PUSKESMAS KALIBAWANG KABUPATEN WONOSOBO

UNIT PELAYANAN FARMASI

Jl. Dempel No.2 Kalibawang Wonosobo Wonosobo Telepon (0286) 321033 Kode Pos 56311

FORM RENCANA KEBUTUHAN OBAT (RKO)

PUSKESMAS KALIBAWANG KABUPATEN WONOSOBO
Untuk memenuhi kebutuhan obat, vaksin, reagen dan BMHP Puskesmas, kami kirimkan RKO 2020 sebagai berikut :
ID ObNama Obat Satuan Harga Rata2 Stok per 3KebutuhanPerkiraan Anggaran Usul DinkTotal Usulan Nilai Anggaran Nilai Usul an ke Total Nilai Usulan
Distribusi Agu 18 bulan Stok 31 DesBLUD BLUD Dinkes
4 Acyclovir cream tube 2,532 3 75 56 62 0 0 0 0 0 0
3 Acyclovir tab 4 tablet 380 75 50 1,350 -250 1,600 0 1,600 608,000 0 608,000
5 Albendazol tab tablet 267 797 200 14,339 -2,986 0 17,325 17,325 0 4,625,775 4,625,775
6 Alopurinol tab 1 tablet 99 76 290 1,372 -15 0 1,387 1,387 0 137,313 137,313
7 Ambroksol syr 1 botol 3,520 13 35 234 -17 251 0 251 883,520 0 883,520
9 Aminofilin inj 2 ampul 2,998 1 5 11 2 0 9 9 0 26,982 26,982
10 Aminofilin tab 2 tablet 91 0 100 0 100 0 0 0 0 0 0
12 amlodipin tab 1 tablet 93 743 3,600 13,365 630 0 12,735 12,735 0 1,184,355 1,184,355
6514 amlodipin tab 5 tablet 70 514 300 9,248 -1,755 0 11,003 11,003 0 770,210 770,210
471 Amoksisilin kap tablet 195 200 300 3,600 -500 4,100 0 4,100 799,500 0 799,500
15 Amoksisilin kapl tablet 233 2,500 4,900 45,000 -5,100 50,100 0 50,100 11,673,300 0 11,673,300
17 Amoksisilin syr botol 2,090 60 0 1,084 -241 1,325 0 1,325 2,769,250 0 2,769,250
484 Amoksisilin syr botol 3,400 23 175 416 82 334 0 334 1,135,600 0 1,135,600
20 Antalgin (Metamtablet 232 313 1,200 5,625 -50 5,675 0 5,675 1,316,600 0 1,316,600
22 Antasida DOEN botol 1,995 35 150 632 10 0 622 622 0 1,240,890 1,240,890
23 Antasida DOEN t ablet 54 1,963 2,600 35,325 -5,250 0 40,575 40,575 0 2,191,050 2,191,050
24 Anti Bakteri DO tube 2,924 13 45 234 -7 241 0 241 704,684 0 704,684
25 Anti Hemoroid supp 3,167 4 80 68 65 0 3 3 0 9,501 9,501
28 Antifungi DOEN tube 4,158 3 28 45 18 27 0 27 112,266 0 112,266
30 Antimigren DOE tablet 167 25 0 450 -100 550 0 550 91,850 0 91,850
36 Asam Ascorbat (tablet 105 1,688 3,500 30,375 -3,250 0 33,625 33,625 0 3,530,625 3,530,625
38 asam asetilsalisitablet 99 13 0 225 -50 0 275 275 0 27,225 27,225
 39 asam folat tab 1 tablet 70 238 1,000 4,275 50 0 4,225 4,225 0 295,750 295,750
40 Asam Mefenamattablet 103 775 2,300 13,950 -800 0 14,750 14,750 0 1,519,250 1,519,250
6550 Asam traneksama
ampul 2,489 15 80 270 20 0 250 250 0 622,250 622,250
6502 Asam traneksama
tablet 1,584 25 100 450 0 0 450 450 0 712,800 712,800
43 Atropin Sulfat in ampul 1,540 0 8 4 7 0 0 0 0 0 0
Hal. 1 dari 8

556 Attapulgit (Antiditablet 152 225 100 4,050 -800 0 4,850 4,850 0 737,200 737,200
6503 Azitromisin tab tablet 1,900 0 60 0 60 0 0 0 0 0 0
485 Betahistin mesil tablet 110 188 600 3,382 -152 0 3,534 3,534 0 388,740 388,740
49 Betametason cr tube 1,340 23 137 412 46 0 366 366 0 490,440 490,440
51 Bisacodil tab tablet 300 12 90 218 42 176 0 176 52,800 0 52,800
482 bisakodil supp supp 5,370 0 36 0 36 0 0 0 0 0 0
6638 Bisoprolol 5mg tablet 236 13 50 225 0 0 225 225 0 53,100 53,100
486 budesonide resputube 9,725 1 10 22 5 9 9 17 82,663 82,663 165,325
464 cefadroxil kapsu kapsul 478 150 0 2,700 -600 3,300 0 3,300 1,577,400 0 1,577,400
487 Cefadroxil syr k botol 3,922 6 50 112 25 87 0 87 341,214 0 341,214
6775 cefadroxil syr ke botol 5,940 6 50 112 25 87 0 87 516,780 0 516,780
6823 Cefixime 200mg kapsul 2,370 0 120 0 120 0 0 0 0 0 0
6612 cetirizine syr 5m botol 2,850 2 35 34 28 0 6 6 0 17,100 17,100
56 cetirizine tab 10 tablet 90 223 300 4,005 -590 0 4,595 4,595 0 413,550 413,550
59 ciprofloxaxin 50 tablet 265 350 400 6,300 -1,000 7,300 0 7,300 1,934,500 0 1,934,500
465 clindamicin kap kapsul 715 25 0 450 -100 550 0 550 393,250 0 393,250
6634 clindamicin kap kapsul 583 13 0 225 -50 275 0 275 160,325 0 160,325
64 Deksametason inampul 1,097 12 50 212 3 0 209 209 0 229,273 229,273
65 Deksametason t tablet 32 1,038 0 18,675 -4,150 22,825 0 22,825 730,400 0 730,400
68 Diazepam inj 5 mampul 4,180 0 10 0 10 0 0 0 0 0 0
488 Diazepam lar rectube 18,279 1 3 16 0 8 8 16 146,232 146,232 292,464
69 Diazepam lar rectube 12,573 1 4 14 1 7 7 13 81,725 81,725 163,449
71 Diazepam tab 5 tablet 109 6 155 101 132 0 0 0 0 0 0
72 dietilkarbamazeptablet 156 11 90 202 45 0 157 157 0 24,492 24,492
73 Difenhidramin HCampul 1,060 0 30 0 30 0 0 0 0 0 0
 74 Digoksin tab 0,2 tablet 104 25 0 450 -100 550 0 550 57,200 0 57,200
76 Diltiasem tab tablet 134 0 200 0 200 0 0 0 0 0 0
77 Dimenhidrinat tablet 99 25 0 450 -100 0 550 550 0 54,450 54,450
557 domperidon syr botol 2,700 0 40 0 40 0 0 0 0 0 0
79 Domperidon tab tablet 85 13 200 225 150 0 75 75 0 6,375 6,375
50 Ekstrak Placentatube 13,420 2 0 32 -7 39 0 39 523,380 0 523,380
85 Eritromisin kaps tablet 750 125 400 2,250 -100 2,350 0 2,350 1,762,500 0 1,762,500
370 Etakridin ( Rivanbotol 2,992 0 18 4 17 0 0 0 0 0 0
6622 Fenofibrat 100m kapsul 1,073 45 270 810 90 0 720 720 0 772,560 772,560
96 fenol gliserol (k botol 2,590 13 72 241 18 0 223 223 0 577,570 577,570
100 Fitomenadion ( Vampul 3,550 15 240 270 180 0 90 90 0 319,500 319,500
101 Fitomenadion ( Vtablet 710 13 600 225 550 0 0 0 0 0 0
106 Framicetin Sulfa sachet 8,990 3 0 45 -10 55 0 55 494,450 0 494,450
108 Furosemid tab 4 tablet 77 75 100 1,350 -200 0 1,550 1,550 0 119,350 119,350
110 Garam oralit komsachet 260 138 1,590 2,475 1,040 0 1,435 1,435 0 373,100 373,100
470 Gemfibrozil 300 kapsul 371 180 500 3,240 -220 0 3,460 3,460 0 1,283,660 1,283,660
Hal. 2 dari 8

6610 Gentamisin Tetebotol 4,232 6 72 108 48 60 0 60 253,920 0 253,920

114 Gentian violet la pot 2,710 13 23 232 -28 0 260 260 0 704,600 704,600
6500 Glimepiride tab tablet 207 156 0 2,812 -625 0 3,437 3,437 0 711,459 711,459
116 Gliseril Guayakotablet 95 811 0 14,591 -3,242 17,833 0 17,833 1,694,135 0 1,694,135
119 Glukosa larutan ibotol 6,900 1 22 14 19 0 0 0 0 0 0
6780 Griseofulvin (mi tablet 849 38 200 675 50 625 0 625 530,625 0 530,625
122 Griseofulvin 125 tablet 247 38 700 675 550 125 0 125 30,875 0 30,875
125 Haloperidol tab tablet 61 66 0 1,192 -265 0 1,457 1,457 0 88,877 88,877
126 Haloperidol tab tablet 56 46 600 832 415 0 417 417 0 23,352 23,352
129 Hidrokortison cr tube 2,475 14 30 250 -26 0 276 276 0 683,100 683,100
130 Hyoscine-N-Buti tablet 1,725 138 1,100 2,475 550 0 1,925 1,925 0 3,320,625 3,320,625
131 ibuprofen Suspe botol 2,550 13 0 225 -50 275 0 275 701,250 0 701,250
490 Ibuprofen Suspebotol 4,465 0 96 0 96 0 0 0 0 0 0
132 Ibuprofen tab 2 tablet 105 625 500 11,250 -2,000 13,250 0 13,250 1,391,250 0 1,391,250
 133 Ibuprofen tab 4 tablet 111 925 0 16,650 -3,700 20,350 0 20,350 2,258,850 0 2,258,850
136 Isoniazida ( INH tablet 65 0 400 0 400 0 0 0 0 0 0
137 Isoniazida ( INH tablet 170 13 0 225 -50 0 275 275 0 46,750 46,750
138 Isosorbid dinitra tablet 89 20 400 360 320 40 0 40 3,560 0 3,560
142 Kalsium Glukonas
ampul 9,955 0 10 0 10 0 0 0 0 0 0
143 Kalsium Lactat ( tablet 59 1,850 3,200 33,300 -4,200 0 37,500 37,500 0 2,212,500 2,212,500
146 Kaptopril tab 25 tablet 84 125 0 2,250 -500 0 2,750 2,750 0 231,000 231,000
147 Karbamazepin t tablet 228 213 100 3,825 -750 0 4,575 4,575 0 1,043,100 1,043,100
6623 Ketokonazol cr tube 2,518 6 75 112 50 62 0 62 156,116 0 156,116
6624 Ketokonazol scalbotol 24,200 1 1 9 -1 10 0 10 242,000 0 242,000
150 ketokonazol tab tablet 270 19 150 338 75 0 263 263 0 71,010 71,010
6562 Ketoprofen supposupp 2,380 7 50 119 24 95 0 95 226,100 0 226,100
492 Ketorolac inj 30 ampul 1,045 0 19 0 19 0 0 0 0 0 0
62 Kloramfenikol + tube 8,250 20 72 351 -6 357 0 357 2,945,250 0 2,945,250
6614 Kloramfenikol k kapsul 1,090 75 100 1,350 -200 1,550 0 1,550 1,689,500 0 1,689,500
6615 Kloramfenikol satube 3,091 6 19 110 -6 116 0 116 358,556 0 358,556
154 Kloramfenikol S tube 1,881 24 33 423 -61 0 484 484 0 910,404 910,404
155 Kloramfenikol sybotol 4,700 11 150 205 104 101 0 101 474,700 0 474,700
156 Kloramfenikol T botol 3,250 5 0 83 -18 101 0 101 328,250 0 328,250
157 Kloramfenikol T botol 6,270 5 15 81 -3 84 0 84 526,680 0 526,680
158 Klorfeniramin Matablet 22 2,332 5,300 41,983 -4,030 0 46,013 46,013 0 1,012,286 1,012,286
160 Klorpromazin HClampul 1,205 1 5 14 2 0 12 12 0 14,460 14,460
161 Klorpromazin HCtablet 147 0 200 0 200 0 0 0 0 0 0
164 Kotrimoksasol tablet 129 150 500 2,700 -100 2,800 0 2,800 361,200 0 361,200
166 Kotrimoksasol F tablet 299 100 0 1,800 -400 2,200 0 2,200 657,800 0 657,800
167 Kotrimoksasol S botol 2,052 14 100 248 45 203 0 203 416,556 0 416,556
496 Levofloxacin ta tablet 424 25 0 450 -100 550 0 550 233,200 0 233,200
Hal. 3 dari 8

171 Lidokain + epinepampul 1,152 39 180 698 25 0 673 673 0 775,296 775,296
497 Lidokain gelli 2%tube 41,600 0 12 0 12 0 0 0 0 0 0
172 Lidokain murni i ampul 1,144 53 0 945 -210 0 1,155 1,155 0 1,321,320 1,321,320
6501 Lisinopril tab 5 tablet 209 150 400 2,700 -200 0 2,900 2,900 0 606,100 606,100
173 Loperamide tablet 80 13 0 225 -50 0 275 275 0 22,000 22,000
174 Loratadine tablet 123 156 400 2,812 -225 0 3,037 3,037 0 373,551 373,551
176 Magnesium sulfavial 3,650 2 7 43 -2 0 45 45 0 164,250 164,250
6499 Meloksikam tab tablet 585 103 0 1,845 -410 2,255 0 2,255 1,319,175 0 1,319,175
179 Metformin 500m tablet 96 325 0 5,850 -1,300 0 7,150 7,150 0 686,400 686,400
6621 Metformin 850m tablet 150 13 1,000 225 950 0 0 0 0 0 0
181 Metilergometrin ampul 2,849 0 100 0 100 0 0 0 0 0 0
180 metilprednisolontablet 134 1,013 700 18,225 -3,350 0 21,575 21,575 0 2,891,050 2,891,050
6495 Metronidazole sybotol 3,800 6 0 101 -22 0 123 123 0 467,400 467,400
188 Metronidazole t tablet 94 13 0 225 -50 275 0 275 25,850 0 25,850
186 Metronidazole t tablet 113 63 0 1,125 -250 1,375 0 1,375 155,375 0 155,375
189 Mikonazol cream/tube 3,414 12 24 216 -24 240 0 240 819,360 0 819,360
6613 N-asetil sistein tablet 426 530 500 9,540 -1,620 0 11,160 11,160 0 4,754,160 4,754,160
197 Natrium Bikarbo tablet 14 13 100 225 50 175 0 175 2,450 0 2,450
6626 Natrium Diklofe tablet 128 131 650 2,362 125 0 2,237 2,237 0 286,336 286,336
196 Natrium Diklofentablet 115 578 600 10,395 -1,710 0 12,105 12,105 0 1,392,075 1,392,075
6524 Natrium Fusidat tube 4,699 3 0 58 -13 71 0 71 333,629 0 333,629
198 Natrium Klorida lbotol 6,410 4 20 65 6 0 59 59 0 378,190 378,190
202 Neurotropik tab tablet 484 575 400 10,350 -1,900 12,250 0 12,250 5,929,000 0 5,929,000
203 Nifedipin tab 10 tablet 105 38 100 675 -50 0 725 725 0 76,125 76,125
204 nistatin suspensibotol 13,500 2 8 27 2 25 0 25 337,500 0 337,500
206 Nistatin vaginal tablet 545 17 200 299 134 165 0 165 89,925 0 89,925
208 OAT FDC anak paket 232,518 0 1 0 1 0 0 0 0 0 0
209 OAT FDC kategorpaket 389,344 0 1 7 0 0 7 7 0 2,725,408 2,725,408
6716 Obat Anti Malari paket 31,482 2 0 40 -9 0 49 49 0 1,542,618 1,542,618
216 obat flu kombinastablet 330 625 0 11,250 -2,500 6,875 6,875 13,750 2,268,750 2,268,750 4,537,500
6766 Obat Flu syr + P botol 6,875 45 0 810 -180 495 495 990 3,403,125 3,403,125 6,806,250
6846 ofloxacin tablet tablet 0 0 800 0 800 0 0 0 0 0 0
223 Oksitoksin inj 10ampul 1,199 54 176 976 -41 0 1,017 1,017 0 1,219,383 1,219,383
455 omeprazole kap kapsul 130 60 0 1,080 -240 0 1,320 1,320 0 171,600 171,600
227 Parasetamol drobotol 6,649 98 336 1,764 -56 0 1,820 1,820 0 12,101,180 12,101,180
 6822 Parasetamol infubotol 11,610 0 5 0 5 0 0 0 0 0 0
500 Parasetamol recttube 12,698 0 10 0 10 0 0 0 0 0 0
228 Parasetamol syr botol 1,107 89 350 1,595 -4 0 1,599 1,599 0 1,770,093 1,770,093
230 Parasetamol tabtablet 53 4,588 17,400 82,575 -950 0 83,525 83,525 0 4,426,825 4,426,825
6518 Perak Sulfadiaz tube 20,700 1 5 14 2 12 0 12 248,400 0 248,400
501 Permetrin creamtube 11,825 14 42 248 -13 261 0 261 3,086,325 0 3,086,325
Hal. 4 dari 8

502 Piracetam tab 8 tablet 440 0 400 0 400 0 0 0 0 0 0

236 Piridoxin HCL (vitablet 123 363 700 6,525 -750 0 7,275 7,275 0 894,825 894,825
430 Povidon Iodine botol 2,900 14 20 256 -37 0 293 293 0 849,700 849,700
431 Povidon Iodine botol 18,000 2 0 40 -9 0 49 49 0 882,000 882,000
240 Prednison tab 5 tablet 76 575 0 10,350 -2,300 0 12,650 12,650 0 961,400 961,400
243 Propranolol HCLtablet 54 25 200 450 100 0 350 350 0 18,900 18,900
248 Ranitidin tab 15 tablet 105 300 0 5,400 -1,200 6,600 0 6,600 693,000 0 693,000
462 Retinol 100.000 kapsul 284 175 850 3,150 150 0 3,000 3,000 0 852,000 852,000
461 Retinol 200.000 kapsul 519 436 2,350 7,852 605 0 7,247 7,247 0 3,761,193 3,761,193
457 Rifampicin 450 kapsul 789 46 0 832 -185 0 1,017 1,017 0 802,413 802,413
258 Rifampicin 600 tablet 1,100 3 0 45 -10 0 55 55 0 60,500 60,500
259 Ringer lactat ( RLbotol 7,150 20 140 367 58 155 155 309 1,104,675 1,104,675 2,209,350
260 risperidon tab 2 tablet 273 38 200 675 50 0 625 625 0 170,625 170,625
504 Salbutamol lar r ampul 4,000 3 20 45 10 0 35 35 0 140,000 140,000
261 Salbutamol tab tablet 63 100 100 1,800 -300 0 2,100 2,100 0 132,300 132,300
262 Salbutamol tab tablet 70 213 0 3,825 -850 0 4,675 4,675 0 327,250 327,250
263 Salep 2 - 4 pot 2,620 2 36 32 29 3 0 3 7,860 0 7,860
264 Salisil bedak 2 pack 1,025 8 0 135 -30 165 0 165 169,125 0 169,125
267 Sianokobalamin a( mpul 1,098 25 400 450 300 0 150 150 0 164,700 164,700
268 Sianokobalamin tablet 46 700 0 12,600 -2,800 0 15,400 15,400 0 708,400 708,400
270 Spirolacton tab tablet 539 13 100 225 50 0 175 175 0 94,325 94,325
6809 sukralfat syr 50 botol 6,789 10 50 178 10 0 168 168 0 1,140,552 1,140,552
6711 Tambah darah kom
tablet 354 7,028 88,560 126,495 60,450 0 66,045 66,045 0 23,379,930 23,379,930
475 Tambah Darah kom
tablet 434 250 2,300 4,500 1,300 0 3,200 3,200 0 1,388,800 1,388,800
 458 Tetrasiklin kaps kapsul 310 25 200 450 100 350 0 350 108,500 0 108,500
286 Tiamin HCL (B 1tablet 85 700 2,100 12,600 -700 0 13,300 13,300 0 1,130,500 1,130,500
288 Triheksifenidil H tablet 85 125 600 2,250 100 0 2,150 2,150 0 182,750 182,750
6625 Urea cream 2% tube 6,800 1 0 16 -4 0 20 20 0 136,000 136,000
6519 Valproat tab SR tablet 1,200 25 200 450 100 0 350 350 0 420,000 420,000
6841 VALSARTAN 16tablet 0 19 0 338 -75 0 413 413 0 0 0
289 Vitamin B kompl tablet 83 1,813 3,400 32,625 -3,850 0 36,475 36,475 0 3,027,425 3,027,425
6496 Zink Sirup 20mgbotol 2,972 5 0 81 -18 0 99 99 0 294,228 294,228
290 Zink tab tablet 466 263 8,100 4,725 7,050 0 0 0 0 0 0
6631 dentin conditionepack 268,840 0 1 2 0 2 0 2 537,680 0 537,680
439 Devitalisasi past pot 259,996 0 1 2 0 0 2 2 0 519,992 519,992
440 Etil klorida spraybotol 178,500 0 1 7 0 0 7 7 0 1,249,500 1,249,500
441 Eugenol cairan botol 18,100 0 2 4 1 0 3 3 0 54,300 54,300
553 formokresol botol 52,800 0 1 2 0 2 0 2 105,600 0 105,600
443 Glass Ionomer cpcs 521,235 0 1 2 0 0 2 2 0 1,042,470 1,042,470
554 Glass Ionomer cem
pack 687,500 0 1 2 0 0 2 2 0 1,375,000 1,375,000
483 Glass Ionomer Un
paket 781,000 0 1 2 0 0 2 2 0 1,562,000 1,562,000
Hal. 5 dari 8

444 Kalsium Hidroks tube 159,500 0 1 2 0 0 2 2 0 319,000 319,000

445 Klorfenol Kamfe botol 55,000 0 1 2 0 2 0 2 110,000 0 110,000
447 Mummifying Pasbotol 605,000 0 1 2 0 2 0 2 1,210,000 0 1,210,000
6630 paper point pack 34,100 0 1 0 1 0 0 0 0 0 0
555 Selluloid strip pack 137,500 0 0 4 -1 5 0 5 687,500 0 687,500
451 Spoon gelatin cupcs 84,700 0 1 4 0 4 0 4 338,800 0 338,800
453 Temporary Felingbotol 154,000 0 1 0 1 0 0 0 0 0 0
6627 Human tetanus im
ampul 176,800 0 2 0 2 0 0 0 0 0 0
335 Serum anti bisa vial 479,996 0 1 0 1 0 0 0 0 0 0
6755 Serum HBIG (Hi ampul 1,325,000 1 0 16 -4 0 20 20 0 26,500,000 26,500,000
343 Vaksin BCG inj vial 61,996 9 12 153 -22 0 175 175 0 10,849,300 10,849,300
468 Vaksin CAMPAKvial 28,204 6 1 104 -22 0 126 126 0 3,553,704 3,553,704
6511 Vaksin DPT-HB-H
vial 78,991 40 22 722 -138 0 860 860 0 67,932,260 67,932,260
 345 Vaksin hepatitis vial 23,991 22 78 387 -8 0 395 395 0 9,476,445 9,476,445
6618 Vaksin IPV vial 158,994 9 12 158 -23 0 181 181 0 28,777,914 28,777,914
346 Vaksin jerap dift vial 17,996 0 3 0 3 0 0 0 0 0 0
6724 vaksin meningiti vial 135,000 0 5 2 4 0 0 0 0 0 0
6726 Vaksin MR vial 155,813 13 10 232 -42 0 274 274 0 42,692,762 42,692,762
6601 Vaksin polio bivavial 19,954 20 10 364 -71 0 435 435 0 8,679,990 8,679,990
469 Vaksin Tetanus vial 16,995 4 5 72 -11 0 83 83 0 1,410,585 1,410,585
6510 Alat suntik imunipcs 1,582 53 515 945 305 0 640 640 0 1,012,480 1,012,480
352 Alat Suntik Sekapcs 1,530 50 500 900 300 0 600 600 0 918,000 918,000
353 Alat Suntik Sekalpcs 1,195 25 1,100 450 1,000 0 0 0 0 0 0
354 Alat Suntik Sekalpcs 762 56 260 1,012 35 0 977 977 0 744,474 744,474
355 Alat Suntik Sekapcs 1,302 3 78 50 67 0 0 0 0 0 0
357 Alat suntik sekal pcs 789 113 1,000 2,025 550 0 1,475 1,475 0 1,163,775 1,163,775
371 Alkohol (Etanol botol 25,000 0 5 4 4 0 0 0 0 0 0
6530 alkohol swab pcs 160 0 400 0 400 0 0 0 0 0 0
362 Cat gut /benang rol 32,800 5 12 81 -6 0 87 87 0 2,853,600 2,853,600
360 Cat gut /benang rol 8,208 3 24 54 12 42 0 42 344,736 0 344,736
363 Cat gut /benang rol 6,583 0 24 0 24 0 0 0 0 0 0
369 Clorin 1 liter 12 botol 20,900 1 0 9 -2 0 11 11 0 229,900 229,900
372 folley catheter 1 pcs 8,239 3 20 45 10 0 35 35 0 288,365 288,365
373 folley catheter 1 pcs 11,800 1 0 18 -4 0 22 22 0 259,600 259,600
6581 gelang bayi biru pcs 850 0 100 0 100 0 0 0 0 0 0
6582 gelang bayi merapack 850 0 100 0 100 0 0 0 0 0 0
6532 hand sanitizer 50botol 60,800 1 6 22 1 0 21 21 0 1,276,800 1,276,800
377 Handscoon panjapasang 17,400 29 0 518 -115 633 0 633 11,014,200 0 11,014,200
378 Handscoon panjapasang 17,400 11 190 202 145 0 57 57 0 991,800 991,800
379 Handscoon panjan
pasang 17,400 5 0 90 -20 0 110 110 0 1,914,000 1,914,000
380 Handscoon pendek
pasang 998 125 400 2,250 -100 0 2,350 2,350 0 2,345,300 2,345,300
Hal. 6 dari 8

381 Handscoon pendek

pasang 998 88 697 1,575 347 0 1,228 1,228 0 1,225,544 1,225,544
382 Handscoon pendek
pasang 992 13 200 225 150 0 75 75 0 74,400 74,400
 383 Handscoon pendek
pasang 7,600 9 80 158 45 0 113 113 0 858,800 858,800
384 Handscoon pendek
pasang 7,600 3 180 45 170 0 0 0 0 0 0
385 Handscoon pendek
pasang 7,600 4 70 68 55 0 13 13 0 98,800 98,800
391 Infusion set Ana pcs 4,400 0 17 0 17 0 0 0 0 0 0
6637 infusion set dew pcs 7,590 13 100 225 50 0 175 175 0 1,328,250 1,328,250
387 IV Catheter no 1 pcs 14,740 14 170 248 115 0 133 133 0 1,960,420 1,960,420
388 IV Catheter no 2 pcs 14,740 3 90 45 80 0 0 0 0 0 0
6543 Jarum jahit /be pcs 22,192 5 12 92 -8 100 0 100 2,219,200 0 2,219,200
405 Kapas pembalut rol 24,000 1 5 18 1 0 17 17 0 408,000 408,000
412 Kasa kompres 40/
rol 1,800 13 100 225 50 0 175 175 0 315,000 315,000
411 Kasa Pembalut hipack 7,900 23 100 405 10 395 0 395 3,120,500 0 3,120,500
407 Kasa Pembalut hirol 103,500 1 4 9 2 0 7 7 0 724,500 724,500
414 Kasa Pembalut hirol 1,450 0 5 0 5 0 0 0 0 0 0
415 Kasa Pembalut hirol 2,100 1 40 22 35 0 0 0 0 0 0
406 Kasa Pembalut hid
rol 5,800 0 16 0 16 0 0 0 0 0 0
6733 Kertas puyer lebpcs 1,470 0 100 0 100 0 0 0 0 0 0
418 Lisol 1000 ml botol 40,997 0 5 0 5 0 0 0 0 0 0
419 masker pcs 466 169 100 3,038 -575 0 3,613 3,613 0 1,683,658 1,683,658
550 Mucus ekstraktopcs 6,900 0 24 0 24 0 0 0 0 0 0
6555 Nasal Oksigen spack 5,900 0 37 0 37 0 0 0 0 0 0
421 NEEDLE 24 G pcs 330 0 250 0 250 0 0 0 0 0 0
6735 Paket Alat Dete paket 409,816 0 1 4 0 0 4 4 0 1,639,264 1,639,264
428 pisau bedah no pcs 3,000 25 100 450 0 450 0 450 1,350,000 0 1,350,000
429 Plaster 5 yard x rol 35,532 2 2 27 -4 31 0 31 1,101,492 0 1,101,492
6753 Plaster polyest rol 43,850 0 11 0 11 0 0 0 0 0 0
561 Plaster polyest rol 27,000 0 27 0 27 0 0 0 0 0 0
6732 Plastik pembungkpack 9,800 0 40 0 40 0 0 0 0 0 0
580 safety box pcs 15,715 0 50 0 50 0 0 0 0 0 0
432 Silk No. 2/0 + ja pcs 23,355 5 12 81 -6 87 0 87 2,031,885 0 2,031,885
359 tranfusion set pcs 6,700 3 75 56 62 0 0 0 0 0 0
434 Umbilical cord c pcs 1,300 31 200 562 75 0 487 487 0 633,100 633,100
6580 Underpads 60 x pcs 7,800 26 150 472 45 0 427 427 0 3,330,600 3,330,600
 540 Aqua demineralisbotol 60,000 0 0 4 -1 5 0 5 300,000 0 300,000
311 Larutan Eosin 2%botol 177,350 0 1 7 0 0 7 7 0 1,241,450 1,241,450
313 Larutan giemsa sbotol 358,028 1 0 11 -2 0 13 13 0 4,654,364 4,654,364
315 Larutan HCl 0.1 botol 46,135 0 2 0 2 0 0 0 0 0 0
512 Larutan Hemoglobotol 43,950 0 1 4 0 0 4 4 0 175,800 175,800
6674 Larutan KOH 10 botol 18,000 0 1 0 1 0 0 0 0 0 0
316 Larutan lugol 3%botol 30,000 0 2 0 2 0 0 0 0 0 0
Hal. 7 dari 8

6588 Larutan Metilen botol 57,600 0 1 0 1 0 0 0 0 0 0

6701 Larutan NaCl 0, botol 18,500 0 1 0 1 0 0 0 0 0 0
317 Larutan natrium sbotol 21,253 0 1 0 1 0 0 0 0 0 0
6590 Reagen EDTA botol 75,145 0 1 4 0 0 4 4 0 300,580 300,580
292 Reagen golonganbotol 68,200 0 1 7 0 0 7 7 0 477,400 477,400
294 Reagen golonganbotol 68,200 0 1 7 0 0 7 7 0 477,400 477,400
297 Reagen Widal antvial 66,660 0 1 2 0 0 2 2 0 133,320 133,320
298 Reagen Widal antvial 66,660 0 1 2 0 0 2 2 0 133,320 133,320
6583 Stik Asam Urat ustrip 5,060 25 500 450 400 50 0 50 253,000 0 253,000
6609 Stik glukosa ut strip 4,200 125 600 2,250 100 1,075 1,075 2,150 4,515,000 4,515,000 9,030,000
306 Stik HbSAg test strip 9,850 50 100 900 -100 0 1,000 1,000 0 9,850,000 9,850,000
328 Stik HCG strip 1,150 159 120 2,858 -515 1,687 1,687 3,373 1,939,475 1,939,475 3,878,950
6756 stik hemoglobin strip 8,000 6 0 112 -25 69 69 137 548,000 548,000 1,096,000
307 Stik HIV test kit Istrip 14,340 63 100 1,125 -150 0 1,275 1,275 0 18,283,500 18,283,500
515 Stik Kolesterol strip 23,100 6 100 112 75 19 19 37 427,350 427,350 854,700
6767 Stik Rapid Test Sstrip 26,636 38 100 675 -50 0 725 725 0 19,311,100 19,311,100
558 blood lancet 100pack 48,400 5 12 90 -8 0 98 98 0 4,743,200 4,743,200
6712 pot sputum sterilpcs 5,105 50 0 900 -200 0 1,100 1,100 0 5,615,500 5,615,500
327 slide/d-glass/ob pack 20,000 1 3 25 -2 0 27 27 0 540,000 540,000
536 Tabung Vac-tub pcs 1,005 25 0 450 -100 550 0 550 552,750 0 552,750
6509 Tabung Vac-tubepcs 974 25 0 450 -100 0 550 550 0 535,700 535,700

Wonosobo, 01 September 2019 Rp818,995 Rp97,238,954 Rp429,163,316 Rp526,402,268

Mengetahui
KEPALA PUSKESMAS KALIBAWANG PENANGGUNG JAWAB PELAYANAN FARMASI

dr.Dian Catur Prabowo SURAHMAN S,Farm.,Apt

NIP. NIP.
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ANAN FARMASI