0.000 0.00 0.000
- - 20/Juni 24 - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - Buffer Prop - 0.000 0.00 0.000
- 145 Buffer Prop 1,583.000 229,535.00 0.000
- - 19/Okt. 23 1,439.000 0.00 0.000
Buffer Prop
19/Feb.24
- - 1,439.000 0.00 0.000
- - 20/Feb.24 - 0.000 0.00 0.000
 10 65 Buffer Prop 19 22,433.000 1,458,145.00 50 1,121,650.000
- - Buffer Prop 20 1,460.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- 50 Buffer Prop 19 14,712.500 735,625.00 0.000
- - Buffer Prop 19/
Buffer Prop 20/ 19,480.000 0.00 0.000
- - 13,750.000 0.00 0.000
- - Juli 21 Prop 20/
Buffer 13,235.000 0.00 0.000
Buffer Prop
- 50 Buffer Prop 12,500.000 625,000.00 0.000
- - 19/Feb 21 13,750.000 0.00 0.000
Buffer Prop
20/Mar 21
- - Buffer Prop 20/ 358.000 0.00 0.000
- - 19/Mar.20 121,750.000 0.00 0.000
Buffer
Feb 21 Prop
- - 486.000 0.00 0.000
- - 19/Nov.21
Buffer Prop 19/- 0.000 0.00 0.000
145 674 11,975.000 8,071,150.00 0.000
- - Apr
DAK 20 Agst 21
Buffer20/
Prop 28,666.670 0.00 0.000
- - Buffer Prop 20/ 13,235.000 0.00 0.000
- - 18/Agst.20 12,500.000 0.00 0.000
- - Mei 2021
0Buffer 11,975.000 0.00 0.000
Prop
- - 11,975.000 0.00 0.000
- - 19/Nov.20
Buffer Prop - 0.000 0.00 0.000
- - 19,480.000 0.00 0.000
- - 18/Jun.20
Buffer Prop - 0.000 0.00 0.000
- - 13,235.000 0.00 0.000
- - 19/Agst. 20 - 0.000 0.00 0.000
Buffer Prop
- - Buffer Prop 19,480.000 0.00 0.000
- - 19/Juni 20 20 13,353.000 0.00 0.000
Buffer
juli 21 Prop.
- - 800.000 0.00 0.000
- - 18/Okt.21
Buffer Prop.20- - 0.000 0.00 0.000
- - Buffer Prop.20 - 323,500.000 0.00 0.000
- - Covid-19 53,000.000 0.00 0.000
Buffer Prop.20 -
Covid-19
- - 386.100 0.00 0.000
- - Covid-19 - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
 - - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19 38,500.000 0.00 0.000
- - DAK 19 71,500.000 0.00 0.000
- - DAK 20 38,500.000 0.00 0.000
- - DAK
DAU 20
ID 20 - 71,500.000 0.00 0.000
- - 333.900 0.00 0.000
- - Covid-19 - 0.000 0.00 0.000
- - Retur PKM - 0.000 0.00 0.000
- - Candipuro, 473.000 0.00 0.000
- - Sumbersari
RETUR - 0.000 0.00 0.000
- - RETUR 110.000 0.00 0.000
- - PASIRIAN
RETUR 1,750.000 0.00 0.000
- - PASIRIAN
RETUR
ROGOTRUNAN 98.000 0.00 0.000
- - RETUR
ROGOTRUNAN 783.000 0.00 0.000
- - ROGOTRUNAN
Buffer Prop 20/ 7,150.000 0.00 0.000
- - 2,134.000 0.00 0.000
- - Apr 21 Pronojiwo
Retur 6,199.900 0.00 0.000
RETUR
- - RETUR 1,155.000 0.00 0.000
- - ROGOTRUNAN 80.000 0.00 0.000
RETUR
ROGOTRUNAN
- - RETUR 396.000 0.00 0.000
- - ROGOTRUNAN 500.000 0.00 0.000
RETUR
ROGOTRUNAN
30 20 RETUR 7,920.000 158,400.00 0.000
- - ROGOTRUNAN 1,302.000 0.00 0.000
RETUR
ROGOTRUNAN
RETUR
- - 1,890.000 0.00 0.000
- - ROGOTRUNAN
YOSOWILANGU 160.000 0.00 0.000
DAK 20 /22 Feb
52 308 N
DAK 20 /01 Sep 6,840.000 2,106,720.00 0.000
- - 23 90.000 0.00 0.000
RETUR
21
DAU PR BG
- - 265.000 0.00 0.000
- - TEKUNG
DAU PRSpesifik
COVID 20/ Jan 14,300.000 0.00 0.000
449 643 20
RETURCovid-19/
22 Non 7,630.000 4,906,090.00 0.000
- - Mar 23
RETUR 167.000 0.00 0.000
- - ROGOTRUNAN 8,355.000 0.00 0.000
Buffer Prop 20/
ROGOTRUNAN
- - 1,457,500.000 0.00 0.000
Mar 22
 - - Buffer Prop 20/
Buffer Prop 20/ 0.000 0.00 0.000
- - Buffer 12,969.000 0.00 0.000
- - Agst 20Prop 20/ 1,506.000 0.00 0.000
Buffer
Feb 25 Prop 20/ 410,777.000
- - Buffer 0.00 0.000
- - Apr 21 Prop 20/ 343,687.000 0.00 0.000
Buffer
Apr 21 Prop
Buffer Prop 20/
20/ 32,493.000
- - 0.00 0.000
- 30 Mar 25
Bantuan 0.000 0.00 0.000
DAK 20
- - DAK 20 TB 2,254.320
Kemenkes 0.00 0.000
- - Penugasan
DAK 20 TB 259,175.000
Penugasan
0.00 0.000
- - DAK 20 15,180.000 0.00 0.000
- 200 Penugasan 31,680.000 6,336,000.00 0.000
DAK 20
Penugasan
3 196 31,405.000 6,155,380.00 0.000
- - Penugasan
PRBG 20 3,300.000 0.00 0.000
- - PRSpesifik
PRSpesifik 20 7,630.000 0.00 0.000
- - PRSpesifik 14,300.000 0.00 0.000
- - Dokter Muter 20 8,426.000 0.00 0.000
PRSpesifik
Dokter Muter 20 627.000
- - PRSpesifik 0.00 0.000
- - Dokter Muter 20 792.000 0.00 0.000
BTT 20Muter
Dokter KE 2 20
- - BTT 20-19
KE 2 1,700.000 0.00 0.000
- - COVID 1,700.000 0.00 0.000
BTT 20-19
COVID KE 2
- - BTT 20-19
KE 2 55,000.000 0.00 0.000
9 16 COVID 58,500.000 936,000.00 0.000
BTT 20-19
COVID KE 2
3,500 2,500 850.000 2,125,000.00 0.000
- 300 COVID
PROP -19
20 4,000.000 1,200,000.00 0.000
RETUR
- - PRSpesifik 20 8,355.000 0.00 0.000
- - ROGOTRUNAN 248,120.000 0.00 0.000
BTTCovid
Non 20 KE 2
- - BTT 20-19
KE 2 186,000.000 0.00 0.000
- - COVID 6,500.000 0.00 0.000
- - COVID -19 Juli 11,250.000
DAK 20/2024 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAU 20 - 0.000 0.00 0.000
- 8 DAU 20
PRSpesifik 236,500.000 1,892,000.00 0.000
- 5 DAU 20 20
PRSpesifik
Covid-19 99,000.000 495,000.00 0.000
- 4 DAU 20 20
PRSpesifik
Covid-19 203,500.000 814,000.00 0.000
- - DAU 20 20
PRSpesifik
Covid-19 275,000.000 0.00 0.000
- - PRSpesifik
Covid-19
DAU 20 20 132,000.000 0.00 0.000
- - Covid-19/20 49,500.000 0.00 0.000
PRSpesifik
 DAU 20
- - PRSpesifik
DAU 5,500.000 0.00 0.000
- - DAU 2020
Covid-19/20 66,000.000 0.00 0.000
- 2,000 PRSpesifik
PRSpesifik 1,023.000 2,046,000.00 0.000
BUFFER
- - Covid-19/20
BUFFER 20 21,736.000 0.00 0.000
- - PROPINSI 386.100 0.00 0.000
BUFFER
PROPINSI
DAU 20 20
- 1,800 340.280 612,504.00 0.000
- 1 PROPINSI
DAU 20 20
PRSpesifik 560,000.000 560,000.00 0.000
- 1 DAU 20
PRSpesifik
Covid-19 20 1,252,000.000 1,252,000.00 0.000
- - DAU 20
PRSpesifik
Covid-19 20 575,000.000 0.00 0.000
- 9 DAU20
PRSpesifik
Covid-19/Des 25 156,000.000 1,404,000.00 0.000
- - PRSpesifik/Des2
Covid-19/Des 26 53,636.000
DAU PR Spesifik 0.00 0.000
- - DAU PRSpesifik 220,000.000
5Covid-19/20 0.00 0.000
- 2 DAU PRS 20 148,500.000 297,000.00 0.000
- - Covid-19
DAU PRSpesifik 7,000.000
Covid-19/20
0.00 0.000
- - DAU ID COVID- 2,200.000 0.00 0.000
- - Covid-19/20 60,000.000 0.00 0.000
DAU
19 20/ID COVID- 6,269.000
- - DAU 0.00 0.000
- - 19 20/ID COVID- 197,000.000 0.00 0.000
DAU
19 20/ID COVID-
Mar 21
5 15 DAU 75,000.000 1,125,000.00 0.000
- - 19 20/ID COVID- 8,500.000 0.00 0.000
DAU
19 20/ID COVID- 220,000.000
12 9 DAU 1,980,000.00 0.000
- - 19 20/ID COVID- 220,000.000 0.00 0.000
DAU
19 20/ID COVID-
Mar 21
- - DAU 75,000.000 0.00 0.000
- 100 19 20/ID COVID- 5,000.000 500,000.00 0.000
DAU
19 20/ID COVID- 200,000.000
- - DAU 0.00 0.000
- - 19 20/ID COVID- 56,000.000 0.00 0.000
DAU
19 20/ID COVID- 80,000.000
- - 0.00 0.000
10 58 19 20/ID COVID- 200,000.000
DAU
11,600,000.00 0.000
BTT
19 20/20 COVID- 138,364.000
- - 0.00 0.000
- - 19 20 COVID- 137,364.000
BTT
0.00 0.000
DAU PRSpesifik
19
- 7 DAU PRSpesifik 45,100.000 315,700.00 0.000
- - Covid-19
DAU PRSpesifik 66,000.000
Covid-19
0.00 0.000
- - DAU ID Covid-19 53,636.000 0.00 0.000
- - Covid-19
DAU ID Covid- 450,000.000
20
0.00 0.000
- 4 DAU ID Covid- 718,500.000 2,874,000.00 0.000
- - 19/20
DAU ID Covid- 69,000.000
19/20
0.00 0.000
- - DAU ID Covid- 60,000.000 0.00 0.000
- 5,100 19/20
DAU ID Covid- 6,000.000
19/20
30,600,000.00 0.000
- - DAU ID Covid- 522,728.000 0.00 0.000
- - 19/20
DAU ID Covid- 180,000.000
19/20
0.00 0.000
- - BTT 20 COVID- 220,000.000 0.00 0.000
- - 19/20 109.090 0.00 0.000
19
 BTT 20 COVID-
- - BTT 20 COVID- 24,091.000 0.00 0.000
- 4,140 19 1,150.000 4,761,000.00 0.000
BTT 20 COVID-
19
1 4 BTT 20 COVID- 47,500.000 190,000.00 0.000
- - 19 200,000.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 2,816.000 0.00 0.000
6 4 19 150,000.000 600,000.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 303.550 0.00 0.000
- - 19 891,275.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 160,500.000 0.00 0.000
2,000 1,000 19 585.000 585,000.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 5,300.000 0.00 0.000
- - 19 5,500.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 60,500.000 0.00 0.000
- - 19 80,000.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 136,564.000 0.00 0.000
- - 19 1,265.000 0.00 0.000
DAU ID 20 non
19
- - DAU ID 20 non 8,400.000 0.00 0.000
- - covid-19 8,400.000 0.00 0.000
BTT ke 2 20
covid-19
- - BTT ke 2 20 98,000.000 0.00 0.000
- 20 COVID-19 90,000.000 1,800,000.00 0.000
BTT ke 2 20
COVID-20
- 50 97,500.000 4,875,000.00 50 4,875,000.000
9 11 COVID-21
DAU 20 22,500.000 247,500.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 7,199.885 0.00 0.000
- - - 1,945.000 0.00 0.000
- - - 2,950.000 0.00 0.000
- - - 139,880.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 1,097.000 0.00 0.000
30 314 - 77.000 24,178.00 0.000
- - - 3,217.500 0.00 0.000
- - - 0.000 0.00 0.000
- - - 15,572.700 0.00 0.000
- - - 270.000 0.00 0.000
- - - 600.000 0.00 0.000
24 214 - 1,106.000 236,684.00 0.000
- - - 45.000 0.00 0.000
- - - 36.000 0.00 0.000
- - - 783.000 0.00 0.000
- - - 1,302.000 0.00 0.000
- - - 74,250.000 0.00 0.000
- - - 43,186.000 0.00 0.000
- - - 7,920.000 0.00 0.000
- - - 8,750.000 0.00 0.000
- - - 7,018.000 0.00 0.000
- - - 8,355.000 0.00 0.000
- - - 20,328.000 0.00 0.000
- - - 12,076.000 0.00 0.000
- - - 6,595.000 0.00 0.000
- - - 1,098,900.000 0.00 0.000
- 1 - 712,800.000 712,800.00 0.000
- - - 56.000 0.00 0.000
- - - 1,640.000 0.00 0.000
- - - 42,800.000 0.00 0.000
- 126 - 2,750.000 346,500.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
 - 0.000 0.00 0.000
0 0 0.00 0.000
- - 212,106,361.45 23,880,650.000

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

RATIS

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
BUFFER P 257

BUFFER P 2728
 LAPORAN PEMAKAIAN DAN LEMBA
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN

UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 60 700 760

12 254
4 A004 0 0 - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial - - -
6 A006 Air Untuk Injeksi Vial @25 ml Vial 131 - 131
7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - -
8 A008 Alopurinol Tablet 100 mg Tablet 728 - 728 160
9 A009 Alopurinol Tablet 100 mg 0 - - -
10 A010 Ambroxol Tablet 30 mg Tablet 1,969 - 1,969
11 A011 0 0 - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - -
13 A013 0 0 - - -
14 A014 Amlodipin Tablet 10 Mg Tablet - - -
15 A015 Amlodipin Tablet 10 Mg Tablet 2,260 - 2,260 85 603
16 A016 0 0 - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet 17,449 - 17,449 1,010 3,640
18 A018 Amoksisilin Kaplet 500 mg Tablet - - -
19 A019 Amoksisilin Kaplet 500 mg Tablet - - -
20 A020 Amoksisilin Kaplet 500 mg Tablet - - -
21 A021 0 0 - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 104 100 204 13 53
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - -
25 A025 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - -
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - -
27 A027 CLABAT,CAPSINAT Tablet - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - -
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 155 - 155 64
30 A030 0 0 - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol - - -
32 A032 0 0 - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
35 A035 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet - - -
36 A036 Tablet 7,520 - 7,520 730 1,880
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - -
40 A040 Pot 24 - 24
41 A041 Salisilat 3% (Marin )
0Antihemoroid 0 - - -
Kombinasi : Bismut Suppgalat 150 mg
42 A042 Supp 15 - 15 5
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - -
45 A045 20% ) HEMOROGARD Tablet - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet - - -
47 A047 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet 3,870 - 3,870 124 1,316
48 A048 Tablet - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - -
50 A050 Asam Folat Tablet 1 mg Tablet - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - -
52 A052 Asam Mefenamat 500 mg 0 - 3,000 3,000 84 346
53 A053 0 0 - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 20 23
55 A055 0 0 - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 146 - 146 24
57 A057 0 0 - - -
58 A058 Asiklovir 5% 5gr Cream Tube 101 - 101 2 11
59 A059 Asiklovir 5% 5gr Cream Tube - - -
60 A060 0 0 - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 106 - 106 10 40
 63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet - 100 100
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - -
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet - - -
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet - - -
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet 1,553 - 1,553 20 70
69 A069 Betahistin Mesylat 6 mg Tablet - - -
70 A070 Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - -
71 A071 Betametason Dipropionat Krim 0,1% Tube - - -
72 A072 Betametason Dipropionat Krim 0,1% gram @ 10 - - -
Tube
gram @ 10
73 A073 Betametason Dipropionat Krim 0,1% 178 - 178 12 46
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - -
77 A077 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - -
78 A078 Bricasma Biji - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - -
80 A080 Zeneca
0Budesonid )I 0 - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 A081 pcs - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - -
84 A084 Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet - - -
85 A085 Cefadroksil Kapsul 500 mg Tablet 1,449 - 1,449 40 300
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 50 - 50 2
88 A088 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule - 50 50
89 A089 Tablet - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 126 - 126 1 48
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet - - -
93 A093 Deksamethason Tab 0,5 mg 0 1,544 - 1,544 33 547
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - -
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 244 - 244 5 117
97 A097 0 0 - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - -
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 170 - 170 26
100 A100 Digoksin Tab 0,25 mg Tablet - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 1,193 - 1,193 84 192
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - -
103 A103 0 0 - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet 314 - 314 52 58
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 2 - 2 2
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 100 - 100 7
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet 190 - 190 45
113 A113 Ethambutol 250 mg Tablet - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 179 - 179 16
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 31 - 31
120 A120 0 0 - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 80 - 80 5 18
128 A128 Gentamycin Krim 1 % mg/ ml Tube - - -
129 A129 Gentian Violet 1% 10 ml Botol 24 24 48 3 10
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 3 - 3 3
131 A131 Glibenklamid Tablet 5 mg Tablet 3,201 - 3,201 20 802
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet - 2,000 2,000
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet 2,166 - 2,166 355 935
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet - - -
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 14 - 14
137 A137 Glukosa Larutan 40% Steril botol - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - -
139 A139 Glukosa Larutan Infus 5% @500ml Botol - - -
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - -
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 806 - 806 180
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 104 - 104 8 35
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10
148 A148 0 0 - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 297 - 297 4 68
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 8,715 - 8,715 435 2,445
152 A152 Ibuprofen Tablet 400 mg Tablet - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - -
154 A154 Isoniazid Tablet 100 mg tablet - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 191 - 191
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
158 A158 0 0 - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 182 - 182
162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - -
163 A163 Tablet - - -
164 A164 Pharmatama)
0 0 - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 564 - 564 564
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet 5,000 - 5,000 1,964
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet - - -
170 A170 Kaptopril Tab 25 mg TAblet 2,780 - 2,780 85 1,105
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube - - -
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube 18 - 18 2 5
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 360 - 360
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - -
176 A176 Ketorolak Inj 30 mg/ml Ampule - - -
177 A177 0 0 - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube 46 - 46 3 43
179 A179 0 0 - - -
180 A180 Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol Vial - - -
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - -
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - -
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 3,435 - 3,435 348 1,302
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,378 - 1,378
190 A190 Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg 2,352 - 2,352 45 495
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol 114 - 114 17
193 A193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma )
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract 20 - 20 1
194 A194 MOLAKRIM
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 6 - 6 5
195 A195 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
- 10 10
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - -
197 A197 Probiotik (Dexa Medica, Sanbe) Tablet - - -
198 A198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 435 - 435 121
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 68 - 68 6 40
203 A203 Loperamid Tablet 2 mg Tablet - - -
204 A204 Loratadin Tablet 10 mg Tablet 126 - 126
205 A205 Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - -
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet - - -
207 A207 Mata/ OCUGARD (Phapros) Tablet - - -
208 A208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - -
209 A209 0 0 - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet - - -
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 1,013 - 1,013 132
213 A213 Metformin HCl Tablet 500 mg Tablet - - -
214 A214 Metformin HCl Tablet 500 mg Tablet 1,540 - 1,540 60 175
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 67 - 67 67
216 A216 0 0 - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet - - -
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet 1,690 - 1,690 60 348
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - -
223 A223 Metronidasol Infus 500mg/100ml Botol - - -
224 A224 Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - -
225 A225 Kapsul - - -
226 A226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) 120 - 120 120
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 A227 Ampule - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - -
229 A229 Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - -
230 A230 Tablet - - -
Ayus )
 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU
231 A231 Multivitamin Curcuma Syr:L-Lysyin 1000 IU Botol - - -
232 A232 vit B1 3 mg, B12 Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) Botol 148 - 148 9 23
Multivitamin Neurotopic
vit B1 3 mg, B12 Plus ATP
Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet
233 A233 Multivitamin - - -
234 A234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) Tablet - - -
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 A235 Femofomarrat 300mg tablet - - -
236 A236 MOLANEURON (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C Tablet - - -
237 A237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet 23 - 23 23
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet 1,000 - 1,000 37
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - -
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 45 - 45 45
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet - - -
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - -
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol - - -
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 20 - 20
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - -
248 A248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet 100 - 100
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - -
252 A252 Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - -
253 A253 Omeprazole Kapsul 20 mg Tablet - - -
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 467 - 467 10
255 A255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - -
256 A256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet - - -
257 A257 Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - -
258 A258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - -
259 A259 400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol
Parasetamol HCl 25Mg/ HUSTAB Tablet - - -
260 A260 (Phapros) Tablet - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 30Mg,
100 mg / COLPICA (Tropika Mas) 0 - - -
Parasetamol Komb Tablet Flu: Parasetamol
262 A262 Tablet - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - -
264 A264 Parasetamol Syrup 120 mg/5ml Botol 223 - 223 15 95
265 A265 Parasetamol tablet 500 mg Tablet - - -
266 A266 Parasetamol tablet 500 mg Tablet - - -
267 A267 Parasetamol tablet 500 mg Tablet - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 17 - 17 17
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 28 60 88 2 15
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - -
271 A271 Piracetam 800 mg Tablet Tablet - 200 200 40
272 A272 Parasetamol tablet 500 mg Tablet 16,282 - 16,282 468 3,422
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule - 30 30 8
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 898 - 898 48 136
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 1,746 - 1,746 910
276 A276 Probiotik Sachet (Probiokid) 0 - - -
277 A277 Polikresulen (Albotyl,Apetil) Botol - - -
278 A278 Prednison Tab 5 mg Tablet - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 2,914 - 2,914 354 872
280 A280 Prednison Tab 5 mg Tablet - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 189 - 189 189
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - 300 300 36
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 1,639 - 1,639 126 372
285 A285 0 0 - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol 300 - 300
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - -
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
290 A290 Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - -
291 A291 Nebule 196 - 196 22
292 A292 (COMBIVENT)
0 I dan II 0 - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - -
294 A294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet 1,202 - 1,202 65 121
295 A295 Salep Pot 108 - 108 2 15
296 A296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - -
298 A298 Salisil Bedak Serbuk 2% Pcs - - -
299 A299 Salisil Bedak Serbuk 2% Pcs 35 - 35 8
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - 1
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 48 - 48 10
304 A304 Setirizin Tab 10 mg (Futamed) Tablet - - -
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 496 - 496 26 198
307 A307 Simvastatin Tablet 10 mg Tablet - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
309 A309 0 0 - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - -
311 A311 Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% Botol 19 - 19 6
312 A312 Botol - - -
313 A313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - -
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - -
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 1,840 - 1,840 36 391
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - -
318 A318 Thiamphenicol Kapsul 500 mg Tablet 898 - 898 10 73
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 12 - 12
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - -
321 A321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek 3,557 - 3,557 363 1,447
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - -
323 A323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
327 A327 0 0 - - -
328 A328 0 0 - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - 3 3 2
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 3 - 3 1
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet 276 - 276 20
336 A336 Diazepam Tablet 5 mg Tablet - - -
337 A337 Fenobarbital Tablet 30 mg Tablet - - -
338 A338 Fenobarbital Tablet 30 mg Tablet - - -
339 A339 Fenobarbital Tablet 30 mg tablet - - -
340 A340 Kodein Tablet 10 mg Tablet - - -
341 A341 0 0 - - -
342 A342 Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON Tablet - - -
343 A343 Tablet - - -
344 A344 (Meprofarm)
0 0 - - -
345 A345 0 0 - - -
346 A346 0 0 - - -
347 A347 Primaquin 15 mg tablet tablet - - -
348 A348 0 0 - - -
OBAT - OBAT PROGRAM 0 - - -
OBAT PROGRAM KECACINGAN 0 - - -
349 A349 Albendazol Tablet 400 mg Tablet - - -
350 A350 Albendazol Tablet 400 mg Tablet 192 - 192 3
OBAT PROGRAM DIARE 0 - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - -
352 A352 Garam Oralit (Kimia Farma) Tablet 1,292 - 1,292 45 135
353 A353 Garam Oralit (Kimia Farma) sachet - - -
354 A354 Garam Oralit (Kimia Farma) sachet - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - -
356 A356 Botol 37 - 37 1 3
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - -
359 A359 Zinc Dispersible 20 mg tablet tablet - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 2,570 - 2,570 10 30
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
363 A363 0 0 - - -
OBAT PROGRAM HEPATITIS 0 - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
OBAT PROGRAM TB PARU 0 - - -
369 A369 OAT FDC Kategori Anak Kit - - -
370 A370 OAT FDC Kategori Anak Kit - - -
371 A371 OAT FDC Kategori Anak Kit - - -
372 A372 OAT FDC Kategori I - IIII Kit - - -
373 A373 OAT FDC Kategori I - IIII Kit 6 - 6 4
374 A374 OAT FDC Kategori II Kit - - -
375 A375 OAT FDC Kategori II Kit - - -
376 A376 OAT FDC Kategori II Kit - 2 2 2
377 A377 OAT FDC Kombipak Kategori I Kit - - -
378 A378 0 0 - - -
379 A379 Isoniazid 100 mg tablet tablet - - -
OBAT POGRAM KUSTA 0 - - -
380 A380 MDT MB Anak Blister - - -
381 A381 MDT MB Anak Blister - - -
382 A382 MDT MB Dewasa Blister - - -
383 A383 MDT MB Dewasa Blister - - -
384 A384 MDT MB Dewasa Blister - - -
385 A385 MDT PB Anak Blister - - -
386 A386 MDT PB Anak Blister - - -
387 A387 MDT PB Anak Blister - - -
388 A388 MDT MB Dewasa Blister 18 - 18 5
389 A389 MDT PB Dewasa Blister - - -
OBAT PROGRAM GIZI 0 - - -
390 A390 Mineral Mix Kombinasi sachet - - -
391 A391 Mineral Mix Kombinasi sachet - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 206 - 206 89
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - -
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
397 A397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul 6 - 6 6
398 A398 Tablet Tablet - - -
399 A399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Tablet 37,480 - 37,480 60 6,460
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros)
400 A400 tablet - - -
401 A401 0,4
0 Mg Tab (Phapros) 0 - - -
402 A402 0 0 - - -
OBAT PROGRAM KESGA 0 - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule - - -
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial - - -
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial 16 - 16 2
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 100 - 100 13
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 460 - 460 180
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 178 - 178 44
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
OBAT PROGRAM JIWA 0 - - -
416 A416 Amitriptilin 25 mg Tablet - - -
417 A417 Amitriptilin 25 mg Tablet - - -
418 A418 Amitriptilin 25 mg Tablet - - -
419 A419 Amitriptilin 25 mg Tablet 154 - 154 6
420 A420 Amitriptilin 25 mg Tablet - - -
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - -
422 A422 Clozapine 100 mg Tablet - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet 180 - 180
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - -
428 A428 Flufenazin sikzonoate inj 5 ml vial 9 - 9
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - -
430 A430 Haloperidol 5 mg tablet Tablet - - -
431 A431 Haloperidol 5 mg tablet Tablet 2,002 - 2,002 195
432 A432 Haloperidol 5 mg tablet Tablet - - -
433 A433 0 0 - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - -
436 A436 Haloperidol/ Lodomer drops 2 mg Botol 8 - 8
437 A437 Karbamazepin Tablet 200 mg Tablet - - -
438 A438 Karbamazepin Tablet 200 mg Tablet - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - 3
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - -
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 1,569 - 1,569 315
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - -
444 A444 0 0 - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - -
447 A447 Risperidon Tab 2 mg Tablet 72 - 72 72
448 A448 Risperidon Tab 2 mg Tablet 1,000 - 1,000 305
449 A449 0 0 - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - -
451 A451 0 0 - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - -
453 A453 Triheksifenidil Tablet 2 mg Tablet 797 - 797 592
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - 800 800
455 A455 0 0 - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - -
457 A457 0 0 - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - -
458 A458 BCG vial 18 - 18 15
459 A459 PELARUT BCG ampul 18 20 38 15
460 A460 BCG vial - - -
461 A461 BCG vial - 20 20
462 A462 CAMPAK 10ds (MR) vial - - -
463 A463 PELARUT CAMPAK ampul 74 - 74 38
464 A464 CAMPAK 10ds (MR) vial 10 - 10 10
465 A465 CAMPAK 10ds (MR) vial - - -
466 A466 DPT HB - Hib/ PENTABIO vial - - -
467 A467 DPT HB - Hib/ PENTABIO vial 15 100 115 44
468 A468 DT vial 48 - 48 37
469 A469 0 0 - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - -
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - 100 100
472 A472 POLIO bOPV 10 ds vial - - -
473 A473 DROPPER POLIO dropper 93 80 173 82
474 A474 POLIO bOPV 10 ds vial - - -
475 A475 POLIO bOPV 10 ds vial - - -
476 A476 Td vial 90 - 90 60
477 A477 0 0 - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial 37 - 37 34
479 A479 POLIO bOPV 10 ds vial - - -
480 A480 Vaksin Meningtis vial - - -
481 A481 CAMPAK 10ds (MR) BIAS vial - - -
482 A482 PELARUT CAMPAK BIAS ampul - - -
483 A483 POLIO bOPV 10 ds vial - 80 80 43
484 A484 IPV vial 20 - 20 17
485 A485 VTM Include Dacron (Biofarma) pcs - - -
486 A486 Vaksin Rabies (Verorab) vial - - -
487 A487 0 0 - - -
488 A488 0 0 - - -
489 A489 0 0 - - -
OBAT PROGRAM HIV/ AIDS 0 - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - -
491 A491 0 0 - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet 66 - 66 66
493 A493 0 0 - - -
494 A494 Lamivudine 150 mg Tablet - - -
495 A495 Lamivudine 150 mg Tablet - - -
496 A496 Nevirapine 200 mg Tablet - - -
497 A497 Nevirapine 200 mg Tablet - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - -
500 A500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - -
501 A501 FDC Dewasa Tablet - - -
502 A502 FDC Dewasa
Tenofovir 300 mg Tablet - - -
503 A503 Tenofovir 300 mg Tablet - - -
504 A504 Zidofudine 100 mg (ZDV) Tablet - - -
505 A505 Zidofudine 100 mg (ZDV) Tablet - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
508 A508 Efavirenz 600 mg tablet tablet - - -
509 A509 Efavirenz 600 mg tablet tablet - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
511 A511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - -
512 A512 Tablet - - -
FDC Dewasa
513 A513 0 0 - - -
514 A514 MB Anak blister - - -
515 A515 0 0 - - -
516 A516 0 0 - - -
517 A517 0 0 - - -
518 A518 0 0 - - -
519 A519 0 0 - - -
520 A520 0 0 - - -
521 A521 0 0 - - -
522 A522 0 0 - - -
523 A523 0 0 - - -
524 A524 0 0 - - -
525 A525 0 0 - - -
526 A526 0 0 - - -
527 A527 0 0 - - -
528 A528 0 0 - - -
529 A529 0 0 - - -
BMHP 0 - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
532 A532 0 0 - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - -
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - - -
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 1,415 - 1,415 631 89
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 1,045 - 1,045 68
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - 36 36 12
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs 46 - 46 6
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - -
542 A542 Alkohol 70% (Medika) Btl 1000 ml - - -
543 A543 Alkohol Swab 2 - ply (one med) 0 - - -
544 A544 Alkohol Swab 2 - ply (one med) Pcs 200 300 500 300
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol 1 - 1 1
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 42 - 42 16
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - -
549 A549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - -
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Pcs - - -
551 A551 Phsda 0 - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - -
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs - - -
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs 28 - 28 2 6
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - 5
561 A561 Mantel Gown (Bisa Dicuci) biji - - -
562 A562 I.V Catheter No. 18 (JELCO) Pcs - - -
563 A563 I.V Catheter No. 18 (NIPRO) Pcs 81 - 81 21
564 A564 I.V Catheter No. 20 JELCO Pcs - - -
565 A565 I.V Catheter No. 20 TERUMO Pcs - - -
566 A566 I.V Catheter No. 20 JELCO Pcs 128 200 328 56
567 A567 I.V Catheter No. 22 NIPRO Pcs - - -
568 A568 I.V Catheter No. 22 NIPRO Pcs 136 50 186 51
569 A569 I.V Catheter No. 24 TERUMO Pcs 49 - 49 16
570 A570 I.V Catheter No. 24 TERUMO 0 100 - 100
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - -
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 59 - 59
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
574 A574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 331 - 331 108
575 A575 Pcs - - -
576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 22 - 22 1 4
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - -
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - -
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 7 - 7 4
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - -
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 42 - 42 3
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - -
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 70 - 70 21
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - -
588 A588 Masker Ear Loop (Masker) Pcs - - -
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - -
590 A590 Masker General Care (MARCOTILA) Pcs - - -
591 A591 0 0 - - -
592 A592 Masker N95 Disposibel Pcs - - -
593 A593 Masker N95 Disposibel (One Med) Pcs - - -
594 A594 Masker Tali Pcs - - -
595 A595 Masker Tali Pcs - - -
596 A596 Masker Elastic Pcs - - -
597 A597 Media Sample Container Pcs 187 - 187 128
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs 11 - 11 11
601 A601 Nurse Cup (Tutup Kepala) Pcs - - -
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - -
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - -
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 70 - 70 30 5
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 7 - 7 1 1
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 38 - 38 12 4
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - -
610 A610 0 0 - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - -
613 A613 0 0 - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - - -
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - -
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir - 6,000 6,000 2,400 600
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 273 - 273 10
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 23 - 23 23
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - 36 36 5
622 A622 0 0 - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - 1 1
625 A625 Underpad 90x 0 cm cosmo I Pcs 30 - 30
626 A626 Underpad 90x 0 cm cosmo II Pcs - - -
627 A627 0 0 - - -
628 A628 Urine Bag Sterile Standard Pcs - - -
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs 53 - 53 2 3
630 A630 0 0 - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs 175 - 175 16
REAGEN 0 - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 400 - 400
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - -
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - -
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - -
639 A639 0 0 - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - -
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - -
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs 8 - 8 2
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - -
649 A649 0 0 - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - -
651 A651 0 0 - - -
652 A652 TPHA (Fokus) Test - - -
653 A653 0 0 - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - -
BMHP (PROGRAM) PROPINSI 0 - - -
PROGRAM MALARIA 0 - - -
656 A656 RDT Malaria Test - - -
PROGRAM SYPHILIS 0 - - -
657 A657 RPR Syphilis Pcs 70 - 70
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline Test
Test 84 - 84
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - -
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - -
662 A662 0 0 - - -
663 A663 Tuberkulin Vial - - -
664 A664 RDT Lepto (Uji Leptospira IgM) test - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - -
666 A666 0 0 - - -
667 A667 0 0 - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - -
668 A668 Test - - -
669 A669 Reagen HBsAg Strip SD Test - - -
670 A670 Reagen HBsAg Strip SD Test 184 - 184 112
671 A671 Reagen HBsAg Strip SD Test - - -
672 A672 0 0 - - -
673 A673 0 0 - - -
674 A674 0 0 - - -
675 A675 0 0 - - -
PROGRAM TB PARU 0 - - -
676 A676 Box Slide Pcs - - -
677 A677 Box Slide Pcs - - -
678 A678 Catridge Genexpart Test - - -
679 A679 Catridge Genexpart Test - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - -
681 A681 Oil Emersi Botol - - -
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - -
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - -
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - -
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - -
686 A686 Reagen Control CD4 0 - - -
687 A687 Reagen Control CD4 0 - - -
688 A688 Reagen Zeil Nelseen Kit - - -
689 A689 Reagen Zeil Nelseen Kit - - -
690 A690 Reagen Zeil Nelseen Kit - - -
691 A691 Reagen Zeil Nelseen Kit - - -
692 A692 Slide Pcs 7 - 7 2
693 A693 Slide/ Object Glass Pcs - - -
694 A694 Stereofoam pcs - - -
695 A695 Masker N 95 TB pcs 23 - 23
696 A696 Masker Tali Bedah TB pcs - - -
OBAT PROGRAM IMUNISASI 0 - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs 395 - 395 95
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs 1,600 500 2,100 1,050
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
708 A708 0 0 - - -
709 A709 0 0 - - -
710 A710 0 0 - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 145 - 145
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
714 A714 0 0 - - -
715 A715 Safety Box 5 L Pcs 65 - 65 8
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
717 A717 0 0 - - -
718 A718 0 0 - - -
719 A719 0 0 - - -
720 A720 0 0 - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - -
721 A721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test 50 - 50
722 A722 Tahap I 0 - - -
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold)
723 A723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - -
724 A724 Tahap I 0 - - -
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
725 A725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test 50 - 50
726 A726 Tahap I 0 - - -
727 A727 Tahap
Kondom I Pcs - - -
728 A728 DBS Collection/ Lasec Pcs - - -
729 A729 Lubricant Pcs - - -
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - -
731 A731 Test 674 - 674 96
732 A732 IRapid HIV 1/2 3.0 SD Bioline test - - -
733 A733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - -
734 A734 Test - - -
735 A735 Tahap
ReagenI HIV (SD) R 1 Test - - -
736 A736 Reagen HIV (SD) R 1 Test - - -
737 A737 0 0 - - -
738 A738 Reagen HIV (VIKIA) R 3 Test - - -
739 A739 0 0 - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - -
741 A741 0 0 - - -
742 A742 Reagen HIV R3 (VIKIA) Test - - -
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - -
744 A744 Sarung Tangan Non Steril Pair - - -
745 A745 0 0 - - -
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - -
747 A747 VTM Include Swab Test - - -
748 A748 Masker Bedah 3 ply Pcs - - -
749 A749 0 0 - - -
750 A750 0 0 - - -
751 A751 0 0 - - -
752 A752 0 0 - - -
753 A753 0 0 - - -
754 A754 0 0 - - -
755 A755 0 0 - - -
756 A756 0 0 - - -
757 A757 0 0 - - -
758 A758 0 0 - - -
759 A759 0 0 - - -
760 A760 0 0 - - -
761 A761 0 0 - - -
762 A762 0 0 - - -
763 A763 0 0 - - -
764 A764 0 0 - - -
OKSIGEN MEDICAL 0 - - -
765 A765 Oksigen 3 m3 Tampon - - -
766 A766 Oksigen 6 m3 Tampon - - -
767 A767 Oksigen 1 m3 Tampon - - -
768 A768 Oksigen 6 m3 Tampon - - -
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - -
770 A770 0 0 - - -
771 A771 0 0 - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - -
TAMBAHAN IFK 0 - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
3 T003 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex Tablet - - -
4 T004 Tablet - - -
5 T005 Thiamphenicol Syr. 0 - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - -
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - -
10 T010 Ketokonazole 200 mg Tablet - - -
11 T011 Kotrimoksazol Forte Tablet - - -
12 T012 Infusion set anak Pcs 20 - 20 20
13 T013 Alat Suntik 10 cc Pcs - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
15 T015 Omeprazole Kapsul 20 mg Tablet - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol 308 - 308 35
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
19 T019 Oseltamivir 75 mg Kapsul - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol 643 - 643 340
21 T021 Amitriptilin 25 mg Tablet - - -
22 T022 I.V Catheter No. 24 TERUMO pcs - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - -
24 T024 RDT COVID - 19 0 - - -
25 T025 Oseltamivir 75 mg 0 - - -
26 T026 Klorokuin
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - -
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - -
28 T028 Viruses) 0 - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) 0 - - -
30 T030 Hazmat/ APD/ Hazmat PPK 0 30 - 30
31 T031 Medical Sample Container Pcs - - -
32 T032 Cepheid Pcs - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - -
34 T034 Tambah Darah drop (Ferriz Drop) pcs 200 - 200
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs 196 - 196 2
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
38 T038 Obat Batuk Sirup / INADRYL Botol - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - -
40 T040 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - -
41 T041 dextromethorpan Hbr Tablet - - -
42 T042 Influenza
Masker Bedah /Bima Sakti pCS - 3,400 3,400 100 650
43 T043 Masker Bedah /Rania pCS - - -
44 T044 Masker N 95 Bima Sakti PCS - 20 20 9
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 16 20 36 12
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS 2,500 - 2,500 1,800 700
47 T047 Albendazol Suspensi 200mg/ 5 ml botol 300 - 300
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - -
49 T049 OAT FDC Kategori Anak 0 - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - -
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - -
53 T053 0 0 - - -
54 T054 0 0 - - -
55 T055 0 0 - - -
56 T056 0 0 - - -
57 T057 0 0 - - -
58 T058 0 0 - - -
59 T059 0 0 - - -
60 T060 APD Set (Rannia) 0 8 - 8
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5
62 T062 Cover
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 4 - 4
63 T063 0 - - -
64 T064 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - -
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs 2,000 - 2,000 1,000
69 T069 Masker N95 Covid 19 Pcs - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - -
71 T071 Masker Eaerlop Hijab Pcs 1,800 - 1,800
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter 1 - 1 1
73 T073 Hand Sanitzer 1 Botol = 20 Liter 1 - 1 1
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs 9 - 9
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - 2
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - -
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs - - -
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - -
84 T084 Masker KN95 (Farmahusada) Box @50 pcs 15 - 15
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - -
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test 9 - 9 9
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - -
89 T089 APRON (Atmosfer) pcs 100 - 100
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - -
91 T091 Hand Sanitzer 2 liter - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 58 - 58 23
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - -
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - -
96 T096 Face Shield (COBRA) 0 7 - 7
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
98 T098 Kit Steril (Rajawali) 0 - - -
99 T099 Alkohol II @20 Liter 0 - - -
100 T100 Cover All (Rajawali) 0 4 - 4
101 T101 Face Shield (ATMOSFER) 0 - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
103 T103 Masker Earloop (KasaHusada) 0 5,100 - 5,100
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - -
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - -
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - -
107 T107 Alkohol Swab (BTT) 0 - - -
108 T108 Antiseptic Gel 500 0 - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 4,140 - 4,140 4,140
110 T110 Kaca mata Goggle (HASTEN) 0 4 - 4 1
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - -
112 T112 Masker Bedah Hijau @50pcs 0 - - -
113 T113 Masker N95 3M 8210 (Hazten) 0 4 - 4 4
114 T114 Nurse Cap Green om 100bh 0 - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - -
117 T117 Sarung tangan Safeglove Exam M 100bh 0 1,000 - 1,000 1,000
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - -
121 T121 Universal Transport Media (UTM) Goongdong 0 - 40 40 22
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - -
127 T127 Rapid Test Lecurate (Bima Sakti) 0 20 - 20 10
128 T128 Rapid Test ZYBIO (Farma Husada) 0 50 - 50
129 T129 Alkohol 96 % Liter 11 - 11 4
130 T130 0 0 - - -
0 0 - - -
TAMBAHAN PUSKESMAS 0 - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - -
3 TP003 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube - - -
4 TP004 pcs - - -
5 TP005 Zeneca)
0 0 - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 314 - 314 42
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - -
9 TP009 0 0 - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - -
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - -
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 214 - 214 18
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - -
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 - - -
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 - - -
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - -
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - -
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - -
24 TP024 Materniti Napkin Slim L 0 - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - -
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1
29 TP029 Haloperidol 5 mg tablet Tablet - - -
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - -
31 TP031 Fixomull Strech 5 cm X 5 m Pcs - - -
32 TP032 Umbilical crd clamp 0 126 - 126
33 TP033 0 0 - - -
34 TP034 0 0 - - -
35 TP035 0 0 - - -
36 TP036 0 0 - - -
37 TP037 0 0 - - -
38 TP038 0 0 - - -
39 TP039 0 0 - - -
40 TP040 0 0 - - -
41 TP041 0 0 - - -
42 TP042 0 0 - - -
43 TP043 0 0 - - -
44 TP044 0 0 - - -
45 TP045 0 0 - - -
46 TP046 0 0 - - -
47 TP047 0 0 - - -
48 TP048 0 0 - - -
49 TP049 0 0 - - -
50 TP050 0 0 - - -
51 TP051 0 0 - - -
52 TP052 0 0 - - -
53 TP053 0 0 - - -
54 TP054 0 0 - - -
55 TP055 0 0 - - -
56 TP056 0 0 - - -
57 TP057 0 0 - - -
58 TP058 0 0 - - -
59 TP059 0 0 - - -
60 TP060 0 0 - - -
0 0 - - -
TOTAL - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep )

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Mengetahui
Plt. KEPALA DINAS KESEHATAN TERTULIS 2 KALI
KABUPATEN LUMAJANG

dr.BAYU WIBOWO IGN

NIP. 19630724 198910 1 002
N LEMBAR PERMINTAAN OBAT
PLPO )

: BULAN
: TAHUN

AN SUMBER HARGA STOK NILAI

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN
JUMLAH ANGGARAN SATUAN OPTIMUM PENERIMAAN

UNIT UNIT RP

- - DAK 18/Okt.19 99.000 0.00 0.000

- - DAK 19/Sept.21 105.000 0.00 0.000

266 494 DAK 20/ Jan 22 105.000 51,870.00 700 73,500.000

- - - 0.000 0.00 0.000
- - DAK 19/Feb.22 2,860.000 0.00 0.000
DAK 20/ 16 -
- 131 2,860.000 374,660.00 0.000
Des 22
- - DAK 18/Apr.20 10,500.000 0.00 0.000
160 568 DAK 19/Mei 23 104.000 59,072.00 0.000
- - DAK 20 L 220.000 0.00 0.000
- 1,969 DAK 19/Juni 21 93.500 184,101.50 0.000
- - DAK 17/AGSTS- - 0.000 0.00 0.000
- - 2,998.000 0.00 0.000
- - 20 - 0.000 0.00 0.000
- - Dak 19/Okt. 20 93.000 0.00 0.000
688 1,572 Dak 20/Okt 21 99.000 155,628.00 0.000
- - - 0.000 0.00 0.000
4,650 12,799 DAK 17/NOV-21 190.000 2,431,810.00 0.000
- - DAK 18/Okt.20 233.000 0.00 0.000
- - DAK 19/Feb 21 233.000 0.00 0.000
- - DAK 20/ April 22 249.000 0.00 0.000
 - - - 0.000 0.00 0.000
66 138 DAK 19/Agst.22 3,025.000 417,450.00 100 302,500.000
- - DAK 20 L 3,025.000 0.00 0.000
- - DAK 19/JULI 21 4,400.000 0.00 0.000
- - DAK 20/ Mart 22 3,628.000 0.00 0.000
- - DAK 18L/Mar.20 10,246.500 0.00 0.000
- - PRBG 20 9,900.000 0.00 0.000
- - DAK 17/MAR-20 8,500.000 0.00 0.000
64 91 DAK 20 / Mei-23 8,237.000 749,567.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Sept. 23 4,950.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR-19 440.000 0.00 0.000
- - DAK 18L/Agst.20 220.000 0.00 0.000
- - DAK 19/Mei20
PRSpesifik 21 165.000 0.00 0.000
2,610 4,910 58.000 284,780.00 0.000
- - non covid-19/ - 0.000 0.00 0.000
- - DAK 18/Apr-22 3,035.000 0.00 0.000
- - - 0.000 0.00 0.000
- 24 DAK 17/ Mei-21 4,496.000 107,904.00 0.000
- - - 0.000 0.00 0.000
5 10 DAK
Buffer Prop.20 - 3,045.000
16/APR-20 30,450.00 0.000
- - 198.000 0.00 0.000
- - Covid-19
DAK 18L/Jan.21 1,485.000 0.00 0.000
- - PRSpesifik L 20/ 1,551.000 0.00 0.000
- - DAK 19/Sept.21 105.000 0.00 0.000
1,440 2,430 DAK 20/Juni 22 105.000 255,150.00 0.000
- - DAK
DAK 17/Jan-21
17/AGSTS- 1,050.000 0.00 0.000
- - 67.000 0.00 0.000
- - 20
DAK 20/Feb 22 75.000 0.00 0.000
- - DAK 19/MAR-22 103.000 0.00 0.000
430 2,570 DAK 20 L 253.000 650,210.00 3,000 759,000.000
- - 0 0.000 0.00 0.000
- 23 DAK 19/Feb.22 2,076.000 47,748.00 20 41,520.000
- - 0 0.000 0.00 0.000
24 122 DAK 19/Feb.22 1,584.000 193,248.00 0.000
- - 0 0.000 0.00 0.000
13 88 DAK 18L/Apr.22 2,915.000 256,520.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 380.000 0.00 0.000
50 56 DAK 19/Des.22 380.000 21,280.00 0.000
 - 100 DAK 20/Des 23 405.000 40,500.00 100 40,500.000
- - Dak
DAK19/Feb 21
20/31-Okt 1,639.000 0.00 0.000
- - 1,639.000 0.00 0.000
- - 21
DAK 18/Apr 23 136.000 0.00 0.000
- - DAK20
DAK 19/Apr 23
/Nov22, 152.000 0.00 0.000
90 1,463 145.000 212,135.00 0.000
- - Mart
DAK 23
PRSpesifik 20 110.000
19/Jan 21 0.00 0.000
- - 110.000 0.00 0.000
- - Non
DAK Covid-19/
18/Feb.20 3,350.000 0.00 0.000
- - DAK 19/Feb.20 3,350.000 0.00 0.000
58 120 DAK 20/Okt 21 3,350.000 402,000.00 0.000
- - DAK 17/JUL-19 300.000 0.00 0.000
- - DAK 20/Feb 24 5,900.000 0.00 0.000
- - DAK 19/ 626.000 0.00 0.000
- - DAK 20 L 18,150.000 0.00 0.000
- - DAK 19/Agst. 20 7,602.000 0.00 0.000
- - DAK 19/Apr.20 7,124.000 0.00 0.000
- - 0 0.000 0.00 0.000
- - DAK 19/Jan 21 149,266.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Mei 24 5,280.000 0.00 0.000
- - DAK 19/Juni 24 660.000 0.00 0.000
340 1,109 PRBG 20/ 671.000 744,139.00 0.000
- - DAK 17/MAR-19 4,282.000 0.00 0.000
2 48 DAK 19/Mar.21 11,000.000 528,000.00 0.000
- 50 PRSpesifik L 20/ 10,098.000 504,900.00 50 504,900.000
- - DAK 19/Okt.21 2,805.000 0.00 0.000
- - DAK
DAK 19/Apr.21
20/ Des 21, 1,097.000 0.00 0.000
49 77 1,097.000 84,469.00 0.000
- - Feb
DAK2219/Juni 21 60.500 0.00 0.000
580 964 DAK 20 L 66.000 63,624.00 0.000
- - DAK 18/Nov 19 10,400.000 0.00 0.000
- - DAK 18L/Agst.20 9,900.000 0.00 0.000
122 122 DAK 19/Juni 22 1,095.000 133,590.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR-21 104.000 0.00 0.000
26 144 DAK 19/Nov.20 104.000 14,976.00 0.000
- - DAK 20/ 104.000 0.00 0.000
276 917 DAK 19/Nov.20 105.000 96,285.00 0.000
- - DAK 19/Mar.24 112.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/JULI21 4,400.000 0.00 0.000
 - - DAK 20/Feb 22 2,700.000 0.00 0.000
110 204 DAK 19/Juni 21 165.000 33,660.00 0.000
- - DAK 20/Mart 23 91.000 0.00 0.000
- - DAK 18/Des 20 1,408.000 0.00 0.000
2 - DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 0.00 0.000
7 93 Buffer 1,408.000 130,944.00 0.000
- - Aprl 21 Prop 730.000 0.00 0.000
45 145 19/Mei
DAK 20/ 20Mei 21 770.000 111,650.00 0.000
- - DAK
DAK 19/Des.23
17/SEPT- 391.000 0.00 0.000
- - 4,167.000 0.00 0.000
- - 20
DAK
Buffer17/AGS-19
Prop.19/ 3,550.000 0.00 0.000
- - 3,682.000 0.00 0.000
16 163 Feb 20 /31-Des
DAK 20
3,682.000 600,166.00 0.000
- - 21;Jan 22
DAK 17/Apr.19 691.000 0.00 0.000
- 31 DAK 18/Apr.21 710.000 22,010.00 0.000
- - DAK 17/ JAN-20 0.000 0.00 0.000
- - DAK
DAK 18/Des.19 1,333.000 0.00 0.000
- - 1,333.000 0.00 0.000
- - Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.00 0.000
- - DAK 20/Mei 22 82.000 0.00 0.000
- - DAK 18/Mei 21 4,232.000 0.00 0.000
- - DAK 19/Sept.22 4,232.000 0.00 0.000
23 57 DAK 20/Feb 23 4,232.000 241,224.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
13 35 DAK 20 L 4,400.000 154,000.00 24 105,600.000
3 - DAK 17/DES-20 2,900.000 0.00 0.000
822 2,379 DAK 19/Feb 24 119.000 283,101.00 0.000
- - DAK 20/ Feb 22 119.000 0.00 0.000
- 2,000 DAU 19/Mei
DAK PR BG 23 77.000 154,000.00 2,000 154,000.000
1,290 876 COVID 20/ Agsts 99.000 86,724.00 0.000
- - DAK 19/Mei 22
21 7,865.000 0.00 0.000
- 14 DAK 19/Mei 21 10,010.000 140,140.00 0.000
- - PRSpesifik L 20/ 10,010.000 0.00 0.000
- - DAK 17/FEB-20 6,900.000 0.00 0.000
- - DAK 20/ 7,363.000 0.00 0.000
- - APBD II - 15 132.000 0.00 0.000
180 626 DAK 16/OKT-21 149.000 93,274.00 0.000
- - DAK 20 L 88.000 0.00 0.000
- - DAK 18/Agst.21 2,787.000 0.00 0.000
43 61 DAK 19/Mei 23 2,475.000 150,975.00 0.000
- - DAK 20/ Juni 23 2,475.000 0.00 0.000
- - DAK 19/Jan 21 176,800.000 0.00 0.000
 - 10 DAK 19/Mei 21 8,800.000 88,000.00 0.000
- - DAK 20 L 0.000 0.00 0.000
- - DAK 19 4,665.000 0.00 0.000
72 225 DAK 20/ Des 21 4,665.000 1,049,625.00 0.000
2,880 5,835 DAK 19/JULI21 264.000 1,540,440.00 0.000
- - DAK 20 L 330.000 0.00 0.000
- - DAK 18L/Mar.20 660.000 0.00 0.000
- - DAK 20 L 187.000 0.00 0.000
- 191 DAK 17/MAR-21 90.000 17,190.00 0.000
- - DAK 18/Jan.22 89.000 0.00 0.000
- - DAK 19/Mart.23 121.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Nov.20 9,644.000 0.00 0.000
- - DAK 18/Jan.21 10,696.000 0.00 0.000
- 182 DAK 19/Jan.22 10,696.000 1,946,672.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Juli 21 770.000 0.00 0.000
- - - 0.000 0.00 0.000
- 100 DAK 18/Mar.21 1,755.000 175,500.00 0.000
564 - DAK 19/Mei 21 187.000 0.00 0.000
1,964 3,036 DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 191,268.00 0.000
- - 63.000 0.00 0.000
- - Jan
DAK2319/Mei 24 94.600 0.00 0.000
1,190 1,590 DAK 20 L 99.000 157,410.00 0.000
- - DAK 19/Mei23 5,610.000 0.00 0.000
7 11 DAK 20/ Juni 23 2,518.000 27,698.00 0.000
- 360 DAK 19/Juli21 396.000 142,560.00 0.000
- - DAK 19/Jun 21 288.000 0.00 0.000
- - DAK 20/Jan 22 288.000 0.00 0.000
- - DAK 19/Des.20 1,089.000 0.00 0.000
- - DAK 17/SEPT-- 0.000 0.00 0.000
46 - 1,810.000 0.00 0.000
- - 20 - 0.000 0.00 0.000
- - DAK 17/FEB-20 10,500.000 0.00 0.000
- - DAK 18L/Mei.20 17,968.500 0.00 0.000
- - DAK 19/Mart21 35,200.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 22.000 0.00 0.000
1,650 1,785 DAK 19/Mar.22 77.000 137,445.00 0.000
- - DAK 20/Feb 22 23.000 0.00 0.000
- - DAK 17/MEI 20 2,750.000 0.00 0.000
- - DAK 18L/Mei.23 495.000 0.00 0.000
 - 1,378 DAK 19/Juni 23 440.000 606,320.00 0.000
540 1,812 DAU PR BG 20/ 319.000 578,028.00 0.000
- - DAK 19/JUN 20 2,052.000 0.00 0.000
17 97 DAK 20/ Mei 22 2,190.000 212,430.00 0.000
1 19 DAK 17/JUNI 21 13,970.000 265,430.00 0.000
5 1 DAK 19/Apr.21 22,550.000
PRSpesifik 22,550.00 0.000
- 10 23,100.000 231,000.00 10 231,000.000
- - Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.00 0.000
- - DAK 19/Mei 21 6,600.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/JUN 21 1,937.000 0.00 0.000
121 314 DAK20/
DAK 19/Mei
Feb 21 2,178.000 683,892.00 0.000
- - 1,222.000 0.00 0.000
46 22 21;Mei22
DAK 19/Juni 21 99.000 2,178.00 0.000
- - DAK 20 L 330.000 0.00 0.000
- 126 DAK 19/Nov.21 123.000 15,498.00 0.000
- - DAK 20/Okt 23 131.000 0.00 0.000
- - DAK 18L/Sept.20 4,680.500 0.00 0.000
- - DAK 19/Jan 22 4,730.000 0.00 0.000
- - DAK 19/ 550.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18L/Apr.20 4,950.000 0.00 0.000
- - DAK 19/Apr 21 5,500.000 0.00 0.000
132 881 PRSpesifik L 20/ 3,707.000 3,265,867.00 0.000
- - DAK 19/Des.20
DAK20/28 Feb22 96.000 0.00 0.000
235 1,305 102.000 133,110.00 0.000
67 - ;DAK 19/Agst. 21 143.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR 22 87.000 0.00 0.000
- - DAK 18/Nov.20 80.000 0.00 0.000
- - DAK 20 / Juni 22 121.000 0.00 0.000
- - DAK19/JULI23 192.500 0.00 0.000
408 1,282 DAK 20 L 275.000 352,550.00 0.000
- - DAK 19/Nov 20 8,110.000 0.00 0.000
- - DAK 20/ 8,110.000 0.00 0.000
- - DAK 18L/Okt.20 14,318.700 0.00 0.000
- - DAK 19/Feb 21 5,500.000 0.00 0.000
120 - DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 0.00 0.000
- - 5,000.000 0.00 0.000
- - 19
DAK 19/FEB 21 4,400.000 0.00 0.000
PRSpesifik
- - 1,265.000 0.00 0.000
- - Dokter Muter 20
DAK 17/APR 20 990.000 0.00 0.000
 - - DAK 19/Apr.21 13,200.000
PRSpesifik 0.00 0.000
32 116 13,167.000 1,527,372.00 0.000
- - Dokter Muter 20 2,332.000
DAK 18L/Des.19 0.00 0.000
- - DAK 18L/Okt.21 528.000 0.00 0.000
- - PRSpesifik L 20/ 594.000 0.00 0.000
- - DAK 17/FEB 21 835.000 0.00 0.000
- - DAK 19/OKT20 115.000 0.00 0.000
23 - DAK 19/Des 20 123.000 0.00 0.000
37 963 DAK20/ 123.000 118,449.00 0.000
- - DAK 17/JUN 21 6,410.000 0.00 0.000
45 - DAK 18/Feb.22 6,410.000 0.00 0.000
- - PRSpesifik 20
DAK19/Jan 22 132.000 0.00 0.000
- - Non Covid-19/ 3,948.000 0.00 0.000
- - DAK2118L/Des.20 23,141.800
Okt 0.00 0.000
- - DAK 19/Juli 21 19,800.000 0.00 0.000
- 20 DAK 18/Agst.20 560.000 11,200.00 0.000
- - DAK 19/Juli 23 560.000 0.00 0.000
- 100 DAK20/Sep 23 598.000 59,800.00 0.000
- - DAK 19/Apr 21 12,100.000 0.00 0.000
- - DAK 19/Mart.21 24,860.000 0.00 0.000
- - DAK 19/ Agst. 21 9,955.000
PRSpesifik 0.00 0.000
- - DAK 16/AGSTS 25,597.000 0.00
- - Dokter Muter 20 160.000 0.00 0.000
10 457 20
DAK 19/Juli 21 1,070.000 488,990.00 0.000
- - DAK 20 1,124.000 0.00 0.000
- - DAK 19/Mei 22 715.000 0.00 0.000
- - DAK 18L/Jul.20 432.300 0.00 0.000
- - DAK19/
PRSpesifik 437.800 0.00 0.000
- - 418.000 0.00 0.000
- - Dokter Muter 20 357.500
DAK 19/JUNI22 0.00 0.000
- - PRSpesifik L 20/ 495.000 0.00 0.000
- - DAK 18L/Sept.22 789.800 0.00 0.000
- - DAK 19 1,181.000 0.00 0.000
110 113 DAK 20/ Des 22 1,181.000 133,453.00 0.000
- - DAK
Hibah19/Des
RSUD 20 53.000 0.00 0.000
- - 56.000 0.00 0.000
- - Pasirian
Buffer Prop 20/ 53.000 0.00 0.000
17 - DAK 17/JUN 20 20,700.000 0.00 0.000
17 71 DAK 19/Feb 21 11,825.000 839,575.00 60 709,500.000
- - DAK 20/Agust 22 11,825.000 0.00 0.000
40 160 DAK19/Apr 21 963.600 154,176.00 200 192,720.000
3,890 12,392 DAK 20 L 115.500 1,431,276.00 0.000
 8 22 DAK 19/Juli 21 4,400.000 96,800.00 30 132,000.000
184 714 DAK 20 L 132.000 94,248.00 0.000
910 836 DAK 19/Sept.21 123.000 102,828.00 0.000
- - PRSpesifik
DAK 17/AGSTSL 20/ 6,600.000 0.00 0.000
- - Buffer Prop 41,500.000 0.00 0.000
- - 20 68.000 0.00 0.000
1,226 1,688 19/Agus.20
DAK 19/Jan.21 73.000 123,224.00 0.000
APBD II-16/JUL-
- - 73.000 0.00 0.000
- - 20
DAK 17/JUL 19 1,000.000 0.00 0.000
189 - DAK 19/Nov 20 1,155.000 0.00 0.000
36 264 PR BG 20/ 1,188.000 313,632.00 300 356,400.000
498 1,141 DAK 19/ 220.000 251,020.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Feb22
DAK 20/24-Jan- 9,646.000 0.00 0.000
- 300 9,646.000 2,893,800.00 0.000
- - 2023
DAK 18L/Apr.23 7,150.000 0.00 0.000
- - DAK
DAK 19/Juli 23
20/06-Jan- 7,150.000 0.00 0.000
- - 7,630.000 0.00 0.000
22 174 2025
DAK 19/Jan 21 4,550.000 791,700.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Nov.22 70.000 0.00 0.000
186 1,016 DAK 20 L 165.000 167,640.00 0.000
17 91 DAK 18/Juni 22 2,620.000 238,420.00 0.000
- - DAK 20/ 2,796.000 0.00 0.000
- - DAK 18/Des.22 6,006.000 0.00 0.000
- - DAK 14/MEI 19
PRSpesifik 5,170.000 0.00 0.000
8 27 2,200.000 59,400.00 0.000
- - Dokter
DAK Muter 20
DAK 19/Agst.20
20/30- 479,996.000 0.00 0.000
- 1 512,204.000 512,204.00 0.000
- - Agust-21
DAK
DAK 19/Sept. 20
20/30-Nov- 130,999.000 0.00 0.000
10 38 130,999.000 4,977,962.00 0.000
- - 21
DAK 18/Apr.20 90.000 0.00 0.000
- - DAK 19/Mei 21 90.000 0.00 0.000
224 272 DAK 19/Juni 20 110.000 29,920.00 0.000
- - DAK 20/ 117.000 0.00 0.000
- - DAK 18/Mar.20 265.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/ 6,789.000 0.00 0.000
6 13 DAK 20/Feb 22 6,789.000 88,257.00 0.000
- - DAK 18L/DES19 13,607.000 0.00 0.000
- - Retur
Buffer PKM/
Prop 310.000 0.00 0.000
- - 86.000 0.00 0.000
19/Agus.21
 - - DAK 19/Juli 23 132.000 0.00 0.000
427 1,413 DAK 20/Feb 22 91.000 128,583.00 0.000
- - DAK 19/Juli 23 935.000 0.00 0.000
83 815 DAK 20 L 935.000 762,025.00 0.000
- 12 DAK19/Juli 23 7,150.000 85,800.00 0.000
- - DAK 17/Mei 21 7,150.000 0.00 0.000
1,810 1,747 DAK 20 89.000 155,483.00 0.000
- - DAK 18L/Sept.20 239.800 0.00 0.000
- - DAK 17/AGST.- 0.000 0.00 0.000
- - 108.000 0.00 0.000
- - 18
DAK 17/FEB 21 1,045.000 0.00 0.000
Buffer Prop
- - Buffer Prop 967.000 0.00 0.000
- - 17/Jul.21 776.006 0.00 0.000
- - 20/ /Des 22 - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Feb.20 12,573.000 0.00 0.000
- - DAK 19/Mar.22 12,573.000 0.00 0.000
2 1 DAK
Buffer20/
Prop 19/ 12,573.000 12,573.00 3 37,719.000
- - Prop 20/ 1,735.000
Buffer20 0.00 0.000
- - Agsts 1,735.000 0.00 0.000
1 2 Agsts
DAK 2020 L 19,789.000 39,578.00 0.000
20 256 DAK
PRSpesifik 20 396.000
18L/Mei.20 101,376.00 0.000
- - 114.000 0.00 0.000
- - non
DAK covid-19/
Buffer Prop 19/ 171.000
17/NOV-19 0.00 0.000
- - 171.000 0.00 0.000
- - Jun 23 Prop 20/ 171.000
Buffer 0.00 0.000
- - DAK 16/APR 19 550.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/JUN 20 779.000 0.00 0.000
- - DAK 19/Feb. 23 1,320.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000
Buffer Prop. 20/ 0.00 0.000
- - 278.300 0.00 0.000
- - Mei 21 - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - Buffer Prop - 0.000 0.00 0.000
- - Buffer Prop 404.000 0.00 0.000
3 189 19/Feb 22 431.000 81,459.00 0.000
- - 20/nov 21 - 0.000 0.00 0.000
Buffer Prop
- - Buffer Prop 19 257.000 0.00 0.000
180 1,112 18/Jul.23 257.000 285,784.00 0.000
Juli 23
 Buffer Prop 20/
- - 274.000 0.00 0.000
- - April
DAK24 19/Agst.22 274.000 0.00 0.000
- - - 0.000 0.00 0.000
4 33 DAK 19 /Nov 20 6,281.000 207,273.00 0.000
- - DAK 18L/Sept.20
Buff Prop 19 /Mei 9,900.000 0.00 0.000
- - Buff Prop 20/ 524.000 0.00 0.000
- - 20 524.000 0.00 0.000
- - Sept.22
DAK 18/Mart 20 524.000 0.00 0.000
40 2,530 DAK
DAK 19/Jan
20/Mei 21 524.000 1,325,720.00 0.000
- - 524.000 0.00 0.000
- - 21;Agust 22 - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK
Buffer Prop 19/ 1,325,000.000
19/Agus.20 0.00 0.000
- - 1,325,000.000 0.00 0.000
- - Agsts.
Hibah 19
Jember 1,325,000.000 0.00 0.000
- - Buffer Prop 20/ 1,325,000.000
DAK 20/Maret 0.00 0.000
- - 1,325,000.000 0.00 0.000
- - 22,SEP 21 - 0.000 0.00 0.000
Buffer
- - Buffer Prop 20 232,518.000 0.00 0.000
- - Prop19/Juni 248,120.000 0.00 0.000
Buffer Prop
19/Jun 21 20/ 248,120.000
- - Buffer 0.00 0.000
- - Mei 21 Prop
Buffer Prop 20/ 389,344.000
19/Juli21
0.00 0.000
4 2 DAU/ 22DAK 415,469.000 830,938.00 0.000
- - Agsts 1,384,983.000 0.00 0.000
Buffer Prop
19/Juni 22
- - Buffer Prop 1,384,983.000 0.00 0.000
2 - 19/Jan 22 20/ 1,384,983.000 0.00 2 2,769,966.000
BUFF.22
Agsts
- - 317,018.000 0.00 0.000
- - PROP19/Agst 22
Buffer Prop 20/ 0.000
- 0.00 0.000
- - 282.000 0.00 0.000
- - Juni 22 - 0.000 0.00 0.000
Buffer Prop
- - Buffer Prop 28,354.000 0.00 0.000
- - 19/Juni 21 28,354.000 0.00 0.000
Buffer Prop
20/Juni 21 19/ 40,913.489
- - Buffer Prop 19/ 0.00 0.000
- - Okt.21
Buffer Prop 20/ 41,784.000
Okt.21
0.00 0.000
- - Buffer Prop 41,784.000 0.00 0.000
- - Okt.21 8,891.000 0.00 0.000
Buffer Prop
17/Mei 19
- - 13,300.000 0.00 0.000
- - 18/Agst.20
DAK
Buffer Prop 20/ 11,738.000
17/2020 0.00 0.000
5 13 Buffer 36,579.000 475,527.00 0.000
- - Nov 22 Prop 20/ 15,014.000 0.00 0.000
- - Nov 22
Buffer Prop - 0.000 0.00 0.000
- - 2,920.000 0.00 0.000
19/Sept 20
 - - Buffer Prop 20/ 2,920.000 0.00 0.000
- - DAK
Buffer19/Agust.21 517.000 0.00 0.000
89 117 DAK 20Prop 517.000 60,489.00 0.000
- - 20/Apr.22
Penugasan/
Buffer Prop 20 552.000
PRSpesifik
Jan 0.00 0.000
- - 23 284.000 0.00 0.000
- - 18/Okt.
Non 20
DAU Penugasan 307.000
Covid-19/ 0.00 0.000
6 - Okt 21 Prop
Buffer 307.000 0.00 0.000
- - 20 354.000 0.00 0.000
Buffer 20
19/Juli Prop
6,520 30,960 354.000 10,959,840.00 0.000
- - 20/Agst 21
DAK Penugasan 354.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - Buffer Prop - 0.000 0.00 0.000
- - 9,955.000 0.00 0.000
- - 18/Agst.20
DAK
DAK GD 20/09- 3,796.000
19/Mar 20 0.00 0.000
2 14 DAK GD 20/09- 3,796.000 53,144.00 0.000
- - Okt/21 10,351.000 0.00 0.000
13 87 Okt/21
DAK 19/ Des 20 2,959.000 257,433.00 0.000
Buffer Prop
- - DAK 20 /30- 2,684.000 0.00 0.000
- - 19/Jul.19
Buffer Propinsi 2,959.000
Sept-21
0.00 0.000
- - 2,500.000 0.00 0.000
180 280 20
DAK/Juli18/Apr.22
21 210.000 58,800.00 0.000
Buffer
- - DAK 20 / 31 - 1,900.000 0.00 0.000
44 134 Prop.19/Sept.19
DAK22GD 20/ 31- 1,199.000
Okt
160,666.00 0.000
- - PR 21BG 20/ Juli 1,639.000 0.00 0.000
- - Okt 1,199.000 0.00 0.000
- - 23 - 0.000 0.00 0.000
- - DAK
Buffer18/Apr.21
Prop 167.000 0.00 0.000
- - 167.000 0.00 0.000
- - 18/Mei
DAK 19/21Jan 23 167.000 0.00 0.000
Buffer Prop 20/
6 148 167.000 24,716.00 0.000
- - Feb.
DAK23 20/ 167.000 0.00 0.000
- - DAK
PRSpesifik 20 1,121.000
19 0.00 0.000
- - 3,288.000 0.00 0.000
- - non
DAKcovid-19/
20/ 1,200.000 0.00 0.000
- - Hibah17/NOV 20 1,750.000
DAK 0.00 0.000
- 180 Penyedia/NOV 1,750.000 315,000.00 0.000
- - DAK
Buffer19/
20 Juni20/
Prop 21 183.000 0.00 0.000
- - Buffer Prop. 20/ 63,986.000 0.00 0.000
- 9 Agst.22 63,813.000 574,317.00 0.000
- - agst.22
DAK 17/JUN 20 57,500.000 0.00 0.000
- - DAK 19/Apr 22 60.000 0.00 0.000
 Buffer Prop. 20/
195 1,807 60.000 108,420.00 0.000
- - Agst.22
DAK 20/ 60.000 0.00 0.000
- - - 0.000 0.00 0.000
- - Buffer Prop 19 5,000.000 0.00 0.000
- - DAK 20 L 13,200.000 0.00 0.000
- 8 DAK 19/Jan 22 19,955.000 159,640.00 0.000
- - DAK
DAK 19/Juni
20/ Nov 22
22, 245.000 0.00 0.000
- - Buffer Prop 19/ 245.000 0.00 0.000
- 3 Des 22 1,243.000 3,729.00 0.000
- - Feb
DAK2120/ 1,326.000 0.00 0.000
- - DAK
Buffer19/Sept.
Prop 20/22 158.000 0.00 0.000
315 1,254 157.000 196,878.00 0.000
- - Sept.
DAK 2220 L 253.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/
Buffer Prop 19/ 287.000 0.00 0.000
- - Buffer 287.000 0.00 0.000
72 - Apr 22 Prop 20/ 287.000 0.00 0.000
305 695 Juli 22
DAK 20/ 287.000 199,465.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Juni 23 287.000 0.00 0.000
- - Buffer Prop 19/- 0.000 0.00 0.000
- - Buffer 91.000 0.00 0.000
592 205 Mei 22 Prop 20/ 91.000 18,655.00 0.000
- 800 Juni
DAK22 20 L 440.000 352,000.00 800 352,000.000
- - PR BG 20/ - 0.000 0.00 0.000
- - 63,986.000 0.00 0.000
- - Nov.22 - 0.000 0.00 0.000
- - -
Buffer Prop/ Jan 0.000 0.00 0.000
15 3 Buffer Prop/ Juli 56,360.000 169,080.00 0.000
15 23 0709S4020 21Buffer Prop/ Juli 0.000 0.00 20 0.000
- - 22 60,140.000 0.00 0.000
Buffer Prop/
- 20 0379G060 21Buffer Prop/ 66,154.000 1,323,080.00 20 1,323,080.000
- - Sept.21 141,648.000 0.00 0.000
Buffer Prop/
Mar.20
38 36 Buffer Prop/ 0.000 0.00 0.000
10 - Mar.23 151,150.000 0.00 0.000
Buffer Prop/
Jul.23
- - Buffer Prop/ Juli 166,265.000 0.00 0.000
- - Agust.21 76,620.000 0.00 0.000
Buffer Prop/ Des
20
44 71 5041919 Buffer Prop/ Apr. 84,282.000 5,984,022.00 100 8,428,200.000
37 11 20 17,450.000 191,950.00 0.000
- - 22
Buffer Prop/ - 0.000 0.00 0.000
- - Buffer Prop/ 23,270.000 0.00 0.000
- 100 3651220 Mar.21 25,597.000 2,559,700.00 100 2,559,700.000
Agust 21
 Buffer Prop/Juli
- - 18,140.000 0.00 0.000
82 91 21
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- - PRSpesifik
Covid-19
DAU 20 20 132,000.000 0.00 0.000
- - Covid-19/20 49,500.000 0.00 0.000
PRSpesifik
 DAU 20
- - PRSpesifik
DAU 5,500.000 0.00 0.000
- - DAU 2020
Covid-19/20 66,000.000 0.00 0.000
1,000 1,000 PRSpesifik
PRSpesifik 1,023.000 1,023,000.00 0.000
BUFFER
- - Covid-19/20
BUFFER 20 21,736.000 0.00 0.000
- - PROPINSI 386.100 0.00 0.000
BUFFER
PROPINSI
DAU 20 20
- 1,800 340.280 612,504.00 0.000
1 - PROPINSI
DAU 20 20
PRSpesifik 560,000.000 0.00 0.000
1 - DAU 20
PRSpesifik
Covid-19 20 1,252,000.000 0.00 0.000
- - DAU 20
PRSpesifik
Covid-19 20 575,000.000 0.00 0.000
- 9 DAU20
PRSpesifik
Covid-19/Des 25 156,000.000 1,404,000.00 0.000
- - PRSpesifik/Des2
Covid-19/Des 26 53,636.000
DAU PR Spesifik 0.00 0.000
- - DAU PRSpesifik 220,000.000
5Covid-19/20 0.00 0.000
- 2 DAU PRS 20 148,500.000 297,000.00 0.000
- - Covid-19
DAU PRSpesifik 7,000.000
Covid-19/20
0.00 0.000
- - DAU ID COVID- 2,200.000 0.00 0.000
- - Covid-19/20 60,000.000 0.00 0.000
DAU
19 20/ID COVID- 6,269.000
- - DAU 0.00 0.000
- - 19 20/ID COVID- 197,000.000 0.00 0.000
DAU
19 20/ID COVID-
Mar 21
- 15 DAU 75,000.000 1,125,000.00 0.000
- - 19 20/ID COVID- 8,500.000 0.00 0.000
DAU
19 20/ID COVID- 220,000.000
9 - DAU 0.00 0.000
- - 19 20/ID COVID- 220,000.000 0.00 0.000
DAU
19 20/ID COVID-
Mar 21
- - DAU 75,000.000 0.00 0.000
- 100 19 20/ID COVID- 5,000.000 500,000.00 0.000
DAU
19 20/ID COVID- 200,000.000
- - DAU 0.00 0.000
- - 19 20/ID COVID- 56,000.000 0.00 0.000
DAU
19 20/ID COVID- 80,000.000
- - 0.00 0.000
23 35 19 20/ID COVID- 200,000.000
DAU
7,000,000.00 0.000
BTT
19 20/20 COVID- 138,364.000
- - 0.00 0.000
- - 19 20 COVID- 137,364.000
BTT
0.00 0.000
DAU PRSpesifik
19
- 7 DAU PRSpesifik 45,100.000 315,700.00 0.000
- - Covid-19
DAU PRSpesifik 66,000.000
Covid-19
0.00 0.000
- - DAU ID Covid-19 53,636.000 0.00 0.000
- - Covid-19
DAU ID Covid- 450,000.000
20
0.00 0.000
- 4 DAU ID Covid- 718,500.000 2,874,000.00 0.000
- - 19/20
DAU ID Covid- 69,000.000
19/20
0.00 0.000
- - DAU ID Covid- 60,000.000 0.00 0.000
- 5,100 19/20
DAU ID Covid- 6,000.000
19/20
30,600,000.00 0.000
- - DAU ID Covid- 522,728.000 0.00 0.000
- - 19/20
DAU ID Covid- 180,000.000
19/20
0.00 0.000
- - BTT 20 COVID- 220,000.000 0.00 0.000
- - 19/20 109.090 0.00 0.000
19
 BTT 20 COVID-
- - BTT 20 COVID- 24,091.000 0.00 0.000
4,140 - 19 1,150.000 0.00 0.000
BTT 20 COVID-
19
1 3 BTT 20 COVID- 47,500.000 142,500.00 0.000
- - 19 200,000.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 2,816.000 0.00 0.000
4 - 19 150,000.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 303.550 0.00 0.000
- - 19 891,275.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 160,500.000 0.00 0.000
1,000 - 19 585.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 5,300.000 0.00 0.000
- - 19 5,500.000 0.00 0.000
BTT 20 COVID-
19
- - BTT 20 COVID- 60,500.000 0.00 0.000
22 18 19 80,000.000 1,440,000.00 40 3,200,000.000
BTT 20 COVID-
19
- - BTT 20 COVID- 136,564.000 0.00 0.000
- - 19 1,265.000 0.00 0.000
DAU ID 20 non
19
- - DAU ID 20 non 8,400.000 0.00 0.000
- - covid-19 8,400.000 0.00 0.000
BTT ke 2 20
covid-19
- - BTT ke 2 20 98,000.000 0.00 0.000
10 10 COVID-19 90,000.000 900,000.00 0.000
BTT ke 2 20
COVID-20
- 50 97,500.000 4,875,000.00 0.000
4 7 COVID-21
DAU 20 22,500.000 157,500.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 7,199.885 0.00 0.000
- - - 1,945.000 0.00 0.000
- - - 2,950.000 0.00 0.000
- - - 139,880.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 1,097.000 0.00 0.000
42 272 - 77.000 20,944.00 0.000
- - - 3,217.500 0.00 0.000
- - - 0.000 0.00 0.000
- - - 15,572.700 0.00 0.000
- - - 270.000 0.00 0.000
- - - 600.000 0.00 0.000
18 196 - 1,106.000 216,776.00 0.000
- - - 45.000 0.00 0.000
- - - 36.000 0.00 0.000
- - - 783.000 0.00 0.000
- - - 1,302.000 0.00 0.000
- - - 74,250.000 0.00 0.000
- - - 43,186.000 0.00 0.000
- - - 7,920.000 0.00 0.000
- - - 8,750.000 0.00 0.000
- - - 7,018.000 0.00 0.000
- - - 8,355.000 0.00 0.000
- - - 20,328.000 0.00 0.000
- - - 12,076.000 0.00 0.000
- - - 6,595.000 0.00 0.000
- - - 1,098,900.000 0.00 0.000
- 1 - 712,800.000 712,800.00 0.000
- - - 56.000 0.00 0.000
- - - 1,640.000 0.00 0.000
- - - 42,800.000 0.00 0.000
- 126 - 2,750.000 346,500.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- - - 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
 - 0.000 0.00 0.000
0 0 0.00 0.000
- - 183,188,668.12 39,211,655.000

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

RATIS

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

Yang Menyerahkan, YANG MENERIMA / PETUGAS

KEPALA INSTALASI FARMASI KABUPATEN PUSKESMAS
YANG MEMINTA / MELAPOR
KEPALA PUSKESMAS

................................................
Dra. TRI MUSYAROFAH, Apt
NIP. 19630411 199203 2 005
......................................................
Ket
BUFFER P 257

BUFFER P 2728
sudah
SUDAH
DI
AMBIL
19
NOVE
MBER
SUDAH 1.000 (19/11)
SUDAH DI AMBIL 19 NOV 19
 LAPORAN PEMAKAIAN DAN LEMBA
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN : PELAPORAN BULAN
KABUPATEN : LUMAJANG PERMINTAAN BULAN
PROPINSI : JAWA TIMUR

SATUAN PEMAKAIAN
Kode
NO Obat NAMA OBAT STOK AWAL PENERIMAAN PERSEDIAAN
KEMASAN RAWAT INAP RAWAT JALAN

UNIT UNIT UNIT

1 A001 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

2 A002 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - -

3 A003 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 494 - 494

10 376
4 A004 0 0 - - -
5 A005 Air Untuk Injeksi Vial @25 ml Vial - - -
6 A006 Air Untuk Injeksi Vial @25 ml Vial 131 - 131
7 A007 Air Untuk Irigasi Infus 1000 ml Botol - - -
8 A008 Alopurinol Tablet 100 mg Tablet 568 - 568 186
9 A009 Alopurinol Tablet 100 mg 0 - - -
10 A010 Ambroxol Tablet 30 mg Tablet 1,969 - 1,969 165 386
11 A011 0 0 - - -
12 A012 Aminofilin Injeksi 24 mg/ml Ampule - - -
13 A013 0 0 - - -
14 A014 Amlodipin Tablet 10 Mg Tablet - - -
15 A015 Amlodipin Tablet 10 Mg Tablet 1,572 - 1,572 89 541
16 A016 0 0 - - -
17 A017 Amoksisilin Kaplet 500 mg Tablet 12,799 - 12,799 405 3,964
18 A018 Amoksisilin Kaplet 500 mg Tablet - - -
19 A019 Amoksisilin Kaplet 500 mg Tablet - - -
20 A020 Amoksisilin Kaplet 500 mg Tablet - - -
21 A021 0 0 - - -
22 A022 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 138 - 138 12 44
23 A023 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - -
24 A024 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - -
25 A025 Amoksisilin
Amoxiclav 625 Syrup
mgKering 250mg500
(Amoksisilin / 5 mg,
ml (Novapharin)
Clavulanat 125 mg) / Botol - - -
26 A026 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / Tablet - - -
27 A027 CLABAT,CAPSINAT Tablet - - -
28 A028 CLABAT,CAPSINAT
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial - - -
29 A029 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial 91 - 91 41
30 A030 0 0 - - -
31 A031 Antacida + Simeticon Suspensi (NOVAMAG) Botol - - -
32 A032 0 0 - - -
33 A033 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
34 A034 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - -
35 A035 Antacida + Simeticon
Antacida tablet kunyahTablet
DOEN, Kunyah (MAGTEN)
kombinasi : Alumunium Tablet - - -
36 A036 Tablet 4,910 - 4,910 576 2,002
37 A037 Hidroksida
0 200 mg + Magnesium Hidroksida 200 mg 0 - - -
38 A038 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - -
39 A039 0Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam 0 - - -
40 A040 Pot 24 - 24
41 A041 Salisilat 3% (Marin )
0Antihemoroid 0 - - -
Kombinasi : Bismut Suppgalat 150 mg
42 A042 Supp 10 - 10 10
43 A043 Heksaklorofen
Asam Ascorbat 2,5
500mgmg Lidokain 10C)mg Seng Oksida 120 mg
(Vitamin Tablet - - -
Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio
44 A044 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio Tablet - - -
45 A045 20% ) HEMOROGARD Tablet - - -
46 A046 20%
Asam) Ascorbat
HEMOROGARD50 mg (Vitamin C) Tablet - - -
47 A047 Asam
Asam Folat 1 mg50Beta
Ascorbat mg (Vitamin C)
Caroten 10000 Multi Mineral/ FOLAMIL Tablet 2,430 - 2,430 214 1,433
48 A048 Tablet - - -
49 A049 (Dexa Medica)
Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - -
50 A050 Asam Folat Tablet 1 mg Tablet - - -
51 A051 Asam Mefenamat 500 mg ( Mersi ) Tablet - - -
52 A052 Asam Mefenamat 500 mg 0 2,570 - 2,570 55 819
53 A053 0 0 - - -
54 A054 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 23 - 23
55 A055 0 0 - - -
56 A056 Asam Tranexamat Tablet 500 mg Tablet 122 - 122 48
57 A057 0 0 - - -
58 A058 Asiklovir 5% 5gr Cream Tube 88 - 88 2 9
59 A059 Asiklovir 5% 5gr Cream Tube - - -
60 A060 0 0 - - -
61 A061 Asiklovir Tab 400 mg ( Phapros ) Tablet - - -
62 A062 Asiklovir Tab 400 mg ( Phapros ) Tablet 56 - 56 10 46
 63 A063 Asiklovir Tab 400 mg ( Phapros ) Tablet 100 - 100 3
64 A064 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - -
65 A065 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
66 A066 Attapulgite Active 630 mg Tab/ New Antides Tablet - - -
67 A067 Attapulgite Active 630 mg Tab/ PULAREX Tablet - - -
68 A068 Attapulgite Active 630 mg Tab/ New Antides Tablet 1,463 - 1,463 18 45
69 A069 Betahistin Mesylat 6 mg Tablet - - -
70 A070 Betahistin Mesylat 6 mg Tablet
Tube @ 10 - - -
71 A071 Betametason Dipropionat Krim 0,1% Tube - - -
72 A072 Betametason Dipropionat Krim 0,1% gram @ 10 - - -
Tube
gram @ 10
73 A073 Betametason Dipropionat Krim 0,1% 120 - 120 13 29
74 A074 Bisakodil Tablet 5 mg (Etercon Pharma ) gram
Tablet - - -
75 A075 Bisakodil Sup 10 mg (Dulcolax) Supp - - -
76 A076 Bisoprolol 2,5 mg/concor 2,5 Tablet - - -
77 A077 Benzatin
BricasmaBenzil Penisilin
Respules 2,4 jt Cairan IH 2,5 mg/ml (Astra
Terbutalin 0 - - -
78 A078 Bricasma Biji - - -
79 A079 Zeneca ) IIRespules Terbutalin Cairan IH 2,5 mg/ml (Astra Biji - - -
80 A080 Zeneca
0Budesonid )I 0 - - -
Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra
81 A081 pcs - - -
82 A082 Zeneca)
Calcium
0 Plus Vit D3 (Coral calcium 500 mg,Naturan 0 - - -
83 A083 Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 Tablet - - -
84 A084 Cefadroksil
mg,Zink 5 mg Kapsul
Boron500 mg CAL - 95
1 mg)/ Tablet - - -
85 A085 Cefadroksil Kapsul 500 mg Tablet 1,109 - 1,109 40 276
86 A086 Cefotaxime serbuk injeksi 1.000 mg Vial - - -
87 A087 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 48 - 48
88 A088 Citicolin
Curcumin250 mgCynarin,Sylimarin,Kapsul/
Plus / 2 ml Inj HEPAGARD Ampule 50 - 50
89 A089 Tablet - - -
90 A090 (Phapros)
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
91 A091 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 77 - 77 2 29
92 A092 Deksamethason Tab 0,5 mg (Promed ) Tablet - - -
93 A093 Deksamethason Tab 0,5 mg 0 964 - 964 48 445
94 A094 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube - - -
95 A095 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - -
96 A096 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 122 - 122 8 55
97 A097 0 0 - - -
98 A098 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - -
99 A099 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 144 - 144 15
100 A100 Digoksin Tab 0,25 mg Tablet - - -
101 A101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet 917 - 917 66 116
102 A102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet - - -
103 A103 0 0 - - -
104 A104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
105 A105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - -
106 A106 Domperidon Tab 10 mg (Novapharin ) Tablet 204 - 204
107 A107 Domperidon Tab 10 mg (Novapharin ) Tablet - - -
108 A108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - -
109 A109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - -
110 A110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 93 - 93 2
111 A111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
112 A112 Eritrosmisin Stearate Kaplet 500 mg Tablet 145 - 145 24
113 A113 Ethambutol 250 mg Tablet - - -
114 A114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - -
115 A115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
116 A116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - -
117 A117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 163 - 163 12
118 A118 Fitomenadion Tabet 10 mg (Phapros ) Tablet - - -
119 A119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 31 - 31 10
120 A120 0 0 - - -
121 A121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
122 A122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - -
123 A123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
124 A124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - -
125 A125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
126 A126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - -
127 A127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 57 - 57 3 12
128 A128 Gentamycin Krim 1 % mg/ ml Tube - - -
129 A129 Gentian Violet 1% 10 ml Botol 35 - 35 6
130 A130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol - - -
131 A131 Glibenklamid Tablet 5 mg Tablet 2,379 - 2,379 630
132 A131 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - -
133 A133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet 2,000 - 2,000
134 A134 Glucosamin HCL 500
Gliseril Guaikoulat Mg,100
Tablet Konrdoitin
mg SO4400Mg, MSM 200 Mg, Tablet 876 - 876 215 661
135 A135 VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Tablet - - -
136 A136 Glukosa Larutan
Gliserofosfat 40% Steril ( Outsuka )
10 mg Botol 14 - 14
137 A137 Glukosa Larutan 40% Steril botol - - -
138 A138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - -
139 A139 Glukosa Larutan Infus 5% @500ml Botol - - -
140 A140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - -
141 A141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 626 - 626 143
142 A142 Gliseril Guaikoulat Tablet 100 mg Tablet - - -
143 A143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - -
144 A144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 61 - 61 7 21
145 A145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - -
146 A146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - -
147 A147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - 10
148 A148 0 0 - - -
149 A149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - -
150 A150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol 225 - 225 3 36
151 A151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 5,835 - 5,835 384 1,771
152 A152 Ibuprofen Tablet 400 mg Tablet - - -
153 A153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - -
154 A154 Isoniazid Tablet 100 mg tablet - - -
155 A155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 191 - 191
156 A156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
157 A157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - -
158 A158 0 0 - - -
159 A159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - -
160 A160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - -
161 A161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 182 - 182
162 A162 0Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian 0 - - -
163 A163 Tablet - - -
164 A164 Pharmatama)
0 0 - - -
165 A165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - 100
166 A166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet - - -
167 A167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet 3,036 - 3,036 1,327
168 A168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - -
169 A169 Kaptopril Tab 25 mg ( Phapros ) Tablet - - -
170 A170 Kaptopril Tab 25 mg TAblet 1,590 - 1,590 204 784
171 A171 Ketokonazol Krim 2 % @ 10 gr Tube - - -
172 A172 Ketokonazol Krim 2 % @ 10 gr Tube 11 - 11 3
173 A173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 360 - 360 19
174 A174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - -
175 A175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - -
176 A176 Ketorolak Inj 30 mg/ml Ampule - - -
177 A177 0 0 - - -
178 A178 Kloramfenikol 1% Salep Mata (KF) Tube - - -
179 A179 0 0 - - -
180 A180 Kloramfenikol Inj 1G/5
Kloramfenikol Tetes ml / Colcancetine
Telinga Inj (Sanbe Farma)
:Kloramfenicol Vial - - -
181 A181 Kloramfenikol Tetes Telinga : Kloramfenicol Tube - - -
182 A182 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube - - -
183 A183 10%,Lidocain,Proplylenglycol
0 / COLME (Interbat) 0 - - -
184 A184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet - - -
185 A185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 1,785 - 1,785 391 853
186 A186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - -
187 A187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - -
188 A188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - -
189 A189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,378 - 1,378
190 A190 Kotrimoksasol
Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol Tablet
Forte / Fasiprim Forte Tab 960 mg 1,812 - 1,812 40 328
191 A191 Kotrimoksazol Kombinasi Tiap 5mlFarma
Suspensi : Sulfametoksazol Botol - - -
192 A192 200mg + Trimetropin
Krim Analgesik (setiap40gram
mg (mengandung
Holi ) : Metyl Salisilat 102 Botol 97 - 97 2 9
193 A193 200mg
mg, + Trimetropin
mg;40Methol
mg ( Holi
53,4Farma )
KrimEugenol 13,6
Jelly Luka Bakar: Tiap Gram mg, Vinishing
Mengandung Cream ad
Placenta 1 gr/ Tube
Extract 19 - 19 1
194 A194 MOLAKRIM
Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract Tube 1 - 1 1
195 A195 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
Lactobasilus
100 mg,NeomycinRhamnosus
Sulfat 5Rmg 11 /2M + Laciophillus
CENTABIO (SanbeR-52 /Lacidofil, Tube
Farma)
10 - 10 2
196 A196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Tablet - - -
197 A197 Probiotik (Dexa Medica, Sanbe) Tablet - - -
198 A198 Probiotik
0 (Dexa Medica, Sanbe) 0 - - -
199 A199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
200 A200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 314 - 314 82
201 A201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - -
202 A202 Loperamid Tablet 2 mg ( Ifars) Tablet 22 - 22
203 A203 Loperamid Tablet 2 mg Tablet - - -
204 A204 Loratadin Tablet 10 mg Tablet 126 - 126
205 A205 Loratadin
Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet
Tablet 10 mg - - -
206 A206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Tablet - - -
207 A207 Mata/ OCUGARD (Phapros) Tablet - - -
208 A208 Mata/ OCUGARD
Meloxicam Tab 15(Phapros)
mg (Bernofarm ) Tablet - - -
209 A209 0 0 - - -
210 A210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - -
211 A211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet - - -
212 A212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 881 - 881 91
213 A213 Metformin HCl Tablet 500 mg Tablet - - -
214 A214 Metformin HCl Tablet 500 mg Tablet 1,305 - 1,305 56 146
215 A215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet - - -
216 A216 0 0 - - -
217 A217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
218 A218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - -
219 A219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - -
220 A220 Metronidasol 500 mg tablet (Novapharin) Tablet - - -
221 A221 Metronidasol 500 mg tablet (Novagyl) Tablet 1,282 - 1,282 60 280
222 A222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - -
223 A223 Metronidasol Infus 500mg/100ml Botol - - -
224 A224 Minyak
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Botol
Kayu Putih 60 ml - - -
225 A225 Kapsul - - -
226 A226 Zink 20 mg, Beta
Multivitamin + Caroten
Pelancar Asi10000 IU, Selenium 30 mcg (LICOXY) Tablet
(NULACVIT) - - -
Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) /
227 A227 Ampule - - -
228 A228 MERSIBION
Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule - - -
229 A229 Multivitamin
Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex tablet
Vitamin/ Suplemen (BECEFORT) - - -
230 A230 Tablet - - -
Ayus )
 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU
231 A231 Multivitamin Curcuma Syr:L-Lysyin 1000 IU Botol - - -
232 A232 vit B1 3 mg, B12 Curcuminoid 2ml /200mg,Betacaroten
LYTACUR (Dexa Medika) Botol 116 - 116 8 16
Multivitamin Neurotopic
vit B1 3 mg, B12 Plus ATP
Curcuminoid 2mlTablet:B1
/ LYTACUR 100,B6
(Dexa200,B12
Medika) Tablet
233 A233 Multivitamin - - -
234 A234 200Mcg,Vit ENeurotopic
30mg, ATPTablet
20mg: B1/ Bio100,B6 200,B12 200 mg/
ATP (Phapros) Tablet - - -
Multivitamin
MOLANEURON Tab TambahTablet
Neurotopic
(Molex Darah: B1
Ayus) : per Tablet200,B12
100,B6 Mengandung200 mg/:
235 A235 Femofomarrat 300mg tablet - - -
236 A236 MOLANEURON (MolexMgso4
Ayus)0,4mg,Cuso4 0,4 mg,Vit C Tablet - - -
237 A237 100mg
Natrium,Asam Folat Tab
Diklofenak 2 Mg,Vit
50 mg B (Phapros
12 15Mcg,Faktor
)I Intirinsik 25mg / Tablet - - -
238 A238 HEMAFORT ( Phapros
Natrium Diklofenak Tab )50 mg (Phapros ) II Tablet - - -
239 A239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet 963 - 963 44
240 A240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - -
241 A241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - -
242 A242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet - - -
243 A243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - -
244 A244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol - - -
245 A245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol - - -
246 A246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 20 - 20
247 A247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - -
248 A248 Obat Batuk
Nistatin Herbal
Vaginal Tab: Tiap 15 MlIU/G
100.000 Vitetrifolia
(Phapros Fill) 1 Gr,Zingiber Tablet 100 - 100
249 A249 Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Botol - - -
250 A250 OBH
Obat Plus
Kumur
Macrocarpa Syr : Per0,20
Fruct 5 mlMg
+Hyaulorinic Megnandung
Acid 1% @ 200ml
/ HERBAKOF Difenhidramin
SANORINE
(Dexa Medica ) Pcs - - -
251 A251 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 Botol - - -
252 A252 Obat
mg,NaKumur
Sitrat +Hyaulorinic Acid 1% @ 200ml SANORINE
50 mg / SANADRYL Botol - - -
253 A253 Omeprazole Kapsul 20 mg Tablet - - -
254 A254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 457 - 457 5
255 A255 Parasetamol
Ondansetron KombHCl InjTablet
2 mg/Antitusif
1ml ( Dexa : Parasetamol
) Ampule - - -
256 A256 Parasetamol Komb Tablet Batuk
500mg,Phenylpropanolamine HClBerdahak:Paraset
chlorpheniramine Tablet - - -
257 A257 Parasetamol Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl
maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus ) 25Mg/ HUSTAB Tablet - - -
258 A258 Parasetamol
(Phapros) Komb
400Mg,Bromheksin Tablet Batuk Berdahak:Paraset
80Mg,Difenhidramin HCl 25Mg/ HUSTAB Tablet - - -
259 A259 400Mg,Bromheksin 80Mg,Difenhidramin
(Phapros) Komb Tablet Flu: Parasetamol
Parasetamol HCl 25Mg/ HUSTAB Tablet - - -
260 A260 (Phapros) Tablet - - -
261 A261 500Mg,Pseudofedrin
Propiltiourasil/ PTU 30Mg,
100 mg / COLPICA (Tropika Mas) 0 - - -
Parasetamol Komb Tablet Flu: Parasetamol
262 A262 Tablet - - -
263 A263 500Mg,Pseudofedrin
Parasetamol Syrup 120 30Mg, Tripolidin
mg/5ml (Mersi2,5 mg / NOZA (Phapros) Botol
Farma) - - -
264 A264 Parasetamol Syrup 120 mg/5ml Botol 113 - 113 18 76
265 A265 Parasetamol tablet 500 mg Tablet - - -
266 A266 Parasetamol tablet 500 mg Tablet - - -
267 A267 Parasetamol tablet 500 mg Tablet - - -
268 A268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube - - -
269 A269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 71 - 71 1 18
270 A270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - -
271 A271 Piracetam 800 mg Tablet Tablet 160 - 160 22
272 A272 Parasetamol tablet 500 mg Tablet 12,392 - 12,392 688 2,772
273 A273 Piracetam Injeksi 1gr/ 5ml Ampule 22 - 22 3
274 A274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 714 - 714
275 A275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 836 - 836 44 792
276 A276 Probiotik Sachet (Probiokid) 0 - - -
277 A277 Polikresulen (Albotyl,Apetil) Botol - - -
278 A278 Prednison Tab 5 mg Tablet - - -
279 A279 Prednison Tab 5 mg (Holi Pharma) Tablet 1,688 - 1,688 387 627
280 A280 Prednison Tab 5 mg Tablet - - -
281 A281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - -
282 A282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - -
283 A283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 264 - 264 103
284 A284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet 1,141 - 1,141 117 289
285 A285 0 0 - - -
286 A286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - -
287 A287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol 300 - 300
288 A288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol - - -
289 A289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
290 A290 Ringer Laktat
Salbutamol cairan
SO4 3,01infus
mg +( OTSUKA/
IpratoniumWIDATRA)
Brom 0,52 @ mg500 ml RL
Nebulizer Botol - - -
291 A291 Nebule 174 - 174 15
292 A292 (COMBIVENT)
0 I dan II 0 - - -
293 A293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet - - -
294 A294 Salbutamol Tab 4 mg:(Pristasma)
Salep 2-4 Kombinasi Asam Salisilat 2%+ Belerang Endap 4% Tablet 1,016 - 1,016 42 94
295 A295 Salep Pot 91 - 91 1 17
296 A296 (Marin2-4
) Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% Pot - - -
297 A297 (Marin )
Salisil Bedak Serbuk 2% (Kimia Farma) Pcs - - -
298 A298 Salisil Bedak Serbuk 2% Pcs - - -
299 A299 Salisil Bedak Serbuk 2% Pcs 27 - 27 12
300 A300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - -
301 A301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - 1
302 A302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - -
303 A303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 38 - 38 8
304 A304 Setirizin Tab 10 mg (Futamed) Tablet - - -
305 A305 Setirizin Tab 10 mg (Futamed) Tablet - - -
306 A306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 272 - 272 23 130
307 A307 Simvastatin Tablet 10 mg Tablet - - -
308 A308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
309 A309 0 0 - - -
310 A310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - -
311 A311 Sukralfat
Tetes mata Susp 500mg/5ml
setiap @100 mlPolietilen
ml mengandung (Mepro) glikol 400 1% Botol 13 - 13 2
312 A312 Botol - - -
313 A313 gliserin 0.25%
Tetrasiklin HCl Hidroksipropil
Kapsul 500 mgmetil selulosa 0,2% VISINE Tablet - - -
314 A314 Thiamin/ Vitamin B1 50 mg Tablet - - -
315 A315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - -
316 A316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 1,413 - 1,413 36 356
317 A317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - -
318 A318 Thiamphenicol Kapsul 500 mg Tablet 815 - 815 10 25
319 A319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 12 - 12
320 A320 Vitamin B Komplek
Thiamphenicol/ Plus Ekstrak
Thiamfilex Hati mg/5
Susp 125 (Substansi Hati Ayus)
ml (Molex Kering 100 Kapsul - - -
321 A321 mg, Vit B1
Vitamin HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 Tablet
B Komplek 1,747 - 1,747 267 1,068
322 A322 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Tablet - - -
OBAT
Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, 0
GOLONGAN PSIKOTROPIKA - - -
323 A323 Alprazolam
CuSO4 0,650,5 mg)mgLIVRPON
(Mersi Farma)
B-PLEX Tablet - - -
324 A324 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
325 A325 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
326 A326 Clobazam Tab 10 mg (Meprofarm) Tablet - - -
327 A327 0 0 - - -
328 A328 0 0 - - -
329 A329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
330 A330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - -
331 A331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 1 - 1
332 A332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
333 A333 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - -
334 A334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 2 - 2
335 A335 Diazepam Tablet 5 mg (VALISANBE) Tablet 256 - 256 14
336 A336 Diazepam Tablet 5 mg Tablet - - -
337 A337 Fenobarbital Tablet 30 mg Tablet - - -
338 A338 Fenobarbital Tablet 30 mg Tablet - - -
339 A339 Fenobarbital Tablet 30 mg tablet - - -
340 A340 Kodein Tablet 10 mg Tablet - - -
341 A341 0 0 - - -
342 A342 Lorazepam Tab 2 mg (Mersi Farma)
Metamizol 500 mg + Diazepam 2 mg / PRONEURON Tablet - - -
343 A343 Tablet - - -
344 A344 (Meprofarm)
0 0 - - -
345 A345 0 0 - - -
346 A346 0 0 - - -
347 A347 Primaquin 15 mg tablet tablet - - -
348 A348 0 0 - - -
OBAT - OBAT PROGRAM 0 - - -
OBAT PROGRAM KECACINGAN 0 - - -
349 A349 Albendazol Tablet 400 mg Tablet - - -
350 A350 Albendazol Tablet 400 mg Tablet 189 - 189 2
OBAT PROGRAM DIARE 0 - - -
351 A351 Garam Oralit (Kimia Farma) Tablet - - -
352 A352 Garam Oralit (Kimia Farma) Tablet 1,112 - 1,112 24 130
353 A353 Garam Oralit (Kimia Farma) sachet - - -
354 A354 Garam Oralit (Kimia Farma) sachet - - -
355 A355 0Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined 0 - - -
356 A356 Botol 33 - 33 2
357 A357 imperial)
Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - -
358 A358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - -
359 A359 Zinc Dispersible 20 mg tablet tablet - - -
360 A360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
361 A361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 2,530 - 2,530 26
362 A362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - -
363 A363 0 0 - - -
OBAT PROGRAM HEPATITIS 0 - - -
364 A364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
365 A365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
366 A366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
367 A367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - 2 2 2
368 A368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - -
OBAT PROGRAM TB PARU 0 - - -
369 A369 OAT FDC Kategori Anak Kit - - -
370 A370 OAT FDC Kategori Anak Kit - - -
371 A371 OAT FDC Kategori Anak Kit - - -
372 A372 OAT FDC Kategori I - IIII Kit - - -
373 A373 OAT FDC Kategori I - IIII Kit 2 - 2 2
374 A374 OAT FDC Kategori II Kit - - -
375 A375 OAT FDC Kategori II Kit - - -
376 A376 OAT FDC Kategori II Kit - - -
377 A377 OAT FDC Kombipak Kategori I Kit - - -
378 A378 0 0 - - -
379 A379 Isoniazid 100 mg tablet tablet - - -
OBAT POGRAM KUSTA 0 - - -
380 A380 MDT MB Anak Blister - - -
381 A381 MDT MB Anak Blister - - -
382 A382 MDT MB Dewasa Blister - - -
383 A383 MDT MB Dewasa Blister - - -
384 A384 MDT MB Dewasa Blister - - -
385 A385 MDT PB Anak Blister - - -
386 A386 MDT PB Anak Blister - - -
387 A387 MDT PB Anak Blister - - -
388 A388 MDT MB Dewasa Blister 13 - 13 5
389 A389 MDT PB Dewasa Blister - - -
OBAT PROGRAM GIZI 0 - - -
390 A390 Mineral Mix Kombinasi sachet - - -
391 A391 Mineral Mix Kombinasi sachet - - -
392 A392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - -
393 A393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul 117 - 117 67
394 A394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - -
395 A395 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
396 A396 Retinol Vit A 100.000 IU (Biru) Kapsul - - -
397 A397 Retinol Vit A 100.000
Tablet Tambah DarahIU (Biru)Ferro Fumarat 60 Mg +As.Folat
/Komb Kapsul - - -
398 A398 Tablet Tablet - - -
399 A399 0,4 MgTambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
Tab (Phapros) Tablet 30,960 - 30,960 30 3,460
Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat
0,4 Mg Tab (Phapros)
400 A400 tablet - - -
401 A401 0,4
0 Mg Tab (Phapros) 0 - - -
402 A402 0 0 - - -
OBAT PROGRAM KESGA 0 - - -
403 A403 Calcii Gluconas Inj (Ethica) Ampule - - -
404 A404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial - - -
405 A405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial 14 - 14
406 A406 Calcii Gluconas Inj 10% (Ethica) Ampule - - -
407 A407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 87 - 87 8
408 A408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
409 A409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - -
410 A410 Oksitetrasiklin 1 % Salep Mata Tablet - - -
411 A411 Metilergometrin Maleat Tablet 0,125 mg Tablet 280 - 280 90
412 A412 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
413 A413 Oksitosin Inj 10 UI/ml (Ethica) Ampule 134 - 134 36
414 A414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - -
415 A415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - -
OBAT PROGRAM JIWA 0 - - -
416 A416 Amitriptilin 25 mg Tablet - - -
417 A417 Amitriptilin 25 mg Tablet - - -
418 A418 Amitriptilin 25 mg Tablet - - -
419 A419 Amitriptilin 25 mg Tablet 148 - 148
420 A420 Amitriptilin 25 mg Tablet - - -
421 A421 Clozapine 25mg (OGB Dexa) Tablet - - -
422 A422 Clozapine 100 mg Tablet - - -
423 A423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
424 A424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
425 A425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet 180 - 180 120
426 A426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - -
427 A427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - -
428 A428 Flufenazin sikzonoate inj 5 ml vial 9 - 9
429 A429 Flufenazin sikzonoate inj 5 ml Vial - - -
430 A430 Haloperidol 5 mg tablet Tablet - - -
431 A431 Haloperidol 5 mg tablet Tablet 1,807 - 1,807 217
432 A432 Haloperidol 5 mg tablet Tablet - - -
433 A433 0 0 - - -
434 A434 Haloperidol Injeksi 5 mg/ml ampule - - -
435 A435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - -
436 A436 Haloperidol/ Lodomer drops 2 mg Botol 8 - 8
437 A437 Karbamazepin Tablet 200 mg Tablet - - -
438 A438 Karbamazepin Tablet 200 mg Tablet - - -
439 A439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule 3 - 3
440 A440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - -
441 A441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet - - -
442 A442 Klorpromazin Tab Salut 100 mg (HCl) Tablet 1,254 - 1,254 277
443 A443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - -
444 A444 0 0 - - -
445 A445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - -
446 A446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - -
447 A447 Risperidon Tab 2 mg Tablet - - -
448 A448 Risperidon Tab 2 mg Tablet 695 - 695 259
449 A449 0 0 - - -
450 A450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - -
451 A451 0 0 - - -
452 A452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - -
453 A453 Triheksifenidil Tablet 2 mg Tablet 205 - 205 205
454 A454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet 800 - 800 296
455 A455 0 0 - - -
456 A456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - -
457 A457 0 0 - - -
PROGRAM IMUNISASI (VAKSIN) 0 - - -
458 A458 BCG vial 3 - 3
459 A459 PELARUT BCG ampul 23 - 23
460 A460 BCG vial - - -
461 A461 BCG vial 20 - 20
462 A462 CAMPAK 10ds (MR) vial - - -
463 A463 PELARUT CAMPAK ampul 36 30 66 41
464 A464 CAMPAK 10ds (MR) vial - - -
465 A465 CAMPAK 10ds (MR) vial - 30 30 5
466 A466 DPT HB - Hib/ PENTABIO vial - - -
467 A467 DPT HB - Hib/ PENTABIO vial 71 - 71 35
468 A468 DT vial 11 - 11
469 A469 0 0 - - -
470 A470 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - -
471 A471 HB UNIJECT/ HB - ADS / HEPATITIS B vial 100 - 100 28
472 A472 POLIO bOPV 10 ds vial - - -
473 A473 DROPPER POLIO dropper 91 30 121 104
474 A474 POLIO bOPV 10 ds vial - - -
475 A475 POLIO bOPV 10 ds vial - - -
476 A476 Td vial 30 - 30
477 A477 0 0 - - -
478 A478 HB UNIJECT/ HB - ADS / HEPATITIS B vial 3 - 3 3
479 A479 POLIO bOPV 10 ds vial - - -
480 A480 Vaksin Meningtis vial - - -
481 A481 CAMPAK 10ds (MR) BIAS vial - - -
482 A482 PELARUT CAMPAK BIAS ampul - - -
483 A483 POLIO bOPV 10 ds vial 37 30 67 50
484 A484 IPV vial 3 20 23 23
485 A485 VTM Include Dacron (Biofarma) pcs - - -
486 A486 Vaksin Rabies (Verorab) vial - - -
487 A487 0 0 - - -
488 A488 0 0 - - -
489 A489 0 0 - - -
OBAT PROGRAM HIV/ AIDS 0 - - -
490 A490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - -
491 A491 0 0 - - -
492 A492 Isoniazid (INH) Tablet 300 mg Tablet - - -
493 A493 0 0 - - -
494 A494 Lamivudine 150 mg Tablet - - -
495 A495 Lamivudine 150 mg Tablet - - -
496 A496 Nevirapine 200 mg Tablet - - -
497 A497 Nevirapine 200 mg Tablet - - -
498 A498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - -
499 A499 0Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple 0 - - -
500 A500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple Tablet - - -
501 A501 FDC Dewasa Tablet - - -
502 A502 FDC Dewasa
Tenofovir 300 mg Tablet - - -
503 A503 Tenofovir 300 mg Tablet - - -
504 A504 Zidofudine 100 mg (ZDV) Tablet - - -
505 A505 Zidofudine 100 mg (ZDV) Tablet - - -
506 A506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
507 A507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
508 A508 Efavirenz 600 mg tablet tablet - - -
509 A509 Efavirenz 600 mg tablet tablet - - -
510 A510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - -
511 A511 Abacavir
Tenofovir(ABC) 300mg 300+ Efaviren 600 (Triple FDC) Triple
300 +Lamivudin Tablet - - -
512 A512 Tablet - - -
FDC Dewasa
513 A513 0 0 - - -
514 A514 MB Anak blister - - -
515 A515 0 0 - - -
516 A516 0 0 - - -
517 A517 0 0 - - -
518 A518 0 0 - - -
519 A519 0 0 - - -
520 A520 0 0 - - -
521 A521 0 0 - - -
522 A522 0 0 - - -
523 A523 0 0 - - -
524 A524 0 0 - - -
525 A525 0 0 - - -
526 A526 0 0 - - -
527 A527 0 0 - - -
528 A528 0 0 - - -
529 A529 0 0 - - -
BMHP 0 - - -
530 A530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
531 A531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - -
532 A532 0 0 - - -
533 A533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - -
534 A534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - - -
535 A535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 695 - 695 588 87
536 A536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 977 - 977 117
537 A537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - -
538 A538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
539 A539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs 24 - 24 12
540 A540 Alat Suntik Sekali Pakai 20 ml Pcs 40 - 40
541 A541 Alkohol 70% Medika (Kimia Farma) 0 - - -
542 A542 Alkohol 70% (Medika) Btl 1000 ml - - -
543 A543 Alkohol Swab 2 - ply (one med) 0 - - -
544 A544 Alkohol Swab 2 - ply (one med) Pcs 200 - 200 200
545 A545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - - -
546 A546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - -
547 A547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs 26 - 26 7
548 A548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs - - -
549 A549 Catgut
Cat GutChromic
Plain No.3/03.075C
70 +C+Jarum1/2 22M
Jarum 1/2 25Demetech I /
M (Demetech) 0 - - -
550 A550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Pcs - - -
551 A551 Phsda 0 - - -
552 A552 Phsda
Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - -
553 A553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs - - -
554 A554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
555 A555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - -
556 A556 Fixomull Strech 5 cm X 5 m Pcs - - -
557 A557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs - - -
558 A558 Foley Catheter 2 Way Ch 16,18 Pcs 20 - 20 2 6
559 A559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - -
560 A560 I.V Cannula No. 26 G Polywin (Polymed) Pcs 5 - 5
561 A561 Mantel Gown (Bisa Dicuci) biji - - -
562 A562 I.V Catheter No. 18 (JELCO) Pcs - - -
563 A563 I.V Catheter No. 18 (NIPRO) Pcs 60 - 60 17
564 A564 I.V Catheter No. 20 JELCO Pcs - - -
565 A565 I.V Catheter No. 20 TERUMO Pcs - - -
566 A566 I.V Catheter No. 20 JELCO Pcs 272 - 272 42
567 A567 I.V Catheter No. 22 NIPRO Pcs - - -
568 A568 I.V Catheter No. 22 NIPRO Pcs 135 - 135 32
569 A569 I.V Catheter No. 24 TERUMO Pcs 33 - 33 6
570 A570 I.V Catheter No. 24 TERUMO 0 100 - 100
571 A571 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - -
572 A572 Infusion Set Anak 60 Drops /(Otsuka) Pcs 59 - 59
573 A573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
574 A574 Infusion
Kantong Set Dewasa
Plastik 20 Drops/
Bio Hazart (OTSUKA)
(Bahan Plastik PE, Panjang 80 Cm, Pcs 223 - 223 97
575 A575 Pcs - - -
576 A576 Lebar 60 Cm, Tebal 0,33 Mm)
Kapas Pembalut Hydrofil 250 gr Pcs - - -
577 A577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 17 - 17 1 5
578 A578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - -
579 A579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs - - -
580 A580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 3 - 3 2
581 A581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - -
582 A582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs - - -
583 A583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 39 - 39 8
584 A584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - -
585 A585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs - - -
586 A586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs 49 - 49 32
587 A587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - -
588 A588 Masker Ear Loop (Masker) Pcs - - -
589 A589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - -
590 A590 Masker General Care (MARCOTILA) Pcs - - -
591 A591 0 0 - - -
592 A592 Masker N95 Disposibel Pcs - - -
593 A593 Masker N95 Disposibel (One Med) Pcs - - -
594 A594 Masker Tali Pcs - - -
595 A595 Masker Tali Pcs - - -
596 A596 Masker Elastic Pcs - - -
597 A597 Media Sample Container Pcs 59 - 59 59
598 A598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - -
599 A599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - -
600 A600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - -
601 A601 Nurse Cup (Tutup Kepala) Pcs - - -
602 A602 Oxygen Mask Elongated Adult (Remedi) Pcs - - -
603 A603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - -
604 A604 Plesterin Bulat Non Woven (One Med) Pcs - - -
605 A605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - -
606 A606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 35 - 35 18 3
607 A607 Povidon Iodine 10% (300 ml) ( One Med) Pcs 5 - 5
608 A608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 22 - 22 9
609 A609 Povidon Iodine 10% (60 ml) ( One Med) Pcs - - -
610 A610 0 0 - - -
611 A611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - -
612 A612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - -
613 A613 0 0 - - -
614 A614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair - - -
615 A615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - -
616 A616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair - - -
617 A617 Sarung Tangan size M dan L (Exam Glove) PAir 3,000 - 3,000 2,000 500
618 A618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 263 - 263 3
619 A619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - -
620 A620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs - - -
621 A621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs 31 - 31 17
622 A622 0 0 - - -
623 A623 Surface Disinfectant 500 ml (Stericide ) Pcs - - -
624 A624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - -
625 A625 Underpad 90x 0 cm cosmo I Pcs 30 - 30
626 A626 Underpad 90x 0 cm cosmo II Pcs - - -
627 A627 0 0 - - -
628 A628 Urine Bag Sterile Standard Pcs - - -
629 A629 Urine Bag Sterile Standard (AXIMED) Pcs 48 - 48 2 2
630 A630 0 0 - - -
631 A631 Umbilical Cord Clamp ( Hospitech ) Pcs 159 - 159 12
REAGEN 0 - - -
632 A632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - -
633 A633 Accu- Check Performa Tes Strip ( Roche ) pcs - - -
634 A634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 400 - 400
635 A635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - -
636 A636 Antimonoclonal A (Anti A) 10 ml Btl - - -
637 A637 Antimonoclonal AB (Anti AB) 10 ml Btl - - -
638 A638 Antimonoclonal B (Anti B) 10 ml Btl - - -
639 A639 0 0 - - -
640 A640 Cholesterol Test Strip (Human Humasens Plus) Tes - - -
641 A641 Cholesterol Test Strip (Human Humasens Plus) 0 - - -
642 A642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - -
643 A643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - -
644 A644 Glucose Test Strip (Human Humasens plus) Tes - - -
645 A645 Glucose Test Strip (Human Humasens plus) II Tes - - -
646 A646 Hemoglobin Strip 50 test mission (Acon) Pcs 6 - 6 2
647 A647 Hemoglobin Strip 50 test mission (Acon) 0 - - -
648 A648 Reagen Hb (HCl 0,1 N) 100ml Btl - - -
649 A649 0 0 - - -
650 A650 Reagen HBsAg Strip (FOKUS) Test - - -
651 A651 0 0 - - -
652 A652 TPHA (Fokus) Test - - -
653 A653 0 0 - - -
654 A654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - -
655 A655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - -
BMHP (PROGRAM) PROPINSI 0 - - -
PROGRAM MALARIA 0 - - -
656 A656 RDT Malaria Test - - -
PROGRAM SYPHILIS 0 - - -
657 A657 RPR Syphilis Pcs 70 - 70 15
658 A658 RPR Syphilis tahap II (FOKUS) Pcs - - -
659 A659 Syphilis 3.0 06FK10 SD Bioline Test
Test 84 60 144 89
660 A660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) Test - - -
661 A661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - -
662 A662 0 0 - - -
663 A663 Tuberkulin Vial - - -
664 A664 RDT Lepto (Uji Leptospira IgM) test - - -
665 A665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - -
666 A666 0 0 - - -
667 A667 0 0 - - -
PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) 0 - - -
668 A668 Test - - -
669 A669 Reagen HBsAg Strip SD Test - - -
670 A670 Reagen HBsAg Strip SD Test 72 - 72 72
671 A671 Reagen HBsAg Strip SD Test - - -
672 A672 0 0 - - -
673 A673 0 0 - - -
674 A674 0 0 - - -
675 A675 0 0 - - -
PROGRAM TB PARU 0 - - -
676 A676 Box Slide Pcs - - -
677 A677 Box Slide Pcs - - -
678 A678 Catridge Genexpart Test - - -
679 A679 Catridge Genexpart Test - - -
680 A680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - -
681 A681 Oil Emersi Botol - - -
682 A682 Pot Spuntum/Pot Dahak Steril Pcs - - -
683 A683 Pot Spuntum/Pot Dahak Steril Pcs - - -
684 A684 Pot Spuntum/Pot Dahak Steril Pcs - - -
685 A685 Pot Spuntum/Pot Dahak Steril Pcs - - -
686 A686 Reagen Control CD4 0 - - -
687 A687 Reagen Control CD4 0 - - -
688 A688 Reagen Zeil Nelseen Kit - - -
689 A689 Reagen Zeil Nelseen Kit - - -
690 A690 Reagen Zeil Nelseen Kit - - -
691 A691 Reagen Zeil Nelseen Kit - - -
692 A692 Slide Pcs 5 - 5 1
693 A693 Slide/ Object Glass Pcs - - -
694 A694 Stereofoam pcs - - -
695 A695 Masker N 95 TB pcs 23 - 23
696 A696 Masker Tali Bedah TB pcs - - -
OBAT PROGRAM IMUNISASI 0 - - -
697 A697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
698 A698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
699 A699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs 300 - 300 80
700 A700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
701 A701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - -
702 A702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs 1,050 - 1,050 850
703 A703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
704 A704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - -
705 A705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
706 A706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
707 A707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - -
708 A708 0 0 - - -
709 A709 0 0 - - -
710 A710 0 0 - - -
711 A711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 145 - 145
712 A712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
713 A713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - -
714 A714 0 0 - - -
715 A715 Safety Box 5 L Pcs 57 - 57 7
716 A716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - -
717 A717 0 0 - - -
718 A718 0 0 - - -
719 A719 0 0 - - -
720 A720 0 0 - - -
PROGRAM
Diagnostar DSHIV/ AIDS
HIV 1/2 One Step Rapid Test (GCHIV-402A) 0 - - -
721 A721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Test 50 - 50
722 A722 Tahap I 0 - - -
KHB Diagnostik
Reagen R3 Kit For HIV (1+2) Antibody (Colloidal Gold)
723 A723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Test - - -
724 A724 Tahap I 0 - - -
KHB Diagnostik
(Reagen R2) Kit For HIV (1+2) Antibody (Colloidal Gold)
725 A725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Test 50 - 50
726 A726 Tahap I 0 - - -
727 A727 Tahap
Kondom I Pcs - - -
728 A728 DBS Collection/ Lasec Pcs - - -
729 A729 Lubricant Pcs - - -
730 A730 0Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap 0 - - -
731 A731 Test 578 - 578 53
732 A732 IRapid HIV 1/2 3.0 SD Bioline test - - -
733 A733 Reagen HIV (FOKUS)
KHB Diagnostik Kit ForRHIV
2 (1+2) Antibody (Colloidal Gold) V2 Test - - -
734 A734 Test - - -
735 A735 Tahap
ReagenI HIV (SD) R 1 Test - - -
736 A736 Reagen HIV (SD) R 1 Test - - -
737 A737 0 0 - - -
738 A738 Reagen HIV (VIKIA) R 3 Test - - -
739 A739 0 0 - - -
740 A740 Reagen HIV R2 (Rapid Test) FOKUS Test - - -
741 A741 0 0 - - -
742 A742 Reagen HIV R3 (VIKIA) Test - - -
743 A743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - -
744 A744 Sarung Tangan Non Steril Pair - - -
745 A745 0 0 - - -
746 A746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - -
747 A747 VTM Include Swab Test - - -
748 A748 Masker Bedah 3 ply Pcs - - -
749 A749 0 0 - - -
750 A750 0 0 - - -
751 A751 0 0 - - -
752 A752 0 0 - - -
753 A753 0 0 - - -
754 A754 0 0 - - -
755 A755 0 0 - - -
756 A756 0 0 - - -
757 A757 0 0 - - -
758 A758 0 0 - - -
759 A759 0 0 - - -
760 A760 0 0 - - -
761 A761 0 0 - - -
762 A762 0 0 - - -
763 A763 0 0 - - -
764 A764 0 0 - - -
OKSIGEN MEDICAL 0 - - -
765 A765 Oksigen 3 m3 Tampon - - -
766 A766 Oksigen 6 m3 Tampon - - -
767 A767 Oksigen 1 m3 Tampon - - -
768 A768 Oksigen 6 m3 Tampon - - -
769 A769 Nurse Cup (Tutup Kepala) One Med 0 - - -
770 A770 0 0 - - -
771 A771 0 0 - - -
772 A772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - 400 400
TAMBAHAN IFK 0 - - -
1 T001 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - -
2 T002 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - -
3 T003 Ranitidin Tablet/ 150
Thiamphenicol mg Kapsul 500 mg
Thiamfilex Tablet - - -
4 T004 Tablet - - -
5 T005 Thiamphenicol Syr. 0 - - -
6 T006 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - -
7 T007 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
8 T008 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - -
9 T009 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - -
10 T010 Ketokonazole 200 mg Tablet - - -
11 T011 Kotrimoksazol Forte Tablet - - -
12 T012 Infusion set anak Pcs - - -
13 T013 Alat Suntik 10 cc Pcs - - -
14 T014 Eritrosmisin Stearate Kaplet 500 mg Tablet - - -
15 T015 Omeprazole Kapsul 20 mg Tablet - - -
16 T016 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol 273 - 273 30 3
17 T017 Setirizin Tab 10 mg (Futamed) Tablet - - -
18 T018 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - -
19 T019 Oseltamivir 75 mg Kapsul - - -
20 T020 Ringer Laktat cairan infus @ 500 ml RL Botol 303 - 303 303
21 T021 Amitriptilin 25 mg Tablet - - -
22 T022 I.V Catheter No. 24 TERUMO pcs - - -
23 T023 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - -
24 T024 RDT COVID - 19 0 - - -
25 T025 Oseltamivir 75 mg 0 - - -
26 T026 Klorokuin
Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0
150 mg tablet - - -
27 T027 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For 0 - - -
28 T028 Viruses) 0 - - -
29 T029 Viruses)
Masker N95 (Particulate Respirator) 0 - - -
30 T030 Hazmat/ APD/ Hazmat PPK 0 30 - 30
31 T031 Medical Sample Container Pcs - - -
32 T032 Cepheid Pcs - - -
33 T033 Natrium Klorida Larutan infus 0,9% @100ml 0 - - -
34 T034 Tambah Darah drop (Ferriz Drop) pcs 200 - 200
35 T035 Tambah Darah Sirup (Ferriz Sirup) pcs 194 - 194
36 T036 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - -
37 T037 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - -
38 T038 Obat Batuk Sirup / INADRYL Botol - - -
39 T039 Parasetamol Komb Tablet
Obat Batuk Expektoran Antitusif : Parasetamol
Sirup Botol - - -
40 T040 500mg,Phenylpropanolamine
Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Tablet
HCl chlorpheniramine maleate, - - -
41 T041 dextromethorpan Hbr Tablet - - -
42 T042 Influenza
Masker Bedah /Bima Sakti pCS 2,650 - 2,650 100 600
43 T043 Masker Bedah /Rania pCS - - -
44 T044 Masker N 95 Bima Sakti PCS 11 - 11 3
45 T045 Sarung tangan panjang steril / meditouche perpasang 0 24 - 24 7
46 T046 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - -
47 T047 Albendazol Suspensi 200mg/ 5 ml botol 300 - 300
48 T048 I.V Catheter No. 24 (BRAUN) pcs - - -
49 T049 OAT FDC Kategori Anak 0 - - -
50 T050 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - -
51 T051 Apron Lengan Panjang Putih (Rannia) 0 - - -
52 T052 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - -
53 T053 0 0 - - -
54 T054 0 0 - - -
55 T055 0 0 - - -
56 T056 0 0 - - -
57 T057 0 0 - - -
58 T058 0 0 - - -
59 T059 0 0 - - -
60 T060 APD Set (Rannia) 0 8 - 8
61 T061 Cover All Disposible (Baju sekali pakai) (Rannia) 0 5 - 5
62 T062 Cover
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya 0
All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 4 - 4
63 T063 0 - - -
64 T064 Mitra
Helm Bersama)
visor (Usaha Karya Mitra Bersama) 0 - - -
65 T065 Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - -
66 T066 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - -
67 T067 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - -
68 T068 Sarung tangan non steril M,L (COBRA) box @100 pcs 1,000 - 1,000 600 400
69 T069 Masker N95 Covid 19 Pcs - - -
70 T070 Masker Tali Bedah 3 ply Covid 19 Pcs - - -
71 T071 Masker Eaerlop Hijab Pcs 1,800 - 1,800
72 T072 Etanol 96 % (Alkohol 1) Botol = 20 Liter - - -
73 T073 Hand Sanitzer 1 Botol = 20 Liter - - -
74 T074 MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - -
75 T075 Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs 9 - 9
76 T076 KIT A1 Operasi Steril (RAJAWALI) Pcs - - -
77 T077 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - -
78 T078 Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair 2 - 2
79 T079 Masker Face/ Masker Bedah (COBRA 1) pcs - - -
80 T080 Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - -
81 T081 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - -
82 T082 Masker Face/ Masker Bedah (COBRA 2) pcs - - -
83 T083 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - -
84 T084 Masker KN95 (Farmahusada) Box @50 pcs 15 - 15
85 T085 Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - -
86 T086 Rapid Test SARS COV 2 (Farmahusada) Test - - -
87 T087 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - -
88 T088 Masker KN95 (Anugrah Sentosa Abadi) pcs - - -
89 T089 APRON (Atmosfer) pcs 100 - 100
90 T090 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - -
91 T091 Hand Sanitzer 2 liter - - -
92 T092 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - -
93 T093 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs 35 - Mengetahui 35
94 T094 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - -
Plt. KEPALA -
DINAS KESEHATAN
95 T095 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - -
KABUPATEN LUMAJANG -
96 T096 Face Shield (COBRA) 0 7 - 7
97 T097 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
98 T098 Kit Steril (Rajawali) 0 - - -
99 T099 Alkohol II @20 Liter 0 - - -
dr.BAYU WIBOWO IGN
100 T100 Cover All (Rajawali) 0 4 - 4
NIP. 19630724 198910 1 002
101 T101 Face Shield (ATMOSFER) 0 - - -
102 T102 Jirigen Putih 20 Liter (Usaha Karya) 0 - - -
103 T103 Masker Earloop (KasaHusada) 0 5,100 - 5,100
104 T104 MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - -
105 T105 Rapid Test Covid-19 (Rajawali) 0 - - -
106 T106 Rapid Test Covid-19 (Dakonan) 0 - - -
107 T107 Alkohol Swab (BTT) 0 - - -
108 T108 Antiseptic Gel 500 0 - - -
109 T109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - - -
110 T110 Kaca mata Goggle (HASTEN) 0 3 - 3
111 T111 Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - -
112 T112 Masker Bedah Hijau @50pcs 0 - - -
113 T113 Masker N95 3M 8210 (Hazten) 0 - - -
114 T114 Nurse Cap Green om 100bh 0 - - -
115 T115 Parafilm (Anugerah Sentosa Abadi) 0 - - -
116 T116 Rapid Test (1.000) Widhi Dharma Adi 0 - - -
117 T117 Sarung tangan Safeglove Exam M 100bh 0 - - -
118 T118 Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - -
119 T119 Sterlisasi Swab stik (5box/ VTM) 0 - - -
120 T120 Stereofoam (Anugerah Sentosa Abadi) 0 - - -
121 T121 Universal Transport Media (UTM) Goongdong 0 18 - 18 3
122 T122 Universal Transport Media (UTM) Sekarguna 0 - - -
123 T123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - -
124 T124 Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - -
125 T125 Infusion Set Anak 60 Drops /(Otsuka) 0 - - -
126 T126 Rapid Test Accu Tell (PT Marcotila Medica) 0 - - -
127 T127 Rapid Test Lecurate (Bima Sakti) 0 10 - 10 5
128 T128 Rapid Test ZYBIO (Farma Husada) 0 50 - 50
129 T129 Alkohol 96 % Liter 7 - 7 3
130 T130 0 0 - - -
0 0 - - -
TAMBAHAN PUSKESMAS 0 - - -
1 TP001 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 - - -
2 TP002 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul - - -
3 TP003 Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Tube - - -
4 TP004 pcs - - -
5 TP005 Zeneca)
0 0 - - -
6 TP006 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - -
7 TP007 Furosemide Tablet 40 mg (Kimia Farma ) Tablet 272 - 272 75
8 TP008 Gentamycin Krim 1 % mg/ ml Tube - - -
9 TP009 0 0 - - -
10 TP010 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule - - -
11 TP011 Ketokonazol Tablet 200 mg (Novapharin) I Tablet - - -
12 TP012 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - -
13 TP013 Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 196 - 196 26
14 TP014 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - -
15 TP015 Thiamin/ Vitamin B1 50 mg Tablet - - -
16 TP016 Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul - - -
17 TP017 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - -
18 TP018 Antimicrobial Liquid Soap 500 ml (Viorex) 0 - - -
19 TP019 Hand Sanitizer 450 ml (Meditol) 0 - - -
20 TP020 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - -
21 TP021 I.V Catheter No. 18 (JELCO) Pcs - - -
22 TP022 I.V Catheter No. 22 NIPRO Pcs - - -
23 TP023 I.V Catheter No. 24 TERUMO Pcs - - -
24 TP024 Materniti Napkin Slim L 0 - - -
25 TP025 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll - - -
26 TP026 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair - - -
27 TP027 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - -
28 TP028 Sterizyme Dual Enymatic Detergent 5 Ltr 0 1 - 1
29 TP029 Haloperidol 5 mg tablet Tablet - - -
30 TP030 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - -
31 TP031 Fixomull Strech 5 cm X 5 m Pcs - - -
32 TP032 Umbilical crd clamp 0 126 - 126
33 TP033 0 0 - - -
34 TP034 0 0 - - -
35 TP035 0 0 - - -
36 TP036 0 0 - - -
37 TP037 0 0 - - -
38 TP038 0 0 - - -
39 TP039 0 0 - - -
40 TP040 0 0 - - -
41 TP041 0 0 - - -
42 TP042 0 0 - - -
43 TP043 0 0 - - -
44 TP044 0 0 - - -
45 TP045 0 0 - - -
46 TP046 0 0 - - -
47 TP047 0 0 - - -
48 TP048 0 0 - - -
49 TP049 0 0 - - -
50 TP050 0 0 - - -
51 TP051 0 0 - - -
52 TP052 0 0 - - -
53 TP053 0 0 - - -
54 TP054 0 0 - - -
55 TP055 0 0 - - -
56 TP056 0 0 - - -
57 TP057 0 0 - - -
58 TP058 0 0 - - -
59 TP059 0 0 - - -
60 TP060 0 0 - - -
0 0 - - -
TOTAL - -

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN RESEP = ( Jumlah Lembar Resep )

UMUM
BAYAR GRATIS
JUMLAH KUNJUNGAN LOKET Rawat Jalan Rawat Inap Rawat Jalan

JUMLAH SETORAN RESTRIBUSI

SUDAH ADA DI LPLPO LAMA

Yang Menyerahkan,
TERTULIS 2 KALI KEPALA INSTALASI FARMASI KABUPATEN

Dra. TRI MUSYAROFAH, Apt

NIP. 19630411 199203 2 005
N LEMBAR PERMINTAAN OBAT
PLPO )

: BULAN
: TAHUN

AN SUMBER HARGA STOK NILAI

SISA STOK NO BATCH NILAI PERSEDIAAN PERMINTAAN PEMBERIAN
JUMLAH ANGGARAN SATUAN OPTIMUM PENERIMAAN

UNIT UNIT RP

- - DAK 18/Okt.19 99.000 0.00 0.000

- - DAK 19/Sept.21 105.000 0.00 0.000

386 108 DAK 20/ Jan 22 105.000 11,340.00 0.000

- - - 0.000 0.00 0.000
- - DAK 19/Feb.22 2,860.000 0.00 0.000
DAK 20/ 16 -
- 131 2,860.000 374,660.00 0.000
Des 22
- - DAK 18/Apr.20 10,500.000 0.00 0.000
186 382 DAK 19/Mei 23 104.000 39,728.00 0.000
- - DAK 20 L 220.000 0.00 0.000
551 1,418 DAK 19/Juni 21 93.500 132,583.00 0.000
- - DAK 17/AGSTS- - 0.000 0.00 0.000
- - 2,998.000 0.00 0.000
- - 20 - 0.000 0.00 0.000
- - Dak 19/Okt. 20 93.000 0.00 0.000
630 942 Dak 20/Okt 21 99.000 93,258.00 0.000
- - - 0.000 0.00 0.000
4,369 8,430 DAK 17/NOV-21 190.000 1,601,700.00 0.000
- - DAK 18/Okt.20 233.000 0.00 0.000
- - DAK 19/Feb 21 233.000 0.00 0.000
- - DAK 20/ April 22 249.000 0.00 0.000
 - - - 0.000 0.00 0.000
56 82 DAK 19/Agst.22 3,025.000 248,050.00 0.000
- - DAK 20 L 3,025.000 0.00 0.000
- - DAK 19/JULI 21 4,400.000 0.00 0.000
- - DAK 20/ Mart 22 3,628.000 0.00 0.000
- - DAK 18L/Mar.20 10,246.500 0.00 0.000
- - PRBG 20 9,900.000 0.00 0.000
- - DAK 17/MAR-20 8,500.000 0.00 0.000
41 50 DAK 20 / Mei-23 8,237.000 411,850.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Sept. 23 4,950.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR-19 440.000 0.00 0.000
- - DAK 18L/Agst.20 220.000 0.00 0.000
- - DAK 19/Mei20
PRSpesifik 21 165.000 0.00 0.000
2,578 2,332 58.000 135,256.00 0.000
- - non covid-19/ - 0.000 0.00 0.000
- - DAK 18/Apr-22 3,035.000 0.00 0.000
- - - 0.000 0.00 0.000
- 24 DAK 17/ Mei-21 4,496.000 107,904.00 0.000
- - - 0.000 0.00 0.000
10 - DAK
Buffer Prop.20 - 3,045.000
16/APR-20 0.00 0.000
- - 198.000 0.00 0.000
- - Covid-19
DAK 18L/Jan.21 1,485.000 0.00 0.000
- - PRSpesifik L 20/ 1,551.000 0.00 0.000
- - DAK 19/Sept.21 105.000 0.00 0.000
1,647 783 DAK 20/Juni 22 105.000 82,215.00 0.000
- - DAK
DAK 17/Jan-21
17/AGSTS- 1,050.000 0.00 0.000
- - 67.000 0.00 0.000
- - 20
DAK 20/Feb 22 75.000 0.00 0.000
- - DAK 19/MAR-22 103.000 0.00 0.000
874 1,696 DAK 20 L 253.000 429,088.00 0.000
- - 0 0.000 0.00 0.000
- 23 DAK 19/Feb.22 2,076.000 47,748.00 0.000
- - 0 0.000 0.00 0.000
48 74 DAK 19/Feb.22 1,584.000 117,216.00 0.000
- - 0 0.000 0.00 0.000
11 77 DAK 18L/Apr.22 2,915.000 224,455.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 380.000 0.00 0.000
56 - DAK 19/Des.22 380.000 0.00 0.000
 3 97 DAK 20/Des 23 405.000 39,285.00 0.000
- - Dak
DAK19/Feb 21
20/31-Okt 1,639.000 0.00 0.000
- - 1,639.000 0.00 0.000
- - 21
DAK 18/Apr 23 136.000 0.00 0.000
- - DAK20
DAK 19/Apr 23
/Nov22, 152.000 0.00 0.000
63 1,400 145.000 203,000.00 0.000
- - Mart
DAK 23
PRSpesifik 20 110.000
19/Jan 21 0.00 0.000
- - 110.000 0.00 0.000
- - Non
DAK Covid-19/
18/Feb.20 3,350.000 0.00 0.000
- - DAK 19/Feb.20 3,350.000 0.00 0.000
42 78 DAK 20/Okt 21 3,350.000 261,300.00 0.000
- - DAK 17/JUL-19 300.000 0.00 0.000
- - DAK 20/Feb 24 5,900.000 0.00 0.000
- - DAK 19/ 626.000 0.00 0.000
- - DAK 20 L 18,150.000 0.00 0.000
- - DAK 19/Agst. 20 7,602.000 0.00 0.000
- - DAK 19/Apr.20 7,124.000 0.00 0.000
- - 0 0.000 0.00 0.000
- - DAK 19/Jan 21 149,266.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Mei 24 5,280.000 0.00 0.000
- - DAK 19/Juni 24 660.000 0.00 0.000
316 793 PRBG 20/ 671.000 532,103.00 0.000
- - DAK 17/MAR-19 4,282.000 0.00 0.000
- 48 DAK 19/Mar.21 11,000.000 528,000.00 0.000
- 50 PRSpesifik L 20/ 10,098.000 504,900.00 0.000
- - DAK 19/Okt.21 2,805.000 0.00 0.000
- - DAK
DAK 19/Apr.21
20/ Des 21, 1,097.000 0.00 0.000
31 46 1,097.000 50,462.00 0.000
- - Feb
DAK2219/Juni 21 60.500 0.00 0.000
493 471 DAK 20 L 66.000 31,086.00 0.000
- - DAK 18/Nov 19 10,400.000 0.00 0.000
- - DAK 18L/Agst.20 9,900.000 0.00 0.000
63 59 DAK 19/Juni 22 1,095.000 64,605.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR-21 104.000 0.00 0.000
15 129 DAK 19/Nov.20 104.000 13,416.00 0.000
- - DAK 20/ 104.000 0.00 0.000
182 735 DAK 19/Nov.20 105.000 77,175.00 0.000
- - DAK 19/Mar.24 112.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/JULI21 4,400.000 0.00 0.000
 - - DAK 20/Feb 22 2,700.000 0.00 0.000
- 204 DAK 19/Juni 21 165.000 33,660.00 0.000
- - DAK 20/Mart 23 91.000 0.00 0.000
- - DAK 18/Des 20 1,408.000 0.00 0.000
- - DAK
DAK 19/Nov.20
GD 20 / 30- 1,408.000 0.00 0.000
2 91 Buffer 1,408.000 128,128.00 0.000
- - Aprl 21 Prop 730.000 0.00 0.000
24 121 19/Mei
DAK 20/ 20Mei 21 770.000 93,170.00 0.000
- - DAK
DAK 19/Des.23
17/SEPT- 391.000 0.00 0.000
- - 4,167.000 0.00 0.000
- - 20
DAK
Buffer17/AGS-19
Prop.19/ 3,550.000 0.00 0.000
- - 3,682.000 0.00 0.000
12 151 Feb 20 /31-Des
DAK 20
3,682.000 555,982.00 0.000
- - 21;Jan 22
DAK 17/Apr.19 691.000 0.00 0.000
10 21 DAK 18/Apr.21 710.000 14,910.00 0.000
- - DAK 17/ JAN-20 0.000 0.00 0.000
- - DAK
DAK 18/Des.19 1,333.000 0.00 0.000
- - 1,333.000 0.00 0.000
- - Farmasi/Jan-22
DAK 19/Jan 22 82.000 0.00 0.000
- - DAK 20/Mei 22 82.000 0.00 0.000
- - DAK 18/Mei 21 4,232.000 0.00 0.000
- - DAK 19/Sept.22 4,232.000 0.00 0.000
15 42 DAK 20/Feb 23 4,232.000 177,744.00 0.000
- - DAK 19/Juni 22 2,750.000 0.00 0.000
6 29 DAK 20 L 4,400.000 127,600.00 0.000
- - DAK 17/DES-20 2,900.000 0.00 0.000
630 1,749 DAK 19/Feb 24 119.000 208,131.00 0.000
- - DAK 20/ Feb 22 119.000 0.00 0.000
- 2,000 DAU 19/Mei
DAK PR BG 23 77.000 154,000.00 0.000
876 - COVID 20/ Agsts 99.000 0.00 0.000
- - DAK 19/Mei 22
21 7,865.000 0.00 0.000
- 14 DAK 19/Mei 21 10,010.000 140,140.00 0.000
- - PRSpesifik L 20/ 10,010.000 0.00 0.000
- - DAK 17/FEB-20 6,900.000 0.00 0.000
- - DAK 20/ 7,363.000 0.00 0.000
- - APBD II - 15 132.000 0.00 0.000
143 483 DAK 16/OKT-21 149.000 71,967.00 0.000
- - DAK 20 L 88.000 0.00 0.000
- - DAK 18/Agst.21 2,787.000 0.00 0.000
28 33 DAK 19/Mei 23 2,475.000 81,675.00 0.000
- - DAK 20/ Juni 23 2,475.000 0.00 0.000
- - DAK 19/Jan 21 176,800.000 0.00 0.000
 - 10 DAK 19/Mei 21 8,800.000 88,000.00 0.000
- - DAK 20 L 0.000 0.00 0.000
- - DAK 19 4,665.000 0.00 0.000
39 186 DAK 20/ Des 21 4,665.000 867,690.00 0.000
2,155 3,680 DAK 19/JULI21 264.000 971,520.00 0.000
- - DAK 20 L 330.000 0.00 0.000
- - DAK 18L/Mar.20 660.000 0.00 0.000
- - DAK 20 L 187.000 0.00 0.000
- 191 DAK 17/MAR-21 90.000 17,190.00 0.000
- - DAK 18/Jan.22 89.000 0.00 0.000
- - DAK 19/Mart.23 121.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Nov.20 9,644.000 0.00 0.000
- - DAK 18/Jan.21 10,696.000 0.00 0.000
- 182 DAK 19/Jan.22 10,696.000 1,946,672.00 0.000
- - - 0.000 0.00 0.000
- - DAK 19/Juli 21 770.000 0.00 0.000
- - - 0.000 0.00 0.000
- 100 DAK 18/Mar.21 1,755.000 175,500.00 0.000
- - DAK 19/Mei 21 187.000 0.00 0.000
1,327 1,709 DAK
DAK 19/ Agst.22
20/ Sept 22, 63.000 107,667.00 0.000
- - 63.000 0.00 0.000
- - Jan
DAK2319/Mei 24 94.600 0.00 0.000
988 602 DAK 20 L 99.000 59,598.00 0.000
- - DAK 19/Mei23 5,610.000 0.00 0.000
3 8 DAK 20/ Juni 23 2,518.000 20,144.00 0.000
19 341 DAK 19/Juli21 396.000 135,036.00 0.000
- - DAK 19/Jun 21 288.000 0.00 0.000
- - DAK 20/Jan 22 288.000 0.00 0.000
- - DAK 19/Des.20 1,089.000 0.00 0.000
- - DAK 17/SEPT-- 0.000 0.00 0.000
- - 1,810.000 0.00 0.000
- - 20 - 0.000 0.00 0.000
- - DAK 17/FEB-20 10,500.000 0.00 0.000
- - DAK 18L/Mei.20 17,968.500 0.00 0.000
- - DAK 19/Mart21 35,200.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18/Mei.22 22.000 0.00 0.000
1,244 541 DAK 19/Mar.22 77.000 41,657.00 0.000
- - DAK 20/Feb 22 23.000 0.00 0.000
- - DAK 17/MEI 20 2,750.000 0.00 0.000
- - DAK 18L/Mei.23 495.000 0.00 0.000
 - 1,378 DAK 19/Juni 23 440.000 606,320.00 0.000
368 1,444 DAU PR BG 20/ 319.000 460,636.00 0.000
- - DAK 19/JUN 20 2,052.000 0.00 0.000
11 86 DAK 20/ Mei 22 2,190.000 188,340.00 0.000
1 18 DAK 17/JUNI 21 13,970.000 251,460.00 0.000
1 - DAK 19/Apr.21 22,550.000
PRSpesifik 0.00 0.000
2 8 23,100.000 184,800.00 0.000
- - Dokter Muter 20 3,811.500
DAK 18L/Nov.20 0.00 0.000
- - DAK 19/Mei 21 6,600.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/JUN 21 1,937.000 0.00 0.000
82 232 DAK20/
DAK 19/Mei
Feb 21 2,178.000 505,296.00 0.000
- - 1,222.000 0.00 0.000
- 22 21;Mei22
DAK 19/Juni 21 99.000 2,178.00 0.000
- - DAK 20 L 330.000 0.00 0.000
- 126 DAK 19/Nov.21 123.000 15,498.00 0.000
- - DAK 20/Okt 23 131.000 0.00 0.000
- - DAK 18L/Sept.20 4,680.500 0.00 0.000
- - DAK 19/Jan 22 4,730.000 0.00 0.000
- - DAK 19/ 550.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 18L/Apr.20 4,950.000 0.00 0.000
- - DAK 19/Apr 21 5,500.000 0.00 0.000
91 790 PRSpesifik L 20/ 3,707.000 2,928,530.00 0.000
- - DAK 19/Des.20
DAK20/28 Feb22 96.000 0.00 0.000
202 1,103 102.000 112,506.00 0.000
- - ;DAK 19/Agst. 21 143.000 0.00 0.000
- - - 0.000 0.00 0.000
- - DAK 17/APR 22 87.000 0.00 0.000
- - DAK 18/Nov.20 80.000 0.00 0.000
- - DAK 20 / Juni 22 121.000 0.00 0.000
- - DAK19/JULI23 192.500 0.00 0.000
340 942 DAK 20 L 275.000 259,050.00 0.000
- - DAK 19/Nov 20 8,110.000 0.00 0.000
- - DAK 20/ 8,110.000 0.00 0.000
- - DAK 18L/Okt.20 14,318.700 0.00 0.000
- - DAK 19/Feb 21 5,500.000 0.00 0.000
- - DAK
DAK 18L/Des.20
17/AGSTS 2,090.000 0.00 0.000
- - 5,000.000 0.00 0.000
- - 19
DAK 19/FEB 21 4,400.000 0.00 0.000
PRSpesifik
- - 1,265.000 0.00 0.000
- - Dokter Muter 20
DAK 17/APR 20 990.000 0.00 0.000
 - - DAK 19/Apr.21 13,200.000
PRSpesifik 0.00 0.000
24 92 13,167.000 1,211,364.00 0.000
- - Dokter Muter 20 2,332.000
DAK 18L/Des.19 0.00 0.000
- - DAK 18L/Okt.21 528.000 0.00 0.000
- - PRSpesifik L 20/ 594.000 0.00 0.000
- - DAK 17/FEB 21 835.000 0.00 0.000
- - DAK 19/OKT20 115.000 0.00 0.000
- - DAK 19/Des 20 123.000 0.00 0.000
44 919 DAK20/ 123.000 113,037.00 0.000
- - DAK 17/JUN 21 6,410.000 0.00 0.000
- - DAK 18/Feb.22 6,410.000 0.00 0.000
- - PRSpesifik 20
DAK19/Jan 22 132.000 0.00 0.000
- - Non Covid-19/ 3,948.000 0.00 0.000
- - DAK2118L/Des.20 23,141.800
Okt 0.00 0.000
- - DAK 19/Juli 21 19,800.000 0.00 0.000
- 20 DAK 18/Agst.20 560.000 11,200.00 0.000
- - DAK 19/Juli 23 560.000 0.00 0.000
- 100 DAK20/Sep 23 598.000 59,800.00 0.000
- - DAK 19/Apr 21 12,100.000 0.00 0.000
- - DAK 19/Mart.21 24,860.000 0.00 0.000
- - DAK 19/ Agst. 21 9,955.000
PRSpesifik 0.00 0.000
- - DAK 16/AGSTS 25,597.000 0.00
- - Dokter Muter 20 160.000 0.00 0.000
5 452 20
DAK 19/Juli 21 1,070.000 483,640.00 0.000
- - DAK 20 1,124.000 0.00 0.000
- - DAK 19/Mei 22 715.000 0.00 0.000
- - DAK 18L/Jul.20 432.300 0.00 0.000
- - DAK19/
PRSpesifik 437.800 0.00 0.000
- - 418.000 0.00 0.000
- - Dokter Muter 20 357.500
DAK 19/JUNI22 0.00 0.000
- - PRSpesifik L 20/ 495.000 0.00 0.000
- - DAK 18L/Sept.22 789.800 0.00 0.000
- - DAK 19 1,181.000 0.00 0.000
94 19 DAK 20/ Des 22 1,181.000 22,439.00 0.000
- - DAK
Hibah19/Des
RSUD 20 53.000 0.00 0.000
- - 56.000 0.00 0.000
- - Pasirian
Buffer Prop 20/ 53.000 0.00 0.000
- - DAK 17/JUN 20 20,700.000 0.00 0.000
19 52 DAK 19/Feb 21 11,825.000 614,900.00 0.000
- - DAK 20/Agust 22 11,825.000 0.00 0.000
22 138 DAK19/Apr 21 963.600 132,976.80 0.000
3,460 8,932 DAK 20 L 115.500 1,031,646.00 0.000
 3 19 DAK 19/Juli 21 4,400.000 83,600.00 0.000
- 714 DAK 20 L 132.000 94,248.00 0.000
836 - DAK 19/Sept.21 123.000 0.00 0.000
- - PRSpesifik
DAK 17/AGSTSL 20/ 6,600.000 0.00 0.000
- - Buffer Prop 41,500.000 0.00 0.000
- - 20 68.000 0.00 0.000
1,014 674 19/Agus.20
DAK 19/Jan.21 73.000 49,202.00 0.000
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Covid-19
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PROPINSI
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DAU 20 20
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PRSpesifik
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- - - 0.000 0.00 0.000
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- - - 0.000 0.00 0.000
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- - - 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
- 0.000 0.00 0.000
 - 0.000 0.00 0.000
0 0 0.00 0.000
- - 156,835,611.96 12,286,500.000

BPJS JUMLAH LBR RESEP JUMLAH TOTAL R

RATIS

BPJS JUMLAH LBR RESEP JUMLAH ANTIBIOTIK & INJEKSI

RATIS
Rawat Inap Rawat Jalan Rawat Inap Rawat Jalan Rawat Inap antibiotik injeksi

YANG MEMINTA / MELAPOR YANG MENERIMA / PETUGAS

KEPALA PUSKESMAS PUSKESMAS

...................................................... ................................................
Ket

43 FALSE
TRUE
0

FALSE
0
300 FALSE
20 FALSE
FALSE
344
240 FALSE
0 FALSE
264 FALSE
4000 FALSE
0 TRUE
0 TRUE
1303 FALSE
0 TRUE
31 FALSE
0 TRUE
0 FALSE
0 TRUE
580 FALSE
0 TRUE
1403 FALSE
0 FALSE
371 FALSE
7668 FALSE
0 TRUE
276 FALSE
0 TRUE
124 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
1591 FALSE
0 TRUE
0 TRUE
2 FALSE
33 FALSE
160 FALSE
0 TRUE
442 FALSE
347 FALSE
4957 FALSE
15 FALSE
25 FALSE
5 FALSE
35 FALSE
0 FALSE
150 FALSE
0 TRUE
22 FALSE
0 TRUE
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244 FALSE
6793 FALSE
0 TRUE
0 FALSE
500 FALSE
0 FALSE
2808 FALSE
0 TRUE
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0 TRUE
 0 FALSE
450 FALSE
200 FALSE
0 TRUE
24 FALSE
0 FALSE
79 FALSE
0 TRUE
205 FALSE
0 TRUE
400 FALSE
0 TRUE
5 FALSE
0 TRUE
0 TRUE
450 FALSE
118 FALSE
500 FALSE
2 FALSE
23 FALSE
70 FALSE
0 TRUE
6 FALSE
0 TRUE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
767 FALSE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
1640 FALSE
0 FALSE
0 TRUE
0 FALSE
0 TRUE
31 FALSE
0 TRUE
 0 TRUE
0 FALSE
1886 FALSE
0 TRUE
0 TRUE
233 FALSE
200 FALSE
0 FALSE
0 TRUE
4376 FALSE
0 TRUE
0 TRUE
27 FALSE
0 TRUE
0 FALSE
0 TRUE
12 FALSE
0 TRUE
0 TRUE
0 TRUE
74 FALSE
0 TRUE
0 FALSE
257 FALSE
240 FALSE
0 TRUE
561 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
34 FALSE
0 TRUE
1303 FALSE
0 TRUE
0 TRUE
7 FALSE
26 FALSE
20 FALSE
0 FALSE
0 TRUE
0 TRUE
 0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
484 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
726 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
78 FALSE
60 FALSE
2 FALSE
54 FALSE
72 FALSE
8 FALSE
37 FALSE
0 FALSE
1300 FALSE
4867 FALSE
0 FALSE
0 TRUE
3254 FALSE
0 TRUE
51 FALSE
300 FALSE
0 TRUE
11 FALSE
0 TRUE
74 FALSE
500 FALSE
101 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
 0 FALSE
0 FALSE
0 TRUE
0 FALSE
0 FALSE
55 FALSE
100 FALSE
0 TRUE
3800 FALSE
287 FALSE
0 TRUE
0 FALSE
185 FALSE
500 FALSE
300 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
280 FALSE
500 FALSE
0 TRUE
56 FALSE
5158 FALSE
0 TRUE
116 FALSE
0 FALSE
1 FALSE
0 TRUE
3673 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
150 FALSE
0 TRUE
 0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
43 FALSE
0 TRUE
0 TRUE
23 FALSE
40 FALSE
47 FALSE
0 TRUE
115 FALSE
4208 FALSE
5020 FALSE
0 FALSE
0 TRUE
100 TRUE
318 FALSE
1764 FALSE
0 TRUE
14 FALSE
21 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
168 FALSE
14 FALSE
59 FALSE
210 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
424 FALSE
0 FALSE
 0 FALSE
0 FALSE
0 TRUE
103 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE BUFFER P 257
1821 FALSE
572 FALSE
0 TRUE
65 FALSE
0 TRUE
100 FALSE
6 FALSE
0 FALSE
0 TRUE
700 FALSE
300 FALSE
0 FALSE
0 TRUE
100 FALSE
0 TRUE
0 FALSE
0 TRUE
11 FALSE
0 TRUE
25 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE BUFFER P 2728
27 FALSE
0 TRUE
0 FALSE
8 FALSE
62 FALSE
0 TRUE
 0 TRUE
0 FALSE
6906 FALSE
0 FALSE
0 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
2 FALSE
52 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
226 FALSE
1136 FALSE
0 FALSE
317 FALSE
0 TRUE
0 TRUE
38 FALSE
0 TRUE
0 TRUE
85 FALSE
0 TRUE
7 FALSE
0 TRUE
0 TRUE
97 FALSE
0 TRUE
34 FALSE
0 TRUE
0 TRUE
1980 FALSE
50 FALSE
0 TRUE
670 FALSE
45 FALSE
 0 TRUE
0 TRUE
0 TRUE
394 FALSE
0 TRUE
0 TRUE
9701 FALSE
0 TRUE
3000 FALSE
3000 FALSE
0 TRUE
56 FALSE
4507 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
13 FALSE
0 TRUE
26 FALSE
0 TRUE
60 FALSE
0 TRUE
0 TRUE
0 TRUE
136 FALSE
0 TRUE
0 TRUE
423 FALSE
4797 FALSE
0 TRUE
0 TRUE
0 TRUE
660 FALSE
3725 FALSE
164 FALSE
0 TRUE
830 FALSE
0 FALSE
0 TRUE
400 FALSE
1006 FALSE
 0 TRUE
173 FALSE
0 FALSE
11 FALSE
109 FALSE
1255 FALSE
0 TRUE
396 FALSE
0 FALSE
577 FALSE
2039 FALSE
7 FALSE
0 TRUE
110 FALSE
0 TRUE
0 FALSE
0 TRUE
4 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
620 FALSE
0 FALSE
0 TRUE
1491 FALSE
0 TRUE
1169 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
24 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
1620 FALSE
0 TRUE
2293 FALSE
0 TRUE
118 FALSE
 0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
36 FALSE
190 FALSE
0 FALSE
0 TRUE
30 FALSE
0 FALSE
0 TRUE
283 FALSE
1906 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
200 FALSE
0 TRUE
2 FALSE
0 FALSE
0 TRUE
0 TRUE
734 FALSE
0 TRUE
97 FALSE
0 FALSE
126 FALSE
5202 FALSE
0 TRUE
0 FALSE
603 FALSE
2 FALSE
607 FALSE
0 FALSE
122 FALSE
0 TRUE
0 TRUE
5 FALSE
 21 FALSE
0 FALSE
0 TRUE
20 FALSE
36 FALSE
1 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
15 FALSE
228 FALSE
39 FALSE
132 FALSE
0 TRUE
28 FALSE
50 FALSE
0 TRUE
5 FALSE
71 FALSE
0 TRUE
0 TRUE
20 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
6 FALSE
289 FALSE
0 TRUE
0 TRUE
92 FALSE
50 FALSE
0 TRUE
45 FALSE
0 TRUE
0 TRUE
 0 TRUE
6 FALSE
22 FALSE
0 TRUE
100 FALSE
0 TRUE
59 FALSE
150 FALSE
5 FALSE
150 FALSE
0 TRUE
0 TRUE
0 TRUE
26 FALSE
15 FALSE
100 FALSE
0 TRUE
3 FALSE
10 FALSE
102 FALSE
34 FALSE
0 TRUE
0 TRUE
384 FALSE
500 FALSE
1220 FALSE
1000 FALSE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
6 FALSE
10 FALSE
0 FALSE
99 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
 0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
3 FALSE
0 TRUE
50 FALSE
23 FALSE
0 TRUE
0 FALSE
0 FALSE
0 FALSE
0 TRUE
0 FALSE
200 FALSE
4652 FALSE
0 TRUE
0 TRUE
36 FALSE
19 FALSE
5 FALSE
0 FALSE
230 FALSE
0 TRUE
0 FALSE
134 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
2 FALSE
0 TRUE
1 FALSE
0 TRUE
20 FALSE
0 TRUE
0 TRUE
 1 FALSE
26 FALSE
0 TRUE
0 TRUE
20 FALSE
0 TRUE
1000 FALSE
200 FALSE
3 FALSE
0 TRUE
0 FALSE
2 FALSE
0 FALSE
2 FALSE
0 TRUE
10 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
30 FALSE
1229 FALSE
0 FALSE
4 FALSE
20 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
 0 TRUE
0 TRUE
0 TRUE
110 FALSE
0 TRUE
0 TRUE
3 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
426 FALSE
0 TRUE
0 TRUE
0 TRUE
367 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
712 FALSE
0 TRUE
0 TRUE
0 TRUE
941 FALSE
0 TRUE
2759 FALSE
0 TRUE
0 TRUE
 0 TRUE
0 TRUE
26 FALSE
0 TRUE
378 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
15 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
800 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
 0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
3 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
3200 FALSE
5000 FALSE
0 TRUE
0 TRUE
7 FALSE
3000 FALSE
97 FALSE
450 FALSE
0 TRUE
 0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
1953 FALSE
0 TRUE
7488 FALSE
0 TRUE
290 FALSE
 0 TRUE
250 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
9 FALSE
0 FALSE
0 TRUE
0 TRUE
570 FALSE
0 TRUE
0 TRUE
0 TRUE
13 FALSE
0 TRUE
0 FALSE
30 FALSE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 FALSE
0 FALSE
104 FALSE
0 TRUE
320 FALSE
 0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
38 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
 0 TRUE
0 TRUE
4 FALSE
2 FALSE
0 TRUE
37 FALSE
136 FALSE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
11 FALSE
0 FALSE
0 FALSE
50 FALSE
0 TRUE
140 FALSE
0 TRUE
0 TRUE
0 TRUE
700 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
183 FALSE
0 TRUE
0 TRUE
0 TRUE
500 FALSE
0 FALSE
0 TRUE
2508 FALSE
100 FALSE
0 TRUE
 0 TRUE
3326 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
0 TRUE
0 TRUE
0 TRUE
0 FALSE
1500 FALSE
0 TRUE
0 TRUE
10 FALSE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
0 TRUE
48 FALSE
 PUSKESMAS ..................
KODE PUSKESMAS
PUSKESMAS
KECAMATAN
KAB / KODYA
PROPINSI

NO NAMA OBAT

1 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI)

2 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI)
3 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI)
4 0
5 Air Untuk Injeksi Vial @25 ml
6 Air Untuk Injeksi Vial @25 ml
7 Air Untuk Irigasi Infus 1000 ml
8 Alopurinol Tablet 100 mg
9 Alopurinol Tablet 100 mg
10 Ambroxol Tablet 30 mg
11 0
12 Aminofilin Injeksi 24 mg/ml
13 0
14 Amlodipin Tablet 10 Mg
15 Amlodipin Tablet 10 Mg
16 0
17 Amoksisilin Kaplet 500 mg
18 Amoksisilin Kaplet 500 mg
19 Amoksisilin Kaplet 500 mg
20 Amoksisilin Kaplet 500 mg
21 0
22 Amoksisilin Syrup Kering 125 mg / 5 ml
23 Amoksisilin Syrup Kering 125 mg / 5 ml
24 Amoksisilin Syrup Kering 250mg / 5 ml
25 Amoksisilin Syrup Kering 250mg / 5 ml (Novapharin)
26 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT
27 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT
28 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin)
29 Ampicilin Serbuk Inj i.v 1.000 mg/vial
30 0
31 Antacida + Simeticon Suspensi (NOVAMAG)
32 0
33 Antacida + Simeticon Tablet Kunyah (MAGTEN)
34 Antacida + Simeticon Tablet Kunyah (MAGTEN)
35 Antacida + Simeticon Tablet Kunyah (MAGTEN)
36 Antacida tablet kunyah DOEN, kombinasi : Alumunium Hidroksida 200 mg + Magnesium Hidroksida 200 mg
37 0
38 Anti Bakteri Doen Salep Kombinasi (Indo Farma)
39 0
40 Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam Salisilat 3% (Marin )
41 0
42 Antihemoroid Kombinasi : Bismut Suppgalat 150 mg Heksaklorofen 2,5 mg Lidokain 10 mg Seng Oksida 120 mg
43 Asam Ascorbat 500 mg (Vitamin C)
44 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD
45 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD
46 Asam Ascorbat 50 mg (Vitamin C)
47 Asam Ascorbat 50 mg (Vitamin C)
48 Asam Folat 1 mg Beta Caroten 10000 Multi Mineral/ FOLAMIL (Dexa Medica)
49 Asam Folat Tablet 1 mg (Marin Liza Farmasi)
50 Asam Folat Tablet 1 mg
51 Asam Mefenamat 500 mg ( Mersi )
52 Asam Mefenamat 500 mg
53 0
54 Asam Tranexamat 100 mg/@5 ml Injeksi
55 0
56 Asam Tranexamat Tablet 500 mg
57 0
58 Asiklovir 5% 5gr Cream
59 Asiklovir 5% 5gr Cream
60 0
61 Asiklovir Tab 400 mg ( Phapros )
62 Asiklovir Tab 400 mg ( Phapros )
63 Asiklovir Tab 400 mg ( Phapros )
64 Atropin Sulfat Injeksi 0,25 mg/ml
65 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k)
66 Attapulgite Active 630 mg Tab/ New Antides
67 Attapulgite Active 630 mg Tab/ PULAREX
68 Attapulgite Active 630 mg Tab/ New Antides
69 Betahistin Mesylat 6 mg
70 Betahistin Mesylat 6 mg
71 Betametason Dipropionat Krim 0,1%
72 Betametason Dipropionat Krim 0,1%
73 Betametason Dipropionat Krim 0,1%
74 Bisakodil Tablet 5 mg (Etercon Pharma )
75 Bisakodil Sup 10 mg (Dulcolax)
76 Bisoprolol 2,5 mg/concor 2,5
77 Benzatin Benzil Penisilin 2,4 jt
78 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) II
79 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) I
80 0
81 Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca)
82 0
83 Calcium Plus Vit D3 (Coral calcium 500 mg,Naturan Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 mg,Zink 5 mg Boron 1 mg)/ CAL - 95
84 Cefadroksil Kapsul 500 mg
85 Cefadroksil Kapsul 500 mg
86 Cefotaxime serbuk injeksi 1.000 mg
87 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros )
88 Citicolin 250 mg / 2 ml Inj
89 Curcumin Plus Cynarin,Sylimarin,Kapsul/ HEPAGARD (Phapros)
90 Deksamethason Inj iv/ im 5 mg/ ml (Mepro)
91 Deksamethason Inj iv/ im 5 mg/ ml (Mepro)
92 Deksamethason Tab 0,5 mg (Promed )
93 Deksamethason Tab 0,5 mg
94 Desoksimetason Krim 0,25% 15gram ( Dexa Medica)
95 Dextromertofan Komb Syr/ BANTIF (Sanbe)
96 Difenhidramin Inj 10 mg/ ml (Phapros )
97 0
98 Digoksin Tab 0,25 mg (Yarindo Farmatama )
99 Digoksin Tab 0,25 mg (Yarindo Farmatama )
100 Digoksin Tab 0,25 mg
101 Dimenhidrinat Tablet 50 mg/ Kimia Farma
102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II
103 0
104 Domperidon Suspensi 5 mg /5 ml (Novapharin )
105 Domperidon Suspensi 5 mg /5 ml (Novapharin )
106 Domperidon Tab 10 mg (Novapharin )
107 Domperidon Tab 10 mg (Novapharin )
108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1%
109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica )
110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica )
111 Eritrosmisin Stearate Kaplet 500 mg
112 Eritrosmisin Stearate Kaplet 500 mg
113 Ethambutol 250 mg
114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros )
115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros )
116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros )
117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros )
118 Fitomenadion Tabet 10 mg (Phapros )
119 Fitomenadion Tabet 10 mg (Phapros )
120 0
121 Furosemide Injeksi 10 mg/ ml (Indofarma)
122 Furosemide Injeksi 10 mg/ ml (Indofarma)
123 Furosemide Tablet 40 mg (Kimia Farma )
124 Furosemide Tablet 40 mg (Kimia Farma )
125 Gentamisin Sulfate tetes mata 0,3% ( ERELA)
126 Gentamisin Sulfate tetes mata 0,3% ( ERELA)
127 Gentamisin Sulfate tetes mata 0,3% ( ERELA)
128 Gentamycin Krim 1 % mg/ ml
129 Gentian Violet 1% 10 ml
130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma)
131 Glibenklamid Tablet 5 mg
132 Glibenklamid Tablet 5 mg ( Indofarma )
133 Gliseril Guaikoulat Tablet 100 mg (Novapharin )
134 Gliseril Guaikoulat Tablet 100 mg
135 Glucosamin HCL 500 Mg, Konrdoitin SO4400Mg, MSM 200 Mg, VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Gliserofosfat 10 mg
136 Glukosa Larutan 40% Steril ( Outsuka )
137 Glukosa Larutan 40% Steril
138 Glukosa Larutan Infus 5% @500ml (Widatra )
139 Glukosa Larutan Infus 5% @500ml
140 Hidroklorotiazid (HCT) Tablet 25 mg
141 Hidroklorotiazid (HCT) Tablet 25 mg
142 Gliseril Guaikoulat Tablet 100 mg
143 Hidrokortison Krim 1 % (Kimia Farma )
144 Hidrokortison Krim 2,5 % (Kimia Farma)
145 Hidrokortison Krim 2,5 % (Kimia Farma)
146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam)
147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat)
148 0
149 Ibuprofen Susp 200 mg/5 ml (Indo Farma )
150 Ibuprofen Susp 200 mg/5 ml (Indo Farma )
151 Ibuprofen Tablet 400 mg (Novapharin )
152 Ibuprofen Tablet 400 mg
153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros)
154 Isoniazid Tablet 100 mg
155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo)
156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo)
157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo)
158 0
159 KA-EN 1B Inj Larutan @500 ml (Otsuka)
160 KA-EN 3A Inj Larutan @500 ml (Otsuka)
161 KA-EN 3B Inj Larutan @500 ml (Otsuka)
162 0
163 Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian Pharmatama)
164 0
165 Kalium Klorida tab. Lepas lambat 600 mg (KSR)
166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars)
167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma)
168 Kalsium Laktat (Kalk) Tab 500 mg
169 Kaptopril Tab 25 mg ( Phapros )
170 Kaptopril Tab 25 mg
171 Ketokonazol Krim 2 % @ 10 gr
172 Ketokonazol Krim 2 % @ 10 gr
173 Ketokonazol Tablet 200 mg (Novapharin) I
174 Ketokonazol Tablet 200 mg (Novapharin) II
175 Ketokonazol Tablet 200 mg (Novapharin)
176 Ketorolak Inj 30 mg/ml
177 0
178 Kloramfenikol 1% Salep Mata (KF)
179 0
180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma)
181 Kloramfenikol Tetes Telinga :Kloramfenicol 10%,Lidocain,Proplylenglycol /Colme (Interbat)
182 Kloramfenikol Tetes Telinga : Kloramfenicol 10%,Lidocain,Proplylenglycol / COLME (Interbat)
183 0
184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi )
185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi )
186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin )
187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris )
188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus )
189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars )
190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg
191 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma )
192 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma )
193 Krim Analgesik (setiap gram mengandung : Metyl Salisilat 102 mg, Eugenol 13,6 mg; Methol 53,4 mg, Vinishing Cream ad 1 gr/ MOLAKRIM
194 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
195 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma)
196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe)
197 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe)
198 0
199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi)
200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi)
201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi)
202 Loperamid Tablet 2 mg ( Ifars)
203 Loperamid Tablet 2 mg
204 Loratadin Tablet 10 mg
205 Loratadin Tablet 10 mg
206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros)
207 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros)
208 Meloxicam Tab 15 mg (Bernofarm )
209 0
210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages)
211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages)
212 Metamizol Sodium Inj 500 mg/ml (Santagesik)
213 Metformin HCl Tablet 500 mg
214 Metformin HCl Tablet 500 mg
215 Metilprednisolon Tab 4 mg (Molex Ayus)
216 0
217 Metoklopramide Tablet 10 mg (Kimia Farma)
218 Metoklopramide Tablet 10 mg (Kimia Farma)
219 Metoklopramide Tablet 5 mg (Kimia Farma)
220 Metronidasol 500 mg tablet (Novapharin)
221 Metronidasol 500 mg tablet (Novagyl)
222 Metronidasol Infus 500mg/100ml
223 Metronidasol Infus 500mg/100ml
224 Minyak Kayu Putih 60 ml
225 Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Zink 20 mg, Beta Caroten 10000 IU, Selenium 30 mcg (LICOXY)
226 Multivitamin + Pelancar Asi (NULACVIT)
227 Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / MERSIBION
228 Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN)
229 Multivitamin Vitamin/ Suplemen (BECEFORT)
230 Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex Ayus )
231 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
232 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
233 Multivitamin Neurotopic Plus ATP Tablet:B1 100,B6 200,B12 200Mcg,Vit E 30mg, ATP 20mg / Bio ATP (Phapros)
234 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus)
235 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus)
236 Multivitamin Tab Tambah Darah : per Tablet Mengandung : Femofomarrat 300mg Mgso4 0,4mg,Cuso4 0,4 mg,Vit C 100mg ,Asam Folat 2 Mg,Vit B 12 15Mcg,Faktor Intirinsik 25mg / HEMAFORT ( Phapros )
237 Natrium Diklofenak Tab 50 mg (Phapros ) I
238 Natrium Diklofenak Tab 50 mg (Phapros ) II
239 Natrium Diklofenak Tab 50 mg (Phapros )
240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra )
241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra )
242 Nifedipin tablet 10 mg ( Dexa Medica )
243 Nifedipin tablet lepas lambat 30 mg (OROS)
244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma)
245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma)
246 Nistatin Vaginal Tab 100.000 IU/G (Phapros )
247 Nistatin Vaginal Tab 100.000 IU/G (Phapros )
248 Nistatin Vaginal Tab 100.000 IU/G (Phapros )
249 Obat Batuk Herbal : Tiap 15 Ml Vitetrifolia Fill 1 Gr,Zingiber Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Macrocarpa Fruct 0,20 Mg / HERBAKOF (Dexa Medica )
250 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE
251 OBH Plus Syr : Per 5 ml Megnandung Difenhidramin 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 mg,Na Sitrat 50 mg / SANADRYL
252 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE
253 Omeprazole Kapsul 20 mg
254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa )
255 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa )
256 Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus )
257 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros)
258 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros)
259 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros)
260 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, / COLPICA (Tropika Mas)
261 Propiltiourasil/ PTU 100 mg
262 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, Tripolidin 2,5 mg / NOZA (Phapros)
263 Parasetamol Syrup 120 mg/5ml (Mersi Farma)
264 Parasetamol Syrup 120 mg/5ml
265 Parasetamol tablet 500 mg
266 Parasetamol tablet 500 mg
267 Parasetamol tablet 500 mg
268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L)
269 Permetrin crem 5% @10 mg (Scabimite crem )
270 Permetrin crem 5% @10 mg (Scabimite crem )
271 Piracetam 800 mg Tablet
272 Parasetamol tablet 500 mg
273 Piracetam Injeksi 1gr/ 5ml
274 Piridoksin HCl (Vit.B6)Tablet 10 mg
275 Piridoksin HCl (Vit.B6)Tablet 10 mg
276 Probiotik Sachet (Probiokid)
277 Polikresulen (Albotyl,Apetil)
278 Prednison Tab 5 mg
279 Prednison Tab 5 mg (Holi Pharma)
280 Prednison Tab 5 mg
281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza)
282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO)
283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO)
284 Ranitidin Tablet 150 mg (Hexapharm Jaya )
285 0
286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING
287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING
288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL
289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL
290 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL
291 Salbutamol SO4 3,01 mg + Ipratonium Brom 0,52 mg Nebulizer (COMBIVENT) I dan II
292 0
293 Salbutamol Tab 4 mg ( Graha Farma )
294 Salbutamol Tab 4 mg (Pristasma)
295 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin )
296 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin )
297 Salisil Bedak Serbuk 2% (Kimia Farma)
298 Salisil Bedak Serbuk 2%
299 Salisil Bedak Serbuk 2%
300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE
301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE
302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT
303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT
304 Setirizin Tab 10 mg (Futamed)
305 Setirizin Tab 10 mg (Futamed)
306 Simvastatin Tablet 10 mg (Yarindo Farmatama)
307 Simvastatin Tablet 10 mg
308 Siprofloksasin Tablet 500 mg (Novapharin)
309 0
310 Sukralfat Susp 500mg/5ml @100 ml (Mepro)
311 Sukralfat Susp 500mg/5ml @100 ml (Mepro)
312 Tetes mata setiap ml mengandung Polietilen glikol 400 1% gliserin 0.25% Hidroksipropil metil selulosa 0,2% VISINE
313 Tetrasiklin HCl Kapsul 500 mg
314 Thiamin/ Vitamin B1 50 mg
315 Thiamin/ Vitamin B1 50 mg (Novapharin )
316 Thiamin/ Vitamin B1 50 mg (Novapharin )
317 Thiamphenicol / Thiamfilex Kapsul 500 mg
318 Thiamphenicol Kapsul 500 mg
319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL)
320 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Molex Ayus)
321 Vitamin B Komplek
322 Vitamin B Komplek Plus Ekstrak Hati (Substansi Hati Kering 100 mg, Vit B1 HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, CuSO4 0,65 mg) LIVRPON B-PLEX
0 OBAT GOLONGAN PSIKOTROPIKA
323 Alprazolam 0,5 mg (Mersi Farma)
324 Clobazam Tab 10 mg (Meprofarm)
325 Clobazam Tab 10 mg (Meprofarm)
326 Clobazam Tab 10 mg (Meprofarm)
327 0
328 0
329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis )
330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis )
331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis )
332 Diazepam Injeksi 5 mg / ml-2 ml
333 Diazepam Injeksi 5 mg / ml-2 ml
334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE
335 Diazepam Tablet 5 mg (VALISANBE)
336 Diazepam Tablet 5 mg
337 Fenobarbital Tablet 30 mg
338 Fenobarbital Tablet 30 mg
339 Fenobarbital Tablet 30 mg
340 Kodein Tablet 10 mg
341 0
342 Lorazepam Tab 2 mg (Mersi Farma)
343 Metamizol 500 mg + Diazepam 2 mg / PRONEURON (Meprofarm)
344 0
345 0
346 0
347 Primaquin 15 mg tablet
348 0
0 OBAT - OBAT PROGRAM
0 OBAT PROGRAM KECACINGAN
349 Albendazol Tablet 400 mg
350 Albendazol Tablet 400 mg
0 OBAT PROGRAM DIARE
351 Garam Oralit (Kimia Farma)
352 Garam Oralit (Kimia Farma)
353 Garam Oralit (Kimia Farma)
354 Garam Oralit (Kimia Farma)
355 0
356 Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined imperial)
357 Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar)
358 Zinc Sulphate Tablet Dispersible 20 mg
359 Zinc Dispersible 20 mg tablet
360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros)
361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros)
362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros)
363 0
0 OBAT PROGRAM HEPATITIS
364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep)
365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep)
366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep)
367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep)
368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep)
0 OBAT PROGRAM TB PARU
369 OAT FDC Kategori Anak
370 OAT FDC Kategori Anak
371 OAT FDC Kategori Anak
372 OAT FDC Kategori I - IIII
373 OAT FDC Kategori I - IIII
374 OAT FDC Kategori II
375 OAT FDC Kategori II
376 OAT FDC Kategori II
377 OAT FDC Kombipak Kategori I
378 0
379 Isoniazid 100 mg tablet
0 OBAT POGRAM KUSTA
380 MDT MB Anak
381 MDT MB Anak
382 MDT MB Dewasa
383 MDT MB Dewasa
384 MDT MB Dewasa
385 MDT PB Anak
386 MDT PB Anak
387 MDT PB Anak
388 MDT MB Dewasa
389 MDT PB Dewasa
0 OBAT PROGRAM GIZI
390 Mineral Mix Kombinasi
391 Mineral Mix Kombinasi
392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln)
393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln)
394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln)
395 Retinol Vit A 100.000 IU (Biru)
396 Retinol Vit A 100.000 IU (Biru)
Retinol Vit A 100.000 IU (Biru)
398 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros)
399 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros)
400 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros)
401 0
402 0
0 OBAT PROGRAM KESGA
403 Calcii Gluconas Inj (Ethica)
404 Magnesium Sulfat Inj.(iv) 40% Otsuka
405 Magnesium Sulfat Inj.(iv) 40% Otsuka
406 Calcii Gluconas Inj 10% (Ethica)
407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica )
408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica )
409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica )
410 Oksitetrasiklin 1 % Salep Mata
411 Metilergometrin Maleat Tablet 0,125 mg
412 Oksitosin Inj 10 UI/ml (Ethica)
413 Oksitosin Inj 10 UI/ml (Ethica)
414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k)
415 Oksitosin Inj 10 UI/ml (Ethica)
0 OBAT PROGRAM JIWA
416 Amitriptilin 25 mg
417 Amitriptilin 25 mg
418 Amitriptilin 25 mg
419 Amitriptilin 25 mg
420 Amitriptilin 25 mg
421 Clozapine 25mg (OGB Dexa)
422 Clozapine 100 mg
423 Depakote Valproat Tab 250 mg ( (Abbott )
424 Depakote Valproat Tab 250 mg ( (Abbott )
425 Depakote Valproat Tab 250 mg ( (Abbott )
426 Fenitoin Sodium 30 mg Kapsul (DECATONA)
427 Flufenazin sikzonoate inj 25 mg/ ml
428 Flufenazin sikzonoate inj 5 ml
429 Flufenazin sikzonoate inj 5 ml
430 Haloperidol 5 mg tablet
431 Haloperidol 5 mg tablet
432 Haloperidol 5 mg tablet
433 0
434 Haloperidol Injeksi 5 mg/ml
435 Haloperidol Injeksi 5 mg/ml (LODOMER)
436 Haloperidol/ Lodomer drops 2 mg
437 Karbamazepin Tablet 200 mg
438 Karbamazepin Tablet 200 mg
439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros)
440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros)
441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma)
442 Klorpromazin Tab Salut 100 mg (HCl)
443 Klorpromazin Tab Salut 100 mg (HCl)
444 0
445 Risperidon Tab 2 mg ( Dexa Medica )
446 Risperidon Tab 2 mg (OGB Dexa)
447 Risperidon Tab 2 mg
448 Risperidon Tab 2 mg
449 0
450 Trifluoperazinehydrochloride 5 mg /Mersi
451 0
452 Triheksifenidil Tablet 2 mg (Mersi)
453 Triheksifenidil Tablet 2 mg
454 Triheksifenidil Tablet 2 mg (HEXYMER)
455 0
456 Flufenazin/ Siksonat Injeksi 25mg/ ml
457 0
0 PROGRAM IMUNISASI (VAKSIN)
458 BCG
459 PELARUT BCG
460 BCG
461 BCG
462 CAMPAK 10ds (MR)
463 PELARUT CAMPAK
464 CAMPAK 10ds (MR)
465 CAMPAK 10ds (MR)
466 DPT HB - Hib/ PENTABIO
467 DPT HB - Hib/ PENTABIO
468 DT
469 0
470 HB UNIJECT/ HB - ADS / HEPATITIS B
471 HB UNIJECT/ HB - ADS / HEPATITIS B
472 POLIO bOPV 10 ds
473 DROPPER POLIO
474 POLIO bOPV 10 ds
475 POLIO bOPV 10 ds
476 Td
477 0
478 HB UNIJECT/ HB - ADS / HEPATITIS B
479 POLIO bOPV 10 ds
480 Vaksin Meningtis
481 CAMPAK 10ds (MR) BIAS
482 PELARUT CAMPAK BIAS
483 POLIO bOPV 10 ds
484 IPV
485 VTM Include Dacron (Biofarma)
486 Vaksin Rabies (Verorab)
487 0
488 0
489 0
0 OBAT PROGRAM HIV/ AIDS
490 Azitromicyn 500 mg + Cefixime 200 mg
491 0
492 Isoniazid (INH) Tablet 300 mg
493 0
494 Lamivudine 150 mg
495 Lamivudine 150 mg
496 Nevirapine 200 mg
497 Nevirapine 200 mg
498 Piridoksin HCl (Vit.B6) Tablet 25 mg
499 0
500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa
501 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa
502 Tenofovir 300 mg
503 Tenofovir 300 mg
504 Zidofudine 100 mg (ZDV)
505 Zidofudine 100 mg (ZDV)
506 Zidofudine 300 mg + Lamifudine 150 mg
507 Zidofudine 300 mg + Lamifudine 150 mg
508 Efavirenz 600 mg tablet
509 Efavirenz 600 mg tablet
510 Zidofudine 300 mg + Lamifudine 150 mg
511 Abacavir (ABC) 300mg
512 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa
513 0
514 MB Anak
515 0
516 0
517 0
518 0
519 0
520 0
521 0
522 0
523 0
524 0
525 0
526 0
527 0
528 0
529 0
0 BMHP
530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro)
531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro)
532 0
533 Alat Suntik Sekali Pakai .3 cc (NIPRO)
534 Alat Suntik Sekali Pakai .3 cc (TERUMO)
535 Alat Suntik Sekali Pakai .3 cc (NIPRO)
536 Alat Suntik Sekali Pakai .5 ml (NIPRO)
537 Alat Suntik Sekali Pakai .5 ml (Win)
538 Alat Suntik Sekali Pakai 10 ml (NIPRO)
539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I
540 Alat Suntik Sekali Pakai 20 ml
541 Alkohol 70% Medika (Kimia Farma)
542 Alkohol 70% (Medika)
543 Alkohol Swab 2 - ply (one med)
544 Alkohol Swab 2 - ply (one med)
545 Antiseptic Hand Scrub 0,5 % (Medicare)
546 Askina Sorb 10X 10 Cm (B-Braun )
547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II
548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I
549 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I
550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda
551 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda
552 Dual Enzymatic Detergen Galon 5 liter (STERYZIME)
553 Ethylcloride Spray 100 ml (Roeko Endo Frost)
554 Film IV Dressing 6 X 7S (Id67S) E - Care
555 Film IV Dressing 6 X 7S (Id67S) E - Care
556 Fixomull Strech 5 cm X 5 m
557 Foley Catheter 2 Way Ch 16,18 (Norta)
558 Foley Catheter 2 Way Ch 16,18
559 Gown Non Woven Onemed (Baju Habis Pakai)
560 I.V Cannula No. 26 G Polywin (Polymed)
561 Mantel Gown (Bisa Dicuci)
562 I.V Catheter No. 18 (JELCO)
563 I.V Catheter No. 18 (NIPRO)
564 I.V Catheter No. 20 JELCO
565 I.V Catheter No. 20 TERUMO
566 I.V Catheter No. 20 JELCO
567 I.V Catheter No. 22 NIPRO
568 I.V Catheter No. 22 NIPRO
569 I.V Catheter No. 24 TERUMO
570 I.V Catheter No. 24 TERUMO
571 Infusion Set Anak 60 Drops /(Otsuka)
572 Infusion Set Anak 60 Drops /(Otsuka)
573 Infusion Set Dewasa 20 Drops/ (Kimsmed)
574 Infusion Set Dewasa 20 Drops/ (OTSUKA)
575 Kantong Plastik Bio Hazart (Bahan Plastik PE, Panjang 80 Cm, Lebar 60 Cm, Tebal 0,33 Mm)
576 Kapas Pembalut Hydrofil 250 gr
577 Kapas Pembalut Hydrofil 250 gr (Surya Husada)
578 Kapas Pembalut Hydrofil 250 gr (One Med)
579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm
580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain)
581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain)
582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med)
583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada)
584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med)
585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA)
586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada)
587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med)
588 Masker Ear Loop (Masker)
589 Masker Ear Loop Jilbab (Golden Gloves)
590 Masker General Care (MARCOTILA)
591 0
592 Masker N95 Disposibel
593 Masker N95 Disposibel (One Med)
594 Masker Tali
595 Masker Tali
596 Masker Elastic
597 Media Sample Container
598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi)
599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi)
600 Norinse Antimicrobial 500 ml (Viorex)
601 Nurse Cup (Tutup Kepala)
602 Oxygen Mask Elongated Adult (Remedi)
603 Oxygen Mask Nasal Canula Size L Dan S (Aximed)
604 Plesterin Bulat Non Woven (One Med)
605 Polifix 5Cm X 1 Cm ( Sna Medika)
606 Polifix 5Cm X 1 Cm ( Sna Medika)
607 Povidon Iodine 10% (300 ml) ( One Med)
608 Plester Kain (Leukoplast 2,5 cm x 4,5 m)
609 Povidon Iodine 10% (60 ml) ( One Med)
610 0
611 Prontosan Wound Gel X 50 Gram( B-Braun )
612 Sarung Tangan Non Steril No M Dan L (ANSELL)
613 0
614 Sarung Tangan Non Steril No S Dan M (MMP MAS)
615 Sarung Tangan Non Steril No S Dan M (Win Glove)
616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang)
617 Sarung Tangan size M dan L (Exam Glove)
618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang)
619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang)
620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech
621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech
622 0
623 Surface Disinfectant 500 ml (Stericide )
624 Surface Disinfectant Galon 5 Liter (Stericide )
625 Underpad 90x 0 cm cosmo I
626 Underpad 90x 0 cm cosmo II
627 0
628 Urine Bag Sterile Standard
629 Urine Bag Sterile Standard (AXIMED)
630 0
631 Umbilical Cord Clamp ( Hospitech )
0 REAGEN
632 Accu - Check Performa Blood Glukose Meter Test (ROCHE)
633 Accu- Check Performa Tes Strip ( Roche )
634 Accu- Check Safe-T-Pro Uno (Roche)
635 Accu- Check Performa Tes Strip ( Roche )
636 Antimonoclonal A (Anti A) 10 ml
637 Antimonoclonal AB (Anti AB) 10 ml
638 Antimonoclonal B (Anti B) 10 ml
639 0
640 Cholesterol Test Strip (Human Humasens Plus)
641 Cholesterol Test Strip (Human Humasens Plus)
642 Family DR HB Hemoglobin Test Meter (Alat)
643 Family DR HB Hemoglobin Test Trip MHS 2
644 Glucose Test Strip (Human Humasens plus)
645 Glucose Test Strip (Human Humasens plus) II
646 Hemoglobin Strip 50 test mission (Acon)
647 Hemoglobin Strip 50 test mission (Acon)
648 Reagen Hb (HCl 0,1 N) 100ml
649 0
650 Reagen HBsAg Strip (FOKUS)
651 0
652 TPHA (Fokus)
653 0
654 Uric Acid Test Strip 2.0 (Human Humasens plus)
655 Uric Acid Test Strip 2.0 (Human Humasens plus)
0 BMHP (PROGRAM) PROPINSI
0 PROGRAM MALARIA
656 RDT Malaria
0 PROGRAM SYPHILIS
657 RPR Syphilis
658 RPR Syphilis tahap II (FOKUS)
659 Syphilis 3.0 06FK10 SD Bioline
660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS)
661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS)
662 0
663 Tuberkulin
664 RDT Lepto (Uji Leptospira IgM)
665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah)
666 0
667 0
0 PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV)
668
669 Reagen HBsAg Strip SD
670 Reagen HBsAg Strip SD
671 Reagen HBsAg Strip SD
672 0
673 0
674 0
675 0
0 PROGRAM TB PARU
676 Box Slide
677 Box Slide
678 Catridge Genexpart
679 Catridge Genexpart
680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit)
681 Oil Emersi
682 Pot Spuntum/Pot Dahak Steril
683 Pot Spuntum/Pot Dahak Steril
684 Pot Spuntum/Pot Dahak Steril
685 Pot Spuntum/Pot Dahak Steril
686 Reagen Control CD4
687 Reagen Control CD4
688 Reagen Zeil Nelseen
689 Reagen Zeil Nelseen
690 Reagen Zeil Nelseen
691 Reagen Zeil Nelseen
692 Slide
693 Slide/ Object Glass
694 Stereofoam
695 Masker N 95 TB
696 Masker Tali Bedah TB
0 OBAT PROGRAM IMUNISASI
697 Alat Suntik Sekali Pakai 0,05 ml
698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT
699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT
700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT
701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT
702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT
703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT
704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT
705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA
706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA
707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA
708 0
709 0
710 0
711 Alat Suntik Sekali Pakai 5 ml (SKIFA)
712 Alat Suntik Sekali Pakai 5 ml One Ject
713 Alat Suntik Sekali Pakai 5 ml One Ject
714 0
715 Safety Box 5 L
716 Alat Suntik Sekali Pakai 0,05 ml
717 0
718 0
719 0
720 0
0 PROGRAM HIV/ AIDS
721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Tahap I
722 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Reagen R3
723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I
724 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) (Reagen R2)
725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I
726 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I
727 Kondom
728 DBS Collection/ Lasec
729 Lubricant
730 0
731 Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap I
732 Rapid HIV 1/2 3.0 SD Bioline
733 Reagen HIV (FOKUS) R 2
734 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I
735 Reagen HIV (SD) R 1
736 Reagen HIV (SD) R 1
737 0
738 Reagen HIV (VIKIA) R 3
739 0
740 Reagen HIV R2 (Rapid Test) FOKUS
741 0
742 Reagen HIV R3 (VIKIA)
743 Reagen HIV R3 /DS HIV DIAGNOSTAR
744 Sarung Tangan Non Steril
745 0
746 APD Set (Cover All, Face Shield, Handscoen, Masker N95)
747 VTM Include Swab
748 Masker Bedah 3 ply
749 0
750 0
751 0
752 0
753 0
754 0
755 0
756 0
757 0
758 0
759 0
760 0
761 0
762 0
763 0
764 0
0 OKSIGEN MEDICAL
765 Oksigen 3 m3
766 Oksigen 6 m3
767 Oksigen 1 m3
768 Oksigen 6 m3
769 Nurse Cup (Tutup Kepala) One Med
770 0
771 0
772 Propilitourasil/ PTU 100 mg (Dexa Medica)
0 TAMBAHAN IFK
1 Simvastatin Tablet 10 mg (Yarindo Farmatama)
2 Depakote Valproat Tab 250 mg ( (Abbott )
3 Ranitidin Tablet 150 mg
Thiamphenicol / Thiamfilex Kapsul 500 mg
4
5 Thiamphenicol Syr.
6 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet
7 Infusion Set Dewasa 20 Drops/ (Kimsmed)
8 Ranitidin Injeksi 25 mg/ 2 ml
9 Isosorbid Dinitrat Tab Sublingual 5 mg
10 Ketokonazole 200 mg
11 Kotrimoksazol Forte
12 Infusion set anak
13 Alat Suntik 10 cc
14 Eritrosmisin Stearate Kaplet 500 mg
15 Omeprazole Kapsul 20 mg
16 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF )
17 Setirizin Tab 10 mg (Futamed)
18 Siprofloksasin Tablet 500 mg (Novapharin)
19 Oseltamivir 75 mg
20 Ringer Laktat cairan infus @ 500 ml RL
21 Amitriptilin 25 mg
22 I.V Catheter No. 24 TERUMO
23 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep)
24 RDT COVID - 19
25 Oseltamivir 75 mg
26 Klorokuin 150 mg tablet
27 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses)
28 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses)
29 Masker N95 (Particulate Respirator)
30 Hazmat/ APD/ Hazmat PPK
31 Medical Sample Container
32 Cepheid
33 Natrium Klorida Larutan infus 0,9% @100ml
34 Tambah Darah drop (Ferriz Drop)
35 Tambah Darah Sirup (Ferriz Sirup)
36 Gentamycin Krim 1 % mg/ ml Gentalex
37 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL
38 Obat Batuk Sirup / INADRYL
39 Obat Batuk Expektoran Sirup
40 Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate, dextromethorpan Hbr
41 Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Influenza
42 Masker Bedah /Bima Sakti
43 Masker Bedah /Rania
44 Masker N 95 Bima Sakti
45 Sarung tangan panjang steril / meditouche perpasang
46 Sarung tangan Non Steril (Shamrock Supreme/ Rannia)
47 Albendazol Suspensi 200mg/ 5 ml
48 I.V Catheter No. 24 (BRAUN)
49 OAT FDC Kategori Anak
50 Handsanitizer Medicare 0,5% (5 liter) KF
51 Apron Lengan Panjang Putih (Rannia)
Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada)
0
0
0
0
0
0
0
APD Set (Rannia)
Cover All Disposible (Baju sekali pakai) (Rannia)
Cover All Re Use (Baju bisa di pakai lagi /dicuci) Rannia
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya Mitra Bersama)
Helm visor (Usaha Karya Mitra Bersama)
Kaca mata Goggle (Usaha Karya Mitra Bersama)
Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama)
Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama)
Sarung tangan non steril M,L (COBRA)
Masker N95 Covid 19
Masker Tali Bedah 3 ply Covid 19
Masker Eaerlop Hijab
Etanol 96 % (Alkohol 1)
Hand Sanitzer 1
MC Bleach Liquid 20 Liter (RAJAWALI)
Cover All Disposable solida size XL, XXL (RAJAWALI)
KIT A1 Operasi Steril (RAJAWALI)
Mantel Gown APD 1 (Usaha Karya Mitra Bersama)
Sepatu Boots APD (Usaha Karya Mitra Bersama)
Masker Face/ Masker Bedah (COBRA 1)
Masker Elastis Hijau 3 ply (RAJAWALI)
Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama)
Masker Face/ Masker Bedah (COBRA 2)
Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2)
Masker KN95 (Farmahusada)
Masker Bedah (Sensi/ Farmahusada)
Rapid Test SARS COV 2 (Farmahusada)
Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma)
Masker KN95 (Anugrah Sentosa Abadi)
APRON (Atmosfer)
Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA)
Hand Sanitzer 2
Virus Transport Media Corich (VTM)/ Setia Andalan Sukses
Mantel Gown APD 2 (Usaha Karya Mitra Bersama)
Virus Transport Media Corich (VTM)/ Sekarguna Medika 1
Virus Transport Media Corich (VTM)/ Sekarguna Medika 2
Face Shield (COBRA)
Jirigen Putih 20 Liter (Usaha Karya)
Kit Steril (Rajawali)
Alkohol II @20 Liter
Cover All (Rajawali)
Face Shield (ATMOSFER)
Jirigen Putih 20 Liter (Usaha Karya)
Masker Earloop (KasaHusada)
MC Bleach Liquid 20 Liter (RAJAWALI)
Rapid Test Covid-19 (Rajawali)
Rapid Test Covid-19 (Dakonan)
Alkohol Swab (BTT)
Antiseptic Gel 500
Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT)
Kaca mata Goggle (HASTEN)
Mantel Gown APD (Usaha Karya Mitra Bersama)
Masker Bedah Hijau @50pcs
Masker N95 3M 8210 (Hazten)
Nurse Cap Green om 100bh
Parafilm (Anugerah Sentosa Abadi)
Rapid Test (1.000) Widhi Dharma Adi
Sarung tangan Safeglove Exam M 100bh
Sarung tangan Safeglove Surgical size 7 dan 7,5
Sterlisasi Swab stik (5box/ VTM)
Stereofoam (Anugerah Sentosa Abadi)
Universal Transport Media (UTM) Goongdong
Universal Transport Media (UTM) Sekarguna
Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi
Infusion Set Dewasa 20 Drops/ (OTSUKA)
Infusion Set Anak 60 Drops /(Otsuka)
Rapid Test Accu Tell (PT Marcotila Medica)
Rapid Test Lecurate (Bima Sakti)
Rapid Test ZYBIO (Farma Husada)
Alkohol 96 %
0
0
TAMBAHAN PUSKESMAS
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin)
Asam Tranexamat 100 mg/@5 ml Injeksi
Asiklovir 5% 5gr Cream
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca)
0
Deksamethason Inj iv/ im 5 mg/ ml (Mepro)
Furosemide Tablet 40 mg (Kimia Farma )
Gentamycin Krim 1 % mg/ ml
0
Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat)
Ketokonazol Tablet 200 mg (Novapharin) I
Meloxicam Tab 15 mg (Bernofarm )
Metamizol 500 mg + Diazepam 2 mg / METANEURON
Piridoksin HCl (Vit.B6)Tablet 10 mg
Thiamin/ Vitamin B1 50 mg
Thiamphenicol / Thiamfilex Kapsul 500 mg
Alat Suntik Sekali Pakai 10 ml (NIPRO)
Antimicrobial Liquid Soap 500 ml (Viorex)
Hand Sanitizer 450 ml (Meditol)
Infusion Set Dewasa 20 Drops/ (Kimsmed)
I.V Catheter No. 18 (JELCO)
I.V Catheter No. 22 NIPRO
I.V Catheter No. 24 TERUMO
Materniti Napkin Slim L
Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H)
Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang)
Surface Disinfectant Galon 5 Liter (Stericide )
Sterizyme Dual Enymatic Detergent 5 Ltr
Haloperidol 5 mg tablet
Alat Suntik Sekali Pakai .5 ml (NIPRO)
Fixomull Strech 5 cm X 5 m
Umbilical crd clamp
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

TOTAL

Mengetahui,
KEPALA PUSKESMAS
.....................................................
PUSKESMAS .......................... TAHUN 2020
:
:
:
: LUMAJANG
: JAWA TIMUR

TOTAL TOTAL
SATUAN KEMASAN STOK AWAL Okt Nov Des Okt Nov Des
PENERIMAAN PEMAKAIAN

Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 300 - 700 - 700 240 266 386 892
0 - - - - - - - - -
Vial - - - - - - - - -
Vial 131 - - - - - - - -
Botol - - - - - - - - -
Tablet 838 - - - - 110 160 186 456
0 - - - - - - - - -
Tablet 1,969 - - - - - - 551 551
0 - - - - - - - - -
Ampule - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 2,970 - - - - 710 688 630 2,028
0 - - - - - - - - -
Tablet 21,659 - - - - 4,210 4,650 4,369 13,229
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Botol 150 - 100 - 100 46 66 56 168
0 - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Vial - - - - - - - - -
Vial 203 - - - - 48 64 41 153
0 - - - - - - - - -
Botol - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
 Tablet - - - - - - - - -
Tablet 50 - - - - 50 - - 50
Tablet 10,000 - - - - 2,480 2,610 2,578 7,668
0 - - - - - - - - -
Tube - - - - - - - - -
0 - - - - - - - - -
Pot 24 - - - - - - - -
0 - - - - - - - - -
Supp 30 - - - - 15 5 10 30
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,517 - - - - 1,517 - - 1,517
Tablet 4,000 - - - - 130 1,440 1,647 3,217
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - 3,000 - 3,000 - 430 874 1,304
0 - - - - - - - - -
Ampul 3 - 20 - 20 - - - -
0 - - - - - - - - -
Tablet 164 - - - - 18 24 48 90
0 - - - - - - - - -
Tube 112 - - - - 11 13 11 35
Tube - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 146 - - - - 40 50 56 146
Tablet - - 100 - 100 - - 3 3
Ampule - - - - - - - - -
Ampule - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,675 - - - - 122 90 63 275
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tube @ 10 gram - - - - - - - - -
Tube @ 10 gram - - - - - - - - -
Tube @ 10 gram 250 - - - - 72 58 42 172
Tablet - - - - - - - - -
Supp - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Biji - - - - - - - - -
Biji - - - - - - - - -
 0 - - - - - - - - -
pcs - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 185 - - - - 185 - - 185
Tablet 1,500 - - - - 51 340 316 707
Vial - - - - - - - - -
Ampule 54 - - - - 4 2 - 6
Ampule - - 50 - 50 - - - -
Tablet - - - - - - - - -
Ampule - - - - - - - - -
Ampule 162 - - - - 36 49 31 116
Tablet 102 - - - - 102 - - 102
0 2,000 - - - - 456 580 493 1,529
Tube - - - - - - - - -
Botol - - - - - - - - -
Ampule 336 - - - - 92 122 63 277
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 200 - - - - 30 26 15 71
Tablet - - - - - - - - -
Tablet 1,513 - - - - 320 276 182 778
Tablet - - - - - - - - -
0 - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Tablet 500 - - - - 186 110 - 296
Tablet - - - - - - - - -
Ampule - - - - - - - - -
Ampule 6 - - - - 4 2 - 6
Ampule 100 - - - - - 7 2 9
Tablet - - - - - - - - -
Tablet 260 - - - - 70 45 24 139
Tablet - - - - - - - - -
Ampule - - - - - - - - -
Ampule - - - - - - - - -
Ampule - - - - - - - - -
Ampule 203 - - - - 24 16 12 52
Tablet - - - - - - - - -
Tablet 63 - - - - 32 - 10 42
0 - - - - - - - - -
Ampule - - - - - - - - -
Ampule - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Botol - - - - - - - - -
 Botol - - - - - - - - -
Botol 112 - - - - 32 23 15 70
Tube - - - - - - - - -
Botol 24 - 24 - 24 - 13 6 19
Botol 21 - - - - 18 3 - 21
Tablet 4,136 - - - - 935 822 630 2,387
Tablet - - - - - - - - -
Tablet - - 2,000 - 2,000 - - - -
Tablet 3,610 - - - - 1,444 1,290 876 3,610
Tablet 108 - - - - 108 - - 108
Botol 14 - - - - - - - -
botol - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,036 - - - - 230 180 143 553
Tablet - - - - - - - - -
Tube - - - - - - - - -
Tube 160 - - - - 56 43 28 127
Tube - - - - - - - - -
Preflied - - - - - - - - -
Ampule 10 - - - - - - - -
0 - - - - - - - - -
Botol - - - - - - - - -
Botol 381 - - - - 84 72 39 195
Tablet 12,061 - - - - 3,346 2,880 2,155 8,381
Tablet - - - - - - - - -
Tablet - - - - - - - - -
tablet - - - - - - - - -
Tablet 191 - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Botol 182 - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet 100 - - - - - - - -
Tablet 2,927 - - - - 2,363 564 - 2,927
Tablet 5,000 - - - - - 1,964 1,327 3,291
Tablet - - - - - - - - -
Tablet 1,217 - - - - 1,217 - - 1,217
TAblet 3,000 - - - - 220 1,190 988 2,398
Tube - - - - - - - - -
 Tube 26 - - - - 8 7 3 18
Tablet 360 - - - - - - 19 19
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Ampule - - - - - - - - -
0 - - - - - - - - -
Tube 151 - - - - 105 46 - 151
0 - - - - - - - - -
Vial - - - - - - - - -
Tube - - - - - - - - -
Tube - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 5,181 - - - - 1,746 1,650 1,244 4,640
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,378 - - - - - - - -
Tablet 3,000 - - - - 648 540 368 1,556
Botol - - - - - - - - -
Botol 135 - - - - 21 17 11 49
Tube 24 - - - - 4 1 1 6
Tube 13 - - - - 7 5 1 13
Tube - - 10 - 10 - - 2 2
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Ampule - - - - - - - - -
Ampule 547 - - - - 112 121 82 315
Ampule - - - - - - - - -
Tablet 134 - - - - 66 46 - 112
Tablet - - - - - - - - -
Tablet 132 - - - - 6 - - 6
Tablet - - - - - - - - -
Tablet 360 - - - - 360 - - 360
Tablet 180 - - - - 180 - - 180
Tablet - - - - - - - - -
0 - - - - - - - - -
Ampul - - - - - - - - -
Tablet - - - - - - - - -
0 1,336 - - - - 323 132 91 546
Tablet - - - - - - - - -
Tablet 1,845 - - - - 305 235 202 742
Tablet 163 - - - - 96 67 - 163
0 - - - - - - - - -
Tablet - - - - - - - - -
 Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 2,214 - - - - 524 408 340 1,272
Btl= 100 ml - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Kapsul - - - - - - - - -
Tablet 360 - - - - 240 120 - 360
Ampule - - - - - - - - -
Ampule - - - - - - - - -
tablet - - - - - - - - -
Tablet - - - - - - - - -
Botol - - - - - - - - -
Botol 192 - - - - 44 32 24 100
Tablet - - - - - - - - -
Tablet - - - - - - - - -
tablet - - - - - - - - -
Tablet 3,158 - - - - 3,158 - - 3,158
Tablet - - - - - - - - -
Tablet 107 - - - - 84 23 - 107
Tablet 1,000 - - - - - 37 44 81
Botol - - - - - - - - -
Botol 45 - - - - - 45 - 45
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Tablet 20 - - - - - - - -
Tablet - - - - - - - - -
Tablet 100 - - - - - - - -
Botol - - - - - - - - -
Pcs - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Tablet - - - - - - - - -
Ampule 482 - - - - 15 10 5 30
Ampule - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Botol - - - - - - - - -
 Botol 348 - - - - 125 110 94 329
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tube 32 - - - - 15 17 - 32
Tube 49 - 60 - 60 21 17 19 57
Tube - - - - - - - - -
Tablet - - 200 - 200 - 40 22 62
Tablet 20,720 - - - - 4,438 3,890 3,460 11,788
Ampule - - 30 - 30 - 8 3 11
Tablet 2,000 - - - - 1,102 184 - 1,286
Tablet 1,746 - - - - - 910 836 1,746
0 - - - - - - - - -
Botol - - - - - - - - -
Tablet - - - - - - - - -
Tablet 4,494 - - - - 1,580 1,226 1,014 3,820
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Ampule 432 - - - - 243 189 - 432
Ampule - - 300 - 300 - 36 103 139
Tablet 2,245 - - - - 606 498 406 1,510
0 - - - - - - - - -
Botol - - - - - - - - -
Botol 300 - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Nebule 224 - - - - 28 22 15 65
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,406 - - - - 204 186 136 526
Pot 130 - - - - 22 17 18 57
Pot - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 60 - - - - 25 8 12 45
Vial - - - - - - - - -
Vial 2 - - - - 1 - - 1
Ampul - - - - - - - - -
Ampul 71 - - - - 23 10 8 41
Tablet 12 - - - - 12 - - 12
Tablet - - - - - - - - -
Tablet 700 - - - - 204 224 153 581
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
 Botol - - - - - - - - -
Botol 23 - - - - 4 6 2 12
Botol - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 2,518 - - - - 678 427 392 1,497
Tablet - - - - - - - - -
Tablet 1,000 - - - - 102 83 35 220
Botol 12 - - - - - - - -
Kapsul - - - - - - - - -
Tablet 5,261 - - - - 1,704 1,810 1,335 4,849
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 3 - 3 - 3 3 2 - 5
Ampule - - - - - - - - -
Ampule - - - - - - - - -
0 3 - - - - - 1 - 1
Tablet 356 - - - - 24 20 14 58
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
tablet - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 192 - - - - - 3 2 5
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,547 - - - - 255 180 154 589
sachet - - - - - - - - -
sachet - - - - - - - - -
0 - - - - - - - - -
Botol 43 - - - - 6 4 2 12
Botol - - - - - - - - -
Tablet - - - - - - - - -
tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 2,630 - - - - 60 40 26 126
Tablet - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - 2 2 - - 2 2
Pcs - - - - - - - - -
0 - - - - - - - - -
Kit - - - - - - - - -
Kit - - - - - - - - -
Kit - - - - - - - - -
Kit - - - - - - - - -
Kit 11 - - - - 5 4 2 11
Kit - - - - - - - - -
Kit - - - - - - - - -
Kit 1 - 2 - 2 1 2 - 3
Kit - - - - - - - - -
0 - - - - - - - - -
tablet - - - - - - - - -
0 - - - - - - - - -
Blister - - - - - - - - -
Blister - - - - - - - - -
Blister - - - - - - - - -
Blister - - - - - - - - -
Blister - - - - - - - - -
Blister - - - - - - - - -
Blister - - - - - - - - -
Blister - - - - - - - - -
Blister 24 - - - - 6 5 5 16
Blister - - - - - - - - -
0 - - - - - - - - -
sachet - - - - - - - - -
sachet - - - - - - - - -
Kapsul - - - - - - - - -
Kapsul 300 - - - - 94 89 67 250
 0 - - - - - - - - -
Kapsul - - - - - - - - -
Kapsul - - - - - - - - -
Kapsul 6 - - - - - 6 - 6
Tablet - - - - - - - - -
Tablet 44,200 - - - - 6,720 6,520 3,490 16,730
tablet - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Ampule - - - - - - - - -
Vial - - - - - - - - -
vial 18 - - - - 2 2 - 4
Ampule - - - - - - - - -
Ampule 100 - - - - - 13 8 21
Ampule - - - - - - - - -
Ampule 12 - - - - 12 - - 12
Tablet - - - - - - - - -
Tablet 610 - - - - 150 180 90 420
Ampule - - - - - - - - -
Ampule 240 - - - - 62 44 36 142
Ampule - - - - - - - - -
Ampule - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 160 - - - - 6 6 - 12
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 300 - - - - 120 - 120 240
Kapsul - - - - - - - - -
Ampul - - - - - - - - -
vial 9 - - - - - - - -
Vial - - - - - - - - -
Tablet - - - - - - - - -
Tablet 2,287 - - - - 285 195 217 697
Tablet - - - - - - - - -
0 - - - - - - - - -
ampule - - - - - - - - -
ampule - - - - - - - - -
Botol 10 - - - - 2 - - 2
Tablet - - - - - - - - -
 Tablet - - - - - - - - -
Ampule 3 - - - - - - - -
Ampule - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,889 - - - - 320 315 277 912
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 497 - - - - 425 72 - 497
Tablet 1,000 - - - - - 305 259 564
0 - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet 1,412 - - - - 615 592 205 1,412
Tablet - - 800 - 800 - - 296 296
0 - - - - - - - - -
ampul - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
vial 36 - - - - 18 15 - 33
ampul 36 - 20 - 20 18 15 - 33
vial - - - - - - - - -
vial - - 20 - 20 - - - -
vial - - - - - - - - -
ampul 149 - - 30 30 75 38 41 154
vial 31 - - - - 21 10 - 31
vial - - - 30 30 - - 5 5
vial - - - - - - - - -
vial 70 - 100 - 100 55 44 35 134
vial - 90 - - 90 42 37 - 79
0 - - - - - - - - -
vial - - - - - - - - -
vial - - 100 - 100 - - 28 28
vial - - - - - - - - -
dropper 203 - 80 30 110 110 82 104 296
vial - - - - - - - - -
vial - - - - - - - - -
vial 15 160 - - 160 85 60 - 145
0 - - - - - - - - -
vial 67 - - - - 30 34 3 67
vial 55 - - - - 55 - - 55
vial - - - - - - - - -
vial - - - - - - - - -
ampul - - - - - - - - -
 vial - - 80 30 110 - 43 50 93
vial - 80 - 20 100 60 17 23 100
pcs - - - - - - - - -
vial - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet 191 - - - - 125 66 - 191
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
tablet - - - - - - - - -
tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
blister - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
 0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs 773 - - - - 773 - - 773
Pcs 1,500 - - - - 85 720 675 1,480
Pcs 1,100 - - - - 55 68 117 240
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Box@12pcs - - 36 - 36 - 12 12 24
Pcs 50 - - - - 4 6 - 10
0 - - - - - - - - -
Btl 1000 ml - - - - - - - - -
0 - - - - - - - - -
Pcs 500 - 300 - 300 300 300 200 800
Botol 2 - - - - 1 1 - 2
Pcs - - - - - - - - -
Pcs 60 - - - - 18 16 7 41
Pcs - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 40 - - - - 12 8 8 28
Pcs - - - - - - - - -
Pcs 5 - - - - - - - -
biji - - - - - - - - -
Pcs - - - - - - - - -
Pcs 109 - - - - 28 21 17 66
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 200 - 200 - 200 72 56 42 170
Pcs - - - - - - - - -
Pcs 201 - 50 - 50 65 51 32 148
Pcs 77 - - - - 28 16 6 50
0 100 - - - - - - - -
Pcs - - - - - - - - -
Pcs 59 - - - - - - - -
 Pcs - - - - - - - - -
Pcs 459 - - - - 128 108 97 333
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 27 2 - - 2 7 5 6 18
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs 10 - - - - 3 4 2 9
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs 48 - - - - 6 3 8 17
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs 100 - - - - 30 21 32 83
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 335 - - - - 148 128 59 335
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 12 - - - - 1 11 - 12
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 112 - - - - 42 35 21 98
Pcs 9 - - - - 2 2 - 4
0 50 - - - - 12 16 9 37
Pcs - - - - - - - - -
0 - - - - - - - - -
Tube - - - - - - - - -
Pair - - - - - - - - -
0 - - - - - - - - -
Pair - - - - - - - - -
Pair - - - - - - - - -
Pair - - - - - - - - -
PAir 300 - 6,000 - 6,000 300 3,000 2,500 5,800
Pair 276 - - - - 3 10 3 16
Pair - - - - - - - - -
Pcs 60 - - - - 37 23 - 60
Pcs - - 36 - 36 - 5 17 22
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs 1 - - - - - 1 - 1
Pcs 30 - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs 60 - - - - 7 5 4 16
0 - - - - - - - - -
Pcs 200 - - - - 25 16 12 53
0 - - - - - - - - -
Pcs - - - - - - - - -
pcs - - - - - - - - -
Pcs 400 - - - - - - - -
Pcs - - - - - - - - -
Btl - - - - - - - - -
Btl - - - - - - - - -
Btl - - - - - - - - -
0 - - - - - - - - -
Tes - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Tes - - - - - - - - -
Tes - - - - - - - - -
Tes - - - - - - - - -
Pcs 10 - - - - 2 2 2 6
0 - - - - - - - - -
Btl - - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
0 - - - - - - - - -
Tes - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
0 - - - - - - - - -
Pcs 100 - - - - 30 - 15 45
Pcs - - - - - - - - -
Test 300 - - 60 60 216 - 89 305
Test
- - - - - - - - -
Test
- - - - - - - - -
0 - - - - - - - - -
Vial - - - - - - - - -
test - - - - - - - - -
test - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
Test - - - - - - - - -
Test 350 - - - - 166 112 72 350
Test - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Test - - - - - - - - -
Test - - - - - - - - -
Test - - - - - - - - -
Botol - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Kit - - - - - - - - -
Kit - - - - - - - - -
Kit - - - - - - - - -
Kit - - - - - - - - -
Pcs 9 - - - - 2 2 1 5
Pcs - - - - - - - - -
pcs - - - - - - - - -
pcs 23 - - - - - - - -
pcs - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 500 - - - - 105 95 80 280
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 800 1,900 500 - 2,400 1,100 1,050 850 3,000
Pcs - - - - - - - - -
 Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Pcs 145 - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
Pcs 25 50 - - 50 10 8 7 25
Pcs - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Test 50 - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
0 - - - - - - - - -
Test 50 - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
Test 819 - - - - 145 96 53 294
test - - - - - - - - -
Test - - - - - - - - -
Test - - - - - - - - -
Test - - - - - - - - -
Test - - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
0 - - - - - - - - -
Test - - - - - - - - -
Test - - - - - - - - -
Pair - - - - - - - - -
0 - - - - - - - - -
Paket - - - - - - - - -
Test - - - - - - - - -
Pcs - - - - - - - - -
 0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Tampon - - - - - - - - -
Tampon - - - - - - - - -
Tampon - - - - - - - - -
Tampon - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
tablet - - - 400 400 - - - -
0 - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
0 - - - - - - - - -
tablet - - - - - - - - -
Pcs - - - - - - - - -
Ampule - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Pcs 50 - - - - 30 20 - 50
Pcs - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Botol 360 - - - - 52 35 33 120
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Kapsul - - - - - - - - -
Botol 1,092 - - - - 449 340 303 1,092
Tablet - - - - - - - - -
pcs - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 30 - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
pcs 200 - - - - - - - -
pcs 199 - - - - 3 2 - 5
Tube - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Botol - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
pCS - - 3,400 - 3,400 - 750 700 1,450
pCS - - - - - - - - -
PCS - - 20 - 20 - 9 3 12
0 25 - 20 - 20 9 12 7 28
PCS 6,000 - - - - 3,500 2,500 - 6,000
botol 300 - - - - - - - -
pcs - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 8 - - - - - - - -
0 5 - - - - - - - -
0 4 - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
 0 - - - - - - - - -
box @100 pcs 2,000 - - - - - 1,000 1,000 2,000
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs 1,800 - - - - - - - -
Botol = 20 Liter 1 - - - - - 1 - 1
Botol = 20 Liter 1 - - - - - 1 - 1
Botol = 20 Liter - - - - - - - - -
Pcs 9 - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pair 2 - - - - - - - -
pcs - - - - - - - - -
Pcs - - - - - - - - -
Botol - - - - - - - - -
pcs - - - - - - - - -
box @40 test - - - - - - - - -
Box @50 pcs 20 - - - - 5 - - 5
Box @40 pcs - - - - - - - - -
Test 21 - - - - 12 9 - 21
test - - - - - - - - -
pcs - - - - - - - - -
pcs 100 - - - - - - - -
TEst - - - - - - - - -
liter - - - - - - - - -
pcs - - - - - - - - -
pcs 68 - - - - 10 23 - 33
pcs - - - - - - - - -
pcs - - - - - - - - -
0 7 - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 4 - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 5,100 - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 4,140 - - - - - 4,140 - 4,140
0 5 - - - - 1 1 - 2
0 - - - - - - - - -
0 - - - - - - - - -
 0 10 - - - - 6 4 - 10
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 3,000 - - - - 2,000 1,000 - 3,000
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - 40 - 40 - 22 3 25
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 20 - - - - - 10 5 15
0 - 50 - - 50 - - - -
Liter 20 - - - - 9 4 3 16
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Ampul - - - - - - - - -
Tube - - - - - - - - -
pcs - - - - - - - - -
0 - - - - - - - - -
Ampule - - - - - - - - -
Tablet 344 - - - - 30 42 75 147
Tube - - - - - - - - -
0 - - - - - - - - -
Ampule - - - - - - - - -
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Tablet 238 - - - - 24 18 26 68
Tablet - - - - - - - - -
Tablet - - - - - - - - -
Kapsul - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 - - - - - - - - -
Roll - - - - - - - - -
Pair - - - - - - - - -
 Pcs - - - - - - - - -
0 1 - - - - - - - -
Tablet - - - - - - - - -
Pcs - - - - - - - - -
Pcs - - - - - - - - -
0 126 - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
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0 - - - - - - - - -
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0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
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0 - - - - - - - - -
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0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
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0 - - - - - - - - -
0 - - - - - - - - -
0 - - - - - - - - -
 SISA Nilai
SISA STOK Ket Harga Nilai Pemakaian Nilai Persediaan
Penerimaan
DES

- - 1 99.000 0.000 0.000 0.000

- - 1 105.000 0.000 0.000 0.000
108 108 1 105.000 73,500.000 93,660.000 11,340.000
- - 1 0.000 0.000 0.000 0.000
- - 1 2,860.000 0.000 0.000 0.000
131 131 1 2,860.000 0.000 0.000 374,660.000
- - 1 10,500.000 0.000 0.000 0.000
382 382 1 104.000 0.000 47,424.000 39,728.000
- - 1 220.000 0.000 0.000 0.000
1,418 1,418 1 93.500 0.000 51,518.500 132,583.000
- - 1 0.000 0.000 0.000 0.000
- - 1 2,998.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 93.000 0.000 0.000 0.000
942 942 1 99.000 0.000 200,772.000 93,258.000
- - 1 0.000 0.000 0.000 0.000
8,430 8,430 1 190.000 0.000 2,513,510.000 1,601,700.000
- - 1 233.000 0.000 0.000 0.000
- - 1 233.000 0.000 0.000 0.000
- - 1 249.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
82 82 1 3,025.000 302,500.000 508,200.000 248,050.000
- - 1 3,025.000 0.000 0.000 0.000
- - 1 4,400.000 0.000 0.000 0.000
- - 1 3,628.000 0.000 0.000 0.000
- - 1 10,246.500 0.000 0.000 0.000
- - 1 9,900.000 0.000 0.000 0.000
- - 1 8,500.000 0.000 0.000 0.000
50 50 1 8,237.000 0.000 1,260,261.000 411,850.000
- - 1 0.000 0.000 0.000 0.000
- - 1 4,950.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 440.000 0.000 0.000 0.000
 - - 1 220.000 0.000 0.000 0.000
- - 1 165.000 0.000 8,250.000 0.000
2,332 2,332 1 58.000 0.000 444,744.000 135,256.000
- - 1 0.000 0.000 0.000 0.000
- - 1 3,035.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
24 24 1 4,496.000 0.000 0.000 107,904.000
- - 1 0.000 0.000 0.000 0.000
- - 1 3,045.000 0.000 91,350.000 0.000
- - 1 198.000 0.000 0.000 0.000
- - 1 1,485.000 0.000 0.000 0.000
- - 1 1,551.000 0.000 0.000 0.000
- - 1 105.000 0.000 159,285.000 0.000
783 783 1 105.000 0.000 337,785.000 82,215.000
- - 1 1,050.000 0.000 0.000 0.000
- - 1 67.000 0.000 0.000 0.000
- - 1 75.000 0.000 0.000 0.000
- - 1 103.000 0.000 0.000 0.000
1,696 1,696 1 253.000 759,000.000 329,912.000 429,088.000
- - 1 0.000 0.000 0.000 0.000
23 23 1 2,076.000 41,520.000 0.000 47,748.000
- - 1 0.000 0.000 0.000 0.000
74 74 1 1,584.000 0.000 142,560.000 117,216.000
- - 1 0.000 0.000 0.000 0.000
77 77 1 2,915.000 0.000 102,025.000 224,455.000
- - 1 2,750.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 380.000 0.000 0.000 0.000
- - 1 380.000 0.000 55,480.000 0.000
97 97 1 405.000 40,500.000 1,215.000 39,285.000
- - 1 1,639.000 0.000 0.000 0.000
- - 1 1,639.000 0.000 0.000 0.000
- - 1 136.000 0.000 0.000 0.000
- - 1 152.000 0.000 0.000 0.000
1,400 1,400 1 145.000 0.000 39,875.000 203,000.000
- - 1 110.000 0.000 0.000 0.000
- - 1 110.000 0.000 0.000 0.000
- - 1 3,350.000 0.000 0.000 0.000
- - 1 3,350.000 0.000 0.000 0.000
78 78 1 3,350.000 0.000 576,200.000 261,300.000
- - 1 300.000 0.000 0.000 0.000
- - 1 5,900.000 0.000 0.000 0.000
- - 1 626.000 0.000 0.000 0.000
- - 1 18,150.000 0.000 0.000 0.000
- - 1 7,602.000 0.000 0.000 0.000
- - 1 7,124.000 0.000 0.000 0.000
 - - 1 0.000 0.000 0.000 0.000
- - 1 149,266.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 5,280.000 0.000 0.000 0.000
- - 1 660.000 0.000 122,100.000 0.000
793 793 1 671.000 0.000 474,397.000 532,103.000
- - 1 4,282.000 0.000 0.000 0.000
48 48 1 11,000.000 0.000 66,000.000 528,000.000
50 50 1 10,098.000 504,900.000 0.000 504,900.000
- - 1 2,805.000 0.000 0.000 0.000
- - 1 1,097.000 0.000 0.000 0.000
46 46 1 1,097.000 0.000 127,252.000 50,462.000
- - 1 60.500 0.000 6,171.000 0.000
471 471 1 66.000 0.000 100,914.000 31,086.000
- - 1 10,400.000 0.000 0.000 0.000
- - 1 9,900.000 0.000 0.000 0.000
59 59 1 1,095.000 0.000 303,315.000 64,605.000
- - 1 0.000 0.000 0.000 0.000
- - 1 104.000 0.000 0.000 0.000
129 129 1 104.000 0.000 7,384.000 13,416.000
- - 1 104.000 0.000 0.000 0.000
735 735 1 105.000 0.000 81,690.000 77,175.000
- - 1 112.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 4,400.000 0.000 0.000 0.000
- - 1 2,700.000 0.000 0.000 0.000
204 204 1 165.000 0.000 48,840.000 33,660.000
- - 1 91.000 0.000 0.000 0.000
- - 1 1,408.000 0.000 0.000 0.000
- - 1 1,408.000 0.000 8,448.000 0.000
91 91 1 1,408.000 0.000 12,672.000 128,128.000
- - 1 730.000 0.000 0.000 0.000
121 121 1 770.000 0.000 107,030.000 93,170.000
- - 1 391.000 0.000 0.000 0.000
- - 1 4,167.000 0.000 0.000 0.000
- - 1 3,550.000 0.000 0.000 0.000
- - 1 3,682.000 0.000 0.000 0.000
151 151 1 3,682.000 0.000 191,464.000 555,982.000
- - 1 691.000 0.000 0.000 0.000
21 21 1 710.000 0.000 29,820.000 14,910.000
- - 1 0.000 0.000 0.000 0.000
- - 1 1,333.000 0.000 0.000 0.000
- - 1 1,333.000 0.000 0.000 0.000
- - 1 82.000 0.000 0.000 0.000
- - 1 82.000 0.000 0.000 0.000
- - 1 4,232.000 0.000 0.000 0.000
 - - 1 4,232.000 0.000 0.000 0.000
42 42 1 4,232.000 0.000 296,240.000 177,744.000
- - 1 2,750.000 0.000 0.000 0.000
29 29 1 4,400.000 105,600.000 83,600.000 127,600.000
- - 1 2,900.000 0.000 60,900.000 0.000
1,749 1,749 1 119.000 0.000 284,053.000 208,131.000
- - 1 119.000 0.000 0.000 0.000
2,000 2,000 1 77.000 154,000.000 0.000 154,000.000
- - 1 99.000 0.000 357,390.000 0.000
- - 1 7,865.000 0.000 849,420.000 0.000
14 14 1 10,010.000 0.000 0.000 140,140.000
- - 1 10,010.000 0.000 0.000 0.000
- - 1 6,900.000 0.000 0.000 0.000
- - 1 7,363.000 0.000 0.000 0.000
- - 1 132.000 0.000 0.000 0.000
483 483 1 149.000 0.000 82,397.000 71,967.000
- - 1 88.000 0.000 0.000 0.000
- - 1 2,787.000 0.000 0.000 0.000
33 33 1 2,475.000 0.000 314,325.000 81,675.000
- - 1 2,475.000 0.000 0.000 0.000
- - 1 176,800.000 0.000 0.000 0.000
10 10 1 8,800.000 0.000 0.000 88,000.000
- - 1 0.000 0.000 0.000 0.000
- - 1 4,665.000 0.000 0.000 0.000
186 186 1 4,665.000 0.000 909,675.000 867,690.000
3,680 3,680 1 264.000 0.000 2,212,584.000 971,520.000
- - 1 330.000 0.000 0.000 0.000
- - 1 660.000 0.000 0.000 0.000
- - 1 187.000 0.000 0.000 0.000
191 191 1 90.000 0.000 0.000 17,190.000
- - 1 89.000 0.000 0.000 0.000
- - 1 121.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 9,644.000 0.000 0.000 0.000
- - 1 10,696.000 0.000 0.000 0.000
182 182 1 10,696.000 0.000 0.000 1,946,672.000
- - 1 0.000 0.000 0.000 0.000
- - 1 770.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
100 100 1 1,755.000 0.000 0.000 175,500.000
- - 1 187.000 0.000 547,349.000 0.000
1,709 1,709 1 63.000 0.000 207,333.000 107,667.000
- - 1 63.000 0.000 0.000 0.000
- - 1 94.600 0.000 115,128.200 0.000
602 602 1 99.000 0.000 237,402.000 59,598.000
- - 1 5,610.000 0.000 0.000 0.000
 8 8 1 2,518.000 0.000 45,324.000 20,144.000
341 341 1 396.000 0.000 7,524.000 135,036.000
- - 1 288.000 0.000 0.000 0.000
- - 1 288.000 0.000 0.000 0.000
- - 1 1,089.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 1,810.000 0.000 273,310.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 10,500.000 0.000 0.000 0.000
- - 1 17,968.500 0.000 0.000 0.000
- - 1 35,200.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 22.000 0.000 0.000 0.000
541 541 1 77.000 0.000 357,280.000 41,657.000
- - 1 23.000 0.000 0.000 0.000
- - 1 2,750.000 0.000 0.000 0.000
- - 1 495.000 0.000 0.000 0.000
1,378 1,378 1 440.000 0.000 0.000 606,320.000
1,444 1,444 1 319.000 0.000 496,364.000 460,636.000
- - 1 2,052.000 0.000 0.000 0.000
86 86 1 2,190.000 0.000 107,310.000 188,340.000
18 18 1 13,970.000 0.000 83,820.000 251,460.000
- - 1 22,550.000 0.000 293,150.000 0.000
8 8 1 23,100.000 231,000.000 46,200.000 184,800.000
- - 1 3,811.500 0.000 0.000 0.000
- - 1 6,600.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 1,937.000 0.000 0.000 0.000
232 232 1 2,178.000 0.000 686,070.000 505,296.000
- - 1 1,222.000 0.000 0.000 0.000
22 22 1 99.000 0.000 11,088.000 2,178.000
- - 1 330.000 0.000 0.000 0.000
126 126 1 123.000 0.000 738.000 15,498.000
- - 1 131.000 0.000 0.000 0.000
- - 1 4,680.500 0.000 1,684,980.000 0.000
- - 1 4,730.000 0.000 851,400.000 0.000
- - 1 550.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 4,950.000 0.000 0.000 0.000
- - 1 5,500.000 0.000 0.000 0.000
790 790 1 3,707.000 0.000 2,024,022.000 2,928,530.000
- - 1 96.000 0.000 0.000 0.000
1,103 1,103 1 102.000 0.000 75,684.000 112,506.000
- - 1 143.000 0.000 23,309.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 87.000 0.000 0.000 0.000
 - - 1 80.000 0.000 0.000 0.000
- - 1 121.000 0.000 0.000 0.000
- - 1 192.500 0.000 0.000 0.000
942 942 1 275.000 0.000 349,800.000 259,050.000
- - 1 8,110.000 0.000 0.000 0.000
- - 1 8,110.000 0.000 0.000 0.000
- - 1 14,318.700 0.000 0.000 0.000
- - 1 5,500.000 0.000 0.000 0.000
- - 1 2,090.000 0.000 752,400.000 0.000
- - 1 5,000.000 0.000 0.000 0.000
- - 1 4,400.000 0.000 0.000 0.000
- - 1 1,265.000 0.000 0.000 0.000
- - 1 990.000 0.000 0.000 0.000
- - 1 13,200.000 0.000 0.000 0.000
92 92 1 13,167.000 0.000 1,316,700.000 1,211,364.000
- - 1 2,332.000 0.000 0.000 0.000
- - 1 528.000 0.000 0.000 0.000
- - 1 594.000 0.000 0.000 0.000
- - 1 835.000 0.000 2,636,930.000 0.000
- - 1 115.000 0.000 0.000 0.000
- - 1 123.000 0.000 13,161.000 0.000
919 919 1 123.000 0.000 9,963.000 113,037.000
- - 1 6,410.000 0.000 0.000 0.000
- - 1 6,410.000 0.000 288,450.000 0.000
- - 1 132.000 0.000 0.000 0.000
- - 1 3,948.000 0.000 0.000 0.000
- - 1 23,141.800 0.000 0.000 0.000
- - 1 19,800.000 0.000 0.000 0.000
20 20 1 560.000 0.000 0.000 11,200.000
- - 1 560.000 0.000 0.000 0.000
100 100 1 598.000 0.000 0.000 59,800.000
- - 1 12,100.000 0.000 0.000 0.000
- - 1 24,860.000 0.000 0.000 0.000
- - 1 9,955.000 0.000 0.000 0.000
- - 1 25,597.000 0.000 0.000 0.000
- - 1 160.000 0.000 0.000 0.000
452 452 1 1,070.000 0.000 32,100.000 483,640.000
- - 1 1,124.000 0.000 0.000 0.000
- - 1 715.000 0.000 0.000 0.000
- - 1 432.300 0.000 0.000 0.000
- - 1 437.800 0.000 0.000 0.000
- - 1 418.000 0.000 0.000 0.000
- - 1 357.500 0.000 0.000 0.000
- - 1 495.000 0.000 0.000 0.000
- - 1 789.800 0.000 0.000 0.000
- - 1 1,181.000 0.000 0.000 0.000
 19 19 1 1,181.000 0.000 388,549.000 22,439.000
- - 1 53.000 0.000 0.000 0.000
- - 1 56.000 0.000 0.000 0.000
- - 1 53.000 0.000 0.000 0.000
- - 1 20,700.000 0.000 662,400.000 0.000
52 52 1 11,825.000 709,500.000 674,025.000 614,900.000
- - 1 11,825.000 0.000 0.000 0.000
138 138 1 963.600 192,720.000 59,743.200 132,976.800
8,932 8,932 1 115.500 0.000 1,361,514.000 1,031,646.000
19 19 1 4,400.000 132,000.000 48,400.000 83,600.000
714 714 1 132.000 0.000 169,752.000 94,248.000
- - 1 123.000 0.000 214,758.000 0.000
- - 1 6,600.000 0.000 0.000 0.000
- - 1 41,500.000 0.000 0.000 0.000
- - 1 68.000 0.000 0.000 0.000
674 674 1 73.000 0.000 278,860.000 49,202.000
- - 1 73.000 0.000 0.000 0.000
- - 1 1,000.000 0.000 0.000 0.000
- - 1 1,155.000 0.000 498,960.000 0.000
161 161 1 1,188.000 356,400.000 165,132.000 191,268.000
735 735 1 220.000 0.000 332,200.000 161,700.000
- - 1 0.000 0.000 0.000 0.000
- - 1 9,646.000 0.000 0.000 0.000
300 300 1 9,646.000 0.000 0.000 2,893,800.000
- - 1 7,150.000 0.000 0.000 0.000
- - 1 7,150.000 0.000 0.000 0.000
- - 1 7,630.000 0.000 0.000 0.000
159 159 1 4,550.000 0.000 295,750.000 723,450.000
- - 1 0.000 0.000 0.000 0.000
- - 1 70.000 0.000 0.000 0.000
880 880 1 165.000 0.000 86,790.000 145,200.000
73 73 1 2,620.000 0.000 149,340.000 191,260.000
- - 1 2,796.000 0.000 0.000 0.000
- - 1 6,006.000 0.000 0.000 0.000
- - 1 5,170.000 0.000 0.000 0.000
15 15 1 2,200.000 0.000 99,000.000 33,000.000
- - 1 479,996.000 0.000 0.000 0.000
1 1 1 512,204.000 0.000 512,204.000 512,204.000
- - 1 130,999.000 0.000 0.000 0.000
30 30 1 130,999.000 0.000 5,370,959.000 3,929,970.000
- - 1 90.000 0.000 1,080.000 0.000
- - 1 90.000 0.000 0.000 0.000
119 119 1 110.000 0.000 63,910.000 13,090.000
- - 1 117.000 0.000 0.000 0.000
- - 1 265.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
 - - 1 6,789.000 0.000 0.000 0.000
11 11 1 6,789.000 0.000 81,468.000 74,679.000
- - 1 13,607.000 0.000 0.000 0.000
- - 1 310.000 0.000 0.000 0.000
- - 1 86.000 0.000 0.000 0.000
- - 1 132.000 0.000 0.000 0.000
1,021 1,021 1 91.000 0.000 136,227.000 92,911.000
- - 1 935.000 0.000 0.000 0.000
780 780 1 935.000 0.000 205,700.000 729,300.000
12 12 1 7,150.000 0.000 0.000 85,800.000
- - 1 7,150.000 0.000 0.000 0.000
412 412 1 89.000 0.000 431,561.000 36,668.000
- - 1 239.800 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 108.000 0.000 0.000 0.000
- - 1 1,045.000 0.000 0.000 0.000
- - 1 967.000 0.000 0.000 0.000
- - 1 776.006 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 12,573.000 0.000 0.000 0.000
- - 1 12,573.000 0.000 0.000 0.000
1 1 1 12,573.000 37,719.000 62,865.000 12,573.000
- - 1 1,735.000 0.000 0.000 0.000
- - 1 1,735.000 0.000 0.000 0.000
2 2 1 19,789.000 0.000 19,789.000 39,578.000
298 242 - 396.000 0.000 22,968.000 118,008.000
- - 1 114.000 0.000 0.000 0.000
- - 1 171.000 0.000 0.000 0.000
- - 1 171.000 0.000 0.000 0.000
- - 1 171.000 0.000 0.000 0.000
- - 1 550.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 779.000 0.000 0.000 0.000
- - 1 1,320.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 278.300 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 404.000 0.000 0.000 0.000
187 187 1 431.000 0.000 2,155.000 80,597.000
- - 1 0.000 0.000 0.000 0.000
- - 1 257.000 0.000 0.000 0.000
 958 958 1 257.000 0.000 151,373.000 246,206.000
- - 1 274.000 0.000 0.000 0.000
- - 1 274.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
31 31 1 6,281.000 0.000 75,372.000 194,711.000
- - 1 9,900.000 0.000 0.000 0.000
- - 1 524.000 0.000 0.000 0.000
- - 1 524.000 0.000 0.000 0.000
- - 1 524.000 0.000 0.000 0.000
2,504 2,504 1 524.000 0.000 66,024.000 1,312,096.000
- - 1 524.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 1,325,000.000 0.000 0.000 0.000
- - 1 1,325,000.000 0.000 0.000 0.000
- - 1 1,325,000.000 0.000 0.000 0.000
- - 1 1,325,000.000 2,650,000.000 2,650,000.000 0.000
- - 1 1,325,000.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 232,518.000 0.000 0.000 0.000
- - 1 248,120.000 0.000 0.000 0.000
- - 1 248,120.000 0.000 0.000 0.000
- - 1 389,344.000 0.000 0.000 0.000
- - 1 415,469.000 0.000 4,570,159.000 0.000
- - 1 1,384,983.000 0.000 0.000 0.000
- - 1 1,384,983.000 0.000 0.000 0.000
- - 1 1,384,983.000 2,769,966.000 4,154,949.000 0.000
- - 1 317,018.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 282.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 28,354.000 0.000 0.000 0.000
- - 1 28,354.000 0.000 0.000 0.000
- - 1 40,913.489 0.000 0.000 0.000
- - 1 41,784.000 0.000 0.000 0.000
- - 1 41,784.000 0.000 0.000 0.000
- - 1 8,891.000 0.000 0.000 0.000
- - 1 13,300.000 0.000 0.000 0.000
- - 1 11,738.000 0.000 0.000 0.000
8 8 1 36,579.000 0.000 585,264.000 292,632.000
- - 1 15,014.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 2,920.000 0.000 0.000 0.000
- - 1 2,920.000 0.000 0.000 0.000
- - 1 517.000 0.000 0.000 0.000
50 50 1 517.000 0.000 129,250.000 25,850.000
 - - 1 552.000 0.000 0.000 0.000
- - 1 284.000 0.000 0.000 0.000
- - 1 307.000 0.000 0.000 0.000
- - 1 307.000 0.000 1,842.000 0.000
- - 1 354.000 0.000 0.000 0.000
27,470 27,470 1 354.000 0.000 5,922,420.000 9,724,380.000
- - 1 354.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 9,955.000 0.000 0.000 0.000
- - 1 3,796.000 0.000 0.000 0.000
14 14 1 3,796.000 0.000 15,184.000 53,144.000
- - 1 10,351.000 0.000 0.000 0.000
79 79 1 2,959.000 0.000 62,139.000 233,761.000
- - 1 2,684.000 0.000 0.000 0.000
- - 1 2,959.000 0.000 35,508.000 0.000
- - 1 2,500.000 0.000 0.000 0.000
190 190 1 210.000 0.000 88,200.000 39,900.000
- - 1 1,900.000 0.000 0.000 0.000
98 98 1 1,199.000 0.000 170,258.000 117,502.000
- - 1 1,639.000 0.000 0.000 0.000
- - 1 1,199.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 167.000 0.000 0.000 0.000
- - 1 167.000 0.000 0.000 0.000
- - 1 167.000 0.000 0.000 0.000
148 148 1 167.000 0.000 2,004.000 24,716.000
- - 1 167.000 0.000 0.000 0.000
- - 1 1,121.000 0.000 0.000 0.000
- - 1 3,288.000 0.000 0.000 0.000
- - 1 1,200.000 0.000 0.000 0.000
- - 1 1,750.000 0.000 0.000 0.000
60 60 1 1,750.000 0.000 420,000.000 105,000.000
- - 1 183.000 0.000 0.000 0.000
- - 1 63,986.000 0.000 0.000 0.000
9 9 1 63,813.000 0.000 0.000 574,317.000
- - 1 57,500.000 0.000 0.000 0.000
- - 1 60.000 0.000 0.000 0.000
1,590 1,590 1 60.000 0.000 41,820.000 95,400.000
- - 1 60.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 5,000.000 0.000 0.000 0.000
- - 1 13,200.000 0.000 0.000 0.000
8 8 1 19,955.000 0.000 39,910.000 159,640.000
- - 1 245.000 0.000 0.000 0.000
 - - 1 245.000 0.000 0.000 0.000
3 3 1 1,243.000 0.000 0.000 3,729.000
- - 1 1,326.000 0.000 0.000 0.000
- - 1 158.000 0.000 0.000 0.000
977 977 1 157.000 0.000 143,184.000 153,389.000
- - 1 253.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 287.000 0.000 0.000 0.000
- - 1 287.000 0.000 0.000 0.000
- - 1 287.000 0.000 142,639.000 0.000
436 436 1 287.000 0.000 161,868.000 125,132.000
- - 1 0.000 0.000 0.000 0.000
- - 1 287.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 91.000 0.000 0.000 0.000
- - 1 91.000 0.000 128,492.000 0.000
504 504 1 440.000 352,000.000 130,240.000 221,760.000
- - 1 0.000 0.000 0.000 0.000
- - 1 63,986.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
3 3 1 56,360.000 0.000 1,859,880.000 169,080.000
23 23 1 0.000 0.000 0.000 0.000
- - 1 60,140.000 0.000 0.000 0.000
20 20 1 66,154.000 1,323,080.000 0.000 1,323,080.000
- - 1 141,648.000 0.000 0.000 0.000
25 25 1 0.000 0.000 0.000 0.000
- - 1 151,150.000 0.000 4,685,650.000 0.000
25 25 1 166,265.000 4,987,950.000 831,325.000 4,156,625.000
- - 1 76,620.000 0.000 0.000 0.000
36 36 1 84,282.000 8,428,200.000 11,293,788.000 3,034,152.000
11 11 1 17,450.000 1,570,500.000 1,378,550.000 191,950.000
- - 1 0.000 0.000 0.000 0.000
- - 1 23,270.000 0.000 0.000 0.000
72 72 1 25,597.000 2,559,700.000 716,716.000 1,842,984.000
- - 1 18,140.000 0.000 0.000 0.000
17 17 1 0.000 0.000 0.000 0.000
- - 1 19,470.270 0.000 0.000 0.000
- - 1 19,954.000 0.000 0.000 0.000
30 30 1 15,450.000 2,472,000.000 2,240,250.000 463,500.000
- - 1 0.000 0.000 0.000 0.000
- - 1 21,810.000 0.000 1,461,270.000 0.000
- - 1 19,350.000 0.000 1,064,250.000 0.000
- - 1 135,000.000 0.000 0.000 0.000
- - 1 151,150.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
17 17 1 21,285.000 2,341,350.000 1,979,505.000 361,845.000
- - 1 144,540.000 14,454,000.000 14,454,000.000 0.000
- - 1 50,000.000 0.000 0.000 0.000
- - 1 165,000.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 34,354.100 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 164.000 0.000 31,324.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 90,000.000 0.000 0.000 0.000
- - 1 90,000.000 0.000 0.000 0.000
- - 1 183,480.000 0.000 0.000 0.000
- - 1 176,400.000 0.000 0.000 0.000
- - 1 77.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 79,154.000 0.000 0.000 0.000
- - 1 79,154.000 0.000 0.000 0.000
- - 1 303,750.000 0.000 0.000 0.000
- - 1 252,720.000 0.000 0.000 0.000
- - 1 106,080.000 0.000 0.000 0.000
- - 1 106,080.000 0.000 0.000 0.000
- - 1 222,000.000 0.000 0.000 0.000
- - 1 222,000.000 0.000 0.000 0.000
- - 1 198,900.000 0.000 0.000 0.000
- - 1 198,900.000 0.000 0.000 0.000
- - 1 230,880.000 0.000 0.000 0.000
- - 1 133,137.000 0.000 0.000 0.000
- - 1 84,050.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 22,794.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
 - - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 990.000 0.000 0.000 0.000
- - 1 1,023.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 924.000 0.000 0.000 0.000
- - 1 1,138.000 0.000 879,674.000 0.000
20 20 1 924.000 0.000 1,367,520.000 18,480.000
860 860 1 979.000 0.000 234,960.000 841,940.000
- - 1 739.200 0.000 0.000 0.000
- - 1 1,463.000 0.000 0.000 0.000
12 12 1 32,522.000 1,170,792.000 780,528.000 390,264.000
40 40 1 2,541.000 0.000 25,410.000 101,640.000
- - 1 23,951.000 0.000 0.000 0.000
- - 1 19,885.446 0.000 0.000 0.000
- - 1 120.000 0.000 0.000 0.000
- - 1 127.260 38,178.000 101,808.000 0.000
- - 1 212,784.000 0.000 425,568.000 0.000
- - 1 70,000.000 0.000 0.000 0.000
19 19 1 22,725.000 0.000 931,725.000 431,775.000
- - 1 22,500.000 0.000 0.000 0.000
- - 1 32,522.000 0.000 0.000 0.000
- - 1 24,583.333 0.000 0.000 0.000
- - 1 34,300.000 0.000 0.000 0.000
- - 1 712,800.000 0.000 0.000 0.000
- - 1 348,480.000 0.000 0.000 0.000
- - 1 2,222.000 0.000 0.000 0.000
- - 1 1,540.000 0.000 0.000 0.000
- - 1 37,440.000 0.000 0.000 0.000
- - 1 13,050.000 0.000 0.000 0.000
12 12 1 9,680.000 0.000 271,040.000 116,160.000
- - 1 20,970.000 0.000 0.000 0.000
5 5 1 13,607.000 0.000 0.000 68,035.000
- - 1 180,000.000 0.000 0.000 0.000
- - 1 8,900.000 0.000 0.000 0.000
43 43 1 5,500.000 0.000 363,000.000 236,500.000
- - 1 8,900.000 0.000 0.000 0.000
- - 1 6,270.000 0.000 0.000 0.000
230 230 1 8,700.000 1,740,000.000 1,479,000.000 2,001,000.000
- - 1 5,500.000 0.000 0.000 0.000
103 103 1 5,500.000 275,000.000 814,000.000 566,500.000
27 27 1 6,270.000 0.000 313,500.000 169,290.000
100 100 1 6,270.000 0.000 0.000 627,000.000
- - 1 7,920.000 0.000 0.000 0.000
59 59 1 8,400.000 0.000 0.000 495,600.000
 - - 1 6,199.900 0.000 0.000 0.000
126 126 1 8,400.000 0.000 2,797,200.000 1,058,400.000
- - 1 1,760.000 0.000 0.000 0.000
- - 1 13,400.000 0.000 0.000 0.000
11 11 1 13,400.000 26,800.000 241,200.000 147,400.000
- - 1 12,500.000 0.000 0.000 0.000
- - 1 2,300.000 0.000 0.000 0.000
1 1 1 136,500.000 0.000 1,228,500.000 136,500.000
- - 1 136,500.000 0.000 0.000 0.000
- - 1 8,000.000 0.000 0.000 0.000
31 31 1 5,950.000 0.000 101,150.000 184,450.000
- - 1 8,000.000 0.000 0.000 0.000
- - 1 1,430.000 0.000 0.000 0.000
17 17 1 2,240.000 0.000 185,920.000 38,080.000
- - 1 2,100.000 0.000 0.000 0.000
- - 1 427.850 0.000 0.000 0.000
- - 1 390.860 0.000 0.000 0.000
- - 1 2,060.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 17,500.000 0.000 0.000 0.000
- - 1 6,512.000 0.000 0.000 0.000
- - 1 339.900 0.000 0.000 0.000
- - 1 339.900 0.000 0.000 0.000
- - 1 2,200.000 0.000 0.000 0.000
- - 1 2,309.375 0.000 773,640.625 0.000
- - 1 10,857.000 0.000 0.000 0.000
- - 1 10,856.250 0.000 0.000 0.000
- - 1 65,340.000 0.000 784,080.000 0.000
- - 1 333.900 0.000 0.000 0.000
- - 1 11,615.000 0.000 0.000 0.000
- - 1 6,600.000 0.000 0.000 0.000
- - 1 154.000 0.000 0.000 0.000
- - 1 7,700.000 0.000 0.000 0.000
14 14 1 7,769.000 0.000 761,362.000 108,766.000
5 5 1 18,000.000 0.000 72,000.000 90,000.000
13 13 1 12,675.000 0.000 468,975.000 164,775.000
- - 1 3,700.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 286,000.000 0.000 0.000 0.000
- - 1 726.953 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 542.520 0.000 0.000 0.000
- - 1 496.650 0.000 0.000 0.000
- - 1 19,360.000 0.000 0.000 0.000
500 500 1 470.530 2,823,180.000 2,729,074.000 235,265.000
260 260 1 3,773.000 0.000 60,368.000 980,980.000
 - - 1 4,134.900 0.000 0.000 0.000
- - 1 20,586.000 0.000 1,235,160.000 0.000
14 14 1 15,150.000 545,400.000 333,300.000 212,100.000
- - 1 0.000 0.000 0.000 0.000
- - 1 87,120.000 0.000 0.000 0.000
- - 1 752,400.000 0.000 752,400.000 0.000
30 30 1 8,295.000 0.000 0.000 248,850.000
- - 1 8,031.579 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 5,368.000 0.000 0.000 0.000
44 44 1 5,785.000 0.000 92,560.000 254,540.000
- - 1 0.000 0.000 0.000 0.000
147 147 1 2,887.500 0.000 153,037.500 424,462.500
- - 1 0.000 0.000 0.000 0.000
- - 1 453,802.994 0.000 0.000 0.000
- - 1 4,200.000 0.000 0.000 0.000
400 400 1 635.250 0.000 0.000 254,100.000
- - 1 4,000.000 0.000 0.000 0.000
- - 1 59,000.000 0.000 0.000 0.000
- - 1 45,000.000 0.000 0.000 0.000
- - 1 45,000.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 546,400.000 0.000 0.000 0.000
- - 1 544,150.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 223,949.367 0.000 0.000 0.000
- - 1 254,300.000 0.000 0.000 0.000
- - 1 252,800.000 0.000 0.000 0.000
4 4 1 401,666.666 0.000 2,409,999.996 1,606,666.664
- - 1 405,000.000 0.000 0.000 0.000
- - 1 10,560.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 10,837.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 19,225.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 552,800.000 0.000 0.000 0.000
- - 1 552,800.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 16,400.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
55 55 1 4,120.000 0.000 185,400.000 226,600.000
- - 1 4,120.000 0.000 0.000 0.000
55 55 1 15,500.000 930,000.000 4,727,500.000 852,500.000
- - 1 9,738.000 0.000 0.000 0.000
 - - 1 9,611.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 625,900.000 0.000 0.000 0.000
- - 1 22,176.000 0.000 0.000 0.000
- - 1 66,876.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 13,252.000 0.000 0.000 0.000
- - 1 10,865.800 0.000 0.000 0.000
- - 1 8,053.000 0.000 2,818,550.000 0.000
- - 1 8,110.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 36,000.000 0.000 0.000 0.000
- - 1 77,690.000 0.000 0.000 0.000
- - 1 825,000.000 0.000 0.000 0.000
- - 1 224,254.000 0.000 0.000 0.000
- - 1 259,175.000 0.000 0.000 0.000
- - 1 70,000.000 0.000 0.000 0.000
- - 1 4,952.830 0.000 0.000 0.000
- - 1 4,952.830 0.000 0.000 0.000
- - 1 2,728.000 0.000 0.000 0.000
- - 1 5,890.000 0.000 0.000 0.000
- - 1 660,000.000 0.000 0.000 0.000
- - 1 158,400.000 0.000 0.000 0.000
- - 1 276,600.000 0.000 0.000 0.000
- - 1 276,500.000 0.000 0.000 0.000
- - 1 257,644.000 0.000 0.000 0.000
- - 1 228,800.000 0.000 0.000 0.000
4 4 1 20,747.000 0.000 103,735.000 82,988.000
- - 1 20,748.000 0.000 0.000 0.000
- - 1 6,700.000 0.000 0.000 0.000
23 23 1 19,835.000 0.000 0.000 456,205.000
- - 1 386.100 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 1,590.000 0.000 0.000 0.000
- - 1 1,550.000 0.000 0.000 0.000
220 220 1 1,463.000 0.000 409,640.000 321,860.000
- - 1 1,518.000 0.000 0.000 0.000
- - 1 1,190.000 0.000 0.000 0.000
200 200 1 1,185.000 2,844,000.000 3,555,000.000 237,000.000
- - 1 1,463.000 0.000 0.000 0.000
 - - 1 1,190.000 0.000 0.000 0.000
- - 1 1,077.000 0.000 0.000 0.000
- - 1 1,081.820 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
145 145 1 1,583.000 0.000 0.000 229,535.000
- - 1 1,439.000 0.000 0.000 0.000
- - 1 1,439.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
50 50 1 22,433.000 1,121,650.000 560,825.000 1,121,650.000
- - 1 1,460.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
50 50 1 14,712.500 0.000 0.000 735,625.000
- - 1 19,480.000 0.000 0.000 0.000
- - 1 13,750.000 0.000 0.000 0.000
- - 1 13,235.000 0.000 0.000 0.000
50 50 1 12,500.000 0.000 0.000 625,000.000
- - 1 13,750.000 0.000 0.000 0.000
- - 1 358.000 0.000 0.000 0.000
- - 1 121,750.000 0.000 0.000 0.000
- - 1 486.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
525 525 1 11,975.000 0.000 3,520,650.000 6,286,875.000
- - 1 28,666.670 0.000 0.000 0.000
- - 1 13,235.000 0.000 0.000 0.000
- - 1 12,500.000 0.000 0.000 0.000
- - 1 11,975.000 0.000 0.000 0.000
- - 1 11,975.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 19,480.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 13,235.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 19,480.000 0.000 0.000 0.000
- - 1 13,353.000 0.000 0.000 0.000
- - 1 800.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 323,500.000 0.000 0.000 0.000
- - 1 53,000.000 0.000 0.000 0.000
- - 1 386.100 0.000 0.000 0.000
 - - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 38,500.000 0.000 0.000 0.000
- - 1 71,500.000 0.000 0.000 0.000
- - 1 38,500.000 0.000 0.000 0.000
- - 1 71,500.000 0.000 0.000 0.000
- - 1 333.900 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
400 400 1 473.000 189,200.000 0.000 189,200.000
- - 1 0.000 0.000 0.000 0.000
- - 1 110.000 0.000 0.000 0.000
- - 1 1,750.000 0.000 0.000 0.000
- - 1 98.000 0.000 0.000 0.000
- - 1 783.000 0.000 0.000 0.000
- - 1 7,150.000 0.000 0.000 0.000
- - 1 2,134.000 0.000 0.000 0.000
- - 1 6,199.900 0.000 0.000 0.000
- - 1 1,155.000 0.000 0.000 0.000
- - 1 80.000 0.000 0.000 0.000
- - 1 396.000 0.000 0.000 0.000
- - 1 500.000 0.000 0.000 0.000
- - 1 7,920.000 0.000 396,000.000 0.000
- - 1 1,302.000 0.000 0.000 0.000
- - 1 1,890.000 0.000 0.000 0.000
- - 1 160.000 0.000 0.000 0.000
240 240 1 6,840.000 0.000 820,800.000 1,641,600.000
- - 1 90.000 0.000 0.000 0.000
- - 1 265.000 0.000 0.000 0.000
- - 1 14,300.000 0.000 0.000 0.000
- - 1 7,630.000 0.000 8,331,960.000 0.000
 - - 1 167.000 0.000 0.000 0.000
- - 1 8,355.000 0.000 0.000 0.000
- - 1 1,457,500.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 12,969.000 0.000 0.000 0.000
- - 1 1,506.000 0.000 0.000 0.000
- - 1 410,777.000 0.000 0.000 0.000
- - 1 343,687.000 0.000 0.000 0.000
- - 1 32,493.000 0.000 0.000 0.000
30 30 1 0.000 0.000 0.000 0.000
- - 1 2,254.320 0.000 0.000 0.000
- - 1 259,175.000 0.000 0.000 0.000
- - 1 15,180.000 0.000 0.000 0.000
200 200 1 31,680.000 0.000 0.000 6,336,000.000
194 194 1 31,405.000 0.000 157,025.000 6,092,570.000
- - 1 3,300.000 0.000 0.000 0.000
- - 1 7,630.000 0.000 0.000 0.000
- - 1 14,300.000 0.000 0.000 0.000
- - 1 8,426.000 0.000 0.000 0.000
- - 1 627.000 0.000 0.000 0.000
- - 1 792.000 0.000 0.000 0.000
1,950 1,950 1 1,700.000 5,780,000.000 2,465,000.000 3,315,000.000
- - 1 1,700.000 0.000 0.000 0.000
8 8 1 55,000.000 1,100,000.000 660,000.000 440,000.000
17 17 1 58,500.000 1,170,000.000 1,638,000.000 994,500.000
- - 1 850.000 0.000 5,100,000.000 0.000
300 300 1 4,000.000 0.000 0.000 1,200,000.000
- - 1 8,355.000 0.000 0.000 0.000
- - 1 248,120.000 0.000 0.000 0.000
- - 1 186,000.000 0.000 0.000 0.000
- - 1 6,500.000 0.000 0.000 0.000
- - 1 11,250.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
8 8 1 236,500.000 0.000 0.000 1,892,000.000
5 5 1 99,000.000 0.000 0.000 495,000.000
4 4 1 203,500.000 0.000 0.000 814,000.000
- - 1 275,000.000 0.000 0.000 0.000
- - 1 132,000.000 0.000 0.000 0.000
- - 1 49,500.000 0.000 0.000 0.000
- - 1 5,500.000 0.000 0.000 0.000
 - - 1 66,000.000 0.000 0.000 0.000
- - 1 1,023.000 0.000 2,046,000.000 0.000
- - 1 21,736.000 0.000 0.000 0.000
- - 1 386.100 0.000 0.000 0.000
1,800 1,800 1 340.280 0.000 0.000 612,504.000
- - 1 560,000.000 0.000 560,000.000 0.000
- - 1 1,252,000.000 0.000 1,252,000.000 0.000
- - 1 575,000.000 0.000 0.000 0.000
9 9 1 156,000.000 0.000 0.000 1,404,000.000
- - 1 53,636.000 0.000 0.000 0.000
- - 1 220,000.000 0.000 0.000 0.000
2 2 1 148,500.000 0.000 0.000 297,000.000
- - 1 7,000.000 0.000 0.000 0.000
- - 1 2,200.000 0.000 0.000 0.000
- - 1 60,000.000 0.000 0.000 0.000
- - 1 6,269.000 0.000 0.000 0.000
- - 1 197,000.000 0.000 0.000 0.000
15 15 1 75,000.000 0.000 375,000.000 1,125,000.000
- - 1 8,500.000 0.000 0.000 0.000
- - 1 220,000.000 0.000 4,620,000.000 0.000
- - 1 220,000.000 0.000 0.000 0.000
- - 1 75,000.000 0.000 0.000 0.000
100 100 1 5,000.000 0.000 0.000 500,000.000
- - 1 200,000.000 0.000 0.000 0.000
- - 1 56,000.000 0.000 0.000 0.000
- - 1 80,000.000 0.000 0.000 0.000
35 35 1 200,000.000 0.000 6,600,000.000 7,000,000.000
- - 1 138,364.000 0.000 0.000 0.000
- - 1 137,364.000 0.000 0.000 0.000
7 7 1 45,100.000 0.000 0.000 315,700.000
- - 1 66,000.000 0.000 0.000 0.000
- - 1 53,636.000 0.000 0.000 0.000
- - 1 450,000.000 0.000 0.000 0.000
4 4 1 718,500.000 0.000 0.000 2,874,000.000
- - 1 69,000.000 0.000 0.000 0.000
- - 1 60,000.000 0.000 0.000 0.000
5,100 5,100 1 6,000.000 0.000 0.000 30,600,000.000
- - 1 522,728.000 0.000 0.000 0.000
- - 1 180,000.000 0.000 0.000 0.000
- - 1 220,000.000 0.000 0.000 0.000
- - 1 109.090 0.000 0.000 0.000
- - 1 24,091.000 0.000 0.000 0.000
- - 1 1,150.000 0.000 4,761,000.000 0.000
3 3 1 47,500.000 0.000 95,000.000 142,500.000
- - 1 200,000.000 0.000 0.000 0.000
- - 1 2,816.000 0.000 0.000 0.000
 - - 1 150,000.000 0.000 1,500,000.000 0.000
- - 1 303.550 0.000 0.000 0.000
- - 1 891,275.000 0.000 0.000 0.000
- - 1 160,500.000 0.000 0.000 0.000
- - 1 585.000 0.000 1,755,000.000 0.000
- - 1 5,300.000 0.000 0.000 0.000
- - 1 5,500.000 0.000 0.000 0.000
- - 1 60,500.000 0.000 0.000 0.000
15 15 1 80,000.000 3,200,000.000 2,000,000.000 1,200,000.000
- - 1 136,564.000 0.000 0.000 0.000
- - 1 1,265.000 0.000 0.000 0.000
- - 1 8,400.000 0.000 0.000 0.000
- - 1 8,400.000 0.000 0.000 0.000
- - 1 98,000.000 0.000 0.000 0.000
5 5 1 90,000.000 0.000 1,350,000.000 450,000.000
50 50 1 97,500.000 4,875,000.000 0.000 4,875,000.000
4 4 1 22,500.000 0.000 360,000.000 90,000.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 7,199.885 0.000 0.000 0.000
- - 1 1,945.000 0.000 0.000 0.000
- - 1 2,950.000 0.000 0.000 0.000
- - 1 139,880.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 1,097.000 0.000 0.000 0.000
197 197 1 77.000 0.000 11,319.000 15,169.000
- - 1 3,217.500 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 15,572.700 0.000 0.000 0.000
- - 1 270.000 0.000 0.000 0.000
- - 1 600.000 0.000 0.000 0.000
170 170 1 1,106.000 0.000 75,208.000 188,020.000
- - 1 45.000 0.000 0.000 0.000
- - 1 36.000 0.000 0.000 0.000
- - 1 783.000 0.000 0.000 0.000
- - 1 1,302.000 0.000 0.000 0.000
- - 1 74,250.000 0.000 0.000 0.000
- - 1 43,186.000 0.000 0.000 0.000
- - 1 7,920.000 0.000 0.000 0.000
- - 1 8,750.000 0.000 0.000 0.000
- - 1 7,018.000 0.000 0.000 0.000
- - 1 8,355.000 0.000 0.000 0.000
- - 1 20,328.000 0.000 0.000 0.000
- - 1 12,076.000 0.000 0.000 0.000
- - 1 6,595.000 0.000 0.000 0.000
 - - 1 1,098,900.000 0.000 0.000 0.000
1 1 1 712,800.000 0.000 0.000 712,800.000
- - 1 56.000 0.000 0.000 0.000
- - 1 1,640.000 0.000 0.000 0.000
- - 1 42,800.000 0.000 0.000 0.000
126 126 1 2,750.000 0.000 0.000 346,500.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000
- - 1 0.000 0.000 0.000 0.000

75,378,805.000 ### ###

PETUGAS
PENGELOLA KEFARMASIAN
.....................................................
 KODE PUSKESMAS :
PUSKESMAS :
KECAMATAN :
KAB / KODYA : LUMAJANG
PROPINSI : JAWA TIMUR

NO NAMA OBAT SATUAN KEMASAN STOK AWAL Jan Feb Mar

1 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -

2 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet 129 - 100 -
3 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) Tablet - - - -
4 0 0 - - - -
5 Air Untuk Injeksi Vial @25 ml Vial 80 - - -
6 Air Untuk Injeksi Vial @25 ml Vial - - - -
7 Air Untuk Irigasi Infus 1000 ml Botol - - - -
8 Alopurinol Tablet 100 mg Tablet 917 - - -
9 Alopurinol Tablet 100 mg 0 - - - -
10 Ambroxol Tablet 30 mg Tablet 961 - - -
11 0 0 - - - -
12 Aminofilin Injeksi 24 mg/ml Ampule - - - -
13 0 0 - - - -
14 Amlodipin Tablet 10 Mg Tablet 751 - - -
15 Amlodipin Tablet 10 Mg Tablet - - - -
16 0 0 - - - -
17 Amoksisilin Kaplet 500 mg Tablet - - - -
18 Amoksisilin Kaplet 500 mg Tablet - - - -
19 Amoksisilin Kaplet 500 mg Tablet 90 - - -
20 Amoksisilin Kaplet 500 mg Tablet - - - -
21 0 0 - - - -
22 Amoksisilin Syrup Kering 125 mg / 5 ml Botol 216 - - -
23 Amoksisilin Syrup Kering 125 mg / 5 ml 0 - - - -
24 Amoksisilin Syrup Kering 250mg / 5 ml Botol - - - -
25 Amoksisilin Syrup Kering 250mg / 5 ml (Novapharin) Botol - - - -
26 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet - - - -
27 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) / CLABAT,CAPSINAT Tablet - - - -
28 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) Vial 577 - - -
29 Ampicilin Serbuk Inj i.v 1.000 mg/vial Vial - - - -
30 0 0 - - - -
31 Antacida + Simeticon Suspensi (NOVAMAG) Botol 87 - - -
32 0 0 - - - -
33 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 47 - - -
34 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet - - - -
35 Antacida + Simeticon Tablet Kunyah (MAGTEN) Tablet 6,014 - - 3,000
36 Antacida tablet kunyah DOEN, kombinasi : Alumunium Hidroksida 200 mg + Magnesium Hidroksida 200 mg Tablet - - - -
37 0 0 - - - -
38 Anti Bakteri Doen Salep Kombinasi (Indo Farma) Tube - - - -
39 0 0 - - - -
40 Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam Salisilat 3% (Marin ) Pot - - - -
41 0 0 - - - -
42 Supp
Antihemoroid Kombinasi : Bismut Suppgalat 150 mg Heksaklorofen 2,5 mg Lidokain 10 mg Seng Oksida 120 mg
570 - - -
43 Asam Ascorbat 500 mg (Vitamin C) Tablet - - - -
44 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet - - - -
45 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citrus Bio 20% ) HEMOROGARD Tablet - - - -
46 Asam Ascorbat 50 mg (Vitamin C) Tablet 2,805 - - -
47 Asam Ascorbat 50 mg (Vitamin C) Tablet - - - -
48 Asam Folat 1 mg Beta Caroten 10000 Multi Mineral/ FOLAMIL (Dexa Medica) Tablet - - - -
49 Asam Folat Tablet 1 mg (Marin Liza Farmasi) Tablet - - - -
50 Asam Folat Tablet 1 mg Tablet - - - -
51 Asam Mefenamat 500 mg ( Mersi ) Tablet - - - -
52 Asam Mefenamat 500 mg 0 - - - -
53 0 0 - - - -
54 Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 20 - - -
55 0 0 - - - -
56 Asam Tranexamat Tablet 500 mg Tablet 316 - - -
57 0 0 - - - -
58 Asiklovir 5% 5gr Cream Tube 150 - - -
59 Asiklovir 5% 5gr Cream Tube - - - -
60 0 0 - - - -
61 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
62 Asiklovir Tab 400 mg ( Phapros ) Tablet 281 - - -
63 Asiklovir Tab 400 mg ( Phapros ) Tablet - - - -
64 Atropin Sulfat Injeksi 0,25 mg/ml Ampule - - - -
65 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
66 Attapulgite Active 630 mg Tab/ New Antides Tablet 669 - - -
67 Attapulgite Active 630 mg Tab/ PULAREX Tablet 2,000 - - -
68 Attapulgite Active 630 mg Tab/ New Antides Tablet - - - -
69 Betahistin Mesylat 6 mg Tablet 99 - - -
70 Betahistin Mesylat 6 mg Tablet - - - -
71 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 83 - - -
72 Betametason Dipropionat Krim 0,1% Tube @ 10 gram 108 - - -
73 Betametason Dipropionat Krim 0,1% Tube @ 10 gram - - - -
74 Bisakodil Tablet 5 mg (Etercon Pharma ) Tablet - - - -
75 Bisakodil Sup 10 mg (Dulcolax) Supp - - - -
76 Bisoprolol 2,5 mg/concor 2,5 Tablet - - - -
77 Benzatin Benzil Penisilin 2,4 jt 0 - - - -
78 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) II Biji - - - -
79 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zeneca ) I Biji - - - -
80 0 0 - - - -
81 Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs - - - -
82 0 0 - - - -
83 Calcium Plus Vit D3 (Coral calcium 500 mg,Naturan Soyisoflavonoid 20 mcg,vit D3 200 IU,Vit K1 25 MCG,mG 100 mg,Zink 5 mg Boron 1 mg)/ CAL - 95
Tablet - - - -
84 Cefadroksil Kapsul 500 mg Tablet 938 - - -
85 Cefadroksil Kapsul 500 mg Tablet - - - -
86 Cefotaxime serbuk injeksi 1.000 mg Vial - - - -
87 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) Ampule 76 - - -
88 Citicolin 250 mg / 2 ml Inj Ampule - - - -
89 Curcumin Plus Cynarin,Sylimarin,Kapsul/ HEPAGARD (Phapros) Tablet - - - -
90 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 137 - - -
91 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule - - - -
92 Deksamethason Tab 0,5 mg (Promed ) Tablet 3,939 - - -
93 Deksamethason Tab 0,5 mg 0 - - - -
94 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) Tube 6 - - -
95 Dextromertofan Komb Syr/ BANTIF (Sanbe) Botol - - - -
96 Difenhidramin Inj 10 mg/ ml (Phapros ) Ampule 232 - - -
97 0 0 - - - -
98 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet 368 - - -
99 Digoksin Tab 0,25 mg (Yarindo Farmatama ) Tablet - - - -
100 Digoksin Tab 0,25 mg Tablet - - - -
101 Dimenhidrinat Tablet 50 mg/ Kimia Farma Tablet - - - -
102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II Tablet 484 - - -
103 0 0 - - - -
104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol 98 - - -
105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) Botol - - - -
106 Domperidon Tab 10 mg (Novapharin ) Tablet 445 - - 500
107 Domperidon Tab 10 mg (Novapharin ) Tablet - - - -
108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% Ampule - - - -
109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule 30 - - -
110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) Ampule - - - -
111 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
112 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
113 Ethambutol 250 mg Tablet - - - -
114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) Ampule - - - -
115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 3 - - -
116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule 428 - - -
117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) Ampule - - - -
118 Fitomenadion Tabet 10 mg (Phapros ) Tablet 26 - - -
119 Fitomenadion Tabet 10 mg (Phapros ) Tablet 334 - - -
120 0 0 - - - -
121 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule 26 - - -
122 Furosemide Injeksi 10 mg/ ml (Indofarma) Ampule - - - -
123 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
124 Furosemide Tablet 40 mg (Kimia Farma ) Tablet - - - -
125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol 95 - - -
127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) Botol - - - -
128 Gentamycin Krim 1 % mg/ ml Tube 68 - - -
129 Gentian Violet 1% 10 ml Botol - - - -
130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) Botol 134 - - -
131 Glibenklamid Tablet 5 mg Tablet 5,830 - - -
132 Glibenklamid Tablet 5 mg ( Indofarma ) Tablet - - - -
133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) Tablet 6,927 - - -
134 Gliseril Guaikoulat Tablet 100 mg Tablet - - - -
135 Glucosamin HCL 500 Mg, Konrdoitin SO4400Mg, MSM 200 Mg, VitC75Mg, Selenium 15mg, Zink 5 mg, Mn50mcg, Mg Gliserofosfat 10 mg Tablet 541 - - -
136 Glukosa Larutan 40% Steril ( Outsuka ) Botol 10 - - -
137 Glukosa Larutan 40% Steril botol - - - -
138 Glukosa Larutan Infus 5% @500ml (Widatra ) Botol - - - -
139 Glukosa Larutan Infus 5% @500ml Botol - - - -
140 Hidroklorotiazid (HCT) Tablet 25 mg Tablet - - - -
141 Hidroklorotiazid (HCT) Tablet 25 mg Tablet 1,871 - - -
142 Gliseril Guaikoulat Tablet 100 mg Tablet - - - -
143 Hidrokortison Krim 1 % (Kimia Farma ) Tube - - - -
144 Hidrokortison Krim 2,5 % (Kimia Farma) Tube 92 - - -
145 Hidrokortison Krim 2,5 % (Kimia Farma) Tube - - - -
146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) Preflied - - - -
147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 10 - - -
148 0 0 - - - -
149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) Botol - - - -
151 Ibuprofen Tablet 400 mg (Novapharin ) Tablet 6,418 - - -
152 Ibuprofen Tablet 400 mg Tablet - - - -
153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) Tablet - - - -
154 Isoniazid Tablet 100 mg tablet - - - -
155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 300 - - -
156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet 24 - - -
157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) Tablet - - - -
158 0 0 - - - -
159 KA-EN 1B Inj Larutan @500 ml (Otsuka) Botol - - - -
160 KA-EN 3A Inj Larutan @500 ml (Otsuka) Botol - - - -
161 KA-EN 3B Inj Larutan @500 ml (Otsuka) Botol 40 - - -
162 0 0 - - - -
163 Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guardian Pharmatama) Tablet - - - -
164 0 0 - - - -
165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) Tablet 100 - - -
166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) Tablet 3,803 - - -
167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) Tablet - - - -
168 Kalsium Laktat (Kalk) Tab 500 mg Tablet - - - -
169 Kaptopril Tab 25 mg ( Phapros ) Tablet 9,412 - - -
170 Kaptopril Tab 25 mg TAblet - - - -
171 Ketokonazol Krim 2 % @ 10 gr Tube 26 - - -
172 Ketokonazol Krim 2 % @ 10 gr Tube - - - -
173 Ketokonazol Tablet 200 mg (Novapharin) I Tablet 400 - - -
174 Ketokonazol Tablet 200 mg (Novapharin) II Tablet - - - -
175 Ketokonazol Tablet 200 mg (Novapharin) Tablet - - - -
176 Ketorolak Inj 30 mg/ml Ampule - - - -
177 0 0 - - - -
178 Kloramfenikol 1% Salep Mata (KF) Tube 137 - - -
179 0 0 - - - -
180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma) Vial - - - -
181 Kloramfenikol Tetes Telinga :Kloramfenicol 10%,Lidocain,Proplylenglycol /Colme (Interbat) Tube 34 - - -
182 Kloramfenikol Tetes Telinga : Kloramfenicol 10%,Lidocain,Proplylenglycol / COLME (Interbat) Tube 58 - - -
183 0 0 - - - -
184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 30 - - -
185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi ) Tablet 8,058 - - -
186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) Tablet - - - -
187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) Tablet - - - -
188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ayus ) Tablet - - - -
189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) Tablet 1,300 - - -
190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg Tablet - - - -
191 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol - - - -
192 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazol 200mg + Trimetropin 40 mg ( Holi Farma ) Botol - - - -
193 Krim Analgesik (setiap gram mengandung : Metyl Salisilat 102 mg, Eugenol 13,6 mg; Methol 53,4 mg, Vinishing Cream ad 1 gr/ MOLAKRIM Tube 17 - - -
194 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma) Tube 5 - - -
195 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Extract 100 mg,Neomycin Sulfat 5 mg / CENTABIO (Sanbe Farma) Tube - - - -
196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet - - - -
197 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidofil, Probiotik (Dexa Medica, Sanbe) Tablet 84 - - -
198 0 0 - - - -
199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 3 - - -
200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule 327 - - -
201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeksi) Ampule - - - -
202 Loperamid Tablet 2 mg ( Ifars) Tablet 294 - - -
203 Loperamid Tablet 2 mg Tablet - - - -
204 Loratadin Tablet 10 mg Tablet 200 - - -
205 Loratadin Tablet 10 mg Tablet - - - -
206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet 580 - - -
207 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suplemen Mata/ OCUGARD (Phapros) Tablet - - - -
208 Meloxicam Tab 15 mg (Bernofarm ) Tablet - - - -
209 0 0 - - - -
210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Ampul - - - -
211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Norages) Tablet 1,683 - - -
212 Metamizol Sodium Inj 500 mg/ml (Santagesik) 0 - - - -
213 Metformin HCl Tablet 500 mg Tablet 1,846 - - -
214 Metformin HCl Tablet 500 mg Tablet - - - -
215 Metilprednisolon Tab 4 mg (Molex Ayus) Tablet 480 - - -
216 0 0 - - - -
217 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet 473 - - -
218 Metoklopramide Tablet 10 mg (Kimia Farma) Tablet - - - -
219 Metoklopramide Tablet 5 mg (Kimia Farma) Tablet - - - -
220 Metronidasol 500 mg tablet (Novapharin) Tablet 70 - - -
221 Metronidasol 500 mg tablet (Novagyl) Tablet - - - -
222 Metronidasol Infus 500mg/100ml Btl= 100 ml - - - -
223 Metronidasol Infus 500mg/100ml Botol - - - -
224 Minyak Kayu Putih 60 ml Botol 4 - - -
225 Kapsul
Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 mg, Zink 20 mg, Beta Caroten 10000 IU, Selenium 30 mcg (LICOXY)
- - - -
226 Multivitamin + Pelancar Asi (NULACVIT) Tablet 900 - - -
227 Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / MERSIBION Ampule 8 - - -
228 Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) Ampule 151 - - -
229 Multivitamin Vitamin/ Suplemen (BECEFORT) tablet - - - -
230 Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Molex Ayus ) Tablet - - - -
231 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
82 - - 192
232 Botol
Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 IU vit B1 3 mg, B12 Curcuminoid 2ml / LYTACUR (Dexa Medika)
- - - -
233 Multivitamin Neurotopic Plus ATP Tablet:B1 100,B6 200,B12 200Mcg,Vit E 30mg, ATP 20mg / Bio ATP (Phapros) Tablet - - - -
234 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) Tablet 1,534 - - -
235 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 mg/ MOLANEURON (Molex Ayus) tablet - - - -
236 Tablet
Multivitamin Tab Tambah Darah : per Tablet Mengandung : Femofomarrat 300mg Mgso4 0,4mg,Cuso4 0,4 mg,Vit C 100mg ,Asam Folat 2 Mg,Vit B 12 15Mcg,Faktor Intirinsik 25mg / HEMAFORT ( Phapros )
- - - -
237 Natrium Diklofenak Tab 50 mg (Phapros ) I Tablet - - - -
238 Natrium Diklofenak Tab 50 mg (Phapros ) II Tablet 2,674 - - -
239 Natrium Diklofenak Tab 50 mg (Phapros ) Tablet - - - -
240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol 40 - - -
241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) Botol - - - -
242 Nifedipin tablet 10 mg ( Dexa Medica ) Tablet 1,052 - - -
243 Nifedipin tablet lepas lambat 30 mg (OROS) Tablet - - - -
244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) Botol 19 - - -
245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) Botol 24 - - -
246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet 75 - - -
247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
248 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) Tablet - - - -
249 Botol
Obat Batuk Herbal : Tiap 15 Ml Vitetrifolia Fill 1 Gr,Zingiber Officinalerhiz 0,25Mg,Abrusprecatorius Fol 0,25 Mg , Phaleria Macrocarpa Fruct 0,20 Mg / HERBAKOF (Dexa Medica )
- - - -
250 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Pcs 3 - - -
251 Botol
OBH Plus Syr : Per 5 ml Megnandung Difenhidramin 12,5mg,Amonium Chlorida 135 mg,Kalium Sulfoguaiakolat 30 mg,Na Sitrat 50 mg / SANADRYL
75 - - -
252 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE Botol - - - -
253 Omeprazole Kapsul 20 mg Tablet 1,157 - - 600
254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule 112 - - -
255 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) Ampule - - - -
256 Tablet
Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate ,dextromethorpan Hbr/ ALPARA ( Molex Ayus )
816 - - -
257 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet - - - -
258 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet 2,681 - - -
259 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,Bromheksin 80Mg,Difenhidramin HCl 25Mg/ HUSTAB (Phapros) Tablet - - - -
260 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, / COLPICA (Tropika Mas) Tablet - - - -
261 Propiltiourasil/ PTU 100 mg 0 - - - -
262 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofedrin 30Mg, Tripolidin 2,5 mg / NOZA (Phapros) Tablet - - - -
263 Parasetamol Syrup 120 mg/5ml (Mersi Farma) Botol 23 - - -
264 Parasetamol Syrup 120 mg/5ml Botol - - - -
265 Parasetamol tablet 500 mg Tablet 1,768 - 5,000 -
266 Parasetamol tablet 500 mg Tablet - - - 5,000
267 Parasetamol tablet 500 mg Tablet - - - -
268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L) Tube 10 - - -
269 Permetrin crem 5% @10 mg (Scabimite crem ) Tube 36 - - -
270 Permetrin crem 5% @10 mg (Scabimite crem ) Tube - - - -
271 Piracetam 800 mg Tablet Tablet 280 - - -
272 Parasetamol tablet 500 mg Tablet - - - -
273 Piracetam Injeksi 1gr/ 5ml Ampule 39 - - -
274 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet - - - -
275 Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 4,491 - - -
276 Probiotik Sachet (Probiokid) 0 - - - -
277 Polikresulen (Albotyl,Apetil) Botol - - - -
278 Prednison Tab 5 mg Tablet - - - -
279 Prednison Tab 5 mg (Holi Pharma) Tablet 5,070 - - -
280 Prednison Tab 5 mg Tablet - - - -
281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) Tablet - - - -
282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule 63 - - -
283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) Ampule - - - -
284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) Tablet - - - 1,500
285 0 0 - - - -
286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING Botol - - - -
288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL Botol 1,949 - - -
289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - 2,000 -
290 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
291 Salbutamol SO4 3,01 mg + Ipratonium Brom 0,52 mg Nebulizer (COMBIVENT) I dan II Nebule 284 - - -
292 0 0 - - - -
293 Salbutamol Tab 4 mg ( Graha Farma ) Tablet 573 - - -
294 Salbutamol Tab 4 mg (Pristasma) Tablet - - - -
295 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot 109 - - -
296 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% (Marin ) Pot - - - -
297 Salisil Bedak Serbuk 2% (Kimia Farma) Pcs 10 - - -
298 Salisil Bedak Serbuk 2% Pcs 56 - - -
299 Salisil Bedak Serbuk 2% Pcs - - - -
300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial 1 - - -
301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE Vial - - - -
302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul 5 - - -
303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT Ampul - - - -
304 Setirizin Tab 10 mg (Futamed) Tablet 110 - - -
305 Setirizin Tab 10 mg (Futamed) Tablet - - - -
306 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet 862 - - -
307 Simvastatin Tablet 10 mg Tablet - - - -
308 Siprofloksasin Tablet 500 mg (Novapharin) Tablet 2,216 - - 5,000
309 0 0 - - - -
310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - -
311 Sukralfat Susp 500mg/5ml @100 ml (Mepro) Botol - - - -
312 Tetes mata setiap ml mengandung Polietilen glikol 400 1% gliserin 0.25% Hidroksipropil metil selulosa 0,2% VISINE Botol - - - -
313 Tetrasiklin HCl Kapsul 500 mg Tablet - - - -
314 Thiamin/ Vitamin B1 50 mg Tablet - - - -
315 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet 4,671 - - -
316 Thiamin/ Vitamin B1 50 mg (Novapharin ) Tablet - - - -
317 Thiamphenicol / Thiamfilex Kapsul 500 mg Tablet - - - -
318 Thiamphenicol Kapsul 500 mg Tablet - - - -
319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONICOL) Botol 58 - - -
320 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Molex Ayus) Kapsul - - - -
321 Vitamin B Komplek Tablet - - - -
322 Vitamin B Komplek Plus Ekstrak Hati (Substansi Hati Kering 100 mg, Vit B1 HCl 0,25 mg B2 HCl 0,25 mg, B6 HCl 0,25 mg, B12 0,5 mg, Vit. C 12,5 mg, Calcium Pantetonat 1,5 mg, Nikotinamida 10 mg, Asam Folat 0,5 mg, FE (II) Glikonat 7,5 mg, CuSO4 0,65 mg) LIVRPON B-PLEX
Tablet - - - -
0 OBAT GOLONGAN PSIKOTROPIKA 0 - - - -
323 Alprazolam 0,5 mg (Mersi Farma) Tablet - - - -
324 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
325 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
326 Clobazam Tab 10 mg (Meprofarm) Tablet - - - -
327 0 0 - - - -
328 0 0 - - - -
329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 1 - - -
330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs 2 - - -
331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) Pcs - - - -
332 Diazepam Injeksi 5 mg / ml-2 ml Ampule - - - -
333 Diazepam Injeksi 5 mg / ml-2 ml Ampule 4 - - -
334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE 0 - - - -
335 Diazepam Tablet 5 mg (VALISANBE) Tablet 126 - - -
336 Diazepam Tablet 5 mg Tablet - - - -
337 Fenobarbital Tablet 30 mg Tablet - - - -
338 Fenobarbital Tablet 30 mg Tablet - - - -
339 Fenobarbital Tablet 30 mg tablet - - - -
340 Kodein Tablet 10 mg Tablet - - - -
341 0 0 - - - -
342 Lorazepam Tab 2 mg (Mersi Farma) Tablet - - - -
343 Metamizol 500 mg + Diazepam 2 mg / PRONEURON (Meprofarm) Tablet - - - -
344 0 0 - - - -
345 0 0 - - - -
346 0 0 - - - -
347 Primaquin 15 mg tablet tablet - - - -
348 0 0 - - - -
0 OBAT - OBAT PROGRAM 0 - - - -
0 OBAT PROGRAM KECACINGAN 0 - - - -
349 Albendazol Tablet 400 mg Tablet 266 - - -
350 Albendazol Tablet 400 mg Tablet - - - -
0 OBAT PROGRAM DIARE 0 - - - -
351 Garam Oralit (Kimia Farma) Tablet - - - -
352 Garam Oralit (Kimia Farma) Tablet 3,369 - - -
353 Garam Oralit (Kimia Farma) sachet - - - -
354 Garam Oralit (Kimia Farma) sachet - - - -
355 0 0 - - - -
356 Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined imperial) Botol 95 - - -
357 Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) Botol - - - -
358 Zinc Sulphate Tablet Dispersible 20 mg Tablet - - - -
359 Zinc Dispersible 20 mg tablet tablet - - - -
360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet 5,340 - - -
362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) Tablet - - - -
363 0 0 - - - -
0 OBAT PROGRAM HEPATITIS 0 - - - -
364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - 1 - -
367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) Pcs - - - -
0 OBAT PROGRAM TB PARU 0 - - - -
369 OAT FDC Kategori Anak Kit - - - -
370 OAT FDC Kategori Anak Kit - - 1 -
371 OAT FDC Kategori Anak Kit - - - -
372 OAT FDC Kategori I - IIII Kit - - - 10
373 OAT FDC Kategori I - IIII Kit - - - -
374 OAT FDC Kategori II Kit - - - -
375 OAT FDC Kategori II Kit - - - -
376 OAT FDC Kategori II Kit - - - -
377 OAT FDC Kombipak Kategori I Kit - - - -
378 0 0 - - - -
379 Isoniazid 100 mg tablet tablet - - - -
0 OBAT POGRAM KUSTA 0 - - - -
380 MDT MB Anak Blister - - - -
381 MDT MB Anak Blister - - - -
382 MDT MB Dewasa Blister - - - -
383 MDT MB Dewasa Blister - - - -
384 MDT MB Dewasa Blister - - 24 -
385 MDT PB Anak Blister - - - -
386 MDT PB Anak Blister - - - -
387 MDT PB Anak Blister - - - -
388 MDT MB Dewasa Blister - - - -
389 MDT PB Dewasa Blister - - - -
0 OBAT PROGRAM GIZI 0 - - - -
390 Mineral Mix Kombinasi sachet - - - -
391 Mineral Mix Kombinasi sachet - - - -
392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - - - -
393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) Kapsul - 3,350 - -
394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) 0 - - - -
395 Retinol Vit A 100.000 IU (Biru) Kapsul - 350 - -
396 Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
Retinol Vit A 100.000 IU (Biru) Kapsul - - - -
398 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet 2,090 53,000 - -
399 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) Tablet - - - -
400 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 0,4 Mg Tab (Phapros) tablet - - - -
401 0 0 - - - -
402 0 0 - - - -
0 OBAT PROGRAM KESGA 0 - - - -
403 Calcii Gluconas Inj (Ethica) Ampule - - - -
404 Magnesium Sulfat Inj.(iv) 40% Otsuka Vial 3 - - -
405 Magnesium Sulfat Inj.(iv) 40% Otsuka vial - - - -
406 Calcii Gluconas Inj 10% (Ethica) Ampule - - - -
407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule 52 - - -
408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) Ampule - - - -
410 Oksitetrasiklin 1 % Salep Mata Tablet - - - -
411 Metilergometrin Maleat Tablet 0,125 mg Tablet 760 - - -
412 Oksitosin Inj 10 UI/ml (Ethica) Ampule 65 - - -
413 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) Ampule - - - -
415 Oksitosin Inj 10 UI/ml (Ethica) Ampule - - - -
0 OBAT PROGRAM JIWA 0 - - - -
416 Amitriptilin 25 mg Tablet - - - -
417 Amitriptilin 25 mg Tablet - - - -
418 Amitriptilin 25 mg Tablet - - - -
419 Amitriptilin 25 mg Tablet 175 - - -
420 Amitriptilin 25 mg Tablet - - - -
421 Clozapine 25mg (OGB Dexa) Tablet - - - -
422 Clozapine 100 mg Tablet - - - -
423 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
424 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
425 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
426 Fenitoin Sodium 30 mg Kapsul (DECATONA) Kapsul - - - -
427 Flufenazin sikzonoate inj 25 mg/ ml Ampul - - - -
428 Flufenazin sikzonoate inj 5 ml vial - - - -
429 Flufenazin sikzonoate inj 5 ml Vial - - - -
430 Haloperidol 5 mg tablet Tablet - - - -
431 Haloperidol 5 mg tablet Tablet 400 - - -
432 Haloperidol 5 mg tablet Tablet - - - -
433 0 0 - - - -
434 Haloperidol Injeksi 5 mg/ml ampule - - - -
435 Haloperidol Injeksi 5 mg/ml (LODOMER) ampule - - - -
436 Haloperidol/ Lodomer drops 2 mg Botol - - - -
437 Karbamazepin Tablet 200 mg Tablet - - - -
438 Karbamazepin Tablet 200 mg Tablet - - - -
439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) Ampule - - - -
441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) Tablet 377 - - -
442 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
443 Klorpromazin Tab Salut 100 mg (HCl) Tablet - - - -
444 0 0 - - - -
445 Risperidon Tab 2 mg ( Dexa Medica ) Tablet - - - -
446 Risperidon Tab 2 mg (OGB Dexa) Tablet - - - -
447 Risperidon Tab 2 mg Tablet 340 - - 500
448 Risperidon Tab 2 mg Tablet - - - -
449 0 0 - - - -
450 Trifluoperazinehydrochloride 5 mg /Mersi Tablet - - - -
451 0 0 - - - -
452 Triheksifenidil Tablet 2 mg (Mersi) Tablet - - - 1,000
453 Triheksifenidil Tablet 2 mg Tablet 725 - - -
454 Triheksifenidil Tablet 2 mg (HEXYMER) Tablet - - - -
455 0 0 - - - -
456 Flufenazin/ Siksonat Injeksi 25mg/ ml ampul - - - -
457 0 0 - - - -
0 PROGRAM IMUNISASI (VAKSIN) 0 - - - -
458 BCG vial - 10 20 30
459 PELARUT BCG ampul - 10 20 30
460 BCG vial - - - -
461 BCG vial - - - -
462 CAMPAK 10ds (MR) vial - 50 50 20
463 PELARUT CAMPAK ampul - 50 50 20
464 CAMPAK 10ds (MR) vial - - - -
465 CAMPAK 10ds (MR) vial - - - -
466 DPT HB - Hib/ PENTABIO vial - 80 50 50
467 DPT HB - Hib/ PENTABIO vial - - - -
468 DT vial - - - -
469 0 0 - - - -
470 HB UNIJECT/ HB - ADS / HEPATITIS B vial - 50 50 -
471 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - -
472 POLIO bOPV 10 ds vial - 50 50 -
473 DROPPER POLIO dropper - 50 50 30
474 POLIO bOPV 10 ds vial - - - 30
475 POLIO bOPV 10 ds vial - - - -
476 Td vial - - - -
477 0 0 - - - -
478 HB UNIJECT/ HB - ADS / HEPATITIS B vial - - - -
479 POLIO bOPV 10 ds vial - - - -
480 Vaksin Meningtis vial - - - -
481 CAMPAK 10ds (MR) BIAS vial - - - -
482 PELARUT CAMPAK BIAS ampul - - - -
483 POLIO bOPV 10 ds vial - - - -
484 IPV vial - - - -
485 VTM Include Dacron (Biofarma) pcs - - - -
486 Vaksin Rabies (Verorab) vial - - - -
487 0 0 - - - -
488 0 0 - - - -
489 0 0 - - - -
0 OBAT PROGRAM HIV/ AIDS 0 - - - -
490 Azitromicyn 500 mg + Cefixime 200 mg Tablet - - - -
491 0 0 - - - -
492 Isoniazid (INH) Tablet 300 mg Tablet 300 - - -
493 0 0 - - - -
494 Lamivudine 150 mg Tablet - - - -
495 Lamivudine 150 mg Tablet - - - -
496 Nevirapine 200 mg Tablet - - - -
497 Nevirapine 200 mg Tablet - - - -
498 Piridoksin HCl (Vit.B6) Tablet 25 mg Tablet - - - -
499 0 0 - - - -
500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
501 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
502 Tenofovir 300 mg Tablet - - - -
503 Tenofovir 300 mg Tablet - - - -
504 Zidofudine 100 mg (ZDV) Tablet - - - -
505 Zidofudine 100 mg (ZDV) Tablet - - - -
506 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
507 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
508 Efavirenz 600 mg tablet tablet - - - -
509 Efavirenz 600 mg tablet tablet - - - -
510 Zidofudine 300 mg + Lamifudine 150 mg Tablet - - - -
511 Abacavir (ABC) 300mg Tablet - - - -
512 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Triple FDC Dewasa Tablet - - - -
513 0 0 - - - -
514 MB Anak blister - - - -
515 0 0 - - - -
516 0 0 - - - -
517 0 0 - - - -
518 0 0 - - - -
519 0 0 - - - -
520 0 0 - - - -
521 0 0 - - - -
522 0 0 - - - -
523 0 0 - - - -
524 0 0 - - - -
525 0 0 - - - -
526 0 0 - - - -
527 0 0 - - - -
528 0 0 - - - -
529 0 0 - - - -
0 BMHP 0 - - - -
530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs - - - -
531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipro) Pcs 444 - - -
532 0 0 - - - -
533 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs 1,347 - 2,000 -
534 Alat Suntik Sekali Pakai .3 cc (TERUMO) Pcs - - - -
535 Alat Suntik Sekali Pakai .3 cc (NIPRO) Pcs - - - -
536 Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs - - - -
537 Alat Suntik Sekali Pakai .5 ml (Win) Pcs - - - -
538 Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs - - - -
539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Box@12pcs - - - -
540 Alat Suntik Sekali Pakai 20 ml Pcs 6 - - -
541 Alkohol 70% Medika (Kimia Farma) 0 - - - -
542 Alkohol 70% (Medika) Btl 1000 ml 16 - - -
543 Alkohol Swab 2 - ply (one med) 0 - - - -
544 Alkohol Swab 2 - ply (one med) Pcs 400 - - -
545 Antiseptic Hand Scrub 0,5 % (Medicare) Botol - - - 1
546 Askina Sorb 10X 10 Cm (B-Braun ) Pcs - - - -
547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II Pcs - - - -
548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I Pcs 109 - - -
549 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I 0 - - - -
550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda Pcs - - - -
551 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / Phsda 0 - - - -
552 Dual Enzymatic Detergen Galon 5 liter (STERYZIME) Pcs - - - -
553 Ethylcloride Spray 100 ml (Roeko Endo Frost) Pcs 9 - - -
554 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs 300 - - -
555 Film IV Dressing 6 X 7S (Id67S) E - Care Pcs - - - -
556 Fixomull Strech 5 cm X 5 m Pcs - - - -
557 Foley Catheter 2 Way Ch 16,18 (Norta) Pcs 46 - - -
558 Foley Catheter 2 Way Ch 16,18 Pcs - - - -
559 Gown Non Woven Onemed (Baju Habis Pakai) Pcs - - - -
560 I.V Cannula No. 26 G Polywin (Polymed) Pcs - - - -
561 Mantel Gown (Bisa Dicuci) biji - - - -
562 I.V Catheter No. 18 (JELCO) Pcs 129 - - -
563 I.V Catheter No. 18 (NIPRO) Pcs - - - -
564 I.V Catheter No. 20 JELCO Pcs - - - -
565 I.V Catheter No. 20 TERUMO Pcs 147 - - -
566 I.V Catheter No. 20 JELCO Pcs - - - -
567 I.V Catheter No. 22 NIPRO Pcs 156 - - -
568 I.V Catheter No. 22 NIPRO Pcs - - - -
569 I.V Catheter No. 24 TERUMO Pcs 135 - - -
570 I.V Catheter No. 24 TERUMO 0 - - - -
571 Infusion Set Anak 60 Drops /(Otsuka) Pcs 112 - - -
572 Infusion Set Anak 60 Drops /(Otsuka) Pcs - - - -
573 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 203 - - -
574 Infusion Set Dewasa 20 Drops/ (OTSUKA) Pcs - - 500 -
575 Kantong Plastik Bio Hazart (Bahan Plastik PE, Panjang 80 Cm, Lebar 60 Cm, Tebal 0,33 Mm) Pcs - - - -
576 Kapas Pembalut Hydrofil 250 gr Pcs 1 - - -
577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) Pcs 14 - - -
578 Kapas Pembalut Hydrofil 250 gr (One Med) 0 - - - -
579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm Pcs 7 - - -
580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) Pcs 3 - - -
581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 0 - - - -
582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) Pcs 9 - - -
583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs 68 - - -
584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 0 - - - -
585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) Pcs 222 - - -
586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) Pcs - - - -
587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) 0 - - - -
588 Masker Ear Loop (Masker) Pcs 602 - - -
589 Masker Ear Loop Jilbab (Golden Gloves) Pcs - - - -
590 Masker General Care (MARCOTILA) Pcs - - - -
591 0 0 - - - -
592 Masker N95 Disposibel Pcs 35 - - -
593 Masker N95 Disposibel (One Med) Pcs - - - -
594 Masker Tali Pcs - - - -
595 Masker Tali Pcs - - - -
596 Masker Elastic Pcs - - - -
597 Media Sample Container Pcs - - - -
598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) Pcs - - - -
599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) Pcs - - - -
600 Norinse Antimicrobial 500 ml (Viorex) Pcs - - - -
601 Nurse Cup (Tutup Kepala) Pcs 90 - - -
602 Oxygen Mask Elongated Adult (Remedi) Pcs - - - -
603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) Pcs - - - -
604 Plesterin Bulat Non Woven (One Med) Pcs - - - -
605 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs 26 - - -
606 Polifix 5Cm X 1 Cm ( Sna Medika) Pcs - - - -
607 Povidon Iodine 10% (300 ml) ( One Med) Pcs - - - -
608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) 0 - - - -
609 Povidon Iodine 10% (60 ml) ( One Med) Pcs 14 - - -
610 0 0 - - - -
611 Prontosan Wound Gel X 50 Gram( B-Braun ) Tube - - - -
612 Sarung Tangan Non Steril No M Dan L (ANSELL) Pair - - - -
613 0 0 - - - -
614 Sarung Tangan Non Steril No S Dan M (MMP MAS) Pair 500 - - -
615 Sarung Tangan Non Steril No S Dan M (Win Glove) Pair - - - -
616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) Pair 33 - - -
617 Sarung Tangan size M dan L (Exam Glove) PAir - - - -
618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 600 - - -
619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) Pair - - - -
620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech Pcs 72 - - -
621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech Pcs - - - -
622 0 0 - - - -
623 Surface Disinfectant 500 ml (Stericide ) Pcs - - - -
624 Surface Disinfectant Galon 5 Liter (Stericide ) Pcs - - - 2
625 Underpad 90x 0 cm cosmo I Pcs - - - -
626 Underpad 90x 0 cm cosmo II Pcs - - - -
627 0 0 - - - -
628 Urine Bag Sterile Standard Pcs 21 - - -
629 Urine Bag Sterile Standard (AXIMED) Pcs - - - -
630 0 0 - - - -
631 Umbilical Cord Clamp ( Hospitech ) Pcs - - - -
0 REAGEN 0 - - - -
632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) Pcs - - - -
633 Accu- Check Performa Tes Strip ( Roche ) pcs - - - -
634 Accu- Check Safe-T-Pro Uno (Roche) Pcs 1,000 - - -
635 Accu- Check Performa Tes Strip ( Roche ) Pcs - - - -
636 Antimonoclonal A (Anti A) 10 ml Btl - - - -
637 Antimonoclonal AB (Anti AB) 10 ml Btl - - - -
638 Antimonoclonal B (Anti B) 10 ml Btl - - - -
639 0 0 - - - -
640 Cholesterol Test Strip (Human Humasens Plus) Tes - - - -
641 Cholesterol Test Strip (Human Humasens Plus) 0 - - - -
642 Family DR HB Hemoglobin Test Meter (Alat) Pcs - - - -
643 Family DR HB Hemoglobin Test Trip MHS 2 Tes - - - -
644 Glucose Test Strip (Human Humasens plus) Tes - - - -
645 Glucose Test Strip (Human Humasens plus) II Tes - - - -
646 Hemoglobin Strip 50 test mission (Acon) Pcs - - 6 -
647 Hemoglobin Strip 50 test mission (Acon) 0 - - - -
648 Reagen Hb (HCl 0,1 N) 100ml Btl - - - -
649 0 0 - - - -
650 Reagen HBsAg Strip (FOKUS) Test - - - -
651 0 0 - - - -
652 TPHA (Fokus) Test - - - -
653 0 0 - - - -
654 Uric Acid Test Strip 2.0 (Human Humasens plus) Tes - - - -
655 Uric Acid Test Strip 2.0 (Human Humasens plus) 0 - - - -
0 BMHP (PROGRAM) PROPINSI 0 - - - -
0 PROGRAM MALARIA 0 - - - -
656 RDT Malaria Test - - - -
0 PROGRAM SYPHILIS 0 - - - -
657 RPR Syphilis Pcs - - - -
658 RPR Syphilis tahap II (FOKUS) Pcs - - - -
659 Syphilis 3.0 06FK10 SD Bioline Test - - - -
Test
660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - 200 -
Test
661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - - - -
662 0 0 - - - -
663 Tuberkulin Vial - - - -
664 RDT Lepto (Uji Leptospira IgM) test - - - -
665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) test - - - -
666 0 0 - - - -
667 0 0 - - - -
0 PROGRAM HEPATITIS 0 - - - -
Rapid Test Anti Hepatitis C (HCV)
668 Test - - - -
669 Reagen HBsAg Strip SD Test - - 200 -
670 Reagen HBsAg Strip SD Test - - - -
671 Reagen HBsAg Strip SD Test - - - -
672 0 0 - - - -
673 0 0 - - - -
674 0 0 - - - -
675 0 0 - - - -
0 PROGRAM TB PARU 0 - - - -
676 Box Slide Pcs - - - -
677 Box Slide Pcs - - - -
678 Catridge Genexpart Test - - - -
679 Catridge Genexpart Test - - - -
680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) Test - - - -
681 Oil Emersi Botol - - - -
682 Pot Spuntum/Pot Dahak Steril Pcs - - - -
683 Pot Spuntum/Pot Dahak Steril Pcs - - - -
684 Pot Spuntum/Pot Dahak Steril Pcs - - 200 -
685 Pot Spuntum/Pot Dahak Steril Pcs - - - -
686 Reagen Control CD4 0 - - - -
687 Reagen Control CD4 0 - - - -
688 Reagen Zeil Nelseen Kit - - 5 -
689 Reagen Zeil Nelseen Kit - - - -
690 Reagen Zeil Nelseen Kit - - 5 -
691 Reagen Zeil Nelseen Kit - - - -
692 Slide Pcs - - - -
693 Slide/ Object Glass Pcs - - - -
694 Stereofoam pcs - - - -
695 Masker N 95 TB pcs - - - -
696 Masker Tali Bedah TB pcs - - - -
0 OBAT PROGRAM IMUNISASI 0 - - - -
697 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - 500 -
700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT Pcs - - - -
702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT Pcs - - - -
703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT Pcs - - - -
705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA Pcs - - - -
708 0 0 - - - -
709 0 0 - - - -
710 0 0 - - - -
711 Alat Suntik Sekali Pakai 5 ml (SKIFA) Pcs 500 - - -
712 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
713 Alat Suntik Sekali Pakai 5 ml One Ject Pcs - - - -
714 0 0 - - - -
715 Safety Box 5 L Pcs - - - -
716 Alat Suntik Sekali Pakai 0,05 ml Pcs - - - -
717 0 0 - - - -
718 0 0 - - - -
719 0 0 - - - -
720 0 0 - - - -
0 PROGRAM HIV/ AIDS 0 - - - -
721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Tahap I Test - - - -
722 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Reagen R3 0 - - - -
723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test - - - -
724 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) (Reagen R2) 0 - - - -
725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) Tahap I Test - - - -
726 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I 0 - - - -
727 Kondom Pcs - - 288 144
728 DBS Collection/ Lasec Pcs - - - -
729 Lubricant Pcs - - 20 20
730 0 0 - - - -
731 Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap I Test - - 200 -
732 Rapid HIV 1/2 3.0 SD Bioline test - - - -
733 Reagen HIV (FOKUS) R 2 Test - - - -
734 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V2 Tahap I Test - - - -
735 Reagen HIV (SD) R 1 Test - - - -
736 Reagen HIV (SD) R 1 Test - - - -
737 0 0 - - - -
738 Reagen HIV (VIKIA) R 3 Test - - - -
739 0 0 - - - -
740 Reagen HIV R2 (Rapid Test) FOKUS Test - - - -
741 0 0 - - - -
742 Reagen HIV R3 (VIKIA) Test - - - -
743 Reagen HIV R3 /DS HIV DIAGNOSTAR Test - - - -
744 Sarung Tangan Non Steril Pair - - - -
745 0 0 - - - -
746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) Paket - - - -
747 VTM Include Swab Test - - - -
748 Masker Bedah 3 ply Pcs - - - -
749 0 0 - - - -
750 0 0 - - - -
751 0 0 - - - -
752 0 0 - - - -
753 0 0 - - - -
754 0 0 - - - -
755 0 0 - - - -
756 0 0 - - - -
757 0 0 - - - -
758 0 0 - - - -
759 0 0 - - - -
760 0 0 - - - -
761 0 0 - - - -
762 0 0 - - - -
763 0 0 - - - -
764 0 0 - - - -
0 OKSIGEN MEDICAL 0 - - - -
765 Oksigen 3 m3 Tampon - - - -
766 Oksigen 6 m3 Tampon - - - -
767 Oksigen 1 m3 Tampon - - - -
768 Oksigen 6 m3 Tampon - - - -
769 Nurse Cup (Tutup Kepala) One Med 0 - - - -
770 0 0 - - - -
771 0 0 - - - -
772 Propilitourasil/ PTU 100 mg (Dexa Medica) tablet - - - -
0 TAMBAHAN IFK 0 - - - -
1 Simvastatin Tablet 10 mg (Yarindo Farmatama) Tablet - - - -
2 Depakote Valproat Tab 250 mg ( (Abbott ) Tablet - - - -
3 Ranitidin Tablet 150 mg Tablet - - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg
4 Tablet - - - -
5 Thiamphenicol Syr. 0 - - - -
6 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet tablet - - - -
7 Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs - - - -
8 Ranitidin Injeksi 25 mg/ 2 ml Ampule - - - -
9 Isosorbid Dinitrat Tab Sublingual 5 mg Tablet - - - -
10 Ketokonazole 200 mg Tablet - - - -
11 Kotrimoksazol Forte Tablet - - - -
12 Infusion set anak Pcs - - - 50
13 Alat Suntik 10 cc Pcs - - - -
14 Eritrosmisin Stearate Kaplet 500 mg Tablet - - - -
15 Omeprazole Kapsul 20 mg Tablet - - - -
16 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) Botol - - - -
17 Setirizin Tab 10 mg (Futamed) Tablet - - - -
18 Siprofloksasin Tablet 500 mg (Novapharin) Tablet - - - -
19 Oseltamivir 75 mg Kapsul - - - -
20 Ringer Laktat cairan infus @ 500 ml RL Botol - - - -
21 Amitriptilin 25 mg Tablet - - - -
22 I.V Catheter No. 24 TERUMO pcs - - - -
23 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) 0 - - - -
24 RDT COVID - 19 0 - - - -
25 Oseltamivir 75 mg 0 - - - -
26 Klorokuin 150 mg tablet 0 - - - -
27 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 - - - -
28 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For Viruses) 0 - - - -
29 Masker N95 (Particulate Respirator) 0 - - - -
30 Hazmat/ APD/ Hazmat PPK 0 - - - -
31 Medical Sample Container Pcs - - - -
32 Cepheid Pcs - - - -
33 Natrium Klorida Larutan infus 0,9% @100ml 0 - - - -
34 Tambah Darah drop (Ferriz Drop) pcs - - - -
35 Tambah Darah Sirup (Ferriz Sirup) pcs - - - -
36 Gentamycin Krim 1 % mg/ ml Gentalex Tube - - - -
37 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL Botol - - - -
38 Obat Batuk Sirup / INADRYL Botol - - - -
39 Obat Batuk Expektoran Sirup Botol - - - -
40 Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Phenylpropanolamine HCl chlorpheniramine maleate, dextromethorpan Hbr
Tablet - - - -
41 Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombinasi Influenza Tablet - - - -
42 Masker Bedah /Bima Sakti pCS - - - -
43 Masker Bedah /Rania pCS - - - -
44 Masker N 95 Bima Sakti PCS - - - -
45 Sarung tangan panjang steril / meditouche perpasang 0 - - - -
46 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) PCS - - - -
47 Albendazol Suspensi 200mg/ 5 ml botol - - - -
48 I.V Catheter No. 24 (BRAUN) pcs - - - -
49 OAT FDC Kategori Anak 0 - - - -
50 Handsanitizer Medicare 0,5% (5 liter) KF 0 - - - -
51 Apron Lengan Panjang Putih (Rannia) 0 - - - -
Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) Pcs - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
APD Set (Rannia) 0 - - - -
Cover All Disposible (Baju sekali pakai) (Rannia) 0 - - - -
Cover All Re Use (Baju bisa di pakai lagi /dicuci) Rannia 0 - - - -
Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Karya Mitra Bersama) 0 - - - -
Helm visor (Usaha Karya Mitra Bersama) 0 - - - -
Kaca mata Goggle (Usaha Karya Mitra Bersama) 0 - - - -
Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) 0 - - - -
Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) 0 - - - -
Sarung tangan non steril M,L (COBRA) box @100 pcs - - - -
Masker N95 Covid 19 Pcs - - - -
Masker Tali Bedah 3 ply Covid 19 Pcs - - - -
Masker Eaerlop Hijab Pcs - - - -
Etanol 96 % (Alkohol 1) Botol = 20 Liter - - - -
Hand Sanitzer 1 Botol = 20 Liter - - - -
MC Bleach Liquid 20 Liter (RAJAWALI) Botol = 20 Liter - - - -
Cover All Disposable solida size XL, XXL (RAJAWALI) Pcs - - - -
KIT A1 Operasi Steril (RAJAWALI) Pcs - - - -
Mantel Gown APD 1 (Usaha Karya Mitra Bersama) Pcs - - - -
Sepatu Boots APD (Usaha Karya Mitra Bersama) Pair - - - -
Masker Face/ Masker Bedah (COBRA 1) pcs - - - -
Masker Elastis Hijau 3 ply (RAJAWALI) Pcs - - - -
Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) Botol - - - -
Masker Face/ Masker Bedah (COBRA 2) pcs - - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) box @40 test - - - -
Masker KN95 (Farmahusada) Box @50 pcs - - - -
Masker Bedah (Sensi/ Farmahusada) Box @40 pcs - - - -
Rapid Test SARS COV 2 (Farmahusada) Test - - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) test - - - -
Masker KN95 (Anugrah Sentosa Abadi) pcs - - - -
APRON (Atmosfer) pcs - - - -
Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) TEst - - - -
Hand Sanitzer 2 liter - - - -
Virus Transport Media Corich (VTM)/ Setia Andalan Sukses pcs - - - -
Mantel Gown APD 2 (Usaha Karya Mitra Bersama) pcs - - - -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 pcs - - - -
Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 pcs - - - -
Face Shield (COBRA) 0 - - - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Kit Steril (Rajawali) 0 - - - -
Alkohol II @20 Liter 0 - - - -
Cover All (Rajawali) 0 - - - -
Face Shield (ATMOSFER) 0 - - - -
Jirigen Putih 20 Liter (Usaha Karya) 0 - - - -
Masker Earloop (KasaHusada) 0 - - - -
MC Bleach Liquid 20 Liter (RAJAWALI) 0 - - - -
Rapid Test Covid-19 (Rajawali) 0 - - - -
Rapid Test Covid-19 (Dakonan) 0 - - - -
Alkohol Swab (BTT) 0 - - - -
Antiseptic Gel 500 0 - - - -
Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFORT) 0 - - - -
Kaca mata Goggle (HASTEN) 0 - - - -
Mantel Gown APD (Usaha Karya Mitra Bersama) 0 - - - -
Masker Bedah Hijau @50pcs 0 - - - -
Masker N95 3M 8210 (Hazten) 0 - - - -
Nurse Cap Green om 100bh 0 - - - -
Parafilm (Anugerah Sentosa Abadi) 0 - - - -
Rapid Test (1.000) Widhi Dharma Adi 0 - - - -
Sarung tangan Safeglove Exam M 100bh 0 - - - -
Sarung tangan Safeglove Surgical size 7 dan 7,5 0 - - - -
Sterlisasi Swab stik (5box/ VTM) 0 - - - -
Stereofoam (Anugerah Sentosa Abadi) 0 - - - -
Universal Transport Media (UTM) Goongdong 0 - - - -
Universal Transport Media (UTM) Sekarguna 0 - - - -
Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi 0 - - - -
Infusion Set Dewasa 20 Drops/ (OTSUKA) 0 - - - -
Infusion Set Anak 60 Drops /(Otsuka) 0 - - - -
Rapid Test Accu Tell (PT Marcotila Medica) 0 - - - -
Rapid Test Lecurate (Bima Sakti) 0 - - - -
Rapid Test ZYBIO (Farma Husada) 0 - - - -
Alkohol 96 % Liter - - - -
0 0 - - - -
0 0 - - - -
TAMBAHAN PUSKESMAS 0 - - - -
Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 0 9 - - -
Asam Tranexamat 100 mg/@5 ml Injeksi Ampul 3 - - -
Asiklovir 5% 5gr Cream Tube 44 - - -
Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astra Zeneca) pcs 4 - - -
0 0 - - - -
Deksamethason Inj iv/ im 5 mg/ ml (Mepro) Ampule 14 - - -
Furosemide Tablet 40 mg (Kimia Farma ) Tablet 608 - - -
Gentamycin Krim 1 % mg/ ml Tube 10 - - -
0 0 - - - -
Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) Ampule 3 - - -
Ketokonazol Tablet 200 mg (Novapharin) I Tablet 20 - - -
Meloxicam Tab 15 mg (Bernofarm ) Tablet 5 - - -
Metamizol 500 mg + Diazepam 2 mg / METANEURON Tablet 344 - - -
Piridoksin HCl (Vit.B6)Tablet 10 mg Tablet 293 - - -
Thiamin/ Vitamin B1 50 mg Tablet 50 - - -
Thiamphenicol / Thiamfilex Kapsul 500 mg Kapsul 330 - - -
Alat Suntik Sekali Pakai 10 ml (NIPRO) Pcs 55 - - -
Antimicrobial Liquid Soap 500 ml (Viorex) 0 13 - - -
Hand Sanitizer 450 ml (Meditol) 0 13 - - -
Infusion Set Dewasa 20 Drops/ (Kimsmed) Pcs 39 - - -
I.V Catheter No. 18 (JELCO) Pcs 1 - - -
I.V Catheter No. 22 NIPRO Pcs 4 - - -
I.V Catheter No. 24 TERUMO Pcs 9 - - -
Materniti Napkin Slim L 0 1 - - -
Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) Roll 11 - - -
Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) Pair 5 - - -
Surface Disinfectant Galon 5 Liter (Stericide ) Pcs 1 - - -
Sterizyme Dual Enymatic Detergent 5 Ltr 0 2 - - -
Haloperidol 5 mg tablet Tablet 148 - - -
Alat Suntik Sekali Pakai .5 ml (NIPRO) Pcs 82 - - -
Fixomull Strech 5 cm X 5 m Pcs 17 - - -
Umbilical crd clamp 0 233 - - -
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 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
0 0 - - - -
TOTAL
 REKAP LAPORAN PERSEDIAAN BAHAN OBAT - OBATAN (ASET) 1 TAHUN
PUSKESMAS ............................................TAHUN 2019

PENERIMAAN
TOTAL
April Mei Juni Juli Agust Sept Okt Nov Des Jan
PENERIMAAN

- - - - - - - - - - -
- 500 - - - - - - - 600 119
- - - - - 300 - 700 - 1,000 -
- - - - - - - - - - -
- - - - - - - - - - 35
- 240 - - - - - - - 240 -
- - - - - - - - - - -
- 800 - - - - - - - 800 333
- - - - - - - - - - -
- 2,000 - - - - - - - 2,000 172
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - 337
- 3,000 - - - 1,200 - - - 4,200 -
- - - - - - - - - - -
- 35,000 - - - - - - - 35,000 -
- - - - - - - - - - -
- - - - - - - - - - 90
- - - - - - - - - - -
- - - - - - - - - - -
- 300 - - - - - 100 - 400 148
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - 186
- - 300 - - - - - - 300 -
- - - - - - - - - - -
- 50 - - - - - - - 50 7
- - - - - - - - - - -
- - - - - - - - - - 44
- - - - - - - - - - -
- 8,000 - - - - - - - 11,000 4,568
- - - - - 10,000 - - - 10,000 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- 24 - - - - - - - 24 -
- - - - - - - - - - -
- - - - - 30 - - - 30 50
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- 5,000 - - - - - - - 5,000 1,326
- - - - - 4,000 - - - 4,000 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - 3,000 - 3,000 -
- - - - - - - - - - -
- - - - - - - 20 - 20 10
- - - - - - - - - - -
- 200 - - - - - - - 200 64
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- 300 - - - - - - - 300 75
- - - - - - - 100 - 100 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - 583
- - - - - - - - - - -
- 2,000 - - - - - - - 2,000 -
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- - - - - - - - - - -
- - 300 - - - - - 60 360 -
- - - - - - - - - 200 -
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- - - - - - - - - - -
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- - - - - - - - - - -
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- - - 360 - - - - - 360 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - 1,500 - - - - - 1,500 -
- - - - - - - - - - -
- - - - - - - - - - -
- - 1 - - - - - - 1 -
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- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - 3,400 - 3,400 -
- - - - - - - - - - -
- - - - - - - 20 - 20 -
- - - - - 25 - 20 - 45 -
- - - - - 6,000 - - - 6,000 -
- - - - 300 - - - - 300 -
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5 - - - - - - - - 5 -
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5 5 - - - - - - - 10 -
- - - - - - - - - - -
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- - - - - - - - - - -
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- - - - - - - - - - -
- - - - - - - - - - -
2,000 - - - - - - - - 2,000 -
1 - - - - - - - - 1 -
1 1 - - - - - - - 2 -
1 - - - - - - - - 1 -
20 - - 9 - - - - - 29 -
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5 - - - - - - - - 5 -
3 - - - - - - - - 3 -
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- - - - - - - - - - -
- - - - - - - - - - -
- - 1,200 - - - - - - 1,200 -
- - - - - - - - - - -
- 40 - - - - - - - 40 -
- - - 1,200 - - - - - 1,200 -
- 25 - - - - - - - 25 -
- - - - - - - - - - -
- - - - - - - - - - -
- 200 - - - - - - - 200 -
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- - - - - - - - - - -
- - - - - - - - - - -
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- - - - - - - - - - -
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- - - - - - - - - - -
- - - 4 - - - - - 4 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - 1,700 3,400 - - - 5,100 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - 5,400 - - - - - - 5,400 -
- - - 5 - - - - - 5 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - 10 - - - - - 10 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - 3,000 3,000 - - - - 6,000 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
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- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - 20 - - - 20 -
- - - - - - 50 - - 50 -
- - - - 20 - - - - 20 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - 9
- - - - - - - - - - 3
- - - - - - - - - - 15
- - - - - - - - - - 4
- - - - - - - - - - -
- - - - - - - - - - 14
- - - - - - - - - - -
- - - - - - - - - - 10
- - - - - - - - - - -
- - - - - - - - - - 1
- - - - - - - - - - 10
- - - - - - - - - - 5
- - - - - - - - - - 10
- - - - - - - - - - 293
- - - - - - - - - - 50
- - - - - - - - - - 330
- - - - - - - - - - 2
- - - - - - - - - - 2
- - - - - - - - - - 2
- - - - - - - - - - 39
- - - - - - - - - - 1
- - - - - - - - - - 4
- - - - - - - - - - 9
- - - - - - - - - - 1
- - - - - - - - - - 11
- - - - - - - - - - 5
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - 130
- - - - - - - - - - 82
- - - - - - - - - - 11
- - - - - - - - - - 9
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
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- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
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- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
(ASET) 1 TAHUN
2019

PEMAKAIAN

Feb Mar April Mei Juni Juli Agust Sept Okt Nov Des

- - - - - - - - - - -
100 10 - 50 445 5 - - - - -
- - - - - - - - 240 266 386
- - - - - - - - - - -
12 12 - 21 - - - - - - -
- - - 60 - 33 16 - - - -
- - - - - - - - - - -
58 109 133 134 - 43 69 - 110 160 186
- - - - - - - - - - -
184 284 321 - - 21 10 - - - 551
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
348 66 - - - - - - - - -
- - - 12 264 691 263 - 710 688 630
- - - - - - - - - - -
- - - 1,112 3,880 5,521 2,828 - 4,210 4,650 4,369
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
38 29 1 - 36 78 36 - 46 66 56
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
62 315 14 - - - - - - - -
- - - - 9 23 65 - 48 64 41
- - - - - - - - - - -
80 - - - - - 50 - - - -
- - - - - - - - - - -
3 - - - - - - - - - -
- - - - - - - - - - -
1,356 1,060 1,530 1,726 3,538 2,909 277 - 50 - -
- - - - - - - - 2,480 2,610 2,578
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
40 60 60 140 220 - - - 15 5 10
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
991 306 182 139 1,893 1,215 236 - 1,517 - -
- - - - - - - - 130 1,440 1,647
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - 430 874
- - - - - - - - - - -
- 1 1 1 4 - - - - - -
- - - - - - - - - - -
8 80 78 - 60 37 25 - 18 24 48
- - - - - - - - - - -
- - 18 2 5 9 4 - 11 13 11
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
28 6 142 70 60 - 54 - 40 50 56
- - - - - - - - - - 3
- - - - - - - - - - -
- - - - - - - - - - -
86 - - - - - - - - - -
262 955 290 308 185 - - - - - -
- - - - 325 - - - 122 90 63
18 39 - - - - - - - - -
- - - - - - - - - - -
36 5 16 - - - - - - - -
27 44 26 - - - - - - - -
- - - 45 52 86 17 - 72 58 42
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
 - - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
20 - - - 170 425 220 - 185 - -
- - - - - - - - 51 340 316
- - - - - - - - - - -
1 - - 5 6 8 - - 4 2 -
- - - - - - - - - - -
- - - - - - - - - - -
40 17 - 14 24 17 - - - - -
- - - - - 26 12 - 36 49 31
759 597 731 566 584 761 216 - 102 - -
- - - - - - - - 456 580 493
- 3 2 1 - - - - - - -
- - - - - - - - - - -
50 50 41 35 24 78 21 - 92 122 63
- - - - - - - - - - -
10 92 39 15 - 119 42 - - - -
- - - - - - - - 30 26 15
- - - - - - - - - - -
- - - 30 - 659 298 - 320 276 182
8 - 50 - - - - - - - -
- - - - - - - - - - -
21 34 7 - - - - - - - -
- - - - - - - - - - -
33 297 157 176 - 120 - - 186 110 -
- - - - - - - - - - -
- - - - - - - - - - -
2 - - 31 - 15 4 - 4 2 -
- - - - - - - - - 7 2
- - - - - - - - - - -
- - - - - - 40 - 70 45 24
- - - - - - - - - - -
- - - - - - - - - - -
- - 3 - - - - - - - -
78 134 147 120 - - - - - - -
- - - 27 - 39 1 - 24 16 12
- - - - - - - - - - -
40 10 92 15 - 52 - - 32 - 10
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
15 32 5 - - - - - - - -
 - - - 80 - - - - 32 23 15
10 3 6 - - - - - - - -
- - - - - - - - - 13 6
34 12 27 8 - 33 2 - 18 3 -
700 683 614 294 - 976 419 - 935 822 630
- - - - - - - - - - -
2,036 1,989 590 - - - - - - - -
- - - 985 - 2,260 945 - 1,444 1,290 876
120 101 13 6 - 12 - - 108 - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - 12 28 - - - -
- - - - - - - - - - -
166 115 - 903 - 240 91 - 230 180 143
- - - - - - - - - - -
- - - - - - - - - - -
32 - 3 - - 68 12 - 56 43 28
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - 28 - - 23 - 84 72 39
262 20 20 100 - 7,336 503 - 3,346 2,880 2,155
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
9 23 13 - - 37 27 - - - -
- 2 22 - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - 8 10 - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
968 933 440 1,540 - 2,917 616 - 2,363 564 -
- - - - - - - - - 1,964 1,327
- - - - - - - - - - -
1,587 1,239 2,281 - - 3,723 266 - 1,217 - -
- - - - - - - - 220 1,190 988
5 8 2 5 - - - - - - -
- - - 4 - 17 3 - 8 7 3
 - - 30 - - 10 - - - - 19
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
10 11 17 71 - 94 15 - 105 46 -
- - - - - - - - - - -
- - - - - - - - - - -
17 1 1 - - - - - - - -
17 19 8 - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
2,316 1,232 1,764 2,830 - 2,217 172 - 1,746 1,650 1,244
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
633 143 - 62 - 380 180 - - - -
- - - - - - - - 648 540 368
- - - - - - - - - - -
- - - - - 60 5 - 21 17 11
1 6 3 2 - 12 - - 4 1 1
- 3 - - - 6 1 - 7 5 1
- - - - - - - - - - 2
- - - - - - - - - - -
10 - 2 10 - 45 4 - - - -
- - - - - - - - - - -
- - - - - - - - - - -
93 85 31 70 - 302 41 - 112 121 82
- - - - - - - - - - -
12 18 44 - - 48 18 - 66 46 -
- - - - - - - - - - -
- 10 34 - - 14 - - 6 - -
- - - - - - - - - - -
120 60 - - - - - - 360 - -
- - - - - - - - 180 - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
380 357 253 290 - 127 - - - - -
- - - - - - 164 - 323 132 91
343 249 414 27 - 362 111 - - - -
- - - - - - 155 - 305 235 202
- 110 41 109 - 17 20 - 96 67 -
- - - - - - - - - - -
200 153 8 - - - - - - - -
- - - - - - - - - - -
 - - - - - - - - - - -
20 - - - - - - - - - -
- - - - - - 86 - 524 408 340
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - 120 - - - - - - -
- 90 30 - - 480 30 - 240 120 -
- - - - - - - - - - -
52 33 2 5 - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
22 96 50 32 - 58 4 - - - -
- - - - - - - - 44 32 24
- - - - - - - - - - -
380 294 - - - - - - - - -
- - - - - - - - - - -
- - - - - 21,602 540 - 3,158 - -
- - - - - - - - - - -
431 443 297 239 - 390 163 - 84 23 -
- - - - - - - - - 37 44
- 4 27 - - - - - - - -
- - - - - 36 58 - - 45 -
83 328 173 218 - 70 - - - - -
- - - - - - - - - - -
- 3 2 - - - - - - - -
- 4 9 - - - 11 - - - -
- 9 3 11 - 7 - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
16 33 - - - - - - - - -
- - - - - - - - - - -
182 51 - 600 - - - - - - -
12 - - - - 164 54 - 15 10 5
- - - - - - - - - - -
6 - - - - - - - - - -
- - - - - - - - - - -
692 694 438 - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - 193 59 - 125 110 94
4,209 551 198 72 - 1,000 - - - - -
- 3,146 1,854 - - - - - - - -
- - - - - - - - - - -
1 3 - 1 - 2 - - 15 17 -
10 8 - 3 - 33 7 - 21 17 19
- - - - - - - - - - -
26 22 116 30 - 50 12 - - 40 22
- - - - - - 1,280 - 4,438 3,890 3,460
5 9 7 10 - 19 - - - 8 3
- - - - - - - - 1,102 184 -
1,070 1,018 946 608 - 951 387 - - 910 836
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
1,644 1,843 791 806 - 2,413 287 - 1,580 1,226 1,014
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - 81 87 - 243 189 -
- - - - - - - - - 36 103
- - 302 362 - 1,245 346 - 606 498 406
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - 8 92 - - - -
684 128 21 - - - - - - - -
- 82 1,318 280 - 320 - - - - -
- - - - - - - - - - -
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- - - - - - - - - - -
- - - - - - - - - - -
- - - - - 3,000 - - 2,000 1,000 -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - 22 3
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - 10 5
- - - - - - - - - - -
- - - - - - - - 9 4 3
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
4 12 13 - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
29 - 27 - - 147 61 - 30 42 75
- - - - - - - - - - -
- - - - - - - - - - -
- 1 1 - - - - - - - -
- - 10 - - - - - - - -
- - - - - - - - - - -
- 10 24 - - 52 10 - 24 18 26
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- 53 - - - - - - - - -
2 - 3 2 - 2 2 - - - -
11 - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - 1 - - - - - - - -
 - - 1 - - - - - - - -
18 - - - - - - - - - -
- - - - - - - - - - -
6 - - - - - - - - - -
71 27 - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
- - - - - - - - - - -
 TOTAL SISA SISA
PEMAKAIAN STOK
Ket Harga Nilai Persediaan
DES

- - - 1 99.000 -
729 - - 1 105.000 -
892 108 108 1 105.000 11,340
- - - 1 - -
80 - - 1 2,860.000 -
109 131 131 1 2,860.000 374,660
- - - 1 10,500.000 -
1,335 382 382 1 104.000 39,728
- - - 1 220.000 -
1,543 1,418 1,418 1 93.500 132,583
- - - 1 - -
- - - 1 2,998.000 -
- - - 1 - -
751 - - 1 93.000 -
3,258 942 942 1 99.000 93,258
- - - 1 - -
26,570 8,430 8,430 1 190.000 1,601,700
- - - 1 233.000 -
90 - - 1 233.000 -
- - - 1 249.000 -
- - - 1 - -
534 82 82 1 3,025.000 248,050
- - - 1 3,025.000 -
- - - 1 4,400.000 -
- - - 1 3,628.000 -
- - - 1 10,246.500 -
- - - 1 9,900.000 -
577 - - 1 8,500.000 -
250 50 50 1 8,237.000 411,850
- - - 1 - -
137 - - 1 4,950.000 -
- - - 1 - -
47 - - 1 440.000 -
- - - 1 220.000 -
17,014 - - 1 165.000 -
7,668 2,332 2,332 1 58.000 135,256
- - - 1 - -
- - - 1 3,035.000 -
- - - 1 - -
- 24 24 1 4,496.000 107,904
- - - 1 - -
600 - - 1 3,045.000 -
- - - 1 198.000 -
- - - 1 1,485.000 -
- - - 1 1,551.000 -
7,805 - - 1 105.000 -
3,217 783 783 1 105.000 82,215
- - - 1 1,050.000 -
- - - 1 67.000 -
- - - 1 75.000 -
- - - 1 103.000 -
1,304 1,696 1,696 1 253.000 429,088
- - - 1 - -
17 23 23 1 2,076.000 47,748
- - - 1 - -
442 74 74 1 1,584.000 117,216
- - - 1 - -
73 77 77 1 2,915.000 224,455
- - - 1 2,750.000 -
- - - 1 - -
- - - 1 380.000 -
581 - - 1 380.000 -
3 97 97 1 405.000 39,285
- - - 1 1,639.000 -
- - - 1 1,639.000 -
669 - - 1 136.000 -
2,000 - - 1 152.000 -
600 1,400 1,400 1 145.000 203,000
99 - - 1 110.000 -
- - - 1 110.000 -
83 - - 1 3,350.000 -
108 - - 1 3,350.000 -
372 78 78 1 3,350.000 261,300
- - - 1 300.000 -
- - - 1 5,900.000 -
- - - 1 626.000 -
- - - 1 18,150.000 -
- - - 1 7,602.000 -
- - - 1 7,124.000 -
- - - 1 - -
 - - - 1 149,266.000 -
- - - 1 - -
- - - 1 5,280.000 -
1,938 - - 1 660.000 -
707 793 793 1 671.000 532,103
- - - 1 4,282.000 -
28 48 48 1 11,000.000 528,000
- 50 50 1 10,098.000 504,900
- - - 1 2,805.000 -
137 - - 1 1,097.000 -
154 46 46 1 1,097.000 50,462
4,939 - - 1 60.500 -
1,529 471 471 1 66.000 31,086
6 - - 1 10,400.000 -
- - - 1 9,900.000 -
653 59 59 1 1,095.000 64,605
- - - 1 - -
368 - - 1 104.000 -
71 129 129 1 104.000 13,416
- - - 1 104.000 -
1,765 735 735 1 105.000 77,175
484 - - 1 112.000 -
- - - 1 - -
98 - - 1 4,400.000 -
- - - 1 2,700.000 -
1,241 204 204 1 165.000 33,660
- - - 1 91.000 -
- - - 1 1,408.000 -
60 - - 1 1,408.000 -
9 91 91 1 1,408.000 128,128
- - - 1 730.000 -
179 121 121 1 770.000 93,170
- - - 1 391.000 -
- - - 1 4,167.000 -
3 - - 1 3,550.000 -
548 - - 1 3,682.000 -
119 151 151 1 3,682.000 555,982
26 - - 1 691.000 -
313 21 21 1 710.000 14,910
- - - 1 - -
26 - - 1 1,333.000 -
- - - 1 1,333.000 -
- - - 1 82.000 -
- - - 1 82.000 -
- - - 1 4,232.000 -
95 - - 1 4,232.000 -
 150 42 42 1 4,232.000 177,744
68 - - 1 2,750.000 -
19 29 29 1 4,400.000 127,600
158 - - 1 2,900.000 -
7,081 1,749 1,749 1 119.000 208,131
- - - 1 119.000 -
6,927 2,000 2,000 1 77.000 154,000
7,800 - - 1 99.000 -
541 - - 1 7,865.000 -
1 14 14 1 10,010.000 140,140
- - - 1 10,010.000 -
- - - 1 6,900.000 -
40 - - 1 7,363.000 -
- - - 1 132.000 -
2,388 483 483 1 149.000 71,967
- - - 1 88.000 -
- - - 1 2,787.000 -
299 33 33 1 2,475.000 81,675
- - - 1 2,475.000 -
- - - 1 176,800.000 -
- 10 10 1 8,800.000 88,000
- - - 1 - -
- - - 1 4,665.000 -
246 186 186 1 4,665.000 867,690
22,738 3,680 3,680 1 264.000 971,520
- - - 1 330.000 -
- - - 1 660.000 -
- - - 1 187.000 -
109 191 191 1 90.000 17,190
24 - - 1 89.000 -
- - - 1 121.000 -
- - - 1 - -
- - - 1 9,644.000 -
- - - 1 10,696.000 -
58 182 182 1 10,696.000 1,946,672
- - - 1 - -
- - - 1 770.000 -
- - - 1 - -
- 100 100 1 1,755.000 175,500
11,803 - - 1 187.000 -
3,291 1,709 1,709 1 63.000 107,667
- - - 1 63.000 -
12,412 - - 1 94.600 -
2,398 602 602 1 99.000 59,598
26 - - 1 5,610.000 -
42 8 8 1 2,518.000 20,144
 59 341 341 1 396.000 135,036
- - - 1 288.000 -
- - - 1 288.000 -
- - - 1 1,089.000 -
- - - 1 - -
377 - - 1 1,810.000 -
- - - 1 - -
- - - 1 10,500.000 -
34 - - 1 17,968.500 -
58 - - 1 35,200.000 -
- - - 1 - -
30 - - 1 22.000 -
17,517 541 541 1 77.000 41,657
- - - 1 23.000 -
- - - 1 2,750.000 -
- - - 1 495.000 -
1,922 1,378 1,378 1 440.000 606,320
1,556 1,444 1,444 1 319.000 460,636
- - - 1 2,052.000 -
114 86 86 1 2,190.000 188,340
35 18 18 1 13,970.000 251,460
25 - - 1 22,550.000 -
2 8 8 1 23,100.000 184,800
- - - 1 3,811.500 -
84 - - 1 6,600.000 -
- - - 1 - -
3 - - 1 1,937.000 -
1,055 232 232 1 2,178.000 505,296
- - - 1 1,222.000 -
272 22 22 1 99.000 2,178
- - - 1 330.000 -
74 126 126 1 123.000 15,498
- - - 1 131.000 -
580 - - 1 4,680.500 -
180 - - 1 4,730.000 -
- - - 1 550.000 -
- - - 1 - -
- - - 1 4,950.000 -
1,833 - - 1 5,500.000 -
710 790 790 1 3,707.000 2,928,530
1,846 - - 1 96.000 -
897 1,103 1,103 1 102.000 112,506
480 - - 1 143.000 -
- - - 1 - -
473 - - 1 87.000 -
- - - 1 80.000 -
 - - - 1 121.000 -
70 - - 1 192.500 -
1,358 942 942 1 275.000 259,050
- - - 1 8,110.000 -
- - - 1 8,110.000 -
4 - - 1 14,318.700 -
120 - - 1 5,500.000 -
990 - - 1 2,090.000 -
8 - - 1 5,000.000 -
151 - - 1 4,400.000 -
- - - 1 1,265.000 -
- - - 1 990.000 -
322 - - 1 13,200.000 -
100 92 92 1 13,167.000 1,211,364
- - - 1 2,332.000 -
1,534 - - 1 528.000 -
- - - 1 594.000 -
25,300 - - 1 835.000 -
- - - 1 115.000 -
2,674 - - 1 123.000 -
81 919 919 1 123.000 113,037
40 - - 1 6,410.000 -
139 - - 1 6,410.000 -
1,052 - - 1 132.000 -
- - - 1 3,948.000 -
19 - - 1 23,141.800 -
24 - - 1 19,800.000 -
55 20 20 1 560.000 11,200
- - - 1 560.000 -
- 100 100 1 598.000 59,800
- - - 1 12,100.000 -
3 - - 1 24,860.000 -
75 - - 1 9,955.000 -
- - - 1 25,597.000 -
1,757 - - 1 160.000 -
360 452 452 1 1,070.000 483,640
- - - 1 1,124.000 -
816 - - 1 715.000 -
- - - 1 432.300 -
2,681 - - 1 437.800 -
- - - 1 418.000 -
- - - 1 357.500 -
- - - 1 495.000 -
- - - 1 789.800 -
23 - - 1 1,181.000 -
581 19 19 1 1,181.000 22,439
 7,768 - - 1 53.000 -
5,000 - - 1 56.000 -
- - - 1 53.000 -
40 - - 1 20,700.000 -
134 52 52 1 11,825.000 614,900
- - - 1 11,825.000 -
342 138 138 1 963.600 132,977
13,068 8,932 8,932 1 115.500 1,031,646
70 19 19 1 4,400.000 83,600
1,286 714 714 1 132.000 94,248
7,491 - - 1 123.000 -
- - - 1 6,600.000 -
- - - 1 41,500.000 -
- - - 1 68.000 -
12,396 674 674 1 73.000 49,202
- - - 1 73.000 -
- - - 1 1,000.000 -
663 - - 1 1,155.000 -
139 161 161 1 1,188.000 191,268
3,765 735 735 1 220.000 161,700
- - - 1 - -
- - - 1 9,646.000 -
100 300 300 1 9,646.000 2,893,800
1,949 - - 1 7,150.000 -
2,000 - - 1 7,150.000 -
- - - 1 7,630.000 -
425 159 159 1 4,550.000 723,450
- - - 1 - -
573 - - 1 70.000 -
620 880 880 1 165.000 145,200
228 73 73 1 2,620.000 191,260
- - - 1 2,796.000 -
10 - - 1 6,006.000 -
56 - - 1 5,170.000 -
45 15 15 1 2,200.000 33,000
1 - - 1 479,996.000 -
2 1 1 1 512,204.000 512,204
5 - - 1 130,999.000 -
80 30 30 1 130,999.000 3,929,970
110 - - 1 90.000 -
- - - 1 90.000 -
1,943 119 119 1 110.000 13,090
- - - 1 117.000 -
7,216 - - 1 265.000 -
- - - 1 - -
- - - 1 6,789.000 -
 14 11 11 1 6,789.000 74,679
- - - 1 13,607.000 -
- - - 1 310.000 -
- - - 1 86.000 -
4,671 - - 1 132.000 -
2,479 1,021 1,021 1 91.000 92,911
- - - 1 935.000 -
220 780 780 1 935.000 729,300
46 12 12 1 7,150.000 85,800
- - - 1 7,150.000 -
5,588 412 412 1 89.000 36,668
- - - 1 239.800 -
- - - 1 - -
- - - 1 108.000 -
- - - 1 1,045.000 -
- - - 1 967.000 -
- - - 1 776.006 -
- - - 1 - -
- - - 1 - -
1 - - 1 12,573.000 -
2 - - 1 12,573.000 -
5 1 1 1 12,573.000 12,573
- - - 1 1,735.000 -
4 - - 1 1,735.000 -
1 2 2 1 19,789.000 39,578
184 242 242 1 396.000 95,832
- - - 1 114.000 -
- - - 1 171.000 -
- - - 1 171.000 -
- - - 1 171.000 -
- - - 1 550.000 -
- - - 1 - -
- - - 1 779.000 -
- - - 1 1,320.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 278.300 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
266 - - 1 404.000 -
2,633 187 187 1 431.000 80,597
- - - 1 - -
- - - 1 257.000 -
4,111 958 958 1 257.000 246,206
 - - - 1 274.000 -
- - - 1 274.000 -
- - - 1 - -
64 31 31 1 6,281.000 194,711
- - - 1 9,900.000 -
500 - - 1 524.000 -
- - - 1 524.000 -
- - - 1 524.000 -
7,836 2,504 2,504 1 524.000 1,312,096
- - - 1 524.000 -
- - - 1 - -
- - - 1 - -
- - - 1 1,325,000.000 -
- - - 1 1,325,000.000 -
1 - - 1 1,325,000.000 -
2 - - 1 1,325,000.000 -
3 - - 1 1,325,000.000 -
- - - 1 - -
- - - 1 232,518.000 -
1 - - 1 248,120.000 -
- - - 1 248,120.000 -
10 - - 1 389,344.000 -
11 - - 1 415,469.000 -
2 - - 1 1,384,983.000 -
- - - 1 1,384,983.000 -
3 - - 1 1,384,983.000 -
- - - 1 317,018.000 -
- - - 1 - -
- - - 1 282.000 -
- - - 1 - -
- - - 1 28,354.000 -
- - - 1 28,354.000 -
- - - 1 40,913.489 -
- - - 1 41,784.000 -
24 - - 1 41,784.000 -
- - - 1 8,891.000 -
- - - 1 13,300.000 -
- - - 1 11,738.000 -
16 8 8 1 36,579.000 292,632
- - - 1 15,014.000 -
- - - 1 - -
- - - 1 2,920.000 -
- - - 1 2,920.000 -
- - - 1 517.000 -
6,700 50 50 1 517.000 25,850
- - - 1 552.000 -
 350 - - 1 284.000 -
50 - - 1 307.000 -
300 - - 1 307.000 -
60,090 - - 1 354.000 -
19,230 27,470 27,470 1 354.000 9,724,380
- - - 1 354.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
10 - - 1 9,955.000 -
3 - - 1 3,796.000 -
4 14 14 1 3,796.000 53,144
- - - 1 10,351.000 -
73 79 79 1 2,959.000 233,761
50 - - 1 2,684.000 -
50 - - 1 2,959.000 -
- - - 1 2,500.000 -
1,070 190 190 1 210.000 39,900
65 - - 1 1,900.000 -
302 98 98 1 1,199.000 117,502
- - - 1 1,639.000 -
- - - 1 1,199.000 -
- - - 1 - -
- - - 1 167.000 -
- - - 1 167.000 -
- - - 1 167.000 -
27 148 148 1 167.000 24,716
- - - 1 167.000 -
- - - 1 1,121.000 -
- - - 1 3,288.000 -
- - - 1 1,200.000 -
- - - 1 1,750.000 -
240 60 60 1 1,750.000 105,000
- - - 1 183.000 -
- - - 1 63,986.000 -
1 9 9 1 63,813.000 574,317
- - - 1 57,500.000 -
- - - 1 60.000 -
1,810 1,590 1,590 1 60.000 95,400
- - - 1 60.000 -
- - - 1 - -
- - - 1 5,000.000 -
- - - 1 13,200.000 -
2 8 8 1 19,955.000 159,640
- - - 1 245.000 -
- - - 1 245.000 -
 - 3 3 1 1,243.000 3,729
- - - 1 1,326.000 -
377 - - 1 158.000 -
2,023 977 977 1 157.000 153,389
- - - 1 253.000 -
- - - 1 - -
- - - 1 287.000 -
- - - 1 287.000 -
2,640 - - 1 287.000 -
564 436 436 1 287.000 125,132
- - - 1 - -
- - - 1 287.000 -
- - - 1 - -
1,000 - - 1 91.000 -
3,725 - - 1 91.000 -
296 504 504 1 440.000 221,760
- - - 1 - -
- - - 1 63,986.000 -
- - - 1 - -
- - - 1 - -
177 3 3 1 56,360.000 169,080
177 23 23 1 - -
- - - 1 60,140.000 -
- 20 20 1 66,154.000 1,323,080
120 - - 1 141,648.000 -
225 25 25 1 - -
130 - - 1 151,150.000 -
5 25 25 1 166,265.000 4,156,625
265 - - 1 76,620.000 -
239 36 36 1 84,282.000 3,034,152
79 11 11 1 17,450.000 191,950
- - - 1 - -
120 - - 1 23,270.000 -
118 72 72 1 25,597.000 1,842,984
180 - - 1 18,140.000 -
443 17 17 1 - -
60 - - 1 19,470.270 -
50 - - 1 19,954.000 -
160 30 30 1 15,450.000 463,500
- - - 1 - -
80 - - 1 21,810.000 -
60 - - 1 19,350.000 -
- - - 1 135,000.000 -
90 - - 1 151,150.000 -
90 - - 1 - -
93 17 17 1 21,285.000 361,845
100 - - 1 144,540.000 -
- - - 1 50,000.000 -
- - - 1 165,000.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 34,354.100 -
- - - 1 - -
300 - - 1 164.000 -
- - - 1 - -
- - - 1 90,000.000 -
- - - 1 90,000.000 -
- - - 1 183,480.000 -
- - - 1 176,400.000 -
- - - 1 77.000 -
- - - 1 - -
- - - 1 79,154.000 -
- - - 1 79,154.000 -
- - - 1 303,750.000 -
- - - 1 252,720.000 -
- - - 1 106,080.000 -
- - - 1 106,080.000 -
- - - 1 222,000.000 -
- - - 1 222,000.000 -
- - - 1 198,900.000 -
- - - 1 198,900.000 -
- - - 1 230,880.000 -
- - - 1 133,137.000 -
- - - 1 84,050.000 -
- - - 1 - -
- - - 1 22,794.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
 - - - 1 - -
- - - 1 - -
- - - 1 990.000 -
444 - - 1 1,023.000 -
- - - 1 - -
3,347 - - 1 924.000 -
3,000 - - 1 1,138.000 -
1,480 20 20 1 924.000 18,480
240 860 860 1 979.000 841,940
- - - 1 739.200 -
- - - 1 1,463.000 -
24 12 12 1 32,522.000 390,264
16 40 40 1 2,541.000 101,640
- - - 1 23,951.000 -
16 - - 1 19,885.446 -
- - - 1 120.000 -
1,500 - - 1 127.260 -
4 - - 1 212,784.000 -
- - - 1 70,000.000 -
161 19 19 1 22,725.000 431,775
109 - - 1 22,500.000 -
- - - 1 32,522.000 -
- - - 1 24,583.333 -
- - - 1 34,300.000 -
- - - 1 712,800.000 -
9 - - 1 348,480.000 -
300 - - 1 2,222.000 -
- - - 1 1,540.000 -
- - - 1 37,440.000 -
56 - - 1 13,050.000 -
28 12 12 1 9,680.000 116,160
- - - 1 20,970.000 -
- 5 5 1 13,607.000 68,035
- - - 1 180,000.000 -
129 - - 1 8,900.000 -
157 43 43 1 5,500.000 236,500
- - - 1 8,900.000 -
347 - - 1 6,270.000 -
170 230 230 1 8,700.000 2,001,000
156 - - 1 5,500.000 -
447 103 103 1 5,500.000 566,500
308 27 27 1 6,270.000 169,290
- 100 100 1 6,270.000 627,000
112 - - 1 7,920.000 -
41 59 59 1 8,400.000 495,600
203 - - 1 6,199.900 -
1,074 126 126 1 8,400.000 1,058,400
- - - 1 1,760.000 -
1 - - 1 13,400.000 -
35 11 11 1 13,400.000 147,400
- - - 1 12,500.000 -
7 - - 1 2,300.000 -
22 1 1 1 136,500.000 136,500
- - - 1 136,500.000 -
9 - - 1 8,000.000 -
87 31 31 1 5,950.000 184,450
- - - 1 8,000.000 -
222 - - 1 1,430.000 -
183 17 17 1 2,240.000 38,080
- - - 1 2,100.000 -
602 - - 1 427.850 -
- - - 1 390.860 -
- - - 1 2,060.000 -
- - - 1 - -
35 - - 1 17,500.000 -
15 - - 1 6,512.000 -
- - - 1 339.900 -
- - - 1 339.900 -
- - - 1 2,200.000 -
1,200 - - 1 2,309.375 -
- - - 1 10,857.000 -
- - - 1 10,856.250 -
13 - - 1 65,340.000 -
190 - - 1 333.900 -
- - - 1 11,615.000 -
- - - 1 6,600.000 -
- - - 1 154.000 -
80 - - 1 7,700.000 -
148 14 14 1 7,769.000 108,766
10 5 5 1 18,000.000 90,000
37 13 13 1 12,675.000 164,775
14 - - 1 3,700.000 -
- - - 1 - -
- - - 1 286,000.000 -
- - - 1 726.953 -
- - - 1 - -
2,000 - - 1 542.520 -
- - - 1 496.650 -
33 - - 1 19,360.000 -
5,800 500 500 1 470.530 235,265
340 260 260 1 3,773.000 980,980
- - - 1 4,134.900 -
192 - - 1 20,586.000 -
22 14 14 1 15,150.000 212,100
- - - 1 - -
- - - 1 87,120.000 -
2 - - 1 752,400.000 -
30 30 30 1 8,295.000 248,850
- - - 1 8,031.579 -
- - - 1 - -
41 - - 1 5,368.000 -
16 44 44 1 5,785.000 254,540
- - - 1 - -
53 147 147 1 2,887.500 424,463
- - - 1 - -
- - - 1 453,802.994 -
- - - 1 4,200.000 -
600 400 400 1 635.250 254,100
- - - 1 4,000.000 -
- - - 1 59,000.000 -
- - - 1 45,000.000 -
- - - 1 45,000.000 -
- - - 1 - -
- - - 1 546,400.000 -
- - - 1 544,150.000 -
- - - 1 - -
- - - 1 223,949.367 -
- - - 1 254,300.000 -
- - - 1 252,800.000 -
14 4 4 1 401,666.666 1,606,667
- - - 1 405,000.000 -
- - - 1 10,560.000 -
- - - 1 - -
- - - 1 10,837.000 -
- - - 1 - -
- - - 1 19,225.000 -
- - - 1 - -
- - - 1 552,800.000 -
- - - 1 552,800.000 -
- - - 1 - -
- - - 1 - -
- - - 1 16,400.000 -
- - - 1 - -
45 55 55 1 4,120.000 226,600
- - - 1 4,120.000 -
305 55 55 1 15,500.000 852,500
200 - - 1 9,738.000 -
- - - 1 9,611.000 -
 - - - 1 - -
- - - 1 625,900.000 -
- - - 1 22,176.000 -
- - - 1 66,876.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 13,252.000 -
200 - - 1 10,865.800 -
350 - - 1 8,053.000 -
- - - 1 8,110.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 36,000.000 -
- - - 1 77,690.000 -
- - - 1 825,000.000 -
- - - 1 224,254.000 -
- - - 1 259,175.000 -
- - - 1 70,000.000 -
- - - 1 4,952.830 -
- - - 1 4,952.830 -
200 - - 1 2,728.000 -
- - - 1 5,890.000 -
- - - 1 660,000.000 -
- - - 1 158,400.000 -
5 - - 1 276,600.000 -
- - - 1 276,500.000 -
5 - - 1 257,644.000 -
- - - 1 228,800.000 -
6 4 4 1 20,747.000 82,988
- - - 1 20,748.000 -
- - - 1 6,700.000 -
7 23 23 1 19,835.000 456,205
- - - 1 386.100 -
- - - 1 - -
- - - 1 1,590.000 -
- - - 1 1,550.000 -
780 220 220 1 1,463.000 321,860
- - - 1 1,518.000 -
- - - 1 1,190.000 -
3,000 200 200 1 1,185.000 237,000
- - - 1 1,463.000 -
- - - 1 1,190.000 -
 - - - 1 1,077.000 -
- - - 1 1,081.820 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
355 145 145 1 1,583.000 229,535
- - - 1 1,439.000 -
- - - 1 1,439.000 -
- - - 1 - -
25 50 50 1 22,433.000 1,121,650
- - - 1 1,460.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- 50 50 1 14,712.500 735,625
- - - 1 19,480.000 -
- - - 1 13,750.000 -
- - - 1 13,235.000 -
- 50 50 1 12,500.000 625,000
- - - 1 13,750.000 -
432 - - 1 358.000 -
- - - 1 121,750.000 -
40 - - 1 486.000 -
- - - 1 - -
575 525 525 1 11,975.000 6,286,875
- - - 1 28,666.670 -
- - - 1 13,235.000 -
- - - 1 12,500.000 -
- - - 1 11,975.000 -
- - - 1 11,975.000 -
- - - 1 - -
- - - 1 19,480.000 -
- - - 1 - -
- - - 1 13,235.000 -
- - - 1 - -
- - - 1 19,480.000 -
- - - 1 13,353.000 -
- - - 1 800.000 -
- - - 1 - -
- - - 1 323,500.000 -
- - - 1 53,000.000 -
- - - 1 386.100 -
- - - 1 - -
 - - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 38,500.000 -
- - - 1 71,500.000 -
- - - 1 38,500.000 -
- - - 1 71,500.000 -
- - - 1 333.900 -
- - - 1 - -
- - - 1 - -
- 400 400 1 473.000 189,200
- - - 1 - -
- - - 1 110.000 -
- - - 1 1,750.000 -
- - - 1 98.000 -
- - - 1 783.000 -
- - - 1 7,150.000 -
- - - 1 2,134.000 -
- - - 1 6,199.900 -
300 - - 1 1,155.000 -
- - - 1 80.000 -
- - - 1 396.000 -
- - - 1 500.000 -
50 - - 1 7,920.000 -
- - - 1 1,302.000 -
- - - 1 1,890.000 -
- - - 1 160.000 -
120 240 240 1 6,840.000 1,641,600
- - - 1 90.000 -
- - - 1 265.000 -
- - - 1 14,300.000 -
1,500 - - 1 7,630.000 -
- - - 1 167.000 -
 - - - 1 8,355.000 -
1 - - 1 1,457,500.000 -
- - - 1 - -
- - - 1 12,969.000 -
- - - 1 1,506.000 -
- - - 1 410,777.000 -
- - - 1 343,687.000 -
- - - 1 32,493.000 -
- 30 30 1 - -
- - - 1 2,254.320 -
- - - 1 259,175.000 -
- - - 1 15,180.000 -
- 200 200 1 31,680.000 6,336,000
6 194 194 1 31,405.000 6,092,570
- - - 1 3,300.000 -
- - - 1 7,630.000 -
- - - 1 14,300.000 -
- - - 1 8,426.000 -
- - - 1 627.000 -
- - - 1 792.000 -
1,450 1,950 1,950 1 1,700.000 3,315,000
- - - 1 1,700.000 -
12 8 8 1 55,000.000 440,000
28 17 17 1 58,500.000 994,500
6,000 - - 1 850.000 -
- 300 300 1 4,000.000 1,200,000
- - - 1 8,355.000 -
- - - 1 248,120.000 -
- - - 1 186,000.000 -
- - - 1 6,500.000 -
- - - 1 11,250.000 -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- 8 8 1 236,500.000 1,892,000
- 5 5 1 99,000.000 495,000
3 4 4 1 203,500.000 814,000
10 - - 1 275,000.000 -
- - - 1 132,000.000 -
- - - 1 49,500.000 -
- - - 1 5,500.000 -
- - - 1 66,000.000 -
4,900 - - 1 1,023.000 -
- - - 1 21,736.000 -
- - - 1 386.100 -
200 1,800 1,800 1 340.280 612,504
1 - - 1 560,000.000 -
2 - - 1 1,252,000.000 -
1 - - 1 575,000.000 -
20 9 9 1 156,000.000 1,404,000
- - - 1 53,636.000 -
5 - - 1 220,000.000 -
1 2 2 1 148,500.000 297,000
1,200 - - 1 7,000.000 -
- - - 1 2,200.000 -
- - - 1 60,000.000 -
1,200 - - 1 6,269.000 -
- - - 1 197,000.000 -
25 15 15 1 75,000.000 1,125,000
1,200 - - 1 8,500.000 -
25 - - 1 220,000.000 -
- - - 1 220,000.000 -
- - - 1 75,000.000 -
100 100 100 1 5,000.000 500,000
- - - 1 200,000.000 -
- - - 1 56,000.000 -
- - - 1 80,000.000 -
48 35 35 1 200,000.000 7,000,000
- - - 1 138,364.000 -
- - - 1 137,364.000 -
- 7 7 1 45,100.000 315,700
- - - 1 66,000.000 -
- - - 1 53,636.000 -
- - - 1 450,000.000 -
- 4 4 1 718,500.000 2,874,000
- - - 1 69,000.000 -
- - - 1 60,000.000 -
- 5,100 5,100 1 6,000.000 30,600,000
- - - 1 522,728.000 -
- - - 1 180,000.000 -
- - - 1 220,000.000 -
- - - 1 109.090 -
- - - 1 24,091.000 -
5,400 - - 1 1,150.000 -
2 3 3 1 47,500.000 142,500
- - - 1 200,000.000 -
- - - 1 2,816.000 -
10 - - 1 150,000.000 -
 - - - 1 303.550 -
- - - 1 891,275.000 -
- - - 1 160,500.000 -
6,000 - - 1 585.000 -
- - - 1 5,300.000 -
- - - 1 5,500.000 -
- - - 1 60,500.000 -
25 15 15 1 80,000.000 1,200,000
- - - 1 136,564.000 -
- - - 1 1,265.000 -
- - - 1 8,400.000 -
- - - 1 8,400.000 -
- - - 1 98,000.000 -
15 5 5 1 90,000.000 450,000
- 50 50 1 97,500.000 4,875,000
16 4 4 1 22,500.000 90,000
- - - 1 - -
- - - 1 - -
- - - 1 - -
9 - - 1 7,199.885 -
3 - - 1 1,945.000 -
44 - - 1 2,950.000 -
4 - - 1 139,880.000 -
- - - 1 - -
14 - - 1 1,097.000 -
411 197 197 1 77.000 15,169
10 - - 1 3,217.500 -
- - - 1 - -
3 - - 1 15,572.700 -
20 - - 1 270.000 -
5 - - 1 600.000 -
174 170 170 1 1,106.000 188,020
293 - - 1 45.000 -
50 - - 1 36.000 -
330 - - 1 783.000 -
55 - - 1 1,302.000 -
13 - - 1 74,250.000 -
13 - - 1 43,186.000 -
39 - - 1 7,920.000 -
1 - - 1 8,750.000 -
4 - - 1 7,018.000 -
9 - - 1 8,355.000 -
1 - - 1 20,328.000 -
11 - - 1 12,076.000 -
5 - - 1 6,595.000 -
1 - - 1 1,098,900.000 -
 1 1 1 1 712,800.000 712,800
148 - - 1 56.000 -
82 - - 1 1,640.000 -
17 - - 1 42,800.000 -
107 126 126 1 2,750.000 346,500
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
- - - 1 - -
156,835,611.964
 LAPORAN PERSEDIAAN OBAT PUSKESMAS
TAHUN 2020
SALDO AWAL 1 JANUARI 2019 MUTASI MASUK 1 JAN S/D 31 DES
HARGA NILAI
NO NAMA OBAT
JUMLAH BRG SATUAN PERSEDIAAN JUMLAH BRG
(Rp) (Rp)
1 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) - 99.000 0 -
2 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) 129 105.000 13545 600
3 Acetosal/Acetylsalicylic Acid Tablet 80 mg (MINIASPI) - 105.000 0 1,000
4 0 - - 0 -
5 Air Untuk Injeksi Vial @25 ml 80 2,860.000 228800 -
6 Air Untuk Injeksi Vial @25 ml - 2,860.000 0 240
7 Air Untuk Irigasi Infus 1000 ml - 10,500.000 0 -
8 Alopurinol Tablet 100 mg 917 104.000 95368 800
9 Alopurinol Tablet 100 mg - 220.000 0 -
10 Ambroxol Tablet 30 mg 961 93.500 89853.5 2,000
11 0 - - 0 -
12 Aminofilin Injeksi 24 mg/ml - 2,998.000 0 -
13 0 - - 0 -
14 Amlodipin Tablet 10 Mg 751 93.000 69843 -
15 Amlodipin Tablet 10 Mg - 99.000 0 4,200
16 0 - - 0 -
17 Amoksisilin Kaplet 500 mg - 190.000 0 35,000
18 Amoksisilin Kaplet 500 mg - 233.000 0 -
19 Amoksisilin Kaplet 500 mg 90 233.000 20970 -
20 Amoksisilin Kaplet 500 mg - 249.000 0 -
21 0 - - 0 -
22 Amoksisilin Syrup Kering 125 mg / 5 ml 216 3,025.000 653400 400
23 Amoksisilin Syrup Kering 125 mg / 5 ml - 3,025.000 0 -
24 Amoksisilin Syrup Kering 250mg / 5 ml - 4,400.000 0 -
25 Amoksisilin Syrup Kering 250mg / 5 ml (Novapharin) - 3,628.000 0 -
26 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) - 10,246.500 0 -
27 Amoxiclav 625 mg (Amoksisilin 500 mg, Clavulanat 125 mg) - 9,900.000 0 -
28 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 577 8,500.000 4904500 -
29 Ampicilin Serbuk Inj i.v 1.000 mg/vial - 8,237.000 0 300
30 0 - - 0 -
31 Antacida + Simeticon Suspensi (NOVAMAG) 87 4,950.000 430650 50
32 0 - - 0 -
33 Antacida + Simeticon Tablet Kunyah (MAGTEN) 47 440.000 20680 -
34 Antacida + Simeticon Tablet Kunyah (MAGTEN) - 220.000 0 -
35 Antacida + Simeticon Tablet Kunyah (MAGTEN) 6,014 165.000 992310 11,000
36 Antacida tablet kunyah DOEN, kombinasi : Alumunium Hidr - 58.000 0 10,000
37 0 - - 0 -
38 Anti Bakteri Doen Salep Kombinasi (Indo Farma) - 3,035.000 0 -
39 0 - - 0 -
40 Antifungi Doen Salep, Kombinasi : Asam Benzoat 6%+Asam Sal - 4,496.000 0 24
41 0 - - 0 -
42 Antihemoroid Kombinasi : Bismut Suppgalat 150 mg Heksakl 570 3,045.000 1735650 30
43 Asam Ascorbat 500 mg (Vitamin C) - 198.000 0 -
44 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citr - 1,485.000 0 -
45 Antihemoroid Tablet (Extrak Graptophili Folium 80% Citr - 1,551.000 0 -
46 Asam Ascorbat 50 mg (Vitamin C) 2,805 105.000 294525 5,000
47 Asam Ascorbat 50 mg (Vitamin C) - 105.000 0 4,000
48 Asam Folat 1 mg Beta Caroten 10000 Multi Mineral/ FOLAM - 1,050.000 0 -
49 Asam Folat Tablet 1 mg (Marin Liza Farmasi) - 67.000 0 -
50 Asam Folat Tablet 1 mg - 75.000 0 -
51 Asam Mefenamat 500 mg ( Mersi ) - 103.000 0 -
52 Asam Mefenamat 500 mg - 253.000 0 3,000
53 0 - - 0 -
54 Asam Tranexamat 100 mg/@5 ml Injeksi 20 2,076.000 41520 20
55 0 - - 0 -
56 Asam Tranexamat Tablet 500 mg 316 1,584.000 500544 200
57 0 - - 0 -
58 Asiklovir 5% 5gr Cream 150 2,915.000 437250 -
59 Asiklovir 5% 5gr Cream - 2,750.000 0 -
60 0 - - 0 -
61 Asiklovir Tab 400 mg ( Phapros ) - 380.000 0 -
62 Asiklovir Tab 400 mg ( Phapros ) 281 380.000 106780 300
63 Asiklovir Tab 400 mg ( Phapros ) - 405.000 0 100
64 Atropin Sulfat Injeksi 0,25 mg/ml - 1,639.000 0 -
65 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) - 1,639.000 0 -
66 Attapulgite Active 630 mg Tab/ New Antides 669 136.000 90984 -
67 Attapulgite Active 630 mg Tab/ PULAREX 2,000 152.000 304000 -
68 Attapulgite Active 630 mg Tab/ New Antides - 145.000 0 2,000
69 Betahistin Mesylat 6 mg 99 110.000 10890 -
70 Betahistin Mesylat 6 mg - 110.000 0 -
71 Betametason Dipropionat Krim 0,1% 83 3,350.000 278050 -
72 Betametason Dipropionat Krim 0,1% 108 3,350.000 361800 -
73 Betametason Dipropionat Krim 0,1% - 3,350.000 0 450
74 Bisakodil Tablet 5 mg (Etercon Pharma ) - 300.000 0 -
75 Bisakodil Sup 10 mg (Dulcolax) - 5,900.000 0 -
76 Bisoprolol 2,5 mg/concor 2,5 - 626.000 0 -
77 Benzatin Benzil Penisilin 2,4 jt - 18,150.000 0 -
78 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zen - 7,602.000 0 -
79 Bricasma Respules Terbutalin Cairan IH 2,5 mg/ml (Astra Zen - 7,124.000 0 -
80 0 - - 0 -
81 Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astr - 149,266.000 0 -
82 0 - - 0 -
83 Calcium Plus Vit D3 (Coral calcium 500 mg,Naturan Soyisof - 5,280.000 0 -
84 Cefadroksil Kapsul 500 mg 938 660.000 619080 1,000
85 Cefadroksil Kapsul 500 mg - 671.000 0 1,500
86 Cefotaxime serbuk injeksi 1.000 mg - 4,282.000 0 -
 87 Citicolin 250 mg / 2 ml Inj /Cercul (Phapros ) 76 11,000.000 836000 -
88 Citicolin 250 mg / 2 ml Inj - 10,098.000 0 50
89 Curcumin Plus Cynarin,Sylimarin,Kapsul/ HEPAGARD (Phapro - 2,805.000 0 -
90 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) 137 1,097.000 150289 -
91 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) - 1,097.000 0 200
92 Deksamethason Tab 0,5 mg (Promed ) 3,939 60.500 238309.5 1,000
93 Deksamethason Tab 0,5 mg - 66.000 0 2,000
94 Desoksimetason Krim 0,25% 15gram ( Dexa Medica) 6 10,400.000 62400 -
95 Dextromertofan Komb Syr/ BANTIF (Sanbe) - 9,900.000 0 -
96 Difenhidramin Inj 10 mg/ ml (Phapros ) 232 1,095.000 254040 480
97 0 - - 0 -
98 Digoksin Tab 0,25 mg (Yarindo Farmatama ) 368 104.000 38272 -
99 Digoksin Tab 0,25 mg (Yarindo Farmatama ) - 104.000 0 200
100 Digoksin Tab 0,25 mg - 104.000 0 -
101 Dimenhidrinat Tablet 50 mg/ Kimia Farma - 105.000 0 2,500
102 Dimenhidrinat Tablet 50 mg/ Kimia Farma II 484 112.000 54208 -
103 0 - - 0 -
104 Domperidon Suspensi 5 mg /5 ml (Novapharin ) 98 4,400.000 431200 -
105 Domperidon Suspensi 5 mg /5 ml (Novapharin ) - 2,700.000 0 -
106 Domperidon Tab 10 mg (Novapharin ) 445 165.000 73425 1,000
107 Domperidon Tab 10 mg (Novapharin ) - 91.000 0 -
108 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% - 1,408.000 0 -
109 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) 30 1,408.000 42240 30
110 Epinefrin (Adrenalin) Inj 1 mg/ ml 0,1% (Ethica ) - 1,408.000 0 100
111 Eritrosmisin Stearate Kaplet 500 mg - 730.000 0 -
112 Eritrosmisin Stearate Kaplet 500 mg - 770.000 0 300
113 Ethambutol 250 mg - 391.000 0 -
114 Fitomenadion (Vit K1) Inj 10 mg/ ml I.M ( Phapros ) - 4,167.000 0 -
115 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) 3 3,550.000 10650 -
116 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) 428 3,682.000 1575896 120
117 Fitomenadion (Vit K1) Inj 2 mg/ ml I.M (Phapros ) - 3,682.000 0 270
118 Fitomenadion Tabet 10 mg (Phapros ) 26 691.000 17966 -
119 Fitomenadion Tabet 10 mg (Phapros ) 334 710.000 237140 -
120 0 - - 0 -
121 Furosemide Injeksi 10 mg/ ml (Indofarma) 26 1,333.000 34658 -
122 Furosemide Injeksi 10 mg/ ml (Indofarma) - 1,333.000 0 -
123 Furosemide Tablet 40 mg (Kimia Farma ) - 82.000 0 -
124 Furosemide Tablet 40 mg (Kimia Farma ) - 82.000 0 -
125 Gentamisin Sulfate tetes mata 0,3% ( ERELA) - 4,232.000 0 -
126 Gentamisin Sulfate tetes mata 0,3% ( ERELA) 95 4,232.000 402040 -
127 Gentamisin Sulfate tetes mata 0,3% ( ERELA) - 4,232.000 0 192
128 Gentamycin Krim 1 % mg/ ml 68 2,750.000 187000 -
129 Gentian Violet 1% 10 ml - 4,400.000 0 48
130 Gentian Violet 1% 10 ml (Cito Ciubrus Farma) 134 2,900.000 388600 24
131 Glibenklamid Tablet 5 mg 5,830 119.000 693770 3,000
132 Glibenklamid Tablet 5 mg ( Indofarma ) - 119.000 0 -
133 Gliseril Guaikoulat Tablet 100 mg (Novapharin ) 6,927 77.000 533379 2,000
134 Gliseril Guaikoulat Tablet 100 mg - 99.000 0 7,800
135 Glucosamin HCL 500 Mg, Konrdoitin SO4400Mg, MSM 200 Mg 541 7,865.000 4254965 -
136 Glukosa Larutan 40% Steril ( Outsuka ) 10 10,010.000 100100 5
137 Glukosa Larutan 40% Steril - 10,010.000 0 -
138 Glukosa Larutan Infus 5% @500ml (Widatra ) - 6,900.000 0 -
139 Glukosa Larutan Infus 5% @500ml - 7,363.000 0 40
140 Hidroklorotiazid (HCT) Tablet 25 mg - 132.000 0 -
141 Hidroklorotiazid (HCT) Tablet 25 mg 1,871 149.000 278779 1,000
142 Gliseril Guaikoulat Tablet 100 mg - 88.000 0 -
143 Hidrokortison Krim 1 % (Kimia Farma ) - 2,787.000 0 -
144 Hidrokortison Krim 2,5 % (Kimia Farma) 92 2,475.000 227700 240
145 Hidrokortison Krim 2,5 % (Kimia Farma) - 2,475.000 0 -
146 Human Tetanus Imunoglobulin Inj 250 UI (Tetagam) - 176,800.000 0 -
147 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) 10 8,800.000 88000 -
148 0 - - 0 -
149 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) - 4,665.000 0 -
150 Ibuprofen Susp 200 mg/5 ml (Indo Farma ) - 4,665.000 0 432
151 Ibuprofen Tablet 400 mg (Novapharin ) 6,418 264.000 1694352 20,000
152 Ibuprofen Tablet 400 mg - 330.000 0 -
153 Isoniazid Tablet 100 mg + Piridoxin HCl 10 mg (Phapros) - 660.000 0 -
154 Isoniazid Tablet 100 mg - 187.000 0 -
155 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) 300 90.000 27000 -
156 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) 24 89.000 2136 -
157 Isosorbid Dinitrat Tab Sublingual 5 mg (Yarindo) - 121.000 0 -
158 0 - - 0 -
159 KA-EN 1B Inj Larutan @500 ml (Otsuka) - 9,644.000 0 -
160 KA-EN 3A Inj Larutan @500 ml (Otsuka) - 10,696.000 0 -
161 KA-EN 3B Inj Larutan @500 ml (Otsuka) 40 10,696.000 427840 200
162 0 - - 0 -
163 Kalium Diklofenak Tab 50 mg/ Diclofenac Potassium (Guard - 770.000 0 -
164 0 - - 0 -
165 Kalium Klorida tab. Lepas lambat 600 mg (KSR) 100 1,755.000 175500 -
166 Kalsium 500 MG + Vit D3 (Calsifar plus) (Ifars) 3,803 187.000 711161 8,000
167 Kalsium Laktat (Kalk) Tab 500 mg (Mersi Farma) - 63.000 0 5,000
168 Kalsium Laktat (Kalk) Tab 500 mg - 63.000 0 -
169 Kaptopril Tab 25 mg ( Phapros ) 9,412 94.600 890375.2 3,000
170 Kaptopril Tab 25 mg - 99.000 0 3,000
171 Ketokonazol Krim 2 % @ 10 gr 26 5,610.000 145860 -
172 Ketokonazol Krim 2 % @ 10 gr - 2,518.000 0 50
173 Ketokonazol Tablet 200 mg (Novapharin) I 400 396.000 158400 -
174 Ketokonazol Tablet 200 mg (Novapharin) II - 288.000 0 -
175 Ketokonazol Tablet 200 mg (Novapharin) - 288.000 0 -
176 Ketorolak Inj 30 mg/ml - 1,089.000 0 -
177 0 - - 0 -
178 Kloramfenikol 1% Salep Mata (KF) 137 1,810.000 247970 240
179 0 - - 0 -
180 Kloramfenikol Inj 1G/5 ml / Colcancetine Inj (Sanbe Farma) - 10,500.000 0 -
181 Kloramfenikol Tetes Telinga :Kloramfenicol 10%,Lidocain,Pro 34 17,968.500 610929 -
182 Kloramfenikol Tetes Telinga : Kloramfenicol 10%,Lidocain,Pr 58 35,200.000 2041600 -
183 0 - - 0 -
184 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi 30 22.000 660 -
185 Klorfeniramina Maleat (CTM) Tab 4 mg (Imfarmindo Farmasi 8,058 77.000 620466 10,000
186 Klorfeniramina Maleat (CTM) Tab 4 mg (Novapharin ) - 23.000 0 -
187 Kolkisin Tab 500Mcg/ L-Cisin ( Lapi Laboratoris ) - 2,750.000 0 -
188 Kotrimoksasol Forte / Infantrim Forte Tab 960 mg ( Molex Ay - 495.000 0 -
189 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg ( Ifars ) 1,300 440.000 572000 2,000
190 Kotrimoksasol Forte / Fasiprim Forte Tab 960 mg - 319.000 0 3,000
191 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazo - 2,052.000 0 -
192 Kotrimoksazol Kombinasi Tiap 5ml Suspensi : Sulfametoksazo - 2,190.000 0 200
193 Krim Analgesik (setiap gram mengandung : Metyl Salisilat 17 13,970.000 237490 36
194 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Ext 5 22,550.000 112750 20
195 Krim Jelly Luka Bakar: Tiap Gram Mengandung Placenta Ext - 23,100.000 0 10
196 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidof - 3,811.500 0 -
197 Lactobasilus Rhamnosus R 11 2M + Laciophillus R-52 /Lacidof 84 6,600.000 554400 -
198 0 - - 0 -
199 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeks 3 1,937.000 5811 -
200 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeks 327 2,178.000 712206 960
201 Lidokain 2% + Epinefrin 1:80.000 2 ml (Lidokain Comp. Injeks - 1,222.000 0 -
202 Loperamid Tablet 2 mg ( Ifars) 294 99.000 29106 -
203 Loperamid Tablet 2 mg - 330.000 0 -
204 Loratadin Tablet 10 mg 200 123.000 24600 -
205 Loratadin Tablet 10 mg - 131.000 0 -
206 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suple 580 4,680.500 2714690 -
207 Lutein 6mg,Bellberry : Mirtl Fructus Ext 80mg Kaps Suple - 4,730.000 0 180
208 Meloxicam Tab 15 mg (Bernofarm ) - 550.000 0 -
209 0 - - 0 -
210 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Nora - 4,950.000 0 -
211 Metamizol Sodium Inj 500 mg/ml (Santagesik/ Antrain/ Nora 1,683 5,500.000 9256500 150
212 Metamizol Sodium Inj 500 mg/ml (Santagesik) - 3,707.000 0 1,500
213 Metformin HCl Tablet 500 mg 1,846 96.000 177216 -
214 Metformin HCl Tablet 500 mg - 102.000 0 2,000
215 Metilprednisolon Tab 4 mg (Molex Ayus) 480 143.000 68640 -
216 0 - - 0 -
217 Metoklopramide Tablet 10 mg (Kimia Farma) 473 87.000 41151 -
218 Metoklopramide Tablet 10 mg (Kimia Farma) - 80.000 0 -
219 Metoklopramide Tablet 5 mg (Kimia Farma) - 121.000 0 -
220 Metronidasol 500 mg tablet (Novapharin) 70 192.500 13475 -
221 Metronidasol 500 mg tablet (Novagyl) - 275.000 0 2,300
222 Metronidasol Infus 500mg/100ml - 8,110.000 0 -
223 Metronidasol Infus 500mg/100ml - 8,110.000 0 -
224 Minyak Kayu Putih 60 ml 4 14,318.700 57274.8 -
225 Multi Vit, VitE 50 mg, Lutein 3 mg, Lycopen 8 mg, Vit C 250 - 5,500.000 0 120
226 Multivitamin + Pelancar Asi (NULACVIT) 900 2,090.000 1881000 90
227 Multivitamin B1 100,B6 200,B12 500Mcg Inj (Biocombin) / 8 5,000.000 40000 -
228 Multivitamin B1 100,B6 200,B12 500Mcg Inj (BIOCOMBIN) 151 4,400.000 664400 -
229 Multivitamin Vitamin/ Suplemen (BECEFORT) - 1,265.000 0 -
230 Multivitamin C 750 mg ,Asam Folat+ Mineral / Vitner -Z ( Mo - 990.000 0 -
231 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 82 13,200.000 1082400 240
232 Multivitamin Curcuma Syr:L-Lysyin 200mg,Betacaroten 1000 - 13,167.000 0 192
233 Multivitamin Neurotopic Plus ATP Tablet:B1 100,B6 200,B12 - 2,332.000 0 -
234 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 1,534 528.000 809952 -
235 Multivitamin Neurotopic Tablet : B1 100,B6 200,B12 200 - 594.000 0 -
236 Multivitamin Tab Tambah Darah : per Tablet Mengandung : - 835.000 0 25,300
237 Natrium Diklofenak Tab 50 mg (Phapros ) I - 115.000 0 -
238 Natrium Diklofenak Tab 50 mg (Phapros ) II 2,674 123.000 328902 -
239 Natrium Diklofenak Tab 50 mg (Phapros ) - 123.000 0 1,000
240 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) 40 6,410.000 256400 -
241 Natrium Klorida Larutan infus 0,9% @500ml(Widatra ) - 6,410.000 0 139
242 Nifedipin tablet 10 mg ( Dexa Medica ) 1,052 132.000 138864 -
243 Nifedipin tablet lepas lambat 30 mg (OROS) - 3,948.000 0 -
244 Nistatin Susp 100.000 IU / NYMICO (Sanbe Farma) 19 23,141.800 439694.2 -
245 Nistatin Susp 100.000 IU / CAZETIN (Sanbe Farma) 24 19,800.000 475200 -
246 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) 75 560.000 42000 -
247 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) - 560.000 0 -
248 Nistatin Vaginal Tab 100.000 IU/G (Phapros ) - 598.000 0 100
249 Obat Batuk Herbal : Tiap 15 Ml Vitetrifolia Fill 1 Gr,Zingib - 12,100.000 0 -
250 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE 3 24,860.000 74580 -
251 OBH Plus Syr : Per 5 ml Megnandung Difenhidramin 12,5mg 75 9,955.000 746625 -
252 Obat Kumur +Hyaulorinic Acid 1% @ 200ml SANORINE - 25,597.000 0 -
253 Omeprazole Kapsul 20 mg 1,157 160.000 185120 600
254 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) 112 1,070.000 119840 700
255 Ondansetron HCl Inj 2 mg/ 1ml ( Dexa ) - 1,124.000 0 -
256 Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,Ph 816 715.000 583440 -
257 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,B - 432.300 0 -
258 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,B 2,681 437.800 1173741.8 -
259 Parasetamol Komb Tablet Batuk Berdahak:Paraset 400Mg,B - 418.000 0 -
260 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofe - 357.500 0 -
261 Propiltiourasil/ PTU 100 mg - 495.000 0 -
262 Parasetamol Komb Tablet Flu: Parasetamol 500Mg,Pseudofed - 789.800 0 -
263 Parasetamol Syrup 120 mg/5ml (Mersi Farma) 23 1,181.000 27163 -
264 Parasetamol Syrup 120 mg/5ml - 1,181.000 0 600
265 Parasetamol tablet 500 mg 1,768 53.000 93704 6,000
266 Parasetamol tablet 500 mg - 56.000 0 5,000
267 Parasetamol tablet 500 mg - 53.000 0 -
268 Perak Sulfadiazin Krim 1% / Sulfadiazine Silver (Darya Varia L 10 20,700.000 207000 30
269 Permetrin crem 5% @10 mg (Scabimite crem ) 36 11,825.000 425700 150
270 Permetrin crem 5% @10 mg (Scabimite crem ) - 11,825.000 0 -
271 Piracetam 800 mg Tablet 280 963.600 269808 200
272 Parasetamol tablet 500 mg - 115.500 0 22,000
273 Piracetam Injeksi 1gr/ 5ml 39 4,400.000 171600 50
274 Piridoksin HCl (Vit.B6)Tablet 10 mg - 132.000 0 2,000
275 Piridoksin HCl (Vit.B6)Tablet 10 mg 4,491 123.000 552393 3,000
276 Probiotik Sachet (Probiokid) - 6,600.000 0 -
277 Polikresulen (Albotyl,Apetil) - 41,500.000 0 -
278 Prednison Tab 5 mg - 68.000 0 -
279 Prednison Tab 5 mg (Holi Pharma) 5,070 73.000 370110 8,000
280 Prednison Tab 5 mg - 73.000 0 -
281 Pseudofedrin 60mg,Tripolidin 2,5mg (Eflin +Tremenza) - 1,000.000 0 -
282 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) 63 1,155.000 72765 600
283 Ranitidin Injeksi 25 mg/ 2 ml (SOHO) - 1,188.000 0 300
284 Ranitidin Tablet 150 mg (Hexapharm Jaya ) - 220.000 0 4,500
285 0 - - 0 -
286 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING - 9,646.000 0 -
287 Ringer Acetat Botol @500 ml (Outsuka)/ ASERING - 9,646.000 0 400
288 Ringer Laktat cairan infus ( OTSUKA) @ 500 ml RL 1,949 7,150.000 13935350 -
289 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL - 7,150.000 0 2,000
290 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL - 7,630.000 0 -
291 Salbutamol SO4 3,01 mg + Ipratonium Brom 0,52 mg Nebuliz 284 4,550.000 1292200 300
292 0 - - 0 -
293 Salbutamol Tab 4 mg ( Graha Farma ) 573 70.000 40110 -
294 Salbutamol Tab 4 mg (Pristasma) - 165.000 0 1,500
295 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% 109 2,620.000 285580 192
296 Salep 2-4 Kombinasi : Asam Salisilat 2%+ Belerang Endap 4% - 2,796.000 0 -
297 Salisil Bedak Serbuk 2% (Kimia Farma) 10 6,006.000 60060 -
298 Salisil Bedak Serbuk 2% 56 5,170.000 289520 -
299 Salisil Bedak Serbuk 2% - 2,200.000 0 60
300 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE 1 479,996.000 479996 -
301 Serum Anti Bisa Ular A.B.U I inj (i.m./i.v) BIOSAVE - 512,204.000 0 3
302 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT 5 130,999.000 654995 -
303 Serum Anti Tetanus ( A.T.S ) inj 1500 IU/ml im BIOSAT - 130,999.000 0 110
304 Setirizin Tab 10 mg (Futamed) 110 90.000 9900 -
305 Setirizin Tab 10 mg (Futamed) - 90.000 0 -
306 Simvastatin Tablet 10 mg (Yarindo Farmatama) 862 110.000 94820 1,200
307 Simvastatin Tablet 10 mg - 117.000 0 -
308 Siprofloksasin Tablet 500 mg (Novapharin) 2,216 265.000 587240 5,000
309 0 - - 0 -
310 Sukralfat Susp 500mg/5ml @100 ml (Mepro) - 6,789.000 0 -
311 Sukralfat Susp 500mg/5ml @100 ml (Mepro) - 6,789.000 0 25
312 Tetes mata setiap ml mengandung Polietilen glikol 400 1% gl - 13,607.000 0 -
313 Tetrasiklin HCl Kapsul 500 mg - 310.000 0 -
314 Thiamin/ Vitamin B1 50 mg - 86.000 0 -
315 Thiamin/ Vitamin B1 50 mg (Novapharin ) 4,671 132.000 616572 -
316 Thiamin/ Vitamin B1 50 mg (Novapharin ) - 91.000 0 3,500
317 Thiamphenicol / Thiamfilex Kapsul 500 mg - 935.000 0 -
318 Thiamphenicol Kapsul 500 mg - 935.000 0 1,000
319 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Ifars) (DIONIC 58 7,150.000 414700 -
320 Thiamphenicol/ Thiamfilex Susp 125 mg/5 ml (Molex Ayus) - 7,150.000 0 -
321 Vitamin B Komplek - 89.000 0 6,000
322 Vitamin B Komplek Plus Ekstrak Hati (Substansi Hati Kering - 239.800 0 -
0 OBAT GOLONGAN PSIKOTROPIKA - - 0 -
323 Alprazolam 0,5 mg (Mersi Farma) - 108.000 0 -
324 Clobazam Tab 10 mg (Meprofarm) - 1,045.000 0 -
325 Clobazam Tab 10 mg (Meprofarm) - 967.000 0 -
326 Clobazam Tab 10 mg (Meprofarm) - 776.006 0 -
327 0 - - 0 -
328 0 - - 0 -
329 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) 1 12,573.000 12573 -
330 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) 2 12,573.000 25146 -
331 Diazepam Enema 5 mg/2,5 ml Stesolid 5 mg (Actavis ) - 12,573.000 0 6
332 Diazepam Injeksi 5 mg / ml-2 ml - 1,735.000 0 -
333 Diazepam Injeksi 5 mg / ml-2 ml 4 1,735.000 6940 -
334 Diazepam Injeksi 5 mg / ml-2 ml VALISANBE - 19,789.000 0 3
335 Diazepam Tablet 5 mg (VALISANBE) 126 396.000 49896 300
336 Diazepam Tablet 5 mg - 114.000 0 -
337 Fenobarbital Tablet 30 mg - 171.000 0 -
338 Fenobarbital Tablet 30 mg - 171.000 0 -
339 Fenobarbital Tablet 30 mg - 171.000 0 -
340 Kodein Tablet 10 mg - 550.000 0 -
341 0 - - 0 -
342 Lorazepam Tab 2 mg (Mersi Farma) - 779.000 0 -
343 Metamizol 500 mg + Diazepam 2 mg / PRONEURON (Meprof - 1,320.000 0 -
344 0 - - 0 -
345 0 - - 0 -
346 0 - - 0 -
347 Primaquin 15 mg tablet - 278.300 0 -
348 0 - - 0 -
0 OBAT - OBAT PROGRAM - - 0 -
0 OBAT PROGRAM KECACINGAN - - 0 -
349 Albendazol Tablet 400 mg 266 404.000 107464 -
350 Albendazol Tablet 400 mg - 431.000 0 2,820
0 OBAT PROGRAM DIARE - - 0 -
351 Garam Oralit (Kimia Farma) - 257.000 0 -
352 Garam Oralit (Kimia Farma) 3,369 257.000 865833 1,700
353 Garam Oralit (Kimia Farma) - 274.000 0 -
354 Garam Oralit (Kimia Farma) - 274.000 0 -
355 0 - - 0 -
356 Zinc Sulphate Drops 10 mg/ml (Zincpro drop/ Combined impe 95 6,281.000 596695 -
357 Zinc Sulphate Sirup 10 mg/ml (Zincpro Sirup/ Combiphar) - 9,900.000 0 -
358 Zinc Sulphate Tablet Dispersible 20 mg - 524.000 0 500
359 Zinc Dispersible 20 mg tablet - 524.000 0 -
360 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) - 524.000 0 -
361 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) 5,340 524.000 2798160 5,000
362 Zinc Sulphate Tablet Dispersible 20 mg (Phapros) - 524.000 0 -
363 0 - - 0 -
0 OBAT PROGRAM HEPATITIS - - 0 -
364 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - 1,325,000.000 0 -
365 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - 1,325,000.000 0 -
366 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - 1,325,000.000 0 1
367 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - 1,325,000.000 0 2
368 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - 1,325,000.000 0 3
0 OBAT PROGRAM TB PARU - - 0 -
369 OAT FDC Kategori Anak - 232,518.000 0 -
370 OAT FDC Kategori Anak - 248,120.000 0 1
371 OAT FDC Kategori Anak - 248,120.000 0 -
372 OAT FDC Kategori I - IIII - 389,344.000 0 10
373 OAT FDC Kategori I - IIII - 415,469.000 0 11
374 OAT FDC Kategori II - 1,384,983.000 0 2
375 OAT FDC Kategori II - 1,384,983.000 0 -
376 OAT FDC Kategori II - 1,384,983.000 0 3
377 OAT FDC Kombipak Kategori I - 317,018.000 0 -
378 0 - - 0 -
379 Isoniazid 100 mg tablet - 282.000 0 -
0 OBAT POGRAM KUSTA - - 0 -
380 MDT MB Anak - 28,354.000 0 -
381 MDT MB Anak - 28,354.000 0 -
382 MDT MB Dewasa - 40,913.489 0 -
383 MDT MB Dewasa - 41,784.000 0 -
384 MDT MB Dewasa - 41,784.000 0 24
385 MDT PB Anak - 8,891.000 0 -
386 MDT PB Anak - 13,300.000 0 -
387 MDT PB Anak - 11,738.000 0 -
388 MDT MB Dewasa - 36,579.000 0 24
389 MDT PB Dewasa - 15,014.000 0 -
0 OBAT PROGRAM GIZI - - 0 -
390 Mineral Mix Kombinasi - 2,920.000 0 -
391 Mineral Mix Kombinasi - 2,920.000 0 -
392 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) - 517.000 0 -
393 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) - 517.000 0 6,750
394 Retinol (vit A) 200.000 IU Kapsul lunak bayi (6-11bln) - 552.000 0 -
395 Retinol Vit A 100.000 IU (Biru) - 284.000 0 350
396 Retinol Vit A 100.000 IU (Biru) - 307.000 0 50
Retinol Vit A 100.000 IU (Biru) - 307.000 0 300
398 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat 2,090 354.000 739860 58,000
399 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat - 354.000 0 46,700
400 Tablet Tambah Darah /Komb Ferro Fumarat 60 Mg +As.Folat - 354.000 0 -
401 0 - - 0 -
402 0 - - 0 -
0 OBAT PROGRAM KESGA - - 0 -
403 Calcii Gluconas Inj (Ethica) - 9,955.000 0 10
404 Magnesium Sulfat Inj.(iv) 40% Otsuka 3 3,796.000 11388 -
405 Magnesium Sulfat Inj.(iv) 40% Otsuka - 3,796.000 0 18
406 Calcii Gluconas Inj 10% (Ethica) - 10,351.000 0 -
407 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) 52 2,959.000 153868 100
408 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) - 2,684.000 0 50
409 Metilergometrin Maleat Inj 0,2 mg/ml (Ethica ) - 2,959.000 0 50
410 Oksitetrasiklin 1 % Salep Mata - 2,500.000 0 -
411 Metilergometrin Maleat Tablet 0,125 mg 760 210.000 159600 500
412 Oksitosin Inj 10 UI/ml (Ethica) 65 1,900.000 123500 -
413 Oksitosin Inj 10 UI/ml (Ethica) - 1,199.000 0 400
414 Atropin Sulfat Injeksi 0,25 mg/ml (i.m/i.v/s.k) - 1,639.000 0 -
415 Oksitosin Inj 10 UI/ml (Ethica) - 1,199.000 0 -
0 OBAT PROGRAM JIWA - - 0 -
416 Amitriptilin 25 mg - 167.000 0 -
417 Amitriptilin 25 mg - 167.000 0 -
418 Amitriptilin 25 mg - 167.000 0 -
419 Amitriptilin 25 mg 175 167.000 29225 -
420 Amitriptilin 25 mg - 167.000 0 -
421 Clozapine 25mg (OGB Dexa) - 1,121.000 0 -
422 Clozapine 100 mg - 3,288.000 0 -
423 Depakote Valproat Tab 250 mg ( (Abbott ) - 1,200.000 0 -
424 Depakote Valproat Tab 250 mg ( (Abbott ) - 1,750.000 0 -
425 Depakote Valproat Tab 250 mg ( (Abbott ) - 1,750.000 0 300
426 Fenitoin Sodium 30 mg Kapsul (DECATONA) - 183.000 0 -
427 Flufenazin sikzonoate inj 25 mg/ ml - 63,986.000 0 -
428 Flufenazin sikzonoate inj 5 ml - 63,813.000 0 10
429 Flufenazin sikzonoate inj 5 ml - 57,500.000 0 -
430 Haloperidol 5 mg tablet - 60.000 0 -
431 Haloperidol 5 mg tablet 400 60.000 24000 3,000
432 Haloperidol 5 mg tablet - 60.000 0 -
433 0 - - 0 -
434 Haloperidol Injeksi 5 mg/ml - 5,000.000 0 -
435 Haloperidol Injeksi 5 mg/ml (LODOMER) - 13,200.000 0 -
436 Haloperidol/ Lodomer drops 2 mg - 19,955.000 0 10
437 Karbamazepin Tablet 200 mg - 245.000 0 -
438 Karbamazepin Tablet 200 mg - 245.000 0 -
439 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) - 1,243.000 0 3
440 Klorpromazin HCl Inj I.M 25 mg/ml (Phapros) - 1,326.000 0 -
441 Klorpromazin Tab Salut 100 mg (HCl) (Mersi Farma) 377 158.000 59566 -
442 Klorpromazin Tab Salut 100 mg (HCl) - 157.000 0 3,000
443 Klorpromazin Tab Salut 100 mg (HCl) - 253.000 0 -
444 0 - - 0 -
445 Risperidon Tab 2 mg ( Dexa Medica ) - 287.000 0 -
446 Risperidon Tab 2 mg (OGB Dexa) - 287.000 0 -
447 Risperidon Tab 2 mg 340 287.000 97580 2,300
448 Risperidon Tab 2 mg - 287.000 0 1,000
449 0 - - 0 -
450 Trifluoperazinehydrochloride 5 mg /Mersi - 287.000 0 -
451 0 - - 0 -
452 Triheksifenidil Tablet 2 mg (Mersi) - 91.000 0 1,000
453 Triheksifenidil Tablet 2 mg 725 91.000 65975 3,000
454 Triheksifenidil Tablet 2 mg (HEXYMER) - 440.000 0 800
455 0 - - 0 -
456 Flufenazin/ Siksonat Injeksi 25mg/ ml - 63,986.000 0 -
457 0 - - 0 -
0 PROGRAM IMUNISASI (VAKSIN) - - 0 -
458 BCG - 56,360.000 0 180
459 PELARUT BCG - - 0 200
460 BCG - 60,140.000 0 -
461 BCG - 66,154.000 0 20
462 CAMPAK 10ds (MR) - 141,648.000 0 120
463 PELARUT CAMPAK - - 0 250
464 CAMPAK 10ds (MR) - 151,150.000 0 130
465 CAMPAK 10ds (MR) - 166,265.000 0 30
466 DPT HB - Hib/ PENTABIO - 76,620.000 0 265
467 DPT HB - Hib/ PENTABIO - 84,282.000 0 275
468 DT - 17,450.000 0 90
469 0 - - 0 -
470 HB UNIJECT/ HB - ADS / HEPATITIS B - 23,270.000 0 120
471 HB UNIJECT/ HB - ADS / HEPATITIS B - 25,597.000 0 190
472 POLIO bOPV 10 ds - 18,140.000 0 180
473 DROPPER POLIO - - 0 460
474 POLIO bOPV 10 ds - 19,470.270 0 60
475 POLIO bOPV 10 ds - 19,954.000 0 50
476 Td - 15,450.000 0 190
477 0 - - 0 -
478 HB UNIJECT/ HB - ADS / HEPATITIS B - 21,810.000 0 80
479 POLIO bOPV 10 ds - 19,350.000 0 60
480 Vaksin Meningtis - 135,000.000 0 -
481 CAMPAK 10ds (MR) BIAS - 151,150.000 0 90
482 PELARUT CAMPAK BIAS - - 0 90
483 POLIO bOPV 10 ds - 21,285.000 0 110
484 IPV - 144,540.000 0 100
485 VTM Include Dacron (Biofarma) - 50,000.000 0 -
486 Vaksin Rabies (Verorab) - 165,000.000 0 -
487 0 - - 0 -
488 0 - - 0 -
489 0 - - 0 -
0 OBAT PROGRAM HIV/ AIDS - - 0 -
490 Azitromicyn 500 mg + Cefixime 200 mg - 34,354.100 0 -
491 0 - - 0 -
492 Isoniazid (INH) Tablet 300 mg 300 164.000 49200 -
493 0 - - 0 -
494 Lamivudine 150 mg - 90,000.000 0 -
495 Lamivudine 150 mg - 90,000.000 0 -
496 Nevirapine 200 mg - 183,480.000 0 -
497 Nevirapine 200 mg - 176,400.000 0 -
498 Piridoksin HCl (Vit.B6) Tablet 25 mg - 77.000 0 -
499 0 - - 0 -
500 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Tr - 79,154.000 0 -
501 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Tr - 79,154.000 0 -
502 Tenofovir 300 mg - 303,750.000 0 -
503 Tenofovir 300 mg - 252,720.000 0 -
504 Zidofudine 100 mg (ZDV) - 106,080.000 0 -
505 Zidofudine 100 mg (ZDV) - 106,080.000 0 -
506 Zidofudine 300 mg + Lamifudine 150 mg - 222,000.000 0 -
507 Zidofudine 300 mg + Lamifudine 150 mg - 222,000.000 0 -
508 Efavirenz 600 mg tablet - 198,900.000 0 -
509 Efavirenz 600 mg tablet - 198,900.000 0 -
510 Zidofudine 300 mg + Lamifudine 150 mg - 230,880.000 0 -
511 Abacavir (ABC) 300mg - 133,137.000 0 -
512 Tenofovir 300 +Lamivudin 300+ Efaviren 600 (Triple FDC) Tr - 84,050.000 0 -
513 0 - - 0 -
514 MB Anak - 22,794.000 0 -
515 0 - - 0 -
516 0 - - 0 -
517 0 - - 0 -
518 0 - - 0 -
519 0 - - 0 -
520 0 - - 0 -
521 0 - - 0 -
522 0 - - 0 -
523 0 - - 0 -
524 0 - - 0 -
525 0 - - 0 -
526 0 - - 0 -
527 0 - - 0 -
528 0 - - 0 -
529 0 - - 0 -
0 BMHP - - 0 -
530 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipr - 990.000 0 -
531 Alat Suntik Sekali Pakai .1 ml Tuberculin W N 26Gx 1/2 (Nipr 444 1,023.000 454212 -
532 0 - - 0 -
533 Alat Suntik Sekali Pakai .3 cc (NIPRO) 1,347 924.000 1244628 2,000
534 Alat Suntik Sekali Pakai .3 cc (TERUMO) - 1,138.000 0 3,000
535 Alat Suntik Sekali Pakai .3 cc (NIPRO) - 924.000 0 1,500
536 Alat Suntik Sekali Pakai .5 ml (NIPRO) - 979.000 0 1,100
537 Alat Suntik Sekali Pakai .5 ml (Win) - 739.200 0 -
538 Alat Suntik Sekali Pakai 10 ml (NIPRO) - 1,463.000 0 -
539 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I - 32,522.000 0 36
540 Alat Suntik Sekali Pakai 20 ml 6 2,541.000 15246 50
541 Alkohol 70% Medika (Kimia Farma) - 23,951.000 0 -
542 Alkohol 70% (Medika) 16 19,885.446 318167.136 -
543 Alkohol Swab 2 - ply (one med) - 120.000 0 -
544 Alkohol Swab 2 - ply (one med) 400 127.260 50904 1,100
545 Antiseptic Hand Scrub 0,5 % (Medicare) - 212,784.000 0 4
546 Askina Sorb 10X 10 Cm (B-Braun ) - 70,000.000 0 -
547 Cat Gut Chromic Demetech 3/0 75c+ jarum 1/2 22 M II - 22,725.000 0 180
548 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I 109 22,500.000 2452500 -
549 Catgut Chromic 3/0 75C + Jarum1/2 22M Demetech I - 32,522.000 0 -
550 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / P - 24,583.333 0 -
551 Cat Gut Plain No. 3.0 70 C+ Jarum 1/2 25 M (Demetech) / P - 34,300.000 0 -
552 Dual Enzymatic Detergen Galon 5 liter (STERYZIME) - 712,800.000 0 -
553 Ethylcloride Spray 100 ml (Roeko Endo Frost) 9 348,480.000 3136320 -
554 Film IV Dressing 6 X 7S (Id67S) E - Care 300 2,222.000 666600 -
555 Film IV Dressing 6 X 7S (Id67S) E - Care - 1,540.000 0 -
556 Fixomull Strech 5 cm X 5 m - 37,440.000 0 -
557 Foley Catheter 2 Way Ch 16,18 (Norta) 46 13,050.000 600300 10
558 Foley Catheter 2 Way Ch 16,18 - 9,680.000 0 40
559 Gown Non Woven Onemed (Baju Habis Pakai) - 20,970.000 0 -
560 I.V Cannula No. 26 G Polywin (Polymed) - 13,607.000 0 5
561 Mantel Gown (Bisa Dicuci) - 180,000.000 0 -
562 I.V Catheter No. 18 (JELCO) 129 8,900.000 1148100 -
563 I.V Catheter No. 18 (NIPRO) - 5,500.000 0 200
564 I.V Catheter No. 20 JELCO - 8,900.000 0 -
565 I.V Catheter No. 20 TERUMO 147 6,270.000 921690 200
566 I.V Catheter No. 20 JELCO - 8,700.000 0 400
567 I.V Catheter No. 22 NIPRO 156 5,500.000 858000 -
568 I.V Catheter No. 22 NIPRO - 5,500.000 0 550
569 I.V Catheter No. 24 TERUMO 135 6,270.000 846450 200
570 I.V Catheter No. 24 TERUMO - 6,270.000 0 100
571 Infusion Set Anak 60 Drops /(Otsuka) 112 7,920.000 887040 -
572 Infusion Set Anak 60 Drops /(Otsuka) - 8,400.000 0 100
573 Infusion Set Dewasa 20 Drops/ (Kimsmed) 203 6,199.900 1258579.7 -
574 Infusion Set Dewasa 20 Drops/ (OTSUKA) - 8,400.000 0 1,200
575 Kantong Plastik Bio Hazart (Bahan Plastik PE, Panjang 80 C - 1,760.000 0 -
576 Kapas Pembalut Hydrofil 250 gr 1 13,400.000 13400 -
577 Kapas Pembalut Hydrofil 250 gr (Surya Husada) 14 13,400.000 187600 32
578 Kapas Pembalut Hydrofil 250 gr (One Med) - 12,500.000 0 -
579 Kasa Pembalut Hidrofil DRC 4 m X 10 cm 7 2,300.000 16100 -
580 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) 3 136,500.000 409500 20
581 Kasa Hidrofil 36 mX 80 cm (DRC T Plain) - 136,500.000 0 -
582 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) 9 8,000.000 72000 -
583 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) 68 5,950.000 404600 50
584 Kasa Hidrofil Steril 16 cm X 16 cm (One Med) - 8,000.000 0 -
585 Kasa Pembalut Hidrofil DRC 3 m X 15 cm (HM HUSADA) 222 1,430.000 317460 -
586 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (Surya Husada) - 2,240.000 0 200
587 Kasa Pembalut Hidrofil DRC 4 m X 15 cm (One Med) - 2,100.000 0 -
588 Masker Ear Loop (Masker) 602 427.850 257565.7 -
589 Masker Ear Loop Jilbab (Golden Gloves) - 390.860 0 -
590 Masker General Care (MARCOTILA) - 2,060.000 0 -
591 0 - - 0 -
592 Masker N95 Disposibel 35 17,500.000 612500 -
593 Masker N95 Disposibel (One Med) - 6,512.000 0 15
594 Masker Tali - 339.900 0 -
595 Masker Tali - 339.900 0 -
596 Masker Elastic - 2,200.000 0 -
597 Media Sample Container - 2,309.375 0 1,200
598 Nebulizer Aerosol with Mask dan Tubing Adult (Remedi) - 10,857.000 0 -
599 Nebulizer Aerosol with Mask dan Tubing Child (Remedi) - 10,856.250 0 -
600 Norinse Antimicrobial 500 ml (Viorex) - 65,340.000 0 13
601 Nurse Cup (Tutup Kepala) 90 333.900 30051 100
602 Oxygen Mask Elongated Adult (Remedi) - 11,615.000 0 -
603 Oxygen Mask Nasal Canula Size L Dan S (Aximed) - 6,600.000 0 -
604 Plesterin Bulat Non Woven (One Med) - 154.000 0 -
605 Polifix 5Cm X 1 Cm ( Sna Medika) 26 7,700.000 200200 54
606 Polifix 5Cm X 1 Cm ( Sna Medika) - 7,769.000 0 162
607 Povidon Iodine 10% (300 ml) ( One Med) - 18,000.000 0 15
608 Plester Kain (Leukoplast 2,5 cm x 4,5 m) - 12,675.000 0 50
609 Povidon Iodine 10% (60 ml) ( One Med) 14 3,700.000 51800 -
610 0 - - 0 -
611 Prontosan Wound Gel X 50 Gram( B-Braun ) - 286,000.000 0 -
612 Sarung Tangan Non Steril No M Dan L (ANSELL) - 726.953 0 -
613 0 - - 0 -
614 Sarung Tangan Non Steril No S Dan M (MMP MAS) 500 542.520 271260 1,500
615 Sarung Tangan Non Steril No S Dan M (Win Glove) - 496.650 0 -
616 Sarung Tangan Steril Gynecolog No 7 (ONE MED) (Pasang) 33 19,360.000 638880 -
617 Sarung Tangan size M dan L (Exam Glove) - 470.530 0 6,300
618 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) 600 3,773.000 2263800 -
619 Sarung Tangan Steril No 7 Dan 7,5 (Win Glove) (Pasang) - 4,134.900 0 -
620 Silk Black 3/0 DS 19 mm (SMI ) I / Demetech 72 20,586.000 1482192 120
621 Silk Black 3/0 DS 19 mm (SMI ) II / Demetech - 15,150.000 0 36
622 0 - - 0 -
623 Surface Disinfectant 500 ml (Stericide ) - 87,120.000 0 -
624 Surface Disinfectant Galon 5 Liter (Stericide ) - 752,400.000 0 2
625 Underpad 90x 0 cm cosmo I - 8,295.000 0 60
626 Underpad 90x 0 cm cosmo II - 8,031.579 0 -
627 0 - - 0 -
628 Urine Bag Sterile Standard 21 5,368.000 112728 20
629 Urine Bag Sterile Standard (AXIMED) - 5,785.000 0 60
630 0 - - 0 -
631 Umbilical Cord Clamp ( Hospitech ) - 2,887.500 0 200
0 REAGEN - - 0 -
632 Accu - Check Performa Blood Glukose Meter Test (ROCHE) - 453,802.994 0 -
633 Accu- Check Performa Tes Strip ( Roche ) - 4,200.000 0 -
634 Accu- Check Safe-T-Pro Uno (Roche) 1,000 635.250 635250 -
635 Accu- Check Performa Tes Strip ( Roche ) - 4,000.000 0 -
636 Antimonoclonal A (Anti A) 10 ml - 59,000.000 0 -
637 Antimonoclonal AB (Anti AB) 10 ml - 45,000.000 0 -
638 Antimonoclonal B (Anti B) 10 ml - 45,000.000 0 -
639 0 - - 0 -
640 Cholesterol Test Strip (Human Humasens Plus) - 546,400.000 0 -
641 Cholesterol Test Strip (Human Humasens Plus) - 544,150.000 0 -
642 Family DR HB Hemoglobin Test Meter (Alat) - - 0 -
643 Family DR HB Hemoglobin Test Trip MHS 2 - 223,949.367 0 -
644 Glucose Test Strip (Human Humasens plus) - 254,300.000 0 -
645 Glucose Test Strip (Human Humasens plus) II - 252,800.000 0 -
646 Hemoglobin Strip 50 test mission (Acon) - 401,666.666 0 18
647 Hemoglobin Strip 50 test mission (Acon) - 405,000.000 0 -
648 Reagen Hb (HCl 0,1 N) 100ml - 10,560.000 0 -
649 0 - - 0 -
650 Reagen HBsAg Strip (FOKUS) - 10,837.000 0 -
651 0 - - 0 -
652 TPHA (Fokus) - 19,225.000 0 -
653 0 - - 0 -
654 Uric Acid Test Strip 2.0 (Human Humasens plus) - 552,800.000 0 -
655 Uric Acid Test Strip 2.0 (Human Humasens plus) - 552,800.000 0 -
0 BMHP (PROGRAM) PROPINSI - - 0 -
0 PROGRAM MALARIA - - 0 -
656 RDT Malaria - 16,400.000 0 -
0 PROGRAM SYPHILIS - - 0 -
657 RPR Syphilis - 4,120.000 0 100
658 RPR Syphilis tahap II (FOKUS) - 4,120.000 0 -
659 Syphilis 3.0 06FK10 SD Bioline - 15,500.000 0 360
660 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - 9,738.000 0 200
661 Trepocheck Syphilis (Rapid Test Syphilis RB-TS) - 9,611.000 0 -
662 0 - - 0 -
663 Tuberkulin - 625,900.000 0 -
664 RDT Lepto (Uji Leptospira IgM) - 22,176.000 0 -
665 RDT DBD IgG/ IgM & NS1 DS-V33 (Demam Berdarah) - 66,876.000 0 -
666 0 - - 0 -
667 0 - - 0 -
0 PROGRAM HEPATITIS
Rapid Test Anti Hepatitis C (HCV) - - 0 -
668 - 13,252.000 0 -
669 Reagen HBsAg Strip SD - 10,865.800 0 200
670 Reagen HBsAg Strip SD - 8,053.000 0 350
671 Reagen HBsAg Strip SD - 8,110.000 0 -
672 0 - - 0 -
673 0 - - 0 -
674 0 - - 0 -
675 0 - - 0 -
0 PROGRAM TB PARU - - 0 -
676 Box Slide - 36,000.000 0 -
677 Box Slide - 77,690.000 0 -
678 Catridge Genexpart - 825,000.000 0 -
679 Catridge Genexpart - 224,254.000 0 -
680 Catridge Genexpart (Xpert MTB/ RIF Assay Kit) - 259,175.000 0 -
681 Oil Emersi - 70,000.000 0 -
682 Pot Spuntum/Pot Dahak Steril - 4,952.830 0 -
683 Pot Spuntum/Pot Dahak Steril - 4,952.830 0 -
684 Pot Spuntum/Pot Dahak Steril - 2,728.000 0 200
685 Pot Spuntum/Pot Dahak Steril - 5,890.000 0 -
686 Reagen Control CD4 - 660,000.000 0 -
687 Reagen Control CD4 - 158,400.000 0 -
688 Reagen Zeil Nelseen - 276,600.000 0 5
689 Reagen Zeil Nelseen - 276,500.000 0 -
690 Reagen Zeil Nelseen - 257,644.000 0 5
691 Reagen Zeil Nelseen - 228,800.000 0 -
692 Slide - 20,747.000 0 10
693 Slide/ Object Glass - 20,748.000 0 -
694 Stereofoam - 6,700.000 0 -
695 Masker N 95 TB - 19,835.000 0 30
696 Masker Tali Bedah TB - 386.100 0 -
0 OBAT PROGRAM IMUNISASI - - 0 -
697 Alat Suntik Sekali Pakai 0,05 ml - 1,590.000 0 -
698 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - 1,550.000 0 -
699 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - 1,463.000 0 1,000
700 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - 1,518.000 0 -
701 Alat Suntik Sekali Pakai 0,05 ml /ONEJECT - 1,190.000 0 -
702 Alat Suntik Sekali Pakai 0,5 ml /ONEJECT - 1,185.000 0 3,200
703 Alat Suntik Sekali Pakai 0,5 ml ONEJECT - 1,463.000 0 -
704 Alat Suntik Sekali Pakai 0,5 ml ONEJECT - 1,190.000 0 -
705 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA - 1,077.000 0 -
706 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA - 1,081.820 0 -
707 Alat Suntik Sekali Pakai 0,5 ml/ Gavi/SKIFA - - 0 -
708 0 - - 0 -
709 0 - - 0 -
710 0 - - 0 -
711 Alat Suntik Sekali Pakai 5 ml (SKIFA) 500 1,583.000 791500 -
712 Alat Suntik Sekali Pakai 5 ml One Ject - 1,439.000 0 -
713 Alat Suntik Sekali Pakai 5 ml One Ject - 1,439.000 0 -
714 0 - - 0 -
715 Safety Box 5 L - 22,433.000 0 75
716 Alat Suntik Sekali Pakai 0,05 ml - 1,460.000 0 -
717 0 - - 0 -
718 0 - - 0 -
719 0 - - 0 -
720 0 - - 0 -
0 PROGRAM HIV/ AIDS - - 0 -
721 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) Ta - 14,712.500 0 50
722 Diagnostar DS HIV 1/2 One Step Rapid Test (GCHIV-402A) R - 19,480.000 0 -
723 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) T - 13,750.000 0 -
724 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) ( - 13,235.000 0 -
725 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) T - 12,500.000 0 50
726 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V - 13,750.000 0 -
727 Kondom - 358.000 0 432
728 DBS Collection/ Lasec - 121,750.000 0 -
729 Lubricant - 486.000 0 40
730 0 - - 0 -
731 Rapid 1 HIV (SD Bioline Reagen Pemeriksaan HIV AIDS) Tahap - 11,975.000 0 1,100
732 Rapid HIV 1/2 3.0 SD Bioline - 28,666.670 0 -
733 Reagen HIV (FOKUS) R 2 - 13,235.000 0 -
734 KHB Diagnostik Kit For HIV (1+2) Antibody (Colloidal Gold) V - 12,500.000 0 -
735 Reagen HIV (SD) R 1 - 11,975.000 0 -
736 Reagen HIV (SD) R 1 - 11,975.000 0 -
737 0 - - 0 -
738 Reagen HIV (VIKIA) R 3 - 19,480.000 0 -
739 0 - - 0 -
740 Reagen HIV R2 (Rapid Test) FOKUS - 13,235.000 0 -
741 0 - - 0 -
742 Reagen HIV R3 (VIKIA) - 19,480.000 0 -
743 Reagen HIV R3 /DS HIV DIAGNOSTAR - 13,353.000 0 -
744 Sarung Tangan Non Steril - 800.000 0 -
745 0 - - 0 -
746 APD Set (Cover All, Face Shield, Handscoen, Masker N95) - 323,500.000 0 -
747 VTM Include Swab - 53,000.000 0 -
748 Masker Bedah 3 ply - 386.100 0 -
749 0 - - 0 -
750 0 - - 0 -
751 0 - - 0 -
752 0 - - 0 -
753 0 - - 0 -
754 0 - - 0 -
755 0 - - 0 -
756 0 - - 0 -
757 0 - - 0 -
758 0 - - 0 -
759 0 - - 0 -
760 0 - - 0 -
761 0 - - 0 -
762 0 - - 0 -
763 0 - - 0 -
764 0 - - 0 -
0 OKSIGEN MEDICAL - - 0 -
765 Oksigen 3 m3 - 38,500.000 0 -
766 Oksigen 6 m3 - 71,500.000 0 -
767 Oksigen 1 m3 - 38,500.000 0 -
768 Oksigen 6 m3 - 71,500.000 0 -
769 Nurse Cup (Tutup Kepala) One Med - 333.900 0 -
770 0 - - 0 -
771 0 - - 0 -
772 Propilitourasil/ PTU 100 mg (Dexa Medica) - 473.000 0 400
0 TAMBAHAN IFK - - 0 -
1 Simvastatin Tablet 10 mg (Yarindo Farmatama) - 110.000 0 -
2 Depakote Valproat Tab 250 mg ( (Abbott ) - 1,750.000 0 -
3 Ranitidin Tablet/150
Thiamphenicol mg
Thiamfilex Kapsul 500 mg - 98.000 0 -
4 - 783.000 0 -
5 Thiamphenicol Syr. - 7,150.000 0 -
6 Dehydro Artemisin 40 mg + Piperakuin 320 mg (DHP) tablet - 2,134.000 0 -
7 Infusion Set Dewasa 20 Drops/ (Kimsmed) - 6,199.900 0 -
8 Ranitidin Injeksi 25 mg/ 2 ml - 1,155.000 0 300
9 Isosorbid Dinitrat Tab Sublingual 5 mg - 80.000 0 -
10 Ketokonazole 200 mg - 396.000 0 -
11 Kotrimoksazol Forte - 500.000 0 -
12 Infusion set anak - 7,920.000 0 50
13 Alat Suntik 10 cc - 1,302.000 0 -
14 Eritrosmisin Stearate Kaplet 500 mg - 1,890.000 0 -
15 Omeprazole Kapsul 20 mg - 160.000 0 -
16 Natrium Klorida Larutan infus 0,9% @500ml (MJB KF ) - 6,840.000 0 360
17 Setirizin Tab 10 mg (Futamed) - 90.000 0 -
18 Siprofloksasin Tablet 500 mg (Novapharin) - 265.000 0 -
19 Oseltamivir 75 mg - 14,300.000 0 -
20 Ringer Laktat cairan infus @ 500 ml RL - 7,630.000 0 1,500
21 Amitriptilin 25 mg - 167.000 0 -
22 I.V Catheter No. 24 TERUMO - 8,355.000 0 -
23 Hepatitis B Imunoglobulin inj 220 IU/ml (Hb Ig) (Hyperhep) - 1,457,500.000 0 1
24 RDT COVID - 19 - - 0 -
25 Oseltamivir 75 mg - 12,969.000 0 -
26 Klorokuin 150 mg tablet - 1,506.000 0 -
27 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For V - 410,777.000 0 -
28 Katrid XPert Xpress SARS-CoV-2. Sample Collection Kit (For V - 343,687.000 0 -
29 Masker N95 (Particulate Respirator) - 32,493.000 0 -
30 Hazmat/ APD/ Hazmat PPK - - 0 30
31 Medical Sample Container - 2,254.320 0 -
32 Cepheid - 259,175.000 0 -
33 Natrium Klorida Larutan infus 0,9% @100ml - 15,180.000 0 -
34 Tambah Darah drop (Ferriz Drop) - 31,680.000 0 200
35 Tambah Darah Sirup (Ferriz Sirup) - 31,405.000 0 200
36 Gentamycin Krim 1 % mg/ ml Gentalex - 3,300.000 0 -
37 Ringer Laktat cairan infus ( OTSUKA/ WIDATRA) @ 500 ml RL - 7,630.000 0 -
38 Obat Batuk Sirup / INADRYL - 14,300.000 0 -
39 Obat Batuk Expektoran Sirup - 8,426.000 0 -
40 Parasetamol Komb Tablet Antitusif : Parasetamol 500mg,P - 627.000 0 -
41 Parasetamol Komb Tablet Flu: Parasetamol 500 mg, Kombina - 792.000 0 -
42 Masker Bedah /Bima Sakti - 1,700.000 0 3,400
43 Masker Bedah /Rania - 1,700.000 0 -
44 Masker N 95 Bima Sakti - 55,000.000 0 20
45 Sarung tangan panjang steril / meditouche perpasang - 58,500.000 0 45
46 Sarung tangan Non Steril (Shamrock Supreme/ Rannia) - 850.000 0 6,000
47 Albendazol Suspensi 200mg/ 5 ml - 4,000.000 0 300
48 I.V Catheter No. 24 (BRAUN) - 8,355.000 0 -
49 OAT FDC Kategori Anak - 248,120.000 0 -
50 Handsanitizer Medicare 0,5% (5 liter) KF - 186,000.000 0 -
51 Apron Lengan Panjang Putih (Rannia) - 6,500.000 0 -
52 Kasa Hidrofil Steril 16 cm X 16 cm (Surya Husada) - 11,250.000 0 -
53 0 - - 0 -
54 0 - - 0 -
55 0 - - 0 -
56 0 - - 0 -
57 0 - - 0 -
58 0 - - 0 -
59 0 - - 0 -
60 APD Set (Rannia) - 236,500.000 0 8
61 Cover All Disposible (Baju sekali pakai) (Rannia) - 99,000.000 0 5
62 Cover All Re Use (Baju bisa di pakai lagi /dicuci) Rannia - 203,500.000 0 7
63 Baju APD Reusable (Bisa bisa dipakai lagi/dicuci) (Usaha Ka - 275,000.000 0 10
64 Helm visor (Usaha Karya Mitra Bersama) - 132,000.000 0 -
65 Kaca mata Goggle (Usaha Karya Mitra Bersama) - 49,500.000 0 -
66 Shoe Cover (sepatu ) / (Usaha Karya Mitra Bersama) - 5,500.000 0 -
67 Jerigen Putih ukuran 20 liter 1 (Usaha Karya Mitra Bersama) - 66,000.000 0 -
68 Sarung tangan non steril M,L (COBRA) - 1,023.000 0 4,900
69 Masker N95 Covid 19 - 21,736.000 0 -
70 Masker Tali Bedah 3 ply Covid 19 - 386.100 0 -
71 Masker Eaerlop Hijab - 340.280 0 2,000
72 Etanol 96 % (Alkohol 1) - 560,000.000 0 1
73 Hand Sanitzer 1 - 1,252,000.000 0 2
74 MC Bleach Liquid 20 Liter (RAJAWALI) - 575,000.000 0 1
75 Cover All Disposable solida size XL, XXL (RAJAWALI) - 156,000.000 0 29
76 KIT A1 Operasi Steril (RAJAWALI) - 53,636.000 0 -
77 Mantel Gown APD 1 (Usaha Karya Mitra Bersama) - 220,000.000 0 5
78 Sepatu Boots APD (Usaha Karya Mitra Bersama) - 148,500.000 0 3
79 Masker Face/ Masker Bedah (COBRA 1) - 7,000.000 0 1,200
80 Masker Elastis Hijau 3 ply (RAJAWALI) - 2,200.000 0 -
81 Jerigen Putih ukuran 20 liter 2 (Usaha Karya Mitra Bersama) - 60,000.000 0 -
82 Masker Face/ Masker Bedah (COBRA 2) - 6,269.000 0 1,200
83 Rapid Test VivaDiag Covid-19 IgM/ IgG (COBRA 2) - 197,000.000 0 -
84 Masker KN95 (Farmahusada) - 75,000.000 0 40
85 Masker Bedah (Sensi/ Farmahusada) - 8,500.000 0 1,200
86 Rapid Test SARS COV 2 (Farmahusada) - 220,000.000 0 25
87 Rapid Test VivaDiag Covid-19 IgM/ IgG (Indofarma) - 220,000.000 0 -
88 Masker KN95 (Anugrah Sentosa Abadi) - 75,000.000 0 -
89 APRON (Atmosfer) - 5,000.000 0 200
90 Rapid Test VivaDiag Covid-19 IgM/ IgG (DIVA) - 200,000.000 0 -
91 Hand Sanitzer 2 - 56,000.000 0 -
 92 Virus Transport Media Corich (VTM)/ Setia Andalan Sukses - 80,000.000 0 -
93 Mantel Gown APD 2 (Usaha Karya Mitra Bersama) - 200,000.000 0 83
94 Virus Transport Media Corich (VTM)/ Sekarguna Medika 1 - 138,364.000 0 -
95 Virus Transport Media Corich (VTM)/ Sekarguna Medika 2 - 137,364.000 0 -
96 Face Shield (COBRA) - 45,100.000 0 7
97 Jirigen Putih 20 Liter (Usaha Karya) - 66,000.000 0 -
98 Kit Steril (Rajawali) - 53,636.000 0 -
99 Alkohol II @20 Liter - 450,000.000 0 -
100 Cover All (Rajawali) - 718,500.000 0 4
101 Face Shield (ATMOSFER) - 69,000.000 0 -
102 Jirigen Putih 20 Liter (Usaha Karya) - 60,000.000 0 -
103 Masker Earloop (KasaHusada) - 6,000.000 0 5,100
104 MC Bleach Liquid 20 Liter (RAJAWALI) - 522,728.000 0 -
105 Rapid Test Covid-19 (Rajawali) - 180,000.000 0 -
106 Rapid Test Covid-19 (Dakonan) - 220,000.000 0 -
107 Alkohol Swab (BTT) - 109.090 0 -
108 Antiseptic Gel 500 - 24,091.000 0 -
109 Vitamin C 500 mg, Vitamin B Kompleks, Vitamin E (BECEFOR - 1,150.000 0 5,400
110 Kaca mata Goggle (HASTEN) - 47,500.000 0 5
111 Mantel Gown APD (Usaha Karya Mitra Bersama) - 200,000.000 0 -
112 Masker Bedah Hijau @50pcs - 2,816.000 0 -
113 Masker N95 3M 8210 (Hazten) - 150,000.000 0 10
114 Nurse Cap Green om 100bh - 303.550 0 -
115 Parafilm (Anugerah Sentosa Abadi) - 891,275.000 0 -
116 Rapid Test (1.000) Widhi Dharma Adi - 160,500.000 0 -
117 Sarung tangan Safeglove Exam M 100bh - 585.000 0 6,000
118 Sarung tangan Safeglove Surgical size 7 dan 7,5 - 5,300.000 0 -
119 Sterlisasi Swab stik (5box/ VTM) - 5,500.000 0 -
120 Stereofoam (Anugerah Sentosa Abadi) - 60,500.000 0 -
121 Universal Transport Media (UTM) Goongdong - 80,000.000 0 40
122 Universal Transport Media (UTM) Sekarguna - 136,564.000 0 -
123 Vakutainer tube tertutup (VTM) Anugerah Sentosa Abadi - 1,265.000 0 -
124 Infusion Set Dewasa 20 Drops/ (OTSUKA) - 8,400.000 0 -
125 Infusion Set Anak 60 Drops /(Otsuka) - 8,400.000 0 -
126 Rapid Test Accu Tell (PT Marcotila Medica) - 98,000.000 0 -
127 Rapid Test Lecurate (Bima Sakti) - 90,000.000 0 20
128 Rapid Test ZYBIO (Farma Husada) - 97,500.000 0 50
129 Alkohol 96 % - 22,500.000 0 20
130 0 - - 0 -
0 0 - - 0 -
0 TAMBAHAN PUSKESMAS - - 0 -
1 Ampicilin Serbuk Inj i.v 1.000 mg/vial (Viccilin) 9 7,199.885 64798.965 -
2 Asam Tranexamat 100 mg/@5 ml Injeksi 3 1,945.000 5835 -
3 Asiklovir 5% 5gr Cream 44 2,950.000 129800 -
4 Budesonid Formoterol Inhaler 160/4,5 mcg/Symbicort (Astr 4 139,880.000 559520 -
5 0 - - 0 -
6 Deksamethason Inj iv/ im 5 mg/ ml (Mepro) 14 1,097.000 15358 -
7 Furosemide Tablet 40 mg (Kimia Farma ) 608 77.000 46816 -
8 Gentamycin Krim 1 % mg/ ml 10 3,217.500 32175 -
9 0 - - 0 -
10 Hyoscine N- Butylbromide 20 mg Inj/ GITAS (Interbat) 3 15,572.700 46718.1 -
11 Ketokonazol Tablet 200 mg (Novapharin) I 20 270.000 5400 -
12 Meloxicam Tab 15 mg (Bernofarm ) 5 600.000 3000 -
13 Metamizol 500 mg + Diazepam 2 mg / METANEURON 344 1,106.000 380464 -
14 Piridoksin HCl (Vit.B6)Tablet 10 mg 293 45.000 13185 -
15 Thiamin/ Vitamin B1 50 mg 50 36.000 1800 -
16 Thiamphenicol / Thiamfilex Kapsul 500 mg 330 783.000 258390 -
17 Alat Suntik Sekali Pakai 10 ml (NIPRO) 55 1,302.000 71610 -
18 Antimicrobial Liquid Soap 500 ml (Viorex) 13 74,250.000 965250 -
19 Hand Sanitizer 450 ml (Meditol) 13 43,186.000 561418 -
20 Infusion Set Dewasa 20 Drops/ (Kimsmed) 39 7,920.000 308880 -
21 I.V Catheter No. 18 (JELCO) 1 8,750.000 8750 -
22 I.V Catheter No. 22 NIPRO 4 7,018.000 28072 -
23 I.V Catheter No. 24 TERUMO 9 8,355.000 75195 -
24 Materniti Napkin Slim L 1 20,328.000 20328 -
25 Plester Roll Kain 2.5 cm x 4.5 cm ( Leukoplast 1622H) 11 12,076.000 132836 -
26 Sarung Tangan Steril No 7 Dan 7,5 (Medic dent) (Pasang) 5 6,595.000 32975 -
27 Surface Disinfectant Galon 5 Liter (Stericide ) 1 1,098,900.000 1098900 -
28 Sterizyme Dual Enymatic Detergent 5 Ltr 2 712,800.000 1425600 -
29 Haloperidol 5 mg tablet 148 56.000 8288 -
30 Alat Suntik Sekali Pakai .5 ml (NIPRO) 82 1,640.000 134480 -
31 Fixomull Strech 5 cm X 5 m 17 42,800.000 727600 -
32 Umbilical crd clamp 233 2,750.000 640750 -
33 0 - - 0 -
34 0 - - 0 -
35 0 - - 0 -
36 0 - - 0 -
37 0 - - 0 -
38 0 - - 0 -
39 0 - - 0 -
40 0 - - 0 -
41 0 - - 0 -
42 0 - - 0 -
43 0 - - 0 -
44 0 - - 0 -
45 0 - - 0 -
46 0 - - 0 -
47 0 - - 0 -
48 0 - - 0 -
49 0 - - 0 -
50 0 - - 0 -
51 0 - - 0 -
52 0 - - 0 -
53 0 - - 0 -
54 0 - - 0 -
55 0 - - 0 -
56 0 - - 0 -
57 0 - - 0 -
58 0 - - 0 -
59 0 - - 0 -
60 0 - - 0 -
0 0 - - 0 -
0 TOTAL - - 0 -
0 TOTAL 113244807.601 TOTAL
BAT PUSKESMAS ..............................
TAHUN 2020
MUTASI MASUK 1 JAN S/D 31 DES PENGGUNAAN 1 JAN S/D 31 DES SALDO AKHIR 31 DES 2019
HARGA NILAI HARGA NILAI HARGA SISA NILAI
SATUAN PENGADAAN JUMLAH BRG SATUAN PENGGUNAAN JUMLAH BRG SATUAN PERSEDIAAN
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
99.000 0 - 99.000 0 - 99.000 0
105.000 63000 729 105.000 76545 - 105.000 0
105.000 105000 892 105.000 93660 108 105.000 11340
- 0 - - 0 - - 0
2,860.000 0 80 2,860.000 228800 - 2,860.000 0
2,860.000 686400 109 2,860.000 311740 131 2,860.000 374660
10,500.000 0 - 10,500.000 0 - 10,500.000 0
104.000 83200 1,335 104.000 138840 382 104.000 39728
220.000 0 - 220.000 0 - 220.000 0
93.500 187000 1,543 93.500 144270.5 1,418 93.500 132583
- 0 - - 0 - - 0
2,998.000 0 - 2,998.000 0 - 2,998.000 0
- 0 - - 0 - - 0
93.000 0 751 93.000 69843 - 93.000 0
99.000 415800 3,258 99.000 322542 942 99.000 93258
- 0 - - 0 - - 0
190.000 6650000 26,570 190.000 5048300 8,430 190.000 1601700
233.000 0 - 233.000 0 - 233.000 0
233.000 0 90 233.000 20970 - 233.000 0
249.000 0 - 249.000 0 - 249.000 0
- 0 - - 0 - - 0
3,025.000 1210000 534 3,025.000 1615350 82 3,025.000 248050
 3,025.000 0 - 3,025.000 0 - 3,025.000 0
4,400.000 0 - 4,400.000 0 - 4,400.000 0
3,628.000 0 - 3,628.000 0 - 3,628.000 0
10,246.500 0 - 10,246.500 0 - 10,246.500 0
9,900.000 0 - 9,900.000 0 - 9,900.000 0
8,500.000 0 577 8,500.000 4904500 - 8,500.000 0
8,237.000 2471100 250 8,237.000 2059250 50 8,237.000 411850
- 0 - - 0 - - 0
4,950.000 247500 137 4,950.000 678150 - 4,950.000 0
- 0 - - 0 - - 0
440.000 0 47 440.000 20680 - 440.000 0
220.000 0 - 220.000 0 - 220.000 0
165.000 1815000 17,014 165.000 2807310 - 165.000 0
58.000 580000 7,668 58.000 444744 2,332 58.000 135256
- 0 - - 0 - - 0
3,035.000 0 - 3,035.000 0 - 3,035.000 0
- 0 - - 0 - - 0
4,496.000 107904 - 4,496.000 0 24 4,496.000 107904
- 0 - - 0 - - 0
3,045.000 91350 600 3,045.000 1827000 - 3,045.000 0
198.000 0 - 198.000 0 - 198.000 0
1,485.000 0 - 1,485.000 0 - 1,485.000 0
1,551.000 0 - 1,551.000 0 - 1,551.000 0
105.000 525000 7,805 105.000 819525 - 105.000 0
105.000 420000 3,217 105.000 337785 783 105.000 82215
1,050.000 0 - 1,050.000 0 - 1,050.000 0
67.000 0 - 67.000 0 - 67.000 0
75.000 0 - 75.000 0 - 75.000 0
103.000 0 - 103.000 0 - 103.000 0
253.000 759000 1,304 253.000 329912 1,696 253.000 429088
- 0 - - 0 - - 0
2,076.000 41520 17 2,076.000 35292 23 2,076.000 47748
 - 0 - - 0 - - 0
1,584.000 316800 442 1,584.000 700128 74 1,584.000 117216
- 0 - - 0 - - 0
2,915.000 0 73 2,915.000 212795 77 2,915.000 224455
2,750.000 0 - 2,750.000 0 - 2,750.000 0
- 0 - - 0 - - 0
380.000 0 - 380.000 0 - 380.000 0
380.000 114000 581 380.000 220780 - 380.000 0
405.000 40500 3 405.000 1215 97 405.000 39285
1,639.000 0 - 1,639.000 0 - 1,639.000 0
1,639.000 0 - 1,639.000 0 - 1,639.000 0
136.000 0 669 136.000 90984 - 136.000 0
152.000 0 2,000 152.000 304000 - 152.000 0
145.000 290000 600 145.000 87000 1,400 145.000 203000
110.000 0 99 110.000 10890 - 110.000 0
110.000 0 - 110.000 0 - 110.000 0
3,350.000 0 83 3,350.000 278050 - 3,350.000 0
3,350.000 0 108 3,350.000 361800 - 3,350.000 0
3,350.000 1507500 372 3,350.000 1246200 78 3,350.000 261300
300.000 0 - 300.000 0 - 300.000 0
5,900.000 0 - 5,900.000 0 - 5,900.000 0
626.000 0 - 626.000 0 - 626.000 0
18,150.000 0 - 18,150.000 0 - 18,150.000 0
7,602.000 0 - 7,602.000 0 - 7,602.000 0
7,124.000 0 - 7,124.000 0 - 7,124.000 0
- 0 - - 0 - - 0
149,266.000 0 - 149,266.000 0 - 149,266.000 0
- 0 - - 0 - - 0
5,280.000 0 - 5,280.000 0 - 5,280.000 0
660.000 660000 1,938 660.000 1279080 - 660.000 0
671.000 1006500 707 671.000 474397 793 671.000 532103
4,282.000 0 - 4,282.000 0 - 4,282.000 0
11,000.000 0 28 11,000.000 308000 48 11,000.000 528000
10,098.000 504900 - 10,098.000 0 50 10,098.000 504900
2,805.000 0 - 2,805.000 0 - 2,805.000 0
1,097.000 0 137 1,097.000 150289 - 1,097.000 0
1,097.000 219400 154 1,097.000 168938 46 1,097.000 50462
60.500 60500 4,939 60.500 298809.5 - 60.500 0
66.000 132000 1,529 66.000 100914 471 66.000 31086
10,400.000 0 6 10,400.000 62400 - 10,400.000 0
9,900.000 0 - 9,900.000 0 - 9,900.000 0
1,095.000 525600 653 1,095.000 715035 59 1,095.000 64605
- 0 - - 0 - - 0
104.000 0 368 104.000 38272 - 104.000 0
104.000 20800 71 104.000 7384 129 104.000 13416
104.000 0 - 104.000 0 - 104.000 0
105.000 262500 1,765 105.000 185325 735 105.000 77175
112.000 0 484 112.000 54208 - 112.000 0
- 0 - - 0 - - 0
4,400.000 0 98 4,400.000 431200 - 4,400.000 0
2,700.000 0 - 2,700.000 0 - 2,700.000 0
165.000 165000 1,241 165.000 204765 204 165.000 33660
91.000 0 - 91.000 0 - 91.000 0
1,408.000 0 - 1,408.000 0 - 1,408.000 0
1,408.000 42240 60 1,408.000 84480 - 1,408.000 0
1,408.000 140800 9 1,408.000 12672 91 1,408.000 128128
730.000 0 - 730.000 0 - 730.000 0
770.000 231000 179 770.000 137830 121 770.000 93170
391.000 0 - 391.000 0 - 391.000 0
4,167.000 0 - 4,167.000 0 - 4,167.000 0
3,550.000 0 3 3,550.000 10650 - 3,550.000 0
3,682.000 441840 548 3,682.000 2017736 - 3,682.000 0
3,682.000 994140 119 3,682.000 438158 151 3,682.000 555982
691.000 0 26 691.000 17966 - 691.000 0
 710.000 0 313 710.000 222230 21 710.000 14910
- 0 - - 0 - - 0
1,333.000 0 26 1,333.000 34658 - 1,333.000 0
1,333.000 0 - 1,333.000 0 - 1,333.000 0
82.000 0 - 82.000 0 - 82.000 0
82.000 0 - 82.000 0 - 82.000 0
4,232.000 0 - 4,232.000 0 - 4,232.000 0
4,232.000 0 95 4,232.000 402040 - 4,232.000 0
4,232.000 812544 150 4,232.000 634800 42 4,232.000 177744
2,750.000 0 68 2,750.000 187000 - 2,750.000 0
4,400.000 211200 19 4,400.000 83600 29 4,400.000 127600
2,900.000 69600 158 2,900.000 458200 - 2,900.000 0
119.000 357000 7,081 119.000 842639 1,749 119.000 208131
119.000 0 - 119.000 0 - 119.000 0
77.000 154000 6,927 77.000 533379 2,000 77.000 154000
99.000 772200 7,800 99.000 772200 - 99.000 0
7,865.000 0 541 7,865.000 4254965 - 7,865.000 0
10,010.000 50050 1 10,010.000 10010 14 10,010.000 140140
10,010.000 0 - 10,010.000 0 - 10,010.000 0
6,900.000 0 - 6,900.000 0 - 6,900.000 0
7,363.000 294520 40 7,363.000 294520 - 7,363.000 0
132.000 0 - 132.000 0 - 132.000 0
149.000 149000 2,388 149.000 355812 483 149.000 71967
88.000 0 - 88.000 0 - 88.000 0
2,787.000 0 - 2,787.000 0 - 2,787.000 0
2,475.000 594000 299 2,475.000 740025 33 2,475.000 81675
2,475.000 0 - 2,475.000 0 - 2,475.000 0
176,800.000 0 - 176,800.000 0 - 176,800.000 0
8,800.000 0 - 8,800.000 0 10 8,800.000 88000
- 0 - - 0 - - 0
4,665.000 0 - 4,665.000 0 - 4,665.000 0
4,665.000 2015280 246 4,665.000 1147590 186 4,665.000 867690
 264.000 5280000 22,738 264.000 6002832 3,680 264.000 971520
330.000 0 - 330.000 0 - 330.000 0
660.000 0 - 660.000 0 - 660.000 0
187.000 0 - 187.000 0 - 187.000 0
90.000 0 109 90.000 9810 191 90.000 17190
89.000 0 24 89.000 2136 - 89.000 0
121.000 0 - 121.000 0 - 121.000 0
- 0 - - 0 - - 0
9,644.000 0 - 9,644.000 0 - 9,644.000 0
10,696.000 0 - 10,696.000 0 - 10,696.000 0
10,696.000 2139200 58 10,696.000 620368 182 10,696.000 1946672
- 0 - - 0 - - 0
770.000 0 - 770.000 0 - 770.000 0
- 0 - - 0 - - 0
1,755.000 0 - 1,755.000 0 100 1,755.000 175500
187.000 1496000 11,803 187.000 2207161 - 187.000 0
63.000 315000 3,291 63.000 207333 1,709 63.000 107667
63.000 0 - 63.000 0 - 63.000 0
94.600 283800 12,412 94.600 1174175.2 - 94.600 0
99.000 297000 2,398 99.000 237402 602 99.000 59598
5,610.000 0 26 5,610.000 145860 - 5,610.000 0
2,518.000 125900 42 2,518.000 105756 8 2,518.000 20144
396.000 0 59 396.000 23364 341 396.000 135036
288.000 0 - 288.000 0 - 288.000 0
288.000 0 - 288.000 0 - 288.000 0
1,089.000 0 - 1,089.000 0 - 1,089.000 0
- 0 - - 0 - - 0
1,810.000 434400 377 1,810.000 682370 - 1,810.000 0
- 0 - - 0 - - 0
10,500.000 0 - 10,500.000 0 - 10,500.000 0
17,968.500 0 34 17,968.500 610929 - 17,968.500 0
35,200.000 0 58 35,200.000 2041600 - 35,200.000 0
 - 0 - - 0 - - 0
22.000 0 30 22.000 660 - 22.000 0
77.000 770000 17,517 77.000 1348809 541 77.000 41657
23.000 0 - 23.000 0 - 23.000 0
2,750.000 0 - 2,750.000 0 - 2,750.000 0
495.000 0 - 495.000 0 - 495.000 0
440.000 880000 1,922 440.000 845680 1,378 440.000 606320
319.000 957000 1,556 319.000 496364 1,444 319.000 460636
2,052.000 0 - 2,052.000 0 - 2,052.000 0
2,190.000 438000 114 2,190.000 249660 86 2,190.000 188340
13,970.000 502920 35 13,970.000 488950 18 13,970.000 251460
22,550.000 451000 25 22,550.000 563750 - 22,550.000 0
23,100.000 231000 2 23,100.000 46200 8 23,100.000 184800
3,811.500 0 - 3,811.500 0 - 3,811.500 0
6,600.000 0 84 6,600.000 554400 - 6,600.000 0
- 0 - - 0 - - 0
1,937.000 0 3 1,937.000 5811 - 1,937.000 0
2,178.000 2090880 1,055 2,178.000 2297790 232 2,178.000 505296
1,222.000 0 - 1,222.000 0 - 1,222.000 0
99.000 0 272 99.000 26928 22 99.000 2178
330.000 0 - 330.000 0 - 330.000 0
123.000 0 74 123.000 9102 126 123.000 15498
131.000 0 - 131.000 0 - 131.000 0
4,680.500 0 580 4,680.500 2714690 - 4,680.500 0
4,730.000 851400 180 4,730.000 851400 - 4,730.000 0
550.000 0 - 550.000 0 - 550.000 0
- 0 - - 0 - - 0
4,950.000 0 - 4,950.000 0 - 4,950.000 0
5,500.000 825000 1,833 5,500.000 10081500 - 5,500.000 0
3,707.000 5560500 710 3,707.000 2631970 790 3,707.000 2928530
96.000 0 1,846 96.000 177216 - 96.000 0
102.000 204000 897 102.000 91494 1,103 102.000 112506
 143.000 0 480 143.000 68640 - 143.000 0
- 0 - - 0 - - 0
87.000 0 473 87.000 41151 - 87.000 0
80.000 0 - 80.000 0 - 80.000 0
121.000 0 - 121.000 0 - 121.000 0
192.500 0 70 192.500 13475 - 192.500 0
275.000 632500 1,358 275.000 373450 942 275.000 259050
8,110.000 0 - 8,110.000 0 - 8,110.000 0
8,110.000 0 - 8,110.000 0 - 8,110.000 0
14,318.700 0 4 14,318.700 57274.8 - 14,318.700 0
5,500.000 660000 120 5,500.000 660000 - 5,500.000 0
2,090.000 188100 990 2,090.000 2069100 - 2,090.000 0
5,000.000 0 8 5,000.000 40000 - 5,000.000 0
4,400.000 0 151 4,400.000 664400 - 4,400.000 0
1,265.000 0 - 1,265.000 0 - 1,265.000 0
990.000 0 - 990.000 0 - 990.000 0
13,200.000 3168000 322 13,200.000 4250400 - 13,200.000 0
13,167.000 2528064 100 13,167.000 1316700 92 13,167.000 1211364
2,332.000 0 - 2,332.000 0 - 2,332.000 0
528.000 0 1,534 528.000 809952 - 528.000 0
594.000 0 - 594.000 0 - 594.000 0
835.000 21125500 25,300 835.000 21125500 - 835.000 0
115.000 0 - 115.000 0 - 115.000 0
123.000 0 2,674 123.000 328902 - 123.000 0
123.000 123000 81 123.000 9963 919 123.000 113037
6,410.000 0 40 6,410.000 256400 - 6,410.000 0
6,410.000 890990 139 6,410.000 890990 - 6,410.000 0
132.000 0 1,052 132.000 138864 - 132.000 0
3,948.000 0 - 3,948.000 0 - 3,948.000 0
23,141.800 0 19 23,141.800 439694.2 - 23,141.800 0
19,800.000 0 24 19,800.000 475200 - 19,800.000 0
560.000 0 55 560.000 30800 20 560.000 11200
 560.000 0 - 560.000 0 - 560.000 0
598.000 59800 - 598.000 0 100 598.000 59800
12,100.000 0 - 12,100.000 0 - 12,100.000 0
24,860.000 0 3 24,860.000 74580 - 24,860.000 0
9,955.000 0 75 9,955.000 746625 - 9,955.000 0
25,597.000 0 - 25,597.000 0 - 25,597.000 0
160.000 96000 1,757 160.000 281120 - 160.000 0
1,070.000 749000 360 1,070.000 385200 452 1,070.000 483640
1,124.000 0 - 1,124.000 0 - 1,124.000 0
715.000 0 816 715.000 583440 - 715.000 0
432.300 0 - 432.300 0 - 432.300 0
437.800 0 2,681 437.800 1173741.8 - 437.800 0
418.000 0 - 418.000 0 - 418.000 0
357.500 0 - 357.500 0 - 357.500 0
495.000 0 - 495.000 0 - 495.000 0
789.800 0 - 789.800 0 - 789.800 0
1,181.000 0 23 1,181.000 27163 - 1,181.000 0
1,181.000 708600 581 1,181.000 686161 19 1,181.000 22439
53.000 318000 7,768 53.000 411704 - 53.000 0
56.000 280000 5,000 56.000 280000 - 56.000 0
53.000 0 - 53.000 0 - 53.000 0
20,700.000 621000 40 20,700.000 828000 - 20,700.000 0
11,825.000 1773750 134 11,825.000 1584550 52 11,825.000 614900
11,825.000 0 - 11,825.000 0 - 11,825.000 0
963.600 192720 342 963.600 329551.2 138 963.600 132976.8
115.500 2541000 13,068 115.500 1509354 8,932 115.500 1031646
4,400.000 220000 70 4,400.000 308000 19 4,400.000 83600
132.000 264000 1,286 132.000 169752 714 132.000 94248
123.000 369000 7,491 123.000 921393 - 123.000 0
6,600.000 0 - 6,600.000 0 - 6,600.000 0
41,500.000 0 - 41,500.000 0 - 41,500.000 0
68.000 0 - 68.000 0 - 68.000 0
 73.000 584000 12,396 73.000 904908 674 73.000 49202
73.000 0 - 73.000 0 - 73.000 0
1,000.000 0 - 1,000.000 0 - 1,000.000 0
1,155.000 693000 663 1,155.000 765765 - 1,155.000 0
1,188.000 356400 139 1,188.000 165132 161 1,188.000 191268
220.000 990000 3,765 220.000 828300 735 220.000 161700
- 0 - - 0 - - 0
9,646.000 0 - 9,646.000 0 - 9,646.000 0
9,646.000 3858400 100 9,646.000 964600 300 9,646.000 2893800
7,150.000 0 1,949 7,150.000 13935350 - 7,150.000 0
7,150.000 14300000 2,000 7,150.000 14300000 - 7,150.000 0
7,630.000 0 - 7,630.000 0 - 7,630.000 0
4,550.000 1365000 425 4,550.000 1933750 159 4,550.000 723450
- 0 - - 0 - - 0
70.000 0 573 70.000 40110 - 70.000 0
165.000 247500 620 165.000 102300 880 165.000 145200
2,620.000 503040 228 2,620.000 597360 73 2,620.000 191260
2,796.000 0 - 2,796.000 0 - 2,796.000 0
6,006.000 0 10 6,006.000 60060 - 6,006.000 0
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4,952.830 0 - 4,952.830 0 - 4,952.830 0
4,952.830 0 - 4,952.830 0 - 4,952.830 0
2,728.000 545600 200 2,728.000 545600 - 2,728.000 0
5,890.000 0 - 5,890.000 0 - 5,890.000 0
660,000.000 0 - 660,000.000 0 - 660,000.000 0
158,400.000 0 - 158,400.000 0 - 158,400.000 0
276,600.000 1383000 5 276,600.000 1383000 - 276,600.000 0
276,500.000 0 - 276,500.000 0 - 276,500.000 0
257,644.000 1288220 5 257,644.000 1288220 - 257,644.000 0
228,800.000 0 - 228,800.000 0 - 228,800.000 0
20,747.000 207470 6 20,747.000 124482 4 20,747.000 82988
20,748.000 0 - 20,748.000 0 - 20,748.000 0
6,700.000 0 - 6,700.000 0 - 6,700.000 0
19,835.000 595050 7 19,835.000 138845 23 19,835.000 456205
386.100 0 - 386.100 0 - 386.100 0
- 0 - - 0 - - 0
1,590.000 0 - 1,590.000 0 - 1,590.000 0
1,550.000 0 - 1,550.000 0 - 1,550.000 0
1,463.000 1463000 780 1,463.000 1141140 220 1,463.000 321860
1,518.000 0 - 1,518.000 0 - 1,518.000 0
1,190.000 0 - 1,190.000 0 - 1,190.000 0
1,185.000 3792000 3,000 1,185.000 3555000 200 1,185.000 237000
1,463.000 0 - 1,463.000 0 - 1,463.000 0
1,190.000 0 - 1,190.000 0 - 1,190.000 0
1,077.000 0 - 1,077.000 0 - 1,077.000 0
1,081.820 0 - 1,081.820 0 - 1,081.820 0
 - 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
1,583.000 0 355 1,583.000 561965 145 1,583.000 229535
1,439.000 0 - 1,439.000 0 - 1,439.000 0
1,439.000 0 - 1,439.000 0 - 1,439.000 0
- 0 - - 0 - - 0
22,433.000 1682475 25 22,433.000 560825 50 22,433.000 1121650
1,460.000 0 - 1,460.000 0 - 1,460.000 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
14,712.500 735625 - 14,712.500 0 50 14,712.500 735625
19,480.000 0 - 19,480.000 0 - 19,480.000 0
13,750.000 0 - 13,750.000 0 - 13,750.000 0
13,235.000 0 - 13,235.000 0 - 13,235.000 0
12,500.000 625000 - 12,500.000 0 50 12,500.000 625000
13,750.000 0 - 13,750.000 0 - 13,750.000 0
358.000 154656 432 358.000 154656 - 358.000 0
121,750.000 0 - 121,750.000 0 - 121,750.000 0
486.000 19440 40 486.000 19440 - 486.000 0
- 0 - - 0 - - 0
11,975.000 13172500 575 11,975.000 6885625 525 11,975.000 6286875
28,666.670 0 - 28,666.670 0 - 28,666.670 0
13,235.000 0 - 13,235.000 0 - 13,235.000 0
12,500.000 0 - 12,500.000 0 - 12,500.000 0
11,975.000 0 - 11,975.000 0 - 11,975.000 0
11,975.000 0 - 11,975.000 0 - 11,975.000 0
- 0 - - 0 - - 0
 19,480.000 0 - 19,480.000 0 - 19,480.000 0
- 0 - - 0 - - 0
13,235.000 0 - 13,235.000 0 - 13,235.000 0
- 0 - - 0 - - 0
19,480.000 0 - 19,480.000 0 - 19,480.000 0
13,353.000 0 - 13,353.000 0 - 13,353.000 0
800.000 0 - 800.000 0 - 800.000 0
- 0 - - 0 - - 0
323,500.000 0 - 323,500.000 0 - 323,500.000 0
53,000.000 0 - 53,000.000 0 - 53,000.000 0
386.100 0 - 386.100 0 - 386.100 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
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
38,500.000 0 - 38,500.000 0 - 38,500.000 0
71,500.000 0 - 71,500.000 0 - 71,500.000 0
38,500.000 0 - 38,500.000 0 - 38,500.000 0
71,500.000 0 - 71,500.000 0 - 71,500.000 0
 333.900 0 - 333.900 0 - 333.900 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
473.000 189200 - 473.000 0 400 473.000 189200
- 0 - - 0 - - 0
110.000 0 - 110.000 0 - 110.000 0
1,750.000 0 - 1,750.000 0 - 1,750.000 0
98.000 0 - 98.000 0 - 98.000 0
783.000 0 - 783.000 0 - 783.000 0
7,150.000 0 - 7,150.000 0 - 7,150.000 0
2,134.000 0 - 2,134.000 0 - 2,134.000 0
6,199.900 0 - 6,199.900 0 - 6,199.900 0
1,155.000 346500 300 1,155.000 346500 - 1,155.000 0
80.000 0 - 80.000 0 - 80.000 0
396.000 0 - 396.000 0 - 396.000 0
500.000 0 - 500.000 0 - 500.000 0
7,920.000 396000 50 7,920.000 396000 - 7,920.000 0
1,302.000 0 - 1,302.000 0 - 1,302.000 0
1,890.000 0 - 1,890.000 0 - 1,890.000 0
160.000 0 - 160.000 0 - 160.000 0
6,840.000 2462400 120 6,840.000 820800 240 6,840.000 1641600
90.000 0 - 90.000 0 - 90.000 0
265.000 0 - 265.000 0 - 265.000 0
14,300.000 0 - 14,300.000 0 - 14,300.000 0
7,630.000 11445000 1,500 7,630.000 11445000 - 7,630.000 0
167.000 0 - 167.000 0 - 167.000 0
8,355.000 0 - 8,355.000 0 - 8,355.000 0
1,457,500.000 1457500 1 1,457,500.000 1457500 - 1,457,500.000 0
- 0 - - 0 - - 0
12,969.000 0 - 12,969.000 0 - 12,969.000 0
1,506.000 0 - 1,506.000 0 - 1,506.000 0
410,777.000 0 - 410,777.000 0 - 410,777.000 0
343,687.000 0 - 343,687.000 0 - 343,687.000 0
32,493.000 0 - 32,493.000 0 - 32,493.000 0
- 0 - - 0 30 - 0
2,254.320 0 - 2,254.320 0 - 2,254.320 0
259,175.000 0 - 259,175.000 0 - 259,175.000 0
15,180.000 0 - 15,180.000 0 - 15,180.000 0
31,680.000 6336000 - 31,680.000 0 200 31,680.000 6336000
31,405.000 6281000 6 31,405.000 188430 194 31,405.000 6092570
3,300.000 0 - 3,300.000 0 - 3,300.000 0
7,630.000 0 - 7,630.000 0 - 7,630.000 0
14,300.000 0 - 14,300.000 0 - 14,300.000 0
8,426.000 0 - 8,426.000 0 - 8,426.000 0
627.000 0 - 627.000 0 - 627.000 0
792.000 0 - 792.000 0 - 792.000 0
1,700.000 5780000 1,450 1,700.000 2465000 1,950 1,700.000 3315000
1,700.000 0 - 1,700.000 0 - 1,700.000 0
55,000.000 1100000 12 55,000.000 660000 8 55,000.000 440000
58,500.000 2632500 28 58,500.000 1638000 17 58,500.000 994500
850.000 5100000 6,000 850.000 5100000 - 850.000 0
4,000.000 1200000 - 4,000.000 0 300 4,000.000 1200000
8,355.000 0 - 8,355.000 0 - 8,355.000 0
248,120.000 0 - 248,120.000 0 - 248,120.000 0
186,000.000 0 - 186,000.000 0 - 186,000.000 0
6,500.000 0 - 6,500.000 0 - 6,500.000 0
11,250.000 0 - 11,250.000 0 - 11,250.000 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
 236,500.000 1892000 - 236,500.000 0 8 236,500.000 1892000
99,000.000 495000 - 99,000.000 0 5 99,000.000 495000
203,500.000 1424500 3 203,500.000 610500 4 203,500.000 814000
275,000.000 2750000 10 275,000.000 2750000 - 275,000.000 0
132,000.000 0 - 132,000.000 0 - 132,000.000 0
49,500.000 0 - 49,500.000 0 - 49,500.000 0
5,500.000 0 - 5,500.000 0 - 5,500.000 0
66,000.000 0 - 66,000.000 0 - 66,000.000 0
1,023.000 5012700 4,900 1,023.000 5012700 - 1,023.000 0
21,736.000 0 - 21,736.000 0 - 21,736.000 0
386.100 0 - 386.100 0 - 386.100 0
340.280 680560 200 340.280 68056 1,800 340.280 612504
560,000.000 560000 1 560,000.000 560000 - 560,000.000 0
1,252,000.000 2504000 2 1,252,000.000 2504000 - 1,252,000.000 0
575,000.000 575000 1 575,000.000 575000 - 575,000.000 0
156,000.000 4524000 20 156,000.000 3120000 9 156,000.000 1404000
53,636.000 0 - 53,636.000 0 - 53,636.000 0
220,000.000 1100000 5 220,000.000 1100000 - 220,000.000 0
148,500.000 445500 1 148,500.000 148500 2 148,500.000 297000
7,000.000 8400000 1,200 7,000.000 8400000 - 7,000.000 0
2,200.000 0 - 2,200.000 0 - 2,200.000 0
60,000.000 0 - 60,000.000 0 - 60,000.000 0
6,269.000 7522800 1,200 6,269.000 7522800 - 6,269.000 0
197,000.000 0 - 197,000.000 0 - 197,000.000 0
75,000.000 3000000 25 75,000.000 1875000 15 75,000.000 1125000
8,500.000 10200000 1,200 8,500.000 10200000 - 8,500.000 0
220,000.000 5500000 25 220,000.000 5500000 - 220,000.000 0
220,000.000 0 - 220,000.000 0 - 220,000.000 0
75,000.000 0 - 75,000.000 0 - 75,000.000 0
5,000.000 1000000 100 5,000.000 500000 100 5,000.000 500000
200,000.000 0 - 200,000.000 0 - 200,000.000 0
56,000.000 0 - 56,000.000 0 - 56,000.000 0
 80,000.000 0 - 80,000.000 0 - 80,000.000 0
200,000.000 16600000 48 200,000.000 9600000 35 200,000.000 7000000
138,364.000 0 - 138,364.000 0 - 138,364.000 0
137,364.000 0 - 137,364.000 0 - 137,364.000 0
45,100.000 315700 - 45,100.000 0 7 45,100.000 315700
66,000.000 0 - 66,000.000 0 - 66,000.000 0
53,636.000 0 - 53,636.000 0 - 53,636.000 0
450,000.000 0 - 450,000.000 0 - 450,000.000 0
718,500.000 2874000 - 718,500.000 0 4 718,500.000 2874000
69,000.000 0 - 69,000.000 0 - 69,000.000 0
60,000.000 0 - 60,000.000 0 - 60,000.000 0
6,000.000 30600000 - 6,000.000 0 5,100 6,000.000 30600000
522,728.000 0 - 522,728.000 0 - 522,728.000 0
180,000.000 0 - 180,000.000 0 - 180,000.000 0
220,000.000 0 - 220,000.000 0 - 220,000.000 0
109.090 0 - 109.090 0 - 109.090 0
24,091.000 0 - 24,091.000 0 - 24,091.000 0
1,150.000 6210000 5,400 1,150.000 6210000 - 1,150.000 0
47,500.000 237500 2 47,500.000 95000 3 47,500.000 142500
200,000.000 0 - 200,000.000 0 - 200,000.000 0
2,816.000 0 - 2,816.000 0 - 2,816.000 0
150,000.000 1500000 10 150,000.000 1500000 - 150,000.000 0
303.550 0 - 303.550 0 - 303.550 0
891,275.000 0 - 891,275.000 0 - 891,275.000 0
160,500.000 0 - 160,500.000 0 - 160,500.000 0
585.000 3510000 6,000 585.000 3510000 - 585.000 0
5,300.000 0 - 5,300.000 0 - 5,300.000 0
5,500.000 0 - 5,500.000 0 - 5,500.000 0
60,500.000 0 - 60,500.000 0 - 60,500.000 0
80,000.000 3200000 25 80,000.000 2000000 15 80,000.000 1200000
136,564.000 0 - 136,564.000 0 - 136,564.000 0
1,265.000 0 - 1,265.000 0 - 1,265.000 0
 8,400.000 0 - 8,400.000 0 - 8,400.000 0
8,400.000 0 - 8,400.000 0 - 8,400.000 0
98,000.000 0 - 98,000.000 0 - 98,000.000 0
90,000.000 1800000 15 90,000.000 1350000 5 90,000.000 450000
97,500.000 4875000 - 97,500.000 0 50 97,500.000 4875000
22,500.000 450000 16 22,500.000 360000 4 22,500.000 90000
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
7,199.885 0 9 7,199.885 64798.965 - 7,199.885 0
1,945.000 0 3 1,945.000 5835 - 1,945.000 0
2,950.000 0 44 2,950.000 129800 - 2,950.000 0
139,880.000 0 4 139,880.000 559520 - 139,880.000 0
- 0 - - 0 - - 0
1,097.000 0 14 1,097.000 15358 - 1,097.000 0
77.000 0 411 77.000 31647 197 77.000 15169
3,217.500 0 10 3,217.500 32175 - 3,217.500 0
- 0 - - 0 - - 0
15,572.700 0 3 15,572.700 46718.1 - 15,572.700 0
270.000 0 20 270.000 5400 - 270.000 0
600.000 0 5 600.000 3000 - 600.000 0
1,106.000 0 174 1,106.000 192444 170 1,106.000 188020
45.000 0 293 45.000 13185 - 45.000 0
36.000 0 50 36.000 1800 - 36.000 0
783.000 0 330 783.000 258390 - 783.000 0
1,302.000 0 55 1,302.000 71610 - 1,302.000 0
74,250.000 0 13 74,250.000 965250 - 74,250.000 0
43,186.000 0 13 43,186.000 561418 - 43,186.000 0
7,920.000 0 39 7,920.000 308880 - 7,920.000 0
8,750.000 0 1 8,750.000 8750 - 8,750.000 0
7,018.000 0 4 7,018.000 28072 - 7,018.000 0
8,355.000 0 9 8,355.000 75195 - 8,355.000 0
 20,328.000 0 1 20,328.000 20328 - 20,328.000 0
12,076.000 0 11 12,076.000 132836 - 12,076.000 0
6,595.000 0 5 6,595.000 32975 - 6,595.000 0
1,098,900.000 0 1 1,098,900.000 1098900 - 1,098,900.000 0
712,800.000 0 1 712,800.000 712800 1 712,800.000 712800
56.000 0 148 56.000 8288 - 56.000 0
1,640.000 0 82 1,640.000 134480 - 1,640.000 0
42,800.000 0 17 42,800.000 727600 - 42,800.000 0
2,750.000 0 107 2,750.000 294250 126 2,750.000 346500
- 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 - - 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 - - 0
 - 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
- 0 - - 0 - - 0
TOTAL 633877795.188 TOTAL 590286990.825 TOTAL 156835611.964
 0.000
0.000
11340.000
0.000
0.000
374660.000
0.000
39728.000
0.000
132583.000
0.000
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0.000
0.000
93258.000
0.000
1601700.000
0.000
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248050.000
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411850.000
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135256.000
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107904.000
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82215.000
0.000
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429088.000
0.000
47748.000
 0.000
117216.000
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224455.000
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39285.000
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261300.000
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532103.000
0.000
528000.000
504900.000
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0.000
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13416.000
0.000
77175.000
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33660.000
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128128.000
0.000
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555982.000
0.000
 14910.000
0.000
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177744.000
0.000
127600.000
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208131.000
0.000
154000.000
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140140.000
0.000
0.000
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0.000
71967.000
0.000
0.000
81675.000
0.000
0.000
88000.000
0.000
0.000
867690.000
 971520.000
0.000
0.000
0.000
17190.000
0.000
0.000
0.000
0.000
0.000
1946672.000
0.000
0.000
0.000
175500.000
0.000
107667.000
0.000
0.000
59598.000
0.000
20144.000
135036.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
 0.000
0.000
41657.000
0.000
0.000
0.000
606320.000
460636.000
0.000
188340.000
251460.000
0.000
184800.000
0.000
0.000
0.000
0.000
505296.000
0.000
2178.000
0.000
15498.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
2928530.000
0.000
112506.000
 0.000
0.000
0.000
0.000
0.000
0.000
259050.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1211364.000
0.000
0.000
0.000
0.000
0.000
0.000
113037.000
0.000
0.000
0.000
0.000
0.000
0.000
11200.000
 0.000
59800.000
0.000
0.000
0.000
0.000
0.000
483640.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
22439.000
0.000
0.000
0.000
0.000
614900.000
0.000
132976.800
1031646.000
83600.000
94248.000
0.000
0.000
0.000
0.000
 49202.000
0.000
0.000
0.000
191268.000
161700.000
0.000
0.000
2893800.000
0.000
0.000
0.000
723450.000
0.000
0.000
145200.000
191260.000
0.000
0.000
0.000
33000.000
0.000
512204.000
0.000
3929970.000
0.000
0.000
13090.000
0.000
0.000
0.000
0.000
 74679.000
0.000
0.000
0.000
0.000
92911.000
0.000
729300.000
85800.000
0.000
36668.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
12573.000
0.000
0.000
39578.000
95832.000
0.000
0.000
0.000
0.000
0.000
0.000
 0.000
0.000
0.000
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0.000
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0.000
0.000
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80597.000
0.000
0.000
246206.000
0.000
0.000
0.000
194711.000
0.000
0.000
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1312096.000
0.000
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 0.000
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292632.000
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25850.000
0.000
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9724380.000
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53144.000
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39900.000
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117502.000
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24716.000
0.000
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105000.000
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574317.000
 0.000
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95400.000
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159640.000
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169080.000
0.000
 0.000
1323080.000
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4156625.000
0.000
3034152.000
191950.000
0.000
0.000
1842984.000
0.000
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