SUMBER STOK STOK

NO NAMA BARANG SATUAN MASUK KELUAR PENYESUAIAN ED No Batch

DANA AWAL AKHIR

20 05 2021 G19149059

40 06 2021 G19210067

5 06 2021 G19212069
DAK 19
70 07 2021 G19245077

1 AUTOCHECK Blood Glucose Test Btl/25 5 07 2021 G19280076

Strip
140

- 80 07 2021 G19281076

DAK 19 195 07 2021 G19280076

- 275

5 12 2020 C19143074A

140 01 2021 C19151072A

AUTOCHECK Total Cholesterol DAK 19
2 Btl/10 80 03 2021 C19202100
Test Strip
225

DAK 19 - 200
55 03 2021 U19102079A

50 04 2021 U19149090
DAK 19
35 05 2021 U19161100

140
3 AUTOCHECK Uric Acid Test Strip Btl/25
260 05 2021 U19165100

9 05 2021 U19166100
DAK 19
6 05 2021 U19161100

275

4 Dulcolax Tab. 5mg Box/10 DAK 19 960 04 2022 19040566

5 Medonic Diluen 20L (900 cycle) Box DAK 19 13 12 2020 1712858

6 Medonic Lyze 5L (900 Cycle) Box DAK 19 13 06 2021 1806953

126 07 2023

996 11 2023
8 Na Diklofenak Tab. 50mg Box/50 DAK 19
378 11 2023

1,500

1,120 08 2023 16364062

345 03 2022 26364016

8 Na Diklofenak Tab. 25mg Box/50 DAK 19
35 12 2021 16364114

1,500

7 Primaquin Tab. 5mg Box/100 DAK 19 1,000 02 2022 26386001

8 Tabung Vacuntainer Pak/100 DAK 19 5 04 2022 190401

1 04 2021 9110739

9 Flashback Needle Pak/50 DAK 19 1 04 2021 9110736

Blood Lancet Box/100 DAK 19 100 07 2020 B1317

Microlit Tips Kuning Pak/1000 DAK 19 10 08 2023 SMI20180901

100 04 2024 69182 32487

60 04 2024 69182 32499

50 04 2024 69182 32496

Sarung Tangan Uk. M Box/100 DAK 19 10 04 2024 69182 32489

50 04 2024 69182 32494

30 04 2024 69182 32490

300

Alkohol Swab Box/100 DAK 19 124 02 2020 B0217

Bracket Handsanitizer Unit DAK 19 10 11041988

 SUMBER STOK STOK
NO NAMA BARANG SATUAN MASUK KELUAR PENYESUAIAN ED No Batch
DANA AWAL AKHIR

Masker Bedah Box/50 DAK 19 500 12111886

Micropipet 10 s/d 100ul Unit DAK 19 1

Micropipet 20 s/d 200ul Unit DAK 19 1

Pipet Karet Pak/100 DAK 19 2

Safety Box Unit DAK 19 49

Spiritus Botol DAK 19 20

Tissue Gulung Roll DAK 19 500

Aseptic Gel Botol 500ml DAK 19 120 - 120 09 2022 11101988

Plesterin Bulat Box/200 DAK 19 100 - 100 07 2024 21081988

Fenitoin Kaps 100mg Botol/100 DAK 19 - 200 - 200 10 2021 391002

 LAPORAN PERSEDIAAN OBAT
Periode Desember 2

SUMBER Rimba KELAPA VGU

NO NAMA BARANG SATUAN
DANA
SAMKAI
Jaya
KARANG
DA
NG

ARANG
INDAH
OBAT
1 Air untuk injeksi amp 25 ml Vial BS PROP
2 Albendazol tab 400 mg Box/100 DAK 18 850 300
DAK 17 900 700
3 Alopurinol tab 100 mg Box/100 DAK 18
DAK 19
DAK 18 3700 2000
4 Ambroksol tab 30mg Box/100
DAK 19
5 Aminofilin inj 24 mg/ml Ampul DAK'18
6 Aminofilin tablet 200 mg Btl/100 DAK 19 200
7 Amlodipin tab 10 mg Box/50 DAK 19 1400 700
8 Amlodipin tab 5 mg Box/50 DAK 19 500
9 Amoksisilin sir forte 250 mg/5 ml Botol DAK 19 40 60
10 Amoksisilin sir kering 125 mg/5 ml Botol DAK 19 88 5
DAK 18 900 450
11 Amoksisilin kapsul 250 mg Box/100
DAK 19
DAK 18 4900 2000
12 Amoksisilin tablet 500 mg Box/100
DAK 19
13 Ampisilin serb inj 1000 mg/vial Vial BS PROP

Anestetik lokal gigi kombinasi : lidokain hcl 2% + Box/30 DAK 16 10

14
epinefrin 1 : 80.000 inj 2 ml Box/30 DAK 18
DAK 18 200 400
15 Antalgin tab 500mg Box/100
DAK 19

16
Antasida, kombinasi : aluminium hidroksida 200 mg + Botol DAK 19 30 55
magnesium hidroksida 200 mg
Antasida, kombinasi : aluminium hidroksida 200 mg + DAK 18 3400 1000
17 Box/100
magnesium hidroksida 200 mg DAK 19
18 Antibakteri DOEN, Kombinasi Tube DAK 18 25 25
Box/24 BS PROP
19 Antifungi DOEN, Kombinasi
Pot DAK 19 20

Antihemoroid, kombinasi: bismut subgalat 150 mg +

20 heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng Box/10 DAK 19 100 20
oksida 120 mg + sup ad 2 g

21 Aquajel Steril Jelly 28g tube

22 Artesunat serb inj 60 mg/ml (i.v./i.m.) Box/8 BS PROP

23 Asam asetilsalisilat (asetosal) tab 80 mg (Miniaspi tab) Box/100 DAK 19

24 Asam askorbat (vitamin C) tab 250 mg Box/100 DAK 18 1000 700

DAK 18 700 1000
25 Asam askorbat (vitamin C) tab 50 mg Box/100
25 Asam askorbat (vitamin C) tab 50 mg Box/100
DAK 19
BS PROP
26 Asam folat tab 1 mg Box/100
DAK 19
27 Asam mefenamat tab 500 mg Box/100 DAK 19 2300 1500
28 Asam traneksamat inj 10% 500mg/5ml Box/10
29 Asiklovir cream Tube BS PROP 20
30 Asiklovir tablet 200 mg Box/50 DAK 19
31 Asiklovir tablet 400 mg Box/50 DAK 19 200 1000
32 Atropin Sulfat Inj. Ampul DAK 19
33 Attalpugit tab 500mg Box/100
34 Azitromisin tab 500 mg Box/20 BS PROP 200
35 Bedak salisil serb 2% Pot DAK 17
36 Benzatin Benzil Penisilin 1,2Jt IU Vial
37 Benzatin Benzil Penisilin 2,4Jt IU Vial BS PROP
DAK 18 55
38 Betametason krim 0,5 mg/g Tube
DAK 19
39 Bisakodil tab sal 5 mg (Dulcolax Tablet) Box/200 DAK 19
40 Bisakodil Supp. 5 mg (Dulcolax Supp.) Supp DAK 19
41 Bisakodil Supp. 10 mg (Dulcolax Supp.) Supp DAK 19 5
42 Bisoprolol tab 5 mg Box/ 30
43 Deksametason inj 5 mg/ml (i.v./i.m.) Box/10 DAK 19 69
44 Deksametason tab 0,5 mg Box/100 DAK 18 3200 800
45 Desoksimetason krim Tube
46 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul DAK 16 5 10
47 Diazepam tab 2 mg BTL/100 DAK 16
48 Dietilkarbamazin tab 100 mg Box/100 BS PROP
DAK 17 73 30
49 Difenhidramin inj 10 mg/ml (i.v./i.m.) Box/30
DAK 18
50 Digoksin tab 0,25 mg Box/100
51 Diltiazem hcl tab 30 mg Box/100
52 Dimenhidrinat tab 50 mg Btl/100 DAK 19 100 700
DAK 16 600
53 Doksisiklin kaps 100 mg Box/100
DAK 18
54 Domperidon susp 5 mg/5 ml BTL 60 ml DAK 19
55 Domperidon tab 10 mg Box/100 BS PROP 400
56 Efedrin tab 25 mg Btl/100
57 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) Ampul BS PROP 177 60
58 Eritromisin tab 500 mg Box/100 DAK 18 200 200
Btl 100ml DAK 17 5
59 Etanol cairan 70%
Btl 300ml DAK 17 11 3
60 Etil klorida semprot 200 ml Botol DAK 19 3 2
61 Fenitoin Na kaps 100 mg Btl/100 DAK 18
62 Fenobarbital inj 50mg/ml Ampul DAK 16
63 Fenobarbital tab 30 mg Btl/100
64 Fenol Gliserol tetes telinga Btl 5ml DAK 18 20
65 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) Ampul DAK 19 30 20
DAK 18 300 200
66 Fitomenadion (vitamin K 1) tab sal 10 mg Box/100
DAK 19
67 Framisetin Sulfat Tulle 1% (Daryantulle) Box/10
68 Furosemid inj 10 mg/ml (i.v./i.m.) Box/25 DAK 19 60
DAK 18 400 100
69 Furosemid tab 40 mg Box/200
DAK 19
Box/100 BS PROP 300
Garam oralit kombinasi : natrium klorida 0,52 g + kalium
70 klorida 0,30 g + trinatrium sitrat 0,58 g + glukosa Box/25 DAK 19
anhidrat 2,7 g
Box/100 DAK 19 600
71 Gentamisin inj Box/5 BS PROP 10
72 Gentamisin salep kulit Tube DAK 18 50
73 Gentamisin tetes mata Botol
74 Gentian violet Botol DAK 18
Btl/100 DAK 18 1100 1500
75 GG tab 100 mg
Box/100 DAK 19
DAK 15 300 200
76 Glibenklamid tab 5 mg Box/100
DAK 16
77 Glimepirid tab 2 mg Box/50
78 Gliserol sol. 100 ml Botol DAK 15 57
79 Glukosa Larutan Infus 10% steril 500 ml Kolf 500 ml DAK 16
80 Glukosa Larutan Infus 40% steril 25 ml Kolf 25ml DAK 19
81 Glukosa Larutan Infus 5% steril 500 ml Kolf 500 ml DAK 18 40 10
82 Griseofulvin (micronized) tab 125 mg Box/100 DAK 19 600 200
83 Griseofulvin (micronized) tab 500 mg Box/100 DAK 19
DAK 18 300
84 Hidroklorotiazid tab 25 mg Box/100 DAK 18
DAK 19
85 Hidrokortison krim 2,5% Tube DAK 18 61 38
86 Hiosina butilbromida Inj (Buscopan Injeksi) Box/10 DAK 16

87 Hiosina butilbromida tab 10 mg (Buscopan Tablet) Box/100

88 Ibuprofen tab 200 mg Box/100 BS PROP 3200

89 Ichtiol salep kulit Pot
90 Isosorbid dinitrat tab 5 mg Box/100 BS PROP 500
91 Isoniazid tab 300 mg Box/100 DAK 18
92 Isoniazid tab 100 mg (PP INH) Box/100 BS PROP
93 Kalsium laktat (kalk) tab 500 mg Box/100 DAK 19 3000 2000
94 Kanamisin serb inj 1000 mg Box/10 DAU 15
95 Kaptopril tab 25 mg Box/100 DAK 19 4500 500
Karbon Aktif Tab. Botol/40 DAK 19 600
96 Ketokonazol salep kulit Tube BS PROP 40 50
DAK 19 250 100
97 Ketokonazol tab 200 mg Box/50
DAK 19
98 Ketorolak inj. 30mg/ml Box/6 DAK 19
99 Klindamisin kaps 150mg Box/50 DAK 18 300 250
100 Klindamisin kaps 300mg Box/50
101 Klonidin tab 0,15 mg Box/100 DAK 15
102 Klopidogrel tab 75 mg Box/30
DAK 18 50 10
103 Kloramfenikol salep mata 1% Tube
DAK 19
104 Kloramfenikol tetes telinga 3% Botol
105 Klorfeniramin tab 4 mg (CTM) Box/100 DAK 19 3900 1500
106 Kodein tab 10 mg Box/100

107
Kombinasi (DHP) : Dihidroartemisin 40 mg + Piperakuin Box/9 BS PROP 108
320 mg tab sal selaput
108 Kombinasi : Ergotamin 1 mg+ Kafein 50 mg Botol/100

Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 mg DAK 18 20310 4350

109 Box/30
tab salut (Tablet Tambah darah) DAK 19

110
Kombinasi : Thiamin HCl + Piridoksin + Sianokobalamin Box/20
inj

111
Kombinasi : Thiamin HCl + Piridoksin + Sianokobalamin Box/200
tablet

112
Kotrimoksazol (dewasa) tablet kombinasi : Box/100 DAK 19 200 500
sulfametoksazol 400 mg+ trimetoprim 80 mg

113
Kotrimoksazol (dewasa) tablet kombinasi : Box/100 BS PROP
sulfametoksazol 800 mg+ trimetoprim 160 mg
Kotrimoksazol sirup kombinasi : sulfametoksazol 200 DAK 18 30 30
114 Botol
mg+ trimetoprim 40 mg per 5ml DAK 19
115 Lamprene Kapsul 100mg Kapsul BS PROP
116 Lansoprazol Kapsul Box/20 DAK 18 600

Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75

117 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27 gr) (KA EN Kolf 500 ml DAK 18
3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34
118 gr, Na Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KA EN Kolf 500 ml DAK 18
3A)
119 Lidokain gel 2% (Xilocain Jel) Tube
120 Lidokain HCl inj 2% Box/100 DAK 16 100
121 Lisinopril tab 10mg Box/30
122 Lisinopril tab 5mg Box/30
123 Loperamid tab 2 mg Box/100
124 Loratadin tab 10 mg Box/50 DAK 18 250
125 Magnesium sulfat inj 20% Vial BS PROP 2
126 Magnesium sulfat inj 40% Vial BS PROP
127 MD/MB COMBI Anak Box/6 blister BS PROP
128 MD/MB COMBI Dewasa Box/6 blister BS PROP
129 Meloksikam tab 15 mg Box/100 DAK 19 2000
130 Meloksikam tab 7,5 mg Box/50 DAK 19 2500
131 Metformin tab 500 mg Box/100 DAK 18 2200 300
BS PROP 20
132 Metilergometrin inj 0,2 mg/ml Ampul
DAK 19
133 Metilergometrin tab salut 0,125 mg Box/100 DAK 18 100
134 Metoklopramid tab 10 mg Box/100 DAK 18
135 Metronidazol tab 250 mg Box/100
136 Metronidazol tab 500 mg Box/100 BS PROP 400
137 Mikonazol krim 2% Tube DAK 18 42 40
BS PROP
138 Mineral Mix Box/40
DAK 19
139 NaCl 0,9% Larutan Kolf 500 ml DAK 18 30 20
BS PROP 550
140 Natrium diklofenak tab 25 mg Box/50
DAK 19
141 Natrium diklofenak tab 50 mg Box/50 DAK 19
142 Nifedipin kaps 10 mg Box/100 100 400
 Nistatin tab 500.000IU Box/100 DAK 19
143 Nistatin tab vaginal 100.000 UI Box/100 DAK 19 200 100
144 Obat Anti Tuberculosis FDC Kategori Anak Paket BS PROP 1 3
145 Obat Anti Tuberculosis FDC Kategori I Paket BS PROP 1 2
146 Obat Anti Tuberculosis FDC Kategori II Paket BS PROP 1 1
147 OBH Sirup Botol
148 Oksitetrasiklin 1% salep mata Tube Dak 18 50
149 Oksitetrasiklin 3% salep kulit Tube DAK 18 50 100
150 Oksitosin inj 10 UI/ml Ampul BS PROP 41
DAK 16 500
DAK 17
151 Omeprazol kaps 20 mg Box/30
DAK 18
DAK 19
152 Papaverin tab 40 mg Box/100 DAK 18
153 Paraformaldehid tab 1 g Btl/100 OP 09
154 Parasetamol infus Botol
155 Parasetamol sir 120 mg/5 ml Botol 110
156 Parasetamol tab 100 mg Botol/100
157 Parasetamol tab 500 mg Box/100 DAK 19 5300 3500
158 Parasetamol tts 60 mg/0,6 ml Botol BS PROP 30
159 PD/PB Anak Box/6 blister BS PROP
160 PD/PB Dewasa Box/6 blister BS PROP
161 Pirantel pamoat susp 125 mg/5 ml Botol DAK 19 25
DAK 18
162 Pirantel pamoat tab scored 125 mg Box/100
DAK 19
DAK 18 700 800
163 Piridoksin (vitamin B6) tab 10 mg Box/100
DAK 19
164 Piroksikam tab 10mg Box/100
Btl 60 ml DAK 17 42
165 Povidon iodin lar 100 mg/ml DAK 17
Btl 300 ml
DAK 18
166 PPD RT 23 (Mantoux Test) Vial BS PROP
Btl/1000 DAK 16
167 Prednison tab 5 mg DAK 18 700
Box/100
DAK 19
BS PROP 700
168 Primakuin tab 15 mg Box/100
DAK 19
169 Propranolol tab 10 mg Btl/100 DAK 19
170 Propranolol tab 40 mg Box/100
171 Ranitidin Inj Box/10 DAK 19
172 Ranitidin tab 150 mg Box/30 DAK 19 1900
173 Retinol (vitamin A) kaps lunak 100.000 UI Btl/50 BS PROP 550
DAK 18 2200
174 Retinol (vitamin A) kaps lunak 200.000 UI Btl/50
DAK 19
175 Rifampisin tab 450mg Box/100 DAK 18
Pengembalian RSUD 20 40
176 Ringer Laktat Larutan Kolf 500 ml
DAK 19
177 Rivanol Sol 10% Botol 300ml DAK 18 4
178 Salbutamol cairan ih 0,1% (Ventolin Nebule) Box/20 amp
179 Salbutamol tab 2 mg Box/100
180 Salbutamol tab 4 mg Box/100 BS PROP 600 1000
DAK 18 55 12
181 Salep 2-4, Kombinasi Pot 30g
DAK 19
182 Sefiksim kaps 100mg Box/30 BS PROP
183 Sefotaksim seb inj 1000 mg Vial DAK 19
184 Seftriakson serb inj 1000 mg Vial DAK 19

Serum anti bisa ular :A.B.U.II (khusus ular dari Papua) inj DAK 19
185 Botol
(i.m./i.v.)

186 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul DAK 18

187 Setirisin tab 10 mg Box/100

188 Sianokobalamin (Vit. B12) inj Ampul
189 Simvastatin tab 10 mg Box/30 BS PROP
190 Siprofloksasin tab scored 500 mg Box/100 400
191 Spironolakton tab 25 mg Box/100 300
192 Sukralfat tab 500mg (Ulsidex) Box/100
193 Tetrasiklin kaps 250 mg Box/100 DAK 18 100
194 Tetrasiklin kaps 500 mg Box/100 DAK 17
195 Tiamin (vitamin B1) inj Box/30
DAK 18 600 500
196 Tiamin (vitamin B1) tab 50 mg Box/100
DAK 19
197 Tramadol inj 100 mg Ampul DAK 18
BS PROP 6600
198 Vitamin B kompleks tablet Box/100
DAK 19 5000
199 Zinc tab disp 20 mg Box/100 DAK 18 900 800

OBAT JIWA
DAK 16
200 Amitriptilin tab sal 25 mg Box/100
DAK 18
201 Alprazolam Tab. 0,5mg Box/100 BS PROP
202 Atarax tab 0,5 mg Box/100
203 Cepezet inj Box/10 RSJ
204 Cepezet tab 100 mg Box/100
RSJ
205 Diazepam tab 5 mg Tablet
BS PROP
206 Elizac tab 20 mg Box/30 BS PROP 169
207 Haloperidol inj 5 mg/ml (i.m.) Box/12
208 Haloperidol tablet 0,5mg Box/100 DAK 18
209 Haloperidol tablet 1,5mg Box/100 DAK 18 100
DAK 18
210 Haloperidol tablet 2mg (Lodomer) Box/100
DAK 19
DAK 18
211 Haloperidol tablet 5mg Box/100 BS PROP
DAK 19
212 Heximer tab 2 mg Box/100
213 Klobazam Tab. 10mg Box/100 BS PROP
214 Klorpromazin inj 25mg Ampul DAK 19
215 Klorpromazin tab sal 100 mg Box/100 DAK 19 164
216 Klorpromazin tab sal 25 mg Box/100
217 Klozapin Tab 25mg Box/50 BS PROP
219 Merlopam tab 0,5 mg Box/100 DAK 19
220 Risperidon tab 2mg Box/100 BS PROP 130
221 Sikzonoat inj Box/5 BS PROP
DAK 19 380
222 Triheksifenidil tab 2 mg Box/100
BS PROP

BAHAN MEDIS HABIS PAKAI (

DAK 17 300
223 Alat suntik sekali pakai 3 ml Box/100
DAK 18
Alat suntik sekali pakai 5 ml (Terumo) DAK 16 200 ###
DAK 16
224 Box/100
Alat suntik sekali pakai 5 ml (MRB) DAK 17
DAK 18
225 Alat suntik sekali pakai 0,05 ml Box/100 100
226 Alat suntik sekali pakai 0,5 ml Box/100 DAK 17 200 ###
227 Alat suntik sekali pakai 10 ml Pcs DAK 18
228 Alat suntik sekali pakai 1ml Pcs
DAK 15
229 Alat suntik sekali pakai 50ml Unit
DAK 18 50
DAK 18 600 ###
230 Alkohol swab Box/100 DAK 19
DAK 19
231 Aquadest Steril 1000 ml Kolf
232 Bisturi no 10 Box/100
233 Bisturi no 20 Box/100
Blood Lancet Box/100 DAK 18 1,400 ###
234 Blood Lancet (Frambusia) Box/200 BS PROP
Blood Lancet Box/100 DAK 19
235 Box Slide Box BS PROP
Cartridge GenXpert Set BS PROP
236 Catgut chromic No. 2/0 Sachet
237 Catgut chromic No. 3/0 Sachet
238 Catgut plain No. 2/0 (Onemed) Box/24 DAK 16
239 Catgut plain No. 3/0 (SMI) Sachet
240 Feeding Tube fr 5 40cm Unit
241 Feeding Tube fr 8 100cm Unit DAK 18
242 Folley Cateter 2 Way no 16 Pcs
243 Folley Cateter 2 Way no 18 Pcs DAK 19
244 Infusion set anak Pcs DAK 18 50
245 Infusion set dewasa Pcs DAK 18 40
DAK 16 40
246 IV Catheter No. 18 G Pcs
DAK 18
DAK 17 50
247 IV Catheter No. 20 G Pcs
DAK 18
DAK 17 50
248 IV Catheter No. 22 G Pcs
DAK 18
 Pcs DAK 17 50
249 IV Catheter No. 24 G
DAK 18
250 Jarum kulit no 10 GT Lusin
251 Jarum kulit no 9 GT Lusin
Jarum otot no 10 BR (MRM) Lusin
252
Jarum otot no 10 GR (DR MORTON) Lusin
253 Jarum otot no 13 BR Lusin
254 Jarum otot no 7 Lusin
255 Jarum otot no 8 Lusin
256 Jarum otot no 9 Lusin
DAK 16 10 8.00
257 Kapas Pembalut / Absorben 250 gram Rol DAK 16
DAK 18
DAK 15 3.00
258 Kasa Pembalut 2 m x 80 cm Rol DAK 16
DAK 18
DAK 18 4 4.00
259 Kasa Pembalut 40 yard x 80 cm Rol
DAK 19
260 Kasa Pembalut 4X15cm Rol DAK 18 100 5.00
DAK 16 2.00
261 Kasa Pembalut 4X5cm Rol
DAK 18
262 Masker Tie On Box/50 DAK 18 ###
263 Masker N95 Pcs DAK 18
264 Maxter Exam Non Powder L Box/100 DAK 19
265 Maxter Exam Non Powder M Box/100 DAK 19
266 Maxter Exam Non Powder S Box/100 DAK 19
267 Nasal Oxygen Bayi Pcs DAK 19
268 Nasal Oxygen Dewasa Pcs DAK 19
269 Nasal Oxygen Size L Pcs DAK 19 3
270 Nasal Oxygen Size M Pcs 3
271 Nasal Oxygen Size S Pcs 3
272 Nasal Oxygen Size XS Pcs DAK 16
273 Pembalut Elastis 10cmx4,55m Rol DAK 16 5 1.00
274 Pembalut Elastis 15cmx4,55m Rol DAK 16 5 2.00
275 Pembalut Elastis 7,5cmx4,55m Rol DAK 16 5 2.00
DAK 15 50
276 Penjepit Tali Pusar Pcs
DAK 18
Pipet Pasteur dengan karet Box/100 DAK 19
277 Plester 2,5cm x 4,5m Rol
278 Plester 7,5cm x 4,5m Rol
279 Plester 5cm X 4,5m Rol
BS PROP
280 Pot sputum Steril Pot DAK 18
DAK 19
281 Regulator Oksigen Unit DAK 18
282 Safety Box Box BS PROP
283 Safegloves Latex Examination Gloves S Box/100 DAK 19
284 Safegloves Latex Examination Gloves M Box/100 DAK 19
285 Safegloves Latex Examination Gloves L Box/100 DAK 19
286 Sarung Tangan Non Steril Uk. M Box/100 BS PROP
287 Sarung Tangan Non Steril Uk. L Box/100 BS PROP
Sarung tangan no.7 (Steril) Frambusia Pasang BS PROP 400
288
Sarung tangan no.7 (Steril) JMI Pasang DAK 18
Sarung tangan no.7,5 (Steril) Frambusia Pasang BS PROP
289
Sarung tangan no.7,5 (Steril) JMI Pasang DAK 18
Sarung tangan no.8 (Steril) Ansell Pasang DAK 17
290 Sarung tangan no.8 (Steril) Aximed Pasang DAK 16 200
Sarung tangan no.8 (Steril) JMI Pasang DAK 18
DAK 17 10
291 Sarung Tangan Obgyn Steril Pasang
DAK 18
292 Silk No. 1 (SMI) Sachet DAK 16
293 Silk No. 3/0 (SMI) Sachet DAK 16 57 10.00
Silk No.2/0 Sachet DAK 15 50.00
294 Silk No.2/0 (Onemed) Box/36 DAK 16
Silk No.2/0 (SMI) Sachet DAK 16
BS PROP 6
295 Slide Box/72
DAK 17
DAK 15
296 Stomach Tube fr 12 Pcs
DAK 18
DAK 15
297 Stomach Tube fr 16 Pcs DAK 16
DAK 18
298 Stomach Tube fr 18 Pcs DAK 18
DAK 16
299 Urine Bag Pcs DAK 18
DAK 19
300 USG Gel 250ml Botol

BAHAN OBAT GIGI

301 Articulating Paper Pak
302 Eugenol cair Botol
303 FUJI GP A2 Pak
304 FUJI GP A3 Pak
305 Micro Brush Pak
306 Saliva Ejector Pak/50
307 Zink Fosfat Pak

REAGEN
288 Alat HB Sahli Kit DAK 18
Botol 100ml DAK 16
289 Alkohol 95%
Botol 300ml DAK 18
290 AUTOCHECK 3IN1 Multi Monitoring System Kit DAK 16
DAK 19
291 AUTOCHECK Blood Glucose Test Strip Btl/25
DAK 19
DAK 19
292 AUTOCHECK Total Cholesterol Test Strip Btl/10
DAK 19
 DAK 19
293 AUTOCHECK Uric Acid Test Strip Btl/25
DAK 19
GF Malaria 2019
294 Carestar Malaria Device PAN-PLDH, Pf-HRP2 Test BS PROP
DAK 19
295 Cleaning kit Kit
296 Control 3 Diff. Normal 16 Parameter 1X4,5ml Kit
297 Dengue Rapid Test Test
298 Diluen 20L (900 cycle) Galon 15L DAK 19
299 ELITech ALT/GPT SL 2X62,5ml Kit DAK 18
300 ELITech AST/GOT SL 2X62,5ml Kit DAK 18
301 ELITech Cholesterol PAP SL 6X100ml + std 5ml Kit DAK 18
302 ELITech Cholesterol Std 200mg 4x5ml Kit
303 ELITech Creatinine Jaffe 2X125ml Kit
304 ELITech Glucose PAP SL 6X100ml Kit DAK 18
305 ELITech Glucose Std 100mg/dl 4x5ml Kit
306 ELITech Trigliserid Mono SL 6X50ml + Std 5ml Kit DAK 18
307 ELITech Urea UV SL 4X62,5ml + Std 5ml Kit
308 ELITech Uric Acid Mono SL 6X100ml Kit DAK 18
309 ELITech Uric Acid Std 6mg/dl 4x5ml Kit
310 Elitrol 1 (Normal) 10x5ml Kit
311 FTS (Filariasis Tes Strip) untuk W. Bancrofti Test
312 Focus Malaria Pan/Pf Casette Box/25 DAK 18
313 Focus RPR Syphillis Box/100
314 Focus TPHA Box/100

315
HEMOSMART GOLD Hemoglobin Screening System Kit
Simple
316 HEMOSMART GOLD Hemoglobin Test Strip Btl/25 DAK 19 150
317 Larutan Anisol Botol 100ml DAK 18
318 Larutan Carbol Fuchsin Botol 100ml DAK 16
319 Larutan Carbol Gentian Violet Botol 100ml DAK 16 28
320 Larutan Emersi oil Botol 100ml DAK 18
321 Larutan Giemsa Btl 500 ml DAK 18
DAK 18
322 Larutan H2O2 3% Botol 100ml
DAK 19
DAK 17
323 Larutan HCl 0,1 N Botol 100ml
DAK 18
324 Larutan Metanol Botol 100ml DAK 18
325 Larutan Methilen Blue Botol 100ml DAK 18
326 Larutan Turk Botol 100ml DAK 18
327 Lugol Botol 100ml DAK 16
328 Lyze 5L (900 Cycle) Galon 5L DAK 19
329 NaCl 0,9% 100ml Botol 100ml
330 Paket Alat Deteksi Resiko Kehamilan Paket Kemenkes 2018
331 Rapid Test Hepatitis (SD) Box/100
Rapid Test HIV 1 / SD Test BS PROP
332
Rapid Test HIV 1 / VIKIA Test
Rapid Test HIV 2 / KHB Diagnostics Test
334 Rapid Test HIV 2 / FOCUS Box/25 BS PROP
334 BS PROP
Rapid Test HIV 2 / TRILINE Test
Rapid Test HIV 3 / VIKIA Box/25
336 BS PROP
Rapid Test HIV 3 / Diagnostar DS Test
Rapid Test Syphillis Hexagon (Frambusia) Box/20
337 BS PROP
RDT Syphillis SD (Frambusia) Test
Rapid Test Syphillis / SD Test
BS PROP
Rapid Sypillis RB-TS 25 Test
338 RDT SD Bioline HBSAg Test BS PROP

BS PROP
339 Reagen Ziehl Nielsen Paket
DAK 17
340 RPR Syphillis (Focus) Test
341 Serum Golongan Darah (Glory) Set
Serum Golongan Darah Anti A (Plasmatec) Vial DAK 18
Serum Golongan Darah Anti B (Plasmatec) Vial DAK 18
342
Serum Golongan Darah Anti AB (Plasmatec) Vial DAK 18
Serum Golongan Darah Anti D (Plasmatec) Vial DAK 18
343 Total Protein Plus 2X125ml Kit
344 Uryxxon Stick 10 Box/100

LAIN-LAIN
345 Air Raksa (Hg) Botol 100g DAK 15
346 Food Sec. ARSENIC Test Kit Kit
347 Food Sec. BORAX Test Kit Kit
348 Food Sec. CYANIDA Test Kit Kit
349 Food Sec. FORMALDEHYDE Test Kit Kit DAK 18
350 Food Sec. NITRATE-NITRITE Test Kit Kit
351 Food Sec.MERCURY Test Kit Kit
352 HCG TEST (Focus) Box/50 DAK 18 200
353 Iodium test btl 10 ml
354 Kertas EKG rol DAU 09
355 Kertas USG rol DAU 09

TAMBAHAN
Sefadroksil Kaps 500 mg JKN
Simvastatin tab 10 mg JKN
Siprofloksasin Tab Scored 500 mg JKN
Betahistin Mesilat Tablet JKN
Asam Asetilsalisilat (asetosal) JKN 300
Allopurinol 300 mg JKN
Bedak Salisil JKN 20
Bisakodil tab 5mg JKN 200
Hiosin butilbromida 10 mg JKN 100
Kloramenikol tetes telinga JKN 25
Lidokain Injeksi JKN 59
Metronidazole tab 500 mg JKN 700
Natrium Diklofenak tab 50 mg JKN 1,750
Natrium Diklofenak tab 25 mg JKN
Parasetamol sir 120mg/5ml JKN 110
Propiltiourasil tab 100 mg JKN 1000
Salbutamol cairan in 0,1 JKN 55
Salbutamol tab 2 mg JKN 8000
cetirizin kaps 10 mg JKN 400
Simvastatin tab 20 mg JKN 600
Asam Traneksamat tab 500 mg JKN 300
Ketorolac inj 30 mg JKN 10
Levertran salep JKN 25
Loperamid tab 2 mg JKN 700
Ondansetron Hcl inj 4mg/2ml JKN 5
Ranitidin inj 50 mg JKN 11
Masker Ear Loop JKN 600
Propanolol 40 mg JKN 500
Bisturi JKN 80
Jelly USG JKN 5
Stik Cholesterol EASY TOUCH JKN 10
Stik Glucose EASY TOUCH JKN 50
Stik Hemoglobin Easy Touch JKN 300
Sianokobalamin (vitamin B12) injeksi GFK 100
Dasabion JKN 400
Papaverin 40 mg JKN
Fluoksetin 20 mg JKN
Clopazin tab JKN
Ramolit JKN
Furosemid inj 10mg/ml JKN
Glimepiride tab 2mg JKN
Isosorbid Dinitrat JKN
Metronidazole lar inf 5mg/ml JKN
Candesartan 8mg JKN
Meloxicam 15mg JKN
Sitikoliin tab 500 mg JKN
Folley Catheter 2 way no 16 JKN
Sarung tangan no 6.5 Steril JKN
Sarung tangan no 7 Steril JKN
Citicolin Sodium inj 250mg/2ml JKN
New Diatab JKN
Demacolin JKN
Erlamycetin tetes telinga JKN
Neurobion inj 5000 JKN
Neurodex JKN
Ventolin Nebulizer JKN
Novabion IFK
Propyretic 160 mg JKN
Salep Ichtiol JKN
ORAN PERSEDIAAN OBAT DAN BMHP
Periode Desember 2019

PUSKESMAS

Mopah KU TANAH M W STOCK HARGA SATUAN

KUMBE JAGEB KURIK NAUK SOTA ULILIN
Baru PRI OB EN UTI AY AKHIR
K NG AU

BUPUL
INDAH MIRING JERAI (Rp)

12 12 39 6 19 6 94 2,860.00
900 1,500 2098 1028 878 700 3088 11342 504.00
1300 5,400 5630 3291 1120 1400 1245 20986 124.00
0 117.00
0 124.00
3500 4,200 6300 5580 4691 900 30871 155.34

400 400 155.34

10 30 90 30 160 3,280.00
200 400 907 150 1633 3490 112.00
950 2,000 1600 1868 242 50 2270 11080 99.00
1150 800 900 1320 600 1390 6660 83.00
24 10 36 83 110 30 393 4,100.00
48 6 29 26 75 277 12,000.00
3200 7,300 2100 4340 810 500 580 20180 208.00
0 222.00
7000 7,300 2000 8023 4145 600 2800 38768 248.00
0 263.00
20 22 6 20 20 88 10,296.00
30 40 40 12 132 2,308.00
0 48.00
2200 1,700 3100 3119 610 910 12239 171.18
0 236.50

14 430 38 607 2,408.00

40
2500 4,000 2250 5866 2820 2700 24536 62.00
2314 2314 66.00
25 100 80 50 305 3,794.00
0 5,188.00
19 64 77 64 2 6 252 5,997.00

110 35 20 81 10 20 396 3,959.00

0
8 8 8 16 40 48,750.00

100 100 100 400 116.00

100
4100 2,800 2600 1968 870 2400 16438 125.00
2100 3,700 4400 4803 4660 1700 1520 24583 131.00
 0 131.00
0 88.00
0 94.00
1500 3,000 3480 3126 1330 1900 736 18872 504.00
9 9
50 10 75 69 175 28 30 457 3,788.00
200 202 750 108 1260 983.40
400 800 1500 538 230 500 225 5393 496.00
5 10 5 20 1,958.00
20 20
100 200 300 40 40 880 5,400.00
7 11 45 3 30 96 1,142.00
0
10 10 10 20 50 18,125.00
100 186 105 67 40 123 676 1,520.00
40 40 1,622.00
0 19,250.00
20 3 10 20 53 6,000.00
13 5 13 36 5,900.00
0
50 79 30 12 54 294 1,450.00
107 7,170 150 1258 3100 2900 18685 36.00
0
4 3 24 3 4 60 113 6,667.00
190 190 60.00
0 148.00
30 40 24 45 40 200 8 490 1,329.00
0 45.73
500 70 570
0
300 300 100 960 100 300 70 2930 140.00
700 800 1002 450 1000 30 4582 336.00
450 450 264.00
3 5 22 5 12 27 74 3,051.00
200 100 130 100 400 238 1568 96.00
0
27 94 43 31 28 38 498 2,486.00
300 500 1000 950 200 200 3550 781.00
5 20 30 2,900.00
4 6 22 5 8 59 8,000.00
3 2 2 2 1 3 18 264,000.00
1000 137 1137 15,800.00
0 2,462.00
400 400
18 27 24 89 2,590.00
40 44 37 23 97 33 324 4,595.00
5,300 1000 896 345 200 20 8261 890.00
0 950.00
 38 38
25 50 135 5,376.80
400 800 1090 800 600 196 4386 88.00
0 94.00
900 500 1072 1000 210 3982 296.00
640 640 858.00
1489 2089 316.00
10 30 50 4,387.00
7 71 4 18 150 2,126.00
0
30 52 82 5,500.00
3100 2,800 1650 7165 1015 1600 3357 23287 108.00
0 234.88
200 1,000 1000 1530 1500 950 6680 169.47
400 400 230.00
170 170
7 11 75 6,600.00
60 22 82 7,500.00
5 3 6 14 14,080.00
40 7 27 25 40 12 201 6,410.00
900 3,400 4000 1835 2760 1600 710 16005 254.00
100 100 100 300 1,131.00
200 300 1430 1083 1100 300 4713 186.00
220 220 194.00
0 194.00
96 112 63 150 57 50 78 705 2,846.00
57 100 157 40,000.00

140 140

500 490 275 300 1830 6595 119.00

8 8
100 165 765 89.00
100 100 190.30
50 100 200 350 125.00
6400 800 5700 3805 2800 1800 3575 29880 69.00
10 21 16 45 5 97 12,000.00
400 3,800 150 3824 3098 600 920 17792 144.64
120 780 360 400 2260 458.33
30 94 65 69 39 54 441 2,893.00
550 500 1150 640 1020 450 450 5110 325.00
0 521.40
12 6 15 33 6,361.67
50 150 7 144 901 893.00
200 400 600
100 100 221.00
0
72 162 54 94 78 25 34 579 2,160.00
0 2,305.00
0
760 3,900 3850 5368 6280 5200 2123 32881 27.00
0

108 45 153 180 54 855 2,140.00

207
0
11,660 5550 7001 4876 5000 3024 61771 445.00
0 445.00

700 200 1265 1140 220 4425 146.00

200

2300 59 2859
500
35 20 7 67 2 36 22 249 2,258.00
0 2,410.00
0 1,234.00
600 359.00

33 20 53 11,314.00

40 40 11,314.00

0
121 24 74 53 372 887.00
0
0

150 149 299

800 400 200 540 200 1070 3460 172.00
30 2 30 64 3,328.00
16 8 16 40 3,796.00
0 123,324.00
1 1 250,704.00
450 2,500 450 1000 1080 7480 487.30
1050 1,600 500 1410 400 520 7980 530.20
300 3,000 3900 5350 350 600 1210 17210 120.00
20 89 45 28 21 223 3,696.00
0 3,696.00
100 600 2900 850 254 500 5304 270.60
0 93.00
500 500
1,600 480 180 10 2670 361.79
48 48 24 42 3 24 100 371 4,268.00
0 2,920.00
0 3,116.00
60 152 40 40 4 346 6,410.00
150 700 163.00
0 444.10
100 150 700 950 555.44
400 190 117 1207
 200 200 1,056.00
264 100 215 284 170 80 2 1415 747.00
6 1 2 13 310,153.00
12 10 5 5 1 36 519,342.00
1 2 2 1 8 1,731,230.00
0
81 157 46 14 15 1 364 2,600.00
75 25 25 63 29 75 231 673 2,500.00
100 10 14 36 19 28 248 1,900.00
2220 780 870 2899 760 300 117 8446 181.00
0 158.00
0 147.00
0 157.00
1800 800 2600 166.28
0 53.64
1 1
1 90 201
0
43 5,800 12400 4428 4170 2000 3892 41533 286.93
6 36 8,311.00
0 79,800.00
30 30 102,552.00
30 28 83 12,698.00
2330 434 246 40 15 3065 361.00
0 385.00
100 6,100 950 2363 3444 1200 1076 16733 154.00
0 164.00
10 10
10 8 4 16 4 84 3,700.00
5 5 14 18 4 4 5 55 18,000.00
0 22,500.00
0 977,181.00
1100 1100 300,000.00
4,500 850 2140 70 900 760 9920 81.00
0 86.00
400 610 100 80 100 1990 253.00
0 424.93
100 300 100 100 600 71.00
0
3 3 3,256.00
300 582 2782 462.00
200 438 50 100 200 1538 287.00
100 1100 2252 146 50 1650 7498 636.00
0 691.00
0 1,134.71
40 64 77 24 80 65 410 7,150.00
0 7,630.00
53 37 4 98 3,900.00
 25 25
190 510 1477 2177
2100 800 206 1990 500 7196 9,200.00
48 144 133 48 47 20 77 584 3,280.00
0 3,500.00
280 280 1,004.00
20 114 50 184 5,020.00
10 30 84 6 130 5,488.00
1 1 0,5 1 3 76,450,000.00
0 91,535,532.00

5 8 130,999.00
3
0
0
236 185 421 117.00
40 33 473
170 470
0
500 600 216.00
800 1826 188 2814 350.00
0
3,100 3770 3851 200 1415 13436 96.00
0 102.00
0 9,700.00
6600 96.00
3100 3,100 2849 100 400 4242 18791 102.00
1500 1,300 4048 885 1300 594 11327 658.00

95 690 300 424 1509 179.00

0 168.00
0 108.00
0
10 10 8,400.00
0
200 200 310.00
0 109.00
390 559 225.00
0
0 55.00
100 59.00
130 500 630 93.00
0 99.00
560 560 62.00
1600 1600 56.00
0 66.00
0
0 967.00
27 27 1,654.00
 1000 500 1664 197.00
0
0 1,550.00
1200 1200 416.00
1100 86 1316 273.00
5 5 12,762.60
1000 3800 86 5266 110.00
0 91.00

BAHAN MEDIS HABIS PAKAI (BMHP)

200 600 325.00 1,870.00 59.00 300.00 442.00 ### 1,412.00
209.00 209.00 973.75
800 300 108.00 453.00 532.00 160.00 ### 5,600.00
- 903.00
- 1,683.00
110.00 110.00 1,210.00
100 500.00 700.00
200 78.00 500.00 300.00 ### 1,375.00
100 284.00 381.00 25.00 170.00 960.00 1,500.00
12.00 316.00 60.00 388.00
20.00 5.00 25.00 3,400.00
50.00 4,250.00
500 600.00 534.00 400.00 16.00 ### 120.00
- 125.00
- 385.00
-
-
1.00 1.00
37 16 839.00 581.00 300.00 ### 167.51
- 5,950.00
1,100.00 ### 297.00
3.00 3.00 86,742.00
- 190,741.00
5.00 25.00 2.00 32.00
11.00 6.00 3.00 20.00
48 110.00 82.00 49.00 24.00 1.00 314.00 5,583.33

5.00 5.00
-
- 9,570.00
-
4 10.00 12.00 5.00 31.00 11,040.00
340 55.00 143.00 102.00 45.00 5.00 740.00 11,966.90
300 59.00 131.00 101.00 45.00 29.00 705.00 8,419.15
50 7.00 83.00 146.00 160.00 486.00 8,355.00
309.00 309.00 9,608.25
100 94.00 136.00 77.00 200.00 657.00 8,499.00
440.00 440.00 9,608.25
70 170.00 143.00 110.00 543.00 8,499.00
- 9,608.25
 200 155.00 134.00 117.00 656.00 8,499.00
- 9,608.25
- 52,360.00
-
3.00 3.00 52,360.00
3.00 3.00 52,360.00
5.00 5.00 52,360.00
- 52,360.00
- 52,360.00
- 52,360.00
11 16.00 16.00 7.00 2.00 70.00 13,400.00
- 28,530.00
- 16,750.00
25 10.00 19.00 2.00 37.00 96.00 7,700.00
- 7,930.00
- 9,910.00
4 10.00 7.00 2.00 2.00 33.00 133,625.00
- 131,250.00
20 5 95.00 38.00 80.00 1.00 344.00 2,800.00
50 140.00 50.00 50.00 292.00 800.00
- 1,080.00
200.00 58.00 358.00 437.50
5.00 5.00 5.00 4.00 19.00 8,140.00
- 728.75
- 728.75
- 728.75
11 28.00 3.00 7.00 17.00 66.00 6,875.00
7.00 3.00 16.00 26.00 6,875.00
5 6.00 9.00 60.00 83.00 6,875.00
5 8.00 1.00 17.00
5 51.00 1.00 60.00
65.00 5.00 15.00 85.00 6,600.00
5 3 5.00 6.00 4.00 5.00 34.00 43,987.00
9 5 36.00 33.00 6.00 5.00 101.00 54,139.00
5 3 25.00 6.00 4.00 4.00 54.00 36,012.00
300 66.00 100.00 516.00 1,925.00
- 1,495.00
- 1,650.00
-
-
-
60 150.00 210.00 3,968.00
- 3,410.00
- 3,410.00
- 2,530,000.00
- 16,608.00
- 445.25
4.00 300.00 304.00 445.25
 100 4.00 300.00 404.00 445.25
200 402.00 400.00 ### 496.10
300 400.00 200.00 400.00 ### 496.10
400.00 7,735.00
41.00 50.00 2.00 93.00 8,032.75
113.00 113.00 16,003.00

30.00 30.00 8,032.75

- 8,090.00
100 150.00 63.00 70.00 307.00 890.00 7,600.00
- 8,032.75
10 20 10.00 2.00 46.00 98.00 20,973.00
- 23,232.00
24 8.00 12.00 44.00 23,900.00
24 114.00 35.00 24.00 20.00 72.00 356.00 22,400.00
24 96.00 2.00 40.00 72.00 284.00 16,064.00
- 110,000.00
- 23,300.00
2 1,440.00 575.00 ### 419.21
- 305.63
2 23.00 5.00 30.00 10,010.00
- 17,678.95
2 18.00 5.00 25.00 10,010.00
- 33,600.00
- 17,678.95
2 19.00 5.00 26.00 17,678.95
30 28.00 40.00 14.00 14.00 126.00 3,000.00
- 3,750.00
- 3,750.00
-

-
-
-
-
-
-
-

- 105,600.00
7 4.00 11.00 15,576.00
- 37,400.00
1 1.00 82,800.00
100.00 50.00 150.00 5,236.00
- 5,236.00
30.00 40.00 70.00 23,980.00
20.00 20.00 23,980.00
 175.00 1,000.00 50.00 ### 6,688.00
- 6,688.00
- 6,476.00
- 6,931.00
72.00 72.00 19,600.00
-
-
-
- 5,225,000.00
- 2,942,500.00
- 2,915,000.00
- 5,060,000.00
-
-
- 2,915,000.00
-
- 5,258,000.00
-
- 5,357,000.00
-
-
-
- 24,200.00
-
-

1 1.00

200 222.00 6.00 578.00 13,948.00

5 5.00 278,300.00
- 11,220.00
28.00 9,504.00
- 963,600.00
- 1,419,000.00
10 5.00 15.00 12,100.00
4.00 4.00 4,368.00
4.00 2.00 2.00 8.00 13,728.00
- 23,100.00
- 53,000.00
4.00 4.00 47,300.00
1.00 1.00 37,400.00
- 175,000.00
- 7,749,500.00
-
- 501,745.00
-
- 11,975.00
-
- 12,500.00
- 352,925.00
 -
- 487,000.00
- 16,511.00
- 27,317.70
- 20,400.00
- 20,400.00
- 12,132.00
- 9,850.00
- 266,410.00
- 254,059.00
- 297,440.00
-
-
3.00 2.00 5.00 215,875.00
3.00 2.00 5.00 215,875.00
3.00 2.00 5.00 215,875.00
3.00 2.00 5.00 215,875.00
-
-

- 500,000.00
-
-
-
- 7,590,000.00
-
-
150 150.00 74.00 50.00 50.00 674.00 2,150.00
-

5.00 5.00 73,125.00

- 354,375.00

400 200 1,870.00 190.00 845.00

500 7,320.00 327.00
200 737.00 479.00
300 318.00 90.00 436.00
100.00 821.00
200.00 425.00
8,470.00
1,887.00

8,910.00
161.00
300 656.00 580.00

1,073.00 260.00
5,390.00
 1375
100 67 396
740
2043
255
36 4110
500
10
810 4240,5
560.00
118.00
1,050.00
70,000.00

347.00
400.00
400.00
81.00 225.00
172.00
150.00 858.00
10.00 4,583.00
2,389.00 819.00
100.00 153.00
5.00 17,000.00
1,050.00 3,780.00
3,046.00 487.00
555.00 5,736.00
65.00
50.00 5,000.00
81.00 28,000.00
50.00
900.00 637.00
736.00 455.00
9.00
511.00 13,084.00
1,600.00 592.00
180.00 11,539.00
500.00 1,080.00
4.00 19,800.00
29.00 7,760.00
TOTAL HARGA

(Rp)

268,840.00
5,716,368.00
2,602,264.00
-
-
4,795,501.14
62,136.00
524,800.00
390,880.00
1,096,920.00
552,780.00
1,611,300.00
3,324,000.00
4,197,440.00
-
9,614,464.00
-
906,048.00
304,656.00
-
2,095,072.02
-

1,461,656.00

1,521,232.00
152,724.00
1,157,170.00
-
1,511,244.00

1,567,764.00

-
1,950,000.00

46,400.00

2,054,750.00
3,220,373.00
 -
-
-
9,511,488.00
-
1,731,116.00
1,239,084.00
2,674,928.00
39,160.00
-
4,752,000.00
109,632.00
-
906,250.00
1,027,520.00
64,880.00
-
318,000.00
212,400.00
-
426,300.00
672,660.00
-
753,371.00
11,400.00
-
651,210.00
-
-
-
410,200.00
1,539,552.00
118,800.00
225,774.00
150,528.00
-
1,238,028.00
2,772,550.00
87,000.00
472,000.00
4,752,000.00
17,964,600.00
-
-
230,510.00
1,488,780.00
7,352,290.00
-
 -
725,868.00
385,968.00
-
1,178,672.00
549,120.00
660,124.00
219,350.00
318,900.00
-
451,000.00
2,514,996.00
-
1,132,059.60
92,000.00
-
495,000.00
615,000.00
197,120.00
1,288,410.00
4,065,270.00
339,300.00
876,618.00
42,680.00
-
2,006,430.00
6,280,000.00

784,805.00
-
68,085.00
19,030.00
43,750.00
2,061,720.00
1,164,000.00
2,573,434.88
1,035,814.50
1,275,813.00
1,660,750.00
-
209,935.00
804,593.00
-
22,100.00
-
1,250,640.00
-
-
 887,787.00
-

1,829,700.00

-
27,488,095.00
-

646,050.00

562,242.00
-
-
215,400.00

599,642.00

452,560.00

-
329,964.00
-
-
-
595,120.00
212,992.00
151,840.00
-
250,704.00
3,645,004.00
4,230,996.00
2,065,200.00
824,208.00
-
1,435,262.40
-
-
965,979.30
1,583,428.00
-
-
2,217,860.00
114,100.00
-
527,668.00
-
 211,200.00
1,057,005.00
4,031,989.00
18,696,312.00
13,849,840.00
-
946,400.00
1,682,500.00
471,200.00
1,528,726.00
-
-
-
432,328.00
-
-
-
-
11,917,063.69
299,196.00
-
3,076,560.00
1,053,934.00
1,106,465.00
-
2,576,882.00
-
-
310,800.00
990,000.00
-
-
330,000,000.00
803,520.00
-
503,470.00
-
42,600.00
-
9,768.00
1,285,284.00
441,406.00
4,768,728.00
-
-
2,931,500.00
-
382,200.00
 -
-
66,203,200.00
1,915,520.00
-
281,120.00
923,680.00
713,440.00
229,350,000.00
-

1,047,992.00

-
-
49,257.00
-
-
-
129,600.00
984,900.00
-
1,289,856.00
-
-
633,600.00
1,916,682.00
7,453,166.00
-

270,111.00
-
-
-
84,000.00
-
62,000.00
-
125,775.00
-
-
5,900.00
58,590.00
-
34,720.00
89,600.00
-
-
-
44,658.00
 327,808.00
-
-
499,200.00
359,268.00
63,813.00
579,260.00
-

5,783,552.00
203,513.75
14,856,800.00
-
-
133,100.00
-
2,444,750.00
1,440,000.00
-
85,000.00
212,500.00
366,000.00
-
-
-
-
-
615,260.56
-
326,700.00
260,226.00
-
-
-
1,753,166.67
-
-
-
-
342,240.00
8,855,506.00
5,935,500.75
4,060,530.00
2,968,949.25
5,583,843.00
4,227,630.00
4,614,957.00
-
5,575,344.00
-
-
-
157,080.00
157,080.00
261,800.00
-
-
-
938,000.00
-
-
739,200.00
-
-
4,409,625.00
-
963,200.00
233,600.00
-
156,625.00
154,660.00
-
-
-
453,750.00
178,750.00
570,625.00
-
-
561,000.00
1,495,558.00
5,468,039.00
1,944,648.00
993,300.00
-
-
-
-
-
833,280.00
-
-
-
-
-
135,356.00
 179,881.00
497,092.20
644,930.00
3,094,000.00
747,045.75
1,808,339.00
240,982.50
-
6,764,000.00
-
2,055,354.00
-
1,051,600.00
7,974,400.00
4,562,176.00
-
-
848,058.46
-
300,300.00
-
250,250.00
-
-
459,652.70
378,000.00
-
-
-

-
171,336.00
-
82,800.00
785,400.00
-
1,678,600.00
479,600.00
8,192,800.00
-
-
-
1,411,200.00
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

8,061,944.00
1,391,500.00
-
266,112.00
-
-
181,500.00
17,472.00
109,824.00
-
-
189,200.00
37,400.00
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
-
-
-
1,079,375.00
1,079,375.00
1,079,375.00
1,079,375.00
-
-
-

-
-
-
-
-
-
-
1,449,100.00
-
365,625.00
-
 LAPORAN PERSEDIAAN OBAT DAN BMHP
Periode Desember 2019

HARGA TOTAL HARGA TOTAL

HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK SATUAN HARGA KELUAR PENYESUAIAN SATUAN HARGA STOK AKHIR
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
OBAT
1 Air untuk injeksi amp 25 ml Vial BS PROP - 2,860.00 - 2,860.00 - - 2,860.00 -
2 Albendazol tab 400 mg Box/100 DAK 18 919 50,400.00 46,317,600.00 50,400.00 - 919 50,400.00 46,317,600.00
DAK 17 1,576 12,400.00 19,542,400.00 12,400.00 - 1,576 12,400.00 19,542,400.00
3 Alopurinol tab 100 mg Box/100 DAK 18 2,000 11,700.00 23,400,000.00 11,700.00 - 2,000 11,700.00 23,400,000.00
DAK 19 100 12,400.00 1,240,000.00 12,400.00 - 100 12,400.00 1,240,000.00
DAK 18 1,104 15,534.00 17,149,536.00 15,534.00 - 1,104 15,534.00 17,149,536.00
4 Ambroksol tab 30mg Box/100
DAK 19 3,800 15,534.00 59,029,200.00 15,534.00 - 3,800 15,534.00 59,029,200.00
5 Aminofilin inj 24 mg/ml Ampul
6 Aminofilin tablet 200 mg Btl/100 DAK 19 855 11,200.00 9,576,000.00 11,200.00 - 855 11,200.00 9,576,000.00
7 Amlodipin tab 10 mg Box/50 DAK 19 1,229 4,950.00 6,083,550.00 4,950.00 - 1,229 4,950.00 6,083,550.00
8 Amlodipin tab 5 mg Box/50 DAK 19 1,298 4,150.00 5,386,700.00 4,150.00 - 1,298 4,150.00 5,386,700.00
9 Amoksisilin sir forte 250 mg/5 ml Botol DAK 19 4,030 4,100.00 16,523,000.00 4,100.00 - 4,030 4,100.00 16,523,000.00
10 Amoksisilin sir kering 125 mg/5 ml Botol DAK 19 88 12,000.00 1,056,000.00 12,000.00 - 88 12,000.00 1,056,000.00
DAK 18 23,026 20,800.00 478,940,800.00 20,800.00 - 23,026 20,800.00 478,940,800.00
11 Amoksisilin kapsul 250 mg Box/100
DAK 19 2,700 22,200.00 59,940,000.00 22,200.00 - 2,700 22,200.00 59,940,000.00
DAK 18 2,319 24,800.00 57,511,200.00 24,800.00 - 2,319 24,800.00 57,511,200.00
12 Amoksisilin tablet 500 mg Box/100
DAK 19 12,000 26,300.00 315,600,000.00 26,300.00 - 12,000 26,300.00 315,600,000.00
13 Ampisilin serb inj 1000 mg/vial Vial BS PROP 60 10,296.00 617,760.00 10,296.00 - 60 10,296.00 617,760.00

Anestetik lokal gigi kombinasi : lidokain hcl 2% + Box/30 DAK 16 200 69,240.00 13,848,000.00 69,240.00 - 200 69,240.00 13,848,000.00
14
epinefrin 1 : 80.000 inj 2 ml Box/30 DAK 18 30 43,200.00 1,296,000.00 43,200.00 - 30 43,200.00 1,296,000.00
DAK 18 2 17,118.00 34,236.00 17,118.00 - 2 17,118.00 34,236.00
15 Antalgin tab 500mg Box/100
DAK 19 1,900 23,650.00 44,935,000.00 23,650.00 - 1,900 23,650.00 44,935,000.00

16
Antasida, kombinasi : aluminium hidroksida 200 mg + Botol DAK 19 5,765 2,408.00 13,882,120.00 2,408.00 - 5,765 2,408.00 13,882,120.00
magnesium hidroksida 200 mg
Antasida, kombinasi : aluminium hidroksida 200 mg + DAK 18 3,315 6,200.00 20,553,000.00 6,200.00 - 3,315 6,200.00 20,553,000.00
17 Box/100
magnesium hidroksida 200 mg DAK 19 7,500 6,600.00 49,500,000.00 6,600.00 - 7,500 6,600.00 49,500,000.00
18 Antibakteri DOEN, Kombinasi Tube DAK 18 3,675 3,794.00 13,942,950.00 3,794.00 - 3,675 3,794.00 13,942,950.00
Box/24 BS PROP - 124,512.00 - 124,512.00 - - 124,512.00 -
19 Antifungi DOEN, Kombinasi
Pot DAK 19 1,260 5,997.00 7,556,220.00 5,997.00 - 1,260 5,997.00 7,556,220.00

Antihemoroid, kombinasi: bismut subgalat 150 mg +

20 heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng Box/10 DAK 19 158 39,590.00 6,255,220.00 39,590.00 - 158 39,590.00 6,255,220.00
oksida 120 mg + sup ad 2 g

21 Aquajel Steril Jelly 28g tube

22 Artesunat serb inj 60 mg/ml (i.v./i.m.) Box/8 BS PROP 8 390,000.00 3,120,000.00 390,000.00 - 8 390,000.00 3,120,000.00

23 Asam asetilsalisilat (asetosal) tab 80 mg (Miniaspi tab) Box/100 DAK 19 78 11,600.00 904,800.00 11,600.00 - 78 11,600.00 904,800.00

24 Asam askorbat (vitamin C) tab 250 mg Box/100 DAK 18 682 12,500.00 8,525,000.00 12,500.00 - 682 12,500.00 8,525,000.00
DAK 18 5,284 13,100.00 69,220,400.00 13,100.00 - 5,284 13,100.00 69,220,400.00
25 Asam askorbat (vitamin C) tab 50 mg Box/100
DAK 19 8,000 13,100.00 104,800,000.00 13,100.00 - 8,000 13,100.00 104,800,000.00
BS PROP 20 8,800.00 176,000.00 8,800.00 - 20 8,800.00 176,000.00
26 Asam folat tab 1 mg Box/100
DAK 19 300 9,400.00 2,820,000.00 9,400.00 - 300 9,400.00 2,820,000.00
27 Asam mefenamat tab 500 mg Box/100 DAK 19 536 50,400.00 27,014,400.00 50,400.00 - 536 50,400.00 27,014,400.00
28 Asam traneksamat inj 10% 500mg/5ml Box/10
29 Asiklovir cream Tube BS PROP 75 3,788.00 284,100.00 3,788.00 - 75 3,788.00 284,100.00
30 Asiklovir tablet 200 mg Box/50 DAK 19 2,000 49,170.00 98,340,000.00 49,170.00 - 2,000 49,170.00 98,340,000.00
31 Asiklovir tablet 400 mg Box/50 DAK 19 1,685 24,800.00 41,788,000.00 24,800.00 - 1,685 24,800.00 41,788,000.00
32 Atropin Sulfat Inj. Ampul DAK 19 525 1,958.00 1,027,950.00 1,958.00 - 525 1,958.00 1,027,950.00
33 Attalpugit tab 500mg Box/100
34 Azitromisin tab 500 mg Box/20 BS PROP 2,394 108,000.00 258,552,000.00 108,000.00 - 2,394 108,000.00 258,552,000.00
35 Bedak salisil serb 2% Pot DAK 17 - 1,142.00 - 1,142.00 - - 1,142.00 -
36 Benzatin Benzil Penisilin 1,2Jt IU Vial
37 Benzatin Benzil Penisilin 2,4Jt IU Vial BS PROP 20 18,125.00 362,500.00 18,125.00 - 20 18,125.00 362,500.00
DAK 18 400 1,520.00 608,000.00 1,520.00 - 400 1,520.00 608,000.00
38 Betametason krim 0,5 mg/g Tube
DAK 19 7,000 1,622.00 11,354,000.00 1,622.00 - 7,000 1,622.00 11,354,000.00
39 Bisakodil tab sal 5 mg (Dulcolax Tablet) Box/200 DAK 19 4,400 19,250.00 84,700,000.00 19,250.00 - 4,400 19,250.00 84,700,000.00
40 Bisakodil Supp. 5 mg (Dulcolax Supp.) Supp DAK 19 116 6,000.00 696,000.00 6,000.00 - 116 6,000.00 696,000.00
41 Bisakodil Supp. 10 mg (Dulcolax Supp.) Supp DAK 19 805 5,900.00 4,749,500.00 5,900.00 - 805 5,900.00 4,749,500.00
42 Bisoprolol tab 5 mg Box/ 30
43 Deksametason inj 5 mg/ml (i.v./i.m.) Box/10 DAK 19 126 14,500.00 1,827,000.00 14,500.00 - 126 14,500.00 1,827,000.00
44 Deksametason tab 0,5 mg Box/100 DAK 18 3,302 3,600.00 11,887,200.00 3,600.00 - 3,302 3,600.00 11,887,200.00
45 Desoksimetason krim Tube
46 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul DAK 16 4,326 6,667.00 28,841,442.00 6,667.00 - 4,326 6,667.00 28,841,442.00
47 Diazepam tab 2 mg BTL/100 DAK 16 - 6,000.00 - 6,000.00 - - 6,000.00 -
48 Dietilkarbamazin tab 100 mg Box/100 BS PROP - 14,800.00 - 14,800.00 - - 14,800.00 -
DAK 17 149 39,870.00 5,940,630.00 39,870.00 - 149 39,870.00 5,940,630.00
49 Difenhidramin inj 10 mg/ml (i.v./i.m.) Box/30
DAK 18 200 41,160.00 8,232,000.00 41,160.00 - 200 41,160.00 8,232,000.00
50 Digoksin tab 0,25 mg Box/100
51 Diltiazem hcl tab 30 mg Box/100
52 Dimenhidrinat tab 50 mg Btl/100 DAK 19 31 14,000.00 434,000.00 14,000.00 - 31 14,000.00 434,000.00
DAK 16 309 33,600.00 10,382,400.00 33,600.00 - 309 33,600.00 10,382,400.00
53 Doksisiklin kaps 100 mg Box/100
DAK 18 100 26,400.00 2,640,000.00 26,400.00 - 100 26,400.00 2,640,000.00
54 Domperidon susp 5 mg/5 ml BTL 60 ml DAK 19 150 3,051.00 457,650.00 3,051.00 - 150 3,051.00 457,650.00
55 Domperidon tab 10 mg Box/100 BS PROP - 9,600.00 - 9,600.00 - - 9,600.00 -
56 Efedrin tab 25 mg Btl/100
57 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) Ampul BS PROP 530 2,486.00 1,317,580.00 2,486.00 - 530 2,486.00 1,317,580.00
58 Eritromisin tab 500 mg Box/100 DAK 18 80 78,100.00 6,248,000.00 78,100.00 - 80 78,100.00 6,248,000.00
Btl 100ml DAK 17 2,069 2,900.00 6,000,100.00 2,900.00 - 2,069 2,900.00 6,000,100.00
59 Etanol cairan 70%
Btl 300ml DAK 17 4,113 8,000.00 32,904,000.00 8,000.00 - 4,113 8,000.00 32,904,000.00
60 Etil klorida semprot 200 ml Botol DAK 19 261 264,000.00 68,904,000.00 264,000.00 - 261 264,000.00 68,904,000.00
61 Fenitoin Na kaps 100 mg Btl/100 DAK 18 22 15,800.00 347,600.00 15,800.00 - 22 15,800.00 347,600.00
62 Fenobarbital inj 50mg/ml Ampul DAK 16 - 2,462.00 - 2,462.00 - - 2,462.00 -
63 Fenobarbital tab 30 mg Btl/100
64 Fenol Gliserol tetes telinga Btl 5ml DAK 18 - 2,590.00 - 2,590.00 - - 2,590.00 -
65 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) Ampul DAK 19 4,380 4,595.00 20,126,100.00 4,595.00 - 4,380 4,595.00 20,126,100.00
DAK 18 52 89,000.00 4,628,000.00 89,000.00 - 52 89,000.00 4,628,000.00
66 Fitomenadion (vitamin K 1) tab sal 10 mg Box/100
DAK 19 150 95,000.00 14,250,000.00 95,000.00 - 150 95,000.00 14,250,000.00
67 Framisetin Sulfat Tulle 1% (Daryantulle) Box/10
68 Furosemid inj 10 mg/ml (i.v./i.m.) Box/25 DAK 19 100 134,420.00 13,442,000.00 134,420.00 - 100 134,420.00 13,442,000.00
DAK 18 41 17,600.00 721,600.00 17,600.00 - 41 17,600.00 721,600.00
69 Furosemid tab 40 mg Box/200
69 Furosemid tab 40 mg Box/200
DAK 19 150 18,800.00 2,820,000.00 18,800.00 - 150 18,800.00 2,820,000.00
Box/100 BS PROP - 29,600.00 - 29,600.00 - - 29,600.00 -
Garam oralit kombinasi : natrium klorida 0,52 g + kalium
70 klorida 0,30 g + trinatrium sitrat 0,58 g + glukosa Box/25 DAK 19 225 21,450.00 4,826,250.00 21,450.00 - 225 21,450.00 4,826,250.00
anhidrat 2,7 g
Box/100 DAK 19 424 31,600.00 13,398,400.00 31,600.00 - 424 31,600.00 13,398,400.00
71 Gentamisin inj Box/5 BS PROP 72 21,935.00 1,579,320.00 21,935.00 - 72 21,935.00 1,579,320.00
72 Gentamisin salep kulit Tube
73 Gentamisin tetes mata Botol
74 Gentian violet Botol DAK 18 2,256 5,500.00 12,408,000.00 5,500.00 - 2,256 5,500.00 12,408,000.00
Btl/100 DAK 18 4,160 10,800.00 44,928,000.00 10,800.00 - 4,160 10,800.00 44,928,000.00
75 GG tab 100 mg
Box/100 DAK 19 - 23,488.00 - 23,488.00 - - 23,488.00 -
DAK 15 287 16,947.00 4,863,789.00 16,947.00 - 287 16,947.00 4,863,789.00
76 Glibenklamid tab 5 mg Box/100
DAK 16 1,000 23,000.00 23,000,000.00 23,000.00 - 1,000 23,000.00 23,000,000.00
77 Glimepirid tab 2 mg Box/50
78 Gliserol sol. 100 ml Botol DAK 15 161 6,600.00 1,062,600.00 6,600.00 - 161 6,600.00 1,062,600.00
79 Glukosa Larutan Infus 10% steril 500 ml Kolf 500 ml DAK 16 120 7,500.00 900,000.00 7,500.00 - 120 7,500.00 900,000.00
80 Glukosa Larutan Infus 40% steril 25 ml Kolf 25ml DAK 19 540 14,080.00 7,603,200.00 14,080.00 - 540 14,080.00 7,603,200.00
81 Glukosa Larutan Infus 5% steril 500 ml Kolf 500 ml DAK 18 9,380 6,410.00 60,125,800.00 6,410.00 - 9,380 6,410.00 60,125,800.00
82 Griseofulvin (micronized) tab 125 mg Box/100 DAK 19 1,752 25,400.00 44,500,800.00 25,400.00 - 1,752 25,400.00 44,500,800.00
83 Griseofulvin (micronized) tab 500 mg Box/100 DAK 19 172 113,100.00 19,453,200.00 113,100.00 - 172 113,100.00 19,453,200.00
DAK 18 49 18,600.00 911,400.00 18,600.00 - 49 18,600.00 911,400.00
84 Hidroklorotiazid tab 25 mg Box/100 DAK 18 200 19,400.00 3,880,000.00 19,400.00 - 200 19,400.00 3,880,000.00
DAK 19 200 19,400.00 3,880,000.00 19,400.00 - 200 19,400.00 3,880,000.00
85 Hidrokortison krim 2,5% Tube DAK 18 3,672 2,846.00 10,450,512.00 2,846.00 - 3,672 2,846.00 10,450,512.00
86 Hiosina butilbromida Inj (Buscopan Injeksi) Box/10 DAK 16 10 400,000.00 4,000,000.00 400,000.00 - 10 400,000.00 4,000,000.00

87 Hiosina butilbromida tab 10 mg (Buscopan Tablet) Box/100

88 Ibuprofen tab 200 mg Box/100 BS PROP - 11,900.00 - 11,900.00 - - 11,900.00 -

89 Ichtiol salep kulit Pot
90 Isosorbid dinitrat tab 5 mg Box/100 BS PROP 1 8,900.00 8,900.00 8,900.00 - 1 8,900.00 8,900.00
91 Isoniazid tab 300 mg Box/100 DAK 18 94 19,030.00 1,788,820.00 19,030.00 - 94 19,030.00 1,788,820.00
92 Isoniazid tab 100 mg (PP INH) Box/100 BS PROP 8 12,500.00 100,000.00 12,500.00 - 8 12,500.00 100,000.00
93 Kalsium laktat (kalk) tab 500 mg Box/100 DAK 19 7,340 6,900.00 50,646,000.00 6,900.00 - 7,340 6,900.00 50,646,000.00
94 Kanamisin serb inj 1000 mg Box/10 DAU 15 27 120,000.00 3,240,000.00 120,000.00 - 27 120,000.00 3,240,000.00
95 Kaptopril tab 25 mg Box/100 DAK 19 2,763 14,464.00 39,964,032.00 14,464.00 - 2,763 14,464.00 39,964,032.00
Karbon Aktif Tab. Botol/40 DAK 19 2,204 18,333.00 40,405,932.00 18,333.00 - 2,204 18,333.00 40,405,932.00
96 Ketokonazol salep kulit Tube
DAK 19 372 16,250.00 6,045,000.00 16,250.00 - 372 16,250.00 6,045,000.00
97 Ketokonazol tab 200 mg Box/50
DAK 19 500 26,070.00 13,035,000.00 26,070.00 - 500 26,070.00 13,035,000.00
98 Ketorolak inj. 30mg/ml Box/6 DAK 19 372 38,170.00 14,199,240.00 38,170.00 - 372 38,170.00 14,199,240.00
99 Klindamisin kaps 150mg Box/50
100 Klindamisin kaps 300mg Box/50
101 Klonidin tab 0,15 mg Box/100 DAK 15 - 22,100.00 - 22,100.00 - - 22,100.00 -
102 Klopidogrel tab 75 mg Box/30
DAK 18 4,176 2,160.00 9,020,160.00 2,160.00 - 4,176 2,160.00 9,020,160.00
103 Kloramfenikol salep mata 1% Tube
DAK 19 7,200 2,305.00 16,596,000.00 2,305.00 - 7,200 2,305.00 16,596,000.00
104 Kloramfenikol tetes telinga 3% Botol
105 Klorfeniramin tab 4 mg (CTM) Box/100 DAK 19 4,303 2,700.00 11,618,100.00 2,700.00 - 4,303 2,700.00 11,618,100.00
106 Kodein tab 10 mg Box/100
107
Kombinasi (DHP) : Dihidroartemisin 40 mg + Piperakuin Box/9 BS PROP 1,882 19,260.00 36,247,320.00 19,260.00 - 1,882 19,260.00 36,247,320.00
320 mg tab sal selaput
108 Kombinasi : Ergotamin 1 mg+ Kafein 50 mg Botol/100

Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 mg DAK 18 7,489 13,350.00 99,978,150.00 13,350.00 - 7,489 13,350.00 99,978,150.00
109 Box/30
tab salut (Tablet Tambah darah) DAK 19 23,000 13,350.00 307,050,000.00 13,350.00 - 23,000 13,350.00 307,050,000.00

110
Kombinasi : Thiamin HCl + Piridoksin + Sianokobalamin Box/20
inj

111
Kombinasi : Thiamin HCl + Piridoksin + Sianokobalamin Box/200
tablet

112
Kotrimoksazol (dewasa) tablet kombinasi : Box/100 DAK 19 4,722 14,600.00 68,941,200.00 14,600.00 - 4,722 14,600.00 68,941,200.00
sulfametoksazol 400 mg+ trimetoprim 80 mg

113
Kotrimoksazol (dewasa) tablet kombinasi : Box/100 BS PROP
sulfametoksazol 800 mg+ trimetoprim 160 mg
Kotrimoksazol sirup kombinasi : sulfametoksazol 200 DAK 18 5,135 2,258.00 11,594,830.00 2,258.00 - 5,135 2,258.00 11,594,830.00
114 Botol
mg+ trimetoprim 40 mg per 5ml DAK 19 15,000 2,410.00 36,150,000.00 2,410.00 - 15,000 2,410.00 36,150,000.00
115 Lamprene Kapsul 100mg Kapsul BS PROP - 1,234.00 - 1,234.00 - - 1,234.00 -
116 Lansoprazol Kapsul Box/20 DAK 18 514 7,180.00 3,690,520.00 7,180.00 - 514 7,180.00 3,690,520.00

Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75

117 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27 gr) (KA EN Kolf 500 ml DAK 18 780 11,314.00 8,824,920.00 11,314.00 - 780 11,314.00 8,824,920.00
3B)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34
118 gr, Na Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KA EN Kolf 500 ml DAK 18 680 11,314.00 7,693,520.00 11,314.00 - 680 11,314.00 7,693,520.00
3A)
119 Lidokain gel 2% (Xilocain Jel) Tube
120 Lidokain HCl inj 2% Box/100
121 Lisinopril tab 10mg Box/30
122 Lisinopril tab 5mg Box/30
123 Loperamid tab 2 mg Box/100
124 Loratadin tab 10 mg Box/50 DAK 18 347 8,600.00 2,984,200.00 8,600.00 - 347 8,600.00 2,984,200.00
125 Magnesium sulfat inj 20% Vial BS PROP 37 3,328.00 123,136.00 3,328.00 - 37 3,328.00 123,136.00
126 Magnesium sulfat inj 40% Vial BS PROP 91 3,796.00 345,436.00 3,796.00 - 91 3,796.00 345,436.00
127 MD/MB COMBI Anak Box/6 blister BS PROP 6 123,324.00 739,944.00 123,324.00 - 6 123,324.00 739,944.00
128 MD/MB COMBI Dewasa Box/6 blister BS PROP - 250,704.00 - 250,704.00 - - 250,704.00 -
129 Meloksikam tab 15 mg Box/100 DAK 19 1,824 48,730.00 88,883,520.00 48,730.00 - 1,824 48,730.00 88,883,520.00
130 Meloksikam tab 7,5 mg Box/50 DAK 19 562 26,510.00 14,898,620.00 26,510.00 - 562 26,510.00 14,898,620.00
131 Metformin tab 500 mg Box/100 DAK 18 2,787 12,000.00 33,444,000.00 12,000.00 - 2,787 12,000.00 33,444,000.00
BS PROP 60 3,696.00 221,760.00 3,696.00 - 60 3,696.00 221,760.00
132 Metilergometrin inj 0,2 mg/ml Ampul
DAK 19 500 3,696.00 1,848,000.00 3,696.00 - 500 3,696.00 1,848,000.00
133 Metilergometrin tab salut 0,125 mg Box/100 DAK 18 443 27,060.00 11,987,580.00 27,060.00 - 443 27,060.00 11,987,580.00
134 Metoklopramid tab 10 mg Box/100 DAK 18 30 9,300.00 279,000.00 9,300.00 - 30 9,300.00 279,000.00
135 Metronidazol tab 250 mg Box/100
136 Metronidazol tab 500 mg Box/100 BS PROP - 36,179.00 - 36,179.00 - - 36,179.00 -
137 Mikonazol krim 2% Tube DAK 18 - 4,268.00 - 4,268.00 - - 4,268.00 -
BS PROP 8 116,800.00 934,400.00 116,800.00 - 8 116,800.00 934,400.00
138 Mineral Mix Box/40
DAK 19 200 124,640.00 24,928,000.00 124,640.00 - 200 124,640.00 24,928,000.00
139 NaCl 0,9% Larutan Kolf 500 ml DAK 18 5,480 6,410.00 35,126,800.00 6,410.00 - 5,480 6,410.00 35,126,800.00
BS PROP - 8,150.00 - 8,150.00 - - 8,150.00 -
140 Natrium diklofenak tab 25 mg Box/50
DAK 19 1,500 22,205.00 33,307,500.00 22,205.00 - 1,500 22,205.00 33,307,500.00
141 Natrium diklofenak tab 50 mg Box/50 DAK 19 1,500 27,772.00 41,658,000.00 27,772.00 - 1,500 27,772.00 41,658,000.00
142 Nifedipin kaps 10 mg Box/100
Nistatin tab 500.000IU Box/100 DAK 19 30 105,600.00 3,168,000.00 105,600.00 - 30 105,600.00 3,168,000.00
143 Nistatin tab vaginal 100.000 UI Box/100 DAK 19 83 74,700.00 6,200,100.00 74,700.00 - 83 74,700.00 6,200,100.00
144 Obat Anti Tuberculosis FDC Kategori Anak Paket BS PROP 16 310,153.00 4,962,448.00 310,153.00 - 16 310,153.00 4,962,448.00
145 Obat Anti Tuberculosis FDC Kategori I Paket BS PROP 141 519,342.00 73,227,222.00 519,342.00 - 141 519,342.00 73,227,222.00
146 Obat Anti Tuberculosis FDC Kategori II Paket BS PROP 15 1,731,230.00 25,968,450.00 1,731,230.00 - 15 1,731,230.00 25,968,450.00
147 OBH Sirup Botol
148 Oksitetrasiklin 1% salep mata Tube
149 Oksitetrasiklin 3% salep kulit Tube DAK 18 1,590 2,500.00 3,975,000.00 2,500.00 - 1,590 2,500.00 3,975,000.00
150 Oksitosin inj 10 UI/ml Ampul BS PROP 928 1,900.00 1,763,200.00 1,900.00 - 928 1,900.00 1,763,200.00
DAK 16 - 5,430.00 - 5,430.00 - - 5,430.00 -
DAK 17 2,000 4,740.00 9,480,000.00 4,740.00 - 2,000 4,740.00 9,480,000.00
151 Omeprazol kaps 20 mg Box/30
DAK 18 57 4,410.00 251,370.00 4,410.00 - 57 4,410.00 251,370.00
DAK 19 150 4,710.00 706,500.00 4,710.00 - 150 4,710.00 706,500.00
152 Papaverin tab 40 mg Box/100 DAK 18 327 16,628.00 5,437,356.00 16,628.00 - 327 16,628.00 5,437,356.00
153 Paraformaldehid tab 1 g Btl/100 OP 09 6 5,364.00 32,184.00 5,364.00 - 6 5,364.00 32,184.00
154 Parasetamol infus Botol
155 Parasetamol sir 120 mg/5 ml Botol
156 Parasetamol tab 100 mg Botol/100
157 Parasetamol tab 500 mg Box/100 DAK 19 2,273 28,693.00 65,219,189.00 28,693.00 - 2,273 28,693.00 65,219,189.00
158 Parasetamol tts 60 mg/0,6 ml Botol BS PROP - 8,311.00 - 8,311.00 - - 8,311.00 -
159 PD/PB Anak Box/6 blister BS PROP 5 79,800.00 399,000.00 79,800.00 - 5 79,800.00 399,000.00
160 PD/PB Dewasa Box/6 blister BS PROP - 102,552.00 - 102,552.00 - - 102,552.00 -
161 Pirantel pamoat susp 125 mg/5 ml Botol DAK 19 750 12,698.00 9,523,500.00 12,698.00 - 750 12,698.00 9,523,500.00
DAK 18 355 36,100.00 12,815,500.00 36,100.00 - 355 36,100.00 12,815,500.00
162 Pirantel pamoat tab scored 125 mg Box/100
DAK 19 2,000 38,500.00 77,000,000.00 38,500.00 - 2,000 38,500.00 77,000,000.00
DAK 18 - 15,400.00 - 15,400.00 - - 15,400.00 -
163 Piridoksin (vitamin B6) tab 10 mg Box/100
DAK 19 1,950 16,400.00 31,980,000.00 16,400.00 - 1,950 16,400.00 31,980,000.00
164 Piroksikam tab 10mg Box/100
Btl 60 ml DAK 17 4,640 3,700.00 17,168,000.00 3,700.00 - 4,640 3,700.00 17,168,000.00
165 Povidon iodin lar 100 mg/ml DAK 17 1,459 18,000.00 26,262,000.00 18,000.00 - 1,459 18,000.00 26,262,000.00
Btl 300 ml
DAK 18 1,000 22,500.00 22,500,000.00 22,500.00 - 1,000 22,500.00 22,500,000.00
166 PPD RT 23 (Mantoux Test) Vial BS PROP 21 977,181.00 20,520,801.00 977,181.00 - 21 977,181.00 20,520,801.00
Btl/1000 DAK 16 - 300,000.00 - 300,000.00 - - 300,000.00 -
167 Prednison tab 5 mg DAK 18 1,918 8,100.00 15,535,800.00 8,100.00 - 1,918 8,100.00 15,535,800.00
Box/100
DAK 19 3,000 8,600.00 25,800,000.00 8,600.00 - 3,000 8,600.00 25,800,000.00
BS PROP 53 25,300.00 1,340,900.00 25,300.00 - 53 25,300.00 1,340,900.00
168 Primakuin tab 15 mg Box/100
DAK 19 1,000 42,493.00 42,493,000.00 42,493.00 - 1,000 42,493.00 42,493,000.00
169 Propranolol tab 10 mg Btl/100 DAK 19 100 7,100.00 710,000.00 7,100.00 - 100 7,100.00 710,000.00
170 Propranolol tab 40 mg Box/100
171 Ranitidin Inj Box/10 DAK 19 55 32,560.00 1,790,800.00 32,560.00 - 55 32,560.00 1,790,800.00
172 Ranitidin tab 150 mg Box/30 DAK 19 - 13,860.00 - 13,860.00 - - 13,860.00 -
173 Retinol (vitamin A) kaps lunak 100.000 UI Btl/50 BS PROP 9 14,350.00 129,150.00 14,350.00 - 9 14,350.00 129,150.00
DAK 18 582 31,800.00 18,507,600.00 31,800.00 - 582 31,800.00 18,507,600.00
174 Retinol (vitamin A) kaps lunak 200.000 UI Btl/50
DAK 19 600 34,550.00 20,730,000.00 34,550.00 - 600 34,550.00 20,730,000.00
175 Rifampisin tab 450mg Box/100 DAK 18 100 113,471.00 11,347,100.00 113,471.00 - 100 113,471.00 11,347,100.00
Pengembalian RSUD 400 7,150.00 2,860,000.00 7,150.00 - 400 7,150.00 2,860,000.00
176 Ringer Laktat Larutan Kolf 500 ml
DAK 19 5,000 7,630.00 38,150,000.00 7,630.00 - 5,000 7,630.00 38,150,000.00
177 Rivanol Sol 10% Botol 300ml DAK 18 261 3,900.00 1,017,900.00 3,900.00 - 261 3,900.00 1,017,900.00
178 Salbutamol cairan ih 0,1% (Ventolin Nebule) Box/20 amp
179 Salbutamol tab 2 mg Box/100
180 Salbutamol tab 4 mg Box/100 BS PROP 116 9,200.00 1,067,200.00 9,200.00 - 116 9,200.00 1,067,200.00
DAK 18 2,640 3,280.00 8,659,200.00 3,280.00 - 2,640 3,280.00 8,659,200.00
181 Salep 2-4, Kombinasi Pot 30g
DAK 19 4,960 3,500.00 17,360,000.00 3,500.00 - 4,960 3,500.00 17,360,000.00
182 Sefiksim kaps 100mg Box/30 BS PROP 94 30,120.00 2,831,280.00 30,120.00 - 94 30,120.00 2,831,280.00
183 Sefotaksim seb inj 1000 mg Vial DAK 19 7,520 5,020.00 37,750,400.00 5,020.00 - 7,520 5,020.00 37,750,400.00
184 Seftriakson serb inj 1000 mg Vial DAK 19 5,500 5,488.00 30,184,000.00 5,488.00 - 5,500 5,488.00 30,184,000.00

Serum anti bisa ular :A.B.U.II (khusus ular dari Papua) inj DAK 19 2 76,450,000.00 152,900,000.00 76,450,000.00 - 2 76,450,000.00 152,900,000.00
185 Botol
(i.m./i.v.) 1 91,535,532.00 91,535,532.00 91,535,532.00 - 1 91,535,532.00 91,535,532.00

186 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul DAK 18 25 130,999.00 3,274,975.00 130,999.00 - 25 130,999.00 3,274,975.00

187 Setirisin tab 10 mg Box/100

188 Sianokobalamin (Vit. B12) inj Ampul
189 Simvastatin tab 10 mg Box/30 BS PROP - 3,510.00 - 3,510.00 - - 3,510.00 -
190 Siprofloksasin tab scored 500 mg Box/100
191 Spironolakton tab 25 mg Box/100
192 Sukralfat tab 500mg (Ulsidex) Box/100
193 Tetrasiklin kaps 250 mg Box/100 DAK 18 65 21,600.00 1,404,000.00 21,600.00 - 65 21,600.00 1,404,000.00
194 Tetrasiklin kaps 500 mg Box/100 DAK 17 216 35,000.00 7,560,000.00 35,000.00 - 216 35,000.00 7,560,000.00
195 Tiamin (vitamin B1) inj Box/30
DAK 18 4,603 9,600.00 44,188,800.00 9,600.00 - 4,603 9,600.00 44,188,800.00
196 Tiamin (vitamin B1) tab 50 mg Box/100
DAK 19 30 10,200.00 306,000.00 10,200.00 - 30 10,200.00 306,000.00
197 Tramadol inj 100 mg Ampul DAK 18 85 9,700.00 824,500.00 9,700.00 - 85 9,700.00 824,500.00
BS PROP 123 9,600.00 1,180,800.00 9,600.00 - 123 9,600.00 1,180,800.00
198 Vitamin B kompleks tablet Box/100
DAK 19 3,000 10,200.00 30,600,000.00 10,200.00 - 3,000 10,200.00 30,600,000.00
199 Zinc tab disp 20 mg Box/100 DAK 18 1,156 65,800.00 76,064,800.00 65,800.00 - 1,156 65,800.00 76,064,800.00

OBAT JIWA
DAK 16 25 17,900.00 447,500.00 17,900.00 - 25 17,900.00 447,500.00
200 Amitriptilin tab sal 25 mg Box/100
DAK 18 5 16,800.00 84,000.00 16,800.00 - 5 16,800.00 84,000.00
201 Alprazolam Tab. 0,5mg Box/100 BS PROP 1 10,800.00 10,800.00 10,800.00 - 1 10,800.00 10,800.00
202 Atarax tab 0,5 mg Box/100
203 Cepezet inj Box/10 RSJ 10 84,000.00 840,000.00 84,000.00 - 10 84,000.00 840,000.00
204 Cepezet tab 100 mg Box/100
RSJ 600 310.00 186,000.00 310.00 - 600 310.00 186,000.00
205 Diazepam tab 5 mg Tablet
BS PROP 700 109.00 76,300.00 109.00 - 700 109.00 76,300.00
206 Elizac tab 20 mg Box/30 BS PROP 14 6,750.00 94,500.00 6,750.00 - 14 6,750.00 94,500.00
207 Haloperidol inj 5 mg/ml (i.m.) Box/12
208 Haloperidol tablet 0,5mg Box/100 DAK 18 5 5,500.00 27,500.00 5,500.00 - 5 5,500.00 27,500.00
209 Haloperidol tablet 1,5mg Box/100 DAK 18 5 5,900.00 29,500.00 5,900.00 - 5 5,900.00 29,500.00
DAK 18 5 9,300.00 46,500.00 9,300.00 - 5 9,300.00 46,500.00
210 Haloperidol tablet 2mg (Lodomer) Box/100
DAK 19 400 9,900.00 3,960,000.00 9,900.00 - 400 9,900.00 3,960,000.00
DAK 18 5 6,200.00 31,000.00 6,200.00 - 5 6,200.00 31,000.00
211 Haloperidol tablet 5mg Box/100 BS PROP 32 5,600.00 179,200.00 5,600.00 - 32 5,600.00 179,200.00
DAK 19 400 6,600.00 2,640,000.00 6,600.00 - 400 6,600.00 2,640,000.00
212 Heximer tab 2 mg Box/100
213 Klobazam Tab. 10mg Box/100 BS PROP 9 96,700.00 870,300.00 96,700.00 - 9 96,700.00 870,300.00
214 Klorpromazin inj 25mg Ampul DAK 19 210 1,654.00 347,340.00 1,654.00 - 210 1,654.00 347,340.00
215 Klorpromazin tab sal 100 mg Box/100 DAK 19 200 19,700.00 3,940,000.00 19,700.00 - 200 19,700.00 3,940,000.00
216 Klorpromazin tab sal 25 mg Box/100
217 Klozapin Tab 25mg Box/50 BS PROP 15 77,500.00 1,162,500.00 77,500.00 - 15 77,500.00 1,162,500.00
219 Merlopam tab 0,5 mg Box/100 DAK 19 200 41,600.00 8,320,000.00 41,600.00 - 200 41,600.00 8,320,000.00
220 Risperidon tab 2mg Box/100 BS PROP 58 27,300.00 1,583,400.00 27,300.00 - 58 27,300.00 1,583,400.00
221 Sikzonoat inj Box/5 BS PROP 4 63,813.00 255,252.00 63,813.00 - 4 63,813.00 255,252.00
DAK 19 200 11,000.00 2,200,000.00 11,000.00 - 200 11,000.00 2,200,000.00
222 Triheksifenidil tab 2 mg Box/100
BS PROP 32 9,100.00 291,200.00 9,100.00 - 32 9,100.00 291,200.00

BAHAN MEDIS HABIS PAKAI (BMHP)

DAK 17 531 141,200.00 74,977,200.00 141,200.00 - 531 141,200.00 74,977,200.00
223 Alat suntik sekali pakai 3 ml Box/100
DAK 18 150 97,375.00 14,606,250.00 97,375.00 - 150 97,375.00 14,606,250.00
Alat suntik sekali pakai 5 ml (Terumo) DAK 16 115 560,000.00 64,400,000.00 560,000.00 - 115 560,000.00 64,400,000.00
DAK 16 500 90,300.00 45,150,000.00 90,300.00 - 500 90,300.00 45,150,000.00
224 Box/100
Alat suntik sekali pakai 5 ml (MRB) DAK 17 500 168,300.00 84,150,000.00 168,300.00 - 500 168,300.00 84,150,000.00
DAK 18 150 121,000.00 18,150,000.00 121,000.00 - 150 121,000.00 18,150,000.00
225 Alat suntik sekali pakai 0,05 ml Box/100
226 Alat suntik sekali pakai 0,5 ml Box/100
227 Alat suntik sekali pakai 10 ml Pcs DAK 18 7,100 1,500.00 10,650,000.00 1,500.00 - 7,100 1,500.00 10,650,000.00
228 Alat suntik sekali pakai 1ml Pcs
DAK 15 - 3,400.00 - 3,400.00 - - 3,400.00 -
229 Alat suntik sekali pakai 50ml Unit
DAK 18 500 4,250.00 2,125,000.00 4,250.00 - 500 4,250.00 2,125,000.00
DAK 18 489 12,000.00 5,868,000.00 12,000.00 - 489 12,000.00 5,868,000.00
230 Alkohol swab Box/100 DAK 19 500 12,500.00 6,250,000.00 12,500.00 - 500 12,500.00 6,250,000.00
DAK 19 124 38,500.00 4,774,000.00 38,500.00 - 124 38,500.00 4,774,000.00
231 Aquadest Steril 1000 ml Kolf
232 Bisturi no 10 Box/100
233 Bisturi no 20 Box/100
Blood Lancet Box/100 DAK 18 1,136 16,750.90 19,029,022.40 16,750.90 - 1,136 16,750.90 19,029,022.40
234 Blood Lancet (Frambusia) Box/200 BS PROP 20 1,190,000.00 23,800,000.00 1,190,000.00 - 20 1,190,000.00 23,800,000.00
Blood Lancet Box/100 DAK 19 100 29,700.00 2,970,000.00 29,700.00 - 100 29,700.00 2,970,000.00
235 Box Slide Box BS PROP 18 86,742.00 1,561,356.00 86,742.00 - 18 86,742.00 1,561,356.00
Cartridge GenXpert Set BS PROP 150 190,741.00 28,611,150.00 190,741.00 - 150 190,741.00 28,611,150.00
236 Catgut chromic No. 2/0 Sachet
237 Catgut chromic No. 3/0 Sachet
238 Catgut plain No. 2/0 (Onemed) Box/24 DAK 16 139 134,000.00 18,626,000.00 134,000.00 - 139 134,000.00 18,626,000.00
239 Catgut plain No. 3/0 (SMI) Sachet
240 Feeding Tube fr 5 40cm Unit
241 Feeding Tube fr 8 100cm Unit DAK 18 92 9,570.00 880,440.00 9,570.00 - 92 9,570.00 880,440.00
242 Folley Cateter 2 Way no 16 Pcs
243 Folley Cateter 2 Way no 18 Pcs DAK 19 103 11,040.00 1,137,120.00 11,040.00 - 103 11,040.00 1,137,120.00
244 Infusion set anak Pcs DAK 18 3,420 11,966.90 40,926,798.00 11,966.90 - 3,420 11,966.90 40,926,798.00
245 Infusion set dewasa Pcs DAK 18 5,090 8,419.15 42,853,473.50 8,419.15 - 5,090 8,419.15 42,853,473.50
DAK 16 350 8,355.00 2,924,250.00 8,355.00 - 350 8,355.00 2,924,250.00
246 IV Catheter No. 18 G Pcs
DAK 18 1,000 9,608.25 9,608,250.00 9,608.25 - 1,000 9,608.25 9,608,250.00
DAK 17 11,500 8,499.00 97,738,500.00 8,499.00 - 11,500 8,499.00 97,738,500.00
247 IV Catheter No. 20 G Pcs
DAK 18 10,000 9,608.25 96,082,500.00 9,608.25 - 10,000 9,608.25 96,082,500.00
DAK 17 4,150 8,499.00 35,270,850.00 8,499.00 - 4,150 8,499.00 35,270,850.00
248 IV Catheter No. 22 G Pcs
248 IV Catheter No. 22 G Pcs
DAK 18 15,000 9,608.25 144,123,750.00 9,608.25 - 15,000 9,608.25 144,123,750.00
Pcs DAK 17 4,500 8,499.00 38,245,500.00 8,499.00 - 4,500 8,499.00 38,245,500.00
249 IV Catheter No. 24 G
DAK 18 10,000 9,608.25 96,082,500.00 9,608.25 - 10,000 9,608.25 96,082,500.00
250 Jarum kulit no 10 GT Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
251 Jarum kulit no 9 GT Lusin
Jarum otot no 10 BR (MRM) Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
252
Jarum otot no 10 GR (DR MORTON) Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
253 Jarum otot no 13 BR Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
254 Jarum otot no 7 Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
255 Jarum otot no 8 Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
256 Jarum otot no 9 Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
DAK 16 3,657 13,400.00 49,003,800.00 13,400.00 - 3,657 13,400.00 49,003,800.00
257 Kapas Pembalut / Absorben 250 gram Rol DAK 16 2,500 28,530.00 71,325,000.00 28,530.00 - 2,500 28,530.00 71,325,000.00
DAK 18 1,000 16,750.00 16,750,000.00 16,750.00 - 1,000 16,750.00 16,750,000.00
DAK 15 148 7,700.00 1,139,600.00 7,700.00 - 148 7,700.00 1,139,600.00
258 Kasa Pembalut 2 m x 80 cm Rol DAK 16 2,000 7,930.00 15,860,000.00 7,930.00 - 2,000 7,930.00 15,860,000.00
DAK 18 2,500 9,910.00 24,775,000.00 9,910.00 - 2,500 9,910.00 24,775,000.00
DAK 18 467 133,625.00 62,402,875.00 133,625.00 - 467 133,625.00 62,402,875.00
259 Kasa Pembalut 40 yard x 80 cm Rol
DAK 19 600 131,250.00 78,750,000.00 131,250.00 - 600 131,250.00 78,750,000.00
260 Kasa Pembalut 4X15cm Rol DAK 18 2,570 2,800.00 7,196,000.00 2,800.00 - 2,570 2,800.00 7,196,000.00
DAK 16 4,610 800.00 3,688,000.00 800.00 - 4,610 800.00 3,688,000.00
261 Kasa Pembalut 4X5cm Rol
DAK 18 3,000 1,080.00 3,240,000.00 1,080.00 - 3,000 1,080.00 3,240,000.00
262 Masker Tie On Box/50 DAK 18 - 21,875.00 - 21,875.00 - - 21,875.00 -
263 Masker N95 Pcs DAK 18 1,859 8,140.00 15,132,260.00 8,140.00 - 1,859 8,140.00 15,132,260.00
264 Maxter Exam Non Powder L Box/100 DAK 19 500 72,875.00 36,437,500.00 72,875.00 - 500 72,875.00 36,437,500.00
265 Maxter Exam Non Powder M Box/100 DAK 19 498 72,875.00 36,291,750.00 72,875.00 - 498 72,875.00 36,291,750.00
266 Maxter Exam Non Powder S Box/100 DAK 19 500 72,875.00 36,437,500.00 72,875.00 - 500 72,875.00 36,437,500.00
267 Nasal Oxygen Bayi Pcs DAK 19 280 6,875.00 1,925,000.00 6,875.00 - 280 6,875.00 1,925,000.00
268 Nasal Oxygen Dewasa Pcs DAK 19 263 6,875.00 1,808,125.00 6,875.00 - 263 6,875.00 1,808,125.00
269 Nasal Oxygen Size L Pcs
270 Nasal Oxygen Size M Pcs
271 Nasal Oxygen Size S Pcs
272 Nasal Oxygen Size XS Pcs DAK 16 - 6,600.00 - 6,600.00 - - 6,600.00 -
273 Pembalut Elastis 10cmx4,55m Rol DAK 16 140 43,987.00 6,158,180.00 43,987.00 - 140 43,987.00 6,158,180.00
274 Pembalut Elastis 15cmx4,55m Rol DAK 16 74 54,139.00 4,006,286.00 54,139.00 - 74 54,139.00 4,006,286.00
275 Pembalut Elastis 7,5cmx4,55m Rol DAK 16 107 36,012.00 3,853,284.00 36,012.00 - 107 36,012.00 3,853,284.00
DAK 15 18,050 1,925.00 34,746,250.00 1,925.00 - 18,050 1,925.00 34,746,250.00
276 Penjepit Tali Pusar Pcs
DAK 18 25,000 1,495.00 37,375,000.00 1,495.00 - 25,000 1,495.00 37,375,000.00
Pipet Pasteur dengan karet Box/100 DAK 19 2 165,000.00 330,000.00 165,000.00 - 2 165,000.00 330,000.00
277 Plester 2,5cm x 4,5m Rol
278 Plester 7,5cm x 4,5m Rol
279 Plester 5cm X 4,5m Rol
BS PROP - 3,968.00 - 3,968.00 - - 3,968.00 -
280 Pot sputum Steril Pot DAK 18 3,630 3,410.00 12,378,300.00 3,410.00 - 3,630 3,410.00 12,378,300.00
DAK 19 5,000 3,410.00 17,050,000.00 3,410.00 - 5,000 3,410.00 17,050,000.00
281 Regulator Oksigen Unit DAK 18 1 2,530,000.00 2,530,000.00 2,530,000.00 - 1 2,530,000.00 2,530,000.00
282 Safety Box Box BS PROP 6 16,608.00 99,648.00 16,608.00 - 6 16,608.00 99,648.00
283 Safegloves Latex Examination Gloves S Box/100 DAK 19 56 44,525.00 2,493,400.00 44,525.00 - 56 44,525.00 2,493,400.00
284 Safegloves Latex Examination Gloves M Box/100 DAK 19 - 44,525.00 - 44,525.00 - - 44,525.00 -
285 Safegloves Latex Examination Gloves L Box/100 DAK 19 4 44,525.00 178,100.00 44,525.00 - 4 44,525.00 178,100.00
286 Sarung Tangan Non Steril Uk. M Box/100 BS PROP - 49,610.00 - 49,610.00 - - 49,610.00 -
287 Sarung Tangan Non Steril Uk. L Box/100 BS PROP - 49,610.00 - 49,610.00 - - 49,610.00 -
Sarung tangan no.7 (Steril) Frambusia Pasang BS PROP 100 7,735.00 773,500.00 7,735.00 - 100 7,735.00 773,500.00
288
Sarung tangan no.7 (Steril) JMI Pasang DAK 18 - 8,032.75 - 8,032.75 - - 8,032.75 -
Sarung tangan no.7,5 (Steril) Frambusia Pasang BS PROP - 16,003.00 - 16,003.00 - - 16,003.00 -
289
Sarung tangan no.7,5 (Steril) JMI Pasang DAK 18 - 8,032.75 - 8,032.75 - - 8,032.75 -
Sarung tangan no.8 (Steril) Ansell Pasang DAK 17 - 8,090.00 - 8,090.00 - - 8,090.00 -
290 Sarung tangan no.8 (Steril) Aximed Pasang DAK 16 1,950 7,600.00 14,820,000.00 7,600.00 - 1,950 7,600.00 14,820,000.00
Sarung tangan no.8 (Steril) JMI Pasang DAK 18 5,000 8,032.75 40,163,750.00 8,032.75 - 5,000 8,032.75 40,163,750.00
DAK 17 1,245 20,973.00 26,111,385.00 20,973.00 - 1,245 20,973.00 26,111,385.00
291 Sarung Tangan Obgyn Steril Pasang
DAK 18 1,000 23,232.00 23,232,000.00 23,232.00 - 1,000 23,232.00 23,232,000.00
292 Silk No. 1 (SMI) Sachet DAK 16 528 23,900.00 12,619,200.00 23,900.00 - 528 23,900.00 12,619,200.00
293 Silk No. 3/0 (SMI) Sachet DAK 16 156 22,400.00 3,494,400.00 22,400.00 - 156 22,400.00 3,494,400.00
Silk No.2/0 Sachet DAK 15 204 16,064.00 3,277,056.00 16,064.00 - 204 16,064.00 3,277,056.00
294 Silk No.2/0 (Onemed) Box/36 DAK 16 100 110,000.00 11,000,000.00 110,000.00 - 100 110,000.00 11,000,000.00
Silk No.2/0 (SMI) Sachet DAK 16 888 23,300.00 20,690,400.00 23,300.00 - 888 23,300.00 20,690,400.00
BS PROP - 30,183.00 - 30,183.00 - - 30,183.00 -
295 Slide Box/72
DAK 17 52 22,005.15 1,144,267.80 22,005.15 - 52 22,005.15 1,144,267.80
DAK 15 99 10,010.00 990,990.00 10,010.00 - 99 10,010.00 990,990.00
296 Stomach Tube fr 12 Pcs
DAK 18 100 17,678.95 1,767,895.00 17,678.95 - 100 17,678.95 1,767,895.00
DAK 15 83 10,010.00 830,830.00 10,010.00 - 83 10,010.00 830,830.00
297 Stomach Tube fr 16 Pcs DAK 16 200 33,600.00 6,720,000.00 33,600.00 - 200 33,600.00 6,720,000.00
DAK 18 100 17,678.95 1,767,895.00 17,678.95 - 100 17,678.95 1,767,895.00
298 Stomach Tube fr 18 Pcs DAK 18 53 17,678.95 936,984.35 17,678.95 - 53 17,678.95 936,984.35
DAK 16 - 3,000.00 - 3,000.00 - - 3,000.00 -
299 Urine Bag Pcs DAK 18 420 3,750.00 1,575,000.00 3,750.00 - 420 3,750.00 1,575,000.00
DAK 19 5,000 3,750.00 18,750,000.00 3,750.00 - 5,000 3,750.00 18,750,000.00
300 USG Gel 250ml Botol

BAHAN OBAT GIGI

301 Articulating Paper Pak
302 Eugenol cair Botol
303 FUJI GP A2 Pak
304 FUJI GP A3 Pak
305 Micro Brush Pak
306 Saliva Ejector Pak/50
307 Zink Fosfat Pak

REAGEN
288 Alat HB Sahli Kit DAK 18 28 105,600.00 2,956,800.00 105,600.00 - 28 105,600.00 2,956,800.00
Botol 100ml DAK 16 22 15,576.00 342,672.00 15,576.00 - 22 15,576.00 342,672.00
289 Alkohol 95%
Botol 300ml DAK 18 24 37,400.00 897,600.00 37,400.00 - 24 37,400.00 897,600.00
290 AUTOCHECK 3IN1 Multi Monitoring System Kit DAK 16 4 82,800.00 331,200.00 82,800.00 - 4 82,800.00 331,200.00
DAK 19 37 130,900.00 4,843,300.00 130,900.00 - 37 130,900.00 4,843,300.00
291 AUTOCHECK Blood Glucose Test Strip Btl/25
DAK 19 145 130,900.00 18,980,500.00 130,900.00 - 145 130,900.00 18,980,500.00
 DAK 19 161 239,800.00 38,607,800.00 239,800.00 - 161 239,800.00 38,607,800.00
292 AUTOCHECK Total Cholesterol Test Strip Btl/10
DAK 19 225 239,800.00 53,955,000.00 239,800.00 - 225 239,800.00 53,955,000.00
DAK 19 81 167,200.00 13,543,200.00 167,200.00 - 81 167,200.00 13,543,200.00
293 AUTOCHECK Uric Acid Test Strip Btl/25
DAK 19 145 167,200.00 24,244,000.00 167,200.00 - 145 167,200.00 24,244,000.00
GF Malaria 2019 - 6,476.00 - 6,476.00 - - 6,476.00 -
294 Carestar Malaria Device PAN-PLDH, Pf-HRP2 Test BS PROP - 6,931.00 - 6,931.00 - - 6,931.00 -
DAK 19 8,650 19,600.00 169,540,000.00 19,600.00 - 8,650 19,600.00 169,540,000.00
295 Cleaning kit Kit
296 Control 3 Diff. Normal 16 Parameter 1X4,5ml Kit
297 Dengue Rapid Test Test
298 Diluen 20L (900 cycle) Galon 15L DAK 19 13 5,225,000.00 67,925,000.00 5,225,000.00 - 13 5,225,000.00 67,925,000.00
299 ELITech ALT/GPT SL 2X62,5ml Kit DAK 18 - 2,942,500.00 - 2,942,500.00 - - 2,942,500.00 -
300 ELITech AST/GOT SL 2X62,5ml Kit DAK 18 - 2,915,000.00 - 2,915,000.00 - - 2,915,000.00 -
301 ELITech Cholesterol PAP SL 6X100ml + std 5ml Kit DAK 18 - 5,060,000.00 - 5,060,000.00 - - 5,060,000.00 -
302 ELITech Cholesterol Std 200mg 4x5ml Kit
303 ELITech Creatinine Jaffe 2X125ml Kit
304 ELITech Glucose PAP SL 6X100ml Kit DAK 18 - 2,915,000.00 - 2,915,000.00 - - 2,915,000.00 -
305 ELITech Glucose Std 100mg/dl 4x5ml Kit
306 ELITech Trigliserid Mono SL 6X50ml + Std 5ml Kit DAK 18 - 5,258,000.00 - 5,258,000.00 - - 5,258,000.00 -
307 ELITech Urea UV SL 4X62,5ml + Std 5ml Kit
308 ELITech Uric Acid Mono SL 6X100ml Kit DAK 18 - 5,357,000.00 - 5,357,000.00 - - 5,357,000.00 -
309 ELITech Uric Acid Std 6mg/dl 4x5ml Kit
310 Elitrol 1 (Normal) 10x5ml Kit
311 FTS (Filariasis Tes Strip) untuk W. Bancrofti Test
312 Focus Malaria Pan/Pf Casette Box/25 DAK 18 - 605,000.00 - 605,000.00 - - 605,000.00 -
313 Focus RPR Syphillis Box/100
314 Focus TPHA Box/100

315
HEMOSMART GOLD Hemoglobin Screening System Kit
Simple
316 HEMOSMART GOLD Hemoglobin Test Strip Btl/25 DAK 19 133 348,700.00 46,377,100.00 348,700.00 - 133 348,700.00 46,377,100.00
317 Larutan Anisol Botol 100ml DAK 18 4 278,300.00 1,113,200.00 278,300.00 - 4 278,300.00 1,113,200.00
318 Larutan Carbol Fuchsin Botol 100ml DAK 16 - 11,220.00 - 11,220.00 - - 11,220.00 -
319 Larutan Carbol Gentian Violet Botol 100ml DAK 16 - 9,504.00 - 9,504.00 - - 9,504.00 -
320 Larutan Emersi oil Botol 100ml DAK 18 12 963,600.00 11,563,200.00 963,600.00 - 12 963,600.00 11,563,200.00
321 Larutan Giemsa Btl 500 ml DAK 18 - 1,419,000.00 - 1,419,000.00 - - 1,419,000.00 -
DAK 18 - 12,100.00 - 12,100.00 - - 12,100.00 -
322 Larutan H2O2 3% Botol 100ml
DAK 19 261 4,368.00 1,140,048.00 4,368.00 - 261 4,368.00 1,140,048.00
DAK 17 57 13,728.00 782,496.00 13,728.00 - 57 13,728.00 782,496.00
323 Larutan HCl 0,1 N Botol 100ml
DAK 18 50 23,100.00 1,155,000.00 23,100.00 - 50 23,100.00 1,155,000.00
324 Larutan Metanol Botol 100ml DAK 18 - 53,000.00 - 53,000.00 - - 53,000.00 -
325 Larutan Methilen Blue Botol 100ml DAK 18 34 47,300.00 1,608,200.00 47,300.00 - 34 47,300.00 1,608,200.00
326 Larutan Turk Botol 100ml DAK 18 7 37,400.00 261,800.00 37,400.00 - 7 37,400.00 261,800.00
327 Lugol Botol 100ml DAK 16 - 175,000.00 - 175,000.00 - - 175,000.00 -
328 Lyze 5L (900 Cycle) Galon 5L DAK 19 13 7,749,500.00 100,743,500.00 7,749,500.00 - 13 7,749,500.00 100,743,500.00
329 NaCl 0,9% 100ml Botol 100ml
330 Paket Alat Deteksi Resiko Kehamilan Paket Kemenkes 2018 4 501,745.00 2,006,980.00 501,745.00 - 4 501,745.00 2,006,980.00
331 Rapid Test Hepatitis (SD) Box/100 -
Rapid Test HIV 1 / SD Test BS PROP - 11,975.00 - - 11,975.00 -
332
332
Rapid Test HIV 1 / VIKIA Test
Rapid Test HIV 2 / KHB Diagnostics Test 12,500.00 - - 12,500.00 -
334 Rapid Test HIV 2 / FOCUS Box/25 BS PROP - 352,925.00 - - 352,925.00 -
Rapid Test HIV 2 / TRILINE Test
Rapid Test HIV 3 / VIKIA Box/25 - 487,000.00 - - 487,000.00 -
336 BS PROP
Rapid Test HIV 3 / Diagnostar DS Test 16,511.00 - - 16,511.00 -
Rapid Test Syphillis Hexagon (Frambusia) Box/20 - 546,354.00 - 546,354.00 - - 546,354.00 -
337 BS PROP
RDT Syphillis SD (Frambusia) Test 675 20,400.00 13,770,000.00 20,400.00 - 675 20,400.00 13,770,000.00
Rapid Test Syphillis / SD Test - 20,400.00 - - 20,400.00 -
BS PROP
Rapid Sypillis RB-TS 25 Test 12,132.00 - - 12,132.00 -
338 RDT SD Bioline HBSAg Test BS PROP 2,870 9,850.00 28,269,500.00 9,850.00 - 2,870 9,850.00 28,269,500.00
16 266,410.00 4,262,560.00 266,410.00 - 16 266,410.00 4,262,560.00
BS PROP
339 Reagen Ziehl Nielsen Paket 30 254,059.00 7,621,770.00 254,059.00 - 30 254,059.00 7,621,770.00
DAK 17 98 297,440.00 29,149,120.00 297,440.00 - 98 297,440.00 29,149,120.00
340 RPR Syphillis (Focus) Test
341 Serum Golongan Darah (Glory) Set
Serum Golongan Darah Anti A (Plasmatec) Vial DAK 18 13 215,875.00 2,806,375.00 215,875.00 - 13 215,875.00 2,806,375.00
Serum Golongan Darah Anti B (Plasmatec) Vial DAK 18 13 215,875.00 2,806,375.00 215,875.00 - 13 215,875.00 2,806,375.00
342
Serum Golongan Darah Anti AB (Plasmatec) Vial DAK 18 13 215,875.00 2,806,375.00 215,875.00 - 13 215,875.00 2,806,375.00
Serum Golongan Darah Anti D (Plasmatec) Vial DAK 18 13 215,875.00 2,806,375.00 215,875.00 - 13 215,875.00 2,806,375.00
343 Total Protein Plus 2X125ml Kit
344 Uryxxon Stick 10 Box/100

LAIN-LAIN
345 Air Raksa (Hg) Botol 100g DAK 15 48 500,000.00 24,000,000.00 500,000.00 - 48 500,000.00 24,000,000.00
346 Food Sec. ARSENIC Test Kit Kit
347 Food Sec. BORAX Test Kit Kit
348 Food Sec. CYANIDA Test Kit Kit
349 Food Sec. FORMALDEHYDE Test Kit Kit DAK 18 1 7,590,000.00 7,590,000.00 7,590,000.00 - 1 7,590,000.00 7,590,000.00
350 Food Sec. NITRATE-NITRITE Test Kit Kit
351 Food Sec.MERCURY Test Kit Kit
352 HCG TEST (Focus) Box/50 DAK 18 160 107,500.00 17,200,000.00 107,500.00 - 160 107,500.00 17,200,000.00
353 Iodium test btl 10 ml
354 Kertas EKG rol DAU 09 16 73,125.00 1,170,000.00 73,125.00 - 16 73,125.00 1,170,000.00
355 Kertas USG rol DAU 09 3 354,375.00 1,063,125.00 354,375.00 - 3 354,375.00 1,063,125.00

Total: 7,239,554,096.05 - - - 7,239,554,096.05

7,239,554,096.05 7,239,554,096.05
Plt. Kepala Dinas Kesehatan Kasie. Kefarmasian
Kabupaten Merauke

Dra. Erny Siahaya, Apt. Eduardus P. Tumanggor, S. Si., Apt

NIP. 19621031 199003 2 002 NIP.19780710 200312 1 008
No Tanggal PBF No Faktur Nama Obat / BMHP Kemasan Jumlah Sumber Dana No Batch ED Harga Satuan Total harga

1 11/4/2019 PT. Papua 01/PPS/XII/2019 AUTOCHECK Uric Acid Test Strip Btl/25 260 DAK 2019 U19165100 05 2021

Pasti Sehat (non Ekatalog) AUTOCHECK Uric Acid Test Strip Btl/25 9 U19166100 05 2021
AUTOCHECK Uric Acid Test Strip Btl/25 6 U19161100 05 2021

275 167,200 45,980,000

AUTOCHECK Blood Glucose Test Strip Btl/25 80 G19281076 07 2021

AUTOCHECK Blood Glucose Test Strip Btl/25 195 G19280076 07 2021

275 130,900 35,997,500

AUTOCHECK Total Cholesterol Test Strip Btl/10 200 C19208100 03 2021 239,800 47,960,000

Hb Strip + Hematocrit Bio sensor Tech. Btl/25 170 YAS2190402 09 2020

Hb Strip + Hematocrit Bio sensor Tech. Btl/25 20 YAS2190402 09 2020

190 348,700 66,253,000

Total: 196,190,500

2 12/13/2019 PT. Kimia DO.KF.19.0000768 Fenitoin Kaps. 100mg Btl/100 200 DAK 2019 391002 10 2021 15,800 3,160,000

Farma (Ekatalog)

Total: 3,160,000

199,350,500