Lampiran Akrual Juni 2022

UPTD Puskesmas Susukan
Pemerintah Kabupaten Semarang
LAPORAN STOK OPNAME PER-REKENING
Kecamatan SUSUKAN
Nomor Rekening: 15.01.5.2.2.02.04
Periode: June 2022
No Kode Nm Barang Satuan Harga Qty Total
1 0001 Albendasol 400 Mg Tablet 365.00 0 0.00
2 0002 Alupurinol Tab 100 Mg Tablet 104.00 0 0.00
3 0003 Aminopilin Inj 24 Mg/Ml Ampul 3,240.00 0 0.00
4 0004 Aminopilin Tab Salut 200 Mg Tablet 90.00 0 0.00
5 0005 Amitriptiline 25 Mg Tablet 112.31 0 0.00
6 0006 Amoksisilin Kaplet 250 Mg Kapsul 200.00 0 0.00
7 0007 Amoksisilin Kaplet 500 Mg Tablet 271.95 0 0.00
8 0008 Amoksisilin Kaplet 500 Mg ,As.Clavulanic125 Tablet 4,550.00 0 0.00
Mg
9 0009 Amoksisilin Serbuk Inj. 1000 Mg Vial 7,500.00 0 0.00
10 0010 Amoksisilin Sirup Kering 125Mg/ 5Ml Botol 2,445.00 0 0.00
11 0012 Antasida Doen Suspensi Botol 2,160.00 0 0.00
12 0013 Antasida Doen Tablet Kombinasi Tablet 75.00 0 0.00
13 0014 Antibacteri Tube 2,516.00 0 0.00
14 0015 Antidiare Suspensi Botol 5,720.00 0 0.00
15 0016 Antiinfluenza (Noza) Tablet 398.50 0 0.00
16 0017 Antiinfluenza Syr (Protexinal) Botol 6,350.00 0 0.00
17 0018 Aqua Pro Injeksi, Bebas Pirogen Vial 5,000.00 0 0.00
18 0019 Asam Asetyl Salisilat (Miniaspi) Tablet 148.01 0 0.00
19 0020 Asam Askorbat (Vit. C) Tab 50Mg Tablet 95.00 0 0.00
20 0021 Asam Folat 1 Mg Tablet 48.00 0 0.00
21 0022 Asam Mefenamat Kaplet 500 Mg Tablet 111.98 0 0.00
22 0023 Asering 500Cc Botol 8,999.10 0 0.00
23 0024 Asiklovir Tab 200Mg Tablet 226.08 0 0.00
26 0027 Atenolol Tablet 50 Mg Tablet 346.00 0 0.00
27 0028 Atropin 0,5 Mg Tablet 68.00 0 0.00
28 0029 Atropin Inj 0.25 Mg/Ml Ampul 1,230.00 0 0.00
29 0030 Azitromisin 500 Mg Tablet 4,500.00 0 0.00
30 0033 Betametason Valerat 0.1%+Neomisin Sulfat Tube 5gr 6,500.00 0 0.00
0.5%
31 0034 Bisakodil 10 Mg Suppositoria Suppositori 6,045.00 0 0.00
a
32 0035 Bisoprolol 5 Mg Tablet 1,935.01 0 0.00
33 0036 Bromheksin Tablet Tablet 50.70 0 0.00
1
34 0037 Budesonide Tube 200 Tube 84,545.00 0 0.00
35 0038 Clobazam 10 Mg Tablet 760.00 0 0.00
36 0039 Clozapine 100 Mg Tablet 2,499.99 0 0.00
37 0040 Dexametason Inj. 5Mg/1Ml Ampul 1,580.00 0 0.00
38 0042 Diazepam 2 Mg Tablet 45.00 0 0.00
39 0043 Diazepam Rectal 11,523.60 0 0.00
40 0045 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 960.00 0 0.00
41 0046 Digoksin Tablet 91.00 0 0.00
42 0047 Diltiazem Hcl 30 Mg Tablet 123.00 0 0.00
43 0048 Dimenhidrinat 50 Mg Tablet 95.00 0 0.00
44 0049 Domperidon Tab. 10 Mg Tablet 176.00 0 0.00
45 0050 Doksisiklin 100 Mg Tablet 220.00 0 0.00
46 0051 Epinefrin (Adrenalin) Inj. 0.1% Ampul 1,500.00 0 0.00
47 0052 Eritromisin Kapsul 250 Mg Tablet 493.00 0 0.00
48 0053 Eritromisin Syrup Botol 7,700.00 0 0.00
49 0054 Ethambutol Tab.250 Mg Tablet 305.00 0 0.00
50 0055 Fenobarbital Inj. I.M/I.V 50Mg/Ml Ampul 1,716.00 0 0.00
51 0056 Fenolgliserol TT Botol 1,008.00 0 0.00
52 0057 Fitominadion Inj./ 10Mg/Ml Ampul 3,417.00 0 0.00
53 0058 Flukonasol 50 Mg Tablet 4,861.50 0 0.00
54 0059 Furosemid Inj. Iv/Im 10 Mg Ampul 1,751.00 0 0.00
56 0061 Furosemida Tab 40Mg Tablet 85.00 0 0.00
58 0063 Garam Oralit Untuk 200Ml Air Sachet 261.82 0 0.00
59 0065 Gentamicin 40Mg/Ml Inj Ampul 3,399.00 0 0.00
60 0066 Gentamicin Salep Mata 0.3% 3.5 Gram Botol 2,600.00 0 0.00
61 0067 Gentian Violet 1%,10 Ml Botol 895.00 0 0.00
62 0068 Glimepirid 2 Mg Tablet 436.00 0 0.00
63 0069 Gliseril Guaiakolat Tab 100Mg Tablet 24.55 0 0.00
64 0070 Glukose Larutan 10% Botol 5,727.00 0 0.00
65 0071 Glukose Larutan Infus 5% Steril Botol 4,727.00 0 0.00
66 0072 Griseovulfin Tab.125 Mg Tablet 219.00 0 0.00
67 0073 Haloperidol Tab 0,5Mg Tablet 59.00 0 0.00
70 0076 Haloperidol Tab 5Mg Tablet 96.00 0 0.00
71 0077 Hidrokortison Salep Kulit 2.5 % Tube 2,700.00 0 0.00
72 0078 Hiosina N Butil Bromida 10 Mg Tablet 1,040.00 0 0.00
73 0079 Hiosina N Butil Bromida Inj/ Spashi Inj Tablet 225.00 0 0.00
20Mg/Ml
74 0080 Ibuprofen Suspensi 100Mg/5Ml Botol 3,499.00 0 0.00
2
75 0081 Isosorbid Dinitrat Tab.Sub Lingual 5Mg Tablet 88.00 0 0.00
76 0082 Kalsium Laktat (Kalk) Tab.500Mg Tablet 44.00 0 0.00
78 0084 Kaptopril Tablet 12,5 Mg Tablet 72.00 0 0.00
79 0085 Kaptopril Tablet 25 Mg Tablet 88.00 0 0.00
80 0086 Ketokonazole 200Mg Tablet 150.00 0 0.00
82 0088 Ketokonazole Krim 2% Tube 2,569.00 0 0.00
83 0090 Klidamisin 300 Mg Tablet 550.00 0 0.00
84 0092 Klonidin Tab 0.15Mg Tablet 184.00 0 0.00
85 0093 Kloramfenikol Kapsul 250 Mg Kapsul 240.00 0 0.00
86 0094 Kloramfenikol Serbuk Inj.1000Mg/Vial Vial 7,260.00 0 0.00
87 0095 Kloramfenikol Serbuk Inj.1000Mg/Vial Vial 13,200.00 0 0.00
88 0096 Kloramfenikol Tetes Mata 1% Botol 5,500.00 0 0.00
89 0097 Klorpromazine 100 mg Tablet 144.10 0 0.00
90 0098 Kodein 10 Mg Tablet 500.00 0 0.00
91 0099 Kotrimoksazol 120 Mg Tablet 75.90 0 0.00
93 0101 Kotrimoksazol Suspensi Botol 2,350.00 0 0.00
94 0102 Levofloksasin 500 Mg Tablet 528.00 0 0.00
95 0103 Linkomisin Kapsul 500 Mg Kapsul 520.00 0 0.00
96 0104 Loperamide Tab.2 Mg Tablet 89.00 0 0.00
97 0109 Metamisol + diazepam (Metaneuron) Tablet 1,142.00 0 0.00
98 0110 Metformin 500 Mg Tablet 105.00 0 0.00
99 0111 Methilergometrin Maleat Inj. 0.200Mg/Ml Tablet 3,500.00 0 0.00
100 0112 Metil Prednisolon Inj500 Mg Ampul 19,200.00 0 0.00
101 0113 Metoklopramid 10 Mg Tablet 89.00 0 0.00
102 0114 Metoklopramid Syrup Botol 2,600.00 0 0.00
103 0115 Metoklopramid 5 Mg/ 5 Ml Inj Ampul 960.00 0 0.00
104 0116 Metronidasol Supositoria Suppositori 3,220.03 0 0.00
a
105 0117 Mikonazole Krim/Salep 2% Tube 3,000.00 0 0.00
106 0118 Multivitamin & Mineral Tablet (Caviplex) Tablet 347.60 0 0.00
107 0119 Multivitamin & Mineral Tablet& Fe (Fitomega) Tablet 1,153.00 0 0.00
108 0120 Multivitamin Anak Syr Botol 7,150.00 0 0.00
109 0121 Natrium Diklofenak 25Mg Tablet 134.00 0 0.00
110 0122 Natrium Klorida Lar. Infus 0,9% Botol 4,272.00 0 0.00
111 0124 Neurotropik (Molaneuron) Tablet 440.00 0 0.00
112 0125 Nifedipin 10 Mg Kapsul 100.00 0 0.00
113 0126 Nistatin 500.000 Iu Tablet Salut Tablet 640.00 0 0.00
114 0129 Obat Batuk & Flu Sirup Botol 8,000.00 0 0.00
115 0130 Obat Batuk & Flu Tablet Tab 237.50 0 0.00
3
116 0131 Obh Cairan Berasa Botol 4,400.00 0 0.00
117 0132 Ofloksasin Tab.200Mg Tablet 590.10 0 0.00
118 0134 Oksitetrasiklin Salep Klulit 3% Tube 2,009.70 0 0.00
119 0135 Oksitosin Inj Ampul 2,650.00 0 0.00
120 0136 Ondansentro 4 Mg Tablet 716.00 0 0.00
121 0137 Papaverin Inj Ampul 1,150.00 0 0.00
122 0138 Parasetamol 500Mg Tablet 81.36 0 0.00
123 0139 Parasetamol Drop 15Mg Botol 5,227.00 0 0.00
124 0140 Parasetamol Sirup 125Mg/5Ml Botol 1,318.90 0 0.00
125 0141 Piracetam Inj 200Mg / Ml Ampul 1,925.00 0 0.00
126 0142 Pirantel 125 Mg Suspensi Botol 8,250.00 0 0.00
127 0143 Pirazinamida Tab. 500Mg Tablet 198.00 0 0.00
128 0144 Piridoksin Tab. 10Mg Tablet 15.38 0 0.00
129 0145 Piroksikam Tab.10Mg Tablet 84.00 0 0.00
130 0146 Polikrosulen Konsentrat Botol 24,970.00 0 0.00
131 0147 Prednison Tab. 5Mg Tablet 114.00 0 0.00
132 0149 Propanolol Tab.10Mg Tablet 77.00 0 0.00
134 0151 Ranitidin 150 Mg Tablet 120.00 0 0.00
135 0152 Resperidon 2 Mg Tablet 1,008.00 0 0.00
136 0153 Rifampisin 300 Mg Tablet 376.00 0 0.00
137 0154 Rifampisin 450 Mg Tablet 660.00 0 0.00
138 0155 Rifampisin 450 Mg Kapsul 594.00 0 0.00
139 0156 Ringer Laktat Larutan Infus Botol 5,200.00 0 0.00
140 0157 Salep 2-4 Pot 2,000.00 0 0.00
141 0158 Salbutamol Inhaler Botol 57,955.00 0 0.00
142 0159 Sefadroksil 500 Mg Kapsul 462.73 0 0.00
143 0160 Sefadroksil Syr Botol 4,896.10 0 0.00
144 0161 Sefalexin 500 Mg Tablet 972.00 0 0.00
145 0163 Sefiksim Syr 100 Mg/5 Mg Botol 8,800.00 0 0.00
146 0164 Sefotaksim Inj Vial 6,800.00 0 0.00
147 0165 Sefriakson Inj.1 G/Vial Vial 4,000.00 0 0.00
148 0166 Sianokobalamin (B12) Inj Ampul 1,077.00 0 0.00
149 0167 Simetidin Tab. 200 Mg Tablet 114.90 0 0.00
150 0168 Simvastatin Tab.10 Mg Tablet 563.00 0 0.00
151 0169 Siprofloxacin Tab 500Mg Tablet 250.00 0 0.00
152 0170 Spirolactone 100Mg Tablet 949.50 0 0.00
153 0171 Tetrasiklin 500 Mg Kapsul 206.00 0 0.00
154 0172 Thiamin Hcl (Vit B1) Inj. 100Mg/-1Ml Ampul 680.00 0 0.00
155 0173 Thiamin Hcl (Vit B1) Tablet 50Mg Tablet 37.79 0 0.00
156 0174 Tiamfenikol Kapsul 500Mg Kapsul 431.00 0 0.00
4
157 0175 Tramadol hcl 50 mg/mL Inj Ampul 2,395.03 0 0.00
158 0176 Trifluoperazine 5 Mg Tablet 4,455.00 0 0.00
159 0177 Valsatran 80mG Kapsul 3,900.00 0 0.00
160 0178 Vitamin A Kapsul 100.000 Iu Kapsul 260.00 0 0.00
161 0181 Yodium Povidon Lart. 10 % 30 Ml Botol 2,000.00 0 0.00
163 0184 Sediaan Menjaga Fungsi Kes. Hati Tablet 2,540.00 0 0.00
164 0185 Sediaan Menjaga Fungsi Kes. Hati Tablet 2,794.40 0 0.00
165 0186 Sediaan Meringankan Wasir (Haemorogard) Kapsul 1,406.67 0 0.00
166 0187 Sediaan Menjaga Fungsi Kes. Hati (Hepagard) Tablet 2,794.00 0 0.00
167 0188 Sediaan Menjaga Kesehatan Mata (Ocugard) Kapsul 4,723.33 0 0.00
168 0189 Sediaan Meringankan Wasir (Haemorogard) Kapsul 1,551.00 0 0.00
169 0191 Glass Ionomer (Fuji Ix) Botol 715,000.00 0 0.00
170 0192 Semen Seng Fosfat Serbuk & Cairan Botol 187,000.00 0 0.00
171 0193 Monoklor Kamfr Cairan/ Chkm Botol 74,965.00 0 0.00
172 0194 Devitalisasi Pasta (Devitec) Botol 519,200.00 0 0.00
173 0195 Etil Klorid Semprot Botol 115,500.00 0 0.00
100mL
174 0196 Kalsidor Botol 314,985.00 0 0.00
175 0197 Mumyfiying Pasta Botol 256,960.00 0 0.00
176 0198 Spongostan (Curaspon 2 X 30) Kotak 334,500.00 0 0.00
177 0199 Trikresol Formalin (Tkf) Botol 89,980.00 0 0.00
178 0200 Tumpatan Sementara / Caviton Botol 187,990.00 0 0.00
179 0201 Amonium Oksalat Botol 47,000.00 0 0.00
180 0202 Anti A Botol 250,000.00 0 0.00
181 0203 Anti B Botol 226,666.67 0 0.00
182 0204 Anti AB Botol 283,333.33 0 0.00
183 0205 Anti D / Resus Botol 450,000.00 0 0.00
184 0206 Antigen S (Parathypi Ao) 50221 Botol 243,750.00 0 0.00
185 0207 Antigen S (Thypi O) 50281 Botol 231,250.00 0 0.00
186 0208 Antigens (Parathypi Ah) 50211 Botol 231,250.00 0 0.00
187 0209 Asam Asetat 6% Botol 45,000.00 0 0.00
100mL
188 0210 Carbol Fuchsin Botol 100,430.00 0 0.00
189 0211 Diluent Kit 3,917,100.00 0 0.00
190 0212 Hb Hemoglobin Test (Mision) Box/ 50 400,000.00 0 0.00
191 0213 Hbsag Entebe Box 660,000.00 0 0.00
192 0215 KOH 10% Botol 250 105,000.00 0 0.00
Ml
193 0216 Larutan EDTA 10% Botol 95,000.00 0 0.00
194 0217 Larutan Eosin 2 % Botol 155,000.00 0 0.00
195 0218 Larutan Gabbet Botol 55,000.00 0 0.00
196 0219 Larutan Giemsa Stain Botol 592,900.00 0 0.00
197 0220 Larutan Hayem Botol 41,800.00 0 0.00
5
198 0221 Larutan Hcl 0.1 N Botol 11,000.00 0 0.00
199 0222 Larutan Turk Botol 49,500.00 0 0.00
200 0223 Lyse Botol 4,243,800.00 0 0.00
201 0224 Metanol Botol 332,600.00 0 0.00
202 0225 Ph Paper Pak 50,000.00 0 0.00
203 0228 Syphilis Reagen (Tpha) STRIP 17,204.00 0 0.00
204 0229 Tes Kehamilan Piecis 1,500.00 0 0.00
205 0230 Xylol Botol 77,000.00 0 0.00
206 0231 Ads 0.05Ml Piecis 3,000.00 0 0.00
207 0232 Ads 0.05Ml Piecis 3,000.00 0 0.00
208 0233 Ads 0.5Ml Piecis 2,517.00 0 0.00
209 0234 Alat Suntik Sekali Pakai 1 ml Tuberculin Piecis 1,045.00 0 0.00
210 0235 Alat Suntik Sekali Pakai 10 ml Piecis 1,320.00 0 0.00
211 0236 Alat Suntik Sekali Pakai 3 ml Piecis 956.99 0 0.00
212 0237 Bisturi No 11 Piecis 2,200.00 0 0.00
213 0239 Cairan Cuci Tangan Bilas (Hand Wash) Botol 52,800.00 0 0.00
214 0240 Cairan Cuci Tangan Tanpa Bilas (Hand Scrap) Botol 88,000.00 0 0.00
215 0241 Catgut 2/0 Set 26,620.00 0 0.00
216 0242 Clorin / Naocl Botol 6,900.00 0 0.00
217 0243 Cotton Aplikator Box 121,000.00 0 0.00
218 0244 Dec Glass Box 220.00 0 0.00
219 0245 Dressing Penutup Luka Roll 101,090.00 0 0.00
220 0246 Etanol 70% Botol 2,499.99 0 0.00
221 0247 Gel Untuk Ekg Tube 44,000.00 0 0.00
222 0248 H2O2 2 % Botol 9,800.00 0 0.00
223 0249 Handscoon / Steril No. 6 Pasang 4,235.00 0 0.00
224 0250 Handscoon / Steril No. 6,5 Pasang 4,235.00 0 0.00
225 0251 Handscoon / Steril No. 7 Pasang 4,235.00 0 0.00
226 0252 Handscoon / Steril No.8 Pasang 8,736.00 0 0.00
227 0255 Infuset Anak Set 3,325.00 0 0.00
228 0256 Masker Nebul Anak Set 30,000.00 0 0.00
229 0257 Masker Nebul Dewasa Set 30,000.00 0 0.00
230 0259 Kasa Pembalut Hidrofil 4M X 15 Cm Roll 3,355.00 0 0.00
231 0260 Lancet Piecis 175.00 0 0.00
232 0261 Masker Telinga/Earloop Piecis 990.00 0 0.00
233 0263 Needle No.23 Piecis 500.00 0 0.00
234 0267 Plester Roll 24,970.00 0 0.00
235 0268 Safety Box 2.5 Lt Piecis 20,700.00 0 0.00
236 0269 Silk 2/0 Set 23,100.00 0 0.00
237 0270 Silk 3/0 Set 6,930.00 0 0.00
238 0271 Urin Bag Buah 8,000.00 0 0.00
6
239 0272 Wing Needle No. 23 Set 5,500.00 0 0.00
240 0273 Alkohol Swab Piecis 100.00 0 0.00
241 0274 Masker Tali/Tie On Piecis 990.00 0 0.00
242 0311 Catgut 3/0 Set 24,530.00 0 0.00
243 0324 Antigen S (Thypi H) 50271 Botol 231,250.00 0 0.00
244 0328 Tule Grase Piecis 14,300.00 0 0.00
245 0329 Glibenklamid Tablet 56.00 0 0.00
246 0330 Cleaner Botol 2,612,500.00 0 0.00
960mL
247 0333 Uric acid lc Kit 798,600.00 0 0.00
249 0336 Cairan Cuci Tangan Bilas ( One Scrub) Botol 62,499.90 0 0.00
250 0345 Fenitoin Natrium 30Mg Tablet 133.10 0 0.00
251 0347 Glucose Kit 822,200.00 0 0.00
252 0348 Metil Prednisolon Tablet 205.00 0 0.00
253 0351 Iv. Catteter No 16 Otsuka Piecis 7,755.00 0 0.00
254 0352 Glucose 112191 Kit 822,800.00 0 0.00
4x100mL
255 0353 Uric Acid 103692 Kit 1,730,300.00 0 0.00
256 0354 Cholesterol 101592 Botol 1,936,000.00 0 0.00
257 0355 SGPT Box 1,277,760.00 0 0.00
258 0356 SGOT Kit 1,277,760.00 0 0.00
259 0357 Triglycerid 116392 Kit 2,795,100.00 0 0.00
260 0358 Urea 110491 Kit 638,880.00 0 0.00
261 0359 Creatinin 105191 Kit 200ml 678,810.00 0 0.00
262 0363 Urinarix 10 Parameter Tube 261,749.50 0 0.00
263 0364 Yellow Tip Piecis 121.00 0 0.00
264 0365 Blue Tips Piecis 60.50 0 0.00
265 0368 Wing Needle No. 25 Set 5,500.00 0 0.00
266 0370 Metil Prednisolon Tablet 205.00 0 0.00
267 0406 Oksitetrasiklin Salep Klulit 3% tube 2,009.70 0 0.00
268 0410 Bur Diamond BC 31 Piecis 23,000.00 0 0.00
269 0411 BUR Diamond BR 45 Piecis 23,000.00 0 0.00
270 0412 BUR Diamond BR 46 Piecis 23,000.00 0 0.00
271 0413 Bur Diamond TC 21 Piecis 23,000.00 0 0.00
272 0424 Urinarix 10 Parameter Tube 268,125.00 0 0.00
273 0426 Flunarisin 10MG (Seremig) Tablet 2,200.00 0 0.00
274 0427 Obh Cairan Berasa Botol 6,050.00 0 0.00
275 0428 Betahistin 6MG Tablet 924.00 0 0.00
276 0429 Sediaan mengandung heparin (Hyco Gel) Tube 15 gr 20,020.00 0 0.00
277 0430 Sediaan mengandung ekstrak plasenta dan Tube 15 gr 12,309.00 0 0.00
neomycin sulfat (Neocenta gel)
278 0431 Sediaan minimal mengandung pancreatin dan Tablet 1,650.00 0 0.00
dimethylpolysiloxane (Berzymplex)
279 0432 Sediaan Mminimal mengandung ekstrak jahe tab 3,294.50 0 0.00
dan Vit B6 (Nuvogin)
7
280 0433 Sediaan mengandung ekstrak Curcuma Tablet 495.00 0 0.00
(Cavicur)
281 0434 Sediaan mengandung glucosamin HCL, Tablet 3,284.00 0 0.00
Chondroitin sulfate, vit C, Mn (Osteotin)
282 0435 Sediaan mengandung ekstak apii herba dan Tablet 2,127.40 0 0.00
ekstrak orthosipon folium (Tensigard)
284 0437 Ambroxol syrup 15mg/5ml Botol 3,296.70 0 0.00
285 0438 Kloramfenikol tetes telinga Botol 5ml 2,365.00 0 0.00
286 0439 Sulfasetamid Tetes mata Botol 5ml 3,443.00 0 0.00
287 0440 Sediaan Menjaga Kesehatan Fungsi Hati Tablet 2,794.00 0 0.00
(Hepagard)
288 0441 Asiklovir Krim 5% Tube 5gr 2,997.50 0 0.00
289 0442 Triamsinolon Asetonida 1mg (Bufacom) Tube 5gr 15,950.00 0 0.00
290 0443 Multivitamin & Mineral Tablet& Fe (Vitalamin) Kaplet 302.50 0 0.00
291 0444 Kasa Elastis 4 X 15 Roll 16,500.00 0 0.00
292 0445 Yellow Tip Piecis 97.90 0 0.00
293 0446 Blue Tips Piecis 110.00 0 0.00
294 0447 Lancet ( Lotus) Piecis 145.20 0 0.00
295 0448 Tabung Vacumtainer EDTA 3ml (onemed) Piecis 1,210.00 0 0.00
296 0451 Minyak kayu Putih Botol 17,300.00 0 0.00
297 0452 Etanol 70% 100ml Botol 4,900.00 0 0.00
298 0453 Plester (leukoplast) piecis 9,400.00 0 0.00
299 0454 Plester (leukoplast) Piecis 9,400.00 0 0.00
300 0455 Yodium Povidon (Betadine) 5ml Botol 3,600.00 0 0.00
301 0456 Rivanol Piecis 5,500.00 0 0.00
302 0457 Kasa Piecis 1,200.00 0 0.00
304 0633 Plester (leukoplast) Roll 35,532.00 0 0.00
305 0638 Masker Telinga Plus (Surgical Mask 3 PLY) Piecis 440.00 0 0.00
306 0639 Alkohol 70% Botol 1L 21,500.00 0 0.00
307 0640 Folly Catteter No.16 Piecis 13,090.00 0 0.00
308 0641 Folly Catteter No.18 Piecis 13,090.00 0 0.00
309 0642 Masker Tali (Face Mask 3 PLY) Piecis 726.00 0 0.00
310 0643 Cairan Cuci Tangan bilas (Softaskin) Botol 58,538.70 0 0.00
311 0644 cairan Cuci Tangan Tanpa Bilas (Softaman) Botol 78,750.10 0 0.00
312 0647 Kloramphenicol Injeksi (Chloramex) Vial 7,953.33 0 0.00
313 0658 Catgut Chromic 2/0 75c 30mm Piecis 22,499.99 0 0.00
315 0660 Masker Telinga (E-Care) Pasang 438.90 0 0.00
316 0663 Handscoon No. 6 Piecis 6,594.50 0 0.00
317 0664 Handscoon No. 6,5 Piecis 6,595.00 0 0.00
318 0665 Handscoon No. 7 Piecis 6,595.00 0 0.00
319 0666 Handscoon No. 7,5 Piecis 6,595.00 0 0.00
8
321 0679 Bioplacenton Tulle Piecis 10,400.00 0 0.00
323 0708 Gliseril Guaiakolat Tab 100Mg Tablet 52.80 0 0.00
324 0709 Obat Batuk Kombinasi Mengandung Botol 8,046.50 0 0.00
Dekstrometorfan (Dextrofen) Sirup
325 0710 Obh Cairan Rasa Jeruk Nipis blister 6,050.00 0 0.00
327 0712 Ambroxol Tablet 30mg Tablet 143.00 0 0.00
328 0713 Bromheksin Tablet Tablet 182.60 0 0.00
332 0717 Handscoon / Steril No. 6 Piecis 6,595.00 0 0.00
333 0751 Aqua gel (82g) Pak 42,588.00 0 0.00
335 0758 Asiklovir Krim 5% Tube 2,970.00 0 0.00
336 0759 Bromheksin Syrup (Hustab P elixir) Botol 8,030.00 0 0.00
337 0760 Enzim pencernaan anak (Elsazym) Sachet 13,750.00 0 0.00
338 0761 Flunarisin 5mg (Cevadil) Tablet 1,100.00 0 0.00
340 0763 Hiosina N Butil Bromida Inj (Spashi Inj Ampul 9,900.00 0 0.00
20Mg/Ml)
341 0764 Kloramfenikol Tetes Mata (Reco) Botol 6,380.00 0 0.00
343 0766 Sediaan mengandung curcumin, cynarin, Kapsul 2,795.10 0 0.00
silymarin (Hepagard)
344 0767 Sediaan mengandung ekstrak Apii herba dan Kapsul 2,126.30 0 0.00
ekstrak orthosiphon folium (Tensigard)
345 0768 Sediaan mengandung glucosamin HCl , Kapsul 3,283.50 0 0.00
Chondroitin sulfate, Vit C , Mn (Osteotin)
346 0769 Sediaan mengandung Ekstrac graptophylli Kapsul 1,540.00 0 0.00
folium dan Citrus bioflavonoid (Hemorogard
347 0770 Sediaan mengandung metamizol 500 mg dan
Agromed) Kaplet 935.00 0 0.00
diazepam 2 mg (Metaneuron)
348 0771 Meloksikam tablet 7.5 mg Tablet 829.40 0 0.00
349 0772 Seftriakson injeksi 1 gr/vial Vial 11,605.00 0 0.00
350 0773 Triamsinolon asetonida IOB (Bufacomb) Tube 15,950.00 0 0.00
351 0774 Prednison tablet 5 mg Tablet 96.80 0 0.00
352 0775 Multivitamin (Panviton) Tablet 825.00 0 0.00
353 0776 Multivitamin syrup (Pacdin Vitcur) Botol 8,800.00 0 0.00
354 0777 Antidiare (Omegdiar) Tablet 352.00 0 0.00
355 0778 Antidiare Syrup (Omegdiar Syrup) Botol 7,733.00 0 0.00
357 0786 Masker Nebul Anak set 28,300.00 0 0.00
358 0788 Salbutamol 2mg Tablet 104.50 0 0.00
359 0789 Betametason + Neomisin Sulfat (Nisagon Tube 6,380.00 0 0.00
Cream)
360 0790 Ektra plasenta + Neomisin Sulfat (Neocenta Tube 24,882.00 0 0.00
Gel)
361 0791 Heparin (Hico) Tube 31,405.00 0 0.00
9
362 0792 Sediaan mengandung Vit B 1 100 mg, B6 200 Tablet 638.00 0 0.00
mg, B12 200 mcg (Nuralix)
363 0795 Antiinfluenza (Noza) Tablet 797.50 0 0.00
364 0800 Selang Oksigen (Oxyflow soft) Dewasa Piecis 5,500.00 0 0.00
365 0801 Selang Oksigen (Oxyflow soft) Anak Piecis 5,500.00 0 0.00
366 0835 Iv. Catteter (Introcan) No 22 Pcs 8,750.50 0 0.00
367 0836 Formalin test (Formaldehyd Macherey Nagel) Kit 1,210,000.00 0 0.00
500mL
500mL
370 0873 Serum Anti Tetanus (Biosat 1.500 IU) Ampul 160,875.00 0 0.00
372 0877 Sefadroksil 500 Mg Tablet 510.00 0 0.00
374 0892 Alat Suntik Sekali Pakai 10 ml Pcs 1,302.00 0 0.00
375 0899 Alat Suntik Sekali Pakai 3 Ml (Terumo) Pcs 1,138.00 0 0.00
376 0900 Alat suntik 1ml (Terumo) Pcs 1,614.00 0 0.00
377 0901 Alat Suntik 5ml (Terumo) Pcs 1,600.00 0 0.00
378 0905 Permethrin 5% (Scabimite) Tube 12,155.00 0 0.00
379 0906 Kalsium Laktat (Kalk) Tab.500mg Tablet 62.99 0 0.00
380 0907 Amoksisilin Sirup Kering 125mg/5ml Botol 2,090.00 0 0.00
381 0908 Asam Mefenamat Kaplet 500 Mg Kaplet 106.00 0 0.00
382 0909 Parasetamol 500mg tablet Tablet 56.00 0 0.00
383 0910 Simvastatin Tab.10mg Tablet 131.00 0 0.00
384 0912 Amlodipin 10mg Tablet 145.00 0 0.00
385 0917 Etil Klorid Semprot Botol kaca Botol 132,990.00 0 0.00
386 0918 Vitamin B.Complek Tablet 114.99 0 0.00
388 0920 Asam Askorbat (Vit. C) Tab 50Mmg Tablet 103.99 0 0.00
389 0921 Eugenol Botol 18,099.40 0 0.00
390 0922 Dexamethasone 0.5mg Tablet 44.00 0 0.00
392 0927 Allopurinol Tablet 100mg Tablet 90.00 0 0.00
394 0929 Amoksisilin Kaplet 500 mg Kaplet 231.99 0 0.00
395 0936 Bedak Salisil 2% Kotak 1,025.00 0 0.00
396 0937 Metronidazol 500Mg kaptab 133.00 0 0.00
399 0955 ADS (BD Syringe Soloshot mini) 0.05 ml Piecis 1,655.50 0 0.00
400 0956 ADS (BD Syringe Soloshot mini) 0.5 ml Piecis 1,655.50 0 0.00
401 0957 Haloperidol Tab 5mg Tablet 75.00 0 0.00
10
403 0959 Triheksipenidil 2mg Tablet 88.00 0 0.00
404 0960 Ibuprofen tablet 200mg Tablet 105.00 0 0.00
405 0961 ondansentron inj. 4 Mg Ampul 1,650.00 0 0.00
409 0974 Ringer Laktat Larutan Infus (Widatra) Botol 7,150.00 0 0.00
410 0975 Glukose Larutan Infus 5% (Widatra) Botol 6,900.00 0 0.00
411 0976 Natrium Klorida Lar. Infus 0,9% (Widatra) Botol 6,410.00 0 0.00
413 0979 Kasa Kompres 40X40 DRC Rol 1,799.99 0 0.00
414 0980 Kasa Hidrofil 2Mx80Cm Rol 9,399.99 0 0.00
415 0981 Kasa Pembalut Hidrofil 4M X 15 Cm Rol 3,800.00 0 0.00
416 0982 Kapas Pembalut Hidrofil Drc25 Rol 23,999.99 0 0.00
417 0983 Serum Anti Bisa Ular I (Biosave) 5mL Vial 624,516.73 0 0.00
418 0987 Oat Kategori 2 Paket 1,199,984.99 0 0.00
419 0989 Bisakodil (Dulcolax) 5mg Suppositori 5,670.00 0 0.00
a
a
421 0992 Prednison Tab. 5Mg Pot 100 126.94 0 0.00
422 0993 Betametason Krim Tube 3,256.00 0 0.00
423 1003 Vitamin B1 (Thiamin) Tablet 86.00 0 0.00
425 1014 Sefadroksil Syr 125mg/ml Botol 4,485.00 0 0.00
426 1048 Sarung tangan (E-Care) no. 6,5 Pasang 4,500.00 0 0.00
427 1049 Sarung tangan (E-Care) no. 7 Pasang 4,500.00 0 0.00
428 1055 Loratadin 10mg Kaplet 134.00 0 0.00
429 1059 Metoklopramid 10mg/2ml Ampul 3,395.00 0 0.00
430 1062 Zink Tablet Dispersible 20mg Tablet 513.00 0 0.00
431 1068 Urin 10 Parameter (Cybow) Kit 135,200.00 0 0.00
435 1072 Klindamisin 300 Mg Tablet 578.00 0 0.00
436 1073 Dressing Penutup Luka (FIXOMULL) 10cm Pcs 70,903.00 0 0.00
437 1074 Handscoon M (Stardec Latex) Pasang 476.00 0 0.00
438 1085 Handscoon M (Mas Examination) Pcs 462.00 0 0.00
439 1086 Handscoon S (Mas Examination) Pcs 462.00 0 0.00
440 1087 Chlorpheniramine Maleat (Ctm) 4mg Tablet 37.00 0 0.00
441 1091 Salbutamol (Ventolin) Nebules 2,5mg Ampul 9,886.80 0 0.00
442 1096 Silk 2/0 75CC 30M C (DEMESILK) Set 14,999.97 0 0.00
443 1097 Bioplacenton Tulle Pcs 10,399.99 0 0.00
11
444 1101 Infuset Anak (Microdrip) Piecis 7,920.00 50 396,000.00
445 1102 Infuset Dewasa (Otsu Y) Piecis 7,920.00 0 0.00
446 1103 MgSO4 20% (OTSU) Ampul 3,200.00 0 0.00
447 1104 Diazepam Rectal (Stesolid) 5mg Tube 12,090.00 0 0.00
448 1105 Fitominadion 10mG Tablet 686.00 0 0.00
449 1106 Fitomenadion Inj. 2mg/ml Ampul 3,549.99 0 0.00
450 1107 Lidokain 2% Ampul 1,109.99 0 0.00
452 1110 Fluticason Propionat (Flixotide) nebules Nebules 14,499.98 0 0.00
0.5mg/2ml
453 1111 Oksitosin Inj. 10 Ul/ml (Ekocin1) Ampul 1,900.00 0 0.00
454 1112 Epinephrine Inj 1mg (Ekepii1) Ampul 1,749.00 0 0.00
458 1116 Silk 3/0 75CC 30M C (DEMESILK) Piecis 14,999.99 0 0.00
459 1117 Aqua Pro Injeksi, Bebas Pirogen Vial 2,301.20 0 0.00
460 1118 Lidokain 2% + ephinefrin Ampul 1,844.99 0 0.00
461 1119 Salep 2-4 Pot 2,527.00 0 0.00
462 1120 Tablet Tambah Darah Tablet 352.00 0 0.00
463 1121 Salbutamol Inhaler 100mcg/dosis (Dipsamol) Botol 41,250.00 0 0.00
465 1127 Cetirizine 10mg Tablet 96.00 0 0.00
466 1135 Metil Prednisolon 4mg Tablet 194.00 0 0.00
467 1139 Ondansentron 4 Mg Tablet 455.00 0 0.00
470 1142 Metoklopramid 10mg/2ml Ampul 3,395.00 0 0.00
471 1144 Kloramfenikol Tetes Mata 0.5 % (Decacetine)) Botol 3,250.01 0 0.00
472 1145 Gentamicin 0.1% Salep Kulit Tube 1,835.15 0 0.00
477 1150 Bisakodil 5mg Tablet Tablet 300.00 0 0.00
478 1153 Domperidon Suspensi 5mg/ 5ml Botol 3,000.00 0 0.00
479 1156 Ranitidin 50mg/2ml Inj Ampul 1,458.00 0 0.00
481 1160 Kloramfenikol Tetes Telinga 3% (RECO) Botol 5,940.00 0 0.00
482 1161 Gentamicin Tetes Mata 0,3% (GAREXIN) Botol 8,800.00 0 0.00
483 1163 Yodium Povidon Lart. 10 % 60 Ml Botol 60mL 3,699.99 0 0.00
484 1164 Alkohol 70% 1L Botol 1L 24,992.00 0 0.00
12
485 1165 Obat Tetes Hidung oksimetazolin ( Iliadin Box 31,300.50 0 0.00
Drop)
486 1166 Obat Tetes Hidung oksimetazolin ( Iliadin Box 31,300.50 0 0.00
Drop)
488 1172 Alat Suntik Sekali Pakai 5 ml (RD) Piecis 902.99 0 0.00
489 1173 Metamisol + diazepam (Metaneuron) Kaplet 1,141.99 0 0.00
490 1174 Salep Antifungi Doen Kombinasi 30gr Tube 4,323.00 0 0.00
491 1175 Suplemen Makanan (Livron B-Plex) Tablet 242.00 0 0.00
493 1182 Rapid Tes HIV 3 (Oncoprobe) Test 57,750.00 0 0.00
494 1183 Rapid Tes HIV 2 (Intec) Test 41,800.00 0 0.00
495 1184 Rapid Tes Hiv (Vikia) Card 19,500.00 0 0.00
497 1198 Flukonasol 150mg Tablet 17,999.96 0 0.00
500 1201 Piridoksin (B6) Tab. 10Mg Tablet 118.00 0 0.00
502 1203 Bromheksin Syrup (Lexavon) Botol 6,050.00 0 0.00
503 1204 Mikonazole Krim/Salep 2% (Moladerm) Tube 7,480.00 0 0.00
505 1215 Nifedipin 10 Mg Tablet 99.00 0 0.00
509 1221 Loperamide Tab 2 mg Tablet 80.00 0 0.00
510 1223 Obh Molex Sirup Botol 5,500.00 0 0.00
511 1224 Bisoprolol 5 Mg Tablet 259.99 0 0.00
512 1225 Sefiksim 100mg Tablet 750.00 0 0.00
515 1228 Bromheksin Tablet (Hustab P) Tablet 183.33 0 0.00
516 1236 Gliseril Guaiakolat Tab 100Mg (Guaifenesin) Tablet 74.48 0 0.00
517 1237 Risperidone 2mg Tablet 347.00 0 0.00
518 1238 Gentamicin Salep Mata 0,3% (GAREXIN) Tube 8,800.00 0 0.00
519 1241 Antidiare Suspensi (Kanina) Botol 5,800.00 0 0.00
520 1242 Hiosina N Butil Bromida 10 Mg (Scopma) Kaplet 1,440.10 0 0.00
521 1243 Nistatin Drop 100.000 Botol 19,360.00 0 0.00
522 1244 Triamsinolon Asetonida 1mg (Bufacom) Tube 16,500.00 0 0.00
524 1248 Yodium Povidon Lart. 10 % 60 Ml Botol 60mL 3,696.00 0 0.00
525 1254 Plester (leukoplast) Rol 35,532.00 0 0.00
13
526 1264 Eritromisin Sirup kering 200mg/5ml Botol 6,150.00 0 0.00
527 1265 Kloramfenikol Sirup 125 mg/5 ml Botol 4,700.00 0 0.00
531 1270 Antiinfluenza Syr (Molexflu) Botol 6,273.85 0 0.00
532 1271 Syphilis Test (Hexagon) Test 26,797.50 0 0.00
533 1276 Omeprazole 20mg Kapsul 140.00 0 0.00
534 1277 Lansoprasol 30mg Kapsul 315.00 0 0.00
536 1279 Bacitracin Polymyxin Salep Kulit Tube 2,924.00 0 0.00
537 1280 Antidiare (Omegdiar) Tablet 277.20 0 0.00
539 1282 Asam Askorbat (Vit. C) Tab 25 Mg Tablet 44.79 0 0.00
540 1283 Obat Batuk Kombinasi Mengandung Tablet 377.30 0 0.00
Dekstrometorfan ( BROCON) Tablet
541 1289 Kloramfenikol salep kulit ( Bufacetin) Tube 3,008.00 0 0.00
544 1292 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 1,060.00 0 0.00
545 1293 Nistatin 100.000 Iu Tablet Vaginal Tablet 545.00 0 0.00
547 1303 Eritromisin Kapsul 500mg Kaplet 730.00 0 0.00
548 1304 Fenitoin Sodium Kapsul 100mg Kapsul 152.00 0 0.00
549 1332 Eritromisin Kapsul 250 Mg Kapsul 565.99 0 0.00
550 1362 Uric Acid 6x100ml+5 ml std kit 3,179,000.00 0 0.00
551 1363 Cholesterol 6x100ml+std 5ml Kit 2,750,000.00 0 0.00
552 1364 HDL Choleterol 2G Direct Combo 1x80ml & Kit 5,500,000.00 0 0.00
cal1x1ml
553 1365 SGPT 5x125ml ALT/GPT Kit 3,014,000.00 0 0.00
554 1366 Boule M-Series Diluent Kit 2,882,000.00 0 0.00
555 1367 Boule M-Series Lyse Kit 4,378,000.00 0 0.00
556 1368 Boule Cleaning Kit Kit 4,400,000.00 0 0.00
557 1369 Amphetamin test (Intec) Kit 990,000.00 0 0.00
558 1370 Benzodeasepin Strip Test (Intec) Box 990,000.00 0 0.00
559 1371 Cocaine test Box 990,000.00 0 0.00
560 1372 Marijuana Test (THC) Box 990,000.00 0 0.00
561 1373 Methamphetamine Test (Intec) Box 990,000.00 0 0.00
562 1374 Morphin Test (Intec) Box 990,000.00 0 0.00
563 1375 Urin Stik Uryxon Box 704,000.00 0 0.00
564 1376 reagen Pemeriksaan Cr Kit 4,248,200.00 0 0.00
565 1377 Reagen Pemeriksaan Fe Kit 5,072,100.00 0 0.00
566 1378 Reagen COD Cell Test Kit 1,874,400.00 0 0.00
14
567 1379 AgNO3 Botol 1,739,100.00 0 0.00
568 1380 Manganese (II) sulfate monohydrate Botol 842,600.00 0 0.00
569 1381 Iron (III) chloride hexyahydrate Kit 1,017,500.00 0 0.00
570 1382 Formalin test (Formaldehyd) Kit 2,803,900.00 0 0.00
571 1383 Sodium Hidroksida (NaOH) Botol 639,100.00 0 0.00
572 1384 Ammonium Solution 25% Botol 612,700.00 0 0.00
573 1385 Lauryl Tryptose Broth (Sulfate) Botol 1,219,900.00 0 0.00
574 1386 Brilliant Green Lactosa Broth Botol 1,621,400.00 0 0.00
575 1387 Extran MA 02 neutral Botol 985,600.00 0 0.00
576 1388 Amlodipin 5mG Tablet 70.00 0 0.00
578 1390 Cholesterol LDL Kit 7,920,000.00 0 0.00
579 1391 Triglycerid Kit 5,250,000.00 0 0.00
580 1392 Creatinin Kit 740,000.00 0 0.00
581 1393 Glucose Kit 1,815,000.00 0 0.00
582 1394 Total Protein Kit 924,000.00 0 0.00
583 1395 Albumin Kit 738,000.00 0 0.00
584 1396 Ureum Kit 1,500,400.00 0 0.00
585 1397 Salep Antifungi Doen Kombinasi Pot 4,496.00 0 0.00
586 1398 Vitamin B12 Tablet 50 Mg Tablet 46.00 0 0.00
587 1399 Alat Tes Kehamilan (Ultra One) Strip 1,939.00 0 0.00
588 1400 Alkohol 70% 1L Botol 25,000.00 0 0.00
589 1401 Plesterin Bulat Soft Box isi 200 30,800.00 0 0.00
590 1402 sarung tangan (E-Care) no. 6,5 Pasang 4,499.99 0 0.00
591 1403 Cairan Cuci Tangan Tanpa Bilas (Hand Rub) Botol 60,799.00 0 0.00
592 1404 Needle 24 G x 25mm (Agani) Pcs 330.00 0 0.00
593 1405 Needle 26 G x 13mm (Agani) pcs 330.00 0 0.00
594 1406 Alat Suntik 3ml (Syringe) Pcs 818.00 0 0.00
595 1407 Alat Suntik 5ml (Syringe) Pcs 950.00 0 0.00
596 1408 Mikonazole Krim/Salep 2% Tube 3,413.30 0 0.00
598 1410 Kloramfenikol 1% salep mata Tube 1,881.00 0 0.00
599 1411 Dimenhidrinat 50 Mg Tablet 105.00 300 31,500.00
600 1412 Salbutamol 2Mg Tablet 63.00 0 0.00
603 1415 Cairan Cuci Tangan Bilas (Softaskin) Botol 58,538.70 0 0.00
604 1416 Silk 2/0 75CC 30M C (DEMESILK) Pcs 14,999.96 0 0.00
605 1417 Silk 3/0 75CC 26M C (DEMESILK) Pcs 14,999.96 0 0.00
606 1418 Sarung Tangan (E-Care) No. 6,5 Pasang 4,499.99 0 0.00
607 1419 Sarung tangan (E-Care) no. 7 Pasang 4,500.00 5 22,500.00
15
610 1424 Transfusi Set pcs 7,700.00 0 0.00
613 1427 Masker Tali (Face Mask 3 PLY) Pcs 726.00 0 0.00
614 1428 Selang Oksigen (Nasal Cannula) L - Adult Piecis 5,082.00 0 0.00
615 1429 Selang Oksigen (Nasal Cannula) M - Infant Pcs 5,082.00 1 5,082.00
617 1431 Iv. Catteter (Introcan) No 22 Pcs 8,750.00 9 78,750.00
619 1433 Fenobarbital Tablet 30mg Tablet 170.99 130 22,228.70
620 1434 Alat Suntik Sekali Pakai 1 ML Tuberculin Pcs 1,614.00 0 0.00
Terumo
621 1435 Alat Suntik Sekali Pakai 3 ml Pcs 1,138.00 4 4,552.00
624 1438 MgSO4 20% (OTSU) Ampul 3,327.99 0 0.00
625 1439 Infuset Anak (Microdrip) Pcs 7,920.00 2 15,840.00
626 1440 Infuset Dewasa (Otsu Y) Pcs 7,920.00 4 31,680.00
627 1441 Plester (Leukoplast) Roll 35,531.99 2 71,063.98
628 1442 Bisakodil 5mg Tablet Tablet 300.00 0 0.00
629 1443 Alat Tes Kehamilan (Ultra One) STRIP 1,939.00 0 0.00
630 1444 Folly Catteter No.16 Pcs 8,000.00 0 0.00
631 1445 Folly Catteter No.18 Pcs 8,000.00 0 0.00
633 1447 Dec Glass Pak (isi 14,460.50 5 72,302.50
100)
634 1448 Objek Glass Box isi 72 17,604.00 0 0.00
635 1449 Safety Box 5 Lt (ONEMED) Piecis 15,715.00 0 0.00
636 1450 Kapas Pembalut OM 250gr Rol 12,500.00 9 112,500.00
637 1451 Lancet Pcs 145.65 0 0.00
639 1453 Alat Suntik Sekali Pakai 10 ml (Stera) Pcs 925.00 0 0.00
641 1455 Kasa Kompres 40X40 DRC Pad 1,799.60 0 0.00
646 1461 Salep 2-4 Tube 2,620.00 0 0.00
647 1462 Masker Nebul Anak set 22,000.00 0 0.00
648 1463 Sefadroksil 500 Mg Kapsul 478.00 0 0.00
16
649 1466 Aqua Pro Injeksi (Otsu) Ampul 2,860.00 0 0.00
650 1467 Golongan Darah Anti B Botol 71,574.99 0 0.00
651 1468 Golongan Darah Anti AB Botol 95,884.98 0 0.00
652 1469 Golongan Darah Anti D Botol 117,444.98 0 0.00
653 1470 Golongan Darah Anti A Botol 71,574.98 0 0.00
654 1471 Antigen S (Thypi H) Botol 70,034.98 0 0.00
655 1472 Antigen S (Thypi O) Botol 70,034.98 0 0.00
656 1473 Antigen S (Parathypi AO) Botol 70,034.98 0 0.00
657 1474 Antigen S (Parathypi AH) Botol 70,034.98 0 0.00
658 1475 Lansoprasol 30mg Tab 302.99 0 0.00
659 1476 Amoksisilin Kaplet 500 Mg Kaplet 260.00 0 0.00
660 1477 Reagen Pemeriksaan Cu cat. 1.14767.0001 Kit 4,772,900.00 0 0.00
661 1478 Reagen pemeriksaan Cn Cat. 1.09701.0001 Kit 3,391,300.00 0 0.00
662 1479 Reagen pemeriksaan Ammonium NH4 cat Kit 3,181,200.00 0 0.00
1.14752.0002
663 1480 Reagen pemeriksaan Fluoride Kit 3,359,400.00 0 0.00
cat.1.114598.0001
664 1481 Reagen Pemeriksaan Zinc Kit 6,287,600.00 0 0.00
665 1482 Reagen Pemeriksaan Mn cat. 1.14770.0001 Kit 4,939,000.00 0 0.00
666 1483 Reagen Pemeriksaan Cadmium Kit 4,313,100.00 0 0.00
cat.1.01745.0001
667 1484 Reagen Pemeriksaan Arsen Cat. Kit 2,899,600.00 0 0.00
1.17917.0001
668 1485 Reagen Pemeriksaan Fe cat. 1.14761.0002 Kit 5,072,100.00 0 0.00
669 1486 CRM Besi cat 1.197810.0500 Kit 697,400.00 0 0.00
670 1487 CRM Mangan cat.1.19789.0500 Kit 845,900.00 0 0.00
671 1488 CRM Flourida Kit 979,000.00 0 0.00
672 1489 CRM Cadmium Cat. 1.19777.0500 Kit 889,900.00 0 0.00
673 1490 CRM Cromium cat 1.19779.0500 Kit 760,100.00 0 0.00
674 1491 Reagen COD Cell Test cat 1.09773.0001 Kit 1,930,500.00 0 0.00
675 1492 Magnesium Oxida cat 1.05865.0100 Kit 3,080,000.00 0 0.00
676 1493 Barium Chlorida Anhidrat cat. 1.01719.0500 Botol 827,200.00 0 0.00
677 1494 Mercury II Sulfat cat. 1.04480.0250 Botol 3,902,800.00 0 0.00
678 1495 Spectroquant Photocheck cat 1.14693.0001 Kit 7,547,100.00 0 0.00
679 1496 Methanyl Yellow Test Kit Kit 5,500,000.00 0 0.00
680 1497 Rhodamin B test Kit Kit 5,500,000.00 0 0.00
681 1498 Borax Test Kit Kit 5,500,000.00 0 0.00
682 1499 Pemanis Test Kit Kit 5,500,000.00 0 0.00
683 1500 Ringer Laktat Larutan Infus Botol 7,150.00 2,016 14,414,400.00
684 1501 Glukose Larutan Infus 5% Botol 6,900.00 0 0.00
685 1502 Natrium Klorida Lar. Infus 0,9% Botol 6,410.00 30 192,300.00
686 1503 Gentamicin Salep Mata 0.3% Tube 2,675.00 0 0.00
687 1504 Tabung Vacumtainer EDTA 3ml Piecis 1,690.92 0 0.00
17
691 1508 ADS (BD Syringe Soloshot mini) 0.05 ml Pcs 1,655.50 0 0.00
693 1510 Eritromisin Kapsul 500mg Kapsul 749.99 0 0.00
694 1511 Urin Bag (Stardec) Buah 5,005.00 0 0.00
695 1512 Masker Oksigen (Stardec) Dewasa Pcs 19,800.00 0 0.00
696 1513 Masker Oksigen (Stardec) Anak Pcs 19,800.00 0 0.00
698 1515 Rapid Tes Hiv (Intec) Test 14,756.50 0 0.00
699 1516 Dressing Penutup Luka (FIXOMULL) 10cm Roll 70,903.00 0 0.00
700 1517 Hiosina N Butil Bromida Inj (Spashi Inj 1 Ml) Ampul 9,405.00 0 0.00
701 1518 Nistatin Drop 100.000 Botol 13,499.20 0 0.00
703 1523 Glass Ionomer (Fuji Ix) Set 521,235.00 0 0.00
704 1524 Tumpatan Sementara (Caviton Pink) Piecis 154,000.00 0 0.00
705 1525 Tumpatan Sementara (Caviton White) Piecis 154,000.00 0 0.00
707 1527 Klindamisin 150 Mg Kapsul 715.00 0 0.00
708 1528 Alat Suntik Sekali Pakai 20 ml (Syringe) Pcs 1,303.50 39 50,836.50
709 1529 Masker Telinga Plus (Surgical Mask 3 PLY) Pcs 440.00 0 0.00
710 1530 Pot Sputum Buah 2,728.00 0 0.00
714 1537 Lidokain 2% Ampul 1,144.00 4 4,576.00
715 1538 Nistatin 100.000 Iu Tablet Vaginal Tab 560.08 0 0.00
717 1540 Lidokain 2% + Ephinefrin Ampul 1,151.99 0 0.00
719 1542 Parasetamol Sirup Botol 1,106.60 0 0.00
724 1547 Zink Sirup Botol 2,972.00 0 0.00
727 1571 Dexamethasone 0.5Mg Tablet 60.50 0 0.00
Gel)
730 1574 Tule Gras (Lomatuell) Piecis 15,801.50 0 0.00
18
731 1575 Alat Suntik Sekali Pakai 50 ml (Stera) Pcs 3,400.00 20 68,000.00
732 1576 Sarung Tangan Obgyn Steril Pasang 19,360.00 1 19,360.00
733 1577 Needle No.18 G (Onemed) Pcs 193.60 0 0.00
734 1578 Gentamicin Tetes Mata 0,3% Botol 4,232.00 0 0.00
736 1580 Thiamin Hcl (Vit B1) Tablet 50Mg Tablet 85.00 0 0.00
737 1581 Domperidon Suspensi 5mg/ 5ml Botol 2,700.00 0 0.00
739 1583 Diluent Botol 3,685,000.00 0 0.00
740 1584 Lyse Botol 4,015,000.00 0 0.00
741 1585 Kalium Diklofenak 50mg Tablet 531.01 0 0.00
742 1586 Antidiare (Attapulgite) New Antides Tablet 136.00 0 0.00
743 1587 Reagen Pemeriksaan PO4 cat.1.00798.0001 Kit 2,853,400.00 0 0.00
744 1588 Reagen Pemeriksaan pH Cat.1.01744.0001 Kit 2,686,200.00 0 0.00
745 1589 CRM Nitrit Cat 1.25042.0100 Botol 965,800.00 0 0.00
746 1590 Reagen BOD Cell Test Kit 3,456,200.00 0 0.00
747 1591 Amonium iron (II) sulfat hexadirat cat. Botol 1,619,200.00 0 0.00
1.03792.0500
748 1592 Potassium hydroxide cat. 1.05033.0500 Botol 490,600.00 0 0.00
749 1593 Standard Count Agar Cat.1.01621.0500 Botol 3,197,700.00 0 0.00
750 1594 Rapid 1/2 HIV (Fokus) Cassette Test 14,876.99 0 0.00
751 1595 Hbsag (Fokus Diagnostic) strip 10,547.00 0 0.00
752 1596 Diazepam Rectal (Stesolid) 5mg Ampul 12,573.00 0 0.00
754 1598 Yellow Tip Piecis 175.69 1,200 210,828.00
755 1599 Kloramfenikol Tetes Telinga 3% (RECO) Botol 5,940.00 0 0.00
756 1600 Bromheksin Tablet (Bromifar) Tablet 150.92 0 0.00
757 1601 Hiosina N Butil Bromida 10 Mg (Scopma) Tablet 1,552.32 0 0.00
758 1602 Sefiksim 100mg Kapsul 1,120.02 0 0.00
760 1604 Asiklovir Tab 200Mg Tablet 445.06 40 17,802.40
761 1605 Methilergometrin Maleat Tablet 211.00 0 0.00
763 1607 Rapid Tes Hiv (Vikia) Card 19,499.99 0 0.00
764 1608 Antidiare Suspensi (Neo Kaominal) Botol 7,365.60 0 0.00
766 1610 SGOT Kit 977,000.00 0 0.00
768 1613 CRM Phosphorus Cat 1.25049.0100 Botol 965,800.00 0 0.00
769 1614 CRM Ammonium Cat.1.25027.0100 Botol 965,800.00 0 0.00
770 1615 CRM Nitrat Cat 1.25040.0100 Botol 965,800.00 0 0.00
19
774 1619 Lidokain Pump Spray (Xylocaine) 10mg Botol 177,215.50 0 0.00
784 1631 Betahistin 6mg Tablet 110.00 0 0.00
786 1633 Antiinfluenza (Noza) Tab 797.50 0 0.00
787 1634 Strip Gula (GE200) Box isi 50 247,500.00 0 0.00
788 1635 Alprazolam 0.5 Mg Tablet 88.00 0 0.00
790 1637 Roeko Endo Frost (Propane/Butane) Botol 387,200.00 3 1,161,600.00
794 1641 Sarung Tangan (Safeglove) No. 6,5 Pasang 4,180.00 0 0.00
795 1642 Sarung Tangan (Safeglove) No. 7 Pasang 4,180.00 3 12,540.00
797 1644 Sefotaksim Serbuk Inj. 1g Vial 4,199.80 0 0.00
799 1646 Diazepam Injeksi Ampul 1,735.03 0 0.00
800 1648 Antasida Doen Tablet Kunyah Tablet 94.10 0 0.00
804 1652 Ambroxol Syrup Botol 2,767.21 0 0.00
809 1657 Masker Nebul Anak Set 22,000.00 0 0.00
811 1659 Natrium Diklofenak 25Mg Tablet 128.00 4,200 537,600.00
20
813 1661 Metronidazol 500Mg Tablet 286.00 0 0.00
817 1669 Ondansetron Inj. 4 Mg Ampul 1,069.99 0 0.00
818 1670 Betametason Valerate 0.1% Krim Tube 1,340.00 0 0.00
829 1689 Amoksisilin Sirup Kering 125mg/5ml Botol 3,025.00 0 0.00
831 1691 Lansoprasol 30mg Kapsul 843.73 0 0.00
834 1694 Tiamfenikol Kapsul 500Mg (Troviakol) Tablet 650.03 0 0.00
839 1699 Karbamazepin 200mg Tablet 230.00 0 0.00
840 1700 Multivitamin & Mineral Tablet (Caviplex) Tablet 495.00 0 0.00
841 1701 Diazepam Rectal (Stesolid) 5mg Ampul 12,573.00 0 0.00
842 1702 Antidiare Suspensi (Novadiar) Botol 4,598.00 0 0.00
843 1704 Zink Sirup (Zanic) Botol 18,150.00 0 0.00
844 1705 Multivitamin Drops (Ferriz) Botol 24,750.00 0 0.00
845 1709 Parasetamol Drop 15mL Botol 6,649.00 0 0.00
846 1735 Lancet Pcs 145.66 0 0.00
847 1736 Sarung Tangan (Safeglove) No. 6,5 Pasang 4,180.00 0 0.00
848 1737 Sarung Tangan (Safeglove) No. 7 Pasang 4,180.00 0 0.00
849 1738 Aseptan Liquid Botol 34,500.00 0 0.00
850 1739 Uric Acid 6x100ml+5 ml std Kit 2,805,000.00 0 0.00
21
858 1747 Tabung Vacumtainer EDTA 3ml Box isi 100 135,000.00 0 0.00
859 1756 Hbsag (Fokus Diagnostic) Strip 10,546.99 0 0.00
860 1765 Lansoprazole 30 mg Tablet 323.00 0 0.00
861 1766 Aqua Pro Injeksi (Otsu) Ampul 2,860.00 0 0.00
862 1768 Vacu Holder Onemed Pcs 742.50 0 0.00
867 1777 Serum Anti Bisa Ular I (Biosave) 5mL Ampul 479,996.00 0 0.00
870 1781 Alprazolam 0.5 Mg Tab 88.00 0 0.00
871 1782 Lodomer Injeksi (Haloperidol) 5mg Ampul 12,523.50 0 0.00
877 1794 Trifluoperazine 5 Mg Tablet 269.00 0 0.00
878 1795 Lidokain 2% Ampul 1,144.00 0 0.00
880 1797 Natrium Diklofenak 50mg Tablet 115.00 0 0.00
881 1798 Nistatin 100.000 Iu Tablet 560.00 0 0.00
886 1803 Cholesterol 6x100ml+std 5ml Kit 2,750,000.00 0 0.00
887 1804 Elical 2 Multiparametic Calibrator 4x3ml Kit 2,420,000.00 0 0.00
888 1805 HDL Cholest Precipitan 3x10ml Kit 1,540,000.00 0 0.00
889 1806 Cholesterol HDL Direct 1x80ml Kit 3,960,000.00 0 0.00
890 1807 Cholesterol HDL Calibrator 1x1ml Kit 1,980,000.00 0 0.00
891 1808 Cholesterol LDL Calibrator 1x1ml Kit 2,200,000.00 0 0.00
892 1809 Albumin 2x125ml Kit 660,000.00 0 0.00
893 1810 Urea UV SL 5x125ml Kit 2,310,000.00 0 0.00
22
896 1813 Hemoglobin Liquid Color 10x25ml Kit 1,515,800.00 0 0.00
897 1814 Urin Stik Uryxon Botol 704,000.00 0 0.00
900 1817 SPADNS Hach Cat. 44449 Kit 770,000.00 0 0.00
901 1818 Manganese (II) sulfate monohydrate cat. Kit 906,400.00 0 0.00
105941.0250
902 1819 Lauryl Tryptose Broth cat. 1.10266.0500 Botol 1,282,600.00 0 0.00
903 1820 Brilliant Green Lactosa Broth cat. 105454.0500 Botol 1,705,000.00 0 0.00
904 1821 Extran MA 02 neutral cat. 1.07553.2500 Botol 1,059,300.00 0 0.00
905 1822 LDL Cholesterol 2G Combo 1x80ml & cal Kit 8,580,000.00 0 0.00
1x1ml
906 1823 Creatinin 4X250ml Kit 2,046,000.00 0 0.00
907 1824 Glucose Pap SL 6x100ml + Std 5ml Kit 1,496,000.00 0 0.00
908 1825 SGOT 5X125ml Kit 3,014,000.00 0 0.00
909 1826 SGPT 5x125ml Kit 3,014,000.00 0 0.00
910 1827 Gamma - GT Plus SL 2x62.5ml Kit 1,056,000.00 0 0.00
911 1828 Total Protein Liquid Color 4x100ml Kit 598,400.00 0 0.00
912 1829 Bilirubin Direct 2x125ml Kit 924,000.00 0 0.00
913 1830 Bilirubin Total 2x125ml Kit 880,000.00 0 0.00
914 1831 Elitrol II Abnormal 10x5ml Kit 5,610,000.00 0 0.00
915 1832 Elitrol I Normal 10x5ml Kit 5,500,000.00 0 0.00
916 1833 Salep 2-4 Pot 2,620.00 0 0.00
917 1836 Flukonasol 50 Mg ( Diflucan ) Kapsul 5,900.00 0 0.00
919 1838 Clopidogrel 75mG Tablet 1,317.99 0 0.00
922 1841 Spironolactone 25 Mg Tablet 195.00 0 0.00
925 1844 Catgut Chromic 3/0 75c 37mm Box 345,000.00 2 690,000.00
926 1845 Catgut Chromic 2/0 75c 37mm Box 350,000.00 0 0.00
927 1846 Silk 2/0 75CC 30M C (DEMESILK) Box 179,999.60 0 0.00
931 1850 Zink Sirup Botol 2,972.00 0 0.00
935 1855 Iv. Catteter (Otsucath) No.18 Pcs 8,250.00 6 49,500.00
23
936 1856 Iv. Catteter (Otsucath) No.20 Pcs 8,250.00 0 0.00
937 1857 Iv. Catteter (Otsucath) No 22 Pcs 8,250.00 0 0.00
940 1860 Bisturi (Aesculap) No 11 Pak 279,000.00 1 279,000.00
944 1864 Ondansentro 4 Mg Tablet 385.00 0 0.00
946 1866 Bisakodil 10 Mg Suppositoria (STOLAX) Suppositori 5,369.99 0 0.00
a
949 1869 Eugenol Botol 18,824.00 0 0.00
951 1871 Antihemoroid Supp Suppositori 3,167.00 0 0.00
a
957 1877 Mikonazole Krim 2% Tube 3,414.00 0 0.00
959 1879 Oksitetrasiklin Salep Mata 1% Tube 2,500.00 0 0.00
963 1883 Selang Oksigen (Stardec) Dewasa Piecis 11,200.00 0 0.00
964 1884 Selang Oksigen (Stardec) Anak Piecis 11,200.00 8 89,600.00
965 1885 Masker Nebul Dewasa Piecis 16,000.00 0 0.00
966 1886 Masker Nebul Anak Piecis 16,000.00 0 0.00
970 1892 Kapas Pembalut Hidrofil Drc250 Roll 20,599.99 0 0.00
971 1893 Kasa Hidrofil 2Mx80Cm Pad 9,870.00 0 0.00
972 1895 Hb Hemoglobin Test (Mision) Pak 400,000.00 0 0.00
a
974 1897 Salbutamol Inhaler 100mcg/dosis (Salbulin) Botol 29,399.99 0 0.00
975 1898 Loratadin 10mg Tablet 122.98 0 0.00
976 1899 Levofloksasin 500 Mg Tablet 423.98 0 0.00
24
977 1900 Povidon Iodine 10% Salep (Betadine Tube 15 gr 11,433.00 0 0.00
Ointment)
978 1901 Yodium Povidon Lart. 10 % 60 Ml (Betadine) Botol 23,889.69 0 0.00
979 1902 Tumpatan Sementara (Cavit W) Piecis 109,714.00 0 0.00
980 1903 Glass Ionomer (Ketac Universal) Set 437,547.00 0 0.00
981 1904 Kalsium Hidroksida Pasta (Calplus) Pcs 87,000.00 0 0.00
982 1905 CHKM (Paramono Clorofenol) Pcs 65,000.00 0 0.00
983 1906 Pulp Devitalizer (Pulp-X) Pcs 217,000.00 0 0.00
984 1907 Semen Seng ( Zinc F ) Pcs 151,000.00 0 0.00
985 1908 Trikresol Formalin (Tkf) Pcs 72,000.00 0 0.00
986 1909 Urin 10 Parameter (Cybow) Box 135,199.99 0 0.00
988 1912 Kodein 10Mg Tablet 570.99 0 0.00
989 1913 Fenobarbital Tablet 30mg Tablet 170.99 0 0.00
990 1914 Salep Antifungi Doen Kombinasi Pot 4,495.99 0 0.00
991 1915 Asam Folat 1 Mg Tablet 70.00 0 0.00
993 1917 Kloramfenikol salep kulit ( Bufacetin) Tube 15 gr 3,037.10 0 0.00
994 1919 Folly Catteter No.18 Piecis 8,000.00 2 16,000.00
995 1920 Alkohol Swab Pcs 100.00 60 6,000.00
996 1921 Gel Untuk Usg Botol 250 12,584.00 0 0.00
Ml
997 1922 Urin Bag 2Lt (T Valve) Buah 3,000.00 0 0.00
998 1923 Kasa Pembalut Hidrofil 4M X 15 Cm Roll 2,100.00 5 10,500.00
999 1924 Natrium Klorida 0,9% (Satoria) Botol 6,839.80 0 0.00
500mL
1000 1934 Bioplacenton Tulle Pak 104,000.00 0 0.00
1001 1935 Diazepam Rectal (Stesolid) 5mg Tube 12,573.00 0 0.00
1003 1937 Kasa Hidrofil 36Mx80Cm (Biokasa) Roll 120,000.00 0 0.00
1005 1939 Sarung tangan (E-Care) no. 7 Pasang 4,499.99 15 67,499.85
1007 1941 KOH 10% Botol 22,620.00 0 0.00
1008 1942 Larutan EDTA 10% Botol 75,824.00 0 0.00
1011 1945 Larutan Hcl 0.1 N Botol 21,672.22 0 0.00
1012 1946 Larutan Na Citrat 3,13% Botol 21,196.43 0 0.00
1013 1947 Immersion Oil Botol 201,223.08 0 0.00
1014 1948 Dressing Penutup Luka (Pharmafix) Roll 30,000.00 0 0.00
1015 1949 Sarung Tangan (Tro-Sensosurge) No. 7,5 Pasang 6,595.00 0 0.00
25
1019 1954 Masker Telinga (Earloop) Jilbab TP Box 16,340.00 0 0.00
1020 1958 Epinephrine Inj 1mg/ml Ampul 1,408.00 0 0.00
1021 1959 Syphilis Test (Hexagon) Box isi 20 527,670.00 0 0.00
1022 1964 Ibuprofen Suspensi 100Mg/5Ml Botol 60ml 2,720.30 0 0.00
1025 1967 Asam Traneksamat Tab 500mg Tablet 1,584.00 0 0.00
1026 1968 Metoklopramid Inj 10mg/2ml Ampul 3,960.00 0 0.00
1028 1970 Kloramfenikol Tetes Mata (Reco 5mL) Botol 7,040.00 0 0.00
1029 1971 Foley Catteter No.16 Pcs 8,000.00 0 0.00
1030 1972 Sarung Tangan Obgyn S Pasang 14,520.00 2 29,040.00
1031 1973 Sarung Tangan Obgyn M Pasang 14,520.00 12 174,240.00
1032 1974 Sarung Tangan Obgyn L Pasang 14,542.00 0 0.00
1033 1975 Amoksisilin Sirup Kering 100mg/ml Botol 13,499.99 0 0.00
1035 1977 Diazepam Injeksi 5mg/ml Ampul 1,735.00 0 0.00
Gel)
1038 1984 Heparin (Hico) Tube 18,480.00 0 0.00
1039 1986 Kotrimoksazol Forte Tablet Tablet 319.00 0 0.00
1040 1987 Blood Transfusion Set Pcs 7,800.00 8 62,400.00
1041 1988 Strip Cholesterol (Autocheck) Box isi 25 368,500.00 0 0.00
1042 1989 KA-EN 3B Larutan Infus Botol 10,696.00 0 0.00
1043 1990 Strip Asam Urat (Nesco) box isi 25 102,850.00 0 0.00
1044 1991 Methanol Botol 453,200.00 0 0.00
1052 2002 Sefadroksil Syr 250mg/5ml Botol 5,548.40 0 0.00
26
1064 2024 Metoklopramid Syrup (Primpen) Botol 2,530.00 12 30,360.00
1066 2031 Amoksisilin Sirup Kering 250Mg/ 5Ml Botol 60mL 3,627.80 0 0.00
1067 2033 Nistatin Drop 100.000 Iu Botol 13,899.60 0 0.00
1068 2034 Sucralfate Suspensi Botol 6,788.10 0 0.00
1070 2038 Handscoon M (Stardec Latex) Piecis 476.00 0 0.00
1071 2041 Prednison tablet 5 mg Tablet 73.00 0 0.00
1072 2043 Oksitosin Inj. 10 Ul/ml Ampul 1,199.00 0 0.00
1076 2078 Glibenklamid 5mg tab Tablet 119.00 0 0.00
1080 2082 Lidokain 2% Ampul 1,221.00 11 13,431.00
1085 2087 Kloramfenikol Kapsul 500mg (Chloramex) Kapsul 1,163.00 0 0.00
1086 2088 Betahistin 6mg Tablet 110.00 0 0.00
27
1102 2108 Diazepam Rectal (Stesolid) 5mg Tube 12,573.00 6 75,438.00
1109 2115 MgSO4 20% (OTSU) Ampul 3,327.99 0 0.00
1111 2117 Lancet (Onemed) Box 14,566.00 0 0.00
1115 2121 Plester (leukoplast) Roll 37,371.00 0 0.00
1116 2122 Permethrin 5% (Scabimite) tube 11,825.00 0 0.00
1118 2124 Alat Suntik Sekali Pakai 1 ml Tuberculin Pcs 1,430.00 0 0.00
1119 2125 Alat Suntik Sekali Pakai 3 Ml (Terumo) Pcs 1,138.00 0 0.00
1120 2126 Masker Telinga Plus (Surgical Mask 3 PLY) Box 26,811.00 0 0.00
1121 2127 Urin Bag (Nousmed) Buah 5,877.00 0 0.00
1125 2131 Sefiksim 200mg Kaplet 2,370.00 0 0.00
1126 2132 Bisturi (Aesculap) No 11 Pak 279,000.00 0 0.00
1128 2134 Yellow Tips (Micropipettes MT-I) Piecis 175.69 0 0.00
1129 2135 Blue Tips (Micropipettes MT-II) Piecis 227.10 0 0.00
1130 2136 Gel Untuk Ekg (Ultra Sound) Botol 14,879.99 0 0.00
1133 2139 Infuset Dewasa (Inochi) Pcs 3,099.80 0 0.00
1135 2141 Ringer Laktat Larutan Infus Botol 7,629.46 2 15,258.92
1136 2142 Ringer Laktat Larutan Infus Botol 7,629.99 486 3,708,175.14
1137 2143 Gentamicin Salep Mata 0.3% Tube 2,675.00 4 10,700.00
1140 2146 Zink Sirup Botol 3,171.00 0 0.00
28
1141 2147 Betametason Dipropionate 0.5mg/gr Tube 3,350.00 0 0.00
1145 2152 Domperidon Suspensi (Rosidon) Botol 3,598.40 0 0.00
1151 2160 Multivitamin Drops (Ferriz) Botol 24,750.00 0 0.00
1152 2161 Omeprazole Injeksi 40mg Vial 10,393.00 0 0.00
1154 2163 Iv. Catteter (Otsucath) No 24 pcs 8,250.00 0 0.00
1157 2166 Ondansentron Tab 4 Mg Tablet 385.00 0 0.00
1160 2169 Alat Suntik 5 ml (Omnivan) Pcs 699.00 5 3,495.00
1161 2170 Alat Suntik 3 ml (Omnivan) Pcs 466.00 0 0.00
1163 2172 Antidiare (Attapulgite) New Antides Tablet 145.87 0 0.00
1164 2181 Obat Herbal Membantu Melancarkan ASI Botol 29,750.00 4 119,000.00
(KATUK)
1165 2182 Obat Herbal Membantu Menjaga Kesehatan Kapsul 4,727.93 0 0.00
Mata (OCUGARD)
Fungsi Hati (HEPAGARD)
1167 2184 Obat Herbal Membantu Menurunkan Botol 29,750.00 0 0.00
Kolesterol (LOSTEROL PLUS)
1168 2185 Obat Herbal Membantu Menurunkan Tekanan Botol 63,250.00 0 0.00
Darah (DARIN)
1169 2186 Obat Herbal Untuk Pegal Linu dan Nyeri Sendi Botol 29,750.00 0 0.00
(SARAT)
1170 2187 Obat Herbal Membantu Meringankan Kencing Botol 29,750.00 0 0.00
Manis (KENIS)
1171 2188 Batugin Elixir Botol 21,429.00 0 0.00
1172 2189 Stimuno Sirup Botol 23,650.00 0 0.00
1173 2190 Obat Batuk Herbal (OBM) Sirup Botol 9,871.00 0 0.00
1174 2191 Obat Batuk Herbal Junior (OB Herbal) Botol 10,600.00 0 0.00
Dekstrometorfan (DEXMOLEX) Sirup
1177 2194 Antiinfluenza (Quantidex) Tablet Tablet 1,070.00 0 0.00
29
1185 2202 Antidiare Suspensi (Neo Kaominal) Botol 5,800.00 0 0.00
1186 2203 Multivitamin syrup (Pacdin Vitcur) Botol 8,800.00 0 0.00
1187 2204 Multivitamin Tablet (Vit-Ever) Tablet 1,173.00 0 0.00
1188 2211 Lansoprazole 30 mg Kapsul 323.00 0 0.00
1190 2213 Silkam Black 3/0 75cm Pcs 25,600.00 0 0.00
1192 2219 Kapas Pembalut Hastamed 1000gr Roll 63,739.00 0 0.00
1193 2220 Kasa Hidrofil 16cm x 16cm Pad 4,555.00 0 0.00
1197 2229 Alkohol Swab Box 12,300.00 0 0.00
1198 2230 sarung tangan (Remedi) No. 6,5 Pasang 4,700.00 0 0.00
1199 2231 sarung tangan (Remedi) No. 7 Pasang 4,700.00 0 0.00
1207 2249 Alkohol 70% 1L Botol 27,500.00 0 0.00
1208 2250 Lancet Box 14,000.00 0 0.00
1210 2252 Plesterin Bulat Soft Box isi 200 35,000.00 0 0.00
1212 2259 Aqua Pro Injeksi (Otsu) Ampul 2,860.00 171 489,060.00
1214 2261 Loratadin 10mg Tablet 123.00 420 51,660.00
1216 2263 Aqua Destilata (Water One) Botol 14,520.00 0 0.00
30
1223 2271 Clopidogrel 75mG Tablet 1,404.00 0 0.00
1225 2273 Omeprazole Injeksi 40mg Vial 10,393.00 0 0.00
1230 2278 Tabung K3EDTA 3ml (Vacusera) Pcs 1,540.00 0 0.00
1231 2279 Tabung Serum Clot Activator 4 ml (Vacusera) Pcs 1,670.00 0 0.00
1234 2284 Antihemoroid supp suppositori 3,167.00 0 0.00
a
1235 2285 Asam Askorbat (Vit. C) Tab 50Mg Tablet 105.00 100 10,500.00
1239 2289 Hidrokortison Salep Kulit 2.5 % Tube 2,475.00 2 4,950.00
1240 2290 Ketokonazole Krim 2% Tube 2,518.00 2 5,036.00
1241 2291 Kloramfenikol 1% salep mata Tube 2,007.00 2 4,014.00
1243 2293 Piridoksin (B6) Tab. 10Mg Tablet 131.00 16 2,096.00
1244 2294 Salbutamol 2Mg Tablet 67.00 585 39,195.00
1247 2302 Gentamicin Tetes Mata 0,3% Botol 4,232.00 50 211,600.00
1248 2303 Kotrimoksazol Suspensi Botol 2,190.00 23 50,370.00
1249 2304 Golongan Darah Anti A Botol 62,000.00 1 62,000.00
1250 2305 Golongan Darah Anti B Botol 62,000.00 2 124,000.00
1252 2307 Zink Sirup Botol 3,171.00 0 0.00
1253 2308 Glibenklamid 5mg tab Tablet 119.00 0 0.00
1255 2312 Ibuprofen Suspensi 100Mg/5Ml Botol 60ml 2,720.30 0 0.00
1256 2313 Nistatin Drop 100.000 Iu Botol 13,900.00 0 0.00
1260 2322 Dimenhidrinat 50 Mg Tablet 111.99 2,000 223,980.00
1261 2323 Salep 2-4 Pot 2,796.00 0 0.00
1262 2324 Sefadroksil Syr 125mg/ml Botol 4,185.00 330 1,381,050.00
1263 2326 Eritromisin Sirup kering 200mg/5ml Botol 60mL 8,982.50 0 0.00
31
1266 2329 Methilergometrin Maleat Tab 225.00 0 0.00
1267 2331 Lidokain 2% Ampul 1,221.00 9 10,989.00
1271 2335 Vitamin B12 Tablet 50 Mg Tablet 49.00 29 1,421.00
1273 2337 Salep Antifungi Doen Kombinasi 30gr Pot 4,798.00 4 19,192.00
1274 2346 Cleaner Kit 2,613,600.00 0 0.00
1275 2347 Diluent Kit 3,209,283.00 0 0.00
1276 2348 Lyse Botol 4,247,100.00 0 0.00
1277 2355 Parasetamol Infus 1gr/100ml Botol 12,389.00 0 0.00
1280 2362 Metronidazol Suspensi Botol 3,949.00 0 0.00
1282 2364 Lidokain 2% + Ephinefrin Ampul 1,228.99 125 153,623.75
1283 2367 Masker Kain Pcs 5,850.00 0 0.00
1284 2368 Baju Plastik Pcs 10,000.00 0 0.00
1285 2369 Sepatu Boot Pasang 86,500.00 0 0.00
1286 2372 Sefiksim 200mg Kaplet 2,370.00 0 0.00
1288 2374 Sefotaksim Serbuk Inj. 1g Vial 7,951.13 0 0.00
1289 2375 Fitomenadion Tab 10mg Tablet 757.99 0 0.00
1292 2381 Diazepam Injeksi 5mg/ml Ampul 1,735.03 7 12,145.21
1293 2382 Borax test kit Box isi 100 1,462,000.00 0 0.00
1294 2383 Larutan Giemsa Botol 714,000.00 0 0.00
1295 2384 Strip Gula (Gluco Dr) Box isi 50 195,000.00 0 0.00
1296 2385 Glucose Pap SL 6x100ml + Std 5ml Kit 1,500,000.00 0 0.00
1297 2386 Kartu Golongan darah Pak isi 100 30,000.00 0 0.00
1298 2387 Methanyl Yellow Test Kit Box isi 100 1,462,000.00 0 0.00
1300 2389 System Solution Elitec Botol 3,168,000.00 0 0.00
1301 2390 Urea UV SL Kit 1,860,000.00 0 0.00
1302 2391 Urin Stik Uryxon Box isi 100 660,000.00 0 0.00
32
1305 2394 Cholesterol SL Kit 3,200,000.00 0 0.00
1306 2395 LDL Cholesterol SL 2G Kit 10,600,000.00 0 0.00
1307 2396 Triglycerid Kit 4,385,000.00 0 0.00
1308 2400 Eritromisin Kapsul 250 Mg Kapsul 583.00 290 169,070.00
1309 2407 Alkohol 70% 1L Botol 27,500.00 0 0.00
1310 2409 Ammonium Solution 25% Botol 691,900.00 0 0.00
1311 2410 BHI (Brain Heart Infusion) Oxoid Botol 2,475,000.00 0 0.00
1312 2411 Brilliant Green Lactosa Broth Botol 1,875,500.00 0 0.00
1313 2412 Escherichia Coli Broth Botol 1,956,900.00 0 0.00
1314 2413 Extran MA 02 neutral Botol 1,116,500.00 0 0.00
1316 2415 Lauryl Tryptose Broth Botol 1,424,500.00 0 0.00
1317 2416 Strain Kuman E.Coli Pcs 1,586,750.00 0 0.00
1318 2417 Strain Kuman Salmonella Pcs 3,081,375.00 0 0.00
1319 2422 Masker Telinga (Earloop) Jilbab Imaske Pcs 411.40 0 0.00
1325 2447 Aqua Destilata (Water One) Botol 14,520.00 0 0.00
1329 2458 Dextrose Injeksi 40% (D40 Otsu) Ampul 9,509.50 0 0.00
1330 2459 Diazepam Rectal (Stesolid) 5mg Tube 12,573.00 18 226,314.00
1332 2464 Hbsag (Fokus Diagnostic) Box isi 25 263,675.00 0 0.00
1333 2465 Marijuana Test (Tetrahydrocannabinol) Box isi 25 227,499.99 0 0.00
1334 2466 Benzodiazepine Test Box isi 25 227,499.99 0 0.00
1335 2467 Amphetamin test Box isi 25 227,499.99 0 0.00
1336 2468 Bioplacenton Tulle Pcs 10,399.99 0 0.00
1337 2471 Mikonazole Krim 2% Tube 3,413.30 65 221,864.50
1338 2478 CRM Besi (Iron Standart Solution) Kit 1,236,400.00 0 0.00
1339 2479 CRM Cadmium Kit 1,391,500.00 0 0.00
1340 2480 CRM Cromium Kit 1,211,100.00 0 0.00
1341 2481 CRM Flourida Kit 1,114,300.00 0 0.00
1342 2482 CRM Mangan Kit 1,324,400.00 0 0.00
1343 2483 Spadns Reagent for Fluoride Kit 825,000.00 0 0.00
1344 2484 Urea Kit 1,778,700.00 0 0.00
1345 2493 Ringer Laktat Larutan Infus (OTSU) Botol 7,629.60 0 0.00
33
1346 2494 Ringer Laktat Larutan Infus (MJB) Botol 7,629.60 0 0.00
1347 2495 Glukose Lar. Infus (Dextrose 5%) SATORIA Botol 7,362.30 0 0.00
1348 2496 Natrium Klorida Lar. Infus 0,9% (SATORIA) Botol 6,839.80 0 0.00
1350 2501 Parasetamol Drop 100mg/ml Botol 6,649.00 0 0.00
1351 2506 Siklamat Test Kit Box 1,462,000.00 0 0.00
1352 2507 Cholesterol HDL 2G + Calibrator Kit 6,300,000.00 0 0.00
1353 2512 Nifedipin 10 Mg Tablet 111.99 150 16,798.50
1354 2519 Bayclin 1 Lt Botol 22,000.00 0 0.00
1355 2520 CRM Nitrit Kit 1,098,900.00 0 0.00
1356 2521 Manganese (II) sulfate monohydrate Kit 955,900.00 0 0.00
1357 2522 Reagen Pemeriksaan CU Kit 5,426,300.00 0 0.00
1358 2523 Reagen pemeriksaan Cn Kit 3,944,600.00 0 0.00
1359 2524 Reagen Pemeriksaan PO4 Kit 3,245,000.00 0 0.00
1360 2525 Reagen Pemeriksaan Arsen Kit 3,297,800.00 0 0.00
1362 2527 Reagen pemeriksaan Cr Kit 4,830,100.00 0 0.00
1363 2528 Reagen Pemeriksaan Fe Kit 2,629,000.00 0 0.00
1364 2529 Reagen Pemeriksaan Mn Kit 5,615,500.00 0 0.00
1365 2530 Reagen Pemeriksaan Pb Kit 3,428,700.00 0 0.00
1366 2536 Alkohol 95% 5L Botol 5 L 279,999.45 0 0.00
1367 2538 Fenobarbital Inj 50mg/ml Ampul 1,982.02 0 0.00
1368 2540 Antigen (Paratyphi HA) Febrile Botol 43,000.00 0 0.00
1369 2541 Antigen (Paratyphi OA) Febrile Botol 43,000.00 2 86,000.00
1370 2542 Antigen (Paratyphi OB) Febrile Botol 43,000.00 0 0.00
1371 2543 SGOT Kit 1,072,000.00 0 0.00
1372 2544 SGPT Kit 1,072,000.00 0 0.00
1374 2546 Creatinin Kit 888,000.00 0 0.00
1375 2547 Bilirubin Total & Direct Kit 1,299,000.00 0 0.00
1376 2548 Elical 2 Kit 1,072,000.00 0 0.00
1377 2555 Ringer Laktat Larutan Infus (SANBE) Softbag 7,630.00 0 0.00
1378 2559 Methilergometrin Maleat Inj. 0.2 Mg/Ml Ampul 4,725.00 0 0.00
1379 2573 Cairan Cuci Tangan Tanpa Bilas ( E-care Galon 5 L 579,999.00 0 0.00
Hand Rub) 5 L
1380 2576 Methilergometrin Maleat Inj. 0.2 Mg/Ml Ampul 2,959.00 17 50,303.00
1381 2583 Sarung Tangan Latex Pasang 17,500.00 0 0.00
1382 2584 Methampetamine Test Box 632,500.00 0 0.00
1383 2585 Morphin Test Box 632,500.00 0 0.00
1384 2586 Cocaine test Box 632,500.00 0 0.00
1385 2589 Multivitamin & Mineral Tablet (Caviplex) Kaplet 998.80 0 0.00
34
1387 2595 Handscoon M (Safeglove) Pcs 1,000.00 0 0.00
1388 2597 Kantong Plastik Limbah Medis (Bioha) Pcs 2,320.00 0 0.00
1391 2602 Masker N95 3M 9105 Respirator Pcs 9,350.00 150 1,402,500.00
1393 2604 Vitamin A Kapsul 200.000 Iu Kapsul 551.99 81 44,711.19
1394 2605 RDT COVID-19 Box 3,437,500.00 0 0.00
1395 2608 CRM Ammonium Kit 1,098,900.00 0 0.00
1396 2609 Reagen Pemeriksaan Fluoride Kit 3,828,300.00 0 0.00
1399 2651 Kloramfenikol Salep Kulit ( Bufacetin) Tube 3,241.70 0 0.00
1401 2656 RDT COVID-19 Box 2,100,000.00 0 0.00
1402 2662 Kloramfenikol Suspensi Botol 6,428.40 0 0.00
1403 2663 Domperidon Suspensi (Rosidon) Botol 3,874.60 0 0.00
1404 2664 Vitamin B1 (Thiamin) Tablet 165.00 212 34,980.00
1406 2666 Digoksin Tab 0.25 mg Tablet 132.27 0 0.00
1407 2667 Control Hematology Botol 1,800,000.00 0 0.00
1410 2675 RDT COVID-19 (Clungene) STRIP 132,000.00 0 0.00
1414 2685 Swab Dacron (ORO) Pcs 14,300.00 0 0.00
1415 2686 Swab Dacron (NASO) Pcs 14,300.00 0 0.00
1416 2687 VTM (Dengan 2 Stick Swab) Pcs 69,999.60 0 0.00
1417 2688 Sarung Tangan Panjang (InTouch) No. 6,5 Pasang 12,320.00 1 12,320.00
1418 2689 Sarung Tangan Panjang (InTouch) No. 7 Pasang 12,320.00 0 0.00
1419 2690 Sarung Tangan Panjang (InTouch) No. 7,5 Pasang 12,320.00 0 0.00
1421 2702 Masker Telinga (Headloop) Jilbab SAFELOCK Pcs 1,799.00 750 1,349,250.00
1422 2703 Ondansetron Tab 4mg Tablet 957.00 0 0.00
1423 2708 Reagen Pemeriksaan Ammonium (NH4) Kit 4,693,700.00 0 0.00
1424 2709 Shoe Cover Pasang 1,687.40 0 0.00
1425 2710 Vaksin Anti Rabies (VERORAB) Ampul 165,000.00 0 0.00
1426 2711 Nurse Cap (VIO) Pcs 462.00 0 0.00
1427 2712 Swab Dacron (ORO) Improswab Pcs 9,735.00 0 0.00
35
1428 2713 VTM (Dengan 1 Stick Swab NASO) Tube 55,165.00 0 0.00
1431 2718 Masker Kain Pcs 3,300.00 0 0.00
1432 2723 Parafilm Roll 880,000.00 0 0.00
1433 2724 Cairan Cuci Tangan Tanpa Bilas (Acticare) 5 L Galon 5 L 310,048.00 0 0.00
1434 2725 Oseltamivir Kapsul 75 mg Kapsul 14,300.00 0 0.00
1435 2726 Kalium Diklofenak 50mg Tablet 462.00 0 0.00
1436 2727 Masker N95 3M 8210 Respirator Pcs 25,850.00 0 0.00
1438 2729 Masker Kain 2 Ply Pcs 3,300.00 0 0.00
1440 2732 Siprofloxacin Tab 500Mg Tablet 394.97 374 147,718.78
1442 2734 RDT COVID-19 (Answer) STRIP 77,000.00 0 0.00
1443 2735 Alkohol Swab Pak 0.00 0 0.00
1444 2737 Alkohol 70% 1L Botol 24,000.90 0 0.00
1447 2741 Uric Acid Kit 2,600,000.00 0 0.00
1448 2745 RDT COVID-19 (Lysun) Pcs 60,000.00 0 0.00
1449 2746 Hiosina N Butil Bromida Inj (Spashi Inj 1 ml) Ampul 9,900.00 4 39,600.00
1450 2747 Hiosina N Butil Bromida Tab (Spashi) 10 mg Tablet 1,870.00 0 0.00
1451 2748 Kloramfenikol Tetes Telinga 3% (RECO) Botol 7,370.00 82 604,340.00
1452 2749 Kloramfenikol Tetes Mata (RECO) Botol 7,260.00 0 0.00
1453 2750 Multivitamin (Recovit) Sirup Botol 7,920.00 0 0.00
1454 2751 Multivitamin (Recovit Plus) Kapsul Kapsul 605.00 0 0.00
1456 2755 Calcii Gluconas i.m./i.v Injeksi Ampul 10,351.00 0 0.00
1457 2756 Calcii Gluconas i.m./i.v Injeksi Ampul 10,351.00 60 621,060.00
1460 2761 Antiinfluenza (Nichofed) Tablet Tablet 699.99 4,820 3,373,951.80
1461 2763 RDT COVID-19 (Altamed) Pcs 55,000.00 0 0.00
1462 2764 Mineral Mix Sachet 3,116.00 10 31,160.00
1463 2773 Antidiare Suspensi (Neo Kaominal) Botol 5,500.44 2 11,000.88
1466 2784 Etil Klorid Semprot Botol 130,000.00 1 130,000.00
1468 2789 Epinephrine Inj 1mg/ml Ampul 1,408.00 0 0.00
36
1469 2790 Oksitosin Inj. 10 Ul/ml Ampul 1,199.00 41 49,159.00
1470 2791 Meloksikam Tablet 7.5 mg Tablet 266.42 0 0.00
1471 2793 OBH Sirup (Jeruk Nipis) Botol 5,928.28 0 0.00
1472 2794 Vitamin B1 (Thiamin) Tablet 171.43 200 34,286.00
1473 2795 Eritromisin Sirup kering 200mg/5ml (Eryra) Botol 10,463.22 0 0.00
1477 2801 Betadine Obat Kumur Botol 25,542.00 0 0.00
1478 2802 Yodium Povidon Lart. 10 % 60 Ml (Betadine) Botol 25,215.00 9 226,935.00
1479 2803 Povidon Iodine 10% Salep (Betadine Tube 11,595.34 0 0.00
Ointment)
1480 2812 Obat Herbal Melancarkan Asi (ASIFIT) Kaplet 2,152.48 0 0.00
1481 2813 Sediaan mengandung Ekstrac graptophylli Kapsul 1,397.15 0 0.00
folium dan Citrus bioflavonoid (Hemorogard
1482 2814 Catgut Chromic 3/0 75c 37mm
Agromed) Box 345,000.00 3 1,035,000.00
1484 2816 Antidiare (Molagit) Tablet Tablet 299.99 2,140 641,978.60
1486 2825 OT Daya Tahan Tubuh (Ektrak Daun Jambu Sachet 8,622.66 0 0.00
Biji dll) DEHAF
1487 2826 Sediaan mengandung ekstak apii herba dan Kapsul 2,126.67 0 0.00
1489 2828 Eritromisin Kapsul 500mg (Eryra Forte) Kapsul 930.00 0 0.00
1490 2829 OT Ekstrak Ikan Gabus (VipAlbumin) Kapsul 6,233.33 0 0.00
1491 2830 Tabung Vacutainer Non EDTA 4 ml (BD Pcs 1,236.00 0 0.00
Vacutainer Serum)
1498 2838 Bisakodil 5mg Tablet Tablet 319.00 80 25,520.00
1500 2842 Masker Telinga (Headloop) Jilbab NAM Pcs 1,000.00 0 0.00
MEDICAL
MEDICAL
1502 2844 Antigen S (Typhi H) Fortress Vial 90,000.00 1 90,000.00
1503 2845 Control Hematology (Cell-Dyn 22 Plus Control) Kit 2,375,000.00 0 0.00
1504 2846 Antigen S (Typhi O) Fortress Vial 90,000.00 1 90,000.00
1505 2847 Swab Dacron (NASO) General Care Pcs 6,500.00 0 0.00
1506 2848 Cairan cuci Tangan Tanpa Bilas (Medika Hand Botol 5 L 144,100.00 2 288,200.00
Rub)
1507 2849 Framycetin Sulfate (Daryant Tulle) Lembar 20,592.00 0 0.00
1508 2850 Ektra Plasenta + Neomisin Sulfat (Neocenta Tube 16,016.00 9 144,144.00
Gel)
1509 2851 Sediaan mengandung ekstak apii herba dan Kapsul 2,126.66 0 0.00
37
1510 2852 Hiosina N Butil Bromida 10 Mg (Scopma) Tablet 1,552.32 800 1,241,856.00
1511 2853 MgSO4 20% (OTSU) Ampul 3,327.50 38 126,445.00
1512 2858 Tisue Roll 7,030.00 0 0.00
1513 2859 Tisue Roll 7,030.00 0 0.00
1514 2860 Tisue Roll 7,030.00 0 0.00
1515 2861 Swab Dacron (NASO) Pcs 6,500.00 100 650,000.00
41,030,060.30
Kepala Puskesmas, Koordinator Apotik,
Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

NIP. 196803312002121004 NIP. 19830605 201001 2 031
38
Total
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39
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40
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42
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43
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44
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45
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46
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47
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48
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49
396,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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50
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0.00
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0.00
0.00
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51
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52
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0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
0.00
0.00
31,500.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
22,500.00
53
0.00
0.00
0.00
0.00
0.00
0.00
0.00
5,082.00
0.00
78,750.00
673,750.00
22,228.70
0.00
4,552.00
880,000.00
0.00
0.00
15,840.00
31,680.00
71,063.98
0.00
0.00
0.00
0.00
0.00
72,302.50
0.00
0.00
112,500.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
54
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0.00
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0.00
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0.00
0.00
0.00
0.00
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0.00
0.00
0.00
0.00
0.00
14,414,400.00
0.00
192,300.00
0.00
0.00
0.00
0.00
55
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
50,836.50
0.00
0.00
0.00
0.00
0.00
4,576.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
56
68,000.00
19,360.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
210,828.00
0.00
0.00
0.00
0.00
0.00
17,802.40
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
57
0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1,161,600.00
0.00
0.00
0.00
0.00
12,540.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
537,600.00
0.00
58
0.00
0.00
0.00
0.00
0.00
0.00
0.00
8,740.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
59
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
60
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
690,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
49,500.00
61
0.00
0.00
0.00
0.00
279,000.00
0.00
0.00
70,800.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
89,600.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
62
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
16,000.00
6,000.00
0.00
0.00
10,500.00
0.00
0.00
0.00
0.00
0.00
0.00
67,499.85
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
63
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
29,040.00
174,240.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
62,400.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
64
0.00
0.00
0.00
0.00
0.00
30,360.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
13,431.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
65
0.00
0.00
75,438.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
15,258.92
3,708,175.14
10,700.00
0.00
0.00
0.00
66
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
3,495.00
0.00
0.00
0.00
119,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
67
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
489,060.00
0.00
51,660.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
68
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
10,500.00
0.00
0.00
0.00
4,950.00
5,036.00
4,014.00
0.00
2,096.00
39,195.00
0.00
0.00
211,600.00
50,370.00
62,000.00
124,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
223,980.00
0.00
1,381,050.00
0.00
69
0.00
0.00
0.00
10,989.00
319,942.10
0.00
0.00
1,421.00
0.00
19,192.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
153,623.75
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
12,145.21
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
70
0.00
0.00
0.00
169,070.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
226,314.00
0.00
0.00
0.00
0.00
0.00
0.00
221,864.50
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
71
0.00
0.00
0.00
0.00
0.00
0.00
0.00
16,798.50
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
86,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
50,303.00
0.00
0.00
0.00
0.00
0.00
0.00
72
0.00
0.00
0.00
0.00
1,402,500.00
0.00
44,711.19
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
34,980.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
12,320.00
0.00
0.00
0.00
1,349,250.00
0.00
0.00
0.00
0.00
0.00
0.00
73
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
147,718.78
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
39,600.00
0.00
604,340.00
0.00
0.00
0.00
0.00
0.00
621,060.00
0.00
0.00
3,373,951.80
0.00
31,160.00
11,000.88
0.00
0.00
130,000.00
0.00
0.00
74
49,159.00
0.00
0.00
34,286.00
0.00
0.00
0.00
0.00
0.00
226,935.00
0.00
0.00
0.00
1,035,000.00
0.00
641,978.60
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
25,520.00
0.00
0.00
0.00
90,000.00
0.00
90,000.00
0.00
288,200.00
0.00
144,144.00
0.00
75
1,241,856.00
126,445.00
0.00
0.00
0.00
650,000.00
41,030,060.30
S.Farm., Apt.
201001 2 031
76
Kecamatan SUSUKAN
Nomor Rekening: 15.01.5.2.2.02.04
Periode: June 2022
No Nm Barang Satuan Harga Qty Total
1 Alat Suntik 5 ml (Omnivan) Pcs 699.00 5 3,495.00
2 Alat Suntik Sekali Pakai 20 ml (Syringe) Pcs 1,303.50 39 50,836.50
3 Alat Suntik Sekali Pakai 3 ml Pcs 1,138.00 4 4,552.00
5 Alat Suntik Sekali Pakai 50 ml (Stera) Pcs 3,400.00 20 68,000.00
6 Alkohol Swab Pcs 100.00 60 6,000.00
7 Antidiare (Molagit) Tablet Tablet 299.99 2,140 641,978.60
8 Antidiare Suspensi (Neo Kaominal) Botol 5,500.44 2 11,000.88
9 Antigen (Paratyphi OA) Febrile Botol 43,000.00 2 86,000.00
10 Antigen S (Typhi H) Fortress Vial 90,000.00 1 90,000.00
11 Antigen S (Typhi O) Fortress Vial 90,000.00 1 90,000.00
12 Antiinfluenza (Nichofed) Tablet Tablet 699.99 4,820 3,373,951.80
13 Aqua Pro Injeksi (Otsu) Ampul 2,860.00 171 489,060.00
14 Asam Askorbat (Vit. C) Tab 50Mg Tablet 105.00 100 10,500.00
15 Asiklovir Tab 200Mg Tablet 236.00 300 70,800.00
19 Bisakodil 5mg Tablet Tablet 319.00 80 25,520.00
20 Bisturi (Aesculap) No 11 Pak 279,000.00 1 279,000.00
21 Blood Transfusion Set Pcs 7,800.00 8 62,400.00
22 Cairan cuci Tangan Tanpa Bilas (Medika Hand Rub) Botol 5 L 144,100.00 2 288,200.00
23 Calcii Gluconas i.m./i.v Injeksi Ampul 10,351.00 60 621,060.00
24 Catgut Chromic 3/0 75c 37mm Box 345,000.00 3 1,035,000.00
25 Catgut Chromic 3/0 75c 37mm Box 345,000.00 2 690,000.00
26 Dec Glass Pak (isi 100) 14,460.50 5 72,302.50
27 Diazepam Injeksi 5mg/ml Ampul 1,735.03 7 12,145.21
28 Diazepam Rectal (Stesolid) 5mg Tube 12,573.00 18 226,314.00
29 Diazepam Rectal (Stesolid) 5mg Tube 12,573.00 6 75,438.00
30 Dimenhidrinat 50 Mg Tablet 111.99 2,000 223,980.00
31 Dimenhidrinat 50 Mg Tablet 105.00 300 31,500.00
32 Ektra Plasenta + Neomisin Sulfat (Neocenta Gel) Tube 16,016.00 9 144,144.00
33 Eritromisin Kapsul 250 Mg Kapsul 583.00 290 169,070.00
34 Etil Klorid Semprot Botol 130,000.00 1 130,000.00
35 Fenobarbital Tablet 30mg Tablet 170.99 130 22,228.70
36 Folly Catteter No.18 Piecis 8,000.00 2 16,000.00
37 Gentamicin Salep Mata 0.3% Tube 2,675.00 4 10,700.00
38 Gentamicin Tetes Mata 0,3% Botol 4,232.00 50 211,600.00
39 Golongan Darah Anti A Botol 62,000.00 1 62,000.00
40 Golongan Darah Anti B Botol 62,000.00 2 124,000.00
77
41 Hidrokortison Salep Kulit 2.5 % Tube 2,475.00 2 4,950.00
42 Hiosina N Butil Bromida 10 Mg (Scopma) Tablet 1,552.32 800 1,241,856.00
43 Hiosina N Butil Bromida Inj (Spashi Inj 1 ml) Ampul 9,900.00 4 39,600.00
44 Infuset Anak (Microdrip) Piecis 7,920.00 50 396,000.00
45 Infuset Anak (Microdrip) Pcs 7,920.00 2 15,840.00
46 Infuset Dewasa (Otsu Y) Pcs 7,920.00 4 31,680.00
47 Iv. Catteter (Introcan) No 22 Pcs 8,750.00 9 78,750.00
49 Iv. Catteter (Otsucath) No.18 Pcs 8,250.00 6 49,500.00
50 Kapas Pembalut OM 250gr Rol 12,500.00 9 112,500.00
51 Kasa Pembalut Hidrofil 4M X 15 Cm Roll 2,100.00 5 10,500.00
52 Ketokonazole Krim 2% Tube 2,518.00 2 5,036.00
53 Kloramfenikol 1% salep mata Tube 2,007.00 2 4,014.00
54 Kloramfenikol Tetes Telinga 3% (RECO) Botol 7,370.00 82 604,340.00
55 Kotrimoksazol Suspensi Botol 2,190.00 23 50,370.00
56 Lidokain 2% Ampul 1,221.00 11 13,431.00
57 Lidokain 2% Ampul 1,221.00 9 10,989.00
58 Lidokain 2% Ampul 1,144.00 4 4,576.00
59 Lidokain 2% + Ephinefrin Ampul 1,228.99 125 153,623.75
60 Loratadin 10mg Tablet 123.00 420 51,660.00
61 Masker N95 3M 9105 Respirator Pcs 9,350.00 150 1,402,500.00
62 Masker Telinga (Headloop) Jilbab SAFELOCK Pcs 1,799.00 750 1,349,250.00
63 Methilergometrin Maleat Inj. 0.2 Mg/Ml Ampul 2,959.00 17 50,303.00
64 Metoklopramid Syrup (Primpen) Botol 2,530.00 12 30,360.00
65 MgSO4 20% (OTSU) Ampul 3,327.50 38 126,445.00
66 Mikonazole Krim 2% Tube 3,413.30 65 221,864.50
67 Mineral Mix Sachet 3,116.00 10 31,160.00
68 Natrium Diklofenak 25Mg Tablet 128.00 4,200 537,600.00
69 Natrium Klorida Lar. Infus 0,9% Botol 6,410.00 30 192,300.00
70 Nifedipin 10 Mg Tablet 111.99 150 16,798.50
71 Obat Herbal Membantu Melancarkan ASI (KATUK) Botol 29,750.00 4 119,000.00
72 Oksitosin Inj. 10 Ul/ml Ampul 1,199.00 41 49,159.00
73 Piridoksin (B6) Tab. 10Mg Tablet 131.00 16 2,096.00
74 Plester (Leukoplast) Roll 35,531.99 2 71,063.98
75 Ringer Laktat Larutan Infus Botol 7,150.00 2,016 14,414,400.00
76 Ringer Laktat Larutan Infus Botol 7,629.99 486 3,708,175.14
77 Ringer Laktat Larutan Infus Botol 7,629.46 2 15,258.92
78 Roeko Endo Frost (Propane/Butane) Botol 387,200.00 3 1,161,600.00
79 Salbutamol 2Mg Tablet 67.00 585 39,195.00
80 Salep Antifungi Doen Kombinasi 30gr Pot 4,798.00 4 19,192.00
81 Sarung tangan (E-Care) no. 7 Pasang 4,499.99 15 67,499.85
82 Sarung tangan (E-Care) no. 7 Pasang 4,500.00 5 22,500.00
83 Sarung Tangan (Safeglove) No. 7 Pasang 4,180.00 3 12,540.00
84 Sarung Tangan Obgyn M Pasang 14,520.00 12 174,240.00
85 Sarung Tangan Obgyn S Pasang 14,520.00 2 29,040.00
86 Sarung Tangan Obgyn Steril Pasang 19,360.00 1 19,360.00
87 Sarung Tangan Panjang (InTouch) No. 6,5 Pasang 12,320.00 1 12,320.00
78
88 Sefadroksil Syr 125mg/ml Botol 4,185.00 330 1,381,050.00
89 Selang Oksigen (Nasal Cannula) M - Infant Pcs 5,082.00 1 5,082.00
90 Selang Oksigen (Stardec) Anak Piecis 11,200.00 8 89,600.00
91 Siprofloxacin Tab 500Mg Tablet 394.97 374 147,718.78
92 Swab Dacron (NASO) Pcs 6,500.00 100 650,000.00
93 Vitamin A Kapsul 200.000 Iu Kapsul 551.99 81 44,711.19
94 Vitamin B1 (Thiamin) Tablet 165.00 212 34,980.00
95 Vitamin B1 (Thiamin) Tablet 171.43 200 34,286.00
96 Vitamin B12 Tablet 50 Mg Tablet 49.00 29 1,421.00
97 Yellow Tip Piecis 175.69 1,200 210,828.00
98 Yodium Povidon Lart. 10 % 60 Ml (Betadine) Botol 25,215.00 9 226,935.00
41,030,060.30

NIP. 196803312002121004 NIP. 19830605 201001 2 031
79
Kecamatan SUSUKAN
Nomor Rekening: 15.01.5.2.2.01.10
Periode: Juni 2022
1 0258 Kaca Mulut + Handle Set 24,530.00 0 0.00
2 0262 Needle No.20 Piecis 500.00 0 0.00
3 0394 Acid Sulfuric @ 35 KG BTL 200,000.00 0 0.00
4 0404 Needle No.26 Piecis 550.00 0 0.00
5 0498 Alat Suntik Sekali Pakai 3 Ml (Terumo) Piecis 957.00 0 0.00
6 0499 creatinin 10051 Kit 200ml 550,000.00 0 0.00
7 0500 Triglycerid 10724 Kit 3,509,000.00 0 0.00
4x100mL
8 0501 Uric Acid 10691 Kit 3,529,900.00 0 0.00
4x100mL
9 0502 Glucose 10260 Kit 1,081,300.00 0 0.00
4x100mL
10 0503 SGOT 12011 kit 10 x 10 687,500.00 0 0.00
ml
11 0504 SGPT 12012 kit 10 x 10 687,500.00 0 0.00
ml
12 0505 Total Protein 157004 Kit 579,700.00 0 0.00
4x100mL
13 0506 Albumin 156004 Kit 489,500.00 0 0.00
4x100mL
14 0507 Urea 10505 kit 610,500.00 0 0.00
2x200mL
15 0508 Hemoglobin 10751 Kit 20 x 1,299,100.00 0 0.00
25mL
16 0541 Needle No.23 Piecis 539.00 0 0.00
17 0542 Needle No.26 Piecis 539.00 0 0.00
18 0543 Etanol 70% 1000mL Botol 33,000.00 0 0.00
100mL
19 0545 Hbsag Entebe Kit 660,000.00 0 0.00
20 0546 1,8-dihidroxy 2(4 sulfophenylazo) naphthalene kit 3,190,000.00 0 0.00
-3, 6 disulfonic acid trisodium salt GR
21 0547 Acetic Acid (glasial) 100% Pak 569,000.00 0 0.00
22 0548 AgNO3 Pak 1,562,000.00 0 0.00
23 0549 Amonium acetat 1 976,000.00 0 0.00
24 0550 Amphetamin test Pak 792,000.00 0 0.00
25 0551 Barium chlorida anhidrat Kit 743,000.00 0 0.00
26 0552 Benzodiazepines test Box 792,000.00 0 0.00
27 0553 Borax test kit Kit 5,500,000.00 0 0.00
28 0554 Brilliant Green Lactosa Broth Pak 1,456,000.00 0 0.00
29 0555 Cocaine test Box 792,000.00 0 0.00
30 0556 CRM Flourida Kit 880,000.00 0 0.00
31 0557 CRM Mangan Kit 1,045,000.00 0 0.00
32 0558 Extran MA 02 neutral Botol 885,000.00 0 0.00
33 0559 Iron (III) chloride hexyahydrate Pak 913,000.00 0 0.00
80
34 0560 Larutan standar Fe Kit 1,026,000.00 0 0.00
35 0561 Lauryl Tryptose Broth Pak 1,063,000.00 0 0.00
36 0562 Manganese (II) sulfate monohydrate Pak 756,000.00 0 0.00
37 0563 Marijuana Test Box 792,000.00 0 0.00
38 0564 Mercury II Sulfat Kit 3,506,000.00 0 0.00
40 0566 Methanyl Yellow Test Kit kit 5,280,000.00 0 0.00
41 0567 Morphin Test Box 792,000.00 0 0.00
42 0568 Na Acetat Kit 759,000.00 0 0.00
43 0569 Na Arsenit Pak 1,087,000.00 0 0.00
44 0570 NItric Acid Botol 1,280,000.00 0 0.00
46 0572 Potassium hydroxide Pak 440,000.00 0 0.00
47 0573 Potassium peroxodisulfate Pak 708,400.00 0 0.00
49 0575 Reagen Pemeriksaan Cadmium kit 3,875,000.00 0 0.00
50 0576 Reagen pemeriksaan Cr Kit 3,816,000.00 0 0.00
51 0577 Reagen Pemeriksaan pH kit 2,413,000.00 0 0.00
52 0578 Reagen pemeriksaan Sulfide Kit 3,668,000.00 0 0.00
54 0580 Sodium dietyl dithiocarbamat Pak 1,762,000.00 0 0.00
55 0581 SPANDS Hac Kit 770,000.00 0 0.00
56 0582 Zirconil klorida Kit 3,793,000.00 0 0.00
57 0585 HDL Cholest Precipitan 4x80ml Kit 1,509,200.00 0 0.00
58 0586 Antigen S (Parathypi AH) HUMATEX Kit 2,225,300.00 0 0.00
59 0587 Antigen S (Thypi H) HUMATEX Kit 2,225,300.00 0 0.00
60 0588 Antigen S (Thypi O) HUMATEX Kit 2,225,300.00 0 0.00
61 0589 Gamma - GT Liq 10x10ml Kit 962,500.00 0 0.00
62 0590 Anti A HUMATYPE vial 269,132.60 0 0.00
63 0591 Anti B HUMATYPE vial 269,132.60 0 0.00
64 0592 Cholesterol Liq 4x100ml kit 2,288,000.00 0 0.00
65 0593 Uric Acid liq 4x100 ml kit 3,529,900.00 0 0.00
66 0594 Glucose liq 4x100 ml kit 1,081,300.00 0 0.00
67 0598 CRM COD Kit 791,000.00 0 0.00
69 0601 Reagen pemeriksaan Cn Kit 3,046,000.00 0 0.00
70 0602 Reagen pemeriksaan NH4 Kit 1,510,000.00 0 0.00
71 0614 Urin 10 Parameter Tube 268,125.00 0 0.00
72 0671 Alat Suntik Sekali Pakai 3 ml Piecis 956.99 0 0.00
500mL
74 0688 cairan Cuci Tangan Tanpa Bilas (Aseptan) Botol 30,000.00 0 0.00
500mL
81
75 0689 Alkohol 70% Botol 1L 21,499.99 0 0.00
77 0691 Plester (Plesterin bulat) Box isi 200 24,750.00 0 0.00
78 0692 Strip Gula (Nesco) Box 90,200.00 0 0.00
79 0693 Strip Cholesterol (Nesco) Box 170,500.00 0 0.00
80 0694 Right Sign AMP Device Box 412,500.00 0 0.00
81 0699 Urin Bag 2Lt (T Valve) Piecis 3,000.00 0 0.00
82 0700 Lancet (Onemed) Piecis 145.66 0 0.00
83 0701 Mumyfiying Pasta Pot 519,200.00 0 0.00
84 0705 Glass Ionomer (Fuji Ix) Set 521,235.00 0 0.00
85 0706 Tumpatan Sementara (Caviton Pink) Piecis 154,000.00 0 0.00
86 0707 Tumpatan Sementara (Caviton White) Piecis 154,000.00 0 0.00
87 0725 Hbsag Entebe strip 15,400.00 0 0.00
88 0726 Antigen S (Parathypi AH) HUMATEX Botol 278,162.50 0 0.00
89 0727 Antigen S (Thypi H) HUMATEX Botol 278,162.50 0 0.00
90 0728 Antigen S (Thypi O) HUMATEX Botol 278,162.50 0 0.00
93 0737 Diluent botol 10L 4,060,000.00 0 0.00
94 0738 Cleaner Botol 2,710,000.00 0 0.00
960mL
95 0739 Lyse Botol 4,400,000.00 0 0.00
960mL
96 0740 Hemoglobin (HB) Kit 10 x 1,170,000.00 0 0.00
500ml
97 0741 SGOT Kit 8 x 1,720,000.00 0 0.00
50ml
98 0742 Uric Acid Kit 1,590,000.00 0 0.00
4x100mL
99 0743 SGPT Kit 8 x 1,720,000.00 0 0.00
50ml
100 0744 Triglycerid Kit 2,570,000.00 0 0.00
4x100mL
101 0745 Ureum kit 2 x 590,000.00 0 0.00
100ml
102 0746 Creatinin Kit 200ml 630,000.00 0 0.00
103 0747 Cholesterol Kit 1,780,000.00 0 0.00
4x100mL
104 0748 HDL Cholest Precipitan kit 4 x 80ml 910,000.00 0 0.00
105 0749 Glucose Kit 760,000.00 0 0.00
4x100mL
106 0750 Bilirubin kit 2 x 730,000.00 0 0.00
100ml
107 0779 Rapid Tes HIV 1 (SD) Card 37,000.00 0 0.00
108 0780 Rapid Tes HIV 2 (Intec) Card 41,000.00 0 0.00
109 0781 Rapid Tes HIV 3 (Oncoprobe) Card 52,200.00 0 0.00
111 0805 Strip Asam Urat (Nesco) Box 99,000.00 0 0.00
112 0841 Handscoon (Maxter) M Piecis 583.00 0 0.00
113 0842 Handscoon (Maxter) S Piecis 583.00 0 0.00
82
118 0884 sarung tangan (E-Care) no. 6,5 Pasang 4,500.00 0 0.00
119 0885 Cairan Cuci Tangan Tanpa Bilas (Hand Scrub) Botol 74,000.00 0 0.00
121 0887 Masker Tali (E-Care) Pcs 438.90 0 0.00
122 0888 Kapas Pembalut OM 1000gr Rol 54,560.00 0 0.00
123 0889 Alkohol 70% 1L Botol 25,000.00 0 0.00
125 0891 Plesterin Bulat Soft Pcs 154.00 0 0.00
126 0911 Trikresol Formalin (Tkf) Botol 60,500.00 0 0.00
127 0916 Devitalisasi Pasta (Devitec) Box 260,000.00 0 0.00
128 0930 Spongostan (Curaspon 2 X 30) Botol 346,500.00 0 0.00
129 0931 Glass Ionomer (Fuji Ix) Box 521,235.00 0 0.00
130 0932 Tumpatan Sementara (Caviton) Botol 154,000.00 0 0.00
131 0933 Strip Gula (Nesco) Box 87,750.00 0 0.00
132 0934 Strip Asam Urat (Nesco) Box 93,600.00 0 0.00
133 0935 Strip Cholesterol (Nesco) Box 170,500.00 0 0.00
134 0940 Albumin liq 4x100 ml (156004) Kit 492,800.00 0 0.00
135 0941 HUMATEX F .Antigen S (Typhi AH) 50211 Kit 2,230,800.00 0 0.00
136 0942 HUMATEX F .Antigen S (Typhi H) 50271 Kit 2,230,800.00 0 0.00
137 0943 HUMATEX F .Antigen S (Typhi O) 50281 Kit 2,230,800.00 0 0.00
138 0944 Uric Acid liq 4x100 ml (10691) Kit 3,556,300.00 0 0.00
139 0945 Cholesterol Liq 4x100ml (10028) Kit 2,288,000.00 0 0.00
140 0946 HDL Cholest Precipitan 4x80ml (10018) Kit 1,520,200.00 0 0.00
141 0947 Creatinin liq 200ml (10051) kit 550,000.00 0 0.00
142 0948 Gamma - GT Liq 10x10ml (12013) Kit 962,500.00 0 0.00
143 0949 Glucose liq 4x100 ml (10260) kit 1,091,200.00 0 0.00
144 0950 Hemoglobin 20x25 ml (10751) kit 1,312,300.00 0 0.00
145 0951 Total Protein liq 4x100ml (157004) Kit 583,000.00 0 0.00
146 0952 Triglycerides liq 4x100ml (10724) Kit 3,536,500.00 0 0.00
147 0953 Urea Liq 2x100ml (10505) Kit 614,900.00 0 0.00
148 0954 Golongan Darah (HUMATYPE) Anti A 71012 Botol 271,700.00 0 0.00
149 0996 Cleaner Botol 2,612,500.00 0 0.00
150 0997 Lyse Botol 4,243,800.00 0 0.00
151 0998 Diluent Botol 3,917,100.00 0 0.00
152 0999 Larutan Hcl 0.1 N (Biomedika) Botol 30,800.00 0 0.00
153 1016 Hbsag Entebe Kit 825,000.00 0 0.00
154 1017 1,8-dihidroxy 2(4 sulfophenylazo) Botol 3,348,400.00 0 0.00
cat.107998.0025
155 1018 AgNO3 cat. 1.01512.0025 Botol 1,640,100.00 0 0.00
156 1019 Amonium acetat cat. 1.01116.0500 Botol 1,025,200.00 0 0.00
83
157 1020 Amonium iron (II) sulfat hexadirat cat. Botol 1,526,800.00 0 0.00
1.03792.0500
158 1021 Amonium solution 25% cat. 1.05432.2500 Botol 577,500.00 0 0.00
159 1022 Barium chlorida anhidrat cat. 1.01719.0500 Botol 779,900.00 0 0.00
161 1024 Brilliant Green Lactosa Broth cat. 105454.0500 Botol 1,529,000.00 0 0.00
162 1025 Extran MA 02 neutral cat. 1.07553.2500 Botol 929,500.00 0 0.00
163 1026 Iron (III) chloride hexyahydrate cat. Botol 959,200.00 0 0.00
1.03943.0250
164 1027 Lauryl Tryptose Broth cat. 1.10266.0500 Botol 1,150,600.00 0 0.00
165 1028 Manganese (II) sulfate monohydrate cat. Botol 794,200.00 0 0.00
105941.0250
166 1029 Mercury II Sulfat cat. 1.04480.0250 Botol 3,681,700.00 0 0.00
168 1031 NItric Acid cat. 1.01799.2500 Botol 1,344,200.00 0 0.00
170 1033 Ph Indikator Box 279,400.00 0 0.00
171 1034 Potassium hydroxide cat. 1.05033.0500 Botol 462,000.00 0 0.00
172 1035 Potassium peroxodisulfate cat. 1.05091.0250 Botol 744,700.00 0 0.00
173 1036 Reagen pemeriksaan Cn Cat. 1.05091.0250 Kit 3,198,800.00 0 0.00
174 1037 Reagen pemeriksaan Cr cat. 1.14758.0001 Kit 4,007,300.00 0 0.00
175 1038 Reagen Pemeriksaan Cu cat. 1.14767.0001 Kit 4,502,300.00 0 0.00
178 1041 Reagen pemeriksaan Pb cat. 1.09717.0001 Kit 2,843,000.00 0 0.00
180 1043 Sodium Hidroksida (NaOH) Cat. 1.06498.1000 Botol 602,800.00 0 0.00
181 1044 SPADNS Hach Cat. 44449 Botol 770,000.00 0 0.00
182 1045 CRM Cadmium Cat. 1.19777.0500 Botol 839,300.00 0 0.00
183 1046 Reagen Pemeriksaan Arsen Cat. Kit 2,603,700.00 0 0.00
1.17917.0001
184 1047 Reagen Pemeriksaan Zn Cat. 1.14412.0001 Kit 3,913,800.00 0 0.00
185 1063 Dec Glass Pak (isi 14,460.50 8 115,684.00
100)
186 1064 Lancet (Onemed) Piecis 145.66 0 0.00
187 1065 Yodium Povidon Lart. 10 % 60ml Botol 3,700.00 0 0.00
188 1066 Aqua Destilata Botol 1L 14,960.00 0 0.00
189 1075 Reagen pemeriksaan Fluoride Kit 3,169,100.00 0 0.00
cat.1.114598.0001
190 1076 CRM Mangan cat.1.19789.0500 Kit 1,097,800.00 0 0.00
cat.1.01745.0001
192 1078 Reagen Pemeriksaan PO4 cat.1.00798.0001 Kit 2,691,700.00 0 0.00
193 1079 Amphetamin test (Intec) Kit 990,000.00 0 0.00
194 1080 Benzodeasepin Strip Test (Intec) Kit 990,000.00 0 0.00
195 1081 THC Strip Test (Intec) Kit 990,000.00 0 0.00
196 1082 Methampetamine Test (Intec) Kit 990,000.00 0 0.00
197 1083 Morphin Test (Intec) Kit 990,000.00 0 0.00
84
198 1084 Formalin test Cat.1.08028.0001 Kit 2,644,400.00 0 0.00
199 1088 Alkohol 70% 1L Botol 1L 25,000.00 0 0.00
201 1090 Kokain strip test (Answer) Box isi 50 680,020.00 0 0.00
205 1128 Kasa Pembalut 4m x 5cm Rol 750.00 0 0.00
206 1129 Kasa Pembalut 4m x 10cm Rol 1,500.00 0 0.00
207 1130 CRM Ammonium Cat.1.25027.0100 Botol 830,500.00 0 0.00
208 1131 CRM Nitrat Cat1 1.125040.0100 Botol 830,500.00 0 0.00
209 1132 CRm Nitrit Cat 1.25042.0100 Botol 830,500.00 0 0.00
210 1133 CRM Sulfat (SO4) Cat.1.25053.0100 Botol 830,500.00 0 0.00
212 1136 Tensocrepe (Pro Crepe) 7.5cm x 4.22m Piecis 27,830.00 0 0.00
213 1137 Tensocrepe (Pro Crepe) 10cm x 4.22m Piecis 33,000.00 0 0.00
214 1138 Tensocrepe (Pro Crepe) 15cm x 4.22m Piecis 41,910.00 0 0.00
215 1143 Bisturi (Aesculap) No 11 Piecis 3,000.00 141 423,000.00
216 1154 Foley Catteter No.16 Piecis 8,000.00 0 0.00
221 1206 Hbsag (Fokus Diagnostic) Box isi 25 263,674.97 0 0.00
225 1258 Larutan Hayem Botol 31,750.00 0 0.00
227 1260 Immersion Oil Botol 201,800.00 0 0.00
231 1272 Kasa Kompres 40X40 Rol 1,600.00 0 0.00
234 1275 Hb Hemoglobin Test (Mision) Box/ 50 400,000.00 0 0.00
85
243 1309 Cholinesterase Kit 16 x 2,676,850.00 0 0.00
3ml
244 1310 Kasa Elastis 4 X 15 Roll 19,140.00 0 0.00
245 1312 Monoklor Kamfr Cairan/ Chkm Botol 106,480.00 0 0.00
246 1313 SGOT KIT 1,381,380.00 0 0.00
247 1314 SGPT Kit 1,381,380.00 0 0.00
248 1315 Triglycerides liq 4x100ml Kit 3,021,810.00 0 0.00
249 1316 cairan Cuci Tangan Bilas ( E-care Handscrub) Botol 73,999.00 0 0.00
250 1317 Tabung Vacumtainer EDTA 3ml Piecis 981.75 0 0.00
252 1319 Box Slide Box 37,715.99 0 0.00
253 1320 Dressing Penutup Luka (FIXOMULL) 10cm pcs 70,903.00 0 0.00
257 1767 Handscoon S (Stardec Latex) Piecis 476.00 0 0.00
258 1769 Plester (leukoplast) Roll 37,371.00 10 373,710.00
259 1772 Cover Glass Box 14,460.50 33 477,196.50
260 1773 Plesterin Bulat Soft Box 30,800.00 13 400,400.00
261 1774 Alkohol Swab Box 10,000.00 0 0.00
263 1783 Yellow Tips (Micropipettes MT-I) Pcs 175.69 0 0.00
264 1784 Blue Tips (Micropipettes MT-II) Pcs 227.10 0 0.00
265 1785 Masker Telinga (Earloop) Jilbab Box 16,340.00 0 0.00
266 1786 Needle 23 G x 1 1/2 Safety Flashback Box 204,166.60 6 1,224,999.60
267 1787 Nedlee 23 G x 32 MM Pcs 310.99 0 0.00
268 1788 Alat Suntik 3ml (Syringe) Pcs 1,137.99 0 0.00
269 1835 Infuset Dewasa (Inochi) Pcs 3,099.80 1 3,099.80
270 1851 Alkohol 70% 1L Botol 18,700.00 0 0.00
271 1887 Handscoon L (Cosmomed) Piecis 551.00 0 0.00
273 1910 Pot Sputum Pcs 2,728.00 0 0.00
274 1918 Tabung Vacumtainer Non EDTA 6 ml Pcs 1,384.00 0 0.00
275 1925 Syphilis Test (Hexagon) Box isi 20 527,670.00 0 0.00
276 1926 Rapid Tes Hiv 1/2 (Vikia) Test 19,499.99 0 0.00
278 1992 Safety Box 2.5 Lt Piecis 16,268.00 0 0.00
279 1993 Ads 0.5Ml (Medeco Inject) Pcs 1,500.00 0 0.00
86
280 1994 Ads 5Ml (Medeco Inject) Pcs 741.00 200 148,200.00
283 2010 Masker Nebul Anak Pcs 16,000.00 6 96,000.00
284 2011 Masker Nebul Dewasa Pcs 16,000.00 0 0.00
285 2012 Rapid Tes HIV 1 (SD) Strip 14,344.00 0 0.00
290 2023 Plester (Zinc Oxide) Roll 42,585.76 0 0.00
291 2032 Strip Gula (GE200) STRIP 4,950.00 0 0.00
292 2035 Foley Catteter No.18 Piecis 8,000.00 0 0.00
293 2036 Urin Bag 2Lt (T Valve) Buah 3,000.00 0 0.00
296 2042 Ads 0.05Ml (Medeco Inject) Pcs 1,900.00 0 0.00
297 2047 Strip Asam Urat (Autocheck) Box isi 50 178,750.00 0 0.00
298 2224 Infuset Dewasa (Otsu Y) Pcs 8,399.60 311 2,612,275.60
299 2225 Masker Oksigen Anak Pcs 23,650.00 5 118,250.00
300 2226 Masker Oksigen Dewasa Pcs 23,650.00 0 0.00
306 2235 Iv. Catteter (Introcan) No 22 Pcs 8,750.00 261 2,283,750.00
307 2236 Iv. Catteter (Introcan) No 24 Pcs 8,750.00 600 5,250,000.00
308 2244 Alat Suntik Sekali Pakai 3 Ml (Terumo) Pcs 1,137.99 304 345,948.96
310 2246 Needle 18 G x 38mm (Agani) Pcs 310.98 82 25,500.36
312 2248 Alat Suntik Sekali Pakai 5 ml (Terumo) Pcs 1,599.98 50 79,999.00
315 2256 Silk 2/0 75CC 30M C (DEMESILK) Box 179,999.60 2 359,999.20
317 2258 Infuset Anak (Microdrip) Pcs 8,399.60 140 1,175,944.00
319 2282 Kasa Kompres 40X40 DRC Roll 1,320.00 8 10,560.00
320 2283 Kasa Hidrofil 2Mx80Cm Pcs 9,870.00 0 0.00
87
324 2300 Handscoon L (Mas Examination) Pcs 462.00 0 0.00
326 2317 Yellow Tips (Micropipettes MT-I) Pcs 175.69 0 0.00
327 2318 Blue Tips (Micropipettes MT-II) Pcs 227.10 400 90,840.00
328 2319 Lancet Box 14,000.00 0 0.00
330 2330 Gel Untuk Ekg (Ultra Sound) Botol 14,879.99 0 0.00
331 2345 Hb Hemoglobin Test (Mision) Box isi 50 400,000.00 0 0.00
333 2435 Handscoon L (Elva Latex) Pcs 549.40 0 0.00
334 2436 Handscoon M (Elva Latex) Pcs 549.40 0 0.00
335 2437 Handscoon S (Elva Latex) Pcs 549.40 0 0.00
336 2442 Kasa Pembalut Hidrofil 4x15cm (Hastamed) Roll 2,361.00 0 0.00
337 2443 Kapas Pembalut Hastamed 250gr Roll 14,996.99 20 299,939.80
342 2502 Masker Nebul Dewasa Pcs 16,000.00 16 256,000.00
343 2503 Masker Nebul Anak Pcs 16,000.00 0 0.00
344 2504 Transfusi Set Pcs 5,519.99 8 44,159.92
345 2505 Urin Bag (Stardec) Pcs 5,500.00 7 38,500.00
346 2511 Strip Cholesterol (Autocheck) Box isi 25 368,500.00 0 0.00
347 2513 Plester (Hansaplast) Roll 35,000.00 5 175,000.00
348 2514 Alat Suntik Sekali Pakai 3 ml (Syringe) Pcs 817.99 0 0.00
349 2531 Strip Asam Urat (Autocheck) Box isi 50 178,750.00 0 0.00
350 2539 Objek Glass Box isi 72 17,604.00 20 352,080.00
351 2549 Tabung EDTA K3 (Vaculab) Pcs 1,060.00 0 0.00
352 2553 Safety Box 5 Lt (Docare) Pcs 21,499.50 0 0.00
353 2554 Rapid Tes HIV 1/2 (SD) STRIP 11,400.00 0 0.00
354 2556 Dengue Rapid Test (NS1) Test 35,548.00 0 0.00
355 2557 Dengue Rapid Test (IgG/IgM) Test 27,521.00 0 0.00
356 2577 Sarung Tangan (Tro-Sensosurge) No. 8 Pasang 6,594.50 0 0.00
357 2578 Sarung Tangan (Tro-Sensosurge) No. 7 Pasang 6,594.50 0 0.00
358 2587 Pot Sputum Buah 2,728.00 0 0.00
359 2592 Rapid Tes HIV 1/2 (INTEC) Strip 15,064.70 0 0.00
360 2593 Yodium Povidon Lart. 10 % 60 ml Botol 4,510.00 4 18,040.00
361 2594 Alkohol Swab Box 10,000.00 0 0.00
88
362 2598 Alkohol 70% 1L Botol 22,950.00 0 0.00
363 2611 Rapid 1/2 HIV (Fokus) STRIP 13,235.00 0 0.00
364 2636 Pemberantas Jentik Nyamuk DBD (BACTIVEC Botol 30,000.00 0 0.00
SL)
365 2650 Reagen Syphilis (SD) Bioline STRIP 15,500.00 0 0.00
366 2670 Catgut Chromic 2/0 90cm 36mm Box 741,600.00 5 3,708,000.00
367 2671 Silk 2/0 76cm 26mm (T-Silk) Box 445,200.00 1 445,200.00
368 2673 Lancet (Serenity) Pcs 120.00 100 12,000.00
369 2674 Alkohol Swab (Serenity) Pcs 100.00 24 2,400.00
370 2676 Selang Oksigen (Nasal Cannula) Adult Pcs 9,350.00 15 140,250.00
371 2693 Bahan Tes Cepat Molekuler TB (TCM) Kartrid Buah 259,175.00 0 0.00
Xpert MTB/Rif
372 2714 VTM (Dengan 1 Stick Swab NASO) Tube 55,165.00 0 0.00
373 2715 Alat Suntik Sekali Pakai 10 ml (Stera) Pcs 925.00 0 0.00
374 2730 VTM (Dengan 2 Stick Swab) ARKAN Pcs 56,250.15 0 0.00
375 2759 Handscoon M (Sensi) Pcs 1,000.00 0 0.00
376 2760 Handscoon L (Safeglove) Pcs 880.00 0 0.00
378 2776 Masker Kain 2 Ply Pcs 3,300.00 0 0.00
379 2778 VTM (Dengan 2 Stick Swab) Yocon Pcs 40,000.00 0 0.00
380 2779 VTM (Dengan 2 Stick Swab) Vircell Pcs 40,000.00 0 0.00
381 2787 Parafilm M Pcs 880.00 0 0.00
382 2792 Handscoon M (Sensi) Pcs 1,250.00 0 0.00
383 2797 Handscoon L (Sensi) Pcs 1,210.00 0 0.00
384 2798 Handscoon L (GP Care) Pcs 1,155.00 0 0.00
385 2804 VTM (Dengan 2 Stick Swab) Jun Nuo Pcs 40,000.00 0 0.00
386 2805 Masker N95 3M 8210 Respirator Pcs 13,200.00 86 1,135,200.00
387 2806 Masker Telinga (Earloop) Jilbab Imaske Pcs 1,200.00 0 0.00
388 2807 Masker Telinga (Mas) Tie On Pcs 1,200.00 0 0.00
389 2833 Tisue Roll 7,030.00 0 0.00
390 2840 VTM (Dengan 2 Stick Swab) Baicare Pcs 33,792.00 0 0.00
MEDICAL
24,309,076.94

NIP. 196803312002121004 NIP. 19830605 201001 2 031
89
Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
90
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
91
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
92
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
93
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
115,684.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
94
0.00
0.00
0.00
0.00
0.00
87,505.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
423,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
95
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
373,710.00
477,196.50
400,400.00
0.00
0.00
0.00
0.00
0.00
1,224,999.60
0.00
0.00
3,099.80
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
96
148,200.00
0.00
0.00
96,000.00
0.00
0.00
0.00
0.00
345,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,612,275.60
118,250.00
0.00
90,695.00
0.00
0.00
848,750.00
0.00
2,283,750.00
5,250,000.00
345,948.96
0.00
25,500.36
0.00
79,999.00
345,000.00
350,000.20
359,999.20
0.00
1,175,944.00
0.00
10,560.00
0.00
97
0.00
0.00
0.00
0.00
0.00
0.00
90,840.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
299,939.80
0.00
0.00
0.00
0.00
256,000.00
0.00
44,159.92
38,500.00
0.00
175,000.00
0.00
0.00
352,080.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
18,040.00
0.00
98
0.00
0.00
0.00
0.00
3,708,000.00
445,200.00
12,000.00
2,400.00
140,250.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1,135,200.00
0.00
0.00
0.00
0.00
0.00
24,309,076.94
S.Farm., Apt.
201001 2 031
99
Kecamatan SUSUKAN
Nomor Rekening: 15.01.5.2.2.01.10
Periode: Juni 2022
1 Dec Glass Pak (isi 100) 14,460.50 8 115,684.00
3 Bisturi (Aesculap) No 11 Piecis 3,000.00 141 423,000.00
4 Plester (leukoplast) Roll 37,371.00 10 373,710.00
5 Cover Glass Box 14,460.50 33 477,196.50
6 Plesterin Bulat Soft Box 30,800.00 13 400,400.00
7 Needle 23 G x 1 1/2 Safety Flashback Box 204,166.60 6 1,224,999.60
8 Infuset Dewasa (Inochi) Pcs 3,099.80 1 3,099.80
9 Ads 5Ml (Medeco Inject) Pcs 741.00 200 148,200.00
10 Masker Nebul Anak Pcs 16,000.00 6 96,000.00
12 Infuset Dewasa (Otsu Y) Pcs 8,399.60 311 2,612,275.60
13 Masker Oksigen Anak Pcs 23,650.00 5 118,250.00
16 Iv. Catteter (Introcan) No 22 Pcs 8,750.00 261 2,283,750.00
17 Iv. Catteter (Introcan) No 24 Pcs 8,750.00 600 5,250,000.00
18 Alat Suntik Sekali Pakai 3 Ml (Terumo) Pcs 1,137.99 304 345,948.96
19 Needle 18 G x 38mm (Agani) Pcs 310.98 82 25,500.36
20 Alat Suntik Sekali Pakai 5 ml (Terumo) Pcs 1,599.98 50 79,999.00
23 Silk 2/0 75CC 30M C (DEMESILK) Box 179,999.60 2 359,999.20
24 Infuset Anak (Microdrip) Pcs 8,399.60 140 1,175,944.00
25 Kasa Kompres 40X40 DRC Roll 1,320.00 8 10,560.00
26 Blue Tips (Micropipettes MT-II) Pcs 227.10 400 90,840.00
27 Kapas Pembalut Hastamed 250gr Roll 14,996.99 20 299,939.80
28 Masker Nebul Dewasa Pcs 16,000.00 16 256,000.00
29 Transfusi Set Pcs 5,519.99 8 44,159.92
30 Urin Bag (Stardec) Pcs 5,500.00 7 38,500.00
31 Plester (Hansaplast) Roll 35,000.00 5 175,000.00
32 Objek Glass Box isi 72 17,604.00 20 352,080.00
33 Yodium Povidon Lart. 10 % 60 ml Botol 4,510.00 4 18,040.00
34 Catgut Chromic 2/0 90cm 36mm Box 741,600.00 5 3,708,000.00
35 Silk 2/0 76cm 26mm (T-Silk) Box 445,200.00 1 445,200.00
100
36 Lancet (Serenity) Pcs 120.00 100 12,000.00
37 Alkohol Swab (Serenity) Pcs 100.00 24 2,400.00
38 Selang Oksigen (Nasal Cannula) Adult Pcs 9,350.00 15 140,250.00
39 Masker N95 3M 8210 Respirator Pcs 13,200.00 86 1,135,200.00
24,309,076.94

NIP. 196803312002121004 NIP. 19830605 201001 2 031
101
Kecamatan SUSUKAN
Nomor Rekening: APBD1
Periode: Juni 2022
1 0491 Amoksisilin Sirup Kering 125Mg/ 5Ml Botol 60mL 2,223.00 0 0.00
2 0492 Parasetamol Sirup 120Mg/5Ml Botol 60mL 1,307.00 0 0.00
5 0495 Parasetamol 500mG Tablet 89.00 0 0.00
6 0858 Aminopilin Inj 24 mg/ml Ampul 3,345.00 0 0.00
7 0859 Amoksisilin Kapsul 250 Mg Kapsul 195.00 0 0.00
8 0860 Amoksisilin Sirup Kering 125Mg/ 5Ml Botol 2,223.00 0 0.00
11 0863 Fitominadion 10mg Tablet 691.00 0 0.00
12 0864 Chlorpheniramine Maleat (Ctm) Tablet 42.00 0 0.00
13 0865 Klorpromazine 25 mg/ml Tablet 148.00 0 0.00
15 0867 Sefotaksim Serbuk Inj. 1mg vial 4,898.00 0 0.00
16 0868 Alat suntik 1ml (Stera) Pcs 669.50 0 0.00
17 0869 Alat suntik 2,5ml (Stera) Pcs 669.50 0 0.00
18 0870 Alat suntik 5ml (Stera) Pcs 669.50 0 0.00
19 0871 Sarung Tangan (Safeglove PF) No.6,5 Pasang 7,195.00 0 0.00
20 0872 Sarung Tangan (Safeglove PF) No.7 Pasang 7,195.00 0 0.00
21 0893 Antihemoroid supp (Bismut subgalat 150mg, Suppositori 3,045.00 0 0.00
heksaklorofen 2.5mg , lidokain 10mg, seng a
22 0894 Dexamethasone
oksida 120mg) 0.5mg Tablet 44.00 0 0.00
500mL
27 0923 Haloperidol Tab 5MG Tablet 75.00 0 0.00
29 0925 Atropin 0,5mg Tablet 73.00 0 0.00
102
34 1337 Amoksisilin Kapsul 250 Mg Kapsul 180.00 0 0.00
35 1338 Amoksisilin Sirup Kering 125mg/5ml Botol 60mL 2,223.00 0 0.00
38 1341 Salep Antifungi Doen Kombinasi 30gr Pot 4,323.00 0 0.00
39 1342 Ergotamin Caffein Tablet 167.00 0 0.00
43 1346 Difenhidramin Hcl Inj. 10 Mg/1Ml ampul 1,060.00 0 0.00
45 1348 Fitominadion Inj./ 10Mg/Ml Ampul 4,167.00 0 0.00
50 1353 NaCl 0.9% Botol 6,410.00 0 0.00
54 1357 Salep 2-4 Tube 2,527.00 0 0.00
55 1358 Sefotaksim Serbuk Inj. 1mg Vial 4,282.00 0 0.00
57 1360 Infuset Anak set 3,597.00 0 0.00
58 1361 Infuset Dewasa Set 3,278.00 0 0.00
59 1520 Epinephrine Inj 1mg Ampul 1,749.00 0 0.00
65 1750 Digoksin 0.25 mg Tablet 104.00 0 0.00
68 1753 Isosorbid Dinitrat Tab 5Mg Tablet 89.00 0 0.00
70 2097 Antihemoroid supp Suppositori 3,167.00 0 0.00
a
72 2099 Fitomenadion Tab 10mg Tablet 710.00 0 0.00
103
77 2176 Diazepam Tablet 5mg Tablet 109.00 0 0.00
79 2178 Clobazam 10 Mg Tablet 776.00 0 0.00
82 2397 Cairan Cuci Tangan Tanpa Bilas (Herborist) 5 Galon 5 L 185,887.00 0 0.00
L
83 2398 RDT COVID-19 Test 0.00 0 0.00
85 2401 VTM Botol 0.00 0 0.00
86 2402 BBL Culture Swab Plus Botol 0.00 0 0.00
87 2427 Baju Coverall (Boho) XL Pcs 0.00 0 0.00
88 2428 Masker Telinga Plus (Surgical Mask 3 PLY) Pcs 0.00 0 0.00
SENSI
89 2429 Handscoon S (Latex Examination) Pcs 0.00 0 0.00
90 2430 BBL Culture Swab Plus Botol 8,361.88 0 0.00
91 2431 VTM (Virus Transport Media) Botol 0.00 0 0.00
92 2432 BD Sterile Swab Applicatiors Pcs 8,361.88 0 0.00
93 2433 Baju Coverall (Solida) XL Pcs 0.00 0 0.00
94 2434 Masker Telinga (Earloop) EVO Pcs 0.00 0 0.00
95 2452 VTM (Dengan 2 Stick Swab) Buah 0.00 0 0.00
96 2453 VTM (Dengan 1 Stick Swab) Buah 0.00 0 0.00
98 2455 Klorokuin Tablet 150mg Tablet 1,506.00 0 0.00
100 2473 VTM Vial 0.00 0 0.00
101 2474 Citoswab Collection Swab Pcs 3,100.00 0 0.00
102 2485 Baju Coverall Pcs 0.00 0 0.00
103 2486 Kacamata Goggle Pcs 0.00 0 0.00
104 2487 Handscoon L (T-Glove) Pcs 0.00 0 0.00
105 2488 Masker Telinga (3-ply Elastic Earloop) Pcs 0.00 0 0.00
106 2489 Masker Kain Pcs 0.00 0 0.00
107 2490 Masker N95 (Medical Respirator) Pcs 0.00 0 0.00
108 2491 Shoe Cover Pcs 0.00 0 0.00
109 2492 Face Shield Pcs 0.00 0 0.00
110 2516 VTM (Dengan 1 Stick Swab) Pcs 0.00 0 0.00
111 2517 RDT COVID-19 Test 0.00 0 0.00
112 2537 VTM (Dengan 1 Stick Swab) merk Genesis Pcs 0.00 0 0.00
113 2560 Masker Bedah Pcs 0.00 0 0.00
114 2561 Masker KN95 Pcs 0.00 0 0.00
115 2562 Sarung Tangan Non Steril Pcs 0.00 0 0.00
104
116 2563 Nurse Cap Pcs 0.00 0 0.00
117 2574 RDT COVID-19 Test 200,000.00 0 0.00
118 2575 VTM Test 114,400.00 0 0.00
119 2582 VTM (Dengan 1 Stick Swab) Pcs 0.00 0 0.00
120 2612 Baju Coverall (Kaltech) Pcs 0.00 0 0.00
121 2613 Masker Telinga (Earloop) 3ply M-i Pcs 2,475.00 0 0.00
123 2615 Klorokuin Tablet 150mg Tablet 850.00 0 0.00
125 2617 Asam Askorbat (Vit. C) Tab 250 Mg Tablet 124.00 0 0.00
126 2618 Masker Kain Pcs 5,450.00 0 0.00
127 2619 Spanduk Penggunaan Masker dan Cuci Pcs 0.00 0 0.00
Tangan
128 2620 Buku Pedoman Progam Pembersihan dan Buah 15,400.00 0 0.00
Sanitasi Edisi Covid-19
129 2621 Sticker Cara Menyimpan Stok Pangan Pcs 15,000.00 0 0.00
130 2622 Sticker Cara Aman dan Sehat Pesan Online Pcs 15,000.00 0 0.00
131 2623 Sticker Gerobak Dagang Pcs 15,000.00 0 0.00
132 2624 Sticker Gerobak Dagang Pcs 5,500.00 0 0.00
133 2625 Sticker Bersatu Melawan Covid-19 Pcs 2,500.00 0 0.00
134 2626 Sticker Jangan Lupa Masker dan Jaga Jarak Pcs 7,500.00 0 0.00
135 2627 Spanduk Kawasan Pakai MAsker dan CTPS Pcs 104,995.00 0 0.00
136 2628 Kacamata Goggle Pcs 60,000.00 6 360,000.00
137 2629 Face Shield Pcs 50,000.00 0 0.00
138 2630 Sepatu Boot Pasang 0.00 0 0.00
139 2631 Cairan Cuci Tangan Tanpa Bilas 1 Liter Botol 0.00 0 0.00
140 2632 Cairan Cuci Tangan Tanpa Bilas 100 ml Botol 0.00 0 0.00
141 2633 Cairan Cuci Tangan Tanpa Bilas 60 ml Botol 0.00 0 0.00
142 2634 RDT COVID-19 (Hightop) Test 130,000.00 0 0.00
143 2637 Tas Jogo Tonggo Pcs 100,000.00 0 0.00
144 2638 Baju Coverall Pcs 78,000.00 0 0.00
146 2640 Sarung Tangan Latex Pasang 13,500.00 0 0.00
147 2641 Thermo Gun Pcs 450,000.00 0 0.00
148 2642 Sprayer Otomatik Pcs 450,000.00 0 0.00
149 2643 Cairan Desinfektan (Anvir) Liter 15,000.00 0 0.00
150 2644 Cairan cuci Tangan Tanpa Bilas (Anvir) Liter 38,000.00 0 0.00
151 2645 Masker Kain Pcs 3,000.00 0 0.00
152 2646 Buku SATGAS Percepatan Penanganan Pcs 3,100.00 0 0.00
Covid-19
153 2647 Buku Percepatan Penanganan Covid-19 Pcs 3,100.00 0 0.00
154 2648 Instruksi Gubernur Pcs 2,800.00 0 0.00
155 2649 Buku Petunjuk Teknis Satgas Jogo Tonggo Pcs 15,500.00 0 0.00
156 2653 VTM (Dengan 2 Stick Swab) Pcs 104,000.00 0 0.00
105
157 2680 RDT COVID-19 (SD) STRIP 0.00 0 0.00
159 2721 VTM (Dengan 1 Stick Swab) Beaver Tube 0.00 0 0.00
162 2743 VTM (Dengan 2 Stick Swab) Rongye Pcs 45,000.00 0 0.00
163 2744 Baju Coverall (M-i) Pcs 190,000.00 0 0.00
164 2780 Face Shield Anak Pcs 0.00 0 0.00
165 2781 Baju Coverall (AE Ataka) Pcs 190,000.00 0 0.00
166 2782 Masker Telinga (Multi One Plus) Pcs 0.00 0 0.00
167 2783 Handscoon M (Safeglove) Pcs 0.00 0 0.00
168 2818 VTM (Dengan 2 Stick Swab) Citoswab Pcs 53,000.00 0 0.00
169 2819 RDT COVID-19 (Hightop) STRIP 122,727.00 0 0.00
170 2820 Masker N95 (Niosh) V-Fold B Pcs 13,200.00 0 0.00
171 2821 Masker KN95 (Tainuoer) Pcs 13,200.00 175 2,310,000.00
172 2822 Cairan cuci Tangan Tanpa Bilas (Instance) Galon 4L 0.00 0 0.00
75% 4L
173 2823 Alkohol 70% Liter 0.00 0 0.00
174 2824 Masker Telinga (Surgical Mask 3 PLY) SENSI Pcs 0.00 0 0.00
175 2856 Baju Coverall (I-Pan) Pcs 0.00 0 0.00
177 2862 Favipiravir Tablet 200mg Tablet 18,260.00 0 0.00
178 2863 Remdesivir Inj 100mg (Covipor) Vial 314,400.00 0 0.00
179 2864 Azitromisin Inj. 500 Mg Vial 110,000.00 0 0.00
181 2866 Masker N95 (DreamCan) Pcs 0.00 0 0.00
182 2867 Handscoon L (Shamrock) Pasang 3,375.00 0 0.00
183 2868 Asam Askorbat (Vit. C) Tab 500 mg Tablet 198.00 0 0.00
184 2869 RDT COVID-19 (Panbio Swab Test Antigen) STRIP 97,450.00 0 0.00
185 2870 RDT COVID-19 (SD Biosensor) STRIP 107,000.00 0 0.00
186 2872 Multivitamin & Zinc Kaplet (Sivit-Zinc) Kaplet 585.00 0 0.00
187 2880 Baju Coverall (Protect-U) Pcs 110,600.00 0 0.00
188 2881 VTM (Dengan 2 Stick Swab) Sorfa Pcs 47,250.00 0 0.00
189 2882 Levofloksasin Infus 750mg/150ml Botol 65,340.00 0 0.00
190 2888 Rapid Test Antigen (Indec) Pcs 107,800.00 0 0.00
106
201 2899 Nifedipin 20 Mg (Adalat Oros) Tablet 3,575.00 0 0.00
204 2902 Ringer Laktat Larutan Infus Botol 7,630.00 10 76,300.00
205 2903 Vitamin B1 (Thiamin) Tab 50mg Tablet 91.00 0 0.00
206 3078 Antihemoroid Supp Suppositori 3,167.00 0 0.00
a
207 3079 Ergotamin Caffein Tablet 185.00 380 70,300.00
211 3105 Remdesivir Inj 100mg (REMDAC) Vial 129,500.00 0 0.00
212 3122 ADS 0.5 Ml (Oneject) Pcs 1,185.00 0 0.00
213 3123 Safety Box 5 Lt Pcs 14,000.00 10 140,000.00
214 3124 Alkohol Swab Box 9,500.00 0 0.00
215 3139 Asam Askorbat (Vit. C) Inj. 200mg (Ascorin) Ampul 10,192.00 0 0.00
216 3140 Rapid Test Antigen (SARS-CoV-2) Flowflex Pcs 50,000.00 0 0.00
218 3142 Acetylcysteine Kapsul 200 mg Kapsul 373.00 0 0.00
219 3143 Levofloksasin Tablet 750 mg Tablet 2,682.00 0 0.00
221 3145 Azitromisin Inj. 500 Mg Vial 47,920.00 0 0.00
222 3161 Rapid Test Antigen (SD Biosensor) Pcs 69,978.00 0 0.00
223 3201 Baju Coverall (B-Safe) Pcs 125,000.00 158 19,750,000.00
224 3202 Rapid Test Antigen (Panbio) Pcs 82,500.00 0 0.00
225 3249 OT Ekstrak Mahkota Dewa (HerbaPAIN) Tablet 1,194.00 0 0.00
226 3250 OT Ekstrak Meniran Hijau (Stimuno Forte) Kapsul 1,815.00 0 0.00
Kapsul
227 3251 OT Ekstrak Meniran Hijau (Stimuno) Sirup Botol 19,690.00 0 0.00
228 3252 OT Silfamin 150mg (HerbaCOLD) Tablet Tablet 1,034.00 0 0.00
229 3265 VTM (Dengan 2 Stick Swab) ARKAN Pcs 40,000.00 0 0.00
MEDICAL
230 3266 Masker N95 (Niosh) V-Fold B Pcs 89,500.00 7 626,500.00
231 3267 Masker Telinga (Earloop) NB Pcs 750.00 0 0.00
232 3268 Masker KN95 (Tainuoer) Pcs 45,000.00 0 0.00
233 3331 Multivitamin Tablet (Becom - C) Kaplet 1,699.00 0 0.00
234 3333 Cooler Box 22L Pcs 500,000.00 0 0.00
235 3334 Cooler Box 5.5L Pcs 230,000.00 0 0.00
236 3335 Ice Gel Pcs 10,000.00 0 0.00
237 3336 Levofloksasin Infus 750mg/150ml Botol 48,290.00 0 0.00
238 3338 Baju Coverall (Solida) Pcs 175,000.00 0 0.00
107
239 3343 Rapid Test Antigen (Lyher) Novel CoronaVirus Pcs 97,450.00 0 0.00
241 3345 Handscoon M (General Care) Pcs 1,500.00 0 0.00
242 3346 Kapas Pembalut 100 gr Pcs 7,205.00 0 0.00
243 3347 Multivitamin Tablet (Bionicom Zinc) Tablet 594.00 30 17,820.00
245 3349 Asam Askorbat (Vit. C) Inj. 200mg Ampul 7,000.00 0 0.00
246 3350 Asam Askorbat (Vit. C) Tab 500 mg (Ramvit- Tablet 198.00 0 0.00
C)
247 3351 Vitamin D3 1000 IU (Caviplex D) Tablet 1,195.00 0 0.00
248 3352 Satu Set APD Paket 98,450.00 0 0.00
249 3407 Baju Coverall (OptimaCare) Pcs 175,000.00 0 0.00
250 3408 Masker Telinga (Earloop) EVO Pcs 3,000.00 500 1,500,000.00
251 3409 Masker KN95 Headloop (Jizhen) Pcs 40,000.00 0 0.00
252 3410 Masker N95 (DreamCan) Pcs 76,000.00 0 0.00
253 3411 Masker Kain Pcs 3,500.00 0 0.00
254 3412 Cairan Cuci Tangan Bilas (Aiken) Galon 4L 45,000.00 0 0.00
255 3413 VTM (Dengan 2 Stick Swab) ARKAN Pcs 24,000.00 123 2,952,000.00
MEDICAL
256 3414 Cairan Desinfektan (Anvir) Galon 5L 65,000.00 0 0.00
257 3415 Cairan cuci Tangan Tanpa Bilas (Anvir) Galon 5L 106,000.00 0 0.00
258 3416 Acetylcysteine Kapsul 200 mg Tablet 301.00 0 0.00
260 3490 Rapid Test Antigen (FlowFlex) Strip 36,363.60 0 0.00
261 3504 Rapid Test Antigen (FlowFlex) Strip 55,000.00 811 44,605,000.00
262 3505 Acetylcysteine Kapsul 200mg Kapsul 373.00 0 0.00
264 3511 Acetylcysteine Kapsul 200mg Kapsul 301.00 0 0.00
265 3512 Vitamin D3 1000 IU (Camvit D3) Tablet 634.00 0 0.00
266 3550 Favipiravir Tablet 200mg (FAVIMOL) Tablet 4,333.00 0 0.00
267 3552 Asam Askorbat (Vit. C) Tab 500 mg (Ramvit- Tablet 225.00 0 0.00
C)
268 3553 Rapid Test Antigen (Longsee) Strip 55,000.00 495 27,225,000.00
99,632,920.00

NIP. 196803312002121004 NIP. 19830605 201001 2 031
108
Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
109
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
110
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
111
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
360,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
112
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,310,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
113
0.00
0.00
0.00
0.00
0.00
0.00
76,300.00
0.00
0.00
70,300.00
0.00
0.00
0.00
0.00
0.00
140,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
19,750,000.00
0.00
0.00
0.00
0.00
0.00
0.00
626,500.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
114
0.00
0.00
0.00
0.00
17,820.00
0.00
0.00
0.00
0.00
0.00
0.00
1,500,000.00
0.00
0.00
0.00
0.00
2,952,000.00
0.00
0.00
0.00
0.00
0.00
44,605,000.00
0.00
0.00
0.00
0.00
0.00
0.00
27,225,000.00
0.00
99,632,920.00
S.Farm., Apt.
201001 2 031
115
Kecamatan SUSUKAN
Nomor Rekening: APBD1
Periode: Juni 2022
1 Kacamata Goggle Pcs 60,000.00 6 360,000.00
2 Masker KN95 (Tainuoer) Pcs 13,200.00 175 2,310,000.00
3 Ringer Laktat Larutan Infus Botol 7,630.00 10 76,300.00
4 Ergotamin Caffein Tablet 185.00 380 70,300.00
5 Safety Box 5 Lt Pcs 14,000.00 10 140,000.00
6 Baju Coverall (B-Safe) Pcs 125,000.00 158 19,750,000.00
7 Masker N95 (Niosh) V-Fold B Pcs 89,500.00 7 626,500.00
8 Multivitamin Tablet (Bionicom Zinc) Tablet 594.00 30 17,820.00
9 Masker Telinga (Earloop) EVO Pcs 3,000.00 500 1,500,000.00
10 VTM (Dengan 2 Stick Swab) ARKAN MEDICAL Pcs 24,000.00 123 2,952,000.00
11 Rapid Test Antigen (FlowFlex) Strip 55,000.00 811 44,605,000.00
12 Rapid Test Antigen (Longsee) Strip 55,000.00 495 27,225,000.00
99,632,920.00

NIP. 196803312002121004 NIP. 19830605 201001 2 031
116
Kecamatan SUSUKAN
Nomor Rekening: PROGRAM
Periode: Juni 2022
2 0044 Dietilcarbamazin 100Mg Tablet 0.00 0 0.00
3 0064 Garam Oralit Untuk 200Ml Air Sachet 292.00 0 0.00
4 0105 Mdt Mb Dewasa Blister 20,906.00 0 0.00
5 0106 Mdt Pb Blister 8,323.00 0 0.00
6 0107 Mdt Pb Dewasa Blister 6,539.00 0 0.00
7 0108 Mdt Pb Anak Blister 8,712.00 0 0.00
8 0123 Natrium Tiroksin 100 Mg Tablet 1,390.00 0 0.00
9 0127 Oat Kategori 1 (Fdc) Paket 359,900.00 0 0.00
10 0128 Oat Kategori Anak (Fdc) Paket 214,990.00 0 0.00
12 0148 Prednison Tab. 5Mg Tablet 64.00 0 0.00
15 0183 Zink Tablet Tablet 433.00 0 0.00
16 0190 Minyak Telon Botol 15,100.00 0 0.00
17 0214 Iodin Tes Botol 5,250.00 0 0.00
18 0227 Reagen Ziechl Nealson Kit 5X 100 267,550.00 0 0.00
Ml
19 0238 Box Slide Piecis 3,600.00 0 0.00
20 0265 Objek Glass Piecis 270.83 0 0.00
21 0266 Objek Glass Piecis 270.83 0 0.00
22 0275 Pot Sputum Piecis 2,790.00 0 0.00
24 0331 Rapid Tes HIV 3 (Vikia) Card 20,237.00 0 0.00
25 0332 Rapid Tes HIV (Oncoprobe) Strip 22,268.00 0 0.00
27 0341 Fenobarbital Inj. I.M/I.V 50Mg/Ml Ampul 1,800.00 0 0.00
30 0344 Iodin Tes Botol 2,750.00 0 0.00
32 0383 Mineral Mix Sachet 2,450.00 0 0.00
33 0384 Alat Test Cepat Garam Beryodium Kit 34,837.00 0 0.00
117
34 0385 MgSO4 20% Ampul 7,800.00 0 0.00
35 0386 CA Glukonas 10 24 Amp/10 CC - E Ampul 2,800.00 0 0.00
37 0400 Dihidro Artemisin + Piperakuin (DHP) Tablet 4,216.00 0 0.00
38 0401 Primakuin 15mG Tablet 2,607.00 0 0.00
39 0402 Artesunate inj. 60mG Vial 33,792.00 0 0.00
41 0458 Alat Test Cepat Garam Beryodium Kit 31,650.00 0 0.00
43 0460 Lamivudine (3TC) 150 mg Tablet 1,400.00 0 0.00
44 0461 Nevirapine 200mG Tablet 2,800.00 0 0.00
45 0462 Tenofovir (TDF) 300 mG Tablet 8,100.00 0 0.00
46 0463 Efavirenz 600mG Tablet 6,375.00 0 0.00
47 0464 Zidovudine + Lamivudine (300mg/150mg) Tablet 3,429.00 0 0.00
48 0465 Dewasa FDC Triple : Tenofovir 300mG + Tablet 11,100.00 0 0.00
Lamivudine 300mG + Efavirenz 600mG
49 0466 Zidovudine
(Tablet) (ZDV) + Lamivudine (3TC) 30mG + Tablet 2,850.00 0 0.00
Nevirapin (NVP) 50mG
50 0467 Rapid Tes HIV (SD) Card 22,330.00 0 0.00
51 0468 Rapid Tes Hiv (Intec) Card 22,358.00 0 0.00
52 0469 Rapid Tes Hiv (Oncoprobe) Card 22,385.00 0 0.00
53 0473 Alat Tes Kehamilan (terdiri dari 100 strip, untuk PKT @100 132,000.00 0 0.00
100kali pemeriksaan) Strip
54 0474 Golongan Darah Anti A Botol 10mL 84,425.00 0 0.00
55 0475 Golongan Darah Anti B Botol 10mL 84,425.00 0 0.00
56 0476 Golongan Darah Anti AB Botol 10mL 84,425.00 0 0.00
57 0477 Golongan Darah Anti D Botol 10mL 84,425.00 0 0.00
58 0478 Kartu Golongan darah PKT @100 27,500.00 0 0.00
buah
59 0479 Autolick Device Buah 27,500.00 0 0.00
60 0480 Jarum autolick Device PKT @100 16,500.00 0 0.00
buah
61 0481 Alat Tes Hemoglobin Tes Metode Sahli BTL 100mL 104,500.00 0 0.00
(Reagen HCL 0.1N)
62 0482 Buku Petunjuk Tehnis Penggunaan Alat Buah 22,000.00 0 0.00
Deteksi Dini Ibu Hamil Pelayanan atenatal
63 0485 Alat
BagiGluko
Bidan Protein Urine (pemeriksaan 3 PKT @100 77,000.00 0 0.00
parameter : pH, Glucose, Protein). Untuk 100 Strip
64 0486 Tempat Penampung Urine
kali pemeriksaa Cup 16,500.00 0 0.00
65 0496 zidovudine (ZDV) 100 mg (REVIRAL) tablet 1,575.00 0 0.00
66 0497 zidovudine (ZDV) 100 mg Tablet 1,575.00 0 0.00
67 0583 Mdt Pb Anak Blister 9,570.00 0 0.00
69 0603 Oat Kategori 1 Dewasa Kombipak Paket 288,199.00 0 0.00
70 0604 Isoniazid 100 mg Tablet 125.00 0 0.00
71 0605 Reagen Ziechl Nealson Kit 276,600.00 0 0.00
73 0607 Box Slide Box 57,100.00 0 0.00
74 0608 Reagen ZN Kit 276,000.00 0 0.00
118
75 0618 Tenofovir (TDF) 300 mg Tablet 1,400.00 0 0.00
77 0620 Zidovudine (ZDV) + Lamivudine (3TC) 30mG + Tablet 700.00 0 0.00
Nevirapin (NVP) 50mG
78 0621 Kotrimoksazol 480 mg Tablet 135.00 0 0.00
79 0649 Rapid 1 HIV (SD) Test 21,815.00 0 0.00
80 0650 Rapid 3 HIV (Oncoprobe) Test 22,475.00 0 0.00
81 0651 Rapid 1 HIV (Intec) Test 22,450.00 0 0.00
84 0814 zidovudine (ZDV) 100 mg Tablet 1,700.00 0 0.00
85 0815 Oat Kategori 1 (FDC) Paket 359,985.00 0 0.00
88 0831 Efavirenz 600mg Tablet 1,405.70 0 0.00
89 0832 Pediatrik FDC Triple : Zidovudine + Tablet 684.40 0 0.00
Lamivudine + Nevirapin
92 0843 Sarung Tangan Disposible Box 49,610.00 0 0.00
93 0844 Swab Desinfektan Kotak 235,000.00 0 0.00
@100Pcs
94 0845 KOH 10% Botol 18,000.00 0 0.00
95 0846 NaCl 0.9% Botol 18,500.00 0 0.00
96 0847 MB (Methylen Blue) 0.3% Botol 57,600.00 0 0.00
97 0848 Xylol Botol 66,000.00 0 0.00
98 0849 Zidovudine (ZDV) 300 mg + Lamivudine (3TC) Tablet 3,700.00 0 0.00
150 mg
100 0851 Pediatrik
(Tablet) FDC Triple : Zidovudine + Botol (60 41,064.00 0 0.00
Lamivudine + Nevirapin tab)
103 0883 Pot Dahak Steril Pcs 5,890.00 0 0.00
105 0977 mineral mix Sachet 2,726.90 0 0.00
106 1050 Zidovudine (ZDV) 300 mg + Lamivudine (3TC) Tablet 3,700.00 0 0.00
150 mg
108 1052 Rapid 1 HIV (SD) Test 22,385.00 0 0.00
111 1056 Reagen ZN Kit 276,500.00 0 0.00
115 1092 Dihidro Artemisin 40mg + Piperakuin 320mg Tablet 3,498.00 0 0.00
(DHP)
119
116 1093 Primakuin 15mg Tablet 224.00 0 0.00
120 1179 Risperidone 2mg Tablet 1,008.00 0 0.00
123 1186 Masker 3M 1860 S N95 Box 396,500.00 0 0.00
124 1187 Masker 3M 1860 N95 Box 396,500.00 0 0.00
125 1188 Masker 3M 1870 + Aura N95 Box 426,500.00 0 0.00
127 1218 Garam Oralit Serbuk Sachet 288.00 0 0.00
130 1232 Ergotamin Caffein Tablet 201.00 0 0.00
132 1234 Gentian Violet 1%,10 Ml Botol 10mL 1,420.00 0 0.00
133 1235 Propanolol Tab 40Mg Tablet 110.00 0 0.00
134 1305 Rapid 1 HIV (SD) Test 14,340.00 0 0.00
135 1306 Rapid 2 HIV (Fokus) Test 14,470.00 0 0.00
136 1307 Rapid 3 HIV (Vikia) Test 495,554.75 0 0.00
137 1308 Swab Desinfektan Kotak 198,500.00 0 0.00
@100Pcs
140 1323 Calcii Gluconas i.m./i.v Injeksi Ampul 9,955.00 0 0.00
141 1324 Euthyrox (Levothyroxine Sodium) 100mg Tablet 944.00 0 0.00
Tablet
145 1329 MgSO4 (OTSU) 40% Ampul 3,650.00 0 0.00
150 1459 Dihidro
(Tablet)Artemisin 40mg + Piperakuin 320mg Tablet 2,160.00 0 0.00
(DHP)
152 1465 Rapid 3 HIV (Vikia) Card 19,822.19 0 0.00
154 1532 Nevirapine 200mG
(Tablet) Tablet 2,940.00 0 0.00
155 1533 Hbsag Wb Multi (SD) strip 9,850.00 0 0.00
156 1548 Glukosa Monohidrat bh 0.00 0 0.00
120
157 1549 Alat Suntik 10 ml (Syringe) bh 0.00 0 0.00
158 1550 Kit RDT Malaria Box 0.00 0 0.00
159 1551 Wing Needle No. 25 bh 0.00 0 0.00
160 1552 Tabung Vacumtainer Plain 10ml bh 0.00 0 0.00
161 1553 Tabung Vacumtainer Plain 5 ml bh 0.00 0 0.00
162 1554 Lancet Pak 0.00 0 0.00
163 1555 Absorbant Pads lbr 0.00 0 0.00
164 1556 Rak Pewarnaan bh 0.00 0 0.00
165 1557 Botol Semprot Botol 0.00 0 0.00
166 1558 Perasa Makanan Botol 0.00 0 0.00
167 1559 Tourniquet 0.00 0 0.00
168 1560 Larutan Giemsa Stock Botol 0.00 0 0.00
169 1561 Stick Hemocur Microcuvettes Botol 0.00 0 0.00
170 1562 Alkohol Swab Box 0.00 0 0.00
171 1563 Alat Suntik 5 ml (Syringe) bh 0.00 0 0.00
172 1564 Gelas Ukur Giemsa bh 0.00 0 0.00
173 1565 Slide Malaria Box 0.00 0 0.00
174 1566 Thermafreeze lbr 0.00 0 0.00
175 1567 Rak Styroform bh 0.00 0 0.00
176 1568 Hemocue Cleaner bh 0.00 0 0.00
180 1647 Catridge GeneXpert Pcs 154,438.00 0 0.00
185 1679 Lugol Botol 30,000.00 0 0.00
186 1680 Plastik Pembungkus Obat Pak 9,800.00 0 0.00
190 1685 Dosis Harian TB HIV Fase Awal Tablet 449.00 0 0.00
191 1686 Dosis Harian TB HIV Fase Lanjutan Tablet 899.00 0 0.00
193 1706 Abacavir Tablet 300 mg Tablet 7,595.50 0 0.00
194 1707 Lopinavir 200mg + Ritonavir 50mg (ALUVIA) Tablet 6,600.00 0 0.00
195 1708 Tenofovir 300mg + Emtricitabine 200mg Tablet 3,275.76 0 0.00
Xpert MTB/Rif
197 1711 Reagen Syphilis Ab Test 20,400.00 0 0.00
121
198 1712 MgSO4 (OTSU) 40% Ampul 3,796.00 0 0.00
199 1713 Mdt Pb Dewasa Blister 12,569.00 0 0.00
201 1715 Reagen
(Tablet) ZN Kit 254,165.00 0 0.00
202 1716 Rapid Tes HIV 1 (SD) Test 11,975.00 0 0.00
203 1717 Rapid 2 HIV (Fokus) Test 13,235.00 0 0.00
204 1718 Rapid 3 HIV (Vikia) Test 19,480.00 0 0.00
205 1719 Kondom Sutra Pcs 358.00 129 46,182.00
213 1727 Nevirapine 200mG Tablet 3,058.00 0 0.00
215 1729 Pediatrik FDC Triple : Zidovudine + Botol (60 44,409.00 0 0.00
217 1731 Masker N95 1860S Buah 23,510.00 0 0.00
218 1732 Masker N95 1860 Buah 23,510.00 0 0.00
219 1733 Masker N95 1870 + Buah 30,996.00 0 0.00
220 1734 Dewasa FDC Triple : Tenofovir 300mG + Botol (30 89,681.00 0 0.00
Lamivudine 300mG + Efavirenz 600mG tab)
221 1759 Lamivudine
(Tablet) (3TC) 150 mg Botol (60 93,600.00 0 0.00
tab)
222 1760 Efavirenz 600mG Botol (30 198,900.00 0 0.00
tab)
223 1761 Nevirapine 200mG Botol (60 183,480.00 0 0.00
tab)
224 1762 Tenofovir (TDF) 300 mG Botol (30 252,720.00 0 0.00
tab)
225 1763 Zidovudine (ZDV) 300 mg + Lamivudine (3TC) Botol (60 230,880.00 0 0.00
150 mg tab)
227 1834 Reagen ZN
(Tablet) Kit 257,151.00 0 0.00
231 1929 MgSO4 (OTSU) 40% Ampul 3,796.00 0 0.00
232 1930 Ampisillin Serbuk Injeksi 1000mg Botol 8,237.00 2 16,474.00
234 1932 Metronidazol Infus 5mg/ml Botol 8,110.00 0 0.00
238 1957 Kondom Sutra Buah 358.00 432 154,656.00
122
Xpert MTB/Rif
240 1961 Lopinavir 200mg + Ritonavir 50mg (ALUVIA) Botol (120 809,613.00 0 0.00
tab)
241 1962 Zidovudine + Lamivudine (300mg/150mg) Botol (60 222,000.00 0 0.00
tab)
242 1963 Tenofovir 300mg + Emtricitabine 200mg Botol (30 70,497.00 0 0.00
tab)
243 1978 Primakuin 15mG Tablet 253.00 0 0.00
(DHP)
248 2027 Pot Dahak Steril Pcs 2,728.00 280 763,840.00
Xpert MTB/Rif
252 2044 Rapid 2 HIV (Fokus) Strip 13,235.00 0 0.00
253 2045 Rapid 3 HIV (Vikia) Strip 19,480.00 0 0.00
256 2050 Lopinavir 200mg + Ritonavir 50mg (ALUVIA) Botol (120 792,000.00 0 0.00
tab)
tab)
258 2052 Tenofovir 300mg + Emtricitabine 200mg Botol (30 303,461.00 0 0.00
tab)
261 2055 Cool Box
(Tablet) Buah 249,000.00 0 0.00
262 2056 Ice Gel Pack Buah 18,500.00 0 0.00
263 2057 Ziplock Plastik Big Size Buah 10,900.00 0 0.00
264 2058 Ziplock Plastik Small Size Buah 5,900.00 0 0.00
265 2059 Parafilm Buah 439,900.00 0 0.00
266 2060 Brown Tape Buah 27,500.00 0 0.00
267 2061 Stiker Buah 10,000.00 0 0.00
268 2062 Spidol Buah 7,500.00 0 0.00
269 2063 ADS 0.5 Ml (Skifa) Pcs 1,185.00 0 0.00
270 2064 ADS 5 Ml ( Skifa ) Pcs 1,583.00 100 158,300.00
271 2065 Safety Box 5 Lt Piecis 24,122.00 100 2,412,200.00
277 2071 Albendazole 400mg Tablet 1,041.97 0 0.00
Xpert MTB/Rif
123
282 2148 Hbsag Wb Multi (SD) Strip 9,850.00 0 0.00
283 2156 Zidovudine + Lamivudine (300mg/150mg) Botol 222,000.00 0 0.00
284 2157 Tenofovir 300mg + Emtricitabine 200mg Botol 75,332.00 0 0.00
285 2205 Zidovudine (ZDV) 100 mg Botol 106,080.00 0 0.00
286 2206 Nevirapine 200mG Botol 176,400.00 0 0.00
290 2210 Pediatrik FDC Triple : Zidovudine + Botol 41,383.00 0 0.00
(DHP)
292 2216 Reagen Syphilis Ab Test 20,400.00 0 0.00
Xpert MTB/Rif
297 2358 Reagen ZN Kit 233,234.00 0 0.00
298 2359 Objek Glass Box isi 72 21,747.00 25 543,675.00
tab)
300 2365 Masker Telinga (Earloop) Jilbab TP Pcs 314.00 1,800 565,200.00
301 2469 Hbsag (Virocheck) STRIP 8,090.00 0 0.00
Xpert MTB/Rif
305 2567 Efavirenz 600mG Botol 198,900.00 0 0.00
309 2571 Dewasa FDC Triple : Tenofovir 300mG + Botol 84,050.00 0 0.00
310 2572 Garam
(Tablet)Oralit Serbuk Sachet 257.00 0 0.00
311 2654 Mdt MB Dewasa Blister 36,579.00 0 0.00
312 2655 Mdt PB Dewasa Blister 15,014.00 0 0.00
314 2660 Lopinavir 200mg + Ritonavir 50mg (ALUVIA) Botol 854,362.00 0 0.00
316 2695 Albendazole Suspensi 200mg/5ml Botol 4,000.00 0 0.00
318 2697 Reagen ZN Kit 233,234.00 0 0.00
319 2698 Masker N95 3M 1860 Respirator Pcs 21,736.00 0 0.00
124
321 2705 DBS Collection Kit Kit 356,953.00 0 0.00
323 2707 Flukonasol 150mg Tablet 18,000.00 0 0.00
324 2719 Reagen Syphilis (Trepocheck) STRIP 9,609.00 0 0.00
325 2720 Reagen Syphilis (Trepocheck) STRIP 9,000.00 0 0.00
326 2740 Hbsag (Virocheck) STRIP 8,210.00 0 0.00
328 2765 Rapid Tes HIV 2 (KHB) STRIP 13,363.00 0 0.00
329 2766 Rapid Tes HIV 3 (DS) STRIP 13,363.00 0 0.00
330 2767 Lamivudine (3TC) 150 mg Botol (60 93,600.00 0 0.00
tab)
tab)
332 2769 Tenofovir (TDF) 300 mG Botol (30 252,720.00 0 0.00
tab)
tab)
336 2854 Lopinavir 200mg + Ritonavir 50mg (ALUVIA)
(Tablet) TENOLAM Botol (120 792,000.00 0 0.00
tab)
339 2873 Efavirenz 600mG Botol 198,900.00 0 0.00
340 2874 Tenofovir (TDF) 300 mG Botol 252,720.00 0 0.00
343 2877 Rilpivirine
(Tablet) (RPV) Tab 25mg Botol 93,810.00 0 0.00
345 2904 Hbsag (Virocheck) Test 9,850.00 217 2,137,450.00
346 2910 Vaksin Anti Rabies (VERORAB) Ampul 164,030.00 0 0.00
348 2958 Oat Kategori 1 (Fdc) Dosis Harian Tablet 409,461.00 0 0.00
349 2959 Dolutegravir 50mg Botol 53,186.00 0 0.00
350 2960 Dolutegravir, Lamivudine, Tenofovir Botol 83,916.00 0 0.00
(50,300,300mg)
351 2961 Kuinin Sulfat 222mg Tab Tablet 670.00 0 0.00
(DHP)
354 2964 Artesunate inj. 60mG Vial 62,500.00 0 0.00
356 2966 RDT Malaria (Combo) Box 7,710.00 0 0.00
359 3084 Reagen Zn Kit 218,000.00 0 0.00
360 3085 Pot Dahak Steril Pcs 2,728.00 0 0.00
361 3086 Masker Telinga (Ekomed Medical) Pcs 386.10 0 0.00
125
362 3103 Tablet Tambah Darah Tablet 226.00 66,140 14,947,640.00
364 3125 Lopinavir 200mg + Ritonavir 50mg (ALUVIA) Botol 792,000.00 0 0.00
367 3128 Abacavir 120 mg + Lamivudine 60 mg Tablet Botol 101,365.00 0 0.00
368 3129 Lopinavir 40mg + Ritonavir 10mg Box 294,122.00 0 0.00
369 3138 ADS 0.05 Ml (Oneject) Pcs 1,460.00 0 0.00
(DHP)
373 3356 Larutan Giemsa Botol 358,800.00 0 0.00
374 3357 Zink Tablet Dispersible 20mg Tablet 524.00 5 2,620.00
376 3420 Tenofovir (TDF) 300 mG Botol 252,720.00 0 0.00
378 3479 Rapid 1 HIV
(Tablet) (ViroCheck)
TELURA pcs 8,094.00 325 2,630,550.00
379 3480 Rapid 2 HIV (Diagnostar) pcs 11,500.00 25 287,500.00
380 3481 Rapid 3 HIV (SD Biosensor) Test 11,200.00 25 280,000.00
381 3483 HCV (Startes) Test 12,000.00 0 0.00
382 3484 Garam Oralit Serbuk Sachet 274.00 61 16,714.00
383 3485 Oat Kategori 1&3 (Fdc) Dosis Harian Paket 409,461.00 0 0.00
389 3495 Dolutegravir
(Tablet) 50mg
TELURA Botol 40,516.00 0 0.00
(50,300,300mg)
391 3497 Abacavir 120 mg + Lamivudine 60 mg Tablet Botol 48,548.00 0 0.00
392 3498 Lopinavir 40mg + Ritonavir 10mg (ALLTERA) Box 294,122.00 0 0.00
394 3500 Albendasol 400 Mg Tablet 380.00 6,200 2,356,000.00
395 3509 Masker N95 (DreamCan) Pcs 19,900.00 40 796,000.00
399 3529 Rapid 2 HIV (Diagnostar) Pcs 11,500.00 0 0.00
400 3530 Rapid 3 HIV (SD Biosensor) Pcs 11,200.00 0 0.00
401 3531 Masker Telinga (Earloop) EKOMED MEDICAL Pcs 693.00 0 0.00
126
(50,300,300mg)
407 3547 Abacavir 120 mg + Lamivudine 60 mg tablet Botol 48,548.00 0 0.00
408 3548 Tenofovir 300mg + Emtricitabine 200mg Tablet 4,600.00 0 0.00
410 3606 Lopinavir 200mg + Ritonavir 50mg (LOPIVIA) Botol (120 618,000.00 0 0.00
tab)
(50,300,300mg)
412 3608 Zidovudine (ZDV) 100 mg botol 121,980.00 0 0.00
413 3609 Lopinavir 40mg + Ritonavir 10 mg (ALLTERA) Box 294,122.00 0 0.00
Xpert MTB/Rif
420 3707 OAT Kategori 1 (Fdc) Dosis Harian Paket 398,362.00 0 0.00
422 3709 Garam Oralit Serbuk Sachet 274.00 100 27,400.00
423 3710 Hbsag (Virocheck) Test 7,338.00 0 0.00
424 3711 Hepatitis B Immune (HyperHep B) Vial 1,325,000.00 0 0.00
425 3718 RDT Malaria (Combo) Test 4,830.00 0 0.00
(DHP)
429 3767 Serum Anti Rabies Vial 1,653,399.00 0 0.00
430 3768 Serum Anti Rabies Vial 153,000.00 0 0.00
28,302,241.00

NIP. 196803312002121004 NIP. 19830605 201001 2 031
127
Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
128
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
129
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
130
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
131
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
132
0.00
0.00
0.00
0.00
0.00
0.00
0.00
46,182.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
16,474.00
0.00
0.00
0.00
0.00
0.00
154,656.00
133
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
763,840.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
158,300.00
2,412,200.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
134
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
543,675.00
0.00
565,200.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
135
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,137,450.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
136
14,947,640.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,620.00
0.00
0.00
0.00
2,630,550.00
287,500.00
280,000.00
0.00
16,714.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,356,000.00
796,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
137
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
159,840.00
27,400.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
28,302,241.00
S.Farm., Apt.
201001 2 031
138
Kecamatan SUSUKAN
Nomor Rekening: PROGRAM
Periode: Juni 2022
1 Kondom Sutra Pcs 358.00 129 46,182.00
2 Ampisillin Serbuk Injeksi 1000mg Botol 8,237.00 2 16,474.00
3 Kondom Sutra Buah 358.00 432 154,656.00
4 Pot Dahak Steril Pcs 2,728.00 280 763,840.00
5 ADS 5 Ml ( Skifa ) Pcs 1,583.00 100 158,300.00
6 Safety Box 5 Lt Piecis 24,122.00 100 2,412,200.00
7 Objek Glass Box isi 72 21,747.00 25 543,675.00
8 Masker Telinga (Earloop) Jilbab TP Pcs 314.00 1,800 565,200.00
9 Hbsag (Virocheck) Test 9,850.00 217 2,137,450.00
10 Tablet Tambah Darah Tablet 226.00 66,140 14,947,640.00
11 Zink Tablet Dispersible 20mg Tablet 524.00 5 2,620.00
12 Rapid 1 HIV (ViroCheck) pcs 8,094.00 325 2,630,550.00
13 Rapid 2 HIV (Diagnostar) pcs 11,500.00 25 287,500.00
14 Rapid 3 HIV (SD Biosensor) Test 11,200.00 25 280,000.00
15 Garam Oralit Serbuk Sachet 274.00 61 16,714.00
16 Albendasol 400 Mg Tablet 380.00 6,200 2,356,000.00
17 Masker N95 (DreamCan) Pcs 19,900.00 40 796,000.00
19 Garam Oralit Serbuk Sachet 274.00 100 27,400.00
28,302,241.00

NIP. 196803312002121004 NIP. 19830605 201001 2 031
139
Kecamatan SUSUKAN
Nomor Rekening: 1.02.02.2.01.16
Periode: Juni 2022
11 2997 Fitomenadion Inj. 2mg/ml Ampul 3,682.00 2 7,364.00
13 3003 Gentamicin 0.1% Salep Kulit Tube 2,937.00 0 0.00
14 3004 Ambroxol Sirup 15mg/5ml Botol 4,960.00 4 19,840.00
15 3005 Kaptopril Tablet 25 Mg Tablet 75.00 0 0.00
16 3006 Asam Folat 1 Mg Tablet 104.28 50 5,214.00
22 3036 Ibuprofen Tablet 200mg Tablet 185.90 34 6,320.60
23 3037 Parasetamol Sirup 120Mg/5Ml Botol 1,160.00 126 146,160.00
24 3041 Salep 2-4 Tube 1,410.00 1 1,410.00
25 3042 Kloramfenikol Salep Kulit (Bufacetin) 2% Tube 3,266.00 42 137,172.00
27 3044 Diltiazem Hcl 30 Mg Tablet 129.00 0 0.00
28 3045 Natrium Diklofenak 50mg Tablet 99.00 500 49,500.00
29 3046 Ondansetron Inj. 4 Mg Ampul 873.00 79 68,967.00
30 3047 Hiosin N Butilbromide Inj 20 mg/ml Ampul 5,678.00 0 0.00
32 3049 Asam Mefenamat Kaplet 500 Mg Tablet 111.00 10,129 1,124,319.00
140
34 3051 Lansoprazole 30 mg Kapsul 278.00 1,570 436,460.00
35 3052 Metformin 500 Mg Tablet 77.00 6,135 472,395.00
36 3053 Amoksisilin Kaplet 500 Mg Kaplet 201.00 15,464 3,108,264.00
37 3054 Omeprazole 20mg Kapsul 129.00 750 96,750.00
40 3058 Hidrokortison Salep Kulit 2.5 % Tube 2,325.00 25 58,125.00
41 3059 Antihemoroid supp Suppositori 3,250.00 17 55,250.00
a
42 3060 Clopidogrel Bisulfate 75 mg Tablet 575.00 0 0.00
43 3061 Metoklopramid Tab 10 Mg Tablet 66.00 800 52,800.00
44 3063 Nistatin Drop 100.000 IU Botol 11,500.00 0 0.00
45 3064 Fenol Gliserol Tetes Telinga 10% Botol 3,300.00 48 158,400.00
46 3065 Domperidone Maleate Tab. 10 Mg Tablet 71.00 1,770 125,670.00
48 3067 Zink Sirup Botol 2,489.00 10 24,890.00
50 3069 Antasida Doen Tablet Kunyah Tablet 54.00 4,335 234,090.00
51 3070 Kalsium Laktat (Kalk) Tab.500Mg Tablet 60.00 11,469 688,140.00
52 3071 Glukose Larutan Infus 5% Botol 6,627.00 120 795,240.00
53 3072 Natrium Klorida Lar. Infus 0,9% Botol 6,800.00 300 2,040,000.00
54 3073 Kaptopril Tablet 25 Mg Tablet 75.00 7,676 575,700.00
58 3108 Permethrin Krim 5% Tube 6,325.00 11 69,575.00
59 3109 Haloperidol Tab 5 Mg Tablet 54.00 0 0.00
60 3110 Vitamin B.Complek Tablet 57.00 348 19,836.00
61 3112 Hepatitis B Immune (HyperHep B) Vial 1,375,000.00 0 0.00
62 3130 Kotrimoksazol 480 Mg Tablet 126.00 2,040 257,040.00
63 3131 Hiosina N Butil Bromida 10 Mg Tablet 1,050.00 200 210,000.00
64 3133 Lidokain 2% Ampul 847.00 104 88,088.00
65 3134 Difenhidramin Hcl Inj. 10 Mg/ Ampul 781.00 0 0.00
66 3135 Dexametason Inj. 5Mg/1Ml Ampul 924.00 168 155,232.00
67 3136 Fitomenadion Tab 10mg Tablet 748.00 5 3,740.00
68 3137 Fitomenadion Inj. 2mg/ml Ampul 1,386.00 125 173,250.00
69 3149 Oseltamivir Kapsul 75 mg Tablet 13,000.00 100 1,300,000.00
70 3151 OT Ekstrak Daun Jati Belanda dll (Prolipid) Kapsul 1,095.71 0 0.00
72 3162 Doksisiklin 100 Mg Kapsul 462.57 260 120,268.20
73 3163 Betahistin Mesilat 6 Mg Tablet 397.39 731 290,492.09
74 3164 Metil Prednisolon 4mg Tablet 319.10 710 226,561.00
141
75 3165 Sefadroksil 500 Mg Kapsul 720.50 1,960 1,412,180.00
76 3166 Azitromisin 500 Mg Tablet 3,235.00 292 944,620.00
77 3167 Multivitamin Tablet (Arkavit C+DEZ) Kapsul 895.00 32 28,640.00
78 3169 Ibuprofen Tablet 200mg Tablet 194.04 1,800 349,272.00
79 3170 Amoksisilin Sirup Kering 125mg/5ml Botol 3,294.50 111 365,689.50
81 3172 Asiklovir Krim 5% Tube 3,047.00 80 243,760.00
83 3174 OT Ekstak Apii Herba dan Orthosipon Folium Kapsul 2,126.00 0 0.00
(TENSIGARD)
84 3175 OT Ekstrak Curcumin, Cynarin, Cardui mariae Kapsul 2,794.00 0 0.00
(HEPAGARD)
85 3176 Metamisol + diazepam (Metaneuron) Kaplet 1,141.98 300 342,594.00
86 3177 Ibuprofen Tablet 400mg Tablet 235.40 800 188,320.00
87 3178 OT Ekstrak graptophylli Folium dan Citrus Kapsul 1,551.00 0 0.00
Bioflavonoid (HEMOROGARD)
88 3179 Obat Batuk Kombinasi Mengandung Botol 11,550.00 34 392,700.00
89 3180 Oksitetrasiklin Salep Klulit 3% Tube 4,554.00 50 227,700.00
90 3181 Sediaan Mengandung Glucosamin HCl, Kapsul 3,283.50 0 0.00
Chondroitin sulfate, Vit C, Mn (OSTEOTIN)
91 3182 Sediaan Mengandung Lutein dan Ekstrak Kapsul 4,727.80 0 0.00
Buah Bilberry (OCUGARD)
92 3183 Antiinfluenza (Noza) Kaplet 797.50 0 0.00
93 3186 Triamsinolon Asetonida 1mg (Genalog) Tube 18,480.00 4 73,920.00
94 3187 Obat Batuk Kombinasi Mengandung Tablet 487.96 90 43,916.40
95 3188 Ekstra plasenta + Neomisin Sulfat (Neocenta Tube 16,808.00 22 369,776.00
Gel)
96 3189 Heparin Sodium (Hico) Gel Tube 20,163.00 18 362,934.00
97 3190 Meloksikam Tablet 7.5 mg Tablet 323.40 0 0.00
98 3195 Multivitamin (Recovit) Sirup Botol 7,920.00 4 31,680.00
99 3196 Prednison tablet 5 mg Tablet 68.00 80 5,440.00
100 3206 OT Ekstrak Meniran Hijau (Stimuno) Sirup Botol 25,548.00 0 0.00
101 3207 OT Ekstrak Meniran Hijau (Stimuno Forte) Kapsul 1,763.00 44 77,572.00
Kapsul
102 3208 Risperidone 2mg Tablet 123.00 140 17,220.00
103 3210 Bisakodil 5mg Tablet Tablet 216.00 300 64,800.00
104 3211 Vitamin B12 Tablet 50 Mg Tablet 43.00 1,180 50,740.00
105 3213 Eritromisin Sirup Kering 200mg/5ml Botol 6,462.00 0 0.00
106 3215 Azitromisin 500 Mg Tablet 1,136.35 2,400 2,727,240.00
107 3216 Serum Anti Tetanus (Biosat 1.500 IU) Ampul 130,999.00 6 785,994.00
108 3217 Obat Herbal Melancarkan Asi (ASIFIT) Kaplet 2,152.50 120 258,300.00
109 3218 Obat Kumur Sariawan (Enkasari Herbal) Botol 18,754.00 26 487,604.00
111 3220 Bromheksin Hcl Tablet 8 mg (Hustab P) Tablet 256.65 0 0.00
112 3221 Bedak Salisil 2% Pcs 6,426.00 144 925,344.00
113 3222 Minyak Kayu Putih (Fitocare) Botol 13,289.00 2 26,578.00
114 3223 Metamisol + Diazepam (Metaneuron) Tablet 1,142.00 244 278,648.00
115 3224 Sediaan Mengandung Glucosamin HCl, Kapsul 3,284.00 0 0.00
Chondroitin sulfate, Vit C, Mn (OSTEOTIN)
142
119 3231 Simetidin Tab. 200 Mg (Lexamet) Tablet 319.00 4,305 1,373,295.00
120 3232 Metronidazol 500Mg (Molazol) Tablet 396.00 1,210 479,160.00
121 3233 Neurotropik (Molaneuron) Tablet 785.00 890 698,650.00
122 3234 Antidiare (Molagit) Tablet Tablet 559.00 300 167,700.00
124 3236 Salbutamol (Ventolin) Nebules 2,5mg Ampul 12,589.00 21 264,369.00
125 3237 Asam Askorbat (Vit. C) Tab 500 mg (Halowell) Kaplet 953.00 0 0.00
126 3238 Mikonazole Krim 2% Tube 4,950.00 50 247,500.00
127 3239 Guaifenesin Tab 100mg Tablet 219.00 145 31,755.00
128 3240 Asam Traneksamat 500mg (Nexitra) Kaplet 1,984.00 0 0.00
129 3241 Vitamin D3 1000 IU (Natureline) Tablet 2,175.00 60 130,500.00
130 3247 Obat Batuk Herbal (Herbakof) Sirup Botol 14,273.00 102 1,455,846.00
132 3281 Domperidon Suspensi 5mg/ 5ml Botol 2,296.00 130 298,480.00
133 3283 Glukose Larutan Infus 5% Botol 6,626.40 40 265,056.00
135 3285 Betadine Obat Kumur Botol 27,000.00 14 378,000.00
136 3286 Yodium Povidon Lart. 10 % 60 Ml (Betadine) Botol 25,016.40 23 575,377.20
137 3287 Betametason + Neomisin Sulfat (Erladerm-N) Tube 5,335.00 21 112,035.00
Krim
138 3288 Kloramfenikol Tetes Telinga 1% (Erlamycetine) Botol 9,460.00 0 0.00
139 3289 Obh Molex Sirup Botol 5,142.50 104 534,820.00
142 3292 Aqua Pro Injeksi (Otsu) Ampul 2,385.90 10 23,859.00
143 3293 Sefiksim 100mg Kapsul 1,314.63 12 15,775.56
144 3294 Asam Asetyl Salisilat (Miniaspi) 80mg Tablet 89.00 0 0.00
145 3295 Multivitamin & Mineral Tablet (Pehavral) Tablet 738.08 0 0.00
146 3296 Multivitamin Tablet (Arkavit C+DEZ) Kapsul 895.00 0 0.00
147 3297 Multivitamin & Mineral Tablet (Recovit Plus) Tablet 605.00 5,430 3,285,150.00
149 3306 Parasetamol Sirup 120Mg/5Ml Botol 1,160.00 712 825,920.00
150 3310 Aminopilin Tab Salut 200 Mg (Erphafillin) Tablet 296.45 0 0.00
151 3311 Glimepirid 2 Mg Tablet 315.04 809 254,867.36
152 3317 Guaifenesin Tab 100mg Tablet 212.00 1,287 272,844.00
153 3318 Ambroxol Tablet 30mg Tablet 140.50 5,881 826,280.50
154 3319 Multivitamin & Mineral Tablet (Hemafort) Tablet 769.00 5,000 3,845,000.00
155 3329 Piridoksin (B6) Tab. 10Mg Tablet 105.15 2,509 263,821.35
156 3330 Vitamin B1 (Thiamin) Tab 100mg Tablet 300.00 2,750 825,000.00
143
157 3340 Dexamethasone 0.5Mg Tablet 47.58 4,055 192,936.90
158 3341 Hepatitis B Immune (HyperHep B) vial 1,375,000.00 1 1,375,000.00
160 3361 Furosemida Tab 40Mg Tablet 200.20 75 15,015.00
161 3362 Vitamin D3 1000 IU (Solvita D) Kaplet 1,430.00 560 800,800.00
162 3363 Metronidazol 500Mg Tablet 320.00 500 160,000.00
163 3364 Bromheksin Syrup (Lexavon) Botol 5,656.75 0 0.00
165 3367 Ketokonazole 200Mg Tablet 658.02 335 220,436.70
166 3368 Oksitosin Inj. 10 Ul/ml Ampul 3,850.00 50 192,500.00
167 3369 Epinephrine Inj 1mg Ampul 13,300.10 36 478,803.60
168 3370 OT Ekstrak graptophylli Folium dan Citrus Kapsul 1,435.00 250 358,750.00
169 3371 Obat Herbal Membantu Menjaga Kesehatan Kapsul 2,795.00 2,030 5,673,850.00
170 3372 Minyak Kayu Putih (Fitocare) Botol 13,289.00 0 0.00
171 3375 Klorpromazine 100 mg Tablet 250.00 540 135,000.00
172 3378 Triheksipenidil 2mg Tablet 63.00 160 10,080.00
175 3391 Ketokonazole Krim 2% Tube 2,349.00 156 366,444.00
177 3396 Kloramfenikol Tetes Telinga 1% (RECO) Botol 8,250.00 100 825,000.00
178 3397 Flunarisin Tablet 5mg Tablet 1,100.00 460 506,000.00
179 3398 Seftriakson injeksi 1 gr/vial vial 6,003.36 0 0.00
180 3399 Parasetamol 500Mg Tablet 105.00 5,000 525,000.00
181 3400 Amlodipin 5mG Tablet 75.72 8,126 615,300.72
182 3401 Amlodipin 10mG Tablet 132.99 8,230 1,094,507.70
183 3402 Kaptopril Tablet 12,5 Mg Tablet 90.00 1,470 132,300.00
184 3403 Simvastatin Tab.10 Mg Tablet 107.87 1,000 107,870.00
185 3404 Meloksikam Tablet 7.5 mg Tablet 175.00 6,380 1,116,500.00
186 3405 Piroksikam Tab.10Mg Tablet 99.00 2,670 264,330.00
187 3406 Kotrimoksazol Suspensi 240mg (Trimeta Botol 3,575.00 0 0.00
Syrup)
188 3417 Antasida Doen Suspensi Botol 3,450.00 107 369,150.00
189 3421 Batugin Elixir Botol 43,913.10 10 439,131.00
191 3423 Multivitamin & Mineral Tablet (Caviplex) Tablet 540.89 11,600 6,274,324.00
194 3438 Antasida Doen Tablet Kunyah Tablet 88.00 1,000 88,000.00
195 3440 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 781.00 18 14,058.00
196 3445 Allopurinol Tablet 100mg Tablet 155.35 510 79,228.50
144
198 3447 Simvastatin Tab.10 Mg Tablet 102.93 400 41,172.00
199 3448 Cetirizine 10mg Tablet 77.00 2,730 210,210.00
200 3451 Kalium Diklofenak 50mg (Kaditic) Tablet 355.08 1,000 355,080.00
201 3452 Piroksikam Tab.20Mg Tablet 121.00 1,000 121,000.00
202 3453 Sefiksim 100mg Tablet 1,010.00 900 909,000.00
203 3454 Sefadroksil 500 Mg Kapsul 720.00 1,200 864,000.00
204 3455 Tiamfenikol Kapsul 500Mg Kapsul 1,460.65 1,310 1,913,451.50
205 3456 Eritromisin Kapsul 500mg (Eryra Forte) Kapsul 1,353.75 300 406,125.00
210 3462 Amoksisilin Kaplet 500 Mg (SOLPENOX) Kaplet 395.00 0 0.00
213 3501 Serum Anti Bisa Ular I (Biosave) 5mL Vial 517,132.00 5 2,585,660.00
214 3502 Serum Anti Tetanus (Biosat 1.500 IU) Ampul 138,924.50 7 972,471.50
215 3513 Obat batuk mengandung DMP (Dextrofen) Botol 11,550.00 83 958,650.00
sirup
217 3515 Favipiravir Tablet 200mg Tablet 8,000.00 180 1,440,000.00
218 3518 Multivitamin Syrup (Seltifort Kids) Botol 7,200.00 189 1,360,800.00
219 3519 Ambroxol Syrup 15mg/5ml Botol 3,600.00 120 432,000.00
220 3520 Betahistin 6mg (LEXIGO) Tablet 660.00 3,000 1,980,000.00
221 3521 Fenolgliserol TT Botol 4,200.00 24 100,800.00
222 3522 Neurotropik (Selesbion) Tablet 530.00 0 0.00
223 3523 OBH Molex Sirup Botol 5,500.00 237 1,303,500.00
224 3524 Gentamicin 0.1% Salep Kulit Tube 3,600.00 100 360,000.00
225 3525 Furosemide 40Mg Tablet 195.00 400 78,000.00
227 3527 Nifedipin 10 Mg Tablet 225.00 200 45,000.00
228 3532 Obat Batuk Kombinasi Mengandung Tablet 580.00 3,665 2,125,700.00
Dekstrometorfan (Calortusin) Tablet
229 3533 Meloksikam 7.5 mg Tablet 145.00 600 87,000.00
230 3534 Tiamfenikol Kapsul 500Mg (THIAMEX) Kapsul 1,347.00 0 0.00
231 3535 Triamsinolon Asetonida (Genalog) Tube 16,900.00 40 676,000.00
233 3537 Antidiare (Omegdiar) Tablet Tablet 260.00 0 0.00
234 3538 Salbutamol Nebulizer 2,5mg Nebules 16,000.00 75 1,200,000.00
235 3539 Gentian Violet Botol 4,200.00 24 100,800.00
236 3540 Gentamicin Salep Mata 0,3%(Genoint) Tube 13,800.00 43 593,400.00
237 3541 Kloramfenikol Tetes Mata (Reco) Botol 9,340.00 251 2,344,340.00
238 3549 Bisakodil 5 Mg (Dulcolax) Suppositori 5,085.00 0 0.00
a
145
239 3551 Bisakodil 10 Mg (Dulcolax) Suppositori 4,325.00 0 0.00
a
243 3557 Triheksipenidil 2mg Tablet 63.00 3,000 189,000.00
244 3558 Amoksisilin Sirup Kering 125mg/5ml Botol 2,050.00 100 205,000.00
245 3559 Bacitracin Polymyxin Salep Kulit Tube 3,477.00 50 173,850.00
248 3562 Hiosina N Butil Bromida 10 Mg Tablet 1,050.00 2,600 2,730,000.00
249 3563 Glimepirid 2 Mg Tablet 123.00 5,000 615,000.00
250 3564 Sefotaksim Inj vial 2,850.00 130 370,500.00
251 3565 Metformin 500mg Tablet 77.00 7,000 539,000.00
252 3566 Seftriakson injeksi 1 gr/vial Vial 2,745.00 113 310,185.00
253 3567 Asam Traneksamat Tab 500mg Tablet 1,697.00 200 339,400.00
254 3568 Prednison 5 mg Tablet 68.00 0 0.00
255 3569 Digoksin 0.25 mg Tablet 124.00 40 4,960.00
256 3570 Hiosin Injeksi 20mg/ml Ampul 5,677.90 35 198,726.50
257 3571 Acetylcysteine 200mg Kapsul 301.00 0 0.00
258 3572 Antiinfluenza Syr (Molexflu) Botol 7,947.50 186 1,478,235.00
259 3573 Klorpromazine 100 mg Tablet 250.00 2,000 500,000.00
260 3576 Haloperidol Tab 5Mg Tablet 54.00 2,410 130,140.00
261 3577 Parasetamol 500Mg Tablet 138.00 11,058 1,526,004.00
264 3580 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 781.00 192 149,952.00
266 3582 Nistatin 500.000 Iu Tablet 825.00 100 82,500.00
267 3583 Ranitidin 25mg/2ml Ampul 814.00 0 0.00
268 3584 Glibenklamid 5mg Tablet 83.00 500 41,500.00
269 3585 Flunarizin 5mg Tablet 1,210.00 0 0.00
270 3597 Griseovulfin 125 Mg Tablet 210.00 0 0.00
272 3600 Multivitamin Tablet (Arkavit C+DEZ) Kapsul 858.00 4,800 4,118,400.00
273 3601 Chlorpheniramine Maleat (Ctm) 4mg Tablet 52.00 4,944 257,088.00
274 3602 Ondansentro 4 Mg Tablet 693.00 470 325,710.00
275 3603 Oksitetrasiklin Salep Kulit 3% Tube 2,420.00 0 0.00
276 3605 Parasetamol 500Mg Tablet 138.00 12,600 1,738,800.00
277 3685 Domperidon Suspensi 5mg/ 5ml Botol 2,316.87 50 115,843.50
278 3686 Ibuprofen suspensi 100mg/5ml Botol 2,256.31 100 225,631.00
279 3687 Salep 2-4 Pot 2,333.00 201 468,933.00
146
280 3689 Ibuprofen 400mg Tablet 190.00 3,000 570,000.00
281 3690 Ondansetron inj 4 mg/2 mL Ampul 5,141.00 200 1,028,200.00
282 3691 Risperidon 2 mg Tablet 414.00 1,000 414,000.00
283 3692 Ranitidin 25mg/2ml Ampul 2,137.00 31 66,247.00
284 3693 Diazepam rectal 5 mg/2,5 ml Tube 13,546.00 0 0.00
285 3694 Permethrin Krim Tube 6,324.78 0 0.00
288 3697 Kalsium Laktat 500mg Tablet 60.55 0 0.00
289 3698 Parasetamol Sirup 120mg/5ml Botol 1,171.05 0 0.00
290 3699 Fitominadion 10mg Tablet 754.80 570 430,236.00
291 3700 Lidokain 2% Ampul 854.70 145 123,931.50
292 3702 Serum Anti Bisa Ular I (Biosave) 5mL Ampul 517,132.00 3 1,551,396.00
293 3703 Stimuno Sirup Botol 28,374.00 144 4,085,856.00
294 3704 Stimuno Tablet Tablet 1,958.00 0 0.00
295 3705 Herbakof Syrup Botol 14,402.00 50 720,100.00
296 3706 Asimor Tablet Tablet 1,776.00 0 0.00
297 3712 Mikonazole Krim 2% Tube 1,900.00 0 0.00
299 3714 Methilergometrin 0,125mg Tablet 214.00 0 0.00
300 3715 MgSO4 20% Botol 3,580.00 40 143,200.00
301 3716 MgSO4 40% Botol 4,090.00 0 0.00
304 3721 Isosorbid Dinitrat Tab 5Mg Tablet 86.00 0 0.00
305 3722 Vitamin B12 Tablet 43.00 0 0.00
307 3724 Lansoprasol 30mg Tablet 278.00 0 0.00
311 3728 Antihemoroid supp Suppositori 3,250.00 0 0.00
a
312 3729 Sediaan mengandung chondroitin, glucosamin Tablet 3,247.10 0 0.00
Hcl (Osteotin)
314 3731 Hemorogard Tablet 1,535.20 0 0.00
315 3732 Hepagard Tablet 2,764.10 0 0.00
316 3733 Tensigard Tablet 2,103.10 0 0.00
319 3736 Sediaan mengandung ekstrak Curcuma Tablet 681.45 0 0.00
(Curcuma Force)
147
322 3739 Nistatin Susp 100.000 IU/ml Botol 11,500.00 0 0.00
323 3740 Candesartan 8mg Tablet 214.00 0 0.00
326 3743 Sefiksim 200mg Tablet 756.00 0 0.00
327 3744 Dexametason Inj. 5Mg Ampul 924.00 0 0.00
328 3745 Kaptopril 25 Mg Tablet 75.00 0 0.00
329 3746 Vaksin Rabies ( RABIVAX ) Ampul 154,391.00 0 0.00
332 3751 Diazepam 5mg Tablet 108.00 0 0.00
333 3753 Parasetamol tts 60mg/0,6ml Botol 4,976.00 0 0.00
334 3755 Clopidogrel 75mg Tablet 575.00 0 0.00
335 3756 Kodein 10 Mg Tablet 600.00 0 0.00
336 3757 Simvastatin 20mg Tablet 150.00 0 0.00
114,136,766.38

NIP. 196803312002121004 NIP. 19830605 201001 2 031
148
Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
7,364.00
0.00
0.00
19,840.00
0.00
5,214.00
0.00
0.00
0.00
0.00
0.00
6,320.60
146,160.00
1,410.00
137,172.00
0.00
0.00
49,500.00
68,967.00
0.00
0.00
1,124,319.00
0.00
149
436,460.00
472,395.00
3,108,264.00
96,750.00
0.00
0.00
58,125.00
55,250.00
0.00
52,800.00
0.00
158,400.00
125,670.00
0.00
24,890.00
0.00
234,090.00
688,140.00
795,240.00
2,040,000.00
575,700.00
0.00
0.00
0.00
69,575.00
0.00
19,836.00
0.00
257,040.00
210,000.00
88,088.00
0.00
155,232.00
3,740.00
173,250.00
1,300,000.00
0.00
0.00
120,268.20
290,492.09
226,561.00
150
1,412,180.00
944,620.00
28,640.00
349,272.00
365,689.50
0.00
243,760.00
22,000.00
0.00
0.00
342,594.00
188,320.00
0.00
392,700.00
227,700.00
0.00
0.00
0.00
73,920.00
43,916.40
369,776.00
362,934.00
0.00
31,680.00
5,440.00
0.00
77,572.00
17,220.00
64,800.00
50,740.00
0.00
2,727,240.00
785,994.00
258,300.00
487,604.00
0.00
0.00
925,344.00
26,578.00
278,648.00
0.00
151
0.00
0.00
0.00
1,373,295.00
479,160.00
698,650.00
167,700.00
0.00
264,369.00
0.00
247,500.00
31,755.00
0.00
130,500.00
1,455,846.00
0.00
298,480.00
265,056.00
0.00
378,000.00
575,377.20
112,035.00
0.00
534,820.00
0.00
0.00
23,859.00
15,775.56
0.00
0.00
0.00
3,285,150.00
0.00
825,920.00
0.00
254,867.36
272,844.00
826,280.50
3,845,000.00
263,821.35
825,000.00
152
192,936.90
1,375,000.00
216,000.00
15,015.00
800,800.00
160,000.00
0.00
0.00
220,436.70
192,500.00
478,803.60
358,750.00
5,673,850.00
0.00
135,000.00
10,080.00
0.00
0.00
366,444.00
0.00
825,000.00
506,000.00
0.00
525,000.00
615,300.72
1,094,507.70
132,300.00
107,870.00
1,116,500.00
264,330.00
0.00
369,150.00
439,131.00
0.00
6,274,324.00
0.00
0.00
88,000.00
14,058.00
79,228.50
0.00
153
41,172.00
210,210.00
355,080.00
121,000.00
909,000.00
864,000.00
1,913,451.50
406,125.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2,585,660.00
972,471.50
958,650.00
0.00
1,440,000.00
1,360,800.00
432,000.00
1,980,000.00
100,800.00
0.00
1,303,500.00
360,000.00
78,000.00
0.00
45,000.00
2,125,700.00
87,000.00
0.00
676,000.00
0.00
0.00
1,200,000.00
100,800.00
593,400.00
2,344,340.00
0.00
154
0.00
0.00
0.00
0.00
189,000.00
205,000.00
173,850.00
0.00
0.00
2,730,000.00
615,000.00
370,500.00
539,000.00
310,185.00
339,400.00
0.00
4,960.00
198,726.50
0.00
1,478,235.00
500,000.00
130,140.00
1,526,004.00
0.00
0.00
149,952.00
0.00
82,500.00
0.00
41,500.00
0.00
0.00
0.00
4,118,400.00
257,088.00
325,710.00
0.00
1,738,800.00
115,843.50
225,631.00
468,933.00
155
570,000.00
1,028,200.00
414,000.00
66,247.00
0.00
0.00
0.00
0.00
0.00
0.00
430,236.00
123,931.50
1,551,396.00
4,085,856.00
0.00
720,100.00
0.00
0.00
0.00
0.00
143,200.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
156
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
114,136,766.38
S.Farm., Apt.
201001 2 031
157
Kecamatan SUSUKAN
Periode: Juni 2022
1 Fitomenadion Inj. 2mg/ml Ampul 3,682.00 2 7,364.00
2 Ambroxol Sirup 15mg/5ml Botol 4,960.00 4 19,840.00
3 Asam Folat 1 Mg Tablet 104.28 50 5,214.00
4 Ibuprofen Tablet 200mg Tablet 185.90 34 6,320.60
5 Parasetamol Sirup 120Mg/5Ml Botol 1,160.00 126 146,160.00
6 Salep 2-4 Tube 1,410.00 1 1,410.00
7 Kloramfenikol Salep Kulit (Bufacetin) 2% Tube 3,266.00 42 137,172.00
8 Natrium Diklofenak 50mg Tablet 99.00 500 49,500.00
9 Ondansetron Inj. 4 Mg Ampul 873.00 79 68,967.00
10 Asam Mefenamat Kaplet 500 Mg Tablet 111.00 10,129 1,124,319.00
11 Lansoprazole 30 mg Kapsul 278.00 1,570 436,460.00
12 Metformin 500 Mg Tablet 77.00 6,135 472,395.00
13 Amoksisilin Kaplet 500 Mg Kaplet 201.00 15,464 3,108,264.00
14 Omeprazole 20mg Kapsul 129.00 750 96,750.00
15 Hidrokortison Salep Kulit 2.5 % Tube 2,325.00 25 58,125.00
16 Antihemoroid supp Suppositoria 3,250.00 17 55,250.00
17 Metoklopramid Tab 10 Mg Tablet 66.00 800 52,800.00
18 Fenol Gliserol Tetes Telinga 10% Botol 3,300.00 48 158,400.00
19 Domperidone Maleate Tab. 10 Mg Tablet 71.00 1,770 125,670.00
20 Zink Sirup Botol 2,489.00 10 24,890.00
21 Antasida Doen Tablet Kunyah Tablet 54.00 4,335 234,090.00
22 Kalsium Laktat (Kalk) Tab.500Mg Tablet 60.00 11,469 688,140.00
23 Glukose Larutan Infus 5% Botol 6,627.00 120 795,240.00
24 Natrium Klorida Lar. Infus 0,9% Botol 6,800.00 300 2,040,000.00
25 Kaptopril Tablet 25 Mg Tablet 75.00 7,676 575,700.00
26 Permethrin Krim 5% Tube 6,325.00 11 69,575.00
27 Vitamin B.Complek Tablet 57.00 348 19,836.00
28 Kotrimoksazol 480 Mg Tablet 126.00 2,040 257,040.00
29 Hiosina N Butil Bromida 10 Mg Tablet 1,050.00 200 210,000.00
30 Lidokain 2% Ampul 847.00 104 88,088.00
31 Dexametason Inj. 5Mg/1Ml Ampul 924.00 168 155,232.00
32 Fitomenadion Tab 10mg Tablet 748.00 5 3,740.00
33 Fitomenadion Inj. 2mg/ml Ampul 1,386.00 125 173,250.00
34 Oseltamivir Kapsul 75 mg Tablet 13,000.00 100 1,300,000.00
35 Doksisiklin 100 Mg Kapsul 462.57 260 120,268.20
36 Betahistin Mesilat 6 Mg Tablet 397.39 731 290,492.09
37 Metil Prednisolon 4mg Tablet 319.10 710 226,561.00
38 Sefadroksil 500 Mg Kapsul 720.50 1,960 1,412,180.00
39 Azitromisin 500 Mg Tablet 3,235.00 292 944,620.00
158
40 Multivitamin Tablet (Arkavit C+DEZ) Kapsul 895.00 32 28,640.00
41 Ibuprofen Tablet 200mg Tablet 194.04 1,800 349,272.00
42 Amoksisilin Sirup Kering 125mg/5ml Botol 3,294.50 111 365,689.50
43 Asiklovir Krim 5% Tube 3,047.00 80 243,760.00
45 Metamisol + diazepam (Metaneuron) Kaplet 1,141.98 300 342,594.00
46 Ibuprofen Tablet 400mg Tablet 235.40 800 188,320.00
47 Obat Batuk Kombinasi Mengandung Botol 11,550.00 34 392,700.00
48 Oksitetrasiklin Salep Klulit 3% Tube 4,554.00 50 227,700.00
49 Triamsinolon Asetonida 1mg (Genalog) Tube 18,480.00 4 73,920.00
50 Obat Batuk Kombinasi Mengandung Tablet 487.96 90 43,916.40
51 Ekstra plasenta + Neomisin Sulfat (Neocenta Tube 16,808.00 22 369,776.00
Gel)
52 Heparin Sodium (Hico) Gel Tube 20,163.00 18 362,934.00
53 Multivitamin (Recovit) Sirup Botol 7,920.00 4 31,680.00
54 Prednison tablet 5 mg Tablet 68.00 80 5,440.00
55 OT Ekstrak Meniran Hijau (Stimuno Forte) Kapsul 1,763.00 44 77,572.00
Kapsul
56 Risperidone 2mg Tablet 123.00 140 17,220.00
57 Bisakodil 5mg Tablet Tablet 216.00 300 64,800.00
58 Vitamin B12 Tablet 50 Mg Tablet 43.00 1,180 50,740.00
59 Azitromisin 500 Mg Tablet 1,136.35 2,400 2,727,240.00
60 Serum Anti Tetanus (Biosat 1.500 IU) Ampul 130,999.00 6 785,994.00
61 Obat Herbal Melancarkan Asi (ASIFIT) Kaplet 2,152.50 120 258,300.00
62 Obat Kumur Sariawan (Enkasari Herbal) Botol 18,754.00 26 487,604.00
63 Bedak Salisil 2% Pcs 6,426.00 144 925,344.00
64 Minyak Kayu Putih (Fitocare) Botol 13,289.00 2 26,578.00
65 Metamisol + Diazepam (Metaneuron) Tablet 1,142.00 244 278,648.00
66 Simetidin Tab. 200 Mg (Lexamet) Tablet 319.00 4,305 1,373,295.00
67 Metronidazol 500Mg (Molazol) Tablet 396.00 1,210 479,160.00
68 Neurotropik (Molaneuron) Tablet 785.00 890 698,650.00
69 Antidiare (Molagit) Tablet Tablet 559.00 300 167,700.00
70 Salbutamol (Ventolin) Nebules 2,5mg Ampul 12,589.00 21 264,369.00
71 Mikonazole Krim 2% Tube 4,950.00 50 247,500.00
72 Guaifenesin Tab 100mg Tablet 219.00 145 31,755.00
73 Vitamin D3 1000 IU (Natureline) Tablet 2,175.00 60 130,500.00
74 Obat Batuk Herbal (Herbakof) Sirup Botol 14,273.00 102 1,455,846.00
75 Domperidon Suspensi 5mg/ 5ml Botol 2,296.00 130 298,480.00
76 Glukose Larutan Infus 5% Botol 6,626.40 40 265,056.00
77 Betadine Obat Kumur Botol 27,000.00 14 378,000.00
78 Yodium Povidon Lart. 10 % 60 Ml (Betadine) Botol 25,016.40 23 575,377.20
79 Betametason + Neomisin Sulfat (Erladerm-N) Tube 5,335.00 21 112,035.00
Krim
80 Obh Molex Sirup Botol 5,142.50 104 534,820.00
81 Aqua Pro Injeksi (Otsu) Ampul 2,385.90 10 23,859.00
82 Sefiksim 100mg Kapsul 1,314.63 12 15,775.56
83 Multivitamin & Mineral Tablet (Recovit Plus) Tablet 605.00 5,430 3,285,150.00
84 Parasetamol Sirup 120Mg/5Ml Botol 1,160.00 712 825,920.00
85 Glimepirid 2 Mg Tablet 315.04 809 254,867.36
159
86 Guaifenesin Tab 100mg Tablet 212.00 1,287 272,844.00
87 Ambroxol Tablet 30mg Tablet 140.50 5,881 826,280.50
88 Multivitamin & Mineral Tablet (Hemafort) Tablet 769.00 5,000 3,845,000.00
89 Piridoksin (B6) Tab. 10Mg Tablet 105.15 2,509 263,821.35
90 Vitamin B1 (Thiamin) Tab 100mg Tablet 300.00 2,750 825,000.00
91 Dexamethasone 0.5Mg Tablet 47.58 4,055 192,936.90
92 Hepatitis B Immune (HyperHep B) vial 1,375,000.00 1 1,375,000.00
94 Furosemida Tab 40Mg Tablet 200.20 75 15,015.00
95 Vitamin D3 1000 IU (Solvita D) Kaplet 1,430.00 560 800,800.00
96 Metronidazol 500Mg Tablet 320.00 500 160,000.00
97 Ketokonazole 200Mg Tablet 658.02 335 220,436.70
98 Oksitosin Inj. 10 Ul/ml Ampul 3,850.00 50 192,500.00
99 Epinephrine Inj 1mg Ampul 13,300.10 36 478,803.60
100 OT Ekstrak graptophylli Folium dan Citrus Kapsul 1,435.00 250 358,750.00
101 Obat Herbal Membantu Menjaga Kesehatan Kapsul 2,795.00 2,030 5,673,850.00
102 Klorpromazine 100 mg Tablet 250.00 540 135,000.00
103 Triheksipenidil 2mg Tablet 63.00 160 10,080.00
104 Ketokonazole Krim 2% Tube 2,349.00 156 366,444.00
105 Kloramfenikol Tetes Telinga 1% (RECO) Botol 8,250.00 100 825,000.00
106 Flunarisin Tablet 5mg Tablet 1,100.00 460 506,000.00
107 Parasetamol 500Mg Tablet 105.00 5,000 525,000.00
108 Amlodipin 5mG Tablet 75.72 8,126 615,300.72
109 Amlodipin 10mG Tablet 132.99 8,230 1,094,507.70
110 Kaptopril Tablet 12,5 Mg Tablet 90.00 1,470 132,300.00
111 Simvastatin Tab.10 Mg Tablet 107.87 1,000 107,870.00
112 Meloksikam Tablet 7.5 mg Tablet 175.00 6,380 1,116,500.00
113 Piroksikam Tab.10Mg Tablet 99.00 2,670 264,330.00
114 Antasida Doen Suspensi Botol 3,450.00 107 369,150.00
115 Batugin Elixir Botol 43,913.10 10 439,131.00
116 Multivitamin & Mineral Tablet (Caviplex) Tablet 540.89 11,600 6,274,324.00
117 Antasida Doen Tablet Kunyah Tablet 88.00 1,000 88,000.00
118 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 781.00 18 14,058.00
119 Allopurinol Tablet 100mg Tablet 155.35 510 79,228.50
120 Simvastatin Tab.10 Mg Tablet 102.93 400 41,172.00
121 Cetirizine 10mg Tablet 77.00 2,730 210,210.00
122 Kalium Diklofenak 50mg (Kaditic) Tablet 355.08 1,000 355,080.00
123 Piroksikam Tab.20Mg Tablet 121.00 1,000 121,000.00
124 Sefiksim 100mg Tablet 1,010.00 900 909,000.00
125 Sefadroksil 500 Mg Kapsul 720.00 1,200 864,000.00
126 Tiamfenikol Kapsul 500Mg Kapsul 1,460.65 1,310 1,913,451.50
127 Eritromisin Kapsul 500mg (Eryra Forte) Kapsul 1,353.75 300 406,125.00
128 Serum Anti Bisa Ular I (Biosave) 5mL Vial 517,132.00 5 2,585,660.00
129 Serum Anti Tetanus (Biosat 1.500 IU) Ampul 138,924.50 7 972,471.50
130 Obat batuk mengandung DMP (Dextrofen) sirup Botol 11,550.00 83 958,650.00
131 Favipiravir Tablet 200mg Tablet 8,000.00 180 1,440,000.00
160
132 Multivitamin Syrup (Seltifort Kids) Botol 7,200.00 189 1,360,800.00
133 Ambroxol Syrup 15mg/5ml Botol 3,600.00 120 432,000.00
134 Betahistin 6mg (LEXIGO) Tablet 660.00 3,000 1,980,000.00
135 Fenolgliserol TT Botol 4,200.00 24 100,800.00
136 OBH Molex Sirup Botol 5,500.00 237 1,303,500.00
137 Gentamicin 0.1% Salep Kulit Tube 3,600.00 100 360,000.00
138 Furosemide 40Mg Tablet 195.00 400 78,000.00
139 Nifedipin 10 Mg Tablet 225.00 200 45,000.00
140 Obat Batuk Kombinasi Mengandung Tablet 580.00 3,665 2,125,700.00
Dekstrometorfan (Calortusin) Tablet
141 Meloksikam 7.5 mg Tablet 145.00 600 87,000.00
142 Triamsinolon Asetonida (Genalog) Tube 16,900.00 40 676,000.00
143 Salbutamol Nebulizer 2,5mg Nebules 16,000.00 75 1,200,000.00
144 Gentian Violet Botol 4,200.00 24 100,800.00
145 Gentamicin Salep Mata 0,3%(Genoint) Tube 13,800.00 43 593,400.00
146 Kloramfenikol Tetes Mata (Reco) Botol 9,340.00 251 2,344,340.00
147 Triheksipenidil 2mg Tablet 63.00 3,000 189,000.00
148 Amoksisilin Sirup Kering 125mg/5ml Botol 2,050.00 100 205,000.00
149 Bacitracin Polymyxin Salep Kulit Tube 3,477.00 50 173,850.00
150 Hiosina N Butil Bromida 10 Mg Tablet 1,050.00 2,600 2,730,000.00
151 Glimepirid 2 Mg Tablet 123.00 5,000 615,000.00
152 Sefotaksim Inj vial 2,850.00 130 370,500.00
153 Metformin 500mg Tablet 77.00 7,000 539,000.00
154 Seftriakson injeksi 1 gr/vial Vial 2,745.00 113 310,185.00
155 Asam Traneksamat Tab 500mg Tablet 1,697.00 200 339,400.00
156 Digoksin 0.25 mg Tablet 124.00 40 4,960.00
157 Hiosin Injeksi 20mg/ml Ampul 5,677.90 35 198,726.50
158 Antiinfluenza Syr (Molexflu) Botol 7,947.50 186 1,478,235.00
159 Klorpromazine 100 mg Tablet 250.00 2,000 500,000.00
160 Haloperidol Tab 5Mg Tablet 54.00 2,410 130,140.00
161 Parasetamol 500Mg Tablet 138.00 11,058 1,526,004.00
162 Difenhidramin Hcl Inj. 10 Mg/1Ml Ampul 781.00 192 149,952.00
163 Nistatin 500.000 Iu Tablet 825.00 100 82,500.00
164 Glibenklamid 5mg Tablet 83.00 500 41,500.00
165 Multivitamin Tablet (Arkavit C+DEZ) Kapsul 858.00 4,800 4,118,400.00
166 Chlorpheniramine Maleat (Ctm) 4mg Tablet 52.00 4,944 257,088.00
167 Ondansentro 4 Mg Tablet 693.00 470 325,710.00
168 Parasetamol 500Mg Tablet 138.00 12,600 1,738,800.00
169 Domperidon Suspensi 5mg/ 5ml Botol 2,316.87 50 115,843.50
170 Ibuprofen suspensi 100mg/5ml Botol 2,256.31 100 225,631.00
171 Salep 2-4 Pot 2,333.00 201 468,933.00
172 Ibuprofen 400mg Tablet 190.00 3,000 570,000.00
173 Ondansetron inj 4 mg/2 mL Ampul 5,141.00 200 1,028,200.00
174 Risperidon 2 mg Tablet 414.00 1,000 414,000.00
175 Ranitidin 25mg/2ml Ampul 2,137.00 31 66,247.00
176 Fitominadion 10mg Tablet 754.80 570 430,236.00
177 Lidokain 2% Ampul 854.70 145 123,931.50
161
178 Serum Anti Bisa Ular I (Biosave) 5mL Ampul 517,132.00 3 1,551,396.00
179 Stimuno Sirup Botol 28,374.00 144 4,085,856.00
180 Herbakof Syrup Botol 14,402.00 50 720,100.00
181 MgSO4 20% Botol 3,580.00 40 143,200.00
114,136,766.38

NIP. 196803312002121004 NIP. 19830605 201001 2 031
162
Kecamatan SUSUKAN
Periode: Juni 2022
1 2883 Parafilm M Pcs 880.00 40 35,200.00
2 2884 Gown Pcs 160,000.00 0 0.00
3 2885 Rapid Test Antigen (Altamed) STRIP 55,000.00 0 0.00
4 2886 Rapid Test Antigen (Altamed) Strip 55,000.00 0 0.00
5 2887 Baju Coverall (OneCare) Pcs 69,999.60 0 0.00
6 2911 Rapid Test Antigen (Altamed) STRIP 45,000.00 0 0.00
7 2912 Handscoon M (Remedi) Pcs 1,550.00 16 24,800.00
8 2914 Rapid Test Antigen (Taishan) STRIP 44,000.00 0 0.00
9 2915 Albumin Kit 855,000.00 0 0.00
10 2916 Uric Acid Kit 2,924,000.00 0 0.00
11 2917 Bilirubin Total & Direct Kit 1,299,000.00 0 0.00
12 2918 Cholesterol SL Kit 3,200,000.00 0 0.00
13 2919 Creatinin Kit 888,000.00 0 0.00
14 2920 Glucose Pap SL Kit 1,500,000.00 0 0.00
15 2921 Cholesterol HDL 2G + Calibrator Kit 7,286,000.00 0 0.00
16 2922 Cholesterol LDL Direct 2G + Calibrator Kit 11,721,000.00 0 0.00
17 2923 SGOT Kit 1,172,000.00 0 0.00
18 2924 SGPT Kit 1,172,000.00 0 0.00
19 2925 Total Protein Kit 1,108,000.00 0 0.00
20 2926 Triglycerid Kit 4,385,000.00 0 0.00
21 2927 Ureum Kit 3,484,000.00 0 0.00
22 2936 Dressing Penutup Luka (Ultrafix) Roll 30,000.00 3 90,000.00
23 2941 Formaldehyd Test Box 3,600,300.00 0 0.00
24 2942 Reagen Pemeriksaan Pb Box 3,206,500.00 0 0.00
25 2945 Boule Con-Diff Normal Vial 1,800,000.00 0 0.00
28 2948 Elical 2 Multiparametic Calibrator Kit 1,072,500.00 0 0.00
30 2950 Lab Pro HCl 0.1% Botol 300,000.00 0 0.00
31 2951 Lab Pro SPF Botol 800,000.00 0 0.00
32 2952 System Solution Elitec Botol 3,168,000.00 0 0.00
33 2953 Strip Urine Uryxon box 600,000.00 0 0.00
163
34 2954 Water Cooling Galon 5 L 95,000.00 0 0.00
37 2968 Amphetamin Test (Answer) Box 426,800.00 0 0.00
38 2969 Benzodiazepine Test (Answer) Box 426,800.00 0 0.00
39 2970 Strip Gula (Gluco Dr) Box 189,200.00 0 0.00
40 2971 Marijuana Test (THC) Answer Box 426,800.00 0 0.00
41 2972 Morphin Test (Answer) Box 426,800.00 0 0.00
43 2974 Reagen Pemeriksaan Cn Kit 3,605,800.00 0 0.00
45 2976 Reagen Pemeriksaan PO4 (Phosphate Test) Kit 3,034,900.00 0 0.00
49 2980 Reagen Pemeriksaan Cr Kit 4,516,600.00 0 0.00
50 2981 Sterikon Plus Bioindicator Kit 1,438,800.00 0 0.00
51 2982 Sulfate Cell Test Kit 3,271,400.00 0 0.00
53 2984 Cell-Dyn 22 Easy Cleaner Kit 3,170,000.00 0 0.00
54 2985 Cell-Dyn 22 Emeral Diluent Kit 3,890,000.00 0 0.00
55 2986 Cell-Dyn Emeral Lyse Kit 5,150,000.00 0 0.00
56 2987 Extran MA 02 Neutral Botol 1,135,000.00 0 0.00
57 2988 Nitrat Test Botol 5,200,000.00 0 0.00
58 2989 Nitrit Test Kit Kit 5,990,000.00 0 0.00
59 2990 Sulfuric Acid Botol 1,500,000.00 0 0.00
61 2999 Framycetin Sulfate (Daryant Tulle) Lembar 25,000.00 0 0.00
62 3000 Kasa Pembalut Hidrofil 4x15cm (Hastamed) Roll 2,048.00 100 204,800.00
63 3001 Apron Putih Long Sleeve Pcs 7,865.00 80 629,200.00
64 3002 Kasa Hidrofil 2m x 80 cm Pcs 7,930.00 86 681,980.00
65 3010 Alkaline Peptone Water Kit 1,397,000.00 0 0.00
66 3011 CRM Cadmium Botol 1,028,500.00 0 0.00
67 3012 CRM Nitrit Kit 1,027,400.00 0 0.00
68 3013 Escherichia Coli Broth Kit 1,763,300.00 0 0.00
69 3014 Hbsag Device Combo (Answer) Box 217,800.00 0 0.00
70 3015 Lauryl Tryptose Broth (Sulfate) Kit 1,184,700.00 0 0.00
74 3019 Siklamat Test Kit Kit 1,746,800.00 0 0.00
164
75 3020 Golongan Darah Anti D Kit 110,000.00 0 0.00
76 3023 Aluminium Test Kit 4,726,700.00 0 0.00
77 3025 Kokain strip test (Answer) box isi 50 426,800.00 0 0.00
78 3026 CRM Ammonium Botol 890,450.00 0 0.00
79 3027 CRM Besi (Iron Standart Solution) Botol 1,028,500.00 0 0.00
80 3028 CRM Cromium Kit 1,028,500.00 0 0.00
81 3029 CRM Flourida Kit 1,032,900.00 0 0.00
82 3030 CRM Mangan Kit 1,032,900.00 0 0.00
83 3031 CRM Nitrat Kit 1,027,400.00 0 0.00
84 3032 CRM Phosphorus Kit 1,027,400.00 0 0.00
85 3033 CRM Sulfat Botol 976,800.00 0 0.00
86 3034 Cell-Dyn 22 Plus Control Kit 12,250,000.00 0 0.00
87 3038 VTM (Dengan 2 Stick Swab) Chaoran Test 20,000.00 0 0.00
88 3040 Rapid Test Antigen (Taishan) Test 36,300.00 0 0.00
89 3075 Baju Coverall (OneCare) Pcs 65,000.00 0 0.00
90 3077 Baju Coverall (Multi One Plus) Pcs 65,000.00 0 0.00
91 3087 Rapid Test Antigen (Taishan) STRIP 35,300.00 0 0.00
92 3088 VTM (Dengan 2 Stick Swab) Altamed Pcs 17,950.00 0 0.00
93 3089 Alkohol Swab Box 19,602.00 0 0.00
94 3090 Aquadest 25 L Galon 127,820.00 0 0.00
95 3091 Bayclin 4 Lt Galon 66,396.00 0 0.00
96 3092 Face Shield Pcs 7,700.00 0 0.00
97 3093 Sarung Tangan (Maxter) No. 6,5 Pasang 9,108.00 0 0.00
98 3094 Kacamata Goggle Pcs 17,501.00 0 0.00
99 3095 Needle 26 G (0.45mm x 13mm) BD Box 61,600.00 0 0.00
100 3096 Plesterin Bulat Soft Box 52,503.00 0 0.00
101 3097 Sarung Tangan Obgyn Non Steril (All Size) Pasang 35,002.00 0 0.00
102 3098 Alat Suntik 3 ml (Onemed) Box 84,007.00 0 0.00
103 3099 Tabung Vacumtainer EDTA 3ml Box 161,700.00 0 0.00
104 3100 Handscoon S (Altamed) Pcs 1,180.00 0 0.00
105 3101 Handscoon M (Altamed) Pcs 1,180.00 0 0.00
106 3102 Rapid Test Antigen (Taishan) Pcs 35,300.00 0 0.00
107 3107 VTM (Dengan 2 Stick Swab) Altamed Pcs 17,950.00 0 0.00
108 3113 Masker Telinga (Earloop) Altamed Pcs 340.00 2,150 731,000.00
109 3114 Masker Hijab (Headloop) Altamed Pcs 340.00 1,728 587,520.00
110 3115 Handscoon L (Altamed) Pcs 1,070.00 622 665,540.00
111 3116 Handscoon M (Altamed) Pcs 1,070.00 212 226,840.00
112 3117 Lancet Pcs 150.00 0 0.00
113 3118 Alkohol Swab Box 11,500.00 0 0.00
114 3119 Handscoon M (Altamed) Pcs 1,180.00 0 0.00
115 3120 Masker Hijab (Headloop) Altamed Pcs 374.00 0 0.00
165
116 3132 Aquabidest 1L Botol 42,966.00 0 0.00
117 3146 Strip Gula (BeneCheck) Strip 3,200.00 0 0.00
118 3147 Strip Asam Urat (BeneCheck) Strip 6,000.00 0 0.00
119 3148 Strip Cholesterol (BeneCheck) Strip 25,000.00 0 0.00
120 3153 Rapid Test Antigen (OnSite) Pcs 35,000.00 0 0.00
121 3154 Folly Catteter No.16 Pcs 8,635.00 1 8,635.00
122 3155 Folly Catteter No.18 Pcs 8,987.00 14 125,818.00
123 3156 Masker Oksigen Dewasa (Forsch) Pcs 11,500.00 9 103,500.00
124 3157 Urin Bag (Forsch) Pcs 5,300.00 18 95,400.00
125 3158 Masker Nebul Anak Pcs 16,200.00 0 0.00
126 3159 Masker Nebul Dewasa (Forsch) Pcs 16,200.00 0 0.00
127 3160 Selang Oksigen (Nasal Cannula) L - Dewasa Pcs 6,400.00 5 32,000.00
128 3168 Rapid Test Antigen (Clungene) Pcs 27,000.00 0 0.00
129 3184 Rapid Test Antigen (OnSite) Pcs 32,000.00 0 0.00
130 3185 Infuset Dewasa (Otsu Y) Pcs 8,596.00 0 0.00
131 3191 Apron Long Sleeve Pcs 4,168.00 230 958,640.00
135 3197 Catgut Chromic 2/0 90cm 36mm Box 807,840.00 2 1,615,680.00
137 3199 Alat Suntik 3ml (Terumo) Pcs 1,121.00 1,047 1,173,687.00
138 3200 Alat Suntik 5ml (Terumo) Pcs 1,467.92 100 146,792.00
139 3203 Dressing Penutup Luka (Pharmafix) Roll 61,050.00 13 793,650.00
140 3204 Silk 2/0 75CC 30M C (Silkam) Pcs 27,284.00 20 545,680.00
141 3205 Silk 3/0 75CC 30M C (Silkam) Pcs 27,284.00 36 982,224.00
142 3214 Rapid Test Antigen (YHLO) Pcs 26,999.00 0 0.00
143 3229 Alkohol 70% 5L Galon 112,350.00 0 0.00
144 3242 Strip Gula (Autocheck) Strip 2,460.00 0 0.00
145 3243 Strip Asam Urat (Autocheck) Strip 3,680.00 64 235,520.00
146 3244 Strip Cholesterol (Autocheck) Strip 14,680.00 0 0.00
147 3245 Rapid Tes HIV (SD Bioline) Pcs 11,322.00 0 0.00
148 3246 Reagen Syphilis (SD Bioline) Pcs 10,666.00 240 2,559,840.00
149 3253 Kacamata Goggle Pcs 19,545.00 13 254,085.00
150 3254 Face Shield Bando Pcs 10,000.00 0 0.00
151 3255 Face Shield Kacamata Pcs 4,545.00 25 113,625.00
152 3256 Cairan Cuci Tangan Tanpa Bilas (Pori Klin) 5L Galon 130,000.00 3 390,000.00
153 3257 Cairan Desinfektan (Pori Klin) 5L Galon 100,000.00 3 300,000.00
154 3258 Cairan Cuci Tangan Bilas (Pori Klin) 5L Galon 61,250.00 6 367,500.00
155 3260 Kasa Hidrofil 2Mx80Cm Pcs 10,358.00 30 310,740.00
166
158 3269 Sarung Tangan Panjang (InTouch) No. 6,5 Pasang 7,186.36 170 1,221,681.20
159 3270 Sarung Tangan Panjang (InTouch) No. 7 Pasang 7,186.36 792 5,691,597.12
160 3271 Sarung Tangan Panjang (InTouch) No. 7,5 Pasang 7,186.36 150 1,077,954.00
161 3276 Gown Pcs 165,000.00 0 0.00
162 3277 Shoe Cover Pasang 1,520.00 150 228,000.00
163 3278 Nurse Cap Pcs 304.54 423 128,820.42
164 3282 Tabung Vacumtainer EDTA 3ml (Vacusera) Pcs 1,413.00 28 39,564.00
165 3299 Plester (Onemed) Roll 41,360.00 24 992,640.00
166 3300 Alkohol Swab (Onemed) Pcs 120.00 0 0.00
167 3301 Blue Tips Pcs 84.40 0 0.00
168 3302 Tabung Vacumtainer Plain 3 ml (Onemed) Pcs 800.00 100 80,000.00
170 3304 HB Hemoglobin Test (Mission) Strip 8,033.64 161 1,293,416.04
171 3312 Alkohol Swab (Altamed) Pcs 95.00 8,084 767,980.00
172 3313 Lancet (Onemed) Pcs 92.00 14,800 1,361,600.00
173 3314 Strip Gula (Gluco Dr) STRIP 1,736.16 5,400 9,375,264.00
174 3315 Strip Gula (Autocheck) STRIP 2,460.00 4,650 11,439,000.00
175 3316 Strip Gula (BeneCheck) Strip 3,200.00 1,750 5,600,000.00
179 3323 Golongan Darah Anti D Botol 205,000.00 1 205,000.00
180 3324 Antigen S (Thypi O) Lorne Botol 103,656.00 1 103,656.00
181 3325 Antigen S (Parathypi AO) Febrile Botol 38,760.00 0 0.00
182 3326 Antigen S (Thypi H) Febrile Botol 38,760.00 1 38,760.00
183 3327 Antigen S (Parathypi AH) Botol 38,760.00 3 116,280.00
184 3328 Rapid Tes HIV (Oncoprobe) Pcs 15,748.00 24 377,952.00
185 3332 Bahan Tes Cepat Molekuler TB (TCM) Kartrid Pcs 252,400.00 0 0.00
Xpert MTB/Rif
187 3339 Rapid Tes HIV (Intec) Pcs 14,740.00 48 707,520.00
188 3353 HBSAG (Intec) Pcs 5,445.00 0 0.00
189 3358 Alkohol Swab (Altamed) Pcs 95.00 0 0.00
190 3359 Framycetin Sulfate (Daryant Tulle) Lembar 25,000.00 47 1,175,000.00
191 3360 Handscoon S (Altamed) Pcs 1,050.00 1,883 1,977,150.00
192 3366 Handscoon M (Altamed) Pcs 1,050.00 3,851 4,043,550.00
193 3373 Selang Oksigen (Nasal Cannula) L - Dewasa Pcs 6,400.00 0 0.00
194 3374 Selang Oksigen (Nasal Cannula) M - Anak Pcs 6,400.00 10 64,000.00
195 3381 Alkohol Swab (Altamed) Pcs 76.00 34,000 2,584,000.00
196 3382 Strip Asam Urat (Autocheck) STRIP 3,680.00 25 92,000.00
197 3383 Strip Cholesterol (Autocheck) STRIP 14,680.00 0 0.00
167
198 3384 Sarung Tangan Obgyn M (Troge) Pasang 36,960.00 0 0.00
199 3385 Sarung Tangan Obgyn S (Troge) Pasang 36,960.00 0 0.00
200 3386 Apron Pendek Pcs 1,849.10 422 780,320.20
201 3387 Plesterin Bulat Soft Pcs 389.34 5,000 1,946,700.00
202 3388 Alat Tes Kehamilan (Ultra One) Pcs 1,900.00 0 0.00
203 3389 Yellow Tip Pcs 32.37 0 0.00
204 3390 Gel Untuk USG Botol 16,000.00 0 0.00
205 3392 Sarung Tangan Obgyn Steril (Onemed) Pasang 19,000.00 100 1,900,000.00
206 3393 Urin 10 Parameter (Cybow) Kit 1,334.88 100 133,488.00
207 3395 Iodium Test 10Ml Botol 60,000.00 0 0.00
208 3418 Foley Catteter No.16 Pcs 7,615.00 3 22,845.00
209 3424 Kantong Plastik Limbah Medis pcs 3,000.00 588 1,764,000.00
210 3426 HDL Cholesterol Kit 4,537,000.00 0 0.00
211 3427 HDL LDL Kalibrator Kit 6,676,000.00 0 0.00
212 3428 SGPT Kit 2,059,000.00 0 0.00
213 3429 SGOT Kit 2,059,000.00 0 0.00
214 3430 Triglycerid Kit 4,385,000.00 0 0.00
215 3431 Urea UV Kit 1,860,000.00 0 0.00
216 3432 Creatinin kit 660,000.00 0 0.00
217 3433 Handscoon M (Super Gard) pcs 525.00 1,000 525,000.00
218 3434 Cairan Cuci Tangan Tanpa Bilas (Pori Klin) 5L Galon 143,000.00 22 3,146,000.00
219 3435 Cairan Cuci Tangan Bilas (Pori Klin) 5L Galon 5 L 67,375.00 6 404,250.00
220 3442 Masker Telinga (Earloop) SUPREME pcs 360.00 850 306,000.00
221 3443 Masker Telinga (Earloop) MAS Pcs 360.00 2,300 828,000.00
222 3444 Iodium Test 10Ml Botol 43,000.00 0 0.00
223 3449 Boule Con-Diff Normal Vial 1,540,000.00 0 0.00
224 3450 Elical 2 Multiparametic Calibrator Kit 1,072,000.00 0 0.00
225 3463 Masker Telinga (Headloop) Jilbab BAYMED pcs 360.00 4,000 1,440,000.00
226 3464 Diluent Botol 4,493,500.00 0 0.00
227 3465 Lyse Botol 5,005,000.00 0 0.00
228 3466 Cleaner Kit 3,150,000.00 0 0.00
229 3467 Lyse Kit 5,120,000.00 0 0.00
230 3468 Diluent Kit 3,750,000.00 0 0.00
231 3469 Diluent Botol 3,300,000.00 0 0.00
232 3470 Lyse Botol 2,200,000.00 0 0.00
233 3471 Cleaner botol 1,100,000.00 0 0.00
234 3472 Diluent Botol 1,996,500.00 0 0.00
235 3473 Cleaner Botol 2,662,000.00 0 0.00
236 3474 Lyse Botol 3,025,000.00 0 0.00
237 3482 Masker Telinga (Headloop) Jilbab SAFELOCK Pcs 340.00 5,000 1,700,000.00
238 3487 Rapid Test Antigen (Clungene) Strip 17,800.00 0 0.00
168
239 3503 Gown Pcs 165,000.00 0 0.00
241 3574 Nurse Cap Pcs 335.00 200 67,000.00
242 3575 Apron Long Sleeve Pcs 4,585.00 50 229,250.00
243 3586 Sarung Tangan Panjang (InTouch) No. 6,5 Pasang 7,905.00 0 0.00
244 3587 Sarung Tangan Panjang (InTouch) No. 7 Pasang 7,905.00 0 0.00
245 3588 Kasa Pembalut Hidrofil 4M X 15 Cm Roll 2,408.00 177 426,216.00
247 3590 Alat Suntik 3 ml (Terumo) Pcs 1,267.00 0 0.00
248 3591 Alat Suntik 5 ml (Terumo) Pcs 1,467.85 50 73,392.50
249 3592 Kasa Hidrofil 2Mx80Cm Roll 10,358.00 250 2,589,500.00
250 3593 Alkohol 70% Botol (1 22,500.00 24 540,000.00
Liter)
251 3594 Alkohol 70% 5L Galon 5 L 117,700.00 6 706,200.00
252 3595 Iv. Catteter (Otsucath) No.18 Pcs 5,300.00 50 265,000.00
254 3610 Antigen widal S.Typhi H (Fortress) Vial 107,800.00 0 0.00
255 3611 Antigen widal S.Typhi O (Fortress) Vial 107,800.00 0 0.00
256 3612 Antigen widal Paratiphy AH (Fortress) Vial 107,800.00 0 0.00
257 3613 Antigen widal Paratiphy BO (Fortress) Vial 107,800.00 0 0.00
258 3614 Reagen Pemeriksaan Cu Kit 5,483,400.00 0 0.00
259 3615 Reagen Pemeriksaan Cn Kit 3,885,000.00 0 0.00
260 3616 Reagen Pemeriksaan NH4 Kit 3,663,000.00 0 0.00
261 3617 Reagen Pemeriksaan PO4 Kit 3,219,000.00 0 0.00
262 3618 Reagen Pemeriksaan Zenk Kit 7,215,000.00 0 0.00
263 3619 CRM Nitrit (Merck/1.25041.0100) Botol 1,100,000.00 0 0.00
264 3620 CRM Phosphorus Botol 1,100,000.00 0 0.00
265 3621 CRM Ammonium Botol 1,100,000.00 0 0.00
266 3622 CRM Mangan Botol 1,100,000.00 0 0.00
267 3623 CRM Flourida Kit 1,100,000.00 0 0.00
268 3624 CRM Cadmium Kit 1,110,000.00 0 0.00
269 3625 CRM Sulfat Botol 1,045,000.00 0 0.00
270 3626 CRM Cromium Botol 1,100,000.00 0 0.00
271 3627 CRM COD Botol 1,012,000.00 0 0.00
272 3628 Calcium Standart Solution Botol 1,281,500.00 0 0.00
273 3629 Clorida Standart Solution Botol 987,900.00 0 0.00
274 3630 Ortho Phosporus 85% Botol 2,579,500.00 0 0.00
275 3631 Plate Count Agar (PCA) Box 1,402,500.00 0 0.00
276 3632 MUG EC Broth Kit 3,013,650.00 0 0.00
277 3633 EC Broth Box 1,897,500.00 0 0.00
278 3634 Lauryl Tryptose Broth Kit 1,221,000.00 0 0.00
279 3635 Alkali Pepton Water Box 1,375,000.00 0 0.00
169
280 3636 Brain Heart Infusion (BHI) Box 1,617,000.00 0 0.00
281 3637 Sterikon plus bioindikator Pak 1,554,000.00 0 0.00
282 3638 Extran MA 02 neutral Box 946,000.00 0 0.00
283 3639 LDL Cholesterol SL 2G Box 7,450,000.00 0 0.00
284 3640 Creatinin Box 888,000.00 0 0.00
285 3641 Glucosa HK SL Box 1,914,000.00 0 0.00
286 3642 SGOT Kit 2,059,000.00 0 0.00
287 3643 SGPT Kit 2,059,000.00 0 0.00
288 3644 Giemsa Stain Botol 714,000.00 0 0.00
289 3645 Na Citrat 3,8% Botol 35,000.00 0 0.00
290 3646 NaCl 0.9% Botol 30,000.00 0 0.00
291 3647 Golongan Darah Anti A (AMA) Vial 88,000.00 0 0.00
292 3648 Golongan Darah Anti B (AMA) Vial 88,000.00 0 0.00
293 3649 Golongan Darah Anti D (AMA) Vial 88,000.00 0 0.00
294 3650 Amphetamin test Box (isi 25) 321,750.00 0 0.00
295 3651 Marijuana Test Box (isi 40) 476,000.00 0 0.00
296 3652 Morphin Test Box (isi 25) 321,750.00 0 0.00
297 3653 Cocaine test Box (isi 40) 476,000.00 0 0.00
298 3654 Methampetamine Test Box (isi 25) 321,750.00 0 0.00
299 3655 Benzodiazepine Test Box (isi40) 476,000.00 0 0.00
300 3657 Siklamat Kit 1,925,000.00 0 0.00
301 3658 Reagen Ziechl Nealson Kit 330,000.00 0 0.00
2x100ml
302 3659 Borax Kit 1,782,000.00 0 0.00
303 3660 Methanyl Yellow Kit 1,708,000.00 0 0.00
304 3661 Rhodamin B Kit 1,893,500.00 0 0.00
305 3662 Oil Emersi Biomedika Botol 50ml 385,000.00 0 0.00
307 3664 Strain Kuman E.Coli Kit 1,722,600.00 0 0.00
308 3665 CRM Besi Botol 775,170.00 0 0.00
309 3666 Boule M-Series Diluent Galon 20L 2,882,000.00 0 0.00
310 3667 Boule M-Series Lyse Galon 5 L 4,378,000.00 0 0.00
311 3668 Elical 2 Multiparametric calibrator Botol 1,422,960.00 0 0.00
312 3669 Ureum - Elitec Kit 1,364,000.00 0 0.00
4x62,5ml
313 3670 HDL Cholesterol 2G Elitec Kit 4x21ml 5,786,000.00 0 0.00
314 3671 Trigliserida - Elitec Kit 3,960,000.00 0 0.00
6x100ml
315 3672 Asam Urat - Elitec Kit
std 6x50ml 2,134,000.00 0 0.00
+ std
316 3673 Calibrator hema analyser Medonic Kit 1x4,5ml 1,914,000.00 0 0.00
317 3674 Anti HIV ( Healgen ) Box (isi 25) 495,000.00 0 0.00
318 3675 Strain Kuman Salmonella Kit 2,876,500.00 0 0.00
319 3681 Kapas 250gram Roll 15,296.00 0 0.00
320 3682 Kapas 1000gram Roll 65,013.00 0 0.00
170
321 3683 Selang Oksigen (Nasal Cannula) M - Anak Pcs 7,500.00 0 0.00
322 3684 Selang Oksigen (Nasal Cannula) L - Adult Pcs 7,500.00 0 0.00
323 3701 Tabung K3EDTA 3ml (Vacusera) Pcs 1,413.00 700 989,100.00
324 3754 Alkohol Swab (Nushi) Box 18,500.00 0 0.00
325 3760 SD Bioline HIV 1/2 Strip 11,425.00 0 0.00
326 3761 SD Bioline Syphilis Test 10,763.00 0 0.00
327 3762 Strip Gula ( Benecheck ) Box 160,000.00 0 0.00
328 3763 Lancet (ABN) Box 13,000.00 0 0.00
329 3764 Strip Gula ( On Call ) Box 150,000.00 0 0.00
330 3765 Strip Gula ( Gluco Dr ) Box 87,500.00 0 0.00
331 3766 Strip Gula ( Humasens ) Box 160,000.00 0 0.00
332 3769 Strip Cholesterol ( Benecheck ) Box 250,000.00 0 0.00
333 3770 Strip Gula ( Benecheck ) Box 160,000.00 0 0.00
334 3771 Strip Asam Urat ( Benecheck ) Box 150,000.00 0 0.00
335 3772 Lancet (MEDT) Box 10,000.00 0 0.00
87,074,542.48

NIP. 196803312002121004 NIP. 19830605 201001 2 031
171
Total
35,200.00
0.00
0.00
0.00
0.00
0.00
24,800.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
90,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
172
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
204,800.00
629,200.00
681,980.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
173
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
731,000.00
587,520.00
665,540.00
226,840.00
0.00
0.00
0.00
0.00
174
0.00
0.00
0.00
0.00
0.00
8,635.00
125,818.00
103,500.00
95,400.00
0.00
0.00
32,000.00
0.00
0.00
0.00
958,640.00
0.00
520,000.00
0.00
1,615,680.00
0.00
1,173,687.00
146,792.00
793,650.00
545,680.00
982,224.00
0.00
0.00
0.00
235,520.00
0.00
0.00
2,559,840.00
254,085.00
0.00
113,625.00
390,000.00
300,000.00
367,500.00
310,740.00
0.00
175
0.00
1,221,681.20
5,691,597.12
1,077,954.00
0.00
228,000.00
128,820.42
39,564.00
992,640.00
0.00
0.00
80,000.00
0.00
1,293,416.04
767,980.00
1,361,600.00
9,375,264.00
11,439,000.00
5,600,000.00
0.00
0.00
0.00
205,000.00
103,656.00
0.00
38,760.00
116,280.00
377,952.00
0.00
0.00
707,520.00
0.00
0.00
1,175,000.00
1,977,150.00
4,043,550.00
0.00
64,000.00
2,584,000.00
92,000.00
0.00
176
0.00
0.00
780,320.20
1,946,700.00
0.00
0.00
0.00
1,900,000.00
133,488.00
0.00
22,845.00
1,764,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
525,000.00
3,146,000.00
404,250.00
306,000.00
828,000.00
0.00
0.00
0.00
1,440,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1,700,000.00
0.00
177
0.00
0.00
67,000.00
229,250.00
0.00
0.00
426,216.00
0.00
0.00
73,392.50
2,589,500.00
540,000.00
706,200.00
265,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
178
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
179
0.00
0.00
989,100.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
87,074,542.48
S.Farm., Apt.
201001 2 031
180
Kecamatan SUSUKAN
Periode: Juni 2022
1 Parafilm M Pcs 880.00 40 35,200.00
2 Handscoon M (Remedi) Pcs 1,550.00 16 24,800.00
3 Dressing Penutup Luka (Ultrafix) Roll 30,000.00 3 90,000.00
4 Kasa Pembalut Hidrofil 4x15cm (Hastamed) Roll 2,048.00 100 204,800.00
5 Apron Putih Long Sleeve Pcs 7,865.00 80 629,200.00
6 Kasa Hidrofil 2m x 80 cm Pcs 7,930.00 86 681,980.00
7 Masker Telinga (Earloop) Altamed Pcs 340.00 2,150 731,000.00
8 Masker Hijab (Headloop) Altamed Pcs 340.00 1,728 587,520.00
9 Handscoon L (Altamed) Pcs 1,070.00 622 665,540.00
10 Handscoon M (Altamed) Pcs 1,070.00 212 226,840.00
11 Folly Catteter No.16 Pcs 8,635.00 1 8,635.00
12 Folly Catteter No.18 Pcs 8,987.00 14 125,818.00
13 Masker Oksigen Dewasa (Forsch) Pcs 11,500.00 9 103,500.00
14 Urin Bag (Forsch) Pcs 5,300.00 18 95,400.00
15 Selang Oksigen (Nasal Cannula) L - Dewasa Pcs 6,400.00 5 32,000.00
16 Apron Long Sleeve Pcs 4,168.00 230 958,640.00
18 Catgut Chromic 2/0 90cm 36mm Box 807,840.00 2 1,615,680.00
19 Alat Suntik 3ml (Terumo) Pcs 1,121.00 1,047 1,173,687.00
20 Alat Suntik 5ml (Terumo) Pcs 1,467.92 100 146,792.00
21 Dressing Penutup Luka (Pharmafix) Roll 61,050.00 13 793,650.00
22 Silk 2/0 75CC 30M C (Silkam) Pcs 27,284.00 20 545,680.00
23 Silk 3/0 75CC 30M C (Silkam) Pcs 27,284.00 36 982,224.00
24 Strip Asam Urat (Autocheck) Strip 3,680.00 64 235,520.00
25 Reagen Syphilis (SD Bioline) Pcs 10,666.00 240 2,559,840.00
26 Kacamata Goggle Pcs 19,545.00 13 254,085.00
27 Face Shield Kacamata Pcs 4,545.00 25 113,625.00
28 Cairan Cuci Tangan Tanpa Bilas (Pori Klin) 5L Galon 130,000.00 3 390,000.00
29 Cairan Desinfektan (Pori Klin) 5L Galon 100,000.00 3 300,000.00
30 Cairan Cuci Tangan Bilas (Pori Klin) 5L Galon 61,250.00 6 367,500.00
31 Kasa Hidrofil 2Mx80Cm Pcs 10,358.00 30 310,740.00
32 Sarung Tangan Panjang (InTouch) No. 6,5 Pasang 7,186.36 170 1,221,681.20
33 Sarung Tangan Panjang (InTouch) No. 7 Pasang 7,186.36 792 5,691,597.12
34 Sarung Tangan Panjang (InTouch) No. 7,5 Pasang 7,186.36 150 1,077,954.00
35 Shoe Cover Pasang 1,520.00 150 228,000.00
181
36 Nurse Cap Pcs 304.54 423 128,820.42
37 Tabung Vacumtainer EDTA 3ml (Vacusera) Pcs 1,413.00 28 39,564.00
38 Plester (Onemed) Roll 41,360.00 24 992,640.00
39 Tabung Vacumtainer Plain 3 ml (Onemed) Pcs 800.00 100 80,000.00
40 HB Hemoglobin Test (Mission) Strip 8,033.64 161 1,293,416.04
41 Alkohol Swab (Altamed) Pcs 95.00 8,084 767,980.00
42 Lancet (Onemed) Pcs 92.00 14,800 1,361,600.00
43 Strip Gula (Gluco Dr) STRIP 1,736.16 5,400 9,375,264.00
44 Strip Gula (Autocheck) STRIP 2,460.00 4,650 11,439,000.00
45 Strip Gula (BeneCheck) Strip 3,200.00 1,750 5,600,000.00
46 Golongan Darah Anti D Botol 205,000.00 1 205,000.00
47 Antigen S (Thypi O) Lorne Botol 103,656.00 1 103,656.00
48 Antigen S (Thypi H) Febrile Botol 38,760.00 1 38,760.00
49 Antigen S (Parathypi AH) Botol 38,760.00 3 116,280.00
50 Rapid Tes HIV (Oncoprobe) Pcs 15,748.00 24 377,952.00
51 Rapid Tes HIV (Intec) Pcs 14,740.00 48 707,520.00
52 Framycetin Sulfate (Daryant Tulle) Lembar 25,000.00 47 1,175,000.00
53 Handscoon S (Altamed) Pcs 1,050.00 1,883 1,977,150.00
54 Handscoon M (Altamed) Pcs 1,050.00 3,851 4,043,550.00
55 Selang Oksigen (Nasal Cannula) M - Anak Pcs 6,400.00 10 64,000.00
56 Alkohol Swab (Altamed) Pcs 76.00 34,000 2,584,000.00
57 Strip Asam Urat (Autocheck) STRIP 3,680.00 25 92,000.00
58 Apron Pendek Pcs 1,849.10 422 780,320.20
59 Plesterin Bulat Soft Pcs 389.34 5,000 1,946,700.00
60 Sarung Tangan Obgyn Steril (Onemed) Pasang 19,000.00 100 1,900,000.00
61 Urin 10 Parameter (Cybow) Kit 1,334.88 100 133,488.00
62 Foley Catteter No.16 Pcs 7,615.00 3 22,845.00
63 Kantong Plastik Limbah Medis pcs 3,000.00 588 1,764,000.00
64 Handscoon M (Super Gard) pcs 525.00 1,000 525,000.00
65 Cairan Cuci Tangan Tanpa Bilas (Pori Klin) 5L Galon 143,000.00 22 3,146,000.00
66 Cairan Cuci Tangan Bilas (Pori Klin) 5L Galon 5 L 67,375.00 6 404,250.00
67 Masker Telinga (Earloop) SUPREME pcs 360.00 850 306,000.00
68 Masker Telinga (Earloop) MAS Pcs 360.00 2,300 828,000.00
69 Masker Telinga (Headloop) Jilbab BAYMED pcs 360.00 4,000 1,440,000.00
70 Masker Telinga (Headloop) Jilbab SAFELOCK Pcs 340.00 5,000 1,700,000.00
71 Nurse Cap Pcs 335.00 200 67,000.00
72 Apron Long Sleeve Pcs 4,585.00 50 229,250.00
73 Kasa Pembalut Hidrofil 4M X 15 Cm Roll 2,408.00 177 426,216.00
74 Alat Suntik 5 ml (Terumo) Pcs 1,467.85 50 73,392.50
75 Kasa Hidrofil 2Mx80Cm Roll 10,358.00 250 2,589,500.00
76 Alkohol 70% Botol (1 Liter) 22,500.00 24 540,000.00
77 Alkohol 70% 5L Galon 5 L 117,700.00 6 706,200.00
182
78 Iv. Catteter (Otsucath) No.18 Pcs 5,300.00 50 265,000.00
79 Tabung K3EDTA 3ml (Vacusera) Pcs 1,413.00 700 989,100.00
87,074,542.48

NIP. 196803312002121004 NIP. 19830605 201001 2 031
183
Kecamatan SUSUKAN
Nomor Rekening: 1.01.33.05.01.5.1.1.02.01
Periode: June 2022
1 B001 Asam Askorbat 50mg Tablet 103.99 0 0.00
2 B002 Amoksisilin Sirup Kering Botol 2,090.00 0 0.00
3 B003 Antihemoroid 3,044.92 0 0.00
4 B004 Calcium Lactat Tablet Tablet 63.00 0 0.00
5 B005 Chlorpeniramin Maleat Tablet 41.99 0 0.00
6 B006 Na Diklofenak 25mg Tablet 132.00 0 0.00
7 B007 Tetraciclyn Kapsul Kapsul 310.00 0 0.00
8 B008 Vitamin B6 10mg Tablet 118.00 0 0.00
9 B009 Vitamin B Complex 114.99 0 0.00
10 B010 Zink Sulphate 20mg Tablet 467.00 0 0.00
11 B011 Introcan G 22 Pcs 8,750.00 0 0.00
12 B012 Introcan G 24 pcs 8,750.00 0 0.00
13 B013 Sarung Tangan Non Steril M 42,200.00 0 0.00
14 B014 Sarung Tangan Non Steril S Box isi 100 42,200.00 0 0.00
15 B015 Tabung Vacum EDTA Glas Pak (isi 1,650.00 0 0.00
100)
16 B016 Larutan KOH 10% 100ml 56,925.00 0 0.00
17 B017 Larutan Xylol 100ml 149,500.00 0 0.00
18 B018 Masker Ear Loop Box/ 50 19,800.00 0 0.00
19 B019 Infuset Dewasa Pcs 4,975.00 0 0.00
20 B020 Urine Bag Cosmomed box isi 10 4,700.00 0 0.00
21 B021 Blood Lunchet 16,000.00 0 0.00
22 B022 Infuset Anak Pcs 7,920.00 189 1,496,880.00
23 B023 Catgut 3/0 22,500.00 0 0.00
24 B024 Silk 2/0 15,000.00 0 0.00
25 B025 Alkohol 70% 25,000.00 0 0.00
26 B026 Plesterin Roll 23,760.00 0 0.00
27 B027 My Jelly 29,546.00 0 0.00
28 B028 Masker N95 Pcs 6,512.00 0 0.00
29 B029 Kassa Hidro 7,700.00 0 0.00
30 B030 Soft Pad 4,162.40 0 0.00
31 B031 Oxiflow Soft Anak 5,500.00 0 0.00
32 B032 Oxiflow Soft Dewasa 5,500.00 0 0.00
33 B033 Folley Cathther 16 7,999.20 0 0.00
184
34 B034 Elite Cement Mini 148,500.00 0 0.00
35 B035 Eugetin Technodent Pcs 396,000.00 0 0.00
36 B036 CHKM Pcs 55,000.00 0 0.00
37 B037 Caviton Pink Pcs 138,600.00 0 0.00
38 B038 Caviton White Pcs 138,600.00 0 0.00
39 B039 Cotton Roll Prodental Pcs 33,000.00 0 0.00
40 B040 Fuji IX Pcs 702,900.00 0 0.00
41 B041 Spuit 3 ml Pcs 792.00 0 0.00
42 B042 Spuit 5 ml Pcs 979.00 0 0.00
43 B043 Surgical Mask 3 ply Box isi 50 16,500.00 0 0.00
44 B044 Surgical Mask Ear Lop 16,500.00 0 0.00
45 B045 Safe Glove M 35,618.00 0 0.00
46 B049 Kasa Elastis 4 X 15 Buah 10,800.00 0 0.00
47 B050 Plester (leukoplast) Roll 27,084.25 0 0.00
48 B051 IV Cathether 26 Pcs 19,500.00 0 0.00
49 B052 Plain Catgut 2/0 Pcs 5,582.96 0 0.00
50 B053 Plain Catgut 3/0 Pcs 5,582.96 33 184,237.68
51 B054 Alkohol Swab Box isi 100 9,999.00 0 0.00
1,681,117.68

NIP. 196803312002121004 NIP. 19830605 201001 2 031
185
Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1,496,880.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
186
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
184,237.68
0.00
1,681,117.68
S.Farm., Apt.
201001 2 031
187
Kecamatan SUSUKAN
Nomor Rekening: 1.01.33.05.01.5.1.1.02.01 ( BLUD 1 )
Periode: June 2022
1 Infuset Anak Pcs 7,920.00 189 1,496,880.00
2 Plain Catgut 3/0 Pcs 5,582.96 33 184,237.68
1,681,117.68

NIP. 196803312002121004 NIP. 19830605 201001 2 031
188
BLUD3
Kecamatan SUSUKAN
Nomor Rekening: 1.01.02.1.01.02.01.33.05.5.2.2.24.02
Periode: Juni 2022
1 B069 Kloramfenikol Tetes Mata 0.5 % (Decacetine)) Botol 3,250.00 0 0.00
2 B070 Cholesterol Liq 4x100ml Kit 2,178,000.00 0 0.00
3 B071 Glucose liq 4x100 ml Kit 1,558,920.00 0 0.00
4 B072 Yellow Tip Pcs 121.00 0 0.00
5 B073 Strip Gula (Gluco DR) Box 4,000.00 0 0.00
7 B075 Antasida Doen Tablet Kunyah Tablet 54.00 0 0.00
8 B076 Ringer Laktat Larutan Infus (Otsuka) 7,150.00 0 0.00
9 B077 Piroksikam Tab.10Mg Tablet 124.00 0 0.00
10 B078 Fargoxin 0.25mg Tablet 178.75 0 0.00
11 B079 Ambroxol syrup 15mg/5ml Botol 2,857.36 0 0.00
12 B080 Vitamin B Complex Tablet 51.43 0 0.00
13 B081 Ambroxol Tablet 30mg Tablet 102.85 0 0.00
14 B082 Metronidazol 500Mg Tablet 171.43 0 0.00
15 B083 Lyscavit Sirup Botol 3,642.76 0 0.00
16 B084 Flutamol Kaplet Kaplet 243.58 0 0.00
17 B085 Flutrop Kaplet Kaplet 400.00 0 0.00
18 B086 Fitominadion 10mG Tablet 710.00 0 0.00
19 B087 Na Diklofenak 25mg Tablet 128.00 0 0.00
20 B088 Asam Asetyl Salisilat (Miniaspi) Tablet 99.00 0 0.00
21 B089 Salbutamol 2 mg Tablet 63.00 0 0.00
22 B090 Asam Askorbat (Vit. C) Tab 50Mg Tablet 104.99 0 0.00
23 B091 Ibuprofen tablet 200mg Tablet 105.00 0 0.00
24 B092 Thiamin Hcl (Vit B1) Tablet 50Mg Tablet 85.00 0 0.00
25 B093 Parasetamol Sirup 120Mg/5Ml Botol 1,106.60 0 0.00
26 B094 Urine Verify 3P STRIP 1,283.70 0 0.00
27 B095 Vaculab 3 ml EDTA K3 Glass Pcs 2,000.00 0 0.00
28 B096 Kloramfenikol tetes telinga (Erlamicetin TT) Botol 10 ml 5,850.05 0 0.00
29 B097 OBH Itrasal Botol 4,300.35 0 0.00
100mL
30 B098 Widal BH Glory Kit 141,460.00 0 0.00
31 B099 Widal CH Glory Kit 141,460.00 0 0.00
32 B100 Widal BO Glory Kit 141,460.00 0 0.00
33 B101 Widal CO Glory Kit 141,460.00 0 0.00
189
34 B102 Dengue IGG/IGM (Triline Card) 25s Kit 90,508.00 0 0.00
35 B103 Dimenhidrinat 50 Mg Tablet 105.00 17 1,785.00
36 B104 Hidrokortison Salep Kulit 2.5 % Tube 2,475.00 0 0.00
37 B105 Antihemoroid supp Suppositori 3,166.90 0 0.00
a
38 B106 Silk 2/0 75CC 30M C (DEMESILK) Pcs 15,750.00 15 236,250.00
39 B107 Scopma tab Tablet 1,372.25 0 0.00
40 B108 Selviplex Tablet 396.00 0 0.00
41 B109 Anaton Syr Botol 6,050.00 0 0.00
42 B110 HBsAg SR STRIP 5,500.00 0 0.00
43 B111 Strip Gula (Gluco DR) STRIP 3,800.00 0 0.00
44 B112 Needle No.23 (BD) Pcs 379.99 0 0.00
45 B113 Soft Pad Pcs 3,799.95 0 0.00
46 B114 Piroksikam Tab.10Mg Tablet 109.28 0 0.00
47 B115 Tropidryl Plus Syr Botol 4,249.58 0 0.00
49 B117 Tropifer Cap Kapsul 218.57 0 0.00
50 B118 Antasida Doen Tablet Kunyah Tab 54.00 0 0.00
51 B119 Kloramfenikol Tetes Mata (Reco) 10 ml fls 6,930.00 0 0.00
52 B120 Kloramfenikol Tetes Telinga 3% (RECO) fls 7,007.00 0 0.00
53 B121 Strip Gula (Gluco DR) Box isi 50 200,000.00 0 0.00
54 B122 Permethrin 5% (Scabimite) Tube 10gr 22,000.00 0 0.00
55 B123 Asiklovir Krim 5% Tube 4,234.23 0 0.00
56 B124 Oksitetrasiklin Salep Klulit 3% Tube 2,412.30 0 0.00
57 B125 Strip Gula (Gluco DR) STRIP 4,125.00 0 0.00
58 B126 Tabung Vacumtainer EDTA 3ml (onemed) Pcs 1,000.00 0 0.00
59 B127 Strip Cholesterol Autocheck box isi 10 18,980.50 0 0.00
60 B128 Kaptopril Tablet 25 Mg Tablet 104.50 0 0.00
61 B129 Bisakodil (Dulcolax) 5mg Tablet 1,386.57 0 0.00
62 B130 Glibenklamid 5mg tab Tablet 89.50 0 0.00
63 B131 Soft Pad Pcs 3,570.00 30 107,100.00
64 B132 Simvastatin Tab.10mg Tablet 252.45 0 0.00
65 B133 KASA ELASTIS 6 NC (4MX15CM) ROLL 26,928.00 0 0.00
66 B134 Multivitamin Anak Syr (LYSCALVIT SIRUP) Botol 3,428.48 0 0.00
67 B135 Alkohol Swab PCS 307.62 0 0.00
68 B136 Domperidon Suspensi 5mg/ 5ml (Rosidon Syr) Botol 3,598.40 0 0.00
69 B137 Ambroksol Syr Botol 2,857.36 0 0.00
70 B138 Ambroksol Tablet 30mg Tablet 102.85 0 0.00
71 B139 Domperidon Tablet 10 Mg Tablet 182.86 0 0.00
72 B140 Tiamfenikol Kapsul 500Mg (Thiamex) Kapsul 830.36 0 0.00
73 B141 OBH Rama Sirup Botol 4,428.74 0 0.00
74 B142 Salbutamol (Ventolin) Nebules 2,5mg Ampul 20,346.92 0 0.00
190
75 B143 Asiklovir Krim 5% Tube 3,370.79 0 0.00
76 B144 Gliseril Guaiakolat Tab 100Mg (Guaifenesin) Tablet 92.53 0 0.00
77 B145 Gliseril Guaiakolat Tab 100Mg (Guaifenesin) Tablet 92.53 0 0.00
78 B146 Asam Mefenamat Kaplet 500 Mg (rama) Tablet 248.57 0 0.00
80 B148 Multivitamin Anak Syr (LYSCALVIT SIRUP) Botol 3,714.48 0 0.00
81 B149 Obat Batuk Kombinasi Mengandung Botol 4,319.92 0 0.00
Dekstrometorfan (COLORTUSIN) Sirup
82 B150 Triamsinolon asetonida IOB (Bufacomb) Tube 5gr 14,499.10 0 0.00
83 B151 Heparin (Hico) Tube 15 gr 13,200.00 0 0.00
84 B152 Kloramfenikol Tetes Mata (Reco) 10 ml Botol 7,260.00 0 0.00
85 B153 Kloramfenikol Tetes Telinga 3% (RECO) Botol 7,342.50 0 0.00
86 B154 Ekstrak Plasenta+Neomisin Sulfate Tube 16,830.00 0 0.00
(Bioplacenton)
87 B155 Multivitamin & Mineral Tablet (Caviplex) Tablet 440.80 0 0.00
88 B156 Bedak Salisil 2% Pot 3,245.00 89 288,805.00
89 B157 Hiosina N Butil Bromida 10 Mg (Scopma) Tablet 1,000.00 0 0.00
90 B158 Obat Batuk Kombinasi Mengandung tablet 306.00 0 0.00
Dekstrometorfan (COLORTUSIN) tablet
91 B159 Metronidazol 500Mg Tablet 194.29 0 0.00
92 B160 Domperidon Suspensi 5mg/ 5ml (Rosidon Syr) Botol 3,598.41 0 0.00
94 B162 OBH AFI Botol 3,300.00 0 0.00
100mL
96 B164 Omeprazole 20mg Kapsul 290.00 0 0.00
97 B165 Domperidon Tablet 10 Mg Tablet 142.50 0 0.00
98 B166 Domperidon Suspensi 5mg/ 5ml Botol 3,599.20 0 0.00
99 B167 Kloramfenikol Tetes Mata (Reco) 10 ml fls 7,260.00 0 0.00
100 B168 BRUSH Pcs 9,900.00 0 0.00
101 B169 BUR DIAMOND MEISSENGER A 801010 PCS 36,300.00 0 0.00
102 B170 BUR DIAMOND MEISSENGER A 801009 Pcs 36,300.00 0 0.00
103 B171 BUR DIAMOND EDENTA A 801-014 Pcs 33,000.00 0 0.00
108 B176 BUR DIAMOND MEISSENGER B 837014 Pcs 47,300.00 0 0.00
109 B177 BUR DIAMOND MEISSENGER B847012 Pcs 47,300.00 0 0.00
110 B178 Thiamin Hcl (Vit B1) Tablet 50Mg Tablet 137.14 0 0.00
112 B180 Antidiare (Attapulgite) New Antides Tablet 182.86 0 0.00
113 B181 Obat Batuk Kombinasi Mengandung Tablet 306.00 0 0.00
Dekstrometorfan (COLORTUSIN) tablet
114 B182 Antiinfluenza (Flutrop) Tablet Tablet 428.57 0 0.00
115 B183 Alkohol Swab (remedi) Pcs 123.00 0 0.00
191
116 B184 Tabung Vacum EDTA Glas Pcs 1,100.00 0 0.00
117 B185 Loperamide Tab 2 mg Tablet 138.71 0 0.00
119 B187 SARUNG TANGAN KARET PANJANG Pasang 10,000.00 0 0.00
120 B188 Baju Coverall PINK Pcs 180,000.00 0 0.00
121 B189 KACAMATA FACESHIELD Pcs 120,000.00 0 0.00
122 B190 Masker N95 Pcs 74,072.72 0 0.00
123 B191 Amoksisilin Kaplet 500 Mg Tablet 253.00 0 0.00
124 B192 Asam Asetyl Salisilat (Miniaspi) Tablet 104.99 0 0.00
125 B193 Handscoon M (Latex) Pcs 462.00 0 0.00
126 B194 Tiamfenikol Kapsul 500Mg (Thiamex) Kapsul 971.43 0 0.00
127 B196 Vitamin B1 (Thiamin) Tablet 176.00 0 0.00
128 B197 CLUNGEN COVID-19 RAPID TEST Pcs 132,000.00 0 0.00
129 B198 CLUNGEN COVID-19 RAPID TEST Pcs 132,000.00 0 0.00
130 B203 Handscoon S Pcs 1,320.00 2,400 3,168,000.00
131 B206 Masker Kain Pcs 2,970.00 0 0.00
132 B208 RDT COVID-19 (Altamed) Pcs 35,000.00 0 0.00
133 B209 MASKER SAFELOCK Pcs 1,000.00 0 0.00
134 B210 RDT COVID-19 (Altamed) PCS 30,000.00 0 0.00
135 B211 Altamed Antigen Test Kit 40,000.00 0 0.00
136 B212 Ambroksol Syr Botol 2,750.20 0 0.00
137 B213 Asiklovir Krim 5% Tube 5gr 2,860.00 75 214,500.00
138 B214 Strip Gula (Autocheck) STRIP 2,750.00 728 2,002,000.00
139 B215 Strip Cholesterol (Autocheck) STRIP 14,740.00 0 0.00
140 B216 Strip Asam Urat (Autocheck) STRIP 3,575.00 0 0.00
141 B217 KASA ELASTIS 6 NC (4MX15CM) Roll 20,328.00 28 569,184.00
142 B218 TEST COVID-19 ANTIGEN ( TAISHAN ) Pcs 35,300.00 0 0.00
143 B219 TEST COVID-19 ANTIGEN ( TAISHAN ) PCS 35,300.00 0 0.00
144 B220 TEST COVID-19 ANTIGEN (ALTAMED) Kit 26,000.00 0 0.00
149 B225 TEST COVID-19 ANTIGEN (ALTAMED) Pcs 25,000.00 0 0.00
153 B229 Fuji IX GP 1-1 Box 915,750.00 2 1,831,500.00
154 B230 Elite Cement Mini Box 199,800.00 2 399,600.00
155 B231 Caviton White Box 183,150.00 3 549,450.00
156 B232 Endoseal Box 251,500.00 0 0.00
192
157 B233 Saliva Box 64,500.00 0 0.00
158 B234 BUR HIGH SPEED ROUND Pcs 26,000.00 0 0.00
159 B235 Bahan Gigi ( CR ) Pak 58,500.00 0 0.00
160 B236 TKF / Tricresolformaline 10 ml Botol 72,150.00 0 0.00
9,368,174.00

NIP. 196803312002121004 NIP. 19830605 201001 2 031
193
Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
194
0.00
1,785.00
0.00
0.00
236,250.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
107,100.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
195
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
288,805.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
196
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
3,168,000.00
0.00
0.00
0.00
0.00
0.00
0.00
214,500.00
2,002,000.00
0.00
0.00
569,184.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
1,831,500.00
399,600.00
549,450.00
0.00
197
0.00
0.00
0.00
0.00
9,368,174.00
S.Farm., Apt.
201001 2 031
198
BLUD3
Kecamatan SUSUKAN
Nomor Rekening: 1.01.02.1.01.02.01.33.05.5.2.2.24.02 ( BLUD 3 )
Periode: Juni 2022
1 Dimenhidrinat 50 Mg Tablet 105.00 17 1,785.00
2 Silk 2/0 75CC 30M C (DEMESILK) Pcs 15,750.00 15 236,250.00
3 Soft Pad Pcs 3,570.00 30 107,100.00
4 Bedak Salisil 2% Pot 3,245.00 89 288,805.00
5 Handscoon S Pcs 1,320.00 2,400 3,168,000.00
6 Asiklovir Krim 5% Tube 5gr 2,860.00 75 214,500.00
7 Strip Gula (Autocheck) STRIP 2,750.00 728 2,002,000.00
8 KASA ELASTIS 6 NC (4MX15CM) Roll 20,328.00 28 569,184.00
9 Fuji IX GP 1-1 Box 915,750.00 2 1,831,500.00
10 Elite Cement Mini Box 199,800.00 2 399,600.00
11 Caviton White Box 183,150.00 3 549,450.00
9,368,174.00

NIP. 196803312002121004 NIP. 19830605 201001 2 031
199

Lampiran Akrual Juni 2022

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UPTD Puskesmas Susukan

Pemerintah Kabupaten Semarang

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

LAPORAN STOK OPNAME PER-REKENING

Kepala Puskesmas, Koordinator Apotik,

Dr ESHA KRESTRIANA RIHA USWATI, S.Farm., Apt.

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