Laporan Puskesmas Tanjung Bintang Jan 2021

PEMERINTAH KABUPATEN LAMPUNG SELATAN
DAFTAR REALISASI PENAMBAHAN DAN PENGURANGAN BARANG PERSEDIAAN DAERAH
NOMOR : 445/ / IV.03 / I / 2021

PUSKESMAS : Rawat Inap Tanjung bintang
KECAMATAN : Tanjung Bintang
KABUPATEN : LAMPUNG SELATAN
BARANG PERSEDIAAN : OBAT - OBATAN, VAKSIN/SERUM DAN BAHAN MEDIS HABIS PAKAI
BULAN : JANUARI 2021
MUTASI TAMBAH MUTASI KURANG
SALDO Penerimaan Puskesmas dari IFK SALDO Per 31

NO JENIS BARANG Penggunaan puskesmas KET
Per 1 Januari 2021 BELANJA Dinas Kabupaten BELANJA
BELANJA
LAIN- Januari 2021
RELOKASI LAIN-LAIN JUMLAH BARANG JUMLAH
BARANG JASA MODAL RELOKASI LAIN
Barang Belanja Barang JASA Barang Belanja Barang
Barang Hibah Barang Hibah
dan Jasa dan Jasa
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 OBAT, BMHP, VAKSIN APBD II 120,336,592.20 - - 18,662,208.46 18,662,208.46 101,674,383.74
OBAT, BMHP, VAKSIN APBD I

2 8,414,374.00 84,876,542.00 84,876,542.00 56,536,964.00 56,536,964.00 36,753,952.00
(PROPINSI)
3 OBAT DAN BMHP BOK 2,270,000.00 - - 2,270,000.00 2,270,000.00 -
BAHAN KEPERLUAN
4 - 3,750,000.00 3,750,000.00 3,750,000.00 3,750,000.00 -
LABORATORIUM
PERALATAN KEBERSIHAN DAN
5 - - - - - -
BAHAN PEMBERSIH
6 APBN - - - - - - -
- - -
JUMLAH 131,020,966.20 - 3,750,000.00 84,876,542.00 - - - 88,626,542.00 - 24,682,208.46 56,536,964.00 - - 81,219,172.46 138,428,335.74 -
MENGETAHUI Tanjung Bintang, 30 Januari 2021
Kepala UPT. Puskesmas Rawat Inap Tanjung Bintang Penyimpan Barang UPT Puskesmas Rawat Inap Tanjung Bintang Pengelola Obat UPT. Puskesmas Rawat Inap Tanjung Bintang
Kabupaten Lampung Selatan Dinas Kesehatan Kab. Lampung Selatan
Ahmad Solich Annas M, S.Farm, Apt

DARMAWAN SKM.M Kes Ns. P. Tri Husodo, S.Kep NIP . 19781002 201001 1 011
NIP. 19720603 199302 1 001 NIP. 19830408 201101 1 003
PEMERINTAHAN KABUPATEN LAMPUNG SELATAN
UPT PUSKESMAS R I TANJUNG BINTANG
DINAS KESEHATAN KABUPATEN LAMPUNG SELATAN
Jalan Budi Santoso No 1 Jatibaru
Kecamatan Tanjung Bintang
BERITA ACARA STOK OPNAME PERSEDIAAN OBAT

Nomor : 442/ /IV.03 / XII / 2020
Pada hari ini, Sabtu tanggal Tiga Puluh, bulan Januari, Tahun Dua Ribu Dua Puluh Satu, yang bertanda tangan dibawah ini Tim Stok Opname
Obat, Perbekalan Kesehatan dan Vaksin Dinas Kesehatan Kabupaten Lampung Selatan.
Telah melakukan pemeriksaan stok opname persediaan obat, perbekalan kesehatan dan vaksin sampai dengan hari ini 30 JANUARI 2021 di
Gudang Farmasi UPT. Instalasi Farmasi Kabupaten Lampung Selatan dengan keadaan sebagai berikut :
HARGA HASIL STOK

NO NAMA OBAT SATUAN JUMLAH HARGA (Rp) KET
SATUAN (Rp) OPNAME
1 OBAT - OBATAN APBD II

SUB OBAT -OBATAN
ACT(Artesunate Tablet 50 mg + Amodiaquine
1 Tablet 1,375.00 - -
anhydrida Tablet 200 mg)
2 Albendazol Tablet Kunyah 400 mg Tablet 392.00 - -
4 Alkohol 70 % - 100 ml Botol 100 ml 2,500.00 - -
5 Alkohol 70 % - 100 ml Botol 100 ml 2,900.00 - -
6 Alkohol 70 % - 1 L Botol 1 L 25,000.00 - -
7 Alkohol 70 & - 1 L Botol 1 L 18,700.00 285 5,329,500.00
8 Alkohol 70 & - 1 L Jrg 20 L 319,000.00 5 1,595,000.00
9 Alopurinol Tablet 100 mg Tablet 86.00 - -
10 Alopurinol Tablet 100 mg Tablet 90.00 300 27,000.00
13 Alprazolam Tablet 1 mg Tablet 233.00 - -
14 Alprazolam Tablet 1 mg Tablet 162.00 - -
15 Alprazolam Tablet 1 mg Tablet 120.00 1,836 220,320.00
16 Alprazolam Tablet 0,25 mg Tablet 380.00 - -
17 Alprazolam Tablet 0,5 mg Tablet 88.00 - -
18 Ambroxol Tablet 30 mg Tablet 124.94 - -
19 Aminofilin Injeksi 24 mg/ml Amp 10 ml 3,823.00 - -
20 Aminofilin Injeksi 24 mg/ml Ampul 3,345.00 - -
21 Aminofilin Tablet 200 mg Tablet 993.00 - -
22 Aminofilin Tablet 150 mg (Decafil) Tablet 139.00 - -
23 Aminofilin Tablet 150 mg (Decafil) Tablet 148.00 - -
24 Amitriptilin Tablet Salut 25 mg (HCl) Tablet 112.00 - -
27 Amlodipine Tablet 10 mg Tablet 330.00 - -
35 Amoksisilin Kaplet 500 mg Tablet 272.00 - -
36 Amoksisilin Kaplet 500 mg kaplet 232.00 - -
37 Amoksisilin Kaplet 500 mg kaplet 233.00 300 69,900.00
38 Amoksisilin Kaplet 500 mg kaplet 249.00 5,000 1,245,000.00
39 Amoksisilin Kapsul 250 mg Kapsul 211.00 - -
40 Amoksisilin Kapsul 250 mg kapsul 195.00 - -
41 Amoksisilin Kapsul 250 mg Kapsul 184.00 - -
42 Amoksisilin Kapsul 250 mg Kapsul 196.00 4,500 882,000.00
43 Amoksisilin Syrup Kering 125 mg/5ml Botol 60 ml 2,445.00 - -
47 Amoksisilin Syrup Kering 250 mg/5ml Botol 60 ml 2,050.00 50 102,500.00
48 Ampisilin Serbuk Injeksi im/iv. 1000 mg/vial Kotak 10 Vial 51,000.00 - -
2
HARGA HASIL STOK
SATUAN (Rp) OPNAME
Antasida DOEN Tablet Kunyah, Kombinasi :

49 Tablet 72.00 - -
AlOH 200 mg + MgOH 200 mg
50 Tablet 62.00 - -
51 Tablet 54.00 - -
52 Tablet 58.00 13,500 783,000.00
53 Antasida DOEN II Suspensi Kombinasi Botol 60 ml 2,025.00 - -
54 Antasida DOEN II Suspensi Kombinasi Botol 60 ml 1,995.00 - -

55 Antasida DOEN II Suspensi Kombinasi Botol 60 ml 2,129.00 50 106,450.00
56 Antibakteri DOEN (Bacitracin Salep Kulit) Tube 2,924.00 - -
57 Antibakteri DOEN (Bacitracin Salep Kulit) Tube 3,035.00 - -
Antifungi DOEN Kombinasi:
58 Pot 30 gr 1,719.00 - -
Asam Benzoat 6% + AsamSalisilat 3%
59 Tube 4,158.00 - -
60 Pot 4,496.00 48 215,808.00
61 Pot 4,798.00 - -
62 Antihemoroid kombinasi Suppositoria 3,045.00 - -
63 Antihemoroid kombinasi Suppositoria 3,167.00 70 221,690.00
Antimalaria DOEN Kombinasi:
64 Tablet 483.00 - -
Pirimetamin 25 mg + Sulfadoksin 500 mg
Antimigren Tablet :
65 Tablet 135.00 - -
Ergotamin Tartrat 1 mg + Kofein 50 mg
Antimigren Tablet : Ergotamin 1 mg + Kafein 50
66 Tablet 173.00 200 34,600.00
mg (Generik Kombinasi)
67 Artemether Injeksi 80 mg/ml ampul 22,000.00 - -
68 Artesunate Injeksi vial 60 mg viaL 38,999.00 - -
69 Asam Asetilsalisilat Tablet 100 mg (Asetosal) Tablet 116.00 - -
70 Asam Askorbat (Vitamin C) Tablet 250mg Tablet 125.00 - -

72 Asam Askorbat (Vitamin C) Tablet 50mg Tablet 105.00 12,000 1,260,000.00
73 Asam Folat Tablet 1 mg Tablet 48.00 - -
74 Asam Folat Tablet 1 mg Tablet 70.00 - -
75 Asam Folat Tablet 1 mg Tablet 75.00 3,900 292,500.00
76 Asam Folat Tablet 0,4 mg Tablet 63.00 - -
77 Asam Folat Tablet 0,4 mg Tablet 55.00 - -
78 Asam Mefenamat Kapsul 500 mg Tablet 112.00 - -
80 Asam Mefenamat Kapsul 500 mg Tablet 103.00 1,400 144,200.00
81 Asiklovir krim 2,5 % Tube 2,995.00 - -
82 Asiklovir krim 5 % Tube 3,850.00 25 96,250.00
83 Asiklovir krim 5 % Tube 3,146.00 - -
84 Asiklovir Tablet 200 mg Tablet 237.00 - -
87 Asiklovir Tablet 400 mg Tablet 380.00 2,400 912,000.00
88 Atropin Sulfat Injeksi. i.m./i.v./s.k. 0,25 mg/ml Amp 1 ml 1,350.00 - -
89 Atropin Sulfat Tablet 0,5mg Tablet 74.00 - -
90 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 9,800.00 - -
Besi (II) Sulfat 200 mg + Asam Folat 0,25mg
91 Tablet 367.00 - -
Tablet (tablet tambah darah kombinasi)
92 Tablet 352.00 - -
93 Betahistin Tablet 6 mg Tablet 149.00 - -
94 Betametason Krim 0,1% (sebagai valerat) Tube 1,520.00 - -
99 Bromheksin Tablet 8 mg Tablet 39.00 - -
100 Cetrizin Syrup 5mg/5ml Botol 2,850.00 - -
101 Cetrizin Tablet 10 mg Tablet 181.00 - -
102 Cetrizin Tablet 10 mg Tablet 90.00 200 18,000.00
103 Cimetidine 200 mg Tablet 192.67 3,100 597,277.00
104 Deksametason 1nj 5 mg/ml Vial 1,500.00 - -
3
HARGA HASIL STOK
SATUAN (Rp) OPNAME
105 Deksametason 1nj 5 mg/ml Ampul 1,097.00 10 10,970.00

106 Deksametason Tablet 0.5 mg Tablet 32.00 - -
108 Deksametason Tablet 0.5 mg Tablet 176.00 1,300 228,800.00
109 Diazepam Injeksi 5 mg/ml Ampul 4,180.00 - -
110 Diazepam Injeksi 5 mg/ml Ampul 1,735.00 10 17,350.00
111 Diazepam Tablet 2 mg Tablet 45.00 - -
112 Diazepam Tablet 2 mg Tablet 86.00 450 38,700.00
113 Diazepam Tablet 5 mg Tablet 109.00 770 83,930.00
114 Diazepam Enema (Stesolid 5 mg/2,5 ml) Tube 12,573.00 - -
115 Dietilkarbamazin 100 mg Tablet 158.00 - -
116 Difenhidramin Injeksi i.m.10 mg/ml (HCl) Ampul 1,054.00 - -
117 Difenhidramin Injeksi i.m.10 mg/ml (HCl) Ampul 1,176.00 - -
118 Difenhidramin Injeksi i.m.10 mg/ml (HCl) Ampul 1,168.00 21 24,528.00
119 Digoksin Tablet 0,25 mg Tablet 97.00 - -
120 Digoksin Tablet 0,25 mg Tablet 105.00 500 52,500.00
121 Dimenhidrinat Tablet 50 mg Tablet 104.00 - -
122 Doksisiklin Kapsul 100 mg Tablet 270.00 - -
123 Doksisiklin Kapsul 100 mg Tablet 269.00 500 134,500.00
124 Doksisiklin Kapsul 100 mg Tablet 280.00 - -
125 Domperidon Suspensi 5 mg/ml Botol 60 ml 3,333.00 - -
126 Domperidon Suspensi 5 mg/ml Botol 60 ml 2,700.00 - -
127 Domperidon Tablet 10 mg Tablet 85.00 - -
129 Epinefrin (Adrenalin) Injeksi 1mg/ml ampul 8,100.00 - -
131 Epinefrin (Adrenalin) Injeksi 1mg/ml ampul 1,408.00 180 253,440.00
133 Ekstarak Beladona Tab 250 mg Tablet 235.00 - -
134 Eritromisin Kapsul 250 mg Tablet 49.00 - -
135 Eritromisin Kapsul 250 mg Tablet 566.00 - -
136 Eritromisin Kapsul 250 mg Kapsul 546.00 - -
137 Eritromisin Syrup 200 mg / 5ml Botol 60 ml 7,700.00 - -
138 Eritromisin Syrup 200 mg / 5ml Botol 60 ml 9,702.00 50 485,100.00
139 Fenobarbital Injeksi i.m./i.v. 50 mg/ml Amp 1ml 1,800.00 - -
140 Fenobarbital 30 mg Tablet Tablet 171.00 309 52,839.00
141 Fenol Gliserol Tetes Telinga10% Botol 5 ml 1,008.00 - -
Kotak 30 Amp
144 Fitomenadion (Vit-K1) Injeksi 10 mg/ml 4,250.10 - -
1ml
145 Fitomenadion (Vit-K1)Tab Salut Gula10 mg Tablet 634.00 - -
147 Fitomenadion (Vit-K1)Tab Salut Gula10 mg Tablet 710.00 100 71,000.00
149 Fitomenadion (Vit-K1) Injeksi 2 mg/ml Amp 1ml 3,417.00 - -
150 Fitomenadion (Vit-K1) Injeksi 2 mg/ml Ampul 3,550.00 - -
151 Fitomenadion (Vit-K1) Injeksi 2 mg/ml Ampul 3,682.00 115 423,430.00
152 Furosemid Injeksi i.v/i.m. 10 mg/ml Amp 2ml 1,829.00 - -
153 Furosemid Tablet 40 mg Tablet 85.00 - -
154 Furosemid Tablet 40 mg Tablet 77.00 1,400 107,800.00
155 Gameksan Lotion 1% Botol 3,000.00 - -
156 Garam Oralit Serbuk Sachet 28.00 - -
157 Garam Oralit Kombinasi Sachet 264.00 - -
158 Gemfibrozil Kapsul 300 mg Kapsul 289.00 - -
159 Gentamisin Injeksi 40 mg/ml Amp 2ml 3,399.00 - -
160 Gentamisin Injeksi 40 mg/ml Vial 2ml 15,450.00 - -
161 Gentamisin Injeksi 40 mg/ml Ampul 3,509.00 - -
162 Gentamisin salep Kulit 0,1 % Tube 3,400.00 - -
163 Gentamisin Sulfat Tetes Mata 0,3% Botol 5 ml 3,194.00 - -
164 Gentamisin Sulfat Tetes Mata 0,3% Botol 5 ml 4,232.00 96 406,272.00
166 Gentamisin Salep mata( GENOINT) Tube 2,830.00 - -
167 Gentamisin Sulfat Salep mata 0,3 % Tube 2,675.00 72 192,600.00
168 Gentian Violet Larutan 1 % Botol 10 ml 2,925.00 - -
169 Gentian Violet Larutan 1 % Botol 10 ml 3,320.00 - -
170 Gentian Violet Larutan 1 % Botol 10 ml 3,344.00 14 46,816.00
171 Glibenklamida Tablet 5 mg Tablet 56.00 - -
172 Glibenklamida Tablet 5 mg Tablet 92.00 - -
173 Glibenklamida Tablet 5 mg Tablet 119.00 2,600 309,400.00
174 Gliserilguaiakolat Tablet 100 mg Tablet 34.12 - -
175 Gliserin Liquid Botol 100 ml 5,333.00 - -
4
HARGA HASIL STOK
SATUAN (Rp) OPNAME
176 Glukosa Larutan Infus 5% steril Botol 500 ml 5,200.00 - -

177 Glukosa Larutan Infus 5% steril Botol 500 ml 6,900.00 - -
178 Glukosa Larutan Infus 5% steril Botol 500 ml 7,363.00 300 2,208,900.00
179 Guaifenisin Botol 178.00 - -
180 Guaifenisin 100 mg Tablet 177.00 - -
181 Guaifenisin 100 mg Tablet 233.20 7,800 1,818,960.00
182 Griseofulvin Tablet 125 mg Tablet 209.00 - -
185 Haloperidol Injeksi 5% Vial 4,000.00 - -
186 Haloperidol Injeksi 50 mg/ml Ampul 101,300.00 - -
187 Haloperidol Tablet 1,5 mg Tablet 69.00 - -
188 Haloperidol Tablet 1,5 mg Tablet 66.00 - -
189 Haloperidol Tablet 2 mg Tablet 126.00 - -
191 Haloperidol Tablet 2 mg (lodomer) Tablet 84.00 - -
192 Haloperidol Tablet 2 mg (lodomer) Tablet 90.00 150 13,500.00
196 Hidrogen Peroksida (H2O2) Larutan 3% Botol 1000 ml 18,700.00 - -
197 Hidrogen Peroksida (H2O2) Larutan 3% Botol 100 ml 4,780.00 - -
198 Hidroklorotiazida Tablet 25 mg Tablet 149.00 - -
199 Hidroklorotiazida Tablet 25 mg Tablet 155.00 - -
200 Hidrokortison krim 2,5% Tube 5 gram 2,798.00 - -
201 Hidrokortison krim 2,5% Tube 5 gram 2,650.00 - -
202 Hidrokortison krim 2,5% Tube 5 gram 2,475.00 24 59,400.00
203 Hidrokortison krim1% Tube 5 gram 2,570.00 - -
204 Ibuprofen Suspensi 100 mg/5ml Botol 60 ml 3,499.00 - -
207 Ibuprofen Suspensi 100 mg/5ml Botol 60 ml 2,721.00 50 136,050.00
208 Ibuprofen Tablet 400 mg Tablet 150.00 - -
212 Ichtiol Salep Tube 5,399.00 - -
213 Ichtiol Salep Tube 5,940.00 - -
214 Isoniazid Tablet 300 mg Tablet 158.00 - -
215 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet 88.00 - -
216 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet 89.00 - -
217 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 58.00 - -
220 Kalsium Laktat (Kalk) Tablet 5 mg Tablet 59.00 4,600 271,400.00
221 Kaptopril Tablet 12,5 mg Tablet 62.00 - -
222 Kaptopril Tablet 12,5 mg Tablet 59.00 - -
223 Kaptopril Tablet 12,5 mg Tablet 66.00 1,000 66,000.00
224 Kaptopril Tablet 25 mg Tablet 84.00 - -
225 Kaptopril Tablet 25 mg Tablet 68.00 1,000 68,000.00
226 Kaptopril Tablet 25 mg Tablet 75.00 2,300 172,500.00
229 Karbamazepin Tablet 200 mg Tablet 230.00 - -
230 Karbamazepin Tablet 200 mg Tablet 245.00 - -
231 Ketokonazol Krim 2 % Tube 15 gram 4,700.00 - -
232 Ketokonazol Krim 2 % Tube 2,545.00 - -
233 Ketokonazol Krim 2 % Tube 2,518.00 40 100,720.00
234 Ketokonazol Tablet 200 mg Tablet 300.00 - -

235 Ketokonazol Tablet 200 mg Tablet 270.00 - -
236 Ketokonazol Tablet 200 mg Tablet 288.00 2,750 792,000.00
237 Ketoprofen Tablet 100 mg Tablet 608.00 - -
238 Klindamisin Kapsul 150 mg Kapsul 361.00 - -
239 Klindamisin Kapsul 150 mg Kapsul 715.00 - -
240 Kloramfenikol Kapsul 250 mg Kapsul 267.00 - -
241 Kloramfenikol Kapsul 250 mg Kapsul 310.00 - -
242 Kloramfenikol Salep Mata 1 % 5 gram Tube 1,600.00 - -
5
HARGA HASIL STOK
SATUAN (Rp) OPNAME

246 Kloramfenikol salep kulit 2 % Tube 3,091.00 - -
247 Kloramfenikol salep kulit 2 % (Bufacetin) Tube 3,008.00 - -
248 Kloramfenikol salep kulit 2 % (Bufacetin) Tube 3,242.00 72 233,424.00
249 Kloramfenikol Suspensi 125mg/5ml Botol 3,955.00 - -
250 Kloramfenikol Suspensi 125mg/5ml Botol 5,015.00 50 250,750.00
Kloramfenikol Tetes Mata Komb. ( Erlamicetin
251 Botol 15,444.00 - -
Plus)
252 Kloramfenikol Tetes Telinga 3 % - 5ml Botol 1,815.00 - -
253 Kloramfenikol Tetes Telinga 1% (Erlamycetin) Botol 8,360.00 10 83,600.00
254 Kloramfenikol Tetes Telinga 1% (Erlamycetin) Botol 7,843.00 - -
255 Klorfeniramina Maleat (CTM )Tablet 4 mg Tablet 51.00 - -
258 Klorfeniramina Maleat (CTM )Tablet 4 mg Tablet 23.00 5,300 121,900.00
259 Klorokuin Tablet 150 mg Tablet 107.00 - -
260 Klorpromazin Tablet Salut 100 mg (HCl) Tablet 149.00 - -

266 Klorpromazin Injeksi i.m.25 mg/ml(HCl) Ampul 2ml 1,100.00 - -
267 Klorpromazin Injeksi i.m.25 mg/ml(HCl) Ampul 1,240.00 - -
268 Kodein Tablet 10 mg Tablet 500.00 - -
269 Kodein Tablet 10 mg Tablet 571.00 - -
270 Kodein Tablet 20 mg Tablet 1,100.00 - -
Kotrimoksazol DOEN (dewasa) Kombinasi :
271 Tablet 138.00 - -
Sulfametoksazol 400mg
Kotrimoksazol DOEN +Trimetoprim
(dewasa) 80mg:
Kombinasi
272 Tablet 138.00 - -
Sulfametoksazol 400mg +Trimetoprim
Kotrimoksazol DOEN (dewasa) Kombinasi 80mg:
273 Tablet 151.00 2,700 407,700.00
(dewasa) 80mg:
Kombinasi
274 Tablet 125.00 - -
(dewasa) 80mg:
Kombinasi
275 Tablet 133.00 - -
Sulfametoksazol 400mg +Trimetoprim 80mg
Kotrimoksazol DOEN (pediatrik) Kombinasi :
276 Tablet 76.00 - -
Sulmetoksazol 100 mg + Trimetoprim 20 mg
Kotrimoksazol Suspensi Kombi : Sulfame-

277 Botol 60 ml 2,190.00 127 278,130.00
toksazol 20 mg + Trimetoprim 40mg/5ml
278 Botol 60 ml 2,140.00 - -
Kotrimoksazol Suspensi Kombi tiap 5ml :
279 Sulfematoksazol 200 mg + Trimetoprim 40mg Botol 60 ml 2,052.00 - -
(susp 240 mg)
280 Kuinin (Kina) Tablet 200 mg Tablet 670.00 - -
281 Kuinin Injeksi i.v. 25% (sebagai 2HCl) Amp 2 ml 6,200.00 - -
282 Kuinin Tablet 222 mg (H2SO4.7H2O) Tablet 540.00 - -

283 Lansoprazol Kapsul 30 mg Kapsul 473.00 - -
284 Levertran Salep pot 3,599.00 - -
285 Levertran Salep Pot 4,268.00 24 102,432.00
286 Levofloksasin Tablet 500 mg Tablet 528.00 - -
287 Lidokain Injeksi 2% Ampul 2 ml 839.00 - -
288 Lidokain Injeksi 2% Ampul 860.00 - -
289 Lidokain Injeksi 2% Ampul 1,221.00 - -
Lidokain Injeksi 2% + Epinefrin 1:80.000 Injeksi 2
290 Ampul 1,145.00 - -
ml
Lidokain Injeksi 2% + Epinefrin 1:80.000 Injeksi 2
291 Ampul 1,222.00 - -
ml
292 Lidokain Spray (Xylocain Spray) Botol 177,216.00 - -
293 Linkomisin Kapsul 500 mg Kapsul 650.00 - -
294 Lisol Larutan Antiseptik Botol 1000 ml 41,000.00 5 205,000.00
295 Loperamid tablet 2 mg Tablet 85.00 - -
296 Loperamid tablet 2 mg Tablet 374.00 700 261,800.00
297 Magnesium Sulfat Injeksi (IV)20%-25ml Vial 2,800.00 - -
298 Magnesium Sulfat Injeksi (IV)20%-25ml Vial 3,200.00 - -
299 Magnesium Sulfat Injeksi (IV)40% Ampul 3,796.00 - -
300 Mebendazol Syrup 100 mg/5ml Botol 30 ml 3,400.00 - -
301 Metampiron Injeksi 250 mg Amp 2 ml 1,333.00 - -
302 Metformin HCl Tablet 500 mg Tablet 100.00 - -
303 Metformin HCl Tablet 500 mg Tablet 102.00 400 40,800.00
304 Metformin HCl Tablet 850 mg Tablet 150.00 - -
6
HARGA HASIL STOK
SATUAN (Rp) OPNAME
305 Metilergometrin Maleat Injeksi 0,2 mg/ml Ampul 2,684.00 - -

306 Metilergometrin Maleat Injeksi 0,2 mg/ml Ampul 2,959.00 - -
307 Metilergometrin Maleat Tab Salut 0,125 mg Tablet 154.00 - -
308 Metilergometrin Maleat Tab Salut 0,125 mg Tablet 210.00 100 21,000.00
309 Metilergometrin Maleat Tab Salut 0,125 mg Tablet 224.00 - -
310 Metilprednisolon Injeksi 500 mg Kotak 1 Vial 8 ml 93,393.00 - -
311 Metilprednisolon kaplet 4 mg Tablet 150.00 - -
312 Metilprednisolon kaplet 4 mg Tablet 134.00 - -
313 Metilprednisolon kaplet 4 mg Tablet 143.00 400 57,200.00
314 Metilprednisolon kaplet 8 mg Kaplet 309.00 - -
315 Metoklorpramid syrup 5 mg/5 ml Botol 2,530.00 100 253,000.00
316 Metoklorpramid 5 mg Tab Tablet 121.00 - -
317 Metoklorpramid 10 mg Tab Tablet 90.00 100 9,000.00
318 Metoklorpramid 10 mg Tab Tablet 80.00 400 32,000.00
319 Metoklorpramid 10 mg Tab Tablet 85.00 - -
320 Metronidazol Tablet 250 mg Tablet 110.00 - -
321 Metronidazol Tablet 250 mg Tablet 94.00 2,100 197,400.00
324 Mikonazol Krim/Salep 2 % (Nitrat) Tube 10 gram 3,000.00 - -
325 Mikonazol Krim/Salep 2 % (Nitrat) Tube 10 gram 3,250.00 - -
326 Mikonazol Krim/Salep 2 % (Nitrat) Tube 10 gram 3,414.00 34 116,076.00
327 Natrium Diklofenak Tablet 25 mg Tablet 133.00 - -
331 Natrium Klorida Larutan Infus 0,9% Botol 500 ml 4,700.00 - -
332 Natrium Klorida Larutan Infus 0,9% Botol 500 ml 6,410.00 - -
333 Natrium Klorida Larutan Infus 0,9% Botol 500 ml 6,840.00 160 1,094,400.00
334 Natrium Tiroxin (Etyrox) Tablet 850.00 - -
335 N-Asetil sistein Kapsul 426.00 - -
336 N-Asetil sistein Kapsul 358.00 - -
337 N-Asetil sistein Kapsul 382.00 7,480 2,857,360.00
338 Nistatin Tablet Salut 500.000 IU/g Tablet 640.00 - -
342 Nistatin vaginal Tablet 100.000 IU/g Tablet 480.00 - -
343 Nistatin vaginal Tablet 100.000 IU/g Tablet 523.00 600 313,800.00
344 Nistatin vaginal Tablet 100.000 IU/g Tablet 560.00 - -
345 Obat Anti Tuberkulosis FDC Kategori 1 Paket 359,990.00 - -
348 Obat Anti Tuberkulosis FDC Kategori 1 Paket 389,344.00 3 1,168,032.00
349 Obat Anti Tuberkulosis FDC Kategori 2 Paket 1,199,985.00 - -
351 Obat Anti Tuberkulosis FDC Kategori Anak Paket 214,990.00 - -
354 Obat Anti Tuberkulosis FDC sisipan Paket 160,000.00 - -
355 Obat Anti Tuberkulosis Kategori 1 Paket 288,199.00 - -
356 Obat Batuk Hitam(O.B.H.) cairan Botol 100 ml 1,716.00 - -
357 Obat Batuk Hitam(O.B.H.) cairan Botol 120 ml 5,735.00 - -
358 Obat Batuk Hitam(O.B.H.) cairan Molex Botol 120 ml 5,500.00 60 330,000.00
359 Obat Batuk Kombinasi (Hustab) tablet Tablet 434.00 - -
360 Obat Batuk Kombinasi (Hustab) tablet Tablet 429.00 - -
361 Ofloxacin Tablet 400 mg Tablet 650.00 - -
362 Oksitetrasiklin HCl Salep Mata 1% Tube 3,5 g 3,220.00 - -
363 Oksitetrasiklin HCl Salep Mata 1% Tube 3,5 g 2,668.00 - -
364 Oksitosin Injeksi 10 IU/ml-1ml ampul 2,200.00 - -
365 Oksitosin Injeksi 10 IU/ml-1ml Ampul 1,900.00 - -
367 Omeprazol Kapsul 20 mg Kapsul 211.00 - -
371 Papaverin Tablet 40 mg Tablet 100.00 - -
372 Papaverin Tablet 40 mg Tablet 298.00 - -
373 Parasetamol Drops Botol 15 ml 5,200.00 - -
374 Parasetamol Drops Botol 15 ml 6,649.00 56 372,344.00
7
HARGA HASIL STOK
SATUAN (Rp) OPNAME
375 Parasetamol Syrup 120 mg/ 5ml Botol 60 ml 1,438.00 - -

380 Parasetamol Tablet 500 mg Tablet 79.00 - -

383 Piracetam Injeksi 3g/15ml Amp 15ml 13,750.00 - -
384 Piracetam Tablet 400 mg Tablet 194.00 - -
385 Pirantel Syrup 125 mg/5ml Botol 60 ml 8,360.00 - -
386 Pirantel Tablet score (base) 125 mg Tablet 298.00 - -
387 Pirantel Tablet score (base) 125 mg Tablet 291.00 - -
388 Pirazinamid Tablet 500 mg Tablet 208.00 - -
389 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 980.00 - -
390 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) Botol 100 Tablet 11,000.00 - -
391 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) tablet 45.00 - -
392 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) Tablet 123.00 4,600 565,800.00
393 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) Tablet 131.00 - -
394 Piroxicam Tablet 10 mg Tablet 84.00 - -
395 Piroxicam Tablet 10 mg Tablet 130.00 - -
396 Povidon Iodida Larutan 10% Botol 30 ml 2,163.00 - -
397 Povidon Iodida Larutan 10% botol 60 ml 6,550.00 - -
399 Povidon Iodida Larutan 10% botol 60 ml 3,700.00 96 355,200.00
400 Povidon Iodida Larutan 10% botol 60 ml 4,620.00 - -
401 Povidon Iodida Larutan 10% Botol 300 ml 18,000.00 20 360,000.00
403 Prednison Tablet 5 mg Tablet 114.00 - -
404 Prednison Tablet 5 mg Kaplet 96.00 - -
405 Prednison Tablet 5 mg Tablet 68.00 - -
406 Prednison Tablet 5 mg Tablet 73.00 6,400 467,200.00
407 Primakuin Tablet Tablet 224.00 100 22,400.00
408 Prokain Benzil Penisilin G.Injeksi 3 jt IU/vial Vial 7,190.00 - -
409 Prokain Penisillin inj Vial 6,017.00 - -
410 Propanolol Tablet 10 mg (HCl) Tablet 65.00 - -
411 Propanolol Tablet 10 mg (HCl) Tablet 60.00 - -
412 Propiltiourasil Tablet 100 mg Tablet 319.00 - -
413 RanitidinTablet 150 mg Tablet 98.00 - -
414 Retinol (Vitamin A) 100.000 IU Kapsul Lunak Botol 50 Kapsul 13,000.00 - -
415 Retinol (Vitamin A) 100.000 IU Kapsul Lunak Botol 50 Kapsul 14,200.00 - -
416 Retinol (Vitamin A) 200.000 IU Kapsul Lunak Kapsul 519.20 - -

418 Rifampisin Tablet Salut 450 mg Tablet 789.00 - -
419 Ringer Laktat Larutan Infus Botol 500 ml 5,200.00 - -
421 Ringer Laktat Larutan Infus Botol 500 ml 7,630.00 4,620 35,250,600.00
422 Risperidon Tablet 1 mg Kapsul 1,500.00 - -
423 Risperidon Tablet 2 mg Kapsul 1,008.00 - -
424 Risperidon Tablet 2 mg Tablet 495.00 - -
425 Risperidon Tablet 2 mg Tablet 273.00 - -
426 Risperidon Tablet 2 mg Tablet 287.00 905 259,735.00
427 Salbutamol Tablet 2 mg (sebagai Sulfat) Tablet 59.00 - -
428 Salbutamol Tablet 2 mg (sebagai Sulfat) tablet 66.00 - -
429 Salbutamol Tablet 2 mg (sebagai Sulfat) tablet 63.00 500 31,500.00
432 Salbutamol Tablet 4 mg (sebagai Sulfat)
Salep 2-4 ,Kombinasi: Tablet 70.00 400 28,000.00
433 Asam Salisilat 2% + Belerang endap
Salep 2-4 ,Kombinasi: Pot 30 gr 2,000.00 - -
434 4% Asam Salisilat 2% + Belerang endap Tube 2,429.00 - -
Salep 2-4 ,Kombinasi:
435 4% Asam Salisilat 2% + Belerang endap Pot 2,621.00 - -
436 4% Asam Salisilat 2% + Belerang endap Pot 2,797.00 24 67,128.00
437 4%
Salisil Bedak 2% Ktk 50 gram 1,250.00 - -
438 Salisil Bedak 2% kotak 1,025.00 - -
439 Salisil Bedak 2% Kotak 1,020.00 - -
440 Salisil Bedak 2% Botol 50 g 4,525.00 - -
441 Salisil Bedak 2% Botol 50 g 4,543.00 24 109,032.00
442 Sefaleksin Kapsul 500 mg Tablet 1,000.00 - -
8
HARGA HASIL STOK
SATUAN (Rp) OPNAME
443 Sianokobalamin (Vit-B12 ) Injeksi 500 mcg amp @1ml 1,077.00 - -

444 Sianokobalamin (Vit-B12 ) Injeksi 500 mcg Ampul 1,098.00 - -
445 Sianokobalamin (Vit-B12) Tablet 50 mcg Tablet 57.00 - -
447 Sianokobalamin (Vit-B12) Tablet 50 mcg Tablet 46.00 500 23,000.00
449 Simvastatin Tablet 10 mg tablet 131.00 - -
450 Simvastatin Tablet 10 mg Tablet 110.00 - -
451 Simvastatin Tablet 10 mg Tablet 117.00 5,610 656,370.00
452 Simvastatin Tablet 20 mg Tablet 391.00 - -
453 Simvastatin Tablet 20 mg tablet 252.00 - -
454 Siprofloksasin Tablet 500 mg (sebagai HCl) Tablet 255.00 - -
455 Siprofloksasin Tablet scored 500 mg Tablet 281.00 - -
458 Siprofloksasin Tablet scored 500 mg Tablet 1,188.00 800 950,400.00
459 Sulfasetamida Natrium Tetes Mata 15% Botol 5ml 1,428.00 - -
460 Tetrakain HCl Tetes Mata 0,5% Botol @ 5ml 11,500.00 - -
461 Tetrasiklin Kapsul 250 mg Kapsul 149.00 - -
462 Tetrasiklin Kapsul 500 mg Kapsul 300.00 - -
463 Tetrasiklin Kapsul 500 mg Tablet 310.00 500 155,000.00
464 Tetrasiklin Kapsul 500 mg Tablet 323.00 - -
465 Tiamin HCl (Vitamin B1) Tablet Kapsul 380.00 - -
466 Tiamin HCl (Vitamin B1) Tablet Tablet 81.00 - -
467 Tiamin HCl (Vitamin B1) Tablet Tablet 86.00 500 43,000.00
468 Tiamin HCl (Vitamin B1) Tablet Tablet 85.00 - -
469 Tramadol Injeksi 50 mg/ml ampul 2,395.00 - -
470 Tramadol Injeksi 50 mg/ml ampul 1,764.00 15 26,460.00
471 Tramadol Kapsul 50 mg Kapsul 322.00 - -
472 Tramadol Injeksi 100 mg/ml ampul 2,700.00 - -
473 Triheksifenidil Tablet 2 mg Tablet 80.00 - -
476 Vitamin B Kompleks Tablet Tablet 107.00 - -
479 Vitamin B Kompleks Tablet Tablet 117.00 200 23,400.00
480 Zinc Tablet 20 mg Tablet 474.00 - -
481 Zinc Tablet dispersible 20 mg Tablet 514.00 - -
482 Zinc Tablet dispersible 20 mg Tablet 524.00 300 157,200.00
483 Ongkir - - - -
- - - -
OBAT GIGI - - - -
1 Calplus Tube 333,830.00 - -
2 Calsium Hidroksi Pasta ( Calplus) Pack 330,491.70 - -
3 Caviton (Temporary Stoping Fleker) Pot 184,240.00 - -
4 Caviton (Temporary Stoping Fleker) Pot 182,397.60 - -
5 CHKM (Monokloramkamfer Menthol Cairan) Botol 77,030.00 - -
6 CHKM (Monokloramkamfer Menthol Cairan) Botol 76,259.70 - -
7 Cold Spray Botol 352,000.00 - -
8 Devitalisasi Pasta (Pulp X) Botol 256,790.00 - -
9 Devitalisasi Pasta NON Arsen ( Devita) Pot 259,996.00 - -
10 Eugenol cairan Botol 18,100.00 - -
11 Glass Ionomer Cement Set 395,000.00 - -
12 Glass Ionomer (Ketac Universal) Botol 761,390.00 - -

13 Glass Ionomer (Ketac Universal) Botol 658,845.00 - -
14 Mummipaying Pasta (Cresotin Pasta) Tube 309,310.00 - -
15 Mummipaying Pasta (Cresotin Pasta) Pot 262,350.00 - -
16 Semen Seng Posfat Sebuk / Cair Botol 30gr 93,500.00 - -
17 Zink Cement (Eliet Cement) Botol 197,730.00 - -
18 Zink Cement (Eliet Cement) Botol 195,800.00 - -
- - - -
PERBEKALAN KESEHATAN - - - -
1 Alat Suntik Sekali Pakai 0,05 ml pieces 1,354.00 - -
2 Alat Suntik Sekali Pakai 0,5 ml pieces 1,175.00 - -
3 Alat Suntik Sekali Pakai 1 ml Pieces 762.00 - -
4 Alat Suntik Sekali Pakai 1 cc Pieces 689.86 100 68,986.00
5 Alat Suntik Sekali Pakai 2,5 cc Pieces 669.80 - -
6 Alat Suntik Sekali Pakai 3 ml pcs 1,038.00 - -
9
HARGA HASIL STOK
SATUAN (Rp) OPNAME
7 Alat Suntik Sekali Pakai 3 ml pieces 916.00 - -

8 Alat Suntik Sekali Pakai 3 ml pieces 1,212.00 - -
9 Alat Suntik Sekali Pakai 3 cc pieces 669.80 - -
10 Alat Suntik Sekali Pakai 5 ml pcs 1,038.00 - -
11 Alat Suntik Sekali Pakai 5 ml pieces 1,030.00 - -
12 Alat Suntik Sekali Pakai 5 cc pieces 804.07 450 361,831.50
13 Aqua jely steril 5 gr Sachet 2,566.00 - -
14 Bisturi (BBraun steril scalpel blades #18) pcs 3,000.00 - -
Catgut / Benang Bedah 2/0, 26 mm (Gabler
15 pieces 64,595.67 - -
Med)
16 pcs 60,438.84 - -
Med)
17 pcs 50,063.09 - -
Med)
Catgut / Benang Bedah 2/0, 1/2 taper 30 mm
18 pcs 58,839.90 60 3,530,394.00
(Gabler Med)
19 Cutgut 2/0,90 cm.1/2TP ( Chromic 2/0) pcs 49,619.29 - -
20 Catgut / Benang Bedah 3/0 Rol 23,600.00 - -
21 Catgut / Benang Bedah 3/0 pcs 58,355.51 - -
22 Catgut / Benang Bedah 3/0 pieces 42,605.12 - -
23 Cutgut 3/0 ,1/2 TP 22mm,75-2PTRO20EE pieces 55,000.00 72 3,960,000.00
24 Folley Catheter No. 18 Pieces 8,495.00 - -
25 Folley Catheter No. 18 Pieces 11,000.00 21 231,000.00
26 Folley Catheter No. 18 pieces 18,450.00 - -
27 Folley Catheter 2- WAY No. 18 pieces 11,565.00 - -
28 Gel Catheter Tube 82,500.00 - -
29 Hand Scone Steril #7,0 (Aximed) Pasang 7,872.00 - -
30 Hand Scone Steril #7,0 (Aximed) Pcs 6,595.00 - -
31 Hand Scone Steril #7,5 (Aximed) Pieces 7,600.00 - -
32 Hand Scone Steril #7,5 (medict dent) pasang 5,000.00 - -
Handscone Steril ( Mas Surgical Gloves 7,5
33 pasang 8,888.00 50 444,400.00
steril)
34 Hand Scone Steril #7,5 (KISMED) pcs 6,595.00 - -
35 Hand Scone / Sarung Tangan Non Steril pcs 69.85 - -
36 Hand Scone Non Steril # L (Aximed) pcs 462.00 - -
37 Hand Scone Non Steril # L (LIGHTY mas latex) pcs 462.00 - -
Hand Scone Non Steril # L (pree powdered mas

38 pcs 462.00 - -
latex)
39 Handscone Non Steril (L ) (Mas pree powdered) pcs 522.06 - -
40 Hand Scone Non Steril # M (Aximed) pcs 462.00 - -
41 Hand Scone Non Steril # M (kismed mask latex) pcs 462.00 - -
42 Handscone Non Steril (M ) (Mas pree powdered) pcs 522.06 - -
43 Handscone Non Steril 7.5 ( Mask Surgical) Pasang 8,701.00 - -

44 Infusion Set Anak (Aximed) Set 5,100.00 130 663,000.00
45 Infusion Set Anak set 4,884.00 - -
46 Infusion Set Anak pcs 5,661.00 - -
49 Infusion Set Dewasa Set 3,500.00 - -
52 Infusion Set Dewasa pcs 5,445.00 - -
54 Infusion Set Dewasa (y - TYPE) pcs 8,061.00 215 1,733,115.00
55 IV Canula non inj & wing no 20 (Eskamed) Pieces 10,386.21 - -
58 IV Catheter No. 20 G pcs 7,787.50 - -
59 IV Catheter NP No. 20 G Pieces 6,105.00 - -
60 IV Catheter No. 20 G Pieces 10,000.00 350 3,500,000.00
61 IV Catheter No. 20 G Pieces 10,500.00 - -
62 IV Catheter No. 20 G pieces 10,483.00 - -
10
HARGA HASIL STOK
SATUAN (Rp) OPNAME

71 IV Catheter No. 24 G pieces 12,100.00 250 3,025,000.00
72 Kapas Berlemak 500 gram Bungkus 17,250.00 - -
73 Kapas Pembalut / Absorben 250 gram Bungkus 7,475.00 - -
74 Kapas Pembalut / Absorben 250 gram Bungkus 12,400.00 - -
75 Kapas Pembalut / Absorben 250 gram Roll 12,500.00 - -
76 Kapas Pembalut / Absorben 250 gram Roll 24,000.00 9 216,000.00
77 Kapas Pembalut / Absorben 250 gram Roll 20,600.00 - -
78 Kassa Hidrofil Steril Ukuran 16 x 16 cm Bungkus 5,750.00 - -
79 Kassa Hidrofil Steril Ukuran 16 x 16 cm box 8,000.00 - -
80 Kassa Hidrofil Steril Ukuran 16 x 16 cm kotak 7,900.00 - -
81 Kassa Hidrofil Steril Ukuran 16 x 16 cm kotak 7,370.00 - -
82 Kassa Hidrofil Steril Ukuran 18 x 22 cm Kotak 4,750.00 - -
83 Kassa Hidrofil Steril Ukuran 18 x 22 cm box 5,900.00 - -
84 Kassa Hidrofil Steril Ukuran 18 x 22 cm Box 7,500.00 52 390,000.00
85 Kassa Hidrofil Ukuran 36 x 10 cm Rol 2,415.00 - -
88 Kassa Hidrofil Ukuran 40 yard x 80 cm Rol 256,250.00 - -
89 Kassa Hidrofil Ukuran 40 yard x 80 cm Roll 250,250.00 1 250,250.00
90 Kassa Pembalut Hidrofil 4m x 10cm Rol 607.00 - -
Kassa Pembalut Hidrofil 4m x 10cm (SN
91 Rol 33,000.00 - -
Medika)
92 Kassa Pembalut Hidrofil 4m x 10cm Rol 1,500.00 - -
93 Kassa Pembalut Hidrofil 4m x 10cm Rol 2,300.00 - -
Kassa Pembalut Hidrofil 4m x 7,5cm (SN
94 Rol 27,830.00 - -
Medika)
95 Kassa Pembalut Hidrofil 4m x 5 cm Rol 607.00 80 48,560.00
96 Kassa Pembalut Hidrofil 4m x 5 cm Rol 750.00 - -
97 Kassa Pembalut Hidrofil 4m x 5 cm Rol 1,100.00 - -
100 Kassa Pembalut elastis 10 cmx4,55m Rol 33,000.00 - -
101 Kassa Pembalut elastis 7,5 cmx4,55m Rol 27,830.00 - -
102 Masker pcs 1,125.00 - -
103 Masker (Aximed Face Mask Ear Loop ) pcs 396.00 - -
104 Masker Face Mask -30ply / Ear Loop ) pcs 726.00 - -
105 Masker N95 pcs 6,512.00 - -
106 Masker N95 pcs 115,000.00 20 2,300,000.00
107 Masker Jilbab pcs 396.00 - -
108 Masker Jilbab (Mas surgical) box 41,019.00 - -
109 Masker Bedah pcs 6,500.00 - -
110 masker bioaxi face mask ear loop pcs 4,800.00 - -
111 Pembalut Gips 3 inch Rol 23,500.00 - -
112 Pembalut Gips 6 inch Rol 42,000.00 - -
113 Plester 5 yard x 2 inch Rol 23,618.00 - -
114 Plester 5 yard x 2 inch Roll 35,532.00 - -
115 Plester Rol Kain 2.5 cm x 1 m ( Hansaplast) Rol 5,017.00 - -
116 Plester Leukoplast 7,5cm x 4,5 cm Roll 35,532.00 50 1,776,600.00

117 Pharmaplast (pharmafix) box 27,000.00 26 702,000.00
Plester Pharmaplast ( PHARMAFIX) 5 cm x 500
118 Rol 16,500.00 - -
cm
119 Paper tape /2,5cm x 9,14m Rol 11,583.00 - -
120 Paper tape / 1,25cm x 9,14m Rol 4,900.00 144 705,600.00
121 Paper tape / 1,25cm x 9,14m Rol 7,029.00 - -
122 Safety Box pcs 15,708.00 - -
123 Silk (Benang Bedah) 3/0 + Jarum rol 705.55 - -
124 Silk (Benang Bedah) 3/0 + Jarum pcs 48,240.17 - -
125 Silk 3/0.1/2 18mm 75cm-2PTR5261E pcs 39,481.00 - -
126 Silk 3/0.1/2 18mm 75cm-2PTR5261E pcs 34,607.26 24 830,574.24
127 Urine Bag Set 3,600.00 - -
128 Urine Bag ( Aximed TVW Hanger) pcs 5,128.00 - -
11
HARGA HASIL STOK
SATUAN (Rp) OPNAME
129 Urine Bag ( Aximed TVW Hanger) pcs 5,500.00 - -

130 Urine Bag ( trode medical trourocol plus) pcs 8,070.00 - -
131 Urine Bag ( AXIMED) pcs 5,785.00 - -
132 Wing Needle No. 21 G pcs 1,400.00 - -
135 Rapid Test Vikia HIV 1/2 Kit 487,500.00 - -
136 Larvasida Galon 3,500,000.00 - -
137 Larvasida (obat DBD / Abate) kg 140,000.00 - -
138 Larvasida Sumilar kg 1,500,000.00 - -
139 Accu-Chek Test Strip kotak 420,000.00 - -
140 KIT Emergensi P3K Posko Mudik Paket 1,000,000.00 - -
141 Ongkir - - - -
- - - -
OBAT - OBATAN LAIN - - - -
1 Antapulgit NEW ANTIDES Tablet 136.00 8,600 1,169,600.00
2 Aqua Pro Injection (OTSU SWI 25 Ml) Ampul 2,750.00 - -
3 Aqua Pro Injection (OTSU SWI 25 Ml) Ampul 2,860.00 175 500,500.00
4 Betason N Tube 9,182.00 - -
5 Becefort Syrup , Multivitamin anak Botol 60 ml 15,686.00 - -
8 Multivitamin Dewasa Tablet 1,743.50 - -
9 Multivitamin Dewasa (AMAROPO) Tablet 2,277.00 - -
Kaptab Salut
10 Bisakodil 5 mg 300.00 - -
Selaput
11 Cairan Antiseptik 1000 ml (A. Class) Botol 1000 ml 344,048.00 - -
12 Cairan Antiseptik ( Hansanitizer 25 L) Jerigen 25 L 3,663,000.00 - -
13 Chloramex - kloramfenikol 500mg Tablet 1,007.00 - -
14 Dehidro Artemisin + Piperazin (DHP) Tablet Tablet 2,756.44 - -
15 Glimipiride Tablet 3 mg tablet 319.18 - -

16 Glukonas Kalsikus Inj 10% Ampul 19,750.00 - -
17 Hemafort tab kombinasi Tablet 757.00 - -
18 HIV Test Box 487,500.00 - -
19 Insektisida Fogging Liter 200,000.00 - -
20 Mineral mix sachet 68.00 - -
21 Mineral mix sachet 2,805.00 - -
22 Mouthiece Smolkilizer Box 1,050,000.00 - -
23 RDT Malaria Box 476,372.60 - -
24 RDT COVID-19 - AntiBody Pcs 245,000.00 - -
27 RDT COVID-19 - AntiGEN Pcs 300,000.00 - -
28 Rivanol 0,1% 300 ml Botol 3,000.00 36 108,000.00
29 Rivanol 0,1% 300 ml Botol 3,400.00 - -
30 Ventolin nebulizer Botol 6,600.00 - -
31 Ventolin nebulizer Ampul 10,373.00 - -
32 Glucose Botol 1,370,000.00 - -
33 Glucose Botol 880,674.30 - -
34 Acid/Uric Botol 1,860,000.00 - -
35 Acid/Uric Botol 1,851,894.00 - -
36 HDL Cholesterol Botol 4,440,000.00 - -
37 LDL Cholesterol Botol 5,160,000.00 - -
38 Cholesterol Botol 2,093,300.00 - -
39 Ongkir - - - -
- - - -
VAKSIN - - - -
1 ADS 0,05 ML (Union) Pcs 1,379.80 - -
2 ADS 0,5 ML (Union) Pcs 1,249.45 - -
3 Anti Bisa Ular Serum Vial 274,000.00 - -
4 Anti Bisa Ular Serum (Biosave) Vial 430,000.00 - -
7 Anti Tetanus Serum 1500 IU Ampul 59,004.00 - -
8 Anti Tetanus Serum 1500 UI (biosat-1,5) Ampul 115,000.00 - -
12
HARGA HASIL STOK
SATUAN (Rp) OPNAME
11 Safety Box Stera Sharp 7 Ltr Pcs 61,600.00 - -

12 Safety Box Stera Sharp 7 Ltr Pcs 15,840.00 - -
13 Spuit 5 ML (aximed) pcs 1,030.00 - -
-
SUB JUMLAH OBAT, BMHP, VAKSIN
101,674,383.74
APBD II
2 OBAT - OBATAN APBD I

( PROPINSI )
SUB OBAT -OBATAN
2 Alkohol 70 % - 100 ml botol 300 ml 9,800.00 - -
3 Alkohol 70 % - 100 ml botol 300 ml 21,500.00 - -
5 Aminofilin Tablet 200 mg Tablet 91.00 - -
7 Artemether Injeksi 80 mg/ml Ampul 25,490.00 - -
9 Artesunate Injeksi vial 60 mg Vial 39,000.00 - -
10 Artesunate Injeksi vial 60 mg Vial 57,585.00 - -
15 Azitromicin Tablet 500 mg Tablet 380.00 - -

16 Tablet 354.00 12,450 4,407,300.00
18 Cetrizin Tablet 10 mg Tablet 90.00 - -

20 Deksametason Tablet Tablet 32.00 - -
24 Fenobarbital Injeksi i.m./i.v. 50 mg/ml Amp 1ml 1,800.00 - -
26 Garam Oralit sachet 257.00 1,900 488,300.00
27 Gentamisin Injeksi 40 mg/ml Ampul 617.00 - -
32 Kaptopril tab 12,5 mg Tablet 66.00 - -
33 Kloramfenikol Tetes Mata ( DECACETIN) Botol 3,250.00 - -
36 Klorokuin Tablet 150 mg Tablet 15.06 - -
37 Botol 60 ml 2,286.00 - -
39 Loperamid tablet 2 mg Tablet 80.00 - -
42 Nifedipin Tablet 10 mg Tablet 110.00 - -
44 Nifedipin Tablet 10 mg Tablet 108.00 - -
45 Obat Anti Tuberkulosis Kombipak Kategori 1 Paket 317,018.00 - -

57 Osetalmivir Kapsul 100 mg Kapsul 129.69 - -
58 Oxytetrasiklin salep mata 1 % tube 2,500.00 - -
61 Primakuin Tablet Tablet 224.00 - -
62 Ranitidin HCl Injeksi 25 mg/ml Ampul 1,155.00 - -

13
HARGA HASIL STOK
SATUAN (Rp) OPNAME

WIDA KDNI ( D 2,5 % + KCl 0,15% + NaCl
70 Botol 11,435.00 - -
0,45%)
WIDA KDN2 ( D 2,5 % + KCl 0,3% + NaCl
71 Botol 11,435.00 - -
0,45%)
72 WIDA KNI ( KCl 0,15% + NaCl 0,9%) Botol 11,011.00 - -
74 WIDA KN2 ( KCl 0,3% + NaCl 09%) Botol 11,011.00 - -
75 Vitamin B Kompleks Tablet 117.00 - -
76 Zinc Tablet Tablet 524.00 - -
- - - -
3 Alkohol Swab pcs 169.88 - -
4 Cutgut 2/0 pcs 33,645.00 - -
12 Kassa Hidrofil Ukuran 40 yard x 80 cm Roll 255,750.00 - -
13 Masker pcs 761.64 - -
14 Masker pcs 339.90 - -
15 Oxygen Nasal Cannula (Adult) pcs 12,200.00 23 280,600.00
16 Oxygen Nasal Cannula (Child) pcs 12,140.00 7 84,980.00
17 Virus Transport Media ( VTM) pcs 39,000.00 -
18 Under Pad pcs 8,295.00 10 82,950.00
19 Urine Bag pcs 6,036.00 15 90,540.00
- - - -
1 Cefotaksim Injeksi Vial 4,500.00 - -
2 Chloramex - kloramfenikol 500mg Tablet 1,007.00 - -
3 Clorampecorth Tube 9,085.00 - -
4 Dehidro Artemisin + Piperazin (DHP) Tablet Tablet 2,160.00 - -
5 Dehidro Artemisin + Piperazin (DHP) Tablet Tablet 2,000.00 27 54,000.00
6 Glukonas Kalsikus Inj 10% ampul 9,955.00 - -
7 Glukonas Kalsikus Inj 10% Ampul 10,351.00 24 248,424.00
8 Mersibion inj Ampul 4,400.00 - -
9 Mineral mix sachet 2,920.00 240 700,800.00
10 Urea ( Soft U derm) Krim 10% tube 3,941.00 - -
11 Spironolakton tab Tablet 244.00 - -
- - - -
VAKSIN - - - -
1 ADS 0,05 ML (Oneject) Pcs 1,650.00 - -
4 ADS 0,05 ML (Skifa) Pcs 1,354.00 - -
6 ADS 0,5 ML (Oneject) pcs 1,210.00 - -
7 ADS 0,5 ML (Skifa) Pcs 1,175.00 - -
8 ADS 0,5 ML (Skifa) Pcs 1,118.18 - -
9 ADS 0,5 ML (Skifa) Pcs 1,240.00 - -
10 ADS 0,5 ML Pcs 1,185.00 109 129,165.00
11 ADS 5 ML (Skifa) Pcs 1,470.00 - -
12 ADS 5 ML (Skifa) Pcs 1,580.00 - -
13 Alkohol Swab Pcs 95.00 109 10,355.00
14 BCG Vial 59,590.00 - -
15 BCG Vial 56,360.00 - -
16 BCG Vial 60,140.00 - -
17 Corona Vaccin Vial 211,282.00 109 23,029,738.00
18 Campak Vaksin Vial 28,204.00 - -
19 DPT - HB -HiB Vial 76,620.00 - -
20 DPT - HB -HiB Vial 71,810.00 - -
21 DT Vial 16,180.00 - -
22 DT Vial 16,360.00 - -
23 DT Vial 17,450.00 - -
24 Hepatitis B pcs 20,900.00 - -
25 Hepatitis B Pcs 23,270.00 - -
14
HARGA HASIL STOK
SATUAN (Rp) OPNAME
26 Polio Injeksi Vial 34,815.00 - -

27 Polio Injeksi Vial 139,760.00 - -
28 Polio Injeksi Vial 144,540.00 30 4,336,200.00
29 Polio Vaksin Vial 19,954.00 - -
30 Polio Vaksin Vial 18,140.00 - -
31 Polio Oral + Droper Vial 19,350.00 60 1,161,000.00
32 Safety Box Pcs 15,708.00 - -
33 Safety Box Pcs 24,122.00 - -
34 Safety Box Pcs 21,929.00 - -
35 Safety Box Pcs 14,000.00 - -
36 Spuit 5 ML (Oneject) Pcs 1,705.00 - -
37 Td Vial 16,500.00 - -
38 Td Vial 16,480.00 20 329,600.00
39 Tetanus Toksoid (TT) Vial 14,498.00 - -
40 Vaksin MR Vial 141,648.00 - -
41 Vaksin MR Vial 151,150.00 - -
42 Vaksin Anti Rabies (VAR) Vial 70,000.00 - -
45 HB Uniject Vial 23,270.00 - -
46 HB Uniject Vial 20,900.00 - -
47 Vaksin Anti Rabies (VAR) Vial 165,000.00 8 1,320,000.00
SUB JUMLAH OBAT-OBATAN,VAKSIN

36,753,952.00
DAN BMHP APBD I (PROPINSI)
3 BOK
1 Desinfektan Botol - - -
2 Handsanitizer 500 ml Botol 500 ml 81,500.00 - -
3 Hand Scone Steril Pasang 8,250.00 - -
4 Hand Scone Non Steril Pcs 950.00 - -
5 Hazmat Pcs 200,000.00 - -
6 Masker Bedah Pcs 4,000.00 - -
7 Masker N-95 Pcs 85,000.00 - -
-
SUB JUMLAH BELANJA BOK -
BAHAN KEPERLUAN
4
LABORATORIUM
1 BHP HIV paket 811,991,100.00 - -

2 BHP Malaria paket 126,000,000.00 - -
3 Botol Sampel Keracunan buah 20,000.00 - -
4 Catride TCM paket 259,175.00 - -
5 Handscone bok @ 50,000.00 - -
6 Holdel Vacuete buah 1,000.00 - -
7 Jarum Vacutener buah 2,000.00 - -
8 Mount piece bok 2,250,000.00 - -
9 Paket Alat Pelindung Diri ( APD) paket 1,500,000.00 - -
Paket Pemeriksaan SHK ( Kertas
10 buah 65,000.00 - -
Saring,Lanset,Alkohol Swab )
11 Pipet test plastik buah 3,000.00 - -
12 Pot Dahak buah 3,000.00 - -
13 Pot Sampel AFP buah 10,000.00 - -
14 Pot Urine buah 5,000.00 - -
15 Rak Tabung Sampel buah 25,000.00 - -
16 RDT DBD bok 1,500,000.00 - -
17 RDT Hepatitis buah 25,000.00 - -
18 Reagen TB paket 500,000.00 - -
19 Safety Bok ADS buah 25,000.00 - -
20 Sampel Cup buah 500.00 - -
21 Slide bok 30,000.00 - -
22 Stick Gula Darah pak 160,000.00 - -
23 Tabung Vacuete buah 3,000.00 - -
24 Alat Suntik 3 cc pcs 920.00 - -
25 Alkohol swab pcs 354.00 - -
15
HARGA HASIL STOK
SATUAN (Rp) OPNAME
26 Lancet (Sentry Lancet) pcs 1,650.00 - -

27 RDT HIV Test Kit pcs 11,506.00 - -
28 RDT Malaria Test Kit pcs 13,950.00 - -
29 RDT Syphilis Test Kit pcs 9,020.00 - -
30 Tabung Vacuate (Vacum Tube Steril k3 EDTA) buah 870.00 - -
31 RDT Covid-19 (Eco Test) pcs 135,000.00 - -
32 Virus Transport Media ( VTM) pcs 80,000.00 - -
33 Gown/Apron pcs 70,000.00 - -
34 RDT Covid-19 Antibody pcs 75,000.00 - -
35 Face Shield pcs 30,000.00 - -
36 Handscone box@ 120,000.00 - -
37 Penutup Kepala pcs 2,500.00 - -
38 Masker N95 pcs 115,000.00 - -
39 Cover All Suit pcs 175,000.00 - -
41 Gown/Apron pcs 180,000.00 - -
42 Under Pad pcs 5,500.00 - -
-
-
-
SUB JUMLAH BELANJA BAHAN
-
KEPERLUAN LABORATORIUM
PERALATAN KEBERSIHAN
5
DAN BAHAN PEMBERSIH
1 Sanitarian Bag Buah 3,000 - -

2 Desinfektan Dirigen 5 L 137,000 - -
JUMLAH BELANJA PERALATAN KEBERSIHAN

-
DAN BAHAN PEMBERSIH
6 APBN
Masker polos / motif jenis earloop untuk

1 pcs 5,500 -
Puskesmas
Masker polos / motif jenis headloop untuk

2 pcs 5,500 -
Puskesmas
JUMLAH BELANJA APBN -
J U M L A H TOTAL 138,428,335.74
Demikian Berita Acara Stok Opname ini dibuat, untuk dapat dipergunakan sebagaimana mestinya
MENGETAHUI Tanjung Bintang, 30 Januari 2021

Kepala UPT. Pengelola Obat
Puskesmas Rawat Inap Tanjungbintang UPT Puskesmas Rawat Inap Tanjungbintang
DARMAWAN SKM.M Kes Ahmad Solich Annas M, S.Farm, Apt

NIP. 19720603 199302 1 001 NIP . 19781002 201001 1 011
16
BUKU BARANG PAKAI HABIS
NOMOR : 445/ / IV.03 / I / 2021
KABUPATEN : LAMPUNG SELATAN
BARANG PERSEDIAAN : OBAT - OBATAN, VAKSIN/SERUM DAN BAHAN MEDIS HABIS PAKAI
SALDO AWAL PENERIMAAN PENGELUARAN SALDO/SISA

SUMBER
NO JENIS BARANG HARGA SATUAN HARGA SATUAN HARGA SATUAN HARGA SATUAN DANA / KET
JUMLAH SATUAN BARANG NILAI JUMLAH SATUAN BARANG NILAI JUMLAH SATUAN BARANG NILAI JUMLAH SATUAN BARANG NILAI BARANG
BARANG BARANG BARANG BARANG
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
1 OBAT - OBATAN APBD II

SUB OBAT -OBATAN
ACT(Artesunate Tablet 50 mg + Amodiaquine
1 - Tablet 1,375.00 - Tablet 1,375.00 - Tablet 1,375.00 - - Tablet 1,375.00 -
anhydrida Tablet 200 mg)
2 Albendazol Tablet Kunyah 400 mg - Tablet 392.00 - Tablet 392.00 - Tablet 392.00 - - Tablet 392.00 -
4 Alkohol 70 % - 100 ml - Botol 100 ml 2,500.00 - Botol 100 ml 2,500.00 - Botol 100 ml 2,500.00 - - Botol 100 ml 2,500.00 -
5 Alkohol 70 % - 100 ml - Botol 100 ml 2,900.00 - Botol 100 ml 2,900.00 - Botol 100 ml 2,900.00 - - Botol 100 ml 2,900.00 -
6 Alkohol 70 % - 1 L - Botol 1 L 25,000.00 - Botol 1 L 25,000.00 - Botol 1 L 25,000.00 - - Botol 1 L 25,000.00 -
7 Alkohol 70 & - 1 L 293 Botol 1 L 18,700.00 5,479,100.00 Botol 1 L 18,700.00 - 8 Botol 1 L 18,700.00 149,600.00 285 Botol 1 L 18,700.00 5,329,500.00
8 Alkohol 70 & - 1 L 5 Jrg 20 L 319,000.00 1,595,000.00 Jrg 20 L 319,000.00 - Jrg 20 L 319,000.00 - 5 Jrg 20 L 319,000.00 1,595,000.00
9 Alopurinol Tablet 100 mg - Tablet 86.00 - Tablet 86.00 - Tablet 86.00 - - Tablet 86.00 -
10 Alopurinol Tablet 100 mg 900 Tablet 90.00 81,000.00 Tablet 90.00 - 600 Tablet 90.00 54,000.00 300 Tablet 90.00 27,000.00
13 Alprazolam Tablet 1 mg - Tablet 233.00 - Tablet 233.00 - Tablet 233.00 - - Tablet 233.00 -
14 Alprazolam Tablet 1 mg - Tablet 162.00 - Tablet 162.00 - Tablet 162.00 - - Tablet 162.00 -
15 Alprazolam Tablet 1 mg 1,896 Tablet 120.00 227,520.00 Tablet 120.00 - 60 Tablet 120.00 7,200.00 1,836 Tablet 120.00 220,320.00
16 Alprazolam Tablet 0,25 mg - Tablet 380.00 - Tablet 380.00 - Tablet 380.00 - - Tablet 380.00 -
17 Alprazolam Tablet 0,5 mg - Tablet 88.00 - Tablet 88.00 - Tablet 88.00 - - Tablet 88.00 -
18 Ambroxol Tablet 30 mg - Tablet 124.94 - Tablet 124.94 - Tablet 124.94 - - Tablet 124.94 -
19 Aminofilin Injeksi 24 mg/ml - Amp 10 ml 3,823.00 - Amp 10 ml 3,823.00 - Amp 10 ml 3,823.00 - - Amp 10 ml 3,823.00 -
20 Aminofilin Injeksi 24 mg/ml - Ampul 3,345.00 - Ampul 3,345.00 - Ampul 3,345.00 - - Ampul 3,345.00 -
21 Aminofilin Tablet 200 mg - Tablet 993.00 - Tablet 993.00 - Tablet 993.00 - - Tablet 993.00 -
22 Aminofilin Tablet 150 mg (Decafil) - Tablet 139.00 - Tablet 139.00 - Tablet 139.00 - - Tablet 139.00 -
23 Aminofilin Tablet 150 mg (Decafil) - Tablet 148.00 - Tablet 148.00 - Tablet 148.00 - - Tablet 148.00 -
24 Amitriptilin Tablet Salut 25 mg (HCl) - Tablet 112.00 - Tablet 112.00 - Tablet 112.00 - - Tablet 112.00 -
27 Amlodipine Tablet 10 mg - Tablet 330.00 - Tablet 330.00 - Tablet 330.00 - - Tablet 330.00 -
30 Amlodipine Tablet 10 mg 330 Tablet 92.00 30,360.00 Tablet 92.00 - 330 Tablet 92.00 30,360.00 - Tablet 92.00 -
34 Amlodipine Tablet 5 mg 300 Tablet 78.00 23,400.00 Tablet 78.00 - 300 Tablet 78.00 23,400.00 - Tablet 78.00 -
35 Amoksisilin Kaplet 500 mg - Tablet 272.00 - Tablet 272.00 - Tablet 272.00 - - Tablet 272.00 -
36 Amoksisilin Kaplet 500 mg - kaplet 232.00 - kaplet 232.00 - kaplet 232.00 - - kaplet 232.00 -
37 Amoksisilin Kaplet 500 mg 1,900 kaplet 233.00 442,700.00 kaplet 233.00 - 1,600 kaplet 233.00 372,800.00 300 kaplet 233.00 69,900.00
38 Amoksisilin Kaplet 500 mg 5,000 kaplet 249.00 1,245,000.00 kaplet 249.00 - kaplet 249.00 - 5,000 kaplet 249.00 1,245,000.00
39 Amoksisilin Kapsul 250 mg - Kapsul 211.00 - Kapsul 211.00 - Kapsul 211.00 - - Kapsul 211.00 -
40 Amoksisilin Kapsul 250 mg - kapsul 195.00 - kapsul 195.00 - kapsul 195.00 - - kapsul 195.00 -
41 Amoksisilin Kapsul 250 mg - Kapsul 184.00 - Kapsul 184.00 - Kapsul 184.00 - - Kapsul 184.00 -
42 Amoksisilin Kapsul 250 mg 4,500 Kapsul 196.00 882,000.00 Kapsul 196.00 - Kapsul 196.00 - 4,500 Kapsul 196.00 882,000.00
43 Amoksisilin Syrup Kering 125 mg/5ml - Botol 60 ml 2,445.00 - Botol 60 ml 2,445.00 - Botol 60 ml 2,445.00 - - Botol 60 ml 2,445.00 -
47 Amoksisilin Syrup Kering 250 mg/5ml 70 Botol 60 ml 2,050.00 143,500.00 Botol 60 ml 2,050.00 - 20 Botol 60 ml 2,050.00 41,000.00 50 Botol 60 ml 2,050.00 102,500.00
48 Ampisilin Serbuk Injeksi im/iv. 1000 mg/vial - Kotak 10 Vial 51,000.00 - Kotak 10 Vial 51,000.00 - Kotak 10 Vial 51,000.00 - - Kotak 10 Vial 51,000.00 -
49 - Tablet 72.00 - Tablet 72.00 - Tablet 72.00 - - Tablet 72.00 -
BHP-01-2021 17
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17

52 17,300 Tablet 58.00 1,003,400.00 Tablet 58.00 - 3,800 Tablet 58.00 220,400.00 13,500 Tablet 58.00 783,000.00
53 Antasida DOEN II Suspensi Kombinasi - Botol 60 ml 2,025.00 - Botol 60 ml 2,025.00 - Botol 60 ml 2,025.00 - - Botol 60 ml 2,025.00 -
54 Antasida DOEN II Suspensi Kombinasi - Botol 60 ml 1,995.00 - Botol 60 ml 1,995.00 - Botol 60 ml 1,995.00 - - Botol 60 ml 1,995.00 -
55 Antasida DOEN II Suspensi Kombinasi 90 Botol 60 ml 2,129.00 191,610.00 Botol 60 ml 2,129.00 - 40 Botol 60 ml 2,129.00 85,160.00 50 Botol 60 ml 2,129.00 106,450.00
56 Antibakteri DOEN (Bacitracin Salep Kulit) - Tube 2,924.00 - Tube 2,924.00 - Tube 2,924.00 - - Tube 2,924.00 -
57 Antibakteri DOEN (Bacitracin Salep Kulit) - Tube 3,035.00 - Tube 3,035.00 - Tube 3,035.00 - - Tube 3,035.00 -
58 - Pot 30 gr 1,719.00 - Pot 30 gr 1,719.00 - Pot 30 gr 1,719.00 - - Pot 30 gr 1,719.00 -
59 - Tube 4,158.00 - Tube 4,158.00 - Tablet 4,158.00 - - Tablet 4,158.00 -
60 48 Pot 4,496.00 215,808.00 Pot 4,496.00 - Pot 4,496.00 - 48 Pot 4,496.00 215,808.00

61 - Pot 4,798.00 - Pot 4,798.00 - Pot 4,798.00 - - Pot 4,798.00 -
62 Antihemoroid kombinasi - Suppositoria 3,045.00 - Suppositoria 3,045.00 - Suppositoria 3,045.00 - - Suppositoria 3,045.00 -
63 Antihemoroid kombinasi 90 Suppositoria 3,167.00 285,030.00 Suppositoria 3,167.00 - 20 Suppositoria 3,167.00 63,340.00 70 Suppositoria 3,167.00 221,690.00
Antimalaria DOEN Kombinasi:

Pirimetamin 25 mg + Sulfadoksin 500 mg
Antimigren Tablet :
Ergotamin Tartrat 1 mg + Kofein 50 mg
Antimigren Tablet : Ergotamin 1 mg + Kafein 50 mg

66 300 Tablet 173.00 51,900.00 Tablet 173.00 - 100 Tablet 173.00 17,300.00 200 Tablet 173.00 34,600.00
(Generik Kombinasi)
67 Artemether Injeksi 80 mg/ml - ampul 22,000.00 - ampul 22,000.00 - ampul 22,000.00 - - ampul 22,000.00 -
68 Artesunate Injeksi vial 60 mg - viaL 38,999.00 - viaL 38,999.00 - viaL 38,999.00 - - viaL 38,999.00 -
69 Asam Asetilsalisilat Tablet 100 mg (Asetosal) - Tablet 116.00 - Tablet 116.00 - Tablet 116.00 - - Tablet 116.00 -
70 Asam Askorbat (Vitamin C) Tablet 250mg - Tablet 125.00 - Tablet 125.00 - Tablet 125.00 - - Tablet 125.00 -
72 Asam Askorbat (Vitamin C) Tablet 50mg 14,800 Tablet 105.00 1,554,000.00 Tablet 105.00 - 2,800 Tablet 105.00 294,000.00 12,000 Tablet 105.00 1,260,000.00
73 Asam Folat Tablet 1 mg - Tablet 48.00 - Tablet 48.00 - Tablet 48.00 - - Tablet 48.00 -
74 Asam Folat Tablet 1 mg - Tablet 70.00 - Tablet 70.00 - Tablet 70.00 - - Tablet 70.00 -
75 Asam Folat Tablet 1 mg 4,400 Tablet 75.00 330,000.00 Tablet 75.00 - 500 Tablet 75.00 37,500.00 3,900 Tablet 75.00 292,500.00
76 Asam Folat Tablet 0,4 mg - Tablet 63.00 - Tablet 63.00 - Tablet 63.00 - - Tablet 63.00 -
77 Asam Folat Tablet 0,4 mg - Tablet 55.00 - Tablet 55.00 - Tablet 55.00 - - Tablet 55.00 -
78 Asam Mefenamat Kapsul 500 mg - Tablet 112.00 - Tablet 112.00 - Tablet 112.00 - - Tablet 112.00 -
80 Asam Mefenamat Kapsul 500 mg 2,700 Tablet 103.00 278,100.00 Tablet 103.00 - 1,300 Tablet 103.00 133,900.00 1,400 Tablet 103.00 144,200.00
81 Asiklovir krim 2,5 % - Tube 2,995.00 - Tube 2,995.00 - Tube 2,995.00 - - Tube 2,995.00 -
82 Asiklovir krim 5 % 25 Tube 3,850.00 96,250.00 Tube 3,850.00 - Tube 3,850.00 - 25 Tube 3,850.00 96,250.00
83 Asiklovir krim 5 % - Tube 3,146.00 - Tube 3,146.00 - Tube 3,146.00 - - Tube 3,146.00 -
84 Asiklovir Tablet 200 mg - Tablet 237.00 - Tablet 237.00 - Tablet 237.00 - - Tablet 237.00 -
87 Asiklovir Tablet 400 mg 2,900 Tablet 380.00 1,102,000.00 Tablet 380.00 - 500 Tablet 380.00 190,000.00 2,400 Tablet 380.00 912,000.00
88 Atropin Sulfat Injeksi. i.m./i.v./s.k. 0,25 mg/ml - Amp 1 ml 1,350.00 - Amp 1 ml 1,350.00 - Amp 1 ml 1,350.00 - - Amp 1 ml 1,350.00 -
89 Atropin Sulfat Tablet 0,5mg - Tablet 74.00 - Tablet 74.00 - Tablet 74.00 - - Tablet 74.00 -
90 Benzatin Benzil Penisilin 1,2 juta IU/ vial - vial 9,800.00 - vial 9,800.00 - vial 9,800.00 - - vial 9,800.00 -
Besi (II) Sulfat 200 mg + Asam Folat 0,25mg Tablet
(tablet tambah darah kombinasi)

93 Betahistin Tablet 6 mg - Tablet 149.00 - Tablet 149.00 - Tablet 149.00 - - Tablet 149.00 -
94 Betametason Krim 0,1% (sebagai valerat) - Tube 1,520.00 - Tube 1,520.00 - Tube 1,520.00 - - Tube 1,520.00 -
98 Betametason Krim 0,1% (sebagai valerat) 25 Tube 3,350.00 83,750.00 Tube 3,350.00 - 25 Tube 3,350.00 83,750.00 - Tube 3,350.00 -
99 Bromheksin Tablet 8 mg - Tablet 39.00 - Tablet 39.00 - Tablet 39.00 - - Tablet 39.00 -
100 Cetrizin Syrup 5mg/5ml - Botol 2,850.00 - Botol 2,850.00 - Botol 2,850.00 - - Botol 2,850.00 -
101 Cetrizin Tablet 10 mg - Tablet 181.00 - Tablet 181.00 - Tablet 181.00 - - Tablet 181.00 -
102 Cetrizin Tablet 10 mg 700 Tablet 90.00 63,000.00 Tablet 90.00 - 500 Tablet 90.00 45,000.00 200 Tablet 90.00 18,000.00
103 Cimetidine 200 mg 3,100 Tablet 192.67 597,277.00 Tablet 192.67 - Tablet 192.67 - 3,100 Tablet 192.67 597,277.00
BHP-01-2021 18
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
104 Deksametason 1nj 5 mg/ml - Vial 1,500.00 - Vial 1,500.00 - Vial 1,500.00 - - Vial 1,500.00 -
105 Deksametason 1nj 5 mg/ml 15 Ampul 1,097.00 16,455.00 Ampul 1,097.00 - 5 Ampul 1,097.00 5,485.00 10 Ampul 1,097.00 10,970.00
106 Deksametason Tablet 0.5 mg - Tablet 32.00 - Tablet 32.00 - Tablet 32.00 - - Tablet 32.00 -
108 Deksametason Tablet 0.5 mg 2,700 Tablet 176.00 475,200.00 Tablet 176.00 - 1,400 Tablet 176.00 246,400.00 1,300 Tablet 176.00 228,800.00
109 Diazepam Injeksi 5 mg/ml - Ampul 4,180.00 - Ampul 4,180.00 - Ampul 4,180.00 - - Ampul 4,180.00 -
110 Diazepam Injeksi 5 mg/ml 10 Ampul 1,735.00 17,350.00 Ampul 1,735.00 - Ampul 1,735.00 - 10 Ampul 1,735.00 17,350.00
111 Diazepam Tablet 2 mg - Tablet 45.00 - Tablet 45.00 - Tablet 45.00 - - Tablet 45.00 -
112 Diazepam Tablet 2 mg 450 Tablet 86.00 38,700.00 Tablet 86.00 - Tablet 86.00 - 450 Tablet 86.00 38,700.00
113 Diazepam Tablet 5 mg 770 Tablet 109.00 83,930.00 Tablet 109.00 - Tablet 109.00 - 770 Tablet 109.00 83,930.00
114 Diazepam Enema (Stesolid 5 mg/2,5 ml) - Tube 12,573.00 - Tube 12,573.00 - Tube 12,573.00 - - Tube 12,573.00 -
115 Dietilkarbamazin 100 mg - Tablet 158.00 - Tablet 158.00 - Tablet 158.00 - - Tablet 158.00 -
116 Difenhidramin Injeksi i.m.10 mg/ml (HCl) - Ampul 1,054.00 - Ampul 1,054.00 - Ampul 1,054.00 - - Ampul 1,054.00 -
117 Difenhidramin Injeksi i.m.10 mg/ml (HCl) - Ampul 1,176.00 - Ampul 1,176.00 - Ampul 1,176.00 - - Ampul 1,176.00 -
118 Difenhidramin Injeksi i.m.10 mg/ml (HCl) 26 Ampul 1,168.00 30,368.00 Ampul 1,168.00 - 5 Ampul 1,168.00 5,840.00 21 Ampul 1,168.00 24,528.00
119 Digoksin Tablet 0,25 mg - Tablet 97.00 - Tablet 97.00 - Tablet 97.00 - - Tablet 97.00 -
120 Digoksin Tablet 0,25 mg 500 Tablet 105.00 52,500.00 Tablet 105.00 - Tablet 105.00 - 500 Tablet 105.00 52,500.00
121 Dimenhidrinat Tablet 50 mg - Tablet 104.00 - Tablet 104.00 - Tablet 104.00 - - Tablet 104.00 -
122 Doksisiklin Kapsul 100 mg - Tablet 270.00 - Tablet 270.00 - Tablet 270.00 - - Tablet 270.00 -
123 Doksisiklin Kapsul 100 mg 500 Tablet 269.00 134,500.00 Tablet 269.00 - Tablet 269.00 - 500 Tablet 269.00 134,500.00
124 Doksisiklin Kapsul 100 mg - Tablet 280.00 - Tablet 280.00 - Tablet 280.00 - - Tablet 280.00 -
125 Domperidon Suspensi 5 mg/ml - Botol 60 ml 3,333.00 - Botol 60 ml 3,333.00 - Botol 60 ml 3,333.00 - - Botol 60 ml 3,333.00 -
126 Domperidon Suspensi 5 mg/ml - Botol 60 ml 2,700.00 - Botol 60 ml 2,700.00 - Botol 60 ml 2,700.00 - - Botol 60 ml 2,700.00 -
127 Domperidon Tablet 10 mg - Tablet 85.00 - Tablet 85.00 - Tablet 85.00 - - Tablet 85.00 -
128 Domperidon Tablet 10 mg 100 Tablet 91.00 9,100.00 Tablet 91.00 - 100 Tablet 91.00 9,100.00 - Tablet 91.00 -
129 Epinefrin (Adrenalin) Injeksi 1mg/ml - ampul 8,100.00 - ampul 8,100.00 - ampul 8,100.00 - - ampul 8,100.00 -
131 Epinefrin (Adrenalin) Injeksi 1mg/ml 200 ampul 1,408.00 281,600.00 ampul 1,408.00 - 20 ampul 1,408.00 28,160.00 180 ampul 1,408.00 253,440.00
133 Ekstarak Beladona Tab 250 mg - Tablet 235.00 - Tablet 235.00 - Tablet 235.00 - - Tablet 235.00 -
134 Eritromisin Kapsul 250 mg - Tablet 49.00 - Tablet 49.00 - Tablet 49.00 - - Tablet 49.00 -
135 Eritromisin Kapsul 250 mg - Tablet 566.00 - Tablet 566.00 - Tablet 566.00 - - Tablet 566.00 -
136 Eritromisin Kapsul 250 mg - Kapsul 546.00 - Kapsul 546.00 - Kapsul 546.00 - - Kapsul 546.00 -
137 Eritromisin Syrup 200 mg / 5ml - Botol 60 ml 7,700.00 - Botol 60 ml 7,700.00 - Botol 60 ml 7,700.00 - - Botol 60 ml 7,700.00 -
138 Eritromisin Syrup 200 mg / 5ml 50 Botol 60 ml 9,702.00 485,100.00 Botol 60 ml 9,702.00 - Botol 60 ml 9,702.00 - 50 Botol 60 ml 9,702.00 485,100.00
139 Fenobarbital Injeksi i.m./i.v. 50 mg/ml - Amp 1ml 1,800.00 - Amp 1ml 1,800.00 - Amp 1ml 1,800.00 - - Amp 1ml 1,800.00 -
140 Fenobarbital 30 mg Tablet 309 Tablet 171.00 52,839.00 Tablet 171.00 - Tablet 171.00 - 309 Tablet 171.00 52,839.00
141 Fenol Gliserol Tetes Telinga10% - Botol 5 ml 1,008.00 - Botol 5 ml 1,008.00 - Botol 5 ml 1,008.00 - - Botol 5 ml 1,008.00 -
Kotak 30 Amp Kotak 30
144 Fitomenadion (Vit-K1) Injeksi 10 mg/ml - Kotak 30 Amp 1ml 4,250.10 - Kotak 30 Amp 1ml 4,250.10 - 4,250.10 - - 4,250.10 -
1ml Amp 1ml
145 Fitomenadion (Vit-K1)Tab Salut Gula10 mg - Tablet 634.00 - Tablet 634.00 - Tablet 634.00 - - Tablet 634.00 -
147 Fitomenadion (Vit-K1)Tab Salut Gula10 mg 100 Tablet 710.00 71,000.00 Tablet 710.00 - Tablet 710.00 - 100 Tablet 710.00 71,000.00
149 Fitomenadion (Vit-K1) Injeksi 2 mg/ml - Amp 1ml 3,417.00 - Amp 1ml 3,417.00 - Amp 1ml 3,417.00 - - Amp 1ml 3,417.00 -
150 Fitomenadion (Vit-K1) Injeksi 2 mg/ml - Ampul 3,550.00 - Ampul 3,550.00 - Ampul 3,550.00 - - Ampul 3,550.00 -
151 Fitomenadion (Vit-K1) Injeksi 2 mg/ml 115 Ampul 3,682.00 423,430.00 Ampul 3,682.00 - Ampul 3,682.00 - 115 Ampul 3,682.00 423,430.00
152 Furosemid Injeksi i.v/i.m. 10 mg/ml - Amp 2ml 1,829.00 - Amp 2ml 1,829.00 - Amp 2ml 1,829.00 - - Amp 2ml 1,829.00 -
153 Furosemid Tablet 40 mg - Tablet 85.00 - Tablet 85.00 - Tablet 85.00 - - Tablet 85.00 -
154 Furosemid Tablet 40 mg 1,600 Tablet 77.00 123,200.00 Tablet 77.00 - 200 Tablet 77.00 15,400.00 1,400 Tablet 77.00 107,800.00
155 Gameksan Lotion 1% - Botol 3,000.00 - Botol 3,000.00 - Botol 3,000.00 - - Botol 3,000.00 -
156 Garam Oralit Serbuk - Sachet 28.00 - Sachet 28.00 - Sachet 28.00 - - Sachet 28.00 -
157 Garam Oralit Kombinasi - Sachet 264.00 - Sachet 264.00 - Sachet 264.00 - - Sachet 264.00 -
158 Gemfibrozil Kapsul 300 mg - Kapsul 289.00 - Kapsul 289.00 - Kapsul 289.00 - - Kapsul 289.00 -
159 Gentamisin Injeksi 40 mg/ml - Amp 2ml 3,399.00 - Amp 2ml 3,399.00 - Amp 2ml 3,399.00 - - Amp 2ml 3,399.00 -
160 Gentamisin Injeksi 40 mg/ml - Vial 2ml 15,450.00 - Vial 2ml 15,450.00 - Vial 2ml 15,450.00 - - Vial 2ml 15,450.00 -
161 Gentamisin Injeksi 40 mg/ml - Ampul 3,509.00 - Ampul 3,509.00 - Ampul 3,509.00 - - Ampul 3,509.00 -
162 Gentamisin salep Kulit 0,1 % - Tube 3,400.00 - Tube 3,400.00 - Tube 3,400.00 - - Tube 3,400.00 -
163 Gentamisin Sulfat Tetes Mata 0,3% - Botol 5 ml 3,194.00 - Botol 5 ml 3,194.00 - Botol 5 ml 3,194.00 - - Botol 5 ml 3,194.00 -
164 Gentamisin Sulfat Tetes Mata 0,3% 96 Botol 5 ml 4,232.00 406,272.00 Botol 5 ml 4,232.00 - Botol 5 ml 4,232.00 - 96 Botol 5 ml 4,232.00 406,272.00
166 Gentamisin Salep mata( GENOINT) - Tube 2,830.00 - Tube 2,830.00 - Tube 2,830.00 - - Tube 2,830.00 -
167 Gentamisin Sulfat Salep mata 0,3 % 72 Tube 2,675.00 192,600.00 Tube 2,675.00 - Tube 2,675.00 - 72 Tube 2,675.00 192,600.00
168 Gentian Violet Larutan 1 % - Botol 10 ml 2,925.00 - Botol 10 ml 2,925.00 - Botol 10 ml 2,925.00 - - Botol 10 ml 2,925.00 -
169 Gentian Violet Larutan 1 % - Botol 10 ml 3,320.00 - Botol 10 ml 3,320.00 - Botol 10 ml 3,320.00 - - Botol 10 ml 3,320.00 -
BHP-01-2021 19
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
170 Gentian Violet Larutan 1 % 14 Botol 10 ml 3,344.00 46,816.00 Botol 10 ml 3,344.00 - Botol 10 ml 3,344.00 - 14 Botol 10 ml 3,344.00 46,816.00
171 Glibenklamida Tablet 5 mg - Tablet 56.00 - Tablet 56.00 - Tablet 56.00 - - Tablet 56.00 -
172 Glibenklamida Tablet 5 mg - Tablet 92.00 - Tablet 92.00 - Tablet 92.00 - - Tablet 92.00 -
173 Glibenklamida Tablet 5 mg 3,100 Tablet 119.00 368,900.00 Tablet 119.00 - 500 Tablet 119.00 59,500.00 2,600 Tablet 119.00 309,400.00
174 Gliserilguaiakolat Tablet 100 mg - Tablet 34.12 - Tablet 34.12 - Tablet 34.12 - - Tablet 34.12 -
175 Gliserin Liquid - Botol 100 ml 5,333.00 - Botol 100 ml 5,333.00 - Botol 100 ml 5,333.00 - - Botol 100 ml 5,333.00 -
176 Glukosa Larutan Infus 5% steril - Botol 500 ml 5,200.00 - Botol 500 ml 5,200.00 - Botol 500 ml 5,200.00 - - Botol 500 ml 5,200.00 -
177 Glukosa Larutan Infus 5% steril - Botol 500 ml 6,900.00 - Botol 500 ml 6,900.00 - Botol 500 ml 6,900.00 - - Botol 500 ml 6,900.00 -
178 Glukosa Larutan Infus 5% steril 300 Botol 500 ml 7,363.00 2,208,900.00 Botol 500 ml 7,363.00 - Botol 500 ml 7,363.00 - 300 Botol 500 ml 7,363.00 2,208,900.00
179 Guaifenisin - Botol 178.00 - Botol 178.00 - Botol 178.00 - - Botol 178.00 -
180 Guaifenisin 100 mg - Tablet 177.00 - Tablet 177.00 - Tablet 177.00 - - Tablet 177.00 -
181 Guaifenisin 100 mg 8,600 Tablet 233.20 2,005,520.00 Tablet 233.20 - 800 Tablet 233.20 186,560.00 7,800 Tablet 233.20 1,818,960.00
182 Griseofulvin Tablet 125 mg - Tablet 209.00 - Tablet 209.00 - Tablet 209.00 - - Tablet 209.00 -
185 Haloperidol Injeksi 5% - Vial 4,000.00 - Vial 4,000.00 - Vial 4,000.00 - - Vial 4,000.00 -
186 Haloperidol Injeksi 50 mg/ml - Ampul 101,300.00 - Ampul 101,300.00 - Ampul 101,300.00 - - Ampul 101,300.00 -
187 Haloperidol Tablet 1,5 mg - Tablet 69.00 - Tablet 69.00 - Tablet 69.00 - - Tablet 69.00 -
188 Haloperidol Tablet 1,5 mg - Tablet 66.00 - Tablet 66.00 - Tablet 66.00 - - Tablet 66.00 -
189 Haloperidol Tablet 2 mg - Tablet 126.00 - Tablet 126.00 - Tablet 126.00 - - Tablet 126.00 -
191 Haloperidol Tablet 2 mg (lodomer) - Tablet 84.00 - Tablet 84.00 - Tablet 84.00 - - Tablet 84.00 -
192 Haloperidol Tablet 2 mg (lodomer) 300 Tablet 90.00 27,000.00 Tablet 90.00 - 150 Tablet 90.00 13,500.00 150 Tablet 90.00 13,500.00
Botol 1000
196 Hidrogen Peroksida (H2O2) Larutan 3% - Botol 1000 ml 18,700.00 - Botol 1000 ml 18,700.00 - Botol 1000 ml 18,700.00 - - 18,700.00 -
ml
197 Hidrogen Peroksida (H2O2) Larutan 3% - Botol 100 ml 4,780.00 - Botol 100 ml 4,780.00 - Botol 100 ml 4,780.00 - - Botol 100 ml 4,780.00 -
198 Hidroklorotiazida Tablet 25 mg - Tablet 149.00 - Tablet 149.00 - Tablet 149.00 - - Tablet 149.00 -
199 Hidroklorotiazida Tablet 25 mg - Tablet 155.00 - Tablet 155.00 - Tablet 155.00 - - Tablet 155.00 -
200 Hidrokortison krim 2,5% - Tube 5 gram 2,798.00 - Tube 5 gram 2,798.00 - Tube 5 gram 2,798.00 - - Tube 5 gram 2,798.00 -
201 Hidrokortison krim 2,5% - Tube 5 gram 2,650.00 - Tube 5 gram 2,650.00 - Tube 5 gram 2,650.00 - - Tube 5 gram 2,650.00 -
202 Hidrokortison krim 2,5% 42 Tube 5 gram 2,475.00 103,950.00 Tube 5 gram 2,475.00 - 18 Tube 5 gram 2,475.00 44,550.00 24 Tube 5 gram 2,475.00 59,400.00
203 Hidrokortison krim1% - Tube 5 gram 2,570.00 - Tube 5 gram 2,570.00 - Tube 5 gram 2,570.00 - - Tube 5 gram 2,570.00 -
204 Ibuprofen Suspensi 100 mg/5ml - Botol 60 ml 3,499.00 - Botol 60 ml 3,499.00 - Botol 60 ml 3,499.00 - - Botol 60 ml 3,499.00 -
207 Ibuprofen Suspensi 100 mg/5ml 200 Botol 60 ml 2,721.00 544,200.00 Botol 60 ml 2,721.00 - 150 Botol 60 ml 2,721.00 408,150.00 50 Botol 60 ml 2,721.00 136,050.00
208 Ibuprofen Tablet 400 mg - Tablet 150.00 - Tablet 150.00 - Tablet 150.00 - - Tablet 150.00 -
212 Ichtiol Salep - Tube 5,399.00 - Tube 5,399.00 - Tube 5,399.00 - - Tube 5,399.00 -
213 Ichtiol Salep - Tube 5,940.00 - Tube 5,940.00 - Tube 5,940.00 - - Tube 5,940.00 -
214 Isoniazid Tablet 300 mg - Tablet 158.00 - Tablet 158.00 - Tablet 158.00 - - Tablet 158.00 -
215 Isosorbid Dinitrat Tablet Sublingual 5 mg - Tablet 88.00 - Tablet 88.00 - Tablet 88.00 - - Tablet 88.00 -
216 Isosorbid Dinitrat Tablet Sublingual 5 mg - Tablet 89.00 - Tablet 89.00 - Tablet 89.00 - - Tablet 89.00 -
217 Kalsium Laktat (Kalk) Tablet 500 mg - Tablet 58.00 - Tablet 58.00 - Tablet 58.00 - - Tablet 58.00 -
220 Kalsium Laktat (Kalk) Tablet 5 mg 7,600 Tablet 59.00 448,400.00 Tablet 59.00 - 3,000 Tablet 59.00 177,000.00 4,600 Tablet 59.00 271,400.00
221 Kaptopril Tablet 12,5 mg - Tablet 62.00 - Tablet 62.00 - Tablet 62.00 - - Tablet 62.00 -
222 Kaptopril Tablet 12,5 mg - Tablet 59.00 - Tablet 59.00 - Tablet 59.00 - - Tablet 59.00 -
223 Kaptopril Tablet 12,5 mg 1,000 Tablet 66.00 66,000.00 Tablet 66.00 - Tablet 66.00 - 1,000 Tablet 66.00 66,000.00
224 Kaptopril Tablet 25 mg - Tablet 84.00 - Tablet 84.00 - Tablet 84.00 - - Tablet 84.00 -
225 Kaptopril Tablet 25 mg 1,000 Tablet 68.00 68,000.00 Tablet 68.00 - Tablet 68.00 - 1,000 Tablet 68.00 68,000.00
226 Kaptopril Tablet 25 mg 2,300 Tablet 75.00 172,500.00 Tablet 75.00 - Tablet 75.00 - 2,300 Tablet 75.00 172,500.00
229 Karbamazepin Tablet 200 mg - Tablet 230.00 - Tablet 230.00 - Tablet 230.00 - - Tablet 230.00 -
230 Karbamazepin Tablet 200 mg - Tablet 245.00 - Tablet 245.00 - Tablet 245.00 - - Tablet 245.00 -
Tube 15
231 Ketokonazol Krim 2 % - Tube 15 gram 4,700.00 - Tube 15 gram 4,700.00 - Tube 15 gram 4,700.00 - - 4,700.00 -
gram
232 Ketokonazol Krim 2 % - Tube 2,545.00 - Tube 2,545.00 - Tube 2,545.00 - - Tube 2,545.00 -
233 Ketokonazol Krim 2 % 40 Tube 2,518.00 100,720.00 Tube 2,518.00 - Tube 2,518.00 - 40 Tube 2,518.00 100,720.00
234 Ketokonazol Tablet 200 mg - Tablet 300.00 - Tablet 300.00 - Tablet 300.00 - - Tablet 300.00 -
235 Ketokonazol Tablet 200 mg - Tablet 270.00 - Tablet 270.00 - Tablet 270.00 - - Tablet 270.00 -
BHP-01-2021 20
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
236 Ketokonazol Tablet 200 mg 2,750 Tablet 288.00 792,000.00 Tablet 288.00 - Tablet 288.00 - 2,750 Tablet 288.00 792,000.00
237 Ketoprofen Tablet 100 mg - Tablet 608.00 - Tablet 608.00 - Tablet 608.00 - - Tablet 608.00 -
238 Klindamisin Kapsul 150 mg - Kapsul 361.00 - Kapsul 361.00 - Kapsul 361.00 - - Kapsul 361.00 -
239 Klindamisin Kapsul 150 mg - Kapsul 715.00 - Kapsul 715.00 - Kapsul 715.00 - - Kapsul 715.00 -
240 Kloramfenikol Kapsul 250 mg - Kapsul 267.00 - Kapsul 267.00 - Kapsul 267.00 - - Kapsul 267.00 -
241 Kloramfenikol Kapsul 250 mg - Kapsul 310.00 - Kapsul 310.00 - Kapsul 310.00 - - Kapsul 310.00 -
242 Kloramfenikol Salep Mata 1 % 5 gram - Tube 1,600.00 - Tube 1,600.00 - Tube 1,600.00 - - Tube 1,600.00 -
246 Kloramfenikol salep kulit 2 % - Tube 3,091.00 - Tube 3,091.00 - Tube 3,091.00 - - Tube 3,091.00 -
247 Kloramfenikol salep kulit 2 % (Bufacetin) - Tube 3,008.00 - Tube 3,008.00 - Tube 3,008.00 - - Tube 3,008.00 -
248 Kloramfenikol salep kulit 2 % (Bufacetin) 96 Tube 3,242.00 311,232.00 Tube 3,242.00 - 24 Tube 3,242.00 77,808.00 72 Tube 3,242.00 233,424.00
249 Kloramfenikol Suspensi 125mg/5ml - Botol 3,955.00 - Botol 3,955.00 - Botol 3,955.00 - - Botol 3,955.00 -
250 Kloramfenikol Suspensi 125mg/5ml 50 Botol 5,015.00 250,750.00 Botol 5,015.00 - Botol 5,015.00 - 50 Botol 5,015.00 250,750.00
251 Kloramfenikol Tetes Mata Komb. ( Erlamicetin Plus) 24 Botol 15,444.00 370,656.00 Botol 15,444.00 - 24 Botol 15,444.00 370,656.00 - Botol 15,444.00 -
252 Kloramfenikol Tetes Telinga 3 % - 5ml - Botol 1,815.00 - Botol 1,815.00 - Botol 1,815.00 - - Botol 1,815.00 -
253 Kloramfenikol Tetes Telinga 1% (Reco) 10 Botol 8,360.00 83,600.00 Botol 8,360.00 - Botol 8,360.00 - 10 Botol 8,360.00 83,600.00
254 Kloramfenikol Tetes Telinga 1% (Erlamycetin) - Botol 7,843.00 - Botol 7,843.00 - Botol 7,843.00 - - Botol 7,843.00 -
255 Klorfeniramina Maleat (CTM )Tablet 4 mg - Tablet 51.00 - Tablet 51.00 - Tablet 51.00 - - Tablet 51.00 -
258 Klorfeniramina Maleat (CTM )Tablet 4 mg 8,800 Tablet 23.00 202,400.00 Tablet 23.00 - 3,500 Tablet 23.00 80,500.00 5,300 Tablet 23.00 121,900.00
259 Klorokuin Tablet 150 mg - Tablet 107.00 - Tablet 107.00 - Tablet 107.00 - - Tablet 107.00 -
260 Klorpromazin Tablet Salut 100 mg (HCl) - Tablet 149.00 - Tablet 149.00 - Tablet 149.00 - - Tablet 149.00 -
266 Klorpromazin Injeksi i.m.25 mg/ml(HCl) - Ampul 2ml 1,100.00 - Ampul 2ml 1,100.00 - Ampul 2ml 1,100.00 - - Ampul 2ml 1,100.00 -
267 Klorpromazin Injeksi i.m.25 mg/ml(HCl) - Ampul 1,240.00 - Ampul 1,240.00 - Ampul 1,240.00 - - Ampul 1,240.00 -
268 Kodein Tablet 10 mg - Tablet 500.00 - Tablet 500.00 - Tablet 500.00 - - Tablet 500.00 -
269 Kodein Tablet 10 mg - Tablet 571.00 - Tablet 571.00 - Tablet 571.00 - - Tablet 571.00 -
270 Kodein Tablet 20 mg - Tablet 1,100.00 - Tablet 1,100.00 - Tablet 1,100.00 - - Tablet 1,100.00 -
Kotrimoksazol DOEN (dewasa) Kombinasi :
(dewasa) 80mg:
Kombinasi
(dewasa) 80mg:
Kombinasi
273 3,700 Tablet 151.00 558,700.00 Tablet 151.00 - 1,000 Tablet 151.00 151,000.00 2,700 Tablet 151.00 407,700.00
(dewasa) 80mg:
Kombinasi
(dewasa) 80mg:
Kombinasi
(pediatrik) 80mg:
Kombinasi
Sulmetoksazol 100 mg + Trimetoprim 20 mg
Kotrimoksazol Suspensi Kombi : Sulfame- toksazol
277 150 Botol 60 ml 2,190.00 328,500.00 Botol 60 ml 2,190.00 - 23 Botol 60 ml 2,190.00 50,370.00 127 Botol 60 ml 2,190.00 278,130.00
20 mg + Trimetoprim 40mg/5ml

278 - Botol 60 ml 2,140.00 - Botol 60 ml 2,140.00 - Botol 60 ml 2,140.00 - - Botol 60 ml 2,140.00 -
Kotrimoksazol Suspensi Kombi tiap 5ml :

279 Sulfematoksazol 200 mg + Trimetoprim 40mg (susp - Botol 60 ml 2,052.00 - Botol 60 ml 2,052.00 - Botol 60 ml 2,052.00 - - Botol 60 ml 2,052.00 -
240 mg)
280 Kuinin (Kina) Tablet 200 mg - Tablet 670.00 - Tablet 670.00 - Tablet 670.00 - - Tablet 670.00 -
281 Kuinin Injeksi i.v. 25% (sebagai 2HCl) - Amp 2 ml 6,200.00 - Amp 2 ml 6,200.00 - Amp 2 ml 6,200.00 - - Amp 2 ml 6,200.00 -
282 Kuinin Tablet 222 mg (H2SO4.7H2O) - Tablet 540.00 - Tablet 540.00 - Tablet 540.00 - - Tablet 540.00 -
283 Lansoprazol Kapsul 30 mg - Kapsul 473.00 - Kapsul 473.00 - Kapsul 473.00 - - Kapsul 473.00 -
284 Levertran Salep - pot 3,599.00 - pot 3,599.00 - pot 3,599.00 - - pot 3,599.00 -
285 Levertran Salep 24 Pot 4,268.00 102,432.00 Pot 4,268.00 - Pot 4,268.00 - 24 Pot 4,268.00 102,432.00
286 Levofloksasin Tablet 500 mg - Tablet 528.00 - Tablet 528.00 - Tablet 528.00 - - Tablet 528.00 -
287 Lidokain Injeksi 2% - Ampul 2 ml 839.00 - Ampul 2 ml 839.00 - Ampul 2 ml 839.00 - - Ampul 2 ml 839.00 -
288 Lidokain Injeksi 2% - Ampul 860.00 - Ampul 860.00 - Ampul 860.00 - - Ampul 860.00 -
289 Lidokain Injeksi 2% - Ampul 1,221.00 - Ampul 1,221.00 - Ampul 1,221.00 - - Ampul 1,221.00 -
290 Lidokain Injeksi 2% + Epinefrin 1:80.000 Injeksi 2 ml - Ampul 1,145.00 - Ampul 1,145.00 - Ampul 1,145.00 - - Ampul 1,145.00 -
291 Lidokain Injeksi 2% + Epinefrin 1:80.000 Injeksi 2 ml - Ampul 1,222.00 - Ampul 1,222.00 - Ampul 1,222.00 - - Ampul 1,222.00 -
292 Lidokain Spray (Xylocain Spray) - Botol 177,216.00 - Botol 177,216.00 - Botol 177,216.00 - - Botol 177,216.00 -
293 Linkomisin Kapsul 500 mg - Kapsul 650.00 - Kapsul 650.00 - Kapsul 650.00 - - Kapsul 650.00 -
Botol 1000
294 Lisol Larutan Antiseptik 5 Botol 1000 ml 41,000.00 205,000.00 Botol 1000 ml 41,000.00 - Botol 1000 ml 41,000.00 - 5 41,000.00 205,000.00
ml
295 Loperamid tablet 2 mg - Tablet 85.00 - Tablet 85.00 - Tablet 85.00 - - Tablet 85.00 -
BHP-01-2021 21
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
296 Loperamid tablet 2 mg 900 Tablet 374.00 336,600.00 Tablet 374.00 - 200 Tablet 374.00 74,800.00 700 Tablet 374.00 261,800.00
297 Magnesium Sulfat Injeksi (IV)20%-25ml - Vial 2,800.00 - Vial 2,800.00 - Vial 2,800.00 - - Vial 2,800.00 -
298 Magnesium Sulfat Injeksi (IV)20%-25ml - Vial 3,200.00 - Vial 3,200.00 - Vial 3,200.00 - - Vial 3,200.00 -
299 Magnesium Sulfat Injeksi (IV)40% 30 Ampul 3,796.00 113,880.00 Ampul 3,796.00 - 30 Ampul 3,796.00 113,880.00 - Ampul 3,796.00 -
300 Mebendazol Syrup 100 mg/5ml - Botol 30 ml 3,400.00 - Botol 30 ml 3,400.00 - Botol 30 ml 3,400.00 - - Botol 30 ml 3,400.00 -
301 Metampiron Injeksi 250 mg - Amp 2 ml 1,333.00 - Amp 2 ml 1,333.00 - Amp 2 ml 1,333.00 - - Amp 2 ml 1,333.00 -
302 Metformin HCl Tablet 500 mg - Tablet 100.00 - Tablet 100.00 - Tablet 100.00 - - Tablet 100.00 -
303 Metformin HCl Tablet 500 mg 700 Tablet 102.00 71,400.00 Tablet 102.00 - 300 Tablet 102.00 30,600.00 400 Tablet 102.00 40,800.00
304 Metformin HCl Tablet 850 mg - Tablet 150.00 - Tablet 150.00 - Tablet 150.00 - - Tablet 150.00 -
305 Metilergometrin Maleat Injeksi 0,2 mg/ml - Ampul 2,684.00 - Ampul 2,684.00 - Ampul 2,684.00 - - Ampul 2,684.00 -
306 Metilergometrin Maleat Injeksi 0,2 mg/ml - Ampul 2,959.00 - Ampul 2,959.00 - Ampul 2,959.00 - - Ampul 2,959.00 -
307 Metilergometrin Maleat Tab Salut 0,125 mg - Tablet 154.00 - Tablet 154.00 - Tablet 154.00 - - Tablet 154.00 -
308 Metilergometrin Maleat Tab Salut 0,125 mg 100 Tablet 210.00 21,000.00 Tablet 210.00 - Tablet 210.00 - 100 Tablet 210.00 21,000.00
309 Metilergometrin Maleat Tab Salut 0,125 mg - Tablet 224.00 - Tablet 224.00 - Tablet 224.00 - - Tablet 224.00 -
Kotak 1 Vial 8 Kotak 1 Vial
310 Metilprednisolon Injeksi 500 mg - Kotak 1 Vial 8 ml 93,393.00 - Kotak 1 Vial 8 ml 93,393.00 - 93,393.00 - - 93,393.00 -
ml 8 ml
311 Metilprednisolon kaplet 4 mg - Tablet 150.00 - Tablet 150.00 - Tablet 150.00 - - Tablet 150.00 -
312 Metilprednisolon kaplet 4 mg - Tablet 134.00 - Tablet 134.00 - Tablet 134.00 - - Tablet 134.00 -
313 Metilprednisolon kaplet 4 mg 600 Tablet 143.00 85,800.00 Tablet 143.00 - 200 Tablet 143.00 28,600.00 400 Tablet 143.00 57,200.00
314 Metilprednisolon kaplet 8 mg - Kaplet 309.00 - Kaplet 309.00 - Kaplet 309.00 - - Kaplet 309.00 -
315 Metoklorpramid syrup 5 mg/5 ml 100 Botol 2,530.00 253,000.00 Botol 2,530.00 - Botol 2,530.00 - 100 Botol 2,530.00 253,000.00
316 Metoklorpramid 5 mg Tab - Tablet 121.00 - Tablet 121.00 - Tablet 121.00 - - Tablet 121.00 -
317 Metoklorpramid 10 mg Tab 100 Tablet 90.00 9,000.00 Tablet 90.00 - Tablet 90.00 - 100 Tablet 90.00 9,000.00
318 Metoklorpramid 10 mg Tab 400 Tablet 80.00 32,000.00 Tablet 80.00 - Tablet 80.00 - 400 Tablet 80.00 32,000.00
319 Metoklorpramid 10 mg Tab - Tablet 85.00 - Tablet 85.00 - Tablet 85.00 - - Tablet 85.00 -
320 Metronidazol Tablet 250 mg - Tablet 110.00 - Tablet 110.00 - Tablet 110.00 - - Tablet 110.00 -
321 Metronidazol Tablet 250 mg 2,100 Tablet 94.00 197,400.00 Tablet 94.00 - Paket 94.00 - 2,100 Paket 94.00 197,400.00
Tube 10
324 Mikonazol Krim/Salep 2 % (Nitrat) - Tube 10 gram 3,000.00 - Tube 10 gram 3,000.00 - Tube 10 gram 3,000.00 - - 3,000.00 -
gram
Tube 10
325 Mikonazol Krim/Salep 2 % (Nitrat) 14 Tube 10 gram 3,250.00 45,500.00 Tube 10 gram 3,250.00 - 14 Tube 10 gram 3,250.00 45,500.00 - 3,250.00 -
gram
Tube 10
326 Mikonazol Krim/Salep 2 % (Nitrat) 48 Tube 10 gram 3,414.00 163,872.00 Tube 10 gram 3,414.00 - 14 Tube 10 gram 3,414.00 47,796.00 34 3,414.00 116,076.00
gram
327 Natrium Diklofenak Tablet 25 mg - Tablet 133.00 - Tablet 133.00 - Tablet 133.00 - - Tablet 133.00 -
330 Natrium Diklofenak Tablet 25 mg 450 Tablet 137.00 61,650.00 Tablet 137.00 - 450 Tablet 137.00 61,650.00 - Tablet 137.00 -
331 Natrium Klorida Larutan Infus 0,9% - Botol 500 ml 4,700.00 - Botol 500 ml 4,700.00 - Botol 500 ml 4,700.00 - - Botol 500 ml 4,700.00 -
332 Natrium Klorida Larutan Infus 0,9% - Botol 500 ml 6,410.00 - Botol 500 ml 6,410.00 - Botol 500 ml 6,410.00 - - Botol 500 ml 6,410.00 -
333 Natrium Klorida Larutan Infus 0,9% 160 Botol 500 ml 6,840.00 1,094,400.00 Botol 500 ml 6,840.00 - Botol 500 ml 6,840.00 - 160 Botol 500 ml 6,840.00 1,094,400.00
334 Natrium Tiroxin (Etyrox) - Tablet 850.00 - Tablet 850.00 - Tablet 850.00 - - Tablet 850.00 -
335 N-Asetil sistein - Kapsul 426.00 - Kapsul 426.00 - Kapsul 426.00 - - Kapsul 426.00 -
336 N-Asetil sistein - Kapsul 358.00 - Kapsul 358.00 - Kapsul 358.00 - - Kapsul 358.00 -
337 N-Asetil sistein 7,480 Kapsul 382.00 2,857,360.00 Kapsul 382.00 - Kapsul 382.00 - 7,480 Kapsul 382.00 2,857,360.00
338 Nistatin Tablet Salut 500.000 IU/g - Tablet 640.00 - Tablet 640.00 - Tablet 640.00 - - Tablet 640.00 -
342 Nistatin vaginal Tablet 100.000 IU/g - Tablet 480.00 - Tablet 480.00 - Tablet 480.00 - - Tablet 480.00 -
343 Nistatin vaginal Tablet 100.000 IU/g 600 Tablet 523.00 313,800.00 Tablet 523.00 - Tablet 523.00 - 600 Tablet 523.00 313,800.00
344 Nistatin vaginal Tablet 100.000 IU/g - Tablet 560.00 - Tablet 560.00 - Tablet 560.00 - - Tablet 560.00 -
345 Obat Anti Tuberkulosis FDC Kategori 1 - Paket 359,990.00 - Paket 359,990.00 - Paket 359,990.00 - - Paket 359,990.00 -
348 Obat Anti Tuberkulosis FDC Kategori 1 7 Paket 389,344.00 2,725,408.00 Paket 389,344.00 - 4 Paket 389,344.00 1,557,376.00 3 Paket 389,344.00 1,168,032.00
349 Obat Anti Tuberkulosis FDC Kategori 2 - Paket 1,199,985.00 - Paket 1,199,985.00 - Paket 1,199,985.00 - - Paket 1,199,985.00 -
351 Obat Anti Tuberkulosis FDC Kategori Anak - Paket 214,990.00 - Paket 214,990.00 - Paket 214,990.00 - - Paket 214,990.00 -
354 Obat Anti Tuberkulosis FDC sisipan - Paket 160,000.00 - Paket 160,000.00 - Paket 160,000.00 - - Paket 160,000.00 -
355 Obat Anti Tuberkulosis Kategori 1 - Paket 288,199.00 - Paket 288,199.00 - Paket 288,199.00 - - Paket 288,199.00 -
356 Obat Batuk Hitam(O.B.H.) cairan - Botol 100 ml 1,716.00 - Botol 100 ml 1,716.00 - Botol 100 ml 1,716.00 - - Botol 100 ml 1,716.00 -
357 Obat Batuk Hitam(O.B.H.) cairan - Botol 120 ml 5,735.00 - Botol 120 ml 5,735.00 - Botol 120 ml 5,735.00 - - Botol 120 ml 5,735.00 -
358 Obat Batuk Hitam(O.B.H.) cairan Molex 60 Botol 120 ml 5,500.00 330,000.00 Botol 120 ml 5,500.00 - Botol 120 ml 5,500.00 - 60 Botol 120 ml 5,500.00 330,000.00
359 Obat Batuk Kombinasi (Hustab) tablet - Tablet 434.00 - Tablet 434.00 - Tablet 434.00 - - Tablet 434.00 -
360 Obat Batuk Kombinasi (Hustab) tablet 1,200 Tablet 429.00 514,800.00 Tablet 429.00 - 1,200 Tablet 429.00 514,800.00 - Tablet 429.00 -
361 Ofloxacin Tablet 400 mg - Tablet 650.00 - Tablet 650.00 - Tablet 650.00 - - Tablet 650.00 -
BHP-01-2021 22
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
362 Oksitetrasiklin HCl Salep Mata 1% - Tube 3,5 g 3,220.00 - Tube 3,5 g 3,220.00 - Tube 3,5 g 3,220.00 - - Tube 3,5 g 3,220.00 -
363 Oksitetrasiklin HCl Salep Mata 1% - Tube 3,5 g 2,668.00 - Tube 3,5 g 2,668.00 - Tube 3,5 g 2,668.00 - - Tube 3,5 g 2,668.00 -
364 Oksitosin Injeksi 10 IU/ml-1ml - ampul 2,200.00 - ampul 2,200.00 - ampul 2,200.00 - - ampul 2,200.00 -
365 Oksitosin Injeksi 10 IU/ml-1ml - Ampul 1,900.00 - Ampul 1,900.00 - Ampul 1,900.00 - - Ampul 1,900.00 -
367 Omeprazol Kapsul 20 mg - Kapsul 211.00 - Kapsul 211.00 - Kapsul 211.00 - - Kapsul 211.00 -
369 Omeprazol Kapsul 20 mg 480 Kapsul 341.00 163,680.00 Kapsul 341.00 - 480 Kapsul 341.00 163,680.00 - Kapsul 341.00 -
371 Papaverin Tablet 40 mg - Tablet 100.00 - Tablet 100.00 - Tablet 100.00 - - Tablet 100.00 -
372 Papaverin Tablet 40 mg - Tablet 298.00 - Tablet 298.00 - Tablet 298.00 - - Tablet 298.00 -
373 Parasetamol Drops - Botol 15 ml 5,200.00 - Botol 15 ml 5,200.00 - Botol 15 ml 5,200.00 - - Botol 15 ml 5,200.00 -
374 Parasetamol Drops 80 Botol 15 ml 6,649.00 531,920.00 Botol 15 ml 6,649.00 - 24 Botol 15 ml 6,649.00 159,576.00 56 Botol 15 ml 6,649.00 372,344.00
375 Parasetamol Syrup 120 mg/ 5ml - Botol 60 ml 1,438.00 - Botol 60 ml 1,438.00 - Botol 60 ml 1,438.00 - - Botol 60 ml 1,438.00 -
380 Parasetamol Tablet 500 mg - Tablet 79.00 - Tablet 79.00 - Tablet 79.00 - - Tablet 79.00 -
381 Parasetamol Tablet 500 mg - Tablet 56.00 - Tablet 56.00 - Tablet 56.00 - - Tablet 56.00 -
382 Parasetamol Tablet 500 mg 3,200 Tablet 53.00 169,600.00 Tablet 53.00 - 3,200 Tablet 53.00 169,600.00 - Tablet 53.00 -
383 Piracetam Injeksi 3g/15ml - Amp 15ml 13,750.00 - Amp 15ml 13,750.00 - Amp 15ml 13,750.00 - - Amp 15ml 13,750.00 -
384 Piracetam Tablet 400 mg - Tablet 194.00 - Tablet 194.00 - Tablet 194.00 - - Tablet 194.00 -
385 Pirantel Syrup 125 mg/5ml - Botol 60 ml 8,360.00 - Botol 60 ml 8,360.00 - Botol 60 ml 8,360.00 - - Botol 60 ml 8,360.00 -
386 Pirantel Tablet score (base) 125 mg - Tablet 298.00 - Tablet 298.00 - Tablet 298.00 - - Tablet 298.00 -
387 Pirantel Tablet score (base) 125 mg - Tablet 291.00 - Tablet 291.00 - Tablet 291.00 - - Tablet 291.00 -
388 Pirazinamid Tablet 500 mg - Tablet 208.00 - Tablet 208.00 - Tablet 208.00 - - Tablet 208.00 -
389 Piridoksin (Vitamin B6) inj 100 mg/ml - ampul 980.00 - ampul 980.00 - ampul 980.00 - - ampul 980.00 -
Botol 100 Botol 100
390 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) - Botol 100 Tablet 11,000.00 - Botol 100 Tablet 11,000.00 - 11,000.00 - - 11,000.00 -
Tablet Tablet
391 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) - tablet 45.00 - tablet 45.00 - tablet 45.00 - - tablet 45.00 -
392 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) 8,100 Tablet 123.00 996,300.00 Tablet 123.00 - 3,500 Tablet 123.00 430,500.00 4,600 Tablet 123.00 565,800.00
393 Piridoksin (Vitamin B6) Tablet 10 mg(HCl) - Tablet 131.00 - Tablet 131.00 - Tablet 131.00 - - Tablet 131.00 -
394 Piroxicam Tablet 10 mg - Tablet 84.00 - Tablet 84.00 - Tablet 84.00 - - Tablet 84.00 -
395 Piroxicam Tablet 10 mg - Tablet 130.00 - Tablet 130.00 - Tablet 130.00 - - Tablet 130.00 -
396 Povidon Iodida Larutan 10% - Botol 30 ml 2,163.00 - Botol 30 ml 2,163.00 - Botol 30 ml 2,163.00 - - Botol 30 ml 2,163.00 -
397 Povidon Iodida Larutan 10% - botol 60 ml 6,550.00 - botol 60 ml 6,550.00 - botol 60 ml 6,550.00 - - botol 60 ml 6,550.00 -
399 Povidon Iodida Larutan 10% 98 botol 60 ml 3,700.00 362,600.00 botol 60 ml 3,700.00 - 2 botol 60 ml 3,700.00 7,400.00 96 botol 60 ml 3,700.00 355,200.00
400 Povidon Iodida Larutan 10% - botol 60 ml 4,620.00 - botol 60 ml 4,620.00 - botol 60 ml 4,620.00 - - botol 60 ml 4,620.00 -
401 Povidon Iodida Larutan 10% 22 Botol 300 ml 18,000.00 396,000.00 Botol 300 ml 18,000.00 - 2 Botol 300 ml 18,000.00 36,000.00 20 Botol 300 ml 18,000.00 360,000.00
403 Prednison Tablet 5 mg - Tablet 114.00 - Tablet 114.00 - Tablet 114.00 - - Tablet 114.00 -
404 Prednison Tablet 5 mg - Kaplet 96.00 - Kaplet 96.00 - Kaplet 96.00 - - Kaplet 96.00 -
405 Prednison Tablet 5 mg - Tablet 68.00 - Tablet 68.00 - Tablet 68.00 - - Tablet 68.00 -
406 Prednison Tablet 5 mg 8,600 Tablet 73.00 627,800.00 Tablet 73.00 - 2,200 Tablet 73.00 160,600.00 6,400 Tablet 73.00 467,200.00
407 Primakuin Tablet 100 Tablet 224.00 22,400.00 Tablet 224.00 - Tablet 224.00 - 100 Tablet 224.00 22,400.00
408 Prokain Benzil Penisilin G.Injeksi 3 jt IU/vial - Vial 7,190.00 - Vial 7,190.00 - Vial 7,190.00 - - Vial 7,190.00 -
409 Prokain Penisillin inj - Vial 6,017.00 - Vial 6,017.00 - Vial 6,017.00 - - Vial 6,017.00 -
410 Propanolol Tablet 10 mg (HCl) - Tablet 65.00 - Tablet 65.00 - Tablet 65.00 - - Tablet 65.00 -
411 Propanolol Tablet 10 mg (HCl) - Tablet 60.00 - Tablet 60.00 - Tablet 60.00 - - Tablet 60.00 -
412 Propiltiourasil Tablet 100 mg - Tablet 319.00 - Tablet 319.00 - Tablet 319.00 - - Tablet 319.00 -
413 RanitidinTablet 150 mg - Tablet 98.00 - Tablet 98.00 - Tablet 98.00 - - Tablet 98.00 -
Botol 50 Botol 50
414 Retinol (Vitamin A) 100.000 IU Kapsul Lunak - Botol 50 Kapsul 13,000.00 - Botol 50 Kapsul 13,000.00 - 13,000.00 - - 13,000.00 -
Kapsul
Botol 50 Kapsul
Botol 50
415 Retinol (Vitamin A) 100.000 IU Kapsul Lunak - Botol 50 Kapsul 14,200.00 - Botol 50 Kapsul 14,200.00 - 14,200.00 - - 14,200.00 -
Kapsul Kapsul
416 Retinol (Vitamin A) 200.000 IU Kapsul Lunak - Kapsul 519.20 - Kapsul 519.20 - Kapsul 519.20 - - Kapsul 519.20 -
418 Rifampisin Tablet Salut 450 mg - Tablet 789.00 - Tablet 789.00 - Tablet 789.00 - - Tablet 789.00 -
419 Ringer Laktat Larutan Infus - Botol 500 ml 5,200.00 - Botol 500 ml 5,200.00 - Botol 500 ml 5,200.00 - - Botol 500 ml 5,200.00 -
421 Ringer Laktat Larutan Infus 4,860 Botol 500 ml 7,630.00 37,081,800.00 Botol 500 ml 7,630.00 - 240 Botol 500 ml 7,630.00 1,831,200.00 4,620 Botol 500 ml 7,630.00 35,250,600.00
422 Risperidon Tablet 1 mg - Kapsul 1,500.00 - Kapsul 1,500.00 - Kapsul 1,500.00 - - Kapsul 1,500.00 -
423 Risperidon Tablet 2 mg - Kapsul 1,008.00 - Kapsul 1,008.00 - Kapsul 1,008.00 - - Kapsul 1,008.00 -
424 Risperidon Tablet 2 mg - Tablet 495.00 - Tablet 495.00 - Tablet 495.00 - - Tablet 495.00 -
425 Risperidon Tablet 2 mg - Tablet 273.00 - Tablet 273.00 - Tablet 273.00 - - Tablet 273.00 -
426 Risperidon Tablet 2 mg 1,015 Tablet 287.00 291,305.00 Tablet 287.00 - 110 Tablet 287.00 31,570.00 905 Tablet 287.00 259,735.00
427 Salbutamol Tablet 2 mg (sebagai Sulfat) - Tablet 59.00 - Tablet 59.00 - Tablet 59.00 - - Tablet 59.00 -
BHP-01-2021 23
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
428 Salbutamol Tablet 2 mg (sebagai Sulfat) - tablet 66.00 - tablet 66.00 - tablet 66.00 - - tablet 66.00 -
429 Salbutamol Tablet 2 mg (sebagai Sulfat) 500 tablet 63.00 31,500.00 tablet 63.00 - tablet 63.00 - 500 tablet 63.00 31,500.00
432 Salbutamol Tablet 4 mg (sebagai Sulfat) 400 Tablet 70.00 28,000.00 Tablet 70.00 - Tablet 70.00 - 400 Tablet 70.00 28,000.00
433 - Pot 30 gr 2,000.00 - Pot 30 gr 2,000.00 - Pot 30 gr 2,000.00 - - Pot 30 gr 2,000.00 -
Asam Salisilat 2% + Belerang endap 4%

434 - Tube 2,429.00 - Tube 2,429.00 - Tube 2,429.00 - - Tube 2,429.00 -

435 - Pot 2,621.00 - Pot 2,621.00 - Pot 2,621.00 - - Pot 2,621.00 -

436 72 Pot 2,797.00 201,384.00 Pot 2,797.00 - 48 Pot 2,797.00 134,256.00 24 Pot 2,797.00 67,128.00
437 Salisil Bedak 2% - Ktk 50 gram 1,250.00 - Ktk 50 gram 1,250.00 - Ktk 50 gram 1,250.00 - - Ktk 50 gram 1,250.00 -
438 Salisil Bedak 2% - kotak 1,025.00 - kotak 1,025.00 - kotak 1,025.00 - - kotak 1,025.00 -
439 Salisil Bedak 2% - Kotak 1,020.00 - Kotak 1,020.00 - Kotak 1,020.00 - - Kotak 1,020.00 -
440 Salisil Bedak 2% - Botol 50 g 4,525.00 - Botol 50 g 4,525.00 - Botol 50 g 4,525.00 - - Botol 50 g 4,525.00 -
441 Salisil Bedak 2% 50 Botol 50 g 4,543.00 227,150.00 Botol 50 g 4,543.00 - 26 Botol 50 g 4,543.00 118,118.00 24 Botol 50 g 4,543.00 109,032.00
442 Sefaleksin Kapsul 500 mg - Tablet 1,000.00 - Tablet 1,000.00 - Tablet 1,000.00 - - Tablet 1,000.00 -
443 Sianokobalamin (Vit-B12 ) Injeksi 500 mcg - amp @1ml 1,077.00 - amp @1ml 1,077.00 - amp @1ml 1,077.00 - - amp @1ml 1,077.00 -
444 Sianokobalamin (Vit-B12 ) Injeksi 500 mcg - Ampul 1,098 - Ampul 1,098.00 - Ampul 1,098.00 - - Ampul 1,098.00 -
445 Sianokobalamin (Vit-B12) Tablet 50 mcg - Tablet 57 - Tablet 57.00 - Tablet 57.00 - - Tablet 57.00 -
447 Sianokobalamin (Vit-B12) Tablet 50 mcg 1,000 Tablet 46 46,000.00 Tablet 46.00 - 500 Tablet 46.00 23,000.00 500 Tablet 46.00 23,000.00
449 Simvastatin Tablet 10 mg - tablet 131 - tablet 131.00 - tablet 131.00 - - tablet 131.00 -
450 Simvastatin Tablet 10 mg - Tablet 110 - Tablet 110.00 - Tablet 110.00 - - Tablet 110.00 -
451 Simvastatin Tablet 10 mg 5,940 Tablet 117 694,980.00 Tablet 117.00 - 330 Tablet 117.00 38,610.00 5,610 Tablet 117.00 656,370.00
452 Simvastatin Tablet 20 mg - Tablet 391 - Tablet 391.00 - Tablet 391.00 - - Tablet 391.00 -
453 Simvastatin Tablet 20 mg - tablet 252 - tablet 252.00 - tablet 252.00 - - tablet 252.00 -
454 Siprofloksasin Tablet 500 mg (sebagai HCl) - Tablet 255 - Tablet 255.00 - Tablet 255.00 - - Tablet 255.00 -
455 Siprofloksasin Tablet scored 500 mg - Tablet 281 - Tablet 281.00 - Tablet 281.00 - - Tablet 281.00 -
458 Siprofloksasin Tablet scored 500 mg 1,900 Tablet 1,188 2,257,200.00 Tablet 1,188.00 - 1,100 Tablet 1,188.00 1,306,800.00 800 Tablet 1,188.00 950,400.00
459 Sulfasetamida Natrium Tetes Mata 15% - Botol 5ml 1,428 - Botol 5ml 1,428.00 - Botol 5ml 1,428.00 - - Botol 5ml 1,428.00 -
460 Tetrakain HCl Tetes Mata 0,5% - Botol @ 5ml 11,500 - Botol @ 5ml 11,500.00 - Botol @ 5ml 11,500.00 - - Botol @ 5ml 11,500.00 -
461 Tetrasiklin Kapsul 250 mg - Kapsul 149 - Kapsul 149.00 - Kapsul 149.00 - - Kapsul 149.00 -
462 Tetrasiklin Kapsul 500 mg - Kapsul 300 - Kapsul 300.00 - Kapsul 300.00 - - Kapsul 300.00 -
463 Tetrasiklin Kapsul 500 mg 700 Tablet 310 217,000.00 Tablet 310.00 - 200 Tablet 310.00 62,000.00 500 Tablet 310.00 155,000.00
464 Tetrasiklin Kapsul 500 mg - Tablet 323 - Tablet 323.00 - Tablet 323.00 - - Tablet 323.00 -
465 Tiamin HCl (Vitamin B1) Tablet - Kapsul 380 - Kapsul 380.00 - Kapsul 380.00 - - Kapsul 380.00 -
466 Tiamin HCl (Vitamin B1) Tablet - Tablet 81 - Tablet 81.00 - Tablet 81.00 - - Tablet 81.00 -
467 Tiamin HCl (Vitamin B1) Tablet 1,500 Tablet 86 129,000.00 Tablet 86.00 - 1,000 Tablet 86.00 86,000.00 500 Tablet 86.00 43,000.00
468 Tiamin HCl (Vitamin B1) Tablet - Tablet 85 - Tablet 85.00 - Tablet 85.00 - - Tablet 85.00 -
469 Tramadol Injeksi 50 mg/ml - ampul 2,395 - ampul 2,395.00 - ampul 2,395.00 - - ampul 2,395.00 -
470 Tramadol Injeksi 50 mg/ml 15 ampul 1,764 26,460.00 ampul 1,764.00 - ampul 1,764.00 - 15 ampul 1,764.00 26,460.00
471 Tramadol Kapsul 50 mg - Kapsul 322 - Kapsul 322.00 - Kapsul 322.00 - - Kapsul 322.00 -
472 Tramadol Injeksi 100 mg/ml - ampul 2,700 - ampul 2,700.00 - ampul 2,700.00 - - ampul 2,700.00 -
473 Triheksifenidil Tablet 2 mg - Tablet 80 - Tablet 80.00 - Tablet 80.00 - - Tablet 80.00 -
474 Triheksifenidil Tablet 2 mg - Tablet 85 - Tablet 85.00 - Tablet 85.00 - - Tablet 85.00 -
475 Triheksifenidil Tablet 2 mg 44 Tablet 91 4,004.00 Tablet 91.00 - 44 Tablet 91.00 4,004.00 - Tablet 91.00 -
476 Vitamin B Kompleks Tablet - Tablet 107 - Tablet 107.00 - Tablet 107.00 - - Tablet 107.00 -
479 Vitamin B Kompleks Tablet 2,900 Tablet 117 339,300.00 Tablet 117.00 - 2,700 Tablet 117.00 315,900.00 200 Tablet 117.00 23,400.00
480 Zinc Tablet 20 mg - Tablet 474 - Tablet 474.00 - Tablet 474.00 - - Tablet 474.00 -
481 Zinc Tablet dispersible 20 mg - Tablet 514 - Tablet 514.00 - Tablet 514.00 - - Tablet 514.00 -
482 Zinc Tablet dispersible 20 mg 600 Tablet 524 314,400.00 Tablet 524.00 - 300 Tablet 524.00 157,200.00 300 Tablet 524.00 157,200.00
483 Ongkir - - - - -
- - - -
OBAT GIGI - -
1 Calplus - Tube 333,830.00 - Tube 333,830.00 - Tube 333,830.00 - - Tube 333,830.00 -
2 Calsium Hidroksi Pasta ( Calplus) - Pack 330,491.70 - Pack 330,491.70 - Pack 330,491.70 - - Pack 330,491.70 -
BHP-01-2021 24
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
3 Caviton (Temporary Stoping Fleker) - Pot 184,240.00 - Pot 184,240.00 - Pot 184,240.00 - - Pot 184,240.00 -
4 Caviton (Temporary Stoping Fleker) - Pot 182,397.60 - Pot 182,397.60 - Pot 182,397.60 - - Pot 182,397.60 -
5 CHKM (Monokloramkamfer Menthol Cairan) - Botol 77,030.00 - Botol 77,030.00 - Botol 77,030.00 - - Botol 77,030.00 -
6 CHKM (Monokloramkamfer Menthol Cairan) - Botol 76,259.70 - Botol 76,259.70 - Botol 76,259.70 - - Botol 76,259.70 -
7 Cold Spray - Botol 352,000.00 - Botol 352,000.00 - Botol 352,000.00 - - Botol 352,000.00 -
8 Devitalisasi Pasta (Pulp X) - Botol 256,790.00 - Botol 256,790.00 - Botol 256,790.00 - - Botol 256,790.00 -
9 Devitalisasi Pasta NON Arsen ( Devita) - Pot 259,996.00 - Pot 259,996.00 - Pot 259,996.00 - - Pot 259,996.00 -
10 Eugenol cairan - Botol 18,100.00 - Botol 18,100.00 - Botol 18,100.00 - - Botol 18,100.00 -
11 Glass Ionomer Cement - Set 395,000.00 - Set 395,000.00 - Set 395,000.00 - - Set 395,000.00 -
12 Glass Ionomer (Ketac Universal) - Botol 761,390.00 - Botol 761,390.00 - Botol 761,390.00 - - Botol 761,390.00 -
13 Glass Ionomer (Ketac Universal) - Botol 658,845.00 - Botol 658,845.00 - Botol 658,845.00 - - Botol 658,845.00 -
14 Mummipaying Pasta (Cresotin Pasta) - Tube 309,310.00 - Tube 309,310.00 - Tube 309,310.00 - - Tube 309,310.00 -
15 Mummipaying Pasta (Cresotin Pasta) - Pot 262,350.00 - Pot 262,350.00 - Pot 262,350.00 - - Pot 262,350.00 -
16 Semen Seng Posfat Sebuk / Cair - Botol 30gr 93,500.00 - Botol 30gr 93,500.00 - Botol 30gr 93,500.00 - - Botol 30gr 93,500.00 -
17 Zink Cement (Eliet Cement) - Botol 197,730.00 - Botol 197,730.00 - Botol 197,730.00 - - Botol 197,730.00 -
18 Zink Cement (Eliet Cement) - Botol 195,800.00 - Botol 195,800.00 - Botol 195,800.00 - - Botol 195,800.00 -
- - -
PERBEKALAN KESEHATAN - -
1 Alat Suntik Sekali Pakai 0,05 ml - pieces 1,354.00 - pieces 1,354.00 - pieces 1,354.00 - - pieces 1,354.00 -
2 Alat Suntik Sekali Pakai 0,5 ml - pieces 1,175.00 - pieces 1,175.00 - pieces 1,175.00 - - pieces 1,175.00 -
3 Alat Suntik Sekali Pakai 1 ml - Pieces 762.00 - Pieces 762.00 - Pieces 762.00 - - Pieces 762.00 -
4 Alat Suntik Sekali Pakai 1 cc 100 Pieces 689.86 68,986.00 Pieces 689.86 - Pieces 689.86 - 100 Pieces 689.86 68,986.00
5 Alat Suntik Sekali Pakai 2,5 cc - Pieces 669.80 - Pieces 669.80 - Pieces 669.80 - - Pieces 669.80 -
6 Alat Suntik Sekali Pakai 3 ml - pcs 1,038.00 - pcs 1,038.00 - pcs 1,038.00 - - pcs 1,038.00 -
7 Alat Suntik Sekali Pakai 3 ml - pieces 916.00 - pieces 916.00 - pieces 916.00 - - pieces 916.00 -
8 Alat Suntik Sekali Pakai 3 ml - pieces 1,212.00 - pieces 1,212.00 - pieces 1,212.00 - - pieces 1,212.00 -
9 Alat Suntik Sekali Pakai 3 cc 100 pieces 669.80 66,980.00 pieces 669.80 - 100 pieces 669.80 66,980.00 - pieces 669.80 -
10 Alat Suntik Sekali Pakai 5 ml - pcs 1,038.00 - pcs 1,038.00 - pcs 1,038.00 - - pcs 1,038.00 -
11 Alat Suntik Sekali Pakai 5 ml - pieces 1,030.00 - pieces 1,030.00 - pieces 1,030.00 - - pieces 1,030.00 -
12 Alat Suntik Sekali Pakai 5 cc 528 pieces 804.07 424,548.96 pieces 804.07 - 78 pieces 804.07 62,717.46 450 pieces 804.07 361,831.50
13 Aqua jely steril 5 gr - Sachet 2,566.00 - Sachet 2,566.00 - Sachet 2,566.00 - - Sachet 2,566.00 -
14 Bisturi (BBraun steril scalpel blades #18) - pcs 3,000.00 - pcs 3,000.00 - pcs 3,000.00 - - pcs 3,000.00 -
15 Catgut / Benang Bedah 2/0, 26 mm (Gabler Med) - pieces 64,595.67 - pieces 64,595.67 - pieces 64,595.67 - - pieces 64,595.67 -
16 Catgut / Benang Bedah 2/0, 24 mm (Gabler Med) - pcs 60,438.84 - pcs 60,438.84 - pcs 60,438.84 - - pcs 60,438.84 -
17 Catgut / Benang Bedah 2/0, 19 mm (Gabler Med) - pcs 50,063.09 - pcs 50,063.09 - pcs 50,063.09 - - pcs 50,063.09 -
Catgut / Benang Bedah 2/0, 1/2 taper 30 mm (Gabler
18 60 pcs 58,839.90 3,530,394.00 pcs 58,839.90 - pcs 58,839.90 - 60 pcs 58,839.90 3,530,394.00
Med)
19 Cutgut 2/0,90 cm.1/2TP ( Chromic 2/0) - pcs 49,619.29 - pcs 49,619.29 - pcs 49,619.29 - - pcs 49,619.29 -
20 Catgut / Benang Bedah 3/0 - Rol 23,600.00 - Rol 23,600.00 - Rol 23,600.00 - - Rol 23,600.00 -
21 Catgut / Benang Bedah 3/0 - pcs 58,355.51 - pcs 58,355.51 - pcs 58,355.51 - - pcs 58,355.51 -
22 Catgut / Benang Bedah 3/0 - pieces 42,605.12 - pieces 42,605.12 - pieces 42,605.12 - - pieces 42,605.12 -
23 Cutgut 3/0 ,1/2 TP 22mm,75-2PTRO20EE 72 pieces 55,000.00 3,960,000.00 pieces 55,000.00 - pieces 55,000.00 - 72 pieces 55,000.00 3,960,000.00
24 Folley Catheter No. 18 - Pieces 8,495.00 - Pieces 8,495.00 - Pieces 8,495.00 - - Pieces 8,495.00 -
25 Folley Catheter No. 18 21 Pieces 11,000.00 231,000.00 Pieces 11,000.00 - Pieces 11,000.00 - 21 Pieces 11,000.00 231,000.00
26 Folley Catheter No. 18 - pieces 18,450.00 - pieces 18,450.00 - pieces 18,450.00 - - pieces 18,450.00 -
27 Folley Catheter 2- WAY No. 18 - pieces 11,565.00 - pieces 11,565.00 - pieces 11,565.00 - - pieces 11,565.00 -
28 Gel Catheter - Tube 82,500.00 - Tube 82,500.00 - Tube 82,500.00 - - Tube 82,500.00 -
29 Hand Scone Steril #7,0 (Aximed) - Pasang 7,872.00 - Pasang 7,872.00 - Pasang 7,872.00 - - Pasang 7,872.00 -
30 Hand Scone Steril #7,0 (Aximed) - Pcs 6,595.00 - Pcs 6,595.00 - Pcs 6,595.00 - - Pcs 6,595.00 -
31 Hand Scone Steril #7,5 (Aximed) - Pieces 7,600.00 - Pieces 7,600.00 - Pieces 7,600.00 - - Pieces 7,600.00 -
32 Hand Scone Steril #7,5 (medict dent) - pasang 5,000.00 - pasang 5,000.00 - pasang 5,000.00 - - pasang 5,000.00 -
33 Handscone Steril ( Mas Surgical Gloves 7,5 steril) 150 pasang 8,888.00 1,333,200.00 pasang 8,888.00 - 100 pasang 8,888.00 888,800.00 50 pasang 8,888.00 444,400.00
34 Hand Scone Steril #7,5 (KISMED) - pcs 6,595.00 - pcs 6,595.00 - pcs 6,595.00 - - pcs 6,595.00 -
35 Hand Scone / Sarung Tangan Non Steril - pcs 69.85 - pcs 69.85 - pcs 69.85 - - pcs 69.85 -
36 Hand Scone Non Steril # L (Aximed) - pcs 462.00 - pcs 462.00 - pcs 462.00 - - pcs 462.00 -
37 Hand Scone Non Steril # L (LIGHTY mas latex) - pcs 462.00 - pcs 462.00 - pcs 462.00 - - pcs 462.00 -
Hand Scone Non Steril # L (pree powdered mas
38 - pcs 462.00 - pcs 462.00 - pcs 462.00 - - pcs 462.00 -
latex)
39 Handscone Non Steril (L ) (Mas pree powdered) - pcs 522.06 - pcs 522.06 - pcs 522.06 - - pcs 522.06 -
40 Hand Scone Non Steril # M (Aximed) - pcs 462.00 - pcs 462.00 - pcs 462.00 - - pcs 462.00 -
41 Hand Scone Non Steril # M (kismed mask latex) - pcs 462.00 - pcs 462.00 - pcs 462.00 - - pcs 462.00 -
42 Handscone Non Steril (M ) (Mas pree powdered) - pcs 522.06 - pcs 522.06 - pcs 522.06 - - pcs 522.06 -
43 Handscone Non Steril 7.5 ( Mask Surgical) - Pasang 8,701.00 - Pasang 8,701.00 - Pasang 8,701.00 - - Pasang 8,701.00 -
44 Infusion Set Anak (Aximed) 130 Set 5,100.00 663,000.00 Set 5,100.00 - Set 5,100.00 - 130 Set 5,100.00 663,000.00
45 Infusion Set Anak - set 4,884.00 - set 4,884.00 - set 4,884.00 - - set 4,884.00 -
46 Infusion Set Anak - pcs 5,661.00 - pcs 5,661.00 - pcs 5,661.00 - - pcs 5,661.00 -
BHP-01-2021 25
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
49 Infusion Set Dewasa - Set 3,500.00 - Set 3,500.00 - Set 3,500.00 - - Set 3,500.00 -
52 Infusion Set Dewasa - pcs 5,445.00 - pcs 5,445.00 - pcs 5,445.00 - - pcs 5,445.00 -
54 Infusion Set Dewasa (y - TYPE) 215 pcs 8,061.00 1,733,115.00 pcs 8,061.00 - pcs 8,061.00 - 215 pcs 8,061.00 1,733,115.00
55 IV Canula non inj & wing no 20 (Eskamed) - Pieces 10,386.21 - Pieces 10,386.21 - Pieces 10,386.21 - - Pieces 10,386.21 -
58 IV Catheter No. 20 G - pcs 7,787.50 - pcs 7,787.50 - pcs 7,787.50 - - pcs 7,787.50 -
59 IV Catheter NP No. 20 G - Pieces 6,105.00 - Pieces 6,105.00 - Pieces 6,105.00 - - Pieces 6,105.00 -
60 IV Catheter No. 20 G 400 Pieces 10,000.00 4,000,000.00 Pieces 10,000.00 - 50 Pieces 10,000.00 500,000.00 350 Pieces 10,000.00 3,500,000.00
61 IV Catheter No. 20 G - Pieces 10,500.00 - Pieces 10,500.00 - Pieces 10,500.00 - - Pieces 10,500.00 -
62 IV Catheter No. 20 G - pieces 10,483.00 - pieces 10,483.00 - pieces 10,483.00 - - pieces 10,483.00 -
65 IV Catheter No. 22 G 300 Pieces 10,000.00 3,000,000.00 Pieces 10,000.00 - 100 Pieces 10,000.00 1,000,000.00 200 Pieces 10,000.00 2,000,000.00
69 IV Catheter No. 24 G 200 Pieces 10,000.00 2,000,000.00 Pieces 10,000.00 - Pieces 10,000.00 - 200 Pieces 10,000.00 2,000,000.00
71 IV Catheter No. 24 G 300 pieces 12,100.00 3,630,000.00 pieces 12,100.00 - 50 pieces 12,100.00 605,000.00 250 pieces 12,100.00 3,025,000.00
72 Kapas Berlemak 500 gram - Bungkus 17,250.00 - Bungkus 17,250.00 - Bungkus 17,250.00 - - Bungkus 17,250.00 -
73 Kapas Pembalut / Absorben 250 gram - Bungkus 7,475.00 - Bungkus 7,475.00 - Bungkus 7,475.00 - - Bungkus 7,475.00 -
74 Kapas Pembalut / Absorben 250 gram - Bungkus 12,400.00 - Bungkus 12,400.00 - Bungkus 12,400.00 - - Bungkus 12,400.00 -
75 Kapas Pembalut / Absorben 250 gram - Roll 12,500.00 - Roll 12,500.00 - Roll 12,500.00 - - Roll 12,500.00 -
76 Kapas Pembalut / Absorben 250 gram 9 Roll 24,000.00 216,000.00 Roll 24,000.00 - Roll 24,000.00 - 9 Roll 24,000.00 216,000.00
77 Kapas Pembalut / Absorben 250 gram - Roll 20,600.00 - Roll 20,600.00 - Roll 20,600.00 - - Roll 20,600.00 -
78 Kassa Hidrofil Steril Ukuran 16 x 16 cm - Bungkus 5,750.00 - Bungkus 5,750.00 - Bungkus 5,750.00 - - Bungkus 5,750.00 -
79 Kassa Hidrofil Steril Ukuran 16 x 16 cm - box 8,000.00 - box 8,000.00 - box 8,000.00 - - box 8,000.00 -
80 Kassa Hidrofil Steril Ukuran 16 x 16 cm - kotak 7,900.00 - kotak 7,900.00 - kotak 7,900.00 - - kotak 7,900.00 -
81 Kassa Hidrofil Steril Ukuran 16 x 16 cm - kotak 7,370.00 - kotak 7,370.00 - kotak 7,370.00 - - kotak 7,370.00 -
82 Kassa Hidrofil Steril Ukuran 18 x 22 cm - Kotak 4,750.00 - Kotak 4,750.00 - Kotak 4,750.00 - - Kotak 4,750.00 -
83 Kassa Hidrofil Steril Ukuran 18 x 22 cm - box 5,900.00 - box 5,900.00 - box 5,900.00 - - box 5,900.00 -
84 Kassa Hidrofil Steril Ukuran 18 x 22 cm 55 Box 7,500.00 412,500.00 Box 7,500.00 - 3 Box 7,500.00 22,500.00 52 Box 7,500.00 390,000.00
85 Kassa Hidrofil Ukuran 36 x 10 cm - Rol 2,415.00 - Rol 2,415.00 - Rol 2,415.00 - - Rol 2,415.00 -
88 Kassa Hidrofil Ukuran 40 yard x 80 cm - Rol 256,250.00 - Rol 256,250.00 - Rol 256,250.00 - - Rol 256,250.00 -
89 Kassa Hidrofil Ukuran 40 yard x 80 cm 2 Roll 250,250.00 500,500.00 Roll 250,250.00 - 1 Roll 250,250.00 250,250.00 1 Roll 250,250.00 250,250.00
90 Kassa Pembalut Hidrofil 4m x 10cm - Rol 607.00 - Rol 607.00 - Rol 607.00 - - Rol 607.00 -
91 Kassa Pembalut Hidrofil 4m x 10cm (SN Medika) - Rol 33,000.00 - Rol 33,000.00 - Rol 33,000.00 - - Rol 33,000.00 -
92 Kassa Pembalut Hidrofil 4m x 10cm - Rol 1,500.00 - Rol 1,500.00 - Rol 1,500.00 - - Rol 1,500.00 -
93 Kassa Pembalut Hidrofil 4m x 10cm - Rol 2,300.00 - Rol 2,300.00 - Rol 2,300.00 - - Rol 2,300.00 -
94 Kassa Pembalut Hidrofil 4m x 7,5cm (SN Medika) - Rol 27,830.00 - Rol 27,830.00 - Rol 27,830.00 - - Rol 27,830.00 -
95 Kassa Pembalut Hidrofil 4m x 5 cm 80 Rol 607.00 48,560.00 Rol 607.00 - Rol 607.00 - 80 Rol 607.00 48,560.00
96 Kassa Pembalut Hidrofil 4m x 5 cm - Rol 750.00 - Rol 750.00 - Rol 750.00 - - Rol 750.00 -
97 Kassa Pembalut Hidrofil 4m x 5 cm - Rol 1,100.00 - Rol 1,100.00 - Rol 1,100.00 - - Rol 1,100.00 -
100 Kassa Pembalut elastis 10 cmx4,55m - Rol 33,000.00 - Rol 33,000.00 - Rol 33,000.00 - - Rol 33,000.00 -
101 Kassa Pembalut elastis 7,5 cmx4,55m - Rol 27,830.00 - Rol 27,830.00 - Rol 27,830.00 - - Rol 27,830.00 -
102 Masker - pcs 1,125.00 - pcs 1,125.00 - pcs 1,125.00 - - pcs 1,125.00 -
103 Masker (Aximed Face Mask Ear Loop ) - pcs 396.00 - pcs 396.00 - pcs 396.00 - - pcs 396.00 -
104 Masker Face Mask -30ply / Ear Loop ) - pcs 726.00 - pcs 726.00 - pcs 726.00 - - pcs 726.00 -
105 Masker N95 - pcs 6,512.00 - pcs 6,512.00 - pcs 6,512.00 - - pcs 6,512.00 -
106 Masker N95 20 pcs 115,000.00 2,300,000.00 pcs 115,000.00 - pcs 115,000.00 - 20 pcs 115,000.00 2,300,000.00
107 Masker Jilbab - pcs 396.00 - pcs 396.00 - pcs 396.00 - - pcs 396.00 -
108 Masker Jilbab (Mas surgical) - box 41,019.00 - box 41,019.00 - box 41,019.00 - - box 41,019.00 -
109 Masker Bedah - pcs 6,500.00 - pcs 6,500.00 - pcs 6,500.00 - - pcs 6,500.00 -
110 masker bioaxi face mask ear loop 200 pcs 4,800.00 960,000.00 pcs 4,800.00 - 200 pcs 4,800.00 960,000.00 - pcs 4,800.00 -
111 Pembalut Gips 3 inch - Rol 23,500.00 - Rol 23,500.00 - Rol 23,500.00 - - Rol 23,500.00 -
112 Pembalut Gips 6 inch - Rol 42,000.00 - Rol 42,000.00 - Rol 42,000.00 - - Rol 42,000.00 -
BHP-01-2021 26
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
113 Plester 5 yard x 2 inch - Rol 23,618.00 - Rol 23,618.00 - Rol 23,618.00 - - Rol 23,618.00 -
114 Plester 5 yard x 2 inch - Roll 35,532.00 - Roll 35,532.00 - Roll 35,532.00 - - Roll 35,532.00 -
115 Plester Rol Kain 2.5 cm x 1 m ( Hansaplast) - Rol 5,017.00 - Rol 5,017.00 - Rol 5,017.00 - - Rol 5,017.00 -
116 Plester Leukoplast 7,5cm x 4,5 cm 58 Roll 35,532.00 2,060,856.00 Roll 35,532.00 - 8 Roll 35,532.00 284,256.00 50 Roll 35,532.00 1,776,600.00
117 Pharmaplast (pharmafix) 27 box 27,000.00 729,000.00 box 27,000.00 - 1 box 27,000.00 27,000.00 26 box 27,000.00 702,000.00
118 Plester Pharmaplast ( PHARMAFIX) 5 cm x 500 cm - Rol 16,500.00 - Rol 16,500.00 - Rol 16,500.00 - - Rol 16,500.00 -
119 Paper tape /2,5cm x 9,14m - Rol 11,583.00 - Rol 11,583.00 - Rol 11,583.00 - - Rol 11,583.00 -
120 Paper tape / 1,25cm x 9,14m 144 Rol 4,900.00 705,600.00 Rol 4,900.00 - Rol 4,900.00 - 144 Rol 4,900.00 705,600.00
121 Paper tape / 1,25cm x 9,14m - Rol 7,029.00 - Rol 7,029.00 - Rol 7,029.00 - - Rol 7,029.00 -
122 Safety Box - pcs 15,708.00 - pcs 15,708.00 - pcs 15,708.00 - - pcs 15,708.00 -
123 Silk (Benang Bedah) 3/0 + Jarum - rol 705.55 - rol 705.55 - rol 705.55 - - rol 705.55 -
124 Silk (Benang Bedah) 3/0 + Jarum - pcs 48,240.17 - pcs 48,240.17 - pcs 48,240.17 - - pcs 48,240.17 -
125 Silk 3/0.1/2 18mm 75cm-2PTR5261E - pcs 39,481.00 - pcs 39,481.00 - pcs 39,481.00 - - pcs 39,481.00 -
126 Silk 3/0.1/2 18mm 75cm-2PTR5261E 24 pcs 34,607.26 830,574.24 pcs 34,607.26 - pcs 34,607.26 - 24 pcs 34,607.26 830,574.24
127 Urine Bag - Set 3,600.00 - Set 3,600.00 - Set 3,600.00 - - Set 3,600.00 -
128 Urine Bag ( Aximed TVW Hanger) - pcs 5,128.00 - pcs 5,128.00 - pcs 5,128.00 - - pcs 5,128.00 -
129 Urine Bag ( Aximed TVW Hanger) - pcs 5,500.00 - pcs 5,500.00 - pcs 5,500.00 - - pcs 5,500.00 -
130 Urine Bag ( trode medical trourocol plus) - pcs 8,070.00 - pcs 8,070.00 - pcs 8,070.00 - - pcs 8,070.00 -
131 Urine Bag ( AXIMED) - pcs 5,785.00 - pcs 5,785.00 - pcs 5,785.00 - - pcs 5,785.00 -
132 Wing Needle No. 21 G - pcs 1,400.00 - pcs 1,400.00 - pcs 1,400.00 - - pcs 1,400.00 -
135 Rapid Test Vikia HIV 1/2 - Kit 487,500.00 - Kit 487,500.00 - Kit 487,500.00 - - Kit 487,500.00 -
136 Larvasida - Galon 3,500,000.00 - Galon 3,500,000.00 - Galon 3,500,000.00 - - Galon 3,500,000.00 -
137 Larvasida (obat DBD / Abate) - kg 140,000.00 - kg 140,000.00 - kg 140,000.00 - - kg 140,000.00 -
138 Larvasida Sumilar - kg 1,500,000.00 - kg 1,500,000.00 - kg 1,500,000.00 - - kg 1,500,000.00 -
139 Accu-Chek Test Strip - kotak 420,000.00 - kotak 420,000.00 - kotak 420,000.00 - - kotak 420,000.00 -
140 KIT Emergensi P3K Posko Mudik - Paket 1,000,000.00 - Paket 1,000,000.00 - Paket 1,000,000.00 - - Paket 1,000,000.00 -
141 Ongkir - - - - - - - - -
- -
OBAT - OBATAN LAIN - -
1 Antapulgit NEW ANTIDES 9,500 Tablet 136.00 1,292,000.00 Tablet 136.00 - 900 Tablet 136.00 122,400.00 8,600 Tablet 136.00 1,169,600.00
2 Aqua Pro Injection (OTSU SWI 25 Ml) - Ampul 2,750.00 - Ampul 2,750.00 - Ampul 2,750.00 - - Ampul 2,750.00 -
3 Aqua Pro Injection (OTSU SWI 25 Ml) 180 Ampul 2,860.00 514,800.00 Ampul 2,860.00 - 5 Ampul 2,860.00 14,300.00 175 Ampul 2,860.00 500,500.00
4 Betason N - Tube 9,182.00 - Tube 9,182.00 - Tube 9,182.00 - - Tube 9,182.00 -
5 Becefort Syrup , Multivitamin anak - Botol 60 ml 15,686.00 - Botol 60 ml 15,686.00 - Botol 60 ml 15,686.00 - - Botol 60 ml 15,686.00 -
6 Becefort Syrup , Multivitamin anak 50 Botol 60 ml 19,470.00 973,500.00 Botol 60 ml 19,470.00 - 50 Botol 60 ml 19,470.00 973,500.00 - Botol 60 ml 19,470.00 -
7 Becefort Syrup , Multivitamin anak - Botol 60 ml 17,358.00 - Botol 60 ml 17,358.00 - Botol 60 ml 17,358.00 - - Botol 60 ml 17,358.00 -
8 Multivitamin Dewasa (BECEFORT TAB) 800 Tablet 1,743.50 1,394,800.00 Tablet 1,743.50 - 800 Tablet 1,743.50 1,394,800.00 - Tablet 1,743.50 -
9 Multivitamin Dewasa (AMAROPO) - Tablet 2,277.00 - Tablet 2,277.00 - Tablet 2,277.00 - - Tablet 2,277.00 -
Kaptab Salut Kaptab Salut Kaptab Salut Kaptab Salut
10 Bisakodil 5 mg - 300.00 - 300.00 - 300.00 - - 300.00 -
Selaput Selaput Selaput Selaput
Botol 1000
11 Cairan Antiseptik 1000 ml (A. Class) - Botol 1000 ml 344,048.00 - Botol 1000 ml 344,048.00 - Botol 1000 ml 344,048.00 - - 344,048.00 -
ml
12 Cairan Antiseptik ( Hansanitizer 25 L) - Jerigen 25 L 3,663,000.00 - Jerigen 25 L 3,663,000.00 - Jerigen 25 L 3,663,000.00 - - Jerigen 25 L 3,663,000.00 -
13 Chloramex - kloramfenikol 500mg - Tablet 1,007.00 - Tablet 1,007.00 - Tablet 1,007.00 - - Tablet 1,007.00 -
14 Dehidro Artemisin + Piperazin (DHP) Tablet - Tablet 2,756.44 - Tablet 2,756.44 - Tablet 2,756.44 - - Tablet 2,756.44 -
15 Glimipiride Tablet 3 mg - tablet 319.18 - tablet 319.18 - tablet 319.18 - - tablet 319.18 -
16 Glukonas Kalsikus Inj 10% - Ampul 19,750.00 - Ampul 19,750.00 - Ampul 19,750.00 - - Ampul 19,750.00 -
17 Hemafort tab kombinasi - Tablet 757.00 - Tablet 757.00 - Tablet 757.00 - - Tablet 757.00 -
18 HIV Test - Box 487,500.00 - Box 487,500.00 - Box 487,500.00 - - Box 487,500.00 -
19 Insektisida Fogging - Liter 200,000.00 - Liter 200,000.00 - Liter 200,000.00 - - Liter 200,000.00 -
20 Mineral mix - sachet 68.00 - sachet 68.00 - sachet 68.00 - - sachet 68.00 -
21 Mineral mix - sachet 2,805.00 - sachet 2,805.00 - sachet 2,805.00 - - sachet 2,805.00 -
22 Mouthiece Smolkilizer - Box 1,050,000.00 - Box 1,050,000.00 - Box 1,050,000.00 - - Box 1,050,000.00 -
23 RDT Malaria - Box 476,372.60 - Box 476,372.60 - Box 476,372.60 - - Box 476,372.60 -
24 RDT COVID-19 - AntiBody - Pcs 245,000.00 - Pcs 245,000.00 - Pcs 245,000.00 - - Pcs 245,000.00 -
27 RDT COVID-19 - AntiGEN - Pcs 300,000.00 - Pcs 300,000.00 - Pcs 300,000.00 - - Pcs 300,000.00 -
28 Rivanol 0,1% 300 ml 36 Botol 3,000.00 108,000.00 Botol 3,000.00 - Botol 3,000.00 - 36 Botol 3,000.00 108,000.00
29 Rivanol 0,1% 300 ml - Botol 3,400.00 - Botol 3,400.00 - Botol 3,400.00 - - Botol 3,400.00 -
30 Ventolin nebulizer - Botol 6,600.00 - Botol 6,600.00 - Botol 6,600.00 - - Botol 6,600.00 -
31 Ventolin nebulizer - Ampul 10,373.00 - Ampul 10,373.00 - Botol 10,373.00 - - Ampul 10,373.00 -
32 Glucose - Botol 1,370,000.00 - Botol 1,370,000.00 - Botol 1,370,000.00 - - Botol 1,370,000.00 -
33 Glucose - Botol 880,674.30 - Botol 880,674.30 - Botol 880,674.30 - - Botol 880,674.30 -
BHP-01-2021 27
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
34 Acid/Uric - Botol 1,860,000.00 - Botol 1,860,000.00 - Botol 1,860,000.00 - - Botol 1,860,000.00 -

35 Acid/Uric - Botol 1,851,894.00 - Botol 1,851,894.00 - Botol 1,851,894.00 - - Botol 1,851,894.00 -
36 HDL Cholesterol - Botol 4,440,000.00 - Botol 4,440,000.00 - Botol 4,440,000.00 - - Botol 4,440,000.00 -
37 LDL Cholesterol - Botol 5,160,000.00 - Botol 5,160,000.00 - Botol 5,160,000.00 - - Botol 5,160,000.00 -
38 Cholesterol - Botol 2,093,300.00 - Botol 2,093,300.00 - Botol 2,093,300.00 - - Botol 2,093,300.00 -
39 Ongkir - - - - - - - - - - - - - -
- - -
VAKSIN - -
1 ADS 0,05 ML (Union) - Pcs 1,379.80 - Pcs 1,379.80 - Pcs 1,379.80 - - Pcs 1,379.80 -
2 ADS 0,5 ML (Union) - Pcs 1,249.45 - Pcs 1,249.45 - Pcs 1,249.45 - - Pcs 1,249.45 -
3 Anti Bisa Ular Serum - Vial 274,000.00 - Vial 274,000.00 - Vial 274,000.00 - - Vial 274,000.00 -
4 Anti Bisa Ular Serum (Biosave) - Vial 430,000.00 - Vial 430,000.00 - Vial 430,000.00 - - Vial 430,000.00 -
7 Anti Tetanus Serum 1500 IU - Ampul 59,004.00 - Ampul 59,004.00 - Ampul 59,004.00 - - Ampul 59,004.00 -
8 Anti Tetanus Serum 1500 UI (biosat-1,5) - Ampul 115,000.00 - Ampul 115,000.00 - Ampul 115,000.00 - - Ampul 115,000.00 -
11 Safety Box Stera Sharp 7 Ltr - Pcs 61,600.00 - Pcs 61,600.00 - Pcs 61,600.00 - - Pcs 61,600.00 -
12 Safety Box Stera Sharp 7 Ltr - Pcs 15,840.00 - Pcs 15,840.00 - Pcs 15,840.00 - - Pcs 15,840.00 -
13 Spuit 5 ML (aximed) - pcs 1,030.00 - pcs 1,030.00 - pcs 1,030.00 - - pcs 1,030.00 -
- -
SUB JUMLAH OBAT, BMHP, VAKSIN APBD II - 120,336,592.20 - 18,662,208.46 - 101,674,383.74 -
- -
2 OBAT - OBATAN APBD I - -

( PROPINSI )
SUB OBAT -OBATAN - -
2 Alkohol 70 % - 100 ml - botol 300 ml 9,800.00 - botol 300 ml 9,800.00 - botol 300 ml 9,800.00 - - botol 300 ml 9,800.00 -
3 Alkohol 70 % - 100 ml - botol 300 ml 21,500.00 - botol 300 ml 21,500.00 - botol 300 ml 21,500.00 - - botol 300 ml 21,500.00 -
5 Aminofilin Tablet 200 mg - Tablet 91.00 - Tablet 91.00 - Tablet 91.00 - - Tablet 91.00 -
7 Artemether Injeksi 80 mg/ml - Ampul 25,490.00 - Ampul 25,490.00 - Ampul 25,490.00 - - Ampul 25,490.00 -
9 Artesunate Injeksi vial 60 mg - Vial 39,000.00 - Vial 39,000.00 - Vial 39,000.00 - - Vial 39,000.00 -
10 Artesunate Injeksi vial 60 mg - Vial 57,585.00 - Vial 57,585.00 - Vial 57,585.00 - - Vial 57,585.00 -
15 Azitromicin Tablet 500 mg - Tablet 380.00 - Tablet 380.00 - Tablet 380.00 - - Tablet 380.00 -
16 15,320 Tablet 354.00 5,423,280.00 Tablet 354.00 - 2,870 Tablet 354.00 1,015,980.00 12,450 Tablet 354.00 4,407,300.00
18 Cetrizin Tablet 10 mg - Tablet 90.00 - Tablet 90.00 - Tablet 90.00 - - Tablet 90.00 -
20 Deksametason Tablet - Tablet 32.00 - Tablet 32.00 - Tablet 32.00 - - Tablet 32.00 -
24 Fenobarbital Injeksi i.m./i.v. 50 mg/ml - Amp 1ml 1,800.00 - Amp 1ml 1,800.00 - Amp 1ml 1,800.00 - - Amp 1ml 1,800.00 -
26 Garam Oralit 2,000 sachet 257.00 514,000.00 sachet 257.00 - 100 sachet 257.00 25,700.00 1,900 sachet 257.00 488,300.00
27 Gentamisin Injeksi 40 mg/ml - Ampul 617.00 - Ampul 617.00 - Ampul 617.00 - - Ampul 617.00 -
32 Kaptopril tab 12,5 mg 800 Tablet 66.00 52,800.00 Tablet 66.00 - 800 Tablet 66.00 52,800.00 - Tablet 66.00 -
33 Kloramfenikol Tetes Mata ( DECACETIN) - Botol 3,250.00 - Botol 3,250.00 - Botol 3,250.00 - - Botol 3,250.00 -
BHP-01-2021 28
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
36 Klorokuin Tablet 150 mg - Tablet 15.06 - Tablet 15.06 - Tablet 15.06 - - Tablet 15.06 -
37 - Botol 60 ml 2,286.00 - Botol 60 ml 2,286.00 - Botol 60 ml 2,286.00 - - Botol 60 ml 2,286.00 -
39 Loperamid tablet 2 mg - Tablet 80.00 - Tablet 80.00 - Tablet 80.00 - - Tablet 80.00 -
40 Magnesium Sulfat Injeksi (IV)40% - Ampul 3,650.00 - Ampul 3,650.00 - Ampul 3,650.00 - - Ampul 3,650.00 -
41 Magnesium Sulfat Injeksi (IV)40% - Ampul 3,796.00 - Ampul 3,796.00 - Ampul 3,796.00 - - Ampul 3,796.00 -
42 Nifedipin Tablet 10 mg - Tablet 110.00 - Tablet 110.00 - Tablet 110.00 - - Tablet 110.00 -
44 Nifedipin Tablet 10 mg - Tablet 108.00 - Tablet 108.00 - Tablet 108.00 - - Tablet 108.00 -
45 Obat Anti Tuberkulosis Kombipak Kategori 1 - Paket 317,018.00 - Paket 317,018.00 - Paket 317,018.00 - - Paket 317,018.00 -
57 Osetalmivir Kapsul 100 mg - Kapsul 129.69 - Kapsul 129.69 - Kapsul 129.69 - - Kapsul 129.69 -
58 Oxytetrasiklin salep mata 1 % - tube 2,500.00 - tube 2,500.00 - tube 2,500.00 - - tube 2,500.00 -
61 Primakuin Tablet - Tablet 224.00 - Tablet 224.00 - Tablet 224.00 - - Tablet 224.00 -
62 Ranitidin HCl Injeksi 25 mg/ml - Ampul 1,155.00 - Ampul 1,155.00 - Ampul 1,155.00 - - Ampul 1,155.00 -
66 Retinol (Vitamin A) 100.000 IU Kapsul Lunak - Kapsul 306.00 - 350 Kapsul 306.00 107,100.00 350 Kapsul 306.00 107,100.00 - Kapsul 306.00 -
67 Retinol (Vitamin A) 200.000 IU Kapsul Lunak - Kapsul 517.00 - 5,400 Kapsul 517.00 2,791,800.00 5,400 Kapsul 517.00 2,791,800.00 - Kapsul 517.00 -
70 WIDA KDNI ( D 2,5 % + KCl 0,15% + NaCl 0,45%) - Botol 11,435.00 - Botol 11,435.00 - Botol 11,435.00 - - Botol 11,435.00 -
71 WIDA KDN2 ( D 2,5 % + KCl 0,3% + NaCl 0,45%) - Botol 11,435.00 - Botol 11,435.00 - Botol 11,435.00 - - Botol 11,435.00 -
72 WIDA KNI ( KCl 0,15% + NaCl 0,9%) - Botol 11,011.00 - Botol 11,011.00 - Botol 11,011.00 - - Botol 11,011.00 -
74 WIDA KN2 ( KCl 0,3% + NaCl 09%) - Botol 11,011.00 - Botol 11,011.00 - Botol 11,011.00 - - Botol 11,011.00 -
75 Vitamin B Kompleks - Tablet 117.00 - Tablet 117.00 - Tablet 117.00 - - Tablet 117.00 -
76 Zinc Tablet - Tablet 524.00 - Tablet 524.00 - Tablet 524.00 - - Tablet 524.00 -
- - - - - -
1 Alat Suntik Sekali Pakai 3 cc - pieces 835.00 - pieces 835.00 - pieces 835.00 - - pieces 835.00 -
2 Alat Suntik Sekali Pakai 5 cc - pieces 889.00 - pieces 889.00 - pieces 889.00 - - pieces 889.00 -
3 Alkohol Swab - pcs 169.88 - pcs 169.88 - pcs 169.88 - - pcs 169.88 -
4 Cutgut 2/0 - pcs 33,645.00 - pcs 33,645.00 - pcs 33,645.00 - - pcs 33,645.00 -
12 Kassa Hidrofil Ukuran 40 yard x 80 cm - Roll 255,750.00 - Roll 255,750.00 - Roll 255,750.00 - - Roll 255,750.00 -
13 Masker - pcs 761.64 - pcs 761.64 - pcs 761.64 - - pcs 761.64 -
14 Masker - pcs 339.90 - pcs 339.90 - pcs 339.90 - - pcs 339.90 -
15 Oxygen Nasal Cannula (Adult) 23 pcs 12,200.00 280,600.00 pcs 12,200.00 - pcs 12,200.00 - 23 pcs 12,200.00 280,600.00
16 Oxygen Nasal Cannula (Child) 7 pcs 12,140.00 84,980.00 pcs 12,140.00 - pcs 12,140.00 - 7 pcs 12,140.00 84,980.00
17 Virus Transport Media ( VTM) - pcs 39,000.00 - 50 pcs 39,000.00 1,950,000.00 50 pcs 39,000.00 1,950,000.00 - pcs 39,000.00 -
18 Under Pad 10 pcs 8,295.00 82,950.00 pcs 8,295.00 - pcs 8,295.00 - 10 pcs 8,295.00 82,950.00
19 Urine Bag 15 pcs 6,036.00 90,540.00 pcs 6,036.00 - pcs 6,036.00 - 15 pcs 6,036.00 90,540.00
BHP-01-2021 29
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
- - - - - - - - - - -
1 Cefotaksim Injeksi - Vial 4,500.00 - Vial 4,500.00 - Vial 4,500.00 - - Vial 4,500.00 -
2 Chloramex - kloramfenikol 500mg - Tablet 1,007.00 - Tablet 1,007.00 - Tablet 1,007.00 - - Tablet 1,007.00 -
3 Clorampecorth - Tube 9,085.00 - Tube 9,085.00 - Tube 9,085.00 - - Tube 9,085.00 -
4 Dehidro Artemisin + Piperazin (DHP) Tablet - Tablet 2,160.00 - Tablet 2,160.00 - Tablet 2,160.00 - - Tablet 2,160.00 -
5 Dehidro Artemisin + Piperazin (DHP) Tablet 27 Tablet 2,000.00 54,000.00 Tablet 2,000.00 - Tablet 2,000.00 - 27 Tablet 2,000.00 54,000.00
6 Glukonas Kalsikus Inj 10% - ampul 9,955.00 - ampul 9,955.00 - ampul 9,955.00 - - ampul 9,955.00 -
7 Glukonas Kalsikus Inj 10% 24 Ampul 10,351.00 248,424.00 Ampul 10,351.00 - Ampul 10,351.00 - 24 Ampul 10,351.00 248,424.00
8 Mersibion inj - Ampul 4,400.00 - Ampul 4,400.00 - Ampul 4,400.00 - - Ampul 4,400.00 -
9 Mineral mix 240 sachet 2,920.00 700,800.00 sachet 2,920.00 - sachet 2,920.00 - 240 sachet 2,920.00 700,800.00
10 Urea ( Soft U derm) Krim 10% - tube 3,941.00 - tube 3,941.00 - tube 3,941.00 - - tube 3,941.00 -
11 Spironolakton tab - Tablet 244.00 - Tablet 244.00 - Tablet 244.00 - - Tablet 244.00 -
- - - - - - - - - - -
VAKSIN - - - -
1 ADS 0,05 ML (Oneject) - Pcs 1,650.00 - Pcs 1,650.00 - Pcs 1,650.00 - - Pcs 1,650.00 -
3 ADS 0,05 ML (Oneject) - Pcs 1,518.00 - 150 Pcs 1,518.00 227,700.00 150 Pcs 1,518.00 227,700.00 - Pcs 1,518.00 -
4 ADS 0,05 ML (Skifa) - Pcs 1,354.00 - Pcs 1,354.00 - Pcs 1,354.00 - - Pcs 1,354.00 -
6 ADS 0,5 ML (Oneject) - pcs 1,210.00 - 600 pcs 1,210.00 726,000.00 600 pcs 1,210.00 726,000.00 - pcs 1,210.00 -
10 ADS 0,5 ML - Pcs 1,185.00 - 216 Pcs 1,185.00 255,960.00 107 Pcs 1,185.00 126,795.00 109 Pcs 1,185.00 129,165.00
11 ADS 5 ML (Skifa) - Pcs 1,470.00 - 100 Pcs 1,470.00 147,000.00 100 Pcs 1,470.00 147,000.00 - Pcs 1,470.00 -
12 ADS 5 ML (Skifa) - Pcs 1,580.00 - Pcs 1,580.00 - Pcs 1,580.00 - - Pcs 1,580.00 -
13 Alkohol Swab - Pcs 95.00 - 216 Pcs 95.00 20,520.00 107 Pcs 95.00 10,165.00 109 Pcs 95.00 10,355.00
14 BCG - Vial 59,590.00 - Pcs 59,590.00 - Pcs 59,590.00 - - Vial 59,590.00 -
15 BCG - Vial 56,360.00 - Vial 56,360.00 - Vial 56,360.00 - - Vial 56,360.00 -
16 BCG - Vial 60,140.00 - 40 Vial 60,140.00 2,405,600.00 40 Vial 60,140.00 2,405,600.00 - Vial 60,140.00 -
17 Corona Vaccin - Vial 211,282.00 - 216 Vial 211,282.00 45,636,912.00 107 Vial 211,282.00 22,607,174.00 109 Vial 211,282.00 23,029,738.00
18 Campak Vaksin - Vial 28,204.00 - Vial 28,204.00 - Vial 28,204.00 - - Vial 28,204.00 -
19 DPT - HB -HiB - Vial 76,620.00 - 125 Vial 76,620.00 9,577,500.00 125 Vial 76,620.00 9,577,500.00 - Vial 76,620.00 -
20 DPT - HB -HiB - Vial 71,810.00 - Vial 71,810.00 - Vial 71,810.00 - - Vial 71,810.00 -
21 DT - Vial 16,180.00 - Vial 16,180.00 - Vial 16,180.00 - - Vial 16,180.00 -
24 Hepatitis B - pcs 20,900.00 - pcs 20,900.00 - pcs 20,900.00 - - pcs 20,900.00 -
25 Hepatitis B - Pcs 23,270.00 - Pcs 23,270.00 - Pcs 23,270.00 - - Pcs 23,270.00 -
26 Polio Injeksi - Vial 34,815.00 - Vial 34,815.00 - Vial 34,815.00 - - Vial 34,815.00 -
27 Polio Injeksi - Vial 139,760.00 - Vial 139,760.00 - Vial 139,760.00 - - Vial 139,760.00 -
28 Polio Injeksi - Vial 144,540.00 - 50 Vial 144,540.00 7,227,000.00 20 Vial 144,540.00 2,890,800.00 30 Vial 144,540.00 4,336,200.00
29 Polio Vaksin - Vial 19,954.00 - Vial 19,954.00 - Vial 19,954.00 - - Vial 19,954.00 -
30 Polio Vaksin - Vial 18,140.00 - Vial 18,140.00 - Vial 18,140.00 - - Vial 18,140.00 -
31 Polio Oral + Droper 20 Vial 19,350.00 387,000.00 90 Vial 19,350.00 1,741,500.00 50 Vial 19,350.00 967,500.00 60 Vial 19,350.00 1,161,000.00
32 Safety Box - Pcs 15,708.00 - Pcs 15,708.00 - Pcs 15,708.00 - - Pcs 15,708.00 -
35 Safety Box - Pcs 14,000.00 - 1 Pcs 14,000.00 14,000.00 1 Pcs 14,000.00 14,000.00 - Pcs 14,000.00 -
36 Spuit 5 ML (Oneject) - Pcs 1,705.00 - Pcs 1,705.00 - Pcs 1,705.00 - - Pcs 1,705.00 -
37 Td - Vial 16,500.00 - Pcs 16,500.00 - Pcs 16,500.00 - - Vial 16,500.00 -
38 Td - Vial 16,480.00 - 30 Pcs 16,480.00 494,400.00 10 Pcs 16,480.00 164,800.00 20 Vial 16,480.00 329,600.00
39 Tetanus Toksoid (TT) - Vial 14,498.00 - Pcs 14,498.00 - Pcs 14,498.00 - - Vial 14,498.00 -
40 Vaksin MR - Vial 141,648.00 - Pcs 141,648.00 - Pcs 141,648.00 - - Vial 141,648.00 -
41 Vaksin MR - Vial 151,150.00 - 50 Vial 151,150.00 7,557,500.00 50 Vial 151,150.00 7,557,500.00 - Vial 151,150.00 -
42 Vaksin Anti Rabies (VAR) - Vial 70,000.00 - Pcs 70,000.00 - Vial 70,000.00 - - Vial 70,000.00 -
43 Vaksin Anti Rabies (VAR) - Vial 78,500.00 - Pcs 78,500.00 - Vial 78,500.00 - - Vial 78,500.00 -
BHP-01-2021 30
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
44 Vaksin Anti Rabies (VAR) - Vial 164,030.00 - Vial 164,030.00 - Vial 164,030.00 - - Vial 164,030.00 -
45 HB Uniject - Vial 23,270.00 - 115 Vial 23,270.00 2,676,050.00 115 Vial 23,270.00 2,676,050.00 - Vial 23,270.00 -
46 HB Uniject - Vial 20,900.00 - Vial 20,900.00 - Vial 20,900.00 - - Vial 20,900.00 -
47 Vaksin Anti Rabies (VAR) 3 Vial 165,000.00 495,000.00 8 Vial 165,000.00 1,320,000.00 3 Vial 165,000.00 495,000.00 8 Vial 165,000.00 1,320,000.00
SUB JUMLAH OBAT-OBATAN,VAKSIN DAN
- 8,414,374.00 84,876,542.00 56,536,964.00 - 36,753,952.00
BMHP PROPINSI
- -
3 BOK - -
- -
1 Desinfektan - Botol - - Botol - - Botol - - - Botol - -
2 Handsanitizer 500 ml - Botol 500 ml 81,500.00 - Botol 500 ml 81,500.00 - Botol 500 ml 81,500.00 - - Botol 500 ml 81,500.00 -
3 Hand Scone Steril - Pasang 8,250.00 - Pasang 8,250.00 - Pasang 8,250.00 - - Pasang 8,250.00 -
4 Hand Scone Non Steril 600 Pcs 950.00 570,000.00 Pcs 950.00 - 600 Pcs 950.00 570,000.00 - Pcs 950.00 -
5 Hazmat - Pcs 200,000.00 - Pcs 200,000.00 - Pcs 200,000.00 - - Pcs 200,000.00 -
6 Masker Bedah - Pcs 4,000.00 - Pcs 4,000.00 - Pcs 4,000.00 - - Pcs 4,000.00 -
7 Masker N-95 20 Pcs 85,000.00 1,700,000.00 Pcs 85,000.00 - 20 Pcs 85,000.00 1,700,000.00 - Pcs 85,000.00 -
- -
SUB JUMLAH BELANJA BOK - 2,270,000.00 - 2,270,000.00 - -

- -
BAHAN KEPERLUAN
4 - -
LABORATORIUM
- -
1 BHP HIV - paket 811,991,100.00 - paket 811,991,100.00 - paket 811,991,100.00 - - paket 811,991,100.00 -
2 BHP Malaria - paket 126,000,000.00 - paket 126,000,000.00 - paket 126,000,000.00 - - paket 126,000,000.00 -
3 Botol Sampel Keracunan - buah 20,000.00 - buah 20,000.00 - buah 20,000.00 - - buah 20,000.00 -
4 Catride TCM - paket 259,175.00 - paket 259,175.00 - paket 259,175.00 - - paket 259,175.00 -
5 Handscone - bok @ 50,000.00 - bok @ 50,000.00 - bok @ 50,000.00 - - bok @ 50,000.00 -
6 Holdel Vacuete - buah 1,000.00 - buah 1,000.00 - buah 1,000.00 - - buah 1,000.00 -
7 Jarum Vacutener - buah 2,000.00 - buah 2,000.00 - buah 2,000.00 - - buah 2,000.00 -
8 Mount piece - bok 2,250,000.00 - bok 2,250,000.00 - bok 2,250,000.00 - - bok 2,250,000.00 -
9 Paket Alat Pelindung Diri ( APD) - paket 1,500,000.00 - paket 1,500,000.00 - paket 1,500,000.00 - - paket 1,500,000.00 -
Paket Pemeriksaan SHK ( Kertas
10 - buah 65,000.00 - buah 65,000.00 - buah 65,000.00 - - buah 65,000.00 -
Saring,Lanset,Alkohol Swab )
11 Pipet test plastik - buah 3,000.00 - buah 3,000.00 - buah 3,000.00 - - buah 3,000.00 -
12 Pot Dahak - buah 3,000.00 - buah 3,000.00 - buah 3,000.00 - - buah 3,000.00 -
13 Pot Sampel AFP - buah 10,000.00 - buah 10,000.00 - buah 10,000.00 - - buah 10,000.00 -
14 Pot Urine - buah 5,000.00 - buah 5,000.00 - buah 5,000.00 - - buah 5,000.00 -
15 Rak Tabung Sampel - buah 25,000.00 - buah 25,000.00 - buah 25,000.00 - - buah 25,000.00 -
16 RDT DBD - bok 1,500,000.00 - bok 1,500,000.00 - bok 1,500,000.00 - - bok 1,500,000.00 -
17 RDT Hepatitis - buah 25,000.00 - buah 25,000.00 - buah 25,000.00 - - buah 25,000.00 -
18 Reagen TB - paket 500,000.00 - paket 500,000.00 - paket 500,000.00 - - paket 500,000.00 -
19 Safety Bok ADS - buah 25,000.00 - buah 25,000.00 - buah 25,000.00 - - buah 25,000.00 -
20 Sampel Cup - buah 500.00 - buah 500.00 - buah 500.00 - - buah 500.00 -
21 Slide - bok 30,000.00 - bok 30,000.00 - bok 30,000.00 - - bok 30,000.00 -
22 Stick Gula Darah - pak 160,000.00 - pak 160,000.00 - pak 160,000.00 - - pak 160,000.00 -
23 Tabung Vacuete - buah 3,000.00 - buah 3,000.00 - buah 3,000.00 - - buah 3,000.00 -
24 Alat Suntik 3 cc - pcs 920.00 - pcs 920.00 - pcs 920.00 - - pcs 920.00 -
25 Alkohol swab - pcs 354.00 - pcs 354.00 - pcs 354.00 - - pcs 354.00 -
26 Lancet (Sentry Lancet) - pcs 1,650.00 - pcs 1,650.00 - pcs 1,650.00 - - pcs 1,650.00 -
27 RDT HIV Test Kit - pcs 11,506.00 - pcs 11,506.00 - pcs 11,506.00 - - pcs 11,506.00 -
28 RDT Malaria Test Kit - pcs 13,950.00 - pcs 13,950.00 - pcs 13,950.00 - - pcs 13,950.00 -
29 RDT Syphilis Test Kit - pcs 9,020.00 - pcs 9,020.00 - pcs 9,020.00 - - pcs 9,020.00 -
30 Tabung Vacuate (Vacum Tube Steril k3 EDTA) - buah 870.00 - buah 870.00 - buah 870.00 - - buah 870.00 -
31 RDT Covid-19 (Eco Test) - pcs 135,000.00 - pcs 135,000.00 - pcs 135,000.00 - - pcs 135,000.00 -
BHP-01-2021 31
SUMBER
1 2 3 4 5 6 8 9 10 11 12.00 13 14 15 16 17
32 Virus Transport Media ( VTM) - pcs 80,000.00 - pcs 80,000.00 - pcs 80,000.00 - - pcs 80,000.00 -
33 Gown/Apron - pcs 70,000.00 - pcs 70,000.00 - pcs 70,000.00 - - pcs 70,000.00 -
34 RDT Covid-19 Antibody - pcs 75,000.00 - 50 pcs 75,000.00 3,750,000.00 50 pcs 75,000.00 3,750,000.00 - pcs 75,000.00 -
35 Face Shield - pcs 30,000.00 - pcs 30,000.00 - pcs 30,000.00 - - pcs 30,000.00 -
36 Handscone - box@ 120,000.00 - box@ 120,000.00 - box@ 120,000.00 - - box@ 120,000.00 -
37 Penutup Kepala - pcs 2,500.00 - pcs 2,500.00 - pcs 2,500.00 - - pcs 2,500.00 -
38 Masker N95 - pcs 115,000.00 - pcs 115,000.00 - pcs 115,000.00 - - pcs 115,000.00 -
39 Cover All Suit - pcs 175,000.00 - pcs 175,000.00 - pcs 175,000.00 - - pcs 175,000.00
40 Face Shield - pcs 20,000.00 - pcs 20,000.00 - pcs 20,000.00 - - pcs 20,000.00
41 Gown/Apron - pcs 180,000.00 - pcs 180,000.00 - pcs 180,000.00 - - pcs 180,000.00
42 Under Pad - pcs 5,500.00 - pcs 5,500.00 - pcs 5,500.00 - - pcs 5,500.00 -
- - - - -
- - - - - - - - - - - -
- - - - - - - - - - - -
SUB JUMLAH BELANJA BAHAN KEPERLUAN

- - 3,750,000.00 3,750,000.00 - -
LABORATORIUM
- -
PERALATAN KEBERSIHAN DAN
5 - -
BAHAN PEMBERSIH
- -
1 Sanitarian Bag - Buah 3,000.00 - Buah 3,000.00 - Buah 3,000.00 - - Buah 3,000.00 -
2 Desinfektan - Dirigen 5 L 137,000.00 - Dirigen 5 L 137,000.00 - Dirigen 5 L 137,000.00 - - Dirigen 5 L 137,000.00 -
- -
JUMLAH BELANJA PERALATAN KEBERSIHAN
- - - - - -
DAN BAHAN PEMBERSIH
- -
6 APBN - -
- -
1 Masker polos / motif jenis earloop untuk Puskesmas - pcs 5,500.00 - pcs 5,500.00 - pcs 5,500.00 - - pcs 5,500.00 -
2 Masker polos / motif jenis headloop untuk Puskesmas - pcs 5,500.00 - pcs 5,500.00 - pcs 5,500.00 - - pcs 5,500.00 -
- -
JUMLAH BELANJA APBN - - - -
J U M L A H TOTAL 131,020,966.20 88,626,542.00 81,219,172.46 138,428,335.74
MENGETAHUI

NIP. 19720603 199302 1 001 NIP. 19830408 201101 1 003
BHP-01-2021 32
BUKU BARANG PAKAI HABIS
NOMOR : 445/ / IV.03 / I / 2021
BARANG PERSEDIAAN : LAMPUNG SELATAN

SUMBER DANA /
NO JENIS BARANG HARGA HARGA HARGA HARGA KET
BARANG
JUMLAH SATUAN BARANG SATUAN NILAI JUMLAH SATUAN BARANG SATUAN NILAI JUMLAH SATUAN BARANG SATUAN NILAI JUMLAH SATUAN BARANG SATUAN NILAI
1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17
A Perabotan kantor
1 Alat Semprot unit 635,000.00 - unit 635,000.00 - unit 635,000.00 - - unit 635,000.00 -
2 Cairan Disenfektan Botol 137,000.00 - Botol 137,000.00 - Botol 137,000.00 - - Botol 137,000.00 -
3 Disenfektan Botol 20,000.00 - Botol 20,000.00 - Botol 20,000.00 - - Botol 20,000.00 -
4 Disenfektan Cairan Wipes ( PT. Aspack) pack 59,900.00 - pack 59,900.00 - pack 59,900.00 - - pack 59,900.00 -
5 Hand Sanitizer Gel Btl 500 ml 20,000.00 - Btl 500 ml 20,000.00 - Btl 500 ml 20,000.00 - - Btl 500 ml 20,000.00 -
6 Spreyer Ukuran 16 Liter Unit 635,000.00 - Unit 635,000.00 - Unit 635,000.00 - - Unit 635,000.00 -
SUB JUMLAH PERABOTAN KANTOR - - - -
B PERLENGKAPAN DINAS
1 APD Lengkap Paket 550,000.00 - Paket 550,000.00 - Paket 550,000.00 - - Paket 550,000.00 -
2 APD Lengkap (5 item) Paket 350,000.00 - Paket 350,000.00 - Paket 350,000.00 - - Paket 350,000.00 -
3 APD Imun Set 151,600.00 - 50 Set 151,600.00 7,580,000.00 50 Set 151,600.00 7,580,000.00 - Set 151,600.00 -
4 Apron Plastik putih Lengan panjang Pack / 10 pcs 37,000.00 - Pack / 10 pcs 37,000.00 - Pack / 10 pcs 37,000.00 - - Pack / 10 pcs 37,000.00 -
5 Blood Transporter Unit 2,173,500.00 - Unit 2,173,500.00 - Unit 2,173,500.00 - - Unit 2,173,500.00 -
6 Cool Box Paket 2,700,000.00 - Paket 2,700,000.00 - Paket 2,700,000.00 - - Paket 2,700,000.00 -
7 Cover All Suit Pcs 76,000.00 - Pcs 76,000.00 - Pcs 76,000.00 - - Pcs 76,000.00 -
8 Cover All Suit + Shoe cover Pcs 77,500.00 - Pcs 77,500.00 - Pcs 77,500.00 - - Pcs 77,500.00 -
9 Face Shield pcs 30,000.00 - pcs 30,000.00 - pcs 30,000.00 - - pcs 30,000.00 -
10 Face Shield Anak Pcs 15,000.00 - Pcs 15,000.00 - Pcs 15,000.00 - - Pcs 15,000.00 -
11 Gown Pcs 180,000.00 - Pcs 180,000.00 - Pcs 180,000.00 - - Pcs 180,000.00 -
12 kacamata Geogle pcs 30,000.00 - pcs 30,000.00 - pcs 30,000.00 - - pcs 30,000.00 -
13 Kantong Plastik Infeksius pack / 20 pcs 60,000.00 - pack / 20 pcs 60,000.00 - pack / 20 pcs 60,000.00 - - pack / 20 pcs 60,000.00 -
14 Kantong Plastik Non Infeksius pack / 20 pcs 15,000.00 - pack / 20 pcs 15,000.00 - pack / 20 pcs 15,000.00 - - pack / 20 pcs 15,000.00 -
15 Masker Bedah pcs 5,000.00 - pcs 5,000.00 - pcs 5,000.00 - - pcs 5,000.00 -
16 Masker ( Softies) pcs 1,933.33 - pcs 1,933.33 - pcs 1,933.33 - - pcs 1,933.33 -
17 Masker kain pcs 4,000.00 - pcs 4,000.00 - pcs 4,000.00 - - pcs 4,000.00 -
18 Masker Kain Hitam ( Cap SIG) pcs 4,000.00 - pcs 4,000.00 - pcs 4,000.00 - - pcs 4,000.00 -
19 Masker kain Warna Warni pcs 4,000.00 - pcs 4,000.00 - pcs 4,000.00 - - pcs 4,000.00 -
20 Masker KN95 pcs 10,000.00 - pcs 10,000.00 - pcs 10,000.00 - - pcs 10,000.00 -
21 Masker N95 pcs 115,000.00 - pcs 115,000.00 - pcs 115,000.00 - - pcs 115,000.00 -
22 Medical Steril Protektive Shoe Cover pcs 1,500.00 - pcs 1,500.00 - pcs 1,500.00 - - pcs 1,500.00 -
23 Parafilm Rol 584,100.00 - Rol 584,100.00 - Rol 584,100.00 - - Rol 584,100.00 -
24 Safety Box 5 L Pcs 22,433.00 - Pcs 22,433.00 - Pcs 22,433.00 - - Pcs 22,433.00 -
25 Safety Box 12,5 L Pcs 25,500.00 - Pcs 25,500.00 - Pcs 25,500.00 - - Pcs 25,500.00 -
26 Sarung Tangan pcs 1,650.00 - pcs 1,650.00 - pcs 1,650.00 - - pcs 1,650.00 -
27 Sarung Tangan Steril Pasang 6,595.00 - Pasang 6,595.00 - Pasang 6,595.00 - - Pasang 6,595.00 -
28 Termometer IR Pcs 106,800.00 - Pcs 106,800.00 - Pcs 106,800.00 - - Pcs 106,800.00 -
SUB JUMLAH PERLENGKAPAN DINAS - 7,580,000.00 7,580,000.00 -
c BAHAN KANTOR LAINNYA

1 Oxymeter pcs 140,000.00 - pcs 140,000.00 - pcs 140,000.00 - - pcs 140,000.00 -
2 Thermo Gun pcs 324,500.00 - pcs 324,500.00 - pcs 324,500.00 - - pcs 324,500.00 -
SUB JUMLAH BAHAN KANTOR LAINNYA - - - -
D OBAT - OBATAN
1 Alkohol Swab pcs 330.00 - pcs 330.00 - pcs 330.00 - - pcs 330.00 -
2 Alkohol Swab kotak/200 pcs 33,000.00 - kotak/200 pcs 33,000.00 - kotak/200 pcs 33,000.00 - - kotak/200 pcs 33,000.00 -
BHP-01-2017 33
SUMBER DANA /
NO JENIS BARANG HARGA HARGA HARGA HARGA KET
BARANG
JUMLAH SATUAN BARANG SATUAN NILAI JUMLAH SATUAN BARANG SATUAN NILAI JUMLAH SATUAN BARANG SATUAN NILAI JUMLAH SATUAN BARANG SATUAN NILAI
1 2 3 4 5 6 7 8 9 10 12 13 14 15 16 17
3 Bionocom Zink kotak / 100 pcs 3,437.50 - kotak / 100 pcs 3,437.50 - kotak / 100 pcs 3,437.50 - - kotak / 100 pcs 3,437.50 -
4 Boufant Cap pcs 2,500.00 - pcs 2,500.00 - pcs 2,500.00 - - pcs 2,500.00 -
5 Rapid Test Antibody pcs 75,000.00 - pcs 75,000.00 - pcs 75,000.00 - - pcs 75,000.00 -
6 Rapid Antigen Test 135,000.00 - Test 135,000.00 - Test 135,000.00 - - Test 135,000.00 -
7 Steril Blood Lancet kotak / 100 pcs 16,000.00 - kotak / 100 pcs 16,000.00 - kotak / 100 pcs 16,000.00 - - kotak / 100 pcs 16,000.00 -
8 Virus Transport Media ( VTM ) pcs 39,000.00 - pcs 39,000.00 - pcs 39,000.00 - - pcs 39,000.00 -
9 Zegavit Tablet kotak 196,000.00 - kotak 196,000.00 - kotak 196,000.00 - - kotak 196,000.00 -
SUB JUMLAH OBAT - OBATAN - - - -
TOTAL - 7,580,000.00 7,580,000.00 -
MENGETAHUI Kalianda,……………………………………... 2021

NIP. 19720603 199302 1 001 NIP. 19830408 201101 1 003
BHP-01-2017 34
PEMERINTAHAN KABUPATEN LAMPUNG SELATAN
UPT PUSKESMAS……
DINAS KESEHATAN KABUPATEN LAMPUNG SELATAN
Jalan………………………………………………
KABUPATEN LAMPUNG SELATAN
BERITA ACARA STOK OPNAME PERSEDIAAN BARANG HIBAH

Nomor : 442/ /III.03/V/2021
Pada hari ini, ……………. Bulan …………….. tahun Dua Ribu Dua Satu, yang bertanda tangan dibawah ini, Pengelola Obat perbekalan
kesehatan dan vaksin UPT Puskesmas……………….kabupaten Lampung selatan.
Telah melakukan pemeriksaan stok opname persediaan obat dan perbekalan kesehatan Hibah yang tersedia sampai dengan hari ini di
Gudang Farmasi UPT.Puskesmas……………..Kabupaten Lampung Selatan dengan keadaan sebagai berikut :
HARGA JUMLAH
NO NAMA VAKSIN DAN PERBEKKES SATUAN NILAI KET
SATUAN BARANG
TERKECIL
1 2 3 4 5 6 = 4x5 7
A Perabotan kantor
1 Alat Semprot unit 635,000.00 - -
2 Cairan Disenfektan Botol 137,000.00 - -
3 Disenfektan Botol 20,000.00 - -
4 Disenfektan Cairan Wipes ( PT. Aspack) pack 59,900.00 - -
5 Hand Sanitizer Gel Btl 500 ml 20,000.00 - -
6 Spreyer Ukuran 16 Liter Unit 635,000.00 - -
SUB JUMLAH PERABOTAN KANTOR -
B PERLENGKAPAN DINAS
1 APD Lengkap Paket 550,000.00 - -
2 APD Lengkap (5 item) Paket 350,000.00 - -
3 APD Imun Set 151,600.00 - -
Apron Plastik putih Lengan panjang Pack / 10 pcs 37,000.00 - -

4
5 Blood Transporter Unit 2,173,500.00 - -
6 Cool Box Paket 2,700,000.00 - -
7 Cover All Suit Pcs 76,000.00 - -
8 Cover All Suit + Shoe cover Pcs 77,500.00 - -
10 Face Shield Anak Pcs 15,000.00 - -
11 Gown Pcs 180,000.00 - -
12 kacamata Geogle pcs 30,000.00 - -
Kantong Plastik Infeksius pack / 20 pcs 60,000.00 - -

13
Kantong Plastik Non Infeksius pack / 20 pcs 15,000.00 - -

14
15 Masker Bedah pcs 5,000.00 - -
16 Masker ( Softies) pcs 1,933.33 - -
17 Masker kain pcs 4,000.00 - -
18 Masker Kain Hitam ( Cap SIG) pcs 4,000.00 - -
19 Masker kain Warna Warni pcs 4,000.00 - -
20 Masker KN95 pcs 10,000.00 - -
21 Masker N95 pcs 115,000.00 - -
HARGA JUMLAH
SATUAN BARANG
TERKECIL
1 2 3 4 5 6 = 4x5 7
22 Medical Steril Protektive Shoe Cover pcs 1,500.00 - -

23 Parafilm Rol 584,100.00 - -
24 Safety Box 5 L Pcs 22,433.00 - -
25 Safety Box 12,5 L Pcs 25,500.00 - -
26 Sarung Tangan pcs 1,650.00 - -
27 Sarung Tangan Steril Pasang 6,595.00 - -
28 Termometer IR Pcs 106,800.00 - -
SUB JUMLAH PERLENGKAPAN DINAS -
c BAHAN KANTOR LAINNYA

1 Oxymeter pcs 140,000.00 - -
2 Thermo Gun pcs 324,500.00 - -
SUB JUMLAH BAHAN KANTOR LAINNYA -
D OBAT - OBATAN
1 Alkohol Swab pcs 330.00 - -
2 Alkohol Swab kotak/200 pcs 33,000.00 - -
kotak / 100
3 Bionocom Zink 3,437.50 - -
pcs
4 Boufant Cap pcs 2,500.00 - -
5 Rapid Test Antibody pcs 75,000.00 - -
6 Rapid Antigen Test 135,000.00 - -
kotak / 100
7 Steril Blood Lancet 16,000.00 - -
pcs
8 Virus Transport Media ( VTM ) pcs 39,000.00 - -
9 Zegavit Tablet kotak 196,000.00 - -
SUB JUMLAH OBAT - OBATAN -
TOTAL -
Demikian berita AcaraStock Opname ini dibuat, untuk dapat di pergunakan Sebagaimana mestinya.
……………... , …………………………….. 2021

Bendahara Penyimpan Barang UPT Puskesmas……………………. Pengelola Obat UPT Puskesmas…………..
KABUPATEN LAMPUNG SELATAN KABUPATEN LAMPUNG SELATAN
………………………………… ……………………………………..
NIP. …………………….. NIP…………………….
MENGETAHUI
HARGA JUMLAH
SATUAN BARANG
TERKECIL
1 2 3 4 5 6 = 4x5 7
Kepala UPT Puskemas…………………….

KABUPATEN LAMPUNG SELATAN
……………………………………………………
NIP……………………………..
PEMERINTAH KABUPATEN LAMPUNG SELATAN
DAFTAR REALISASI PENAMBAHAN DAN PENGURANGAN BARANG PERSEDIAAN DAERAH
NOMOR : 445/ / IV.03 / I / 2021

BARANG PERSEDIAAN : LAMPUNG SELATAN
MUTASI TAMBAH MUTASI KURANG

NO JENIS BARANG
SALDO Penggunaan
Per 1 JANUARI 2021
BELANJA BARANG BELANJA LAIN- BELANJA BARANG
HIBAH REKLASASI JUMLAH HIBAH
JASA MODAL LAIN JASA
1 2 3 4 5 6 7 8 9 10 11
PERABOT KANTOR DAN

1 - - - -
BAHAN PEMBERSIH
2 PERLENGKAPAN DINAS - 7,580,000.00 7,580,000.00 7,580,000.00
3 BAHAN KANTOR LAINNYA - - -
OBAT - OBATAN ( APBD II,

4 APBD I,BOK,BHN KEP 131,020,966.20 3,750,000.00 84,876,542.00 88,626,542.00 24,682,208.46 56,536,964.00
LAB,APBN, OBAT HIBAH)
JUMLAH 131,020,966.20 3,750,000.00 92,456,542.00 - - - 96,206,542.00 24,682,208.46 64,116,964.00
MENGETAHUI
Kepala UPT. Puskesmas Rawat Inap Tanjung Bintang Penyimpan Barang UPT Puskesmas Rawat Inap Tanjung Bintang
DARMAWAN SKM.M Kes Ns. P. Tri Husodo, S.Kep

NIP. 19720603 199302 1 001 NIP. 19830408 201101 1 003
-
MUTASI KURANG
SALDO Per 31
LAIN- KET
REKLASASI JUMLAH JANUARI 2021
LAIN
12 13 14 15 16
- -
7,580,000.00 -
- -
81,219,172.46 138,428,335.74
- - 88,799,172.46 138,428,335.74 -
…………., ………………………………
Pengelola Obat UPT. Puskesmas Rawat Inap Tanjung Bintang

NIP . 19781002 201001 1 011
```````

Laporan Puskesmas Tanjung Bintang Jan 2021

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Laporan Puskesmas Tanjung Bintang Jan 2021

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PEMERINTAH KABUPATEN LAMPUNG SELATAN

DAFTAR REALISASI PENAMBAHAN DAN PENGURANGAN BARANG PERSEDIAAN DAERAH

NOMOR : 445/ / IV.03 / I / 2021

MUTASI TAMBAH MUTASI KURANG

SALDO Penerimaan Puskesmas dari IFK SALDO Per 31

1 OBAT, BMHP, VAKSIN APBD II 120,336,592.20 - - 18,662,208.46 18,662,208.46 101,674,383.74

OBAT, BMHP, VAKSIN APBD I

3 OBAT DAN BMHP BOK 2,270,000.00 - - 2,270,000.00 2,270,000.00 -

JUMLAH 131,020,966.20 - 3,750,000.00 84,876,542.00 - - - 88,626,542.00 - 24,682,208.46 56,536,964.00 - - 81,219,172.46 138,428,335.74 -

MENGETAHUI Tanjung Bintang, 30 Januari 2021

Ahmad Solich Annas M, S.Farm, Apt

BERITA ACARA STOK OPNAME PERSEDIAAN OBAT

HARGA HASIL STOK

1 OBAT - OBATAN APBD II

48 Ampisilin Serbuk Injeksi im/iv. 1000 mg/vial Kotak 10 Vial 51,000.00 - -

Antasida DOEN Tablet Kunyah, Kombinasi :

53 Antasida DOEN II Suspensi Kombinasi Botol 60 ml 2,025.00 - -

54 Antasida DOEN II Suspensi Kombinasi Botol 60 ml 1,995.00 - -

69 Asam Asetilsalisilat Tablet 100 mg (Asetosal) Tablet 116.00 - -

70 Asam Askorbat (Vitamin C) Tablet 250mg Tablet 125.00 - -

105 Deksametason 1nj 5 mg/ml Ampul 1,097.00 10 10,970.00

176 Glukosa Larutan Infus 5% steril Botol 500 ml 5,200.00 - -

230 Karbamazepin Tablet 200 mg Tablet 245.00 - -

231 Ketokonazol Krim 2 % Tube 15 gram 4,700.00 - -

232 Ketokonazol Krim 2 % Tube 2,545.00 - -

233 Ketokonazol Krim 2 % Tube 2,518.00 40 100,720.00

234 Ketokonazol Tablet 200 mg Tablet 300.00 - -

243 Kloramfenikol Salep Mata 1 % 5 gram Tube 1,798.00 - -

260 Klorpromazin Tablet Salut 100 mg (HCl) Tablet 149.00 - -

261 Klorpromazin Tablet Salut 100 mg (HCl) Tablet 162.00 - -

Kotrimoksazol Suspensi Kombi : Sulfame-

281 Kuinin Injeksi i.v. 25% (sebagai 2HCl) Amp 2 ml 6,200.00 - -

282 Kuinin Tablet 222 mg (H2SO4.7H2O) Tablet 540.00 - -

305 Metilergometrin Maleat Injeksi 0,2 mg/ml Ampul 2,684.00 - -

375 Parasetamol Syrup 120 mg/ 5ml Botol 60 ml 1,438.00 - -

378 Parasetamol Syrup 120 mg/ 5ml Botol 60 ml 1,107.00 - -

379 Parasetamol Syrup 120 mg/ 5ml Botol 60 ml 1,181.00 - -

380 Parasetamol Tablet 500 mg Tablet 79.00 - -

416 Retinol (Vitamin A) 200.000 IU Kapsul Lunak Kapsul 519.20 - -

443 Sianokobalamin (Vit-B12 ) Injeksi 500 mcg amp @1ml 1,077.00 - -

11 Glass Ionomer Cement Set 395,000.00 - -

12 Glass Ionomer (Ketac Universal) Botol 761,390.00 - -

7 Alat Suntik Sekali Pakai 3 ml pieces 916.00 - -

37 Hand Scone Non Steril # L (LIGHTY mas latex) pcs 462.00 - -

Hand Scone Non Steril # L (pree powdered mas

39 Handscone Non Steril (L ) (Mas pree powdered) pcs 522.06 - -

40 Hand Scone Non Steril # M (Aximed) pcs 462.00 - -

41 Hand Scone Non Steril # M (kismed mask latex) pcs 462.00 - -

42 Handscone Non Steril (M ) (Mas pree powdered) pcs 522.06 - -

43 Handscone Non Steril 7.5 ( Mask Surgical) Pasang 8,701.00 - -

65 IV Catheter No. 22 G Pieces 10,000.00 200 2,000,000.00

115 Plester Rol Kain 2.5 cm x 1 m ( Hansaplast) Rol 5,017.00 - -

116 Plester Leukoplast 7,5cm x 4,5 cm Roll 35,532.00 50 1,776,600.00

129 Urine Bag ( Aximed TVW Hanger) pcs 5,500.00 - -

14 Dehidro Artemisin + Piperazin (DHP) Tablet Tablet 2,756.44 - -

15 Glimipiride Tablet 3 mg tablet 319.18 - -

11 Safety Box Stera Sharp 7 Ltr Pcs 61,600.00 - -

2 OBAT - OBATAN APBD I

Besi (II) Sulfat 200 mg + Asam Folat 0,25mg

18 Cetrizin Tablet 10 mg Tablet 90.00 - -

49 Obat Anti Tuberkulosis FDC Kategori 2 Paket 1,297,894.00 - -

50 Obat Anti Tuberkulosis FDC Kategori 2 Paket 1,384,983.00 - -

63 Retinol (Vitamin A) 100.000 IU Kapsul Lunak Kapsul 284.00 - -

65 Retinol (Vitamin A) 100.000 IU Kapsul Lunak Kapsul 287.00 - -