Seborokrapyak Lplpo 2022

SATUAN HARGA
SISA STOK
No. NAMA OBAT KEMASAN SATUAN
NOV
1 2 3
- OBAT ESENSIAL/GENERIK
01000003 Albendazol tablet 400 mg tablet 4,000
01000004 Alopurinol tablet 100 mg tablet 402 180
01000005 Alprazolam tablet 0,5 mg tablet 105
01000006 Ambroksol tablet 30 mg tablet 94
01000008 Aminofilin tablet 200 mg tablet 112
01000010 Amitriptilin tablet 25 mg tablet 2,976
01000011 Amlodipin tablet 10 mg tablet 95
Amlodipin tablet 10 mg tablet 70 580
01000012 Amlodipin tablet 5 mg tablet 167
Amlodipin tablet 5 mg tablet 99 314
01000014 Amoksisilin kapsul 500 mg kapsul 75 1652
01000016 Amoksisilin s.k. Forte 250 mg/5 ml botol 180
01000017 Amoksisilin sirup 125 mg/5 ml botol 249
01000020 Antasida DOEN I - tablet kunyah tablet 3,300 1114
01000021 Antasida DOEN II - suspensi botol 8,237
Antasida DOEN II - suspensi botol 34,000 10
01000022 Antibakteri DOEN salep (Bacitracin) tube 58
01000023 Antifungi DOEN salep Pot 2,129
01000024 Antihemoroid supositoria suppos 1,679
Antihemoroid supositoria suppos 3,035
01000025 Asam asetilsalisilat tablet 80 mg (MINIASPI) tablet 4,798
01000026 Asam askorbat (Vit. C) 50 mg tablet kapsul 3,167 295
01000027 Asam folat 1 mg tablet tablet 3,250
01000028 Asam Folat 400 mcg tablet 105 620
01000029 Asam mefenamat 500 mg tablet 105
Asam mefenamat 500 mg tablet 67 1053
01000030 Asam mefenamat tablet 250 mg tablet 55
01000032 Asam traneksamat tablet 500 mg tablet 111 90
01000033 Asiklovir 200 mg Tab 139
01000034 Asiklovir salep krim 5 % (Acifar) tube 2,076
01000037 Asiklovir tablet 400 mg tablet 14,157 31
01000040 Attapulgit tablet 650 mg tablet 405 128
01000041 Bedak salisil serbuk 2 % ktk/pot 1,639
01000042 Betahistin messilat 6 mg tablet 200
Betahistin messilat 24 mg tablet 220 72
01000043 Betametason Dipropionate 0,5 g tube 5 gram 1,020
01000044 Betametason krim 5 gram tube 920
01000045 Betametason valerat krim 0,1 % tube 5 gram 4,959 5
01000046 Bisakodil supositoria 10 mg (stolax) supp 3,350
Bisakodil supositoria 10 mg supp 1,340
01000047 Bisakodil supositoria 5 mg suppos 1,430
01000048 Bisakodil tablet 5 mg tablet 5,730
01000053 Deksametason tablet 0,5 mg tablet 7,709 228
01000057 Diazepam tablet 2 mg tablet 1,735
01000059 Digoksin tablet 0,25 mg tablet 12,573 125
01000061 Dimenhidrinat tablet 50 mg tablet 1,095
01000063 Domperidon sirup 5 mg/5 ml botol 142
01000064 Domperidon tablet 10 mg tablet 112 220
01000068 Eritromisin kapsul 250 mg kapsul 7,480 40
01000069 Eritromisin kapsul 500 mg kapsul 51
01000070 Eritromisin sirup kering 200 mg/5 ml botol 1,408
01000071 Fenitoin Na 30 mg kapsul (decatona ) kapsul 583
01000072 Fenitoin natrium kapsul 100 mg kapsul 750
01000074 Fenobarbital tablet 30 mg tablet 183
01000076 Fitomenadion (Vit K) tablet 10 mg tablet 1,800
01000078 Furosemid tablet 40 mg tablet 3,682 311
01000079 Gemfibrosil 600 mg kapsul kapsul 758 90
01000080 Gemfibrozil kapsul 300 mg kapsul 1,333
01000082 Gentamisin salep mata 0,3 % tube 794 5
01000083 Gentamisin tetes mata 0,3 % botol 371
Gentamisin tetes mata 0,3 % Botol 3,083 20
01000084 Glibenklamid tablet 5 mg tablet 2,675 90
01000085 Glimepirid tablet 2 mg tablet 4,232 680
01000086 Gliserilguayakolat tablet 100 mg tablet 4,520 636
01000090 Griseofulvin tablet 125 mg micronized tablet 5,333
01000091 Haloperidol 2 mg tablet 8,003
01000092 Haloperidol injeksi 5 mg/ml ampul 7,363
01000093 Haloperidol injeksi 50 mg/ml ampul 224
01000094 Haloperidol tablet 1,5 mg tablet 90
01000095 Haloperidol tablet 2 mg (Lodomer 2 mg) tablet 6,250
01000096 Haloperidol tablet 5 mg tablet 101,300
01000097 Hidroklorotiazid tablet 25 mg tablet 66
01000098 Hidrokortison acetat krim 2,5% tube 90 10
01000099 Hidrokortison krim 1 % - 5 g tube 60
01000100 Hyosin butilbromide tablet 10 mg tablet 149
01000101 Ibu profen sirup 200 mg / 5 ml botol 2,475 3
01000102 Ibuprofen sirup 100 mg/5 ml botol 2,974
01000103 Ibuprofen tablet 200 mg tablet 2,604
01000104 Ibuprofen tablet 400 mg tablet 4,665
01000105 Isoniasida tablet 100 mg tablet 2,550
01000106 Isosorbid Dinitrat 10 mg tablet 110
01000107 Isosorbid Dinitrat 5 mg tablet 270
01000108 Kalium aspartat kaplet salut selaput 300 mg tablet 231
01000109 Kalsium glukonat 10 % injeksi ampul 189
01000110 Kalsium laktat 500 mg tablet 89 585
01000111 Kaptopril 12,5 mg tablet 647 260
01000112 Kaptopril 25 mg tablet (Vapril) tablet 9,955
01000113 Karbamazepin kaplet 200 mg tablet 63
01000114 Karbol gliserin tetes telinga 10 % botol 62
01000115 Ketokonazol krim tube 193
01000116 Ketokonazol tablet 200 mg tablet 245
01000118 Klindamisin kapsul 150 mg kapsul 2,518
01000119 Klindamisin kapsul 300 mg kapsul 288
Klindamisin kapsul 300 mg kapsul 1,089 188
01000120 Klobazam 10 mg tablet tablet 759
01000121 Klonidin tablet 0,15 tablet tablet 583
01000122 Kloramfenikol kapsul 250 mg kapsul 522
01000123 Kloramfenikol kapsul 500 mg tablet 776
Kloramfenikol kapsul 500 mg tablet 174 50
01000124 Kloramfenikol salep kulit 2 % (Bufacetin) tube 605
01000125 Kloramfenikol salep mata 0,5 % tube 1,090
01000126 Kloramfenikol salep mata 1 % tube 1,174
01000127 Kloramfenikol suspensi 125 mg/5 ml botol 3,038
01000128 Kloramfenikol Tetes Telinga botol 3,250
01000129 Kloramfenikol tetes telinga botol 1,881
01000130 Kloramfenikol tts.mt 0,5% botol 4,700
01000131 Kloramfenikol tts.mt 0,5% (Reco) botol 7,500
01000132 Kloramfenikol tts.telinga 3% (Reco) botol 6,600
01000133 Klorfeniramin maleat 4 mg tablet tablet 7,500 342
01000134 Klorfeniramin Maleat tablet 4 mg box-288 tabl 8,250
01000135 Klorpromazin 100 mg tablet 8,250
01000136 Klorpromazin 25 mg tablet 23
01000137 Klozapin tablet 25 mg tablet 15,050
01000138 Kodein tablet 10 mg tablet 147
01000139 Komb : ergotamin 1 mg + kofein 50 mg tablet tablet 181
01000140 Kombinasi fero fumarat 60 mg + asam folat 0,4 mg tablet satablet 1,121
Kombinasi fero fumarat 60 mg + asam folat 0,4 mg tablet satablet 571
01000141 Kotrimoksasol (dewasa) kombinasi : sulfametoksazol 400 mtablet 185 166
01000142 Kotrimoksasol suspensi botol 60 ml 354
01000144 Lanzoprazol kapsul 30 mg kapsul 133
01000157 Loperamid tablet 2 mg tablet 1,229
01000158 Lorazepam tablet 2 mg tablet 177,216
01000159 Magnesium sulfat injeksi 20 % ampul 220
01000160 Magnesium sulfat injeksi 40 % ampul 99
01000161 Mecobalamin injeksi 500 mg ampul 864
01000162 Mecobalamin kapsul 500 mg kapsul 2,800
01000163 Meloxicam tablet 7,5 mg tablet 3,500
01000164 Metampiron tablet 500 mg Tablet 8,213
01000165 Metformin 850 mg tablet 719
01000166 Metformin tablet 500 mg tablet 365
Metformin tablet 500 mg tablet 172 15
01000167 Metformin tablet 850 mg tablet 262
01000169 Metilergometrin maleat tablet 0,125 mg tablet 160
01000170 Metilprednisolon 16 mg tablet 2,959 90
01000171 Metilprednisolon 4 mg tablet 1,023 3
01000177 Metronidasol kaptab 500 mg kaptab 121
01000178 Metronidasol tablet 250 mg tablet 9,950
01000179 Metronidazol sirup 125 mg/ 5 ml botol 8,110
01000180 Mikonazol krim tube 198 2
01000181 n-Asetil sistein tablet tablet 89
01000182 Natrium diklofenak 50 mg tablet tablet 3,950
Natrium diklofenak 50 mg tablet tablet 3,214 1042
01000184 Nifedipin tablet 10 mg tablet 123 65
01000186 Obat batuk hitam botol 6,840
01000187 Oksitetrasiklin 1 % salep mata tube 112
01000190 Omeprazol kapsul 20 mg kapsul 2,500
Omeprazol kapsul 20 mg kapsul 1,199 22
01000193 Ondansentron tablet 4 mg tabllet 129
01000194 Parasetamol drop 100 mg/ml botol 1,124
01000195 Parasetamol sirup 120 mg / 5 ml botol 1,124
Parasetamol sirup 120 mg / 5 ml baru botol 455 9
01000196 Parasetamol tablet 500 mg tablet 6,649 1242
01000197 Permetrin krim 5 % (Scabimite) tube 1,181
01000198 Piracetam injeksi 1 gr ampul 1,160
01000199 Piracetam tablet 800 mg tablet 165
01000200 Pirantel pamoat suspensi 125 mg/ botol 11,825
01000201 Pirantel pamoat tablet tablet 5,198
01000202 Piridoksin (Vit B 6) tablet 10 mg (HCl) tablet 704
01000203 Piroksikam tablet 20 mg tablet 9,510
01000205 Prednison tablet 5 mg tablet 123 28
01000207 Probenesid tablet 500 mg (Probenid) tablet 17,393
01000208 Propanolol tablet 10 mg tablet 73
01000209 Propanolol tablet 40 mg tablet 224
01000210 Propiltiourasil tablet 100 mg tablet 1,914
01000212 Ranitidin tablet 150 mg tablet 74 326
01000213 Ranitidin tablet 150 mg botol 279
01000216 Risperidon 1 mg Tablet 7,630
01000217 Risperidon 2 mg Tablet
01000218 Salbutamol 2 mg tablet tablet 7,630
01000220 Salbutamol 4 mg tablet tablet 495 349
01000223 Salep 2-4 Pot 70
Salep 2-4 Pot 31,373 6
01000224 Sefadroksil kaplet/kapsul 250 mg kaplet/kaps 6,600
01000225 Sefadroksil kapsul 500 mg kapsul 2,796
01000226 Sefadroksil sirup kering 125 mg/5 ml botol 1,410
01000227 Sefadroksil sirup kering 250 mg/5 ml botol 690
01000233 Setirizin sirup 5 mg/5 ml botol 4,708 1
01000234 Setirizin tablet 10 mg tablet 512,204
01000236 Simetidin tablet 200 mg tablet 2,915
01000237 Simvastatin tablet 10 mg tablet 462
01000238 Simvastatin tablet 20 mg tablet 1,104 970
01000239 Siprofloksasin 500 mg tablet 341 420
01000240 Sukralfat suspensi 500 mg/5 ml botol 117
01000241 Sukralfat tablet 500 mg tablet 217
01000244 Tetrasiklin kapsul 250 mg kapsul 296
01000245 Tetrasiklin kapsul 500 mg kapsul 20,700
01000246 Thiamfenikol kaplet 500 mg kaplet 188,663
01000247 Thiamin (Vit B1) tablet 50 mg (HCl/Nitrat) tablet 163
01000249 Triheksifenidil tablet 2 mg tablet 726
01000251 Vitamin B kompleks tablet tablet 60
01000252 Zinc sirup 20 mg/5 ml botol 91
01000253 Zincpro sirup 10mg/ml botol 165,000
01000254 Zink sulfat dispersibel tablet 20 mg tablet 83
Zink sulfat dispersibel tablet 20 mg tablet 2,972 55
- - - 6,281
- OBAT TAMBAHAN / BRANDED - 34,000
03000001 Multifitamin : Bionicum C - 201,300
03000002 Multivitamin : Becefort tablet
03000003 Multivitamin dan mineral sirup (Biolysin Smart) botol
03000004 Multivitamin dan penambah nafsu makan sirup (Biolysin) botol 2,200
03000005 Multivitamin dan suplemen : Askorbic acid 150 mg, Niacinatablet 1,265
03000006 Multivitamin kaplet - (Caviplex) kaplet 12,650
03000007 Multivitamin sirup Botol 11,495
03000008 Multivitamin sirup anak - ANAGEN botol 2,200
03000009 Multivitamin sirup anak. Komposisi : AA 60 mg, DHA 20 mg,botol 60 ml 605
03000010 Multivitamin suplemen ibu hamil - VITALEX kaplet 10,670
03000011 Neurotropik injeksi - NEUROTROPIC vial 12,870
03000012 Neurotropik kaplet - CORSANEURON kaplet 8,300
03000013 Neurotropik kaplet (Neucompli) kaplet 440
03000014 Neurotropik kaplet mengandung :Vit B1 100 mg + vit B6 2 tablet 8,250
03000015 Obat antidiare sirup : Kanina - 759
03000016 Obat antidiare sirup : Kaolin + Pektin / KANINA botol 660
03000017 Obat antiflu kombinasi sirup : succus liq 500 mg + CTM 0 botol 682
03000018 Obat antiflu kombinasi sirup (Betaflu) botol 7,500
03000019 Obat antiflu kombinasi tablet (Betaflu) tablet 8,250
03000020 Obat antiflu kombinasi tablet (HUSTAB) tablet 7,200
03000021 Obat Batidiare : Molagit tablet 9,500
03000022 Obat batuk (Dextrofen) botol 297
03000023 Obat Batuk dan Flu Samcodryl Syr Botol 440
03000024 Obat batuk hitam -Per 15 ml Succus liquiritae 500 mg, botol 450
03000025 Obat batuk hitam (Ikapharmin) botol 11,550
03000026 Obat batuk hitam AFI 100 ml botol 8,910
03000027 Obat batuk kombinasi sirup (Licodry) botol 6,200
03000028 Obat Batuk Sirup : Samkodryl botol 6,200
03000029 Obat batuk sirup (TDR) botol 1,997
03000030 Obat Flu : Wicold sirup botol 8,800
03000031 Obat Flu dan Batuk : Dextral tablet tab 16,500 380
03000032 Obat Sariawan - Triamkinolon 1 mg (Bufacomb) tube 5,566
03000033 OBH 100 ml Ikafarmindo BTL 8,250
03000034 Scopma - 782
03000035 Suplemen zat besi sirup - Ferriz botol 18,150 5
- PROGRAM DIARE - 2,134

09000001 Garam oralit serbuk kombinasi saset 205
09000002 Zink dispersible tablet 20 mg tablet
- - -
- PROGRAM KIA/ GIZI - 3,661
10000001 Mineral Mix saset 524
10000002 Retinol (Vitamin A) 100.000 IU kapsul lunak kapsul
10000003 Retinol (Vitamin A) 200.000 IU kapsul lunak kapsul
10000004 Tablet tambah darah kombinasi : Besi II Sulfat 200 mg + A tablet 3,116
- TTD (Ferofumarat)/ Dinkesprop tablet 306 955
Garam Oralit serbuk (program diare) sachet 20,400 77
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT PUSKESMAS
(LPLPO)
PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : DESEMBER 2021 DINKES KAB.
KABUPATEN : PURWOREJO PERMINTAAN BULAN / PERIODE : JANUARI 2022 PUSKESMAS 445/08/I/2022 17-Jan-22
SATUAN HARGA STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- DROPING PEMBELIAN JUMLAH KET
No. NAMA OBAT KEMASAN SATUAN AWAL MAAN DIAAN KAIAN STOK OPTIMUM TAAN DAU DAK PRO- APBD LAIN-2 SENDIRI
GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
01000001 Air untuk injeksi 25 ml ampul 2,860.00 51 51 0 51
01000002 Albendazol sirup botol 4,000.00 0 0 0 0
01000003 Albendazol tablet 400 mg tablet 402.00 0 400 400 0 400 1000
01000004 Alopurinol tablet 100 mg tablet 105.00 500 500 0 500
01000005 Alprazolam tablet 0,5 mg tablet 94.00 66 66 18 48
Ambroksol tablet 30 mg tablet 330.00 0 1000 1000 100 900 1000
01000007 Aminofilin injeksi 24 mg/ml ampul 2,976.00 0 0 0 0
01000008 Aminofilin tablet 200 mg tablet 95.00 0 0 0 0 500
01000009 Aminofluid 500 ml botol 67,590.00 0 0 0 0
01000010 Amitriptilin tablet 25 mg tablet 167.00 0 0 0 0
Amlodipin tablet 10 mg tablet 70.00 2000 1000 3000 500 2500 3000
Amlodipin tablet 5 mg tablet 53.00 2300 1200 3500 800 2700 3000
01000013 Amoksisilin kapsul 250 mg kapsul 180.00 0 0 0 0
01000014 Amoksisilin kapsul 500 mg kapsul 249.00 2900 1000 3900 500 3400 2000
01000015 Amoksisilin kapsul 500 mg (Pehamoxil Forte) kapsul 751.30 0 0 0 0
01000016 Amoksisilin s.k. Forte 250 mg/5 ml botol 3,628.00 0 0 0 0 20
Amoksisilin sirup 125 mg/5 ml botol 2,050.00 0 100 100 30 70
01000018 Ampisilin 1 gram kombinasi, injeksi vial 8,237.00 0 0 0 0
01000019 Ampisilin 1,5 gram kombinasi, injeksi vial 34,000.00 0 0 0 0
01000020 Antasida DOEN I - tablet kunyah tablet 58.00 4600 1000 5600 300 5300 2000
Antasida DOEN II - suspensi botol 1,679.00 74 74 40 34 100
01000022 Antibakteri DOEN salep (Bacitracin) tube 3,035.00 0 0 0 0
01000023 Antifungi DOEN salep Pot 4,798.00 0 0 0 0
Antihemoroid supositoria suppos 3,250.00 50 50 10 40
01000025 Asam asetilsalisilat tablet 80 mg (MINIASPI) tablet 105.00 0 0 0 0 500
01000026 Asam askorbat (Vit. C) 50 mg tablet kapsul 42.00 1800 1000 2800 1000 1800 2000
01000027 Asam folat 1 mg tablet tablet 67.00 0 0 0 0
Asam Folat 400 mcg tablet 42.00 0 1000 1000 0 1000
Asam mefenamat 500 mg tablet 111.00 2700 1000 3700 200 3500 2000
01000030 Asam mefenamat tablet 250 mg tablet 139.00 0 0
01000031 Asam traneksamat injeksi 100 mg/ml ampul 2,076.00 0 0 0 0
01000032 Asam traneksamat tablet 500 mg tablet 1,584.00 0 0 0 0
01000033 Asiklovir 200 mg Tab 249.00 0 0 0 0 ED Oktober
01000034 Asiklovir salep krim 5 % (Acifar) tube 14,157.00 0 0 0 0 10 ED Oktober
01000035 Asiklovir salep mata 3 % (LACYVIR) tube 19,900.00 0 0 0 0
01000036 Asiklovir tablet 200 mg (Acifar) tablet 1,180.00 0 0 0 0
01000037 Asiklovir tablet 400 mg tablet 405.00 100 100 0 100 500
01000038 Atropin injeksi 0,25 mg/ml ampul 1,639.00 0 0 0 0
01000039 Attapulgit tablet 500 mg tablet 200.00 0 0 0 0
01000041 Bedak salisil serbuk 2 % ktk/pot 1,020.00 0 0 0 0 30
01000042 Betahistin messilat 6 mg tablet 919.60 0 0 0 0
Betahistin messilat 24 mg tablet 4,959.00 210 210 60 150
01000043 Betametason Dipropionate 0,5 g tube 5 gram 3,350.00 0 0 0 0
01000044 Betametason krim 5 gram tube 1,340.00 0 0 0 0
01000045 Betametason valerat krim 0,1 % tube 5 gram 1,430.00 52 52 0 52
01000046 Bisakodil supositoria 10 mg (stolax) supp 5,730.00 0 0 0 0
Bisakodil supositoria 10 mg supp 4,325.00 30 30 3 27
01000047 Bisakodil supositoria 5 mg suppos 6,000.00 0 0 0 0
01000048 Bisakodil tablet 5 mg tablet 300.00 0 0 0 0
01000049 Ceftriaxon injeksi 1 gr vial 4,700.00 0 0 0 0
01000050 Citicolin injeksi 250 mg ampul 7,708.80 0 0 0 0
01000051 Citicolin tablet 500 mg tablet 5,012.33 0 0 0 0
01000052 Deksametason injeksi i.v./i.m. 5 mg/ml ampul 1,097.00 0 0 0 0
01000053 Deksametason tablet 0,5 mg tablet 72.60 400 400 400 0 2000
01000054 Diazepam injeksi 5 mg/ml ampul 1,735.00 0 0 0 0
01000055 Diazepam larutan rektal 10 mg/2,5 ml (Stesold) tube 18,279.00 0 0 0 0
01000056 Diazepam larutan rektal 5 mg/2,5 ml (Stesold) tube 12,573.00 0 10 10 5 5 ED NOVEMBER
01000057 Diazepam tablet 2 mg tablet 70.00 200 200 100 100
01000058 Difenhidramin injeksi 10 mg/ml ampul 1,095.00 0 0 0 0
01000059 Digoksin tablet 0,25 mg tablet 104.00 0 300 300 100 200
01000060 Diltiazem HCl Tablet 30 mg tablet 142.00 0 0 0 0
01000061 Dimenhidrinat tablet 50 mg tablet 112.00 400 400 0 400
01000062 Doksisiklin kapsul 100 mg tablet 275.00 0 0 0 0
01000063 Domperidon sirup 5 mg/5 ml botol 2,700.00 0 0 0 0 ED OKTOBER
01000064 Domperidon tablet 10 mg tablet 91.00 100 100 50 50 500
01000065 Dopamin injeksi 40 mg/ml ampul 7,480.00 0 0 0 0
01000066 Efedrin HCl tablet 25 mg tablet 51.26 0 0 0 0
01000067 Epinefrin (Adrenalin) injeksi 0,1 % sebagai HCl) ampul 1,408.00 0 0 0 0
01000068 Eritromisin kapsul 250 mg kapsul 583.00 0 0 0 0
01000070 Eritromisin sirup kering 200 mg/5 ml botol 6,150.00 0 0 0 0
01000071 Fenitoin Na 30 mg kapsul (decatona ) kapsul 190.00 100 100 100 0 100 RETURN DES
01000072 Fenitoin natrium kapsul 100 mg kapsul 158.00 0 0 0 0
01000073 Fenobarbital injeksi ampul 1,800.00 0 0 0 0
01000074 Fenobarbital tablet 30 mg tablet 182.00 0 0 0 0
01000075 Fitomenadion (Vit K) injeksi 1.m. 2 mg /ml ampul 3,682.00 90 90 0 90
01000076 Fitomenadion (Vit K) tablet 10 mg tablet 758.00 100 100 0 100 ED OKTOBER
01000077 Furosemid injeksi 10 mg/ml ampul 1,333.00 0 0 0 0
01000078 Furosemid tablet 40 mg tablet 82.00 200 200 0 200
01000079 Gemfibrosil 600 mg kapsul kapsul 794.00 500 500 0 500
01000080 Gemfibrozil kapsul 300 mg kapsul 370.99 0 0 0 0 500
01000081 Gentamisin injeksi 40 mg/ml ampul 3,083.00 0 0 0 0
01000082 Gentamisin salep mata 0,3 % tube 2,675.00 67 67 0 67
Gentamisin tetes mata 0,3 % Botol 4,520.00 24 48 72 0 72
01000084 Glibenklamid tablet 5 mg tablet 119.00 1300 1300 100 1200
01000085 Glimepirid tablet 2 mg tablet 207.00 3000 3000 1000 2000 2000
01000086 Gliserilguayakolat tablet 100 mg tablet 116.00 0 0 0 0 4000
01000087 Gliserin lar 50 % botol-100 ml 5,333.00 0 0 0 0
01000088 Glukosa larutan infus 10 % botol 500 ml 8,003.00 0 0 0 0
01000090 Griseofulvin tablet 125 mg micronized tablet 224.00 0 0 0 0
01000091 Haloperidol 2 mg tablet 90.00 0 0 0 0 3000
01000092 Haloperidol injeksi 5 mg/ml ampul 6,250.00 0 0 0 0
01000094 Haloperidol tablet 1,5 mg tablet 66.00 0 0 0 0
01000095 Haloperidol tablet 2 mg (Lodomer 2 mg) tablet 90.00 0 0 0 0 3000
01000096 Haloperidol tablet 5 mg tablet 60.00 2035 1000 3035 705 2330 2000
01000097 Hidroklorotiazid tablet 25 mg tablet 149.00 0 0 0 0 200
01000098 Hidrokortison acetat krim 2,5% tube 2,475.00 34 24 58 0 58
01000099 Hidrokortison krim 1 % - 5 g tube 2,974.00 0 0 0 0
01000100 Hyosin butilbromide tablet 10 mg tablet 2,604.00 0 0 0 0 ED OKTOBER
01000101 Ibu profen sirup 200 mg / 5 ml botol 4,665.00 0 0 0 0
01000102 Ibuprofen sirup 100 mg/5 ml botol 2,550.00 0 0 0 0
01000103 Ibuprofen tablet 200 mg tablet 110.00 0 0 0 0
01000105 Isoniasida tablet 100 mg tablet 231.00 497 497 0 497
01000106 Isosorbid Dinitrat 10 mg tablet 189.00 0 0 0 0 100
01000108 Kalium aspartat kaplet salut selaput 300 mg tablet 647.00 0 0 0 0
01000109 Kalsium glukonat 10 % injeksi ampul 9,955.00 0 0 0 0
01000110 Kalsium laktat 500 mg tablet 63.00 2000 2000 4000 1200 2800 2000
01000111 Kaptopril 12,5 mg tablet 62.00 800 800 0 800
01000112 Kaptopril 25 mg tablet (Vapril) tablet 193.00 0 0 0 0 1000
01000113 Karbamazepin kaplet 200 mg tablet 245.00 0 0 0 0
Karbamazepin kaplet 200 mg tablet 189.00 0 100 100 0 100
01000114 Karbol gliserin tetes telinga 10 % botol 2,500.00 0 0 0 0
01000115 Ketokonazol krim tube 2,518.00 0 0 0 0 50
01000116 Ketokonazol tablet 200 mg tablet 288.00 0 0 0 0 ED AGUSTUS
01000117 Ketorolac injeksi 30 mg/ml ampul 1,089.00 29 29 0 29
01000118 Klindamisin kapsul 150 mg kapsul 759.00 0 0 0 0 1000
01000119 Klindamisin kapsul 300 mg kapsul 583.00 0
Klindamisin kapsul 300 mg kapsul 522.00 450 450 0 450
01000120 Klobazam 10 mg tablet tablet 776.00 0 0 0 0
Klobazam 10 mg tablet tablet 384.00 500 500 5 495
01000121 Klonidin tablet 0,15 tablet tablet 174.00 0 0 0 0
01000122 Kloramfenikol kapsul 250 mg kapsul 605.00 0 0 0 0 500
01000123 Kloramfenikol kapsul 500 mg tablet 1,090.00 0 0
Kloramfenikol kapsul 500 mg tablet 1,174.00 400 400 100 300
01000124 Kloramfenikol salep kulit 2 % (Bufacetin) tube 3,038.00 75 75 20 55
01000125 Kloramfenikol salep mata 0,5 % tube 3,250.00 0 0 0 0
01000126 Kloramfenikol salep mata 1 % tube 1,881.00 0 0 0 0
01000127 Kloramfenikol suspensi 125 mg/5 ml botol 4,700.00 0 0 0 0
01000128 Kloramfenikol Tetes Telinga botol 7,500.00 0 0 0 0 100
01000129 Kloramfenikol tetes telinga botol 6,600.00 0 0 0 0
01000130 Kloramfenikol tts.mt 0,5% botol 7,500.00 0 0 0 0 100
01000131 Kloramfenikol tts.mt 0,5% (Reco) botol 8,250.00 0 0 0 0 100
01000132 Kloramfenikol tts.telinga 3% (Reco) botol 8,250.00 0 0 0 0 100
01000133 Klorfeniramin maleat 4 mg tablet tablet 43.00 500 500 500 0 2000
Klorfeniramin maleat 4 mg tablet Dehista tablet 103.40 2000 2000 1000 1500 2000
01000135 Klorpromazin 100 mg tablet 147.00 0 0 0 0 2000
01000136 Klorpromazin 25 mg tablet 181.00 1370 200 1570 490 1080 2000
01000137 Klozapin tablet 25 mg tablet 1,121.00 30 30 20 10 300
01000138 Kodein tablet 10 mg tablet 571.00 0 0 0 0
01000139 Komb : ergotamin 1 mg + kofein 50 mg tablet tablet 185.00 0 0 0 0
01000140 Kombinasi fero fumarat 60 mg + asam folat 0,4 mg tablet satablet 354.00 0 0 0 0
Kombinasi fero fumarat 60 mg + asam folat 0,4 mg tablet satablet 226.00 0 0 0 0
01000141 Kotrimoksasol (dewasa) kombinasi : sulfametoksazol 400 mtablet 133.00 500 500 0 500
01000142 Kotrimoksasol suspensi botol 60 ml 2,052.00 0 0 0 0
01000143 Kuinin tablet salut selaput tablet 670.00 0 0 0 0
01000144 Lanzoprazol kapsul 30 mg kapsul 303.00 0 0 0 0 500
01000145 Larutan Asering botol-500 ml 9,646.00 0 0 0 0
01000146 Larutan KA-EN 3A botol 11,500.00 0 0 0 0
01000147 Larutan KA-EN 3B botol 11,500.00 0 0 0 0
01000148 Levotiroksin / Euthyrox 100 mg tablet tablet 944.00 0 0 0 0
01000150 Levotiroksin 100 mcg tablet 771.00 0 0 0 0
01000152 Lidokain HCl Jely 20 mg/ml botol 41,600.00 0 0 0 0
01000153 Lidokain injeksi 2 % (HCl) ampul 1,221.00 0
Lidokain injeksi 2 % (HCl) ampul 847.00 30 30 0 30 60
01000154 Lidokain injeksi comp : lidokain 2 % HCl + epinefrin 1 : 80. ampul 1,229.00 0 0 0 0 60
01000155 Lidokain spray botol 177,216.00 0 0 0 0 5
01000156 Lisinopril 5 Mg tablet 145.00 0 0 0 0
01000157 Loperamid tablet 2 mg tablet 99.00 0 0 0 0
01000158 Lorazepam tablet 2 mg tablet 864.00 0 0 0 0
01000159 Magnesium sulfat injeksi 20 % ampul 3,580.00 0 0 0 0
01000161 Mecobalamin injeksi 500 mg ampul 8,213.33 0 0 0 0
01000162 Mecobalamin kapsul 500 mg kapsul 719.40 0 0 0 0
01000163 Meloxicam tablet 7,5 mg tablet 365.20 0 0 0 0
01000164 Metampiron tablet 500 mg Tablet 172.00 0 0 0 0
01000165 Metformin 850 mg tablet 262.00 0 0 0 0
Metformin tablet 500 mg tablet 102.00 4000 4000 2000 2000 2000
01000167 Metformin tablet 850 mg tablet 160.00 0 0 0 0
01000168 Metilergometrin injeksi 0,2 mg/ml ampul 2,959.00 0 0 0 0
Metilergometrin injeksi 0,2 mg/ml ampul 1,023.00 0 25 25 0 25
01000169 Metilergometrin maleat tablet 0,125 mg tablet 214.00 0 0 0 0
01000170 Metilprednisolon 16 mg tablet 551.00 300 300 100 200
01000172 Metoklopramid injeksi 5 mg/ml ampul 3,960.00 0 0 0 0
01000173 Metoklopramid sirup 5 mg/5 ml botol 2,580.00 0 0 0 0
01000174 Metoklopramid tablet 5 mg tablet 121.00 0 0 0 0
01000175 Metronidasol 500 mg/ml infus botol 9,950.00 0 0 0 0
01000176 Metronidasol infus 5 mg/ ml botol 8,110.00 0 0 0 0
01000177 Metronidasol kaptab 500 mg kaptab 198.00 0 0 0 0 500
01000178 Metronidasol tablet 250 mg tablet 89.00 0 0 0 0
01000179 Metronidazol sirup 125 mg/ 5 ml botol 3,950.00 0 0 0 0
01000180 Mikonazol krim tube 1,900.00 57 57 25 32
01000181 n-Asetil sistein tablet tablet 426.00 0 0 0 0
Natrium diklofenak 50 mg tablet tablet 99.00 3900 2000 5900 200 5700
01000183 Natrium Klorida Larutan Infus 0,9% steril botol-500 ml 6,800.00 0 20 20 0 20
01000184 Nifedipin tablet 10 mg tablet 112.00 2000 2000 100 1900
01000185 Nistatin 10.000 IU vaginal tablet tablet 560.00 0 0 0 0
01000186 Obat batuk hitam botol 5,520.00 0 0 0 0
01000187 Oksitetrasiklin 1 % salep mata tube 2,500.00 0 0 0 0 24 ED OKTOBER
01000188 Oksitosin injeksi 10 IU/ml ampul 1,199.00 160 160 0 160
01000189 omeprazol injeksi 40 mg/vial injeksi + pelarut ampul 36,000.00 0 0 0 0
Omeprazol kapsul 20 mg kapsul 129.00 600 400 1000 400 600 600
01000191 Ondansentron inj. 2 mg/ml ampul 1,124.00 0 0 0 0
01000192 Ondansentron inj. 4 mg/2ml ampul 1,124.00 0 0 0 0
01000193 Ondansentron tablet 4 mg tabllet 455.00 0 0 0 0
01000194 Parasetamol drop 100 mg/ml botol 6,649.00 0 0 0 0
Parasetamol sirup 120 mg / 5 ml botol 1,160.00 90 90 24 66 100
01000196 Parasetamol tablet 500 mg tablet 203.50 0 0 0 0 2000
Nasamol (Parasetamol 500 mg tab ) tablet 357.50 0 3000 3000 0 3000 2000
Permetrin krim 5 % (Scabimite) tube 6,325.00 0 10 10 10 0
01000198 Piracetam injeksi 1 gr ampul 5,197.50 0 0 0 0
01000199 Piracetam tablet 800 mg tablet 704.00 0 0 0 0
01000200 Pirantel pamoat suspensi 125 mg/ botol 9,510.00 0 0 0 0
01000201 Pirantel pamoat tablet tablet 289.00 0 0 0 0
01000202 Piridoksin (Vit B 6) tablet 10 mg (HCl) tablet 123.00 0 0 0 0 4000
Piroksikam tablet 20 mg tablet 225.00 0 200 200 100 100 2000
01000204 Polikresulen cairanan 50 mg/ml (APTIL) botol 17,393.00 0 0 0 0
01000205 Prednison tablet 5 mg tablet 73.00 1100 1100 600 500 1000
01000206 Primaquin tablet 15 mg (terima 50.000) tablet 224.00 0 0 0 0
01000207 Probenesid tablet 500 mg (Probenid) tablet 1,914.00 0 0 0 0 2000
01000208 Propanolol tablet 10 mg tablet 58.00 0 0 0 0 ED JULI
01000209 Propanolol tablet 40 mg tablet 74.00 0 0 0 0
01000210 Propiltiourasil tablet 100 mg tablet 385.00 0 0 0 0
01000211 Ranitidin injeksi 25 mg/ml ampul 1,188.00 0 0 0 0
01000212 Ranitidin tablet 150 mg tablet 108.00 2700 1000 3700 0 3700
01000214 Rifampisin 450mg tablet 0 0 0 0
01000215 Ringer laktat larutan botol 7,630.00 0 20 20 0 20
01000216 Risperidon 1 mg Tablet 102.00 0 0 0 0 1000
01000218 Salbutamol 2 mg tablet tablet 67.00 0 0 0 0 1000
01000219 Salbutamol 2,5 mg nebulizer (Ventolin) Pcs 10,379.60 0 0 0 0
01000220 Salbutamol 4 mg tablet tablet 63.00 500 500 0 500
01000221 Salbutamol aerosol 100 mcg - Salbulin botol 31,373.00 0 0 0 0
01000222 Salbutamol cairan inh. 0,1 % nebulles 6,600.00 0 0 0 0
Salep 2-4 Pot 1,410.00 15 15 5 10
01000224 Sefadroksil kaplet/kapsul 250 mg kaplet/kaps 690.00 0 0 0 0
01000225 Sefadroksil kapsul 500 mg kapsul 478.00 0 0 0 0
Sefadroksil kapsul 500 mg kapsul 803.00 0 1500 1500 300 1200
01000226 Sefadroksil sirup kering 125 mg/5 ml botol 4,485.00 0 0 0 0
01000228 Sefotaksim injeksi 1 gram vial 4,200.00 0 0 0 0
01000229 Sefotaksim injeksi 500 mg vial 3,188.00 0 0 0 0
01000230 Seftriakson injeksi 1.000 mg vial 4,708.00 0 0 0 0
01000231 Serum A.B.U. I (khusus ular dari luar Papua) inj (i.m./i.v.) ampul 512,204.00 0 0 0 0
01000232 Serum antitetanus (ATS) cairan injeksi 1.500 IU/ampul - B ampul 130,999.00 0 0 0 0
01000233 Setirizin sirup 5 mg/5 ml botol 2,915.00 20 20 15 5
01000234 Setirizin tablet 10 mg tablet 49.00 0 0 0 0 2000
01000235 Sianokobalamin injeksi 500 mcg/ml ampul 1,104.00 0 0 0 0
01000236 Simetidin tablet 200 mg tablet 341.00 0 0 0 0 1000
01000237 Simvastatin tablet 10 mg tablet 117.00 0 0 0 0
01000239 Siprofloksasin 500 mg tablet 281.00 0 0 0 0 1000
01000240 Sukralfat suspensi 500 mg/5 ml botol 6,789.00 0 0 0 0
01000241 Sukralfat tablet 500 mg tablet 296.00 0 0 0 0
01000242 Sulfadiazin perak krim 1 % tube 20,700.00 0 0 0 0
01000243 Tetagam ampul 146,800.00 0 0 0 0
01000244 Tetrasiklin kapsul 250 mg kapsul 163.00 0 0 0 0
01000246 Thiamfenikol kaplet 500 mg kaplet 726.00 0 0 0 0 500
01000247 Thiamin (Vit B1) tablet 50 mg (HCl/Nitrat) tablet 91.00 0 0 0 0 4000
01000248 Trifluoperasin tablet 5 mg tablet 220.00 0 0 0 0
01000249 Triheksifenidil tablet 2 mg tablet 91.00 1930 1500 3430 1020 2410 2000
01000250 Vaksin Anti Rabies vial 153,000.00 0 0 0 0
01000251 Vitamin B kompleks tablet tablet 83.00 0 0 0 0 2000
01000252 Zinc sirup 20 mg/5 ml botol 2,972.00 0 0 0 0 10
01000253 Zincpro sirup 10mg/ml botol 6,281.00 0 0 0 0 10
Zink sulfat dispersibel tablet 20 mg tablet 208.00 100 100 100 0 200
- - - - 0
- OBAT DAN BAHAN KEDOKTERAN GIGI - - 0
02000001 Alvogyl paste, tiap 100 g mengandung : 25.7 g butamben; 1Dus 495,500.00 0 0 0 0
02000002 Articulating papper Rol 154,500.00 0 0 0 0
02000003 Bahan tambalan sementara gigi siap pakai (cavit, willman botol 28 gram 46,200.00 0 0 0 0
02000004 Dentin conditioner Botol 141,600.00 0 0 0 0
02000005 Devitalisasi pasta (Non Arsen) botol/kotak 585,600.00 0 0 0 0
02000006 Etil klorida spray vial/100 ml 84,900.00 0 0 0 0
02000007 Eugenol cairan botol@10 ml 16,667.00 0 0 0 0
02000008 Fuji IX Dus 817,465.00 0 0 0 0
02000009 Fuji VII Dus 883,400.00 0 0 0 0
02000010 Glass ionomer cement ART (willman & pein) set/botol 423,500.00 0 0 0 0
02000011 Gutta percha dan papper point : 15 - 40 kotak/pasang 173,800.00 0 0 0 0
02000013 K- File 25 set 109,400.00 0 0 0 0
02000014 K- File 30 set 109,400.00 0 0 0 0
02000015 K-File No. 15 Set 109,400.00 0 0 0 0
02000016 K-File No. 20 Set 109,400.00 0 0 0 0
02000017 Kalsium hidroksida pasta kotak 2 tube 315,400.00 0 0 0 0
02000018 Klorfenol Kamfer Menthol (CHKM) botol 10 ml 103,000.00 0 0 0 0
02000019 Mata bur gigi type inverted No. 010 buah 25,800.00 0 0 0 0
02000020 Mata bur gigi type round No. 010 buah 25,800.00 0 0 0 0
02000021 Mata bur gigi type silinder No. 010 buah 25,800.00 0 0 0 0
02000022 Mata bur gigi type tuppered No. 010 buah 25,800.00 0 0 0 0
02000023 Mummifying pasta botol/kotak 534,200.00 0 0 0 0
02000024 Pasta pengisi saluran akar botol 277,200.00 0 0 0 0
02000025 Seluloid strip rol 160,900.00 0 0 0 0
02000026 Semen Seng Fosfat serbuk dan cairan set/botol 208,900.00 0 0 0 0
02000027 Spon gelatin cubicles 1 x 1 x 1 box-10 187,000.00 0 0 0 0
02000028 Temporary stoping fletcher serbuk+cairan botol @ 100 gram 34,000.00 0 0 0 0
02000029 Tooth mouse box 201,300.00 0 0 0 0
- - - 0
- OBAT TAMBAHAN / BRANDED - 0
03000001 Multifitamin : Bionicum C - 2,200.00 0 0 0 0
03000002 Multivitamin : Becefort tablet 1,265.00 0 0 0 0
03000003 Multivitamin dan mineral sirup (Biolysin Smart) botol 12,650.00 0 0 0 0 50
03000004 Multivitamin dan penambah nafsu makan sirup (Biolysin) botol 11,495.00 0 0 0 0 50
03000005 Multivitamin dan suplemen : Askorbic acid 150 mg, Niacinatablet 2,200.00 0 0 0 0
03000006 Multivitamin kaplet - (Caviplex) kaplet 605.00 0 0 0 0 2000
03000007 Multivitamin sirup Botol 10,670.00 0 0 0 0
03000008 Multivitamin sirup anak - ANAGEN botol 12,870.00 0 0 0 0 50
03000009 Multivitamin sirup anak. Komposisi : AA 60 mg, DHA 20 mg,botol 60 ml 8,299.50 0 0 0 0
03000010 Multivitamin suplemen ibu hamil - VITALEX kaplet 440.00 0 0 0 0 2000
03000011 Neurotropik injeksi - NEUROTROPIC vial 8,250.00 0 0 0 0
03000012 Neurotropik kaplet - CORSANEURON kaplet 759.00 0 0 0 0 2000
03000013 Neurotropik kaplet (Neucompli) kaplet 660.00 0 0 0 0
03000014 Neurotropik kaplet mengandung :Vit B1 100 mg + vit B6 2 tablet 682.00 0 0 0 0
03000015 Obat antidiare sirup : Kanina - 7,500.00 0 0 0 0 30
03000016 Obat antidiare sirup : Kaolin + Pektin / KANINA botol 8,250.00 0 0 0 0 30
03000017 Obat antiflu kombinasi sirup : succus liq 500 mg + CTM 0 botol 7,200.00 0 0 0 0 100
03000018 Obat antiflu kombinasi sirup (Betaflu) botol 9,500.00 0 0 0 0 100
03000019 Obat antiflu kombinasi tablet (Betaflu) tablet 297.00 0 0 0 0
03000020 Obat antiflu kombinasi tablet (HUSTAB) tablet 440.00 800 800 550 250
03000021 Obat Batidiare : Molagit tablet 450.00 0 0 0 0
03000022 Obat batuk (Dextrofen) botol 11,550.00 0 0 0 0
03000023 Obat Batuk dan Flu Samcodryl Syr Botol 8,910.00 0 0 0 0
03000024 Obat batuk hitam -Per 15 ml Succus liquiritae 500 mg, botol 6,199.60 0 0 0 0
03000025 Obat batuk hitam (Ikapharmin) botol 6,200.00 0 0 0 0 50
03000026 Obat batuk hitam AFI 100 ml botol 1,997.00 0 0 0 0 50
03000027 Obat batuk kombinasi sirup (Licodry) botol 8,800.00 0 0 0 0 50
03000028 Obat Batuk Sirup : Samkodryl botol 16,500.00 0 0 0 0
03000029 Obat batuk sirup (TDR) botol 5,566.00 0 0 0 0 100
03000030 Obat Flu : Wicold sirup botol 8,250.00 0 0 0 0 50
03000031 Obat Flu dan Batuk : Dextral tablet tab 782.00 750 750 0 750
03000032 Obat Sariawan - Triamkinolon 1 mg (Bufacomb) tube 18,150.00 0 0 0 0 20 ED OKTOBER
03000033 OBH 100 ml Ikafarmindo BTL 5,060.00 0 0 0 0 100
03000034 Scopma / Spasmolit tab 1,623.00 0 0 0 0
03000035 Suplemen zat besi sirup - Ferriz botol 33,000.00 63 63 10 53
03000036 Ambefaz 10 kapsul 1,349.70 0 0 0 0
03000037 Echinacea mpl 500 mg tablet 2,585.00 0 0 0 0
03000038 Ocugard kapsul 4,726.66 0 0 0 0
- - - 0
- PERBEKALAN KESEHATAN - 0
04000001 ADS 0.05 ml Pcs 1,550.00 0 0 0 0
04000002 ADS 0.5 ml pcs 1,190.00 0 0 0 0
04000003 ADS 5ml Pcs 1,582.00 0 0 0 0
04000004 Alat suntik sekali pakai 1 cc pcs 689.86 92 92 0 92
04000005 Alat suntik sekali pakai 10 cc buah 2,000.00 0 0 0 0
04000006 Alat suntik sekali pakai 2,5 cc (Stera) pcs 670.00 0 0 0 0
04000007 Alat suntik sekali pakai 3 cc buah 887.78 300 300 200 100 300
04000009 Alat suntik sekali pakai 5 cc ( Aximed) pcs 984.00 0 0 0 0
04000010 Alat suntik sekali pakai 5 cc (Stera) pcs 773.00 0 0 0 0
04000011 Arm sling (L, M dan S) buah 15,840.00 0 0 0 0
04000012 Blood Lancet 26 - 14,000.00 17 17 1 16
04000013 Blood Lancet 28 box @100 14,566.00 0 5 5 0 5
04000014 Blood lancet-Accucheck Safe T-Pro Box-200 127,050.00 0 0 0 0
04000015 Blood Transfusion set with inject 20 drops/ml (MAS) pieces 11,550.00 30 30 0 30
04000016 Catgut-chromic 2/0 100 M roll 959,304.00 0 0 0 0 24
04000017 Catgut-Chromic 2/0 75 C 30M R saset 51,627.73 0 0 0 0 24
04000018 Catgut-chromic 2/0 75 CM saset 29,750.00 0 0 0 0 24
04000021 Catgut-Chromic C. 3/0 75 C 22M R saset 44,240.21 0 0 0 0 24
04000022 Catgut-plain 1 70 CM saset 29,319.44 0 0 0 0
04000023 Catgut-plain 3/0 70 CM saset 24,583.33 0 0 0 0
04000024 Catgut-Plain C 1 70C 40M R saset 28,750.00 0 0 0 0
04000025 Catgut-Plain C 2/0 70C 25M R saset 26,666.67 0 0 0 0
04000027 Cathejell lidokain 2 % box 41,600.00 5 5 0 5
04000028 Cervical collar SR-N1 (Serenity) unit 114,000.00 4 4 0 4
04000029 Cuticell Classic 10cm x 40cm lembar 15,600.00 0 0 0 0
04000030 CUTICELL CUTICELL Oinment Dressing 7.5cm x 20cm lembar 12,830.00 0 0 0 0
04000031 Demetech slik 0 75C 36M R saset 21,250.00 0 0 0 0
04000032 Demetech slik 2/0 75C 30M C saset 15,000.00 0 0 0 0
04000033 Demetech slik 2/0 75C 30M R saset 20,833.33 0 0 0 0
04000036 Disposible blood tranfusion set with Y-injector 20 drops/mlpcs 11,550.00 0 0 0 0
04000037 EXAMINATION GLOVES M (MAS) Box 53,771.00 0 0 0 0
04000038 EXAMINATION GLOVES S (MAS) Box 53,772.00 0 0 0 0
04000039 Film IV dressing 6 x 7 S (E Care) box-100 pcs 220,000.00 0 0 0 0
04000040 Film IV dressing 7 x 8 P (E-care) box-100 300,000.00 0 0 0 0
04000041 Fixer untuk Film Rontgen Galon 20 liter 825,000.00 0 0 0 0
04000042 Folley catheter 2 way fr. 16 (Serenity) pcs 10,073.40 0 0 0 0 10
04000043 Folley catheter 2 way fr. 16 all silicone (Fesco) pcs 27,269.00 0 0 0 0 10
04000046 Folley catheter no 16 Aximed pcs 10,073.00 0 0 0 0
04000047 Folley catheter no. 16 (Aximed) pieces 11,000.00 0 0 0 0
04000048 Folley catheter no. 18 pieces 11,565.00 0 0 0 0
04000049 Folley catheter no. 18 ( Norta) pieces 12,100.00 0 0 0 0
04000051 Folley catheter no. 20 (Norta) pieces 12,860.00 0 0 0 0
04000052 Folley catheter no. 20 (Serenity) pieces 9,975.00 0 0 0 0
04000055 France advantime 3/0, 1/2 TP, pieces 2,486.00 0 0 0 0
04000056 France advantime 3/0, 3/8 XC, 24 mm, 70 cm - 2PTRA20 pieces 2,350.00 0 0 0 0
04000057 France Advantine 3/0, 1/2 kotak 84,601.00 0 0 0 0
04000058 France optime 2/0, 1/2 TP 26 mm, 75 cm - 2PTRO3OKE pieces 1,849.00 0 0 0 0
04000059 France optime 2/0, 3/8 RC 24 mm, 75 cm - 2PTRO3OJE pieces 2,235.00 0 0 0 0
04000060 France optime 3/0, 1/2 TP, 22 mm, 75 cm - 2PTRO20EE pieces 3,037.00 0 0 0 0
04000061 France optime 3/0, 3/8 RC, 19 mm, 75 cm - 2PTRO2OJE pieces 2,058.00 0 0 0 0
04000062 France optime 3/0, 3/8 RC, 24 mm, 75 cm - 2PTRO2OJE pcs 55,000.00 0 0 0 0
04000063 France peter silk 2/0, 1/2 TP 30 mm, 75 cm - 2PTR534OE pieces 902.78 0 0 0 0
04000064 France peter silk 2/0, 3/8 RC 25 mm, 75 cm - 2PTR5363E pieces 1,096.69 0 0 0 0
04000065 France peter silk 3/0, 1/2 TP 25 mm, 75 cm - 2PTR5266E pieces 1,148.92 0 0 0 0
04000066 France peter silk 3/0, 3/8 RC 25 mm, 75 cm - 2PTR529OE pieces 1,527.78 0 0 0 0
04000067 Hi Oxygen Mask Anak (NR Mask) Bh 24,640.00 5 5 0 5
04000068 Hi Oxygen Mask Dws (NR Mask) Bh 24,640.00 0 0 0 0
04000069 ID Patient adult - Biru pcs 850.00 0 0 0 0
04000070 ID Patient adult - Kuning pcs 850.00 0 0 0 0
04000071 ID Patient adult - Merah pcs 850.00 0 0 0 0
04000072 ID Patient adult - Pink pcs 850.00 0 0 0 0
04000073 ID Patient anak - Biru pcs 850.00 0 0 0 0
04000074 ID Patient anak - Kuning pcs 850.00 0 0 0 0
04000075 ID Patient anak - Merah pcs 850.00 0 0 0 0
04000076 ID Patient anak - Pnk pcs 850.00 0 0 0 0
04000077 Infus set anak set/kantong 3,850.00 0 0 0 0
04000078 Infus set dewasa (Polymed) pcs 6,798.00 0 0 0 0
04000079 Infus set dewasa (with Y injector) pcs 4,781.00 0 0 0 0
04000080 Infus set New (Kimsmed) pcs 5,950.00 0 0 0 0
04000081 Infuset dewasa - Nousmed Pcs 4,780.00 0 0 0 0
04000082 Infuset dewasa - Nousmed pcs 4,782.00 0 0 0 0
04000083 Infusi Set Anak - Aximed Pcs 5,100.00 5 5 0 5
04000084 IV CANNULA 18 Buah 10,494.00 0 0 0 0
04000085 IV CANNULA 20 Buah 10,494.00 0 0 0 0
04000086 IV CANNULA 22 Buah 10,494.00 0 0 0 0
04000087 IV CANNULA 24 Buah 10,494.00 0 0 0 0
04000088 IV cannula retension dressing ( Curafix) box 232,416.00 0 0 0 0
04000089 IV Cath Type 18 - Aximed Pcs 6,277.00 30 30 30 0 50
04000090 IV Cath Type 20 - Aximed Pcs 6,277.00 100 100 0 100
04000093 IV CATHETER 22 G (STERA) Buah 3,914.00 0 0 0 0
04000095 IV catheter No. 18 G Pices 7,700.00 0 0 0 0
04000097 IV catheter No. 20 G Polywin Pices 10,494.00 30 30 0 30
04000098 IV catheter No. 22 G Pieces 11,000.00 0 0 0 0
04000099 IV catheter No. 22 G Polywin pieces 11,330.00 0 0 0 0
04000101 IV catheter No. 24 G pieces 11,000.00 0 0 0 0
04000102 Jarum jahit kulit lusin 9,658.33 0 0 0 0
04000103 Jarum jahit otot lusin 9,658.33 0 0 0 0
04000104 Kapas bola mini 100 gram (Wellness) bungkus 15,200.00 0 0 0 0
04000105 Kapas dental 12 x 50 (Wellness) bungkus 34,400.00 0 0 0 0
04000106 Kapas pembalut hidrofil 250 gram bungkus 29,900.00 4 4 0 4
04000107 Kasa 10 cm x 10 cm pouch 9,430.80 0 0 0 0
04000108 Kasa Hidrofil DRC 2M x 80 CM Pad 9,400.00 0 0 0 0
04000109 Kasa Hidrofil DRC 36M x 80 CM Rol 136,500.00 0 0 0 0
Kasa Hidrofil 40y x 80 cm Rol 128,500.00 2 1 3 0 3 2
04000110 Kasa kompres 40/40 steril bungkus 1,805.00 0 0 0 0
04000111 Kasa pembalut hidrofil 4 m x 3 cm elastic rol 1,250.00 0 0 0 0
04000112 Kasa Pembalut Hidrofil 4M x 10CM Rol 2,300.00 0 0 0 0
04000115 Kasa Steril 16CM x 16CM Dos 7,050.00 39 39 3 36
04000116 Kertas EKG ( 50 x 30) rol 33,000.00 0 0 0 0
04000117 Lancing device pieces 17,416.00 0 0 0 0
04000118 Masker 3 Ply With Ear Loop Kotak 38,500.00 0 0 0 0
04000119 Masker 3 Ply With Tie On Kotak 38,500.00 0 0 0 0
04000120 Masker Earloop (Aximed) kotak 19,800.00 0 0 0 0
04000121 Masker Earloop (MAS) (=Terima 500 box) kotak-50 pcs 22,385.00 0 0 0 0
04000122 Masker earloop hijab (program) kotak 15,700.00 0 0 0 0
04000123 Masker Hijab ( Axell) Box 27,500.00 0 0 0 0
04000124 Masker hijab nousmed box 41,349.00 0 0 0 0
04000125 Masker N95 box 130,240.00 0 0 0 0
04000126 Masker N95 (Program) pcs 21,736.00 0 0 0 0
04000127 Masker nebulizer set dewasa set 22,000.00 0 0 0 0
04000128 Masker Tie On (MAS) (=Terima 500 box) kotak-50 pcs 36,300.00 0 0 0 0
04000129 Microscop cover glass kotak 125,743.94 0 0 0 0
04000130 Muccus extractor (Onemed) pcs 7,040.00 0 0 0 0
04000131 Nasal Oksigen bayi buah 4,944.00 0 0 0 0
04000132 Nasal Oxygen Size L Pcs 6,600.00 0 0 0 0
04000133 Nasal Oxygen Size M - Aximed Pcs 6,600.00 0 0 0 0
04000134 Nasal Oxygen Size S - Aximed Pcs 6,600.00 10 10 0 10
04000135 Nasal Oxygen Size XS - Aximed Pcs 6,600.00 0 0 0 0
04000136 Nassal oxygen canulla anak set 10,000.00 0 0 0 0
04000137 Nassal oxygen canulla bayi set 6,600.00 0 0 0 0
04000138 Nassal oxygen canulla dewasa set 10,000.00 0 0 0 0
04000139 Nebulizer aerosol with mask (adult) - Remedi pcs 10,340.00 10 10 0 10
04000140 Nebulizer aerosol with mask (child) - Remedi pcs 10,340.00 3 3 0 3
04000141 Nebulizer with mask (adult) - Stardec pcs 28,300.00 0 0 0 0
04000142 Nebulizer with mask (pediatric) - Stardec pcs 28,300.00 0 0 0 0
04000143 Non woven fixation 20 x 10 cm - Aximed dos 127,000.00 2 2 0 2
04000144 Non woven fixation 5 x 10 cm - Aximed dos 43,850.00 0 0 0 0 5
04000145 Object glass kotak 21,747.00 2 2 0 2
04000146 Oxygen mask-dewasa (serenity) pcs 9,500.00 0 0 0 0
04000147 Oxygen mask-stardec (adult) pcs 19,800.00 0 0 0 0
04000148 Oxygen mask-stardec (pediatric) pcs 19,800.00 0 0 0 0
04000149 Oxygen nasal dewasa (Serenity) pcs 4,800.00 0 0 0 0
04000150 Pembalut elastis 7,5 cm x 4,5 M (Uniflex) roll 20,300.00 0 0 0 0
04000151 Pembalut Siku / Mittela kain Bh 16,665.00 0 0 0 0
04000152 Penutup luka dengan antibiotil (Bioplacenton) pieces 10,400.00 4 4 0 4
04000153 Penutup luka dengan antibiotil (Cuticell) pieces 5,198.00 0 0 0 0
04000154 Peter silk 2/0 -3/8 kotak 80,465.00 0 0 0 0
04000155 Pharmafix 10 cm x 500 cm rol 51,305.00 0 0 0 0
04000157 Pharmafix 5 cm x 500 cm box 16,500.00 0 0 0 0
04000158 Plester 2,5 cm x 4,5 M (Leukoplast) roll 12,675.00 7 7 0 7
04000159 Plester Dermafit 10 x 15 roll 8,316.00 0 0 0 0
04000160 Plester elastis 10 Cm x 500 cm (Fixomull) rol 70,903.00 0 0 0 0
04000162 Pot sputum buah 2,728.00 200 200 0 200
04000163 Pot urin buah 2,331.00 0 0 0 0 200
04000164 Safety Box 5 Ltr Kuning Dus 14,500.00 8 10 18 0 18
04000165 Sampel container pot 1,695.00 80 80 0 80
04000166 Sarung tangan 6.5 remedi pasang 17,400.00 0 0 0 0
04000167 Sarung tangan 7 remedi pasang 17,400.00 0 0 0 0
04000169 Sarung tangan Fowder Smooth S (golden) box 148,500.00 0 0 0 0
04000170 Sarung tangan Fowder Smooth M (golden) pcs 1,485.00 0 0 0 0
04000171 Sarung tangan gynaecolog Steril - 6,5 Psg 17,400.00 0 0 0 0 100
04000172 Sarung tangan gynaecolog Steril - 7 Psg 17,400.00 0 0 0 0 100
04000173 Sarung tangan gynaecolog Steril - M (Troge) Psg 40,733.00 0 0 0 0 100
04000174 Sarung tangan gynaecolog Steril - S (Troge) Psg 40,733.00 0 0 0 0 100
04000175 Sarung tangan M (saveguard) box 49,610.00 0 0 0 0
04000176 Sarung tangan Nitrile M - Superlife box 57,200.00 0 0 0 0
04000177 Sarung tangan Nitrile S - Superlife box 57,200.00 0 0 0 0
04000178 Sarung tangan obsgyn pasang 19,360.00 0 0 0 0 100
04000179 Sarung tangan Troge sensosurge - plus No 6,5 ( Steril ) pcs 13,178.00 25 25 0 25
04000180 Sarung tangan Troge sensosurge - plus No 7 ( Steril ) pcs 8,635.00 60 60 0 60
04000181 Scalpel blades (bisturi - Aesculap BBraun) box 300,000.00 0 0 0 0
04000182 Silk ( benang bedah sutra No. 3/0 dg jarum ) pcs 15,990.00 0 0 0 0
04000183 Spalk First Aid (Onemed) Bh 109,670.00 0 0 0 0
04000184 Suction catheter No.6 (Aximed) pcs 7,370.00 0 0 0 0
04000185 Surgical Face Mask - Tie On/hijab kotak 27,500.00 0 0 0 0
04000186 Surgical gloves steril 6,5 pcs 3,630.00 0 0 0 0
04000187 Surgical gloves steril 7 - MAS pair 7,865.00 0 0 0 0
04000188 Surgical gloves steril 7,5 - MAS pcs 7,865.00 0 0 0 0
04000189 Surgical gloves steril 8 pcs 6,270.00 0 0 0 0
04000190 Surgical slik 3/0 sachet 15,000.00 0 0 0 0
04000191 Tips for micropipet MT - 1 - 200 uL pak 180,971.00 0 0 0 0
04000192 Tips for micropipet MT - 11 - 1 ml pak 233,913.00 0 0 0 0
04000193 Tube EDTA 17 x 75 box 100,500.00 0 0 0 0
04000194 Tube Steril EDTA K-3 (3 ml) box 103,000.00 0 0 0 0
04000195 Umbilical cord klem (Onemed) pcs 1,300.00 50 50 0 50
04000196 Underpad (Cosmomed) buah 7,900.00 0 0 0 0
04000197 Underpad premium 60 x 90 cm pcs 6,000.00 0 0 0 0
Underpad premium 60 x 90 cm pcs 3,850.00 0 0 0 0 50
04000198 Urin bag pcs 5,700.00 0 0 0 0 5
04000199 Urine Bag steril with hanger Pcs 8,000.00 0 0 0 0
04000200 Vaginal Speculum M pcs 4,000.00 0 0 0 0
04000201 Vaginal Speculum S pcs 4,000.00 0 0 0 0
- - - 0
- REAGEN - 0
05000001 Aquabidest steril botol 1000 ml 9,900.00 0 0 0 0
05000002 Contour Plus Gula darah strip 4,392.00 0 0 0 0
05000003 Hb Sahli - Onemed set 88,000.00 0 0 0 0
05000004 Hbsag ( Monotes) tes 7,000.00 0 0 0 0
05000005 Hbsag ( Nova test) tes 6,000.00 0 0 0 0
05000006 Hbsag ( Vikocheck ) tes 9,850.00 50 50 0 50 100
05000007 HBsAg (Fokus) - 10,836.00 0 0 0 0
05000008 Hemolyzer - 3 cleaner botol 1,650,000.00 0 0 0 0
05000009 Hemolyzer - 3 control normal 1 kit 770,000.00 0 0 0 0
05000010 Hemolyzer - 3 diluent botol 20 ml 2,420,000.00 0 0 0 0
05000011 Hemolyzer - 3 hypocleaner botol 100 ml 2,090,000.00 0 0 0 0
05000012 Hemolyzer - 3 Lyser botol 1 L 2,750,000.00 0 0 0 0
05000013 HEP.B(PID) vial 20,900.00 0 0 0 0
05000014 HIV (Fokus) tes 13,235.00 0 0 0 0
05000015 HIV Fokus tes 14,470.00 0 0 0 0
05000016 HIV Monotes box 345,000.00 0 0 0 0
05000017 HIV Vikia tes 19,480.00 0 0 0 0
05000018 HIV Viro Check box @25 288,636.00 0 0 0 0 4
05000019 Kertas lakmus box 53,494.10 0 0 0 0
05000020 Larutan Asam Asetat 6% Botol 100 ml 64,400.00 0 0 0 0
05000021 Larutan Asam Klorida 0,1 N btl 100 ml 25,800.00 0 0 0 0
05000022 Larutan EDTA 10 % botol 74,100.00 0 0 0 0
05000023 Larutan Eosin 2 % botol 176,225.00 0 0 0 0
05000024 Larutan Giemsa botol 356,250.00 0 0 0 0
05000025 Larutan Karbol Fuksin Botol 100 ml 48,400.00 0 0 0 0
05000026 Larutan Metilen Blue Botol 100 ml 20,680.00 0 0 0 0
05000027 Larutan Na Sitrat 3.13 % botol 19,475.00 0 0 0 0
05000028 Larutan TURK botol 47,157.41 0 0 0 0
05000029 Larutan Ziehl Neelsen set-5 btl 218,000.00 0 0 0 0
05000030 Oil emersi botol 100 ml 707,900.00 0 0 0 0
05000031 Pemeriksaan Rapid Gluco Nesco tes 85,800.00 0 0 0 0
05000032 Rapid 1 HIV 1/2 3.0 (SD Bioline) tes 11,975.00 0 0 0 0
05000033 Rapid Diagnostic Test Dengue IgG/IgM tes 40,000.00 25 25 0 25
05000034 Rapid Diagnostic Test Malaria tes 4,830.00 0 0 0 0
05000035 Rapid HIV I & II Antibody Test. Senitivitas 100%, spesifisi tes 47,300.00 0 0 0 0
05000036 Rapid tes 3 Hiv (one step) tes 13,437.00 0 0 0 0
05000037 Rapid Tes Narkoba : Babiturat (Fokus) tes 7,282.00 0 0 0 0
05000038 Rapid Tes Narkoba : Benzodiasepin (Fokus) tes 7,282.00 0 0 0 0
05000039 Rapid Tes Narkoba : marijuana- THC (Fokus) tes 7,282.00 0 0 0 0
05000040 Rapid Tes Narkoba : Morphin (Fokus) tes 7,282.00 0 0 0 0
05000041 Rapid Tes Narkoba :Amphetamin (Fokus) tes 7,282.00 0 0 0 0
05000042 Rapid Tes Narkoba Multi parameter : Monotes box 1,850,000.00 0 0 0 0
05000043 Rapid test GDS Contourplus - 219,600.00 0 0 0 0
05000044 Rapid test HbSAg (Bioline) tes 10,547.00 0 0 0 0
05000045 Rapid test Kolesterol Easy Touch box 180,200.00 0 0 0 0
05000046 Rapid Test Leptospirosis tes 20,100.00 0 0 0 0
05000047 Rapid Test untuk pemeriksaan Asam Urat : Benecheck tes 5,060.00 0 0 0 0
05000048 Rapid Test untuk pemeriksaan Asam Urat : Nesco tes 4,120.00 0 0 0 0
05000049 Rapid Test untuk pemeriksaan Asam Urat : UA Sure tes 11,844.00 0 0 0 0
05000050 Rapid test untuk pemeriksaan Gula Darah : Accucheck tes 4,200.00 0 0 0 0
05000051 Rapid test untuk pemeriksaan Gula Darah : Accutrand tes 9,328.00 0 0 0 0
05000052 Rapid test untuk pemeriksaan Gula Darah : Benecheck) tes 2,992.00 50 50 50 0 500
05000053 Rapid test untuk pemeriksaan Gula Darah : GE box 247,500.00 0 0 0 0 10
05000054 Rapid test untuk pemeriksaan Gula Darah : Gluco Dr (type tes 8,187.52 0 0 0 0
05000055 Rapid test untuk pemeriksaan Kolesterol : Nesco tes 16,720.00 0 0 0 0 10
05000056 Rapid test untuk pemeriksaan Kolesterol : Accutrand tes 15,928.00 0 0 0 0 10
05000057 Rapid test untuk pemeriksaan Kolesterol : Benecheck box-10 250,000.00 10 10 0 10
05000058 Rapid test untuk pemeriksaan Kolesterol : Easy touch kotak/10 198,000.00 0 0 0 0 10
05000059 Rapid test untuk pemeriksaan Trigliserida : Accutrand tes 18,568.00 0 0 0 0
05000060 Rapid Test untuk pemeriksaan Trigliserida : Multicare tes 28,316.00 0 0 0 0
05000061 Reagen fotometer : reagen asam urat botol @ 100 ml 467,665.00 0 0 0 0 1
05000062 Reagen fotometer : Reagen glukosa botol @ 100 ml 222,392.50 0 0 0 0 1
05000063 Reagen fotometer : Reagen kolesterol botol @ 100 ml 523,325.00 0 0 0 0 1
05000064 Reagen fotometer : Reagen trigliserida botol @ 100 ml 755,452.50 0 0 0 0 1
05000065 Reagen pemeriksaan yodium botol 5,275.00 0 0 0 0
05000066 Reagen pengujian pangan : boraks tes 19,800.00 0 0 0 0
05000067 Reagen pengujian pangan : formalin tes 22,000.00 0 0 0 0
05000068 Reagen pengujian pangan : rhodamin b tes 22,000.00 0 0 0 0
05000069 Reagen Siphylis Monotes tes 16,000.00 0 0 0 0
05000070 Reagen Syphilis RPR Antingen box 2,040,000.00 0 0 0 0
05000071 Siphilis Trypo Check tes 9,000.00 0 0 0 0 100
05000072 Strip gula contour plus kotak/50 221,266.00 0 0 0 0
05000073 Syphilis AB tes 20,400.00 0 0 0 0
05000074 Tes Golongan darah : Anti A Monoclonal btl 10 ml 68,200.00 0 0 0 0
05000075 Tes golongan darah : Anti AB monoclonal botol 10 ml 45,000.00 0 0 0 0
05000076 Tes golongan darah : Anti B monoclonal botol 10 ml 45,000.00 0 0 0 0
05000077 Tes kehamilan - Ulltra One tes 1,900.00 0 0 0 0
05000078 Tes Mantoux (PPD test) ampul-1,5 ml 625,800.00 0 0 0 0
05000079 Tes Widal Salmonella Typhi H vial-5 ml 66,660.00 0 0 0 0
05000080 Tes Widal Salmonella Typhi O vial-5 ml 66,660.00 0 0 0 0
05000081 Urin tes strip (U11 plus) kotak 317,750.00 0 0 0 0
05000082 Urinalysys 10 SG insight 100 tes botol 220,000.00 0 0 0 0
- - - 0
- BAHAN MEDIS HABIS PAKAI - 0
06000001 Alcohol swab, 2 ply box-100 pcs 11,604.00 14 14 4.00 10 20
06000002 Alkacid 1 Liter botol 3,217,500.00 0 0 0 0
06000003 Alkohol 70% Btl-1000 ml 27,373.00 0 0 0
06000004 Alkohol 70% Btl-100 ml 7,579.00 5 5 0 5
06000005 Alkohol swab ( E-care) box 31,031.00 0 0 0 0
06000006 Antimicrobial - Viorex No Rinse botol 500 ml 65,340.00 10 10 0 10
06000007 Aseptin liquid (aseptan) botol 30,000.00 0 0 0 0
06000008 Autoclick set 19,158.00 0 0 0 0
06000009 Bahan sterilisasi instrumen-Alkazyme sachet 25 mg pack 801,000.00 0 0 0 0
06000010 Bahan sterilisasi instrumen-Stericlin flat 15 cm / 200 m roll 1,266,000.00 0 0 0 0
06000012 Bahan sterilisasi-Stericide 3 galon 1,098,900.00 0 0 0 0
06000013 Bahan sterilisasi-Sterizyme galon 712,800.00 1 1 0 1
06000014 Desinfectant concentrate (Cetride) galon 752,400.00 0 0 0 0
06000015 Desinfectant surface - 500 ml ( Stericide) botol 87,120.00 0 0 0 0
06000016 Etakridin (rivanol) larutan botol 3,000.00 0 0 0 0
06000017 Jelly 82 gr - Ecolab Aquagel Sterile tube 43,388.00 0 0 0 0
06000018 Jelly-My Jelly 82 Gr Tube 29,550.00 5 5 2 3 5
06000019 Kotak slide kotak 57,100.00 0 0 0 0
06000020 Lisol, mengandung kresol tersabun 50% botol 1000 ml 40,700.00 0 0 0 0 3 ED
06000021 LUGOL botol 0 0 0 0
06000022 Povidon iodida 10 % - 60 ml botol 4,510.00 0 0 0 0
06000023 Povidone iodine 10% 30 ml Btl 3,200.00 11 11 2 9
06000025 Povidone iodine 10% 60 (Stardine Sol) Btl 15,750.00 0 0 0 0
06000026 Stericide 5 liter galon 752,400.00 0 0 0 0
06000027 Surgical hand scrubs (E-care) botol 75,480.00 0 0 0 0
- - -
- TAMBAHAN PERBEKALAN KESEHATAN -
07000001 Accu Chek Performa test set 420,000.00 0 0 0 0
07000002 Benecheck Monitoring system 3 in 1 set 182,600.00 0 0 0 0
07000003 Blood Glucose Monitoring system ( Contour plus) set 0 0 0 0
07000004 Catridge Genexpert (TCM) buah 258,172.00 0 0 0 0
07000005 Catridge GeneXpert (TCM) tes 190,741.37 0 0 0 0
07000006 Kantung jenazah buah 250,000.00 0 0 0 0
07000007 Micropipete Acura 825 - volume 1 - 10 uL set 3,372,600.00 0 0 0 0
07000010 Tabung hematokrit tube/100 182,930.00 0 0 0 0
07000011 Termometer klinis (GP Care) pcs 11,500.00 0 0 0 0
- - -
- OBAT PROGRAM -
- OBAT PROGRAM MALARIA (P2M) - 0 0 0 0
08000001 Artesunat inj 60 mg vial 33,792.00 0 0 0 0
08000002 Dehidroartemisin 40 mg + Piperaquin (DHP) tabLet 2,134.00 0 0 0 0
08000003 Primaquin tablet 15 mg tablet 205.00 0 0 0 0
- - -
- PROGRAM DIARE -
09000001 Garam oralit serbuk kombinasi saset 3,661.00 0 0 0 0
09000002 Zink dispersible tablet 20 mg tablet 524.00 0 0 0 0
- - -
- PROGRAM KIA/ GIZI -
10000001 Mineral Mix saset 3,116.00 0 0 0 0
10000002 Retinol (Vitamin A) 100.000 IU kapsul lunak kapsul 306.00 18 18 0 18 Ed Mei
10000003 Retinol (Vitamin A) 200.000 IU kapsul lunak kapsul 552.00 116 116 22 94
10000004 Tablet tambah darah kombinasi : Besi II Sulfat 200 mg + A tablet 50.00 0 0 0 0
- TTD (Fero fumarat)/ Dinkesprop tablet 226.00 1200 2000 3200 1200 2000 3300
- OBAT ANTI TUBERKULOSIS -
11000001 Obat FDC kategori 1 paket 415,467.00 0 0 0 0
11000002 Obat FDC kategori 2 paket 1,384,983.00 0 0 0 0
11000003 OAT FDC Anak paket 248,120.00 0 0 0 0
11000004 OAT Kombipak 1 paket 288,199.00 0 0 0 0
11000005 FDC Sisipan paket 160,000.00 0 0 0 0
- - - 0
- OBAT PROGRAM KEBIDANAN - 0
12000001 Fenobarbital injeksi i.m./i.v. 50 mg/ml ampul 1,800.00 0 0 0 0
12000003 Kalsium glukonat inj. i.v. 100% ampul 9,955.00 0 0 0 0
- - - 0
- OBAT PROGRAM KUSTA - 0
13000001 Obat MDT Kusta MB Dewasa blister 28,424.00 0 0 0 0
13000002 Obat MDT Kusta PB Dewasa blister 8,891.00 0 0 0 0
13000003 Sandoz PB listerpack anak blister 8,750.00 0 0 0 0
- - - 0
- OBAT PROGRAM HIV / AIDS - 0
14000001 Edurant (rilpivirine 25 mg) tablet 3,127.00 0 0 0 0
14000002 Efavirenz 600 mg tablet 6,630.00 0 0 0 0
14000003 FDC Triple (Tenovofir 300 mg + Lamivudin 300 mg + Efavir tablet 2,802.00 0 0 0 0
14000004 Lamivudin 150 mg tablet tablet 3,404.00 0 0 0 0
14000005 Lopinovir 200 mg+ritanovir 50 mg (Aluvia) tablet 6,600.00 0 0 0 0
14000006 Nevirapin 200 mg tablet 3,058.00 0 0 0 0
14000007 Tenofovir (TDF) 300 mg tablet 8,424.00 0 0 0 0
14000008 Tenofovir + Lamivudin + Evafirens (Dws Fdc Triple) tablet 3,058.00 0 0 0 0
14000009 Zidovudin + lamivudin (300 mg/150 mg tablet 3,848.00 0 0 0 0
14000010 Zidovudin 100 mg tabLet 1,768.00 0 0 0 0
14000011 Zidovudin+lamivudin+niverapin (Pediatric FDC Triple) tablet 741.00 0 0 0 0
14000012 Kondom Sutra (P2PL) ktk/144pcs 51,552.00 0 0 0 0
- OBAT SIFILIS - 0 0 0 0
15000001 Benzatin bensil penisilin vial 14,500.00 0 0 0 0
- - - 0
- VAKSIN/IMUNISASI - 0
16000001 Vaksin BCG vial 59,950.00 0 0 0 0
16000002 VAKSIN DPT HB Hib vial 76,285.00 0 0 0 0
16000003 VAKSIN POLIO bOPV vial 19,954.00 0 0 0 0
16000004 VAKSIN IPV vial 153,736.00 0 0 0 0
16000005 VAKSIN CAMPAK vial 28,205.00 0 0 0 0
16000006 VAKSIN MR vial 149,820.00 0 0 0 0
16000007 VAKSIN HEPATITIS B vial 55,539.00 0 0 0 0
16000008 VAKSIN TT vial 14,498.00 0 0 0 0
16000009 VAKSIN Td vial 16,500.00 0 0 0 0
16000010 VAKSIN DT vial 17,798.00 0 0 0 0
HBIG (Hiperheb-B) vial 1,325,000.00 0 0 0 0
Reagen Syphilis (SD Biosensor Standar Q Syphilis) tes 20,400.00 0 0 0 0
Hemocue Hb 201 Microcuvettes botol 1,824,680.33 0 0 0 0
V00003 MASKER EARLOOP HIJAB (PROGRAM) kotak 19,305.00 0 0 0 0 5
Garam Oralit serbuk (program diare) sachet 257.00 0 0 0 0
Masker bedah 3 Ply Earloop Program (S+UPAMED) bok 19,305.00 0 0 0 0
Rapid Tes 2 HIV ( Merk KHB ) tes 12,500.00 0 0 0 0
Rapid Tes 3 HIV (Diagnostar) tes 13,363.00 0 0 0 0
Doxyciclin 100 mg ( Prop )/ program malaria tablet 253.00 0 0 0 0
SPALK FRAKTUR 90CM PCS 38,000.00 0 0 0 0
FDC KATEGORI 1 & 3 DOSIS HARIAN PAKET 409,461.00 0 0 0 0
Sarung Tangan Latex Examination Gloves M box 137,500.00 0 0 0 0 5
Sarung Tangan Latex Examination Gloves S box 137,500.00 0 0 0 0 5
MASKER EARLOOP (MAS) box 25,000.00 0 0 0 0 5
MASKER EAELOOP HIJAB (IMASKE) box 25,000.00 0 0 0 0 5
Sarung Tangan Protos S box 115,500.00 15 15 5 10 10
Sarung Tangan Protos M box 115,500.00 5 10 15 5 10 10
Masker Earloop Soujella box 36,200.00 10 10 20 20 0 10
Masker hijab nousmed box 41,349.00 5 10 15 0 15 10
Rapid 1 HIV (SD Bioline) Pengadaan box 339,668.00 2 2 0 2
JUMLAH KUNJUNNGAN RESEP UMUM / BAYAR BPJS LAIN-2 JUMLAH
Purworejo, 17 Januari 2022

Mengetahui Yang meminta Yang menerima
Kepala Dinas Kesehatan Kepala Sub Koordinator Sarana Prasarana Kesehatan Kepala Puskesmas Seborokrapyak Petugas Puskesmas Seborokrapyak
Kabupaten Purworejo
Dr. SUDARMI, MM Sigit Heru Waluyo, SKM drg. Maharani Mantusiana Sonia Sahara, S.Farm., Apt
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 2006 04 2 001 NIP. 19920125 201903 2 014
LAPORAN PEMBELIAN SENDIRI DAN PEMAIAKAIN OBAT PUSKESMAS

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : NOVEMBER 2021 INST. FARMASI
KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : DESEMBER 2021 PUSKESMAS 445/1220/I/2022 3-Jan-22
SATUAN HARGA STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN PEMBELIAN JUMLAH KET
No. NAMA OBAT KEMASAN SATUAN AWAL MAAN DIAAN KAIAN STOK OPTIMUM TAAN APBD DAK PRO- APBD LAIN-2 SENDIRI
KAB GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
0000001 Altamed Gloves Size S Box 135,000.00 0 0 0 0

0000002 Ambroksol 30 mg Tablet 225.5 0 0 0 0
0000003 Antasida DOEN Tablet Tablet 99.0 0 0 0 0 JULI
0000004 Asam Mefenamat 500 mg Tablet 192.00 0 0 0 0
0000005 Betahistin Mesylate Tablet 733.33 0 0 0 0 APRIL
0000006 Cat Gut Chromic 2/0 GEA Buah 8,250.00 12 12 0 12 FEB
0000007 Ethyl Cloride Spray Kaleng 150,000.0 1 1 0 1 FEB
0000008 Klorpromazin 100 mg Tablet 250.00 0 0 0 0 MAR
0000009 Lodomer 2 mg Tablet 90.00 0 0 0 0
0000010 Nasal Canul Adult N3 Buah 4,400.00 10 10 5 5
0000011 Paracetamol 500 mg Tablet 132.00 0 0 0 0
0000013 Siprofloxacin 500 mg Tablet 222.00 0 0 0 0
0000014 Guaifenesin 100 mg Tablet 115.87 7000 7000 1000 6000 Nov
0000015 Vitamin B6 10 mg Tablet 158.55 0 0 0 0
0000016 Siprofloxacin 500 mg Tablet 847.00 300 300 0 300 JULI
Purworejo, 3 Januari 2021

Mengetahui Yang meminta
Kepala Dinas Kesehatan Kepala Seksi Farmamin dan Perbekes Kepala Puskesmas Seborokrapyak Petugas Puskesmas Farmasi Seborokrapyak
Kabupaten Purworejo
dr. SUDARMI, MM Drs. Nanang Wijayanto, Apt. drg. Maharani Mantusiana Sonia Sahara, S.Farm., Apt
NIP. 19690220 200212 2004 NIP. 19680601 199312 1 002 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN BMHP DAN VAKSIN COVID 19 PUSKESMAS

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : OKTOBER 2021 INST. FARMASI
KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : NOVEMBER 2021 PUSKESMAS 445/1088/XI/2021 1-Nov-21
HARGA STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAN PEMBELIANJUMLAH
NO OBAT SATUAN KET
SATUAN AWAL MAAN DIAAN KAIAN STOK OPTIMUM TAAN APBD DAK PRO- APBD LAIN-2 SENDIRI
DROPING KAB GRAM PROV
APD SET 3 item (baju hazmad, kaca mata google, medical
1 cap) set 300,000.00
mulya sejahtera 0 0
2 Masker bedah Mulya Sejahtera kotak 275,000.00 0 0
APD 4 set (baju hazmad, kaca mata google, medical cap,
3 set 490,000.00
masker N95) Mulya Sejahtera 0 0
4 Masker bedah Erlang kotak 291,500.00 0 0
5 coverall Erlang pcs 181,500.00 0 0
6 Hand Sanitizer Azzahra botol-500ml 150,000.00 0 0
7 Masker KN 95 Rajawali pcs 95,000.00 0 0
8 Alkohol 70% Kimia Farma 1000 ml 37,638.00 0 0
9 Sarung Tangan Tugu Andalan box-100 99,000.00 0 0
10 Sepatu boot Azzahra psg 150,000.00 0 0
11 Pritavit (Dwi Mustika) tablet 1,100.00 0 0
12 Gown Boogie pcs 112,500.00 0 0
13 Selkom-C sapta Sari Tama kotak 95,000.00 0 0
14 Selkom-C sapta Sari Tama tablet 950.00 0 0
15 Masker GP-Care Tugu Andalan box 100,000.00 0 0
16 Masker GP-Care Tugu Andalan PCS 2,000.00 0 0
17 Masker Enseval box 80,000.00 0 0
18 Masker Enseval pcs 1,600.00 0 0
19 Kantong Jenazah restu mulya pcs 203,500.00 0 0
20 Sarung Tangan Exam MMP box 80,000.00 0 0
21 Lisol Intisumber Hasil Sempurna botol 40,700.00 0 0
22 MASKER RESTU MULIA (P2PL) BOX 85,000.00 0 0
23 MASKER RESTU MULIA (P2PL) PCS 1,700.00 0 0
24 GOWN (SARANA MEDIKA) Pcs 115,500.00 0 0
25 APD (Sejahtera bersama) P2 pcs 99,000.00 0 0
26 N95 (SARANA MEDIKA SEJAHTERA) P2 PCS 44,000.00 0 0
27 Sarung Tangan Exam Golden M (Anugrah Bintang Meditama box 166,365.00 0 0
28 Masker N95 (Anugrah Bintang Meditama) pcs 27,500.00 0 0
29 Masker N95 Kemenkes pcs 104,500.00 0 0
30 Sarung tangan steril Kemenkes psg 5,500.00 0 0
31 Kaca Mata Google Kemenkes pcs 99,000.00 0 0
32 APD Kemenkes pcs 181,500.00 0 0
33 APD Kaltech/Toho DINKESPROP pcs 181,500.00 0 0
34 APD BPBD pcs 181,500.00 0 0
35 APD BLK pcs 181,500.00 0 0
36 APD PICCI pcs 181,500.00 0 0
37 Masker bedah Kemenkes RI kotak 275,000.00 0 0
38 Masker bedah Kemenkes RI psc 5,500.00 0 0
39 Gown BPBD pcs 134,750.00 0 0
40 Masker BPBD pcs 5,500.00 0 0
41 Tutup Kepala BPBD pcs 2,000.00 0 0
42 Sarung tangan BPBD kotak 99,000.00 0 0
43 MASKER SOLIDA Box 275,000.00 0 0
44 OSELTAMIVIR 75MG Propinsi KAPSUL 8,943.00 0 0
45 Azitromicin 500mg Propinsi (kotak@20 tablet) tablet 1,888.00 60 0 60 0 60
46 Azitromicin 500mg Propinsi (kotak@3 tablet) tablet 42,000.00 0 0
47 Kloroquin 150mg Propinsi tablet 850.00 0 0
48 Vitamin C 250 mg Propinsi tablet 124.00 0 0
49 Vitamin C 500 mg Propinsi tablet 198.00 200 200 400 200 200
50 Parasetamol 500mg tablet 131.00 0 0
51 APD Dinkes Prop pcs 181,500.00 0 0
52 HAND SANITIZER 1L (PROPINSI) BOTOL 150,000.00 0 0
53 HAND SANITIZER 4L (PROPINSI) GALON 185,000.00 0 0
54 HAZMAT STERIL (DINKES PROPINSI) PCS 181,500.00 0 0
55 MASKER ERARLOOP (BPBD) BOX 275,000.00 0 0
56 hand SANITIZER 5 L (DINKES PROP) galon 185,000.00 0 0
57 Face Shield Dinkes Prop buah 35,200.00 0 0
58 Alkohol 20L Dinkes Prop Galon 300,000.00 0 0
59 Masker N95 DINKES PROP pcs 104,500.00 0 0
60 Remdesivir inj 100mg vial 314,400.00 0 0
61 Favipiravir 200mg tablet 18,260.00 0 0
62 Masker Bedah Dinkes Prop pcs 5,500.00 0 0
63 Sarung Tangan Non-Steril dinkes Prop pcs 990.00 0 0
64 Sarung Tangan non-Steril Kemenkes kotak-100 99,000.00 0 0
65 Sarung Tangan non steril S PCS 990.00 0 0
66 VTM COVID (CITO SWAB) DINKES PROP SET 53,000.00 66 66 5 61 LAB
67 PRALON PCS 32,000.00 0 0
68 SD-BIOSENSOR /RAPID TEST ANTIGEN (DINKESPROP) TEST 80,000.00 154 154 139 15 LAB
69 INDEC COVID-19 ANTIGEN (DINKES PROP) TEST 107,800.00 0 0
70 ALTAMED COVID-19 RAPID TEST ANTIGEN (SAPTA SARI TA TEST 60,000.00 0 0
71 RAPID TES ANTIBODI COVID 19 INDEC DINKES PROP TEST 108,300.00 0 0
72 MASKER BEDAH DINKES PROP BOX 275,000.00 0 0
73 MASKER BEDAH DINKES PROP PCS 5,500.00 0 0
74 SARUNG TANGAN POWDERED NONSTERIL S REMEDI (P2PL BOX 165,000.00 0 0
75 SURGICAL FACE MASK 3 PLY HIJAB (P2PL)/SANTIS BOX 44,000.00 0 0
76 SURGICAL FACE MASK 3 PLY HIJAB (P2PL)/SANTIS PCS 880.00 0 0
77 SIVIT-ZINC VITAMIN DINKES PROP BOTOL 17,550.00 0 0
78 MASKER KAIN KEMENKES (3 LAPIS) PCS 5,500.00 0 0
79 SARS /RAPID TEST ANTIGEN (DINKESPROP) TEST 80,000.00 0 0
80 Azitromicin 500mg Propinsi (kotak@20 tablet) tablet 1,250.00 20 20 0 20
81 Baju APD TT pieces 134,750.00 0 0
82 Baju APD DRW pieces 181,500.00 0 0
83 Baju APD Dinprop pieces 181,500.00 0 0
84 Baju APD MG 82 pieces 181,500.00 0 0
85 Baju APD Waskita pieces 181,500.00 0 0
86 Baju APD Hanafi pieces 181,500.00 0 0
87 Baju APD Polsa pieces 181,500.00 0 0
88 Baju APD toho Kemenkes pieces 181,500.00 0 0
89 Baju APD Ass 2 pieces 181,500.00 0 0
90 Baju APD Mutiara Pieces 181,500.00 0 0
91 Baju APD CSC Pieces 181,500.00 0 0
92 Baju APD Iprakom Pieces 181,500.00 0 0
93 Baju APD Innomed Pieces 181,500.00 0 0
94 APD set 7 item Set 625,000.00 0 0
95 APD set 5 item Set 500,000.00 0 0
96 Baju APD MG 81 Pieces 181,500.00 0 0
97 Baju APD Kominfo Pieces 181,500.00 0 0
98 Baju APD Kaltech Kemenkes Pieces 181,500.00 0 0
99 Masker bedah Hijab TP (Prov) box-50 pcs 15,700.00 0 0
100 Masker bedah Earloop TP box-50 pcs 275,000.00 0 0
101 Masker bedah APP box-50 pcs 275,000.00 0 0
102 Masker bedah APP PCS 5,500.00 0 0
103 Masker bedah yi bin Kantong-10 pcs 60,000.00 0 0
104 Masker Bedah Safe lock box-50 pcs 275,000.00 0 0
105 Masker Bedah Gwmerno box-50 pcs 275,000.00 0 0
106 Masker kain pieces 4,400.00 0 0
107 Masker Kain Ass 2 pieces 4,400.00 0 0
108 Masker Spunbon DRW pieces 4,400.00 0 0
109 Masker Spunbon Polsa pieces 5,000.00 0 0
110 Masker Biru spunbon MG 16 pieces 5,500.00 0 0
111 Masker N95 Ass 2 pieces 104,500.00 0 0
112 Masker N95 Kemenkes pieces 104,500.00 0 0
113 Dust Mask Pieces 15,000.00 0 0
114 Masker Kain Purwoko Pieces 4,400.00 0 0
115 Masker N95 MG 81 Pieces 104,500.00 0 0
116 Masker Kain Mutiara Pcs 4,400.00 0 0
117 Masker Sensi Mutiara Box/50 pc 275,000.00 0 0
118 Masker Solida Mutiara Pack/5 pc 27,500.00 0 0
119 Masker bedah Dinprop Pcs 5,500.00 0 0
120 Masker N95 Dinprop Pcs 104,500.00 0 0
121 Refill Hand Sanitizer Bank PWR Galon - 20 ltr 500,000.00 0 0
122 Refill Hand Sanitizer Arami Jaya Galon - 20 ltr 500,000.00 0 0
123 Refill Hand Sanitizer For TJ Ling Galon - 20 ltr 500,000.00 0 0
124 Refill Hand Sanitizer Polsa Galon - 5 ltr 185,000.00 0 0
125 Hand sanitizer 250 ml Botol 68,181.00 0 0
126 Hand sanitizer 1 Liter DRW Botol 1 Ltr 150,000.00 0 0
127 Hand sanitiser 1 Liter CSC Botol 1 Ltr 150,000.00 0 0
128 Hand sanitizer 2 Liter MG 16 Galon - 2 ltr 185,000.00 0 0
129 Hand sanitizer 5 liter Tekagama UGM Galon - 5 ltr 350,000.00 0 0
130 Hand Sanitiser Mutiara Botol 30 ml 50,000.00 0 0
131 Kacamata Google Dinkesprop pieces 99,000.00 0 0
132 Kacamata Google GGM pieces 49,500.00 0 0
133 Face shield Dwi Mustika pieces 35,200.00 0 0
134 Face shield Mutiara pieces 35,200.00 0 0
135 Face Shield Dinprop pieces 35,200.00 0 0
136 Face shield Romora pcs 30,000.00 0 0
137 Sarung tangan non steril Kemenkes Kotak-100 pcs 99,000.00 0 0
138 Sarung tangan non steril UGM UPN Kotak-100 pcs 550,000.00 0 0
139 Sarung tangan exam S Kemenkes Ktk-100 pcs 550,000.00 0 0
140 Sarung tangan exam L Kemenkes Ktk-100 pcs 550,000.00 0 0
141 Sarung tangan M Safe glove MG 16 Kotak-100 pcs 550,000.00 0 0
142 Sarung tangan exam L MG 16 Kotak-100 pcs 550,000.00 0 0
143 Sarung Tangan Nonster dinprop Pcs 990.00 0 0
144 Imboost Box/30 tab 212,960.00 0 0
145 Pritavit Tab 1,100.00 0 0
146 Selimut Buah 75,000.00 0 0
147 Masker Kain DinsosdukKB Pcs 4,400.00 0 0
148 Gown TT pcs 214,500.00 0 0
149 Gown MG 81 pcs 155,000.00 0 0
150 Gown Marsma Purwoko pcs 155,000.00 0 0
151 Hand sanitizer 100 ml Dinprop botol 60,000.00 0 0
153 Antibodi Answer pieces 88,000.00 0 0
154 Kacamata Google Kemenkes pieces 99,000.00 0 0
155 Panbio Covid-19 Ag Rapid Test Device (Dinkesprop) test 82,500.00 50 50 2 48
156 Acetylcystein Kapsul 200 mg KAPSUL 373.00 100 100 0 100
158 Favipiravir 200mg tablet 14,850.00 400 400 0 400
159 Novel Coronavirus (covid-19) Antigen Test Kit Test 97,450.00 300 300 0 300 LAB
160 Vitamin C 500 mg Propinsi tablet 198.0 100 100 0 100
161 Parasetamol 500mg tablet 131.0 500 500 0 500
162 Herbapain Biru KAPSUL 1,194.0 30 30 0 30
163 Stimuno Forte Hijau KAPSUL 1,815.0 10 10 0 10
164 Stimuno Ungu btl 19,690.0 1 1 0 1
165 Silfamin 150mg (Herbacold Merah) KAPSUL 1,034.0 30 30 0 30
166 Multivitamin Dewasa (Bionicom Zink) tab 594.0 200 200 0 200
167 Vitamin D (caviplex) 1000 IU tab 1,195.0 60 60 0 60
168 Ramvit-C tab 500 mg tab 198.0 200 200 0 200
169 APD Coverall Dinkesprop PCS 175,000.0 50 50 0 50
JUMLAH DROPING
PENGADAAN PUSKESMAS
1 Handsanitizer 500 ml Botol 136,363.36 24 24 10 14 FARMASI
2 SOS Handsoap Botol 28,409.09 36 36 0 36 FARMASI
JUMLAH PENGADAAN
HIBAH
1 0 0 0
2 0 0 0
3 0 0 0
4 0 0 0
JUMLAH HIBAH
VAKSIN COV-19
1 Vaksin Covid-19 Single dose Vial 232,410.00 IMUNISASI
2 Vaksin Covid-19 Multi dose Batch 24200421 Vial 1,339,441.00 0 0 0 0 0 IMUNISASI
3 ADS 0,5 ml Pcs 1,050.00 394 1322 1716 1361 355 IMUNISASI
4 Alkohol Swab Pcs 950.00 392 1204 1596 1445 151 IMUNISASI
5 APD Set (Masker bedah 30 dll) Set 98,450.00 0 0 IMUNISASI
6 Safety Box Pcs 14,000.00 0 20 20 20 0 IMUNISASI
14 Vaksin Covid 19 Sinopharm 2021040436 Vial 0.00 3 0 3 2 1 IMUNISASI
15 Vaksin Covid 19 Moderna 021D21A Vial 0.00 0 0 0 0 0 IMUNISASI
16 Vaksin Covid 19 Moderna 008D21A Vial 0.00 0 0 0 0 IMUNISASI
17 Vaksin Covid 19 Moderna 066D21A Vial 0.00 0 0 0 0 IMUNISASI
19 Vaksin Covid 19 SINOVAC (2 dosis) Batch 202108146G Vial 0.00 103 103 103 0 IMUNISASI
20 Vaksin Covid 19 SINOVAC (2 dosis) Batch 202108163I Vial 0.00 356 356 356 0 IMUNISASI
22 Vaksin Covid 19 SINOVAC (2 dosis) Batch 202108147G Vial 0.00 60 0 60 60 0 IMUNISASI
23 Vaksin Covid 19 SINOVAC (2 dosis) Batch 202108173F Vial 0.00 593 593 537 56 IMUNISASI
25 Vaksin Covid 19 AZ THAILAND (10 DOSIS) A1078 Vial 0.00 40 40 6 34 IMUNISASI
26 Vaksin Covid 19 AZ VAXZEFRIA (8 DOSIS) PW40166 Vial 0.00 38 38 0 38 IMUNISASI
IMUNISASI
IMUNISASI
IMUNISASI
JUMLAH VAKSIN COVID
JUMLAH COVID 19
Purworejo, 1 November 2021

Kabupaten Purworejo
dr. SUDARMI, MM Drs. Nanang Wijayanto, Apt. drg. Maharani Mantusiana Sonia Sahara, S.Farm., Apt
NIP. 19690220 200212 2004 NIP. 19680601 199312 1 002 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014
(LPLPO)

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : JANUARI 2022 DINKES KAB.
KABUPATEN : PURWOREJO PERMINTAAN BULAN / PERIODE : FEBRUARI 2022 PUSKESMAS 445/ /II/2022 7 Februari 2022
GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
01000006 Ambroksol tablet 30 mg tablet 330.00 900 900 700 200 2000
01000011 Amlodipin tablet 10 mg tablet 70.00 2500 2500 500 2000 4000
01000012 Amlodipin tablet 5 mg tablet 53.00 2700 900 3600 1500 2100 4000
01000015 Amoksisilin kapsul 500 mg kapsul 201.00 2000 2000 0 2000 3000
01000018 Amoksisilin sirup 125 mg/5 ml botol 2,050.00 70 70 70 0 100
01000022 Antasida DOEN II - suspensi botol 1,679.00 34 100 134 54 80 100
01000025 Antihemoroid supositoria suppos 3,250.00 40 40 7 33
01000027 Asam askorbat (Vit. C) 50 mg tablet kapsul 42.00 1800 1800 1800 0 3000
01000029 Asam Folat 400 mcg tablet 42.00 1000 1000 500 500 1000
01000030 Asam mefenamat 500 mg tablet 111.00 3500 3500 300 3200
01000034 Asiklovir 200 mg Tab 249.00 0 0 0 0
01000035 Asiklovir salep krim 5 % (Acifar) tube 14,157.00 0 0 0 0 10
01000038 Asiklovir tablet 400 mg tablet 405.00 100 500 600 100 500
01000043 Betahistin messilat 6 mg tablet 919.60 0 0 0 0 500
01000044 Betahistin messilat 24 mg tablet 4,959.00 150 150 90 60 500
01000049 Bisakodil supositoria 10 mg supp 4,325.00 26 26 0 26
01000055 Deksametason injeksi i.v./i.m. 5 mg/ml ampul 1,097.00 0 0 0 0
01000056 Deksametason tablet 0,5 mg tablet 72.60 0 2000 2000 500 1500 2000
01000062 Digoksin tablet 0,25 mg tablet 104.00 200 200 0 200
01000066 Domperidon sirup 5 mg/5 ml botol 2,700.00 0 0 0 0
01000074 Fenitoin Na 30 mg kapsul (decatona ) kapsul 190.00 0 100 100 60 40 100
01000079 Fitomenadion (Vit K) tablet 10 mg tablet 758.00 100 100 0 100 200
01000086 Gentamisin tetes mata 0,3 % Botol 4,520.00 72 72 29 43 100
01000088 Glimepirid tablet 2 mg tablet 207.00 2000 1000 3000 2000 1000 3000
01000096 Haloperidol injeksi 50 mg/ml ampul 101,300.00 4 4 1 3 10
01000101 Hidrokortison acetat krim 2,5% tube 2,475.00 58 58 10 48
01000103 Hyosin butilbromide tablet 10 mg tablet 2,604.00 0 0 0 0
01000114 Kaptopril 12,5 mg tablet 62.00 800 800 500 300 1000
01000120 Ketokonazol tablet 200 mg tablet 288.00 0 0 0 0
01000123 Klindamisin kapsul 300 mg kapsul 522.00 450 450 0 450
01000127 Kloramfenikol kapsul 250 mg kapsul 605.00 0 0 0 0
01000128 Kloramfenikol kapsul 500 mg tablet 1,090.00 0 0
01000129 Kloramfenikol kapsul 500 mg tablet 1,174.00 300 300 100 200 500
01000130 Kloramfenikol salep kulit 2 % (Bufacetin) tube 3,038.00 55 55 25 30
01000139 Klorfeniramin maleat 4 mg tablet tablet 43.00 0 2000 2000 500 1500 3000
01000140 Klorfeniramin maleat 4 mg tablet Dehista tablet 103.40 2000
01000143 Klozapin tablet 25 mg tablet 1,121.00 10 100 110 55 55 300
01000160 Lidokain injeksi 2 % (HCl) ampul 1,221.00 0
01000161 Lidokain injeksi 2 % (HCl) ampul 847.00 30 30 30 0 90
01000162 Lidokain injeksi comp : lidokain 2 % HCl + epinefrin 1 : 80. ampul 1,229.00 0 60 60 30 30 90
01000173 Metformin 850 mg tablet 262.00 0 0 0 0
01000174 Metformin tablet 500 mg tablet 102.00 2000 2000 2000 0 4000
01000176 Metilergometrin injeksi 0,2 mg/ml ampul 1,023.00 25 25 0 25 100
01000185 Metronidasol kaptab 500 mg kaptab 198.00 0 0 0 0 500
01000188 Mikonazol krim tube 1,900.00 32 32 12 20 50
01000190 Natrium diklofenak 50 mg tablet tablet 99.00 5700 5700 700 5000 2000
01000194 Obat batuk hitam botol 5,520.00 0 0 0 0
01000195 Oksitetrasiklin 1 % salep mata tube 2,500.00 0 0 0 0 24
01000198 Omeprazol kapsul 20 mg kapsul 129.00 600 600 1200 0 1200 1000
01000203 Parasetamol sirup 120 mg / 5 ml botol 1,160.00 66 100 166 26 140 100
01000204 Parasetamol tablet 500 mg tablet 203.50 2000 2000 0 2000 4000
01000205 Nasamol (Parasetamol 500 mg tab ) tablet 357.50 3000 3000 100 2900 2000
01000206 Permetrin krim 5 % (Scabimite) tube 6,325.00 0 0 0 0 20
01000212 Piroksikam tablet 20 mg tablet 225.00 100 200 300 0 300 2000
01000214 Prednison tablet 5 mg tablet 73.00 500 1000 1500 500 1000 1000
01000222 Rifampisin 450mg tablet 0 0 0 0
01000227 Salbutamol 2,5 mg nebulizer (Ventolin) Pcs 10,379.60 0 0 0 0 30
01000231 Salep 2-4 Pot 1,410.00 10 10 10 0 30
01000247 Simvastatin tablet 20 mg tablet 217.00 1000 1000 0 1000 0
01000252 Tetagam ampul 146,800.00 0 0 0 0
01000255 Thiamfenikol kaplet 500 mg kaplet 726.00 0 0 0 0 500
01000263 Zink sulfat dispersibel tablet 20 mg tablet 208.00 0 200 200 50 150
- - - - 0
02000003 Bahan tambalan sementara gigi siap pakai (cavit, willman botol 28 gram 46,200.00 0 0 0 0 1
02000007 Eugenol cairan botol@10 ml 16,667.00 0 0 0 0 1
02000008 Fuji IX Dus 817,465.00 0 0 0 0 1
02000009 Fuji VII Dus 883,400.00 0 0 0 0
02000013 K- File 25 set 109,400.00 0 0 0 0
02000014 K- File 30 set 109,400.00 0 0 0 0
02000015 K-File No. 15 Set 109,400.00 0 0 0 0
02000016 K-File No. 20 Set 109,400.00 0 0 0 0
02000017 Kalsium hidroksida pasta kotak 2 tube 315,400.00 0 0 0 0 1
02000029 Tooth mouse box 201,300.00 0 0 0 0
- - - 0
03000007 Multivitamin sirup Botol 10,670.00 0 0 0 0 50
03000009 Multivitamin sirup anak. Komposisi : AA 60 mg, DHA 20 mg,botol 60 ml 8,299.50 0 0 0 0 50
03000011 Neurotropik injeksi - NEUROTROPIC vial 8,250.00 0 0 0 0 2000
03000013 Neurotropik kaplet (Neucompli) kaplet 660.00 0 0 0 0 2000
03000014 Neurotropik kaplet mengandung :Vit B1 100 mg + vit B6 2 tablet 682.00 0 0 0 0 2000
03000020 Obat antiflu kombinasi tablet (HUSTAB) tablet 440.00 250 250 250 0 450
03000032 Obat Sariawan - Triamkinolon 1 mg (Bufacomb) tube 18,150.00 0 0 0 0 20
03000035 Suplemen zat besi sirup - Ferriz botol 33,000.00 53 53 13 40 50
03000036 Ambefaz 10 kapsul 1,349.70 0 0 0 0
03000038 Ocugard kapsul 4,726.66 0 0 0 0
- - - 0
04000001 ADS 0.05 ml Pcs 1,550.00 0 0 0 0
04000002 ADS 0.5 ml pcs 1,190.00 0 0 0 0
04000003 ADS 5ml Pcs 1,582.00 0 0 0 0
04000007 Alat suntik sekali pakai 3 cc buah 887.78 100 300 400 0 400 300
04000009 Alat suntik sekali pakai 5 cc ( Aximed) pcs 984.00 0 0 0 0
04000010 Alat suntik sekali pakai 5 cc (Stera) pcs 773.00 0 0 0 0
04000012 Blood Lancet 26 - 14,000.00 16 16 0 16
04000013 Blood Lancet 28 box @100 14,566.00 5 3 8 0 8
04000046 Folley catheter no 16 Aximed pcs 10,073.00 0 0 0 0
04000048 Folley catheter no. 18 pieces 11,565.00 0 0 0 0
04000049 Folley catheter no. 18 ( Norta) pieces 12,100.00 0 0 0 0
04000084 IV CANNULA 18 Buah 10,494.00 0 0 0 0
04000085 IV CANNULA 20 Buah 10,494.00 0 0 0 0
04000086 IV CANNULA 22 Buah 10,494.00 0 0 0 0
04000087 IV CANNULA 24 Buah 10,494.00 0 0 0 0
IV Cath Type 18 - Aximed pcs 6,930.00 50 50 0 50
04000103 Jarum jahit otot lusin 9,658.33 0 0 0 0 10
04000107 Kasa 10 cm x 10 cm pouch 9,430.80 0 0 0 0
04000109 Kasa Hidrofil DRC 36M x 80 CM Rol 136,500.00 0 0 0 0
Kasa Hidrofil 40y x 80 cm Rol 128,500.00 3 3 2 1 2
04000116 Kertas EKG ( 50 x 30) rol 33,000.00 0 0 0 0
04000125 Masker N95 box 130,240.00 0 0 0 0
04000154 Peter silk 2/0 -3/8 kotak 80,465.00 0 0 0 0
04000162 Pot sputum buah 2,728.00 200 200 400 0 400
04000163 Pot urin buah 2,331.00 0 0 0 0
04000164 Safety Box 5 Ltr Kuning Dus 14,500.00 18 18 0 18
04000179 Sarung tangan Troge sensosurge - plus No 6,5 ( Steril ) pcs 13,178.00 25 25 0 25 100
04000180 Sarung tangan Troge sensosurge - plus No 7 ( Steril ) pcs 8,635.00 60 60 20 40 100
04000181 Scalpel blades (bisturi - Aesculap BBraun) box 300,000.00 0 0 0 0 10
04000193 Tube EDTA 17 x 75 box 100,500.00 0 0 0 0
04000195 Umbilical cord klem (Onemed) pcs 1,300.00 50 50 0 50 100
04000197 Underpad premium 60 x 90 cm pcs 6,000.00 0 0 0 0
04000198 Urin bag pcs 5,700.00 0 0 0 0 5
04000199 Urine Bag steril with hanger Pcs 8,000.00 0 0 0 0 5
- - - 0
- REAGEN - 0
05000006 Hbsag ( Vikocheck ) tes 9,850.00 50 100 150 50 100
05000007 HBsAg (Fokus) - 10,836.00 0 0 0 0
05000013 HEP.B(PID) vial 20,900.00 0 0 0 0
05000014 HIV (Fokus) tes 13,235.00 0 0 0 0
05000015 HIV Fokus tes 14,470.00 0 0 0 0
05000016 HIV Monotes box 345,000.00 0 0 0 0
05000017 HIV Vikia tes 19,480.00 0 0 0 0
HIV Viro Check box @25 202,350.00 0 4 4 0 4
05000055 Rapid test untuk pemeriksaan Kolesterol : Nesco tes 16,720.00 0 0 0 0
05000056 Rapid test untuk pemeriksaan Kolesterol : Accutrand tes 15,928.00 0 0 0 0
Reagen fotometer : Reagen kolesterol botol @ 100 ml 1,600,000.00 0 1 1 0 1
Reagen fotometer : Reagen trigliserida botol @ 100 ml 2,750,000.00 0 1 1 0 1
05000073 Syphilis AB tes 20,400.00 0 0 0 0
- - -
- BAHAN MEDIS HABIS PAKAI -
06000001 Alcohol swab, 2 ply box-100 pcs 11,604.00 10 10 20 1 19 20
06000003 Alkohol 70% Btl-1000 ml 27,373.00 0 0 0
06000004 Alkohol 70% Btl-100 ml 7,579.00 5 5 0 5
06000006 Antimicrobial - Viorex No Rinse botol 500 ml 65,340.00 10 10 0 10 10
06000008 Autoclick set 19,158.00 0 0 0 0
06000020 Lisol, mengandung kresol tersabun 50% botol 1000 ml 40,700.00 0 0 0 0 2
06000021 LUGOL botol 0 0 0 0
TAMBAHAN PERBEKALAN KESEHATAN

OBAT PROGRAM
OBAT PROGRAM MALARIA (P2M)
PROGRAM DIARE
09000001 Garam oralit serbuk kombinasi saset 3,661.00 0 0 0 0
PROGRAM KIA/ GIZI

10000002 Retinol (Vitamin A) 100.000 IU kapsul lunak kapsul 306.00 18 100 118 68 50
10000003 Retinol (Vitamin A) 200.000 IU kapsul lunak kapsul 552.00 100 700 800 700 100
TTD (Fero fumarat)/ Dinkesprop tablet 226.00 2000 2000 4000 1100 2900 2000
OBAT ANTI TUBERKULOSIS -
- - - 0
- - - 0
13000001 Obat MDT Kusta MB Dewasa blister 28,424.00 0 1 1 1 0
- - - 0
- - - 0
16000001 Vaksin BCG vial 59,950.00 0 0 0 0
16000004 VAKSIN IPV vial 153,736.00 0 0 0 0
16000006 VAKSIN MR vial 149,820.00 0 0 0 0
16000008 VAKSIN TT vial 14,498.00 0 0 0 0
16000009 VAKSIN Td vial 16,500.00 0 0 0 0
16000010 VAKSIN DT vial 17,798.00 0 0 0 0
Masker bedah 3 Ply Earloop Program (S+UPAMED) bok 19,305.00 0 0 0 0 10
Sarung Tangan Protos M box 115,500.00 10 10 5 5 10
Maxter Exam Gloves S box 69,080.00 0 5 5 0 5 10
Maxter Exam Gloves M box 69,080.00 0 5 5 0 5 10
Rapid 1 HIV (SD Bioline) Pengadaan box 339,668.00 2 2 2 0 2
Purworejo, 7 Februari 2022

Kabupaten Purworejo
dr. Sudarmi, MM Sigit Heru Waluyo, SKM drg. Maharani Mantusiana Sonia Sahara, S.Farm., Apt
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 2006 04 2 001 NIP. 19920125 201903 2 014
LAPORAN PEMBELIAN SENDIRI DAN PEMAKAIAN OBAT PUSKESMAS

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : JANUARI 2022 INST. FARMASI
KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : FEBRUARI 2022 PUSKESMAS 445/ /II/2022 7 Februari 2022
KAB GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
0000001 Cat Gut Chromic 2/0 GEA Buah 8,250.00 12 12 12 0 FEB

0000005 Guaifenesin 100 mg Tablet 115.87 6000 6000 1100 4900 NOV

Mengetahui
Kepala Dinas Kesehatan Kepala Seksi Farmamin dan Perbekes Kepala Puskesmas Seborokrapyak Petugas Puskesmas Seborokrapyak
Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014

KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : FEBRUARI 2022 PUSKESMAS 445/ /II/2022 7 Februari 2022
NO OBAT SATUAN KET
1 cap) set 300,000.00
mulya sejahtera 0 0
3 set 490,000.00
12 Gown Boogie pcs 112,500.00 0 0
14 Selkom-C sapta Sari Tama tablet 950.00 0 0
21 Lisol Intisumber Hasil Sempurna botol 40,700.00 3 3 0 3
34 APD BPBD pcs 181,500.00 0 0
35 APD BLK pcs 181,500.00 0 0
36 APD PICCI pcs 181,500.00 0 0
39 Gown BPBD pcs 134,750.00 0 0
45 Azitromicin 500mg Propinsi (kotak@20 tablet) tablet 1,888.00 60 0 60 60 0 RETURN
66 VTM COVID (CITO SWAB) DINKES PROP SET 53,000.00 0 0
67 PRALON PCS 32,000.00 0 0
68 SD-BIOSENSOR /RAPID TEST ANTIGEN (DINKESPROP) TEST 80,000.00 0 0
70 ALTAMED COVID-19 RAPID TEST ANTIGEN (SAPTA SARI TA TEST 60,000.00 0 0
94 APD set 7 item Set 625,000.00 0 0
95 APD set 5 item Set 500,000.00 0 0
144 Imboost Box/30 tab 212,960.00 0 0
145 Pritavit Tab 1,100.00 0 0
146 Selimut Buah 75,000.00 0 0
148 Gown TT pcs 214,500.00 0 0
149 Gown MG 81 pcs 155,000.00 0 0
155 Panbio Covid-19 Ag Rapid Test Device (Dinkesprop) test 82,500.00 0 0
157 OSELTAMIVIR 75MG Propinsi KAPSUL 7,000.00 100 100 100 0 RETURN
159 Novel Coronavirus (covid-19) Antigen Test Kit Test 97,450.00 175 175 0 175 500
163 Stimuno Forte Hijau KAPSUL 1,815.0 10 10 0 10
164 Stimuno Ungu btl 19,690.0 1 1 0 1
166 Multivitamin Dewasa (Bionicom Zink) tab 594.0 200 200 0 200 500
JUMLAH DROPING
HIBAH
1 0 0 0
2 0 0 0
3 0 0 0
JUMLAH HIBAH

Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014
(LPLPO)

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : FEBRUARI 2022 DINKES KAB.
KABUPATEN : PURWOREJO PERMINTAAN BULAN / PERIODE : MARET 2022 PUSKESMAS 445/198 /III/2022 11 Maret 2022
GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
01000001 Air untuk injeksi 25 ml ampul 2,650.00 51 51 30 21 30
01000003 Albendazol tablet 400 mg tablet 402.00 800 800 0 800
01000022 Antasida DOEN II - suspensi botol 1,679.00 80 100 180 36 144
01000030 Asam mefenamat 500 mg tablet 111.00 3200 3200 1800 1400 2000
01000034 Asiklovir 200 mg Tab 249.00 0 0 0 0
01000038 Asiklovir tablet 400 mg tablet 405.00 500 500 100 400
01000044 Betahistin 24 mg tablet 4,945.00 60 480 540 0 540
01000055 Deksametason injeksi i.v./i.m. 5 mg/ml ampul 924.00 0 0 0 0
01000056 Deksametason tablet 0,5 mg tablet 72.60 1500 2000 3500 700 2800 2000
01000062 Digoksin tablet 0,25 mg tablet 104.00 200 200 0 200
01000074 Fenitoin Na 30 mg kapsul (decatona ) kapsul 190.00 40 100 140 120 20 100
01000075 Fenitoin natrium kapsul 100 mg kapsul 158.00 0 0 0 0 100
01000079 Fitomenadion (Vit K) tablet 10 mg tablet 758.00 100 200 300 50 250
01000086 Gentamisin tetes mata 0,3 % Botol 4,520.00 43 72 115 28 87 100
01000088 Glimepirid tablet 2 mg tablet 207.00 1000 1000 0 1000 3000
Glimepirid tablet 3 mg 143.00 3000 3000 0 3000 2000
01000114 Kaptopril 12,5 mg tablet 65.00 300 300 0 300 1000
01000129 Kloramfenikol kapsul 500 mg tablet 1,174.00 200 500 700 0 700
01000130 Kloramfenikol salep kulit 2 % (Bufacetin) tube 3,038.00 30 30 0 30 50
01000143 Klozapin tablet 25 mg tablet 1,121.00 55 300 355 0 355
01000161 Lidokain injeksi 2 % (HCl) ampul 847.00 0 100 100 0 100
01000162 Lidokain injeksi comp : lidokain 2 % HCl + epinefrin 1 : 80. ampul 1,229.00 30 30 60 0 60
01000167 Magnesium sulfat injeksi 20 % ampul 3,580.00 0 0 0 0 5
01000173 Metformin 850 mg tablet 262.00 0 0 0 0 4000
01000185 Metronidasol kaptab 500 mg kaptab 198.00 0 0 0 0
01000190 Natrium diklofenak 50 mg tablet tablet 99.00 5000 2000 7000 1200 5800 2000
01000194 Obat batuk hitam botol 5,520.00 0 0 0 0 100
01000195 Oksitetrasiklin 1 % salep mata tube 2,500.00 0 0 0 0 24
01000198 Omeprazol kapsul 20 mg kapsul 129.00 1200 1200 0 1200 500
01000203 Parasetamol sirup 120 mg / 5 ml botol 1,160.00 140 100 240 29 211
01000204 Parasetamol tablet 500 mg tablet 203.50 2000 3000 5000 2000 3000 4000
01000206 Permetrin krim 5 % (Scabimite) tube 6,325.00 0 20 20 0 20
01000212 Piroksikam tablet 20 mg tablet 222.33 300 300 100 200 2000
01000214 Prednison tablet 5 mg tablet 73.00 1000 1000 2000 700 1300 1000
01000224 Risperidon 1 mg Tablet 102.00 1000 1000 0 1000
01000231 Salep 2-4 Pot 1,410.00 0 30 30 0 30
01000252 Tetagam ampul 146,800.00 0 0 0 0
01000255 Thiamfenikol kaplet 500 mg kaplet 726.00 0 0 0 0
- - - - 0
02000008 Fuji IX Dus 817,465.00 0 0 0 0 1
02000009 Fuji VII Dus 883,400.00 0 0 0 0
02000013 K- File 25 set 109,400.00 0 0 0 0
02000014 K- File 30 set 109,400.00 0 0 0 0
02000015 K-File No. 15 Set 109,400.00 0 0 0 0
02000016 K-File No. 20 Set 109,400.00 0 0 0 0
02000029 Tooth mouse box 201,300.00 0 0 0 0
- - - 0
03000036 Ambefaz 10 kapsul 1,349.70 0 0 0 0
03000038 Ocugard kapsul 4,726.66 0 0 0 0
- - - 0
04000001 ADS 0.05 ml Pcs 1,550.00 0 0 0 0
04000002 ADS 0.5 ml pcs 1,190.00 0 0 0 0
04000003 ADS 5ml Pcs 1,582.00 0 0 0 0
04000007 Alat suntik sekali pakai 3 cc buah 887.78 400 300 700 0 700
04000009 Alat suntik sekali pakai 5 cc ( Aximed) pcs 1,600.00 0 0 0 0
04000010 Alat suntik sekali pakai 5 cc (Stera) pcs 1,600.00 0 0 0 0
04000012 Blood Lancet 26 - 14,000.00 16 16 0 16
04000013 Blood Lancet 28 box @100 14,566.00 8 8 0 8
04000046 Folley catheter no 16 Aximed pcs 27,269.00 0 0 0 0 10
04000047 Folley catheter no. 16 (Aximed) pieces 27,269.00 0 0 0 0 10
04000048 Folley catheter no. 18 pieces 11,565.00 0 0 0 0 10
04000049 Folley catheter no. 18 ( Norta) pieces 11,565.00 0 0 0 0 10
04000084 IV CANNULA 18 Buah 10,494.00 0 0 0 0
04000085 IV CANNULA 20 Buah 10,494.00 0 0 0 0
04000086 IV CANNULA 22 Buah 10,494.00 0 0 0 0
04000087 IV CANNULA 24 Buah 10,494.00 0 0 0 0
04000107 Kasa 10 cm x 10 cm pouch 9,430.80 0 0 0 0
04000115 Kasa Steril 16CM x 16CM Dos 7,050.00 36 36 0 36 30
04000116 Kertas EKG ( 50 x 30) rol 33,000.00 0 0 0 0
04000125 Masker N95 (Pengadaan) pcs 17,500.00 0 0 0 0
04000154 Peter silk 2/0 -3/8 kotak 80,465.00 0 0 0 0
04000162 Pot sputum buah 2,728.00 400 400 50 350
04000163 Pot urin buah 2,331.00 0 0 0 0
04000179 Sarung tangan Troge sensosurge - plus No 6,5 ( Steril ) pcs 13,178.00 25 25 0 25 100
04000180 Sarung tangan Troge sensosurge - plus No 7 ( Steril ) pcs 8,635.00 40 30 70 30 40 100
04000193 Tube EDTA 17 x 75 box 100,500.00 0 0 0 0
04000195 Umbilical cord klem (Onemed) pcs 1,300.00 50 100 150 50 100
04000198 Urin bag pcs 5,700.00 0 0 0 0 5
- Sarung Tangan Obsgyn (Pengadaan) pasang 42,900.00 150 150 0 150
- REAGEN - 0
05000006 Hbsag ( Vikocheck ) tes 9,850.00 100 100 0 100
05000007 HBsAg (Fokus) - 10,836.00 0 0 0 0
05000013 HEP.B(PID) vial 20,900.00 0 0 0 0
05000014 HIV (Fokus) tes 13,235.00 0 0 0 0
05000015 HIV Fokus tes 14,470.00 0 0 0 0
05000016 HIV Monotes box 345,000.00 0 0 0 0
05000017 HIV Vikia tes 19,480.00 0 0 0 0
Reagen fotometer : Reagen kolesterol botol @ 100 ml 1,600,000.00 1 1 1 0
Reagen fotometer : Reagen trigliserida botol @ 100 ml 2,750,000.00 1 1 1 0
05000073 Syphilis AB tes 20,400.00 0 0 0 0
- - -
06000003 Alkohol 70% Btl-1000 ml 37,638.00 0 0 0
06000004 Alkohol 70% Btl-100 ml 7,579.00 5 5 0 5
06000006 Antimicrobial - Viorex No Rinse botol 500 ml 65,340.00 10 5 15 10 5 5
06000008 Autoclick set 19,158.00 0 0 0 0
06000018 Jelly-My Jelly 82 Gr Tube 29,550.00 6 6 0 6
06000020 Lisol, mengandung kresol tersabun 50% botol 1000 ml 40,700.00 0 0 0 0
06000021 LUGOL botol 0 0 0 0

OBAT PROGRAM
PROGRAM DIARE
09000001 Garam oralit serbuk kombinasi saset 280.00 0 0 0 0
PROGRAM KIA/ GIZI

TTD (Fero fumarat)/ Dinkesprop tablet 226.00 2900 4000 6900 1000 5900
- - - 0
- - - 0
- - - 0
- - - 0
16000001 Vaksin BCG vial 59,950.00 0 0 0 0
16000004 VAKSIN IPV vial 153,736.00 0 0 0 0
16000006 VAKSIN MR vial 149,820.00 0 0 0 0
16000008 VAKSIN TT vial 14,498.00 0 0 0 0
16000009 VAKSIN Td vial 16,500.00 0 0 0 0
16000010 VAKSIN DT vial 17,798.00 0 0 0 0
Rapid 1 HIV (SD Bioline) Pengadaan tes 11,322.30 0 0 0 0 2
Purworejo, 11 Maret 2022

Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 2006 04 2 001 NIP. 19920125 201903 2 014

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : FEBRUARI 2022 INST. FARMASI
KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : MARET 2022 PUSKESMAS 445/198 /III/2022 11 Maret 2022
KAB GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
0000001 Cat Gut Chromic 2/0 GEA Buah 8,250.00 0 0 0 0


Mengetahui
Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014

KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : FEBRUARI 2022 PUSKESMAS 445/198/III/2022 11 Maret 2022
NO OBAT SATUAN KET
1 cap) set 300,000.00
mulya sejahtera 0 0
3 set 490,000.00
12 Gown Boogie pcs 112,500.00 0 0
14 Selkom-C sapta Sari Tama tablet 950.00 215 215 200 15
21 Lisol Intisumber Hasil Sempurna botol 40,700.00 3 3 6 0 6
34 APD BPBD pcs 181,500.00 0 0
35 APD BLK pcs 181,500.00 0 0
36 APD PICCI pcs 181,500.00 0 0
39 Gown BPBD pcs 134,750.00 0 0
67 PRALON PCS 32,000.00 0 0
94 APD set 7 item Set 625,000.00 0 0
95 APD set 5 item Set 500,000.00 0 0
144 Imboost Box/30 tab 212,960.00 0 0
145 Pritavit Tab 1,100.00 0 0
146 Selimut Buah 75,000.00 0 0
148 Gown TT pcs 214,500.00 0 0
149 Gown MG 81 pcs 155,000.00 0 0
157 OSELTAMIVIR 75MG Propinsi KAPSUL 7,000.00 100 100 100 0 RETURN
159 Novel Coronavirus (covid-19) Antigen Test Kit Test 97,450.00 175 500 675 450 225 300
163 Stimuno Forte Hijau KAPSUL 1,815.0 10 10 10 -
164 Stimuno Ungu btl 19,690.0 1 1 1 -
166 Multivitamin Dewasa (Bionicom Zink) tab 594.0 200 200 200 - 500
170 APD SET SARANA MEDIKA SEJAHTERA P2PL SET 100,000.0 45 45 0 45
JUMLAH DROPING
HIBAH
1 0 0 0
2 0 0 0
3 0 0 0
JUMLAH HIBAH

Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014
(LPLPO)

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : MARET 2022 DINKES KAB.
KABUPATEN : PURWOREJO PERMINTAAN BULAN / PERIODE : APRIL 2022 PUSKESMAS 445/242/IV/2022 4 April 2022
GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
01000001 Air untuk injeksi 25 ml ampul 2,650.00 21 30 51 0 51
01000003 Albendazol tablet 400 mg tablet 402.00 800 800 0 800 1000
01000022 Antasida DOEN II - suspensi botol 1,679.00 144 144 27 117
01000029 Asam Folat 400 mcg tablet 42.00 1500 1500 500 1000
01000030 Asam mefenamat 500 mg tablet 111.00 1400 2000 3400 300 3100 2000
01000034 Asiklovir 200 mg Tab 249.00 0 0 0 0
01000044 Betahistin 24 mg tablet 4,945.00 540 540 0 540
01000047 Betametason valerat krim 0,1 % tube 5 gram 1,430.00 52 52 52 0 ED
01000056 Deksametason tablet 0,5 mg tablet 72.60 2800 2000 4800 100 4700
01000074 Fenitoin Na 30 mg kapsul (decatona ) kapsul 190.00 40 100 140 20 120
01000078 Fitomenadion (Vit K) injeksi 1.m. 2 mg /ml ampul 3,682.00 60 60 60 0 90 ED
01000079 Fitomenadion (Vit K) tablet 10 mg tablet 758.00 250 250 0 250
01000083 Gemfibrozil kapsul 300 mg kapsul 370.99 0 0 0 0
01000087 Glibenklamid tablet 5 mg tablet 119.00 1000 1000 0 1000 1000
01000088 Glimepirid tablet 2 mg tablet 207.00 1000 1000 1000 0
01000094 Haloperidol 2 mg tablet 90.00 0 0 0 0
01000098 Haloperidol tablet 2 mg (Lodomer 2 mg) tablet 90.00 0 0 0 0
01000099 Haloperidol tablet 5 mg tablet 54.00 2520 1000 3520 260 3260
01000100 Hidroklorotiazid tablet 25 mg tablet 149.00 0 0 0 0
01000109 Isosorbid Dinitrat 10 mg tablet 189.00 0 0 0 0
01000113 Kalsium laktat 500 mg tablet 63.00 4300 4300 2100 2200 3000
01000115 Kaptopril 25 mg tablet (Vapril) tablet 193.00 0 0 0 0
01000119 Ketokonazol krim tube 2,518.00 0 0 0 0
01000129 Kloramfenikol kapsul 500 mg tablet 1,174.00 700 700 0 700
01000131 Kloramfenikol salep mata 0,5 % tube 3,250.00 0 0 0 0 10
01000132 Kloramfenikol salep mata 1 % tube 1,881.00 0 0 0 0 10
01000135 Kloramfenikol tetes telinga botol 6,600.00 0 0 0 0 100
01000143 Klozapin tablet 25 mg tablet 1,121.00 355 355 75 280
01000161 Lidokain injeksi 2 % (HCl) ampul 847.00 100 100 0 100
01000162 Lidokain injeksi comp : lidokain 2 % HCl + epinefrin 1 : 80. ampul 1,229.00 60 60 0 60
01000190 Natrium diklofenak 50 mg tablet tablet 99.00 5800 5800 1300 4500 2000
01000191 Natrium Klorida Larutan Infus 0,9% steril botol-500 ml 6,800.00 20 20 0 20
01000195 Oksitetrasiklin 1 % salep mata tube 2,500.00 0 0 0 0
01000198 Omeprazol kapsul 20 mg kapsul 129.00 1200 1200 400 800 400
01000203 Parasetamol sirup 120 mg / 5 ml botol 1,160.00 211 211 25 186
01000206 Permetrin krim 5 % (Scabimite) tube 6,325.00 20 20 0 20
01000212 Piroksikam tablet 20 mg tablet 222.33 200 200 0 200
01000214 Prednison tablet 5 mg tablet 73.00 1300 1000 2300 400 1900
01000216 Probenesid tablet 500 mg (Probenid) tablet 1,914.00 0 0 0 0
01000223 Ringer laktat larutan botol 7,630.00 20 20 0 20
01000231 Salep 2-4 Pot 1,410.00 30 30 0 30
01000245 Simetidin tablet 200 mg tablet 341.00 0 0 0 0
01000252 Tetagam ampul 146,800.00 0 0 0 0
01000258 Triheksifenidil tablet 2 mg tablet 91.00 2290 1000 3290 710 2580
- - - - 0
02000008 Fuji IX Dus 817,465.00 0 0 0 0 1
02000009 Fuji VII Dus 883,400.00 0 0 0 0
02000013 K- File 25 set 109,400.00 0 0 0 0
02000014 K- File 30 set 109,400.00 0 0 0 0
02000015 K-File No. 15 Set 109,400.00 0 0 0 0
02000016 K-File No. 20 Set 109,400.00 0 0 0 0
02000029 Tooth mouse box 201,300.00 0 0 0 0
- - - 0
03000005 Multivitamin dan suplemen : Askorbic acid 150 mg, Niacinatablet 2,200.00 0 0 0 0 2000
03000036 Ambefaz 10 kapsul 1,349.70 0 0 0 0
03000038 Ocugard kapsul 4,726.66 0 0 0 0
- - - 0
04000001 ADS 0.05 ml Pcs 1,550.00 0 0 0 0
04000002 ADS 0.5 ml pcs 1,190.00 0 0 0 0
04000003 ADS 5ml Pcs 1,582.00 0 0 0 0
04000007 Alat suntik sekali pakai 3 cc buah 887.78 700 700 0 700
04000012 Blood Lancet 26 - 14,000.00 16 16 10 6 20
04000013 Blood Lancet 28 box @100 14,566.00 8 8 0 8 20
04000084 IV CANNULA 18 Buah 10,494.00 0 0 0 0
04000085 IV CANNULA 20 Buah 10,494.00 0 0 0 0
04000086 IV CANNULA 22 Buah 10,494.00 0 0 0 0
04000087 IV CANNULA 24 Buah 10,494.00 0 0 0 0
04000107 Kasa 10 cm x 10 cm pouch 9,430.80 0 0 0 0
04000113 Kasa Pembalut Hidrofil 4M x 15CM Rol 3,800.00 0 0 0 0 10
04000115 Kasa Steril 16CM x 16CM Dos 7,050.00 36 30 66 30 36 30
04000116 Kertas EKG ( 50 x 30) rol 33,000.00 0 0 0 0
04000154 Peter silk 2/0 -3/8 kotak 80,465.00 0 0 0 0
04000162 Pot sputum buah 2,728.00 350 350 0 350
04000163 Pot urin buah 2,331.00 0 0 0 0
04000178 Sarung tangan obsgyn pasang 19,360.00 0 0 0 0
04000180 Sarung tangan Troge sensosurge - plus No 7 ( Steril ) pcs 8,635.00 40 50 90 1 89
04000193 Tube EDTA 17 x 75 box 100,500.00 0 0 0 0
04000198 Urin bag pcs 5,700.00 0 0 0 0 5
- Sarung Tangan Obsgyn (Pengadaan) pasang 42,900.00 150 30 180 20 160 50
- REAGEN - 0
05000007 HBsAg (Fokus) - 10,836.00 0 0 0 0
05000013 HEP.B(PID) vial 20,900.00 0 0 0 0
05000014 HIV (Fokus) tes 13,235.00 0 0 0 0
05000015 HIV Fokus tes 14,470.00 0 0 0 0
05000016 HIV Monotes box 345,000.00 0 0 0 0
05000017 HIV Vikia tes 19,480.00 0 0 0 0
05000061 Reagen fotometer : reagen asam urat botol @ 100 ml 467,665.00 0 0 0 0
05000073 Syphilis AB tes 20,400.00 0 0 0 0
- - -
06000003 Alkohol 70% Btl-1000 ml 37,638.00 0 0 0
06000004 Alkohol 70% Btl-100 ml 7,579.00 5 5 5 0
06000008 Autoclick set 19,158.00 0 0 0 0
06000018 Jelly-My Jelly 82 Gr Tube 29,550.00 6 6 0 6
06000021 LUGOL botol 0 0 0 0

OBAT PROGRAM
PROGRAM DIARE
PROGRAM KIA/ GIZI

TTD (Fero fumarat)/ Dinkesprop tablet 226.00 5900 5900 2200 3700
- - - 0
- - - 0
- - - 0
- - - 0
16000001 Vaksin BCG vial 59,950.00 0 0 0 0
16000004 VAKSIN IPV vial 153,736.00 0 0 0 0
16000006 VAKSIN MR vial 149,820.00 0 0 0 0
16000008 VAKSIN TT vial 14,498.00 0 0 0 0
16000009 VAKSIN Td vial 16,500.00 0 0 0 0
16000010 VAKSIN DT vial 17,798.00 0 0 0 0
Rapid 1 HIV (SD Bioline) Pengadaan tes 11,322.30 0 0 0 0
Purworejo, 4 April 2022

Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 2006 04 2 001 NIP. 19920125 201903 2 014

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : MARET 2022 INST. FARMASI
KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : APRIL 2022 PUSKESMAS 445/198 /III/2022 11 Maret 2022
KAB GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
0000001 Cat Gut Chromic 2/0 GEA Buah 8,250.00 0 0 0 0


Mengetahui
Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : APRIL 2022 INST. FARMASI
KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : MEI 2022 PUSKESMAS /IV/2022 11 MARET 2022
NO OBAT SATUAN KET
1 cap) set 300,000.00
mulya sejahtera 0 0
3 set 490,000.00
12 Gown Boogie pcs 112,500.00 0 0
14 Selkom-C sapta Sari Tama tablet 950.00 15 15 15
34 APD BPBD pcs 181,500.00 0 0
35 APD BLK pcs 181,500.00 0 0
36 APD PICCI pcs 181,500.00 0 0
39 Gown BPBD pcs 134,750.00 0 0
67 PRALON PCS 32,000.00 0 0
94 APD set 7 item Set 625,000.00 0 0
95 APD set 5 item Set 500,000.00 0 0
144 Imboost Box/30 tab 212,960.00 0 0
145 Pritavit Tab 1,100.00 0 0
146 Selimut Buah 75,000.00 0 0
148 Gown TT pcs 214,500.00 0 0
149 Gown MG 81 pcs 155,000.00 0 0
157 OSELTAMIVIR 75MG Propinsi KAPSUL 7,000.00 0 0 0 0
158 Favipiravir 200mg tablet 14,850.00 178 178 178 0 ED
159 Novel Coronavirus (covid-19) Antigen Test Kit Test 97,450.00 225 225 75 150
162 Stimuno Forte Hijau KAPSUL 1,815.0 0 - 0 -
163 Stimuno Ungu btl 19,690.0 0 - 0 -
165 Multivitamin Dewasa (Bionicom Zink) tab 594.0 0 - 0 - 500
166 Vitamin D (caviplex) 1000 IU tab 1,195.0 60 60 60 -
JUMLAH DROPING
HIBAH
1 0 0 0
2 0 0 0
3 0 0 0
JUMLAH HIBAH

Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014
(LPLPO)

KECAMATAN : BANYUURIP LAPORAN BULAN / PERIODE : APRIL 2022 DINKES KAB.
KABUPATEN : PURWOREJO PERMINTAAN BULAN / PERIODE : MEI 2022 PUSKESMAS 9 Mei 2022
GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
01000004 Alopurinol tablet 100 mg tablet 87.00 300 300 300 0 500
01000017 Amoksisilin s.k. Forte 250 mg/5 ml botol 3,628.00 0 0 0 0
01000022 Antasida DOEN II - suspensi botol 1,679.00 117 117 25 92
01000030 Asam mefenamat 500 mg tablet 111.00 3100 1000 4100 300 3800 500
01000034 Asiklovir 200 mg Tab 249.00 0 0 0 0
01000044 Betahistin 24 mg tablet 4,945.00 540 540 60 480
01000047 Betametason valerat krim 0,1 % tube 5 gram 1,430.00 0 0 0 0 ED
01000056 Deksametason tablet 0,5 mg tablet 72.60 4700 4700 600 4100
01000067 Domperidon tablet 10 mg tablet 91.00 500 500 0 500
01000074 Fenitoin Na 30 mg kapsul (decatona ) kapsul 190.00 120 120 0 120
01000078 Fitomenadion (Vit K) injeksi 1.m. 2 mg /ml ampul 3,682.00 0 150 150 60 90 ED
01000079 Fitomenadion (Vit K) tablet 10 mg tablet 758.00 250 250 0 250
01000081 Furosemid tablet 40 mg tablet 82.00 200 200 200 0 100 ED
01000083 Gemfibrozil kapsul 300 mg kapsul 370.99 0 0 0 0
01000088 Glimepirid tablet 2 mg tablet 207.00 0 0 0 0
01000094 Haloperidol 2 mg tablet 90.00 0 0 0 0
01000098 Haloperidol tablet 2 mg (Lodomer 2 mg) tablet 90.00 0 0 0 0
01000099 Haloperidol tablet 5 mg tablet 54.00 3260 3260 675 2585 500
01000100 Hidroklorotiazid tablet 25 mg tablet 149.00 0 0 0 0
01000108 Isoniasida tablet 100 mg tablet 145.00 196 196 140 56 500
01000113 Kalsium laktat 500 mg tablet 63.00 2200 2200 100 2100 3000
01000115 Kaptopril 25 mg tablet (Vapril) tablet 193.00 0 0 0 0
01000119 Ketokonazol krim tube 2,518.00 0 0 0 0
01000129 Kloramfenikol kapsul 500 mg tablet 1,174.00 700 700 0 700
01000131 Kloramfenikol salep mata 0,5 % tube 3,250.00 0 0 0 0 10
01000132 Kloramfenikol salep mata 1 % tube 1,881.00 0 0 0 0 10
01000135 Kloramfenikol tetes telinga botol 6,600.00 0 0 0 0 100
01000143 Klozapin tablet 25 mg tablet 1,121.00 280 280 60 220
01000148 Kotrimoksasol (dewasa) kombinasi : sulfametoksazol 400 mtablet 133.00 400 400 400 0 500 ED
01000161 Lidokain injeksi 2 % (HCl) ampul 847.00 100 100 30 70
01000162 Lidokain injeksi comp : lidokain 2 % HCl + epinefrin 1 : 80. ampul 1,229.00 60 60 0 60
01000190 Natrium diklofenak 50 mg tablet tablet 99.00 4500 4500 300 4200
01000195 Oksitetrasiklin 1 % salep mata tube 2,500.00 0 0 0 0
01000198 Omeprazol kapsul 20 mg kapsul 129.00 800 800 0 800
01000203 Parasetamol sirup 120 mg / 5 ml botol 1,160.00 186 186 10 176
01000206 Permetrin krim 5 % (Scabimite) tube 6,325.00 20 20 15 5
01000212 Piroksikam tablet 20 mg tablet 222.33 200 200 0 200
01000214 Prednison tablet 5 mg tablet 73.00 1900 1900 100 1800
01000216 Probenesid tablet 500 mg (Probenid) tablet 1,914.00 0 0 0 0
01000223 Ringer laktat larutan botol 7,630.00 20 20 0 20
01000231 Salep 2-4 Pot 1,410.00 30 30 10 20
01000245 Simetidin tablet 200 mg tablet 341.00 0 0 0 0
01000252 Tetagam ampul 146,800.00 0 0 0 0
01000258 Triheksifenidil tablet 2 mg tablet 91.00 3680 3680 1000 2680 1000
01000263 Zink sulfat dispersibel tablet 20 mg tablet 208.00 200 200 0 200
- - - - 0
02000008 Fuji IX Dus 817,465.00 0 0 0 0 1
02000009 Fuji VII Dus 883,400.00 0 0 0 0
02000013 K- File 25 set 109,400.00 0 0 0 0
02000014 K- File 30 set 109,400.00 0 0 0 0
02000015 K-File No. 15 Set 109,400.00 0 0 0 0
02000016 K-File No. 20 Set 109,400.00 0 0 0 0
02000029 Tooth mouse box 201,300.00 0 0 0 0
- - - 0
03000005 Multivitamin dan suplemen : Askorbic acid 150 mg, Niacinatablet 2,200.00 0 0 0 0 2000
03000030 Obat Flu : Wicold sirup botol 7,260.00 0 10 10 0 10 50
03000031 Obat Flu dan Batuk : Dextral tablet tab 782.00 100 100 100 0 500
03000036 Ambefaz 10 kapsul 1,349.70 0 0 0 0
03000038 Ocugard kapsul 4,726.66 0 0 0 0
- - - 0
04000001 ADS 0.05 ml Pcs 1,550.00 0 0 0 0
04000002 ADS 0.5 ml pcs 1,190.00 0 0 0 0
04000003 ADS 5ml Pcs 1,582.00 0 0 0 0
04000007 Alat suntik sekali pakai 3 cc buah 887.78 700 700 0 700
04000012 Blood Lancet 26 - 14,000.00 6 6 6 0 20
04000013 Blood Lancet 28 box @100 14,566.00 8 20 28 0 28
04000084 IV CANNULA 18 Buah 10,494.00 0 0 0 0
04000085 IV CANNULA 20 Buah 10,494.00 0 0 0 0
04000086 IV CANNULA 22 Buah 10,494.00 0 0 0 0
04000087 IV CANNULA 24 Buah 10,494.00 0 0 0 0
04000107 Kasa 10 cm x 10 cm pouch 9,430.80 0 0 0 0
Kasa Hidrofil 40y x 80 cm Rol 128,500.00 2 2 0 2
04000113 Kasa Pembalut Hidrofil 4M x 15CM Rol 3,800.00 0 0 0 0 10
04000116 Kertas EKG ( 50 x 30) rol 33,000.00 0 0 0 0
04000154 Peter silk 2/0 -3/8 kotak 80,465.00 0 0 0 0
04000162 Pot sputum buah 2,728.00 350 350 0 350
04000163 Pot urin buah 2,331.00 0 0 0 0
04000164 Safety Box 5 Ltr Kuning Dus 14,500.00 20 20 0 20
04000178 Sarung tangan obsgyn pasang 19,360.00 0 0 0 0
04000180 Sarung tangan Troge sensosurge - plus No 7 ( Steril ) pcs 8,635.00 89 89 0 89
04000193 Tube EDTA 17 x 75 box 100,500.00 0 0 0 0
04000196 Underpad (Cosmomed) buah 3,850.00 0 0 0 0 50
04000198 Urin bag pcs 5,700.00 0 0 0 0 5
- Sarung Tangan Obsgyn (Pengadaan) pasang 42,900.00 160 20 180 20 160
- REAGEN - 0
05000007 HBsAg (Fokus) - 10,836.00 0 0 0 0
05000013 HEP.B(PID) vial 20,900.00 0 0 0 0
05000014 HIV (Fokus) tes 13,235.00 0 0 0 0
05000015 HIV Fokus tes 14,470.00 0 0 0 0
05000016 HIV Monotes box 345,000.00 0 0 0 0
05000017 HIV Vikia tes 19,480.00 0 0 0 0
HIV Viro Check box @25 202,350.00 6 6 0 6
05000057 Rapid test untuk pemeriksaan Kolesterol : Benecheck box-10 250,000.00 5 5 5 0 10
05000061 Reagen fotometer : reagen asam urat botol @ 100 ml 467,665.00 0 0 0 0
05000071 Siphilis Trypo Check tes 9,000.00 300 300 0 300
05000073 Syphilis AB tes 20,400.00 0 0 0 0
- - -
06000001 Alcohol swab, 2 ply box-100 pcs 11,604.00 20 20 40 13 27
06000003 Alkohol 70% Btl-1000 ml 37,638.00 0 0 0
06000004 Alkohol 70% Btl-100 ml 7,579.00 0 0 0 0
06000008 Autoclick set 19,158.00 0 0 0 0
06000021 LUGOL botol 0 0 0 0
06000023 Povidone iodine 10% 30 ml Btl 3,200.00 9 9 6 3 10

OBAT PROGRAM
PROGRAM DIARE
PROGRAM KIA/ GIZI

10000001 Mineral Mix saset 3,116.00 0 40 40 0 40
TTD (Fero fumarat)/ Dinkesprop tablet 226.00 3700 3100 6800 1300 5500

- - - 0
- - - 0
- - - 0
- - - 0
16000001 Vaksin BCG vial 59,950.00 0 0 0 0
16000004 VAKSIN IPV vial 153,736.00 0 0 0 0
16000006 VAKSIN MR vial 149,820.00 0 0 0 0
16000008 VAKSIN TT vial 14,498.00 0 0 0 0
16000009 VAKSIN Td vial 16,500.00 0 0 0 0
16000010 VAKSIN DT vial 17,798.00 0 0 0 0
Masker hijab nousmed box 41,349.00 20 20 15 5 10
Rapid 1 HIV (SD Bioline) Pengadaan tes 11,322.30 0 0 0 0
Purworejo, 9 Mei 2022

Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 2006 04 2 001 NIP. 19920125 201903 2 014

KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : MEI 2022 PUSKESMAS /IV/2022 9 MEI 2022
KAB GRAM PROV
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
0000001 Cat Gut Chromic 2/0 DS 24 MM 235 1524 Buah 30,893.29 0 36 36 12 24 APRIL
0000002 Ethyl Cloride Spray Kaleng 150,000.0 0 0 0 0
0000006 Siprofloxacin 500 mg Tablet 847.00 0 0 0 0
Purworejo, 9 MEI 2022

Mengetahui
Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014

KABUPATEN : PURWOREJO PEMBELIAN BULAN / PERIODE : MEI 2022 PUSKESMAS /IV/2022 9 MEI 2022
NO OBAT SATUAN KET
1 cap) set 300,000.00
mulya sejahtera 0 0
3 set 490,000.00
12 Gown Boogie pcs 112,500.00 0 0
14 Selkom-C sapta Sari Tama tablet 950.00 15 15 15 0
34 APD BPBD pcs 181,500.00 0 0
35 APD BLK pcs 181,500.00 0 0
36 APD PICCI pcs 181,500.00 0 0
39 Gown BPBD pcs 134,750.00 0 0
67 PRALON PCS 32,000.00 0 0
94 APD set 7 item Set 625,000.00 0 0
95 APD set 5 item Set 500,000.00 0 0
144 Imboost Box/30 tab 212,960.00 0 0
145 Pritavit Tab 1,100.00 0 0
146 Selimut Buah 75,000.00 0 0
148 Gown TT pcs 214,500.00 0 0
149 Gown MG 81 pcs 155,000.00 0 0
157 OSELTAMIVIR 75MG Propinsi KAPSUL 7,000.00 0 0 0 0
159 Novel Coronavirus (covid-19) Antigen Test Kit Test 97,450.00 150 150 0 150
162 Stimuno Forte Hijau KAPSUL 1,815.0 0 - 0 -
163 Stimuno Ungu btl 19,690.0 0 - 0 -
165 Multivitamin Dewasa (Bionicom Zink) tab 594.0 0 - 0 -
166 Vitamin D (caviplex) 1000 IU tab 1,195.0 0 60 60 -
JUMLAH DROPING
HIBAH
1 0 0 0
2 0 0 0
3 0 0 0
JUMLAH HIBAH
Purworejo, 9 MEI 2022

Kabupaten Purworejo
NIP. 19690220 200212 2004 NIP. 19730606 199103 1 001 NIP. 19700827 200604 2 001 NIP. 19920125 201903 2 014

Seborokrapyak Lplpo 2022

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SATUAN HARGA

- PROGRAM DIARE - 2,134

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

JUMLAH KUNJUNNGAN RESEP UMUM / BAYAR BPJS LAIN-2 JUMLAH

Purworejo, 17 Januari 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

0000001 Altamed Gloves Size S Box 135,000.00 0 0 0 0

Purworejo, 3 Januari 2021

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

Purworejo, 1 November 2021

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

TAMBAHAN PERBEKALAN KESEHATAN

PROGRAM KIA/ GIZI

JUMLAH KUNJUNNGAN RESEP UMUM / BAYAR BPJS LAIN-2 JUMLAH

Purworejo, 7 Februari 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

0000001 Cat Gut Chromic 2/0 GEA Buah 8,250.00 12 12 12 0 FEB

Purworejo, 7 Februari 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

Purworejo, 7 Februari 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

TAMBAHAN PERBEKALAN KESEHATAN

PROGRAM KIA/ GIZI

JUMLAH KUNJUNNGAN RESEP UMUM / BAYAR BPJS LAIN-2 JUMLAH

Purworejo, 11 Maret 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

0000001 Cat Gut Chromic 2/0 GEA Buah 8,250.00 0 0 0 0

Purworejo, 11 Maret 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

Purworejo, 11 Maret 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

TAMBAHAN PERBEKALAN KESEHATAN

PROGRAM KIA/ GIZI

JUMLAH KUNJUNNGAN RESEP UMUM / BAYAR BPJS LAIN-2 JUMLAH

Purworejo, 4 April 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

0000001 Cat Gut Chromic 2/0 GEA Buah 8,250.00 0 0 0 0

Purworejo, 11 Maret 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

Purworejo, 11 Maret 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

TAMBAHAN PERBEKALAN KESEHATAN

PROGRAM KIA/ GIZI

OBAT ANTI TUBERKULOSIS -

JUMLAH KUNJUNNGAN RESEP UMUM / BAYAR BPJS LAIN-2 JUMLAH

Purworejo, 9 Mei 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

Purworejo, 9 MEI 2022

PUSKESMAS : SEBOROKRAPYAK DOKUMEN NOMOR TANGGAL

Purworejo, 9 MEI 2022

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