Laporan Mutasi Persediaan 2022 Puskesmas Mekarwangi (April) New

DATA MUTASI PERSEDIAAN OBAT DAN BMHP SUMBER ANGGARAN JKN
UPTD PUSKESMAS MEKARWANGI

DINAS KESEHATAN KABUPATEN KUNINGAN
PERIODE BULAN APRIL TAHUN 2022
STOK AWAL APRIL 2022 JUMLAH PENERIMAAN APRIL 2022 PENGELUARAN APRIL 2022 SALDO AKHIR APRIL
NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

HARGA SATUAN HARGA HARGA SATUAN HARGA SATUAN
(RP) BANYAKNYA NILAI RP. SATUAN (RP) BANYAKNYA NILAI RP. (RP) BANYAKNYA NILAI RP. (RP)
A. O B A T
1 Air Raksa Dental Use Botol - - - - - -
2 Albendazole Tablet 400 mg Tablet - - - - - -
3 Albendazole susp 200 mg/5 ml Botol - - - - - -
4 Alopurinol Tablet 100 mg Tablet 105.00 4,280 449,400.73 105.00 - 105.00 - 105.00
5 Alopurinol Tablet 300 mg Tablet 200.00 2,000 400,000.00 200.00 - 200.00 - 200.00
6 Alprazolam tablet 1 mg Tablet - - - - - -
7 Ambroksol Tablet 30 mg Tablet 308.00 3,150 970,200.00 308.00 - 308.00 - 308.00
8 Ambroksol sirup 15 mg/5 ml Botol 2,750.00 149 409,750.00 2,750.00 - 2,750.00 - 2,750.00
Ambroksol sirup 15 mg/5 ml Botol 3,627.00 - - 3,627.00 - 3,627.00 - 3,627.00
9 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 2,704.00 30 81,120.00 2,704.00 - 2,704.00 - 2,704.00
10 Aminofillin Tablet 200 mg Tablet 91.00 - - 139.00 - 91.00 - 91.00
Aminofillin Tablet 200 mg Tablet 95.00 - - 95.00 - 95.00 - 95.00
11 Amitriptillin Hcl Tablet Salut 25 mg Tablet - - - - - -
12 Amlodipin Tablet 5 mg Tablet 53.00 6,000 318,000.00 53.00 - 53.00 270.00 14,310.00 53.00
Amlodipin Tablet 5 mg Tablet 75.00 - - 75.00 - 75.00 - 75.00
13 Amlodipin Tablet 10 mg Tablet 70.00 7,240 506,828.96 70.00 - 70.00 310.00 21,701.24 70.00
Amlodipin Tablet 10 mg Tablet 99.00 - - 99.00 - 99.00 - 99.00
14 Amoksisillin Kapsul 250 mg Kapsul 374.00 2,640 987,360.00 374.00 - 374.00 - 374.00
Amoksisillin Kapsul 250 mg Kapsul 180.00 - - - 180.00 - 180.00
15 Amoksisillin Kaplet 500 mg Kaplet 232.00 - - 233.00 - 232.00 - 232.00
Amoksisillin Kaplet 500 mg Kaplet 190.00 - - - 190.00 - 190.00
Amoksisillin Kaplet 500 mg Kaplet 201.00 8,840 1,776,840.00 201.00 - 201.00 - 201.00
16 Amoksisillin Serbuk Injeksi 1000 mg vial - - - - - -
17 Amoksisillin Sirup Kering 125 mg/5ml Botol 3,531.00 172 607,332.00 3,531.00 - 3,531.00 - 3,531.00
18
Amoksisillin Double Strengh Sirup Kering 250 mg/5 ml Botol
3,400.00 - - 3,400.00 - 3,400.00 - 3,400.00
Amoksisillin Double Strengh Sirup Kering 250 mg/5 ml Botol
3,626.00 - - 3,626.00 - 3,626.00 - 3,626.00
Amoksisilin drop 100 mg/ml Botol 13,077.60 44 575,414.40 13,077.60 - 13,077.60 - 13,077.60

BANYAKNYA NILAI RP. BANYAKNYA NILAI RP. BANYAKNYA NILAI RP.
(RP) SATUAN (RP) (RP) (RP)
19 Ampisilin Kapsul 250 mg Kapsul - - - - - -
20 Ampisillin Kaplet 500 mg Tablet - - - - - -
21 Ampisilin Sirup 125 mg / 5 ml Botol - - - - - -
22 Ampisillin Injeksi 1000 mg Vial - - - - - -
23 Analgetik Plus Tablet - - - - - -
24 Antasida Doen Suspensi Kombinasi : Magnesium
Hidroksida 200 mg+ Alumunium Hidroksida 200 mg/5 Botol
ml 2,129.00 - - 2,129.00 - 2,129.00 - 2,129.00
Antasida Doen Suspensi Kombinasi : Magnesium
Hidroksida 200 mg+ Alumunium Hidroksida 200 mg/5 Botol
ml 1,679.00 278 466,762.00 1,679.00 - 1,679.00 76.00 127,604.00 1,679.00
25
Antasida Doen Tablet, Kombinasi : Magnesium
Hidroksida 200 mg+ Alumunium Hidroksida 200 mg Tablet
54.00 990 53,460.00 54.00 - 54.00 - 54.00
Antasida Doen Tablet, Kombinasi : Magnesium

Hidroksida 200 mg+ Alumunium Hidroksida 200 mg Tablet
54.00 8,410 454,140.00 54.00 - 54.00 - 54.00
26 Antasida Plus Tablet Tablet - - 187.00 - - - -
27 Antalgin (Metampiron) Tablet 500 mg Tablet 170.00 16,310 2,772,700.00 214.00 - 170.00 - 170.00
28 Antalgin Injeksi 250 mg/ml-2ml Ampul - - - - - -
29 Anti Bakteri DOEN Salep Kombinasi :
Basitrasin 500 IU/g + Polimiksin 1000 IU/g Tube
3,035.00 67 203,345.00 3,035.00 - 3,035.00 - 3,035.00
30 Anti Hemoroid Doen komb Supp 3,250.00 150 487,500.00 3,250.00 - 3,250.00 10.00 32,500.00 3,250.00
Anti Hemoroid Doen komb Supp 3,280.00 - - - 3,280.00 - 3,280.00
31 Anti Fungi DOEN Kombinasi :
Asam Benzoat 6% + Asam Salisilat 3% Pot
3,477.00 104 361,608.00 3,477.00 - 3,477.00 - 3,477.00
Anti Fungi DOEN Kombinasi :
Pot
Asam Benzoat 6% + Asam Salisilat 3% 4,323.00 - - - 4,323.00 - 4,323.00
32 Antimigren DOEN Kombinasi :
Tablet
Ergotamin Tartrat 1 mg + Kofein 50 mg - - - - - -
33 Anti Diare Suspensi Botol - - - - - -
34 Anti Diare Tablet Tablet - - - - - -
35 Anti Dotum Oral Tablet Tablet - - - - - -
36 Anti Hipertensi Kapsul Tablet - - - - - -
37 Antihistamin Tablet kombinasi Tablet 185.00 22,940 4,243,900.00 185.00 - 185.00 1,040.00 192,400.00 185.00
Antihistamin Tablet kombinasi Tablet 195.00 - - - 195.00 - 195.00
38 Antispasmodik Tablet Tablet 1,050.00 1,920 2,016,000.00 1,050.00 - 1,050.00 26.00 27,300.00 1,050.00
Antispasmodik Tablet Tablet 1,195.00 - - - 1,195.00 - 1,195.00

39 Antitusiva Sirup Botol 8,000.00 - - 11,400.00 - 8,000.00 - 8,000.00
40 Antitusiva Tablet Tablet - - - - - -
41 Asam Folat Tablet 1 mg Tablet 56.00 4,090 229,040.00 56.00 - 56.00 160.00 8,960.00 56.00
Asam Folat Tablet 1 mg Tablet 75.00 - - 75.00 - 75.00 - 75.00
42 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 42.00 10,000 420,000.00 42.00 - 42.00 100.00 4,200.00 42.00
43 Asam Mefenamat Kapsul 500 mg Kapsul 249.70 2,500 624,250.00 249.70 - 249.70 - 249.70
44 Acetylsistein tablet Tablet 990.00 480 475,200.00 990.00 - 990.00 - 990.00
45 Asetosal Tablet 80 mg Tablet - - - - - -
46 Asetosal Tablet 100 mg Tablet 125.00 - - - 125.00 - 125.00
48 Asiklovir Krim 5 % Tube 2,997.00 38 113,886.00 2,997.00 - 2,997.00 - 2,997.00
49 Asiklovir Tablet 200 mg Tablet - - 236.00 - - - -
50 Asiklovir Tablet 400 mg Tablet 380.00 2,210 839,800.00 380.00 - 380.00 - 380.00
Asiklovir Tablet 400 mg Tablet 349.00 - - - 349.00 - 349.00
51 Attapulgit Tablet 152.00 50 7,599.90 152.00 - 152.00 - 152.00
Attapulgit Tablet 145.00 500 72,500.00 145.00 - 145.00 - 145.00
Attapulgit Tablet 142.00 - - - 142.00 - 142.00
52 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul - - - - - -
53 Aqua Pro Injeksi Steril, bebas Pirogen 20 ml Vial 2,860.00 10 28,600.00 2,860.00 - 2,860.00 - 2,860.00
54 Bahan Tambal Sementara Set - - - - - -
55 Benzatin Benzil Penisilin injeksi Vial - - - - - -
56 Betahistin Mesilat 6 mg Tablet 110.00 - - 110.00 - 110.00 - 110.00
Betahistin Mesilat 6 mg Tablet 149.00 - - - 149.00 - 149.00
57 Betametason Krim 0,1 %- 5g Tube 1,339.80 204 273,319.20 1,340.00 - 1,339.80 - 1,339.80
Betametason Krim 0,1 %- 5g Tube 1,430.00 - - 1,430.00 - 1,430.00 - 1,430.00
Betametason Krim 0,1 %- 5g Tube 1,349.00 - - - 1,349.00 - 1,349.00
58 Bisakodil suppositoria 10 mg Supp - - - - - -
59 Bisoprolol Tablet 5 mg Tablet - - - - - -
60 Bromheksin 8 mg Tablet 250.00 9,600 2,400,000.00 250.00 - 250.00 - 250.00
61 Cresotin Pasta Botol - - - - - -
62 Cresotin Liquid No 2 Botol - - - - - -
63 Deksametason Injeksi 5mg/ml-1ml Ampul 924.00 20 18,480.00 924.00 - 924.00 - 924.00
64 Deksametason Tablet 0,5 mg Tablet 133.10 4,155 553,030.50 133.10 - 133.10 96.00 12,777.60 133.10
Deksametason Tablet 0,5 mg Tablet 41.00 - - - 41.00 - 41.00

65 Devitalisasi Pasta (Non Arsen) Botol - - - - - -
66 Diazepam tablet 2 mg Tablet - - - - - -
67 Diazepam tablet 5 mg Tablet - - 109.00 - - - -
68 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul - - 1,735.00 - - - -
69 Diazepam Larutan Rektal 5 mg/ml Supp - - - - - -
70 Diazepam Larutan Rektal 10 mg/ml Supp - - - - - -
71 Dietilkarbamazin Sitrat Tablet 100 mg Tablet - - - - - -
72 Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul 781.00 10 7,810.00 781.00 - 781.00 - 781.00
73 Digoksin Tablet 0,25 mg Tablet - - 104.00 - - - -
74 Dimenhidrinat Tablet 50 mg Tablet 99.00 200 19,800.00 99.00 - 99.00 - 99.00
Dimenhidrinat Tablet 50 mg Tablet 108.00 - - 108.00 - 108.00 - 108.00
75 Domperidon Tablet 10 mg Tablet 71.01 1,800 127,809.00 71.01 - 71.01 - 71.01
76 Donperidon Suspensi 5 mg/5ml Botol 2,296.00 84 192,864.00 2,296.00 - 2,296.00 - 2,296.00
77 Efedrin Hcl Tablet 25 mg Tablet - - - - - -
78 Ekstrak Belladone Tablet 10 mg Tablet - - - - - -
79 Epinefrin HCl / Bitartrat
(Epinefrina / Adrenalina) Injeksi 0,1%/- 1ml Ampul
2,204.00 - - 1,408.00 - 2,204.00 - 2,204.00
Epinefrin HCl / Bitartrat
(Epinefrina / Adrenalina) Injeksi 0,1%/- 1ml Ampul
1,749.00 - - - 1,749.00 - 1,749.00
80 Eritromisin Kapsul 250 mg Kapsul - - - - - -
81 Eritromisin Kapsul 500 mg Kapsul 775.00 440 341,000.00 775.00 - 775.00 - 775.00
82 Eritromisin Sirup 200 mg / 5 ml Botol 6,150.00 - - - 6,150.00 - 6,150.00
83 Etambutol Tablet 500 mg Tablet - - - - - -
84 Etanol 70 % 100 ml Botol - - - - - -
85 Etil Klorida Semprot -100 ml Botol 246,000.00 5 1,230,000.00 246,000.00 - 246,000.00 - 246,000.00
Etil Klorida Semprot -100 ml Botol 154,000.00 5 770,000.00 154,000.00 - 154,000.00 - 154,000.00
86 Eugenol Cairan -10 ml Botol - - 18,824.00 - - - -
87 Fenitoin Natrium Kapsul 100 mg Kapsul - - - - - -
88 Fenobarbital tablet 30 mg Tablet 182.00 - - 182.00 - 182.00 - 182.00
89 Fenobarbital injeksi 50 mg / ml Ampul - - 1,857.00 - - - -
90 Fenoksimeti Penisilin 250 mg tablet Tablet 350.00 - - - 350.00 - 350.00
91 Fenoksimeti Penisilin 500 mg tablet Tablet 605.00 - - 629.00 - 605.00 - 605.00
92 Fenol Gliserol TK Botol 2,590.00 - - 2,590.00 - 2,590.00 - 2,590.00
93 Flufenazine decanoat injeksi 25 mg/ml Ampul - - - - - -
94 Flukonazole tablet 150 mg Tablet - - - - - -

95 Fitomenadion tablet 10 mg Tablet 748.00 1,470 1,099,560.00 748.00 - 748.00 - 748.00
Fitomenadion tablet 10 mg Tablet 695.00 - - - 695.00 - 695.00
96 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 1,386.00 30 41,580.00 1,386.00 - 1,386.00 - 1,386.00
97 Furosemid Tablet 40 mg Tablet 87.00 - - 77.00 - 87.00 - 87.00
98 Furosemid injeksi Ampul - - 1,333.00 - - - -
99
Garam Oralit I serbuk, kombinasi :
( Nacl 0,52 gr, Kalium Klorida 0,30 gr, Trinatrium
Kantong
Sitrat dihidrat 0,58 gr, Glukosa Anhidrat 2,70 g )200 ml
Air
274.00 1,244 340,854.76 274.00 - 274.00 - 274.00
Garam Oralit I serbuk, kombinasi :
( Nacl 0,52 gr, Kalium Klorida 0,30 gr, Trinatrium
Kantong
Sitrat dihidrat 0,58 gr, Glukosa Anhidrat 2,70 g )200 ml
Air
280.00 - - 280.00 - 280.00 - 280.00
100 Gemfibrozil Tablet 600 mg Tablet 794.00 - - 794.00 - 794.00 - 794.00
101 Gentian Violet Botol - - - - - -
102 Gentamisin injeksi 80 mg / 2 ml Vial - - - - - -
103 Gentamisin Salep Kulit 0,1 % Tube 2,115.00 - - 1,830.00 - 2,115.00 - 2,115.00
Gentamisin Salep Kulit 0,1 % Tube 2,860.00 90 257,400.00 2,860.00 - 2,860.00 - 2,860.00
104 Glass Ionomer Set - - - - - -
105 Glibenklamid Tablet 5 mg Tablet 83.00 - - 83.00 - 83.00 - 83.00
106 Glimepiride 2 mg Tablet 123.00 2,800 344,400.00 123.00 - 123.00 260.00 31,980.00 123.00
107 Gliseril Guayakolat Tablet 100 mg Tablet 85.99 - - 86.00 - 85.99 - 85.99
Gliseril Guayakolat Tablet 100 mg Tablet 87.00 - - - 87.00 - 87.00
108 Gliseril Guayakolat sirup Botol 7,800.00 - - 7,800.00 - 7,800.00 - 7,800.00
Gliseril Guayakolat sirup Botol 9,020.00 55 496,100.00 9,020.00 - 9,020.00 40.00 360,800.00 9,020.00
109 Glukonas Kalsikus injeksi Ampul - - 10,351.00 - - - -
110 Glukosa Larutan Infus 5 % Botol - - 6,900.00 - - - -
111 Glukosa Larutan Infus10 % Botol - - - - - -
112 Griseofulvin Tablet 125 mg,micronized Tablet 210.00 900 189,000.00 210.00 - 210.00 - 210.00
113 Haloperidol Tablet 0,5 mg Tablet 47.00 800 37,600.00 47.00 - 47.00 - 47.00
114 Haloperidol Tablet 1,5 mg Tablet 51.00 3,000 153,000.00 51.00 - 51.00 - 51.00
Haloperidol Tablet 1,5 mg Tablet 61.00 - - - 61.00 - 61.00
115 Haloperidol Tablet 5 mg Tablet 54.00 500 27,000.00 54.00 - 54.00 - 54.00
116 Haloperidol injeksi 5 mg/ml Ampul - - - - - -
117 Haloperidol injeksi 50 mg/ml Ampul - - 101,300.00 - - - -
118 Hidroklortiazid (HCT) Tablet 25 mg Tablet 155.00 1,280 198,400.00 155.00 - 155.00 - 155.00

Hidroklortiazid (HCT) Tablet 25 mg Tablet 148.00 - - 148.00 - 148.00 - 148.00
119 Hidrokortison Krim 2,5 % Tube 2,475.00 260 643,500.00 2,475.00 - 2,475.00 - 2,475.00
Hidrokortison Krim 2,5 % Tube 2,639.00 - - - 2,639.00 - 2,639.00
120 Ibuprofen Tablet 200 mg Tablet 102.00 - - - 102.00 - 102.00
121 Ibuprofen Tablet 400 mg Tablet 111.00 - - - 111.00 - 111.00
Ibuprofen Tablet 400 mg Tablet 308.00 - - 308.00 - 308.00 - 308.00
122 Ibuprofen Suspensi 200 mg/5 ml Botol 3,200.00 60 192,000.00 3,200.00 - 3,200.00 - 3,200.00
123 Ichtyol salep Kulit Pot - - - - - -
124 Isoniazid tablet 100 mg Tablet - - - - - -
125 Isoniazid tablet 300 mg Tablet - - - - - -
126 Isosorbid Dinitrat 5 mg Tablet - - 89.00 - - - -
127 Kalium Diklofenak Tablet 25 mg Tablet - - - - - -
128 Kalium Diklofenak Tablet 50 mg Tablet - - 275.00 - - - -
129 Kalsium Hidroksida Pasta Tube - - - - - -
130 Kalsium Laktat Tablet 500 mg Tablet 60.00 5,000 300,000.00 60.00 - 60.00 580.00 34,800.00 60.00
Kalsium Laktat Tablet 500 mg Tablet 63.00 10 630.00 63.00 - 63.00 - 63.00
131 Kaptopril 12,5 mg Tablet - - - - - -
132 Kaptopril 25 mg Tablet 187.00 - - 187.00 - 187.00 - 187.00
Kaptopril 25 mg Tablet 75.00 130 9,750.00 75.00 - 75.00 - 75.00
133 Karbamazepin Tablet 200 mg Tablet 189.00 300 56,700.00 189.00 - 189.00 - 189.00
134 Ketokonazole Krim 2 % - 15 gr Tube 2,545.00 - - 2,518.00 - 2,545.00 - 2,545.00
135 Ketokonazole Tablet 200 mg Tablet 280.00 500 140,000.00 270.00 - 280.00 - 280.00
136 Ketoprofen Tablet 100 mg Tablet - - - - - -
137 Ketoprofen Injeksi 100 mg / 1 ml Ampul - - - - - -
138 Ketorolac 10 mg injeksi Ampul - - - - - -
139 Ketorolac 30 mg injeksi Ampul - - 1,450.00 - - - -
140 Klindamisin Kapsul 150 mg Kapsul 715.00 - - 715.00 - 715.00 - 715.00
141 Klindamisin Kapsul 300 mg Kapsul - - 583.00 - - - -
142 Kloramfenikol Kapsul 250 mg Kapsul 310.00 420 130,200.00 310.00 - 310.00 - 310.00
143 Kloramfenikol suspensi125mg/5 ml Botol 4,700.00 - - 4,700.00 - 4,700.00 - 4,700.00
144 Kloramfenikol Salep Mata 1%-3,5 g Tube 1,810.00 - - 1,881.00 - 1,810.00 - 1,810.00
Kloramfenikol Salep Mata 1%-3,5 g Tube 2,006.00 23 46,138.00 2,006.00 - 2,006.00 - 2,006.00
145 Kloramfenikol Salep Kulit 2% Tube 3,038.00 - - 3,038.00 - 3,038.00 - 3,038.00
Kloramfenikol Salep Kulit 2% Tube 3,266.00 48 156,768.00 3,266.00 - 3,266.00 - 3,266.00

146 Kloramfenikol Tetes Mata -5 ml Botol 11,000.00 127 1,397,000.00 11,000.00 - 11,000.00 - 11,000.00
147 Kloramfenikol Tetes Telinga 3%-5 ml Botol 7,700.00 150 1,155,000.00 7,700.00 - 7,700.00 - 7,700.00
Kloramfenikol Tetes Telinga 3%-5 ml Botol 6,899.00 - - 6,899.00 - 6,899.00 - 6,899.00
148 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 42.00 - - 22.00 - 42.00 - 42.00
Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 37.00 27,200 1,006,400.00 - 37.00 - 37.00
149 Klorpromazin Hcl Tablet Salut 25 mg Tablet 181.00 500 90,500.00 181.00 - 181.00 40.00 7,240.00 181.00
150 Klorpromazin Hcl Tablet Salut 100 mg Tablet - - 147.00 - - - -
151 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul - - 1,510.00 - - - -
152 Kombinasi Ipatropium Bromide + Salbutamol
Sulphate for inhalation 2,5 ml Vial
- - 4,550.00 - - - -
153 Kombipak Cefixime+ Azithromisin Kotak - - - - - -
154
Kotrimoksazol Pedriatik Tablet, Kombinasi :
Tablet
Sulfametoksazol 100 mg + Trimetroprim 20 mg
- - - - - -
155
Kotrimoksazol Tablet, Kombinasi :
Tablet
Sulfametoksazol 400 mg + Trimetroprim 80 mg
123.00 1,000 123,000.00 123.00 - 123.00 - 123.00
156
Kotrimoksazol Suspensi Kombinasi :
Botol
Sulfametoksazol 200 mg + Trimetroprim 40 mg/5 ml
2,120.00 - - 2,052.00 - 2,120.00 - 2,120.00
Kotrimoksazol Suspensi Kombinasi :

Botol
Sulfametoksazol 200 mg + Trimetroprim 40 mg/5 ml
2,100.00 100 210,000.00 2,100.00 - 2,100.00 - 2,100.00
157 Lansoprazole 30 mg Kapsul Tablet 278.00 - - 278.00 - 278.00 - 278.00
158
Larutan mengadung Elektrolit
(Na 130 mEq,Cl 109 mEq, Asetat 28 mEq) /Asering Botol
- - 9,646.00 - - - -
159 Larutan mengadung Elektrolit
(Nacl 1,125 gr , Dekstrosa 18,75 gr) Botol
- - 9,644.00 - - - -
160 Larutan mengadung Karbohidrat + Elektrolit
(Nacl 1,75 gr, KCL 1,5 gr, Na Lactat 2,24 gr, Botol
Dekstrosa 27 gr) - - 10,696.00 - - - -
161 Lidokain injeksi 2 % Tablet 1,111.00 - - 1,144.00 - 1,111.00 - 1,111.00
Lidokain injeksi 2 % Tablet 847.00 100 84,700.00 847.00 - 847.00 - 847.00
162 Lidokain Komp Injeksi, Kombinasi :
Ampul
Lidokain Hcl 2% +Epinefrin 1 : 80.000-2 ml 803.00 150 120,450.00 803.00 - 803.00 - 803.00
Lidokain Komp Injeksi, Kombinasi :
Ampul
Lidokain Hcl 2% +Epinefrin 1 : 80.000-2 ml 1,937.00 - - - 1,937.00 - 1,937.00
163 Lidokain Spray Botol - - - - - -
164 Loperamid Tablet 2 mg Tablet 80.00 - - 120.00 - 80.00 - 80.00

165 Loratadin tablet 10 mg Tablet 131.00 350 45,850.00 131.00 - 131.00 - 131.00
166 Magnesium Sulfat (IV) 20 %-25 ml Ampul 3,200.00 - - 3,328.00 - 3,200.00 - 3,200.00
167 Magnesium Sulfat (IV) 40 %-25 ml Ampul 3,620.00 - - 3,796.00 - 3,620.00 - 3,620.00
168 MB Anak Blister - - - - - -
169 MB Dewasa Blister - - - - - -
170 Meloksikam tablet 15 mg Tablet 707.00 - - 700.00 - 707.00 - 707.00
171 Meloksikam Suppositoria Supp - - - - - -
172 Metformin Hcl Tablet 500 mg Tablet 95.99 - - 96.00 - 95.99 - 95.99
Metformin Hcl Tablet 500 mg Tablet 102.00 - - 102.00 - 102.00 - 102.00
Metformin Hcl Tablet 500 mg Tablet 94.00 - - - 94.00 - 94.00
173 Metformin 850 mg Tablet 150.00 - - 150.00 - 150.00 - 150.00
174 Metildopa 250 mg tablet Tablet 985.00 1,000 985,000.00 985.00 - 985.00 - 985.00
175 Methisoprinol 500 mg Tablet 3,300.00 420 1,386,000.00 3,300.00 - 3,300.00 - 3,300.00
176
Metilergometrin Maleat (Metergin) Tablet 0,125 mg Tablet
210.00 720 151,200.00 210.00 - 210.00 - 210.00
Metilergometrin Maleat (Metergin) Tablet 0,125 mg Tablet
420.00 - - - 420.00 - 420.00
177 Metilergometrin Maleat Injeksi 0,200 mg-1ml Ampul 1,023.00 100 102,300.00 1,023.00 - 1,023.00 - 1,023.00
178 Metilprednisolon tablet 4 mg Tablet 330.00 1,160 382,800.00 330.00 - 330.00 70.00 23,100.00 330.00
Metilprednisolon tablet 4 mg Tablet 143.00 - - 143.00 - 143.00 - 143.00
179 Metoklopramid 10 mg Tablet - - 80.00 - - - -
180 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul - - - - - -
181 Metronidazol Tablet 250 mg Tablet 90.00 - - - 90.00 - 90.00
182 Metronidazole Tablet 500 mg Tablet 113.00 - - - 113.00 - 113.00
Metronidazole Tablet 500 mg Tablet 232.00 440 102,080.00 232.00 - 232.00 - 232.00
183 Metronidazole sirup 125 mg/ml Botol 3,950.00 - - 3,950.00 - 3,950.00 - 3,950.00
184 Metronidazole Infus 500 mg /100 ml Ampul - - 8,110.00 - - - -
185 Mikonazole KrIm 2 % - 10 gr Tube 3,250.00 - - 3,414.00 - 3,250.00 - 3,250.00
186 Multivitamin + Mineral tablet Tablet 800.00 - - 793.00 - 800.00 - 800.00
187 Multivitamin sirup Botol 12,500.00 67 837,500.00 12,500.00 - 12,500.00 - 12,500.00
Multivitamin sirup Botol 12,100.00 200 2,420,000.00 12,100.00 - 12,100.00 - 12,100.00
188 Mummifying Pasta Botol - - - - - -
189 Natrium Bikarbonat Tablet 500 mg Tablet - - - - - -
190 Natrum Diklofenak Tablet 25 mg Tablet 114.00 1,000 114,000.00 114.00 - 114.00 - 114.00
191 Natrium Diklofenak Tablet 50 mg Tablet 99.00 540 53,460.00 99.00 - 99.00 100.00 9,900.00 99.00

192
Natrium Klorida Larutan infus 0,9%-Steril 500 ml Botol
6,410.00 - - 6,410.00 - 6,410.00 - 6,410.00
193 Nipedifin Tablet 10 mg Tablet 190.00 - - 190.00 - 190.00 - 190.00
Nipedifin Tablet 10 mg Tablet 209.00 1,910 399,190.00 209.00 - 209.00 - 209.00
Nipedifin Tablet 10 mg Tablet 99.00 - - - 99.00 - 99.00
194 Nistatin suspensi 100.000 IU/ml Botol 11,500.00 49 563,500.00 11,500.00 - 11,500.00 - 11,500.00
195 Nistatin 100.000 IU/gram Tablet Vagina Tablet 550.00 - - 550.00 - 550.00 - 550.00
196 Nistatin 500.000 IU/gram Tablet Salut Tablet 825.00 500 412,500.00 825.00 - 825.00 - 825.00
Nistatin 500.000 IU/gram Tablet Salut Tablet 745.00 - - - 745.00 - 745.00
Nistatin 500.000 IU/gram Tablet Salut Tablet 765.00 - - - 765.00 - 765.00
197 Obat Antitiuberkolosis Kategori Anak Paket - - - - - -
198 Obat Antitiuberkolosis Kategori 1 Dewasa Paket - - - - - -
201 Obat Anti Tuberkulosis FDC Kat Anak Paket - - - - - -
202 Obat Anti Tuberkulosis FDC Kat I & II Paket - - - - - -
203 Obat Anti Tuberkulosis FDC Kat I & III Paket - - - - - -
204 Obat Anti Tuberkolosis FDC Sisipan Dewasa Paket - - - - - -
205 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 5,000.00 - - 5,000.00 - 5,000.00 - 5,000.00
Obat Batuk Hitam (OBH) Cairan 100 ml Botol 6,270.00 - - 6,270.00 - 6,270.00 - 6,270.00
206 Obat Batuk Cair Sirup (Ekspektoran) Botol 7,180.00 25 179,500.00 7,180.00 - 7,180.00 - 7,180.00
Obat Batuk Cair Sirup (Ekspektoran) Botol 6,759.00 - - - 6,759.00 - 6,759.00
207 Obat Batuk Hitam Plus Sirup Botol - - - - - -
208 Obat Flu Sirup Botol - - - - - -
209 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 ml Vial - - - - - -
210 Oksiterasiklin Salep Mata 1%-3,5g Tube 2,667.00 31 82,677.00 2,667.00 - 2,667.00 - 2,667.00
211 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2,005.00 - - 1,969.00 - 2,005.00 - 2,005.00
212 Oksitosin Injeksi 10 IU/ml-1ml Ampul 1,126.00 100 112,600.00 1,126.00 - 1,126.00 - 1,126.00
213 Omeprazole injeksi 40mg/10ml Ampul 5,093.00 9 45,837.00 5,093.00 - 5,093.00 - 5,093.00
214 Omeprazole Kapsul 20 mg Tablet 357.50 2,940 1,051,050.00 357.50 - 357.50 180.00 64,350.00 357.50
Omeprazole Kapsul 20 mg Tablet 140.00 - - - 140.00 - 140.00
215 Ondansetron inj 4 mg/ 2 mL Ampul - - 1,070.00 - - - -
216
Parasetamol drop 100 mg/ml btl @15ml (60mg/0,6ml) Botol
4,976.00 86 427,936.00 4,976.00 - 4,976.00 - 4,976.00
217 Parasetamol Sirup 120 mg/5ml-60 ml Botol 1,160.00 400 464,000.00 1,160.00 - 1,160.00 - 1,160.00

218 Parasetamol Tablet 100 mg Tablet - - - - - -
219 Parasetamol Tablet 500 mg Tablet 91.35 3,100 283,185.00 - 91.35 575.00 52,526.25 91.35
Parasetamol Tablet 500 mg Tablet 143.00 10,000 1,430,000.00 143.00 - 143.00 - 143.00
220 PB Anak Blister - - - - - -
221 PB Dewasa Blister - - - - - -
222 Pehacain injeksi Ampul 3,000.00 - - 3,100.00 - 3,000.00 - 3,000.00
223 Perak Sulfadiazin krim 1 % 35 gr Tube 20,700.00 - - 20,700.00 - 20,700.00 - 20,700.00
224 Permetrin krim 5 % Tube 11,825.00 - - 11,825.00 - 11,825.00 - 11,825.00
225 Piracetam Tablet 400 mg Tablet - - - - - -
226 Piracetam Tablet 800 mg Tablet - - - - - -
227 Piroksikam Tablet 20 mg Tablet 130.00 - - 200.00 - 130.00 - 130.00
Piroksikam Tablet 20 mg Tablet 165.00 - - 165.00 - 165.00 - 165.00
228 Pirantel Pamoat Tablet 365 mg (Setara dng 125 mg
Basa) Tablet
269.00 - - - 269.00 - 269.00
229 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 128.70 1,400 180,180.00 128.70 - 128.70 - 128.70
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 131.00 - - 131.00 - 131.00 - 131.00
230 Piridoksin Hcl (Vit.B6) Tablet 25 mg Tablet - - - - - -
231 Povidon Iodida 10% 30 ml Botol 3,045.00 - - 3,045.00 - 3,045.00 - 3,045.00
232 Povidon Iodida 10% 60 ml Botol 3,885.00 - - - 3,885.00 - 3,885.00
233 Povidon Iodida 10% 300 ml Botol 18,900.00 - - 18,900.00 - 18,900.00 - 18,900.00
234 Prednison Tablet 5 mg Tablet 68.00 775 52,700.00 68.00 - 68.00 - 68.00
235 Primakuin tablet 15 mg Tablet - - - - - -
236 Prokain Benzil Penisilin Injeksi 3,000,000 IU Vial - - - - - -
237 Propanolol Hcl Tablet 40 mg Tablet 74.00 - - 76.00 - 74.00 - 74.00
238 Propilturasil Tablet 100 mg Tablet 385.00 500 192,500.00 385.00 - 385.00 - 385.00
239 Ranitidin Injeksi 25 mg / ml Ampul - - 1,155.00 - - - -
240 Ranitidin Tablet 150 mg Tablet 85.00 1,000 85,000.00 85.00 - 85.00 100.00 8,500.00 85.00
Ranitidin Tablet 150 mg Tablet 98.00 - - - 98.00 - 98.00
241 Retinol (Vit. A) 100.000 IU Kapsul Kapsul - - 288.00 - - - -
242 Retinol (Vit. A) 200.000 IU Kapsul Kapsul - - 517.00 - - - -
243 Reserpin Tablet 0, 25 mg Tablet - - - - - -
244 Rifampisin Tablet 450 mg Tablet - - - - - -
245 Ringer Laktat Larutan Infus Steril 500 ml Botol 7,150.00 15 107,250.00 7,150.00 - 7,150.00 1.00 7,150.00 7,150.00
246 Salbutamol Tablet 2 mg Tablet 117.70 830 97,691.00 117.70 - 117.70 - 117.70
247 Salbutamol Tablet 4 mg Tablet 83.00 - - 70.00 - 83.00 - 83.00

Salbutamol Tablet 4 mg Tablet 87.00 - - - 87.00 - 87.00
248 Salbutamol solution for Inhalation single dose units 2,5
ml Ampul
4,550.00 - - 4,550.00 - 4,550.00 - 4,550.00
249
Salep 2-4 Kombinasi :
Asam Salisilat 2 % + Belerang Endap 4 % - 30 gram Pot
2,621.00 160 419,360.00 2,621.00 - 2,621.00 5.00 13,105.00 2,621.00
Salep 2-4 Kombinasi :

Asam Salisilat 2 % + Belerang Endap 4 % - 30 gram Pot
2,333.00 120 279,960.00 2,333.00 - 2,333.00 - 2,333.00
250 Salisil bedak 2% -50 gr Kotak 6,006.00 194 1,165,164.00 6,006.00 - 6,006.00 - 6,006.00
251 Salep Luka Bakar Tube 10,958.00 - - 11,500.00 - 10,958.00 - 10,958.00
252 Sefadroksil Sirup Kering 125 mg / 5 ml sirup Botol 3,980.00 - - 3,922.00 - 3,980.00 - 3,980.00
253 Sefadroksil Tablet 500 mg Tablet 1,430.00 310 443,300.00 1,430.00 - 1,430.00 40.00 57,200.00 1,430.00
Sefadroksil Tablet 500 mg Tablet 450.00 - - - 450.00 - 450.00
254 Sefiksim Kapsul 100 mg Kapsul 750.00 - - - 750.00 - 750.00
255 Sefiksim 400 mg + Azitromisin 1000 mg Paket - - - - - -
256 Sefotaksim Injeksi 1 gr Ampul - - - - - -
257 Seftriakson Injeksi 1 gr / vial Ampul - - 4,483.00 - - - -
258 Semen Seng Fosfat Serbuk & Cairan Botol - - - - - -
259 Setirizin Tablet 10 mg Tablet 49.01 1,520 74,487.60 49.01 - 49.01 290.00 14,211.45 49.01
260 Setirizin Sirup 5 mg / 5 ml Botol 2,090.00 173 361,570.00 2,090.00 - 2,090.00 - 2,090.00
261 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul - - 46.00 - - - -
262 Sianokobalamin Tablet 50 mcg Tablet 51.00 2,300 117,300.00 - 51.00 - 51.00
263 Silver Amalgam Serbuk 65-75% Botol - - - - - -
264 Simetidin 200 mg Tablet Tablet 363.00 - - 363.00 - 363.00 - 363.00
265 Simvastatin Tablet 10 mg Tablet 68.00 660 44,880.00 68.00 - 68.00 200.00 13,600.00 68.00
266 Siprofloksasin 500mg Tablet 591.80 480 284,064.00 591.80 - 591.80 - 591.80
Siprofloksasin 500mg Tablet 240.00 - - - 240.00 - 240.00
267 Spironolakton Tablet 25 mg Tablet 190.00 500 95,000.00 190.00 - 190.00 - 190.00
268 Sulfacetamid Tetes Mata 15 %-5ml Botol - - - - - -
269 Tablet Tambah Darah Kombinasi:
Besi II Sulfat 200 mg + Asam Folat 0,25 mg Tablet
350.00 - - - 350.00 - 350.00
270
Temporary Stopping Fletcher (Fletcher) Serbuk & Cairan Set
- - - - - -
271 Trikesol formalin ( T K F ) Cairan 10 ml Botol - - - - - -
272 Tetrasiklin Kapsul 250 mg Kapsul - - - - - -
273 Tetrasiklin Kapsul 500 mg Kapsul 310.00 - - 303.00 - 310.00 - 310.00

274 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1ml Ampul - - - - - -
275 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 184.80 4,400 813,120.00 184.80 - 184.80 - 184.80
Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 82.00 - - - 82.00 - 82.00
276 Thiamfenikol Kapsul 500 mg Kapsul - - - - - -
277 Tramadol Injeksi 50 mg/ ml Ampul - - - - - -
278 Tramadol Tablet 50 mg Tablet - - - - - -
279 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 63.00 5,000 315,000.00 63.00 - 63.00 130.00 8,190.00 63.00
Triheksifenidil Hidroklorida Tablet 2 mg Tablet 80.00 - - - 80.00 - 80.00
280 Vitamin B .Komplek Tablet Tablet 55.00 12,300 676,500.00 55.00 - 55.00 640.00 35,200.00 55.00
281 Vitamin Neurotropik Tablet Tablet 866.00 - - 866.00 - 866.00 - 866.00
282 Zinc Tablet 20 mg Tablet 208.00 2,000 416,000.00 208.00 - 208.00 - 208.00
Zinc Tablet 20 mg Tablet 514.00 - - - 514.00 - 514.00
283 Zinc Sulfat 20 mg/5 ml Botol 2,489.00 50 124,450.00 2,489.00 - 2,489.00 - 2,489.00
284 Aminofillin Tablet 150 mg Tablet - - 139.00 - - - -
285 Asam Folat Tablet 0,4 mg Tablet - - 52.00 - - - -
286 Gentamisin Sulfat tetes mata 0,3% Botol 4,232.00 - - 4,232.00 - 4,232.00 - 4,232.00
Gentamisin Sulfat tetes mata 0,3% Botol 4,519.90 240 1,084,776.00 4,519.90 - 4,519.90 - 4,519.90
287 Obat Kumur Botol - - 16,962.00 - - - -
288 Salep Betametason + Neomisin Tube 12,793.00 - - 12,793.00 - 12,793.00 - 12,793.00
289 Salep Kloramfenikol + Hidrokortison Tube 13,200.00 - - 13,200.00 - 13,200.00 - 13,200.00
290 PP test Pcs 1,997.17 - - - 1,997.17 - 1,997.17
291 Risperidon 2 mg Tablet 123.00 4,580 563,340.00 123.00 - 123.00 250.00 30,750.00 123.00
292 Klozapin 25 mg Tablet 473.00 5,000 2,365,000.00 473.00 - 473.00 200.00 94,600.00 473.00
293 Bisoprolol Tablet 2,5 mg Tablet 123.00 2,950 362,850.00 123.00 - 123.00 - 123.00
294 Asam Askorbat (Vit. C) Tablet 500 mg Tablet 489.50 2,390 1,169,905.00 489.50 - 489.50 - 489.50
Asam Askorbat (Vit. C) Tablet 500 mg Tablet 225.00 4,000 900,000.00 225.00 - 225.00 - 225.00
295 Multivitamin Tablet Tablet 979.00 790 773,410.00 979.00 - 979.00 300.00 293,700.00 979.00
296 Vitamin D 1000 IU Tablet 2,502.50 576 1,441,440.00 2,502.50 - 2,502.50 - 2,502.50
297 Klozapin 100 mg Tablet 997.00 500 498,500.00 997.00 - 997.00 - 997.00
298 - - - - - -
299 - - - - - -
300 - - - - - -
- - - - - -
B. BAHAN MEDIS HABIS PAKAI (BMHP) - - - - - -

1 Abbocath No 18 ( IV Chateter 18 ) Buah - - 6,277.00 - - - -
5 Alat Gula, Kolesterol, Asam Urat Unit 805,950.00 2 1,611,900.00 - 805,950.00 - 805,950.00
6 Alat Suntik Sekali Pakai 1 ml Set 679.25 100 67,925.00 679.29 - 679.25 - 679.25
Alat Suntik Sekali Pakai 1 ml Set 646.10 29 18,736.90 - 646.10 - 646.10
7 Set
Alat Suntik Sekali Pakai 3 ml 802.00 - - 685.14 - 802.00 - 802.00
Alat Suntik Sekali Pakai 3 ml Set 848.00 300 254,400.00 848.00 - 848.00 2.00 1,696.00 848.00
8 Alat Suntik Sekali Pakai 5 ml Set 903.00 100 90,300.00 815.15 - 903.00 2.00 1,806.00 903.00
9 Alat Suntik Sekali Pakai 10 ml Set 1,250.00 100 125,000.00 1,250.00 - 1,250.00 - 1,250.00
10 Alkohol Swab Kotak 116.04 - - 116.04 - 116.04 - 116.04
Alkohol Swab Kotak 126.00 3,000 378,000.00 126.00 - 126.00 100.00 12,600.00 126.00
11 Auto Disposable Syringe (ADS) 0,05 ml Set - - 1,354.00 - - - -
12 Auto Disposable Syringe (ADS) 0,5 ml Set - - 1,185.00 - - - -
13 Auto Disposable Syringe (ADS) 5 ml Set - - 1,583.00 - - - -
14 Blood Set Set - - 10,430.00 - - - -
15 Catgut/Benang Bedah No.2/0 Plain Sachet - - 26,666.67 - - - -
16 Catgut/Benang Bedah No.3/0 Cromic Sachet - - 34,170.00 - - - -
17 Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 3,150.00 - - 3,150.00 - 3,150.00 - 3,150.00
18 Etanol 70 % 1.000 ml Botol 26,250.00 - - 26,250.00 - 26,250.00 - 26,250.00
19 Eter Alkohol Botol - - - - - -
20 Folley Catheter no 14 Set 18,450.00 - - - 18,450.00 - 18,450.00
21 Folley Catheter no 16 Set 18,450.00 - - 18,450.00 - 18,450.00 - 18,450.00
22 Folley Catheter no 18 Set 18,450.00 - - 18,450.00 - 18,450.00 - 18,450.00
23 Infus set Anak Set - - 6,457.50 - - - -
24 Infus set Dewasa Set 9,070.00 20 181,400.00 5,445.00 - 9,070.00 - 9,070.00
25 Iodina Test Botol - - - - - -
26 Kaca Slide Pcs - - - - - -
27 Kapas Berlemak 500 gram Bungkus - - - - - -
28 Kapas Pembalut / Adsorbens 250 gram Bungkus 24,000.00 1 24,000.00 20,600.00 - 24,000.00 - 24,000.00
29 Kassa Pembalut 2 m x 80 cm Rol - - 9,400.00 - - - -
30 Kassa Pembalut Hidrofil 4 m x 3 cm Rol - - 805.00 - - - -
31 Kassa Pembalut Hidrofil 4 m x 15 cm Rol 3,800.00 1 3,800.00 3,800.00 - 3,800.00 - 3,800.00

Kassa Pembalut Hidrofil 4 m x 15 cm Rol 3,800.00 164 623,200.00 - 3,800.00 - 3,800.00
32 Kassa Hidrofil Steril 16 x 16 Kotak 8,240.00 50 412,000.00 8,240.00 - 8,240.00 9.00 74,160.00 8,240.00
33 Kassa Kompres 40 x 40 steril Bungkus - - 1,320.00 - - - -
34 Kertas Puyer Pcs - - - - - -
35 Kertas Saring Lembar - - - - - -
36 Kertas Lensa Lembar - - - - - -
37 Lysol 1,000 ml Botol 43,050.00 - - 43,050.00 - 43,050.00 - 43,050.00
38 Masker Buah 982.40 3,150 3,094,560.00 982.40 - 982.40 - 982.40
Masker Buah 339.90 - - - 339.90 - 339.90
39 Masker N 95 Pcs 9,517.20 40 380,688.00 9,517.20 - 9,517.20 - 9,517.20
40 Minyak Imersi Botol - - - - - -
41 Plester Kertas Rol 15,333.33 3 45,999.99 15,333.33 - 15,333.33 - 15,333.33
42 Polifix Rol 39,217.00 - - 51,305.00 - 39,217.00 - 39,217.00
43 Pot Dahak Pcs - - - - - -
44 Rapid 2 HIV Fokus Test - - - - - -
45 Rapid HIV 1 (SD HIV) Test - - - - - -
46 Rapid HIV 2 (Intec HIV) Test - - - - - -
47 Rapid HIV 2 (Biomeriux HIV) Test - - - - - -
48 Rapid Tes SD Bioline HBSAG Test - - - - - -
49 Rapid Test Syphilis Test - - - - - -
50 Reagen CD 4 Control Test - - - - - -
51 Reagen CD 4 Test - - - - - -
52 Reagen Ziehl Nielsen Botol - - - - - -
53 RPR Test Syphilis Test - - - - - -
54 Silk( Benang Bedah Sutra ) No 3/0 Sachet 20,150.00 - - 20,610.00 - 20,150.00 - 20,150.00
55 Safety Box Pcs - - 16,186.80 - - - -
56 Sarung tangan Steril No 6 Pcs - - 6,595.00 - - - -
57 Sarung tangan Steril No 7 Pcs 6,595.00 100 659,500.00 6,595.00 - 6,595.00 - 6,595.00
Sarung tangan Steril No 7 Pcs 8,635.00 100 863,500.00 8,635.00 - 8,635.00 - 8,635.00
58 Sarung tangan Steril No 7,5 Pcs 4,500.00 - - 6,595.00 - 4,500.00 - 4,500.00
Sarung tangan Steril No 7,5 Pcs 8,635.00 92 794,420.00 8,635.00 - 8,635.00 - 8,635.00
59 Sarung tangan Non Steril S Pcs - - 600.49 - - - -
60 Sarung tangan Non Steril M Pcs 711.52 2,500 1,778,800.00 711.52 - 711.52 - 711.52
Sarung tangan Non Steril M Pcs 590.00 - - - 590.00 - 590.00

Sarung tangan Non Steril M Pcs 600.49 - - - 600.49 - 600.49
61 Sarung tangan Non Steril L Pcs 590.00 - - 600.49 - 590.00 - 590.00
Sarung tangan Non Steril L Pcs 600.49 - - - 600.49 - 600.49
62 Sountimer Buah - - - - - -
63 Stik Pemeriksaan Gula Darah Test 6,106.58 600 3,663,948.00 6,106.58 - 6,106.58 - 6,106.58
Stik Pemeriksaan Gula Darah Test 6,106.58 - - - 6,106.58 - 6,106.58
64 Stik Pemeriksaan Kolesterol Test 25,000.00 250 6,250,000.00 25,000.00 - 25,000.00 - 25,000.00
Stik Pemeriksaan Kolesterol Test 25,163.30 - - 25,163.30 - 25,163.30 - 25,163.30
65 Stik Pemeriksaan Asam Urat Test 5,095.48 - - 5,086.15 - 5,095.48 - 5,095.48
Stik Pemeriksaan Asam Urat Test 6,000.00 50 300,000.00 6,000.00 - 6,000.00 - 6,000.00
66 Supratul Lembar 10,400.00 - - 10,400.00 - 10,400.00 - 10,400.00
67 Urine Bag set 3,090.00 50 154,500.00 8,070.00 - 3,090.00 - 3,090.00
68 Wing Neddle No 23 Set - - - - - -
69 Blood Lancet Pcs 150.00 500 75,000.00 150.03 - 150.00 - 150.00
70 Cairan Antiseptik Botol 500 ml Botol 78,200.00 4 312,800.00 78,200.00 - 78,200.00 - 78,200.00
Cairan Antiseptik Botol 500 ml Botol 68,200.00 5 341,000.00 68,200.00 - 68,200.00 - 68,200.00
71 Bisturi Pcs - - 12,681.82 - - - -
72 Cairan Antiseptik Botol 5 Liter Botol 580,000 - - 580,000.00 - 580,000.00 - 580,000.00
73 Cairan Desinfektan 5 Liter Botol 396,000 - - 396,000.00 - 396,000.00 - 396,000.00
74 Cairan Detergen 5 Liter Botol - - 712,800.00 - - - -
75 Gel USG Botol 14,554.00 2 29,108.00 14,554.00 - 14,554.00 - 14,554.00
76 IV Dressing Pcs - - 220,000.00 - - - -
77 Mucus Extractor Pcs 5,432.00 1 5,432.00 5,432.00 - 5,432.00 - 5,432.00
78 Nasal Oxygen Anak Pcs - - 6,160.00 - - - -
79 Nasal Oxygen Bayi Pcs - - 5,665.00 - - - -
80 Nasal Oxygen Dewasa Pcs - - 6,160.00 - - - -
81 Plester Bulat Non Woven Pcs - - 317.24 - - - -
82 Plester Transparan Pcs 1,629.00 - - 1,677.87 - 1,629.00 - 1,629.00
83 PP test Pcs - - 1,997.17 - - - -
84 Sarung tangan Steril No 6,5 Pcs - - 6,595.00 - - - -
85 Sarung Tangan Obgyn Steril Pcs - - 19,940.80 - - - -
86 Stik Pemeriksaan Hb Pcs 8,033.64 500 4,016,820.00 8,033.64 - 8,033.64 - 8,033.64
Stik Pemeriksaan Hb Pcs 8,058.82 - - 8,058.82 - 8,058.82 - 8,058.82
87 Umbilical Cord Klem Steril Nylon Pcs - - 2,678.00 - - - -

88 Underpad 60x90 cm Non Steril Pcs - - 42,872.71 - - - -
89 Combur Test Pcs 1,352 - - 1,352.00 - 1,352.00 - 1,352.00
90 - - - - - -
- - - - - -
C. SERUM DAN VAKSIN - - - - - -
1 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (ABU I ) Vial 517,132 - - 517,132.00 - 517,132.00 - 517,132.00
2 Serum Anti Rabies untuk manusia Vial - - - - - -
3 Serum Anti Tetanus (ATS) Injeksi 1.500 IU/ampul Ampul - - - - - -
4 Serum Anti Tetanus (ATS) Injeksi 20.000 IU/ampul Vial - - - - - -
5 Human Tetanus Imunoglobin inj 250 IU Vial 146,800 - - 146,800.00 - 146,800.00 - 146,800.00
6 Vaksin BCG Ampul - - - - - -
7 Vaksin Campak 10 Dosis Vial - - - - - -
8 Vaksin DT Vial - - - - - -
9 Vaksin TD Vial - - - - - -
10 Vaksin DTP-HB Vial - - - - - -
11 Vaksin DPT-HB/Hib Vial - - - - - -
12 Vaksin HB Uniject Pcs - - - - - -
13 Vaksin MR (VVM.A) Vial - - - - - -
14 Vaksin Polio Vial - - - - - -
15 Vaksin Polio IPV 5 Dosis Vial - - - - - -
16 Vaksin Polio 10 IPV Dosis Vial - - - - - -
17 Vaksin TT Vial - - - - - -
18 - - - - - -
19 - - - - - -
20 - - - - - -
-
JUMLAH TOTAL OBAT 63,471,143.04 - 1,602,655.54
JUMLAH TOTAL BMHP 26,556,737.89 - 90,262.00
JUMLAH TOTAL VAKSIN SERUM - - -
JUMLAH TOTAL KESELURUHAN 90,027,880.93 - 1,692,917.54
BMHP SUMBER ANGGARAN JKN
EKARWANGI
PATEN KUNINGAN
L TAHUN 2022
SALDO AKHIR APRIL 2022

KONTROL
JKN
BANYAKNYA NILAI RP. STOK TOTAL HARGA
- - - -
- - - -
- - - -
4,280.00 449,400.73 - -
2,000.00 400,000.00 - -
- - - -
3,150.00 970,200.00 - -
149.00 409,750.00 - -
- -
30.00 81,120.00 - -
- - - -
- -
- - - -
5,730.00 303,690.00 - 28,620
- -
6,930.00 485,127.72 - 43,402
- -
2,640.00 987,360.00 - -
- - -
- - - -
- - -
8,840.00 1,776,840.00 -
- - - -
172.00 607,332.00 - -
- - - -
- -
44.00 575,414.40
KONTROL
JKN
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
202.00 339,158.00
990.00 53,460.00 - -
8,410.00 454,140.00
- - - -
16,310.00 2,772,700.00 - -
- - - -
67.00 203,345.00 - -
140.00 455,000.00 - 65,000
- -
104.00 361,608.00 - -
- - -
- - - -
- - - -
- - - -
- - - -
- - - -
21,900.00 4,051,500.00 - 384,800
- -
1,894.00 1,988,700.00 - 54,600
- -
KONTROL
JKN
- - - -
- - - -
3,930.00 220,080.00 - 17,920
- -
9,900.00 415,800.00 - 8,400
2,500.00 624,250.00 - -
480.00 475,200.00 - -
- - - -
- - - -
- - - -
38.00 113,886.00 - -
- - - -
2,210.00 839,800.00 - -
- -
50.00 7,599.90 - -
500.00 72,500.00 -
- -
- - - -
10.00 28,600.00 - -
- - - -
- - - -
- - - -
- -
204.00 273,319.20 - -
- - -
- -
- - - -
- - - -
9,600.00 2,400,000.00 - -
- - - -
- - - -
20.00 18,480.00 - -
4,059.00 540,252.90 - 25,555
- - -
KONTROL
JKN
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
10.00 7,810.00 - -
- - - -
200.00 19,800.00 - -
- -
1,800.00 127,809.00 - -
84.00 192,864.00 - -
- - - -
- - - -
- - - -
- - -
- - - -
440.00 341,000.00 - -
- - - -
- - - -
- - - -
5.00 1,230,000.00 - -
5.00 770,000.00
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
KONTROL
JKN
1,470.00 1,099,560.00 - -
- -
30.00 41,580.00 - -
- - - -
- - - -
1,244.00 340,854.76 - -
- -
- - - -
- - - -
- - - -
- - - -
90.00 257,400.00
- - - -
- - - -
2,540.00 312,420.00 - 63,960
- - - -
- - -
- - - -
15.00 135,300.00 - 721,600
- - - -
- - - -
- - - -
900.00 189,000.00 - -
800.00 37,600.00 - -
3,000.00 153,000.00 - -
- -
500.00 27,000.00 - -
- - - -
- - - -
1,280.00 198,400.00 - -
KONTROL
JKN
- -
260.00 643,500.00 - -
- -
- - - -
- - - -
- - -
60.00 192,000.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
4,420.00 265,200.00 - 69,600
10.00 630.00
- - - -
- - - -
130.00 9,750.00 -
300.00 56,700.00 - -
- - - -
500.00 140,000.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
420.00 130,200.00 - -
- - - -
- - - -
23.00 46,138.00
- - - -
48.00 156,768.00
KONTROL
JKN
127.00 1,397,000.00 - -
150.00 1,155,000.00 - -
- -
- - - -
27,200.00 1,006,400.00 -
460.00 83,260.00 - 14,480
- - - -
- - - -
- - - -
- - - -
- - - -
1,000.00 123,000.00 - -
- - - -
100.00 210,000.00
- - - -
- - - -
- - - -
- - - -
- - - -
100.00 84,700.00
150.00 120,450.00 - -
- -
- - - -
- - - -
KONTROL
JKN
350.00 45,850.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- -
- - - -
1,000.00 985,000.00 - -
420.00 1,386,000.00 - -
720.00 151,200.00 - -
- -
100.00 102,300.00 - -
1,090.00 359,700.00 - 46,200
- -
- - - -
- - - -
- - - -
- - - -
440.00 102,080.00
- - - -
- - - -
- - - -
- - - -
67.00 837,500.00 - -
200.00 2,420,000.00
- - - -
- - - -
1,000.00 114,000.00 - -
440.00 43,560.00 - 19,800
KONTROL
JKN
- - - -
- - - -
1,910.00 399,190.00 -
- -
49.00 563,500.00 - -
- - - -
500.00 412,500.00 - -
- - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
25.00 179,500.00 - -
- -
- - - -
- - - -
- - - -
31.00 82,677.00 - -
- - - -
100.00 112,600.00 - -
9.00 45,837.00 - -
2,760.00 986,700.00 - 128,700
- - -
- - - -
86.00 427,936.00 - -
400.00 464,000.00 - -
KONTROL
JKN
- - - -
2,525.00 230,658.75 - 105,053
10,000.00 1,430,000.00
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
1,400.00 180,180.00 - -
- - -
- - - -
- - - -
- - - -
- - - -
775.00 52,700.00 - -
- - - -
- - - -
- - - -
500.00 192,500.00 - -
- - - -
900.00 76,500.00 - 17,000
- -
- - - -
- - - -
- - - -
- - - -
14.00 100,100.00 - 14,300
830.00 97,691.00 - -
- - - -
KONTROL
JKN
- -
- - - -
155.00 406,255.00 - 26,210
120.00 279,960.00 -
194.00 1,165,164.00 - -
- - - -
- - - -
270.00 386,100.00 - 114,400
- - -
- - - -
- - - -
- - - -
- - - -
- - - -
1,230.00 60,276.15 - 28,423
173.00 361,570.00 - -
- - - -
2,300.00 117,300.00 - -
- - - -
- - - -
460.00 31,280.00 - 27,200
480.00 284,064.00 - -
- - -
500.00 95,000.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
KONTROL
JKN
- - - -
4,400.00 813,120.00 - -
- -
- - - -
- - - -
- - - -
4,870.00 306,810.00 - 16,380
- -
11,660.00 641,300.00 - 70,400
- - - -
2,000.00 416,000.00 - -
- -
50.00 124,450.00 - -
- - - -
- - - -
- - - -
240.00 1,084,776.00
- - - -
- - - -
- - - -
- - - -
4,330.00 532,590.00 - 61,500
4,800.00 2,270,400.00 - 189,200
2,950.00 362,850.00 - -
2,390.00 1,169,905.00 - -
4,000.00 900,000.00
490.00 479,710.00 - 587,400
576.00 1,441,440.00 - -
500.00 498,500.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
KONTROL
JKN
- - - -
- - - -
- - - -
- - - -
2.00 1,611,900.00 - -
100.00 67,925.00 - -
29.00 18,736.90 -
- - - -
298.00 252,704.00
98.00 88,494.00 - 3,612
100.00 125,000.00 - -
- - - -
2,900.00 365,400.00
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
20.00 181,400.00 - -
- - - -
- - - -
- - - -
1.00 24,000.00 - -
- - - -
- - - -
1.00 3,800.00 - -
KONTROL
JKN
164.00 623,200.00 -
41.00 337,840.00 - 148,320
- - - -
- - - -
- - - -
- - - -
- - - -
3,150.00 3,094,560.00 - -
- -
40.00 380,688.00 - -
- - - -
3.00 45,999.99 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
100.00 659,500.00 - -
100.00 863,500.00
- - - -
92.00 794,420.00
- - - -
2,500.00 1,778,800.00 - -
- -
KONTROL
JKN
- -
- - - -
- - -
- - - -
600.00 3,663,948.00 - -
- -
250.00 6,250,000.00 - -
- -
- - - -
50.00 300,000.00
- - - -
50.00 154,500.00 - -
- - - -
500.00 75,000.00 - -
4.00 312,800.00 - -
5.00 341,000.00 -
- - - -
- - - -
- - - -
- - - -
2.00 29,108.00 - -
- - - -
1.00 5,432.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
500.00 4,016,820.00 - -
- -
- - - -
KONTROL
JKN
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- -
61,868,487.50 - 3,205,311
26,466,475.89 - 180,524
- - -
88,334,963.39 - - 3,385,835
DATA MUTASI PERSEDIAAN OBAT DAN BMHP
STOK AWAL APRIL 2022 JUMLAH PENERIMAAN APRIL 2022 PENGELUARAN APRIL 2022
NO NAMA SEDIAAN SATUAN DAK DAK DAK
HARGA SATUAN (RP) BANYAKNYA NILAI RP. HARGA SATUAN (RP) BANYAKNYA NILAI RP. HARGA SATUAN (RP) BANYAKNYA NILAI RP.
A. O B A T
1 Air Raksa Dental Use Botol - - - - - -
2 Albendazole Tablet 400 mg Tablet 430.00 - - 430.00 - 430.00 -
Albendazole Tablet 400 mg Tablet 292.00 - - - 292.00 -
3 Albendazole susp 200 mg/5 ml Botol 4,300.00 - - 4,300.00 - 4,300.00 -
4 Alopurinol Tablet 100 mg Tablet 105.00 - - 105.00 - 105.00 -
5 Alopurinol Tablet 300 mg Tablet - - 99.00 - - -
6 Alprazolam tablet 1 mg Tablet 128.00 90.00 11,520.00 128.00 - 128.00 -
7 Ambroksol Tablet 30 mg Tablet 143.55 - - 143.55 - 143.55 -
Ambroksol Tablet 30 mg Tablet 151.80 - - 151.80 - 151.80 -
8 Ambroksol sirup 15 mg/5 ml Botol 2,500.30 - - 2,500.30 - 2,500.30 -
Ambroksol sirup 15 mg/5 ml Botol 3,619.00 - - 3,619.00 - 3,619.00 -
9 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 3,822.00 - - 2,998.00 - 3,822.00 -
10 Aminofillin Tablet 200 mg Tablet 95.00 300.00 28,500.00 95.00 - 95.00 100.00 9,500.00
Aminofillin Tablet 200 mg Tablet 91.00 - - - 91.00 -
11 Amitriptillin Hcl Tablet Salut 25 mg Tablet 143.00 - - 167.00 - 143.00 -
Amitriptillin Hcl Tablet Salut 25 mg Tablet 171.44 - - - 171.44 -
12 Amlodipin Tablet 5 mg Tablet 75.00 - - 75.00 - 75.00 -
Amlodipin Tablet 5 mg Tablet 53.00 180.00 9,540.00 53.00 300.00 15,900.00 53.00 -
13 Amlodipin Tablet 10 mg Tablet 99.00 - - 99.00 - 99.00 -
Amlodipin Tablet 10 mg Tablet 104.00 - - - 104.00 -
14 Amoksisillin Kapsul 250 mg Kapsul 196.00 - - 196.00 - 196.00 -
Amoksisillin Kapsul 250 mg Kapsul 195.00 - - - 195.00 -
15 Amoksisillin Kaplet 500 mg Kaplet 249.00 6,000.00 1,494,000.00 249.00 - 249.00 -
Amoksisillin Kaplet 500 mg Kaplet 190.00 - - 190.00 - 190.00 -
16 Amoksisillin Serbuk Injeksi 1000 mg vial - - 8,100.00 - - -
17 Amoksisillin Sirup Kering 125 mg/5ml Botol 3,500.00 100.00 350,000.00 3,500.00 - 3,500.00 -
18 Amoksisillin Double Strengh Sirup Kering 250 mg/ Botol 3,628.00 - - 3,628.00 - 3,628.00 -
Amoksisillin Double Strengh Sirup Kering 250 mg/ Botol 3,473.00 - - - 3,473.00 -
19 Ampisilin Kapsul 250 mg Kapsul - - - - - -
20 Ampisillin Kaplet 500 mg Tablet - - - - - -
21 Ampisilin Sirup 125 mg / 5 ml Botol - - - - - -
22 Ampisillin Injeksi 1000 mg Vial 8,237.00 70.00 576,590.00 8,237.00 - 8,237.00 -
23 Analgetik Plus Tablet - - - - - -
24 Antasida Doen Suspensi Kombinasi : Magnesium Botol 1,679.00 6.00 10,074.00 1,679.00 - 1,679.00 6.00 10,074.00
Antasida Doen Suspensi Kombinasi : Magnesium Botol 2,129.00 - - 2,129.00 - 2,129.00 -
25 Antasida Doen Tablet, Kombinasi : Magnesium Tablet 58.00 2,420.00 140,360.00 58.00 - 58.00 1,300.00 75,400.00
Antasida Doen Tablet, Kombinasi : Magnesium Tablet 58.00 - - - 58.00 -
26 Antasida Plus Tablet Tablet 189.05 - - 189.05 - 189.05 -
27 Antalgin (Metampiron) Tablet 500 mg Tablet - - 203.30 - - -
Antalgin (Metampiron) Tablet 500 mg Tablet 170.00 500.00 85,000.00 - 170.00 -
28 Antalgin Injeksi 250 mg/ml-2ml Ampul - - 1,455.00 - - -
29 Anti Bakteri DOEN Salep Kombinasi : Tube 2,924.00 - - 3,035.00 - 2,924.00 -
30 Anti Hemoroid Doen komb Supp 3,167.00 40.00 126,680.00 3,167.00 - 3,167.00 -
31 Anti Fungi DOEN Kombinasi : Pot 4,798.00 25.00 119,950.00 4,798.00 - 4,798.00 -
Anti Fungi DOEN Kombinasi : Pot 4,158.00 - - - 4,158.00 -
32 Antimigren DOEN Kombinasi : Tablet 173.00 100.00 17,300.00 173.00 - 173.00 -
Antimigren DOEN Kombinasi : Tablet 167.00 - - - 167.00 -
33 Anti Diare Suspensi Botol - - - - - -
34 Anti Diare Tablet Tablet 233.20 - - 233.20 - 233.20 -
Anti Diare Tablet Tablet 253.00 500.00 126,500.00 253.00 - 253.00 -
35 Anti Dotum Oral Tablet Tablet 253.00 - - 253.00 - 253.00 -
36 Anti Hipertensi Kapsul Tablet 2,112.00 - - - - 2,112.00 -
37 Antihistamin Tablet kombinasi Tablet 208.00 - - 208.00 - 208.00 -
38 Antispasmodik Tablet Tablet 1,195.10 - - - - 1,195.10 -
39 Antitusiva Sirup Botol 11,550.00 - - 11,550.00 - 11,550.00 -
40 Antitusiva Tablet Tablet - - - - - -
41 Asam Folat Tablet 1 mg Tablet 75.00 - - 75.00 - 75.00 -
42 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 105.00 114.00 11,970.00 105.00 1,000.00 105,000.00 105.00 671.00 70,455.00
Asam Askorbat (Vit. C) Tablet 500 mg Tablet 225.00 2,000.00 450,000.00 225.00 - 225.00 -
43 Asam Mefenamat Kapsul 500 mg Kapsul 111.00 - - 111.00 500.00 55,500.00 111.00 500.00 55,500.00
Asam Mefenamat Kapsul 500 mg Kapsul 177.90 870.00 154,773.00 177.90 - 177.90 150.00 26,685.00
44 Acetylsistein tablet Tablet 382.00 390.00 148,980.00 382.00 - 382.00 130.00 49,660.00
45 Asetosal Tablet 80 mg Tablet 105.00 - - 105.00 - 105.00 -
Asetosal Tablet 80 mg Tablet 114.00 - - - 114.00 -
48 Asiklovir Krim 5 % Tube 3,619.00 25.00 90,475.00 - 3,619.00 -
3,619.00
Asiklovir Krim 5 % Tube 3,600.00 - - - 3,600.00 -
49 Asiklovir Tablet 200 mg Tablet 237.00 - - 249.00 - 237.00 -
50 Asiklovir Tablet 400 mg Tablet 405.00 300.00 121,500.00 405.00 - 405.00 -
Asiklovir Tablet 400 mg Tablet 380.00 - - 380.00 - 380.00 -
51 Attapulgit Tablet 162.00 500.00 81,000.00 162.00 - 162.00 -
52 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 1,639.00 10.00 16,390.00 1,639.00 - 1,639.00 -
53 Aqua Pro Injeksi Steril, bebas Pirogen 20 ml Vial 2,860.00 39.00 111,540.00 2,860.00 - 2,860.00 -
54 Bahan Tambal Sementara Set 130,000.00 - - 150,000.00 - 130,000.00 -
55 Benzatin Benzil Penisilin injeksi Vial 14,500.00 20.00 290,000.00 14,500.00 - 14,500.00 -
56 Betahistin Mesilat 6 mg Tablet 110.00 - - 110.00 - 110.00 -
Betahistin Mesilat 6 mg Tablet 660.00 - - - 660.00 -
57 Betametason Krim 0,1 %- 5g Tube 1,430.00 - - 1,430.00 - 1,430.00 -
Betametason Krim 0,1 %- 5g Tube 1,380.00 - - - 1,380.00 -
58 Bisakodil suppositoria 10 mg Supp - - - - - -
59 Bisoprolol Tablet 5 mg Tablet 319.00 - - 319.00 - 319.00 -
60 Bromheksin 8 mg Tablet 250.80 630.00 158,004.00 - - 250.80 -
61 Cresotin Pasta Botol 112,000.00 - - 112,000.00 - 112,000.00 -
62 Cresotin Liquid No 2 Botol 160,500.00 - - 160,500.00 - 160,500.00 -
63 Deksametason Injeksi 5mg/ml-1ml Ampul 1,097.00 20.00 21,940.00 1,097.00 - 1,097.00 -
64 Deksametason Tablet 0,5 mg Tablet 61.60 600.00 36,960.00 61.60 - 61.60 200.00 12,320.00
Deksametason Tablet 0,5 mg Tablet 44.00 - - - 44.00 -
Deksametason Tablet 0,5 mg Tablet 41.00 - - - 41.00 -
65 Devitalisasi Pasta (Non Arsen) Botol 220,000.00 - - - - 220,000.00 -
66 Diazepam tablet 2 mg Tablet 86.00 107.00 9,202.00 86.00 - 86.00 -
67 Diazepam tablet 5 mg Tablet 114.00 700.00 79,800.00 114.00 - 114.00 -
68 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul 1,735.00 19.00 32,965.00 1,735.00 - 1,735.00 -
69 Diazepam Larutan Rektal 5 mg/ml Supp 12,090.00 - - 12,573.00 - 12,090.00 -
Diazepam Larutan Rektal 5 mg/ml Supp 12,573.00 8.00 100,584.00 12,573.00 - 12,573.00 -
70 Diazepam Larutan Rektal 10 mg/ml Supp 16,742.00 - - - - 16,742.00 -
71 Dietilkarbamazin Sitrat Tablet 100 mg Tablet 156.00 - - 156.00 - 156.00 -
72 Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul 1,095.00 10.00 10,950.00 1,095.00 - 1,095.00 -
73 Digoksin Tablet 0,25 mg Tablet 104.00 - - 104.00 - 104.00 -
74 Dimenhidrinat Tablet 50 mg Tablet 99.00 193.00 19,107.00 99.00 - 99.00 -
Dimenhidrinat Tablet 50 mg Tablet 104.00 - - - 104.00 -
Dimenhidrinat Tablet 50 mg Tablet 141.90 - - - 141.90 -
75 Domperidon Tablet 10 mg Tablet 71.00 - - 71.00 - 71.00 -
Domperidon Tablet 10 mg Tablet 95.00 - - - 95.00 -
76 Donperidon Suspensi 5 mg/5ml Botol 2,700.00 - - 2,700.00 - 2,700.00 -
77 Efedrin Hcl Tablet 25 mg Tablet - - - - - -
78 Ekstrak Belladone Tablet 10 mg Tablet - - - - - -
79 Epinefrin HCl / Bitartrat Ampul 1,515.00 - - 1,515.00 - 1,515.00 -
Epinefrin HCl / Bitartrat Ampul 1,408.00 10.00 14,080.00 1,408.00 - 1,408.00 -
80 Eritromisin Kapsul 250 mg Kapsul - - - - - -
81 Eritromisin Kapsul 500 mg Kapsul 730.00 - - 750.00 - 730.00 -
82 Eritromisin Sirup 200 mg / 5 ml Botol - - - - - -
83 Etambutol Tablet 500 mg Tablet - - 505.00 - - -
84 Etanol 70 % 100 ml Botol - - - - - -
Etanol 70 % 100 ml Botol 2,500.00 - - - 2,500.00 -
85 Etil Klorida Semprot -100 ml Botol 108,720.93 2.00 217,441.86 108,720.93 - 108,720.93 -
86 Eugenol Cairan -10 ml Botol 20,087.00 - - 20,087.00 - 20,087.00 -
87 Fenitoin Natrium Kapsul 100 mg Kapsul 158.00 - - 158.00 - 158.00 -
Fenitoin Natrium Kapsul 100 mg Kapsul 154.00 - - - 154.00 -
88 Fenobarbital tablet 30 mg Tablet 1,540.00 - - 171.00 - 1,540.00 -
89 Fenobarbital injeksi 50 mg / ml Ampul 1,969.00 - - 1,857.00 - 1,969.00 -
90 Fenoksimeti Penisilin 250 mg tablet Tablet - - - - - -
91 Fenoksimeti Penisilin 500 mg tablet Tablet 605.00 - - - - 605.00 -
92 Fenol Gliserol TK Botol 2,764.00 - - 2,764.00 - 2,764.00 -
93 Flufenazine decanoat injeksi 25 mg/ml Ampul - - - - - -
94 Flukonazole tablet 150 mg Tablet - - - - - -
95 Fitomenadion tablet 10 mg Tablet 748.00 - - 748.00 - 748.00 -
96 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 3,682.00 90.00 331,380.00 3,682.00 - 3,682.00 -
Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 3,550.00 - - - 3,550.00 -
97 Furosemid Tablet 40 mg Tablet 82.00 - - 82.00 - 82.00 -
98 Furosemid injeksi Ampul - - - - - -
99 Garam Oralit I serbuk, kombinasi : Kantong 257.00 3,200.00 822,400.00 257.00 - 257.00 -
Garam Oralit I serbuk, kombinasi : Kantong 260.00 - - - 260.00 -
100 Gemfibrozil Tablet 600 mg Tablet - - - - - -
101 Gentian Violet Botol - - - - - -
102 Gentamisin injeksi 80 mg / 2 ml Vial - - 1,834.80 - - -
103 Gentamisin Salep Kulit 0,1 % Tube 1,834.80 - - - - 1,834.80 -
Gentamisin Salep Kulit 0,1 % Tube 1,834.80 - - 1,834.80 - 1,834.80 -
Gentamisin Salep Kulit 0,1 % Tube 5,390.00 25.00 134,750.00 5,390.00 - 5,390.00 -
104 Glass Ionomer Set 680,000.00 - - 687,500.00 - 680,000.00 -
105 Glibenklamid Tablet 5 mg Tablet 119.00 - - 119.00 - 119.00 -
Glibenklamid Tablet 5 mg Tablet 83.00 60.00 4,980.00 83.00 - 83.00 -
106 Glimepiride 2 mg Tablet 207.00 - - 207.00 - 207.00 -
107 Gliseril Guayakolat Tablet 100 mg Tablet 82.50 5,000.00 412,500.00 82.50 - 82.50 -
Gliseril Guayakolat Tablet 100 mg Tablet 120.00 1,100.00 132,000.00 120.00 - 120.00 416.00 49,920.00
108 Gliseril Guayakolat sirup Botol 7,370.00 - - 7,370.00 - 7,370.00 -
Gliseril Guayakolat sirup Botol 8,800.00 - - 8,800.00 - 8,800.00 -
109 Glukonas Kalsikus injeksi Ampul - - 10,351.00 - - -
110 Glukosa Larutan Infus 5 % Botol 6,900.00 - - 6,900.00 - 6,900.00 -
111 Glukosa Larutan Infus10 % Botol 5,700.00 - - 7,500.00 - 5,700.00 -
Glukosa Larutan Infus10 % Botol 7,500.00 - - - 7,500.00 -
112 Griseofulvin Tablet 125 mg,micronized Tablet 1,773.00 460.00 815,580.00 1,773.00 - 1,773.00 -
Griseofulvin Tablet 125 mg,micronized Tablet 224.00 - - 224.00 - 224.00 -
113 Haloperidol Tablet 0,5 mg Tablet 47.00 500.00 23,500.00 47.00 - 47.00 -
Haloperidol Tablet 0,5 mg Tablet 55.00 - - 55.00 - 55.00 -
114 Haloperidol Tablet 1,5 mg Tablet 51.00 8,370.00 426,870.00 51.00 - 51.00 30.00 1,530.00
115 Haloperidol Tablet 5 mg Tablet 54.00 700.00 37,800.00 54.00 - 54.00 -
Haloperidol Tablet 5 mg Tablet 75.00 - - - 75.00 -
116 Haloperidol injeksi 5 mg/ml Ampul 1,190.00 50.00 59,500.00 1,190.00 - 1,190.00 -
117 Haloperidol injeksi 50 mg/ml Ampul 97,500.00 - - 101,300.00 - 97,500.00 -
118 Hidroklortiazid (HCT) Tablet 25 mg Tablet - - - - - -
Hidroklortiazid (HCT) Tablet 25 mg Tablet 149.00 - - - 149.00 -
119 Hidrokortison Krim 2,5 % Tube 2,475.00 24.00 59,400.00 2,475.00 - 2,475.00 24.00 59,400.00
120 Ibuprofen Tablet 200 mg Tablet 105.00 - - 105.00 - 105.00 -
Ibuprofen Tablet 200 mg Tablet 102.00 - - - 102.00 -

121 Ibuprofen Tablet 400 mg Tablet 30.28 - - 30.28 - 30.28 -
Ibuprofen Tablet 400 mg Tablet 111.00 - - - 111.00 -
122 Ibuprofen Suspensi 100 mg/5 ml Botol 2,236.00 50.00 111,800.00 2,236.00 - 2,236.00 -
Ibuprofen Suspensi 100 mg/5 ml Botol 4,665.00 - - 4,665.00 - 4,665.00 -
123 Ichtyol salep Kulit Pot - - - - - -
124 Isoniazid tablet 100 mg Tablet 145.00 - - 145.00 - 145.00 -
125 Isoniazid tablet 300 mg Tablet 170.00 135.00 22,950.00 173.00 - 170.00 -
126 Isosorbid Dinitrat 5 mg Tablet 88.00 - - - - 88.00 -
127 Kalium Diklofenak Tablet 25 mg Tablet - - - - -
128 Kalium Diklofenak Tablet 50 mg Tablet 682.00 - - 287.85 - 682.00 -
129 Kalsium Hidroksida Pasta Tube - - - - - -
130 Kalsium Laktat Tablet 500 mg Tablet 59.00 - - 59.00 - 59.00 -
Kalsium Laktat Tablet 500 mg Tablet 63.00 1,210.00 76,230.00 63.00 - 63.00 450.00 28,350.00
131 Kaptopril 12,5 mg Tablet 62.00 525.00 32,550.00 62.00 - 62.00 -
132 Kaptopril 25 mg Tablet 75.00 100 7,500.00 75.00 - 75.00 -
Kaptopril 25 mg Tablet 94.00 - - 94.00 - 94.00 -
133 Karbamazepin Tablet 200 mg Tablet 245.00 80.00 19,600.00 245.00 - 245.00 -
Karbamazepin Tablet 200 mg Tablet 270.00 - - - 270.00 -
134 Ketokonazole Krim 2 % - 15 gr Tube 2,518.00 22.00 55,396.00 2,518.00 - 2,518.00 -
135 Ketokonazole Tablet 200 mg Tablet 252.00 100.00 25,200.00 252.00 - 252.00 -
Ketokonazole Tablet 200 mg Tablet 528.00 - - - 528.00 -
136 Ketoprofen Tablet 100 mg Tablet - - - - - -
137 Ketoprofen Injeksi 100 mg / 1 ml Ampul - - - - - -
138 Ketorolac 10 mg injeksi Ampul - - - - - -
139 Ketorolac 30 mg injeksi Ampul - - 1,045.00 - - -
140 Klindamisin Kapsul 150 mg Kapsul 759.00 - - 759.00 - 759.00 -
141 Klindamisin Kapsul 300 mg Kapsul 522.00 100.00 52,200.00 522.00 - 522.00 -
142 Kloramfenikol Kapsul 250 mg Kapsul 266.00 - - - - 266.00 -
143 Kloramfenikol suspensi125mg/5 ml Botol - - - - - -
144 Kloramfenikol Salep Mata 1%-3,5 g Tube 1,881.00 21.00 39,501.00 1,881.00 - 1,881.00 -
Kloramfenikol Salep Mata 1%-3,5 g Tube 1,810.00 - - - 1,810.00 -
145 Kloramfenikol Salep Kulit 2% Tube 3,008.00 - - - - 3,008.00 -
Kloramfenikol Salep Kulit 2% Tube 3,242.00 24.00 77,808.00 3,242.00 - 3,242.00 -
146 Kloramfenikol Tetes Mata -5 ml Botol 7,260.00 - - 7,260.00 - 7,260.00 -
Kloramfenikol Tetes Mata -5 ml Botol 3,250.00 - - - 3,250.00 -
147 Kloramfenikol Tetes Telinga 3%-5 ml Botol 7,370.00 28.00 206,360.00 7,370.00 - 7,370.00 -
148 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 40.17 3,900.00 156,663.00 40.17 - 40.17 100.00 4,017.00
Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 23.00 - - 23.00 - 23.00 -
149 Klorpromazin Hcl Tablet Salut 25 mg Tablet 212.00 - - 212.00 - 212.00 -
Klorpromazin Hcl Tablet Salut 25 mg Tablet 148.00 - - - 148.00 -
150 Klorpromazin Hcl Tablet Salut 100 mg Tablet 147.00 - - 147.00 - 147.00 -
Klorpromazin Hcl Tablet Salut 100 mg Tablet 144.00 - - - 144.00 -
151 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 1,510.00 - - 1,510.00 - 1,510.00 -
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 1,240.00 - - - 1,240.00 -
152 Kombinasi Ipatropium Bromide + Salbutamol Vial 4,550.00 - - 4,550.00 - 4,550.00 -
153 Kombipak Cefixime+ Azithromisin Kotak 30,030.00 - - 30,030.00 - 30,030.00 -
154 Kotrimoksazol Pedriatik Tablet, Kombinasi :
Sulfametoksazol 100 mg + Trimetroprim 20 Tablet
mg 76.00 - - - - 76.00 -
155 Kotrimoksazol Tablet, Kombinasi : Tablet 125.00 900.00 112,500.00 125.00 - 125.00 -
156 Kotrimoksazol Suspensi Kombinasi : Botol 2,052.00 32.00 65,664.00 2,052.00 - 2,052.00 -
Kotrimoksazol Suspensi Kombinasi : Botol 2,140.00 - - - 2,140.00 -
157 Lansoprazole 30 mg Kapsul Tablet 315.00 - - 303.00 - 315.00 -
Lansoprazole 30 mg Kapsul Tablet 323.00 - - 323.00 - 323.00 -
158 Larutan mengadung Elektrolit Botol 9,275.00 - - 9,646.00 - 9,275.00 -
159 Larutan mengadung Elektrolit Botol - - 9,644.00 - - -
160 Larutan mengadung Karbohidrat + Elektrolit Botol - - 10,696.00 - - -
161 Lidokain injeksi 2 % Ampul 1,221.00 13.00 15,873.00 1,221.00 - 1,221.00 -
Lidokain injeksi 2 % Ampul 847.00 - - 847.00 10.00 8,470.00 847.00 -
Lidokain Hcl 2% +Epinefrin 1 : 80.000- Ampul
2 ml 1,845.00 - - - - 1,845.00 -
Lidokain Komp Injeksi, Kombinasi :
Lidokain Hcl 2% +Epinefrin 1 : 80.000- Ampul
2 ml 803.00 - - 803.00 30.00 24,090.00 803.00 -
163 Lidokain Spray Botol 177,216.00 - - - - 177,216.00 -
164 Loperamid Tablet 2 mg Tablet 80.30 - - 80.30 - 80.30 -
165 Loratadin tablet 10 mg Tablet 131.00 100.00 13,100.00 131.00 - 131.00 -
166 Magnesium Sulfat (IV) 20 %-25 ml Ampul 3,328.00 - - 3,328.00 - 3,328.00 -
167 Magnesium Sulfat (IV) 40 %-25 ml Ampul 3,796.00 - - 3,796.00 - 3,796.00 -
168 MB Anak Blister - - 20,554.00 - - -
169 MB Dewasa Blister 39,880.00 - - 39,880.00 - 39,880.00 -
170 Meloksikam tablet 15 mg Tablet 718.20 - - 718.20 - 718.20 -
171 Meloksikam Suppositoria Supp - - - - - -
172 Metformin Hcl Tablet 500 mg Tablet 77.00 110.00 8,470.00 77.00 - 77.00 110.00 8,470.00
173 Metformin 850 mg Tablet 160.00 - - 160.00 - 160.00 -
174 Metildopa 250 mg tablet Tablet 946.00 - - 946.00 - 946.00 - -
175 Methisoprinol 500 mg Tablet 3,300.00 - - 3,300.00 - 3,300.00 -
176 Metilergometrin Maleat (Metergin) Tablet 0,125 Tablet 154.00 - - 210.00 - 154.00 -
Metilergometrin Maleat (Metergin) Tablet 0,125 Tablet 444.00 - - - 444.00 -
177 Metilergometrin Maleat Injeksi 0,200 mg-1ml Ampul 2,959.00 10.00 29,590.00 2,959.00 - 2,959.00 -
Metilergometrin Maleat Injeksi 0,200 mg-1ml Ampul 1,023.00 106.00 108,438.00 1,023.00 - 1,023.00 -
178 Metilprednisolon tablet 4 mg Tablet 102.00 200.00 20,400.00 102.00 - 102.00 -
Metilprednisolon tablet 4 mg Tablet 150.00 - - - 150.00 -
179 Metoklopramid 10 mg Tablet 85.00 560.00 47,600.00 85.00 - 85.00 -
180 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul - - 4,400.00 - - -
181 Metronidazol Tablet 250 mg Tablet - - - - - -
182 Metronidazole Tablet 500 mg Tablet 211.20 100.00 21,120.00 211.20 - 211.20 -
183 Metronidazole sirup 125 mg/ml Botol - - - - - -
184 Metronidazole Infus 500 mg /100 ml Ampul - - 8,110.00 - - -
185 Mikonazole KrIm 2 % - 10 gr Tube 3,414.00 26.00 88,764.00 3,414.00 - 3,414.00 -
186 Multivitamin + Mineral tablet Tablet 826.10 - - 826.10 - 826.10 -
Multivitamin + Mineral tablet Tablet 792.00 - - 792.00 - 792.00 -
187 Multivitamin sirup Botol 7,100.00 - - 7,100.00 - 7,100.00 -
188 Mummifying Pasta Botol - - - - - -
189 Natrium Bikarbonat Tablet 500 mg Tablet 50.00 - - 50.00 - 50.00 -
Natrium Bikarbonat Tablet 500 mg Tablet 50.00 - - - 50.00 -
190 Natrum Diklofenak Tablet 25 mg Tablet 145.00 - - - 145.00 -
Natrum Diklofenak Tablet 25 mg Tablet 128.00 - - 128.00 - 128.00 -
191 Natrium Diklofenak Tablet 50 mg Tablet 115.00 - - 115.00 - 115.00 -
Natrium Diklofenak Tablet 50 mg Tablet 200.00 - - - 200.00 -
192 Natrium Klorida Larutan infus 0,9%-Steril 500 ml Botol 6,410.00 - - 6,410.00 - 6,410.00 -
Natrium Klorida Larutan infus 0,9%-Steril 500 ml Botol 6,840.00 30.00 205,200.00 6,840.00 - 6,840.00 -
193 Nipedifin Tablet 10 mg Tablet 193.60 - - 193.60 - 193.60 -
194 Nistatin suspensi 100.000 IU/ml Botol 11,500.00 1.00 11,500.00 11,500.00 - 11,500.00 -
195 Nistatin 100.000 IU/gram Tablet Vagina Tablet 598.00 42.00 25,116.00 598.00 - 598.00 -
Nistatin 100.000 IU/gram Tablet Vagina Tablet 550.00 100 55,000.00 550.00 - 550.00 -
196 Nistatin 500.000 IU/gram Tablet Salut Tablet 843.00 130.00 109,590.00 843.00 - 843.00 -
197 Obat Antitiuberkolosis Kategori Anak Paket - - 232,518.00 - - -
198 Obat Antitiuberkolosis Kategori 1 Dewasa Paket 317,018.00 - - 317,018.00 - 317,018.00 -
201 Obat Anti Tuberkulosis FDC Kat Anak Paket 248,120.00 - - 248,120.00 - 248,120.00 -
202 Obat Anti Tuberkulosis FDC Kat I & II Paket 1,297,889.00 - - 1,297,889.00 - 1,297,889.00 -
203 Obat Anti Tuberkulosis FDC Kat I & III Paket 415,469.00 - - 415,469.00 - 415,469.00 -
204 Obat Anti Tuberkolosis FDC Sisipan Dewasa Paket - - - - - -
205 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 4,697.00 - - 4,697.00 - 4,697.00 -
Obat Batuk Hitam (OBH) Cairan 100 ml Botol 6,050.00 - - 6,050.00 - 6,050.00 -
206 Obat Batuk Cair Sirup (Ekspektoran) Botol 7,106.00 - - 7,106.00 - 7,106.00 -
Obat Batuk Cair Sirup (Ekspektoran) Botol 6,760.00 - - - 6,760.00 -
207 Obat Batuk Hitam Plus Sirup Botol 4,697.00 - - 4,697.00 - 4,697.00 -
208 Obat Flu Sirup Botol - - - - - -
209 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 ml Vial - - - - - -
210 Oksiterasiklin Salep Mata 1%-3,5g Tube 2,500.00 100.00 250,000.00 2,500.00 - 2,500.00 45.00 112,500.00
Oksiterasiklin Salep Mata 1%-3,5g Tube 2,500.00 - - 2,500.00 - 2,500.00 -
211 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2,412.30 - - 2,412.30 - 2,412.30 -
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2,005.00 - - - 2,005.00 -
212 Oksitosin Injeksi 10 IU/ml-1ml Ampul 1,199.00 34.00 40,766.00 1,199.00 - 1,199.00 -
Oksitosin Injeksi 10 IU/ml-1ml Ampul 1,126.00 205.00 230,830.00 1,126.00 - 1,126.00 -
213 Omeprazole injeksi 40mg/10ml Ampul 16,997.00 - - 9,898.00 - 16,997.00 -
214 Omeprazole Kapsul 20 mg Tablet 341.81 40.00 13,672.40 341.81 - 341.81 40.00 13,672.40
215 Ondansetron inj 4 mg/ 2 mL Ampul 1,650.00 - - 1,070.00 - 1,650.00 -
216 Parasetamol drop 100 mg/ml btl @15ml (60mg/0 Botol 4,976.00 36.00 179,136.00 4,976.00 - 4,976.00 -
217 Parasetamol Sirup 120 mg/5ml-60 ml Botol 1,107.00 - - 1,107.00 - 1,107.00 -
Parasetamol Sirup 120 mg/5ml-60 ml Botol 1,181.00 64.00 75,584.00 1,181.00 - 1,181.00 -
218 Parasetamol Tablet 100 mg Tablet - - - - - -
219 Parasetamol Tablet 500 mg Tablet 53.00 - - 53.00 - 53.00 -
Parasetamol Tablet 500 mg Tablet 100.74 600.00 60,444.00 100.74 - 100.74 -
220 PB Anak Blister - - - - - -
221 PB Dewasa Blister - - 12,569.00 - - -
222 Pehacain injeksi Ampul 3,051.40 40.00 122,056.00 3,051.40 - 3,051.40 -
Pehacain injeksi Ampul 3,080.00 - - - 3,080.00 -
223 Perak Sulfadiazin krim 1 % 35 gr Tube 23,000.00 - - - - 23,000.00 -
224 Permetrin krim 5 % Tube 11,250.00 15.00 168,750.00 11,250.00 - 11,250.00 -
225 Piracetam Tablet 400 mg Tablet 451.00 - - 459.80 - 451.00 -
226 Piracetam Tablet 800 mg Tablet 803.00 - - 800.80 - 803.00 -
227 Piroksikam Tablet 20 mg Tablet 156.20 - - 156.20 - 156.20 -
Piroksikam Tablet 20 mg Tablet 130.00 - - - 130.00 -
228 Pirantel Pamoat Tablet 365 mg (Setara dng 125
mg Basa) Tablet
291.00 - - - - 291.00 -
229 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 131.00 500.00 65,500.00 131.00 - 131.00 -
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 128.00 - - 128.00 500.00 64,000.00 128.00 -
230 Piridoksin Hcl (Vit.B6) Tablet 25 mg Tablet - - - - - -
231 Povidon Iodida 10% 30 ml Botol 3,360.00 - - 3,360.00 - 3,360.00 -
232 Povidon Iodida 10% 60 ml Botol - - - - - -
233 Povidon Iodida 10% 300 ml Botol 23,971.20 - - 23,971.20 2.00 47,942.40 23,971.20 -
234 Prednison Tablet 5 mg Tablet 68.00 690.00 46,920.00 68.00 - 68.00 -
Prednison Tablet 5 mg Tablet 96.00 - - - 96.00 -
235 Primakuin tablet 15 mg Tablet - - - - - -
236 Prokain Benzil Penisilin Injeksi 3,000,000 IU Vial - - - - - -
237 Propanolol Hcl Tablet 40 mg Tablet 76.00 - - 76.00 - 76.00 -
238 Propilturasil Tablet 100 mg Tablet 385.00 80.00 30,800.00 385.00 - 385.00 -
239 Ranitidin Injeksi 25 mg / ml Ampul - - 1,155.00 - - -
240 Ranitidin Tablet 150 mg Tablet 85.00 170.00 14,450.00 85.00 - 85.00 30.00 2,550.00
Ranitidin Tablet 150 mg Tablet 98.00 - - - 98.00 -
241 Retinol (Vit. A) 100.000 IU Kapsul Kapsul 307.00 - - 307.00 - 307.00 -
242 Retinol (Vit. A) 200.000 IU Kapsul Kapsul 517.00 - - 517.00 - 517.00 -
243 Reserpin Tablet 0, 25 mg Tablet - - - - - -
244 Rifampisin Tablet 450 mg Tablet - - - - - -
245 Ringer Laktat Larutan Infus Steril 500 ml Botol - - 7,150.00 - - -
Ringer Laktat Larutan Infus Steril 500 ml Botol 7,150.00 25.00 178,750.00 - 7,150.00 -
246 Salbutamol Tablet 2 mg Tablet 63.00 - - 63.00 - 63.00 -
Salbutamol Tablet 2 mg Tablet 67.00 100.00 6,700.00 67.00 - 67.00 -
247 Salbutamol Tablet 4 mg Tablet 70.00 - - 70.00 - 70.00 -
248 Salbutamol solution for Inhalation single dose
Ampul
units 2,5 ml 4,550.00 - - 4,550.00 - 4,550.00 -
249 Salep 2-4 Kombinasi : Pot 2,621.00 - - 2,621.00 - 2,621.00 -
Salep 2-4 Kombinasi : Pot 2,429.00 - - - 2,429.00 -
Salep 2-4 Kombinasi : Pot 2,527.00 - - - 2,527.00 -
250 Salisil bedak 2% -50 gr Kotak 1,025.00 - - 1,020.00 - 1,025.00 -
Salisil bedak 2% -50 gr Kotak 5,856.40 - - 5,856.40 - 5,856.40 -
Salisil bedak 2% -50 gr Kotak 920.00 - - 920.00 20.00 18,400.00 920.00
251 Salep Luka Bakar Tube 11,718.25 - - 11,718.25 - 11,718.25 -
Salep Luka Bakar Tube 19,690.00 - - - 19,690.00 -
252 Sefadroksil Sirup Kering 125 mg / 5 ml sirup Botol 4,185.00 43.00 179,955.00 4,185.00 - 4,185.00 -
253 Sefadroksil Tablet 500 mg Tablet 450.00 - - 478.00 - 450.00 -
254 Sefiksim Kapsul 100 mg Kapsul - - 31,231.00 - - -
255 Sefiksim 400 mg + Azitromisin 1000 mg Paket - - 31,231.00 - - -
256 Sefotaksim Injeksi 1 gr Ampul - - 4,200.00 - - -
257 Seftriakson Injeksi 1 gr / vial Ampul - - 4,483.00 - - -
258 Semen Seng Fosfat Serbuk & Cairan Botol - - - - - -
259 Setirizin Tablet 10 mg Tablet 90.00 - - 90.00 - 90.00 -
Setirizin Tablet 10 mg Tablet 96.00 - - - 96.00 -
260 Setirizin Sirup 5 mg / 5 ml Botol 2,090.00 - - 2,090.00 - 2,090.00 -
Setirizin Sirup 5 mg / 5 ml Botol 3,150.00 - - - 3,150.00 -
261 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul 1,098.00 - - 1,035.00 - 1,098.00 -
262 Sianokobalamin Tablet 50 mcg Tablet 49.00 900.00 44,100.00 49.00 - 49.00 -
263 Silver Amalgam Serbuk 65-75% Botol - - - - - -
264 Simetidin 200 mg Tablet Tablet 176.00 - - 163.90 - 176.00 -
265 Simvastatin Tablet 10 mg Tablet 117.00 - - 117.00 - 117.00 -
Simvastatin Tablet 10 mg Tablet 117.00 - - 117.00 - 117.00 -
Simvastatin Tablet 10 mg Tablet 111.00 - - - 111.00 -
266 Siprofloksasin 500mg Tablet 530.20 - - 530.20 - 530.20 -
267 Spironolakton Tablet 25 mg Tablet 190.00 80.00 15,200.00 190.00 - 190.00 -
268 Sulfacetamid Tetes Mata 15 %-5ml Botol - - - - - -
269 Tablet Tambah Darah Kombinasi: Tablet 353.00 - - 353.00 - 353.00 -
Tablet Tambah Darah Kombinasi: Tablet 350.00 - - 350.00 - 350.00 -
270 Temporary Stopping Fletcher (Fletcher) Serbuk &
Set
Cairan - - - - - -
271 Trikesol formalin ( T K F ) Cairan 10 ml Botol - - - - - -
272 Tetrasiklin Kapsul 250 mg Kapsul 163.00 - - 174.00 - 163.00 -
273 Tetrasiklin Kapsul 500 mg Kapsul 310.00 - - - - 310.00 -
274 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1ml Ampul 1,140.00 - - 1,139.60 - 1,140.00 -
275 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 91.30 1,630.00 148,819.00 91.30 - 91.30 -
Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 91.00 - - 91.00 - 91.00 -
276 Thiamfenikol Kapsul 500 mg Kapsul 837.00 - - 837.00 - 837.00 -
Thiamfenikol Kapsul 500 mg Kapsul 921.00 200.00 184,200.00 921.00 - 921.00 -
277 Tramadol Injeksi 50 mg/ ml Ampul - - - - - -
278 Tramadol Tablet 50 mg Tablet - - - - - -
279 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 63.00 13,500.00 850,500.00 63.00 - 63.00 -
Triheksifenidil Hidroklorida Tablet 2 mg Tablet 91.00 - - 91.00 - 91.00 -
280 Vitamin B .Komplek Tablet Tablet 89.00 - - 89.00 - 89.00 -
281 Vitamin Neurotropik Tablet Tablet 1,177.00 620.00 729,740.00 1,177.00 - 1,177.00 135.00 158,895.00
Vitamin Neurotropik Tablet Tablet 660.00 - - - 660.00 -
282 Zinc Tablet 20 mg Tablet 208.00 - - 208.00 - 208.00 -
Zinc Tablet 20 mg Tablet 524.00 - - - 524.00 -
283 Zinc Sulfat 20 mg/5 ml Botol 2,489.00 10.00 24,890.00 2,489.00 - 2,489.00 -
284 Hepatorotector tablet (Curcuma) Tablet - - 462.00 - - -
285 Obat Batuk Herbal Botol 9,680.00 - - 9,680.00 - 9,680.00 -
286 Obat Kumur Botol 16,962.00 - - 16,962.00 - 16,962.00 -
287 Salep Kloramfenikol + Hidrokortison Tube 14,371.50 - - 14,371.50 - 14,371.50 -
288 Tablet Pemanis Botol 33,000.00 14.00 462,000.00 33,000.00 - 33,000.00 -
289 Bahan Pembersih Kavitas Botol 150,000.00 - - - - 150,000.00 -
290 Flour Gel Botol 49,500.00 - - - - 49,500.00 -
291 Glass Ionomer Posterior Set 775,000.00 - - - - 775,000.00 -
292 Hyposol 3 % Botol 78,100.00 - - - - 78,100.00 -
293 Paramonochlorofenol/CHKM Botol 50,000.00 - - - - 50,000.00 -
294 Saliva Ejector Pcs 660.00 - - - - 660.00 -
295 Salep Betameson + Neomisin Tube 12,793.00 - - - - 12,793.00 -
Salep Betameson + Neomisin Tube 13,138.40 - - 13,138.40 - 13,138.40 -
296 Curcuma Tablet 462.00 - - - - 462.00 -
Bisakodil Tablet 5 mg Tablet 319.00 200.00 63,800.00 319.00 - 319.00 -
297 Gentamisin injeksi 40 mg/ml Ampul 5,900.00 20.00 118,000.00 5,900.00 - 5,900.00 -
298 Bisoprolol Tablet 2,5 mg Tablet 626.00 - - 626.00 - 626.00 -
299 Klobazam 10 mg Tablet 776.00 206.00 159,856.00 776.00 - 776.00 -
300 Klozapin 100 mg Tablet 997.00 200.00 199,400.00 997.00 - 997.00 -
Klozapin 25 mg Tablet 473.00 1,220.00 577,060.00 473.00 - 473.00 270.00 127,710.00
301 Risperidon 2 mg Tablet 123.00 400 49,200.00 123.00 - 123.00 -
302 Gentamisin Tetes Mata 0,3% Botol 4,232.00 - - 4,232.00 - 4,232.00 -
Simvastatin Tablet 20 mg Tablet 217.00 - - 217.00 - 217.00 -
Asam Valproat 250 mg Tablet 2,954.00 100.00 295,400.00 2,954.00 - 2,954.00 -
Kalsitriol 0,5 mcg Kapsul 2,600.00 300.00 780,000.00 2,600.00 - 2,600.00 -
B. BAHAN MEDIS HABIS PAKAI (BMHP) - - - - - -
1 Abbocath No 18 ( IV Chateter 18 ) Buah 6,930.00 10.00 69,300.00 6,930.00 - 6,930.00 -
Abbocath No 20 ( IV Chateter 20 ) Buah 6,930.00 - - 6,930.00 - 6,930.00 -
Abbocath No 22 ( IV Chateter 22 ) Buah 3,800.00 - - 3,800.00 - 3,800.00 -
5 Alat Gula, Kolesterol, Asam Urat Unit - - - - - -
6 Alat Suntik Sekali Pakai 1 ml Set 854.00 200.00 170,800.00 854.00 - 854.00 -
7 Alat Suntik Sekali Pakai 3 ml Set 965.40 - - 965.40 - 965.40 -
8 Set
Alat Suntik Sekali Pakai 5 ml 1,045.00 100.00 104,500.00 1,045.00 - 1,045.00 -
Alat Suntik Sekali Pakai 5 ml Set 1,540.00 500.00 770,000.00 1,540.00 - 1,540.00 -
9 Alat Suntik Sekali Pakai 10 ml Set - - 1,298.00 - - -
10 Alkohol Swab Kotak 120.00 1,400.00 168,000.00 120.00 - 120.00 -
Alkohol Swab Kotak 95.00 - - 95.00 - 95.00 -
11 Auto Disposable Syringe (ADS) 0,05 ml Set 1,101.00 - - 1,101.00 - 1,101.00 -
12 Auto Disposable Syringe (ADS) 0,5 ml Set 1,050.00 - - 1,050.00 - 1,050.00 -
13 Auto Disposable Syringe (ADS) 5 ml Set 1,640.00 - - 1,640.00 - 1,640.00 -
14 Blood Set Set - - 10,430.00 - - -
15 Catgut/Benang Bedah No.2/0 Plain Sachet 26,666.67 - - 26,666.67 - 26,666.67 -
Catgut/Benang Bedah No.2/0 Plain Sachet 34,300.00 12.00 411,600.00 34,300.00 - 34,300.00 -
16 Catgut/Benang Bedah No.3/0 Cromic Sachet 33,250.00 - - 37,203.00 - 33,250.00 -
Catgut/Benang Bedah No.3/0 Cromic Sachet 33,538.00 24.00 804,912.00 33,538.00 - 33,538.00 -
17 Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 3,150.00 - - 3,150.00 - 3,150.00 -
Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 2,677.50 - - - 2,677.50 -
18 Etanol 70 % 1.000 ml Botol 15,246.00 - - 15,246.00 - 15,246.00 -
19 Eter Alkohol Botol - - - - - -
20 Folley Catheter no 14 Set 18,450.00 10.00 184,500.00 18,450.00 - 18,450.00 -
Folley Catheter no 19 Set 8,100.95 10.00 81,009.50 8,100.95 - 8,100.95 -
23 Infus set Anak Set 9,900.00 - - 9,900.00 - 9,900.00 -
24 Infus set Dewasa Set 5,445.00 5.00 27,225.00 5,445.00 - 5,445.00 -
Infus set Dewasa set 5,800.00 10 58,000.00 5,800.00 - 5,800.00 -
25 Iodina Test Botol 10,725.00 - - 10,725.00 - 10,725.00 -
26 Kaca Slide Pcs - - 55,000.00 - - -
27 Kapas Berlemak 500 gram Bungkus - - - - - -
28 Kapas Pembalut / Adsorbens 100 gram Bungkus 7,205.00 - - 7,205.00 - 7,205.00 -
Kapas Pembalut / Adsorbens 250 gram Bungkus 12,875.00 3.00 38,625.00 12,875.00 - 12,875.00 -
29 Kassa Pembalut 2 m x 80 cm Rol 9,400.00 44.00 413,600.00 - - 9,400.00 -
30 Kassa Pembalut Hidrofil 4 m x 3 cm Rol 800.00 10.00 8,000.00 - - 800.00 -
31 Kassa Pembalut Hidrofil 4 m x 15 cm Rol 3,800.00 100.00 380,000.00 3,800.00 - 3,800.00 -
32 Kassa Hidrofil Steril 16 x 16 Kotak 8,140.00 10.00 81,400.00 8,140.00 - 8,140.00 -
Kassa Hidrofil Steril 16 x 16 Kotak 8,240.00 - - 8,240.00 - 8,240.00 -
33 Kassa Kompres 40 x 40 steril Bungkus 1,393.00 - - 1,800.00 - 1,393.00 -
34 Kertas Puyer Pcs 75.90 12,000.00 910,800.00 75.90 - 75.90 -
35 Kertas Saring Lembar - - 10,000.10 - - -
36 Kertas Lensa Lembar - - - - - -
37 Lysol 1,000 ml Botol 43,050.00 - - 43,050.00 - 43,050.00 -
38 Masker Buah 982.40 2,000.00 1,964,800.00 982.40 - 982.40 -
39 Masker N 95 Pcs 30,842.19 - - 30,842.19 - 30,842.19 -
40 Minyak Imersi Botol 1,548,088.30 - - 1,548,088.30 - 1,548,088.30 -
41 Plester Kertas Rol 15,333.33 - - 15,333.33 - 15,333.33 -
42 Polifix 5 cm x 5 m Rol - - - - - -
Polifix 5 cm x 5 m Rol 39,749.00 - - - 39,749.00 -
43 Pot Dahak Pcs 3,096.96 - - 3,096.96 - 3,096.96 -
44 Rapid HIV 1/2 Vikia DS Test 12,948.00 - - 12,948.00 - 12,948.00 -
45 Rapid HIV 1 (SD HIV) Test 11,975.00 - - 11,975.00 - 11,975.00 -
46 Rapid HIV 2 (Intec HIV) Test - - 74,002.50 - - -
47 Rapid HIV 2 (Biomeriux HIV) Test - - 19,500.00 - - -
48 Rapid Tes SD Bioline HBSAG Test - - 9,878.00 - - -
49 Rapid Test Syphilis Test 20,400.00 - - 20,400.00 - 20,400.00 -
50 Reagen CD 4 Control Test - - - - - -
51 Reagen CD 4 Test - - - - - -
52 Reagen Ziehl Nielsen Botol 133,500.00 - - 133,500.00 - 133,500.00 -
53 RPR Test Syphilis Test 12,564.00 - - 12,564.00 - 12,564.00 -
54 Silk( Benang Bedah Sutra ) No 3/0 Sachet 20,186.00 9.00 181,674.00 20,186.00 - 20,186.00 2.00 40,372.00
55 Safety Box Pcs 14,935.00 50.00 746,750.00 14,935.00 - 14,935.00 -
56 Sarung tangan Steril No 6 Pcs 4,500.00 50.00 225,000.00 4,500.00 - 4,500.00 -
57 Sarung tangan Steril No 7 Pcs 2,673.33 100.00 267,333.00 2,673.33 - 2,673.33 -
Sarung tangan Steril No 7 Pcs 6,595.00 - - 6,595.00 - 6,595.00 -
58 Sarung tangan Steril No 7,5 Pcs 6,595.00 50.00 329,750.00 6,595.00 - 6,595.00 -
59 Sarung tangan Non Steril S Pcs - - 600.49 - - -
60 Sarung tangan Non Steril M Pcs 1,503.33 - - 1,503.33 - 1,503.33 -
61 Sarung tangan Non Steril L Pcs 600.49 - - 600.49 - 600.49 -
Sarung tangan Non Steril L Pcs 990.00 - - 990.00 - 990.00 -
62 Sountimer Buah - - - - - -
63 Stik Pemeriksaan Gula Darah Test - - - - - -
64 Stik Pemeriksaan Kolesterol Test - - - - - -
65 Stik Pemeriksaan Asam Urat Test - - - - - -
66 Supratul Lembar 10,400.00 - - 10,400.00 - 10,400.00 -
67 Urine Bag set - - 3,090.00 - - -
68 Wing Neddle No 23 Set - - - - - -
69 Blood Lancet Pcs 150.03 - - 150.03 - 150.03 -
Blood Lancet Pcs 144.20 100.00 14,420.00 144.20 - 144.20 -
70 Cairan Antiseptik Botol 500 ml Botol 66,700.00 - - 66,700.00 - 66,700.00 -
71 Vaccum Tube Sterile EDTA K-3 (3ml) Pcs 102,600.00 - - 102,600.00 - 102,600.00 -
72 Vaccum Tube Sterile Clot Activator (3ml) Pcs 99,500.00 - - 99,500.00 - 99,500.00 -
73 Detergent 5 Liter Galon 712,800.00 - - - - 712,800.00 -
74 Desinfektan 5 Liter Galon 396,000.00 - - - - 396,000.00 -
75 Saliva Ejector 968.00 100.00 96,800.00 - - 968.00 -
76 Pharmafix Rol 30,000.00 5.00 150,000.00 30,000.00 - 30,000.00 -
77 Slide Pcs 31,347.00 - - 31,347.00 - 31,347.00 -
78 Vikia Biumerc Test 19,480.00 - - 19,480.00 - 19,480.00 -
79 Baju APD Pcs 312,500.10 - - 312,500.10 - 312,500.10 -
80 Sepatu Boot Safety Pcs 262,499.60 - - 262,499.60 - 262,499.60 -
81 Kacamata Google Pcs 131,249.80 - - 131,249.80 - 131,249.80 -
82 Sarung Tangan Karet Latex Pcs 56,249.60 - - 56,249.60 - 56,249.60 -
83 Box Object Glass Pcs 38,848.51 - - 38,848.51 - 38,848.51 -
84 Masker Kain Headloop Pcs 5,500.00 - - 5,500.00 - 5,500.00 -
85 Plester Bulat Non Woven Kotak 36,050.00 4.00 144,200.00 36,050.00 - 36,050.00 -
86 Masker KN 95 Pcs - - - - - - -
87 Calcetin Calcium Hidroxide Paste Botol 134,214.29 - - 134,214.29 - 134,214.29 -
88 Cresotin Paste Pot 112,214.29 - - 112,214.29 - 112,214.29 -
89 Cresotin Liquid No 2 Pot 160,714.29 - - 160,714.29 - 160,714.29 -
90 Hyposol 3 % Botol 78,750.00 1 78,750.00 78,750.00 - 78,750.00 -
91 Pulp X Pot 217,214.29 - - 217,214.29 - 217,214.29 -
92 Trioresolformalina Botol 72,214.29 - - 72,214.29 - 72,214.29 -
93 Paramonochlorofenol/CHKM Botol 65,214.29 - - 65,214.29 - 65,214.29 -
94 Saliva Ejector Kantong 88,750.00 1.00 88,750.00 88,750.00 - 88,750.00 -
95 APD Vaksinasi Covid Paket 98,450.00 - - 98,450.00 - 98,450.00 -
96 Rompi Vaksinator Pcs 148,000.00 - - 148,000.00 - 148,000.00 -
97 Coverall DISPO Survailens Pcs 323,500.00 - - 323,500.00 - 323,500.00 -
98 Povidon Iodine 300 ml Botol 22,050.00 - - 22,050.00 - 22,050.00 -
Povidon Iodine 300 ml Botol 22,050.00 - - 22,050.00 - 22,050.00 -
Povidon Iodine 30 ml Botol 3,360.00 2.00 6,720.00 3,360.00 - 3,360.00 -
99 Box Object Glass Pcs 38,848.51 - - 38,848.51 - 38,848.51 -
Object Glass Pcs 15,089.50 - - 15,089.50 - 15,089.50 -
Abate Kotak 412,002.80 - - 412,002.80 - 412,002.80 -
100 Water One 1 Liter Botol 15,246.00 2.00 30,492.00 15,246.00 - 15,246.00 -
- - - - -
C. SERUM DAN VAKSIN - - - - - -
1 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (ABU I Vial 479,996.00 - - 479,996.00 - 479,996.00 -
Serum Anti Bisa Ular Polivalen Injeksi 5 ml (ABU I Vial 512,204.00 2.00 1,024,408.00 512,204.00 - 512,204.00 -
2 Serum Anti Rabies untuk manusia Vial - - - - - -
3 Serum Anti Tetanus (ATS) Injeksi 1.500 IU/ampul Ampul - - 176,800.00 - - -
4 Serum Anti Tetanus (ATS) Injeksi 20.000 Vial - - - - - -
IU/ampul
5 Human Tetanus Imunoglobin inj 250 IU Vial 188,663 5.00 943,315.00 188,663.00 - 188,663.00 -
6 Vaksin BCG Ampul 59,950 - - 61,996.00 - 59,950.00 -
Vaksin BCG Ampul 66,154 - - 66,154.00 - 66,154.00 -
7 Vaksin Campak 10 Dosis Vial - - - - - -
8 Vaksin DT Vial - - 17,996.00 - - -
9 Vaksin TD Vial 18,128 - - 18,128.00 - 18,128.00 -
Vaksin TD Vial 16,995 - - 16,995.00 - 16,995.00 -
10 Vaksin DTP-HB Vial - - - - - -
11 Vaksin DPT-HB/Hib Vial 76,285 - - - - 76,285.00 -
Vaksin DPT-HB/Hib Vial 84,282 - - 84,282.00 - 84,282.00 -
12 Vaksin HB Uniject Pcs 20,900 - - 23,991.00 - 20,900.00 -
Vaksin HB Uniject Pcs 25,597 - - 25,597.00 - 25,597.00 -
13 Vaksin MR (VVM.A) Vial 166,265 - - 166,265.00 - 166,265.00 -
14 Vaksin Polio Vial 21,285 - - 21,285.00 - 21,285.00 -
Vaksin Polio Vial 19,954 - - 19,954.00 - 19,954.00 -
15 Vaksin Polio IPV 5 Dosis Vial 158,994 - - 158,994.00 - 158,994.00 -
Vaksin Polio IPV 5 Dosis Vial 144,540 - - 144,540.00 - 144,540.00 -
16 Vaksin Polio 10 IPV Dosis Vial - - - - - -
17 Vaksin TT Vial - - - - - -
18 Vaksin Covid 19 (CoronaVac) Vial 211,282 - - 211,282.00 - 211,282.00 -
19 Vaksin Covid 19 (Multidosis) Vial 1,339,441 - - 1,339,440.50 - 1,339,440.50 -
20 - - - - - -
JUMLAH TOTAL OBAT 16,722,497.26 339,302.40 876,608.40

JUMLAH TOTAL BMHP 9,549,960.50 - 40,372.00
JUMLAH TOTAL VAKSIN SERUM 1,967,723.00 - -
JUMLAH TOTAL KESELURUHAN 28,240,180.76 339,302.40 916,980.40
AN OBAT DAN BMHP
MEKARWANGI
UPATEN KUNINGAN
RIL TAHUN 2022

KONTROL
DAK
HARGA SATUAN
(RP) BANYAKNYA NILAI RP. STOK TOTAL HARGA
- - - - -
430.00 - - - -
292.00 - -
4,300.00 - - - -
105.00 - - - -
- - - - -
128.00 90.00 11,520.00 - -
143.55 - - - -
151.80 - -
2,500.30 - - - -
3,619.00 - -
3,822.00 - - - -
95.00 200.00 19,000.00 - 19,000
91.00 - - -
143.00 - - - -
171.44 - - -
75.00 - - - -
53.00 480.00 25,440.00
99.00 - - - -
104.00 - -
196.00 - - - -
195.00 - -
249.00 6,000.00 1,494,000.00 - -
190.00 - - -
- - - - -
3,500.00 100.00 350,000.00 - -
3,628.00 - - - -
3,473.00 - -
KONTROL
DAK
HARGA SATUAN
(RP)
- - - - -
- - - - -
- - - - -
8,237.00 70.00 576,590.00 - -
- - - - -
1,679.00 - - - 20,148
2,129.00 - -
58.00 1,120.00 64,960.00 - 150,800
58.00 - -
189.05 - - - -
- - - - -
170.00 500.00 85,000.00
- - - - -
2,924.00 - - - -
3,167.00 40.00 126,680.00 - -
4,798.00 25.00 119,950.00 - -
4,158.00 - -
173.00 100.00 17,300.00 - -
167.00 - -
- - - - -
233.20 - - - -
253.00 500.00 126,500.00 -
253.00 - - - -
2,112.00 - - - -
208.00 - - - -
1,195.10 - - - -
11,550.00 - - - -
- - - - -
75.00 - - - -
105.00 443.00 46,515.00 - 140,910
225.00 2,000.00 450,000.00 -
111.00 - - - 111,000
177.90 720.00 128,088.00 -
382.00 260.00 99,320.00 - 99,320
KONTROL
DAK
HARGA SATUAN
(RP)
105.00 - - - -
114.00 - -
- - - - -
- - - - -
3,619.00 25.00 90,475.00 - -
3,600.00 - -
237.00 - - - -
405.00 300.00 121,500.00 - -
380.00 - -
162.00 500.00 81,000.00 - -
1,639.00 10.00 16,390.00 - -
2,860.00 39.00 111,540.00 - -
130,000.00 - - - -
14,500.00 20.00 290,000.00 - -
110.00 - - - -
660.00 - -
1,430.00 - - - -
1,380.00 - -
- - - - -
319.00 - - - -
250.80 630.00 158,004.00 - -
112,000.00 - - - -
160,500.00 - - - -
1,097.00 20.00 21,940.00 - -
61.60 400.00 24,640.00 - 24,640
44.00 - -
41.00 - -
220,000.00 - - - -
86.00 107.00 9,202.00 - -
114.00 700.00 79,800.00 - -
1,735.00 19.00 32,965.00 - -
12,090.00 - - - -
12,573.00 8.00 100,584.00
16,742.00 - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
156.00 - - - -
1,095.00 10.00 10,950.00 - -
104.00 - - - -
99.00 193.00 19,107.00 - -
104.00 - - -
141.90 - -
71.00 - - - -
95.00 - -
2,700.00 - - - -
- - - - -
- - - - -
1,515.00 - - - -
1,408.00 10.00 14,080.00 -
- - - - -
730.00 - - - -
- - - - -
- - - - -
- - - - -
2,500.00 - -
108,720.93 2.00 217,441.86 - -
20,087.00 - - - -
158.00 - - - -
154.00 - -
1,540.00 - - - -
1,969.00 - - - -
- - - - -
605.00 - - - -
2,764.00 - - - -
- - - - -
- - - - -
748.00 - - - -
3,682.00 90.00 331,380.00 - -
3,550.00 - -
82.00 - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
- - - - -
257.00 3,200.00 822,400.00 - -
260.00 - -
- - - - -
- - - - -
- - - - -
1,834.80 - - - -
1,834.80 - - -
5,390.00 25.00 134,750.00
680,000.00 - - - -
119.00 - - - -
83.00 60.00 4,980.00
207.00 - - - -
82.50 5,000.00 412,500.00 - -
120.00 684.00 82,080.00
7,370.00 - - - -
8,800.00 - -
- - - - -
6,900.00 - - - -
5,700.00 - - - -
7,500.00 - -
1,773.00 460.00 815,580.00 - -
224.00 - -
47.00 500.00 23,500.00 - -
55.00 - -
51.00 8,340.00 425,340.00 - 3,060
54.00 700.00 37,800.00 - -
75.00 - - -
1,190.00 50.00 59,500.00 - -
97,500.00 - - - -
- - - - -
149.00 - -
2,475.00 - - - 118,800
105.00 - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
102.00 - -
30.28 - - - -
111.00 - -
2,236.00 50.00 111,800.00 - -
4,665.00 - - -
- - - - -
145.00 - - - -
170.00 135.00 22,950.00 - -
88.00 - - - -
- - - - -
682.00 - - - -
- - - - -
59.00 - - - -
63.00 760.00 47,880.00
62.00 525.00 32,550.00 - -
75.00 100.00 7,500.00 - -
94.00 - -
245.00 80.00 19,600.00 - -
270.00 - -
2,518.00 22.00 55,396.00 - -
252.00 100.00 25,200.00 - -
528.00 - -
- - - - -
- - - - -
- - - - -
- - - - -
759.00 - - - -
522.00 100.00 52,200.00 - -
266.00 - - - -
- - - - -
1,881.00 21.00 39,501.00 - -
1,810.00 - -
3,008.00 - - - -
3,242.00 24.00 77,808.00
KONTROL
DAK
HARGA SATUAN
(RP)
7,260.00 - - - -
3,250.00 - -
7,370.00 28.00 206,360.00 - -
40.17 3,800.00 152,646.00 - 8,034
23.00 - -
212.00 - - - -
148.00 - -
147.00 - - - -
144.00 - -
1,510.00 - - - -
1,240.00 - -
4,550.00 - - - -
30,030.00 - - - -
76.00 - - - -
125.00 900.00 112,500.00 - -
2,052.00 32.00 65,664.00 - -
2,140.00 - -
315.00 - - - -
323.00 - - -
9,275.00 - - - -
- - - - -
- - - - -
1,221.00 13.00 15,873.00 - -
847.00 10.00 8,470.00
1,845.00 - - - -
803.00 30.00 24,090.00

177,216.00 - - - -
80.30 - - - -
131.00 100.00 13,100.00 - -
3,328.00 - - - -
3,796.00 - - - -
- - - - -
39,880.00 - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
718.20 - - - -
- - - - -
77.00 - - - 16,940
160.00 - - - -
946.00 - - - -
3,300.00 - - - -
154.00 - - - -
444.00 - -
2,959.00 10.00 29,590.00 - -
1,023.00 106.00 108,438.00 -
102.00 200.00 20,400.00 - -
150.00 - -
85.00 560.00 47,600.00 - -
- - - - -
- - - - -
211.20 100.00 21,120.00 - -
- - - - -
- - - - -
3,414.00 26.00 88,764.00 - -
826.10 - - - -
792.00 - - -
7,100.00 - - - -
- - - - -
50.00 - - - -
50.00 - -
145.00 - - - -
128.00 - -
115.00 - - - -
200.00 - -
6,410.00 - - - -
6,840.00 30.00 205,200.00
193.60 - - - -
11,500.00 1.00 11,500.00 - -
598.00 42.00 25,116.00 - -
KONTROL
DAK
HARGA SATUAN
(RP)
550.00 100.00 55,000.00
843.00 130.00 109,590.00 - -
- - - - -
317,018.00 - - - -
- - - - -
- - - - -
248,120.00 - - - -
1,297,889.00 - - - -
415,469.00 - - - -
- - - - -
4,697.00 - - - -
6,050.00 - -
7,106.00 - - - -
6,760.00 - -
4,697.00 - - - -
- - - - -
- - - - -
2,500.00 55.00 137,500.00 - 225,000
2,500.00 - - -
2,412.30 - - - -
2,005.00 - - -
1,199.00 34.00 40,766.00 - -
1,126.00 205.00 230,830.00 -
16,997.00 - - - -
341.81 - - - 27,345
1,650.00 - - - -
4,976.00 36.00 179,136.00 - -
1,107.00 - - - -
1,181.00 64.00 75,584.00
- - - - -
53.00 - - - -
100.74 600.00 60,444.00
- - - - -
- - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
3,051.40 40.00 122,056.00 - -
3,080.00 - -
23,000.00 - - - -
11,250.00 15.00 168,750.00 - -
451.00 - - - -
803.00 - - - -
156.20 - - - -
130.00 - - -
291.00 - - - -
131.00 500.00 65,500.00 - -
128.00 500.00 64,000.00
- - - - -
3,360.00 - - - -
- - - - -
23,971.20 2.00 47,942.40 - -
68.00 690.00 46,920.00 - -
96.00 - -
- - - - -
- - - - -
76.00 - - - -
385.00 80.00 30,800.00 - -
- - - - -
85.00 140.00 11,900.00 - 5,100
98.00 - -
307.00 - - - -
517.00 - - - -
- - - - -
- - - - -
- - - - -
7,150.00 25.00 178,750.00
63.00 - - - -
67.00 100.00 6,700.00
70.00 - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
4,550.00 - - - -
2,621.00 - - - -
2,429.00 - - -
2,527.00 - -
1,025.00 - - - -
5,856.40 - -
920.00 20.00 18,400.00
11,718.25 - - - -
19,690.00 - -
4,185.00 43.00 179,955.00 - -
450.00 - - - -
- - - - -
- - - - -
- - - - -
- - - - -
- - - - -
90.00 - - - -
96.00 - -
2,090.00 - - - -
3,150.00 - -
1,098.00 - - - -
49.00 900.00 44,100.00 - -
- - - - -
176.00 - - - -
117.00 - - - -
117.00 - - -
111.00 - -
530.20 - - - -
190.00 80.00 15,200.00 - -
- - - - -
353.00 - - - -
350.00 - -
- - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
- - - - -
163.00 - - - -
310.00 - - - -
1,140.00 - - - -
91.30 1,630.00 148,819.00 - -
91.00 - -
837.00 - - - -
921.00 200.00 184,200.00 -
- - - - -
- - - - -
63.00 13,500.00 850,500.00 - -
91.00 - -
89.00 - - - -
1,177.00 485.00 570,845.00 - 317,790
660.00 - -
208.00 - - - -
524.00 - -
2,489.00 10.00 24,890.00 - -
- - - - -
9,680.00 - - - -
16,962.00 - - - -
14,371.50 - - - -
33,000.00 14.00 462,000.00 - -
150,000.00 - - - -
49,500.00 - - - -
775,000.00 - - - -
78,100.00 - - - -
50,000.00 - - - -
660.00 - - - -
12,793.00 - - - -
13,138.40 - -
462.00 - - - -
319.00 200.00 63,800.00
5,900.00 20.00 118,000.00 - -
KONTROL
DAK
HARGA SATUAN
(RP)
626.00 - - - -
776.00 206.00 159,856.00 - -
997.00 200.00 199,400.00 - -
473.00 950.00 449,350.00 -
123.00 400.00 49,200.00 -
4,232.00 - - -
217.00 - - -
2,954.00 100.00 295,400.00 - -
2,600.00 300.00 780,000.00 -
- - - - -
6,930.00 10.00 69,300.00 - -
6,930.00 10.00 69,300.00 - -
6,930.00 - - -
6,930.00 10.00 69,300.00 - -
3,800.00 - -
6,930.00 5.00 34,650.00 - -
- - - - -
854.00 200.00 170,800.00 - -
965.40 - - - -
1,045.00 100.00 104,500.00 - -
1,540.00 500.00 770,000.00 -
- - - - -
120.00 1,400.00 168,000.00 - -
95.00 - -
1,101.00 - - - -
1,050.00 - - - -
1,640.00 - - - -
- - - - -
26,666.67 - - - -
34,300.00 12.00 411,600.00
33,250.00 - - - -
33,538.00 24.00 804,912.00 -
3,150.00 - - - -
2,677.50 - -
KONTROL
DAK
HARGA SATUAN
(RP)
15,246.00 - - - -
- - - - -
18,450.00 10.00 184,500.00 - -
18,450.00 10.00 184,500.00 - -
18,450.00 10.00 184,500.00 - -
8,100.95 10.00 81,009.50 -
9,900.00 - - - -
5,445.00 5.00 27,225.00 - -
5,800.00 10.00 58,000.00
10,725.00 - - - -
- - - - -
- - - - -
7,205.00 - - - -
12,875.00 3.00 38,625.00 -
9,400.00 44.00 413,600.00 - -
800.00 10.00 8,000.00 - -
3,800.00 100.00 380,000.00 - -
8,140.00 10.00 81,400.00 - -
8,240.00 - -
1,393.00 - - - -
75.90 12,000.00 910,800.00 - -
- - - - -
- - - - -
43,050.00 - - - -
982.40 2,000.00 1,964,800.00 - -
30,842.19 - - - -
1,548,088.30 - - - -
15,333.33 - - - -
- - - - -
39,749.00 - -
3,096.96 - - - -
12,948.00 - - - -
11,975.00 - - - -
- - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
- - - - -
- - - - -
20,400.00 - - - -
- - - - -
- - - - -
133,500.00 - - - -
12,564.00 - - - -
20,186.00 7.00 141,302.00 - 80,744
14,935.00 50.00 746,750.00 - -
4,500.00 50.00 225,000.00 - -
2,673.33 100.00 267,333.00 - -
6,595.00 - - -
6,595.00 50.00 329,750.00 - -
- - - - -
1,503.33 - - - -
600.49 - - - -
990.00 - -
- - - - -
- - - - -
- - - - -
- - - - -
10,400.00 - - - -
- - - - -
- - - - -
150.03 - - - -
144.20 100.00 14,420.00 -
66,700.00 - - - -
102,600.00 - - - -
99,500.00 - - - -
712,800.00 - - - -
396,000.00 - - - -
968.00 100.00 96,800.00 - -
30,000.00 5.00 150,000.00 -
31,347.00 - -
KONTROL
DAK
HARGA SATUAN
(RP)
19,480.00 - -
312,500.10 - -
262,499.60 - -
131,249.80 - -
56,249.60 - -
38,848.51 - -
5,500.00 - -
36,050.00 4.00 144,200.00
- - -
134,214.29 - -
112,214.29 - -
160,714.29 - -
78,750.00 1.00 78,750.00
217,214.29 - -
72,214.29 - -
65,214.29 - -
88,750.00 1.00 88,750.00
98,450.00 - -
148,000.00 - -
323,500.00 - -
22,050.00 - -
22,050.00 - -
3,360.00 2.00 6,720.00
38,848.51 - -
15,089.50 - -
412,002.80 - -
15,246.00 2.00 30,492.00
- - -
- - - - -
479,996.00 - - - -
512,204.00 2.00 1,024,408.00
- - - - -
- - - - -
- - - - -
KONTROL
DAK
HARGA SATUAN
(RP)
188,663.00 5.00 943,315.00 - -
59,950.00 - - - -
66,154.00 - -
- - - - -
- - - - -
18,128.00 - - - -
16,995.00 - -
- - - - -
76,285.00 - - - -
84,282.00 - -
20,900.00 - - - -
25,597.00 - -
166,265.00 - - - -
21,285.00 - - - -
19,954.00 - -
158,994.00 - - - -
144,540.00 - -
- - - - -
- - - - -
211,282.00 - - - -
1,339,440.50 - - - -
- - - - -
16,185,191.26 - 1,753,217
9,509,588.50 - 80,744
1,967,723.00 - -
27,662,502.76 - - 1,833,961
DATA MUTASI PE
UPTD PUSK
DINAS KESEHAT
PERIODE BU
STOK AWAL APRIL 2022
NO NAMA SEDIAAN SATUAN APBD

HARGA SATUAN BANYAKNYA NILAI RP.
(RP)
A. O B A T
1 Air Raksa Dental Use Botol - -
2 Albendazole Tablet 400 mg Tablet 1,041.98 - -
Albendazole Tablet 400 mg Tablet 292.00 - -
3 Albendazole susp 200 mg/5 ml Botol 4,000.00 - -
4 Alopurinol Tablet 100 mg Tablet 105.00 - -
5 Alopurinol Tablet 300 mg Tablet - -
6 Alprazolam tablet 1 mg Tablet - -
7 Ambroksol Tablet 30 mg Tablet 143.55 - -
Ambroksol Tablet 30 mg Tablet 151.80 - -
8 Ambroksol sirup 15 mg/5 ml Botol 3,626.70 - -
Ambroksol sirup 15 mg/5 ml Botol 3,619.00 - -
9 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 3,822.00 - -
10 Aminofillin Tablet 200 mg Tablet 95.00 - -
Aminofillin Tablet 200 mg Tablet 91.00 - -
11 Amitriptillin Hcl Tablet Salut 25 mg Tablet 143.00 - -
Amitriptillin Hcl Tablet Salut 25 mg Tablet 171.44 - -
12 Amlodipin Tablet 5 mg Tablet 75.00 - -
Amlodipin Tablet 5 mg Tablet 85.00 - -
13 Amlodipin Tablet 10 mg Tablet 99.00 - -
14 Amoksisillin Kapsul 250 mg Kapsul 196.00 - -
Amoksisillin Kapsul 250 mg Kapsul 195.00 - -
15 Amoksisillin Kaplet 500 mg Kaplet 249.00 - -
Amoksisillin Kaplet 500 mg Kaplet 232.00 - -
16 Amoksisillin Serbuk Injeksi 1000 mg vial - -
17 Amoksisillin Sirup Kering 125 mg/5ml Botol 3,500.00 - -
18 Amoksisillin Double Strengh Sirup Kering 250 mg/5 ml Botol 3,628.00 - -
Amoksisillin Double Strengh Sirup Kering 250 mg/5 ml Botol 3,473.00 - -
19 Ampisilin Kapsul 250 mg Kapsul - -
20 Ampisillin Kaplet 500 mg Tablet - -
21 Ampisilin Sirup 125 mg / 5 ml Botol - -
22 Ampisillin Injeksi 1000 mg Vial 8,237.00 - -
23 Analgetik Plus Tablet - -
24 Antasida Doen Suspensi Kombinasi : Magnesium Hidrok Botol 1,995.00 - -
Antasida Doen Suspensi Kombinasi : Magnesium Hidrok Botol 2,129.00 - -
25 Antasida Doen Tablet, Kombinasi : Magnesium Hidroks Tablet 58.00 - -
Antasida Doen Tablet, Kombinasi : Magnesium Hidroks Tablet 58.00 - -
26 Antasida Plus Tablet Tablet 189.05 - -
27 Antalgin (Metampiron) Tablet 500 mg Tablet - -
Antalgin (Metampiron) Tablet 500 mg Tablet 170.00 - -
28 Antalgin Injeksi 250 mg/ml-2ml Ampul - -
29 Anti Bakteri DOEN Salep Kombinasi : Tube 2,924.00 - -
30 Anti Hemoroid Doen komb Supp 3,167.00 - -
31 Anti Fungi DOEN Kombinasi : Pot 4,798.00 - -
Anti Fungi DOEN Kombinasi : Pot 4,158.00 - -
32 Antimigren DOEN Kombinasi : Tablet - -
Antimigren DOEN Kombinasi : Tablet 167.00 - -
33 Anti Diare Suspensi Botol - -
34 Anti Diare Tablet Tablet 233.20 - -
Anti Diare Tablet Tablet 253.00 - -
35 Anti Dotum Oral Tablet Tablet 253.00 - -
36 Anti Hipertensi Kapsul Tablet 2,112.00 - -
37 Antihistamin Tablet kombinasi Tablet 208.00 - -
38 Antispasmodik Tablet Tablet 1,195.10 - -
39 Antitusiva Sirup Botol 11,550.00 - -
40 Antitusiva Tablet Tablet - -
41 Asam Folat Tablet 1 mg Tablet 75.00 - -
42 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 105.00 - -
Asam Askorbat (Vit. C) Tablet 50 mg Tablet 104.00 - -
43 Asam Mefenamat Kapsul 500 mg Kapsul 103.40 - -
Asam Mefenamat Kapsul 500 mg Kapsul 177.90 - -
44 Acetylsistein tablet Tablet 382.00 - -
45 Asetosal Tablet 80 mg Tablet 105.00 - -
Asetosal Tablet 80 mg Tablet 114.00 - -
46 Asetosal Tablet 100 mg Tablet - -
47 Asetosal Tablet 500 mg Tablet - -
48 Asiklovir Krim 5 % Tube 2,996.40 - -
Asiklovir Krim 5 % Tube 3,600.00 - -
49 Asiklovir Tablet 200 mg Tablet 237.00 - -
50 Asiklovir Tablet 400 mg Tablet 345.00 - -
Asiklovir Tablet 400 mg Tablet 380.00 - -
51 Attapulgit Tablet 152.00 - -
52 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 1,639.00 - -
53 Aqua Pro Injeksi Steril, bebas Pirogen 20 ml Vial 2,860.00 - -
54 Bahan Tambal Sementara Set 130,000.00 - -
55 Benzatin Benzil Penisilin injeksi Vial 14,500.00 - -
56 Betahistin Mesilat 6 mg Tablet 110.00 - -
Betahistin Mesilat 6 mg Tablet 660.00 - -
57 Betametason Krim 0,1 %- 5g Tube - -
Betametason Krim 0,1 %- 5g Tube 1,380.00 - -
58 Bisakodil suppositoria 10 mg Supp - -
59 Bisoprolol Tablet 5 mg Tablet - -
60 Bromheksin 8 mg Tablet 250.80 - -
61 Cresotin Pasta Botol 112,000.00 - -
62 Cresotin Liquid No 2 Botol 160,500.00 - -
63 Deksametason Injeksi 5mg/ml-1ml Ampul 1,097.00 - -
64 Deksametason Tablet 0,5 mg Tablet 32.00 - -
Deksametason Tablet 0,5 mg Tablet 44.00 - -
65 Devitalisasi Pasta (Non Arsen) Botol 220,000.00 - -
66 Diazepam tablet 2 mg Tablet 86.00 - -
67 Diazepam tablet 5 mg Tablet 114.00 - -
68 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul 1,735.00 - -
69 Diazepam Larutan Rektal 5 mg/ml Supp 12,090.00 - -
Diazepam Larutan Rektal 5 mg/ml Supp 12,573.00 - -
70 Diazepam Larutan Rektal 10 mg/ml Supp 16,742.00 - -
71 Dietilkarbamazin Sitrat Tablet 100 mg Tablet 156.00 - -
72 Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul 1,095.00 - -
73 Digoksin Tablet 0,25 mg Tablet 104.00 - -
74 Dimenhidrinat Tablet 50 mg Tablet 99.00 - -
Dimenhidrinat Tablet 50 mg Tablet 104.00 - -
75 Domperidon Tablet 10 mg Tablet 85.00 - -
Domperidon Tablet 10 mg Tablet 95.00 - -
76 Donperidon Suspensi 5 mg/5ml Botol 2,700.00 - -
77 Efedrin Hcl Tablet 25 mg Tablet - -
78 Ekstrak Belladone Tablet 10 mg Tablet - -
79 Epinefrin HCl / Bitartrat Ampul 1,749.00 - -
Epinefrin HCl / Bitartrat Ampul 1,408.00 - -
80 Eritromisin Kapsul 250 mg Kapsul - -
81 Eritromisin Kapsul 500 mg Kapsul 730.00 - -
82 Eritromisin Sirup 200 mg / 5 ml Botol - -
83 Etambutol Tablet 500 mg Tablet - -
84 Etanol 70 % 100 ml Botol - -
Etanol 70 % 100 ml Botol 2,500.00 - -
85 Etil Klorida Semprot -100 ml Botol 246,400.00 - -
86 Eugenol Cairan -10 ml Botol 20,087.00 - -
87 Fenitoin Natrium Kapsul 100 mg Kapsul 158.00 - -
Fenitoin Natrium Kapsul 100 mg Kapsul 154.00 - -
88 Fenobarbital tablet 30 mg Tablet 1,540.00 - -
89 Fenobarbital injeksi 50 mg / ml Ampul 1,969.00 - -
90 Fenoksimeti Penisilin 250 mg tablet Tablet - -
91 Fenoksimeti Penisilin 500 mg tablet Tablet 605.00 - -
92 Fenol Gliserol TK Botol - -
93 Flufenazine decanoat injeksi 25 mg/ml Ampul - -
94 Flukonazole tablet 150 mg Tablet - -
95 Fitomenadion tablet 10 mg Tablet 710.00 - -
96 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 3,550.00 - -
Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 3,550.00 - -
97 Furosemid Tablet 40 mg Tablet 82.00 - -
98 Furosemid injeksi Ampul - -
99 Garam Oralit I serbuk, kombinasi : Kantong 257.00 - -
Garam Oralit I serbuk, kombinasi : Kantong 260.00 - -
100 Gemfibrozil Tablet 600 mg Tablet - -
101 Gentian Violet Botol - -
102 Gentamisin injeksi 80 mg / 2 ml Vial - -
103 Gentamisin Salep Kulit 0,1 % Tube 1,834.80 - -
Gentamisin Salep Kulit 0,1 % Tube 1,834.80 - -
104 Glass Ionomer Set 680,000.00 - -
105 Glibenklamid Tablet 5 mg Tablet 119.00 - -
Glibenklamid Tablet 5 mg Tablet 86.00 - -
106 Glimepiride 2 mg Tablet 207.00 - -
107 Gliseril Guayakolat Tablet 100 mg Tablet 82.50 - -
Gliseril Guayakolat Tablet 100 mg Tablet 120.00 - -
108 Gliseril Guayakolat sirup Botol 7,370.00 - -
Gliseril Guayakolat sirup Botol 8,800.00 - -
109 Glukonas Kalsikus injeksi Ampul - -
110 Glukosa Larutan Infus 5 % Botol 6,900.00 - -
111 Glukosa Larutan Infus10 % Botol 5,700.00 - -
Glukosa Larutan Infus10 % Botol 7,500.00 - -
112 Griseofulvin Tablet 125 mg,micronized Tablet 224.00 - -
Griseofulvin Tablet 125 mg,micronized Tablet 224.00 - -
113 Haloperidol Tablet 0,5 mg Tablet 55.00 - -
Haloperidol Tablet 0,5 mg Tablet 55.00 - -
114 Haloperidol Tablet 1,5 mg Tablet 59.00 - -
115 Haloperidol Tablet 5 mg Tablet 60.00 - -
Haloperidol Tablet 5 mg Tablet 75.00 - -
116 Haloperidol injeksi 5 mg/ml Ampul 6,250.00 - -
118 Hidroklortiazid (HCT) Tablet 25 mg Tablet - -
Hidroklortiazid (HCT) Tablet 25 mg Tablet 149.00 - -
119 Hidrokortison Krim 2,5 % Tube 2,475.00 - -
120 Ibuprofen Tablet 200 mg Tablet 105.00 - -
Ibuprofen Tablet 200 mg Tablet 102.00 - -
121 Ibuprofen Tablet 400 mg Tablet - -
122 Ibuprofen Suspensi 100 mg/5 ml Botol 2,365.00 - -
Ibuprofen Suspensi 100 mg/5 ml Botol 4,665.00 - -
123 Ichtyol salep Kulit Pot - -
124 Isoniazid tablet 100 mg Tablet 145.00 - -
125 Isoniazid tablet 300 mg Tablet 170.00 - -
126 Isosorbid Dinitrat 5 mg Tablet 88.00 - -
127 Kalium Diklofenak Tablet 25 mg Tablet - -
128 Kalium Diklofenak Tablet 50 mg Tablet 682.00 - -
129 Kalsium Hidroksida Pasta Tube - -
130 Kalsium Laktat Tablet 500 mg Tablet 59.00 - -
Kalsium Laktat Tablet 500 mg Tablet 63.00 - -
131 Kaptopril 12,5 mg Tablet 62.00 - -
132 Kaptopril 25 mg Tablet 75.00 - -
Kaptopril 25 mg Tablet 94.00 - -
133 Karbamazepin Tablet 200 mg Tablet 245.00 - -
Karbamazepin Tablet 200 mg Tablet 270.00 - -
134 Ketokonazole Krim 2 % - 15 gr Tube 2,518.00 - -
135 Ketokonazole Tablet 200 mg Tablet 288.00 - -
Ketokonazole Tablet 200 mg Tablet 528.00 - -
136 Ketoprofen Tablet 100 mg Tablet - -
137 Ketoprofen Injeksi 100 mg / 1 ml Ampul - -
138 Ketorolac 10 mg injeksi Ampul - -
139 Ketorolac 30 mg injeksi Ampul - -
140 Klindamisin Kapsul 150 mg Kapsul 759.00 - -
141 Klindamisin Kapsul 300 mg Kapsul - -
142 Kloramfenikol Kapsul 250 mg Kapsul 266.00 - -
143 Kloramfenikol suspensi125mg/5 ml Botol - -
144 Kloramfenikol Salep Mata 1%-3,5 g Tube 1,881.00 - -
Kloramfenikol Salep Mata 1%-3,5 g Tube 1,810.00 - -
145 Kloramfenikol Salep Kulit 2% Tube 3,008.00 - -
Kloramfenikol Salep Kulit 2% Tube 3,242.00 - -
146 Kloramfenikol Tetes Mata -5 ml Botol 6,828.80 - -
Kloramfenikol Tetes Mata -5 ml Botol 3,250.00 - -
147 Kloramfenikol Tetes Telinga 3%-5 ml Botol 6,828.80 - -
148 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 42.00 - -
Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 23.00 - -
149 Klorpromazin Hcl Tablet Salut 25 mg Tablet 212.00 - -
Klorpromazin Hcl Tablet Salut 25 mg Tablet 148.00 - -
150 Klorpromazin Hcl Tablet Salut 100 mg Tablet 147.00 - -
151 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 1,510.00 - -
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 1,240.00 - -
152 Kombinasi Ipatropium Bromide + Salbutamol Vial 4,550.00 - -
153 Kombipak Cefixime+ Azithromisin Kotak 30,030.00 - -
154
Kotrimoksazol Pedriatik Tablet, Kombinasi :
Sulfametoksazol 100 mg + Trimetroprim 20 mg Tablet
76.00 - -
155 Kotrimoksazol Tablet, Kombinasi : Tablet 125.00 - -
156 Kotrimoksazol Suspensi Kombinasi : Botol - -
Kotrimoksazol Suspensi Kombinasi : Botol 2,140.00 - -
157 Lansoprazole 30 mg Kapsul Tablet 315.00 - -
Lansoprazole 30 mg Kapsul Tablet 323.00 - -
158 Larutan mengadung Elektrolit Botol 9,275.00 - -
159 Larutan mengadung Elektrolit Botol - -
160 Larutan mengadung Karbohidrat + Elektrolit Botol - -
161 Lidokain injeksi 2 % Tablet 1,111.00 - -
Ampul
Lidokain Hcl 2% +Epinefrin 1 : 80.000-2 ml 1,845.00 - -
163 Lidokain Spray Botol 177,216.00 - -
164 Loperamid Tablet 2 mg Tablet 80.30 - -
165 Loratadin tablet 10 mg Tablet 131.00 - -
166 Magnesium Sulfat (IV) 20 %-25 ml Ampul 3,328.00 - -
167 Magnesium Sulfat (IV) 40 %-25 ml Ampul 3,796.00 - -
168 MB Anak Blister - -
169 MB Dewasa Blister 39,880.00 - -
170 Meloksikam tablet 15 mg Tablet 718.20 - -
171 Meloksikam Suppositoria Supp - -
172 Metformin Hcl Tablet 500 mg Tablet 102.00 - -
173 Metformin 850 mg Tablet 160.00 - -
174 Metildopa 250 mg tablet Tablet 946.00 - -
175 Methisoprinol 500 mg Tablet 3,300.00 - -
176 Metilergometrin Maleat (Metergin) Tablet 0,125 mg Tablet 154.00 - -
Metilergometrin Maleat (Metergin) Tablet 0,125 mg Tablet 444.00 - -
177 Metilergometrin Maleat Injeksi 0,200 mg-1ml Ampul 2,684.00 - -
Metilergometrin Maleat Injeksi 0,200 mg-1ml Ampul 2,959.00 - -
178 Metilprednisolon tablet 4 mg Tablet 143.00 - -
Metilprednisolon tablet 4 mg Tablet 150.00 - -
179 Metoklopramid 10 mg Tablet 85.00 - -
180 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul - -
181 Metronidazol Tablet 250 mg Tablet - -
182 Metronidazole Tablet 500 mg Tablet 211.20 - -
183 Metronidazole sirup 125 mg/ml Botol - -
184 Metronidazole Infus 500 mg /100 ml Ampul - -
185 Mikonazole KrIm 2 % - 10 gr Tube 3,414.00 - -
186 Multivitamin + Mineral tablet Tablet 826.10 - -
Multivitamin + Mineral tablet Tablet 792.00 - -
187 Multivitamin sirup Botol 7,100.00 - -
188 Mummifying Pasta Botol - -
189 Natrium Bikarbonat Tablet 500 mg Tablet 50.00 - -
Natrium Bikarbonat Tablet 500 mg Tablet 50.00 - -
190 Natrum Diklofenak Tablet 25 mg Tablet 145.00 - -
Natrum Diklofenak Tablet 25 mg Tablet 128.00 - -
191 Natrium Diklofenak Tablet 50 mg Tablet 115.00 - -
Natrium Diklofenak Tablet 50 mg Tablet 200.00 - -
192 Natrium Klorida Larutan infus 0,9%-Steril 500 ml Botol 6,410.00 - -
Natrium Klorida Larutan infus 0,9%-Steril 500 ml Botol 6,840.00 - -
193 Nipedifin Tablet 10 mg Tablet 193.60 - -
194 Nistatin suspensi 100.000 IU/ml Botol 13,900.00 - -
195 Nistatin 100.000 IU/gram Tablet Vagina Tablet 598.00 - -
196 Nistatin 500.000 IU/gram Tablet Salut Tablet 843.00 - -
197 Obat Antitiuberkolosis Kategori Anak Paket - -
198 Obat Antitiuberkolosis Kategori 1 Dewasa Paket 317,018.00 - -
199 Obat Antitiuberkolosis Kategori 2 Dewasa Paket - -
200 Obat Antitiuberkolosis Kategori 3 Dewasa Paket - -
201 Obat Anti Tuberkulosis FDC Kat Anak Paket 248,120.00 - -
202 Obat Anti Tuberkulosis FDC Kat I & II Paket 1,297,889.00 - -
203 Obat Anti Tuberkulosis FDC Kat I & III Paket 415,469.00 - -
204 Obat Anti Tuberkolosis FDC Sisipan Dewasa Paket - -
205 Obat Batuk Hitam (OBH) Cairan 100 ml Botol 4,697.00 - -
Obat Batuk Hitam (OBH) Cairan 100 ml Botol 6,050.00 - -
206 Obat Batuk Cair Sirup (Ekspektoran) Botol 7,106.00 - -
Obat Batuk Cair Sirup (Ekspektoran) Botol 6,760.00 - -
207 Obat Batuk Hitam Plus Sirup Botol 4,697.00 - -
208 Obat Flu Sirup Botol - -
209 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 ml Vial - -
210 Oksiterasiklin Salep Mata 1%-3,5g Tube 2,500.00 - -
Oksiterasiklin Salep Mata 1%-3,5g Tube 2,500.00 - -
211 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2,412.30 - -
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2,005.00 - -
212 Oksitosin Injeksi 10 IU/ml-1ml Ampul 1,199.00 - -
213 Omeprazole injeksi 40mg/10ml Ampul 16,997.00 - -
214 Omeprazole Kapsul 20 mg Tablet 341.81 - -
215 Ondansetron inj 4 mg/ 2 mL Ampul 1,650.00 - -
216 Parasetamol drop 100 mg/ml btl @15ml (60mg/0,6ml) Botol 6,649.00 - -
217 Parasetamol Sirup 120 mg/5ml-60 ml Botol 1,107.00 - -
Parasetamol Sirup 120 mg/5ml-60 ml Botol 1,010.00 - -
218 Parasetamol Tablet 100 mg Tablet - -
219 Parasetamol Tablet 500 mg Tablet 53.00 - -
Parasetamol Tablet 500 mg Tablet 49.00 - -
220 PB Anak Blister - -
221 PB Dewasa Blister - -
222 Pehacain injeksi Ampul 3,051.40 - -
Pehacain injeksi Ampul 3,080.00 - -
223 Perak Sulfadiazin krim 1 % 35 gr Tube 23,000.00 - -
224 Permetrin krim 5 % Tube 11,825.00 - -
225 Piracetam Tablet 400 mg Tablet 451.00 - -
226 Piracetam Tablet 800 mg Tablet 803.00 - -
227 Piroksikam Tablet 20 mg Tablet 156.20 - -
Piroksikam Tablet 20 mg Tablet 130.00 - -
228 Pirantel Pamoat Tablet 365 mg (Setara dng 125 mg
Tablet
Basa) 291.00 - -
229 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 123.00 - -
230 Piridoksin Hcl (Vit.B6) Tablet 25 mg Tablet - -
231 Povidon Iodida 10% 30 ml Botol 3,360.00 - -
232 Povidon Iodida 10% 60 ml Botol - -
233 Povidon Iodida 10% 300 ml Botol 18,900.00 - -
234 Prednison Tablet 5 mg Tablet 73.00 - -
Prednison Tablet 5 mg Tablet 96.00 - -
235 Primakuin tablet 15 mg Tablet - -
236 Prokain Benzil Penisilin Injeksi 3,000,000 IU Vial - -
237 Propanolol Hcl Tablet 40 mg Tablet 76.00 - -
238 Propilturasil Tablet 100 mg Tablet 586.30 - -
239 Ranitidin Injeksi 25 mg / ml Ampul - -
240 Ranitidin Tablet 150 mg Tablet 112.00 - -
Ranitidin Tablet 150 mg Tablet 98.00 - -
241 Retinol (Vit. A) 100.000 IU Kapsul Kapsul 307.00 - -
242 Retinol (Vit. A) 200.000 IU Kapsul Kapsul 517.00 - -
243 Reserpin Tablet 0, 25 mg Tablet - -
244 Rifampisin Tablet 450 mg Tablet - -
245 Ringer Laktat Larutan Infus Steril 500 ml Botol - -
Ringer Laktat Larutan Infus Steril 500 ml Botol 7,150.00 - -
246 Salbutamol Tablet 2 mg Tablet 63.00 - -
247 Salbutamol Tablet 4 mg Tablet 70.00 - -
248 Salbutamol solution for Inhalation single dose units 2,5
Ampul
ml 4,550.00 - -
249 Salep 2-4 Kombinasi : Pot 2,621.00 - -
Salep 2-4 Kombinasi : Pot 2,429.00 - -
250 Salisil bedak 2% -50 gr Kotak 1,025.00 - -
Salisil bedak 2% -50 gr Kotak 5,856.40 - -
251 Salep Luka Bakar Tube 11,718.25 - -
Salep Luka Bakar Tube 19,690.00 - -
252 Sefadroksil Sirup Kering 125 mg / 5 ml sirup Botol 3,980.00 - -
253 Sefadroksil Tablet 500 mg Tablet 450.00 - -
254 Sefiksim Kapsul 100 mg Kapsul - -
255 Sefiksim 400 mg + Azitromisin 1000 mg Paket - -
256 Sefotaksim Injeksi 1 gr Ampul - -
257 Seftriakson Injeksi 1 gr / vial Ampul - -
258 Semen Seng Fosfat Serbuk & Cairan Botol - -
259 Setirizin Tablet 10 mg Tablet 90.00 - -
Setirizin Tablet 10 mg Tablet 96.00 - -
260 Setirizin Sirup 5 mg / 5 ml Botol 2,915.00 - -
Setirizin Sirup 5 mg / 5 ml Botol 3,150.00 - -
261 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul 1,098.00 - -
262 Sianokobalamin Tablet 50 mcg Tablet 49.00 - -
263 Silver Amalgam Serbuk 65-75% Botol - -
264 Simetidin 200 mg Tablet Tablet 176.00 - -
265 Simvastatin Tablet 10 mg Tablet 117.00 - -
Simvastatin Tablet 10 mg Tablet 117.00 - -
266 Siprofloksasin 500mg Tablet 530.20 - -
267 Spironolakton Tablet 25 mg Tablet 208.00 - -
268 Sulfacetamid Tetes Mata 15 %-5ml Botol - -
269 Tablet Tambah Darah Kombinasi: Tablet 353.00 - -
Tablet Tambah Darah Kombinasi: Tablet 350.00 - -
270
Temporary Stopping Fletcher (Fletcher) Serbuk & Cairan Set
- -
271 Trikesol formalin ( T K F ) Cairan 10 ml Botol - -
272 Tetrasiklin Kapsul 250 mg Kapsul 163.00 - -
273 Tetrasiklin Kapsul 500 mg Kapsul 310.00 - -
274 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1ml Ampul 1,140.00 - -
275 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 85.00 - -
Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 mg Tablet 91.00 - -
276 Thiamfenikol Kapsul 500 mg Kapsul 837.00 - -
Thiamfenikol Kapsul 500 mg Kapsul 921.00 - -
277 Tramadol Injeksi 50 mg/ ml Ampul - -
278 Tramadol Tablet 50 mg Tablet - -
279 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 85.00 - -
Triheksifenidil Hidroklorida Tablet 2 mg Tablet 88.00 - -
280 Vitamin B .Komplek Tablet Tablet 89.00 - -
281 Vitamin Neurotropik Tablet Tablet 856.90 - -
Vitamin Neurotropik Tablet Tablet 660.00 - -
282 Zinc Tablet 20 mg Tablet 508.00 - -
Zinc Tablet 20 mg Tablet 524.00 - -
283 Zinc Sulfat 20 mg/5 ml Botol 3,171.00 - -
284 Hepatorotector tablet (Curcuma) Tablet - -
285 Obat Batuk Herbal Botol 9,680.00 - -
286 Obat Kumur Botol 16,962.00 - -
287 Salep Kloramfenikol + Hidrokortison Tube 13,200.00 - -
288 Tablet Pemanis Botol 33,000.00 - -
289 Bahan Pembersih Kavitas Botol 150,000.00 - -
290 Flour Gel Botol 49,500.00 - -
291 Glass Ionomer Posterior Set 775,000.00 - -
292 Hyposol 3 % Botol 78,100.00 - -
293 Paramonochlorofenol/CHKM Botol 50,000.00 - -
294 Saliva Ejector Pcs 660.00 - -
295 Salep Betameson + Neomisin Tube 12,793.00 - -
Salep Betameson + Neomisin Tube 13,138.40 - -
296 Curcuma Tablet 462.00 - -
Curcuma Tablet 416.20 - -
297 Gentamisin injeksi 40 mg/ml Ampul 5,900.00 - -
298 Bisoprolol Tablet 2,5 mg Tablet 626.00 - -
299 Klobazam 10 mg Tablet 776.00 - -
300 Klozapin 25 mg Tablet 1,121.00 - -
301 Risperidon 2 mg Tablet 287.00 - -
302 Gentamisin Tetes Mata 0,3% Botol 4,232.00 - -
Vitamin D 1000 IU Tablet 1,089.53 1,500 1,634,295.00
B. BAHAN MEDIS HABIS PAKAI (BMHP) - -
1 Abbocath No 18 ( IV Chateter 18 ) Buah 8,950.00 - -
5 Alat Gula, Kolesterol, Asam Urat Unit - -
6 Alat Suntik Sekali Pakai 1 ml Set - -
8 Set
Alat Suntik Sekali Pakai 5 ml 1,045.00 - -
10 Alkohol Swab Kotak 116.04 - -
Alkohol Swab Kotak 95.00 - -
11 Auto Disposable Syringe (ADS) 0,05 ml Set 1,101.00 - -
12 Auto Disposable Syringe (ADS) 0,5 ml Set 1,050.00 - -
13 Auto Disposable Syringe (ADS) 5 ml Set 1,640.00 - -
14 Blood Set Set - -
15 Catgut/Benang Bedah No.2/0 Plain Sachet 26,666.67 - -
Catgut/Benang Bedah No.2/0 Plain Sachet 34,300.00 - -
16 Catgut/Benang Bedah No.3/0 Cromic Sachet 33,250.00 - -
Catgut/Benang Bedah No.3/0 Cromic Sachet 33,538.00 - -
17 Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 3,150.00 - -
Etakridin Larutan (Rivanol) 0,1% - 300 ml Botol 2,677.50 - -
18 Etanol 70 % 1.000 ml Botol 26,250.00 - -
19 Eter Alkohol Botol - -
20 Folley Catheter no 14 Set 18,450.00 - -
23 Infus set Anak Set 9,900.00 - -
24 Infus set Dewasa Set 9,070.00 - -
25 Iodina Test Botol 10,725.00 - -
26 Kaca Slide Pcs - -
27 Kapas Berlemak 500 gram Bungkus - -
28 Kapas Pembalut / Adsorbens 250 gram Bungkus 24,000.00 - -
Kapas Pembalut / Adsorbens 250 gram Bungkus 12,875.00 - -
29 Kassa Pembalut 2 m x 80 cm Rol 9,400.00 - -
30 Kassa Pembalut Hidrofil 4 m x 3 cm Rol 800.00 - -
31 Kassa Pembalut Hidrofil 4 m x 15 cm Rol 3,800.00 - -
32 Kassa Hidrofil Steril 16 x 16 Kotak 7,900.00 - -
Kassa Hidrofil Steril 16 x 16 Kotak 8,240.00 - -
33 Kassa Kompres 40 x 40 steril Bungkus 1,393.00 - -
34 Kertas Puyer Pcs 75.90 - -
35 Kertas Saring Lembar - -
36 Kertas Lensa Lembar - -
37 Lysol 1,000 ml Botol 43,050.00 - -
38 Masker Buah 3,758.37 - -
39 Masker N 95 Pcs - -
40 Minyak Imersi Botol - -
41 Plester Kertas Rol 15,333.33 - -
42 Polifix 5 cm x 5 m Rol - -
Polifix 5 cm x 5 m Rol 39,749.00 - -
43 Pot Dahak Pcs 2,728.00 - -
44 Rapid 2 HIV Fokus Test 13,235.00 - -
45 Rapid HIV 1 (SD HIV) Test 11,975.00 - -
46 Rapid HIV 2 (Intec HIV) Test - -
47 Rapid HIV 2 (Biomeriux HIV) Test - -
48 Rapid Tes SD Bioline HBSAG Test - -
49 Rapid Test Syphilis Test 20,400.00 - -
50 Reagen CD 4 Control Test - -
51 Reagen CD 4 Test - -
52 Reagen Ziehl Nielsen Botol 232,440.00 - -
53 RPR Test Syphilis Test 4,120.00 - -
54 Silk( Benang Bedah Sutra ) No 3/0 Sachet - -
55 Safety Box Pcs 14,000.00 - -
56 Sarung tangan Steril No 6 Pcs 4,500.00 - -
57 Sarung tangan Steril No 7 Pcs 4,500.00 - -
Sarung tangan Steril No 7 Pcs 6,595.00 - -
58 Sarung tangan Steril No 7,5 Pcs 6,595.00 - -
59 Sarung tangan Non Steril S Pcs 1,050.00 - -
60 Sarung tangan Non Steril M Pcs 1,050.00 - -
61 Sarung tangan Non Steril L Pcs 1,050.00 - -
Sarung tangan Non Steril L Pcs 990.00 - -
62 Sountimer Buah - -
63 Stik Pemeriksaan Gula Darah Test - -
64 Stik Pemeriksaan Kolesterol Test - -
65 Stik Pemeriksaan Asam Urat Test - -
66 Supratul Lembar 10,400.00 - -
67 Urine Bag set - -
68 Wing Neddle No 23 Set - -
69 Blood Lancet Pcs 150.03 - -
Blood Lancet Pcs 144.20 - -
70 Cairan Antiseptik Botol 500 ml Botol 60,800.00 - -
71 Rapin HIV Oncoprobe Test - -
73 Detergent 5 Liter Galon 712,800.00 - -
74 Desinfektan 5 Liter Galon 396,000.00 - -
75 Saliva Ejector 968.00 - -
76 Pharmafix Rol 30,000.00 - -
77 Slide Pcs 31,347.00 - -
78 Vikia Biumerc Test 19,480.00 - -
79 Baju APD Pcs 312,500.10 - -
80 Sepatu Boot Safety Pcs 262,499.60 - -
81 Kacamata Google Pcs 131,249.80 - -
82 Sarung Tangan Karet Latex Pcs 56,249.60 - -
83 Rapid Test Antigen Test 40,000.00 125 5,000,000.00
Indoswab Covid-19 Antigen Rapid Test 18,182.00 -
84 Masker Kain Headloop Pcs 5,500.00 - -
85 Masker Kain Earloop Pcs 5,500.00 - -
86 Masker N 95 Pcs 22,500.00 60 1,350,000.00
87 Calcetin Calcium Hidroxide Paste Botol 134,214.29 - -
88 Cresotin Paste Pot 112,214.29 - -
89 Cresotin Liquid No 2 Pot 160,714.29 - -
90 Hyposol 3 % Botol 78,750.00 - -
91 Pulp X Pot 217,214.29 - -
92 Trioresolformalina Botol 72,214.29 - -
93 Faceshield Pcs 10,000.00 50 500,000.00
94 Handrub 100 ml Botol 8,000.00 9 72,000.00
95 Handrub 500 ml Botol 30,000.00 22 660,000.00
96 Gown Pcs 254,500.00 5 1,272,500.00
- -
C. SERUM DAN VAKSIN - -
1 Serum Anti Bisa Ular Polivalen Injeksi 5 ml (ABU I ) Vial 479,996.00 - -
Serum Anti Bisa Ular Polivalen Injeksi 5 ml (ABU I ) Vial 512,204.00 - -
2 Serum Anti Rabies untuk manusia Vial - -
3 Serum Anti Tetanus (ATS) Injeksi 1.500 IU/ampul Ampul - -
4 Serum Anti Tetanus (ATS) Injeksi 20.000 IU/ampul Vial - -
5 Human Tetanus Imunoglobin inj 250 IU Vial - -
6 Vaksin BCG Ampul 59,950 - -
Vaksin BCG Ampul 66,154 - -
7 Vaksin Campak 10 Dosis Vial - -
8 Vaksin DT Vial - -
9 Vaksin TD Vial 18,128 - -
Vaksin TD Vial 16,995 - -
10 Vaksin DTP-HB Vial - -
11 Vaksin DPT-HB/Hib Vial 76,285 - -
Vaksin DPT-HB/Hib Vial 84,282 - -
12 Vaksin HB Uniject Pcs 20,900 - -
Vaksin HB Uniject Pcs 25,597 - -
13 Vaksin MR (VVM.A) Vial 166,265 - -
14 Vaksin Polio Vial 21,285 - -
Vaksin Polio Vial 19,954 - -
15 Vaksin Polio IPV 5 Dosis Vial 158,994 - -
Vaksin Polio IPV 5 Dosis Vial 144,540 - -
16 Vaksin Polio 10 IPV Dosis Vial - -
17 Vaksin TT Vial - -
18 Vaksin Covid 19 (CoronaVac) Vial 211,282 - -
19 -
20 -
JUMLAH TOTAL OBAT 1,634,295.00

JUMLAH TOTAL BMHP 8,854,500.00
JUMLAH TOTAL VAKSIN SERUM -
JUMLAH TOTAL KESELURUHAN 10,488,795.00
JUMLAH PENERIMAAN APRIL 2022 PENGELUARAN APRILRET 2022 SALDO AKHIR A

APBD APBD APBD
HARGA SATUAN BANYAKNYA NILAI RP. HARGA SATUAN BANYAKNYA NILAI RP. HARGA SATUAN
(RP) (RP) (RP)
- - - - -
1,041.98 - 1,041.98 - 1,041.98
- 292.00 - 292.00
4,000.00 - 4,000.00 - 4,000.00
105.00 - 105.00 - 105.00
99.00 - - - -
- - - - -
143.55 - 143.55 - 143.55
151.80 - 151.80 - 151.80
3,626.70 - 3,626.70 - 3,626.70
3,619.00 - 3,619.00 - 3,619.00
2,998.00 - 3,822.00 - 3,822.00
95.00 - 95.00 - 95.00
- 91.00 - 91.00
167.00 - 143.00 - 143.00
- 171.44 - 171.44
75.00 - 75.00 - 75.00
- 85.00 - 85.00
99.00 - 99.00 - 99.00
- 104.00 - 104.00
196.00 - 196.00 - 196.00
- 195.00 - 195.00
249.00 - 249.00 - 249.00
- 232.00 - 232.00
8,100.00 - - - -
3,500.00 - 3,500.00 - 3,500.00
3,628.00 - 3,628.00 - 3,628.00
- 3,473.00 - 3,473.00
- - - - -
- - - - -
- - - - -
8,237.00 - 8,237.00 - 8,237.00
- - - - -
1,995.00 - 1,995.00 - 1,995.00
2,129.00 - 2,129.00 - 2,129.00
58.00 - 58.00 - 58.00
- 58.00 - 58.00
189.05 - 189.05 - 189.05
203.30 - - - -
- 170.00 - 170.00
1,455.00 - - - -
3,035.00 - 2,924.00 - 2,924.00
3,167.00 - 3,167.00 - 3,167.00
4,798.00 - 4,798.00 - 4,798.00
- 4,158.00 - 4,158.00
173.00 - - - -
- 167.00 - 167.00
- - - - -
233.20 - 233.20 - 233.20
253.00 - 253.00 - 253.00
253.00 - 253.00 - 253.00
- - 2,112.00 - 2,112.00
208.00 - 208.00 - 208.00
- - 1,195.10 - 1,195.10
11,550.00 - 11,550.00 - 11,550.00
- - - - -
75.00 - 75.00 - 75.00
105.00 - 105.00 - 105.00
- 104.00 - 104.00
103.40 - 103.40 - 103.40
177.90 - 177.90 - 177.90
382.00 - 382.00 - 382.00
105.00 - 105.00 - 105.00
- 114.00 - 114.00
- - - - -
- - - - -
2,996.40 - 2,996.40 - 2,996.40
- 3,600.00 - 3,600.00
249.00 - 237.00 - 237.00
380.00 - 345.00 - 345.00
380.00 - 380.00 - 380.00
152.00 - 152.00 - 152.00
1,639.00 - 1,639.00 - 1,639.00
2,860.00 - 2,860.00 - 2,860.00
150,000.00 - 130,000.00 - 130,000.00
14,500.00 - 14,500.00 - 14,500.00
110.00 - 110.00 - 110.00
- 660.00 - 660.00
1,340.00 - - - -
- 1,380.00 - 1,380.00
- - - - -
- - - - -
- - 250.80 - 250.80
112,000.00 - 112,000.00 - 112,000.00
160,500.00 - 160,500.00 - 160,500.00
1,097.00 - 1,097.00 - 1,097.00
32.00 - 32.00 - 32.00
- 44.00 - 44.00
- 41.00 - 41.00
- - 220,000.00 - 220,000.00
86.00 - 86.00 - 86.00
114.00 - 114.00 - 114.00
1,735.00 - 1,735.00 - 1,735.00
12,573.00 - 12,090.00 - 12,090.00
12,573.00 - 12,573.00 - 12,573.00
- - 16,742.00 - 16,742.00
156.00 - 156.00 - 156.00
1,095.00 - 1,095.00 - 1,095.00
104.00 - 104.00 - 104.00
99.00 - 99.00 - 99.00
- 104.00 - 104.00
- 141.90 - 141.90
85.00 - 85.00 - 85.00
- 95.00 - 95.00
2,700.00 - 2,700.00 - 2,700.00
- - - - -
- - - - -
1,408.00 - 1,749.00 - 1,749.00
1,408.00 - 1,408.00 - 1,408.00
- - - - -
750.00 - 730.00 - 730.00
- - - - -
505.00 - - - -
- - - - -
- 2,500.00 - 2,500.00
246,400.00 - 246,400.00 - 246,400.00
20,087.00 - 20,087.00 - 20,087.00
158.00 - 158.00 - 158.00
- 154.00 - 154.00
171.00 - 1,540.00 - 1,540.00
1,857.00 - 1,969.00 - 1,969.00
- - - - -
- - 605.00 - 605.00
- - - - -
- - - - -
- - - - -
710.00 - 710.00 - 710.00
3,550.00 - 3,550.00 - 3,550.00
- 3,550.00 - 3,550.00
82.00 - 82.00 - 82.00
- - - - -
257.00 - 257.00 - 257.00
- 260.00 - 260.00
- - - - -
- - - - -
1,834.80 - - - -
- - 1,834.80 - 1,834.80
1,834.80 - 1,834.80 - 1,834.80
687,500.00 - 680,000.00 - 680,000.00
119.00 - 119.00 - 119.00
- 86.00 - 86.00
207.00 - 207.00 - 207.00
82.50 - 82.50 - 82.50
120.00 - 120.00 - 120.00
7,370.00 - 7,370.00 - 7,370.00
8,800.00 - 8,800.00 - 8,800.00
10,351.00 - - - -
6,900.00 - 6,900.00 - 6,900.00
7,500.00 - 5,700.00 - 5,700.00
- 7,500.00 - 7,500.00
224.00 - 224.00 - 224.00
224.00 - 224.00 - 224.00
55.00 - 55.00 - 55.00
55.00 - 55.00 - 55.00
59.00 - 59.00 - 59.00
60.00 - 60.00 - 60.00
- 75.00 - 75.00
6,250.00 - 6,250.00 - 6,250.00
101,300.00 - 97,500.00 - 97,500.00
- - - - -
- 149.00 - 149.00
2,475.00 - 2,475.00 - 2,475.00
105.00 - 105.00 - 105.00
- 102.00 - 102.00
122.00 - - - -
- 111.00 - 111.00
2,365.00 - 2,365.00 - 2,365.00
4,665.00 - 4,665.00 - 4,665.00
- - - - -
145.00 - 145.00 - 145.00
173.00 - 170.00 - 170.00
- - 88.00 - 88.00
- - - -
287.85 - 682.00 - 682.00
- - - - -
59.00 - 59.00 - 59.00
- 63.00 - 63.00
62.00 - 62.00 - 62.00
75.00 - 75.00 - 75.00
94.00 - 94.00 - 94.00
245.00 - 245.00 - 245.00
- 270.00 - 270.00
2,518.00 - 2,518.00 - 2,518.00
288.00 - 288.00 - 288.00
- 528.00 - 528.00
- - - - -
- - - - -
- - - - -
1,045.00 - - - -
759.00 - 759.00 - 759.00
- - - - -
- - 266.00 - 266.00
- - - - -
1,881.00 - 1,881.00 - 1,881.00
- 1,810.00 - 1,810.00
- - 3,008.00 - 3,008.00
3,242.00 - 3,242.00 - 3,242.00
6,828.80 - 6,828.80 - 6,828.80
- 3,250.00 - 3,250.00
6,828.80 - 6,828.80 - 6,828.80
22.00 - 42.00 - 42.00
23.00 - 23.00 - 23.00
212.00 - 212.00 - 212.00
- 148.00 - 148.00
147.00 - 147.00 - 147.00
- 144.00 - 144.00
1,510.00 - 1,510.00 - 1,510.00
- 1,240.00 - 1,240.00
4,550.00 - 4,550.00 - 4,550.00
30,030.00 - 30,030.00 - 30,030.00
- - 76.00 - 76.00
125.00 - 125.00 - 125.00
2,052.00 - - - -
- 2,140.00 - 2,140.00
303.00 - 315.00 - 315.00
323.00 - 323.00 - 323.00
9,646.00 - 9,275.00 - 9,275.00
9,644.00 - - - -
10,696.00 - - - -
- - 1,111.00 - 1,111.00
- - 1,845.00 - 1,845.00
- - 177,216.00 - 177,216.00
80.30 - 80.30 - 80.30
131.00 - 131.00 - 131.00
3,328.00 - 3,328.00 - 3,328.00
3,796.00 - 3,796.00 - 3,796.00
20,554.00 - - - -
39,880.00 - 39,880.00 - 39,880.00
718.20 - 718.20 - 718.20
- - - - -
102.00 - 102.00 - 102.00
160.00 - 160.00 - 160.00
946.00 - 946.00 - 946.00
3,300.00 - 3,300.00 - 3,300.00
210.00 - 154.00 - 154.00
- 444.00 - 444.00
- 2,684.00 - 2,684.00
2,959.00 - 2,959.00 - 2,959.00
143.00 - 143.00 - 143.00
- 150.00 - 150.00
85.00 - 85.00 - 85.00
4,400.00 - - - -
- - - - -
211.20 - 211.20 - 211.20
- - - - -
8,110.00 - - - -
3,414.00 - 3,414.00 - 3,414.00
826.10 - 826.10 - 826.10
792.00 - 792.00 - 792.00
7,100.00 - 7,100.00 - 7,100.00
- - - - -
50.00 - 50.00 - 50.00
- 50.00 - 50.00
- 145.00 - 145.00
128.00 - 128.00 - 128.00
115.00 - 115.00 - 115.00
- 200.00 - 200.00
6,410.00 - 6,410.00 - 6,410.00
6,840.00 - 6,840.00 - 6,840.00
193.60 - 193.60 - 193.60
13,900.00 - 13,900.00 - 13,900.00
598.00 - 598.00 - 598.00
843.00 - 843.00 - 843.00
232,518.00 - - - -
317,018.00 - 317,018.00 - 317,018.00
- - - - -
- - - - -
248,120.00 - 248,120.00 - 248,120.00
1,297,889.00 - 1,297,889.00 - 1,297,889.00
415,469.00 - 415,469.00 - 415,469.00
- - - - -
4,697.00 - 4,697.00 - 4,697.00
6,050.00 - 6,050.00 - 6,050.00
7,106.00 - 7,106.00 - 7,106.00
- 6,760.00 - 6,760.00
4,697.00 - 4,697.00 - 4,697.00
- - - - -
- - - - -
2,500.00 - 2,500.00 - 2,500.00
2,500.00 - 2,500.00 - 2,500.00
2,412.30 - 2,412.30 - 2,412.30
- 2,005.00 - 2,005.00
1,199.00 - 1,199.00 - 1,199.00
9,898.00 - 16,997.00 - 16,997.00
341.81 - 341.81 - 341.81
1,070.00 - 1,650.00 - 1,650.00
6,649.00 - 6,649.00 - 6,649.00
1,107.00 - 1,107.00 - 1,107.00
- 1,010.00 - 1,010.00
- - - - -
53.00 - 53.00 - 53.00
- 49.00 - 49.00
- - - - -
12,569.00 - - - -
3,051.40 - 3,051.40 - 3,051.40
- 3,080.00 - 3,080.00
- - 23,000.00 - 23,000.00
11,825.00 - 11,825.00 - 11,825.00
459.80 - 451.00 - 451.00
800.80 - 803.00 - 803.00
156.20 - 156.20 - 156.20
- 130.00 - 130.00
- - 291.00 - 291.00
123.00 - 123.00 - 123.00
- - - - -
3,360.00 - 3,360.00 - 3,360.00
- - - - -
18,900.00 - 18,900.00 - 18,900.00
73.00 - 73.00 - 73.00
- 96.00 - 96.00
- - - - -
- - - - -
76.00 - 76.00 - 76.00
586.30 - 586.30 - 586.30
1,155.00 - - - -
112.00 - 112.00 - 112.00
- 98.00 - 98.00
307.00 - 307.00 - 307.00
517.00 - 517.00 - 517.00
- - - - -
- - - - -
7,150.00 - - - -
- 7,150.00 - 7,150.00
63.00 - 63.00 - 63.00
70.00 - 70.00 - 70.00
4,550.00 - 4,550.00 - 4,550.00

2,621.00 - 2,621.00 - 2,621.00
- 2,429.00 - 2,429.00
- 2,527.00 - 2,527.00
1,020.00 - 1,025.00 - 1,025.00
5,856.40 - 5,856.40 - 5,856.40
11,718.25 - 11,718.25 - 11,718.25
- 19,690.00 - 19,690.00
3,922.00 - 3,980.00 - 3,980.00
478.00 - 450.00 - 450.00
31,231.00 - - - -
31,231.00 - - - -
4,200.00 - - - -
4,483.00 - - - -
- - - - -
90.00 - 90.00 - 90.00
- 96.00 - 96.00
2,915.00 - 2,915.00 - 2,915.00
- 3,150.00 - 3,150.00
1,035.00 - 1,098.00 - 1,098.00
49.00 - 49.00 - 49.00
- - - - -
163.90 - 176.00 - 176.00
117.00 - 117.00 - 117.00
117.00 - 117.00 - 117.00
- 111.00 - 111.00
530.20 - 530.20 - 530.20
208.00 - 208.00 - 208.00
- - - - -
353.00 - 353.00 - 353.00
350.00 - 350.00 - 350.00
- - - - -
- - - - -
174.00 - 163.00 - 163.00
- - 310.00 - 310.00
1,139.60 - 1,140.00 - 1,140.00
85.00 - 85.00 - 85.00
91.00 - 91.00 - 91.00
837.00 - 837.00 - 837.00
921.00 - 921.00 - 921.00
- - - - -
- - - - -
85.00 - 85.00 - 85.00
- 88.00 - 88.00
89.00 - 89.00 - 89.00
856.90 - 856.90 - 856.90
- 660.00 - 660.00
508.00 - 508.00 - 508.00
- 524.00 - 524.00
3,171.00 - 3,171.00 - 3,171.00
462.00 - - - -
9,680.00 - 9,680.00 - 9,680.00
16,962.00 - 16,962.00 - 16,962.00
13,200.00 - 13,200.00 - 13,200.00
33,000.00 - 33,000.00 - 33,000.00
- - 150,000.00 - 150,000.00
- - 49,500.00 - 49,500.00
- - 775,000.00 - 775,000.00
- - 78,100.00 - 78,100.00
- - 50,000.00 - 50,000.00
- - 660.00 - 660.00
- - 12,793.00 - 12,793.00
13,138.40 - 13,138.40 - 13,138.40
- - 462.00 - 462.00
416.20 - 416.20 - 416.20
5,900.00 - 5,900.00 - 5,900.00
626.00 - 626.00 - 626.00
776.00 - 776.00 - 776.00
1,121.00 - 1,121.00 - 1,121.00
287.00 - 287.00 - 287.00
4,232.00 - 4,232.00 - 4,232.00
217.00 - 217.00 - 217.00
1,089.53 - 1,089.53 - 1,089.53
- - - - -
3,914.00 - 8,950.00 - 8,950.00
3,914.00 - 7,334.00 - 7,334.00
8,700.00 - 8,950.00 - 8,950.00
- - 8,950.00 - 8,950.00
- - - - -
- - - - -
792.00 - - - -
1,045.00 - 1,045.00 - 1,045.00
1,298.00 - - - -
116.04 - 116.04 - 116.04
95.00 - 95.00 - 95.00
1,101.00 - 1,101.00 - 1,101.00
1,050.00 - 1,050.00 - 1,050.00
1,640.00 - 1,640.00 - 1,640.00
10,430.00 - - - -
26,666.67 - 26,666.67 - 26,666.67
34,300.00 - 34,300.00 - 34,300.00
37,203.00 - 33,250.00 - 33,250.00
33,538.00 - 33,538.00 - 33,538.00
3,150.00 - 3,150.00 - 3,150.00
- 2,677.50 - 2,677.50
26,250.00 - 26,250.00 - 26,250.00
- - - - -
18,450.00 - 18,450.00 - 18,450.00
18,450.00 - 18,450.00 - 18,450.00
18,450.00 - 18,450.00 - 18,450.00
9,900.00 - 9,900.00 - 9,900.00
9,070.00 - 9,070.00 - 9,070.00
10,725.00 - 10,725.00 - 10,725.00
55,000.00 - - - -
- - - - -
24,000.00 - 24,000.00 - 24,000.00
12,875.00 - 12,875.00 - 12,875.00
- - 9,400.00 - 9,400.00
- - 800.00 - 800.00
3,800.00 - 3,800.00 - 3,800.00
7,900.00 - 7,900.00 - 7,900.00
8,240.00 - 8,240.00 - 8,240.00
1,800.00 - 1,393.00 - 1,393.00
75.90 - 75.90 - 75.90
10,000.10 - - - -
- - - - -
43,050.00 - 43,050.00 - 43,050.00
3,758.37 - 3,758.37 - 3,758.37
23,750.00 - - - -
- - - - -
15,333.33 - 15,333.33 - 15,333.33
- - - - -
- 39,749.00 - 39,749.00
2,728.00 - 2,728.00 - 2,728.00
13,235.00 - 13,235.00 - 13,235.00
11,975.00 - 11,975.00 - 11,975.00
74,002.50 - - - -
19,500.00 - - - -
9,878.00 - - - -
20,400.00 - 20,400.00 - 20,400.00
- - - - -
- - - - -
232,440.00 - 232,440.00 - 232,440.00
4,120.00 - 4,120.00 - 4,120.00
35,077.00 - - - -
14,000.00 - 14,000.00 - 14,000.00
4,500.00 - 4,500.00 - 4,500.00
4,500.00 - 4,500.00 - 4,500.00
6,595.00 - 6,595.00 - 6,595.00
6,595.00 - 6,595.00 - 6,595.00
1,050.00 - 1,050.00 - 1,050.00
1,050.00 - 1,050.00 - 1,050.00
1,050.00 - 1,050.00 - 1,050.00
990.00 - 990.00 - 990.00
- - - - -
- - - - -
- - - - -
- - - - -
10,400.00 - 10,400.00 - 10,400.00
3,090.00 - - - -
- - - - -
150.03 - 150.03 - 150.03
144.20 - 144.20 - 144.20
60,800.00 - 60,800.00 - 60,800.00
86,680.00 - - - -
- - 97,500.00 - 97,500.00
- - 712,800.00 - 712,800.00
- - 396,000.00 - 396,000.00
- - 968.00 - 968.00
30,000.00 - 30,000.00 - 30,000.00
31,347.00 - 31,347.00 - 31,347.00
19,480.00 - 19,480.00 - 19,480.00
312,500.10 - 312,500.10 - 312,500.10
262,499.60 - 262,499.60 - 262,499.60
131,249.80 - 131,249.80 - 131,249.80
56,249.60 - 56,249.60 - 56,249.60
40,000.00 - 40,000.00 - 40,000.00
18,182.00 200.00 3,636,400.00 18,182.00 - 18,182.00
5,500.00 - 5,500.00 - 5,500.00
5,500.00 - 5,500.00 - 5,500.00
22,500.00 - 22,500.00 - 22,500.00
134,214.29 - 134,214.29 - 134,214.29
112,214.29 - 112,214.29 - 112,214.29
160,714.29 - 160,714.29 - 160,714.29
78,750.00 - 78,750.00 - 78,750.00
217,214.29 - 217,214.29 - 217,214.29
72,214.29 - 72,214.29 - 72,214.29
10,000.00 - 10,000.00 - 10,000.00
8,000.00 - 8,000.00 - 8,000.00
30,000.00 - 30,000.00 - 30,000.00
254,500.00 - 254,500.00 - 254,500.00
- - - -
- - - - -
479,996.00 - 479,996.00 - 479,996.00
512,204.00 - 512,204.00 - 512,204.00
- - - - -
176,800.00 - - - -
- - - - -
- - - - -
61,996.00 - 59,950.00 - 59,950.00
66,154.00 - 66,154.00 - 66,154.00
- - - - -
17,996.00 - - - -
18,128.00 - 18,128.00 - 18,128.00
16,995.00 - 16,995.00 - 16,995.00
- - - - -
- - 76,285.00 - 76,285.00
84,282.00 - 84,282.00 - 84,282.00
23,991.00 - 20,900.00 - 20,900.00
25,597.00 - 25,597.00 - 25,597.00
166,265.00 - 166,265.00 - 166,265.00
21,285.00 - 21,285.00 - 21,285.00
19,954.00 - 19,954.00 - 19,954.00
158,994.00 - 158,994.00 - 158,994.00
144,540.00 - 144,540.00 - 144,540.00
- - - - -
- - - - -
211,282.00 - 211,282.00 - 211,282.00
- - - - -
- - - - -
- -
3,636,400.00 -
- -
3,636,400.00 -
KONTROL
APBD
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- -
- - - -
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- - -
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- -
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- -
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- -
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- -
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- -
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- -
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- -
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- -
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- - - -
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- - - -
- -
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- -
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- - - -
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- - - -
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- -
- -
- - - -
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- - - -
- - - -
- - - -
- -
- - - -
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- - - -
- - - -
- - -
- -
- - - -
- -
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- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - -
- - - -
- - - -
- -
- - - -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- -
- - - -
- -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- -
- - - -
- -
- - - -
- - - -
- -
- - - -
- -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- -
- - - -
- -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - -
- - - -
- - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - -
- -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - -
- -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - -
- - -
- - -
1,500.00 1,634,295.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - -
- -
- -
- -
- -
- -
- -
125.00 5,000,000.00
200.00 3,636,400.00
- -
- -
60.00 1,350,000.00
- -
- -
- -
- -
- -
- -
50.00 500,000.00
9.00 72,000.00
22.00 660,000.00
5.00 1,272,500.00
- -
- - - -
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14,125,195.00 - - -
DATA MUTASI PERSEDIAA
UPTD PUSKESMAS
DINAS KESEHATAN KAB
PERIODE BULAN APR
STOK AWAL APRIL 2022 JUMLAH PENERIMAAN APRIL
NO NAMA SEDIAAN SATUAN PROGRAM PROGRAM

HARGA SATUAN BANYAKNYA NILAI RP. HARGA SATUAN
(RP) (RP)
A. O B A T
1 Air Raksa Dental Use Botol - - - -
2 Albendazole Tablet 400 mg Tablet 1,041.98 - - 1,041.98
Albendazole Tablet 400 mg Tablet 367.00 5,000.00 1,835,000.00 367.00
3 Albendazole susp 200 mg/5 ml Botol 4,000.00 - - 4,000.00
4 Alopurinol Tablet 100 mg Tablet - - - 105.00
5 Alopurinol Tablet 300 mg Tablet - - - 99.00
6 Alprazolam tablet 1 mg Tablet - - - -
7 Ambroksol Tablet 30 mg Tablet 143.55 - - 143.55
Ambroksol Tablet 30 mg Tablet 151.80 - - 151.80
8 Ambroksol sirup 15 mg/5 ml Botol 3,626.70 - - 3,626.70
Ambroksol sirup 15 mg/5 ml Botol 3,619.00 - - 3,619.00
9 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 3,822.00 - - 2,998.00
10 Aminofillin Tablet 200 mg Tablet 95.00 - - 95.00
Aminofillin Tablet 200 mg Tablet 91.00 - -
11 Amitriptillin Hcl Tablet Salut 25 mg Tablet 143.00 - - 167.00
Amitriptillin Hcl Tablet Salut 25 mg Tablet 171.44 - -
12 Amlodipin Tablet 5 mg Tablet 75.00 - - 75.00
13 Amlodipin Tablet 10 mg Tablet 99.00 - - 99.00
14 Amoksisillin Kapsul 250 mg Kapsul 196.00 - - 196.00
Amoksisillin Kapsul 250 mg Kapsul 195.00 - -
15 Amoksisillin Kaplet 500 mg Kaplet 249.00 - - 249.00
Amoksisillin Kaplet 500 mg Kaplet 232.00 - -
16 Amoksisillin Serbuk Injeksi 1000 mg vial - - 8,100.00
17 Amoksisillin Sirup Kering 125 mg/5ml Botol 3,500.00 - - 3,500.00
18 Amoksisillin Double Strengh Sirup Ke Botol 3,628.00 - - 3,628.00
Amoksisillin Double Strengh Sirup Ke Botol 3,473.00 - -
19 Ampisilin Kapsul 250 mg Kapsul - - -
20 Ampisillin Kaplet 500 mg Tablet - - -
21 Ampisilin Sirup 125 mg / 5 ml Botol - - -
22 Ampisillin Injeksi 1000 mg Vial 8,237.00 - - 8,237.00
23 Analgetik Plus Tablet - - -
24 Antasida Doen Suspensi Kombinasi Botol 1,995.00 - - 1,995.00
Antasida Doen Suspensi Kombinasi Botol 2,129.00 - - 2,129.00
25 Antasida Doen Tablet, Kombinasi : Tablet 58.00 - - 58.00
Antasida Doen Tablet, Kombinasi : Tablet 58.00 - -
26 Antasida Plus Tablet Tablet 189.05 - - 189.05
27 Antalgin (Metampiron) Tablet 500 mg Tablet - - 203.30
Antalgin (Metampiron) Tablet 500 mg Tablet 170.00 - -
28 Antalgin Injeksi 250 mg/ml-2ml Ampul - - 1,455.00
29 Anti Bakteri DOEN Salep Kombinasi : Tube 2,924.00 - - 3,035.00
30 Anti Hemoroid Doen komb Supp 3,167.00 - - 3,167.00
31 Anti Fungi DOEN Kombinasi : Pot 4,798.00 - - 4,798.00
Anti Fungi DOEN Kombinasi : Pot 4,158.00 - -
32 Antimigren DOEN Kombinasi : Tablet - - 173.00
Antimigren DOEN Kombinasi : Tablet 167.00 - -
33 Anti Diare Suspensi Botol - - -
34 Anti Diare Tablet Tablet 233.20 - - 233.20
Anti Diare Tablet Tablet 253.00 - - 253.00
35 Anti Dotum Oral Tablet Tablet 253.00 - - 253.00
36 Anti Hipertensi Kapsul Tablet 2,112.00 - - -
37 Antihistamin Tablet kombinasi Tablet 208.00 - - 208.00
38 Antispasmodik Tablet Tablet 1,195.10 - - -
39 Antitusiva Sirup Botol 11,550.00 - - 11,550.00
40 Antitusiva Tablet Tablet - - -
41 Asam Folat Tablet 1 mg Tablet 75.00 - - 75.00
42 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 105.00 - - 105.00
Asam Askorbat (Vit. C) Tablet 50 mg Tablet 104.00 - -
43 Asam Mefenamat Kapsul 500 mg Kapsul 103.40 - - 103.40
Asam Mefenamat Kapsul 500 mg Kapsul 177.90 - - 177.90
44 Acetylsistein tablet Tablet 382.00 - - 382.00
45 Asetosal Tablet 80 mg Tablet 105.00 - - 105.00
Asetosal Tablet 80 mg Tablet 114.00 - -
46 Asetosal Tablet 100 mg Tablet - - -
47 Asetosal Tablet 500 mg Tablet - - -
48 Asiklovir Krim 5 % Tube 2,996.40 - - 2,996.40
Asiklovir Krim 5 % Tube 3,600.00 - -
49 Asiklovir Tablet 200 mg Tablet 237.00 - - 249.00
50 Asiklovir Tablet 400 mg Tablet 345.00 - - 380.00
Asiklovir Tablet 400 mg Tablet 380.00 - - 380.00
51 Attapulgit Tablet 152.00 - - 152.00
52 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 1,639.00 - - 1,639.00
53 Aqua Pro Injeksi Steril, bebas Pirogen Vial 2,860.00 - - 2,860.00
54 Bahan Tambal Sementara Set 130,000.00 - - 150,000.00
55 Benzatin Benzil Penisilin injeksi Vial 14,500.00 5.00 72,500.00 14,500.00
56 Betahistin Mesilat 6 mg Tablet 110.00 - - 110.00
Betahistin Mesilat 6 mg Tablet 660.00 - -
57 Betametason Krim 0,1 %- 5g Tube - - 1,340.00
Betametason Krim 0,1 %- 5g Tube 1,380.00 - -
58 Bisakodil suppositoria 10 mg Supp - - -
59 Bisoprolol Tablet 5 mg Tablet - - -
60 Bromheksin 8 mg Tablet 250.80 - - -
61 Cresotin Pasta Botol 112,000.00 - - 112,000.00
62 Cresotin Liquid No 2 Botol 160,500.00 - - 160,500.00
63 Deksametason Injeksi 5mg/ml-1ml Ampul 1,097.00 - - 1,097.00
64 Deksametason Tablet 0,5 mg Tablet 32.00 - - 32.00
65 Devitalisasi Pasta (Non Arsen) Botol 220,000.00 - - -
66 Diazepam tablet 2 mg Tablet 86.00 - - 86.00
67 Diazepam tablet 5 mg Tablet 114.00 - - 114.00
68 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul 1,735.00 - - 1,735.00
69 Diazepam Larutan Rektal 5 mg/ml Supp 12,090.00 - - 12,573.00
Diazepam Larutan Rektal 5 mg/ml Supp 12,573.00 - - 12,573.00
70 Diazepam Larutan Rektal 10 mg/ml Supp 16,742.00 - - -
71 Dietilkarbamazin Sitrat Tablet 100 Tablet 156.00 - - 156.00
mg
72 Difenhidramin HCl Injeksi 10 mg/ml- Ampul 1,095.00 - - 1,095.00
73 Digoksin Tablet 0,25 mg Tablet 104.00 - - 104.00
74 Dimenhidrinat Tablet 50 mg Tablet 99.00 - - 99.00
75 Domperidon Tablet 10 mg Tablet 85.00 - - 85.00
Domperidon Tablet 10 mg Tablet 95.00 - -
76 Donperidon Suspensi 5 mg/5ml Botol 2,700.00 - - 2,700.00
77 Efedrin Hcl Tablet 25 mg Tablet - - -
78 Ekstrak Belladone Tablet 10 mg Tablet - - -
79 Epinefrin HCl / Bitartrat Ampul 1,515.00 - - 1,515.00
Epinefrin HCl / Bitartrat Ampul 1,408.00 - - 1,408.00
80 Eritromisin Kapsul 250 mg Kapsul - - -
81 Eritromisin Kapsul 500 mg Kapsul 730.00 - - 750.00
82 Eritromisin Sirup 200 mg / 5 ml Botol - - -
83 Etambutol Tablet 500 mg Tablet - - 505.00
84 Etanol 70 % 100 ml Botol - - -
Etanol 70 % 100 ml Botol 2,500.00 - -
85 Etil Klorida Semprot -100 ml Botol 246,400.00 - - 246,400.00
86 Eugenol Cairan -10 ml Botol 20,087.00 - - 20,087.00
87 Fenitoin Natrium Kapsul 100 mg Kapsul 158.00 - - 158.00
Fenitoin Natrium Kapsul 100 mg Kapsul 154.00 - -
88 Fenobarbital tablet 30 mg Tablet 1,540.00 - - 171.00
89 Fenobarbital injeksi 50 mg / ml Ampul 1,969.00 - - 1,857.00
90 Fenoksimeti Penisilin 250 mg tablet Tablet - - -
91 Fenoksimeti Penisilin 500 mg tablet Tablet 605.00 - - -
92 Fenol Gliserol TK Botol - - -
93 Flufenazine decanoat injeksi 25 Ampul 63,813.00 2.00 127,626.00 63,813.00
mg/ml
94 Flukonazole tablet 150 mg Tablet 18,720.00 20.00 374,400.00 18,720.00
95 Fitomenadion tablet 10 mg Tablet 710.00 - - 710.00
96 Fitomenadion (Vit K1) Injeksi 2 mg/m Ampul 3,550.00 - - 3,550.00
Fitomenadion (Vit K1) Injeksi 2 mg/m Ampul 3,550.00 - -
97 Furosemid Tablet 40 mg Tablet 82.00 - - 82.00
98 Furosemid injeksi Ampul - - -
99 Garam Oralit I serbuk, kombinasi : 257.00 1,100.00 282,700.00 257.00
Kantong
Garam Oralit I serbuk, kombinasi : 260.00 - -
Kantong
100 Gemfibrozil Tablet 600 mg Tablet - - -
101 Gentian Violet Botol - - -
102 Gentamisin injeksi 80 mg / 2 ml Vial - - 1,834.80
103 Gentamisin Salep Kulit 0,1 % Tube 1,834.80 - - -
Gentamisin Salep Kulit 0,1 % Tube 1,834.80 - - 1,834.80
104 Glass Ionomer Set 680,000.00 - - 687,500.00
105 Glibenklamid Tablet 5 mg Tablet 119.00 - - 119.00
Glibenklamid Tablet 5 mg Tablet 86.00 - -
106 Glimepiride 2 mg Tablet 207.00 - - 207.00
107 Gliseril Guayakolat Tablet 100 mg Tablet 82.50 - - 82.50
Gliseril Guayakolat Tablet 100 mg Tablet 120.00 - - 120.00
108 Gliseril Guayakolat sirup Botol 7,370.00 - - 7,370.00
Gliseril Guayakolat sirup Botol 8,800.00 - - 8,800.00
109 Glukonas Kalsikus injeksi Ampul - - 10,351.00
110 Glukosa Larutan Infus 5 % Botol 6,900.00 - - 6,900.00
111 Glukosa Larutan Infus10 % Botol 5,700.00 - - 7,500.00
Glukosa Larutan Infus10 % Botol 7,500.00 - -
112 Griseofulvin Tablet 125 mg,micronize Tablet 224.00 - - 224.00
Griseofulvin Tablet 125 mg,micronize Tablet 224.00 - - 224.00
113 Haloperidol Tablet 0,5 mg Tablet 55.00 - - 55.00
Haloperidol Tablet 0,5 mg Tablet 55.00 - - 55.00
114 Haloperidol Tablet 1,5 mg Tablet 59.00 - - 59.00
115 Haloperidol Tablet 5 mg Tablet 60.00 400.00 24,000.00 60.00
Haloperidol Tablet 5 mg Tablet 75.00 - -
116 Haloperidol injeksi 5 mg/ml Ampul 1,190.00 9.00 10,710.00 1,190.00
117 Haloperidol injeksi 50 mg/ml Ampul 97,500.00 - - 101,300.00
118 Hidroklortiazid (HCT) Tablet 25 mg Tablet - - -
Hidroklortiazid (HCT) Tablet 25 mg Tablet 149.00 - -
119 Hidrokortison Krim 2,5 % Tube 2,475.00 - - 2,475.00
120 Ibuprofen Tablet 200 mg Tablet 105.00 - - 105.00
121 Ibuprofen Tablet 400 mg Tablet - - 122.00
122 Ibuprofen Suspensi 100 mg/5 ml Botol 2,365.00 - - 2,365.00
Ibuprofen Suspensi 100 mg/5 ml Botol 4,665.00 - - 4,665.00
123 Ichtyol salep Kulit Pot - - -
124 Isoniazid tablet 100 mg Tablet 145.00 500.00 72,500.00 145.00
125 Isoniazid tablet 300 mg Tablet 170.00 - - 173.00
126 Isosorbid Dinitrat 5 mg Tablet 88.00 - - -
127 Kalium Diklofenak Tablet 25 mg Tablet - -
128 Kalium Diklofenak Tablet 50 mg Tablet 682.00 - - 287.85
129 Kalsium Hidroksida Pasta Tube - - -
130 Kalsium Laktat Tablet 500 mg Tablet 59.00 - - 59.00
Kalsium Laktat Tablet 500 mg Tablet 63.00 - -
131 Kaptopril 12,5 mg Tablet 62.00 - - 62.00
132 Kaptopril 25 mg Tablet 75.00 - - 75.00
Kaptopril 25 mg Tablet 94.00 - - 94.00
133 Karbamazepin Tablet 200 mg Tablet 245.00 - - 245.00
Karbamazepin Tablet 200 mg Tablet 270.00 - -
134 Ketokonazole Krim 2 % - 15 gr Tube 2,518.00 - - 2,518.00
135 Ketokonazole Tablet 200 mg Tablet 288.00 - - 288.00
Ketokonazole Tablet 200 mg Tablet 528.00 - -
136 Ketoprofen Tablet 100 mg Tablet - - -
137 Ketoprofen Injeksi 100 mg / 1 ml Ampul - - -
138 Ketorolac 10 mg injeksi Ampul - - -
139 Ketorolac 30 mg injeksi Ampul - - 1,045.00
140 Klindamisin Kapsul 150 mg Kapsul 759.00 - - 759.00
141 Klindamisin Kapsul 300 mg Kapsul - - -
142 Kloramfenikol Kapsul 250 mg Kapsul 266.00 - - -
143 Kloramfenikol suspensi125mg/5 ml Botol - - -
144 Kloramfenikol Salep Mata 1%-3,5 g Tube 1,881.00 - - 1,881.00
Kloramfenikol Salep Mata 1%-3,5 g Tube 1,810.00 - -
145 Kloramfenikol Salep Kulit 2% Tube 3,008.00 - - -
Kloramfenikol Salep Kulit 2% Tube 3,242.00 - - 3,242.00
146 Kloramfenikol Tetes Mata -5 ml Botol 6,828.80 - - 6,828.80
Kloramfenikol Tetes Mata -5 ml Botol 3,250.00 - -
147 Kloramfenikol Tetes Telinga 3%-5 ml Botol 6,828.80 - - 6,828.80
148 Klorfeniramin Maleat (CTM) Tablet 4 Tablet 42.00 - - 22.00
Klorfeniramin Maleat (CTM) Tablet 4 Tablet 23.00 - - 23.00
149 Klorpromazin Hcl Tablet Salut 25 mg Tablet 212.00 - - 212.00
150 Klorpromazin Hcl Tablet Salut 100 m Tablet 147.00 - - 147.00
Klorpromazin Hcl Tablet Salut 100 m Tablet 144.00 - -
151 Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 1,510.00 - - 1,510.00
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul 1,240.00 - -
152 Kombinasi Ipatropium Bromide + Salbutamol
Vial 4,550.00 - - 4,550.00
153 Kombipak Cefixime+ Azithromisin Kotak 30,030.00 45.00 1,351,350.00 30,030.00
Kombipak Cefixime+ Azithromisin Kotak 31,231.00 20.00 624,620.00 31,231.00
154 Kotrimoksazol Pedriatik Tablet,
Kombinasi :
Tablet
Sulfametoksazol 100 mg +
Trimetroprim 20 mg 76.00 - - -
155 Kotrimoksazol Tablet, Kombinasi : Tablet 125.00 - - 125.00
156 Kotrimoksazol Suspensi Kombinasi : Botol - - 2,052.00
Kotrimoksazol Suspensi Kombinasi : Botol 2,140.00 - -
157 Lansoprazole 30 mg Kapsul Tablet 315.00 - - 303.00
Lansoprazole 30 mg Kapsul Tablet 323.00 - - 323.00
158 Larutan mengadung Elektrolit Botol 9,275.00 - - 9,646.00
159 Larutan mengadung Elektrolit Botol - - 9,644.00
160 Larutan mengadung Karbohidrat + Elektrolit
Botol - - 10,696.00
161 Lidokain injeksi 2 % Tablet 1,111.00 - - -
Lidokain Hcl Ampul
2% +Epinefrin 1 : 80.000-2 ml 1,845.00 - - -
163 Lidokain Spray Botol 177,216.00 - - -
164 Loperamid Tablet 2 mg Tablet 80.30 - - 80.30
165 Loratadin tablet 10 mg Tablet 131.00 - - 131.00
166 Magnesium Sulfat (IV) 20 %-25 ml Ampul 3,328.00 - - 3,328.00
167 Magnesium Sulfat (IV) 40 %-25 ml Ampul 3,796.00 - - 3,796.00
168 MB Anak Blister - - 20,554.00
169 MB Dewasa Blister 39,880.00 - - 39,880.00
170 Meloksikam tablet 15 mg Tablet 718.20 - - 718.20
171 Meloksikam Suppositoria Supp - - -
172 Metformin Hcl Tablet 500 mg Tablet 102.00 - - 102.00
173 Metformin 850 mg Tablet 160.00 - - 160.00
174 Metildopa 250 mg tablet Tablet 946.00 - - 946.00
175 Methisoprinol 500 mg Tablet - - -
176 Metilergometrin Maleat (Metergin) Tablet 154.00 - - 210.00
Metilergometrin Maleat (Metergin) Tablet 444.00 - -
177 Metilergometrin Maleat Injeksi 0,20 Ampul 2,684.00 - -
Metilergometrin Maleat Injeksi 0,20 Ampul 2,959.00 - - 2,959.00
178 Metilprednisolon tablet 4 mg Tablet 143.00 - - 143.00
Metilprednisolon tablet 4 mg Tablet 150.00 - -
179 Metoklopramid 10 mg Tablet 85.00 - - 85.00
180 Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul - - 4,400.00
181 Metronidazol Tablet 250 mg Tablet - - -
182 Metronidazole Tablet 500 mg Tablet 211.20 - - 211.20
183 Metronidazole sirup 125 mg/ml Botol - - -
184 Metronidazole Infus 500 mg /100 ml Ampul - - 8,110.00
185 Mikonazole KrIm 2 % - 10 gr Tube 3,414.00 - - 3,414.00
186 Multivitamin + Mineral tablet Tablet 585.00 - - 585.00
Multivitamin tablet Tablet 585.00 - - 585.00
187 Multivitamin sirup Botol 7,100.00 - - 7,100.00
188 Mummifying Pasta Botol - - -
189 Natrium Bikarbonat Tablet 500 mg Tablet 50.00 - - 50.00
Natrium Bikarbonat Tablet 500 mg Tablet 50.00 - -
190 Natrum Diklofenak Tablet 25 mg Tablet 145.00 - -
Natrum Diklofenak Tablet 25 mg Tablet 128.00 - - 128.00
191 Natrium Diklofenak Tablet 50 mg Tablet 115.00 - - 115.00
Natrium Diklofenak Tablet 50 mg Tablet 200.00 - -
192 Natrium Klorida Larutan infus 0,9%-St Botol 6,410.00 - - 6,410.00
Natrium Klorida Larutan infus 0,9%-St Botol 6,840.00 - - 6,840.00
193 Nipedifin Tablet 10 mg Tablet 193.60 - - 193.60
194 Nistatin suspensi 100.000 IU/ml Botol 13,900.00 - - 13,900.00
195 Nistatin 100.000 IU/gram Tablet Vagi Tablet 598.00 - - 598.00
196 Nistatin 500.000 IU/gram Tablet Salut Tablet 843.00 - - 843.00
197 Obat Antitiuberkolosis Kategori Paket - - 232,518.00
Anak
198 Obat Antitiuberkolosis Kategori 1 De Paket 415,721.00 - - 415,721.00
199 Obat Antitiuberkolosis Kategori 2 Paket - - -
Dewasa
200 Obat Antitiuberkolosis Kategori 3 Paket - - -
Dewasa
201 Obat Anti Tuberkulosis FDC Kat Anak Paket 248,120.00 - - 248,120.00
202 Obat Anti Tuberkulosis FDC Kat I & II Paket 1,297,889.00 - - 1,297,889.00
203 Obat Anti Tuberkulosis FDC Kat I & II Paket 415,469.00 - - 415,469.00
204 Obat Anti Tuberkolosis FDC Sisipan Paket - - -
Dewasa
205 Obat Batuk Hitam (OBH) Cairan 100 m Botol 4,697.00 - - 4,697.00
Obat Batuk Hitam (OBH) Cairan 100 m Botol 6,050.00 - - 6,050.00
206 Obat Batuk Cair Sirup (Ekspektoran) Botol 7,106.00 - - 7,106.00
Obat Batuk Cair Sirup (Ekspektoran) Botol 6,760.00 - -
207 Obat Batuk Hitam Plus Sirup Botol 4,697.00 - - 4,697.00
208 Obat Flu Sirup Botol - - -
209 Oksiterasiklin Hcl injeksi i.m.50 Vial - - -
mg/ml-10 ml
210 Oksiterasiklin Salep Mata 1%-3,5g Tube 2,500.00 - - 2,500.00
Oksiterasiklin Salep Mata 1%-3,5g Tube 2,500.00 - - 2,500.00
211 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2,412.30 - - 2,412.30
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube 2,005.00 - -
212 Oksitosin Injeksi 10 IU/ml-1ml Ampul 1,199.00 - - 1,199.00
213 Omeprazole injeksi 40mg/10ml Ampul 16,997.00 - - 9,898.00
214 Omeprazole Kapsul 20 mg Tablet 341.81 - - 341.81
215 Ondansetron inj 4 mg/ 2 mL Ampul 1,650.00 - - 1,070.00
216 Parasetamol drop 100 mg/ml btl @15 Botol 6,649.00 - - 6,649.00
217 Parasetamol Sirup 120 mg/5ml-60 ml Botol 1,107.00 - - 1,107.00
Parasetamol Sirup 120 mg/5ml-60 ml Botol 1,010.00 - -
218 Parasetamol Tablet 100 mg Tablet - - -
219 Parasetamol Tablet 500 mg Tablet 53.00 - - 53.00
Parasetamol Tablet 500 mg Tablet 49.00 - -
220 PB Anak Blister - - -
221 PB Dewasa Blister - - 12,569.00
222 Pehacain injeksi Ampul 3,051.40 - - 3,051.40
Pehacain injeksi Ampul 3,080.00 - -
223 Perak Sulfadiazin krim 1 % 35 gr Tube 23,000.00 - - -
224 Permetrin krim 5 % Tube 11,825.00 - - 11,825.00
225 Piracetam Tablet 400 mg Tablet 451.00 - - 459.80
226 Piracetam Tablet 800 mg Tablet 803.00 - - 800.80
227 Piroksikam Tablet 20 mg Tablet 156.20 - - 156.20
Piroksikam Tablet 20 mg Tablet 130.00 - -
228 Pirantel Pamoat Tablet 365 mg
Tablet
(Setara dng 125 mg Basa) 291.00 - - -
229 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet 123.00 - - 123.00
230 Piridoksin Hcl (Vit.B6) Tablet 25 mg Tablet - - -
231 Povidon Iodida 10% 30 ml Botol 3,360.00 - - 3,360.00
232 Povidon Iodida 10% 60 ml Botol - - -
233 Povidon Iodida 10% 300 ml Botol 18,900.00 - - 18,900.00
234 Prednison Tablet 5 mg Tablet 73.00 - - 73.00
Prednison Tablet 5 mg Tablet 96.00 - -
235 Primakuin tablet 15 mg Tablet - - -
236 Prokain Benzil Penisilin Injeksi Vial - - -
3,000,000 IU
237 Propanolol Hcl Tablet 40 mg Tablet 76.00 - - 76.00
238 Propilturasil Tablet 100 mg Tablet 586.30 - - 586.30
239 Ranitidin Injeksi 25 mg / ml Ampul - - 1,155.00
240 Ranitidin Tablet 150 mg Tablet 112.00 - - 112.00
Ranitidin Tablet 150 mg Tablet 98.00 - -
241 Retinol (Vit. A) 100.000 IU Kapsul Kapsul 305.00 - - 305.00
242 Retinol (Vit. A) 200.000 IU Kapsul Kapsul 553.00 - - 553.00
243 Reserpin Tablet 0, 25 mg Tablet - - -
244 Rifampisin Tablet 450 mg Tablet - - -
245 Ringer Laktat Larutan Infus Steril 500 Botol - - 7,150.00
Ringer Laktat Larutan Infus Steril 500 Botol 7,150.00 - -
246 Salbutamol Tablet 2 mg Tablet 63.00 - - 63.00
247 Salbutamol Tablet 4 mg Tablet 70.00 - - 70.00
248 Salbutamol solution for Inhalation
Ampul
single dose units 2,5 ml 4,550.00 - - 4,550.00
249 Salep 2-4 Kombinasi : Pot 2,621.00 - - 2,621.00
250 Salisil bedak 2% -50 gr Kotak 1,025.00 - - 1,020.00
Salisil bedak 2% -50 gr Kotak 5,856.40 - - 5,856.40
251 Salep Luka Bakar Tube 11,718.25 - - 11,718.25
Salep Luka Bakar Tube 19,690.00 - -
252 Sefadroksil Sirup Kering 125 mg / 5 m Botol 3,980.00 - - 3,922.00
253 Sefadroksil Tablet 500 mg Tablet 450.00 - - 478.00
254 Sefiksim Kapsul 100 mg Kapsul - - 31,231.00
255 Sefiksim 400 mg + Azitromisin 1000 Paket - - 31,231.00
256 Sefotaksim Injeksi 1 gr Ampul - - 4,200.00
257 Seftriakson Injeksi 1 gr / vial Ampul - - 4,483.00
258 Semen Seng Fosfat Serbuk & Cairan Botol - - -
259 Setirizin Tablet 10 mg Tablet 90.00 - - 90.00
Setirizin Tablet 10 mg Tablet 96.00 - -
260 Setirizin Sirup 5 mg / 5 ml Botol 2,915.00 - - 2,915.00
Setirizin Sirup 5 mg / 5 ml Botol 3,150.00 - -
261 Sianokobalamin Injeksi 500 mcg/ml-1 Ampul 1,098.00 - - 1,035.00
262 Sianokobalamin Tablet 50 mcg Tablet 49.00 - - 49.00
263 Silver Amalgam Serbuk 65-75% Botol - - -
264 Simetidin 200 mg Tablet Tablet 176.00 - - 163.90
265 Simvastatin Tablet 10 mg Tablet 117.00 - - 117.00
Simvastatin Tablet 10 mg Tablet 117.00 - - 117.00
266 Siprofloksasin 500mg Tablet 530.20 - - 530.20
267 Spironolakton Tablet 25 mg Tablet 208.00 - - 208.00
268 Sulfacetamid Tetes Mata 15 %-5ml Botol - - -
269 Tablet Tambah Darah Kombinasi: Tablet 353.00 - - 353.00
Tablet Tambah Darah Kombinasi: Tablet 226.00 51,900.00 11,729,400.00 226.00
270 Temporary Stopping Fletcher
Set
(Fletcher) Serbuk & Cairan - - -
271 Trikesol formalin ( T K F ) Cairan 10 Botol - - -
ml
272 Tetrasiklin Kapsul 250 mg Kapsul 163.00 - - 174.00
273 Tetrasiklin Kapsul 500 mg Kapsul 310.00 - - -
274 Thiamin Hcl (Vit B1) Injeksi 100 mg/m Ampul 1,140.00 - - 1,139.60
275 Tiamin Hcl /Mononitrat (Vit.B1) Tabl Tablet 85.00 - - 85.00
Tiamin Hcl /Mononitrat (Vit.B1) Tabl Tablet 91.00 - - 91.00
276 Thiamfenikol Kapsul 500 mg Kapsul 837.00 - - 837.00
Thiamfenikol Kapsul 500 mg Kapsul 921.00 - - 921.00
277 Tramadol Injeksi 50 mg/ ml Ampul - - -
278 Tramadol Tablet 50 mg Tablet - - -
279 Triheksifenidil Hidroklorida Tablet 2 Tablet 91.00 400.00 36,400.00 91.00
Triheksifenidil Hidroklorida Tablet 2 Tablet 88.00 - -
280 Vitamin B .Komplek Tablet Tablet 89.00 - - 89.00
281 Vitamin Neurotropik Tablet Tablet 856.90 - - 856.90
Vitamin Neurotropik Tablet Tablet 660.00 - -
282 Zinc Tablet 20 mg Tablet 524.00 2,000.00 1,048,000.00 524.00
Zinc Tablet 20 mg Tablet 524.00 - -
283 Zinc Sulfat 20 mg/5 ml Botol 3,171.00 - - 3,171.00
284 Hepatorotector tablet (Curcuma) Tablet - - 462.00
285 Obat Batuk Herbal Botol 9,680.00 - - 9,680.00
286 Obat Kumur Botol 16,962.00 - - 16,962.00
287 Salep Kloramfenikol + Hidrokortison Tube 13,200.00 - - 13,200.00
288 Tablet Pemanis Botol 33,000.00 - - 33,000.00
289 Bahan Pembersih Kavitas Botol 150,000.00 - - -
290 Flour Gel Botol 49,500.00 - - -
291 Glass Ionomer Posterior Set 775,000.00 - - -
292 Hyposol 3 % Botol 78,100.00 - - -
293 Paramonochlorofenol/CHKM Botol 50,000.00 - - -
294 Saliva Ejector Pcs 660.00 - - -
295 Salep Betameson + Neomisin Tube 12,793.00 - - -
Favipiravir 200 mg Tablet 14,850.00 - - 14,850.00
296 Curcuma Tablet 462.00 - - -
Trifluoperazine Hcl 5 mg Tablet 287.00 100.00 28,700.00 287.00
297 Gentamisin injeksi 40 mg/ml Ampul 5,900.00 - - 5,900.00
298 Bisoprolol Tablet 2,5 mg Tablet 626.00 - - 626.00
299 Klobazam 10 mg Tablet 776.00 - - 776.00
300 Klozapin 25 mg Tablet 1,121.00 - - 1,121.00
301 Risperidon 2 mg Tablet 287.00 - - 287.00
302 Gentamisin Tetes Mata 0,3% Botol 4,232.00 - - 4,232.00
Favipiravir 200 mg Tablet 14,850.00 - - 14,850.00
Mineral Mix Sachet 2,981.00 - - 2,981.00
Vitamin C 500 mg Tablet 198.00 - - 198.00
NaCl 10 mL Botol 24.00 -
NaCl 10 mL Botol 3,280.00 40.00 131,200.00 3,280.00
B. BAHAN MEDIS HABIS PAKAI (BMHP) - - -
1 Abbocath No 18 ( IV Chateter 18 ) Buah 8,950.00 - - 3,914.00
4 Abbocath No 24 ( IV Chateter 24 ) Buah 8,950.00 - - -
5 Alat Gula, Kolesterol, Asam Urat Unit - - -
6 Alat Suntik Sekali Pakai 1 ml Set 650.00 - - 650.00
7 Alat Suntik Sekali Pakai 3 ml Set 569.00 30.00 17,070.00 569.00
Alat Suntik Sekali Pakai 3 ml Set 24.00 -
8 Set
Alat Suntik Sekali Pakai 5 ml 1,045.00 - - 1,045.00
9 Alat Suntik Sekali Pakai 10 ml Set - - 1,298.00
10 Alkohol Swab Kotak 123.60 14,081.00 1,740,411.60 123.60
Alkohol Swab Kotak 88.00 740.00 65,120.00 88.00
Alkohol Swab Kotak 79.00 1,395.00 110,205.00 79.00
Alkohol Swab Kotak - 144.00 - -
11 Auto Disposable Syringe (ADS) 0,05 m Set 1,518.00 231.00 350,658.00 1,518.00
Auto Disposable Syringe (ADS) 0,3 ml Set - 144.00 -
Auto Dispossible Syringe (ADS) 0,3 ml Set 1,165.00 400.00 466,000.00 1,165.00
12 Auto Disposable Syringe (ADS) 0,5 ml Set 1,165.00 50.00 58,250.00 1,165.00
Auto Disposable Syringe (ADS) 0,5 ml Set 1,540.00 100.00 154,000.00 1,185.00
Auto Disposable Syringe (ADS) 0,5 ml Set - 250.00 -
13 Auto Disposable Syringe (ADS) 5 ml Set 1,439.00 - - 1,439.00
Auto Disposable Syringe (ADS) 5 ml Set 1,540.00 - - 1,540.00
14 Blood Set Set - - 10,430.00
15 Catgut/Benang Bedah No.2/0 Plain Sachet 26,666.67 - - 26,666.67
Catgut/Benang Bedah No.2/0 Plain Sachet 34,300.00 - - 34,300.00
16 Catgut/Benang Bedah No.3/0 Cromic Sachet 33,250.00 - - 37,203.00
Catgut/Benang Bedah No.3/0 Cromic Sachet 33,538.00 - - 33,538.00
17 Etakridin Larutan (Rivanol) 0,1% - 300 Botol 3,150.00 - - 3,150.00
Etakridin Larutan (Rivanol) 0,1% - 300 Botol 2,677.50 - -
18 Etanol 70 % 1.000 ml Botol 26,250.00 - - 26,250.00
19 Eter Alkohol Botol - - -
20 Folley Catheter no 14 Set 18,450.00 - - 18,450.00
23 Infus set Anak Set 9,900.00 - - 9,900.00
24 Infus set Dewasa Set 9,070.00 - - 9,070.00
25 Iodina Test Botol 10,725.00 - - 10,725.00
26 Kaca Slide Pcs - - 55,000.00
27 Kapas Berlemak 500 gram Bungku - - -
s
28 Kapas Pembalut / Adsorbens 100 gra Bungku 7,205.00 - - 7,205.00
s
Kapas Pembalut / Adsorbens 250 gra Bungku 12,875.00 - - 12,875.00
29 Kassa Pembalut 2 m x 80 cm s
Rol 9,400.00 - - -
30 Kassa Pembalut Hidrofil 4 m x 3 cm Rol 800.00 - - -
31 Kassa Pembalut Hidrofil 4 m x 15 cm Rol 3,800.00 - - 3,800.00
32 Kassa Hidrofil Steril 16 x 16 Kotak 7,900.00 - - 7,900.00
Kassa Hidrofil Steril 16 x 16 Kotak 8,240.00 - - 8,240.00
33 Kassa Kompres 40 x 40 steril Bungku 1,393.00 - - 1,800.00
34 Kertas Puyer s
Pcs 75.90 - - 75.90
35 Kertas Saring Lembar - - 10,000.10
36 Kertas Lensa Lembar - - -
37 Lysol 1,000 ml Botol 43,050.00 - - 43,050.00
38 Masker Buah 2,290.00 - - 2,290.00
Masker Buah 693.00 1,000.00 693,000.00 693.00
39 Masker N 95 Pcs - - 23,750.00
40 Minyak Imersi Botol - - -
41 Plester Kertas Rol 15,333.33 - - 15,333.33
42 Polifix 5 cm x 5 m Rol - - -
Polifix 5 cm x 5 m Rol 39,749.00 - -
43 Pot Dahak Pcs 2,728.00 200.00 545,600.00 2,728.00
44 Rapid HIV 1/2 Vikia DS Test 12,827.00 - - 12,827.00
Rapid HIV 1/2 Vikia DS Test 11,400.00 100.00 1,140,000.00 11,400.00
45 Rapid HIV 1 (SD HIV) Test 11,975.00 - - 11,975.00
46 Rapid HIV 2 (Intec HIV) Test - - 74,002.50
47 Rapid HIV 2 (Biomeriux HIV) Test - - 19,500.00
48 Rapid Tes SD Bioline HBSAG Test 7,805.00 100.00 780,500.00 7,805.00
49 Rapid Test Syphilis Test 12,564.00 - - 12,564.00
Rapid Test Syphilis Test 9,300.00 - - 9,300.00
50 Reagen CD 4 Control Test - - -
51 Reagen CD 4 Test - - -
52 Reagen Ziehl Nielsen Botol 232,440.00 - - 232,440.00
53 RPR Test Syphilis Test 4,120.00 - - 4,120.00
54 Silk( Benang Bedah Sutra ) No 3/0 Sachet - - 35,077.00
55 Safety Box Pcs 22,433.00 20.00 448,660.00 22,433.00
Safety Box Pcs 14,000.00 - - 14,000.00
Safety Box Pcs - 6.00 - -
Safety Box Pcs 13,600.00 5.00 68,000.00 13,600.00
Safety Box Pcs 5,382.00 4.00 21,528.00 5,382.00
56 Sarung tangan Steril No 6 Pcs 4,500.00 - - 4,500.00
57 Sarung tangan Steril No 7 Pcs 4,500.00 - - 4,500.00
Sarung tangan Steril No 7 Pcs 6,595.00 - - 6,595.00
58 Sarung tangan Steril No 7,5 Pcs 6,595.00 - - 6,595.00
59 Sarung tangan Non Steril S Pcs - - 600.49
60 Sarung tangan Non Steril M Pcs 1,503.33 - - 1,503.33
61 Sarung tangan Non Steril L Pcs 600.49 - - 600.49
Sarung tangan Non Steril L Pcs 990.00 - - 990.00
62 Sountimer Buah - - -
63 Stik Pemeriksaan Gula Darah Test 3,230.00 9,000.00 29,070,000.00 3,230.00
64 Stik Pemeriksaan Kolesterol Test - - -
65 Stik Pemeriksaan Asam Urat Test - - -
66 Supratul Lembar 10,400.00 - - 10,400.00
67 Urine Bag set - - 3,090.00
68 Wing Neddle No 23 Set - - -
69 Blood Lancet Pcs 95.07 14,250.00 1,354,747.50 95.07
Blood Lancet Pcs 144.20 - - 144.20
70 Cairan Antiseptik Botol 500 ml Botol 60,800.00 - - 60,800.00
71 Rapin HIV Oncoprobe Test - - 86,680.00
72 Haloperidol injeksi 50 mg/ml Ampul 97,500.00 - - -
73 Detergent 5 Liter Galon 712,800.00 - - -
74 Desinfektan 5 Liter Galon 396,000.00 - - -
75 Saliva Ejector 968.00 - - -
76 Pharmafix Rol 30,000.00 - - 30,000.00
77 Slide Pcs 31,347.00 - - 31,347.00
78 Vikia Biumerc Test 19,480.00 - - 19,480.00
79 Baju APD Pcs 312,500.10 - - 312,500.10
80 Sepatu Boot Safety Pcs 262,499.60 - - 262,499.60
81 Kacamata Google Pcs 131,249.80 - - 131,249.80
82 Sarung Tangan Karet Latex Pcs 56,249.60 - - 56,249.60
83 Rapid Test Kit Test 165,000.00 - - 165,000.00
84 Masker Kain Headloop Pcs 5,500.00 - - 5,500.00
85 Masker Kain Earloop Pcs 5,500.00 - - 5,500.00
86 Masker KN 95 Pcs - - - -
87 Calcetin Calcium Hidroxide Paste Botol 134,214.29 - - 134,214.29
88 Cresotin Paste Pot 112,214.29 - - 112,214.29
89 Cresotin Liquid No 2 Pot 160,714.29 - - 160,714.29
90 Hyposol 3 % Botol 78,750.00 - - 78,750.00
91 Pulp X Pot 217,214.29 - - 217,214.29
92 Trioresolformalina Botol 72,214.29 - - 72,214.29
93 Paramonochlorofenol/CHKM Botol 65,214.29 - - 65,214.29
94 Saliva Ejector 88,750.00 - - 88,750.00
Kantong
95 APD Vaksinasi Covid Paket 98,450.00 - - 98,450.00
96 Rompi Vaksinator Pcs 148,000.00 - - 148,000.00
97 Coverall DISPO Survailens Pcs 323,500.00 - - 323,500.00
98 Rapid Antigen Pcs 81,784.00 - - 81,784.00
99 VTM & Swab Dacron Citodia Pcs 55,000.00 - - 55,000.00
VTM & Swab Dacron Citodia Pcs 42,000.00 - - 42,000.00
Reagen Rapid Test HBsAG Test 7,805.00 - - 7,805.00
100 APD Vaksinasi Covid Paket 98,450.00 - - 98,450.00
- -
C. SERUM DAN VAKSIN - - -
1 Serum Anti Bisa Ular Polivalen Injeksi Vial 479,996.00 - - 479,996.00
Serum Anti Bisa Ular Polivalen Injeksi Vial 512,204.00 - - 512,204.00
2 Serum Anti Rabies untuk manusia Vial - - -
3 Serum Anti Tetanus (ATS) Injeksi 1.5 Ampul - - 176,800.00
4 Serum Anti Tetanus (ATS) Injeksi Vial - - -
20.000 IU/ampul
5 Human Tetanus Imunoglobin inj 250 Vial - - -
IU
6 Vaksin BCG Ampul 59,950 - - 61,996.00
Vaksin BCG Ampul 66,154 5.00 330,770.00 66,154.00
7 Vaksin Campak 10 Dosis Vial - - -
8 Vaksin DT Vial - - 17,996.00
9 Vaksin TD Vial 18,128 3.00 54,384.00 18,128.00
Vaksin TD Vial 16,995 - - 16,995.00
10 Vaksin DTP-HB Vial - - -
11 Vaksin DPT-HB/Hib Vial 85,103 11.00 936,133.00 85,103.00
Vaksin DPT-HB/Hib Vial 84,282 - - 84,282.00
12 Vaksin HB Uniject Pcs 25,839 20.00 516,780.00 25,839.00
Vaksin HB Uniject Pcs 25,597 - - 25,597.00
13 Vaksin MR (VVM.A) Vial 166,265 6.00 997,590.00 166,265.00
14 Vaksin Polio Vial 21,285 - - 21,285.00
Vaksin Polio Vial 21,494 10.00 214,940.00 21,494.00
15 Vaksin Polio IPV 5 Dosis Vial 158,994 - - 158,994.00
Vaksin Polio IPV 5 Dosis Vial 144,540 - - 144,540.00
16 Vaksin Polio 10 IPV Dosis Vial - - -
17 Vaksin TT Vial - - -
18 Vaksin Covid 19 (AstraZeneca) Vial - - -
19 Vaksin Covid 19 (Sinovac MDV) Vial 1,339,441 - - 1,339,440.50
Vaksin Covid 19 (Sinovac SIngledose) Vial - - -
Vaksin Covid 19 (Sinovac 2 dosis) Vial - 670.00 -
Vaksin Covid 19 (Moderna 10 dosis) Vial - 1.00 -
Vaksin Covid 19 (Pfizer 6 dosis) Vial - 40.00 -
Vaksin Conecavac (Astrazeneca) Vial 25.00 -
Vaksin Covovax Vial 45.00 -
Hyperhep B S/D Cairan injeksi 220
IU/ML Vial 1,325,000 - - 1,325,000.00
20
Syringe
HB Ig 1,325,000 - - 1,325,000.00
JUMLAH TOTAL OBAT 17,749,106.00

JUMLAH TOTAL BMHP 37,083,750.10
JUMLAH TOTAL VAKSIN SERUM 3,050,597.00
JUMLAH TOTAL KESELURUHAN 57,883,453.10 -
JUMLAH PENERIMAAN APRIL 2022 PENGELUARAN APRIL 2022 SALDO AKHIR APRIL 2022
PROGRAM PROGRAM PROGRAM
BANYAKNYA NILAI RP. HARGA SATUAN BANYAKNYA NILAI RP. HARGA SATUAN
(RP) (RP)
- - - -
- 1,041.98 - 1,041.98
- 367.00 - 367.00
- 4,000.00 - 4,000.00
- - - -
- - - -
- - - -
- 143.55 - 143.55
- 151.80 - 151.80
- 3,626.70 - 3,626.70
- 3,619.00 - 3,619.00
- 3,822.00 - 3,822.00
- 95.00 - 95.00
- 91.00 - 91.00
- 143.00 - 143.00
- 171.44 - 171.44
- 75.00 - 75.00
- 85.00 - 85.00
- 99.00 - 99.00
- 104.00 - 104.00
- 196.00 - 196.00
- 195.00 - 195.00
- 249.00 - 249.00
- 232.00 - 232.00
- - - -
- 3,500.00 - 3,500.00
- 3,628.00 - 3,628.00
- 3,473.00 - 3,473.00
- - - -
- - - -
- - - -
- 8,237.00 - 8,237.00
- - - -
- 1,995.00 - 1,995.00
- 2,129.00 - 2,129.00
- 58.00 - 58.00
- 58.00 - 58.00
- 189.05 - 189.05
- - - -
- 170.00 - 170.00
- - - -
- 2,924.00 - 2,924.00
- 3,167.00 - 3,167.00
- 4,798.00 - 4,798.00
- 4,158.00 - 4,158.00
- - - -
- 167.00 - 167.00
- - - -
- 233.20 - 233.20
- 253.00 - 253.00
- 253.00 - 253.00
- 2,112.00 - 2,112.00
- 208.00 - 208.00
- 1,195.10 - 1,195.10
- 11,550.00 - 11,550.00
- - - -
- 75.00 - 75.00
- 105.00 - 105.00
- 104.00 - 104.00
- 103.40 - 103.40
- 177.90 - 177.90
- 382.00 - 382.00
- 105.00 - 105.00
- 114.00 - 114.00
- - - -
- - - -
- 2,996.40 - 2,996.40
- 3,600.00 - 3,600.00
- 237.00 - 237.00
- 345.00 - 345.00
- 380.00 - 380.00
- 152.00 - 152.00
- 1,639.00 - 1,639.00
- 2,860.00 - 2,860.00
- 130,000.00 - 130,000.00
- 14,500.00 - 14,500.00
- 110.00 - 110.00
- 660.00 - 660.00
- - - -
- 1,380.00 - 1,380.00
- - - -
- - - -
- 250.80 - 250.80
- 112,000.00 - 112,000.00
- 160,500.00 - 160,500.00
- 1,097.00 - 1,097.00
- 32.00 - 32.00
- 44.00 - 44.00
- 41.00 - 41.00
- 220,000.00 - 220,000.00
- 86.00 - 86.00
- 114.00 - 114.00
- 1,735.00 - 1,735.00
- 12,090.00 - 12,090.00
- 12,573.00 - 12,573.00
- 16,742.00 - 16,742.00
- 156.00 - 156.00
- 1,095.00 - 1,095.00
- 104.00 - 104.00
- 99.00 - 99.00
- 104.00 - 104.00
- 141.90 - 141.90
- 85.00 - 85.00
- 95.00 - 95.00
- 2,700.00 - 2,700.00
- - - -
- - - -
- 1,515.00 - 1,515.00
- 1,408.00 - 1,408.00
- - - -
- 730.00 - 730.00
- - - -
- - - -
- - - -
- 2,500.00 - 2,500.00
- 246,400.00 - 246,400.00
- 20,087.00 - 20,087.00
- 158.00 - 158.00
- 154.00 - 154.00
- 1,540.00 - 1,540.00
- 1,969.00 - 1,969.00
- - - -
- 605.00 - 605.00
- - - -
- 63,813.00 - 63,813.00
- 18,720.00 - 18,720.00
- 710.00 - 710.00
- 3,550.00 - 3,550.00
- 3,550.00 - 3,550.00
- 82.00 - 82.00
- - - -
- 257.00 - 257.00
- 260.00 - 260.00
- - - -
- - - -
- - - -
- 1,834.80 - 1,834.80
- 1,834.80 - 1,834.80
- 680,000.00 - 680,000.00
- 119.00 - 119.00
- 86.00 - 86.00
- 207.00 - 207.00
- 82.50 - 82.50
- 120.00 - 120.00
- 7,370.00 - 7,370.00
- 8,800.00 - 8,800.00
- - - -
- 6,900.00 - 6,900.00
- 5,700.00 - 5,700.00
- 7,500.00 - 7,500.00
- 224.00 - 224.00
- 224.00 - 224.00
- 55.00 - 55.00
- 55.00 - 55.00
- 59.00 - 59.00
- 60.00 - 60.00
- 75.00 - 75.00
- 1,190.00 - 1,190.00
- 97,500.00 - 97,500.00
- - - -
- 149.00 - 149.00
- 2,475.00 - 2,475.00
- 105.00 - 105.00
- 102.00 - 102.00
- - - -
- 111.00 - 111.00
- 2,365.00 - 2,365.00
- 4,665.00 - 4,665.00
- - - -
- 145.00 - 145.00
- 170.00 - 170.00
- 88.00 - 88.00
- - - -
- 682.00 - 682.00
- - - -
- 59.00 - 59.00
- 63.00 - 63.00
- 62.00 - 62.00
- 75.00 - 75.00
- 94.00 - 94.00
- 245.00 - 245.00
- 270.00 - 270.00
- 2,518.00 - 2,518.00
- 288.00 - 288.00
- 528.00 - 528.00
- - - -
- - - -
- - - -
- - - -
- 759.00 - 759.00
- - - -
- 266.00 - 266.00
- - - -
- 1,881.00 - 1,881.00
- 1,810.00 - 1,810.00
- 3,008.00 - 3,008.00
- 3,242.00 - 3,242.00
- 6,828.80 - 6,828.80
- 3,250.00 - 3,250.00
- 6,828.80 - 6,828.80
- 42.00 - 42.00
- 23.00 - 23.00
- 212.00 - 212.00
- 148.00 - 148.00
- 147.00 - 147.00
- 144.00 - 144.00
- 1,510.00 - 1,510.00
- 1,240.00 - 1,240.00
- 4,550.00 - 4,550.00
- 30,030.00 - 30,030.00
- 31,231.00 - 31,231.00
- 76.00 - 76.00
- 125.00 - 125.00
- - - -
- 2,140.00 - 2,140.00
- 315.00 - 315.00
- 323.00 - 323.00
- 9,275.00 - 9,275.00
- - - -
- - - -
- 1,111.00 - 1,111.00
- 1,845.00 - 1,845.00
- 177,216.00 - 177,216.00
- 80.30 - 80.30
- 131.00 - 131.00
- 3,328.00 - 3,328.00
- 3,796.00 - 3,796.00
- - - -
- 39,880.00 - 39,880.00
- 718.20 - 718.20
- - - -
- 102.00 - 102.00
- 160.00 - 160.00
- 946.00 - 946.00
- - - -
- 154.00 - 154.00
- 444.00 - 444.00
- 2,684.00 - 2,684.00
- 2,959.00 - 2,959.00
- 143.00 - 143.00
- 150.00 - 150.00
- 85.00 - 85.00
- - - -
- - - -
- 211.20 - 211.20
- - - -
- - - -
- 3,414.00 - 3,414.00
- 585.00 - 585.00
- 585.00 - 585.00
- 7,100.00 - 7,100.00
- - - -
- 50.00 - 50.00
- 50.00 - 50.00
- 145.00 - 145.00
- 128.00 - 128.00
- 115.00 - 115.00
- 200.00 - 200.00
- 6,410.00 - 6,410.00
- 6,840.00 - 6,840.00
- 193.60 - 193.60
- 13,900.00 - 13,900.00
- 598.00 - 598.00
- 843.00 - 843.00
- - - -
- 415,721.00 - 415,721.00
- - - -
- - - -
- 248,120.00 - 248,120.00
- 1,297,889.00 - 1,297,889.00
- 415,469.00 - 415,469.00
- - - -
- 4,697.00 - 4,697.00
- 6,050.00 - 6,050.00
- 7,106.00 - 7,106.00
- 6,760.00 - 6,760.00
- 4,697.00 - 4,697.00
- - - -
- - - -
- 2,500.00 - 2,500.00
- 2,500.00 - 2,500.00
- 2,412.30 - 2,412.30
- 2,005.00 - 2,005.00
- 1,199.00 - 1,199.00
- 16,997.00 - 16,997.00
- 341.81 - 341.81
- 1,650.00 - 1,650.00
- 6,649.00 - 6,649.00
- 1,107.00 - 1,107.00
- 1,010.00 - 1,010.00
- - - -
- 53.00 - 53.00
- 49.00 - 49.00
- - - -
- - - -
- 3,051.40 - 3,051.40
- 3,080.00 - 3,080.00
- 23,000.00 - 23,000.00
- 11,825.00 - 11,825.00
- 451.00 - 451.00
- 803.00 - 803.00
- 156.20 - 156.20
- 130.00 - 130.00
- 291.00 - 291.00
- 123.00 - 123.00
- - - -
- 3,360.00 - 3,360.00
- - - -
- 18,900.00 - 18,900.00
- 73.00 - 73.00
- 96.00 - 96.00
- - - -
- - - -
- 76.00 - 76.00
- 586.30 - 586.30
- - - -
- 112.00 - 112.00
- 98.00 - 98.00
- 305.00 - 305.00
- 553.00 - 553.00
- - - -
- - - -
- - - -
- 7,150.00 - 7,150.00
- 63.00 - 63.00
- 70.00 - 70.00
- 4,550.00 - 4,550.00
- 2,621.00 - 2,621.00
- 2,429.00 - 2,429.00
- 2,527.00 - 2,527.00
- 1,025.00 - 1,025.00
- 5,856.40 - 5,856.40
- 11,718.25 - 11,718.25
- 19,690.00 - 19,690.00
- 3,980.00 - 3,980.00
- 450.00 - 450.00
- - - -
- - - -
- - - -
- - - -
- - - -
- 90.00 - 90.00
- 96.00 - 96.00
- 2,915.00 - 2,915.00
- 3,150.00 - 3,150.00
- 1,098.00 - 1,098.00
- 49.00 - 49.00
- - - -
- 176.00 - 176.00
- 117.00 - 117.00
- 117.00 - 117.00
- 111.00 - 111.00
- 530.20 - 530.20
- 208.00 - 208.00
- - - -
- 353.00 - 353.00
- 226.00 48,600.00 10,983,600.00 226.00
- - - -
- - - -
- 163.00 - 163.00
- 310.00 - 310.00
- 1,140.00 - 1,140.00
- 85.00 - 85.00
- 91.00 - 91.00
- 837.00 - 837.00
- 921.00 - 921.00
- - - -
- - - -
- 91.00 - 91.00
- 88.00 - 88.00
- 89.00 - 89.00
- 856.90 - 856.90
- 660.00 - 660.00
- 524.00 - 524.00
- 524.00 - 524.00
- 3,171.00 - 3,171.00
- - - -
- 9,680.00 - 9,680.00
- 16,962.00 - 16,962.00
- 13,200.00 - 13,200.00
- 33,000.00 - 33,000.00
- 150,000.00 - 150,000.00
- 49,500.00 - 49,500.00
- 775,000.00 - 775,000.00
- 78,100.00 - 78,100.00
- 50,000.00 - 50,000.00
- 660.00 - 660.00
- 12,793.00 - 12,793.00
- 14,850.00 - 14,850.00
- 462.00 - 462.00
- 287.00 - 287.00
- 5,900.00 - 5,900.00
- 626.00 - 626.00
- 776.00 - 776.00
- 1,121.00 - 1,121.00
- 287.00 - 287.00
- 4,232.00 - 4,232.00
- 14,850.00 - 14,850.00
- 2,981.00 - 2,981.00
- 198.00 - 198.00
- - - -
20.00 65,600.00 3,280.00 5.00 16,400.00 3,280.00
- - - -
- 8,950.00 - 8,950.00
- 7,334.00 - 7,334.00
- 3,800.00 - 3,800.00
- 8,950.00 - 8,950.00
- - - -
- 650.00 - 650.00
20.00 11,380.00 569.00 10.00 5,690.00 569.00
- - - -
- 1,045.00 - 1,045.00
- - - -
- 123.60 1,346.00 166,365.60 123.60
1,000.00 88,000.00 88.00 220.00 19,360.00 88.00
130.00 10,270.00 79.00 - 79.00
- - - -
- 1,518.00 - 1,518.00
- - - -
120.00 139,800.00 1,165.00 480.00 559,200.00 1,165.00
1,010.00 1,176,650.00 1,165.00 526.00 612,790.00 1,165.00
- 1,540.00 - 1,540.00
- - 220.00 - -
- 1,439.00 - 1,439.00
- 1,540.00 - 1,540.00
- - - -
- 26,666.67 - 26,666.67
- 34,300.00 - 34,300.00
- 33,250.00 - 33,250.00
- 33,538.00 - 33,538.00
- 3,150.00 - 3,150.00
- 2,677.50 - 2,677.50
- 26,250.00 - 26,250.00
- - - -
- 18,450.00 - 18,450.00
- 18,450.00 - 18,450.00
- 18,450.00 - 18,450.00
- 9,900.00 - 9,900.00
- 9,070.00 - 9,070.00
- 10,725.00 - 10,725.00
- - - -
- - - -
- 7,205.00 - 7,205.00
- 12,875.00 - 12,875.00
- 9,400.00 - 9,400.00
- 800.00 - 800.00
- 3,800.00 - 3,800.00
- 7,900.00 - 7,900.00
- 8,240.00 - 8,240.00
- 1,393.00 - 1,393.00
- 75.90 - 75.90
- - - -
- - - -
- 43,050.00 - 43,050.00
- 2,290.00 - 2,290.00
- 693.00 - 693.00
- - - -
- - - -
- 15,333.33 - 15,333.33
- - - -
- 39,749.00 - 39,749.00
- 2,728.00 - 2,728.00
- 12,827.00 - 12,827.00
- 11,400.00 - 11,400.00
- 11,975.00 - 11,975.00
- - - -
- - - -
- 7,805.00 - 7,805.00
- 12,564.00 - 12,564.00
- 9,300.00 - 9,300.00
- - - -
- - - -
- 232,440.00 - 232,440.00
- 4,120.00 - 4,120.00
- - - -
- 22,433.00 - 22,433.00
- 14,000.00 - 14,000.00
- - - -
- 13,600.00 - 13,600.00
11.00 59,202.00 5,382.00 - 5,382.00
- 4,500.00 - 4,500.00
- 4,500.00 - 4,500.00
- 6,595.00 - 6,595.00
- 6,595.00 - 6,595.00
- - - -
- 1,503.33 - 1,503.33
- 600.49 - 600.49
- 990.00 - 990.00
- - - -
- 3,230.00 - 3,230.00
- - - -
- - - -
- 10,400.00 - 10,400.00
- - - -
- - - -
- 95.07 - 95.07
- 144.20 - 144.20
- 60,800.00 - 60,800.00
- - - -
- 97,500.00 - 97,500.00
- 712,800.00 - 712,800.00
- 396,000.00 - 396,000.00
- 968.00 - 968.00
- 30,000.00 - 30,000.00
- 31,347.00 - 31,347.00
- 19,480.00 - 19,480.00
- 312,500.10 - 312,500.10
- 262,499.60 - 262,499.60
- 131,249.80 - 131,249.80
- 56,249.60 - 56,249.60
- 165,000.00 - 165,000.00
- 5,500.00 - 5,500.00
- 5,500.00 - 5,500.00
- - - -
- 134,214.29 - 134,214.29
- 112,214.29 - 112,214.29
- 160,714.29 - 160,714.29
- 78,750.00 - 78,750.00
- 217,214.29 - 217,214.29
- 72,214.29 - 72,214.29
- 65,214.29 - 65,214.29
- 88,750.00 - 88,750.00
- 98,450.00 - 98,450.00
- 148,000.00 - 148,000.00
- 323,500.00 - 323,500.00
- 81,784.00 - 81,784.00
- 55,000.00 - 55,000.00
- 42,000.00 - 42,000.00
- 7,805.00 - 7,805.00
- 98,450.00 - 98,450.00
- - - -
- - - -
- 479,996.00 - 479,996.00
- 512,204.00 - 512,204.00
- - - -
- - - -
- - - -
- - - -
- 59,950.00 - 59,950.00
20.00 1,323,080.00 66,154.00 9.00 595,386.00 66,154.00
- - - -
- - - -
10.00 181,280.00 18,128.00 8.00 145,024.00 18,128.00
- 16,995.00 - 16,995.00
- - - -
20.00 1,702,060.00 85,103.00 23.00 1,957,369.00 85,103.00
- 84,282.00 - 84,282.00
30.00 775,170.00 25,839.00 28.00 723,492.00 25,839.00
- 25,597.00 - 25,597.00
10.00 1,662,650.00 166,265.00 11.00 1,828,915.00 166,265.00
- 21,285.00 - 21,285.00
20.00 429,880.00 21,494.00 24.00 515,856.00 21,494.00
- 158,994.00 - 158,994.00
- 144,540.00 - 144,540.00
10.00 - - - -
- - - -
- - - -
- 1,339,440.50 - 1,339,440.50
- - - -
- - 496.00 - -
1.00 - - - -
20.00 - - 41.00 - -
50.00 - - 52.00 - -
50.00 - - 55.00 - -
- 1,325,000.00 - 1,325,000.00
- 1,325,000.00 - 1,325,000.00
65,600.00 11,000,000.00
1,485,302.00 1,363,405.60
6,074,120.00 5,766,042.00
- 7,625,022.00 - - 18,129,447.60 -
KONTROL
PROGRAM
- - - -
- - - -
5,000.00 1,835,000.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
5.00 72,500.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
2.00 127,626.00 - -
20.00 374,400.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
1,100.00 282,700.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
400.00 24,000.00 - -
- - - -
9.00 10,710.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
500.00 72,500.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
45.00 1,351,350.00 - -
20.00 624,620.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
3,300.00 745,800.00 - 21,967,200
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
400.00 36,400.00 - -
- - - -
- - - -
- - - -
- - - -
2,000.00 1,048,000.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
100.00 28,700.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
24.00 - - -
55.00 180,400.00 - 32,800
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
40.00 22,760.00 - 11,380
24.00 - - -
- - - -
- - - -
12,735.00 1,574,046.00 - 332,731
1,520.00 133,760.00 - 38,720
1,525.00 120,475.00 - -
144.00 - - -
231.00 350,658.00 - -
144.00 - - -
40.00 46,600.00 - 1,118,400
534.00 622,110.00 - 1,225,580
100.00 154,000.00 - -
30.00 - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
1,000.00 693,000.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
200.00 545,600.00 - -
- - - -
100.00 1,140,000.00 - -
- - - -
- - - -
- - - -
100.00 780,500.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
20.00 448,660.00 - -
- - - -
6.00 - - -
5.00 68,000.00 - -
15.00 80,730.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
9,000.00 29,070,000.00 - -
- - - -
- - - -
- - - -
- - - -
- - - -
14,250.00 1,354,747.50 - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
16.00 1,058,464.00 - 1,190,772
- - - -
- - - -
5.00 90,640.00 - 290,048
- - - -
- - - -
8.00 680,824.00 - 3,914,738
- - - -
22.00 568,458.00 - 1,446,984
- - - -
5.00 831,325.00 - 3,657,830
- - - -
6.00 128,964.00 - 1,031,712
- - - -
- - - -
10.00 - - -
- - - -
- - - -
- - - -
- - - -
174.00 - - -
2.00 - - -
19.00 - - -
23.00 - - -
40.00 - - -
- - - -
- - - -
6,814,706.00 - 22,000,000
37,205,646.50 - 2,726,811
3,358,675.00 - 11,532,084
- 47,379,027.50 - 36,258,895
MUTASI PERSEDIAAN OBAT DAN BMHP
STOK AWAL PENERIMAAN PENGELUARAN JUMLAH NOMINAL STOK AKHIR (RP)

NO NAMA SUMBER
OBAT BMHP OBAT BMHP OBAT BMHP OBAT BMHP
1 UPTD PUSKESMAS MEKARWANGI
- JKN 63,471,143.04 26,556,737.89 - - 1,602,655.54 90,262.00 61,868,487.50 26,466,475.89
- DAK 18,690,220.26 9,549,960.50 339,302.40 - 876,608.40 40,372.00 18,152,914.26 9,509,588.50
- APBD 1,634,295.00 8,854,500.00 - 3,636,400.00 - - 1,634,295.00 12,490,900.00
- PROGRAM 20,799,703.00 37,083,750.10 6,139,720.00 1,485,302.00 16,766,042.00 1,363,405.60 10,173,381.00 37,205,646.50
JUMLAH TOTAL 104,595,361.30 82,044,948.49 6,479,022.40 5,121,702.00 19,245,305.94 1,494,039.60 91,829,077.76 85,672,610.89
Mengetahui, Kuningan, 30 April 2022

Kepala UPTD Puskesmas Mekarwangi Petugas Obat
dr. Asikin apt. Novi Angga Permana, S. Farm

NIP. 19711109 201001 1 004 NIPNP. 6114 19911210 1 001
PETUNJUK PENGISIAN
1
2
6
7
8
9
10
11
PETUNJUK PENGISIAN
Data yang diinput berdasarkan data laporan tahunan periode januari - desember 2018
Stok awal berdasarkan laporan desember 2017 yang telah dikunci oleh BPKAD dan TIDAK BISA DIRUBAH!
Berdasarkan hasil pemeriksaan BPK, laporan persediaan tahun 2018 mengacu kepada Peraturan Bupati Tahun Nomor 50 Tahu
Perubahan Ketiga Atas Peraturan Bupati Nomor 51 Tahun 2013 Tentag Kebijakan Akuntansu Pemerintah Daerah kabupaten Ku
Nomor 55. yaitu " Persediaan dinilai dengan menggunakan Persediaan akhir dinilai dengan metode Harga Pembelian Terakhir"
Stok awal yang masih bervariasi harga dipisahkan dengan menginsert ke bawah,,bukan ke samping
Penerimaan menggunakan harga perolehan terakhir yang sudah diinput, kecuali yang harganya belum ada bisa ditanyakan lan
atau Beta
Sistem Pengeluaran berdasarkan sistem FIFO (First In First Out)
Hasil akhir diharapkan hanya muncul satu harga,,yaitu harga yg baru
Jika stok awal masih muncul di stok akhir,,biarin ajah!abaikan
HARUS SELESAI MAKSIMAL HARI JUMAT TANGAL 29 FEBRUARI PUKUL 06.00
TIDAK MENERIMA ALASAN BELUM SELESAI
SEMANGAAATT TEMAN TEMAAAANNNN
PEMERINTAH KABUPATEN KUNINGAN
DINAS KESEHATAN
Jalan Raya Mekarwangi No. 274 Kecamatan Lebakwangi
Email : mekarwangi274@gmail.com
Kuningan
Kode Pos 45574
BERITA ACARA PEMERIKSAAN DAN PENGHITUNGAN

OBAT DAN PERBEKALAN KESEHATAN
KECAMATAN LEBAKWANGI
KABUPATEN KUNINGAN
NOMOR : 442/ /PKM-MKW/2022
Pada hari ini Selasa tanggal Lima bulan April tahun Dua Ribu Dua Puluh Dua kami yang
bertandatangan di bawah ini, Kepala UPTD Puskesmas Mekarwangi Kecamatan Lebakwangi
Kabupaten Kuningan yang diangkat berdasarkan Surat Perintah Pelaksana Tugas Nomor :
821.27/160/BKPSDM tanggal 21 Januari 2020 telah melaksanakan pemeriksaan dan
penghitungan obat-obatan dan perbekalan kesehatan yang menjadi tanggung jawab pengelola
obat di UPTD Puskesmas Mekarwangi
Berdasarkan hasil perhitungan atas obat dan perbekalan kesehatan yang berada pada
UPTD Puskesmas Mekarwangi Kabupaten Kuningan per tanggal 30 April 2022 yang kami
periksa dan hitung adalah sesuai dengan kartu barang pencatatan seperti terlampir pada
Lampiran Berita Acara ini dengan nilai Rp 176.383.305.65
Demikian berita acara ini kami buat dengan sesungguhnya agar yang berkepentingan
menjadi maklum.
Kuningan, 5 April 2022

Yang memeriksa, Yang diperiksa,
Kepala UPTD Puskesmas Mekarwangi Pengelola Obat Puskesmas
dr. Asikin apt. Novi Angga Permana, S. Farm

NIP. 19711109 201001 1 004 NIPNP. 6114 19911210 1 001

Laporan Mutasi Persediaan 2022 Puskesmas Mekarwangi (April) New

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Laporan Mutasi Persediaan 2022 Puskesmas Mekarwangi (April) New

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DATA MUTASI PERSEDIAAN OBAT DAN BMHP SUMBER ANGGARAN JKN

UPTD PUSKESMAS MEKARWANGI

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

Antasida Doen Tablet, Kombinasi : Magnesium

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

Kotrimoksazol Suspensi Kombinasi :

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

Salep 2-4 Kombinasi :

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

NO NAMA SEDIAAN SATUAN JKN JKN JKN JKN

SALDO AKHIR APRIL 2022

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

155.00 406,255.00 - 26,210

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

BANYAKNYA NILAI RP. STOK TOTAL HARGA

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

Ibuprofen Tablet 200 mg Tablet 102.00 - - - 102.00 -

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

NO NAMA SEDIAAN SATUAN DAK DAK DAK

JUMLAH TOTAL OBAT 16,722,497.26 339,302.40 876,608.40

SALDO AKHIR APRIL 2022

803.00 30.00 24,090.00

STOK AWAL APRIL 2022

NO NAMA SEDIAAN SATUAN APBD

JUMLAH TOTAL OBAT 1,634,295.00