LAPORAN PERSEDIAAN OBAT

GUDANG OBAT PUSKESMAS UJUNG LERO
TRIWULAN I

STOK AWAL STOK AWAL DIREVISI P E N E R I M AA N PE NG E LUARAN SISA PERSEDIAAN
SAT-
No. NA M A O B A T
UAN
BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI
1 Alat Suntik 1 ml Set 100 1,050.00 105,000.00 100 1,050.00 105,000.00 70 1,050.00 73,500.00 170 1,050.00 178,500.00 - 1,050.00 -
2 Abbocath No. 18 Set 5 8,200.00 41,000.00 5 8,200.00 41,000.00 35 8,200.00 287,000.00 40 8,200.00 328,000.00 - 8,200.00 -
3 Abbocath No. 20 Set 5 8,200.00 41,000.00 5 8,200.00 41,000.00 65 8,200.00 533,000.00 70 8,200.00 574,000.00 - 8,200.00 -
4 Abbocath No. 22 Set 6 8,200.00 49,200.00 6 8,200.00 49,200.00 58 8,200.00 475,600.00 64 8,200.00 524,800.00 - 8,200.00 -
5 Abbocath No. 24 Set 25 8,200.00 205,000.00 25 8,200.00 205,000.00 40 8,200.00 328,000.00 65 8,200.00 533,000.00 - 8,200.00 -
6 Alat Suntik 2,5 ml Set 100 1,100.00 110,000.00 100 1,100.00 110,000.00 130 1,100.00 143,000.00 190 1,100.00 209,000.00 40 1,100.00 44,000.00
7 Alat Suntik 5 ml Set 80 1,100.00 88,000.00 80 1,100.00 88,000.00 85 1,100.00 93,500.00 165 1,100.00 181,500.00 - 1,100.00 -
8 Albendazole Tab 60 363.00 21,780.00 60 363.00 21,780.00 363.00 - 30 363.00 10,890.00 30 363.00 10,890.00
9 Alopurinol tablet 100 mg Tab 100 90.00 9,000.00 100 90.00 9,000.00 500 90.00 45,000.00 600 90.00 54,000.00 - 90.00 -
10 Aminofilin injeksi Amp 5 4,200.00 21,000.00 5 4,200.00 21,000.00 4 4,200.00 16,800.00 9 4,200.00 37,800.00 - 4,200.00 -
11 Aminofilin tablet 200 mg Tab 100 86.00 8,600.00 100 86.00 8,600.00 300 86.00 25,800.00 200 86.00 17,200.00 200 86.00 17,200.00
12 Amitriptilin hcl tab salut 25 mg Tab 200 123.00 24,600.00 200 123.00 24,600.00 123.00 - 123.00 - 200 123.00 24,600.00
13 Amlodipin 10 mg Tablet Tab 352.00 - 352.00 - 700 352.00 246,400.00 700 352.00 246,400.00 352.00 -
14 Amoksisilin Kapsul 250 mg Kap 220.00 - - 220.00 - 720 220.00 158,400.00 480 220.00 105,600.00 240 220.00 52,800.00
15 Amoksisilin Kapsul 500 mg Kap 500 292.00 146,000.00 500 292.00 146,000.00 9,000 292.00 2,628,000.00 8,800 292.00 2,569,600.00 700 292.00 204,400.00
16 Amoksisilin sirup kering Btl 2,560.00 - - 2,560.00 - 110 2,560.00 281,600.00 110 2,560.00 281,600.00 - 2,560.00 -
17 Ampisilin Inj Vial 15 5,610.00 84,150.00 15 5,610.00 84,150.00 10 5,610.00 56,100.00 5,610.00 - 25 5,610.00 140,250.00
18 Ampisilin Kaplet 500 mg Kapl 419.00 - 419.00 - 419.00 - 419.00 - - 419.00 -
19 Antalgin Tab 500 mg Tab 141.85 - 141.85 - 141.85 - 141.85 - - 141.85 -
20 Antasida doen tablet kombinasi Tab 1,600 78.00 124,800.00 1,600 78.00 124,800.00 7,000 78.00 546,000.00 7,800 78.00 608,400.00 800 78.00 62,400.00
21 Antifungi doen kombinasi Pot 2,096.00 - 2,096.00 - 2,096.00 - 2,096.00 - - 2,096.00 -
22 Antihemoroid doen kombinasi Sup 2,200.00 - 2,200.00 - 10 2,200.00 22,000.00 2,200.00 - 10 2,200.00 22,000.00
23 Antimigrain doen kombinasi Tab 100 149.00 14,900.00 100 149.00 14,900.00 100 149.00 14,900.00 100 149.00 14,900.00 100 149.00 14,900.00
24 Aqua proinjeksi steril Vial 1 5,800.00 5,800.00 1 5,800.00 5,800.00 7 5,800.00 40,600.00 8 5,800.00 46,400.00 - 5,800.00 -
25 Artesunate Anak Blister - - - - - - - - - - - -
26 Artesunate Dewasa Blister - - - - - - - - - - - - -
27 Artesunate Inj Vial - - - - - - - - - - - - -
28 Artesunate Remaja Blister - - - - - - - - - - - - -
29 Asam askorbat ( Vit c ) tab 50 mg Tab 3,000 105.00 315,000.00 3,000 105.00 315,000.00 8,000 105.00 840,000.00 8,000 105.00 840,000.00 3,000 105.00 315,000.00
30 Asam Mefenamat tablet Tab 100 122.00 12,200.00 100 122.00 12,200.00 3,900 122.00 475,800.00 3,900 122.00 475,800.00 100 122.00 12,200.00
31 Asam Traneksamat Inj Amp 3,250.00 - - 3,250.00 - 3,250.00 - 3,250.00 - - 3,250.00 -
32 Asetosal tablet 100 mg Tab 100 127.00 12,700.00 100 127.00 12,700.00 127.00 - 127.00 - 100 127.00 12,700.00
33 Asklovir 400 mg Tab 362.00 - 362.00 - 500 362.00 181,000.00 300 362.00 108,600.00 200 362.00 72,400.00
34 Atropin sulfat injeksi 0,25 mg/ml Amp 5 - - 5 1,500.00 7,500.00 25 1,500.00 37,500.00 1,500.00 - 30 1,500.00 45,000.00
35 Benzatin benzil penisilin injeksi Amp 10,780.00 - 10,780.00 - 10,780.00 - 10,780.00 - - 10,780.00 -

36 Betahistin Tab 1,016.00 - 1,016.00 - 1,016.00 - 1,016.00 - - 1,016.00 -
37 Betametason krim 0,1 % Tube 1,596.00 - 1,596.00 - 57 1,596.00 90,972.00 44 1,596.00 70,224.00 13 1,596.00 20,748.00
38 Captopril 25 mg Tab 100.00 - 100.00 - 4,000 100.00 400,000.00 2,600 100.00 260,000.00 1,400 100.00 140,000.00
39 Catgut/benang bedah no.2/0 - 3/0 Sak 7 26,500.00 185,500.00 7 26,500.00 185,500.00 27 26,500.00 715,500.00 23 26,500.00 609,500.00 11 26,500.00 291,500.00
40 Cefotaksim 1 g Injeksi Vial - - 3,500.00 - 20 3,500.00 70,000.00 - 3,500.00 - 20 3,500.00 70,000.00
41 Ciprofloksasin 500 mg Kaps 265.00 - 265.00 - 2,200 265.00 583,000.00 2,100 265.00 556,500.00 100 265.00 26,500.00
42 Deksametason injeksi 5 mg/ml Amp 80 1,738.00 139,040.00 80 1,738.00 139,040.00 80 1,738.00 139,040.00 15 1,738.00 26,070.00 145 1,738.00 252,010.00
43 Deksametason tablet 0,5 mg Tab 1,800 74.00 133,200.00 1,800 74.00 133,200.00 6,500 74.00 481,000.00 6,500 74.00 481,000.00 1,800 74.00 133,200.00
44 Dekstrometorfan sirup 10 mg/5m Btl 1,467.00 - 1,467.00 - 1,467.00 - 1,467.00 - - 1,467.00 -
45 Dekstrometorfan hbr tab 15 mg Tab 102.00 - 102.00 - 102.00 - 102.00 - - 102.00 -
46 Devitalisasi pasta ( non Arsen ) Btl 429,000.00 - 429,000.00 - 429,000.00 - 429,000.00 - - 429,000.00 -
47 Diazepam tablet 2 mg Tab 1,000 39.00 39,000.00 1,000 39.00 39,000.00 4,000 39.00 156,000.00 4,000 39.00 156,000.00 1,000 39.00 39,000.00
48 Diazepam inj 5 mg/ml - 2 ml Amp 15 2,578.00 38,670.00 15 2,578.00 38,670.00 2,578.00 - 10 2,578.00 25,780.00 5 2,578.00 12,890.00
49 Difenhidramin inj 10 mg/ml-1ml Amp 59 1,156.00 68,204.00 59 1,156.00 68,204.00 1 1,156.00 1,156.00 1,156.00 - 60 1,156.00 69,360.00
50 Digoksin tablet 0,25 mg Tab 100 103.00 10,300.00 100 103.00 10,300.00 100 103.00 10,300.00 100 103.00 10,300.00 100 103.00 10,300.00
51 Doksisiklin Tab 100 278.00 27,800.00 100 278.00 27,800.00 500 278.00 139,000.00 278.00 - 600 278.00 166,800.00
52 Efedrin tablet 25 mg Tab 1,000 56.34 56,340.00 1,000 56.34 56,340.00 3,000 56.34 169,020.00 1,250 56.34 70,425.00 2,750 56.34 154,935.00
53 Ekstrak belladon tablet 10 mg Tab 42.00 - 42.00 - 42.00 - 42.00 - - 42.00 -
54 Epinefrin (adrenalin) inj.0,1%-1ml Amp 14 8,910.00 124,740.00 14 8,910.00 124,740.00 5 8,910.00 44,550.00 1 8,910.00 8,910.00 18 8,910.00 160,380.00
55 Eritromisin Kaps 250 mg Kaps - - - - - -
56 Etakridin ( rivanol ) lar. 0,1% Btl 2 2,354.00 4,708.00 2 2,354.00 4,708.00 2 2,354.00 4,708.00 3 2,354.00 7,062.00 1 2,354.00 2,354.00
57 Etanol 70% Btl 18,698.00 - 18,698.00 - 5 18,698.00 93,490.00 4 18,698.00 74,792.00 1 18,698.00 18,698.00
58 Etilklorida semprot Btl 1 11,550.00 11,550.00 1 11,550.00 11,550.00 11,550.00 - 1 11,550.00 11,550.00 11,550.00 -
59 Eugenol cairan Btl 18,333.00 - 18,333.00 - 1 18,333.00 18,333.00 18,333.00 - 1 18,333.00 18,333.00
60 Fenobarbital Inj Amp 15 1,980.00 29,700.00 15 1,980.00 29,700.00 - 1,980.00 - 1,980.00 - 15 1,980.00 29,700.00
61 Fenobarbital tablet 30 mg Tab 1,000 74.00 74,000.00 1,000 74.00 74,000.00 2,000 74.00 148,000.00 1,000 74.00 74,000.00 2,000 74.00 148,000.00
62 Fenol gliserol tetes telinga 10% Btl 5 1,108.80 5,544.00 5 1,108.80 5,544.00 22 1,108.80 24,393.60 13 1,108.80 14,414.40 14 1,108.80 15,523.20
63 Ferro Sulfat 300 mg Tab 2,000 24.00 48,000.00 2,000 24.00 48,000.00 - 24.00 - 24.00 - 2,000 24.00 48,000.00
64 Fitomenadion ( vit k 1) injeksi Amp 30 3,754.00 112,620.00 30 3,754.00 112,620.00 3,754.00 - 3,754.00 - 30 3,754.00 112,620.00
65 Fitomenadion ( vit k 1) tab 10 mg Tab 200 690.00 138,000.00 200 690.00 138,000.00 100 690.00 69,000.00 100 690.00 69,000.00 200 690.00 138,000.00
66 Furosemida tablet 40 mg Tab 84.00 - 84.00 - 400 84.00 33,600.00 100 84.00 8,400.00 300 84.00 25,200.00
67 Garam oralit untuk 200 ml Sak 100 317.00 31,700.00 100 317.00 31,700.00 385 317.00 122,045.00 160 317.00 50,720.00 325 317.00 103,025.00
68 Gentamisin Inj Amp 30 3,739.00 112,170.00 30 3,739.00 112,170.00 5 3,739.00 18,695.00 3,739.00 - 35 3,739.00 130,865.00
69 Gentian violet larutan 1 % Btl 985.00 - 985.00 - 985.00 - 985.00 - - 985.00 -
70 Glass Ionomer cement (gc ix ) Set 1 435,500.00 435,500.00 1 435,500.00 435,500.00 1 435,500.00 435,500.00 1 435,500.00 435,500.00 1 435,500.00 435,500.00
71 Glibenklamid tablet 5 mg Tab 200 61.00 12,200.00 200 61.00 12,200.00 100 61.00 6,100.00 200 61.00 12,200.00 100 61.00 6,100.00
72 Gliseril guayakolat tab 100 mg Tab 1,000 3.69 3,690.00 1,000 3.69 3,690.00 5,000 3.69 18,450.00 5,000 3.69 18,450.00 1,000 3.69 3,690.00
73 Glukonas Kalsikus Inj Inj 19 - - 19 - - 5 - - - - 24 - -
74 Glukosa 5 % Btl 35 5,720.00 200,200.00 35 5,720.00 200,200.00 10 5,720.00 57,200.00 40 5,720.00 228,800.00 5 5,720.00 28,600.00
75 Griseofulvin tab 125 mg Tab 200 241.00 48,200.00 200 241.00 48,200.00 800 241.00 192,800.00 600 241.00 144,600.00 400 241.00 96,400.00
76 Haloperidol tablet 1,5 mg Tab 76.00 - 76.00 - 600 76.00 45,600.00 300 76.00 22,800.00 300 76.00 22,800.00
77 Handshoen No. 7 Psg 4,675.00 - 4,675.00 - 30 4,675.00 140,250.00 30 4,675.00 140,250.00 - 4,675.00 -

78 Hidroklorotiazid (hct) tab 25 mg Tab 2,000 40.00 80,000.00 2,000 40.00 80,000.00 500 40.00 20,000.00 1,000 40.00 40,000.00 1,500 40.00 60,000.00
79 Hidrokotrizon krim 2,5 % Tube 2,938.00 - 2,938.00 - 50 2,938.00 146,900.00 25 2,938.00 73,450.00 25 2,938.00 73,450.00
80 Ibuprofen 200 mg Tab 400 96.21 38,484.00 400 96.21 38,484.00 1,800 96.21 173,178.00 1,100 96.21 105,831.00 1,100 96.21 105,831.00
81 Ibuprofen 400 mg Tab 157.00 - 157.00 - 1,400 157.00 219,800.00 1,400 157.00 219,800.00 - 157.00 -
82 Infusion set anak Set 17 4,400.00 74,800.00 17 4,400.00 74,800.00 63 4,400.00 277,200.00 80 4,400.00 352,000.00 - 4,400.00 -
83 Infusion set dewasa Set 9 3,850.00 34,650.00 9 3,850.00 34,650.00 110 3,850.00 423,500.00 119 3,850.00 458,150.00 - 3,850.00 -
84 Iodiol Kapsul Lunak Kaps 1,023.00 - 1,023.00 - 1,023.00 - 1,023.00 - - 1,023.00 -
85 Isosorbit dinitrat tab 5 mg Tab 300 98.00 29,400.00 300 98.00 29,400.00 - 98.00 - 98.00 - 300 98.00 29,400.00
86 Kalsium hidroksida pasta Tube 266,200.00 - 266,200.00 - 266,200.00 - 266,200.00 - - 266,200.00 -
87 Kalsium laktat ( kalk ) tab 500 m Tab 2,000 57.20 114,400.00 2,000 57.20 114,400.00 5,000 57.20 286,000.00 5,000 57.20 286,000.00 2,000 57.20 114,400.00
88 Kapas pembalut 250 gr Bks 2 8,000.00 16,000.00 2 8,000.00 16,000.00 1 8,000.00 8,000.00 2 8,000.00 16,000.00 1 8,000.00 8,000.00
89 Karbamazepin tab 200 mg Tab 300 269.00 80,700.00 300 269.00 80,700.00 300 269.00 80,700.00 300 269.00 80,700.00 300 269.00 80,700.00
90 Kasa 4 m x 15 cm Rol 3,708.00 - 3,708.00 - 3,708.00 - 3,708.00 - - 3,708.00 -
91 Kasa 4 m x 3 cm Rol 806.00 - 806.00 - 806.00 - 806.00 - - 806.00 -
92 Kasa Gulung 40 y x 80 cm Rol 60,720.00 - 60,720.00 - 5 60,720.00 303,600.00 5 60,720.00 303,600.00 - 60,720.00 -
93 Kasa kompres 40/40 steril Rol 1,532.00 - 1,532.00 - 1,532.00 - 1,532.00 - - 1,532.00 -
94 Kasa steril uk. 18 x 22 Rol 297.00 - 297.00 - 16 297.00 4,752.00 297.00 - 16 297.00 4,752.00
95 Ketokenazole Tab Tab 320.00 - 320.00 - 550 320.00 176,000.00 450 320.00 144,000.00 100 320.00 32,000.00
96 Kina Tab ( Quinine ) Tab 30 737.00 22,110.00 30 737.00 22,110.00 737.00 - 737.00 - 30 737.00 22,110.00
97 Kloramfenikol kapsul 250 mg Kap 2,000 250.00 500,000.00 2,000 250.00 500,000.00 4,000 250.00 1,000,000.00 5,000 250.00 1,250,000.00 1,000 250.00 250,000.00
98 Kloramfenikol Salep mata 1 % Tube 3 1,680.00 5,040.00 3 1,680.00 5,040.00 32 1,680.00 53,760.00 20 1,680.00 33,600.00 15 1,680.00 25,200.00
99 Kloramfenikol Tetes Mata Btl 1 1,759.00 1,759.00 1 1,759.00 1,759.00 10 1,759.00 17,590.00 1 1,759.00 1,759.00 10 1,759.00 17,590.00
100 Klorfeniramin ( ctm ) tab 4 mg Tab 1,000 23.00 23,000.00 1,000 23.00 23,000.00 8,000 23.00 184,000.00 8,000 23.00 184,000.00 1,000 23.00 23,000.00
101 Klorfenol ( CHKM) Btl 50,500.00 - 50,500.00 - 50,500.00 - 50,500.00 - - 50,500.00 -
102 Kloroquin fosfat tablet 250 mg Tab 112.00 - 112.00 - 112.00 - 112.00 - - 112.00 -
103 Klorpromazin hcl tab salut 100 m Tab 300 165.00 49,500.00 300 165.00 49,500.00 1,200 165.00 198,000.00 500 165.00 82,500.00 1,000 165.00 165,000.00
104 Klorpromazin hcl tab salut 25 mg Tab 40.00 - 40.00 - 40.00 - 40.00 - - 40.00 -
105 Kodein tablet 10 mg Tab 550.00 - 550.00 - 650 550.00 357,500.00 650 550.00 357,500.00 - 550.00 -
106 Kontrasepsi Implant Susuk KB Set - - - - - - - - - - - - - -
107 Kontrasepsi KB 3 Bulan Amp - - - - - - - - - - - - - -
108 Kotrimoksazol pediatrik tablet Tab 400 79.00 31,600.00 400 79.00 31,600.00 100 79.00 7,900.00 200 79.00 15,800.00 300 79.00 23,700.00
109 Kotrimoksazol suspensi Btl 35 2,298.00 80,430.00 35 2,298.00 80,430.00 38 2,298.00 87,324.00 36 2,298.00 82,728.00 37 2,298.00 85,026.00
110 Kotrmoksazol dewasa tablet Tab 500 152.00 76,000.00 500 152.00 76,000.00 1,700 152.00 258,400.00 1,400 152.00 212,800.00 800 152.00 121,600.00
111 Kuinin dihidroklorida inj. 25%-2ml Amp 6,820.00 - 6,820.00 - 6,820.00 - 6,820.00 - - 6,820.00 -
112 Larutan Anisol Btl 910,000.00 - 910,000.00 - 910,000.00 - 910,000.00 - - 910,000.00 -
113 Larutan benedict Btl 1 28,935.00 28,935.00 1 28,935.00 28,935.00 28,935.00 - 28,935.00 - 1 28,935.00 28,935.00
114 Larutan Spiritus Btl 17,000.00 - 17,000.00 - 17,000.00 - 17,000.00 - - 17,000.00 -
115 Larutan Ziehl Nielsen ( TB ) Btl 154,038.00 - 154,038.00 - 154,038.00 - 154,038.00 - - 154,038.00 -
116 Lidokain kompositum injeksi Amp 1,499.00 - 1,499.00 - - 1,499.00 - - 1,499.00 - - 1,499.00 -
117 Lisol Btl 2 49,861.00 99,722.00 2 49,861.00 99,722.00 49,861.00 - 49,861.00 - 2 49,861.00 99,722.00
118 Masker Set 1,237.00 - 1,237.00 - 34 1,237.00 42,058.00 34 1,237.00 42,058.00 - 1,237.00 -
119 MB Anak Blister - - - - - -

999.00 1.00 18.400.00 .000. 9.40 19.00 200 118. .00 3.999.900.600.319. 110.00 77.00 22.680. 660.700.500.00 33.080.00 299.963.967.00 .530. 2.00 100 169.00 100 2.344.800.000 88.00 .340. 221.340.00 - 137 OAT ( FDC ) Kategori Anak Pkt 236.00 600 193.00 - 142 OAT (Kombipak) Kategori Sisipan Pkt 176. .00 60 318.00 36.963.00 .00 45. 7 25.00 128. . .00 2.00 .967.00 37.00 56.629.900.00 . 395.680.000.629.769.170.300.00 126 MgSO4 Inj 20% Vial .400.200 mg-1ml Amp 30 1.500. 1. 189.00 .00 .300.090.00 .00 122 Metilergometrin inj 0.00 600 34.00 700 88. 1.00 54.500. .900.535.106.00 .530.500.000 iu Tab 528.00 .00 .00 - 135 Nistatin 500. - 156 Pirantel pamoat tab 125 mg Tab 60 318.125 m Tab 200 121.00 .840.00 .344.963.00 3.400.00 .700.00 .120 MB Dewasa Blister .00 - 145 Oksitetrasiklin hcl injeksi Amp 341. I Pkt 317.680.00 . - 155 PB Dewasa Blister .503.00 - 133 Nifedipin 10 mg Tab 100 2.200.200.00 8.00 .00 500 169.400.902.00 .00 10.00 .260.00 14. 121. 600 169.00 25 1. .00 14.00 154 PB Anak Blister .50 23.00 - 141 OAT (Kombipak) Kategori anak Pkt 189. .344.000.00 .00 45.503.112.015. .195.00 .00 24. .00 16.00 147 Oksitetrasiklin Salep mata Tube 1 1.646.880.771. .00 600 34.600.900. 221.100. - 127 MgSO4 Inj 40% Vial 4 2. 317.112. .680.00 300 2.530.00 200 121. 25.503.015.900.00 14.000.00 101.535. . 169.00 .00 45. .902.00 77.00 12.629.00 200 34. .00 20 1.00 135.00 - 143 Obat batuk hitam ( OBH ) cairan Btl 1.00 54.00 66 1.00 .646. 3.00 101.40 19.00 123 Metilergometrin tab salut 0.00 .999. 341.967. 10 395.503.00 39.400.00 1.000.720.00 33 1.50 23. 700 110.00 .00 .51 6.530.516.00 600.00 .00 100 193.00 50 1.00 4 9.600.00 600.00 - 132 Natrium Tiroksin Tab Tab 1.000.680. 341.00 24 1. .170.00 100 2.00 128.00 - 140 OAT ( Kombipak) Kat. .51 6.000.090.000.994.00 90 1.00 .170.00 600.00 .000.319.00 - 138 OAT ( FDC ) Kategori I Pkt 395. .000 19.00 .00 84. 176.00 .530. .106.00 79.00 700 110.900.00 6 9.00 36.319.015.00 . 100 118.000.00 .780.00 50.00 14.00 4 2.500.000.688.680.00 8 1.000 iu Tab 528.195.00 - 129 Mummifying pasta Btl 193.00 88.00 .900.535.00 12. .000.00 200 34.00 84.318.00 88.769.00 19.00 .00 26 1.000.00 158 Plester 5 yard x 2 inch Rol 25.318.00 - 161 Pot Dahak Set 600 1.00 - 160 Poly Katether 22 Set 9.00 31.00 139 OAT ( FDC ) Kategori II Pkt 1.600.170.840.00 - 159 Poly Katether 18 Set 2 9. 660. . . .344.00 1.00 118.00 . .200.000 19.340.00 181.000.00 310.195.00 60 5. 236.00 2 9.00 730.00 100 121.516.706.40 58. .00 26.408.344. 1.00 .260. . .000.00 . 193.900.00 1.600.00 - 146 Oksitetrasiklin salep 3 % Tube 11 1.963. 341.994.902.00 300 2.00 100 118.629.340.700.00 .959.40 58.344.00 . .00 . 9. 193. - 121 Metformin 500 mg Tab 200 118. 1. 128. . 600 1.00 149 Omeprazole Tab 221. 660. 176.00 899.700.00 .00 - 152 Parasetamol tablet 100 mg Tab 200 34. 5.00 33 1. .300.000 128.00 .50 .100. 3.319.300 88. 528.00 - 130 Natrium Diklofenak Tab 193.00 . 1.00 26.994.00 .00 90. 1.00 310. 189. 660.994. .900.00 47.646. .51 6.00 10.400.00 899.00 18.187. 317.00 .400.000.340.629.688. 193.706.994.300.00 47.00 20 1. .00 61.00 9. 100 121.00 1.00 47.200.700.00 .00 16 1.00 - 150 Papaverin Tab Tab 128.646. .000.00 .00 1.646. 1.00 131 Natrium Klorida Infus Steril Btl 5.850.000.376.00 .00 600 1. .000 128.000 19.00 . 317.00 256.516.00 .170.00 1.080.310.00 . .500.300.00 .00 7 395.00 528.00 . . 528. 221.500.00 .00 .00 1 1.00 .00 1.700.00 39. 189.000 128.900. 176.150. 2.015.600. 528.00 138. . . 25. 25 1. 5. 1.00 .000.00 150 318.000 19.344.00 42.40 19.00 151 Parasetamol sirup 120 mg/5 ml Btl 24 1.00 .994. 1 14.00 124 Metoklopramida Tab Tab 110.50 11.00 2.00 . .00 19.00 148 Oksitosin Injeksi 10 iu/ml . 193. 30 1.503.00 299.900.000.00 .535.00 14.090.000.00 128 Mineral Mix Sach 3.850.00 144 Objek Glass set 1 14.00 . 9.00 .100.00 .994.999.00 10.00 19. 528.00 1.00 153 Parasetamol tablet 500 mg Tab 1.00 704.680. .967.00 24.967.000.195.00 3 395. 700 193. .00 . 236.00 .50 11.900.000.064.00 .999.300.1 ml Amp 24 1.00 181.00 .00 10. 3.000 88.900.530. 176.00 43. 50 528.00 . 4 2. .015. 317.00 134 Nistatin 100. 1.00 1.00 136 Oil Emersi Tab 660.00 .00 250 318.200.00 115.00 .900. 1.994.00 .319.00 . 1.51 20.00 299.00 24 1.00 .00 7 25. .00 18.500. 1. 9.00 3. . 528. . 236.000.00 18. . .00 .00 - 125 Metronidazol tablet 500 mg Tab 169. 3. 189.344. 221.00 .00 . 60 5. . .00 30 1.00 .00 8.000 19. . 236.00 17 1.00 1 14.00 . 110.000 88.00 11 1. 193.00 .00 .00 55 1.00 157 Piridoksin hcl tab 10 mg Tab 1.51 20. 341.00 .344.195.00 . 50 528.00 .680.00 160 318.535.344.300.200.963.

00 .00 5.00 89.345.780. 730.313.00 678.00 6. 11.00 .00 .00 8 1.00 - 190 Vitamin b kompleks tablet Tab 112. .200. 11.000.00 165 Propiltiourasil tab 100 mg Tab 100 297.51 .200. 37.000.00 2.4 kombinasi Pot 2.200. 2. 6.00 3.00 89.00 . .600.00 75 1.00 .720.500.00 300 297.00 .00 1.00 38. .00 3.00 148.745.00 1. 6.00 184 Tetrasiklin hcl kapsul 500 mg Kap 100 226.618.047.200.00 3.00 .00 .180.00 .891.00 11.00 20 189.067.00 - 176 Semen fosfat serbuk dan cairan Set 102.00 22.00 226.00 .00 .00 148.00 - 177 Sianokobalamin ( Vit.440.855. .00 - 189 Urine bag Set 1 4.000.000.00 .960.00 .00 105.64 77.00 1.00 .00 1. 297.700.00 528. 2 1.00 258.102.00 196 Zinc Tablet 20 mg Tab 521.440.00 .00 .00 - 194 Yodium povidon lar.728.00 226. 7.00 .440.00 .000.697.000.000.00 162.00 5 4.00 .00 95.345. 11. 286.00 .100.067.00 200 2.100.618.500.200.400. 57.00 4.00 . 2.200.00 .697. 2.618. .00 600 65.000 162.950.51 . 85.500.00 1 4.00 572.00 .400.00 9. 6.500.400. 15.00 162.00 4.00 44.313.00 212.100. .00 9.00 1. 6.900.855.100 114.64 77.00 .400.00 .500. 177.728.00 .000.850.000 226.500.720.200.00 .000.200.00 105.00 185 Tiamin hcl ( Vit.400.800.025.096.00 - .00 100 226.00 88.00 500 297.000.000 15. 2.00 678.000. 3.00 180 Simvastatin Tab . 102.000.00 .00 .000 226. 39 6. 2. 286.000.00 . . 102. 500 521. 6.00 132.b1) injeksi Amp 20 189.750.00 260.600.00 240 2. 7.500.00 16.00 118. 2.700. 112.00 . 6.00 11.00 80.00 .00 .000 112. 102.00 30.720.00 100 297.950.00 .00 192.00 16. 2. 1.00 80.00 1. 2.855. 400 480.890.00 45.850.00 19.00 .00 16.100 112.00 167 Ranitidin 150 mg Tab 132.00 .00 200 80.697. 730.00 - 163 Primakuin tablet 15 mg Tab .00 186 Tiamin hcl ( Vit.00 500 521. 286.180.682.047.00 - 195 Yodium povidon lar. 30 189. 1.100.00 22 1. 388. 7. 505.682. 37.400.00 1.00 1.00 3.00 45. 2.500.00 - 170 Retinol 200. 37.300 114.134.00 258. .3/0 Sak 4 7.00 .100.00 25.00 .440.600.00 215.400.00 28.00 175 Salisil spiritus 10 % Btl 1.313.00 9. 700 297.000.10% 30 ml Btl 2.00 191 Wing Needle 23G Set 6.400.000 15.500.00 166 Propranolol hcl tablet 40 mg Tab 200 80.00 5 15.00 .697.b 12 ) injeks Amp 75 1. .00 200 57. 730. 505.000 226.00 29.950.00 .00 125.000.300 114.000 162.618. - 164 Prokain penisilin injeksi Amp 39 6.700.00 39.00 192.000.00 22.00 38 1.00 800 132.800.000.00 - 188 Trireksol formalin ( tkf ) cairan Btl 85.232.00 .180. 100 226.00 73 1.00 22. 505.600.180.400.855. 85.51 .000.600.047.067.00 5. 6.00 .00 - 181 Tablet tambah darah kombinasi Sach 240 2. 730.00 521.00 .670. 2. 6.00 . 85.000. 177.00 572. 40 2.00 5 7.855.400.00 300 297.00 3.00 169 Retinol 100.00 2.720.200.00 77.025.00 400 65. 2. 85. 25 mg Tab 1.00 29.697.000. .047.51 - 203 Simvastatin 10 mg Tab 177. 11. 1.682.00 .000.000 15.00 187 Triheksifenidil tablet 2 mg Tab 730.000.00 200 80.000.00 .200.00 - 174 Salisil bedak 2 % Ktk 8 1.00 39 6. 480.067.850. 480.00 .00 .00 .000.00 200 388.00 .00 217.00 .00 .00 62.00 . 505. 15.410.00 3.00 .00 .00 . 388. 2.00 .950. .500.047.00 - 192 Wing Needle 27G Set 6.00 202 Stesolid Injeksi Amp 11.728.00 26.200. 480.00 .200.00 . 6. .950. 2.000 IU Kaps 505. 521.00 155.000.313. 177.400. 200 57.00 1.000.00 .00 .00 27 7.000.100.00 207.200.00 .00 .180.500.000.00 199 Ketokonazol Krim Tube 2. 177.51 .00 .00 179 Silk no.b1) tablet Tab 3. 132. 226.720. 2.00 300 65.345.320.00 207.400.000 IU Kaps 286.102.00 30.00 178 Sianokobalamin tablet Tab 15. .00 148.00 90.64 .00 24 1.600.00 20 3.200.00 45.00 .000. .00 182 Temporary stopping fletcher Set 37.000.400.000 226.200. 6.000.000.00 1.00 15.00 .10% 300 ml Btl 15.728.00 700 65.00 226.019.00 1 15.00 3.317.00 .00 200 80.618.00 162.000 162.400. 7.00 400 480.200.00 4.00 . 800 132.200.200. 6 15.00 .00 .00 - 197 Amaropo Kaplet Kapl .00 258.00 .000.400.600.00 22. 2.00 400 297. 1.414.00 .728.800.400.00 4 7.00 - 200 Pehacain Injeksi Amp . 286.00 .000.102.00 . .00 .162 Prednison tablet 5 mg Tab 57.00 . 2.00 . 162.100. 37. 102.00 10 189.00 89.00 16.00 .00 .00 .345.440.00 201 Pospargin Tab Tab 200 388.00 .00 300 297.00 .00 28 7. .900 112.00 .00 580 5.00 - 168 Reserpin tablet 0.00 480 5.000 226.00 162.00 440.00 173 Salep 2 . 70 3.00 678.00 79.00 .00 - 193 Yodina Test Btl 7.00 .00 100 5.00 . 189.64 .00 - 171 Ringer laktat larutan infus steril Btl 100 5.00 6 4.00 .682.00 - 172 Salbutamol tablet 2 mg Tab 300 65.00 22.950. 11. 1. 200 114.780.440. .00 528.067.440. 200 388.00 50 3.000.00 200 80.00 .345.00 2. .00 - 198 Heximer 2 mg Tab Tab 297.840.313.00 19.00 114.682.64 77.850. 57.00 - 183 Tetrasiklin hcl kapsul 250 mg Kap 1.00 26.00 16.00 260.00 .00 .000.

247.340.00 .00 16.213. Kepala Puskesmas Ujung Lero Yang Menyerahkan. 19720411 199803 2 006 Damayanti Baharuddin.Farm. 1.00 8.340. .00 7.831. 1.340.997. . 1.166.00 ### ### ### TOTAL 8. .328. .865. SKM. Petugas Gudang Obat SUNDARI.669. 1.340.422.00 .181.Kes NIP. . - TOTAL 8. M.50 ### ### 5.340.Apt.269.S.147.00 .00 . . .404.50 ### ### ### Mengetahui.15 16. 204 Ranitidin Injeksi Amp 1.00 - 205 Darflex Tab .488. .

800 10.050.00 363.560.00 242.00 63.800.200.200.00 . 2. . 4.00 253.00 45.00 240 1.00 22.700.00 .096.00 10.00 135 1.00 10.85 - 20 Antasida doen tablet kombinasi Tab 800 78.00 .800 292.500 16 Amoksisilin sirup kering Btl .00 690 352. 30 363.00 54.00 945.096.00 .200.00 .200.200.00 100 34 Atropin sulfat injeksi 0. 8.00 .700 5.400.200.300.00 25 5.00 52.780.100.050.00 45.200.00 .880.00 . 10.00 .00 10.00 90. .00 240 240 7 Alat Suntik 5 ml Set .00 . 127.00 . 11 5.00 563.00 647. 1.00 54.000.800.00 150 135 2 Abbocath No.780. 79 8.00 44.800.00 . 150 1.00 100 100 13 Amlodipin 10 mg Tablet Tab 352.100.100. 150 1. .00 369.200.00 300 149.00 842. 419.500.050.000 11. 20 Set .500 292.000.200. .250.00 500 86. .800 78.200. 8. 45 8.00 .00 .00 10 2.00 22.00 22.00 100 123.500.00 720 690 14 Amoksisilin Kapsul 250 mg Kap 240 220. 2. 3. .000.600.00 850.00 100 362.00 8. 2.00 672.200.200.00 3. 100 362.000.800.200.100. .00 . 10.600 122.00 683.00 82 8.00 36.800.00 500 500 12 Amitriptilin hcl tab salut 25 mg Tab 200 123.861. 8.800.000.00 10.500.00 43. 100 127.200.00 41.250.00 17.00 .200. .700.00 87 82 5 Abbocath No. 2.500. 4.00 44.050.00 8.5 ml Set 40 1.000. .200.00 2. 3. .00 10 1. 600 600 10 Aminofilin injeksi Amp . 720 352.00 12.000.096.00 1.00 10 10 35 Benzatin benzil penisilin injeksi Amp .000 105.00 10 1. .00 200 122. 11 11 25 Artesunate Anak Blister . .00 105.00 24.00 24.00 369. 3.000.00 9.400.00 140. 75 75 6 Alat Suntik 2.560.00 11. .00 . - 28 Artesunate Remaja Blister . 10.00 . 9.85 .00 .000 105.200.200.000. 10. 220 2.000.200.200.00 15.00 165.000.00 240 1.00 63. . .000.00 10. .00 10 5.000.00 43.100. .600.000.00 .440.500. .000 30 Asam Mefenamat tablet Tab 100 122. LAPORAN PERSEDIAAN OBAT GUDANG OBAT PUSKESMAS UJUNG LERO TRIWULAN II STOK AWAL P E N E R I MAA N PENGELUARAN SISA PERSEDIAAN SAT- No.00 .00 140. - 26 Artesunate Dewasa Blister .00 75 8.750.00 600 90.200.00 . 363.000.00 12.200.00 100 123.600.00 44.00 10 10 18 Ampisilin Kaplet 500 mg Kapl .00 200 149.000.00 .700 122.400.800.00 713.00 615.610.750. 141.00 . 200 300 24 Aqua proinjeksi steril Vial .00 264. 141.00 211. .000 105. .00 5.00 125 1.000.00 2.200.00 22.00 149.200.800.000.00 12. 22 Set .610.780.200.00 62.00 15. .00 264.780.00 .100.200.00 9 Alopurinol tablet 100 mg Tab .00 500 86. 18 Set .00 960 220.000 105.85 . .00 563.800.00 9.200.00 .100.00 15.100. .066. 45 45 3 Abbocath No. - 29 Asam askorbat ( Vit c ) tab 50 mg Tab 3.00 56. 8. 8.00 240 220.400. 600 90.00 56.890.200.00 .00 362.250.00 .100.00 30 352. 5.00 . 1. .500.500.560.00 14. 141.560. - 27 Artesunate Inj Vial .000.00 .25 mg/ml Amp 30 1. . 4.00 40 1.00 24.900 78.000. 419.00 17. NA M A O B A T UAN BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI 1 Alat Suntik 1 ml Set . .00 .00 70.00 10 2.700.00 200 86.00 . 87 8.155.610.200.00 15 1. 24 Set .00 . 3.00 12. .00 33 Asklovir 400 mg Tab 200 362. .610.400.00 - .200.00 960 220.00 292.000.000.00 .00 52.00 79 8.250.00 1.00 647.00 29.00 30 1.00 - 11 Aminofilin tablet 200 mg Tab 200 86.00 36. 141.000.00 27.560. 75 8.00 10 2.800.00 220 2.85 .00 9.00 10 10 23 Antimigrain doen kombinasi Tab 100 149.200.00 .00 10. . 419.00 960 960 15 Amoksisilin Kapsul 500 mg Kap 700 292. 4.00 900 78.000.00 211. 220 220 17 Ampisilin Inj Vial 25 5.00 - 19 Antalgin Tab 500 mg Tab . 90.200.200.00 157.00 615.00 72. . .300.00 5 8.00 5.096.00 25 1.00 . 5. .00 11 5.00 695.250. .200.00 10 5.00 200 123.00 .00 .900 10.00 10. .00 141.00 127.00 204.200.600 31 Asam Traneksamat Inj Amp . 419.800 21 Antifungi doen kombinasi Pot . . 79 79 4 Abbocath No.000.00 137.00 - 22 Antihemoroid doen kombinasi Sup 10 2. .200.00 12.00 315.000.400.400.00 . .890.400.00 . 2.00 - 32 Asetosal tablet 100 mg Tab 100 127.250.900.00 45 8.00 150 125 8 Albendazole Tab 30 363.800.000.100. .00 5.

738.000 64 Fitomenadion ( vit k 1) injeksi Amp 30 3. 985.00 37.000.000 44 Dekstrometorfan sirup 10 mg/5ml Btl .333.00 343.2/0 . 20 1.00 148.500. 1.00 103.00 12 55 Eritromisin Kaps 250 mg Kaps .00 60.250.00 .620.00 - 70 Glass Ionomer cement (gc ix ) Set 1 435.3/0 Sak 11 26.00 40 3.00 .00 60 5.980.00 800 241.500.00 435.00 112.000.00 22.00 3.00 300 690.00 95.00 .100.00 18.00 .1% Btl 1 2.00 2.000 39.698.00 20.108.00 56.00 - 37 Betametason krim 0.800 74. 1.00 - 45 Dekstrometorfan hbr tab 15 mg Tab . 985.00 . 429.34 112.00 25 21 40 Cefotaksim 1 g Injeksi Vial 20 3.000.00 .000.00 149.910. 5 11.00 . 102.00 900 74. 1.00 8.754. .00 188.500.00 39. 24 .000.00 10.00 435.000. 429.00 - 54 Epinefrin (adrenalin) inj. .00 6. 100 103.738. 1. 103. 3.00 198.000 56.80 13. 73 86 38 Captopril 25 mg Tab 1.739.00 25 3. 429.698.000 24.5 mg Tab 1. - 56 Etakridin ( rivanol ) lar.550.500.00 24.00 .300 42 Deksametason injeksi 5 mg/ml Amp 145 1.00 15 10 69 Gentian violet larutan 1 % Btl .00 .00 .500. 18.00 10 10 49 Difenhidramin inj 10 mg/ml-1ml Amp 60 1.00 592.016.00 57. 0.00 217.00 9.00 280.00 .00 207.760. 6.00 25.467. 2.910.00 24. 265.016.750.000 3.00 .00 130.500. .500.300.00 30 3.00 100 61.00 8 18.00 500 76. 2.390.00 183.354. 5.125.000.550.596.108.700.500.600.00 - 46 Devitalisasi pasta ( non Arsen ) Btl .00 .354.34 126. 1.00 100 76.935.400.00 1.00 .00 .300 100.00 116.00 25.000 7. 1.690. 7 Psg .00 234.00 103.000 74.400. .00 69.000. 4 5 57 Etanol 70% Btl 1 18.00 1 1 71 Glibenklamid tablet 5 mg Tab 100 61.00 20 43 Deksametason tablet 0.040.000. 985.830.00 .00 .738.0.305.00 100 241.500.500.000.00 24.00 60.00 .754.2 ml Amp 5 2. 42.500.750 56.00 3 11.200.00 100 690.250 56.739. 102.760.00 300 317.500.00 24.000.156.00 138.780.00 4.20 7 1. 42.00 .00 .00 12.000.00 1.00 106.800.00 .016.00 435.00 60 4.500 56.00 21 26.00 662.738. .500.00 34.720.00 8.333.508.256.00 .600.200.00 34.34 140.800. 74.00 38. 600 278.00 200 690.578.00 556.100 74.500.60 7 9 63 Ferro Sulfat 300 mg Tab 2.00 7.800.00 29.00 500 241.00 .578.00 12.980.00 .00 .00 .00 87.675.00 400 61. 429.850.00 61 Fenobarbital tablet 30 mg Tab 2.739.00 5.00 157.00 .354.240.00 24. 4.00 18.467.00 .300 100.748.865.00 62 Fenol gliserol tetes telinga 10% Btl 14 1. . .00 267.00 120.000. 1.675.00 .000.00 25.100.00 440. .000 24.596.00 18.00 137.00 .00 .00 16.300 4.780. 1.00 32 5. 1 18.00 .00 52 Efedrin tablet 25 mg Tab 2.025.500.000 3.698.00 .80 9.333.000.00 10 2.800.00 225.00 .800.00 24.560.00 12 8.550.550.00 430.69 25.108.00 140.400.720.761. 1.00 25 26.720.00 280.00 300 76.100.000.680. 102.00 195.00 1.00 69.00 200 100 66 Furosemida tablet 40 mg Tab 300 84.00 278.400 100.500.00 7.300.00 5 2.00 2.108.016.000 3.156. 30 8.00 130.00 4 2.500.34 154.000 6.578.890.886.400.00 6.00 130.010.00 60 Fenobarbital Inj Amp 15 1.00 2.00 7.333.675.000 24.596.800. 1.00 133.770.500 40. .00 .500.25 mg Tab 100 103.00 .800.00 609. 25 45 41 Ciprofloksasin 500 mg Kaps 100 265. 4.00 25.300 265.00 .000 48 Diazepam inj 5 mg/ml . 985.500.700.00 .00 73 1.000.156.00 .980.698.416.000 73 Glukonas Kalsikus Inj Inj 24 .467.00 1.500.00 .00 500 800 76 Haloperidol tablet 1.333.890.000.00 1 435. .000.00 1 435.00 .300.00 33 5.80 15.00 291.500.1 % Tube 13 1.00 23.00 138. 1. 60 1.000.000.523.00 300 500 77 Handshoen No.085.00 .000 39.00 22.200 265.360.00 74.00 1. 40.754.00 18.00 148.765. 42.00 300 84.910.00 200 300 67 Garam oralit untuk 200 ml Sak 325 317.00 10.00 397.596. 30 60 65 Fitomenadion ( vit k 1) tab 10 mg Tab 200 690.000 2.578.69 3. .600.00 6.140.380.500.00 .467.920. 60 4.00 1.00 40. .00 16.620.00 .00 166.100 8.000.00 2.00 .00 70.00 15 3. 1.00 525.00 .00 2 11. 15 1.000.1%-1ml Amp 18 8.00 200 84.200.200 2.00 4.00 2.000. .500.00 192.00 10 3. 1. 3.100.354.00 69.360.500.00 6.00 149.000 39. 102.00 45 3.000.500.00 66.00 60 3.00 400 400 72 Gliseril guayakolat tab 100 mg Tab 1.00 2.00 435.500.00 10 2.36 Betahistin Tab .100.979.500.000.00 39.00 86 1.00 60 32 75 Griseofulvin tab 125 mg Tab 400 241.60 9 1.00 .00 .00 18.00 .00 . 2. 278.00 50 Digoksin tablet 0.00 5 2.00 29.200.00 28.00 125 1.584.400 39 Catgut/benang bedah no.00 4.650.00 5 2 59 Eugenol cairan Btl 1 18.00 200 84.00 1 435. - 74 Glukosa 5 % Btl 5 5.333. 42.739.675.354.00 .69 22.80 7.698.00 96.00 48.00 51 Doksisiklin Tab 600 278.00 7 18.00 112.00 . .00 26.00 400 61.00 .69 .500 53 Ekstrak belladon tablet 10 mg Tab . 300 625 68 Gentamisin Inj Amp 35 3.000 74.910. 317.156.00 15 26.754.00 - 47 Diazepam tablet 2 mg Tab 1.00 166.500 40.00 252.980. 60 60 78 Hidroklorotiazid (hct) tab 25 mg Tab 1.00 11.000 74.5 mg Tab 300 76.00 583.00 625 317.720.00 7.00 2.20 12 1. .00 160.00 .400 100. 7 8 58 Etilklorida semprot Btl 11.

00 1.400.000 23.800 96.000.600.00 98.500.00 39 2.00 5.00 110 94 95 Ketokenazole Tab Tab 100 320.200.752.00 286.00 .000.200.00 1. .00 165. .00 .499. . 1.315. 910. 28.000 104 Klorpromazin hcl tab salut 25 mg Tab .00 143. 17.00 57 54 110 Kotrmoksazol dewasa tablet Tab 800 152.00 - 113 Larutan benedict Btl 1 28.00 165.000 57. 3. .00 .708.00 12 4.000. 49. 1. 4.00 1 8. .023.00 73.00 . .00 38.000.00 1.000.00 94 297.00 28.00 .00 79. .400 111 Kuinin dihidroklorida inj.21 144. 1.450.00 - 87 Kalsium laktat ( kalk ) tab 500 mg Tab 2.00 5 8.00 100 269.00 25. 50.00 - 103 Klorpromazin hcl tab salut 100 mg Tab 1.00 364.499.820.00 44.023. 100 .00 303.20 57. .00 22.21 76.500 800 81 Ibuprofen 400 mg Tab .00 .00 3 5 100 Klorfeniramin ( ctm ) tab 4 mg Tab 1.000. 6.00 - 115 Larutan Ziehl Nielsen ( TB ) Btl .00 - 117 Lisol Btl 2 49.00 737.000 101 Klorfenol ( CHKM) Btl . 17.00 . .00 8.850. 79 Hidrokotrizon krim 2.00 .00 30.20 114.00 128.00 118.00 111.00 17 1.00 .00 86 Kalsium hidroksida pasta Tube . .00 29.00 29.00 5 60.00 118 Masker Set .400.00 32.298.00 .00 49. .00 .500.200.00 400 320.21 105.000 98 Kloramfenikol Salep mata 1 % Tube 15 1.000.600.00 8 1. .00 462.850.00 27.00 200 152.720.00 31.000 250.935.00 400 400 96 Kina Tab ( Quinine ) Tab 30 737.000 57.00 . 118. .00 .680.800.962. 6.720.00 99.00 . 1.400.400.21 173.708.00 17.000 1.000.000 11. 1. 40.298. 3.000.237. 112. 806.00 . 266. 6. 300 98.00 .023. 157. 60.000.50 11.795.00 253.722.00 91.000.850.00 .800 2.00 110 297.00 .720.831.000. 40.000.00 330.00 32. 50.820.920.298.00 165.00 345.00 128.00 57 2.072. .00 .00 .00 .00 5 1.00 100 109 Kotrimoksazol suspensi Btl 37 2.000.00 2.00 114 Larutan Spiritus Btl . 1.00 31.820.600.861.00 1.00 250.000. 50.000.000 250. - 108 Kotrimoksazol pediatrik tablet Tab 300 79.00 11.00 90 59 119 MB Anak Blister .850.00 . - 120 MB Dewasa Blister .00 120 3.00 .861.000.000.50 11. .00 1. .110.00 800 96.00 35.000.000.237. 2.000 82 Infusion set anak Set .532. 910. 550. 77 4. 910.820.000 57.20 171. - 121 Metformin 500 mg Tab 100 118.600. 5 5 93 Kasa kompres 40/40 steril Rol .00 130. . 154.00 314.500.00 100 79. 120 3.500 96.000.499. 50.00 . .00 165.800.986.00 . 154.000 165.00 .600. 18 x 22 Rol 16 297.861.504.00 40.938.00 .00 .532.532.00 200 157.00 7.000 157.00 500.00 5 8. .00 14. 3.50 . . 17.00 .900.00 8.00 124.023.00 28.00 100 90 Kasa 4 m x 15 cm Rol . .000. 1.000. .000 165.00 250. 2 49. 120 120 84 Iodiol Kapsul Lunak Kaps .00 .680. .000 88 Kapas pembalut 250 gr Bks 1 8. 1.000.00 - 94 Kasa steril uk.200 2.00 9.00 - 102 Kloroquin fosfat tablet 250 mg Tab .00 462.000 23. 806.400. .000.00 - 91 Kasa 4 m x 3 cm Rol . 1.00 1.00 32 297.00 269.00 3 1.400. - 107 Kontrasepsi KB 3 Bulan Amp .200.00 72. .200 157. .00 4.00 21 1.00 .759.968.00 .00 8.700. 112.000. 112.00 1.759.00 59 1.00 15 2.00 3.347.000.00 - 116 Lidokain kompositum injeksi Amp .00 . 266.00 2. .00 52. 400 79.00 - 85 Isosorbit dinitrat tab 5 mg Tab 300 98.800.038.00 - 105 Kodein tablet 10 mg Tab . 17.400.938.00 2.00 1.00 26.178.560.237.298.00 .000. .000 23.00 97 Kloramfenikol kapsul 250 mg Kap 1.000.640.00 2.00 . 40. 600 600 106 Kontrasepsi Implant Susuk KB Set .200.00 1.000.038.000.00 230.935. 1 28.400.00 303.935.026.00 .500.600.00 .00 38.00 .00 . .700. .00 .00 23. 266.00 .00 .5 % Tube 25 2.938.00 23.092.00 .000 165. .50 .900. 266.000. 1.00 .000.110.00 . 5 60.237.00 .00 .00 23 21 99 Kloramfenikol Tetes Mata Btl 10 1.720.00 77 65 83 Infusion set dewasa Set . 3.00 39 49 80 Ibuprofen 200 mg Tab 1.918. 3.00 23.00 .400. 60.00 85.800 152.000. 2.590.680.708.00 .708.00 80.00 23 1.00 121.280. 25%-2ml Amp .00 .00 . 90 1.00 1.000 1. .861.00 32.000 165.00 .00 .850.100 96.00 .000. 10.00 273.00 - 92 Kasa Gulung 40 y x 80 cm Rol .935.400.00 31 1.938.532. 3.070.00 40 2.00 28.00 338.00 114. 400 269.00 .00 107. 806. 30 737. .00 .00 49 2.038.935.00 40.00 - 112 Larutan Anisol Btl .00 2.330.582.00 54 2. 737.00 330.00 99.00 10.200. 100 118. . 40.00 .400 152.00 . 910.00 65 4. 1. 1.722.00 1.00 100 320.20 114.00 .670.00 1.00 5 5 89 Karbamazepin tab 200 mg Tab 300 269. 6. .680.000 57. 600 550.038.983. 154.935.499.000.759. .00 600 550. 154.277. 1.850. 806. 550.000 250.00 22.600.759.400.00 . 112. . 98.00 250.00 .00 .00 400 320.00 .00 .00 28.

1. 193.00 .000.00 62.500.00 .51 13.400.195.240.100.1 ml Amp 20 1.00 4 395.00 28.00 .00 .00 - 161 Pot Dahak Set 600 1.800.00 18 1.800.900.00 . 528.503. 25. 5.00 98.00 - 146 Oksitetrasiklin salep 3 % Tube 33 1.00 - 142 OAT (Kombipak) Kategori Sisipan Pkt .00 20 1. 189.00 .00 200 153 Parasetamol tablet 500 mg Tab 700 88. 1.00 39.840. .00 .700. .40 19.00 10.00 29 1.00 16.000 193.00 128.00 .516.548.000.00 18 31 148 Oksitosin Injeksi 10 iu/ml . .200 mg-1ml Amp 30 1. . 600 1.344. 176.340. .000.618. .00 924. 100 121.680. 8 8 159 Poly Katether 18 Set 9.00 .344. 1.00 6.00 5 4 139 OAT ( FDC ) Kategori II Pkt .340.00 10.00 8 5 160 Poly Katether 22 Set .516.00 240 300 157 Piridoksin hcl tab 10 mg Tab 1.000. . . 341.00 258.00 207.00 .00 200 34.319.00 98.00 77.00 310.000. 900 1.00 .00 75 1.00 .00 .170.00 . 1.500 154 PB Anak Blister .344.00 400 169.015.00 76.000 3.800. 236.00 .900.00 207.530.500.00 .340.00 . 1.00 124 Metoklopramida Tab Tab .00 .170. 236.00 50 50 149 Omeprazole Tab 221.000. .00 10.00 121.000. 8 9. 528.975.00 10.000 128.00 .00 52.160.00 600.00 - 129 Mummifying pasta Btl . .00 193.00 31.00 162 Prednison tablet 5 mg Tab .646.000.00 . 14.902.700.00 50 1. 9. 528.00 .00 .900. .00 - 130 Natrium Diklofenak Tab 100 193.400.00 .900.880. 1.600.00 1.600.530. .00 74. 317.195.00 64.00 43.967.535.00 128.260.000 19.260.00 .51 6.900. 14.600. . 60 5.00 .00 .00 100 110.00 1.00 .963.318. 341.200.00 - 140 OAT ( Kombipak) Kat.000. 317.999.499.629.00 22.100.600. 193. 260 1. 660.00 3 9.00 8 25.646. .032. 193.00 1.00 11. 236.587.535. 800 110.00 .000 19.320.00 .00 .00 5 9. 221.00 500 2.900.00 .344.680.503.00 20.00 .629. 2.00 88. .618.963.00 1 123 Metilergometrin tab salut 0.000 128.00 100 318.125 mg Tab 100 121. 3. 189. 14.900.00 30.820.015. .00 .600.319.00 .00 .00 932. 660.00 50.00 32 1.00 26.00 . I Pkt .00 299.00 23 1.00 400 169.00 50 1.00 26 23 144 Objek Glass set 14.999.00 800 700 125 Metronidazol tablet 500 mg Tab 100 169.00 42.00 . - 156 Pirantel pamoat tab 125 mg Tab 160 318.400. 128. 189.000.00 38 39 147 Oksitetrasiklin Salep mata Tube 25 1. 193.900.00 . .00 . .00 5 395.00 900 193. 221. .629.00 70. . 9.170. 57.600 88.00 16.00 .600. 60 60 132 Natrium Tiroksin Tab Tab . 50 528.000.00 - 141 OAT (Kombipak) Kategori anak Pkt .00 12.194.618.150. 176.00 10.102.00 .967.500.00 185 1.100.300.122 Metilergometrin inj 0. .125.000.00 .000 131 Natrium Klorida Infus Steril Btl . 176. 1.530.583.102.000 158 Plester 5 yard x 2 inch Rol .00 38 1.51 .00 61.00 34.00 12.979.00 12 1.00 60 5.994. 9.00 1. .00 .00 46.015.00 .672. 528.00 3.00 - 137 OAT ( FDC ) Kategori Anak Pkt .00 115.00 .00 26.344.40 58.000.500 88. - 164 Prokain penisilin injeksi Amp 39 6.40 19. . 57. 189.015.618.736.170.00 . 1 1.752.00 .00 .00 .344. 25.00 . .00 - 145 Oksitetrasiklin hcl injeksi Amp .00 .00 700 110.00 34. .967.500.00 1.963.00 1.00 - 135 Nistatin 500.300.00 700 500 134 Nistatin 100.344. 3.00 52.00 - 163 Primakuin tablet 15 mg Tab .00 .300.000 iu Tab 50 528.900.00 258. 57. . 236. 57. 1.00 .00 400 400 126 MgSO4 Inj 20% Vial .200.344.00 .00 2. 5.00 20 1.646. .600.600 10.646. .00 .963.00 399.00 .600.150. .500.00 . 341.00 - 133 Nifedipin 10 mg Tab 100 2. 176.00 4 395.00 1.00 600.187.00 95.535. 8 25.900.000.00 173. 4 2.00 3. .00 128. .400.600.902. 341.099.999.999.300. 400 34.400.00 .200.503.780.000.00 67.967.00 67.00 - 150 Papaverin Tab Tab 1.00 151 Parasetamol sirup 120 mg/5 ml Btl 1.00 .51 6.300.400.319.994.900.00 300 2. .680.00 . 317. 9.994.629.080.319. 110.195.00 240 318. .000 iu Tab 528.00 310.00 . .00 3.994.00 26 1.000.00 - 143 Obat batuk hitam ( OBH ) cairan Btl 17 1. 3.00 45.00 1.00 1.000.00 800 88. 1.736. . 221.00 - 138 OAT ( FDC ) Kategori I Pkt 3 395.000. 660. 1.00 26. .583.00 2. 193.720.00 . - 155 PB Dewasa Blister .195.00 . 317.00 39.503.535. 39 6.40 58.00 .00 128 Mineral Mix Sach .00 39 1. 121.000 19.00 31 1. . 6.340.00 300 318. .00 54.700. 660.00 100 169.200. .300.00 .503. 3.680.00 30.000 19.00 .530.00 .090.00 899. .00 700 2.00 1.00 .00 .804.00 260 185 152 Parasetamol tablet 100 mg Tab 200 34.00 136 Oil Emersi Tab . - 127 MgSO4 Inj 40% Vial 4 2.00 19.00 .00 528.500.00 283.

800.440.00 25 10 180 Simvastatin Tab .00 226.00 162. 3 4. 286.00 158.000 3.00 - 194 Yodium povidon lar.00 60 3. .200.b1) tablet Tab 3.00 .00 .000 10. 6.00 .64 77. 6.700.00 .400.00 80.00 .000 IU Kaps . 102. 11. 2.000.00 .00 158.067. .00 167 Ranitidin 150 mg Tab 132. 388.00 .00 202 Stesolid Injeksi Amp . 5 6 196 Zinc Tablet 20 mg Tab 521. .00 .50 . 1 1.000. 11. 2.00 .200.00 2.200.180. 2.00 .00 .00 76.00 678. 297.00 .313.00 200 297.00 5.345.000 15. .600.855. 3 3 190 Vitamin b kompleks tablet Tab 1.00 22. 505.00 .000 15.00 212.00 400 297.00 678.000.00 1.00 16.00 .00 - 177 Sianokobalamin ( Vit.728.000 179 Silk no.800. 102.908. 226.000.067.951. .00 - 205 Darflex Tab .047. 65.00 5 15.00 20 1.00 48.850.00 .200.00 .00 300 400 199 Ketokonazol Krim Tube 2.000.00 - 171 Ringer laktat larutan infus steril Btl 5. 2.00 - 204 Ranitidin Injeksi Amp 1.00 38.345.00 1.100.100. 7.00 15.047.00 .000.000.00 26.00 .00 15.85 7. 2.000 226.000.00 77. .000.00 114. . .00 . .697.647. 730.00 79. 100 226. 2.00 . 7.400.00 - 200 Pehacain Injeksi Amp 20 3.000 226. 6.00 246.00 16.728.488.00 .00 10 7.950.850. 480. 37.700 191 Wing Needle 23G Set .10% 30 ml Btl . 100 480.00 .180. 162.500.00 59.00 - 189 Urine bag Set 4. 100 400 166 Propranolol hcl tablet 40 mg Tab 200 80.900 112.00 114.340.400.00 .00 22. .00 - 183 Tetrasiklin hcl kapsul 250 mg Kap 1.400. .000 226.000.000 112.500.00 .198.00 1.960.400.000.00 153. 200 388. 1. 25 mg Tab 1.894.00 11.400.140.000.64 77.950. 2. 37.345. 6.00 . 100 100 181 Tablet tambah darah kombinasi Sach 200 2. - TOTAL ### ### ### ### 5.200 132.00 11.00 1.000.047.00 13.00 .100.00 .000 226.00 440.100.00 . 1.00 100 297. 2.00 .820. .00 .800.000.00 .000.00 20 5.00 186.00 10.00 .00 1.440.400.00 .00 2.400.600. 400 65. 6.00 .00 1.000.765.00 . 2.00 72 1. 1.00 1.213. 286.100.000 187 Triheksifenidil tablet 2 mg Tab 730. 6. 11.200. 521.00 400 297.00 - 174 Salisil bedak 2 % Ktk 22 1.00 .950.340. 85.340.950.00 1.00 . 7.00 .200.00 .64 . 200 80. 2.313.00 .00 .00 540 520 172 Salbutamol tablet 2 mg Tab 400 65. 1.000.00 226.00 .00 .400.00 . 200 2.313.720.000 15. .00 .697.00 - 197 Amaropo Kaplet Kapl 2. 100 114.00 . 521.200. 177.00 11.670.00 .00 3 4.000. 1.00 1.400.00 100 480.00 45.00 25 7.00 186 Tiamin hcl ( Vit.00 189.00 .b1) injeksi Amp 30 189. 165 Propiltiourasil tab 100 mg Tab 300 297.00 65.850.00 1 178 Sianokobalamin tablet Tab 3.000.400.00 .200 1. .340. .00 440. 60 80 201 Pospargin Tab Tab 200 388.850.3/0 Sak 5 7.00 3. 540 5.00 162. 286.00 .00 .180.00 .950.00 3.00 .00 - 170 Retinol 200.00 .00 388.00 23 25 175 Salisil spiritus 10 % Btl .20 27.00 173 Salep 2 .00 . 730.345.00 25 1.00 1.00 . 480.682.440.000 162.200. 505.200 132.800.00 27. .00 29.100.400. 177. 1.00 . 1. 30 189.000. 3.00 23.616.64 .640. 2.00 - 198 Heximer 2 mg Tab Tab 300 297.000.00 .00 100 169 Retinol 100.000.00 . 15.00 89.00 .000 3.00 .000.00 .00 45.000.00 5.200 168 Reserpin tablet 0.180.00 .670.51 - 203 Simvastatin 10 mg Tab 177. . 80. 521.700.00 .00 .4 kombinasi Pot .00 .974.000.000.200.00 - 188 Trireksol formalin ( tkf ) cairan Btl . 730.00 114. 200 182 Temporary stopping fletcher Set 37.00 62.00 .00 80 3.00 118. 286.00 520 5. .00 - 195 Yodium povidon lar.00 300 297.00 3.00 15.00 248.200.700 112.00 . 189. 2.00 89.697.313. 7.400. 177.00 .00 .200. .600. 37.00 20 7. .00 76.00 26.00 125. 85.000 114.682.00 . 4.000 15.15 29. 2. 6. 505.067.00 95.232.00 .400.00 .b 12 ) injeksi Amp 73 1.500.00 . 1.400.00 13.00 48.51 .00 29.891.00 162.00 118.855.720.00 192. 2.855. 102.51 .00 .00 1.00 - 192 Wing Needle 27G Set .047.000 IU Kaps .050.500. 2.720.51 .00 . 1.00 185 Tiamin hcl ( Vit.00 - 176 Semen fosfat serbuk dan cairan Set 102. 505.200. 85.697. 6. 1.750.067.500.855.00 184 Tetrasiklin hcl kapsul 500 mg Kap 100 226.00 .10% 300 ml Btl 1 15.00 - 193 Yodina Test Btl .100. 11.00 .00 .200.410.824.200 112.00 6 15.100 114.00 .00 . 85.000.00 25.00 23 1. 132.682.200.720.682.400.440.00 2.00 .400.088.00 89.000 162.067.00 226.00 1.

899.Mengetahui.80 57. SKM.007.660.013.Kes Damayanti Baharuddin. 15.35 59.Farm.202. 18.05 Yang Menyerahkan. NIP.10 Kepala Puskesmas Ujung Lero Petugas Gudang Obat SUNDARI.963.Apt.S.561.556. M. 19720411 199803 2 006 .

10 10 20 30 50 1. - 1.000 480 500 980 270 200 470 200 0 100 100 100 200 300 1. - .700 10695 10. 25 25 .200 .005 .600 11. - . - . 285 125 135 260 10 15 25 90 45 45 90 . .000 9828 11. . . . - 480 220 240 460 20 40 60 275 115 125 240 10 25 35 . 10 10 500 270 300 570 30 30 22 11 11 22 3 . .000 3. - 158 79 79 158 . 3 .410 705 690 1.300 10488 10. . 200 200 .495 105 900 1. . 30 30 1. . 0 . . 60 100 160 100 100 100 200 150 100 250 20 1 10 11 9 30 39 . - 20.500 20. 0 .672 11. . 5 5 150 75 75 150 . 0 . - . .200 600 600 1. . - 20 10 10 20 .000 20. - .680 280 240 520 20. - . . 0 . . - 21. . . - . . 0 .988 15 15 440 225 220 445 3 3 20 10 10 20 . . . . 0 . - 169 82 82 164 .920 720 960 1.200 . 0 .300 5600 5.828 2. 0 . 0 . .672 1.395 . 0 .800 21. 0 .

. 10 60 70 .175 675 2.500 5.000 .630 1. 12 12 1. . - 7 2 2 4 . 0 . 1 1 .250 2. .200 4. .640 20 20 20 40 5 125 130 15. 3 15 8 8 16 . 0 .640 .500 2675 2.000 2. 0 . 0 .650 1.925 .300 800 800 1.710 2. 0 .285 1. 0 .000 5285 7. 0 . . 600 600 4.000 12. 1 1 800 470 400 870 80 100 180 13. 15 15 70 45 45 90 . 49 300 100 100 200 .220 .630 1. 0 .100 900 5. 0 . . - 2 1 1 2 .300 2. .630 90 11 60 71 49 . 100 100 .000 11.000 2. . 125 25 0 10 10 10 40 50 .990 16 9 9 18 . 0 .000 5270 6. 300 300 500 300 300 600 340 200 540 925 680 625 1. 10 30 40 . .000 2. 260 260 1.600 200 100 300 800 600 500 1.500 3. . . 3 3 . - 4. 80 80 100 100 200 .270 1. - .730 1. .000 13. - .950 46 21 21 42 . . - 9 2 5 7 3 . . 15 15 .100 5200 8. - 11. . - .300 4. 0 .720 1.715 . - 8.070 1. . . .500 2410 2.000 1070 1. . 18 24 42 92 29 32 61 30 33 63 1.715 1.100 100 100 200 120 60 60 120 .700 3330 4.630 20 10 10 20 26 5 31 .400 7. - 12 0 . . - 159 86 86 172 . 2. 10 10 990 2.305 125 .

0 . . 0 .245 2.310 4. 1 1 100 0 . - . .245 44 21 21 42 .000 1. . . - . 150 400 550 111 70 54 124 6 40 46 4. 0 . 60 . 17 17 8 8 5 13 .465 4. - 204 94 94 188 . 31 31 .200 200 200 400 . - . - 10 5 5 10 . .400 5.480 7.700 300 200 500 142 65 65 130 . - . 32 32 800 520 400 920 50 100 150 . 400 400 800 . . . . 8 8 21. .800 2. . 0 . . . 0 . - 1.000 5. . - .500 800 1. . - 100 0 . - . 0 . 0 . 0 . .000 17. .000 500 1. 0 . 1 1 .300 1050 800 1. . 0 . . .000 1. - . 0 . 0 . .200 2800 2.390 10 5 5 10 . . .200 1700 2.480 . . 0 . .000 2. . - . - 100 240 100 340 60 . 88 49 49 98 25 15 40 2. 2 2 149 59 59 118 . - 3. 0 . .200 600 600 1. - . 0 .000 7. 0 . - . - 2.000 6150 11. . 12 12 240 120 120 240 . 18 30 48 1.000 1310 1. .000 3. 0 .200 .000 500 500 3. 0 . . - . - .150 7. 0 . .800 .390 3. . 50 300 350 . . 0 . . . . - . 0 . . . .850 665 1. .

0 .900 1000 1. 4 4 . 1 0 1 1 1 29 30 . 0 . . 0 . 0 . - 9 4 4 8 .000 2. 0 . 0 .100 10265 10.870 16 8 8 16 . 0 . 0 . 0 . . - 49 12 23 35 18 20 38 . 0 . . . 0 . - .870 1. . . - .350 130 100 230 800 230 400 630 300 100 400 . . 0 . . - . . . . 1. . - . 0 . .000 2. .000 5. - . - 120 60 60 120 . . 30 39 69 . 0 .500 650 700 1. - . - 1. . - . . . 3 3 . 0 .000 2130 3. - 540 170 300 470 190 100 290 6. 0 . - 77 49 39 88 5 32 37 49 57 31 88 12 12 24 100 36 50 86 14 20 34 .200 445 130 185 315 55 75 130 200 200 200 800 400 1. 0 .130 1.200 21. - . 0 . . 0 .765 240 800 1. . - 1. . . . - .200 1.040 . 0 . 0 . . - . .500 20. . - . 0 . . . - . - . . 170 170 50 100 150 1. . . . 4 4 .200 370 500 870 250 300 550 . . . . . . .000 2. - . . 0 .000 . 30 50 80 . 0 . . - 13 5 5 10 . 600 600 . .

. 0 .295 35 10 10 20 .300 .000 3. . - 21.450 .000 3. - . 0 . 1. 20 20 200 100 100 200 . - 11 6 6 12 . . 500 300 400 700 220 . . . 140 140 40 400 440 . . 0 .000 .295 1. . 0 . 0 .850 2. . 0 . - 6 3 3 6 . . . . - . 0 . - 700 350 400 750 50 200 250 . 0 . - . 0 . 200 200 . 0 . . 0 . 50 50 400 200 600 2. . . . 0 . . 0 . .400 .000 2850 3. - 1. - . - . 0 . . .400 1200 1. - 48 20 25 45 5 20 25 . .000 1. . 0 . . 0 . 0 . - 100 200 100 300 300 1. . 0 . 0 . . - .200 7.060 500 520 1.640 1.000 1. .860 2. . .020 20 20 40 . .000 4. . 220 . - . - 200 130 200 330 70 . . . . - 1 3 1 4 .200 2. .700 6450 10. . . - . 70 . . - . 0 . - . . - 140 80 80 160 . .640 . - . . 72 72 4. - . - .150 5. 0 . .700 17. .000 5. 0 . - . 150 150 . 30 30 4. . 100 100 .250 2.000 1860 3.

00 .000.00 5.00 17.200.00 31.000.00 17 Ampisilin Inj Vial 25 5.500.200.00 30 8.200.00 22.00 25 Artesunate Anak Blister . .00 10.200.800.000.400.00 .000.000. - 26 Artesunate Dewasa Blister .00 10 2.00 72.00 287.00 41.00 683.00 36. 123.00 22.00 11 Aminofilin tablet 200 mg Tab 200 86.00 . 27 4.00 .250. 2.00 135 1.066.00 115 1. 141.000.00 33 Asklovir 400 mg Tab 100 362.00 105.750.00 120 220. 141.400.00 200 86.00 2 Abbocath No.00 58.00 717.00 10.800. 18 Set . 100 149. 292.00 270 1. 22 Set 5 8.500. .00 .00 200 362.500.000 105.800.00 10 2.200.00 200 362. . .016.00 - .500.000.00 7 Alat Suntik 5 ml Set 25 1.00 30 Asam Mefenamat tablet Tab 200 122.00 72.000. .600. .00 8 4. .000.780.00 6 Alat Suntik 2. 1.200.00 - 32 Asetosal tablet 100 mg Tab 100 127.800.016. .200.00 8 Albendazole Tab 30 363. 1.600. 3.00 . 8.000.00 140.00 23 Antimigrain doen kombinasi Tab 149.600.00 29 2.000. .00 70 8.016.500.096.610.500.85 .700.000.100.600 122.360.00 20 1.00 . . 5.85 .00 127. 8.00 .000.00 14. 30 363. 10. .00 12 Amitriptilin hcl tab salut 25 mg Tab 200 123. . 100 149.00 214 2.000. 4.00 30 1.00 100 1.500 122. 419.00 352.00 41.00 26.00 - 10 Aminofilin injeksi Amp .100.00 18 Ampisilin Kaplet 500 mg Kapl .700 78.00 15.00 44.600.200. 35 8.00 508.400.00 300 86.00 28.00 24.00 945.00 25.00 112.00 9 Alopurinol tablet 100 mg Tab 90.00 67 8.00 25 8. 3. .00 141.00 157. .00 132. 243 2.00 15 Amoksisilin Kapsul 500 mg Kap 292.200.000.00 5 5.00 . 100 127.00 3.00 36.560. 363.00 10 2.00 671.00 25. .00 62 8. - 27 Artesunate Inj Vial .00 13 Amlodipin 10 mg Tablet Tab 30 352.00 40 1.00 3.000 105.560.00 40 1. 419.000. . NA M A O B A T UAN BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI 1 Alat Suntik 1 ml Set 15 1.00 79.00 .00 205.610. 3.00 420. 10.00 52.000. .900.00 22.100. . 10.00 .000.250.00 6.00 800 90. .00 .000.00 72.000 78.00 123.000.5 ml Set 40 1.00 5 8. . 2.00 87.00 10.00 36.00 900 352.500.00 .00 270 1.00 .200.00 .00 74.200 78.00 .240. 20 Set 8.250.00 297.200.066.00 - 22 Antihemoroid doen kombinasi Sup 10 2.00 630. 50 1.200.00 10. 8.00 33. 1.00 110.890.00 930 352.00 547.100.200.00 .780.00 .000 105.560.400.080. .100.00 105.00 1. . STOK AWAL P E N E R I MAA N PENGELUARAN SISA PERSEDIAAN No.050.200. .00 300 122. .00 .00 3 Abbocath No.00 5.00 .00 .00 - 4 Abbocath No. - 29 Asam askorbat ( Vit c ) tab 50 mg Tab 1.000.000 105.00 34 Atropin sulfat injeksi 0.610. .00 300 86. .00 9.00 .00 5.200.250.00 .780.560.85 - 20 Antasida doen tablet kombinasi Tab 900 78.050.00 75. - 28 Artesunate Remaja Blister .00 . 70 8.00 - 19 Antalgin Tab 500 mg Tab .500 292. .200. 10. .00 30 8.00 19 4.00 .00 10 5. 419. 55 8.100.00 480 220.000.00 35 Benzatin benzil penisilin injeksi Amp . 10.000.00 24.00 150 1.400.050.200.00 316.100.000.000.096.25 mg/ml Amp 30 1. 419.00 12.00 20 5.016.800.00 . LAPORAN PERSEDIAAN OBAT GUDANG OBAT PUSKESMAS UJUNG LERO TRIWULAN III SAT. .00 574.00 - 14 Amoksisilin Kapsul 250 mg Kap 240 220. 141. 2.800.250.000. 90.00 126.610.750.200.600.000.000.500.000.00 . .00 22.200.200.800.00 - 16 Amoksisilin sirup kering Btl 2.560.00 44.780.000.00 . .800.00 . 800 90.00 4. 2.500 292.200.00 .096. 3.00 . .00 21 Antifungi doen kombinasi Pot . .840.800.000.00 246.00 100 362.900.000. .200.00 297.600.000.200.00 10. 141.050. 15 5.00 574.00 1.00 30. .00 622. 200 123.00 113. . 5 5.00 17.00 600 220.600.200.200.00 . 24 Set 8.200.000.00 70.00 246. 127.200.85 .200.00 72. .400.00 9.00 780.890.700.00 .400.00 14.00 24 Aqua proinjeksi steril Vial .00 - 36 Betahistin Tab .00 27.00 - 5 Abbocath No. . .00 363.00 .200.050.00 31 Asam Traneksamat Inj Amp .00 45.00 132.200.000.00 29.00 .00 12.000.100.00 549.00 327.00 149.00 .00 24.00 451.00 44. 1.096.00 .200.

00 35 2.000 3. 4. 1. 102.00 29.00 72. 102.910.00 103.00 .00 - 58 Etilklorida semprot Btl 3 11.333.00 . 5. 3.00 6.25 mg Tab 100 103.500.00 45 26. 1.00 51 Doksisiklin Tab 600 278.620.360.00 87.00 .354.890.00 24. 429.00 217.980.000 24.938.00 63.300.250.500.500.250. .00 - 47 Diazepam tablet 2 mg Tab 39.00 600 76.354.00 5 2. 30 .700.500.100.739.00 66.938.1%-1ml Amp 30 8.00 .00 57 Etanol 70% Btl 18.00 .250 56.780.00 - 42 Deksametason injeksi 5 mg/ml Amp 125 1.00 25.760.00 .675.00 122.00 4 5. 42.00 .00 60 Fenobarbital Inj Amp 15 1.00 217.00 2.500. 1.00 .00 300 61.00 .00 55 Eritromisin Kaps 250 mg Kaps . 4 2.00 74.200. 985.680.792.00 - 71 Glibenklamid tablet 5 mg Tab 100 61.305.400.640.00 132.00 .00 8.00 .500.80 13.00 10 2.00 2.00 18.578.00 .00 166. 32 4.300 74.467.000.69 11.880. .400.00 44 Dekstrometorfan sirup 10 mg/5ml Btl .910.00 78.00 3 2.00 95.550.00 .00 45.00 7.00 74. 600 278.00 .00 149.00 53 Ekstrak belladon tablet 10 mg Tab .2/0 .596.070.00 31.754. .00 7.00 188.00 435.333.00 8 11. 40.60 12 1.300.000.00 2.00 225.5 mg Tab 900 74.578.00 435.00 2.690. .00 .00 6.1% Btl .000. 0.00 - 59 Eugenol cairan Btl 1 18.800.792.00 66 Furosemida tablet 40 mg Tab 200 84.00 102.00 .00 10 26.300 100.00 500 76.00 .00 .00 22.34 126.00 73 Glukonas Kalsikus Inj Inj 24 .00 - 45 Dekstrometorfan hbr tab 15 mg Tab .00 3.500 40.00 40 Cefotaksim 1 g Injeksi Vial .00 65 Fitomenadion ( vit k 1) tab 10 mg Tab 300 690.578. 40 3.108.100.00 .00 9. . 1. 435.00 .00 300 241.00 155.00 .500.900.37 Betametason krim 0.830.000 3. 278.00 5.00 540.00 7.00 95.000. 100 103.00 200 690.00 .305.00 68 Gentamisin Inj Amp 40 3.00 78 Hidroklorotiazid (hct) tab 25 mg Tab 1. 1 18. 2.500 40. 15 2.00 2.980. 60 3.00 43 Deksametason tablet 0.500.754.00 12.800.00 1.938.00 76 Haloperidol tablet 1. 429.00 - 70 Glass Ionomer cement (gc ix ) Set 1 435. 102.5 mg Tab 100 76. 18.800 100.00 3.720.596. 18. .675.00 8.550.560.00 15.698.300.192.500. - 56 Etakridin ( rivanol ) lar. .062.00 24. 1 435.00 - 52 Efedrin tablet 25 mg Tab 2.00 35 3.000.00 5 11.600.00 .00 138.34 126.000. 500 317.1 % Tube .34 98.754.00 .750 56. 30 8.000.00 300 61.765.620.300 100.550.333.00 .670.00 1.00 .108.00 60 1.00 .698.00 .00 148.700.00 .920.675.00 63.800 100.00 . .69 22.00 75 Griseofulvin tab 125 mg Tab 100 241. 2.00 62 Fenol gliserol tetes telinga 10% Btl 12 1.00 1. 102. 2.00 61 Fenobarbital tablet 30 mg Tab 2.500.00 40 26. 1.00 18.00 149.467.00 .500.000.596. 1.100. . 1.00 267.00 180.00 1 2.00 .300.00 .00 149.750 56.00 55 1.000.00 40.00 60.00 48 Diazepam inj 5 mg/ml .000.00 .240.938.00 3.00 57.00 . 3.00 . 7 Psg .200.400. 6 . .070.00 112.34 98.000.00 4 18.739.00 168.00 1.910.00 18.00 20 1. 6.0.000.00 44.354.00 166.00 .060.00 9.00 636. 5 1. 15 1.00 . 60 3. 80 1.720.354.739.00 .500.00 38.00 69 Gentian violet larutan 1 % Btl . 429.00 .00 - 54 Epinefrin (adrenalin) inj.00 18.738.00 30 3.00 14.00 636.350.00 38.416.550. 100 690.596.00 74.00 16.00 39 Catgut/benang bedah no.100.000.3/0 Sak 15 26.00 41 Ciprofloksasin 500 mg Kaps .00 216.500.720.00 38 Captopril 25 mg Tab 1.00 117.400.00 211.00 451.00 207.00 29.100 74.980.00 2 4. 985.800.00 .00 158.156.000.00 1.765.500.00 69.00 .00 435.595.980.156. 1.354.400 265.000. 985.00 49 Difenhidramin inj 10 mg/ml-1ml Amp 60 1.00 280.00 127.000.00 30 4.467.500.00 . .00 .00 .00 6.750.250 56.00 200 76.00 900 241.000.000.00 3.00 700 241.00 1. .560.780.00 148.000 24.000 39. 74.210.000 74.700.00 265.00 200 317.760.60 63 Ferro Sulfat 300 mg Tab 1.00 100 61.333.000.00 .333.00 397.2 ml Amp 5 2.500.00 69.400.600.400 265.000.00 10.00 67 Garam oralit untuk 200 ml Sak .00 .000 74.000.675.00 112.467.300. 4 18.00 195.000 39.000.00 45 2.00 8.720. 42.600.00 .250.754.00 330.140.000 39.000. 265.698.738.80 13.00 77 Handshoen No. 100 84.00 30 3.00 300 317.305. 125 1.69 .738.00 .00 100 84.500. 8. 37 5.00 .60 12 1.070.00 72 Gliseril guayakolat tab 100 mg Tab 3.698. 42.00 92.156.80 13.00 .108.100 74.595.00 60.305. 429.00 2.000.00 210.80 13. 3.156.00 25 3.00 267.000 3. 11.5 % Tube 15 2. .578. 985.00 1.000.300. 42.333.300.739.580. 317.500.00 34.60 12 1.910.400.00 - 46 Devitalisasi pasta ( non Arsen ) Btl . - 74 Glukosa 5 % Btl 33 5.00 278.00 .108.00 18.650.00 690.500.738.00 50 Digoksin tablet 0.00 .00 130. 265.600.00 24. 1.00 2. 103.00 3.00 24.000.00 5.00 140.00 79 Hidrokotrizon krim 2.00 . 24.00 64 Fitomenadion ( vit k 1) injeksi Amp .00 .00 84.69 11.00 1.00 10.

00 .00 89 Karbamazepin tab 200 mg Tab 400 269.00 230. .000. 60.00 - 102 Kloroquin fosfat tablet 250 mg Tab .503.00 70 3.00 .00 - 113 Larutan benedict Btl 1 28.00 111 Kuinin dihidroklorida inj.500.00 6 1. 6. 17. 118.00 269.590. 297.21 . 154.499.21 173.00 500.00 .00 23.000 23.00 . 17.023.000 57.00 2.800.00 .532.00 .400. . 1. 269.298.600.00 3.587. .00 28. 165. 50.820.503. 266.000. 112. 737.00 1.620.00 364.00 . .759. 910.00 400 320.00 28.00 .800.00 - 105 Kodein tablet 10 mg Tab . 1. .861. 40.00 - 106 Kontrasepsi Implant Susuk KB Set .504.00 207.700.680.100 157.00 49.132.400.00 .023. .00 - 119 MB Anak Blister .00 88 Kapas pembalut 250 gr Bks 1 8. 154.00 .00 8. .038.00 98.00 303. 3.040.038. .20 171. 297. .00 28. .078.920.00 .000 165.00 - 112 Larutan Anisol Btl .00 .600.000.680. .00 158.00 395. .00 . . 29 1. .00 400 152. 28.178.00 90 Kasa 4 m x 15 cm Rol .21 .00 29.850.00 166.000.000.503.00 - 87 Kalsium laktat ( kalk ) tab 500 mg Tab 3.00 200 157.00 107.000. 6.038.00 .499.00 - 117 Lisol Btl 2 49.850.759.00 36 4.00 .664.680.00 .00 9.00 33. 1.820. 154. 1 28.935.00 .00 15. 910. 112.00 . 118.00 .861.00 - 103 Klorpromazin hcl tab salut 100 mg Tab 1.00 44 4.00 200 79.600.00 29.000 250.00 43.00 255.708. 1.00 .000.000.00 25. 40.00 14.038.00 128. 3.298.00 550 550.00 8 1.000.00 60.00 9. 49.00 114 Larutan Spiritus Btl .400.00 737.00 .820.00 31. 10.00 .400.200.00 .600.00 .200.00 .00 99.00 28 1.935.000.722.800.532. - 120 MB Dewasa Blister . 806.50 .00 99.00 250.00 28.00 . . 550.00 38. 18 x 22 Rol 32 297. 3.720.00 24.00 34 2.499. 400 269.935.00 .000. 25%-2ml Amp .560. 57.00 1.587.00 22.00 8.850.178.00 165.00 30. 320. - 108 Kotrimoksazol pediatrik tablet Tab 400 79. 32 297.00 82 Infusion set anak Set 12 4.00 .00 107.200.237.00 7. 80 3.00 31.00 .00 52.720.720.00 . .00 165. .00 250. 1.400. 300 98. .200 mg-1ml Amp 29 1. 6.00 .00 308. 806.000.400. 266.00 91.680. - 121 Metformin 500 mg Tab .000. 1.935.850. 266. .400.110.00 24. .20 171.000.00 31. .023.000.00 .00 .648.600 152.00 105 2.00 38.237.600.00 3.00 . 6. 1.00 .20 . . 550 550. 550.00 . . 1.600.720.200.00 104 Klorpromazin hcl tab salut 25 mg Tab .000.00 98 Kloramfenikol Salep mata 1 % Tube 17 1. . 40. 910.072. 118.00 300 79.500. 806.00 5 60.700.000 250.00 100 79.00 10 3.00 .00 .200. . 1.000.00 29.000 165.532. 30 737.00 .50 .000 23.00 9.500.00 43.00 500 320.00 118 Masker Set 31 1.400. 118.00 14.00 10 1.554.00 3 8. .00 31 1.00 303.00 99 Kloramfenikol Tetes Mata Btl 8 1.080.000.000. 1.700.00 22.00 302. 96. .000.100 157. 1.956. 60. 266.500.00 .820. 1.00 101 Klorfenol ( CHKM) Btl .00 165. 50. .00 - 85 Isosorbit dinitrat tab 5 mg Tab 300 98.00 269. 15 3.00 135 1.400.500.500.000.00 - 116 Lidokain kompositum injeksi Amp . 1.21 173. .00 241.00 2. .400 152.110.290. 1. 17.00 .00 .00 . 154.722.072.50 - 122 Metilergometrin inj 0.347.00 111 2.00 110 Kotrmoksazol dewasa tablet Tab 200 152.00 .298.00 104 1.00 23.00 - 96 Kina Tab ( Quinine ) Tab 30 737.00 57.00 55.499.000 23.00 160. 1.20 .00 91 Kasa 4 m x 3 cm Rol .708.237.00 .800 96.00 - 93 Kasa kompres 40/40 steril Rol .400.00 109 Kotrimoksazol suspensi Btl 40 2.759.900. 910. . .935.503.00 - 115 Larutan Ziehl Nielsen ( TB ) Btl .237.00 86 Kalsium hidroksida pasta Tube .000.00 - 92 Kasa Gulung 40 y x 80 cm Rol .00 .00 47.935. 112.00 20 1.600.00 302.00 - 95 Ketokenazole Tab Tab 100 320.000.800 96.000. 50.00 32.00 486. 2 49.00 3 8.500.000. 806.00 .00 . 17. 80 Ibuprofen 200 mg Tab 1.00 .00 .708.00 .000.00 20 4. 1.504.00 1.708. .861. .800.00 7 3.00 . .00 . 5 60.000 57.000.00 486.00 96.000.50 .00 . 112.00 128. .00 .00 84 Iodiol Kapsul Lunak Kaps .00 83 Infusion set dewasa Set .00 . 98.532.023.995.500.00 193.00 . .600.00 - 94 Kasa steril uk.00 .861.00 .759.00 . 40.298.00 8 3. - 107 Kontrasepsi KB 3 Bulan Amp .00 .00 97 Kloramfenikol kapsul 250 mg Kap 2.600.00 .00 81 Ibuprofen 400 mg Tab 200 157. 50.00 250.00 17.000.000 250.00 78.00 .00 52.00 100 Klorfeniramin ( ctm ) tab 4 mg Tab 23. 1.00 88.00 10.00 1 8.00 .

00 - 132 Natrium Tiroksin Tab Tab .00 149 Omeprazole Tab 221.618.00 - 130 Natrium Diklofenak Tab .195.00 . 176.00 26. .00 62.00 . 34. .000 19.00 162 Prednison tablet 5 mg Tab . .170. 236.00 700 110. 1.00 259.00 .999.967. - 127 MgSO4 Inj 40% Vial 4 2.00 - 146 Oksitetrasiklin salep 3 % Tube 32 1. . 20 1. 19.00 .00 650. 1.400 88.535.00 37 1.530.00 .000.100. 14.00 63.00 - 124 Metoklopramida Tab Tab 100 110. 297.500.00 .100. 9. 660.920. 9.00 - 129 Mummifying pasta Btl . . 189. 2. 193.516.40 19. 57.900.000.00 52. 1.804.00 .00 118.00 16.00 80.125 mg Tab 100 121.000.999.999.344. 60 5. 6.646. 660. 4 2.00 - 144 Objek Glass set .00 45.00 .00 .999.000 19.319.00 .00 - 150 Papaverin Tab Tab 1.618. 193. .000. 14.00 .00 .646.00 .000.00 .00 500 169.00 - 161 Pot Dahak Set 600 1.00 33.00 .629.600.015.200 57.00 1.00 2 395.000 128.00 .300. . .000. .00 173.963.100.00 .00 599.535.340. 176.629.516. 176.00 152 Parasetamol tablet 100 mg Tab 400 34.200.800. 1. . .00 121. - 156 Pirantel pamoat tab 125 mg Tab 100 318. 14.00 128.00 .000.00 127.200.00 51.40 58.530.600.00 211.149.900. 9.00 50.000.00 - 133 Nifedipin 10 mg Tab 300 2. 100 528.00 - 140 OAT ( Kombipak) Kat.00 300 169.00 .00 2.344.500. .629.000 88.967.00 78.800.00 .00 207.344.400.00 77.700.736.900.300.994.00 134 Nistatin 100.900.800. 1.300. .1 ml Amp 20 1.00 - 145 Oksitetrasiklin hcl injeksi Amp .51 13.40 - 158 Plester 5 yard x 2 inch Rol .00 70.00 31. - 164 Prokain penisilin injeksi Amp 39 6.00 10 1.000 iu Tab 50 528.530.800.00 165 Propiltiourasil tab 100 mg Tab .700 57.771.00 299.340.200. 189. 900 193. 317.934. 9.00 128.00 50 1. 1.00 258.300.00 150 1.000.00 100 1.00 - 141 OAT (Kombipak) Kategori anak Pkt .032.00 28.000. .00 200 318.00 . 317.00 - 137 OAT ( FDC ) Kategori Anak Pkt .00 . .00 12. 221. I Pkt .00 9 395. 50 528.00 899. 193. 4.102.00 2.00 84.00 .00 154 PB Anak Blister .260.00 231.00 528. 9. 193.100.00 - 138 OAT ( FDC ) Kategori I Pkt 4 395. 189. 1.00 125 Metronidazol tablet 500 mg Tab 100 169.00 - 151 Parasetamol sirup 120 mg/5 ml Btl 75 1.00 880.015. 341.319.646.00 95.994.900.00 147 Oksitetrasiklin Salep mata Tube 12 1.00 .400 88.00 9. .500.00 . 236.00 23 1.700.00 600.00 135 Nistatin 500.170. 128.340. 100 528.00 . 3.00 .00 60 5.646. 193.00 .910.00 791.00 650 1.000. .00 39.015.51 .00 .530.600.00 .00 16.00 .00 82. 176.963.300. 39 6.000 iu Tab 528.000. 100 2.00 . .00 3.00 .00 900 193.00 500 57.000.00 11.535.00 173.200. 25.032.00 310.00 .00 126 MgSO4 Inj 20% Vial .00 .000.00 50 1.600.319. 1.00 . .51 13. 3.800.680. 341.800.00 72. 100 121.500.00 2.00 .000 19.618.800. .00 - 142 OAT (Kombipak) Kategori Sisipan Pkt . . 341.000.00 160 Poly Katether 22 Set .00 .00 136 Oil Emersi Tab .00 .00 32. .00 210.00 77.700.170.00 528.804.583. 193.00 55.00 26.00 .00 163 Primakuin tablet 15 mg Tab .700.00 46 1.600.00 4. 236. 660.400.800. . .00 148 Oksitosin Injeksi 10 iu/ml .00 12. 14.344.600.000.00 .963.00 52.800.00 176.900.00 .00 300 318.618.344.00 3.00 50.280. 10 25.967.00 .680.00 300 169.200.00 .00 8.00 .00 10.00 157 Piridoksin hcl tab 10 mg Tab 1.00 .900.00 8 25.563.00 128 Mineral Mix Sach .00 20 1.963. .672. .500. .00 50.00 300 297. .00 128.51 .00 346. .00 3. .00 115. .00 500 110.400.00 1.680. . 400 34.344.00 . 3.00 258.00 .125. 1.00 176.00 26.319.700.629.640.195.00 - 143 Obat batuk hitam ( OBH ) cairan Btl 20 1. 3. 236. 341.00 40 1.40 77. . 5.00 239.00 310.00 .00 38 1.600. 189.123 Metilergometrin tab salut 0.00 2 25. 5.967.000.00 226 1.800.00 . . - 155 PB Dewasa Blister .00 52.195.00 6.00 - 131 Natrium Klorida Infus Steril Btl . 800 221.00 28.00 .170.631.00 .00 153 Parasetamol tablet 500 mg Tab 800 88. 660.00 .00 100 297.344.535.680.548.00 159 Poly Katether 18 Set 3 9.00 .00 10.785.300.00 139 OAT ( FDC ) Kategori II Pkt .00 300 110.900.015.900.700. 1.00 34.160.00 .340.670.900.200. 528.00 2.195.994. . 317.00 .00 400 318. 3 9.00 .00 200 2.00 . .00 100.994.800.00 .000.000 128. .00 29.00 89.00 .400.00 . . .00 230.00 800 221.000. .344.400.500. 317.00 151 1.520.00 10.900.102.250.00 28.00 20.400.00 48 1. 121.00 739.00 .00 .00 26. 400 297.00 7 395.00 .

100.000.800.809.000 15.00 .00 114.790. 4.00 13 2.824.067.850.00 3. 250 286. 6.00 2 4.00 - 205 Darflex Tab .047. 37.00 560 5.00 226. 521.00 26.160.950.00 .00 .500.00 .00 25 7.200.682.500. 1.00 .400. 102. 85.50 ### 29.670.b1) tablet Tab 1.00 .00 .00 - 183 Tetrasiklin hcl kapsul 250 mg Kap 1.00 268. 125 3. .00 10 7. .313. 3.728.200.00 .00 196 Zinc Tablet 20 mg Tab .700 112.00 1.00 .00 .697.00 .00 22.855.00 .100.176.00 1.51 .000 226.00 250 286.00 114.00 .00 3. 480.200.00 300 521.00 468.050. 11. .950.00 . 38 2. 1.000.720.00 114.00 187 Triheksifenidil tablet 2 mg Tab 730.250.00 .047.00 76.640.440. 1. 80.00 83. 37.60 Triwulan III 7.00 .169. .728.000 226.00 3. 200 297.067.00 .00 12 1. 6. 102.00 - 204 Ranitidin Injeksi Amp 1.200.400. 1.64 77.00 904.400. 7.00 6 7.00 19.00 30.088. 6.00 .00 45.00 191 Wing Needle 23G Set .200 521.00 15.00 202 Stesolid Injeksi Amp .600.00 286.00 189.616.00 .232.440.000 114.00 90 132.00 . 2. 25 mg Tab 1.345.00 .3/0 Sak 20 7.000 15. 100 226.00 40 5. 15.00 .00 .64 .00 26. 2.000 IU Kaps . 200 388.200. 2.00 1.00 .880. 37.000.345.00 .00 . .047.440.000.200.00 .400.720.600.00 1.00 400 65.200.00 - 177 Sianokobalamin ( Vit. 3 4. 2.682. .00 13.800.951.00 .720.00 .00 59.00 1 4. 6 7.00 156. 85. 730.00 .00 64.00 - 176 Semen fosfat serbuk dan cairan Set . 30 189.440. 2.250.00 .00 .00 71.00 8.00 5.400.00 127.00 .10% 30 ml Btl .00 10.00 - 168 Reserpin tablet 0.4 kombinasi Pot .00 .200.00 900 521.00 4.000.00 162.067.200. 480. .00 167 Ranitidin 150 mg Tab .458.00 .64 .300.00 226.00 2.00 .000. . 11.00 - 200 Pehacain Injeksi Amp .00 . 480.00 - 201 Pospargin Tab Tab 200 388.00 .00 - 189 Urine bag Set .00 452.00 25 2.00 2.00 25 1.00 11.00 300 65.00 3.500.00 - 188 Trireksol formalin ( tkf ) cairan Btl .00 - 195 Yodium povidon lar. 2.00 175 Salisil spiritus 10 % Btl . 177. .00 - 193 Yodina Test Btl .00 2.00 .000.000 114.000.00 4. 6.169.000.00 .00 186 Tiamin hcl ( Vit.00 190.00 71. .00 .100.000.400.00 35 7.367. 6.340.00 .00 - 182 Temporary stopping fletcher Set .00 - 199 Ketokonazol Krim Tube . 2. 102.00 .180.00 .670.00 .400.00 228.00 .400.500.000.500.000. 7. 2.000.00 . 1.10% 300 ml Btl .00 .00 - 170 Retinol 200.00 28.00 .00 .600. - TOTAL ### ### 29.00 7 15.050 505.000 IU Kaps .000.650.613.500.200.00 - 192 Wing Needle 27G Set .000.340.00 27 1. 6. 85. 114.682. 132.400. 1.067. .00 162.60 8.00 22. 505.035.00 .855.200.000.00 540 5.363. 177.000.00 125 3.060.047. 297.00 29.826.00 .500.00 .00 197 Amaropo Kaplet Kapl .43 29.200.169. 11.00 16.313.870.00 174 Salisil bedak 2 % Ktk 20 1.00 .697.60 11.00 17 1.000.166 Propranolol hcl tablet 40 mg Tab 200 80.00 76.00 28.000 226.00 180 Simvastatin Tab . 286.000 226.00 11. 3. 90 132.400.720.00 185 Tiamin hcl ( Vit.00 16.400. . 6. 162. 2.00 41.850.358. 1. 1.00 .00 60.00 .00 11.697.00 297.00 59.00 39 1.00 505.203.400.000.790.645.340.00 14.500.51 - 203 Simvastatin 10 mg Tab 177.00 625.000.200.00 387.00 20. 102.180.850. 37.00 169 Retinol 100.682.00 184 Tetrasiklin hcl kapsul 500 mg Kap 100 226.013.000 112.00 162.00 190 Vitamin b kompleks tablet Tab 2.850.035.203.313.00 .00 . 2. 2.000. 8 15.00 .202.00 5.b1) injeksi Amp 30 189. .b 12 ) injeksi Amp 72 1.500.00 387. 226.855.00 60 1. .313.20 19.00 15. 730.000 15. 2.950.000.51 . 177.00 114.000.800.180.00 .00 55.00 .950.00 173 Salep 2 .000 162.500 112.60 18. 132.020.855.566.00 1 15.00 388.00 300 65.00 246. 2. 200 80. 2. 1.00 111.900.500.000. 11.000.00 - 181 Tablet tambah darah kombinasi Sach .00 19. 2. .00 153.180. 480.00 1.51 .00 178 Sianokobalamin tablet Tab 1.950. 189.00 - 171 Ringer laktat larutan infus steril Btl 20 5.400.600.00 678.00 .00 .00 80.820.200 112. 1.00 45.400.050 505.03 .000 15.200. 6.00 172 Salbutamol tablet 2 mg Tab 400 65. 85.345. 388.000 162. . 2.500.600.10 60.00 .00 192.00 4.880. 2.00 - 198 Heximer 2 mg Tab Tab 200 297.64 77.697.00 45.340.00 23.00 - 194 Yodium povidon lar. .345. 2.200.600. 730.100.00 179 Silk no.790.00 . .00 .

Kes Damayanti Baharuddin.S. Kepala Puskesmas Ujung Lero Penerimaan Petugas Gudang Obat Pengeluaran 9.057 sisa saldo SUNDARI. Yang Menyerahkan. M.Mengetahui. SKM. 19720411 199803 2 006 .Farm.930. NIP.Apt.

.

.00 120 352.00 42.00 500 90.050. . 90. 10.00 100 149.00 100 122.00 100 149.200.000.200.25 mg/ml Amp 50 1.200.00 .00 115 1.900. 419.00 . 86.000. .000.00 108. .500. .00 10.00 .096.200.00 246.000.00 2.00 112. .00 10. 8.00 .200.800. 18 Set 5 8.500.00 269.500.100.200.00 108.00 118.85 141.000.00 242. 24 Set 30 8.00 21.00 72.890. .00 140.560. 900 352.00 . .00 525.00 .000 292.00 631.00 .800.780.00 42.00 574.00 522.00 14 4.600.00 120 1.700 78.200 220. 10.016.780.00 .00 30 Asam Mefenamat tablet Tab 300 122.000 105.00 719.050.00 500 86. 100 127.100.00 24 Aqua proinjeksi steril Vial 5 5.430. .00 316.00 10.000. .00 55 8.00 147. .00 287.00 . . .016.800.00 36.800.500.400.200.00 . 10.430.050.00 10 2. 8.00 2.610. .00 .200. 90. LAPORAN PERSEDIAAN OBAT GUDANG OBAT PUSKESMAS UJUNG LERO TRIWULAN IV SAT. 77 8.00 2 Abbocath No. .00 900 141.00 912.00 31.00 14.00 14.00 .00 - 19 Antalgin Tab 500 mg Tab .780.00 45.250.00 10. .00 .500.500.000.00 .00 246. .500. - 26 Artesunate Dewasa Blister .100.000. 419.000.00 24.100.500. .200.000. 3. .00 11.00 12.00 - 4 Abbocath No.200.00 .700.00 .400.900.00 72.155.00 204 2.400.500.00 15 1.00 1.00 26.000 78.00 75.600.00 41.00 .000.200.250. 500 90.200.00 .890.00 205.780. - 28 Artesunate Remaja Blister .600.00 274.00 2.600. 70 8. .00 77 8.000.00 .200.00 .00 . .250.000.00 13 Amlodipin 10 mg Tablet Tab 352.000.00 630. NA M A O B A T UAN BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI BANYAK HARGA NILAI 1 Alat Suntik 1 ml Set 30 1.00 .00 1. .00 29. 220.600. 2.900 122.00 .00 10 4.00 - 3 Abbocath No.00 22.00 - 10 Aminofilin injeksi Amp 19 4.800. 10.100.00 100 149.00 50 1.00 237.00 30 363.00 5.200.000.00 300 362.00 17.00 - 17 Ampisilin Inj Vial 20 5. 292.00 - 36 Betahistin Tab .00 - 23 Antimigrain doen kombinasi Tab 100 149.800.5 ml Set 40 1. 8.000. .000.800.00 - 6 Alat Suntik 2.560.080 220.00 14 Amoksisilin Kapsul 250 mg Kap 120 220.000.00 780 352.00 15 1.700. 419.00 33 Asklovir 400 mg Tab 200 362.00 14.00 35 8.00 60.00 9 Alopurinol tablet 100 mg Tab .240.050.00 1 1.560. 5.00 .00 .100 122.00 45.00 52.00 .00 5.00 .00 448.00 1.610.900.00 6. .000.200.250.00 7 Alat Suntik 5 ml Set 40 1.00 - 12 Amitriptilin hcl tab salut 25 mg Tab 200 123.500.00 .00 12.00 947. 1. .00 79.00 . 419. .000.00 780.00 70 8.600. 1.500.000.00 451. STOK AWAL P E N E R I MAA N PENGELUARAN SISA PERSEDIAAN No.00 28.00 .00 30 8. 22 Set .00 .100.00 - 5 Abbocath No. .00 31 Asam Traneksamat Inj Amp .00 30 1.00 45.200.00 24.00 - 22 Antihemoroid doen kombinasi Sup 10 2.200.100.200.185.00 154.00 .200.00 74.240. 141.200. . .628.00 .200. 2. .85 127.00 35 Benzatin benzil penisilin injeksi Amp .00 245 1.000.400.000.016.00 947.800.200.00 58.00 .00 8 Albendazole Tab 30 363.000.000.00 - 15 Amoksisilin Kapsul 500 mg Kap .00 264.850.00 .00 1.900.00 22. .610. .00 744.00 44.00 - 32 Asetosal tablet 100 mg Tab 100 127.050.00 25 8. .00 9.00 44.00 175 2.000. . - 27 Artesunate Inj Vial . 1.00 300 362.00 - 25 Artesunate Anak Blister .00 10 5. .000.240.00 18 Ampisilin Kaplet 500 mg Kapl . .500.00 16. 127.00 126. 3. 123. 8. 123.200.00 1.00 - 16 Amoksisilin sirup kering Btl 29 2.00 220 1.000 292.00 43.00 16.00 200 362.00 631. 2.560.200.200. .200.000.700 78.00 .00 140 1.200.00 20 Antasida doen tablet kombinasi Tab 1.00 - 21 Antifungi doen kombinasi Pot .00 .000.000 105. 3.00 132.00 14. 8.00 34 Atropin sulfat injeksi 0. 2.85 14.016.250.000. .000. 9. 5.600. 292.00 11.050.00 5 5.000.00 44.00 100 141. 2.610 363. . - 29 Asam askorbat ( Vit c ) tab 50 mg Tab 6.00 . 127.560.200.000.000.00 . 25 5.000.00 79 1. . 8. .096. 2.00 140 1.000 105. 1.00 2.00 126.665.00 5 4.100.85 . 1. 78.00 12.628. .610.00 700 86.00 58. .096. 3.00 29.000. .00 - .00 5 5.000 141.000 105.610 363.200.00 11 Aminofilin tablet 200 mg Tab 200 86.400.600. 20 Set .096.00 .00 574. 200 123.00 20 2.

00 - 64 Fitomenadion ( vit k 1) injeksi Amp 30 3.830.800.800.00 2.00 112.00 . 2.354. 3.105.100.00 435.739.938.00 100 690.333.1% Btl 1 2.720.980.00 60. 42.596. 40. 84.739.000.000.00 .00 .800.00 6.440.354. 690. 1.00 49 Difenhidramin inj 10 mg/ml-1ml Amp 55 1.00 - 70 Glass Ionomer cement (gc ix ) Set .80 22.000.00 - 52 Efedrin tablet 25 mg Tab 2. 1.00 112. 18.00 .100. 102.00 - 67 Garam oralit untuk 200 ml Sak 200 317.00 53 Ekstrak belladon tablet 10 mg Tab . 15 2.00 60.00 33. . 985.00 424.00 60 2.400.80 17.00 10 3.00 140.00 4.754.00 76 Haloperidol tablet 1.00 - 55 Eritromisin Kaps 250 mg Kaps .560.000. .00 39.5 % Tube 5 2. 985. 5. 7 Psg 30 4. .500.00 69 Gentian violet larutan 1 % Btl .80 13. 1. 42.938.754.00 35 5.00 .00 78.108.738.00 149.500.00 43 26.800.00 43 Deksametason tablet 0.000.00 27. 1.600 265.00 265.200.000 39. 11.00 500 76. .700.765. 278.500.200.754. 11.00 200 317. 3. 1. .00 40 Cefotaksim 1 g Injeksi Vial 35 3.670.420. .00 75 Griseofulvin tab 125 mg Tab 300 241.34 197.00 24. 1.550. .00 400 84.980.00 . .000 39.00 11 3.00 .00 490.000.00 300 317.596.69 22.00 .00 . 40. .60 16 1.000.690.250 56.00 130.00 155. 1 . .00 95.00 4.660.00 124.156. . 24.190. 2. 31 .740.00 176.00 72 Gliseril guayakolat tab 100 mg Tab 3.00 2. . .00 .670.00 .00 - 47 Diazepam tablet 2 mg Tab 2.00 100 103. 103.000.00 72.00 6.720.200.500 74.00 48 26.000.100.00 7 18.00 - 78 Hidroklorotiazid (hct) tab 25 mg Tab 1.00 629. 1.850. 102.00 .00 8.00 - 51 Doksisiklin Tab .00 200 61.500.000 3.100 100.300.467.500.00 510.129.333.500.00 .600 100.00 31.00 29.550.250 56.00 190. 100 278.00 44 Dekstrometorfan sirup 10 mg/5ml Btl .200. .00 .200.00 .698.00 217.00 45.578.400.00 15. 429. 265.550.00 122.910.69 11.000.00 .00 211.00 500 84.708.980.000.00 . 8.00 .100 74.738. 1 435.00 1.00 .156.00 222.00 4. 74.00 200 103.108.000 3.500.00 14.00 1 18.00 - 42 Deksametason injeksi 5 mg/ml Amp 125 1.00 65 2.400.00 11.1 % Tube 20 1. 985.00 5.00 - 66 Furosemida tablet 40 mg Tab 100 84.00 .580.00 18.5 mg Tab 2.00 30 3.467.00 1.00 1.500.00 29.00 200.00 1 2.00 50 1. .00 38.00 42.00 105. 1. 429.640.00 78.920.34 183.00 .00 50 Digoksin tablet 0.780.00 46.00 .600.720. .700.821.00 .00 1.00 200 61.800 100.00 22.675.00 25 3.000.00 4 11.675.467.00 .700 74.34 126.00 61 Fenobarbital tablet 30 mg Tab 2.354.070.00 68 Gentamisin Inj Amp 40 3.00 600 76.00 .870.00 424. 4 11. 1 435.00 105 4.00 300 76.938.000. 1.00 27.000.580. 42.000.00 20.00 90 1.578.875.240.354.739.00 6.272.00 105 1.00 300 690.108.25 mg Tab 100 103.00 .00 .754.00 41.500 56.739. 1.00 30 3.00 1.000. - 74 Glukosa 5 % Btl 37 5.000.500 56.34 140.354.00 168.000 74.40 63 Ferro Sulfat 300 mg Tab 1.00 1.00 10.00 65 Fitomenadion ( vit k 1) tab 10 mg Tab 200 690.00 .00 12.00 .00 1.00 39 Catgut/benang bedah no. 7 18.00 .00 24.00 100 278.00 18. 42.00 225. 429.000.00 180.00 .00 30 3.596.354. 429.040.400.000 24.000.300.00 - 58 Etilklorida semprot Btl .156.00 .500.500 40.000.00 - .00 87.00 392.690.520.2 ml Amp 15 2.69 29.00 57 Etanol 70% Btl .00 60.000.00 - 59 Eugenol cairan Btl 1 18.698.00 . .00 .000.00 156.500.00 41 Ciprofloksasin 500 mg Kaps .2/0 . . - 56 Etakridin ( rivanol ) lar.00 57.00 35 1.00 .00 267.000.00 71 Glibenklamid tablet 5 mg Tab 100 61.37 Betametason krim 0. .740.000 74.910.00 85 1.00 46.00 18. 278.000 39.00 207.00 130.00 .600.000.00 1.00 800 241.333.250.500.00 117.00 73 Glukonas Kalsikus Inj Inj 30 .708.00 63.596.00 .500.500.00 - 54 Epinefrin (adrenalin) inj.390.700.156.000.000.00 700 241.000 74.00 - 45 Dekstrometorfan hbr tab 15 mg Tab .108.500.800.00 2 2.140.00 - 38 Captopril 25 mg Tab 1.00 .00 48 Diazepam inj 5 mg/ml .00 148.00 350.938.333.000.00 60 Fenobarbital Inj Amp 15 1.80 8. 24.000.00 12.00 145.00 192.625.980.00 5 1.00 .578.00 38.00 2 5.00 95.886.500 40.5 mg Tab 200 76.00 .00 .698.00 .00 63.675.00 62 Fenol gliserol tetes telinga 10% Btl 12 1.00 22.000 3.00 167.00 100 61.00 .00 435.578. 2.467.00 8. 18.00 460.000 3. 60 3.00 79 Hidrokotrizon krim 2.00 69. 18.00 .200.00 - 46 Devitalisasi pasta ( non Arsen ) Btl .00 38.200.00 138.305.69 3.00 .333.00 3.675.00 397.00 .000.00 135.00 77 Handshoen No.3/0 Sak 10 26. 435. .00 39 3.176. 985. 15 1.800.00 74.886.698.500.139.000 24.300 100.970. 1.00 200 241.333.00 63.00 37.550.00 300 317.00 495.00 .000. 265.100.620.00 2 2.00 2.000.80 20 1.910.0.00 .000 39.600. 435.00 2.720.200.00 105.00 14 8.00 .500.300. 102.00 48.00 130. 102.500.250.00 300 74.00 8 1.00 8.00 .00 5.00 .620.00 15 26.00 3.738. 4.00 10.00 44 8.00 75 4.910.500.1%-1ml Amp 30 8. 0.00 3.280.00 6.600 265.00 .300.738.

00 - 92 Kasa Gulung 40 y x 80 cm Rol .722.00 15.00 .850.00 20 2.935.00 38 3. 28.00 .00 5.20 57.00 .00 4 8.500.105. 737. .038.00 - 103 Klorpromazin hcl tab salut 100 mg Tab 1. - 108 Kotrimoksazol pediatrik tablet Tab 200 79.820. 1. . 737.50 47. 1. . 154. 118.00 86 Kalsium hidroksida pasta Tube .00 502.960.00 .00 99. . 6. 60.00 . .023. 266. 1.00 . 1.00 26.900.00 .038.000. .00 .935. .00 3.00 600 320.800.00 60 2.800.00 1.200. 6. 910. - 120 MB Dewasa Blister .00 43. 6 60.00 .052. 49. . .000.861.680. 910.708.900. . .00 .00 - 83 Infusion set dewasa Set 10 3.00 .00 700 165.00 . .00 .00 250. .720. 100 1. 600 550.00 78. .800.00 .298.00 7.000 165.600.400.00 8 1.960.400.503. .000 23.000.20 114. 98.200.00 200 157.200 mg-1ml Amp 29 1.00 . .00 2. .000. 17.00 99.000.00 - 85 Isosorbit dinitrat tab 5 mg Tab 300 98.00 60 1.00 .000.00 137.00 330.00 45. 40.00 . 550.750.00 - 96 Kina Tab ( Quinine ) Tab 30 737.000.00 72 1.00 600 550.000 165.21 230. . 910. 266.00 - 113 Larutan benedict Btl 1 28.110.00 45.820.00 - 106 Kontrasepsi Implant Susuk KB Set .400.00 90 Kasa 4 m x 15 cm Rol 8 3.499. .00 19 1. 1.00 250.00 21.00 165.00 26. 112.00 400 118.00 364.000.861.00 33.00 111. .00 . .298.00 29.00 .00 . 3. . 600 320.000.00 .00 114 Larutan Spiritus Btl . 154.00 .200.00 380.00 2.00 400 269.00 .00 170. 297. .500.00 3. . 1.00 .00 1.00 . 297. .20 171.00 38.00 101 Klorfenol ( CHKM) Btl .00 100.000 250.680.00 . 550.50 47.00 115. .00 81 Ibuprofen 400 mg Tab 200 157.935. 98.00 .00 140.480. . .400 96.00 .680.00 88. .800 96.600.00 60 1.00 75 3.680.00 115.400. 50.00 22.00 100 Klorfeniramin ( ctm ) tab 4 mg Tab 1.000.708.00 1.00 104 Klorpromazin hcl tab salut 25 mg Tab .038.850.00 28. . .00 6 60.00 250.00 3.00 13.00 - 102 Kloroquin fosfat tablet 250 mg Tab .00 - 112 Larutan Anisol Btl .820.00 - 95 Ketokenazole Tab Tab . 1. 297.00 .50 .00 107.00 .090.00 .00 . . .00 109 Kotrimoksazol suspensi Btl 34 2.038.00 .237.50 - 122 Metilergometrin inj 0.708.00 .00 .000.00 .000 57.600.000 57. 2 49.00 250.00 192.532.00 - 91 Kasa 4 m x 3 cm Rol .00 .000.00 .00 .499.700.820.00 - 87 Kalsium laktat ( kalk ) tab 500 mg Tab 3.00 500 96.000.250.00 13 1.00 - 111 Kuinin dihidroklorida inj.00 15 1. 17. 112. 6.00 17.720.00 . .503.00 29.400.00 .503.00 12 1.000 23. 8.000.935. 40.500.240.861. 1. .320. 49.00 30 1.00 . 30 737.590.00 60.298. 297.00 29. 112.00 23. 60.000.400.21 105. .00 1.237.00 .21 48. 118.110. .00 100 269.00 1.00 .400.00 28.023.861.722.000.00 74 2.00 32.00 2.298.00 107.00 .00 330. 266.000. 17. 266.00 88 Kapas pembalut 250 gr Bks 1 8.904.00 .880.00 115. 806.831.00 .00 700 165.00 8.720.00 - 93 Kasa kompres 40/40 steril Rol .00 161.00 31.440. .000. 28. 1.00 26.00 - 94 Kasa steril uk.00 288. 112.400.759.904. 25%-2ml Amp .720. .400.00 . 50.000.499. 1.00 24.200. - 107 Kontrasepsi KB 3 Bulan Amp .00 100 269.00 167.00 28.00 .850.000.759. 17.000. .00 .800.759.00 364.023.00 118 Masker Set . .00 255.000 250.000.400.499.200. - 121 Metformin 500 mg Tab .00 .000. 154. .00 74.00 - 89 Karbamazepin tab 200 mg Tab 400 269.00 69. .00 . 154. 50.20 114. 806.00 - 105 Kodein tablet 10 mg Tab .00 - 115 Larutan Ziehl Nielsen ( TB ) Btl .000 250. 1.220. 400 118. 3.000 57. .759. 18 x 22 Rol .108.00 30.00 98 Kloramfenikol Salep mata 1 % Tube 20 1.557.00 20 1.935.00 2.00 . 910.00 65 3.000. 4.132.000 23.000. . 806.00 23.385.000.21 173. 50.587. 152.000.00 110 Kotrmoksazol dewasa tablet Tab 400 152.00 2.00 3 8.000 57. .500.00 - 84 Iodiol Kapsul Lunak Kaps .00 - 116 Lidokain kompositum injeksi Amp .00 165.237. .00 200 79.00 . 1 28.850.00 1.00 40 1.000.400.00 502.700.000 250.00 440. .00 82 Infusion set anak Set 20 4. 1.867.00 .000.00 49.708.00 . .532.200. .00 .00 97 Kloramfenikol kapsul 250 mg Kap 1.532.935.500.532. 320. 320.00 . . 1.00 .600.00 .023.00 7.00 30 3.200 157.400.00 22.00 120.178.664.00 - 117 Lisol Btl 2 49.800.000.900.00 .00 22.000. 40.400.00 58 4. .00 100 79.00 123.00 .00 99 Kloramfenikol Tetes Mata Btl 10 1. 806. .900 152.320.400.00 250.00 15.000 23. 300 98. .80 Ibuprofen 200 mg Tab 1.500 152.00 31.500.200.237.00 119 MB Anak Blister .00 38 4.500.200 157. 6.100 96.060.00 .00 .503.00 192.00 . 40.00 300 79.

00 .900. 1.000.00 59.994.00 968.00 11.015.00 100 34. 193.170.618.00 77.800. 189.516.00 .618.00 .000.000 128.900.00 .00 .500. .40 77.200. .600.00 256.00 200 318. 236. . .535.195. 6. .500.000. 19.400.00 176.00 .00 28.00 484.00 .167.00 .600.51 13.00 . 236.299. 236. 14.00 28.934.00 - 137 OAT ( FDC ) Kategori Anak Pkt . 14.00 .646.00 . 1.00 134 Nistatin 100.400.530.00 50. 193.00 800 221.00 . 2.00 .00 .00 70.000.00 52.00 148.00 151 Parasetamol sirup 120 mg/5 ml Btl 151 1.00 .199.000.00 247 1.000.00 258. 528.00 100 318. .200. 9. 176.000.00 8.300.720.00 110.920.680.00 32 1.720.00 52.319. . .00 1. 2.00 899.500.000.00 .00 95.00 154 PB Anak Blister .319. - 156 Pirantel pamoat tab 125 mg Tab 200 318.00 . 189. .00 .600.00 132.618.00 . .530. 528.00 .00 .00 .195. 9.00 128. .00 792.00 - 129 Mummifying pasta Btl .00 128 Mineral Mix Sach .00 500 110.500. - 127 MgSO4 Inj 40% Vial 4 2.600.00 1.629. . 14.530. .00 .170.530.319.618.631.00 - 146 Oksitetrasiklin salep 3 % Tube 20 1.00 - 163 Primakuin tablet 15 mg Tab .00 .00 152 Parasetamol tablet 100 mg Tab 400 34.967.344.00 115. . 341. . 9.00 - 124 Metoklopramida Tab Tab 300 110. .00 . 1.00 .400. 34.000. 3. .340.00 - 161 Pot Dahak Set 650 1. 57.499.00 136 Oil Emersi Tab .00 . 193. .340.00 - 130 Natrium Diklofenak Tab .00 231.00 63. .000 88.00 - 159 Poly Katether 18 Set 3 9.00 600.500 57.015.736. .344. .00 400 88.00 - 143 Obat batuk hitam ( OBH ) cairan Btl .00 .600. 1. - 164 Prokain penisilin injeksi Amp 39 6.800. 121.145.600.600.535.00 9.800.00 10.00 26.00 130.802. . 1.00 .500.200.400 88.00 .000 128.00 800 169.00 207.000.000 19.785. 660.00 32.000.994.646. .00 600 169.800.000 19.00 157 Piridoksin hcl tab 10 mg Tab .00 176.000. 193.195. 9. I Pkt .255.999.282.00 - 131 Natrium Klorida Infus Steril Btl .00 .800.00 . 25.629.700.00 .00 600 1.51 17.00 300 318.000.015. 317. .40 .102. .00 118. 9. 1. 14. 8 1.344. 317. 121. .000 88.00 8 1.994.000.400.999.00 900 193.400.00 173. .825. .500. 1.000 128.00 16.00 2.963.00 .00 145.00 - 145 Oksitetrasiklin hcl injeksi Amp .00 155.00 .00 500 2.00 .00 . .00 79 1. 3.00 - 140 OAT ( Kombipak) Kat.00 .00 .700. .720. 176.000.00 293.344. .00 - 132 Natrium Tiroksin Tab Tab .00 791.00 89.920.535.00 100 110.700.700. .340.00 . 4 2.900. 193.00 3.00 .00 513.00 173.00 6 25. 900 193.00 200 297. .000.195. 128. .00 72. 341.00 100 169. 176.300. 189.900.600.804.00 .344.00 . 1. 528. 189. .967.200. 5.999.00 .40 77. . 1.00 4.963.00 .00 1.800.00 400 297.800.00 69 1.00 55.40 - 158 Plester 5 yard x 2 inch Rol 2 25. 3. .00 .00 95 1.00 .00 9. 341. 1. 5.00 .00 11.900.319.00 - 141 OAT (Kombipak) Kategori anak Pkt .340. .963.00 135.375.00 .451.00 10. 317.1 ml Amp 37 1.00 258.00 - 139 OAT ( FDC ) Kategori II Pkt .00 . 200 528.00 165 Propiltiourasil tab 100 mg Tab 300 297.344.200.200.00 650.672. - 155 PB Dewasa Blister .00 .00 211.00 52. .00 - 160 Poly Katether 22 Set . .680. . 39 6.00 . . 341.00 60 5.185.00 - 138 OAT ( FDC ) Kategori I Pkt 2 395.800.300.102.900. . .999.00 - 133 Nifedipin 10 mg Tab 200 2.00 8 395.032.516.000.344.00 400 2.00 79 1. .00 36 1.00 . .00 128.600. 3.00 135 Nistatin 500.646.00 . 9.00 125 Metronidazol tablet 500 mg Tab 300 169.00 300 2. 660.900.00 8 25.00 599.00 3 9. 660. .00 50.00 51. 317.00 . 221.00 33.00 50 1.00 .00 31.00 - 150 Papaverin Tab Tab . 6. .123 Metilergometrin tab salut 0.629.646.000.00 101. 19.00 .629.967.00 .1.00 . 236.000. . 500 34.00 700 110.00 .00 105.00 28.800.00 .00 67 1. . 2.400. .034. .00 - 142 OAT (Kombipak) Kategori Sisipan Pkt . 121. 4. 193.00 162 Prednison tablet 5 mg Tab 500 57.00 6 395.00 . .00 .344.680.500. 221.00 126 MgSO4 Inj 20% Vial . 50 528.900.100.963.00 26.51 . 800 221.00 379.015.00 - 149 Omeprazole Tab .00 73 1.00 10.00 .994.00 .032.00 310.00 500 297.967. .000.00 147 Oksitetrasiklin Salep mata Tube 10 1.00 - 148 Oksitosin Injeksi 10 iu/ml .00 16.00 191 1.170. 1.00 100 528. .1. 121.00 . . 60 5.00 35.00 63.00 .00 1.00 .668.500.535.680.000 iu Tab 50 528.00 10. .00 143. 176.00 310.51 3.00 .000 57. 395.00 153 Parasetamol tablet 500 mg Tab 2.300.125 mg Tab .900. .600.00 .000 iu Tab 100 528. 660.00 - 144 Objek Glass set .170.000.

565.00 43 2.00 191 Wing Needle 23G Set . 60 1. 189.00 60. 80.100.000 112. 30 189. .950.00 .000. .200.00 . . 1.00 19. 80.000.900 162.000 114. 102.00 .00 38 5.429.00 .00 810. 2. 226. 6.00 .00 16.00 2.000.000 162.200. 114.400.500.00 .00 664.682.000 226. 11.00 .00 .00 .00 . 7. .552.00 26. 85.600.429. .500.800.3/0 Sak 10 7.650.300.00 7 4. .00 .00 .000.00 1.00 26.340.166 Propranolol hcl tablet 40 mg Tab 200 80.340.020. 20 1.360.00 12.00 - 199 Ketokonazol Krim Tube .800.10% 300 ml Btl 1 15.00 175 Salisil spiritus 10 % Btl .00 3.00 678.00 185 Tiamin hcl ( Vit.00 22. 7. 2.682.00 678.4 kombinasi Pot 25 2.697. 6. 37.00 .00 .00 5. 505.00 .855.00 .b1) injeksi Amp 30 189. 2.00 .00 .000 226. 2.00 4.345.00 6. 2.400. 1.00 - 205 Darflex Tab .00 3.00 2 15.313.000.200.850.00 174 Salisil bedak 2 % Ktk 25 1.64 . 2. 100 226.00 - 189 Urine bag Set 1 4.00 .300 112.000 114.200. 25 mg Tab 1.00 187 Triheksifenidil tablet 2 mg Tab . 1.00 .b 12 ) injeksi Amp 60 1.670.00 - 200 Pehacain Injeksi Amp .100.000 15.180.900.00 114.00 39. 730.00 178 Sianokobalamin tablet Tab 3.00 .00 .000 15. .00 190.000.00 6 15.00 105. 480. 2.00 177. .720.00 100 65. .00 452. .840.00 64.00 8. 102. . 521.00 38 1.00 400 65. 730.00 - 204 Ranitidin Injeksi Amp 1.00 35.00 162.067. 2.200.00 26.200. 480.00 . 6.00 .00 8 4.00 76.000.00 - 177 Sianokobalamin ( Vit.697. 6.400.00 . 102.00 - 201 Pospargin Tab Tab 200 388. 85. 388.00 172 Salbutamol tablet 2 mg Tab 300 65.00 .697.00 1.300 521.153.00 5.047.200.00 114. 6.100 162.220.00 196 Zinc Tablet 20 mg Tab 300 521.00 .400.00 .067.600.00 167 Ranitidin 150 mg Tab .00 20 1.200. 100 3.00 .00 51 2. . 37.313.00 16.00 .906. .00 186 Tiamin hcl ( Vit.00 190 Vitamin b kompleks tablet Tab 1.00 179 Silk no.00 677.402.100.800.697.00 422 5.000 IU Kaps . .00 - 197 Amaropo Kaplet Kapl .00 .000.180.340. .00 60.00 29 1.000. 132.440. 480. 297. .64 .000.00 .00 2. .10% 30 ml Btl .200. 730. .00 . 102.000 162.440.00 - 168 Reserpin tablet 0.00 .00 - 193 Yodina Test Btl .00 55.00 353.00 184 Tetrasiklin hcl kapsul 500 mg Kap 100 226.728.51 .00 - 182 Temporary stopping fletcher Set . 2.00 64. .00 . 200 80.00 30. 3. 7.413.000.400.400.00 .400 112. .00 .b1) tablet Tab 3. . 6.800.00 310.067.670.800.047.950.000.100.950.00 - 194 Yodium povidon lar.00 .00 .00 72. 200 388. 2.000.000.00 .00 800 132.00 900 2.00 45. 1. .000 226.345.00 177.820. 7.000.000. .00 307. 297.00 . 11. .000. .00 1. 286.000.600. - TOTAL ### ### 36. 297. .700. 189.800.00 380.00 2.500.500.00 .600.00 . 11.000.00 34. 800 132.00 2. .000.300. 480.00 4.00 - 195 Yodium povidon lar. 505.000 521.313.400.00 420 5. 286. 1.855.000. 37.200.00 169 Retinol 100.00 - 198 Heximer 2 mg Tab Tab .850.728.200.00 .00 .00 22.00 .00 - 176 Semen fosfat serbuk dan cairan Set . 37.00 - 180 Simvastatin Tab .000.00 . 388.00 .00 112. 6. 1. . 85. 177. 2.00 ### 36.000 226.51 .00 452.00 .800.400.000.00 . 3.00 46 7. .00 310.00 18.500.00 4.840.00 1.00 .00 .64 77. 505.682. 2.906.00 .00 7 15.000 177.720. .600.00 600 65. .00 . 1.00 5.00 31.00 - 181 Tablet tambah darah kombinasi Sach .00 .64 77.180.950.340.00 .020.00 . 505.345. 132.00 .047.00 217.00 4.00 .200.00 . . .000.400.00 45.00 - 171 Ringer laktat larutan infus steril Btl 40 5.400.00 - 183 Tetrasiklin hcl kapsul 250 mg Kap 1.00 10.00 29.000 15.00 - 188 Trireksol formalin ( tkf ) cairan Btl .440.000.180. . 900 2.000 15.000.00 - 192 Wing Needle 27G Set . 2.00 . 1. 286.000.500.565.00 1. . .00 44.00 156.00 .720.00 521.067.00 15.51 .440.00 33 2.700 112.00 .51 - 203 Simvastatin 10 mg Tab 177. 286.00 .00 .200.00 .00 94.000 IU Kaps .00 105.000 177.400.345.372.00 16 1.00 2.600.00 202 Stesolid Injeksi Amp .200.000.000.00 . 730.855.313.00 .00 .00 173 Salep 2 .850.00 100 3. 114.00 111.950.00 . 6.200.500.00 . .600.00 226. 11.047.00 . 297.00 276.850.00 1. 2. 1. 7.00 228.00 2 4.720.880.00 95.855.344. 85.00 - 170 Retinol 200.682. .00 .00 2.00 3.00 36 7. .

NIP.31 Desember 2015 Mengetahui.Kes Damayanti Baharuddin. M.Farm.S. Kepala Puskesmas Ujung Lero Petugas Gudang Obat SUNDARI. SKM. 19720411 199803 2 006 . Yang Menyerahkan.Apt. Ujung Lero.