UPTD Puskesmas Susukan

Pemerintah Kabupaten Semarang

Periode: 01-01-2022 s/d 31-08-2022
PENERIMAAN OBAT TOTAL
Kecamatan SUSUKAN

No Kode Nama Obat Satuan Rekening Harga Jumlah Total

1 1623 Chlorpheniramine Maleat (Ctm) 4mg Tablet 15.01.5.2.2.02.04 22.00 8,000 176,000.00
2 2091 Seftriakson injeksi 1 gr/vial Vial 15.01.5.2.2.02.04 4,708.00 20 94,160.00
3 2143 Gentamicin Salep Mata 0.3% Tube 15.01.5.2.2.02.04 2,675.00 40 107,000.00
4 2236 Iv. Catteter (Introcan) No 24 Pcs 15.01.5.2.2.01.10 8,750.00 300 2,625,000.00
5 2261 Loratadin 10mg Tablet 15.01.5.2.2.02.04 123.00 1,000 123,000.00
6 2291 Kloramfenikol 1% salep mata Tube 15.01.5.2.2.02.04 2,007.00 50 100,350.00
7 2302 Gentamicin Tetes Mata 0,3% Botol 15.01.5.2.2.02.04 4,232.00 158 668,656.00
8 2322 Dimenhidrinat 50 Mg Tablet 15.01.5.2.2.02.04 111.99 2,000 223,980.00
9 2332 Asiklovir Tab 400Mg Tablet 15.01.5.2.2.02.04 404.99 800 323,992.00
10 2337 Salep Antifungi Doen Kombinasi 30gr Pot 15.01.5.2.2.02.04 4,798.00 24 115,152.00
11 2493 Ringer Laktat Larutan Infus (OTSU) Botol 15.01.5.2.2.02.04 7,629.60 5 38,148.00
12 2495 Glukose Lar. Infus (Dextrose 5%) SATORIA Botol 15.01.5.2.2.02.04 7,362.30 140 1,030,722.00
13 2635 Klindamisin 150 Mg Kapsul 15.01.5.2.2.02.04 759.00 1,000 759,000.00
14 2728 Ranitidin 50mg/2ml Inj Ampul 15.01.5.2.2.02.04 1,188.00 10 11,880.00
15 2732 Siprofloxacin Tab 500Mg Tablet 15.01.5.2.2.02.04 394.97 400 157,988.00
16 2761 Antiinfluenza (Nichofed) Tablet Tablet 15.01.5.2.2.02.04 699.99 600 419,994.00
17 2791 Meloksikam Tablet 7.5 mg Tablet 15.01.5.2.2.02.04 266.42 1,000 266,420.00
18 2816 Antidiare (Molagit) Tablet Tablet 15.01.5.2.2.02.04 299.99 2,400 719,976.00
19 2821 Masker KN95 (Tainuoer) Pcs APBD1 13,200.00 100 1,320,000.00
20 2861 Swab Dacron (NASO) Pcs 15.01.5.2.2.02.04 6,500.00 100 650,000.00
21 2883 Parafilm M Pcs 1.02.02.2.01.17 880.00 50 44,000.00
22 2902 Ringer Laktat Larutan Infus Botol APBD1 7,630.00 10 76,300.00
23 2904 Hbsag (Virocheck) Test PROGRAM 9,850.00 400 3,940,000.00
24 3000 Kasa Pembalut Hidrofil 4x15cm (Hastamed) Roll 1.02.02.2.01.17 2,048.00 100 204,800.00
25 3042 Kloramfenikol Salep Kulit (Bufacetin) 2% Tube 1.02.02.2.01.16 3,266.00 50 163,300.00
26 3049 Asam Mefenamat Kaplet 500 Mg Tablet 1.02.02.2.01.16 111.00 12,700 1,409,700.00
27 3051 Lansoprazole 30 mg Kapsul 1.02.02.2.01.16 278.00 1,560 433,680.00
28 3053 Amoksisilin Kaplet 500 Mg Kaplet 1.02.02.2.01.16 201.00 17,200 3,457,200.00
29 3054 Omeprazole 20mg Kapsul 1.02.02.2.01.16 129.00 1,100 141,900.00
30 3058 Hidrokortison Salep Kulit 2.5 % Tube 1.02.02.2.01.16 2,325.00 96 223,200.00
31 3059 Antihemoroid supp Supposit 1.02.02.2.01.16 3,250.00 10 32,500.00
oria
32 3065 Domperidone Maleate Tab. 10 Mg Tablet 1.02.02.2.01.16 71.00 400 28,400.00
33 3067 Zink Sirup Botol 1.02.02.2.01.16 2,489.00 36 89,604.00
34 3069 Antasida Doen Tablet Kunyah Tablet 1.02.02.2.01.16 54.00 5,400 291,600.00

1
35 3070 Kalsium Laktat (Kalk) Tab.500Mg Tablet 1.02.02.2.01.16 60.00 10,000 600,000.00
36 3071 Glukose Larutan Infus 5% Botol 1.02.02.2.01.16 6,627.00 180 1,192,860.00
37 3072 Natrium Klorida Lar. Infus 0,9% Botol 1.02.02.2.01.16 6,800.00 315 2,142,000.00
38 3073 Kaptopril Tablet 25 Mg Tablet 1.02.02.2.01.16 75.00 2,000 150,000.00
39 3074 Serum Anti Bisa Ular I (Biosave) 5mL Vial 1.02.02.2.01.16 517,132.00 2 1,034,264.00
40 3103 Tablet Tambah Darah Tablet PROGRAM 226.00 92,800 20,972,800.00
41 3107 VTM (Dengan 2 Stick Swab) Altamed Pcs 1.02.02.2.01.17 17,950.00 20 359,000.00
42 3108 Permethrin Krim 5% Tube 1.02.02.2.01.16 6,325.00 20 126,500.00
43 3110 Vitamin B.Complek Tablet 1.02.02.2.01.16 57.00 7,000 399,000.00
44 3115 Handscoon L (Altamed) Pcs 1.02.02.2.01.17 1,070.00 400 428,000.00
45 3130 Kotrimoksazol 480 Mg Tablet 1.02.02.2.01.16 126.00 2,500 315,000.00
46 3131 Hiosina N Butil Bromida 10 Mg Tablet 1.02.02.2.01.16 1,050.00 200 210,000.00
47 3133 Lidokain 2% Ampul 1.02.02.2.01.16 847.00 30 25,410.00
48 3135 Dexametason Inj. 5Mg/1Ml Ampul 1.02.02.2.01.16 924.00 200 184,800.00
49 3136 Fitomenadion Tab 10mg Tablet 1.02.02.2.01.16 748.00 100 74,800.00
50 3137 Fitomenadion Inj. 2mg/ml Ampul 1.02.02.2.01.16 1,386.00 125 173,250.00
51 3149 Oseltamivir Kapsul 75 mg Tablet 1.02.02.2.01.16 13,000.00 100 1,300,000.00
52 3155 Folly Catteter No.18 Pcs 1.02.02.2.01.17 8,987.00 5 44,935.00
53 3157 Urin Bag (Forsch) Pcs 1.02.02.2.01.17 5,300.00 10 53,000.00
54 3162 Doksisiklin 100 Mg Kapsul 1.02.02.2.01.16 462.57 1,400 647,598.00
55 3164 Metil Prednisolon 4mg Tablet 1.02.02.2.01.16 319.10 1,500 478,650.00
56 3169 Ibuprofen Tablet 200mg Tablet 1.02.02.2.01.16 194.04 800 155,232.00
57 3170 Amoksisilin Sirup Kering 125mg/5ml Botol 1.02.02.2.01.16 3,294.50 150 494,175.00
58 3179 Obat Batuk Kombinasi Mengandung Botol 1.02.02.2.01.16 11,550.00 100 1,155,000.00
Dekstrometorfan (Dextrofen) Sirup
59 3187 Obat Batuk Kombinasi Mengandung Tablet 1.02.02.2.01.16 487.96 500 243,980.00
Dekstrometorfan ( BROCON) Tablet
60 3188 Ekstra plasenta + Neomisin Sulfat (Neocenta Tube 1.02.02.2.01.16 16,808.00 30 504,240.00
Gel)
61 3190 Meloksikam Tablet 7.5 mg Tablet 1.02.02.2.01.16 323.40 1,000 323,400.00
62 3193 Iv. Catteter (Introcan) No 22 Pcs 1.02.02.2.01.17 6,500.00 80 520,000.00
63 3195 Multivitamin (Recovit) Sirup Botol 1.02.02.2.01.16 7,920.00 165 1,306,800.00
64 3197 Catgut Chromic 2/0 90cm 36mm Box 1.02.02.2.01.17 807,840.00 2 1,615,680.00
65 3201 Baju Coverall (B-Safe) Pcs APBD1 125,000.00 90 11,250,000.00
66 3204 Silk 2/0 75CC 30M C (Silkam) Pcs 1.02.02.2.01.17 27,284.00 108 2,946,672.00
67 3205 Silk 3/0 75CC 30M C (Silkam) Pcs 1.02.02.2.01.17 27,284.00 72 1,964,448.00
68 3208 Risperidone 2mg Tablet 1.02.02.2.01.16 123.00 200 24,600.00
69 3210 Bisakodil 5mg Tablet Tablet 1.02.02.2.01.16 216.00 300 64,800.00
70 3211 Vitamin B12 Tablet 50 Mg Tablet 1.02.02.2.01.16 43.00 6,200 266,600.00
71 3215 Azitromisin 500 Mg Tablet 1.02.02.2.01.16 1,136.35 400 454,540.00
72 3216 Serum Anti Tetanus (Biosat 1.500 IU) Ampul 1.02.02.2.01.16 130,999.00 10 1,309,990.00
73 3230 Rapid Test Antigen (SD Biosensor) Pcs APBN 2021 82,239.00 400 32,895,600.00
74 3231 Simetidin Tab. 200 Mg (Lexamet) Tablet 1.02.02.2.01.16 319.00 1,000 319,000.00
75 3232 Metronidazol 500Mg (Molazol) Tablet 1.02.02.2.01.16 396.00 1,000 396,000.00

2
76 3260 Kasa Hidrofil 2Mx80Cm Pcs 1.02.02.2.01.17 10,358.00 30 310,740.00
77 3264 Vitamin A Kapsul 200.000 Iu Kapsul PROGRAM 553.00 1,250 691,250.00
78 3270 Sarung Tangan Panjang (InTouch) No. 7 Pasang 1.02.02.2.01.17 7,186.36 350 2,515,226.00
79 3277 Shoe Cover Pasang 1.02.02.2.01.17 1,520.00 150 228,000.00
80 3281 Domperidon Suspensi 5mg/ 5ml Botol 1.02.02.2.01.16 2,296.00 130 298,480.00
81 3283 Glukose Larutan Infus 5% Botol 1.02.02.2.01.16 6,626.40 100 662,640.00
82 3286 Yodium Povidon Lart. 10 % 60 Ml (Betadine) Botol 1.02.02.2.01.16 25,016.40 20 500,328.00
83 3287 Betametason + Neomisin Sulfat (Erladerm-N) Tube 1.02.02.2.01.16 5,335.00 10 53,350.00
Krim
84 3289 Obh Molex Sirup Botol 1.02.02.2.01.16 5,142.50 50 257,125.00
85 3290 Antiinfluenza Syr (Molexflu) Botol 1.02.02.2.01.16 6,273.85 50 313,692.50
86 3294 Asam Asetyl Salisilat (Miniaspi) 80mg Tablet 1.02.02.2.01.16 89.00 400 35,600.00
87 3299 Plester (Onemed) Roll 1.02.02.2.01.17 41,360.00 15 620,400.00
88 3306 Parasetamol Sirup 120Mg/5Ml Botol 1.02.02.2.01.16 1,160.00 320 371,200.00
89 3317 Guaifenesin Tab 100mg Tablet 1.02.02.2.01.16 212.00 3,200 678,400.00
90 3318 Ambroxol Tablet 30mg Tablet 1.02.02.2.01.16 140.50 5,700 800,850.00
91 3329 Piridoksin (B6) Tab. 10Mg Tablet 1.02.02.2.01.16 105.15 3,000 315,450.00
92 3330 Vitamin B1 (Thiamin) Tab 100mg Tablet 1.02.02.2.01.16 300.00 3,000 900,000.00
93 3340 Dexamethasone 0.5Mg Tablet 1.02.02.2.01.16 47.58 8,000 380,640.00
94 3341 Hepatitis B Immune (HyperHep B) vial 1.02.02.2.01.16 1,375,000.00 2 2,750,000.00
95 3343 Rapid Test Antigen (Lyher) Novel CoronaVirus Pcs APBD1 97,450.00 1,400 136,430,000.00
96 3353 HBSAG (Intec) Pcs 1.02.02.2.01.17 5,445.00 100 544,500.00
97 3357 Zink Tablet Dispersible 20mg Tablet PROGRAM 524.00 500 262,000.00
98 3359 Framycetin Sulfate (Daryant Tulle) Lembar 1.02.02.2.01.17 25,000.00 10 250,000.00
99 3363 Metronidazol 500Mg Tablet 1.02.02.2.01.16 320.00 1,000 320,000.00
100 3368 Oksitosin Inj. 10 Ul/ml Ampul 1.02.02.2.01.16 3,850.00 50 192,500.00
101 3369 Epinephrine Inj 1mg Ampul 1.02.02.2.01.16 13,300.10 30 399,003.00
102 3370 OT Ekstrak graptophylli Folium dan Citrus Kapsul 1.02.02.2.01.16 1,435.00 450 645,750.00
Bioflavonoid (HEMOROGARD)
103 3371 Obat Herbal Membantu Menjaga Kesehatan Kapsul 1.02.02.2.01.16 2,795.00 2,100 5,869,500.00
Fungsi Hati (HEPAGARD)
104 3375 Klorpromazine 100 mg Tablet 1.02.02.2.01.16 250.00 300 75,000.00
105 3378 Triheksipenidil 2mg Tablet 1.02.02.2.01.16 63.00 1,500 94,500.00
106 3391 Ketokonazole Krim 2% Tube 1.02.02.2.01.16 2,349.00 70 164,430.00
107 3393 Urin 10 Parameter (Cybow) Kit 1.02.02.2.01.17 1,334.88 100 133,488.00
108 3396 Kloramfenikol Tetes Telinga 1% (RECO) Botol 1.02.02.2.01.16 8,250.00 100 825,000.00
109 3398 Seftriakson injeksi 1 gr/vial vial 1.02.02.2.01.16 6,003.36 20 120,067.20
110 3399 Parasetamol 500Mg Tablet 1.02.02.2.01.16 105.00 7,100 745,500.00
111 3401 Amlodipin 10mG Tablet 1.02.02.2.01.16 132.99 1,000 132,990.00
112 3403 Simvastatin Tab.10 Mg Tablet 1.02.02.2.01.16 107.87 1,000 107,870.00
113 3404 Meloksikam Tablet 7.5 mg Tablet 1.02.02.2.01.16 175.00 7,000 1,225,000.00
114 3406 Kotrimoksazol Suspensi 240mg (Trimeta Syrup) Botol 1.02.02.2.01.16 3,575.00 50 178,750.00
115 3413 VTM (Dengan 2 Stick Swab) ARKAN MEDICAL Pcs APBD1 24,000.00 350 8,400,000.00
116 3417 Antasida Doen Suspensi Botol 1.02.02.2.01.16 3,450.00 100 345,000.00

3
117 3422 Amlodipin 5mG Tablet 1.02.02.2.01.16 73.00 1,300 94,900.00
118 3423 Multivitamin & Mineral Tablet (Caviplex) Tablet 1.02.02.2.01.16 540.89 12,000 6,490,680.00
119 3433 Handscoon M (Super Gard) pcs 1.02.02.2.01.17 525.00 1,000 525,000.00
120 3434 Cairan Cuci Tangan Tanpa Bilas (Pori Klin) 5L Galon 1.02.02.2.01.17 143,000.00 20 2,860,000.00
121 3435 Cairan Cuci Tangan Bilas (Pori Klin) 5L Galon 5 1.02.02.2.01.17 67,375.00 4 269,500.00
L
122 3438 Antasida Doen Tablet Kunyah Tablet 1.02.02.2.01.16 88.00 6,000 528,000.00
123 3440 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 1.02.02.2.01.16 781.00 3 2,343.00
124 3443 Masker Telinga (Earloop) MAS Pcs 1.02.02.2.01.17 360.00 2,300 828,000.00
125 3445 Allopurinol Tablet 100mg Tablet 1.02.02.2.01.16 155.35 1,100 170,885.00
126 3447 Simvastatin Tab.10 Mg Tablet 1.02.02.2.01.16 102.93 1,000 102,930.00
127 3448 Cetirizine 10mg Tablet 1.02.02.2.01.16 77.00 3,700 284,900.00
128 3452 Piroksikam Tab.20Mg Tablet 1.02.02.2.01.16 121.00 1,000 121,000.00
129 3453 Sefiksim 100mg Tablet 1.02.02.2.01.16 1,010.00 1,200 1,212,000.00
130 3454 Sefadroksil 500 Mg Kapsul 1.02.02.2.01.16 720.00 1,200 864,000.00
131 3455 Tiamfenikol Kapsul 500Mg Kapsul 1.02.02.2.01.16 1,460.65 1,500 2,190,975.00
132 3456 Eritromisin Kapsul 500mg (Eryra Forte) Kapsul 1.02.02.2.01.16 1,353.75 300 406,125.00
133 3460 Vitamin A Kapsul 100.000 Iu Kapsul 1.02.02.2.01.16 406.00 400 162,400.00
134 3461 Vitamin A Kapsul 200.000 Iu Kapsul 1.02.02.2.01.16 700.00 1,400 980,000.00
135 3463 Masker Telinga (Headloop) Jilbab BAYMED pcs 1.02.02.2.01.17 360.00 5,000 1,800,000.00
136 3482 Masker Telinga (Headloop) Jilbab SAFELOCK Pcs 1.02.02.2.01.17 340.00 5,000 1,700,000.00
137 3484 Garam Oralit Serbuk Sachet PROGRAM 274.00 100 27,400.00
138 3486 OAT Kategori 1 (Fdc) Paket PROGRAM 415,467.00 1 415,467.00
139 3489 Vitamin A Kapsul 100.000 Iu Kapsul PROGRAM 305.00 700 213,500.00
140 3500 Albendasol 400 Mg Tablet PROGRAM 380.00 9,300 3,534,000.00
141 3501 Serum Anti Bisa Ular I (Biosave) 5mL Vial 1.02.02.2.01.16 517,132.00 6 3,102,792.00
142 3502 Serum Anti Tetanus (Biosat 1.500 IU) Ampul 1.02.02.2.01.16 138,924.50 20 2,778,490.00
143 3504 Rapid Test Antigen (FlowFlex) Strip APBD1 55,000.00 1,500 82,500,000.00
144 3509 Masker N95 (DreamCan) Pcs PROGRAM 19,900.00 60 1,194,000.00
145 3512 Vitamin D3 1000 IU (Camvit D3) Tablet APBD1 634.00 840 532,560.00
146 3513 Obat Batuk Kombinasi Mengandung Botol 1.02.02.2.01.16 11,550.00 120 1,386,000.00
Dekstrometorfan (Dextrofen) Sirup
147 3515 Favipiravir Tablet 200mg Tablet 1.02.02.2.01.16 8,000.00 300 2,400,000.00
148 3516 Oat Kategori 1 (Fdc) Paket PROGRAM 416,696.00 6 2,500,176.00
149 3518 Multivitamin Syrup (Seltifort Kids) Botol 1.02.02.2.01.16 7,200.00 260 1,872,000.00
150 3519 Ambroxol Syrup 15mg/5ml Botol 1.02.02.2.01.16 3,600.00 120 432,000.00
151 3520 Betahistin 6mg Tablet 1.02.02.2.01.16 660.00 3,500 2,310,000.00
152 3521 Fenolgliserol TT Botol 1.02.02.2.01.16 4,200.00 24 100,800.00
153 3523 OBH Molex Sirup Botol 1.02.02.2.01.16 5,500.00 240 1,320,000.00
154 3524 Gentamicin 0.1% Salep Kulit Tube 1.02.02.2.01.16 3,600.00 100 360,000.00
155 3525 Furosemide 40Mg Tablet 1.02.02.2.01.16 195.00 800 156,000.00
156 3527 Nifedipin 10 Mg Tablet 1.02.02.2.01.16 225.00 600 135,000.00
157 3528 Vitamin A Kapsul 100.000 Iu Kapsul PROGRAM 305.00 200 61,000.00

4
158 3532 Obat Batuk Kombinasi Mengandung Tablet 1.02.02.2.01.16 580.00 4,800 2,784,000.00
Dekstrometorfan (Calortusin) Tablet
159 3533 Meloksikam 7.5 mg Tablet 1.02.02.2.01.16 145.00 1,200 174,000.00
160 3535 Triamsinolon Asetonida (Genalog) Tube 1.02.02.2.01.16 16,900.00 50 845,000.00
161 3538 Salbutamol Nebulizer 2,5mg Nebules 1.02.02.2.01.16 16,000.00 80 1,280,000.00
162 3539 Gentian Violet Botol 1.02.02.2.01.16 4,200.00 24 100,800.00
163 3540 Gentamicin Salep Mata 0,3%(Genoint) Tube 1.02.02.2.01.16 13,800.00 50 690,000.00
164 3541 Kloramfenikol Tetes Mata (Reco) Botol 1.02.02.2.01.16 9,340.00 300 2,802,000.00
165 3542 Mdt Mb Dewasa Blister PROGRAM 40,128.00 6 240,768.00
166 3553 Rapid Test Antigen (Longsee) Strip APBD1 55,000.00 500 27,500,000.00
167 3557 Triheksipenidil 2mg Tablet 1.02.02.2.01.16 63.00 3,500 220,500.00
168 3558 Amoksisilin Sirup Kering 125mg/5ml Botol 1.02.02.2.01.16 2,050.00 100 205,000.00
169 3559 Bacitracin Polymyxin Salep Kulit Tube 1.02.02.2.01.16 3,477.00 50 173,850.00
170 3561 Asam Askorbat (Vit. C) Tab 50Mg Tablet 1.02.02.2.01.16 42.00 20,000 840,000.00
171 3562 Hiosina N Butil Bromida 10 Mg Tablet 1.02.02.2.01.16 1,050.00 2,600 2,730,000.00
172 3563 Glimepirid 2 Mg Tablet 1.02.02.2.01.16 123.00 5,000 615,000.00
173 3564 Sefotaksim Inj vial 1.02.02.2.01.16 2,850.00 130 370,500.00
174 3565 Metformin 500mg Tablet 1.02.02.2.01.16 77.00 7,000 539,000.00
175 3566 Seftriakson injeksi 1 gr/vial Vial 1.02.02.2.01.16 2,745.00 146 400,770.00
176 3567 Asam Traneksamat Tab 500mg Tablet 1.02.02.2.01.16 1,697.00 200 339,400.00
177 3569 Digoksin 0.25 mg Tablet 1.02.02.2.01.16 124.00 200 24,800.00
178 3570 Hiosin Injeksi 20mg/ml Ampul 1.02.02.2.01.16 5,677.90 35 198,726.50
179 3572 Antiinfluenza Syr (Molexflu) Botol 1.02.02.2.01.16 7,947.50 236 1,875,610.00
180 3573 Klorpromazine 100 mg Tablet 1.02.02.2.01.16 250.00 2,200 550,000.00
181 3574 Nurse Cap Pcs 1.02.02.2.01.17 335.00 200 67,000.00
182 3575 Apron Long Sleeve Pcs 1.02.02.2.01.17 4,585.00 50 229,250.00
183 3576 Haloperidol Tab 5 Mg Tablet 1.02.02.2.01.16 54.00 3,000 162,000.00
184 3577 Parasetamol 500Mg Tablet 1.02.02.2.01.16 138.00 16,500 2,277,000.00
185 3580 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 1.02.02.2.01.16 781.00 210 164,010.00
186 3582 Nistatin 500.000 Iu Tablet 1.02.02.2.01.16 825.00 100 82,500.00
187 3584 Glibenklamid 5mg Tablet 1.02.02.2.01.16 83.00 500 41,500.00
188 3588 Kasa Pembalut Hidrofil 4M X 15 Cm Roll 1.02.02.2.01.17 2,408.00 250 602,000.00
189 3590 Alat Suntik 3 ml (Terumo) Pcs 1.02.02.2.01.17 1,267.00 500 633,500.00
190 3591 Alat Suntik 5 ml (Terumo) Pcs 1.02.02.2.01.17 1,467.85 50 73,392.50
191 3592 Kasa Hidrofil 2Mx80Cm Roll 1.02.02.2.01.17 10,358.00 250 2,589,500.00
192 3593 Alkohol 70% Botol (1 1.02.02.2.01.17 22,500.00 24 540,000.00
Liter)
193 3594 Alkohol 70% 5L Galon 5 1.02.02.2.01.17 117,700.00 6 706,200.00
L
194 3595 Iv. Catteter (Otsucath) No.18 Pcs 1.02.02.2.01.17 5,300.00 50 265,000.00
195 3598 Hidrokortison Salep Kulit 2.5 % Tube 1.02.02.2.01.16 2,325.00 96 223,200.00
196 3599 Rapid Test Antigen (GenBody) Strip BANTUAN 55,000.00 800 44,000,000.00
197 3600 Multivitamin Tablet (Arkavit C+DEZ) Kapsul 1.02.02.2.01.16 858.00 5,400 4,633,200.00
198 3601 Chlorpheniramine Maleat (Ctm) 4mg Tablet 1.02.02.2.01.16 52.00 15,000 780,000.00

5
199 3602 Ondansentro 4 Mg Tablet 1.02.02.2.01.16 693.00 500 346,500.00
200 3605 Parasetamol 500Mg Tablet 1.02.02.2.01.16 138.00 12,600 1,738,800.00
201 3676 Vitamin A Kapsul 200.000 Iu Kapsul PROGRAM 553.00 9,000 4,977,000.00
202 3685 Domperidon Suspensi 5mg/ 5ml Botol 1.02.02.2.01.16 2,316.87 50 115,843.50
203 3686 Ibuprofen suspensi 100mg/5ml Botol 1.02.02.2.01.16 2,256.31 100 225,631.00
204 3687 Salep 2-4 Pot 1.02.02.2.01.16 2,333.00 244 569,252.00
205 3689 Ibuprofen 400mg Tablet 1.02.02.2.01.16 190.00 3,500 665,000.00
206 3690 Ondansetron inj 4 mg/2 mL Ampul 1.02.02.2.01.16 5,141.00 200 1,028,200.00
207 3691 Risperidon 2 mg Tablet 1.02.02.2.01.16 414.00 1,300 538,200.00
208 3692 Ranitidin 25mg/2ml Ampul 1.02.02.2.01.16 2,137.00 60 128,220.00
209 3696 Antasida Doen Tablet Kombinasi Tablet 1.02.02.2.01.16 54.48 1,000 54,480.00
210 3697 Kalsium Laktat 500mg Tablet 1.02.02.2.01.16 60.55 2,500 151,375.00
211 3698 Parasetamol Sirup 120mg/5ml Botol 1.02.02.2.01.16 1,171.05 250 292,762.50
212 3699 Fitominadion 10mg Tablet 1.02.02.2.01.16 754.80 700 528,360.00
213 3700 Lidokain 2% Ampul 1.02.02.2.01.16 854.70 150 128,205.00
214 3701 Tabung K3EDTA 3ml (Vacusera) Pcs 1.02.02.2.01.17 1,413.00 700 989,100.00
215 3702 Serum Anti Bisa Ular I (Biosave) 5mL Ampul 1.02.02.2.01.16 517,132.00 3 1,551,396.00
216 3703 Stimuno Sirup Botol 1.02.02.2.01.16 28,374.00 244 6,923,256.00
217 3704 OT Ekstrak Meniran Hijau (Stimuno Forte) Kapsul 1.02.02.2.01.16 1,958.00 150 293,700.00
Kapsul
218 3705 Herbakof Syrup Botol 1.02.02.2.01.16 14,402.00 50 720,100.00
219 3708 Zink Tablet Dispersible 20mg Tablet PROGRAM 216.00 800 172,800.00
220 3709 Garam Oralit Serbuk Sachet PROGRAM 274.00 100 27,400.00
221 3715 MgSO4 20% Botol 1.02.02.2.01.16 3,580.00 40 143,200.00
222 3723 Vitamin B.Complek Tablet 1.02.02.2.01.16 57.00 10,000 570,000.00
223 3724 Lansoprasol 30mg Tablet 1.02.02.2.01.16 278.00 300 83,400.00
224 3725 Loratadin 10mg Tablet 1.02.02.2.01.16 109.00 2,000 218,000.00
225 3726 Metil Prednisolon 4mg Tablet 1.02.02.2.01.16 102.00 500 51,000.00
226 3729 Sediaan mengandung chondroitin, glucosamin Tablet 1.02.02.2.01.16 3,247.10 420 1,363,782.00
Hcl (Osteotin)
227 3731 OT Ekstrak graptophylli Folium dan Citrus Tablet 1.02.02.2.01.16 1,535.20 420 644,784.00
Bioflavonoid (HEMOROGARD)
228 3732 OT Ekstrak Curcumin, Cynarin, Cardui mariae Tablet 1.02.02.2.01.16 2,764.10 1,200 3,316,920.00
(HEPAGARD)
229 3733 OT Fitofarmaka Ekstak Apii Herba dan Tablet 1.02.02.2.01.16 2,103.10 1,500 3,154,650.00
Orthosipon Folium (TENSIGARD)
230 3735 Asam Mefenamat Kaplet 500 Mg Tablet 1.02.02.2.01.16 111.00 5,000 555,000.00
231 3738 Klindamisin 300 Mg Tablet 1.02.02.2.01.16 526.74 1,000 526,740.00
232 3739 Nistatin Susp 100.000 IU/ml Botol 1.02.02.2.01.16 11,604.55 20 232,091.00
233 3747 Ketokonazole 200Mg Tablet 1.02.02.2.01.16 252.00 500 126,000.00
234 3748 Epinephrine Inj 1mg Ampul 1.02.02.2.01.16 1,514.99 10 15,149.90
235 3752 Asam Asetyl Salisilat (Miniaspi) Tablet 1.02.02.2.01.16 89.81 500 44,905.00
236 3753 Parasetamol tts 60mg/0,6ml Botol 1.02.02.2.01.16 5,021.24 150 753,186.00
237 3773 Cairan Desinfektan (NKCL) Galon 5 BANTUAN 65,000.00 2 130,000.00
L
238 3782 Domperidon 10 Mg Tablet 1.02.02.2.01.16 177.60 4,000 710,400.00
239 3784 Antidiare Suspensi (Guanistrep) Botol 1.02.02.2.01.16 5,550.00 220 1,221,000.00

6
240 3786 Tetrasiklin 500 Mg Kapsul 1.02.02.2.01.16 638.25 100 63,825.00
241 3787 Zink Sirup Botol 1.02.02.2.01.16 3,885.00 96 372,960.00
242 3788 OT Ekstrak Guazima Ulmifolia, Muraya Kapsul 1.02.02.2.01.16 1,554.00 120 186,480.00
paniculata (Prolipid)
243 3791 Hepatitis B Immune (HyperHep B) Vial PROGRAM 1,325,000.00 1 1,325,000.00
244 3800 Piridoksin (B6) Tab. 10Mg Tablet 1.02.02.2.01.16 173.16 5,000 865,800.00
245 3804 GOWN PCS 1.02.02.2.01.17 185,000.00 20 3,700,000.00
246 3813 Etil Klorid Semprot Botol 1.02.02.2.01.17 182,262.00 5 911,310.00
247 3814 Cairan Cuci Tangan Bilas ( E-care ) Botol 1.02.02.2.01.17 70,000.00 15 1,050,000.00
500mL
248 3816 Alkohol Swab Box 1.02.02.2.01.17 8,380.00 10 83,800.00
249 3817 Handscoon M (Sriex) Box 1.02.02.2.01.17 53,000.00 20 1,060,000.00
250 3819 Cairan Cuci Tangan Tanpa Bilas ( Nam Medical ) Botol 1.02.02.2.01.17 24,500.00 15 367,500.00
500mL
251 3820 Masker Hijab (Headloop) NOUSMED Pcs 1.02.02.2.01.17 360.00 2,000 720,000.00
252 3824 Sarung Tangan Panjang (TG Medical) No. 8 Pasang 1.02.02.2.01.17 7,900.00 100 790,000.00
253 3825 Sarung Tangan Panjang (TG Medical) No. 6 Pasang 1.02.02.2.01.17 7,900.00 100 790,000.00
254 3826 Stik Hb Mision box 1.02.02.2.01.17 400,000.00 10 4,000,000.00
255 3829 Masker Hijab (Headloop) NAM MEDICAL Pcs 1.02.02.2.01.17 400.00 2,000 800,000.00
256 3830 Strip Asam Urat ( Accugence ) Box (isi 1.02.02.2.01.17 92,500.00 3 277,500.00
25)
257 3831 Strip Cholesterol ( Mission ) Box (isi 1.02.02.2.01.17 500,000.00 10 5,000,000.00
25)
258 3863 OT Ekstrak Psidium Guajava ( Dehaf ) box 1.02.02.2.01.16 48,826.00 5 244,130.00
259 3871 Enzim pencernaan anak ( L-Bio) Sachet 1.02.02.2.01.16 8,602.50 150 1,290,375.00
260 3872 OT Ekstrak Ophiocephalus Striatus (VipAlbumin) Kapsul 1.02.02.2.01.16 6,290.00 150 943,500.00
261 3874 Multivitamin & Mineral Tablet Fe (Hemafort) Tablet 1.02.02.2.01.16 854.70 9,000 7,692,300.00
262 3883 Alat Tes Kehamilan ( Hcg Strip ) 50 1.02.02.2.01.17 1,887.00 150 283,050.00
strip/box
263 3889 Strip Cholesterol ( Family Dr ) STRIP 1.02.02.2.01.17 18,671.32 500 9,335,660.00
264 3891 Strip Asam Urat ( Famili Dr ) STRIP 1.02.02.2.01.17 5,235.88 2,000 10,471,760.00
265 B228 TEST COVID-19 ANTIGEN (ALTAMED) Pcs 1.01.02.1.01.02.01.33.05 16,000.00 50 800,000.00
.5.2.2.24.02
266 B229 Fuji IX GP 1-1 Box 1.01.02.1.01.02.01.33.05 915,750.00 2 1,831,500.00
.5.2.2.24.02
267 B230 Elite Cement Mini Box 1.01.02.1.01.02.01.33.05 199,800.00 2 399,600.00
.5.2.2.24.02
268 B231 Caviton White Box 1.01.02.1.01.02.01.33.05 183,150.00 3 549,450.00
.5.2.2.24.02
269 B232 Endoseal Box 1.01.02.1.01.02.01.33.05 251,500.00 1 251,500.00
.5.2.2.24.02
270 B233 Saliva Box 1.01.02.1.01.02.01.33.05 64,500.00 1 64,500.00
.5.2.2.24.02
271 B234 BUR HIGH SPEED ROUND Pcs 1.01.02.1.01.02.01.33.05 26,000.00 5 130,000.00
.5.2.2.24.02
272 B235 Bahan Gigi ( CR ) Pak 1.01.02.1.01.02.01.33.05 58,500.00 5 292,500.00
.5.2.2.24.02
273 B237 TKF / Tricresolformaline 10 ml Botol 1.01.02.1.01.02.01.33.05 72,150.00 1 72,150.00
.5.2.2.24.02
274 B238 Diluent Pak 1.01.02.1.01.02.01.33.05 2,014,650.00 2 4,029,300.00
.5.2.2.24.02
275 B239 Lyse Pak 1.01.02.1.01.02.01.33.05 3,052,500.00 1 3,052,500.00
.5.2.2.24.02
276 B240 Control Hematology Botol 1.01.02.1.01.02.01.33.05 915,750.00 1 915,750.00
.5.2.2.24.02
277 BA023 Masker (face mask) Buah KBPP APBN 1,996.00 60 119,760.00
278 BA031 Syringe, 3 ml (Suntik KB) Buah KBPP APBN 1,138.00 100 113,800.00
279 BA032 SUNTIKAN VIAL KBPP APBN 4,800.00 500 2,400,000.00
280 BA034 Lidocaine, 2%, Injeksi, Ampul Buah KBPP APBN 1,221.00 60 73,260.00

7
281 BA035 Syringe, 3 ml (Suntik KB) Buah KBPP APBN 699.00 500 349,500.00
282 BA038 Safety Box Buah KBPP APBN 26,589.00 2 53,178.00
283 BA041 Syringe, 3 ml (Implant) Buah KBPP APBN 1,359.00 60 81,540.00
284 BA045 Asam Mefenamat Kaplet 500 Mg STRIP KBPP APBN 1,782.00 50 89,100.00
285 BA046 KONDOM GROSS KBPP APBN 124,800.00 3 374,400.00
286 BA047 SUNTIKAN (OBAT KB) Vial KBPP APBN 4,825.00 300 1,447,500.00
287 BA048 IMPLANT Set KBPP APBN 150,015.00 110 16,501,650.00
288 BA049 Alkohol swab 2-ply Buah KBPP APBN 127.00 110 13,970.00
289 BA050 Asam Mefenamat Kaplet 500 Mg STRIP KBPP APBN 1,782.00 60 106,920.00
290 BA051 Kain penutup operasi steril (Doek Steril Buah KBPP APBN 6,863.00 110 754,930.00
Disposable)
291 BA052 Kasa Steril Buah KBPP APBN 500.00 110 55,000.00
292 BA053 Lidokain 2% Buah KBPP APBN 1,221.00 50 61,050.00
293 BA054 Masker (face mask) Buah KBPP APBN 2,500.00 50 125,000.00
294 BA055 PLESTER STERIL Buah KBPP APBN 4,212.00 110 463,320.00
295 BA056 Povidone Iodine, 30 ml Buah KBPP APBN 2,750.00 3 8,250.00
296 BA057 Povidone Iodine, 30 ml Buah KBPP APBN 3,200.00 8 25,600.00
297 BA058 SARUNG TANGAN STERIL Pasang KBPP APBN 4,600.00 110 506,000.00
298 BA059 Syringe, 3 ml (Implant) Buah KBPP APBN 1,358.00 50 67,900.00
299 BA060 Syringe, 3 ml (Suntik KB) Buah KBPP APBN 1,380.00 300 414,000.00
300 BA061 IUD (COPPER T) Pcs KBPP APBN 12,500.00 75 937,500.00
301 BA062 GESTIN F3, 1CC VIAL KBPP APBN 11,210.00 100 1,121,000.00
302 BP001 Baju Coverall Pcs 02.35 50,542.73 36 1,819,538.28
303 BP002 Sarung Tangan Disposable Box 02.35 122,727.27 72 8,836,363.44
304 BP003 Gown Pcs 02.35 96,655.14 36 3,479,585.04
305 BP004 Masker Telinga Jilbab Pcs 02.35 334.71 2,300 769,833.00
306 BP005 Masker Telinga Pcs 02.35 334.71 2,100 702,891.00
307 BP006 Handsanitizer Botol 02.35 17,272.73 150 2,590,909.50
Total 657,730,982.86

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

NIP. 196803312002121004 NIP. 19830605 201001 2 031

8
Total
176,000.00
94,160.00
107,000.00
2,625,000.00
123,000.00
100,350.00
668,656.00
223,980.00
323,992.00
115,152.00
38,148.00
1,030,722.00
759,000.00
11,880.00
157,988.00
419,994.00
266,420.00
719,976.00
1,320,000.00
650,000.00
44,000.00
76,300.00
3,940,000.00
204,800.00
163,300.00
1,409,700.00
433,680.00
3,457,200.00
141,900.00
223,200.00
32,500.00
28,400.00
89,604.00
291,600.00

9
 600,000.00
1,192,860.00
2,142,000.00
150,000.00
1,034,264.00
20,972,800.00
359,000.00
126,500.00
399,000.00
428,000.00
315,000.00
210,000.00
25,410.00
184,800.00
74,800.00
173,250.00
1,300,000.00
44,935.00
53,000.00
647,598.00
478,650.00
155,232.00
494,175.00
1,155,000.00
243,980.00
504,240.00
323,400.00
520,000.00
1,306,800.00
1,615,680.00
11,250,000.00
2,946,672.00
1,964,448.00
24,600.00
64,800.00
266,600.00
454,540.00
1,309,990.00
32,895,600.00
319,000.00
396,000.00

10
 310,740.00
691,250.00
2,515,226.00
228,000.00
298,480.00
662,640.00
500,328.00
53,350.00
257,125.00
313,692.50
35,600.00
620,400.00
371,200.00
678,400.00
800,850.00
315,450.00
900,000.00
380,640.00
2,750,000.00
136,430,000.00
544,500.00
262,000.00
250,000.00
320,000.00
192,500.00
399,003.00
645,750.00
5,869,500.00
75,000.00
94,500.00
164,430.00
133,488.00
825,000.00
120,067.20
745,500.00
132,990.00
107,870.00
1,225,000.00
178,750.00
8,400,000.00
345,000.00

11
 94,900.00
6,490,680.00
525,000.00
2,860,000.00
269,500.00
528,000.00
2,343.00
828,000.00
170,885.00
102,930.00
284,900.00
121,000.00
1,212,000.00
864,000.00
2,190,975.00
406,125.00
162,400.00
980,000.00
1,800,000.00
1,700,000.00
27,400.00
415,467.00
213,500.00
3,534,000.00
3,102,792.00
2,778,490.00
82,500,000.00
1,194,000.00
532,560.00
1,386,000.00
2,400,000.00
2,500,176.00
1,872,000.00
432,000.00
2,310,000.00
100,800.00
1,320,000.00
360,000.00
156,000.00
135,000.00
61,000.00

12
 2,784,000.00
174,000.00
845,000.00
1,280,000.00
100,800.00
690,000.00
2,802,000.00
240,768.00
27,500,000.00
220,500.00
205,000.00
173,850.00
840,000.00
2,730,000.00
615,000.00
370,500.00
539,000.00
400,770.00
339,400.00
24,800.00
198,726.50
1,875,610.00
550,000.00
67,000.00
229,250.00
162,000.00
2,277,000.00
164,010.00
82,500.00
41,500.00
602,000.00
633,500.00
73,392.50
2,589,500.00
540,000.00
706,200.00
265,000.00
223,200.00
44,000,000.00
4,633,200.00
780,000.00

13
 346,500.00
1,738,800.00
4,977,000.00
115,843.50
225,631.00
569,252.00
665,000.00
1,028,200.00
538,200.00
128,220.00
54,480.00
151,375.00
292,762.50
528,360.00
128,205.00
989,100.00
1,551,396.00
6,923,256.00
293,700.00
720,100.00
172,800.00
27,400.00
143,200.00
570,000.00
83,400.00
218,000.00
51,000.00
1,363,782.00
644,784.00
3,316,920.00
3,154,650.00
555,000.00
526,740.00
232,091.00
126,000.00
15,149.90
44,905.00
753,186.00
130,000.00
710,400.00
1,221,000.00

14
 63,825.00
372,960.00
186,480.00
1,325,000.00
865,800.00
3,700,000.00
911,310.00
1,050,000.00
83,800.00
1,060,000.00
367,500.00
720,000.00
790,000.00
790,000.00
4,000,000.00
800,000.00
277,500.00
5,000,000.00
244,130.00
1,290,375.00
943,500.00
7,692,300.00
283,050.00
9,335,660.00
10,471,760.00
800,000.00
1,831,500.00
399,600.00
549,450.00
251,500.00
64,500.00
130,000.00
292,500.00
72,150.00
4,029,300.00
3,052,500.00
915,750.00
119,760.00
113,800.00
2,400,000.00
73,260.00

15
 349,500.00
53,178.00
81,540.00
89,100.00
374,400.00
1,447,500.00
16,501,650.00
13,970.00
106,920.00
754,930.00
55,000.00
61,050.00
125,000.00
463,320.00
8,250.00
25,600.00
506,000.00
67,900.00
414,000.00
937,500.00
1,121,000.00
1,819,538.28
8,836,363.44
3,479,585.04
769,833.00
702,891.00
2,590,909.50
657,730,982.86

S.Farm., Apt.
201001 2 031

16