PERSEDIAAN BAHAN LABORATORIUN

KABUPATEN MADIUN
PER 31 DESEMBER 2020
PUSKESMAS : KAIBON
STOK AWAL PENGADAAN PEMAKAIAN SISA STOK HARGA
NO NAMA BMHP KEMASAN 2018 2020 2020 AKHIR 2020 TOTAL HARGA
SATUAN
1 2 3 4 5 6 7 8 Rp 9.00
DAU + DAK :
1 Aqua Dest 1 Liter BOTOL 0 0 Rp -
2 Asam Asetat 6% 100 ml / Asam Cuka BOTOL 0 0 Rp -
3 Asam Klorida 0,1 N 100ml / HCL BOTOL 6 1 5 10,560.00 Rp 52,800.00
Benecheck plus multi monitoring system
4 (ALAT) PCS 0 0 Rp -
5 Cholesterol Test (Benecheck) KOTAK 1 110 99 12 253,525.00 Rp 3,042,300.00
6 EDTA Powder 10 gram BOTOL 0 0 Rp -
7 eter alkohol 1:4 250ml BOTOL 0 0 Rp -
8 giemsa buffer 250ml BOTOL 0 0 Rp -
9 giemsa stain 250ml BOTOL 0 0 Rp -
10 Glucose Test (Benecheck) PCS 30 49 54 25 165,000.00 Rp 4,125,000.00
11 HBSAG strip fokus PCS 225 300 300 225 8,053.00 Rp 1,811,925.00
12 human hexagon syphilis PCS 0 0 26,671.00 Rp -
13 Imertion Oil BOTOL 0 0 Rp -
14 Iodina Test Kit @6 botol PACK 0 0 6,600.00 Rp -
Perhidrol 3% 100ml/Hidrogen Peroksida
15 (H2O2) BOTOL 0 0 Rp -
16 Rapid Syphillis 3.0 (Multi) @100 KOTAK 0 0 7,250.00 Rp -

17 Rapid sd bio syphylis (syphylis Ab test) @ 25 PCS 75 175 250 0 22,440.00 Rp -

18 reagen HIV RPR (focus) PCS 0 0 Rp -
19 Reagent (I) TEST HIV1/2 3.0_SD BIOLINE @25 PCS 600 500 600 500 11,975.00 Rp 5,987,500.00
20 Reagent (II) Test HIV_INTEC PCS 0 0 49,005.00 Rp -
21 Reagent (III) Test HIV 1/2_VIKIA PCS 50 50 0 20,501.00 Rp -
22 Reagent CHOLESTEROL KIT 0 0 Rp -
23 Reagent CREATININE KIT 0 0 Rp -
24 Reagent DENGUE KOTAK 0 0 Rp -
25 Reagent GOT (ASAT) KIT 0 0 Rp -
26 Reagent GPT (ALAT) KIT 0 0 Rp -
27 Reagent GRAM SET KOTAK 0 0 Rp -
28 Reagent HIV (I) Antibody - INTEC KOTAK 0 0 Rp -
29 Reagent HIV (II) - ONCOPROBE KOTAK 0 0 Rp -
30 Reagent II HIV (FOCUS) PCS 0 0 14,470.00 Rp -
31 Reagent MALARIA KOTAK 0 0 Rp -
32 Reagent TRIGLYCERIDES KIT 0 0 Rp -
33 Reagent Uji Asam Urat KOTAK 0 0 Rp -
34 Reagent Uji Glucosa KOTAK 0 0 Rp -
35 Reagent UREA / BUN KIT 0 0 Rp -
36 REAGENT WIDAL H TYPHI BOTOL 0 1 1 43,725.00 Rp 43,725.00
37 REAGENT WIDAL O-A BOTOL 0 1 1 43,725.00 Rp 43,725.00
38 REAGENT WIDAL O-B BOTOL 0 1 1 43,725.00 Rp 43,725.00
39 REAGENT WIDAL O-O BOTOL 0 1 1 43,725.00 Rp 43,725.00
40 Reagent Ziehl Nielson / ZN KIT 9 9 0 257,644.00 Rp -
41 Rees Ecker BOTOL 0 0 Rp -
42 RPR TEST KIT SYPHILLIS @100 AMPUL 0 75 75 0 9,738.00 Rp -
43 SFRI CLEANER 3.1 BOTOL 0 1 1 0 5,160,100.00 Rp -
44 SFRI DILUENT 3.1 BOTOL 0 1 1 0 1,426,700.00 Rp -
45 SFRI LYSE 3.1 BOTOL 0 2 2 0 4,279,000.00 Rp -
46 spiritus 1L BOTOL 0 0 Rp -
47 Test Asam Urat (easy touch) KOTAK 0 0 Rp -
48 Test Cholesterol (easy touch) KOTAK 0 0 Rp -
49 Test GOLONGAN DARAH (A,B,AB) SET 0 0 Rp -
50 Test GOLONGAN DARAH A BOTOL 0 0 68,249.50 Rp -
51 Test GOLONGAN DARAH A,B BOTOL 0 0 90,249.50 Rp -
52 Test GOLONGAN DARAH B BOTOL 0 0 68,249.50 Rp -
53 Test GOLONGAN DARAH D BOTOL 0 0 110,250.00 Rp -
54 Test GULA DARAH (easy touch) KOTAK 0 0 Rp -
55 TEST HBA1C + ALAT KOTAK 0 0 Rp -
56 Test HCG (Kehamilan) KOTAK 0 0 4,425.00 Rp -
57 Test URINE 10 Parameter / CYBOW KOTAK 1 1 0 135,920.00 Rp -
58 Test Urine 3 parameter KOTAK 2 2 0 55,926.00 Rp -
59 Test WIDAL (AO,BO,O,H) SET 0 0 Rp -
60 TRULAB N (KONTROL NORMAL) PROLINE E PCS 0 0 Rp -
61 tuberculin PPD 2 UT RT 23 SSI VIAL 0 0 Rp -
62 Turk BOTOL 0 0 Rp -
63 Uric Acid Test (Benecheck) KOTAK 10 67 43 34 153,275.00 Rp 5,211,350.00
64 RDT COVID 19 PCS 820 520 300 81,950.00 Rp 24,585,000.00
65 REAGEN VTM COVID 19 PCS 10 10 50,000.00 Rp 500,000.00
66 SFRI CLAIR 3,1 BOTOL 2 2 0 272,800.00 Rp -
67 SFRI CLEAN EZ 3.1 5 5 0 752,400.00 Rp -
VACUUM TUBE STERILE K3 3ML soft needle
68 tendre BOX 300 280 580 0 790.91 Rp -
JUMLAH Rp 45,490,775.00

MENGETAHUI
KEPALA PUSKESMAS KAIBON
 STOK AWAL PENGADAAN PEMAKAIAN SISA STOK HARGA
NO NAMA BMHP KEMASAN 2018 2020 2020 AKHIR 2020 TOTAL HARGA
SATUAN
1 2 3 4 5 6 7 8 Rp 9.00
dr. RETNOWULAN PRAWITOSARI
NIP. 19691002 200212 2 002
KET

10
KET

10
 PERSEDIAAN BAHAN MEDIS HABIS PAKAI
KABUPATEN MADIUN
PER 31 DESEMBER 2020
PUSKESMAS : KAIBON
STOK AWAL PENGADAA PEMAKAIA SISA STOK HARGA
NO NAMA BMHP KEMASAN 2018 N 2020 N 2020 AKHIR 2020 TOTAL HARGA KET
SATUAN
1 2 3 4 5 6 7 8 Rp 9.00 10
DAU + DAK :
1 ALAT SUNTIK 0.05 ml PCS 0 0 Rp -
2 ALAT SUNTIK 0.5 ML PCS 0 0 Rp -
3 Alat Suntik Sekali pakai 1 ml PCS 150 100 1 249 1,430.00 Rp 356,070.00
4 Alat Suntik Sekali pakai 10 ml PCS 0 0 Rp -
5 Alat Suntik Sekali pakai 20 ml PCS 0 0 Rp -
6 Alat Suntik Sekali pakai 3 ml PCS 746 1700 1695 751 924.00 Rp 693,924.00
7 Alat Suntik Sekali pakai 5 ml PCS 74 0 74 0 1,600.00 Rp -
8 Alkohol 70% 1000ml BOTOL 4 0 4 0 25,000.00 Rp -
9 Alkohol swabs PCS 1300 5500 4100 2700 120.00 Rp 324,000.00
ASEPTAN+DISPENSER 500ML PCS 0 0 Rp -
10 (CHLORHEXIDINE)

Aseptic Gel (Ethyl Alkohol 70%) + BOTOL 4 87 43 48 280,000.00 Rp 13,440,000.00

11 Dispenser / cairan pembersih tangan

12 ASEPTIC Gel 5L GALON 4 1 3 638,000.00 Rp 1,914,000.00

13 Blood Lancet PCS 0 6000 1500 4500 159.50 Rp 717,750.00
14 Box Slide KOTAK 2 5 3 4 36,000.00 Rp 144,000.00
BRACKET ABS (CANTOLAN HAND SCRUB / PCS 13 0 1 12 17,600.00 Rp 211,200.00
15 ASEPTAN GEL)

16 CatGut Cromic 2/0+jarum 1/2 GT PCS 9 24 9 24 7,500.00 Rp 180,000.00

17 CatGut Cromic 3/0+jarum 1/2 GT PCS 9 24 15 18 7,500.00 Rp 135,000.00
18 CatGut Plain 2/0+jarum 1/2 GT PCS 0 24 24 6,916.67 Rp 166,000.08
19 CatGut Plain 3/0+jarum 1/2 GT PCS 0 24 24 6,916.67 Rp 166,000.08
20 Etanol 70% 100 ml BOTOL 0 0 Rp -
21 Etanol 70% 1000 ml BOTOL 0 0 Rp -
22 Folley Catether No. 16 PCS 7 0 0 7 7,999.20 Rp 55,994.40
23 Folley Catether No. 18 PCS 0 0 Rp -
Hand Schoen non Steril Free Powder PCS 0 3000 400 2600 572.00 Rp 1,487,200.00
24 ukuran M
Hand Schoen non Steril Free Powder PCS 300 300 0 572.00 Rp -
25 ukuran L

26 Hand schoen steril ukuran 6,5 PASANG 0 0 Rp -

27 Hand Schoen steril ukuran 7 PASANG 237 0 32 205 4,180.00 Rp 856,900.00
28 Hand Schoen steril ukuran 7,5 PASANG 126 0 65 61 4,180.00 Rp 254,980.00
29 Hand Schoen ukuran S/M/L PCS 1520 8000 9470 50 572.00 Rp 28,600.00
30 I.V Catether No.18 PCS 37 0 2 35 5,500.00 Rp 192,500.00
31 I.V Catether No.20 PCS 10 10 5,500.00 Rp 55,000.00
32 I.V Catether No.22 PCS 0 0 Rp -
33 I.V Catether No.24 PCS 19 0 0 19 5,500.00 Rp 104,500.00
34 Infusion Set Anak (PKD-2) SET 0 0 Rp -
Infusion Set Dewasa (NIPRO / OTSUKA) SET 25 0 6 19 5,790.00 Rp 110,010.00
35

36 jarum jahit kulit G/T-13 KOTAK 0 0 Rp -

37 Jarum Suture Kulit (Dozen) KOTAK 0 0 Rp -
38 Kapas Berlemak 500 gram ROLL 0 0 Rp -
39 Kapas Pembalut 250 gram ROLL 20 10 16 14 12,500.00 Rp 175,000.00
40 Kasa Hidrofil 16x16cm KOTAK 53 100 58 95 7,997.00 Rp 759,715.00
41 Kasa Kompres 40x40 Steril PACK 0 0 Rp -
Kasa Pembalut 40yardx80cm (potong) ROLL 2 0 1 1 105,000.00 Rp 105,000.00
42

43 Kasa Pembalut Hidrofil 2mx80cm PACK 0 0 Rp -

44 Kasa Pembalut Hidrofil 4mx15cm ROLL 54 100 52 102 2,100.00 Rp 214,200.00
45 Kasa Pembalut Hidrofil 4mx3cm ROLL 87 0 35 52 800.00 Rp 41,600.00
46 KONDOM@144/KTK PCS 144 0 34 110 358.00 Rp 39,380.00
47 Lisol 1 L BOTOL 5 0 1 4 40,997.00 Rp 163,988.00
48 LUBRICANT @20/KTK SACHET 40 0 30 10 486.00 Rp 4,860.00
49 MASKER N95 (1870) TB MDR @20 PCS 40 20 60 0 135,000.00 Rp -
MASKER N95 1860 (UNTUK TB MDR) PCS 10 10 0 19,835.00 Rp -
50 @20/KTK

51 MASKER KN95 PCS 20 20 0 99,000.00 Rp -

52 MASKER RE USE/ KAIN PCS 2851 2791 60 5,450.00 Rp 327,000.00
53 MASKER HIJAB PCS 800 150 650 340.28 Rp 221,182.00
54 Masker Karet (face mask ear loop) PCS 0 5600 2581 2919 3,909.10 Rp 11,410,662.90
100 1,800.00 Rp 180,000.00
55 Masker Tali (face mask ties on) PCS 0 5500 5210 290 396.00 Rp 114,840.00
Masker Tali + Karet (Tie On + EarLoop) PCS 500 1000 1500 0 330.00 Rp -
56
Nasal Oxygen CANULA Adult / Dewasa PACK 0 0 Rp -
57

58 Nasal Oxygen CANULA Child / Anak PACK 0 0 Rp -

59 Nebulizer With Mask Pediatric PACK 0 0 Rp -
60 Needle 23Gx1/4 PCS 0 0 Rp -
OBJECT GLASS FROSTED box isi 72 pcs / BOX 0 5 5 0 20,746.00 Rp -
61 SLIDE FROSTED
 STOK AWAL PENGADAA PEMAKAIA SISA STOK HARGA
NO NAMA BMHP KEMASAN 2018 N 2020 N 2020 AKHIR 2020 TOTAL HARGA KET
SATUAN
1 2 3 4 5 6 7 8 Rp 9.00 10
Onescrub 500cc (clhorhexidine gluconate BOTOL 23 15 8 62,500.00 Rp 500,000.00
62 4%) + dispenser / SABUN ANTISEPTIK

63 HAND SCRUB 500 ML 5 1 4 91,666.70 Rp 366,666.80

Onescrub gel Galon 5L / SABUN GALON 0 0 420,000.00 Rp -
64 ANTISEPTIK

65 Paraformaldehyde tablet 1 gram TABLET 0 0 Rp -

66 Pembalut Gips ROLL 0 0 Rp -
67 Plester 5 Yard x 1 inch (4,5m x 2,5cm) ROLL 0 0 Rp -
68 Plester 5 Yard x 2 inch ROLL 0 0 Rp -
69 Plester 5 Yard x 3 inch (4,5m x 7,5cm) ROLL 0 0 35,532.00 Rp -
70 plester non woven 10cm x 5m ROLL 5 20 12 13 41,360.00 Rp 537,680.00
PLESTER NON WOVEN 10cm X 8cm / PCS 0 0 Rp -
71 DERMAFIX T
plester non woven 5cm x 5m/ FIXOMULL ROLL 0 0 Rp -
72
Plester Non Woven 5cmx10m / AXIMED ROLL 0 0 Rp -
73
POLI AID cairan Antiseptik cuci alkes BOTOL 13 3 4 12 123,273.00 Rp 1,479,276.00
74 (Klorheksidin+Cetrimide) / galon 1 liter

75 Pot Sputum PCS 0 200 200 0 2,728.00 Rp -

Povidon Iodine larutan 100mg/ml BOTOL 9 9 0 18,000.00 Rp -
76 kemasan 300ml
Povidon Iodine larutan 100mg/ml BOTOL 0 50 50 0 2,900.00 Rp -
77 kemasan 30ml
Povidon Iodine larutan 100mg/ml BOTOL 0 0 Rp -
78 kemasan 60ml

79 Rivanol (Etakridin) solutio 300ml BOTOL 0 0 Rp -

80 SAFETY BOX 2.5 LITER PCS 0 0 Rp -
81 SAFETY BOX 5 LITER PCS 8 8 15,715.00 Rp 125,720.00
82 Silk 3/0+jarum 1/2 GT PCS 0 36 1 35 4,214.75 Rp 147,516.25
83 Slide / Obyeg Glass KOTAK 0 0 19,500.00 Rp -
84 Transfusi Set PACK 0 0 7,700.00 Rp -
85 UNDERPAD PCS 180 60 120 4,620.00 Rp 554,400.00
86 URINE BAG steril PACK 0 0 3,000.00 Rp -
87 APD BAJU RE USED 0 30 30 159,450.00 Rp 4,783,500.00
88 APD HAZMAT 0 86 74 12 0.00 Rp -
89 APD LENGKAP 0 7 2 5 401,500.00 Rp 2,007,500.00
90 BAYCLIN 0 22 1 21 17,930.00 Rp 376,530.00
91 FACE SHIELD 0 20 4 16 20,000.00 Rp 320,000.00
92 ICE COOL GEL 0 35 35 7,100.00 Rp 248,500.00
93 KACAMATA GOOGLE 0 27 20 55,000.00 Rp 1,100,000.00
0 7 65,000.00 Rp 455,000.00
94 KANTONG JENAZAH 0 25 25 125,000.00 Rp 3,125,000.00
95 KARBOL LIQUID 0 30 6 24 10,455.00 Rp 250,920.00
96 LARUTAN DESINFECTAN LITERAN 0 55 55 120,000.00 Rp 6,600,000.00
97 SEPATU BOOT 0 10 10 90,000.00 Rp 900,000.00
98 ST GYNAECOLOG STERIL 0 75 41 34 80,000.00 Rp 2,720,000.00
99 STEREO FOAM 0 20 15 5 30,000.00 Rp 150,000.00
100 THERMOMETER GUN/INFRA RED 0 6 6 0 2,250,000.00 Rp -
101 ALAT SPRAYER DESINFEKTAN 0 1 1 0 1,400,000.00 Rp -
JUMLAH Rp 62,099,265.51

MENGETAHUI
KEPALA PUSKESMAS KAIBON
 PERSEDIAAN OBAT PELAYANAN KESEHATAN DASAR (PKD)
KABUPATEN MADIUN
PER 31 DESEMBER 2020
PUSKESMAS : KAIBON
STOK AWAL PENGADAAN PEMAKAIAN SISA STOK
NO NAMA OBAT KEMASAN 2020 2020 2019 AKHIR 2019 TOTAL HARGA KET

1 2 3 4 5 6 7 Rp 9.00 10
OBAT :
1 0bat batuk kombinasi tablet/ HUSTAB TABLET 0 0 Rp -
(bromhexine, parasetamol,
diphenhidramin)

2 Air Raksa BOTOL 0 0 Rp -

3 Akarbose 100 mg TABLET 0 0 Rp -
4 Akarbose 50 mg TABLET 0 0 Rp -
5 Albendazole 400 mg TABLET 60 1410 1422 48 404.00 Rp 19,392.00
6 Albendazole suspensi 200mg/5ml BOTOL 0 0 Rp -
7 Allopurinol 100 mg TABLET 3360 8000 10960 400 182.60 Rp 73,040.00
8 Allopurinol 300mg TABLET 0 0 Rp -
9 Ambroksol 30 mg TABLET 2626 1000 3626 0 202.84 Rp -
10 Ambroksol sirup BOTOL 0 0 Rp -
11 Aminofilin 200 mg TABLET 1548 2000 2277 1271 89.00 Rp 113,119.00
12 Aminofilin injeksi 24mg/ml AMPUL 0 0 Rp -
13 Amiodarone HCl 200 mg/ TYARIT TABLET 0 0 Rp -
14 Amitriptilin 25 mg TABLET 139 1500 915 724 167.00 Rp 120,908.00
15 Amlodipin 10 mg TABLET 730 9600 8268 2062 99.00 Rp 204,138.00
16 Amlodipin 5 mg TABLET 263 6300 6563 0 75 Rp -
17 Amoksisilin 1000 mg injeksi VIAL 0 0 Rp -
18 Amoksisilin Sirup Kering 125mg/5ml BOTOL 0 0 Rp -
19 Amoksisillin 500 mg TABLET 7930 33000 33988 6942 253.00 Rp 1,756,326.00
20 Amoksisillin Forte sirup kering 250mg/5ml BOTOL 140 0 140 0 3628.00 Rp -

21 Ampisilin serbuk injeksi 1000mg (i.v.) VIAL 0 0 Rp -

22 Antasida kombinasi suspensi BOTOL 6 450 305 151 2129.00 Rp 321,479.00
23 Antasida kombinasi tablet kunyah TABLET 6661 25000 22137 9524 58.00 Rp 552,392.00
24 Anti Anemia / LIVRON B PLEX/HEMAFORT TABLET 0 0 Rp -

25 Anti Bakteri komb. Polymixin+Bacitracin TUBE 65 25 87 3 5060.00 Rp 15,180.00

salep
26 Anti Flu / DEMACOLIN TABLET 4377 1000 5144 233 224.00 Rp 52,192.00
27 Anti Flu syrup/DEMACOLIN syrup BOTOL 0 0 Rp -
28 Anti Fungi kombinasi salep POT 71 96 116 51 4323.00 Rp 220,473.00
29 Anti Hemoroid kombinasi suppositoria SUPPO 0 50 6 44 3167.00 Rp 139,348.00

30 Anti Parkinson DOEN tablet kombinasi TABLET 100 0 100 0 1168 Rp -

Benserazid 25mg+Levodopa 100mg /
LEVOPAR 100MG

31 Anti Virus / KALOBA TABLET 0 0 Rp -

32 Aqua Pro Injeksi VIAL 21 0 0 21 2860.00 Rp 60,060.00
33 Artemeter injeksi 80mg/ml AMPUL 0 0 Rp -
34 Asam Asetilsalisilat 100 mg (ASETOSAL) TABLET 0 0 Rp -

35 Asam Asetilsalisilat 80mg/MINIASPI TABLET 820 1500 1135 1185 105.00 Rp 124,425.00

36 Asam askorbat 250 mg (Vitamin C) TABLET 0 0 Rp -

37 Asam Askorbat 50 mg (Vitamin C) TABLET 6553 26400 25933 7020 105.00 Rp 737,100.00
38 Asam Folat 1 mg TABLET 2080 3000 2874 2206 70.00 Rp 154,420.00
39 Asam Mefenamat 500 mg TABLET 7713 6551 1162 299.20 Rp 347,670.40
40 Asam Traneksamat injeksi 50mg/ml AMPUL 0 0 Rp -
41 Asetyl Sistein 200 mg KAPSUL 2658 13000 5707 9951 373.00 Rp 3,711,723.00
42 Asiklovir 200 mg TABLET 587 0 259 328 236.00 Rp 77,408.00
43 Asiklovir 400 mg TABLET 45 500 60 485 380.00 Rp 184,300.00
44 Asiklovir krim TUBE 0 0 Rp -
45 Asiklovir salep mata 3% / TEMIRAL TUBE 0 0 Rp -
46 Atapulgit 600 mg / NEW ANTIDES TABLET 2464 0 2243 221 136.00 Rp 30,056.00
47 ATAPULgit 630 mg / PULAREX TABLET 0 3000 200 2800 162.00 Rp 453,600.00
48 Atenolol 50 mg / FARNORMIN TABLET 600 0 600 0 330.00 Rp -
49 Atropin 0,5 mg TABLET 0 0 Rp -
50 Atropin injeksi 0,25mg/ml (i.v./i.m./s.k.) AMPUL 12 0 2 10 1639.00 Rp 16,390.00

51 Bedak Salicyl Serbuk 2% KOTAK 60 190 237 13 5775.00 Rp 75,075.00

52 benzatin penisilin 2.4jt VIAL 0 0 Rp -
53 Betahistine 6 mg TABLET 0 2000 931 1069 110.00 Rp 117,590.00
54 Betamethasone krim 0,1% TUBE 50 250 219 81 1340.00 Rp 108,540.00
55 Bisakodil 5 mg / MELAXAN TABLET 440 600 775 265 319.00 Rp 84,535.00
56 bisakodil 5mg suppositoria SUPPO 0 0 Rp -
57 Bisakodil suppo 10 mg / STOLAX/DULCOLAX SUPPO 0 50 10 40 5900.00 Rp 236,000.00

58 Bisoprolol 5 mg (salut selaput) TABLET 0 0 Rp -

59 Ceftriaxone Pwd INJ 1 GR VIAL 0 0 Rp -
60 Cimetidin 200 mg TABLET 0 0 Rp -
61 clindamycin 300 mg BOX 0 0 Rp -
62 Clozapin 25 mg TABLET 450 2500 1070 1880 1121.00 Rp 2,107,480.00
63 Deksamethasone 0,5 mg TABLET 925 6000 6750 175 77.00 Rp 13,475.00
 STOK AWAL PENGADAAN PEMAKAIAN SISA STOK
NO NAMA OBAT KEMASAN 2020 2020 2019 AKHIR 2019 TOTAL HARGA KET

1 2 3 4 5 6 7 Rp 9.00 10
64 Deksamethasone injeksi 5mg/ml (i.v./i.m.) AMPUL 100 10 104 6 1097.00 Rp 6,582.00

65 Difenhidramin injeksi 10mg/ml (i.v./i.m.) AMPUL 475 0 141 334 1168.00 Rp 390,112.00

66 Digoksin 0,25 mg TABLET 373 0 373 0 225.00 Rp -

67 Diltiazem 30 mg TABLET 150 1400 880 670 133.00 Rp 89,110.00
68 Dimenhidrinat 50 mg TABLET 513 3500 1843 2170 112.00 Rp 243,040.00
69 DIONICOL TABLET 0 0 Rp -
70 Doksisiklin 100 mg KAPSUL 0 0 Rp -
71 Domperidon 10 mg TABLET 1352 1000 1478 874 91.00 Rp 79,534.00
72 Domperidon Drops 5mg/ml BOTOL 0 0 Rp -
73 Domperidon suspensi 5mg/5ml BOTOL 16 50 23 43 2700.00 Rp 116,100.00
74 dosis harian TB/HIV fase awal TABLET 0 0 Rp -
75 dosis harian TB/HIV fase lanjutan TABLET 0 0 Rp -
76 Efavirenz (EFV) 600mg TABLET 0 0 Rp -
77 Epinefrin (adrenalin) injeksi 0,1% AMPUL 6 30 34 2 1408.00 Rp 2,816.00
(i.v./s.k./i.m.)
78 Ergotamin+Kafein komb. 1mg+50mg (ANTI TABLET 0 2000 45 1955 173.00 Rp 338,215.00
79 MIGRAIN)
Eritromisin 250 mg KAPSUL 0 0 Rp -
80 Eritromisin 500 mg TABLET 500 0 0 500 750.00 Rp 375,000.00
81 Eritromisin Sirup Kering 125mg/5ml BOTOL 0 0 Rp -
82 Eritromisin sirup kering 200mg/5ml BOTOL 0 0 Rp -
83 Etil Klorida spray 100 ml BOTOL 0 0 Rp -
84 Famotidin 20 mg TABLET 0 0 Rp -
85 Fenitoin 100 mg KAPSUL 1480 500 1480 500 158.00 Rp 79,000.00
86 Fenitoin injeksi 50mg/ml AMPUL 0 0 Rp -
87 Fenitoin Na 30mg / DECATONA KAPSUL 0 0 Rp -
88 Fenoksimetil Penisilin (Penisilin V) 500mg TABLET 0 0 Rp -

89 Ferro Fumarat 60mg + Asam Folat 0,4mg / TABLET 15375 47500 44985 17890 354.00 Rp 6,333,060.00
TTD untuk ibu hamil
90 Ferro Sulfat+Asam Folat kombinasi TABLET 0 0 Rp -
200mg+0,25mg/TTD untuk Remaja
91 Fitomenadion 10 mg (Vitamin K) TABLET 672 500 675 497 710.00 Rp 352,870.00
92 Fitomenadion injeksi 10mg/ml (i.m.) AMPUL 18 0 18 0 3450.00 Rp -
93 Fitomenadion injeksi 2mg/ml (i.m.) / AMPUL 26 60 6 80 3682.00 Rp 294,560.00
INFANT
94 Flufenazin injeksi 25mg/ml AMPUL 23 115 102 36 63986.00 Rp 2,303,496.00
(i.m.)/SIKZONOATE
95 Fluoksetin 10 mg / FORANSI KAPSUL 94 0 0 94 225.00 Rp 21,150.00
96 Furosemid 40 mg TABLET 788 0 134 654 77.00 Rp 50,358.00
97 Furosemid injeksi 10mg/ml (i.v./i.m.) AMPUL 0 0 Rp -
98 gabapentin TABLET 0 0 Rp -
99 Garam Oralit Kombinasi Serbuk (200 ml air) SACHET 3521 0 1077 2444 257.00 Rp 628,108.00

100 Gemfibrozil 300 mg KAPSUL 0 0 Rp -

101 Gentamisin injeksi 40mg/ml AMPUL 55 0 55 0 3509.00 Rp -
102 Gentamisin salep kulit 0,1% TUBE 0 0 Rp -
103 Gentamisin salep mata 0,3% TUBE 0 120 29 91 2675.00 Rp 243,425.00
104 Gentamisin Sulfate tetes mata 0,3% BOTOL 192 280 372 100 4232.00 Rp 423,200.00
105 Gentian Violet 1% BOTOL 0 0 Rp -
106 GERIAVITA / MULTIVITAMIN (BOTOL 30 TABLET 0 0 Rp -
TABLET)
107 Glibenklamid 5 mg TABLET 585 2000 1690 895 119.00 Rp 106,505.00
108 Glimepiride 1 mg TABLET 4068 10000 14068 0 174.00 Rp -
109 Glimepiride 2 mg TABLET 0 12000 8950 3050 207.00 Rp 631,350.00
110 Gliseril Guaiyakolat 100 mg TABLET 3549 14000 11140 6409 124.00 Rp 794,716.00
111 Gliseril Trinitrat 0,5 mg / NITRAL TABLET 0 0 Rp -
112 Gliserin cairan obat luar 100mg/ml BOTOL 0 0 Rp -
113 Glukose larutan infus 10% 500 ML 0 0 Rp -
114 Glukose larutan infus 40% 500 ML 10 0 0 10 10010.00 Rp 100,100.00
115 Glukose larutan infus 5% 500 ML 0 0 Rp -
116 Griseofulvin (micronized) 125 mg TABLET 128 0 0 128 224.00 Rp 28,672.00
117 Haloperidol 0,5 mg TABLET 0 2700 1225 1475 55.00 Rp 81,125.00
118 Haloperidol 1,5 mg TABLET 3144 11000 11644 2500 59.00 Rp 147,500.00
119 Haloperidol 5 mg TABLET 615 0 615 0 56.00 Rp -
120 haloperidol drop 2 mg/ml /LODOMER BOTOL 0 0 Rp -
DROP
121 Haloperidol injeksi 50mg/ml / HALDOL AMPUL 0 0 Rp -
DECANOAS
122 Haloperidol injeksi 5mg/ml (i.m.) / AMPUL 0 0 Rp -
LODOMER
123 Hidroklortiazid 25 mg (HCT) TABLET 1049 500 1079 470 155.00 Rp 72,850.00
124 Hidrokortison Krim 2,5% TUBE 92 120 160 52 2475.00 Rp 128,700.00
125 Hiosina Butilbromid 10 mg / SPASMECO TABLET 0 0 Rp -

126 Human Tetanus imunoglobulin (i.m.) 250 IU VIAL 5 0 0 5 176800.00 Rp 884,000.00

injeksi / TETAGAM
127 hyperhep 0.5 ml/ HB1g/ vaksin hepatitis VIAL 0 0 Rp -
 STOK AWAL PENGADAAN PEMAKAIAN SISA STOK
NO NAMA OBAT KEMASAN 2020 2020 2019 AKHIR 2019 TOTAL HARGA KET

1 2 3 4 5 6 7 Rp 9.00 10
128 Ibuprofen 200 mg TABLET 0 0 Rp -
129 ibuprofen 200 mg/5 ml suspensi BOTOL 103 0 42 61 4665.00 Rp 284,565.00
130 Ibuprofen 400 mg TABLET 0 3500 3148 352 265.65 Rp 93,508.80
131 Ibuprofen suspensi 100mg/5ml BOTOL 0 0 Rp -
132 Imipramine HCL 25 mg / TOFRANIL TABLET 0 0 Rp -
133 IMS kombipak (Azithromicyn + cefixime) PACK 0 0 Rp -

134 Infus D5 - 1/2 NS (glukosa55.0g : NaCl 4,5g) 500 ML 0 0 Rp -

135 Infus D5 - 1/4 NS (glukosa55.0g : NaCl 500 ML 0 0 Rp -

2.25g)
136 Infus Ringer Asetat / ASERING 500 ML 0 0 Rp -
137 Ipatropium Bromida serbuk inhalasi BOTOL 0 0 Rp -
20mcg/semprot / ATROVENT
138 Ipatropium Bromida monohydrate 0,5 mg + AMPUL 10 0 10 0 4550 Rp -
salbutamol ,5 mg (COMBIVENT UDV)

139 Isoniazid 100 mg TABLET 100 0 100 0 145 Rp -

140 Isosorbid DiNitrat 5 mg (ISDN) TABLET 392 500 395 497 143.00 Rp 71,071.00
141 Kalium Diklofenak 50 mg / MEZAC TABLET 0 0 Rp -
142 Kalium Permanganat serbuk POT 0 0 Rp -
143 Kalsium Glukonat 10% injeksi AMPUL 25 0 25 0 9955.00 Rp -
144 Kalsium Karbonat 500mg komb. / TABLET 0 0 Rp -
CALPOROSIS
145 Kalsium Laktat 500 mg (KALK) TABLET 6735 23000 23692 6043 63.00 Rp 380,709.00
146 Kaolin+Pektin Komb. / MOLAGIT TABLET 0 0 Rp -
147 Kaptopril 12,5 mg TABLET 3790 8000 6860 4930 88.55 Rp 436,551.50
148 Kaptopril 25 mg TABLET 0 0 Rp -
149 Karbamazepin 200 mg TABLET 1330 1000 1559 771 245.00 Rp 188,895.00
150 Karbogliserin tetes telinga 10% / FENOL BOTOL 10 96 27 79 2764.00 Rp 218,356.00
GLISEROL
151 KDT/FDC KATEGORI II KIT 0 1 1 0 1384983.00 Rp -
152 KDT/FDC KOMBIPAK KATEGORI I KIT 0 0 Rp -
153 KDT/FDC untuk ANAK KIT 2 0 2 0 248120.00 Rp -
154 KDT/FDC untuk DEWASA (KATEGORI I) KIT 12 28 23 17 389344.00 Rp 6,618,848.00

155 Ketokonazole 200 mg TABLET 384 500 676 208 288.00 Rp 59,904.00
156 Ketokonazole Krim 2% TUBE 0 100 43 57 2518.00 Rp 143,526.00
157 Ketoprofen 100 mg Suppo / SUPRAFENID SUPPO 0 0 Rp -

158 Ketoprofen 100 mg tab. TABLET 0 0 Rp -

159 Ketoprofen injeksi AMPUL 0 0 Rp -
160 Ketorolac 30mg/ml injeksi AMPUL 0 0 Rp -
161 Kloramfenikol 250 mg KAPSUL 230 1000 40 1190 492.80 Rp 586,432.00
162 Kloramfenikol salep kulit 2% 15 g TUBE 77 96 120 53 3242.00 Rp 171,826.00
(Bufacetin)
163 Kloramfenikol salep mata 1% TUBE 94 48 85 57 1881.00 Rp 107,217.00
164 Kloramfenikol suspensi 125mg/5ml BOTOL 0 0 Rp -
165 Kloramfenikol Tetes Mata 0,5% / BOTOL 0 0 Rp -
DECACETIN
166 Kloramfenikol tetes mata 1% / RECO BOTOL 2 2 0 9570.00 Rp -
167 Kloramfenikol tetes telinga 3% BOTOL 0 0 Rp -
168 Klorfeniramin Maleat 4 mg (CTM) TABLET 12049 45000 44822 12227 23.00 Rp 281,221.00
169 Klorpromazin 100 mg TABLET 0 7000 5265 1735 147.00 Rp 255,045.00
170 Klorpromazin 25 mg TABLET 0 500 500 181.00 Rp 90,500.00
171 Klorpromazin injeksi 25mg/ml (i.m.) AMPUL 0 0 Rp -
172 Kotrimoksazol Forte Kombinasi 960 mg TABLET 1453 1453 0 299.00 Rp -
(dewasa)
173 Kotrimoksazol Kombinasi 480 mg (dewasa) TABLET 1960 5000 2978 3982 125.00 Rp 497,750.00

174 Kotrimoksazol Kombinasi Suspensi 240 mg BOTOL 229 200 232 197 2190.00 Rp 431,430.00

175 Kuinina (KINA) 200 mg TABLET 0 0 Rp -

176 lamivudine 150mg TABLET 0 0 Rp -
177 levonorgestrel+ ethinyl Estradiol (pil kb) TABLET 0 0 Rp -

178 licovir PCS 0 0 Rp -

179 Lidokain 2% injeksi AMPUL 249 0 64 185 1149.00 Rp 212,565.00
180 Loperamid 2 mg (salut selaput) TABLET 0 0 Rp -
181 Loratadin 10 mg TABLET 0 1500 980 520 55.00 Rp 28,600.00
182 Magnesium Sulfat 20% injeksi (i.v.) FLACON 97 10 92 15 3328.00 Rp 49,920.00
183 Magnesium Sulfat 40% injeksi (i.v.) untuk FLACON 102 10 97 15 3796.00 Rp 56,940.00
Eklampsi
184 Magnesium Sulfat serbuk SACHET 0 0 Rp -
185 MB Dewasa (KUSTA) BLISTER 0 12 12 0 41784.00 Rp -
186 MDT MB ANAK BLISTER 0 0 Rp -
187 MDT PB ANAK BLISTER 0 0 Rp -
188 MDT PB DEWASA BLISTER 0 0 Rp -
189 Mebendazole 500 mg / VERMOX TABLET 0 0 Rp -
190 Meloxicam 15 mg TABLET 0 0 Rp -
 STOK AWAL PENGADAAN PEMAKAIAN SISA STOK
NO NAMA OBAT KEMASAN 2020 2020 2019 AKHIR 2019 TOTAL HARGA KET

1 2 3 4 5 6 7 Rp 9.00 10
191 Metakresol 5ml / ALBOTHYL BOTOL 0 0 Rp -
192 Metamizol inj./Antalgin inj. AMPUL 0 0 Rp -
193 Metformin 500 mg TABLET 8162 7000 12492 2670 102.00 Rp 272,340.00
194 Metil Ergometrin 0,125 mg TABLET 470 470 210.00 Rp 98,700.00
195 Metil Ergometrin injeksi 0,2mg/ml / AMPUL 439 439 0 2959.00 Rp -
MYOMERGIN
196 Metil Prednisolon 4 mg TABLET 770 3000 2742 1028 143.00 Rp 147,004.00
197 Metoklopramid 10 mg TABLET 0 0 Rp -
198 Metoklopramid 5 mg TABLET 190 0 190 0 115.00 Rp -
199 Metronidazole 250 mg TABLET 0 0 Rp -
200 Metronidazole 500 mg TABLET 2680 0 359 2321 227.27 Rp 527,493.67
201 Metronidazole 500 mg suppositoria / SUPPO 0 0 Rp -
FLAGYL
202 Metronidazole infus 5mg/ml (100cc) BOTOL 2 0 2 0 8523 Rp -
203 Metronidazole ovula / VAGIZOL TABLET 0 0 Rp -
204 Metronidazole sirup 125mg/5ml BOTOL 0 0 Rp -
205 Mikonazole Krim 2% (Nitrat) TUBE 24 120 144 0 3250 Rp -
206 MINERAL MIX SACHET 0 0 Rp -
207 Mometasone Furoat krim 0,1% TUBE 0 0 Rp -
208 Multivitamin anak sirup / BETAFORT BOTOL 0 0 Rp -
209 Natrium Diklofenak 25 mg TABLET 1202 5000 6202 0 128 Rp -
210 Natrium Diklofenak 50 mg TABLET 2731 24400 22190 4941 123.00 Rp 607,743.00
211 Natrium Klorida infus 0,9% (NaCl) 500 ML 32 20 16 36 6839.85 Rp 246,234.60
212 Nevirapine (NVP) 200mg TABLET 0 0 Rp -
213 Nifedipin 10 mg TABLET 0 0 Rp -
214 Nistatin 100.000 IU (tablet vaginal) TABLET 69 400 101 368 598.00 Rp 220,064.00
215 Nistatin 500.000 IU (tablet salut gula) TABLET 110 0 56 54 790.00 Rp 42,660.00
216 NORAGES AMPUL 0 0 Rp -
217 Norepinefrin 8mg/8ml injeksi / LEVOSOL AMPUL 0 0 Rp -

218 Obat Anti Malaria (OAM) DHP frimal TABLET 0 0 Rp -

219 Obat Batuk Hitam ( OBH ) BOTOL 239 180 239 180 4500.00 Rp 810,000.00
220 Obat Digestan Kombinasi / ENZYPLEX TABLET 0 0 Rp -
221 Oksigen inhalasi, gas dalam tabung M3 0 0 Rp -
222 Oksimetazolin tetes hidung 0,025% / BOTOL 0 0 Rp -
ILLIADIN
223 Oksitetrasiklin salep kulit 3% TUBE 0 0 Rp -
224 Oksitetrasiklin salep mata TUBE 125 16 109 2500.00 Rp 272,500.00
225 Oksitosin injeksi 10 IU/ml / OXYTOSIN `S AMPUL 110 0 110 1199.00 Rp 131,890.00

226 Olopatadin HCl/PATANOL Tetes Mata BOTOL 0 0 Rp -

227 Omeprazole 20 mg KAPSUL 0 0 Rp -
228 Omeprazole serbuk injeksi 40mg/10ml VIAL 0 0 Rp -
229 Ondansetron 4 mg TABLET 0 0 Rp -
230 ONDANSETRON 4mg/2ml injeksi AMPUL 8 5 10 3 1124.00 Rp 3,372.00
231 Papaverin 40 mg TABLET 0 0 Rp -
232 Parasetamol 100 Mg TABLET 0 0 Rp -
233 Parasetamol 500 mg TABLET 366 46500 25917 20949 175.00 Rp 3,666,075.00
234 Parasetamol Drop 100mg/ml BOTOL 0 0 Rp -
235 Parasetamol Forte 650mg / TERMAGON TABLET 0 0 Rp -
FORTE
236 Parasetamol Syrup 120mg/5ml BOTOL 151 600 595 156 1107.00 Rp 172,692.00
237 PEHAVRAL / multi vitamin TABLET 0 0 Rp -
238 Perak Sulfadiazin Krim 1% / BURNAZIN TUBE 43 0 8 35 20700.00 Rp 724,500.00
239 Permetrin Krim 5% / SCABIMITE TUBE 33 40 43 30 11825.00 Rp 354,750.00
240 Piracetam 800 mg TABLET 0 0 Rp -
241 Pirantel Pamoat 125 mg TABLET 0 0 Rp -
242 Pirantel Pamoat suspensi 125mg/ml BOTOL 0 0 Rp -
243 Pirazinamid 500 mg (untuk MDR) TABLET 0 0 Rp -
244 Piridoksin 10 mg (Vitamin B6) TABLET 1071 0 1071 0 123.00 Rp -
245 Piroksikam 20 mg TABLET 0 0 Rp -
246 Potasium Iodide/CENDO CATARLENT BOTOL 0 0 Rp -
247 Prednison 5 mg TABLET 430 1000 676 754 73.00 Rp 55,042.00
248 Primaquin 15mg tablet TABLET 0 0 Rp -
249 Probion TABLET 0 0 Rp -
250 Prokain Benzil Penisillin 3jt UI AMPUL 0 0 Rp -
251 PropilTioUrasil 100 mg (PTU) TABLET 0 0 Rp -
252 Propranolol 10 mg TABLET 70 700 170 600 58.00 Rp 34,800.00
253 Ranitidin 150 mg TABLET 0 0 Rp -
254 Ranitidin injeksi 25mg/ml AMPUL 0 100 5 95 1188.00 Rp 112,860.00
255 reagen HIV III RIGN SIGN PCS 0 0 Rp -
256 Retinol kapsul lunak 100.000 IU (Vitamin A KAPSUL 0 200 100 100 279.10 Rp 27,910.00
Biru)
257 Retinol kapsul lunak 200.000 IU (Vitamin A KAPSUL 250 200 184 266 517.00 Rp 137,522.00
Merah)
258 Ringer Laktat larutan infus (RL) 500 ML 16 20 18 18 7630.00 Rp 137,340.00
259 Risperidone 1 mg TABLET 870 1000 1870 0 240.00 Rp -
260 Risperidone 2 mg 2400 420 1980 287.00 Rp 568,260.00
261 Salbutamol 2 mg TABLET 0 1000 354 646 67.00 Rp 43,282.00
262 Salbutamol 4 mg TABLET 23 0 23 0 70.00 Rp -
 STOK AWAL PENGADAAN PEMAKAIAN SISA STOK
NO NAMA OBAT KEMASAN 2020 2020 2019 AKHIR 2019 TOTAL HARGA KET

1 2 3 4 5 6 7 Rp 9.00 10
263 Salbutamol cairan inhalasi 1mg/ml 0,1% / FLACON 0 0 Rp -
VENTOLIN NEBULES
264 salbutamol syr 2mg/5ml BOTOL 0 0 Rp -
265 Salep 2 - 4 Kombinasi POT 70 120 127 63 2620.00 Rp 165,060.00
266 sd bio syphilis (syphylis Ab Test) PCS 0 0 Rp -
267 Sefadroksil 500 mg KAPSUL 0 0 Rp -
268 Sefadroksil sirup kering 125mg/5ml BOTOL 21 70 53 38 4185.00 Rp 159,030.00
269 Sefaleksin 500 mg KAPSUL 0 0 Rp -
270 Sefiksim 100 mg (salut selaput) TABLET 0 0 Rp -
271 Sefiksim sirup 100 mg/5ml BOTOL 0 0 Rp -
272 Sefotaksim 1000 mg injeksi VIAL 0 0 Rp -
273 Serum Anti Bisa Ular injeksi (A.B.U.) VIAL 0 0 Rp -
(i.m./i.v.)
274 Serum Anti Difteri injeksi 20.000 IU/ml VIAL 0 0 Rp -
(A.D.S.)(i.m.)
275 Serum Anti Tetanus injeksi 1.500 IU (A.T.S.) AMPUL 0 0 Rp -

276 Setirizin 10 mg TABLET 0 0 Rp -

277 Setirizin sirup 5mg/5ml BOTOL 0 0 Rp -
278 Sianokobalamin injeksi 500mcg/ml AMPUL 266 0 18 248 1087.00 Rp 269,576.00
279 Sianokobalamin tablet 50 mcg (Vitamin TABLET 296 0 296 0 17.60 Rp -
B12)
280 Simvastatin 10 mg (salut selaput) TABLET 0 0 Rp -
281 Simvastatin 20 mg (salut selaput) TABLET 3170 10000 11030 2140 217.00 Rp 464,380.00
282 Siprofloksasin 500 mg (salut selaput) TABLET 306 0 306 0 240.00 Rp -
283 Spironolakton 25 mg TABLET 0 0 Rp -
284 SOFT U DERM 10% TUBE 9 0 4 5 6809.00 Rp 34,045.00
285 Sukralfat 500mg / Ulsidex TABLET 0 0 Rp -
286 Sulfacetamid Natrium Tetes Mata 15% BOTOL 0 0 Rp -
287 TDF(300)+3TC(300)+EFV(600) triple FDC TABLET 0 0 Rp -

288 tenofovir 300mg (TDF) TABLET 0 0 Rp -

289 Tensigard KAPSUL 0 0 Rp -
290 Terbutalin injeksi 0,5mg/ml (s.k./i.v.) AMPUL 5 0 5 0 99.00 Rp -
291 Terbutalin sulfat 2,5 mg / MOLASMA TABLET 0 0 Rp -
292 Tetes Mata Kombinasi / CENDO LYTEERS BOTOL 0 0 Rp -

293 Tetrakain Tetes Mata 0,5% / CENDO BOTOL 0 0 Rp -

PANTOCAIN
294 Tetrasiklin 250 mg KAPSUL 0 0 Rp -
295 Tetrasiklin 500 mg KAPSUL 630 0 292 338 310.00 Rp 104,780.00
296 Thiamin 50 mg (Vitamin B1) TABLET 14720 30000 35700 9020 91.00 Rp 820,820.00
297 Tramadol 50 mg TABLET 0 0 Rp -
298 Trifluoperazine 5 mg (salut selaput) TABLET 0 2500 1800 700 287.00 Rp 200,900.00
299 Triheksifenidil 2 mg TABLET 1550 10500 11140 910 312.00 Rp 283,920.00
300 Valproat 250 mg (salut enterik) / DEPAKOTE TABLET 0 0 Rp -

301 Valproat SR 500/ DEPAKOTE ER TABLET 450 300 750 0 5928.00 Rp -

302 Vitamin B Kompleks TABLET 3064 43000 42457 3607 89.00 Rp 321,023.00
303 Vitamin Neurotropik / NEURODEX TABLET 0 0 Rp -
304 Zidofudine (ZDV) 300mg + Lamivudine TABLET 0 0 Rp -
(3TC) 150mg
305 zidovudin syr 50mg/5ml BOTOL 0 0 Rp -
306 Zinc 20 mg (dispersible) TABLET 4145 2000 4175 1970 524.00 Rp 1,032,280.00
307 Zinc sirup (Sulfate) 20mg/5ml BOTOL 81 0 81 0 4788.30 Rp -
NARKOTIKA :
308 Kodein 10 mg TABLET 0 0 Rp -
PSIKOTROPIKA :
309 Alprazolam 0.5 mg TABLET 0 0 Rp -
310 Alprazolam 1 mg TABLET 0 0 Rp -
311 Diazepam 2 mg TABLET 377 200 239 338 86.00 Rp 29,068.00
0 0 Rp -
Diazepam Enema 10mg/2,5ml (RECTAL) /
312 STESOLID TUBE
3 5 3 5 12573.00 Rp 62,865.00
Diazepam Enema 5mg/2,5ml (RECTAL) /
313 STESOLID
314 Diazepam injeksi 5mg/ml (i.v./i.m.) AMPUL 9 0 9 0 1735.00 Rp -
315 Fenobarbital 30 mg TABLET 1151 2000 1558 1593 240.00 Rp 382,320.00
316 Fenobarbital 50mg/ml injeksi AMPUL 0 0 Rp -
317 Klobazam 10 mg TABLET 65 0 65 967.00 Rp 62,855.00
318 Lorazepam 2 mg / MERLOPAM TABLET 0 0 Rp -
GIGI :
319 Aqua Dest Cairan 500ml (Steril) BOTOL 0 0 Rp -
320 Eugenol cairan KOTAK 0 0 Rp -
321 Formocresol cairan (pengganti TKF) KOTAK 1 0 1 76500.00 Rp 76,500.00
0 Rp -
Glass Ionomer ART (Atraumatic Restorative
322 Treatment) KOTAK 0
323 Guttae Percha 45-80mm KOTAK 0 0 Rp -
324 Kalsium Hidroksida bubuk Pasta KOTAK 0 0 Rp -
0 Rp -
325 Klorfenol Kamfer Mentol (CHKM) cairan KOTAK 1 0 1 55000.00
 STOK AWAL PENGADAAN PEMAKAIAN SISA STOK
NO NAMA OBAT KEMASAN 2020 2020 2019 AKHIR 2019 TOTAL HARGA KET

1 2 3 4 5 6 7 Rp 9.00 10
0 300 65 235 1222.00 Rp 287,170.00
Lidokain 2%+Epinefrin 1:80.000 injeksi 2ml
326 (COMP.) AMPUL
327 Paper Points 45-80mm KOTAK 2 0 2 28600.00 Rp 57,200.00
328 Pasta Devitalisasi (non Arsen) KOTAK 0 0 Rp -
329 Silver Amalgam (GIGI) BOTOL 0 0 Rp -
JUMLAH Rp 53,067,294.97

MENGETAHUI
KEPALA PUSKESMAS KAIBON

dr. RETNOWULAN PRAWITOSARI

NIP. 19691002 200212 2 002