Format Neraca UGD BARU

NERACA UGD
STOK AWAL (LPLPO Desember 2012) STOK MASUK (PENERIMAAN DARI PUSKESMAS 2013) STOK KELUAR (PEMAKAIAN Selama TA 2013)
No. Nama Obat Satuan Jumlah Harga Total Jumlah Harga Total Ket. Jumlah Harga
1 2 3 4 5 6 7 8 9 10 11 12
1 Acyclovir Salep Tube 2,152.00 - 2,152.00 - 2,152.00
2 Acyclovir 400 mg Tab Tablet 340.00 - 340.00 - 340.00
3 Air raksa dental use Botol 400,000.00 - 400,000.00 - 400,000.00
4 Alat suntik sekali pakai 1 ml Pcs 1,092.00 - 1,092.00 - 1,092.00
5 Alat suntik sekali pakai 2,5 ml Pcs 540.00 - 540.00 - 540.00
6 Alat suntik sekali pakai 5 ml Pcs 743.00 - 4 743.00 2,972 2 743.00
7 Albendazol 400 mg tab Tablet 366.00 - 366.00 - 366.00
8 Alprazolam 0.5 mg Tablet 460.00 - 460.00 - 460.00
9 Alupurinol 100 mg tab / Selespurin/ Proxuric Tablet 104.00 - 104.00 - 104.00
10 Ambroxol syr Botol 2,475.00 - 2,475.00 - 2,475.00
11 Ambroxol tab 30 mg / Promukus Tablet 85.93 - 85.93 - 85.93
12 Aminofilina injeksi 24 mg/ ml. 10 ml Ampul 3,240.00 - 3,240.00 - 3,240.00
13 Aminofilna tablet 200 mg Tablet 87.15 - 87.15 - 87.15
14 Amitriptilina hcl tablet salut 25 mg Tablet 102.00 - 102.00 - 102.00
15 Amoksilina kapsul 500 mg Tablet 220.00 - 220.00 - 220.00
16 Amoksilna sirup kering 125 mg/ 5 mg Botol 2,277.00 - 2,277.00 - 2,277.00
17 Antasida doen tablet kombinasi Tablet 77.94 - 77.94 - 77.94

1 2 3 4 5 6 7 8 9 10 11 12
18 Anti hemmoroid suppositoria Supp 2,000.00 - 2,000.00 - 2,000.00
19 Aqua pro injeksi streril. Bebas priogen 20 ml Vial 5,300.00 - 5,300.00 - 5,300.00
20 Aquadest steril 500 ml Botol - -
21 As salisilat 2% + belerang endap 4%(2-4 salep Pot 1,800.00 - 1,800.00 - 1,800.00
22 As. Benzoat 3 % + as salisilat 6%(whitefield) Pot 1,904.00 - 1,904.00 - 1,904.00
23 Asam askorbat (Vit. C) tablet 250 mg Tablet - -
24 Asam askorbat (Vit. C) tablet 50 mg Tablet 19.00 - 19.00 - 19.00
25 Asam mefenamat 500 mg Tablet 100.00 - 100.00 - 100.00
26 Asetosal 100 mg Tablet 100.00 - 100.00 - 100.00
27 Asetosal tablet 500 mg Tablet 162.00 - 162.00 - 162.00
28 Antalgin (metampiron) tablet 500 mg Tablet 116.00 - 116.00 - 116.00
29 Atropina sulfat injeksi 0 .25 mg / ml - 1 ml Ampul 1,230.00 - 1,230.00 - 1,230.00
30 Basitrasin Polimiksin Tube 2,491.00 - 2,491.00 - 2,491.00
31 Besi (ii) sulfat tablet salut .kombinasi Tablet 44.00 - 44.00 - 44.00
32 Betahistin tab Tablet 924.00 - 924.00 - 924.00
33 Betametazon salep kulit Tube 1,525.00 - 1,525.00 - 1,525.00
34 Captopril 12.5 mg tablet Tablet 63.00 - 63.00 - 63.00
35 Captopril 25 mg tablet Tablet 88.00 - 88.00 - 88.00

1 2 3 4 5 6 7 8 9 10 11 12
36 Carbamazepina 200 mg talet Tablet 243.00 - 243.00 - 243.00
37 Catgut / benang bedah no 2/0 chromic Sachet 2,750.00 - 2,750.00 - 2,750.00
38 Catgut / benang bedah no 3/0 plain Sachet 2,750.00 - 2,750.00 - 2,750.00
39 Cefadroxil 125mg/5ml Sirup Botol 5,248.00 - 5,248.00 - 5,248.00
40 Cefadroxill 500 mg tablet Tablet 521.00 - 521.00 - 521.00
41 Cefotaxim 1 gr Injeksi Ampul 6,860.00 - 6,860.00 - 6,860.00
42 Cetirizin10 mg tab Tablet 225.00 - 225.00 - 225.00
43 Cimetidine/Selestidin Tablet 111.00 - 111.00 - 111.00
44 Ciprofloxazin tablet 500 mg Tablet 245.00 - 245.00 - 245.00
45 Deksametason injeksi 5 mg / ml - 1 ml Ampul 1,500.00 - 1,500.00 - 1,500.00
46 Deksametason tablet 0.5 mg Tablet 70.00 - 70.00 - 70.00
47 Dekstrometofan HBR tablet 15 mg Tablet 92.00 - 92.00 - 92.00
48 Dekstrometopan HBR sirup 10 mg / ml Botol 1,378.85 - 1,378.85 - 1,378.85
49 Devitalisasi pasta Tube 475,000.00 - 475,000.00 - 475,000.00
50 Diazepam 5 mg Tablet - -
51 Diazepam injeksi 5 mg / ml - 2 ml Ampul 2,344.00 - 2,344.00 - 2,344.00
52 Diazepam tablet 2 mg Tablet 27.00 - 27.00 - 27.00

Difenhidramin HCL injeksi 10 mg / ml - ml
53 Ampul 960.00 - 960.00 - 960.00
1 2 3 4 5 6 7 8 9 10 11 12
54 Digoksina tablet 0. 25 mg Tablet 91.00 - 91.00 - 91.00
55 Domperidon tablet 10 mg Tablet 176.00 - 176.00 - 176.00
56 Doxycicline 100 mg tab Tablet 220.00 - 220.00 - 220.00
57 Efedrina HCL (efedrina) tablet 25 mg Tablet 35.00 - 35.00 - 35.00

Epinefrina HCL / bitartat (aderenalina) inj 01%
58 Ampul 4 1,500.00 6,000 1,500.00 - 4 1,500.00
Ergotamina tartrat 1 mg + kofeina 50 mg tab
59 Tablet 103.00 - 103.00 - 103.00
60 Erytromysin 200mg/5ml Syrup Botol 7,220.00 - 7,220.00 - 7,220.00
61 Erytromysin tablet 500 mg Tablet 864.25 - 864.25 - 864.25
62 Etakridina (rivanol) larutan 0.1 % Botol 2,212.16 - 2,212.16 - 2,212.16
63 Etanol 70 % Botol 0.50 30,000.00 15,000 2 30,000.00 60,000 2.50 30,000.00
64 Etil klorida semprot Botol 1 137,500.00 137,500 4 137,500.00 550,000 4 137,500.00
65 Eugenol cairan Botol 55,660.00 - 55,660.00 - 55,660.00
66 Fenobarbital inj 50 mg /ml -2ml Ampul 1,716.00 - 1,716.00 - 1,716.00
67 Fenobarbital tablet 100mg Tablet - -
68 Fenobarbital tablet 30 mg Tablet 66.00 - 66.00 - 66.00
69 Fenol gliserol tetes telnga 10% Botol 1,008.00 - 1,008.00 - 1,008.00
70 Fitomenadion (vit. K1) inj 10 / ml 1 ml Ampul 1,566.00 - 1,566.00 - 1,566.00

Fitomenadion (vit. K1) tablet salut 10 mg
71 Tablet 579.00 - 579.00 - 579.00
1 2 3 4 5 6 7 8 9 10 11 12
72 Furosemida tablet 40 mg Tablet 84.85 - 84.85 - 84.85
73 Gameksan emulisi 1 % Botol - -
74 Garam Oralit untuk 100 ml. Air Sachet - -
75 Garam Oralit untuk 200 ml air Sachet 292.00 - 292.00 - 292.00
76 Gentamisin Salep Mata Tube - -
77 Gentamysin SK Tube - -
78 Gentamysin TM/Genoint TM Botol 2,904.00 - 2,904.00 - 2,904.00
79 Gentian violet larutan 1 % Botol 900.00 - 900.00 - 900.00
80 Glibenklamida tablet 5 mg Tablet 54.00 - 54.00 - 54.00
81 Gliseril guayakolat tablet 10 mg Tablet 38.00 - 38.00 - 38.00
82 Glukosa larutan infus 10 % steril Botol 5,727.00 - 5,727.00 - 5,727.00
83 Glukosa larutan infus 40 % steril Botol 898.00 - 898.00 - 898.00
84 Glukosa larutan infus 5 % steril Botol 5,313.00 - 5,313.00 - 5,313.00
85 Griseofulvin tablet 125 mg. Mikronized Tablet 194.00 - 194.00 - 194.00
86 Haloperidol 0,5 mg. Tablet Tablet 52.52 - 52.52 - 52.52
87 Haloperidol 1,5 mg tablet Tablet 60.47 - 60.47 - 60.47
88 Haloperidol 5 mg tablet Tablet 88.23 - 88.23 - 88.23
89 Hidroklorotiasida (HCT) tablet 25 mg Tablet 49.00 - 49.00 - 49.00

1 2 3 4 5 6 7 8 9 10 11 12
90 Hidrokortison krim 2.5 % Tube 2,399.00 - 2,399.00 - 2,399.00
91 Ibuprofen tablet 200 mg Tablet 92.57 - 92.57 - 92.57
92 Ibuprofen tablet 400 mg Tablet 146.00 - 146.00 - 146.00
93 Infusion set anak Set 3,850.00 - 2 3,850.00 7,700 2 3,850.00
94 Infusion set dewasa Set 2 3,850.00 7,700 3 3,850.00 11,550 3 3,850.00
95 Isoniazide 100 mg Tablet 44.00 - 44.00 - 44.00
96 Isoniazide 300 mg Tablet - -
97 Isosorbid dinitrat Tablet 92.00 - 92.00 - 92.00
98 Jarum injeksi Pcs 556.00 - 130 556.00 72,280 110 556.00
99 Jarum jahit (bedah) no. 9 s/d 14 Set - -
100 Kalsium hidroksida pasta Pot 242,000.00 - 242,000.00 - 242,000.00
101 Kalsium laktat (kalk) tablet 500 mg Tablet 57.00 - 57.00 - 57.00
102 Kapas pembalut / absorben 250 gram Roll 15,100.00 - 2 15,100.00 30,200 1 15,100.00
103 Kasa gulung 40 x 80 Roll 123,750.00 - 4 123,750.00 495,000 3.5 123,750.00
104 Kasa Hidrofil 4 x 10 Roll 607.00 - 607.00 - 607.00
105 Kasa kompres 40 / 40 steril Roll 5 1,870.00 9,350 20 1,870.00 37,400 15 1,870.00
106 Kasa pembalut 2 x 80 Roll 13,750.00 - 13,750.00 - 13,750.00
107 Kasa pembalut hidrofil 4 m x 15 cm Roll 6 3,050.00 18,300 75 3,050.00 228,750 78 3,050.00
1 2 3 4 5 6 7 8 9 10 11 12
108 Kasa pembalut hidrofin 4m x 3 cm Roll 10 715.00 7,150 25 715.00 17,875 32 715.00
109 Kasa Steril ( 18 x 22 ) Kotak 4,750.00 - 4,750.00 - 4,750.00
110 Ketokonazole 200 mg tablet Tablet 267.00 - 267.00 - 267.00

Kinina dihidroklorida (kinina) inj 25 % - 2 ml
111 Ampul - -
112 Kinina sulfat tablet 222 mg (7 h20 ) Tablet 15.00 - 15.00 - 15.00
113 Kloramfenicol salep kulit Tube - -
114 Kloramfenikol kapsul 250 mg Tablet 213.00 - 213.00 - 213.00
115 Kloramfenikol salep mata 1 % Tube 1,450.00 - 1,450.00 - 1,450.00
116 Kloramfenikol tetes Mata Botol 2,500.00 - 2,500.00 - 2,500.00
117 Kloramfenikol tetes telinga 3 % Botol 1,599.00 - 1,599.00 - 1,599.00
118 Klorfeniramina maleat (CTM) tablet 4 mg Tablet 21.00 - 21.00 - 21.00
119 Klorpromazin 100 mg tablet Tablet 133.00 - 133.00 - 133.00
120 Klorpromazina Hcl inj 25 mg / ml - 1 ml Ampul - -
121 Klorpromazina Hcl inj 5 mg / ml - 2 ml Ampul - -
122 Klorpromazina hcl tablet salut 25 mg Tablet 45.00 - 45.00 - 45.00
123 Kodeina Hcl (kodeina) tablet 10 mg Tablet - -
124 Kotrimoksasol suspensi Botol 2,035.00 - 2,035.00 - 2,035.00
125 Kotrimoksasol tablet kombinasi Tablet 140.00 - 140.00 - 140.00

1 2 3 4 5 6 7 8 9 10 11 12
126 Kotrimoksasol tablet pediatrik. Kombinasi Tablet - -
127 Lidokain inj Ampul 10 900.00 9,000 40 900.00 36,000 35 900.00
128 Lidokaina comp inj kombinasi Ampul 19 1,295.00 24,605 40 1,295.00 51,800 44 1,295.00
129 Lisol mengandung kresol Botol 35,000.00 - 35,000.00 - 35,000.00
130 Magnesium sulfat serbuk 30 grm Sachet - -

Metakresol sulfonat dan metanol kondensai
131 (Albotyl) Botol 22,727.00 - 22,727.00 - 22,727.00
132 Metformin 500 mg tablet Tablet 105.00 - 105.00 - 105.00

Metilergometrina maleat inj 0. 200 g / ml- ml
133 Ampul 3,876.00 - 3,876.00 - 3,876.00
Metilergometrina malet tablet salut 0. 125 mg
134 Tablet 110.00 - 110.00 - 110.00
135 Metilprednisolon tablet 4 mg Tablet 295.83 - 295.83 - 295.83

Metoklopramide 10 mg tablet/Noristal
136 Tablet 89.00 - 89.00 - 89.00
137 Metronidazol 500 mg Tablet 163.74 - 163.74 - 163.74
138 Metronidazol tablet 250 mg Tablet 122.80 - 122.80 - 122.80
139 Mikonazole salep Tube 3,000.00 - 3,000.00 - 3,000.00

Monoklorkamfer mentolcairan (CHKM)
140 Botol - -
141 Mumifyng pasta Botol 219,890.00 - 219,890.00 - 219,890.00
142 Natrium bikarbonat tablet 500 mg Tablet 9.00 - 9.00 - 9.00
143 Natrium Diklofenak 25 Tablet - -

1 2 3 4 5 6 7 8 9 10 11 12
Natrium Diklofenak 50 (Nadifen/Prostanac)

144 Tablet 210.00 - 210.00 - 210.00
Natrium klorida larutan infus 0. 9 steril
145 Botol 4,900.00 - 21 4,900.00 102,900 20 4,900.00
146 Nifedipin tablet 10 mg Tablet 112.00 - 112.00 - 112.00
147 Nistatin 100. 000 iu/g tablet vaginal Tab Vag 407.00 - 407.00 - 407.00
148 Obat batuk hitam (OBH) cairan Botol 100 ml - -
149 Ofloxacin tab 400mg Tablet - -
150 Oksigen gas dalam tabung 3 m3 Tabung 83,000.00 - 83,000.00 - 83,000.00
151 Oksigen gas dalam tabung 6 m3 Tabung 100,000.00 - 100,000.00 - 100,000.00
152 Oksitetrasiklina hcl salep 3 % Tube 1,529.00 - 1,529.00 - 1,529.00

Oksitetrasiklina hcl salep mata 1 %
153 Tube 1,600.00 - 1,600.00 - 1,600.00
154 Oksitosina inj 10 iu/ml - 1 ml Ampul 5,230.00 - 5,230.00 - 5,230.00
155 Papaverin Injeksi Ampul - -
156 Papaverin Tablet Tablet - -
157 Parasetamol sirup 120 mg / 5 ml Botol 1,318.90 - 1,318.90 - 1,318.90
158 Parasetamol tab 100 mg Tablet - -
159 Parasetamol tablet 500mg Tablet 83.93 - 83.93 - 83.93

Pirantel pamoat (pirantel) tablet 125 mg basa
160 Tablet 311.00 - 311.00 - 311.00
161 Piroxicam 10 Mg Tablet 69.54 - 69.54 - 69.54

1 2 3 4 5 6 7 8 9 10 11 12
162 Piroxicam 20 Mg Tablet 91.96 - 91.96 - 91.96
163 Plester 5 yard x 2 inch Roll 6,873.00 - 3 6,873.00 20,619 2 6,873.00
164 Prednison tablet 5 mgn Tablet 52.00 - 52.00 - 52.00

Pridoksina hcl (vit. B 6) tablet 10 mg
165 Tablet 23.00 - 23.00 - 23.00
166 Primakina tablet 15 mg Tablet - -
167 Prokaina penisilina g inj 3 juta iu Vial - -
168 Propiltionurasil tablet 100 mg Tablet 264.00 - 264.00 - 264.00

Propranolol hcl (Propranolol) tablet 40 mg
169 Tablet 108.00 - 108.00 - 108.00
170 Pyridoxin injeksi Ampul - -
171 Ranitidin inj 25 mg/2 ml Ampul 1,928.00 - 1,928.00 - 1,928.00
172 Ranitidin tablet 150 mg Tablet 110.00 - 110.00 - 110.00
173 Reserpina tablet 0, 10 mg Tablet - -
174 Reserpina tablet 0, 25 mg Tablet 103.00 - 103.00 - 103.00

Retinol (vit. A) kapsul lunak 200.000 iu
175 Tablet 431.54 - 431.54 - 431.54
Retinol (vit. A) tablet salut 100. 000 iu
176 Tablet 242.00 - 242.00 - 242.00
177 Ringer laktat larutan infus steril Botol 3 5,200.00 15,600 6 5,200.00 31,200 6 5,200.00
178 Risperidon Tablet 1,781.00 - 1,781.00 - 1,781.00
179 Salbutamol tablet 2 mg Tablet - -

1 2 3 4 5 6 7 8 9 10 11 12
180 Salbutamol tablet 4 mg Tablet 82.00 - 82.00 - 82.00
181 Salisil bedak 2 % Bks - -
182 Salisil spiritus 10 % Botol - -

Semen seng fosfat serbuk dan cairan
183 Botol 125,000.00 - 125,000.00 - 125,000.00
Serum anti bisa ular polivalen inj. 50 ml
184 Vial - -
Serum anti bisa ular polivalen inj. 5ml
185 Ampul 471,719.00 - 1 471,719.00 471,719 471,719.00
186 Serum anti tetanus inj. 1.500 iu Ampul 7 126,310.00 884,170 22 126,310.00 2,778,820 18 126,310.00
187 Serum anti tetanus inj. 20.000 iu Ampul - -

Sianokobalamina (vit.b12) inj. 500 mcg
188 Ampul 916.00 - 916.00 - 916.00
189 Silk (benang bedah sutera) no.3/0 Pcs 7,810.00 - 7,810.00 - 7,810.00
190 Silver amalgam serbuk 65-75% Botol 660,000.00 - 660,000.00 - 660,000.00
191 Simvastatin tab 10 mg Tablet 180.00 - 180.00 - 180.00
192 Sulfacetamide tetes mata Botol 3,226.00 - 3,226.00 - 3,226.00

Synthetic filing material larutan dan serbuk
193 Set - -
Temporary stopping fletcher serbuk dan cairan
194 Set 6,862.00 - 6,862.00 - 6,862.00
Tetrasiklina hcl (tetrasiklina) kapsul 250 mg
195 Tablet 140.00 - 140.00 - 140.00
196 Tablet 206.00 - 206.00 - 206.00
197 Thiamfenikol 500 Tablet 431.00 - 431.00 - 431.00

1 2 3 4 5 6 7 8 9 10 11 12
Tiamin hcl /mononitrat (vit.b1) tablet 50 mg

198 Tablet 38.00 - 38.00 - 38.00
199 Tiamina hcl (vit.b1) inj. 100 mg/ml Ampul 690.00 - 690.00 - 690.00
200 Tramadol Tablet 188.93 - 188.93 - 188.93
201 Trifluoperazine (Stelazin) Tablet - -
202 Triheksfenidil hcl 2 mg tablet Tablet 40.00 - 40.00 - 40.00
203 Trikresol formalin (tkf) cairan Botol 67,200.00 - 67,200.00 - 67,200.00
204 Vitamin B kompleks tablet Tablet 30.00 - 30.00 - 30.00
205 Yodium povidan larutan 10% 300 ml Botol 0.50 14,000.00 7,000 1 14,000.00 14,000 1.50 14,000.00
206 Yodium povidon larutan 10% 30 ml Botol 2,000.00 - 4 2,000.00 8,000 4 2,000.00
207 Zink tablet Tablet 455.00 - 455.00 - 455.00
- -
Obat Tambahan - -
208
Adimidon injk / Xylomidon injk Vial - -
209
ADS 0.5 ml Pcs 1.00 - 1.00 - 1.00
210
ADS 0.05 ml Pcs 1.00 - 1.00 - 1.00
211
ADS 5 ml Pcs 1.00 - 1.00 - 1.00
212
Aleterol TM Botol 10,321.00 - 10,321.00 - 10,321.00
213
Antalgin injeksi Ampul - -
1 2 3 4 5 6 7 8 9 10 11 12
214
Arsuamon tablet Tablet - -
215
Artesunat inj Vial 12,955.00 - 12,955.00 - 12,955.00
216
Azitromisin+cefixim Tablet 1.00 - 1.00 - 1.00
217
Bisturi no 13 Pcs 2,220.00 - 2,220.00 - 2,220.00
218
Bisturi no 14 Pcs 2,220.00 - 2,220.00 - 2,220.00
219
Bisturi no 19/20 Pcs 2,220.00 - 2,220.00 - 2,220.00
220
Bisturi no 21 Pcs 2,220.00 - 2,220.00 - 2,220.00
221
Bonding Set 1,100,500.00 - 1,100,500.00 - 1,100,500.00
222
Bufacomb salep Tube 13,750.00 - 13,750.00 - 13,750.00
223
Buscopan inj Ampul - -
224
Clopramel inj Ampul - -
225
Composite (tumpatan sinar)A3 Set 279,000.00 - 279,000.00 - 279,000.00
226
Composite (tumpatan sinar)A3.5 Set 260,000.00 - 260,000.00 - 260,000.00
227
Daryantulle Lembar 8 16,500.00 132,000 55 16,500.00 907,500 58 16,500.00
228
Dermazine/Burnazin Tube 58,520.00 - 2 58,520.00 117,040 1 58,520.00
229 Dextina / Dextamin/Dextamec/Polofar Plus
Tablet 540.00 - 540.00 - 540.00
230
Diaform tablet/selesdiar Tablet 81.00 - 81.00 - 81.00
231
Dormi/Scopma Tablet - -
1 2 3 4 5 6 7 8 9 10 11 12
232
Dulcolac anak supp Supp 7,207.00 - 7,207.00 - 7,207.00
233
Dulcolac dewasa supp Supp - -
234
Dulkolak tablet Tablet 1,950.00 - 1,950.00 - 1,950.00
235
Ericaf Tablet - -
236
ETSA Set 235,000.00 - 235,000.00 - 235,000.00
237
Folley catheter Pcs 17,600.00 - 17,600.00 - 17,600.00
238
Glass ionomer (Ketac Molar) Tube 525,000.00 - 525,000.00 - 525,000.00
239
Hypavix (Ultrafik) Roll 105,000.00 - 12 105,000.00 1,260,000 12 105,000.00
240
I.V Catheter 22 Pcs 6,000.00 - 6,000.00 - 6,000.00
241
I.V Catheter 24 Pcs 6,000.00 - 6,000.00 - 6,000.00
242
IV Catheter 18 Pcs 6,000.00 - 6,000.00 - 6,000.00
243
IV Catheter 20 Pcs 6,000.00 - 6,000.00 - 6,000.00
244
Jarum Otot dan Kulit Set 30,200.00 - 30,200.00 - 30,200.00
245
MY Jelly Tube 28,500.00 - 28,500.00 - 28,500.00
246
Klip Kecil Pak 8,500.00 - 8,500.00 - 8,500.00
247
Klip Tanggung Pak 15,000.00 - 15,000.00 - 15,000.00
248
Masker Pcs 35 1,100.00 38,500 324 1,100.00 356,400 309 1,100.00
249
Meylon inj Botol - -
1 2 3 4 5 6 7 8 9 10 11 12
250
Microlax Supp 16,000.00 - 16,000.00 - 16,000.00
251
Multivitamin (Livron B plek) Tablet 220.00 - 220.00 - 220.00
252
Multivitamin sirup( Xanvit syr) Botol 9,500.00 - 9,500.00 - 9,500.00
253
Norit Botol 8,650.00 - 8,650.00 - 8,650.00
254
Obat anti tuberkulosis FDC anak Paket 214,898.00 - 214,898.00 - 214,898.00
255
Obat anti tuberkulosis FDC katagori I Paket 358,200.00 - 358,200.00 - 358,200.00
256
Obat anti tuberkulosis FDC katagori II Paket 1,199,900.00 - 1,199,900.00 - 1,199,900.00
257
Obat anti tuberkulosis kategori I Paket 288,100.00 - 288,100.00 - 288,100.00
258
Obat anti tuberkulosis FDC sisipan Paket 159,898.00 - 159,898.00 - 159,898.00
259
Obat Batuk Kombinasi Botol - -
Obat Flu kombinasi CTM, PPA (Anaflu),
260
Demacolin Tablet 330.00 - 330.00 - 330.00
261 Obat Flu Kombinasi/Mecofed/Quantidex
Tablet 350.00 - 350.00 - 350.00
262 Obat maag kombinasi/Indomag/Myloxan
Tablet - -
263
Obat maag suspensi (novamaag) Botol - -
264 Obat sakit kepala komb (Parasetamol + Kofein)
Tablet - -
265
Orpen Tablet 129.00 - 129.00 - 129.00
266
Oseltamivir Tablet 1.00 - 1.00 - 1.00
267
Pehacain Injeksi Ampul - -
1 2 3 4 5 6 7 8 9 10 11 12
268
Pembalut Gips Roll 5,519.00 - 5,519.00 - 5,519.00
269
Perhidrol (H2O2) Botol 10,399.00 - 4 10,399.00 41,596 3 10,399.00
270
Perkamen Pak 16,000.00 - 16,000.00 - 16,000.00
271
Proris supp Supp 4,790.00 - 20 4,790.00 95,800 14 4,790.00
272
Sarung Tangan L Pasang 1,650.00 - 1,650.00 - 1,650.00
273
Sarung Tangan M Pasang 50 4,668.00 233,400 300 4,668.00 1,400,400 350 4,668.00
274
Sarung Tangan S Pasang 1,650.00 - 600 1,650.00 990,000 570 1,650.00
275
Sarung Tangan Steril Pasang 4,250.00 - 4,250.00 - 4,250.00
276
Seremig tablet Tablet - -
277
Spalk tungkai atas anak Pcs 40,500.00 - 40,500.00 - 40,500.00
278
Spalk tungkai atas dewasa Pcs 40,500.00 - 40,500.00 - 40,500.00
279
Spalk tungkai bawah anak Pcs 34,500.00 - 34,500.00 - 34,500.00
280
Spalk tungkai bawah dewasa Pcs 34,500.00 - 34,500.00 - 34,500.00
281
Spashi inj Ampul 8,415.00 - 8,415.00 - 8,415.00
282
Stesolid rectal Supp 17,600.00 - 2 17,600.00 35,200 17,600.00
283
Strop indra Botol 4,000.00 - 4,000.00 - 4,000.00
284
Tranexid inj (Asam tranexamat inj) Ampul 5,280.00 - 5,280.00 - 5,280.00
285
Transamin tab Tablet - -
1 2 3 4 5 6 7 8 9 10 11 12
286
Urinebag Set 3,982.00 - 3,982.00 - 3,982.00
287
Ventolin Nebulizer Ampul 9,240.00 - 10 9,240.00 92,400 2 9,240.00
288
Vitamin B12 tab Tablet - -
289
Vitamin Neurotropik inj Ampul 6,600.00 - 6,600.00 - 6,600.00
290 Vitamin Neurotropik tablet (Nutrifar, Sohobion)
Tablet 441.00 - 441.00 - 441.00
291
Wing Needle 21 Pcs - -
292
Wing Needle 23 Pcs 1,950.00 - 1,950.00 - 1,950.00
293
Wing Needle 25 Pcs 1,950.00 - 1,950.00 - 1,950.00
294
Wing Needle 27 Pcs 1,950.00 - 1,950.00 - 1,950.00
295
Omeprasole tablet 20 mg Tablet 265.00 - 265.00 - 265.00
296
Silk 3/0 roll Roll 321,600.00 - 321,600.00 - 321,600.00
297
Catgut 2/0 Chromic Roll Roll 1,172,600.00 - 1,172,600.00 - 1,172,600.00
298
Catgut 3/0 Chromic Roll Roll 1,172,600.00 - 1,172,600.00 - 1,172,600.00
299
Catgut 1/0 Chromic Pcs 26,667.00 - 26,667.00 - 26,667.00
300
Kertas EKG Roll 268,550.00 - 268,550.00 - 268,550.00
301
Kertas USG Roll 386,100.00 - 386,100.00 - 386,100.00
302
Jelly RO Tube 30,140.00 - 30,140.00 - 30,140.00
305
Primperan inj Ampul 10,000.00 - 10,000.00 - 10,000.00
1 2 3 4 5 6 7 8 9 10 11 12
306
Pantocain Tetes Mata Botol 14,575.00 - 14,575.00 - 14,575.00
308
Underpad Pak 5,720.00 - 5,720.00 - 5,720.00
309
Caviton Tube 125,000.00 - 125,000.00 - 125,000.00
310
Amlodipin 5 mg tab Tablet 240.00 - 240.00 - 240.00
311
Amlodipin 10 mg tab Tablet 440.00 - 440.00 - 440.00
312
ADS 2 ml Pcs 1.00 - 1.00 - 1.00
313
Roverton tablet Tablet 407.00 - 407.00 - 407.00
314
Roverton syr Botol 9,790.00 - 9,790.00 - 9,790.00
315
IV Catheter no 18 G Terumo Pcs 13,200.00 - 13,200.00 - 13,200.00
316
IV Catheter no 20 G Terumo Pcs 13,200.00 - 13,200.00 - 13,200.00
317
Ketoprofen tablet 100 mg Tablet 608.00 - 608.00 - 608.00
318
Ketoprofen inj 10 mg Ampul 2,542.00 - 2,542.00 - 2,542.00
319
Jarum Kulit Set 110,000.00 - 110,000.00 - 110,000.00
320
Cefixim tablet 100 mg Tablet 958.00 - 958.00 - 958.00
321
Cefixim syr 100 mg/5 ml Botol 10,588.00 - 10,588.00 - 10,588.00
322
Masker N95 Pcs 1.00 - 1.00 - 1.00
323
Masker Bedah Pcs 1.00 - 1.00 - 1.00
324
Piracetam 400 mg Tablet 194.00 - 194.00 - 194.00
1 2 3 4 5 6 7 8 9 10 11 12
325
Piracetam inj 200mg/1ml Ampul 1,925.00 - 1,925.00 - 1,925.00
326
Tramadol inj 50 mg/ml Ampul 5,400.00 - 5,400.00 - 5,400.00
327
Jarum Jahit Bedah no 12 Set 1.00 - 1.00 - 1.00
328
329
330
Film Rontgen 18 x 24 Set 1,031,800.00 - 1,031,800.00 - 1,031,800.00
331
Antasida syr Botol 1,865.00 - 1,865.00 - 1,865.00
332
Asam Folat 1 mg Tablet 44.87 - 44.87 - 44.87
333
Metil prednisolon inj 500 mg Vial 10.00 - 10.00 - 10.00
334
Parasetamol drop Botol 5,227.00 - 5,227.00 - 5,227.00
335
Ceftriaxon inj Vial 8,100.00 - 8,100.00 - 8,100.00
Cairan prosessing film rontgen(developer dan
336
fixer) set 1,320,000.00 - 1,320,000.00 - 1,320,000.00
337
Lytamin syr botol 6,098.00 - 6,098.00 - 6,098.00
338
Prenatin plus tablet tablet 605.00 - 605.00 - 605.00
339
Flumeco Tablet 772.00 - 772.00 - 772.00
340
Faktu Supp Supp 9,370.00 - 9,370.00 - 9,370.00
341
Stelosi tab 5 mg Tablet 550.00 - 550.00 - 550.00
342
Ondancetron 4 mg Tablet 1,400.00 - 1,400.00 - 1,400.00
1 2 3 4 5 6 7 8 9 10 11 12
343
Asam tranexamat 500 mg Tablet 1,300.00 - 1,300.00 - 1,300.00
344
D1/4 NS Botol 11,000.00 - 11,000.00 - 11,000.00
345
D1/2 NS botol 10,825.00 - 10,825.00 - 10,825.00
346
IV Cath dgn Katup pcs 14,825.00 - 14,825.00 - 14,825.00
347
Nasal cannula Oksigen pcs 8,250.00 - 8,250.00 - 8,250.00
348
Sarung Tangan Gynaecologi pasang 14,419.90 - 14,419.90 - 14,419.90
349
Klem Tali Pusar pcs 2,700.00 - 2,700.00 - 2,700.00
350
VitKa infan Ampul 9,070.00 - 9,070.00 - 9,070.00
351
OBH plus botol 8,000.00 - 8,000.00 - 8,000.00
352
Kantung Puyer Pak 1.00 - 1.00 - 1.00
353
Sarung Tangan Surgiglove Pasang 1.00 - 1.00 - 1.00
354
Spashi tab Tablet 1,091.00 - 1,091.00 - 1,091.00
355 Safety box Pcs 1.00 - 1.00 - 1.00
356 Pot Sputum Pcs 1.00 - 1.00 - 1.00
357 Box slide kotak 1.00 - 1.00 - 1.00
358 Lampu spiritus botol 1.00 - 1.00 - 1.00
359 Sarung Tangan Biotech M Pasang 1.00 - 1.00 - 1.00
360 Sarung Tangan Biotech S Pasang 1.00 - 1.00 - 1.00

1 2 3 4 5 6 7 8 9 10 11 12
361 Sarung Tangan Biotech L Pasang 1.00 - 1.00 - 1.00
362 Slide Prosted Pak 1.00 - 1.00 - 1.00
363 Spuit 2/3 ml Pcs 5 1.00 5 135 1.00 135 125 1.00
364 Kertas saring Lembar 1.00 - 1.00 - 1.00
365 Oil Emersi Botol 1.00 - 1.00 - 1.00
366 Reagen TBC Botol 1.00 - 1.00 - 1.00
367 Slide Non Prosted pak 1.00 - 1.00 - 1.00
368 Tisu Lensa Lembar 1.00 - 1.00 - 1.00
369 Sound timer buah 1.00 - 1.00 - 1.00
370 Primaquin Tablet 1.00 - 1.00 - 1.00
371 Arterakine Tablet 1.00 - 1.00 - 1.00
372 Depo Ampul 1.00 - 1.00 - 1.00
373 Pehatrim Forte (Kotrimoksasol tab forte 960 mg) Tablet 1.00 - 1.00 - 1.00
374 Fluconasol tab Tablet 1.00 - 1.00 - 1.00

Ampisilin Serbuk Injeksi i.m/i.v. 1000 mg/ml Ampul 1.00 1.00 1.00
375 - -
Prokain Benzil Penicillin G Injeksi 3 jt IU/vial Vial 180,500.00 180,500.00 180,500.00
376 - -
Dextran 70% Botol 1.00 1.00 1.00
377 - -
Transfusi Set Pcs 1.00 1.00 1.00
378 - -
1 2 3 4 5 6 7 8 9 10 11 12
Magnesium Sulfat 20% - 25 ml Botol 1.00 1.00 1.00

379 - -
Magnesium Sulfat 40% - 25 ml Botol 1,948.00 1,948.00 1,948.00
380 - -
Glukonas Calcicus 10%- 10ml Ampul 1.00 1.00 1.00
381 - -
Ampisillin injeksi i.m/i.v 1000 mg/ml 1.00 1.00 1.00
382 Ampul - -
Gentamisin Injeksi 80 mg/2ml 3,782.00 3,782.00 3,782.00
383 Ampul - -
Metronidazole 500 mg Infus/100 ml Botol 1.00 1.00 1.00
384 - -
Cutgut Chromic No.1 atraumatik (sachet) Sachet 1.00 1.00 1.00
385 - -
Urine strip untuk pemeriksaan Protein dan Gula Pcs 1.00 1.00 1.00
386 - -
Rapid test untuk sifilis Pcs 1.00 1.00 1.00
387 - -
Kontasepsi Injeksi Progesteron Depot (3 bln.1ml) Ampul 1.00 1.00 1.00
388 - -
Kontasepsi Pil Kombinasi (micrdiol) Blister 1.00 1.00 1.00
389 - -
Implan KB (isi 2) Set 1.00 1.00 1.00
390 - -
391 Spuit 10 ml Pcs 1.00 - 2 1.00 2 2 1.00
392 Alkohol Swab Sachet 1.00 - 1.00 - 1.00
393 Giemsa Solution Botol 1.00 - 1.00 - 1.00
394 Determine 1/2 Set 1.00 - 1.00 - 1.00
395 SD bio HIV 1/2 3.0 Set 1.00 - 1.00 - 1.00
396 One Step Anti HIV 1 dan 2 intec Set 1.00 - 1.00 - 1.00
1 2 3 4 5 6 7 8 9 10 11 12
397 SD bio Syphilis 3.0 Set 1.00 - 1.00 - 1.00
398 SD bio Syphilis 1/2 3.0 Set 1.00 - 1.00 - 1.00
399 Benzatin Penisillin Vial 1.00 - 1.00 - 1.00
400 Rotator Pcs 1.00 - 1.00 - 1.00
401 RPR Test Kit (Plasmatec) Set 1.00 - 1.00 - 1.00
402 VDRL/RPR anti gen Set 1.00 - 1.00 - 1.00
403 Cefixim tablet 200 mg Tablet 1.00 - 1.00 - 1.00
404 Clarithromysin 500 mg Tablet 1.00 - 1.00 - 1.00
405 Pirimethamine tablet Tablet 1.00 - 1.00 - 1.00
406 Sulfadiazin tablet Tablet 116.85 - 116.85 - 116.85
407 Azytromisin tablet 500 mg Tablet 1.00 - 1.00 - 1.00
408 Clindamisin 300 mg Tablet 1.00 - 1.00 - 1.00
409 Clindamisin 150 mg Tablet 1.00 - 1.00 - 1.00
410 BD Vacuntainer Pcs 1.00 - 1.00 - 1.00
411 Metil Prednisolon 16 mg Tablet 1,430.00 - 1,430.00 - 1,430.00
412 Amox-clav Tablet 5,055.00 - 5,055.00 - 5,055.00
413 Acyclovir tablet 200 mg Tablet 388.18 - 388.18 - 388.18
414 HIV 1&2 Antibody Oncoprobe Reagen 3 Set 1.00 - 1.00 - 1.00
1 2 3 4 5 6 7 8 9 10 11 12
415 Vixia 1/2 Biomeriux 1.00 - 1.00 - 1.00

416 Duradryl
417 Ketorolac inj
418 Paket bonding
1,545,280 10,325,258
Mengetahui
Kepala Puskesmas
dr. H. Panggah Pramono

NIP:19690306 199903 1 007
ELUAR (PEMAKAIAN Selama TA 2013) STOK AKHIR (LPLPO Desember 2013)
STOK MASUK (PENERIMAAN DARI PUSKESMAS 1 Jan 2014 s.d. 26 Maret
STOK2014)
KELUAR (PEMAKAIAN 1 Jan 2014 s.d. 26 Maret 2014) STOK AKHIR (Stok Opname 26 M
Total Jumlah Harga Total Ket. Jumlah Harga Total Ket. Jumlah Harga Total Ket. Jumlah
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 2,152.00 - 2,152.00 - 2,152.00 -
- 340.00 - 340.00 - 340.00 -
- 400,000.00 - 400,000.00 - 400,000.00 -
- 1,092.00 - 1,092.00 - 1,092.00 -
- 540.00 - 540.00 - 540.00 -
1,486 2 743.00 1,486 743.00 - 743.00 - 2
- 366.00 - 366.00 - 366.00 -
- 460.00 - 460.00 - 460.00 -
- 104.00 - 104.00 - 104.00 -
- 2,475.00 - 2,475.00 - 2,475.00 -
- 85.93 - 85.93 - 85.93 -
- 3,240.00 - 3,240.00 - 3,240.00 -
- 87.15 - 87.15 - 87.15 -
- 102.00 - 102.00 - 102.00 -
- 220.00 - 220.00 - 220.00 -
- 2,277.00 - 2,277.00 - 2,277.00 -
- 77.94 - 77.94 - 77.94 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 2,000.00 - 2,000.00 - 2,000.00 -
- 5,300.00 - 5,300.00 - 5,300.00 -
- - - -
- 1,800.00 - 1,800.00 - 1,800.00 -
- 1,904.00 - 1,904.00 - 1,904.00 -
- - - -
- 19.00 - 19.00 - 19.00 -
- 100.00 - 100.00 - 100.00 -
- 100.00 - 100.00 - 100.00 -
- 162.00 - 162.00 - 162.00 -
- 116.00 - 116.00 - 116.00 -
- 1,230.00 - 1,230.00 - 1,230.00 -
- 2,491.00 - 2,491.00 - 2,491.00 -
- 44.00 - 44.00 - 44.00 -
- 924.00 - 924.00 - 924.00 -
- 1,525.00 - 1,525.00 - 1,525.00 -
- 63.00 - 63.00 - 63.00 -
- 88.00 - 88.00 - 88.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 243.00 - 243.00 - 243.00 -
- 2,750.00 - 2,750.00 - 2,750.00 -
- 2,750.00 - 2,750.00 - 2,750.00 -
- 5,248.00 - 5,248.00 - 5,248.00 -
- 521.00 - 521.00 - 521.00 -
- 6,860.00 - 6,860.00 - 6,860.00 -
- 225.00 - 225.00 - 225.00 -
- 111.00 - 111.00 - 111.00 -
- 245.00 - 245.00 - 245.00 -
- 1,500.00 - 1,500.00 - 1,500.00 -
- 70.00 - 70.00 - 70.00 -
- 92.00 - 92.00 - 92.00 -
- 1,378.85 - 1,378.85 - 1,378.85 -
- 475,000.00 - 475,000.00 - 475,000.00 -
- - - -
- 2,344.00 - 2,344.00 - 2,344.00 -
- 27.00 - 27.00 - 27.00 -
- 960.00 - 960.00 - 960.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 91.00 - 91.00 - 91.00 -
- 176.00 - 176.00 - 176.00 -
- 220.00 - 220.00 - 220.00 -
- 35.00 - 35.00 - 35.00 -
6,000 1,500.00 - 1,500.00 - 1,500.00 -
- 103.00 - 103.00 - 103.00 -
- 7,220.00 - 7,220.00 - 7,220.00 -
- 864.25 - 864.25 - 864.25 -
- 2,212.16 - 2,212.16 - 2,212.16 -
75,000 30,000.00 - 30,000.00 - 30,000.00 -
550,000 1 137,500.00 137,500 137,500.00 - 137,500.00 - 1
- 55,660.00 - 55,660.00 - 55,660.00 -
- 1,716.00 - 1,716.00 - 1,716.00 -
- - - -
- 66.00 - 66.00 - 66.00 -
- 1,008.00 - 1,008.00 - 1,008.00 -
- 1,566.00 - 1,566.00 - 1,566.00 -
- 579.00 - 579.00 - 579.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 84.85 - 84.85 - 84.85 -
- - - -
- - - -
- 292.00 - 292.00 - 292.00 -
- - - -
- - - -
- 2,904.00 - 2,904.00 - 2,904.00 -
- 900.00 - 900.00 - 900.00 -
- 54.00 - 54.00 - 54.00 -
- 38.00 - 38.00 - 38.00 -
- 5,727.00 - 5,727.00 - 5,727.00 -
- 898.00 - 898.00 - 898.00 -
- 5,313.00 - 5,313.00 - 5,313.00 -
- 194.00 - 194.00 - 194.00 -
- 52.52 - 52.52 - 52.52 -
- 60.47 - 60.47 - 60.47 -
- 88.23 - 88.23 - 88.23 -
- 49.00 - 49.00 - 49.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 2,399.00 - 2,399.00 - 2,399.00 -
- 92.57 - 92.57 - 92.57 -
- 146.00 - 146.00 - 146.00 -
7,700 3,850.00 - 3,850.00 - 3,850.00 -
11,550 2 3,850.00 7,700 4 3,850.00 15,400 3 3,850.00 11,550 3
- 44.00 - 44.00 - 44.00 -
- - - -
- 92.00 - 92.00 - 92.00 -
61,160 20 556.00 11,120 50 556.00 27,800 55 556.00 30,580 15
- - - -
- 242,000.00 - 242,000.00 - 242,000.00 -
- 57.00 - 57.00 - 57.00 -
15,100 1 15,100.00 15,100 15,100.00 - 15,100.00 - 1
433,125 0.5 123,750.00 61,875 123,750.00 - 0.5 123,750.00 61,875
- 607.00 - 607.00 - 607.00 -
28,050 10 1,870.00 18,700 10 1,870.00 18,700 10 1,870.00 18,700 10
- 13,750.00 - 13,750.00 - 13,750.00 -
237,900 3 3,050.00 9,150 54 3,050.00 164,700 57 3,050.00 173,850

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
22,880 3 715.00 2,145 715.00 - 715.00 - 3
- 4,750.00 - 4,750.00 - 4,750.00 -
- 267.00 - 267.00 - 267.00 -
- - - -
- 15.00 - 15.00 - 15.00 -
- - - -
- 213.00 - 213.00 - 213.00 -
- 1,450.00 - 1,450.00 - 1,450.00 -
- 2,500.00 - 2,500.00 - 2,500.00 -
- 1,599.00 - 1,599.00 - 1,599.00 -
- 21.00 - 21.00 - 21.00 -
- 133.00 - 133.00 - 133.00 -
- - - -
- - - -
- 45.00 - 45.00 - 45.00 -
- - - -
- 2,035.00 - 2,035.00 - 2,035.00 -
- 140.00 - 140.00 - 140.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- - - -
31,500 15 900.00 13,500 15 900.00 13,500 10 900.00 9,000 20
56,980 15 1,295.00 19,425 15 1,295.00 19,425 19 1,295.00 24,605 11
- 35,000.00 - 35,000.00 - 35,000.00 -
- - - -
- 22,727.00 - 22,727.00 - 22,727.00 -
- 105.00 - 105.00 - 105.00 -
- 3,876.00 - 3,876.00 - 3,876.00 -
- 110.00 - 110.00 - 110.00 -
- 295.83 - 295.83 - 295.83 -
- 89.00 - 89.00 - 89.00 -
- 163.74 - 163.74 - 163.74 -
- 122.80 - 122.80 - 122.80 -
- 3,000.00 - 3,000.00 - 3,000.00 -
- - - -
- 219,890.00 - 219,890.00 - 219,890.00 -
- 9.00 - 9.00 - 9.00 -
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 210.00 - 210.00 - 210.00 -
98,000 1 4,900.00 4,900 5 4,900.00 24,500 5 4,900.00 24,500 1
- 112.00 - 112.00 - 112.00 -
- 407.00 - 407.00 - 407.00 -
- - - -
- - - -
- 83,000.00 - 83,000.00 - 83,000.00 -
- 100,000.00 - 100,000.00 - 100,000.00 -
- 1,529.00 - 1,529.00 - 1,529.00 -
- 1,600.00 - 1,600.00 - 1,600.00 -
- 5,230.00 - 5,230.00 - 5,230.00 -
- - - -
- - - -
- 1,318.90 - 1,318.90 - 1,318.90 -
- - - -
- 83.93 - 83.93 - 83.93 -
- 311.00 - 311.00 - 311.00 -
- 69.54 - 69.54 - 69.54 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 91.96 - 91.96 - 91.96 -
13,746 1 6,873.00 6,873 6,873.00 - 6,873.00 - 1
- 52.00 - 52.00 - 52.00 -
- 23.00 - 23.00 - 23.00 -
- - - -
- - - -
- 264.00 - 264.00 - 264.00 -
- 108.00 - 108.00 - 108.00 -
- - - -
- 1,928.00 - 1,928.00 - 1,928.00 -
- 110.00 - 110.00 - 110.00 -
- - - -
- 103.00 - 103.00 - 103.00 -
- 431.54 - 431.54 - 431.54 -
- 242.00 - 242.00 - 242.00 -
31,200 3 5,200.00 15,600 2 5,200.00 10,400 1 5,200.00 5,200 4
- 1,781.00 - 1,781.00 - 1,781.00 -
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 82.00 - 82.00 - 82.00 -
- - - -
- - - -
- 125,000.00 - 125,000.00 - 125,000.00 -
- - - -
- 1 471,719.00 471,719 471,719.00 - 471,719.00 - 1
2,273,580 11 126,310.00 1,389,410 126,310.00 - 4 126,310.00 505,240 7
- - - -
- 916.00 - 916.00 - 916.00 -
- 7,810.00 - 7,810.00 - 7,810.00 -
- 660,000.00 - 660,000.00 - 660,000.00 -
- 180.00 - 180.00 - 180.00 -
- 3,226.00 - 3,226.00 - 3,226.00 -
- - - -
- 6,862.00 - 6,862.00 - 6,862.00 -
- 140.00 - 140.00 - 140.00 -
- 206.00 - 206.00 - 206.00 -
- 431.00 - 431.00 - 431.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 38.00 - 38.00 - 38.00 -
- 690.00 - 690.00 - 690.00 -
- 188.93 - 188.93 - 188.93 -
- - - -
- 40.00 - 40.00 - 40.00 -
- 67,200.00 - 67,200.00 - 67,200.00 -
- 30.00 - 30.00 - 30.00 -
21,000 14,000.00 - 14,000.00 - 14,000.00 -
8,000 2,000.00 - 3 2,000.00 6,000 2 2,000.00 4,000 1
- 455.00 - 455.00 - 455.00 -
- - - -
- - - -
- - - -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 10,321.00 - 10,321.00 - 10,321.00 -
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- - - -
- 12,955.00 - 12,955.00 - 12,955.00 -
- 1.00 - 1.00 - 1.00 -
- 2,220.00 - 2,220.00 - 2,220.00 -
- 2,220.00 - 2,220.00 - 2,220.00 -
- 2,220.00 - 2,220.00 - 2,220.00 -
- 2,220.00 - 2,220.00 - 2,220.00 -
- 1,100,500.00 - 1,100,500.00 - 1,100,500.00 -
- 13,750.00 - 13,750.00 - 13,750.00 -
- - - -
- - - -
- 279,000.00 - 279,000.00 - 279,000.00 -
- 260,000.00 - 260,000.00 - 260,000.00 -
957,000 5 16,500.00 82,500 40 16,500.00 660,000 35 16,500.00 577,500 10
58,520 1 58,520.00 58,520 58,520.00 - 58,520.00 - 1
- 540.00 - 540.00 - 540.00 -
- 81.00 - 81.00 - 81.00 -
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 7,207.00 - 7,207.00 - 7,207.00 -
- - - -
- 1,950.00 - 1,950.00 - 1,950.00 -
- - - -
- 235,000.00 - 235,000.00 - 235,000.00 -
- 17,600.00 - 17,600.00 - 17,600.00 -
- 525,000.00 - 525,000.00 - 525,000.00 -
1,260,000 105,000.00 - 6 105,000.00 630,000 5 105,000.00 525,000 1
- 6,000.00 - 6,000.00 - 6,000.00 -
- 6,000.00 - 6,000.00 - 6,000.00 -
- 6,000.00 - 6,000.00 - 6,000.00 -
- 6,000.00 - 6,000.00 - 6,000.00 -
- 30,200.00 - 30,200.00 - 30,200.00 -
- 28,500.00 - 28,500.00 - 28,500.00 -
- 8,500.00 - 8,500.00 - 8,500.00 -
- 15,000.00 - 15,000.00 - 15,000.00 -
339,900 50 1,100.00 55,000 100 1,100.00 110,000 100 1,100.00 110,000 50
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 16,000.00 - 16,000.00 - 16,000.00 -
- 220.00 - 220.00 - 220.00 -
- 9,500.00 - 9,500.00 - 9,500.00 -
- 8,650.00 - 8,650.00 - 8,650.00 -
- 214,898.00 - 214,898.00 - 214,898.00 -
- 358,200.00 - 358,200.00 - 358,200.00 -
- 1,199,900.00 - 1,199,900.00 - 1,199,900.00 -
- 288,100.00 - 288,100.00 - 288,100.00 -
- 159,898.00 - 159,898.00 - 159,898.00 -
- - - -
- 330.00 - 330.00 - 330.00 -
- 350.00 - 350.00 - 350.00 -
- - - -
- - - -
- - - -
- 129.00 - 129.00 - 129.00 -
- 1.00 - 1.00 - 1.00 -
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 5,519.00 - 5,519.00 - 5,519.00 -
31,197 1 10,399.00 10,399 10,399.00 - 10,399.00 - 1
- 16,000.00 - 16,000.00 - 16,000.00 -
67,060 6 4,790.00 28,740 4,790.00 - 4 4,790.00 19,160 2
- 1,650.00 - 1,650.00 - 1,650.00 -
1,633,800 4,668.00 - 200 4,668.00 933,600 150 4,668.00 700,200 50
940,500 30 1,650.00 49,500 200 1,650.00 330,000 230 1,650.00 379,500
- 4,250.00 - 4,250.00 - 4,250.00 -
- - - -
- 40,500.00 - 40,500.00 - 40,500.00 -
- 40,500.00 - 40,500.00 - 40,500.00 -
- 34,500.00 - 34,500.00 - 34,500.00 -
- 34,500.00 - 34,500.00 - 34,500.00 -
- 8,415.00 - 8,415.00 - 8,415.00 -
- 2 17,600.00 35,200 17,600.00 - 17,600.00 - 2
- 4,000.00 - 4,000.00 - 4,000.00 -
- 5,280.00 - 5,280.00 - 5,280.00 -
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 3,982.00 - 3,982.00 - 3,982.00 -
18,480 8 9,240.00 73,920 9,240.00 - 1 9,240.00 9,240 7
- - - -
- 6,600.00 - 6,600.00 - 6,600.00 -
- 441.00 - 441.00 - 441.00 -
- - - -
- 1,950.00 - 1,950.00 - 1,950.00 -
- 1,950.00 - 1,950.00 - 1,950.00 -
- 1,950.00 - 1,950.00 - 1,950.00 -
- 265.00 - 265.00 - 265.00 -
- 321,600.00 - 321,600.00 - 321,600.00 -
- 1,172,600.00 - 1,172,600.00 - 1,172,600.00 -
- 1,172,600.00 - 1,172,600.00 - 1,172,600.00 -
- 26,667.00 - 26,667.00 - 26,667.00 -
- 268,550.00 - 268,550.00 - 268,550.00 -
- 386,100.00 - 386,100.00 - 386,100.00 -
- 30,140.00 - 30,140.00 - 30,140.00 -
- 10,000.00 - 10,000.00 - 10,000.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 14,575.00 - 14,575.00 - 14,575.00 -
- 5,720.00 - 5,720.00 - 5,720.00 -
- 125,000.00 - 125,000.00 - 125,000.00 -
- 240.00 - 240.00 - 240.00 -
- 440.00 - 440.00 - 440.00 -
- 1.00 - 1.00 - 1.00 -
- 407.00 - 407.00 - 407.00 -
- 9,790.00 - 9,790.00 - 9,790.00 -
- 13,200.00 - 13,200.00 - 13,200.00 -
- 13,200.00 - 13,200.00 - 13,200.00 -
- 608.00 - 608.00 - 608.00 -
- 2,542.00 - 2,542.00 - 2,542.00 -
- 110,000.00 - 110,000.00 - 110,000.00 -
- 958.00 - 958.00 - 958.00 -
- 10,588.00 - 10,588.00 - 10,588.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 194.00 - 194.00 - 194.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 1,925.00 - 1,925.00 - 1,925.00 -
- 5,400.00 - 5,400.00 - 5,400.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1,031,800.00 - 1,031,800.00 - 1,031,800.00 -
- 1,865.00 - 1,865.00 - 1,865.00 -
- 44.87 - 44.87 - 44.87 -
- 10.00 - 10.00 - 10.00 -
- 5,227.00 - 5,227.00 - 5,227.00 -
- 8,100.00 - 8,100.00 - 8,100.00 -
- 1,320,000.00 - 1,320,000.00 - 1,320,000.00 -
- 6,098.00 - 6,098.00 - 6,098.00 -
- 605.00 - 605.00 - 605.00 -
- 772.00 - 772.00 - 772.00 -
- 9,370.00 - 9,370.00 - 9,370.00 -
- 550.00 - 550.00 - 550.00 -
- 1,400.00 - 1,400.00 - 1,400.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 1,300.00 - 1,300.00 - 1,300.00 -
- 11,000.00 - 11,000.00 - 11,000.00 -
- 10,825.00 - 10,825.00 - 10,825.00 -
- 14,825.00 - 14,825.00 - 14,825.00 -
- 8,250.00 - 8,250.00 - 8,250.00 -
- 14,419.90 - 14,419.90 - 14,419.90 -
- 2,700.00 - 2,700.00 - 2,700.00 -
- 9,070.00 - 9,070.00 - 9,070.00 -
- 8,000.00 - 8,000.00 - 8,000.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1,091.00 - 1,091.00 - 1,091.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
125 15 1.00 15 45 1.00 45 40 1.00 40 20
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -

1.00 1.00 1.00
- - - -
180,500.00 180,500.00 180,500.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
1.00 1.00 1.00

- - - -
1,948.00 1,948.00 1,948.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
3,782.00 3,782.00 3,782.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
1.00 1.00 1.00
- - - -
2 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 116.85 - 116.85 - 116.85 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1.00 - 1.00 - 1.00 -
- 1,430.00 - 1,430.00 - 1,430.00 -
- 5,055.00 - 5,055.00 - 5,055.00 -
- 388.18 - 388.18 - 388.18 -
- 1.00 - 1.00 - 1.00 -

STOK2014)
13 15 16 17 18 19 20 21 22 23 24 25 26 27 28
- 1.00 - 1.00 - 1.00 -
9,290,541 2,579,997 2,964,070 3,189,740

STOK AKHIR (Stok Opname 26 Maret 2014)
Harga Total Ket.
29 30 31
2,152.00 -
340.00 -
400,000.00 -
1,092.00 -
540.00 -
743.00 1,486
366.00 -
460.00 -
104.00 -
2,475.00 -
85.93 -
3,240.00 -
87.15 -
102.00 -
220.00 -
2,277.00 -
77.94 -
Harga Total Ket.
29 30 31
2,000.00 -
5,300.00 -
1,800.00 -
1,904.00 -
19.00 -
100.00 -
100.00 -
162.00 -
116.00 -
1,230.00 -
2,491.00 -
44.00 -
924.00 -
1,525.00 -
63.00 -
88.00 -
Harga Total Ket.
29 30 31
243.00 -
2,750.00 -
2,750.00 -
5,248.00 -
521.00 -
6,860.00 -
225.00 -
111.00 -
245.00 -
1,500.00 -
70.00 -
92.00 -
1,378.85 -
475,000.00 -
2,344.00 -
27.00 -
960.00 -
Harga Total Ket.
29 30 31
91.00 -
176.00 -
220.00 -
35.00 -
1,500.00 -
103.00 -
7,220.00 -
864.25 -
2,212.16 -
30,000.00 -
137,500.00 137,500
55,660.00 -
1,716.00 -
66.00 -
1,008.00 -
1,566.00 -
579.00 -
Harga Total Ket.
29 30 31
84.85 -
292.00 -
2,904.00 -
900.00 -
54.00 -
38.00 -
5,727.00 -
898.00 -
5,313.00 -
194.00 -
52.52 -
60.47 -
88.23 -
49.00 -
Harga Total Ket.
29 30 31
2,399.00 -
92.57 -
146.00 -
3,850.00 -
3,850.00 11,550
44.00 -
92.00 -
556.00 8,340
242,000.00 -
57.00 -
15,100.00 15,100
123,750.00 -
607.00 -
1,870.00 18,700
13,750.00 -
3,050.00 -
Harga Total Ket.
29 30 31
715.00 2,145
4,750.00 -
267.00 -
15.00 -
213.00 -
1,450.00 -
2,500.00 -
1,599.00 -
21.00 -
133.00 -
45.00 -
2,035.00 -
140.00 -
Harga Total Ket.
29 30 31
900.00 18,000
1,295.00 14,245
35,000.00 -
22,727.00 -
105.00 -
3,876.00 -
110.00 -
295.83 -
89.00 -
163.74 -
122.80 -
3,000.00 -
219,890.00 -
9.00 -
-
Harga Total Ket.
29 30 31
210.00 -
4,900.00 4,900
112.00 -
407.00 -
83,000.00 -
100,000.00 -
1,529.00 -
1,600.00 -
5,230.00 -
1,318.90 -
83.93 -
311.00 -
69.54 -
Harga Total Ket.
29 30 31
91.96 -
6,873.00 6,873
52.00 -
23.00 -
264.00 -
108.00 -
1,928.00 -
110.00 -
103.00 -
431.54 -
242.00 -
5,200.00 20,800
1,781.00 -
-
Harga Total Ket.
29 30 31
82.00 -
125,000.00 -
471,719.00 471,719
126,310.00 884,170
916.00 -
7,810.00 -
660,000.00 -
180.00 -
3,226.00 -
6,862.00 -
140.00 -
206.00 -
431.00 -
Harga Total Ket.
29 30 31
38.00 -
690.00 -
188.93 -
40.00 -
67,200.00 -
30.00 -
14,000.00 -
2,000.00 2,000
455.00 -
1.00 -
1.00 -
1.00 -
10,321.00 -
-
Harga Total Ket.
29 30 31
12,955.00 -
1.00 -
2,220.00 -
2,220.00 -
2,220.00 -
2,220.00 -
1,100,500.00 -
13,750.00 -
279,000.00 -
260,000.00 -
16,500.00 165,000
58,520.00 58,520
540.00 -
81.00 -
-
Harga Total Ket.
29 30 31
7,207.00 -
1,950.00 -
235,000.00 -
17,600.00 -
525,000.00 -
105,000.00 105,000
6,000.00 -
6,000.00 -
6,000.00 -
6,000.00 -
30,200.00 -
28,500.00 -
8,500.00 -
15,000.00 -
1,100.00 55,000
-
Harga Total Ket.
29 30 31
16,000.00 -
220.00 -
9,500.00 -
8,650.00 -
214,898.00 -
358,200.00 -
1,199,900.00 -
288,100.00 -
159,898.00 -
330.00 -
350.00 -
129.00 -
1.00 -
-
Harga Total Ket.
29 30 31
5,519.00 -
10,399.00 10,399
16,000.00 -
4,790.00 9,580
1,650.00 -
4,668.00 233,400
1,650.00 -
4,250.00 -
40,500.00 -
40,500.00 -
34,500.00 -
34,500.00 -
8,415.00 -
17,600.00 35,200
4,000.00 -
5,280.00 -
-
Harga Total Ket.
29 30 31
3,982.00 -
9,240.00 64,680
6,600.00 -
441.00 -
1,950.00 -
1,950.00 -
1,950.00 -
265.00 -
321,600.00 -
1,172,600.00 -
1,172,600.00 -
26,667.00 -
268,550.00 -
386,100.00 -
30,140.00 -
10,000.00 -
Harga Total Ket.
29 30 31
14,575.00 -
5,720.00 -
125,000.00 -
240.00 -
440.00 -
1.00 -
407.00 -
9,790.00 -
13,200.00 -
13,200.00 -
608.00 -
2,542.00 -
110,000.00 -
958.00 -
10,588.00 -
1.00 -
1.00 -
194.00 -
Harga Total Ket.
29 30 31
1,925.00 -
5,400.00 -
1.00 -
1.00 -
1.00 -
1,031,800.00 -
1,865.00 -
44.87 -
10.00 -
5,227.00 -
8,100.00 -
1,320,000.00 -
6,098.00 -
605.00 -
772.00 -
9,370.00 -
550.00 -
1,400.00 -
Harga Total Ket.
29 30 31
1,300.00 -
11,000.00 -
10,825.00 -
14,825.00 -
8,250.00 -
14,419.90 -
2,700.00 -
9,070.00 -
8,000.00 -
1.00 -
1.00 -
1,091.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
Harga Total Ket.
29 30 31
1.00 -
1.00 -
1.00 20
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00
-
180,500.00
-
1.00
-
1.00
-
Harga Total Ket.
29 30 31
1.00
-
1,948.00
-
1.00
-
1.00
-
3,782.00
-
1.00
-
1.00
-
1.00
-
1.00
-
1.00
-
1.00
-
1.00
-
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
Harga Total Ket.
29 30 31
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
1.00 -
116.85 -
1.00 -
1.00 -
1.00 -
1.00 -
1,430.00 -
5,055.00 -
388.18 -
1.00 -
Harga Total Ket.
29 30 31
1.00 -
2,354,327
Penatahan, 12 April 2014

Petugas Sub Unit UGD
Ni Wayan Kusumawat
NIP: 196403071984102010
NERACA PUSTU .....................
No. Nama Obat Satuan Jumlah Harga Total Jumlah Harga Total Ket. Jumlah Harga Total Ket.
1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 Acyclovir Salep Tube 2,152.00 - 2,152.00 - 2,152.00 -
2 Acyclovir 400 mg Tab Tablet 340.00 - 340.00 - 340.00 -
3 Air raksa dental use Botol 400,000.00 - 400,000.00 - 400,000.00 -
4 Alat suntik sekali pakai 1 ml Pcs 1,092.00 - 1,092.00 - 1,092.00 -
5 Alat suntik sekali pakai 2,5 ml Pcs 540.00 - 540.00 - 540.00 -
6 Alat suntik sekali pakai 5 ml Pcs 743.00 - 743.00 - 743.00 -
7 Albendazol 400 mg tab Tablet 366.00 - 366.00 - 366.00 -
8 Alprazolam 0.5 mg Tablet 460.00 - 460.00 - 460.00 -
9 Alupurinol 100 mg tab / Selespurin/ Proxuric Tablet 104.00 - 104.00 - 104.00 -
10 Ambroxol syr Botol 2,475.00 - 2,475.00 - 2,475.00 -
11 Ambroxol tab 30 mg / Promukus Tablet 85.93 - 85.93 - 85.93 -
12 Aminofilina injeksi 24 mg/ ml. 10 ml Ampul 3,240.00 - 3,240.00 - 3,240.00 -
13 Aminofilna tablet 200 mg Tablet 87.15 - 87.15 - 87.15 -
14 Amitriptilina hcl tablet salut 25 mg Tablet 102.00 - 102.00 - 102.00 -
15 Amoksilina kapsul 500 mg Tablet 220.00 - 220.00 - 220.00 -
16 Amoksilna sirup kering 125 mg/ 5 mg Botol 2,277.00 - 2,277.00 - 2,277.00 -
17 Antasida doen tablet kombinasi Tablet 77.94 - 77.94 - 77.94 -
18 Anti hemmoroid suppositoria Supp 2,000.00 - 2,000.00 - 2,000.00 -
19 Aqua pro injeksi streril. Bebas priogen 20 ml Vial 5,300.00 - 5,300.00 - 5,300.00 -
20 Aquadest steril 500 ml Botol - - -
21 As salisilat 2% + belerang endap 4%(2-4 salep Pot 1,800.00 - 1,800.00 - 1,800.00 -
22 As. Benzoat 3 % + as salisilat 6%(whitefield) Pot 1,904.00 - 1,904.00 - 1,904.00 -
23 Asam askorbat (Vit. C) tablet 250 mg Tablet - - -
24 Asam askorbat (Vit. C) tablet 50 mg Tablet 19.00 - 19.00 - 19.00 -
25 Asam mefenamat 500 mg Tablet 100.00 - 100.00 - 100.00 -
26 Asetosal 100 mg Tablet 100.00 - 100.00 - 100.00 -
27 Asetosal tablet 500 mg Tablet 162.00 - 162.00 - 162.00 -
28 Antalgin (metampiron) tablet 500 mg Tablet 116.00 - 116.00 - 116.00 -
29 Atropina sulfat injeksi 0 .25 mg / ml - 1 ml Ampul 1,230.00 - 1,230.00 - 1,230.00 -
30 Basitrasin Polimiksin Tube 2,491.00 - 2,491.00 - 2,491.00 -
31 Besi (ii) sulfat tablet salut .kombinasi Tablet 44.00 - 44.00 - 44.00 -
32 Betahistin tab Tablet 924.00 - 924.00 - 924.00 -
33 Betametazon salep kulit Tube 1,525.00 - 1,525.00 - 1,525.00 -
34 Captopril 12.5 mg tablet Tablet 63.00 - 63.00 - 63.00 -
35 Captopril 25 mg tablet Tablet 88.00 - 88.00 - 88.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
36Carbamazepina 200 mg talet Tablet 243.00 - 243.00 - 243.00 -
37Catgut / benang bedah no 2/0 chromic Sachet 2,750.00 - 2,750.00 - 2,750.00 -
38Catgut / benang bedah no 3/0 plain Sachet 2,750.00 - 2,750.00 - 2,750.00 -
39Cefadroxil 125mg/5ml Sirup Botol 5,248.00 - 5,248.00 - 5,248.00 -
40Cefadroxill 500 mg tablet Tablet 521.00 - 521.00 - 521.00 -
41Cefotaxim 1 gr Injeksi Ampul 6,860.00 - 6,860.00 - 6,860.00 -
42Cetirizin10 mg tab Tablet 225.00 - 225.00 - 225.00 -
43Cimetidine/Selestidin Tablet 111.00 - 111.00 - 111.00 -
44Ciprofloxazin tablet 500 mg Tablet 245.00 - 245.00 - 245.00 -
45Deksametason injeksi 5 mg / ml - 1 ml Ampul 1,500.00 - 1,500.00 - 1,500.00 -
46Deksametason tablet 0.5 mg Tablet 70.00 - 70.00 - 70.00 -
47Dekstrometofan HBR tablet 15 mg Tablet 92.00 - 92.00 - 92.00 -
48Dekstrometopan HBR sirup 10 mg / ml Botol 1,378.85 - 1,378.85 - 1,378.85 -
49Devitalisasi pasta Tube 475,000.00 - 475,000.00 - 475,000.00 -
50Diazepam 5 mg Tablet - - -
51Diazepam injeksi 5 mg / ml - 2 ml Ampul 2,344.00 - 2,344.00 - 2,344.00 -
52Diazepam tablet 2 mg Tablet 27.00 - 27.00 - 27.00 -
53Difenhidramin HCL injeksi 10 mg / ml - ml Ampul 960.00 - 960.00 - 960.00 -
54Digoksina tablet 0. 25 mg Tablet 91.00 - 91.00 - 91.00 -
55Domperidon tablet 10 mg Tablet 176.00 - 176.00 - 176.00 -
56Doxycicline 100 mg tab Tablet 220.00 - 220.00 - 220.00 -
57Efedrina HCL (efedrina) tablet 25 mg Tablet 35.00 - 35.00 - 35.00 -
Epinefrina HCL / bitartat (aderenalina) inj
58 01% Ampul 1,500.00 - 1,500.00 - 1,500.00 -
Ergotamina tartrat 1 mg + kofeina 50 mg tab
59 Tablet 103.00 - 103.00 - 103.00 -
60 Erytromysin 200mg/5ml Syrup Botol 7,220.00 - 7,220.00 - 7,220.00 -
61 Erytromysin tablet 500 mg Tablet 864.25 - 864.25 - 864.25 -
62 Etakridina (rivanol) larutan 0.1 % Botol 2,212.16 - 2,212.16 - 2,212.16 -
63 Etanol 70 % Botol 30,000.00 - 30,000.00 - 30,000.00 -
64 Etil klorida semprot Botol 137,500.00 - 137,500.00 - 137,500.00 -
65 Eugenol cairan Botol 55,660.00 - 55,660.00 - 55,660.00 -
66 Fenobarbital inj 50 mg /ml -2ml Ampul 1,716.00 - 1,716.00 - 1,716.00 -
67 Fenobarbital tablet 100mg Tablet - - -
68 Fenobarbital tablet 30 mg Tablet 66.00 - 66.00 - 66.00 -
69 Fenol gliserol tetes telnga 10% Botol 1,008.00 - 1,008.00 - 1,008.00 -
70 Fitomenadion (vit. K1) inj 10 / ml 1 ml Ampul 1,566.00 - 1,566.00 - 1,566.00 -
71 Fitomenadion (vit. K1) tablet salut 10 mg Tablet 579.00 - 579.00 - 579.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
72 Furosemida tablet 40 mg Tablet 84.85 - 84.85 - 84.85 -
73 Gameksan emulisi 1 % Botol - - -
74 Garam Oralit untuk 100 ml. Air Sachet - - -
75 Garam Oralit untuk 200 ml air Sachet 292.00 - 292.00 - 292.00 -
76 Gentamisin Salep Mata Tube - - -
77 Gentamysin SK Tube - - -
78 Gentamysin TM/Genoint TM Botol 2,904.00 - 2,904.00 - 2,904.00 -
79 Gentian violet larutan 1 % Botol 900.00 - 900.00 - 900.00 -
80 Glibenklamida tablet 5 mg Tablet 54.00 - 54.00 - 54.00 -
81 Gliseril guayakolat tablet 10 mg Tablet 38.00 - 38.00 - 38.00 -
82 Glukosa larutan infus 10 % steril Botol 5,727.00 - 5,727.00 - 5,727.00 -
83 Glukosa larutan infus 40 % steril Botol 898.00 - 898.00 - 898.00 -
84 Glukosa larutan infus 5 % steril Botol 5,313.00 - 5,313.00 - 5,313.00 -
85 Griseofulvin tablet 125 mg. Mikronized Tablet 194.00 - 194.00 - 194.00 -
86 Haloperidol 0,5 mg. Tablet Tablet 52.52 - 52.52 - 52.52 -
87 Haloperidol 1,5 mg tablet Tablet 60.47 - 60.47 - 60.47 -
88 Haloperidol 5 mg tablet Tablet 88.23 - 88.23 - 88.23 -
89 Hidroklorotiasida (HCT) tablet 25 mg Tablet 49.00 - 49.00 - 49.00 -
90 Hidrokortison krim 2.5 % Tube 2,399.00 - 2,399.00 - 2,399.00 -
91 Ibuprofen tablet 200 mg Tablet 92.57 - 92.57 - 92.57 -
92 Ibuprofen tablet 400 mg Tablet 146.00 - 146.00 - 146.00 -
93 Infusion set anak Set 3,850.00 - 3,850.00 - 3,850.00 -
94 Infusion set dewasa Set 3,850.00 - 3,850.00 - 3,850.00 -
95 Isoniazide 100 mg Tablet 44.00 - 44.00 - 44.00 -
96 Isoniazide 300 mg Tablet - - -
97 Isosorbid dinitrat Tablet 92.00 - 92.00 - 92.00 -
98 Jarum injeksi Pcs 556.00 - 556.00 - 556.00 -
99 Jarum jahit (bedah) no. 9 s/d 14 Set - - -
100 Kalsium hidroksida pasta Pot 242,000.00 - 242,000.00 - 242,000.00 -
101 Kalsium laktat (kalk) tablet 500 mg Tablet 57.00 - 57.00 - 57.00 -
102 Kapas pembalut / absorben 250 gram Roll 15,100.00 - 15,100.00 - 15,100.00 -
103 Kasa gulung 40 x 80 Roll 123,750.00 - 123,750.00 - 123,750.00 -
104 Kasa Hidrofil 4 x 10 Roll 607.00 - 607.00 - 607.00 -
105 Kasa kompres 40 / 40 steril Roll 1,870.00 - 1,870.00 - 1,870.00 -
106 Kasa pembalut 2 x 80 Roll 13,750.00 - 13,750.00 - 13,750.00 -
107 Kasa pembalut hidrofil 4 m x 15 cm Roll 3,050.00 - 3,050.00 - 3,050.00 -
108 Kasa pembalut hidrofin 4m x 3 cm Roll 715.00 - 715.00 - 715.00 -
109 Kasa Steril ( 18 x 22 ) Kotak 4,750.00 - 4,750.00 - 4,750.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
110 Ketokonazole 200 mg tablet Tablet 267.00 - 267.00 - 267.00 -
Kinina dihidroklorida (kinina) inj 25 % - 2 ml
111 Ampul - - -
112 Kinina sulfat tablet 222 mg (7 h20 ) Tablet 15.00 - 15.00 - 15.00 -
113 Kloramfenicol salep kulit Tube - - -
114 Kloramfenikol kapsul 250 mg Tablet 213.00 - 213.00 - 213.00 -
115 Kloramfenikol salep mata 1 % Tube 1,450.00 - 1,450.00 - 1,450.00 -
116 Kloramfenikol tetes Mata Botol 2,500.00 - 2,500.00 - 2,500.00 -
117 Kloramfenikol tetes telinga 3 % Botol 1,599.00 - 1,599.00 - 1,599.00 -
118 Klorfeniramina maleat (CTM) tablet 4 mg Tablet 21.00 - 21.00 - 21.00 -
119 Klorpromazin 100 mg tablet Tablet 133.00 - 133.00 - 133.00 -
120 Klorpromazina Hcl inj 25 mg / ml - 1 ml Ampul - - -
121 Klorpromazina Hcl inj 5 mg / ml - 2 ml Ampul - - -
122 Klorpromazina hcl tablet salut 25 mg Tablet 45.00 - 45.00 - 45.00 -
123 Kodeina Hcl (kodeina) tablet 10 mg Tablet - - -
124 Kotrimoksasol suspensi Botol 2,035.00 - 2,035.00 - 2,035.00 -
125 Kotrimoksasol tablet kombinasi Tablet 140.00 - 140.00 - 140.00 -
126 Kotrimoksasol tablet pediatrik. Kombinasi Tablet - - -
127 Lidokain inj Ampul 900.00 - 900.00 - 900.00 -
128 Lidokaina comp inj kombinasi Ampul 1,295.00 - 1,295.00 - 1,295.00 -
129 Lisol mengandung kresol Botol 35,000.00 - 35,000.00 - 35,000.00 -
130 Magnesium sulfat serbuk 30 grm Sachet - - -
Metakresol sulfonat dan metanol kondensai
131 (Albotyl) Botol 22,727.00 - 22,727.00 - 22,727.00 -
132 Metformin 500 mg tablet Tablet 105.00 - 105.00 - 105.00 -
Metilergometrina maleat inj 0. 200 g / ml- ml
133 Ampul 3,876.00 - 3,876.00 - 3,876.00 -
Metilergometrina malet tablet salut 0. 125 mg
134 Tablet 110.00 - 110.00 - 110.00 -
135 Metilprednisolon tablet 4 mg Tablet 295.83 - 295.83 - 295.83 -
136 Metoklopramide 10 mg tablet/Noristal Tablet 89.00 - 89.00 - 89.00 -
137 Metronidazol 500 mg Tablet 163.74 - 163.74 - 163.74 -
138 Metronidazol tablet 250 mg Tablet 122.80 - 122.80 - 122.80 -
139 Mikonazole salep Tube 3,000.00 - 3,000.00 - 3,000.00 -
140 Monoklorkamfer mentolcairan (CHKM) Botol - - -
141 Mumifyng pasta Botol 219,890.00 - 219,890.00 - 219,890.00 -
142 Natrium bikarbonat tablet 500 mg Tablet 9.00 - 9.00 - 9.00 -
143 Natrium Diklofenak 25 Tablet - - -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
144 Natrium Diklofenak 50 (Nadifen/Prostanac) Tablet 210.00 - 210.00 - 210.00 -
145 Natrium klorida larutan infus 0. 9 steril Botol 4,900.00 - 4,900.00 - 4,900.00 -
146 Nifedipin tablet 10 mg Tablet 112.00 - 112.00 - 112.00 -
147 Nistatin 100. 000 iu/g tablet vaginal Tab Vag 407.00 - 407.00 - 407.00 -
148 Obat batuk hitam (OBH) cairan Botol 100 ml - - -
149 Ofloxacin tab 400mg Tablet - - -
150 Oksigen gas dalam tabung 3 m3 Tabung 83,000.00 - 83,000.00 - 83,000.00 -
151 Oksigen gas dalam tabung 6 m3 Tabung 100,000.00 - 100,000.00 - 100,000.00 -
152 Oksitetrasiklina hcl salep 3 % Tube 1,529.00 - 1,529.00 - 1,529.00 -
153 Oksitetrasiklina hcl salep mata 1 % Tube 1,600.00 - 1,600.00 - 1,600.00 -
154 Oksitosina inj 10 iu/ml - 1 ml Ampul 5,230.00 - 5,230.00 - 5,230.00 -
155 Papaverin Injeksi Ampul - - -
156 Papaverin Tablet Tablet - - -
157 Parasetamol sirup 120 mg / 5 ml Botol 1,318.90 - 1,318.90 - 1,318.90 -
158 Parasetamol tab 100 mg Tablet - - -
159 Parasetamol tablet 500mg Tablet 83.93 - 83.93 - 83.93 -
Pirantel pamoat (pirantel) tablet 125 mg basa
160 Tablet 311.00 - 311.00 - 311.00 -
161 Piroxicam 10 Mg Tablet 69.54 - 69.54 - 69.54 -
162 Piroxicam 20 Mg Tablet 91.96 - 91.96 - 91.96 -
163 Plester 5 yard x 2 inch Roll 6,873.00 - 6,873.00 - 6,873.00 -
164 Prednison tablet 5 mgn Tablet 52.00 - 52.00 - 52.00 -
165 Pridoksina hcl (vit. B 6) tablet 10 mg Tablet 23.00 - 23.00 - 23.00 -
166 Primakina tablet 15 mg Tablet - - -
167 Prokaina penisilina g inj 3 juta iu Vial - - -
168 Propiltionurasil tablet 100 mg Tablet 264.00 - 264.00 - 264.00 -
169 Propranolol hcl (Propranolol) tablet 40 mg Tablet 108.00 - 108.00 - 108.00 -
170 Pyridoxin injeksi Ampul - - -
171 Ranitidin inj 25 mg/2 ml Ampul 1,928.00 - 1,928.00 - 1,928.00 -
172 Ranitidin tablet 150 mg Tablet 110.00 - 110.00 - 110.00 -
173 Reserpina tablet 0, 10 mg Tablet - - -
174 Reserpina tablet 0, 25 mg Tablet 103.00 - 103.00 - 103.00 -
175 Retinol (vit. A) kapsul lunak 200.000 iu Tablet 431.54 - 431.54 - 431.54 -
176 Retinol (vit. A) tablet salut 100. 000 iu Tablet 242.00 - 242.00 - 242.00 -
177 Ringer laktat larutan infus steril Botol 5,200.00 - 5,200.00 - 5,200.00 -
178 Risperidon Tablet 1,781.00 - 1,781.00 - 1,781.00 -
179 Salbutamol tablet 2 mg Tablet - - -
180 Salbutamol tablet 4 mg Tablet 82.00 - 82.00 - 82.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
181 Salisil bedak 2 % Bks - - -
182 Salisil spiritus 10 % Botol - - -
183 Semen seng fosfat serbuk dan cairan Botol 125,000.00 - 125,000.00 - 125,000.00 -
184 Serum anti bisa ular polivalen inj. 50 ml Vial - - -
185 Serum anti bisa ular polivalen inj. 5ml Ampul 471,719.00 - 471,719.00 - 471,719.00 -
186 Serum anti tetanus inj. 1.500 iu Ampul 126,310.00 - 126,310.00 - 126,310.00 -
187 Serum anti tetanus inj. 20.000 iu Ampul - - -
188 Sianokobalamina (vit.b12) inj. 500 mcg Ampul 916.00 - 916.00 - 916.00 -
189 Silk (benang bedah sutera) no.3/0 Pcs 7,810.00 - 7,810.00 - 7,810.00 -
190 Silver amalgam serbuk 65-75% Botol 660,000.00 - 660,000.00 - 660,000.00 -
191 Simvastatin tab 10 mg Tablet 180.00 - 180.00 - 180.00 -
192 Sulfacetamide tetes mata Botol 3,226.00 - 3,226.00 - 3,226.00 -
Synthetic filing material larutan dan serbuk
193 Set - - -
Temporary stopping fletcher serbuk dan
194 cairan Set 6,862.00 - 6,862.00 - 6,862.00 -
195 Tablet 140.00 - 140.00 - 140.00 -
196 Tablet 206.00 - 206.00 - 206.00 -
197 Thiamfenikol 500 Tablet 431.00 - 431.00 - 431.00 -
198 Tiamin hcl /mononitrat (vit.b1) tablet 50 mg Tablet 38.00 - 38.00 - 38.00 -
199 Tiamina hcl (vit.b1) inj. 100 mg/ml Ampul 690.00 - 690.00 - 690.00 -
200 Tramadol Tablet 188.93 - 188.93 - 188.93 -
201 Trifluoperazine (Stelazin) Tablet - - -
202 Triheksfenidil hcl 2 mg tablet Tablet 40.00 - 40.00 - 40.00 -
203 Trikresol formalin (tkf) cairan Botol 67,200.00 - 67,200.00 - 67,200.00 -
204 Vitamin B kompleks tablet Tablet 30.00 - 30.00 - 30.00 -
205 Yodium povidan larutan 10% 300 ml Botol 14,000.00 - 14,000.00 - 14,000.00 -
206 Yodium povidon larutan 10% 30 ml Botol 2,000.00 - 2,000.00 - 2,000.00 -
207 Zink tablet Tablet 455.00 - 455.00 - 455.00 -
- - -
Obat Tambahan - - -
208 Adimidon injk / Xylomidon injk Vial - - -
209 ADS 0.5 ml Pcs 1.00 - 1.00 - 1.00 -
210 ADS 0.05 ml Pcs 1.00 - 1.00 - 1.00 -
211 ADS 5 ml Pcs 1.00 - 1.00 - 1.00 -
212 Aleterol TM Botol 10,321.00 - 10,321.00 - 10,321.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
213 Antalgin injeksi Ampul - - -
214 Arsuamon tablet Tablet - - -
215 Artesunat inj Vial 12,955.00 - 12,955.00 - 12,955.00 -
216 Azitromisin+cefixim Tablet 1.00 - 1.00 - 1.00 -
217 Bisturi no 13 Pcs 2,220.00 - 2,220.00 - 2,220.00 -
218 Bisturi no 14 Pcs 2,220.00 - 2,220.00 - 2,220.00 -
219 Bisturi no 19/20 Pcs 2,220.00 - 2,220.00 - 2,220.00 -
220 Bisturi no 21 Pcs 2,220.00 - 2,220.00 - 2,220.00 -
221 Bonding Set 1,100,500.00 - 1,100,500.00 - 1,100,500.00 -
222 Bufacomb salep Tube 13,750.00 - 13,750.00 - 13,750.00 -
223 Buscopan inj Ampul - - -
224 Clopramel inj Ampul - - -
225 Composite (tumpatan sinar)A3 Set 279,000.00 - 279,000.00 - 279,000.00 -
226 Composite (tumpatan sinar)A3.5 Set 260,000.00 - 260,000.00 - 260,000.00 -
227 Daryantulle Lembar 16,500.00 - 16,500.00 - 16,500.00 -
228 Dermazine/Burnazin Tube 58,520.00 - 58,520.00 - 58,520.00 -
229 Dextina / Dextamin/Dextamec/Polofar Plus Tablet 540.00 - 540.00 - 540.00 -
230 Diaform tablet/selesdiar Tablet 81.00 - 81.00 - 81.00 -
231 Dormi/Scopma Tablet - - -
232 Dulcolac anak supp Supp 7,207.00 - 7,207.00 - 7,207.00 -
233 Dulcolac dewasa supp Supp - - -
234 Dulkolak tablet Tablet 1,950.00 - 1,950.00 - 1,950.00 -
235 Ericaf Tablet - - -
236 ETSA Set 235,000.00 - 235,000.00 - 235,000.00 -
237 Folley catheter Pcs 17,600.00 - 17,600.00 - 17,600.00 -
238 Glass ionomer (Ketac Molar) Tube 525,000.00 - 525,000.00 - 525,000.00 -
239 Hypavix (Ultrafik) Roll 105,000.00 - 105,000.00 - 105,000.00 -
240 I.V Catheter 22 Pcs 6,000.00 - 6,000.00 - 6,000.00 -
241 I.V Catheter 24 Pcs 6,000.00 - 6,000.00 - 6,000.00 -
242 IV Catheter 18 Pcs 6,000.00 - 6,000.00 - 6,000.00 -
243 IV Catheter 20 Pcs 6,000.00 - 6,000.00 - 6,000.00 -
244 Jarum Otot dan Kulit Set 30,200.00 - 30,200.00 - 30,200.00 -
245 MY Jelly Tube 28,500.00 - 28,500.00 - 28,500.00 -
246 Klip Kecil Pak 8,500.00 - 8,500.00 - 8,500.00 -
247 Klip Tanggung Pak 15,000.00 - 15,000.00 - 15,000.00 -
248 Masker Pcs 1,100.00 - 1,100.00 - 1,100.00 -
249 Meylon inj Botol - - -
250 Microlax Supp 16,000.00 - 16,000.00 - 16,000.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
251 Multivitamin (Livron B plek) Tablet 220.00 - 220.00 - 220.00 -
252 Multivitamin sirup( Xanvit syr) Botol 9,500.00 - 9,500.00 - 9,500.00 -
253 Norit Botol 8,650.00 - 8,650.00 - 8,650.00 -
254 Obat anti tuberkulosis FDC anak Paket 214,898.00 - 214,898.00 - 214,898.00 -
255 Obat anti tuberkulosis FDC katagori I Paket 358,200.00 - 358,200.00 - 358,200.00 -
256 Obat anti tuberkulosis FDC katagori II Paket 1,199,900.00 - 1,199,900.00 - 1,199,900.00 -
257 Obat anti tuberkulosis kategori I Paket 288,100.00 - 288,100.00 - 288,100.00 -
258 Obat anti tuberkulosis FDC sisipan Paket 159,898.00 - 159,898.00 - 159,898.00 -
259 Obat Batuk Kombinasi Botol - - -
Obat Flu kombinasi CTM, PPA (Anaflu),
260
Demacolin Tablet 330.00 - 330.00 - 330.00 -
261 Obat Flu Kombinasi/Mecofed/Quantidex Tablet 350.00 - 350.00 - 350.00 -
262 Obat maag kombinasi/Indomag/Myloxan Tablet - - -
263 Obat maag suspensi (novamaag) Botol - - -
Obat sakit kepala komb (Parasetamol +
264
Kofein) Tablet - - -
265 Orpen Tablet 129.00 - 129.00 - 129.00 -
266 Oseltamivir Tablet 1.00 - 1.00 - 1.00 -
267 Pehacain Injeksi Ampul - - -
268 Pembalut Gips Roll 5,519.00 - 5,519.00 - 5,519.00 -
269 Perhidrol (H2O2) Botol 10,399.00 - 10,399.00 - 10,399.00 -
270 Perkamen Pak 16,000.00 - 16,000.00 - 16,000.00 -
271 Proris supp Supp 4,790.00 - 4,790.00 - 4,790.00 -
272 Sarung Tangan L Pasang 1,650.00 - 1,650.00 - 1,650.00 -
273 Sarung Tangan M Pasang 4,668.00 - 4,668.00 - 4,668.00 -
274 Sarung Tangan S Pasang 1,650.00 - 1,650.00 - 1,650.00 -
275 Sarung Tangan Steril Pasang 4,250.00 - 4,250.00 - 4,250.00 -
276 Seremig tablet Tablet - - -
277 Spalk tungkai atas anak Pcs 40,500.00 - 40,500.00 - 40,500.00 -
278 Spalk tungkai atas dewasa Pcs 40,500.00 - 40,500.00 - 40,500.00 -
279 Spalk tungkai bawah anak Pcs 34,500.00 - 34,500.00 - 34,500.00 -
280 Spalk tungkai bawah dewasa Pcs 34,500.00 - 34,500.00 - 34,500.00 -
281 Spashi inj Ampul 8,415.00 - 8,415.00 - 8,415.00 -
282 Stesolid rectal Supp 17,600.00 - 17,600.00 - 17,600.00 -
283 Strop indra Botol 4,000.00 - 4,000.00 - 4,000.00 -
284 Tranexid inj (Asam tranexamat inj) Ampul 5,280.00 - 5,280.00 - 5,280.00 -
285 Transamin tab Tablet - - -
286 Urinebag Set 3,982.00 - 3,982.00 - 3,982.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
287 Ventolin Nebulizer Ampul 9,240.00 - 9,240.00 - 9,240.00 -
288 Vitamin B12 tab Tablet - - -
289 Vitamin Neurotropik inj Ampul 6,600.00 - 6,600.00 - 6,600.00 -
Vitamin Neurotropik tablet (Nutrifar,
290
Sohobion) Tablet 441.00 - 441.00 - 441.00 -
291 Wing Needle 21 Pcs - - -
292 Wing Needle 23 Pcs 1,950.00 - 1,950.00 - 1,950.00 -
293 Wing Needle 25 Pcs 1,950.00 - 1,950.00 - 1,950.00 -
294 Wing Needle 27 Pcs 1,950.00 - 1,950.00 - 1,950.00 -
295 Omeprasole tablet 20 mg Tablet 265.00 - 265.00 - 265.00 -
296 Silk 3/0 roll Roll 321,600.00 - 321,600.00 - 321,600.00 -
297 Catgut 2/0 Chromic Roll Roll 1,172,600.00 - 1,172,600.00 - 1,172,600.00 -
298 Catgut 3/0 Chromic Roll Roll 1,172,600.00 - 1,172,600.00 - 1,172,600.00 -
299 Catgut 1/0 Chromic Pcs 26,667.00 - 26,667.00 - 26,667.00 -
300 Kertas EKG Roll 268,550.00 - 268,550.00 - 268,550.00 -
301 Kertas USG Roll 386,100.00 - 386,100.00 - 386,100.00 -
302 Jelly RO Tube 30,140.00 - 30,140.00 - 30,140.00 -
305 Primperan inj Ampul 10,000.00 - 10,000.00 - 10,000.00 -
306 Pantocain Tetes Mata Botol 14,575.00 - 14,575.00 - 14,575.00 -
308 Underpad Pak 5,720.00 - 5,720.00 - 5,720.00 -
309 Caviton Tube 125,000.00 - 125,000.00 - 125,000.00 -
310 Amlodipin 5 mg tab Tablet 240.00 - 240.00 - 240.00 -
311 Amlodipin 10 mg tab Tablet 440.00 - 440.00 - 440.00 -
312 ADS 2 ml Pcs 1.00 - 1.00 - 1.00 -
313 Roverton tablet Tablet 407.00 - 407.00 - 407.00 -
314 Roverton syr Botol 9,790.00 - 9,790.00 - 9,790.00 -
315 IV Catheter no 18 G Terumo Pcs 13,200.00 - 13,200.00 - 13,200.00 -
316 IV Catheter no 20 G Terumo Pcs 13,200.00 - 13,200.00 - 13,200.00 -
317 Ketoprofen tablet 100 mg Tablet 608.00 - 608.00 - 608.00 -
318 Ketoprofen inj 10 mg Ampul 2,542.00 - 2,542.00 - 2,542.00 -
319 Jarum Kulit Set 110,000.00 - 110,000.00 - 110,000.00 -
320 Cefixim tablet 100 mg Tablet 958.00 - 958.00 - 958.00 -
321 Cefixim syr 100 mg/5 ml Botol 10,588.00 - 10,588.00 - 10,588.00 -
322 Masker N95 Pcs 1.00 - 1.00 - 1.00 -
323 Masker Bedah Pcs 1.00 - 1.00 - 1.00 -
324 Piracetam 400 mg Tablet 194.00 - 194.00 - 194.00 -
325 Piracetam inj 200mg/1ml Ampul 1,925.00 - 1,925.00 - 1,925.00 -
326 Tramadol inj 50 mg/ml Ampul 5,400.00 - 5,400.00 - 5,400.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
327 Jarum Jahit Bedah no 12 Set 1.00 - 1.00 - 1.00 -
330 Film Rontgen 18 x 24 Set 1,031,800.00 - 1,031,800.00 - 1,031,800.00 -
331 Antasida syr Botol 1,865.00 - 1,865.00 - 1,865.00 -
332 Asam Folat 1 mg Tablet 44.87 - 44.87 - 44.87 -
333 Metil prednisolon inj 500 mg Vial 10.00 - 10.00 - 10.00 -
334 Parasetamol drop Botol 5,227.00 - 5,227.00 - 5,227.00 -
335 Ceftriaxon inj Vial 8,100.00 - 8,100.00 - 8,100.00 -
Cairan prosessing film rontgen(developer dan
336
fixer) set 1,320,000.00 - 1,320,000.00 - 1,320,000.00 -
337 Lytamin syr botol 6,098.00 - 6,098.00 - 6,098.00 -
338 Prenatin plus tablet tablet 605.00 - 605.00 - 605.00 -
339 Flumeco Tablet 772.00 - 772.00 - 772.00 -
340 Faktu Supp Supp 9,370.00 - 9,370.00 - 9,370.00 -
341 Stelosi tab 5 mg Tablet 550.00 - 550.00 - 550.00 -
342 Ondancetron 4 mg Tablet 1,400.00 - 1,400.00 - 1,400.00 -
343 Asam tranexamat 500 mg Tablet 1,300.00 - 1,300.00 - 1,300.00 -
344 D1/4 NS Botol 11,000.00 - 11,000.00 - 11,000.00 -
345 D1/2 NS botol 10,825.00 - 10,825.00 - 10,825.00 -
346 IV Cath dgn Katup pcs 14,825.00 - 14,825.00 - 14,825.00 -
347 Nasal cannula Oksigen pcs 8,250.00 - 8,250.00 - 8,250.00 -
348 Sarung Tangan Gynaecologi pasang 14,419.90 - 14,419.90 - 14,419.90 -
349 Klem Tali Pusar pcs 2,700.00 - 2,700.00 - 2,700.00 -
350 VitKa infan Ampul 9,070.00 - 9,070.00 - 9,070.00 -
351 OBH plus botol 8,000.00 - 8,000.00 - 8,000.00 -
352 Kantung Puyer Pak 1.00 - 1.00 - 1.00 -
353 Sarung Tangan Surgiglove Pasang 1.00 - 1.00 - 1.00 -
354 Spashi tab Tablet 1,091.00 - 1,091.00 - 1,091.00 -
355 Safety box Pcs 1.00 - 1.00 - 1.00 -
356 Pot Sputum Pcs 1.00 - 1.00 - 1.00 -
357 Box slide kotak 1.00 - 1.00 - 1.00 -
358 Lampu spiritus botol 1.00 - 1.00 - 1.00 -
359 Sarung Tangan Biotech M Pasang 1.00 - 1.00 - 1.00 -
360 Sarung Tangan Biotech S Pasang 1.00 - 1.00 - 1.00 -
361 Sarung Tangan Biotech L Pasang 1.00 - 1.00 - 1.00 -
362 Slide Prosted Pak 1.00 - 1.00 - 1.00 -
363 Spuit 2/3 ml Pcs 1.00 - 1.00 - 1.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
364 Kertas saring Lembar 1.00 - 1.00 - 1.00 -
365 Oil Emersi Botol 1.00 - 1.00 - 1.00 -
366 Reagen TBC Botol 1.00 - 1.00 - 1.00 -
367 Slide Non Prosted pak 1.00 - 1.00 - 1.00 -
368 Tisu Lensa Lembar 1.00 - 1.00 - 1.00 -
369 Sound timer buah 1.00 - 1.00 - 1.00 -
370 Primaquin Tablet 1.00 - 1.00 - 1.00 -
371 Arterakine Tablet 1.00 - 1.00 - 1.00 -
372 Depo Ampul 1.00 - 1.00 - 1.00 -
373 Pehatrim Forte (Kotrimoksasol tab forte 960 m Tablet 1.00 - 1.00 - 1.00 -
374 Fluconasol tab Tablet 1.00 - 1.00 - 1.00 -
375 Ampisilin Serbuk Injeksi i.m/i.v. 1000 mg/ml Ampul 1.00 - 1.00 - 1.00 -
Prokain Benzil Penicillin G Injeksi 3 jt IU/vial Vial 180,500.00 180,500.00 180,500.00
376 - - -
377 Dextran 70% Botol 1.00 - 1.00 - 1.00 -
378 Transfusi Set Pcs 1.00 - 1.00 - 1.00 -
379 Magnesium Sulfat 20% - 25 ml Botol 1.00 - 1.00 - 1.00 -
380 Magnesium Sulfat 40% - 25 ml Botol 1,948.00 - 1,948.00 - 1,948.00 -
381 Glukonas Calcicus 10%- 10ml Ampul 1.00 - 1.00 - 1.00 -
382 Ampisillin injeksi i.m/i.v 1000 mg/ml Ampul 1.00 - 1.00 - 1.00 -
383 Gentamisin Injeksi 80 mg/2ml Ampul 3,782.00 - 3,782.00 - 3,782.00 -
384 Metronidazole 500 mg Infus/100 ml Botol 1.00 - 1.00 - 1.00 -
385 Cutgut Chromic No.1 atraumatik (sachet) Sachet 1.00 - 1.00 - 1.00 -
Urine strip untuk pemeriksaan Protein dan
Pcs 1.00 1.00 1.00
386 Gula - - -
387 Rapid test untuk sifilis Pcs 1.00 - 1.00 - 1.00 -
Kontasepsi Injeksi Progesteron Depot (3
Ampul 1.00 1.00 1.00
388 bln.1ml) - - -
389 Kontasepsi Pil Kombinasi (micrdiol) Blister 1.00 - 1.00 - 1.00 -
390 Implan KB (isi 2) Set 1.00 - 1.00 - 1.00 -
391 Spuit 10 ml Pcs 1.00 - 1.00 - 1.00 -
392 Alkohol Swab Sachet 1.00 - 1.00 - 1.00 -
393 Giemsa Solution Botol 1.00 - 1.00 - 1.00 -
394 Determine 1/2 Set 1.00 - 1.00 - 1.00 -
395 SD bio HIV 1/2 3.0 Set 1.00 - 1.00 - 1.00 -
396 One Step Anti HIV 1 dan 2 intec Set 1.00 - 1.00 - 1.00 -
397 SD bio Syphilis 3.0 Set 1.00 - 1.00 - 1.00 -
1 2 3 4 5 6 7 8 9 10 11 12 13 14
398 SD bio Syphilis 1/2 3.0 Set 1.00 - 1.00 - 1.00 -
399 Benzatin Penisillin Vial 1.00 - 1.00 - 1.00 -
400 Rotator Pcs 1.00 - 1.00 - 1.00 -
401 RPR Test Kit (Plasmatec) Set 1.00 - 1.00 - 1.00 -
402 VDRL/RPR anti gen Set 1.00 - 1.00 - 1.00 -
403 Cefixim tablet 200 mg Tablet 1.00 - 1.00 - 1.00 -
404 Clarithromysin 500 mg Tablet 1.00 - 1.00 - 1.00 -
405 Pirimethamine tablet Tablet 1.00 - 1.00 - 1.00 -
406 Sulfadiazin tablet Tablet 116.85 - 116.85 - 116.85 -
407 Azytromisin tablet 500 mg Tablet 1.00 - 1.00 - 1.00 -
408 Clindamisin 300 mg Tablet 1.00 - 1.00 - 1.00 -
409 Clindamisin 150 mg Tablet 1.00 - 1.00 - 1.00 -
410 BD Vacuntainer Pcs 1.00 - 1.00 - 1.00 -
411 Metil Prednisolon 16 mg Tablet 1,430.00 - 1,430.00 - 1,430.00 -
412 Amox-clav Tablet 5,055.00 - 5,055.00 - 5,055.00 -
413 Acyclovir tablet 200 mg Tablet 388.18 - 388.18 - 388.18 -
414 HIV 1&2 Antibody Oncoprobe Reagen 3 Set 1.00 - 1.00 - 1.00 -
415 Vixia 1/2 Biomeriux 1.00 - 1.00 - 1.00 -
Jumlah - - -
Mengetahui
Kepala Puskesmas ...........................
Dinas Kesehatan Kabupaten Tabanan
STOK AKHIR (LPLPO Desember 2013)
STOK KELUAR
2014) (PEMAKAIAN 1 Jan 2014 s.d. 26 Maret 2014) STOK AKHIR (Stok Opname 26 Maret 2014)
Jumlah Harga Total Ket. Jumlah Harga Total Ket. Jumlah Harga Total Ket. Jumlah Harga Total
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
2,152.00 - 2,152.00 - 2,152.00 - 2,152.00 -
340.00 - 340.00 - 340.00 - 340.00 -
400,000.00 - 400,000.00 - 400,000.00 - 400,000.00 -
1,092.00 - 1,092.00 - 1,092.00 - 1,092.00 -
540.00 - 540.00 - 540.00 - 540.00 -
743.00 - 743.00 - 743.00 - 743.00 -
366.00 - 366.00 - 366.00 - 366.00 -
460.00 - 460.00 - 460.00 - 460.00 -
104.00 - 104.00 - 104.00 - 104.00 -
2,475.00 - 2,475.00 - 2,475.00 - 2,475.00 -
85.93 - 85.93 - 85.93 - 85.93 -
3,240.00 - 3,240.00 - 3,240.00 - 3,240.00 -
87.15 - 87.15 - 87.15 - 87.15 -
102.00 - 102.00 - 102.00 - 102.00 -
220.00 - 220.00 - 220.00 - 220.00 -
2,277.00 - 2,277.00 - 2,277.00 - 2,277.00 -
77.94 - 77.94 - 77.94 - 77.94 -
2,000.00 - 2,000.00 - 2,000.00 - 2,000.00 -
5,300.00 - 5,300.00 - 5,300.00 - 5,300.00 -
- - - -
1,800.00 - 1,800.00 - 1,800.00 - 1,800.00 -
1,904.00 - 1,904.00 - 1,904.00 - 1,904.00 -
- - - -
19.00 - 19.00 - 19.00 - 19.00 -
100.00 - 100.00 - 100.00 - 100.00 -
100.00 - 100.00 - 100.00 - 100.00 -
162.00 - 162.00 - 162.00 - 162.00 -
116.00 - 116.00 - 116.00 - 116.00 -
1,230.00 - 1,230.00 - 1,230.00 - 1,230.00 -
2,491.00 - 2,491.00 - 2,491.00 - 2,491.00 -
44.00 - 44.00 - 44.00 - 44.00 -
924.00 - 924.00 - 924.00 - 924.00 -
1,525.00 - 1,525.00 - 1,525.00 - 1,525.00 -
63.00 - 63.00 - 63.00 - 63.00 -
88.00 - 88.00 - 88.00 - 88.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
243.00 - 243.00 - 243.00 - 243.00 -
2,750.00 - 2,750.00 - 2,750.00 - 2,750.00 -
2,750.00 - 2,750.00 - 2,750.00 - 2,750.00 -
5,248.00 - 5,248.00 - 5,248.00 - 5,248.00 -
521.00 - 521.00 - 521.00 - 521.00 -
6,860.00 - 6,860.00 - 6,860.00 - 6,860.00 -
225.00 - 225.00 - 225.00 - 225.00 -
111.00 - 111.00 - 111.00 - 111.00 -
245.00 - 245.00 - 245.00 - 245.00 -
1,500.00 - 1,500.00 - 1,500.00 - 1,500.00 -
70.00 - 70.00 - 70.00 - 70.00 -
92.00 - 92.00 - 92.00 - 92.00 -
1,378.85 - 1,378.85 - 1,378.85 - 1,378.85 -
475,000.00 - 475,000.00 - 475,000.00 - 475,000.00 -
- - - -
2,344.00 - 2,344.00 - 2,344.00 - 2,344.00 -
27.00 - 27.00 - 27.00 - 27.00 -
960.00 - 960.00 - 960.00 - 960.00 -
91.00 - 91.00 - 91.00 - 91.00 -
176.00 - 176.00 - 176.00 - 176.00 -
220.00 - 220.00 - 220.00 - 220.00 -
35.00 - 35.00 - 35.00 - 35.00 -
1,500.00 - 1,500.00 - 1,500.00 - 1,500.00 -
103.00 - 103.00 - 103.00 - 103.00 -

7,220.00 - 7,220.00 - 7,220.00 - 7,220.00 -
864.25 - 864.25 - 864.25 - 864.25 -
2,212.16 - 2,212.16 - 2,212.16 - 2,212.16 -
30,000.00 - 30,000.00 - 30,000.00 - 30,000.00 -
137,500.00 - 137,500.00 - 137,500.00 - 137,500.00 -
55,660.00 - 55,660.00 - 55,660.00 - 55,660.00 -
1,716.00 - 1,716.00 - 1,716.00 - 1,716.00 -
- - - -
66.00 - 66.00 - 66.00 - 66.00 -
1,008.00 - 1,008.00 - 1,008.00 - 1,008.00 -
1,566.00 - 1,566.00 - 1,566.00 - 1,566.00 -
579.00 - 579.00 - 579.00 - 579.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
84.85 - 84.85 - 84.85 - 84.85 -
- - - -
- - - -
292.00 - 292.00 - 292.00 - 292.00 -
- - - -
- - - -
2,904.00 - 2,904.00 - 2,904.00 - 2,904.00 -
900.00 - 900.00 - 900.00 - 900.00 -
54.00 - 54.00 - 54.00 - 54.00 -
38.00 - 38.00 - 38.00 - 38.00 -
5,727.00 - 5,727.00 - 5,727.00 - 5,727.00 -
898.00 - 898.00 - 898.00 - 898.00 -
5,313.00 - 5,313.00 - 5,313.00 - 5,313.00 -
194.00 - 194.00 - 194.00 - 194.00 -
52.52 - 52.52 - 52.52 - 52.52 -
60.47 - 60.47 - 60.47 - 60.47 -
88.23 - 88.23 - 88.23 - 88.23 -
49.00 - 49.00 - 49.00 - 49.00 -
2,399.00 - 2,399.00 - 2,399.00 - 2,399.00 -
92.57 - 92.57 - 92.57 - 92.57 -
146.00 - 146.00 - 146.00 - 146.00 -
3,850.00 - 3,850.00 - 3,850.00 - 3,850.00 -
3,850.00 - 3,850.00 - 3,850.00 - 3,850.00 -
44.00 - 44.00 - 44.00 - 44.00 -
- - - -
92.00 - 92.00 - 92.00 - 92.00 -
556.00 - 556.00 - 556.00 - 556.00 -
- - - -
242,000.00 - 242,000.00 - 242,000.00 - 242,000.00 -
57.00 - 57.00 - 57.00 - 57.00 -
15,100.00 - 15,100.00 - 15,100.00 - 15,100.00 -
123,750.00 - 123,750.00 - 123,750.00 - 123,750.00 -
607.00 - 607.00 - 607.00 - 607.00 -
1,870.00 - 1,870.00 - 1,870.00 - 1,870.00 -
13,750.00 - 13,750.00 - 13,750.00 - 13,750.00 -
3,050.00 - 3,050.00 - 3,050.00 - 3,050.00 -
715.00 - 715.00 - 715.00 - 715.00 -
4,750.00 - 4,750.00 - 4,750.00 - 4,750.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
267.00 - 267.00 - 267.00 - 267.00 -
- - - -
15.00 - 15.00 - 15.00 - 15.00 -
- - - -
213.00 - 213.00 - 213.00 - 213.00 -
1,450.00 - 1,450.00 - 1,450.00 - 1,450.00 -
2,500.00 - 2,500.00 - 2,500.00 - 2,500.00 -
1,599.00 - 1,599.00 - 1,599.00 - 1,599.00 -
21.00 - 21.00 - 21.00 - 21.00 -
133.00 - 133.00 - 133.00 - 133.00 -
- - - -
- - - -
45.00 - 45.00 - 45.00 - 45.00 -
- - - -
2,035.00 - 2,035.00 - 2,035.00 - 2,035.00 -
140.00 - 140.00 - 140.00 - 140.00 -
- - - -
900.00 - 900.00 - 900.00 - 900.00 -
1,295.00 - 1,295.00 - 1,295.00 - 1,295.00 -
35,000.00 - 35,000.00 - 35,000.00 - 35,000.00 -
- - - -
22,727.00 - 22,727.00 - 22,727.00 - 22,727.00 -

105.00 - 105.00 - 105.00 - 105.00 -
3,876.00 - 3,876.00 - 3,876.00 - 3,876.00 -
110.00 - 110.00 - 110.00 - 110.00 -

295.83 - 295.83 - 295.83 - 295.83 -
89.00 - 89.00 - 89.00 - 89.00 -
163.74 - 163.74 - 163.74 - 163.74 -
122.80 - 122.80 - 122.80 - 122.80 -
3,000.00 - 3,000.00 - 3,000.00 - 3,000.00 -
- - - -
219,890.00 - 219,890.00 - 219,890.00 - 219,890.00 -
9.00 - 9.00 - 9.00 - 9.00 -
- - - -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
210.00 - 210.00 - 210.00 - 210.00 -
4,900.00 - 4,900.00 - 4,900.00 - 4,900.00 -
112.00 - 112.00 - 112.00 - 112.00 -
407.00 - 407.00 - 407.00 - 407.00 -
- - - -
- - - -
83,000.00 - 83,000.00 - 83,000.00 - 83,000.00 -
100,000.00 - 100,000.00 - 100,000.00 - 100,000.00 -
1,529.00 - 1,529.00 - 1,529.00 - 1,529.00 -
1,600.00 - 1,600.00 - 1,600.00 - 1,600.00 -
5,230.00 - 5,230.00 - 5,230.00 - 5,230.00 -
- - - -
- - - -
1,318.90 - 1,318.90 - 1,318.90 - 1,318.90 -
- - - -
83.93 - 83.93 - 83.93 - 83.93 -
311.00 - 311.00 - 311.00 - 311.00 -

69.54 - 69.54 - 69.54 - 69.54 -
91.96 - 91.96 - 91.96 - 91.96 -
6,873.00 - 6,873.00 - 6,873.00 - 6,873.00 -
52.00 - 52.00 - 52.00 - 52.00 -
23.00 - 23.00 - 23.00 - 23.00 -
- - - -
- - - -
264.00 - 264.00 - 264.00 - 264.00 -
108.00 - 108.00 - 108.00 - 108.00 -
- - - -
1,928.00 - 1,928.00 - 1,928.00 - 1,928.00 -
110.00 - 110.00 - 110.00 - 110.00 -
- - - -
103.00 - 103.00 - 103.00 - 103.00 -
431.54 - 431.54 - 431.54 - 431.54 -
242.00 - 242.00 - 242.00 - 242.00 -
5,200.00 - 5,200.00 - 5,200.00 - 5,200.00 -
1,781.00 - 1,781.00 - 1,781.00 - 1,781.00 -
- - - -
82.00 - 82.00 - 82.00 - 82.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
- - - -
- - - -
125,000.00 - 125,000.00 - 125,000.00 - 125,000.00 -
- - - -
471,719.00 - 471,719.00 - 471,719.00 - 471,719.00 -
126,310.00 - 126,310.00 - 126,310.00 - 126,310.00 -
- - - -
916.00 - 916.00 - 916.00 - 916.00 -
7,810.00 - 7,810.00 - 7,810.00 - 7,810.00 -
660,000.00 - 660,000.00 - 660,000.00 - 660,000.00 -
180.00 - 180.00 - 180.00 - 180.00 -
3,226.00 - 3,226.00 - 3,226.00 - 3,226.00 -
- - - -
6,862.00 - 6,862.00 - 6,862.00 - 6,862.00 -
140.00 - 140.00 - 140.00 - 140.00 -
206.00 - 206.00 - 206.00 - 206.00 -

431.00 - 431.00 - 431.00 - 431.00 -
38.00 - 38.00 - 38.00 - 38.00 -
690.00 - 690.00 - 690.00 - 690.00 -
188.93 - 188.93 - 188.93 - 188.93 -
- - - -
40.00 - 40.00 - 40.00 - 40.00 -
67,200.00 - 67,200.00 - 67,200.00 - 67,200.00 -
30.00 - 30.00 - 30.00 - 30.00 -
14,000.00 - 14,000.00 - 14,000.00 - 14,000.00 -
2,000.00 - 2,000.00 - 2,000.00 - 2,000.00 -
455.00 - 455.00 - 455.00 - 455.00 -
- - - -
- - - -
- - - -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
10,321.00 - 10,321.00 - 10,321.00 - 10,321.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
- - - -
- - - -
12,955.00 - 12,955.00 - 12,955.00 - 12,955.00 -
1.00 - 1.00 - 1.00 - 1.00 -
2,220.00 - 2,220.00 - 2,220.00 - 2,220.00 -
2,220.00 - 2,220.00 - 2,220.00 - 2,220.00 -
2,220.00 - 2,220.00 - 2,220.00 - 2,220.00 -
2,220.00 - 2,220.00 - 2,220.00 - 2,220.00 -
1,100,500.00 - 1,100,500.00 - 1,100,500.00 - 1,100,500.00 -
13,750.00 - 13,750.00 - 13,750.00 - 13,750.00 -
- - - -
- - - -
279,000.00 - 279,000.00 - 279,000.00 - 279,000.00 -
260,000.00 - 260,000.00 - 260,000.00 - 260,000.00 -
16,500.00 - 16,500.00 - 16,500.00 - 16,500.00 -
58,520.00 - 58,520.00 - 58,520.00 - 58,520.00 -
540.00 - 540.00 - 540.00 - 540.00 -
81.00 - 81.00 - 81.00 - 81.00 -
- - - -
7,207.00 - 7,207.00 - 7,207.00 - 7,207.00 -
- - - -
1,950.00 - 1,950.00 - 1,950.00 - 1,950.00 -
- - - -
235,000.00 - 235,000.00 - 235,000.00 - 235,000.00 -
17,600.00 - 17,600.00 - 17,600.00 - 17,600.00 -
525,000.00 - 525,000.00 - 525,000.00 - 525,000.00 -
105,000.00 - 105,000.00 - 105,000.00 - 105,000.00 -
6,000.00 - 6,000.00 - 6,000.00 - 6,000.00 -
6,000.00 - 6,000.00 - 6,000.00 - 6,000.00 -
6,000.00 - 6,000.00 - 6,000.00 - 6,000.00 -
6,000.00 - 6,000.00 - 6,000.00 - 6,000.00 -
30,200.00 - 30,200.00 - 30,200.00 - 30,200.00 -
28,500.00 - 28,500.00 - 28,500.00 - 28,500.00 -
8,500.00 - 8,500.00 - 8,500.00 - 8,500.00 -
15,000.00 - 15,000.00 - 15,000.00 - 15,000.00 -
1,100.00 - 1,100.00 - 1,100.00 - 1,100.00 -
- - - -
16,000.00 - 16,000.00 - 16,000.00 - 16,000.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
220.00 - 220.00 - 220.00 - 220.00 -
9,500.00 - 9,500.00 - 9,500.00 - 9,500.00 -
8,650.00 - 8,650.00 - 8,650.00 - 8,650.00 -
214,898.00 - 214,898.00 - 214,898.00 - 214,898.00 -
358,200.00 - 358,200.00 - 358,200.00 - 358,200.00 -
1,199,900.00 - 1,199,900.00 - 1,199,900.00 - 1,199,900.00 -
288,100.00 - 288,100.00 - 288,100.00 - 288,100.00 -
159,898.00 - 159,898.00 - 159,898.00 - 159,898.00 -
- - - -
330.00 - 330.00 - 330.00 - 330.00 -

350.00 - 350.00 - 350.00 - 350.00 -
- - - -
- - - -
- - - -
129.00 - 129.00 - 129.00 - 129.00 -
1.00 - 1.00 - 1.00 - 1.00 -
- - - -
5,519.00 - 5,519.00 - 5,519.00 - 5,519.00 -
10,399.00 - 10,399.00 - 10,399.00 - 10,399.00 -
16,000.00 - 16,000.00 - 16,000.00 - 16,000.00 -
4,790.00 - 4,790.00 - 4,790.00 - 4,790.00 -
1,650.00 - 1,650.00 - 1,650.00 - 1,650.00 -
4,668.00 - 4,668.00 - 4,668.00 - 4,668.00 -
1,650.00 - 1,650.00 - 1,650.00 - 1,650.00 -
4,250.00 - 4,250.00 - 4,250.00 - 4,250.00 -
- - - -
40,500.00 - 40,500.00 - 40,500.00 - 40,500.00 -
40,500.00 - 40,500.00 - 40,500.00 - 40,500.00 -
34,500.00 - 34,500.00 - 34,500.00 - 34,500.00 -
34,500.00 - 34,500.00 - 34,500.00 - 34,500.00 -
8,415.00 - 8,415.00 - 8,415.00 - 8,415.00 -
17,600.00 - 17,600.00 - 17,600.00 - 17,600.00 -
4,000.00 - 4,000.00 - 4,000.00 - 4,000.00 -
5,280.00 - 5,280.00 - 5,280.00 - 5,280.00 -
- - - -
3,982.00 - 3,982.00 - 3,982.00 - 3,982.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
9,240.00 - 9,240.00 - 9,240.00 - 9,240.00 -
- - - -
6,600.00 - 6,600.00 - 6,600.00 - 6,600.00 -
441.00 - 441.00 - 441.00 - 441.00 -

- - - -
1,950.00 - 1,950.00 - 1,950.00 - 1,950.00 -
1,950.00 - 1,950.00 - 1,950.00 - 1,950.00 -
1,950.00 - 1,950.00 - 1,950.00 - 1,950.00 -
265.00 - 265.00 - 265.00 - 265.00 -
321,600.00 - 321,600.00 - 321,600.00 - 321,600.00 -
1,172,600.00 - 1,172,600.00 - 1,172,600.00 - 1,172,600.00 -
1,172,600.00 - 1,172,600.00 - 1,172,600.00 - 1,172,600.00 -
26,667.00 - 26,667.00 - 26,667.00 - 26,667.00 -
268,550.00 - 268,550.00 - 268,550.00 - 268,550.00 -
386,100.00 - 386,100.00 - 386,100.00 - 386,100.00 -
30,140.00 - 30,140.00 - 30,140.00 - 30,140.00 -
10,000.00 - 10,000.00 - 10,000.00 - 10,000.00 -
14,575.00 - 14,575.00 - 14,575.00 - 14,575.00 -
5,720.00 - 5,720.00 - 5,720.00 - 5,720.00 -
125,000.00 - 125,000.00 - 125,000.00 - 125,000.00 -
240.00 - 240.00 - 240.00 - 240.00 -
440.00 - 440.00 - 440.00 - 440.00 -
1.00 - 1.00 - 1.00 - 1.00 -
407.00 - 407.00 - 407.00 - 407.00 -
9,790.00 - 9,790.00 - 9,790.00 - 9,790.00 -
13,200.00 - 13,200.00 - 13,200.00 - 13,200.00 -
13,200.00 - 13,200.00 - 13,200.00 - 13,200.00 -
608.00 - 608.00 - 608.00 - 608.00 -
2,542.00 - 2,542.00 - 2,542.00 - 2,542.00 -
110,000.00 - 110,000.00 - 110,000.00 - 110,000.00 -
958.00 - 958.00 - 958.00 - 958.00 -
10,588.00 - 10,588.00 - 10,588.00 - 10,588.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
194.00 - 194.00 - 194.00 - 194.00 -
1,925.00 - 1,925.00 - 1,925.00 - 1,925.00 -
5,400.00 - 5,400.00 - 5,400.00 - 5,400.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1,031,800.00 - 1,031,800.00 - 1,031,800.00 - 1,031,800.00 -
1,865.00 - 1,865.00 - 1,865.00 - 1,865.00 -
44.87 - 44.87 - 44.87 - 44.87 -
10.00 - 10.00 - 10.00 - 10.00 -
5,227.00 - 5,227.00 - 5,227.00 - 5,227.00 -
8,100.00 - 8,100.00 - 8,100.00 - 8,100.00 -
1,320,000.00 - 1,320,000.00 - 1,320,000.00 - 1,320,000.00 -

6,098.00 - 6,098.00 - 6,098.00 - 6,098.00 -
605.00 - 605.00 - 605.00 - 605.00 -
772.00 - 772.00 - 772.00 - 772.00 -
9,370.00 - 9,370.00 - 9,370.00 - 9,370.00 -
550.00 - 550.00 - 550.00 - 550.00 -
1,400.00 - 1,400.00 - 1,400.00 - 1,400.00 -
1,300.00 - 1,300.00 - 1,300.00 - 1,300.00 -
11,000.00 - 11,000.00 - 11,000.00 - 11,000.00 -
10,825.00 - 10,825.00 - 10,825.00 - 10,825.00 -
14,825.00 - 14,825.00 - 14,825.00 - 14,825.00 -
8,250.00 - 8,250.00 - 8,250.00 - 8,250.00 -
14,419.90 - 14,419.90 - 14,419.90 - 14,419.90 -
2,700.00 - 2,700.00 - 2,700.00 - 2,700.00 -
9,070.00 - 9,070.00 - 9,070.00 - 9,070.00 -
8,000.00 - 8,000.00 - 8,000.00 - 8,000.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1,091.00 - 1,091.00 - 1,091.00 - 1,091.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
180,500.00 180,500.00 180,500.00 180,500.00
- - - -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1,948.00 - 1,948.00 - 1,948.00 - 1,948.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
3,782.00 - 3,782.00 - 3,782.00 - 3,782.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 1.00 1.00 1.00
- - - -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 1.00 1.00 1.00
- - - -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
STOK KELUAR
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
116.85 - 116.85 - 116.85 - 116.85 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
1,430.00 - 1,430.00 - 1,430.00 - 1,430.00 -
5,055.00 - 5,055.00 - 5,055.00 - 5,055.00 -
388.18 - 388.18 - 388.18 - 388.18 -
1.00 - 1.00 - 1.00 - 1.00 -
1.00 - 1.00 - 1.00 - 1.00 -
- - - -
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NERACA UGD

1 Acyclovir Salep Tube 2,152.00 - 2,152.00 - 2,152.00

2 Acyclovir 400 mg Tab Tablet 340.00 - 340.00 - 340.00

3 Air raksa dental use Botol 400,000.00 - 400,000.00 - 400,000.00

4 Alat suntik sekali pakai 1 ml Pcs 1,092.00 - 1,092.00 - 1,092.00

5 Alat suntik sekali pakai 2,5 ml Pcs 540.00 - 540.00 - 540.00

6 Alat suntik sekali pakai 5 ml Pcs 743.00 - 4 743.00 2,972 2 743.00

7 Albendazol 400 mg tab Tablet 366.00 - 366.00 - 366.00

8 Alprazolam 0.5 mg Tablet 460.00 - 460.00 - 460.00

9 Alupurinol 100 mg tab / Selespurin/ Proxuric Tablet 104.00 - 104.00 - 104.00

10 Ambroxol syr Botol 2,475.00 - 2,475.00 - 2,475.00

11 Ambroxol tab 30 mg / Promukus Tablet 85.93 - 85.93 - 85.93

12 Aminofilina injeksi 24 mg/ ml. 10 ml Ampul 3,240.00 - 3,240.00 - 3,240.00

13 Aminofilna tablet 200 mg Tablet 87.15 - 87.15 - 87.15

14 Amitriptilina hcl tablet salut 25 mg Tablet 102.00 - 102.00 - 102.00

15 Amoksilina kapsul 500 mg Tablet 220.00 - 220.00 - 220.00

16 Amoksilna sirup kering 125 mg/ 5 mg Botol 2,277.00 - 2,277.00 - 2,277.00

17 Antasida doen tablet kombinasi Tablet 77.94 - 77.94 - 77.94

18 Anti hemmoroid suppositoria Supp 2,000.00 - 2,000.00 - 2,000.00

20 Aquadest steril 500 ml Botol - -

21 As salisilat 2% + belerang endap 4%(2-4 salep Pot 1,800.00 - 1,800.00 - 1,800.00

22 As. Benzoat 3 % + as salisilat 6%(whitefield) Pot 1,904.00 - 1,904.00 - 1,904.00

23 Asam askorbat (Vit. C) tablet 250 mg Tablet - -

24 Asam askorbat (Vit. C) tablet 50 mg Tablet 19.00 - 19.00 - 19.00

25 Asam mefenamat 500 mg Tablet 100.00 - 100.00 - 100.00

26 Asetosal 100 mg Tablet 100.00 - 100.00 - 100.00

27 Asetosal tablet 500 mg Tablet 162.00 - 162.00 - 162.00

28 Antalgin (metampiron) tablet 500 mg Tablet 116.00 - 116.00 - 116.00

29 Atropina sulfat injeksi 0 .25 mg / ml - 1 ml Ampul 1,230.00 - 1,230.00 - 1,230.00

30 Basitrasin Polimiksin Tube 2,491.00 - 2,491.00 - 2,491.00

32 Betahistin tab Tablet 924.00 - 924.00 - 924.00

33 Betametazon salep kulit Tube 1,525.00 - 1,525.00 - 1,525.00

34 Captopril 12.5 mg tablet Tablet 63.00 - 63.00 - 63.00

35 Captopril 25 mg tablet Tablet 88.00 - 88.00 - 88.00

36 Carbamazepina 200 mg talet Tablet 243.00 - 243.00 - 243.00

37 Catgut / benang bedah no 2/0 chromic Sachet 2,750.00 - 2,750.00 - 2,750.00

38 Catgut / benang bedah no 3/0 plain Sachet 2,750.00 - 2,750.00 - 2,750.00

39 Cefadroxil 125mg/5ml Sirup Botol 5,248.00 - 5,248.00 - 5,248.00

40 Cefadroxill 500 mg tablet Tablet 521.00 - 521.00 - 521.00

41 Cefotaxim 1 gr Injeksi Ampul 6,860.00 - 6,860.00 - 6,860.00

42 Cetirizin10 mg tab Tablet 225.00 - 225.00 - 225.00

43 Cimetidine/Selestidin Tablet 111.00 - 111.00 - 111.00

44 Ciprofloxazin tablet 500 mg Tablet 245.00 - 245.00 - 245.00

45 Deksametason injeksi 5 mg / ml - 1 ml Ampul 1,500.00 - 1,500.00 - 1,500.00

46 Deksametason tablet 0.5 mg Tablet 70.00 - 70.00 - 70.00

47 Dekstrometofan HBR tablet 15 mg Tablet 92.00 - 92.00 - 92.00

48 Dekstrometopan HBR sirup 10 mg / ml Botol 1,378.85 - 1,378.85 - 1,378.85

49 Devitalisasi pasta Tube 475,000.00 - 475,000.00 - 475,000.00

51 Diazepam injeksi 5 mg / ml - 2 ml Ampul 2,344.00 - 2,344.00 - 2,344.00

52 Diazepam tablet 2 mg Tablet 27.00 - 27.00 - 27.00

54 Digoksina tablet 0. 25 mg Tablet 91.00 - 91.00 - 91.00

55 Domperidon tablet 10 mg Tablet 176.00 - 176.00 - 176.00

56 Doxycicline 100 mg tab Tablet 220.00 - 220.00 - 220.00

57 Efedrina HCL (efedrina) tablet 25 mg Tablet 35.00 - 35.00 - 35.00

60 Erytromysin 200mg/5ml Syrup Botol 7,220.00 - 7,220.00 - 7,220.00

61 Erytromysin tablet 500 mg Tablet 864.25 - 864.25 - 864.25

62 Etakridina (rivanol) larutan 0.1 % Botol 2,212.16 - 2,212.16 - 2,212.16

63 Etanol 70 % Botol 0.50 30,000.00 15,000 2 30,000.00 60,000 2.50 30,000.00

64 Etil klorida semprot Botol 1 137,500.00 137,500 4 137,500.00 550,000 4 137,500.00

65 Eugenol cairan Botol 55,660.00 - 55,660.00 - 55,660.00

66 Fenobarbital inj 50 mg /ml -2ml Ampul 1,716.00 - 1,716.00 - 1,716.00

67 Fenobarbital tablet 100mg Tablet - -

68 Fenobarbital tablet 30 mg Tablet 66.00 - 66.00 - 66.00

69 Fenol gliserol tetes telnga 10% Botol 1,008.00 - 1,008.00 - 1,008.00