1.persediaan Obat Puskesmas Babahrot 2021 Ok

LAMPIRAN : PERSEDIAAN OBAT-OBATAN DAN BMHP
PUSKESMAS ALUE SUNGAI PINANG

PER 31 JANUARI 2018
BERSUMBER DARI DINAS KESEHATAN KAB. ACEH BARAT DAYA
SALDO AWAL PER 01 JANUARI 2018 PENERIMAAN PEMAKAIAN

NO URAIAN Satuan
Nilai Persediaan
Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit)
(Rp)
1 2 3 3 4 5 6 8 9
1 Albendazol tab 400 mg Tab 147.00 359.00 52,773.00 0.00 0.00 0.00 67.00
2 Alopurinol tab 100 mg Tab 205.00 117.00 23,985.00 0.00 0.00 0.00 0.00
Alopurinol tab 100 mg Tab 0.00 0.00 0.00 800.00 95.00 76,000.00 390.00
3 Ambroxol syrup 15 mg/ml - 60 ml Tab 89.00 4,000.00 356,000.00 216.00 4,000.00 864,000.00 160.00
4 Ambroxol tablet 30 mg Tab 360.00 150.00 54,000.00 1,000.00 150.00 150,000.00 450.00
5 Amitriptilin tab sal 25 mg Tab sal 180.00 200.00 36,000.00 0.00 0.00 0.00 0.00
6 Amlodipin tab 10 mg Tab 830.00 107.00 88,810.00 0.00 0.00 0.00 260.00
8 Amoksisilin sir kering 125 mg/5 ml Botol 43.00 2,200.00 94,600.00 180.00 2,200.00 396,000.00 148.00
9 Amoksisilin tab 250 mg Tab 235.00 191.00 44,885.00 500.00 191.00 95,500.00 235.00
10 Amoksisilin tab 500 mg Tab 1,380.00 191.00 263,580.00 0.00 0.00 0.00 1,380.00
Amoksisilin tab 500 mg Tab 0.00 0.00 0.00 2,000.00 233.00 466,000.00 1,300.00
Anestetik lokal gigi kombinasi : lidokain hcl
11 Vial 25.00 2,227.00 55,675.00 0.00 0.00 0.00 0.00
2% + epinefrin 1 : 80.000 inj 2 ml
Antasida, kombinasi : aluminium hidroksida

12 Tab 390.00 64.00 24,960.00 0.00 0.00 0.00 390.00
200 mg + magnesium hidroksida 200 mg

Tab 0.00 0.00 0.00 2,000.00 78.00 156,000.00 1,030.00

13 Botol 133.00 3,100.00 412,300.00 0.00 0.00 0.00 133.00

Botol 0.00 0.00 0.00 200.00 2,106.00 421,200.00 6.00
Antibakteri, kombinasi : basitrasin 500 UI/g+

14 Tube 65.00 3,365.00 218,725.00 0.00 0.00 0.00 65.00
Polimiskin B 10.000 UI/g
Tube 0.00 0.00 0.00 100.00 2,767.00 276,700.00 83.00
Antifungi salep, kombinasi : asam benzoat
15 Tube 20.00 4,972.00 99,440.00 0.00 0.00 0.00 3.00
6%+ asam salisilat 3%
16 Asam askorbat (vitamin C) tab 250 mg Tab 460.00 139.00 63,940.00 0.00 0.00 0.00 100.00
17 Asam askorbat (vitamin C) tab 50 mg Tab 1,150.00 120.00 138,000.00 1,000.00 120.00 120,000.00 860.00
18 Asam mefenamat kaps 500 mg Kaps 180.00 113.00 20,340.00 0.00 0.00 0.00 180.00
Asam mefenamat kaps 500 mg Kaps 0.00 0.00 0.00 1,500.00 127.00 190,500.00 870.00
19 Asam Traneksamat tablet (Nexa tab) tablet 920.00 1,800.00 1,656,000.00 0.00 0.00 0.00 10.00
20 Asam Traneksamat injeksi 100 mg/5 ml Ampul 5.00 2,536.00 12,680.00 10.00 2,536.00 25,360.00 0.00
21 Asiklovir krim 5 % - 5 gram Tube 74.00 3,000.00 222,000.00 25.00 3,000.00 75,000.00 11.00
22 Asiklovir tab 400 mg Tab 540.00 415.00 224,100.00 800.00 368.00 294,400.00 280.00
23 Atapulgit 600 mg Tab 730.00 166.00 121,180.00 500.00 166.00 83,000.00 530.00
24 Bedak salisil serb 2% Botol 27.00 1,071.00 28,917.00 0.00 0.00 0.00 27.00
Bedak salisil serb 2% Botol 0.00 0.00 0.00 50.00 1,066.00 53,300.00 9.00
25 Betametason krim 0,5 mg/g Tube 22.00 1,450.00 31,900.00 0.00 0.00 0.00 22.00
Betametason krim 0,5 mg/g Tube 0.00 0.00 0.00 192.00 1,435.00 275,520.00 95.00
26 Bisakodil tab sal 5 mg (Dulcolax) Tab sal 330.00 2,700.00 891,000.00 0.00 0.00 0.00 0.00
27 Cetirizine tablet 10 mg Tab 193.00 115.00 22,195.00 1,500.00 115.00 172,500.00 903.00
28 Cetirizine sir 5 mg/5 ml. Botol 113.00 3,300.00 372,900.00 120.00 3,300.00 396,000.00 21.00
29 Deksametason inj 5 mg/ml (i.v./i.m.) Vial 36.00 1,805.00 64,980.00 0.00 0.00 0.00 2.00
30 Deksametason tab 0,5 mg Tab 744.00 45.00 33,480.00 0.00 0.00 0.00 744.00
Deksametason tab 0,5 mg Tab 0.00 0.00 0.00 1,500.00 48.00 72,000.00 761.00
31 Diazepam tab 2 mg Tab 483.00 100.00 48,300.00 0.00 0.00 202.00
32 Difenhidramin inj 10 mg/ml (i.v./i.m.) Ampul 37.00 1,222.00 45,214.00 0.00 0.00 0.00
33 Digoksin tab 0,25 mg Tab 200.00 103.00 20,600.00 0.00 0.00 0.00
34 Domperidon susp 5 mg/5 ml Botol 104.00 3,180.00 330,720.00 0.00 0.00 0.00 44.00
35 Domperidon tab 10 mg Tab 900.00 116.00 104,400.00 0.00 0.00 0.00 180.00
36 Efedrin HCl tablet 25 mg Tab 240.00 200.00 48,000.00 0.00 0.00 0.00 0.00
37 Eritromisin kaps 250 mg Kaps 440.00 647.00 284,680.00 0.00 0.00 0.00 140.00
38 Eritromisin sir 200 mg/5 ml Botol 0.00 0.00 0.00 5.00 6,461.00 32,305.00 3.00
39 Eritromisin tab 500 mg Tab 0.00 0.00 0.00 595.00 781.00 464,695.00 155.00
40 Etakridin ( Rivanol ) larutan 0,1% - 300 ml botol 5.00 3,060.00 15,300.00 5.00 3,060.00 15,300.00 2.00
41 Etanol 70 % 1000 ml Botol 1.00 25,800.00 25,800.00 2.00 25,800.00 51,600.00 0.00
42 Etanol 70% 100 ml Botol 10.00 2,625.00 26,250.00 5.00 2,625.00 13,125.00 1.00
43 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 180.00 698.00 125,640.00 0.00 0.00 0.00 30.00
44 Flunarizin tablet 5 mg Tab 0.00 0.00 0.00 500.00 1,000.00 500,000.00 60.00
45 Furosemid tab 40 mg Tab 190.00 84.00 15,960.00 200.00 84.00 16,800.00 340.00
Garam oralit kombinasi : natrium klorida

46 0,52 g + kalium klorida 0,30 g + trinatrium Sachet 150.00 273.00 40,950.00 200.00 273.00 54,600.00 111.00
sitrat 0,58 g + glukosa anhidrat 2,7 g
47 Gentamisin salep kulit 3 % - 5 gram Tube 1.00 3,000.00 3,000.00 150.00 3,000.00 450,000.00 53.00
48 Gentian Violet larutan 1 % -10 ml Botol 46.00 2,500.00 115,000.00 0.00 2,500.00 0.00 22.00
49 Glibenklamid tab 5 mg Tab 500.00 135.00 67,500.00 1,000.00 135.00 135,000.00 630.00
50 Glimepirid tab 2 mg Tab 500.00 296.00 148,000.00 0.00 0.00 0.00 0.00
51 Gliseril Guayakolat tablet 100 mg Tab 900.00 100.00 90,000.00 4,000.00 100.00 400,000.00 2,750.00
52 Gliserin tts 100 mg/ml Botol 4.00 6,600.00 26,400.00 0.00 0.00 0.00 0.00
53 Glukosa Larutan Infus 5% steril 500 ml Botol 5.00 5,720.00 28,600.00 10.00 5,720.00 57,200.00 0.00
54 Griseofulvin (micronized) tab 125 mg Tab 650.00 263.00 170,950.00 500.00 263.00 131,500.00 50.00
55 Haloperidol tab 0,5 mg Tab 1,730.00 64.00 110,720.00 0.00 0.00 0.00 0.00
57 Haloperidol tab 5 mg Tab 1,230.00 74.00 91,020.00 0.00 0.00 0.00 60.00
58 Hidrokortison krim 2,5% Tube 47.00 2,838.00 133,386.00 72.00 2,838.00 204,336.00 86.00
59 Ibuprofen tab 200 mg Tab 870.00 108.00 93,960.00 1,000.00 108.00 108,000.00 1,230.00
60 Ibuprofen tab 400 mg Tab 240.00 113.00 27,120.00 0.00 0.00 0.00 240.00
Ibuprofen tab 400 mg Tab 0.00 0.00 0.00 1,000.00 133.00 133,000.00 310.00
61 Isosorbid dinitrat tab 5 mg Tab 600.00 98.00 58,800.00 0.00 0.00 0.00 0.00
62 Kalsium laktat (kalk) tab 500 mg Tab 1,000.00 82.00 82,000.00 0.00 82.00 0.00 470.00
63 Kaolin pektin syrup Botol 104.00 4,000.00 416,000.00 0.00 0.00 0.00 29.00
64 Kaptopril tab 12,5 mg Tab 260.00 69.00 17,940.00 0.00 0.00 0.00 170.00
65 Kaptopril tab 25 mg Tab 595.00 86.00 51,170.00 1,500.00 86.00 129,000.00 455.00
66 Karbamazepin Tab 200 mg Tablet 160.00 230.00 36,800.00 0.00 0.00 0.00 0.00
67 Kenalaog in orabase salep Tube 4.00 65,000.00 260,000.00 0.00 0.00 0.00 1.00
68 Ketokonazol krim 2 % - 15 grm Tube 42.00 3,135.00 131,670.00 0.00 0.00 0.00 8.00
69 Ketokonazol tab 200 mg Tab 250.00 358.00 89,500.00 0.00 0.00 0.00 70.00
70 Kloramfenikol salep kulit 2% Tube 0.00 0.00 0.00 48.00 3,327.00 159,696.00 0.00
71 Kloramfenikol salep mata 1% Tube 39.00 1,850.00 72,150.00 72.00 1,850.00 133,200.00 23.00
72 Kloramfenikol susp 125 mg/5 ml Botol 5.00 4,982.00 24,910.00 0.00 0.00 0.00 0.00
73 Kloramfenikol tetes telinga 3% Botol 21.00 7,700.00 161,700.00 20.00 7,700.00 154,000.00 10.00
74 Kloramfenikol tts mata 0,5% Botol 33.00 7,700.00 254,100.00 50.00 7,700.00 385,000.00 6.00
75 Klorfeniramin tab 4 mg Tab 3,157.00 39.00 123,123.00 0.00 0.00 0.00 3,157.00
Klorfeniramin tab 4 mg Tab 0.00 0.00 0.00 3,000.00 45.00 135,000.00 820.00
76 Klorpromazin tab sal 100 mg Tab sal 1,244.00 148.00 184,112.00 0.00 0.00 0.00 130.00
77 Kombinasi : ergotamin 1 mg+ kafein 50 mg Tab 0.00 0.00 0.00 100.00 210.00 21,000.00 20.00
Kombinasi : ferro sulfat 200 mg+ as. Folat
78 Tab sal 1,354.00 223.00 301,942.00 900.00 223.00 200,700.00 2,016.00
0,25 mg
Tab sal 0.00 0.00 0.00 710.00 45.00 31,950.00 0.00
0,25 mg
Kotrimoksazol (dewasa) kombinasi :

79 Tab 420.00 131.00 55,020.00 0.00 0.00 0.00 220.00
sulfametoksazol 400 mg+ trimetoprim 80 mg

80 Tab 0.00 0.00 0.00 200.00 158.00 31,600.00 0.00
Kotrimoksazol (dewasa) kombinasi tiap 5 ml

81 suspensi : sulfametoksazol 200 mg + Botol 72.00 2,225.00 160,200.00 50.00 2,225.00 111,250.00 20.00
trimetoprim 40 mg
82 Lidokain injeksi 2% - 2 ml Ampul 30.00 1,280.00 38,400.00 0.00 0.00 0.00 5.00
83 Magnesium sulfat inj 20% Vial 2.00 3,200.00 6,400.00 0.00 0.00 0.00 2.00
84 Magnesium sulfat inj 40% Vial 1.00 3,650.00 3,650.00 0.00 0.00 0.00 1.00
85 Metformin tab 500 mg Tab 460.00 103.00 47,380.00 0.00 0.00 0.00 460.00
86 Metformin tab 500 mg Tab 0.00 0.00 0.00 500.00 119.00 0.00 100.00
87 Metilergometrin inj 0,2 mg/ml Ampul 20.00 3,278.00 65,560.00 0.00 0.00 0.00 0.00
88 Metronidazol tab 250 mg Tab 620.00 94.00 58,280.00 500.00 94.00 47,000.00 65.00
89 Metronidazol tab 500 mg Tab 478.00 115.00 54,970.00 500.00 115.00 57,500.00 328.00
90 Mikonazol krim 2% Tube 99.00 4,250.00 420,750.00 72.00 4,250.00 306,000.00 95.00
91 Multivitamin Tab 1,200.00 249.00 298,800.00 2,000.00 249.00 498,000.00 1,350.00
92 Multivitamin Syrup Botol 91.00 3,850.00 350,350.00 200.00 3,850.00 770,000.00 205.00
93 NaCl 0,9% Larutan Botol 33.00 5,170.00 170,610.00 0.00 0.00 0.00 0.00
94 Natrium Bikarbonat tablet 500 mg Tab 1,200.00 58.00 69,600.00 0.00 0.00 0.00 0.00
95 Natrium diklofenak tab 25 mg Tab 205.00 150.00 30,750.00 0.00 0.00 0.00 205.00
Natrium diklofenak tab 25 mg Tab 0.00 0.00 0.00 500.00 167.00 83,500.00 430.00
Natrium diklofenak tab 50 mg Tab 0.00 0.00 0.00 500.00 161.00 80,500.00 0.00
97 Nifedipin kaps 10 mg Kaps 345.00 120.00 41,400.00 1,300.00 120.00 156,000.00 695.00
98 Nistatin tab salut 500.000 UI Tab 200.00 881.00 176,200.00 0.00 0.00 0.00 0.00
99 Obat Batuk Anak Sirup Botol 63.00 4,000.00 252,000.00 0.00 0.00 0.00 63.00
100 Obat Batuk Hitam ( O.B.H. ) cairan - 100 ml Botol 25.00 3,000.00 75,000.00 50.00 3,000.00 150,000.00 9.00
101 Obat Flu tablet Tablet 1,080.00 1,000.00 1,080,000.00 0.00 1,000.00 0.00 610.00
102 Obat Flu Syrup Botol 13.00 10,000.00 130,000.00 144.00 10,000.00 1,440,000.00 98.00
103 Oksitetrasiklin salep kulit 3% (HCl) - 5 gr Tube 86.00 2,864.00 246,304.00 100.00 2,864.00 286,400.00 84.00
104 Oksitetrasiklin salep mata 1% (HCl) - 3,5 gr Tube 26.00 3,000.00 78,000.00 50.00 3,000.00 150,000.00 5.00
105 Omeprazol kaps 20 mg Kaps 705.00 148.00 104,340.00 900.00 148.00 133,200.00 435.00
106 Parasetamol sir 120 mg/5 ml Botol 154.00 2,500.00 385,000.00 0.00 0.00 0.00 154.00
Parasetamol sir 120 mg/5 ml Botol 0.00 0.00 0.00 200.00 1,119.00 223,800.00 129.00
107 Parasetamol tab 500 mg Tab 2,383.00 105.00 250,215.00 6,400.00 105.00 672,000.00 5,843.00
108 Pehacain Injeksi ampul 48.00 0.00 0.00 0.00 0.00 0.00 0.00
109 Perak sulfadiazin krim 1% Tube 6.00 20,700.00 124,200.00 0.00 0.00 0.00 0.00
110 Pirantel pamoat tab scored 125 mg Tab 101.00 318.00 32,118.00 0.00 0.00 0.00 1.00
111 Piridoksin (vitamin B6) tab 10 mg Tab 477.00 136.00 64,872.00 500.00 136.00 68,000.00 397.00
112 Piroksikam kapsul 10 mg Tab 385.00 90.00 34,650.00 500.00 90.00 45,000.00 225.00
113 Piroksikam kapsul 20 mg Tab 435.00 150.00 65,250.00 500.00 150.00 75,000.00 685.00
114 Povidon iodin lar 100 mg/ml Botol 30 ml 0.00 0.00 0.00 10.00 4,150.00 41,500.00 0.00
115 Povidon iodin lar 100 mg/ml Botol 300 ml 3.00 35,000.00 105,000.00 2.00 35,000.00 70,000.00 1.00
116 Prednison tab 5 mg Tab 975.00 85.00 82,875.00 500.00 85.00 42,500.00 405.00
117 Ranitidin tab 150 mg Tab 1,085.00 110.00 119,350.00 1,500.00 110.00 165,000.00 1,690.00
118 Ringer Laktat Larutan Botol 10.00 7,150.00 71,500.00 10.00 7,150.00 71,500.00 7.00
119 Salbutamol tab 2 mg Tab 570.00 68.00 38,760.00 550.00 68.00 37,400.00 0.00
120 Salbutamol tab 4 mg Tab 1,240.00 89.00 110,360.00 500.00 89.00 44,500.00 640.00
Salep 2-4, kombinasi : asam salisilat 2 %+
121 Tube 12.00 2,907.00 34,884.00 0.00 0.00 0.00 0.00
belerang endap 4 %
Tube 0.00 0.00 0.00 24.00 2,797.00 67,128.00 0.00
belerang endap 4 %
122 Sefadroksil kapsul 500 mg Tab 420.00 455.00 191,100.00 0.00 0.00 0.00 110.00
Sefadroksil kapsul 500 mg Tab 0.00 0.00 0.00 800.00 557.00 445,600.00 0.00
123 Sefadroksil sirup kering 125mg/5ml - 60 ml Botol 71.00 4,133.00 293,443.00 0.00 0.00 11.00
124 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 77.00 1,226.00 94,402.00 0.00 0.00 27.00
125 Sianokobalamin (vitamin B12) tab 50 mcg Tab 415.00 55.00 22,825.00 0.00 0.00 0.00 415.00
Sianokobalamin (vitamin B12) tab 50 mcg Tab 0.00 0.00 0.00 1,500.00 58.00 87,000.00 410.00
126 Simvastatin tab sal 10 mg Tab sal 655.00 113.00 74,015.00 0.00 0.00 0.00 125.00
128 Siprofloksasin tab scored 500 mg Tab 520.00 254.00 132,080.00 0.00 0.00 0.00 160.00
Siprofloksasin tab scored 500 mg Tab 0.00 0.00 0.00 800.00 298.00 238,400.00 0.00
129 Tetrasiklin kaps 250 mg Kaps 0.00 0.00 0.00 800.00 181.00 144,800.00 0.00
130 Tetrasiklin kaps 500 mg Kaps 360.00 329.00 118,440.00 1,000.00 329.00 329,000.00 40.00
131 Tiamin (vitamin B1) tab 50 mg Tab 270.00 87.00 23,490.00 0.00 0.00 0.00 270.00
Tiamin (vitamin B1) tab 50 mg Tab 0.00 0.00 0.00 1,000.00 91.00 91,000.00 510.00
132 Triheksifenidil tab 2 mg Tab 565.00 80.00 45,200.00 500.00 80.00 40,000.00 90.00
133 Trombopop gel Tube 2.00 65,000.00 130,000.00 2.00 65,000.00 130,000.00 2.00
134 Ulsidex - Sukralfat tablet 500 mg Tab 670.00 368.00 246,560.00 0.00 0.00 0.00 270.00
135 Vitamin B kompleks Tab 1,135.00 132.00 149,820.00 2,000.00 132.00 264,000.00 995.00
136 Zinc sir 20 mg/5 ml Botol 71.00 4,959.00 352,089.00 50.00 4,959.00 247,950.00 19.00
137 Zinc tab disp 20 mg Tab 690.00 591.00 407,790.00 500.00 591.00 295,500.00 520.00
138 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul 10.00 17,500.00 175,000.00 0.00 0.00 0.00 0.00
139 Betahistin tablet 6 mg Tablet 840.00 151.00 126,840.00 0.00 0.00 0.00 160.00
140 Alat Suntik Sekali Pakai 1 ml Pcs 168.00 848.00 142,464.00 0.00 0.00 0.00 35.00
141 Alat Suntik Sekali Pakai 2,5 ml Pcs 66.00 713.90 47,117.40 200.00 714.00 142,800.00 24.00
143 Aseptic gel 500 ml Botol 1.00 26,400.00 26,400.00 6.00 26,400.00 158,400.00 1.00
Catgut / Benang Bedah No. 2/0 dengan
144 Pcs 32.00 7,286.25 233,160.00 0.00 0.00 0.00 0.00
jarum bedah
145 HandScun pcs 540.00 520.30 280,962.00 500.00 520.00 260,000.00 266.00
146 Infusion Set Dewasa Set 9.00 5,856.00 52,704.00 0.00 0.00 0.00 0.00
147 IV Catheter No. 20 G Set 19.00 4,959.00 94,221.00 0.00 0.00 0.00 0.00
148 IV Catheter No. 22 G Set 10.00 5,254.37 52,543.70 5.00 5,254.00 26,270.00 0.00
150 Kapas Pembalut / Absorben 250 gram Roll 2.00 16,312.50 32,625.00 0.00 0.00 0.00 0.00
151 Kasa Hydrophil 40 x 80 cm roll 2.00 120,750.00 241,500.00 0.00 0.00 0.00 1.00
152 Kasa Kompres 40/40 Steril pcs 0.00 0.00 0.00 49.00 1,532.00 75,068.00 0.00
153 Kasa Pembalut 2 m x 80 cm roll 13.00 8,855.00 115,115.00 0.00 0.00 5.00
154 Kasa Pembalut Hidrofil 4 m x 15 cm Elastic Rol 15.00 2,415.00 36,225.00 0.00 0.00 10.00
155 Kasa Pembalut Hidrofil 4 m x 5 cm Elastic roll 0.00 0.00 0.00 36.00 334.00 12,024.00 8.00
156 Kassa steril 16 cm x 16 cm roll 17.00 5,000.00 85,000.00 0.00 0.00 0.00 3.00
157 Lomatuell H/Lomatul Pcs 10.00 15,000.00 150,000.00 0.00 0.00 0.00 1.00
158 Masker pcs 288.00 585.60 168,652.80 100.00 586.00 58,600.00 106.00
159 Masker N 95 pcs 39.00 7,323.75 285,626.25 0.00 0.00 0.00 19.00
160 Pisau Bisturi No. 10 Buah 10.00 3,150.00 31,500.00 15.00 3,150.00 47,250.00 0.00
161 Pisau Bisturi no. 15 set 13.00 3,150.00 40,950.00 10.00 3,150.00 31,500.00 6.00
162 Plester 5 yards x 2 inch roll 11.00 40,000.00 440,000.00 0.00 0.00 0.00 2.00
Silk (Benang Bedah Sutera) No 3/0 dengan
163 pcs 26.00 3,513.89 91,361.11 0.00 0.00 0.00 7.00
jarum bedah
164 Strip tes asam urat (easytouch) Btl 25 pcs 3.00 90,000.00 270,000.00 0.00 0.00 0.00 2.00
165 Strip tes gula darah (easytouch) Btl 25 pcs 4.00 90,000.00 360,000.00 0.00 0.00 0.00 4.00
166 Strip tes HB (easytouch) Btl 25 pcs 4.00 165,000.00 660,000.00 0.00 0.00 0.00 1.00
167 Strip tes kolesterol (easytouch) Btl 10 pcs 5.00 170,000.00 850,000.00 0.00 0.00 0.00 4.00
168 Test pek Hamil Pcs 0.00 0.00 0.00 50.00 3,000.00 150,000.00 0.00
169 Etil klorida semprot 100 ml Botol 2.00 125,000.00 250,000.00 0.00 0.00 0.00 0.00
170 Eugenol Botol 2.00 18,333.00 36,666.00 0.00 0.00 0.00 0.00
171 Saliva ejector blue woodpecker pcs 0.00 0.00 0.00 100.00 79,069.00 7,906,900.00 0.00
172 Risperidon 2 mg Tablet 1,000.00 347.00 347,000.00 0.00 0.00 0.00 0.00
TOTAL HARGA 55,462.00 24,358,671.06 58,622.00 25,882,327.00 46,890.00
Jeumpa, 31 Januari 2018

Yang diperiksa
Pengelola Obat Alue Sungai Pinang
Kabupaten Aceh Barat Daya
Lisa Triana, Amd.Farm

Nip. 19830727 201212 2 004
SALDO EXPIRE DATE PER 31 JANUARI
PEMAKAIAN SALDO AKHIR PER 31 JANUARI 2018
2018
Nilai Persediaan Nilai Persediaan
Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan
(Rp) (Rp)
11 12 14 15 16 17
359.00 24,053.00 80.00 359.00 28,720 0.00 0.00 -
0.00 - 0.00 95.00 - 0.00 0.00 -
95.00 37,050.00 410.00 95.00 38,950 0.00
4,000.00 640,000.00 145.00 4,000.00 580,000 0.00 0.00 -
150.00 67,500.00 910.00 150.00 136,500 0.00 0.00 -
0.00 - 180.00 200.00 36,000 0.00 0.00 -
107.00 27,820.00 570.00 107.00 60,990 0.00 0.00 -
90.00 7,200.00 360.00 90.00 32,400 0.00 0.00 -
2,200.00 325,600.00 75.00 2,200.00 165,000 0.00 0.00 -
191.00 44,885.00 500.00 191.00 95,500 0.00 0.00 -
191.00 263,580.00 0.00 0.00 - 0.00 0.00 -
233.00 302,900.00 700.00 233.00 163,100 0.00
0.00 - 25.00 2,227.00 55,675 0.00 0.00 -
0.00 - 0.00 0.00 - 0.00 0.00 -
78.00 80,340.00 970.00 78.00 75,660 0.00 0.00 -
3,100.00 412,300.00 0.00 0.00 - 0.00 0.00 -
2,106.00 12,636.00 194.00 2,106.00 408,564 0.00 0.00 -
3,365.00 218,725.00 0.00 0.00 - 0.00 0.00 -
2,767.00 229,661.00 17.00 2,767.00 47,039 0.00
4,972.00 14,916.00 17.00 4,972.00 84,524 0.00 0.00 -
139.00 13,900.00 360.00 139.00 50,040 0.00 0.00 -
120.00 103,200.00 1,290.00 120.00 154,800 0.00 0.00 -
113.00 20,340.00 0.00 0.00 - 0.00 0.00 -
127.00 110,490.00 630.00 127.00 80,010 0.00 0.00
1,800.00 18,000.00 910.00 1,800.00 1,638,000 0.00 0.00 -
0.00 - 15.00 2,536.00 38,040 0.00 0.00 -
3,000.00 33,000.00 88.00 3,000.00 264,000 0.00 0.00 -
368.00 103,040.00 1,060.00 368.00 390,080 0.00 0.00 -
166.00 87,980.00 700.00 166.00 116,200 0.00 0.00 -
1,066.00 28,782.00 0.00 0.00 - 0.00 0.00 -
1,066.00 9,594.00 41.00 1,066.00 43,706 0.00 0.00
1,450.00 31,900.00 0.00 0.00 - 0.00 0.00 -
1,435.00 136,325.00 97.00 1,435.00 139,195 0.00 0.00
0.00 - 330.00 2,700.00 891,000 0.00 0.00 -
115.00 103,845.00 790.00 115.00 90,850 0.00 0.00 -
3,300.00 69,300.00 212.00 3,300.00 699,600 0.00 0.00 -

1,805.00 3,610.00 34.00 1,805.00 61,370 0.00 0.00 -
45.00 33,480.00 0.00 0.00 - 0.00 0.00 -
48.00 36,528.00 739.00 48.00 35,472 0.00 0.00
100.00 20,200.00 281.00 100.00 28,100 0.00 0.00 -
0.00 - 37.00 1,222.00 45,214 0.00 0.00 -
0.00 - 200.00 103.00 20,600 0.00 0.00 -
3,180.00 139,920.00 60.00 3,180.00 190,800 0.00 0.00 -
116.00 20,880.00 720.00 116.00 83,520 0.00 0.00 -
0.00 - 240.00 200.00 48,000 0.00 0.00 -
647.00 90,580.00 300.00 647.00 194,100 0.00 0.00 -
6,461.00 19,383.00 2.00 6,461.00 12,922 0.00 0.00 -
781.00 121,055.00 440.00 781.00 343,640 0.00 0.00 -
3,060.00 6,120.00 8.00 3,060.00 24,480 0.00 0.00 -
0.00 - 3.00 25,800.00 77,400 0.00 0.00 -
2,625.00 2,625.00 14.00 2,625.00 36,750 0.00 0.00 -
698.00 20,940.00 150.00 698.00 104,700 0.00 0.00 -
1,000.00 60,000.00 440.00 1,000.00 440,000 0.00 0.00 -
84.00 28,560.00 50.00 84.00 4,200 0.00 0.00 -
273.00 30,303.00 239.00 273.00 65,247 0.00 0.00 -
3,000.00 159,000.00 98.00 3,000.00 294,000 0.00 0.00 -
2,500.00 55,000.00 24.00 2,500.00 60,000 0.00 0.00 -
135.00 85,050.00 870.00 135.00 117,450 0.00 0.00 -
0.00 - 500.00 296.00 148,000 0.00 0.00 -
100.00 275,000.00 2,150.00 100.00 215,000 0.00 0.00 -
0.00 - 4.00 6,600.00 26,400 0.00 0.00 -
0.00 - 15.00 5,720.00 85,800 0.00 0.00 -
263.00 13,150.00 1,100.00 263.00 289,300 0.00 0.00 -
0.00 - 1,730.00 64.00 110,720 0.00 0.00 -
76.00 9,120.00 1,060.00 76.00 80,560 0.00 0.00 -
74.00 4,440.00 1,170.00 74.00 86,580 0.00 0.00 -
2,838.00 244,068.00 33.00 2,838.00 93,654 0.00 0.00 -
108.00 132,840.00 640.00 108.00 69,120 0.00 0.00 -
113.00 27,120.00 0.00 0.00 - 0.00 0.00 -
133.00 41,230.00 690.00 133.00 91,770 0.00 0.00
0.00 - 600.00 98.00 58,800 0.00 0.00 -
82.00 38,540.00 530.00 82.00 43,460 0.00 0.00 -
4,000.00 116,000.00 75.00 4,000.00 300,000 0.00 0.00 -
69.00 11,730.00 90.00 69.00 6,210 0.00 0.00 -
86.00 39,130.00 1,640.00 86.00 141,040 0.00 0.00 -
0.00 - 160.00 230.00 36,800 0.00 0.00 -
65,000.00 65,000.00 3.00 65,000.00 195,000 0.00 0.00 -
3,135.00 25,080.00 34.00 3,135.00 106,590 0.00 0.00 -
358.00 25,060.00 180.00 358.00 64,440 0.00 0.00 -
0.00 - 48.00 3,327.00 159,696 0.00 0.00 -

1,850.00 42,550.00 88.00 1,850.00 162,800 0.00 0.00 -
0.00 - 5.00 4,982.00 24,910 0.00 0.00 -
7,700.00 77,000.00 31.00 7,700.00 238,700 0.00 0.00 -
7,700.00 46,200.00 77.00 7,700.00 592,900 0.00 0.00 -
39.00 123,123.00 0.00 0.00 - 0.00 0.00 -
45.00 36,900.00 2,180.00 45.00 98,100 0.00 0.00
148.00 19,240.00 1,114.00 148.00 164,872 0.00 0.00 -
210.00 4,200.00 80.00 210.00 16,800 0.00 0.00 -
223.00 449,568.00 238.00 223.00 53,074 0.00 0.00 -
0.00 - 710.00 45.00 31,950 0.00 0.00
131.00 28,820.00 200.00 131.00 26,200 0.00 0.00 -
0.00 - 200.00 158.00 31,600 0.00 0.00
2,225.00 44,500.00 102.00 2,225.00 226,950 0.00 0.00 -
1,280.00 6,400.00 25.00 1,280.00 32,000 0.00 0.00 -
3,200.00 6,400.00 0.00 0.00 -
3,650.00 3,650.00 0.00 0.00 -
103.00 47,380.00 0.00 0.00 - 0.00 0.00 -
119.00 11,900.00 400.00 119.00 47,600 0.00 0.00
0.00 - 20.00 3,278.00 65,560 0.00 0.00 -
94.00 6,110.00 1,055.00 94.00 99,170 0.00 0.00 -
115.00 37,720.00 650.00 115.00 74,750 0.00 0.00 -
4,250.00 403,750.00 76.00 4,250.00 323,000 0.00 0.00 -
249.00 336,150.00 1,850.00 249.00 460,650 0.00 0.00 -
3,850.00 789,250.00 86.00 3,850.00 331,100 0.00 0.00 -
0.00 - 33.00 5,170.00 170,610 0.00 0.00 -
0.00 - 1,200.00 58.00 69,600 0.00 0.00 -
150.00 30,750.00 0.00 0.00 - 0.00 0.00 -
167.00 71,810.00 70.00 167.00 11,690 0.00 0.00
200.00 140,000.00 40.00 200.00 8,000 0.00 0.00 -
0.00 - 500.00 161.00 80,500 0.00 0.00
120.00 83,400.00 950.00 120.00 114,000 0.00 0.00 -
0.00 - 200.00 881.00 176,200 0.00 0.00 -
4,000.00 252,000.00 0.00 0.00 - 0.00 0.00 -
3,000.00 27,000.00 66.00 3,000.00 198,000 0.00 0.00 -
1,000.00 610,000.00 470.00 1,000.00 470,000 0.00 0.00 -
10,000.00 980,000.00 59.00 10,000.00 590,000 0.00 0.00 -
2,864.00 240,576.00 102.00 2,864.00 292,128 0.00 0.00 -
3,000.00 15,000.00 71.00 3,000.00 213,000 0.00 0.00 -
148.00 64,380.00 1,170.00 148.00 173,160 0.00 0.00 -
2,500.00 385,000.00 0.00 0.00 - 0.00 0.00 -
1,119.00 144,351.00 71.00 1,119.00 79,449 0.00 0.00
105.00 613,515.00 2,940.00 105.00 308,700 0.00 0.00 -
0.00 - 48.00 313.00 15,024 0.00 0.00 -
0.00 - 6.00 20,700.00 124,200 0.00 0.00 -

318.00 318.00 100.00 318.00 31,800 0.00 0.00 -
136.00 53,992.00 580.00 136.00 78,880 0.00 0.00 -
90.00 20,250.00 660.00 90.00 59,400 0.00 0.00 -
150.00 102,750.00 250.00 150.00 37,500 0.00 0.00 -
0.00 - 10.00 4,150.00 41,500 0.00 0.00 -
35,000.00 35,000.00 4.00 35,000.00 140,000 0.00 0.00 -
85.00 34,425.00 1,070.00 85.00 90,950 0.00 0.00 -
110.00 185,900.00 895.00 110.00 98,450 0.00 0.00 -
7,150.00 50,050.00 13.00 7,150.00 92,950 0.00 0.00 -
0.00 - 1,120.00 68.00 76,160 0.00 0.00 -
89.00 56,960.00 1,100.00 89.00 97,900 0.00 0.00 -
0.00 - 12.00 2,907.00 34,884 0.00 0.00 -
0.00 - 24.00 2,797.00 67,128 0.00 0.00
455.00 50,050.00 310.00 455.00 141,050 0.00 0.00 -
0.00 - 800.00 557.00 445,600 0.00 0.00
4,133.00 45,463.00 60.00 4,133.00 247,980 0.00 0.00 -
1,226.00 33,102.00 50.00 1,226.00 61,300 0.00 0.00 -
55.00 22,825.00 0.00 0.00 - 0.00 0.00 -
58.00 23,780.00 1,090.00 58.00 63,220 0.00 0.00
113.00 14,125.00 530.00 113.00 59,890 0.00 0.00 -
252.00 12,600.00 320.00 252.00 80,640 0.00 0.00 -
254.00 40,640.00 360.00 254.00 91,440 0.00 0.00 -
0.00 - 800.00 298.00 238,400 0.00 0.00
0.00 - 800.00 181.00 144,800 0.00 0.00 -
329.00 13,160.00 1,320.00 329.00 434,280 0.00 0.00 -
87.00 23,490.00 0.00 0.00 - 0.00 0.00 -
91.00 46,410.00 490.00 91.00 44,590 0.00 0.00
80.00 7,200.00 975.00 80.00 78,000 0.00 0.00 -
65,000.00 130,000.00 2.00 65,000.00 130,000 0.00 0.00 -
368.00 99,360.00 400.00 368.00 147,200 0.00 0.00 -
132.00 131,340.00 2,140.00 132.00 282,480 0.00 0.00 -
4,959.00 94,221.00 102.00 4,959.00 505,818 0.00 0.00 -
591.00 307,320.00 670.00 591.00 395,970 0.00 0.00 -
0.00 - 10.00 17,500.00 175,000 0.00 0.00 -
151.00 24,160.00 680.00 151.00 102,680 0.00 0.00 -
848.00 29,680.00 133.00 848.00 112,784 0.00 0.00 -
714.00 17,136.00 242.00 714.00 172,788 0.00 0.00 -
774.00 20,124.00 86.00 774.00 66,564 0.00 0.00 -
26,400.00 26,400.00 6.00 26,400.00 158,400 0.00 0.00 -
7,286.00 - 32.00 7,286.00 233,152 0.00 0.00 -
520.00 138,320.00 774.00 520.00 402,480 0.00 0.00 -
0.00 - 9.00 5,856.00 52,704 1.00 52,704.00 52,704.00
0.00 - 19.00 4,959.00 94,221 0.00 0.00 -
0.00 - 15.00 5,254.00 78,810 0.00 0.00 -
5,687.00 22,748.00 19.00 5,687.00 108,053 0.00 0.00 -
0.00 - 2.00 16,313.00 32,626 0.00 0.00 -

120,750.00 120,750.00 1.00 120,750.00 120,750 0.00 0.00 -
0.00 - 49.00 1,532.00 75,068 0.00 0.00 -
8,855.00 44,275.00 8.00 8,855.00 70,840 0.00 0.00 -
2,415.00 24,150.00 5.00 2,415.00 12,075 0.00 0.00 -
334.00 2,672.00 28.00 334.00 9,352 0.00 0.00 -
5,000.00 15,000.00 14.00 5,000.00 70,000 0.00 0.00 -
15,000.00 15,000.00 9.00 15,000.00 135,000 0.00 0.00 -
586.00 62,116.00 282.00 586.00 165,252 0.00 0.00 -
7,324.00 139,156.00 20.00 7,324.00 146,480 0.00 0.00 -
0.00 - 25.00 3,150.00 78,750 0.00 0.00 -
3,150.00 18,900.00 17.00 3,150.00 53,550 0.00 0.00 -
40,000.00 80,000.00 9.00 40,000.00 360,000 0.00 0.00 -
3,514.00 24,598.00 19.00 3,514.00 66,766 0.00 0.00 -
90,000.00 180,000.00 1.00 90,000.00 90,000 0.00 0.00 -
90,000.00 360,000.00 0.00 0.00 - 0.00 0.00 -
165,000.00 165,000.00 3.00 165,000.00 495,000 0.00 0.00 -
170,000.00 680,000.00 1.00 170,000.00 170,000 0.00 0.00 -
0.00 - 50.00 3,000.00 150,000 0.00 0.00 -
0.00 - 2.00 125,000.00 250,000 0.00 0.00 -
0.00 - 2.00 18,333.00 36,666 0.00 0.00 -
0.00 - 100.00 79,069.00 7,906,900 0.00 0.00 -
0.00 - 1,000.00 347.00 347,000 0.00 0.00 -
15,603,113.00 66,989.00 34,637,866.00 1.00 52,704.00
Kepala Puskesmas
Alue Sungai Pinang
Wildan, SKM
Nip. 19691225 199303 1 002
bulan 1-5 harga 2016
PER 28 FEBRUARI 2018
SALDO AWAL PER 01 FEBRUARI 2018 PENERIMAAN PEMAKAIAN

NO URAIAN Satuan
Nilai Persediaan
Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan
(Rp)
1 2 3 3 4 5 6 8 9
1 Albendazol tab 400 mg Tab 80.00 359.00 28,720.00 0.00 0.00 0.00 0.00 0.00
2 Alopurinol tab 100 mg Tab 410.00 95.00 38,950.00 500.00 95.00 47,500.00 230.00 95.00
3 Ambroxol syrup 15 mg/ml - 60 ml Tab 145.00 4,000.00 580,000.00 144.00 4,000.00 576,000.00 228.00 4,000.00
4 Ambroxol tablet 30 mg Tab 910.00 150.00 136,500.00 200.00 150.00 30,000.00 820.00 150.00
5 Amitriptilin tab sal 25 mg Tab sal 180.00 200.00 36,000.00 0.00 0.00 0.00 0.00 0.00
6 Amlodipin tab 10 mg Tab 570.00 107.00 60,990.00 0.00 0.00 0.00 130.00 107.00
8 Amoksisilin sir kering 125 mg/5 ml Botol 75.00 2,200.00 165,000.00 120.00 2,200.00 264,000.00 94.00 2,200.00
9 Amoksisilin tab 250 mg Tab 500.00 191.00 95,500.00 0.00 0.00 0.00 500.00 191.00
10 Amoksisilin tab 500 mg Tab 700.00 233.00 163,100.00 3,500.00 233.00 815,500.00 2,360.00 233.00

11 Vial 25.00 2,227.00 55,675.00 0.00 0.00 0.00 0.00 0.00

12 Tab 970.00 78.00 75,660.00 1,000.00 78.00 78,000.00 1,050.00 78.00

13 Botol 194.00 2,106.00 408,564.00 50.00 2,106.00 105,300.00 136.00 2,106.00

14 Tube 17.00 2,767.00 47,039.00 200.00 2,767.00 553,400.00 63.00 2,767.00
15 Tube 17.00 4,972.00 84,524.00 0.00 0.00 0.00 4.00 4,972.00
16 Asam askorbat (vitamin C) tab 250 mg Tab 360.00 139.00 50,040.00 500.00 139.00 69,500.00 120.00 139.00
17 Asam askorbat (vitamin C) tab 50 mg Tab 1,290.00 120.00 154,800.00 0.00 0.00 0.00 470.00 120.00
18 Asam mefenamat kaps 500 mg Kaps 630.00 127.00 80,010.00 1,000.00 127.00 127,000.00 980.00 127.00
19 Asam Traneksamat tablet (Nexa tab) tablet 910.00 1,800.00 1,638,000.00 0.00 0.00 0.00 40.00 1,800.00
20 Asam Traneksamat injeksi 100 mg/5 ml Ampul 15.00 2,536.00 38,040.00 0.00 0.00 0.00 0.00 0.00
21 Asiklovir krim 5 % - 5 gram Tube 88.00 3,000.00 264,000.00 0.00 0.00 0.00 66.00 3,000.00
22 Asiklovir tab 400 mg Tab 1,060.00 368.00 390,080.00 0.00 0.00 0.00 80.00 368.00
23 Atapulgit 600 mg Tab 700.00 166.00 116,200.00 200.00 166.00 33,200.00 490.00 166.00
24 Bedak salisil serb 2% Botol 41.00 1,066.00 43,706.00 20.00 1,066.00 21,320.00 19.00 1,066.00
25 Betametason krim 0,5 mg/g Tube 97.00 1,435.00 139,195.00 144.00 1,435.00 206,640.00 113.00 1,435.00
26 Bisakodil tab sal 5 mg (Dulcolax) Tab sal 330.00 2,700.00 891,000.00 0.00 0.00 0.00 0.00 0.00
27 Cetirizine tablet 10 mg Tab 790.00 115.00 90,850.00 1,500.00 115.00 172,500.00 1,420.00 115.00
28 Cetirizine sir 5 mg/5 ml. Botol 212.00 3,300.00 699,600.00 0.00 0.00 0.00 27.00 3,300.00
29 Deksametason inj 5 mg/ml (i.v./i.m.) Vial 34.00 1,805.00 61,370.00 0.00 0.00 0.00 11.00 1,805.00
30 Deksametason tab 0,5 mg Tab 739.00 48.00 35,472.00 2,000.00 45.00 90,000.00 1,619.00 45.00
31 Diazepam tab 2 mg Tab 281.00 100.00 28,100.00 0.00 0.00 0.00 125.00 100.00
32 Difenhidramin inj 10 mg/ml (i.v./i.m.) Ampul 37.00 1,222.00 45,214.00 0.00 0.00 0.00 0.00 0.00
33 Digoksin tab 0,25 mg Tab 200.00 103.00 20,600.00 0.00 0.00 0.00 0.00 0.00
34 Domperidon susp 5 mg/5 ml Botol 60.00 3,180.00 190,800.00 0.00 0.00 0.00 36.00 3,180.00
35 Domperidon tab 10 mg Tab 720.00 116.00 83,520.00 0.00 0.00 0.00 50.00 116.00
36 Efedrin HCl tablet 25 mg Tab 240.00 200.00 48,000.00 0.00 0.00 0.00 240.00 0.00
37 Eritromisin kaps 250 mg Kaps 300.00 647.00 194,100.00 0.00 0.00 0.00 0.00 0.00
38 Eritromisin sir 200 mg/5 ml Botol 2.00 6,461.00 12,922.00 0.00 0.00 0.00 2.00 6,461.00
39 Eritromisin tab 500 mg Tab 440.00 781.00 343,640.00 0.00 0.00 0.00 60.00 781.00
40 Etakridin ( Rivanol ) larutan 0,1% - 300 ml botol 8.00 3,060.00 24,480.00 0.00 0.00 0.00 0.00 0.00
41 Etanol 70 % 1000 ml Botol 3.00 25,800.00 77,400.00 0.00 0.00 0.00 0.00 0.00
42 Etanol 70% 100 ml Botol 14.00 2,625.00 36,750.00 0.00 0.00 0.00 1.00 2,625.00
43 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 150.00 698.00 104,700.00 0.00 0.00 0.00 0.00 0.00
44 Flunarizin tablet 5 mg Tab 440.00 1,000.00 440,000.00 200.00 1,000.00 200,000.00 110.00 1,000.00
45 Furosemid tab 40 mg Tab 50.00 84.00 4,200.00 200.00 84.00 16,800.00 130.00 84.00

46 0,52 g + kalium klorida 0,30 g + trinatrium Sachet 239.00 273.00 65,247.00 0.00 0.00 0.00 16.00 273.00
47 Gentamisin salep kulit 3 % - 5 gram Tube 98.00 3,000.00 294,000.00 20.00 3,000.00 60,000.00 54.00 3,000.00
48 Gentian Violet larutan 1 % -10 ml Botol 24.00 2,500.00 60,000.00 12.00 2,500.00 30,000.00 11.00 2,500.00
49 Glibenklamid tab 5 mg Tab 870.00 135.00 117,450.00 500.00 135.00 67,500.00 640.00 135.00
50 Glimepirid tab 2 mg Tab 500.00 296.00 148,000.00 0.00 0.00 0.00 0.00 0.00
51 Gliseril Guayakolat tablet 100 mg Tab 2,150.00 100.00 215,000.00 2,000.00 100.00 200,000.00 2,080.00 100.00
52 Gliserin tts 100 mg/ml Botol 4.00 6,600.00 26,400.00 0.00 0.00 0.00 0.00 0.00
53 Glukosa Larutan Infus 5% steril 500 ml Botol 15.00 5,720.00 85,800.00 0.00 0.00 0.00 1.00 5,720.00
54 Griseofulvin (micronized) tab 125 mg Tab 1,100.00 263.00 289,300.00 0.00 0.00 0.00 30.00 263.00
55 Haloperidol tab 0,5 mg Tab 1,730.00 64.00 110,720.00 0.00 0.00 0.00 30.00 64.00
57 Haloperidol tab 5 mg Tab 1,170.00 74.00 86,580.00 0.00 0.00 0.00 0.00 74.00
58 Hidrokortison krim 2,5% Tube 33.00 2,838.00 93,654.00 96.00 2,838.00 272,448.00 28.00 2,838.00
59 Ibuprofen tab 200 mg Tab 640.00 108.00 69,120.00 700.00 108.00 75,600.00 930.00 108.00
61 Isosorbid dinitrat tab 5 mg Tab 600.00 98.00 58,800.00 0.00 0.00 0.00 0.00 0.00
62 Kalsium laktat (kalk) tab 500 mg Tab 530.00 82.00 43,460.00 1,000.00 82.00 82,000.00 230.00 82.00
63 Kaolin pektin syrup Botol 75.00 4,000.00 300,000.00 0.00 0.00 0.00 12.00 4,000.00
64 Kaptopril tab 12,5 mg Tab 90.00 69.00 6,210.00 0.00 0.00 0.00 90.00 69.00
65 Kaptopril tab 25 mg Tab 1,640.00 86.00 141,040.00 0.00 0.00 0.00 820.00 86.00
66 Karbamazepin Tab 200 mg Tablet 160.00 230.00 36,800.00 0.00 0.00 0.00 60.00 230.00
67 Kenalaog in orabase salep Tube 3.00 65,000.00 195,000.00 0.00 0.00 0.00 0.00 0.00
68 Ketokonazol krim 2 % - 15 grm Tube 34.00 3,135.00 106,590.00 0.00 0.00 0.00 34.00 3,135.00
69 Ketokonazol tab 200 mg Tab 180.00 358.00 64,440.00 0.00 0.00 0.00 70.00 358.00
70 Kloramfenikol salep kulit 2% Tube 48.00 3,327.00 159,696.00 0.00 0.00 0.00 13.00 3,327.00
71 Kloramfenikol salep mata 1% Tube 88.00 1,850.00 162,800.00 0.00 0.00 0.00 29.00 1,850.00
72 Kloramfenikol susp 125 mg/5 ml Botol 5.00 4,982.00 24,910.00 0.00 0.00 0.00 0.00 0.00
73 Kloramfenikol tetes telinga 3% Botol 31.00 7,700.00 238,700.00 0.00 0.00 0.00 7.00 7,700.00
74 Kloramfenikol tts mata 0,5% Botol 77.00 7,700.00 592,900.00 0.00 0.00 0.00 23.00 7,700.00
75 Klorfeniramin tab 4 mg Tab 2,180.00 45.00 98,100.00 3,000.00 45.00 135,000.00 2,740.00 45.00
76 Klorpromazin tab sal 100 mg Tab sal 1,114.00 148.00 164,872.00 0.00 0.00 171.00 148.00
77 Kombinasi : ergotamin 1 mg+ kafein 50 mg Tab 80.00 210.00 16,800.00 200.00 210.00 42,000.00 34.00 210.00

78 Tab sal 238.00 223.00 53,074.00 2,000.00 223.00 446,000.00 478.00 223.00
0,25 mg
Tab sal 710.00 45.00 31,950.00 0.00 0.00 0.00 560.00 45.00
0,25 mg

79 Tab 200.00 131.00 26,200.00 0.00 0.00 0.00 40.00 131.00
Tab 200.00 158.00 31,600.00 0.00 0.00 0.00 0.00 0.00

80 suspensi : sulfametoksazol 200 mg + Botol 102.00 2,225.00 226,950.00 0.00 0.00 0.00 83.00 2,225.00
trimetoprim 40 mg
81 Lidokain injeksi 2% - 2 ml Ampul 25.00 1,280.00 32,000.00 0.00 0.00 0.00 0.00 0.00
82 Metformin tab 500 mg Tab 400.00 119.00 47,600.00 500.00 119.00 59,500.00 450.00 119.00
83 Metilergometrin inj 0,2 mg/ml Ampul 20.00 3,278.00 65,560.00 0.00 0.00 0.00 0.00 0.00
84 Metronidazol tab 250 mg Tab 1,055.00 94.00 99,170.00 0.00 0.00 0.00 45.00 94.00
85 Metronidazol tab 500 mg Tab 650.00 115.00 74,750.00 0.00 0.00 0.00 150.00 115.00
86 Mikonazol krim 2% Tube 76.00 4,250.00 323,000.00 120.00 4,250.00 510,000.00 65.00 4,250.00
87 Multivitamin Tab 1,850.00 249.00 460,650.00 0.00 0.00 0.00 940.00 249.00
88 Multivitamin Syrup Botol 86.00 3,850.00 331,100.00 250.00 3,850.00 962,500.00 155.00 3,850.00
89 NaCl 0,9% Larutan Botol 33.00 5,170.00 170,610.00 0.00 0.00 0.00 5.00 5,170.00
90 Natrium Bikarbonat tablet 500 mg Tab 1,200.00 58.00 69,600.00 0.00 0.00 0.00 0.00 58.00
91 Natrium diklofenak tab 25 mg Tab 70.00 167.00 11,690.00 700.00 167.00 116,900.00 510.00 167.00
92 Natrium diklofenak tab 50 mg Tab 40.00 200.00 8,000.00 0.00 0.00 0.00 0.00 0.00
Natrium diklofenak tab 50 mg Tab 500.00 161.00 80,500.00 500.00 161.00 80,500.00 0.00 0.00
93 Nifedipin kaps 10 mg Kaps 950.00 120.00 114,000.00 1,000.00 120.00 120,000.00 980.00 120.00
94 Nistatin tab salut 500.000 UI Tab 200.00 881.00 176,200.00 0.00 0.00 0.00 0.00 0.00
95 Obat Batuk Hitam ( O.B.H. ) cairan - 100 ml Botol 66.00 3,000.00 198,000.00 0.00 0.00 0.00 26.00 3,000.00
96 Obat Flu tablet Tablet 470.00 1,000.00 470,000.00 300.00 1,000.00 300,000.00 360.00 1,000.00
97 Obat Flu Syrup Botol 59.00 10,000.00 590,000.00 0.00 0.00 0.00 59.00 10,000.00
98 Oksitetrasiklin salep kulit 3% (HCl) - 5 gr Tube 102.00 2,864.00 292,128.00 50.00 2,864.00 143,200.00 65.00 2,864.00
99 Oksitetrasiklin salep mata 1% (HCl) - 3,5 gr Tube 71.00 3,000.00 213,000.00 0.00 0.00 0.00 7.00 3,000.00
100 Omeprazol kaps 20 mg Kaps 1,170.00 148.00 173,160.00 0.00 0.00 0.00 500.00 148.00
101 Parasetamol sir 120 mg/5 ml Botol 71.00 1,119.00 79,449.00 300.00 1,119.00 335,700.00 232.00 1,119.00
102 Parasetamol tab 500 mg Tab 2,940.00 105.00 308,700.00 6,400.00 105.00 672,000.00 5,830.00 105.00
103 Pehacain Injeksi ampul 48.00 313.00 15,024.00 0.00 0.00 0.00 10.00 313.00
104 Perak sulfadiazin krim 1% Tube 6.00 20,700.00 124,200.00 0.00 0.00 0.00 1.00 20,700.00
105 Pirantel pamoat tab scored 125 mg Tab 100.00 318.00 31,800.00 0.00 0.00 0.00 9.00 318.00
106 Piridoksin (vitamin B6) tab 10 mg Tab 580.00 136.00 78,880.00 500.00 136.00 68,000.00 490.00 136.00
107 Piroksikam kapsul 10 mg Tab 660.00 90.00 59,400.00 500.00 90.00 45,000.00 160.00 90.00
109 Povidon iodin lar 100 mg/ml Botol 30 ml 10.00 4,150.00 41,500.00 0.00 0.00 0.00 4.00 4,150.00
Botol 300
110 Povidon iodin lar 100 mg/ml 4.00 35,000.00 140,000.00 0.00 0.00 0.00 2.00 35,000.00
ml
111 Prednison tab 5 mg Tab 1,070.00 85.00 90,950.00 500.00 85.00 42,500.00 620.00 85.00
112 Ranitidin injeksi 25 mg/ml - 2ml Ampul 0.00 0.00 0.00 10.00 1,677.00 16,770.00 10.00 1,677.00
113 Ranitidin tab 150 mg Tab 895.00 110.00 98,450.00 2,000.00 110.00 220,000.00 1,795.00 110.00
114 Retinol (vitamin A) kaps lunak 200.000 UI Kaps lunak 0.00 0.00 0.00 50.00 500.00 25,000.00 8.00 500.00
115 Ringer Laktat Larutan Botol 13.00 7,150.00 92,950.00 0.00 0.00 0.00 0.00
116 Salbutamol tab 2 mg Tab 1,120.00 68.00 76,160.00 0.00 0.00 0.00 130.00 68.00
118 Tube 12.00 2,907.00 34,884.00 0.00 0.00 0.00 0.00 0.00
belerang endap 4 %
Tube 24.00 2,797.00 67,128.00 0.00 0.00 0.00 0.00 0.00
belerang endap 4 %
119 Sefadroksil kapsul 500 mg Tab 310.00 455.00 141,050.00 0.00 0.00 0.00 280.00 455.00
Sefadroksil kapsul 500 mg Tab 800.00 557.00 445,600.00 0.00 0.00 0.00 0.00 0.00
120 Sefadroksil sirup kering 125mg/5ml - 60 ml Botol 60.00 4,133.00 247,980.00 0.00 0.00 0.00 3.00 4,133.00
121 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 50.00 1,226.00 61,300.00 0.00 0.00 0.00 11.00 1,226.00
122 Sianokobalamin (vitamin B12) tab 50 mcg Tab 1,090.00 58.00 63,220.00 500.00 58.00 29,000.00 760.00 58.00
123 Simvastatin tab sal 10 mg Tab sal 530.00 113.00 59,890.00 0.00 0.00 0.00 80.00 113.00
125 Siprofloksasin tab scored 500 mg Tab 360.00 254.00 91,440.00 0.00 0.00 0.00 310.00 254.00
Siprofloksasin tab scored 500 mg Tab 800.00 298.00 238,400.00 0.00 0.00 0.00 0.00 0.00
126 Tetrasiklin kaps 250 mg Kaps 800.00 181.00 144,800.00 0.00 0.00 0.00 0.00 0.00
127 Tetrasiklin kaps 500 mg Kaps 1,320.00 329.00 434,280.00 0.00 0.00 0.00 120.00 329.00
128 Tiamin (vitamin B1) tab 50 mg Tab 490.00 91.00 44,590.00 1,000.00 91.00 91,000.00 890.00 91.00
129 Triheksifenidil tab 2 mg Tab 975.00 80.00 78,000.00 0.00 0.00 0.00 245.00 80.00
130 Trombopop gel Tube 2.00 65,000.00 130,000.00 0.00 0.00 0.00 0.00 0.00
131 Ulsidex - Sukralfat tablet 500 mg Tab 400.00 368.00 147,200.00 0.00 0.00 0.00 200.00 368.00
132 Vitamin B kompleks Tab 2,140.00 132.00 282,480.00 0.00 0.00 0.00 300.00 132.00
133 Zinc sir 20 mg/5 ml Botol 102.00 4,959.00 505,818.00 0.00 0.00 0.00 37.00 4,959.00
134 Zinc tab disp 20 mg Tab 670.00 591.00 395,970.00 0.00 0.00 0.00 150.00 591.00
136 Betahistin tablet 6 mg Tablet 680.00 151.00 102,680.00 0.00 0.00 0.00 210.00 151.00
137 Alat Suntik Sekali Pakai 1 ml Pcs 133.00 848.00 112,784.00 0.00 0.00 0.00 1.00 848.00
138 Alat Suntik Sekali Pakai 2,5 ml Pcs 242.00 714.00 172,788.00 0.00 0.00 0.00 105.00 714.00
140 Alkohol Swab set 0.00 0.00 200.00 181.00 36,200.00 0.00 0.00
141 Aseptic gel 500 ml Botol 6.00 26,400.00 158,400.00 0.00 0.00 0.00 0.00 0.00
142 Pcs 32.00 7,286.00 233,152.00 0.00 0.00 0.00 0.00 0.00
jarum bedah
143 Disposible needle 23 Set 0.00 0.00 100.00 362.00 36,200.00 0.00 0.00
144 HandScun pcs 774.00 520.00 402,480.00 0.00 0.00 0.00 200.00 520.00
145 Infusion Set Dewasa Set 9.00 5,856.00 52,704.00 0.00 0.00 0.00 0.00 0.00
146 IV Catheter No. 20 G Set 19.00 4,959.00 94,221.00 0.00 0.00 0.00 0.00 0.00
147 IV Catheter No. 22 G Set 15.00 5,254.00 78,810.00 0.00 0.00 0.00 3.00 5,254.00
149 Kapas Pembalut / Absorben 250 gram Roll 2.00 16,313.00 32,626.00 0.00 0.00 0.00 2.00 16,313.00
150 Kasa Hydrophil 40 x 80 cm roll 1.00 120,750.00 120,750.00 1.00 120,750.00 120,750.00 1.00 120,750.00
151 Kasa Kompres 40/40 Steril pcs 49.00 1,532.00 75,068.00 100.00 1,532.00 153,200.00 33.00 1,532.00
152 Kasa Pembalut 2 m x 80 cm roll 8.00 8,855.00 70,840.00 10.00 8,855.00 88,550.00 5.00 8,855.00
153 Kasa Pembalut Hidrofil 4 m x 15 cm Elastic Rol 5.00 2,415.00 12,075.00 10.00 2,415.00 24,150.00 0.00 0.00
154 Kasa Pembalut Hidrofil 4 m x 5 cm Elastic roll 28.00 334.00 9,352.00 0.00 0.00 0.00 0.00 0.00
155 Kassa steril 16 cm x 16 cm roll 14.00 5,000.00 70,000.00 0.00 0.00 0.00 2.00 5,000.00
156 Lomatuell H/Lomatul Pcs 9.00 15,000.00 135,000.00 10.00 15,000.00 150,000.00 0.00 0.00
157 Masker pcs 282.00 586.00 165,252.00 0.00 0.00 0.00 10.00 586.00
158 Masker N 95 pcs 20.00 7,324.00 146,480.00 0.00 0.00 0.00 0.00 0.00
159 Pisau Bisturi No. 10 Buah 25.00 3,150.00 78,750.00 0.00 0.00 0.00 6.00 3,150.00
160 Pisau Bisturi no. 15 set 17.00 3,150.00 53,550.00 0.00 0.00 0.00 1.00 3,150.00
161 Plester 5 yards x 2 inch roll 9.00 40,000.00 360,000.00 0.00 0.00 0.00 3.00 40,000.00
162 pcs 19.00 3,514.00 66,766.00 0.00 0.00 0.00 0.00 0.00
jarum bedah
163 Strip tes asam urat (easytouch) Btl 25 pcs 1.00 90,000.00 90,000.00 7.00 90,000.00 630,000.00 4.00 90,000.00
164 Strip tes gula darah (autocheck) Btl 25 pcs 0.00 0.00 0.00 7.00 90,000.00 630,000.00 3.00 90,000.00
165 Strip tes gula darah (easytouch) Btl 25 pcs 0.00 0.00 0.00 2.00 90,000.00 180,000.00 0.00 0.00
166 Strip tes HB (easytouch) Btl 25 pcs 3.00 165,000.00 495,000.00 0.00 0.00 1.00 165,000.00
167 Strip tes kolesterol (autocheck) Btl 10 pcs 0.00 0.00 0.00 5.00 165,000.00 825,000.00 1.00 165,000.00
168 Strip tes kolesterol (easytouch) Btl 10 pcs 1.00 170,000.00 170,000.00 0.00 0.00 0.00 1.00 0.00
169 Test pek Hamil Pcs 50.00 3,000.00 150,000.00 0.00 0.00 0.00 0.00 0.00
170 Etil klorida semprot 100 ml Botol 2.00 125,000.00 250,000.00 0.00 0.00 0.00 0.00 0.00
171 Eugenol Botol 2.00 18,333.00 36,666.00 0.00 0.00 0.00 0.00 0.00
172 Saliva ejector blue woodpecker pcs 100.00 79,069.00 7,906,900.00 0.00 0.00 0.00 0.00 0.00
173 Risperidon 2 mg Tablet 1,000.00 347.00 347,000.00 0.00 0.00 0.00 0.00 0.00
TOTAL HARGA 66,989.00 34,637,866.00 37,638.00 11,670,328.00 39,918.00
Jeumpa, 28 Februari 2018

Yang diperiksa

Nip. 19830727 201212 2 004
SALDO EXPIRE DATE PER 28 FEBRUARI
PEMAKAIAN SALDO AKHIR PER 28 FEBRUARI 2018
2018
Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan
(Rp) (Rp)
11 12 14 15 16 17
- 80.00 359.00 28,720 0.00 0.00 -
21,850.00 680.00 95.00 64,600 0.00 0.00 -
912,000.00 61.00 4,000.00 244,000 0.00 0.00 -
123,000.00 290.00 150.00 43,500 0.00 0.00 -
- 180.00 200.00 36,000 0.00 0.00 -
13,910.00 440.00 107.00 47,080 0.00 0.00 -
1,800.00 340.00 90.00 30,600 0.00 0.00 -
206,800.00 101.00 2,200.00 222,200 0.00 0.00 -
95,500.00 0.00 0.00 - 0.00 0.00 -
549,880.00 1,840.00 233.00 428,720 0.00 0.00 -
- 25.00 2,227.00 55,675 0.00 0.00 -
81,900.00 920.00 78.00 71,760 0.00 0.00 -
286,416.00 108.00 2,106.00 227,448 0.00 0.00 -
174,321.00 154.00 2,767.00 426,118 0.00 0.00 -
19,888.00 13.00 4,972.00 64,636 0.00 0.00 -
16,680.00 740.00 139.00 102,860 0.00 0.00 -
56,400.00 820.00 120.00 98,400 0.00 0.00 -
124,460.00 650.00 127.00 82,550 0.00 0.00 -
72,000.00 870.00 1,800.00 1,566,000 0.00 0.00 -
- 15.00 2,536.00 38,040 0.00 0.00 -
198,000.00 22.00 3,000.00 66,000 0.00 0.00 -
29,440.00 980.00 368.00 360,640 0.00 0.00 -
81,340.00 410.00 166.00 68,060 0.00 0.00 -
20,254.00 42.00 1,066.00 44,772 0.00 0.00 -
162,155.00 128.00 1,435.00 183,680 0.00 0.00 -
- 330.00 2,700.00 891,000 0.00 0.00 -
163,300.00 870.00 115.00 100,050 0.00 0.00 -
89,100.00 185.00 3,300.00 610,500 0.00 0.00 -
19,855.00 23.00 1,805.00 41,515 0.00 0.00 -
72,855.00 1,120.00 45.00 50,400 0.00 0.00 -
12,500.00 156.00 100.00 15,600 0.00 0.00 -
- 37.00 1,222.00 45,214 0.00 0.00 -
- 200.00 103.00 20,600 0.00 0.00 -
114,480.00 24.00 3,180.00 76,320 0.00 0.00 -
5,800.00 670.00 116.00 77,720 0.00 0.00 -
- 0.00 0.00 - 240.00 200.00 48,000.00
- 300.00 647.00 194,100 0.00 0.00 -

12,922.00 0.00 6,461.00 - 0.00 0.00 -
46,860.00 380.00 781.00 296,780 0.00 0.00 -
- 8.00 3,060.00 24,480 0.00 0.00 -
- 3.00 25,800.00 77,400 0.00 0.00 -
2,625.00 13.00 2,625.00 34,125 0.00 0.00 -
- 150.00 698.00 104,700 0.00 0.00 -
110,000.00 530.00 1,000.00 530,000 0.00 0.00 -
10,920.00 120.00 84.00 10,080 0.00 0.00 -
4,368.00 223.00 273.00 60,879 0.00 0.00 -
162,000.00 64.00 3,000.00 192,000 0.00 0.00 -
27,500.00 25.00 2,500.00 62,500 0.00 0.00 -
86,400.00 730.00 135.00 98,550 0.00 0.00 -
- 500.00 296.00 148,000 0.00 0.00 -
208,000.00 2,070.00 100.00 207,000 0.00 0.00 -
- 4.00 6,600.00 26,400 0.00 0.00 -
5,720.00 14.00 5,720.00 80,080 0.00 0.00 -
7,890.00 1,070.00 263.00 281,410 0.00 0.00 -
1,920.00 1,700.00 64.00 108,800 0.00 0.00 -
11,400.00 910.00 76.00 69,160 0.00 0.00 -
- 1,170.00 74.00 86,580 0.00 0.00 -
79,464.00 101.00 2,838.00 286,638 0.00 0.00 -
100,440.00 410.00 108.00 44,280 0.00 0.00 -
75,810.00 620.00 133.00 82,460 0.00 0.00 -
- 600.00 98.00 58,800 0.00 0.00 -
18,860.00 1,300.00 82.00 106,600 0.00 0.00 -
48,000.00 63.00 4,000.00 252,000 0.00 0.00 -
6,210.00 0.00 0.00 - 0.00 0.00 -
70,520.00 820.00 86.00 70,520 0.00 0.00 -
13,800.00 100.00 230.00 23,000 0.00 0.00 -
- 3.00 65,000.00 195,000 0.00 0.00 -
106,590.00 0.00 - 22.00 3,135.00 68,970.00
25,060.00 110.00 358.00 39,380 0.00 0.00 -
43,251.00 35.00 3,327.00 116,445 0.00 0.00 -
53,650.00 59.00 1,850.00 109,150 15.00 1,850.00 27,750.00
- 5.00 4,982.00 24,910 0.00 0.00 -
53,900.00 24.00 7,700.00 184,800 0.00 0.00 -
177,100.00 54.00 7,700.00 415,800 0.00 0.00 -
123,300.00 2,440.00 45.00 109,800 0.00 0.00 -
25,308.00 943.00 148.00 139,564 0.00 0.00 -
7,140.00 246.00 210.00 51,660 0.00 0.00 -
106,594.00 1,760.00 223.00 392,480 0.00 0.00 -
25,200.00 150.00 45.00 6,750 0.00 0.00 -
5,240.00 160.00 131.00 20,960 0.00 0.00 -

- 200.00 158.00 31,600 0.00 0.00 -
184,675.00 19.00 2,225.00 42,275 0.00 0.00 -
- 25.00 1,280.00 32,000 0.00 0.00 -
53,550.00 450.00 119.00 53,550 0.00 0.00 -
- 20.00 3,278.00 65,560 0.00 0.00 -
4,230.00 1,010.00 94.00 94,940 0.00 0.00 -
17,250.00 500.00 115.00 57,500 0.00 0.00 -
276,250.00 131.00 4,250.00 556,750 0.00 0.00 -
234,060.00 910.00 249.00 226,590 0.00 0.00 -
596,750.00 181.00 3,850.00 696,850 0.00 0.00 -
25,850.00 28.00 5,170.00 144,760 0.00 0.00 -
- 1,200.00 58.00 69,600 0.00 0.00 -
85,170.00 260.00 167.00 43,420 0.00 0.00 -
- 40.00 200.00 8,000 0.00 0.00 -
- 1,000.00 161.00 161,000 0.00 0.00 -
117,600.00 970.00 120.00 116,400 0.00 0.00 -
- 200.00 881.00 176,200 0.00 0.00 -
78,000.00 40.00 3,000.00 120,000 0.00 0.00 -
360,000.00 410.00 1,000.00 410,000 0.00 0.00 -
590,000.00 0.00 0.00 - 0.00 0.00 -
186,160.00 87.00 2,864.00 249,168 0.00 0.00 -
21,000.00 64.00 3,000.00 192,000 0.00 0.00 -
74,000.00 670.00 148.00 99,160 0.00 0.00 -
259,608.00 139.00 1,119.00 155,541 0.00 0.00 -
612,150.00 3,510.00 105.00 368,550 0.00 0.00 -
3,130.00 38.00 313.00 11,894 0.00 0.00 -
20,700.00 5.00 20,700.00 103,500 0.00 0.00 -
2,862.00 91.00 318.00 28,938 209.00 91.00 19,019.00
66,640.00 590.00 136.00 80,240 0.00 0.00 -
14,400.00 1,000.00 90.00 90,000 0.00 0.00 -
39,000.00 490.00 150.00 73,500 0.00 0.00 -
16,600.00 6.00 4,150.00 24,900 0.00 0.00 -
70,000.00 2.00 35,000.00 70,000 0.00 0.00 -
52,700.00 950.00 85.00 80,750 0.00 0.00 -
16,770.00 0.00 0.00 - 0.00 0.00 -
197,450.00 1,100.00 110.00 121,000 0.00 0.00 -
4,000.00 42.00 500.00 21,000 0.00 0.00 -
- 13.00 7,150.00 92,950 0.00 0.00 -
8,840.00 990.00 68.00 67,320 0.00 0.00 -
2,670.00 1,070.00 89.00 95,230 0.00 0.00 -
- 12.00 2,907.00 34,884 0.00 0.00 -
0.00 24.00 2,797.00 67,128 0.00 0.00 -
127,400.00 30.00 455.00 13,650 0.00 0.00 -
0.00 800.00 557.00 445,600 0.00 0.00 -
12,399.00 57.00 4,133.00 235,581 0.00 0.00 -

13,486.00 39.00 1,226.00 47,814 0.00 0.00 -
44,080.00 830.00 58.00 48,140 0.00 0.00 -
9,040.00 450.00 113.00 50,850 0.00 0.00 -
37,800.00 170.00 252.00 42,840 0.00 0.00 -
78,740.00 50.00 254.00 12,700 0.00 0.00 -
- 800.00 298.00 238,400 0.00 0.00 -
- 800.00 181.00 144,800 0.00 0.00 -
39,480.00 1,200.00 329.00 394,800 0.00 0.00 -
80,990.00 600.00 91.00 54,600 0.00 0.00 -
19,600.00 730.00 80.00 58,400 0.00 0.00 -
- 2.00 65,000.00 130,000 0.00 0.00 -
73,600.00 200.00 368.00 73,600 0.00 0.00 -
39,600.00 1,840.00 132.00 242,880 0.00 0.00 -
183,483.00 65.00 4,959.00 322,335 0.00 0.00 -
88,650.00 520.00 591.00 307,320 0.00 0.00 -
- 10.00 17,500.00 175,000 0.00 0.00 -
31,710.00 470.00 151.00 70,970 0.00 0.00 -
848.00 132.00 848.00 111,936 0.00 0.00 -
74,970.00 137.00 714.00 97,818 0.00 0.00 -
3,096.00 82.00 774.00 63,468 0.00 0.00 -
- 200.00 181.00 36,200 0.00 0.00 -
- 6.00 26,400.00 158,400 0.00 0.00 -
- 32.00 7,286.00 233,152 0.00 0.00 -
- 100.00 362.00 36,200 0.00 0.00 -
104,000.00 574.00 520.00 298,480 0.00 0.00 -
- 9.00 5,856.00 52,704 0.00 0.00 -
- 19.00 4,959.00 94,221 0.00 0.00 -
15,762.00 12.00 5,254.00 63,048 0.00 0.00 -
- 19.00 5,687.00 108,053 0.00 0.00 -
32,626.00 0.00 0.00 - 0.00 0.00 -
120,750.00 1.00 120,750.00 120,750 0.00 0.00 -
50,556.00 116.00 1,532.00 177,712 0.00 0.00 -
44,275.00 13.00 8,855.00 115,115 0.00 0.00 -
- 15.00 2,415.00 36,225 0.00 0.00 -
- 28.00 334.00 9,352 0.00 0.00 -
10,000.00 12.00 5,000.00 60,000 0.00 0.00 -
- 19.00 15,000.00 285,000 0.00 0.00 -
5,860.00 272.00 586.00 159,392 0.00 0.00 -
- 20.00 7,324.00 146,480 0.00 0.00 -
18,900.00 19.00 3,150.00 59,850 0.00 0.00 -
3,150.00 16.00 3,150.00 50,400 0.00 0.00 -
120,000.00 6.00 40,000.00 240,000 0.00 0.00 -
- 19.00 3,514.00 66,766 0.00 0.00 -
360,000.00 4.00 90,000.00 360,000 0.00 0.00 -
270,000.00 4.00 90,000.00 360,000 0.00 0.00 -
- 2.00 90,000.00 180,000 0.00 0.00 -

165,000.00 2.00 165,000.00 330,000 0.00 0.00 -
165,000.00 4.00 165,000.00 660,000 0.00 0.00 -
- 0.00 0.00 - 0.00 0.00 -
- 50.00 3,000.00 150,000 0.00 0.00 -
- 2.00 125,000.00 250,000 0.00 0.00 -
- 2.00 18,333.00 36,666 1.00 18,333.00 18,333.00
- 100.00 79,069.00 7,906,900 0.00 0.00 -
- 1,000.00 347.00 347,000 0.00 0.00 -
12,326,762.00 64,709.00 33,761,215.00 487.00 182,072.00
Kepala Puskesmas
Alue Sungai Pinang
Wildan, SKM
Nip. 19691225 199303 1 002
PER 29 MARET 2018
SALDO AWAL PER 01 MARET 2018 PENERIMAAN PEMAKAIAN

NO URAIAN Satuan
Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan
(Rp) (Rp)
1 2 3 3 4 5 6 8 9
3 Ambroxol syrup 15 mg/ml - 60 ml Tab 61.00 4,000.00 244,000.00 360.00 4,000.00 1,440,000.00 227.00 4,000.00
4 Ambroxol tablet 30 mg Tab 290.00 150.00 43,500.00 1,500.00 150.00 225,000.00 842.00 150.00
9 Amoksisilin tab 250 mg Tab 0.00 0.00 1,000.00 191.00 191,000.00 450.00 191.00
10 Amoksisilin tab 500 mg Tab 1,840.00 233.00 428,720.00 2,000.00 233.00 466,000.00 2,719.00 233.00

11 Vial 25.00 2,227.00 55,675.00 0.00 0.00 0.00 0.00

12 Tab 920.00 78.00 71,760.00 1,500.00 78.00 117,000.00 1,608.00 78.00

13 Botol 108.00 2,106.00 227,448.00 250.00 2,106.00 526,500.00 177.00 2,106.00

14 Tube 154.00 2,767.00 426,118.00 50.00 2,767.00 138,350.00 95.00 2,767.00
15 Tube 13.00 4,972.00 64,636.00 0.00 0.00 0.00 0.00
16 Asam askorbat (vitamin C) tab 250 mg Tab 740.00 139.00 102,860.00 0.00 0.00 0.00 70.00 139.00
18 Asam mefenamat kaps 500 mg Kaps 650.00 127.00 82,550.00 1,500.00 127.00 190,500.00 1,175.00 127.00
20 Asam Traneksamat injeksi 100 mg/5 ml Ampul 15.00 2,536.00 38,040.00 0.00 0.00 0.00 0.00
21 Asiklovir krim 5 % - 5 gram Tube 22.00 3,000.00 66,000.00 75.00 3,000.00 225,000.00 41.00 3,000.00
22 Asiklovir tab 400 mg Tab 980.00 368.00 360,640.00 0.00 0.00 0.00 30.00 415.00
23 Atapulgit 600 mg Tab 410.00 166.00 68,060.00 300.00 166.00 49,800.00 242.00 166.00
26 Bisakodil tab sal 5 mg (Dulcolax) Tab sal 330.00 2,700.00 891,000.00 0.00 0.00 0.00 14.00 2,700.00
27 Cetirizine tablet 10 mg Tab 870.00 115.00 100,050.00 2,000.00 115.00 230,000.00 1,405.00 115.00
28 Cetirizine sir 5 mg/5 ml. Botol 185.00 3,300.00 610,500.00 60.00 3,300.00 198,000.00 43.00 3,300.00
29 Deksametason inj 5 mg/ml (i.v./i.m.) Vial 23.00 1,805.00 41,515.00 30.00 1,805.00 54,150.00 30.00 1,805.00
30 Deksametason tab 0,5 mg Tab 1,120.00 45.00 50,400.00 1,500.00 45.00 67,500.00 1,584.00 45.00
31 Diazepam tab 2 mg Tab 156.00 100.00 15,600.00 200.00 100.00 20,000.00 136.00 100.00
34 Domperidon susp 5 mg/5 ml Botol 24.00 3,180.00 76,320.00 0.00 0.00 0.00 19.00 3,180.00
35 Domperidon tab 10 mg Tab 670.00 116.00 77,720.00 500.00 116.00 58,000.00 459.00 116.00
37 Eritromisin sir 200 mg/5 ml Botol 0.00 0.00 30.00 6,461.00 193,830.00 1.00 6,461.00
39 Etakridin ( Rivanol ) larutan 0,1% - 300 ml botol 8.00 3,060.00 24,480.00 0.00 0.00 0.00 1.00 3,060.00
40 Etanol 70 % 1000 ml Botol 3.00 25,800.00 77,400.00 0.00 0.00 0.00 0.00 0.00
41 Etanol 70% 100 ml Botol 13.00 2,625.00 34,125.00 0.00 0.00 0.00 2.00 2,625.00
Fitomenadion (vitamin K1) inj 10 mg/ml
43 Ampul 0.00 0.00 30.00 3,754.00 112,620.00 0.00 0.00
(i.m)
44 Flunarizin tablet 5 mg Tab 530.00 1,000.00 530,000.00 0.00 0.00 0.00 110.00 1,000.00
45 Furosemid tab 40 mg Tab 120.00 84.00 10,080.00 0.00 0.00 0.00 0.00 0.00

46 0,52 g + kalium klorida 0,30 g + trinatrium Sachet 223.00 273.00 60,879.00 100.00 273.00 27,300.00 56.00 273.00
48 Gentian Violet larutan 1 % -10 ml Botol 25.00 2,500.00 62,500.00 24.00 2,500.00 60,000.00 9.00 2,500.00
49 Glibenklamid tab 5 mg Tab 730.00 135.00 98,550.00 500.00 135.00 67,500.00 805.00 135.00
51 Gliseril Guayakolat tablet 100 mg Tab 2,070.00 100.00 207,000.00 1,000.00 100.00 100,000.00 984.00 100.00
53 Glukosa Larutan Infus 5% steril 500 ml Botol 14.00 5,720.00 80,080.00 0.00 0.00 0.00 0.00 0.00
54 Griseofulvin (micronized) tab 125 mg Tab 1,070.00 263.00 281,410.00 0.00 0.00 0.00 300.00 263.00
56 Haloperidol tab 1,5 mg Tab 910.00 76.00 69,160.00 0.00 0.00 0.00 140.00 76.00
59 Ibuprofen tab 200 mg Tab 410.00 108.00 44,280.00 1,000.00 108.00 108,000.00 505.00 108.00
60 Ibuprofen tab 400 mg Tab 620.00 133.00 82,460.00 1,000.00 133.00 133,000.00 720.00 133.00
62 Kalsium laktat (kalk) tab 500 mg Tab 1,300.00 82.00 106,600.00 0.00 0.00 0.00 390.00 82.00
63 Kaolin pektin syrup Botol 63.00 4,000.00 252,000.00 0.00 0.00 0.00 0.00 0.00
64 Kaptopril tab 25 mg Tab 820.00 86.00 70,520.00 500.00 86.00 43,000.00 850.00 86.00
67 Ketokonazol krim 2 % - 15 grm Tube 0.00 0.00 0.00 50.00 3,135.00 156,750.00 9.00 3,135.00
69 Kloramfenikol salep kulit 2% Tube 35.00 3,327.00 116,445.00 0.00 0.00 0.00 0.00 0.00
70 Kloramfenikol salep mata 1% Tube 59.00 1,850.00 109,150.00 0.00 0.00 0.00 41.00 1,850.00
72 Kloramfenikol tetes telinga 3% Botol 24.00 7,700.00 184,800.00 0.00 0.00 0.00 15.00 7,700.00
73 Kloramfenikol tts mata 0,5% Botol 54.00 7,700.00 415,800.00 0.00 0.00 0.00 54.00 7,700.00
75 Klorpromazin tab sal 100 mg Tab sal 943.00 148.00 139,564.00 0.00 0.00 0.00 96.00 148.00
76 Kombinasi : ergotamin 1 mg+ kafein 50 mg Tab 246.00 210.00 51,660.00 0.00 0.00 0.00 106.00 210.00
77 Tab sal 1,760.00 223.00 392,480.00 0.00 0.00 0.00 1,615.00 223.00
0,25 mg
Tab sal 150.00 45.00 6,750.00 600.00 45.00 27,000.00 83.00 45.00
0,25 mg

78 Tab 160.00 131.00 20,960.00 0.00 0.00 0.00 160.00 131.00

Tab 200.00 158.00 31,600.00 500.00 158.00 79,000.00 105.00 158.00
79 suspensi : sulfametoksazol 200 mg + Botol 19.00 2,225.00 42,275.00 50.00 2,225.00 111,250.00 27.00 2,225.00
trimetoprim 40 mg
80 Lidokain injeksi 2% - 2 ml Ampul 25.00 1,280.00 32,000.00 0.00 0.00 0.00 5.00 1,280.00
81 Metformin tab 500 mg Tab 450.00 119.00 53,550.00 1,000.00 119.00 119,000.00 611.00 119.00
86 Multivitamin Tab 910.00 249.00 226,590.00 500.00 249.00 124,500.00 975.00 249.00
Natrium diklofenak tab 50 mg Tab 1,000.00 161.00 161,000.00 0.00 0.00 0.00 590.00 161.00
92 Nifedipin kaps 10 mg Kaps 970.00 120.00 116,400.00 1,500.00 110.00 165,000.00 1,170.00 110.00
95 Obat Flu tablet Tablet 410.00 1,000.00 410,000.00 0.00 0.00 0.00 90.00 1,000.00
98 Omeprazol kaps 20 mg Kaps 670.00 148.00 99,160.00 300.00 148.00 44,400.00 300.00 148.00
102 Perak sulfadiazin krim 1% Tube 5.00 20,700.00 103,500.00 0.00 0.00 0.00 1.00 20,700.00
105 Piroksikam kapsul 10 mg Tab 1,000.00 90.00 90,000.00 0.00 0.00 0.00 475.00 90.00
107 Povidon iodin lar 100 mg/ml Botol 30 ml 6.00 4,150.00 24,900.00 15.00 4,150.00 62,250.00 0.00 0.00
108 Povidon iodin lar 100 mg/ml Botol 300 ml 2.00 35,000.00 70,000.00 0.00 0.00 0.00 0.00 0.00
109 Prednison tab 5 mg Tab 950.00 85.00 80,750.00 500.00 85.00 42,500.00 995.00 85.00
110 Ranitidin injeksi 25 mg/ml - 2ml Ampul 0.00 0.00 0.00 20.00 1,677.00 33,540.00 20.00 1,677.00
111 Ranitidin tab 150 mg Tab 1,100.00 110.00 121,000.00 2,000.00 110.00 220,000.00 2,455.00 110.00
112 Retinol (vitamin A) kaps lunak 200.000 UI Kaps lunak 42.00 500.00 21,000.00 0.00 0.00 0.00 9.00 500.00
113 Ringer Laktat Larutan Botol 13.00 7,150.00 92,950.00 0.00 0.00 0.00 0.00 0.00
114 Salbutamol tab 2 mg Tab 990.00 68.00 67,320.00 0.00 0.00 0.00 30.00 68.00
116 Tube 12.00 2,907.00 34,884.00 0.00 0.00 0.00 3.00 2,907.00
belerang endap 4 %
Tube 24.00 2,797.00 67,128.00 0.00 0.00 0.00 0.00 0.00
belerang endap 4 %
Sefadroksil kapsul 500 mg Tab 800.00 557.00 445,600.00 0.00 0.00 0.00 120.00 557.00
119 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 39.00 1,226.00 47,814.00 0.00 0.00 0.00 27.00 1,226.00
120 Sianokobalamin (vitamin B12) tab 50 mcg Tab 830.00 58.00 48,140.00 1,000.00 58.00 58,000.00 1,030.00 58.00
Siprofloksasin tab scored 500 mg Tab 800.00 298.00 238,400.00 0.00 0.00 0.00 210.00 298.00
125 Tetrasiklin kaps 500 mg Kaps 1,200.00 329.00 394,800.00 0.00 0.00 0.00 570.00 329.00
129 Ulsidex - Sukralfat tablet 500 mg Tab 200.00 368.00 73,600.00 200.00 368.00 73,600.00 120.00 368.00
130 Vitamin B kompleks Tab 1,840.00 132.00 242,880.00 0.00 0.00 0.00 1,228.00 132.00
131 Zinc sir 20 mg/5 ml Botol 65.00 4,959.00 322,335.00 50.00 4,959.00 247,950.00 45.00 4,959.00
133 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul 10.00 17,500.00 175,000.00 0.00 0.00 0.00 0.00 0.00
136 Alat Suntik Sekali Pakai 2,5 ml Pcs 137.00 714.00 97,818.00 200.00 714.00 142,800.00 58.00 714.00
138 Alkohol Swab set 200.00 181.00 36,200.00 0.00 0.00 0.00 0.00 0.00
140 Pcs 32.00 7,286.00 233,152.00 0.00 0.00 0.00 7.00 7,286.00
jarum bedah
141 Disposible needle 23 Set 100.00 362.00 36,200.00 0.00 0.00 0.00 0.00 0.00
142 HandScun pcs 574.00 520.00 298,480.00 0.00 0.00 0.00 174.00 520.00
143 Infusion Set Anak Set 0.00 0.00 0.00 10.00 4,025.00 40,250.00 0.00 0.00
Infusion Set Dewasa Set 0.00 0.00 0.00 10.00 4,176.00 41,760.00 0.00 0.00
145 Infusion Set Y-Connector Pcs 0.00 0.00 0.00 20.00 6,280.00 125,600.00 0.00 0.00
149 Kapas Pembalut / Absorben 250 gram Roll 0.00 0.00 0.00 4.00 16,313.00 65,252.00 1.00 16,313.00
150 Kasa Hydrophil 40 x 80 cm roll 1.00 120,750.00 120,750.00 1.00 120,750.00 120,750.00 1.00 120,750.00
151 Kasa Kompres 40/40 Steril pcs 116.00 1,532.00 177,712.00 0.00 0.00 0.00 31.00 1,532.00
152 Kasa Pembalut 2 m x 80 cm roll 13.00 8,855.00 115,115.00 0.00 0.00 0.00 0.00 0.00
153 Kasa Pembalut Hidrofil 4 m x 15 cm Elastic Rol 15.00 2,415.00 36,225.00 0.00 0.00 0.00 0.00 0.00
156 Lomatuell H/Lomatul Pcs 19.00 15,000.00 285,000.00 0.00 0.00 0.00 2.00 15,000.00
157 Masker pcs 272.00 586.00 159,392.00 0.00 0.00 0.00 0.00 0.00
158 Masker N 95 pcs 20.00 7,324.00 146,480.00 0.00 0.00 0.00 0.00 0.00
159 Pisau Bisturi No. 10 Buah 19.00 3,150.00 59,850.00 0.00 0.00 0.00 0.00 0.00
161 Plester 5 yards x 2 inch roll 6.00 40,000.00 240,000.00 0.00 0.00 0.00 2.00 40,000.00
162 pcs 19.00 3,514.00 66,766.00 0.00 0.00 0.00 4.00 3,514.00
jarum bedah
163 Strip tes asam urat (easytouch) Btl 25 pcs 4.00 90,000.00 360,000.00 1.00 90,000.00 90,000.00 0.00 90,000.00
164 Strip tes gula darah (autocheck) Btl 25 pcs 4.00 90,000.00 360,000.00 0.00 0.00 0.00 1.00 90,000.00
165 Strip tes gula darah (easytouch) Btl 25 pcs 2.00 90,000.00 180,000.00 0.00 0.00 0.00 2.00 90,000.00
166 Strip tes HB (easytouch) Btl 25 pcs 2.00 165,000.00 330,000.00 0.00 0.00 0.00 0.00 0.00
167 Strip tes kolesterol (autocheck) Btl 10 pcs 4.00 165,000.00 660,000.00 0.00 0.00 0.00 2.00 165,000.00
170 Eugenol Botol 2.00 18,333.00 36,666.00 0.00 0.00 0.00 0.00 0.00
171 Saliva ejector blue woodpecker pcs 100.00 79,069.00 7,906,900.00 0.00 0.00 0.00 0.00 0.00
TOTAL HARGA 64,709.00 33,761,215.00 35,452.00 10,694,334.00 45,357.00
Jeumpa, 29 Maret 2018

Yang diperiksa

Nip. 19830727 201212 2 004
SALDO EXPIRE DATE PER 29 MARET
PEMAKAIAN SALDO AKHIR PER 29 MARET 2018
2018
Nilai
Nilai Persediaan
Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Jumlah(Unit)Harga Satuan Persediaan
(Rp)
(Rp)
11 12 14 15 16 17
- 80.00 359.00 28,720 0.00 0.00 -
37,525.00 785.00 95.00 74,575 0.00 0.00 -
908,000.00 194.00 4,000.00 776,000 0.00 0.00 -
126,300.00 948.00 150.00 142,200 0.00 0.00 -
- 180.00 200.00 36,000 0.00 0.00 -
15,515.00 295.00 107.00 31,565 0.00 0.00 -
3,600.00 300.00 90.00 27,000 0.00 0.00 -
242,000.00 111.00 2,200.00 244,200 0.00 0.00 -
85,950.00 550.00 191.00 105,050 0.00 0.00 -
633,527.00 1,121.00 233.00 261,193 0.00 0.00 -
- 25.00 2,227.00 55,675 0.00 0.00 -
125,424.00 812.00 78.00 63,336 0.00 0.00 -
372,762.00 181.00 2,106.00 381,186 0.00 0.00 -
262,865.00 109.00 2,767.00 301,603 0.00 0.00 -
- 13.00 4,972.00 64,636 0.00 0.00 -
9,730.00 670.00 139.00 93,130 0.00 0.00 -
24,000.00 620.00 120.00 74,400 0.00 0.00 -
149,225.00 975.00 127.00 123,825 0.00 0.00 -
27,000.00 855.00 1,800.00 1,539,000 0.00 0.00 -
- 15.00 2,536.00 38,040 0.00 0.00 -
123,000.00 56.00 3,000.00 168,000 0.00 0.00 -
12,450.00 950.00 415.00 394,250 0.00 0.00 -
40,172.00 468.00 166.00 77,688 0.00 0.00 -
26,650.00 37.00 1,066.00 39,442 0.00 0.00 -
252,300.00 104.00 1,450.00 150,800 0.00 0.00 -
37,800.00 316.00 2,700.00 853,200 0.00 0.00 -
161,575.00 1,465.00 115.00 168,475 0.00 0.00 -
141,900.00 202.00 3,300.00 666,600 0.00 0.00 -
54,150.00 23.00 1,805.00 41,515 0.00 0.00 -
71,280.00 1,036.00 45.00 46,620 0.00 0.00 -
13,600.00 220.00 100.00 22,000 0.00 0.00 -
- 37.00 1,222.00 45,214 0.00 0.00 -
10,300.00 100.00 103.00 10,300 0.00 0.00 -
60,420.00 5.00 3,180.00 15,900 0.00 0.00 -
53,244.00 711.00 116.00 82,476 0.00 0.00 -
38,820.00 240.00 647.00 155,280 0.00 0.00 -
6,461.00 29.00 6,461.00 187,369 0.00 0.00 -

132,770.00 210.00 781.00 164,010 0.00 0.00 -
3,060.00 7.00 3,060.00 21,420 0.00 0.00 -
- 3.00 25,800.00 77,400 0.00 0.00 -
5,250.00 11.00 2,625.00 28,875 0.00 0.00 -
18,148.00 124.00 698.00 86,552 0.00 0.00 -
- 30.00 3,754.00 112,620 0.00 0.00 -
110,000.00 420.00 1,000.00 420,000 0.00 0.00 -
- 120.00 84.00 10,080 0.00 0.00 -
15,288.00 267.00 273.00 72,891 0.00 0.00 -
129,000.00 121.00 3,000.00 363,000 0.00 0.00 -
22,500.00 40.00 2,500.00 100,000 0.00 0.00 -
108,675.00 425.00 135.00 57,375 0.00 0.00 -
- 500.00 296.00 148,000 0.00 0.00 -
98,400.00 2,086.00 100.00 208,600 0.00 0.00 -
- 4.00 6,600.00 26,400 0.00 0.00 -
- 14.00 5,720.00 80,080 0.00 0.00 -
78,900.00 770.00 263.00 202,510 0.00 0.00 -
1,536.00 1,676.00 64.00 107,264 0.00 0.00 -
10,640.00 770.00 76.00 58,520 0.00 0.00 -
1,480.00 1,150.00 74.00 85,100 0.00 0.00 -
175,956.00 63.00 2,838.00 178,794 0.00 0.00 -
54,540.00 905.00 108.00 97,740 0.00 0.00 -
95,760.00 900.00 133.00 119,700 0.00 0.00 -
- 600.00 98.00 58,800 0.00 0.00 -
31,980.00 910.00 82.00 74,620 0.00 0.00 -
- 63.00 4,000.00 252,000 0.00 0.00 -
73,100.00 470.00 86.00 40,420 0.00 0.00 -
- 100.00 230.00 23,000 0.00 0.00 -
- 3.00 65,000.00 195,000 0.00 0.00 -
28,215.00 41.00 3,135.00 128,535 0.00 0.00 -
35,200.00 0.00 0.00 - 0.00 0.00 -
- 35.00 3,327.00 116,445 0.00 0.00 -
75,850.00 18.00 1,850.00 33,300 0.00 0.00 -
- 5.00 4,982.00 24,910 0.00 0.00 -
115,500.00 9.00 7,700.00 69,300 0.00 0.00 -
415,800.00 0.00 0.00 - 0.00 0.00 -
153,990.00 1,018.00 45.00 45,810 0.00 0.00 -
14,208.00 847.00 148.00 125,356 0.00 0.00 -
22,260.00 140.00 210.00 29,400 0.00 0.00 -
360,145.00 145.00 223.00 32,335 0.00 0.00 -
3,735.00 667.00 45.00 30,015 0.00 0.00
20,960.00 0.00 0.00 - 0.00 0.00 -
16,590.00 595.00 158.00 94,010 0.00 0.00 -

60,075.00 42.00 2,225.00 93,450 0.00 0.00 -
6,400.00 20.00 1,280.00 25,600 0.00 0.00 -
72,709.00 839.00 119.00 99,841 0.00 0.00 -
- 20.00 3,278.00 65,560 0.00 0.00 -
62,980.00 340.00 94.00 31,960 0.00 0.00 -
20,700.00 320.00 115.00 36,800 0.00 0.00 -
408,000.00 83.00 4,250.00 352,750 0.00 0.00 -
242,775.00 435.00 249.00 108,315 0.00 0.00 -
758,450.00 184.00 3,850.00 708,400 0.00 0.00 -
20,680.00 24.00 5,170.00 124,080 0.00 0.00 -
- 1,200.00 58.00 69,600 0.00 0.00 -
112,725.00 185.00 167.00 30,895 0.00 0.00 -
8,000.00 0.00 0.00 - 0.00 0.00 -
94,990.00 410.00 161.00 66,010 0.00 0.00 -
128,700.00 1,300.00 110.00 143,000 0.00 0.00 -
- 200.00 881.00 176,200 0.00 0.00 -
48,000.00 24.00 3,000.00 72,000 0.00 0.00 -
90,000.00 320.00 1,000.00 320,000 0.00 0.00 -
389,504.00 101.00 2,864.00 289,264 0.00 0.00 -
90,000.00 34.00 3,000.00 102,000 0.00 0.00 -
44,400.00 670.00 148.00 99,160 0.00 0.00 -
313,320.00 159.00 1,119.00 177,921 0.00 0.00 -
574,875.00 2,035.00 105.00 213,675 0.00 0.00 -
939.00 35.00 313.00 10,955 0.00 0.00 -
20,700.00 4.00 20,700.00 82,800 0.00 0.00 -
954.00 88.00 318.00 27,984 0.00 0.00 -
54,400.00 390.00 136.00 53,040 0.00 0.00 -
42,750.00 525.00 90.00 47,250 0.00 0.00 -
60,750.00 585.00 150.00 87,750 0.00 0.00 -
- 21.00 4,150.00 87,150 0.00 0.00 -
- 2.00 35,000.00 70,000 0.00 0.00 -
84,575.00 455.00 85.00 38,675 0.00 0.00 -
33,540.00 0.00 0.00 - 0.00 0.00 -
270,050.00 645.00 110.00 70,950 0.00 0.00 -
4,500.00 33.00 500.00 16,500 0.00 0.00 -
- 13.00 7,150.00 92,950 0.00 0.00 -
2,040.00 960.00 68.00 65,280 0.00 0.00 -
16,020.00 890.00 89.00 79,210 0.00 0.00 -
8,721.00 9.00 2,907.00 26,163 0.00 0.00 -
- 24.00 2,797.00 67,128 0.00 0.00 -
13,650.00 0.00 0.00 - 0.00 0.00 -
66,840.00 680.00 557.00 378,760 0.00 0.00 -
37,197.00 48.00 4,133.00 198,384 0.00 0.00 -
33,102.00 12.00 1,226.00 14,712 0.00 0.00 -
59,740.00 800.00 58.00 46,400 0.00 0.00 -

7,910.00 380.00 113.00 42,940 0.00 0.00 -
- 170.00 252.00 42,840 0.00 0.00 -
12,700.00 0.00 0.00 - 0.00 0.00 -
62,580.00 590.00 298.00 175,820 0.00 0.00 -
- 800.00 181.00 144,800 0.00 0.00 -
187,530.00 630.00 329.00 207,270 0.00 0.00 -
83,720.00 680.00 91.00 61,880 0.00 0.00 -
14,400.00 550.00 80.00 44,000 0.00 0.00 -
- 2.00 65,000.00 130,000 0.00 0.00 -
44,160.00 280.00 368.00 103,040 0.00 0.00 -
162,096.00 612.00 132.00 80,784 0.00 0.00 -
223,155.00 70.00 4,959.00 347,130 0.00 0.00 -
118,200.00 320.00 591.00 189,120 0.00 0.00 -
- 10.00 17,500.00 175,000 0.00 0.00 -
1,510.00 460.00 151.00 69,460 0.00 0.00 -
6,784.00 124.00 848.00 105,152 0.00 0.00 -
41,412.00 279.00 714.00 199,206 0.00 0.00 -
21,672.00 54.00 774.00 41,796 0.00 0.00 -
- 200.00 181.00 36,200 0.00 0.00 -
- 6.00 26,400.00 158,400 0.00 0.00 -
51,002.00 25.00 7,286.00 182,150 0.00 0.00 -
- 100.00 362.00 36,200 0.00 0.00 -
90,480.00 400.00 520.00 208,000 0.00 0.00 -
- 10.00 4,025.00 40,250 0.00 0.00 -
- 9.00 5,856.00 52,704 0.00 0.00 -
- 10.00 4,176.00 41,760 0.00
- 20.00 6,280.00 125,600 0.00 0.00 -
- 19.00 4,959.00 94,221 0.00 0.00 -
- 12.00 5,254.00 63,048 0.00 0.00 -
- 19.00 5,687.00 108,053 0.00 0.00 -
16,313.00 3.00 16,313.00 48,939 0.00 0.00 -
120,750.00 1.00 120,750.00 120,750 0.00 0.00 -
47,492.00 85.00 1,532.00 130,220 0.00 0.00 -
- 13.00 8,855.00 115,115 0.00 0.00 -
- 15.00 2,415.00 36,225 0.00 0.00 -
334.00 27.00 334.00 9,018 0.00 0.00 -
20,000.00 8.00 5,000.00 40,000 0.00 0.00 -
30,000.00 17.00 15,000.00 255,000 0.00 0.00 -
- 272.00 586.00 159,392 0.00 0.00 -
- 20.00 7,324.00 146,480 0.00 0.00 -
- 19.00 3,150.00 59,850 0.00 0.00 -
6,300.00 14.00 3,150.00 44,100 0.00 0.00 -
80,000.00 4.00 40,000.00 160,000 0.00 0.00 -
14,056.00 15.00 3,514.00 52,710 0.00 0.00 -
- 5.00 90,000.00 450,000 0.00 0.00 -
90,000.00 3.00 90,000.00 270,000 0.00 0.00 -

180,000.00 0.00 0.00 - 0.00 0.00 -
- 2.00 165,000.00 330,000 0.00 0.00 -
330,000.00 2.00 165,000.00 330,000 0.00 0.00 -
- 50.00 3,000.00 150,000 0.00 0.00 -
- 2.00 125,000.00 250,000 0.00 0.00 -
- 2.00 18,333.00 36,666 0.00 0.00 -
- 100.00 79,069.00 7,906,900 0.00 0.00 -
- 1,000.00 347.00 347,000 0.00 0.00 -
12,979,288.00 54,804.00 31,510,361.00 0.00 0.00
Kepala Puskesmas
Alue Sungai Pinang
Wildan, SKM
Nip. 19691225 199303 1 002
PER 30 APRIL 2018
SALDO AWAL PER 02 APRIL 2018 PENERIMAAN PEMAKAIAN

NO URAIAN Satuan
(Rp) (Rp)
1 2 3 3 4 5 6 8 9
3 Ambroxol syrup 15 mg/ml - 60 ml Tab 194.00 4,000.00 776,000.00 72.00 4,000.00 288,000.00 145.00 4,000.00
4 Ambroxol tablet 30 mg Tab 948.00 150.00 142,200.00 500.00 150.00 75,000.00 768.00 150.00
9 Amoksisilin tab 250 mg Tab 550.00 191.00 105,050.00 0.00 0.00 160.00 191.00
10 Amoksisilin tab 500 mg Tab 1,121.00 233.00 261,193.00 2,500.00 233.00 582,500.00 2,321.00 233.00

11 Vial 25.00 2,227.00 55,675.00 0.00 0.00 0.00 25.00 2,227.00

12 Tab 812.00 78.00 63,336.00 2,000.00 64.00 128,000.00 1,532.00 64.00

13 Botol 181.00 2,106.00 381,186.00 150.00 3,100.00 465,000.00 127.00 3,100.00

14 Tube 109.00 2,767.00 301,603.00 75.00 2,767.00 207,525.00 73.00 2,767.00
15 Tube 13.00 4,972.00 64,636.00 0.00 0.00 0.00 0.00 0.00
Tube 0.00 0.00 0.00 24.00 4,782.00 114,768.00 0.00 0.00
17 Asam askorbat (vitamin C) tab 50 mg Tab 620.00 120.00 74,400.00 500.00 120.00 60,000.00 640.00 120.00
18 Asam mefenamat kaps 500 mg Kaps 975.00 127.00 123,825.00 1,000.00 127.00 127,000.00 1,175.00 127.00
21 Asiklovir krim 5 % - 5 gram Tube 56.00 3,000.00 168,000.00 50.00 3,000.00 150,000.00 45.00 3,000.00
23 Atapulgit 600 mg Tab 468.00 166.00 77,688.00 200.00 166.00 33,200.00 238.00 166.00
26 Bisakodil tab sal 5 mg (Dulcolax) Tab sal 316.00 2,700.00 853,200.00 0.00 2,700.00 0.00 6.00 2,700.00
27 Cetirizine tablet 10 mg Tab 1,465.00 115.00 168,475.00 1,000.00 115.00 115,000.00 585.00 115.00
29 Deksametason inj 5 mg/ml (i.v./i.m.) Vial 23.00 1,805.00 41,515.00 100.00 1,805.00 180,500.00 0.00 0.00
30 Deksametason tab 0,5 mg Tab 1,036.00 45.00 46,620.00 1,000.00 45.00 45,000.00 1,606.00 45.00
34 Domperidon susp 5 mg/5 ml Botol 5.00 3,180.00 15,900.00 0.00 0.00 0.00 0.00 0.00
35 Domperidon tab 10 mg Tab 711.00 116.00 82,476.00 500.00 116.00 58,000.00 241.00 116.00
40 Etanol 70 % 1000 ml Botol 3.00 25,800.00 77,400.00 0.00 0.00 0.00 0.00 0.00
41 Etanol 70% 100 ml Botol 11.00 2,625.00 28,875.00 0.00 0.00 0.00 3.00 2,625.00
43 Ampul 30.00 3,754.00 112,620.00 0.00 0.00 0.00 0.00 0.00
(i.m)
44 Flunarizin tablet 5 mg Tab 420.00 1,000.00 420,000.00 150.00 1,000.00 150,000.00 40.00 1,000.00

48 Gentian Violet larutan 1 % -10 ml Botol 40.00 2,500.00 100,000.00 0.00 0.00 0.00 13.00 2,500.00
49 Glibenklamid tab 5 mg Tab 425.00 135.00 57,375.00 1,000.00 135.00 135,000.00 615.00 135.00
51 Gliseril Guayakolat tablet 100 mg Tab 2,086.00 100.00 208,600.00 1,000.00 100.00 100,000.00 1,736.00 100.00
53 Glukosa Larutan Infus 5% steril 500 ml Botol 14.00 5,720.00 80,080.00 0.00 0.00 0.00 3.00 5,720.00
54 Griseofulvin (micronized) tab 125 mg Tab 770.00 263.00 202,510.00 0.00 0.00 0.00 290.00 263.00
56 Haloperidol tab 1,5 mg Tab 770.00 76.00 58,520.00 0.00 0.00 0.00 60.00 76.00
59 Ibuprofen tab 200 mg Tab 905.00 108.00 97,740.00 0.00 0.00 0.00 120.00 108.00
62 Kalsium laktat (kalk) tab 500 mg Tab 910.00 82.00 74,620.00 1,000.00 82.00 82,000.00 910.00 82.00
64 Kaptopril tab 25 mg Tab 470.00 86.00 40,420.00 1,000.00 86.00 86,000.00 720.00 86.00
68 Ketokonazol tab 200 mg Tab 0.00 0.00 0.00 500.00 320.00 160,000.00 40.00 320.00
69 Kloramfenikol tts mata 0,5% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
70 Kloramfenikol salep kulit 2% Tube 35.00 3,327.00 116,445.00 0.00 0.00 0.00 0.00 0.00
71 Kloramfenikol salep mata 1% Tube 18.00 1,850.00 33,300.00 48.00 1,850.00 88,800.00 26.00 1,850.00
73 Kloramfenikol tetes telinga 3% Botol 9.00 7,700.00 69,300.00 30.00 7,700.00 231,000.00 6.00 7,700.00
75 Klorpromazin tab sal 100 mg Tab sal 847.00 148.00 125,356.00 0.00 0.00 0.00 127.00 148.00
77 Tab sal 145.00 223.00 32,335.00 1,000.00 223.00 223,000.00 695.00 223.00
0,25 mg
Tab sal 667.00 45.00 30,015.00 0.00 0.00 0.00 25.00 45.00
0,25 mg

78 Tab 595.00 158.00 94,010.00 0.00 0.00 0.00 55.00 158.00
79 suspensi : sulfametoksazol 200 mg + Botol 42.00 2,225.00 93,450.00 100.00 2,225.00 222,500.00 54.00 2,225.00
trimetoprim 40 mg
80 Lidokain injeksi 2% - 2 ml Ampul 20.00 1,280.00 25,600.00 0.00 0.00 0.00 10.00 1,280.00
81 Metformin tab 500 mg Tab 839.00 119.00 99,841.00 500.00 119.00 59,500.00 459.00 119.00
86 Multivitamin Tab 435.00 249.00 108,315.00 1,000.00 249.00 249,000.00 545.00 249.00
92 Nifedipin kaps 10 mg Kaps 1,300.00 110.00 143,000.00 500.00 110.00 55,000.00 920.00 110.00
94 Obat Batuk Hitam ( O.B.H. ) cairan - 100 ml Botol 24.00 3,000.00 72,000.00 50.00 3,000.00 150,000.00 9.00 3,000.00
97 Oksitetrasiklin salep mata 1% (HCl) - 3,5 gr Tube 34.00 3,000.00 102,000.00 25.00 3,000.00 75,000.00 8.00 3,000.00
98 Omeprazol kaps 20 mg Kaps 670.00 148.00 99,160.00 300.00 148.00 44,400.00 500.00 148.00
102 Perak sulfadiazin krim 1% Tube 4.00 20,700.00 82,800.00 0.00 0.00 0.00 0.00 0.00
106 Piroksikam kapsul 20 mg Tab 585.00 150.00 87,750.00 0.00 0.00 0.00 275.00 150.00
107 Povidon iodin lar 100 mg/ml Botol 30 ml 21.00 4,150.00 87,150.00 0.00 0.00 0.00 5.00 4,150.00
109 Prednison tab 5 mg Tab 455.00 85.00 38,675.00 1,000.00 85.00 85,000.00 840.00 85.00
110 Ranitidin injeksi 25 mg/ml - 2ml Ampul 0.00 0.00 0.00 10.00 1,677.00 16,770.00 0.00 0.00
111 Ranitidin tab 150 mg Tab 645.00 110.00 70,950.00 3,000.00 110.00 330,000.00 2,195.00 110.00
112 Retinol (vitamin A) kaps lunak 200.000 UI Kaps lunak 33.00 500.00 16,500.00 0.00 0.00 0.00 18.00 500.00
113 Ringer Laktat Larutan Botol 13.00 7,150.00 92,950.00 0.00 0.00 0.00 2.00 7,150.00
116 Tube 9.00 2,907.00 26,163.00 0.00 0.00 0.00 0.00 0.00
belerang endap 4 %
Tube 24.00 2,797.00 67,128.00 0.00 0.00 0.00 0.00 0.00
belerang endap 4 %
117 Sefadroksil kapsul 500 mg Tab 680.00 557.00 378,760.00 200.00 557.00 111,400.00 90.00 557.00
119 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 12.00 1,226.00 14,712.00 100.00 1,226.00 122,600.00 1.00 1,226.00
120 Sianokobalamin (vitamin B12) tab 50 mcg Tab 800.00 58.00 46,400.00 1,000.00 58.00 58,000.00 1,190.00 58.00
122 Simvastatin tab sal 20 mg Tab sal 170.00 252.00 42,840.00 500.00 252.00 126,000.00 270.00 252.00
123 Siprofloksasin tab scored 500 mg Tab 590.00 298.00 175,820.00 500.00 298.00 149,000.00 300.00 298.00
130 Vitamin B kompleks Tab 612.00 132.00 80,784.00 1,500.00 132.00 198,000.00 172.00 132.00
132 Zinc tab disp 20 mg Tab 320.00 591.00 189,120.00 500.00 591.00 295,500.00 150.00 591.00
133 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul 10.00 17,500.00 175,000.00 0.00 0.00 0.00 0.00 0.00
136 Alat Suntik Sekali Pakai 2,5 ml Pcs 279.00 714.00 199,206.00 100.00 714.00 71,400.00 88.00 714.00
138 Alkohol Swab set 200.00 181.00 36,200.00 0.00 0.00 0.00 0.00 0.00
139 Aseptic gel 500 ml Botol 6.00 26,400.00 158,400.00 2.00 26,400.00 52,800.00 2.00 26,400.00
140 Pcs 25.00 7,286.00 182,150.00 0.00 0.00 0.00 6.00 7,286.00
jarum bedah
142 HandScun pcs 400.00 520.00 208,000.00 200.00 520.00 104,000.00 300.00 520.00
143 Infusion Set Anak Set 10.00 4,025.00 40,250.00 0.00 0.00 0.00 2.00 4,025.00
144 Infusion Set Dewasa Set 9.00 5,856.00 52,704.00 0.00 0.00 0.00 7.00 5,856.00
Infusion Set Dewasa Set 10.00 4,176.00 41,760.00 0.00 0.00 0.00 0.00 0.00
145 Infusion Set Y-Connector Pcs 20.00 6,280.00 125,600.00 0.00 0.00 0.00 0.00 0.00
149 Kapas Pembalut / Absorben 250 gram Roll 3.00 16,313.00 48,939.00 0.00 0.00 0.00 0.00 0.00
150 Kasa Hydrophil 40 x 80 cm roll 1.00 120,750.00 120,750.00 0.00 0.00 0.00 1.00 120,750.00
151 Kasa Kompres 40/40 Steril pcs 85.00 1,532.00 130,220.00 50.00 1,532.00 76,600.00 40.00 1,532.00
152 Kasa Pembalut 2 m x 80 cm roll 13.00 8,855.00 115,115.00 5.00 8,855.00 44,275.00 4.00 8,855.00
155 Kassa steril 16 cm x 16 cm roll 8.00 5,000.00 40,000.00 10.00 5,000.00 50,000.00 2.00 5,000.00
156 Lomatuell H/Lomatul Pcs 17.00 15,000.00 255,000.00 0.00 0.00 0.00 2.00 15,000.00
157 Masker pcs 272.00 586.00 159,392.00 100.00 586.00 58,600.00 212.00 586.00
158 Masker N 95 pcs 20.00 7,324.00 146,480.00 0.00 0.00 0.00 0.00 0.00
161 Plester 5 yards x 2 inch roll 4.00 40,000.00 160,000.00 5.00 40,000.00 200,000.00 2.00 40,000.00
162 pcs 15.00 3,514.00 52,710.00 0.00 0.00 0.00 10.00 3,514.00
jarum bedah
163 Strip tes asam urat (easytouch) Btl 25 pcs 5.00 90,000.00 450,000.00 0.00 0.00 0.00 3.00 90,000.00
164 Strip tes gula darah (autocheck) Btl 25 pcs 3.00 90,000.00 270,000.00 3.00 90,000.00 270,000.00 3.00 90,000.00
165 Strip tes gula darah (easytouch) Btl 25 pcs 0.00 0.00 0.00 3.00 90,000.00 270,000.00 0.00 0.00
166 Strip tes HB (easytouch) Btl 25 pcs 2.00 165,000.00 330,000.00 0.00 0.00 0.00 0.00 0.00
167 Strip tes kolesterol (autocheck) Btl 10 pcs 2.00 165,000.00 330,000.00 5.00 165,000.00 825,000.00 3.00 165,000.00
169 Etil klorida semprot 100 ml Botol 2.00 125,000.00 250,000.00 0.00 0.00 0.00 2.00 125,000.00
170 Eugenol Botol 2.00 18,333.00 36,666.00 0.00 0.00 0.00 1.00 18,333.00
171 Saliva ejector blue woodpecker pcs 100.00 79,069.00 7,906,900.00 0.00 0.00 0.00 100.00 79,069.00
TOTAL HARGA 54,804.00 31,510,361.00 39,917.00 11,494,834.00 39,447.00
Jeumpa, 30 April 2018

Yang diperiksa

Nip. 19830727 201212 2 004
PEMAKAIAN SALDO AKHIR PER 30 APRIL 2018 SALDO EXPIRE DATE PER 30 APRIL 2018
(Rp) (Rp)
11 12 14 15 16 17
70.00 359.00 0.00 0.00 -

3,590.00 25,130
620.00 95.00 0.00 0.00 -
44,175.00 58,900
121.00 4,000.00 0.00 0.00 -
580,000.00 484,000
680.00 150.00 0.00 0.00 -
115,200.00 102,000
180.00 200.00 0.00 0.00 -
- 36,000
200.00 107.00 0.00 0.00 -
10,165.00 21,400
190.00 90.00 0.00 0.00 -
9,900.00 17,100
81.00 2,200.00 0.00 0.00 -
330,000.00 178,200
390.00 191.00 0.00 0.00 -
30,560.00 74,490
1,300.00 233.00 0.00 0.00 -
540,793.00 302,900
0.00 0.00 0.00 0.00 -

55,675.00 -
1,280.00 64.00 0.00 0.00 -

98,048.00 81,920
204.00 3,100.00 0.00 0.00 -

393,700.00 632,400
111.00 2,767.00 0.00 0.00 -
201,991.00 307,137
13.00 4,972.00 0.00 0.00 -
- 64,636
24.00 4,782.00 0.00
- 114,768
630.00 139.00 0.00 0.00 -
5,560.00 87,570
480.00 120.00 0.00 0.00 -
76,800.00 57,600
800.00 127.00 0.00 0.00 -
149,225.00 101,600
830.00 1,800.00 0.00 0.00 -
45,000.00 1,494,000
15.00 2,536.00 0.00 0.00 -
- 38,040
61.00 3,000.00 0.00 0.00 -
135,000.00 183,000
890.00 415.00 0.00 0.00 -
24,900.00 369,350
430.00 166.00 0.00 0.00 -
39,508.00 71,380
23.00 1,071.00 0.00 0.00 -
25,704.00 24,633
90.00 1,450.00 0.00 0.00 -
237,800.00 130,500
310.00 2,700.00 0.00 0.00 -
16,200.00 837,000
1,880.00 115.00 0.00 0.00 -
67,275.00 216,200
172.00 3,300.00 0.00 0.00 -
99,000.00 567,600
123.00 1,805.00 0.00 0.00 -
- 222,015
430.00 45.00 0.00 0.00 -
72,270.00 19,350
100.00 100.00 0.00 0.00 -
12,000.00 10,000
37.00 1,222.00 0.00 0.00 -
- 45,214
100.00 103.00 0.00 0.00 -
- 10,300
5.00 3,180.00 0.00 0.00 -
- 15,900
970.00 116.00 0.00 0.00 -
27,956.00 112,520
140.00 647.00 0.00 0.00 -
64,700.00 90,580
22.00 6,461.00 0.00 0.00 -
45,227.00 142,142
0.00 0.00 0.00 0.00 -
164,010.00 -
5.00 3,060.00 0.00 0.00 -
6,120.00 15,300
3.00 25,800.00 0.00 0.00 -
- 77,400
8.00 2,625.00 0.00 0.00 -
7,875.00 21,000
100.00 698.00 0.00 0.00 -
16,752.00 69,800
30.00 3,754.00 0.00 0.00 -
- 112,620
530.00 1,000.00 0.00 0.00 -
40,000.00 530,000
120.00 84.00 0.00 0.00 -
- 10,080
151.00 273.00 0.00 0.00 -

31,668.00 41,223
179.00 3,000.00 0.00 0.00 -
126,000.00 537,000
27.00 2,500.00 0.00 0.00 -
32,500.00 67,500
810.00 135.00 0.00 0.00 -
83,025.00 109,350
500.00 296.00 0.00 0.00 -
- 148,000
1,350.00 100.00 0.00 0.00 -
173,600.00 135,000
4.00 6,600.00 0.00 0.00 -
- 26,400
11.00 5,720.00 0.00 0.00 -
17,160.00 62,920
480.00 263.00 0.00 0.00 -
76,270.00 126,240
1,616.00 64.00 0.00 0.00 -
3,840.00 103,424
710.00 76.00 0.00 0.00 -
4,560.00 53,960
1,060.00 74.00 0.00 0.00 -
6,660.00 78,440
83.00 2,838.00 0.00 0.00 -
147,576.00 235,554
785.00 108.00 0.00 0.00 -
12,960.00 84,780
1,040.00 133.00 0.00 0.00 -
47,880.00 138,320
600.00 98.00 0.00 0.00 -
- 58,800
1,000.00 82.00 0.00 0.00 -
74,620.00 82,000
63.00 4,000.00 0.00 0.00 -
- 252,000
750.00 86.00 0.00 0.00 -
61,920.00 64,500
100.00 230.00 0.00 0.00 -
- 23,000
3.00 65,000.00 0.00 0.00 -
- 195,000
29.00 3,135.00 0.00 0.00 -
37,620.00 90,915
460.00 320.00 0.00 0.00 -
12,800.00 147,200
0.00 0.00 45.00 7,700.00 346,500.00
- -
35.00 3,327.00 0.00 0.00 -
- 116,445
40.00 1,850.00 0.00 0.00 -
48,100.00 74,000
5.00 4,982.00 0.00 0.00 -
- 24,910
33.00 7,700.00 0.00 0.00 -
46,200.00 254,100
2,100.00 45.00 0.00 0.00 -
131,310.00 94,500
720.00 148.00 0.00 0.00 -
18,796.00 106,560
135.00 210.00 0.00 0.00 -
1,050.00 28,350
450.00 223.00 0.00 0.00 -
154,985.00 100,350
642.00 45.00 0.00

1,125.00 28,890
540.00 158.00 0.00 0.00 -

8,690.00 85,320
88.00 2,225.00 0.00 0.00 -
120,150.00 195,800
10.00 1,280.00 0.00 0.00 -
12,800.00 12,800
880.00 119.00 0.00 0.00 -
54,621.00 104,720
20.00 3,278.00 0.00 0.00 -
- 65,560
240.00 94.00 0.00 0.00 -
9,400.00 22,560
130.00 115.00 0.00 0.00 -
21,850.00 14,950
60.00 4,250.00 0.00 0.00 -
301,750.00 255,000
890.00 249.00 0.00 0.00 -
135,705.00 221,610
124.00 3,850.00 0.00 0.00 -
616,000.00 477,400
20.00 5,170.00 0.00 0.00 -
20,680.00 103,400
1,200.00 58.00 0.00 0.00 -
- 69,600
300.00 167.00 0.00 0.00 -
64,295.00 50,100
280.00 200.00 0.00 0.00 -
26,000.00 56,000
880.00 110.00 0.00 0.00 -
101,200.00 96,800
100.00 881.00 0.00 0.00 -
88,100.00 88,100
65.00 3,000.00 0.00 0.00 -
27,000.00 195,000
245.00 1,000.00 0.00 0.00 -
75,000.00 245,000
82.00 2,864.00 0.00 0.00 -
340,816.00 234,848
51.00 3,000.00 0.00 0.00 -
24,000.00 153,000
470.00 148.00 0.00 0.00 -
74,000.00 69,560
124.00 1,119.00 0.00 0.00 -
318,915.00 138,756
1,660.00 105.00 0.00 0.00 -
564,375.00 174,300
28.00 313.00 0.00 0.00 -
2,191.00 8,764
4.00 20,700.00 0.00 0.00 -
- 82,800
0.00 0.00 0.00 0.00 -
27,984.00 -
530.00 136.00 0.00 0.00 -
48,960.00 72,080
430.00 90.00 0.00 0.00 -
53,550.00 38,700
310.00 150.00 0.00 0.00 -
41,250.00 46,500
16.00 4,150.00 0.00 0.00 -
20,750.00 66,400
2.00 35,000.00 0.00 0.00 -
- 70,000
615.00 85.00 0.00 0.00 -
71,400.00 52,275
10.00 1,677.00 0.00 0.00 -
- 16,770
1,450.00 110.00 0.00 0.00 -
241,450.00 159,500
15.00 500.00 0.00 0.00 -
9,000.00 7,500
11.00 7,150.00 0.00 0.00 -
14,300.00 78,650
930.00 68.00 0.00 0.00 -
2,040.00 63,240
620.00 89.00 0.00 0.00 -
24,030.00 55,180
9.00 2,907.00 0.00 0.00 -
- 26,163
24.00 2,797.00 0.00
- 67,128
790.00 557.00 0.00 0.00 -
50,130.00 440,030
40.00 4,133.00 0.00 0.00 -
33,064.00 165,320
111.00 1,226.00 0.00 0.00 -
1,226.00 136,086
610.00 58.00 0.00 0.00 -
69,020.00 35,380
290.00 113.00 0.00 0.00 -
10,170.00 32,770
400.00 252.00 0.00 0.00 -
68,040.00 100,800
790.00 298.00 0.00 0.00 -
89,400.00 235,420
800.00 181.00 0.00 0.00 -
- 144,800
590.00 329.00 0.00 0.00 -
13,160.00 194,110
710.00 91.00 0.00 0.00 -
88,270.00 64,610
380.00 80.00 0.00 0.00 -
13,600.00 30,400
2.00 65,000.00 0.00 0.00 -
- 130,000
80.00 368.00 0.00 0.00 -
73,600.00 29,440
1,940.00 132.00 0.00 0.00 -
22,704.00 256,080
60.00 4,959.00 0.00 0.00 -
49,590.00 297,540
670.00 591.00 0.00 0.00 -
88,650.00 395,970
10.00 17,500.00 0.00 0.00 -
- 175,000
120.00 151.00 0.00 0.00 -
51,340.00 18,120
124.00 848.00 0.00 0.00 -
- 105,152
291.00 714.00 0.00 0.00 -
62,832.00 207,774
46.00 774.00 0.00 0.00 -
6,192.00 35,604
200.00 181.00 0.00 0.00 -
- 36,200
6.00 26,400.00 0.00 0.00 -
52,800.00 158,400
19.00 7,286.00 0.00 0.00 -
43,716.00 138,434
100.00 362.00 0.00 0.00 -
- 36,200
300.00 520.00 0.00 0.00 -
156,000.00 156,000
8.00 4,025.00 0.00 0.00 -
8,050.00 32,200
2.00 5,856.00 0.00 0.00 -
40,992.00 11,712
10.00 4,176.00 0.00
- 41,760
20.00 6,280.00 0.00 0.00 -
- 125,600
18.00 4,959.00 0.00 0.00 -
4,959.00 89,262
12.00 5,254.00 0.00 0.00 -
- 63,048
19.00 5,687.00 0.00 0.00 -
- 108,053
3.00 16,313.00 0.00 0.00 -
- 48,939
0.00 120,750.00 0.00 0.00 -
120,750.00 -
95.00 1,532.00 0.00 0.00 -
61,280.00 145,540
14.00 8,855.00 0.00 0.00 -
35,420.00 123,970
15.00 2,415.00 0.00 0.00 -
- 36,225
27.00 334.00 0.00 0.00 -
- 9,018
16.00 5,000.00 0.00 0.00 -
10,000.00 80,000
15.00 15,000.00 0.00 0.00 -
30,000.00 225,000
160.00 586.00 0.00 0.00 -
124,232.00 93,760
20.00 7,324.00 0.00 0.00 -
- 146,480
19.00 3,150.00 0.00 0.00 -
- 59,850
13.00 3,150.00 0.00 0.00 -
3,150.00 40,950
7.00 40,000.00 0.00 0.00 -
80,000.00 280,000
5.00 3,514.00 0.00 0.00 -
35,140.00 17,570
2.00 90,000.00 0.00 0.00 -
270,000.00 180,000
3.00 90,000.00 0.00 0.00 -
270,000.00 270,000
3.00 90,000.00 0.00 0.00 -
- 270,000
2.00 165,000.00 0.00 0.00 -
- 330,000
4.00 165,000.00 0.00 0.00 -
495,000.00 660,000
50.00 3,000.00 0.00 0.00 -
- 150,000
0.00 0.00 0.00 0.00 -
250,000.00 -
1.00 18,333.00 0.00 0.00 -
18,333.00 18,333
0.00 0.00 0.00 0.00 -
7,906,900.00 -
1,000.00 347.00 0.00 0.00 -
- 347,000
19,514,866.00 55,274.00 23,675,050.00 45.00 346,500.00
Kepala Puskesmas
Alue Sungai Pinang
Wildan, SKM
Nip. 19691225 199303 1 002
PER 31 MEI 2018
SALDO AWAL PER 01 MEI 2018 PENERIMAAN PEMAKAIAN

NO URAIAN Satuan
Nilai Persediaan
Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit)
(Rp)
1 2 3 3 4 5 6 8 9
2 Alopurinol tab 100 mg Tab 620.00 95.00 58,900.00 800.00 95.00 76,000.00 1,050.00
3 Ambroxol syrup 15 mg/ml - 60 ml Tab 121.00 4,000.00 484,000.00 0.00 0.00 0.00 90.00
4 Ambroxol tablet 30 mg Tab 680.00 150.00 102,000.00 4,000.00 150.00 600,000.00 1,960.00
8 Amoksisilin sir kering 125 mg/5 ml Botol 81.00 2,200.00 178,200.00 300.00 2,200.00 660,000.00 192.00
9 Amoksisilin tab 250 mg Tab 390.00 191.00 74,490.00 0.00 0.00 0.00 390.00
10 Amoksisilin tab 500 mg Tab 1,300.00 233.00 302,900.00 4,000.00 233.00 932,000.00 3,470.00
11 Vial 0.00 0.00 0.00 120.00 2,227.00 267,240.00 0.00

12 Tab 1,280.00 64.00 81,920.00 4,000.00 64.00 256,000.00 1,650.00

13 Botol 204.00 3,100.00 632,400.00 300.00 3,100.00 930,000.00 197.00

14 Tube 111.00 2,767.00 307,137.00 200.00 2,767.00 553,400.00 139.00
15 Tube 13.00 4,972.00 64,636.00 0.00 0.00 0.00 0.00

Tube 24.00 4,782.00 114,768.00 0.00 0.00 0.00 0.00
16 Asam askorbat (vitamin C) tab 250 mg Tab 630.00 139.00 87,570.00 0.00 0.00 0.00 40.00
17 Asam askorbat (vitamin C) tab 50 mg Tab 480.00 120.00 57,600.00 1,500.00 120.00 180,000.00 1,480.00
18 Asam mefenamat kaps 500 mg Kaps 800.00 127.00 101,600.00 2,500.00 127.00 317,500.00 1,410.00
19 Asam Traneksamat tablet (Nexa tab) tablet 830.00 1,800.00 1,494,000.00 0.00 0.00 0.00 50.00
20 Asam Traneksamat injeksi 100 mg/5 ml Ampul 15.00 2,536.00 38,040.00 0.00 0.00 0.00 0.00
21 Asiklovir krim 5 % - 5 gram Tube 61.00 3,000.00 183,000.00 50.00 3,000.00 150,000.00 30.00
22 Asiklovir tab 400 mg Tab 890.00 415.00 369,350.00 0.00 0.00 0.00 0.00
23 Atapulgit 600 mg Tab 430.00 166.00 71,380.00 600.00 166.00 99,600.00 330.00
24 Bedak salisil serb 2% Botol 23.00 1,071.00 24,633.00 100.00 1,071.00 107,100.00 49.00
25 Betametason krim 0,5 mg/g Tube 90.00 1,450.00 130,500.00 300.00 1,450.00 435,000.00 253.00
26 Bisakodil tab sal 5 mg (Dulcolax) Tab sal 310.00 2,700.00 837,000.00 0.00 0.00 0.00 0.00
27 Cetirizine tablet 10 mg Tab 1,880.00 115.00 216,200.00 1,000.00 115.00 115,000.00 835.00
28 Cetirizine sir 5 mg/5 ml. Botol 172.00 3,300.00 567,600.00 0.00 0.00 0.00 47.00
29 Deksametason inj 5 mg/ml (i.v./i.m.) Vial 123.00 1,805.00 222,015.00 0.00 0.00 0.00 42.00
30 Deksametason tab 0,5 mg Tab 430.00 45.00 19,350.00 3,500.00 45.00 157,500.00 1,910.00
31 Diazepam tab 2 mg Tab 100.00 100.00 10,000.00 600.00 100.00 60,000.00 91.00
32 Difenhidramin inj 10 mg/ml (i.v./i.m.) Ampul 37.00 1,222.00 45,214.00 0.00 1,222.00 0.00 31.00
33 Digoksin tab 0,25 mg Tab 100.00 103.00 10,300.00 0.00 0.00 0.00 0.00
34 Domperidon susp 5 mg/5 ml Botol 5.00 3,180.00 15,900.00 0.00 0.00 0.00 5.00
35 Domperidon tab 10 mg Tab 970.00 116.00 112,520.00 0.00 0.00 0.00 220.00
36 Eritromisin kaps 250 mg Kaps 140.00 647.00 90,580.00 0.00 0.00 0.00 140.00
37 Eritromisin sir 200 mg/5 ml Botol 22.00 6,461.00 142,142.00 30.00 6,461.00 193,830.00 11.00
38 Etakridin ( Rivanol ) larutan 0,1% - 300 ml botol 5.00 3,060.00 15,300.00 10.00 3,060.00 30,600.00 5.00
39 Etanol 70 % 1000 ml Botol 3.00 25,800.00 77,400.00 3.00 25,800.00 77,400.00 2.00
40 Etanol 70% 100 ml Botol 8.00 2,625.00 21,000.00 10.00 2,625.00 26,250.00 4.00
41 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 100.00 698.00 69,800.00 200.00 698.00 139,600.00 0.00
42 Ampul 30.00 3,754.00 112,620.00 0.00 0.00 0.00 10.00
(i.m)
43 Flunarizin tablet 5 mg Tab 530.00 1,000.00 530,000.00 0.00 0.00 0.00 110.00
44 Furosemid tab 40 mg Tab 120.00 84.00 10,080.00 0.00 0.00 0.00 0.00

45 0,52 g + kalium klorida 0,30 g + trinatrium Sachet 151.00 273.00 41,223.00 200.00 273.00 54,600.00 55.00
46 Gentamisin salep kulit 3 % - 5 gram Tube 179.00 3,000.00 537,000.00 100.00 3,000.00 300,000.00 111.00
47 Gentamisin sulfat tetes mata 0,3 % - 5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
48 Gentian Violet larutan 1 % -10 ml Botol 27.00 2,500.00 67,500.00 48.00 2,500.00 120,000.00 16.00
49 Glibenklamid tab 5 mg Tab 810.00 135.00 109,350.00 1,500.00 135.00 202,500.00 1,370.00
50 Glimepirid tab 2 mg Tab 500.00 296.00 148,000.00 0.00 0.00 0.00 0.00
51 Gliseril Guayakolat tablet 100 mg Tab 1,350.00 100.00 135,000.00 3,000.00 100.00 300,000.00 200.00
52 Gliserin tts 100 mg/ml Botol 4.00 6,600.00 26,400.00 0.00 0.00 0.00 0.00
53 Glukosa Larutan Infus 5% steril 500 ml Botol 11.00 5,720.00 62,920.00 0.00 0.00 0.00 1.00
54 Griseofulvin (micronized) tab 125 mg Tab 480.00 263.00 126,240.00 200.00 263.00 52,600.00 10.00
56 Haloperidol tab 1,5 mg Tab 710.00 76.00 53,960.00 500.00 76.00 38,000.00 150.00
57 Haloperidol tab 5 mg Tab 1,060.00 74.00 78,440.00 0.00 0.00 0.00 30.00
58 Hidrokortison krim 2,5% Tube 83.00 2,838.00 235,554.00 120.00 2,838.00 340,560.00 50.00
59 Ibuprofen tab 200 mg Tab 785.00 108.00 84,780.00 500.00 108.00 54,000.00 410.00
60 Ibuprofen tab 400 mg Tab 1,040.00 133.00 138,320.00 500.00 133.00 66,500.00 960.00
61 Isosorbid dinitrat tab 5 mg Tab 600.00 98.00 58,800.00 0.00 0.00 0.00 5.00
62 Kalsium laktat (kalk) tab 500 mg Tab 1,000.00 82.00 82,000.00 2,000.00 82.00 164,000.00 700.00
63 Kaolin pektin syrup Botol 63.00 4,000.00 252,000.00 0.00 0.00 0.00 14.00
64 Kaptopril tab 25 mg Tab 750.00 86.00 64,500.00 1,000.00 86.00 86,000.00 1,170.00
65 Karbamazepin Tab 200 mg Tablet 100.00 230.00 23,000.00 0.00 0.00 0.00 40.00
66 Kenalaog in orabase salep Tube 3.00 65,000.00 195,000.00 0.00 0.00 0.00 1.00
67 Ketokonazol krim 2 % - 15 grm Tube 29.00 3,135.00 90,915.00 50.00 3,135.00 156,750.00 41.00
68 Ketokonazol tab 200 mg Tab 460.00 320.00 147,200.00 0.00 0.00 0.00 0.00
69 Kloramfenikol salep kulit 2% Tube 35.00 3,327.00 116,445.00 48.00 3,327.00 159,696.00 24.00
70 Kloramfenikol salep mata 1% Tube 40.00 1,850.00 74,000.00 0.00 0.00 0.00 36.00
71 Kloramfenikol susp 125 mg/5 ml Botol 5.00 4,982.00 24,910.00 50.00 4,982.00 249,100.00 0.00
72 Kloramfenikol tetes telinga 3% Botol 33.00 7,700.00 254,100.00 0.00 0.00 0.00 12.00
73 Klorfeniramin tab 4 mg Tab 2,100.00 45.00 94,500.00 3,600.00 45.00 162,000.00 2,860.00
74 Klorpromazin tab sal 100 mg Tab sal 720.00 148.00 106,560.00 500.00 148.00 74,000.00 91.00
75 Kombinasi : ergotamin 1 mg+ kafein 50 mg Tab 135.00 210.00 28,350.00 0.00 0.00 0.00 35.00
76 Tab sal 450.00 223.00 100,350.00 2,000.00 223.00 446,000.00 1,170.00
0,25 mg
77 Tab sal 642.00 45.00 28,890.00 0.00 0.00 0.00 222.00
0,25 mg

78 Tab 540.00 158.00 85,320.00 500.00 131.00 65,500.00 20.00

79 suspensi : sulfametoksazol 200 mg + Botol 88.00 2,225.00 195,800.00 0.00 0.00 0.00 25.00
trimetoprim 40 mg
80 Lidokain injeksi 2% - 2 ml Ampul 10.00 1,280.00 12,800.00 0.00 0.00 0.00 2.00
81 Metformin tab 500 mg Tab 880.00 119.00 104,720.00 1,500.00 103.00 154,500.00 750.00
82 Metilergometrin inj 0,2 mg/ml Ampul 20.00 3,278.00 65,560.00 0.00 0.00 0.00 20.00
83 Metronidazol tab 250 mg Tab 240.00 94.00 22,560.00 0.00 0.00 0.00 0.00
84 Metronidazol tab 500 mg Tab 130.00 115.00 14,950.00 1,000.00 115.00 115,000.00 120.00
85 Mikonazol krim 2% Tube 60.00 4,250.00 255,000.00 120.00 4,250.00 510,000.00 87.00
86 Multivitamin Tab 890.00 249.00 221,610.00 2,000.00 249.00 498,000.00 1,210.00
87 Multivitamin Syrup Botol 124.00 3,850.00 477,400.00 300.00 3,850.00 1,155,000.00 205.00
88 NaCl 0,9% Larutan Botol 20.00 5,170.00 103,400.00 20.00 5,170.00 103,400.00 17.00
89 Natrium Bikarbonat tablet 500 mg Tab 1,200.00 58.00 69,600.00 0.00 0.00 0.00 0.00
90 Natrium diklofenak tab 25 mg Tab 300.00 167.00 50,100.00 2,000.00 167.00 334,000.00 710.00
92 Nifedipin kaps 10 mg Kaps 880.00 110.00 96,800.00 3,000.00 110.00 330,000.00 1,610.00
93 Nistatin tab salut 500.000 UI Tab 100.00 881.00 88,100.00 0.00 0.00 0.00 0.00
94 Obat Batuk Hitam ( O.B.H. ) cairan - 100 ml Botol 65.00 3,000.00 195,000.00 100.00 3,000.00 300,000.00 55.00
95 Obat Flu tablet Tablet 245.00 1,000.00 245,000.00 0.00 1,000.00 0.00 15.00
96 Oksitetrasiklin salep kulit 3% (HCl) - 5 gr Tube 82.00 2,864.00 234,848.00 200.00 2,864.00 572,800.00 250.00
97 Oksitetrasiklin salep mata 1% (HCl) - 3,5 gr Tube 51.00 3,000.00 153,000.00 50.00 3,000.00 150,000.00 20.00
98 Omeprazol kaps 20 mg Kaps 470.00 148.00 69,560.00 1,200.00 148.00 177,600.00 530.00
99 Parasetamol sir 120 mg/5 ml Botol 124.00 1,119.00 138,756.00 500.00 1,119.00 559,500.00 323.00
100 Parasetamol tab 500 mg Tab 1,660.00 105.00 174,300.00 10,000.00 105.00 1,050,000.00 5,150.00
101 Pehacain Injeksi ampul 28.00 313.00 8,764.00 0.00 0.00 0.00 6.00
102 Perak sulfadiazin krim 1% Tube 4.00 20,700.00 82,800.00 0.00 0.00 0.00 0.00
103 Piridoksin (vitamin B6) tab 10 mg Tab 530.00 136.00 72,080.00 500.00 136.00 68,000.00 540.00
104 Piroksikam kapsul 10 mg Tab 430.00 90.00 38,700.00 1,500.00 90.00 135,000.00 400.00
105 Piroksikam kapsul 20 mg Tab 310.00 150.00 46,500.00 1,500.00 150.00 225,000.00 1,330.00
106 Povidon iodin lar 100 mg/ml Botol 30 ml 16.00 4,150.00 66,400.00 0.00 0.00 0.00 0.00
107 Povidon iodin lar 100 mg/ml Botol 300 ml 2.00 35,000.00 70,000.00 10.00 35,000.00 350,000.00 11.00
108 Prednison tab 5 mg Tab 615.00 85.00 52,275.00 0.00 0.00 0.00 615.00
109 Ranitidin injeksi 25 mg/ml - 2ml Ampul 10.00 1,677.00 16,770.00 0.00 0.00 0.00 10.00
110 Ranitidin tab 150 mg Tab 1,450.00 110.00 159,500.00 5,000.00 110.00 550,000.00 3,480.00
111 Retinol (vitamin A) kaps lunak 200.000 UI Kaps lunak 15.00 500.00 7,500.00 0.00 0.00 0.00 15.00
112 Ringer Laktat Larutan Botol 11.00 7,150.00 78,650.00 0.00 0.00 0.00 2.00
113 Salbutamol tab 2 mg Tab 930.00 68.00 63,240.00 0.00 0.00 0.00 230.00
114 Salbutamol tab 4 mg Tab 620.00 89.00 55,180.00 0.00 0.00 0.00 60.00
115 Tube 9.00 2,907.00 26,163.00 0.00 0.00 0.00 6.00
belerang endap 4 %
Tube 24.00 2,797.00 67,128.00 0.00 0.00 0.00 0.00
belerang endap 4 %
116 Sefadroksil kapsul 500 mg Tab 790.00 557.00 440,030.00 1,000.00 557.00 557,000.00 910.00
117 Sefadroksil sirup kering 125mg/5ml - 60 ml Botol 40.00 4,133.00 165,320.00 0.00 0.00 0.00 7.00
118 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 111.00 1,226.00 136,086.00 0.00 0.00 0.00 31.00
119 Sianokobalamin (vitamin B12) tab 50 mcg Tab 610.00 58.00 35,380.00 5,000.00 58.00 290,000.00 2,200.00
Simvastatin tab sal 10 mg Tab sal 0.00 0.00 0.00 150.00 135.00 20,250.00 0.00
122 Siprofloksasin tab scored 500 mg Tab 790.00 298.00 235,420.00 500.00 298.00 149,000.00 540.00
123 Tetrasiklin kaps 250 mg Kaps 800.00 181.00 144,800.00 0.00 0.00 0.00 0.00
124 Tetrasiklin kaps 500 mg Kaps 590.00 329.00 194,110.00 0.00 0.00 0.00 150.00
125 Tiamin (vitamin B1) tab 50 mg Tab 710.00 91.00 64,610.00 5,000.00 91.00 455,000.00 1,760.00
126 Triheksifenidil tab 2 mg Tab 380.00 80.00 30,400.00 1,000.00 80.00 80,000.00 150.00
127 Trombopop gel Tube 2.00 65,000.00 130,000.00 0.00 0.00 0.00 0.00
128 Ulsidex - Sukralfat tablet 500 mg Tab 80.00 368.00 29,440.00 0.00 0.00 0.00 30.00
129 Vitamin B kompleks Tab 1,940.00 132.00 256,080.00 1,000.00 132.00 132,000.00 1,060.00
130 Zinc sir 20 mg/5 ml Botol 60.00 4,959.00 297,540.00 50.00 4,959.00 247,950.00 54.00
131 Zinc tab disp 20 mg Tab 670.00 591.00 395,970.00 200.00 591.00 118,200.00 320.00
133 Betahistin tablet 6 mg Tablet 120.00 151.00 18,120.00 900.00 151.00 135,900.00 340.00
135 Alat Suntik Sekali Pakai 2,5 ml Pcs 291.00 714.00 207,774.00 300.00 714.00 214,200.00 54.00
136 Alat Suntik Sekali Pakai 5 ml Pcs 46.00 774.00 35,604.00 100.00 774.00 77,400.00 12.00
137 Alkohol Swab set 200.00 181.00 36,200.00 0.00 0.00 0.00 0.00
138 Aseptic gel 500 ml Botol 6.00 26,400.00 158,400.00 0.00 0.00 0.00 0.00
139 Pcs 19.00 7,286.00 138,434.00 24.00 7,286.00 174,864.00 4.00
jarum bedah
140 Disposible needle 23 Set 100.00 362.00 36,200.00 0.00 0.00 0.00 0.00
141 HandScun pcs 300.00 520.00 156,000.00 0.00 0.00 0.00 300.00
142 Hidrogen peroksida lar. Konsentrat 3% Botol 800 ml 0.00 0.00 0.00 2.00 30,000.00 60,000.00 0.00
143 Infusion Set Anak Set 8.00 4,025.00 32,200.00 10.00 4,025.00 40,250.00 0.00
144 Infusion Set Dewasa Set 2.00 5,856.00 11,712.00 0.00 0.00 0.00 0.00
Infusion Set Dewasa Set 10.00 4,176.00 41,760.00 10.00 4,176.00 41,760.00 0.00
145 Infusion Set Y-Connector Pcs 20.00 6,280.00 125,600.00 0.00 0.00 0.00 0.00
146 IV Catheter No. 20 G Set 18.00 4,959.00 89,262.00 10.00 4,959.00 49,590.00 0.00
149 Kapas Pembalut / Absorben 250 gram Roll 3.00 16,313.00 48,939.00 0.00 0.00 0.00 2.00
150 Kasa Kompres 40/40 Steril pcs 95.00 1,532.00 145,540.00 100.00 1,532.00 153,200.00 71.00
151 Kasa Pembalut 2 m x 80 cm roll 14.00 8,855.00 123,970.00 10.00 8,855.00 88,550.00 6.00
152 Kasa Pembalut Hidrofil 4 m x 15 cm Elastic Rol 15.00 2,415.00 36,225.00 0.00 0.00 0.00 0.00
153 Kasa Pembalut Hidrofil 4 m x 5 cm Elastic roll 27.00 334.00 9,018.00 0.00 0.00 0.00 0.00
154 Kassa steril 16 cm x 16 cm roll 16.00 5,000.00 80,000.00 24.00 5,000.00 120,000.00 8.00
155 Lomatuell H/Lomatul Pcs 15.00 15,000.00 225,000.00 0.00 0.00 0.00 1.00
156 Masker pcs 160.00 586.00 93,760.00 0.00 0.00 0.00 10.00
157 Masker N 95 pcs 20.00 7,324.00 146,480.00 0.00 0.00 0.00 0.00
158 Pisau Bisturi No. 10 Buah 19.00 3,150.00 59,850.00 0.00 0.00 0.00 0.00
159 Pisau Bisturi no. 15 set 13.00 3,150.00 40,950.00 0.00 0.00 0.00 6.00
160 Plester 5 yards x 2 inch roll 7.00 40,000.00 280,000.00 0.00 0.00 0.00 5.00
161 pcs 5.00 3,514.00 17,570.00 36.00 3,514.00 126,504.00 10.00
jarum bedah
162 Strip tes asam urat (easytouch) Btl 25 pcs 2.00 90,000.00 180,000.00 0.00 0.00 0.00 0.00
163 Strip tes gula darah (autocheck) Btl 25 pcs 3.00 90,000.00 270,000.00 0.00 0.00 0.00 2.00
164 Strip tes gula darah (easytouch) Btl 25 pcs 3.00 90,000.00 270,000.00 0.00 0.00 0.00 0.00
165 Strip tes HB (easytouch) Btl 25 pcs 2.00 165,000.00 330,000.00 0.00 0.00 0.00 1.00
166 Strip tes kolesterol (autocheck) Btl 10 pcs 4.00 165,000.00 660,000.00 0.00 0.00 0.00 2.00
167 Test pek Hamil Pcs 50.00 3,000.00 150,000.00 0.00 0.00 0.00 50.00
168 Bonding SDI / Stae Bond pcs 0.00 0.00 0.00 1.00 200,000.00 200,000.00 1.00
169 Cocoa butter 10 gr pcs 0.00 0.00 0.00 1.00 125,000.00 125,000.00 1.00
170 Dentin conditioner mini pack 6 gram pcs 0.00 0.00 0.00 1.00 155,000.00 155,000.00 1.00
171 Etil klorida semprot 100 ml Botol 0.00 0.00 0.00 6.00 125,000.00 750,000.00 1.00
172 Eugenol Botol 1.00 18,333.00 18,333.00 0.00 0.00 0.00 0.00
Glass ionomer ART (Atraumatic Restorative
173 Botol 0.00 0.00 0.00 1.00 125,000.00 125,000.00 1.00
Treatment) lar
174 Nald Carpul set 0.00 0.00 0.00 100.00 2,000.00 200,000.00 100.00
175 Saliva ejector blue woodpecker pcs 0.00 0.00 0.00 100.00 79,069.00 7,906,900.00 100.00
176 Shield activ dendro pcs 0.00 0.00 0.00 1.00 190,000.00 190,000.00 1.00
177 Risperidon 2 mg Tablet 1,000.00 347.00 347,000.00 0.00 0.00 0.00 0.00
TOTAL HARGA 55,274.00 23,675,050.00 86,676.00 29,777,144.00 52,892.00
Jeumpa, 31 Mei 2018

Yang diperiksa

Nip. 19830727 201212 2 004
PEMAKAIAN SALDO AKHIR PER 31 MEI 2018
2018
Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan
(Rp) (Rp)
11 12 14 15 16 17
359.00 8,975.00 45.00 359.00 16,155 111.00 359.00 39,849.00
95.00 99,750.00 370.00 95.00 35,150 0.00 0.00 -
4,000.00 360,000.00 31.00 4,000.00 124,000 0.00 0.00 -
150.00 294,000.00 2,720.00 150.00 408,000 0.00 0.00 -
0.00 - 180.00 200.00 36,000 0.00 0.00 -
107.00 20,330.00 10.00 107.00 1,070 0.00 0.00 -
90.00 8,100.00 100.00 90.00 9,000 0.00 0.00 -
2,200.00 422,400.00 189.00 2,200.00 415,800 0.00 0.00 -
191.00 74,490.00 0.00 - 0.00 0.00 -
233.00 808,510.00 1,830.00 233.00 426,390 0.00 0.00 -
0.00 - 120.00 2,227.00 267,240 0.00 0.00 -
64.00 105,600.00 3,630.00 64.00 232,320 0.00 0.00 -
3,100.00 610,700.00 307.00 3,100.00 951,700 0.00 0.00 -
2,767.00 384,613.00 172.00 2,767.00 475,924 0.00 0.00 -
0.00 - 13.00 4,972.00 64,636 0.00 0.00 -
0.00 - 24.00 4,782.00 114,768 0.00
139.00 5,560.00 590.00 139.00 82,010 0.00 0.00 -
120.00 177,600.00 500.00 120.00 60,000 0.00 0.00 -
127.00 179,070.00 1,890.00 127.00 240,030 0.00 0.00 -
1,800.00 90,000.00 780.00 1,800.00 1,404,000 0.00 0.00 -
0.00 - 15.00 2,536.00 38,040 0.00 0.00 -
3,000.00 90,000.00 81.00 3,000.00 243,000 0.00 0.00 -
0.00 - 890.00 415.00 369,350 0.00 0.00 -
166.00 54,780.00 700.00 166.00 116,200 0.00 0.00 -
1,071.00 52,479.00 74.00 1,071.00 79,254 0.00 0.00 -
1,450.00 366,850.00 137.00 1,450.00 198,650 0.00 0.00 -
0.00 - 310.00 2,700.00 837,000 0.00 0.00 -
115.00 96,025.00 2,045.00 115.00 235,175 0.00 0.00 -
3,300.00 155,100.00 125.00 3,300.00 412,500 0.00 0.00 -
1,805.00 75,810.00 81.00 1,805.00 146,205 0.00 0.00 -
45.00 85,950.00 2,020.00 45.00 90,900 0.00 0.00 -
100.00 9,100.00 609.00 100.00 60,900 0.00 0.00 -
1,222.00 37,882.00 6.00 1,222.00 7,332 0.00 0.00 -
0.00 - 100.00 103.00 10,300 0.00 0.00 -
3,180.00 15,900.00 0.00 0.00 - 0.00 0.00 -
116.00 25,520.00 750.00 116.00 87,000 0.00 0.00 -
647.00 90,580.00 0.00 0.00 - 0.00 0.00 -

6,461.00 71,071.00 41.00 6,461.00 264,901 0.00 0.00 -
3,060.00 15,300.00 10.00 3,060.00 30,600 0.00 0.00 -
25,800.00 51,600.00 4.00 25,800.00 103,200 0.00 0.00 -
2,625.00 10,500.00 14.00 2,625.00 36,750 0.00 0.00 -
0.00 - 300.00 698.00 209,400 0.00 0.00 -
3,754.00 37,540.00 20.00 3,754.00 75,080 0.00 0.00 -
1,000.00 110,000.00 420.00 1,000.00 420,000 0.00 0.00 -
0.00 - 120.00 84.00 10,080 0.00 0.00 -
273.00 15,015.00 296.00 273.00 80,808 0.00 0.00 -
3,000.00 333,000.00 168.00 3,000.00 504,000 0.00 0.00 -
0.00 - 0.00 0.00 - 0.00 0.00 -
2,500.00 40,000.00 59.00 2,500.00 147,500 0.00 0.00 -
135.00 184,950.00 940.00 135.00 126,900 0.00 0.00 -
0.00 - 500.00 296.00 148,000 0.00 0.00 -
100.00 20,000.00 4,150.00 100.00 415,000 0.00 0.00 -
0.00 - 4.00 6,600.00 26,400 0.00 0.00 -
5,720.00 5,720.00 10.00 5,720.00 57,200 0.00 0.00 -
263.00 2,630.00 670.00 263.00 176,210 0.00 0.00 -
0.00 - 1,616.00 64.00 103,424 0.00 0.00 -
76.00 11,400.00 1,060.00 76.00 80,560 0.00 0.00 -
74.00 2,220.00 1,030.00 74.00 76,220 0.00 0.00 -
2,838.00 141,900.00 153.00 2,838.00 434,214 0.00 0.00 -
108.00 44,280.00 875.00 108.00 94,500 0.00 0.00 -
133.00 127,680.00 580.00 133.00 77,140 0.00 0.00 -
98.00 490.00 595.00 98.00 58,310 0.00 0.00 -
82.00 57,400.00 2,300.00 82.00 188,600 0.00 0.00 -
4,000.00 56,000.00 49.00 4,000.00 196,000 0.00 0.00 -
86.00 100,620.00 580.00 86.00 49,880 0.00 0.00 -
230.00 9,200.00 60.00 230.00 13,800 0.00 0.00 -
65,000.00 65,000.00 2.00 65,000.00 130,000 0.00 0.00 -
3,135.00 128,535.00 38.00 3,135.00 119,130 51.00 3,135.00 159,885.00
0.00 - 460.00 320.00 147,200 0.00 0.00 -
3,327.00 79,848.00 59.00 3,327.00 196,293 0.00 0.00 -
1,850.00 66,600.00 4.00 1,850.00 7,400 0.00 0.00 -
0.00 - 55.00 4,982.00 274,010 0.00 0.00 -
7,700.00 92,400.00 21.00 7,700.00 161,700 0.00 0.00 -
45.00 128,700.00 2,840.00 45.00 127,800 0.00 0.00 -
148.00 13,468.00 1,129.00 148.00 167,092 0.00 0.00 -
210.00 7,350.00 100.00 210.00 21,000 0.00 0.00 -
223.00 260,910.00 1,280.00 223.00 285,440 0.00 0.00 -
45.00 9,990.00 420.00 45.00 18,900 0.00 0.00 -
131.00 2,620.00 1,020.00 131.00 133,620 0.00 0.00 -
2,225.00 55,625.00 63.00 2,225.00 140,175 0.00 0.00 -

1,280.00 2,560.00 8.00 1,280.00 10,240 0.00 0.00 -
103.00 77,250.00 1,630.00 103.00 167,890 0.00 0.00 -
3,278.00 65,560.00 0.00 0.00 - 20.00 3,278.00 65,560.00
0.00 - 240.00 94.00 22,560 0.00 0.00 -
115.00 13,800.00 1,010.00 115.00 116,150 0.00 0.00 -
4,250.00 369,750.00 93.00 4,250.00 395,250 0.00 0.00 -
249.00 301,290.00 1,680.00 249.00 418,320 0.00 0.00 -
3,850.00 789,250.00 219.00 3,850.00 843,150 0.00 0.00 -
5,170.00 87,890.00 23.00 5,170.00 118,910 0.00 0.00 -
0.00 - 1,200.00 58.00 69,600 0.00 0.00 -
167.00 118,570.00 1,590.00 167.00 265,530 0.00 0.00 -
200.00 50,000.00 30.00 200.00 6,000 0.00 0.00 -
110.00 177,100.00 2,270.00 110.00 249,700 0.00 0.00 -
0.00 - 100.00 881.00 88,100 0.00 0.00 -
3,000.00 165,000.00 110.00 3,000.00 330,000 0.00 0.00 -
1,000.00 15,000.00 230.00 1,000.00 230,000 0.00 0.00 -
2,864.00 716,000.00 32.00 2,864.00 91,648 0.00 0.00 -
3,000.00 60,000.00 81.00 3,000.00 243,000 0.00 0.00 -
148.00 78,440.00 1,140.00 148.00 168,720 0.00 0.00 -
1,119.00 361,437.00 301.00 1,119.00 336,819 0.00 0.00 -
105.00 540,750.00 6,510.00 105.00 683,550 0.00 0.00 -
313.00 1,878.00 22.00 313.00 6,886 0.00 0.00 -
0.00 - 4.00 20,700.00 82,800 0.00 0.00 -
136.00 73,440.00 490.00 136.00 66,640 0.00 0.00 -
90.00 36,000.00 1,530.00 90.00 137,700 0.00 0.00 -
150.00 199,500.00 480.00 150.00 72,000 0.00 0.00 -
0.00 - 16.00 4,150.00 66,400 0.00 0.00 -
35,000.00 385,000.00 1.00 35,000.00 35,000 0.00 0.00 -
85.00 52,275.00 0.00 0.00 - 0.00 0.00 -
1,677.00 16,770.00 0.00 0.00 - 0.00 0.00 -
110.00 382,800.00 2,970.00 110.00 326,700 0.00 0.00 -
500.00 7,500.00 0.00 0.00 - 0.00 0.00 -
7,150.00 14,300.00 9.00 7,150.00 64,350 0.00 0.00 -
68.00 15,640.00 700.00 68.00 47,600 0.00 0.00 -
89.00 5,340.00 560.00 89.00 49,840 0.00 0.00 -
2,907.00 17,442.00 3.00 2,907.00 8,721 0.00 0.00 -
0.00 - 24.00 2,797.00 67,128 0.00
557.00 506,870.00 880.00 557.00 490,160 0.00 0.00 -
4,133.00 28,931.00 33.00 4,133.00 136,389 0.00 0.00 -
1,226.00 38,006.00 80.00 1,226.00 98,080 0.00 0.00 -
58.00 127,600.00 3,410.00 58.00 197,780 0.00 0.00 -
113.00 6,780.00 230.00 113.00 25,990 130.00 113.00 14,690.00
0.00 - 150.00 135.00 20,250 0.00 0.00 -
252.00 25,200.00 300.00 252.00 75,600 0.00 0.00 -
298.00 160,920.00 750.00 298.00 223,500 0.00 0.00 -
0.00 - 800.00 181.00 144,800 0.00 0.00 -

329.00 49,350.00 440.00 329.00 144,760 260.00 329.00 85,540.00
91.00 160,160.00 3,950.00 91.00 359,450 0.00 0.00 -
80.00 12,000.00 1,230.00 80.00 98,400 0.00 0.00 -
0.00 - 2.00 65,000.00 130,000 0.00 0.00 -
368.00 11,040.00 50.00 368.00 18,400 0.00 0.00 -
132.00 139,920.00 1,880.00 132.00 248,160 0.00 0.00 -
4,959.00 267,786.00 56.00 4,959.00 277,704 0.00 0.00 -
591.00 189,120.00 550.00 591.00 325,050 0.00 0.00 -
0.00 - 10.00 17,500.00 175,000 0.00 0.00 -
151.00 51,340.00 680.00 151.00 102,680 0.00 0.00 -
848.00 20,352.00 100.00 848.00 84,800 0.00 0.00 -
714.00 38,556.00 537.00 714.00 383,418 0.00 0.00 -
774.00 9,288.00 134.00 774.00 103,716 0.00 0.00 -
0.00 - 200.00 181.00 36,200 0.00 0.00 -
0.00 - 6.00 26,400.00 158,400 0.00 0.00 -
7,286.00 29,144.00 39.00 7,286.00 284,154 0.00 0.00 -
0.00 - 100.00 362.00 36,200 0.00 0.00 -
520.00 156,000.00 0.00 0.00 - 0.00 0.00 -
0.00 - 2.00 30,000.00 60,000 0.00 0.00 -
0.00 - 18.00 4,025.00 72,450 0.00 0.00 -
0.00 - 2.00 5,856.00 11,712 0.00 0.00 -
0.00 - 20.00 4,176.00 83,520 0.00
0.00 - 20.00 6,280.00 125,600 0.00 0.00 -
0.00 - 28.00 4,959.00 138,852 0.00 0.00 -
0.00 - 12.00 5,254.00 63,048 0.00 0.00 -
0.00 - 19.00 5,687.00 108,053 0.00 0.00 -
16,313.00 32,626.00 1.00 16,313.00 16,313 0.00 0.00 -
1,532.00 108,772.00 124.00 1,532.00 189,968 0.00 0.00 -
8,855.00 53,130.00 18.00 8,855.00 159,390 0.00 0.00 -
0.00 - 15.00 2,415.00 36,225 0.00 0.00 -
0.00 - 27.00 334.00 9,018 0.00 0.00 -
5,000.00 40,000.00 32.00 5,000.00 160,000 0.00 0.00 -
15,000.00 15,000.00 14.00 15,000.00 210,000 0.00 0.00 -
586.00 5,860.00 150.00 586.00 87,900 0.00 0.00 -
0.00 - 20.00 7,324.00 146,480 0.00 0.00 -
0.00 - 19.00 3,150.00 59,850 0.00 0.00 -
3,150.00 18,900.00 7.00 3,150.00 22,050 0.00 0.00 -
40,000.00 200,000.00 2.00 40,000.00 80,000 0.00 0.00 -
3,514.00 35,140.00 31.00 3,514.00 108,934 0.00 0.00 -
0.00 - 2.00 90,000.00 180,000 0.00 0.00 -
90,000.00 180,000.00 1.00 90,000.00 90,000 0.00 0.00 -
0.00 - 3.00 90,000.00 270,000 0.00 0.00 -
165,000.00 165,000.00 1.00 165,000.00 165,000 0.00 0.00 -
165,000.00 330,000.00 2.00 165,000.00 330,000 0.00 0.00 -
3,000.00 150,000.00 0.00 0.00 - 0.00 0.00 -
200,000.00 200,000.00 0.00 0.00 - 0.00 0.00 -

125,000.00 125,000.00 0.00 0.00 - 0.00 0.00 -
155,000.00 155,000.00 0.00 0.00 - 0.00 0.00 -
125,000.00 125,000.00 5.00 125,000.00 625,000 0.00 0.00 -
0.00 - 1.00 18,333.00 18,333 0.00 0.00 -
125,000.00 125,000.00 0.00 0.00 - 0.00 0.00 -
2,000.00 200,000.00 0.00 0.00 - 0.00 0.00 -
79,069.00 7,906,900.00 0.00 0.00 - 0.00 0.00 -
190,000.00 190,000.00 0.00 0.00 - 0.00 0.00 -
0.00 - 1,000.00 347.00 347,000 0.00 0.00 -
24,752,459.00 89,058.00 28,671,075.00 572.00 365,524.00
Kepala Puskesmas
Alue Sungai Pinang
Wildan, SKM
Nip. 19691225 199303 1 002
PER 29 JUNI 2018
SALDO AWAL PER 01 JUNI 2018 PENERIMAAN PEMAKAIAN

NO URAIAN Satuan
(Rp) (Rp)
1 2 3 3 4 5 6 8 9
2 Alopurinol tab 100 mg Tab 370.00 95.00 35,150.00 0.00 0.00 0.00 130.00 95.00
3 Ambroxol syrup 15 mg/ml - 60 ml Tab 31.00 4,000.00 124,000.00 0.00 0.00 0.00 31.00 4,000.00
4 Ambroxol tablet 30 mg Tab 2,720.00 150.00 408,000.00 0.00 0.00 0.00 960.00 150.00
8 Amoksisilin sir kering 125 mg/5 ml Botol 189.00 2,200.00 415,800.00 0.00 0.00 0.00 50.00 2,200.00
9 Amoksisilin tab 500 mg Tab 1,830.00 233.00 426,390.00 0.00 0.00 0.00 480.00 233.00
10 Vial 120.00 2,227.00 267,240.00 0.00 0.00 0.00 0.00 0.00

11 Tab 3,630.00 64.00 232,320.00 0.00 0.00 0.00 630.00 64.00

12 Botol 307.00 3,100.00 951,700.00 0.00 0.00 0.00 45.00 3,100.00

13 Tube 172.00 2,767.00 475,924.00 0.00 0.00 0.00 34.00 2,767.00
14 Tube 13.00 4,972.00 64,636.00 0.00 0.00 0.00 0.00 0.00
Tube 24.00 4,782.00 114,768.00 0.00 0.00 0.00 0.00 0.00
17 Asam mefenamat kaps 500 mg Kaps 1,890.00 127.00 240,030.00 0.00 0.00 0.00 750.00 127.00
18 Asam Traneksamat tablet (Nexa tab) tablet 780.00 1,800.00 1,404,000.00 0.00 0.00 0.00 0.00 0.00
20 Asiklovir krim 5 % - 5 gram Tube 81.00 3,000.00 243,000.00 0.00 0.00 0.00 24.00 3,000.00
22 Atapulgit 600 mg Tab 700.00 166.00 116,200.00 0.00 0.00 0.00 65.00 166.00
23 Bedak salisil serb 2% Botol 74.00 1,071.00 79,254.00 0.00 0.00 0.00 34.00 1,071.00
24 Betametason krim 0,5 mg/g Tube 137.00 1,450.00 198,650.00 0.00 0.00 0.00 82.00 1,450.00
25 Bisakodil tab sal 5 mg (Dulcolax) Tab sal 310.00 2,700.00 837,000.00 0.00 0.00 0.00 30.00 2,700.00
26 Cetirizine tablet 10 mg Tab 2,045.00 115.00 235,175.00 0.00 0.00 0.00 1,105.00 115.00
28 Deksametason inj 5 mg/ml (i.v./i.m.) Vial 81.00 1,805.00 146,205.00 0.00 0.00 0.00 0.00 0.00
29 Deksametason tab 0,5 mg Tab 2,020.00 45.00 90,900.00 0.00 0.00 0.00 1,028.00 45.00
33 Domperidon tab 10 mg Tab 750.00 116.00 87,000.00 0.00 0.00 0.00 570.00 116.00
36 Etanol 70 % 1000 ml Botol 4.00 25,800.00 103,200.00 0.00 0.00 0.00 0.00 0.00
37 Etanol 70% 100 ml Botol 14.00 2,625.00 36,750.00 0.00 0.00 0.00 0.00 0.00
39 Ampul 20.00 3,754.00 75,080.00 0.00 0.00 0.00 0.00 0.00
(i.m)
40 Flunarizin tablet 5 mg Tab 420.00 1,000.00 420,000.00 0.00 0.00 0.00 100.00 1,000.00

43 Gentamisin salep kulit 3 % - 5 gram Tube 168.00 3,000.00 504,000.00 0.00 0.00 0.00 73.00 3,000.00
44 Gentian Violet larutan 1 % -10 ml Botol 59.00 2,500.00 147,500.00 0.00 0.00 0.00 11.00 2,500.00
45 Glibenklamid tab 5 mg Tab 940.00 135.00 126,900.00 0.00 0.00 0.00 240.00 135.00
47 Gliseril Guayakolat tablet 100 mg Tab 4,150.00 100.00 415,000.00 0.00 0.00 0.00 854.00 100.00
49 Glukosa Larutan Infus 5% steril 500 ml Botol 10.00 5,720.00 57,200.00 0.00 0.00 0.00 0.00 0.00
50 Griseofulvin (micronized) tab 125 mg Tab 670.00 263.00 176,210.00 0.00 0.00 0.00 130.00 263.00
54 Hidrokortison krim 2,5% Tube 153.00 2,838.00 434,214.00 0.00 0.00 0.00 45.00 2,838.00
58 Kalsium laktat (kalk) tab 500 mg Tab 2,300.00 82.00 188,600.00 0.00 0.00 0.00 72.00 82.00
60 Kaptopril tab 25 mg Tab 580.00 86.00 49,880.00 0.00 0.00 0.00 480.00 86.00
65 Kloramfenikol salep kulit 2% Tube 59.00 3,327.00 196,293.00 0.00 0.00 0.00 1.00 3,327.00
66 Kloramfenikol salep mata 1% Tube 4.00 1,850.00 7,400.00 0.00 0.00 0.00 0.00 0.00
67 Kloramfenikol susp 125 mg/5 ml Botol 55.00 4,982.00 274,010.00 0.00 0.00 0.00 5.00 4,982.00
68 Kloramfenikol tetes telinga 3% Botol 21.00 7,700.00 161,700.00 0.00 0.00 0.00 0.00 0.00
69 Klorfeniramin tab 4 mg Tab 2,840.00 45.00 127,800.00 0.00 0.00 0.00 910.00 45.00
70 Klorpromazin tab sal 100 mg Tab sal 1,129.00 148.00 167,092.00 0.00 0.00 0.00 139.00 148.00
72 Tab sal 1,280.00 223.00 285,440.00 0.00 0.00 0.00 860.00 223.00
0,25 mg
Tab sal 420.00 45.00 18,900.00 0.00 0.00 0.00 18.00 45.00
0,25 mg

73 Tab 1,020.00 131.00 133,620.00 0.00 0.00 0.00 200.00 131.00

74 suspensi : sulfametoksazol 200 mg + Botol 63.00 2,225.00 140,175.00 0.00 0.00 0.00 23.00 2,225.00
trimetoprim 40 mg
75 Lidokain injeksi 2% - 2 ml Ampul 8.00 1,280.00 10,240.00 0.00 0.00 0.00 0.00 0.00
76 Metformin tab 500 mg Tab 1,630.00 103.00 167,890.00 0.00 0.00 0.00 410.00 103.00
79 Mikonazol krim 2% Tube 93.00 4,250.00 395,250.00 0.00 0.00 0.00 43.00 4,250.00
80 Multivitamin Tab 1,680.00 249.00 418,320.00 0.00 0.00 0.00 390.00 249.00
81 Multivitamin Syrup Botol 219.00 3,850.00 843,150.00 0.00 0.00 0.00 71.00 3,850.00
84 Natrium diklofenak tab 25 mg Tab 1,590.00 167.00 265,530.00 0.00 0.00 0.00 200.00 167.00
86 Nifedipin kaps 10 mg Kaps 2,270.00 110.00 249,700.00 0.00 0.00 0.00 640.00 110.00
90 Oksitetrasiklin salep kulit 3% (HCl) - 5 gr Tube 32.00 2,864.00 91,648.00 0.00 0.00 0.00 3.00 2,864.00
92 Omeprazol kaps 20 mg Kaps 1,140.00 148.00 168,720.00 0.00 0.00 0.00 420.00 148.00
93 Parasetamol sir 120 mg/5 ml Botol 301.00 1,119.00 336,819.00 0.00 0.00 0.00 144.00 1,119.00
94 Parasetamol tab 500 mg Tab 6,510.00 105.00 683,550.00 0.00 0.00 0.00 3,090.00 105.00
96 Perak sulfadiazin krim 1% Tube 4.00 20,700.00 82,800.00 0.00 0.00 0.00 0.00 0.00
97 Piridoksin (vitamin B6) tab 10 mg Tab 490.00 136.00 66,640.00 0.00 0.00 0.00 50.00 136.00
98 Piroksikam kapsul 10 mg Tab 1,530.00 90.00 137,700.00 0.00 0.00 0.00 220.00 90.00
99 Piroksikam kapsul 20 mg Tab 480.00 150.00 72,000.00 0.00 0.00 0.00 300.00 150.00
102 Ranitidin tab 150 mg Tab 2,970.00 110.00 326,700.00 0.00 0.00 0.00 1,310.00 110.00
103 Ringer Laktat Larutan Botol 9.00 7,150.00 64,350.00 0.00 0.00 0.00 0.00 0.00
106 Tube 3.00 2,907.00 8,721.00 0.00 0.00 0.00 3.00 2,907.00
belerang endap 4 %
Tube 24.00 2,797.00 67,128.00 0.00 0.00 0.00 0.00 0.00
belerang endap 4 %
109 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 80.00 1,226.00 98,080.00 0.00 0.00 0.00 0.00 0.00
110 Sianokobalamin (vitamin B12) tab 50 mcg Tab 3,410.00 58.00 197,780.00 0.00 0.00 0.00 470.00 58.00
Simvastatin tab sal 10 mg Tab sal 150.00 135.00 20,250.00 0.00 0.00 0.00 0.00 0.00
116 Tiamin (vitamin B1) tab 50 mg Tab 3,950.00 91.00 359,450.00 0.00 0.00 0.00 390.00 91.00
117 Triheksifenidil tab 2 mg Tab 1,230.00 80.00 98,400.00 0.00 0.00 0.00 180.00 80.00
120 Vitamin B kompleks Tab 1,880.00 132.00 248,160.00 0.00 0.00 0.00 190.00 132.00
123 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul 10.00 17,500.00 175,000.00 0.00 0.00 0.00 2.00 17,500.00
126 Alat Suntik Sekali Pakai 2,5 ml Pcs 537.00 714.00 383,418.00 0.00 0.00 0.00 19.00 714.00
128 Alkohol Swab set 200.00 181.00 36,200.00 0.00 0.00 0.00 0.00 0.00
130 Pcs 39.00 7,286.00 284,154.00 0.00 0.00 0.00 0.00 0.00
jarum bedah
132 Hidrogen peroksida lar. Konsentrat 3% Botol 800 ml 2.00 30,000.00 60,000.00 0.00 0.00 0.00 0.00 0.00
133 Infusion Set Anak Set 18.00 4,025.00 72,450.00 0.00 0.00 0.00 0.00 0.00
Infusion Set Dewasa Set 20.00 4,176.00 83,520.00 0.00 0.00 0.00 0.00 0.00
135 Infusion Set Y-Connector Pcs 20.00 6,280.00 125,600.00 0.00 0.00 0.00 0.00 0.00
139 Kapas Pembalut / Absorben 250 gram Roll 1.00 16,313.00 16,313.00 0.00 0.00 0.00 0.00 0.00
140 Kasa Kompres 40/40 Steril pcs 124.00 1,532.00 189,968.00 0.00 0.00 0.00 9.00 1,532.00
141 Kasa Pembalut 2 m x 80 cm roll 18.00 8,855.00 159,390.00 0.00 0.00 0.00 0.00 0.00
145 Lomatuell H/Lomatul Pcs 14.00 15,000.00 210,000.00 0.00 0.00 0.00 0.00 0.00
146 Masker pcs 150.00 586.00 87,900.00 0.00 0.00 0.00 0.00 0.00
147 Masker N 95 pcs 20.00 7,324.00 146,480.00 0.00 0.00 0.00 0.00 0.00
149 Pisau Bisturi no. 15 set 7.00 3,150.00 22,050.00 0.00 0.00 0.00 0.00 0.00
150 Plester 5 yards x 2 inch roll 2.00 40,000.00 80,000.00 0.00 0.00 0.00 0.00 0.00
151 pcs 31.00 3,514.00 108,934.00 0.00 0.00 0.00 2.00 3,514.00
jarum bedah
152 Strip tes asam urat (easytouch) Btl 25 pcs 2.00 900,000.00 1,800,000.00 0.00 0.00 0.00 0.00 0.00
153 Strip tes gula darah (autocheck) Btl 25 pcs 1.00 90,000.00 90,000.00 0.00 0.00 0.00 0.00 0.00
154 Strip tes gula darah (easytouch) Btl 25 pcs 3.00 90,000.00 270,000.00 0.00 0.00 0.00 0.00 0.00
155 Strip tes HB (easytouch) Btl 25 pcs 1.00 165,000.00 165,000.00 0.00 0.00 0.00 1.00 165,000.00
156 Strip tes kolesterol (autocheck) Btl 10 pcs 2.00 165,000.00 330,000.00 0.00 0.00 0.00 1.00 165,000.00
158 Eugenol Botol 1.00 18,333.00 18,333.00 0.00 0.00 0.00 1.00 18,333.00
TOTAL HARGA 89,058.00 30,291,075.00 0.00 0.00 21,267.00
Jeumpa, 29 Juni 2018

Yang diperiksa

Nip. 19830727 201212 2 004
PEMAKAIAN SALDO AKHIR PER 29 JUNI 2018
2018
(Rp) (Rp)
11 12 14 15 16 17
16,155.00 0.00 359.00 - 0.00 0.00

-
12,350.00 240.00 95.00 22,800 0.00 0.00
-
124,000.00 0.00 0.00 - 0.00 0.00
-
144,000.00 1,760.00 150.00 264,000 0.00 0.00
-
- 180.00 200.00 36,000 0.00 0.00
-
1,070.00 0.00 0.00 - 0.00 0.00
-
6,750.00 25.00 90.00 2,250 0.00 0.00
-
110,000.00 139.00 2,200.00 305,800 0.00 0.00
-
111,840.00 1,350.00 233.00 314,550 0.00 0.00
-
- 120.00 2,227.00 267,240 0.00 0.00
-
40,320.00 3,000.00 64.00 192,000 0.00 0.00

-
139,500.00 262.00 3,100.00 812,200 0.00 0.00

-
94,078.00 138.00 2,767.00 381,846 0.00 0.00

-
- 13.00 4,972.00 64,636 0.00 0.00
-
- 24.00 4,782.00 114,768
5,560.00 550.00 139.00 76,450 0.00 0.00

-
29,760.00 252.00 120.00 30,240 0.00 0.00
-
95,250.00 1,140.00 127.00 144,780 0.00 0.00
-
- 780.00 1,800.00 1,404,000 0.00 0.00
-
- 15.00 2,536.00 38,040 0.00 0.00
-
72,000.00 57.00 3,000.00 171,000 0.00 0.00
-
26,975.00 825.00 415.00 342,375 0.00 0.00
-
10,790.00 635.00 166.00 105,410 0.00 0.00
-
36,414.00 40.00 1,071.00 42,840 0.00 0.00
-
118,900.00 55.00 1,450.00 79,750 0.00 0.00
-
81,000.00 280.00 2,700.00 756,000 0.00 0.00
-
127,075.00 940.00 115.00 108,100 0.00 0.00
-
128,700.00 86.00 3,300.00 283,800 0.00 0.00
-
- 81.00 1,805.00 146,205 0.00 0.00
-
46,260.00 992.00 45.00 44,640 0.00 0.00
-
3,800.00 571.00 100.00 57,100 0.00 0.00
-
- 6.00 1,222.00 7,332 0.00 0.00
-
10,300.00 0.00 103.00 - 0.00 0.00
-
66,120.00 180.00 116.00 20,880 0.00 0.00
-
6,461.00 40.00 6,461.00 258,440 0.00 0.00
-
3,060.00 9.00 3,060.00 27,540 0.00 0.00
-
- 4.00 25,800.00 103,200 0.00 0.00
-
- 14.00 2,625.00 36,750 0.00 0.00
-
8,376.00 288.00 698.00 201,024 0.00 0.00
-
- 20.00 3,754.00 75,080 0.00 0.00
-
100,000.00 320.00 1,000.00 320,000 0.00 0.00
-
5,880.00 50.00 84.00 4,200 0.00 0.00
-
17,745.00 231.00 273.00 63,063 0.00 0.00

-
219,000.00 95.00 3,000.00 285,000 0.00 0.00
-
27,500.00 48.00 2,500.00 120,000 0.00 0.00
-
32,400.00 700.00 135.00 94,500 0.00 0.00
-
- 500.00 296.00 148,000 0.00 0.00
-
85,400.00 3,296.00 100.00 329,600 0.00 0.00
-
- 4.00 6,600.00 26,400 0.00 0.00
-
- 10.00 5,720.00 57,200 0.00 0.00
-
34,190.00 540.00 263.00 142,020 0.00 0.00
-
- 1,616.00 64.00 103,424 0.00 0.00
-
9,120.00 940.00 76.00 71,440 0.00 0.00
-
4,440.00 970.00 74.00 71,780 0.00 0.00
-
127,710.00 108.00 2,838.00 306,504 0.00 0.00
-
11,340.00 770.00 108.00 83,160 0.00 0.00
-
23,940.00 400.00 133.00 53,200 0.00 0.00
-
- 595.00 98.00 58,310 0.00 0.00
-
5,904.00 2,228.00 82.00 182,696 0.00 0.00
-
- 49.00 4,000.00 196,000 0.00 0.00
-
41,280.00 100.00 86.00 8,600 0.00 0.00
-
- 60.00 230.00 13,800 0.00 0.00
-
- 2.00 65,000.00 130,000 0.00 0.00
-
119,130.00 0.00 - 0.00 0.00
-
- 460.00 320.00 147,200 0.00 0.00
-
3,327.00 58.00 3,327.00 192,966 0.00 0.00
-
- 4.00 1,850.00 7,400 0.00 0.00
-
24,910.00 50.00 4,982.00 249,100 0.00 0.00
-
- 21.00 7,700.00 161,700 0.00 0.00
-
40,950.00 1,930.00 45.00 86,850 0.00 0.00
-
20,572.00 990.00 148.00 146,520 0.00 0.00
-
7,560.00 64.00 210.00 13,440 0.00 0.00
-
191,780.00 420.00 223.00 93,660 0.00 0.00
-
810.00 402.00 45.00 18,090 0.00 0.00
-
26,200.00 820.00 131.00 107,420 0.00 0.00

-
51,175.00 40.00 2,225.00 89,000 0.00 0.00

-
- 8.00 1,280.00 10,240 0.00 0.00
-
42,230.00 1,220.00 103.00 125,660 0.00 0.00
-
- 240.00 94.00 22,560 0.00 0.00
-
17,250.00 860.00 115.00 98,900 0.00 0.00
-
182,750.00 50.00 4,250.00 212,500 0.00 0.00
-
97,110.00 1,290.00 249.00 321,210 0.00 0.00
-
273,350.00 148.00 3,850.00 569,800 0.00 0.00
-
5,170.00 22.00 5,170.00 113,740 0.00 0.00
-
- 1,200.00 58.00 69,600 0.00 0.00
-
33,400.00 1,390.00 167.00 232,130 0.00 0.00
-
6,000.00 0.00 - 0.00 0.00
-
70,400.00 1,630.00 110.00 179,300 0.00 0.00
-
26,430.00 70.00 881.00 61,670 0.00 0.00
-
63,000.00 89.00 3,000.00 267,000 0.00 0.00
-
30,000.00 200.00 1,000.00 200,000 0.00 0.00
-
8,592.00 29.00 2,864.00 83,056 0.00 0.00
-
3,000.00 80.00 3,000.00 240,000 0.00 0.00
-
62,160.00 720.00 148.00 106,560 0.00 0.00
-
161,136.00 157.00 1,119.00 175,683 0.00 0.00
-
324,450.00 3,420.00 105.00 359,100 0.00 0.00
-
- 22.00 313.00 6,886 0.00 0.00
-
- 4.00 20,700.00 82,800 0.00 0.00
-
6,800.00 440.00 136.00 59,840 0.00 0.00
-
19,800.00 1,310.00 90.00 117,900 0.00 0.00
-
45,000.00 180.00 150.00 27,000 0.00 0.00
-
- 16.00 4,150.00 66,400 0.00 0.00
-
- 1.00 35,000.00 35,000 0.00 0.00
-
144,100.00 1,660.00 110.00 182,600 0.00 0.00
-
- 9.00 7,150.00 64,350 0.00 0.00
-
680.00 690.00 68.00 46,920 0.00 0.00
-
2,670.00 530.00 89.00 47,170 0.00 0.00
-
8,721.00 0.00 0.00 - 0.00 0.00
-
- 24.00 2,797.00 67,128 0.00 0.00
-
8,355.00 865.00 557.00 481,805 0.00 0.00
-
12,399.00 30.00 4,133.00 123,990 0.00 0.00
-
- 80.00 1,226.00 98,080 0.00 0.00
-
27,260.00 2,940.00 58.00 170,520 0.00 0.00
-
10,170.00 140.00 113.00 15,820 0.00 0.00
-
- 150.00 135.00 20,250 0.00 0.00
-
12,600.00 250.00 252.00 63,000 0.00 0.00
-
65,560.00 530.00 298.00 157,940 0.00 0.00
-
- 800.00 181.00 144,800 0.00 0.00
-
49,350.00 290.00 329.00 95,410 0.00 0.00
-
35,490.00 3,560.00 91.00 323,960 0.00 0.00
-
14,400.00 1,050.00 80.00 84,000 0.00 0.00
-
- 2.00 65,000.00 130,000 0.00 0.00
-
18,400.00 0.00 - 0.00 0.00
-
25,080.00 1,690.00 132.00 223,080 0.00 0.00
-
19,836.00 52.00 4,959.00 257,868 0.00 0.00
-
118,200.00 350.00 591.00 206,850 0.00 0.00
-
35,000.00 8.00 17,500.00 140,000 0.00 0.00
-
7,550.00 630.00 151.00 95,130 0.00 0.00
-
6,784.00 92.00 848.00 78,016 0.00 0.00
-
13,566.00 518.00 714.00 369,852 0.00 0.00
-
- 134.00 774.00 103,716 0.00 0.00
-
- 200.00 181.00 36,200 0.00 0.00
-
- 6.00 26,400.00 158,400 0.00 0.00
-
- 39.00 7,286.00 284,154 0.00 0.00
-
- 100.00 362.00 36,200 0.00 0.00
-
- 2.00 30,000.00 60,000 0.00 0.00
-
- 18.00 4,025.00 72,450 0.00 0.00
-
- 2.00 5,856.00 11,712 0.00 0.00
-
- 20.00 4,176.00 83,520 0.00
- 20.00 6,280.00 125,600 0.00 0.00

-
14,877.00 25.00 4,959.00 123,975 0.00 0.00
-
- 12.00 5,254.00 63,048 0.00 0.00
-
- 19.00 5,687.00 108,053 0.00 0.00
-
- 1.00 16,313.00 16,313 0.00 0.00
-
13,788.00 115.00 1,532.00 176,180 0.00 0.00
-
- 18.00 8,855.00 159,390 0.00 0.00
-
- 15.00 2,415.00 36,225 0.00 0.00
-
- 27.00 334.00 9,018 0.00 0.00
-
25,000.00 27.00 5,000.00 135,000 0.00 0.00
-
- 14.00 15,000.00 210,000 0.00 0.00
-
- 150.00 586.00 87,900 0.00 0.00
-
- 20.00 7,324.00 146,480 0.00 0.00
-
- 19.00 3,150.00 59,850 0.00 0.00
-
- 7.00 3,150.00 22,050 0.00 0.00
-
- 2.00 40,000.00 80,000 0.00 0.00
-
7,028.00 29.00 3,514.00 101,906 0.00 0.00
-
- 2.00 90,000.00 180,000 0.00 0.00
-
- 1.00 90,000.00 90,000 0.00 0.00
-
- 3.00 90,000.00 270,000 0.00 0.00
-
165,000.00 0.00 - 0.00 0.00
-
165,000.00 1.00 165,000.00 165,000 0.00 0.00
-
- 5.00 125,000.00 625,000 0.00 0.00
-
18,333.00 0.00 0.00 - 0.00 0.00
-
- 1,000.00 347.00 347,000 0.00 0.00
-
5,432,352.00 67,791.00 23,238,723.00 0.00 0.00
Kepala Puskesmas
Alue Sungai Pinang
Murti, SKM
Nip. 19720802 199101 2 001
PER 29 JUNI 2018

SALDO AWAL PER 01 JUNI 2018 PENERIMAAN PEMAKAIAN SALDO AKHIR PER 29 JUNI 2018
2018
NO URAIAN Satuan
Nilai Persediaan Nilai Persediaan Nilai Persediaan Nilai Persediaan
Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan
(Rp) (Rp) (Rp) (Rp)
1 2 3 3 4 5 6 8 9 11 12 14 15 16 17
1 Air untuk injeksi amp 20 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
2 Air untuk injeksi amp 25 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
3 Albendazol susp 200 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
4 Albendazol tab 400 mg Tab 45.00 359.00 16,155.00 0.00 0.00 45.00 359.00 0.00 359.00 0.00
16,155.00 - -
5 Alopurinol tab 100 mg Tab 370.00 95.00 35,150.00 0.00 0.00 130.00 95.00 240.00 95.00 0.00 bulan 1-5 harga 2016
12,350.00 22,800 -
6 Alopurinol tab 300 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
7 Alprazolam tablet 0,5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
8 Ambroxol syrup 15 mg/ml - 60 ml Tab 31.00 4,000.00 124,000.00 0.00 0.00 31.00 4,000.00 0.00 0.00
124,000.00 - -
9 Ambroxol tablet 30 mg Tab 2,720.00 150.00 408,000.00 0.00 0.00 960.00 150.00 1,760.00 150.00 0.00
144,000.00 264,000 -
10 Amilorid tab 5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
11 Aminofilin inj 24 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
12 Aminofilin tab 150 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
13 Aminofilin Tab 200 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00 bulan 1-6 harga 2016
- - -
14 Aminofilina injeksi 24 mg/ml - 10 ml ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
15 Amitriptilin tab sal 25 mg Tab sal 180.00 200.00 36,000.00 0.00 0.00 0.00 180.00 200.00 0.00
- 36,000 -
16 Amlodipin tab 10 mg Tab 10.00 107.00 1,070.00 0.00 0.00 10.00 107.00 0.00 0.00
1,070.00 - -
17 Amlodipin tab 5 mg Tab 100.00 90.00 9,000.00 0.00 0.00 75.00 90.00 25.00 90.00 0.00
6,750.00 2,250 -
18 Amoksisilin drops 100 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
19 Amoksisilin sir forte 250 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
20 Amoksisilin sir kering 125 mg/5 ml Botol 189.00 2,200.00 415,800.00 0.00 0.00 50.00 2,200.00 139.00 2,200.00 0.00
110,000.00 305,800 -
21 Amoksisilin tab 250 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
22 Amoksisilin tab 500 mg Tab 1,830.00 233.00 426,390.00 0.00 0.00 480.00 233.00 1,350.00 233.00 0.00 bulan 1-7 harga 2016
111,840.00 314,550 -
23 Ampisilin serb inj 1000 mg/vial Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
24 Ampisilin serb inj 250 mg/vial Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
25 Vial 120.00 2,227.00 267,240.00 0.00 0.00 0.00 120.00 2,227.00 0.00
2% + epinefrin 1 : 80.000 inj 2 ml - 267,240 -
26 Tab 3,630.00 64.00 232,320.00 0.00 0.00 630.00 64.00 3,000.00 64.00 0.00 bulan 1-3 harga 2015
200 mg + magnesium hidroksida 200 mg 40,320.00 192,000 -
27 Botol 307.00 3,100.00 951,700.00 0.00 0.00 45.00 3,100.00 262.00 3,100.00 0.00 bulan 1-3 harga 2016
200 mg + magnesium hidroksida 200 mg 139,500.00 812,200 -
Anti Parkinson kombinasi : benzerasid 25 mg
28 Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
+ levodopa 100 mg - - -
29 Tube 172.00 2,767.00 475,924.00 0.00 0.00 34.00 2,767.00 138.00 2,767.00 0.00 bulan 1-6 harga 2014
Polimiskin B 10.000 UI/g 94,078.00 381,846 -
30 Tube 37.00 4,782.00 176,934.00 0.00 0.00 10.00 4,782.00 27.00 4,782.00 0.00 bulan 1-6 harga 2016
6%+ asam salisilat
Antihemoroid, 3% bismut subgalat
kombinasi: 47,820.00 129,114 -
150 mg + heksaklorofen 2,5 mg + lidokain
31 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
lidokain 10 mg+ seng oksida 120 mg + sup - - -
ad 2 g
Antimalaria kombinasi : sulfadoksin 500 mg
32 Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
+ primetamin 25 mg - - -
33 Artemether inj 80 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
34 Artesunat serb inj 60 mg/ml (i.v./i.m.) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
35 Asam askorbat (vitamin C) tab 250 mg Tab 590.00 139.00 82,010.00 0.00 0.00 40.00 139.00 550.00 139.00 0.00
5,560.00 76,450 -
36 Asam askorbat (vitamin C) tab 50 mg Tab 500.00 120.00 60,000.00 0.00 0.00 248.00 120.00 252.00 120.00 0.00 bulan 1-7 harga 2016
29,760.00 30,240 -
37 Asam folat tab 0,4 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
38 Asam folat tab 1 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
39 Asam folat tab 5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
40 Asam mefenamat kaps 250 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
41 Asam mefenamat kaps 500 mg Kaps 1,890.00 127.00 240,030.00 0.00 0.00 750.00 127.00 1,140.00 127.00 0.00 bulan 1-5 harga 2015
95,250.00 144,780 -
42 Asam salisilat lar 0,1% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
43 Asam salisilat salep 5% Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
44 Asam Traneksamat tablet (Nexa tab) tablet 780.00 1,800.00 1,404,000.00 0.00 0.00 0.00 780.00 1,800.00 0.00
- 1,404,000 -
45 Asam Traneksamat injeksi 100 mg/5 ml Ampul 15.00 2,536.00 38,040.00 0.00 0.00 0.00 15.00 2,536.00 0.00
- 38,040 -
46 Asering infus 500 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
47 Asiklovir krim 5 % - 5 gram Tube 81.00 3,000.00 243,000.00 0.00 0.00 24.00 3,000.00 57.00 3,000.00 0.00
72,000.00 171,000 -
48 Asiklovir tab 200 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
49 Asiklovir tab 400 mg Tab 890.00 415.00 369,350.00 0.00 0.00 65.00 415.00 825.00 415.00 0.00 bulan 1-2 harga 2016
26,975.00 342,375 -
50 Atapulgit 600 mg Tab 700.00 166.00 116,200.00 0.00 0.00 65.00 166.00 635.00 166.00 0.00
10,790.00 105,410 -
51 Atapulgit tab 630 mg Tablet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
52 Atapulgit tablet 650 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
53 Atapulgit tablet 750 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
54 Atenolol tab 100 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
55 Atenolol tab 50 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
56 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
57 Atropin tab 0,5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
58 Bedak salisil serb 2% Botol 74.00 1,071.00 79,254.00 0.00 0.00 34.00 1,071.00 40.00 1,071.00 0.00 bulan 1-3 harga 2016
36,414.00 42,840 -
59 Betametason krim 0,5 mg/g Tube 137.00 1,450.00 198,650.00 0.00 0.00 82.00 1,450.00 55.00 1,450.00 0.00 bulan 1-2(1296)harga 2016
118,900.00 79,750 -
60 Betametason tts mata 1 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
61 Bisakodil sup 10 mg Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
62 Bisakodil sup 5 mg Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
63 Bisakodil tab sal 5 mg (Dulcolax) Tab sal 310.00 2,700.00 837,000.00 0.00 0.00 30.00 2,700.00 280.00 2,700.00 0.00
81,000.00 756,000 -
64 Budesonid cairan ih 0,25mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
65 Budesonid ih 200 mcg/dosis Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
66 Budesonid serb ih 100 mcg/dosis Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
67 Cetirizine tablet 10 mg Tab 2,045.00 115.00 235,175.00 0.00 0.00 1,105.00 115.00 940.00 115.00 0.00
127,075.00 108,100 -
68 Cetirizine sir 5 mg/5 ml. Botol 125.00 3,300.00 412,500.00 0.00 0.00 39.00 3,300.00 86.00 3,300.00 0.00
128,700.00 283,800 -
69 Deksametason inj 5 mg/ml (i.v./i.m.) Vial 81.00 1,805.00 146,205.00 0.00 0.00 0.00 81.00 1,805.00 0.00
- 146,205 -
70 Deksametason tab 0,5 mg Tab 2,020.00 45.00 90,900.00 0.00 0.00 1,028.00 45.00 992.00 45.00 0.00 bulan 1=26400 harga 2016,bulan 2 harga 2017
46,260.00 44,640 -
71 Diazepam lar rektal 5 mg/2,5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
72 Diazepam tab 2 mg Tab 609.00 100.00 60,900.00 0.00 0.00 38.00 100.00 571.00 100.00 0.00
3,800.00 57,100 -
73 Diazepam tab 5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
74 Dietilkarbamazin tab 100 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
75 Difenhidramin inj 10 mg/ml (i.v./i.m.) Ampul 6.00 1,222.00 7,332.00 0.00 0.00 0.00 6.00 1,222.00 0.00
- 7,332 -
76 Digoksin tab 0,25 mg Tab 100.00 103.00 10,300.00 0.00 0.00 100.00 103.00 0.00 103.00 0.00
10,300.00 - -
77 Diltiazem hcl tab 30 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
78 Diltiazem kaps SR 100 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
79 Diltiazem kaps SR 200 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
80 Diltiazem tab 30 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
81 Dimenhidrinat tab 50 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
82 Doksazosin tab 1 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
83 Doksazosin tab 2 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
84 Doksisiklin kaps 100 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
85 Domperidon susp 5 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
86 Domperidon tab 10 mg Tab 750.00 116.00 87,000.00 0.00 0.00 570.00 116.00 180.00 116.00 0.00 bulan 1-6 harga 2017, bulan 7 4200 tab harga 2017
66,120.00 20,880 -
87 Efedrin HCl tablet 25 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
88 Enoksaparin sodium inj 20 mg/0,2 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
89 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
90 Epinefrin (adrenalin) inj 1 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
91 Ergotamin tab 1 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
92 Eritromisin kaps 250 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
93 Eritromisin sir 200 mg/5 ml Botol 41.00 6,461.00 264,901.00 0.00 0.00 1.00 6,461.00 40.00 6,461.00 0.00
6,461.00 258,440 -
94 Eritromisin tab 500 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
95 Estrogen terkonjugasi tab sal 0,3 mg Tab sal 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
96 Estrogen terkonjugasi tab sal 0,625 mg Tab sal 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
97 Etakridin ( Rivanol ) larutan 0,1% - 300 ml botol 10.00 3,060.00 30,600.00 0.00 0.00 1.00 3,060.00 9.00 3,060.00 0.00
3,060.00 27,540 -
98 Etambutol tab 250 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
99 Etambutol tab 500 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
100 Etanol 70 % 1000 ml Botol 4.00 25,800.00 103,200.00 0.00 0.00 0.00 4.00 25,800.00 0.00
- 103,200 -
101 Etanol 70% 100 ml Botol 14.00 2,625.00 36,750.00 0.00 0.00 0.00 14.00 2,625.00 0.00
- 36,750 -
102 Etonogestrel implan 68 mg Set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
103 Fenitoin Na inj 100 mg/2 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
104 Fenitoin Na inj 50 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
105 Fenitoin Na kaps 100 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
106 Fenitoin Na kaps 30 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
107 Fenobarbital injeksi i.m 50 mg/ml - 2 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
108 Fenobarbital tab 100 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
109 Fenobarbital tab 30 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Fenoksimetil penisilin (penisilin V) tab 250
110 Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
mg - - -
Fenoksimetil penisilin (penisilin V) tab 500
111 Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
mg - - -
112 Ferro fumarat kaps lunak 300 mg Kaps lunak 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
113 Ferro sulfat sir. 15 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
114 Ferro sulfat tab salut 300 mg/Samcobion Tab sal 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
115 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
116 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 300.00 698.00 209,400.00 0.00 0.00 12.00 698.00 288.00 698.00 0.00
8,376.00 201,024 -
117 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) Ampul 20.00 3,754.00 75,080.00 0.00 0.00 0.00 20.00 3,754.00 0.00
- 75,080 -
118 Flunarizin tablet 10 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
119 Flunarizin tablet 5 mg Tab 420.00 1,000.00 420,000.00 0.00 0.00 100.00 1,000.00 320.00 1,000.00 0.00
100,000.00 320,000 -
120 Fluor kapl 1 mg Kaplet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
121 Fluor sediaan topikal Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
122 Fluor tab 0,5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
123 Fluoresein tts mata 2,5 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
124 Formokresol Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
125 Framisetin Sulfat Tulle 1% Patch 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
126 Furosemid inj 10 mg/ml (i.v./i.m.) Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
127 Furosemid tab 40 mg Tab 120.00 84.00 10,080.00 0.00 0.00 70.00 84.00 50.00 84.00 0.00
5,880.00 4,200 -
Galactose microparticle 200-400 mg
128 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
micropart/ml - - -
129 0,52 g + kalium klorida 0,30 g + trinatrium Sachet 296.00 273.00 80,808.00 0.00 0.00 65.00 273.00 231.00 273.00 0.00
17,745.00 63,063 -
130 Gentamisin salep kulit 3 % - 5 gram Tube 168.00 3,000.00 504,000.00 0.00 0.00 73.00 3,000.00 95.00 3,000.00 0.00
219,000.00 285,000 -
131 Gentamisin sulfat tetes mata 0,3 % - 5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
132 Gentian Violet larutan 1 % -10 ml Botol 59.00 2,500.00 147,500.00 0.00 0.00 11.00 2,500.00 48.00 2,500.00 0.00
27,500.00 120,000 -
133 Glibenklamid tab 2,5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
134 Glibenklamid tab 5 mg Tab 940.00 135.00 126,900.00 0.00 0.00 240.00 135.00 700.00 135.00 0.00
32,400.00 94,500 -
135 Gliklazid tablet 30 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
136 Glikuidon tab 30 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
137 Glimepirid tab 1 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
138 Glimepirid tab 2 mg Tab 500.00 296.00 148,000.00 0.00 0.00 0.00 500.00 296.00 0.00
- 148,000 -
139 Glimepiride tablet 4 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
140 Glipizid tab 5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
141 Gliseril Guayakolat tablet 100 mg Tab 4,150.00 100.00 415,000.00 0.00 0.00 854.00 100.00 3,296.00 100.00 0.00
85,400.00 329,600 -
142 Gliseril trinitrat tab 0,5 mg Tab sub 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
143 Gliserin tts 10 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
144 Gliserin tts 100 mg/ml Botol 4.00 6,600.00 26,400.00 0.00 0.00 0.00 4.00 6,600.00 0.00
- 26,400 -
145 Glukosa Larutan Infus 10% steril 100 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
- - -
- - -
- - -
- - -
150 Glukosa Larutan Infus 5% steril 500 ml Botol 10.00 5,720.00 57,200.00 0.00 0.00 0.00 10.00 5,720.00 0.00
- 57,200 -
151 Griseofulvin (micronized) tab 125 mg Tab 670.00 263.00 176,210.00 0.00 0.00 130.00 263.00 540.00 263.00 0.00
34,190.00 142,020 -
152 Griseofulvin (micronized) tab scored 250 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
153 Gutta percha dan paper points 15 - 40 mm Roll 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
154 Gutta percha dan paper points 45 - 80 mm Roll 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
155 Haloperidol inj 5 mg/ml (i.m.) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
156 Haloperidol tab 0,5 mg Tab 1,616.00 64.00 103,424.00 0.00 0.00 0.00 1,616.00 64.00 0.00
- 103,424 -
157 Haloperidol tab 1,5 mg Tab 1,060.00 76.00 80,560.00 0.00 0.00 120.00 76.00 940.00 76.00 0.00
9,120.00 71,440 -
158 Haloperidol tab 2 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
159 Haloperidol tab 5 mg Tab 1,030.00 74.00 76,220.00 0.00 0.00 60.00 74.00 970.00 74.00 0.00
4,440.00 71,780 -
160 Haloperidol tts 2 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
161 Hepatitis B imunoglobulin (human) inj 0,5 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
162 Hidroklorotiazid tab 25 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
163 Hidrokortison krim 2,5% Tube 153.00 2,838.00 434,214.00 0.00 0.00 45.00 2,838.00 108.00 2,838.00 0.00
127,710.00 306,504 -
164 Hidrokortison serb inj 100 mg/vial Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
165 Hiosina butilbromida tab 10 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Human tetanus imunoglobulin inj 250 UI
166 Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(Tetagam inj) - - -
Human tetanus imunoglobulin inj 500 UI
167 Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(i.m.) - - -
168 Ibuprofen sir 100 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
169 Ibuprofen sir 200 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
170 Ibuprofen tab 200 mg Tab 875.00 108.00 94,500.00 0.00 0.00 105.00 108.00 770.00 108.00 0.00
11,340.00 83,160 -
171 Ibuprofen tab 400 mg Tab 580.00 133.00 77,140.00 0.00 0.00 180.00 133.00 400.00 133.00 0.00 bulan 1-6 harga 2016
23,940.00 53,200 -
172 Ipratropium bromida ih padat 20 mcg Puff 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
173 Ipratropium bromida nebulizer 0,025% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
174 Isoniazid tab 100 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
175 Isoniazid tab 300 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
176 Isosorbid dinitrat tab 5 mg Tab 595.00 98.00 58,310.00 0.00 0.00 0.00 595.00 98.00 0.00
- 58,310 -
177 IUD Cu T 380 A Set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
178 IUD Levonorgestrel Set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
179 Kalamin Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
180 Kalsium glukonat inj 100 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
181 Kalsium hidroksida bubuk, pasta Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
182 Kalsium karbonat tab 500 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
183 Kalsium laktat (kalk) tab 500 mg Tab 2,300.00 82.00 188,600.00 0.00 0.00 72.00 82.00 2,228.00 82.00 0.00
5,904.00 182,696 -
184 Kaolin pektin syrup Botol 49.00 4,000.00 196,000.00 0.00 0.00 0.00 49.00 4,000.00 0.00
- 196,000 -
185 Kaolin pektin tablet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
186 Kaptopril tab 12,5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
187 Kaptopril tab 25 mg Tab 580.00 86.00 49,880.00 0.00 0.00 480.00 86.00 100.00 86.00 0.00
41,280.00 8,600 -
188 Kaptopril tab 50 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
189 Karbamazepin sir 100 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
190 Karbamazepin tab 100 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
191 Karbamazepin Tab 200 mg Tablet 60.00 230.00 13,800.00 0.00 0.00 0.00 60.00 230.00 0.00
- 13,800 -
192 Karbo adsorben tab 0,5 g Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
193 Karbogliserin tts telinga 10 % Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
194 Karbon aktif tab 0,5 mg Tablet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
195 Kenalaog in orabase salep Tube 2.00 65,000.00 130,000.00 0.00 0.00 0.00 2.00 65,000.00 0.00
- 130,000 -
196 Ketokonazol krim 2 % - 15 grm Tube 38.00 3,135.00 119,130.00 0.00 0.00 38.00 3,135.00 0.00 0.00
119,130.00 - -
197 Ketokonazol tab 200 mg Tab 460.00 320.00 147,200.00 0.00 0.00 0.00 460.00 320.00 0.00 bulan 1-4 harga 2015
- 147,200 -
198 Ketorolac injeksi 10 mg - 1 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
199 Klindamisin kaps 150 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
200 Klindamisin kaps 300 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
201 Klofazimin, micronized kaps 50 mg Kapsul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
202 Klofazimin, micronizedkaps 100 mg kapsul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
203 Klonidin tab 0,15 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
204 Kloramfenikol kaps 250 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
205 Kloramfenikol salep kulit 2% Tube 59.00 3,327.00 196,293.00 0.00 0.00 1.00 3,327.00 58.00 3,327.00 0.00
3,327.00 192,966 -
206 Kloramfenikol salep mata 1% Tube 4.00 1,850.00 7,400.00 0.00 0.00 0.00 4.00 1,850.00 0.00 bulan 1-4 harga 2015
- 7,400 -
207 Kloramfenikol susp 125 mg/5 ml Botol 55.00 4,982.00 274,010.00 0.00 0.00 5.00 4,982.00 50.00 4,982.00 0.00
24,910.00 249,100 -
208 Kloramfenikol tetes telinga 3% Botol 21.00 7,700.00 161,700.00 0.00 0.00 0.00 21.00 7,700.00 0.00
- 161,700 -
209 Kloramfenikol tts mata 0,5% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
210 Kloramfenikol tts mata 1% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Kloramphenicol suspensi 125 mg/5 ml - 60
211 botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
ml - - -
212 Klorfeniramin tab 4 mg Tab 2,840.00 45.00 127,800.00 0.00 0.00 910.00 45.00 1,930.00 45.00 0.00 bulan 1-6 harga 2016
40,950.00 86,850 -
213 Klorfenol kamfer mentol (CHKM) Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
214 Klorheksidin lar 0,2% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
215 Klorheksidin lar 15% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
216 Klorpromazin inj 25 mg/ml (i.m.) Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
217 Klorpromazin inj 5 mg/ml (i.m.) Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
218 Klorpromazin tab sal 100 mg Tab sal 1,129.00 148.00 167,092.00 0.00 0.00 139.00 148.00 990.00 148.00 0.00
20,572.00 146,520 -
219 Klorpromazin tab sal 25 mg Tab sal 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
220 Klortalidon tab 50 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
221 Kodein tab 10 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Kombinasi (DHP) : dihidroartemisin 40 mg +
222 Tablet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Piperakuin 320 mg tab sal selaput - - -
Kombinasi : (Difenhidramin 2%, Kalamin
223 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
5%, Zinc 10%, Gliserin 5%) lotion - - -
Kombinasi : artemether 20 mg + lumefantrin
224 Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
120 mg - - -
Kombinasi : artesunat tab 50 mg +
225 Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
amodiakuin tab 200 - - -
Kombinasi : Desogestrel 150 mcg
226 Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Etinilestradiol 30 mcg - - -
227 Kombinasi : ergotamin 1 mg+ kafein 50 mg Tab 100.00 210.00 21,000.00 0.00 0.00 36.00 210.00 64.00 210.00 0.00
7,560.00 13,440 -
Kombinasi : Ferro fumarat 60 mg + asam
228 Tablet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
folat 0,4 mg tab salut - - -
229 Tab sal 1,280.00 223.00 285,440.00 0.00 0.00 860.00 223.00 420.00 223.00 0.00 bulan 1-5 harga 2015 tab.tambah darah, harga 2017 ut samcobion
0,25 mg 191,780.00 93,660 -
Tab sal 420.00 45.00 18,900.00 0.00 0.00 18.00 45.00 402.00 45.00 0.00
0,25 mg 810.00 18,090 -
Kombinasi : levonorgestrel 150 mcg +
230 Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
etinilestradiol 30 mcg - - -
Kombinasi: ipratropium Br 0,5 mg+
231 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
salbutamol 2,5 mg nebules - - -
232 Kombinasi: kaolin 550 mg + pektin 20 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
233 Komposit resin Set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
234 Tab 1,020.00 131.00 133,620.00 0.00 0.00 200.00 131.00 820.00 131.00 0.00 bulan 1-3 harga 2016
sulfametoksazol 400 mg+ trimetoprim 80 mg 26,200.00 107,420 -
235 sulfametoksazol 800 mg+ trimetoprim 160 Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
mg
236 suspensi : sulfametoksazol 200 mg + Botol 63.00 2,225.00 140,175.00 0.00 0.00 23.00 2,225.00 40.00 2,225.00 0.00
51,175.00 89,000 -
trimetoprim 40 mg
237 Kuinin inj 25% (i.v.) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
238 Kuinin tab 200 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
239 Kuinin tab 222 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
240 Kuinin tab 250 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Larutan mengandung Elektrolit (Kalium
241 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Klorida) - - -
Larutan mengandung Elektrolit (Na 130
242 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) - - -
Larutan mengandung Elektrolit (NaCl 1.125
243 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
gr, Dekstrosa
Larutan 18.75 gr)
mengandung Elektrolit (Sodium - - -
Lactate sol (50%) 113 gr/L, Potassium
244 Larutan mengandung Elektrolit (Tiap 1000 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Chloride
ml 0.3 gr/L,electrolit:
mengandung Calcium Chloride 0.2 gr/L,
Sodium 145 - - -
elektrolit)
mmol/l, Potassium 4.0 mmol/l, Calcium 2.5
245 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
mmol/l, Magnesium 1.0 mmol/l, Chloride 118 - - -
Larutan
mmol/l, mengandung Karbohidrat
Acetate 24 mmol/l, Malate(Fructose
5.0
246 mmol/l)
120 g, glucose 66 g, Xylitol 60 g/ L + Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
elektrolit)
Larutan mengandung Karbohidrat (Fructose
247 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
60 g, glucose 33 g, Xylitol 30 g/ L) - - -
Larutan mengandung Karbohidrat (Maltose
248 Larutan mengandung Karbohidrat + Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
100 gr) - - -
Elektrolit (25.00g maltose, 3.00 g sodium
249 chloride, 0.15 g potassium chloride, 0.10 g Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
calcium chloride
Larutan dihydrate
mengandung dan 1.55
Karbohidrat +g
sodium lactate)
250 Elektrolit (Acetate, Na, K, Cl, Ca, Mg, Sorbitol Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
50 gr/L) mengandung Karbohidrat +
Larutan
251 Elektrolit (Fructose 60 g, glucose 33 g, Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Larutan - - -
Xylitol 30mengandung
g/ L) Karbohidrat +
Elektrolit (Glukosa 25 g, NaCl 2,0 g, KCl 1,3
252 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
g, Natrium Laktat 3,1 g, air untuk injeksi ad - - -
Larutan
1000 ml) mengandung Karbohidrat +
253 Elektrolit (Glukosa 55 g ; Natrium Chloride 9 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
g, air untuk injeksi ad 1000 ml) (D5-NS)
Larutan mengandung Karbohidrat +
254 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Elektrolit (Glukosa: 25,0 g; NaCl: 4,5 g) - - -
255 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Elektrolit (Glukosa: 55.0 g; NaCl: 2.25 g) - - -
256 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Elektrolit (Glukosa: 55.0 g; NaCl: 4.5 g) - - -
Elektrolit (Larutan nutrisi kombinasi infus per
257 L: Na. 100mEQ, K 18mEQ, Ca. 4mEQ, Mg Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
6mEQ, Cl 90mEQ, Asetat 38mEQ, Sorbitol
258 50g) Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Elektrolit (Larutan Ringer & Glukosa 5%) - - -
259 Elektrolit (NaCl 1.75 g, KCL 1.5g, Glukosa Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
100 gr) mengandung Karbohidrat +
Larutan
260 Elektrolit (Nacl 1.75 gr, KCl 1.5 gr, Na Lactat Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
2.24 gr, mengandung
Larutan Dekstrosa 27 Karbohidrat
gr) (KA EN 3B)
+
261 Elektrolit (Nacl 2.34 gr, Na Laktat 2.24 gr, Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
KCL 0.75 gr Dekstrosa 27 gr) (KA EN 3A)
Levonorgestrel implan 2 rods, 75 mg (3-4
262 Set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
tahun) - - -
263 Lidokain gel 2% Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
264 Lidokain injeksi 2% - 2 ml Ampul 8.00 1,280.00 10,240.00 0.00 0.00 0.00 8.00 1,280.00 0.00
- 10,240 -
265 Lidokain spray oral 10% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
266 Linestrenol tab 0,5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
267 Loperamid tab 2 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
268 Loratadin tab 10 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
269 Lugol Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
270 Magnesium sulfat inj 20% Vial 2.00 3,200.00 6,400.00 0.00 0.00 0.00 2.00 3,200.00 0.00
- 6,400 -
271 Magnesium sulfat inj 40% Vial 1.00 3,650.00 3,650.00 0.00 0.00 0.00 1.00 3,650.00 0.00
- 3,650 -
272 Magnesium sulfat serb, ktg 30 g Sachet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
273 Mebendazol sir 50 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
274 Mebendazol tab 100 mg Tan 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
275 Mebendazol tab 500 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
276 Medroksi progesteron asetat inj 150 mg/ml Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
277 Meloksikam tablet 7,5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
278 Metamizol injeksi Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Metenamin mandelat (heksamin mandelat)
279 Tab salut 0.00 0.00 0.00 0.00 0.00 0.00 0.00
tab salut enterik 500 mg - - -
280 Metformin tab 500 mg Tab 1,630.00 103.00 167,890.00 0.00 0.00 410.00 103.00 1,220.00 103.00 0.00 bulan 1-4 harga 2016
42,230.00 125,660 -
281 Metformin tab 850 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
282 Metilergometrin inj 0,2 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
283 Metilergometrin tab salut 0,125 mg Tab sal 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
284 Metilprednisolon tab 4 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
285 Metoklopramid tab 10 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
286 Metoklopramid tab 5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
287 Metoklopramide injeksi 5 mg/ml ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
288 Metoklopropamide Sirup 5 mg/ml - 60 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
289 Metronidazol lar inf 5 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
290 Metronidazol sir 125 mg/5 Ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
291 Metronidazol tab 250 mg Tab 240.00 94.00 22,560.00 0.00 0.00 0.00 240.00 94.00 0.00
- 22,560 -
292 Metronidazol tab 500 mg Tab 1,010.00 115.00 116,150.00 0.00 0.00 150.00 115.00 860.00 115.00 0.00
17,250.00 98,900 -
293 Mikonazol krim 2% Tube 93.00 4,250.00 395,250.00 0.00 0.00 43.00 4,250.00 50.00 4,250.00 0.00
182,750.00 212,500 -
294 Mikonazol serb 2% Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
295 Multivitamin Tab 1,680.00 249.00 418,320.00 0.00 0.00 390.00 249.00 1,290.00 249.00 0.00
97,110.00 321,210 -
296 Multivitamin Syrup Botol 219.00 3,850.00 843,150.00 0.00 0.00 71.00 3,850.00 148.00 3,850.00 0.00
273,350.00 569,800 -
297 NaCl 0,9% Larutan Botol 23.00 5,170.00 118,910.00 0.00 0.00 1.00 5,170.00 22.00 5,170.00 0.00
5,170.00 113,740 -
298 N-asetil sistein kaps 200 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
299 Natrium Bikarbonat tablet 500 mg Tab 1,200.00 58.00 69,600.00 0.00 0.00 0.00 1,200.00 58.00 0.00
- 69,600 -
300 Natrium diklofenak tab 25 mg Tab 1,590.00 167.00 265,530.00 0.00 0.00 200.00 167.00 1,390.00 167.00 0.00 bulan 1-5 harga 2016
33,400.00 232,130 -
301 Natrium diklofenak tab 50 mg Tab 30.00 200.00 6,000.00 0.00 0.00 30.00 200.00 0.00 0.00 bulan 1-3 harga 2016
6,000.00 - -
302 Natrium Diklofenak Tetes Mata 1 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
303 Natrium hipoklorit cairan konsentrat 5% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
304 Natrium tiosulfat inj 25% (i.v.) Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
305 Nifedipin kaps 10 mg Kaps 2,270.00 110.00 249,700.00 0.00 0.00 640.00 110.00 1,630.00 110.00 0.00 bulan1-2harga 2017,selanjutnya harga2014
70,400.00 179,300 -
306 Nikotinamid tab 100 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
- - -
- - -
309 Nistatin susp 100.000 UI/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
310 Nistatin tab salut 500.000 UI Tab 100.00 881.00 88,100.00 0.00 0.00 30.00 881.00 70.00 881.00 0.00
26,430.00 61,670 -
311 Nistatin tab vaginal 100.000 UI Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
312 Nitrofurantoin tab 50 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
313 Norepinefrin inj 1 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
314 Obat Anti Tuberculosis FDC Kategori Anak Paket 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
315 Obat Anti Tuberculosis FDC Kategori I Paket 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
316 Obat Anti Tuberculosis FDC Kategori II Paket 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
317 Obat Anti Tuberculosis FDC Kategori Sisipan Paket 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
318 Obat Anti Tuberculosis Kombipak Anak Paket 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
319 Obat Anti Tuberculosis Kombipak Dewasa Paket 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
320 Obat Batuk Anak Sirup Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
321 Obat Batuk Hitam ( O.B.H. ) cairan - 100 ml Botol 110.00 3,000.00 330,000.00 0.00 0.00 21.00 3,000.00 89.00 3,000.00 0.00
63,000.00 267,000 -
322 Obat Flu tablet Tablet 230.00 1,000.00 230,000.00 0.00 0.00 30.00 1,000.00 200.00 1,000.00 0.00
30,000.00 200,000 -
323 Obat Flu Syrup Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
324 Oksigen ih, gas dlm tabung Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
325 Oksimetazolin tts hidung 0,025% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
326 Oksimetazolin tts hidung 0,050% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Oksitetrasiklin HCl injeksi i.m. 50 mg/ml - 10
327 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
ml - - -
328 Oksitetrasiklin salep kulit 3% (HCl) - 5 gr Tube 32.00 2,864.00 91,648.00 0.00 0.00 3.00 2,864.00 29.00 2,864.00 0.00
8,592.00 83,056 -
329 Oksitetrasiklin salep mata 1% (HCl) - 3,5 gr Tube 81.00 3,000.00 243,000.00 0.00 0.00 1.00 3,000.00 80.00 3,000.00 0.00
3,000.00 240,000 -
330 Oksitosin inj 10 UI/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
331 Olopatadin tts mata 0,1% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
332 Omeprazol inj 40 mg/10 ml Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
333 Omeprazol kaps 20 mg Kaps 1,140.00 148.00 168,720.00 0.00 0.00 420.00 148.00 720.00 148.00 0.00
62,160.00 106,560 -
334 Ondansentron injeksi 4 mg/2 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
335 Ondansentron tablet 4 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
336 Paraformaldehid tab 1 g Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
337 Parasetamol 125 mg suppos supp 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
338 Parasetamol sir 120 mg/5 ml Botol 301.00 1,119.00 336,819.00 0.00 0.00 144.00 1,119.00 157.00 1,119.00 0.00 bulan 1-6 harga 2016
161,136.00 175,683 -
339 Parasetamol tab 500 mg Tab 6,510.00 105.00 683,550.00 0.00 0.00 3,090.00 105.00 3,420.00 105.00 0.00 bulan 1-4 harga 2016
324,450.00 359,100 -
340 Parasetamol tts 60 mg/0,6 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
341 Pasta devitalisasi (non arsen) Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
342 Pasta pengisi saluran akar (pasta) Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
343 Pehacain Injeksi ampul 22.00 313.00 6,886.00 0.00 0.00 0.00 22.00 313.00 0.00
- 6,886 -
344 Perak nitrat lar 20% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
345 Perak sulfadiazin krim 1% Tube 4.00 31,000.00 124,000.00 0.00 0.00 0.00 4.00 31,000.00 0.00 bulan 1-12 harga 2016
- 124,000 -
346 Permetrin krim 5 % Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
347 Piracetam injeksi 3 g/15 ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
348 Pirantel pamoat susp 125 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
349 Pirantel pamoat tab 500 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
350 Pirantel pamoat tab scored 125 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
351 Pirantel pamoat tab scored 250 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
352 Pirazinamid tab 500 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
353 Piridoksin (vitamin B6) inj 100 mg/ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
354 Piridoksin (vitamin B6) tab 10 mg Tab 490.00 136.00 66,640.00 0.00 0.00 50.00 136.00 440.00 136.00 0.00
6,800.00 59,840 -
355 Piridoksin (vitamin B6) tab 25 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
356 Piroksikam kapsul 10 mg Tab 1,530.00 90.00 137,700.00 0.00 0.00 220.00 90.00 1,310.00 90.00 0.00
19,800.00 117,900 -
357 Piroksikam kapsul 20 mg Tab 480.00 150.00 72,000.00 0.00 0.00 300.00 150.00 180.00 150.00 0.00
45,000.00 27,000 -
358 Povidon iodin lar 100 mg/ml Botol 30 ml 16.00 4,150.00 66,400.00 0.00 0.00 0.00 16.00 4,150.00 0.00
- 66,400 -
359 Povidon iodin lar 100 mg/ml Botol 60 ml 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
360 Povidon iodin lar 100 mg/ml Botol 300 ml 1.00 35,000.00 35,000.00 0.00 0.00 0.00 1.00 35,000.00 0.00
- 35,000 -
361 Povidon iodin lar 100 mg/ml Botol 1000 ml 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
362 Prednison tab 5 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
363 Primakuin tab 15 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
364 Probenesid tab 500 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Prokain benzilpenisilin serb inj 1 juta UI/vial
365 Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(i.m.) - - -
Prokain benzilpenisilin serb inj 3 juta UI/vial
366 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(i.m.) - - -
367 Propanolol tablet 10 mg (HCl) Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
368 Propanolol tablet 40 mg (HCl) Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
369 Propiltiourasil tab 100 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
370 Propranolol tab 10 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
371 Ranitidin injeksi 25 mg/ml - 2ml Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
372 Ranitidin tab 150 mg Tab 2,970.00 110.00 326,700.00 0.00 0.00 1,310.00 110.00 1,660.00 110.00 0.00
144,100.00 182,600 -
373 Retinol (vitamin A) kaps lunak 100.000 UI Kaps lunak 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
374 Retinol (vitamin A) kaps lunak 200.000 UI Kaps lunak 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
375 Rifampisin kaps 300 mg Kaps 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
376 Ringer Laktat Larutan Botol 9.00 7,150.00 64,350.00 0.00 0.00 0.00 9.00 7,150.00 0.00
- 64,350 -
377 Salbutamol cairan ih 0,1% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
378 Salbutamol lar ih 0,5 % Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
379 Salbutamol sir 2 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
380 Salbutamol tab 2 mg Tab 700.00 68.00 47,600.00 0.00 0.00 10.00 68.00 690.00 68.00 0.00
680.00 46,920 -
381 Salbutamol tab 4 mg Tab 560.00 89.00 49,840.00 0.00 0.00 30.00 89.00 530.00 89.00 0.00
2,670.00 47,170 -
382 Tube 27.00 2,797.00 75,519.00 0.00 0.00 3.00 2,797.00 24.00 2,797.00 0.00 bulan 1-5 harga 2016
belerang endap 4 % 8,391.00 67,128 -
383 Sefadroksil kapsul 500 mg Tab 880.00 557.00 490,160.00 0.00 0.00 15.00 557.00 865.00 557.00 0.00 bulan 1-6 harga 2016
8,355.00 481,805 -
384 Sefadroksil sirup kering 125mg/5ml - 60 ml Botol 33.00 7,500.00 247,500.00 0.00 0.00 3.00 7,500.00 30.00 7,500.00 0.00 bulan 1-6 harga 2016
22,500.00 225,000 -
385 Sefotaksim serbuk injeksi 1000 mg/vial Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
386 Seftriakson injeksi 1000 mg / vial - 10 ml Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Serum anti bisa ular : A.B.U. I (khusus ular
387 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
dari luar ) inj (i.m./i.v.) Papua - - -
Serum anti bisa ular :A.B.U.II (khusus ular
388 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
dari Papua) inj (i.m./i.v.) - - -
Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m
389 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
10.000 UI/ - - -
Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m
390 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
20.000 UI/ - - -
391 Serum antirabies inj 100 UI/ml Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
392 Serum antirabies inj 200 UI/ml Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Serum antitetanus (A.T.S) (i.m.) Inj 10.000
393 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
UI/vial (i.m /i.v.) - - -
Serum antitetanus (A.T.S) inj 1500 UI/amp
394 Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(i.m.) - - -
Serum antitetanus (A.T.S) inj 20.000 UI/vial
395 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(i.m /i.v.) - - -
396 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml Ampul 80.00 1,226.00 98,080.00 0.00 0.00 0.00 80.00 1,226.00 0.00
- 98,080 -
397 Sianokobalamin (vitamin B12) tab 50 mcg Tab 3,410.00 58.00 197,780.00 0.00 0.00 470.00 58.00 2,940.00 58.00 0.00 bulan 1-6 harga 2016
27,260.00 170,520 -
398 Simvastatin tab sal 10 mg Tab sal 380.00 135.00 51,300.00 0.00 0.00 60.00 135.00 320.00 135.00 0.00 bulan 1-5 harga 2016
8,100.00 43,200 -
399 Simvastatin tab sal 20 mg Tab sal 300.00 252.00 75,600.00 0.00 0.00 50.00 252.00 250.00 252.00 0.00
12,600.00 63,000 -
400 Siprofloksasin tab scored 500 mg Tab 750.00 298.00 223,500.00 0.00 0.00 220.00 298.00 530.00 298.00 0.00 bulan 1-12 harga 2016
65,560.00 157,940 -
401 Siprofloksasin tetes mata 3 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
402 Spironolakton tab 25 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Stannous pyrophosphate 27,6 mg sodium
403 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
pyrophosphate/vial - - -
404 Stesolid 5 mg rectal Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
405 Streptomisin serb inj 1.000 mg/vial Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
406 Surgical ginggival pack Tube 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
407 Telmisartan tab 40 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
408 Telmisartan tab 80 mg Tab 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
409 Tetanus toxoid inj Ampul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
410 Tetrakain tts mata 0,5% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
411 Tetrasiklin kaps 250 mg Kaps 800.00 181.00 144,800.00 0.00 0.00 0.00 800.00 181.00 0.00
- 144,800 -
412 Tetrasiklin kaps 500 mg Kaps 440.00 329.00 144,760.00 0.00 0.00 150.00 329.00 290.00 329.00 0.00
49,350.00 95,410 -
413 Thiampenicol 500 mg kapsul 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
414 Tiamin (vitamin B1) tab 50 mg Tab 3,950.00 91.00 359,450.00 0.00 0.00 390.00 91.00 3,560.00 91.00 0.00 bulan 1-7 harga 2016
35,490.00 323,960 -
415 Tiotropium serb ih 18 mcg + handihaller Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
416 Tiotropium serb ih 18 mcg, refill Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
417 Triheksifenidil tab 2 mg Tab 1,230.00 80.00 98,400.00 0.00 0.00 180.00 80.00 1,050.00 80.00 0.00
14,400.00 84,000 -
418 Trombopop gel Tube 2.00 65,000.00 130,000.00 0.00 0.00 0.00 2.00 65,000.00 0.00
- 130,000 -
419 Ulsidex - Sukralfat tablet 500 mg Tab 50.00 368.00 18,400.00 0.00 0.00 50.00 368.00 0.00 0.00
18,400.00 - -
420 Vaksin BCG inj (i.k) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
421 Vaksin campak inj (s.k.) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
422 Vaksin jerap difteri tetanus (DT) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
423 Vaksin jerap difteri tetanus (Td) Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Vaksin jerap difteri tetanus pertusis (DTP) inj
424 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(i.m.) - - -
Vaksin jerap tetanus (tetanus adsorbed
425 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
toxoid) inj (i.m.) - - -
426 Vaksin kombinasi DPT-HB-Hib Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
427 Vaksin polio IPV inj 0,5 ml Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
428 Vaksin polio t-OPV drops 10 dosis Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Vaksin rabies, untuk manusia serb inj
429 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(s.k./i.k) + booster - - -
430 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
431 Valproat sir 250 mg/5 ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
432 Valproat tab sal 250 mg Tab sal 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
433 Valproat tab sal 500 mg Tab sal 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
434 Vitamin B kompleks Tab 1,880.00 132.00 248,160.00 0.00 0.00 190.00 132.00 1,690.00 132.00 0.00
25,080.00 223,080 -
435 Zinc drops 10 mg/ml Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
436 Zinc serb 10 mg Sachet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
437 Zinc sir 20 mg/5 ml Botol 56.00 4,959.00 277,704.00 0.00 0.00 4.00 4,959.00 52.00 4,959.00 0.00
19,836.00 257,868 -
438 Zinc tab disp 20 mg Tab 550.00 591.00 325,050.00 0.00 0.00 200.00 591.00 350.00 591.00 0.00
118,200.00 206,850 -
439 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul 10.00 17,500.00 175,000.00 0.00 0.00 2.00 17,500.00 8.00 17,500.00 0.00
35,000.00 140,000 -
440 Betahistin tablet 6 mg Tablet 680.00 151.00 102,680.00 0.00 0.00 50.00 151.00 630.00 151.00 0.00
7,550.00 95,130 -
441 Vaksin flu bio influenza Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
442 Alat Suntik Sekali Pakai 1 ml Pcs 100.00 848.00 84,800.00 0.00 0.00 8.00 848.00 92.00 848.00 0.00
6,784.00 78,016 -
443 Alat Suntik Sekali Pakai 2,5 ml Pcs 537.00 714.00 383,418.00 0.00 0.00 19.00 714.00 518.00 714.00 0.00
13,566.00 369,852 -
444 Alat Suntik Sekali Pakai 3 ml set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
445 Alat Suntik Sekali Pakai 5 ml Pcs 134.00 774.00 103,716.00 0.00 0.00 0.00 134.00 774.00 0.00
- 103,716 -
446 Alkohol Swab set 200.00 181.00 36,200.00 0.00 0.00 0.00 200.00 181.00 0.00
- 36,200 -
Kertas warna
Articulating paper kertas warna penanda
447 penanda 0.00 0.00 0.00 0.00 0.00 0.00 0.00
oklusi - - -
oklusi
448 Aseptic gel 500 ml Botol 6.00 26,400.00 158,400.00 0.00 0.00 0.00 6.00 26,400.00 0.00
- 158,400 -
449 Pcs 39.00 7,286.00 284,154.00 0.00 0.00 0.00 39.00 7,286.00 0.00
jarum bedah - 284,154 -
450 Copper T set/buah 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
451 Disposible needle 23 Set 100.00 362.00 36,200.00 0.00 0.00 0.00 100.00 362.00 0.00
- 36,200 -
452 Disposible needle 25 Set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
453 Folley Catheter No. 14 Pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
- - -
- - -
456 HandScun pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
457 Hidrogen peroksida cairan 3% Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
458 Hidrogen peroksida lar. Konsentrat 3% Botol 800 ml 2.00 30,000.00 60,000.00 0.00 0.00 0.00 2.00 30,000.00 0.00
- 60,000 -
459 Infusion Set Anak Set 18.00 4,025.00 72,450.00 0.00 0.00 0.00 18.00 4,025.00 0.00 bulan 1-7 harga 2016
- 72,450 -
460 Infusion Set Dewasa Set 22.00 4,176.00 91,872.00 0.00 0.00 0.00 22.00 4,176.00 0.00 bulan 1-7 harga 2015
- 91,872 -
461 Infusion Set Y-Connector Pcs 20.00 6,280.00 125,600.00 0.00 0.00 0.00 20.00 6,280.00 0.00
- 125,600 -
462 IV Catheter No. 20 G Set 28.00 4,959.00 138,852.00 0.00 0.00 3.00 4,959.00 25.00 4,959.00 0.00
14,877.00 123,975 -
463 IV Catheter No. 22 G Set 12.00 5,254.00 63,048.00 0.00 0.00 0.00 12.00 5,254.00 0.00
- 63,048 -
464 IV Catheter No. 24 G Set 19.00 5,687.00 108,053.00 0.00 0.00 0.00 19.00 5,687.00 0.00
- 108,053 -
465 Jarum jahit (bedah) No. 12 set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
466 Kapas Pembalut 500 gram Roll 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
467 Kapas Pembalut / Absorben 250 gram Roll 1.00 16,313.00 16,313.00 0.00 0.00 0.00 1.00 16,313.00 0.00
- 16,313 -
468 Kasa Hydrophil 40 x 80 cm roll 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
469 Kasa Kompres 40/40 Steril pcs 124.00 1,532.00 189,968.00 0.00 0.00 9.00 1,532.00 115.00 1,532.00 0.00
13,788.00 176,180 -
470 Kasa Pembalut 2 m x 80 cm roll 18.00 8,855.00 159,390.00 0.00 0.00 0.00 18.00 8,855.00 0.00
- 159,390 -
471 Kasa Pembalut Hidrofil 4 m x 15 cm Elastic Rol 15.00 2,415.00 36,225.00 0.00 0.00 0.00 15.00 2,415.00 0.00
- 36,225 -
472 Kasa Pembalut Hidrofil 4 m x 5 cm Elastic roll 27.00 334.00 9,018.00 0.00 0.00 0.00 27.00 334.00 0.00
- 9,018 -
473 Kassa steril 16 cm x 16 cm roll 32.00 5,000.00 160,000.00 0.00 0.00 5.00 5,000.00 27.00 5,000.00 0.00
25,000.00 135,000 -
474 Lomatuell H/Lomatul Pcs 14.00 15,000.00 210,000.00 0.00 0.00 0.00 14.00 15,000.00 0.00
- 210,000 -
475 Masker pcs 150.00 586.00 87,900.00 0.00 0.00 0.00 150.00 586.00 0.00
- 87,900 -
476 Masker N 95 pcs 20.00 7,324.00 146,480.00 0.00 0.00 0.00 20.00 7,324.00 0.00
- 146,480 -
477 Nasal Cannula Child pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
478 Nasal Cannula Adult pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
479 Objeck Glass Frosted 7105, box isi 72 pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
480 Osygen Mask Child pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
481 Osygen Mask Adult pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
482 Pisau Bisturi No. 10 Buah 19.00 3,150.00 59,850.00 0.00 0.00 0.00 19.00 3,150.00 0.00
- 59,850 -
483 Pisau Bisturi no. 15 set 7.00 3,150.00 22,050.00 0.00 0.00 0.00 7.00 3,150.00 0.00
- 22,050 -
484 Pisau Bisturi no. 21 set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
485 Plester 5 yards x 2 inch roll 2.00 40,000.00 80,000.00 0.00 0.00 0.00 2.00 40,000.00 0.00
- 80,000 -
486 pcs 31.00 3,514.00 108,934.00 0.00 0.00 2.00 3,514.00 29.00 3,514.00 0.00
jarum bedah 7,028.00 101,906 -
487 Strip tes asam urat (easytouch) Btl 25 pcs 2.00 900,000.00 1,800,000.00 0.00 0.00 0.00 2.00 90,000.00 0.00
- 180,000 -
488 Strip tes gula darah (autocheck) Btl 25 pcs 1.00 90,000.00 90,000.00 0.00 0.00 0.00 1.00 90,000.00 0.00
- 90,000 -
489 Strip tes gula darah (easytouch) Btl 25 pcs 3.00 90,000.00 270,000.00 0.00 0.00 0.00 3.00 90,000.00 0.00
- 270,000 -
490 Strip tes HB (easytouch) Btl 25 pcs 1.00 165,000.00 165,000.00 0.00 0.00 1.00 165,000.00 0.00 0.00
165,000.00 - -
491 Strip tes kolesterol (autocheck) Btl 10 pcs 2.00 165,000.00 330,000.00 0.00 0.00 1.00 165,000.00 1.00 165,000.00 0.00
165,000.00 165,000 -
492 Strip tes kolesterol (easytouch) Btl 10 pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
493 Test pek Hamil Pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
494 Urine bag Pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
495 Bahan tumpatan sementara lar, serb Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
496 Bonding SDI / Stae Bond pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
497 Caviton pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
498 Coal tar lar 5 % Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
499 Cocoa butter 10 gr pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
500 Dentin conditioner mini pack 6 gram pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
501 Etil klorida semprot 100 ml Botol 5.00 125,000.00 625,000.00 0.00 0.00 0.00 5.00 125,000.00 0.00
- 625,000 -
502 Eugenol Botol 1.00 18,333.00 18,333.00 0.00 0.00 1.00 18,333.00 0.00 0.00
18,333.00 - -
503 Sachet 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Treatment) cocoa butter 5 g - - -
504 Botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Treatment) lar - - -
505 Vial 0.00 0.00 0.00 0.00 0.00 0.00 0.00
Treatment) serb - - -
506 Klorfenol kamfer Menthol ( CHKM ) - 10 ml botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
507 Mummifying Pasta botol 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
508 Nald Carpul set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
509 Occo set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
510 Saliva ejector blue woodpecker pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
511 Shield activ dendro pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
512 Solare Anterior # A3,5 GC pcs 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
513 Pot dahak 150 ml pot 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
514 Glucose (God-pap) set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
515 Cholesterol (chod-pap) set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
516 Hemoglobin (hb cyanide) set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
517 Uric Acid set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
518 Reagen Pemeriksaan TB set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
2*30 ml +
519 Creatinine Kit (Crea)-S 1*20 ml (80 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
ml)
4*36 ml +
520 Glucosa Kit (Gluc ) - HK 2*34 ml 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
(212 ml)
1*40 ml +
521 HDL - Cholesterol Kit (HDL-C) 1*14 ml (54 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
ml)
1*40 ml +
522 HDL - Cholesterol Kit (LDL-C) 1*14 ml (54 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
ml)
4*40 ml
523 Total Cholesterol Kit (TC) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(160 ml) - - -
4*40 ml
524 Triglycerides Kit (Tg) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(160 ml) - - -
4*40 ml
525 Total Protein Kit (TP) 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(160 ml) - - -
4*40 ml +
526 Uric Acid Kit (UA) 2*20 ml 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
(200 ml)
527 M-30 Diluent 20 L 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
528 M-30 CFL Lyse 500 ml 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
529 M-18E E-Z Cleanser 17 ml 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
530 PB-Cleaner (Labnovation) 100 ml 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
Botol 100
531 Urine Analyzer Reagent UA-600T 0.00 0.00 0.00 0.00 0.00 0.00 0.00
strip - - -
532 AutoChek Tri in One (GCU) Set 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
533 Risperidon 2 mg Tablet 1,000.00 347.00 347,000.00 0.00 0.00 0.00 1,000.00 347.00 0.00
- 347,000 -
534 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
535 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
536 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
537 0.00 0.00 0.00 0.00 0.00 0.00 0.00
- - -
TOTAL HARGA 89,061.00 30,452,336.00 0.00 0.00 21,247.00 5,487,873.00 67,814.00 23,344,463.00 0.00 0.00
Jeumpa, 29 Juni 2018 Kepala Puskesmas

Yang diperiksa Alue Sungai Pinang
Pengelola Obat Alue Sungai Pinang Kabupaten Aceh Barat Daya

Nip. 19830727 201212 2 004
Murti, SKM
Nip. 19720802 199101 2 001

bulan 1-2(1296)harga 2016
bulan 1=26400 harga 2016,bulan 2 harga 2017

bulan 1-6 harga 2017, bulan 7 4200 tab harga 2017

bulan 1-5 harga 2015 tab.tambah darah, harga 2017 ut samcobion


bulan1-2harga 2017,selanjutnya harga2014




6400 harga 2016,bulan 2 harga 2017
harga 2017, bulan 7 4200 tab harga 2017
harga 2015 tab.tambah darah, harga 2017 ut samcobion
arga 2017,selanjutnya harga2014
PUSKESMAS RAWAT INAP BABAHROT
PER 30 JUNI 2021
SALDO AWAL PER 31 DESEMBER 2020 PENERIMAAN PEMAKAIAN SALDO AKHIR PER 30 JUNI 2021 SALDO EXPIRE DATE PER 31 DESEMBER 2019
NO URAIAN Satuan
Jumlah(Unit) Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Nilai Persediaan (Rp) Jumlah(Unit) Harga Satuan Jumlah(Unit) Harga Satuan
(Rp) (Rp)
1 2 3 3 4 5 6 8 9 11 12 14
4 5 6
1 Albendazol tab 400 mg Tab 180 463.00 83,340.00 120.00 463.00 55,560.00 120.00 463.00 55,560.00 180 463.00 83,340.00 180 463.00 83,340.00
2 Air untuk injeksi Ampul 10 2,685.00 26,850.00 60.00 2,685.00 161,100.00 70.00 2,685.00 187,950.00 2,685.00 0.00 2,685.00 -
3 Allopurinol 100 mg Tab 4,267 105.00 448,035.00 4,000.00 105.00 420,000.00 7,313.00 105.00 767,865.00 954 105.00 100,170.00 -
4 Alfrazolam Tab 200 88.00 17,600.00 0.00 88.00 0.00 25.00 88.00 2,200.00 175 88.00 15,400.00 88.00 -
5 Aminofiline injeksi Ampul 0 3,080.00 - 5.00 3,080.00 15,400.00 0.00 3,080.00 - 5 3,080.00 15,400.00 -
6 Ambroxol tablet 30 mg Tab 1,657 152.00 251,864.00 4,500.00 152.00 684,000.00 5,967.00 152.00 906,984.00 190 152.00 28,880.00 -
7 Amitriptilin tab sal 25 mg Tab sal 115 168.00 19,320.00 1,400.00 168.00 235,200.00 1,420.00 168.00 238,560.00 95 168.00 15,960.00 -
8 Amlodipin tab 10 mg Tab 1,228 95.00 116,660.00 2,850.00 95.00 270,750.00 3,106.00 95.00 295,070.00 972 95.00 92,340.00 -
9 Amlodipin tab 5 mg Tab 444 79.00 35,076.00 3,900.00 79.00 308,100.00 3,757.00 79.00 296,803.00 587 79.00 46,373.00 -
10 Amoksisilin sir kering 125 mg/5 ml Botol 145 4,350.00 630,750.00 690.00 4,350.00 3,001,500.00 477.00 4,350.00 2,074,950.00 358 4,350.00 1,557,300.00 4,350.00 -
11 Amoksisilin tab 250 mg Tab 620 209.00 129,580.00 209.00 0.00 620.00 209.00 129,580.00 209.00 0.00 209.00 -
12 Amoksisilin tab 500 mg Tab 2,790 260.00 725,400.00 17,000.00 260.00 4,420,000.00 17,890.00 260.00 4,651,400.00 1,900 260.00 494,000.00 -
Anestetik lokal gigi kombinasi :

13 lidokain hcl 2% + epinefrin 1 : 80.000 Vial 448 2,227.00 997,696.00 90.00 2,227.00 200,430.00 538.00 2,227.00 1,198,126.00 2,227.00 0.00 330 2,227.00 734,910.00
inj 2 ml
Antasida, kombinasi : aluminium
14 hidroksida 200 mg + magnesium tab 2,102 60.00 126,120.00 11,200.00 60.00 672,000.00 12,422.00 60.00 745,320.00 880 60.00 52,800.00 -
hidroksida 200 mg
Antasida, kombinasi : aluminium
15 hidroksida 200 mg + magnesium Botol 79.00 2,239.00 176,881.00 1,600.00 2,239.00 3,582,400.00 1,569.00 2,239.00 3,512,991.00 110.00 2,239.00 246,290.00 51 2,239.00 114,189.00
hidroksida 200 mg
Antifungi salep, kombinasi : asam
16 Tube 217.00 4,972.00 1,078,924.00 4,972.00 0.00 102.00 4,972.00 507,144.00 115.00 4,972.00 571,780.00 -
benzoat 6%+ asam salisilat 3%
17 Antihemoroid Tab 3,642.00 0.00 40.00 3,642.00 145,680.00 20.00 3,642.00 72,840.00 20.00 3,642.00 72,840.00 3,642.00 -
18 Asam askorbat (vitamin C) tab 50 mg Tab 3,008.00 120.00 360,960.00 11,800.00 120.00 1,416,000.00 12,505.00 120.00 1,500,600.00 2,303.00 120.00 276,360.00 -
19 Asam mefenamat kaps 500 mg kaps 1,720.00 103.00 177,160.00 11,200.00 103.00 1,153,600.00 8,262.00 103.00 850,986.00 4,658.00 103.00 479,774.00 -
20 Asiklofir krim 5%- 5 Gram Tube 100.00 4,048.00 404,800.00 312.00 4,048.00 1,262,976.00 327.00 4,048.00 1,323,696.00 85.00 4,048.00 344,080.00 -
21 Asiklovir 200 mg Tab 206.00 440.00 90,640.00 2,200.00 440.00 968,000.00 739.00 440.00 325,160.00 1,667.00 440.00 733,480.00 400 440.00 176,000.00
22 Asiklofirtab 400 mg Tab 1,444.00 454.00 655,576.00 1,600.00 454.00 726,400.00 1,676.00 454.00 760,904.00 1,368.00 454.00 621,072.00 -
23 Atapulgit 600 mg Tab 1,244.00 159.00 197,796.00 3,200.00 159.00 508,800.00 3,060.00 159.00 486,540.00 1,384.00 159.00 220,056.00 -
24 Bedak salisil serb 2% Botol 40.00 3,850.00 154,000.00 350.00 3,850.00 1,347,500.00 256.00 3,850.00 985,600.00 134.00 3,850.00 515,900.00 -
25 Betametason krim 0,5 mg/g tube 20.00 1,465.00 29,300.00 600.00 1,465.00 879,000.00 556.00 1,465.00 814,540.00 64.00 1,465.00 93,760.00 -
26 Cetirizine sir 5 mg/5 ml. Botol 77.00 3,061.00 235,697.00 340.00 3,061.00 1,040,740.00 417.00 3,061.00 1,276,437.00 3,061.00 0.00 -
27 Desametasone inj 5 mg/ml(i.v/i.m) Ampul 100.00 1,210.00 121,000.00 450.00 1,210.00 544,500.00 420.00 1,210.00 508,200.00 130.00 1,210.00 157,300.00 1,210.00 -
28 Desametasone tab 0.5 mg Tab 1,792.00 100.00 179,200.00 1,650.00 100.00 165,000.00 311.00 100.00 31,100.00 3,131.00 100.00 313,100.00 -
29 Diazepam tab 2 mg Tab 209.00 100.00 20,900.00 1,000.00 100.00 100,000.00 939.00 100.00 93,900.00 270.00 100.00 27,000.00 1,222.00 -
30 Difenhidramin inj 10 mg/ml (i.v./i.m.) Ampul 90.00 1,222.00 109,980.00 450.00 1,222.00 549,900.00 540.00 1,222.00 659,880.00 1,222.00 0.00
31 Digoksin tab 0,25 mg Tab 103.00 0.00 200.00 103.00 20,600.00 0.00 103.00 - 200.00 103.00 20,600.00 -
32 Domperidon susp 5 mg/5 ml Botol 333.00 2,862.00 953,046.00 400.00 2,862.00 1,144,800.00 464.00 2,862.00 1,327,968.00 269.00 2,862.00 769,878.00 -
33 Domperidone tab 10 mg Tab 1,534.00 86.00 131,924.00 7,200.00 86.00 619,200.00 3,687.00 86.00 317,082.00 5,047.00 86.00 434,042.00 -
34 Epinefrrin (adrenaline) Ampul 9,800.00 0.00 15.00 9,800.00 147,000.00 0.00 9,800.00 - 15.00 9,800.00 147,000.00 15 9,800.00 147,000.00
Etakridin ( Rivanol ) larutan 0,1% - 300

35 Botol 5,500.00 0.00 19.00 5,500.00 104,500.00 19.00 5,500.00 104,500.00 5,500.00 0.00 -
ml
36 Fitomenadion (vitamin K 1) injeksi Ampul 80.00 3,754.00 300,320.00 150.00 3,754.00 563,100.00 140.00 3,754.00 525,560.00 90.00 3,754.00 337,860.00 90 3,754.00 337,860.00
Fitomenadion (vitamin K 1) tab sal 10

37 Tab sal 348.00 818.00 284,664.00 1,100.00 818.00 899,800.00 888.00 818.00 726,384.00 560.00 818.00 458,080.00 -
mg
38 Fenobarbital tab Tab 220.00 197.00 43,340.00 600.00 197.00 118,200.00 500.00 197.00 98,500.00 320.00 197.00 63,040.00 -
39 Fenobarbital injeksi Ampul 30.00 1,980.00 59,400.00 1,980.00 0.00 0.00 1,980.00 - 30.00 1,980.00 59,400.00 -
40 Furosemide 40 mg Tab 347.00 197.00 68,359.00 1,000.00 197.00 197,000.00 447.00 197.00 88,059.00 900.00 197.00 177,300.00 -
Garam oralit kombinasi : natrium
klorida 0,52 g + kalium klorida 0,30 g +
41 Sachet 184.00 263.00 48,392.00 200.00 263.00 52,600.00 161.00 263.00 42,343.00 223.00 263.00 58,649.00 -
trinatrium sitrat 0,58 g + glukosa
anhidrat 2,7 g
42 Gentamicine salep kulit 3 % -5 gram tube 23.00 3,740.00 86,020.00 170.00 3,740.00 635,800.00 193.00 3,740.00 721,820.00 3,740.00 0.00 -
43 Glibenklamid tab 5 mg Tab 229.00 137.00 31,373.00 2,000.00 137.00 274,000.00 1,879.00 137.00 257,423.00 350.00 137.00 47,950.00 -
44 Glimepirid tab 2 mg Tab 380.00 207.00 78,660.00 800.00 207.00 165,600.00 798.00 207.00 165,186.00 382.00 207.00 79,074.00 -
45 Gliseril Guayakolat tablet 100 mg Tab 1,509.00 110.00 165,990.00 6,300.00 110.00 693,000.00 5,179.00 110.00 569,690.00 2,630.00 110.00 289,300.00 -
46 Glukosa Larutan Infus 5% steril 500 ml Botol 60.00 7,363.00 441,780.00 140.00 7,363.00 1,030,820.00 60.00 7,363.00 441,780.00 140.00 7,363.00 1,030,820.00 7,363.00 -
116 Griseofulvin (micronized) tab 125 mg Tab 526.00 263.00 138,338.00 1,200.00 263.00 315,600.00 949.00 263.00 249,587.00 777.00 263.00 204,351.00 -
47 Hallopuridol 0.5 tab 0.00 500.00 0.00 180.00 - 320.00 0.00 -
48 Haloperidol tab 5 mg Tab 50.00 64.00 3,200.00 600.00 64.00 38,400.00 70.00 64.00 4,480.00 580.00 64.00 37,120.00 -
49 Haloperidol tab 1,5 mg Tab 76.00 0.00 1,700.00 76.00 129,200.00 1,619.00 76.00 123,044.00 81.00 76.00 6,156.00 -
50 Halopuridol tab inkesi Ampul 59.00 0.00 10.00 101,300.00 1,013,000.00 0.00 101,300.00 - 10.00 101,300.00 1,013,000.00 -
51 Hidroklortiazid Tab 334.00 171.00 57,114.00 1,600.00 171.00 273,600.00 1,149.00 171.00 196,479.00 785.00 171.00 134,235.00 171.00 -
52 Hidrokortison krim 2,5% Tube 2,533.00 0.00 216.00 2,533.00 547,128.00 216.00 2,533.00 547,128.00 2,533.00 0.00 -
53 Ibuprofen sirup botol 112.00 0.00 40.00 112.00 4,480.00 6.00 112.00 672.00 34.00 112.00 3,808.00 -
54 Ibuprofen 200 mg Tab 1,440.00 242.00 348,480.00 5,400.00 242.00 1,306,800.00 5,020.00 242.00 1,214,840.00 1,820.00 242.00 440,440.00 -
55 Ibuprofen tab 400 mg Tab 1,168.00 300.00 350,400.00 6,000.00 300.00 1,800,000.00 5,281.00 300.00 1,584,300.00 1,887.00 300.00 566,100.00 -
56 Isosorbid dinitrat tab 5 mg Tab 1,160.00 150.00 174,000.00 500.00 150.00 75,000.00 1,115.00 150.00 167,250.00 545.00 150.00 81,750.00 -
57 Kalsium laktat (kalk) tab 500 mg Tab 59.00 0.00 3,700.00 59.00 218,300.00 3,700.00 59.00 218,300.00 59.00 0.00 59.00 -
58 Kaptopril tab 12,5 mg Tab 2,594.00 65.00 168,610.00 2,500.00 65.00 162,500.00 2,606.00 65.00 169,390.00 2,488.00 65.00 161,720.00 -
59 Kaptropil 25 mg Tab 1,100.00 150.00 165,000.00 1,700.00 150.00 255,000.00 2,190.00 150.00 328,500.00 610.00 150.00 91,500.00 -
60 Karbamazepin Tab 200 mg Tablet 234.00 0.00 700.00 234.00 163,800.00 595.00 234.00 139,230.00 105.00 234.00 24,570.00 234.00 -
61 Ketokonazol krim 2 % - 15 grm Tube 124.00 2,577.00 319,548.00 150.00 2,577.00 386,550.00 240.00 2,577.00 618,480.00 34.00 2,577.00 87,618.00 -
62 Ketokonazol 200 mg Tab 607.00 305.00 185,135.00 1,200.00 305.00 366,000.00 1,807.00 305.00 551,135.00 305.00 0.00 650 305.00 198,250.00
63 Ketorolak injeksi Ampul 1,045.00 0.00 620.00 1,045.00 647,900.00 620.00 1,045.00 647,900.00 1,045.00 0.00 -
64 Kloramfenikol salep kulit 2% Tube 67.00 3,585.00 240,195.00 120.00 3,585.00 430,200.00 71.00 3,585.00 254,535.00 116.00 3,585.00 415,860.00 -
65 Kloramfenikol salp mata 1 % Tube 56.00 2,054.00 115,024.00 168.00 2,054.00 345,072.00 174.00 2,054.00 357,396.00 50.00 2,054.00 102,700.00 -
66 Kloramfenikol tetes telinga 3% Botol 7.00 10,000.00 70,000.00 120.00 10,000.00 1,200,000.00 41.00 10,000.00 410,000.00 86.00 10,000.00 860,000.00 -
67 Klorfeniramine maleat tab 4 mg Tab 1,965.00 50.00 98,250.00 19,000.00 50.00 950,000.00 18,747.00 50.00 937,350.00 2,218.00 50.00 110,900.00 -
68 Klorpromazin tab sal 100 mg Tab sal 135.00 550.00 74,250.00 1,300.00 550.00 715,000.00 1,413.00 550.00 777,150.00 22.00 550.00 12,100.00 -
69 Klorformazine injeksi Ampul 24.00 1,531.00 36,744.00 60.00 1,531.00 91,860.00 41.00 1,531.00 62,771.00 43.00 1,531.00 65,833.00 20 1,531.00 30,620.00
70 Kodein Tab sal 95.00 657.00 62,415.00 657.00 0.00 10.00 657.00 6,570.00 85.00 657.00 55,845.00 657.00 -
Kotrimoksazole (dewasa) kombinasi:

71 Tab 1,384.00 133.00 184,072.00 4,800.00 133.00 638,400.00 4,302.00 133.00 572,166.00 1,882.00 133.00 250,306.00 -
sulfametoksazol 400mg
Kombinasi itrapium Br
72 40.00 4,550.00 182,000.00 20.00 4,550.00 91,000.00 60.00 4,550.00 273,000.00 4,550.00 0.00 -
0,5mg+salbutamol2,5 mg nebules
Kotrimoksazol (dewasa) kombinasi tiap
73 5 ml suspensi : sulfametoksazol 200 mg Botol 74.00 2,052.00 151,848.00 400.00 2,052.00 820,800.00 182.00 2,052.00 373,464.00 292.00 2,052.00 599,184.00 -
+ trimetoprim 40 mg
Kombinasi:Ferro fumarat 60 mg+asam
74 2,485.00 24.00 59,640.00 9,040.00 24.00 216,960.00 9,154.00 24.00 219,696.00 2,371.00 24.00 56,904.00 -
folat0,4mg tab
75 Lidokain injeksi 2% - 2 ml Ampul 185.00 1,280.00 236,800.00 300.00 1,280.00 384,000.00 348.00 1,280.00 445,440.00 137.00 1,280.00 175,360.00 -
76 Magnesium sulfat inj 20% Vial 3,328.00 0.00 6.00 3,328.00 19,968.00 6.00 3,328.00 19,968.00 3,328.00 0.00 -
77 Metformin tab 500 mg Tab 220.00 102.00 22,440.00 1,000.00 102.00 102,000.00 1,220.00 102.00 124,440.00 102.00 0.00 -
78 Metilergometrine tablet Tab 380.00 244.00 92,720.00 500.00 244.00 122,000.00 380.00 244.00 92,720.00 500.00 244.00 122,000.00
79 Metilegometrin inj 0,2 mg/ml Ampul 87.00 3,399.00 295,713.00 110.00 3,399.00 373,890.00 187.00 3,399.00 635,613.00 10.00 3,399.00 33,990.00 60 3,399.00 203,940.00
80 Metilprednisolon 4mg Tab 125.00 139.00 17,375.00 3,000.00 139.00 417,000.00 3,125.00 139.00 434,375.00 139.00 0.00 -
81 Metro srup Botol 227.00 3,950.00 896,650.00 200.00 3,950.00 790,000.00 81.00 3,950.00 319,950.00 346.00 3,950.00 1,366,700.00 -
82 Metronidazol tab 500 mg Tab 305.00 280.00 85,400.00 2,700.00 280.00 756,000.00 2,720.00 280.00 761,600.00 285.00 280.00 79,800.00 -
83 Metoklopramid tab 10 mg Tab 1,820.00 83.00 151,060.00 500.00 83.00 41,500.00 1,150.00 83.00 95,450.00 1,170.00 83.00 97,110.00 -
84 Metokloporamid injeksi Ampul 3,500.00 0.00 200.00 3,500.00 700,000.00 200.00 3,500.00 700,000.00 3,500.00 0.00 -
85 Mikonazol krim 2% Tube 91.00 3,926.00 357,266.00 264.00 3,926.00 1,036,464.00 283.00 3,926.00 1,111,058.00 72.00 3,926.00 282,672.00 -
86 Multivitamin Syrup Botol 9.00 4,500.00 40,500.00 450.00 4,500.00 2,025,000.00 259.00 4,500.00 1,165,500.00 200.00 4,500.00 900,000.00 -
87 NaCl 0,9% Larutan Botol 120.00 6,410.00 769,200.00 240.00 6,410.00 1,538,400.00 260.00 6,410.00 1,666,600.00 100.00 6,410.00 641,000.00 6,410.00 -
88 Natriumdiklofenak25 mg Tab 2,330.00 152.00 354,160.00 8,500.00 152.00 1,292,000.00 9,050.00 152.00 1,375,600.00 1,780.00 152.00 270,560.00 -
89 Natrium diklofenak tab 50 mg Tab 1,110.00 145.00 160,950.00 4,000.00 145.00 580,000.00 4,685.00 145.00 679,325.00 425.00 145.00 61,625.00 145.00 -
90 Nifedipine 10 mg Kaps 288.00 200.00 57,600.00 300.00 200.00 60,000.00 588.00 200.00 117,600.00 200.00 0.00 300 200.00 60,000.00
91 Nistatin tab salut 500.000 UI Tab 130.00 971.00 126,230.00 400.00 971.00 388,400.00 250.00 971.00 242,750.00 280.00 971.00 271,880.00 -
92 Obat anti Tuberkolsis katagori I paket 447,791.00 0.00 16.00 447,791.00 7,164,656.00 16.00 447,791.00 7,164,656.00 447,791.00 0.00 -
93 Obat Batuk Anak Sirup Botol 165.00 6,500.00 1,072,500.00 492.00 6,500.00 3,198,000.00 338.00 6,500.00 2,197,000.00 319.00 6,500.00 2,073,500.00 -
94 Obat Anti Tuberkulosis katagori II Paket 3,850.00 0.00 1.00 3,850.00 3,850.00 1.00 3,850.00 3,850.00 3,850.00 0.00 -
Obat Batuk Hitam ( O.B.H. ) cairan -

95 Botol 214.00 4,500.00 963,000.00 450.00 4,500.00 2,025,000.00 664.00 4,500.00 2,988,000.00 4,500.00 0.00 -
100 ml
Oksitetrasikline salep kulit 3% (HCL)-

96 Tube 133.00 3,300.00 438,900.00 500.00 3,300.00 1,650,000.00 533.00 3,300.00 1,758,900.00 100.00 3,300.00 330,000.00 -
5gr
Oksitetrasiklin salep mata 1% (HCl) -

97 Tube 142.00 2,687.00 381,554.00 250.00 2,687.00 671,750.00 322.00 2,687.00 865,214.00 70.00 2,687.00 188,090.00 -
3,5 gr
98 Oksitoksine injeksi Ampul 1,232.00 0.00 270.00 1,232.00 332,640.00 170.00 1,232.00 209,440.00 100.00 1,232.00 123,200.00 1,232.00 -
99 Omeprazol kaps 20 mg Kaps 1,330.00 500.00 665,000.00 1,590.00 500.00 795,000.00 2,920.00 500.00 1,460,000.00 500.00 0.00 -
100 Parasetamol sir 120 mg/5 ml Botol 125.00 3,300.00 412,500.00 1,300.00 3,300.00 4,290,000.00 1,068.00 3,300.00 3,524,400.00 357.00 3,300.00 1,178,100.00 -
101 Parasemol tab 500 mg Tab 1,757.00 150.00 263,550.00 21,200.00 150.00 3,180,000.00 21,840.00 150.00 3,276,000.00 1,117.00 150.00 167,550.00 -
102 Perak sulfadiazin krim 1% Tube 12.00 20,700.00 248,400.00 20,700.00 0.00 2.00 20,700.00 41,400.00 10.00 20,700.00 207,000.00 -
103 Pehacain injeksi Ampul 131.00 0.00 60.00 131.00 7,860.00 0.00 131.00 - 60.00 131.00 7,860.00 -
104 Piridoksin (vitamin B6) tab 10 mg Tab 1,538.00 141.00 216,858.00 6,500.00 141.00 916,500.00 7,504.00 141.00 1,058,064.00 534.00 141.00 75,294.00 1400 141.00 197,400.00
105 Piroksikam kapsul 10 mg Tab 512.00 121.00 61,952.00 3,300.00 121.00 399,300.00 2,840.00 121.00 343,640.00 972.00 121.00 117,612.00 -
106 Piroksikam kapsul 20 mg Tab 725.00 165.00 119,625.00 2,900.00 165.00 478,500.00 1,726.00 165.00 284,790.00 1,899.00 165.00 313,335.00 -
107 Povidon iodin lar 100 mg/ml Botol 30 ml 5.00 2,900.00 14,500.00 15.00 2,900.00 43,500.00 20.00 2,900.00 58,000.00 0.00 2,900.00 0.00 3 2,900.00 8,700.00
108 Povidon iodin lar 100 mg/ml Botol 300 ml 5.00 18,000.00 90,000.00 6.00 18,000.00 108,000.00 11.00 18,000.00 198,000.00 0.00 18,000.00 0.00 5 18,000.00 90,000.00
109 Propanolol tab 40 mg (HCL) Tab 1,022.00 215.00 219,730.00 200.00 215.00 43,000.00 243.00 215.00 52,245.00 979.00 215.00 210,485.00 -
110 Prednison tab 5 mg Tab 85.00 0.00 4,100.00 85.00 348,500.00 3,900.00 85.00 331,500.00 200.00 85.00 17,000.00 -
111 Ranitidine injeksi 25 mg/ml-2ml Ampul 50.00 1,155.00 57,750.00 900.00 1,155.00 1,039,500.00 950.00 1,155.00 1,097,250.00 0.00 1,155.00 0.00 157 1,155.00 181,335.00
112 Ranitidine tab 150 mg Tab 1,355.00 114.00 154,470.00 9,500.00 114.00 1,083,000.00 10,266.00 114.00 1,170,324.00 589.00 114.00 67,146.00 -
Retinol(Vitmin A) kap lunak1000000

113 Tab 310.00 331.00 102,610.00 1,300.00 331.00 430,300.00 1,310.00 331.00 433,610.00 300.00 331.00 99,300.00 -
UI!
Retinol (Vitamin A) kap lunak 200.000

114 Tab 596.00 0.00 2,650.00 596.00 1,579,400.00 2,650.00 596.00 1,579,400.00 596.00 0.00 -
UI
Retinol (vitamin A) kap lunak 200000

115 Tab 200.00 596.00 119,200.00 596.00 0.00 100.00 596.00 59,600.00 100.00 596.00 59,600.00 -
UI
116 Ringer Laktat Larutan Botol 140.00 7,150.00 1,001,000.00 1,600.00 7,150.00 11,440,000.00 1,580.00 7,150.00 11,297,000.00 160.00 7,150.00 1,144,000.00 -
117 Salbutamol 2mg Tab 482.00 64.00 30,848.00 2,200.00 64.00 140,800.00 1,962.00 64.00 125,568.00 720.00 64.00 46,080.00 -
118 Salbutamol 4 mg Tab 695.00 77.00 53,515.00 3,000.00 77.00 231,000.00 2,381.00 77.00 183,337.00 1,314.00 77.00 101,178.00 -
Salep 2-4, kombinasi : asam salisilat 2
119 Tube 37.00 3,114.00 115,218.00 264.00 3,114.00 822,096.00 229.00 3,114.00 713,106.00 72.00 3,114.00 224,208.00 -
%+ belerang endap 4 %
120 Sefadroxil kapsul 500 mg Tab 717.00 675.00 483,975.00 500.00 675.00 337,500.00 1,217.00 675.00 821,475.00 675.00 0.00 -
121 Seftriasone injeksi Vial 4,959.00 0.00 350.00 4,959.00 1,735,650.00 350.00 4,959.00 1,735,650.00 4,959.00 0.00 -
122 Serum anti bisa ular Vial 479,000.00 0.00 10.00 479,000.00 4,790,000.00 8.00 479,000.00 3,832,000.00 2.00 479,000.00 958,000.00 479,000.00 -
123 Serum anti tetanus Ampul 130,999.00 0.00 10.00 130,999.00 1,309,990.00 0.00 130,999.00 - 10.00 130,999.00 1,309,990.00 10 130,999.00 1,309,990.00
124 Sefadrosil sirup kering 125mg/ml-60 ml Botol 151.00 4,133.00 624,083.00 450.00 4,133.00 1,859,850.00 415.00 4,133.00 1,715,195.00 186.00 4,133.00 768,738.00 21 4,133.00 86,793.00
125 Sianokobalamine (VitBb12) Tab 820.00 49.00 40,180.00 3,200.00 49.00 156,800.00 4,020.00 49.00 196,980.00 0.00 49.00 0.00 -
126 Simvastatin 10 mg Tab 117.00 0.00 1,200.00 117.00 140,400.00 1,200.00 117.00 140,400.00 0.00 117.00 0.00 -
127 Simvastatin tab sal 20 mg Tab sal 425.00 237.00 100,725.00 1,300.00 237.00 308,100.00 1,725.00 237.00 408,825.00 0.00 237.00 0.00 -
128 Siprofloksasin tab scored 500 mg Tab 790.00 495.00 391,050.00 1,100.00 495.00 544,500.00 1,890.00 495.00 935,550.00 0.00 495.00 0.00 -
129 Stesolid 5 mg rectal 7.00 14,459.00 101,213.00 14,459.00 0.00 2.00 14,459.00 28,918.00 5.00 14,459.00 72,295.00 14,459.00 -
130 Tetrasiklin kaps 500 mg Kaps 680.00 330.00 224,400.00 3,100.00 330.00 1,023,000.00 2,120.00 330.00 699,600.00 1,660.00 330.00 547,800.00 -
131 Tiamin (vitamin B1) tab 50 mg Tab 2,744.00 94.00 257,936.00 8,000.00 94.00 752,000.00 10,614.00 94.00 997,716.00 130.00 94.00 12,220.00 -
132 Triheksifenidil tab 2 mg Tab 70.00 95.00 6,650.00 1,900.00 95.00 180,500.00 1,770.00 95.00 168,150.00 200.00 95.00 19,000.00 -
133 Vitamin B kompleks Tab 3,142.00 95.00 298,490.00 750.00 95.00 71,250.00 3,892.00 95.00 369,740.00 0.00 95.00 0.00 95.00 -
134 Zinc sir 20 mg/5 ml Botol 146.00 3,285.00 479,610.00 100.00 3,285.00 328,500.00 116.00 3,285.00 381,060.00 130.00 3,285.00 427,050.00 24.00 3,285.00 78,840.00
135 Zinc tab disp 20 mg Tab 260.00 604.00 157,040.00 1,000.00 604.00 604,000.00 505.00 604.00 305,020.00 755.00 604.00 456,020.00 604.00 -
136 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul 20.00 1,913.00 38,260.00 10.00 1,913.00 19,130.00 23.00 1,913.00 43,999.00 7.00 1,913.00 13,391.00 1,913.00 -
137 Alat suntik sekali pakai 1 ml Pcs 100.00 746.35 74,635.00 300.00 746.35 223,905.00 400.00 746.35 298,540.00 0.00 746.35 0.00 -
138 Alat Suntik Sekali Pakai 2,5 ml Pcs 200.00 746.35 149,270.00 1,700.00 746.35 1,268,795.00 1,300.00 746.35 970,255.00 600.00 746.35 447,810.00 -
139 Alat suktik 3 ml Pcs 770.00 726.00 559,020.00 1,000.00 726.00 726,000.00 1,410.00 726.00 1,023,660.00 360.00 726.00 261,360.00 -
140 Alat suktik 5 ml Pcs 500.00 788.48 394,240.00 1,000.00 788.48 788,480.00 840.00 788.48 662,323.20 660.00 788.48 520,396.80 -
141 Alkohol Swab Set 100.00 138.00 13,800.00 1,800.00 138.00 248,400.00 1,700.00 138.00 234,600.00 200.00 138.00 27,600.00 -
340 Aseptic gel 500 ml Botol 26,400.00 0.00 5.00 26,400.00 132,000.00 4.00 26,400.00 105,600.00 1.00 26,400.00 26,400.00 -
Cutgut/ Benang bedah No 20 dengan

142 Pcs 168.00 4,168.88 700,371.84 144.00 4,168.88 600,318.72 186.00 4,168.88 775,411.68 126.00 4,168.88 525,278.88 4,168.88 -
jarum bedah
143 Folly Cathter N0 14 pcs 3.00 9,200.00 27,600.00 12.00 9,200.00 110,400.00 5.00 9,200.00 46,000.00 10.00 9,200.00 92,000.00 -
144 Folly catheter No.16 Pcs 3.00 9,200.00 27,600.00 10.00 9,200.00 92,000.00 7.00 9,200.00 64,400.00 6.00 9,200.00 55,200.00 -
145 HandScun Pcs 64.35 0.00 5,500.00 64.35 353,925.00 5,500.00 64.35 353,925.00 0.00 64.35 0.00 -
146 Infusion Set Anak Set 435.00 6,222.00 2,706,570.00 6,222.00 0.00 240.00 6,222.00 1,493,280.00 195.00 6,222.00 1,213,290.00 -
350 Infusion Set Dewasa Set 150.00 5,856.00 878,400.00 320.00 5,856.00 1,873,920.00 370.00 5,856.00 2,166,720.00 100.00 5,856.00 585,600.00 -
147 Infusion Set Y-Connector Pcs 6,280.00 0.00 100.00 6,280.00 628,000.00 100.00 6,280.00 628,000.00 0.00 6,280.00 0.00 -
352 IV Catheter No. 20 G Set 4,959.00 0.00 200.00 4,959.00 991,800.00 200.00 4,959.00 991,800.00 0.00 4,959.00 0.00 -
148 IV Cateter No 20 G Set 518.00 7,824.96 4,053,329.28 900.00 7,824.96 7,042,464.00 1,103.00 7,824.96 8,630,930.88 315.00 7,824.96 2,464,862.40 -
149 IV Catheter No. 22 G Set 150.00 7,893.00 1,183,950.00 7,893.00 0.00 50.00 7,893.00 394,650.00 100.00 7,893.00 789,300.00 -
150 IV Cateter No 24 G Set 660.00 7,824.96 5,164,473.60 7,824.96 0.00 300.00 7,824.96 2,347,488.00 360.00 7,824.96 2,816,985.60 -
151 Kapas Pembalut / Absorben 250 gram Roll 5.00 22,660.00 113,300.00 15.00 22,660.00 339,900.00 9.00 22,660.00 203,940.00 11.00 22,660.00 249,260.00 -
152 Kasa Hydrophil 40 x 80 cm roll 3.00 163,850.00 491,550.00 13.00 163,850.00 2,130,050.00 12.00 163,850.00 1,966,200.00 4.00 163,850.00 655,400.00 -
153 Kasa Kompres 40/40 Steril Pcs 50.00 1,452.00 72,600.00 60.00 1,452.00 87,120.00 70.00 1,452.00 101,640.00 40.00 1,452.00 58,080.00 -
154 Kasa Pembalut 2 m x 80 cm Roll 29.00 10,857.00 314,853.00 45.00 10,857.00 488,565.00 34.00 10,857.00 369,138.00 40.00 10,857.00 434,280.00 -
Kasa pembalut hidrofil 4mx15 cm

155 Roll 45.00 2,415.00 108,675.00 20.00 2,415.00 48,300.00 55.00 2,415.00 132,825.00 10.00 2,415.00 24,150.00 -
elastis
156 Kasa pembalut hidrofil 4x5cm elastis Roll 50.00 333.85 16,692.50 333.85 0.00 50.00 333.85 16,692.50 0.00 333.85 0.00 -
157 Kasa steril 16x16 cm Roll 6.00 8,107.00 48,642.00 50.00 8,107.00 405,350.00 31.00 8,107.00 251,317.00 25.00 8,107.00 202,675.00 -
158 Masker N 95 box 20.00 6,512.00 130,240.00 6,512.00 0.00 20.00 6,512.00 130,240.00 0.00 6,512.00 0.00 -
159 Pisau Bisturi no. 15 Buah 15.00 3,069.00 46,035.00 3,069.00 0.00 15.00 3,069.00 46,035.00 0.00 3,069.00 0.00 -
160 Pisau Bisturi no. 21 Buah 10.00 3,069.00 30,690.00 3,069.00 0.00 10.00 3,069.00 30,690.00 0.00 3,069.00 0.00 -
161 Plester 5 yards x 2 inch Roll 6.00 40,000.00 240,000.00 75.00 40,000.00 3,000,000.00 81.00 40,000.00 3,240,000.00 0.00 40,000.00 0.00 -
Silk (Benang Bedah Sutera) No 3/0

162 Pcs 132.00 3,514.00 463,848.00 3,514.00 0.00 108.00 3,514.00 379,512.00 24.00 3,514.00 84,336.00 -
dengan jarum bedah
163 Strip tes gula darah (easytouch) Btl 25 pcs 120,000.00 0.00 2.00 120,000.00 240,000.00 2.00 120,000.00 240,000.00 0.00 120,000.00 0.00 -
164 Strip tes kolesterol (easytouch) Btl 10 pcs 200,000.00 0.00 4.00 200,000.00 800,000.00 4.00 200,000.00 800,000.00 0.00 200,000.00 0.00 -
165 Urine bag Pcs 2.00 5,905.00 11,810.00 10.00 5,905.00 59,050.00 12.00 5,905.00 70,860.00 0.00 5,905.00 0.00 -
166 Etil klorida semprot 100 ml Botol 2.00 254,000.00 508,000.00 254,000.00 0.00 2.00 254,000.00 508,000.00 0.00 254,000.00 0.00 -
167 Risperidone 1 mg Tab 400.00 0.00 100.00 - 300.00
168 Eugenol Botol 2.00 22,375.00 44,750.00 22,375.00 0.00 2.00 22,375.00 44,750.00 0.00 22,375.00 0.00 -
169 Occo botol 2.00 295,000.00 590,000.00 295,000.00 0.00 2.00 295,000.00 590,000.00 0.00 295,000.00 0.00 -
170 Antalgin injeksi Ampul 4,025.00 0.00 500.00 4,025.00 2,012,500.00 300.00 4,025.00 1,207,500.00 200.00 4,025.00 805,000.00 -
171 Risperidone 2 mg Tab 340.00 347.00 117,980.00 600.00 347.00 208,200.00 510.00 347.00 176,970.00 430.00 347.00 149,210.00 -
172 Dentinconditioner Tube 1.00 250,000.00 250,000.00 250,000.00 0.00 1.00 250,000.00 250,000.00 0.00 250,000.00 0.00 -
173 Postofix Pcs 80,051.14 0.00 20.00 80,051.14 1,601,022.80 0.00 80,051.14 - 20.00 80,051.14 1,601,022.80 -
174 Cocoa butter 10 gr Pcs 1.00 180,000.00 180,000.00 180,000.00 0.00 1.00 180,000.00 180,000.00 0.00 180,000.00 0.00 -
175 Sikzonoat injeksi Ampul 33.00 299.00 9,867.00 20.00 299.00 5,980.00 42.00 299.00 12,558.00 11.00 299.00 3,289.00 -
176 Glass ionomer ART 88,000.00 0.00 88,000.00 0.00 0.00 88,000.00 - 88,000.00 0.00 -
177 Pot dahak botol 265,000.00 0.00 200.00 265,000.00 53,000,000.00 200.00 265,000.00 53,000,000.00 0.00 265,000.00 0.00 -
178 Glass ionomer ART Tablet 2.00 500,000.00 1,000,000.00 500,000.00 0.00 2.00 500,000.00 1,000,000.00 500,000.00 0.00 -
TOTAL HARGA 78,130.00 47,873,589.22 291,504.00 191,419,495.52 296,992.00 193,031,006.26 72,642.00 46,262,078.48 2,151 4,039,167.00
Babhrot, 30 juni 2021

Yang diperiksa
Pengelola Obat Babahrot
Nurlina,AMKG
Nip. 19820717 200604 2 019
BERITA ACARA STOCK OPNAME
Pada hari Rabu Tanggal tiga puluh bulan Juni Tahun Dua ribu dua puluh satu bertempat di Puskesmas Rawat Inap Babahrot
Yang bertanda tangan di bawah ini
Nama : FIRDAUS,SKM
NIP : 197220315 199403 1 004
Jabatan : Kepala Puskesmas Rawat inap Babahrot
Sesuai dengan Peraturan Menteri Dalam Negeri Nomor 13 Tahun 2006 sebagaimana telah diubah terakhir kali dengan
Peraturan Menteri Dalam Negeri Nomor 21 Tahun 2011, Kami melakukan pemeriksaan setempat atas sisa barang
(Stock opname) yang dikelola oleh :
Nama : Nurlina,AMKG
NIP : 19820717 200604 2 019
Jabatan : Pengelola Obat Puskesmas Rawat Inap Babahrot
Berdasarkan Keputusan Kepala Puskesmas ditugaskan sebagai pengelola obat puskesmas rawat inap babahrot,telah
mengadakan Stok Opname Obat - obatan dan BMHP di Apotek Puskesmas rawat inap Babahrot pada tanggal tersebut
diatas, berdasarkan hasil pemeriksaan fisik barang (stock opname), kami mendapatkan hasil sebagai berikut :
Nilai
NO Nama Persediaan Sumber Obat
2021 ED
Obat-obatan dan Bahan Medis Habis
1 46,262,078.48 4,039,167.00 DAK
Pakai
Jumlah 46,262,078.48 4,039,167.00
Rincian hasil pemeriksaan fisik terlampir.
Yang diperiksa
Pengelola Obat Puskesmas Babahrot Kepala Puskesmas Rawat Inap Babahrot
NURLINA,AMKG FIRDAUS,SKM
NIP. 19820717 200604 2 019 Nip. 19720315 199403 1 004

1.persediaan Obat Puskesmas Babahrot 2021 Ok

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LAMPIRAN : PERSEDIAAN OBAT-OBATAN DAN BMHP

PUSKESMAS ALUE SUNGAI PINANG

SALDO AWAL PER 01 JANUARI 2018 PENERIMAAN PEMAKAIAN

Antasida, kombinasi : aluminium hidroksida

Antasida, kombinasi : aluminium hidroksida

Antasida, kombinasi : aluminium hidroksida

Antasida, kombinasi : aluminium hidroksida

Antibakteri, kombinasi : basitrasin 500 UI/g+

31 Diazepam tab 2 mg Tab 483.00 100.00 48,300.00 0.00 0.00 202.00

Garam oralit kombinasi : natrium klorida

Kotrimoksazol (dewasa) kombinasi :

Kotrimoksazol (dewasa) kombinasi :

Kotrimoksazol (dewasa) kombinasi tiap 5 ml

91 Multivitamin Tab 1,200.00 249.00 298,800.00 2,000.00 249.00 498,000.00 1,350.00

TOTAL HARGA 55,462.00 24,358,671.06 58,622.00 25,882,327.00 46,890.00

Jeumpa, 31 Januari 2018

Lisa Triana, Amd.Farm

359.00 24,053.00 80.00 359.00 28,720 0.00 0.00 -

0.00 - 0.00 95.00 - 0.00 0.00 -

95.00 37,050.00 410.00 95.00 38,950 0.00

4,000.00 640,000.00 145.00 4,000.00 580,000 0.00 0.00 -

150.00 67,500.00 910.00 150.00 136,500 0.00 0.00 -

0.00 - 180.00 200.00 36,000 0.00 0.00 -

107.00 27,820.00 570.00 107.00 60,990 0.00 0.00 -

90.00 7,200.00 360.00 90.00 32,400 0.00 0.00 -

2,200.00 325,600.00 75.00 2,200.00 165,000 0.00 0.00 -

191.00 44,885.00 500.00 191.00 95,500 0.00 0.00 -

191.00 263,580.00 0.00 0.00 - 0.00 0.00 -

233.00 302,900.00 700.00 233.00 163,100 0.00

0.00 - 25.00 2,227.00 55,675 0.00 0.00 -

0.00 - 0.00 0.00 - 0.00 0.00 -

78.00 80,340.00 970.00 78.00 75,660 0.00 0.00 -

3,100.00 412,300.00 0.00 0.00 - 0.00 0.00 -

2,106.00 12,636.00 194.00 2,106.00 408,564 0.00 0.00 -

3,365.00 218,725.00 0.00 0.00 - 0.00 0.00 -

2,767.00 229,661.00 17.00 2,767.00 47,039 0.00

4,972.00 14,916.00 17.00 4,972.00 84,524 0.00 0.00 -

139.00 13,900.00 360.00 139.00 50,040 0.00 0.00 -

120.00 103,200.00 1,290.00 120.00 154,800 0.00 0.00 -

113.00 20,340.00 0.00 0.00 - 0.00 0.00 -

127.00 110,490.00 630.00 127.00 80,010 0.00 0.00

1,800.00 18,000.00 910.00 1,800.00 1,638,000 0.00 0.00 -

0.00 - 15.00 2,536.00 38,040 0.00 0.00 -

3,000.00 33,000.00 88.00 3,000.00 264,000 0.00 0.00 -

368.00 103,040.00 1,060.00 368.00 390,080 0.00 0.00 -

166.00 87,980.00 700.00 166.00 116,200 0.00 0.00 -

1,066.00 28,782.00 0.00 0.00 - 0.00 0.00 -

1,066.00 9,594.00 41.00 1,066.00 43,706 0.00 0.00

1,450.00 31,900.00 0.00 0.00 - 0.00 0.00 -

1,435.00 136,325.00 97.00 1,435.00 139,195 0.00 0.00

0.00 - 330.00 2,700.00 891,000 0.00 0.00 -

115.00 103,845.00 790.00 115.00 90,850 0.00 0.00 -

3,300.00 69,300.00 212.00 3,300.00 699,600 0.00 0.00 -

45.00 33,480.00 0.00 0.00 - 0.00 0.00 -

48.00 36,528.00 739.00 48.00 35,472 0.00 0.00

100.00 20,200.00 281.00 100.00 28,100 0.00 0.00 -

0.00 - 37.00 1,222.00 45,214 0.00 0.00 -

0.00 - 200.00 103.00 20,600 0.00 0.00 -

3,180.00 139,920.00 60.00 3,180.00 190,800 0.00 0.00 -

116.00 20,880.00 720.00 116.00 83,520 0.00 0.00 -

0.00 - 240.00 200.00 48,000 0.00 0.00 -

647.00 90,580.00 300.00 647.00 194,100 0.00 0.00 -

6,461.00 19,383.00 2.00 6,461.00 12,922 0.00 0.00 -