No. Kode Nama Barang Satuan Stok Awal Penerimaan Persediaan Obat-Obatan

DINAS KESEHATAN KABUPATEN BANDUNG
PUSKESMAS CIBEUNYING
Jalan Ligar Ayu No. 05
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

Periode Laporan: Juni 2020
Kode Puskesmas : P3204310202
Nama Puskesmas : CIBEUNYING
Pelaporan Bulan : Juni
Permintaan Bulan : Juli
No. Kode Nama Barang Satuan Stok Awal Penerimaan Persediaan
OBAT-OBATAN
1 GFK0001 Acetylcystein Tablet 200 mg Tablet 6960 6960
2 GFK0327 Albendazol susp 200mg/5mL BOTTLE 0 0
3 GFK0002 Albendazole Tablet 400 mg Tablet 0 0
4 GFK0003 Allopurinol Tablet 100 mg Tablet 3800 3800
6 GFK0005 Ambroxol Sirup 15 mg / 5 ml Botol 0 0
7 GFK0006 Ambroxol Tablet 30 mg Tablet 0 0
8 GFK0008 Aminofilin Injeksi 24 mg / ml Ampul 0 0
9 GFK0007 Aminofilin Tablet 200 mg Tablet 0 0
10 GFK0009 Amitripillin Tablet Salut 25 mg Tablet 458 200 658
11 GFK0010 Amlodipine Tablet 10 mg Tablet 5500 5400 10900
12 GFK0011 Amlodipine Tablet 5 mg Tablet 7800 7800
13 GFK0012 Amoxicilin Injeksi 1000 mg/ml Ampul 0 0
14 GFK0013 Amoxicilin Kaplet 250 mg Tablet 9200 9200
15 GFK0014 Amoxicilin Kaplet 500 mg Tablet 0 5000 5000
16 GFK0015 Amoxicilin Sirup Kering 125 mg/5 ml Botol 0 0

18 GFK0017 Antalgin (Metampiron) Injeksi 250 mg/ml Ampul 0 0
19 GFK0018 Antalgin (Metampiron) Tablet 500 mg Tablet 0 0
20 GFK0019 Antasida DOEN Suspensi Botol 300 300
21 GFK0020 Antasida DOEN Tablet Tablet 2200 1000 3200

Antifungi DOEN Salep (Kombinasi : Asam
22 GFK0021 Benzoat 6% + Asam Salisilat 3%) Pot 0 0
23 GFK0022 Antihemoroid DOEN Suppositoria Tablet 0 100 100

Antimigren DOEN Tablet (Kombinasi :
24 GFK0023 Ergotamin Tartat 1 mg + Caffein 50 mg) Tablet 0 0
25 GFK0024 Aqua Pro Injeksi Steril Bebas Pirogen 20 ml Ampul 0 0
26 GFK0025 Asam Asetil Salisilat (Asetosal) Tablet 80 mg Tablet 1000 1000
27 GFK0026 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 3500 7000 10500
28 GFK0027 Asam Folat Tablet 1 mg Tablet 1100 1100
29 GFK0028 Asam Mefenamat Tablet 500 mg Tablet 0 0
30 GFK0029 Asiklovir Krim 5% Tube 0 0
31 GFK0296 Asiklovir Tablet 200 mg Tablet 0 0
33 GFK0031 Atropin Sulfat Injeksi 0,25 mg/ml - 1 ml Ampul 0 0
34 GFK0032 Bedak Salisil 2% - 50 gram Sachet 0 0
35 GFK0033 Betametason Krim 0,1% Tube 25 50 75
36 GFK0034 Cefadroxil Sirup Kering 125 mg/5 ml Botol 323 323
37 GFK0349 CHLORQUINE PHOSPHATE Tablet TABLET 0 0
38 GFK0035 Deksametason Injeksi 5 mg/ml Ampul 1 1
39 GFK0036 Deksametason Tablet 0,5 mg Tablet 0 0
40 GFK0342 Desinfektan 5 Liter GALLON 0 0

41 GFK0037 Diazepam Injeksi 5 mg/ml Ampul 0 0
42 GFK0038 Diazepam Rectal 10 mg Suppositoria 5 5
44 GFK0040 Diazepam Tablet 2 mg Tablet 24 100 124
45 GFK0041 Difenhidramin Hcl Injeksi 10 mg/ml Ampul 29 29
46 GFK0042 Digoxin Tablet 0,25 mg Tablet 0 0
47 GFK0307 Dimenhidrinat Tablet 50 mg TABLET 0 0
48 GFK0326 Diphteria Antitoxin Serum VIAL 0 0
49 GFK0305 Domperidon sir 5mg/5mL BOTTLE 50 50
50 GFK0043 Domperidon Tablet 10 mg Tablet 500 500
51 GFK0044 Epinefrin HCl injeksi 0,1% - 1 ml Ampul 0 0
52 GFK0046 Eritromisin Kapsul 250 mg 0 0
53 GFK0045 Eritromisin Kapsul 500 mg Tablet 400 400
54 GFK0047 Eritromisin Sirup 200 mg/5 ml Botol 0 0
55 GFK0048 Etakridin (Rivanol) 0,1% Botol 14 14
56 GFK0049 Etanol 70% - 1000 ml Botol 1 1
58 GFK0324 Etil Klorida spray 100 mL BOTTLE 0 0
59 GFK0051 Eugenol 10 ml Botol 0 0
60 GFK0052 Fenobarbital Injeksi 50 mg/ ml Ampul 0 0
61 GFK0053 Fenobarbital Tablet 30 mg Tablet 30 200 230
62 GFK0055 Fenoksimetil Fenisilin Tablet 250 mg Tablet 0 0
64 GFK0056 Fenol Griseol Tetes Telinga 10% Botol 96 96

65 GFK0057 Fitomenadion (Vit. K) Injeksi 10 mg/ml Ampul 0 0
67 GFK0059 Fitomenadion (Vit. K) Tablet Salut 10 mg Tablet 200 200
68 GFK0061 Furosemida Injeksi IV/IM 10 mg/ml-2ml Ampul 0 0
69 GFK0060 Furosemida Tablet 40 mg Tablet 400 400
70 GFK0062 Gentamisin Injeksi 80 mg/2,5 ml Ampul 0 0
71 GFK0063 Gentamisin Salep Kulit 0,1% Tube 0 0
72 GFK0064 Gentamisin Salep Mata Tube 120 120
73 GFK0065 Gentamisin Tetes Mata Botol 72 72
74 GFK0066 Glibenclamide Tablet 5 mg Tablet 2000 2000
75 GFK0067 Glimepirid Tablet 1 mg Tablet 0 0
77 GFK0069 Gliserin Cairan 100 ml Botol 0 0
78 GFK0070 Gluconas calcicus 10% - 10 ml Ampul 0 0
79 GFK0071 Glukosa Lar. Steril Cairan Infus 10% Botol 0 0
81 GFK0073 Griseofulvin Tablet 125 mg Tablet 0 0
82 GFK0074 Griseril Guaiakolat Tablet 100 mg Tablet 0 0
83 GFK0075 Haloperidol Tablet 0,5 mg Tablet 0 0
85 GFK0077 Haloperidol Tablet 2 mg Tablet 0 0
87 GFK0079 Hidroklortiazid (HCT) Tablet 25 mg Tablet 900 900
88 GFK0080 Hidrokortison Krim 2,5% Tube 48 72 120

89 GFK0081 Ibuprofen Suspensi 100 mg/ 5 ml 60 ml Botol 0 0
90 GFK0082 Ibuprofen Suspensi 200 mg/ 5 ml 60 ml Botol 0 72 72
91 GFK0083 Ibuprofen Tablet 400 mg Tablet 0 0
92 GFK0084 Isoniazide (INH) 100 mg Tablet 0 0

Isosorbid Dinitrat (ISDN) Tablet Sublingual 5
94 GFK0086 mg Tablet 0 0
95 GFK0087 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 0 0
96 GFK0088 Kaptopril Tablet 12,5 mg Tablet 34900 34900
97 GFK0089 Kaptopril Tablet 25 mg Tablet 0 0
98 GFK0090 Karbamazepin Tablet 200 mg Tablet 0 0
99 GFK0091 Ketoconazole Tablet 200 mg Tablet 2800 500 3300
100 GFK0092 Klindamisin Kapsul 150 mg Kapsul 0 0
102 GFK0094 Kloramfenikol Kapsul 250 mg Kapsul 0 0
103 GFK0095 Kloramfenikol Salep Kulit (Bufacetine) 2% Tube 120 120
104 GFK0096 Kloramfenikol Salep Mata 1% Tube 96 96
105 GFK0097 Kloramfenikol Suspensi 125 mg/5 ml - 60 ml Botol 0 0
106 GFK0098 Kloramfenikol Tetes Mata 0,5% Botol 0 0
107 GFK0099 Kloramfenikol Tetes Telinga 3% Botol 0 0
108 GFK0100 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 3900 3900
109 GFK0102 Klorpromazin HCL Tablet Salut 100 mg Tablet 430 430
111 GFK0321 Kolekalsiferol (Vit. D3) 400 unit tablet TABLET 0 0
112 GFK0322 Kolekalsiferol (Vit. D3) 400 unit/5 ml syr BOTTLE 0 0

Kotrimoksazol Suspensi 60 ml (Kombinasi :
Sulfametaksazol 200 mg/5 ml + Trimetropim
113 GFK0103 40 mg/5 ml) Botol 138 138
Kotrimoksazol Tablet 480 mg (Kombinasi :

114 GFK0104 Sulfametaksazol 400 mg + Trimetropim 80 mg) Tablet 2000 400 2400
115 GFK0105 Lidokain Injeksi Ampul 0 0
Lidokain Injeksi Komb. (Kombinasi : Lidokain

116 GFK0106 HCl 2% + Epinefrin 1: 80.000) 2 ml Ampul 120 120
117 GFK0107 Loratadin Tablet 10 mg Tablet 0 0
118 GFK0108 Magnesium Sulfat Injeksi 20% - 25 ml Vial 0 2 2
119 GFK0109 Magnesium Sulfat Injeksi 40% - 25 ml Vial 0 0
120 GFK0110 Mebendazole Sirup 100 mg/5 ml Botol 0 0
121 GFK0111 Mebendazole Tablet 100 mg Tablet 0 0
122 GFK0112 Meloxicam Tablet 15 mg Tablet 0 0
123 GFK0113 Metformin Tablet 500 mg Tablet 7900 7900
124 GFK0114 Metildopa (Dopamet) Tablet 250 mg Tablet 1100 1100

Metilergometrin Maleat (Metergin) Injeksi 0,2
125 GFK0115 mg/ml Ampul 0 0
Metilergometrin Maleat (Metergin) Tablet
126 GFK0116 Salut 0,125 mg Tablet 400 400
127 GFK0117 Metilprednisolon Tablet 4 mg Tablet 0 0
128 GFK0118 Metoklorpramid Injeksi 5 mg/ml Ampul 0 0
129 GFK0119 Metoklorpramid Tablet 10 mg Tablet 0 0
130 GFK0120 Metronidazole Syrup Botol 0 0
131 GFK0121 Metronidazole Tablet 250 mg Tablet 0 0
133 GFK0123 Mikonazole Krim 2% Tube 24 96 120
134 GFK0124 Multivitamin + Mineral Tablet Tablet 0 0
135 GFK0125 Multivitamin Sirup Botol 0 0

136 GFK0126 Multivitamin Tablet Tablet 0 0
137 GFK0127 Natrium Bikarbonat Tablet 500 mg Tablet 0 0
138 GFK0128 Natrium Diklofenak Tablet 50 mg Tablet 0 1000 1000
139 GFK0129 Natrium Klorida Cairan Infus 0,9% - 500 ml Botol 0 0
140 GFK0130 Nifedipine Tablet 10 mg Tablet 0 0
141 GFK0132 Nistatin Tablet 500.000 IU Tablet 0 0
142 GFK0131 Nistatin Tablet Vaginal 100.000 IU Tablet Vaginal 0 100 100
143 GFK0133 Obat Flu Sirup Botol 0 0
144 GFK0134 Obat Flu Tablet Tablet 0 0
145 GFK0323 Oksigen ih, gas dalam tabung BOTTLE 0 0
146 GFK0135 Oksitetrasiklin HCl Salep Kulit 3% Tube 0 0
147 GFK0136 Oksitetrasiklin HCl Salep Mata 1% Tube 25 25
148 GFK0137 Oksitosin Injeksi 10 IU/ml Ampul 89 89
149 GFK0138 Omeprazol Tablet 20 mg Tablet 1200 1200
150 GFK0304 Oseltamivir Kapsul 75 Mg KAPSUL 0 0
151 GFK0139 Parasetamol Drops 100mg/ml Botol 0 0
152 GFK0140 Parasetamol Sirup 120 mg/5 ml Botol 200 100 300
153 GFK0141 Parasetamol Suppositoria Suppositoria 0 0
154 GFK0142 Parasetamol Tablet 500 mg Tablet 0 0
155 GFK0348 Pehavral Tablet TABLET 0 0
156 GFK0143 Piridoksin (Vit. B6) Tablet 10 mg Tablet 3200 3200
158 GFK0145 Piroxicam Kapsul 20 mg Tablet 0 0
159 GFK0146 Povidon Iodida 10% Cairan 30 ml Botol 3 5 8

160 GFK0147 Povidon Iodida 10% Cairan 300 ml Botol 25 25
161 GFK0148 Prednison Tablet 5 mg Tablet 2300 2300
162 GFK0149 Propanolol Tablet 10 mg Tablet 0 200 200
163 GFK0150 Propanolol Tablet 40 mg Tablet 0 0
164 GFK0151 Propiltiourasil Tablet 100 mg Tablet 0 0
165 GFK0152 Ranitidine Injeksi 25 mg/ml Ampul 2 2
166 GFK0153 Ranitidine Tablet 150 mg Tablet 1500 1500
167 GFK0154 Ringer Laktat Cairan Infus 500 ml Botol 0 0
168 GFK0155 Risperidone Tablet 2 mg Tablet 140 100 240
169 GFK0156 Salbutamol Nebulizer 1 mg/ml - 2,5 ml Ampul 32 32
170 GFK0157 Salbutamol Tablet 2 mg Tablet 1200 1200

Salep 2-4 (Kombinasi : Asam Salisilat 2% +
172 GFK0159 Belerang Endap 2%) Pot 48 48
173 GFK0160 Scabimite Cream (Premetrin 5% krim) Tube 30 60 90
174 GFK0161 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Ampul 0 0
175 GFK0162 Sianokobalamin (Vit. B12) Injeksi 500 mcg/ml Ampul 1400 1400
176 GFK0163 Sianokobalamin (Vit. B12) Tablet 50 mcg Tablet 0 0
177 GFK0164 Simvastatin Tablet 10 mg Tablet 1680 1680 3360
178 GFK0165 Simvastatin Tablet 20 mg Tablet 0 0
179 GFK0166 Siprofloksasin Tablet 500 mg Tablet 0 0
180 GFK0167 Tetrasiklin Kapsul 250 mg Kapsul 0 0
182 GFK0169 Thiamfenikol Kapsul 500 mg Kapsul 0 0
183 GFK0170 Thiamin HCl (Vit. B1) Injeksi 100 mcg/ml Ampul 0 0
184 GFK0171 Thiamin HCl (Vit. B1) Tablet 50 mg Tablet 4200 200 4400
185 GFK0306 Tiamin (vitamin B1) tab 100 mg TABLET 0 0
186 GFK0172 Trihexifenidil Hidroksida Tablet 2 mg Tablet 370 370
187 GFK0173
BMH Vitamin B Kompleks Tablet Tablet 7300 500 7800
P 0
188 GFK0341 ALAT SEMPROT BUAH 0 0
189 GFK0186 Alat Suntik Sekali Pakai 0,05 ml Pcs 0 0
190 GFK0187 Alat Suntik Sekali Pakai 1 ml Pcs 300 300
194 GFK0211 Alkohol Swab Pcs 300 1000 1300
195 GFK0330 BARA COAT/GOWN NAVY BIRU PCS 0 0
196 GFK0212 Blood Lancet Pcs 0 1000 1000
197 GFK0191 Canula Oksigen Pcs 0 0

Catgut/Benang Bedah No. 2/0 dengan jarum
198 GFK0192 bedah Pcs 9 9
200 GFK0334 COVER SHOES PCS 0 50 50
201 GFK0332 COVERALL DISPO PCS 0 0

COVERALL PP+PE COATED ZIPPER WITH HOOD
202 GFK0329 L PCS 0 0
204 GFK0314 EXTRADINE 5 LITER GALLON 0 0
205 GFK0194 Fixomull Stretch 5cm x 5m Pcs 9 9
206 GFK0195 Folley Catheter No. 16 Pcs 0 0

209 GFK0343 Helm + Visor Mask BUAH 0 0
210 GFK0198 Infus Set Adult 20 drops/mL Pcs 12 12
211 GFK0199 Infus Set Pedriatic 60 drops/mL Pcs 0 0
212 GFK0200 IV Catheter No. 18 Pcs 0 0
216 GFK0340 JAS HUJAN PCS 0 0
217 GFK0339 KACAMATA GOOGLE PCS 0 0
218 GFK0213 Kantong mayat Pcs 0 0
219 GFK0220 Kapas Pembalut/Absorben 250 gram Rol 0 0
220 GFK0179 Kaporit Serbuk Kg 0 0
221 GFK0180 Kaporit Tablet serbuk Kg 0 0
222 GFK0221 Kasa Gulung Besar 40 x 80 cm Rol 0 0
223 GFK0222 Kasa Pembalut Hidrofil 4 m x 10 cm Rol 5 5
225 GFK0182 Kasa Steril 16 x 16 cm Kotak 100 100
226 GFK0308 Klor Fenol Kamfer (CHKM) KOTAK 0 0
227 GFK0174 Lisol Botol 15 15
228 GFK0204 Masker 3 Ply Tie One Pcs 0 0
229 GFK0205 Masker N95 Pcs 0 0
230 GFK0333 NURSE CAP PCS 0 0
231 GFK0181 PAC Kg 0 0

232 GFK0224 Plester 2,5 cm x 4,5 cm (Kecil) Rol 4 2 6
233 GFK0225 Plester 7,5 cm x 5 cm (Besar) Rol 1 2 3
234 GFK0226 Plesterin Bulat Soft Rol 0 0

Polybag Sampah/Limbah Warna Hitam 50x70
235 GFK0183 cm pack @ 24 lbr 0 0
236 GFK0184 cm pack @ 24 lbr 0 1 1
Polybag Sampah/Limbah Warna Kuning
237 GFK0185 60x100 cm pack @ 24 lbr 0 1 1
238 GFK0206 Safety Box Pcs 0 0
239 GFK0336 SAFETY GLASS PCS 0 0
240 GFK0335 Sarung Tangan Kain PCS 0 0
241 GFK0344 Sarung Tangan Karet PAIR 0 0
242 GFK0328 Sarung Tangan Non Steril Uk. L PCS 0 0
243 GFK0214 Sarung Tangan Non Steril Uk. M Psg 0 0
244 GFK0215 Sarung Tangan Non Steril Uk. S Psg 0 0
245 GFK0216 Sarung Tangan Non Steril Uk. XL 0 0
246 GFK0217 Sarung Tangan Obgyn Steril Psg 0 0
247 GFK0218 Sarung Tangan Steril 6,5 G Psg 0 0
248 GFK0219 Sarung Tangan Steril 7 G Psg 0 0
249 GFK0337 SEPATU BOOT PAIR 0 0

Silk (Benang Bedah Sutera) No. 3/0 dengan
250 GFK0207 jarum bedah Pcs 0 0
251 GFK0177 Softanol 5 Liter Botol/Galon 0 0
252 GFK0175 Softanol 500 ml Botol 0 0
253 GFK0331 STANDARD SHOE COVER PAIR 0 0
254 GFK0312 STERALD 5 LITER GALLON 0 0
255 GFK0310 STERICIDE 5 LITER GALLON 0 0

256 GFK0313 STERICIDE 500 ML BOTTLE 0 0
257 GFK0309 STERICIDE-3 5 LITER GALLON 0 0
258 GFK0311 STERIZYME 5 LITER GALLON 0 0
259 GFK0347 SURGEON CAP WITH TIE PCS 0 0
260 GFK0208 Umbical Clam Pcs 0 0
261 GFK0209 Underpad (Softpad) 60x90 cm Pcs 0 0
262 GFK0210 Urine Bag Steril 2 L Pcs 0 0
263 GFK0227 Verband Elastis 10 cm Rol 0 0
264 GFK0178 Viorex 2% 5 Liter Botol/Galon 0 0

BAH
AN265 GFK0176 Viorex 2% 500 ml Botol 0 0
LABO
RAT
266 GFK0346
ORIU Visor Mask Mika BUAH 0 0
M 0
267 GFK0228 Benecheck Plus Glucose Test Strip Strip 0 500 500
268 GFK0229 Benecheck Plus Total Cholesterol Test Strip Strip 0 0
269 GFK0230 Benecheck Plus Uric Test Strip Strip 0 0
270 GFK0231
PRO Benecheck Test System Pcs 0 0
GRA
M271 GFK0338 RAPID TEST CORONA TEST 0 0
KUST
A 0
272 GFK0233 MDT MB Anak Tablet Blister 0 0

BAH
AN273 GFK0234 MDT MB Dewasa Tablet Blister 0 0
LABO
RAT
274 GFK0235 MDT PB Anak Tablet Blister 0 0
ORIU
M 0
IMU
275 GFK0232
NISA Media Amies Pcs 0 0
SI
PRO 0
GRA
M276 VAC0304 Alat Suntik Sekali Pakai 0,5 ml TABLET 0 0
KUST
A 0
PRO
GRA
M
IMU
277 GFK0236 MDT PB Dewasa Tablet Blister 0 0
NISA
SI 0
278 VAC0249 Pelarut BCG Vial 0 0
279 VAC0250 Pelarut Campak Vial 0 0
280 VAC0252 Pelarut MR Vial 0 0
281 VAC0303 Penetes Vaksin Polio (BOPV) Buah 0 0
282 VAC0237 Vaksin Anti Rabies (VAR) Verorab Vial 0 0
283 VAC0238 Vaksin BCG Vial 0 0
284 VAC0239 Vaksin Campak Vial 0 0
285 VAC0240 Vaksin DTP HB/HIB Vial 0 0
286 VAC0242 Vaksin HBV Vial 0 0
287 VAC0243 Vaksin Hepatitis B Immunoglobulin (HBIg) Vial 0 0
288 VAC0251 Vaksin Hepatitis B Recombinant Injeksi 0,5ml Vial 0 0
289 VAC0241 Vaksin Jerap DT Vial 0 0
290 VAC0247 Vaksin Jerap Td Vial 0 0
291 VAC0256 Vaksin Meningitis (Formening) Vial 0 0
292 VAC0255 Vaksin Meningitis (Menivax) Vial 0 0
293 VAC0244 Vaksin MR Vial 0 0
294 VAC0245 Vaksin Polio (BOPV) Vial 0 0
295 VAC0253 Vaksin Polio (IPV 10 ds) Vial 0 0
PRO
298 VAC0248
GRA Vaksin Tuberkulin Vial 0 0
M TB 0
299 GFK0257 Kaca Sediaan (Object Glass) Pcs 0 0

300 GFK0258 Obat antituberkulosa FDC Anak Paket 1 1
301 GFK0259 Obat antituberkulosa FDC kat. 1 Paket 5 5
303 GFK0320 Obat antituberkulosa kombipak kat. 1 PACKAGE 0 0
304 GFK0261 Pot Dahak Pcs 0 0

PRO
GRA
M305 GFK0262 Reagen Ziehl Neelsen Paket 0 0
GIZI 0
306 GFK0263 Besi (Fe) Tablet Tambah Darah + Asam Folat Tablet 58320 58320
307 GFK0264 Mineral Mix Sachet 0 0
308 GFK0265
PRO Retinol (Vit. A) Kapsul Lunak 100.000 IU Kapsul Lunak 1150 1150
GRA
M309 GFK0266 Retinol (Vit. A) Kapsul Lunak 200.000 IU Kapsul Lunak 750 750
HIV
AIDS 0
310 GFK0315 DBS Collection Kit KIT 0 0
311 GFK0267 Duviral (ZDV 300 mg + 3TC 150 mg) Tablet 0 0
312 GFK0268 Efavirenz 200 mg (EFV 1) Tablet 0 0
314 GFK0270 FDC (TDF 300 mg + 3TC 300 mg + EFV 600 mg) Tablet 0 0
FDC Anak (ZDV 60 MG + 3TC 30 mg + NVF 50
315 GFK0271 mg) Tablet 0 0
316 GFK0272 HIV Test 1 (SD) tes/ kit 0 0
317 GFK0273 HIV Test 2 (FOKUS) tes/ kit 0 0
318 GFK0274 HIV Test 3 (VIKIA) tes/ kit 0 0
319 GFK0275 Lamivudine 150 mg (3TC) Tablet 0 0
320 GFK0276 Nevirapine 200 mg (NVP) Tablet 0 0
321 GFK0277 Rapid Test Syphillis tes/ kit 0 0
322 GFK0278 RDT Leptospira tes/ kit 0 0

323 GFK0325 REAGEN CD4 Tipe 1 TEST 0 0
324 GFK0279 RPR Syphilis tes/ kit 0 0
325 GFK0280
PRO Tenofovir 300 mg (TDF) Tablet 0 0
GRA
M
326 GFK0281
HEPA Zidovudine 100 mg (ZDV) Tablet 0 0
TITIS
PRO 0
GRA
M
327 GFK0282
DIAR Reagen Rapid Test HBsAg tes/ kit 0 0
E 0
328 GFK0283 Garam Oralit II (200 ml) Serbuk Sachet 900 900
329 GFK0284 Obat Antidiare Nonspesifik Sirup Botol 0 0
330 GFK0285 Obat Antidiare Nonspesifik Tablet 600 mg Tablet 0 0
331 GFK0286 Zink Sirup 60 ml Botol 0 0
332 GFK0297 Zink Syrup 20mg/5 ml Tablet 54 72 126
333 GFK0287
PRO Zink Tablet 200 mg Dispersible Tablet 0 0
GRA
M334 GFK0298 Zink Tablet Dispersible 20 mg Tablet 0 0
FILAR
IASIS 0
335 GFK0319 Alat Pelindung Diri (APD) PACKAGE 0 0
336 GFK0317 Bactivec 30 ML BOTTLE 0 0
337 GFK0288 Dehidroartemisin + Piperaquine Tablet (DHP) Tablet 0 0
338 GFK0289 Dietilkarbamazine (DEC) Tablet 100 mg Tablet 0 0
339 GFK0318 Jumantik Kit PACKAGE 0 0
340 GFK0290 Primakuin Tablet 15 mg Tablet 0 0

PRO
GRA
M341 GFK0316 RDT DBD Combo TEST 0 0
IMS 0
342 GFK0291 Artesunat Injeksi 60mg/ml Ampul 0 0
343 GFK0292 Azitromisin Tablet 500 mg Tablet 0 0
344 GFK0293 Benzatin Penisilin Injeksi 2,4 mg Ampul 12 12

345 GFK0294 Cefixime + Azitromisin Kombipak Paket 0 0
346 GFK0295
COVI Flukonazol Tablet 150 mg Tablet 0 0
D-19 0
347 GFK0351 ALAT SEMPROT SET 0 0
348 GFK0355 BARA COAT/GOWN NAVY BIRU SET 0 80 80
350 GFK0357 COVER SHOES PACKAGE 0 0
351 GFK0367 COVERALL DISPO PCS 75 50 125
352 GFK0356 COVERALL HAZMAT SET 0 0

353 GFK0377 L PCS 0 0
354 GFK0385 Desinfektan 20 Liter BOTTLE 0 0
356 GFK0397 ELECTRIC BED 3 CRACK & MATRAS SEMI LATEX UNITS 0 0
357 GFK0387 Handklin100 BOTTLE 0 0
358 GFK0362 Helm + Visor Mask SET 0 0
359 GFK0354 JAS HUJAN BUAH 0 0
360 GFK0350 KACAMATA GOOGLE BUAH 3 3
361 GFK0360 LARUTAN DESINFEKTAN LITER 0 0
362 GFK0361 LARUTAN HAND SANITIZER LITER 1 5 6
363 GFK0384 LARUTAN HAND SANITIZER BOTTLE 14 12 26
364 GFK0378 Masker bedah 3fly PCS 700 700
365 GFK0391 Masker KN95 PCS 0 0
366 GFK0372 Masker N95 PCS 60 60
367 GFK0390 Masker Non Medis PCS 0 0

370 GFK0396 OTC LIANHUA QINGWEN JIAONANG TABLET 0 0
371 GFK0400 POLYBAG PACKAGE 0 0
372 GFK0379 Pulse Oximeter (Serenity/SR.90) BUAH 0 0
373 GFK0364 RAPID TEST CORONA BUAH 80 25 105
376 GFK0371 Sarung Tangan Karet PAIR 5 25 30
378 GFK0369 Sarung Tangan Non Steril Uk. S PCS 0 0
382 GFK0380 Stetoskop Anak (ABN/Classic) BUAH 0 0
383 GFK0381 Stetoskop Dewasa (Serenity/SR-601P) BUAH 0 0
384 GFK0399 SUCTION PUMP UNITS 0 0
385 GFK0358 SURGEON CAP BUAH 0 0
386 GFK0392 TEMPAT SAMPAH MEDIS 15 L BUAH 0 0
387 GFK0393 TEMPAT SAMPAH NON MEDIS 87 L BUAH 0 0
388 GFK0382 Tensimeter (Beureu/BM 58) BUAH 0 0
389 GFK0383 Termometer Gun IR BUAH 0 0
390 GFK0398 VENTILATOR UNITS 0 0
391 GFK0389 VIRUS TRANSFORT MEDIUM [VTM] TUBE 40 40
392 GFK0363 Visor Mask Mika BUAH 18 15 33

393 GFK0359 VTM TUBE 0 0
394 GFK0394 WHELL BEEN 660 L BUAH 0 0
Kepala Puskesmas Diterima Oleh
(..............................) (..............................)
N BANDUNG
NG
5
MINTAAN OBAT (LPLPO)

020
Pemakaian Sisa Akhir Stok Optimum Permintaan Pemberian Ket.
6960 0 APBD
0 0 APBD
0 0 APBD
0 3800 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
200 458 APBD
5500 5400 APBD
0 7800 APBD
0 0 APBD
0 9200 APBD
5000 APBD
0 0 APBD
-60 360 APBD
0 0 APBD
0 0 APBD
0 300 APBD
1000 2200 APBD
0 0 APBD
100 0 APBD
0 0 APBD
0 0 APBD
1000 APBD
7000 3500 APBD
0 1100 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
50 25 APBD
0 323 APBD
0 0 APBD
0 1 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 5 APBD
0 4 APBD
124 APBD
0 29 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 50 APBD
0 500 APBD
0 0 APBD
0 0 APBD
0 400 APBD
0 0 APBD
2 12 APBD
1 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
200 30 APBD
0 0 APBD
2200 0 APBD
0 96 APBD
0 0 APBD
0 29 APBD
0 200 APBD
0 0 APBD
0 400 APBD
0 0 APBD
0 0 APBD
0 120 APBD
0 72 APBD
0 2000 APBD
0 0 APBD
1900 2100 APBD
-9 9 APBD
0 0 APBD
0 0 APBD
0 0 APBD
-600 600 APBD
0 0 APBD
0 0 APBD
0 180 APBD
0 0 APBD
0 11 APBD
0 900 APBD
72 48 APBD
0 0 APBD
72 0 APBD
0 0 APBD
0 0 APBD
0 200 APBD
0 0 APBD
0 0 APBD
-5100 40000 APBD
0 0 APBD
0 0 APBD
1500 1800 APBD
0 0 APBD
-150 700 APBD
0 0 APBD
0 120 APBD
0 96 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 3900 APBD
0 430 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 138 APBD
-400 2800 APBD
0 0 APBD
0 120 APBD
0 0 APBD
2 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 7900 APBD
0 1100 APBD
0 0 APBD
0 400 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
96 24 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
1000 0 APBD
-29 29 APBD
0 0 APBD
0 0 APBD
100 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 25 APBD
21 68 APBD
0 1200 APBD
0 0 APBD
0 0 APBD
100 200 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 3200 APBD
0 0 APBD
0 0 APBD
8 0 APBD
13 12 APBD
0 2300 APBD
200 0 APBD
0 0 APBD
0 0 APBD
2 0 APBD
0 1500 APBD
0 0 APBD
100 140 APBD
-4 36 APBD
0 1200 APBD
0 0 APBD
0 48 APBD
90 0 APBD
0 0 APBD
-200 1600 APBD
-1400 1400 APBD
540 2820 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
200 4200 APBD
0 0 APBD
0 370 APBD
500 7300 APBD

0
0 0 APBD
0 0 APBD
0 300 APBD
0 0 APBD
0 0 APBD
0 0 APBD
500 800 APBD
0 0 APBD
1000 0 APBD
0 0 APBD
0 9 APBD
0 8 APBD
50 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 9 APBD
0 0 APBD
-2 2 APBD
-2 2 APBD
0 0 APBD
0 12 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
-2 2 APBD
0 0 APBD
0 0 APBD
0 0 APBD
-170 175 APBD
-200 200 APBD
-100 200 APBD
0 0 APBD
0 15 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
2 4 APBD
3 0 APBD
0 0 APBD
0 0 APBD
1 0 APBD
1 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0
500 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0
0 0 APBD
0 0 APBD
0 0 APBD
0 0
0 0 APBD
0 0
0 0 APBD
0 0
0 0 APBD
0 0
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0
0 0 APBD
0 1 APBD
-5 10 APBD
0 3 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0
58320 0 APBD
0 0 APBD
0 1150 APBD
0 750 APBD
0
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0
0 0 APBD
0
0 900 APBD
0 0 APBD
0 0 APBD
0 0 APBD
126 0 APBD
0 0 APBD
0 0 APBD
0
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0
0 0 APBD
0 0 APBD
0 12 APBD
0 0 APBD
0 0 APBD
0
0 0 APBD
80 0 APBD
0 0 APBD
0 0 APBD
125 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
2 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
3 0 APBD
0 0 APBD
6 0 APBD
26 0 APBD
700 0 APBD
0 0 APBD
60 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
105 0 APBD
0 0 APBD
0 0 APBD
30 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
40 0 APBD
33 0 APBD
0 0 APBD
0 0 APBD
0 0 APBD
Diserahkan Oleh
(..............................)

Periode Laporan: Juli 2020
Pelaporan Bulan : Juli
Permintaan Bulan : Agustus
OBAT-OBATAN
2 GFK0327 Albendazol susp 200mg/5mL BOTTLE 0 0 0
3 GFK0002 Albendazole Tablet 400 mg Tablet 0 0 0
4 GFK0003 Allopurinol Tablet 100 mg Tablet 3800 4000 7800
5 GFK0004 Allopurinol Tablet 400 mg Tablet 0 0 0
6 GFK0005 Ambroxol Sirup 15 mg / 5 ml Botol 0 0 0
7 GFK0006 Ambroxol Tablet 30 mg Tablet 0 0 0
8 GFK0008 Aminofilin Injeksi 24 mg / ml Ampul 0 0 0
9 GFK0007 Aminofilin Tablet 200 mg Tablet 0 0 0
10 GFK0009 Amitripillin Tablet Salut 25 mg Tablet 458 200 658
13 GFK0012 Amoxicilin Injeksi 1000 mg/ml Ampul 0 0 0
15 GFK0014 Amoxicilin Kaplet 500 mg Tablet 5000 5000
16 GFK0015 Amoxicilin Sirup Kering 125 mg/5 ml Botol 0 0 0

17 GFK0016 Amoxicilin Sirup Kering 250 mg/5 ml Botol 360 0 360
18 GFK0017 Antalgin (Metampiron) Injeksi 250 mg/ml Ampul 0 0 0
19 GFK0018 Antalgin (Metampiron) Tablet 500 mg Tablet 0 0 0
20 GFK0019 Antasida DOEN Suspensi Botol 300 0 300

22 GFK0021 Benzoat 6% + Asam Salisilat 3%) Pot 0 0 0

24 GFK0023 Ergotamin Tartat 1 mg + Caffein 50 mg) Tablet 0 0 0
25 GFK0024 Aqua Pro Injeksi Steril Bebas Pirogen 20 ml Ampul 0 0 0
26 GFK0025 Asam Asetil Salisilat (Asetosal) Tablet 80 mg Tablet 0 0
28 GFK0027 Asam Folat Tablet 1 mg Tablet 1100 0 1100
29 GFK0028 Asam Mefenamat Tablet 500 mg Tablet 0 0 0
30 GFK0029 Asiklovir Krim 5% Tube 0 0 0
31 GFK0296 Asiklovir Tablet 200 mg Tablet 0 0 0
32 GFK0030 Asiklovir Tablet 400 mg Tablet 0 0 0
33 GFK0031 Atropin Sulfat Injeksi 0,25 mg/ml - 1 ml Ampul 0 0 0
34 GFK0032 Bedak Salisil 2% - 50 gram Sachet 0 0 0
36 GFK0034 Cefadroxil Sirup Kering 125 mg/5 ml Botol 323 0 323
37 GFK0349 CHLORQUINE PHOSPHATE Tablet TABLET 0 0 0
38 GFK0035 Deksametason Injeksi 5 mg/ml Ampul 1 0 1
39 GFK0036 Deksametason Tablet 0,5 mg Tablet 0 0 0
40 GFK0342 Desinfektan 5 Liter GALLON 0 0 0

41 GFK0037 Diazepam Injeksi 5 mg/ml Ampul 0 0 0
42 GFK0038 Diazepam Rectal 10 mg Suppositoria 5 0 5
43 GFK0039 Diazepam Rectal 5 mg Suppositoria 4 0 4
44 GFK0040 Diazepam Tablet 2 mg Tablet 100 100
45 GFK0041 Difenhidramin Hcl Injeksi 10 mg/ml Ampul 29 0 29
46 GFK0042 Digoxin Tablet 0,25 mg Tablet 0 0 0
47 GFK0307 Dimenhidrinat Tablet 50 mg TABLET 0 0 0
48 GFK0326 Diphteria Antitoxin Serum VIAL 0 0 0
49 GFK0305 Domperidon sir 5mg/5mL BOTTLE 50 0 50
50 GFK0043 Domperidon Tablet 10 mg Tablet 500 0 500
51 GFK0044 Epinefrin HCl injeksi 0,1% - 1 ml Ampul 0 0 0
52 GFK0046 Eritromisin Kapsul 250 mg 0 0 0
53 GFK0045 Eritromisin Kapsul 500 mg Tablet 400 0 400
54 GFK0047 Eritromisin Sirup 200 mg/5 ml Botol 0 0 0
55 GFK0048 Etakridin (Rivanol) 0,1% Botol 12 0 12
56 GFK0049 Etanol 70% - 1000 ml Botol 0 1 1
57 GFK0050 Etanol 70% - 300 ml Botol 0 0 0
58 GFK0324 Etil Klorida spray 100 mL BOTTLE 0 0 0
59 GFK0051 Eugenol 10 ml Botol 0 0 0
60 GFK0052 Fenobarbital Injeksi 50 mg/ ml Ampul 0 0 0
61 GFK0053 Fenobarbital Tablet 30 mg Tablet 30 200 230
62 GFK0055 Fenoksimetil Fenisilin Tablet 250 mg Tablet 0 0 0
63 GFK0054 Fenoksimetil Fenisilin Tablet 500 mg Tablet 0 0 0
64 GFK0056 Fenol Griseol Tetes Telinga 10% Botol 96 0 96

65 GFK0057 Fitomenadion (Vit. K) Injeksi 10 mg/ml Ampul 0 0 0
66 GFK0058 Fitomenadion (Vit. K) Injeksi 2 mg/ml Ampul 29 0 29
67 GFK0059 Fitomenadion (Vit. K) Tablet Salut 10 mg Tablet 200 0 200
68 GFK0061 Furosemida Injeksi IV/IM 10 mg/ml-2ml Ampul 0 0 0
69 GFK0060 Furosemida Tablet 40 mg Tablet 400 0 400
70 GFK0062 Gentamisin Injeksi 80 mg/2,5 ml Ampul 0 0 0
71 GFK0063 Gentamisin Salep Kulit 0,1% Tube 0 0 0
72 GFK0064 Gentamisin Salep Mata Tube 120 0 120
73 GFK0065 Gentamisin Tetes Mata Botol 72 0 72
74 GFK0066 Glibenclamide Tablet 5 mg Tablet 2000 0 2000
75 GFK0067 Glimepirid Tablet 1 mg Tablet 0 0 0
76 GFK0068 Glimepirid Tablet 2 mg Tablet 2100 0 2100
77 GFK0069 Gliserin Cairan 100 ml Botol 9 0 9
78 GFK0070 Gluconas calcicus 10% - 10 ml Ampul 0 0 0
79 GFK0071 Glukosa Lar. Steril Cairan Infus 10% Botol 0 0 0
80 GFK0072 Glukosa Lar. Steril Cairan Infus 5% Botol 0 0 0
81 GFK0073 Griseofulvin Tablet 125 mg Tablet 600 0 600
82 GFK0074 Griseril Guaiakolat Tablet 100 mg Tablet 0 0 0
83 GFK0075 Haloperidol Tablet 0,5 mg Tablet 0 0 0
84 GFK0076 Haloperidol Tablet 1,5 mg Tablet 180 0 180
85 GFK0077 Haloperidol Tablet 2 mg Tablet 0 0 0
86 GFK0078 Haloperidol Tablet 5 mg Tablet 11 0 11
87 GFK0079 Hidroklortiazid (HCT) Tablet 25 mg Tablet 900 0 900

91 GFK0083 Ibuprofen Tablet 400 mg Tablet 0 0 0
92 GFK0084 Isoniazide (INH) 100 mg Tablet 0 0 0
93 GFK0085 Isoniazide (INH) 300 mg Tablet 200 0 200

94 GFK0086 mg Tablet 0 0 0
95 GFK0087 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 0 0 0
96 GFK0088 Kaptopril Tablet 12,5 mg Tablet 40000 0 40000
97 GFK0089 Kaptopril Tablet 25 mg Tablet 0 0 0
98 GFK0090 Karbamazepin Tablet 200 mg Tablet 0 500 500
99 GFK0091 Ketoconazole Tablet 200 mg Tablet 1800 0 1800
100 GFK0092 Klindamisin Kapsul 150 mg Kapsul 0 0 0
101 GFK0093 Klindamisin Kapsul 300 mg Kapsul 700 0 700
102 GFK0094 Kloramfenikol Kapsul 250 mg Kapsul 0 0 0
103 GFK0095 Kloramfenikol Salep Kulit (Bufacetine) 2% Tube 120 0 120
104 GFK0096 Kloramfenikol Salep Mata 1% Tube 96 0 96
105 GFK0097 Kloramfenikol Suspensi 125 mg/5 ml - 60 ml Botol 0 0 0
106 GFK0098 Kloramfenikol Tetes Mata 0,5% Botol 0 0 0
107 GFK0099 Kloramfenikol Tetes Telinga 3% Botol 0 0 0
108 GFK0100 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 3900 0 3900
109 GFK0102 Klorpromazin HCL Tablet Salut 100 mg Tablet 430 0 430
110 GFK0101 Klorpromazin HCL Tablet Salut 25 mg Tablet 0 0 0
111 GFK0321 Kolekalsiferol (Vit. D3) 400 unit tablet TABLET 0 0 0
112 GFK0322 Kolekalsiferol (Vit. D3) 400 unit/5 ml syr BOTTLE 0 0 0

113 GFK0103 40 mg/5 ml) Botol 138 0 138

114 GFK0104 Sulfametaksazol 400 mg + Trimetropim 80 mg) Tablet 2800 0 2800
115 GFK0105 Lidokain Injeksi Ampul 0 0 0

116 GFK0106 HCl 2% + Epinefrin 1: 80.000) 2 ml Ampul 120 0 120
117 GFK0107 Loratadin Tablet 10 mg Tablet 0 0 0
120 GFK0110 Mebendazole Sirup 100 mg/5 ml Botol 0 0 0
121 GFK0111 Mebendazole Tablet 100 mg Tablet 0 0 0
122 GFK0112 Meloxicam Tablet 15 mg Tablet 0 0 0
123 GFK0113 Metformin Tablet 500 mg Tablet 7900 5000 12900
124 GFK0114 Metildopa (Dopamet) Tablet 250 mg Tablet 1100 0 1100

125 GFK0115 mg/ml Ampul 0 0 0
126 GFK0116 Salut 0,125 mg Tablet 400 0 400
127 GFK0117 Metilprednisolon Tablet 4 mg Tablet 0 0 0
128 GFK0118 Metoklorpramid Injeksi 5 mg/ml Ampul 0 0 0
129 GFK0119 Metoklorpramid Tablet 10 mg Tablet 0 0 0
130 GFK0120 Metronidazole Syrup Botol 0 0 0
131 GFK0121 Metronidazole Tablet 250 mg Tablet 0 0 0
132 GFK0122 Metronidazole Tablet 500 mg Tablet 0 0 0
134 GFK0124 Multivitamin + Mineral Tablet Tablet 0 0 0
135 GFK0125 Multivitamin Sirup Botol 0 0 0

136 GFK0126 Multivitamin Tablet Tablet 0 0 0
137 GFK0127 Natrium Bikarbonat Tablet 500 mg Tablet 0 0 0
139 GFK0129 Natrium Klorida Cairan Infus 0,9% - 500 ml Botol 29 0 29
140 GFK0130 Nifedipine Tablet 10 mg Tablet 0 0 0
141 GFK0132 Nistatin Tablet 500.000 IU Tablet 0 0 0
143 GFK0133 Obat Flu Sirup Botol 0 0 0
144 GFK0134 Obat Flu Tablet Tablet 0 0 0
145 GFK0323 Oksigen ih, gas dalam tabung BOTTLE 0 0 0
146 GFK0135 Oksitetrasiklin HCl Salep Kulit 3% Tube 0 0 0
147 GFK0136 Oksitetrasiklin HCl Salep Mata 1% Tube 25 0 25
148 GFK0137 Oksitosin Injeksi 10 IU/ml Ampul 68 0 68
149 GFK0138 Omeprazol Tablet 20 mg Tablet 1200 0 1200
150 GFK0304 Oseltamivir Kapsul 75 Mg KAPSUL 0 0 0
151 GFK0139 Parasetamol Drops 100mg/ml Botol 0 0 0
152 GFK0140 Parasetamol Sirup 120 mg/5 ml Botol 200 100 300
153 GFK0141 Parasetamol Suppositoria Suppositoria 0 0 0
154 GFK0142 Parasetamol Tablet 500 mg Tablet 0 0 0
155 GFK0348 Pehavral Tablet TABLET 0 0 0
156 GFK0143 Piridoksin (Vit. B6) Tablet 10 mg Tablet 3200 0 3200
157 GFK0144 Piridoksin (Vit. B6) Tablet 25 mg Tablet 0 0 0
158 GFK0145 Piroxicam Kapsul 20 mg Tablet 0 0 0

161 GFK0148 Prednison Tablet 5 mg Tablet 2300 0 2300
164 GFK0151 Propiltiourasil Tablet 100 mg Tablet 0 0 0
165 GFK0152 Ranitidine Injeksi 25 mg/ml Ampul 0 0 0
166 GFK0153 Ranitidine Tablet 150 mg Tablet 1500 0 1500
167 GFK0154 Ringer Laktat Cairan Infus 500 ml Botol 0 0 0
169 GFK0156 Salbutamol Nebulizer 1 mg/ml - 2,5 ml Ampul 36 0 36
170 GFK0157 Salbutamol Tablet 2 mg Tablet 1200 0 1200
171 GFK0158 Salbutamol Tablet 4 mg Tablet 0 0 0

172 GFK0159 Belerang Endap 2%) Pot 48 0 48
173 GFK0160 Scabimite Cream (Premetrin 5% krim) Tube 0 60 60
174 GFK0161 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Ampul 0 0 0
175 GFK0162 Sianokobalamin (Vit. B12) Injeksi 500 mcg/ml Ampul 1600 0 1600
176 GFK0163 Sianokobalamin (Vit. B12) Tablet 50 mcg Tablet 1400 0 1400
179 GFK0166 Siprofloksasin Tablet 500 mg Tablet 0 0 0
180 GFK0167 Tetrasiklin Kapsul 250 mg Kapsul 0 0 0
182 GFK0169 Thiamfenikol Kapsul 500 mg Kapsul 0 0 0
183 GFK0170 Thiamin HCl (Vit. B1) Injeksi 100 mcg/ml Ampul 0 0 0
184 GFK0171 Thiamin HCl (Vit. B1) Tablet 50 mg Tablet 4200 0 4200
185 GFK0306 Tiamin (vitamin B1) tab 100 mg TABLET 0 0 0
186 GFK0172 Trihexifenidil Hidroksida Tablet 2 mg Tablet 370 0 370
187 GFK0173
BMH Vitamin B Kompleks Tablet Tablet 7300 500 7800
P 0
188 GFK0341 ALAT SEMPROT BUAH 0 0 0
189 GFK0186 Alat Suntik Sekali Pakai 0,05 ml Pcs 0 0 0
190 GFK0187 Alat Suntik Sekali Pakai 1 ml Pcs 300 0 300
194 GFK0211 Alkohol Swab Pcs 800 1000 1800
195 GFK0330 BARA COAT/GOWN NAVY BIRU PCS 0 0 0
196 GFK0212 Blood Lancet Pcs 0 1000 1000
197 GFK0191 Canula Oksigen Pcs 0 0 0

198 GFK0192 bedah Pcs 9 0 9
199 GFK0193 bedah Pcs 8 0 8

202 GFK0329 L PCS 0 0 0
204 GFK0314 EXTRADINE 5 LITER GALLON 0 0 0
205 GFK0194 Fixomull Stretch 5cm x 5m Pcs 9 0 9
206 GFK0195 Folley Catheter No. 16 Pcs 0 0 0

209 GFK0343 Helm + Visor Mask BUAH 0 0 0
210 GFK0198 Infus Set Adult 20 drops/mL Pcs 12 0 12
211 GFK0199 Infus Set Pedriatic 60 drops/mL Pcs 0 0 0
212 GFK0200 IV Catheter No. 18 Pcs 0 0 0
216 GFK0340 JAS HUJAN PCS 0 0 0
217 GFK0339 KACAMATA GOOGLE PCS 0 0 0
218 GFK0213 Kantong mayat Pcs 0 0 0
219 GFK0220 Kapas Pembalut/Absorben 250 gram Rol 2 0 2
220 GFK0179 Kaporit Serbuk Kg 0 0 0
221 GFK0180 Kaporit Tablet serbuk Kg 0 0 0
222 GFK0221 Kasa Gulung Besar 40 x 80 cm Rol 0 0 0
223 GFK0222 Kasa Pembalut Hidrofil 4 m x 10 cm Rol 175 0 175
224 GFK0223 Kasa Pembalut Hidrofil 4 m x 5 cm Rol 200 0 200
225 GFK0182 Kasa Steril 16 x 16 cm Kotak 200 0 0
226 GFK0308 Klor Fenol Kamfer (CHKM) KOTAK 0 0 0
227 GFK0174 Lisol Botol 15 0 15
228 GFK0204 Masker 3 Ply Tie One Pcs 0 0 0
229 GFK0205 Masker N95 Pcs 0 0 0
230 GFK0333 NURSE CAP PCS 0 0 0
231 GFK0181 PAC Kg 0 0 0

234 GFK0226 Plesterin Bulat Soft Rol 0 0 0

235 GFK0183 cm pack @ 24 lbr 0 0 0
236 GFK0184 cm pack @ 24 lbr 0 0 0
237 GFK0185 60x100 cm pack @ 24 lbr 0 0 0
238 GFK0206 Safety Box Pcs 0 0 0
239 GFK0336 SAFETY GLASS PCS 0 0 0
240 GFK0335 Sarung Tangan Kain PCS 0 0 0
242 GFK0328 Sarung Tangan Non Steril Uk. L PCS 0 0 0
243 GFK0214 Sarung Tangan Non Steril Uk. M Psg 0 0 0
244 GFK0215 Sarung Tangan Non Steril Uk. S Psg 0 0 0
245 GFK0216 Sarung Tangan Non Steril Uk. XL 0 0 0
246 GFK0217 Sarung Tangan Obgyn Steril Psg 0 0 0
247 GFK0218 Sarung Tangan Steril 6,5 G Psg 0 0 0
248 GFK0219 Sarung Tangan Steril 7 G Psg 0 0 0
249 GFK0337 SEPATU BOOT PAIR 0 0 0

250 GFK0207 jarum bedah Pcs 0 0 0
251 GFK0177 Softanol 5 Liter Botol/Galon 0 0 0
252 GFK0175 Softanol 500 ml Botol 0 0 0
253 GFK0331 STANDARD SHOE COVER PAIR 0 0 0
254 GFK0312 STERALD 5 LITER GALLON 0 0 0
255 GFK0310 STERICIDE 5 LITER GALLON 0 0 0

256 GFK0313 STERICIDE 500 ML BOTTLE 0 0 0
257 GFK0309 STERICIDE-3 5 LITER GALLON 0 0 0
258 GFK0311 STERIZYME 5 LITER GALLON 0 0 0
259 GFK0347 SURGEON CAP WITH TIE PCS 0 0 0
260 GFK0208 Umbical Clam Pcs 0 0 0
261 GFK0209 Underpad (Softpad) 60x90 cm Pcs 0 0 0
262 GFK0210 Urine Bag Steril 2 L Pcs 0 0 0
263 GFK0227 Verband Elastis 10 cm Rol 0 0 0
264 GFK0178 Viorex 2% 5 Liter Botol/Galon 0 0 0

BAH
AN265 GFK0176 Viorex 2% 500 ml Botol 0 0 0
LABO
RAT
266 GFK0346
ORIU Visor Mask Mika BUAH 0 0 0
M 0 0
268 GFK0229 Benecheck Plus Total Cholesterol Test Strip Strip 0 0 0
269 GFK0230 Benecheck Plus Uric Test Strip Strip 0 0 0
270 GFK0231
PRO Benecheck Test System Pcs 0 0 0
GRA
M271 GFK0338 RAPID TEST CORONA TEST 0 0 0
KUST
A 0 0
272 GFK0233 MDT MB Anak Tablet Blister 0 0 0

BAH
AN273 GFK0234 MDT MB Dewasa Tablet Blister 0 0 0
LABO
RAT
274 GFK0235 MDT PB Anak Tablet Blister 0 0 0
ORIU
M 0 0
IMU
275 GFK0232
NISA Media Amies Pcs 0 0 0
SI
PRO 0 0
GRA
M276 VAC0304 Alat Suntik Sekali Pakai 0,5 ml TABLET 0 0 0
KUST
A 0 0
PRO
GRA
M
IMU
277 GFK0236 MDT PB Dewasa Tablet Blister 0 0 0
NISA
SI 0 0
278 VAC0249 Pelarut BCG Vial 0 0 0
279 VAC0250 Pelarut Campak Vial 0 0 0
280 VAC0252 Pelarut MR Vial 0 0 0
281 VAC0303 Penetes Vaksin Polio (BOPV) Buah 0 0 0
282 VAC0237 Vaksin Anti Rabies (VAR) Verorab Vial 0 0 0
283 VAC0238 Vaksin BCG Vial 0 0 0
284 VAC0239 Vaksin Campak Vial 0 0 0
285 VAC0240 Vaksin DTP HB/HIB Vial 0 0 0
286 VAC0242 Vaksin HBV Vial 0 0 0
287 VAC0243 Vaksin Hepatitis B Immunoglobulin (HBIg) Vial 0 0 0
288 VAC0251 Vaksin Hepatitis B Recombinant Injeksi 0,5ml Vial 0 0 0
289 VAC0241 Vaksin Jerap DT Vial 0 0 0
290 VAC0247 Vaksin Jerap Td Vial 0 0 0
291 VAC0256 Vaksin Meningitis (Formening) Vial 0 0 0
292 VAC0255 Vaksin Meningitis (Menivax) Vial 0 0 0
293 VAC0244 Vaksin MR Vial 0 0 0
294 VAC0245 Vaksin Polio (BOPV) Vial 0 0 0
295 VAC0253 Vaksin Polio (IPV 10 ds) Vial 0 0 0
PRO
298 VAC0248
GRA Vaksin Tuberkulin Vial 0 0 0
M TB 0 0
299 GFK0257 Kaca Sediaan (Object Glass) Pcs 0 0 0

300 GFK0258 Obat antituberkulosa FDC Anak Paket 1 0 1
301 GFK0259 Obat antituberkulosa FDC kat. 1 Paket 10 0 10
302 GFK0260 Obat antituberkulosa FDC kat. 2 Paket 3 0 3
303 GFK0320 Obat antituberkulosa kombipak kat. 1 PACKAGE 0 0 0
304 GFK0261 Pot Dahak Pcs 0 0 0

PRO
GRA
M305 GFK0262 Reagen Ziehl Neelsen Paket 0 0 0
GIZI 0 0
306 GFK0263 Besi (Fe) Tablet Tambah Darah + Asam Folat Tablet 0 0 0
307 GFK0264 Mineral Mix Sachet 0 0 0
308 GFK0265
PRO Retinol (Vit. A) Kapsul Lunak 100.000 IU Kapsul Lunak 1150 0 1150
GRA
M309 GFK0266 Retinol (Vit. A) Kapsul Lunak 200.000 IU Kapsul Lunak 750 0 750
HIV
AIDS 0
310 GFK0315 DBS Collection Kit KIT 0 0 0
311 GFK0267 Duviral (ZDV 300 mg + 3TC 150 mg) Tablet 0 0 0
312 GFK0268 Efavirenz 200 mg (EFV 1) Tablet 0 0 0
313 GFK0269 Efavirenz 600 mg (EFV 2) Tablet 0 0 0
314 GFK0270 FDC (TDF 300 mg + 3TC 300 mg + EFV 600 mg) Tablet 0 0 0
315 GFK0271 mg) Tablet 0 0 0
316 GFK0272 HIV Test 1 (SD) tes/ kit 0 0 0
317 GFK0273 HIV Test 2 (FOKUS) tes/ kit 0 0 0
318 GFK0274 HIV Test 3 (VIKIA) tes/ kit 0 0 0
319 GFK0275 Lamivudine 150 mg (3TC) Tablet 0 0 0
320 GFK0276 Nevirapine 200 mg (NVP) Tablet 0 0 0
321 GFK0277 Rapid Test Syphillis tes/ kit 0 0 0
322 GFK0278 RDT Leptospira tes/ kit 0 0 0

323 GFK0325 REAGEN CD4 Tipe 1 TEST 0 0 0
324 GFK0279 RPR Syphilis tes/ kit 0 0 0
325 GFK0280
PRO Tenofovir 300 mg (TDF) Tablet 0 0 0
GRA
M
326 GFK0281
HEPA Zidovudine 100 mg (ZDV) Tablet 0 0 0
TITIS
PRO 0 0
GRA
M
327 GFK0282
DIAR Reagen Rapid Test HBsAg tes/ kit 0 0 0
E 0
328 GFK0283 Garam Oralit II (200 ml) Serbuk Sachet 900 0 900
329 GFK0284 Obat Antidiare Nonspesifik Sirup Botol 0 0 0
330 GFK0285 Obat Antidiare Nonspesifik Tablet 600 mg Tablet 0 0 0
331 GFK0286 Zink Sirup 60 ml Botol 0 0 0
332 GFK0297 Zink Syrup 20mg/5 ml Tablet 0 72 72
333 GFK0287
PRO Zink Tablet 200 mg Dispersible Tablet 0 0 0
GRA
M334 GFK0298 Zink Tablet Dispersible 20 mg Tablet 0 0 0
FILAR
IASIS 0
335 GFK0319 Alat Pelindung Diri (APD) PACKAGE 0 0 0
336 GFK0317 Bactivec 30 ML BOTTLE 0 0 0
337 GFK0288 Dehidroartemisin + Piperaquine Tablet (DHP) Tablet 0 0 0
338 GFK0289 Dietilkarbamazine (DEC) Tablet 100 mg Tablet 0 0 0
339 GFK0318 Jumantik Kit PACKAGE 0 0 0
340 GFK0290 Primakuin Tablet 15 mg Tablet 0 0 0

PRO
GRA
M341 GFK0316 RDT DBD Combo TEST 0 0 0
IMS 0 0
342 GFK0291 Artesunat Injeksi 60mg/ml Ampul 0 0 0
343 GFK0292 Azitromisin Tablet 500 mg Tablet 0 0 0
344 GFK0293 Benzatin Penisilin Injeksi 2,4 mg Ampul 12 0 12

345 GFK0294 Cefixime + Azitromisin Kombipak Paket 0 0 0
346 GFK0295
COVI Flukonazol Tablet 150 mg Tablet 0 0 0
D-19 0
347 GFK0351 ALAT SEMPROT SET 0 0 0
349 GFK0365 CHLORQUINE PHOSPHATE Tablet TABLET 0 0 0
350 GFK0357 COVER SHOES PACKAGE 0 0 0
352 GFK0356 COVERALL HAZMAT SET 0 0 0

353 GFK0377 L PCS 0 0 0
354 GFK0385 Desinfektan 20 Liter BOTTLE 0 0 0
355 GFK0388 Desinfektan 5 Liter BOTTLE 0 2 2
356 GFK0397 ELECTRIC BED 3 CRACK & MATRAS SEMI LATEX UNITS 0 0 0
357 GFK0387 Handklin100 BOTTLE 0 0 0
358 GFK0362 Helm + Visor Mask SET 0 0 0
359 GFK0354 JAS HUJAN BUAH 0 0 0
360 GFK0350 KACAMATA GOOGLE BUAH 0 3 3
361 GFK0360 LARUTAN DESINFEKTAN LITER 0 0 0
363 GFK0384 LARUTAN HAND SANITIZER BOTTLE 0 14 14
364 GFK0378 Masker bedah 3fly PCS 0 700 700
365 GFK0391 Masker KN95 PCS 0 0 0
366 GFK0372 Masker N95 PCS 0 60 60
367 GFK0390 Masker Non Medis PCS 0 0 0

369 GFK0366 Oseltamivir Kapsul 75 Mg KAPSUL 0 0 0
370 GFK0396 OTC LIANHUA QINGWEN JIAONANG TABLET 0 0 0
371 GFK0400 POLYBAG PACKAGE 0 0 0
372 GFK0379 Pulse Oximeter (Serenity/SR.90) BUAH 0 0 0
373 GFK0364 RAPID TEST CORONA BUAH 0 80 80
374 GFK0373 SAFETY GLASS PCS 0 0 0
375 GFK0374 Sarung Tangan Kain PCS 0 0 0
377 GFK0368 Sarung Tangan Non Steril Uk. L PCS 0 0 0
378 GFK0369 Sarung Tangan Non Steril Uk. S PCS 0 0 0
379 GFK0353 SEPATU BOOT PAIR 0 0 0
380 GFK0376 STANDARD SHOE COVER PAIR 0 0 0
381 GFK0386 STERICIDE-3 5 LITER GALLON 0 0 0
382 GFK0380 Stetoskop Anak (ABN/Classic) BUAH 0 0 0
383 GFK0381 Stetoskop Dewasa (Serenity/SR-601P) BUAH 0 0 0
384 GFK0399 SUCTION PUMP UNITS 0 0 0
385 GFK0358 SURGEON CAP BUAH 0 0 0
386 GFK0392 TEMPAT SAMPAH MEDIS 15 L BUAH 0 0 0
387 GFK0393 TEMPAT SAMPAH NON MEDIS 87 L BUAH 0 0 0
388 GFK0382 Tensimeter (Beureu/BM 58) BUAH 0 0 0
389 GFK0383 Termometer Gun IR BUAH 0 0 0
390 GFK0398 VENTILATOR UNITS 0 0 0
391 GFK0389 VIRUS TRANSFORT MEDIUM [VTM] TUBE 0 40 40

393 GFK0359 VTM TUBE 0 0 0
394 GFK0394 WHELL BEEN 660 L BUAH 0 0 0
395 GFK0395 WHELL BEEN 660 L BUAH 0 0 0
(..............................) (..............................)
N BANDUNG
NG
5

20
0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
4200 3600 12600 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
15 643 45 0 APBD
1200 9600 3600 0 APBD
0 7800 0 0 APBD
0 0 0 0 APBD
1600 7600 4800 0 APBD
1200 3800 3600 2000 APBD
0 0 0 0 APBD
60 300 180 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
50 250 150 0 APBD
1700 1500 5100 3000 APBD
0 0 0 0 APBD
0 100 0 100 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 APBD
1000 9500 3000 5000 APBD
1000 100 3000 2000 APBD
0 0 0 0 APBD
0 0 50 APBD
0 0 0 0 APBD
0 0 0 1000 APBD
0 0 0 0 APBD
0 0 0 0 APBD
50 25 150 125 APBD
0 323 0 0 APBD
0 0 0 0 APBD
0 1 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 5 0 0 APBD
1 3 3 0 APBD
16 84 48 100 APBD
0 29 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 50 0 0 APBD
0 500 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 400 0 0 APBD
0 0 0 0 APBD
0 12 0 0 APBD
1 0 3 0 APBD
0 0 0 0 APBD
0 0 0 5 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 230 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 96 0 0 APBD
0 0 0 0 APBD
5 24 15 0 APBD
100 100 300 200 APBD
0 0 0 0 APBD
400 0 1200 600 APBD
0 0 0 0 APBD
0 0 0 100 APBD
0 120 0 0 APBD
0 72 0 0 APBD
0 2000 0 0 APBD
0 0 0 0 APBD
0 2100 0 0 APBD
0 9 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 600 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 180 0 0 APBD
0 0 0 0 APBD
0 11 0 0 APBD
0 900 0 0 APBD
72 48 216 72 APBD
0 0 0 0 APBD
0 72 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 200 0 0 APBD
0 0 0 100 APBD
0 0 0 3000 APBD
1500 38500 4500 0 APBD
0 0 0 0 APBD
100 400 300 0 APBD
0 1800 0 0 APBD
0 0 0 0 APBD
200 500 600 0 APBD
0 0 0 0 APBD
24 96 72 0 APBD
24 72 72 0 APBD
0 0 0 0 APBD
0 0 0 50 APBD
0 0 0 0 APBD
0 3900 0 0 APBD
10 420 30 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 138 0 0 APBD
800 2000 2400 0 APBD
0 0 0 0 APBD
94 26 282 100 APBD
0 0 0 0 APBD
0 0 0 2 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 1000 APBD
8600 4300 25800 10000 APBD
0 1100 0 0 APBD
0 0 0 0 APBD
0 400 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 120 0 96 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 1000 APBD
550 450 1650 2000 APBD
4 25 12 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
100 0 300 100 APBD
0 0 0 0 APBD
0 0 0 1000 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 25 0 0 APBD
14 54 42 0 APBD
0 1200 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 300 0 0 APBD
0 0 0 10 APBD
0 0 0 0 APBD
0 0 0 0 APBD
300 2900 900 0 APBD
0 0 0 0 APBD
0 0 0 1000 APBD
0 0 0 5 APBD
0 12 0 0 APBD
0 2300 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 1500 0 0 APBD
0 0 0 0 APBD
120 120 360 100 APBD
4 32 12 0 APBD
100 1100 300 0 APBD
0 0 0 500 APBD
24 24 72 24 APBD
0 60 0 0 APBD
0 0 0 0 APBD
200 1400 600 0 APBD
0 1400 0 0 APBD
1380 3120 4140 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
200 0 600 100 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 4200 0 0 APBD
0 0 0 0 APBD
20 350 60 0 APBD
2100 5700 6300 0 APBD

0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 300 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 1800 0 1000 APBD
0 0 0 0 APBD
0 1000 0 1000 APBD
0 0 0 0 APBD
0 9 0 0 APBD
0 8 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 9 0 0 APBD
0 0 0 5 APBD
1 1 3 5 APBD
1 1 3 5 APBD
0 0 0 0 APBD
1 11 3 0 APBD
0 0 0 5 APBD
0 0 0 5 APBD
0 0 0 5 APBD
0 0 0 5 APBD
0 0 0 5 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 2 0 -2 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 175 0 0 APBD
0 200 0 0 APBD
100 200 300 0 APBD
0 0 0 0 APBD
0 15 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
1 5 3 5 APBD
0 2 0 5 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 1000 APBD
0 0 0 1000 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 1 0 0 APBD
2 8 6 0 APBD
0 3 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 1150 0 0 APBD
0 750 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0
0 900 0 0 APBD
0 0 0 500 APBD
0 0 0 500 APBD
0 0 0 0 APBD
18 54 54 0 APBD
0 0 0 0 APBD
0 0 0 1000 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 12 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 75 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 2 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 3 0 0 APBD
0 0 0 0 APBD
0 1 0 0 APBD
0 14 0 0 APBD
0 700 0 0 APBD
0 0 0 0 APBD
0 60 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 80 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 5 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 40 0 0 APBD
0 18 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
0 0 0 0 APBD
Diserahkan Oleh
(..............................)

Periode Laporan: Agustus 2020
Pelaporan Bulan : Agustus
Permintaan Bulan : September
OBAT-OBATAN
2 GFK0327 Albendazol susp 200mg/5mL BOTTLE 0 0
3 GFK0002 Albendazole Tablet 400 mg Tablet 0 0
6 GFK0005 Ambroxol Sirup 15 mg / 5 ml Botol 0 0
7 GFK0006 Ambroxol Tablet 30 mg Tablet 0 0
8 GFK0008 Aminofilin Injeksi 24 mg / ml Ampul 0 0
9 GFK0007 Aminofilin Tablet 200 mg Tablet 0 0
10 GFK0009 Amitripillin Tablet Salut 25 mg Tablet 643 643
13 GFK0012 Amoxicilin Injeksi 1000 mg/ml Ampul 0 0

18 GFK0017 Antalgin (Metampiron) Injeksi 250 mg/ml Ampul 0 0
19 GFK0018 Antalgin (Metampiron) Tablet 500 mg Tablet 0 500 500
20 GFK0019 Antasida DOEN Suspensi Botol 250 250

22 GFK0021 Benzoat 6% + Asam Salisilat 3%) Pot 0 0

24 GFK0023 Ergotamin Tartat 1 mg + Caffein 50 mg) Tablet 0 0
25 GFK0024 Aqua Pro Injeksi Steril Bebas Pirogen 20 ml Ampul 0 0
26 GFK0025 Asam Asetil Salisilat (Asetosal) Tablet 80 mg Tablet 0
28 GFK0027 Asam Folat Tablet 1 mg Tablet 100 2300 2400
29 GFK0028 Asam Mefenamat Tablet 500 mg Tablet 0 0
30 GFK0029 Asiklovir Krim 5% Tube 0 0
33 GFK0031 Atropin Sulfat Injeksi 0,25 mg/ml - 1 ml Ampul 0 0
34 GFK0032 Bedak Salisil 2% - 50 gram Sachet 0 0
36 GFK0034 Cefadroxil Sirup Kering 125 mg/5 ml Botol 323 323
38 GFK0035 Deksametason Injeksi 5 mg/ml Ampul 1 1
39 GFK0036 Deksametason Tablet 0,5 mg Tablet 0 0

41 GFK0037 Diazepam Injeksi 5 mg/ml Ampul 0 0
44 GFK0040 Diazepam Tablet 2 mg Tablet 84 100 184
45 GFK0041 Difenhidramin Hcl Injeksi 10 mg/ml Ampul 29 29
46 GFK0042 Digoxin Tablet 0,25 mg Tablet 0 0
47 GFK0307 Dimenhidrinat Tablet 50 mg TABLET 0 0
48 GFK0326 Diphteria Antitoxin Serum VIAL 0 0
49 GFK0305 Domperidon sir 5mg/5mL BOTTLE 50 50
50 GFK0043 Domperidon Tablet 10 mg Tablet 500 500
51 GFK0044 Epinefrin HCl injeksi 0,1% - 1 ml Ampul 0 0
52 GFK0046 Eritromisin Kapsul 250 mg 0 0
53 GFK0045 Eritromisin Kapsul 500 mg Tablet 400 400
54 GFK0047 Eritromisin Sirup 200 mg/5 ml Botol 0 0
55 GFK0048 Etakridin (Rivanol) 0,1% Botol 12 12
58 GFK0324 Etil Klorida spray 100 mL BOTTLE 0 0
59 GFK0051 Eugenol 10 ml Botol 0 0
60 GFK0052 Fenobarbital Injeksi 50 mg/ ml Ampul 0 0
61 GFK0053 Fenobarbital Tablet 30 mg Tablet 230 230
64 GFK0056 Fenol Griseol Tetes Telinga 10% Botol 96 96

67 GFK0059 Fitomenadion (Vit. K) Tablet Salut 10 mg Tablet 100 100 200
68 GFK0061 Furosemida Injeksi IV/IM 10 mg/ml-2ml Ampul 0 0
69 GFK0060 Furosemida Tablet 40 mg Tablet 0 600 600
70 GFK0062 Gentamisin Injeksi 80 mg/2,5 ml Ampul 0 0
71 GFK0063 Gentamisin Salep Kulit 0,1% Tube 0 0
72 GFK0064 Gentamisin Salep Mata Tube 120 120
73 GFK0065 Gentamisin Tetes Mata Botol 72 72
74 GFK0066 Glibenclamide Tablet 5 mg Tablet 2000 2000
77 GFK0069 Gliserin Cairan 100 ml Botol 9 9
78 GFK0070 Gluconas calcicus 10% - 10 ml Ampul 0 0
81 GFK0073 Griseofulvin Tablet 125 mg Tablet 600 600
82 GFK0074 Griseril Guaiakolat Tablet 100 mg Tablet 0 0
87 GFK0079 Hidroklortiazid (HCT) Tablet 25 mg Tablet 900 900

91 GFK0083 Ibuprofen Tablet 400 mg Tablet 0 0

94 GFK0086 mg Tablet 0 0
95 GFK0087 Kalsium Laktat (Kalk) Tablet 500 mg Tablet 0 0
96 GFK0088 Kaptopril Tablet 12,5 mg Tablet 38500 38500
97 GFK0089 Kaptopril Tablet 25 mg Tablet 0 0
98 GFK0090 Karbamazepin Tablet 200 mg Tablet 400 400
99 GFK0091 Ketoconazole Tablet 200 mg Tablet 1800 1800
102 GFK0094 Kloramfenikol Kapsul 250 mg Kapsul 0 0
103 GFK0095 Kloramfenikol Salep Kulit (Bufacetine) 2% Tube 96 96
104 GFK0096 Kloramfenikol Salep Mata 1% Tube 72 72
105 GFK0097 Kloramfenikol Suspensi 125 mg/5 ml - 60 ml Botol 0 0
106 GFK0098 Kloramfenikol Tetes Mata 0,5% Botol 0 0
107 GFK0099 Kloramfenikol Tetes Telinga 3% Botol 0 0
108 GFK0100 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 3900 3900
111 GFK0321 Kolekalsiferol (Vit. D3) 400 unit tablet TABLET 0 300 300
112 GFK0322 Kolekalsiferol (Vit. D3) 400 unit/5 ml syr BOTTLE 0 24 24

113 GFK0103 40 mg/5 ml) Botol 138 138

114 GFK0104 Sulfametaksazol 400 mg + Trimetropim 80 mg) Tablet 2000 2000
115 GFK0105 Lidokain Injeksi Ampul 0 0

116 GFK0106 HCl 2% + Epinefrin 1: 80.000) 2 ml Ampul 26 90 116
117 GFK0107 Loratadin Tablet 10 mg Tablet 0 0
120 GFK0110 Mebendazole Sirup 100 mg/5 ml Botol 0 0
121 GFK0111 Mebendazole Tablet 100 mg Tablet 0 0
122 GFK0112 Meloxicam Tablet 15 mg Tablet 0 0
123 GFK0113 Metformin Tablet 500 mg Tablet 4300 10000 14300
124 GFK0114 Metildopa (Dopamet) Tablet 250 mg Tablet 1100 1100

125 GFK0115 mg/ml Ampul 0 0
126 GFK0116 Salut 0,125 mg Tablet 400 400
127 GFK0117 Metilprednisolon Tablet 4 mg Tablet 0 0
128 GFK0118 Metoklorpramid Injeksi 5 mg/ml Ampul 0 0
129 GFK0119 Metoklorpramid Tablet 10 mg Tablet 0 0
130 GFK0120 Metronidazole Syrup Botol 0 0
134 GFK0124 Multivitamin + Mineral Tablet Tablet 0 0
135 GFK0125 Multivitamin Sirup Botol 0 0

136 GFK0126 Multivitamin Tablet Tablet 0 0
137 GFK0127 Natrium Bikarbonat Tablet 500 mg Tablet 0 0
139 GFK0129 Natrium Klorida Cairan Infus 0,9% - 500 ml Botol 25 25
140 GFK0130 Nifedipine Tablet 10 mg Tablet 0 0
141 GFK0132 Nistatin Tablet 500.000 IU Tablet 0 0
143 GFK0133 Obat Flu Sirup Botol 0 0
144 GFK0134 Obat Flu Tablet Tablet 0 0
145 GFK0323 Oksigen ih, gas dalam tabung BOTTLE 0 0
146 GFK0135 Oksitetrasiklin HCl Salep Kulit 3% Tube 0 0
147 GFK0136 Oksitetrasiklin HCl Salep Mata 1% Tube 25 25
148 GFK0137 Oksitosin Injeksi 10 IU/ml Ampul 54 54
149 GFK0138 Omeprazol Tablet 20 mg Tablet 1200 1200
151 GFK0139 Parasetamol Drops 100mg/ml Botol 0 0
152 GFK0140 Parasetamol Sirup 120 mg/5 ml Botol 300 300
153 GFK0141 Parasetamol Suppositoria Suppositoria 0 0
154 GFK0142 Parasetamol Tablet 500 mg Tablet 0 0
155 GFK0348 Pehavral Tablet TABLET 0 0
158 GFK0145 Piroxicam Kapsul 20 mg Tablet 0 0

161 GFK0148 Prednison Tablet 5 mg Tablet 2300 2300
164 GFK0151 Propiltiourasil Tablet 100 mg Tablet 0 0
165 GFK0152 Ranitidine Injeksi 25 mg/ml Ampul 0 0
166 GFK0153 Ranitidine Tablet 150 mg Tablet 1500 1500
167 GFK0154 Ringer Laktat Cairan Infus 500 ml Botol 0 0
169 GFK0156 Salbutamol Nebulizer 1 mg/ml - 2,5 ml Ampul 32 32

172 GFK0159 Belerang Endap 2%) Pot 24 24 48
173 GFK0160 Scabimite Cream (Premetrin 5% krim) Tube 60 60
174 GFK0161 Serum Anti Tetanus Injeksi 1.500 IU (ATS) Ampul 0 0
175 GFK0162 Sianokobalamin (Vit. B12) Injeksi 500 mcg/ml Ampul 0 0
176 GFK0163 Sianokobalamin (Vit. B12) Tablet 50 mcg Tablet 1400 1400
179 GFK0166 Siprofloksasin Tablet 500 mg Tablet 0 0
182 GFK0169 Thiamfenikol Kapsul 500 mg Kapsul 0 0
183 GFK0170 Thiamin HCl (Vit. B1) Injeksi 100 mcg/ml Ampul 0 0
184 GFK0171 Thiamin HCl (Vit. B1) Tablet 50 mg Tablet 4200 4200
185 GFK0306 Tiamin (vitamin B1) tab 100 mg TABLET 0 0
186 GFK0172 Trihexifenidil Hidroksida Tablet 2 mg Tablet 350 350
187 GFK0173
BMH Vitamin B Kompleks Tablet Tablet 5700 5700
P 0
188 GFK0341 ALAT SEMPROT BUAH 0 0
189 GFK0186 Alat Suntik Sekali Pakai 0,05 ml Pcs 0 0
194 GFK0211 Alkohol Swab Pcs 1800 1800
195 GFK0330 BARA COAT/GOWN NAVY BIRU PCS 0 0
196 GFK0212 Blood Lancet Pcs 1000 1000
197 GFK0191 Canula Oksigen Pcs 0 0

201 GFK0332 COVERALL DISPO PCS 0 0

202 GFK0329 L PCS 0 0
204 GFK0314 EXTRADINE 5 LITER GALLON 0 0
205 GFK0194 Fixomull Stretch 5cm x 5m Pcs 9 9

209 GFK0343 Helm + Visor Mask BUAH 0 0
210 GFK0198 Infus Set Adult 20 drops/mL Pcs 11 11
211 GFK0199 Infus Set Pedriatic 60 drops/mL Pcs 0 5 5
216 GFK0340 JAS HUJAN PCS 0 0
217 GFK0339 KACAMATA GOOGLE PCS 0 0
218 GFK0213 Kantong mayat Pcs 0 0
219 GFK0220 Kapas Pembalut/Absorben 250 gram Rol 2 2 4
220 GFK0179 Kaporit Serbuk Kg 0 0
221 GFK0180 Kaporit Tablet serbuk Kg 0 0
222 GFK0221 Kasa Gulung Besar 40 x 80 cm Rol 0 0
225 GFK0182 Kasa Steril 16 x 16 cm Kotak 200 200
226 GFK0308 Klor Fenol Kamfer (CHKM) KOTAK 0 0
227 GFK0174 Lisol Botol 15 15
228 GFK0204 Masker 3 Ply Tie One Pcs 0 1050 1050
229 GFK0205 Masker N95 Pcs 100 75 175
231 GFK0181 PAC Kg 0 0

234 GFK0226 Plesterin Bulat Soft Rol 0 0

235 GFK0183 cm pack @ 24 lbr 0 0
236 GFK0184 cm pack @ 24 lbr 0 2 2
237 GFK0185 60x100 cm pack @ 24 lbr 0 2 2
238 GFK0206 Safety Box Pcs 0 0
241 GFK0344 Sarung Tangan Karet PAIR 0 0
243 GFK0214 Sarung Tangan Non Steril Uk. M Psg 0 0
244 GFK0215 Sarung Tangan Non Steril Uk. S Psg 0 0
245 GFK0216 Sarung Tangan Non Steril Uk. XL 0 0
246 GFK0217 Sarung Tangan Obgyn Steril Psg 0 0
247 GFK0218 Sarung Tangan Steril 6,5 G Psg 0 0
248 GFK0219 Sarung Tangan Steril 7 G Psg 0 0

250 GFK0207 jarum bedah Pcs 0 0
251 GFK0177 Softanol 5 Liter Botol/Galon 0 0
252 GFK0175 Softanol 500 ml Botol 0 0
254 GFK0312 STERALD 5 LITER GALLON 0 0
255 GFK0310 STERICIDE 5 LITER GALLON 0 0

256 GFK0313 STERICIDE 500 ML BOTTLE 0 0
258 GFK0311 STERIZYME 5 LITER GALLON 0 0
259 GFK0347 SURGEON CAP WITH TIE PCS 0 0
260 GFK0208 Umbical Clam Pcs 0 0
261 GFK0209 Underpad (Softpad) 60x90 cm Pcs 0 0
262 GFK0210 Urine Bag Steril 2 L Pcs 0 0
263 GFK0227 Verband Elastis 10 cm Rol 0 0
264 GFK0178 Viorex 2% 5 Liter Botol/Galon 0 0

BAH
AN265 GFK0176 Viorex 2% 500 ml Botol 0 0
LABO
RAT
266 GFK0346
ORIU Visor Mask Mika BUAH 0 0
M 0
268 GFK0229 Benecheck Plus Total Cholesterol Test Strip Strip 0 0
269 GFK0230 Benecheck Plus Uric Test Strip Strip 0 0
270 GFK0231
PRO Benecheck Test System Pcs 0 0
GRA
M271 GFK0338 RAPID TEST CORONA TEST 0 0
KUST
A 0
272 GFK0233 MDT MB Anak Tablet Blister 0 0

BAH
AN273 GFK0234 MDT MB Dewasa Tablet Blister 0 0
LABO
RAT
274 GFK0235 MDT PB Anak Tablet Blister 0 0
ORIU
M 0
IMU
275 GFK0232
NISA Media Amies Pcs 0 0
SI
PRO 0
GRA
M276 VAC0304 Alat Suntik Sekali Pakai 0,5 ml TABLET 0 0
KUST
A 0
PRO
GRA
M
IMU
277 GFK0236 MDT PB Dewasa Tablet Blister 0 0
NISA
SI 0
278 VAC0249 Pelarut BCG Vial 0 0
279 VAC0250 Pelarut Campak Vial 0 0
280 VAC0252 Pelarut MR Vial 0 0
281 VAC0303 Penetes Vaksin Polio (BOPV) Buah 0 0
282 VAC0237 Vaksin Anti Rabies (VAR) Verorab Vial 0 0
283 VAC0238 Vaksin BCG Vial 0 0
284 VAC0239 Vaksin Campak Vial 0 0
285 VAC0240 Vaksin DTP HB/HIB Vial 0 0
286 VAC0242 Vaksin HBV Vial 0 0
287 VAC0243 Vaksin Hepatitis B Immunoglobulin (HBIg) Vial 0 0
288 VAC0251 Vaksin Hepatitis B Recombinant Injeksi 0,5ml Vial 0 0
289 VAC0241 Vaksin Jerap DT Vial 0 0
290 VAC0247 Vaksin Jerap Td Vial 0 0
291 VAC0256 Vaksin Meningitis (Formening) Vial 0 0
292 VAC0255 Vaksin Meningitis (Menivax) Vial 0 0
293 VAC0244 Vaksin MR Vial 0 0
294 VAC0245 Vaksin Polio (BOPV) Vial 0 0
PRO
298 VAC0248
GRA Vaksin Tuberkulin Vial 0 0
M TB 0
299 GFK0257 Kaca Sediaan (Object Glass) Pcs 0 0

300 GFK0258 Obat antituberkulosa FDC Anak Paket 1 1
303 GFK0320 Obat antituberkulosa kombipak kat. 1 PACKAGE 0 0
304 GFK0261 Pot Dahak Pcs 0 0

PRO
GRA
M305 GFK0262 Reagen Ziehl Neelsen Paket 0 0
GIZI 0
306 GFK0263 Besi (Fe) Tablet Tambah Darah + Asam Folat Tablet 0 0
307 GFK0264 Mineral Mix Sachet 0 0
308 GFK0265
PRO Retinol (Vit. A) Kapsul Lunak 100.000 IU Kapsul Lunak 1150 1150
GRA
M309 GFK0266 Retinol (Vit. A) Kapsul Lunak 200.000 IU Kapsul Lunak 750 750
HIV
AIDS 0
310 GFK0315 DBS Collection Kit KIT 0 0
311 GFK0267 Duviral (ZDV 300 mg + 3TC 150 mg) Tablet 0 0
314 GFK0270 FDC (TDF 300 mg + 3TC 300 mg + EFV 600 mg) Tablet 0 0
315 GFK0271 mg) Tablet 0 0
316 GFK0272 HIV Test 1 (SD) tes/ kit 0 0
317 GFK0273 HIV Test 2 (FOKUS) tes/ kit 0 0
318 GFK0274 HIV Test 3 (VIKIA) tes/ kit 0 0
319 GFK0275 Lamivudine 150 mg (3TC) Tablet 0 0
320 GFK0276 Nevirapine 200 mg (NVP) Tablet 0 0
321 GFK0277 Rapid Test Syphillis tes/ kit 0 0
322 GFK0278 RDT Leptospira tes/ kit 0 0

323 GFK0325 REAGEN CD4 Tipe 1 TEST 0 0
324 GFK0279 RPR Syphilis tes/ kit 0 0
325 GFK0280
PRO Tenofovir 300 mg (TDF) Tablet 0 0
GRA
M
326 GFK0281
HEPA Zidovudine 100 mg (ZDV) Tablet 0 0
TITIS
PRO 0
GRA
M
327 GFK0282
DIAR Reagen Rapid Test HBsAg tes/ kit 0 0
E 0
328 GFK0283 Garam Oralit II (200 ml) Serbuk Sachet 900 900
329 GFK0284 Obat Antidiare Nonspesifik Sirup Botol 0 0
330 GFK0285 Obat Antidiare Nonspesifik Tablet 600 mg Tablet 0 0
331 GFK0286 Zink Sirup 60 ml Botol 0 0
332 GFK0297 Zink Syrup 20mg/5 ml Tablet 54 54
333 GFK0287
PRO Zink Tablet 200 mg Dispersible Tablet 0 1000 1000
GRA
M334 GFK0298 Zink Tablet Dispersible 20 mg Tablet 0 0
FILAR
IASIS 0
335 GFK0319 Alat Pelindung Diri (APD) PACKAGE 0 0
336 GFK0317 Bactivec 30 ML BOTTLE 0 0
337 GFK0288 Dehidroartemisin + Piperaquine Tablet (DHP) Tablet 0 0
338 GFK0289 Dietilkarbamazine (DEC) Tablet 100 mg Tablet 0 0
339 GFK0318 Jumantik Kit PACKAGE 0 0
340 GFK0290 Primakuin Tablet 15 mg Tablet 0 0

PRO
GRA
M341 GFK0316 RDT DBD Combo TEST 0 0
IMS 0
342 GFK0291 Artesunat Injeksi 60mg/ml Ampul 0 0
343 GFK0292 Azitromisin Tablet 500 mg Tablet 0 0
344 GFK0293 Benzatin Penisilin Injeksi 2,4 mg Ampul 12 12

345 GFK0294 Cefixime + Azitromisin Kombipak Paket 0 0
346 GFK0295
COVI Flukonazol Tablet 150 mg Tablet 0 0
D-19 0
347 GFK0351 ALAT SEMPROT SET 0 0
350 GFK0357 COVER SHOES PACKAGE 0 0
352 GFK0356 COVERALL HAZMAT SET 0 0

353 GFK0377 L PCS 0 0
356 GFK0397 ELECTRIC BED 3 CRACK & MATRAS SEMI LATEX UNITS 0 0
357 GFK0387 Handklin100 BOTTLE 0 0
358 GFK0362 Helm + Visor Mask SET 0 0
359 GFK0354 JAS HUJAN BUAH 0 0
360 GFK0350 KACAMATA GOOGLE BUAH 3 3
361 GFK0360 LARUTAN DESINFEKTAN LITER 0 0
363 GFK0384 LARUTAN HAND SANITIZER BOTTLE 14 14
364 GFK0378 Masker bedah 3fly PCS 700 700
365 GFK0391 Masker KN95 PCS 0 0
366 GFK0372 Masker N95 PCS 60 60
367 GFK0390 Masker Non Medis PCS 0 0

370 GFK0396 OTC LIANHUA QINGWEN JIAONANG TABLET 0 0
371 GFK0400 POLYBAG PACKAGE 0 0
372 GFK0379 Pulse Oximeter (Serenity/SR.90) BUAH 0 0
373 GFK0364 RAPID TEST CORONA BUAH 80 80
378 GFK0369 Sarung Tangan Non Steril Uk. S PCS 0 0
382 GFK0380 Stetoskop Anak (ABN/Classic) BUAH 0 0
383 GFK0381 Stetoskop Dewasa (Serenity/SR-601P) BUAH 0 0
384 GFK0399 SUCTION PUMP UNITS 0 0
385 GFK0358 SURGEON CAP BUAH 0 0
386 GFK0392 TEMPAT SAMPAH MEDIS 15 L BUAH 0 0
387 GFK0393 TEMPAT SAMPAH NON MEDIS 87 L BUAH 0 0
388 GFK0382 Tensimeter (Beureu/BM 58) BUAH 0 0
389 GFK0383 Termometer Gun IR BUAH 0 0
390 GFK0398 VENTILATOR UNITS 0 0
391 GFK0389 VIRUS TRANSFORT MEDIUM [VTM] TUBE 40 322 362

393 GFK0359 VTM TUBE 0 0
(..............................) (..............................)
N BANDUNG
NG
5

2020
0 APBD
0 APBD
0 APBD
1200 2400 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
25 618 APBD
9600 APBD
7800 APBD
0 APBD
12600 APBD
5800 APBD
0 APBD
240 60 APBD
0 APBD
0 500 APBD
0 250 APBD
3000 1500 APBD
0 APBD
90 110 APBD
0 APBD
0 APBD
0 APBD
4500 12000 APBD
1100 1300 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
125 25 APBD
323 0 APBD
0 APBD
0 1 APBD
0 APBD
1 APBD
0 APBD
0 5 APBD
0 3 APBD
163 21 APBD
0 29 APBD
0 APBD
0 APBD
0 APBD
0 50 APBD
0 500 APBD
0 APBD
0 APBD
200 200 APBD
0 APBD
3 9 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
12 218 APBD
0 APBD
0 APBD
0 96 APBD
0 APBD
0 24 APBD
0 200 APBD
0 APBD
200 400 APBD
0 APBD
0 APBD
96 24 APBD
48 24 APBD
400 1600 APBD
0 APBD
0 2100 APBD
0 9 APBD
0 APBD
0 APBD
0 APBD
0 600 APBD
0 APBD
0 APBD
90 90 APBD
0 APBD
0 11 APBD
100 800 APBD
120 APBD
0 APBD
6 66 APBD
0 APBD
0 APBD
200 APBD
0 APBD
0 APBD
6500 32000 APBD
0 APBD
400 0 APBD
1050 750 APBD
0 0 APBD
500 APBD
0 APBD
96 APBD
-24 96 APBD
0 APBD
0 APBD
0 APBD
1500 2400 APBD
420 APBD
0 APBD
0 300 APBD
0 24 APBD
138 APBD
2000 APBD
0 0 APBD
116 APBD
0 0 APBD
0 0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
4900 9400 APBD
400 700 APBD
0 APBD
400 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
96 120 APBD
0 APBD
0 APBD
0 APBD
0 APBD
2350 900 APBD
0 25 APBD
0 APBD
0 APBD
100 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 25 APBD
0 54 APBD
1200 APBD
0 APBD
0 APBD
200 100 APBD
0 APBD
0 APBD
0 APBD
700 2200 APBD
0 APBD
0 APBD
5 0 APBD
4 10 APBD
0 2300 APBD
0 APBD
0 APBD
0 APBD
0 APBD
1400 100 APBD
0 APBD
60 160 APBD
22 10 APBD
600 500 APBD
0 APBD
0 48 APBD
60 APBD
0 APBD
0 APBD
700 700 APBD
1680 1440 APBD
0 APBD
0 APBD
0 APBD
100 APBD
0 APBD
0 APBD
4200 APBD
0 APBD
60 290 APBD
5700 APBD
0
0 APBD
0 APBD
300 APBD
0 APBD
0 APBD
0 APBD
1100 700 APBD
0 APBD
0 1000 APBD
0 APBD
9 APBD
8 APBD
200 APBD
0 APBD
0 APBD
0 APBD
0 APBD
6 3 APBD
0 5 APBD
1 5 APBD
1 0 APBD
0 APBD
0 11 APBD
0 5 APBD
0 5 APBD
0 5 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
2 2 APBD
0 APBD
0 APBD
0 APBD
10 165 APBD
0 200 APBD
50 150 APBD
0 APBD
5 10 APBD
1050 0 APBD
75 100 APBD
0 APBD
0 APBD
10 APBD
7 APBD
0 APBD
0 APBD
2 APBD
2 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0
100 APBD
0 0 APBD
0 0 APBD
0 APBD
0 APBD
0
0 APBD
0 APBD
0 APBD
0
0 APBD
0
0 APBD
0
0 APBD
0
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0
0 APBD
1 APBD
4 4 APBD
3 APBD
0 APBD
0 APBD
0 APBD
0
0 0 APBD
0 APBD
0 1150 APBD
0 750 APBD
0
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0
0 APBD
0
200 700 APBD
0 APBD
0 APBD
0 0 APBD
54 APBD
0 1000 APBD
0 APBD
0
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0
0 APBD
0 APBD
12 APBD
0 APBD
0 APBD
0
0 APBD
33 APBD
0 APBD
0 APBD
90 APBD
0 APBD
0 APBD
0 APBD
2 APBD
0 APBD
0 APBD
0 APBD
0 APBD
3 APBD
0 APBD
2 APBD
14 APBD
700 APBD
0 APBD
60 APBD
0 APBD
0 100 APBD
0 APBD
0 APBD
0 APBD
0 APBD
80 APBD
0 APBD
0 APBD
15 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
0 APBD
362 APBD
48 APBD
0 APBD
0 APBD
0 APBD
Diserahkan Oleh
(..............................)
REKAPITULASI PEMAKAIAN OBAT TAHUN 2020
UPTD PUSKESMAS CILEMBANG
HARGA
NO NAMA OBAT SATUAN JUNI JULI AGUST JUMLAH
SATUAN
1 2 3 9 10 11 16 17
I OBAT DAN BMHP
I.1 Acetylcystein 200 mg kapsul - - - - 382.00
I.2 Alopurinol tablet 100 mg tablet - - - - 89.00
Alopurinol tablet 100 mg tablet - 99.00
I.3 - - -
Aminofillin 200 mg tablet tablet - 95.00

I.4 - - -
Amitriptilin tablet 25 mg tablet 200 167.00

I.5 - - 200
Amlodipine Tab 10 mg tablet - 93.00

I.6 - - -
Amlodipine Tab 10 mg tablet 5,400 99.00

I.7 - - 5,400
I.8 Amlodipine Tab 10 mg tablet - - - - 330.00

I.11 Amoksisilin kaplet 500 mg tablet - - - - 233.00

Amoksisilin kaplet 500 mg tablet 5,000 249.00
I.12 - 2,000 7,000
I.13 Amoksisilin kapsul 250 mg kapsul - - - - 184.00

Amoksisilin kapsul 250 mg kapsul 196.00
I.14 - 5,000 5,000
I.15 Amoksisilin Sirup Forte 250 mg / 5 mbotol - - - - 3,400.00

I.16 Amoksisilin Sirup Forte 250 mg / 5 mbotol - - - - 3,628.00
I.17 Amoksisilin Sirup Kering 125 mg / 5 botol - - - - 3,960.00
Antalgin tablet 500
I.18 Antasida DOEN suspensi botol - - - - 1,995.00
Antasida DOEN tablet tablet 1,000 54.00
I.19 - - 1,000
Antasida DOEN tablet tablet - 58.00

I.20 - 3,000 3,000
Antifungi Doen pot - 4,496.00

I.21 - - -
Antihemoroid Supp supp 100 3,167.00
I.22 - 100 200
Asam Askorbat (Vit. C) tablet 50 tablet 7,000 105.00

I.23
mg - 7,000 14,000
Asam Folat 1 mg tablet tablet - 75.00

I.24 - 2,300 2,300
Asam Mefenamat tablet 500 mg tablet - 103.00

I.25 - - -
Asiklovir tablet 400 mg tablet - 380.00

I.26 - - -
I.27 Atropin injeksi 0,25 mg/ml ampul - - - - 1,672.00
Bedak Salisil kotak - 1,250.00

I.28 - - -
Betametason krim 0.1 % tube 50 1,340.00

I.29 - 125 175
Deksametason tablet 0,5 mg tablet - 32.00

I.30 - - -
I.31 Deksametason tablet 0,5 mg tablet - - - 74.80

Deksametason inj ampule - 1,097.00
I.32 - - -
Diazepam Rectal 10 mg Supp - 18,279.00

I.33 - - -
Diazepam Rectal 5 mg Supp - 12,679.00

I.34 - - -
Diazepam tablet 2 mg tablet 100 86.00

I.35 - 100 200
Diphenydramin HCl Inj ampul - 1,095.00

I.36 - - -
Domperidon 10 mg tablet 91.00

I.37 - - -
Domperidon suspensi 5 mg / 5 ml btl - 2,700.00

I.38 - - -
Epinefrin HCl injeksi 0,1% - 1 ml ampul - 1,749.00

I.39 - - -
Ergotamin Kofein tab tablet - 173.00
I.40 - - -
I.41 Eritromisin kapsul 500 mg kapsul - - - - 730.00

Eritromisin kapsul 500 mg kapsul - 770.00
I.42 - - -
I.43 Etanol larutan 70 % - 1000 ml botol - - - - 25,000.00

I.46 Fenobarbital tablet 30 mg tablet - - - - 165.00
I.47 Fenobarbital tablet 30 mg tablet 200 - - 200 171.00
Fenoksimetil Penisilin 500 mg tablet - 629.00
I.48 - - -
Fenol Gliserol 10% Tetes Telinga botol 2,764.00

I.49 - - -
I.50 Fitomenadion ( Vit K) injeksi 2 mg/mlampul - - - - 3,682.00
Fitomenadion (Vit. K) tablet 10 mg tablet - 758.00

I.51 - 200 200
I.52 Furosemid 40 mg tablet - - 600 600 77.00

Garam Oralit sase - 257.00
I.53 - - -
Garam Oralit sase - 257.00

I.54 - - -
Garam Oralit saset - 292.00

I.55 - - -
Gentamisin salep mata tube - 2,675.00

I.56 - - -
Gentamisin salep mata tube - 2,675.00

I.57 - - -
I.58 Gentamisin tetes mata tube - - - - 4,232.00
I.59 Glibenclamide 5 mg tablet tablet - - - - 119.00

I.60 Glimepirid 2 mg tablet - - - - 207.00
I.61 Gliserol botol - - - - 5,333.00
I.62 Griseofulvin 125 mg tablet - - - - 224.00
I.63 Haloperidol tablet 5 mg tablet - - - - 56.00
Haloperidol tablet 1.5 mg tablet - 61.00
I.64 - - -
I.65 Hidroklortiazid tablet 25 mg tablet - - - - 149.00

I.66 Hidroklortiazid tablet 25 mg tablet - - - - 155.00
I.67 Hidrokortison krim 2,5% tube 72 - 72 144 2,475.00
Ibuprofen Suspensi 200 mg/ 5 ml botol 72 4,465.00
I.68 - - 72
60 ml
I.69 Kalsium lactat 500 mg tablet - - - 59.00
I.70 Kaptopril tablet 12.5 mg tablet - - - 62.00
Kaptopril tablet 25 mg tablet - 75.00

I.71 - - -
Karbamazepin 200 mg tablet tablet - 230.00

I.72 - - -
Karbamazepin 200 mg tablet tablet 500 245.00

I.73 - - 500
Ketoconazole 200 mg tablet - 288.00

I.74 - - -
Klindamisin kapsul 150 mg kapsul - 759.00

I.75 - - -
Kloramfenikol 1% Salep Mata tube 1,881.00

I.76 - - -
Kloramfenikol 2% Salep Kulit tube - 3,038.00

I.77 (Bufacetin) - - -
Klorfeniramin maleat (CTM) tablet tablet - 22.00

I.78 - - -
4 mg
I.79 - - -
4 mg
I.80 4 mg - - -
Klorpromazin 100 mg tablet - 157.00

I.81 - - -
Klorpromazin 100 mg tablet - 144.00

I.82 - - -
Kotrimoksazol susp. 120 mg/5 ml - botol - 2,052.00

I.83 60ml - - -
Kotrimosazol tablet 480 mg tablet 400 125.00

I.84 - - 400
Lidocain komp. injeksi 2 % - ml ampul - 1,299.00

I.85 - 90 90
I.86 Lidocain komp. injeksi 2 % - ml ampul - - - - 1,229.00

Magnesium sulfat injeksi 40% - 25 vial 3,796.00
ml
I.87 - - -
Magnesium sulfat injeksi 40% - 25 vial 2 3,328.00
I.88 ml - - 2
I.89 Metformin tablet 500 mg tablet - - - - 96.00

I.90 Metformin tablet 500 mg tablet - - 10,000 10,000 102.00
Metildopa (Dopamet) 250mg tablet - 946.00
I.91 - - -
I.92 Metilergometrin maleat (Metergin) tablet - - - 210.00

tablet salut 0,125 mg
Metilergometrin maleat injeksi 0,2 ampul - 2,959.00
I.93 - - -
mg/ml
I.94 Metilprednisolon 4 mg tablet tablet - - - - 143.00
I.95 Metronidazole 500 mg tablet - - - - 233.20

I.96 Mikonazol krim 2% tube 96 - 96 192 3,414.00
Natrium Diklofenak 50 mg tablet - 115.00
I.97 - - -
Natrium Diklofenak 50 mg tablet 1,000 123.00

I.98 2,800 2,800 6,600
Natrium Klorida larutan infus 0,9% botol - 4,700.00

- 500 ml
I.99 - - -
Nistatin tablet vaginal 100.000 IU tablet 100 560.00

I.100 vaginal - 100 200
Oksitetrasiklin Salep Mata 1% tube - 2,500.00

I.101 - - -
Oksitosin injeksi 10 IU/ml ampul 1,199.00

I.102 - - -
I.103 Omeprazol 20 mg tab kapsul - - - - 130.00
I.104 Omeprazol 20 mg tab kapsul - - - 139.00

I.105 Parasetamol sirup 120 mg/ 5 ml botol 100 - - 100 1,107.00
Parasetamol tablet 500 mg tablet - 53.00
I.106 - - -
Piridoksin 10 mg tablet tablet - 118.00

I.107 - - -
Piridoksin 10 mg tablet tablet - 123.00

I.108 - - -
Povidon iodida 10% larutan - 30 ml botol 2,900.00

I.109 - 5 5
Povidon iodida 10% larutan - 30 ml botol 5 2,900.00
I.110 - - 5
Povidon iodida 10% larutan - 300 botol - 17,550.00

I.111 ml - 2 2
I.112 Prednison 5mg tablet - - - - 73.00

I.113 Propanolol 10 mg tablet 200 - - 200 64.00
I.114 Ranitidine 25 mg/ ml Injeksi ampul - - - - 1,188.00
Ranitidine tablet 150 mg tablet 105.00
I.115 - - -
I.116 Ranitidine tablet 150 mg tablet - - - - 112.00

I.117 Retinol kapsul lunak 100.000 IU kapsul - - - - 288.00
Retinol kapsul lunak 200.000 IU kapsul 517.00
I.118 3,300 - 3,300
Ringer Laktat larutan infus - 500 ml botol - 7,150.00

I.119 - - -
I.120 Riperidone 2 mg tablet 100 - 200 300 273.00

I.121 Rivanol 0,1% 300 ml botol - - - - 3,000.00
Salbutamol 2 mg tablet tablet - 63.00
I.122 - - -
Salbutamol 2 mg tablet tablet - 67.00

I.123 - - -
I.124 Salbutamol 4 mg tablet tablet - - - - 70.00

Salbutamol Nebules 2,5mg (Combivampul 4,550.00
I.125 - - -
Salep 2-4 kombinasi : Asam Salisil pot - 2,797.00

I.126 - 24 24
Salep 2-4 kombinasi : Asam Salisil pot - 2,621.00

I.127 - - -
Scabimite Cream (Premetrin 5% kri tube 60 11,825.00

I.128 - - 60
Sianokobalamin (Vit. B12) 50 mcg tatablet - 49.00

I.129 - - -
I.130 Simvastatin tablet 10 mg tablet 1,680 - - 1,680 110.00
I.131 Siprofloksasin tablet 500 mg tablet - - - - 453.20
Softanol 5 Liter botol - 550,000.00

I.132 - - -
I.133 Softanol 500 ML botol - - - 55,000.00

I.134 Tetrasiklin 500 mg kapsul kapsul - - - - 310.00
Tetrasiklin 500 mg kapsul kapsul 323.00

I.135 - 100 100
Tetrasiklin 500 mg kapsul kapsul 200 323.00

I.136 - - 200
Thiamin Hcl (Vit B1) tablet - 91.00

I.137 - - -
Thiamin Hcl (Vit B1) tablet - 85.00

I.138 - - -
Trihexifenidril Hidroksida tablet 2 m tablet - 91.00

I.139 - - -
Vitamin B Kompleks tablet tablet - 83.00

I.140 - - -
Vitamin B Kompleks tablet tablet 500 89.00

I.141 - - 500
I.142 Zink Syr 60ml botol - - - 2,972.00

I.143 Zink Syr 60ml botol 72 - - 72 3,171.00
I.144 Zink tablet 200 mg dispersible tablet - - 1,000 1,000 524.00
Zink tablet 200 mg dispersible tablet - 524.00
I.145 - - -
Isoniazide 300 mg tablet - 173.00

I.146 - - -
New Antides tablet - 136.00

I.147 - - -
Multivitamin Horvita tablet 1,100.00

I.148 - - -
Erlamycetin Plus Tetes Mata botol - 5,015.00

I.149 - - -
Fludane Plus tablet 818.00

I.150 - - -
Vitever tablet - 900.00

I.151 - - -
Miniaspi 80 tablet - 105.00

I.152 - - -
131.00
Loratadin tablet 500
-
Cetirizine syr botol 100
2,732.00
300
vit d tab tablet
32,890.00
24
vit d syr syr
I.153 Masflu tablet - - - - 330.00
I.154 Aqua pro injeksi botol - - - - 2,449.00
I.156 Alat Suntik sekali pakai 1 ml pcs - - - - 1,100.00

I.157 Alat Suntik sekali pakai 1 ml pcs - - - - 850.00
I.160 Alkohol Swab pcs 1,000 - - 1,000 1,809.00
Benecheck Plus Glucose Test Strip strip
I.161
50'S - - - - 6,800.00
Benecheck Plus Total Cholesterol strip

I.162 - 500 - 500 25,000.00
Test Strip 10'S
Benecheck Plus Total Cholesterol strip
I.163
Test Strip 10'S 500 - - 500 4,700.00
Benecheck Plus Uric Test Strip strip

I.164 - - 100 100 6,000.00
25'S
I.165 Blood Lance 26G ktk - - - - 440.00
I.166 Blood Lance 26G ktk 1,000 - - 1,000 299.00
I.167 Catgut 2/0 pcs - - - - 2,120.00
I.168 Catgut 3/0 pcs - - - - 129.00
I.169 Fixomull Stretch 5cm x 5m pcs - - - - 1,700.00
Foley catheter 18 pcs 5 11,585.00
Foley catheter 20 pcs 5 11,585.00
I.170 IV Catheter no.18 pcs - - 5 5 6,748.00
I.171 IV Catheter no.20 pcs - - 5 5 6,748.00
I.172 I.V CHAT 20GX 1 1/4 pcs - - - - 11,435.00
I.173 I.V CHAT 24G X 3/4 pcs - - - - 11,011.00
I.174 Infus Set Adult 20 drops/mL Set - - - - 528.00
I.175 Infus Set Adult 20 drops/mL set - - - - 1,229.00
I.176 Infus Set Pedriatic 60 drops/mL set - - 5 5 7,000.00
I.177 Infus Set Pedriatic 60 drops/mL set - - - - 142,000.00
Kapas Pembalut/Absorben 250 bks
I.178 - - 2 2 12,500.00
gram
I.179 Kaporit serbuk kilo - - - - 40,997.00
I.180 Kasa 16 x 16 cm kotak - - - - 150.00
Kasa Pembalut Hidrofil 4 m x 10 bks
I.181 - 175 - 175 1,100.00
cm
Kasa Pembalut Hidrofil 4 m x 5 cm bks
I.182 - - - - 810.00
I.183 Lisol botol - - - - 1,540.00

I.184 Lisol botol - - - - 3,650.00
I.185 Masker 3 ply pcs - - 550 550 3,000.00
I.186 Masker 3 ply pcs - - - - 411.40
I.187 Masker 3 ply pcs - - - - 668.00
I.188 Masker 3 ply pcs - - - - 5,800.00
I.189 Masker N 95 pcs - 750 500 1,250 3,636.00
I.190 Masker N 95 pcs - - 40 40 61,600.00
I.191 Masker N 95 pcs - - - - 46,750.00
I.192 Plester 2,5 cm x 4,5 cm (kecil) roll - - 5 5 12,675.00
I.193 Plester 2,5 cm x 4,5 cm (kecil) roll 2 - 5 7 2,849.00
I.194 Plester 7,5 cm x 5 cm (besar) roll 2 - - 2 143.00
I.195 Softanol 5 L botol - - - - 910.99
I.196 Softanol 500 ml botol - - - - 2,100.00
I.197 Sarung tangan non steril uk.M psg - - - - 92.50
I.198 Sarung tangan non steril uk. S psg - - - - 909.00
I.199 Sarung tangan non steril uk. S psg - - - - 89.99
I.200 Sarung tangan obgyn steril pcs - - - - 124.00
I.201 Sepatu boot warna kuning psg - - - - 9,950.00
I.202 Silk 3/0 - - - - 3,414.00
I.203 Silk 3/0 pcs - - - - 1,066.00
I.204 Alat Suntik sekali pakai 0,05 ml pcs - - - - 16,340.00
I.205 Verband elastis 4 cm pcs - - - - 3,040.00
I.206 Benecheck Test System pcs - - - - 600.00
I.207 Alat Suntik sekali pakai 0,5 ml pcs - - - - 45,118.00
I.208 Stericide 500 mL pcs - - - - 6,160.00
I.209 Stericide 5 L botol - - - - 1,430.00
I.210 Viorex 5 L galon - - - - 695.45
I.211 Viorex 500 mL galon - - - - 160,000.00
I.212 Bara coat/gown navy biru botol - - 3 3 100,000.00
I.213 Bara coat/gown navy biru pcs 40 - 30 70 27,528.00
I.214 Bara coat/gown navy biru apron pcs 40 - - 40 3,303.00
Coverall pp+pe coated zipper with pcs
I.215 - - - 123.00
hood l
I.216 Sepatu Boot pcs - - - - 1,194.00
I.217 Standard shoe coer pair - - - - 100.00
I.218 Coverall dispo pair - 60 - 60 3,285.00
I.219 Coverall dispo Pcs 50 - - 50 790.00
I.220 Larutan handsanitizer 500 mL Pcs 12 - - 12 13,500.00
I.221 Larutan Handsanitizer 5 L Botol 5 - - 5 560.00
I.222 Rapid Test Corona TEST 25 - - 25 43,850.00
Rapid Test Corona TEST 25 180,000.00
I.223 Sarung Tangan Karet Test - 21 10 31 60,600.00
I.224 Sarung Tangan Karet Kotak - - - - 7,400.00
I.225 Sarung Tangan Karet pair 25 - - 25 957.00
I.226 VTM Kotak - 322 322 -
I.227 Visor Mask Mika Tube - - 30 30 -
I.228 Visor Mask Mika Set 15 - - 15 8,800.00
I.229 Desinfektan 5 L Set 2 1 3 112,000.00
I.230 Kacamata google Botol 3 - 3 112,000.00
I.231 Larutan Handsanizer 5 L Pcs - - - - 103,000.00
I.232 Cover Shoes galon 50 - 50 139.00
Cover Shoes galon 50 50 1,085.00
nurse cap pcs 100 379.00
I.233 Polybag kuning Paket 1 - - 1 1,124.00
I.234 Polybag hitam paket 1 - - 1 2,400.00
Mengetahui :
Kepala Puskesmas Cilembang
(Wawan Setiawan ,SKM)

NIP. 19700215 198912 1 002
2020
JUMLAH
HARGA
18
-
-
33,400
534,600
-
-
1,743,000
980,000
-
-
-
54,000
174,000
-
633,400
1,470,000
172,500
234,500
17,200
-
-
-
-
-
34,200
151,600
46,200
-
-
-
-
-
-
-
356,400
321,480
122,500
50,000
116,910
-
6,656
-
1,020,000
-
655,488
811,800
112,000
-
110,700
14,500
14,500
35,100
-
12,800
-
-
-
1,706,100
81,900
-
67,128
709,500
184,800
-
-
32,300
64,600
44,500
-
228,312
524,000
-
-
-
-
-
-
1,809,000
12,500,000
2,350,000
600,000
-
299,000
-
-
-
33,740
33,740
-
-
-
-
35,000
-
25,000
-
-
192,500
-
-
1,650,000
-
-
-
4,545,000
2,464,000
-
63,375
19,943
286
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
300,000
1,926,960
132,120
-
-
197,100
39,500
162,000
2,800
1,096,250
-
1,878,600
-
23,925
-
-
132,000
336,000
336,000
-
6,950
1,124
2,400

No. Kode Nama Barang Satuan Stok Awal Penerimaan Persediaan Obat-Obatan

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No. Kode Nama Barang Satuan Stok Awal Penerimaan Persediaan Obat-Obatan

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DINAS KESEHATAN KABUPATEN BANDUNG

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

No. Kode Nama Barang Satuan Stok Awal Penerimaan Persediaan

1 GFK0001 Acetylcystein Tablet 200 mg Tablet 6960 6960

2 GFK0327 Albendazol susp 200mg/5mL BOTTLE 0 0

3 GFK0002 Albendazole Tablet 400 mg Tablet 0 0

4 GFK0003 Allopurinol Tablet 100 mg Tablet 3800 3800

5 GFK0004 Allopurinol Tablet 400 mg Tablet 0 0

6 GFK0005 Ambroxol Sirup 15 mg / 5 ml Botol 0 0

7 GFK0006 Ambroxol Tablet 30 mg Tablet 0 0

8 GFK0008 Aminofilin Injeksi 24 mg / ml Ampul 0 0

9 GFK0007 Aminofilin Tablet 200 mg Tablet 0 0

10 GFK0009 Amitripillin Tablet Salut 25 mg Tablet 458 200 658

11 GFK0010 Amlodipine Tablet 10 mg Tablet 5500 5400 10900

12 GFK0011 Amlodipine Tablet 5 mg Tablet 7800 7800

13 GFK0012 Amoxicilin Injeksi 1000 mg/ml Ampul 0 0

14 GFK0013 Amoxicilin Kaplet 250 mg Tablet 9200 9200

15 GFK0014 Amoxicilin Kaplet 500 mg Tablet 0 5000 5000

16 GFK0015 Amoxicilin Sirup Kering 125 mg/5 ml Botol 0 0

18 GFK0017 Antalgin (Metampiron) Injeksi 250 mg/ml Ampul 0 0

19 GFK0018 Antalgin (Metampiron) Tablet 500 mg Tablet 0 0

20 GFK0019 Antasida DOEN Suspensi Botol 300 300

21 GFK0020 Antasida DOEN Tablet Tablet 2200 1000 3200

23 GFK0022 Antihemoroid DOEN Suppositoria Tablet 0 100 100

25 GFK0024 Aqua Pro Injeksi Steril Bebas Pirogen 20 ml Ampul 0 0

26 GFK0025 Asam Asetil Salisilat (Asetosal) Tablet 80 mg Tablet 1000 1000

27 GFK0026 Asam Askorbat (Vit. C) Tablet 50 mg Tablet 3500 7000 10500

28 GFK0027 Asam Folat Tablet 1 mg Tablet 1100 1100

29 GFK0028 Asam Mefenamat Tablet 500 mg Tablet 0 0

30 GFK0029 Asiklovir Krim 5% Tube 0 0

31 GFK0296 Asiklovir Tablet 200 mg Tablet 0 0

32 GFK0030 Asiklovir Tablet 400 mg Tablet 0 0

33 GFK0031 Atropin Sulfat Injeksi 0,25 mg/ml - 1 ml Ampul 0 0

34 GFK0032 Bedak Salisil 2% - 50 gram Sachet 0 0

35 GFK0033 Betametason Krim 0,1% Tube 25 50 75

36 GFK0034 Cefadroxil Sirup Kering 125 mg/5 ml Botol 323 323

37 GFK0349 CHLORQUINE PHOSPHATE Tablet TABLET 0 0

38 GFK0035 Deksametason Injeksi 5 mg/ml Ampul 1 1

39 GFK0036 Deksametason Tablet 0,5 mg Tablet 0 0

40 GFK0342 Desinfektan 5 Liter GALLON 0 0

42 GFK0038 Diazepam Rectal 10 mg Suppositoria 5 5

43 GFK0039 Diazepam Rectal 5 mg Suppositoria 4 4

44 GFK0040 Diazepam Tablet 2 mg Tablet 24 100 124

45 GFK0041 Difenhidramin Hcl Injeksi 10 mg/ml Ampul 29 29

46 GFK0042 Digoxin Tablet 0,25 mg Tablet 0 0

47 GFK0307 Dimenhidrinat Tablet 50 mg TABLET 0 0

48 GFK0326 Diphteria Antitoxin Serum VIAL 0 0

49 GFK0305 Domperidon sir 5mg/5mL BOTTLE 50 50

50 GFK0043 Domperidon Tablet 10 mg Tablet 500 500

51 GFK0044 Epinefrin HCl injeksi 0,1% - 1 ml Ampul 0 0

52 GFK0046 Eritromisin Kapsul 250 mg 0 0

53 GFK0045 Eritromisin Kapsul 500 mg Tablet 400 400

54 GFK0047 Eritromisin Sirup 200 mg/5 ml Botol 0 0

55 GFK0048 Etakridin (Rivanol) 0,1% Botol 14 14

56 GFK0049 Etanol 70% - 1000 ml Botol 1 1

57 GFK0050 Etanol 70% - 300 ml Botol 0 0

58 GFK0324 Etil Klorida spray 100 mL BOTTLE 0 0

59 GFK0051 Eugenol 10 ml Botol 0 0

60 GFK0052 Fenobarbital Injeksi 50 mg/ ml Ampul 0 0

61 GFK0053 Fenobarbital Tablet 30 mg Tablet 30 200 230

62 GFK0055 Fenoksimetil Fenisilin Tablet 250 mg Tablet 0 0

63 GFK0054 Fenoksimetil Fenisilin Tablet 500 mg Tablet 2200 2200

64 GFK0056 Fenol Griseol Tetes Telinga 10% Botol 96 96