LAPORAN PERSEDIAAN OBAT DAN BMHP

Periode September 2019

HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)

OBAT
DAK 18 - 2,860.00 - 2,860.00 - - 2,860.00 - 07 2021 94G48A
1 Air untuk injeksi amp 25 ml Vial
BS PROP 360 2,860.00 1,029,600.00 105 2,860.00 300,300.00 255 2,860.00 729,300.00 07 2021 78G48B
YPPM 17 - 35,800.00 - 35,800.00 - - 35,800.00 - 07 2020 G71179B
2 Albendazol tab 400 mg Box/100
DAK 18 1,232 50,400.00 62,092,800.00 105 50,400.00 5,292,000.00 1,127 50,400.00 56,800,800.00 07 2021 H80164BI
DAK 17 2,100 12,400.00 26,040,000.00 185 12,400.00 2,294,000.00 1,915 12,400.00 23,746,000.00 08 2020 170840106
3 Alopurinol tab 100 mg Box/100
DAK 18 2,000 11,700.00 23,400,000.00 - 11,700.00 - 2,000 11,700.00 23,400,000.00 06 2020 A81362
DAK 18 2,346 15,534.00 36,442,764.00 298 15,534.00 4,629,132.00 2,048 15,534.00 31,813,632.00 10 2020 171001146
4 Ambroksol tab 30mg Box/100
DAK 19 356 15,534.00 5,530,104.00 - 15,534.00 - 356 15,534.00 5,530,104.00 05 2021 F91492B
DAK 16 - 3,349.00 - - 3,349.00 - - 3,349.00 - 06 2019 953070322
5 Aminofilin inj 24 mg/ml Ampul
DAK 18 210 3,280.00 688,800.00 150 3,280.00 492,000.00 60 3,280.00 196,800.00 05 2020 63070022
6 Aminofilin tablet 200 mg Btl/100 DAK 19 1,000 11,200.00 11,200,000.00 34 11,200.00 380,800.00 966 11,200.00 10,819,200.00 05 2021 18CE002
7 Amlodipin tab 10 mg Box/50 DAK 19 1,828 4,950.00 9,048,600.00 112 4,950.00 554,400.00 1,716 4,950.00 8,494,200.00 07 2023 H81490B
8 Amlodipin tab 5 mg Box/50 DAK 19 1,980 4,150.00 8,217,000.00 147 4,150.00 610,050.00 1,833 4,150.00 7,606,950.00 01 2024 B90188B
3,760 4,100.00 15,416,000.00 4,100.00 - 3,760 4,100.00 15,416,000.00 08 2021 1908-03-193
9 Amoksisilin sir forte 250 mg/5 ml Botol DAK 19
1,220 4,100.00 5,002,000.00 4,100.00 - 1,220 4,100.00 5,002,000.00 08 2021 1908-04-193
10 Amoksisilin sir kering 125 mg/5 ml Botol DAK 19 2,043 12,000.00 24,516,000.00 190 12,000.00 2,280,000.00 1,853 12,000.00 22,236,000.00 07 2021 1907-33-96
11 Amoksisilin kapsul 250 mg Box/100 DAK 18 23,588 20,800.00 490,630,400.00 90 20,800.00 1,872,000.00 23,498 20,800.00 488,758,400.00 05 2020 18054551
DAK 18 4,630 24,800.00 114,824,000.00 615 24,800.00 15,252,000.00 4,015 24,800.00 99,572,000.00 06 2020 CAMXA80462
12 Amoksisilin tablet 500 mg Box/100
DAK 19 12,000 26,300.00 315,600,000.00 - 26,300.00 - 12,000 26,300.00 315,600,000.00 06 2023
10 10,296.00 102,960.00 30 10,296.00 308,880.00 - 10,296.00 - 40 10,296.00 411,840.00 10 2020 PSL 37147
13 Ampisilin serb inj 1000 mg/vial Vial BS PROP
40 10,296.00 411,840.00 - 10,296.00 - 40 10,296.00 411,840.00 11

Anestetik lokal gigi kombinasi : lidokain hcl 2% + Box/30 DAK 16 219 69,240.00 15,163,560.00 3 69,240.00 207,720.00 216 69,240.00 14,955,840.00 08 2020 16IH039
14
epinefrin 1 : 80.000 inj 2 ml Box/30 DAK 18 30 43,200.00 1,296,000.00 - 43,200.00 - 30 43,200.00 1,296,000.00 05 2021 16815037
95 17,118.00 1,626,210.00 95 17,118.00 1,626,210.00 - 17,118.00 - 03 2023 C80468T
15 Antalgin tab 500mg Box/100 DAK 18
460 17,118.00 7,874,280.00 24 17,118.00 410,832.00 436 17,118.00 7,463,448.00 03 2023 C80604T

Antasida, kombinasi : aluminium hidroksida 200 mg +

16 Botol DAK 19 7,000 2,408.00 16,856,000.00 300 2,408.00 722,400.00 6,700 2,408.00 16,133,600.00 07 2021 S07004AJ
magnesium hidroksida 200 mg
Antasida, kombinasi : aluminium hidroksida 200 mg +
17 Box/100 DAK 18 4,535 6,200.00 28,117,000.00 288 6,200.00 1,785,600.00 4,247 6,200.00 26,331,400.00 08 2020 A81743
magnesium hidroksida 200 mg
18 Antibakteri DOEN, Kombinasi Tube DAK 18 4,125 3,794.00 15,650,250.00 25 3,794.00 94,850.00 4,100 3,794.00 15,555,400.00 07 2020 1307038
Box/24 BS PROP 17 124,512.00 2,116,704.00 5 124,512.00 622,560.00 12 124,512.00 1,494,144.00 05 2021 17SE025A
19 Antifungi DOEN, Kombinasi
Pot DAK 19 1,500 5,997.00 8,995,500.00 - 5,997.00 - 1,500 5,997.00 8,995,500.00 07 2023 19SG025A

Antihemoroid, kombinasi: bismut subgalat 150 mg + DAK 18 44 39,590.00 1,741,960.00 40 39,590.00 1,583,600.00 4 39,590.00 158,360.00 10 2021 172205W
20 heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng Box/10
oksida 120 mg + sup ad 2 g DAK 19 200 39,590.00 7,918,000.00 - 39,590.00 - 200 39,590.00 7,918,000.00 10 2021 J72653W

21 Aquajel Steril Jelly 28g tube

22 Artesunat serb inj 60 mg/ml (i.v./i.m.) Box/8 BS PROP 15 390,000.00 5,850,000.00 1 390,000.00 390,000.00 14 390,000.00 5,460,000.00 08 2020 LA170940

23 Asam asetilsalisilat (asetosal) tab 80 mg (Miniaspi tab) Box/100

24 Asam askorbat (vitamin C) tab 250 mg Box/100 DAK 18 1,435 12,500.00 17,937,500.00 141 12,500.00 1,762,500.00 1,294 12,500.00 16,175,000.00 03 2020 C70246B
DAK 18 134 13,000.00 1,742,000.00 134 13,000.00 1,742,000.00 - 13,000.00 - 06 2020 F70046B1
25 Asam askorbat (vitamin C) tab 50 mg Box/100 DAK 18 6,000 13,100.00 78,600,000.00 135 13,100.00 1,768,500.00 5,865 13,100.00 76,831,500.00 09 2020 H70083B1
DAK 19 3,755 13,100.00 49,190,500.00 1,380 13,100.00 18,078,000.00 - 13,100.00 - 5,135 13,100.00 67,268,500.00 08 2021 I8014BI
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
BS PROP 20 8,800.00 176,000.00 - 8,800.00 - 20 8,800.00 176,000.00 07 2020 I18TG012
26 Asam folat tab 1 mg Box/100
DAK 19 300 9,400.00 2,820,000.00 - 9,400.00 - 300 9,400.00 2,820,000.00
DAK 18 - 11,300.00 - 11,300.00 - - 11,300.00 - 09 2020 A81901
27 Asam mefenamat tab 500 mg Box/100
DAK 19 1,625 50,400.00 81,900,000.00 190 50,400.00 9,576,000.00 1,435 50,400.00 72,324,000.00 07 2021 1907-32-120
28 Asam traneksamat inj 10% 500mg/5ml Box/10 DAK 16 - 37,890.00 - 37,890.00 - - 37,890.00 - 07 2019 2861438
DAK 18 - 3,619.00 - 3,619.00 - - 3,619.00 - 01 2022 A70077J
29 Asiklovir cream Tube
BS PROP 450 3,788.00 1,704,600.00 100 3,788.00 378,800.00 350 3,788.00 1,325,800.00 09 2022 172808J
30 Asiklovir tablet 200 mg Box/100
BS PROP - 23,250.00 - 23,250.00 - - 23,250.00 - 07 2022 16304053
12 24,800.00 297,600.00 12 24,800.00 297,600.00 - 24,800.00 - 06 2023 26304037
31 Asiklovir tablet 400 mg Box/50
DAK 19 1,404 24,800.00 34,819,200.00 24 24,800.00 595,200.00 1,380 24,800.00 34,224,000.00 06 2023 26304041
560 24,800.00 13,888,000.00 - 24,800.00 - 560 24,800.00 13,888,000.00 06 2023 26304042
32 Attalpugit tab 500mg Box/100
33 Azitromisin tab 500 mg Box/20 BS PROP 2,450 108,000.00 264,600,000.00 36 108,000.00 3,888,000.00 2,414 108,000.00 260,712,000.00 01 2021 AG0086J
34 Bedak salisil serb 2% Pot DAK 17 - 1,142.00 - 1,142.00 - - 1,142.00 - 10 2020 A80JGC0590
35 Benzatin Benzil Penisilin 1,2Jt IU Vial
36 Benzatin Benzil Penisilin 2,4Jt IU Vial BS PROP 60 18,125.00 1,087,500.00 10 18,125.00 181,250.00 50 18,125.00 906,250.00 11 2020 95319023
DAK 18 1,350 1,520.00 2,052,000.00 150 1,520.00 228,000.00 1,200 1,520.00 1,824,000.00 10 2020 J71645T
37 Betametason krim 0,5 mg/g Tube
DAK 19 7,000 1,622.00 11,354,000.00 - 1,622.00 - 7,000 1,622.00 11,354,000.00 07 2021 G81347T
38 Bisakodil tab sal 5 mg (Dulcolax Tablet) Box/200 -
Bisakodil Supp. 5 mg (Dulcolax Supp.) Supp DAK 19 244 6,000.00 1,464,000.00 48 6,000.00 288,000.00 196 6,000.00 1,176,000.00 03 2023 19030457
306 5,900.00 1,805,400.00 65 5,900.00 383,500.00 241 5,900.00 1,421,900.00 10 2021 17101425
Bisakodil Supp. 10 mg (Dulcolax Supp.) Supp DAK 19 250 5,900.00 1,475,000.00 - 5,900.00 - 250 5,900.00 1,475,000.00 04 2022 18050644
400 5,900.00 2,360,000.00 - 5,900.00 - 400 5,900.00 2,360,000.00 11 2022 18121651
39 Bisoprolol tab 5 mg Box/ 30
Box/100 DAK 16 - 250,000.00 - 250,000.00 - - 250,000.00 - 11 2019 PIM63945
40 Deksametason inj 5 mg/ml (i.v./i.m.)
Box/10 DAK 19 250 14,500.00 3,625,000.00 25 14,500.00 362,500.00 225 14,500.00 3,262,500.00 06 2021 F9F012
DAK 17 - 4,700.00 - 4,700.00 - - 4,700.00 - 08 2020 170806150
41 Deksametason tab 0,5 mg Box/100
DAK 18 5,000 3,600.00 18,000,000.00 371 3,600.00 1,335,600.00 4,629 3,600.00 16,664,400.00 07 2020 180745150
42 Desoksimetason krim Tube
43 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul DAK 16 4,331 6,667.00 28,874,777.00 5 6,667.00 33,335.00 4,326 6,667.00 28,841,442.00 04 2020 1503008
44 Diazepam tab 2 mg BTL/100 DAK 16 100 6,000.00 600,000.00 16 6,000.00 96,000.00 84 6,000.00 504,000.00 12 2019 L60629J
45 Dietilkarbamazin tab 100 mg Box/100 BS PROP 70 14,800.00 1,036,000.00 - 14,800.00 - 70 14,800.00 1,036,000.00 - 14,800.00 - 11 2019 1411021
DAK 17 164 39,870.00 6,538,680.00 3 39,870.00 119,610.00 161 39,870.00 6,419,070.00 05 2021 63420071
46 Difenhidramin inj 10 mg/ml (i.v./i.m.) Box/30
DAK 18 200 41,160.00 8,232,000.00 - 41,160.00 - 200 41,160.00 8,232,000.00 10 2021 63420162
47 Digoksin tab 0,25 mg Box/100
48 Diltiazem hcl tab 30 mg Box/100
49 Dimenhidrinat tab 50 mg Btl/100 DAK 19 72 14,000.00 1,008,000.00 6 14,000.00 84,000.00 66 14,000.00 924,000.00 09 2022 J72527B
DAK 16 323 33,600.00 10,852,800.00 6 33,600.00 201,600.00 317 33,600.00 10,651,200.00 05 2020 1605014
50 Doksisiklin kaps 100 mg Box/100
DAK 18 100 26,400.00 2,640,000.00 - 26,400.00 - 100 26,400.00 2,640,000.00 07 2020 C0312GV
51 Domperidon susp 5 mg/5 ml BTL 60 ml DAK 19 500 3,051.00 1,525,500.00 - 3,051.00 - 500 3,051.00 1,525,500.00 08 2021 1908-19-186
52 Domperidon tab 10 mg Box/100 BS PROP 70 9,600.00 672,000.00 - 9,600.00 - 70 9,600.00 672,000.00 07 2022 A5008GW
53 Efedrin tab 25 mg Btl/100
310 2,486.00 770,660.00 25 2,486.00 62,150.00 285 2,486.00 708,510.00 11 2020 97LL00080
54 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) Ampul BS PROP
2,486.00 - 300 2,486.00 745,800.00 - 2,486.00 - 300 2,486.00 745,800.00 12 2020 97LM0007
55 Eritromisin tab 500 mg Box/100 DAK 18 105 78,100.00 8,200,500.00 10 78,100.00 781,000.00 95 78,100.00 7,419,500.00 08 2022 B2536GV
Btl 100ml DAK 17 2,181 2,900.00 6,324,900.00 6 2,900.00 17,400.00 2,175 2,900.00 6,307,500.00 08 2020 G48735
56 Etanol cairan 70%
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
56 Etanol cairan 70%
Btl 300ml DAK 17 4,463 8,000.00 35,704,000.00 60 8,000.00 480,000.00 4,403 8,000.00 35,224,000.00 08 2020 G48717
57 Etil klorida semprot 200 ml Botol DAK 18 - 440,000.00 - 440,000.00 - - 440,000.00 - 12 2022 185375
DAK 18 - 15,200.00 - 15,200.00 - - 15,200.00 - 10 2019 371006
58 Fenitoin Na kaps 100 mg Btl/100
DAK 18 50 15,800.00 790,000.00 3 15,800.00 47,400.00 4 15,800.00 63,200.00 43 15,800.00 679,400.00 03 2020 380305
59 Fenobarbital inj 50mg/ml Ampul DAK 16 758 2,462.00 1,866,196.00 - 2,462.00 - 758 2,462.00 1,866,196.00 12 2019 85803005
60 Fenobarbital tab 30 mg Btl/100
61 Fenol Gliserol tetes telinga Btl 5ml DAK 18 35 2,590.00 90,650.00 - 2,590.00 - 35 2,590.00 90,650.00 05 2020 1804LE114
- 133,140.00 - 133,140.00 - - 133,140.00 - 09 2019 64780432
Box/30 BS PROP 29 137,850.00 3,997,650.00 4 137,850.00 551,400.00 25 137,850.00 3,446,250.00 - 137,850.00 - 11 2019 6478067
62 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.)
40 137,850.00 5,514,000.00 137,850.00 - 40 137,850.00 5,514,000.00 05 2020 16478025
Ampul DAK 19 5,000 4,595.00 22,975,000.00 4,595.00 - 5,000 4,595.00 22,975,000.00 07 2021 26478030
DAK 18 82 89,000.00 7,298,000.00 4 89,000.00 356,000.00 78 89,000.00 6,942,000.00 04 2021 16381005
63 Fitomenadion (vitamin K 1) tab sal 10 mg Box/100
DAK 19 150 95,000.00 14,250,000.00 - 95,000.00 - 150 95,000.00 14,250,000.00 10 2021 16381018
64 Framisetin Sulfat Tulle 1% (Daryantulle) Box/10
65 Furosemid inj 10 mg/ml (i.v./i.m.) Box/25
DAK 18 27 16,000.00 432,000.00 5 16,000.00 80,000.00 22 16,000.00 352,000.00 08 2020 I72012B
66 Furosemid tab 40 mg Box/200 DAK 18 50 17,600.00 880,000.00 - 17,600.00 - 50 17,600.00 880,000.00 01 2020 B70063B
DAK 19 150 18,800.00 2,820,000.00 - 18,800.00 - 150 18,800.00 2,820,000.00 08 2021 I81856B

- 25,700.00 - 25,700.00 - - 25,700.00 - 10 2023 K82361B

Garam oralit kombinasi : natrium klorida 0,52 g + Box/100 BS PROP
67 kalium klorida 0,30 g + trinatrium sitrat 0,58 g + glukosa 108 29,600.00 3,196,800.00 - 29,600.00 - 108 29,600.00 3,196,800.00 02 2022 C90631B
anhidrat 2,7 g
Box/25 DAK 19 61 21,450.00 1,308,450.00 25 21,450.00 536,250.00 36 21,450.00 772,200.00 11 2021 P11012AH

68 Gentamisin inj Box/5 BS PROP 33 21,935.00 723,855.00 4 21,935.00 87,740.00 29 21,935.00 636,115.00 10 2020 BF18I093
69 Gentamisin salep kulit Tube DAK 18 190 2,126.00 403,940.00 190 2,126.00 403,940.00 - 2,126.00 - 03 2022 C80591T
70 Gentamisin tetes mata Botol
71 Gentian violet Botol DAK 18 2,712 5,500.00 14,916,000.00 96 5,500.00 528,000.00 2,616 5,500.00 14,388,000.00 05 2022 21061888
Btl/100 DAK 16 - 14,500.00 - 14,500.00 - - 14,500.00 - 11 2021 KQ03T14B
350 10,800.00 3,780,000.00 - 10,800.00 - 350 10,800.00 3,780,000.00 02 2023 B80346T
72 GG tab 100 mg Btl/100 DAK 18 3,500 10,800.00 37,800,000.00 - 10,800.00 - 3,500 10,800.00 37,800,000.00 04 2023 D80813T
400 10,800.00 4,320,000.00 - 10,800.00 - 400 10,800.00 4,320,000.00 09 2023 I81961T
Box/100 DAK 19 1,185 23,488.00 27,833,280.00 270 23,488.00 6,341,760.00 915 23,488.00 21,491,520.00 03 2021 C.90080T
DAK 15 458 16,947.00 7,761,726.00 48 16,947.00 813,456.00 410 16,947.00 6,948,270.00 11 2020 1510078
73 Glibenklamid tab 5 mg Box/100
DAK 16 1,000 23,000.00 23,000,000.00 - 23,000.00 - 1,000 23,000.00 23,000,000.00 12 2020 1511094
74 Glimepirid tab 2 mg Box/50
75 Gliserol sol. 100 ml Botol DAK 15 174 6,600.00 1,148,400.00 - 6,600.00 - 174 6,600.00 1,148,400.00 08 2020 15LH010
76 Glukosa Larutan Infus 10% steril 500 ml Kolf 500 ml DAK 16 280 7,500.00 2,100,000.00 20 7,500.00 150,000.00 260 7,500.00 1,950,000.00 04 2020 250505
77 Glukosa Larutan Infus 40% steril 25 ml Kolf 25ml
DAK 18 9,660 6,410.00 61,920,600.00 - 6,410.00 - 9,660 6,410.00 61,920,600.00 07 2020 270820
78 Glukosa Larutan Infus 5% steril 500 ml Kolf 500 ml
Retur PKM 240 6,240.00 1,497,600.00 60 6,240.00 374,400.00 180 6,240.00 1,123,200.00 07 2020 270820
DAK 18 90 23,800.00 2,142,000.00 58 23,800.00 1,380,400.00 32 23,800.00 761,600.00 04 2020 180405176
79 Griseofulvin (micronized) tab 125 mg Box/100
DAK 19 2,000 25,400.00 50,800,000.00 - 25,400.00 - 2,000 25,400.00 50,800,000.00
Griseofulvin (micronized) tab 500 mg Box/100 DAK 19 200 113,100.00 22,620,000.00 - 113,100.00 - 200 113,100.00 22,620,000.00 06 2021 RF12E010
DAK 18 90 18,600.00 1,674,000.00 11 18,600.00 204,600.00 79 18,600.00 1,469,400.00 08 2022 I72008B
96 19,400.00 1,862,400.00 - 19,400.00 - 96 19,400.00 1,862,400.00 05 2022 F70891B
80 Hidroklorotiazid tab 25 mg Box/100 DAK 18 52 19,400.00 1,008,800.00 - 19,400.00 - 52 19,400.00 1,008,800.00 06 2022 G71114B
52 19,400.00 1,008,800.00 - 19,400.00 - 52 19,400.00 1,008,800.00 08 2022 I72008B
DAK 19 60 19,400.00 1,164,000.00 - 19,400.00 - 60 19,400.00 1,164,000.00 01 2023 B80165B
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
81 Hidrokortison krim 2,5% Tube DAK 18 4,584 2,846.00 13,046,064.00 144 2,846.00 409,824.00 4,440 2,846.00 12,636,240.00 10 2021 J71528T
82 Hiosina butilbromida Inj (Buscopan Injeksi) Box/10 DAK 16 24 400,000.00 9,600,000.00 2 400,000.00 800,000.00 22 400,000.00 8,800,000.00 04 2021 627282B

83 Hiosina butilbromida tab 10 mg (Buscopan Tablet) Box/100

84 Ibuprofen tab 200 mg Box/100 BS PROP 264 11,900.00 3,141,600.00 - 11,900.00 - 264 11,900.00 3,141,600.00 07 2020 1807.10.177
85 Ichtiol salep kulit Pot
86 Isosorbid dinitrat tab 5 mg Box/100 BS PROP 7 8,900.00 62,300.00 - 8,900.00 - 7 8,900.00 62,300.00 03 2023 A2325W
87 Isoniazid tab 300 mg Box/100 DAK 18 94 19,030.00 1,788,820.00 - 19,030.00 - 94 19,030.00 1,788,820.00 08 2022 I72310B
88 Isoniazid tab 100 mg (PP INH) Box/100 BS PROP 28 12,500.00 350,000.00 6 12,500.00 75,000.00 22 12,500.00 275,000.00 02 2020 A501857
89 Kalsium laktat (kalk) tab 500 mg Box/100
90 Kanamisin serb inj 1000 mg Box/10 DAU 15 29 120,000.00 3,480,000.00 - 120,000.00 - 29 120,000.00 3,480,000.00 07 2020 15927
91 Kaptopril tab 25 mg Box/100 DAK 19 133 14,464.00 1,923,712.00 133 14,464.00 1,923,712.00 - 14,464.00 - 01 2024 B.90316B
- 2,985.00 - 2,985.00 - - 2,985.00 - 07 2021 G.70654T
92 Ketokonazol salep kulit Tube BS PROP
75 2,893.00 216,975.00 250 2,893.00 723,250.00 75 2,893.00 216,975.00 250 2,893.00 723,250.00 04 2022 D.80865T
DAK 18 - 15,250.00 - 15,250.00 - - 15,250.00 - 05 2020 180501103
93 Ketokonazol tab 200 mg Box/50
DAK 19 568 16,250.00 9,230,000.00 52 16,250.00 845,000.00 516 16,250.00 8,385,000.00 06 2021 1906-07-103
94 Ketorolak inj. 30mg/ml Ampul
95 Klindamisin kaps 150mg Box/50
96 Klindamisin kaps 300mg Box/50
97 Klonidin tab 0,15 mg Box/100 DAK 15 100 22,100.00 2,210,000.00 - 22,100.00 - 100 22,100.00 2,210,000.00 02 2020 B150221B
98 Klopidogrel tab 75 mg Box/30 - - - - -
DAK 18 5,544 2,160.00 11,975,040.00 216 2,160.00 466,560.00 5,328 2,160.00 11,508,480.00 04 2021 D81172W
99 Kloramfenikol salep mata 1% Tube
DAK 19 7,200 2,305.00 16,596,000.00 - 2,305.00 - 7,200 2,305.00 16,596,000.00 09 2021 I82597W
100 Kloramfenikol tetes telinga 3% Botol
DAK 18 - 2,500.00 - 2,500.00 - - 2,500.00 - 07 2022 180745152
188 4,700.00 883,600.00 - 4,700.00 - 188 4,700.00 883,600.00 11 2020 1611-41-152
BS PROP
594 2,500.00 1,485,000.00 - 2,500.00 - 594 2,500.00 1,485,000.00 07 2022 1807-23-152
101 Klorfeniramin tab 4 mg (CTM) Box/100
1 2,700.00 2,700.00 - 2,700.00 - 1 2,700.00 2,700.00 07 2021 1907-81-152
DAK 19 2,167 2,700.00 5,850,900.00 - 2,700.00 - 2,167 2,700.00 5,850,900.00 07 2021 1907-87-152
2,832 2,700.00 7,646,400.00 - 2,700.00 - 2,832 2,700.00 7,646,400.00 07 2021 1907-88-152
102 Kodein tab 10 mg Box/100 DAK 16 - 68,800.00 - 68,800.00 - - 68,800.00 - 11 2019 ME2993J

Kombinasi (DHP) : Dihidroartemisin 40 mg + 187 19,260.00 3,601,620.00 187 19,260.00 3,601,620.00 - 19,260.00 - 05 2020 180519
103 Box/9 BS PROP
Piperakuin 320 mg tab sal selaput 2,160 19,260.00 41,601,600.00 19 19,260.00 365,940.00 2,141 19,260.00 41,235,660.00 05 2020 180520
104 Kombinasi : Ergotamin 1 mg+ Kafein 50 mg Botol/100
- 13,440.00 - 13,440.00 - - 13,440.00 - 10 2019 6818412-1
BS PROP
- 13,440.00 - 13,440.00 - - 13,440.00 - 10 2019 6818413
Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 mg
105 Box/30 14,517 13,350.00 193,801,950.00 2,990 13,350.00 39,916,500.00 11,527 13,350.00 153,885,450.00 07 2020 18TD1049
tab salut (Tablet Tambah darah)
DAK 18 1,984 13,350.00 26,486,400.00 - 13,350.00 - 1,984 13,350.00 26,486,400.00 07 2020 18TD1041
1,868 13,350.00 24,937,800.00 - 13,350.00 - 1,868 13,350.00 24,937,800.00 07 2020 18TD1043

Kombinasi : Thiamin HCl + Piridoksin +

106 Box/20
Sianokobalamin inj
Kombinasi : Thiamin HCl + Piridoksin +
107 Box/200
Sianokobalamin tablet
Kotrimoksazol (dewasa) tablet kombinasi :
108 Box/100 DAK 18 - 13,700.00 - 13,700.00 - - 13,700.00 - 09 2019 171884
sulfametoksazol 400 mg+ trimetoprim 80 mg
Kotrimoksazol (dewasa) tablet kombinasi :
Box/100 BS PROP 100 33,500.00 3,350,000.00 - 33,500.00 - 100 33,500.00 3,350,000.00 07 2020 A81414
sulfametoksazol 800 mg+ trimetoprim 160 mg
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)

Kotrimoksazol sirup kombinasi : sulfametoksazol 200

109 Botol DAK 18 5,905 2,258.00 13,333,490.00 170 2,258.00 383,860.00 5,735 2,258.00 12,949,630.00 05 2020 A81216
mg+ trimetoprim 40 mg per 5ml
110 Lamprene Kapsul 100mg Kapsul BS PROP 500 1,234.00 617,000.00 - 1,234.00 - 500 1,234.00 617,000.00 03 2021 GW8468
111 Lansoprazol Kapsul Box/20 DAK 18 594 7,180.00 4,264,920.00 20 7,180.00 143,600.00 574 7,180.00 4,121,320.00 02 2021 YB237A
Larutan mengandung Karbohidrat + Elektrolit (Nacl DAK 16 90 15,000.00 1,350,000.00 15,000.00 - 90 15,000.00 1,350,000.00 - 15,000.00 - 11 2019 46K76A
112 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27 gr) Kolf 500 ml
(KA EN 3B) DAK 18 1,000 11,314.00 11,314,000.00 40 11,314.00 452,560.00 960 11,314.00 10,861,440.00 07 2021 48G94A

Larutan mengandung Karbohidrat + Elektrolit (Nacl

113 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27 Kolf 500 ml DAK 18 860 11,314.00 9,730,040.00 120 11,314.00 1,357,680.00 740 11,314.00 8,372,360.00 04 2021 48D99A
gr) (KA EN 3A)
114 Lidokain gel 2% (Xilocain Jel) Tube
115 Lidokain HCl inj 2% Box/100
116 Lisinopril tab 10mg Box/30
117 Lisinopril tab 5mg Box/30
118 Loperamid tab 2 mg Box/100 BS PROP - 9,700.00 - 9,700.00 - - 9,700.00 - 08 2020 70608
119 Loratadin tab 10 mg Box/50 DAK 18 710 8,600.00 6,106,000.00 80 8,600.00 688,000.00 630 8,600.00 5,418,000.00 05 2020 10217 E0010
120 Magnesium sulfat inj 20% Vial BS PROP 65 3,328.00 216,320.00 15 3,328.00 49,920.00 50 3,328.00 166,400.00 07 2020 74G48B
121 Magnesium sulfat inj 40% Vial BS PROP 93 3,796.00 353,028.00 2 3,796.00 7,592.00 91 3,796.00 345,436.00 07 2020 75G48A
122 MD/MB COMBI Anak Box/6 blister BS PROP 13 123,324.00 1,603,212.00 3 123,324.00 369,972.00 10 123,324.00 1,233,240.00 08 2020 BGS9813
- 170,544.00 - 170,544.00 - - 170,544.00 - 08 2019 B. GE6401
- 250,704.00 - 250,704.00 - - 250,704.00 - 10 2021 B. HT3988
123 MD/MB COMBI Dewasa Box/6 blister BS PROP
14 250,704.00 3,509,856.00 8 250,704.00 2,005,632.00 6 250,704.00 1,504,224.00 10 2021 B. HZ9323
16 250,704.00 4,011,264.00 - 250,704.00 - 16 250,704.00 4,011,264.00 03 2022 B.HZ9323
124 Meloksikam tab 15 mg Box/20
125 Meloksikam tab 7,5 mg Box/20
126 Metformin tab 500 mg Box/100 DAK 18 3,200 12,000.00 38,400,000.00 110 12,000.00 1,320,000.00 3,090 12,000.00 37,080,000.00 05 2020 HTMFNA83815
127 Metilergometrin inj 0,2 mg/ml Ampul BS PROP 445 3,696.00 1,644,720.00 65 3,696.00 240,240.00 380 3,696.00 1,404,480.00 11 2020 9618L0248A
36 27,060.00 974,160.00 5 27,060.00 135,300.00 31 27,060.00 838,860.00 01 2021 AG0004J
165 27,060.00 4,464,900.00 - 27,060.00 - 165 27,060.00 4,464,900.00 03 2022 C70296J
128 Metilergometrin tab salut 0,125 mg Box/100 DAK 18
67 27,060.00 1,813,020.00 - 27,060.00 - 67 27,060.00 1,813,020.00 04 2022 D70898J
201 27,060.00 5,439,060.00 - 27,060.00 - 201 27,060.00 5,439,060.00 10 2020 LE2851J
129 Metoklopramid tab 10 mg Box/100 DAK 18 30 9,300.00 279,000.00 - 9,300.00 - 30 9,300.00 279,000.00 06 2020 F150933B
130 Metronidazol tab 250 mg Box/100
131 Metronidazol tab 500 mg Box/100 BS PROP - 36,179.00 - - 36,179.00 - - 36,179.00 - 10 2023 K82274B
132 Mikonazol krim 2% Tube DAK 18 264 4,268.00 1,126,752.00 192 4,268.00 819,456.00 72 4,268.00 307,296.00 11 2021 K73065W
133 Mineral Mix Box/40 BS PROP 9 116,800.00 1,051,200.00 - 116,800.00 - 9 116,800.00 1,051,200.00 08 2020 1808012
134 NaCl 0,9% Larutan Kolf 500 ml DAK 18 6,771 6,410.00 43,402,110.00 440 6,410.00 2,820,400.00 6,331 6,410.00 40,581,710.00 05 2023 280617
135 Natrium diklofenak tab 25 mg Box/50 BS PROP 102 8,150.00 831,300.00 - 8,150.00 - 102 8,150.00 831,300.00 06 2023 16364029
136 Natrium diklofenak tab 50 mg Box/50
137 Nifedipin kaps 10 mg Box/100
BS PROP 5 70,000.00 350,000.00 2 70,000.00 140,000.00 3 70,000.00 210,000.00 05 2022 16372010
138 Nistatin tab vaginal 100.000 UI Box/100
DAK 19 30 74,700.00 2,241,000.00 - 74,700.00 - 30 74,700.00 2,241,000.00 07 2022 16372022
- 232,518.00 - 232,518.00 - - 232,518.00 - 11 2020 16493043
139 Obat Anti Tuberculosis FDC Kategori Anak Paket BS PROP 12 232,518.00 2,790,216.00 12 232,518.00 2,790,216.00 - 232,518.00 - 06 2020 16493024
48 310,153.00 14,887,344.00 11 310,153.00 3,411,683.00 37 310,153.00 11,475,661.00 03 2021 19PK2005
54 486,685.00 26,280,990.00 54 486,685.00 26,280,990.00 - 486,685.00 - 02 2021 16461004
140 Obat Anti Tuberculosis FDC Kategori I Paket BS PROP 128 519,342.00 66,475,776.00 41 519,342.00 21,293,022.00 87 519,342.00 45,182,754.00 07 2021 16461221-1
80 519,342.00 41,547,360.00 - 519,342.00 - 80 519,342.00 41,547,360.00 07 2021 16461222
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
- 1,297,889.00 - - 1,297,889.00 - - 1,297,889.00 - 05 2021 16471021
141 Obat Anti Tuberculosis FDC Kategori II Paket BS PROP 1 1,297,889.00 1,297,889.00 - 1,297,889.00 - 1 1,297,889.00 1,297,889.00 07 2021 16471042-6
16 1,731,230.00 27,699,680.00 - 1,731,230.00 - 16 1,731,230.00 27,699,680.00 07 2021 26471004-5
142 OBH Sirup Botol
143 Oksitetrasiklin 1% salep mata Tube DAK 18 - 2,600.00 - 2,600.00 - - 2,600.00 - 07 2021 H80164BI
- 2,500.00 - 2,500.00 - - 2,500.00 - 03 2021 C80854W
144 Oksitetrasiklin 3% salep kulit Tube DAK 18
4,263 2,500.00 10,657,500.00 249 2,500.00 622,500.00 4,014 2,500.00 10,035,000.00 03 2021 C80967W
- 1,900.00 - 1,900.00 - - 1,900.00 - 08 2020 97LH0050
145 Oksitosin inj 10 UI/ml Ampul BS PROP
668 1,900.00 1,269,200.00 1,000 1,900.00 1,900,000.00 140 1,900.00 266,000.00 1,528 1,900.00 2,903,200.00 08 2020 97LH0052
DAK 16 620 5,430.00 3,366,600.00 125 5,430.00 678,750.00 495 5,430.00 2,687,850.00 12 2020 16120253
146 Omeprazol kaps 20 mg Box/30 DAK 17 2,000 4,740.00 9,480,000.00 - 4,740.00 - 2,000 4,740.00 9,480,000.00 05 2020 18050853
DAK 18 150 4,410.00 661,500.00 - 4,410.00 - 150 4,410.00 661,500.00 08 2021 17082453
147 Papaverin tab 40 mg Box/100 DAK 18 360 16,628.00 5,986,080.00 - 16,628.00 - 360 16,628.00 5,986,080.00 10 2021 J60014B
148 Paraformaldehid tab 1 g Btl/100 OP 09 6 5,364.00 32,184.00 - 5,364.00 - 6 5,364.00 32,184.00 51011H1
149 Parasetamol infus Botol DAK 18 - 22,000.00 - - 22,000.00 - - 22,000.00 - 11 2019 LY7E045
150 Parasetamol sir 120 mg/5 ml Botol BS PROP 65 3,159.00 205,335.00 65 3,159.00 205,335.00 - 3,159.00 - 07 2020 1808016
151 Parasetamol tab 100 mg Botol/100
DAK 18 - 6,600.00 - 6,600.00 - - 6,600.00 - 10 2019 172710
510 28,693.00 14,633,430.00 510 28,693.00 14,633,430.00 - 28,693.00 - 10 2022 J821171T
152 Parasetamol tab 500 mg Box/100
DAK 19 3,168 28,693.00 90,899,424.00 221 28,693.00 6,341,153.00 2,947 28,693.00 84,558,271.00 04 2021 D90359T
1,932 28,693.00 55,434,876.00 - 28,693.00 - 1,932 28,693.00 55,434,876.00 10 2022 J82157T
DAK 18 - 8,311.00 - 8,311.00 - - 8,311.00 - 07 2020 1807044
153 Parasetamol tts 60 mg/0,6 ml Botol
BS PROP 244 8,311.00 2,027,884.00 - 8,311.00 - 244 8,311.00 2,027,884.00 10 2020 1810078
154 PD/PB Anak Box/6 blister BS PROP 7 79,800.00 558,600.00 2 79,800.00 159,600.00 5 79,800.00 399,000.00 08 2020 BGU4822
155 PD/PB Dewasa Box/6 blister BS PROP 3 102,552.00 307,656.00 3 102,552.00 307,656.00 2 102,552.00 205,104.00 4 102,552.00 410,208.00 10 2021 B. HI3247
156 Pirantel pamoat susp 125 mg/5 ml Botol
157 Pirantel pamoat tab scored 125 mg Box/100 DAK 18 417 36,100.00 15,053,700.00 17 36,100.00 613,700.00 400 36,100.00 14,440,000.00 06 2020 1806011
DAK 18 456 15,400.00 7,022,400.00 115 15,400.00 1,771,000.00 341 15,400.00 5,251,400.00 09 2020 J72504B
158 Piridoksin (vitamin B6) tab 10 mg Box/100
DAK 19 2,000 16,400.00 32,800,000.00 - 16,400.00 - 2,000 16,400.00 32,800,000.00 02 2021 C80480B
159 Piroksikam tab 10mg Box/100
DAK 16 - 7,532.00 - - 7,532.00 - - 7,532.00 - 08 2019 086145W
Btl 60 ml
DAK 17 4,713 3,700.00 17,438,100.00 - 3,700.00 - 4,713 3,700.00 17,438,100.00 07 2020 23081786
160 Povidon iodin lar 100 mg/ml
DAK 17 1,636 18,000.00 29,448,000.00 19 18,000.00 342,000.00 1,617 18,000.00 29,106,000.00 07 2020 2081788
Btl 300 ml
DAK 18 1,000 22,500.00 22,500,000.00 - 22,500.00 - 1,000 22,500.00 22,500,000.00 03 2021 160418888
162 PPD RT 23 (Mantoux Test) Vial BS PROP 10 977,181.00 9,771,810.00 20 977,181.00 19,543,620.00 5 977,181.00 4,885,905.00 25 977,181.00 24,429,525.00 06 2020 6500218
Btl/1000 DAK 16 89 300,000.00 26,700,000.00 - 300,000.00 - 89 300,000.00 26,700,000.00 11 2020 16110739
163 Prednison tab 5 mg DAK 18 - 9,100.00 - - 9,100.00 - - 9,100.00 - 09 2019 1709052
Box/100
DAK 18 2,615 8,100.00 21,181,500.00 166 8,100.00 1,344,600.00 2,449 8,100.00 19,836,900.00 05 2020 1805211
DAK 16 - 28,000.00 - 28,000.00 - - 28,000.00 - 08 2019 95386004
164 Primakuin tab 15 mg Box/100
BS PROP 78 25,300.00 1,973,400.00 72 25,300.00 1,821,600.00 59 25,300.00 1,492,700.00 91 25,300.00 2,302,300.00 05 2021 16386003
165 Propranolol tab 10 mg Btl/100
166 Propranolol tab 40 mg Box/100
Ranitidin Inj Box/10 DAK 19 70 32,560.00 2,279,200.00 - 32,560.00 - 70 32,560.00 2,279,200.00 12 2021 IRNTB80137
Box/100 DAK 16 - 12,800.00 - 12,800.00 - - 12,800.00 - 08 2019 160801140A
167 Ranitidin tab 150 mg
Box/30 DAK 19 2,839 13,860.00 39,348,540.00 809 13,860.00 11,212,740.00 758 13,860.00 10,505,880.00 2,890 13,860.00 40,055,400.00 06 2023 G.81405B
DAK 18 - 17,750.00 - 17,750.00 - - 17,750.00 - 08 2020 H71745W
168 Retinol (vitamin A) kaps lunak 100.000 UI Btl/50 DAK 19 14 19,250.00 269,500.00 14 19,250.00 269,500.00 - 19,250.00 -
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
168 Retinol (vitamin A) kaps lunak 100.000 UI Btl/50 (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
BS PROP 120 14,350.00 1,722,000.00 - 14,350.00 - 120 14,350.00 1,722,000.00 08 2021 H82357W
169 Retinol (vitamin A) kaps lunak 200.000 UI Btl/50 DAK 18 826 31,800.00 26,266,800.00 165 31,800.00 5,247,000.00 661 31,800.00 21,019,800.00 08 2020 H71755W
170 Rifampisin tab 450mg Box/100 DAK 18 100 113,471.00 11,347,100.00 - 113,471.00 - 100 113,471.00 11,347,100.00 04 2022 D80981J
DAK 18 2,020 7,150.00 14,443,000.00 820 7,150.00 5,863,000.00 1,200 7,150.00 8,580,000.00 03 2023 380407
171 Ringer Laktat Larutan Kolf 500 ml Pengembalian RSUD 2,000 7,150.00 14,300,000.00 - 7,150.00 - 2,000 7,150.00 14,300,000.00 03 2024 490403
DAK 18 5,000 7,630.00 38,150,000.00 - 7,630.00 - 5,000 7,630.00 38,150,000.00 07 2024 490702
172 Rivanol Sol 10% Botol 300ml DAK 18 366 3,900.00 1,427,400.00 29 3,900.00 113,100.00 337 3,900.00 1,314,300.00 10 2020 14111788
173 Salbutamol cairan ih 0,1% (Ventolin Nebule) Box/20 amp
174 Salbutamol tab 2 mg Box/100 DAK 18 - 6,400.00 - 6,400.00 - - 6,400.00 - 10 2020 A8251JU
Salbutamol tab 4 mg Box/100 BS PROP 498 9,200.00 4,581,600.00 - 9,200.00 - 498 9,200.00 4,581,600.00 02 2022 C70176B1
DAK 18 3,240 3,280.00 10,627,200.00 - 3,280.00 - 3,240 3,280.00 10,627,200.00 05 2022 18SE019B
1,152 3,500.00 4,032,000.00 - 3,500.00 - 1,152 3,500.00 4,032,000.00 06 2023 19SF060B
1,140 3,500.00 3,990,000.00 - 1,140 3,500.00 3,990,000.00 07 2023 19SG042B
175 Salep 2-4, Kombinasi Pot 30g 1,152 3,500.00 4,032,000.00 - 1,152 3,500.00 4,032,000.00 07 2023 19SG041C
DAK 19
880 3,500.00 3,080,000.00 - 880 3,500.00 3,080,000.00 07 2023 19SG042A
288 3,500.00 1,008,000.00 - 288 3,500.00 1,008,000.00 07 2023 19SG043C
48 3,500.00 168,000.00 - 48 3,500.00 168,000.00 07 2023 19SF061A
176 Sefiksim kaps 100mg Box/30 BS PROP 125 30,120.00 3,765,000.00 30,120.00 - 125 30,120.00 3,765,000.00 09 2020 182809J
177 Sefotaksim seb inj 1000 mg Vial
BS PROP - 5,143.00 - 5,143.00 - - 5,143.00 - 11 2020 I11008AH
178 Seftriakson serb inj 1000 mg Vial
DAK 19
- 62,892,500.00 - 62,892,500.00 - - 62,892,500.00 - 03 2021 555-19901
DAK 18
Serum anti bisa ular :A.B.U.II (khusus ular dari Papua) 1 62,892,500.00 62,892,500.00 1 62,892,500.00 62,892,500.00 - 62,892,500.00 - 04 2021 555-20001
179 Botol
inj (i.m./i.v.) Pengembalian RSUD 1 62,892,500.00 62,892,500.00 1 62,892,500.00 62,892,500.00 - 62,892,500.00 - 09 2021 555-20101
DAK 19 6 76,450,000.00 458,700,000.00 - 76,450,000.00 - 6 76,450,000.00 458,700,000.00 09 2021 55520101
180 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul DAK 18 35 130,999.00 4,584,965.00 5 130,999.00 654,995.00 30 130,999.00 3,929,970.00 12 2019 4203417
181 Setirisin tab 10 mg Box/100
182 Sianokobalamin (Vit. B12) inj Ampul DAK 18 700 1,335.00 934,500.00 300 1,335.00 400,500.00 400 1,335.00 534,000.00 04 2022 1810004
183 Simvastatin tab 10 mg Box/30 BS PROP 112 3,510.00 393,120.00 - 3,510.00 - 112 3,510.00 393,120.00 05 2021 A8730EW
184 Siprofloksasin tab scored 500 mg Box/100
185 Spironolakton tab 25 mg Box/100
186 Sukralfat tab 500mg (Ulsidex) Box/100
DAK 18 - 19,500.00 - 19,500.00 - - 19,500.00 - 09 2019 1709064
187 Tetrasiklin kaps 250 mg Box/100
DAK 18 111 21,600.00 2,397,600.00 26 21,600.00 561,600.00 85 21,600.00 1,836,000.00 07 2022 1807023
188 Tetrasiklin kaps 500 mg Box/100 DAK 17 222 35,000.00 7,770,000.00 1 35,000.00 35,000.00 221 35,000.00 7,735,000.00 08 2021 17082452
189 Tiamin (vitamin B1) inj Box/30
DAK 18 5,473 9,600.00 52,540,800.00 135 9,600.00 1,296,000.00 5,338 9,600.00 51,244,800.00 05 2022 188513158
190 Tiamin (vitamin B1) tab 50 mg Box/100
DAK 19 30 10,200.00 306,000.00 - 10,200.00 - 30 10,200.00 306,000.00
191 Tramadol inj 100 mg Ampul DAK 18 89 9,700.00 863,300.00 - 9,700.00 - 89 9,700.00 863,300.00 02 2021 D80030
DAK 18 - 14,400.00 - 14,400.00 - - 14,400.00 - 05 2020 E70577T
192 Vitamin B kompleks tablet Box/100
BS PROP 1,425 9,600.00 13,680,000.00 257 9,600.00 2,467,200.00 1,168 9,600.00 11,212,800.00 07 2020
193 Zinc tab disp 20 mg Box/100 DAK 18 1,641 65,800.00 107,977,800.00 62 65,800.00 4,079,600.00 1,579 65,800.00 103,898,200.00 06 2021 18ZC1017

OBAT JIWA
DAK 16 28 17,900.00 501,200.00 - 17,900.00 - 28 17,900.00 501,200.00 09 2020 A1417IT
194 Amitriptilin tab sal 25 mg Box/100
DAK 18 5 16,800.00 84,000.00 - 16,800.00 - 5 16,800.00 84,000.00 09 2022 A1416IV
Alprazolam Tab. 0,5mg Box/100 BS PROP 1 10,800.00 10,800.00 - 10,800.00 - 1 10,800.00 10,800.00 01 2020 A80008
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
195 Atarax tab 0,5 mg Box/100
196 Cepezet inj Box/10 RSJ 10 84,000.00 840,000.00 - 84,000.00 - 10 84,000.00 840,000.00 10 2020 470197
197 Cepezet tab 100 mg Box/100
RSJ 600 310.00 186,000.00 - 310.00 - 600 310.00 186,000.00 02 2021 170110
198 Diazepam tab 5 mg Tablet
BS PROP 700 109.00 76,300.00 - 109.00 - 700 109.00 76,300.00 02 2022 A80480
199 Elizac tab 20 mg Box/30 BS PROP 14 6,750.00 94,500.00 - 6,750.00 - 14 6,750.00 94,500.00 10 2021 172755
200 Haloperidol inj 5 mg/ml (i.m.) Box/12
201 Haloperidol tablet 0,5mg Box/100 DAK 18 5 5,500.00 27,500.00 - 5,500.00 - 5 5,500.00 27,500.00 07 2023 A1806FV
202 Haloperidol tablet 1,5mg Box/100 DAK 18 5 5,900.00 29,500.00 - 5,900.00 - 5 5,900.00 29,500.00 08 2023 A1920HV
DINKES MAPPI 2 9,500.00 19,000.00 2 9,500.00 19,000.00 - 9,500.00 - 05 2021 170622
203 Haloperidol tablet 2mg (Lodomer) Box/100
DAK 18 5 9,300.00 46,500.00 - 9,300.00 - 5 9,300.00 46,500.00 02 2022 A80483
DINKES MAPPI - 8,800.00 - 8,800.00 - - 8,800.00 - 09 2019 172417
204 Haloperidol tablet 5mg Box/100 DAK 18 5 6,200.00 31,000.00 - 6,200.00 - 5 6,200.00 31,000.00 08 2020 A81831
BS PROP 42 5,600.00 235,200.00 10 5,600.00 56,000.00 32 5,600.00 179,200.00 02 2020 A80391
205 Heximer tab 2 mg Box/100
206 Klobazam Tab. 10mg Box/100 BS PROP 9 96,700.00 870,300.00 - 96,700.00 - 9 96,700.00 870,300.00 02 2021 48B0402
DAK 18 - 1,550.00 - 1,550.00 - - 1,550.00 - 08 2019 95329002
207 Klorpromazin inj 25mg Ampul
BS PROP 30 1,243.00 37,290.00 30 1,243.00 37,290.00 - 1,243.00 -
208 Klorpromazin tab sal 100 mg Box/100
209 Klorpromazin tab sal 25 mg Box/100
210 Klozapin Tab 25mg Box/50 BS PROP 15 77,500.00 1,162,500.00 - 77,500.00 - 15 77,500.00 1,162,500.00 05 2021 170757
211 Lodomer tab 2 mg Box/100
212 Merlopam tab 0,5 mg Box/100 RSJ - 130,000.00 - 130,000.00 - - 130,000.00 - 05 2020 170883
213 Risperidon tab 2mg Box/100 BS PROP 58 27,300.00 1,583,400.00 - 27,300.00 - 58 27,300.00 1,583,400.00 03 2021 4900089
214 Sikzonoat inj Box/5
215 Triheksifenidil tab 2 mg Box/100 BS PROP 3 8,500.00 25,500.00 3 8,500.00 25,500.00 - 8,500.00 - 04 2020 A80942

BAHAN MEDIS HABIS PAKAI (BMHP)

DAK 17 624 141,200.00 88,108,800.00 23 141,200.00 3,247,600.00 601 141,200.00 84,861,200.00 02 2022 1703401
216 Alat suntik sekali pakai 3 ml Box/100
DAK 18 150 97,375.00 14,606,250.00 - 97,375.00 - 150 97,375.00 14,606,250.00 03 2023 16041888
Alat suntik sekali pakai 5 ml (Terumo) DAK 16 134 560,000.00 75,040,000.00 3 560,000.00 1,680,000.00 131 560,000.00 73,360,000.00 05 2021 160606R
DAK 16 500 90,300.00 45,150,000.00 - 90,300.00 - 500 90,300.00 45,150,000.00 07 2021 1602201
217 Box/100
Alat suntik sekali pakai 5 ml (MRB) DAK 17 500 168,300.00 84,150,000.00 - 168,300.00 - 500 168,300.00 84,150,000.00 02 2022 1704401
DAK 18 150 121,000.00 18,150,000.00 - 121,000.00 - 150 121,000.00 18,150,000.00 03 2023 2051888
218 Alat suntik sekali pakai 0,05 ml Box/100 DAK 16 - 150,500.00 - - 150,500.00 - - 150,500.00 - 10 2019 1411419
219 Alat suntik sekali pakai 0,5 ml Box/100 DAK 17 68 137,500.00 9,350,000.00 54 137,500.00 7,425,000.00 14 137,500.00 1,925,000.00 02 2022 170841
220 Alat suntik sekali pakai 10 ml Pcs DAK 18 6,600 1,500.00 9,900,000.00 100 1,500.00 150,000.00 6,500 1,500.00 9,750,000.00 04 2023 2051888
221 Alat suntik sekali pakai 1ml Pcs
DAK 15 60 3,400.00 204,000.00 - 3,400.00 - 60 3,400.00 204,000.00 01 2020 2021588
222 Alat suntik sekali pakai 50ml Unit
DAK 18 500 4,250.00 2,125,000.00 - 4,250.00 - 500 4,250.00 2,125,000.00 03 2023 23041888
DAK 18 734 12,000.00 8,808,000.00 52 12,000.00 624,000.00 682 12,000.00 8,184,000.00 10 2020 13111788
223 Alkohol swab Box/100
DAK 19 500 12,500.00 6,250,000.00 - 12,500.00 - 500 12,500.00 6,250,000.00 05 2022 10061988
224 Aquadest Steril 1000 ml Kolf
225 Bisturi no 10 Box/100
226 Bisturi no 20 Box/100
Blood Lancet Box/100 DAK 18 1,354 16,750.90 22,680,718.60 54 16,750.90 904,548.60 1,300 16,750.90 21,776,170.00 06 2022 18071788
227
Blood Lancet (Frambusia) Box/200 BS PROP 20 1,190,000.00 23,800,000.00 - 1,190,000.00 - 20 1,190,000.00 23,800,000.00 06 2022 X4048F5
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
228 Box Slide Box BS PROP 31 86,742.00 2,689,002.00 - 86,742.00 - 31 86,742.00 2,689,002.00
229 Catgut chromic No. 2/0 Sachet
230 Catgut chromic No. 3/0 Sachet
231 Catgut plain No. 2/0 (Onemed) Box/24 DAK 16 165 134,000.00 22,110,000.00 4 134,000.00 536,000.00 161 134,000.00 21,574,000.00 06 2021 1606130
232 Catgut plain No. 3/0 (SMI) Sachet
233 Feeding Tube fr 5 40cm Unit
234 Feeding Tube fr 8 100cm Unit DAK 18 100 9,570.00 957,000.00 - 9,570.00 - 100 9,570.00 957,000.00 11 2021 27121688
235 Folley Cateter 2 Way no 16 Pcs
236 Folley Cateter 2 Way no 18 Pcs DAK 19 170 11,040.00 1,876,800.00 19 11,040.00 209,760.00 151 11,040.00 1,667,040.00 08 2020 15G02J
DAK 17 - 11,108.00 - 11,108.00 - - 11,108.00 - 09 2019 170414K
237 Infusion set anak Pcs
DAK 18 4,690 11,966.90 56,124,761.00 310 11,966.90 3,709,739.00 4,380 11,966.90 52,415,022.00 05 2020 171207K
238 Infusion set dewasa Pcs DAK 18 6,990 8,419.15 58,849,858.50 360 8,419.15 3,030,894.00 6,630 8,419.15 55,818,964.50 06 2020 180124K
DAK 16 950 8,355.00 7,937,250.00 100 8,355.00 835,500.00 850 8,355.00 7,101,750.00 10 2020 151121SD
239 IV Catheter No. 18 G Pcs DAK 18 1,000 9,608.25 9,608,250.00 - 9,608.25 - 1,000 9,608.25 9,608,250.00 03 2022 170423SD
BS PROP 11,502.00 - - 11,502.00 - 09 2019 141010SD
DAK 17 12,400 8,499.00 105,387,600.00 300 8,499.00 2,549,700.00 12,100 8,499.00 102,837,900.00 02 2022 170316SD
240 IV Catheter No. 20 G Pcs
DAK 18 10,000 9,608.25 96,082,500.00 - 9,608.25 - 10,000 9,608.25 96,082,500.00 03 2022 170419SD
DAK 17 5,500 8,499.00 46,744,500.00 350 8,499.00 2,974,650.00 5,150 8,499.00 43,769,850.00 02 2022 170319SE
241 IV Catheter No. 22 G Pcs
DAK 18 15,000 9,608.25 144,123,750.00 - 9,608.25 - 15,000 9,608.25 144,123,750.00 04 2022 170516SE
Pcs DAK 17 5,350 8,499.00 45,469,650.00 250 8,499.00 2,124,750.00 5,100 8,499.00 43,344,900.00 03 2022 170427SC
242 IV Catheter No. 24 G
DAK 18 10,000 9,608.25 96,082,500.00 - 9,608.25 - 10,000 9,608.25 96,082,500.00 04 2022 170519SB
243 Jarum kulit no 10 GT Lusin 1 52,360.00 52,360.00 - 52,360.00 - 1 52,360.00 52,360.00
244 Jarum kulit no 9 GT Lusin
Jarum otot no 10 BR (MRM) Lusin 2 52,360.00 104,720.00 52,360.00 - 2 52,360.00 104,720.00
245
Jarum otot no 10 GR (DR MORTON) Lusin 11 52,360.00 575,960.00 52,360.00 - 11 52,360.00 575,960.00
246 Jarum otot no 13 BR Lusin 15 52,360.00 785,400.00 52,360.00 - 15 52,360.00 785,400.00
247 Jarum otot no 7 Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
244 Jarum otot no 8 Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
245 Jarum otot no 9 Lusin - 52,360.00 - 52,360.00 - - 52,360.00 -
DAK 16 3,761 13,400.00 50,397,400.00 36 13,400.00 482,400.00 3,725 13,400.00 49,915,000.00 171016
246 Kapas Pembalut / Absorben 250 gram Rol DAK 16 2,500 28,530.00 71,325,000.00 - 28,530.00 - 2,500 28,530.00 71,325,000.00 08 2021 1608079
DAK 18 1,000 16,750.00 16,750,000.00 - 16,750.00 - 1,000 16,750.00 16,750,000.00 08 2021
DAK 15 218 7,700.00 1,678,600.00 30 7,700.00 231,000.00 188 7,700.00 1,447,600.00
247 Kasa Pembalut 2 m x 80 cm Rol DAK 16 2,000 7,930.00 15,860,000.00 - 7,930.00 - 2,000 7,930.00 15,860,000.00
DAK 18 2,500 9,910.00 24,775,000.00 - 9,910.00 - 2,500 9,910.00 24,775,000.00 08 2021
DAK 18 565 133,625.00 75,498,125.00 28 133,625.00 3,741,500.00 537 133,625.00 71,756,625.00 08 2021
248 Kasa Pembalut 40 yard x 80 cm Rol
DAK 19 100 131,250.00 13,125,000.00 - 131,250.00 - 100 131,250.00 13,125,000.00
249 Kasa Pembalut 4X15cm Rol DAK 18 3,690 2,800.00 10,332,000.00 410 2,800.00 1,148,000.00 3,280 2,800.00 9,184,000.00 08 2021
DAK 16 5,460 800.00 4,368,000.00 400 800.00 320,000.00 5,060 800.00 4,048,000.00 38090816
250 Kasa Pembalut 4X5cm Rol
DAK 18 3,000 1,080.00 3,240,000.00 - 1,080.00 - 3,000 1,080.00 3,240,000.00 08 2021
251 Masker Tie On Box/50 DAK 18 94 21,875.00 2,056,250.00 36 21,875.00 787,500.00 58 21,875.00 1,268,750.00 12 2022
252 Masker N95 Pcs DAK 18 1,866 8,140.00 15,189,240.00 - 8,140.00 - 1,866 8,140.00 15,189,240.00
Maxter Exam Non Powder L Box/100 DAK 19 500 72,875.00 36,437,500.00 - 72,875.00 - 500 72,875.00 36,437,500.00
Maxter Exam Non Powder S Box/100 DAK 19 500 72,875.00 36,437,500.00 - 72,875.00 - 500 72,875.00 36,437,500.00 6926144062
253 Nasal Oxygen Bayi Pcs DAK 19 420 6,875.00 2,887,500.00 30 6,875.00 206,250.00 390 6,875.00 2,681,250.00 1111788
Nasal Oxygen Dewasa Pcs DAK 19 460 6,875.00 3,162,500.00 25 6,875.00 171,875.00 435 6,875.00 2,990,625.00 05 2023 25061988
254 Nasal Oxygen Size L Pcs
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
255 Nasal Oxygen Size M Pcs
256 Nasal Oxygen Size S Pcs
257 Nasal Oxygen Size XS Pcs DAK 16 - 6,600.00 - 6,600.00 - - 6,600.00 - 03 2021 160330
258 Pembalut Elastis 10cmx4,55m Rol DAK 16 227 43,987.00 9,985,049.00 9 43,987.00 395,883.00 218 43,987.00 9,589,166.00 09 2021 1609245
259 Pembalut Elastis 15cmx4,55m Rol DAK 16 145 54,139.00 7,850,155.00 4 54,139.00 216,556.00 141 54,139.00 7,633,599.00 09 2021 1609252
260 Pembalut Elastis 7,5cmx4,55m Rol DAK 16 172 36,012.00 6,194,064.00 6 36,012.00 216,072.00 166 36,012.00 5,977,992.00 09 2021 1609232
DAK 15 18,350 1,925.00 35,323,750.00 - 1,925.00 - 18,350 1,925.00 35,323,750.00 08 2020 1091588
261 Penjepit Tali Pusar Pcs
DAK 18 25,000 1,495.00 37,375,000.00 - 1,495.00 - 25,000 1,495.00 37,375,000.00 06 2023 10071888
262 Plester 2,5cm x 4,5m Rol
263 Plester 7,5cm x 4,5m Rol
264 Plester 5cm X 4,5m Rol
BS PROP 1,015 3,968.00 4,027,520.00 950 3,968.00 3,769,600.00 65 3,968.00 257,920.00 07 2022 17017
265 Pot sputum Steril Pot DAK 18 5,000 3,410.00 17,050,000.00 - 3,410.00 - 5,000 3,410.00 17,050,000.00 04 2023 8051888
DAK 19 5,000 3,410.00 17,050,000.00 - 3,410.00 - 5,000 3,410.00 17,050,000.00 01 2024 3071988
266 Regulator Oksigen Unit DAK 18 3 2,530,000.00 7,590,000.00 1 2,530,000.00 2,530,000.00 2 2,530,000.00 5,060,000.00
267 Safety Box Box BS PROP 18 16,608.00 298,944.00 1 16,608.00 16,608.00 17 16,608.00 282,336.00
Safegloves Latex Examination Gloves S Box/100 DAK 19 100 44,525.00 4,452,500.00 16 44,525.00 712,400.00 84 44,525.00 3,740,100.00 02 2024 220190508452
Safegloves Latex Examination Gloves M Box/100 DAK 19 100 44,525.00 4,452,500.00 11 44,525.00 489,775.00 89 44,525.00 3,962,725.00 03 2024 32019190147
Safegloves Latex Examination Gloves L Box/100 DAK 19 100 44,525.00 4,452,500.00 7 44,525.00 311,675.00 93 44,525.00 4,140,825.00 03 2024 3201905090024
Sarung Tangan Non Steril Uk. M Box/100 BS PROP 8 49,610.00 396,880.00 8 49,610.00 396,880.00 - 49,610.00 - 08 2020
Sarung Tangan Non Steril Uk. L Box/100 BS PROP 8 49,610.00 396,880.00 8 49,610.00 396,880.00 - 49,610.00 - 08 2020
Sarung tangan no.7 (Steril) Frambusia Pasang BS PROP 100 7,735.00 773,500.00 - 7,735.00 - 100 7,735.00 773,500.00 02 2022 2974870
268
Sarung tangan no.7 (Steril) JMI Pasang DAK 18 - 8,032.75 - 8,032.75 - - 8,032.75 - 12 2022 3181070
Sarung tangan no.7,5 (Steril) Frambusia Pasang BS PROP 300 16,003.00 4,800,900.00 - 16,003.00 - 300 16,003.00 4,800,900.00 04 2019 1405106705
269
Sarung tangan no.7,5 (Steril) JMI Pasang DAK 18 - 8,032.75 - 8,032.75 - - 8,032.75 - 04 2023 3255975
Sarung tangan no.8 (Steril) Ansell Pasang DAK 17 3,600 8,090.00 29,124,000.00 8,090.00 - 3,600 8,090.00 29,124,000.00 - 8,090.00 - 09 2019 1610563004
270 Sarung tangan no.8 (Steril) Aximed Pasang DAK 16 3,000 7,600.00 22,800,000.00 - 7,600.00 - 3,000 7,600.00 22,800,000.00 11 2021 16336311
Sarung tangan no.8 (Steril) JMI Pasang DAK 18 5,000 8,032.75 40,163,750.00 - 8,032.75 - 5,000 8,032.75 40,163,750.00 07 2022 3091180
DAK 17 1,325 20,973.00 27,789,225.00 30 20,973.00 629,190.00 1,295 20,973.00 27,160,035.00 07 2022 25081788
271 Sarung Tangan Obgyn Steril Pasang
DAK 18 1,000 23,232.00 23,232,000.00 - 23,232.00 - 1,000 23,232.00 23,232,000.00 03 2023 12041888
272 Silk No. 1 (SMI) Sachet DAK 16 660 23,900.00 15,774,000.00 60 23,900.00 1,434,000.00 600 23,900.00 14,340,000.00 12 2020 151217
273 Silk No. 3/0 (SMI) Sachet DAK 16 384 22,400.00 8,601,600.00 60 22,400.00 1,344,000.00 324 22,400.00 7,257,600.00 06 2021 160611
Silk No.2/0 Sachet DAK 15 384 16,064.00 6,168,576.00 60 16,064.00 963,840.00 324 16,064.00 5,204,736.00 05 2020 150501
274 Silk No.2/0 (Onemed) Box/36 DAK 16 100 110,000.00 11,000,000.00 - 110,000.00 - 100 110,000.00 11,000,000.00 06 2021 1606130
Silk No.2/0 (SMI) Sachet DAK 16 888 23,300.00 20,690,400.00 - 23,300.00 - 888 23,300.00 20,690,400.00 12 2020 151218
BS PROP 1 30,183.00 30,183.00 50 30,183.00 1,509,150.00 - 30,183.00 - 51 30,183.00 1,539,333.00 09 2022 -
275 Slide Box/72
DAK 17 71 22,005.15 1,562,365.65 1 22,005.15 22,005.15 70 22,005.15 1,540,360.50
DAK 15 125 10,010.00 1,251,250.00 10 10,010.00 100,100.00 115 10,010.00 1,151,150.00 08 2020 150919B
276 Stomach Tube fr 12 Pcs
DAK 18 100 17,678.95 1,767,895.00 - 17,678.95 - 100 17,678.95 1,767,895.00 01 2021 160219B
DAK 15 104 10,010.00 1,041,040.00 5 10,010.00 50,050.00 99 10,010.00 990,990.00 04 2020 150527B
277 Stomach Tube fr 16 Pcs DAK 16 200 33,600.00 6,720,000.00 - 33,600.00 - 200 33,600.00 6,720,000.00 11 2020 151210B
DAK 18 100 17,678.95 1,767,895.00 - 17,678.95 - 100 17,678.95 1,767,895.00 01 2023 180201B
278 Stomach Tube fr 18 Pcs DAK 18 74 17,678.95 1,308,242.30 5 17,678.95 88,394.75 69 17,678.95 1,219,847.55 12 2022 180102B
DAK 16 - 3,000.00 - - 3,000.00 - - 3,000.00 - 07 2021 8081688
279 Urine Bag Pcs DAK 18 480 3,750.00 1,800,000.00 35 3,750.00 131,250.00 445 3,750.00 1,668,750.00
DAK 19 5,000 3,750.00 18,750,000.00 - 3,750.00 - 5,000 3,750.00 18,750,000.00
280 USG Gel 250ml Botol 14031888
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)

BAHAN OBAT GIGI

281 Articulating Paper Pak
282 Eugenol cair Botol
283 FUJI GP A2 Pak
284 FUJI GP A3 Pak
285 Micro Brush Pak
286 Saliva Ejector Pak/50
287 Zink Fosfat Pak

REAGEN
288 Alat HB Sahli Kit DAK 18 35 105,600.00 3,696,000.00 4 105,600.00 422,400.00 31 105,600.00 3,273,600.00 14021888
Botol 100ml DAK 16 32 15,576.00 498,432.00 - 15,576.00 - 32 15,576.00 498,432.00 11 2020 15121688
289 Alkohol 95%
Botol 300ml DAK 18 24 37,400.00 897,600.00 - 37,400.00 - 24 37,400.00 897,600.00 09 2022 4101888
290 AUTOCHECK 3IN1 Multi Monitoring System Kit DAK 16 13 82,800.00 1,076,400.00 5 82,800.00 414,000.00 8 82,800.00 662,400.00 RAF01003544
278 130,900.00 36,390,200.00 70 130,900.00 9,163,000.00 208 130,900.00 27,227,200.00
291 AUTOCHECK Blood Glucose Test Strip Btl/25 DAK 19 42 130,900.00 5,497,800.00 - 130,900.00 - 42 130,900.00 5,497,800.00 05 2021 GI9155056
20 130,900.00 2,618,000.00 - 130,900.00 - 20 130,900.00 2,618,000.00 05 2021 GI9149059
241 239,800.00 57,791,800.00 75 239,800.00 17,985,000.00 166 239,800.00 39,806,800.00
292 AUTOCHECK Total Cholesterol Test Strip Btl/10 DAK 19
259 239,800.00 62,108,200.00 - 239,800.00 - 259 239,800.00 62,108,200.00 10 2020 CI9090042A
337 167,200.00 56,346,400.00 70 167,200.00 11,704,000.00 267 167,200.00 44,642,400.00
293 AUTOCHECK Uric Acid Test Strip Btl/25 DAK 19
8 167,200.00 1,337,600.00 - 167,200.00 - 8 167,200.00 1,337,600.00 03 2021 UI9117080
GF Malaria 2019 - 6,476.00 - 6,476.00 - - 6,476.00 - 02 2021 MR18J61
294 Carestar Malaria Device PAN-PLDH, Pf-HRP2 Test BS PROP 125 6,931.00 866,375.00 125 6,931.00 866,375.00 - 6,931.00 - 02 2021 MR18J61
DAK 19 12,500 19,600.00 245,000,000.00 1,575 19,600.00 30,870,000.00 10,925 19,600.00 214,130,000.00
295 Cleaning kit Kit
296 Control 3 Diff. Normal 16 Parameter 1X4,5ml Kit
297 Dengue Rapid Test Test
298 Diluen 20L (900 cycle) Box DAK 18 - 5,582,500.00 - 5,582,500.00 - - 5,582,500.00 - 05 2021 1805936
299 ELITech ALT/GPT SL 2X62,5ml Kit DAK 18 4 2,942,500.00 11,770,000.00 4 2,942,500.00 11,770,000.00 - 2,942,500.00 - 11 2019 180873
300 ELITech AST/GOT SL 2X62,5ml Kit DAK 18 4 2,915,000.00 11,660,000.00 4 2,915,000.00 11,660,000.00 - 2,915,000.00 - 12 2019 180994
301 ELITech Cholesterol PAP SL 6X100ml + std 5ml Kit DAK 18 - 5,060,000.00 - 5,060,000.00 - - 5,060,000.00 - 06 2020 180909
302 ELITech Cholesterol Std 200mg 4x5ml Kit
303 ELITech Creatinine Jaffe 2X125ml Kit
304 ELITech Glucose PAP SL 6X100ml Kit DAK 18 4 2,915,000.00 11,660,000.00 4 2,915,000.00 11,660,000.00 - 2,915,000.00 - 08 2020 180846
305 ELITech Glucose Std 100mg/dl 4x5ml Kit
306 ELITech Trigliserid Mono SL 6X50ml + Std 5ml Kit DAK 18 4 5,258,000.00 21,032,000.00 4 5,258,000.00 21,032,000.00 - 5,258,000.00 - 12 2019 181061
307 ELITech Urea UV SL 4X62,5ml + Std 5ml Kit
308 ELITech Uric Acid Mono SL 6X100ml Kit DAK 18 4 5,357,000.00 21,428,000.00 - 5,357,000.00 - 4 5,357,000.00 21,428,000.00 - 5,357,000.00 - 09 2019 180963
309 ELITech Uric Acid Std 6mg/dl 4x5ml Kit
310 Elitrol 1 (Normal) 10x5ml Kit
311 FTS (Filariasis Tes Strip) untuk W. Bancrofti Test
312 Focus Malaria Pan/Pf Casette Box/25 DAK 18 - 605,000.00 - 605,000.00 - - 605,000.00 - 06 2020 101313
313 Focus RPR Syphillis Box/100
314 Focus TPHA Box/100

HEMOSMART GOLD Hemoglobin Screening System

315 Kit
Simple
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
316 HEMOSMART GOLD Hemoglobin Test Strip Btl/25 DAK 19 320 348,700.00 111,584,000.00 40 348,700.00 13,948,000.00 280 348,700.00 97,636,000.00
317 Larutan Anisol Botol 100ml DAK 18 12 278,300.00 3,339,600.00 3 278,300.00 834,900.00 9 278,300.00 2,504,700.00 09 2021 31101888
318 Larutan Carbol Fuchsin Botol 100ml DAK 16 92 11,220.00 1,032,240.00 11,220.00 - 92 11,220.00 1,032,240.00 - 11,220.00 - 11 2019 8121688
319 Larutan Carbol Gentian Violet Botol 100ml DAK 16 92 9,504.00 874,368.00 9,504.00 - 92 9,504.00 874,368.00 - 9,504.00 - 11 2019 6121688
320 Larutan Emersi oil Botol 100ml DAK 18 14 963,600.00 13,490,400.00 1 963,600.00 963,600.00 13 963,600.00 12,526,800.00 01 2021 HX75020199
321 Larutan Giemsa Btl 500 ml DAK 18 3 1,419,000.00 4,257,000.00 - 1,419,000.00 - 3 1,419,000.00 4,257,000.00 03 2021 HX85310104
DAK 18 21 12,100.00 254,100.00 21 12,100.00 254,100.00 - 12,100.00 - 08 2021 18091888
322 Larutan H2O2 3% Botol 100ml
DAK 19 288 4,368.00 1,257,984.00 2 4,368.00 8,736.00 286 4,368.00 1,249,248.00 06 2022 20071988
DAK 17 62 13,728.00 851,136.00 3 13,728.00 41,184.00 59 13,728.00 809,952.00 04 2020 22051788
323 Larutan HCl 0,1 N Botol 100ml
DAK 18 50 23,100.00 1,155,000.00 - 23,100.00 - 50 23,100.00 1,155,000.00 06 2021 10071888
324 Larutan Metanol Botol 100ml DAK 18 - 53,000.00 - 53,000.00 - - 53,000.00 - 10 2019 30111688
325 Larutan Methilen Blue Botol 100ml DAK 18 40 47,300.00 1,892,000.00 - 47,300.00 - 40 47,300.00 1,892,000.00 09 2021 4101888
326 Larutan Turk Botol 100ml DAK 18 8 37,400.00 299,200.00 - 37,400.00 - 8 37,400.00 299,200.00 09 2021 31101888
327 Lugol Botol 100ml DAK 16 97 175,000.00 16,975,000.00 2 175,000.00 350,000.00 95 175,000.00 16,625,000.00 - 175,000.00 - 11 2019 9126188
328 Lyze 5L (900 Cycle) Box
329 NaCl 0,9% 100ml Botol 100ml
330 Paket Alat Deteksi Resiko Kehamilan Paket Kemenkes 2018 5 501,745.00 2,508,725.00 - 501,745.00 - 5 501,745.00 2,508,725.00
331 Rapid Test Hepatitis (SD) Box/100 -
332 Rapid Test HIV 1 / SD Test BS PROP - 4,500 11,975.00 53,887,500.00 4,500 11,975.00 53,887,500.00 - 11,975.00 - 05 2021 03ADE011A
333 Rapid Test HIV 1 / VIKIA Test
334 Rapid Test HIV 2 / FOCUS Box/25 BS PROP - 352,925.00 - - 352,925.00 - 07 2020 1816147
335 Rapid Test HIV 2 / TRILINE Test
336 Rapid Test HIV 3 / VIKIA Box/25 BS PROP - 487,000.00 - - 487,000.00 - 06 2020 1006684110
Rapid Test Syphillis Hexagon (Frambusia) Box/20 BS PROP - 546,354.00 - 546,354.00 - - 546,354.00 - 09 2019 17016
337
Rapid Test Syphillis / SD Test BS PROP - 1,000 20,400.00 20,400,000.00 1,000 20,400.00 20,400,000.00 - 20,400.00 - 03 2020 QSY1018005
Test BS PROP 9,850.00 - 9,850.00 - - 9,850.00 - 12 2019 01EMC017A
338 RDT SD Bioline HBSAg Test BS PROP 730 9,850.00 7,190,500.00 700 9,850.00 6,895,000.00 30 9,850.00 295,500.00 03 2020 01EMD011A
Test BS PROP 4,000 9,850.00 39,400,000.00 100 9,850.00 985,000.00 3,900 9,850.00 38,415,000.00 11 2020 O1EMD020A
28 266,410.00 7,459,480.00 7 266,410.00 1,864,870.00 21 266,410.00 5,594,610.00 08 2020 030618-ZN
BS PROP
339 Reagen Ziehl Nielsen Paket 30 254,059.00 7,621,770.00 - 254,059.00 - 30 254,059.00 7,621,770.00 06 2021 013/2019
DAK 17 98 297,440.00 29,149,120.00 - 297,440.00 - 98 297,440.00 29,149,120.00 08 2020 8091786
340 RPR Syphillis (Focus) Test
341 Serum Golongan Darah (Glory) Set
Serum Golongan Darah Anti A (Plasmatec) Vial DAK 18 17 215,875.00 3,669,875.00 1 215,875.00 215,875.00 16 215,875.00 3,454,000.00 05 2020 128048
Serum Golongan Darah Anti B (Plasmatec) Vial DAK 18 17 215,875.00 3,669,875.00 1 215,875.00 215,875.00 16 215,875.00 3,454,000.00 04 2020 99038
342
Serum Golongan Darah Anti AB (Plasmatec) Vial DAK 18 17 215,875.00 3,669,875.00 1 215,875.00 215,875.00 16 215,875.00 3,454,000.00 01 2020 9028
Serum Golongan Darah Anti D (Plasmatec) Vial DAK 18 17 215,875.00 3,669,875.00 1 215,875.00 215,875.00 16 215,875.00 3,454,000.00 02 2020 50018
343 Total Protein Plus 2X125ml Kit
344 Uryxxon Stick 10 Box/100

LAIN-LAIN
345 Air Raksa (Hg) Botol 100g DAK 15 48 500,000.00 24,000,000.00 - 500,000.00 - 48 500,000.00 24,000,000.00
346 Food Sec. ARSENIC Test Kit Kit
347 Food Sec. BORAX Test Kit Kit
348 Food Sec. CYANIDA Test Kit Kit
349 Food Sec. FORMALDEHYDE Test Kit Kit DAK 18 1 7,590,000.00 7,590,000.00 - 7,590,000.00 - 1 7,590,000.00 7,590,000.00 02 2021 13711185
350 Food Sec. NITRATE-NITRITE Test Kit Kit
 HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA HARGA SATUAN TOTAL HARGA
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch
(Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp) (Rp)
351 Food Sec.MERCURY Test Kit Kit
352 HCG TEST (Focus) Box/50 DAK 18 222 107,500.00 23,865,000.00 23 107,500.00 2,472,500.00 199 107,500.00 21,392,500.00 10 2020 1820072
Iodium test btl 10 ml DAU 14 - 22,000.00 - 22,000.00 - - 22,000.00 - 07 2019 7412010
353
Iodium test btl 10 ml DAU 15 - 42,000.00 - 42,000.00 - - 42,000.00 - 07 2019 7412010
354 Kertas EKG rol DAU 09 16 73,125.00 1,170,000.00 - 73,125.00 - 16 73,125.00 1,170,000.00
355 Kertas USG rol DAU 09 3 354,375.00 1,063,125.00 - 354,375.00 - 3 354,375.00 1,063,125.00

Total: 5,954,213,286.05 1,312,970,552.00 664,849,031.50 74,979,058.00 6,527,355,748.55

7,267,183,838.05 7,267,183,838.05
 LAPORAN PERSEDIAAN OBAT DAN BMHP
Periode September 2019

NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch

OBAT
DAK 18 - 07 2021 94G48A
1 Air untuk injeksi amp 25 ml Vial
BS PROP 360 07 2021 78G48B
YPPM 17 - 07 2020 G71179B
2 Albendazol tab 400 mg Box/100
DAK 18 1,232 07 2021 H80164BI
DAK 17 2,100 08 2020 170840106
3 Alopurinol tab 100 mg Box/100
DAK 18 2,000 06 2020 A81362
4 Ambroksol tab 30mg Box/100 DAK 18 2,346 10 2020 171001146
DAK 16 - 06 2019 953070322
5 Aminofilin inj 24 mg/ml Ampul
DAK 18 210 05 2020 63070022
6 Aminofilin tablet 200 mg Btl/100 DAK 19 1,000
7 Amlodipin tab 10 mg Box/50 DAK 19 1,828 07 2023 H81490B
8 Amlodipin tab 5 mg Box/50 DAK 19 1,980 01 2024 B90188B
9 Amoksisilin sir forte 250 mg/5 ml Botol
10 Amoksisilin sir kering 125 mg/5 ml Botol DAK 19 2,043
11 Amoksisilin kapsul 250 mg Box/100 DAK 18 23,588 05 2020 18054551
DAK 18 4,630 06 2020 CAMXA80462
12 Amoksisilin tablet 500 mg Box/100
DAK 19 12,000 06 2023
13 Ampisilin serb inj 1000 mg/vial Vial BS PROP 10 10 2020 PSL 37147

Anestetik lokal gigi kombinasi : lidokain hcl 2% + Box/30 DAK 16 219 08 2020 16IH039
14
epinefrin 1 : 80.000 inj 2 ml Box/30 DAK 18 30 05 2021 16815037
95 03 2023 C80468T
15 Antalgin tab 500mg Box/100 DAK 18
460 03 2023 C80604T

Antasida, kombinasi : aluminium hidroksida 200 mg +

16 Botol DAK 19 7,000
magnesium hidroksida 200 mg
Antasida, kombinasi : aluminium hidroksida 200 mg +
17 Box/100 DAK 18 4,535 08 2020 A81743
magnesium hidroksida 200 mg
18 Antibakteri DOEN, Kombinasi Tube DAK 18 4,125 07 2020 1307038
Box/24 BS PROP 17 05 2021 17SE025A
19 Antifungi DOEN, Kombinasi
Pot DAK 19 1,500 07 2023 19SG025A
Antihemoroid, kombinasi: bismut subgalat 150 mg + DAK 18 44 10 2021 172205W
20 heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng Box/10
oksida 120 mg + sup ad 2 g DAK 19 200 10 2021 J72653W
21 Aquajel Steril Jelly 28g tube
22 Artesunat serb inj 60 mg/ml (i.v./i.m.) Box/8 BS PROP 15 08 2020 LA170940

23 Asam asetilsalisilat (asetosal) tab 80 mg (Miniaspi tab) Box/100

24 Asam askorbat (vitamin C) tab 250 mg Box/100 DAK 18 1,435 03 2020 C70246B
DAK 18 134 06 2020 F70046B1
25 Asam askorbat (vitamin C) tab 50 mg Box/100 DAK 18 6,000 09 2020 H70083B1
DAK 19 3,755 1,380 08 2021 I8014BI
BS PROP 20 07 2020 I18TG012
26 Asam folat tab 1 mg Box/100
DAK 19 300
DAK 18 - 09 2020 A81901
27 Asam mefenamat tab 500 mg Box/100
DAK 19 1,625
28 Asam traneksamat inj 10% 500mg/5ml Box/10 DAK 16 - 07 2019 2861438
DAK 18 - 01 2022 A70077J
29 Asiklovir cream Tube
BS PROP 450 09 2022 172808J
30 Asiklovir tablet 200 mg Box/100
BS PROP - 07 2022 16304053
12 06 2023 26304037
31 Asiklovir tablet 400 mg Box/50
DAK 19 1,404 06 2023 26304041
560 06 2023 26304042
32 Attalpugit tab 500mg Box/100
33 Azitromisin tab 500 mg Box/20 BS PROP 2,450 01 2021 AG0086J
34 Bedak salisil serb 2% Pot DAK 17 - 10 2020 A80JGC0590
35 Benzatin Benzil Penisilin 1,2Jt IU Vial
36 Benzatin Benzil Penisilin 2,4Jt IU Vial BS PROP 60 11 2020 95319023
DAK 18 1,350 10 2020 J71645T
37 Betametason krim 0,5 mg/g Tube
DAK 19 7,000 07 2021 G81347T
38 Bisakodil tab sal 5 mg (Dulcolax Tablet) Box/200
Bisakodil Supp. 5 mg (Dulcolax Supp.) Supp DAK 19 244 03 2023 19030457
306 10 2021 17101425
Bisakodil Supp. 10 mg (Dulcolax Supp.) Supp DAK 19 250 04 2022 18050644
400 11 2022 18121651
39 Bisoprolol tab 5 mg Box/ 30
Box/100 DAK 16 - 11 2019 PIM63945
40 Deksametason inj 5 mg/ml (i.v./i.m.)
Box/10 DAK 19 250 06 2021 F9F012
DAK 17 - 08 2020 170806150
41 Deksametason tab 0,5 mg Box/100
DAK 18 5,000 07 2020 180745150
42 Desoksimetason krim Tube
43 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul DAK 16 4,331 04 2020 1503008
44 Diazepam tab 2 mg BTL/100 DAK 16 100 12 2019 L60629J
45 Dietilkarbamazin tab 100 mg Box/100 BS PROP 70 11 2019 1411021
DAK 17 164 05 2021 63420071
46 Difenhidramin inj 10 mg/ml (i.v./i.m.) Box/30
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch

OBAT
46 Difenhidramin inj 10 mg/ml (i.v./i.m.) Box/30
DAK 18 200 10 2021 63420162
47 Digoksin tab 0,25 mg Box/100
48 Diltiazem hcl tab 30 mg Box/100
49 Dimenhidrinat tab 50 mg Btl/100 DAK 19 72 09 2022 J72527B
DAK 16 323 05 2020 1605014
50 Doksisiklin kaps 100 mg Box/100
DAK 18 100 07 2020 C0312GV
51 Domperidon susp 5 mg/5 ml BTL 60 ml
52 Domperidon tab 10 mg Box/100
53 Efedrin tab 25 mg Btl/100
- 12 2020 97LM0006
54 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) Ampul BS PROP
310 11 2020 97LL00080
55 Eritromisin tab 500 mg Box/100 DAK 18 105 08 2022 B2536GV
Btl 100ml DAK 17 2,181 08 2020 G48735
56 Etanol cairan 70%
Btl 300ml DAK 17 4,463 08 2020 G48717
57 Etil klorida semprot 200 ml Botol DAK 18 - 12 2022 185375
DAK 18 - 10 2019 371006
58 Fenitoin Na kaps 100 mg Btl/100
DAK 18 50 03 2020 380305
59 Fenobarbital inj 50mg/ml Ampul DAK 16 758 12 2019 85803005
60 Fenobarbital tab 30 mg Btl/100
61 Fenol Gliserol tetes telinga Btl 5ml DAK 18 35 05 2020 1804LE114
- 09 2019 64780432
62 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) Box/30 BS PROP
29 11 2019 6478067
DAK 18 82 04 2021 16381005
63 Fitomenadion (vitamin K 1) tab sal 10 mg Box/100
DAK 19 150 10 2021 16381018
64 Framisetin Sulfat Tulle 1% (Daryantulle) Box/10
65 Furosemid inj 10 mg/ml (i.v./i.m.) Box/25
DAK 18 27 08 2020 I72012B
66 Furosemid tab 40 mg Box/200 DAK 18 50 01 2020 B70063B
DAK 19 150 08 2021 I81856B
Garam oralit kombinasi : natrium klorida 0,52 g + Box/100 BS PROP - 10 2023 K82361B
67 kalium klorida 0,30 g + trinatrium sitrat 0,58 g + glukosa
anhidrat 2,7 g Box/25 DAK 19 61
68 Gentamisin inj Box/5 BS PROP 33 10 2020 BF18I093
69 Gentamisin salep kulit Tube DAK 18 190 03 2022 C80591T
70 Gentamisin tetes mata Botol
71 Gentian violet Botol DAK 18 2,712 05 2022 21061888
Btl/100 DAK 16 - 11 2021 KQ03T14B
350 02 2023 B80346T
72 GG tab 100 mg Btl/100 DAK 18 3,500 04 2023 D80813T
400 09 2023 I81961T
Box/100 DAK 19 1,185 03 2021 C.90080T
DAK 15 458 11 2020 1510078
73 Glibenklamid tab 5 mg Box/100
DAK 16 1,000 12 2020 1511094
74 Glimepirid tab 2 mg Box/50
75 Gliserol sol. 100 ml Botol DAK 15 174 08 2020 15LH010
76 Glukosa Larutan Infus 10% steril 500 ml Kolf 500 ml DAK 16 280 04 2020 250505
77 Glukosa Larutan Infus 40% steril 25 ml Kolf 25ml
DAK 18 9,660 07 2020 270820
78 Glukosa Larutan Infus 5% steril 500 ml Kolf 500 ml
Retur PKM 240 07 2020 270820
DAK 18 90 04 2020 180405176
79 Griseofulvin (micronized) tab 125 mg Box/100
DAK 19 2,000
Griseofulvin (micronized) tab 500 mg Box/100 DAK 19 200 06 2021 RF12E010
DAK 18 90 08 2022 I72008B
96 05 2022 F70891B
80 Hidroklorotiazid tab 25 mg Box/100 DAK 18 52 06 2022 G71114B
52 08 2022 I72008B
DAK 19 60 01 2023 B80165B
81 Hidrokortison krim 2,5% Tube DAK 18 4,584 10 2021 J71528T
82 Hiosina butilbromida Inj (Buscopan Injeksi) Box/10 DAK 16 24 02 2021 627282B
83 Hiosina butilbromida tab 10 mg (Buscopan Tablet) Box/100
84 Ibuprofen tab 200 mg Box/100
85 Ichtiol salep kulit Pot
86 Isosorbid dinitrat tab 5 mg Box/100
87 Isoniazid tab 300 mg Box/100 DAK 18 94 08 2022 I72310B
88 Isoniazid tab 100 mg (PP INH) Box/100 BS PROP 28 02 2020 A501857
89 Kalsium laktat (kalk) tab 500 mg Box/100
90 Kanamisin serb inj 1000 mg Box/10 DAU 15 29 07 2020 15927
91 Kaptopril tab 25 mg Box/100 DAK 19 133 01 2024 B.90316B
- 07 2021 G.70654T
92 Ketokonazol salep kulit Tube BS PROP
75 04 2022 D.80865T
DAK 18 - 05 2020 180501103
93 Ketokonazol tab 200 mg Box/50
DAK 19 568
94 Ketorolak inj. 30mg/ml Ampul
95 Klindamisin kaps 150mg Box/50
96 Klindamisin kaps 300mg Box/50
97 Klonidin tab 0,15 mg Box/100 DAK 15 100 02 2020 B150221B
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch

OBAT
98 Klopidogrel tab 75 mg Box/30 -
DAK 18 5,544 04 2021 D81172W
99 Kloramfenikol salep mata 1% Tube
DAK 19 7,200 09 2021 I82597W
100 Kloramfenikol tetes telinga 3% Botol
101 Klorfeniramin tab 4 mg (CTM) Box/100 DAK 18 - 07 2022 180745152
102 Kodein tab 10 mg Box/100 DAK 16 - 11 2019 ME2993J

Kombinasi (DHP) : Dihidroartemisin 40 mg + 187 05 2020 180519

103 Box/9 BS PROP
Piperakuin 320 mg tab sal selaput 2,160 05 2020 180520
104 Kombinasi : Ergotamin 1 mg+ Kafein 50 mg Botol/100
- 10 2019 6818412-1
BS PROP
- 10 2019 6818413
Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 mg
105 Box/30 14,517 07 2020 18TD1049
tab salut (Tablet Tambah darah)
DAK 18 1,984 07 2020 18TD1041
1,868 07 2020 18TD1043

Kombinasi : Thiamin HCl + Piridoksin +

106 Box/20
Sianokobalamin inj
Kombinasi : Thiamin HCl + Piridoksin +
107 Box/200
Sianokobalamin tablet
Kotrimoksazol (dewasa) tablet kombinasi :
108 Box/100 DAK 18 - 09 2019 171884
sulfametoksazol 400 mg+ trimetoprim 80 mg
Kotrimoksazol sirup kombinasi : sulfametoksazol 200
109 Botol DAK 18 5,905 05 2020 A81216
mg+ trimetoprim 40 mg per 5ml
110 Lamprene Kapsul 100mg Kapsul
111 Lansoprazol Kapsul Box/20 DAK 18 594 02 2021 YB237A
Larutan mengandung Karbohidrat + Elektrolit (Nacl DAK 16 90 11 2019 46K76A
112 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27 gr) Kolf 500 ml
(KA EN 3B) DAK 18 1,000 07 2021 48G94A

Larutan mengandung Karbohidrat + Elektrolit (Nacl

113 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27 Kolf 500 ml DAK 18 860 04 2021 48D99A
gr) (KA EN 3A)
114 Lidokain gel 2% (Xilocain Jel) Tube
115 Lidokain HCl inj 2% Box/100
116 Lisinopril tab 10mg Box/30
117 Lisinopril tab 5mg Box/30
118 Loperamid tab 2 mg Box/100 BS PROP - 08 2020 70608
119 Loratadin tab 10 mg Box/50 DAK 18 710 05 2020 10217 E0010
120 Magnesium sulfat inj 20% Vial BS PROP 65 07 2020 74G48B
121 Magnesium sulfat inj 40% Vial BS PROP 93 07 2020 75G48A
122 MD/MB COMBI Anak Box/6 blister BS PROP 13 08 2020 BGS9813
- 08 2019 B. GE6401
123 MD/MB COMBI Dewasa Box/6 blister BS PROP - 10 2021 B. HT3988
14 10 2021 B. HZ9323
124 Meloksikam tab 15 mg Box/20
125 Meloksikam tab 7,5 mg Box/20
126 Metformin tab 500 mg Box/100 DAK 18 3,200 05 2020 HTMFNA83815
127 Metilergometrin inj 0,2 mg/ml Ampul BS PROP 445 11 2020 9618L0248A
36 01 2021 AG0004J
165 03 2022 C70296J
128 Metilergometrin tab salut 0,125 mg Box/100 DAK 18
67 04 2022 D70898J
201 10 2020 LE2851J
129 Metoklopramid tab 10 mg Box/100 DAK 18 30 06 2020 F150933B
130 Metronidazol tab 250 mg Box/100
131 Metronidazol tab 500 mg Box/100 BS PROP - 10 2023 K82274B
132 Mikonazol krim 2% Tube DAK 18 264 11 2021 K73065W
133 Mineral Mix Box/40 BS PROP 9 08 2020 1808012
134 NaCl 0,9% Larutan Kolf 500 ml DAK 18 6,771 05 2023 280617
135 Natrium diklofenak tab 25 mg Box/50
136 Natrium diklofenak tab 50 mg Box/50
137 Nifedipin kaps 10 mg Box/100
BS PROP 5 05 2022 16372010
138 Nistatin tab vaginal 100.000 UI Box/100
DAK 19 30 07 2022 16372022
- 11 2020 16493043
139 Obat Anti Tuberculosis FDC Kategori Anak Paket BS PROP 12 06 2020 16493024
48 03 2021 19PK2005
54 02 2021 16461004
140 Obat Anti Tuberculosis FDC Kategori I Paket BS PROP
128 07 2021 16461221-1
- 05 2021 16471021
141 Obat Anti Tuberculosis FDC Kategori II Paket BS PROP
1 07 2021 16471042-6
142 OBH Sirup Botol
143 Oksitetrasiklin 1% salep mata Tube DAK 18 - 07 2021 H80164BI
- 03 2021 C80854W
144 Oksitetrasiklin 3% salep kulit Tube DAK 18
4,263 03 2021 C80967W
- 08 2020 97LH0050
145 Oksitosin inj 10 UI/ml Ampul BS PROP
668 08 2020 97LH0052
DAK 16 620 12 2020 16120253
146 Omeprazol kaps 20 mg Box/30 DAK 17 2,000 05 2020 18050853
DAK 18 150 08 2021 17082453
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch

OBAT
147 Papaverin tab 40 mg Box/100 DAK 18 360 10 2021 J60014B
148 Paraformaldehid tab 1 g Btl/100 OP 09 6 51011H1
149 Parasetamol infus Botol DAK 18 - 11 2019 LY7E045
150 Parasetamol sir 120 mg/5 ml Botol BS PROP 65 07 2020 1808016
151 Parasetamol tab 100 mg Botol/100
DAK 18 - 10 2019 172710
510 10 2022 J821171T
152 Parasetamol tab 500 mg Box/100
DAK 19 3,168 04 2021 D90359T
1,932 10 2022 J82157T
153 Parasetamol tts 60 mg/0,6 ml Botol DAK 18 - 07 2020 1807044
154 PD/PB Anak Box/6 blister BS PROP 7 08 2020 BGU4822
155 PD/PB Dewasa Box/6 blister BS PROP 3 10 2021 B. HI3247
156 Pirantel pamoat susp 125 mg/5 ml Botol
157 Pirantel pamoat tab scored 125 mg Box/100 DAK 18 417 06 2020 1806011
DAK 18 456 09 2020 J72504B
158 Piridoksin (vitamin B6) tab 10 mg Box/100
DAK 19 2,000 02 2021 C80480B
159 Piroksikam tab 10mg Box/100
DAK 16 - 08 2019 086145W
Btl 60 ml
DAK 17 4,713 07 2020 23081786
160 Povidon iodin lar 100 mg/ml
DAK 17 1,636 07 2020 2081788
Btl 300 ml
DAK 18 1,000 03 2021 160418888
162 PPD RT 23 (Mantoux Test) Vial BS PROP 10 06 2020 6500218
Btl/1000 DAK 16 89 11 2020 16110739
163 Prednison tab 5 mg DAK 18 - 09 2019 1709052
Box/100
DAK 18 2,615 05 2020 1805211
DAK 16 - 08 2019 95386004
164 Primakuin tab 15 mg Box/100
BS PROP 78 05 2021 16386003
165 Propranolol tab 10 mg Btl/100
166 Propranolol tab 40 mg Box/100
Box/100 DAK 16 - 08 2019 160801140A
167 Ranitidin tab 150 mg
Box/30 DAK 19 2,839 809 06 2023 G.81405B
DAK 18 - 08 2020 H71745W
168 Retinol (vitamin A) kaps lunak 100.000 UI Btl/50
DAK 19 14
169 Retinol (vitamin A) kaps lunak 200.000 UI Btl/50 DAK 18 826 08 2020 H71755W
170 Rifampisin tab 450mg Box/100 DAK 18 100 04 2022 D80981J
DAK 18 2,020 03 2023 380407
171 Ringer Laktat Larutan Kolf 500 ml Pengembalian RSUD 2,000 03 2024 490403
DAK 18 5,000 07 2024 490702
172 Rivanol Sol 10% Botol 300ml DAK 18 366 10 2020 14111788
173 Salbutamol cairan ih 0,1% (Ventolin Nebule) Box/20 amp
174 Salbutamol tab 2 mg Box/100 DAK 18 - 10 2020 A8251JU
DAK 18 3,240 05 2022 18SE019B
175 Salep 2-4, Kombinasi Pot 30g
DAK 19 1,152 06 2023 19SF060B
176 Sefiksim kaps 100mg Box/50
177 Sefotaksim seb inj 1000 mg Vial
178 Seftriakson serb inj 1000 mg Vial BS PROP - 11 2020 I11008AH
- 03 2021 555-19901
DAK 18
Serum anti bisa ular :A.B.U.II (khusus ular dari Papua) 1 04 2021 555-20001
179 Botol
inj (i.m./i.v.) Pengembalian RSUD 1 09 2021 555-20101
DAK 19 6 09 2021 55520101
180 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul DAK 18 35 12 2019 4203417
181 Setirisin tab 10 mg Box/100
182 Sianokobalamin (Vit. B12) inj Ampul DAK 18 700 04 2022 1810004
183 Simvastatin tab 10 mg Box/30
184 Siprofloksasin tab scored 500 mg Box/100
185 Spironolakton tab 25 mg Box/100
186 Sukralfat tab 500mg (Ulsidex) Box/100
DAK 18 - 09 2019 1709064
187 Tetrasiklin kaps 250 mg Box/100
DAK 18 111 07 2022 1807023
188 Tetrasiklin kaps 500 mg Box/100 DAK 17 222 08 2021 17082452
189 Tiamin (vitamin B1) inj Box/30
DAK 18 5,473 05 2022 188513158
190 Tiamin (vitamin B1) tab 50 mg Box/100
DAK 19 30
191 Tramadol inj 100 mg Ampul DAK 18 89 02 2021 D80030
DAK 18 - 05 2020 E70577T
192 Vitamin B kompleks tablet Box/100
BS PROP 1,425 07 2020
193 Zinc tab disp 20 mg Box/100 DAK 18 1,641 06 2021 18ZC1017

OBAT JIWA
DAK 16 28 09 2020 A1417IT
194 Amitriptilin tab sal 25 mg Box/100
DAK 18 5 09 2022 A1416IV
Alprazolam Tab. 0,5mg Box/100 BS PROP 1 01 2020 A80008
195 Atarax tab 0,5 mg Box/100
196 Cepezet inj Box/10 RSJ 10 10 2020 470197
197 Cepezet tab 100 mg Box/100
NO NAMA BARANG SATUAN SUMBER DANA STOK AWAL MASUK KELUAR PENYESUAIAN STOK AKHIR ED No Batch

OBAT
RSJ 600 02 2021 170110
198 Diazepam tab 5 mg Tablet
BS PROP 700 02 2022 A80480
199 Elizac tab 20 mg Box/30 BS PROP 14 10 2021 172755
200 Haloperidol inj 5 mg/ml (i.m.) Box/12
201 Haloperidol tablet 0,5mg Box/100 DAK 18 5 07 2023 A1806FV
202 Haloperidol tablet 1,5mg Box/100 DAK 18 5 08 2023 A1920HV
DINKES MAPPI 2 05 2021 170622
203 Haloperidol tablet 2mg (Lodomer) Box/100
DAK 18 5 02 2022 A80483
DINKES MAPPI - 09 2019 172417
204 Haloperidol tablet 5mg Box/100 DAK 18 5 08 2020 A81831
BS PROP 42 02 2020 A80391
205 Heximer tab 2 mg Box/100
206 Klobazam Tab. 10mg Box/100 BS PROP 9 02 2021 48B0402
DAK 18 - 08 2019 95329002
207 Klorpromazin inj 25mg Ampul
BS PROP 30
208 Klorpromazin tab sal 100 mg Box/100
209 Klorpromazin tab sal 25 mg Box/100
210 Klozapin Tab 25mg Box/50 BS PROP 15 05 2021 170757
211 Lodomer tab 2 mg Box/100
212 Merlopam tab 0,5 mg Box/100 RSJ - 05 2020 170883
213 Risperidon tab 2mg Box/100 BS PROP 58 - 03 2021 4900089
214 Sikzonoat inj Box/5
215 Triheksifenidil tab 2 mg Box/100 BS PROP 3 - 04 2020 A80942