NEW Data Obat RSJ TAHUN 2019

KARTU PERSEDIAAN OBAT
RUMAH SAKIT JIWA PROV. SULAWESI TENGGARA

BULAN : JANUARI 2017
STOK AWAL PENERIMAAN TOTAL PERSEDIAAN PEMAKAIAN PER TANG

HARGA SATUAN
NO URAIAN KEMASAN JUMLAH JUMLAH JUMLAH
( Rp) JUMLAH JUMLAH JUMLAH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
HARGA (Rp) HARGA (Rp) HARGA (Rp)
1 Allopurinol 100 mg (inf) 100 tablet/kotak 11,682 97 1,133,154 0 0 97 1,133,154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Alprazolam 0,5 mg 100 tablet/kotak 53,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Alprazolam 1 mg 100 tablet/kotak 22,273 152 3,385,496 0 0 152 3,385,496 0 0 0 4 0 0 0 0 0 5 0 0 0 5 0 0
4 Aminofilin inj 30 ampul/kotak 107,998 1 107,998 0 0 1 107,998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Amitriptilin 25 mg 100 tablet/kotak 11,182 372 4,159,637 0 0 372 4,159,637 0 0 0 6 0 0 0 0 0 6 0 0 0 4 0 0
6 Amlodipin 10 mg 30 tablet/kotak 9,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Amlodipin 10 mg (bern) 100 tablet/kotak 129,309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Amlodipin 5 mg 30 tablet/kotak 21,576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Amoksisilin 500 mg 100 tablet/kotak 33,636 47 1,580,892 0 0 47 1,580,892 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0
10 Antasida Syrup botol 60 ml 3,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Asam Mefenamat 100 tablet/kotak 24,624 85 2,093,040 0 0 85 2,093,040 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
12 Asetosal 100 mg 100 tablet/kotak 11,590 10 115,900 0 0 10 115,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Betahistin 6 mg 100 tablet/kotak 73,846 15 1,107,690 0 0 15 1,107,690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Bamgetol 200 mg 100 tablet/kotak 135,000 33 4,455,000 0 0 33 4,455,000 0 0 0 4 0 0 0 0 0 5 0 0 0 4 0 0
15 Cairan RL 500 ml 500 ml/botol 5,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Cairan NaCl 0,9 % 500 ml/botol 4,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 candesartan 16 mg 30 tablet/kotak 147,000 58 8,526,000 0 0 58 8,526,000 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0
18 Captopril 50 mg 1000 tablet/kotak 20,376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Carbamazepine 200 mg 100 tablet/kotak 24,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Cefadroxyl 500 mg 100 kapsul/kotak 57,273 53 3,035,469 0 0 53 3,035,469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Cetirizin 10 mg 50 tablet/kotak 8,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Chloramfenicol 250 mg 120 kapsul/kotak 29,062 6 174,372 0 0 6 174,372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 1 of 156
HARGA SATUAN
23 Chlorpromazine 100 mg 1000 tablet/botol 138,044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Chlorpromazine 100 mg 100 tablet/kotak 13,058 1,264 16,505,312 0 0 1,264 16,505,312 0 0 0 28 0 0 0 0 0 36 0 0 0 40 0 0
25 Chlorpromazine 25 mg 100 tablet/kotak 16,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Chlorpromazine 25 mg/ml 30 ampul/kotak 33,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Ciprofloxacin 500 mg 100 tablet/kotak 25,792 6 154,752 0 0 6 154,752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Citicholin 500 mg 30 tablet/kotak 153,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
29 Clobazam 10 mg 100 tablet/kotak 86,365 48 4,145,496 0 0 48 4,145,496 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
30 Clozapin 100 mg 100 tablet/kotak 227,273 18 4,090,914 0 0 18 4,090,914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Clopidogrel 75 mg 30 tablet/kotak 97,855 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Cotrimoxazole 480 mg 100 tablet/kotak 17,325 28 485,100 0 0 28 485,100 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0
33 Dexamethason 0,5 mg 1000 tablet/botol 50,949 1 50,949 0 0 1 50,949 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Diazepam 2 mg 1000 tablet/botol 28,808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Diazepam 2 mg 100 tablet/kbotol 4,273 1,617 6,909,441 0 0 1,617 6,909,441 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0
Page 2 of 156
HARGA SATUAN
36 Ergotamin-coffein 100 tablet/botol 12,149 24 291,576 0 0 24 291,576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Fenobarbital 30 mg 1000 tablet/botol 33,784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Fenobarbital 30 mg 100 tablet/botol 6,372 137 872,964 0 0 137 872,964 0 0 3 0 0 0 0 0 0 3 0 0 0 0 0 0
39 Glibenclamid 5mg 100 tablet/kotak 6,539 15 98,085 0 0 15 98,085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Gliceril Guaicolate 100 mg 1000tablet/botol 24,364 3 73,092 0 0 3 73,092 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
41 Haloperidol 0,5 mg 100 tablet/kotak 5,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Haloperidol 1,5 mg 100 tablet/kotak 6,909 1,683 11,627,998 0 0 1,683 11,627,998 0 0 0 10 0 0 0 0 0 20 0 0 0 20 0 0
43 Haloperidol 5 mg 100 tablet/kotak 9,546 879 8,390,934 0 0 879 8,390,934 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0
44 Hexymer 2 mg 1000 tablet/kaleng 243,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Hexymer 2 mg 250 tablet/kaleng 78,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Hydrocortison 2,5 % 24 tube/kotak 64,935 1 64,935 0 0 1 64,935 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Ibuprofen 200 mg 100 tablet/botol 10,496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Ibuprofen 400 mg 100 tablet/kotak 18,621 4 74,484 0 0 4 74,484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Kapsul 0 1000 kapsul/sak 84,000 5 420,000 13 1,092,000 18 1,512,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Kapsul 00 1000 kapsul/sak 55,000 0 0 10 550,000 10 550,000 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0
51 Kapsul 01 1000 kapsul/sak 84,000 1 84,000 10 840,000 11 924,000 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0
52 Lodomer Inj. 12 ampul/kotak 75,000 22 1,650,000 0 0 22 1,650,000 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
53 Nopres 20 mg 30 tablet/kotak 12,955 155 2,008,025 0 0 155 2,008,025 0 0 0 3 0 0 0 0 0 2 0 0 0 0 0 0
54 Meloxicam 15 mg 50 tablet/kotak 20,002 47 940,094 0 0 47 940,094 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0
55 Meloxicam 7,5 mg 50 tablet/kotak 31,418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Metformin 500 mg (hexpharm) 100 tablet/kotak 14,850 4 59,400 0 0 4 59,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Methylprednisolon 16 mg 30 tablet/kotak 31,877 8 255,016 0 0 8 255,016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Metronidasol 500 mg 100 tablet/kotak 20,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 Miconazole cream 24 tube/kotak 2,727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Natrium Diklofenak 50 mg (bern) 100 tablet/kotak 23,747 27 641,169 0 0 27 641,169 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0
61 Oksitetrasiklin salep kulit 3 % 25 tube/kotak 1,827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Omeprazole 20 mg 30 kapsul/kotak 8,863 136 1,205,368 0 0 136 1,205,368 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0
Page 3 of 156
HARGA SATUAN
63 Parasetamol 500 mg (kimia farma) 100 kaplet/kotak 15,000 114 1,710,000 0 0 114 1,710,000 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0
64 Piracetam 1200 mg (inf) 30 tablet/kotak 18,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Piracetam 800 mg 100 tablet/kotak 84,672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Prednison 5 mg 100 tablet/pot 13,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Ranitidin 150 mg (bern) 100 tablet/kotak 16,634 141 2,345,394 0 0 141 2,345,394 0 0 0 2 0 0 0 0 0 2 0 0 0 3 0 0
68 Ranitidin Inj. 25 ampul/kotak 18,691 4 74,764 0 0 4 74,764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Risperidon 3 mg 50 tablet/kotak 104,549 45 4,704,693 0 0 45 4,704,693 0 0 0 14 0 0 0 0 0 0 0 0 0 14 0 0
70 Risperidon 2 mg 50 tablet/kotak 48,581 220 10,687,738 0 0 220 10,687,738 0 0 0 14 0 0 0 0 0 14 0 0 0 28 0 0
71 Salbutamol 2mg 100 tablet/kotak 7,631 4 30,524 0 0 4 30,524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Salbutamol 4mg 100tablet/kotak 8,854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Salicyl powder pot 3,727 5 18,635 0 0 5 18,635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Simvastatin 20 mg 30 tablet/kotak 34,977 25 874,425 0 0 25 874,425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 Spironolakton 25 mg 100 tablet/kotak 31,818 4 127,270 0 0 4 127,270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Stelosi 5 mg 100 tablet/kotak 40,000 28 1,120,000 0 0 28 1,120,000 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
78 Sulfas Feros 300 mg 1000 tablet/botol 65,909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Thiamfenikol 500 mg 100 kaplet/kotak 53,147 4 212,587 0 0 4 212,587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 4 of 156
HARGA SATUAN
80 Tramadol 50 mg (kimia farma) 50 kapsul/kotak 14,636 7 102,452 0 0 7 102,452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 380 1,423,480 0 0 380 1,423,480 0 0 0 40 0 0 0 0 0 20 0 0 0 20 0 0
82 Vitamin B - kompleks 100 tablet/botol 9,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Vitamin B1 ( Thiamin HCl) 1000 tablet/botol 34,364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Vitamin B12 1000 tablet/botol 1,375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Vitamin B6 (pyridoksin HCl) 1000 tablet/botol 15,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Atropin Sulfat Injeksi 30 ampul/kotak 6 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
87 Alkohol botol 1 liter 33 0 0 0 33 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0
88 Antasida DOEN tablet 100 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Aricept tab 28 tablet/kotak 8 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Atovarstatin 10 mg 30 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Atovarstatin 20 mg 30 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
92 Cefotaxim 1 gram vial 10 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Depakote 100 tablet/botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Diazepam 5 mg 100 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Lidokain injeksi 100 ampul/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Metil prednisolon 8 mg 100 tablet/kotak 45 0 0 0 45 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0
97 Valesco 80 mg 30 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GRAND TOTAL 114,571,314 2,482,000 117,053,314
11,457,131 PPN 10% 11,705,331
126,028,445 Jumlah 128,758,645
Mengetahui,
Direktur RS.Jiwa Kendari Kepala Sub Bidang La
Page 5 of 156
HARGA SATUAN
dr.H. Abd. Razak, S.Ked.,M.Kes Ayu Putu

NIP.19660312 200003 1 002 Nip. 198
Page 6 of 156
N PER TANGGAL
Jlh
SISA
Pemak
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 6 0 0 0 0 5 0 0 0 0 0 0 6 31 121
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 4 0 0 0 0 3 0 0 0 0 0 0 6 29 343
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 4 43
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 4 81
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 14
0 0 0 0 0 0 0 5 0 0 0 0 0 0 4 22 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 6 52
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 51
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 7 of 156
N PER TANGGAL
Jlh
SISA
Pemak
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 13 0 0 0 0 22 0 0 0 0 0 0 26 165 1,099
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 44
0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2 16
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 26
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 1,569
Page 8 of 156
N PER TANGGAL
Jlh
SISA
Pemak
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 8 129
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 40 0 0 0 0 0 0 0 90 1,593
0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 30 849
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 3 7
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 3 8
0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 6 16
0 0 0 0 0 0 0 6 0 0 0 0 0 0 3 14 141
0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 9 38
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 3 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 8 128
Page 9 of 156
N PER TANGGAL
Jlh
SISA
Pemak
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 111
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 9 132
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 42 3
0 0 0 0 0 0 0 28 0 0 0 0 0 0 0 84 136
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 4 21
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 27
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 10 of 156
N PER TANGGAL
Jlh
SISA
Pemak
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 10 0 0 0 0 40 0 0 0 0 0 0 20 150 230
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 31
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 43
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kendari, 02 Februari 2017

dang Laboratorium, Farmasi dan Gizi
Page 11 of 156
N PER TANGGAL
Jlh
SISA
Pemak
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
Ayu Putu Nurhaeni, S.si.,Apt

Nip. 19811128 200604 2 017
Page 12 of 156
BULAN : FEBRUARI 2017
STOK AWAL PENERIMAAN TOTAL PERSEDIAAN PEMAKAIAN

HARGA SATUAN
( Rp) JUMLAH JUMLAH JUMLAH 1 2 3 4 5 6 7 8 9 10 11 12 13 14
1 Allopurinol 100 mg (inf) 100 tablet/kotak 11,682 97 1,133,154 0 0 97 1,133,154 0 0 0 0 0 0 0 3 0 0 0 0 0 0
2 Alprazolam 0,5 mg 100 tablet/kotak 53,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Alprazolam 1 mg 100 tablet/kotak 22,273 121 2,695,033 0 0 121 2,695,033 6 0 0 0 0 0 0 10 0 0 0 0 0 6
4 Aminofilin inj 30 ampul/kotak 107,998 1 107,998 0 0 1 107,998 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Amitriptilin 25 mg 100 tablet/kotak 11,182 343 3,835,364 0 0 343 3,835,364 2 0 0 0 0 0 0 10 0 0 0 0 0 0
6 Amlodipin 10 mg 30 tablet/kotak 9,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 Amlodipin 10 mg (bern) 100 tablet/kotak 129,309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Amoksisilin 500 mg 100 tablet/kotak 33,636 43 1,446,348 0 0 43 1,446,348 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Antasida Syrup botol 60 ml 3,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Asam Mefenamat 100 tablet/kotak 24,624 81 1,994,544 0 0 81 1,994,544 0 0 0 0 0 0 0 2 0 0 0 0 0 0
12 Asetosal 100 mg 100 tablet/kotak 11,590 10 115,900 0 0 10 115,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Betahistin 6 mg 100 tablet/kotak 73,846 14 1,033,844 0 0 14 1,033,844 0 0 0 0 0 0 0 2 0 0 0 0 0 0
14 Bamgetol 200 mg 100 tablet/kotak 135,000 11 1,485,000 0 0 11 1,485,000 0 0 0 0 0 0 0 5 0 0 0 0 0 6
15 Cairan RL 500 ml 500 ml/botol 5,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Cairan NaCl 0,9 % 500 ml/botol 4,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 candesartan 16 mg 30 tablet/kotak 147,000 52 7,644,000 0 0 52 7,644,000 0 0 0 0 0 0 0 4 0 0 0 0 0 0
18 Captopril 50 mg 1000 tablet/kotak 20,376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Carbamazepine 200 mg 100 tablet/kotak 24,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Cefadroxyl 500 mg 100 kapsul/kotak 57,273 51 2,920,923 0 0 51 2,920,923 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Cetirizin 10 mg 50 tablet/kotak 8,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Chloramfenicol 250 mg 120 kapsul/kotak 29,062 6 174,372 0 0 6 174,372 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 13 of 156
HARGA SATUAN
23 Chlorpromazine 100 mg 1000 tablet/botol 138,044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Chlorpromazine 100 mg 100 tablet/kotak 13,058 1,099 14,350,742 0 0 1,099 14,350,742 15 0 0 0 0 0 0 31 0 0 0 0 0 38
25 Chlorpromazine 25 mg 100 tablet/kotak 16,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 Chlorpromazine 25 mg/ml 30 ampul/kotak 33,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Ciprofloxacin 500 mg 100 tablet/kotak 25,792 6 154,752 0 0 6 154,752 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Citicholin 500 mg 30 tablet/kotak 153,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
29 Clobazam 10 mg 100 tablet/kotak 86,365 44 3,800,038 0 0 44 3,800,038 0 0 0 0 0 0 0 4 0 0 0 0 0 0
30 Clozapin 100 mg 100 tablet/kotak 227,273 16 3,636,368 0 0 16 3,636,368 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Clopidogrel 75 mg 30 tablet/kotak 97,855 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Cotrimoxazole 480 mg 100 tablet/kotak 17,325 26 450,450 0 0 26 450,450 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Dexamethason 0,5 mg 1000 tablet/botol 50,949 1 50,949 0 0 1 50,949 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Diazepam 2 mg 1000 tablet/botol 28,808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Diazepam 2 mg 100 tablet/kbotol 4,273 1,569 6,704,337 0 0 1,569 6,704,337 48 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 14 of 156
HARGA SATUAN
36 Ergotamin-coffein 100 tablet/botol 12,149 24 291,576 0 0 24 291,576 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Fenobarbital 30 mg 1000 tablet/botol 33,784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Fenobarbital 30 mg 100 tablet/botol 6,372 129 821,988 0 0 129 821,988 2 0 0 0 0 0 0 2 0 0 0 0 0 0
39 Glibenclamid 5mg 100 tablet/kotak 6,539 15 98,085 0 0 15 98,085 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Gliceril Guaicolate 100 mg 1000tablet/botol 24,364 3 73,092 0 0 3 73,092 0 0 0 0 0 0 0 0 0 0 0 0 0 0
41 Haloperidol 0,5 mg 100 tablet/kotak 5,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Haloperidol 1,5 mg 100 tablet/kotak 6,909 1,593 11,006,180 0 0 1,593 11,006,180 20 0 0 0 0 0 0 30 0 0 0 0 0 20
43 Haloperidol 5 mg 100 tablet/kotak 9,546 849 8,104,554 0 0 849 8,104,554 0 0 0 0 0 0 0 20 0 0 0 0 0 0
44 Hexymer 2 mg 1000 tablet/kaleng 243,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Hydrocortison 2,5 % 24 tube/kotak 64,935 1 64,935 0 0 1 64,935 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Ibuprofen 200 mg 100 tablet/botol 10,496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Ibuprofen 400 mg 100 tablet/kotak 18,621 4 74,484 0 0 4 74,484 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Kapsul 0 1000 kapsul/sak 84,000 18 1,512,000 0 0 18 1,512,000 1 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Kapsul 00 1000 kapsul/sak 55,000 7 385,000 0 0 7 385,000 1 0 0 0 0 0 0 0 1 0 0 0 0 1
52 Lodomer Inj. 12 ampul/kotak 75,000 16 1,200,000 0 0 16 1,200,000 0 0 0 0 0 0 0 0 0 0 0 0 0 4
53 Nopres 20 mg 30 tablet/kotak 12,955 141 1,826,655 0 0 141 1,826,655 2 0 0 0 0 0 0 2 0 0 0 0 0 0
54 Meloxicam 15 mg 50 tablet/kotak 20,002 38 760,076 0 0 38 760,076 2 0 0 0 0 0 0 4 0 0 0 0 0 0
55 Meloxicam 7,5 mg 50 tablet/kotak 31,418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Metformin 500 mg (hexpharm) 100 tablet/kotak 14,850 4 59,400 0 0 4 59,400 0 0 0 0 0 0 0 3 0 0 0 0 0 0
57 Methylprednisolon 16 mg 30 tablet/kotak 31,877 8 255,016 0 0 8 255,016 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Metronidasol 500 mg 100 tablet/kotak 20,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 Miconazole cream 24 tube/kotak 2,727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Natrium Diklofenak 50 mg (bern) 100 tablet/kotak 23,747 24 569,928 0 0 24 569,928 2 0 0 0 0 0 0 0 0 0 0 0 0 2
61 Oksitetrasiklin salep kulit 3 % 25 tube/kotak 1,827 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Omeprazole 20 mg 30 kapsul/kotak 8,863 128 1,134,464 0 0 128 1,134,464 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 15 of 156
HARGA SATUAN
63 Parasetamol 500 mg (kimia farma) 100 kaplet/kotak 15,000 111 1,665,000 0 0 111 1,665,000 1 0 0 0 0 0 0 1 0 0 0 0 0 0
64 Piracetam 1200 mg (inf) 30 tablet/kotak 18,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Piracetam 800 mg 100 tablet/kotak 84,672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Prednison 5 mg 100 tablet/pot 13,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Ranitidin 150 mg (bern) 100 tablet/kotak 16,634 132 2,195,688 0 0 132 2,195,688 0 0 0 0 0 0 0 3 0 0 0 0 0 0
68 Ranitidin Inj. 25 ampul/kotak 18,691 4 74,764 0 0 4 74,764 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Risperidon 3 mg 50 tablet/kotak 104,549 3 313,646 0 0 3 313,646 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Risperidon 2 mg 50 tablet/kotak 48,581 136 6,606,965 0 0 136 6,606,965 28 0 0 0 0 0 0 28 0 0 0 0 0 28
71 Salbutamol 2mg 100 tablet/kotak 7,631 4 30,524 0 0 4 30,524 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Salbutamol 4mg 100tablet/kotak 8,854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Salicyl powder pot 3,727 5 18,635 0 0 5 18,635 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Simvastatin 20 mg 30 tablet/kotak 34,977 21 734,517 0 0 21 734,517 0 0 0 0 0 0 0 4 0 0 0 0 0 0
76 Spironolakton 25 mg 100 tablet/kotak 31,818 4 127,270 0 0 4 127,270 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Stelosi 5 mg 100 tablet/kotak 40,000 27 1,080,000 0 0 27 1,080,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Sulfas Feros 300 mg 1000 tablet/botol 65,909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Thiamfenikol 500 mg 100 kaplet/kotak 53,147 4 212,587 0 0 4 212,587 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 16 of 156
HARGA SATUAN
80 Tramadol 50 mg (kimia farma) 50 kapsul/kotak 14,636 7 102,452 0 0 7 102,452 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 230 861,580 0 0 230 861,580 20 0 0 0 0 0 0 30 0 0 0 0 0 30
82 Vitamin B - kompleks 100 tablet/botol 9,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Vitamin B1 ( Thiamin HCl) 1000 tablet/botol 34,364 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Vitamin B12 1000 tablet/botol 1,375 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Vitamin B6 (pyridoksin HCl) 1000 tablet/botol 15,818 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Atropin Sulfat Injeksi 30 ampul/kotak 6 0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
87 Alkohol botol 1 liter 31 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Antasida DOEN tablet 100 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Aricept tab 28 tablet/kotak 8 0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
90 Atovarstatin 10 mg 30 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
92 Cefotaxim 1 gram vial 10 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
93 Depakote 100 tablet/botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Diazepam 5 mg 100 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Lidokain injeksi 100 ampul/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Metil prednisolon 8 mg 100 tablet/kotak 43 0 0 0 43 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
97 Valesco 80 mg 30 tablet/kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GRAND TOTAL 96,832,778 0 96,832,778
9,683,278 PPN 10% 9,683,278
106,516,055 Jumlah 106,516,055
Mengetahui,
Direktur RS.Jiwa Kendari Kepala Sub B
Page 17 of 156
HARGA SATUAN
dr.H. Abd. Razak, S.Ked.,M.Kes

NIP.19660312 200003 1 002
Page 18 of 156
PEMAKAIAN PER TANGGAL
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 6 0 0 0 0 0 0 6 0 0 0 34 87
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 9 0 0 0 0 0 0 7 0 0 0 28 315
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 2 41
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 79
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 12
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 19 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 38 0 0 0 0 0 0 26 0 0 0 148 951
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 40
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 96 1,473
Page 20 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 125
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 30 0 0 0 0 0 0 30 0 0 0 130 1,463
0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 50 799
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 17
0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 5 2
0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 4 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 12
0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 9 132
0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 12 26
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128
Page 21 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 109
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 7 125
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 3 0
0 0 0 0 0 0 28 0 0 0 0 0 0 24 0 0 0 136 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 17
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 22 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 30 0 0 0 0 0 0 30 0 0 0 140 90
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kendari, 02 Maret 2017

pala Sub Bidang Laboratorium, Farmasi dan Gizi
Page 23 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 24 of 156
BULAN : MARET 2017

HARGA SATUAN
13 Betahistin 6 mg 100 tablet/kotak 73,846 12 886,152 0 0 12 886,152 0 0 0 0 0 0 3 0 0 0 0 0 0 0
14 Bamgetol 200 mg 100 tablet/kotak 135,000 0 0 10 1,350,000 10 1,350,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 25 of 156
HARGA SATUAN
24 Chlorpromazine 100 mg 100 tablet/kotak 13,058 951 12,418,158 0 0 951 12,418,158 0 0 0 0 0 10 24 0 0 26 0 0 0 0
28 Citicholin 500 mg 30 tablet/kotak 153,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 26 of 156
HARGA SATUAN
52 Lodomer Inj. 12 ampul/kotak 75,000 12 900,000 0 0 12 900,000 0 0 0 0 0 3 0 0 0 0 0 0 0 0
Page 27 of 156
HARGA SATUAN
69 Risperidon 3 mg 50 tablet/kotak 104,549 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Risperidon 2 mg 50 tablet/kotak 48,581 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 28 of 156
HARGA SATUAN
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 90 337,140 0 0 90 337,140 0 0 0 0 0 10 30 0 0 20 0 0 0 0
GRAND TOTAL 79,851,100 1,350,000 81,201,100
7,985,110 PPN 10% 8,120,110
87,836,210 Jumlah 89,321,210
Mengetahui,
Page 29 of 156
HARGA SATUAN

NIP.19660312 200003 1 002
Page 30 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 9 0 0 0 0 0 5 0 0 0 0 10 0 0 0 0 43 44
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 6 0 0 0 0 0 6 0 0 0 0 5 0 0 0 2 29 286
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 3 38
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 4 75
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 9
0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 10 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 43
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 31 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 26 0 0 0 0 0 32 0 0 0 0 23 0 0 0 13 154 797
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 38
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 4 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,473
Page 32 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 4 121
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 20 0 0 0 0 0 20 0 0 0 0 20 0 0 0 0 90 1,373
0 10 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 30 769
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 16
0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 1
0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 10 2
0 0 0 0 0 0 0 4 0 0 0 0 4 0 0 0 0 8 124
0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 19
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 19
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 126
Page 33 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 3 106
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 121
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 13
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
3 0 0 0 0 0 2 4 0 0 0 0 4 0 0 0 0 19 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 34 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 10 0 0 0 0 0 12 0 0 0 0 8 0 0 0 0 90 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 2 28
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2 41
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kendari, 02 April 2017

Page 35 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 36 of 156
BULAN : APRIL 2017

HARGA SATUAN
3 Alprazolam 1 mg 100 tablet/kotak 22,273 44 980,012 0 0 44 980,012 0 0 0 0 0 0 3 0 0 0 0 4 0 0
6 Amlodipin 10 mg 30 tablet/kotak 9,600 0 0 200 1,920,000 200 1,920,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Bamgetol 200 mg 100 tablet/kotak 135,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 37 of 156
HARGA SATUAN
28 Citicholin 500 mg 30 tablet/kotak 153,000 0 0 10 1,530,000 10 1,530,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 38 of 156
HARGA SATUAN
50 Kapsul 00 1000 kapsul/sak 55,000 0 0 10 550,000 10 550,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Kapsul 01 1000 kapsul/sak 84,000 1 84,000 10 840,000 11 924,000 0 0 0 0 0 0 0 0 0 0 0 0 1 0
62 Omeprazole 20 mg 30 kapsul/kotak 8,863 126 1,116,738 50 443,150 176 1,559,888 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 39 of 156
HARGA SATUAN
69 Risperidon 3 mg 50 tablet/kotak 104,549 0 0 100 10,454,873 100 10,454,873 0 0 0 0 0 0 0 0 0 0 0 14 0 0
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Stelosi 5 mg 100 tablet/kotak 40,000 8 320,000 0 0 8 320,000 0 0 4 0 2 0 0 0 0 0 2 0 0 0
Page 40 of 156
HARGA SATUAN
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GRAND TOTAL 70,556,996 23,025,117 93,582,113
7,055,700 PPN 10% 9,358,211
77,612,696 Jumlah 102,940,324
Mengetahui,
Page 41 of 156
HARGA SATUAN

NIP.19660312 200003 1 002
Page 42 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 6 0 0 0 0 0 6 0 0 0 5 0 4 0 0 28 16
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 6 0 0 0 0 0 5 0 0 0 5 0 4 0 0 27 259
0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 4 196
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 2 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 73
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 43
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 49
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 43 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 23 0 0 0 0 0 35 0 0 0 22 0 10 0 0 142 655
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 5 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 38
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 9
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 1,425
Page 44 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 0 0 0 0 4 0 0 0 0 0 0 0 0 6 115
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 30 0 0 0 0 0 30 0 0 0 0 0 10 0 0 100 1,273
0 0 20 0 0 0 0 0 0 0 0 0 20 0 0 0 0 40 729
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 9
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2 9
0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 6 0 0 0 0 0 0 0 0 0 0 4 0 0 0 10 114
0 0 0 0 0 0 0 0 3 0 0 0 0 0 3 0 0 6 13
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 4 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176
Page 45 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 5 101
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 4 0 0 0 0 0 2 0 0 0 0 0 0 0 0 6 115
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 72
0 0 14 0 0 0 0 0 28 0 0 0 28 0 0 0 0 108 42
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 10
0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 46 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 58
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Kendari, 02 Mei 2017

Page 47 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 48 of 156
BULAN : MEI 2017

HARGA SATUAN
3 Alprazolam 1 mg 100 tablet/kotak 22,273 16 356,368 100 2,227,300 116 2,583,668 0 0 6 0 2 0 0 6 0 0 0 0 0 0
6 Amlodipin 10 mg 30 tablet/kotak 9,600 196 1,881,600 0 0 196 1,881,600 0 0 0 0 6 0 0 0 0 0 0 0 2 0
14 Bamgetol 200 mg 100 tablet/kotak 135,000 0 0 100 13,500,000 100 13,500,000 0 0 0 0 4 0 0 0 0 0 0 0 2 0
Page 49 of 156
HARGA SATUAN
28 Citicholin 500 mg 30 tablet/kotak 153,000 5 765,000 0 0 5 765,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 50 of 156
HARGA SATUAN
52 Lodomer Inj. 12 ampul/kotak 75,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Metformin 500 mg (hexpharm) 100 tablet/kotak 14,850 1 14,850 50 742,500 51 757,350 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Oksitetrasiklin salep kulit 3 % 25 tube/kotak 1,827 0 0 75 137,025 75 137,025 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 51 of 156
HARGA SATUAN
69 Risperidon 3 mg 50 tablet/kotak 104,549 72 7,527,509 48 5,018,339 120 12,545,848 0 0 14 0 0 0 0 0 0 0 0 0 0 0
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Stelosi 5 mg 100 tablet/kotak 40,000 0 0 50 2,000,000 50 2,000,000 0 0 0 0 0 0 0 0 0 3 0 0 1 0
Page 52 of 156
HARGA SATUAN
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Vitamin B1 ( Thiamin HCl) 1000 tablet/botol 34,364 0 0 30 1,030,920 30 1,030,920 0 0 0 1 2 0 0 0 0 0 0 0 3 0
GRAND TOTAL 78,207,710 24,656,084 102,863,794
7,820,771 PPN 10% 10,286,379
86,028,481 Jumlah 113,150,174
Mengetahui,
Direktur RS.Jiwa Kendari Kepala Sub Bidan
Page 53 of 156
HARGA SATUAN
dr.H. Abd. Razak, S.Ked.,M.Kes Ayu

NIP.19660312 200003 1 002 Nip
Page 54 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 8 29 87
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 4 0 0 0 4 0 0 5 0 0 0 0 0 5 32 227
0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 5 17 179
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 2 34
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 0 0 0 0 0 0 2 0 0 0 0 0 0 4 69
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 2 0 0 0 0 0 0 3 0 0 0 0 0 3 14 86
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 4 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 55 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 21 0 0 0 27 0 0 25 0 0 0 0 0 25 142 513
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 3
0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 7 31
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 48 0 0 0 0 0 0 0 0 0 0 0 0 0 96 1,329
Page 56 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 4 6 109
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 20 0 0 0 20 0 0 30 0 0 0 0 0 30 130 1,143
0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 20 709
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 3 5 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 5 4
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 3 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 0 0 0 4 0 0 0 0 0 0 0 0 6 12 102
0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 6 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 2 49
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 13
0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 2 73
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176
Page 57 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 0 0 0 0 0 0 2 0 0 0 0 0 0 8 107
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 14 0 0 0 0 0 0 9 0 0 0 0 0 14 51 69
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 3 9 41
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 58 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
1 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 7 51
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 26
Kendari, 02 Juni 2017

Sub Bidang Laboratorium, Farmasi dan Gizi
Page 59 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 60 of 156
BULAN : JUNI 2017

HARGA SATUAN
3 Alprazolam 1 mg 100 tablet/kotak 22,273 87 1,937,751 313 6,971,449 400 8,909,200 0 0 0 0 0 0 6 0 7 0 0 0 0 0
Page 61 of 156
HARGA SATUAN
Page 62 of 156
HARGA SATUAN
61 Oksitetrasiklin salep kulit 3 % 25 tube/kotak 1,827 73 133,371 0 0 73 133,371 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 63 of 156
HARGA SATUAN
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 64 of 156
HARGA SATUAN
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 0 0 2,620 9,814,520 2,620 9,814,520 0 0 0 0 0 0 0 10 10 0 0 14 0 0
83 Vitamin B1 ( Thiamin HCl) 1000 tablet/botol 34,364 24 824,736 0 0 24 824,736 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Diazepam 5 mg 100 tablet/kotak 0 0 1,000 0 1,000 0 0 0 0 0 0 0 0 0 0 0 0 5 0 5
GRAND TOTAL 84,921,268 42,313,363 127,234,631
8,492,127 PPN 10% 12,723,463
93,413,395 Jumlah 139,958,094
Mengetahui,
Page 65 of 156
HARGA SATUAN

NIP.19660312 200003 1 002 Nip
Page 66 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 6 0 0 10 6 0 0 0 0 0 0 0 0 0 39 361
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 2 0 0 8 0 0 0 0 0 0 0 0 0 0 28 199
5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 174
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 32
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 67
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 2 0 0 3 3 0 0 0 0 0 0 0 0 0 12 74
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 67 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 0 0 15 0 0 18 40 0 0 0 0 0 0 0 0 0 142 371
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 5 26
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 3 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 1,281
Page 68 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 109
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 30 30 0 0 0 0 0 0 0 0 0 100 1,043
0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 20 689
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 4 98
6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 5 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 176
Page 69 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 3 0 0 0 0 0 0 0 0 0 7 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 183
0 0 0 5 0 5 10 20 0 0 0 0 0 0 0 0 0 75 175
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 3 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 70 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
8 10 0 0 18 20 10 30 0 0 0 0 0 0 0 0 0 130 2,490
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 4 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 1 0 0 1 0 0 3 0 0 0 0 0 0 0 0 0 6 45
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 6 0 0 8 10 0 0 0 0 0 0 0 0 0 34 966
1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 2 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40
0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 4 22
Kendari, 02 Juli 2017

Page 71 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 72 of 156
BULAN : JULI 2017

HARGA SATUAN
13 Betahistin 6 mg 100 tablet/kotak 73,846 7 516,922 165 12,184,590 172 12,701,512 0 0 0 0 0 0 0 0 0 1 0 0 0 0
Page 73 of 156
HARGA SATUAN
24 Chlorpromazine 100 mg 100 tablet/kotak 13,058 371 4,844,518 384 5,014,272 755 9,858,790 0 0 0 0 11 24 0 0 0 14 0 0 17 0
30 Clozapin 100 mg 100 tablet/kotak 227,273 4 909,092 0 0 4 909,092 0 0 0 0 0 0 0 0 0 2 0 0 0 0
Page 74 of 156
HARGA SATUAN
50 Kapsul 00 1000 kapsul/sak 55,000 2 110,000 17 935,000 19 1,045,000 0 0 0 0 0 1 0 0 0 0 0 0 1 0
51 Kapsul 01 1000 kapsul/sak 84,000 5 420,000 12 1,008,000 17 1,428,000 0 0 1 0 2 0 0 0 0 0 0 0 0 0
52 Lodomer Inj. 12 ampul/kotak 75,000 0 0 45 3,375,000 45 3,375,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Meloxicam 15 mg 50 tablet/kotak 20,002 1 20,002 100 2,000,200 101 2,020,202 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 75 of 156
HARGA SATUAN
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 76 of 156
HARGA SATUAN
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 2,490 9,327,540 0 0 2,490 9,327,540 0 0 10 10 10 60 0 0 0 10 0 0 30 0
GRAND TOTAL 113,760,961 29,375,125 143,136,086
11,376,096 PPN 10% 14,313,609
125,137,058 Jumlah 157,449,694
Mengetahui,
Page 77 of 156
HARGA SATUAN

NIP.19660312 200003 1 002 Nip
Page 78 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 30 331
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 21 178
0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 13 161
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 30
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 65
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 3 169
0 0 0 0 0 0 0 0 0 3 0 0 2 0 0 0 0 12 62
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 79 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 27 0 0 0 0 0 20 0 0 16 0 0 0 0 129 626
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 48 1,233
Page 80 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 7 102
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 30 0 0 0 0 0 0 0 0 30 0 0 0 0 80 963
0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 40 649
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9
0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 3 16
0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 4 13
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2 43
0 0 0 6 0 0 0 0 0 4 0 0 0 0 0 0 0 14 84
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 101
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 73
0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 174
Page 81 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 4 96
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 98
0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28 155
0 0 0 0 0 0 0 0 0 10 0 0 6 0 0 0 0 36 239
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 82 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 30 0 0 0 0 0 30 0 0 50 10 0 0 0 250 2,240
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 3 42
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 4 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 24 942
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22
Kendari, 02 Agustus 2017

Page 83 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 84 of 156
BULAN : AGUSTUS 2017

HARGA SATUAN
14 Bamgetol 200 mg 100 tablet/kotak 135,000 62 8,370,000 50 6,750,000 112 15,120,000 3 0 0 0 0 0 0 0 0 0 5 0 0 0
15 Cairan RL 500 ml 500 ml/botol 5,200 0 0 40 208,000 40 208,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Cairan NaCl 0,9 % 500 ml/botol 4,900 0 0 40 196,000 40 196,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 85 of 156
HARGA SATUAN
30 Clozapin 100 mg 100 tablet/kotak 227,273 2 454,546 0 0 2 454,546 0 0 0 0 0 0 0 0 2 0 0 0 0 0
Page 86 of 156
HARGA SATUAN
42 Haloperidol 1,5 mg 100 tablet/kotak 6,909 963 6,653,454 0 0 963 6,653,454 0 0 0 24 0 0 0 0 0 0 0 0 0 0
54 Meloxicam 15 mg 50 tablet/kotak 20,002 101 2,020,202 0 0 101 2,020,202 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 87 of 156
HARGA SATUAN
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 88 of 156
HARGA SATUAN
GRAND TOTAL 129,718,131 7,154,000 136,872,131
12,971,813 PPN 10% 13,687,213
142,689,944 Jumlah 150,559,344
Mengetahui,
Page 89 of 156
HARGA SATUAN

NIP.19660312 200003 1 002 Nip
Page 90 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 0 0 6 0 0 8 0 0 0 5 0 0 0 48 283
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 8 0 0 6 0 0 0 0 0 0 7 0 0 0 43 135
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 161
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 6 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 63
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169
0 0 0 3 0 0 3 0 0 0 0 0 0 3 0 0 0 17 95
0 3 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 6 34
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 91 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 20 0 0 0 0 0 30 0 0 0 30 0 0 0 170 456
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1
0 5 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 8 18
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,233
Page 92 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2 0 0 0 4 0 0 0 6 96
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 30 0 30 0 0 0 0 0 0 0 0 0 30 0 0 0 114 849
0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 40 609
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 2 7
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 3 13
0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 4 9
0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 12 31
0 0 0 6 0 0 4 0 0 0 0 0 0 0 0 0 0 16 68
0 0 0 4 0 0 0 0 0 0 0 0 0 0 0 0 0 4 97
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 2 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 48
0 0 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 6 168
Page 93 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 4 92
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 95
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1
0 3 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0 50 105
0 0 0 0 0 0 6 0 0 8 0 0 0 10 0 0 0 52 187
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 6 33
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 94 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 40 0 0 0 0 0 0 60 0 0 0 210 2,030
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 3 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 119
0 0 0 9 0 0 2 0 0 0 0 0 0 8 0 0 0 52 890
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22
Kendari, 02 September 2017

Page 95 of 156
Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 96 of 156
BULAN : SEPTEMBER 2017

HARGA SATUAN
9 Amoksisilin 500 mg 100 tablet/kotak 33,636 24 807,264 0 0 24 807,264 0 0 0 0 0 0 2 0 0 0 0 0 0 0
11 Asam Mefenamat 100 tablet/kotak 24,624 63 1,551,312 60 1,477,440 123 3,028,752 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Cairan RL 500 ml 500 ml/botol 5,200 34 176,800 0 0 34 176,800 0 0 0 0 0 0 0 0 0 0 0 0 20 0
16 Cairan NaCl 0,9 % 500 ml/botol 4,900 40 196,000 0 0 40 196,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 97 of 156
HARGA SATUAN
30 Clozapin 100 mg 100 tablet/kotak 227,273 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Cotrimoxazole 480 mg 100 tablet/kotak 17,325 24 415,800 50 866,250 74 1,282,050 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 98 of 156
HARGA SATUAN
53 Nopres 20 mg 30 tablet/kotak 12,955 68 880,940 0 0 68 880,940 0 0 0 0 0 0 4 0 0 0 0 0 0 0
Page 99 of 156
HARGA SATUAN
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 100 of 156

HARGA SATUAN
82 Vitamin B - kompleks 100 tablet/kotak 9,455 0 0 500 4,727,500 500 4,727,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Vitamin B12 1000 tablet/botol 1,375 0 0 100 137,500 100 137,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Vitamin B6 (pyridoksin HCl) 1000 tablet/botol 15,818 0 0 100 1,581,800 100 1,581,800 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GRAND TOTAL 116,972,191 8,790,490 125,762,681
11,697,219 PPN 10% 12,576,268
128,669,410 Jumlah 138,338,949
Mengetahui,
Page 101 of 156

HARGA SATUAN

NIP.19660312 200003 1 002 Nip
Page 102 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 6 0 0 0 0 0 6 12 8 0 0 0 0 56 227
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 10 0 0 0 0 0 0 0 3 0 0 0 0 35 100
0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 6 155
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 22
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169
0 0 0 0 3 0 0 0 0 0 2 0 0 0 3 0 0 16 79
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 14
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 2 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 103 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 30 0 0 0 0 0 0 0 30 0 0 0 0 130 326
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 14
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0 0 48 1,185
Page 104 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 96
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 90 759
0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 20 589
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 4 9
0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 2 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15 16
0 0 0 0 0 0 0 0 0 0 6 0 0 5 0 0 0 15 53
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 168
Page 105 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 88
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 10 95
0 0 0 0 20 0 0 0 0 0 10 0 0 0 0 0 0 64 123
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 27
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 106 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 30 0 10 0 0 0 60 0 0 0 0 0 0 220 1,810
0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 5 495
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 19
0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 3 97
0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 0 6 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 36
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 2 117
0 0 0 0 9 0 0 0 0 0 6 0 8 0 0 0 0 55 835
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22
Kendari, 02 Oktober 2017

Page 107 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 108 of 156

BULAN : OKTOBER 2017

HARGA SATUAN
19 Carbamazepine 200 mg 100 tablet/kotak 24,455 0 0 1,500 36,682,500 1,500 36,682,500 0 0 0 0 0 0 0 0 0 0 0 5 0 0
Page 109 of 156

HARGA SATUAN
30 Clozapin 100 mg 100 tablet/kotak 227,273 0 0 50 11,363,650 50 11,363,650 0 0 4 0 0 0 0 0 0 0 0 0 6 0
32 Cotrimoxazole 480 mg 100 tablet/kotak 17,325 74 1,282,050 0 0 74 1,282,050 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 110 of 156

HARGA SATUAN
Page 111 of 156

HARGA SATUAN
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 112 of 156

HARGA SATUAN
82 Vitamin B - kompleks 100 tablet/kotak 9,455 495 4,680,225 0 0 495 4,680,225 0 5 0 0 0 0 0 5 0 0 0 0 6 0
84 Vitamin B12 1000 tablet/botol 1,375 97 133,375 0 0 97 133,375 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Vitamin B6 (pyridoksin HCl) 1000 tablet/botol 15,818 94 1,486,892 0 0 94 1,486,892 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GRAND TOTAL 111,237,766 48,046,150 159,283,916
11,123,777 PPN 10% 15,928,392
122,361,542 Jumlah 175,212,307
Mengetahui,
Page 113 of 156

HARGA SATUAN

NIP.19660312 200003 1 002
Page 114 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 8 0 0 0 0 0 5 0 0 4 0 0 0 4 0 48 179
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 8 0 0 0 0 0 6 0 0 8 0 0 0 0 0 51 49
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 11 144
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 3 0 7 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 120
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 70
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14
0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 3 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 3 0 0 0 0 0 4 0 0 0 0 0 0 3 0 15 1,485
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 115 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 54 0 0 36 0 0 0 0 0 202 124
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 9
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 40
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1,185
Page 116 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 7 89
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 20 0 0 0 0 0 20 0 0 20 0 0 0 0 0 121 638
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 569
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 2 4
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2 7
0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 3 4
0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 0 14 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 42
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48
0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 0 0 10 158
Page 117 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 88
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 85
0 0 20 0 0 0 0 0 10 0 0 5 0 0 0 0 0 70 53
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 27
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 118 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 60 0 0 50 0 0 0 0 0 270 1,540
0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 23 472
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 1 0 0 0 0 0 2 0 0 0 0 0 0 0 0 7 29
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 9
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 115
0 0 10 0 0 0 0 0 6 0 0 6 0 0 0 6 0 57 778
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22
Kendari, 02 November 2017

Page 119 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 120 of 156

BULAN : NOVEMBER 2017

HARGA SATUAN
5 Amitriptilin 25 mg 100 tablet/kotak 11,182 49 547,909 0 0 49 547,909 8 0 0 0 6 0 0 0 15 0 0 0 0 0
19 Carbamazepine 200 mg 100 tablet/kotak 24,455 1,485 36,315,675 0 0 1,485 36,315,675 4 0 0 0 5 0 0 0 0 0 0 0 0 3
Page 121 of 156

HARGA SATUAN
29 Clobazam 10 mg 100 tablet/kotak 86,365 9 777,281 0 0 9 777,281 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 122 of 156

HARGA SATUAN
Page 123 of 156

HARGA SATUAN
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 124 of 156

HARGA SATUAN
82 Vitamin B - kompleks 100 tablet/botol 9,455 472 4,462,760 0 0 472 4,462,760 5 0 0 0 0 0 0 0 10 0 0 0 0 0
GRAND TOTAL 141,701,270 0 141,701,270
14,170,127 PPN 10% 14,170,127
155,871,397 Jumlah 155,871,397
Mengetahui,
Page 125 of 156

HARGA SATUAN

NIP.19660312 200003 1 002
Page 126 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 10 0 9 0 0 0 0 0 6 0 5 0 64 115
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
5 0 0 0 0 8 0 0 0 0 0 0 5 2 0 0 0 49 0
0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 8 136
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 117
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169
3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 67
0 0 0 0 0 0 0 0 14 0 0 0 0 0 0 0 0 14 0
0 0 0 0 0 0 0 0 17 0 0 0 0 0 0 1 0 18 19
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0 0 0 0 0 0 6 0 0 0 24 1,461
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 43
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 127 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 30 0 0 0 0 0 0 12 24 0 0 0 124 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 3 0 6 0 0 0 0 0 0 0 0 0 9 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 74
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 48 0 0 0 0 0 0 0 0 0 48 1,137
Page 128 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 3 86
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 20 0 0 0 0 30 0 0 0 0 0 40 0 8 0 158 480
0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 30 539
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 3
0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2 5
0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 3 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
0 9 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 19 23
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 3 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48
3 0 0 0 0 0 0 4 0 0 0 0 3 0 0 0 0 10 148
Page 129 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 86
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
10 0 0 0 0 0 0 0 0 0 0 0 10 0 0 10 0 30 55
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 51 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 130 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
50 0 0 0 0 0 0 50 0 0 0 0 0 60 0 0 0 260 1,280
0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 20 452
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 19
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 3 91
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 1 3 0 0 0 0 0 0 0 5 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 44
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1
1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 114
6 0 6 0 0 6 0 7 0 0 0 0 10 0 0 10 0 78 700
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22
Kendari, 02 Desember 2017

Page 131 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 132 of 156

BULAN : DESEMBER 2017

HARGA SATUAN
5 Amitriptilin 25 mg 100 tablet/kotak 11,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Carbamazepine 200 mg 100 tablet/kotak 24,455 1,461 35,728,755 0 0 1,461 35,728,755 0 0 0 0 3 0 0 6 0 0 0 0 0 0
Page 133 of 156

HARGA SATUAN
25 Chlorpromazine 25 mg 100 tablet/kotak 16,900 0 0 108 1,825,200 108 1,825,200 0 0 0 0 0 0 0 0 23 0 20 20 0 15
29 Clobazam 10 mg 100 tablet/kotak 86,365 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 134 of 156

HARGA SATUAN
Page 135 of 156

HARGA SATUAN
70 Risperidon 2 mg 50 tablet/kotak 48,581 2 97,161 103 5,003,804 105 5,100,966 0 0 0 0 2 0 0 0 0 0 10 0 0 8
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Stelosi 5 mg 100 tablet/kotak 40,000 20 800,000 0 0 20 800,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 136 of 156

HARGA SATUAN
82 Vitamin B - kompleks 100 tablet/botol 9,455 452 4,273,660 0 0 452 4,273,660 0 0 0 0 10 0 0 0 0 0 0 0 0 7
83 Vitamin B1 ( Thiamin HCl) 1000 tablet/botol 34,364 19 652,916 100 3,436,400 119 4,089,316 0 0 0 0 0 0 0 0 0 0 0 0 0 0
GRAND TOTAL 125,435,346 10,265,404 135,700,750
12,543,535 PPN 10% 13,570,075
137,978,881 Jumlah 149,270,825
Mengetahui,
Page 137 of 156

HARGA SATUAN

NIP.19660312 200003 1 002
Page 138 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 6 0 0 0 10 0 0 0 0 10 0 0 0 0 50 65
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 126
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0 4 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0 4 113
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 169
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 67
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 18
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 4 0 0 0 0 0 0 5 0 0 0 0 18 1,443
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 41
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
Page 139 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 108 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 28
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 72
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 48 1,089
Page 140 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 81
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 20 0 0 0 0 0 0 30 0 0 100 380
0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 40 499
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 2 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 23 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 93
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 140
Page 141 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 3 83
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 10 0 0 0 0 0 0 0 0 10 0 0 0 0 39 16
0 0 0 10 0 0 0 10 0 0 0 0 10 0 20 0 0 70 35
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 6 14
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
Page 142 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 210 1,070
0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 22 430
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 91
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 2 0 0 0 0 0 0 1 0 0 3 21
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 44
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 113
0 0 0 1 0 12 0 10 0 0 0 0 8 8 8 0 10 88 612
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22
Kendari, 02 Januari 2018

Page 143 of 156

Jlh
SISA
Pemak
15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 STOK
aian

Nip. 19811128 200604 2 017
Page 144 of 156

LAPORAN MUTASI PERSEDIAAN OBAT
TAHUN 2017
STOK AWAL PENERIMAAN

BULAN B
HARGA SATUAN
September
NO NAMA OBAT KEMASAN TOTAL
Nopember
Desember
( Rp) JUMLAH JUMLAH
JUMLAH PENERI
Pebruari
Pebruari
Agustus
Oktober
HARGA (Rp) HARGA (Rp)
Januari
Januari
MAAN
Maret
Maret
April
April
Juni
Juli
Mei
Mei
1 Allopurinol 100 mg (inf) 100 tablet/kotak 11,682 97 1,133,154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0
2 Alprazolam 0,5 mg 100 tablet/kotak 53,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 Alprazolam 1 mg 100 tablet/kotak 22,273 152 3,385,496 0 0 0 0 100 313 0 0 0 0 0 0 413 9,198,749 31 34 43 28 29
4 Aminofilin inj 30 ampul/kotak 107,998 1 107,998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Amitriptilin 25 mg 100 tablet/kotak 11,182 372 4,159,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 29 28 29 27 32
6 Amlodipin 10 mg 30 tablet/kotak 9,600 0 0 0 0 0 200 0 0 0 0 0 0 0 0 200 1,920,000 0 0 0 4 17
7 Amlodipin 10 mg (bern) 100 tablet/kotak 129,309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 Amlodipin 5 mg 30 tablet/kotak 21,576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Amoksisilin 500 mg 100 tablet/kotak 33,636 47 1,580,892 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2 3 2 2
10 Antasida Syrup botol 60 ml 3,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 Asam Mefenamat 100 tablet/kotak 24,624 85 2,093,040 0 0 0 0 0 0 0 0 60 0 0 0 60 1,477,440 4 2 4 2 4
12 Asetosal 100 mg 100 tablet/kotak 11,590 10 115,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 Betahistin 6 mg 100 tablet/kotak 73,846 15 1,107,690 0 0 0 0 0 0 165 0 0 0 0 0 165 12,184,590 1 2 3 2 0
14 Bamgetol 200 mg 100 tablet/kotak 135,000 33 4,455,000 0 0 10 0 100 0 0 50 0 0 0 0 160 21,600,000 22 11 10 0 14
15 Cairan RL 500 ml 500 ml/botol 5,200 0 0 0 0 0 0 0 0 0 40 0 0 0 0 40 208,000 0 0 0 0 0
16 Cairan NaCl 0,9 % 500 ml/botol 4,900 0 0 0 0 0 0 0 0 0 40 0 0 0 0 40 196,000 0 0 0 0 0
17 candesartan 16 mg 30 tablet/kotak 147,000 58 8,526,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 4 5 0 4
18 Captopril 50 mg 1000 tablet/kotak 20,376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Carbamazepine 200 mg 100 tablet/kotak 24,455 0 0 0 0 0 0 0 0 0 0 0 1,500 0 0 1,500 36,682,500 0 0 0 0 0
20 Cefadroxyl 500 mg 100 kapsul/kotak 57,273 53 3,035,469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 0
21 Cetirizin 10 mg 50 tablet/kotak 8,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 145 of 156

BULAN B
HARGA SATUAN TOTAL
September
NO NAMA OBAT KEMASAN
Nopember
Desember
( Rp) JUMLAH JUMLAH
JUMLAH PENERI
Pebruari
Pebruari
Agustus
Oktober
Januari
Januari
MAAN
Maret
Maret
April
April
Juni
Juli
Mei
Mei
22 Chloramfenicol 250 mg 120 kapsul/kotak 29,062 6 174,372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Chlorpromazine 100 mg 1000 tablet/botol 138,044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Chlorpromazine 100 mg 100 tablet/kotak 13,058 1,264 16,505,312 0 0 0 0 0 0 384 0 0 0 0 0 384 5,014,272 165 148 154 142 142
25 Chlorpromazine 25 mg 100 tablet/kotak 16,900 0 0 0 0 0 0 0 0 0 0 0 0 0 108 108 1,825,200 0 0 0 0 0
26 Chlorpromazine 25 mg/ml 30 ampul/kotak 33,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Ciprofloxacin 500 mg 100 tablet/kotak 25,792 6 154,752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 Citicholin 500 mg 30 tablet/kotak 153,000 0 0 0 0 0 10 0 0 0 0 0 0 0 0 10 1,530,000 0 0 0 5 2
29 Clobazam 10 mg 100 tablet/kotak 86,365 48 4,145,496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 2 0 7
30 Clozapin 100 mg 100 tablet/kotak 227,273 18 4,090,914 0 0 0 0 0 0 0 0 0 50 0 0 50 11,363,650 2 1 4 2 2
31 Clopidogrel 75 mg 30 tablet/kotak 97,855 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Cotrimoxazole 480 mg 100 tablet/kotak 17,325 28 485,100 0 0 0 0 0 0 0 0 50 0 0 0 50 866,250 2 0 0 2 0
33 Dexamethason 0,5 mg 1000 tablet/botol 50,949 1 50,949 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Diazepam 2 mg 1000 tablet/botol 28,808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 Diazepam 2 mg 100 tablet/kbotol 4,273 1,617 6,909,441 0 0 0 0 0 0 0 0 0 0 0 0 0 0 48 96 0 48 96
Page 146 of 156

BULAN B
HARGA SATUAN TOTAL
September
Nopember
Desember
( Rp) JUMLAH JUMLAH
JUMLAH PENERI
Pebruari
Pebruari
Agustus
Oktober
Januari
Januari
MAAN
Maret
Maret
April
April
Juni
Juli
Mei
Mei
36 Ergotamin-coffein 100 tablet/botol 12,149 24 291,576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Fenobarbital 30 mg 1000 tablet/botol 33,784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Fenobarbital 30 mg 100 tablet/botol 6,372 137 872,964 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 4 4 6 6
39 Glibenclamid 5mg 100 tablet/kotak 6,539 15 98,085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Gliceril Guaicolate 100 mg 1000tablet/botol 24,364 3 73,092 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
41 Haloperidol 0,5 mg 100 tablet/kotak 5,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Haloperidol 1,5 mg 100 tablet/kotak 6,909 1,683 11,627,998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 130 90 100 130
43 Haloperidol 5 mg 100 tablet/kotak 9,546 879 8,390,934 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 50 30 40 20
44 Hexymer 2 mg 1000 tablet/kaleng 243,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Hexymer 2 mg 250 tablet/kaleng 78,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Hydrocortison 2,5 % 24 tube/kotak 64,935 1 64,935 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Ibuprofen 200 mg 100 tablet/botol 10,496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Ibuprofen 400 mg 100 tablet/kotak 18,621 4 74,484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Kapsul 0 1000 kapsul/sak 84,000 5 420,000 13 0 0 0 0 0 0 0 0 0 0 0 13 1,092,000 0 1 1 1 5
50 Kapsul 00 1000 kapsul/sak 55,000 0 0 10 0 0 10 0 0 17 0 0 0 0 0 37 2,035,000 3 5 2 1 5
51 Kapsul 01 1000 kapsul/sak 84,000 1 84,000 10 0 0 10 0 0 12 0 0 0 0 0 32 2,688,000 3 4 3 2 3
52 Lodomer Inj. 12 ampul/kotak 75,000 22 1,650,000 0 0 0 0 0 0 45 0 0 0 0 0 45 3,375,000 6 4 10 2 0
53 Nopres 20 mg 30 tablet/kotak 12,955 155 2,008,025 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 9 8 10 12
54 Meloxicam 15 mg 50 tablet/kotak 20,002 47 940,094 0 0 0 0 0 0 100 0 0 0 0 0 100 2,000,200 9 12 7 6 6
55 Meloxicam 7,5 mg 50 tablet/kotak 31,418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Metformin 500 mg (hexpharm) 100 tablet/kotak 14,850 4 59,400 0 0 0 0 50 0 0 0 0 0 0 0 50 742,500 0 3 0 0 2
57 Methylprednisolon 16 mg 30 tablet/kotak 31,877 8 255,016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Metronidasol 500 mg 100 tablet/kotak 20,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 Miconazole cream 24 tube/kotak 2,727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 Natrium Diklofenak 50 mg (bern) 100 tablet/kotak 23,747 27 641,169 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 4 1 4 2
61 Oksitetrasiklin salep kulit 3 % 25 tube/kotak 1,827 0 0 0 0 0 0 75 0 0 0 0 0 0 0 75 137,025 0 0 0 0 2
Page 147 of 156

BULAN B
HARGA SATUAN TOTAL
September
Nopember
Desember
( Rp) JUMLAH JUMLAH
JUMLAH PENERI
Pebruari
Pebruari
Agustus
Oktober
Januari
Januari
MAAN
Maret
Maret
April
April
Juni
Juli
Mei
Mei
62 Omeprazole 20 mg 30 kapsul/kotak 8,863 136 1,205,368 0 0 0 50 0 0 0 0 0 0 0 0 50 443,150 8 0 2 0 0
63 Parasetamol 500 mg (kimia farma) 100 kaplet/kotak 15,000 114 1,710,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 2 3 5 0
64 Piracetam 1200 mg (inf) 30 tablet/kotak 18,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Piracetam 800 mg 100 tablet/kotak 84,672 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Prednison 5 mg 100 tablet/pot 13,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Ranitidin 150 mg (bern) 100 tablet/kotak 16,634 141 2,345,394 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 7 4 6 8
68 Ranitidin Inj. 25 ampul/kotak 18,691 4 74,764 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Risperidon 3 mg 50 tablet/kotak 104,549 45 4,704,693 0 0 0 100 48 128 0 0 0 0 0 0 276 28,855,449 42 3 0 28 51
70 Risperidon 2 mg 50 tablet/kotak 48,581 220 10,687,738 0 0 0 150 0 250 100 0 0 0 0 103 603 29,294,117 84 136 0 108 42
71 Salbutamol 2mg 100 tablet/kotak 7,631 4 30,524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Salbutamol 4mg 100tablet/kotak 8,854 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Salep 2-4 24 tube/kotak 3,600 46 165,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Salicyl powder pot 3,727 5 18,635 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Simvastatin 20 mg 30 tablet/kotak 34,977 25 874,425 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 4 4 3 0
76 Spironolakton 25 mg 100 tablet/kotak 31,818 4 127,270 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
77 Stelosi 5 mg 100 tablet/kotak 40,000 28 1,120,000 0 0 0 0 50 0 0 0 0 0 0 0 50 2,000,000 1 0 19 8 9
78 Sulfas Feros 300 mg 1000 tablet/botol 65,909 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Thiamfenikol 500 mg 100 kaplet/kotak 53,147 4 212,587 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Page 148 of 156

BULAN B
HARGA SATUAN TOTAL
September
Nopember
Desember
( Rp) JUMLAH JUMLAH
JUMLAH PENERI
Pebruari
Pebruari
Agustus
Oktober
Januari
Januari
MAAN
Maret
Maret
April
April
Juni
Juli
Mei
Mei
80 Tramadol 50 mg (kimia farma) 50 kapsul/kotak 14,636 7 102,452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Trihexypenidil 2 mg 100 tablet/kotak 3,746 380 1,423,480 0 0 0 0 0 2,620 0 0 0 0 0 0 2,620 9,814,520 150 140 90 0 0
82 Vitamin B - kompleks 100 tablet/botol 9,455 0 0 0 0 0 0 0 0 0 0 500 0 0 0 500 4,727,500 0 0 0 0 0
83 Vitamin B1 ( Thiamin HCl) 1000 tablet/botol 34,364 0 0 0 0 0 0 30 0 0 0 0 0 0 100 130 4,467,320 0 0 0 0 6
84 Vitamin B12 1000 tablet/botol 1,375 0 0 0 0 0 0 0 0 0 0 100 0 0 0 100 137,500 0 0 0 0 0
85 Vitamin B6 (pyridoksin HCl) 1000 tablet/botol 15,818 0 0 0 0 0 0 0 0 0 0 100 0 0 0 100 1,581,800 0 0 0 0 0
86 Atropin Sulfat Injeksi 30 ampul/kotak 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
87 Alkohol botol 1 liter 33 0 0 0 0 30 0 0 0 0 0 0 0 0 30 0 2 1 2 0 7
88 Antasida DOEN tablet 100 tablet/kotak 0 0 0 0 0 0 0 0 0 0 50 0 0 0 50 0 0 0 0 0 0
89 Aricept tab 28 tablet/kotak 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0
90 Atovarstatin 10 mg 30 tablet/kotak 0 0 0 0 0 0 10 0 0 0 0 0 0 0 10 0 0 0 0 0 0
91 Atovarstatin 20 mg 30 tablet/kotak 0 0 0 0 0 0 10 0 0 0 0 0 0 0 10 0 0 0 0 0 0
92 Cefotaxim 1 gram vial 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0
93 Depakote 100 tablet/botol 0 0 0 0 0 0 0 0 0 120 0 0 0 0 120 0 0 0 0 0 0
94 Diazepam 5 mg 100 tablet/kotak 0 0 0 0 0 0 0 1,000 0 0 0 0 0 0 1,000 0 0 0 0 0 0
95 Lidokain injeksi 100 ampul/kotak 0 0 0 0 0 0 5 0 0 0 0 0 0 0 5 0 0 0 0 0 0
96 Metil prednisolon 8 mg 100 tablet/kotak 45 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 2 0 1
97 Valesco 80 mg 30 tablet/kotak 0 0 0 0 0 0 32 0 0 0 0 0 0 0 32 0 0 0 0 0 6
GRAND TOTAL 114,571,314 197,457,732
PPN 10% 11,457,131 19,745,773
Jumlah 126,028,445 217,203,506
Mengetahui,
Direktur RS.Jiwa Kendari Kepala Sub
Page 149 of 156
BULAN B
HARGA SATUAN TOTAL
September
Nopember
Desember
( Rp) JUMLAH JUMLAH
JUMLAH PENERI
Pebruari
Pebruari
Agustus
Oktober
Januari
Januari
MAAN
Maret
Maret
April
April
Juni
Juli
Mei
Mei
NIP.19660312 200003 1 002
Page 150 of 156

PEMAKAIAN SISA STOK
BULAN
KET.
September
TOTAL
Nopember
Desember
JUMLAH JUMLAH HARGA
PEMAKA JUMLAH
Agustus
Oktober
HARGA (Rp) (Rp)

IAN
Juni
Juli
0 0 0 0 0 0 0 3 35,046 94 1,098,108
0 0 0 0 0 0 0 0 0 0 0
39 30 48 56 48 64 50 500 11,136,500 65 1,447,745
0 0 0 0 0 0 0 0 0 1 107,998
28 21 43 35 51 49 0 372 4,159,637 0 0
5 13 0 6 11 8 10 74 710,400 126 1,209,600
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
2 2 6 2 7 0 4 36 1,210,896 11 369,996
0 0 0 0 0 0 0 0 0 0 0
2 2 2 0 3 3 4 32 787,968 113 2,782,512
0 0 0 0 0 0 0 0 0 10 115,900
0 3 0 0 0 0 0 11 812,306 169 12,479,974
12 12 17 16 9 3 0 126 17,010,000 67 9,045,000
0 0 6 20 0 14 0 40 208,000 0 0
0 0 0 0 3 18 1 22 107,800 18 88,200
0 2 0 0 0 0 0 21 3,087,000 37 5,439,000
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 15 24 18 57 1,393,935 1,443 35,288,565
0 1 0 2 0 3 2 12 687,276 41 2,348,193
0 0 0 0 0 0 0 0 0 0 0
Page 151 of 156

PEMAKAIAN SISA STOK
BULAN
TOTAL KET.
September
Nopember
Desember
JUMLAH JUMLAH HARGA
PEMAKA JUMLAH
Agustus
Oktober
HARGA (Rp) (Rp)
IAN
Juni
Juli
0 0 0 0 0 0 0 0 0 6 174,372
0 0 0 0 0 0 0 0 0 0 0
142 129 170 130 202 124 0 1,648 21,519,584 0 0
0 0 0 0 0 0 108 108 1,825,200 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 6 154,752
0 0 2 0 0 0 0 9 1,377,000 1 153,000
5 0 8 4 5 9 0 48 4,145,496 0 0
3 2 2 0 10 3 9 40 9,090,920 28 6,363,644
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 6 103,950 72 1,247,400
0 0 0 0 0 0 0 0 0 1 50,949
0 0 0 0 0 0 0 0 0 0 0
48 48 0 48 0 48 48 528 2,256,144 1,089 4,653,297
Page 152 of 156

PEMAKAIAN SISA STOK
BULAN
TOTAL KET.
September
Nopember
Desember
JUMLAH JUMLAH HARGA
PEMAKA JUMLAH
Agustus
Oktober
HARGA (Rp) (Rp)
IAN
Juni
Juli
0 0 0 0 0 0 0 0 0 24 291,576
0 0 0 0 0 0 0 0 0 0 0
0 7 6 0 7 3 5 56 356,832 81 516,132
0 0 0 0 0 0 0 0 0 15 98,085
0 0 0 0 0 0 0 0 0 3 73,092
0 0 0 0 0 0 0 0 0 0 0
100 80 114 90 121 158 100 1,303 9,002,544 380 2,625,454
20 40 40 20 20 30 40 380 3,627,480 499 4,763,454
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 64,935
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 4 74,484
0 1 2 1 2 1 2 17 1,428,000 1 84,000
2 3 3 4 2 2 2 34 1,870,000 3 165,000
1 4 4 2 3 3 1 33 2,772,000 0 0
0 2 12 15 14 2 0 67 5,025,000 0 0
4 14 16 15 11 19 23 155 2,008,025 0 0
6 0 4 0 0 0 4 54 1,080,108 93 1,860,186
0 0 0 0 0 0 0 0 0 0 0
0 0 2 0 0 0 0 7 103,950 47 697,950
0 0 0 0 1 0 0 1 31,877 7 223,139
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
5 0 0 3 0 3 2 27 641,169 0 0
0 0 25 0 0 0 0 27 49,329 48 87,696
Page 153 of 156

PEMAKAIAN SISA STOK
BULAN
TOTAL KET.
September
Nopember
Desember
JUMLAH JUMLAH HARGA
PEMAKA JUMLAH
Agustus
Oktober
HARGA (Rp) (Rp)
IAN
Juni
Juli
0 2 6 0 10 10 8 46 407,698 140 1,240,820
1 4 4 4 0 2 3 31 465,000 83 1,245,000
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
7 2 3 0 0 0 0 46 765,164 95 1,580,230 ED
0 2 1 0 0 0 0 3 56,073 1 18,691
14 28 50 10 10 30 39 305 31,887,363 16 1,672,780
75 36 52 64 70 51 70 788 38,281,533 35 1,700,322
0 0 0 0 0 0 0 0 0 4 30,524
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 46 165,600
0 0 0 0 0 0 0 0 0 5 18,635
3 0 0 0 0 0 1 19 664,563 6 209,862
0 0 0 0 0 0 0 1 31,818 3 95,453
0 2 6 6 0 7 6 64 2,560,000 14 560,000
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 4 212,587
Page 154 of 156

PEMAKAIAN SISA STOK
BULAN
TOTAL KET.
September
Nopember
Desember
JUMLAH JUMLAH HARGA
PEMAKA JUMLAH
Agustus
Oktober
HARGA (Rp) (Rp)
IAN
Juni
Juli
0 0 0 0 0 0 0 0 0 7 102,452 ED
130 250 210 220 270 260 210 1,930 7,229,780 1,070 4,008,220
0 0 0 5 23 20 22 70 661,850 430 4,065,650
4 0 0 1 0 0 0 11 378,004 119 4,089,316
0 0 0 3 0 0 0 3 4,125 97 133,375
0 0 0 6 0 3 0 9 142,362 91 1,439,438
0 0 0 0 0 0 0 0 0 6 0
6 3 3 3 7 5 3 42 0 21 0
0 0 0 3 1 2 0 6 0 44 0
0 0 0 0 0 0 0 2 0 6 0
0 0 0 0 0 0 0 0 0 10 0
0 0 0 0 1 0 0 1 0 9 0
0 4 2 0 0 1 0 9 0 1 0
0 0 1 2 2 1 1 7 0 113 0
34 24 52 55 57 78 88 388 0 612 0
2 0 0 0 0 0 0 2 0 3 0
0 1 0 0 0 0 0 6 0 39 0
4 0 0 0 0 0 0 10 0 22 0
193,196,704 118,832,342
19,319,670 11,883,234
212,516,374 130,715,576
Kendari, 02 Januari 2018

ala Sub Bidang Laboratorium, Farmasi dan Gizi
Page 155 of 156
PEMAKAIAN SISA STOK
BULAN
TOTAL KET.
September
Nopember
Desember
JUMLAH JUMLAH HARGA
PEMAKA JUMLAH
Agustus
Oktober
HARGA (Rp) (Rp)
IAN
Juni
Juli

Nip. 19811128 200604 2 017
Page 156 of 156

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KARTU PERSEDIAAN OBAT

RUMAH SAKIT JIWA PROV. SULAWESI TENGGARA

STOK AWAL PENERIMAAN TOTAL PERSEDIAAN PEMAKAIAN PER TANG

1 Allopurinol 100 mg (inf) 100 tablet/kotak 11,682 97 1,133,154 0 0 97 1,133,154 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2 Alprazolam 0,5 mg 100 tablet/kotak 53,182 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

3 Alprazolam 1 mg 100 tablet/kotak 22,273 152 3,385,496 0 0 152 3,385,496 0 0 0 4 0 0 0 0 0 5 0 0 0 5 0 0

4 Aminofilin inj 30 ampul/kotak 107,998 1 107,998 0 0 1 107,998 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

5 Amitriptilin 25 mg 100 tablet/kotak 11,182 372 4,159,637 0 0 372 4,159,637 0 0 0 6 0 0 0 0 0 6 0 0 0 4 0 0

6 Amlodipin 10 mg 30 tablet/kotak 9,600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

7 Amlodipin 10 mg (bern) 100 tablet/kotak 129,309 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

8 Amlodipin 5 mg 30 tablet/kotak 21,576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

9 Amoksisilin 500 mg 100 tablet/kotak 33,636 47 1,580,892 0 0 47 1,580,892 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0

10 Antasida Syrup botol 60 ml 3,500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

11 Asam Mefenamat 100 tablet/kotak 24,624 85 2,093,040 0 0 85 2,093,040 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0

12 Asetosal 100 mg 100 tablet/kotak 11,590 10 115,900 0 0 10 115,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

13 Betahistin 6 mg 100 tablet/kotak 73,846 15 1,107,690 0 0 15 1,107,690 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

14 Bamgetol 200 mg 100 tablet/kotak 135,000 33 4,455,000 0 0 33 4,455,000 0 0 0 4 0 0 0 0 0 5 0 0 0 4 0 0

15 Cairan RL 500 ml 500 ml/botol 5,200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

16 Cairan NaCl 0,9 % 500 ml/botol 4,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

17 candesartan 16 mg 30 tablet/kotak 147,000 58 8,526,000 0 0 58 8,526,000 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0

18 Captopril 50 mg 1000 tablet/kotak 20,376 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

19 Carbamazepine 200 mg 100 tablet/kotak 24,455 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

20 Cefadroxyl 500 mg 100 kapsul/kotak 57,273 53 3,035,469 0 0 53 3,035,469 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

21 Cetirizin 10 mg 50 tablet/kotak 8,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

22 Chloramfenicol 250 mg 120 kapsul/kotak 29,062 6 174,372 0 0 6 174,372 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

23 Chlorpromazine 100 mg 1000 tablet/botol 138,044 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

24 Chlorpromazine 100 mg 100 tablet/kotak 13,058 1,264 16,505,312 0 0 1,264 16,505,312 0 0 0 28 0 0 0 0 0 36 0 0 0 40 0 0

25 Chlorpromazine 25 mg 100 tablet/kotak 16,900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

26 Chlorpromazine 25 mg/ml 30 ampul/kotak 33,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

27 Ciprofloxacin 500 mg 100 tablet/kotak 25,792 6 154,752 0 0 6 154,752 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

28 Citicholin 500 mg 30 tablet/kotak 153,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

29 Clobazam 10 mg 100 tablet/kotak 86,365 48 4,145,496 0 0 48 4,145,496 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0

30 Clozapin 100 mg 100 tablet/kotak 227,273 18 4,090,914 0 0 18 4,090,914 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

31 Clopidogrel 75 mg 30 tablet/kotak 97,855 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

32 Cotrimoxazole 480 mg 100 tablet/kotak 17,325 28 485,100 0 0 28 485,100 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0

33 Dexamethason 0,5 mg 1000 tablet/botol 50,949 1 50,949 0 0 1 50,949 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

34 Diazepam 2 mg 1000 tablet/botol 28,808 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

35 Diazepam 2 mg 100 tablet/kbotol 4,273 1,617 6,909,441 0 0 1,617 6,909,441 0 0 0 0 0 0 0 0 0 0 0 0 48 0 0 0

36 Ergotamin-coffein 100 tablet/botol 12,149 24 291,576 0 0 24 291,576 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

37 Fenobarbital 30 mg 1000 tablet/botol 33,784 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

38 Fenobarbital 30 mg 100 tablet/botol 6,372 137 872,964 0 0 137 872,964 0 0 3 0 0 0 0 0 0 3 0 0 0 0 0 0

39 Glibenclamid 5mg 100 tablet/kotak 6,539 15 98,085 0 0 15 98,085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

40 Gliceril Guaicolate 100 mg 1000tablet/botol 24,364 3 73,092 0 0 3 73,092 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

41 Haloperidol 0,5 mg 100 tablet/kotak 5,637 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

42 Haloperidol 1,5 mg 100 tablet/kotak 6,909 1,683 11,627,998 0 0 1,683 11,627,998 0 0 0 10 0 0 0 0 0 20 0 0 0 20 0 0

43 Haloperidol 5 mg 100 tablet/kotak 9,546 879 8,390,934 0 0 879 8,390,934 0 0 0 10 0 0 0 0 0 0 0 0 0 10 0 0

44 Hexymer 2 mg 1000 tablet/kaleng 243,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

45 Hexymer 2 mg 250 tablet/kaleng 78,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

46 Hydrocortison 2,5 % 24 tube/kotak 64,935 1 64,935 0 0 1 64,935 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

47 Ibuprofen 200 mg 100 tablet/botol 10,496 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

48 Ibuprofen 400 mg 100 tablet/kotak 18,621 4 74,484 0 0 4 74,484 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

49 Kapsul 0 1000 kapsul/sak 84,000 5 420,000 13 1,092,000 18 1,512,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

50 Kapsul 00 1000 kapsul/sak 55,000 0 0 10 550,000 10 550,000 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0

51 Kapsul 01 1000 kapsul/sak 84,000 1 84,000 10 840,000 11 924,000 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0

52 Lodomer Inj. 12 ampul/kotak 75,000 22 1,650,000 0 0 22 1,650,000 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0

53 Nopres 20 mg 30 tablet/kotak 12,955 155 2,008,025 0 0 155 2,008,025 0 0 0 3 0 0 0 0 0 2 0 0 0 0 0 0

54 Meloxicam 15 mg 50 tablet/kotak 20,002 47 940,094 0 0 47 940,094 0 0 0 3 0 0 0 0 0 0 0 0 0 3 0 0

55 Meloxicam 7,5 mg 50 tablet/kotak 31,418 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

56 Metformin 500 mg (hexpharm) 100 tablet/kotak 14,850 4 59,400 0 0 4 59,400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

57 Methylprednisolon 16 mg 30 tablet/kotak 31,877 8 255,016 0 0 8 255,016 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

58 Metronidasol 500 mg 100 tablet/kotak 20,000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

59 Miconazole cream 24 tube/kotak 2,727 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

60 Natrium Diklofenak 50 mg (bern) 100 tablet/kotak 23,747 27 641,169 0 0 27 641,169 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0