Obat Desember

Temanggung Dharmarini Tlogomulyo Selopampang Temba
Nama Obat dan Alat Satu-

No. Kode 1 2 3 4 5
Kesehatan an
DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK
1 2 3 4
TABLET
1 Albendazol 400 tab 900 983 1,958 200
2 Alopurinol 100 mg tab

545 1,507 1,210 1,463 1,272
3 Alprazolam 0,25 mg tab
100 240 0 193 0
4 Ambroxol 30 mg tab 400 1,382 2,011 34
5 Aminofilin 200 mg tab

775 428 0 441 751
6 Amitriptilin 25 mg tab
175 500 0 484 300
7 Amlodipin 5 mg tab
1,500 948 2,957 2,555 2,128
8 Amlodipin 10 mg tab
1,340 0 317 0 0
9 Amoksisilin 250 mg tab
1,622 1,524 0 668 3,800
10 Amoksisilin 500 mg tab
6,347 6,803 7,464 20,048 6,582
11 Antasida DOEN tab
12,797 3,048 5,629 2,350 8,513
12 Antimigrein tab
200 8 0 474
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
13 Asam Askorbat 50 mg tab

8,411 3,984 2,626 1,936 5,141
14 Asam Askorbat 250 mg tab
0 0 0 0 0
15 Asam Folat 0,4 mg tab
1,385 968 1,882 940 710
16 Asam Mefenamat 500 mg tab
6,757 1,928 5,062 4,054 7,759
17 Asetosal 80 mg tab
120 116 480 412 239
18 Asifit kap 300 280 0 290
19 Asiklofir 200 mg tab

244 1,247 0 107 301
20 Asiklofir 400 mg tab
245 686 354 913 762
21 Atropin sulfat 0,5 mg tab
0 0 0 0 0
22 Azitromisin 500 mg tab
0 0 0 0 0
23 Bekarbon / Norit tab
0 0 0 0 0
24 Betahistin/versilon 6 mg tab
70 12 44 13 227
25 Bisakodil 5 mg/ Laxana tab
60 219 0 10 0
26 Cetirizin 10 mg tab
970 1,801 951 1,687 728
27 Dexametason 0,5 mg tab
9,622 4,420 5,886 6,375 8,841
28 Dextral tablet tab 1,036 730 70 36
29 Diazepam 2 mg tab
161 125 98 93 62
30 Diazepam 5 mg tab
100 300 0 0 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
31 Dietil Carbamazin 100 mg tab 0 0 0 0
32 Digoksin 0,25 mg tab

139 77 0 314 548
33 Diltiazem 30 mg tab
20 1,355 0 60 0
34 Dimenhidrinat 50 mg tab
142 244 140 97 70
35 Doksisiklin 100 mg kap
60 230 0 44 221
36 Domperidon 10 mg tab
1,063 738 848 2,846 662
37 Erytromisin 250 mg kap
20 90 0 0 0
38 Erytromisin 500 mg tab
298 0 0 50 138
39 Fenitoin Na 100 mg/ Kutoin kap
395 658 325 0 0
40 Fenobarbital 30 mg tab
373 1,030 0 10 100
41 Fitomenadion/ K1 10 mg tab
640 683 148 828 300
42 Flunarizin 10 mg tab 85 150 0 0
43 Furosemida 40 mg tab
264 703 205 493 508
44 G.G 100 mg/ Guaifenesin 100 tab 462 29 4,086 1,922
45 Garam Oralit tab

218 15 836 108 125
46 Gemfibrozil 300 mg tab
358 1,126 1,179 180 235
47 Glibenklamid 5 mg tab 253 493 274 293
48 Glimepirid 2 mg tab
0 978 70 1,546 652
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
49 Griseovulvin 125 mg tab

343 482 314 228 504
50 Haemorogard tab 410 522 300 180
51 Haloperidol 0,5 mg tab

0 0 0 0 0
52 Haloperidol 1,5 mg tab
271 860 250 361 344
53 Haloperidol 5 mg tab
331 1,188 0 664 370
54 HCT 25 mg tab
342 569 0 295 316
55 Hepagard tab 310 0 20 0
56 Hiosina + Metampiron/ Dormi tab 433 510 710 743
57 Ibuprofen 200 mg tab 207 0 0 0
58 Ibuprofen 400 mg tab

0 0 0 70 70
59 Isosorbid Dinitrat 5 mg tab
610 645 209 415 281
60 K.Aspartat 300 mg tab
210 100 89 0 0
61 Kalium Diklofenak 50 mg tab 610 1,575 398 0
62 Kalk tab
2,292 2,777 2,972 4,367 3,014
63 Kalsium Karbonat 500 mg/ Calp tab 0 1,920 190 0 0
64 Kandersatan 8 mg tab
330 70 0 288 266
65 Kaolin + Pectin tab/ Omegdiar tab 80 1 490 0
66 Kaptopril 12,5 mg tab

804 990 0 108 1,574
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
67 Kaptopril 25 mg tab
3,949 1,574 1,047 890 2,265
68 Karbamazepim 200 mg tab
240 294 88 0 0
69 Karbazokrom 10 mg/ Adona tab 150 100 88 130
70 Ketokonazol 200 mg tab

385 900 473 598 212
71 Klobazam 10 mg tab
104 140 0 0 0
72 Klonidin 0,15 mg tab
2 0 0 0 0
73 Kloramfenikol 250 mg tab
0 0 0 0 0
74 Kloramfenikol 500 mg kap
0 579 200 90 495
75 Klorfeniramin Maleat/ CTM 4 tab
6,978 4,084 9,977 17,641 5,911
76 Klorpromazin 100 mg tab
66 652 170 504 69
77 Klozapin 100 mg tab
0 1,094 68 0 0
78 Kodein 10 mg tab
155 122 0 0 100
79 Kotrimoksazol 480 mg tab
1,223 1,170 3,061 1,052 1,398
80 Levofloksasin 500 mg tab
0 30 0 33 0
81 Lisinopril tab 5 mg tab
0 0 200 0 0
82 Litium Karbonat 400 mg/ Frima tab 0 200 0 0 0
83 Loperamid 2 mg tab
0 0 0 0 0
84 Loratadin 10 mg tab
360 495 162 553 459
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
85 MB Kusta strip 0 0 0 0
86 Meloksikam 15 mg tab 0 435 500 33
87 Metformin 500 mg tab

580 3,887 1,529 1,839 414
88 Metil Prednisolon 4 mg tab
0 1,237 1,511 0 0
89 Metil Prednisolon 8 mg tab
1,110 918 796 1,717 419
90 Metilergometrin 0,125 mg tab
100 300 170 330 187
91 Metoklopramid 10 mg tab
30 444 59 0 120
92 Metronidazol 500 mg tab
885 283 2,006 915 938
93 Na Bikarbonat 500 mg tab 385 570 3,855 0
94 N-Asetil Sistein 200 mg kap

3,874 134 0 727 2,820
95 Natrium Diklofenak 50 mg tab
2,170 1,169 421 1,723 2,507
96 Neurotropik tab/ Corsaneuron tab 460 992 0 95
97 New Pro Uric kap 0 0 0 0
98 Nifedipin 10 mg tab
420 270 184 647 248
99 Nistatin tab 500.000 IU/ g tab
90 159 99 40 73
100 Nodiar tab 0 0 0 0
101 OAT Anak/ FDC pkt 0 0 0 0
102 OAT FDC I/III pkt 2 0 0 1
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
103 OAT kat I/ Kombipak pkt 0 0 0 0
104 OAT kat II pkt 0 0 0 0
105 Omeprazol 20 mg tab

390 499 162 89 147
106 Ondansetron 4 mg tab
0 0 0 0 24
107 Papaverin 40 mg tab
0 20 0 0 0
108 Parasetamol 500 mg tab
20,461 6,852 11,801 9,846 2,361
109 PB Kusta Anak strip 0 0 0 0
110 Piracetam 800 mg tab 70 190 25 60
111 Piridoksin/ B6 10 mg tab

5,044 5,112 4,845 2,761 9,463
112 Piroksikam 20 mg tab 660 994 1,900 1,034
113 Prednison 5 mg tab

0 467 167 1,019 460
114 Primaquin 15 mg tab 0 0 0 0
115 Pro Lipid tab 0 360 0 0
116 Propanolol 40 mg tab

0 100 0 0 100
117 PTU 100 mg tab
0 100 0 180 0
118 Ranitidin 150 mg tab
5,450 3,535 1,599 687 3,345
119 Retinol 100.000 UI tab 135 0 0 300
120 Retinol 200.000 UI tab 506 0 0 2,758
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
121 Risperidon 2 mg tab

190 290 140 820 0
122 Salbutamol 2 mg tab
385 1,199 1,045 1,120 734
123 Salbutamol 4 mg tab
190 250 0 0 0
124 Samcobion kap 10,990 10,810 6,046 5,311
125 Sefadroksil 500 mg tab

310 830 1,313 499 687
126 Sefiksim 100 mg tab
0 100 22 32 132
127 Sianokobalamin / B12 50 mcg tab
4,810 5,057 4,998 5,641 2,745
128 Simvastatin 10 mg tab
785 2,271 277 453 468
129 Simvastatin 20 mg tab
120 370 0 0 0
130 Siprofloksasin 500 mg tab
1,224 1,631 846 1,695 3,289
131 Spironolakton 100 mg tab
0 157 85 0 0
132 Tablet Tambah darah tab
127,215 93,310 18,900 96,863 31,970
133 Tensigard tab 0 0 0 0
134 Teofilin 150 mg tab

80 205 0 40 100
135 Teofilin SR / Retaphyl SR tab
240 100 0 100 0
136 Tetrasiklin 250 mg tab
0 0 0 0 0
137 Tetrasiklin 500 tab
108 0 42 380 0
138 Tiamfenikol 500 mg tab 126 502 44 317
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
139 Tiamin 50 mg/ B1 tab

13,070 5,438 5,064 4,062 5,806
140 Triheksifenidil 2 mg tab
418 400 5 436 4
141 Vitalamin tab
0 0 0 0 0
142 Vitamin B komplek tab
9,576 4,656 5,696 5,192 4,414
143 Zink 20 mg tab 480 300 348 0
0 0
SYRUP 0 0
1 Albendazol susp 200mg/ 5 ml btl
0 0 20 0 0
2 Ambroxol sirup 15 mg/ 5 ml btl 212 159 312 143
3 Amoksisilin sir 250 mg/ 5 ml btl

0 40 38 22 0
4 Amoksisilin sirup 125 mg/ 5 ml btl 37 203 225 11 168
5 Antasida DOEN susp btl
136 210 161 71 246
6 Batugin elixir btl 7 2 20 0
7 Dextrofen sirup btl 38 32 86 57
8 Domperidon sirup 5 mg/ 5 ml btl

44 159 42 69 100
9 Domperidon tetes 5 mg/ ml btl
0 0 5 0 0
10 Erytromisin sirup 200 mg/ 5 ml btl 0 0 0 0 0
11 Haloperidol drops 2 mg/ml (L btl 0 0 0 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
12 Ibuprofen susp 100mg/5ml btl

146 220 58 0 0
13 Ibuprofen Susp 200 mg/ 5 ml btl
0 0 0 26 128
14 Kaolin + Pectin syr/ Kanina btl 11 36 62 69
15 Kloramfenikol susp 125 mg/ 5 btl

14 1 0 4 0
16 Kotrimoksazol suspensi btl
132 102 199 107 94
17 Laxadin susp btl 0 0 0 0
18 Metokloperamid drops btl

0 20 0 0 0
19 Metronidasol sirup btl
0 4 9 15 8
20 OBH btl 190 52 102 49
21 Pacdin Vitcur sirup btl
22 Parasetamol drops btl

242 60 67 30 110
23 Parasetamol sirup 120 mg/ 5 ml btl 335 20 206 28 108
24 Salbutamol sirup btl
0 2 0 22 0
25 Sefadroksil sirup 125 mg/ 5 ml btl
0 33 83 8 105
26 Sefadroksil sirup 250 mg/ 5 ml btl
0 0 72 0 0
27 Setirizin sirup btl
0 10 0 0 2
28 Sukralfat susp btl
13 6 26 19 2
29 Tiamfenikol sirup btl 0 7 0 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
30 Zink drops 10 mg/ml btl

0 0 0 0 0
31 Zink sirup btl
66 66 31 28 46
0 0
INJEKSI 0 0
1 Aminofilin injeksi 24 mg/ ml amp
10 5 0 0 0
2 Ampisilin inj 1.000 mg vial
0 0 0 0 0
3 Aqua pro injeksi btl
6 23 31 50 0
4 Asam Traneksamat inj amp 0 0 0 0
5 Atropin Sulsat inj amp

5 0 0 0 0
6 Dexametason injeksi 5 mg/ ml amp
97 10 50 150 30
7 Diazepam inj 5 mg/ ml amp 8 2 5 5
8 Difenhidramin injeksi 10 mg/ m amp 16 2 45 29 19

9 Epinefrin injeksi 0,1 % amp
7 19 44 3 0
10 Fenobarbital inj 50 mg/ ml amp 8 8 0 15
11 Flufenazin inj 25mg/ml - Sikzo amp 0 50 0 0
12 Furosemid inj 10 mg/ ml amp

0 0 0 0 0
13 Gentamisin inj 40 mg/ ml amp 0 0 0 0
14 Glukonas Calcicus inj 10% amp

0 5 0 0 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
15 Haloperidol inj i.m. 5 mg/ml (L amp 0 12 0 0
16 Human Tetanus Imuno 250 UI amp

7 13 4 23 2
17 Ketorolac inj 30 mg/ml amp
23 0 40 112 0
18 Lidokain Comp. inj amp
172 84 125 121 94
19 Lidokain inj 2% amp
64 0 0 212 34
20 Metilergometrin inj amp
21 15 42 18 7
21 Meylon / Na Bic inj amp
0 15 0 0 0
22 MgSO4 20% amp
0 20 5 3 0
23 MgSO4 40% amp 0 20 10 14
24 Nalokson inj 0,4 mg/ml (Nokob amp 0 0 0 0
25 Oksitosin injeksi 10 UI/ ml amp

97 38 152 180 25
26 Ondansetron 4 mg inj amp
0 0 52 109 0
27 Piracetam 1 gr/ 5 ml amp 0 0 0 0
28 Ranitidin inj 25 mg/ 2 ml amp

50 0 50 178 6
29 Sefotaksim 1 gr/ vial amp
0 0 0 110 0
30 Serum ABU I / Biosave vial
0 1 1 0 0
31 Serum ATS 1.500 amp
0 0 0 0 0
32 Sianokobalamin inj 500 mcg/ m amp 0 20 41 0 15
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
33 Vit K1/Fitomenadion inj 2 mg/ amp 83 120 30 84 60 0
0 0
OBAT LUAR 0 0
1 Alkohol 96 % 1 L btl 0 0 0 3
2 Antibakteri SK tube
0 0 0 0 0
3 Antifungi sk pot
41 60 53 0 98
4 Antihemoroid supp supp
39 29 38 106 32
5 Asam Fusidat krim 20mg/g - Ac tube 73 150 150 132 188
6 Asiklovir krim 5 % tube 29 67 29 87
7 Betametason krim 0,1 % tube

97 86 100 77 119
8 Bisakodil sup anak supo 44 0 0 29
9 Bisakodil sup dws supo

0 0 0 0 1
10 Budesonid/ Pulmicort res 0,25m btl 0 0 3 0 0
11 Budesonid-formeterol/ Symbicor btl 0 0 0 0 0
12 Desoksimetason krim tube
71 61 78 90 110
13 Diazepam Rectal 5mg/2,5ml - St tube 11 5 0 20 3
14 Enkasari btl 28 17 10 22
15 Etakridin Larutan 0,1 % btl 19 0 29 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
16 Etanol 70% 100 ml btl

244 267 277 11 121
17 Feneterol HBr/ Berotec inh btl
0 2 0 2 0
18 Fenol gliserol TT 10 % btl
83 14 37 46 118
19 Flusinolon Asetat 0.025% tube
0 0 0 0 0
20 Framisetin tulle/ Daryanttulle lbr
0 0 0 3 0
21 Gentamisin SM tube
84 120 54 36 153
22 Gentamisin TM 0,3 % btl
102 172 67 117 51
23 Gentien Violet 1 % btl 57 51 29 43
24 Gliserin btl 2 2 1 1
25 Hidrokortison krim 2,5 % tube

120 87 75 78 186
26 Ikhtiol SK btl 45 52 16 18
27 Ketokonazol krim 2 % tube

85 87 32 55 82
28 Klobetasol 0,05% krim tube
0 0 0 0 0
29 Kloramfenikol SM 1 % tube
47 110 92 55 114
30 Kloramfenikol SK 2% tube
80 102 3 7 0
31 Kloramfenikol TM btl
29 24 4 4 74
32 Kloramfenikol TT 3 % btl 108 82 61 50
33 Lidokain Spray 10%/ Xylocaine btl 0 0 2 0 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
34 Mikonazol krim 2 % tube

10 29 14 4 2
35 Minyak ikan SK pot 21 18 11 12
36 Mometason krim tube 0 0 0 0
37 Nistatin tab vag 100.000 UI/ g supp

84 26 14 47 44
38 Oksitetrasiklin 1 % SM tube
0 0 0 0 0
39 Oksitetrasiklin 3 % SK tube
0 0 0 0 0
40 Perak Sulfadiazin/ burnazin tube 0 0 10 0
41 Perhidrol/ H2O2 btl 0 0 2 0
42 Permetrin krim 5%/ Scabimite tube

94 104 105 52 207
43 Permetrin lotion 1%/ Peditox btl
0 0 0 0 0
44 Polikresulen btl
0 0 6 8 5
45 Povidon Iodida 300 ml btl 5 10 4 5 2
46 Povidon Iodin 30 ml btl 77 100 25 10 24
47 Salbutamol inh 100 mcg/ Ventol btl 0 0 0 0 0
48 Salbutamol neb/ Ventolin Nebul tube 0 12 5 30 5
49 Salep 2-4 pot
13 1 59 25 95
50 Salisil bedak pot
72 29 48 40 37
51 Sulfasetamid TM 15 % btl 95 113 32 72
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
52 Tetrakain TM btl
0 0 0 0 0
55 Triamcinolon/ Bufacomb tube 36 46 19 79
0 0
INFUS 0 0
1 Assering btl
0 0 0 52 0
2 Glucosa 40% btl
0 0 5 0 0
3 Glucosa 5% btl
7 40 0 28 2
4 Ka-En 3A btl
0 0 0 41 0
5 Ka-En 3B btl
0 0 0 40 0
6 Ka-En Mg 3 btl
0 20 0 0 0
7 Metronidazol infus btl
0 0 0 0 0
8 NaCl btl
53 31 27 35 3
9 Parasetamol 10 mg/ml infus btl
0 0 0 3 0
10 RL btl
19 31 18 423 9
0 0
BMHP 0 0
1 Alat suntik 1 ml set
420 233 125 690 143
373 799 277 540 617
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4

340 534 254 477 66
4 Alat Suntik 10 ml set
29 20 600 14 10
5 Alat Suntik 20 ml set
22 9 64 19 10
6 Alat suntik ADS 0.05 ml set 0 0 62 0
7 Alat suntik ADS 0.5 ml (Solosh set 400 0 0 100 200

8 Alkazym 250 mg sack 0 1 1 1
9 Alkacide 1 L High Level btl 0 0 0 1
10 Alkohol 70 % 1 L btl 3 0 2 0
11 Alkohol Swab box

19 0 17 10 1
12 Alkohol swab 2 % box 12 0 48 0
13 Aseptan Liquid 500 cc btl 17 37 34 0
14 Aseptic Gel 500 cc btl 13 30 8 8
15 Bioplacentol tulle lbr 0 0 40 0
16 Bisturi box 4 1 1 2
17 Bracket Hand Wash Plastik biji 0 0 0 0
18 Cat gut Chromic No. 2/0 DS 2 biji

31 0 24 16 0
19 Cat gut Chromic No. 2/0 HR 3 biji
18 52 24 35 9
20 Catgut Chromic 3/0 DS 24 mm biji 8 12 10 12 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
21 Cat gut Plain No. 2/0 DS 24 m biji

7 0 17 12 0
22 Cat gut Plain No. 3/0 DS 24 m biji 27 0 44 30
23 Cover Glass/ Deck Glass box 2 1 0 3
24 Endotracheal Tube - 2.0 biji

1 5 0 0 0
25 Endotracheal Tube - 3.0 biji
1 5 0 0 0
26 Feeding Tube FR 5 biji 0 0 5 0
27 Feeding Tube FR 8 biji 2 15 5 0
28 Female Catheter No. 14 biji 0 1 14 3
29 Foley cateter No. 14 biji 0 18 0 6
32 Gelang ID Pasien anak biru biji

40 100 0 81 100
33 Gelang ID Pasien anak pink biji
50 100 0 82 100
34 Gelang ID Pasien dewasa biru biji
0 0 0 53 0
35 Gelang ID Pasien dewasa pink biji
80 100 0 130 0
36 Handschoen Disposible (M) biji
700 678 3,700 2,700 500
37 Handschoen Disposible (S) biji
500 1,299 500 3,100 300
38 Handschoen Nitril (M) biji 700 100 500 100
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
39 Hansdchoen Nitril (S) biji

0 400 120 100 100
40 Handschoon panjang/obgin ster psg 9 103 55 105
41 Handscoon steril no 7 psg 69 0 0 95
42 Handscoon steril no. 7,5 psg 80 0 491 132
43 Infusion set anak biji 9 13 13 143
44 Infusion set dewasa biji

16 24 29 158 0
45 IV Catheter No. 18 biji
12 20 10 88 3
14 20 36 189 3
47 w. port IV Catheter No. 22 biji
0 0
2 29 0 128 3
49 IV Catheter No.20 with port set
0 0 0 0 2
50 IV Catheter No.22 with port set
18 11 28 91 3
51 Jarum Jahit Kulit No. 10 biji 2 1 0 0
52 Jarum Jahit Kulit No. 15 biji 2 1 1 0
53 Jarum Jahit Mukosa No. 10 biji 1 0 7 0
54 Jarum Jahit Mukosa No. 15 biji 1 0 0 0
55 Jelly 5 gr/ My Jelly sach

0 0 0 92 22
56 Kanul Oksigen Anak biji
2 1 11 6 2
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
57 Kanul Oksigen Dewasa biji

6 1 29 6 0
58 Kapas 250 g bks 4 3 7 13
59 Kasa 2 m x 80 cm rol
61 0 57 41 33
60 Kasa 36 x 80 cm rol
0 2 0 0 16
61 Kasa 4 m x 10 cm rol 46 82 60 340
62 Kassa steril rol 59 69 150 43
63 Kondom kateter ( M ) biji 0 10 2 0
64 Kondom kateter ( S ) biji 0 0 3 5
65 Lidi Kapas Non Steril pak 28 40 3 3
66 Lidi Kapas Steril biji 700 0 500 3
67 Lysol 1 L btl
3 5 6 3 0
68 Masker disposible biji 1,150 1,229 2,218 2,800
69 Masker Oksigen anak set

0 1 0 14 0
70 Masker Oksigen dewasa set
0 1 0 6 0
71 Masker Oksigen cungkup set 0 0 0 1
72 Mucus Extractor set 30 41 0 44
73 N2O gas tbg 0 0 0 0
74 Nebulizer with masker anak set

9 1 10 21 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
75 Nebulizer with masker dewasa set

8 1 10 39 0
76 Non Adhesive Bandage 10 x 4,5 rol 0 5 2 3
77 Object Glass box 0 0 0 0
78 Object Glass Frosted box 0 7 0 0
79 Oksigen gas tbg 0 2 0 0
80 Onescrub 500 cc btl

6 4 1 1 5
81 Plester rol 0 36 35 5
82 Plester putih/ hipavix 5 cm biji 13 32 13 31
83 Pot Sputum biji 60 200 0 176
84 Pot Sputum Steril biji 100 50 0 140
85 Pot Urin biji 100 100 100 400
86 Sabun Cuci Tangan/ Softaskin btl 13 46 17 0
87 Savety box biji

0 101 47 36 30
88 Silk 2/0 DS 24 mm sac
2 11 14 12 0
89 Silk 3/0 DS 24 mm sac
3 12 10 12 3
90 Suction catether no FR 8 biji 2 5 5 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
95 Three way stop cock biji

0 5 5 0 0
96 Tranfusi set biji 20 2 12 10
97 Umbilical cord klem nylon steri biji 81 345 100 68
98 Underpad Steril lbr

70 64 113 6 20
99 Urine bag biji
2 6 11 11 5
0 0
GIGI 0 0
1 Bonding Composite box 1 2 0 1
2 Bur Polish Composite set 0 5 0 3
3 Cavit box 0 1 0 1
4 Composit warna A2 box 1 1 0 2
5 Composit warna A3 box 1 1 0 1
6 Dentin Conditioner btl 1 1 0 2
7 Devitalisasi Pasta Non Arsen btl 2 1 0 1
8 Disclosing Solution btl 0 2 0 1
9 Disposible Dental Suction/ Sali box 0 2 0 1
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
10 Disposible Mikro Aplikator box 0 1 0 1
11 Etil klorid btl 0 0 0 0
12 Etsa Asam box 0 3 0 1
13 Eugenol btl
3 8 0 1 6
14 Forinokresol / T K F btl 2 2 0 0
15 Glass Ionomer Cement - Fuji I btl 2 1 0 0
16 Glass Ionomer Cement - Fuji VI btl 1 1 0 1
17 Iodoform Pasta pot 0 2 0 0
18 Kalsium hidroksida pasta set 1 3 0 0
19 Klorfenol/CHKM btl 1 1 0 0
20 Mata Bur high speed set 1 0 0 1
21 Mata Bur low speed set 0 0 0 0
22 Mumifying pasta btl 0 1 0 0
23 OCO btl 0 0 0 0
24 Pasta pengisi saluran akar/ Vita btl 1 2 0 0
25 Semen seng fosfat set 2 1 0 1
26 Sodium Hipochloride btl 1 1 0 0
27 Spons Gelatin/ Hemospon biji 0 0 0 2
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
28 T S Fletcher set 0 1 0 0
29 Tips Scaler ART biji 0 1 0 0
30 Tips Scaler Woodpecker biji 0 0 0 0
0 0
LABORAT 0 0
1 Ammonium oxalat 1 % btl 0 0 0 0 0
2 Blood lancet box 29 15 15 18
3 Botol sampel darah 10 ml btl 5 0 0 0
4 Botol sampel darah 20 ml btl 100 0 0 10 0

5 Box Slide biji 0 0 0 0
6 Bufer 1 L btl 0 0 0 0 0
7 Eosin 2 % btl 0 0 0 1 0
8 Film rontgen 24 x 30 box 0 0 0 0 0
11 Giemsa pekat btl 0 0 0 0
12 H2SO4 btl 0 1 0 0
13 Hayem btl 0 0 0 0 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
14 HCl 0,1 N btl 0 3 0 1
15 Iodium Test btl 0 300 0 0
16 Jelly EKG btl 2 1 0 0
17 Kertas EKG 50mm x 30mm rol 0 0 0 0 0

18 Kertas EKG 63 30 mm rol 0 0 0 0 0
19 Kertas EKG AT 1: 90x90mm box 0 0 0 0 0
20 Kertas lensa sach 1 1 0 2
21 Kondom Katether M biji 0 0 0 0 0

22 Kondom Katether S biji 0 0 0 0 0
23 Larutan EDTA btl 0 2 0 0
24 Metanol btl 0 6 0 0 0
25 Minyak immersi btl 0 0 0 0
26 Na citrat 3,8 % btl 0 4 0 0 0

27 Object glass box 2 0 3 3
28 Pipet tetes biji 0 0 0 8 0

29 Reagen golongan darah btl 0 0 0 1 0
30 Salmonella Thypi H Widhal Tes set 0 3 0 0 0
31 Salmonella Thypi O Widhal Tes set 0 3 0 0 0
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
32 Spiritus btl 1 0 0 0
33 Stik gula darah Accucheck Perf btl 0 0 0 2
34 Stik asam urat Nesco btl 0 0 0 0
35 Stik asam urat UA Sure btl 0 0 0 0
36 Stik cholesterol Accutrend btl 0 0 0 0
37 Stik gula darah gluco DR btl 3 4 0 11
38 Stik gula darah Nesco btl 0 0 3 5
39 Stik trigliserid Accutrend btl 0 0 0 0
40 Stik urinalisa 3 parameter btl 1 0 1 0
41 Stik urinalisa 10 parameter btl 0 0 0 1
42 Tes kehamilan sach 110 350 239 87 40

43 Turk btl 0 0 0 0
44 Ziehl nelson btl 0 6 0 0
VAKSIN
1 BCG amp
2 DPT - HB amp
3 DPT HB HIB amp
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
4 POLIO amp
5 CAMPAK amp
6 TT amp
7 HB U amp
8 DT amp
9 TD amp
10 ADS 0.05 ml set
11 ADS 0.5 ml set
12 ADS 5 ml set
13 SAFETY BOX biji
OBAT BARU 2018
Rapid I HIV test
Micropipet biji
Sukralfat tab
Paket Alat Deteksi Resiko Keha paket 2
Trifluoperazin tab 1,010
RDT Combo Malaria test
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
Atalpulgit/ New Antides tab 1,030 2,366 60 2,919
Stik Cholesterol Benecheck btl 3
Stik Gula Darah Benecheck btl 5
Jelly 82 gr/ My Jelly tube
Mineral Mix sachet
Na Divalproat 250 mg (Depakot tab 510
Nistatin drops btl 41 35 26
Omeprazole injeksi amp
Stik Asam Urat Benecheck btl 3 9 8
Panviton tab 1,050 420 220
Naia tab 240 240
Intunal syr btl 87 76 95
Mekobalamin kap
Biocombin inj amp 4
Lugol btl
Larsi kap
Omevita syr btl 56 8 33 63
Fluoksetin 20 mg tab/Peprezal tab
1
No. Kode 1 2 3 4 5
Kesehatan an
1 2 3 4
Klorpromazin inj amp
Klozapin 25 mg tab 165 1,000 50
1
Tembarak Kranggan Pare Rejosari Pringsurat Kaloran Tepusen
5 6 7 8 9 10
Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2
802 0 0 0 800 0 2,012
1,155 277 150 626 2,760 569
0 133 0 0 0 0
132 40 0 225 471 1,030
0 331 524 482 133 710
0 87 55 147 594 100
534 437 659 4,465 1,480 621
110 745 475 2,349 1,520 300
5 0 0 0 500 1,688
674 4,419 5,699 17,172 3,860 5,134
2,002 3,684 1,077 9,063 3,040 1,493

180 60 330 100 65 0
1
5 6 7 8 9 10
14 4,099 5,267 3,653 3,705 4,124
0 0 0 0 0 0
90 145 930 629 1,010 868
1,913 2,614 7,085 6,400 3,531 2,104
20 0 100 269 120 510

200 0 0 240 0 850
181 378 0 480 30 975
68 0 474 295 361 521
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 145 250 200 510 42
65 0 50 40 20 117
45 1,774 445 444 440 521
575 4,732 5,645 9,595 5,126 2,806

1,293 630 0 200 535 391
6 196 113 54 225 928
0 0 0 0 345 0
1
5 6 7 8 9 10
0 0 0 0 0 0 0
90 100 144 61 0 134
0 90 200 89 470 200
227 100 100 1,218 200 199
0 100 0 44 0 0
0 75 160 852 640 805
0 0 0 0 100 0
0 0 140 0 320 240
20 140 160 0 146 320
0 54 100 59 170 134
361 137 0 152 180 287

0 0 0 0 0 0
65 55 855 180 270 303

47 0 0 509 6 190
0 56 122 288 157 248
85 352 0 241 1,351 281

1,534 273 379 160 200 535
190 252 281 36 350 257
1
5 6 7 8 9 10
88 236 200 202 710 544

474 365 34 0 190 380
0 0 0 0 0 0
0 244 0 85 382 0
0 63 170 80 900 414
0 388 1,292 108 1,523 155

140 0 0 0 72 0
359 170 140 253 513 248
210 0 0 0 100 70
0 0 88 4 0 95
68 100 645 167 331 521
0 0 0 0 0 0
926 1,500 1,000 410 250 160
2,000 799 6,378 3,797 1,070 3,008
0 60 0 210 10 0
0 301 0 107 0 212

1,472 0 488 0 609 0
10 0 885 631 2,540 559
1
5 6 7 8 9 10
806 1,759 2,559 792 4,690 1,528
0 100 0 140 0 570

200 0 140 120 59 0
149 154 60 92 120 367
0 0 100 0 0 0
78 195 0 0 490 0
0 0 0 0 0 0
0 0 0 226 500 200
138 2,672 5,465 8,413 4,580 2,402
0 0 100 7 320 297
0 0 0 0 0 380
0 40 0 100 0 148
712 320 758 1,011 1,796 1,374
0 0 0 0 0 76
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 45 335
125 0 0 286 100 394
1
5 6 7 8 9 10
0 0 0 0 0 0 0
180 0 300 260 300 500
482 530 589 842 1,565 1,226
1,102 3,193 560 957 190 0
0 0 0 0 100 1,032
0 0 90 100 200 100
0 0 0 8 0 190
90 330 1,325 643 468 622

0 0 0 0 100 438
0 0 608 2,688 80 3,175
1,544 467 140 1,876 0 943

140 400 450 563 240 520
0 0 0 0 0 0
205 195 1,423 295 100 250
0 0 0 0 86 35
0 0 0 0 0 1,045
0 0 0 0 0 2 0
2 0 1 0 0 1 2
1
5 6 7 8 9 10
0 0 0 0 0 0 0
0 0 1 0 0 0 0
0 85 50 167 75 174
0 0 0 0 0 0
0 0 0 0 0 90
1,327 6,838 6,752 12,557 11,628 8,282

0 0 0 0 0 0 0
124 0 151 0 131 200
3,366 2,493 3,900 4,182 895 4,824

148 802 1,604 1,194 3,330 490
383 0 0 0 95 575
0 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 63 0 0
0 90 0 0 0 0
958 1,513 3,801 2,833 1,240 1,540

0 0 0 20 100 0 146
125 0 0 37 96 200 136
1
5 6 7 8 9 10
0 0 0 0 0 395
265 120 577 591 370 571
0 0 0 0 440 0
6,934 1,410 2,850 9,610 13,475 8,210
128 194 320 336 1,090 559
0 80 0 0 200 0
0 2,877 4,918 4,015 2,771 1,388
2,145 452 638 748 1,420 982
5 0 0 0 0 0
1,707 868 1,147 543 780 508
0 0 0 0 0 0
71,700 23,074 49,334 43,830 61,254 31,106 27,463 10,200
0 0 0 0 0 0
0 60 0 130 100 0
0 275 0 0 200 200
0 0 0 0 0 0
0 0 0 50 150 0
0 150 160 0 443 378
1
5 6 7 8 9 10
574 258 3,960 5,009 4,155 2,790
0 250 100 90 98 1,000 220 200
0 0 0 0 0 0
2,000 4,440 3,964 3,872 230 3,518

1,000 204 0 645 400 800 395
0 0 0
0 0 0
0 1 31 6 31 49
193 0 26 96 146 1
0 0 58 60 63 53
0 50 55 143 60 48
16 78 157 90 82 51
0 3 0 0 0 2
3 0 67 40 38 65
0 32 29 53 16 51
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1
5 6 7 8 9 10
2 23 166 0 10 136
0 0 0 0 1 0
47 8 14 31 44 25
0 0 8 0 0 3
31 41 102 88 87 36
0 0 0 0 0 0
0 0 0 0 12 0
0 7 9 13 20 8
120 57 16 21 37 6
0 63 3 4
87 292 139 194 210 105
9 50 95 134 213 78
0 4 9 4 0 0
0 0 0 28 15 0
0 0 0 0 0 0
0 1 0 7 0 0
0 5 53 0 10 6
11 0 0 0 1 0
1
5 6 7 8 9 10
0 0 11 7 0 0
31 28 61 61 72 33
0 0 0
0 0 0
0 30 0 6 0 0
0 0 0 0 0 0
7 0 0 37 3 0
0 0 0 0 0 0
0 5 5 10 0 5
4 0 17 177 97 20
4 0 5 1 5 0 5
0 25 12 49 30 18
5 10 16 25 20 10
0 7 10 0 10 10 0
0 0 0 0 0 0 0
0 0 0 24 20 0
0 0 0 0 0 0
2 5 0 8 0 0
1
5 6 7 8 9 10
0 0 0 0 0 0
0 9 4 23 5 9
0 10 11 25 9 10
48 90 37 180 21 174
8 0 13 256 15 120
8 20 5 9 20 28
8 5 0 0 0 0
2 0 0 0 0 0
0 7 0 0 0 0 0
0 0 0 0 0 0
6 99 32 35 5 93
0 0 0 64 0 0
0 0 0 0 19 0
0 0 20 91 1 16
0 0 0 0 0 0
0 1 0 1 0 0
0 0 0 0 0 0
0 20 0 0 71 0
1
5 6 7 8 9 10
0 57 0 65 12 0
0 0 0
0 0 0
1 0 1 0 0 0
0 0 0 0 0 0
17 29 0 32 41 126
7 44 42 25 22 43
18 137 119 69 10 63
99 0 32 53 62 80
73 75 105 60 138 73
24 0 10 2 27 8
0 9 0 2 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 12 71 51 22 49
1 4 2 15 3 5
9 7 6 3 9 10
17 20 0 0 30 0
1
5 6 7 8 9 10
100 0 101 161 2 247
0 0 5 0 3 1
37 17 0 33 123 6
0 0 0 0 91 0
0 0 0 0 0 0
9 26 51 48 37 146
35 28 58 66 3 121
49 0 24 51 31 36
1 0 1 0 1 1
45 59 112 41 84 75
36 0 14 63 35 24
51 58 95 71 47 125
0 0 0 0 0 0
28 4 0 7 49 96
26 23 69 164 69 53
0 0 32 22 3 42
27 35 16 64 26 33
0 0 0 0 1 0
1
5 6 7 8 9 10
14 42 16 16 0 28
92 0 2 23 17 0
0 0 20 7 0 0
0 40 58 9 20 33
0 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1 0 0 0 0 1
103 114 130 75 151 70
0 0 0 0 0
0 0 0 0 5 0
5 5 6 4 6
8 20 43 57 27 35
0 0 0 0 0
0 0 0 5 2 4
0 5 37 7 1 26
26 38 90 44 18 48
22 24 0 24 15 18
1
5 6 7 8 9 10
0 0 0 0 0 0
37 37 31 34 42 31
0 0 0
0 0 0
0 0 0 237 0 0
0 0 0 0 0 0
0 4 9 27 0 0
0 0 0 21 0 0
0 0 0 20 0 0
0 0 0 40 0 0
0 0 0 0 0 0
7 5 12 94 19 7
0 0 0 0 0 0
5 18 75 536 22 24
0 0 0
0 0 0
0 523 235 261 131 233
200 35 388 931 152 395
1
5 6 7 8 9 10
0 100 609 252 298 170
0 0 0 13 8 0
0 0 0 10 0 0
0 0 0 0 0 0
0 0 100 200 365 0

0 0 0 0 1 2
1 2 0 1 1 2
0 0 0 0 3 2
6 0 0 5 4 0
19 0 0 3 0 2
2 0 0 0 13 7
26 15 0 0 16 13
0 0 0 0 0 0
1 1 2 2 3 5
0 0 0 0 0 5
0 0 22 24 6 3
0 12 34 39 7 12
0 0 12 34 0 6
1
5 6 7 8 9 10
0 12 30 32 8 6
3 0 15 22 29 15
0 0 0 0 8 0
0 0 3 0 0 0
0 0 3 0 0 0
0 0 0 0 0 5
0 0 0 5 3 0
5 0 0 5 3 10
0 0 0 2 0 12
1 0 0 3 7 12
4 0 5 5 14 14
0 0 0 135 25 0
0 0 50 105 25 0
0 0 0 300 25 0
0 0 50 200 45 0
0 1,900 1,900 478 490 1,200
500 100 1,042 1,346 400 500

0 0 0 0 0 0
1
5 6 7 8 9 10
0 0 1,062 100 0 0
21 0 0 10 100 10
14 0 19 0 77 28
45 0 20 0 0 27
1 0 5 23 138 2
4 22 21 184 11 19
5 20 6 25 33 12
0 0 8 50 10 3
0 0 0
0 10 13 43 3 2
0 0 0 0 0 0
2 0 23 102 7 9
0 0 5 0 9 1
0 0 1 0 10 1
2 0 0 1 10 1
0 0 0 3 0 1
0 0 0 6 0 0
2 5 9 14 5 2
1
5 6 7 8 9 10
2 7 9 28 0 5
4 0 4 8 9 0
0 20 76 62 2 74
0 0 0 0 3 0
83 0 10 25 196 1
31 0 38 32 57 32
0 0 0 0 5 2
0 0 0 0 18 2
28 0 0 0 0 0
200 0 0 500 0 0
0 5 0 1 3 1
500 400 450 1,400 2,064 2,000
0 0 0 2 7 5
0 0 0 2 3 2
0 7 0 0 0 0
2 0 39 50 17 21
0 0 0 0 0 0
0 0 10 9 20 0
1
5 6 7 8 9 10
0 0 4 11 20 0
0 0 1 0 1 0
7 0 2 0 7 3
0 0 0 0 0 0 0
0 0 0 0 14 0
0 1 2 2 2 6
0 0 0 0 11 0
10 0 41 26 27 35
400 0 0 0 50 0
50 0 0 0 100 0 0
200 0 0 99 0 80
5 0 0 0 0 5
0 90 51 44 40 59
0 1 20 24 5 12
0 1 23 23 2 14
0 0 0 0 0 0
0 0 0 0 0 2
0 0 0 0 0 1
1
5 6 7 8 9 10
0 0 0 0 0 1
0 0 0 0 0 1
0 0 0 0 4 0
2 5 28 31 38 10
29 0 10 20 69 12
0 0 60 33 8 95
0 10 9 13 4 2
0 0 0
0 0 0
2 0 1 0 0 0
0 0 0 0 1 0
1 0 1 0 1 0
2 0 0 0 1 0
2 0 1 0 0 1
1 0 1 0 0 0
0 0 0 0 1 0
0 0 0 0 0 0
3 0 0 0 2 0
1
5 6 7 8 9 10
4 0 0 0 2 0
0 0 0 0 1 0
2 0 0 0 1 0
0 3 1 2 3 0
1 0 1 0 1 0
2 0 2 0 2 1
1 0 1 0 0 0
0 0 0 0 1 0
1 0 0 0 2 0
2 0 1 0 1 0
5 0 0 0 1 0
0 0 0 0 0 0
1 0 0 0 1 0
1 0 0 0 2 0
0 0 0 0 1 0
2 0 2 0 0 0
0 0 0 0 0 0
1 0 0 0 0 0
1
5 6 7 8 9 10
0 0 0 0 1 0
1 0 0 0 1 0
0 0 0 0 0 0
0 0 0
0 0 0
0 0 0 0 0 0
22 8 7 32 22 22
0 0 0 0 34 0
0 0 0 0 0 0
0 0 0 0 2 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 1 1
0 0 0 0 1 0
0 0 0 0 0 0
1
5 6 7 8 9 10
0 0 0 0 3 2
0 0 0 0 0 0 0
3 0 0 1 0 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
3 0 0 0 0 0
0 0 0 0 0 0
1 0 0 0 1 0
0 0 0 0 0 0
0 0 0 0 0 0
1
5 6 7 8 9 10
0 1 0 0 1 0
0 0 0 0 2 1
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 6 0 4 0
4 0 1 0 0 5
0 0 0 0 0 0
0 0 0 0 0 0
1 0 0 0 0 0
0 50 153 38 11 50
1 0 0 0 0 0
3 0 0 0 0 0 0
1
5 6 7 8 9 10
200 117 0
1
5 6 7 8 9 10
580 2,052 2,998 501
1 2 3 3
4 3
1 4 1 2
10 26 19
1 2 2
290 430 510 500 500
45 50 94 40 93 26
5 50
1 1 1 1 1
440
42 58 33 50 54 100
1
5 6 7 8 9 10
1
Tepusen Bulu Parakan Traji Bansari Kledung Kedu
10 11 12 13 14 15 16
APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II
0 100 800 0 200 1,030
402 1,735 300 800 804 1,016
4 0 15 0 0 0
452 0 60 0 216 473 0
520 341 400 0 515 191
93 268 88 0 80 40
250 1,579 2,100 590 900 1,078
0 896 1,500 900 1,340 1,360
30 490 700 0 460 0
13,288 6,999 3,570 9,197 9,082 4,070
141 4,130 1,381 5,423 6,167 5,249

370 224 192 500 0 50 170
1
10 11 12 13 14 15 16
296 3,483 1,505 8,549 1,178 5,688
0 0 0 0 0 0
280 2,631 1,270 280 750 1,480
1,146 4,478 1,362 6,220 6,081 2,437
0 422 200 15 100 300

0 0 610 0 0 90 75
214 0 400 0 66 322
220 543 400 1,148 338 325
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 662 0 510 80 79
0 97 0 36 10 0
536 1,846 884 1,812 200 491
4,372 2,120 4,080 2,036 8,821 6,216

5 360 506 150 160 0 0
25 0 90 0 130 352
0 0 0 0 0 0
1
10 11 12 13 14 15 16
0 0 0 0 0 0
202 147 170 80 0 549
105 0 260 400 203 100
382 52 438 180 160 203
100 176 80 130 100 150
368 1,908 696 1,819 573 461
100 100 0 260 0 0
100 180 0 0 0 100
161 300 395 80 180 450
26 379 136 0 98 755
30 278 10 700 52 392

0 0 0 0 0 0 80
232 496 299 0 280 272

297 0 179 500 81 815 302
0 562 0 0 0 874
430 479 200 288 120 1,230

846 195 9 309 258 120 480
50 310 100 165 360 670
1
10 11 12 13 14 15 16
110 250 100 100 70 192

290 180 348 240 270 50 326
0 0 0 0 0 0
396 285 70 0 0 709
286 407 700 0 250 0
2,079 367 270 884 385 933

466 190 40 0 330 60 325
361 454 349 700 190 154 705
70 0 0 0 20 0 193
0 95 0 125 0 70
558 85 400 305 56 465
0 10 0 0 0 23
1,172 783 808 250 50 460 1,495
2,093 2,189 593 3,816 5,875 5,837
0 0 0 0 0 50
110 478 710 250 150 125

365 0 880 1,100 0 0 0
1,407 935 710 35 950 553
1
10 11 12 13 14 15 16
574 5,161 1,490 3,837 3,356 385
270 484 0 0 250 320

0 181 258 210 140 100 100
286 183 100 236 120 170
63 100 96 0 0 100
0 0 100 0 0 0
0 146 0 0 0 0
0 100 0 0 0 290
1,170 8,176 1,835 8,717 8,644 4,334
300 95 405 0 280 360
0 68 520 0 0 0
301 70 0 0 0 0
742 938 390 1,562 1,299 1,630
0 0 0 0 0 0
64 0 600 0 0 0
55 0 0 0 0 0
0 0 0 0 0 0
56 335 450 0 100 70
1
10 11 12 13 14 15 16
0 0 0 0 0 0
264 132 197 0 150 40 994
0 1,763 200 2,130 2,350 1,380
1,053 874 1,234 1,700 140 0
484 745 650 0 0 362
100 290 80 0 100 0
93 51 90 0 150 90
448 734 400 961 2,035 1,464

260 0 0 100 0 100 0
0 2,569 180 2,780 4,245 6,950
1,589 3,072 790 90 1,392 4,389

354 328 472 500 90 200 1,210
0 0 0 0 0 170 0
546 329 110 280 860 250
0 105 100 0 110 94

0 0 0 0 0 0 0
0 0 0 0 0 0
2 7 3 0 1 1
1
10 11 12 13 14 15 16
0 0 0 0 0 0
0 0 0 0 0 0
332 582 0 114 94 120
0 0 0 0 0 0
0 0 0 0 0 0
8,085 8,435 4,866 39,571 12,733 13,740

0 0 0 0 0 0
67 81 460 155 40 0 50
5,763 5,476 5,690 5,620 3,480 9,302

820 199 1,658 2,100 964 910 1,676
469 0 0 742 0 100

0 0 0 0 0 0
0 0 0 0 0 0 15
0 54 76 0 0 111
0 232 160 0 0 235
2,016 2,692 900 5,144 581 3,080

0 50 0 50 0 47
2,361 834 0 951 0 144
1
10 11 12 13 14 15 16
210 90 0 0 0 50
679 1,449 100 3,076 60 865
175 968 290 0 230 0

2,915 9,010 17,474 9,219 4,560 4,690 14,862
562 188 1,045 67 150 410
0 243 0 0 0 0
2,179 4,513 1,740 12,174 4,023 3,148
56 718 570 165 1,051 1,072
0 0 170 0 0 0
534 368 100 520 50 876
0 0 0 0 0 100
65,155 97,153 73,610 90,700 48,430 118,503

150 0 467 270 0 180 159
216 61 140 90 0 100
159 120 140 90 0 0
0 0 0 0 0 0
780 0 0 400 0 38
140 6 96 160 0 80 448
1
10 11 12 13 14 15 16
1,297 5,338 720 9,080 3,250 4,830

706 90 498 0 200 62 1,000
0 0 0 0 0 0
1,402 5,170 2,200 9,629 6,207 4,751

600 990 0 490 300 740
0 0
0 0
0 0 8 29 0 10
72 111 188 44 227 95 13
0 58 55 0 45 11
141 102 37 45 37 42
81 96 66 156 82 76
9 0 12 0 0 0 3
75 29 43 55 38 6 43
66 87 80 91 41 46
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0
1
10 11 12 13 14 15 16
145 111 85 24 12 0
0 64 0 96 0 123
43 1 24 42 0 0 65
0 0 0 0 0 7
99 69 20 217 104 125

0 0 0 0 0 0 0
0 0 0 0 0 0
7 18 22 0 6 42
87 11 13 43 90 22 149
0 15 0
39 263 131 5 102 31
218 171 87 401 172 66
0 19 0 0 0 0
46 37 85 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
35 87 65 8 5 20
0 0 0 0 0 0 0
1
10 11 12 13 14 15 16
0 10 0 0 0 0
67 174 87 79 28 82
0 0
0 0
0 0 0 0 0 3
0 0 0 0 0 0
2 0 2 0 0 38
0 0 0 0 0 0 0
10 2 10 5 0 5
5 10 24 25 14 17
5 10 1 0 0 4 2
0 4 10 27 20 26
0 6 18 10 15 5
10 5 10 9 0 0
5 2 0 0 0 0
0 5 0 0 0 0
0 0 0 0 0 0 0
0 0 11 9 3 5
1
10 11 12 13 14 15 16
0 4 0 0 0 0 0
0 9 4 8 2 0
0 0 10 0 0 3
20 125 90 272 50 44
30 103 32 13 90 0
5 25 13 9 10 5
0 0 5 0 6 5
0 0 0 0 10 0
0 0 0 0 10 0
0 0 0 0 0 0 0
36 47 91 100 45 8
0 0 0 3 0 0
0 0 0 0 0 0 0
0 10 10 13 10 14
0 0 0 0 0 0
0 1 0 0 1 1
0 0 0 0 0
5 10 100 142 60 0
1
10 11 12 13 14 15 16
19 222 30 49 60 53
0 0 0
0 0 0
1 0 0 0 0 0 1
0 0 0 64 0 0
49 64 17 77 8 52
89 96 50 39 13 32
67 48 72 100 19 145
28 62 92 24 39 48 80
122 121 40 94 96 104

10 46 65 24 32 4 31
0 0 10 4 0 0
0 0 0 0 0 0
0 0 0 0 0 0
14 48 72 24 19 65
3 6 2 7 4 3
21 20 28 10 4 6 10
0 18 10 37 0 8 25
1
10 11 12 13 14 15 16
255 13 210 100 0 97
3 0 4 0 2 4
122 34 47 32 41 45
0 0 0 0 0 0
5 15 10 0 0 0
76 86 39 16 18 31
7 55 15 69 43 13
2 19 53 30 31 46 35
0 0 0 0 0 0 1
16 129 47 96 60 99
5 9 32 10 26 17 21
187 122 80 109 29 164
0 0 0 0 0 0
37 33 28 35 19 90
45 54 40 25 25 0
0 12 0 24 0 4
67 0 54 0 30 54 58
0 0 0 0 0 0
1
10 11 12 13 14 15 16
2 8 0 22 18 6
44 28 10 18 22 1 15
6 0 0 15 0 0 0
54 73 34 6 15 37
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0
2 0 1 0 0 0 0
124 112 43 46 57 184
0 0 0 0 0 0
10 0 0 0 0 0
0 5 0 4 5 7
28 24 40 30 20 41
0 0 0 0 0 0
5 2 10 0 0 0
8 1 0 8 0 10
61 58 51 25 91 61
50 16 44 24 20 40 70
1
10 11 12 13 14 15 16
0 0 0 0 0 0
46 45 67 24 8 48 59
0 0
0 0
0 0 0 2 0 0
0 0 0 0 0 0
15 9 0 5 0 18
0 0 0 0 0 5
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
11 19 3 35 5 26
0 0 0 0 0 0
13 40 8 42 7 7
0 0
0 0
100 642 200 346 79 555
100 576 0 753 260 572
1
10 11 12 13 14 15 16
193 122 100 176 120 192
3 13 0 0 25 10
17 9 0 3 0 0
100 0 0 0 0 0 0
0 0 200 0 0 200
0 0 1 3 0 0 0
0 0 1 3 1 0 0
1 1 0 0 0 3 0
0 0 0 0 5 9
18 0 8 0 0 0 1
10 11 0 14 0 1 0
5 28 0 13 12 5 10
48 0 0 0 0 0 0
2 0 3 5 1 5 4
0 0 0 3 2 0 0
2 21 3 0 2 0
0 0 5 24 1 6
3 21 0 12 18 2
1
10 11 12 13 14 15 16
0 0 13 18 1 0
12 2 0 13 20 8 4
0 0 2 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 2 0 5 0 0 0
0 4 0 0 0 0 0
0 1 5 0 5 0 3
4 0 0 0 0 0 2
0 0 0 7 2 0 4
4 0 0 2 4 1 7
0 0 0 50 30 50
0 0 0 50 30 50
0 0 0 50 0 0
0 0 0 50 0 0
1,100 1,048 1,600 1,720 800 2,041
600 2,490 1,200 2,100 700 981

0 500 500 100 0 1,030 200 0
1
10 11 12 13 14 15 16
0 350 0 0 0 300
65 24 11 33 46 0 0
32 104 13 6 0 0 100
0 150 0 0 73 0 103
5 1 5 10 9 10 4
20 7 6 6 5 0
10 8 0 49 20 26
2 18 5 8 0 28
5 12 12 8 0 5
0 14 0 0 0 0
3 7 7 10 0 18
2 0 1 1 0 0 20
2 1 1 1 6 0 5
2 1 0 0 6 4 13
2 1 1 1 0 4 4
0 0 60 0 0 20
5 3 2 9 2 0
1
10 11 12 13 14 15 16
6 8 2 7 2 2
7 7 19 6 1 3 5
10 54 20 18 24 45
0 0 1 0 0 0
49 10 63 93 0 120 44
73 30 213 42 4 80 17
5 1 0 0 0 0 0
0 1 0 0 0 0 0
15 6 10 0 12 0 0
0 1,100 800 4 300 0 900
2 2 5 0 0 2
907 200 1,534 1,600 1,379 550 1,955
10 0 5 5 1 0
2 0 5 3 0 0
2 5 0 2 0 0 0
10 0 0 5 18 0 37
0 0 0 0 0 0 0
0 3 5 9 0 0
1
10 11 12 13 14 15 16
0 3 7 8 0 0
0 0 4 10 2 0 0
8 0 0 0 0 0 5
2 3 3 4 0 1
0 0 0 0 0 0 0
2 2 2 3 0 1
6 21 5 8 2 14 9
26 30 28 34 22 14 32
100 100 250 50 137 50 147
0 140 40 106 80 40
250 100 130 100 126 90 43
14 18 0 8 0 0 0
100 70 50 70 0 90
5 19 7 15 13 8
5 24 5 19 6 12
0 0 0 1 0 0 0
1 0 0 1 2 0 0
2 0 0 1 2 0 0
1
10 11 12 13 14 15 16
0 0 0 1 2 0 0
0 0 0 1 2 0 0
0 0 5 1 0 0
14 11 11 0 37 5 25
121 50 0 0 50 0 0
20 15 10 49 60 20
4 0 1 4 0 3
0 0
0 0
0 1 1 2 1 0 0
0 0 0 0 0 0 1
0 0 1 2 0 0 0
0 0 1 0 1 1 1
0 0 1 0 0 0 1
0 0 0 2 0 0 1
0 0 0 1 0 0 0
0 0 0 2 0 0 0
0 0 2 0 1 0 0
1
10 11 12 13 14 15 16
0 0 0 0 1 0 1
0 0 0 0 0 0 0
0 2 3 2 0 0 1
3 5 5 4 0 4
0 0 1 0 0 1 0
0 0 2 2 2 1 1
0 0 1 0 1 0 0
0 0 0 0 0 0 0
0 0 1 0 1 0 0
0 0 0 0 0 1 0
0 0 2 0 0 0 1
0 0 0 0 0 0 0
0 0 0 0 0 1 0
0 0 0 0 0 0 1
0 0 0 0 0 0 0
0 0 1 0 1 0
0 1 1 1 1 0 0
0 0 0 0 0 0 0
1
10 11 12 13 14 15 16
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0
0 0
1 0 0 0 0 0
13 33 17 24 20 8 13
0 0 0 0 0 0 0
20 0 0 3 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0
0 1 1 1 1 1 1
0 0 0 0 0 0
1
10 11 12 13 14 15 16
0 3 3 1 2 0 0
0 46 70 0 0 130
4 2 2 0 1 0 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 1 0 1 1 0
0 0 0 0 0 0
0 0 0 0 0 0
1 0 0 0 0 0 0
0 0 0 0 0 0
0 1 2 0 1 0 1
2 0 0 0 0 0
3 0 5 0 1 0 0
0 0 0 4 0 4
0 0 0 2 0 1
0 0 0 0 0 0
0 0 0 0 0 0
1
10 11 12 13 14 15 16
2 1 3 0 2 1 1
0 1 3 5 0 3 4
0 0 0 2 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
4 0 0 0 3 1 3
0 0 0 5 0 0 4
0 0 0 0 0 0 0
0 0 2 0 1 1 2
0 0 0 0 0 0 0
0 120 100 88 50 175

0 0 0 0 0 0 1
2 3 3 0 0 1
1
10 11 12 13 14 15 16
112 100 100 100 119
2 2
1
10 11 12 13 14 15 16
190 2,324 1,040 2,245 1,000 825
5 1 4 4
12 19 36 8 5 27
1 5 9 2 3 4
243 378 450 250 300 290
240 110
34 9 74 71 35 112
1 1 1
48
60 62 24 35 29 80 118
100
1
10 11 12 13 14 15 16
155
1
Kandangan Gemawang Jumo Ngadirejo Candiroto Bejen Wono
17 18 19 20 21 22 2
DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK
3,800 1,580 399 0 198
882
2,033 335 570 1,209 461 1,630
0
0 0 0 341 0 0
0 31 0 247 113 80
194
0 455 340 1,931 396 370
100
86 0 100 352 60 190
57
2,490 427 0 1,977 312 850
440
460 0 0 2,904 211 0
97
0 0 0 610 639 270
7,095
614 9,111 3931 5,500 2,926 17,167
7,969
4,864 3,547 2374 6,151 4,309 5,470
0 300 310 480 0 123 300

1
17 18 19 20 21 22 2
3,822
4,735 4,437 824 4,595 1,472 2,130
0
0 0 0 0 0 0
455
2,539 490 353 552 970 2,580
4,065
1,906 8,810 2950 2,370 4,973 4,630
90
280 100 110 625 111 78
0 0 120 0 300 240
836
510 0 190 527 327 275
214
652 700 0 615 593 290
0
0 0 0 0 0 0
0
0 0 0 90 0 0
0
0 0 0 0 0 0
30
0 0 69 42 0 70
0
0 0 58 30 10 120
661
539 490 914 971 1,090 165
4,477
2,145 9,369 1726 5,206 3,810 11,420
150 130 40 1,015 0 0
32
431 95 182 1,602 516 100
0
0 89 0 301 200 0
1
17 18 19 20 21 22 2
0 0 0 0 0 0
55
228 190 55 1,376 250 180
200
0 0 183 114 114 350
156
0 280 75 1,052 352 190
88
0 0 70 90 0 440
187
111 707 165 1,917 1,213 590
0
0 0 0 0 100 300
0
0 0 0 0 100 100
55
792 0 0 197 155 400
76
431 80 88 267 116 90
297
2 150 121 550 179 200
0 0 0 81 0 0
100
0 173 192 900 88 385
0 0 0 428 0 153
102
60 600 60 639 113 212
322
1,784 490 205 782 132 90
172 895 330 901 324 539
0
919 207 200 456 139 180
1
17 18 19 20 21 22 2
340
0 10 200 445 417 185
0 300 90 400 0 256
0
0 0 0 0 0 0
214
906 0 0 850 186 150
0
0 409 40 250 159 0
94
836 73 496 860 355 897
117 0 0 410 0 0
560 580 48 1,253 164 701
0 0 0 161 0 0
35
0 0 0 220 60 0
41
700 250 232 458 404 450
0
0 0 0 141 0 50
880 0 30 864 190 867
7,520
2,750 8,162 2236 2,243 1,839 4,985
0
0 0 0 580 300 0
0
0 0 0 510 0 90
0 70 0 964 0 0
1,558
160 1,750 157 840 353 795
1
17 18 19 20 21 22 2
542
5,613 3,025 414 5,897 847 4,420
0
40 0 120 260 144 0
0 183 0 363 62 125
180
235 170 90 504 135 220
0
100 0 0 90 0 75
0
0 0 0 0 0 0
0
0 0 0 0 0 0
98
0 0 0 1,000 0 200
6,072
339 9,808 1007 5,292 4,107 7,659
285
265 382 58 1,691 105 230
0
0 0 0 0 0 0
94
0 0 0 625 126 0
6,108
228 1,742 224 742 1,054 464
0
0 0 0 0 0 0
100
0 0 0 540 0 0
0
0 0 0 0 100 0
0
0 0 0 0 0 0
100
47 0 110 657 151 225
1
17 18 19 20 21 22 2
0 0 0 4 0 0
0 0 35 108 195 268
585
3,022 290 781 997 584 2,510
200
29 0 0 0 439 500
310
547 293 0 1,948 868 552
100
97 0 0 100 170 510
0
0 0 0 0 0 0
853
190 500 670 1,768 770 390
0 90 0 100 27 111
1,404
2,664 9,653 2470 5,410 1,132 6,088
566
1,319 1,504 1240 2,210 980 1,560
438 0 1,545 1,868 316 378
0 0 0 240 0 0
425
100 390 180 1,027 570 200
0
0 0 0 267 0 0
200 0 0 0 0 0
0 0 0 1 0 0
1 3 0 15 1 2
1
17 18 19 20 21 22 2
0 0 0 0 0 0
0 0 0 1 0 0
107
0 120 166 724 100 55
46
0 0 0 30 0 0
0
0 0 0 0 0 0
7,535
3,474 6,393 2659 24,468 13,057 14,290
0 0 0 0 0 0
0 207 35 722 66 173
3,037
7,202 6,296 4302 5,668 4,447 9,140
401 790 370 2,247 348 1,521
256
0 0 0 0 0 250
0 0 0 0 0 0
0 0 0 0 300 0
52
0 0 0 540 100 0
100
0 0 90 348 70 0
355
7,146 3,654 1769 4,487 3,144 460
0 4 100 50 170 93
279 360 260 400 442 91
1
17 18 19 20 21 22 2
100
0 0 90 710 100 80
334
100 530 92 896 939 775
0
0 0 0 0 0 0
11,162 15,877 3,790 13,840 2,980 6,595
22
573 240 0 764 389 470
0
0 0 0 90 0 0
3,804
2,073 4,742 722 3,741 1,889 2,330
569
198 220 921 1,342 557 810
0
0 0 0 40 0 0
1,230
844 0 156 1,470 2,037 756
0
0 0 0 0 0 0
84,030 59219 71,470

44,120 22,680 38,540 53,770
173,434
7 0 0 0 0 0
31
0 100 120 200 50 90
100
0 100 0 605 187 200
0
0 0 0 0 0 0
87
0 0 0 0 100 0
0 290 0 1,266 185 0
1
17 18 19 20 21 22 2
5,247
3,203 3,980 601 4,912 3,544 6,690
234
2,272 369 0 1,110 196 24
0
0 0 0 0 0 0
7,399
1,921 7,174 2437 2,698 3,855 6,265
0 380 0 420 0 325
0
0 0
0
0 0
59
0 0 0 0 0 6
236 38 48 423 14 69
0 0 0 60 47 56 57
11
128 98 21 87 20 36
84
155 6 33 113 376 59
0 0 0 9 5 0
0 0 0 79 9 38
5
48 64 1 150 83 19
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 0 0 0 0 0
1
17 18 19 20 21 22 2
0
0 129 2 50 83 113
0
18 0 0 43 0 0
7 38 0 0 14
1
0 0 24 0 0 0
77
48 90 83 61 36
0 0 0 0 0
4
0 0 0 0 0
0
22 9 8 19 13 10
69 22 82 200 23 3
3 71 45
3
127 173 95 114 63 194
62
343 355 16 408 238 220
0
7 0 18 4 0
0
0 1 54 27 46
0
0 0 0 0 0
0
0 0 0 0 0
0
24 0 0 42 0 16
0 0 0 20 0 0
1
17 18 19 20 21 22 2
0
0 0 0 0 0 0
12
42 92 15 263 107 49
0
0 0
0 0 0
0 0 0 26 0 22 1
0
0 0 0 0 0 0
3
0 0 6 164 0 0
0 0 0 0 0 0
0
0 0 0 2 10 5
24
10 277 30 156 3,330 23
5 5 3 0 5 4 3 3
27
9 15 0 25 15 6
2
4 8 0 6 1 6
0 20 0 30 0 50
0 0 0 30 0 0
0
0 50 5 50 175 5
0 0 0 30 0 20
0
0 17 5 12 24 0
1
17 18 19 20 21 22 2
0 0 0 0 0 0
10
0 16 7 26 6 2
2
0 12 6 109 58 4
293
20 70 0 245 181 123
47
30 166 0 164 25 2
8
0 5 0 10 34 45
0
20 5 0 0 12 0
0
0 0 0 0 0 2
10 0 0 0 0 0
0 0 0 0 0 0
98
0 56 0 80 53 45
5
10 168 0 435 239 5
0 4 0 48 0 40
0
5 120 0 455 4 2
0
0 0 0 64 249 0
1
0 1 0 1 0 1
0
0 0 0 0 0 0
27
0 155 30 112 200 21
1
17 18 19 20 21 22 2
0 87 60 65 56 60
0
0 0
0
0 0
0 0 1 1 0 0
0
21 4 0 7 0 0
54
0 25 11 39 38 16
33
14 58 17 67 37 20
31
192 82 63 116 143 139
11 74 0 48 40 42
80 63 0 98 10 73 77
30 32 20 68 30 92
3
0 0 0 8 0 0
0
2 0 0 0 0 0
0
0 0 0 0 0
23
0 0 0 68 55 40
5
5 13 0 31 4 2
3 3 0 64 3 13
24 0 0 0 1 11
1
17 18 19 20 21 22 2
44
83 287 90 146 100 88
0
1 0 0 0 2 0
35
54 0 0 66 0 35
0
0 0 0 0 0 0
0
0 0 0 0 19 2
25
160 47 0 62 3 23
23
187 30 10 103 32 22
0 38 7 53 23 29
0 0 0 4 1 2
20
20 58 12 76 25 69
0 21 2 30 35 25
57
66 96 101 113 128 137
0
0 0 0 0 0 0
12
8 31 20 84 54 42
30
0 0 47 44 161 92
18
11 11 0 20 0 0
8 45 17 35 73 60
0
0 0 0 0 0 0
1
17 18 19 20 21 22 2
1
66 7 0 70 4 0
0 0 7 46 30 20
0 0 0 0 0 0
15
30 70 17 149 29 11
0 0 0 0 0 0
0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 1 1
100
301 95 28 112 32 61
0 0 0 0 0 0
0
0 0 0 0 0 0
2 0 0 6 1 4 1
33 46 19 150 33 11
0 0 0 0 0
20
5 50 0 110 20 4
0
34 0 0 14 19 5
54
32 57 8 128 27 36
0 21 8 81 0 37
1
17 18 19 20 21 22 2
0
0 0 0 0 0 0
25 12 1 59 30 48
0
0 0
0
0 0
0
0 0 0 100 10 0
0
0 0 0 0 0 0
1
0 37 0 136 309 12
0
0 0 0 180 0 0
0
0 0 0 140 0 0
0
0 35 0 100 100 0
0 0 0 0 0 0 0
5
11 7 5 22 33 9
0
0 0 0 7 0 0
44
0 285 3 1,127 66 9
0
0 0
0
0 0
219
38 0 100 795 289 163
310
2 900 100 800 845 233
1
17 18 19 20 21 22 2
201
172 290 165 600 362 138
16
0 9 0 13 10 5
8
0 6 0 40 10 1
44 400 0 0 0 288
0 100 200 0 0 200 100

0 0 0 1 0 0
0 0 0 1 1 0
0 1 0 2 0 2
0
0 1 0 26 7 5
0 3 0 3 19 0
8 16 0 0 20 26
22 36 0 1 25 25
0 0 0 0 0 0
1 5 3 6 2 4
0 0 0 0 0 0
6
6 0 0 3 12 0
22
30 29 0 24 24 5
7
0 41 0 36 12 2
1
17 18 19 20 21 22 2
20
2 29 0 51 12 6
2 34 12 36 13 0
0 2 0 0 1 2
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 0 0 0 0 5
0 3 0 5 0 5
0 3 0 20 0 10
1 8 0 30 0 9
0 3 5 30 5 13
7 27 5 30 7 8
0
0 100 100 100 70 100
0
0 100 100 100 100 100
0
0 400 0 450 260 0
0
0 100 100 200 98 100
2,880
900 4,900 1000 4,000 726 587
1,850
1,200 3,900 400 3,000 494 601
0 400 0 100 0 376 200
1
17 18 19 20 21 22 2
100
0 0 0 200 0 200
0 50 0 100 58 125
0 62 0 150 81 32
20 0 0 100 74 65
0 284 7 200 29 300
19
6 176 2 101 196 16
29
2 72 2 90 100 12
21
18 104 10 100 132 18
0 0 0 0
28
0 27 0 50 126 3
0
0 0 0 0 0 20
36
0 92 5 400 139 15
0 0 2 1 1 0
0 0 0 1 6 0
1 0 0 1 1 0
0 0 0 1 5 2
0
0 0 0 0 0 0
8
0 41 6 15 5 16
1
17 18 19 20 21 22 2
4
1 56 0 20 2 10
5 4 11 10 6 1
95
5 53 20 50 95 13
1
0 0 0 2 0 1
130 100 0 300 97 82
45 49 9 179 39 65
0 0 0 0 0 5
0 0 0 0 0 13
0 25 0 0 3 8
0 8 0 0 0 500
3
0 2 0 0 3 5
1,000 2,000 900 1,761 400 982
0
0 0 0 24 2 5
0
0 0 0 27 0 20
0 3 0 0 0 0
0 50 2 0 30 6
0 0 0 0 0 1
10
0 43 0 35 31 9
1
17 18 19 20 21 22 2
10
0 30 0 30 13 7
0 4 0 8 0 2
5 3 1 0 0 3
0 0 0 0 2 0
0 4 0 0 0 3
1
0 1 3 3 0 1
34 49 0 7 25 4
38 24 28 66 3 62
50 100 100 0 400 35
0 100 100 0 200 0
0 100 0 183 350 64
0 3 0 0 0 0
90 75 79 0
97
68 20
1
2 24 0 60 24 4
0
5 0 0 72 12 4
0 1 0 5 0 0
0 2 0 4 0 0
0 2 0 4 0 0
1
17 18 19 20 21 22 2
0 1 0 4 0 0
0 3 0 4 0 2
0
0 0 5 5 10 4
0 70 10 14 16 10
0 50 100 140 50 50
72
0 60 0 160 40 7
15
5 20 10 20 23 7
0
0 0
0
0 0
0 1 0 1 0 0
0 0 0 0 0 0
0 0 1 1 0 1
1 0 0 1 0 1
0 0 0 0 0 1
0 1 0 0 0 1
0 0 1 2 0 0
0 0 0 0 0 0
0 0 0 0 0 1
1
17 18 19 20 21 22 2
0 1 0 0 0 1
0 0 0 0 0 0
0 2 0 3 0 1
4
1 2 1 3 4 2
0 0 0 0 1 0
0 0 1 1 3 1
0 1 0 0 1 0
0 0 0 0 0 0
0 1 0 1 0 1
0 0 0 0 1 1
0 1 0 1 2 2
0 0 0 0 0 0
0 0 0 1 0 0
0 0 0 0 0 0
0 0 1 0 0 0
0 1 0 1 0 0
0 0 0 0 0 0
0 0 0 1 0 0
1
17 18 19 20 21 22 2
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0
0 0 0
0
0 0
0
0 0 0 0 0
10 25 20 24 14 19
0 0 0 0 0 0
0
0 0 0 0 0 10
0 0 0 0 0 0
0
1 0 0 0 0 0
1
0 1 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 0 0 0 0 0
0 1 1 0 0 0
0
0 0 0 0 0 0
1
17 18 19 20 21 22 2
0 1 1 0 0 2
12 142 0 0 0 0
1 1 1 7 2 0
0
0 0 0 0 0 0
0
0 0 0 5 8 0
0
0 0 0 3 0 0
0 0 1 0 0 0
0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 0 0 0 1 0
0
0 0 0 0 0 0
0 0 0 0 0 0
0
0 0 0 0 0 0
0 0 0 0 0 0
0
0 0 0 0 0 3
0 1 1 0 0 1
0 0 0 1 0 0
0 0 0 1 0 0
1
17 18 19 20 21 22 2
1 1 2 0 1 1
0 0 11 0 3
0 0 1 0 0
0 0 0 0 0
0 0 0 0 0
2 2 0 0 5
0 0 1 1 1
0 0 0 0 0
0 0 3 0 0
0 0 0 0 0 0
50 100 50 150 150 110 204

0 0 0 0 0 0
0 0 0 3 0 0
1
17 18 19 20 21 22 2
200
1 2 1
1
17 18 19 20 21 22 2
1,600 550 1,753 881 442 1,180
2 2
2 2 4 1
16 48 10
30 138 30
3 1 8 1 5
370 490 500 494
92 90 50 79
710
212
1 1
88 24 95 50 44 49
80
1
17 18 19 20 21 22 2
525
1
Wonoboyo Tretep Banjarsari
Jumlah
23 24 25
Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II DAK Lain2 APBD II
3,000 992 1,527 0 21,281 0
1,033 612 25,356 0 0
80 0 1,106 0 0
0 50 170 0 0 7,617
180 532 10,940 0 0
0 0 3,415 484 0
744 204 31,842 0 0
660 300 18,127 0 0
2,794 1,057 16,954 0 0
9,960 6,109 192,821 0 0
6,097 2,934 118,902 0 0
300 160 350 2,999 523 1,724

1
Jumlah
23 24 25
1,108 3,043 89,825 0 0
0 0 0 0 0
1,600 900 26,687 0 0
4,801 3,215 108,651 0 0
410 261 5,488 0 0
90 300 0 0 0 3,985
51 88 7,749 0 0
437 105 11,259 0 0
0 0 0 0 0
0 0 90 0 0
0 0 0 0 0
41 258 3,354 0 0
91 0 1,033 0 0
685 380 21,470 0 0
6,544 3,583 139,548 0 0
0 606 380 0 0 8,423
70 152 5,838 0 0
100 0 1,435 0 0
1
Jumlah
23 24 25
0 0 0 0 0 0
289 155 5,533 0 0
100 130 4,743 0 0
134 306 6,697 0 0
0 0 2,123 0 0
607 515 20,526 0 0
100 0 1,170 0 0
90 0 1,856 0 0
0 200 5,529 0 0
20 79 4,671 0 0
615 60 7,352 0 0
0 0 0 0 0 396
445 208 7,971 0 0
0 110 75 0 0 10,191
82 106 5,583 0 0
410 398 12,748 0 0
260 245 263 0 0 10,540
388 150 8,906 0 0
1
Jumlah
23 24 25
677 368 7,315 0 0
80 94 0 0 0 5,779
0 0 0 0 0
220 100 6,883 0 0
0 200 6,881 0 0
100 355 13,972 0 0
0 160 276 0 0 2,916
760 210 345 0 0 11,613
0 180 400 0 0 1,611
0 0 932 0 0
275 100 8,771 0 0
0 0 623 0 0
1,360 400 550 0 0 16,988
5,091 3,270 90,973 0 0
0 160 3,480 0 0
0 120 4,117 0 0
900 502 290 0 0 8,211
2,605 202 21,111 0 0
1
Jumlah
23 24 25
4,802 2,611 64,833 0 0
330 0 3,650 0 0
185 90 100 0 0 3,084
322 250 6,711 0 0
0 0 968 0 0
0 0 865 0 0
0 0 146 0 0
341 145 4,464 0 0
6,671 4,967 147,059 0 0
190 0 6,831 0 0
100 0 2,230 0 0
100 0 1,981 0 0
2,498 860 34,356 0 0
80 0 219 0 0
0 0 1,504 0 0
0 0 355 0 0
0 0 380 0 0
158 234 5,627 0 0
1
Jumlah
23 24 25
0 2 0 0 6 0
400 270 190 0 0 5,751
1,172 670 31,917 0 0
380 90 15,389 0 0
248 350 13,449 0 0
116 100 3,340 0 0
35 81 1,441 0 0
3,111 865 23,664 0 0
0 60 0 0 0 6,196
525 1,190 61,366 0 0
2,536 674 36,871 0 0
375 65 361 0 0 12,360
0 0 0 0 0 410
1,255 493 11,252 0 0
90 0 1,348 0 0
0 0 0 0 0 1,245
1 0 0 0 4 0
1 2 2 0 50 0
1
Jumlah
23 24 25
0 0 0 0 0 0
0 0 0 0 2 0
197 90 4,639 0 0
0 0 100 0 0
0 0 110 0 0
16,076 1,410 275,497 0 0
0 0 0 0 0 0
250 150 100 0 0 3,507
5,442 1,892 129,642 0 0
1,290 1,179 541 0 0 29,170
1,983 0 6,966 0 0
0 0 0 0 0 0
0 0 0 0 0 675
0 100 1,296 0 0
0 0 1,605 0 0
5,466 2,257 69,652 0 0
50 188 400 0 1,903 0
200 334 1,245 0 11,759 0
1
Jumlah
23 24 25
50 0 3,315 0 0
489 365 17,726 0 0
413 80 3,036 0 0
9,400 5,290 2,704 0 0 210,014
856 240 12,242 0 0
0 0 899 0 0
4,117 4,149 94,564 0 0
606 0 19,494 0 0
113 0 818 0 0
1,542 374 25,095 0 0
0 0 342 0 0
58,065 14,880 1,744,024 55,954 0
120 0 110 0 0 1,463
60 0 1,973 0 0
100 0 2,916 0 0
0 0 0 0 0
180 0 2,315 0 0
280 314 158 0 0 5,543
1
Jumlah
23 24 25
4,075 2,143 109,096 0 0
246 220 0 6,901 3,547 0
0 0 0 0 0
4,081 2,444 115,191 0 0
400 410 0 0 9,627 0
0 0 0 0 0
0 0 0 0 0
0 0 250 0 0
81 269 23 0 0 3,239
58 0 781 0 0
35
134 1,974 0 0
175 118 2,974 0 0
5 5 4 0 0 86
117 98 18 0 0 1,074
99 64 1,539 0 0
0 0 5 0 0
0 0 0 0 0
0 0 0 0 0 0
1
Jumlah
23 24 25
158 17 1,690 0 0
0 0 499 0 0
51 45 28 0 0 705
5 0 67 0 0
187 83 2,318 0 0
0 0 0 0 0 0
0 0 36 0 0
26 5 300 0 0
133 101 56 0 0 1,754
9 14 0 0 227
212 33 3,121 0 0
394 167 4,594 0 0
15 2 106 0 0
48 7 633 0 0
0 0 72 0 0
0 0 20 0 0
15 9 466 0 0
0 0 0 0 0 39
1
Jumlah
23 24 25
0 0 28 0 0
39 24 1,683 0 0
0 0 0 0 0
0 0 0 0 0
4 0 107 0 0
0 0 0 0 0
0 0 372 0 0
6 0 0 0 0 6
0 0 79 0 0
25 3 4,625 0 0
5 3 2 38 16 46
23 3 455 0 0
2 5 247 0 0
3 0 10 0 215 0
0 0 0 0 87 0
0 0 334 0 0
0 0 0 0 0 50
0 0 106 0 0
1
Jumlah
23 24 25
0 0 0 0 0 16
3 3 195 0 0
3 0 447 0 0
179 150 3,008 0 0
153 180 1,757 0 0
28 19 409 0 0
0 0 81 0 0
0 1 43 0 0
0 0 1 0 72 0
0 0 0 0 0 0
41 40 1,502 0 0
0 0 1,090 0 0
0 0 0 0 0 111
30 0 1,085 0 0
0 0 423 0 0
0 0 11 0 0
0 0 0 0 0
211 0 1,240 0 0
1
Jumlah
23 24 25
44 24 25 811 554 0
0 0 0 0 0
0 0 0 0 0
0 2 0 0 0 11
0 0 96 0 0
74 43 1,064 0 0
84 40 1,116 0 0
123 78 2,527 0 0
23 40 49 0 0 1,238
105 43 2,129 0 0
1 20 21 0 0 670
9 1 47 0 0
0 0 5 0 0
0 0 0 0 0
45 26 1,114 0 0
4 2 160 0 0
6 12 8 0 0 332
3 0 0 0 0 252
1
Jumlah
23 24 25
0 0 3,044 0 0
5 0 34 0 0
0 42 1,067 0 0
0 0 91 0 0
0 0 54 0 0
18 55 1,423 0 0
117 51 1,597 0 0
15 115 24 0 0 891
2 1 0 0 0 21
121 49 1,859 0 0
16 47 24 0 0 623
174 60 2,411 0 0
0 0 0 0 0
86 11 1,192 0 0
94 23 1,276 0 0
1 31 366 0 0
23 91 54 0 0 1,171
0 0 3 0 0
1
Jumlah
23 24 25
8 3 390 0 0
0 50 33 0 0 520
0 16 0 0 0 64
17 0 932 0 0
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 10
0 0 0 0 0 9
96 62 2,658 0 0
0 0 0 0 0
0 0 34 0 0
0 2 43 0 46
41 92 8 287 0 755
0 0 0 0 0
0 0 289 0 0
7 4 379 0 0
52 8 1,239 0 0
63 24 18 0 0 931
1
Jumlah
23 24 25
0 0 0 0 0
33 45 11 0 0 953
0 0 0 0 0
0 0 0 0 0
0 0 401 0 0
0 0 5 0 0
11 8 678 0 0
0 0 247 0 0
0 0 200 0 0
0 0 295 0 0
0 0 0 0 0
9 6 499 0 0
0 0 10 0 0
22 11 2,864 0 0
0 0 0 0 0
0 0 0 0 0
200 420 7,140 0 0
420 495 11,073 0 0
1
Jumlah
23 24 25
282 195 6,408 0 0
3 0 801 0 0
9 1 238 0 0
0 0 0 0 0 894
0 200 2,565 0 0
1 0 0 0 0 12
1 0 0 0 0 16
0 1 0 0 0 21
10 0 125 0 0
1 10 0 0 0 147
1 23 0 0 0 240
9 21 0 0 0 341
0 8 0 0 0 96
4 3 1 0 0 71
0 2 0 0 0 12
11 4 196 0 0
11 3 426 0 0
9 0 257 0 0
1
Jumlah
23 24 25
12 1 289 0 0
6 14 3 0 0 364
2 3 0 0 0 26
0 0 9 0 0
0 0 9 0 0
1 0 0 0 0 23
1 5 0 0 0 53
3 5 0 0 0 96
0 0 0 0 0 92
7 4 1 0 0 154
1 3 0 0 0 184
100 0 1,181 0 0
100 0 1,242 0 0
0 0 1,538 0 0
0 0 1,253 0 0
600 650 38,798 0 0
800 650 30,553 0 0
0 0 1,200 0 3,606
1
Jumlah
23 24 25
300 300 3,632 0 0
16 44 44 0 0 1,029
185 46 0 0 0 1,113
60 23 52 0 0 1,515
0 9 1 0 0 1,221
13 10 1,071 0 0
3 9 666 0 0
12 8 817 0 0
0 0 0 0
24 8 541 0 0
20 0 56 0 0
8 0 1,034 0 0
5 15 0 0 0 66
5 0 1 0 0 45
1 4 1 0 0 57
6 5 1 0 0 38
0 0 200 0 0
6 1 178 0 0
1
Jumlah
23 24 25
4 5 222 0 0
3 8 4 0 0 152
11 15 954 0 0
1 1 28 0 0
72 352 90 0 0 2,445
26 49 41 0 0 1,472
0 0 1 0 0 31
0 0 0 0 0 42
0 12 0 0 0 193
100 800 100 0 0 6,515
5 0 56 0 0
389 600 600 0 0 30,968
0 0 81 0 0
5 0 76 0 0
1 0 0 0 0 21
45 25 0 0 0 472
0 0 0 0 0 1
6 0 231 0 0
1
Jumlah
23 24 25
6 0 207 0 0
0 2 0 0 0 44
11 3 0 0 0 58
0 0 1 0 23 0
1 0 0 0 0 24
0 0 49 0 0
3 0 1 0 0 275
16 21 25 0 0 697
70 100 44 0 0 2,619
0 20 20 0 1,286 0
100 0 18 0 0 2,733
9 0 0 0 0 138
57 22 1,271 0 115
22 0 305 0 0
9 0 276 0 0
1 2 0 0 0 22
1 2 0 0 0 22
1 2 0 0 0 22
1
Jumlah
23 24 25
1 2 0 0 0 19
1 2 0 0 0 22
5 0 49 0 0
10 5 5 0 0 401
9 42 0 0 0 1,396
50 20 1,052 0 0
31 1 217 0 0
0 0 0 0 0
0 0 0 0 0
1 0 1 0 0 16
0 0 0 0 0 10
1 1 2 0 0 15
1 0 1 0 0 16
0 0 1 0 0 11
1 0 0 0 0 12
1 1 2 0 0 13
1 0 0 0 0 6
0 0 1 0 0 13
1
Jumlah
23 24 25
0 0 0 0 0 12
0 0 0 0 0 1
2 0 1 0 0 24
3 2 70 0 0
1 1 1 0 0 13
1 0 2 0 0 27
1 0 0 0 0 10
0 0 0 0 0 3
1 0 0 0 0 13
1 0 1 0 0 11
0 0 0 0 0 17
0 0 0 0 0 0
2 0 0 0 0 7
0 0 0 0 0 4
1 0 0 0 0 6
1 0 0 0 0 13
0 0 0 0 0 6
0 0 0 0 0 4
1
Jumlah
23 24 25
0 0 0 0 0 2
0 0 0 0 0 3
0 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 1 0 0
20 16 35 0 0 501
0 0 0 0 0 39
0 0 143 0 0
0 0 0 0 2 0
0 0 1 0 0
0 0 3 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0 2
1 0 0 0 0 11
0 0 0 0 0
1
Jumlah
23 24 25
0 0 1 0 0 23
126 0 0 0 826 0
0 0 0 0 0 32
0 0 0 0 0
0 0 13 0 0
0 0 3 0 0
1 0 0 0 0 9
0 0 0 0 0
0 0 0 0 0
0 2 0 0 0 6
0 0 6 0 0
1 1 0 0 0 7
0 0 6 0 0
0 0 0 0 0 20
0 3 22 0 0
1 1 11 0 0
0 0 4 0 0
0 0 4 0 0
1
Jumlah
23 24 25
0 0 1 0 0 20
0 0 0 0 0 35
0 0 0 0 0 3
0 0 0 0 0 0
0 0 0 0 0 0
3 4 3 0 0 58
0 2 0 0 0 32
0 0 0 0 0 0
0 1 2 0 0 14
0 0 0 0 0 2
180 80 2,735 0 0
0 1 0 0 0 3
3 2 1 0 27 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
1
Jumlah
23 24 25
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
100 0 1,148 0
0 0 0
0 0 0
0 11 0
20 1,030 0 0
0 0 0
1
Jumlah
23 24 25
1,328 693 28,557 0 0
3 2 0 0 23
0 0 30
18 0 0
0 0 0
510 0 0
9 347 0 0
198 0 0
2 2 0 0 71
375 460 0 0 8,520
0 0 830
37 83 50 0 0 1,422
0 0 710
0 0 271
1 1 0 12 0
60 0 0 548
100 79 28 0 0 1,462
55 0 235 0
1
Jumlah
23 24 25
0 4 0
100 0 1,995 0
1
PEMERINTAH KABUPATEN TEMANGGUNG
DINAS KESEHATAN
GUDANG OBAT DAN PEBEKALAN KESEHATAN
Jalan Jenderal Sudirman Nomor 81A Temanggung 562018
Telepon ( 0293 ) 491024 Surat Elektronik : gf.temanggung@gmail.com
LAPORAN NILAI OBAT DAN PERBEKALAN KESEHATAN

DI PUSKESMAS SE KABUPATEN TEMANGGUNG
SUMBER ANGGARAN : DAK
Daftar sisa persediaan (Habis Pakai / jual)
Per Akhir Bulan / Tanggal : 31 Desember 2018
No. Nama obat dan Perbekes Satuan Jumlah Barang Harga Satuan (Rp)
1 2 3 4 5
TABLET
1 Alopurinol 100 mg tab 25,356 86.00
2 Alprazolam 0,25 mg tab 1,106 316.00
3 Aminofilin 200 mg tab 10,940 91.00
4 Amitriptilin 25 mg tab 3,415 167.00
5 Amlodipin 5 mg tab 31,842 70.00
7 Amoksisilin 250 mg tab 16,954 195.00
9 Antasida DOEN tab 118,902 62.00
10 Antimigrein tab 2,999 173.00
11 Asam Askorbat 50 mg tab 89,825 105.00
12 Asam Askorbat 250 mg tab - 195.00
13 Asam Folat 0,4 mg tab 26,687 63.00
14 Asam Mefenamat 500 mg tab 108,651 103.00
15 Asetosal 80 mg tab 5,488 148.00
16 Asiklofir 200 mg tab 7,749 249.00
17 Asiklofir 400 mg tab 11,259 349.00
18 Azitromisin 500 mg tab 90 1,900.00
19 Bekarbon / Norit tab - 92.40
20 Betahistin/versilon 6 mg tab 3,354 110.00
21 Bisakodil 5 mg/ Laxana tab 1,033 300.00
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22 Cetirizin 10 mg tab 21,470 89.98
23 Dexametason 0,5 mg tab 139,548 32.00
24 Diazepam 2 mg tab 5,838 86.00
25 Diazepam 5 mg tab 1,435 109.00
26 Digoksin 0,25 mg tab 5,533 97.00
27 Diltiazem 30 mg tab 4,743 134.00
28 Dimenhidrinat 50 mg tab 6,697 104.00
29 Doksisiklin 100 mg kap 2,123 264.00
30 Domperidon 10 mg tab 20,526 118.00
31 Erytromisin 250 mg kap 1,170 546.00
32 Erytromisin 500 mg tab 1,856 750.00
33 Fenitoin Na 100 mg/ Kutoin kap 5,529 158.00
34 Fenobarbital 30 mg tab 4,671 171.00
35 Fitomenadion/ K1 10 mg tab 7,352 710.00
36 Furosemida 40 mg tab 7,971 78.00
37 Garam Oralit tab 5,583 257.00
38 Gemfibrozil 300 mg tab 12,748 380.00
39 Glimepirid 2 mg tab 8,906 207.00
40 Griseovulvin 125 mg tab 7,315 210.00
41 Haloperidol 0,5 mg tab - 52.52
42 Haloperidol 1,5 mg tab 6,883 59.00
43 Haloperidol 5 mg tab 6,881 56.00
44 HCT 25 mg tab 13,972 149.00
45 Ibuprofen 400 mg tab 932 127.00
46 Isosorbid Dinitrat 5 mg tab 8,771 88.00
47 K.Aspartat 300 mg tab 623 647.00
48 Kalk tab 90,973 59.00
49 Kalsium Karbonat 500 mg/ Calporos tab 3,480 430.00
50 Kandersatan 8 mg tab 4,117 519.00
51 Kaptopril 12,5 mg tab 21,111 62.00
52 Kaptopril 25 mg tab 64,833 84.00
53 Karbamazepim 200 mg tab 3,650 230.00
54 Ketokonazol 200 mg tab 6,711 280.00
55 Klobazam 10 mg tab 968 970.00
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1 2 3 4 5
56 Klonidin 0,15 mg tab 865 184.00
57 Kloramfenikol 250 mg tab 146 240.00
58 Kloramfenikol 500 mg kap 4,464 1,089.95
59 Klorfeniramin Maleat/ CTM 4 mg tab 147,059 42.00
60 Klorpromazin 100 mg tab 6,831 147.00
61 Klozapin 100 mg tab 2,230 3,288.00
62 Kodein 10 mg tab 1,981 550.00
63 Kotrimoksazol 480 mg tab 34,356 150.93
64 Levofloksasin 500 mg tab 219 495.00
65 Lisinopril tab 5 mg tab 1,504 209.00
66 Litium Karbonat 400 mg/ Frimania tab 355 1,672.00
67 Loperamid 2 mg tab 380 89.00
68 Loratadin 10 mg tab 5,627 123.00
69 Metformin 500 mg tab 31,917 96.00
70 Metil Prednisolon 4 mg tab 15,389 150.00
72 Metilergometrin 0,125 mg tab 3,340 211.00
73 Metoklopramid 10 mg tab 1,441 90.00
74 Metronidazol 500 mg tab 23,664 160.00
75 N-Asetil Sistein 200 mg kap 61,366 426.00
76 Natrium Diklofenak 50 mg tab 36,871 115.00
77 Nifedipin 10 mg tab 11,252 100.00
78 Nistatin tab 500.000 IU/ g tab 1,348 745.00
79 Omeprazol 20 mg tab 4,639 130.00
80 Ondansetron 4 mg tab 100 472.00
81 Papaverin 40 mg tab 110 119.00
82 Parasetamol 500 mg tab 275,497 56.00
83 Piridoksin/ B6 10 mg tab 129,642 118.00
84 Prednison 5 mg tab 6,966 68.00
85 Propanolol 40 mg tab 1,296 74.00
86 PTU 100 mg tab 1,605 279.00
87 Ranitidin 150 mg tab 69,652 105.00
88 Risperidon 2 mg tab 3,315 273.00
89 Salbutamol 2 mg tab 17,726 59.00
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1 2 3 4 5
91 Sefadroksil 500 mg tab 12,242 550.00
92 Sefiksim 100 mg tab 899 590.00
93 Sianokobalamin / B12 50 mcg tab 94,564 51.00
94 Simvastatin 10 mg tab 19,494 131.00
95 Simvastatin 20 mg tab 818 205.00
96 Siprofloksasin 500 mg tab 25,095 281.07
97 Spironolakton 100 mg tab 342 876.00
98 Tablet Tambah darah tab 1,744,024 354.00
99 Teofilin 150 mg tab 1,973 250.00
100 Teofilin SR / Retaphyl SR tab 2,916 1,050.00
101 Tetrasiklin 250 mg tab - -
102 Tetrasiklin 500 tab 2,315 309.99
103 Tiamin 50 mg/ B1 tab 109,096 86.00
104 Triheksifenidil 2 mg tab 6,901 85.00
105 Vitamin B komplek tab 115,191 115.00
106 Zink 20 mg tab - 473.00
SYRUP
1 Albendazol susp 200mg/ 5 ml btl 250 4,000.00
2 Ambroxol sirup 15 mg/ 5 ml btl -
3 Amoksisilin sir 250 mg/ 5 ml btl 781 3,400.00
4 Amoksisilin sirup 125 mg/ 5 ml btl 1,974 2,090.00
5 Antasida DOEN susp btl 2,974 2,025.00
6 Domperidon sirup 5 mg/ 5 ml btl 1,539 2,700.00
7 Domperidon tetes 5 mg/ ml btl 5 15,599.76
8 Erytromisin sirup 200 mg/ 5 ml btl - 7,700.00
9 Ibuprofen susp 100mg/5ml btl 1,690 2,475.00
10 Ibuprofen Susp 200 mg/ 5 ml btl 499 4,465.00
11 Kloramfenikol susp 125 mg/ 5 ml btl 67 3,955.00
12 Kotrimoksazol suspensi btl 2,318 2,140.00
13 Metokloperamid drops btl 36 5,280.00
14 Metronidasol sirup btl 300 3,800.00
15 Parasetamol drops btl 3,121 5,200.00
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1 2 3 4 5
16 Parasetamol sirup 120 mg/ 5 ml btl 4,594 1,106.00
17 Salbutamol sirup btl 106 4,446.00
18 Sefadroksil sirup 125 mg/ 5 ml btl 633 3,922.00
20 Setirizin sirup btl 20 6,745.00
21 Sukralfat susp btl 466 6,789.00
22 Zink drops 10 mg/ml btl 28 10,798.70
23 Zink sirup btl 1,683 6,290.00
INJEKSI
1 Aminofilin injeksi 24 mg/ ml amp 107 1,823.00
2 Aqua pro injeksi btl 372 2,750.00
3 Atropin Sulsat inj amp 79 1,540.00
4 Dexametason injeksi 5 mg/ ml amp 4,625 1,400.00
Diazepam inj 5 mg/ ml amp 38 1,712.70
5 Difenhidramin injeksi 10 mg/ ml amp 455 1,050.00
6 Epinefrin injeksi 0,1 % amp 247 1,749.00
7 Fenobarbital inj 50 mg/ ml amp - 1,740.00
8 Flufenazin inj 25mg/ml - Sikzonoate amp - 57,500.00
9 Furosemid inj 10 mg/ ml amp 334 1,516.00
10 Glukonas Calcicus inj 10% amp 106 9,955.00
11 Human Tetanus Imuno 250 UI amp 195 176,800.00
12 Ketorolac inj 30 mg/ml amp 447 1,290.00
13 Lidokain Comp. inj amp 3,008 1,152.00
14 Lidokain inj 2% amp 1,757 1,144.00
15 Metilergometrin inj amp 409 2,959.00
16 Meylon / Na Bic inj amp 81 6,200.00
17 MgSO4 20% amp 43 3,200.00
18 MgSO4 40% amp - 3,650.00
19 Oksitosin injeksi 10 UI/ ml amp 1,502 1,900.00
20 Ondansetron 4 mg inj amp 1,090 1,070.00
21 Ranitidin inj 25 mg/ 2 ml amp 1,085 1,390.00
22 Sefotaksim 1 gr/ vial amp 423 4,200.00
23 Serum ABU I / Biosave vial 11 462,000.00
Page 150
1 2 3 4 5
24 Sianokobalamin inj 500 mcg/ ml amp 1,240 1,098.00
25 Vit K1/Fitomenadion inj 2 mg/ml amp 811 3,682.00
OBAT LUAR
1 Antibakteri SK tube 96 2,924.00
2 Antifungi sk pot 1,064 4,496.00
3 Antihemoroid supp supp 1,116 3,045.00
4 Asam Fusidat krim 20mg/g - Acdat tube 2,527 5,997.00
5 Betametason krim 0,1 % tube 2,129 1,348.00
6 Bisakodil sup anak supo - 5,800.00
7 Bisakodil sup dws supo 47 5,800.00
8 Budesonid/ Pulmicort res 0,25mg/ m btl 5 9,724.99
9 Desoksimetason krim tube 1,114 10,400.00
10 Diazepam Rectal 5mg/2,5ml - Stesol tube 160 11,517.00
11 Etakridin Larutan 0,1 % btl - 3,000.00
12 Etanol 70% 100 ml btl 3,044 2,500.00
13 Feneterol HBr/ Berotec inh btl 34 83,190.00
14 Fenol gliserol TT 10 % btl 1,067 2,590.00
15 Flusinolon Asetat 0.025% tube 91 2,400.00
16 Framisetin tulle/ Daryanttulle lbr 54 8,989.97
17 Gentamisin SM tube 1,423 2,675.00
18 Gentamisin TM 0,3 % btl 1,597 4,232.00
19 Hidrokortison krim 2,5 % tube 1,859 2,798.00
20 Ketokonazol krim 2 % tube 2,411 2,569.00
21 Klobetasol 0,05% krim tube - 4,000.00
22 Kloramfenikol SM 1 % tube 1,192 1,881.00
23 Kloramfenikol SK 2% tube 1,276 3,008.00
24 Kloramfenikol TM btl 366 3,250.00
25 Lidokain Spray 10%/ Xylocaine btl 3 170,399.90
26 Mikonazol krim 2 % tube 390 3,000.00
27 Nistatin tab vag 100.000 UI/ g supp 932 523.00
28 Permetrin krim 5%/ Scabimite krim tube 2,658 12,155.00
29 Polikresulen btl 34 17,393.00
30 Povidon Iodida 300 ml btl 43 18,000.00
Page 151
1 2 3 4 5
31 Povidon Iodin 30 ml btl 287 2,900.00
32 Salbutamol inh 100 mcg/ Ventolin In btl - -
33 Salbutamol neb/ Ventolin Nebuliser tube 289 3,999.98
34 Salep 2-4 pot 379 2,527.00
35 Salisil bedak pot 1,239 1,025.00
36 Tetrakain TM btl - 11,500.00
INFUS
1 Assering btl 401 9,646.00
2 Glucosa 40% btl 5 1,452.00
3 Glucosa 5% btl 678 6,900.00
4 Ka-En 3A btl 247 10,050.00
5 Ka-En 3B btl 200 10,696.00
6 Ka-En Mg 3 btl 295 9,599.67
7 NaCl btl 499 6,410.00
Parasetamol 10 mg/ml infus btl 10 11,610.00
8 RL btl 2,864 7,150.00
BMHP
1 Alat suntik 1 ml set 7,140 1,694.00
2 Alat suntik 3 ml set 11,073 968.00
3 Alat suntik 5 ml set 6,408 1,310.00
4 Alat Suntik 10 ml set 801 924.00
5 Alat Suntik 20 ml set 238 1,499.30
6 Alat suntik ADS 0.5 ml (Soloshot Mi set 2,565 1,655.50
7 Alkohol Swab box 125 10,000.00
8 Cat gut Chromic No. 2/0 DS 24 mm biji 196 40,200.00
9 Cat gut Chromic No. 2/0 HR 37 mm biji 426 32,800.00
10 Catgut Chromic 3/0 DS 24 mm biji 257 41,740.02
11 Cat gut Plain No. 2/0 DS 24 mm biji 289 40,198.39
12 Endotracheal Tube - 2.0 biji 9 18,530.00
14 Gelang ID Pasien anak biru biji 1,181 850.00
15 Gelang ID Pasien anak pink biji 1,242 850.00
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1 2 3 4 5
16 Gelang ID Pasien dewasa biru biji 1,538 850.00
17 Gelang ID Pasien dewasa pink biji 1,253 850.00
18 Handschoen Disposible (M) biji 38,798 462.00
19 Handschoen Disposible (S) biji 30,553 462.00
20 Handschoen Nitril (M) biji 1,200 627.00
21 Hansdchoen Nitril (S) biji 3,632 627.00
22 Infusion set dewasa biji 1,071 7,920.00
23 IV Catheter No. 18 biji 666 7,700.00
25 IV Catheter No. 22 biji - 7,700.00
27 IV Catheter No.20 with port set 56 16,100.00
28 IV Catheter No.22 with port set 1,034 16,100.00
29 Jelly 5 gr/ My Jelly sach 200 2,200.59
30 Kanul Oksigen Anak biji 178 10,000.00
31 Kanul Oksigen Dewasa biji 222 10,000.00
32 Kasa 2 m x 80 cm rol 954 9,449.99
33 Kasa 36 x 80 cm rol 28 130,000.00
34 Lysol 1 L btl 56 41,000.00
35 Masker Oksigen anak set 81 19,800.00
36 Masker Oksigen dewasa set 76 19,800.00
37 Nebulizer with masker anak set 231 28,300.00
38 Nebulizer with masker dewasa set 207 28,300.00
39 Onescrub 500 cc btl 49 62,500.00
40 Savety box biji 1,271 15,715.35
41 Silk 2/0 DS 24 mm sac 305 23,300.00
42 Silk 3/0 DS 24 mm sac 276 22,400.00
43 Three way stop cock biji 49 3,249.84
44 Underpad Steril lbr 1,052 7,626.00
45 Urine bag biji 217 5,005.00
GIGI
1 Eugenol btl 70 16,667.00
Page 153
1 2 3 4 5
LABORAT
1 Ammonium oxalat 1 % btl 1 150,000.00
2 Botol sampel darah 20 ml btl 143 4,400.00
3 Bufer 1 L btl 1 80,000.00
4 Eosin 2 % btl 3 230,000.00
5 Hayem btl - 220,000.00
6 Kertas EKG 63 30 mm rol 13 90,200.00
7 Kertas EKG AT 1: 90x90mm box 3 320,000.00
8 Metanol btl 6 88,000.00
9 Na citrat 3,8 % btl 6 27,500.00
10 Pipet tetes biji 22 495.00
11 Reagen golongan darah btl 11 234,909.12
12 Salmonella Thypi H Widhal Test set 4 66,660.00
13 Salmonella Thypi O Widhal Test set 4 66,660.00
14 Tes kehamilan sach 2,735 1,199.02
OBAT BARU 2018

1 Sukralfat tab - 368.00
2 Trifluoperazin tab 1,030 269.00
3 Atalpulgit/ New Antides tab 28,557 136.00
4 Jelly 82 gr/ My Jelly tube 18 29,549.00
5 Na Divalproat 250 mg (Depakote) tab 510 1,200.00
6 Nistatin drops btl 347 12,272.70
7 Omeprazole injeksi amp 198 9,898.00
JUMLAH
Temanggung, Januari 2018

Kepala UPTD Gudang Obat
dan Perbekalan Kesehatan
Palupi,S.Si.Apt
NIP.19750711 200312 2 002
Page 154
GUNG
N
ESEHATAN
ng@gmail.com
KESEHATAN
GGUNG
al)
2018
Jumlah Harga (Rp) Ket.
2,180,616.00
349,496.00
995,540.00 hrg 91
570,305.00
2,228,940.00
1,685,811.00
3,306,030.00
44,734,472.00
7,371,924.00
518,827.00
9,431,625.00 hrg 105
- habis, sdh lama tdk py (cek tlogomulyo)
1,681,281.00
11,191,053.00 hrg 103
812,224.00 hrg 148
1,929,501.00 hrg 249
3,929,391.00
171,000.00
-
368,940.00
309,900.00
Page 155
6
1,931,870.60
4,465,536.00
502,068.00
156,415.00
536,701.00
635,562.00
696,488.00
560,472.00
2,422,068.00
638,820.00 hrg 546
1,392,000.00 hrg 750
873,582.00 hrg 158
798,741.00 hrg 171
5,219,920.00
621,738.00
1,434,831.00
4,844,240.00
1,843,542.00 hrg 207
1,536,150.00
-
406,097.00 hrg 59
385,336.00
2,081,828.00
118,364.00
771,848.00
403,081.00
5,367,407.00
1,496,400.00
2,136,723.00
1,308,882.00 hrg 62
5,445,972.00
839,500.00
1,879,080.00
938,960.00
Page 156
6
159,160.00
35,040.00
4,865,536.80
6,176,478.00
1,004,157.00
7,332,240.00 hrg 3288
1,089,550.00
5,185,351.08
108,405.00
314,336.00 hrg 209
593,560.00
33,820.00
692,121.00
3,064,032.00 hrg 96
2,308,350.00
4,034,700.00
704,740.00
129,690.00
3,786,240.00
26,141,916.00
4,240,165.00 hrg 115
1,125,200.00
1,004,260.00
603,070.00
47,200.00
13,090.00
15,427,832.00
15,297,756.00
473,688.00
95,904.00
447,795.00
7,313,460.00
904,995.00
1,045,834.00
Page 157
6
212,520.00
6,733,100.00 hrg 550
530,410.00
4,822,764.00
2,553,714.00
167,690.00
7,053,451.65
299,592.00
617,384,496.00
493,250.00
3,061,800.00
-
717,626.85
9,382,256.00
586,585.00
13,246,965.00
-
1,000,000.00
-
2,655,400.00 hrg 3400
4,125,660.00
6,022,350.00
4,155,300.00 hrg 2700
77,998.80
-
4,182,750.00
2,228,035.00
264,985.00
4,960,520.00
190,080.00
1,140,000.00
16,229,200.00
Page 158
6
5,080,964.00 hrg 1106
471,276.00
2,482,626.00
427,680.00
134,900.00
3,163,674.00
302,363.60
10,586,070.00
195,061.00
1,023,000.00
121,660.00
6,475,000.00
65,082.60
477,750.00
432,003.00
-
-
506,344.00
1,055,230.00 DAK
34,476,000.00
576,630.00
3,465,216.00
2,010,008.00 hrg 1144
1,210,231.00
502,200.00
137,600.00
- program
2,853,800.00
1,166,300.00
1,508,150.00
1,776,600.00
5,082,000.00
Page 159
6
1,361,520.00
2,986,102.00
280,704.00
4,783,744.00
3,398,220.00
15,154,419.00
2,869,892.00
-
272,600.00
48,624.95
11,585,600.00
1,842,720.00
-
7,610,000.00
2,828,460.00
2,763,530.00 hrg 2590
218,400.00
485,458.38
3,806,525.00 hrg 2675
6,758,504.00 hrg 4231
5,201,482.00
6,193,859.00
-
2,242,152.00 hrg 1881
3,838,208.00
1,189,500.00
511,199.70
1,170,000.00
487,436.00 hrg 523
32,307,990.00
591,362.00
774,000.00 sbag apbd
Page 160
6
832,300.00 sbag apbd
-
1,155,994.22
957,733.00
1,269,975.00
-
3,868,046.00 hrg 9646

7,260.00
4,678,200.00
2,482,350.00
2,139,200.00 hrg 10.696
2,831,902.65
3,198,590.00
116,100.00
20,476,885.00
12,095,160.00
10,718,664.00
8,394,480.00
740,124.00
356,833.40
4,246,357.50
1,250,000.00 hrg 10.000
7,879,200.00
13,972,800.00
10,727,185.14
11,617,334.71
166,770.00
166,770.00
1,003,850.00
1,055,700.00
Page 161
6
1,307,300.00
1,065,050.00
17,924,676.00
14,115,486.00 hrg 462
752,400.00
2,277,264.00
8,482,320.00
5,128,200.00
6,290,900.00 hrg 7.700
- hrg 7.700. tp pusk tdk py stok
4,706,700.00 DAK
901,600.00
16,647,400.00
440,118.00 My Jely 5 gr : selo, tembarak, kranggan, prings, traji, kedu
1,780,000.00
2,220,000.00
9,015,290.46
3,640,000.00
2,296,000.00
1,603,800.00
1,504,800.00
6,537,300.00
5,858,100.00
3,062,500.00
19,974,209.85
7,106,500.00
6,182,400.00
159,242.16
8,022,552.00
1,086,085.00
1,166,690.00
Page 162
150,000.00
629,200.00
80,000.00
690,000.00
-
1,172,600.00
960,000.00
528,000.00
165,000.00
10,890.00
2,584,000.32
266,640.00
266,640.00
3,279,319.70 hrg 1199,02
-
277,070.00
3,883,752.00
531,882.00
612,000.00
4,258,626.90
1,959,804.00
Rp 1,502,028,974.02

Palupi,S.Si.Apt
NIP.19750711 200312 2 002
Page 163
n, prings, traji, kedu
Page 164
DINAS KESEHATAN

SUMBER ANGGARAN : APBD II

Satua Jumlah Harga Satuan

No. Nama obat dan Perbekes Jumlah Harga (Rp)
n Barang (Rp)
1 2 3 4 5 6
TABLET
1 Ambroxol 30 mg tab 7,617 201.30 1,533,302
2 Antimigrein tab 1,724 5,625.40 9,698,190
3 Asifit kap 3,985 1,026.67 4,091,267
4 Bisakodil 5 mg/ Laxana tab - 614.90 -
5 Dextral tablet tab 8,423 506.00 4,262,038
6 Flunarizin 10 mg tab 396 1,232.00 487,872
7 G.G 100 mg/ Guaifenesin 100 tab 10,191 179.96 1,833,972
8 Glibenklamid 5 mg tab 10,540 56.00 590,240
9 Haemorogard tab 5,779 1,552.10 8,969,586
10 Hepagard tab 2,916 2,794.00 8,147,304
11 Hiosina + Metampiron/ Dormi tab 11,613 2,069.00 24,027,297
12 Ibuprofen 200 mg tab 1,611 110.00 177,210
13 Kalium Diklofenak 50 mg tab 16,988 694.32 11,795,108
14 Kaolin + Pectin tab/ Omegdiar tab 8,211 453.04 3,719,870
15 Karbazokrom 10 mg/ Adona tab 3,084 1,980.00 6,106,320
Page 165
n Barang (Rp)
1 2 3 4 5 6
16 Ketokonazol 200 mg tab - 300.00 -
17 Klozapin 100 mg tab - 5,000.00 -
18 Kodein 10 mg tab - 500.00 -
19 Meloksikam 15 mg tab 5,751 759.00 4,365,009
20 Na Bikarbonat 500 mg tab 6,196 40.70 252,177
21 Neurotropik tab/ Corsaneuron tab 12,360 757.90 9,367,644
22 New Pro Uric kap 410 889.17 364,560
23 Nifedipin 10 mg tab - 100.00 -
24 Nodiar tab 1,245 453.04 564,035
25 Ondansetron 4 mg tab - 716.00 -
26 Piracetam 800 mg tab 3,507 783.20 2,746,682
27 Piridoksin/ B6 10 mg tab - 110.00 -
28 Piroksikam 20 mg tab 29,170 163.79 4,777,754
29 Pro Lipid tab 675 858.00 579,150
30 Salbutamol 2 mg tab - 59.00 -
31 Samcobion kap 210,014 429.00 90,096,006
32 Tablet Tambah darah tab - 352.00 -
33 Tensigard tab 1,463 2,112.00 3,089,856
34 Tiamfenikol 500 mg tab 5,543 1,446.50 8,017,950
35 Tiamin 50 mg/ B1 tab - 58.96 -
36 Vitalamin tab - 499.40 -
SYRUP
1 Ambroxol sirup 15 mg/ 5 ml btl 3,239 5,148.00 16,674,372
2 Batugin elixir btl 86 21,450.00 1,844,700
Page 166
n Barang (Rp)
1 2 3 4 5 6
3 Dextrofen sirup btl 1,074 8,046.50 8,641,941
4 Haloperidol drops 2 mg/ml (L btl - 16,500.00 -
5 Kaolin + Pectin syr/ Kanina btl 705 5,720.00 4,032,600
6 Laxadin susp btl - 12,449.80 -
7 OBH btl 1,754 5,797.00 10,167,938
8 Pacdin Vitcur sirup btl 227 8,140.00 1,847,780
9 Tiamfenikol sirup btl 39 10,648.00 415,272
INJEKSI
1 Aqua pro injeksi btl - 2,200.00 -
2 Asam Traneksamat inj amp 6 6,199.60 37,198
3 Diazepam inj 5 mg/ ml amp 46 12,540.00 576,840
4 Gentamisin inj 40 mg/ ml amp 50 3,399.00 169,950
5 Haloperidol inj i.m. 5 mg/ml (L amp 16 6,250.00 100,000
6 Piracetam 1 gr/ 5 ml amp 111 5,445.00 604,395
7 Serum ABU I / Biosave vial - 473,000.00 -
OBAT LUAR
1 Alkohol 96 % 1 L btl 11 75,600.00 831,600

2 Asiklovir krim 5 % tube 1,238 2,860.00 3,540,680
3 Bisakodil sup anak supo 670 4,990.00 3,343,300
4 Enkasari btl 332 17,863.00 5,930,516
5 Etakridin Larutan 0,1 % btl 252 2,550.00 642,600
6 Gentien Violet 1 % btl 891 2,750.00 2,450,250
7 Gliserin btl 21 4,500.00 94,500
Page 167
n Barang (Rp)
1 2 3 4 5 6
8 Ikhtiol SK btl 623 4,950.00 3,083,850
9 Kloramfenikol TT 3 % btl 1,171 7,590.00 8,887,890
10 Minyak ikan SK pot 520 3,300.00 1,716,000
11 Mometason krim tube 64 17,820.00 1,140,480
12 Perak Sulfadiazin/ burnazin tube 10 22,999.90 229,999
13 Perhidrol/ H2O2 btl 9 23,980.00 215,820
14 Permetrin krim 5%/ Scabimite tube - 11,473.00 -
15 Permetrin lotion 1%/ Peditox btl - 4,568.30 -
16 Polikresulen btl - 17,393.00 -
17 Povidon Iodida 300 ml btl 46 18,000.00 828,000
16 Povidon Iodin 30 ml btl 755 2,900.00 2,189,500
19 Sulfasetamid TM 15 % btl 931 9,350.00 8,704,850
20 Triamcinolon/ Bufacomb tube 953 16,500.00 15,724,500
INFUS
1 Parasetamol 10 mg/ml infus btl - 22,000.00 -
BMHP
1 Alat suntik ADS 0.05 ml set 894 3,575.00 3,196,050
2 Alkazym 250 mg sack 12 800,978.20 9,611,738
3 Alkacide 1 L High Level btl 16 2,702,700.00 43,243,200
4 Alkohol 70 % 1 L btl 21 21,500.00 451,500
5 Alkohol swab 2 % box 147 15,730.00 2,312,310
6 Aseptan Liquid 500 cc btl 240 30,000.00 7,200,000
7 Aseptic Gel 500 cc btl 341 22,000.00 7,502,000
Page 168
n Barang (Rp)
1 2 3 4 5 6
8 Bioplacentol tulle lbr 96 10,607.96 1,018,364
9 Bisturi box 71 83,600.00 5,935,600
10 Bracket Hand Wash Plastik biji 12 17,600.00 211,200
11 Cat gut Plain No. 3/0 DS 24 m biji 364 5,583.33 2,032,332
12 Cover Glass/ Deck Glass box 26 144,605.53 3,759,744
13 Feeding Tube FR 5 biji 23 3,564.00 81,972
14 Feeding Tube FR 8 biji 53 7,700.00 408,100
15 Female Catheter No. 14 biji 96 5,720.00 549,120
16 Foley cateter No. 14 biji 92 13,090.00 1,204,280
19 Handschoen Nitril (M) biji 3,606 627.00 2,260,962
20 Hansdchoen Nitril (S) biji - 627.00 -
21 Handschoon panjang/obgin ster psg 1,029 30,000.00 30,870,000
22 Handscoon steril no 7 psg 1,113 7,865.00 8,753,745
23 Handscoon steril no. 7,5 psg 1,515 7,865.00 11,915,475
24 Infusion set anak biji 1,221 7,920.00 9,670,320
25 IV Catheter No. 24 biji - 8,748.40 -
26 Jarum Jahit Kulit No. 10 biji 66 26,317.50 1,736,955
27 Jarum Jahit Kulit No. 15 biji 45 16,390.00 737,550
28 Jarum Jahit Mukosa No. 10 biji 57 26,317.50 1,500,098
29 Jarum Jahit Mukosa No. 15 biji 38 16,390.00 622,820
30 Kanul Oksigen Dewasa biji - 10,000.00 -
31 Kapas 250 g bks 152 24,000.00 3,648,000
32 Kasa 2 m x 80 cm rol - 7,700.00 -
Page 169
n Barang (Rp)
1 2 3 4 5 6
33 Kasa 4 m x 10 cm rol 2,445 1,500.00 3,667,500
34 Kassa steril rol 1,472 8,000.00 11,776,000
35 Kondom kateter ( M ) biji 31 6,300.00 195,300
36 Kondom kateter ( S ) biji 42 6,300.00 264,600
37 Lidi Kapas Non Steril pak 193 27,500.00 5,307,500
38 Lidi Kapas Steril biji 6,515 1,120.00 7,296,800
39 Lysol 1 L btl - 41,000.00 -
40 Masker disposible biji 30,968 440.00 13,625,920
41 Masker Oksigen cungkup set 21 13,750.00 288,750
42 Mucus Extractor set 472 10,120.00 4,776,640
43 N2O gas tbg 1 3,250,000.00 3,250,000
44 Non Adhesive Bandage 10 x 4,5 rol 44 66,973.50 2,946,834
45 Object Glass box 58 12,650.00 733,700
46 Object Glass Frosted box - 20,747.75 -
47 Oksigen gas tbg 24 66,000.00 1,584,000
48 Plester rol 275 12,076.00 3,320,900
49 Plester putih/ hipavix 5 cm biji 697 55,000.00 38,335,000
50 Pot Sputum biji 2,619 1,540.00 4,033,260
51 Pot Urin biji 2,733 440.00 1,202,520
52 Sabun Cuci Tangan/ Softaskin btl 138 58,538.70 8,078,341
53 Savety box biji 115 15,708.00 1,806,420
54 Suction catether no FR 8 biji 22 3,520.00 77,440
Page 170
n Barang (Rp)
1 2 3 4 5 6
59 Tranfusi set biji 401 8,646.00 3,467,046
60 Umbilical cord klem nylon steri biji 1,396 1,299.98 1,814,772
61 Underpad Steril lbr - 7,626.15 -
GIGI
1 Bonding Composite box 16 880,610.00 14,089,760
2 Bur Polish Composite set 10 44,000.00 440,000
3 Cavit box 15 154,000.00 2,310,000
4 Composit warna A2 box 16 363,800.00 5,820,800
5 Composit warna A3 box 11 363,800.00 4,001,800
6 Dentin Conditioner btl 12 121,000.00 1,452,000

7 Devitalisasi Pasta Non Arsen btl 13 220,000.00 2,860,000
8 Disclosing Solution btl 6 55,000.00 330,000
9 Disposible Dental Suction/ Sali box 13 79,373.80 1,031,859
10 Disposible Mikro Aplikator box 12 165,000.00 1,980,000
11 Etil klorid btl 1 90,200.00 90,200
12 Etsa Asam box 24 178,690.00 4,288,560
13 Forinokresol / T K F btl 13 66,000.00 858,000
14 Glass Ionomer Cement - Fuji I btl 27 781,000.00 20,696,500
15 Glass Ionomer Cement - Fuji VI btl 10 686,400.00 6,520,800
16 Iodoform Pasta pot 3 176,000.00 528,000
17 Kalsium hidroksida pasta set 13 159,500.00 2,073,500
18 Klorfenol/CHKM btl 11 55,000.00 605,000
19 Mata Bur high speed set 17 165,000.00 2,805,000
Page 171
n Barang (Rp)
1 2 3 4 5 6
20 Mumifying pasta btl 7 616,000.00 4,312,000
21 OCO btl 4 125,400.00 501,600
22 Pasta pengisi saluran akar/ Vita btl 6 265,000.00 1,590,000
23 Semen seng fosfat set 13 165,000.00 2,145,000
24 Sodium Hipochloride btl 6 78,100.00 468,600
25 Spons Gelatin/ Hemospon biji 4 84,700.00 338,800
26 T S Fletcher set 2 35,999.99 72,000
27 Tips Scaler ART biji 3 220,000.00 660,000
28 Tips Scaler Woodpecker biji - 132,000.00 -
LABORAT
1 Blood lancet box 501 19,965.00 10,002,465
2 Botol sampel darah 10 ml btl 39 2,400.00 93,600
3 Giemsa pekat btl 2 198,000.00 396,000
4 H2SO4 btl 11 18,612.00 204,732
5 HCl 0,1 N btl 23 9,317.00 214,291
6 Jelly EKG btl 32 126,500.00 4,048,000
7 Kertas lensa sach 9 60,005.00 540,045
8 Larutan EDTA btl 6 52,800.00 316,800
9 Minyak immersi btl 7 483,120.00 3,381,840
10 Object glass box 20 12,650.00 253,000

11 Pipet tetes biji - 1,400.00 -
12 Spiritus btl 20 23,408.00 468,160
13 Stik gula darah Accucheck Perf btl 35 276,100.00 9,663,500
14 Stik asam urat Nesco btl 3 102,047.00 306,141
Page 172
n Barang (Rp)
1 2 3 4 5 6
15 Stik asam urat UA Sure btl - 323,400.00 -
16 Stik cholesterol Accutrend btl - 384,175.00 -
17 Stik gula darah gluco DR btl 58 189,420.00 10,986,360
18 Stik gula darah Nesco btl 32 96,360.00 3,083,520
19 Stik trigliserid Accutrend btl - 447,810.00 -
20 Stik urinalisa 3 parameter btl 14 330,000.00 4,620,000
21 Stik urinalisa 10 parameter btl 2 660,000.00 1,320,000
22 Tes kehamilan sach - 1,939.00 -
23 Turk btl 3 29,051.00 87,153
OBAT BARU 2018
1 Stik Cholesterol Benecheck btl 23 231,000.00 5,313,000
2 Stik Gula Darah Benecheck btl 30 149,600.00 4,488,000
3 Stik Asam Urat Benecheck btl 71 126,500.00 8,981,500
4 Panviton tab 8,520 1,173.33 9,996,738
5 Naia tab 830 1,664.67 1,381,673
6 Intunal syr btl 1,422 12,430.00 17,675,460
7 Mekobalamin kap 710 869.00 616,990
8 Biocombin inj amp 271 5,390.00 1,460,690
9 Larsi kap 548 1,026.67 562,613
10 Omevita syr btl 1,462 5,393.00 7,884,566
JUMLAH Rp 788,550,633.88

Page 173
n Barang (Rp)
1 2 3 4 5 6
Palupi,S.Si.Apt
NIP.19750711 200312 2 002
Page 174
NG
HATAN
anggung@gmail.com
EHATAN
Keterangan
7
sbag DAK
larsi hrg 1026,67
hrg 2069
Page 175
Keterangan
7
hrg 759
hrg 757,9
hrg 783,2
pare
hrg 2112
Page 176
Keterangan
7
hrg 5720
rejo, pring, kal, par, gmw, ngadi, wono, tretep
hrg 10.648
DAK sbg buffer, apbd tdk py
hrg 5445
hrg 2860
Page 177
Keterangan
7
hrg 7590
Page 178
Keterangan
7
hrg 30.000
hrg 7865
hrg 7920
DAK
Page 179
Keterangan
7
hrg 8.000
Page 180
Keterangan
7
hrg 8646
Page 181
Keterangan
7
traji, ngadi
Page 182
Keterangan
7
ung, Januari 2018

UPTD Gudang Obat
bekalan Kesehatan
Page 183
Keterangan
7
lupi,S.Si.Apt
0711 200312 2 002
Page 184
DINAS KESEHATAN

DI PUSKESMAS SE KABUPATEN TEMANGGUNG
SUMBER ANGGARAN : APBD I (Buffer Prof) dan Program

n Barang (Rp)
1 2 3 4 5 6
TABLET
1 Albendazol 400 tab 21,281 288.00 6,128,928
Amitriptilin 25 mg tab 484 167.00 80,828
2 Antimigrein tab 523 167.00 87,341
3 Garam Oralit tab - 264.00 -
4 MB Kusta strip 6 28,424.00 170,544
5 OAT Anak/ FDC pkt 4 195,441.92 781,768
6 OAT FDC I/III pkt 50 317,018.00 15,850,900
7 OAT kat I/ Kombipak pkt - 288,199.00 -
8 OAT kat II pkt 2 1,199,985.00 2,399,970
9 Primaquin 15 mg tab - 205.00 -
10 Retinol 100.000 UI tab 1,903 284.00 540,452
11 Retinol 200.000 UI tab 11,759 519.20 6,105,273
12 Tablet Tambah darah tab 55,954 352.00 19,695,808
Triheksifenidil 2 mg tab 3,547 85.00 301,495
Page 185
n Barang (Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 9,627 513.00 4,938,651
INJEKSI
1 Atropin Sulsat inj amp - 1,540.00 -
2 Diazepam inj 5 mg/ ml amp 16 1,735.00 27,760
3 Fenobarbital inj 50 mg/ ml amp 215 1,969.00 423,335
Flufenazin inj 25mg/ml - Sikzo amp 87 59,800.00 5,202,600
4 Gentamisin inj 40 mg/ ml amp - 3,108.00 -
5 Glukonas Calcicus inj 10% amp - 9,955.00 -
6 Vit K1/Fitomenadion inj 2 mg/ amp 554 3,550.00 1,966,700
OBAT LUAR
1 Oksitetrasiklin 1 % SM tube - 3,220.00 -
BMHP
1 Object Glass Frosted box 23 20,000.00 460,000
2 Pot Sputum Steril biji 1,286 5,890.00 7,574,540
LABORAT
1 Box Slide biji 2 77,690.00 155,380
2 Iodium Test btl 826 5,275.00 4,357,150
3 Ziehl nelson btl 27 276,500.00 7,465,500
OBAT BARU 2018
1 Rapid I HIV test 1,148 14,340.00 16,462,320
2 Micropipet biji - 980.00 -
Page 186
n Barang (Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 11 522,083.00 5,742,913
4 RDT Combo Malaria test - 19,760.00 -
5 Mineral Mix sachet - 2,726.90 -
6 Lugol btl 12 30,000.00 360,000
7 Fluoksetin 20 mg tab/Peprezal tab 235 225.00 52,875
8 Klorpromazin inj amp 4 1,243.00 4,972
9 Klozapin 25 mg tab 1,995 1,121.00 2,236,395
JUMLAH Rp 109,574,397.48

Palupi,S.Si.Apt
NIP.19750711 200312 2 002
Page 187
NG
HATAN
manggung@gmail.com
EHATAN
UNG
Program
Keterangan
candi DAK, banjarsari DAK, kandangan DAK, traji DAK, krnggan DAK, selo DAK, tmg DA
cek TTD, buufer hy tepusen dan gmw. Lainnya DAK semus
Page 188
Keterangan
7
hrg 513
DAK
hrg 5275
hrg 14340
Page 189
Keterangan
ung, Januari 2018

UPTD Gudang Obat
bekalan Kesehatan
lupi,S.Si.Apt
50711 200312 2 002
Page 190
DAK, selo DAK, tmg DAK
Page 191
LAPORAN OBAT DAN PERBEKALAN KESEHATAN
PUSKESMAS TEMANGGUNG
1 2 3 4 5
TABLET
0 TABLET 0 - -
0 Albendazol 400 tab - -
1 Alopurinol 100 mg tab 545 86.00
2 Alprazolam 0,25 mg tab 100 316.00
0 Ambroxol 30 mg tab - -
3 Aminofilin 200 mg tab 775 91.00
4 Amitriptilin 25 mg tab 175 167.00
10 Antimigrein tab 200 173.00
13 Asam Folat 0,4 mg tab 1,385 63.00
15 Asetosal 80 mg tab 120 148.00
0 Asifit kap - -
1
1 2 3 4 5
16 Asiklofir 200 mg tab 244 249.00
0 Atropin sulfat 0,5 mg tab - -
18 Azitromisin 500 mg tab - 1,900.00
20 Betahistin/versilon 6 mg tab 70 110.00
21 Bisakodil 5 mg/ Laxana tab 60 300.00
22 Cetirizin 10 mg tab 970 89.98
0 Dextral tablet tab - -
24 Diazepam 2 mg tab 161 86.00
0 Dietil Carbamazin 100 mg tab - -
26 Digoksin 0,25 mg tab 139 97.00
27 Diltiazem 30 mg tab 20 134.00
28 Dimenhidrinat 50 mg tab 142 104.00
29 Doksisiklin 100 mg kap 60 264.00
31 Erytromisin 250 mg kap 20 546.00
32 Erytromisin 500 mg tab 298 750.00
33 Fenitoin Na 100 mg/ Kutoin kap 395 158.00
34 Fenobarbital 30 mg tab 373 171.00
35 Fitomenadion/ K1 10 mg tab 640 710.00
0 Flunarizin 10 mg tab - -
36 Furosemida 40 mg tab 264 78.00
0 G.G 100 mg/ Guaifenesin 100 mg tab - -
37 Garam Oralit tab 218 257.00

1
1 2 3 4 5
38 Gemfibrozil 300 mg tab 358 380.00
0 Glibenklamid 5 mg tab - -
39 Glimepirid 2 mg tab - 207.00
40 Griseovulvin 125 mg tab 343 210.00
0 Haemorogard tab - -
42 Haloperidol 1,5 mg tab 271 59.00
43 Haloperidol 5 mg tab 331 56.00
44 HCT 25 mg tab 342 149.00
0 Hepagard tab - -
0 Hiosina + Metampiron/ Dormi comp tab - -
0 Ibuprofen 200 mg tab - -
45 Ibuprofen 400 mg tab - 127.00
46 Isosorbid Dinitrat 5 mg tab 610 88.00
0 Kalium Diklofenak 50 mg tab - -
48 Kalk tab 2,292 59.00
49 Kalsium Karbonat 500 mg/ Calporos tab - 430.00
50 Kandersatan 8 mg tab 330 519.00
0 Kaolin + Pectin tab/ Omegdiar tab - -
51 Kaptopril 12,5 mg tab 804 62.00
53 Karbamazepim 200 mg tab 240 230.00
0 Karbazokrom 10 mg/ Adona tab - -
54 Ketokonazol 200 mg tab 385 280.00
56 Klonidin 0,15 mg tab 2 184.00

1
1 2 3 4 5
57 Kloramfenikol 250 mg tab - 240.00
58 Kloramfenikol 500 mg kap - 1,089.95
60 Klorpromazin 100 mg tab 66 147.00
61 Klozapin 100 mg tab - 3,288.00
62 Kodein 10 mg tab 155 550.00
64 Levofloksasin 500 mg tab - 495.00
65 Lisinopril tab 5 mg tab - 209.00
66 Litium Karbonat 400 mg/ Frimania tab - 1,672.00
67 Loperamid 2 mg tab - 89.00
68 Loratadin 10 mg tab 360 123.00
0 MB Kusta strip - -
0 Meloksikam 15 mg tab - -
69 Metformin 500 mg tab 580 96.00
70 Metil Prednisolon 4 mg tab - 150.00
72 Metilergometrin 0,125 mg tab 100 211.00
73 Metoklopramid 10 mg tab 30 90.00
74 Metronidazol 500 mg tab 885 160.00
0 Na Bikarbonat 500 mg tab - -
75 N-Asetil Sistein 200 mg kap 3,874 426.00
0 Neurotropik tab/ Corsaneuron tab - -
0 New Pro Uric kap - -
77 Nifedipin 10 mg tab 420 100.00
78 Nistatin tab 500.000 IU/ g tab 90 745.00

1
1 2 3 4 5
0 Nodiar tab - -
0 OAT Anak/ FDC pkt - -
0 OAT FDC I/III pkt - -
0 OAT kat I/ Kombipak pkt - -
0 OAT kat II pkt - -
79 Omeprazol 20 mg tab 390 130.00
80 Ondansetron 4 mg tab - 472.00
81 Papaverin 40 mg tab - 119.00
0 PB Kusta Anak strip - -
0 Piracetam 800 mg tab - -
0 Piroksikam 20 mg tab - -
84 Prednison 5 mg tab - 68.00
0 Primaquin 15 mg tab - -
0 Pro Lipid tab - -
85 Propanolol 40 mg tab - 74.00
86 PTU 100 mg tab - 279.00
87 Ranitidin 150 mg tab 5,450 105.00
0 Retinol 100.000 UI tab - -
88 Risperidon 2 mg tab 190 273.00
89 Salbutamol 2 mg tab 385 59.00
0 Samcobion kap - -
91 Sefadroksil 500 mg tab 310 550.00
92 Sefiksim 100 mg tab - 590.00

1
1 2 3 4 5
97 Spironolakton 100 mg tab - 876.00
98 Tablet Tambah darah tab 127,215 354.00
0 Tensigard tab - -
99 Teofilin 150 mg tab 80 250.00
100 Teofilin SR / Retaphyl SR tab 240 1,050.00
102 Tetrasiklin 500 tab 108 309.99
0 Tiamfenikol 500 mg tab - -
103 Tiamin 50 mg/ B1 tab 13,070 86.00
104 Triheksifenidil 2 mg tab 418 85.00
0 Vitalamin tab - -
106 Zink 20 mg tab - 473.00
0 0 0 - -
0 SYRUP 0 - -
1 Albendazol susp 200mg/ 5 ml btl - 4,000.00
2 Ambroxol sirup 15 mg/ 5 ml btl - -
3 Amoksisilin sir 250 mg/ 5 ml btl - 3,400.00
4 Amoksisilin sirup 125 mg/ 5 ml btl 37 2,090.00
5 Antasida DOEN susp btl 136 2,025.00
0 Batugin elixir btl - -
0 Dextrofen sirup btl - -
6 Domperidon sirup 5 mg/ 5 ml btl 44 2,700.00

1
1 2 3 4 5
7 Domperidon tetes 5 mg/ ml btl - 15,599.76
0 Haloperidol drops 2 mg/ml (Lodome btl - -
9 Ibuprofen susp 100mg/5ml btl 146 2,475.00
10 Ibuprofen Susp 200 mg/ 5 ml btl - 4,465.00
0 Kaolin + Pectin syr/ Kanina btl - -
12 Kotrimoksazol suspensi btl 132 2,140.00
0 Laxadin susp btl - -
13 Metokloperamid drops btl - 5,280.00
14 Metronidasol sirup btl - 3,800.00
0 OBH btl - -
0 Pacdin Vitcur sirup btl - -
15 Parasetamol drops btl 242 5,200.00
16 Parasetamol sirup 120 mg/ 5 ml btl 335 1,106.00
17 Salbutamol sirup btl - 4,446.00
18 Sefadroksil sirup 125 mg/ 5 ml btl - 3,922.00
20 Setirizin sirup btl - 6,745.00
0 Tiamfenikol sirup btl - -
22 Zink drops 10 mg/ml btl - 10,798.70
23 Zink sirup btl 66 6,290.00
0 0 0 - -
0 INJEKSI 0 - -
0 Ampisilin inj 1.000 mg vial - -

1
1 2 3 4 5
0 Asam Traneksamat inj amp - -
4 Dexametason injeksi 5 mg/ ml amp 97 1,400.00
0 Diazepam inj 5 mg/ ml amp - 1,712.70
9 Furosemid inj 10 mg/ ml amp - 1,516.00
0 Gentamisin inj 40 mg/ ml amp - -
10 Glukonas Calcicus inj 10% amp - 9,955.00
0 Haloperidol inj i.m. 5 mg/ml (Lodome amp - -
13 Lidokain Comp. inj amp 172 1,152.00
14 Lidokain inj 2% amp 64 1,144.00
16 Meylon / Na Bic inj amp - 6,200.00
17 MgSO4 20% amp - 3,200.00
18 MgSO4 40% amp - 3,650.00
0 Nalokson inj 0,4 mg/ml (Nokoba) amp - -
19 Oksitosin injeksi 10 UI/ ml amp 97 1,900.00
20 Ondansetron 4 mg inj amp - 1,070.00
0 Piracetam 1 gr/ 5 ml amp - -
21 Ranitidin inj 25 mg/ 2 ml amp 50 1,390.00
22 Sefotaksim 1 gr/ vial amp - 4,200.00

1
1 2 3 4 5
23 Serum ABU I / Biosave vial - 462,000.00
0 Serum ATS 1.500 amp - -
24 Sianokobalamin inj 500 mcg/ ml amp - 1,098.00
25 Vit K1/Fitomenadion inj 2 mg/ml amp - 3,682.00
0 0 0 - -
0 OBAT LUAR 0 - -
0 Alkohol 96 % 1 L btl - -
1 Antibakteri SK tube - 2,924.00
2 Antifungi sk pot 41 4,496.00
3 Antihemoroid supp supp 39 3,045.00
4 Asam Fusidat krim 20mg/g - Acdat tube 73 5,997.00
0 Asiklovir krim 5 % tube - -
5 Betametason krim 0,1 % tube 97 1,348.00
7 Bisakodil sup dws supo - 5,800.00
8 Budesonid/ Pulmicort res 0,25mg/ m btl - 9,724.99
0 Budesonid-formeterol/ Symbicort in btl - -
9 Desoksimetason krim tube 71 10,400.00
0 Enkasari btl - -
12 Etanol 70% 100 ml btl 244 2,500.00
13 Feneterol HBr/ Berotec inh btl - 83,190.00
14 Fenol gliserol TT 10 % btl 83 2,590.00
15 Flusinolon Asetat 0.025% tube - 2,400.00
16 Framisetin tulle/ Daryanttulle lbr - 8,989.97
17 Gentamisin SM tube 84 2,675.00

1
1 2 3 4 5
18 Gentamisin TM 0,3 % btl 102 4,232.00
0 Gentien Violet 1 % btl - -
0 Gliserin btl - -
19 Hidrokortison krim 2,5 % tube 120 2,798.00
0 Ikhtiol SK btl - -
20 Ketokonazol krim 2 % tube 85 2,569.00
22 Kloramfenikol SM 1 % tube 47 1,881.00
23 Kloramfenikol SK 2% tube 80 3,008.00
0 Kloramfenikol TT 3 % btl - -
25 Lidokain Spray 10%/ Xylocaine btl - 170,399.90
0 Minyak ikan SK pot - -
0 Mometason krim tube - -
0 Oksitetrasiklin 1 % SM tube - -
0 Oksitetrasiklin 3 % SK tube - -
0 Perak Sulfadiazin/ burnazin tube - -
0 Perhidrol/ H2O2 btl - -
28 Permetrin krim 5%/ Scabimite krim tube 94 12,155.00
0 Permetrin lotion 1%/ Peditox btl - -
29 Polikresulen btl - 17,393.00
30 Povidon Iodida 300 ml btl - 18,000.00
31 Povidon Iodin 30 ml btl - 2,900.00
33 Salbutamol neb/ Ventolin Nebuliser tube - 3,999.98

1
1 2 3 4 5
34 Salep 2-4 pot 13 2,527.00
35 Salisil bedak pot 72 1,025.00
0 Sulfasetamid TM 15 % btl - -
0 Triamcinolon/ Bufacomb tube - -
0 0 0 - -
0 INFUS 0 - -
1 Assering btl - 9,646.00
2 Glucosa 40% btl - 1,452.00
3 Glucosa 5% btl 7 6,900.00
4 Ka-En 3A btl - 10,050.00
5 Ka-En 3B btl - 10,696.00
6 Ka-En Mg 3 btl - 9,599.67
0 Metronidazol infus btl - -
7 NaCl btl 53 6,410.00
0 Parasetamol 10 mg/ml infus btl - 11,610.00
8 RL btl 19 7,150.00
0 0 0 - -
0 BMHP 0 - -
1 Alat suntik 1 ml set 420 1,694.00
2 Alat suntik 3 ml set 373 968.00
0 Alat suntik ADS 0.05 ml set - -
6 Alat suntik ADS 0.5 ml (Soloshot Mi set 400 1,655.50
0 Alkazym 250 mg sack - -

1
1 2 3 4 5
0 Alkacide 1 L High Level btl - -
0 Alkohol swab 2 % box - -
0 Aseptan Liquid 500 cc btl - -
0 Aseptic Gel 500 cc btl - -
0 Bioplacentol tulle lbr - -
0 Bisturi box - -
0 Bracket Hand Wash Plastik biji - -
0 Cat gut Plain No. 3/0 DS 24 mm biji - -
0 Cover Glass/ Deck Glass box - -
0 Feeding Tube FR 5 biji - -
0 Female Catheter No. 14 biji - -
0 Foley cateter No. 14 biji - -
14 Gelang ID Pasien anak biru biji 40 850.00
15 Gelang ID Pasien anak pink biji 50 850.00
16 Gelang ID Pasien dewasa biru biji - 850.00
17 Gelang ID Pasien dewasa pink biji 80 850.00

1
1 2 3 4 5
18 Handschoen Disposible (M) biji 700 462.00
19 Handschoen Disposible (S) biji 500 462.00
20 Handschoen Nitril (M) biji - 627.00
21 Hansdchoen Nitril (S) biji - 627.00
0 Handschoon panjang/obgin steril psg - -
0 Handscoon steril no 7 psg - -
0 Handscoon steril no. 7,5 psg - -
0 Infusion set anak biji - -
22 Infusion set dewasa biji 16 7,920.00
27 IV Catheter No.20 with port set - 16,100.00
0 Jarum Jahit Kulit No. 10 biji - -
0 Jarum Jahit Mukosa No. 10 biji - -
29 Jelly 5 gr/ My Jelly sach - 2,200.59
0 Kapas 250 g bks - -
32 Kasa 2 m x 80 cm rol 61 9,449.99
33 Kasa 36 x 80 cm rol - 130,000.00
0 Kasa 4 m x 10 cm rol - -
0 Kassa steril rol - -

1
1 2 3 4 5
0 Kondom kateter ( M ) biji - -
0 Kondom kateter ( S ) biji - -
0 Lidi Kapas Non Steril pak - -
0 Lidi Kapas Steril biji - -
34 Lysol 1 L btl 3 41,000.00
0 Masker disposible biji - -
35 Masker Oksigen anak set - 19,800.00
36 Masker Oksigen dewasa set - 19,800.00
0 Masker Oksigen cungkup set - -
0 Mucus Extractor set - -
0 N2O gas tbg - -
0 Non Adhesive Bandage 10 x 4,5/ Ten rol - -
0 Object Glass box - -
0 Object Glass Frosted box - -
0 Oksigen gas tbg - -
39 Onescrub 500 cc btl 6 62,500.00
0 Plester rol - -
0 Plester putih/ hipavix 5 cm biji - -
0 Pot Sputum biji - -
0 Pot Sputum Steril biji - -
0 Pot Urin biji - -
0 Sabun Cuci Tangan/ Softaskin btl - -
40 Savety box biji - 15,715.35
41 Silk 2/0 DS 24 mm sac 2 23,300.00
42 Silk 3/0 DS 24 mm sac 3 22,400.00

1
1 2 3 4 5
0 Suction catether no FR 8 biji - -
43 Three way stop cock biji - 3,249.84
0 Tranfusi set biji - -
0 Umbilical cord klem nylon steril biji - -
44 Underpad Steril lbr 70 7,626.00
0 0 0 - -
0 GIGI 0 - -
0 Bonding Composite box - -
0 Bur Polish Composite set - -
0 Cavit box - -
0 Composit warna A2 box - -
0 Dentin Conditioner btl - -
0 Devitalisasi Pasta Non Arsen btl - -
0 Disclosing Solution btl - -
0 Disposible Dental Suction/ Saliva Ej box - -
0 Disposible Mikro Aplikator box - -
0 Etil klorid btl - -
0 Etsa Asam box - -
1 Eugenol btl 3 16,667.00
0 Forinokresol / T K F btl - -
0 Glass Ionomer Cement - Fuji IX btl - -

1
1 2 3 4 5
0 Glass Ionomer Cement - Fuji VII btl - -
0 Iodoform Pasta pot - -
0 Kalsium hidroksida pasta set - -
0 Klorfenol/CHKM btl - -
0 Mata Bur high speed set - -
0 Mata Bur low speed set - -
0 Mumifying pasta btl - -
0 OCO btl - -
0 Pasta pengisi saluran akar/ Vitapex btl - -
0 Semen seng fosfat set - -
0 Sodium Hipochloride btl - -
0 Spons Gelatin/ Hemospon biji - -
0 T S Fletcher set - -
0 Tips Scaler ART biji - -
0 Tips Scaler Woodpecker biji - -
0 0 0 - -
0 LABORAT 0 - -
1 Ammonium oxalat 1 % btl - 150,000.00
0 Blood lancet box - -
0 Botol sampel darah 10 ml btl - -
0 Box Slide biji - -
3 Bufer 1 L btl - 80,000.00
4 Eosin 2 % btl - 230,000.00
0 Film rontgen 24 x 30 box - -

1
1 2 3 4 5
0 Giemsa pekat btl - -
0 H2SO4 btl - -
5 Hayem btl - 220,000.00
0 HCl 0,1 N btl - -
0 Iodium Test btl - -
0 Jelly EKG btl - -
0 Kertas EKG 50mm x 30mm rol - -
6 Kertas EKG 63 30 mm rol - 90,200.00
7 Kertas EKG AT 1: 90x90mm box - 320,000.00
0 Kertas lensa sach - -
0 Kondom Katether M biji - -
0 Kondom Katether S biji - -
0 Larutan EDTA btl - -
8 Metanol btl - 88,000.00
0 Minyak immersi btl - -
9 Na citrat 3,8 % btl - 27,500.00
0 Object glass box - -
10 Pipet tetes biji - 495.00
11 Reagen golongan darah btl - 234,909.12
12 Salmonella Thypi H Widhal Test set - 66,660.00
13 Salmonella Thypi O Widhal Test set - 66,660.00
0 Spiritus btl - -
0 Stik gula darah Accucheck Performa btl - -
0 Stik asam urat Nesco btl - -
0 Stik asam urat UA Sure btl - -
0 Stik cholesterol Accutrend btl - -
0 Stik gula darah gluco DR btl - -

1
1 2 3 4 5
0 Stik gula darah Nesco btl - -
0 Stik trigliserid Accutrend btl - -
0 Stik urinalisa 3 parameter btl - -
14 Tes kehamilan sach 110 1,199.02
0 Turk btl - -
0 Ziehl nelson btl - -
0 0 0 - -
0 VAKSIN 0 - -
0 BCG amp - -
0 DPT - HB amp - -
0 DPT HB HIB amp - -
0 POLIO amp - -
0 CAMPAK amp - -
0 TT amp - -
0 HB U amp - -
0 DT amp - -
0 TD amp - -
0 ADS 0.05 ml set - -
0 ADS 0.5 ml set - -
0 ADS 5 ml set - -
0 SAFETY BOX biji - -
0 0 0 - -
0 OBAT BARU 2018 0 - -
0 Rapid I HIV test - -
0 Micropipet biji - -

1
1 2 3 4 5
0 Paket Alat Deteksi Resiko Kehamila paket - -
2 Trifluoperazin tab - 269.00
0 RDT Combo Malaria test - -
0 Stik Cholesterol Benecheck btl - -
0 Stik Gula Darah Benecheck btl - -
4 Jelly 82 gr/ My Jelly tube - 29,549.00
0 Mineral Mix sachet - -
5 Na Divalproat 250 mg (Depakote) tab - 1,200.00
7 Omeprazole injeksi amp - 9,898.00
0 Stik Asam Urat Benecheck btl - -
0 Panviton tab - -
0 Naia tab - -
0 Intunal syr btl - -
0 Mekobalamin kap - -
0 Biocombin inj amp - -
0 Lugol btl - -
0 Larsi kap - -
0 Omevita syr btl - -
0 Fluoksetin 20 mg tab/Peprezal tab - -
0 Klorpromazin inj amp - -
0 Klozapin 25 mg tab - -
JUMLAH
1
OBAT DAN PERBEKALAN KESEHATAN
PUSKESMAS TEMANGGUNG
ar sisa persediaan (Habis Pakai / jual)
hir Bulan / Tanggal : 31 Desember 2018
Jumlah Harga (Rp)
46,870.00
31,600.00
70,525.00
29,225.00
105,000.00
124,620.00
316,290.00
1,472,504.00
793,414.00
34,600.00
883,155.00
87,255.00
695,971.00
17,760.00
1
Jumlah Harga (Rp)
60,756.00
85,505.00
7,700.00
18,000.00
87,280.60
307,904.00
13,846.00
10,900.00
13,483.00
2,680.00
14,768.00
15,840.00
125,434.00
10,920.00
223,500.00
62,410.00
63,783.00
454,400.00
20,592.00
56,026.00
1
Jumlah Harga (Rp)
136,040.00
72,030.00
15,989.00
18,536.00
50,958.00
53,680.00
135,870.00
135,228.00
171,270.00
49,848.00
331,716.00
55,200.00
107,800.00
100,880.00
368.00
1
Jumlah Harga (Rp)
293,076.00
9,702.00
85,250.00
184,587.39
44,280.00
55,680.00
333,000.00
21,100.00
2,700.00
141,600.00
1,650,324.00
249,550.00
42,000.00
67,050.00
1
Jumlah Harga (Rp)
50,700.00
1,145,816.00
595,192.00
572,250.00
51,870.00
22,715.00
13,300.00
170,500.00
-
1
Jumlah Harga (Rp)
245,310.00
102,835.00
24,600.00
344,029.68
45,034,110.00
20,000.00
252,000.00
33,478.92
1,124,020.00
35,530.00
1,101,240.00
77,330.00
275,400.00
118,800.00
1
Jumlah Harga (Rp)
361,350.00
55,370.00
282,480.00
1,258,400.00
370,510.00
88,257.00
415,140.00
18,230.00
-
1
Jumlah Harga (Rp)
16,500.00
7,700.00
135,800.00
16,800.00
12,243.00
1,237,600.00
29,670.00
198,144.00
73,216.00
62,139.00
184,300.00
69,500.00
-
1
Jumlah Harga (Rp)
184,336.00
118,755.00
437,781.00
130,756.00
738,400.00
126,687.00
610,000.00
214,970.00
224,700.00
1
Jumlah Harga (Rp)
431,664.00
335,760.00
218,365.00
88,407.00
240,640.00
94,250.00
30,000.00
43,932.00
1,142,570.00
-
1
Jumlah Harga (Rp)
32,851.00
73,800.00
48,300.00
339,730.00
135,850.00
711,480.00
361,064.00
445,400.00
26,796.00
32,984.60
662,200.00
-
1
Jumlah Harga (Rp)
190,000.00
1,246,200.00
590,400.00
333,920.16
281,388.73
18,530.00
18,530.00
34,000.00
42,500.00
68,000.00
1
Jumlah Harga (Rp)
323,400.00
231,000.00
126,720.00
92,400.00
107,800.00
17,400.00
289,800.00
20,000.00
60,000.00
576,449.39
-
1
Jumlah Harga (Rp)
123,000.00
254,700.00
226,400.00
375,000.00
46,600.00
67,200.00
1
Jumlah Harga (Rp)
533,820.00
10,010.00
50,001.00
-
1
Jumlah Harga (Rp)
440,000.00
-
1
Jumlah Harga (Rp)
-
1
Jumlah Harga (Rp)
131,892.20
-
1
Jumlah Harga (Rp)
140,080.00
503,180.70
Rp 83,136,955.37
1
DI PUSKESMAS TEMANGGUNG
Harga Satuan
No. Nama obat dan Perbekes Satuan Jumlah Barang Jumlah Harga (Rp)
(Rp)
1 2 3 4 5 6
TABLET
0 TABLET 0 0 Rp - Rp -
0 Albendazol 400 tab 0 Rp - Rp -
0 Alopurinol 100 mg tab 0 Rp - Rp -
0 Alprazolam 0,25 mg tab 0 Rp - Rp -
1 Ambroxol 30 mg tab 400 Rp 201.30 Rp 80,520.00
0 Aminofilin 200 mg tab 0 Rp - Rp -
0 Amitriptilin 25 mg tab 0 Rp - Rp -
0 Amlodipin 5 mg tab 0 Rp - Rp -
0 Amoksisilin 250 mg tab 0 Rp - Rp -
0 Antasida DOEN tab 0 Rp - Rp -
2 Antimigrein tab 0 Rp 5,625.40 Rp -
0 Asam Askorbat 50 mg tab 0 Rp - Rp -
0 Asam Folat 0,4 mg tab 0 Rp - Rp -
0 Asam Mefenamat 500 mg tab 0 Rp - Rp -
0 Asetosal 80 mg tab 0 Rp - Rp -
3 Asifit kap 300 Rp 1,026.67 Rp 308,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Asiklofir 200 mg tab 0 Rp - Rp -
0 Atropin sulfat 0,5 mg tab 0 Rp - Rp -
0 Azitromisin 500 mg tab 0 Rp - Rp -
0 Bekarbon / Norit tab 0 Rp - Rp -
0 Betahistin/versilon 6 mg tab 0 Rp - Rp -
4 Bisakodil 5 mg/ Laxana tab 0 Rp 614.90 Rp -
0 Cetirizin 10 mg tab 0 Rp - Rp -
0 Dexametason 0,5 mg tab 0 Rp - Rp -
5 Dextral tablet tab 1,036 Rp 506.00 Rp 524,216.00
0 Diazepam 2 mg tab 0 Rp - Rp -
0 Dietil Carbamazin 100 mg tab 0 Rp - Rp -
0 Digoksin 0,25 mg tab 0 Rp - Rp -
0 Diltiazem 30 mg tab 0 Rp - Rp -
0 Dimenhidrinat 50 mg tab 0 Rp - Rp -
0 Doksisiklin 100 mg kap 0 Rp - Rp -
0 Domperidon 10 mg tab 0 Rp - Rp -
0 Erytromisin 250 mg kap 0 Rp - Rp -
0 Erytromisin 500 mg tab 0 Rp - Rp -
0 Fenitoin Na 100 mg/ Kutoin kap 0 Rp - Rp -
0 Fenobarbital 30 mg tab 0 Rp - Rp -
0 Fitomenadion/ K1 10 mg tab 0 Rp - Rp -
6 Flunarizin 10 mg tab 85 Rp 1,232.00 Rp 104,720.00
0 Furosemida 40 mg tab 0 Rp - Rp -
7 G.G 100 mg/ Guaifenesin 100 mg tab 462 Rp 179.96 Rp 83,141.52
0 Garam Oralit tab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gemfibrozil 300 mg tab 0 Rp - Rp -
8 Glibenklamid 5 mg tab 253 Rp 56.00 Rp 14,168.00
0 Glimepirid 2 mg tab 0 Rp - Rp -
0 Griseovulvin 125 mg tab 0 Rp - Rp -
9 Haemorogard tab 410 Rp 1,552.10 Rp 636,361.00
0 Haloperidol 0,5 mg tab 0 Rp - Rp -
0 Haloperidol 5 mg tab 0 Rp - Rp -
0 HCT 25 mg tab 0 Rp - Rp -
10 Hepagard tab 310 Rp 2,794.00 Rp 866,140.00
11 Hiosina + Metampiron/ Dormi comp tab 433 Rp 2,069.00 Rp 895,877.00
12 Ibuprofen 200 mg tab 207 Rp 110.00 Rp 22,770.00
0 Ibuprofen 400 mg tab 0 Rp - Rp -
0 Isosorbid Dinitrat 5 mg tab 0 Rp - Rp -
0 K.Aspartat 300 mg tab 0 Rp - Rp -
13 Kalium Diklofenak 50 mg tab 610 Rp 694.32 Rp 423,535.20
0 Kalk tab 0 Rp - Rp -
0 Kalsium Karbonat 500 mg/ Calporosi tab 0 Rp - Rp -
0 Kandersatan 8 mg tab 0 Rp - Rp -
14 Kaolin + Pectin tab/ Omegdiar tab 80 Rp 453.04 Rp 36,242.80
0 Kaptopril 12,5 mg tab 0 Rp - Rp -
0 Kaptopril 25 mg tab 0 Rp - Rp -
0 Karbamazepim 200 mg tab 0 Rp - Rp -
15 Karbazokrom 10 mg/ Adona tab 150 Rp 1,980.00 Rp 297,000.00
16 Ketokonazol 200 mg tab 0 Rp 300.00 Rp -
0 Klobazam 10 mg tab 0 Rp - Rp -
0 Klonidin 0,15 mg tab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kloramfenikol 250 mg tab 0 Rp - Rp -
0 Kloramfenikol 500 mg kap 0 Rp - Rp -
0 Klorfeniramin Maleat/ CTM 4 mg tab 0 Rp - Rp -
0 Klorpromazin 100 mg tab 0 Rp - Rp -
17 Klozapin 100 mg tab 0 Rp 5,000.00 Rp -
18 Kodein 10 mg tab 0 Rp 500.00 Rp -
0 Kotrimoksazol 480 mg tab 0 Rp - Rp -
0 Levofloksasin 500 mg tab 0 Rp - Rp -
0 Lisinopril tab 5 mg tab 0 Rp - Rp -
0 Litium Karbonat 400 mg/ Frimania tab 0 Rp - Rp -
0 Loperamid 2 mg tab 0 Rp - Rp -
0 Loratadin 10 mg tab 0 Rp - Rp -
0 MB Kusta strip 0 Rp - Rp -
19 Meloksikam 15 mg tab 0 Rp 759.00 Rp -
0 Metformin 500 mg tab 0 Rp - Rp -
0 Metil Prednisolon 4 mg tab 0 Rp - Rp -
0 Metilergometrin 0,125 mg tab 0 Rp - Rp -
0 Metoklopramid 10 mg tab 0 Rp - Rp -
0 Metronidazol 500 mg tab 0 Rp - Rp -
20 Na Bikarbonat 500 mg tab 385 Rp 40.70 Rp 15,669.50
0 N-Asetil Sistein 200 mg kap 0 Rp - Rp -
0 Natrium Diklofenak 50 mg tab 0 Rp - Rp -
21 Neurotropik tab/ Corsaneuron tab 460 Rp 757.90 Rp 348,634.00
22 New Pro Uric kap 0 Rp 889.17 Rp -
23 Nifedipin 10 mg tab 0 Rp 100.00 Rp -
0 Nistatin tab 500.000 IU/ g tab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
24 Nodiar tab 0 Rp 453.04 Rp -
0 OAT Anak/ FDC pkt 0 Rp - Rp -
0 OAT FDC I/III pkt 0 Rp - Rp -
0 OAT kat I/ Kombipak pkt 0 Rp - Rp -
0 OAT kat II pkt 0 Rp - Rp -
0 Omeprazol 20 mg tab 0 Rp - Rp -
25 Ondansetron 4 mg tab 0 Rp 716.00 Rp -
0 Papaverin 40 mg tab 0 Rp - Rp -
0 Parasetamol 500 mg tab 0 Rp - Rp -
0 PB Kusta Anak strip 0 Rp - Rp -
26 Piracetam 800 mg tab 70 Rp 783.20 Rp 54,824.00
27 Piridoksin/ B6 10 mg tab 0 Rp 110.00 Rp -
28 Piroksikam 20 mg tab 660 Rp 163.79 Rp 108,101.40
0 Prednison 5 mg tab 0 Rp - Rp -
0 Primaquin 15 mg tab 0 Rp - Rp -
29 Pro Lipid tab 0 Rp 858.00 Rp -
0 Propanolol 40 mg tab 0 Rp - Rp -
0 PTU 100 mg tab 0 Rp - Rp -
0 Ranitidin 150 mg tab 0 Rp - Rp -
0 Retinol 100.000 UI tab 0 Rp - Rp -
0 Risperidon 2 mg tab 0 Rp - Rp -
30 Salbutamol 2 mg tab 0 Rp 59.00 Rp -
0 Salbutamol 4 mg tab 0 Rp - Rp -
31 Samcobion kap 10,990 Rp 429.00 Rp 4,714,710.00
0 Sefadroksil 500 mg tab 0 Rp - Rp -
0 Sefiksim 100 mg tab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sianokobalamin / B12 50 mcg tab 0 Rp - Rp -
0 Simvastatin 10 mg tab 0 Rp - Rp -
0 Siprofloksasin 500 mg tab 0 Rp - Rp -
0 Spironolakton 100 mg tab 0 Rp - Rp -
32 Tablet Tambah darah tab 0 Rp 352.00 Rp -
33 Tensigard tab 0 Rp 2,112.00 Rp -
0 Teofilin 150 mg tab 0 Rp - Rp -
0 Teofilin SR / Retaphyl SR tab 0 Rp - Rp -
0 Tetrasiklin 250 mg tab 0 Rp - Rp -
0 Tetrasiklin 500 tab 0 Rp - Rp -
34 Tiamfenikol 500 mg tab 126 Rp 1,446.50 Rp 182,259.00
35 Tiamin 50 mg/ B1 tab 0 Rp 58.96 Rp -
0 Triheksifenidil 2 mg tab 0 Rp - Rp -
36 Vitalamin tab 0 Rp 499.40 Rp -
0 Vitamin B komplek tab 0 Rp - Rp -
0 Zink 20 mg tab 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 SYRUP 0 0 Rp - Rp -
0 Albendazol susp 200mg/ 5 ml btl 0 Rp - Rp -
1 Ambroxol sirup 15 mg/ 5 ml btl 212 Rp 5,148.00 Rp 1,091,376.00
0 Amoksisilin sir 250 mg/ 5 ml btl 0 Rp - Rp -
0 Amoksisilin sirup 125 mg/ 5 ml btl 0 Rp - Rp -
0 Antasida DOEN susp btl 0 Rp - Rp -
2 Batugin elixir btl 7 Rp 21,450.00 Rp 150,150.00
3 Dextrofen sirup btl 38 Rp 8,046.50 Rp 305,767.00
0 Domperidon sirup 5 mg/ 5 ml btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Domperidon tetes 5 mg/ ml btl 0 Rp - Rp -
0 Erytromisin sirup 200 mg/ 5 ml btl 0 Rp - Rp -
4 Haloperidol drops 2 mg/ml (Lodomerbtl 0 Rp 16,500.00 Rp -
0 Ibuprofen susp 100mg/5ml btl 0 Rp - Rp -
0 Ibuprofen Susp 200 mg/ 5 ml btl 0 Rp - Rp -
5 Kaolin + Pectin syr/ Kanina btl 11 Rp 5,720.00 Rp 62,920.00
0 Kloramfenikol susp 125 mg/ 5 ml btl 0 Rp - Rp -
0 Kotrimoksazol suspensi btl 0 Rp - Rp -
6 Laxadin susp btl 0 Rp 12,449.80 Rp -
0 Metokloperamid drops btl 0 Rp - Rp -
0 Metronidasol sirup btl 0 Rp - Rp -
7 OBH btl 190 Rp 5,797.00 Rp 1,101,430.00
8 Pacdin Vitcur sirup btl 0 Rp 8,140.00 Rp -
0 Parasetamol drops btl 0 Rp - Rp -
0 Parasetamol sirup 120 mg/ 5 ml btl 0 Rp - Rp -
0 Salbutamol sirup btl 0 Rp - Rp -
0 Sefadroksil sirup 125 mg/ 5 ml btl 0 Rp - Rp -
0 Setirizin sirup btl 0 Rp - Rp -
0 Sukralfat susp btl 0 Rp - Rp -
9 Tiamfenikol sirup btl 0 Rp 10,648.00 Rp -
0 Zink drops 10 mg/ml btl 0 Rp - Rp -
0 Zink sirup btl 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 INJEKSI 0 0 Rp - Rp -
0 Aminofilin injeksi 24 mg/ ml amp 0 Rp - Rp -
0 Ampisilin inj 1.000 mg vial 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1 Aqua pro injeksi btl 0 Rp 2,200.00 Rp -
2 Asam Traneksamat inj amp 0 Rp 6,199.60 Rp -
0 Atropin Sulsat inj amp 0 Rp - Rp -
0 Dexametason injeksi 5 mg/ ml amp 0 Rp - Rp -
3 Diazepam inj 5 mg/ ml amp 0 Rp 12,540.00 Rp -
0 Difenhidramin injeksi 10 mg/ ml amp 0 Rp - Rp -
0 Epinefrin injeksi 0,1 % amp 0 Rp - Rp -
0 Fenobarbital inj 50 mg/ ml amp 0 Rp - Rp -
0 Flufenazin inj 25mg/ml - Sikzonoate amp 0 Rp - Rp -
0 Furosemid inj 10 mg/ ml amp 0 Rp - Rp -
4 Gentamisin inj 40 mg/ ml amp 0 Rp 3,399.00 Rp -
0 Glukonas Calcicus inj 10% amp 0 Rp - Rp -
5 Haloperidol inj i.m. 5 mg/ml (Lodomer

amp 0 Rp 6,250.00 Rp -
0 Human Tetanus Imuno 250 UI amp 0 Rp - Rp -
0 Ketorolac inj 30 mg/ml amp 0 Rp - Rp -
0 Lidokain Comp. inj amp 0 Rp - Rp -
0 Lidokain inj 2% amp 0 Rp - Rp -
0 Metilergometrin inj amp 0 Rp - Rp -
0 Meylon / Na Bic inj amp 0 Rp - Rp -
0 MgSO4 20% amp 0 Rp - Rp -
0 Nalokson inj 0,4 mg/ml (Nokoba) amp 0 Rp - Rp -
0 Oksitosin injeksi 10 UI/ ml amp 0 Rp - Rp -
0 Ondansetron 4 mg inj amp 0 Rp - Rp -
6 Piracetam 1 gr/ 5 ml amp 0 Rp 5,445.00 Rp -
0 Ranitidin inj 25 mg/ 2 ml amp 0 Rp - Rp -
0 Sefotaksim 1 gr/ vial amp 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 Serum ABU I / Biosave vial 0 Rp 473,000.00 Rp -
0 Serum ATS 1.500 amp 0 Rp - Rp -
0 Sianokobalamin inj 500 mcg/ ml amp 0 Rp - Rp -
0 Vit K1/Fitomenadion inj 2 mg/ml amp 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 OBAT LUAR 0 0 Rp - Rp -
1 Alkohol 96 % 1 L btl 0 Rp 75,600.00 Rp -
0 Antibakteri SK tube 0 Rp - Rp -
0 Antifungi sk pot 0 Rp - Rp -
0 Antihemoroid supp supp 0 Rp - Rp -
0 Asam Fusidat krim 20mg/g - Acdat tube 0 Rp - Rp -
2 Asiklovir krim 5 % tube 29 Rp 2,860.00 Rp 82,940.00
0 Betametason krim 0,1 % tube 0 Rp - Rp -
3 Bisakodil sup anak supo 44 Rp 4,990.00 Rp 219,560.00
0 Bisakodil sup dws supo 0 Rp - Rp -
0 Budesonid/ Pulmicort res 0,25mg/ ml btl 0 Rp - Rp -
0 Budesonid-formeterol/ Symbicort inh btl 0 Rp - Rp -
0 Desoksimetason krim tube 0 Rp - Rp -
0 Diazepam Rectal 5mg/2,5ml - Stesoli tube 0 Rp - Rp -
4 Enkasari btl 28 Rp 17,863.00 Rp 500,164.00
5 Etakridin Larutan 0,1 % btl 19 Rp 2,550.00 Rp 48,450.00
0 Etanol 70% 100 ml btl 0 Rp - Rp -
0 Feneterol HBr/ Berotec inh btl 0 Rp - Rp -
0 Fenol gliserol TT 10 % btl 0 Rp - Rp -
0 Flusinolon Asetat 0.025% tube 0 Rp - Rp -
0 Framisetin tulle/ Daryanttulle lbr 0 Rp - Rp -
0 Gentamisin SM tube 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gentamisin TM 0,3 % btl 0 Rp - Rp -
6 Gentien Violet 1 % btl 57 Rp 2,750.00 Rp 156,750.00
7 Gliserin btl 2 Rp 4,500.00 Rp 9,000.00
0 Hidrokortison krim 2,5 % tube 0 Rp - Rp -
8 Ikhtiol SK btl 45 Rp 4,950.00 Rp 222,750.00
0 Ketokonazol krim 2 % tube 0 Rp - Rp -
0 Klobetasol 0,05% krim tube 0 Rp - Rp -
0 Kloramfenikol SM 1 % tube 0 Rp - Rp -
0 Kloramfenikol SK 2% tube 0 Rp - Rp -
0 Kloramfenikol TM btl 0 Rp - Rp -
9 Kloramfenikol TT 3 % btl 108 Rp 7,590.00 Rp 819,720.00
0 Lidokain Spray 10%/ Xylocaine btl 0 Rp - Rp -
0 Mikonazol krim 2 % tube 0 Rp - Rp -
10 Minyak ikan SK pot 21 Rp 3,300.00 Rp 69,300.00
11 Mometason krim tube 0 Rp 17,820.00 Rp -
0 Nistatin tab vag 100.000 UI/ g supp 0 Rp - Rp -
0 Oksitetrasiklin 1 % SM tube 0 Rp - Rp -
0 Oksitetrasiklin 3 % SK tube 0 Rp - Rp -
12 Perak Sulfadiazin/ burnazin tube 0 Rp 22,999.90 Rp -
13 Perhidrol/ H2O2 btl 0 Rp 23,980.00 Rp -
14 Permetrin krim 5%/ Scabimite krim tube 0 Rp 11,473.00 Rp -
15 Permetrin lotion 1%/ Peditox btl 0 Rp 4,568.30 Rp -
16 Polikresulen btl 0 Rp 17,393.00 Rp -
17 Povidon Iodida 300 ml btl 5 Rp 18,000.00 Rp 90,000.00
16 Povidon Iodin 30 ml btl 77 Rp 2,900.00 Rp 223,300.00
0 Salbutamol inh 100 mcg/ Ventolin Inhbtl 0 Rp - Rp -
0 Salbutamol neb/ Ventolin Nebuliser tube 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Salep 2-4 pot 0 Rp - Rp -
0 Salisil bedak pot 0 Rp - Rp -
19 Sulfasetamid TM 15 % btl 95 Rp 9,350.00 Rp 888,250.00
0 Tetrakain TM btl 0 Rp - Rp -
20 Triamcinolon/ Bufacomb tube 36 Rp 16,500.00 Rp 594,000.00
0 0 0 0 Rp - Rp -
0 INFUS 0 0 Rp - Rp -
0 Assering btl 0 Rp - Rp -
0 Glucosa 40% btl 0 Rp - Rp -
0 Ka-En 3A btl 0 Rp - Rp -
0 Ka-En 3B btl 0 Rp - Rp -
0 Ka-En Mg 3 btl 0 Rp - Rp -
0 Metronidazol infus btl 0 Rp - Rp -
0 NaCl btl 0 Rp - Rp -
1 Parasetamol 10 mg/ml infus btl 0 Rp 22,000.00 Rp -
0 RL btl 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 BMHP 0 0 Rp - Rp -
0 Alat suntik 1 ml set 0 Rp - Rp -
0 Alat Suntik 10 ml set 0 Rp - Rp -
1 Alat suntik ADS 0.05 ml set 0 Rp 3,575.00 Rp -
0 Alat suntik ADS 0.5 ml (Soloshot Minset 0 Rp - Rp -
2 Alkazym 250 mg sack 0 Rp 800,978.20 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Alkacide 1 L High Level btl 0 Rp 2,702,700.00 Rp -
4 Alkohol 70 % 1 L btl 3 Rp 21,500.00 Rp 64,500.00
0 Alkohol Swab box 0 Rp - Rp -
5 Alkohol swab 2 % box 12 Rp 15,730.00 Rp 188,760.00
6 Aseptan Liquid 500 cc btl 17 Rp 30,000.00 Rp 510,000.00
7 Aseptic Gel 500 cc btl 13 Rp 22,000.00 Rp 286,000.00
8 Bioplacentol tulle lbr 0 Rp 10,607.96 Rp -
9 Bisturi box 4 Rp 83,600.00 Rp 334,400.00
10 Bracket Hand Wash Plastik biji 0 Rp 17,600.00 Rp -
0 Cat gut Chromic No. 2/0 DS 24 mm biji 0 Rp - Rp -
0 Cat gut Chromic No. 2/0 HR 37 mm biji 0 Rp - Rp -
0 Catgut Chromic 3/0 DS 24 mm biji 0 Rp - Rp -
0 Cat gut Plain No. 2/0 DS 24 mm biji 0 Rp - Rp -
11 Cat gut Plain No. 3/0 DS 24 mm biji 27 Rp 5,583.33 Rp 150,749.91
12 Cover Glass/ Deck Glass box 2 Rp 144,605.53 Rp 289,211.06
0 Endotracheal Tube - 2.0 biji 0 Rp - Rp -
13 Feeding Tube FR 5 biji 0 Rp 3,564.00 Rp -
14 Feeding Tube FR 8 biji 2 Rp 7,700.00 Rp 15,400.00
15 Female Catheter No. 14 biji 0 Rp 5,720.00 Rp -
16 Foley cateter No. 14 biji 0 Rp 13,090.00 Rp -
17 Foley cateter No. 16 biji 4 Rp 13,090.00 Rp 52,360.00
0 Gelang ID Pasien anak biru biji 0 Rp - Rp -
0 Gelang ID Pasien anak pink biji 0 Rp - Rp -
0 Gelang ID Pasien dewasa biru biji 0 Rp - Rp -
0 Gelang ID Pasien dewasa pink biji 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Handschoen Disposible (M) biji 0 Rp - Rp -
0 Handschoen Disposible (S) biji 0 Rp - Rp -
19 Handschoen Nitril (M) biji 700 Rp 627.00 Rp 438,900.00
20 Hansdchoen Nitril (S) biji 0 Rp 627.00 Rp -
21 Handschoon panjang/obgin steril psg 9 Rp 30,000.00 Rp 270,000.00
22 Handscoon steril no 7 psg 69 Rp 7,865.00 Rp 542,685.00
23 Handscoon steril no. 7,5 psg 80 Rp 7,865.00 Rp 629,200.00
24 Infusion set anak biji 9 Rp 7,920.00 Rp 71,280.00
0 Infusion set dewasa biji 0 Rp - Rp -
0 IV Catheter No. 18 biji 0 Rp - Rp -
25 IV Catheter No. 24 biji 0 Rp 8,748.40 Rp -
0 IV Catheter No.20 with port set 0 Rp - Rp -
26 Jarum Jahit Kulit No. 10 biji 2 Rp 26,317.50 Rp 52,635.00
28 Jarum Jahit Mukosa No. 10 biji 1 Rp 26,317.50 Rp 26,317.50
0 Jelly 5 gr/ My Jelly sach 0 Rp - Rp -
0 Kanul Oksigen Anak biji 0 Rp - Rp -
30 Kanul Oksigen Dewasa biji 0 Rp 10,000.00 Rp -
31 Kapas 250 g bks 4 Rp 24,000.00 Rp 96,000.00
32 Kasa 2 m x 80 cm rol 0 Rp 7,700.00 Rp -
0 Kasa 36 x 80 cm rol 0 Rp - Rp -
33 Kasa 4 m x 10 cm rol 46 Rp 1,500.00 Rp 69,000.00
34 Kassa steril rol 59 Rp 8,000.00 Rp 472,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
35 Kondom kateter ( M ) biji 0 Rp 6,300.00 Rp -
36 Kondom kateter ( S ) biji 0 Rp 6,300.00 Rp -
37 Lidi Kapas Non Steril pak 28 Rp 27,500.00 Rp 770,000.00
38 Lidi Kapas Steril biji 700 Rp 1,120.00 Rp 784,000.00
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
40 Masker disposible biji 1,150 Rp 440.00 Rp 506,000.00
0 Masker Oksigen anak set 0 Rp - Rp -
0 Masker Oksigen dewasa set 0 Rp - Rp -
41 Masker Oksigen cungkup set 0 Rp 13,750.00 Rp -
42 Mucus Extractor set 30 Rp 10,120.00 Rp 303,600.00
43 N2O gas tbg 0 Rp 3,250,000.00 Rp -
0 Nebulizer with masker anak set 0 Rp - Rp -
0 Nebulizer with masker dewasa set 0 Rp - Rp -
44 Non Adhesive Bandage 10 x 4,5/ Tensrol 0 Rp 66,973.50 Rp -
45 Object Glass box 0 Rp 12,650.00 Rp -
46 Object Glass Frosted box 0 Rp 20,747.75 Rp -
47 Oksigen gas tbg 0 Rp 66,000.00 Rp -
0 Onescrub 500 cc btl 0 Rp - Rp -
48 Plester rol 0 Rp 12,076.00 Rp -
49 Plester putih/ hipavix 5 cm biji 13 Rp 55,000.00 Rp 715,000.00
50 Pot Sputum biji 60 Rp 1,540.00 Rp 92,400.00
0 Pot Sputum Steril biji 0 Rp - Rp -
51 Pot Urin biji 100 Rp 440.00 Rp 44,000.00
52 Sabun Cuci Tangan/ Softaskin btl 13 Rp 58,538.70 Rp 761,003.10
53 Savety box biji 0 Rp 15,708.00 Rp -
0 Silk 2/0 DS 24 mm sac 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
54 Suction catether no FR 8 biji 2 Rp 3,520.00 Rp 7,040.00
58 Suction catether no FR 16 biji 0 Rp 3,520.00 Rp -
0 Three way stop cock biji 0 Rp - Rp -
59 Tranfusi set biji 20 Rp 8,646.00 Rp 172,920.00
60 Umbilical cord klem nylon steril biji 81 Rp 1,299.98 Rp 105,298.38
61 Underpad Steril lbr 0 Rp 7,626.15 Rp -
0 Urine bag biji 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 GIGI 0 0 Rp - Rp -
1 Bonding Composite box 1 Rp 880,610.00 Rp 880,610.00
2 Bur Polish Composite set 0 Rp 44,000.00 Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
4 Composit warna A2 box 1 Rp 363,800.00 Rp 363,800.00
6 Dentin Conditioner btl 1 Rp 121,000.00 Rp 121,000.00
7 Devitalisasi Pasta Non Arsen btl 2 Rp 220,000.00 Rp 440,000.00
8 Disclosing Solution btl 0 Rp 55,000.00 Rp -
9 Disposible Dental Suction/ Saliva Eje box 0 Rp 79,373.80 Rp -
10 Disposible Mikro Aplikator box 0 Rp 165,000.00 Rp -
11 Etil klorid btl 0 Rp 90,200.00 Rp -
12 Etsa Asam box 0 Rp 178,690.00 Rp -
0 Eugenol btl 0 Rp - Rp -
13 Forinokresol / T K F btl 2 Rp 66,000.00 Rp 132,000.00
14 Glass Ionomer Cement - Fuji IX btl 2 Rp 781,000.00 Rp 1,562,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
15 Glass Ionomer Cement - Fuji VII btl 1 Rp 686,400.00 Rp 686,400.00
16 Iodoform Pasta pot 0 Rp 176,000.00 Rp -
17 Kalsium hidroksida pasta set 1 Rp 159,500.00 Rp 159,500.00
18 Klorfenol/CHKM btl 1 Rp 55,000.00 Rp 55,000.00
19 Mata Bur high speed set 1 Rp 165,000.00 Rp 165,000.00
0 Mata Bur low speed set 0 Rp - Rp -
20 Mumifying pasta btl 0 Rp 616,000.00 Rp -
21 OCO btl 0 Rp 125,400.00 Rp -
22 Pasta pengisi saluran akar/ Vitapex btl 1 Rp 265,000.00 Rp 265,000.00
23 Semen seng fosfat set 2 Rp 165,000.00 Rp 330,000.00
24 Sodium Hipochloride btl 1 Rp 78,100.00 Rp 78,100.00
25 Spons Gelatin/ Hemospon biji 0 Rp 84,700.00 Rp -
26 T S Fletcher set 0 Rp 35,999.99 Rp -
27 Tips Scaler ART biji 0 Rp 220,000.00 Rp -
28 Tips Scaler Woodpecker biji 0 Rp 132,000.00 Rp -
0 0 0 0 Rp - Rp -
0 LABORAT 0 0 Rp - Rp -
0 Ammonium oxalat 1 % btl 0 Rp - Rp -
1 Blood lancet box 29 Rp 19,965.00 Rp 578,985.00
2 Botol sampel darah 10 ml btl 5 Rp 2,400.00 Rp 12,000.00
0 Botol sampel darah 20 ml btl 0 Rp - Rp -
0 Box Slide biji 0 Rp - Rp -
0 Bufer 1 L btl 0 Rp - Rp -
0 Eosin 2 % btl 0 Rp - Rp -
0 Film rontgen 24 x 30 box 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Giemsa pekat btl 0 Rp 198,000.00 Rp -
4 H2SO4 btl 0 Rp 18,612.00 Rp -
0 Hayem btl 0 Rp - Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
0 Iodium Test btl 0 Rp - Rp -
6 Jelly EKG btl 2 Rp 126,500.00 Rp 253,000.00
0 Kertas EKG 50mm x 30mm rol 0 Rp - Rp -
0 Kertas EKG 63 30 mm rol 0 Rp - Rp -
0 Kertas EKG AT 1: 90x90mm box 0 Rp - Rp -
7 Kertas lensa sach 1 Rp 60,005.00 Rp 60,005.00
0 Kondom Katether M biji 0 Rp - Rp -
0 Kondom Katether S biji 0 Rp - Rp -
8 Larutan EDTA btl 0 Rp 52,800.00 Rp -
0 Metanol btl 0 Rp - Rp -
9 Minyak immersi btl 0 Rp 483,120.00 Rp -
0 Na citrat 3,8 % btl 0 Rp - Rp -
10 Object glass box 2 Rp 12,650.00 Rp 25,300.00
11 Pipet tetes biji 0 Rp 1,400.00 Rp -
0 Reagen golongan darah btl 0 Rp - Rp -
0 Salmonella Thypi H Widhal Test set 0 Rp - Rp -
0 Salmonella Thypi O Widhal Test set 0 Rp - Rp -
12 Spiritus btl 1 Rp 23,408.00 Rp 23,408.00
13 Stik gula darah Accucheck Performa btl 0 Rp 276,100.00 Rp -
14 Stik asam urat Nesco btl 0 Rp 102,047.00 Rp -
15 Stik asam urat UA Sure btl 0 Rp 323,400.00 Rp -
16 Stik cholesterol Accutrend btl 0 Rp 384,175.00 Rp -
17 Stik gula darah gluco DR btl 3 Rp 189,420.00 Rp 568,260.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
18 Stik gula darah Nesco btl 0 Rp 96,360.00 Rp -
19 Stik trigliserid Accutrend btl 0 Rp 447,810.00 Rp -
20 Stik urinalisa 3 parameter btl 1 Rp 330,000.00 Rp 330,000.00
21 Stik urinalisa 10 parameter btl 0 Rp 660,000.00 Rp -
22 Tes kehamilan sach 0 Rp 1,939.00 Rp -
23 Turk btl 0 Rp 29,051.00 Rp -
0 Ziehl nelson btl 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 VAKSIN 0 0 Rp - Rp -
0 BCG amp 0 Rp - Rp -
0 DPT - HB amp 0 Rp - Rp -
0 DPT HB HIB amp 0 Rp - Rp -
0 POLIO amp 0 Rp - Rp -
0 CAMPAK amp 0 Rp - Rp -
0 TT amp 0 Rp - Rp -
0 HB U amp 0 Rp - Rp -
0 DT amp 0 Rp - Rp -
0 TD amp 0 Rp - Rp -
0 ADS 0.05 ml set 0 Rp - Rp -
0 ADS 5 ml set 0 Rp - Rp -
0 SAFETY BOX biji 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 OBAT BARU 2018 0 0 Rp - Rp -
0 Rapid I HIV test 0 Rp - Rp -
0 Micropipet biji 0 Rp - Rp -
0 Sukralfat tab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Paket Alat Deteksi Resiko Kehamilan paket 0 Rp - Rp -
0 Trifluoperazin tab 0 Rp - Rp -
0 RDT Combo Malaria test 0 Rp - Rp -
0 Atalpulgit/ New Antides tab 0 Rp - Rp -
1 Stik Cholesterol Benecheck btl 0 Rp 231,000.00 Rp -
2 Stik Gula Darah Benecheck btl 0 Rp 149,600.00 Rp -
0 Jelly 82 gr/ My Jelly tube 0 Rp - Rp -
0 Mineral Mix sachet 0 Rp - Rp -
0 Na Divalproat 250 mg (Depakote) tab 0 Rp - Rp -
0 Nistatin drops btl 0 Rp - Rp -
0 Omeprazole injeksi amp 0 Rp - Rp -
3 Stik Asam Urat Benecheck btl 3 Rp 126,500.00 Rp 379,500.00
4 Panviton tab 1,050 Rp 1,173.33 Rp 1,231,992.30
5 Naia tab 240 Rp 1,664.67 Rp 399,520.00
6 Intunal syr btl 87 Rp 12,430.00 Rp 1,081,410.00
7 Mekobalamin kap 0 Rp 869.00 Rp -
8 Biocombin inj amp 0 Rp 5,390.00 Rp -
0 Lugol btl 0 Rp 5,391.00 Rp -
9 Larsi kap 0 Rp 1,026.67 Rp -
10 Omevita syr btl 56 Rp 5,393.00 Rp 302,008.00
0 Fluoksetin 20 mg tab/Peprezal tab 0 Rp 5,394.00 Rp -
0 Klorpromazin inj amp 0 Rp 5,395.00 Rp -
JUMLAH Rp 36,182,894.67
1
Harga Satuan
(Rp)
1 2 3 4 5 6
Mengetahui / Menyetujui:
Kepala DKK Temanggung
Dr. SUPARJO, M.Kes.

NIP. 19610731 198903 1 008
1
Harga Satuan
(Rp)
1 2 3 4 5 6
Kepala Dinas Kesehatan
1
ORAN OBAT DAN PERBEKALAN KESEHATAN
Keterangan
1
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1
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1
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1
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1
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1
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1
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1
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1
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1
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1
SUMBER ANGGARAN : APBD I (Buffer Prof), JPKMM dan Program
Harga Satuan
No. Nama obat dan Perbekes Satuan Jumlah Bara Jumlah Harga (Rp)
(Rp)
1 2 3 4 5 6
TABLET
0 TABLET 0 - Rp - Rp -
1 Albendazol 400 tab 900 Rp 288.00 Rp 259,200.00
0 Alopurinol 100 mg tab - Rp - Rp -
0 Alprazolam 0,25 mg tab - Rp - Rp -
0 Ambroxol 30 mg tab - Rp - Rp -
0 Aminofilin 200 mg tab - Rp - Rp -
0 Amitriptilin 25 mg tab - Rp 167.00 Rp -
0 Amlodipin 5 mg tab - Rp - Rp -
0 Amoksisilin 250 mg tab - Rp - Rp -
0 Antasida DOEN tab - Rp - Rp -
2 Antimigrein tab - Rp 167.00 Rp -
0 Asam Askorbat 50 mg tab - Rp - Rp -
0 Asam Folat 0,4 mg tab - Rp - Rp -
0 Asam Mefenamat 500 mg tab - Rp - Rp -
0 Asetosal 80 mg tab - Rp - Rp -
0 Asifit kap - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Asiklofir 200 mg tab - Rp - Rp -
0 Atropin sulfat 0,5 mg tab - Rp - Rp -
0 Azitromisin 500 mg tab - Rp - Rp -
0 Bekarbon / Norit tab - Rp - Rp -
0 Betahistin/versilon 6 mg tab - Rp - Rp -
0 Bisakodil 5 mg/ Laxana tab - Rp - Rp -
0 Cetirizin 10 mg tab - Rp - Rp -
0 Dexametason 0,5 mg tab - Rp - Rp -
0 Dextral tablet tab - Rp - Rp -
0 Diazepam 2 mg tab - Rp - Rp -
0 Dietil Carbamazin 100 mg tab - Rp - Rp -
0 Digoksin 0,25 mg tab - Rp - Rp -
0 Diltiazem 30 mg tab - Rp - Rp -
0 Dimenhidrinat 50 mg tab - Rp - Rp -
0 Doksisiklin 100 mg kap - Rp - Rp -
0 Domperidon 10 mg tab - Rp - Rp -
0 Erytromisin 250 mg kap - Rp - Rp -
0 Erytromisin 500 mg tab - Rp - Rp -
0 Fenitoin Na 100 mg/ Kutoin kap - Rp - Rp -
0 Fenobarbital 30 mg tab - Rp - Rp -
0 Fitomenadion/ K1 10 mg tab - Rp - Rp -
0 Flunarizin 10 mg tab - Rp - Rp -
0 Furosemida 40 mg tab - Rp - Rp -
0 G.G 100 mg/ Guaifenesin 100 tab - Rp - Rp -
3 Garam Oralit tab - Rp 264.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gemfibrozil 300 mg tab - Rp - Rp -
0 Glibenklamid 5 mg tab - Rp - Rp -
0 Glimepirid 2 mg tab - Rp - Rp -
0 Griseovulvin 125 mg tab - Rp - Rp -
0 Haemorogard tab - Rp - Rp -
0 Haloperidol 0,5 mg tab - Rp - Rp -
0 Haloperidol 5 mg tab - Rp - Rp -
0 HCT 25 mg tab - Rp - Rp -
0 Hepagard tab - Rp - Rp -
0 Hiosina + Metampiron/ Dormi tab - Rp - Rp -
0 Ibuprofen 200 mg tab - Rp - Rp -
0 Isosorbid Dinitrat 5 mg tab - Rp - Rp -
0 K.Aspartat 300 mg tab - Rp - Rp -
0 Kalium Diklofenak 50 mg tab - Rp - Rp -
0 Kalk tab - Rp - Rp -
0 Kalsium Karbonat 500 mg/ Calp tab - Rp - Rp -
0 Kandersatan 8 mg tab - Rp - Rp -
0 Kaolin + Pectin tab/ Omegdiar tab - Rp - Rp -
0 Kaptopril 12,5 mg tab - Rp - Rp -
0 Kaptopril 25 mg tab - Rp - Rp -
0 Karbamazepim 200 mg tab - Rp - Rp -
0 Karbazokrom 10 mg/ Adona tab - Rp - Rp -
0 Ketokonazol 200 mg tab - Rp - Rp -
0 Klobazam 10 mg tab - Rp - Rp -
0 Klonidin 0,15 mg tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kloramfenikol 250 mg tab - Rp - Rp -
0 Kloramfenikol 500 mg kap - Rp - Rp -
0 Klorfeniramin Maleat/ CTM 4 tab - Rp - Rp -
0 Klorpromazin 100 mg tab - Rp - Rp -
0 Klozapin 100 mg tab - Rp - Rp -
0 Kodein 10 mg tab - Rp - Rp -
0 Kotrimoksazol 480 mg tab - Rp - Rp -
0 Levofloksasin 500 mg tab - Rp - Rp -
0 Lisinopril tab 5 mg tab - Rp - Rp -
0 Litium Karbonat 400 mg/ Frima tab - Rp - Rp -
0 Loperamid 2 mg tab - Rp - Rp -
0 Loratadin 10 mg tab - Rp - Rp -
4 MB Kusta strip - Rp 28,424.00 Rp -
0 Meloksikam 15 mg tab - Rp - Rp -
0 Metformin 500 mg tab - Rp - Rp -
0 Metil Prednisolon 4 mg tab - Rp - Rp -
0 Metilergometrin 0,125 mg tab - Rp - Rp -
0 Metoklopramid 10 mg tab - Rp - Rp -
0 Metronidazol 500 mg tab - Rp - Rp -
0 Na Bikarbonat 500 mg tab - Rp - Rp -
0 N-Asetil Sistein 200 mg kap - Rp - Rp -
0 Natrium Diklofenak 50 mg tab - Rp - Rp -
0 Neurotropik tab/ Corsaneuron tab - Rp - Rp -
0 New Pro Uric kap - Rp - Rp -
0 Nifedipin 10 mg tab - Rp - Rp -
0 Nistatin tab 500.000 IU/ g tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Nodiar tab - Rp - Rp -
5 OAT Anak/ FDC pkt - Rp 195,441.92 Rp -
6 OAT FDC I/III pkt 2 Rp 317,018.00 Rp 634,036.00
7 OAT kat I/ Kombipak pkt - Rp 288,199.00 Rp -
8 OAT kat II pkt - ### Rp -
0 Omeprazol 20 mg tab - Rp - Rp -
0 Ondansetron 4 mg tab - Rp - Rp -
0 Papaverin 40 mg tab - Rp - Rp -
0 Parasetamol 500 mg tab - Rp - Rp -
0 PB Kusta Anak strip - Rp - Rp -
0 Piracetam 800 mg tab - Rp - Rp -
0 Piridoksin/ B6 10 mg tab - Rp - Rp -
0 Piroksikam 20 mg tab - Rp - Rp -
0 Prednison 5 mg tab - Rp - Rp -
9 Primaquin 15 mg tab - Rp 205.00 Rp -
0 Pro Lipid tab - Rp - Rp -
0 Propanolol 40 mg tab - Rp - Rp -
0 PTU 100 mg tab - Rp - Rp -
0 Ranitidin 150 mg tab - Rp - Rp -
10 Retinol 100.000 UI tab 135 Rp 284.00 Rp 38,340.00
0 Risperidon 2 mg tab - Rp - Rp -
0 Salbutamol 2 mg tab - Rp - Rp -
0 Samcobion kap - Rp - Rp -
0 Sefadroksil 500 mg tab - Rp - Rp -
0 Sefiksim 100 mg tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sianokobalamin / B12 50 mcg tab - Rp - Rp -
0 Simvastatin 10 mg tab - Rp - Rp -
0 Siprofloksasin 500 mg tab - Rp - Rp -
0 Spironolakton 100 mg tab - Rp - Rp -
12 Tablet Tambah darah tab - Rp 352.00 Rp -
0 Tensigard tab - Rp - Rp -
0 Teofilin 150 mg tab - Rp - Rp -
0 Teofilin SR / Retaphyl SR tab - Rp - Rp -
0 Tetrasiklin 250 mg tab - Rp - Rp -
0 Tetrasiklin 500 tab - Rp - Rp -
0 Tiamfenikol 500 mg tab - Rp - Rp -
0 Tiamin 50 mg/ B1 tab - Rp - Rp -
0 Triheksifenidil 2 mg tab - Rp 85.00 Rp -
0 Vitalamin tab - Rp - Rp -
0 Vitamin B komplek tab - Rp - Rp -
13 Zink 20 mg tab 480 Rp 513.00 Rp 246,240.00
0 0 0 - Rp - Rp -
0 SYRUP 0 - Rp - Rp -
0 Albendazol susp 200mg/ 5 ml btl - Rp - Rp -
0 Ambroxol sirup 15 mg/ 5 ml btl - Rp - Rp -
0 Amoksisilin sir 250 mg/ 5 ml btl - Rp - Rp -
0 Amoksisilin sirup 125 mg/ 5 ml btl - Rp - Rp -
0 Antasida DOEN susp btl - Rp - Rp -
0 Batugin elixir btl - Rp - Rp -
0 Dextrofen sirup btl - Rp - Rp -
0 Domperidon sirup 5 mg/ 5 ml btl - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Domperidon tetes 5 mg/ ml btl - Rp - Rp -
0 Erytromisin sirup 200 mg/ 5 ml btl - Rp - Rp -
0 Haloperidol drops 2 mg/ml (L btl - Rp - Rp -
0 Ibuprofen susp 100mg/5ml btl - Rp - Rp -
0 Ibuprofen Susp 200 mg/ 5 ml btl - Rp - Rp -
0 Kaolin + Pectin syr/ Kanina btl - Rp - Rp -
0 Kloramfenikol susp 125 mg/ 5 btl - Rp - Rp -
0 Kotrimoksazol suspensi btl - Rp - Rp -
0 Laxadin susp btl - Rp - Rp -
0 Metokloperamid drops btl - Rp - Rp -
0 Metronidasol sirup btl - Rp - Rp -
0 OBH btl - Rp - Rp -
0 Pacdin Vitcur sirup btl - Rp - Rp -
0 Parasetamol drops btl - Rp - Rp -
0 Parasetamol sirup 120 mg/ 5 ml btl - Rp - Rp -
0 Salbutamol sirup btl - Rp - Rp -
0 Sefadroksil sirup 125 mg/ 5 ml btl - Rp - Rp -
0 Setirizin sirup btl - Rp - Rp -
0 Sukralfat susp btl - Rp - Rp -
0 Tiamfenikol sirup btl - Rp - Rp -
0 Zink drops 10 mg/ml btl - Rp - Rp -
0 Zink sirup btl - Rp - Rp -
0 0 0 - Rp - Rp -
0 INJEKSI 0 - Rp - Rp -
0 Aminofilin injeksi 24 mg/ ml amp - Rp - Rp -
0 Ampisilin inj 1.000 mg vial - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Aqua pro injeksi btl - Rp - Rp -
0 Asam Traneksamat inj amp - Rp - Rp -
1 Atropin Sulsat inj amp - Rp 1,540.00 Rp -
0 Dexametason injeksi 5 mg/ ml amp - Rp - Rp -
2 Diazepam inj 5 mg/ ml amp 8 Rp 1,735.00 Rp 13,880.00
0 Difenhidramin injeksi 10 mg/ m amp - Rp - Rp -
0 Epinefrin injeksi 0,1 % amp - Rp - Rp -
3 Fenobarbital inj 50 mg/ ml amp 8 Rp 1,969.00 Rp 15,752.00
0 Flufenazin inj 25mg/ml - Sikzo amp - Rp 59,800.00 Rp -
0 Furosemid inj 10 mg/ ml amp - Rp - Rp -
4 Gentamisin inj 40 mg/ ml amp - Rp 3,108.00 Rp -
5 Glukonas Calcicus inj 10% amp - Rp 9,955.00 Rp -
0 Haloperidol inj i.m. 5 mg/ml (L amp - Rp - Rp -
0 Human Tetanus Imuno 250 UI amp - Rp - Rp -
0 Ketorolac inj 30 mg/ml amp - Rp - Rp -
0 Lidokain Comp. inj amp - Rp - Rp -
0 Lidokain inj 2% amp - Rp - Rp -
0 Metilergometrin inj amp - Rp - Rp -
0 Meylon / Na Bic inj amp - Rp - Rp -
0 MgSO4 20% amp - Rp - Rp -
0 Nalokson inj 0,4 mg/ml (Nokob amp - Rp - Rp -
0 Oksitosin injeksi 10 UI/ ml amp - Rp - Rp -
0 Ondansetron 4 mg inj amp - Rp - Rp -
0 Piracetam 1 gr/ 5 ml amp - Rp - Rp -
0 Ranitidin inj 25 mg/ 2 ml amp - Rp - Rp -
0 Sefotaksim 1 gr/ vial amp - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Serum ABU I / Biosave vial - Rp - Rp -
0 Serum ATS 1.500 amp - Rp - Rp -
0 Sianokobalamin inj 500 mcg/ m amp - Rp - Rp -
6 Vit K1/Fitomenadion inj 2 mg/ amp 83 Rp 3,550.00 Rp 294,650.00
0 0 0 - Rp - Rp -
0 OBAT LUAR 0 - Rp - Rp -
0 Alkohol 96 % 1 L btl - Rp - Rp -
0 Antibakteri SK tube - Rp - Rp -
0 Antifungi sk pot - Rp - Rp -
0 Antihemoroid supp supp - Rp - Rp -
0 Asam Fusidat krim 20mg/g - Ac tube - Rp - Rp -
0 Asiklovir krim 5 % tube - Rp - Rp -
0 Betametason krim 0,1 % tube - Rp - Rp -
0 Bisakodil sup anak supo - Rp - Rp -
0 Bisakodil sup dws supo - Rp - Rp -
0 Budesonid/ Pulmicort res 0,25m btl - Rp - Rp -
0 Budesonid-formeterol/ Symbicor btl - Rp - Rp -
0 Desoksimetason krim tube - Rp - Rp -
0 Diazepam Rectal 5mg/2,5ml - Sttube - Rp - Rp -
0 Enkasari btl - Rp - Rp -
0 Etakridin Larutan 0,1 % btl - Rp - Rp -
0 Etanol 70% 100 ml btl - Rp - Rp -
0 Feneterol HBr/ Berotec inh btl - Rp - Rp -
0 Fenol gliserol TT 10 % btl - Rp - Rp -
0 Flusinolon Asetat 0.025% tube - Rp - Rp -
0 Framisetin tulle/ Daryanttulle lbr - Rp - Rp -
0 Gentamisin SM tube - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gentamisin TM 0,3 % btl - Rp - Rp -
0 Gentien Violet 1 % btl - Rp - Rp -
0 Gliserin btl - Rp - Rp -
0 Hidrokortison krim 2,5 % tube - Rp - Rp -
0 Ikhtiol SK btl - Rp - Rp -
0 Ketokonazol krim 2 % tube - Rp - Rp -
0 Klobetasol 0,05% krim tube - Rp - Rp -
0 Kloramfenikol SM 1 % tube - Rp - Rp -
0 Kloramfenikol SK 2% tube - Rp - Rp -
0 Kloramfenikol TM btl - Rp - Rp -
0 Kloramfenikol TT 3 % btl - Rp - Rp -
0 Lidokain Spray 10%/ Xylocaine btl - Rp - Rp -
0 Mikonazol krim 2 % tube - Rp - Rp -
0 Minyak ikan SK pot - Rp - Rp -
0 Mometason krim tube - Rp - Rp -
0 Nistatin tab vag 100.000 UI/ g supp - Rp - Rp -
1 Oksitetrasiklin 1 % SM tube - Rp 3,220.00 Rp -
0 Oksitetrasiklin 3 % SK tube - Rp - Rp -
0 Perak Sulfadiazin/ burnazin tube - Rp - Rp -
0 Perhidrol/ H2O2 btl - Rp - Rp -
0 Permetrin krim 5%/ Scabimite tube - Rp - Rp -
0 Permetrin lotion 1%/ Peditox btl - Rp - Rp -
0 Polikresulen btl - Rp - Rp -
0 Povidon Iodida 300 ml btl - Rp - Rp -
0 Povidon Iodin 30 ml btl - Rp - Rp -
0 Salbutamol inh 100 mcg/ Ventol btl - Rp - Rp -
0 Salbutamol neb/ Ventolin Nebul tube - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Salep 2-4 pot - Rp - Rp -
0 Salisil bedak pot - Rp - Rp -
0 Sulfasetamid TM 15 % btl - Rp - Rp -
0 Tetrakain TM btl - Rp - Rp -
0 Triamcinolon/ Bufacomb tube - Rp - Rp -
2 0 0 - Rp - Rp -
0 INFUS 0 - Rp - Rp -
0 Assering btl - Rp - Rp -
0 Glucosa 40% btl - Rp - Rp -
0 Ka-En 3A btl - Rp - Rp -
0 Ka-En 3B btl - Rp - Rp -
0 Ka-En Mg 3 btl - Rp - Rp -
0 Metronidazol infus btl - Rp - Rp -
0 NaCl btl - Rp - Rp -
0 Parasetamol 10 mg/ml infus btl - Rp - Rp -
0 RL btl - Rp - Rp -
0 0 0 - Rp - Rp -
0 BMHP 0 - Rp - Rp -
0 Alat suntik 1 ml set - Rp - Rp -
0 Alat Suntik 10 ml set - Rp - Rp -
0 Alat suntik ADS 0.05 ml set - Rp - Rp -
0 Alat suntik ADS 0.5 ml (Solosh set - Rp - Rp -
0 Alkazym 250 mg sack - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Alkacide 1 L High Level btl - Rp - Rp -
0 Alkohol Swab box - Rp - Rp -
0 Alkohol swab 2 % box - Rp - Rp -
0 Aseptan Liquid 500 cc btl - Rp - Rp -
0 Aseptic Gel 500 cc btl - Rp - Rp -
0 Bioplacentol tulle lbr - Rp - Rp -
0 Bisturi box - Rp - Rp -
0 Bracket Hand Wash Plastik biji - Rp - Rp -
0 Cat gut Chromic No. 2/0 DS 2 biji - Rp - Rp -
0 Cat gut Chromic No. 2/0 HR 3 biji - Rp - Rp -
0 Catgut Chromic 3/0 DS 24 mm biji - Rp - Rp -
0 Cat gut Plain No. 2/0 DS 24 m biji - Rp - Rp -
0 Cover Glass/ Deck Glass box - Rp - Rp -
0 Endotracheal Tube - 2.0 biji - Rp - Rp -
0 Feeding Tube FR 5 biji - Rp - Rp -
0 Female Catheter No. 14 biji - Rp - Rp -
0 Foley cateter No. 14 biji - Rp - Rp -
0 Gelang ID Pasien anak biru biji - Rp - Rp -
0 Gelang ID Pasien anak pink biji - Rp - Rp -
0 Gelang ID Pasien dewasa biru biji - Rp - Rp -
0 Gelang ID Pasien dewasa pink biji - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Handschoen Disposible (M) biji - Rp - Rp -
0 Handschoen Disposible (S) biji - Rp - Rp -
0 Handschoen Nitril (M) biji - Rp - Rp -
0 Hansdchoen Nitril (S) biji - Rp - Rp -
0 Handschoon panjang/obgin ster psg - Rp - Rp -
0 Handscoon steril no 7 psg - Rp - Rp -
0 Handscoon steril no. 7,5 psg - Rp - Rp -
0 Infusion set anak biji - Rp - Rp -
0 Infusion set dewasa biji - Rp - Rp -
0 IV Catheter No. 18 biji - Rp - Rp -
0 IV Catheter No.20 with port set - Rp - Rp -
0 Jarum Jahit Kulit No. 10 biji - Rp - Rp -
0 Jarum Jahit Mukosa No. 10 biji - Rp - Rp -
0 Jelly 5 gr/ My Jelly sach - Rp - Rp -
0 Kanul Oksigen Anak biji - Rp - Rp -
0 Kanul Oksigen Dewasa biji - Rp - Rp -
0 Kapas 250 g bks - Rp - Rp -
0 Kasa 2 m x 80 cm rol - Rp - Rp -
0 Kasa 36 x 80 cm rol - Rp - Rp -
0 Kassa steril rol - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kondom kateter ( M ) biji - Rp - Rp -
0 Kondom kateter ( S ) biji - Rp - Rp -
0 Lidi Kapas Non Steril pak - Rp - Rp -
0 Lidi Kapas Steril biji - Rp - Rp -
0 Lysol 1 L btl - Rp - Rp -
0 Masker disposible biji - Rp - Rp -
0 Masker Oksigen anak set - Rp - Rp -
0 Masker Oksigen dewasa set - Rp - Rp -
0 Masker Oksigen cungkup set - Rp - Rp -
0 Mucus Extractor set - Rp - Rp -
0 N2O gas tbg - Rp - Rp -
0 Nebulizer with masker anak set - Rp - Rp -
0 Nebulizer with masker dewasa set - Rp - Rp -
0 Non Adhesive Bandage 10 x 4,5 rol - Rp - Rp -
0 Object Glass box - Rp - Rp -
1 Object Glass Frosted box - Rp 20,000.00 Rp -
0 Oksigen gas tbg - Rp - Rp -
0 Onescrub 500 cc btl - Rp - Rp -
0 Plester rol - Rp - Rp -
0 Plester putih/ hipavix 5 cm biji - Rp - Rp -
0 Pot Sputum biji - Rp - Rp -
2 Pot Sputum Steril biji 100 Rp 5,890.00 Rp 589,000.00
0 Pot Urin biji - Rp - Rp -
0 Sabun Cuci Tangan/ Softaskin btl - Rp - Rp -
0 Savety box biji - Rp - Rp -
0 Silk 2/0 DS 24 mm sac - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Suction catether no FR 8 biji - Rp - Rp -
0 Three way stop cock biji - Rp - Rp -
0 Tranfusi set biji - Rp - Rp -
0 Umbilical cord klem nylon steri biji - Rp - Rp -
0 Underpad Steril lbr - Rp - Rp -
0 Urine bag biji - Rp - Rp -
0 0 0 - Rp - Rp -
0 GIGI 0 - Rp - Rp -
0 Bonding Composite box - Rp - Rp -
0 Bur Polish Composite set - Rp - Rp -
0 Cavit box - Rp - Rp -
0 Composit warna A2 box - Rp - Rp -
0 Dentin Conditioner btl - Rp - Rp -
0 Devitalisasi Pasta Non Arsen btl - Rp - Rp -
0 Disclosing Solution btl - Rp - Rp -
0 Disposible Dental Suction/ Sali box - Rp - Rp -
0 Disposible Mikro Aplikator box - Rp - Rp -
0 Etil klorid btl - Rp - Rp -
0 Etsa Asam box - Rp - Rp -
0 Eugenol btl - Rp - Rp -
0 Forinokresol / T K F btl - Rp - Rp -
0 Glass Ionomer Cement - Fuji I btl - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Glass Ionomer Cement - Fuji VI btl - Rp - Rp -
0 Iodoform Pasta pot - Rp - Rp -
0 Kalsium hidroksida pasta set - Rp - Rp -
0 Klorfenol/CHKM btl - Rp - Rp -
0 Mata Bur high speed set - Rp - Rp -
0 Mata Bur low speed set - Rp - Rp -
0 Mumifying pasta btl - Rp - Rp -
0 OCO btl - Rp - Rp -
0 Pasta pengisi saluran akar/ Vita btl - Rp - Rp -
0 Semen seng fosfat set - Rp - Rp -
0 Sodium Hipochloride btl - Rp - Rp -
0 Spons Gelatin/ Hemospon biji - Rp - Rp -
0 T S Fletcher set - Rp - Rp -
0 Tips Scaler ART biji - Rp - Rp -
0 Tips Scaler Woodpecker biji - Rp - Rp -
0 0 0 - Rp - Rp -
0 LABORAT 0 - Rp - Rp -
0 Ammonium oxalat 1 % btl - Rp - Rp -
0 Blood lancet box - Rp - Rp -
0 Botol sampel darah 10 ml btl - Rp - Rp -
1 Box Slide biji - Rp 77,690.00 Rp -
0 Bufer 1 L btl - Rp - Rp -
0 Eosin 2 % btl - Rp - Rp -
0 Film rontgen 24 x 30 box - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Giemsa pekat btl - Rp - Rp -
0 H2SO4 btl - Rp - Rp -
0 Hayem btl - Rp - Rp -
0 HCl 0,1 N btl - Rp - Rp -
2 Iodium Test btl - Rp 5,275.00 Rp -
0 Jelly EKG btl - Rp - Rp -
0 Kertas EKG 50mm x 30mm rol - Rp - Rp -
0 Kertas EKG 63 30 mm rol - Rp - Rp -
0 Kertas EKG AT 1: 90x90mm box - Rp - Rp -
0 Kertas lensa sach - Rp - Rp -
0 Kondom Katether M biji - Rp - Rp -
0 Kondom Katether S biji - Rp - Rp -
0 Larutan EDTA btl - Rp - Rp -
0 Metanol btl - Rp - Rp -
0 Minyak immersi btl - Rp - Rp -
0 Na citrat 3,8 % btl - Rp - Rp -
0 Object glass box - Rp - Rp -
0 Pipet tetes biji - Rp - Rp -
0 Reagen golongan darah btl - Rp - Rp -
0 Salmonella Thypi H Widhal Tes set - Rp - Rp -
0 Salmonella Thypi O Widhal Tes set - Rp - Rp -
0 Spiritus btl - Rp - Rp -
0 Stik gula darah Accucheck Perf btl - Rp - Rp -
0 Stik asam urat Nesco btl - Rp - Rp -
0 Stik asam urat UA Sure btl - Rp - Rp -
0 Stik cholesterol Accutrend btl - Rp - Rp -
0 Stik gula darah gluco DR btl - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Stik gula darah Nesco btl - Rp - Rp -
0 Stik trigliserid Accutrend btl - Rp - Rp -
0 Stik urinalisa 3 parameter btl - Rp - Rp -
0 Tes kehamilan sach - Rp - Rp -
0 Turk btl - Rp - Rp -
3 Ziehl nelson btl - Rp 276,500.00 Rp -
0 0 0 - Rp - Rp -
0 VAKSIN 0 - Rp - Rp -
0 BCG amp - Rp - Rp -
0 DPT - HB amp - Rp - Rp -
0 DPT HB HIB amp - Rp - Rp -
0 POLIO amp - Rp - Rp -
0 CAMPAK amp - Rp - Rp -
0 TT amp - Rp - Rp -
0 HB U amp - Rp - Rp -
0 DT amp - Rp - Rp -
0 TD amp - Rp - Rp -
0 ADS 0.05 ml set - Rp - Rp -
0 ADS 5 ml set - Rp - Rp -
0 SAFETY BOX biji - Rp - Rp -
0 0 0 - Rp - Rp -
0 OBAT BARU 2018 0 - Rp - Rp -
1 Rapid I HIV test - Rp 14,340.00 Rp -
2 Micropipet biji - Rp 980.00 Rp -
0 Sukralfat tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket - Rp 522,083.00 Rp -
0 Trifluoperazin tab - Rp - Rp -
4 RDT Combo Malaria test - Rp 19,760.00 Rp -
0 Atalpulgit/ New Antides tab - Rp - Rp -
0 Stik Cholesterol Benecheck btl - Rp - Rp -
0 Stik Gula Darah Benecheck btl - Rp - Rp -
0 Jelly 82 gr/ My Jelly tube - Rp - Rp -
5 Mineral Mix sachet - Rp 2,726.90 Rp -
0 Na Divalproat 250 mg (Depakot tab - Rp - Rp -
0 Nistatin drops btl - Rp - Rp -
0 Omeprazole injeksi amp - Rp - Rp -
0 Stik Asam Urat Benecheck btl - Rp - Rp -
0 Panviton tab - Rp - Rp -
0 Naia tab - Rp - Rp -
0 Intunal syr btl - Rp - Rp -
0 Mekobalamin kap - Rp - Rp -
0 Biocombin inj amp - Rp - Rp -
6 Lugol btl - Rp 30,000.00 Rp -
0 Larsi kap - Rp - Rp -
0 Omevita syr btl - Rp - Rp -
7 Fluoksetin 20 mg tab/Peprezal tab - Rp 225.00 Rp -
8 Klorpromazin inj amp - Rp 1,243.00 Rp -
9 Klozapin 25 mg tab 165 Rp 1,121.00 Rp 184,965.00
JUMLAH Rp 2,538,778.20
1
AN OBAT DAN PERBEKALAN KESEHATAN
GARAN : APBD I (Buffer Prof), JPKMM dan Program
aftar sisa persediaan (Habis Pakai / jual)
Akhir Bulan / Tanggal : 31 Desember 2018
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS DHARMARINI
1 2 3 4 5
TABLET
0 TABLET 0 - -
5 Amlodipin 5 mg tab 948 70.00
6 Amlodipin 10 mg tab - 93.00
10 Antimigrein tab - 173.00
13 Asam Folat 0,4 mg tab 968 63.00
0 Asifit kap - -
1
1 2 3 4 5
16 Asiklofir 200 mg tab 1,247 249.00
26 Digoksin 0,25 mg tab 77 97.00
27 Diltiazem 30 mg tab 1,355 134.00
30 Domperidon 10 mg tab 738 118.00
32 Erytromisin 500 mg tab - 750.00
34 Fenobarbital 30 mg tab 1,030 171.00

1
1 2 3 4 5
39 Glimepirid 2 mg tab 978 207.00
43 Haloperidol 5 mg tab 1,188 56.00
44 HCT 25 mg tab 569 149.00
0 Hepagard tab - -
48 Kalk tab 2,777 59.00
49 Kalsium Karbonat 500 mg/ Calporos tab 1,920 430.00
56 Klonidin 0,15 mg tab - 184.00

1
1 2 3 4 5
58 Kloramfenikol 500 mg kap 579 1,089.95
61 Klozapin 100 mg tab 1,094 3,288.00
62 Kodein 10 mg tab 122 550.00
65 Lisinopril tab 5 mg tab - 209.00
69 Metformin 500 mg tab 3,887 96.00
71 Metil Prednisolon 8 mg tab 918 300.00
75 N-Asetil Sistein 200 mg kap 134 426.00

1
1 2 3 4 5
0 Nodiar tab - -
84 Prednison 5 mg tab 467 68.00
0 Pro Lipid tab - -
85 Propanolol 40 mg tab 100 74.00
86 PTU 100 mg tab 100 279.00
87 Ranitidin 150 mg tab 3,535 105.00
0 Samcobion kap - -
92 Sefiksim 100 mg tab 100 590.00

1
1 2 3 4 5
94 Simvastatin 10 mg tab 2,271 131.00
0 Tensigard tab - -
99 Teofilin 150 mg tab 205 250.00
102 Tetrasiklin 500 tab - 309.99
103 Tiamin 50 mg/ B1 tab 5,438 86.00
0 Vitalamin tab - -
106 Zink 20 mg tab - 473.00
0 0 0 - -
0 SYRUP 0 - -
1 Albendazol susp 200mg/ 5 ml btl - 4,000.00

1
1 2 3 4 5
7 Domperidon tetes 5 mg/ ml btl - 15,599.76
0 OBH btl - -
0 0 0 - -
0 INJEKSI 0 - -

1
1 2 3 4 5
3 Atropin Sulsat inj amp - 1,540.00
12 Ketorolac inj 30 mg/ml amp - 1,290.00
14 Lidokain inj 2% amp - 1,144.00
17 MgSO4 20% amp 20 3,200.00
18 MgSO4 40% amp - 3,650.00
20 Ondansetron 4 mg inj amp - 1,070.00
21 Ranitidin inj 25 mg/ 2 ml amp - 1,390.00

1
1 2 3 4 5
24 Sianokobalamin inj 500 mcg/ ml amp 20 1,098.00
0 0 0 - -
0 OBAT LUAR 0 - -
8 Budesonid/ Pulmicort res 0,25mg/ m btl - 9,724.99
0 Enkasari btl - -
12 Etanol 70% 100 ml btl 267 2,500.00

1
1 2 3 4 5
0 Gliserin btl - -
25 Lidokain Spray 10%/ Xylocaine btl - 170,399.90
29 Polikresulen btl - 17,393.00

1
1 2 3 4 5
34 Salep 2-4 pot 1 2,527.00
0 0 0 - -
0 INFUS 0 - -
2 Glucosa 40% btl - 1,452.00
3 Glucosa 5% btl 40 6,900.00
4 Ka-En 3A btl - 10,050.00
5 Ka-En 3B btl - 10,696.00
6 Ka-En Mg 3 btl 20 9,599.67
7 NaCl btl 31 6,410.00
8 RL btl 31 7,150.00
0 0 0 - -
0 BMHP 0 - -
6 Alat suntik ADS 0.5 ml (Soloshot Mi set - 1,655.50

1
1 2 3 4 5
7 Alkohol Swab box - 10,000.00
0 Bisturi box - -
8 Cat gut Chromic No. 2/0 DS 24 mm biji - 40,200.00
11 Cat gut Plain No. 2/0 DS 24 mm biji - 40,198.39

1
1 2 3 4 5
18 Handschoen Disposible (M) biji 678 462.00
21 Hansdchoen Nitril (S) biji 400 627.00
32 Kasa 2 m x 80 cm rol - 9,449.99
33 Kasa 36 x 80 cm rol 2 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 5 41,000.00
0 N2O gas tbg - -
39 Onescrub 500 cc btl 4 62,500.00
0 Plester rol - -
0 Pot Urin biji - -
40 Savety box biji 101 15,715.35
41 Silk 2/0 DS 24 mm sac 11 23,300.00
42 Silk 3/0 DS 24 mm sac 12 22,400.00

1
1 2 3 4 5
0 0 0 - -
0 GIGI 0 - -
0 Cavit box - -
0 Etsa Asam box - -

1
1 2 3 4 5
0 OCO btl - -
0 0 0 - -
0 LABORAT 0 - -
2 Botol sampel darah 20 ml btl - 4,400.00
3 Bufer 1 L btl - 80,000.00
4 Eosin 2 % btl - 230,000.00

1
1 2 3 4 5
0 H2SO4 btl - -
5 Hayem btl - 220,000.00
0 HCl 0,1 N btl - -
0 Jelly EKG btl - -
6 Kertas EKG 63 30 mm rol - 90,200.00
9 Na citrat 3,8 % btl 4 27,500.00
0 Spiritus btl - -

1
1 2 3 4 5
0 Turk btl - -
0 0 0 - -
0 VAKSIN 0 - -
0 BCG amp - -
0 DPT - HB amp - -
0 POLIO amp - -
0 CAMPAK amp - -
0 TT amp - -
0 HB U amp - -
0 DT amp - -
0 TD amp - -
0 ADS 0.05 ml set - -
0 ADS 5 ml set - -
0 0 0 - -
0 OBAT BARU 2018 0 - -

1
1 2 3 4 5
2 Trifluoperazin tab 1,010 269.00
0 Panviton tab - -
0 Naia tab - -
0 Lugol btl - -
0 Larsi kap - -
JUMLAH
1
1 2 3 4 5
1
PUSKESMAS DHARMARINI
Jumlah Harga (Rp)
129,602.00
75,840.00
38,948.00
83,500.00
66,360.00
297,180.00
1,578,296.00
188,976.00
418,320.00
60,984.00
198,584.00
17,168.00
1
Jumlah Harga (Rp)
310,503.00
239,414.00
1,320.00
65,700.00
162,053.98
141,440.00
10,750.00
32,700.00
7,469.00
181,570.00
25,376.00
60,720.00
87,084.00
49,140.00
103,964.00
176,130.00
484,930.00
54,834.00
3,855.00
1
Jumlah Harga (Rp)
427,880.00
202,446.00
101,220.00
50,740.00
66,528.00
84,781.00
56,760.00
64,700.00
163,843.00
825,600.00
36,330.00
61,380.00
132,216.00
67,620.00
252,000.00
135,800.00
-
1
Jumlah Harga (Rp)
631,081.05
171,528.00
95,844.00
3,597,072.00
67,100.00
176,588.10
14,850.00
334,400.00
60,885.00
373,152.00
185,550.00
275,400.00
63,300.00
39,960.00
45,280.00
57,084.00
134,435.00
27,000.00
118,455.00
1
Jumlah Harga (Rp)
64,870.00
2,380.00
383,712.00
603,216.00
31,756.00
7,400.00
27,900.00
371,175.00
79,170.00
70,741.00
17,500.00
456,500.00
59,000.00
1
Jumlah Harga (Rp)
257,907.00
297,501.00
75,850.00
458,425.17
137,532.00
33,031,740.00
51,250.00
105,000.00
467,668.00
34,000.00
535,440.00
136,000.00
424,270.00
425,250.00
429,300.00
1
Jumlah Harga (Rp)
544,500.00
3,955.00
218,280.00
105,600.00
15,200.00
312,000.00
22,120.00
8,892.00
129,426.00
67,450.00
40,734.00
415,140.00
9,115.00
-
1
Jumlah Harga (Rp)
63,250.00
14,000.00
2,100.00
33,231.00
49,775.00
2,298,400.00
96,768.00
44,385.00
93,000.00
64,000.00
72,200.00
-
1
Jumlah Harga (Rp)
462,000.00
21,960.00
441,840.00
269,760.00
88,305.00
899,550.00
115,928.00
634,400.00
57,585.00
667,500.00
166,380.00
36,260.00
321,000.00
1
Jumlah Harga (Rp)
727,904.00
243,426.00
223,503.00
206,910.00
306,816.00
78,000.00
87,000.00
13,598.00
1,264,120.00
180,000.00
290,000.00
47,999.76
1
Jumlah Harga (Rp)
2,527.00
29,725.00
276,000.00
191,993.40
198,710.00
221,650.00
394,702.00
773,432.00
699,540.00
18,480.00
13,493.70
-
1
Jumlah Harga (Rp)
1,705,600.00
500,880.24
92,650.00
92,650.00
85,000.00
85,000.00
85,000.00
1
Jumlah Harga (Rp)
313,236.00
600,138.00
250,800.00
190,080.00
154,000.00
154,000.00
252,300.00
177,100.00
10,000.00
10,000.00
260,000.00
-
1
Jumlah Harga (Rp)
205,000.00
19,800.00
19,800.00
28,300.00
28,300.00
250,000.00
1,587,250.35
256,300.00
268,800.00
1
Jumlah Harga (Rp)
16,249.20
488,064.00
30,030.00
133,336.00
-
1
Jumlah Harga (Rp)
-
1
Jumlah Harga (Rp)
528,000.00
110,000.00
199,980.00
199,980.00
-
1
Jumlah Harga (Rp)
419,657.00
-
1
Jumlah Harga (Rp)
271,690.00
321,776.00
612,000.00
429,544.50
Rp 80,431,782.45
1
Jumlah Harga (Rp)
1
DI PUSKESMAS DHARMARINI
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1 Ambroxol 30 mg tab 1,382 Rp 201.30 Rp 278,196.60
2 Antimigrein tab 8 Rp 5,625.40 Rp 45,003.20
3 Asifit kap 280 Rp 1,026.67 Rp 287,466.67
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Dextral tablet tab 730 Rp 506.00 Rp 369,380.00
7 G.G 100 mg/ Guaifenesin 100 tab 29 Rp 179.96 Rp 5,218.84
1
Harga Satuan
(Rp)
1 2 3 4 5 6
10 Hepagard tab 0 Rp 2,794.00 Rp -
11 Hiosina + Metampiron/ Dormi tab 510 Rp 2,069.00 Rp 1,055,190.00
12 Ibuprofen 200 mg tab 0 Rp 110.00 Rp -
13 Kalium Diklofenak 50 mg tab 1,575 Rp 694.32 Rp 1,093,554.00
0 Kalsium Karbonat 500 mg/ Calp tab 0 Rp - Rp -
14 Kaolin + Pectin tab/ Omegdiar tab 1 Rp 453.04 Rp 453.04
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Klorfeniramin Maleat/ CTM 4 tab 0 Rp - Rp -
0 Litium Karbonat 400 mg/ Frima tab 0 Rp - Rp -
19 Meloksikam 15 mg tab 435 Rp 759.00 Rp 330,165.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
29 Pro Lipid tab 360 Rp 858.00 Rp 308,880.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1 Ambroxol sirup 15 mg/ 5 ml btl 159 Rp 5,148.00 Rp 818,532.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 Haloperidol drops 2 mg/ml (L btl 0 Rp 16,500.00 Rp -
0 Kloramfenikol susp 125 mg/ 5 btl 0 Rp - Rp -
7 OBH btl 52 Rp 5,797.00 Rp 301,444.00
9 Tiamfenikol sirup btl 7 Rp 10,648.00 Rp 74,536.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Difenhidramin injeksi 10 mg/ m amp 0 Rp - Rp -
0 Flufenazin inj 25mg/ml - Sikzo amp 0 Rp - Rp -
5 Haloperidol inj i.m. 5 mg/ml (L amp 12 Rp 6,250.00 Rp 75,000.00
0 Nalokson inj 0,4 mg/ml (Nokob amp 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sianokobalamin inj 500 mcg/ m amp 0 Rp - Rp -
0 Vit K1/Fitomenadion inj 2 mg/ amp 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Asam Fusidat krim 20mg/g - Ac tube 0 Rp - Rp -
3 Bisakodil sup anak supo 0 Rp 4,990.00 Rp -
0 Budesonid/ Pulmicort res 0,25m btl 0 Rp - Rp -
0 Budesonid-formeterol/ Symbicor btl 0 Rp - Rp -
0 Diazepam Rectal 5mg/2,5ml - Sttube 0 Rp - Rp -
5 Etakridin Larutan 0,1 % btl 0 Rp 2,550.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
14 Permetrin krim 5%/ Scabimite tube 0 Rp 11,473.00 Rp -
17 Povidon Iodida 300 ml btl 0 Rp 18,000.00 Rp -
16 Povidon Iodin 30 ml btl 0 Rp 2,900.00 Rp -
0 Salbutamol inh 100 mcg/ Ventol btl 0 Rp - Rp -
0 Salbutamol neb/ Ventolin Nebul tube 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
19 Sulfasetamid TM 15 % btl 113 Rp 9,350.00 Rp 1,056,550.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Alat suntik ADS 0.5 ml (Solosh set 0 Rp - Rp -
2 Alkazym 250 mg sack 1 Rp 800,978.20 Rp 800,978.20
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Alkacide 1 L High Level btl 0 Rp 2,702,700.00 Rp -
5 Alkohol swab 2 % box 0 Rp 15,730.00 Rp -
6 Aseptan Liquid 500 cc btl 37 Rp 30,000.00 Rp 1,110,000.00
9 Bisturi box 1 Rp 83,600.00 Rp 83,600.00
0 Cat gut Chromic No. 2/0 DS 2 biji 0 Rp - Rp -
0 Cat gut Chromic No. 2/0 HR 3 biji 0 Rp - Rp -
0 Cat gut Plain No. 2/0 DS 24 m biji 0 Rp - Rp -
11 Cat gut Plain No. 3/0 DS 24 m biji 0 Rp 5,583.33 Rp -
15 Female Catheter No. 14 biji 1 Rp 5,720.00 Rp 5,720.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Handschoon panjang/obgin ster psg 103 Rp 30,000.00 Rp 3,090,000.00
22 Handscoon steril no 7 psg 0 Rp 7,865.00 Rp -
23 Handscoon steril no. 7,5 psg 0 Rp 7,865.00 Rp -
28 Jarum Jahit Mukosa No. 10 biji 0 Rp 26,317.50 Rp -
31 Kapas 250 g bks 3 Rp 24,000.00 Rp 72,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
35 Kondom kateter ( M ) biji 10 Rp 6,300.00 Rp 63,000.00
37 Lidi Kapas Non Steril pak 40 Rp 27,500.00 Rp 1,100,000.00
38 Lidi Kapas Steril biji 0 Rp 1,120.00 Rp -
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp 3,250,000.00 Rp -
44 Non Adhesive Bandage 10 x 4,5 rol 5 Rp 66,973.50 Rp 334,867.50
47 Oksigen gas tbg 2 Rp 66,000.00 Rp 132,000.00
48 Plester rol 36 Rp 12,076.00 Rp 434,736.00
49 Plester putih/ hipavix 5 cm biji 32 Rp 55,000.00 Rp 1,760,000.00
52 Sabun Cuci Tangan/ Softaskin btl 46 Rp 58,538.70 Rp 2,692,780.20
1
Harga Satuan
(Rp)
1 2 3 4 5 6
60 Umbilical cord klem nylon steri biji 345 Rp 1,299.98 Rp 448,493.10
0 0 0 0 Rp - Rp -
1 Bonding Composite box 2 Rp 880,610.00 Rp 1,761,220.00
2 Bur Polish Composite set 5 Rp 44,000.00 Rp 220,000.00
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
8 Disclosing Solution btl 2 Rp 55,000.00 Rp 110,000.00
9 Disposible Dental Suction/ Sali box 2 Rp 79,373.80 Rp 158,747.60
10 Disposible Mikro Aplikator box 1 Rp 165,000.00 Rp 165,000.00
12 Etsa Asam box 3 Rp 178,690.00 Rp 536,070.00
14 Glass Ionomer Cement - Fuji I btl 1 Rp 781,000.00 Rp 781,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
15 Glass Ionomer Cement - Fuji VI btl 1 Rp 686,400.00 Rp 686,400.00
16 Iodoform Pasta pot 2 Rp 176,000.00 Rp 352,000.00
19 Mata Bur high speed set 0 Rp 165,000.00 Rp -
20 Mumifying pasta btl 1 Rp 616,000.00 Rp 616,000.00
21 OCO btl 0 Rp 125,400.00 Rp -
22 Pasta pengisi saluran akar/ Vita btl 2 Rp 265,000.00 Rp 530,000.00
26 T S Fletcher set 1 Rp 35,999.99 Rp 35,999.99
27 Tips Scaler ART biji 1 Rp 220,000.00 Rp 220,000.00
0 0 0 0 Rp - Rp -
2 Botol sampel darah 10 ml btl 0 Rp 2,400.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 3 Rp 9,317.00 Rp 27,951.00
8 Larutan EDTA btl 2 Rp 52,800.00 Rp 105,600.00
10 Object glass box 0 Rp 12,650.00 Rp -
0 Salmonella Thypi H Widhal Tes set 0 Rp - Rp -
0 Salmonella Thypi O Widhal Tes set 0 Rp - Rp -
12 Spiritus btl 0 Rp 23,408.00 Rp -
13 Stik gula darah Accucheck Perf btl 0 Rp 276,100.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Paket Alat Deteksi Resiko Keha paket 0 Rp - Rp -
1 Stik Cholesterol Benecheck btl 3 Rp 231,000.00 Rp 693,000.00
0 Na Divalproat 250 mg (Depakot tab 0 Rp - Rp -
3 Stik Asam Urat Benecheck btl 9 Rp 126,500.00 Rp 1,138,500.00
4 Panviton tab 420 Rp 1,173.33 Rp 492,796.92
5 Naia tab 0 Rp 1,664.67 Rp -
6 Intunal syr btl 76 Rp 12,430.00 Rp 944,680.00
8 Biocombin inj amp 4 Rp 5,390.00 Rp 21,560.00
JUMLAH Rp 45,688,488.14
1
N OBAT DAN PERBEKALAN KESEHATAN
tar sisa persediaan (Habis Pakai / jual)
khir Bulan / Tanggal : 31 Desember 2018
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
0 TABLET 0 - Rp - Rp -
0 Alopurinol 100 mg tab - Rp - Rp -
0 Alprazolam 0,25 mg tab - Rp - Rp -
0 Ambroxol 30 mg tab - Rp - Rp -
0 Aminofilin 200 mg tab - Rp - Rp -
0 Amitriptilin 25 mg tab - Rp 167.00 Rp -
0 Antasida DOEN tab - Rp - Rp -
2 Antimigrein tab - Rp 167.00 Rp -
0 Asam Folat 0,4 mg tab - Rp - Rp -
0 Asam Mefenamat 500 mg tab - Rp - Rp -
0 Asetosal 80 mg tab - Rp - Rp -
0 Asifit kap - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Atropin sulfat 0,5 mg tab - Rp - Rp -
0 Azitromisin 500 mg tab - Rp - Rp -
0 Bekarbon / Norit tab - Rp - Rp -
0 Betahistin/versilon 6 mg tab - Rp - Rp -
0 Bisakodil 5 mg/ Laxana tab - Rp - Rp -
0 Cetirizin 10 mg tab - Rp - Rp -
0 Dexametason 0,5 mg tab - Rp - Rp -
0 Dextral tablet tab - Rp - Rp -
0 Dietil Carbamazin 100 mg tab - Rp - Rp -
0 Digoksin 0,25 mg tab - Rp - Rp -
0 Diltiazem 30 mg tab - Rp - Rp -
0 Dimenhidrinat 50 mg tab - Rp - Rp -
0 Doksisiklin 100 mg kap - Rp - Rp -
0 Domperidon 10 mg tab - Rp - Rp -
0 Erytromisin 250 mg kap - Rp - Rp -
0 Erytromisin 500 mg tab - Rp - Rp -
0 Fenitoin Na 100 mg/ Kutoin kap - Rp - Rp -
0 Fenobarbital 30 mg tab - Rp - Rp -
0 Fitomenadion/ K1 10 mg tab - Rp - Rp -
0 Flunarizin 10 mg tab - Rp - Rp -
0 Furosemida 40 mg tab - Rp - Rp -
0 G.G 100 mg/ Guaifenesin 100 tab - Rp - Rp -
3 Garam Oralit tab - Rp 264.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gemfibrozil 300 mg tab - Rp - Rp -
0 Glibenklamid 5 mg tab - Rp - Rp -
0 Glimepirid 2 mg tab - Rp - Rp -
0 Griseovulvin 125 mg tab - Rp - Rp -
0 Haemorogard tab - Rp - Rp -
0 Haloperidol 5 mg tab - Rp - Rp -
0 HCT 25 mg tab - Rp - Rp -
0 Hepagard tab - Rp - Rp -
0 Hiosina + Metampiron/ Dormi tab - Rp - Rp -
0 Isosorbid Dinitrat 5 mg tab - Rp - Rp -
0 K.Aspartat 300 mg tab - Rp - Rp -
0 Kalium Diklofenak 50 mg tab - Rp - Rp -
0 Kalk tab - Rp - Rp -
0 Kalsium Karbonat 500 mg/ Calp tab - Rp - Rp -
0 Kandersatan 8 mg tab - Rp - Rp -
0 Kaolin + Pectin tab/ Omegdiar tab - Rp - Rp -
0 Kaptopril 12,5 mg tab - Rp - Rp -
0 Kaptopril 25 mg tab - Rp - Rp -
0 Karbamazepim 200 mg tab - Rp - Rp -
0 Karbazokrom 10 mg/ Adona tab - Rp - Rp -
0 Ketokonazol 200 mg tab - Rp - Rp -
0 Klobazam 10 mg tab - Rp - Rp -
0 Klonidin 0,15 mg tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kloramfenikol 250 mg tab - Rp - Rp -
0 Kloramfenikol 500 mg kap - Rp - Rp -
0 Klorfeniramin Maleat/ CTM 4 tab - Rp - Rp -
0 Klorpromazin 100 mg tab - Rp - Rp -
0 Klozapin 100 mg tab - Rp - Rp -
0 Kodein 10 mg tab - Rp - Rp -
0 Kotrimoksazol 480 mg tab - Rp - Rp -
0 Levofloksasin 500 mg tab - Rp - Rp -
0 Lisinopril tab 5 mg tab - Rp - Rp -
0 Litium Karbonat 400 mg/ Frima tab - Rp - Rp -
0 Loperamid 2 mg tab - Rp - Rp -
0 Loratadin 10 mg tab - Rp - Rp -
4 MB Kusta strip - Rp 28,424.00 Rp -
0 Meloksikam 15 mg tab - Rp - Rp -
0 Metformin 500 mg tab - Rp - Rp -
0 Metilergometrin 0,125 mg tab - Rp - Rp -
0 Metoklopramid 10 mg tab - Rp - Rp -
0 Metronidazol 500 mg tab - Rp - Rp -
0 Na Bikarbonat 500 mg tab - Rp - Rp -
0 N-Asetil Sistein 200 mg kap - Rp - Rp -
0 Natrium Diklofenak 50 mg tab - Rp - Rp -
0 Neurotropik tab/ Corsaneuron tab - Rp - Rp -
0 New Pro Uric kap - Rp - Rp -
0 Nifedipin 10 mg tab - Rp - Rp -
0 Nistatin tab 500.000 IU/ g tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Nodiar tab - Rp - Rp -
5 OAT Anak/ FDC pkt - Rp 195,441.92 Rp -
6 OAT FDC I/III pkt - Rp 317,018.00 Rp -
7 OAT kat I/ Kombipak pkt - Rp 288,199.00 Rp -
8 OAT kat II pkt - ### Rp -
0 Omeprazol 20 mg tab - Rp - Rp -
0 Ondansetron 4 mg tab - Rp - Rp -
0 Papaverin 40 mg tab - Rp - Rp -
0 Parasetamol 500 mg tab - Rp - Rp -
0 PB Kusta Anak strip - Rp - Rp -
0 Piracetam 800 mg tab - Rp - Rp -
0 Piridoksin/ B6 10 mg tab - Rp - Rp -
0 Piroksikam 20 mg tab - Rp - Rp -
0 Prednison 5 mg tab - Rp - Rp -
9 Primaquin 15 mg tab - Rp 205.00 Rp -
0 Pro Lipid tab - Rp - Rp -
0 Propanolol 40 mg tab - Rp - Rp -
0 PTU 100 mg tab - Rp - Rp -
0 Ranitidin 150 mg tab - Rp - Rp -
10 Retinol 100.000 UI tab - Rp 284.00 Rp -
11 Retinol 200.000 UI tab - Rp 519.20 Rp -
0 Risperidon 2 mg tab - Rp - Rp -
0 Samcobion kap - Rp - Rp -
0 Sefadroksil 500 mg tab - Rp - Rp -
0 Sefiksim 100 mg tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sianokobalamin / B12 50 mcg tab - Rp - Rp -
0 Siprofloksasin 500 mg tab - Rp - Rp -
0 Spironolakton 100 mg tab - Rp - Rp -
12 Tablet Tambah darah tab - Rp 352.00 Rp -
0 Tensigard tab - Rp - Rp -
0 Teofilin 150 mg tab - Rp - Rp -
0 Teofilin SR / Retaphyl SR tab - Rp - Rp -
0 Tetrasiklin 250 mg tab - Rp - Rp -
0 Tetrasiklin 500 tab - Rp - Rp -
0 Tiamfenikol 500 mg tab - Rp - Rp -
0 Tiamin 50 mg/ B1 tab - Rp - Rp -
0 Triheksifenidil 2 mg tab - Rp 85.00 Rp -
0 Vitalamin tab - Rp - Rp -
0 Vitamin B komplek tab - Rp - Rp -
13 Zink 20 mg tab 300 Rp 513.00 Rp 153,900.00
0 0 0 - Rp - Rp -
0 SYRUP 0 - Rp - Rp -
0 Albendazol susp 200mg/ 5 ml btl - Rp - Rp -
0 Ambroxol sirup 15 mg/ 5 ml btl - Rp - Rp -
0 Amoksisilin sir 250 mg/ 5 ml btl - Rp - Rp -
0 Amoksisilin sirup 125 mg/ 5 ml btl - Rp - Rp -
0 Antasida DOEN susp btl - Rp - Rp -
0 Batugin elixir btl - Rp - Rp -
0 Dextrofen sirup btl - Rp - Rp -
0 Domperidon sirup 5 mg/ 5 ml btl - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Domperidon tetes 5 mg/ ml btl - Rp - Rp -
0 Erytromisin sirup 200 mg/ 5 ml btl - Rp - Rp -
0 Haloperidol drops 2 mg/ml (L btl - Rp - Rp -
0 Ibuprofen susp 100mg/5ml btl - Rp - Rp -
0 Ibuprofen Susp 200 mg/ 5 ml btl - Rp - Rp -
0 Kaolin + Pectin syr/ Kanina btl - Rp - Rp -
0 Kloramfenikol susp 125 mg/ 5 btl - Rp - Rp -
0 Kotrimoksazol suspensi btl - Rp - Rp -
0 Laxadin susp btl - Rp - Rp -
0 Metokloperamid drops btl - Rp - Rp -
0 Metronidasol sirup btl - Rp - Rp -
0 OBH btl - Rp - Rp -
0 Pacdin Vitcur sirup btl - Rp - Rp -
0 Parasetamol drops btl - Rp - Rp -
0 Parasetamol sirup 120 mg/ 5 ml btl - Rp - Rp -
0 Salbutamol sirup btl - Rp - Rp -
0 Setirizin sirup btl - Rp - Rp -
0 Sukralfat susp btl - Rp - Rp -
0 Tiamfenikol sirup btl - Rp - Rp -
0 Zink drops 10 mg/ml btl - Rp - Rp -
0 Zink sirup btl - Rp - Rp -
0 0 0 - Rp - Rp -
0 INJEKSI 0 - Rp - Rp -
0 Aminofilin injeksi 24 mg/ ml amp - Rp - Rp -
0 Ampisilin inj 1.000 mg vial - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Aqua pro injeksi btl - Rp - Rp -
0 Asam Traneksamat inj amp - Rp - Rp -
1 Atropin Sulsat inj amp - Rp 1,540.00 Rp -
0 Dexametason injeksi 5 mg/ ml amp - Rp - Rp -
2 Diazepam inj 5 mg/ ml amp - Rp 1,735.00 Rp -
0 Difenhidramin injeksi 10 mg/ m amp - Rp - Rp -
0 Epinefrin injeksi 0,1 % amp - Rp - Rp -
0 Flufenazin inj 25mg/ml - Sikzo amp 50 Rp 59,800.00 Rp 2,990,000.00
0 Furosemid inj 10 mg/ ml amp - Rp - Rp -
4 Gentamisin inj 40 mg/ ml amp - Rp 3,108.00 Rp -
5 Glukonas Calcicus inj 10% amp - Rp 9,955.00 Rp -
0 Haloperidol inj i.m. 5 mg/ml (L amp - Rp - Rp -
0 Human Tetanus Imuno 250 UI amp - Rp - Rp -
0 Ketorolac inj 30 mg/ml amp - Rp - Rp -
0 Lidokain Comp. inj amp - Rp - Rp -
0 Lidokain inj 2% amp - Rp - Rp -
0 Metilergometrin inj amp - Rp - Rp -
0 Meylon / Na Bic inj amp - Rp - Rp -
0 MgSO4 40% amp 20 Rp - Rp -
0 Nalokson inj 0,4 mg/ml (Nokob amp - Rp - Rp -
0 Oksitosin injeksi 10 UI/ ml amp - Rp - Rp -
0 Ondansetron 4 mg inj amp - Rp - Rp -
0 Piracetam 1 gr/ 5 ml amp - Rp - Rp -
0 Ranitidin inj 25 mg/ 2 ml amp - Rp - Rp -
0 Sefotaksim 1 gr/ vial amp - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Serum ABU I / Biosave vial - Rp - Rp -
0 Serum ATS 1.500 amp - Rp - Rp -
0 Sianokobalamin inj 500 mcg/ m amp - Rp - Rp -
6 Vit K1/Fitomenadion inj 2 mg/ amp - Rp 3,550.00 Rp -
0 0 0 - Rp - Rp -
0 OBAT LUAR 0 - Rp - Rp -
0 Antibakteri SK tube - Rp - Rp -
0 Antifungi sk pot - Rp - Rp -
0 Antihemoroid supp supp - Rp - Rp -
0 Asam Fusidat krim 20mg/g - Ac tube - Rp - Rp -
0 Asiklovir krim 5 % tube - Rp - Rp -
0 Betametason krim 0,1 % tube - Rp - Rp -
0 Bisakodil sup anak supo - Rp - Rp -
0 Bisakodil sup dws supo - Rp - Rp -
0 Budesonid/ Pulmicort res 0,25m btl - Rp - Rp -
0 Budesonid-formeterol/ Symbicor btl - Rp - Rp -
0 Desoksimetason krim tube - Rp - Rp -
0 Diazepam Rectal 5mg/2,5ml - Sttube - Rp - Rp -
0 Enkasari btl - Rp - Rp -
0 Etakridin Larutan 0,1 % btl - Rp - Rp -
0 Etanol 70% 100 ml btl - Rp - Rp -
0 Feneterol HBr/ Berotec inh btl - Rp - Rp -
0 Fenol gliserol TT 10 % btl - Rp - Rp -
0 Flusinolon Asetat 0.025% tube - Rp - Rp -
0 Framisetin tulle/ Daryanttulle lbr - Rp - Rp -
0 Gentamisin SM tube - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gentamisin TM 0,3 % btl - Rp - Rp -
0 Gentien Violet 1 % btl - Rp - Rp -
0 Gliserin btl - Rp - Rp -
0 Hidrokortison krim 2,5 % tube - Rp - Rp -
0 Ikhtiol SK btl - Rp - Rp -
0 Ketokonazol krim 2 % tube - Rp - Rp -
0 Klobetasol 0,05% krim tube - Rp - Rp -
0 Kloramfenikol SM 1 % tube - Rp - Rp -
0 Kloramfenikol SK 2% tube - Rp - Rp -
0 Kloramfenikol TM btl - Rp - Rp -
0 Kloramfenikol TT 3 % btl - Rp - Rp -
0 Lidokain Spray 10%/ Xylocaine btl - Rp - Rp -
0 Mikonazol krim 2 % tube - Rp - Rp -
0 Minyak ikan SK pot - Rp - Rp -
0 Mometason krim tube - Rp - Rp -
0 Nistatin tab vag 100.000 UI/ g supp - Rp - Rp -
1 Oksitetrasiklin 1 % SM tube - Rp 3,220.00 Rp -
0 Oksitetrasiklin 3 % SK tube - Rp - Rp -
0 Perak Sulfadiazin/ burnazin tube - Rp - Rp -
0 Perhidrol/ H2O2 btl - Rp - Rp -
0 Permetrin krim 5%/ Scabimite tube - Rp - Rp -
0 Permetrin lotion 1%/ Peditox btl - Rp - Rp -
0 Polikresulen btl - Rp - Rp -
0 Povidon Iodida 300 ml btl - Rp - Rp -
0 Povidon Iodin 30 ml btl - Rp - Rp -
0 Salbutamol inh 100 mcg/ Ventol btl - Rp - Rp -
0 Salbutamol neb/ Ventolin Nebul tube - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Salep 2-4 pot - Rp - Rp -
0 Salisil bedak pot - Rp - Rp -
0 Sulfasetamid TM 15 % btl - Rp - Rp -
0 Tetrakain TM btl - Rp - Rp -
0 Triamcinolon/ Bufacomb tube - Rp - Rp -
2 0 0 - Rp - Rp -
0 INFUS 0 - Rp - Rp -
0 Assering btl - Rp - Rp -
0 Ka-En 3A btl - Rp - Rp -
0 Ka-En 3B btl - Rp - Rp -
0 Ka-En Mg 3 btl - Rp - Rp -
0 Metronidazol infus btl - Rp - Rp -
0 NaCl btl - Rp - Rp -
0 Parasetamol 10 mg/ml infus btl - Rp - Rp -
0 RL btl - Rp - Rp -
0 0 0 - Rp - Rp -
0 BMHP 0 - Rp - Rp -
0 Alat suntik ADS 0.05 ml set - Rp - Rp -
0 Alat suntik ADS 0.5 ml (Solosh set - Rp - Rp -
0 Alkazym 250 mg sack - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Alkacide 1 L High Level btl - Rp - Rp -
0 Alkohol Swab box - Rp - Rp -
0 Alkohol swab 2 % box - Rp - Rp -
0 Aseptan Liquid 500 cc btl - Rp - Rp -
0 Aseptic Gel 500 cc btl - Rp - Rp -
0 Bioplacentol tulle lbr - Rp - Rp -
0 Bisturi box - Rp - Rp -
0 Bracket Hand Wash Plastik biji - Rp - Rp -
0 Cat gut Chromic No. 2/0 DS 2 biji - Rp - Rp -
0 Cat gut Chromic No. 2/0 HR 3 biji - Rp - Rp -
0 Catgut Chromic 3/0 DS 24 mm biji - Rp - Rp -
0 Cover Glass/ Deck Glass box - Rp - Rp -
0 Female Catheter No. 14 biji - Rp - Rp -
0 Gelang ID Pasien anak biru biji - Rp - Rp -
0 Gelang ID Pasien anak pink biji - Rp - Rp -
0 Gelang ID Pasien dewasa biru biji - Rp - Rp -
0 Gelang ID Pasien dewasa pink biji - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Handschoen Disposible (M) biji - Rp - Rp -
0 Handschoen Disposible (S) biji - Rp - Rp -
0 Handschoen Nitril (M) biji - Rp - Rp -
0 Hansdchoen Nitril (S) biji - Rp - Rp -
0 Handschoon panjang/obgin ster psg - Rp - Rp -
0 Handscoon steril no 7 psg - Rp - Rp -
0 Handscoon steril no. 7,5 psg - Rp - Rp -
0 Infusion set anak biji - Rp - Rp -
0 Infusion set dewasa biji - Rp - Rp -
0 Jelly 5 gr/ My Jelly sach - Rp - Rp -
0 Kanul Oksigen Anak biji - Rp - Rp -
0 Kanul Oksigen Dewasa biji - Rp - Rp -
0 Kapas 250 g bks - Rp - Rp -
0 Kasa 36 x 80 cm rol - Rp - Rp -
0 Kassa steril rol - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kondom kateter ( M ) biji - Rp - Rp -
0 Kondom kateter ( S ) biji - Rp - Rp -
0 Lidi Kapas Non Steril pak - Rp - Rp -
0 Lidi Kapas Steril biji - Rp - Rp -
0 Lysol 1 L btl - Rp - Rp -
0 Masker disposible biji - Rp - Rp -
0 Masker Oksigen anak set - Rp - Rp -
0 Masker Oksigen dewasa set - Rp - Rp -
0 Masker Oksigen cungkup set - Rp - Rp -
0 Mucus Extractor set - Rp - Rp -
0 N2O gas tbg - Rp - Rp -
0 Nebulizer with masker anak set - Rp - Rp -
0 Nebulizer with masker dewasa set - Rp - Rp -
0 Non Adhesive Bandage 10 x 4,5 rol - Rp - Rp -
0 Object Glass box - Rp - Rp -
1 Object Glass Frosted box 7 Rp 20,000.00 Rp 140,000.00
0 Oksigen gas tbg - Rp - Rp -
0 Onescrub 500 cc btl - Rp - Rp -
0 Plester rol - Rp - Rp -
0 Plester putih/ hipavix 5 cm biji - Rp - Rp -
0 Pot Sputum biji - Rp - Rp -
0 Pot Urin biji - Rp - Rp -
0 Sabun Cuci Tangan/ Softaskin btl - Rp - Rp -
0 Savety box biji - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Three way stop cock biji - Rp - Rp -
0 Tranfusi set biji - Rp - Rp -
0 Umbilical cord klem nylon steri biji - Rp - Rp -
0 Underpad Steril lbr - Rp - Rp -
0 Urine bag biji - Rp - Rp -
0 0 0 - Rp - Rp -
0 GIGI 0 - Rp - Rp -
0 Bonding Composite box - Rp - Rp -
0 Bur Polish Composite set - Rp - Rp -
0 Cavit box - Rp - Rp -
0 Dentin Conditioner btl - Rp - Rp -
0 Devitalisasi Pasta Non Arsen btl - Rp - Rp -
0 Disclosing Solution btl - Rp - Rp -
0 Disposible Dental Suction/ Sali box - Rp - Rp -
0 Disposible Mikro Aplikator box - Rp - Rp -
0 Etil klorid btl - Rp - Rp -
0 Etsa Asam box - Rp - Rp -
0 Eugenol btl - Rp - Rp -
0 Forinokresol / T K F btl - Rp - Rp -
0 Glass Ionomer Cement - Fuji I btl - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Glass Ionomer Cement - Fuji VI btl - Rp - Rp -
0 Iodoform Pasta pot - Rp - Rp -
0 Kalsium hidroksida pasta set - Rp - Rp -
0 Klorfenol/CHKM btl - Rp - Rp -
0 Mata Bur high speed set - Rp - Rp -
0 Mata Bur low speed set - Rp - Rp -
0 Mumifying pasta btl - Rp - Rp -
0 OCO btl - Rp - Rp -
0 Pasta pengisi saluran akar/ Vita btl - Rp - Rp -
0 Semen seng fosfat set - Rp - Rp -
0 Sodium Hipochloride btl - Rp - Rp -
0 Spons Gelatin/ Hemospon biji - Rp - Rp -
0 T S Fletcher set - Rp - Rp -
0 Tips Scaler ART biji - Rp - Rp -
0 Tips Scaler Woodpecker biji - Rp - Rp -
0 0 0 - Rp - Rp -
0 LABORAT 0 - Rp - Rp -
0 Ammonium oxalat 1 % btl - Rp - Rp -
0 Blood lancet box - Rp - Rp -
1 Box Slide biji - Rp 77,690.00 Rp -
0 Bufer 1 L btl - Rp - Rp -
0 Eosin 2 % btl - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Giemsa pekat btl - Rp - Rp -
0 H2SO4 btl - Rp - Rp -
0 Hayem btl - Rp - Rp -
0 HCl 0,1 N btl - Rp - Rp -
2 Iodium Test btl 300 Rp 5,275.00 Rp 1,582,500.00
0 Jelly EKG btl - Rp - Rp -
0 Kertas EKG 50mm x 30mm rol - Rp - Rp -
0 Kertas EKG 63 30 mm rol - Rp - Rp -
0 Kertas EKG AT 1: 90x90mm box - Rp - Rp -
0 Kertas lensa sach - Rp - Rp -
0 Kondom Katether M biji - Rp - Rp -
0 Kondom Katether S biji - Rp - Rp -
0 Larutan EDTA btl - Rp - Rp -
0 Metanol btl - Rp - Rp -
0 Minyak immersi btl - Rp - Rp -
0 Na citrat 3,8 % btl - Rp - Rp -
0 Object glass box - Rp - Rp -
0 Pipet tetes biji - Rp - Rp -
0 Reagen golongan darah btl - Rp - Rp -
0 Salmonella Thypi H Widhal Tes set - Rp - Rp -
0 Salmonella Thypi O Widhal Tes set - Rp - Rp -
0 Spiritus btl - Rp - Rp -
0 Stik gula darah Accucheck Perf btl - Rp - Rp -
0 Stik asam urat Nesco btl - Rp - Rp -
0 Stik asam urat UA Sure btl - Rp - Rp -
0 Stik cholesterol Accutrend btl - Rp - Rp -
0 Stik gula darah gluco DR btl - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Stik gula darah Nesco btl - Rp - Rp -
0 Stik trigliserid Accutrend btl - Rp - Rp -
0 Tes kehamilan sach - Rp - Rp -
0 Turk btl - Rp - Rp -
3 Ziehl nelson btl 6 Rp 276,500.00 Rp 1,659,000.00
0 0 0 - Rp - Rp -
0 VAKSIN 0 - Rp - Rp -
0 BCG amp - Rp - Rp -
0 DPT - HB amp - Rp - Rp -
0 DPT HB HIB amp - Rp - Rp -
0 POLIO amp - Rp - Rp -
0 CAMPAK amp - Rp - Rp -
0 TT amp - Rp - Rp -
0 HB U amp - Rp - Rp -
0 DT amp - Rp - Rp -
0 TD amp - Rp - Rp -
0 ADS 5 ml set - Rp - Rp -
0 SAFETY BOX biji - Rp - Rp -
0 0 0 - Rp - Rp -
0 OBAT BARU 2018 0 - Rp - Rp -
1 Rapid I HIV test - Rp 14,340.00 Rp -
2 Micropipet biji - Rp 980.00 Rp -
0 Sukralfat tab - Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 2 Rp 522,083.00 Rp 1,044,166.00
0 Trifluoperazin tab - Rp - Rp -
4 RDT Combo Malaria test - Rp 19,760.00 Rp -
0 Atalpulgit/ New Antides tab - Rp - Rp -
0 Stik Cholesterol Benecheck btl - Rp - Rp -
0 Stik Gula Darah Benecheck btl - Rp - Rp -
0 Jelly 82 gr/ My Jelly tube - Rp - Rp -
5 Mineral Mix sachet - Rp 2,726.90 Rp -
0 Na Divalproat 250 mg (Depakot tab - Rp - Rp -
0 Nistatin drops btl - Rp - Rp -
0 Omeprazole injeksi amp - Rp - Rp -
0 Stik Asam Urat Benecheck btl - Rp - Rp -
0 Panviton tab - Rp - Rp -
0 Naia tab - Rp - Rp -
0 Intunal syr btl - Rp - Rp -
0 Mekobalamin kap - Rp - Rp -
0 Biocombin inj amp - Rp - Rp -
6 Lugol btl - Rp 30,000.00 Rp -
0 Larsi kap - Rp - Rp -
0 Omevita syr btl - Rp - Rp -
7 Fluoksetin 20 mg tab/Peprezal tab - Rp 225.00 Rp -
8 Klorpromazin inj amp - Rp 1,243.00 Rp -
9 Klozapin 25 mg tab 1,000 Rp 1,121.00 Rp 1,121,000.00
JUMLAH Rp 9,283,922.00
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS TLOGOMULYO
1 2 3 4 5
TABLET
0 TABLET 0 - -
2 Alprazolam 0,25 mg tab - 316.00
3 Aminofilin 200 mg tab - 91.00
4 Amitriptilin 25 mg tab - 167.00
7 Amoksisilin 250 mg tab - 195.00
10 Antimigrein tab - 173.00
13 Asam Folat 0,4 mg tab 1,882 63.00
0 Asifit kap - -
1
1 2 3 4 5
16 Asiklofir 200 mg tab - 249.00
21 Bisakodil 5 mg/ Laxana tab - 300.00
25 Diazepam 5 mg tab - 109.00
26 Digoksin 0,25 mg tab - 97.00
27 Diltiazem 30 mg tab - 134.00
29 Doksisiklin 100 mg kap - 264.00
30 Domperidon 10 mg tab 848 118.00
31 Erytromisin 250 mg kap - 546.00
32 Erytromisin 500 mg tab - 750.00
34 Fenobarbital 30 mg tab - 171.00

1
1 2 3 4 5
39 Glimepirid 2 mg tab 70 207.00
43 Haloperidol 5 mg tab - 56.00
44 HCT 25 mg tab - 149.00
0 Hepagard tab - -
48 Kalk tab 2,972 59.00
49 Kalsium Karbonat 500 mg/ Calporos tab 190 430.00
50 Kandersatan 8 mg tab - 519.00
51 Kaptopril 12,5 mg tab - 62.00
55 Klobazam 10 mg tab - 970.00
56 Klonidin 0,15 mg tab - 184.00

1
1 2 3 4 5
61 Klozapin 100 mg tab 68 3,288.00
62 Kodein 10 mg tab - 550.00
64 Levofloksasin 500 mg tab - 495.00
65 Lisinopril tab 5 mg tab 200 209.00
66 Litium Karbonat 400 mg/ Frimania tab - 1,672.00
74 Metronidazol 500 mg tab 2,006 160.00
75 N-Asetil Sistein 200 mg kap - 426.00
76 Natrium Diklofenak 50 mg tab 421 115.00

1
1 2 3 4 5
0 Nodiar tab - -
81 Papaverin 40 mg tab - 119.00
84 Prednison 5 mg tab 167 68.00
0 Pro Lipid tab - -
85 Propanolol 40 mg tab - 74.00
86 PTU 100 mg tab - 279.00
87 Ranitidin 150 mg tab 1,599 105.00
90 Salbutamol 4 mg tab - 70.00
0 Samcobion kap - -
91 Sefadroksil 500 mg tab 1,313 550.00
92 Sefiksim 100 mg tab 22 590.00

1
1 2 3 4 5
95 Simvastatin 20 mg tab - 205.00
96 Siprofloksasin 500 mg tab 846 281.07
0 Tensigard tab - -
99 Teofilin 150 mg tab - 250.00
100 Teofilin SR / Retaphyl SR tab - 1,050.00
103 Tiamin 50 mg/ B1 tab 5,064 86.00
104 Triheksifenidil 2 mg tab - 85.00
0 Vitalamin tab - -
106 Zink 20 mg tab - 473.00
0 0 0 - -
0 SYRUP 0 - -

1
1 2 3 4 5
11 Kloramfenikol susp 125 mg/ 5 ml btl - 3,955.00
13 Metokloperamid drops btl - 5,280.00
0 OBH btl - -
17 Salbutamol sirup btl - 4,446.00
20 Setirizin sirup btl - 6,745.00
0 0 0 - -
0 INJEKSI 0 - -
1 Aminofilin injeksi 24 mg/ ml amp - 1,823.00

1
1 2 3 4 5
3 Atropin Sulsat inj amp - 1,540.00
10 Glukonas Calcicus inj 10% amp - 9,955.00
14 Lidokain inj 2% amp - 1,144.00
16 Meylon / Na Bic inj amp - 6,200.00
17 MgSO4 20% amp 5 3,200.00
18 MgSO4 40% amp - 3,650.00
20 Ondansetron 4 mg inj amp 52 1,070.00

1
1 2 3 4 5
25 Vit K1/Fitomenadion inj 2 mg/ml amp - 3,682.00
0 0 0 - -
0 OBAT LUAR 0 - -
10 Diazepam Rectal 5mg/2,5ml - Stesol tube - 11,517.00
0 Enkasari btl - -
12 Etanol 70% 100 ml btl 277 2,500.00
13 Feneterol HBr/ Berotec inh btl - 83,190.00

1
1 2 3 4 5
0 Gliserin btl - -

1
1 2 3 4 5
34 Salep 2-4 pot 59 2,527.00
0 0 0 - -
0 INFUS 0 - -
2 Glucosa 40% btl 5 1,452.00
3 Glucosa 5% btl - 6,900.00
4 Ka-En 3A btl - 10,050.00
5 Ka-En 3B btl - 10,696.00
6 Ka-En Mg 3 btl - 9,599.67
7 NaCl btl 27 6,410.00
8 RL btl 18 7,150.00
0 0 0 - -
0 BMHP 0 - -
6 Alat suntik ADS 0.5 ml (Soloshot Mi set - 1,655.50

1
1 2 3 4 5
0 Bisturi box - -
12 Endotracheal Tube - 2.0 biji - 18,530.00
13 Endotracheal Tube - 3.0 biji - 18,530.00
14 Gelang ID Pasien anak biru biji - 850.00
15 Gelang ID Pasien anak pink biji - 850.00
17 Gelang ID Pasien dewasa pink biji - 850.00

1
1 2 3 4 5
19 Handschoen Disposible (S) biji 500 462.00
32 Kasa 2 m x 80 cm rol 57 9,449.99
33 Kasa 36 x 80 cm rol - 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 6 41,000.00
35 Masker Oksigen anak set - 19,800.00
36 Masker Oksigen dewasa set - 19,800.00
0 N2O gas tbg - -
39 Onescrub 500 cc btl 1 62,500.00
0 Plester rol - -
0 Pot Urin biji - -
41 Silk 2/0 DS 24 mm sac 14 23,300.00
42 Silk 3/0 DS 24 mm sac 10 22,400.00

1
1 2 3 4 5
0 0 0 - -
0 GIGI 0 - -
0 Cavit box - -
0 Etsa Asam box - -
1 Eugenol btl - 16,667.00

1
1 2 3 4 5
0 OCO btl - -
0 0 0 - -
0 LABORAT 0 - -
2 Botol sampel darah 20 ml btl - 4,400.00
3 Bufer 1 L btl - 80,000.00
4 Eosin 2 % btl - 230,000.00

1
1 2 3 4 5
0 H2SO4 btl - -
5 Hayem btl - 220,000.00
0 HCl 0,1 N btl - -
0 Jelly EKG btl - -
6 Kertas EKG 63 30 mm rol - 90,200.00
8 Metanol btl - 88,000.00
9 Na citrat 3,8 % btl - 27,500.00
12 Salmonella Thypi H Widhal Test set - 66,660.00
13 Salmonella Thypi O Widhal Test set - 66,660.00
0 Spiritus btl - -

1
1 2 3 4 5
0 Turk btl - -
0 0 0 - -
0 VAKSIN 0 - -
0 BCG amp - -
0 DPT - HB amp - -
0 POLIO amp - -
0 CAMPAK amp - -
0 TT amp - -
0 HB U amp - -
0 DT amp - -
0 TD amp - -
0 ADS 0.05 ml set - -
0 ADS 5 ml set - -
0 0 0 - -
0 OBAT BARU 2018 0 - -

1
1 2 3 4 5
2 Trifluoperazin tab - 269.00
3 Atalpulgit/ New Antides tab 60 136.00
5 Na Divalproat 250 mg (Depakote) tab - 1,200.00
6 Nistatin drops btl - 12,272.70
0 Panviton tab - -
0 Naia tab - -
0 Lugol btl - -
0 Larsi kap - -
JUMLAH
1
PUSKESMAS TLOGOMULYO
Jumlah Harga (Rp)
104,060.00
206,990.00
29,481.00
1,731,648.00
348,998.00
275,730.00
118,566.00
521,386.00
71,040.00
1
Jumlah Harga (Rp)
123,546.00
4,840.00
85,570.98
188,352.00
8,428.00
14,560.00
100,064.00
51,350.00
105,080.00
15,990.00
214,852.00
1
Jumlah Harga (Rp)
448,020.00
14,490.00
65,940.00
14,750.00
18,392.00
57,583.00
175,348.00
81,700.00
87,948.00
20,240.00
132,440.00
-
1
Jumlah Harga (Rp)
217,990.00
419,034.00
24,990.00
223,584.00
461,996.73
41,800.00
19,926.00
146,784.00
226,650.00
238,800.00
35,870.00
5,310.00
320,960.00
48,415.00
18,400.00
73,755.00
1
Jumlah Harga (Rp)
21,060.00
660,856.00
571,710.00
11,356.00
167,895.00
38,220.00
61,655.00
722,150.00
12,980.00
1
Jumlah Harga (Rp)
254,898.00
36,287.00
237,785.22
74,460.00
6,690,600.00
13,019.58
435,504.00
655,040.00
80,000.00
129,200.00
470,250.00
326,025.00
113,400.00
1
Jumlah Harga (Rp)
77,998.80
143,550.00
425,860.00
34,200.00
348,400.00
227,836.00
325,526.00
427,680.00
176,514.00
194,990.00
-
1
Jumlah Harga (Rp)
85,250.00
70,000.00
47,250.00
76,956.00
707,200.00
51,600.00
144,000.00
124,278.00
16,000.00
288,800.00
55,640.00
69,500.00
-
1
Jumlah Harga (Rp)
462,000.00
45,018.00
238,288.00
115,710.00
899,550.00
134,800.00
29,174.97
811,200.00
692,500.00
95,830.00
144,450.00
1
Jumlah Harga (Rp)
283,544.00
209,850.00
82,208.00
173,052.00
9,024.00
13,000.00
340,799.80
42,000.00
7,322.00
1,276,275.00
104,358.00
72,000.00
72,500.00
19,999.90
1
Jumlah Harga (Rp)
149,093.00
49,200.00
7,260.00
173,070.00
128,700.00
211,750.00
268,136.00
332,740.00
554,400.00
95,955.20
-
1
Jumlah Harga (Rp)
170,000.00
964,800.00
787,200.00
417,400.20
683,372.63
-
1
Jumlah Harga (Rp)
1,709,400.00
231,000.00
75,240.00
229,680.00
77,000.00
277,200.00
450,800.00
110,000.00
290,000.00
538,649.43
-
1
Jumlah Harga (Rp)
246,000.00
283,000.00
283,000.00
62,500.00
738,621.45
326,200.00
224,000.00
1
Jumlah Harga (Rp)
16,249.20
861,738.00
55,055.00
-
1
Jumlah Harga (Rp)
-
1
Jumlah Harga (Rp)
-
1
Jumlah Harga (Rp)
286,565.78
-
1
Jumlah Harga (Rp)
8,160.00
Rp 42,612,616.87
1
DI PUSKESMAS TLOGOMULYO
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 0 Rp 1,026.67 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Flunarizin 10 mg tab 0 Rp 1,232.00 Rp -
7 G.G 100 mg/ Guaifenesin 100 tab 4,086 Rp 179.96 Rp 735,316.56
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
20 Na Bikarbonat 500 mg tab 3,855 Rp 40.70 Rp 156,898.50
21 Neurotropik tab/ Corsaneuron tab 0 Rp 757.90 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
28 Piroksikam 20 mg tab 1,900 Rp 163.79 Rp 311,201.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 102 Rp 5,797.00 Rp 591,294.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Haloperidol inj i.m. 5 mg/ml (L amp 0 Rp 6,250.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
12 Perak Sulfadiazin/ burnazin tube 10 Rp 22,999.90 Rp 229,999.00
13 Perhidrol/ H2O2 btl 2 Rp 23,980.00 Rp 47,960.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1 Alat suntik ADS 0.05 ml set 62 Rp 3,575.00 Rp 221,650.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Alkacide 1 L High Level btl 0 Rp2,702,700.00 Rp -
6 Aseptan Liquid 500 cc btl 34 Rp 30,000.00 Rp 1,020,000.00
8 Bioplacentol tulle lbr 40 Rp 10,607.96 Rp 424,318.40
9 Bisturi box 1 Rp 83,600.00 Rp 83,600.00
11 Cat gut Plain No. 3/0 DS 24 m biji 44 Rp 5,583.33 Rp 245,666.52
12 Cover Glass/ Deck Glass box 0 Rp 144,605.53 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Handscoon steril no. 7,5 psg 491 Rp 7,865.00 Rp 3,861,715.00
26 Jarum Jahit Kulit No. 10 biji 0 Rp 26,317.50 Rp -
31 Kapas 250 g bks 7 Rp 24,000.00 Rp 168,000.00
34 Kassa steril rol 150 Rp 8,000.00 Rp 1,200,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
36 Kondom kateter ( S ) biji 3 Rp 6,300.00 Rp 18,900.00
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
42 Mucus Extractor set 0 Rp 10,120.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
48 Plester rol 35 Rp 12,076.00 Rp 422,660.00
50 Pot Sputum biji 0 Rp 1,540.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1 Bonding Composite box 0 Rp 880,610.00 Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
4 Composit warna A2 box 0 Rp 363,800.00 Rp -
6 Dentin Conditioner btl 0 Rp 121,000.00 Rp -
7 Devitalisasi Pasta Non Arsen btl 0 Rp 220,000.00 Rp -
9 Disposible Dental Suction/ Sali box 0 Rp 79,373.80 Rp -
13 Forinokresol / T K F btl 0 Rp 66,000.00 Rp -
14 Glass Ionomer Cement - Fuji I btl 0 Rp 781,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
15 Glass Ionomer Cement - Fuji VI btl 0 Rp 686,400.00 Rp -
17 Kalsium hidroksida pasta set 0 Rp 159,500.00 Rp -
18 Klorfenol/CHKM btl 0 Rp 55,000.00 Rp -
21 OCO btl 0 Rp 125,400.00 Rp -
22 Pasta pengisi saluran akar/ Vita btl 0 Rp 265,000.00 Rp -
23 Semen seng fosfat set 0 Rp 165,000.00 Rp -
24 Sodium Hipochloride btl 0 Rp 78,100.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
6 Jelly EKG btl 0 Rp 126,500.00 Rp -
7 Kertas lensa sach 0 Rp 60,005.00 Rp -
17 Stik gula darah gluco DR btl 0 Rp 189,420.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
18 Stik gula darah Nesco btl 3 Rp 96,360.00 Rp 289,080.00
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Stik Asam Urat Benecheck btl 0 Rp 126,500.00 Rp -
4 Panviton tab 0 Rp 1,173.33 Rp -
5 Naia tab 0 Rp 1,664.67 Rp -
6 Intunal syr btl 0 Rp 12,430.00 Rp -
JUMLAH Rp 30,083,768.39
1
ftar sisa persediaan (Habis Pakai / jual)
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1 Albendazol 400 tab 1,958 Rp 288.00 Rp 563,904.00
0 Ambroxol 30 mg tab 0 Rp - Rp -
0 Amitriptilin 25 mg tab 0 Rp 167.00 Rp -
2 Antimigrein tab 0 Rp 167.00 Rp -
0 Asifit kap 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Bisakodil 5 mg/ Laxana tab 0 Rp - Rp -
0 Dextral tablet tab 0 Rp - Rp -
0 Flunarizin 10 mg tab 0 Rp - Rp -
0 G.G 100 mg/ Guaifenesin 100 tab 0 Rp - Rp -
3 Garam Oralit tab 0 Rp 264.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Glibenklamid 5 mg tab 0 Rp - Rp -
0 Haemorogard tab 0 Rp - Rp -
0 Hepagard tab 0 Rp - Rp -
0 Hiosina + Metampiron/ Dormi tab 0 Rp - Rp -
0 Kalium Diklofenak 50 mg tab 0 Rp - Rp -
0 Kaolin + Pectin tab/ Omegdiar tab 0 Rp - Rp -
0 Karbazokrom 10 mg/ Adona tab 0 Rp - Rp -
0 Ketokonazol 200 mg tab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Klozapin 100 mg tab 0 Rp - Rp -
0 Kodein 10 mg tab 0 Rp - Rp -
4 MB Kusta strip 0 Rp 28,424.00 Rp -
0 Meloksikam 15 mg tab 0 Rp - Rp -
0 Na Bikarbonat 500 mg tab 0 Rp - Rp -
0 Neurotropik tab/ Corsaneuron tab 0 Rp - Rp -
0 New Pro Uric kap 0 Rp - Rp -
0 Nifedipin 10 mg tab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Nodiar tab 0 Rp - Rp -
5 OAT Anak/ FDC pkt 0 ### Rp -
6 OAT FDC I/III pkt 0 ### Rp -
7 OAT kat I/ Kombipak pkt 0 ### Rp -
8 OAT kat II pkt 0 ### Rp -
0 Ondansetron 4 mg tab 0 Rp - Rp -
0 Piracetam 800 mg tab 0 Rp - Rp -
0 Piridoksin/ B6 10 mg tab 0 Rp - Rp -
0 Piroksikam 20 mg tab 0 Rp - Rp -
9 Primaquin 15 mg tab 0 Rp 205.00 Rp -
0 Pro Lipid tab 0 Rp - Rp -
10 Retinol 100.000 UI tab 0 Rp 284.00 Rp -
0 Samcobion kap 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Tensigard tab 0 Rp - Rp -
0 Tiamfenikol 500 mg tab 0 Rp - Rp -
0 Tiamin 50 mg/ B1 tab 0 Rp - Rp -
0 Triheksifenidil 2 mg tab 5 Rp 85.00 Rp 425.00
0 Vitalamin tab 0 Rp - Rp -
13 Zink 20 mg tab 348 Rp 513.00 Rp 178,524.00
0 0 0 0 Rp - Rp -
0 Ambroxol sirup 15 mg/ 5 ml btl 0 Rp - Rp -
0 Batugin elixir btl 0 Rp - Rp -
0 Dextrofen sirup btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Haloperidol drops 2 mg/ml (L btl 0 Rp - Rp -
0 Kaolin + Pectin syr/ Kanina btl 0 Rp - Rp -
0 Laxadin susp btl 0 Rp - Rp -
0 OBH btl 0 Rp - Rp -
0 Pacdin Vitcur sirup btl 0 Rp - Rp -
0 Tiamfenikol sirup btl 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Aqua pro injeksi btl 0 Rp - Rp -
0 Asam Traneksamat inj amp 0 Rp - Rp -
1 Atropin Sulsat inj amp 0 Rp 1,540.00 Rp -
3 Fenobarbital inj 50 mg/ ml amp 0 Rp 1,969.00 Rp -
0 Flufenazin inj 25mg/ml - Sikzo amp 0 Rp 59,800.00 Rp -
5 Glukonas Calcicus inj 10% amp 0 Rp 9,955.00 Rp -
0 Haloperidol inj i.m. 5 mg/ml (L amp 0 Rp - Rp -
0 MgSO4 40% amp 10 Rp - Rp -
0 Piracetam 1 gr/ 5 ml amp 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Serum ABU I / Biosave vial 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Alkohol 96 % 1 L btl 0 Rp - Rp -
0 Asiklovir krim 5 % tube 0 Rp - Rp -
0 Bisakodil sup anak supo 0 Rp - Rp -
0 Enkasari btl 0 Rp - Rp -
0 Etakridin Larutan 0,1 % btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gentien Violet 1 % btl 0 Rp - Rp -
0 Gliserin btl 0 Rp - Rp -
0 Ikhtiol SK btl 0 Rp - Rp -
0 Kloramfenikol TT 3 % btl 0 Rp - Rp -
0 Minyak ikan SK pot 0 Rp - Rp -
0 Mometason krim tube 0 Rp - Rp -
1 Oksitetrasiklin 1 % SM tube 0 Rp 3,220.00 Rp -
0 Perak Sulfadiazin/ burnazin tube 0 Rp - Rp -
0 Perhidrol/ H2O2 btl 0 Rp - Rp -
0 Permetrin krim 5%/ Scabimite tube 0 Rp - Rp -
0 Permetrin lotion 1%/ Peditox btl 0 Rp - Rp -
0 Polikresulen btl 0 Rp - Rp -
0 Povidon Iodida 300 ml btl 0 Rp - Rp -
0 Povidon Iodin 30 ml btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sulfasetamid TM 15 % btl 0 Rp - Rp -
0 Triamcinolon/ Bufacomb tube 0 Rp - Rp -
2 0 0 0 Rp - Rp -
0 Parasetamol 10 mg/ml infus btl 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Alat suntik ADS 0.05 ml set 0 Rp - Rp -
0 Alkazym 250 mg sack 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Alkacide 1 L High Level btl 0 Rp - Rp -
0 Alkohol swab 2 % box 0 Rp - Rp -
0 Aseptan Liquid 500 cc btl 0 Rp - Rp -
0 Aseptic Gel 500 cc btl 0 Rp - Rp -
0 Bioplacentol tulle lbr 0 Rp - Rp -
0 Bisturi box 0 Rp - Rp -
0 Bracket Hand Wash Plastik biji 0 Rp - Rp -
0 Cover Glass/ Deck Glass box 0 Rp - Rp -
0 Feeding Tube FR 5 biji 0 Rp - Rp -
0 Female Catheter No. 14 biji 0 Rp - Rp -
0 Foley cateter No. 14 biji 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Handschoen Nitril (M) biji 0 Rp - Rp -
0 Hansdchoen Nitril (S) biji 0 Rp - Rp -
0 Handschoon panjang/obgin ster psg 0 Rp - Rp -
0 Handscoon steril no 7 psg 0 Rp - Rp -
0 Handscoon steril no. 7,5 psg 0 Rp - Rp -
0 Infusion set anak biji 0 Rp - Rp -
0 Jarum Jahit Kulit No. 10 biji 0 Rp - Rp -
0 Jarum Jahit Mukosa No. 10 biji 0 Rp - Rp -
0 Kanul Oksigen Dewasa biji 0 Rp - Rp -
0 Kapas 250 g bks 0 Rp - Rp -
0 Kasa 2 m x 80 cm rol 0 Rp - Rp -
0 Kassa steril rol 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kondom kateter ( M ) biji 0 Rp - Rp -
0 Kondom kateter ( S ) biji 0 Rp - Rp -
0 Lidi Kapas Non Steril pak 0 Rp - Rp -
0 Lidi Kapas Steril biji 0 Rp - Rp -
0 Lysol 1 L btl 0 Rp - Rp -
0 Masker disposible biji 0 Rp - Rp -
0 Masker Oksigen cungkup set 0 Rp - Rp -
0 Mucus Extractor set 0 Rp - Rp -
0 N2O gas tbg 0 Rp - Rp -
0 Non Adhesive Bandage 10 x 4,5 rol 0 Rp - Rp -
0 Object Glass box 0 Rp - Rp -
0 Oksigen gas tbg 0 Rp - Rp -
0 Plester rol 0 Rp - Rp -
0 Plester putih/ hipavix 5 cm biji 0 Rp - Rp -
0 Pot Sputum biji 0 Rp - Rp -
2 Pot Sputum Steril biji 0 Rp 5,890.00 Rp -
0 Pot Urin biji 0 Rp - Rp -
0 Sabun Cuci Tangan/ Softaskin btl 0 Rp - Rp -
0 Savety box biji 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Suction catether no FR 8 biji 0 Rp - Rp -
0 Tranfusi set biji 0 Rp - Rp -
0 Umbilical cord klem nylon steri biji 0 Rp - Rp -
0 Underpad Steril lbr 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Bonding Composite box 0 Rp - Rp -
0 Bur Polish Composite set 0 Rp - Rp -
0 Cavit box 0 Rp - Rp -
0 Composit warna A2 box 0 Rp - Rp -
0 Dentin Conditioner btl 0 Rp - Rp -
0 Devitalisasi Pasta Non Arsen btl 0 Rp - Rp -
0 Disclosing Solution btl 0 Rp - Rp -
0 Disposible Dental Suction/ Sali box 0 Rp - Rp -
0 Disposible Mikro Aplikator box 0 Rp - Rp -
0 Etil klorid btl 0 Rp - Rp -
0 Etsa Asam box 0 Rp - Rp -
0 Forinokresol / T K F btl 0 Rp - Rp -
0 Glass Ionomer Cement - Fuji I btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Glass Ionomer Cement - Fuji VI btl 0 Rp - Rp -
0 Iodoform Pasta pot 0 Rp - Rp -
0 Kalsium hidroksida pasta set 0 Rp - Rp -
0 Klorfenol/CHKM btl 0 Rp - Rp -
0 Mata Bur high speed set 0 Rp - Rp -
0 Mumifying pasta btl 0 Rp - Rp -
0 OCO btl 0 Rp - Rp -
0 Pasta pengisi saluran akar/ Vita btl 0 Rp - Rp -
0 Semen seng fosfat set 0 Rp - Rp -
0 Sodium Hipochloride btl 0 Rp - Rp -
0 Spons Gelatin/ Hemospon biji 0 Rp - Rp -
0 T S Fletcher set 0 Rp - Rp -
0 Tips Scaler ART biji 0 Rp - Rp -
0 Tips Scaler Woodpecker biji 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Blood lancet box 0 Rp - Rp -
1 Box Slide biji 0 Rp 77,690.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Giemsa pekat btl 0 Rp - Rp -
0 H2SO4 btl 0 Rp - Rp -
0 HCl 0,1 N btl 0 Rp - Rp -
2 Iodium Test btl 0 Rp 5,275.00 Rp -
0 Jelly EKG btl 0 Rp - Rp -
0 Kertas lensa sach 0 Rp - Rp -
0 Larutan EDTA btl 0 Rp - Rp -
0 Minyak immersi btl 0 Rp - Rp -
0 Object glass box 0 Rp - Rp -
0 Pipet tetes biji 0 Rp - Rp -
0 Spiritus btl 0 Rp - Rp -
0 Stik gula darah Accucheck Perf btl 0 Rp - Rp -
0 Stik asam urat Nesco btl 0 Rp - Rp -
0 Stik asam urat UA Sure btl 0 Rp - Rp -
0 Stik cholesterol Accutrend btl 0 Rp - Rp -
0 Stik gula darah gluco DR btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Stik gula darah Nesco btl 0 Rp - Rp -
0 Stik trigliserid Accutrend btl 0 Rp - Rp -
0 Stik urinalisa 3 parameter btl 0 Rp - Rp -
0 Tes kehamilan sach 0 Rp - Rp -
0 Turk btl 0 Rp - Rp -
3 Ziehl nelson btl 0 ### Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1 Rapid I HIV test 0 Rp 14,340.00 Rp -
2 Micropipet biji 0 Rp 980.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 0 ### Rp -
4 RDT Combo Malaria test 0 Rp 19,760.00 Rp -
0 Stik Cholesterol Benecheck btl 0 Rp - Rp -
0 Stik Gula Darah Benecheck btl 0 Rp - Rp -
5 Mineral Mix sachet 0 Rp 2,726.90 Rp -
0 Stik Asam Urat Benecheck btl 0 Rp - Rp -
0 Panviton tab 0 Rp - Rp -
0 Naia tab 0 Rp - Rp -
0 Intunal syr btl 0 Rp - Rp -
0 Mekobalamin kap 0 Rp - Rp -
0 Biocombin inj amp 0 Rp - Rp -
6 Lugol btl 0 Rp 30,000.00 Rp -
0 Larsi kap 0 Rp - Rp -
0 Omevita syr btl 0 Rp - Rp -
7 Fluoksetin 20 mg tab/Peprezal tab 0 Rp 225.00 Rp -
JUMLAH Rp 905,403.00
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS SELOPAMPANG
1 2 3 4 5
TABLET
0 TABLET 0 0 0.00
0 Albendazol 400 tab 0 0.00
0 Ambroxol 30 mg tab 0 0.00
7 Amoksisilin 250 mg tab 668 195.00
10 Antimigrein tab 474 173.00
12 Asam Askorbat 250 mg tab 0 195.00
13 Asam Folat 0,4 mg tab 940 63.00
0 Asifit kap 0 0.00
1
1 2 3 4 5
0 Atropin sulfat 0,5 mg tab 0 0.00
18 Azitromisin 500 mg tab 0 1,900.00
19 Bekarbon / Norit tab 0 92.40
0 Dextral tablet tab 0 0.00
0 Dietil Carbamazin 100 mg tab 0 0.00
26 Digoksin 0,25 mg tab 314 97.00
27 Diltiazem 30 mg tab 60 134.00
32 Erytromisin 500 mg tab 50 750.00
34 Fenobarbital 30 mg tab 10 171.00
0 Flunarizin 10 mg tab 0 0.00
0 G.G 100 mg/ Guaifenesin 100 mg tab 0 0.00

1
1 2 3 4 5
38 Gemfibrozil 300 mg tab 180 380.00
0 Glibenklamid 5 mg tab 0 0.00
39 Glimepirid 2 mg tab 1,546 207.00
0 Haemorogard tab 0 0.00
43 Haloperidol 5 mg tab 664 56.00
44 HCT 25 mg tab 295 149.00
0 Hepagard tab 0 0.00
0 Hiosina + Metampiron/ Dormi comp tab 0 0.00
0 Kalium Diklofenak 50 mg tab 0 0.00
48 Kalk tab 4,367 59.00
49 Kalsium Karbonat 500 mg/ Calporos tab 0 430.00
0 Kaolin + Pectin tab/ Omegdiar tab 0 0.00
52 Kaptopril 25 mg tab 890 84.00
0 Karbazokrom 10 mg/ Adona tab 0 0.00
56 Klonidin 0,15 mg tab 0 184.00

1
1 2 3 4 5
57 Kloramfenikol 250 mg tab 0 240.00
61 Klozapin 100 mg tab 0 3,288.00
62 Kodein 10 mg tab 0 550.00
65 Lisinopril tab 5 mg tab 0 209.00
67 Loperamid 2 mg tab 0 89.00
0 MB Kusta strip 0 0.00
0 Meloksikam 15 mg tab 0 0.00
0 Na Bikarbonat 500 mg tab 0 0.00
75 N-Asetil Sistein 200 mg kap 727 426.00
0 Neurotropik tab/ Corsaneuron tab 0 0.00
0 New Pro Uric kap 0 0.00

1
1 2 3 4 5
0 Nodiar tab 0 0.00
0 OAT Anak/ FDC pkt 0 0.00
0 OAT FDC I/III pkt 0 0.00
0 OAT kat I/ Kombipak pkt 0 0.00
0 OAT kat II pkt 0 0.00
80 Ondansetron 4 mg tab 0 472.00
0 PB Kusta Anak strip 0 0.00
0 Piracetam 800 mg tab 0 0.00
0 Piroksikam 20 mg tab 0 0.00
84 Prednison 5 mg tab 1,019 68.00
0 Primaquin 15 mg tab 0 0.00
0 Pro Lipid tab 0 0.00
85 Propanolol 40 mg tab 0 74.00
86 PTU 100 mg tab 180 279.00
87 Ranitidin 150 mg tab 687 105.00
0 Retinol 100.000 UI tab 0 0.00
0 Retinol 200.000 UI tab 0 0.00
0 Samcobion kap 0 0.00
92 Sefiksim 100 mg tab 32 590.00

1
1 2 3 4 5
0 Tensigard tab 0 0.00
99 Teofilin 150 mg tab 40 250.00
101 Tetrasiklin 250 mg tab 0 0.00
0 Tiamfenikol 500 mg tab 0 0.00
103 Tiamin 50 mg/ B1 tab 4,062 86.00
0 Vitalamin tab 0 0.00
106 Zink 20 mg tab 0 473.00
0 0 0 0 0.00
0 SYRUP 0 0 0.00
2 Ambroxol sirup 15 mg/ 5 ml btl 0 0.00
0 Batugin elixir btl 0 0.00
0 Dextrofen sirup btl 0 0.00

1
1 2 3 4 5
8 Erytromisin sirup 200 mg/ 5 ml btl 0 7,700.00
0 Haloperidol drops 2 mg/ml (Lodome btl 0 0.00
10 Ibuprofen Susp 200 mg/ 5 ml btl 26 4,465.00
0 Kaolin + Pectin syr/ Kanina btl 0 0.00
0 Laxadin susp btl 0 0.00
0 OBH btl 0 0.00
0 Pacdin Vitcur sirup btl 0 0.00
0 Tiamfenikol sirup btl 0 0.00
22 Zink drops 10 mg/ml btl 0 10,798.70
0 0 0 0 0.00
0 INJEKSI 0 0 0.00
0 Ampisilin inj 1.000 mg vial 0 0.00

1
1 2 3 4 5
0 Asam Traneksamat inj amp 0 0.00
0 Diazepam inj 5 mg/ ml amp 0 1,712.70
7 Fenobarbital inj 50 mg/ ml amp 0 1,740.00
8 Flufenazin inj 25mg/ml - Sikzonoate amp 0 57,500.00
9 Furosemid inj 10 mg/ ml amp 0 1,516.00
0 Gentamisin inj 40 mg/ ml amp 0 0.00
0 Haloperidol inj i.m. 5 mg/ml (Lodome amp 0 0.00
14 Lidokain inj 2% amp 212 1,144.00
17 MgSO4 20% amp 3 3,200.00
18 MgSO4 40% amp 0 3,650.00
0 Nalokson inj 0,4 mg/ml (Nokoba) amp 0 0.00
20 Ondansetron 4 mg inj amp 109 1,070.00
0 Piracetam 1 gr/ 5 ml amp 0 0.00
22 Sefotaksim 1 gr/ vial amp 110 4,200.00

1
1 2 3 4 5
0 Serum ATS 1.500 amp 0 0.00
0 0 0 0 0.00
0 OBAT LUAR 0 0 0.00
0 Alkohol 96 % 1 L btl 0 0.00
1 Antibakteri SK tube 0 2,924.00
0 Asiklovir krim 5 % tube 0 0.00
6 Bisakodil sup anak supo 0 5,800.00
7 Bisakodil sup dws supo 0 5,800.00
0 Budesonid-formeterol/ Symbicort in btl 0 0.00
0 Enkasari btl 0 0.00
11 Etakridin Larutan 0,1 % btl 0 3,000.00
12 Etanol 70% 100 ml btl 11 2,500.00
15 Flusinolon Asetat 0.025% tube 0 2,400.00
16 Framisetin tulle/ Daryanttulle lbr 3 8,989.97

1
1 2 3 4 5
0 Gentien Violet 1 % btl 0 0.00
0 Gliserin btl 0 0.00
0 Ikhtiol SK btl 0 0.00
21 Klobetasol 0,05% krim tube 0 4,000.00
0 Kloramfenikol TT 3 % btl 0 0.00
0 Minyak ikan SK pot 0 0.00
0 Mometason krim tube 0 0.00
0 Oksitetrasiklin 1 % SM tube 0 0.00
0 Oksitetrasiklin 3 % SK tube 0 0.00
0 Perak Sulfadiazin/ burnazin tube 0 0.00
0 Perhidrol/ H2O2 btl 0 0.00
0 Permetrin lotion 1%/ Peditox btl 0 0.00
32 Salbutamol inh 100 mcg/ Ventolin In btl 0 0.00

1
1 2 3 4 5
34 Salep 2-4 pot 25 2,527.00
0 Sulfasetamid TM 15 % btl 0 0.00
36 Tetrakain TM btl 0 11,500.00
0 Triamcinolon/ Bufacomb tube 0 0.00
0 0 0 0 0.00
0 INFUS 0 0 0.00
1 Assering btl 52 9,646.00
2 Glucosa 40% btl 0 1,452.00
3 Glucosa 5% btl 28 6,900.00
4 Ka-En 3A btl 41 10,050.00
5 Ka-En 3B btl 40 10,696.00
6 Ka-En Mg 3 btl 0 9,599.67
0 Metronidazol infus btl 0 0.00
7 NaCl btl 35 6,410.00
0 Parasetamol 10 mg/ml infus btl 3 11,610.00
8 RL btl 423 7,150.00
0 0 0 0 0.00
0 BMHP 0 0 0.00
0 Alat suntik ADS 0.05 ml set 0 0.00
6 Alat suntik ADS 0.5 ml (Soloshot Mi set 100 1,655.50
0 Alkazym 250 mg sack 0 0.00

1
1 2 3 4 5
0 Alkacide 1 L High Level btl 0 0.00
0 Alkohol 70 % 1 L btl 0 0.00
0 Alkohol swab 2 % box 0 0.00
0 Aseptan Liquid 500 cc btl 0 0.00
0 Aseptic Gel 500 cc btl 0 0.00
0 Bioplacentol tulle lbr 0 0.00
0 Bisturi box 0 0.00
0 Bracket Hand Wash Plastik biji 0 0.00
0 Cat gut Plain No. 3/0 DS 24 mm biji 0 0.00
0 Cover Glass/ Deck Glass box 0 0.00
0 Feeding Tube FR 5 biji 0 0.00
0 Feeding Tube FR 8 biji 0 0.00
0 Female Catheter No. 14 biji 0 0.00
0 Foley cateter No. 14 biji 0 0.00
16 Gelang ID Pasien dewasa biru biji 53 850.00

1
1 2 3 4 5
20 Handschoen Nitril (M) biji 0 627.00
0 Handschoon panjang/obgin steril psg 0 0.00
0 Handscoon steril no 7 psg 0 0.00
0 Handscoon steril no. 7,5 psg 0 0.00
0 Infusion set anak biji 0 0.00
0 Jarum Jahit Kulit No. 10 biji 0 0.00
0 Jarum Jahit Kulit No. 15 biji 0 0.00
0 Jarum Jahit Mukosa No. 10 biji 0 0.00
0 Jarum Jahit Mukosa No. 15 biji 0 0.00
29 Jelly 5 gr/ My Jelly sach 92 2,200.59
0 Kapas 250 g bks 0 0.00
32 Kasa 2 m x 80 cm rol 41 9,449.99
33 Kasa 36 x 80 cm rol 0 130,000.00
0 Kasa 4 m x 10 cm rol 0 0.00
0 Kassa steril rol 0 0.00

1
1 2 3 4 5
0 Kondom kateter ( M ) biji 0 0.00
0 Kondom kateter ( S ) biji 0 0.00
0 Lidi Kapas Non Steril pak 0 0.00
0 Lidi Kapas Steril biji 0 0.00
34 Lysol 1 L btl 3 41,000.00
0 Masker disposible biji 0 0.00
0 Masker Oksigen cungkup set 0 0.00
0 Mucus Extractor set 0 0.00
0 N2O gas tbg 0 0.00
0 Non Adhesive Bandage 10 x 4,5/ Ten rol 0 0.00
0 Object Glass box 0 0.00
0 Object Glass Frosted box 0 0.00
0 Oksigen gas tbg 0 0.00
39 Onescrub 500 cc btl 1 62,500.00
0 Plester rol 0 0.00
0 Plester putih/ hipavix 5 cm biji 0 0.00
0 Pot Sputum biji 0 0.00
0 Pot Sputum Steril biji 0 0.00
0 Pot Urin biji 0 0.00
0 Sabun Cuci Tangan/ Softaskin btl 0 0.00
41 Silk 2/0 DS 24 mm sac 12 23,300.00
42 Silk 3/0 DS 24 mm sac 12 22,400.00

1
1 2 3 4 5
0 Suction catether no FR 8 biji 0 0.00
0 Tranfusi set biji 0 0.00
0 Umbilical cord klem nylon steril biji 0 0.00
0 0 0 0 0.00
0 GIGI 0 0 0.00
0 Bonding Composite box 0 0.00
0 Bur Polish Composite set 0 0.00
0 Cavit box 0 0.00
0 Composit warna A2 box 0 0.00
0 Composit warna A3 box 0 0.00
0 Dentin Conditioner btl 0 0.00
0 Devitalisasi Pasta Non Arsen btl 0 0.00
0 Disclosing Solution btl 0 0.00
0 Disposible Dental Suction/ Saliva Ej box 0 0.00
0 Disposible Mikro Aplikator box 0 0.00
0 Etil klorid btl 0 0.00
0 Etsa Asam box 0 0.00
0 Forinokresol / T K F btl 0 0.00
0 Glass Ionomer Cement - Fuji IX btl 0 0.00

1
1 2 3 4 5
0 Glass Ionomer Cement - Fuji VII btl 0 0.00
0 Iodoform Pasta pot 0 0.00
0 Kalsium hidroksida pasta set 0 0.00
0 Klorfenol/CHKM btl 0 0.00
0 Mata Bur high speed set 0 0.00
0 Mata Bur low speed set 0 0.00
0 Mumifying pasta btl 0 0.00
0 OCO btl 0 0.00
0 Pasta pengisi saluran akar/ Vitapex btl 0 0.00
0 Semen seng fosfat set 0 0.00
0 Sodium Hipochloride btl 0 0.00
0 Spons Gelatin/ Hemospon biji 0 0.00
0 T S Fletcher set 0 0.00
0 Tips Scaler ART biji 0 0.00
0 Tips Scaler Woodpecker biji 0 0.00
0 0 0 0 0.00
0 LABORAT 0 0 0.00
1 Ammonium oxalat 1 % btl 0 150,000.00
0 Blood lancet box 0 0.00
0 Botol sampel darah 10 ml btl 0 0.00
0 Box Slide biji 0 0.00
3 Bufer 1 L btl 0 80,000.00
4 Eosin 2 % btl 1 230,000.00
0 Film rontgen 24 x 30 box 0 0.00

1
1 2 3 4 5
0 Giemsa pekat btl 0 0.00
0 H2SO4 btl 0 0.00
5 Hayem btl 0 220,000.00
0 HCl 0,1 N btl 0 0.00
0 Iodium Test btl 0 0.00
0 Jelly EKG btl 0 0.00
0 Kertas EKG 50mm x 30mm rol 0 0.00
6 Kertas EKG 63 30 mm rol 0 90,200.00
7 Kertas EKG AT 1: 90x90mm box 0 320,000.00
0 Kertas lensa sach 0 0.00
0 Kondom Katether M biji 0 0.00
0 Kondom Katether S biji 0 0.00
0 Larutan EDTA btl 0 0.00
0 Minyak immersi btl 0 0.00
9 Na citrat 3,8 % btl 0 27,500.00
0 Object glass box 0 0.00
10 Pipet tetes biji 8 495.00
11 Reagen golongan darah btl 1 234,909.12
0 Spiritus btl 0 0.00
0 Stik gula darah Accucheck Performa btl 0 0.00
0 Stik asam urat Nesco btl 0 0.00
0 Stik asam urat UA Sure btl 0 0.00
0 Stik cholesterol Accutrend btl 0 0.00
0 Stik gula darah gluco DR btl 0 0.00

1
1 2 3 4 5
0 Stik gula darah Nesco btl 0 0.00
0 Stik trigliserid Accutrend btl 0 0.00
0 Stik urinalisa 3 parameter btl 0 0.00
0 Stik urinalisa 10 parameter btl 0 0.00
0 Turk btl 0 0.00
0 Ziehl nelson btl 0 0.00
0 0 0 0 0.00
0 VAKSIN 0 0 0.00
0 BCG amp 0 0.00
0 DPT - HB amp 0 0.00
0 DPT HB HIB amp 0 0.00
0 POLIO amp 0 0.00
0 CAMPAK amp 0 0.00
0 TT amp 0 0.00
0 HB U amp 0 0.00
0 DT amp 0 0.00
0 TD amp 0 0.00
0 ADS 0.05 ml set 0 0.00
0 ADS 0.5 ml set 0 0.00
0 ADS 5 ml set 0 0.00
0 SAFETY BOX biji 0 0.00
0 0 0 0 0.00
0 OBAT BARU 2018 0 0 0.00
0 Rapid I HIV test 0 0.00
0 Micropipet biji 0 0.00
1 Sukralfat tab 0 368.00

1
1 2 3 4 5
0 Paket Alat Deteksi Resiko Kehamila paket 0 0.00
2 Trifluoperazin tab 0 269.00
0 RDT Combo Malaria test 0 0.00
0 Stik Cholesterol Benecheck btl 0 0.00
0 Stik Gula Darah Benecheck btl 0 0.00
4 Jelly 82 gr/ My Jelly tube 0 29,549.00
0 Mineral Mix sachet 0 0.00
7 Omeprazole injeksi amp 0 9,898.00
0 Stik Asam Urat Benecheck btl 0 0.00
0 Panviton tab 0 0.00
0 Naia tab 0 0.00
0 Intunal syr btl 0 0.00
0 Mekobalamin kap 0 0.00
0 Biocombin inj amp 0 0.00
0 Lugol btl 0 0.00
0 Larsi kap 0 0.00
0 Omevita syr btl 0 0.00
0 Fluoksetin 20 mg tab/Peprezal tab 0 0.00
0 Klorpromazin inj amp 0 0.00
0 Klozapin 25 mg tab 0 0.00
JUMLAH
1
1 2 3 4 5
1
PUSKESMAS SELOPAMPANG
Jumlah Harga (Rp)
125818
60988
40131
178850
130260
4651136
145700
82002
203280
59220
417562
60976
1
Jumlah Harga (Rp)
26643
318637
1430
3000
151796.26
204000
7998
30458
8040
10088
11616
335828
37500
1710
587880
38454
27756
1
Jumlah Harga (Rp)
68400
320022
47880
21299
37184
43955
8890
36520
257653
149472
6696
74760
167440
0
1
Jumlah Harga (Rp)
98095.5
740922
74088
158778.36
16335
68019
176544
515100
69630
146400
309702
198145
64700
29800
1
Jumlah Harga (Rp)
11570
551376
325798
69292
50220
72135
223860
66080
274450
18880
1
Jumlah Harga (Rp)
287691
59343
476413.65
34289502
10000
105000
117796.2
349332
37060
597080
74800
22990
143775
186300
1
Jumlah Harga (Rp)
116090
15820
228980
57000
156000
30968
97812
31376
128991
176120
0
1
Jumlah Harga (Rp)
137500
210000
30450
5247
4066400
144480
139392
242528
53262
9600
342000
116630
247420
462000
1
Jumlah Harga (Rp)
309288
322770
791604
103796
936000
230340
27500
166380
119140
26969.91
96300
1
Jumlah Harga (Rp)
495144
218244
141295
103455
21056
13000
12000
24581
632060
139144
119999.4
1
Jumlah Harga (Rp)
63175
41000
501592
193200
412050
427840
224350
34830
3024450
1168860
522720
624870
12936
28486.7
165550
0
1
Jumlah Harga (Rp)
100000
643200
1148000
500880.24
482380.68
68850
69700
45050
110500
1
Jumlah Harga (Rp)
1247400
1432200
62700
1251360
677600
1455300
1113600
1465100
202454.28
60000
60000
387449.59
0
1
Jumlah Harga (Rp)
123000
277200
118800
594300
1103700
62500
279600
268800
1
Jumlah Harga (Rp)
45756
55055
16667
0
1
Jumlah Harga (Rp)
44000
230000
0
1
Jumlah Harga (Rp)
3960
234909.12
0
1
Jumlah Harga (Rp)
104314.74
0
1
Jumlah Harga (Rp)
396984
Rp 86,571,243.63
1
Jumlah Harga (Rp)
1
DI PUSKESMAS SELOPAMPANG
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 290 Rp 1,026.67 Rp 297,733.33
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 G.G 100 mg/ Guaifenesin 100 tab 1,922 Rp 179.96 Rp 345,883.12
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Kalium Diklofenak 50 mg tab 0 Rp 694.32 Rp -
14 Kaolin + Pectin tab/ Omegdiar tab 0 Rp 453.04 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
20 Na Bikarbonat 500 mg tab 0 Rp 40.70 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
2 Batugin elixir btl 0 Rp 21,450.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 49 Rp 5,797.00 Rp 284,053.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
20 Triamcinolon/ Bufacomb tube 79 Rp 16,500.00 Rp 1,303,500.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Alkacide 1 L High Level btl 1 Rp2,702,700.00 Rp 2,702,700.00
6 Aseptan Liquid 500 cc btl 0 Rp 30,000.00 Rp -
9 Bisturi box 2 Rp 83,600.00 Rp 167,200.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
24 Infusion set anak biji 143 Rp 7,920.00 Rp 1,132,560.00
31 Kapas 250 g bks 13 Rp 24,000.00 Rp 312,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
40 Masker disposible biji 2,800 Rp 440.00 Rp 1,232,000.00
41 Masker Oksigen cungkup set 1 Rp 13,750.00 Rp 13,750.00
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
48 Plester rol 5 Rp 12,076.00 Rp 60,380.00
52 Sabun Cuci Tangan/ Softaskin btl 0 Rp 58,538.70 Rp -
53 Savety box biji 36 Rp 15,708.00 Rp 565,488.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
25 Spons Gelatin/ Hemospon biji 2 Rp 84,700.00 Rp 169,400.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 1 Rp 9,317.00 Rp 9,317.00
13 Stik gula darah Accucheck Perf btl 2 Rp 276,100.00 Rp 552,200.00
17 Stik gula darah gluco DR btl 11 Rp 189,420.00 Rp 2,083,620.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 Stik Gula Darah Benecheck btl 5 Rp 149,600.00 Rp 748,000.00
5 Naia tab 240 Rp 1,664.67 Rp 399,520.00
Rp 41,166,149.36
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
0 Amitriptilin 25 mg tab 484 Rp 167.00 Rp 80,828.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 OAT FDC I/III pkt 1 ### Rp 317,018.00
11 Retinol 200.000 UI tab 2,758 Rp 519.20 Rp 1,431,953.60
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Triheksifenidil 2 mg tab 0 Rp 85.00 Rp -
13 Zink 20 mg tab 0 Rp 513.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 MgSO4 40% amp 14 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 0 Rp 30,000.00 Rp -
Rp 3,048,409.60
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS TEMBARAK
1 2 3 4 5
TABLET
0 TABLET 0 0 0
0 Albendazol 400 tab 0 0
1 Alopurinol 100 mg tab 1,272 86
2 Alprazolam 0,25 mg tab 0 316
0 Ambroxol 30 mg tab 0 0
3 Aminofilin 200 mg tab 751 91
4 Amitriptilin 25 mg tab 300 167
5 Amlodipin 5 mg tab 2,128 70
6 Amlodipin 10 mg tab 0 93
7 Amoksisilin 250 mg tab 3,800 195
8 Amoksisilin 500 mg tab 6,582 232
9 Antasida DOEN tab 8,513 62
10 Antimigrein tab 0 173
11 Asam Askorbat 50 mg tab 5,141 105
12 Asam Askorbat 250 mg tab 0 195
13 Asam Folat 0,4 mg tab 710 63
14 Asam Mefenamat 500 mg tab 7,759 103
15 Asetosal 80 mg tab 239 148
0 Asifit kap 0 0
1
1 2 3 4 5
16 Asiklofir 200 mg tab 301 249
17 Asiklofir 400 mg tab 762 349
0 Atropin sulfat 0,5 mg tab 0 0
18 Azitromisin 500 mg tab 0 1900
19 Bekarbon / Norit tab 0 92.4
20 Betahistin/versilon 6 mg tab 227 110
21 Bisakodil 5 mg/ Laxana tab 0 300
23 Dexametason 0,5 mg tab 8,841 32
0 Dextral tablet tab 0 0
24 Diazepam 2 mg tab 62 86
25 Diazepam 5 mg tab 0 109
0 Dietil Carbamazin 100 mg tab 0 0
26 Digoksin 0,25 mg tab 548 97
27 Diltiazem 30 mg tab 0 134
28 Dimenhidrinat 50 mg tab 70 104
29 Doksisiklin 100 mg kap 221 264
30 Domperidon 10 mg tab 662 118
31 Erytromisin 250 mg kap 0 546
32 Erytromisin 500 mg tab 138 750
33 Fenitoin Na 100 mg/ Kutoin kap 0 158
34 Fenobarbital 30 mg tab 100 171
35 Fitomenadion/ K1 10 mg tab 300 710
0 Flunarizin 10 mg tab 0 0
36 Furosemida 40 mg tab 508 78
0 G.G 100 mg/ Guaifenesin 100 mg tab 0 0
37 Garam Oralit tab 125 257

1
1 2 3 4 5
38 Gemfibrozil 300 mg tab 235 380
0 Glibenklamid 5 mg tab 0 0
39 Glimepirid 2 mg tab 652 207
40 Griseovulvin 125 mg tab 504 210
0 Haemorogard tab 0 0
42 Haloperidol 1,5 mg tab 344 59
43 Haloperidol 5 mg tab 370 56
44 HCT 25 mg tab 316 149
0 Hepagard tab 0 0
0 Hiosina + Metampiron/ Dormi comp tab 0 0
0 Ibuprofen 200 mg tab 0 0
45 Ibuprofen 400 mg tab 70 127
46 Isosorbid Dinitrat 5 mg tab 281 88
47 K.Aspartat 300 mg tab 0 647
0 Kalium Diklofenak 50 mg tab 0 0
48 Kalk tab 3,014 59
49 Kalsium Karbonat 500 mg/ Calporos tab 0 430
50 Kandersatan 8 mg tab 266 519
0 Kaolin + Pectin tab/ Omegdiar tab 0 0
51 Kaptopril 12,5 mg tab 1,574 62
52 Kaptopril 25 mg tab 2,265 84
53 Karbamazepim 200 mg tab 0 230
0 Karbazokrom 10 mg/ Adona tab 0 0
54 Ketokonazol 200 mg tab 212 280
55 Klobazam 10 mg tab 0 970
56 Klonidin 0,15 mg tab 0 184

1
1 2 3 4 5
57 Kloramfenikol 250 mg tab 0 240
58 Kloramfenikol 500 mg kap 495 1089.95
59 Klorfeniramin Maleat/ CTM 4 mg tab 5,911 42
60 Klorpromazin 100 mg tab 69 147
61 Klozapin 100 mg tab 0 3288
62 Kodein 10 mg tab 100 550
64 Levofloksasin 500 mg tab 0 495
65 Lisinopril tab 5 mg tab 0 209
66 Litium Karbonat 400 mg/ Frimania tab 0 1672
67 Loperamid 2 mg tab 0 89
68 Loratadin 10 mg tab 459 123
0 MB Kusta strip 0 0
0 Meloksikam 15 mg tab 0 0
69 Metformin 500 mg tab 414 96
70 Metil Prednisolon 4 mg tab 0 150
71 Metil Prednisolon 8 mg tab 419 300
72 Metilergometrin 0,125 mg tab 187 211
73 Metoklopramid 10 mg tab 120 90
74 Metronidazol 500 mg tab 938 160
0 Na Bikarbonat 500 mg tab 0 0
75 N-Asetil Sistein 200 mg kap 2,820 426
76 Natrium Diklofenak 50 mg tab 2,507 115
0 Neurotropik tab/ Corsaneuron tab 0 0
0 New Pro Uric kap 0 0
77 Nifedipin 10 mg tab 248 100
78 Nistatin tab 500.000 IU/ g tab 73 745

1
1 2 3 4 5
0 Nodiar tab 0 0
0 OAT Anak/ FDC pkt 0 0
0 OAT FDC I/III pkt 0 0
0 OAT kat I/ Kombipak pkt 0 0
0 OAT kat II pkt 0 0
79 Omeprazol 20 mg tab 147 130
80 Ondansetron 4 mg tab 24 472
81 Papaverin 40 mg tab 0 119
82 Parasetamol 500 mg tab 2,361 56
0 PB Kusta Anak strip 0 0
0 Piracetam 800 mg tab 0 0
83 Piridoksin/ B6 10 mg tab 9,463 118
0 Piroksikam 20 mg tab 0 0
84 Prednison 5 mg tab 460 68
0 Primaquin 15 mg tab 0 0
0 Pro Lipid tab 0 0
85 Propanolol 40 mg tab 100 74
86 PTU 100 mg tab 0 279
87 Ranitidin 150 mg tab 3,345 105
0 Retinol 100.000 UI tab 0 0
0 Retinol 200.000 UI tab 0 0
88 Risperidon 2 mg tab 0 273
89 Salbutamol 2 mg tab 734 59
90 Salbutamol 4 mg tab 0 70
0 Samcobion kap 0 0
91 Sefadroksil 500 mg tab 687 550
92 Sefiksim 100 mg tab 132 590

1
1 2 3 4 5
93 Sianokobalamin / B12 50 mcg tab 2,745 51
94 Simvastatin 10 mg tab 468 131
95 Simvastatin 20 mg tab 0 205
97 Spironolakton 100 mg tab 0 876
98 Tablet Tambah darah tab 31,970 354
0 Tensigard tab 0 0
99 Teofilin 150 mg tab 100 250
100 Teofilin SR / Retaphyl SR tab 0 1050
101 Tetrasiklin 250 mg tab 0 0
0 Tiamfenikol 500 mg tab 0 0
103 Tiamin 50 mg/ B1 tab 5,806 86
104 Triheksifenidil 2 mg tab 4 85
0 Vitalamin tab 0 0
105 Vitamin B komplek tab 4,414 115
106 Zink 20 mg tab 0 473
0 0 0 0 0
0 SYRUP 0 0 0
1 Albendazol susp 200mg/ 5 ml btl 0 4000
2 Ambroxol sirup 15 mg/ 5 ml btl 0 0
3 Amoksisilin sir 250 mg/ 5 ml btl 0 3400
4 Amoksisilin sirup 125 mg/ 5 ml btl 168 2090
5 Antasida DOEN susp btl 246 2025
0 Batugin elixir btl 0 0
0 Dextrofen sirup btl 0 0
6 Domperidon sirup 5 mg/ 5 ml btl 100 2700

1
1 2 3 4 5
7 Domperidon tetes 5 mg/ ml btl 0 15599.76
8 Erytromisin sirup 200 mg/ 5 ml btl 0 7700
0 Haloperidol drops 2 mg/ml (Lodome btl 0 0
9 Ibuprofen susp 100mg/5ml btl 0 2475
10 Ibuprofen Susp 200 mg/ 5 ml btl 128 4465
0 Kaolin + Pectin syr/ Kanina btl 0 0
11 Kloramfenikol susp 125 mg/ 5 ml btl 0 3955
12 Kotrimoksazol suspensi btl 94 2140
0 Laxadin susp btl 0 0
13 Metokloperamid drops btl 0 5280
14 Metronidasol sirup btl 8 3800
0 OBH btl 0 0
0 Pacdin Vitcur sirup btl 0 0
15 Parasetamol drops btl 110 5200
16 Parasetamol sirup 120 mg/ 5 ml btl 108 1106
17 Salbutamol sirup btl 0 4446
18 Sefadroksil sirup 125 mg/ 5 ml btl 105 3922
19 Sefadroksil sirup 250 mg/ 5 ml btl 0 5940
20 Setirizin sirup btl 2 6745
21 Sukralfat susp btl 2 6789
0 Tiamfenikol sirup btl 0 0
22 Zink drops 10 mg/ml btl 0 10798.7
23 Zink sirup btl 46 6290
0 0 0 0 0
0 INJEKSI 0 0 0
1 Aminofilin injeksi 24 mg/ ml amp 0 1823
0 Ampisilin inj 1.000 mg vial 0 0

1
1 2 3 4 5
2 Aqua pro injeksi btl 0 2750
0 Asam Traneksamat inj amp 0 0
3 Atropin Sulsat inj amp 0 1540
4 Dexametason injeksi 5 mg/ ml amp 30 1400
0 Diazepam inj 5 mg/ ml amp 0 1712.7
5 Difenhidramin injeksi 10 mg/ ml amp 19 1050
6 Epinefrin injeksi 0,1 % amp 0 1749
7 Fenobarbital inj 50 mg/ ml amp 0 1740
8 Flufenazin inj 25mg/ml - Sikzonoate amp 0 57500
9 Furosemid inj 10 mg/ ml amp 0 1516
0 Gentamisin inj 40 mg/ ml amp 0 0
10 Glukonas Calcicus inj 10% amp 0 9955
0 Haloperidol inj i.m. 5 mg/ml (Lodome amp 0 0
11 Human Tetanus Imuno 250 UI amp 2 176800
12 Ketorolac inj 30 mg/ml amp 0 1290
13 Lidokain Comp. inj amp 94 1152
14 Lidokain inj 2% amp 34 1144
15 Metilergometrin inj amp 7 2959
16 Meylon / Na Bic inj amp 0 6200
17 MgSO4 20% amp 0 3200
18 MgSO4 40% amp 0 3650
0 Nalokson inj 0,4 mg/ml (Nokoba) amp 0 0
19 Oksitosin injeksi 10 UI/ ml amp 25 1900
20 Ondansetron 4 mg inj amp 0 1070
0 Piracetam 1 gr/ 5 ml amp 0 0
21 Ranitidin inj 25 mg/ 2 ml amp 6 1390
22 Sefotaksim 1 gr/ vial amp 0 4200

1
1 2 3 4 5
23 Serum ABU I / Biosave vial 0 462000
0 Serum ATS 1.500 amp 0 0
24 Sianokobalamin inj 500 mcg/ ml amp 15 1098
25 Vit K1/Fitomenadion inj 2 mg/ml amp 0 3682
0 0 0 0 0
0 OBAT LUAR 0 0 0
0 Alkohol 96 % 1 L btl 0 0
1 Antibakteri SK tube 0 2924
2 Antifungi sk pot 98 4496
3 Antihemoroid supp supp 32 3045
4 Asam Fusidat krim 20mg/g - Acdat tube 188 5997
0 Asiklovir krim 5 % tube 0 0
5 Betametason krim 0,1 % tube 119 1348
6 Bisakodil sup anak supo 0 5800
7 Bisakodil sup dws supo 1 5800
8 Budesonid/ Pulmicort res 0,25mg/ m btl 0 9724.99
0 Budesonid-formeterol/ Symbicort in btl 0 0
9 Desoksimetason krim tube 110 10400
10 Diazepam Rectal 5mg/2,5ml - Stesol tube 3 11517
0 Enkasari btl 0 0
11 Etakridin Larutan 0,1 % btl 0 3000
12 Etanol 70% 100 ml btl 121 2500
13 Feneterol HBr/ Berotec inh btl 0 83190
14 Fenol gliserol TT 10 % btl 118 2590
15 Flusinolon Asetat 0.025% tube 0 2400
16 Framisetin tulle/ Daryanttulle lbr 0 8989.97
17 Gentamisin SM tube 153 2675

1
1 2 3 4 5
18 Gentamisin TM 0,3 % btl 51 4232
0 Gentien Violet 1 % btl 0 0
0 Gliserin btl 0 0
19 Hidrokortison krim 2,5 % tube 186 2798
0 Ikhtiol SK btl 0 0
20 Ketokonazol krim 2 % tube 82 2569
21 Klobetasol 0,05% krim tube 0 4000
22 Kloramfenikol SM 1 % tube 114 1881
23 Kloramfenikol SK 2% tube 0 3008
24 Kloramfenikol TM btl 74 3250
0 Kloramfenikol TT 3 % btl 0 0
25 Lidokain Spray 10%/ Xylocaine btl 0 170399.9
26 Mikonazol krim 2 % tube 2 3000
0 Minyak ikan SK pot 0 0
0 Mometason krim tube 0 0
27 Nistatin tab vag 100.000 UI/ g supp 44 523
0 Oksitetrasiklin 1 % SM tube 0 0
0 Oksitetrasiklin 3 % SK tube 0 0
0 Perak Sulfadiazin/ burnazin tube 0 0
0 Perhidrol/ H2O2 btl 0 0
28 Permetrin krim 5%/ Scabimite krim tube 207 12155
0 Permetrin lotion 1%/ Peditox btl 0 0
29 Polikresulen btl 5 17393
30 Povidon Iodida 300 ml btl 2 18000
31 Povidon Iodin 30 ml btl 24 2900
32 Salbutamol inh 100 mcg/ Ventolin In btl 0 0
33 Salbutamol neb/ Ventolin Nebuliser tube 5 3999.98

1
1 2 3 4 5
34 Salep 2-4 pot 95 2527
35 Salisil bedak pot 37 1025
0 Sulfasetamid TM 15 % btl 0 0
36 Tetrakain TM btl 0 11500
0 Triamcinolon/ Bufacomb tube 0 0
0 0 0 0 0
0 INFUS 0 0 0
1 Assering btl 0 9646
2 Glucosa 40% btl 0 1452
3 Glucosa 5% btl 2 6900
4 Ka-En 3A btl 0 10050
5 Ka-En 3B btl 0 10696
6 Ka-En Mg 3 btl 0 9599.67
0 Metronidazol infus btl 0 0
7 NaCl btl 3 6410
0 Parasetamol 10 mg/ml infus btl 0 11610
8 RL btl 9 7150
0 0 0 0 0
0 BMHP 0 0 0
1 Alat suntik 1 ml set 143 1694
4 Alat Suntik 10 ml set 10 924
0 Alat suntik ADS 0.05 ml set 0 0
6 Alat suntik ADS 0.5 ml (Soloshot Mi set 200 1655.5
0 Alkazym 250 mg sack 0 0

1
1 2 3 4 5
0 Alkacide 1 L High Level btl 0 0
0 Alkohol 70 % 1 L btl 0 0
7 Alkohol Swab box 1 10000
0 Alkohol swab 2 % box 0 0
0 Aseptan Liquid 500 cc btl 0 0
0 Aseptic Gel 500 cc btl 0 0
0 Bioplacentol tulle lbr 0 0
0 Bisturi box 0 0
0 Bracket Hand Wash Plastik biji 0 0
8 Cat gut Chromic No. 2/0 DS 24 mm biji 0 40200
9 Cat gut Chromic No. 2/0 HR 37 mm biji 9 32800
10 Catgut Chromic 3/0 DS 24 mm biji 0 41740.02
11 Cat gut Plain No. 2/0 DS 24 mm biji 0 40198.39
0 Cat gut Plain No. 3/0 DS 24 mm biji 0 0
0 Cover Glass/ Deck Glass box 0 0
12 Endotracheal Tube - 2.0 biji 0 18530
13 Endotracheal Tube - 3.0 biji 0 18530
0 Feeding Tube FR 5 biji 0 0
0 Feeding Tube FR 8 biji 0 0
0 Female Catheter No. 14 biji 0 0
0 Foley cateter No. 14 biji 0 0
14 Gelang ID Pasien anak biru biji 100 850
15 Gelang ID Pasien anak pink biji 100 850
16 Gelang ID Pasien dewasa biru biji 0 850
17 Gelang ID Pasien dewasa pink biji 0 850

1
1 2 3 4 5
18 Handschoen Disposible (M) biji 500 462
19 Handschoen Disposible (S) biji 300 462
20 Handschoen Nitril (M) biji 0 627
21 Hansdchoen Nitril (S) biji 100 627
0 Handschoon panjang/obgin steril psg 0 0
0 Handscoon steril no 7 psg 0 0
0 Handscoon steril no. 7,5 psg 0 0
0 Infusion set anak biji 0 0
22 Infusion set dewasa biji 0 7920
23 IV Catheter No. 18 biji 3 7700
27 IV Catheter No.20 with port set 2 16100
28 IV Catheter No.22 with port set 3 16100
0 Jarum Jahit Kulit No. 10 biji 0 0
0 Jarum Jahit Kulit No. 15 biji 0 0
0 Jarum Jahit Mukosa No. 10 biji 0 0
0 Jarum Jahit Mukosa No. 15 biji 0 0
29 Jelly 5 gr/ My Jelly sach 22 2200.59
30 Kanul Oksigen Anak biji 2 10000
31 Kanul Oksigen Dewasa biji 0 10000
0 Kapas 250 g bks 0 0
32 Kasa 2 m x 80 cm rol 33 9449.99
33 Kasa 36 x 80 cm rol 16 130000
0 Kasa 4 m x 10 cm rol 0 0
0 Kassa steril rol 0 0

1
1 2 3 4 5
0 Kondom kateter ( M ) biji 0 0
0 Kondom kateter ( S ) biji 0 0
0 Lidi Kapas Non Steril pak 0 0
0 Lidi Kapas Steril biji 0 0
34 Lysol 1 L btl 0 41000
0 Masker disposible biji 0 0
35 Masker Oksigen anak set 0 19800
36 Masker Oksigen dewasa set 0 19800
0 Masker Oksigen cungkup set 0 0
0 Mucus Extractor set 0 0
0 N2O gas tbg 0 0
37 Nebulizer with masker anak set 0 28300
38 Nebulizer with masker dewasa set 0 28300
0 Non Adhesive Bandage 10 x 4,5/ Ten rol 0 0
0 Object Glass box 0 0
0 Object Glass Frosted box 0 0
0 Oksigen gas tbg 0 0
39 Onescrub 500 cc btl 5 62500
0 Plester rol 0 0
0 Plester putih/ hipavix 5 cm biji 0 0
0 Pot Sputum biji 0 0
0 Pot Sputum Steril biji 0 0
0 Pot Urin biji 0 0
0 Sabun Cuci Tangan/ Softaskin btl 0 0
40 Savety box biji 30 15715.35
41 Silk 2/0 DS 24 mm sac 0 23300
42 Silk 3/0 DS 24 mm sac 3 22400

1
1 2 3 4 5
0 Suction catether no FR 8 biji 0 0
43 Three way stop cock biji 0 3249.84
0 Tranfusi set biji 0 0
0 Umbilical cord klem nylon steril biji 0 0
44 Underpad Steril lbr 20 7626
45 Urine bag biji 5 5005
0 0 0 0 0
0 GIGI 0 0 0
0 Bonding Composite box 0 0
0 Bur Polish Composite set 0 0
0 Cavit box 0 0
0 Composit warna A2 box 0 0
0 Composit warna A3 box 0 0
0 Dentin Conditioner btl 0 0
0 Devitalisasi Pasta Non Arsen btl 0 0
0 Disclosing Solution btl 0 0
0 Disposible Dental Suction/ Saliva Ej box 0 0
0 Disposible Mikro Aplikator box 0 0
0 Etil klorid btl 0 0
0 Etsa Asam box 0 0
1 Eugenol btl 6 16667
0 Forinokresol / T K F btl 0 0
0 Glass Ionomer Cement - Fuji IX btl 0 0

1
1 2 3 4 5
0 Glass Ionomer Cement - Fuji VII btl 0 0
0 Iodoform Pasta pot 0 0
0 Kalsium hidroksida pasta set 0 0
0 Klorfenol/CHKM btl 0 0
0 Mata Bur high speed set 0 0
0 Mata Bur low speed set 0 0
0 Mumifying pasta btl 0 0
0 OCO btl 0 0
0 Pasta pengisi saluran akar/ Vitapex btl 0 0
0 Semen seng fosfat set 0 0
0 Sodium Hipochloride btl 0 0
0 Spons Gelatin/ Hemospon biji 0 0
0 T S Fletcher set 0 0
0 Tips Scaler ART biji 0 0
0 Tips Scaler Woodpecker biji 0 0
0 0 0 0 0
0 LABORAT 0 0 0
1 Ammonium oxalat 1 % btl 0 150000
0 Blood lancet box 0 0
0 Botol sampel darah 10 ml btl 0 0
2 Botol sampel darah 20 ml btl 0 4400
0 Box Slide biji 0 0
3 Bufer 1 L btl 0 80000
4 Eosin 2 % btl 0 230000
0 Film rontgen 24 x 30 box 0 0

1
1 2 3 4 5
0 Giemsa pekat btl 0 0
0 H2SO4 btl 0 0
5 Hayem btl 0 220000
0 HCl 0,1 N btl 0 0
0 Iodium Test btl 0 0
0 Jelly EKG btl 0 0
0 Kertas EKG 50mm x 30mm rol 0 0
6 Kertas EKG 63 30 mm rol 0 90200
7 Kertas EKG AT 1: 90x90mm box 0 320000
0 Kertas lensa sach 0 0
0 Kondom Katether M biji 0 0
0 Kondom Katether S biji 0 0
0 Larutan EDTA btl 0 0
8 Metanol btl 0 88000
0 Minyak immersi btl 0 0
9 Na citrat 3,8 % btl 0 27500
0 Object glass box 0 0
10 Pipet tetes biji 0 495
11 Reagen golongan darah btl 0 234909.12
12 Salmonella Thypi H Widhal Test set 0 66660
13 Salmonella Thypi O Widhal Test set 0 66660
0 Spiritus btl 0 0
0 Stik gula darah Accucheck Performa btl 0 0
0 Stik asam urat Nesco btl 0 0
0 Stik asam urat UA Sure btl 0 0
0 Stik cholesterol Accutrend btl 0 0
0 Stik gula darah gluco DR btl 0 0

1
1 2 3 4 5
0 Stik gula darah Nesco btl 0 0
0 Stik trigliserid Accutrend btl 0 0
0 Stik urinalisa 3 parameter btl 0 0
0 Stik urinalisa 10 parameter btl 0 0
14 Tes kehamilan sach 40 1199.02
0 Turk btl 0 0
0 Ziehl nelson btl 0 0
0 0 0 0 0
0 VAKSIN 0 0 0
0 BCG amp 0 0
0 DPT - HB amp 0 0
0 DPT HB HIB amp 0 0
0 POLIO amp 0 0
0 CAMPAK amp 0 0
0 TT amp 0 0
0 HB U amp 0 0
0 DT amp 0 0
0 TD amp 0 0
0 ADS 0.05 ml set 0 0
0 ADS 0.5 ml set 0 0
0 ADS 5 ml set 0 0
0 SAFETY BOX biji 0 0
0 0 0 0 0
0 OBAT BARU 2018 0 0 0
0 Rapid I HIV test 0 0
0 Micropipet biji 0 0
1 Sukralfat tab 0 368

1
1 2 3 4 5
0 Paket Alat Deteksi Resiko Kehamila paket 0 0
2 Trifluoperazin tab 0 269
0 RDT Combo Malaria test 0 0
3 Atalpulgit/ New Antides tab 0 136
0 Stik Cholesterol Benecheck btl 0 0
0 Stik Gula Darah Benecheck btl 0 0
4 Jelly 82 gr/ My Jelly tube 0 29549
0 Mineral Mix sachet 0 0
5 Na Divalproat 250 mg (Depakote) tab 0 1200
6 Nistatin drops btl 26 12272.7
7 Omeprazole injeksi amp 0 9898
0 Stik Asam Urat Benecheck btl 0 0
0 Panviton tab 0 0
0 Naia tab 0 0
0 Intunal syr btl 0 0
0 Mekobalamin kap 0 0
0 Biocombin inj amp 0 0
0 Lugol btl 0 0
0 Larsi kap 0 0
0 Omevita syr btl 0 0
0 Fluoksetin 20 mg tab/Peprezal tab 0 0
0 Klorpromazin inj amp 0 0
0 Klozapin 25 mg tab 0 0
JUMLAH
1
PUSKESMAS TEMBARAK
Jumlah Harga (Rp)
109392
68341
50100
148960
741000
1527024
527806
539805
44730
799177
35372
1
Jumlah Harga (Rp)
74949
265938
24970
65505.44
282912
5332
53156
7280
58344
78116
103500
17100
213000
39624
32125
1
Jumlah Harga (Rp)
89300
134964
105840
20296
20720
47084
8890
24728
177826
138054
97588
190260
59360
0
1
Jumlah Harga (Rp)
539525.25
248262
10143
55000
211000.14
56457
39744
125700
39457
10800
150080
1201320
288305
24800
54385
1
Jumlah Harga (Rp)
19110
11328
132216
1116634
31280
7400
351225
43306
377850
77880
1
Jumlah Harga (Rp)
139995
61308
924439.23
11317380
25000
499316
340
507610
351120
498150
270000
1
Jumlah Harga (Rp)
571520
201160
30400
572000
119448
411810
13490
13578
289340
0
1
Jumlah Harga (Rp)
42000
19950
353600
108288
38896
20713
47500
8340
0
1
Jumlah Harga (Rp)
16470
440608
97440
1127436
160412
5800
1144000
34551
302500
305620
409275
1
Jumlah Harga (Rp)
215832
520428
210658
214434
240500
6000
23012
2516085
86965
36000
69600
19999.9
1
Jumlah Harga (Rp)
240065
37925
13800
19230
64350
242242
597256
86460
9240
14993
331100
0
1
Jumlah Harga (Rp)
10000
295200
85000
85000
0
1
Jumlah Harga (Rp)
231000
138600
62700
23100
23100
26100
32200
48300
48412.98
20000
311849.67
2080000
0
1
Jumlah Harga (Rp)
312500
471460.5
67200
1
Jumlah Harga (Rp)
152520
25025
100002
0
1
Jumlah Harga (Rp)
0
1
Jumlah Harga (Rp)
0
1
Jumlah Harga (Rp)
47960.8
0
1
Jumlah Harga (Rp)
319090.2
Rp 44,584,975.11
1
DI PUSKESMAS TEMBARAK
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
2 Antimigrein tab 180 Rp 5,625.40 Rp 1,012,572.00
3 Asifit kap 200 Rp 1,026.67 Rp 205,333.33
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
8 Glibenklamid 5 mg tab 1,534 Rp 56.00 Rp 85,904.00
11 Hiosina + Metampiron/ Dormi tab 359 Rp 2,069.00 Rp 742,771.00
14 Kaolin + Pectin tab/ Omegdiar tab 1,472 Rp 453.04 Rp 666,867.52
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
34 Tiamfenikol 500 mg tab 0 Rp 1,446.50 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 120 Rp 5,797.00 Rp 695,640.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 1 Rp 83,600.00 Rp 83,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
19 Handschoen Nitril (M) biji 0 Rp 627.00 Rp -
21 Handschoon panjang/obgin ster psg 21 Rp 30,000.00 Rp 630,000.00
31 Kapas 250 g bks 4 Rp 24,000.00 Rp 96,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
40 Masker disposible biji 500 Rp 440.00 Rp 220,000.00
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
44 Non Adhesive Bandage 10 x 4,5 rol 0 Rp 66,973.50 Rp -
45 Object Glass box 7 Rp 12,650.00 Rp 88,550.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
14 Glass Ionomer Cement - Fuji I btl 2 Rp 781,000.00 Rp 1,562,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 1 Rp 125,400.00 Rp 125,400.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 1 Rp 29,051.00 Rp 29,051.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
9 Larsi kap 440 Rp 1,026.67 Rp 451,733.33
JUMLAH Rp 35,103,080.70
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 1,000 Rp 513.00 Rp 513,000.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Vit K1/Fitomenadion inj 2 mg/ amp 0 Rp 3,550.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Ziehl nelson btl 3 ### Rp 829,500.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 2,596,912.00
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS KRANGGAN
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Albendazol 400 tab 0 Rp -
1 Alopurinol 100 mg tab 1,155 Rp 86.00
2 Alprazolam 0,25 mg tab 0 Rp 316.00
0 Ambroxol 30 mg tab 0 Rp -
3 Aminofilin 200 mg tab 0 Rp 91.00
4 Amitriptilin 25 mg tab 0 Rp 167.00
5 Amlodipin 5 mg tab 534 Rp 70.00
7 Amoksisilin 250 mg tab 5 Rp 195.00
9 Antasida DOEN tab 2,002 Rp 62.00
10 Antimigrein tab 0 Rp 173.00
11 Asam Askorbat 50 mg tab 14 Rp 105.00
13 Asam Folat 0,4 mg tab 90 Rp 63.00
14 Asam Mefenamat 500 mg tab 1,913 Rp 103.00
15 Asetosal 80 mg tab 20 Rp 148.00
0 Asifit kap 0 Rp -
1
1 2 3 4 5
16 Asiklofir 200 mg tab 181 Rp 249.00
0 Atropin sulfat 0,5 mg tab 0 Rp -
18 Azitromisin 500 mg tab 0 Rp 1,900.00
19 Bekarbon / Norit tab 0 Rp 92.40
20 Betahistin/versilon 6 mg tab 0 Rp 110.00
21 Bisakodil 5 mg/ Laxana tab 65 Rp 300.00
22 Cetirizin 10 mg tab 45 Rp 89.98
23 Dexametason 0,5 mg tab 575 Rp 32.00
0 Dextral tablet tab 0 Rp -
24 Diazepam 2 mg tab 6 Rp 86.00
0 Dietil Carbamazin 100 mg tab 0 Rp -
26 Digoksin 0,25 mg tab 90 Rp 97.00
27 Diltiazem 30 mg tab 0 Rp 134.00
28 Dimenhidrinat 50 mg tab 227 Rp 104.00
29 Doksisiklin 100 mg kap 0 Rp 264.00
30 Domperidon 10 mg tab 0 Rp 118.00
31 Erytromisin 250 mg kap 0 Rp 546.00
32 Erytromisin 500 mg tab 0 Rp 750.00
33 Fenitoin Na 100 mg/ Kutoin kap 20 Rp 158.00
34 Fenobarbital 30 mg tab 0 Rp 171.00
35 Fitomenadion/ K1 10 mg tab 361 Rp 710.00
0 Flunarizin 10 mg tab 0 Rp -
36 Furosemida 40 mg tab 65 Rp 78.00
0 G.G 100 mg/ Guaifenesin 100 mg tab 0 Rp -
37 Garam Oralit tab 0 Rp 257.00

1
1 2 3 4 5
38 Gemfibrozil 300 mg tab 85 Rp 380.00
0 Glibenklamid 5 mg tab 0 Rp -
39 Glimepirid 2 mg tab 190 Rp 207.00
40 Griseovulvin 125 mg tab 88 Rp 210.00
0 Haemorogard tab 0 Rp -
41 Haloperidol 0,5 mg tab 0 Rp 52.52
43 Haloperidol 5 mg tab 0 Rp 56.00
44 HCT 25 mg tab 0 Rp 149.00
0 Hepagard tab 0 Rp -
0 Hiosina + Metampiron/ Dormi comp tab 0 Rp -
0 Ibuprofen 200 mg tab 0 Rp -
45 Ibuprofen 400 mg tab 0 Rp 127.00
46 Isosorbid Dinitrat 5 mg tab 68 Rp 88.00
47 K.Aspartat 300 mg tab 0 Rp 647.00
0 Kalium Diklofenak 50 mg tab 0 Rp -
48 Kalk tab 2,000 Rp 59.00
49 Kalsium Karbonat 500 mg/ Calporos tab 0 Rp 430.00
50 Kandersatan 8 mg tab 0 Rp 519.00
0 Kaolin + Pectin tab/ Omegdiar tab 0 Rp -
51 Kaptopril 12,5 mg tab 10 Rp 62.00
52 Kaptopril 25 mg tab 806 Rp 84.00
53 Karbamazepim 200 mg tab 0 Rp 230.00
0 Karbazokrom 10 mg/ Adona tab 0 Rp -
54 Ketokonazol 200 mg tab 149 Rp 280.00
55 Klobazam 10 mg tab 0 Rp 970.00
56 Klonidin 0,15 mg tab 78 Rp 184.00

1
1 2 3 4 5
57 Kloramfenikol 250 mg tab 0 Rp 240.00
58 Kloramfenikol 500 mg kap 0 Rp 1,089.95
59 Klorfeniramin Maleat/ CTM 4 mg tab 138 Rp 42.00
60 Klorpromazin 100 mg tab 0 Rp 147.00
61 Klozapin 100 mg tab 0 Rp 3,288.00
62 Kodein 10 mg tab 0 Rp 550.00
63 Kotrimoksazol 480 mg tab 712 Rp 150.93
64 Levofloksasin 500 mg tab 0 Rp 495.00
65 Lisinopril tab 5 mg tab 0 Rp 209.00
66 Litium Karbonat 400 mg/ Frimania tab 0 Rp 1,672.00
67 Loperamid 2 mg tab 0 Rp 89.00
68 Loratadin 10 mg tab 125 Rp 123.00
0 MB Kusta strip 0 Rp -
0 Meloksikam 15 mg tab 0 Rp -
69 Metformin 500 mg tab 482 Rp 96.00
70 Metil Prednisolon 4 mg tab 1,102 Rp 150.00
71 Metil Prednisolon 8 mg tab 0 Rp 300.00
72 Metilergometrin 0,125 mg tab 0 Rp 211.00
73 Metoklopramid 10 mg tab 0 Rp 90.00
74 Metronidazol 500 mg tab 90 Rp 160.00
0 Na Bikarbonat 500 mg tab 0 Rp -
75 N-Asetil Sistein 200 mg kap 0 Rp 426.00
76 Natrium Diklofenak 50 mg tab 1,544 Rp 115.00
0 Neurotropik tab/ Corsaneuron tab 0 Rp -
0 New Pro Uric kap 0 Rp -
77 Nifedipin 10 mg tab 205 Rp 100.00
78 Nistatin tab 500.000 IU/ g tab 0 Rp 745.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
0 OAT Anak/ FDC pkt 0 Rp -
0 OAT FDC I/III pkt 0 Rp -
0 OAT kat I/ Kombipak pkt 0 Rp -
0 OAT kat II pkt 0 Rp -
79 Omeprazol 20 mg tab 0 Rp 130.00
80 Ondansetron 4 mg tab 0 Rp 472.00
81 Papaverin 40 mg tab 0 Rp 119.00
82 Parasetamol 500 mg tab 1,327 Rp 56.00
0 PB Kusta Anak strip 0 Rp -
0 Piracetam 800 mg tab 0 Rp -
83 Piridoksin/ B6 10 mg tab 3,366 Rp 118.00
0 Piroksikam 20 mg tab 0 Rp -
84 Prednison 5 mg tab 383 Rp 68.00
0 Primaquin 15 mg tab 0 Rp -
0 Pro Lipid tab 0 Rp -
85 Propanolol 40 mg tab 0 Rp 74.00
86 PTU 100 mg tab 0 Rp 279.00
87 Ranitidin 150 mg tab 958 Rp 105.00
0 Retinol 100.000 UI tab 0 Rp -
88 Risperidon 2 mg tab 0 Rp 273.00
89 Salbutamol 2 mg tab 265 Rp 59.00
0 Samcobion kap 0 Rp -
91 Sefadroksil 500 mg tab 128 Rp 550.00
92 Sefiksim 100 mg tab 0 Rp 590.00

1
1 2 3 4 5
93 Sianokobalamin / B12 50 mcg tab 0 Rp 51.00
94 Simvastatin 10 mg tab 2,145 Rp 131.00
95 Simvastatin 20 mg tab 5 Rp 205.00
96 Siprofloksasin 500 mg tab 1,707 Rp 281.07
97 Spironolakton 100 mg tab 0 Rp 876.00
98 Tablet Tambah darah tab 71,700 Rp 354.00
0 Tensigard tab 0 Rp -
99 Teofilin 150 mg tab 0 Rp 250.00
100 Teofilin SR / Retaphyl SR tab 0 Rp 1,050.00
101 Tetrasiklin 250 mg tab 0 Rp -
102 Tetrasiklin 500 tab 0 Rp 309.99
0 Tiamfenikol 500 mg tab 0 Rp -
103 Tiamin 50 mg/ B1 tab 574 Rp 86.00
104 Triheksifenidil 2 mg tab 0 Rp 85.00
0 Vitalamin tab 0 Rp -
105 Vitamin B komplek tab 2,000 Rp 115.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -
1 Albendazol susp 200mg/ 5 ml btl 0 Rp 4,000.00
2 Ambroxol sirup 15 mg/ 5 ml btl 0 Rp -
3 Amoksisilin sir 250 mg/ 5 ml btl 0 Rp 3,400.00
4 Amoksisilin sirup 125 mg/ 5 ml btl 0 Rp 2,090.00
5 Antasida DOEN susp btl 16 Rp 2,025.00
0 Batugin elixir btl 0 Rp -
0 Dextrofen sirup btl 0 Rp -
6 Domperidon sirup 5 mg/ 5 ml btl 0 Rp 2,700.00

1
1 2 3 4 5
7 Domperidon tetes 5 mg/ ml btl 0 Rp 15,599.76
8 Erytromisin sirup 200 mg/ 5 ml btl 0 Rp 7,700.00
0 Haloperidol drops 2 mg/ml (Lodome btl 0 Rp -
9 Ibuprofen susp 100mg/5ml btl 2 Rp 2,475.00
10 Ibuprofen Susp 200 mg/ 5 ml btl 0 Rp 4,465.00
0 Kaolin + Pectin syr/ Kanina btl 0 Rp -
11 Kloramfenikol susp 125 mg/ 5 ml btl 0 Rp 3,955.00
12 Kotrimoksazol suspensi btl 31 Rp 2,140.00
0 Laxadin susp btl 0 Rp -
13 Metokloperamid drops btl 0 Rp 5,280.00
14 Metronidasol sirup btl 0 Rp 3,800.00
0 OBH btl 0 Rp -
0 Pacdin Vitcur sirup btl 0 Rp -
15 Parasetamol drops btl 87 Rp 5,200.00
16 Parasetamol sirup 120 mg/ 5 ml btl 9 Rp 1,106.00
17 Salbutamol sirup btl 0 Rp 4,446.00
18 Sefadroksil sirup 125 mg/ 5 ml btl 0 Rp 3,922.00
20 Setirizin sirup btl 0 Rp 6,745.00
21 Sukralfat susp btl 0 Rp 6,789.00
0 Tiamfenikol sirup btl 0 Rp -
22 Zink drops 10 mg/ml btl 0 Rp 10,798.70
23 Zink sirup btl 31 Rp 6,290.00
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -
1 Aminofilin injeksi 24 mg/ ml amp 0 Rp 1,823.00
0 Ampisilin inj 1.000 mg vial 0 Rp -

1
1 2 3 4 5
2 Aqua pro injeksi btl 7 Rp 2,750.00
0 Asam Traneksamat inj amp 0 Rp -
3 Atropin Sulsat inj amp 0 Rp 1,540.00
4 Dexametason injeksi 5 mg/ ml amp 4 Rp 1,400.00
0 Diazepam inj 5 mg/ ml amp 0 Rp 1,712.70
5 Difenhidramin injeksi 10 mg/ ml amp 0 Rp 1,050.00
6 Epinefrin injeksi 0,1 % amp 5 Rp 1,749.00
7 Fenobarbital inj 50 mg/ ml amp 0 Rp 1,740.00
8 Flufenazin inj 25mg/ml - Sikzonoate amp 0 Rp 57,500.00
9 Furosemid inj 10 mg/ ml amp 0 Rp 1,516.00
0 Gentamisin inj 40 mg/ ml amp 0 Rp -
10 Glukonas Calcicus inj 10% amp 2 Rp 9,955.00
0 Haloperidol inj i.m. 5 mg/ml (Lodome amp 0 Rp -
11 Human Tetanus Imuno 250 UI amp 0 Rp 176,800.00
12 Ketorolac inj 30 mg/ml amp 0 Rp 1,290.00
13 Lidokain Comp. inj amp 48 Rp 1,152.00
14 Lidokain inj 2% amp 8 Rp 1,144.00
15 Metilergometrin inj amp 8 Rp 2,959.00
16 Meylon / Na Bic inj amp 8 Rp 6,200.00
17 MgSO4 20% amp 2 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00
0 Nalokson inj 0,4 mg/ml (Nokoba) amp 0 Rp -
19 Oksitosin injeksi 10 UI/ ml amp 6 Rp 1,900.00
20 Ondansetron 4 mg inj amp 0 Rp 1,070.00
0 Piracetam 1 gr/ 5 ml amp 0 Rp -
21 Ranitidin inj 25 mg/ 2 ml amp 0 Rp 1,390.00
22 Sefotaksim 1 gr/ vial amp 0 Rp 4,200.00

1
1 2 3 4 5
23 Serum ABU I / Biosave vial 0 Rp 462,000.00
0 Serum ATS 1.500 amp 0 Rp -
24 Sianokobalamin inj 500 mcg/ ml amp 0 Rp 1,098.00
25 Vit K1/Fitomenadion inj 2 mg/ml amp 0 Rp 3,682.00
0 0 0 0 Rp -
0 OBAT LUAR 0 0 Rp -
0 Alkohol 96 % 1 L btl 0 Rp -
1 Antibakteri SK tube 0 Rp 2,924.00
2 Antifungi sk pot 17 Rp 4,496.00
3 Antihemoroid supp supp 7 Rp 3,045.00
4 Asam Fusidat krim 20mg/g - Acdat tube 18 Rp 5,997.00
0 Asiklovir krim 5 % tube 0 Rp -
5 Betametason krim 0,1 % tube 73 Rp 1,348.00
6 Bisakodil sup anak supo 0 Rp 5,800.00
7 Bisakodil sup dws supo 0 Rp 5,800.00
8 Budesonid/ Pulmicort res 0,25mg/ m btl 0 Rp 9,724.99
0 Budesonid-formeterol/ Symbicort in btl 0 Rp -
9 Desoksimetason krim tube 0 Rp 10,400.00
10 Diazepam Rectal 5mg/2,5ml - Stesol tube 1 Rp 11,517.00
0 Enkasari btl 0 Rp -
11 Etakridin Larutan 0,1 % btl 0 Rp 3,000.00
12 Etanol 70% 100 ml btl 100 Rp 2,500.00
13 Feneterol HBr/ Berotec inh btl 0 Rp 83,190.00
14 Fenol gliserol TT 10 % btl 37 Rp 2,590.00
15 Flusinolon Asetat 0.025% tube 0 Rp 2,400.00
16 Framisetin tulle/ Daryanttulle lbr 0 Rp 8,989.97
17 Gentamisin SM tube 9 Rp 2,675.00

1
1 2 3 4 5
18 Gentamisin TM 0,3 % btl 35 Rp 4,232.00
0 Gentien Violet 1 % btl 0 Rp -
0 Gliserin btl 0 Rp -
19 Hidrokortison krim 2,5 % tube 45 Rp 2,798.00
0 Ikhtiol SK btl 0 Rp -
20 Ketokonazol krim 2 % tube 51 Rp 2,569.00
21 Klobetasol 0,05% krim tube 0 Rp 4,000.00
22 Kloramfenikol SM 1 % tube 28 Rp 1,881.00
23 Kloramfenikol SK 2% tube 26 Rp 3,008.00
24 Kloramfenikol TM btl 0 Rp 3,250.00
0 Kloramfenikol TT 3 % btl 0 Rp -
25 Lidokain Spray 10%/ Xylocaine btl 0 Rp 170,399.90
26 Mikonazol krim 2 % tube 14 Rp 3,000.00
0 Minyak ikan SK pot 0 Rp -
0 Mometason krim tube 0 Rp -
27 Nistatin tab vag 100.000 UI/ g supp 0 Rp 523.00
0 Oksitetrasiklin 1 % SM tube 0 Rp -
0 Oksitetrasiklin 3 % SK tube 0 Rp -
0 Perak Sulfadiazin/ burnazin tube 0 Rp -
0 Perhidrol/ H2O2 btl 0 Rp -
28 Permetrin krim 5%/ Scabimite krim tube 103 Rp 12,155.00
0 Permetrin lotion 1%/ Peditox btl 0 Rp -
29 Polikresulen btl 0 Rp 17,393.00
30 Povidon Iodida 300 ml btl 0 Rp 18,000.00
31 Povidon Iodin 30 ml btl 8 Rp 2,900.00
32 Salbutamol inh 100 mcg/ Ventolin In btl 0 Rp -
33 Salbutamol neb/ Ventolin Nebuliser tube 0 Rp 3,999.98

1
1 2 3 4 5
34 Salep 2-4 pot 0 Rp 2,527.00
35 Salisil bedak pot 26 Rp 1,025.00
0 Sulfasetamid TM 15 % btl 0 Rp -
36 Tetrakain TM btl 0 Rp 11,500.00
0 Triamcinolon/ Bufacomb tube 0 Rp -
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
1 Assering btl 0 Rp 9,646.00
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 0 Rp 6,900.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
0 Metronidazol infus btl 0 Rp -
7 NaCl btl 7 Rp 6,410.00
0 Parasetamol 10 mg/ml infus btl 0 Rp 11,610.00
8 RL btl 5 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -
1 Alat suntik 1 ml set 0 Rp 1,694.00
2 Alat suntik 3 ml set 200 Rp 968.00
4 Alat Suntik 10 ml set 0 Rp 924.00
5 Alat Suntik 20 ml set 0 Rp 1,499.30
0 Alat suntik ADS 0.05 ml set 0 Rp -
6 Alat suntik ADS 0.5 ml (Soloshot Mi set 0 Rp 1,655.50
0 Alkazym 250 mg sack 0 Rp -

1
1 2 3 4 5
0 Alkacide 1 L High Level btl 0 Rp -
7 Alkohol Swab box 6 Rp 10,000.00
0 Alkohol swab 2 % box 0 Rp -
0 Aseptan Liquid 500 cc btl 0 Rp -
0 Aseptic Gel 500 cc btl 0 Rp -
0 Bioplacentol tulle lbr 0 Rp -
0 Bisturi box 0 Rp -
0 Bracket Hand Wash Plastik biji 0 Rp -
8 Cat gut Chromic No. 2/0 DS 24 mm biji 0 Rp 40,200.00
9 Cat gut Chromic No. 2/0 HR 37 mm biji 0 Rp 32,800.00
10 Catgut Chromic 3/0 DS 24 mm biji 0 Rp 41,740.02
11 Cat gut Plain No. 2/0 DS 24 mm biji 0 Rp 40,198.39
0 Cat gut Plain No. 3/0 DS 24 mm biji 0 Rp -
0 Cover Glass/ Deck Glass box 0 Rp -
12 Endotracheal Tube - 2.0 biji 0 Rp 18,530.00
0 Feeding Tube FR 5 biji 0 Rp -
0 Female Catheter No. 14 biji 0 Rp -
0 Foley cateter No. 14 biji 0 Rp -
14 Gelang ID Pasien anak biru biji 0 Rp 850.00
15 Gelang ID Pasien anak pink biji 0 Rp 850.00
16 Gelang ID Pasien dewasa biru biji 0 Rp 850.00
17 Gelang ID Pasien dewasa pink biji 0 Rp 850.00

1
1 2 3 4 5
18 Handschoen Disposible (M) biji 0 Rp 462.00
19 Handschoen Disposible (S) biji 500 Rp 462.00
20 Handschoen Nitril (M) biji 0 Rp 627.00
21 Hansdchoen Nitril (S) biji 0 Rp 627.00
0 Handschoon panjang/obgin steril psg 0 Rp -
0 Handscoon steril no 7 psg 0 Rp -
0 Handscoon steril no. 7,5 psg 0 Rp -
0 Infusion set anak biji 0 Rp -
22 Infusion set dewasa biji 4 Rp 7,920.00
23 IV Catheter No. 18 biji 5 Rp 7,700.00
27 IV Catheter No.20 with port set 0 Rp 16,100.00
0 Jarum Jahit Kulit No. 10 biji 0 Rp -
0 Jarum Jahit Mukosa No. 10 biji 0 Rp -
29 Jelly 5 gr/ My Jelly sach 0 Rp 2,200.59
30 Kanul Oksigen Anak biji 2 Rp 10,000.00
31 Kanul Oksigen Dewasa biji 2 Rp 10,000.00
0 Kapas 250 g bks 0 Rp -
32 Kasa 2 m x 80 cm rol 0 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00
0 Kasa 4 m x 10 cm rol 0 Rp -
0 Kassa steril rol 0 Rp -

1
1 2 3 4 5
0 Kondom kateter ( M ) biji 0 Rp -
0 Kondom kateter ( S ) biji 0 Rp -
0 Lidi Kapas Non Steril pak 0 Rp -
0 Lidi Kapas Steril biji 0 Rp -
34 Lysol 1 L btl 0 Rp 41,000.00
0 Masker disposible biji 0 Rp -
35 Masker Oksigen anak set 0 Rp 19,800.00
36 Masker Oksigen dewasa set 0 Rp 19,800.00
0 Masker Oksigen cungkup set 0 Rp -
0 Mucus Extractor set 0 Rp -
0 N2O gas tbg 0 Rp -
37 Nebulizer with masker anak set 0 Rp 28,300.00
38 Nebulizer with masker dewasa set 0 Rp 28,300.00
0 Non Adhesive Bandage 10 x 4,5/ Ten rol 0 Rp -
0 Object Glass box 0 Rp -
0 Object Glass Frosted box 0 Rp -
0 Oksigen gas tbg 0 Rp -
39 Onescrub 500 cc btl 0 Rp 62,500.00
0 Plester rol 0 Rp -
0 Plester putih/ hipavix 5 cm biji 0 Rp -
0 Pot Sputum biji 0 Rp -
0 Pot Sputum Steril biji 0 Rp -
0 Pot Urin biji 0 Rp -
0 Sabun Cuci Tangan/ Softaskin btl 0 Rp -
40 Savety box biji 0 Rp 15,715.35
41 Silk 2/0 DS 24 mm sac 0 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 0 Rp 22,400.00

1
1 2 3 4 5
0 Suction catether no FR 8 biji 0 Rp -
43 Three way stop cock biji 0 Rp 3,249.84
0 Tranfusi set biji 0 Rp -
0 Umbilical cord klem nylon steril biji 0 Rp -
44 Underpad Steril lbr 0 Rp 7,626.00
45 Urine bag biji 0 Rp 5,005.00
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Bonding Composite box 0 Rp -
0 Bur Polish Composite set 0 Rp -
0 Cavit box 0 Rp -
0 Composit warna A2 box 0 Rp -
0 Dentin Conditioner btl 0 Rp -
0 Devitalisasi Pasta Non Arsen btl 0 Rp -
0 Disclosing Solution btl 0 Rp -
0 Disposible Dental Suction/ Saliva Ej box 0 Rp -
0 Disposible Mikro Aplikator box 0 Rp -
0 Etil klorid btl 0 Rp -
0 Etsa Asam box 0 Rp -
1 Eugenol btl 0 Rp 16,667.00
0 Forinokresol / T K F btl 0 Rp -
0 Glass Ionomer Cement - Fuji IX btl 0 Rp -

1
1 2 3 4 5
0 Glass Ionomer Cement - Fuji VII btl 0 Rp -
0 Iodoform Pasta pot 0 Rp -
0 Kalsium hidroksida pasta set 0 Rp -
0 Klorfenol/CHKM btl 0 Rp -
0 Mata Bur high speed set 0 Rp -
0 Mata Bur low speed set 0 Rp -
0 Mumifying pasta btl 0 Rp -
0 OCO btl 0 Rp -
0 Pasta pengisi saluran akar/ Vitapex btl 0 Rp -
0 Semen seng fosfat set 0 Rp -
0 Sodium Hipochloride btl 0 Rp -
0 Spons Gelatin/ Hemospon biji 0 Rp -
0 T S Fletcher set 0 Rp -
0 Tips Scaler ART biji 0 Rp -
0 Tips Scaler Woodpecker biji 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
1 Ammonium oxalat 1 % btl 0 Rp 150,000.00
0 Blood lancet box 0 Rp -
0 Botol sampel darah 10 ml btl 0 Rp -
2 Botol sampel darah 20 ml btl 0 Rp 4,400.00
0 Box Slide biji 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00
0 Film rontgen 24 x 30 box 0 Rp -

1
1 2 3 4 5
0 Giemsa pekat btl 0 Rp -
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
0 HCl 0,1 N btl 0 Rp -
0 Iodium Test btl 0 Rp -
0 Jelly EKG btl 0 Rp -
0 Kertas EKG 50mm x 30mm rol 0 Rp -
6 Kertas EKG 63 30 mm rol 0 Rp 90,200.00
7 Kertas EKG AT 1: 90x90mm box 0 Rp 320,000.00
0 Kertas lensa sach 0 Rp -
0 Kondom Katether M biji 0 Rp -
0 Kondom Katether S biji 0 Rp -
0 Larutan EDTA btl 0 Rp -
8 Metanol btl 0 Rp 88,000.00
0 Minyak immersi btl 0 Rp -
9 Na citrat 3,8 % btl 0 Rp 27,500.00
0 Object glass box 0 Rp -
10 Pipet tetes biji 0 Rp 495.00
11 Reagen golongan darah btl 1 Rp 234,909.12
12 Salmonella Thypi H Widhal Test set 0 Rp 66,660.00
13 Salmonella Thypi O Widhal Test set 0 Rp 66,660.00
0 Spiritus btl 0 Rp -
0 Stik gula darah Accucheck Performa btl 0 Rp -
0 Stik asam urat Nesco btl 0 Rp -
0 Stik asam urat UA Sure btl 0 Rp -
0 Stik cholesterol Accutrend btl 0 Rp -
0 Stik gula darah gluco DR btl 0 Rp -

1
1 2 3 4 5
0 Stik gula darah Nesco btl 0 Rp -
0 Stik trigliserid Accutrend btl 0 Rp -
0 Stik urinalisa 3 parameter btl 0 Rp -
14 Tes kehamilan sach 0 Rp 1,199.02
0 Turk btl 0 Rp -
0 Ziehl nelson btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 DPT - HB amp 0 Rp -
0 DPT HB HIB amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 ADS 0.05 ml set 0 Rp -
0 ADS 5 ml set 0 Rp -
0 SAFETY BOX biji 0 Rp -
0 0 0 0 Rp -
0 OBAT BARU 2018 0 0 Rp -
0 Rapid I HIV test 0 Rp -
0 Micropipet biji 0 Rp -
1 Sukralfat tab 0 Rp 368.00

1
1 2 3 4 5
0 Paket Alat Deteksi Resiko Kehamila paket 0 Rp -
2 Trifluoperazin tab 0 Rp 269.00
0 RDT Combo Malaria test 0 Rp -
3 Atalpulgit/ New Antides tab 0 Rp 136.00
0 Stik Cholesterol Benecheck btl 0 Rp -
0 Stik Gula Darah Benecheck btl 0 Rp -
4 Jelly 82 gr/ My Jelly tube 0 Rp 29,549.00
0 Mineral Mix sachet 0 Rp -
5 Na Divalproat 250 mg (Depakote) tab 0 Rp 1,200.00
6 Nistatin drops btl 0 Rp 12,272.70
7 Omeprazole injeksi amp 0 Rp 9,898.00
0 Stik Asam Urat Benecheck btl 0 Rp -
0 Panviton tab 0 Rp -
0 Naia tab 0 Rp -
0 Intunal syr btl 0 Rp -
0 Mekobalamin kap 0 Rp -
0 Biocombin inj amp 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
0 Omevita syr btl 0 Rp -
0 Fluoksetin 20 mg tab/Peprezal tab 0 Rp -
0 Klorpromazin inj amp 0 Rp -
0 Klozapin 25 mg tab 0 Rp -
JUMLAH
1
PUSKESMAS KRANGGAN
Jumlah Harga (Rp)
Rp -
Rp -
Rp 99,330.00
Rp -
Rp -
Rp -
Rp -
Rp 37,380.00
Rp 10,230.00
Rp 975.00
Rp 156,368.00
Rp 124,124.00
Rp -
Rp 1,470.00
Rp -
Rp 5,670.00
Rp 197,039.00
Rp 2,960.00
Rp -
1
Jumlah Harga (Rp)
Rp 45,069.00
Rp 23,732.00
Rp -
Rp -
Rp -
Rp -
Rp 19,500.00
Rp 4,049.10
Rp 18,400.00
Rp -
Rp 516.00
Rp -
Rp -
Rp 8,730.00
Rp -
Rp 23,608.00
Rp -
Rp -
Rp -
Rp -
Rp 3,160.00
Rp -
Rp 256,310.00
Rp -
Rp 5,070.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 32,300.00
Rp -
Rp 39,330.00
Rp 18,480.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,984.00
Rp -
Rp -
Rp 118,000.00
Rp -
Rp -
Rp -
Rp 620.00
Rp 67,704.00
Rp -
Rp -
Rp 41,720.00
Rp -
Rp 14,352.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 5,796.00
Rp -
Rp -
Rp -
Rp 107,462.16
Rp -
Rp -
Rp -
Rp -
Rp 15,375.00
Rp -
Rp -
Rp 46,272.00
Rp 165,300.00
Rp -
Rp -
Rp -
Rp 14,400.00
Rp -
Rp -
Rp 177,560.00
Rp -
Rp -
Rp 20,500.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 74,312.00
Rp -
Rp -
Rp 397,188.00
Rp -
Rp 26,044.00
Rp -
Rp -
Rp -
Rp -
Rp 100,590.00
Rp -
Rp -
Rp -
Rp 15,635.00
Rp -
Rp -
Rp 70,400.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 280,995.00
Rp 1,025.00
Rp 479,786.49
Rp -
Rp 25,381,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 49,364.00
Rp -
Rp -
Rp 230,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 32,400.00
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 4,950.00
Rp -
Rp -
Rp -
Rp 66,340.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 452,400.00
Rp 9,954.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 194,990.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 19,250.00
Rp -
Rp -
Rp 5,600.00
Rp -
Rp -
Rp 8,745.00
Rp -
Rp -
Rp -
Rp -
Rp 19,910.00
Rp -
Rp -
Rp -
Rp 55,296.00
Rp 9,152.00
Rp 23,672.00
Rp 49,600.00
Rp 6,400.00
Rp -
Rp -
Rp 11,400.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 76,432.00
Rp 21,315.00
Rp 107,946.00
Rp -
Rp 98,404.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 11,517.00
Rp -
Rp -
Rp 250,000.00
Rp -
Rp 95,830.00
Rp -
Rp -
Rp 24,075.00
1
Jumlah Harga (Rp)
Rp 148,120.00
Rp -
Rp -
Rp 125,910.00
Rp -
Rp 131,019.00
Rp -
Rp 52,668.00
Rp 78,208.00
Rp -
Rp -
Rp -
Rp 42,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,251,965.00
Rp -
Rp -
Rp -
Rp 23,200.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 26,650.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 44,870.00
Rp -
Rp 35,750.00
Rp -
Rp -
Rp -
Rp 193,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 60,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 231,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 31,680.00
Rp 38,500.00
Rp -
Rp -
Rp -
Rp -
Rp 32,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 20,000.00
Rp 20,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 33,519,811.87
1
DI PUSKESMAS KRANGGAN
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 G.G 100 mg/ Guaifenesin 100 tab 0 Rp 179.96 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
15 Karbazokrom 10 mg/ Adona tab 0 Rp 1,980.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
26 Piracetam 800 mg tab 0 Rp 783.20 Rp -
31 Samcobion kap 1,410 Rp 429.00 Rp 604,890.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1 Ambroxol sirup 15 mg/ 5 ml btl 0 Rp 5,148.00 Rp -
3 Dextrofen sirup btl 0 Rp 8,046.50 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 57 Rp 5,797.00 Rp 330,429.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
2 Asiklovir krim 5 % tube 0 Rp 2,860.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Gentien Violet 1 % btl 0 Rp 2,750.00 Rp -
7 Gliserin btl 0 Rp 4,500.00 Rp -
8 Ikhtiol SK btl 0 Rp 4,950.00 Rp -
10 Minyak ikan SK pot 0 Rp 3,300.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Alkacide 1 L High Level btl 2 ### Rp 5,405,400.00
9 Bisturi box 1 Rp 83,600.00 Rp 83,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Handschoon panjang/obgin ster psg 0 Rp 30,000.00 Rp -
24 Infusion set anak biji 0 Rp 7,920.00 Rp -
31 Kapas 250 g bks 0 Rp 24,000.00 Rp -
34 Kassa steril rol 0 Rp 8,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
37 Lidi Kapas Non Steril pak 0 Rp 27,500.00 Rp -
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 ### Rp -
49 Plester putih/ hipavix 5 cm biji 0 Rp 55,000.00 Rp -
51 Pot Urin biji 0 Rp 440.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
60 Umbilical cord klem nylon steri biji 0 Rp 1,299.98 Rp -
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 12,991,287.08
1
Harga Satuan
(Rp)
1 2 3 4 5 6
Dr. SUPARJO, M.Kes.

NIP. 19610731 198903 1 008
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1 Albendazol 400 tab 0 Rp 288.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
12 Tablet Tambah darah tab 23,074 Rp 352.00 Rp 8,122,048.00
13 Zink 20 mg tab 204 Rp 513.00 Rp 104,652.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 0 Rp 30,000.00 Rp -
JUMLAH Rp 8,240,483.00
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS PARE
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
1 Alopurinol 100 mg tab 277 Rp 86.00
8 Amoksisilin 500 mg tab 4,419 Rp 232.00
11 Asam Askorbat 50 mg tab 4,099 Rp 105.00
0 Asifit kap 0 Rp -
1
1 2 3 4 5
22 Cetirizin 10 mg tab 1,774 Rp 89.98
23 Dexametason 0,5 mg tab 4,732 Rp 32.00

1
1 2 3 4 5
44 HCT 25 mg tab 388 Rp 149.00
48 Kalk tab 799 Rp 59.00
52 Kaptopril 25 mg tab 1,759 Rp 84.00

1
1 2 3 4 5
59 Klorfeniramin Maleat/ CTM 4 mg tab 2,672 Rp 42.00
76 Natrium Diklofenak 50 mg tab 467 Rp 115.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 90 Rp 279.00
87 Ranitidin 150 mg tab 1,513 Rp 105.00

1
1 2 3 4 5
93 Sianokobalamin / B12 50 mcg tab 2,877 Rp 51.00
96 Siprofloksasin 500 mg tab 868 Rp 281.07
103 Tiamin 50 mg/ B1 tab 258 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 0 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 5 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 5 Rp 6,410.00
8 RL btl 18 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
18 Handschoen Disposible (M) biji 1,900 Rp 462.00
32 Kasa 2 m x 80 cm rol 20 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 5 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 1 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 1 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS PARE
Jumlah Harga (Rp)
Rp -
Rp -
Rp 23,822.00
Rp 42,028.00
Rp -
Rp 30,121.00
Rp 14,529.00
Rp 30,590.00
Rp 69,285.00
Rp -
Rp 1,025,208.00
Rp 228,408.00
Rp 57,090.00
Rp 430,395.00
Rp -
Rp 9,135.00
Rp 269,242.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 94,122.00
Rp -
Rp -
Rp -
Rp -
Rp 15,950.00
Rp -
Rp 159,624.52
Rp 151,424.00
Rp -
Rp 16,856.00
Rp -
Rp -
Rp 9,700.00
Rp 12,060.00
Rp 10,400.00
Rp 26,400.00
Rp 8,850.00
Rp -
Rp -
Rp 22,120.00
Rp 9,234.00
Rp 97,270.00
Rp -
Rp 4,290.00
Rp -
Rp 14,392.00
1
Jumlah Harga (Rp)
Rp 133,760.00
Rp -
Rp 52,164.00
Rp 49,560.00
Rp -
Rp -
Rp 14,396.00
Rp 3,528.00
Rp 57,812.00
Rp -
Rp -
Rp -
Rp -
Rp 8,800.00
Rp -
Rp -
Rp 47,141.00
Rp 25,800.00
Rp 156,219.00
Rp -
Rp -
Rp 147,756.00
Rp 23,000.00
Rp -
Rp 43,120.00
Rp -
Rp 35,880.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 112,224.00
Rp -
Rp -
Rp 22,000.00
Rp 48,297.60
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,880.00
Rp 478,950.00
Rp -
Rp -
Rp -
Rp 52,800.00
Rp -
Rp -
Rp 53,705.00
Rp -
Rp -
Rp 19,500.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 11,050.00
Rp -
Rp -
Rp 382,928.00
Rp -
Rp -
Rp 294,174.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 25,110.00
Rp 158,865.00
Rp -
Rp -
Rp -
Rp 7,080.00
Rp -
Rp -
Rp 106,700.00
Rp 47,200.00
1
Jumlah Harga (Rp)
Rp 146,727.00
Rp 59,212.00
Rp -
Rp 243,968.76
Rp -
Rp 17,464,236.00
Rp -
Rp 15,000.00
Rp 288,750.00
Rp -
Rp -
Rp -
Rp 22,188.00
Rp 21,250.00
Rp -
Rp 510,600.00
Rp -
Rp -
Rp -
Rp 4,000.00
Rp -
Rp -
Rp 104,500.00
Rp 157,950.00
Rp -
Rp -
Rp 86,400.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 56,925.00
Rp -
Rp -
Rp -
Rp 87,740.00
Rp -
Rp -
Rp 26,600.00
Rp -
Rp -
Rp 1,518,400.00
Rp 55,300.00
Rp 17,784.00
Rp -
Rp -
Rp 6,745.00
Rp 33,945.00
Rp -
Rp -
Rp 176,120.00
Rp -
Rp -
Rp 54,690.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 7,700.00
Rp -
Rp -
Rp 26,250.00
Rp 17,490.00
Rp -
Rp -
Rp -
Rp -
Rp 49,775.00
Rp -
Rp 1,591,200.00
Rp 12,900.00
Rp 103,680.00
Rp -
Rp 59,180.00
Rp 31,000.00
Rp -
Rp -
Rp -
Rp 188,100.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp 21,960.00
Rp 209,874.00
Rp -
Rp -
Rp -
Rp -
Rp 130,384.00
Rp 133,980.00
Rp 821,589.00
Rp -
Rp 101,100.00
Rp -
Rp 52,200.00
Rp -
Rp -
Rp 124,800.00
Rp 46,068.00
Rp -
Rp -
Rp -
Rp -
Rp 44,030.00
Rp -
Rp -
Rp 69,550.00
1
Jumlah Harga (Rp)
Rp 118,496.00
Rp -
Rp -
Rp 165,082.00
Rp -
Rp 149,002.00
Rp -
Rp 7,524.00
Rp 69,184.00
Rp -
Rp -
Rp -
Rp 126,000.00
Rp -
Rp -
Rp 20,920.00
Rp -
Rp -
Rp -
Rp -
Rp 1,385,670.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 12,635.00
Rp 38,950.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 27,600.00
Rp -
Rp -
Rp -
Rp -
Rp 32,050.00
Rp -
Rp 128,700.00
Rp -
Rp -
Rp 885,962.00
Rp 33,880.00
Rp 131,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 393,600.00
Rp -
Rp 482,380.68
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 877,800.00
Rp 46,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 174,240.00
Rp 154,000.00
Rp -
Rp -
Rp 87,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,000.00
Rp 70,000.00
Rp -
Rp 188,999.80
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 205,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 62,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,414,381.50
Rp 23,300.00
Rp 22,400.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,050.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,001.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 59,951.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 78,880.00
Rp -
Rp -
Rp 29,549.00
Rp -
Rp -
Rp 122,727.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 38,992,400.86
1
DI PUSKESMAS PARE
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1 Ambroxol 30 mg tab 0 Rp 201.30 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Dextral tablet tab 0 Rp 506.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Kalium Diklofenak 50 mg tab 1,000 Rp 694.32 Rp 694,320.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 16 Rp 5,797.00 Rp 92,752.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
11 Mometason krim tube 20 Rp 17,820.00 Rp 356,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
19 Sulfasetamid TM 15 % btl 0 Rp 9,350.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 Aseptic Gel 500 cc btl 0 Rp 22,000.00 Rp -
9 Bisturi box 2 Rp 83,600.00 Rp 167,200.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 4 Rp 24,000.00 Rp 96,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
17 Stik gula darah gluco DR btl 6 Rp 189,420.00 Rp 1,136,520.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 19,054,635.27
1
DI PUSKESMAS PARE
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS PARE
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
8 OAT kat II pkt 1 ### Rp 1,199,985.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 0 Rp 513.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 1 ### Rp 522,083.00
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 2,088,776.00
1
DI PUSKESMAS PARE
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS PARE
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 1,292 Rp 149.00
48 Kalk tab 6,378 Rp 59.00

1
1 2 3 4 5
74 Metronidazol 500 mg tab 1,325 Rp 160.00
77 Nifedipin 10 mg tab 1,423 Rp 100.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 3,960 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 101 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 37 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 12 Rp 6,410.00
8 RL btl 75 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
19 Handschoen Disposible (S) biji 1,042 Rp 462.00
21 Hansdchoen Nitril (S) biji 1,062 Rp 627.00
32 Kasa 2 m x 80 cm rol 76 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 0 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 20 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 23 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
3 Atalpulgit/ New Antides tab 2,052 Rp 136.00
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS PARE
Jumlah Harga (Rp)
Rp -
Rp -
Rp 12,900.00
Rp -
Rp -
Rp 47,684.00
Rp 9,185.00
Rp 46,130.00
Rp 44,175.00
Rp -
Rp 1,322,168.00
Rp 66,774.00
Rp -
Rp 553,035.00
Rp -
Rp 58,590.00
Rp 729,755.00
Rp 14,800.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 165,426.00
Rp -
Rp -
Rp -
Rp 27,500.00
Rp 15,000.00
Rp 40,041.10
Rp 180,640.00
Rp -
Rp 9,718.00
Rp -
Rp -
Rp 13,968.00
Rp 26,800.00
Rp 10,400.00
Rp -
Rp 18,880.00
Rp -
Rp 105,000.00
Rp 25,280.00
Rp 17,100.00
Rp -
Rp -
Rp 66,690.00
Rp -
Rp 31,354.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 58,167.00
Rp 42,000.00
Rp -
Rp -
Rp -
Rp 9,520.00
Rp 192,508.00
Rp -
Rp -
Rp -
Rp 11,176.00
Rp 56,760.00
Rp -
Rp -
Rp 376,302.00
Rp -
Rp -
Rp -
Rp 54,870.00
Rp 214,956.00
Rp -
Rp -
Rp 16,800.00
Rp 97,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 229,530.00
Rp 14,700.00
Rp -
Rp -
Rp 114,404.94
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 56,544.00
Rp 84,000.00
Rp -
Rp 18,990.00
Rp -
Rp 212,000.00
Rp -
Rp 259,008.00
Rp 16,100.00
Rp -
Rp -
Rp 142,300.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 6,500.00
Rp -
Rp -
Rp 378,112.00
Rp -
Rp -
Rp 460,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 399,105.00
Rp -
Rp -
Rp -
Rp 34,043.00
Rp -
Rp -
Rp 176,000.00
Rp -
1
Jumlah Harga (Rp)
Rp 250,818.00
Rp 83,578.00
Rp -
Rp 322,387.29
Rp -
Rp 15,515,820.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 340,560.00
Rp -
Rp -
Rp 455,860.00
Rp -
Rp -
Rp -
Rp 124,000.00
Rp -
Rp 197,200.00
Rp 114,950.00
Rp 317,925.00
Rp -
Rp -
Rp 78,300.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 410,850.00
Rp -
Rp -
Rp 31,640.00
Rp 218,280.00
Rp -
Rp -
Rp 34,200.00
Rp -
Rp -
Rp 722,800.00
Rp 105,070.00
Rp 40,014.00
Rp -
Rp -
Rp -
Rp 359,817.00
Rp -
Rp 118,785.70
Rp 383,690.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 7,700.00
Rp 23,800.00
Rp -
Rp 12,600.00
Rp 27,984.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 707,200.00
Rp 14,190.00
Rp 42,624.00
Rp 14,872.00
Rp 14,795.00
Rp -
Rp -
Rp -
Rp -
Rp 60,800.00
Rp -
Rp -
Rp 27,800.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 127,890.00
Rp 713,643.00
Rp -
Rp 141,540.00
Rp -
Rp -
Rp -
Rp -
Rp 738,400.00
Rp 23,034.00
Rp -
Rp -
Rp 252,500.00
Rp 415,950.00
Rp -
Rp -
Rp -
Rp 136,425.00
1
Jumlah Harga (Rp)
Rp 245,456.00
Rp -
Rp -
Rp 313,376.00
Rp -
Rp 244,055.00
Rp -
Rp -
Rp 207,552.00
Rp 104,000.00
Rp -
Rp -
Rp 48,000.00
Rp -
Rp -
Rp 30,334.00
Rp -
Rp -
Rp -
Rp -
Rp 1,580,150.00
Rp -
Rp -
Rp 90,000.00
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 93,499.00
Rp 92,250.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 62,100.00
Rp -
Rp -
Rp -
Rp -
Rp 76,920.00
Rp -
Rp 536,250.00
Rp -
Rp -
Rp 398,090.00
Rp 375,584.00
Rp 797,790.00
Rp -
Rp -
Rp -
Rp 165,550.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 884,400.00
Rp 1,115,200.00
Rp 500,880.24
Rp 1,205,951.70
Rp -
Rp -
Rp 55,590.00
Rp 55,590.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 42,500.00
Rp -
Rp 42,500.00
1
Jumlah Harga (Rp)
Rp 877,800.00
Rp 481,404.00
Rp -
Rp 665,874.00
Rp -
Rp -
Rp -
Rp -
Rp 166,320.00
Rp 46,200.00
Rp 61,600.00
Rp -
Rp 113,100.00
Rp -
Rp 370,300.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 90,000.00
Rp 90,000.00
Rp -
Rp 718,199.24
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 283,000.00
Rp 113,200.00
Rp -
Rp -
Rp -
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 801,482.85
Rp 466,000.00
Rp 515,200.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 457,560.00
Rp 45,045.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,667.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 183,450.06
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 279,072.00
Rp -
Rp -
Rp 118,196.00
Rp -
Rp -
Rp 319,090.20
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 47,888,209.32
1
DI PUSKESMAS PARE
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 240 Rp 1,026.67 Rp 246,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Haemorogard tab 0 Rp 1,552.10 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 21 Rp 5,797.00 Rp 121,737.00
8 Pacdin Vitcur sirup btl 63 Rp 8,140.00 Rp 512,820.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 2 Rp 83,600.00 Rp 167,200.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 8 Rp 24,000.00 Rp 192,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 20,246,989.92
1
DI PUSKESMAS PARE
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS PARE
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
2 Antimigrein tab 100 Rp 167.00 Rp 16,700.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Triheksifenidil 2 mg tab 100 Rp 85.00 Rp 8,500.00
13 Zink 20 mg tab 645 Rp 513.00 Rp 330,885.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1 Rapid I HIV test 200 Rp 14,340.00 Rp 2,868,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 3,278,975.40
1
DI PUSKESMAS PARE
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS PRINGSURAT
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
5 Amlodipin 5 mg tab 4,465 Rp 70.00
0 Asifit kap 0 Rp -
1
1 2 3 4 5
28 Dimenhidrinat 50 mg tab 1,218 Rp 104.00

1
1 2 3 4 5
44 HCT 25 mg tab 108 Rp 149.00
48 Kalk tab 3,797 Rp 59.00

1
1 2 3 4 5
62 Kodein 10 mg tab 100 Rp 550.00
63 Kotrimoksazol 480 mg tab 1,011 Rp 150.93
75 N-Asetil Sistein 200 mg kap 2,688 Rp 426.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 5,009 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 161 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 7 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 27 Rp 6,900.00
4 Ka-En 3A btl 21 Rp 10,050.00
5 Ka-En 3B btl 20 Rp 10,696.00
6 Ka-En Mg 3 btl 40 Rp 9,599.67
7 NaCl btl 94 Rp 6,410.00
8 RL btl 536 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 62 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 1 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 24 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 23 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS PRINGSURAT
Jumlah Harga (Rp)
Rp -
Rp -
Rp 53,836.00
Rp -
Rp -
Rp 43,862.00
Rp 24,549.00
Rp 312,550.00
Rp 218,457.00
Rp -
Rp 3,983,904.00
Rp 561,906.00
Rp 11,245.00
Rp 383,565.00
Rp -
Rp 39,627.00
Rp 659,200.00
Rp 39,812.00
Rp -
1
Jumlah Harga (Rp)
Rp 119,520.00
Rp 102,955.00
Rp -
Rp -
Rp -
Rp 22,000.00
Rp 12,000.00
Rp 39,951.12
Rp 307,040.00
Rp -
Rp 4,644.00
Rp -
Rp -
Rp 5,917.00
Rp 11,926.00
Rp 126,672.00
Rp 11,616.00
Rp 100,536.00
Rp -
Rp -
Rp -
Rp 10,089.00
Rp 107,920.00
Rp -
Rp 14,040.00
Rp -
Rp 74,016.00
1
Jumlah Harga (Rp)
Rp 91,580.00
Rp -
Rp 7,452.00
Rp 42,420.00
Rp -
Rp -
Rp 5,015.00
Rp 4,480.00
Rp 16,092.00
Rp -
Rp -
Rp -
Rp 508.00
Rp 14,696.00
Rp -
Rp -
Rp 224,023.00
Rp 90,300.00
Rp 55,533.00
Rp -
Rp 39,122.00
Rp 66,528.00
Rp 32,200.00
Rp -
Rp 25,760.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 246,328.70
Rp 353,346.00
Rp 1,029.00
Rp -
Rp 55,000.00
Rp 152,590.23
Rp -
Rp -
Rp -
Rp -
Rp 35,178.00
Rp -
Rp -
Rp 80,832.00
Rp 143,550.00
Rp -
Rp 21,100.00
Rp 720.00
Rp 102,880.00
Rp -
Rp 1,145,088.00
Rp 215,740.00
Rp -
Rp -
Rp 29,500.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 21,710.00
Rp -
Rp -
Rp 703,192.00
Rp -
Rp -
Rp 493,476.00
Rp -
Rp -
Rp -
Rp -
Rp 4,662.00
Rp -
Rp 297,465.00
Rp -
Rp -
Rp -
Rp 34,869.00
Rp -
Rp -
Rp 184,800.00
Rp -
1
Jumlah Harga (Rp)
Rp 204,765.00
Rp 97,988.00
Rp -
Rp 152,621.01
Rp -
Rp 21,683,916.00
Rp -
Rp 32,500.00
Rp -
Rp -
Rp 15,499.50
Rp -
Rp 430,774.00
Rp -
Rp -
Rp 445,280.00
Rp -
Rp -
Rp -
Rp 24,000.00
Rp -
Rp 204,000.00
Rp 298,870.00
Rp 182,250.00
Rp -
Rp -
Rp 143,100.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 188,320.00
Rp -
Rp -
Rp 49,400.00
Rp -
Rp -
Rp 1,008,800.00
Rp 148,204.00
Rp 17,784.00
Rp 109,816.00
Rp -
Rp 47,215.00
Rp -
Rp -
Rp 75,590.90
Rp 383,690.00
Rp -
Rp -
Rp 10,938.00
Rp -
1
Jumlah Harga (Rp)
Rp 101,750.00
Rp -
Rp 15,400.00
Rp 247,800.00
Rp 8,563.50
Rp 51,450.00
Rp 43,725.00
Rp -
Rp -
Rp 36,384.00
Rp -
Rp 79,640.00
Rp -
Rp 4,066,400.00
Rp 32,250.00
Rp 207,360.00
Rp 292,864.00
Rp 26,631.00
Rp -
Rp -
Rp -
Rp -
Rp 66,500.00
Rp 68,480.00
Rp -
Rp 126,490.00
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp -
Rp 239,330.00
Rp -
Rp -
Rp -
Rp -
Rp 143,872.00
Rp 76,125.00
Rp 413,793.00
Rp -
Rp 80,880.00
Rp -
Rp 11,600.00
Rp -
Rp -
Rp 530,400.00
Rp 172,755.00
Rp -
Rp -
Rp 402,500.00
Rp -
Rp 85,470.00
Rp -
Rp -
Rp 128,400.00
1
Jumlah Harga (Rp)
Rp 279,312.00
Rp -
Rp -
Rp 114,718.00
Rp -
Rp 182,399.00
Rp -
Rp 13,167.00
Rp 493,312.00
Rp 71,500.00
Rp -
Rp -
Rp 48,000.00
Rp -
Rp -
Rp 4,707.00
Rp -
Rp -
Rp -
Rp -
Rp 911,625.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 19,999.90
1
Jumlah Harga (Rp)
Rp 17,689.00
Rp 45,100.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 2,286,102.00
Rp -
Rp 186,300.00
Rp 211,050.00
Rp 213,920.00
Rp 383,986.80
Rp -
Rp 602,540.00
Rp -
Rp 3,832,400.00
Rp -
Rp -
Rp 442,134.00
Rp 901,208.00
Rp 330,120.00
Rp 12,012.00
Rp 14,993.00
Rp -
Rp 331,100.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 50,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 964,800.00
Rp 1,279,200.00
Rp 1,419,160.68
Rp 1,286,348.48
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 114,750.00
Rp 89,250.00
Rp 255,000.00
Rp 170,000.00
1
Jumlah Harga (Rp)
Rp 220,836.00
Rp 621,852.00
Rp -
Rp 62,700.00
Rp -
Rp -
Rp -
Rp -
Rp 1,457,280.00
Rp 192,500.00
Rp 385,000.00
Rp -
Rp 374,100.00
Rp -
Rp 1,642,200.00
Rp -
Rp -
Rp -
Rp -
Rp 13,203.54
Rp 140,000.00
Rp 280,000.00
Rp -
Rp 585,899.38
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 41,000.00
Rp -
Rp 39,600.00
Rp 39,600.00
Rp -
Rp -
Rp -
Rp 254,700.00
Rp 311,300.00
Rp -
Rp -
Rp -
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 691,475.40
Rp 559,200.00
Rp 515,200.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 251,658.00
Rp 65,065.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 33,334.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 45,562.76
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 407,728.00
Rp -
Rp -
Rp 29,549.00
Rp -
Rp -
Rp 233,181.30
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 73,812,882.20
1
DI PUSKESMAS PRINGSURAT
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 37 Rp 5,797.00 Rp 214,489.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Piracetam 1 gr/ 5 ml amp 19 Rp 5,445.00 Rp 103,455.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 3 Rp 83,600.00 Rp 250,800.00
12 Cover Glass/ Deck Glass box 8 Rp 144,605.53 Rp 1,156,844.24
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 9 Rp 24,000.00 Rp 216,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
48 Plester rol 11 Rp 12,076.00 Rp 132,836.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
11 Etil klorid btl 1 Rp 90,200.00 Rp 90,200.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
16 Iodoform Pasta pot 1 Rp 176,000.00 Rp 176,000.00
21 OCO btl 2 Rp 125,400.00 Rp 250,800.00
26 T S Fletcher set 1 Rp 35,999.99 Rp 35,999.99
0 0 0 0 Rp - Rp -
2 Botol sampel darah 10 ml btl 34 Rp 2,400.00 Rp 81,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Giemsa pekat btl 1 Rp 198,000.00 Rp 198,000.00
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 3 Rp 9,317.00 Rp 27,951.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 41,987,985.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
Dr. SUPARJO, M.Kes.

NIP. 19610731 198903 1 008
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 400 Rp 513.00 Rp 205,200.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1 Box Slide biji 2 Rp 77,690.00 Rp 155,380.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 2,993,343.20
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS KALORAN
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
13 Asam Folat 0,4 mg tab 1,010 Rp 63.00
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
38 Gemfibrozil 300 mg tab 1,351 Rp 380.00
44 HCT 25 mg tab 1,523 Rp 149.00
48 Kalk tab 1,070 Rp 59.00
51 Kaptopril 12,5 mg tab 2,540 Rp 62.00

1
1 2 3 4 5
69 Metformin 500 mg tab 1,565 Rp 96.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
83 Piridoksin/ B6 10 mg tab 895 Rp 118.00
86 PTU 100 mg tab 0 Rp 279.00
91 Sefadroksil 500 mg tab 1,090 Rp 550.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 4,155 Rp 86.00
105 Vitamin B komplek tab 230 Rp 115.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 2 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 1 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 19 Rp 6,410.00
8 RL btl 22 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 2 Rp 9,449.99
33 Kasa 36 x 80 cm rol 3 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 3 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 5 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 2 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
Mengetahui
1
1 2 3 4 5
Kepala Puskesmas Kalor
drg. Dahlia Puspa, MM

NIP. 1963101219890 2 0
1
PUSKESMAS KALORAN
Jumlah Harga (Rp)
Rp -
Rp -
Rp 237,360.00
Rp -
Rp -
Rp 12,103.00
Rp 99,198.00
Rp 103,600.00
Rp 141,360.00
Rp 97,500.00
Rp 895,520.00
Rp 188,480.00
Rp -
Rp 389,025.00
Rp -
Rp 63,630.00
Rp 363,693.00
Rp 17,760.00
Rp -
1
Jumlah Harga (Rp)
Rp 7,470.00
Rp 125,989.00
Rp -
Rp -
Rp -
Rp 56,100.00
Rp 6,000.00
Rp 39,591.20
Rp 164,032.00
Rp -
Rp 19,350.00
Rp 37,605.00
Rp -
Rp -
Rp 62,980.00
Rp 20,800.00
Rp -
Rp 75,520.00
Rp 54,600.00
Rp 240,000.00
Rp 23,068.00
Rp 29,070.00
Rp 127,800.00
Rp -
Rp 21,060.00
Rp -
Rp 40,349.00
1
Jumlah Harga (Rp)
Rp 513,380.00
Rp -
Rp 72,450.00
Rp 149,100.00
Rp -
Rp -
Rp 22,538.00
Rp 50,400.00
Rp 226,927.00
Rp -
Rp -
Rp -
Rp -
Rp 29,128.00
Rp -
Rp -
Rp 63,130.00
Rp 4,300.00
Rp -
Rp -
Rp 157,480.00
Rp 393,960.00
Rp -
Rp -
Rp 33,600.00
Rp -
Rp 90,160.00
1
Jumlah Harga (Rp)
Rp -
Rp 544,975.00
Rp 192,360.00
Rp 47,040.00
Rp -
Rp -
Rp 271,070.28
Rp -
Rp -
Rp -
Rp 4,005.00
Rp 12,300.00
Rp -
Rp -
Rp 150,240.00
Rp 28,500.00
Rp 30,000.00
Rp 42,200.00
Rp -
Rp 74,880.00
Rp -
Rp 34,080.00
Rp -
Rp -
Rp -
Rp 10,000.00
Rp 64,070.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 9,750.00
Rp -
Rp -
Rp 651,168.00
Rp -
Rp -
Rp 105,610.00
Rp -
Rp 6,460.00
Rp -
Rp -
Rp -
Rp -
Rp 130,200.00
Rp -
Rp -
Rp -
Rp 21,830.00
Rp 30,800.00
Rp -
Rp 599,500.00
Rp 118,000.00
1
Jumlah Harga (Rp)
Rp 141,321.00
Rp 186,020.00
Rp -
Rp 219,234.60
Rp -
Rp 11,011,524.00
Rp -
Rp 25,000.00
Rp 210,000.00
Rp -
Rp 46,498.50
Rp -
Rp 357,330.00
Rp 8,330.00
Rp -
Rp 26,450.00
Rp -
Rp -
Rp -
Rp 124,000.00
Rp -
Rp 214,200.00
Rp 125,400.00
Rp 166,050.00
Rp -
Rp -
Rp 43,200.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 24,750.00
Rp 4,465.00
Rp -
Rp -
Rp 186,180.00
Rp -
Rp 63,360.00
Rp 76,000.00
Rp -
Rp -
Rp 1,092,000.00
Rp 235,578.00
Rp -
Rp 58,830.00
Rp -
Rp -
Rp 67,890.00
Rp -
Rp -
Rp 452,880.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 8,250.00
Rp -
Rp -
Rp 135,800.00
Rp -
Rp 31,500.00
Rp 34,980.00
Rp -
Rp -
Rp 30,320.00
Rp -
Rp -
Rp -
Rp 884,000.00
Rp 11,610.00
Rp 24,192.00
Rp 17,160.00
Rp 59,180.00
Rp -
Rp -
Rp -
Rp -
Rp 9,500.00
Rp -
Rp -
Rp 1,390.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 77,958.00
Rp 44,184.00
Rp -
Rp -
Rp -
Rp -
Rp 184,336.00
Rp 66,990.00
Rp 59,970.00
Rp -
Rp 186,024.00
Rp -
Rp -
Rp -
Rp -
Rp 228,800.00
Rp 34,551.00
Rp -
Rp -
Rp 5,000.00
Rp 249,570.00
Rp 318,570.00
Rp 218,400.00
Rp -
Rp 98,975.00
1
Jumlah Harga (Rp)
Rp 12,696.00
Rp -
Rp -
Rp 235,032.00
Rp -
Rp 120,743.00
Rp -
Rp 92,169.00
Rp 207,552.00
Rp 9,750.00
Rp -
Rp 170,399.90
Rp -
Rp -
Rp -
Rp 10,460.00
Rp -
Rp -
Rp -
Rp -
Rp 1,835,405.00
Rp -
Rp 86,965.00
Rp -
Rp -
Rp -
Rp 7,999.96
1
Jumlah Harga (Rp)
Rp 2,527.00
Rp 18,450.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 121,790.00
Rp -
Rp 157,300.00
Rp -
Rp -
Rp 221,914.00
Rp 147,136.00
Rp 390,380.00
Rp 7,392.00
Rp -
Rp -
Rp 604,257.50
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 40,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 241,200.00
Rp 229,600.00
Rp -
Rp 321,587.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 21,250.00
Rp 21,250.00
Rp 21,250.00
Rp 38,250.00
1
Jumlah Harga (Rp)
Rp 226,380.00
Rp 184,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 87,120.00
Rp 254,100.00
Rp 77,000.00
Rp -
Rp 26,100.00
Rp -
Rp 112,700.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,000.00
Rp -
Rp -
Rp 18,899.98
Rp 390,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 123,000.00
Rp -
Rp 138,600.00
Rp 59,400.00
Rp -
Rp -
Rp -
Rp 566,000.00
Rp 566,000.00
Rp -
Rp -
Rp -
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 628,614.00
Rp 116,500.00
Rp 44,800.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 12,999.36
Rp -
Rp -
Rp 61,008.00
Rp 20,020.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,001.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 13,189.22
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 36,515,751.74
Mengetahui
1
Jumlah Harga (Rp)
6
Kepala Puskesmas Kaloran

NIP. 1963101219890 2 005
1
DI PUSKESMAS KALORAN
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 850 Rp 1,026.67 Rp 872,666.67
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
24 Nodiar tab 1,045 Rp 453.04 Rp 473,426.80
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 6 Rp 5,797.00 Rp 34,782.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
2 Alkazym 250 mg sack 2 Rp 800,978.20 Rp 1,601,956.40
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 5 Rp 83,600.00 Rp 418,000.00
10 Bracket Hand Wash Plastik biji 5 Rp 17,600.00 Rp 88,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 0 Rp 24,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Giemsa pekat btl 1 Rp 198,000.00 Rp 198,000.00
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 2 Rp 9,317.00 Rp 18,634.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 29,452,009.88
Mengetahui
1
Harga Satuan
(Rp)
1 2 3 4 5 6

NIP. 1963101219890 2 005
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 OAT Anak/ FDC pkt 2 Rp 195,441.92 Rp 390,883.84
7 OAT kat I/ Kombipak pkt 0 Rp 288,199.00 Rp -
8 OAT kat II pkt 0 Rp 1,199,985.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Triheksifenidil 2 mg tab 1,000 Rp 85.00 Rp 85,000.00
13 Zink 20 mg tab 800 Rp 513.00 Rp 410,400.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Ziehl nelson btl 0 Rp 276,500.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 0 Rp 522,083.00 Rp -
6 Lugol btl 0 Rp 30,000.00 Rp -
JUMLAH Rp 1,326,831.84
Mengetahui
1
Harga Satuan
(Rp)
1 2 3 4 5 6

NIP. 1963101219890 2 005
1
ARAN : APBD I (Buffer Prof), JPKMM dan Program
tar sisa persediaan (Habis Pakai / jual)
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS TEPUSEN
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 155 Rp 149.00
48 Kalk tab 3,008 Rp 59.00

1
1 2 3 4 5
62 Kodein 10 mg tab 148 Rp 550.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 2,790 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 247 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 26 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 7 Rp 6,410.00
8 RL btl 24 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 74 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 1 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 12 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 14 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS TEPUSEN
Jumlah Harga (Rp)
Rp -
Rp -
Rp 48,934.00
Rp -
Rp -
Rp 64,610.00
Rp 16,700.00
Rp 43,470.00
Rp 27,900.00
Rp 329,160.00
Rp 1,191,088.00
Rp 92,566.00
Rp -
Rp 433,020.00
Rp -
Rp 54,684.00
Rp 216,712.00
Rp 75,480.00
Rp -
1
Jumlah Harga (Rp)
Rp 242,775.00
Rp 181,829.00
Rp -
Rp -
Rp -
Rp 4,620.00
Rp 35,100.00
Rp 46,879.58
Rp 89,792.00
Rp -
Rp 79,808.00
Rp -
Rp -
Rp 12,998.00
Rp 26,800.00
Rp 20,696.00
Rp -
Rp 94,990.00
Rp -
Rp 180,000.00
Rp 50,560.00
Rp 22,914.00
Rp 203,770.00
Rp -
Rp 23,634.00
Rp -
Rp 63,736.00
1
Jumlah Harga (Rp)
Rp 106,780.00
Rp -
Rp 53,199.00
Rp 114,240.00
Rp -
Rp -
Rp -
Rp 23,184.00
Rp 23,095.00
Rp -
Rp -
Rp -
Rp 12,065.00
Rp 45,848.00
Rp -
Rp -
Rp 177,472.00
Rp -
Rp 110,028.00
Rp -
Rp 34,658.00
Rp 128,352.00
Rp 131,100.00
Rp -
Rp 102,760.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 217,990.00
Rp 100,884.00
Rp 43,659.00
Rp 1,249,440.00
Rp 81,400.00
Rp 207,377.82
Rp 37,620.00
Rp -
Rp -
Rp 29,815.00
Rp 48,462.00
Rp -
Rp -
Rp 117,696.00
Rp -
Rp 309,600.00
Rp 21,100.00
Rp 17,100.00
Rp 99,520.00
Rp -
Rp 1,352,550.00
Rp 108,445.00
Rp -
Rp -
Rp 25,000.00
Rp 26,075.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 22,620.00
Rp -
Rp 10,710.00
Rp 463,792.00
Rp -
Rp -
Rp 569,232.00
Rp -
Rp 39,100.00
Rp -
Rp -
Rp -
Rp -
Rp 161,700.00
Rp -
Rp -
Rp 107,835.00
Rp 33,689.00
Rp -
Rp -
Rp 307,450.00
Rp -
1
Jumlah Harga (Rp)
Rp 70,788.00
Rp 128,642.00
Rp -
Rp 142,783.56
Rp -
Rp 9,721,902.00
Rp -
Rp -
Rp 210,000.00
Rp -
Rp -
Rp -
Rp 239,940.00
Rp 18,700.00
Rp -
Rp 404,570.00
Rp -
Rp -
Rp -
Rp 196,000.00
Rp -
Rp 180,200.00
Rp 100,320.00
Rp 103,275.00
Rp -
Rp -
Rp 137,700.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 336,600.00
Rp -
Rp -
Rp 11,865.00
Rp 77,040.00
Rp -
Rp -
Rp 30,400.00
Rp -
Rp -
Rp 546,000.00
Rp 86,268.00
Rp -
Rp -
Rp -
Rp -
Rp 40,734.00
Rp -
Rp -
Rp 207,570.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 7,700.00
Rp 28,000.00
Rp 8,563.50
Rp 18,900.00
Rp 17,490.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,591,200.00
Rp 12,900.00
Rp 200,448.00
Rp 137,280.00
Rp 82,852.00
Rp -
Rp -
Rp -
Rp -
Rp 176,700.00
Rp -
Rp -
Rp 22,240.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 566,496.00
Rp 130,935.00
Rp 377,811.00
Rp -
Rp 98,404.00
Rp -
Rp -
Rp -
Rp -
Rp 509,600.00
Rp 57,585.00
Rp -
Rp -
Rp 617,500.00
Rp 83,190.00
Rp 15,540.00
Rp -
Rp -
Rp 390,550.00
1
Jumlah Harga (Rp)
Rp 512,072.00
Rp -
Rp -
Rp 209,850.00
Rp -
Rp 321,125.00
Rp -
Rp 180,576.00
Rp 159,424.00
Rp 136,500.00
Rp -
Rp -
Rp 84,000.00
Rp -
Rp -
Rp 17,259.00
Rp -
Rp -
Rp -
Rp -
Rp 850,850.00
Rp -
Rp -
Rp 108,000.00
Rp 101,500.00
Rp -
Rp 15,999.92
1
Jumlah Harga (Rp)
Rp 65,702.00
Rp 49,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 44,870.00
Rp -
Rp 171,600.00
Rp -
Rp -
Rp 394,702.00
Rp 382,360.00
Rp 222,700.00
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 120,600.00
Rp 393,600.00
Rp 250,440.12
Rp 241,190.34
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 554,400.00
Rp 231,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 150,480.00
Rp 92,400.00
Rp 23,100.00
Rp -
Rp 17,400.00
Rp -
Rp 144,900.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 20,000.00
Rp 50,000.00
Rp -
Rp 699,299.26
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 41,000.00
Rp -
Rp 99,000.00
Rp 39,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 375,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 927,205.65
Rp 279,600.00
Rp 313,600.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 724,470.00
Rp 10,010.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 59,951.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 68,136.00
Rp -
Rp -
Rp 59,098.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 39,004,820.75
1
DI PUSKESMAS TEPUSEN
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
10 Hepagard tab 466 Rp 2,794.00 Rp 1,302,004.00
0 Kalsium Karbonat 500 mg/ Calptab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Litium Karbonat 400 mg/ Frimatab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
33 Tensigard tab 150 Rp 2,112.00 Rp 316,800.00
0 0 0 0 Rp - Rp -
0 Amoksisilin sirup 125 mg/ 5 mlbtl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Erytromisin sirup 200 mg/ 5 mlbtl 0 Rp - Rp -
7 OBH btl 87 Rp 5,797.00 Rp 504,339.00
0 Parasetamol sirup 120 mg/ 5 mlbtl 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Difenhidramin injeksi 10 mg/ mamp 0 Rp - Rp -
5 Haloperidol inj i.m. 5 mg/ml (Lamp 0 Rp 6,250.00 Rp -
0 Nalokson inj 0,4 mg/ml (Nokobamp 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sianokobalamin inj 500 mcg/ mamp 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Asam Fusidat krim 20mg/g - Actube 0 Rp - Rp -
0 Budesonid/ Pulmicort res 0,25mbtl 0 Rp - Rp -
0 Budesonid-formeterol/ Symbicor
btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Lidokain Spray 10%/ Xylocainebtl 0 Rp - Rp -
0 Salbutamol inh 100 mcg/ Ventolbtl 0 Rp - Rp -
0 Salbutamol neb/ Ventolin Nebultube 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Alat suntik ADS 0.5 ml (Soloshset 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 2 Rp 83,600.00 Rp 167,200.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Handschoon panjang/obgin sterpsg 65 Rp 30,000.00 Rp 1,950,000.00
31 Kapas 250 g bks 7 Rp 24,000.00 Rp 168,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
44 Non Adhesive Bandage 10 x 4,5rol 0 Rp 66,973.50 Rp -
48 Plester rol 6 Rp 12,076.00 Rp 72,456.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
60 Umbilical cord klem nylon steribiji 121 Rp 1,299.98 Rp 157,297.58
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
15 Glass Ionomer Cement - Fuji VIbtl 0 Rp 686,400.00 Rp -
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
0 Salmonella Thypi H Widhal Tesset 0 Rp - Rp -
0 Salmonella Thypi O Widhal Tesset 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Paket Alat Deteksi Resiko Kehapaket 0 Rp - Rp -
0 Na Divalproat 250 mg (Depakottab 0 Rp - Rp -
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 24,400,222.26
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 395 Rp 513.00 Rp 202,635.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 5,165,602.20
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS BULU
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
9 Antasida DOEN tab 141 Rp 62.00
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 2,079 Rp 149.00
48 Kalk tab 2,093 Rp 59.00

1
1 2 3 4 5
62 Kodein 10 mg tab 301 Rp 550.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 1,297 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 255 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 8 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 15 Rp 6,900.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 11 Rp 6,410.00
8 RL btl 13 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 10 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 2 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 5 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 5 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 2 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS BULU
Jumlah Harga (Rp)
Rp -
Rp -
Rp 34,572.00
Rp 1,264.00
Rp -
Rp 47,320.00
Rp 15,531.00
Rp 17,500.00
Rp -
Rp 5,850.00
Rp 3,082,816.00
Rp 8,742.00
Rp -
Rp 31,080.00
Rp -
Rp 17,640.00
Rp 118,038.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 53,286.00
Rp 76,780.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 48,229.28
Rp 139,904.00
Rp -
Rp 2,150.00
Rp -
Rp -
Rp 19,594.00
Rp 14,070.00
Rp 39,728.00
Rp 26,400.00
Rp 43,424.00
Rp 54,600.00
Rp 75,000.00
Rp 25,438.00
Rp 4,446.00
Rp 21,300.00
Rp -
Rp 18,096.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 163,400.00
Rp -
Rp 10,350.00
Rp 23,100.00
Rp -
Rp -
Rp 23,364.00
Rp 16,016.00
Rp 309,771.00
Rp -
Rp -
Rp -
Rp -
Rp 49,104.00
Rp -
Rp -
Rp 123,487.00
Rp -
Rp 57,090.00
Rp -
Rp 87,234.00
Rp 48,216.00
Rp 62,100.00
Rp -
Rp 80,080.00
Rp 61,110.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 49,140.00
Rp 44,100.00
Rp -
Rp 165,550.00
Rp 111,990.06
Rp -
Rp 13,376.00
Rp 91,960.00
Rp -
Rp 6,888.00
Rp -
Rp -
Rp -
Rp 157,950.00
Rp 145,200.00
Rp 21,100.00
Rp 8,370.00
Rp 71,680.00
Rp -
Rp -
Rp 182,735.00
Rp -
Rp -
Rp 54,600.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 43,160.00
Rp -
Rp -
Rp 452,760.00
Rp -
Rp -
Rp 680,034.00
Rp -
Rp 31,892.00
Rp -
Rp -
Rp -
Rp -
Rp 211,680.00
Rp -
Rp -
Rp 57,330.00
Rp 40,061.00
Rp 12,250.00
Rp -
Rp 309,100.00
Rp -
1
Jumlah Harga (Rp)
Rp 111,129.00
Rp 7,336.00
Rp -
Rp 150,091.38
Rp -
Rp 23,064,870.00
Rp -
Rp 54,000.00
Rp 166,950.00
Rp -
Rp 241,792.20
Rp -
Rp 111,542.00
Rp -
Rp -
Rp 161,230.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 294,690.00
Rp 164,025.00
Rp -
Rp -
Rp 178,200.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 358,875.00
Rp -
Rp -
Rp -
Rp 211,860.00
Rp -
Rp -
Rp 26,600.00
Rp -
Rp -
Rp 202,800.00
Rp 241,108.00
Rp -
Rp 180,412.00
Rp -
Rp -
Rp 237,615.00
Rp -
Rp -
Rp 421,430.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 5,500.00
Rp -
Rp 15,400.00
Rp 7,000.00
Rp 8,563.50
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 23,040.00
Rp 34,320.00
Rp 14,795.00
Rp -
Rp -
Rp -
Rp -
Rp 68,400.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 5,490.00
Rp 69,958.00
Rp -
Rp -
Rp -
Rp -
Rp 220,304.00
Rp 271,005.00
Rp 401,799.00
Rp -
Rp 164,456.00
Rp -
Rp -
Rp -
Rp -
Rp 145,600.00
Rp 34,551.00
Rp -
Rp -
Rp 637,500.00
Rp 249,570.00
Rp 315,980.00
Rp -
Rp 44,949.85
Rp 203,300.00
1
Jumlah Harga (Rp)
Rp 29,624.00
Rp -
Rp -
Rp 44,768.00
Rp -
Rp 480,403.00
Rp -
Rp 69,597.00
Rp 135,360.00
Rp -
Rp -
Rp -
Rp 6,000.00
Rp -
Rp -
Rp 28,242.00
Rp -
Rp -
Rp -
Rp -
Rp 1,507,220.00
Rp -
Rp 173,930.00
Rp -
Rp -
Rp -
Rp 19,999.90
1
Jumlah Harga (Rp)
Rp 20,216.00
Rp 62,525.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 103,500.00
Rp -
Rp -
Rp -
Rp -
Rp 70,510.00
Rp -
Rp 92,950.00
Rp -
Rp -
Rp 169,400.00
Rp 96,800.00
Rp 252,830.00
Rp 2,772.00
Rp 25,488.10
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 80,400.00
Rp -
Rp 125,220.06
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 508,200.00
Rp 277,200.00
Rp 313,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 158,400.00
Rp 77,000.00
Rp 15,400.00
Rp -
Rp 43,500.00
Rp -
Rp 48,300.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,000.00
Rp 60,000.00
Rp -
Rp 94,499.90
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 82,000.00
Rp -
Rp 198,000.00
Rp 39,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,571,535.00
Rp 116,500.00
Rp 112,000.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 152,520.00
Rp 20,020.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,001.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 150,000.00
Rp -
Rp -
Rp 88,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 55,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 25,840.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 147,272.40
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 45,825,206.63
1
DI PUSKESMAS BULU
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kalsium Karbonat 500 mg/ Calptab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Litium Karbonat 400 mg/ Frimatab 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 Amoksisilin sirup 125 mg/ 5 mlbtl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Erytromisin sirup 200 mg/ 5 mlbtl 0 Rp - Rp -
7 OBH btl 11 Rp 5,797.00 Rp 63,767.00
0 Parasetamol sirup 120 mg/ 5 mlbtl 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Difenhidramin injeksi 10 mg/ mamp 0 Rp - Rp -
5 Haloperidol inj i.m. 5 mg/ml (Lamp 4 Rp 6,250.00 Rp 25,000.00
0 Nalokson inj 0,4 mg/ml (Nokobamp 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sianokobalamin inj 500 mcg/ mamp 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Asam Fusidat krim 20mg/g - Actube 0 Rp - Rp -
0 Budesonid/ Pulmicort res 0,25mbtl 0 Rp - Rp -
0 Budesonid-formeterol/ Symbicor
btl 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Kloramfenikol TT 3 % btl 0 Rp 7,590.00 Rp -
0 Lidokain Spray 10%/ Xylocainebtl 0 Rp - Rp -
0 Salbutamol inh 100 mcg/ Ventolbtl 0 Rp - Rp -
0 Salbutamol neb/ Ventolin Nebultube 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
0 Alat suntik ADS 0.5 ml (Soloshset 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 0 Rp 83,600.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Handschoon panjang/obgin sterpsg 24 Rp 30,000.00 Rp 720,000.00
31 Kapas 250 g bks 7 Rp 24,000.00 Rp 168,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
38 Lidi Kapas Steril biji 1,100 Rp 1,120.00 Rp 1,232,000.00
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
44 Non Adhesive Bandage 10 x 4,5rol 0 Rp 66,973.50 Rp -
48 Plester rol 21 Rp 12,076.00 Rp 253,596.00
52 Sabun Cuci Tangan/ Softaskin btl 18 Rp 58,538.70 Rp 1,053,696.60
1
Harga Satuan
(Rp)
1 2 3 4 5 6
60 Umbilical cord klem nylon steribiji 50 Rp 1,299.98 Rp 64,999.00
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
15 Glass Ionomer Cement - Fuji VIbtl 0 Rp 686,400.00 Rp -
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 3 Rp 9,317.00 Rp 27,951.00
9 Minyak immersi btl 1 Rp 483,120.00 Rp 483,120.00
0 Salmonella Thypi H Widhal Tesset 0 Rp - Rp -
0 Salmonella Thypi O Widhal Tesset 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Paket Alat Deteksi Resiko Kehapaket 0 Rp - Rp -
0 Na Divalproat 250 mg (Depakottab 0 Rp - Rp -
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 24,195,601.25
1
DI PUSKESMAS BULU
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS BULU
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
11 Retinol 200.000 UI tab 2,361 Rp 519.20 Rp 1,225,831.20
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 600 Rp 513.00 Rp 307,800.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Flufenazin inj 25mg/ml - Sikzo amp 5 Rp 59,800.00 Rp 299,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 2 ### Rp 1,044,166.00
6 Lugol btl 0 Rp 30,000.00 Rp -
7 Fluoksetin 20 mg tab/Peprezal tab 100 Rp 225.00 Rp 22,500.00
JUMLAH Rp 5,985,868.20
1
DI PUSKESMAS BULU
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS PARAKAN
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5
30 Domperidon 10 mg tab 1,908 Rp 118.00

1
1 2 3 4 5
44 HCT 25 mg tab 367 Rp 149.00
48 Kalk tab 2,189 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 232 Rp 279.00
89 Salbutamol 2 mg tab 1,449 Rp 59.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 5,338 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 13 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 1 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 19 Rp 6,410.00
8 RL btl 40 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 54 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 2 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 19 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 24 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
1 2 3 4 5
1
PUSKESMAS PARAKAN
Jumlah Harga (Rp)
Rp -
Rp -
Rp 149,210.00
Rp -
Rp -
Rp 31,031.00
Rp 44,756.00
Rp 110,530.00
Rp 83,328.00
Rp 95,550.00
Rp 1,623,768.00
Rp 256,060.00
Rp -
Rp 365,715.00
Rp -
Rp 165,753.00
Rp 461,234.00
Rp 62,456.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 189,507.00
Rp -
Rp -
Rp -
Rp 72,820.00
Rp 29,100.00
Rp 166,103.08
Rp 67,840.00
Rp -
Rp -
Rp -
Rp -
Rp 14,259.00
Rp -
Rp 5,408.00
Rp 46,464.00
Rp 225,144.00
Rp 54,600.00
Rp 135,000.00
Rp 47,400.00
Rp 64,809.00
Rp 197,380.00
Rp -
Rp 38,688.00
Rp -
Rp 144,434.00
1
Jumlah Harga (Rp)
Rp 182,020.00
Rp -
Rp 64,170.00
Rp 52,500.00
Rp -
Rp -
Rp 16,815.00
Rp 22,792.00
Rp 54,683.00
Rp -
Rp -
Rp -
Rp 12,065.00
Rp 7,480.00
Rp 6,470.00
Rp -
Rp 129,151.00
Rp -
Rp 248,082.00
Rp -
Rp 57,970.00
Rp 433,524.00
Rp 111,320.00
Rp -
Rp 51,240.00
Rp 97,000.00
Rp -
1
Jumlah Harga (Rp)
Rp 35,040.00
Rp 108,995.00
Rp 343,392.00
Rp 13,965.00
Rp 223,584.00
Rp 38,500.00
Rp 141,572.34
Rp -
Rp -
Rp -
Rp -
Rp 41,205.00
Rp -
Rp -
Rp 169,248.00
Rp 131,100.00
Rp 223,500.00
Rp 61,190.00
Rp 4,590.00
Rp 117,440.00
Rp -
Rp 1,094,394.00
Rp 353,280.00
Rp -
Rp -
Rp 32,900.00
Rp 78,225.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 75,660.00
Rp -
Rp -
Rp 472,360.00
Rp -
Rp -
Rp 646,168.00
Rp -
Rp -
Rp -
Rp -
Rp 3,996.00
Rp 64,728.00
Rp 282,660.00
Rp -
Rp -
Rp 24,570.00
Rp 85,491.00
Rp 67,760.00
Rp -
Rp 103,400.00
Rp 143,370.00
1
Jumlah Harga (Rp)
Rp 230,163.00
Rp 94,058.00
Rp -
Rp 103,433.76
Rp -
Rp 34,392,162.00
Rp -
Rp 15,250.00
Rp 126,000.00
Rp -
Rp -
Rp -
Rp 459,068.00
Rp 7,650.00
Rp -
Rp 594,550.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 197,200.00
Rp 213,180.00
Rp 194,400.00
Rp -
Rp -
Rp 234,900.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 274,725.00
Rp 285,760.00
Rp -
Rp -
Rp 147,660.00
Rp -
Rp -
Rp 68,400.00
Rp -
Rp -
Rp 1,367,600.00
Rp 189,126.00
Rp 84,474.00
Rp 145,114.00
Rp -
Rp -
Rp 590,643.00
Rp -
Rp 107,987.00
Rp 1,094,460.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 3,080.00
Rp 14,000.00
Rp 17,127.00
Rp 4,200.00
Rp 10,494.00
Rp -
Rp -
Rp 7,580.00
Rp -
Rp -
Rp -
Rp 1,591,200.00
Rp -
Rp 144,000.00
Rp 117,832.00
Rp 73,975.00
Rp -
Rp -
Rp -
Rp -
Rp 89,300.00
Rp -
Rp -
Rp 13,900.00
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp 10,980.00
Rp 817,404.00
Rp -
Rp -
Rp -
Rp -
Rp 287,744.00
Rp 292,320.00
Rp 287,856.00
Rp -
Rp 163,108.00
Rp -
Rp -
Rp -
Rp -
Rp 499,200.00
Rp 69,102.00
Rp -
Rp -
Rp 32,500.00
Rp -
Rp 88,060.00
Rp -
Rp 134,849.55
Rp 230,050.00
1
Jumlah Harga (Rp)
Rp 232,760.00
Rp -
Rp -
Rp 360,942.00
Rp -
Rp 313,418.00
Rp -
Rp 62,073.00
Rp 162,432.00
Rp 39,000.00
Rp -
Rp -
Rp 24,000.00
Rp -
Rp -
Rp 38,179.00
Rp -
Rp -
Rp -
Rp -
Rp 1,361,360.00
Rp -
Rp -
Rp 90,000.00
Rp 69,600.00
Rp -
Rp 7,999.96
1
Jumlah Harga (Rp)
Rp 2,527.00
Rp 59,450.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 62,100.00
Rp -
Rp -
Rp -
Rp -
Rp 121,790.00
Rp -
Rp 286,000.00
Rp -
Rp -
Rp 1,087,548.00
Rp 557,568.00
Rp 159,820.00
Rp 12,012.00
Rp 13,493.70
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 844,200.00
Rp -
Rp 876,540.42
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 484,176.00
Rp 1,150,380.00
Rp 313,500.00
Rp 219,450.00
Rp -
Rp -
Rp -
Rp -
Rp 55,440.00
Rp 61,600.00
Rp 138,600.00
Rp -
Rp 104,400.00
Rp 225,400.00
Rp 112,700.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 30,000.00
Rp 80,000.00
Rp -
Rp 510,299.46
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 82,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 84,900.00
Rp 84,900.00
Rp -
Rp -
Rp -
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,100,074.50
Rp 442,700.00
Rp 537,600.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 114,390.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 83,335.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 143,882.40
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 316,064.00
Rp -
Rp -
Rp 29,549.00
Rp -
Rp -
Rp 233,181.30
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 72,066,072.47
1
Jumlah Harga (Rp)
1
DI PUSKESMAS PARAKAN
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 610 Rp 1,026.67 Rp 626,266.67
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
8 Glibenklamid 5 mg tab 9 Rp 56.00 Rp 504.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 13 Rp 5,797.00 Rp 75,361.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
20 Triamcinolon/ Bufacomb tube 67 Rp 16,500.00 Rp 1,105,500.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 3 Rp 83,600.00 Rp 250,800.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 19 Rp 24,000.00 Rp 456,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
48 Plester rol 5 Rp 12,076.00 Rp 60,380.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 3 Rp 9,317.00 Rp 27,951.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1 Stik Cholesterol Benecheck btl 5 Rp 231,000.00 Rp 1,155,000.00
5 Naia tab 240 Rp 1,664.67 Rp 399,520.00
JUMLAH Rp 44,448,413.17
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
0 TABLET 0 0 0.00 0.00
1 Albendazol 400 tab 100 288.00 28,800.00
0 Alopurinol 100 mg tab 0 0.00 0.00
0 Alprazolam 0,25 mg tab 0 0.00 0.00
0 Ambroxol 30 mg tab 0 0.00 0.00
0 Aminofilin 200 mg tab 0 0.00 0.00
0 Amitriptilin 25 mg tab 0 167.00 0.00
0 Amlodipin 5 mg tab 0 0.00 0.00
0 Amlodipin 10 mg tab 0 0.00 0.00
0 Amoksisilin 250 mg tab 0 0.00 0.00
0 Amoksisilin 500 mg tab 0 0.00 0.00
0 Antasida DOEN tab 0 0.00 0.00
2 Antimigrein tab 0 167.00 0.00
0 Asam Askorbat 50 mg tab 0 0.00 0.00
0 Asam Askorbat 250 mg tab 0 0.00 0.00
0 Asam Folat 0,4 mg tab 0 0.00 0.00
0 Asam Mefenamat 500 mg tab 0 0.00 0.00
0 Asetosal 80 mg tab 0 0.00 0.00
0 Asifit kap 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Asiklofir 200 mg tab 0 0.00 0.00
0 Asiklofir 400 mg tab 0 0.00 0.00
0 Atropin sulfat 0,5 mg tab 0 0.00 0.00
0 Azitromisin 500 mg tab 0 0.00 0.00
0 Bekarbon / Norit tab 0 0.00 0.00
0 Betahistin/versilon 6 mg tab 0 0.00 0.00
0 Bisakodil 5 mg/ Laxana tab 0 0.00 0.00
0 Cetirizin 10 mg tab 0 0.00 0.00
0 Dexametason 0,5 mg tab 0 0.00 0.00
0 Dextral tablet tab 0 0.00 0.00
0 Diazepam 2 mg tab 0 0.00 0.00
0 Diazepam 5 mg tab 0 0.00 0.00
0 Dietil Carbamazin 100 mg tab 0 0.00 0.00
0 Digoksin 0,25 mg tab 0 0.00 0.00
0 Diltiazem 30 mg tab 0 0.00 0.00
0 Dimenhidrinat 50 mg tab 0 0.00 0.00
0 Doksisiklin 100 mg kap 0 0.00 0.00
0 Domperidon 10 mg tab 0 0.00 0.00
0 Erytromisin 250 mg kap 0 0.00 0.00
0 Erytromisin 500 mg tab 0 0.00 0.00
0 Fenitoin Na 100 mg/ Kutoin kap 0 0.00 0.00
0 Fenobarbital 30 mg tab 0 0.00 0.00
0 Fitomenadion/ K1 10 mg tab 0 0.00 0.00
0 Flunarizin 10 mg tab 0 0.00 0.00
0 Furosemida 40 mg tab 0 0.00 0.00
0 G.G 100 mg/ Guaifenesin 100 tab 0 0.00 0.00
3 Garam Oralit tab 0 264.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gemfibrozil 300 mg tab 0 0.00 0.00
0 Glibenklamid 5 mg tab 0 0.00 0.00
0 Glimepirid 2 mg tab 0 0.00 0.00
0 Griseovulvin 125 mg tab 0 0.00 0.00
0 Haemorogard tab 0 0.00 0.00
0 Haloperidol 0,5 mg tab 0 0.00 0.00
0 Haloperidol 1,5 mg tab 0 0.00 0.00
0 Haloperidol 5 mg tab 0 0.00 0.00
0 HCT 25 mg tab 0 0.00 0.00
0 Hepagard tab 0 0.00 0.00
0 Hiosina + Metampiron/ Dormi tab 0 0.00 0.00
0 Ibuprofen 200 mg tab 0 0.00 0.00
0 Ibuprofen 400 mg tab 0 0.00 0.00
0 Isosorbid Dinitrat 5 mg tab 0 0.00 0.00
0 K.Aspartat 300 mg tab 0 0.00 0.00
0 Kalium Diklofenak 50 mg tab 0 0.00 0.00
0 Kalk tab 0 0.00 0.00
0 Kalsium Karbonat 500 mg/ Calp tab 0 0.00 0.00
0 Kandersatan 8 mg tab 0 0.00 0.00
0 Kaolin + Pectin tab/ Omegdiar tab 0 0.00 0.00
0 Kaptopril 12,5 mg tab 0 0.00 0.00
0 Kaptopril 25 mg tab 0 0.00 0.00
0 Karbamazepim 200 mg tab 0 0.00 0.00
0 Karbazokrom 10 mg/ Adona tab 0 0.00 0.00
0 Ketokonazol 200 mg tab 0 0.00 0.00
0 Klobazam 10 mg tab 0 0.00 0.00
0 Klonidin 0,15 mg tab 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kloramfenikol 250 mg tab 0 0.00 0.00
0 Kloramfenikol 500 mg kap 0 0.00 0.00
0 Klorfeniramin Maleat/ CTM 4 tab 0 0.00 0.00
0 Klorpromazin 100 mg tab 0 0.00 0.00
0 Klozapin 100 mg tab 0 0.00 0.00
0 Kodein 10 mg tab 0 0.00 0.00
0 Kotrimoksazol 480 mg tab 0 0.00 0.00
0 Levofloksasin 500 mg tab 0 0.00 0.00
0 Lisinopril tab 5 mg tab 0 0.00 0.00
0 Litium Karbonat 400 mg/ Frima tab 0 0.00 0.00
0 Loperamid 2 mg tab 0 0.00 0.00
0 Loratadin 10 mg tab 0 0.00 0.00
4 MB Kusta strip 0 28,424.00 0.00
0 Meloksikam 15 mg tab 0 0.00 0.00
0 Metformin 500 mg tab 0 0.00 0.00
0 Metil Prednisolon 4 mg tab 0 0.00 0.00
0 Metil Prednisolon 8 mg tab 0 0.00 0.00
0 Metilergometrin 0,125 mg tab 0 0.00 0.00
0 Metoklopramid 10 mg tab 0 0.00 0.00
0 Metronidazol 500 mg tab 0 0.00 0.00
0 Na Bikarbonat 500 mg tab 0 0.00 0.00
0 N-Asetil Sistein 200 mg kap 0 0.00 0.00
0 Natrium Diklofenak 50 mg tab 0 0.00 0.00
0 Neurotropik tab/ Corsaneuron tab 0 0.00 0.00
0 New Pro Uric kap 0 0.00 0.00
0 Nifedipin 10 mg tab 0 0.00 0.00
0 Nistatin tab 500.000 IU/ g tab 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Nodiar tab 0 0.00 0.00
5 OAT Anak/ FDC pkt 0 195,441.92 0.00
6 OAT FDC I/III pkt 7 317,018.00 2,219,126.00
7 OAT kat I/ Kombipak pkt 0 288,199.00 0.00
8 OAT kat II pkt 0 1,199,985.00 0.00
0 Omeprazol 20 mg tab 0 0.00 0.00
0 Ondansetron 4 mg tab 0 0.00 0.00
0 Papaverin 40 mg tab 0 0.00 0.00
0 Parasetamol 500 mg tab 0 0.00 0.00
0 PB Kusta Anak strip 0 0.00 0.00
0 Piracetam 800 mg tab 0 0.00 0.00
0 Piridoksin/ B6 10 mg tab 0 0.00 0.00
0 Piroksikam 20 mg tab 0 0.00 0.00
0 Prednison 5 mg tab 0 0.00 0.00
9 Primaquin 15 mg tab 0 205.00 0.00
0 Pro Lipid tab 0 0.00 0.00
0 Propanolol 40 mg tab 0 0.00 0.00
0 PTU 100 mg tab 0 0.00 0.00
0 Ranitidin 150 mg tab 0 0.00 0.00
10 Retinol 100.000 UI tab 50 284.00 14,200.00
11 Retinol 200.000 UI tab 834 519.20 433,012.80
0 Risperidon 2 mg tab 0 0.00 0.00
0 Salbutamol 2 mg tab 0 0.00 0.00
0 Salbutamol 4 mg tab 0 0.00 0.00
0 Samcobion kap 0 0.00 0.00
0 Sefadroksil 500 mg tab 0 0.00 0.00
0 Sefiksim 100 mg tab 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Sianokobalamin / B12 50 mcg tab 0 0.00 0.00
0 Simvastatin 10 mg tab 0 0.00 0.00
0 Simvastatin 20 mg tab 0 0.00 0.00
0 Siprofloksasin 500 mg tab 0 0.00 0.00
0 Spironolakton 100 mg tab 0 0.00 0.00
12 Tablet Tambah darah tab 0 352.00 0.00
0 Tensigard tab 0 0.00 0.00
0 Teofilin 150 mg tab 0 0.00 0.00
0 Teofilin SR / Retaphyl SR tab 0 0.00 0.00
0 Tetrasiklin 250 mg tab 0 0.00 0.00
0 Tetrasiklin 500 tab 0 0.00 0.00
0 Tiamfenikol 500 mg tab 0 0.00 0.00
0 Tiamin 50 mg/ B1 tab 0 0.00 0.00
0 Triheksifenidil 2 mg tab 0 85.00 0.00
0 Vitalamin tab 0 0.00 0.00
0 Vitamin B komplek tab 0 0.00 0.00
13 Zink 20 mg tab 990 513.00 507,870.00
0 0 0 0 0.00 0.00
0 SYRUP 0 0 0.00 0.00
0 Albendazol susp 200mg/ 5 ml btl 0 0.00 0.00
0 Ambroxol sirup 15 mg/ 5 ml btl 0 0.00 0.00
0 Amoksisilin sir 250 mg/ 5 ml btl 0 0.00 0.00
0 Amoksisilin sirup 125 mg/ 5 ml btl 0 0.00 0.00
0 Antasida DOEN susp btl 0 0.00 0.00
0 Batugin elixir btl 0 0.00 0.00
0 Dextrofen sirup btl 0 0.00 0.00
0 Domperidon sirup 5 mg/ 5 ml btl 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Domperidon tetes 5 mg/ ml btl 0 0.00 0.00
0 Erytromisin sirup 200 mg/ 5 ml btl 0 0.00 0.00
0 Haloperidol drops 2 mg/ml (L btl 0 0.00 0.00
0 Ibuprofen susp 100mg/5ml btl 0 0.00 0.00
0 Ibuprofen Susp 200 mg/ 5 ml btl 0 0.00 0.00
0 Kaolin + Pectin syr/ Kanina btl 0 0.00 0.00
0 Kloramfenikol susp 125 mg/ 5 btl 0 0.00 0.00
0 Kotrimoksazol suspensi btl 0 0.00 0.00
0 Laxadin susp btl 0 0.00 0.00
0 Metokloperamid drops btl 0 0.00 0.00
0 Metronidasol sirup btl 0 0.00 0.00
0 OBH btl 0 0.00 0.00
0 Pacdin Vitcur sirup btl 0 0.00 0.00
0 Parasetamol drops btl 0 0.00 0.00
0 Parasetamol sirup 120 mg/ 5 ml btl 0 0.00 0.00
0 Salbutamol sirup btl 0 0.00 0.00
0 Sefadroksil sirup 125 mg/ 5 ml btl 0 0.00 0.00
0 Sefadroksil sirup 250 mg/ 5 ml btl 0 0.00 0.00
0 Setirizin sirup btl 0 0.00 0.00
0 Sukralfat susp btl 0 0.00 0.00
0 Tiamfenikol sirup btl 0 0.00 0.00
0 Zink drops 10 mg/ml btl 0 0.00 0.00
0 Zink sirup btl 0 0.00 0.00
0 0 0 0 0.00 0.00
0 INJEKSI 0 0 0.00 0.00
0 Aminofilin injeksi 24 mg/ ml amp 0 0.00 0.00
0 Ampisilin inj 1.000 mg vial 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Aqua pro injeksi btl 0 0.00 0.00
0 Asam Traneksamat inj amp 0 0.00 0.00
1 Atropin Sulsat inj amp 0 1,540.00 0.00
0 Dexametason injeksi 5 mg/ ml amp 0 0.00 0.00
2 Diazepam inj 5 mg/ ml amp 0 1,735.00 0.00
0 Difenhidramin injeksi 10 mg/ m amp 0 0.00 0.00
0 Epinefrin injeksi 0,1 % amp 0 0.00 0.00
3 Fenobarbital inj 50 mg/ ml amp 5 1,969.00 9,845.00
0 Flufenazin inj 25mg/ml - Sikzo amp 2 59,800.00 119,600.00
0 Furosemid inj 10 mg/ ml amp 0 0.00 0.00
4 Gentamisin inj 40 mg/ ml amp 0 3,108.00 0.00
5 Glukonas Calcicus inj 10% amp 0 9,955.00 0.00
0 Haloperidol inj i.m. 5 mg/ml (L amp 0 0.00 0.00
0 Human Tetanus Imuno 250 UI amp 0 0.00 0.00
0 Ketorolac inj 30 mg/ml amp 0 0.00 0.00
0 Lidokain Comp. inj amp 0 0.00 0.00
0 Lidokain inj 2% amp 0 0.00 0.00
0 Metilergometrin inj amp 0 0.00 0.00
0 Meylon / Na Bic inj amp 0 0.00 0.00
0 MgSO4 20% amp 0 0.00 0.00
0 MgSO4 40% amp 0 0.00 0.00
0 Nalokson inj 0,4 mg/ml (Nokob amp 0 0.00 0.00
0 Oksitosin injeksi 10 UI/ ml amp 0 0.00 0.00
0 Ondansetron 4 mg inj amp 0 0.00 0.00
0 Piracetam 1 gr/ 5 ml amp 0 0.00 0.00
0 Ranitidin inj 25 mg/ 2 ml amp 0 0.00 0.00
0 Sefotaksim 1 gr/ vial amp 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Serum ABU I / Biosave vial 0 0.00 0.00
0 Serum ATS 1.500 amp 0 0.00 0.00
0 Sianokobalamin inj 500 mcg/ m amp 0 0.00 0.00
6 Vit K1/Fitomenadion inj 2 mg/ amp 0 3,550.00 0.00
0 0 0 0 0.00 0.00
0 OBAT LUAR 0 0 0.00 0.00
0 Alkohol 96 % 1 L btl 0 0.00 0.00
0 Antibakteri SK tube 0 0.00 0.00
0 Antifungi sk pot 0 0.00 0.00
0 Antihemoroid supp supp 0 0.00 0.00
0 Asam Fusidat krim 20mg/g - Ac tube 0 0.00 0.00
0 Asiklovir krim 5 % tube 0 0.00 0.00
0 Betametason krim 0,1 % tube 0 0.00 0.00
0 Bisakodil sup anak supo 0 0.00 0.00
0 Bisakodil sup dws supo 0 0.00 0.00
0 Budesonid/ Pulmicort res 0,25m btl 0 0.00 0.00
0 Budesonid-formeterol/ Symbicor btl 0 0.00 0.00
0 Desoksimetason krim tube 0 0.00 0.00
0 Diazepam Rectal 5mg/2,5ml - Sttube 0 0.00 0.00
0 Enkasari btl 0 0.00 0.00
0 Etakridin Larutan 0,1 % btl 0 0.00 0.00
0 Etanol 70% 100 ml btl 0 0.00 0.00
0 Feneterol HBr/ Berotec inh btl 0 0.00 0.00
0 Fenol gliserol TT 10 % btl 0 0.00 0.00
0 Flusinolon Asetat 0.025% tube 0 0.00 0.00
0 Framisetin tulle/ Daryanttulle lbr 0 0.00 0.00
0 Gentamisin SM tube 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Gentamisin TM 0,3 % btl 0 0.00 0.00
0 Gentien Violet 1 % btl 0 0.00 0.00
0 Gliserin btl 0 0.00 0.00
0 Hidrokortison krim 2,5 % tube 0 0.00 0.00
0 Ikhtiol SK btl 0 0.00 0.00
0 Ketokonazol krim 2 % tube 0 0.00 0.00
0 Klobetasol 0,05% krim tube 0 0.00 0.00
0 Kloramfenikol SM 1 % tube 0 0.00 0.00
0 Kloramfenikol SK 2% tube 0 0.00 0.00
0 Kloramfenikol TM btl 0 0.00 0.00
0 Kloramfenikol TT 3 % btl 0 0.00 0.00
0 Lidokain Spray 10%/ Xylocaine btl 0 0.00 0.00
0 Mikonazol krim 2 % tube 0 0.00 0.00
0 Minyak ikan SK pot 0 0.00 0.00
0 Mometason krim tube 0 0.00 0.00
0 Nistatin tab vag 100.000 UI/ g supp 0 0.00 0.00
1 Oksitetrasiklin 1 % SM tube 0 3,220.00 0.00
0 Oksitetrasiklin 3 % SK tube 0 0.00 0.00
0 Perak Sulfadiazin/ burnazin tube 0 0.00 0.00
0 Perhidrol/ H2O2 btl 0 0.00 0.00
0 Permetrin krim 5%/ Scabimite tube 0 0.00 0.00
0 Permetrin lotion 1%/ Peditox btl 0 0.00 0.00
0 Polikresulen btl 0 0.00 0.00
0 Povidon Iodida 300 ml btl 0 0.00 0.00
0 Povidon Iodin 30 ml btl 0 0.00 0.00
0 Salbutamol inh 100 mcg/ Ventol btl 0 0.00 0.00
0 Salbutamol neb/ Ventolin Nebul tube 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Salep 2-4 pot 0 0.00 0.00
0 Salisil bedak pot 0 0.00 0.00
0 Sulfasetamid TM 15 % btl 0 0.00 0.00
0 Tetrakain TM btl 0 0.00 0.00
0 Triamcinolon/ Bufacomb tube 0 0.00 0.00
2 0 0 0 0.00 0.00
0 INFUS 0 0 0.00 0.00
0 Assering btl 0 0.00 0.00
0 Glucosa 40% btl 0 0.00 0.00
0 Glucosa 5% btl 0 0.00 0.00
0 Ka-En 3A btl 0 0.00 0.00
0 Ka-En 3B btl 0 0.00 0.00
0 Ka-En Mg 3 btl 0 0.00 0.00
0 Metronidazol infus btl 0 0.00 0.00
0 NaCl btl 0 0.00 0.00
0 Parasetamol 10 mg/ml infus btl 0 0.00 0.00
0 RL btl 0 0.00 0.00
0 0 0 0 0.00 0.00
0 BMHP 0 0 0.00 0.00
0 Alat suntik 1 ml set 0 0.00 0.00
0 Alat Suntik 10 ml set 0 0.00 0.00
0 Alat Suntik 20 ml set 0 0.00 0.00
0 Alat suntik ADS 0.05 ml set 0 0.00 0.00
0 Alat suntik ADS 0.5 ml (Solosh set 0 0.00 0.00
0 Alkazym 250 mg sack 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Alkacide 1 L High Level btl 0 0.00 0.00
0 Alkohol 70 % 1 L btl 0 0.00 0.00
0 Alkohol Swab box 0 0.00 0.00
0 Alkohol swab 2 % box 0 0.00 0.00
0 Aseptan Liquid 500 cc btl 0 0.00 0.00
0 Aseptic Gel 500 cc btl 0 0.00 0.00
0 Bioplacentol tulle lbr 0 0.00 0.00
0 Bisturi box 0 0.00 0.00
0 Bracket Hand Wash Plastik biji 0 0.00 0.00
0 Cat gut Chromic No. 2/0 DS 2 biji 0 0.00 0.00
0 Cat gut Chromic No. 2/0 HR 3 biji 0 0.00 0.00
0 Catgut Chromic 3/0 DS 24 mm biji 0 0.00 0.00
0 Cat gut Plain No. 2/0 DS 24 m biji 0 0.00 0.00
0 Cat gut Plain No. 3/0 DS 24 m biji 0 0.00 0.00
0 Cover Glass/ Deck Glass box 0 0.00 0.00
0 Endotracheal Tube - 2.0 biji 0 0.00 0.00
0 Endotracheal Tube - 3.0 biji 0 0.00 0.00
0 Feeding Tube FR 5 biji 0 0.00 0.00
0 Feeding Tube FR 8 biji 0 0.00 0.00
0 Female Catheter No. 14 biji 0 0.00 0.00
0 Foley cateter No. 14 biji 0 0.00 0.00
0 Gelang ID Pasien anak biru biji 0 0.00 0.00
0 Gelang ID Pasien anak pink biji 0 0.00 0.00
0 Gelang ID Pasien dewasa biru biji 0 0.00 0.00
0 Gelang ID Pasien dewasa pink biji 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Handschoen Disposible (M) biji 0 0.00 0.00
0 Handschoen Disposible (S) biji 0 0.00 0.00
0 Handschoen Nitril (M) biji 0 0.00 0.00
0 Hansdchoen Nitril (S) biji 0 0.00 0.00
0 Handschoon panjang/obgin ster psg 0 0.00 0.00
0 Handscoon steril no 7 psg 0 0.00 0.00
0 Handscoon steril no. 7,5 psg 0 0.00 0.00
0 Infusion set anak biji 0 0.00 0.00
0 Infusion set dewasa biji 0 0.00 0.00
0 IV Catheter No. 18 biji 0 0.00 0.00
0 IV Catheter No.20 with port set 0 0.00 0.00
0 IV Catheter No.22 with port set 0 0.00 0.00
0 Jarum Jahit Kulit No. 10 biji 0 0.00 0.00
0 Jarum Jahit Kulit No. 15 biji 0 0.00 0.00
0 Jarum Jahit Mukosa No. 10 biji 0 0.00 0.00
0 Jarum Jahit Mukosa No. 15 biji 0 0.00 0.00
0 Jelly 5 gr/ My Jelly sach 0 0.00 0.00
0 Kanul Oksigen Anak biji 0 0.00 0.00
0 Kanul Oksigen Dewasa biji 0 0.00 0.00
0 Kapas 250 g bks 0 0.00 0.00
0 Kasa 2 m x 80 cm rol 0 0.00 0.00
0 Kasa 36 x 80 cm rol 0 0.00 0.00
0 Kasa 4 m x 10 cm rol 0 0.00 0.00
0 Kassa steril rol 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Kondom kateter ( M ) biji 0 0.00 0.00
0 Kondom kateter ( S ) biji 0 0.00 0.00
0 Lidi Kapas Non Steril pak 0 0.00 0.00
0 Lidi Kapas Steril biji 0 0.00 0.00
0 Lysol 1 L btl 0 0.00 0.00
0 Masker disposible biji 0 0.00 0.00
0 Masker Oksigen anak set 0 0.00 0.00
0 Masker Oksigen dewasa set 0 0.00 0.00
0 Masker Oksigen cungkup set 0 0.00 0.00
0 Mucus Extractor set 0 0.00 0.00
0 N2O gas tbg 0 0.00 0.00
0 Nebulizer with masker anak set 0 0.00 0.00
0 Nebulizer with masker dewasa set 0 0.00 0.00
0 Non Adhesive Bandage 10 x 4,5 rol 0 0.00 0.00
0 Object Glass box 0 0.00 0.00
1 Object Glass Frosted box 3 20,000.00 60,000.00
0 Oksigen gas tbg 0 0.00 0.00
0 Onescrub 500 cc btl 0 0.00 0.00
0 Plester rol 0 0.00 0.00
0 Plester putih/ hipavix 5 cm biji 0 0.00 0.00
0 Pot Sputum biji 0 0.00 0.00
2 Pot Sputum Steril biji 140 5,890.00 824,600.00
0 Pot Urin biji 0 0.00 0.00
0 Sabun Cuci Tangan/ Softaskin btl 0 0.00 0.00
0 Savety box biji 0 0.00 0.00
0 Silk 2/0 DS 24 mm sac 0 0.00 0.00
0 Silk 3/0 DS 24 mm sac 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Suction catether no FR 8 biji 0 0.00 0.00
0 Three way stop cock biji 0 0.00 0.00
0 Tranfusi set biji 0 0.00 0.00
0 Umbilical cord klem nylon steri biji 0 0.00 0.00
0 Underpad Steril lbr 0 0.00 0.00
0 Urine bag biji 0 0.00 0.00
0 0 0 0 0.00 0.00
0 GIGI 0 0 0.00 0.00
0 Bonding Composite box 0 0.00 0.00
0 Bur Polish Composite set 0 0.00 0.00
0 Cavit box 0 0.00 0.00
0 Composit warna A2 box 0 0.00 0.00
0 Composit warna A3 box 0 0.00 0.00
0 Dentin Conditioner btl 0 0.00 0.00
0 Devitalisasi Pasta Non Arsen btl 0 0.00 0.00
0 Disclosing Solution btl 0 0.00 0.00
0 Disposible Dental Suction/ Sali box 0 0.00 0.00
0 Disposible Mikro Aplikator box 0 0.00 0.00
0 Etil klorid btl 0 0.00 0.00
0 Etsa Asam box 0 0.00 0.00
0 Eugenol btl 0 0.00 0.00
0 Forinokresol / T K F btl 0 0.00 0.00
0 Glass Ionomer Cement - Fuji I btl 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Glass Ionomer Cement - Fuji VI btl 0 0.00 0.00
0 Iodoform Pasta pot 0 0.00 0.00
0 Kalsium hidroksida pasta set 0 0.00 0.00
0 Klorfenol/CHKM btl 0 0.00 0.00
0 Mata Bur high speed set 0 0.00 0.00
0 Mata Bur low speed set 0 0.00 0.00
0 Mumifying pasta btl 0 0.00 0.00
0 OCO btl 0 0.00 0.00
0 Pasta pengisi saluran akar/ Vita btl 0 0.00 0.00
0 Semen seng fosfat set 0 0.00 0.00
0 Sodium Hipochloride btl 0 0.00 0.00
0 Spons Gelatin/ Hemospon biji 0 0.00 0.00
0 T S Fletcher set 0 0.00 0.00
0 Tips Scaler ART biji 0 0.00 0.00
0 Tips Scaler Woodpecker biji 0 0.00 0.00
0 0 0 0 0.00 0.00
0 LABORAT 0 0 0.00 0.00
0 Ammonium oxalat 1 % btl 0 0.00 0.00
0 Blood lancet box 0 0.00 0.00
0 Botol sampel darah 10 ml btl 0 0.00 0.00
0 Botol sampel darah 20 ml btl 0 0.00 0.00
1 Box Slide biji 0 77,690.00 0.00
0 Bufer 1 L btl 0 0.00 0.00
0 Eosin 2 % btl 0 0.00 0.00
0 Film rontgen 24 x 30 box 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Giemsa pekat btl 0 0.00 0.00
0 H2SO4 btl 0 0.00 0.00
0 Hayem btl 0 0.00 0.00
0 HCl 0,1 N btl 0 0.00 0.00
2 Iodium Test btl 46 5,275.00 242,650.00
0 Jelly EKG btl 0 0.00 0.00
0 Kertas EKG 50mm x 30mm rol 0 0.00 0.00
0 Kertas EKG 63 30 mm rol 0 0.00 0.00
0 Kertas EKG AT 1: 90x90mm box 0 0.00 0.00
0 Kertas lensa sach 0 0.00 0.00
0 Kondom Katether M biji 0 0.00 0.00
0 Kondom Katether S biji 0 0.00 0.00
0 Larutan EDTA btl 0 0.00 0.00
0 Metanol btl 0 0.00 0.00
0 Minyak immersi btl 0 0.00 0.00
0 Na citrat 3,8 % btl 0 0.00 0.00
0 Object glass box 0 0.00 0.00
0 Pipet tetes biji 0 0.00 0.00
0 Reagen golongan darah btl 0 0.00 0.00
0 Salmonella Thypi H Widhal Tes set 0 0.00 0.00
0 Salmonella Thypi O Widhal Tes set 0 0.00 0.00
0 Spiritus btl 0 0.00 0.00
0 Stik gula darah Accucheck Perf btl 0 0.00 0.00
0 Stik asam urat Nesco btl 0 0.00 0.00
0 Stik asam urat UA Sure btl 0 0.00 0.00
0 Stik cholesterol Accutrend btl 0 0.00 0.00
0 Stik gula darah gluco DR btl 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Stik gula darah Nesco btl 0 0.00 0.00
0 Stik trigliserid Accutrend btl 0 0.00 0.00
0 Stik urinalisa 3 parameter btl 0 0.00 0.00
0 Stik urinalisa 10 parameter btl 0 0.00 0.00
0 Tes kehamilan sach 0 0.00 0.00
0 Turk btl 0 0.00 0.00
3 Ziehl nelson btl 3 276,500.00 829,500.00
0 0 0 0 0.00 0.00
0 VAKSIN 0 0 0.00 0.00
0 BCG amp 0 0.00 0.00
0 DPT - HB amp 0 0.00 0.00
0 DPT HB HIB amp 0 0.00 0.00
0 POLIO amp 0 0.00 0.00
0 CAMPAK amp 0 0.00 0.00
0 TT amp 0 0.00 0.00
0 HB U amp 0 0.00 0.00
0 DT amp 0 0.00 0.00
0 TD amp 0 0.00 0.00
0 ADS 0.05 ml set 0 0.00 0.00
0 ADS 0.5 ml set 0 0.00 0.00
0 ADS 5 ml set 0 0.00 0.00
0 SAFETY BOX biji 0 0.00 0.00
0 0 0 0 0.00 0.00
0 OBAT BARU 2018 0 0 0.00 0.00
1 Rapid I HIV test 100 14,340.00 1,434,000.00
2 Micropipet biji 0 980.00 0.00
0 Sukralfat tab 0 0.00 0.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 0 522,083.00 0.00
0 Trifluoperazin tab 0 0.00 0.00
4 RDT Combo Malaria test 0 19,760.00 0.00
0 Atalpulgit/ New Antides tab 0 0.00 0.00
0 Stik Cholesterol Benecheck btl 0 0.00 0.00
0 Stik Gula Darah Benecheck btl 0 0.00 0.00
0 Jelly 82 gr/ My Jelly tube 0 0.00 0.00
5 Mineral Mix sachet 0 2,726.90 0.00
0 Na Divalproat 250 mg (Depakot tab 0 0.00 0.00
0 Nistatin drops btl 0 0.00 0.00
0 Omeprazole injeksi amp 0 0.00 0.00
0 Stik Asam Urat Benecheck btl 0 0.00 0.00
0 Panviton tab 0 0.00 0.00
0 Naia tab 0 0.00 0.00
0 Intunal syr btl 0 0.00 0.00
0 Mekobalamin kap 0 0.00 0.00
0 Biocombin inj amp 0 0.00 0.00
6 Lugol btl 0 30,000.00 0.00
0 Larsi kap 0 0.00 0.00
0 Omevita syr btl 0 0.00 0.00
7 Fluoksetin 20 mg tab/Peprezal tab 0 225.00 0.00
8 Klorpromazin inj amp 0 1,243.00 0.00
9 Klozapin 25 mg tab 0 1,121.00 0.00
JUMLAH 6,723,203.80
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS TRAJI
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 270 Rp 149.00
48 Kalk tab 593 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 160 Rp 279.00
91 Sefadroksil 500 mg tab 1,045 Rp 550.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 720 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 210 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 0 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 3 Rp 6,410.00
8 RL btl 8 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 20 Rp 9,449.99
33 Kasa 36 x 80 cm rol 1 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 5 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 7 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 5 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS TRAJI
Jumlah Harga (Rp)
Rp -
Rp -
Rp 25,800.00
Rp 4,740.00
Rp -
Rp 36,400.00
Rp 14,696.00
Rp 147,000.00
Rp 139,500.00
Rp 136,500.00
Rp 828,240.00
Rp 85,622.00
Rp 86,500.00
Rp 158,025.00
Rp -
Rp 80,010.00
Rp 140,286.00
Rp 29,600.00
Rp -
1
Jumlah Harga (Rp)
Rp 99,600.00
Rp 139,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 79,542.32
Rp 130,560.00
Rp -
Rp 7,740.00
Rp -
Rp -
Rp 16,490.00
Rp 34,840.00
Rp 45,552.00
Rp 21,120.00
Rp 82,128.00
Rp -
Rp -
Rp 62,410.00
Rp 23,256.00
Rp 7,100.00
Rp -
Rp 23,322.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 76,000.00
Rp -
Rp 20,700.00
Rp 21,000.00
Rp -
Rp -
Rp 4,130.00
Rp 39,200.00
Rp 40,230.00
Rp -
Rp -
Rp -
Rp -
Rp 35,200.00
Rp -
Rp -
Rp 34,987.00
Rp -
Rp 368,490.00
Rp -
Rp 44,020.00
Rp 125,160.00
Rp -
Rp -
Rp 28,000.00
Rp 93,120.00
Rp 18,400.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 77,070.00
Rp 59,535.00
Rp 1,709,760.00
Rp -
Rp 58,862.70
Rp -
Rp 125,400.00
Rp -
Rp -
Rp 55,350.00
Rp -
Rp -
Rp 19,200.00
Rp 185,100.00
Rp 195,000.00
Rp 16,880.00
Rp 8,100.00
Rp 64,000.00
Rp -
Rp 76,680.00
Rp 90,850.00
Rp -
Rp -
Rp 11,000.00
Rp 74,500.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 272,496.00
Rp -
Rp -
Rp 671,420.00
Rp -
Rp -
Rp -
Rp -
Rp 5,624.00
Rp 44,640.00
Rp 94,500.00
Rp -
Rp -
Rp -
Rp 5,900.00
Rp 20,300.00
Rp -
Rp 574,750.00
Rp -
1
Jumlah Harga (Rp)
Rp 88,740.00
Rp 74,670.00
Rp 34,850.00
Rp 28,107.00
Rp -
Rp 26,057,940.00
Rp -
Rp 35,000.00
Rp 147,000.00
Rp -
Rp -
Rp -
Rp 61,920.00
Rp 42,330.00
Rp -
Rp 253,000.00
Rp -
Rp -
Rp -
Rp 32,000.00
Rp -
Rp 187,000.00
Rp 77,330.00
Rp 133,650.00
Rp -
Rp -
Rp 216,000.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 210,375.00
Rp -
Rp -
Rp -
Rp 42,800.00
Rp -
Rp -
Rp 83,600.00
Rp -
Rp -
Rp 681,200.00
Rp 96,222.00
Rp -
Rp 333,370.00
Rp -
Rp -
Rp 441,285.00
Rp -
Rp -
Rp 547,230.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 5,500.00
Rp -
Rp 15,400.00
Rp 33,600.00
Rp -
Rp 10,500.00
Rp 31,482.00
Rp -
Rp -
Rp -
Rp -
Rp 109,505.00
Rp -
Rp 707,200.00
Rp 12,900.00
Rp 103,680.00
Rp 36,608.00
Rp 38,467.00
Rp 31,000.00
Rp -
Rp -
Rp -
Rp 172,900.00
Rp -
Rp -
Rp 13,900.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 109,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 76,432.00
Rp 152,250.00
Rp 431,784.00
Rp -
Rp 53,920.00
Rp -
Rp 58,000.00
Rp -
Rp -
Rp 748,800.00
Rp 23,034.00
Rp -
Rp -
Rp 525,000.00
Rp 332,760.00
Rp 121,730.00
Rp -
Rp 89,899.70
Rp 104,325.00
1
Jumlah Harga (Rp)
Rp 63,480.00
Rp -
Rp -
Rp 131,506.00
Rp -
Rp 205,520.00
Rp -
Rp 52,668.00
Rp 120,320.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 17,782.00
Rp -
Rp -
Rp -
Rp -
Rp 522,665.00
Rp -
Rp -
Rp -
Rp 116,000.00
Rp -
Rp 39,999.80
1
Jumlah Harga (Rp)
Rp -
Rp 52,275.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 19,230.00
Rp -
Rp 57,200.00
Rp -
Rp -
Rp 338,800.00
Rp -
Rp 131,000.00
Rp -
Rp -
Rp -
Rp 331,100.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 120,600.00
Rp 164,000.00
Rp -
Rp 522,579.07
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 739,200.00
Rp 554,400.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 47,520.00
Rp -
Rp 38,500.00
Rp -
Rp 104,400.00
Rp -
Rp 112,700.00
Rp -
Rp -
Rp -
Rp -
Rp 132,035.40
Rp 20,000.00
Rp 20,000.00
Rp -
Rp 188,999.80
Rp 130,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 205,000.00
Rp -
Rp 99,000.00
Rp 99,000.00
Rp -
Rp -
Rp -
Rp 141,500.00
Rp 198,100.00
Rp -
Rp -
Rp -
Rp -
Rp 125,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 785,767.50
Rp 163,100.00
Rp 112,000.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,249.20
Rp -
Rp -
Rp 76,260.00
Rp 5,005.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 83,335.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 119,902.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 141,440.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 441,817.20
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,114,685.69
1
DI PUSKESMAS TRAJI
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
14 Kaolin + Pectin tab/ Omegdiar tab 1,100 Rp 453.04 Rp 498,338.50
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 43 Rp 5,797.00 Rp 249,271.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Kloramfenikol TT 3 % btl 0 Rp 7,590.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
2 Alkazym 250 mg sack 3 Rp 800,978.20 Rp 2,402,934.60
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Alkacide 1 L High Level btl 3 Rp 2,702,700.00 Rp 8,108,100.00
9 Bisturi box 5 Rp 83,600.00 Rp 418,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 6 Rp 24,000.00 Rp 144,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp 3,250,000.00 Rp -
48 Plester rol 8 Rp 12,076.00 Rp 96,608.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
59 Tranfusi set biji 0 Rp 8,646.00 Rp -
0 0 0 0 Rp - Rp -
3 Cavit box 2 Rp 154,000.00 Rp 308,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 1 Rp 9,317.00 Rp 9,317.00
13 Stik gula darah Accucheck Perf btl 5 Rp 276,100.00 Rp 1,380,500.00
14 Stik asam urat Nesco btl 2 Rp 102,047.00 Rp 204,094.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 110 Rp 1,664.67 Rp 183,113.33
JUMLAH Rp 38,367,189.02
1
DI PUSKESMAS TRAJI
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS TRAJI
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 0 Rp 513.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 Iodium Test btl 70 Rp 5,275.00 Rp 369,250.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 0 Rp 30,000.00 Rp -
JUMLAH Rp 2,801,994.00
1
DI PUSKESMAS TRAJI
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS BANSARI
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5
17 Asiklofir 400 mg tab 1,148 Rp 349.00

1
1 2 3 4 5
44 HCT 25 mg tab 884 Rp 149.00
48 Kalk tab 3,816 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00
89 Salbutamol 2 mg tab 3,076 Rp 59.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 9,080 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 100 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 8 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 35 Rp 6,410.00
8 RL btl 42 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 18 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 0 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 15 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 19 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS BANSARI
Jumlah Harga (Rp)
Rp -
Rp -
Rp 68,800.00
Rp -
Rp -
Rp -
Rp -
Rp 41,300.00
Rp 83,700.00
Rp -
Rp 2,133,704.00
Rp 336,226.00
Rp -
Rp 897,645.00
Rp -
Rp 17,640.00
Rp 640,660.00
Rp 2,220.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 400,652.00
Rp -
Rp -
Rp -
Rp 56,100.00
Rp 10,800.00
Rp 163,043.76
Rp 65,152.00
Rp -
Rp -
Rp -
Rp -
Rp 7,760.00
Rp 53,600.00
Rp 18,720.00
Rp 34,320.00
Rp 214,642.00
Rp 141,960.00
Rp -
Rp 12,640.00
Rp -
Rp 497,000.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 109,440.00
Rp -
Rp 34,155.00
Rp 21,000.00
Rp -
Rp -
Rp -
Rp -
Rp 131,716.00
Rp -
Rp -
Rp -
Rp 15,875.00
Rp 26,840.00
Rp -
Rp -
Rp 225,144.00
Rp -
Rp 129,750.00
Rp -
Rp 2,170.00
Rp 322,308.00
Rp -
Rp -
Rp 66,080.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 366,114.00
Rp -
Rp -
Rp -
Rp 235,752.66
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 204,480.00
Rp 255,000.00
Rp -
Rp -
Rp -
Rp 153,760.00
Rp -
Rp 1,184,280.00
Rp 10,350.00
Rp -
Rp -
Rp 28,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 14,820.00
Rp -
Rp -
Rp 2,215,976.00
Rp -
Rp -
Rp 663,160.00
Rp -
Rp 50,456.00
Rp -
Rp -
Rp -
Rp -
Rp 540,120.00
Rp -
Rp -
Rp -
Rp 181,484.00
Rp -
Rp -
Rp 36,850.00
Rp -
1
Jumlah Harga (Rp)
Rp 620,874.00
Rp 21,615.00
Rp -
Rp 146,156.40
Rp -
Rp 32,107,800.00
Rp -
Rp 22,500.00
Rp 94,500.00
Rp -
Rp 123,996.00
Rp -
Rp 780,880.00
Rp -
Rp -
Rp 1,107,335.00
Rp -
Rp -
Rp -
Rp 116,000.00
Rp -
Rp -
Rp 94,050.00
Rp 315,900.00
Rp -
Rp -
Rp 245,700.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 59,400.00
Rp 428,640.00
Rp -
Rp -
Rp 464,380.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 26,000.00
Rp 443,506.00
Rp -
Rp -
Rp -
Rp -
Rp 54,312.00
Rp -
Rp -
Rp 496,910.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 7,700.00
Rp 35,000.00
Rp -
Rp 28,350.00
Rp 17,490.00
Rp -
Rp -
Rp -
Rp -
Rp 89,595.00
Rp -
Rp 1,414,400.00
Rp -
Rp 313,344.00
Rp 14,872.00
Rp 26,631.00
Rp -
Rp -
Rp -
Rp -
Rp 190,000.00
Rp 3,210.00
Rp -
Rp 18,070.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 155,916.00
Rp -
Rp -
Rp -
Rp -
Rp 187,136.00
Rp 346,192.00
Rp 118,755.00
Rp 599,700.00
Rp -
Rp 126,712.00
Rp -
Rp 23,200.00
Rp -
Rp -
Rp 249,600.00
Rp 80,619.00
Rp -
Rp -
Rp 250,000.00
Rp -
Rp 82,880.00
Rp -
Rp -
Rp 42,800.00
1
Jumlah Harga (Rp)
Rp 292,008.00
Rp -
Rp -
Rp 268,608.00
Rp -
Rp 280,021.00
Rp -
Rp 65,835.00
Rp 75,200.00
Rp 78,000.00
Rp -
Rp -
Rp 66,000.00
Rp -
Rp -
Rp 3,138.00
Rp -
Rp -
Rp -
Rp -
Rp 559,130.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 20,216.00
Rp 25,625.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 19,292.00
Rp -
Rp 34,500.00
Rp -
Rp -
Rp -
Rp -
Rp 224,350.00
Rp -
Rp 300,300.00
Rp -
Rp -
Rp 586,124.00
Rp 728,904.00
Rp 230,560.00
Rp -
Rp 4,497.90
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 787,200.00
Rp 500,880.24
Rp 723,571.02
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 42,500.00
Rp 42,500.00
Rp 42,500.00
Rp 42,500.00
1
Jumlah Harga (Rp)
Rp 794,640.00
Rp 970,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 47,520.00
Rp 377,300.00
Rp 61,600.00
Rp -
Rp 69,600.00
Rp -
Rp 161,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 90,000.00
Rp 70,000.00
Rp -
Rp 170,099.82
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 99,000.00
Rp 59,400.00
Rp -
Rp -
Rp -
Rp 254,700.00
Rp 226,400.00
Rp -
Rp -
Rp -
Rp -
Rp 187,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,100,074.50
Rp 349,500.00
Rp 425,600.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,249.84
Rp -
Rp -
Rp 373,674.00
Rp 20,020.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,668.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 13,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,980.00
Rp 469,818.24
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 105,513.76
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 305,320.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 98,181.60
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 68,331,711.74
1
DI PUSKESMAS BANSARI
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Kaolin + Pectin syr/ Kanina btl 0 Rp 5,720.00 Rp -
7 OBH btl 90 Rp 5,797.00 Rp 521,730.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 1 Rp 83,600.00 Rp 83,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
19 Handschoen Nitril (M) biji 1,030 Rp 627.00 Rp 645,810.00
31 Kapas 250 g bks 1 Rp 24,000.00 Rp 24,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
48 Plester rol 2 Rp 12,076.00 Rp 24,152.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 2 Rp 9,317.00 Rp 18,634.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
9 Larsi kap 48 Rp 1,026.67 Rp 49,280.00
JUMLAH Rp 24,739,722.02
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 490 Rp 513.00 Rp 251,370.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 3,119,340.20
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS KLEDUNG
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 385 Rp 149.00
48 Kalk tab 5,875 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 3,250 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 10 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 0 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 0 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 5 Rp 6,410.00
8 RL btl 7 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 24 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 0 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 13 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 6 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS KLEDUNG
Jumlah Harga (Rp)
Rp -
Rp -
Rp 69,144.00
Rp -
Rp -
Rp 46,865.00
Rp 13,360.00
Rp 63,000.00
Rp 124,620.00
Rp 89,700.00
Rp 2,107,024.00
Rp 382,354.00
Rp -
Rp 123,690.00
Rp -
Rp 47,250.00
Rp 626,343.00
Rp 14,800.00
Rp -
1
Jumlah Harga (Rp)
Rp 16,434.00
Rp 117,962.00
Rp -
Rp -
Rp -
Rp 8,800.00
Rp 3,000.00
Rp 17,996.00
Rp 282,272.00
Rp -
Rp 11,180.00
Rp -
Rp -
Rp -
Rp 27,202.00
Rp 16,640.00
Rp 26,400.00
Rp 67,614.00
Rp -
Rp -
Rp 28,440.00
Rp 16,758.00
Rp 36,920.00
Rp -
Rp 21,840.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 45,600.00
Rp -
Rp 74,520.00
Rp 14,700.00
Rp -
Rp -
Rp -
Rp 14,000.00
Rp 57,365.00
Rp -
Rp -
Rp -
Rp -
Rp 4,928.00
Rp -
Rp -
Rp 346,625.00
Rp -
Rp 77,850.00
Rp -
Rp 58,900.00
Rp 281,904.00
Rp 57,500.00
Rp -
Rp 33,600.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 363,048.00
Rp 41,160.00
Rp -
Rp -
Rp 196,058.07
Rp -
Rp -
Rp -
Rp -
Rp 12,300.00
Rp -
Rp -
Rp 225,600.00
Rp 21,000.00
Rp -
Rp 21,100.00
Rp 13,500.00
Rp 325,600.00
Rp -
Rp 1,808,370.00
Rp 160,080.00
Rp -
Rp -
Rp 86,000.00
Rp 81,950.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 12,220.00
Rp -
Rp -
Rp 713,048.00
Rp -
Rp -
Rp 410,640.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 61,005.00
Rp -
Rp -
Rp -
Rp 3,540.00
Rp 16,100.00
Rp -
Rp 82,500.00
Rp -
1
Jumlah Harga (Rp)
Rp 205,173.00
Rp 137,681.00
Rp -
Rp 14,053.50
Rp -
Rp 17,144,220.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 279,500.00
Rp -
Rp -
Rp 713,805.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 153,000.00
Rp 77,330.00
Rp 166,050.00
Rp -
Rp -
Rp 110,700.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 29,700.00
Rp -
Rp -
Rp -
Rp 222,560.00
Rp -
Rp -
Rp 22,800.00
Rp -
Rp -
Rp 530,400.00
Rp 190,232.00
Rp -
Rp -
Rp -
Rp -
Rp 33,945.00
Rp -
Rp -
Rp 176,120.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 19,600.00
Rp -
Rp 21,000.00
Rp 26,235.00
Rp -
Rp -
Rp -
Rp -
Rp 29,865.00
Rp -
Rp 353,600.00
Rp -
Rp 57,600.00
Rp 102,960.00
Rp 29,590.00
Rp 37,200.00
Rp 32,000.00
Rp -
Rp -
Rp 85,500.00
Rp -
Rp -
Rp 13,900.00
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp 65,880.00
Rp 220,920.00
Rp -
Rp -
Rp -
Rp -
Rp 35,968.00
Rp 39,585.00
Rp 113,943.00
Rp -
Rp 129,408.00
Rp -
Rp -
Rp -
Rp -
Rp 197,600.00
Rp 46,068.00
Rp -
Rp -
Rp -
Rp 166,380.00
Rp 106,190.00
Rp -
Rp -
Rp 48,150.00
1
Jumlah Harga (Rp)
Rp 181,976.00
Rp -
Rp -
Rp 167,880.00
Rp -
Rp 74,501.00
Rp -
Rp 35,739.00
Rp 75,200.00
Rp -
Rp -
Rp -
Rp 54,000.00
Rp -
Rp -
Rp 7,845.00
Rp -
Rp -
Rp -
Rp -
Rp 692,835.00
Rp -
Rp -
Rp -
Rp 58,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 93,275.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 32,050.00
Rp -
Rp 50,050.00
Rp -
Rp -
Rp 133,826.00
Rp 251,680.00
Rp 157,200.00
Rp 23,100.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 50,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 80,400.00
Rp 32,800.00
Rp 751,320.36
Rp 40,198.39
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 25,500.00
Rp 25,500.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 369,600.00
Rp 323,400.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 39,600.00
Rp 154,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 20,000.00
Rp 20,000.00
Rp -
Rp 226,799.76
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 19,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 302,900.00
Rp 134,400.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 457,560.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 59,951.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 136,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 61,363.50
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 38,198,580.58
1
DI PUSKESMAS KLEDUNG
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 90 Rp 1,026.67 Rp 92,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
22 New Pro Uric kap 170 Rp 889.17 Rp 151,158.90
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 22 Rp 5,797.00 Rp 127,534.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Alkacide 1 L High Level btl 0 ### Rp -
9 Bisturi box 5 Rp 83,600.00 Rp 418,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 3 Rp 24,000.00 Rp 72,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
48 Plester rol 14 Rp 12,076.00 Rp 169,064.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 16,718,532.74
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 300 Rp 513.00 Rp 153,900.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 MgSO4 40% amp 10 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 2,480,718.00
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS KEDU
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 933 Rp 149.00
48 Kalk tab 5,837 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 235 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 4,830 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 97 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 10 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 18 Rp 6,900.00
4 Ka-En 3A btl 5 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 26 Rp 6,410.00
8 RL btl 7 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 45 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 2 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 8 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 12 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
1 2 3 4 5
1
PUSKESMAS KEDU
Jumlah Harga (Rp)
Rp -
Rp -
Rp 87,376.00
Rp -
Rp -
Rp 17,381.00
Rp 6,680.00
Rp 75,460.00
Rp 126,480.00
Rp -
Rp 944,240.00
Rp 325,438.00
Rp 29,410.00
Rp 597,240.00
Rp -
Rp 93,240.00
Rp 251,011.00
Rp 44,400.00
Rp -
1
Jumlah Harga (Rp)
Rp 80,178.00
Rp 113,425.00
Rp -
Rp -
Rp -
Rp 8,690.00
Rp -
Rp 44,180.18
Rp 198,912.00
Rp -
Rp 30,272.00
Rp -
Rp -
Rp 53,253.00
Rp 13,400.00
Rp 21,112.00
Rp 39,600.00
Rp 54,398.00
Rp -
Rp 75,000.00
Rp 71,100.00
Rp 129,105.00
Rp 278,320.00
Rp -
Rp 21,216.00
Rp -
Rp 224,618.00
1
Jumlah Harga (Rp)
Rp 467,400.00
Rp -
Rp 138,690.00
Rp 40,320.00
Rp -
Rp -
Rp 41,831.00
Rp -
Rp 139,017.00
Rp -
Rp -
Rp -
Rp 8,890.00
Rp 40,920.00
Rp 14,881.00
Rp -
Rp 344,383.00
Rp 21,500.00
Rp 64,875.00
Rp -
Rp 34,286.00
Rp 32,340.00
Rp 73,600.00
Rp -
Rp 47,600.00
Rp 97,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 316,085.50
Rp 182,028.00
Rp 52,920.00
Rp -
Rp -
Rp 246,015.90
Rp -
Rp -
Rp -
Rp -
Rp 8,610.00
Rp -
Rp -
Rp 132,480.00
Rp -
Rp 108,600.00
Rp -
Rp 8,100.00
Rp 234,240.00
Rp -
Rp 2,960,700.00
Rp 504,735.00
Rp -
Rp -
Rp 25,000.00
Rp 70,030.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 15,600.00
Rp -
Rp -
Rp 769,440.00
Rp -
Rp -
Rp 1,097,636.00
Rp -
Rp 6,800.00
Rp -
Rp -
Rp 8,214.00
Rp 65,565.00
Rp 323,400.00
Rp -
Rp -
Rp 13,650.00
Rp 51,035.00
Rp -
Rp -
Rp 225,500.00
Rp -
1
Jumlah Harga (Rp)
Rp 160,548.00
Rp 140,432.00
Rp -
Rp 246,217.32
Rp 87,600.00
Rp 41,950,062.00
Rp -
Rp 25,000.00
Rp -
Rp -
Rp 11,779.62
Rp -
Rp 415,380.00
Rp 5,270.00
Rp -
Rp 546,365.00
Rp -
Rp -
Rp -
Rp 40,000.00
Rp -
Rp 37,400.00
Rp 87,780.00
Rp 153,900.00
Rp -
Rp -
Rp 124,200.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 549,195.00
Rp -
Rp 27,685.00
Rp 267,500.00
Rp -
Rp -
Rp 159,600.00
Rp -
Rp -
Rp 161,200.00
Rp 72,996.00
Rp -
Rp 39,220.00
Rp -
Rp -
Rp 135,780.00
Rp -
Rp -
Rp 515,780.00
Rp -
Rp -
Rp 5,469.00
Rp -
1
Jumlah Harga (Rp)
Rp 104,500.00
Rp -
Rp 7,700.00
Rp 23,800.00
Rp -
Rp 27,300.00
Rp 8,745.00
Rp -
Rp -
Rp -
Rp -
Rp 49,775.00
Rp -
Rp -
Rp 3,870.00
Rp 50,688.00
Rp -
Rp 14,795.00
Rp 31,000.00
Rp -
Rp -
Rp -
Rp 15,200.00
Rp -
Rp -
Rp 19,460.00
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 233,792.00
Rp 97,440.00
Rp 869,565.00
Rp -
Rp 140,192.00
Rp -
Rp -
Rp -
Rp -
Rp 676,000.00
Rp 34,551.00
Rp -
Rp -
Rp 242,500.00
Rp 332,760.00
Rp 116,550.00
Rp -
Rp -
Rp 82,925.00
1
Jumlah Harga (Rp)
Rp 55,016.00
Rp -
Rp -
Rp 277,002.00
Rp -
Rp 421,316.00
Rp -
Rp 169,290.00
Rp -
Rp 13,000.00
Rp -
Rp -
Rp 18,000.00
Rp -
Rp -
Rp 19,351.00
Rp -
Rp -
Rp -
Rp -
Rp 2,236,520.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 25,270.00
Rp 62,525.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 124,200.00
Rp 50,250.00
Rp -
Rp -
Rp -
Rp 166,660.00
Rp -
Rp 50,050.00
Rp -
Rp -
Rp 940,170.00
Rp 553,696.00
Rp 251,520.00
Rp 9,240.00
Rp -
Rp -
Rp 331,100.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 90,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 196,800.00
Rp 83,480.04
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 42,500.00
Rp 42,500.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 942,942.00
Rp 453,222.00
Rp -
Rp 188,100.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 200,200.00
Rp 215,600.00
Rp -
Rp 43,500.00
Rp -
Rp 289,800.00
Rp -
Rp -
Rp -
Rp -
Rp 44,011.80
Rp -
Rp 20,000.00
Rp -
Rp 425,249.55
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 82,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 62,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,414,381.50
Rp 186,400.00
Rp 268,800.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 152,520.00
Rp 15,015.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,668.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,980.00
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 209,828.50
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 112,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 331,362.90
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 74,891,165.93
1
Jumlah Harga (Rp)
1
DI PUSKESMAS KEDU
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 75 Rp 1,026.67 Rp 77,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Neurotropik tab/ Corsaneuron tab 1,210 Rp 757.90 Rp 917,059.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 149 Rp 5,797.00 Rp 863,753.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 4 Rp 83,600.00 Rp 334,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 5 Rp 24,000.00 Rp 120,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
38 Lidi Kapas Steril biji 900 Rp 1,120.00 Rp 1,008,000.00
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
48 Plester rol 9 Rp 12,076.00 Rp 108,684.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 1 Rp 125,400.00 Rp 125,400.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 1 Rp 29,051.00 Rp 29,051.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 36,698,891.82
1
DI PUSKESMAS KEDU
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS KEDU
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Triheksifenidil 2 mg tab 1,000 Rp 85.00 Rp 85,000.00
13 Zink 20 mg tab 740 Rp 513.00 Rp 379,620.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 5,353,016.80
1
DI PUSKESMAS KEDU
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS KANDANGAN
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 836 Rp 149.00
48 Kalk tab 2,750 Rp 59.00

1
1 2 3 4 5
59 Klorfeniramin Maleat/ CTM 4 mg tab 339 Rp 42.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 3,203 Rp 86.00
104 Triheksifenidil 2 mg tab 2,272 Rp 85.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 83 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 34 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 11 Rp 6,410.00
8 RL btl 0 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 5 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 0 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 2 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 5 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 1 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
1 2 3 4 5
1
PUSKESMAS KANDANGAN
Jumlah Harga (Rp)
Rp -
Rp -
Rp 174,838.00
Rp -
Rp -
Rp -
Rp 14,362.00
Rp 174,300.00
Rp 42,780.00
Rp -
Rp 142,448.00
Rp 301,568.00
Rp -
Rp 497,175.00
Rp -
Rp 159,957.00
Rp 196,318.00
Rp 41,440.00
Rp -
1
Jumlah Harga (Rp)
Rp 126,990.00
Rp 227,548.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 48,499.22
Rp 68,640.00
Rp -
Rp 37,066.00
Rp -
Rp -
Rp 22,116.00
Rp -
Rp -
Rp -
Rp 13,098.00
Rp -
Rp -
Rp 125,136.00
Rp 73,701.00
Rp 1,420.00
Rp -
Rp -
Rp -
Rp 15,420.00
1
Jumlah Harga (Rp)
Rp 677,920.00
Rp -
Rp 190,233.00
Rp -
Rp -
Rp -
Rp 53,454.00
Rp -
Rp 124,564.00
Rp -
Rp -
Rp -
Rp -
Rp 61,600.00
Rp -
Rp -
Rp 162,250.00
Rp -
Rp -
Rp -
Rp 9,920.00
Rp 471,492.00
Rp 9,200.00
Rp -
Rp 65,800.00
Rp 97,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 14,238.00
Rp 38,955.00
Rp -
Rp -
Rp 34,412.04
Rp -
Rp -
Rp -
Rp -
Rp 5,781.00
Rp -
Rp -
Rp 290,112.00
Rp 4,350.00
Rp 164,100.00
Rp 20,467.00
Rp -
Rp 30,400.00
Rp -
Rp 1,134,864.00
Rp 151,685.00
Rp -
Rp -
Rp 10,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 194,544.00
Rp -
Rp -
Rp 849,836.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 750,330.00
Rp -
Rp -
Rp -
Rp 5,900.00
Rp -
Rp -
Rp 315,150.00
Rp -
1
Jumlah Harga (Rp)
Rp 105,723.00
Rp 25,938.00
Rp -
Rp 237,223.08
Rp -
Rp 61,395,636.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 275,458.00
Rp 193,120.00
Rp -
Rp 220,915.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 267,520.00
Rp 313,875.00
Rp -
Rp -
Rp 129,600.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 80,370.00
Rp -
Rp -
Rp 102,720.00
Rp -
Rp -
Rp 83,600.00
Rp -
Rp -
Rp 660,400.00
Rp 379,358.00
Rp 31,122.00
Rp -
Rp -
Rp -
Rp 162,936.00
Rp -
Rp -
Rp 264,180.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 14,000.00
Rp -
Rp 9,450.00
Rp 6,996.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 23,040.00
Rp 34,320.00
Rp -
Rp 124,000.00
Rp -
Rp -
Rp -
Rp -
Rp 10,700.00
Rp -
Rp 6,950.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 61,404.00
Rp -
Rp 42,630.00
Rp 1,151,424.00
Rp -
Rp 107,840.00
Rp -
Rp -
Rp 19,449.98
Rp -
Rp -
Rp 57,585.00
Rp -
Rp -
Rp 207,500.00
Rp 83,190.00
Rp 139,860.00
Rp -
Rp -
Rp 428,000.00
1
Jumlah Harga (Rp)
Rp 791,384.00
Rp -
Rp -
Rp 55,960.00
Rp -
Rp 169,554.00
Rp -
Rp 15,048.00
Rp -
Rp 35,750.00
Rp -
Rp -
Rp 198,000.00
Rp -
Rp -
Rp 15,690.00
Rp -
Rp -
Rp -
Rp -
Rp 3,658,655.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 19,999.90
1
Jumlah Harga (Rp)
Rp 85,918.00
Rp 32,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 70,510.00
Rp -
Rp -
Rp -
Rp -
Rp 64,372.00
Rp 1,936.00
Rp 225,320.00
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 241,200.00
Rp 984,000.00
Rp -
Rp 80,396.78
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 415,800.00
Rp 554,400.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 47,520.00
Rp 15,400.00
Rp 138,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 10,000.00
Rp -
Rp 47,249.95
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,414,381.50
Rp 46,600.00
Rp 112,000.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 25,025.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,667.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 80,000.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 59,951.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 59,098.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 85,690,596.45
1
Jumlah Harga (Rp)
1
DI PUSKESMAS KANDANGAN
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
24 Nodiar tab 200 Rp 453.04 Rp 90,608.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 69 Rp 5,797.00 Rp 399,993.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Gentien Violet 1 % btl 0 Rp 2,750.00 Rp -
8 Ikhtiol SK btl 0 Rp 4,950.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 1 Rp 83,600.00 Rp 83,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 5 Rp 24,000.00 Rp 120,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
48 Plester rol 34 Rp 12,076.00 Rp 410,584.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
59 Tranfusi set biji 0 Rp 8,646.00 Rp -
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 17,058,651.75
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 0 Rp 513.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 MgSO4 40% amp 10 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 0 Rp 30,000.00 Rp -
JUMLAH Rp 525,174.80
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS GEMAWANG
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 73 Rp 149.00
48 Kalk tab 8,162 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 3,980 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 287 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 0 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 37 Rp 6,900.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 35 Rp 9,599.67
7 NaCl btl 7 Rp 6,410.00
8 RL btl 285 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 53 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 2 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 24 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 0 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 1 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS GEMAWANG
Jumlah Harga (Rp)
Rp -
Rp -
Rp 28,810.00
Rp -
Rp -
Rp 41,405.00
Rp -
Rp 29,890.00
Rp -
Rp -
Rp 2,113,752.00
Rp 219,914.00
Rp -
Rp 465,885.00
Rp -
Rp 30,870.00
Rp 907,430.00
Rp 14,800.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 244,300.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 44,090.20
Rp 299,808.00
Rp -
Rp 8,170.00
Rp 9,701.00
Rp -
Rp 18,430.00
Rp -
Rp 29,120.00
Rp -
Rp 83,426.00
Rp -
Rp -
Rp -
Rp 13,680.00
Rp 106,500.00
Rp -
Rp 13,494.00
Rp -
Rp 154,200.00
1
Jumlah Harga (Rp)
Rp 186,200.00
Rp -
Rp 42,849.00
Rp 2,100.00
Rp -
Rp -
Rp -
Rp 22,904.00
Rp 10,877.00
Rp -
Rp -
Rp -
Rp -
Rp 22,000.00
Rp -
Rp -
Rp 481,558.00
Rp -
Rp -
Rp -
Rp 108,500.00
Rp 254,100.00
Rp -
Rp -
Rp 47,600.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 411,936.00
Rp 56,154.00
Rp -
Rp -
Rp 262,920.06
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 27,840.00
Rp -
Rp 87,900.00
Rp -
Rp -
Rp 80,000.00
Rp -
Rp 4,112,178.00
Rp 172,960.00
Rp -
Rp -
Rp 39,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 15,600.00
Rp -
Rp -
Rp 358,008.00
Rp -
Rp -
Rp 742,928.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 383,670.00
Rp -
Rp -
Rp -
Rp 31,270.00
Rp -
Rp -
Rp 132,000.00
Rp -
1
Jumlah Harga (Rp)
Rp 241,842.00
Rp 28,820.00
Rp -
Rp -
Rp -
Rp 29,746,620.00
Rp -
Rp 25,000.00
Rp 105,000.00
Rp -
Rp -
Rp -
Rp 342,280.00
Rp 31,365.00
Rp -
Rp 825,010.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 204,820.00
Rp 12,150.00
Rp -
Rp -
Rp 172,800.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 319,275.00
Rp -
Rp -
Rp -
Rp 192,600.00
Rp -
Rp -
Rp 34,200.00
Rp -
Rp -
Rp 899,600.00
Rp 392,630.00
Rp -
Rp 3,922.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 578,680.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 387,800.00
Rp 8,563.50
Rp 15,750.00
Rp 13,992.00
Rp -
Rp -
Rp 75,800.00
Rp -
Rp 169,235.00
Rp -
Rp 2,828,800.00
Rp 15,480.00
Rp 80,640.00
Rp 189,904.00
Rp 14,795.00
Rp 31,000.00
Rp -
Rp -
Rp -
Rp 106,400.00
Rp 179,760.00
Rp -
Rp 166,800.00
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp 170,190.00
Rp 320,334.00
Rp -
Rp -
Rp -
Rp 11,696.00
Rp 112,400.00
Rp 176,610.00
Rp 491,754.00
Rp -
Rp 84,924.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 149,721.00
Rp -
Rp -
Rp 717,500.00
Rp -
Rp -
Rp -
Rp -
Rp 125,725.00
1
Jumlah Harga (Rp)
Rp 126,960.00
Rp -
Rp -
Rp 162,284.00
Rp -
Rp 246,624.00
Rp -
Rp 58,311.00
Rp -
Rp 35,750.00
Rp -
Rp -
Rp 21,000.00
Rp -
Rp -
Rp 36,610.00
Rp -
Rp -
Rp -
Rp -
Rp 1,154,725.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 199,999.00
1
Jumlah Harga (Rp)
Rp -
Rp 58,425.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 255,300.00
Rp -
Rp -
Rp 335,988.45
Rp -
Rp 44,870.00
Rp -
Rp 2,037,035.00
Rp -
Rp -
Rp -
Rp 871,200.00
Rp 379,900.00
Rp 8,316.00
Rp 8,995.80
Rp -
Rp 165,550.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 10,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 951,200.00
Rp 1,711,340.82
Rp 1,165,753.31
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 85,000.00
Rp 85,000.00
Rp 340,000.00
Rp 85,000.00
1
Jumlah Harga (Rp)
Rp 2,263,800.00
Rp 1,801,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,393,920.00
Rp 554,400.00
Rp 800,800.00
Rp -
Rp 234,900.00
Rp -
Rp 1,481,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 410,000.00
Rp 560,000.00
Rp -
Rp 500,849.47
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 82,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,216,900.00
Rp 849,000.00
Rp -
Rp -
Rp -
Rp -
Rp 62,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,178,651.25
Rp 559,200.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 457,560.00
Rp 100,100.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 33,334.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 230,000.00
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 119,902.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 217,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 196,363.20
Rp 296,940.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 80,712,681.18
1
DI PUSKESMAS GEMAWANG
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Kalium Diklofenak 50 mg tab 0 Rp 694.32 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Neurotropik tab/ Corsaneuron tab 0 Rp 757.90 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 22 Rp 5,797.00 Rp 127,534.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1 Alat suntik ADS 0.05 ml set 400 Rp 3,575.00 Rp 1,430,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 5 Rp 83,600.00 Rp 418,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 4 Rp 24,000.00 Rp 96,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
48 Plester rol 49 Rp 12,076.00 Rp 591,724.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 1 Rp 9,317.00 Rp 9,317.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 32,502,849.25
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1 Albendazol 400 tab 3,800 Rp 288.00 Rp 1,094,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 OAT Anak/ FDC pkt 0 Rp 195,441.92 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 380 Rp 513.00 Rp 194,940.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 4,413,260.00
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS JUMO
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 496 Rp 149.00
48 Kalk tab 2,236 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 90 Rp 279.00

1
1 2 3 4 5
93 Sianokobalamin / B12 50 mcg tab 722 Rp 51.00
103 Tiamin 50 mg/ B1 tab 601 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 90 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 0 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 5 Rp 6,410.00
8 RL btl 3 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 20 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 0 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 0 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 0 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS JUMO
Jumlah Harga (Rp)
Rp -
Rp -
Rp 49,020.00
Rp -
Rp -
Rp 30,940.00
Rp 16,700.00
Rp -
Rp -
Rp -
Rp 911,992.00
Rp 147,188.00
Rp 53,630.00
Rp 86,520.00
Rp -
Rp 22,239.00
Rp 303,850.00
Rp 16,280.00
Rp -
1
Jumlah Harga (Rp)
Rp 47,310.00
Rp -
Rp -
Rp -
Rp -
Rp 7,590.00
Rp 17,400.00
Rp 82,241.72
Rp 55,232.00
Rp -
Rp 15,652.00
Rp -
Rp -
Rp 5,335.00
Rp 24,522.00
Rp 7,800.00
Rp 18,480.00
Rp 19,470.00
Rp -
Rp -
Rp -
Rp 15,048.00
Rp 85,910.00
Rp -
Rp 14,976.00
Rp -
Rp 15,420.00
1
Jumlah Harga (Rp)
Rp 77,900.00
Rp -
Rp 41,400.00
Rp 42,000.00
Rp -
Rp -
Rp -
Rp 2,240.00
Rp 73,904.00
Rp -
Rp -
Rp -
Rp -
Rp 20,416.00
Rp -
Rp -
Rp 131,924.00
Rp -
Rp -
Rp -
Rp 9,734.00
Rp 34,776.00
Rp 27,600.00
Rp -
Rp 25,200.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 42,294.00
Rp 8,526.00
Rp -
Rp -
Rp 33,808.32
Rp -
Rp -
Rp -
Rp -
Rp 13,530.00
Rp -
Rp -
Rp 74,976.00
Rp -
Rp -
Rp -
Rp -
Rp 107,200.00
Rp -
Rp 1,052,220.00
Rp 142,600.00
Rp -
Rp -
Rp 18,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 21,580.00
Rp -
Rp -
Rp 148,904.00
Rp -
Rp -
Rp 507,636.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 25,110.00
Rp 185,745.00
Rp -
Rp -
Rp 24,570.00
Rp 5,428.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 36,822.00
Rp 120,651.00
Rp -
Rp 43,846.92
Rp -
Rp 20,963,526.00
Rp -
Rp 30,000.00
Rp -
Rp -
Rp -
Rp -
Rp 51,686.00
Rp -
Rp -
Rp 280,255.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 43,890.00
Rp 66,825.00
Rp -
Rp -
Rp 2,700.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 4,950.00
Rp -
Rp -
Rp 94,920.00
Rp -
Rp -
Rp -
Rp 30,400.00
Rp -
Rp -
Rp 494,000.00
Rp 17,696.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 94,350.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 16,500.00
Rp -
Rp -
Rp 42,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 7,580.00
Rp -
Rp 49,775.00
Rp -
Rp 1,237,600.00
Rp 7,740.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 32,940.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 49,456.00
Rp 51,765.00
Rp 377,811.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 225,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 42,320.00
Rp -
Rp -
Rp 33,576.00
Rp -
Rp 259,469.00
Rp -
Rp 37,620.00
Rp 141,376.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 8,891.00
Rp -
Rp -
Rp -
Rp -
Rp 340,340.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 8,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 32,050.00
Rp -
Rp 21,450.00
Rp -
Rp -
Rp 169,400.00
Rp 96,800.00
Rp 216,150.00
Rp -
Rp -
Rp -
Rp 331,100.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 85,000.00
Rp 85,000.00
Rp -
Rp 85,000.00
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp 184,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 15,840.00
Rp 15,400.00
Rp 77,000.00
Rp -
Rp -
Rp -
Rp 80,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 60,000.00
Rp -
Rp -
Rp 188,999.80
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 187,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,249.20
Rp -
Rp -
Rp -
Rp 50,050.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,667.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 59,951.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 74,800.00
Rp -
Rp -
Rp 59,098.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 32,987,248.96
1
DI PUSKESMAS JUMO
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 120 Rp 1,026.67 Rp 123,200.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Neurotropik tab/ Corsaneuron tab 1,545 Rp 757.90 Rp 1,170,955.50
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 82 Rp 5,797.00 Rp 475,354.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
2 Asiklovir krim 5 % tube 0 Rp 2,860.00 Rp -
4 Enkasari btl 0 Rp 17,863.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 3 Rp 83,600.00 Rp 250,800.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 11 Rp 24,000.00 Rp 264,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
53 Savety box biji 79 Rp 15,708.00 Rp 1,240,932.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 1 Rp 9,317.00 Rp 9,317.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 14,022,743.10
1
DI PUSKESMAS JUMO
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS JUMO
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 0 Rp 513.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 0 Rp 30,000.00 Rp -
JUMLAH Rp 1,420,432.00
1
DI PUSKESMAS JUMO
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS NGADIREJO
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
3 Aminofilin 200 mg tab 1,931 Rp 91.00
0 Asifit kap 0 Rp -
1
1 2 3 4 5
24 Diazepam 2 mg tab 1,602 Rp 86.00
26 Digoksin 0,25 mg tab 1,376 Rp 97.00
28 Dimenhidrinat 50 mg tab 1,052 Rp 104.00

1
1 2 3 4 5
44 HCT 25 mg tab 860 Rp 149.00
48 Kalk tab 2,243 Rp 59.00

1
1 2 3 4 5
58 Kloramfenikol 500 mg kap 1,000 Rp 1,089.95
60 Klorpromazin 100 mg tab 1,691 Rp 147.00
62 Kodein 10 mg tab 625 Rp 550.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 348 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 4,912 Rp 86.00
104 Triheksifenidil 2 mg tab 1,110 Rp 85.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 146 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 14 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 136 Rp 6,900.00
4 Ka-En 3A btl 180 Rp 10,050.00
5 Ka-En 3B btl 140 Rp 10,696.00
6 Ka-En Mg 3 btl 100 Rp 9,599.67
7 NaCl btl 22 Rp 6,410.00
8 RL btl 1,127 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 50 Rp 9,449.99
33 Kasa 36 x 80 cm rol 2 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 0 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 60 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 72 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS NGADIREJO
Jumlah Harga (Rp)
Rp -
Rp -
Rp 103,974.00
Rp 107,756.00
Rp -
Rp 175,721.00
Rp 58,784.00
Rp 138,390.00
Rp 270,072.00
Rp 118,950.00
Rp 1,276,000.00
Rp 381,362.00
Rp -
Rp 482,475.00
Rp -
Rp 34,776.00
Rp 244,110.00
Rp 92,500.00
Rp -
1
Jumlah Harga (Rp)
Rp 131,223.00
Rp 214,635.00
Rp -
Rp 171,000.00
Rp -
Rp 4,620.00
Rp 9,000.00
Rp 87,370.58
Rp 166,592.00
Rp -
Rp 137,772.00
Rp 32,809.00
Rp -
Rp 133,472.00
Rp 15,276.00
Rp 109,408.00
Rp 23,760.00
Rp 226,206.00
Rp -
Rp -
Rp 31,126.00
Rp 45,657.00
Rp 390,500.00
Rp -
Rp 70,200.00
Rp -
Rp 164,223.00
1
Jumlah Harga (Rp)
Rp 297,160.00
Rp -
Rp 94,392.00
Rp 93,450.00
Rp -
Rp -
Rp 50,150.00
Rp 14,000.00
Rp 128,140.00
Rp -
Rp -
Rp -
Rp 27,940.00
Rp 40,304.00
Rp 91,227.00
Rp -
Rp 132,337.00
Rp 249,400.00
Rp 264,690.00
Rp -
Rp 52,080.00
Rp 495,348.00
Rp 59,800.00
Rp -
Rp 141,120.00
Rp 87,300.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 1,089,950.00
Rp 222,264.00
Rp 248,577.00
Rp -
Rp 343,750.00
Rp 111,990.06
Rp -
Rp 112,860.00
Rp -
Rp -
Rp 80,811.00
Rp -
Rp -
Rp 95,712.00
Rp -
Rp 584,400.00
Rp 21,100.00
Rp -
Rp 282,880.00
Rp -
Rp 2,304,660.00
Rp 254,150.00
Rp -
Rp -
Rp 102,700.00
Rp 198,915.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 94,120.00
Rp 14,160.00
Rp -
Rp 1,370,208.00
Rp -
Rp -
Rp 668,824.00
Rp -
Rp -
Rp -
Rp -
Rp 39,960.00
Rp 97,092.00
Rp 471,135.00
Rp -
Rp -
Rp 193,830.00
Rp 52,864.00
Rp -
Rp -
Rp 420,200.00
Rp 53,100.00
1
Jumlah Harga (Rp)
Rp 190,791.00
Rp 175,802.00
Rp 8,200.00
Rp 413,172.90
Rp -
Rp 25,300,380.00
Rp -
Rp 50,000.00
Rp 635,250.00
Rp -
Rp -
Rp -
Rp 422,432.00
Rp 94,350.00
Rp -
Rp 310,270.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 204,000.00
Rp 181,830.00
Rp 228,825.00
Rp -
Rp -
Rp 405,000.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 123,750.00
Rp 191,995.00
Rp -
Rp -
Rp 177,620.00
Rp -
Rp -
Rp 72,200.00
Rp -
Rp -
Rp 592,800.00
Rp 451,248.00
Rp 80,028.00
Rp 211,788.00
Rp -
Rp -
Rp 285,138.00
Rp -
Rp -
Rp 1,654,270.00
Rp -
Rp -
Rp 47,398.00
Rp -
1
Jumlah Harga (Rp)
Rp 451,000.00
Rp -
Rp 3,080.00
Rp 218,400.00
Rp 8,563.50
Rp 26,250.00
Rp 10,494.00
Rp -
Rp -
Rp 75,800.00
Rp -
Rp 119,460.00
Rp -
Rp 4,596,800.00
Rp 140,610.00
Rp 282,240.00
Rp 187,616.00
Rp 29,590.00
Rp -
Rp -
Rp -
Rp -
Rp 152,000.00
Rp 465,450.00
Rp -
Rp 632,450.00
Rp 268,800.00
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp 122,976.00
Rp -
Rp -
Rp -
Rp -
Rp 20,468.00
Rp 175,344.00
Rp 204,015.00
Rp 695,652.00
Rp -
Rp 132,104.00
Rp -
Rp 46,400.00
Rp -
Rp -
Rp 707,200.00
Rp 357,027.00
Rp -
Rp -
Rp 365,000.00
Rp -
Rp 170,940.00
Rp -
Rp -
Rp 165,850.00
1
Jumlah Harga (Rp)
Rp 435,896.00
Rp -
Rp -
Rp 212,648.00
Rp -
Rp 290,297.00
Rp -
Rp 158,004.00
Rp 132,352.00
Rp 65,000.00
Rp -
Rp -
Rp 210,000.00
Rp -
Rp -
Rp 77,927.00
Rp -
Rp -
Rp -
Rp -
Rp 1,361,360.00
Rp -
Rp -
Rp 108,000.00
Rp -
Rp -
Rp 439,997.80
1
Jumlah Harga (Rp)
Rp 35,378.00
Rp 131,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 964,600.00
Rp -
Rp 938,400.00
Rp 1,809,000.00
Rp 1,497,440.00
Rp 959,967.00
Rp -
Rp 141,020.00
Rp 81,270.00
Rp 8,058,050.00
Rp -
Rp -
Rp 1,346,730.00
Rp 774,400.00
Rp 786,000.00
Rp 12,012.00
Rp 59,972.00
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 260,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 120,600.00
Rp 787,200.00
Rp 1,502,640.72
Rp 2,050,117.89
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 85,000.00
Rp 85,000.00
Rp 382,500.00
Rp 170,000.00
1
Jumlah Harga (Rp)
Rp 1,848,000.00
Rp 1,386,000.00
Rp -
Rp 125,400.00
Rp -
Rp -
Rp -
Rp -
Rp 799,920.00
Rp 693,000.00
Rp 770,000.00
Rp -
Rp 435,000.00
Rp -
Rp 6,440,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 150,000.00
Rp 200,000.00
Rp -
Rp 472,499.50
Rp 260,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 475,200.00
Rp 534,600.00
Rp -
Rp -
Rp -
Rp 990,500.00
Rp 849,000.00
Rp -
Rp -
Rp -
Rp -
Rp 187,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,398,000.00
Rp 1,612,800.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,249.20
Rp -
Rp -
Rp 1,220,160.00
Rp 100,100.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,001.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 451,000.00
Rp 960,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 179,853.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 238,408.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 589,089.60
Rp 1,365,924.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 112,863,979.87
1
DI PUSKESMAS NGADIREJO
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
10 Hepagard tab 410 Rp 2,794.00 Rp 1,145,540.00
11 Hiosina + Metampiron/ Dormi tab 1,253 Rp 2,069.00 Rp 2,592,457.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 Neurotropik tab/ Corsaneuron tab 1,868 Rp 757.90 Rp 1,415,757.20
22 New Pro Uric kap 240 Rp 889.17 Rp 213,400.80
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
34 Tiamfenikol 500 mg tab 1,266 Rp 1,446.50 Rp 1,831,269.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 200 Rp 5,797.00 Rp 1,159,400.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 Gentamisin inj 40 mg/ ml amp 30 Rp 3,399.00 Rp 101,970.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
4 Enkasari btl 64 Rp 17,863.00 Rp 1,143,232.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 6 Rp 83,600.00 Rp 501,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
22 Handscoon steril no 7 psg 150 Rp 7,865.00 Rp 1,179,750.00
31 Kapas 250 g bks 10 Rp 24,000.00 Rp 240,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 0 Rp3,250,000.00 Rp -
48 Plester rol 7 Rp 12,076.00 Rp 84,532.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
14 Stik asam urat Nesco btl 1 Rp 102,047.00 Rp 102,047.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
7 Mekobalamin kap 710 Rp 869.00 Rp 616,990.00
8 Biocombin inj amp 212 Rp 5,390.00 Rp 1,142,680.00
JUMLAH Rp 64,226,478.51
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 MB Kusta strip 4 Rp 28,424.00 Rp 113,696.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 OAT Anak/ FDC pkt 1 ### Rp 195,441.92
6 OAT FDC I/III pkt 15 ### Rp 4,755,270.00
8 OAT kat II pkt 1 ### Rp 1,199,985.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 420 Rp 513.00 Rp 215,460.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Flufenazin inj 25mg/ml - Sikzo amp 30 Rp 59,800.00 Rp 1,794,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 0 Rp 30,000.00 Rp -
8 Klorpromazin inj amp 4 Rp 1,243.00 Rp 4,972.00
JUMLAH Rp 14,253,627.92
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS CANDIROTO
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 94 Rp 149.00
48 Kalk tab 7,520 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 100 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 5,247 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 44 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 0 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 5 Rp 6,410.00
8 RL btl 44 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 95 Rp 9,449.99
33 Kasa 36 x 80 cm rol 1 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 3 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 1 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 0 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 1 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS CANDIROTO
Jumlah Harga (Rp)
Rp -
Rp -
Rp 75,852.00
Rp -
Rp -
Rp 17,654.00
Rp 16,700.00
Rp 3,990.00
Rp 40,920.00
Rp 18,915.00
Rp 1,646,040.00
Rp 494,078.00
Rp -
Rp 401,310.00
Rp -
Rp 28,665.00
Rp 418,695.00
Rp 13,320.00
Rp -
1
Jumlah Harga (Rp)
Rp 208,164.00
Rp 74,686.00
Rp -
Rp -
Rp -
Rp 3,300.00
Rp -
Rp 59,476.78
Rp 143,264.00
Rp -
Rp 2,752.00
Rp -
Rp -
Rp 5,335.00
Rp 26,800.00
Rp 16,224.00
Rp 23,232.00
Rp 22,066.00
Rp -
Rp -
Rp 8,690.00
Rp 12,996.00
Rp 210,870.00
Rp -
Rp 7,800.00
Rp -
Rp 26,214.00
1
Jumlah Harga (Rp)
Rp 122,360.00
Rp -
Rp -
Rp 71,400.00
Rp -
Rp -
Rp 12,626.00
Rp -
Rp 14,006.00
Rp -
Rp -
Rp -
Rp 4,445.00
Rp 3,608.00
Rp -
Rp -
Rp 443,680.00
Rp -
Rp -
Rp -
Rp 96,596.00
Rp 45,528.00
Rp -
Rp -
Rp 50,400.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 106,815.10
Rp 255,024.00
Rp 41,895.00
Rp -
Rp 51,700.00
Rp 921,880.44
Rp -
Rp 20,900.00
Rp -
Rp -
Rp 12,300.00
Rp -
Rp -
Rp 56,160.00
Rp 30,000.00
Rp 93,000.00
Rp 21,100.00
Rp -
Rp 136,480.00
Rp -
Rp 598,104.00
Rp 65,090.00
Rp -
Rp -
Rp 42,500.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 13,910.00
Rp 21,712.00
Rp -
Rp 421,960.00
Rp -
Rp -
Rp 358,366.00
Rp -
Rp 17,408.00
Rp -
Rp -
Rp 3,848.00
Rp 27,900.00
Rp 37,275.00
Rp -
Rp -
Rp 27,300.00
Rp 19,706.00
Rp -
Rp -
Rp 12,100.00
Rp -
1
Jumlah Harga (Rp)
Rp 194,004.00
Rp 74,539.00
Rp -
Rp 345,716.10
Rp -
Rp 15,618,480.00
Rp -
Rp 7,750.00
Rp 105,000.00
Rp -
Rp 26,969.13
Rp -
Rp 451,242.00
Rp 19,890.00
Rp -
Rp 850,885.00
Rp -
Rp -
Rp -
Rp 236,000.00
Rp -
Rp 159,800.00
Rp 22,990.00
Rp 170,100.00
Rp -
Rp -
Rp 13,500.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 3,955.00
Rp 164,780.00
Rp -
Rp 21,120.00
Rp -
Rp -
Rp -
Rp 15,600.00
Rp 68,572.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 75,480.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 8,250.00
Rp -
Rp -
Rp 33,600.00
Rp -
Rp 28,350.00
Rp 3,498.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,768,000.00
Rp 2,580.00
Rp 337,536.00
Rp 53,768.00
Rp 23,672.00
Rp -
Rp -
Rp -
Rp -
Rp 186,200.00
Rp 5,350.00
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp 29,646.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 242,784.00
Rp 100,485.00
Rp 185,907.00
Rp -
Rp 13,480.00
Rp -
Rp 17,400.00
Rp -
Rp -
Rp 239,200.00
Rp 57,585.00
Rp -
Rp -
Rp 110,000.00
Rp -
Rp 90,650.00
Rp -
Rp -
Rp 66,875.00
1
Jumlah Harga (Rp)
Rp 97,336.00
Rp -
Rp -
Rp 55,960.00
Rp -
Rp 146,433.00
Rp -
Rp 22,572.00
Rp 90,240.00
Rp 58,500.00
Rp -
Rp -
Rp 3,000.00
Rp -
Rp -
Rp 7,845.00
Rp -
Rp -
Rp -
Rp -
Rp 1,215,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 79,999.60
1
Jumlah Harga (Rp)
Rp -
Rp 55,350.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 6,900.00
Rp -
Rp -
Rp -
Rp -
Rp 32,050.00
Rp -
Rp 314,600.00
Rp -
Rp -
Rp 370,986.00
Rp 300,080.00
Rp 263,310.00
Rp 14,784.00
Rp 11,994.40
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 241,200.00
Rp 721,600.00
Rp 292,180.14
Rp 803,967.80
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 1,330,560.00
Rp 854,700.00
Rp -
Rp 62,700.00
Rp -
Rp -
Rp -
Rp -
Rp 150,480.00
Rp 223,300.00
Rp 161,700.00
Rp -
Rp 243,600.00
Rp -
Rp 579,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 80,000.00
Rp 40,000.00
Rp -
Rp 897,749.05
Rp 130,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 123,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 283,000.00
Rp 283,000.00
Rp -
Rp -
Rp -
Rp -
Rp 62,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,524,388.95
Rp 23,300.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 549,072.00
Rp 75,075.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,668.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 230,000.00
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,660.00
Rp 66,660.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 179,853.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 119,816.00
Rp -
Rp -
Rp 118,196.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 44,752,245.49
1
DI PUSKESMAS CANDIREJO
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 300 Rp 1,026.67 Rp 308,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 23 Rp 5,797.00 Rp 133,331.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 2 Rp 83,600.00 Rp 167,200.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 6 Rp 24,000.00 Rp 144,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
48 Plester rol 25 Rp 12,076.00 Rp 301,900.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 0 Rp 154,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 21,080,304.94
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 0 Rp 513.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 Pot Sputum Steril biji 200 Rp 5,890.00 Rp 1,178,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 0 Rp 30,000.00 Rp -
JUMLAH Rp 10,517,027.40
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS BEJEN
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 355 Rp 149.00
48 Kalk tab 1,839 Rp 59.00

1
1 2 3 4 5
62 Kodein 10 mg tab 126 Rp 550.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 70 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 3,544 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
4 Dexametason injeksi 5 mg/ ml amp 3,330 Rp 1,400.00
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 100 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 19 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 309 Rp 6,900.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 100 Rp 9,599.67
7 NaCl btl 33 Rp 6,410.00
8 RL btl 66 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 95 Rp 9,449.99
33 Kasa 36 x 80 cm rol 0 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 3 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 24 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 12 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS BEJEN
Jumlah Harga (Rp)
Rp -
Rp -
Rp 39,646.00
Rp -
Rp -
Rp 36,036.00
Rp 10,020.00
Rp 21,840.00
Rp 19,623.00
Rp 124,605.00
Rp 678,832.00
Rp 267,158.00
Rp -
Rp 154,560.00
Rp -
Rp 61,110.00
Rp 512,219.00
Rp 16,428.00
Rp -
1
Jumlah Harga (Rp)
Rp 81,423.00
Rp 206,957.00
Rp -
Rp -
Rp -
Rp -
Rp 3,000.00
Rp 98,078.20
Rp 121,920.00
Rp -
Rp 44,376.00
Rp 21,800.00
Rp -
Rp 24,250.00
Rp 15,276.00
Rp 36,608.00
Rp -
Rp 143,134.00
Rp 54,600.00
Rp 75,000.00
Rp 24,490.00
Rp 19,836.00
Rp 127,090.00
Rp -
Rp 6,864.00
Rp -
Rp 29,041.00
1
Jumlah Harga (Rp)
Rp 50,160.00
Rp -
Rp 28,773.00
Rp 87,570.00
Rp -
Rp -
Rp 10,974.00
Rp 8,904.00
Rp 52,895.00
Rp -
Rp -
Rp -
Rp 7,620.00
Rp 35,552.00
Rp -
Rp -
Rp 108,501.00
Rp 129,000.00
Rp -
Rp -
Rp 21,886.00
Rp 71,148.00
Rp 33,120.00
Rp -
Rp 37,800.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 172,494.00
Rp 15,435.00
Rp -
Rp 69,300.00
Rp 159,080.22
Rp -
Rp -
Rp 167,200.00
Rp -
Rp 18,573.00
Rp -
Rp -
Rp 56,064.00
Rp 65,850.00
Rp 260,400.00
Rp 35,870.00
Rp -
Rp 123,200.00
Rp -
Rp 482,232.00
Rp 112,700.00
Rp -
Rp -
Rp 57,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 13,000.00
Rp -
Rp -
Rp 731,192.00
Rp -
Rp -
Rp 524,746.00
Rp -
Rp -
Rp -
Rp -
Rp 7,400.00
Rp 19,530.00
Rp 330,120.00
Rp -
Rp -
Rp 27,300.00
Rp 55,401.00
Rp -
Rp -
Rp 213,950.00
Rp -
1
Jumlah Harga (Rp)
Rp 96,339.00
Rp 72,967.00
Rp -
Rp 572,539.59
Rp -
Rp 13,643,160.00
Rp -
Rp 12,500.00
Rp 196,350.00
Rp -
Rp 30,999.00
Rp -
Rp 304,784.00
Rp 16,660.00
Rp -
Rp 443,325.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 190,400.00
Rp 41,800.00
Rp 761,400.00
Rp -
Rp -
Rp 224,100.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 205,425.00
Rp -
Rp -
Rp -
Rp 130,540.00
Rp -
Rp -
Rp 49,400.00
Rp -
Rp -
Rp 327,600.00
Rp 263,228.00
Rp 17,784.00
Rp 105,894.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 673,030.00
Rp -
Rp -
Rp 40,106.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 15,400.00
Rp 4,662,000.00
Rp 5,138.10
Rp 15,750.00
Rp 1,749.00
Rp -
Rp -
Rp 265,300.00
Rp -
Rp 238,920.00
Rp -
Rp 1,060,800.00
Rp 74,820.00
Rp 208,512.00
Rp 28,600.00
Rp 100,606.00
Rp 74,400.00
Rp -
Rp -
Rp -
Rp 100,700.00
Rp 255,730.00
Rp -
Rp 5,560.00
Rp 1,045,800.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 219,600.00
Rp 220,920.00
Rp -
Rp -
Rp -
Rp -
Rp 170,848.00
Rp 112,665.00
Rp 857,571.00
Rp -
Rp 98,404.00
Rp -
Rp -
Rp -
Rp -
Rp 572,000.00
Rp 46,068.00
Rp -
Rp -
Rp 250,000.00
Rp 166,380.00
Rp -
Rp -
Rp 170,809.43
Rp 8,025.00
1
Jumlah Harga (Rp)
Rp 135,424.00
Rp -
Rp -
Rp 69,950.00
Rp -
Rp 328,832.00
Rp -
Rp 101,574.00
Rp 484,288.00
Rp -
Rp -
Rp -
Rp 12,000.00
Rp -
Rp -
Rp 15,167.00
Rp -
Rp -
Rp -
Rp -
Rp 388,960.00
Rp -
Rp -
Rp 72,000.00
Rp 31,900.00
Rp -
Rp 79,999.60
1
Jumlah Harga (Rp)
Rp 48,013.00
Rp 27,675.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 96,460.00
Rp -
Rp 2,132,100.00
Rp -
Rp -
Rp 959,967.00
Rp -
Rp 211,530.00
Rp -
Rp 471,900.00
Rp -
Rp -
Rp 489,566.00
Rp 817,960.00
Rp 474,220.00
Rp 9,240.00
Rp 14,993.00
Rp -
Rp 331,100.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 70,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 482,400.00
Rp 787,200.00
Rp 500,880.24
Rp 482,380.68
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 59,500.00
Rp 85,000.00
Rp 221,000.00
Rp 83,300.00
1
Jumlah Harga (Rp)
Rp 335,412.00
Rp 228,228.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,552,320.00
Rp 770,000.00
Rp 1,016,400.00
Rp -
Rp 1,096,200.00
Rp -
Rp 2,237,900.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,000.00
Rp 20,000.00
Rp -
Rp 897,749.05
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 123,000.00
Rp -
Rp 39,600.00
Rp -
Rp -
Rp -
Rp -
Rp 877,300.00
Rp 367,900.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,068,643.80
Rp 559,200.00
Rp 268,800.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 32,498.40
Rp -
Rp -
Rp 305,040.00
Rp 115,115.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 66,668.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 721,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 131,892.20
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 60,112.00
Rp -
Rp -
Rp 29,549.00
Rp -
Rp -
Rp 122,727.00
Rp 296,940.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 60,918,440.51
1
DI PUSKESMAS BEJEN
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 240 Rp 1,026.67 Rp 246,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 3 Rp 5,797.00 Rp 17,391.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 Gentamisin inj 40 mg/ ml amp 20 Rp 3,399.00 Rp 67,980.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1 Alat suntik ADS 0.05 ml set 288 Rp 3,575.00 Rp 1,029,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 4 Rp 83,600.00 Rp 334,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 1 Rp 24,000.00 Rp 24,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
43 N2O gas tbg 1 ### Rp 3,250,000.00
48 Plester rol 4 Rp 12,076.00 Rp 48,304.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 2 Rp 9,317.00 Rp 18,634.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 38,069,700.91
1
DI PUSKESMAS BEJEN
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS BEJEN
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 325 Rp 513.00 Rp 166,725.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 1,080,435.20
1
DI PUSKESMAS BEJEN
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS WONOBOYO
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 897 Rp 149.00
48 Kalk tab 4,985 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 6,690 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 2 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 88 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 5 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 12 Rp 6,900.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 9 Rp 6,410.00
8 RL btl 9 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 13 Rp 9,449.99
33 Kasa 36 x 80 cm rol 1 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 5 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 4 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 4 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
PUSKESMAS WONOBOYO
Jumlah Harga (Rp)
Rp -
Rp -
Rp 140,180.00
Rp -
Rp -
Rp 33,670.00
Rp 31,730.00
Rp 59,500.00
Rp -
Rp 52,650.00
Rp 3,982,744.00
Rp 339,140.00
Rp 51,900.00
Rp 223,650.00
Rp -
Rp 162,540.00
Rp 476,890.00
Rp 11,544.00
Rp -
1
Jumlah Harga (Rp)
Rp 68,475.00
Rp 101,210.00
Rp -
Rp -
Rp -
Rp 7,700.00
Rp 36,000.00
Rp 14,846.70
Rp 365,440.00
Rp -
Rp 8,600.00
Rp -
Rp -
Rp 17,460.00
Rp 46,900.00
Rp 19,760.00
Rp 116,160.00
Rp 69,620.00
Rp 163,800.00
Rp 75,000.00
Rp 63,200.00
Rp 15,390.00
Rp 142,000.00
Rp -
Rp 30,030.00
Rp -
Rp 54,484.00
1
Jumlah Harga (Rp)
Rp 34,200.00
Rp -
Rp 37,260.00
Rp 38,850.00
Rp -
Rp -
Rp 8,850.00
Rp -
Rp 133,653.00
Rp -
Rp -
Rp -
Rp -
Rp 39,600.00
Rp 32,350.00
Rp -
Rp 294,115.00
Rp -
Rp 46,710.00
Rp -
Rp 49,290.00
Rp 371,280.00
Rp -
Rp -
Rp 61,600.00
Rp 72,750.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 217,990.00
Rp 321,678.00
Rp 33,810.00
Rp -
Rp -
Rp 70,031.52
Rp -
Rp -
Rp -
Rp -
Rp 27,675.00
Rp -
Rp -
Rp 240,960.00
Rp 75,000.00
Rp 165,600.00
Rp 107,610.00
Rp -
Rp 62,400.00
Rp -
Rp 2,593,488.00
Rp 179,400.00
Rp -
Rp -
Rp 20,000.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 7,150.00
Rp -
Rp -
Rp 800,240.00
Rp -
Rp -
Rp 1,078,520.00
Rp -
Rp 17,000.00
Rp -
Rp -
Rp -
Rp -
Rp 48,300.00
Rp -
Rp -
Rp 21,840.00
Rp 45,725.00
Rp -
Rp -
Rp 258,500.00
Rp -
1
Jumlah Harga (Rp)
Rp 118,830.00
Rp 106,110.00
Rp -
Rp 212,488.92
Rp -
Rp 19,034,580.00
Rp -
Rp 22,500.00
Rp 210,000.00
Rp -
Rp -
Rp -
Rp 575,340.00
Rp 2,040.00
Rp -
Rp 720,475.00
Rp -
Rp -
Rp -
Rp 24,000.00
Rp -
Rp 193,800.00
Rp 75,240.00
Rp 119,475.00
Rp -
Rp -
Rp 51,300.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 279,675.00
Rp -
Rp -
Rp -
Rp 77,040.00
Rp -
Rp -
Rp 38,000.00
Rp -
Rp -
Rp 1,008,800.00
Rp 243,320.00
Rp -
Rp 180,412.00
Rp -
Rp -
Rp 108,624.00
Rp -
Rp -
Rp 308,210.00
Rp -
Rp -
Rp 1,823.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 7,700.00
Rp 32,200.00
Rp -
Rp 6,300.00
Rp 10,494.00
Rp -
Rp -
Rp 7,580.00
Rp -
Rp -
Rp -
Rp 353,600.00
Rp 5,160.00
Rp 141,696.00
Rp 2,288.00
Rp 133,155.00
Rp -
Rp 6,400.00
Rp -
Rp -
Rp 85,500.00
Rp 5,350.00
Rp -
Rp 2,780.00
Rp -
1
Jumlah Harga (Rp)
Rp 462,000.00
Rp -
Rp 23,058.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 71,936.00
Rp 60,900.00
Rp 833,583.00
Rp -
Rp 103,796.00
Rp -
Rp -
Rp -
Rp -
Rp 416,000.00
Rp 23,034.00
Rp -
Rp -
Rp 220,000.00
Rp -
Rp 90,650.00
Rp -
Rp 17,979.94
Rp 61,525.00
1
Jumlah Harga (Rp)
Rp 93,104.00
Rp -
Rp -
Rp 193,062.00
Rp -
Rp 351,953.00
Rp -
Rp 79,002.00
Rp 276,736.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 5,753.00
Rp -
Rp -
Rp -
Rp -
Rp 741,455.00
Rp -
Rp -
Rp 18,000.00
Rp -
Rp -
Rp 15,999.92
1
Jumlah Harga (Rp)
Rp 12,635.00
Rp 36,900.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 82,800.00
Rp -
Rp -
Rp -
Rp -
Rp 57,690.00
Rp -
Rp 64,350.00
Rp -
Rp -
Rp 276,122.00
Rp 225,544.00
Rp 180,780.00
Rp 4,620.00
Rp 1,499.30
Rp -
Rp 165,550.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 50,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 164,000.00
Rp 83,480.04
Rp 241,190.34
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 85,000.00
Rp 85,000.00
Rp -
Rp 85,000.00
1
Jumlah Harga (Rp)
Rp 271,194.00
Rp 277,662.00
Rp 125,400.00
Rp 125,400.00
Rp -
Rp -
Rp -
Rp -
Rp 126,720.00
Rp 92,400.00
Rp 138,600.00
Rp -
Rp 26,100.00
Rp 322,000.00
Rp 241,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 160,000.00
Rp 100,000.00
Rp -
Rp 122,849.87
Rp 130,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 205,000.00
Rp -
Rp 99,000.00
Rp 396,000.00
Rp -
Rp -
Rp -
Rp 254,700.00
Rp 198,100.00
Rp -
Rp -
Rp -
Rp -
Rp 62,500.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 314,307.00
Rp 93,200.00
Rp 89,600.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 12,999.36
Rp -
Rp -
Rp 53,382.00
Rp 35,035.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 33,334.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 44,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,485.00
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 244,600.08
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 160,480.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 49,962,070.11
1
DI PUSKESMAS WONOBOYO
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 90 Rp 1,026.67 Rp 92,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 133 Rp 5,797.00 Rp 771,001.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 Asam Traneksamat inj amp 6 Rp 6,199.60 Rp 37,197.60
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 4 Rp 83,600.00 Rp 334,400.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
22 Handscoon steril no 7 psg 185 Rp 7,865.00 Rp 1,455,025.00
31 Kapas 250 g bks 3 Rp 24,000.00 Rp 72,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
48 Plester rol 3 Rp 12,076.00 Rp 36,228.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
20 Mumifying pasta btl 2 Rp 616,000.00 Rp 1,232,000.00
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 1 Rp 18,612.00 Rp 18,612.00
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 33,466,535.01
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 OAT Anak/ FDC pkt 1 ### Rp 195,441.92
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 400 Rp 513.00 Rp 205,200.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 3,518,966.92
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS BEJEN
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 100 Rp 149.00
48 Kalk tab 5,091 Rp 59.00

1
1 2 3 4 5
62 Kodein 10 mg tab 100 Rp 550.00

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
84 Prednison 5 mg tab 1,983 Rp 68.00
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 4,075 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 0 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 0 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 7 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
3 Glucosa 5% btl 11 Rp 6,900.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 9 Rp 6,410.00
8 RL btl 22 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 11 Rp 9,449.99
33 Kasa 36 x 80 cm rol 1 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 5 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 22 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 9 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
1 2 3 4 5

1
PUSKESMAS BEJEN
Jumlah Harga (Rp)
Rp -
Rp -
Rp 88,838.00
Rp 25,280.00
Rp -
Rp 16,380.00
Rp -
Rp 52,080.00
Rp 61,380.00
Rp 544,830.00
Rp 2,310,720.00
Rp 378,014.00
Rp 51,900.00
Rp 116,340.00
Rp -
Rp 100,800.00
Rp 494,503.00
Rp 60,680.00
Rp -
1
Jumlah Harga (Rp)
Rp 12,699.00
Rp 152,513.00
Rp -
Rp -
Rp -
Rp 4,510.00
Rp 27,300.00
Rp 61,636.30
Rp 209,408.00
Rp -
Rp 6,020.00
Rp 10,900.00
Rp -
Rp 28,033.00
Rp 13,400.00
Rp 13,936.00
Rp -
Rp 71,626.00
Rp 54,600.00
Rp 67,500.00
Rp -
Rp 3,420.00
Rp 436,650.00
Rp -
Rp 34,710.00
Rp -
Rp 21,074.00
1
Jumlah Harga (Rp)
Rp 155,800.00
Rp -
Rp 80,316.00
Rp 142,170.00
Rp -
Rp -
Rp 12,980.00
Rp -
Rp 14,900.00
Rp -
Rp -
Rp -
Rp -
Rp 24,200.00
Rp -
Rp -
Rp 300,369.00
Rp -
Rp -
Rp -
Rp 161,510.00
Rp 403,368.00
Rp 75,900.00
Rp -
Rp 90,160.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 371,672.95
Rp 280,182.00
Rp 27,930.00
Rp 328,800.00
Rp 55,000.00
Rp 377,023.14
Rp 39,600.00
Rp -
Rp -
Rp -
Rp 19,434.00
Rp -
Rp -
Rp 112,512.00
Rp 57,000.00
Rp 74,400.00
Rp 24,476.00
Rp 3,150.00
Rp 497,760.00
Rp -
Rp 223,650.00
Rp 291,640.00
Rp -
Rp -
Rp 125,500.00
Rp 67,050.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 25,610.00
Rp -
Rp -
Rp 900,256.00
Rp -
Rp -
Rp 642,156.00
Rp -
Rp 134,844.00
Rp -
Rp -
Rp -
Rp -
Rp 573,930.00
Rp -
Rp -
Rp 13,650.00
Rp 28,851.00
Rp 28,910.00
Rp -
Rp 470,800.00
Rp -
1
Jumlah Harga (Rp)
Rp 209,967.00
Rp 79,386.00
Rp 23,165.00
Rp 433,409.94
Rp -
Rp 20,555,010.00
Rp -
Rp 15,000.00
Rp 105,000.00
Rp -
Rp 55,798.20
Rp -
Rp 350,450.00
Rp 18,700.00
Rp -
Rp 469,315.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 197,200.00
Rp 73,150.00
Rp 354,375.00
Rp -
Rp -
Rp 267,300.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 391,050.00
Rp -
Rp -
Rp 19,775.00
Rp 400,180.00
Rp -
Rp -
Rp 98,800.00
Rp -
Rp -
Rp 1,102,400.00
Rp 435,764.00
Rp 66,690.00
Rp 188,256.00
Rp -
Rp -
Rp 101,835.00
Rp -
Rp -
Rp 245,310.00
Rp -
Rp -
Rp 7,292.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 35,000.00
Rp -
Rp 24,150.00
Rp 3,498.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 530,400.00
Rp 3,870.00
Rp 206,208.00
Rp 175,032.00
Rp 82,852.00
Rp -
Rp -
Rp -
Rp -
Rp 77,900.00
Rp -
Rp -
Rp 41,700.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 231,678.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 332,704.00
Rp 255,780.00
Rp 737,631.00
Rp -
Rp 141,540.00
Rp -
Rp 52,200.00
Rp -
Rp -
Rp 468,000.00
Rp 46,068.00
Rp -
Rp -
Rp -
Rp 415,950.00
Rp -
Rp -
Rp -
Rp 48,150.00
1
Jumlah Harga (Rp)
Rp 495,144.00
Rp -
Rp -
Rp 338,558.00
Rp -
Rp 447,006.00
Rp -
Rp 161,766.00
Rp 282,752.00
Rp 3,250.00
Rp -
Rp -
Rp 24,000.00
Rp -
Rp -
Rp 8,891.00
Rp -
Rp -
Rp -
Rp -
Rp 1,166,880.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 17,689.00
Rp 53,300.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 75,900.00
Rp -
Rp -
Rp -
Rp -
Rp 57,690.00
Rp -
Rp 157,300.00
Rp -
Rp -
Rp 338,800.00
Rp 406,560.00
Rp 369,420.00
Rp 2,772.00
Rp 13,493.70
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp 100,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 442,200.00
Rp 360,800.00
Rp 375,660.18
Rp 482,380.68
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 85,000.00
Rp 85,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 277,200.00
Rp 369,600.00
Rp -
Rp 188,100.00
Rp -
Rp -
Rp -
Rp -
Rp 102,960.00
Rp 23,100.00
Rp 92,400.00
Rp -
Rp 208,800.00
Rp 322,000.00
Rp 128,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 60,000.00
Rp 40,000.00
Rp -
Rp 103,949.89
Rp 130,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 205,000.00
Rp -
Rp -
Rp 99,000.00
Rp -
Rp -
Rp -
Rp 169,800.00
Rp 169,800.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 895,774.95
Rp 512,600.00
Rp 201,600.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 16,249.20
Rp -
Rp -
Rp 381,300.00
Rp 155,155.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 50,001.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 215,823.60
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 5,380.00
Rp -
Rp 180,608.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 110,454.30
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 54,966,607.15
1
Jumlah Harga (Rp)
1
DI PUSKESMAS TRETEP
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
3 Asifit kap 300 Rp 1,026.67 Rp 308,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 101 Rp 5,797.00 Rp 585,497.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 3 Rp 83,600.00 Rp 250,800.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 8 Rp 24,000.00 Rp 192,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 1 Rp 154,000.00 Rp 154,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 0 Rp 9,317.00 Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 1 Rp 29,051.00 Rp 29,051.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
JUMLAH Rp 28,089,784.99
1
DI PUSKESMAS TRETEP
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
DI PUSKESMAS TRETEP
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 MB Kusta strip 2 Rp 28,424.00 Rp 56,848.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 410 Rp 513.00 Rp 210,330.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
2 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Ziehl nelson btl 2 Rp 276,500.00 Rp 553,000.00
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
3 Paket Alat Deteksi Resiko Keha paket 0 Rp 522,083.00 Rp -
6 Lugol btl 1 Rp 30,000.00 Rp 30,000.00
JUMLAH Rp 3,646,089.80
1
DI PUSKESMAS TRETEP
ARAN : APBD I (Buffer Prof), JPKMM dan Program
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
PUSKESMAS BANJARSARI
1 2 3 4 5
TABLET
0 TABLET 0 0 Rp -
0 Asifit kap 0 Rp -
1
1 2 3 4 5

1
1 2 3 4 5
44 HCT 25 mg tab 355 Rp 149.00
48 Kalk tab 3,270 Rp 59.00

1
1 2 3 4 5

1
1 2 3 4 5
0 Nodiar tab 0 Rp -
86 PTU 100 mg tab 0 Rp 279.00

1
1 2 3 4 5
103 Tiamin 50 mg/ B1 tab 2,143 Rp 86.00
106 Zink 20 mg tab 0 Rp 473.00
0 0 0 0 Rp -
0 SYRUP 0 0 Rp -

1
1 2 3 4 5
0 OBH btl 0 Rp -
0 0 0 0 Rp -
0 INJEKSI 0 0 Rp -

1
1 2 3 4 5
17 MgSO4 20% amp 1 Rp 3,200.00
18 MgSO4 40% amp 0 Rp 3,650.00

1
1 2 3 4 5
0 0 0 0 Rp -
12 Etanol 70% 100 ml btl 0 Rp 2,500.00

1
1 2 3 4 5

1
1 2 3 4 5
34 Salep 2-4 pot 4 Rp 2,527.00
0 0 0 0 Rp -
0 INFUS 0 0 Rp -
2 Glucosa 40% btl 0 Rp 1,452.00
4 Ka-En 3A btl 0 Rp 10,050.00
5 Ka-En 3B btl 0 Rp 10,696.00
6 Ka-En Mg 3 btl 0 Rp 9,599.67
7 NaCl btl 6 Rp 6,410.00
8 RL btl 11 Rp 7,150.00
0 0 0 0 Rp -
0 BMHP 0 0 Rp -

1
1 2 3 4 5

1
1 2 3 4 5
32 Kasa 2 m x 80 cm rol 15 Rp 9,449.99
33 Kasa 36 x 80 cm rol 1 Rp 130,000.00

1
1 2 3 4 5
34 Lysol 1 L btl 0 Rp 41,000.00
41 Silk 2/0 DS 24 mm sac 0 Rp 23,300.00
42 Silk 3/0 DS 24 mm sac 0 Rp 22,400.00

1
1 2 3 4 5
0 0 0 0 Rp -
0 GIGI 0 0 Rp -
0 Cavit box 0 Rp -

1
1 2 3 4 5
0 OCO btl 0 Rp -
0 0 0 0 Rp -
0 LABORAT 0 0 Rp -
3 Bufer 1 L btl 0 Rp 80,000.00
4 Eosin 2 % btl 0 Rp 230,000.00

1
1 2 3 4 5
0 H2SO4 btl 0 Rp -
5 Hayem btl 0 Rp 220,000.00
9 Na citrat 3,8 % btl 0 Rp 27,500.00

1
1 2 3 4 5
0 Turk btl 0 Rp -
0 0 0 0 Rp -
0 VAKSIN 0 0 Rp -
0 BCG amp 0 Rp -
0 POLIO amp 0 Rp -
0 CAMPAK amp 0 Rp -
0 TT amp 0 Rp -
0 HB U amp 0 Rp -
0 DT amp 0 Rp -
0 TD amp 0 Rp -
0 0 0 0 Rp -

1
1 2 3 4 5
0 Naia tab 0 Rp -
0 Lugol btl 0 Rp -
0 Larsi kap 0 Rp -
JUMLAH
1
1 2 3 4 5

1
PUSKESMAS BANJARSARI
Jumlah Harga (Rp)
Rp -
Rp -
Rp 52,632.00
Rp -
Rp -
Rp 48,412.00
Rp -
Rp 14,280.00
Rp 27,900.00
Rp 206,115.00
Rp 1,417,288.00
Rp 181,908.00
Rp 60,550.00
Rp 319,515.00
Rp -
Rp 56,700.00
Rp 331,145.00
Rp 38,628.00
Rp -
1
Jumlah Harga (Rp)
Rp 21,912.00
Rp 36,645.00
Rp -
Rp -
Rp -
Rp 28,380.00
Rp -
Rp 34,192.40
Rp 114,656.00
Rp -
Rp 13,072.00
Rp -
Rp -
Rp 15,035.00
Rp 17,420.00
Rp 31,824.00
Rp -
Rp 60,770.00
Rp -
Rp -
Rp 31,600.00
Rp 13,509.00
Rp 42,600.00
Rp -
Rp 16,224.00
Rp -
Rp 27,242.00
1
Jumlah Harga (Rp)
Rp 151,240.00
Rp -
Rp 31,050.00
Rp 77,280.00
Rp -
Rp -
Rp 5,900.00
Rp 11,200.00
Rp 52,895.00
Rp -
Rp -
Rp -
Rp -
Rp 8,800.00
Rp -
Rp -
Rp 192,930.00
Rp 68,800.00
Rp 62,280.00
Rp -
Rp 12,524.00
Rp 219,324.00
Rp -
Rp -
Rp 70,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp 158,042.75
Rp 208,614.00
Rp -
Rp -
Rp -
Rp 129,799.80
Rp -
Rp -
Rp -
Rp -
Rp 28,782.00
Rp -
Rp -
Rp 64,320.00
Rp 13,500.00
Rp 105,000.00
Rp 21,100.00
Rp 7,290.00
Rp 138,400.00
Rp -
Rp 506,940.00
Rp 77,510.00
Rp -
Rp -
Rp 49,300.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 11,700.00
Rp -
Rp -
Rp 78,960.00
Rp -
Rp -
Rp 223,256.00
Rp -
Rp -
Rp -
Rp -
Rp 7,400.00
Rp -
Rp 236,985.00
Rp -
Rp -
Rp -
Rp 21,535.00
Rp 5,600.00
Rp -
Rp 132,000.00
Rp -
1
Jumlah Harga (Rp)
Rp 211,599.00
Rp -
Rp -
Rp 105,120.18
Rp -
Rp 5,267,520.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 184,298.00
Rp -
Rp -
Rp 281,060.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 280,060.00
Rp 238,950.00
Rp -
Rp -
Rp 172,800.00
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 42,075.00
Rp -
Rp -
Rp -
Rp 177,620.00
Rp -
Rp -
Rp 19,000.00
Rp -
Rp -
Rp 171,600.00
Rp 184,702.00
Rp 8,892.00
Rp 27,454.00
Rp -
Rp -
Rp 61,101.00
Rp -
Rp -
Rp 150,960.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 4,200.00
Rp -
Rp 3,150.00
Rp 8,745.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 530,400.00
Rp -
Rp 172,800.00
Rp 205,920.00
Rp 56,221.00
Rp -
Rp 3,200.00
Rp -
Rp -
Rp 76,000.00
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 92,050.00
Rp -
Rp -
Rp -
Rp -
Rp 193,328.00
Rp 121,800.00
Rp 467,766.00
Rp -
Rp 57,964.00
Rp -
Rp 5,800.00
Rp -
Rp -
Rp 270,400.00
Rp 23,034.00
Rp -
Rp -
Rp -
Rp -
Rp 108,780.00
Rp -
Rp -
Rp 147,125.00
1
Jumlah Harga (Rp)
Rp 215,832.00
Rp -
Rp -
Rp 137,102.00
Rp -
Rp 154,140.00
Rp -
Rp 20,691.00
Rp 69,184.00
Rp 100,750.00
Rp -
Rp -
Rp 9,000.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 753,610.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 10,108.00
Rp 8,200.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 55,200.00
Rp -
Rp -
Rp -
Rp -
Rp 38,460.00
Rp -
Rp 78,650.00
Rp -
Rp -
Rp 711,480.00
Rp 479,160.00
Rp 255,450.00
Rp -
Rp 1,499.30
Rp -
Rp 331,100.00
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 160,800.00
Rp 98,400.00
Rp -
Rp 40,198.39
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp 300,300.00
Rp 300,300.00
Rp -
Rp 188,100.00
Rp -
Rp -
Rp -
Rp -
Rp 79,200.00
Rp 69,300.00
Rp 61,600.00
Rp -
Rp 69,600.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 10,000.00
Rp 50,000.00
Rp -
Rp 141,749.85
Rp 130,000.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 345,737.70
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 152,520.00
Rp 5,005.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 33,334.00
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,485.00
Rp 234,909.12
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp -
Rp 95,921.60
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
1
Jumlah Harga (Rp)
Rp -
Rp -
Rp -
Rp 94,248.00
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 22,676,231.09
1
Jumlah Harga (Rp)
1
DI PUSKESMAS BANJARSARI
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
7 OBH btl 56 Rp 5,797.00 Rp 324,632.00
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
9 Bisturi box 1 Rp 83,600.00 Rp 83,600.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
31 Kapas 250 g bks 4 Rp 24,000.00 Rp 96,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
39 Lysol 1 L btl 0 Rp 41,000.00 Rp -
48 Plester rol 1 Rp 12,076.00 Rp 12,076.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
3 Cavit box 2 Rp 154,000.00 Rp 308,000.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
21 OCO btl 0 Rp 125,400.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
4 H2SO4 btl 0 Rp 18,612.00 Rp -
5 HCl 0,1 N btl 1 Rp 9,317.00 Rp 9,317.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
23 Turk btl 0 Rp 29,051.00 Rp -
0 0 0 0 Rp - Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
5 Naia tab 0 Rp 1,664.67 Rp -
9 Larsi kap 60 Rp 1,026.67 Rp 61,600.00
JUMLAH Rp 18,507,724.73
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Keterangan
7
1
Harga Satuan
(Rp)
1 2 3 4 5 6
TABLET
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
11 Retinol 200.000 UI tab 1,245 Rp 519.20 Rp 646,404.00
1
Harga Satuan
(Rp)
1 2 3 4 5 6
13 Zink 20 mg tab 0 Rp 513.00 Rp -
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 0 0 0 Rp - Rp -
1
Harga Satuan
(Rp)
1 2 3 4 5 6
0 Salbutamol inh 100 mcg/ Ventol btl

Obat Desember

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Obat Desember

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Temanggung Dharmarini Tlogomulyo Selopampang Temba

Nama Obat dan Alat Satu-

1 Albendazol 400 tab 900 983 1,958 200

2 Alopurinol 100 mg tab

5 Aminofilin 200 mg tab

13 Asam Askorbat 50 mg tab

19 Asiklofir 200 mg tab

31 Dietil Carbamazin 100 mg tab 0 0 0 0

32 Digoksin 0,25 mg tab

45 Garam Oralit tab

49 Griseovulvin 125 mg tab

51 Haloperidol 0,5 mg tab

56 Hiosina + Metampiron/ Dormi tab 433 510 710 743

57 Ibuprofen 200 mg tab 207 0 0 0

58 Ibuprofen 400 mg tab

66 Kaptopril 12,5 mg tab

70 Ketokonazol 200 mg tab

86 Meloksikam 15 mg tab 0 435 500 33

87 Metformin 500 mg tab

94 N-Asetil Sistein 200 mg kap

97 New Pro Uric kap 0 0 0 0

101 OAT Anak/ FDC pkt 0 0 0 0

102 OAT FDC I/III pkt 2 0 0 1

103 OAT kat I/ Kombipak pkt 0 0 0 0

104 OAT kat II pkt 0 0 0 0

105 Omeprazol 20 mg tab

110 Piracetam 800 mg tab 70 190 25 60

111 Piridoksin/ B6 10 mg tab

113 Prednison 5 mg tab

115 Pro Lipid tab 0 360 0 0

116 Propanolol 40 mg tab

120 Retinol 200.000 UI tab 506 0 0 2,758

121 Risperidon 2 mg tab

125 Sefadroksil 500 mg tab

134 Teofilin 150 mg tab

139 Tiamin 50 mg/ B1 tab

3 Amoksisilin sir 250 mg/ 5 ml btl

7 Dextrofen sirup btl 38 32 86 57

8 Domperidon sirup 5 mg/ 5 ml btl

12 Ibuprofen susp 100mg/5ml btl

15 Kloramfenikol susp 125 mg/ 5 btl

18 Metokloperamid drops btl

21 Pacdin Vitcur sirup btl

22 Parasetamol drops btl

30 Zink drops 10 mg/ml btl

5 Atropin Sulsat inj amp

8 Difenhidramin injeksi 10 mg/ m amp 16 2 45 29 19

11 Flufenazin inj 25mg/ml - Sikzo amp 0 50 0 0

12 Furosemid inj 10 mg/ ml amp

14 Glukonas Calcicus inj 10% amp

15 Haloperidol inj i.m. 5 mg/ml (L amp 0 12 0 0

16 Human Tetanus Imuno 250 UI amp

24 Nalokson inj 0,4 mg/ml (Nokob amp 0 0 0 0

25 Oksitosin injeksi 10 UI/ ml amp

28 Ranitidin inj 25 mg/ 2 ml amp

33 Vit K1/Fitomenadion inj 2 mg/ amp 83 120 30 84 60 0

7 Betametason krim 0,1 % tube

9 Bisakodil sup dws supo

15 Etakridin Larutan 0,1 % btl 19 0 29 0

16 Etanol 70% 100 ml btl

25 Hidrokortison krim 2,5 % tube

27 Ketokonazol krim 2 % tube

33 Lidokain Spray 10%/ Xylocaine btl 0 0 2 0 0