SISA STOK OBAT PKD DI PUSKESMAS SIMPANG IV SIPIN PER 31 DESEMBER 2017

SIMP IV SIPIN
KEMASAN
NO NAMA OBAT HARGA OBAT

1 2 3 14 29.00

1 Albendazol 400 mg Set 427.00

2 Allupurinol 300 mg Tab 1000 225.00
3 Allupurinol tablet Tab 1700 93.00
4 Aminofilina tablet Tab 1300 82.00
5 Aminofilina injeksi Tab -
6 Amlodipin 10mg Tab 603.33
7 Amlodipin 5mg Tab 2100 88.00
8 Amitriptilina tab 25 mg Tab 2000 117.00
9 Amoksisilina sirup kering Btl 2,152.00
10 Amoksisilin kap 250 mg Kap -
11 Amoksisilin kap 500 mg Kap 233.00
12 Ampisilina kaplet 500 mg Kap 400.00
13 Ampisillina syrup kering Btl 4,620.00
14 Antalgin tablet 500 mg Tab 1600 178.20
15 Antalgin injeksi Ampul 2,065.83
16 Ambroxol tab 30 mg Tab 3,642.00
17 Ambroxol syrup Btl 50 4,330.00
18 Antasida Doen susp /Syrup btl 2,065.00
19 Antasida Doen tab Tab 74.00
20 Anti Bakteri Salap /Bacitracin Salep Tube 3,071.00
21 Anti Fungi kombinasi Pot 148 4,540.00
22 Anti Hemaroid Pot 3,197.00
23 Anti Migrain tab Tab 2400 142.00
24 Asam Askorbat tab 50 mg Tab 109.00
25 Asetosal tablet 100 mg Tab 266.00
26 Asetosal 500 mg tab 266.00
27 Asetosal tablet 80 mg Tab 300 118.00
28 Asam folat Tab 70.00
29 Asam Mefenamat 500 mg Tab 1100 112.00
30 Acyclovir cream 5 % tube 3,034.00
31 Acyclovir tablet 200 mg Tab 600 239.00
32 Acyclovir tab 400 mg Tab 600 345.00
33 Betahistin mesilat Tab 162.00
34 Benzatin benzil penicillin inj.2,4 jt I Ampul 11,235.00
35 Besi Syrup btl 6,641.00
36 Bisacodyl 10mg Tab 6,045.00
37 Betametason kream 0,1 % Tube 1,407.00
38 Captopril 12,5 mg Tab 76.00
39 Captopril 25 mg Tab 89.00
40 Captopril 50mg Tab 141.00
41 Clindamicine 300 mg Kap 589.00
42 Clindamicine 150 mg Kap 948.19
43 Cefotaxime inj 1 g Ampul 790.39
44 Cefadroksil 500 kap 3800 451.00
45 Cetirizin tab 10 mg Kap 3800 145.00
46 Ciprofloksasin Tab 3400 268.00
47 Dekstrose 10% kolf 10,909.00
48 Dekstrose 40% kolf 3,363.00
49 Deksametason injeksi Ampul 100 1,659.00
50 Dexamethason tab Tab 12000 43.00
51 Domperidon tab Tab 118.00
52 Devitalisasi pasta Btl 258,780.00
53 Diazepam injeksi Ampul 30 2,461.00
54 Diazepam tab 5 mg Tab 122.00
55 Diazepam tablet 2 mg Tab 37.00
56 Difenhidramin injeksi Ampul 30 1,236.00
57 Doxicillin Tab 241.50
58 Dulcolax supp supp 5,670.00
59 Digoksin tab Tab 106.00
60 Epinephrin HCL injeksi Ampul 30 1,749.00
61 Efedrin hcl tablet 25 mg Tab 5300 52.00
62 Ekstrak belladona tab 10 mg Tab 39.90
63 Erytromycin kaps 250 mg Kap 1900 587.00
64 Erytromycin kaps 500 mg Kap 2900 751.00
65 Erytromycin syrp Btl 205 6,303.00
66 Etakridina rivanol Btl 67 2,250.00
67 Etambutol hcl tab 250 mg Tab 314.00
68 Etambutol hcl tab 500 mg Tab 100 602.28
69 Ethyl Klorida semprot Btl 129,600.00
70 Eugenol cairan Btl 17,500.00
71 Fenitoin Natrium Kap 100 mg Kap 400 154.00
72 Fenitoin Natrium Kap 30mg Kap 97.00
73 Fenobarbital Inj Ampul 30 1,802.00
74 Fenobarbital tab 100 mg Tab 577.50
75 Fenobarbital tab 30 mg Tab 4200 71.50
76 Fenoksimetil fenisilin tab 250 mg Tab 275.10
77 Fenoksimetil Fenisilina tab 500 mg Tab 535.00
78 Fenol Gliserol tetes telinga Btl 2,500.00
79 Fitomenadion injeksi Ampul 3,728.00
80 Flukonazol Tab 40 18,900.00
81 Fitomenadion tablet Tab 1300 730.00
82 Furosemida tablet Tab 400 81.00
83 Gameksan Emulsi 1 % Tube 2,310.00
84 Garam Oralit untuk 200 ml air Set 1700 269.00
85 Gentamycin salep kulit 0,1 % Tube 2,400.00
86 Gentamycin sulfat tetes mata 0,3 % Btl 4,380.00
87 Gentamycin salep mata tube 118 2,830.00
88 Gentian Violet larutan Btl 96 2,895.00
89 Glass Ionomer (GC IX ) Btl 505,400.00
90 Glibenklamida tablet Tab 2100 102.20
91 Glimepiride 1mg Tab 265.00
92 Glimepiride 2mg Tab 436.00
93 Gliseril Guaiakolat tab Tab 133.50
94 Glukosa Larutan Infus 5 % Steril Btl 10 5,579.00
95 Griseofulvin tablet 500mg Tab 700 1,291.00
96 Griseofulvin tablet 125mg Tab 245.00
97 Halloperidol tab 0,5 mg Tab 2500 61.00
98 Halloperidol tab 1,5 mg Tab 72.00
99 Halloperidol tab 5 mg Tab 200 100.00
100 Hidroklortiazida tablet Tab 1000 156.00
101 Hidrokortison kream 2,5 % Pot 240 2,650.00
102 Ibuprofen tablet 200 mg Tab 1100 108.00
103 Ibuprofen tablet 400 mg Tab 130.00
104 Isoniazida tab 100 mg Tab 78.00
105 Isoniazida tab 300 mg Tab 173.00
106 Isosorbiddinitrat tablet sub Tab 96.00
107 Kalsium Hidroksida pasta Tab 424,600.00
108 Kalsium Laktat tablet Tab 11500 66.00
109 Karbamazepin tablet Tab 700 280.00
110 Kandersatran 8 mg Tab 726.00
111 Kloramphenikol salep kulit tube 48 3,140.00
112 Klorampenikol salep mata 1 % Pot 1,800.00
113 Kloramfenikol tetes mata Btl 3,522.00
114 Klorampenikol tetes telinga 3 % Btl 24 2,245.00
115 Kloramphenikol kap 250 mg Kap 769.50
116 Klorfeniramina maleat tablet ( CTM Tab 43.00
117 Klorfenol Kamfer Menthol ( CHKM ) Btl 48,762.00
118 Klorokuina tab 250 mg Tab 107.00
119 Klorpromazina tablet 25 mg Tab 100 71.00
120 Klorpromazin hcl inj Ampul 679.27
121 Klorpromazina tab salut 100 mg Tab 769.50
122 Kodein tablet 10 mg Tab 500 1,235.00
123 Ketorolac inj Ampul 32,636.00
124 Kotimoxazol suspensi Btl 2,183.00
125 Kotrimoksazol tab pediatrik Tab 75.00
126 Kotrimoksazoltab 480 mg Tab 2400 154.00
127 K omb.primetamin 25mg+suldok 5 Tab 496.65
128 Lidokain Compositum injeksi Ampul 30 1,937.00
129 Lidokain injeksi Ampul 200 870.00
130 Loperamid tab 2 mg /novadium 2mg Tab 82.00
Loratadin 10 mg Tab 128.00
131 Meloxicam 7,5 mg Tab 1500 539.80
132 Mebendazol tab 100 mg Tab 132.30
133 Methyl prednisolon tab 4 mg Tab 900 160.00
134 Magnesium sulfat inj.20%-25 ml Btl 16,168.00
135 Magnesium sulfat injeksi 40 % Btl 20,453.00
136 Metformin Hcl tab 500 mg Tab 3100 99.00
137 Metilergometrina maleat injeksi Ampul 2,684.00
138 Metilergometrina maleat tab Tab 143.50
139 Metronidazol tablet 250 mg Tab 100 113.00
140 Metronidazol Infus kolf 77,431.00
141 Metronidazol tablet 500 mg Tab 164.00
142 Metoklorprifamid 10 mg Tab 95.00
143 Miconazol cream tube 768 3,410.00
144 Mummyfying Pasta Btl 137,853.00
145 Natrium bikarbonat tab Tab 25.00
146 Natrium Diklofenak 50 mg Tab 600 160.00
147 Natrium Diklopenac 25 mg Tab 250 140.00
148 Natrium Klorida Lart.inf 0,9 Steril Btl 25 6,410.00
149 Nifedipin tablet Tab 300 110.00
150 Nistatin Tablet salut 500.000 IU Tab 672.00
151 Nistatin Tablet Vaginal 100.000 IU Tab 260 549.00
152 OBH Btl 3,360.00
153 Oksitetrasiklin hcl zalf 3 % Pot 2,137.20
154 Oksitetrasiklin hcl salep mata 1 % tube 1,600.00
155 Oksitetrasiklin injeksi vial 8,050.00
156 Oksitosin injeksi /Pitogen Ampul 2,310.00
157 Ondansetron inj Ampul 2,400.00
158 Ofloxacin tab 450 381.80
159 Omeprazole kaps 20 mg Kap 144.00
160 Papaverin tablet Tab 1300 124.00
161 Paraformaldehida tablet Tab 60.75
162 Parasetamol drop Btl 100 5,460.00
163 Parasetamol syrup Btl 250 1,119.00
164 Parasetamol tablet 100 mg Tab 32.96
165 Parasetamol tab 500 mg Tab 3700 57.00
166 Pirazinamide tablet 500 mg Tab 240.00
167 Piroxicam 10 mg Tab 105.00
168 Piridoksin tablet 10 mg Tab 124.00
169 Pirantel pamoat tab 125 mg Tab 1000 308.00
170 Perak Sulfadiazine cream 3% btl 20,700.00
171 Polikresulen /Albotil Btl 9 37,500.00
172 Prednison tablet Tab 2000 86.00
173 Primakuina tablet Tab 900 120.00
174 Prokain Benzil Penisilin injeksi Ampul 6,318.00
175 Propilthiourasil tab Tab 376.00
176 Proris supp supp 989.18
177 Pronalges supp supp 11,818.00
178 Propanolol 10 mg Tab 300 79.00
179 Propanolol tab 40- mg Tab 114.00
180 Ranitidin Injeksi Ampul 1,157.00
181 Ranitidin tab 150 mg Tab 4100 115.00
182 Reserpin tab 0,1 mg Tab 85.00
183 Reserpin tab 0,25 mg Tab 747.00
184 Retinol kapsul 100.000 IU Btl 273.00
185 Retinol kapsul 200.000 IU Btl 482.00
186 Rifampisin kapsul 300 mg Kap 200 504.00
187 Rifampisin 450 mg Kap 870.00
188 Rifampisin tablet 600mg Kap 1,296.00
189 Ringer Laktat infus Steril Btl 19 5,460.00
190 Salbutamol tablet 2 mg Tab 62.00
191 Salbutamol 4 mg Tab 2900 89.00
192 Salep 2-4 Tube 72 2,100.00
193 Salisil bedak 2 % 1,250.00
194 Sianokobalamin tab tab 60.00
195 Sianokobalamin inj 500 mcg/ml Ampul 300 1,018.00
196 Seng Semen Serbuk & cairan /Zink Btl 80,659.00
197 Serum Anti Bisa Ular Injeksi Vial 462,546.00
198 Serum Anti tetanus Inj 1500 IU vial 124,850.00
199 Simvastatin 10 mg Tab 538.60
200 Silver Amalgamserbuk Btl 618,636.00
201 Solvitron tab kap 605.80
202 Stesolid 5mg tube 10 12,155.00
203 Stesolid 10 mg tube 17,600.00
204 Semen seng fosfat serbuk dan cairan Btl 80,659.00
205 Sulfasetamid tetes mata Btl 3,180.00
206 Tablet tambah darah komb Tab 4000 62.00
207 Temporary / fletcher set 7,205.10
208 Tetrasiklin kapsul 250 mg Kap 1800 154.00
209 Tetrasiklin kapsul 500 mg Kap 376.00
210 Tiamina injeksi Ampul 1,045.00
211 Tiamina tablet 50 mg Tab 24000 89.00
212 Trihexylphenidil tab 2 mg Tab 3400 38.50
213 Trikresol Formalin cairan Btl 29,485.50
214 Valsatran 80mg tab 3,900.00
215 Ventolin nebulizer fls 4,000.00
216 Vaksin Rabies Vero Ampul 136,409.00
217 Yodium povido lart 10%-300 ml Btl 10 14,771.00
218 Yodium povido lart 10%-30 ml Btl 2,250.00
219 Vitamin B Komplek tab Tab 110.00
220 Zinc tab 20 mg Tab 3300 497.00
TOTAL
KEMASAN

SIMP IV SIPIN

NO. REAGENSIA / ALKES / BMHP HARGA OBAT

1 Alat Suntik 1 ml Set 1,089.00

 2 Alat Suntik 2,5 ml Set 717.76
3 Alat Suntik 3 ml Set 1500 968.00
4 Alat suntik 5 ml Set 1,038.00
5 Alkohol 70 % / Etanol 70% Btl 41 27,305.00
6 Aqua Destilata steril 500 ml Botol 9 20,909.00
7 Aqua pro injeksi steril Botol 2,750.00
8 Abocath 18 pcs 7,700.00
9 Abocath 20 pcs 7,700.00
10 Abocath 24 pcs 7,700.00
11 Abocath no 22 /IV cateter pcs 7,700.00
12 Bisturi no 10,11,20,22 Set 2,912.00
13 Blood Lancet Ktk 476.64
14 Catgut/benang bedah no.2/0-3/0 Sachet 13,874.08
15 Cell Clean ( CL-50) Set 2 1,370,600.00
16 Cell Pack ( Pk-30L) Set 3 2,035,000.00
17 Stomalyzer set 4 1,340,400.00
18 Deck Glass Set 432 1,670.00
19 Hand scoon / Sarung Tangan Bungkus 2600 952.00
20 Infusion set anak Set 7,920.00
21 Infusion set dewasa Set 7,920.00
22 Jarum Jahit 3,702.00
23 Kapas pembalut/Absorben 250 gra Rol 15,624.00
24 Kasa kompres 40/40 steril Rol 1,822.00
25 Kasa pembalut hidrofil 4mx3cm Rol 854.00
26 Kasa pembalut hidrofil 4mx15cm Rol 3,871.00
27 Kertas perkamen Rol 90 2,180.00
28 Kertas Saring Whatman Rol 4 2,989.00
29 Lisol Btl 25 52,070.00
30 Larutan turk Btl 5 36,000.00
31 Larutan karbol fuksin Btl 5 64,240.00
32 Larutan asam klorida 0,1 N Btl 1 51,600.00
33 Larutan asam sulfosalisilat 20% Btl 5 415,000.00
34 Larutan barium klorida Btl 2 46,750.00
35 Larutan Metanol Btl 8 97,000.00
36 Larutan Metilen Biru Btl 6 68,800.00
37 Larutan Giemsa Stalin Btl 1 536,000.00
38 Larutan Etanol Asam Btl 64,240.00
39 Larutan Eosin 2 % Btl 321,750.00
40 Larutan Bupper PH 7,2 Btl 1 79,909.00
41 Larutan spiritus 100 ml Btl 6 32,000.00
42 Larutan Benedict Btl 3 30,000.00
43 Larutan Rees echer Btl 2 65,340.00
44 Larutan H2O2 Btl 6 29,700.00
45 Larutan Imersen oil HB Btl 475,200.00
46 Larutan Natrium Sitrat 38 % Btl 5 46,175.00
47 Larutan Fauchet btl 2 244,750.00
48 Masker pcs 1800 419.10
49 Objek Gllas Ktk 300 277.14
50 Poli Chateter no. 16 pcs 35,454.50
51 Poli chateter no.12 pcs 35,454.50
52 Plester 5 yard x 2 inch Rol 18 28,991.00
53 Plastik obat Set 52000 121.00
54 Pipet Tetes panjang Ktk 100 1,595.00
55 Printer paper roll 7 43,000.00
56 S il k no. 03/0 Rol 2,591.75
57 Spon Gelatin cubikles Sak 38,500.00
58 Stik Asam Urat ktk 5,691.20
59 Stick gluko DR /50 stick ktk 7,403.00
60 Stik Kolesterol ktk 20,680.00
61 Tabung K2EDTA 2ml pcs 100 1,914.00
62 Tabung Reaksi Set 30 5,970.00
63 Tes kehamilan HCG Pcs 50 1,513.80
64 Urine bag pcs 13,918.00
65 Tisu lensa Bngks 40,890.00
66 Tes Gol Darah (A,B,AB ) Ktk 4 242,000.00
TOTAL
69,131,201.40

Jambi, 31 Desember 2016

Mengetahui,
Kepala Puskesmas Simpang IV Sipin
Kota Jambi

dr. Tety Ariestianty

Nip.19750420 200604 2 005
ER 31 DESEMBER 2017

JUMLAH ( Rp )

30.00

-
290,000.00
158,100.00
106,600.00
-
-
220,500.00
234,000.00
-
-
-
-
-
185,600.00
-
-
162,250.00
-
-
-
301,180.00
-
340,800.00
-
-
-
35,400.00
-
123,200.00
-
143,400.00
207,000.00
-
-
-
-
-
-
-
 -
-
-
-
2,029,200.00
551,000.00
982,600.00
-
-
155,000.00
768,000.00
-
-
73,830.00
-
-
37,080.00
-
-
-
255,150.00
275,600.00
-
944,300.00
2,177,900.00
1,407,735.00
150,750.00
-
60,228.00
-
-
50,800.00
-
54,060.00
-
300,300.00
-
-
-
-
756,000.00
865,800.00
32,000.00
-
457,300.00
-
-
313,880.00
 237,600.00
-
121,800.00
-
-
-
55,790.00
903,700.00
-
135,000.00
-
25,682.00
38,115.00
636,000.00
118,800.00
-
-
-
-
-
759,000.00
179,900.00
-
154,704.00
-
-
44,160.00
-
-
-
-
7,100.00
-
-
61,750.00
-
-
-
348,000.00
-
40,800.00
175,800.00
-

1,125,000.00
-
189,000.00
-
 -
325,500.00
-
-
11,300.00
-
-
-
2,304,000.00
-
-
222,000.00
44,000.00
123,375.00
33,000.00
-
131,040.00
-
-
-
-
-
-
171,810.00
-
161,200.00
-
546,000.00
279,750.00
-
310,800.00
-
-
-
308,000.00
-
161,937.00
172,000.00
108,000.00
-
-
-
-
23,700.00
-
-
471,500.00
-
 -
-
-
100,800.00
-
-
103,740.00
-
258,100.00
151,200.00
-
-
305,400.00
-
-
-
-
-
-
121,550.00
-
-
-
248,000.00
-
277,200.00
-
-
2,136,000.00
130,900.00
-
-
-
-
147,710.00
-
-
1,640,100.00
32,093,856.00

JUMLAH ( Rp )

-
 -
1,452,000.00
-
1,119,505.00
188,181.00
-
-
-
-
-
-
-
-
2,741,200.00
6,105,000.00
5,361,600.00
721,440.00
2,475,200.00
-
-
-
-
-
-
-
196,200.00
11,956.00
1,301,750.00
180,000.00
321,200.00
51,600.00
2,075,000.00
93,500.00
776,000.00
412,800.00
536,000.00
-
-
79,909.00
192,000.00
90,000.00
130,680.00
178,200.00
-
230,875.00
489,500.00
754,380.00
83,141.40
 -
-
521,838.00
6,292,000.00
159,500.00
301,000.00
-
-
-
-
-
191,400.00
179,100.00
75,690.00
-
-
968,000.00
37,037,345.40
69,131,201.40

i, 31 Desember 2016
Mengetahui,
skesmas Simpang IV Sipin
Kota Jambi

r. Tety Ariestianty
750420 200604 2 005
SISA STOK OBAT BLUD DI PUSKESMAS SIMPANG IV SIPIN PER 31 DESEMBER 2017

SIMP IV SIPIN
KEMASAN
NO NAMA OBAT HARGA OBAT JUMLAH ( Rp )

1 2 3 14 29.00 30.00

1 Albendazol 400 mg Set 427.00 -

2 Allupurinol 300 mg Tab 1000 225.00 290,000.00
3 Allupurinol tablet Tab 1700 93.00 158,100.00
4 Aminofilina tablet Tab 1300 82.00 106,600.00
5 Aminofilina injeksi Tab - -
6 Amlodipin 10mg Tab 603.33 -
7 Amlodipin 5mg Tab 2100 88.00 220,500.00
8 Amitriptilina tab 25 mg Tab 2000 117.00 234,000.00
9 Amoksisilina sirup kering Btl 2,152.00 -
10 Amoksisilin kap 250 mg Kap - -
11 Amoksisilin kap 500 mg Kap 233.00 -
12 Ampisilina kaplet 500 mg Kap 400.00 -
13 Ampisillina syrup kering Btl 4,620.00 -
14 Antalgin tablet 500 mg Tab 1600 178.20 185,600.00
15 Antalgin injeksi Ampul 2,065.83 -
16 Ambroxol tab 30 mg Tab 3,642.00 -
17 Ambroxol syrup Btl 50 4,330.00 162,250.00
18 Antasida Doen susp /Syrup btl 2,065.00 -
19 Antasida Doen tab Tab 74.00 -
20 Anti Bakteri Salap /Bacitracin S Tube 3,071.00 -
21 Anti Fungi kombinasi Pot 148 4,540.00 301,180.00
22 Anti Hemaroid Pot 3,197.00 -
23 Anti Migrain tab Tab 2400 142.00 340,800.00
24 Asam Askorbat tab 50 mg Tab 109.00 -
25 Asetosal tablet 100 mg Tab 266.00 -
26 Asetosal 500 mg tab 266.00 -
27 Asetosal tablet 80 mg Tab 300 118.00 35,400.00
28 Asam folat Tab 70.00 -
29 Asam Mefenamat 500 mg Tab 1100 112.00 123,200.00
30 Acyclovir cream 5 % tube 3,034.00 -
31 Acyclovir tablet 200 mg Tab 600 239.00 143,400.00
32 Acyclovir tab 400 mg Tab 600 345.00 207,000.00
33 Betahistin mesilat Tab 162.00 -
34 Benzatin benzil penicillin inj.2,4 Ampul 11,235.00 -
35 Besi Syrup btl 6,641.00 -
36 Bisacodyl 10mg Tab 6,045.00 -
37 Betametason kream 0,1 % Tube 1,407.00 -
38 Captopril 12,5 mg Tab 76.00 -
39 Captopril 25 mg Tab 89.00 -
40 Captopril 50mg Tab 141.00 -
41 Clindamicine 300 mg Kap 589.00 -
42 Clindamicine 150 mg Kap 948.19 -
43 Cefotaxime inj 1 g Ampul 790.39 -
44 Cefadroksil 500 kap 3800 451.00 2,029,200.00
45 Cetirizin tab 10 mg Kap 3800 145.00 551,000.00
46 Ciprofloksasin Tab 3400 268.00 982,600.00
47 Dekstrose 10% kolf 10,909.00 -
48 Dekstrose 40% kolf 3,363.00 -
49 Deksametason injeksi Ampul 100 1,659.00 155,000.00
50 Dexamethason tab Tab 12000 43.00 768,000.00
51 Domperidon tab Tab 118.00 -
52 Devitalisasi pasta Btl 258,780.00 -
53 Diazepam injeksi Ampul 30 2,461.00 73,830.00
54 Diazepam tab 5 mg Tab 122.00 -
55 Diazepam tablet 2 mg Tab 37.00 -
56 Difenhidramin injeksi Ampul 30 1,236.00 37,080.00
57 Doxicillin Tab 241.50 -
58 Dulcolax supp supp 5,670.00 -
59 Digoksin tab Tab 106.00 -
60 Epinephrin HCL injeksi Ampul 30 1,749.00 255,150.00
61 Efedrin hcl tablet 25 mg Tab 5300 52.00 275,600.00
62 Ekstrak belladona tab 10 mg Tab 39.90 -
63 Erytromycin kaps 250 mg Kap 1900 587.00 944,300.00
64 Erytromycin kaps 500 mg Kap 2900 751.00 2,177,900.00
65 Erytromycin syrp Btl 205 6,303.00 1,407,735.00
66 Etakridina rivanol Btl 67 2,250.00 150,750.00
67 Etambutol hcl tab 250 mg Tab 314.00 -
68 Etambutol hcl tab 500 mg Tab 100 602.28 60,228.00
69 Ethyl Klorida semprot Btl 129,600.00 -
70 Eugenol cairan Btl 17,500.00 -
71 Fenitoin Natrium Kap 100 mg Kap 400 154.00 50,800.00
72 Fenitoin Natrium Kap 30mg Kap 97.00 -
73 Fenobarbital Inj Ampul 30 1,802.00 54,060.00
74 Fenobarbital tab 100 mg Tab 577.50 -
75 Fenobarbital tab 30 mg Tab 4200 71.50 300,300.00
76 Fenoksimetil fenisilin tab 250 m Tab 275.10 -
77 Fenoksimetil Fenisilina tab 500 Tab 535.00 -
78 Fenol Gliserol tetes telinga Btl 2,500.00 -
79 Fitomenadion injeksi Ampul 3,728.00 -
80 Flukonazol Tab 40 18,900.00 756,000.00
81 Fitomenadion tablet Tab 1300 730.00 865,800.00
82 Furosemida tablet Tab 400 81.00 32,000.00
83 Gameksan Emulsi 1 % Tube 2,310.00 -
 84 Garam Oralit untuk 200 ml air Set 1700 269.00 457,300.00
85 Gentamycin salep kulit 0,1 % Tube 2,400.00 -
86 Gentamycin sulfat tetes mata 0, Btl 4,380.00 -
87 Gentamycin salep mata tube 118 2,830.00 313,880.00
88 Gentian Violet larutan Btl 96 2,895.00 237,600.00
89 Glass Ionomer (GC IX ) Btl 505,400.00 -
90 Glibenklamida tablet Tab 2100 102.20 121,800.00
91 Glimepiride 1mg Tab 265.00 -
92 Glimepiride 2mg Tab 436.00 -
93 Gliseril Guaiakolat tab Tab 133.50 -
94 Glukosa Larutan Infus 5 % Steril Btl 10 5,579.00 55,790.00
95 Griseofulvin tablet 500mg Tab 700 1,291.00 903,700.00
96 Griseofulvin tablet 125mg Tab 245.00 -
97 Halloperidol tab 0,5 mg Tab 2500 61.00 135,000.00
98 Halloperidol tab 1,5 mg Tab 72.00 -
99 Halloperidol tab 5 mg Tab 200 100.00 25,682.00
100 Hidroklortiazida tablet Tab 1000 156.00 38,115.00
101 Hidrokortison kream 2,5 % Pot 240 2,650.00 636,000.00
102 Ibuprofen tablet 200 mg Tab 1100 108.00 118,800.00
103 Ibuprofen tablet 400 mg Tab 130.00 -
104 Isoniazida tab 100 mg Tab 78.00 -
105 Isoniazida tab 300 mg Tab 173.00 -
106 Isosorbiddinitrat tablet sub Tab 96.00 -
107 Kalsium Hidroksida pasta Tab 424,600.00 -
108 Kalsium Laktat tablet Tab 11500 66.00 759,000.00
109 Karbamazepin tablet Tab 700 280.00 179,900.00
110 Kandersatran 8 mg Tab 726.00 -
111 Kloramphenikol salep kulit tube 48 3,140.00 154,704.00
112 Klorampenikol salep mata 1 % Pot 1,800.00 -
113 Kloramfenikol tetes mata Btl 3,522.00 -
114 Klorampenikol tetes telinga 3 % Btl 24 2,245.00 44,160.00
115 Kloramphenikol kap 250 mg Kap 769.50 -
116 Klorfeniramina maleat tablet ( Tab 43.00 -
117 Klorfenol Kamfer Menthol ( CHK Btl 48,762.00 -
118 Klorokuina tab 250 mg Tab 107.00 -
119 Klorpromazina tablet 25 mg Tab 100 71.00 7,100.00
120 Klorpromazin hcl inj Ampul 679.27 -
121 Klorpromazina tab salut 100 mg Tab 769.50 -
122 Kodein tablet 10 mg Tab 500 1,235.00 61,750.00
123 Ketorolac inj Ampul 32,636.00 -
124 Kotimoxazol suspensi Btl 2,183.00 -
125 Kotrimoksazol tab pediatrik Tab 75.00 -
126 Kotrimoksazoltab 480 mg Tab 2400 154.00 348,000.00
127 K omb.primetamin 25mg+suldo Tab 496.65 -
128 Lidokain Compositum injeksi Ampul 30 1,937.00 40,800.00
129 Lidokain injeksi Ampul 200 870.00 175,800.00
130 Loperamid tab 2 mg /novadium Tab 82.00 -
Loratadin 10 mg Tab 128.00
131 Meloxicam 7,5 mg Tab 1500 539.80 1,125,000.00
132 Mebendazol tab 100 mg Tab 132.30 -
133 Methyl prednisolon tab 4 mg Tab 900 160.00 189,000.00
134 Magnesium sulfat inj.20%-25 ml Btl 16,168.00 -
135 Magnesium sulfat injeksi 40 % Btl 20,453.00 -
136 Metformin Hcl tab 500 mg Tab 3100 99.00 325,500.00
137 Metilergometrina maleat injeksi Ampul 2,684.00 -
138 Metilergometrina maleat tab Tab 143.50 -
139 Metronidazol tablet 250 mg Tab 100 113.00 11,300.00
140 Metronidazol Infus kolf 77,431.00 -
141 Metronidazol tablet 500 mg Tab 164.00 -
142 Metoklorprifamid 10 mg Tab 95.00 -
143 Miconazol cream tube 768 3,410.00 2,304,000.00
144 Mummyfying Pasta Btl 137,853.00 -
145 Natrium bikarbonat tab Tab 25.00 -
146 Natrium Diklofenak 50 mg Tab 600 160.00 222,000.00
147 Natrium Diklopenac 25 mg Tab 250 140.00 44,000.00
148 Natrium Klorida Lart.inf 0,9 Steri Btl 25 6,410.00 123,375.00
149 Nifedipin tablet Tab 300 110.00 33,000.00
150 Nistatin Tablet salut 500.000 IU Tab 672.00 -
151 Nistatin Tablet Vaginal 100.000 Tab 260 549.00 131,040.00
152 OBH Btl 3,360.00 -
153 Oksitetrasiklin hcl zalf 3 % Pot 2,137.20 -
154 Oksitetrasiklin hcl salep mata 1 tube 1,600.00 -
155 Oksitetrasiklin injeksi vial 8,050.00 -
156 Oksitosin injeksi /Pitogen Ampul 2,310.00 -
157 Ondansetron inj Ampul 2,400.00 -
158 Ofloxacin tab 450 381.80 171,810.00
159 Omeprazole kaps 20 mg Kap 144.00 -
160 Papaverin tablet Tab 1300 124.00 161,200.00
161 Paraformaldehida tablet Tab 60.75 -
162 Parasetamol drop Btl 100 5,460.00 546,000.00
163 Parasetamol syrup Btl 250 1,119.00 279,750.00
164 Parasetamol tablet 100 mg Tab 32.96 -
165 Parasetamol tab 500 mg Tab 3700 57.00 310,800.00
166 Pirazinamide tablet 500 mg Tab 240.00 -
167 Piroxicam 10 mg Tab 105.00 -
168 Piridoksin tablet 10 mg Tab 124.00 -
169 Pirantel pamoat tab 125 mg Tab 1000 308.00 308,000.00
170 Perak Sulfadiazine cream 3% btl 20,700.00 -
171 Polikresulen /Albotil Btl 9 37,500.00 161,937.00
172 Prednison tablet Tab 2000 86.00 172,000.00
173 Primakuina tablet Tab 900 120.00 108,000.00
174 Prokain Benzil Penisilin injeksi Ampul 6,318.00 -
175 Propilthiourasil tab Tab 376.00 -
176 Proris supp supp 989.18 -
177 Pronalges supp supp 11,818.00 -
178 Propanolol 10 mg Tab 300 79.00 23,700.00
179 Propanolol tab 40- mg Tab 114.00 -
180 Ranitidin Injeksi Ampul 1,157.00 -
181 Ranitidin tab 150 mg Tab 4100 115.00 471,500.00
182 Reserpin tab 0,1 mg Tab 85.00 -
183 Reserpin tab 0,25 mg Tab 747.00 -
184 Retinol kapsul 100.000 IU Btl 273.00 -
185 Retinol kapsul 200.000 IU Btl 482.00 -
186 Rifampisin kapsul 300 mg Kap 200 504.00 100,800.00
187 Rifampisin 450 mg Kap 870.00 -
188 Rifampisin tablet 600mg Kap 1,296.00 -
189 Ringer Laktat infus Steril Btl 19 5,460.00 103,740.00
190 Salbutamol tablet 2 mg Tab 62.00 -
191 Salbutamol 4 mg Tab 2900 89.00 258,100.00
192 Salep 2-4 Tube 72 2,100.00 151,200.00
193 Salisil bedak 2 % 1,250.00 -
194 Sianokobalamin tab tab 60.00 -
195 Sianokobalamin inj 500 mcg/ml Ampul 300 1,018.00 305,400.00
196 Seng Semen Serbuk & cairan /Zi Btl 80,659.00 -
197 Serum Anti Bisa Ular Injeksi Vial 462,546.00 -
198 Serum Anti tetanus Inj 1500 IU vial 124,850.00 -
199 Simvastatin 10 mg Tab 538.60 -
200 Silver Amalgamserbuk Btl 618,636.00 -
201 Solvitron tab kap 605.80 -
202 Stesolid 5mg tube 10 12,155.00 121,550.00
203 Stesolid 10 mg tube 17,600.00 -
204 Semen seng fosfat serbuk dan ca Btl 80,659.00 -
205 Sulfasetamid tetes mata Btl 3,180.00 -
206 Tablet tambah darah komb Tab 4000 62.00 248,000.00
207 Temporary / fletcher set 7,205.10 -
208 Tetrasiklin kapsul 250 mg Kap 1800 154.00 277,200.00
209 Tetrasiklin kapsul 500 mg Kap 376.00 -
210 Tiamina injeksi Ampul 1,045.00 -
211 Tiamina tablet 50 mg Tab 24000 89.00 2,136,000.00
212 Trihexylphenidil tab 2 mg Tab 3400 38.50 130,900.00
213 Trikresol Formalin cairan Btl 29,485.50 -
214 Valsatran 80mg tab 3,900.00 -
215 Ventolin nebulizer fls 4,000.00 -
216 Vaksin Rabies Vero Ampul 136,409.00 -
217 Yodium povido lart 10%-300 ml Btl 10 14,771.00 147,710.00
218 Yodium povido lart 10%-30 ml Btl 2,250.00 -
219 Vitamin B Komplek tab Tab 110.00 -
220 Zinc tab 20 mg Tab 3300 497.00 1,640,100.00
TOTAL 32,093,856.00

KEMASAN

SIMP IV SIPIN
NO. REAGENSIA / ALKES / BMHP HARGA OBAT JUMLAH ( Rp )

1 Alat Suntik 1 ml Set 1,089.00 -

2 Alat Suntik 2,5 ml Set 717.76 -
3 Alat Suntik 3 ml Set 1500 968.00 1,452,000.00
4 Alat suntik 5 ml Set 1,038.00 -
5 Alkohol 70 % / Etanol 70% Btl 41 27,305.00 1,119,505.00
6 Aqua Destilata steril 500 ml Botol 9 20,909.00 188,181.00
7 Aqua pro injeksi steril Botol 2,750.00 -
8 Abocath 18 pcs 7,700.00 -
9 Abocath 20 pcs 7,700.00 -
10 Abocath 24 pcs 7,700.00 -
11 Abocath no 22 /IV cateter pcs 7,700.00 -
12 Bisturi no 10,11,20,22 Set 2,912.00 -
13 Blood Lancet Ktk 476.64 -
14 Catgut/benang bedah no.2/0-3/ Sachet 13,874.08 -
15 Cell Clean ( CL-50) Set 2 1,370,600.00 2,741,200.00
16 Cell Pack ( Pk-30L) Set 3 2,035,000.00 6,105,000.00
17 Stomalyzer set 4 1,340,400.00 5,361,600.00
18 Deck Glass Set 432 1,670.00 721,440.00
19 Hand scoon / Sarung Tangan Bungkus 2600 952.00 2,475,200.00
20 Infusion set anak Set 7,920.00 -
21 Infusion set dewasa Set 7,920.00 -
22 Jarum Jahit 3,702.00 -
23 Kapas pembalut/Absorben 250 Rol 15,624.00 -
24 Kasa kompres 40/40 steril Rol 1,822.00 -
25 Kasa pembalut hidrofil 4mx3cm Rol 854.00 -
26 Kasa pembalut hidrofil 4mx15c Rol 3,871.00 -
27 Kertas perkamen Rol 90 2,180.00 196,200.00
28 Kertas Saring Whatman Rol 4 2,989.00 11,956.00
29 Lisol Btl 25 52,070.00 1,301,750.00
30 Larutan turk Btl 5 36,000.00 180,000.00
31 Larutan karbol fuksin Btl 5 64,240.00 321,200.00
32 Larutan asam klorida 0,1 N Btl 1 51,600.00 51,600.00
33 Larutan asam sulfosalisilat 20% Btl 5 415,000.00 2,075,000.00
34 Larutan barium klorida Btl 2 46,750.00 93,500.00
35 Larutan Metanol Btl 8 97,000.00 776,000.00
36 Larutan Metilen Biru Btl 6 68,800.00 412,800.00
37 Larutan Giemsa Stalin Btl 1 536,000.00 536,000.00
38 Larutan Etanol Asam Btl 64,240.00 -
39 Larutan Eosin 2 % Btl 321,750.00 -
40 Larutan Bupper PH 7,2 Btl 1 79,909.00 79,909.00
41 Larutan spiritus 100 ml Btl 6 32,000.00 192,000.00
42 Larutan Benedict Btl 3 30,000.00 90,000.00
43 Larutan Rees echer Btl 2 65,340.00 130,680.00
44 Larutan H2O2 Btl 6 29,700.00 178,200.00
45 Larutan Imersen oil HB Btl 475,200.00 -
46 Larutan Natrium Sitrat 38 % Btl 5 46,175.00 230,875.00
47 Larutan Fauchet btl 2 244,750.00 489,500.00
48 Masker pcs 1800 419.10 754,380.00
49 Objek Gllas Ktk 300 277.14 83,141.40
50 Poli Chateter no. 16 pcs 35,454.50 -
51 Poli chateter no.12 pcs 35,454.50 -
52 Plester 5 yard x 2 inch Rol 18 28,991.00 521,838.00
53 Plastik obat Set 52000 121.00 6,292,000.00
54 Pipet Tetes panjang Ktk 100 1,595.00 159,500.00
55 Printer paper roll 7 43,000.00 301,000.00
56 S il k no. 03/0 Rol 2,591.75 -
57 Spon Gelatin cubikles Sak 38,500.00 -
58 Stik Asam Urat ktk 5,691.20 -
59 Stick gluko DR /50 stick ktk 7,403.00 -
60 Stik Kolesterol ktk 20,680.00 -
61 Tabung K2EDTA 2ml pcs 100 1,914.00 191,400.00
62 Tabung Reaksi Set 30 5,970.00 179,100.00
63 Tes kehamilan HCG Pcs 50 1,513.80 75,690.00
64 Urine bag pcs 13,918.00 -
65 Tisu lensa Bngks 40,890.00 -
66 Tes Gol Darah (A,B,AB ) Ktk 4 242,000.00 968,000.00
TOTAL 37,037,345.40
69,131,201.40

Jambi, 31 Desember 2016

Mengetahui,
Kepala Puskesmas Simpang IV Sipin
Kota Jambi

dr. Tety Ariestianty

Nip.19750420 200604 2 005