LAPORAN PENERIMAN DAN PEMAKAIAN OBAT PUSKESMAS

KABUPATEN BREBES TAHUN 2015

PUSKESMAS : KEMURANG
BULAN : APRIL 2015
SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14

OBAT GENERIK
1 Alopurinol tablet 100 mg kotak 100 tablet tablet 13,200 132 164 21,648 0 0 40 5,280 124 16,368
2 Alprazolam tablet 0,25 mg kotak 100 tablet tablet 48,400 484 0 0 0 0 0
3 Ambroxol tablet 30 mg kotak 100 tablet tablet 12,507 125 1,457 182,125 0 0 254 31,750 1,203 150,375
4 Aminofllin tablet 200 mg botol 100 tablet tablet 11,330 113 1,357 153,341 0 0 21 2,373 1,336 150,968
5 Aminofillin injeksi 24 mg/ml kotak 30 ampul ampul 90,000 3,000 0 0 0 0 0
6 Amitriptilin tab salut 25 mg (HCl) kotak 100 tablet tablet 12,001 120 0 0 0 0 0
7 Amlodipin tablet 5 mg kotak 30 tablet tablet 28,800 960 0 0 0 0 0 0 0 0
8 Amoksisilin+As. Klavulanat TAB 625mg kotak 30 tablet tablet 151,668 5,056 0 0 0 0 0 0 0 0
9 Amoksisilin kapsul 250 mg kotak 120 kapsul kapsul 34,650 289 5,488 1,586,032 0 0 1,498 432,922 3,990 1,153,110
10 Amoksisilin kapsul 500 mg kotak 100 kapsul kapsul 37,000 370 22,255 8,234,350 0 0 4,942 1,828,540 17,313 6,405,810
11 Amoksisilin serbuk injeksi 1 g kotak 10 vial vial 75,000 7,500 0 0 0 0 0
12 Amoksisilin sirup kering 125mg/5ml botol 60 ml botol 3,700 3,700 499 1,846,300 120 444,000 131 484,700 488 1,805,600
13 Ampisillin kaplet 500 mg kotak 100 kaplet kaplet 38,100 381 0 0 0 0 0 0 0 0
14 Ampisllin serbuk injeksi 1 g/ml kotak 10 vial vial 53,680 5,368 0 0 0 0 0
15 Ampisillin sirup kering 125 mg/5ml botol 60 ml botol 4,400 4,400 0 0 0 0 0
16 Antasida DOEN I tablet kunyah botol 1000 tablet tablet 30,530 31 0 0 0 0 0 0 0 0
17 Antasida DOEN I tablet kunyah kotak 100 tablet tablet 16,200 162 14,978 2,426,436 0 0 3,007 487,134 11,971 1,939,302
18 Antasida DOEN suspensi botol 60 ml botol 3,850 3,850 0 0 0 0 0
19 Antibakteri DOEN kotak 25 tube tube 62,920 2,517 0 0 0 0 0
20 Antifungi DOEN kotak 24 pot pot 41,250 1,719 17 29,223 0 0 2 3,438 15 25,785
21 Antihaemoroid DOEN kotak 10 supp suppos 20,000 2,000 0 0 50 100,000 0 0 50 100,000
22 Antimigren tablet botol 100 tablet tablet 12,330 123 884 108,732 0 0 10 1,230 874 107,502
23 Aqua pro injeksi steril kotak 10 vial @ 20ml vial 55,000 5,500 16 88,000 0 0 0 0 16 88,000
24 Asam Asetil salisilat tablet 100 mg kotak 100 tablet tablet 9,600 96 0 0 0 0 0
25 Asam Askorbat (Vit.C) tab.50 mg botol 1000 tablet tablet 32,000 32 3,734 119,488 0 0 627 20,064 3,107 99,424

file:///conversion/tmp/scratch/397469105.xlsx 1
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
26 Asam Mefenamat kaplet 500mg kotak 100 kaplet kaplet 17,600 176 1,453 255,728 1,000 176,000 651 114,576 1,802 317,152
27 Asam Folat tablet 1 mg botol 100 tablet TABLET 6,800 68 324 22,032 1,000 68,000 124 8,432 1,200 81,600
28 Asiklovir krim 5 % tube 5 gram tube 3,150 3,150 47 148,050 0 0 34 107,100 13 40,950
29 Asiklovir tablet 200 mg kotak 30 tablet tablet 14,550 485 601 291,485 0 0 90 43,650 511 247,835
Atropin injeksi 1.m./1.v./s.k. 0,25 mg/ ml
30 ( Sulfat) kotak 30 ampul@1ml ampul 37,950 1,265 30 37,950 0 0 0 0 30 37,950
31 Atropin tablet 0,5 mg botol 100 tablet tablet 6,000 60 490 29,400 0 0 0 0 490 29,400
32 tablet tambah darah sase 30 tablet tablet 2,000 67 0 0 0 0 0 0 0 0
33 Betahistin mesilat tablet 6 mg kotak 30 tablet tablet 27,720 924 177 163,548 0 0 34 31,416 143 132,132
34 Betametason krim 0,1 % kotak 25 tube@5 g tube 46,650 1,866 152 283,632 0 0 40 74,640 112 208,992
35 Bisoprolol tablet 5 mg kotak 30 tablet tablet 69,650 2,322 0 0 0 0 0
36 Bromheksin tablet 8 mg kotak 100 tablet tablet 3,852 39 1,039 40,521 0 0 0 0 1,039 40,521
37 Cetirizine kapsul 10 mg kotak 50 kapsul kapsul 15,675 314 0 0 0 0 0
38 Cetirizine HCl 5 mg/ 5 ml botol 60 ml botol 10,450 10,450 0 0 0 0 0
39 Deksametason injeksi 5 mg/ml kotak 100 ampul ampul 200,200 2,002 0 0 0 0 0
40 Deksametason tablet 0,5 mg botol 1000 tablet tablet 38,544 39 29,691 1,157,949 20,000 780,000 15,141 590,499 34,550 1,347,450
41 Deksametason tablet 0,5 mg kotak 100 tablet tablet 8,700 87 0 0 0 0 0 0 0 0
42 Dekstran 70 - larutan infus 6% steril botol 500 ml botol 35,526 35,526 0 0 0 0 0
43 Dekstrometorfan sirup 10 mg/5ml botol 60 ml botol 2,865 2,865 0 0 0 0 0 0 0 0
44 Dektrometorfan tablet 15 mg botol 1000 tablet tablet 35,640 36 0 0 0 0 0
45 Dektrometorfan tablet 15 mg kotak 100 tablet tablet 11,000 110 0 0 0 0 0 0 0 0
46 Diazepam injeksi 5mg/ml kotak 30 ampul@2ml ampul 71,043 2,368 14 33,152 0 0 0 0 14 33,152
47 Diazepam tablet 2 mg botol 1000 tablet tablet 19,800 20 0 0 0 0 0 0 0 0
48 Diazepam tablet 2 mg kotak 100 tablet tablet 3,190 32 0 0 0 0 0
49 Difenhidramin inj. Im 10mg/ml kotak 30 amp@1ml ampul 28,800 960 0 0 0 0 0
50 Digoksin tablet 0,25 mg kotak 100 tablet tablet 14,300 143 250 35,750 0 0 8 1,144 242 34,606
51 Dimenhidrinat tablet 50 mg botol 100 tablet tablet 9,600 96 0 0 0 0 0
52 Diltiazem HCl tablet 30 mg kotak 100 tablet tablet 15,163 152 0 0 0 0 0
53 Doksisiklin kapsul 100 mg kotak 100 kapsul kapsul 25,300 253 0 0 0 0 0
54 Domperidon suspensi 5 mg/ 5ml botol 60 ml botol 12,650 12,650 0 0 0 0 0
55 Domperidon tablet 10 mg kotak 100 tablet tablet 40,362 404 462 186,648 0 0 62 25,048 400 161,600

file:///conversion/tmp/scratch/397469105.xlsx 2
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
56 Efedrin tablet 25 mg botol 1000 tablet tablet 20,742 21 0 0 0 0 0
57 Efedrin tablet 25 mg kotak 250 tablet tablet 12,815 51 0 0 0 0 0 0 0 0
58 Ekstrak belladon tablet 10mg botol 1000 tablet tablet 31,680 32 816 26,112 0 0 24 768 792 25,344
59 Efinefrin(adrenalin)inj 0,1% kotak 30 ampul@1ml ampul 37,200 1,240 21 26,040 0 0 0 0 21 26,040
60 Eritromisin kapsul 250mg kotak 100 kapsul kapsul 50,400 504 0 0 0 0 0 0 0 0
61 Eritromisin kapsul 500mg kotak 100 kapsul kapsul 93,000 930 80 74,400 0 0 0 0 80 74,400
62 Eritrimisin sirup 200 mg botol 60 ml botol 8,100 8,100 41 332,100 0 0 0 0 41 332,100
63 Etakridin larutan 0,1 % botol 300 ml botol 1,800 1,800 18 32,400 0 0 0 0 18 32,400
64 Etambutol tablet 250 mg kotak 200 tablet tablet 69,600 348 862 299,976 0 0 0 0 862 299,976
65 Fenilbutason tablet 200 mg botol 1000 tablet tablet 81,000 81 2,857 231,417 0 0 687 55,647 2,170 175,770
66 Fenitoin kapsul 100 mg botol 250 kapsul kapsul 19,884 80 656 52,480 0 0 100 8,000 556 44,480
67 Fenolbarbital tablet 30 mg botol 1000 tablet tablet 31,000 31 765 23,715 0 0 50 1,550 715 22,165
68 Fenolbarbital tablet 30 mg botol 100 tablet tablet 6,490 65 0 0 0 0 0
69 Fenol Gliserol tetes telinga 10% kotak 24 botol botol 24,200 1,008 31 31,248 0 0 15 15,120 16 16,128
70 Fitomenadion tablet 10 mg botol 100 tablet tablet 68,062 681 534 363,654 0 0 99 67,419 435 296,235
71 Fitomenadion injeksi 10 mg/ ml kotak 30 ampul ampul 52,200 1,450 0 0 0 0 0
72 Furosemid injeksi 10 mg/ ml - 2 ml kotak 25 ampul ampul 51,502 2,060 0 0 0 0 0
73 Furosemid tablet 40 mg kotak 200 tablet tablet 20,200 101 452 45,652 0 0 148 14,948 304 30,704
74 Gameksan lotion 1 % botol 30 ml botol 2,200 2,200 0 0 0 0 0
75 Garam Oralit kotak 100 sachet sachet 38,000 380 1,400 532,000 0 0 82 31,160 1,318 500,840
76 Gemfibrozil kapsul 300 mg kotak 120 kapsul kapsul 34,900 291 0 0 0 0 0
77 Gentamisin injeksi 80 mg2ml kotak 1 vial@2ml vial 3,782 3,782 0 0 0 0 0
78 Gentamisin salep kulit 0,1% kotak 10 tube 5g tube 18,370 1,837 89 163,493 0 0 9 16,533 80 146,960
79 Gentamisin tetes mata 0,3 % botol 5 ml botol 3,300 3,300 0 0 0 0 0 0 0 0
80 Gentian Violet larutan 1 % botol 10 ml botol 450 450 0 0 0 0 0 0 0 0
81 Glibenklamid tablet 5 mg kotak 100 tablet tablet 7,200 72 1,481 106,632 0 0 51 3,672 1,430 102,960
82 Glimepiride tablet 1 mg kotak 30 tablet tablet 22,838 761 0 0 0 0 0
83 Gliseril Guaiakolat tablet 100 mg botol 1000 tablet tablet 27,900 28 31,283 875,924 0 0 13,886 388,808 17,397 487,116
84 Gliserin botol 100 ml botol 4,730 4,730 0 0 0 0 0
85 Glukosa larutan infus 5% botol 500 ml botol 5,060 5,060 0 0 0 0 0

file:///conversion/tmp/scratch/397469105.xlsx 3
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
86 Glukosa larutan infus 40% kotak 10 ampul ampul 14,524 1,452 0 0 0 0 0
87 Griseofulvin tablet 125 mg botol 100 tablet tablet 24,000 240 517 124,080 0 0 215 51,600 302 72,480
88 Haloperidol tablet 0,5 mg kotak 100 tablet tablet 6,024 60 0 0 0 0 0
89 Hidroklordiazida tablet 25 mg botol 1000 tablet tablet 36,300 36 1,710 61,560 0 0 81 2,916 1,629 58,644
90 Hidrokortison krim 1 % tube 5 gram tube 2,300 2,300 0 0 0 0 0
91 Hidrokortison krim 2,5 % kotak 24 tube @5g tube 71,500 2,979 173 515,367 0 0 5 14,895 168 500,472
92 Hyoscine -N- Butilbromide tablet 10 mg kotak 100 tablet tablet 30,000 3,000 500 1,500,000 0 0 0 0 500 1,500,000
93 Ibuprofen tablet 200 mg botol 100 tablet tablet 11,550 116 659 76,444 1,000 116,000 481 55,796 1,178 136,648
94 Ibuprofen suspensi 200mg botol 60 ml botol 4,500 4,500 0 0 0 0 0 0 0 0
95 Iodiol kapsul lunak botol 100 kapsul kapsul 93,000 930 0 0 0 0 0
96 Isoniazida tablet 100 mg botol 1000 tablet tablet 41,000 41 0 0 0 0 0
97 Isoniazida tablet 300 mg botol 1000 tablet tablet 97,000 97 820 79,540 0 0 64 6,208 756 73,332
98 Isosorbid Dinitrat tablet 5 mg kotak 100 tablet tablet 9,735 97 500 48,500 0 0 0 0 500 48,500
99 Kalium Diklofenak tablet 25 mg kotak 50 tablet tablet 19,542 391 366 143,106 0 0 0 0 366 143,106
100 Kalium Laktat tablet 500 mg botol 1000 tablet tablet 52,000 52 326 16,952 0 0 326 16,952 0 0
101 Kaptopril tablet 25 mg kotak 100 tablet tablet 13,775 138 200 27,600 0 0 63 8,694 137 18,906
102 Karbamazepin tablet 200 mg kotak 100 tablet tablet 24,645 246 0 0 0 0 0
103 Ketokenazol krim 2,5% tube 15 gram tube 7,000 7,000 31 217,000 0 0 15 105,000 16 112,000
104 Ketokenazol tablet 200 mg kotak 50 tablet tablet 20,500 410 356 145,960 0 0 43 17,630 313 128,330
105 Ketoprofen tablet 100 mg kotak 100 tablet tablet 135,000 1,350 0 0 0 0 0 0 0 0
106 Klindamisin kapsul 150 mg kotak 100 kapsul kapsul 51,000 510 119 60,690 0 0 0 0 119 60,690
107 Klindamisin kapsul 300 mg kotak 100 kapsul kapsul 75,275 753 1,300 978,900 0 0 0 0 1,300 978,900
108 Klonidin tablet 0,15 mg kotak 100 tablet tablet 20,500 205 402 82,410 0 0 23 4,715 379 77,695
109 Kloramfenikol kapsul 250 mg botol 250 kapsul kapsul 57,750 231 3,129 722,799 0 0 341 78,771 2,788 644,028
110 Kloramfenikol salep mata 1 % tube 5 gram tube 1,563 1,563 112 175,056 0 0 18 28,134 94 146,922
111 Kloramfenikol suspensi 125mg/5ml botol 60 ml botol 4,500 4,500 137 616,500 0 0 2 9,000 135 607,500
112 Kloramfenikol tetes mata 0,5% botol 5 ml botol 2,500 2,500 36 90,000 0 0 33 82,500 3 7,500
113 Kloramfenikol tetes telinga 3% botol 5 ml botol 1,600 1,600 53 84,800 0 0 4 6,400 49 78,400
114 Klorfeniramin Maleat(CTM)tab 4mg botol 1000 tablet tablet 24,000 24 36,313 871,512 10,000 240,000 11,113 266,712 35,200 844,800
115 Klorpromazin tablet salut 100 mg botol 250 tablet tablet 30,500 122 0 0 0 0 0

file:///conversion/tmp/scratch/397469105.xlsx 4
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
116 Kodein tablet 10 mg botol 250 tablet tablet 106,821 427 0 0 0 0 0 0 0 0
117 Kotrinoksazol DOEN I tablet (dewasa) kotak 100 tablet tablet 16,500 165 5,474 903,210 0 0 2,493 411,345 2,981 491,865
118 Kotrimoksazol suspensi komb. botol 60 ml botol 3,960 3,960 467 1,849,320 0 0 77 304,920 390 1,544,400
119 Lanzoprazol 30 mg kotak 20 kapsul kapsul 27,027 1,351 0 0 0 0 0 0 0 0
120 Lidokain inj.2%+epinefrin - 2ml kotak 30 vial @ 2ml vial 34,100 1,137 46 52,302 0 0 11 12,507 35 39,795
121 Linkomisin kapsul 500 mg kotak 60 kapsul kapsul 39,000 650 0 0 0 0 0
122 Loperamid tablet 2 mg kotak 100 tablet tablet 9,155 92 3,430 315,560 0 0 654 60,168 2,776 255,392
123 Loratadin tablet 10 mg kotak 50 tablet tablet 16,654 333 0 0 0 0 0
124 Magnesium Sulfat injeksi (IV) 20% kotak 10 vial vial 15,398 1,535 20 30,700 0 0 0 0 20 30,700
125 Magnesium Sulfat injeksi (IV) 40% kotak 10 vial vial 19,479 1,948 30 58,440 0 0 0 0 30 58,440
126 Meloksikam tablet 15 mg kotak 50 tablet tablet 59,950 1,199 0 0 0 0 0 0 0 0
127 Metampiron (antalgin)tablet 500 mg botol 1000 tablet tablet 51,578 52 0 0 0 0 0 0 0 0
128 Metampiron (antalgin)tablet 500 mg kotak 100 tablet tablet 14,900 149 33,956 5,059,444 0 0 8,800 1,311,200 25,156 3,748,244
129 Metformin HCl tablet 500 mg kotak 100 tablet tablet 18,150 182 120 21,840 0 0 0 0 120 21,840
130 Metilergometrin Maleat tab.0,125mg kotak 100 tablet tablet 12,100 121 0 0 0 0 0 0 0 0
131 Metilergometrin Maleat inj.0,200mg kotak 30 ampul ampul 44,700 1,490 20 29,800 0 0 0 0 20 29,800
132 Metilprednisolon tablet 4 mg kotak 100 tablet tablet 44,055 441 1,000 441,000 0 0 200 88,200 800 352,800
133 Metoklopramide inj. 5mg/ml kotak 10 ampul ampul 10,000 1,000 0 0 0 0 0
134 Metoklopramide tablet 10 mg kotak 100 tablet tablet 11,000 110 200 22,000 500 55,000 0 0 700 77,000
135 Metronidazol tablet 250 mg kotak 100 tablet tablet 14,300 143 1,273 182,039 0 0 0 0 1,273 182,039
136 Mikonazol Krim/Salep 2% tube 10 gram tube 3,000 3,000 36 108,000 0 0 0 0 36 108,000
137 Mineral Mix 8 gram kotak 40 sachet sachet 99,000 2,475 0 0 0 0 0
138 Natrium bikarbinat tablet 500mg botol 1000 tablet tablet 14,300 14 0 0 0 0 0
139 Natrium diklofenak tablet 50mg kotak 50 tablet tablet 10,884 218 500 109,000 0 0 140 30,520 360 78,480
140 Natrium Klorida larutan inf.0,9% botol 500 ml botol 4,900 4,900 3 14,700 0 0 0 0 3 14,700
141 Nipedipin tablet 10 mg kotak 100 tablet tablet 12,900 129 395 50,955 0 0 27 3,483 368 47,472
142 Nistatin tablet salut 500.000 IU kotak 100 tablet tablet 60,000 600 0 0 0 0 0
143 Nistatin Vaginal tab.100.000IU/g kotak 100 tab.Vag. tablet vag. 37,000 370 0 0 0 0 0 0 0 0
144 Obat Antituberkulosis (FDC) kat 1 paket/ kotak 360,000 360,000 0 0 0 0 0
145 Obat Antituberkulosis (FDC) sisipan paket/ kotak 160,000 160,000 0 0 0 0 0

file:///conversion/tmp/scratch/397469105.xlsx 5
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
146 Obat Antituberkulosis (FDC) kat anK paket/ kotak 215,000 215,000 0 0 0 0 0
147 Obat Batuk Hitam (OBH) cairan botol 100 ml botol 1,430 1,430 417 596,310 0 0 121 173,030 296 423,280
148 Ofloxacin tablet 200 mg kotak 50 tablet tablet 29,505 590 0 0 0 0 0
149 Oksitetrasiklin salep mata 1 % kotak 25 tube@3,5 g tube 48,000 1,920 91 174,720 0 0 2 3,840 89 170,880
150 Oksitetrasiklin salep kulit 3 % tube 5 gram tube 1,675 1,675 100 167,500 0 0 10 16,750 90 150,750
151 Oksitosin injeksi 10 IU/ml-1ml kotak 30 ampul ampul 53,550 1,785 10 17,850 0 0 10 17,850 0 0
152 Omeprazol kapsul 20 mg kotak 30 kapsul kapsul 12,250 408 250 102,000 0 0 40 16,320 210 85,680
153 Papaverin tablet 40 mg botol 1000 tablet tablet 99,500 100 970 97,000 0 0 378 37,800 592 59,200
154 Paresetamol sirup 120mg/5ml botol 60 ml botol 2,300 2,300 472 1,085,600 252 579,600 394 906,200 330 759,000
155 Parasetamol drop botol 15 ml botol 5,280 4,800 0 0 0 0 0
156 Paresetamol tablet 500 mg botol 1000 tablet tablet 33,700 34 0 0 0 0 0 0 0 0
157 Paresetamol tablet 500 mg kotak 100 tablet tablet 10,500 105 31,796 3,338,580 10,000 1,050,000 11,743 1,233,015 30,053 3,155,565
158 Piracetam injeksi 1g/ 5ml kotak 10 ampul ampul 55,000 5,500 0 0 0 0 0
159 Piracetam tablet 400 mg kotak 100 tablet tablet 45,100 451 190 85,690 0 0 0 0 190 85,690
160 Pirantel tab.score(base)125mg kotak 60 tablet tablet 18,600 310 61 18,910 300 93,000 63 19,530 298 92,380
161 Pirasinamid tablet 500 mg kotak 100 tablet tablet 23,400 234 0 0 0 0 0
162 Piridoksin tablet 10 mg botol 1000 tablet tablet 17,400 17 11,663 198,271 3,000 51,000 3,791 64,447 10,872 184,824
163 Piroksikam tablet 20 mg kotak 100 tablet tablet 10,500 105 2,412 253,260 1,000 105,000 1,206 126,630 2,206 231,630
164 Polikresulen 360mg/g ( Albothyl) botol 10 ml botol 18,590 18,590 0 0 0 0 0 0 0 0
165 Povidon Iodida larutan 10% botol 30 ml botol 2,400 2,400 52 124,800 0 0 2 4,800 50 120,000
166 Povidon Iodida larutan 10% botol 300 ml botol 14,500 14,500 5 72,500 0 0 2 29,000 3 43,500
167 Prednison tablet 5mg botol 1000 tablet tablet 62,500 63 10,188 641,844 0 0 407 25,641 9,781 616,203
168 Propanolol tablet 40 mg botol 100 tablet tablet 12,100 121 0 0 0 0 0
169 Propiltiourasil tablet 100 mg botol 100 tablet tablet 29,957 300 200 60,000 0 0 0 0 200 60,000
170 Ranitidin injeksi 25 mg/2ml kotak 25 ampul ampul 64,250 2,570 0 0 0 0 0
171 Ranitidin tablet 150 mg kotak 100 tablet tablet 22,000 220 1,055 232,100 0 0 40 8,800 1,015 223,300
172 Reserpin tablet 0,25 mg botol 1000 tablet tablet 88,000 88 1,990 175,120 0 0 200 17,600 1,790 157,520
173 Retinol(vit.a)100.000 IU kaps. lunak botol 50 kaps. Lunak kapsul 14,300 286 0 0 0 0 0
174 Retinol(vit.a)200.000 IU kaps. lunak botol 50 kaps. Lunak kapsul 23,100 462 0 0 0 0 0
175 Retinol(vit.a) tablet 50.000 IU botol 1000 tablet tablet 160,000 160 0 0 0 0 0

file:///conversion/tmp/scratch/397469105.xlsx 6
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
176 Rifampisin kaplet 450 mg kotak 100 kaplet kaplet 66,000 660 500 330,000 0 0 0 0 500 330,000
177 Rifampisin kaplet 600 mg kotak 100 kaplet kaplet 92,250 923 50 46,150 0 0 50 46,150 0 0
178 Ringer Laktat larutan infus botol 500 ml botol 5,200 5,200 70 364,000 0 0 10 52,000 60 312,000
179 Salbutamol tablet 2 mg kotak 100 tablet tablet 8,403 84 924 77,616 500 42,000 381 32,004 1,043 87,612
180 Salbutamol 2 mg/ 5 ml sirup boto; 100 ml botol 5,500 5,500 0 0 0 0 0
181 Salep 2-4 kotak 24 pot@30 g pot 29,500 1,229 38 46,702 0 0 0 0 38 46,702
182 Salisil Bedak 2 % kotak 50 gram kotak 1,430 1,430 74 105,820 0 0 6 8,580 68 97,240
183 Sefadroksil kapsul 500 mg kotak 100 kapsul kotak 84,000 840 1,200 1,008,000 0 0 0 0 1,200 1,008,000
184 Sefiksim kapsul 100 mg kotak 30 kapsul kapsul 71,838 2,395 0 0 0 0 0
185 Sefiksim sirup kering 100 mg botol 30 ml botol 30,250 30,250 0 0 0 0 0
186 Sefotaksin injeksi 1 g kotak 2 vial vial 13,860 6,930 0 0 0 0 0
187 Seftriaxon injeksi 1 g kotak 2 vial vial 17,188 8,594 0 0 0 0 0
188 Serum ABU I injeksi 5 ml kotak 10 vial vial 3,014,000 301,400 0 0 0 0 0
189 Serum ATS injeksi 1.500 kotak 10 ampul ampul 680,000 68,000 0 0 0 0 0
190 Serum ATS injeksi 20.000 kotak 10 vial vial 4,510,000 451,000 0 0 0 0 0
191 Sianokobalamin (Vit.B12)inj. 500 mcg kotak 100 ampul ampul 103,700 1,037 0 0 0 0 0 0 0 0
192 Simetidin tablet 200 mg kotak 100 tablet tablet 11,490 105 896 94,080 1,000 105,000 349 36,645 1,547 162,435
193 Simvastatin tablet 10 mg kotak 50 tablet tablet 25,650 513 100 51,300 0 0 0 0 100 51,300
194 Siprofloksasin tablet 500 mg kotak 50 tablet tablet 13,000 260 1,137 295,620 500 130,000 38 9,880 1,599 415,740
195 Spironolakton tablet 25 mg kotak 100 tablet tablet 34,637 346 0 0 0 0 0
196 Sulfasetamid Natrium Tesma 15% kotak 24 btl @5ml botol 82,686 3,445 41 141,245 72 248,040 51 175,695 62 213,590
197 Taburia kotak 30 sachet sachet 19,800 660 0 0 0 0 0
198 Tetrasiklin kapsul 250 mg botol 1000 kapsul kapsul 166,750 167 9,174 1,532,058 0 0 658 109,886 8,516 1,422,172
199 Tiamfenikol kapsul 500 mg kotak 100 kapsul kapsul 61,600 616 652 401,632 0 0 0 0 652 401,632
200 Tiamin (Vit.B1) injeksi 100mg/ml kotak 30 ampul ampul 23,000 7,667 0 0 0 0 0
201 Tiamin (Vit.B1) tablet 50mg botol 1000 tablet tablet 37,800 38 3,834 145,692 0 0 2,165 82,270 1,669 63,422
202 Tramadol injeksi 50mg/ml kotak 5 ampul ampul 32,010 6,402 0 0 0 0 0
203 Tramadol kapsul 50 mg kotak 50 kapsul kapsul 16,500 330 290 95,700 0 0 40 13,200 250 82,500
204 Triheksipenidil tablet 2 mg kotak 100 tablet tablet 4,125 41 0 0 0 0 0
205 Vitamin B kompleks tablet botol 1000 tablet tablet 22,200 22 19,423 427,306 10,000 220,000 6,691 147,202 22,732 500,104

file:///conversion/tmp/scratch/397469105.xlsx 7
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
206 zinc tablet kotak 100 tablet tablet 47,500 475 1,342 637,450 1,000 475,000 322 152,950 2,020 959,500
OBAT GENERIK TAMBAHAN 0 0 0 0 0
207 Asam Ascorbat ( Vit.C ) Tab 250 mg botol 250 tablet tablet 33,750 135 0 0 0 0 0 0 0 0
208 Batugin sirup botol 100 ml botol 13,530 13,530 0 0 0 0 0 0 0 0
209 Bionic sirup botol 60 ml botol 15,290 15,290 0 0 0 0 0 0 0 0
210 Bismecon gel tube tube 11,990 11,990 0 0 0 0 0 0 0 0
211 Bufabron sirup botol 100 ml botol 9,900 9,900 0 0 0 0 0 0 0 0
212 Captopril tablet 12,5 mg kotak 100 tablet kotak 6,200 62 1,852 114,824 0 0 602 37,324 1,250 77,500
213 Calcidol sirup vitamin botol 60 ml botol 21,403 21,403 2 42,806 0 0 2 42,806 0 0
214 Dulcolak tablet kotak 100 tablet tablet 85,500 855 0 0 0 0 0 0 0 0
215 Ersylan sirup botol 60 ml botol 12,643 12,643 1 12,643 10 126,430 1 12,643 10 126,430
216 Fucilex cream tube tube 6,490 6,490 24 155,760 0 0 0 0 24 155,760
217 Gastulen tablet kotak 100 tablet tablet 55,000 550 0 0 0 0 0 0 0 0
218 Hemafort tablet kotak 100 tablet tablet 42,900 429 0 0 0 0 0 0 0 0
219 Hexon sirup botol 60 ml botol 7,370 7,370 0 0 0 0 0 0 0 0
220 Imulan sirup botol 60 ml botol 15,000 15,000 2 30,000 0 0 0 0 2 30,000
221 Kejibeling kapsul kotak 100 kapsul kapsul 44,000 440 0 0 0 0 0 0 0 0
222 Metronidazol tablet 500 mg kotak 100 tablet tablet 22,000 220 818 179,960 0 0 10 2,200 808 177,760
223 Magalat sirup botol 100 ml botol 22,825 22,825 0 0 0 0 0 0 0 0
224 Nemicap kapsul kotak 100 kapsul kapsul 67,100 671 1,046 701,866 0 0 0 0 1,046 701,866
225 Neo Kaominal sirup botol 60 ml botol 5,445 5,445 0 0 0 0 0 0 0 0
226 Neurotropik tablet kotak 100 tablet tablet 52,800 528 0 0 0 0 0 0 0 0
227 Nodiar tablet kotak 100 tablet tablet 96,300 963 1,098 1,057,374 0 0 22 21,186 1,076 1,036,188
228 Neurovit E tablet kotak 60 tablet tablet 52,800 880 0 0 0 0 0 0 0 0
229 Solvitron kapsul kotak 100 kapsul kapsul 49,400 494 4,361 2,154,334 0 0 751 370,994 3,610 1,783,340
230 Tensigard kapsul kotak 30 kapsul kapsul 45,000 1,500 0 0 0 0 0 0 0 0
231 Zink kids sirup botol 60 ml botol 22,550 22,550 23 518,650 0 0 3 67,650 20 451,000
232 Zolacord krim tube 5 gram tube 22,000 22,000 0 0 0 0 0 0 0 0
JUMLAH 332,588 54,796,492 61,304 5,204,070 97,657 11,998,345 296,235 48,002,217

file:///conversion/tmp/scratch/397469105.xlsx 8
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA OBAT KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Mengetahui : Brebes. 30 APRIL 2015

Kepala Puskesmas Petugas Obat Puskesmas
KEMURANG Puskesmas KEMURANG

dr. ARIS SETIAWAN NOOR HIDAYATI, A.Md AFM

Nip. 19710218 200604 1 008 Nip. 19841117 201001 2 028

file:///conversion/tmp/scratch/397469105.xlsx 9
 LAPORAN PENERIMAN DAN PEMAKAIAN BHP PUSKESMAS
KABUPATEN BREBES TAHUN 2015
PUSKESMAS : KEMURANG
BULAN : APRIL 2015
SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA BAHAN HABIS PAKAI ( BHP ) KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14

1 Alat suntik sekali pakai 1 ml kotak 100 set set 109,250 1,093 0 0 0 0
2 Alat suntik sekali pakai 2,5 ml kotak 100 set set 103,800 1,038 465 482,670 0 0 15 15,570 450 467,100
3 Alat suntik sekali pakai 5 ml kotak 100 set set 103,800 1,038 500 519,000 0 0 30 0 470 487,860
Antiseptic and cleansing liquid soap
4 (Masterscrub) botol 5 liter botol 1,086,800 1,086,800 0 0 0 0

5 Blood lancet autoclik kotak 100 buah buah 110,000 1,100 0 0 0 0

6 Box slide kotak buah 89,570 89,570 0 0 0 0
Catgut/Benang bedah no 3/0 dengan jarum
7 bedah kotak 24 x 70 cm sachet 640,000 26,667 34 906,678 0 0 3 80,001 31 826,677
Catgut/Benang bedah no.2/0 dengan jarum
8 bedah kotak 24 x 70 cm sachet 590,000 24,583 45 1,106,235 0 0 0 0 45 1,106,235
Clean and pre-disinfection of medico surgical
9 instruments (Mastersliym) botol 5 liter botol 1,086,800 1,086,800 0 0 0 0
10 Cover glass 22 x 22 x 0,16 mm kotak 100 pieces pieces 52,000 520 0 0 0 0
11 Disposible Needle 26GX1/2 kotak 100 pieces pieces 40,000 400 0 0 0 0 0 0 0
12 Etanol 70 % botol 1000 ml botol 18,698 18,698 11 205,678 0 0 1 18,698 10 186,980
13 Folley cateter 16 pieces pieces 8,495 8,495 0 0 0 0
14 Folley cateter 18 pieces pieces 8,495 8,495 0 0 0 0
15 Handcoon ( L, M ) kotak 50 pasang set 212,500 4,250 50 212,500 100 425,000 100 425,000 50 212,500
16 Infusion set anak set / kantong set 4,000 4,000 0 0 0 0
17 Infusion set dewasa set / kantong set 3,500 3,500 80 280,000 0 0 10 35,000 70 245,000
18 IV Cateter No. 18 G kotak 50 buah buah 389,375 7,788 40 311,500 0 0 40 0 0 0
19 IV Cateter No. 22 G kotak 50 buah buah 389,375 7,788 0 0 0 0
20 IV Cateter No. 24 G kotak 50 buah buah 389,375 7,788 49 381,612 0 0 28 218,064 21 163,548
21 Kapas berlemak 500 g bungkus bungkus 17,250 17,250 0 0 0 0
22 Kapas pembalut/ absorben 250 g bungkus bungkus 7,500 7,500 8 60,000 0 0 3 22,500 5 37,500

file:///conversion/tmp/scratch/397469105.xlsx 10
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA BAHAN HABIS PAKAI ( BHP ) KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
23 Kassa hidrofil steril 16 x 16 kotak 16 lembar lembar 8,500 8,500 0 0 0 0
24 Kassa kompres 40/40 steril rol rol 1,266 1,266 0 0 40 50,640 0 0 40 50,640
25 Kassa pembalut hidrofil 4mx15cm elastis rol rol 3,066 3,066 40 122,640 0 0 15 45,990 25 76,650
26 Kassa pembalut hidrofil 4mx3cm elastis rol rol 666 666 0 0 25 16,650 0 0 25 16650
27 Kassa pembelut 2mx80cm rol rol 7,999 7,999 16 127,984 30 239,970 3 23,997 43 343,957
28 Kertas saring kotak 10 lembar lembar 45,000 4,500 0 0 0 0
29 Lisol, mengandung kresol 50% botol 1000 ml botol 49,862 49,862 2 99,724 0 0 0 0 2 99,724
30 Masker / Mouth cap ( spek : tali, karet ) kotak 20 pieces pieces 22,500 1,125 250 281,250 0 0 50 56,250 200 225,000
31 Obyek glas/ slides kotak 100 pieces pieces 10,000 100 0 0 0 0
32 Pembalut gips 3 inch rol rol 23,500 23,500 0 0 0 0
33 Plester 5 yard x 2 inch rol rol 23,625 23,625 3 70,875 6 141,750 0 0 9 212,625
34 Plester mengandung obat kotak 10 lembar lembar 149,500 14,950 0 0 0 0
35 Plester tahan air 10 cm x 5 m rol rol 42,400 42,400 4 169,600 0 0 0 0 4 169,600
36 Polikresulen 360mg/g botol 10 ml botol 18,590 18,590 0 0 5 92,950 0 0 5 92,950
37 Pot sputum, spec : bouble layer + sendok pieces pieces 5,500 5,500 0 0 0 0
38 Selang oksigen masker anak set set 30,000 30,000 0 0 0 0
39 Selang oksigen masker dewasa set set 30,000 30,000 0 0 0 0
Silk(Benang Bedah Sutera)no.3/0 denganjarum
40 bedah kotak 12 x 3 x 75 cm sachet 251,400 6,983 0 0 0 0 0 0 0 0
41 Tambung Hematokrit kotak 100 tabung tabung 310,000 3,100 0 0 0 0
42 Tissue/ Kertas Lensa Box box 46,000 46,000 0 0 0 0
43 Urine Bag pieces pieces 4,000 4,000 0 0 0 0
44 Vacutainer tabung 3 ml EDTA kotak 100 tube tube 200,000 2,000 0 0 0 0
45 Wing Needle no. 25 G kotak 100 buah set 577,000 5,770 0 0 0 0
46 Blue tipe kotak 1000 pieces pieces 140,000 140,000 0 0 0 0
47 White tipe kotak 1000 pieces pieces 140,000 140,000 0 0 0 0
48 Yellow tipe kotak 1000 pieces 140,000 140,000 0 0 0 0
49 Film dan Cairan Rontgen 0 0 0 0
- Film 35 x 35 kotak 100 pieces 1,500,000 15,000 0 0 0 0
- Film 30 x 40 kotak 100 pieces 1,500,000 15,000 0 0 0 0
- Film 24 x 30 kotak 100 pieces 1,500,000 15,000 0 0 0 0

file:///conversion/tmp/scratch/397469105.xlsx 11
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA BAHAN HABIS PAKAI ( BHP ) KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
- Cairan developer dan fixer set 850,000 850,000 0 0 0 0
50 Obat Gigi 0 0 0 0
- Devitalisasi pasta (non arsen) botol/kotak botol 390,000 390,000 0 0 0 0
- Etil klodida spray vial/can 100 ml vial 105,000 105,000 0 0 0 0 0 0 0 0
- Eugenol cairan kotak 12 btl @ 10 ml botol 550,000 45,833 1 45,833 0 0 0 0 1 45,833
- Glass Ionomer cement ART set / botol botol 395,000 395,000 2 790,000 0 0 0 0 2 790,000
- Kalsium Hidroksida Pasta kotak 2 tube kotak 242,000 242,000 0 0 0 0
- Klorfenol Kamfer Menthol botol 10 ml botol 55,000 55,000 0 0 0 0
- Mummifying Pasta botol/kotak botol 176,000 176,000 0 0 0 0
- Semen Seng Fosfat serbuk,cairan set / botol 30 gram botol 93,500 93,500 0 0 0 0
Sintetik Filling Material botol botol 140,000 140,000 0 0 0 0
- Fletcher serbuk dan cairan set / botol 100 gram botol 34,000 34,000 0 0 0 0
BHP TAMBAHAN
51 Aquabidest 500 ml botol 500 ml botol 9,500 9,500 1 9,500 0 0 0 0 1 9,500
52 Kasa kompres 40/80 cm rol rol 1,266 1,266 20 25,320 0 0 0 0 20 25,320
53 0
54
55
56
57
58
59 DST . . . . . 1,621 6,208,599 206 966,960 298 941,070 1,529 5,891,849

Mengetahui : Brebes. 30 APRIL 2015

Kepala Puskesmas Petugas Obat Puskesmas
KEMURANG Puskesmas KEMURANG

dr. ARIS SETIAWAN NOOR HIDAYATI, A.Md AFM

file:///conversion/tmp/scratch/397469105.xlsx 12
 SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA BAHAN HABIS PAKAI ( BHP ) KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14
NIP. 19710218 200604 1 008 NIP. 19841117 201001 2 028

file:///conversion/tmp/scratch/397469105.xlsx 13
 LAPORAN PENERIMAN DAN PEMAKAIAN BHP PUSKESMAS
KABUPATEN BREBES TAHUN 2015
PUSKESMAS : KEMURANG
BULAN : APRIL 2015
SATUAN HARGA HARGA SISA AWAL PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA BAHAN HABIS PAKAI ( BHP ) KEMASAN
KEMASAN KEMASAN SATUAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 6 7 8 9 10 11 12 13 14

1 Alat suntik sekali pakai 1 ml kotak 100 set set 109,250 1,093 0 0 0 0
2 Alat suntik sekali pakai 2,5 ml kotak 100 set set 103,800 1,038 465 482,670 0 0 15 15,570 450 467,100
3 Alat suntik sekali pakai 5 ml kotak 100 set set 103,800 1,038 500 519,000 0 0 30 0 470 487,860
Antiseptic and cleansing liquid soap
4 (Masterscrub) botol 5 liter botol 1,086,800 1,086,800 0 0 0 0

5 Blood lancet autoclik kotak 100 buah buah 110,000 1,100 0 0 0 0

6 Box slide kotak buah 89,570 89,570 0 0 0 0
Catgut/Benang bedah no 3/0 dengan jarum
7 bedah kotak 24 x 70 cm sachet 640,000 26,667 34 906,678 0 0 3 80,001 31 826,677
Catgut/Benang bedah no.2/0 dengan jarum
8 bedah kotak 24 x 70 cm sachet 590,000 24,583 45 1,106,235 0 0 0 0 45 1,106,235
Clean and pre-disinfection of medico surgical
9 instruments (Mastersliym) botol 5 liter botol 1,086,800 1,086,800 0 0 0 0
10 Cover glass 22 x 22 x 0,16 mm kotak 100 pieces pieces 52,000 520 0 0 0 0
11 Disposible Needle 26GX1/2 kotak 100 pieces pieces 40,000 400 0 0 0 0 0 0 0
12 Etanol 70 % botol 1000 ml botol 18,698 18,698 11 205,678 0 0 1 18,698 10 186,980
13 Folley cateter 16 pieces pieces 8,495 8,495 0 0 0 0
14 Folley cateter 18 pieces pieces 8,495 8,495 0 0 0 0
15 Handcoon ( L, M ) kotak 50 pasang set 212,500 4,250 50 212,500 100 425,000 100 425,000 50 212,500
16 Infusion set anak set / kantong set 4,000 4,000 0 0 0 0
17 Infusion set dewasa set / kantong set 3,500 3,500 80 280,000 0 0 10 35,000 70 245,000
18 IV Cateter No. 18 G kotak 50 buah buah 389,375 7,788 40 311,500 0 0 40 0 0 0
19 IV Cateter No. 22 G kotak 50 buah buah 389,375 7,788 0 0 0 0
20 IV Cateter No. 24 G kotak 50 buah buah 389,375 7,788 49 381,612 0 0 28 218,064 21 163,548
21 Kapas berlemak 500 g bungkus bungkus 17,250 17,250 0 0 0 0
22 Kapas pembalut/ absorben 250 g bungkus bungkus 7,500 7,500 8 60,000 0 0 3 22,500 5 37,500

file:///conversion/tmp/scratch/397469105.xlsx 14
 LAPORAN PENERIMAN DAN PEMAKAIAN REAGEN PUSKESMAS
KABUPATEN BREBES TAHUN 2014
PUSKESMAS : ……………………………………………………
BULAN :
SATUAN HARGA SISA PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA REAGEN KEMASAN
KEMASAN KEMASAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 7 8 9 10 11 12 13 14

BAHAN KIMIA/ REAGEN

1 Asam Sulfosalisilat 20 % Botol 100 ml Botol 545,500 0.00 0.00 0.00 0.00
2 Asam Urat Cair Kit 2 X 50 ml Kit 288,100 0.00 0.00 0.00 0.00
3 Asam Urat Stick Easy Touch Paket 25 strip Paket 158,000 0.00 0.00 0.00 0.00
4 Benedict Botol 500 ml Botol 60,000 0.00 0.00 0.00 0.00
5 Cholesterol Cair Kit 2 X 125 ml Kit 379,000 0.00 0.00 0.00 0.00
6 Cholesterol Stick Easy Touch Paket 10 strip Paket 284,999 0.00 0.00 0.00 0.00
7 Creatinin Kit 2 x 50 ml Kit 379,000 0.00 0.00 0.00 0.00
8 EDTA Botol 100 ml Botol 176,000 0.00 0.00 0.00 0.00
9 Geimsa Stain Botol 100 ml Botol 594,000 0.00 0.00 0.00 0.00
10 Glukosa Cair Kit 2 X 125 ml Kit 231,498 0.00 0.00 0.00 0.00
11 Glukosa Stick Arkray Box 50 strip Box 428,500 0.00 0.00 0.00 0.00
12 Glukosa Stick DR Box 25 strip Box 198,000 0.00 0.00 0.00 0.00
13 Glukosa Touch In Box 25 strip Box 220,000 0.00 0.00 0.00 0.00
14 Gol Darah A, B, AB, dan Rhesus/ D Kit 10 ml Kit 442,000 0.00 0.00 0.00 0.00
15 Hayem Botol 100 ml Botol 40,899 0.00 0.00 0.00 0.00
16 HCl 0,1 N Botol 100 ml Botol 20,500 0.00 0.00 0.00 0.00
17 HCG Urine Strep/ PP test Box 50 strip Box 196,999 0.00 0.00 0.00 0.00
18 Hemoglobin C/ Cyanmeth/ Drabkin Botol 500 ml Botol 47,200 0.00 0.00 0.00 0.00
19 Immersion OilL Botol 100 ml Botol 852,998 0.00 0.00 0.00 0.00
20 Kartu Gol Darah/ Glukocard Kotak 100 lembar Kotak 49,998 0.00 0.00 0.00 0.00
21 Malaria ICT Box 30 test Box 3,428,999 0.00 0.00 0.00 0.00
22 Metanol Botol 500 ml Botol 365,000 0.00 0.00 0.00 0.00

file:///conversion/tmp/scratch/397469105.xlsx 15
 SATUAN HARGA SISA PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA REAGEN KEMASAN
KEMASAN KEMASAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 7 8 9 10 11 12 13 14
23 NaCl 0, 85 % Botol 500 ml Botol 40,899 0.00 0.00 0.00 0.00
24 Natrium Citrat 3,8% Botol 500 ml Botol 97,500 0.00 0.00 0.00 0.00
25 Rees Ecker Botol 100 ml Botol 67,598 0.00 0.00 0.00 0.00
26 SGOT Kit 40 + 10 ml Kit 225,000 0.00 0.00 0.00 0.00
27 SGPT Kit 40 + 10 ml Kit 225,000 0.00 0.00 0.00 0.00
28 Tissue/ Kertas Lensa Box Box 46,000 0.00 0.00 0.00 0.00
29 Triglycerid Kit 2 x 50 ml Kit 847,000 0.00 0.00 0.00 0.00
30 Turk Botol 100 ml Botol 50,300 0.00 0.00 0.00 0.00
31 Ureum Kit 40 + 10 ml Kit 249,999 0.00 0.00 0.00 0.00
32 Urinalysis Stick Parameter 10 Tube 100 pieces Tube 385,000 0.00 0.00 0.00 0.00
33 Widal O Kit 5 ml Kit 142,900 0.00 0.00 0.00 0.00
34 WIidal H Kit 5 ml Kit 142,900 0.00 0.00 0.00 0.00
35 Wax/ Lilin Tabung Kapiler Tube 100 pieces Tube 66,000 0.00 0.00 0.00 0.00
36 Xylene Botol 2,500 ml Botol 1,243,000 0.00 0.00 0.00 0.00
37 Xylol Botol 100 ml Botol 125,000 0.00 0.00 0.00 0.00
38 Poch - Pack D Paket 5.000 ml Paket 539,770 0.00 0.00 0.00 0.00
39 Poch - Pack L Paket 1 X 500 ml Paket 1,702,800 0.00 0.00 0.00 0.00
40 Cell clean Paket 50 ml Paket 1,089,000 0.00 0.00 0.00 0.00
41 Eight - Check Paket 1,5 ml Paket 861,306 0.00 0.00 0.00 0.00
42 Dilluent Botol 20 liter Botol 1,650,000 0.00 0.00 0.00 0.00
43 Rinse Botol 20 liter Botol 1,571,999 0.00 0.00 0.00 0.00
44 Lyse Botol 500 ml Botol 3,645,699 0.00 0.00 0.00 0.00
45 Probe Cleanser Botol 17 ml Botol 62,899 0.00 0.00 0.00 0.00
46 E - Z Cleanser Botol 100 ml Botol 722,999 0.00 0.00 0.00 0.00
47 Ziehl Neelsen KIT 3 X 100 ml KIT 270,999 0.00 0.00 0.00 0.00
REAGEN TAMBAHAN 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00

file:///conversion/tmp/scratch/397469105.xlsx 16
 SATUAN HARGA SISA PENERIMAAN PEMAKAIAN SISA AKHIR
NO NAMA REAGEN KEMASAN
KEMASAN KEMASAN VOLUME HARGA VOLUME HARGA VOLUME HARGA VOLUME HARGA
1 2 3 4 5 7 8 9 10 11 12 13 14
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Mengetahui : Brebes.
Kepala Puskesmas Petugas Obat Puskesmas
………………………………. Puskesmas

………………………………… ……………………………………………

file:///conversion/tmp/scratch/397469105.xlsx 17
 HARGA OBAT NON GENERIK

HARGA
NO NAMA OBAT SATUAN
SATUAN
1 Asam askorbat (vit.C) tab.25o mg tablet 135
2 Asiklovir 400mg tablet tablet 631
3 Aspar K tablet tablet 2,079
4 Astherin tablet tablet 1,507
5 Adona Ac 17 Tablet tablet 2,153
6 Batugin sirup botol 13,530
7 Berlosid sirup botol 8,775
8 Bionic sirup botol 15,290
9 Bismecon gel tube 11,990
10 Boraginol N suppos suppos 5,809
11 Bravodem cream tube 8,250
12 Bufabron sirup botol 9,900
13 Bufacom IOB tube 12,100
14 Calsium gluconas injeksi ampul 1,201
15 Catapres injjeksi ampul 39,006
16 Chloramfecort cream tube 8,250
17 Citicolin injeksi ampul 16,500
18 Clonex injeksi ampul 7,500
19 Coredril sirup botol 5,280
20 Coredril kapsul kapsul 418
21 Dextral tablet tablet 297
22 Dextral sirup botol 5,830
23 Dulcolak supp anak suppos 8,672
24 Dulcolak supp dewasa suppos 11,079
25 Dulcolak tablet tablet 855
26 Enkasari sirup botol 9,625
27 erelamicetin tm botol 4,510
28 Etambutol 500 mg Tablet 478
29 Fenobarbital injeksi ampul 1,716
30 Fitogen kapsul kapsul 2,420
31 Fludane plus sirup botol 15,950
32 Garexin tesma botol 8,800
33 Gastulen tablet tablet 550
34 Gentamisin 40 mg/ 2 ml ampul 3,360
35 Hemafort tablet tablet 429
36 Hexon sirup botol 7,370
37 Imulan sirup botol 15,000
38 Inakain injeksi ampul 2,640
39 Interhistin tablet tablet 550
40 Justin tablet tablet 2,090
41 Kejibeling kapsul kapsul 440
 HARGA
NO NAMA OBAT SATUAN
SATUAN
42 Kloramidina injeksi vial 18,920
43 Klorpromazin tablet salut 25 mg tablet 36
44 Lapbal kapsul kapsul 1,210
45 Lexavit tablet tablet 488
46 Lodecon F tablet tablet 404
47 Lysmin botol 30,797
48 Magalat sirup botol 22,825
49 Maxon tablet tablet 869
50 Myomergin injeksi ampul 1,462
51 mytaderm krim tube 6,380
52 Nemicap kapsul kapsul 671
53 Neo Kaominal Sirup botol 5,445
54 Neurotropik tabelt tablet 528
55 Neurotropik Plus Tablet tablet 572
56 Neuroval tablet tablet 825
57 Neurovit E tablet tablet 880
58 Nexa injeksi ampul 5,250
59 Nodiar tablet tablet 963
60 OBH Indoplus botol 6,999
61 Oregan botol 15,400
62 Pardoz tablet tablet 3,000
63 Pehacain Injeksi ampul 2,063
64 Pronalges Suppos suppos 9,350
65 Recovit kapsul kapsul 517
66 Retinol 6.000 iu tablet 297
67 Rhinifed tablet tablet 1,540
68 RifaNH tablet 1,925
69 Rifastar kaplet tablet 3,630
70 Scabicid salep tube 19,426
71 sesden injeksi ampul 12,813
72 Silax injeksi ampul 1,980
73 Solvitron kapsul Kapsul 494
74 Spasmacine tablet tablet 660
75 Spashi plus kaplet 1,430
76 Spashi injeksi ampul 1,830
77 Stopdiar tablet tablet 400
78 Tensigard kapsul kapsul 1,500
79 Trombophob krim tube 44,000
80 Vical sirup botol 6,380
81 Vometa drop botol 37,950
82 Zinkid sirup botol 22,550
83 Zolacort krim tube 22,000