LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

(LPLPO)

KODE PUSKESMAS : 7313120101

PUSKESMAS : PITUMPANUA Pelaporan Bulan : DESEMBER 2020 Dokumen Nomor Tanggal
KECAMATAN : PITUMPANUA Permintaan Bulan : JANUARI 2021 Dinkes Kab. Wajo
KAB / KOTA : WAJO IF Kab. Wajo
PROVINSI : SULAWESI SELATAN Puskesmas 094/ 3142 /PKM PIT 04 JANUARI 2021

PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 ACT Tab tablet - -
2 ACT inj vial - -
3 Obat Suntik KB I : inj depo 150 mg - -
Medroxyprogesteron Acetat 150 mg - -
4 Air untuk irigasi 1000 ml botol 1000ml - -
5 Albendazol tablet 400 mg tablet 6,120.00 6,120.00 5,130.00 990.00
6 Albendazol suspensi 200 mg/ 5 ml botol 10 ml 673.00 673.00 33.00 640.00
7 Alopurinol Tablet 100 mg tablet 325.00 325.00 325.00 - 1,000.00
8 Alopurinol Tablet 300 mg tablet - - - -
9 Ambroxol tablet 30mg tablet 273.00 273.00 129.00 144.00 2,000.00
10 Ambroxol sirup 15 mg/ 5 ml btl 60 ml 120.00 120.00 4.00 116.00
11 Aminofilin injeksi 24 mg/ml ampul - - - -
12 Aminofilin tablet 200 mg tablet - - - -
13 Amitriptilin tablet salut 25 mg (HCl) tablet 465.00 500 965.00 139.00 826.00
14 Amlodipin tablet 5 mg tablet 460.00 460.00 - 460.00 1,200.00
15 Amlodipin tablet 10 mg tablet 1,320.00 1200 2,520.00 760.00 1,760.00
16 Amoksisilin kapsul 250 mg kapsul 1,137.00 1000 2,137.00 337.00 1,800.00
17 Amoksisilin kaplet 500 mg kaplet 5,161.00 5,161.00 3,418.00 1,743.00 10,000.00
18 Amoksisilin sirup kering 125 mg/5 ml btl 60 ml 11.00 11.00 11.00 - 50.00
Amoksisilin sirup kering forte 250 mg/5
19 btl 60 ml 17.00 17.00 1.00 16.00
ml
20 Ampisillin serbuk inj. i.v. 1000 mg/vial ktk 10 vial 41.00 41.00 - 41.00
21 Ampisilin sirup kering 125 mg/ 5 ml btl 60 ml - - - -
22 Antasida DOEN Tab tablet - - - - 5,000.00
23 Antasida DOEN II suspensi btl 60 ml 123.00 0 123.00 123.00 - 300.00
24 Anti Bakteri DOEN salep tube @ 5 g - - - -
25 Antifungi DOEN pot @ 30 g - - - -
26 Antihemoroid DOEN supp @ 2 g 28.00 30 58.00 5.00 53.00
27 Antimigren tablet 300.00 300.00 - 300.00
28 Antiparkinson DOEN tablet tablet - - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
29 Aqua pro injeksi steril, bebas pirogen vial @ 20 ml 5.00 5.00 - 5.00
30 Artemether injeksi 1 ml : 80 ml ampul - - - -
Articain hidrokloride 4 mg : efinefrin
31 ampul 205.00 205.00 39.00 166.00
bitartrat 0,01 mg (ORABLOC)
32 Asam asetilsalisilat tablet 80 mg tablet - - - -
33 Asam asetilsalisilat tablet 100 mg tablet - - - -
34 Asam asetilsalisilat tablet 500 mg tablet - - - -
35 Asam askorbat (Vit.C) tablet 50 mg tablet 12,696.00 7000 19,696.00 5,791.00 13,905.00 7,000.00
36 Asam askorbat (Vit.C) tablet 100 mg tablet - - - -
37 Asam askorbat (Vit.C) tablet 250 mg tablet - - - -
38 Asam Mefenamat kaplet 500 mg tablet 4,697.00 5000 9,697.00 2,292.00 7,405.00 5,000.00
39 Asam valproat sirup botol - - - -
40 Asetil sistein kapsul 200 mg tablet 1,070.00 1,070.00 790.00 280.00 2,800.00
41 Asiklovir krim 5 % tube 5 g 67.00 67.00 4.00 63.00
42 Asiklovir tablet 200 mg tablet - 500 500.00 - 500.00
43 Asiklovir tablet 400 mg tablet 1,200.00 1,200.00 - 1,200.00
44 Attapulgite tablet 600 mg tablet 3,091.00 1000 4,091.00 470.00 3,621.00
45 Atropin injeksi 0,25 mg/ml ampul 90.00 90.00 - 90.00
46 Benzatin benzil penisilin inj. 2,4 juta IU vial 20.00 20.00 - 20.00
47 Betametason krim 0,1 % tube @ 5 g 189.00 189.00 101.00 88.00 150.00
48 Betametason tetes mata 1 mg/ml botol @ 5 ml - - -
49 Bisakodil tab 5 mg tablet - - - - 200.00
50 Bisakodil suppositoria 5 mg Suppositoria - - - - 20.00
51 Bisakodil suppositoria 10 mg Suppositoria 29.00 29.00 - 29.00 30.00
52 Bromheksin HCl 8 mg tablet - - - -
53 Bromheksin HCl sirup botol - - - -
54 Dehidro Atemisin + Piperakuin (DHP) tablet 67.00 67.00 - 67.00
55 Deksametason injeksi i.v 0,5 mg/ml ampul 10.00 10.00 10.00 - 10.00
56 Deksametason tablet 0,5 mg tablet - - - -
57 Dekstrometorfan sirup 10 mg/5 ml btl 60 ml - - - -
Dekstrometorfan sirup 10 mg/5 ml
58 btl 60 ml 163.00 100 263.00 44.00 219.00
kombinasi
59 Dekstrometorfan tablet 15 mg (HBr) tablet - - - -
60 Diazepam injeksi 5 mg/ml ampul 10.00 10 20.00 6.00 14.00
61 Diazepam larutan rektal 5 mg/2,5 ml tube @ 2,5 ml 10.00 10.00 - 10.00

62 Diazepam rectal 10 mg/2,5 ml tube - - - -

63 Diazepam tablet 2 mg tablet - - - -

64 Diazepam tablet 5 mg tablet 855.00 1000 1,855.00 70.00 1,785.00
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Difenhidramin injeksi i.m 10 mg/ml
65 ampul - - - -
(HCl)
66 Digoksin tablet 0,25 mg tablet 345.00 345.00 40.00 305.00
67 Diltiazem HCl tablet 30 mg tablet - - - -
68 Dimenhidrinat tablet 50 mg tablet 326.00 326.00 - 326.00
69 Doksisiklin 100 mg kapsul 500.00 500.00 - 500.00
70 Domperidon tablet 10 mg tablet 550.00 2000 2,550.00 450.00 2,100.00
71 Efedrin tablet 25 mg (HCl) tablet - - - -
72 Ekstraks Belladona tablet 10 mg tablet - - - -
Epinefrin (Adrenalin) injeksi 0,1 %
73 ampul - - - -
(sebagai HCl)
74 Eritromisin kapsul 250 mg kapsul - - - -
75 Eritromisin kapsul 500 mg tablet 360.00 360.00 - 360.00
76 Eritromisin sirup kering 200 mg/ 5 ml btl 60 ml - - - -
77 Etanol 70 % btl 100 ml - - - -
78 Fenilbutason tablet 200 mg tablet - - - -
79 Fenobarbital injeksi i.m/i.v 50 mg/ml ampul - - - -
80 Fenobarbital tablet 30 mg tablet 1,365.00 1,365.00 - 1,365.00
81 Fenol Gliserol tetes telinga 10% botol 5 ml - - - -
Fitomenadion (Vit K) tablet salut gula 10
82 tablet 1,340.00 1000 2,340.00 60.00 2,280.00
mg
83 Fitomenadion (Vit K) injeksi 10 mg/ml ampul - - -
84 Fitomenadion (Vit K) injeksi i.m.2 mg/ml ampul 103.00 90 193.00 72.00 121.00
85 Furosemid tab 40 mg tablet 366.00 366.00 - 366.00
86 Garam Oralit serbuk 200 ml sachet 105.00 105.00 105.00 - 200.00
87 Gentamisin inj.40 mg/ml ampul 90.00 90.00 - 90.00 -
88 Gentian violet larutan 1 % btl 10 ml - - - -
89 Glibenklamida tablet 5 mg tablet 920.00 1000 1,920.00 60.00 1,860.00
90 Glimepiride tablet 1 mg tablet 1,095.00 1,095.00 237.00 858.00 1,000.00
91 Glimepiride tablet 2 mg tablet - - - -
92 Gliseril Guaiakolat tablet 100 mg tablet 7,821.00 7,821.00 1,775.00 6,046.00
93 Glukosa larutan infus 10% steril btl 500 ml - - - -
94 Glukosa larutan infus 5% btl 500 ml 106.00 106.00 32.00 74.00 100.00
95 Griseofulvin tablet 125mg Micorinized tablet - - - -
96 Griseofulvin tablet 500 mg tablet - - - -
97 Haloperidol tablet 1,5 mg tablet - - - -
98 Haloperidol tablet 5 mg tablet - - - -
99 Haloperidol inj 5 mg/ml ampul 5.00 5.00 - 5.00
100 Haloperidol inj 50 mg/ml ampul @ 1 ml 3.00 3.00 1.00 2.00
101 Hidroklortiazid tablet 25 mg tablet 500.00 500.00 - 500.00
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
102 Hidrokortison krim 2,5% tube @ 5 g 1.00 1.00 1.00 - 50.00
103 Hyosicine-N-Butilbromide tablet 10mg tablet - - - - 1,000.00
104 Ibuprofen sirup 100 mg/ 5 ml btl 60 ml 59.00 59.00 22.00 37.00 50.00
105 Ibuprofen tablet 200 mg tablet 13.00 13.00 13.00 - 2,000.00
106 Ibuprofen tablet 400 mg tablet 2,755.00 3000 5,755.00 2,080.00 3,675.00 5,000.00
107 Iodiol kapsul lunak kapsul - - - -
108 Isoniazid tablet 100 mg tablet - - - - - 500.00
109 Isoniazid tablet 300 mg tablet 56.00 56.00 56.00 - 500.00
110 Isosorbid Dinitrat tablet sublingual 5mg tablet - - - -
111 Kalsium Laktat (Kalk) tablet 500 mg tablet - - - -
Kalsium Glukonat injeksi i.v. 10%
112 ampul - - - -
(100mg/ml)
113 Kaptopril 25 mg tablet 830.00 830.00 - 830.00
114 Karbamazepin tablet 200 mg tablet - - - -
115 Ketokonazol tablet 200mg tablet - - - -
116 Klobazam 10 mg tablet - - - -
117 Kloramfenikol kapsul 250 mg kapsul - - - -
118 Kloramfenikol salep kulit 2 % tube @ 15 g - - - -
119 Kloramfenikol salep mata 1 % tube @ 5 g 84.00 84.00 6.00 78.00
120 Kloramfenikol suspensi 125 mg/5 ml btl 60 ml - - - -
121 Kloramfenikol tetes telinga 3% btl @ 10 ml - - - -
122 Klorfeniramin Maleat (CTM) tablet 4 mg tablet 268.00 4000 4,268.00 1,152.00 3,116.00 5,000.00
123 Klorpromazin injeksi i.m 5 mg/ml - 2 ml ampul - - - -
124 Klorpromazin tablet salut 25 mg (HCl) tablet - - - -
125 Klorpromazin tablet salut 100 mg (HCl) tablet 653.00 1000 1,653.00 480.00 1,173.00 500.00
126 Klozapin 25 mg tablet - - - -
127 Kodein tablet 10 mg tablet - - - -
128 Kodein tablet 20 mg tablet - - - -
129 Kotrimoksazol DOEN (dewasa) tablet 644.00 644.00 588.00 56.00 500.00
130 Kotrimoksazol DOEN (Pediatrik) tablet - - - -
131 Kotrimoksazol suspensi btl 60 ml 34.00 34.00 12.00 22.00 50.00
Kombipak PMS (Azithomycin 500
132 paket - - - -
mg+Cefixime 200 mg)
133 Kuinin dihidroklorida injeksi 25% - 2ml ampul - - - -
134 Kuinin (kina) tablet 222 mg tablet - - - -
135 Lidokain injeksi 2% ampul @ 2 ml - - - -
Lidokain injeksi 2% (HCl) + Epinefrin 1 :
136 ampul 67.00 120 187.00 39.00 148.00
80.000 - 2 ml
137 Loratadin tablet 10 mg tablet - - - -
138 Magnesium sulfat inj 20% vial 25 ml - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
139 Magnesium sulfat inj 40% vial 25 ml 16.00 10 26.00 4.00 22.00
140 Mebendazol sirup 100 mg/ 5ml btl 30 ml - - - -
141 Mebendazol tablet 500 mg tablet - - - -
142 Metampiron injeksi 250 mg/ml ampul - - - -
143 Metampiron tablet 500 mg tablet - - - -
144 Metformin HCl tablet 500 mg tablet - - - -
145 Metformin HCl tablet 850 mg tablet - - - -
Metil Ergometrin Maleat
146 tablet 40.00 200 240.00 235.00 5.00 300.00
(Metilergometrin) tablet salut
Metilergometrin Maleat 0,125
injeksi mg
0.200
147 ampul 90.00 90.00 - 90.00
mg/ml
148 Metilprednisolon 4 mg tablet - - - -
149 Metoklopramide tablet 5 mg tablet - - - -
150 Metoklopramide tablet 10 mg tablet - - - -
151 Metronidazol tablet 500 mg tablet 2,416.00 2,416.00 490.00 1,926.00
152 Metronidazol infus 500 mg/100 ml botol @ 100 ml - - - -
153 Metronidazol sirup 125 mg/5 ml botol @ 60 ml - - - -
154 Mikonazol krim/salep 2 % (Nitrat) tube @ 10 g 91.00 91.00 32.00 59.00 50.00
155 Mineral Mix sachet - - - -
156 Natrium Bikarbonat tablet 500 mg tablet - - - -
157 Natrium Bikarbonat injeksi i.v. 8,4% ampul 25 ml - - - -
158 Natrium Diklofenak tablet 50 mg tablet 5,140.00 2800 7,940.00 2,490.00 5,450.00
159 Natrium Diklofenak tablet 25 mg tablet - - - -
Natrium Diklofenak Gel emulsi (hotin
160 Tube - - - -
DCL)
161 Natrium Klorida larutan infus 0,9% btl 500 ml - - - -
162 Natrium Tiroksin 100 mcg tablet - - - -
163 N.B Topical Oint tube 5 g - - - -
164 Nifedipin tablet 10 mg tablet 180.00 180.00 - 180.00
165 Nifedipin tablet 20 mg (adalat oros) tablet - - - -
166 Nistatin drops botol - - - -
167 Nistatin tablet salut 100.000 IU/g tablet - - - -
168 Nistatin tablet 500.000 IU/g tablet - - - -
169 Obat antituberkulosis kategori 1 dewasa paket 30.00 30.00 7.00 23.00
170 Obat antituberkulosis kategori 2 dewasa paket 3.00 3.00 - 3.00
171 Kombipak Kategori 1 paket - - - -
172 Obat antituberkulosis kategori anak paket 5.00 5.00 - 5.00
173 Obat antituberkulosis sisipan dewasa paket - - - -
174 Obat Batuk Hitam ( O.B.H ) cairan btl 100 ml - - - -
175 Obat Batuk Hitam ( OBH Itra) btl 120 ml - - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Obat gigi : - - - -
Bahan Tumpatan sementara
176 pot @ 30 g - - - -
(Ceivitron)
177 Etil Klorida Spray btl 100 ml 11.00 11.00 1.00 10.00
178 Eugenol cairan Botol @ 10 ml - - - -
179 Glass Ionomer Cement ART set - - - -
180 Hemospon set - - - -
181 Kalsium Hidroksida Pasta set - - - -
182 Klorfenol kamfer Menthol (CHKM) set - - - -
183 Mummiffying pasta set - - - -
184 Semen seng Fosfat serbuk dan cairan set - - - -
185 Silver Amalgam set - - - -
Temporary Stopping Fletcher serbuk
186 set - - - -
dan cairan
187 Oksimetazolin tetes hidung 0,025% Botol @ 10 ml - - - -
188 Oksitetrasiklin salep mata 1% (HCl) tube @ 3,5 g 68.00 68.00 34.00 34.00
189 Oksitetrasiklin salep kulit 3% tube @ 5 g - - - -
190 Oksitosin injeksi 10 IU/ml - ml ampul @ 1 ml 40.00 40.00 20.00 20.00
191 Omeprazol kapsul 20 mg kapsul 2,070.00 900 2,970.00 1,005.00 1,965.00
192 Omeprazol injeksi 40 mg/10 ml vial - - - -
193 Papaverin tab 40 mg tablet 1,274.00 1,274.00 56.00 1,218.00
194 Paracetamol drops 100 mg/ml btl 15 ml 10.00 10 20.00 2.00 18.00
195 Parasetamol sirup 120 mg/ 5 ml btl 60 ml 175.00 100 275.00 37.00 238.00 100.00
196 Parasetamol tablet 100 mg tablet - - - -
197 Parasetamol tablet 500 mg tablet 5,612.00 10000 15,612.00 3,663.00 11,949.00 5,000.00
198 Perak sulfadiazin krim 1% tube @ 35 g - - - -
199 Permetrin krim 5% tube @ 10 g - - - -
200 Pirantel suspensi 125 mg/ 5 ml btl 60 ml - - - -
201 Pirantel tab.Score (base) 125 mg tablet 57.00 57.00 - 57.00
202 Piridoksin (Vit. B6) tablet 10 mg (HCl) tablet 436.00 436.00 436.00 - 3,000.00
203 Piridoksin tab 25 mg tablet - - - -
204 Piroksikam tablet 10 mg tablet - - - -
205 Piroksikam tablet 20 mg tablet - - - -
206 Polikresulen cairan btl 10 ml - - - -
207 Povidon Iodida larutan 10% btl @ 300 ml - - - -
208 Prednison tablet 5 mg tablet 720.00 720.00 720.00 - 2,000.00
209 Primakuin tablet 15 mg tablet 98.00 98.00 - 98.00
210 Probenesid tab 500 mg tablet - - - -
211 Prokain Benzil Penisilin injeksi 3 jt IU vial - - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
212 Propanolol tablet 10 mg (HCl) tablet - - -
213 Propranolol 40 mg tablet 550.00 550.00 - 550.00
214 Propiltiourasil tablet 100 mg tablet 500.00 800 1,300.00 60.00 1,240.00
215 Ranitidin tablet 150 mg tablet 1,490.00 1000 2,490.00 310.00 2,180.00
216 Ranitidin injeksi ampul - - - -
217 Reserpin tablet 0,25 mg tablet - - - -
218 Retinol (Vit.A) 100.000 IU kapsul lunak kapsul 171.00 171.00 - 171.00 200.00
219 Retinol (Vit.A) 200.000 IU kapsul lunak kapsul 7,244.00 7,244.00 43.00 7,201.00 - 2,000.00
220 Ringer Laktat larutan infus btl 500 ml 412.00 412.00 226.00 186.00
221 Risperidon 2 mg tablet - - - -
222 Salbutamol tablet 2 mg (sebagai sulfat) tablet - - - -

223 Salbutamol tablet 4 mg (sebagai sulfat) tablet 1,175.00 1000 2,175.00 620.00 1,555.00

224 Salbutamol cairan ih 0,1% botol @ 2,5 ml - - - -

Salep 2-4,kombinasi : Asam sulfat 2 %
225 pot @ 30 g 70.00 48 118.00 15.00 103.00
+ Belerang endap 4 %
226 Salisil bedak serbuk 2 % ktk 50 gram 136.00 100 236.00 22.00 214.00
227 Sefadroxil sirup 250 mg/5 ml botol - - - -
228 Sefadroxil 500 mg kaplet - - - -
229 Setrizin drops botol - - - -
230 Setirizin sirup 5 mg/5 ml Botol @ 60 ml - - - -
231 Setrizin tab 10 mg tablet - - - -
Sianokobalamin (Vit.B 12) tablet 50
232 tablet 2,200.00 2,200.00 1,360.00 840.00 3,000.00
mcg
Sianokobalamin (Vit.B 12) tablet 10
233 tablet - - - -
mcg
Sianokobalamin (Vit.B 12) injeksi 500
234 ampul - - - -
mcg
235 Simetidine tablet 200 mg tablet - - - -
236 Simvastatin tablet 10 mg tablet 60.00 600 660.00 660.00 - 600.00
237 Simvastatin tablet 20 mg tablet - - - - 500.00
238 Siprofloksasin tablet 500 mg (HCl) tablet - - - - 1,000.00
239 Spironolakton tablet 25 mg tablet - - - -
Tablet tambah darah : tablet - - - -
_ Besi (II) sulfat 200 mg, asam folat
tablet - - - -
240 0,25 mcg
_ Ferrous Fumarate 180 mg, Folic Acid
tablet 10,640.00 10350 20,990.00 4,490.00 16,500.00 13,800.00
400 mcg
241 Taburia sachet - - - -
242 Tetrakain HCl tetes mata 0,5% botol 5 ml - - - -
243 Tetrasiklin kapsul 250 mg kapsul - - - -
244 Tiamin (Vit.B1) tablet 50 mg tablet 5,393.00 5000 10,393.00 1,990.00 8,403.00 5,000.00
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
245 Tiamin (Vit.B1) injeksi 100 mg/ml ampul - - - -
246 Triheksifenidil tablet 2 mg tablet - - - - 5,000.00
247 Triheksifenidil tablet 2 mg (Arkine) tablet - - - - 5,000.00
Vaksin BCG serb inj. 0,75 mg/ml +
248 vial 7.00 20 27.00 20.00 7.00
pelarut
249 Vaksin campak serb inj. + pelarut vial - - - -
250 Vaksin kombinasi DPT-HB-Hib inj vial 13.00 70 83.00 59.00 24.00
Vaksin jerap difteri tetanus (DT) inj.
251 vial - - - -
40/15 Ifjerap
Vaksin per mldifteri tetanus pertusis
252 vial - - - -
(DPT) inj.
253 Vaksin HB-PID vial - - - -
254 Vaksin polio b-OPV drops 10 dosis vial 11.00 40 51.00 36.00 15.00
255 Vaksin polio IPV inj. 0,5 ml vial 32.00 30 62.00 34.00 28.00
256 Vaksin Td vial 59.00 59.00 8.00 51.00
257 Vaksin rabies serb inj +booster vial - - - -
258 Vaksin HBIG vial - - - -
259 Vaksin MR vial - 30 30.00 24.00 6.00
260 Vaksin Hepatitus B syringe - - - -
261 Vitamin B Kompleks tablet tablet 11,878.00 10000 21,878.00 5,608.00 16,270.00
262 Zinc Tab 20 mg tablet 2,506.00 1000 3,506.00 365.00 3,141.00
263 Zinc drop 10 mg/ml botol @ 15 ml - - - -
264 Zinc sirup 10 mg/ml botol 100 ml - - - -
265 Zinc sirup 20 mg/5 ml botol 60 ml 74.00 74.00 20.00 54.00 50.00
266 Efavirens (EFV) 600 mg botol @ 30 tab - - - -
267 Nevirapine (NVP) 200 mg botol @ 60 tab - - - -
268 Lamivudin (3TC) 150 mg botol @ 60 tab - - - -
269 Tenofovir (TDF) 300 mg botol @ 30 tab - - - -
270 Zidovudin (ZDV) 100 mg botol @ 60 tab - - - -
ZDV+3TC+NVP Ped Triple FDC
271 botol @ 30 tab - - - -
(60/30/50)
TDF+3TC+EFV (300/300/600) Triple
272 botol @ 30 tab - - - -
FDC
Zidovudin (300 mg) + Lamivudin (150
273 botol @ 60 tab - - - -
mg)
Multivitamin : - - - -
- Anagens sirup botol @ 60 ml - - - -
- Becefort sirup botol @ 60 ml - - -
- Biovitan syr botol - - - -
- Bioron tablet tablet - - - -
274
- Bioron injeksi amp 206.00 206.00 1.00 205.00
- Corobion tab tablet - - - -
- Corovit sirup botol @ 60 ml 22.00 22.00 20.00 2.00
274 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
- Corovit tablet tablet - - - -
- Takana sirup botol - - - -
275 Helmezin sirup botol - - - -
276 Hemafort tab tablet - - - -
277 Hustab tab tablet - - -
278 Hustab P sirup botol 60 ml 2.00 2.00 2.00 -
279 Lactulose sirup botol - - - -
280 L-Bio sachet 511.00 511.00 197.00 314.00
281 Livron B plex tablet - - - -
282 Pehacain inj. ampul - - - -
283 Potensik (diaz, metampiron) tablet - - - -
284 Flufenazine decanoat 25 mg/ml ampul - -
285 Trifluoperazine HCl 5 mg tablet - - - -
286 Betahistin mesilate 6 mg tablet - - - -
287 Oseltamivir 75 mg tablet - - - -
288 Azithromycin 500 mg tablet - - - -
289 Chloroquine phosphate 150 mg tablet - - - -
290 Pehavral tab tablet 1,479.00 1,479.00 257.00 1,222.00
291 Becefort tab tablet - - - -
292 Klorpromazin injeksi i.m 25 mg/ml - 2 ml ampul - - - -
- - - -

1 Alat suntik 0,05 ml set - - -

2 Alat suntik 0,5 ml set 1,353.00 1,353.00 475.00 878.00

3 Alat suntik 1 ml set 54.00 200 254.00 85.00 169.00
4 Alat suntik 2,5 ml set 96.00 96.00 40.00 56.00 300.00
5 Alat suntik 3 ml set 613.00 300 913.00 218.00 695.00
6 Alat suntik 5 ml set 196.00 200 396.00 47.00 349.00
7 Alat suntik 10 ml Set 49.00 20 69.00 16.00 53.00
8 Alat suntik 20 ml Set - - - -
9 Alat suntik 50 ml Set - - - -
10 Alkohol swab ktk 100 lbr 5.00 10 15.00 6.00 9.00 5.00
11 Aquades steril btl 1000 ml - - - -
12 Aquades 20 liter gallon 20 L 5.00 5.00 1.00 4.00
13 Aquagel Steril Jelly 82 gram Tube 1.00 1.00 1.00 - 5.00
14 Asam Klorida (HCl) 0,1 N btl 1000 ml - - - -
15 Asam sulfosalisilat 20 % btl 100 ml - - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
16 Aseptic Gel btl 500 ml - - - -
17 Blood Lancet ktk 100 pcs 16.00 3 19.00 4.00 15.00
Blood Lancet (BD Microtainer Contact
18 Pcs - - - -
Actived Lancet 21 G x 1.8 m)
19 Blood Collection Tube (BD Vacutainer) Tube - - -
20 Blood Collection Tube (EDTA) tube 470.00 470.00 153.00 317.00
21 Boule cleaning kit set (3x450 ml) - - - -
22 Bracket Handwash plastik Pcs - - - -
23 Brugia Rapid (filariasis test) Test - - - -
24 Control Hematologi Normal vial - - - -
25 Cover glass 22x22 ktk 10 pak @ 10 pcs - - - -
26 CutGut No. 3-0 100 m set - - - -
CutGut Cromic SMI 3/0 HR 26 MM set - - - -
27
CutGut Cromic SMI 3/0 HR 30 MM set 148.00 120 268.00 65.00 203.00
28 Cutgut Cromic SMI 4/0 HR 30 MM set - - - -
29 Dengue Test/RDT Ns1 test - - - -
30 Etakridin larutan 0,1 % btl 300 ml 4.00 4.00 4.00 -
31 Etanol 70 % 1 Liter btl 1000 ml - - - -
32 Folley Catheher 12 Set - - - -
33 Folley Catheher 14 Set - - - -
34 Folley Catheher 16 Set - - - -
35 Folley Catheher 18 Set - - - -
36 Folley Catheher 20 Set - - - -
37 Folley Catheher 22 Set - - - -
38 HbsAg Fast Test test - - -
39 HIV Test 1/2 3.0 test 3.00 3.00 3.00 -
40 HIV Test (Fokus) test - - - -
41 HIV Test (Vikia 1/2) test - - - -
42 HIV Test (Fokus HIV 1+2 (KHB)) test - - - -
43 ID Band Baby Pink ktk 100 pcs 11.00 11.00 4.00 7.00
44 ID Band Baby Blue ktk 100 pcs 25.00 25.00 5.00 20.00
45 ID Band Dws Pink ktk 100 pcs 20.00 20.00 10.00 10.00
46 ID Band Dws Blue ktk 100 pcs 10.00 10.00 10.00 -
47 Infuset Anak set 61.00 61.00 17.00 44.00
48 Infuset Dewasa set 90.00 100 190.00 135.00 55.00 200.00
49 IV Catheter No. 16 G set - - - -
50 IV Catheter No. 18 G set 18.00 18.00 18.00 - 50.00
51 IV Catheter No. 20 G set 94.00 50 144.00 42.00 102.00
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
52 IV Catheter No. 22 G set 86.00 50 136.00 58.00 78.00
53 IV Catheter No. 24 G set 40.00 40.00 21.00 19.00
IV Cannula with inj.port, snap fit cap,
54 set - - - -
and suture wings (22)
55 Immersion oil btl 100 ml - - - -
56 Iodium Test btl 10 ml - - - -
57 Kapas pembalut 250 g roll 2.00 2.00 2.00 - 5.00
58 Kapas Pembalut 500 g roll - - - -
59 Kartu golongan darah pak 100 lbr 5.00 2 7.00 2.00 5.00
60 Kasa kompres 40/40 steril roll - - - -
61 Kasa 2 x 80 cm roll 34.00 34.00 4.00 30.00
62 Kasa 4 x 15 cm roll 174.00 174.00 5.00 169.00
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
63 Kasa 4 x 10 cm roll - - - -
64 Kasa 4 x 5 cm roll - - - -
65 Kasa 4 x 3 cm roll - - - -
66 Kasa hidrofil uk. 36 m x 80 cm roll - - - -
67 Kasa Hydrophil 40 x 80 cm roll 9.00 5 14.00 7.00 7.00 5.00
68 Kapas pembalut 1000 gram Roll - - - -
69 Kasa steril 16x16 Lbr - - - -
70 Kasa steril 18x22 Lbr - - - -
71 Kertas Perkamen bks 200 lbr - - - -
72 Kantong urine steril 2L Pcs 5.00 10 15.00 11.00 4.00 20.00
73 Labstrip U11 Plus Urine Test Tube 150 strip - - - - 10.00
btl 1000 ml - - - -
74 Larutan Turk
btl 100 ml - - - -
btl 100 ml - - - -
75 Larutan Giemsa Stain
btl 500 ml - - - -
76 Larutan Karbol Fucsin btl 100 ml - - - -
77 Larutan HCl- Alkohol btl 100 ml - - - -
78 Larutan Metilen Blue btl 100 ml - - - -
79 Larutan Benedict btl 1000 ml - - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
80 Larutan EDTA btl 100 ml - - - -
81 Larutan Eosin btl 100 ml - - - -
82 Larutan Hayem btl 1000 ml - - - -
83 Larutan Natrium Sitrat 3,8 % btl 500 ml - - - -
84 Larutan Rees Ekker btl 100 ml - - - -
85 Larutan Spiritus btl 1000 ml 2.00 2.00 - 2.00
86 Lisol btl 1000 ml 3.00 5 8.00 3.00 5.00 5.00
87 Malaria Test test 10.00 10.00 1.00 9.00 5.00
88 Masker 3 ply E/L Lbr - - - - 1,000.00
89 Masker 3 ply plus E/L Lbr 114.00 500 614.00 614.00 - 1,000.00
90 Masker 3 ply T/O Lbr - - - 1,000.00
91 My Jelly 82 g btl - 2 2.00 1.00 1.00 5.00
92 Nasal Oxygen canula child pcs 16.00 16.00 5.00 11.00
93 Nasal Oxygen canula adult pcs - 20 20.00 3.00 17.00
94 Object glass pcs - - -
95 One Clean (Chlorine) botol 1 L 1.00 5 6.00 - 6.00 5.00
96 Oxygen mask pediatric pcs 10.00 10.00 2.00 8.00
97 Oxygen mask adult pcs 16.00 20 36.00 1.00 35.00
98 Paraformaldehid tab tablet - - - -
99 Penjepit tali pusat Buah 162.00 162.00 79.00 83.00
100 Plester 2" x 5 yard roll - - - -
101 Plester hospital 2,5 cm x 4,5 m roll - 20 20.00 16.00 4.00 10.00
102 Plester hospital 7,5 cm x 4,5 m roll - - - -
103 Pot sputum buah 2,503.00 2,503.00 50.00 2,453.00
104 Povidon iodida larutan 10 % (betadine) btl 60 ml 10.00 10.00 10.00 - 20.00
105 Povidon iodida larutan 10 % btl 300 ml - - - -
106 Reagensia Ziehl Neelsen 100 ml/btl paket - - - -
107 Refil strip asam urat strip 273.00 273.00 155.00 118.00 200.00
108 Refil strip glukosa strip 846.00 846.00 141.00 705.00
109 Refil strip Hb strip - - - -
110 Refil strip kolesterol strip 114.00 114.00 100.00 14.00 200.00
111 RDT Anti HCV (Hepatitis C) Test - - - -
112 Reagen Dual Pack Hematologi set - - - -
113 Reagen kimia cholesterol set (6 x 100 ml) - - - -
114 Reagen kimia creatinine set (2 x 125 ml) - - - -
115 Reagen kimia glukosa set (2 x 100 ml) - - - -
116 Reagen kimia SGOT (AST) set (2 x 62,5 ml) 0 - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
117 Reagen kimia SGPT (ALT) set (2 x 62,5 ml) - - - -
118 Reagen kimia triglyserides set (4 x 50 ml) 0 - - -
119 Reagen kimia urea set (2 x 62,5 ml) 0 - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
120 Reagen kimia uric acid set (4 x 50 ml) 0 - - -
121 Safety Box 2,5 Lt ktk 13 13.00 2.00 11.00
122 Safety Box 5 Lt kuning ktk 27 27.00 - 27.00
123 Salmonella Test/Widal Test test 50 50.00 - 50.00
124 Sarung tangan uk. 6 Psg 0 - - -
125 Sarung tangan uk. 6,5 Psg 110 200 310.00 243.00 67.00 400
126 Sarung tangan uk. 7 Psg 375 200 575.00 155.00 420.00 400
127 Sarung tangan uk. 7,5 Psg 0 - -
128 Sarung tangan uk. 8 Psg - - - -
129 Sarung tangan S pcs 200.00 500 700.00 654.00 46.00 1,000.00
130 Sarung tangan M pcs 136.00 500 636.00 624.00 12.00 1,000.00
131 Sarung tangan L pcs 300.00 300.00 - 300.00
132 Sarung tangan XL pcs - - - -
133 Shypilis 3,0 test test - - - -
134 Shypilis Test (RPR Fokus) test 50.00 50.00 50.00 -
Silk (benang bedah sutera) no.3/0 HR
135 set 11.00 11.00 - 11.00
30 MM
136 Silk Black 3/0 HR 26 MM set - - - -
137 Silk 4-0 100M roll - - - -
138 Silk braided black 6/0 DS 12 mm roll - - - -
139 Soft cloth tape on liner roll - - - - 10.00
140 Stomach tube FR 18 Set - - - -
141 Suction Catheter No. 6 Set - - - -
142 Suction Catheter No. 8 Set - - - -
143 Suction Catheter No. 10 Set - - - -
144 Suction Catheter No. 12 Set - - - -
145 Suction Catheter No. 14 Set - - - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
146 Surgical Blade No. 10 ktk 100 pcs - - - -
147 Surgical Blade No. 11 ktk 100 pcs - - - -
148 Surgical Blade No. 18 ktk 100 pcs - - - -
149 Surgical Scrub (hydrex) btl 500ml - - - -
Surgical glove sterile gynecolog No. 6,5
150 pasang - - - - 200.00
(Remedi)
Surgical glove sterile gynecolog No. 7
151 pasang - - - - 200.00
(Remedi)
Surgical glove sterile gynecolog No. 7,5
152 pasang - - - -
(Remedi)
153 Suture needle (jarum hecting) BT bks 12 pcs 1.00 1.00 - 1.00
154 Suture needle (jarum hecting) BR bks 12 pcs 2.00 2.00 - 2.00
155 Suture needle (jarum hecting) GT bks 12 pcs 2.00 2.00 - 2.00
156 Suture needle (jarum hecting) GR bks 12 pcs 1.00 1.00 - 1.00
157 Tes golongan darah A, B, AB set - - - -
158 Tes kehamilan (Ultraone) Strip 544.00 100 644.00 190.00 454.00
159 Tip warna putih Pcs 620.00 620.00 20.00 600.00
160 Tip warna putih (kecil) (10 ul) Pcs - - -
161 Tip warna biru (1 ml) Pcs 440.00 440.00 - 440.00
162 Tip warna kuning (200 ul) Pcs - - - -
163 Transfusi set Set - - - -
164 Three way stopcock Pcs 20.00 20.00 - 20.00
165 Underpad 60 x 90 cm pads 63.00 63.00 61.00 2.00
166 Plastik klip 4 x 6 cm bks 100 lbr 78.00 78.00 - 78.00
167 Plastik klip 5x8 cm bks 100 lbr 27.00 27.00 - 27.00
168 Plastik klip beretiket 5 x 8 cm bks 100 lbr - - - -
169 Plastik klip 10 x 7 cm bks 100 lbr 32.00 32.00 - 32.00
170 Plastik klip beretiket 10 x 7 cm bks 100 lbr - - - -
171 Plastik 14 x 25 cm pak 45.00 20 65.00 - 65.00
172 Cavidagel tube 10.00 10.00 - 10.00
173 MILDEX 30 (glutaraldehyde 2,5 %) galon - - - -
174 MILZYME TRIPLE ENZYME botol 1 L - - - -
175 Pharmafix 10 cm x 500 cm roll 3.00 10 13.00 3.00 10.00 5.00
176 Softanol (etanol, propanol) botol 1 L - - - -
177 RDT SARS-CoV-2 Antibody Test - 200 200.00 65.00 135.00
178 Septalkan - - - - 3.00
179 Plesterin bulat non woven - - - -
- -
- -
- -
- -
- -
- - -
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
1 PENUTUP KEPALA REMEDI BOX ISI 50 PCS 700.00 30.00 670.00 ASET
2 MASKER HIJAB/KERUDUNG BOX ISI 50 PCS - - - ASET
3 MASKER TELINGA/BEDAH BOX ISI 50 PCS 2,150.00 2,150.00 1,499.00 651.00 ASET
4 MASKER N-95 BOX ISI 20 PCS 21.00 21.00 8.00 13.00 ASET
5 APPRON 21.00 21.00 5.00 16.00 ASET
6 HAZMAT 7.00 40 47.00 12.00 35.00 ASET
7 KACAMATA PELINDUNG 6.00 6.00 2.00 4.00 ASET
8 SARUNG TANGAN STERIL NO 6,5 BOX ISI 50 PCS 125.00 125.00 125.00 - ASET
9 SARUNG TANGAN S BOX ISI 100 PCS 4,483.00 4,483.00 2,270.00 2,213.00 ASET
10 SARUNG TANGAN M BOX ISI 100 PCS - - - - ASET
11 SARUNG TANGAN L BOX ISI 100 PCS - - - - ASET
12 FACE SHIELD 58.00 58.00 7.00 51.00 ASET
13 RAPID TEST COVID 19 BOX ISI 25 TEST - 140.00 ASET

UMUM BPJS JUMLAH

JUMLAH KUNJUNGAN RESEP
-
Siwa, 04 JANUARI 2021

Mengetahui / Menyetujui Yang Menyerahkan Yang Menerima / Melapor Yang Menerima

Kepala Dinas Kesehatan Kab. Wajo Pengelola IFK Kepala Puskesmas Pitumpanua Petugas Puskesmas Pitumpanua

Dr.drg.HJ.ARMIN,M.Kes., Hj. ANDI ASMANIAR, S.Si., Apt. dr. SUSANNI SAID,S.Ked., HASNINDAR,S.Farm.,
NIP : 19700916 200012 2 002 NIP : 19790523 201406 2 002 NIP.19850427 201503 2 003 NIP.19831214 200902 2 002
 PENGELUARAN
STOK PENERIMA PERSEDIA STOK PERMINTA PEMBERIAN
NO NAMA OBAT / BMHP SATUAN PEMA- RUSAK/ DLL SISA STOK KET.
AWAL AN AN OPT AN
KAIAN ED PROG APBD BUFFER LAIN JML
1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

OBAT JKN PENGADAAN TH.2020

1 ALLOPURINOL 100 MG - 1500 - 1,500.00 - 1,500.00
BECEFORT TABLET 100 100.00 100.00
2 BECEFORT SYRUP 100 100.00 19.00 81.00
3 COROVIT TABLET 100 100.00 100.00
4 COROVIT SYRUP 300 300.00 20.00 280.00
5 COROBION TABLET 5000 5,000.00 5,000.00
6 DEXAMETASONE TABLET 10000 10,000.00 10,000.00
7 ETHYL CHLORIDE SPRAY 15 15.00 15.00
8 GLYCERIL GUAIACOLATE TAB 100 MG 10000 10,000.00 10,000.00
9 GLIMEPIRIDE 1 MG 500 - 500.00 500.00
10 HUSTAB TABLET 15000 15,000.00 10.00 14,990.00
11 IM BOOST FORCE TAB 60 60.00 20.00 40.00
12 IMUNOS TABLET 3300 3,300.00 3,300.00
13 IMUNOS SYRUP 100 100.00 100.00
14 LIDOCAIN AMPUL 2 % 200 - 200.00 200.00
15 LIDOCAIN AMPUL 2 % 600 - 600.00 600.00
16 METFORMIN TAB 500 MG 10000 - 10,000.00 10,000.00
17 OMEPRAZOLE CAP 30MG 3000 - 3,000.00 3,000.00
18 PARASETAMOL SYRUP 125 MG 500 500.00 500.00
19 PEHACAIN INJEKSI 320 - 200.00 320.00
20 RANITIDINE AMPUL 200 - 200.00 200.00

BHP JKN PENGADAAN TAHUN 2020

1 ALKOHOL 70% KEMASAN 1 LITER 30 30.00 5.00 25.00
2 ASEPTIC GEL 20 20.00 4.00 16.00
3 LARUTAN H2O2 20 20.00 - 20.00
4 LARUTAN HCL 20 20.00 - 20.00
5 MASKER HIJAB 2500 2,500.00 - 2,500.00
6 PAMPERS UKURAN M 500 500.00 20.00 480.00
7 STRIP HB EASY TOUCH KOTAK ISI 25 STRIP 750 750.00 39.00 711.00
8 NASAL CANULA DEWASA 50 50.00 10.00 40.00
9 DENTAL NEEDLE 30 G NO.16 300 300.00 300.00
10 DENTAL NEEDLE 30 G NO.21 300 300.00 300.00
11 BAYCLYN 5 LITER 20 20.00 8.00 12.00