<table border="1">

<tr>
<th>NO.</th>
<th>TGL. KWITANSI</th>
<th>NO. KWITANSI</th>
<th>No RM</th>
<th>NAMA</th>
<th>TGL_LAHIR</th>
<th>ALAMAT</th>
<th>PENANGGUNG</th>
<th>DPJP</th>
<th>JENIS RAWAT</th>
<th>ID_BARANG</th>
<th>NAMA BARANG</th>
<th>Suplier</th>
<th>PERUSAHAAN</th>
<th>ASURANSI</th>
<th>UNIT</th>
<th>BANYAK</th>
<th>HARGA JUAL</th>
<th>JUMLAH</th>
<th>DISKON</th>
<th>PAJAK</th>
<th>TOTAL</th>

</tr>

<tr>
<td>1</td>
<td>08-10-2018 11:35:10</td>
<td>8094</td>
<td>90979</td>
<td>ADDINA MARSHA, NY</td>
<td>06-03-1991</td>
<td>T BOUGENVILLE ESTATE D2/3 04/05</td>
<td>MUHAMMAD AGIYA FERSYA, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>693</td>
<td>CAVIT D3 </td>
<td>MERCK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>2,852.00</td>
<td>42,780.00</td>
<td>0.00</td>
<td>4,278.00</td>
<td>47,058.00</td>

</tr>

<tr>
<td>2</td>
<td>08-10-2018 11:35:10</td>
 <td>8094</td>
<td>90979</td>
<td>ADDINA MARSHA, NY</td>
<td>06-03-1991</td>
<td>T BOUGENVILLE ESTATE D2/3 04/05</td>
<td>MUHAMMAD AGIYA FERSYA, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>4301</td>
<td>VITAMIN D3 1000IU</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>4,138.00</td>
<td>62,070.00</td>
<td>0.00</td>
<td>6,207.00</td>
<td>68,277.00</td>

</tr>

<tr>
<td>3</td>
<td>08-10-2018 11:18:33</td>
<td>8100</td>
<td>49575</td>
<td>SUMINAH.NY</td>
<td>10-11-1968</td>
<td></td>
<td>PEGAWAI YPK</td>
<td>dr.Dewinta Wahyu Maha Endry</td>
<td>IGD</td>
<td>1231</td>
<td>SIMVASTATIN 10 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>709.00</td>
<td>7,090.00</td>
<td>0.00</td>
<td>709.00</td>
<td>7,799.00</td>

</tr>

<tr>
<td>4</td>
<td>08-10-2018 09:01:29</td>
<td>8107</td>
<td>89034</td>
<td>SHRI SHAHANA LAVANYA PRABU, AN</td>
<td>08-06-2018</td>
<td>TAMAN MERUYA ILIR BLOK I-4 NO.14 RT.009 RW.007</td>
 <td>SHRI PRABU ADITYAWARMAN, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1199</td>
<td>ROTARIX 1 ML </td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>374,072.00</td>
<td>374,072.00</td>
<td>0.00</td>
<td>37,407.20</td>
<td>411,479.20</td>

</tr>

<tr>
<td>5</td>
<td>08-10-2018 09:01:29</td>
<td>8107</td>
<td>89034</td>
<td>SHRI SHAHANA LAVANYA PRABU, AN</td>
<td>08-06-2018</td>
<td>TAMAN MERUYA ILIR BLOK I-4 NO.14 RT.009 RW.007</td>
<td>SHRI PRABU ADITYAWARMAN, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>2717</td>
<td>INFANRIX HEXA</td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>812,592.00</td>
<td>812,592.00</td>
<td>0.00</td>
<td>81,259.20</td>
<td>893,851.20</td>

</tr>

<tr>
<td>6</td>
<td>08-10-2018 09:01:29</td>
<td>8107</td>
<td>89034</td>
<td>SHRI SHAHANA LAVANYA PRABU, AN</td>
<td>08-06-2018</td>
<td>TAMAN MERUYA ILIR BLOK I-4 NO.14 RT.009 RW.007</td>
<td>SHRI PRABU ADITYAWARMAN, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
 <td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>7</td>
<td>08-10-2018 13:11:44</td>
<td>8108</td>
<td>75187</td>
<td>DEA ANNISA VIOLETA, NY</td>
<td>09-06-1991</td>
<td>JL. BALADEWA KIRI NO. 2 RT012/011</td>
<td>RAMA MAGRAHANA, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>693</td>
<td>CAVIT D3 </td>
<td>MERCK </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>30.00</td>
<td>2,252.00</td>
<td>67,560.00</td>
<td>0.00</td>
<td>6,756.00</td>
<td>74,316.00</td>

</tr>

<tr>
<td>8</td>
<td>08-10-2018 09:13:41</td>
<td>8110</td>
<td>91892</td>
<td>M. ZIAN AZALIN, AN</td>
<td>08-01-2011</td>
<td>KB KACANG 37 NO.27 TNH ABANG</td>
<td>M. RIZA, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1193</td>
<td>RHINOS JUNIOR SIRUP 60ML</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
 <td>45,600.00</td>
<td>45,600.00</td>
<td>0.00</td>
<td>4,560.00</td>
<td>50,160.00</td>

</tr>

<tr>
<td>9</td>
<td>08-10-2018 09:13:41</td>
<td>8110</td>
<td>91892</td>
<td>M. ZIAN AZALIN, AN</td>
<td>08-01-2011</td>
<td>KB KACANG 37 NO.27 TNH ABANG</td>
<td>M. RIZA, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1365</td>
<td>ZAMEL SYRUP </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>57,000.00</td>
<td>57,000.00</td>
<td>0.00</td>
<td>5,700.00</td>
<td>62,700.00</td>

</tr>

<tr>
<td>10</td>
<td>08-10-2018 09:13:41</td>
<td>8110</td>
<td>91892</td>
<td>M. ZIAN AZALIN, AN</td>
<td>08-01-2011</td>
<td>KB KACANG 37 NO.27 TNH ABANG</td>
<td>M. RIZA, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4429</td>
<td>LASAL SYR 100 ML</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>38,000.00</td>
<td>38,000.00</td>
<td>0.00</td>
<td>3,800.00</td>
<td>41,800.00</td>
</tr>

<tr>
<td>11</td>
<td>08-10-2018 10:33:56</td>
<td>8114</td>
<td>91893</td>
<td>HILMI RUHAMA, NY</td>
<td>23-06-1990</td>
<td>JL KH AHMAD DAHLAN III NO.18</td>
<td>AKBAR TRI KERSTIANTO, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>4301</td>
<td>VITAMIN D3 1000IU</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>4,138.00</td>
<td>124,140.00</td>
<td>0.00</td>
<td>12,414.00</td>
<td>136,554.00</td>

</tr>

<tr>
<td>12</td>
<td>08-10-2018 10:33:56</td>
<td>8114</td>
<td>91893</td>
<td>HILMI RUHAMA, NY</td>
<td>23-06-1990</td>
<td>JL KH AHMAD DAHLAN III NO.18</td>
<td>AKBAR TRI KERSTIANTO, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
 <td>13</td>
<td>08-10-2018 10:33:56</td>
<td>8114</td>
<td>91893</td>
<td>HILMI RUHAMA, NY</td>
<td>23-06-1990</td>
<td>JL KH AHMAD DAHLAN III NO.18</td>
<td>AKBAR TRI KERSTIANTO, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1310</td>
<td>UTROGESTAN 100 MG CAPS </td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>40,425.00</td>
<td>1,212,750.00</td>
<td>0.00</td>
<td>121,275.00</td>
<td>1,334,025.00</td>

</tr>

<tr>
<td>14</td>
<td>08-10-2018 10:33:56</td>
<td>8114</td>
<td>91893</td>
<td>HILMI RUHAMA, NY</td>
<td>23-06-1990</td>
<td>JL KH AHMAD DAHLAN III NO.18</td>
<td>AKBAR TRI KERSTIANTO, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>911</td>
<td>HYSTOLAN STR 20MG</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>6,840.00</td>
<td>68,400.00</td>
<td>0.00</td>
<td>6,840.00</td>
<td>75,240.00</td>

</tr>

<tr>
<td>15</td>
<td>08-10-2018 10:12:30</td>
<td>8118</td>
<td>91372</td>
<td>ARIELLE ALLEGRA TEJOKUSUMO, BY</td>
 <td>28-09-2018</td>
<td>SATU 8 RESIDENCE</td>
<td>ALVIN TEJOKUSUMO, TN</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>8,512.00</td>
<td>8,512.00</td>
<td>0.00</td>
<td>851.20</td>
<td>9,363.20</td>

</tr>

<tr>
<td>16</td>
<td>08-10-2018 10:12:30</td>
<td>8118</td>
<td>91372</td>
<td>ARIELLE ALLEGRA TEJOKUSUMO, BY</td>
<td>28-09-2018</td>
<td>SATU 8 RESIDENCE</td>
<td>ALVIN TEJOKUSUMO, TN</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>1313</td>
<td>VACCIN BCG </td>
<td>BIO FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>209,000.00</td>
<td>209,000.00</td>
<td>0.00</td>
<td>20,900.00</td>
<td>229,900.00</td>

</tr>

<tr>
<td>17</td>
<td>08-10-2018 10:12:30</td>
<td>8118</td>
<td>91372</td>
<td>ARIELLE ALLEGRA TEJOKUSUMO, BY</td>
<td>28-09-2018</td>
<td>SATU 8 RESIDENCE</td>
<td>ALVIN TEJOKUSUMO, TN</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
 <td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>18</td>
<td>08-10-2018 10:12:30</td>
<td>8118</td>
<td>91372</td>
<td>ARIELLE ALLEGRA TEJOKUSUMO, BY</td>
<td>28-09-2018</td>
<td>SATU 8 RESIDENCE</td>
<td>ALVIN TEJOKUSUMO, TN</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
<td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>19</td>
<td>08-10-2018 08:59:29</td>
<td>8119</td>
<td>91229</td>
<td>NURUL FITRIANA RAHMAWATI, NY</td>
<td>05-02-1990</td>
<td>PANCORAN, PENGADEGAN UTARA 1 10/6</td>
<td>RIZAL EKA RISDIANTO, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
 <td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>20</td>
<td>08-10-2018 08:59:29</td>
<td>8119</td>
<td>91229</td>
<td>NURUL FITRIANA RAHMAWATI, NY</td>
<td>05-02-1990</td>
<td>PANCORAN, PENGADEGAN UTARA 1 10/6</td>
<td>RIZAL EKA RISDIANTO, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>812</td>
<td>EAZYCAL TAB </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,600.00</td>
<td>228,000.00</td>
<td>0.00</td>
<td>22,800.00</td>
<td>250,800.00</td>

</tr>

<tr>
<td>21</td>
<td>08-10-2018 08:59:29</td>
<td>8119</td>
<td>91229</td>
<td>NURUL FITRIANA RAHMAWATI, NY</td>
<td>05-02-1990</td>
<td>PANCORAN, PENGADEGAN UTARA 1 10/6</td>
<td>RIZAL EKA RISDIANTO, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>904</td>
<td>HEMOBION </td>
<td>MERCK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>2,803.00</td>
<td>84,090.00</td>
<td>0.00</td>
 <td>8,409.00</td>
<td>92,499.00</td>

</tr>

<tr>
<td>22</td>
<td>08-10-2018 10:36:00</td>
<td>8121</td>
<td>91895</td>
<td>FADILA HASNADHIA, NY</td>
<td>27-09-1994</td>
<td>JL TEUKU CIK DITIRO NO.74 MENTENG</td>
<td>FITRAHADI NUGRAHA HADIAN, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>608</td>
<td>ASCARDIA 80MG TAB</td>
<td>PHAROS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,292.00</td>
<td>12,920.00</td>
<td>0.00</td>
<td>1,292.00</td>
<td>14,212.00</td>

</tr>

<tr>
<td>23</td>
<td>08-10-2018 10:36:00</td>
<td>8121</td>
<td>91895</td>
<td>FADILA HASNADHIA, NY</td>
<td>27-09-1994</td>
<td>JL TEUKU CIK DITIRO NO.74 MENTENG</td>
<td>FITRAHADI NUGRAHA HADIAN, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>4301</td>
<td>VITAMIN D3 1000IU</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>4,138.00</td>
<td>124,140.00</td>
<td>0.00</td>
<td>12,414.00</td>
<td>136,554.00</td>

</tr>
<tr>
<td>24</td>
<td>08-10-2018 10:36:00</td>
<td>8121</td>
<td>91895</td>
<td>FADILA HASNADHIA, NY</td>
<td>27-09-1994</td>
<td>JL TEUKU CIK DITIRO NO.74 MENTENG</td>
<td>FITRAHADI NUGRAHA HADIAN, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>25</td>
<td>08-10-2018 10:36:00</td>
<td>8121</td>
<td>91895</td>
<td>FADILA HASNADHIA, NY</td>
<td>27-09-1994</td>
<td>JL TEUKU CIK DITIRO NO.74 MENTENG</td>
<td>FITRAHADI NUGRAHA HADIAN, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1310</td>
<td>UTROGESTAN 100 MG CAPS </td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>40,425.00</td>
<td>404,250.00</td>
<td>0.00</td>
<td>40,425.00</td>
<td>444,675.00</td>

</tr>

<tr>
<td>26</td>
<td>08-10-2018 09:26:34</td>
<td>8122</td>
 <td>84299</td>
<td>MISHA ARSYILA NAURA SULTONI,AN</td>
<td>13-12-2017</td>
<td>JL. EMPANG BAHAGIA NO.2 JELAMBAR</td>
<td>ACHMAD AGUNG SULTONI, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1194</td>
<td>RHINOS NEO DROP </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>65,360.00</td>
<td>65,360.00</td>
<td>0.00</td>
<td>6,536.00</td>
<td>71,896.00</td>

</tr>

<tr>
<td>27</td>
<td>08-10-2018 09:26:34</td>
<td>8122</td>
<td>84299</td>
<td>MISHA ARSYILA NAURA SULTONI,AN</td>
<td>13-12-2017</td>
<td>JL. EMPANG BAHAGIA NO.2 JELAMBAR</td>
<td>ACHMAD AGUNG SULTONI, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4429</td>
<td>LASAL SYR 100 ML</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>38,000.00</td>
<td>38,000.00</td>
<td>0.00</td>
<td>3,800.00</td>
<td>41,800.00</td>

</tr>

<tr>
<td>28</td>
<td>08-10-2018 09:26:34</td>
<td>8122</td>
<td>84299</td>
<td>MISHA ARSYILA NAURA SULTONI,AN</td>
<td>13-12-2017</td>
<td>JL. EMPANG BAHAGIA NO.2 JELAMBAR</td>
<td>ACHMAD AGUNG SULTONI, TN</td>
 <td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3662</td>
<td>VAPORIN</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>8,360.00</td>
<td>83,600.00</td>
<td>0.00</td>
<td>8,360.00</td>
<td>91,960.00</td>

</tr>

<tr>
<td>29</td>
<td>08-10-2018 09:26:34</td>
<td>8122</td>
<td>84299</td>
<td>MISHA ARSYILA NAURA SULTONI,AN</td>
<td>13-12-2017</td>
<td>JL. EMPANG BAHAGIA NO.2 JELAMBAR</td>
<td>ACHMAD AGUNG SULTONI, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>714</td>
<td>CENDO XITROL </td>
<td>CENDO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>41,420.00</td>
<td>41,420.00</td>
<td>0.00</td>
<td>4,142.00</td>
<td>45,562.00</td>

</tr>

<tr>
<td>30</td>
<td>08-10-2018 09:02:22</td>
<td>8123</td>
<td>81558</td>
<td>ROSIDA, NY</td>
<td>25-07-1985</td>
<td>DENPASAR RESIDENT JL. PROF.DR. SATRIO TOWER UBUD UNIT 28
B9</td>
<td>HYWEL JOHN DAVIES, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1096</td>
<td>OSSORAL 800 </td>
 <td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,232.00</td>
<td>186,960.00</td>
<td>0.00</td>
<td>18,696.00</td>
<td>205,656.00</td>

</tr>

<tr>
<td>31</td>
<td>08-10-2018 09:02:22</td>
<td>8123</td>
<td>81558</td>
<td>ROSIDA, NY</td>
<td>25-07-1985</td>
<td>DENPASAR RESIDENT JL. PROF.DR. SATRIO TOWER UBUD UNIT 28
B9</td>
<td>HYWEL JOHN DAVIES, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>32</td>
<td>08-10-2018 10:43:54</td>
<td>8124</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>992</td>
<td>MALTOFER TABLET </td>
<td>COMBIPHAR </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
 <td>10.00</td>
<td>3,080.00</td>
<td>30,800.00</td>
<td>0.00</td>
<td>3,080.00</td>
<td>33,880.00</td>

</tr>

<tr>
<td>33</td>
<td>08-10-2018 09:04:51</td>
<td>8127</td>
<td>42579</td>
<td>PURWANDARI NY.</td>
<td>31-12-1980</td>
<td></td>
<td>KARYAWAN YPK</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>4000</td>
<td>XEPAZYM CAP</td>
<td>METISKA FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>24.00</td>
<td>3,800.00</td>
<td>91,200.00</td>
<td>0.00</td>
<td>9,120.00</td>
<td>100,320.00</td>

</tr>

<tr>
<td>34</td>
<td>08-10-2018 09:04:51</td>
<td>8127</td>
<td>42579</td>
<td>PURWANDARI NY.</td>
<td>31-12-1980</td>
<td></td>
<td>KARYAWAN YPK</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>4624</td>
<td>ORINOX 90MG</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>11,400.00</td>
<td>34,200.00</td>
<td>0.00</td>
<td>3,420.00</td>
 <td>37,620.00</td>

</tr>

<tr>
<td>35</td>
<td>08-10-2018 11:56:34</td>
<td>8128</td>
<td>44769</td>
<td>GABRIEL KAYANA WIADJI,BY</td>
<td>30-05-2012</td>
<td></td>
<td>ARIES SIMON WIADJI, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4417</td>
<td>CONSTANTIA ORAL DROP</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>45,602.00</td>
<td>45,602.00</td>
<td>0.00</td>
<td>4,560.20</td>
<td>50,162.20</td>

</tr>

<tr>
<td>36</td>
<td>08-10-2018 11:56:34</td>
<td>8128</td>
<td>44769</td>
<td>GABRIEL KAYANA WIADJI,BY</td>
<td>30-05-2012</td>
<td></td>
<td>ARIES SIMON WIADJI, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>934</td>
<td>ISPRINOL SIRUP </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>114,000.00</td>
<td>114,000.00</td>
<td>0.00</td>
<td>11,400.00</td>
<td>125,400.00</td>

</tr>
<tr>
<td>37</td>
<td>08-10-2018 11:56:01</td>
<td>8129</td>
<td>54317</td>
<td>MIKAEL ALEA WIADJI</td>
<td>06-11-2013</td>
<td></td>
<td>-</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4417</td>
<td>CONSTANTIA ORAL DROP</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>45,602.00</td>
<td>45,602.00</td>
<td>0.00</td>
<td>4,560.20</td>
<td>50,162.20</td>

</tr>

<tr>
<td>38</td>
<td>08-10-2018 11:56:01</td>
<td>8129</td>
<td>54317</td>
<td>MIKAEL ALEA WIADJI</td>
<td>06-11-2013</td>
<td></td>
<td>-</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>931</td>
<td>ISOPRINOSIN SYR.60ML </td>
<td>DARYA VARIA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>149,626.00</td>
<td>149,626.00</td>
<td>0.00</td>
<td>14,962.60</td>
<td>164,588.60</td>

</tr>

<tr>
<td>39</td>
<td>08-10-2018 13:08:58</td>
<td>8131</td>
<td>88099</td>
 <td>ARKAN RAFARDHAN, BY</td>
<td>02-05-2018</td>
<td>JL. MENTENG GRANIT GANG 2 NO.14 RT.013 RW.07</td>
<td>MAH'DIAR KUSUMA R, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>538.80</td>
<td>538.80</td>
<td>0.00</td>
<td>53.88</td>
<td>592.68</td>

</tr>

<tr>
<td>40</td>
<td>08-10-2018 13:08:58</td>
<td>8131</td>
<td>88099</td>
<td>ARKAN RAFARDHAN, BY</td>
<td>02-05-2018</td>
<td>JL. MENTENG GRANIT GANG 2 NO.14 RT.013 RW.07</td>
<td>MAH'DIAR KUSUMA R, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1143</td>
<td>PREVENAR 13 PFS0,5ML </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>741,818.40</td>
<td>741,818.40</td>
<td>0.00</td>
<td>74,181.84</td>
<td>816,000.24</td>

</tr>

<tr>
<td>41</td>
<td>08-10-2018 13:08:58</td>
<td>8131</td>
<td>88099</td>
<td>ARKAN RAFARDHAN, BY</td>
<td>02-05-2018</td>
<td>JL. MENTENG GRANIT GANG 2 NO.14 RT.013 RW.07</td>
<td>MAH'DIAR KUSUMA R, TN</td>
<td>dr. Erlin Juwita , SpA</td>
 <td>RAWAT JALAN</td>
<td>865</td>
<td>FERRIZ DROPS </td>
<td>NICHOLAS </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>36,000.00</td>
<td>36,000.00</td>
<td>0.00</td>
<td>3,600.00</td>
<td>39,600.00</td>

</tr>

<tr>
<td>42</td>
<td>08-10-2018 13:05:30</td>
<td>8133</td>
<td>91896</td>
<td>DELLA AMELIA RULIANTI, NY</td>
<td>29-04-1994</td>
<td>JL. CEMPAKA RAYA NO. 29 012/07</td>
<td>OLIVERDINAND, TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>2768</td>
<td>SUMAGESIC TAB</td>
<td>UAP </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>651.00</td>
<td>1,953.00</td>
<td>0.00</td>
<td>195.30</td>
<td>2,148.30</td>

</tr>

<tr>
<td>43</td>
<td>08-10-2018 14:45:58</td>
<td>8136</td>
<td>91897</td>
<td>FADYA ALLYSA NAZELLYN, NN</td>
<td>15-04-2004</td>
<td>JL PEJAMBON I NO.1 01/01</td>
<td>HALIMAH, NY (IBU)</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>476</td>
<td>TRANSOFIX 4090500 </td>
<td>B.Braun </td>
<td>UMUM</td>
 <td>BPJS</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>10,488.00</td>
<td>10,488.00</td>
<td>0.00</td>
<td>1,048.80</td>
<td>11,536.80</td>

</tr>

<tr>
<td>44</td>
<td>08-10-2018 14:45:58</td>
<td>8136</td>
<td>91897</td>
<td>FADYA ALLYSA NAZELLYN, NN</td>
<td>15-04-2004</td>
<td>JL PEJAMBON I NO.1 01/01</td>
<td>HALIMAH, NY (IBU)</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>701</td>
<td>CEFIXIME 100 </td>
<td>OGB </td>
<td>UMUM</td>
<td>BPJS</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>3,309.00</td>
<td>19,854.00</td>
<td>0.00</td>
<td>1,985.40</td>
<td>21,839.40</td>

</tr>

<tr>
<td>45</td>
<td>08-10-2018 14:45:58</td>
<td>8136</td>
<td>91897</td>
<td>FADYA ALLYSA NAZELLYN, NN</td>
<td>15-04-2004</td>
<td>JL PEJAMBON I NO.1 01/01</td>
<td>HALIMAH, NY (IBU)</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>BPJS</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>20,976.00</td>
<td>20,976.00</td>
 <td>0.00</td>
<td>2,097.60</td>
<td>23,073.60</td>

</tr>

<tr>
<td>46</td>
<td>08-10-2018 10:03:15</td>
<td>8137</td>
<td>66675</td>
<td>HEINRICH JASON HANDOYO, AN</td>
<td>15-07-2015</td>
<td>TORONTO YB 5/40 LIMUSNUNGGAL KOTA WISATA</td>
<td>YUSTINUS TRI HANDOYO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1036</td>
<td>MUCOPECT PED.ELIX 15/5ML 60ML</td>
<td>BOEHRINGER INGELHEIM </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>71,288.00</td>
<td>71,288.00</td>
<td>0.00</td>
<td>7,128.80</td>
<td>78,416.80</td>

</tr>

<tr>
<td>47</td>
<td>08-10-2018 10:03:15</td>
<td>8137</td>
<td>66675</td>
<td>HEINRICH JASON HANDOYO, AN</td>
<td>15-07-2015</td>
<td>TORONTO YB 5/40 LIMUSNUNGGAL KOTA WISATA</td>
<td>YUSTINUS TRI HANDOYO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1274</td>
<td>TEMPRA FORTE SYR 60 ML </td>
<td>TAISHO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>55,936.00</td>
<td>55,936.00</td>
<td>0.00</td>
<td>5,593.60</td>
<td>61,529.60</td>
</tr>

<tr>
<td>48</td>
<td>08-10-2018 10:03:15</td>
<td>8137</td>
<td>66675</td>
<td>HEINRICH JASON HANDOYO, AN</td>
<td>15-07-2015</td>
<td>TORONTO YB 5/40 LIMUSNUNGGAL KOTA WISATA</td>
<td>YUSTINUS TRI HANDOYO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3662</td>
<td>VAPORIN</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>8,360.00</td>
<td>83,600.00</td>
<td>0.00</td>
<td>8,360.00</td>
<td>91,960.00</td>

</tr>

<tr>
<td>49</td>
<td>08-10-2018 10:03:15</td>
<td>8137</td>
<td>66675</td>
<td>HEINRICH JASON HANDOYO, AN</td>
<td>15-07-2015</td>
<td>TORONTO YB 5/40 LIMUSNUNGGAL KOTA WISATA</td>
<td>YUSTINUS TRI HANDOYO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>914</td>
<td>ILIADIN PEAD DROP </td>
<td>MERCK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>75,585.00</td>
<td>75,585.00</td>
<td>0.00</td>
<td>7,558.50</td>
<td>83,143.50</td>

</tr>

<tr>
<td>50</td>
<td>08-10-2018 10:03:15</td>
 <td>8137</td>
<td>66675</td>
<td>HEINRICH JASON HANDOYO, AN</td>
<td>15-07-2015</td>
<td>TORONTO YB 5/40 LIMUSNUNGGAL KOTA WISATA</td>
<td>YUSTINUS TRI HANDOYO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1193</td>
<td>RHINOS JUNIOR SIRUP 60ML</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>45,600.00</td>
<td>45,600.00</td>
<td>0.00</td>
<td>4,560.00</td>
<td>50,160.00</td>

</tr>

<tr>
<td>51</td>
<td>08-10-2018 10:03:15</td>
<td>8137</td>
<td>66675</td>
<td>HEINRICH JASON HANDOYO, AN</td>
<td>15-07-2015</td>
<td>TORONTO YB 5/40 LIMUSNUNGGAL KOTA WISATA</td>
<td>YUSTINUS TRI HANDOYO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>962</td>
<td>LACTO-B </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>8,968.00</td>
<td>134,520.00</td>
<td>0.00</td>
<td>13,452.00</td>
<td>147,972.00</td>

</tr>

<tr>
<td>52</td>
<td>08-10-2018 10:07:26</td>
<td>8138</td>
<td>82241</td>
<td>JOURELL OMAR YASHASKAR, BY</td>
<td>03-09-2017</td>
<td>PADURENAN RT.02 RW.03 NO.70</td>
 <td>YOHANES TRIHARTANTO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1249</td>
<td>STESOLID RECTAL 5 MG </td>
<td>ACTAVIS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>36,115.00</td>
<td>36,115.00</td>
<td>0.00</td>
<td>3,611.50</td>
<td>39,726.50</td>

</tr>

<tr>
<td>53</td>
<td>08-10-2018 10:07:26</td>
<td>8138</td>
<td>82241</td>
<td>JOURELL OMAR YASHASKAR, BY</td>
<td>03-09-2017</td>
<td>PADURENAN RT.02 RW.03 NO.70</td>
<td>YOHANES TRIHARTANTO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1153</td>
<td>PROLACTA FOR BABY </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,600.00</td>
<td>228,000.00</td>
<td>0.00</td>
<td>22,800.00</td>
<td>250,800.00</td>

</tr>

<tr>
<td>54</td>
<td>08-10-2018 10:15:27</td>
<td>8140</td>
<td>91898</td>
<td>SURYATI PANGESTU PRIHANDINI, NY</td>
<td>08-04-1978</td>
<td>PTB DUREN SAWIT BLOK R3/27 08/09 DUREN SAWIT JAKTIM</td>
<td>DIDI SURYADI, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>475</td>
<td>TRAMAL SUPP </td>
 <td>PHAROS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>22,800.00</td>
<td>22,800.00</td>
<td>0.00</td>
<td>2,280.00</td>
<td>25,080.00</td>

</tr>

<tr>
<td>55</td>
<td>08-10-2018 11:00:26</td>
<td>8141</td>
<td>80334</td>
<td>DEWI KUMALASARI, NY</td>
<td>26-09-1988</td>
<td>APARTMENT PANCORAN RIVERSIDE JAKSEL</td>
<td>OMAR AKBAR, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>2187</td>
<td>NEBACETIN OINT 5 GR </td>
<td>PHAROS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>25,840.00</td>
<td>25,840.00</td>
<td>0.00</td>
<td>2,584.00</td>
<td>28,424.00</td>

</tr>

<tr>
<td>56</td>
<td>08-10-2018 10:28:45</td>
<td>8143</td>
<td>73241</td>
<td>FERIAL SAAD HADI.DRG, NY</td>
<td>04-03-1970</td>
<td>JL. AMIL II, KAV.3 PEJATEN PAS.MINGGU JKSEL</td>
<td>ANDRI HADI, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>665</td>
<td>BUSCOPAN PLUS </td>
<td>BOEHRINGER INGELHEIM </td>
<td>UMUM</td>
<td>JASINDO HEALTH CARE</td>
<td>FARMASI B</td>
<td>6.00</td>
 <td>5,849.00</td>
<td>35,094.00</td>
<td>0.00</td>
<td>3,509.40</td>
<td>38,603.40</td>

</tr>

<tr>
<td>57</td>
<td>08-10-2018 10:28:45</td>
<td>8143</td>
<td>73241</td>
<td>FERIAL SAAD HADI.DRG, NY</td>
<td>04-03-1970</td>
<td>JL. AMIL II, KAV.3 PEJATEN PAS.MINGGU JKSEL</td>
<td>ANDRI HADI, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1096</td>
<td>OSSORAL 800 </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>JASINDO HEALTH CARE</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,232.00</td>
<td>186,960.00</td>
<td>0.00</td>
<td>18,696.00</td>
<td>205,656.00</td>

</tr>

<tr>
<td>58</td>
<td>08-10-2018 10:28:45</td>
<td>8143</td>
<td>73241</td>
<td>FERIAL SAAD HADI.DRG, NY</td>
<td>04-03-1970</td>
<td>JL. AMIL II, KAV.3 PEJATEN PAS.MINGGU JKSEL</td>
<td>ANDRI HADI, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>4470</td>
<td>INBUMIN</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>JASINDO HEALTH CARE</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,600.00</td>
<td>228,000.00</td>
<td>0.00</td>
<td>22,800.00</td>
<td>250,800.00</td>
</tr>

<tr>
<td>59</td>
<td>08-10-2018 10:28:45</td>
<td>8143</td>
<td>73241</td>
<td>FERIAL SAAD HADI.DRG, NY</td>
<td>04-03-1970</td>
<td>JL. AMIL II, KAV.3 PEJATEN PAS.MINGGU JKSEL</td>
<td>ANDRI HADI, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>4394</td>
<td>FLUOMIZIN TABLET</td>
<td>EXELTIS</td>
<td>UMUM</td>
<td>JASINDO HEALTH CARE</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>44,333.00</td>
<td>265,998.00</td>
<td>0.00</td>
<td>26,599.80</td>
<td>292,597.80</td>

</tr>

<tr>
<td>60</td>
<td>08-10-2018 10:28:45</td>
<td>8143</td>
<td>73241</td>
<td>FERIAL SAAD HADI.DRG, NY</td>
<td>04-03-1970</td>
<td>JL. AMIL II, KAV.3 PEJATEN PAS.MINGGU JKSEL</td>
<td>ANDRI HADI, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1015</td>
<td>MEZATRIN 250MG </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>JASINDO HEALTH CARE</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>20,930.00</td>
<td>125,580.00</td>
<td>0.00</td>
<td>12,558.00</td>
<td>138,138.00</td>

</tr>

<tr>
 <td>61</td>
<td>08-10-2018 10:21:22</td>
<td>8145</td>
<td>45773</td>
<td>JOVAUGHN CORNELIS P, AN</td>
<td>25-07-2012</td>
<td></td>
<td>YUSTIAN PANGGABEAN,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4774</td>
<td>DEXYCLAV 250 MG FDS SYR</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>116,280.00</td>
<td>116,280.00</td>
<td>0.00</td>
<td>11,628.00</td>
<td>127,908.00</td>

</tr>

<tr>
<td>62</td>
<td>08-10-2018 10:21:22</td>
<td>8145</td>
<td>45773</td>
<td>JOVAUGHN CORNELIS P, AN</td>
<td>25-07-2012</td>
<td></td>
<td>YUSTIAN PANGGABEAN,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1204</td>
<td>RYVEL SIRUP </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>76,000.00</td>
<td>76,000.00</td>
<td>0.00</td>
<td>7,600.00</td>
<td>83,600.00</td>

</tr>

<tr>
<td>63</td>
<td>08-10-2018 10:20:47</td>
<td>8146</td>
<td>28209</td>
<td>JORDYNN BIANCA G, AN</td>
 <td>29-09-2009</td>
<td></td>
<td>YUSTIAN AMRI ADI PANGABEAN TN.</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>64</td>
<td>08-10-2018 10:20:47</td>
<td>8146</td>
<td>28209</td>
<td>JORDYNN BIANCA G, AN</td>
<td>29-09-2009</td>
<td></td>
<td>YUSTIAN AMRI ADI PANGABEAN TN.</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3589</td>
<td>SPUIT 3 CC TERUMO</td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>6,992.00</td>
<td>6,992.00</td>
<td>0.00</td>
<td>699.20</td>
<td>7,691.20</td>

</tr>

<tr>
<td>65</td>
<td>08-10-2018 10:20:47</td>
<td>8146</td>
<td>28209</td>
<td>JORDYNN BIANCA G, AN</td>
<td>29-09-2009</td>
<td></td>
<td>YUSTIAN AMRI ADI PANGABEAN TN.</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
 <td>4675</td>
<td>VACCIN BIO TD</td>
<td>BIO FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>55,176.00</td>
<td>55,176.00</td>
<td>0.00</td>
<td>5,517.60</td>
<td>60,693.60</td>

</tr>

<tr>
<td>66</td>
<td>08-10-2018 11:10:59</td>
<td>8147</td>
<td>89614</td>
<td>FITRIA SABARUDDIN, NY</td>
<td>11-03-1985</td>
<td>JL HIBRIDA RAYA NO.41 RT.04 RW.06 </td>
<td>FABI HIMAWAN, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>2187</td>
<td>NEBACETIN OINT 5 GR </td>
<td>PHAROS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>25,840.00</td>
<td>25,840.00</td>
<td>0.00</td>
<td>2,584.00</td>
<td>28,424.00</td>

</tr>

<tr>
<td>67</td>
<td>08-10-2018 11:10:59</td>
<td>8147</td>
<td>89614</td>
<td>FITRIA SABARUDDIN, NY</td>
<td>11-03-1985</td>
<td>JL HIBRIDA RAYA NO.41 RT.04 RW.06 </td>
<td>FABI HIMAWAN, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>1004</td>
<td>MEFINAL 500MG </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
 <td>FARMASI B</td>
<td>15.00</td>
<td>1,923.00</td>
<td>28,845.00</td>
<td>0.00</td>
<td>2,884.50</td>
<td>31,729.50</td>

</tr>

<tr>
<td>68</td>
<td>08-10-2018 11:10:59</td>
<td>8147</td>
<td>89614</td>
<td>FITRIA SABARUDDIN, NY</td>
<td>11-03-1985</td>
<td>JL HIBRIDA RAYA NO.41 RT.04 RW.06 </td>
<td>FABI HIMAWAN, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>3792</td>
<td>METVELL 0.125 MG TAB</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>12.00</td>
<td>3,762.00</td>
<td>45,144.00</td>
<td>0.00</td>
<td>4,514.40</td>
<td>49,658.40</td>

</tr>

<tr>
<td>69</td>
<td>08-10-2018 11:15:39</td>
<td>8150</td>
<td>65293</td>
<td>HERA DIANI, NY</td>
<td>17-11-1976</td>
<td>APT. TAMAN RASUNA TOWER 2/LGD KUNINGAN JAKARTA SELATAN</td>
<td>PRIMATMOJO DJANOE, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>EQUITY</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
 <td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>70</td>
<td>08-10-2018 11:15:39</td>
<td>8150</td>
<td>65293</td>
<td>HERA DIANI, NY</td>
<td>17-11-1976</td>
<td>APT. TAMAN RASUNA TOWER 2/LGD KUNINGAN JAKARTA SELATAN</td>
<td>PRIMATMOJO DJANOE, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>889</td>
<td>GARDASIL </td>
<td>MERCK </td>
<td>UMUM</td>
<td>EQUITY</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>1,026,000.00</td>
<td>1,026,000.00</td>
<td>0.00</td>
<td>102,600.00</td>
<td>1,128,600.00</td>

</tr>

<tr>
<td>71</td>
<td>08-10-2018 10:55:01</td>
<td>8151</td>
<td>80580</td>
<td>BENAYA YESAYA SIAGIAN, AN</td>
<td>17-06-2017</td>
<td>JL.O NO.19 07/01 CIPINANG MUARA</td>
<td>HERNA SELVIA P.S, NY</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1212</td>
<td>SANMOL DROPS </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>AIA</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>22,648.00</td>
<td>22,648.00</td>
<td>0.00</td>
<td>2,264.80</td>
<td>24,912.80</td>

</tr>
<tr>
<td>72</td>
<td>08-10-2018 10:55:01</td>
<td>8151</td>
<td>80580</td>
<td>BENAYA YESAYA SIAGIAN, AN</td>
<td>17-06-2017</td>
<td>JL.O NO.19 07/01 CIPINANG MUARA</td>
<td>HERNA SELVIA P.S, NY</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4320</td>
<td>IPROX SYR 60ML</td>
<td>UMUM</td>
<td>UMUM</td>
<td>AIA</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>68,400.00</td>
<td>68,400.00</td>
<td>0.00</td>
<td>6,840.00</td>
<td>75,240.00</td>

</tr>

<tr>
<td>73</td>
<td>08-10-2018 11:09:59</td>
<td>8152</td>
<td>90222</td>
<td>NURSYITA PURNAMI, NY</td>
<td>19-05-1991</td>
<td>KP RANCASARI 003/004 BOGOR</td>
<td>SONA TRIYANTO, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>1345</td>
<td>VITAMAM 2 </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>28.00</td>
<td>5,211.00</td>
<td>145,908.00</td>
<td>0.00</td>
<td>14,590.80</td>
<td>160,498.80</td>

</tr>

<tr>
<td>74</td>
<td>08-10-2018 11:09:59</td>
<td>8152</td>
 <td>90222</td>
<td>NURSYITA PURNAMI, NY</td>
<td>19-05-1991</td>
<td>KP RANCASARI 003/004 BOGOR</td>
<td>SONA TRIYANTO, TN</td>
<td>dr. Dyah Irawati, SpOG</td>
<td>RAWAT JALAN</td>
<td>1094</td>
<td>OSFIT DHA TAB </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,570.67</td>
<td>197,120.10</td>
<td>0.00</td>
<td>19,712.01</td>
<td>216,832.11</td>

</tr>

<tr>
<td>75</td>
<td>08-10-2018 10:56:36</td>
<td>8154</td>
<td>60246</td>
<td>BATARA YODA TOHA WALUYO, AN</td>
<td>16-09-2014</td>
<td>JL. H. MURTADO VIII NO. B59 013/05</td>
<td>MASHURI WALUYO PUTRA,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1689</td>
<td>CENDO FENICOL 0,25 % EYE DROP</td>
<td>CENDO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>36,575.00</td>
<td>36,575.00</td>
<td>0.00</td>
<td>3,657.50</td>
<td>40,232.50</td>

</tr>

<tr>
<td>76</td>
<td>08-10-2018 10:56:36</td>
<td>8154</td>
<td>60246</td>
<td>BATARA YODA TOHA WALUYO, AN</td>
<td>16-09-2014</td>
<td>JL. H. MURTADO VIII NO. B59 013/05</td>
<td>MASHURI WALUYO PUTRA,TN</td>
 <td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3316</td>
<td>CENDO LYTEERS 15ML</td>
<td>CENDO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>34,200.00</td>
<td>34,200.00</td>
<td>0.00</td>
<td>3,420.00</td>
<td>37,620.00</td>

</tr>

<tr>
<td>77</td>
<td>08-10-2018 10:57:27</td>
<td>8155</td>
<td>74667</td>
<td>FAZIA SAIRA WALUYO, BY</td>
<td>07-09-2016</td>
<td>JL. H. MURTADO 8 NO. 59 B RT. 013 RW. 05 SALEMBA BLUNTAS</td>
<td>MASHURI WALUYO PUTRA, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>78</td>
<td>08-10-2018 10:57:27</td>
<td>8155</td>
<td>74667</td>
<td>FAZIA SAIRA WALUYO, BY</td>
<td>07-09-2016</td>
<td>JL. H. MURTADO 8 NO. 59 B RT. 013 RW. 05 SALEMBA BLUNTAS</td>
<td>MASHURI WALUYO PUTRA, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1286</td>
<td>TYPHIM (TYPUS) </td>
<td>Sanofi Pasteur </td>
 <td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>230,160.00</td>
<td>230,160.00</td>
<td>0.00</td>
<td>23,016.00</td>
<td>253,176.00</td>

</tr>

<tr>
<td>79</td>
<td>08-10-2018 12:34:46</td>
<td>8157</td>
<td>61055</td>
<td>ARYA ALEXANDER SEBASTIAN, AN</td>
<td>24-09-2014</td>
<td>JL. KEBON PALA 2 NO. 11 KAMPUNG MELAYU</td>
<td>PITER ALWIN SUTIOSO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>723</td>
<td>CETIRIZIN TAB 10 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>BPJS</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>866.00</td>
<td>2,598.00</td>
<td>0.00</td>
<td>259.80</td>
<td>2,857.80</td>

</tr>

<tr>
<td>80</td>
<td>08-10-2018 12:34:46</td>
<td>8157</td>
<td>61055</td>
<td>ARYA ALEXANDER SEBASTIAN, AN</td>
<td>24-09-2014</td>
<td>JL. KEBON PALA 2 NO. 11 KAMPUNG MELAYU</td>
<td>PITER ALWIN SUTIOSO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4429</td>
<td>LASAL SYR 100 ML</td>
<td>LAPI </td>
<td>UMUM</td>
<td>BPJS</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>38,000.00</td>
 <td>38,000.00</td>
<td>0.00</td>
<td>3,800.00</td>
<td>41,800.00</td>

</tr>

<tr>
<td>81</td>
<td>08-10-2018 12:34:46</td>
<td>8157</td>
<td>61055</td>
<td>ARYA ALEXANDER SEBASTIAN, AN</td>
<td>24-09-2014</td>
<td>JL. KEBON PALA 2 NO. 11 KAMPUNG MELAYU</td>
<td>PITER ALWIN SUTIOSO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>BPJS</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>285.00</td>
<td>285.00</td>
<td>0.00</td>
<td>28.50</td>
<td>313.50</td>

</tr>

<tr>
<td>82</td>
<td>08-10-2018 12:34:46</td>
<td>8157</td>
<td>61055</td>
<td>ARYA ALEXANDER SEBASTIAN, AN</td>
<td>24-09-2014</td>
<td>JL. KEBON PALA 2 NO. 11 KAMPUNG MELAYU</td>
<td>PITER ALWIN SUTIOSO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>BPJS</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>69.66</td>
<td>696.60</td>
<td>0.00</td>
<td>69.66</td>
<td>766.26</td>
</tr>

<tr>
<td>83</td>
<td>08-10-2018 10:24:15</td>
<td>8158</td>
<td>78751</td>
<td>IBRAHIM ICHSAN, AN</td>
<td>13-04-2012</td>
<td>JL.MOTI NO.8 ROXY </td>
<td>ICHSAN CHOZIE, TN ( AYAH )</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>549</td>
<td>ACTIFED EXPECTORANT 60 ML (HI</td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>67,798.00</td>
<td>67,798.00</td>
<td>0.00</td>
<td>6,779.80</td>
<td>74,577.80</td>

</tr>

<tr>
<td>84</td>
<td>08-10-2018 11:38:41</td>
<td>8167</td>
<td>84500</td>
<td>DEBBY PRIYAYI, NY</td>
<td>23-01-1992</td>
<td>JL.PERDATA 3 BLOK BG NO.8 TANGGERANG</td>
<td>BANGUN SUGITO, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>607</td>
<td>ASAM MEFENAMAT 500 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>10.00</td>
<td>238.00</td>
<td>2,380.00</td>
<td>0.00</td>
<td>238.00</td>
<td>2,618.00</td>

</tr>

<tr>
<td>85</td>
 <td>08-10-2018 11:38:41</td>
<td>8167</td>
<td>84500</td>
<td>DEBBY PRIYAYI, NY</td>
<td>23-01-1992</td>
<td>JL.PERDATA 3 BLOK BG NO.8 TANGGERANG</td>
<td>BANGUN SUGITO, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>4572</td>
<td>LEXATRANS 500</td>
<td>MOLEX AYUS</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>15.00</td>
<td>1,512.00</td>
<td>22,680.00</td>
<td>0.00</td>
<td>2,268.00</td>
<td>24,948.00</td>

</tr>

<tr>
<td>86</td>
<td>08-10-2018 12:10:53</td>
<td>8169</td>
<td>81811</td>
<td>IGNATIUS ALDRIC RISKIANO, AN</td>
<td>20-08-2017</td>
<td>JL. TAMAN PULO ASEM UTARA NO. 4 RT007/001</td>
<td>ANTONIUS RISKIANU, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1194</td>
<td>RHINOS NEO DROP </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>ASKES RAMAYANA</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>65,360.00</td>
<td>65,360.00</td>
<td>0.00</td>
<td>6,536.00</td>
<td>71,896.00</td>

</tr>

<tr>
<td>87</td>
<td>08-10-2018 12:10:53</td>
<td>8169</td>
<td>81811</td>
<td>IGNATIUS ALDRIC RISKIANO, AN</td>
<td>20-08-2017</td>
 <td>JL. TAMAN PULO ASEM UTARA NO. 4 RT007/001</td>
<td>ANTONIUS RISKIANU, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1246</td>
<td>STERIMAR BABY NASAL HYGIENE </td>
<td>HYPHENS </td>
<td>UMUM</td>
<td>ASKES RAMAYANA</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>179,360.00</td>
<td>179,360.00</td>
<td>0.00</td>
<td>17,936.00</td>
<td>197,296.00</td>

</tr>

<tr>
<td>88</td>
<td>08-10-2018 12:10:53</td>
<td>8169</td>
<td>81811</td>
<td>IGNATIUS ALDRIC RISKIANO, AN</td>
<td>20-08-2017</td>
<td>JL. TAMAN PULO ASEM UTARA NO. 4 RT007/001</td>
<td>ANTONIUS RISKIANU, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3662</td>
<td>VAPORIN</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>ASKES RAMAYANA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>8,360.00</td>
<td>83,600.00</td>
<td>0.00</td>
<td>8,360.00</td>
<td>91,960.00</td>

</tr>

<tr>
<td>89</td>
<td>08-10-2018 12:10:53</td>
<td>8169</td>
<td>81811</td>
<td>IGNATIUS ALDRIC RISKIANO, AN</td>
<td>20-08-2017</td>
<td>JL. TAMAN PULO ASEM UTARA NO. 4 RT007/001</td>
<td>ANTONIUS RISKIANU, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4429</td>
 <td>LASAL SYR 100 ML</td>
<td>LAPI </td>
<td>UMUM</td>
<td>ASKES RAMAYANA</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>38,000.00</td>
<td>38,000.00</td>
<td>0.00</td>
<td>3,800.00</td>
<td>41,800.00</td>

</tr>

<tr>
<td>90</td>
<td>08-10-2018 10:53:55</td>
<td>8174</td>
<td>27145</td>
<td>ONIE FARIED.NY</td>
<td>10-08-1961</td>
<td></td>
<td>FARID D MUHAMMAD. TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>20,976.00</td>
<td>20,976.00</td>
<td>0.00</td>
<td>2,097.60</td>
<td>23,073.60</td>

</tr>

<tr>
<td>91</td>
<td>08-10-2018 10:53:55</td>
<td>8174</td>
<td>27145</td>
<td>ONIE FARIED.NY</td>
<td>10-08-1961</td>
<td></td>
<td>FARID D MUHAMMAD. TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>476</td>
<td>TRANSOFIX 4090500 </td>
<td>B.Braun </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
 <td>1.00</td>
<td>10,488.00</td>
<td>10,488.00</td>
<td>0.00</td>
<td>1,048.80</td>
<td>11,536.80</td>

</tr>

<tr>
<td>92</td>
<td>08-10-2018 10:04:09</td>
<td>8175</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>342</td>
<td>PEMBALUT BERSALIN(SOFTEX)</td>
<td>SOFTEX </td>
<td></td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>25,840.00</td>
<td>25,840.00</td>
<td>0.00</td>
<td>2,584.00</td>
<td>28,424.00</td>

</tr>

<tr>
<td>93</td>
<td>08-10-2018 11:28:09</td>
<td>8179</td>
<td>36531</td>
<td>NAMIAH AISHA ABHINAYA AN.</td>
<td>11-03-2011</td>
<td></td>
<td>TITTO DEVIANTO TN.</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>599</td>
<td>APIALYS SYRUP 100ML</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>50,160.00</td>
<td>50,160.00</td>
<td>0.00</td>
<td>5,016.00</td>
 <td>55,176.00</td>

</tr>

<tr>
<td>94</td>
<td>08-10-2018 11:28:59</td>
<td>8180</td>
<td>24691</td>
<td>NADINI MAHANANI NY.</td>
<td>01-06-1981</td>
<td></td>
<td>TITTO DEVIANTO TN.</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>939</td>
<td>KALNEX 500MG </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>4,864.00</td>
<td>48,640.00</td>
<td>0.00</td>
<td>4,864.00</td>
<td>53,504.00</td>

</tr>

<tr>
<td>95</td>
<td>08-10-2018 20:37:32</td>
<td>8181</td>
<td>91832</td>
<td>JESY TAFIANI, NY</td>
<td>19-06-1993</td>
<td>JL.MESJID ALHUSNA DUA RT.004/001</td>
<td>ARDITYO WIBOWO, TN</td>
<td>dr. H. Finekri Abidin, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>1061</td>
<td>NOPROSTOL TAB </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>16,088.10</td>
<td>16,088.10</td>
<td>0.00</td>
<td>0.00</td>
<td>16,088.10</td>

</tr>
<tr>
<td>96</td>
<td>08-10-2018 13:01:02</td>
<td>8182</td>
<td>1712</td>
<td>DIAN SITA SARI, NY</td>
<td>25-05-1969</td>
<td>JL CIBULAN 1 NO.14 PETOGOGAN KEB.BARU JAKSEL</td>
<td>ARI HARDONO,TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1015</td>
<td>MEZATRIN 250MG </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>20,930.00</td>
<td>125,580.00</td>
<td>0.00</td>
<td>12,558.00</td>
<td>138,138.00</td>

</tr>

<tr>
<td>97</td>
<td>08-10-2018 13:01:02</td>
<td>8182</td>
<td>1712</td>
<td>DIAN SITA SARI, NY</td>
<td>25-05-1969</td>
<td>JL CIBULAN 1 NO.14 PETOGOGAN KEB.BARU JAKSEL</td>
<td>ARI HARDONO,TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1066</td>
<td>NOVA T </td>
<td>BAYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>380,395.00</td>
<td>380,395.00</td>
<td>0.00</td>
<td>38,039.50</td>
<td>418,434.50</td>

</tr>

<tr>
<td>98</td>
<td>08-10-2018 13:01:02</td>
<td>8182</td>
<td>1712</td>
 <td>DIAN SITA SARI, NY</td>
<td>25-05-1969</td>
<td>JL CIBULAN 1 NO.14 PETOGOGAN KEB.BARU JAKSEL</td>
<td>ARI HARDONO,TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>397</td>
<td>SARUNG TANGAN N0 8 </td>
<td>GAMEX </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>27,360.00</td>
<td>27,360.00</td>
<td>0.00</td>
<td>2,736.00</td>
<td>30,096.00</td>

</tr>

<tr>
<td>99</td>
<td>08-10-2018 13:01:02</td>
<td>8182</td>
<td>1712</td>
<td>DIAN SITA SARI, NY</td>
<td>25-05-1969</td>
<td>JL CIBULAN 1 NO.14 PETOGOGAN KEB.BARU JAKSEL</td>
<td>ARI HARDONO,TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1004</td>
<td>MEFINAL 500MG </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>1,923.00</td>
<td>11,538.00</td>
<td>0.00</td>
<td>1,153.80</td>
<td>12,691.80</td>

</tr>

<tr>
<td>100</td>
<td>08-10-2018 11:59:21</td>
<td>8183</td>
<td>67396</td>
<td>LASAPRIMA KENZAHRA, NY</td>
<td>04-05-1988</td>
<td>JL. BULUH NO. 19A RT/07/01 BALEKAMBANG KRAMAT JATI</td>
<td>ADI PRAJA, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
 <td>RAWAT JALAN</td>
<td>911</td>
<td>HYSTOLAN STR 20MG</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>RELIANCE</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>6,840.00</td>
<td>68,400.00</td>
<td>0.00</td>
<td>6,840.00</td>
<td>75,240.00</td>

</tr>

<tr>
<td>101</td>
<td>08-10-2018 11:12:59</td>
<td>8184</td>
<td>86263</td>
<td>DEASY NATALIA SIBARANI, NY</td>
<td>06-12-1990</td>
<td>APARTEMNT KUSUMA CANDRA TOWER 2 UNIT ZE SCBD RT.005
RW.003</td>
<td>LUCAS WELFRIED PANDJAITAN, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1368</td>
<td>ZEGAVIT </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>4,250.40</td>
<td>127,512.00</td>
<td>0.00</td>
<td>12,751.20</td>
<td>140,263.20</td>

</tr>

<tr>
<td>102</td>
<td>08-10-2018 11:12:59</td>
<td>8184</td>
<td>86263</td>
<td>DEASY NATALIA SIBARANI, NY</td>
<td>06-12-1990</td>
<td>APARTEMNT KUSUMA CANDRA TOWER 2 UNIT ZE SCBD RT.005
RW.003</td>
<td>LUCAS WELFRIED PANDJAITAN, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>967</td>
<td>LANAKELOID-E CREAM 10GR </td>
 <td>LANDSON </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>136,800.00</td>
<td>136,800.00</td>
<td>0.00</td>
<td>13,680.00</td>
<td>150,480.00</td>

</tr>

<tr>
<td>103</td>
<td>08-10-2018 11:12:59</td>
<td>8184</td>
<td>86263</td>
<td>DEASY NATALIA SIBARANI, NY</td>
<td>06-12-1990</td>
<td>APARTEMNT KUSUMA CANDRA TOWER 2 UNIT ZE SCBD RT.005
RW.003</td>
<td>LUCAS WELFRIED PANDJAITAN, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1094</td>
<td>OSFIT DHA TAB </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>60.00</td>
<td>6,570.67</td>
<td>394,240.20</td>
<td>0.00</td>
<td>39,424.02</td>
<td>433,664.22</td>

</tr>

<tr>
<td>104</td>
<td>08-10-2018 13:05:04</td>
<td>8185</td>
<td>91896</td>
<td>DELLA AMELIA RULIANTI, NY</td>
<td>29-04-1994</td>
<td>JL. CEMPAKA RAYA NO. 29 012/07</td>
<td>OLIVERDINAND, TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>1310</td>
<td>UTROGESTAN 100 MG CAPS </td>
<td>LAPI </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
 <td>15.00</td>
<td>40,425.00</td>
<td>606,375.00</td>
<td>0.00</td>
<td>60,637.50</td>
<td>667,012.50</td>

</tr>

<tr>
<td>105</td>
<td>08-10-2018 13:05:04</td>
<td>8185</td>
<td>91896</td>
<td>DELLA AMELIA RULIANTI, NY</td>
<td>29-04-1994</td>
<td>JL. CEMPAKA RAYA NO. 29 012/07</td>
<td>OLIVERDINAND, TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>881</td>
<td>FOLAVIT </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>1,199.00</td>
<td>17,985.00</td>
<td>0.00</td>
<td>1,798.50</td>
<td>19,783.50</td>

</tr>

<tr>
<td>106</td>
<td>08-10-2018 13:16:32</td>
<td>8188</td>
<td>66064</td>
<td>IRDYA MELLYNA IVANNY, NY</td>
<td>30-05-1988</td>
<td>TARIAN RAYA TIMUR B 4 NO. 2 PEGANGSAAN DUA</td>
<td>WENDI BIMO CAHYO, TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>1345</td>
<td>VITAMAM 2 </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>PT. AXA INDONESIA </td>
<td>FARMASI B</td>
<td>28.00</td>
<td>5,211.00</td>
<td>145,908.00</td>
<td>0.00</td>
<td>14,590.80</td>
 <td>160,498.80</td>

</tr>

<tr>
<td>107</td>
<td>08-10-2018 13:16:32</td>
<td>8188</td>
<td>66064</td>
<td>IRDYA MELLYNA IVANNY, NY</td>
<td>30-05-1988</td>
<td>TARIAN RAYA TIMUR B 4 NO. 2 PEGANGSAAN DUA</td>
<td>WENDI BIMO CAHYO, TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>4301</td>
<td>VITAMIN D3 1000IU</td>
<td>UMUM</td>
<td>UMUM</td>
<td>PT. AXA INDONESIA </td>
<td>FARMASI B</td>
<td>30.00</td>
<td>4,138.00</td>
<td>124,140.00</td>
<td>0.00</td>
<td>12,414.00</td>
<td>136,554.00</td>

</tr>

<tr>
<td>108</td>
<td>08-10-2018 13:16:32</td>
<td>8188</td>
<td>66064</td>
<td>IRDYA MELLYNA IVANNY, NY</td>
<td>30-05-1988</td>
<td>TARIAN RAYA TIMUR B 4 NO. 2 PEGANGSAAN DUA</td>
<td>WENDI BIMO CAHYO, TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>1096</td>
<td>OSSORAL 800 </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>PT. AXA INDONESIA </td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,232.00</td>
<td>186,960.00</td>
<td>0.00</td>
<td>18,696.00</td>
<td>205,656.00</td>

</tr>
<tr>
<td>109</td>
<td>08-10-2018 11:27:21</td>
<td>8190</td>
<td>45896</td>
<td>MARYANA SETYANINGRUM,NY</td>
<td>19-05-1986</td>
<td></td>
<td>KRIS FERDIYANTO,TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>110</td>
<td>08-10-2018 11:27:21</td>
<td>8190</td>
<td>45896</td>
<td>MARYANA SETYANINGRUM,NY</td>
<td>19-05-1986</td>
<td></td>
<td>KRIS FERDIYANTO,TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1094</td>
<td>OSFIT DHA TAB </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,570.67</td>
<td>197,120.10</td>
<td>0.00</td>
<td>19,712.01</td>
<td>216,832.11</td>

</tr>

<tr>
<td>111</td>
<td>08-10-2018 11:27:21</td>
<td>8190</td>
<td>45896</td>
 <td>MARYANA SETYANINGRUM,NY</td>
<td>19-05-1986</td>
<td></td>
<td>KRIS FERDIYANTO,TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>4301</td>
<td>VITAMIN D3 1000IU</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>4,138.00</td>
<td>124,140.00</td>
<td>0.00</td>
<td>12,414.00</td>
<td>136,554.00</td>

</tr>

<tr>
<td>112</td>
<td>08-10-2018 13:16:17</td>
<td>8191</td>
<td>52003</td>
<td>ELFRIDA DINAR P. NY</td>
<td>17-06-1984</td>
<td></td>
<td>CHRISMICUM FERNANDO SIAHAAN,TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1154</td>
<td>PROLACTA FOR MOTHER </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>7,220.00</td>
<td>108,300.00</td>
<td>0.00</td>
<td>10,830.00</td>
<td>119,130.00</td>

</tr>

<tr>
<td>113</td>
<td>08-10-2018 13:16:17</td>
<td>8191</td>
<td>52003</td>
<td>ELFRIDA DINAR P. NY</td>
<td>17-06-1984</td>
<td></td>
<td>CHRISMICUM FERNANDO SIAHAAN,TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
 <td>RAWAT JALAN</td>
<td>904</td>
<td>HEMOBION </td>
<td>MERCK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>2,803.00</td>
<td>84,090.00</td>
<td>0.00</td>
<td>8,409.00</td>
<td>92,499.00</td>

</tr>

<tr>
<td>114</td>
<td>08-10-2018 13:16:17</td>
<td>8191</td>
<td>52003</td>
<td>ELFRIDA DINAR P. NY</td>
<td>17-06-1984</td>
<td></td>
<td>CHRISMICUM FERNANDO SIAHAAN,TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1096</td>
<td>OSSORAL 800 </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>6,232.00</td>
<td>93,480.00</td>
<td>0.00</td>
<td>9,348.00</td>
<td>102,828.00</td>

</tr>

<tr>
<td>115</td>
<td>08-10-2018 12:32:53</td>
<td>8193</td>
<td>87070</td>
<td>FA ALESHA KHUMAIRA, AN </td>
<td>08-01-2018</td>
<td>JL.K.NO.1 </td>
<td>MIMBO BRAHMANTIKO, TN ( AYAH )</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1153</td>
<td>PROLACTA FOR BABY </td>
<td>NOVELL </td>
<td>UMUM</td>
 <td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,600.00</td>
<td>228,000.00</td>
<td>0.00</td>
<td>22,800.00</td>
<td>250,800.00</td>

</tr>

<tr>
<td>116</td>
<td>08-10-2018 12:32:53</td>
<td>8193</td>
<td>87070</td>
<td>FA ALESHA KHUMAIRA, AN </td>
<td>08-01-2018</td>
<td>JL.K.NO.1 </td>
<td>MIMBO BRAHMANTIKO, TN ( AYAH )</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>117</td>
<td>08-10-2018 12:32:53</td>
<td>8193</td>
<td>87070</td>
<td>FA ALESHA KHUMAIRA, AN </td>
<td>08-01-2018</td>
<td>JL.K.NO.1 </td>
<td>MIMBO BRAHMANTIKO, TN ( AYAH )</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3589</td>
<td>SPUIT 3 CC TERUMO</td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>6,992.00</td>
<td>6,992.00</td>
 <td>0.00</td>
<td>699.20</td>
<td>7,691.20</td>

</tr>

<tr>
<td>118</td>
<td>08-10-2018 12:32:53</td>
<td>8193</td>
<td>87070</td>
<td>FA ALESHA KHUMAIRA, AN </td>
<td>08-01-2018</td>
<td>JL.K.NO.1 </td>
<td>MIMBO BRAHMANTIKO, TN ( AYAH )</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>8,512.00</td>
<td>8,512.00</td>
<td>0.00</td>
<td>851.20</td>
<td>9,363.20</td>

</tr>

<tr>
<td>119</td>
<td>08-10-2018 12:32:53</td>
<td>8193</td>
<td>87070</td>
<td>FA ALESHA KHUMAIRA, AN </td>
<td>08-01-2018</td>
<td>JL.K.NO.1 </td>
<td>MIMBO BRAHMANTIKO, TN ( AYAH )</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>
</tr>

<tr>
<td>120</td>
<td>08-10-2018 12:32:53</td>
<td>8193</td>
<td>87070</td>
<td>FA ALESHA KHUMAIRA, AN </td>
<td>08-01-2018</td>
<td>JL.K.NO.1 </td>
<td>MIMBO BRAHMANTIKO, TN ( AYAH )</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>2628</td>
<td>VACCIN CAMPAK </td>
<td>BIO FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>145,464.00</td>
<td>145,464.00</td>
<td>0.00</td>
<td>14,546.40</td>
<td>160,010.40</td>

</tr>

<tr>
<td>121</td>
<td>08-10-2018 12:32:53</td>
<td>8193</td>
<td>87070</td>
<td>FA ALESHA KHUMAIRA, AN </td>
<td>08-01-2018</td>
<td>JL.K.NO.1 </td>
<td>MIMBO BRAHMANTIKO, TN ( AYAH )</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>865</td>
<td>FERRIZ DROPS </td>
<td>NICHOLAS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>45,600.00</td>
<td>45,600.00</td>
<td>0.00</td>
<td>4,560.00</td>
<td>50,160.00</td>

</tr>

<tr>
<td>122</td>
<td>08-10-2018 12:40:08</td>
 <td>8195</td>
<td>89550</td>
<td>ABDUL MUGHNI MUBARAK, BY</td>
<td>01-05-2018</td>
<td>JL. ADHYAKSA VI NO. 5</td>
<td>ARIE KURNIAWAN, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>2583</td>
<td>TRANSPULMIN BB 20 GR. </td>
<td>TRANSFARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>80,864.00</td>
<td>80,864.00</td>
<td>0.00</td>
<td>8,086.40</td>
<td>88,950.40</td>

</tr>

<tr>
<td>123</td>
<td>08-10-2018 12:40:08</td>
<td>8195</td>
<td>89550</td>
<td>ABDUL MUGHNI MUBARAK, BY</td>
<td>01-05-2018</td>
<td>JL. ADHYAKSA VI NO. 5</td>
<td>ARIE KURNIAWAN, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>2205</td>
<td>NIPE DROPS </td>
<td>MUGI LAB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>87,552.00</td>
<td>87,552.00</td>
<td>0.00</td>
<td>8,755.20</td>
<td>96,307.20</td>

</tr>

<tr>
<td>124</td>
<td>08-10-2018 12:40:08</td>
<td>8195</td>
<td>89550</td>
<td>ABDUL MUGHNI MUBARAK, BY</td>
<td>01-05-2018</td>
<td>JL. ADHYAKSA VI NO. 5</td>
 <td>ARIE KURNIAWAN, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3662</td>
<td>VAPORIN</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>8,360.00</td>
<td>83,600.00</td>
<td>0.00</td>
<td>8,360.00</td>
<td>91,960.00</td>

</tr>

<tr>
<td>125</td>
<td>08-10-2018 13:35:55</td>
<td>8196</td>
<td>28394</td>
<td>ALVINO ZAYYAN R AN </td>
<td>10-10-2009</td>
<td></td>
<td>ROMMY INDRA PUTRA TN </td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>OWLEXA HEALTH CARE</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>126</td>
<td>08-10-2018 13:35:55</td>
<td>8196</td>
<td>28394</td>
<td>ALVINO ZAYYAN R AN </td>
<td>10-10-2009</td>
<td></td>
<td>ROMMY INDRA PUTRA TN </td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4675</td>
<td>VACCIN BIO TD</td>
 <td>BIO FARMA </td>
<td>UMUM</td>
<td>OWLEXA HEALTH CARE</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>55,176.00</td>
<td>55,176.00</td>
<td>0.00</td>
<td>5,517.60</td>
<td>60,693.60</td>

</tr>

<tr>
<td>127</td>
<td>08-10-2018 13:35:55</td>
<td>8196</td>
<td>28394</td>
<td>ALVINO ZAYYAN R AN </td>
<td>10-10-2009</td>
<td></td>
<td>ROMMY INDRA PUTRA TN </td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>3589</td>
<td>SPUIT 3 CC TERUMO</td>
<td>TERUMO</td>
<td>UMUM</td>
<td>OWLEXA HEALTH CARE</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>6,992.00</td>
<td>6,992.00</td>
<td>0.00</td>
<td>699.20</td>
<td>7,691.20</td>

</tr>

<tr>
<td>128</td>
<td>08-10-2018 13:32:00</td>
<td>8197</td>
<td>32270</td>
<td>AIRLANGGA RASTAROMEO AN.</td>
<td>13-09-2005</td>
<td></td>
<td>ROMMY INDIRA PUTRA TN.</td>
<td>dr. Hazrul Lutfi Hamish,Sp.THT</td>
<td>RAWAT JALAN</td>
<td>691</td>
<td>CATAFLAM 50MG TAB </td>
<td>NOVARTIS </td>
<td>UMUM</td>
<td>OWLEXA HEALTH CARE</td>
<td>FARMASI B</td>
<td>12.00</td>
 <td>7,976.00</td>
<td>95,712.00</td>
<td>0.00</td>
<td>9,571.20</td>
<td>105,283.20</td>

</tr>

<tr>
<td>129</td>
<td>08-10-2018 13:32:00</td>
<td>8197</td>
<td>32270</td>
<td>AIRLANGGA RASTAROMEO AN.</td>
<td>13-09-2005</td>
<td></td>
<td>ROMMY INDIRA PUTRA TN.</td>
<td>dr. Hazrul Lutfi Hamish,Sp.THT</td>
<td>RAWAT JALAN</td>
<td>4717</td>
<td>DESLOTINE TABLET</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>OWLEXA HEALTH CARE</td>
<td>FARMASI B</td>
<td>4.00</td>
<td>7,600.00</td>
<td>30,400.00</td>
<td>0.00</td>
<td>3,040.00</td>
<td>33,440.00</td>

</tr>

<tr>
<td>130</td>
<td>08-10-2018 13:32:00</td>
<td>8197</td>
<td>32270</td>
<td>AIRLANGGA RASTAROMEO AN.</td>
<td>13-09-2005</td>
<td></td>
<td>ROMMY INDIRA PUTRA TN.</td>
<td>dr. Hazrul Lutfi Hamish,Sp.THT</td>
<td>RAWAT JALAN</td>
<td>3052</td>
<td>BETADINE OBAT KUMUR 190ML</td>
<td>MAHAKAM BETA FARMA </td>
<td>UMUM</td>
<td>OWLEXA HEALTH CARE</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>29,678.00</td>
<td>29,678.00</td>
<td>0.00</td>
<td>2,967.80</td>
<td>32,645.80</td>
</tr>

<tr>
<td>131</td>
<td>08-10-2018 13:32:00</td>
<td>8197</td>
<td>32270</td>
<td>AIRLANGGA RASTAROMEO AN.</td>
<td>13-09-2005</td>
<td></td>
<td>ROMMY INDIRA PUTRA TN.</td>
<td>dr. Hazrul Lutfi Hamish,Sp.THT</td>
<td>RAWAT JALAN</td>
<td>4215</td>
<td>PLASMINEX TABLET</td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>OWLEXA HEALTH CARE</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>3,914.00</td>
<td>19,570.00</td>
<td>0.00</td>
<td>1,957.00</td>
<td>21,527.00</td>

</tr>

<tr>
<td>132</td>
<td>08-10-2018 11:11:58</td>
<td>8198</td>
<td>58210</td>
<td>ANNE ANGELINE SOMPIE, NY</td>
<td>14-10-1983</td>
<td>KOMP. KALIBATA INDAH JL. RAMBUTAN BLOK F/5</td>
<td>AGUSTINUS POERNOMO WIDODO,TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>889</td>
<td>GARDASIL </td>
<td>MERCK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>923,400.00</td>
<td>923,400.00</td>
<td>0.00</td>
<td>92,340.00</td>
<td>1,015,740.00</td>

</tr>

<tr>
 <td>133</td>
<td>08-10-2018 11:11:58</td>
<td>8198</td>
<td>58210</td>
<td>ANNE ANGELINE SOMPIE, NY</td>
<td>14-10-1983</td>
<td>KOMP. KALIBATA INDAH JL. RAMBUTAN BLOK F/5</td>
<td>AGUSTINUS POERNOMO WIDODO,TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>3635</td>
<td>MASKER KARET GP CARE</td>
<td>PT.GLOBAL PHARMA</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>50.00</td>
<td>1,520.00</td>
<td>76,000.00</td>
<td>0.00</td>
<td>7,600.00</td>
<td>83,600.00</td>

</tr>

<tr>
<td>134</td>
<td>08-10-2018 10:58:31</td>
<td>8199</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1173</td>
<td>PROVULA 50MG</td>
<td>DEXA MEDICA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>19,760.00</td>
<td>98,800.00</td>
<td>0.00</td>
<td>9,880.00</td>
<td>108,680.00</td>

</tr>

<tr>
<td>135</td>
<td>08-10-2018 12:43:36</td>
<td>8201</td>
<td>91449</td>
<td>ADIARTI NURSASANTI, NY</td>
 <td>16-11-1989</td>
<td>APARTEMEN BASSURA CITY TOWER UNIT 31 AH JL BASUKI</td>
<td>HANS BUDI FINDRANOV, TN</td>
<td>dr. Berryl Imran Burhan, SpOG</td>
<td>RAWAT JALAN</td>
<td>679</td>
<td>CANESTEN SD </td>
<td>BAYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>162,512.00</td>
<td>162,512.00</td>
<td>0.00</td>
<td>16,251.20</td>
<td>178,763.20</td>

</tr>

<tr>
<td>136</td>
<td>08-10-2018 12:43:36</td>
<td>8201</td>
<td>91449</td>
<td>ADIARTI NURSASANTI, NY</td>
<td>16-11-1989</td>
<td>APARTEMEN BASSURA CITY TOWER UNIT 31 AH JL BASUKI</td>
<td>HANS BUDI FINDRANOV, TN</td>
<td>dr. Berryl Imran Burhan, SpOG</td>
<td>RAWAT JALAN</td>
<td>1101</td>
<td>OVIDREL 250MCG </td>
<td>MERCK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>924,084.00</td>
<td>924,084.00</td>
<td>0.00</td>
<td>92,408.40</td>
<td>1,016,492.40</td>

</tr>

<tr>
<td>137</td>
<td>08-10-2018 12:25:22</td>
<td>8202</td>
<td>87048</td>
<td>KEN LARASDRIYA, NY</td>
<td>07-03-1992</td>
<td>JL. MENTENG NO. 17 RT004/07</td>
<td>ARIF TRIASMORO, TN</td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
 <td>992</td>
<td>MALTOFER TABLET </td>
<td>COMBIPHAR </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>20.00</td>
<td>3,901.00</td>
<td>78,020.00</td>
<td>0.00</td>
<td>7,802.00</td>
<td>85,822.00</td>

</tr>

<tr>
<td>138</td>
<td>08-10-2018 14:02:03</td>
<td>8204</td>
<td>87684</td>
<td>GENI FITRIA HERDIANTI, NY</td>
<td>18-05-1988</td>
<td>JL.MUIARA 1 NO.18</td>
<td>ANDREAN MALTA, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1154</td>
<td>PROLACTA FOR MOTHER </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,220.00</td>
<td>216,600.00</td>
<td>0.00</td>
<td>21,660.00</td>
<td>238,260.00</td>

</tr>

<tr>
<td>139</td>
<td>08-10-2018 14:02:03</td>
<td>8204</td>
<td>87684</td>
<td>GENI FITRIA HERDIANTI, NY</td>
<td>18-05-1988</td>
<td>JL.MUIARA 1 NO.18</td>
<td>ANDREAN MALTA, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
 <td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>140</td>
<td>08-10-2018 14:02:03</td>
<td>8204</td>
<td>87684</td>
<td>GENI FITRIA HERDIANTI, NY</td>
<td>18-05-1988</td>
<td>JL.MUIARA 1 NO.18</td>
<td>ANDREAN MALTA, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1096</td>
<td>OSSORAL 800 </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,232.00</td>
<td>186,960.00</td>
<td>0.00</td>
<td>18,696.00</td>
<td>205,656.00</td>

</tr>

<tr>
<td>141</td>
<td>08-10-2018 13:09:41</td>
<td>8207</td>
<td>72200</td>
<td>ELFATHAN ALI HARYOSENO, BY</td>
<td>20-04-2016</td>
<td>TAMAN BUARAN INDAH IV BLOK LC 5 NO.30 </td>
<td>TOMY HARYOSENO, TN.</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1204</td>
<td>RYVEL SIRUP </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>76,000.00</td>
<td>76,000.00</td>
<td>0.00</td>
 <td>7,600.00</td>
<td>83,600.00</td>

</tr>

<tr>
<td>142</td>
<td>08-10-2018 13:09:41</td>
<td>8207</td>
<td>72200</td>
<td>ELFATHAN ALI HARYOSENO, BY</td>
<td>20-04-2016</td>
<td>TAMAN BUARAN INDAH IV BLOK LC 5 NO.30 </td>
<td>TOMY HARYOSENO, TN.</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>714</td>
<td>CENDO XITROL </td>
<td>CENDO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>41,420.00</td>
<td>41,420.00</td>
<td>0.00</td>
<td>4,142.00</td>
<td>45,562.00</td>

</tr>

<tr>
<td>143</td>
<td>08-10-2018 12:00:42</td>
<td>8208</td>
<td>40487</td>
<td>FARRAS SATRIA MAULANA AN.</td>
<td>28-11-2006</td>
<td></td>
<td>BABAY PARID WADZI TN. </td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>1111</td>
<td>PARACETAMOL 500MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>12.00</td>
<td>305.00</td>
<td>3,660.00</td>
<td>0.00</td>
<td>366.00</td>
<td>4,026.00</td>

</tr>
<tr>
<td>144</td>
<td>08-10-2018 12:00:42</td>
<td>8208</td>
<td>40487</td>
<td>FARRAS SATRIA MAULANA AN.</td>
<td>28-11-2006</td>
<td></td>
<td>BABAY PARID WADZI TN. </td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>763</td>
<td>CTM </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>9.00</td>
<td>144.00</td>
<td>1,296.00</td>
<td>0.00</td>
<td>129.60</td>
<td>1,425.60</td>

</tr>

<tr>
<td>145</td>
<td>08-10-2018 12:00:42</td>
<td>8208</td>
<td>40487</td>
<td>FARRAS SATRIA MAULANA AN.</td>
<td>28-11-2006</td>
<td></td>
<td>BABAY PARID WADZI TN. </td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>3405</td>
<td>LAPIFED TAB</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>9.00</td>
<td>3,896.20</td>
<td>35,065.80</td>
<td>0.00</td>
<td>3,506.58</td>
<td>38,572.38</td>

</tr>

<tr>
<td>146</td>
<td>08-10-2018 12:00:42</td>
<td>8208</td>
 <td>40487</td>
<td>FARRAS SATRIA MAULANA AN.</td>
<td>28-11-2006</td>
<td></td>
<td>BABAY PARID WADZI TN. </td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>684</td>
<td>CAPSUL KOSONG NO.2 </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>32.00</td>
<td>53.00</td>
<td>1,696.00</td>
<td>0.00</td>
<td>169.60</td>
<td>1,865.60</td>

</tr>

<tr>
<td>147</td>
<td>08-10-2018 11:58:00</td>
<td>8210</td>
<td>91279</td>
<td>ANDRIAN NOVA PALOH, BY</td>
<td>06-08-2018</td>
<td>GUDANG PELURU BARAT IV W/540</td>
<td>NOVA HARIVAN PALOH, TN</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>4207</td>
<td>HEXAXIM</td>
<td>Sanofi Pasteur </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>817,050.00</td>
<td>817,050.00</td>
<td>0.00</td>
<td>81,705.00</td>
<td>898,755.00</td>

</tr>

<tr>
<td>148</td>
<td>08-10-2018 11:58:00</td>
<td>8210</td>
<td>91279</td>
<td>ANDRIAN NOVA PALOH, BY</td>
<td>06-08-2018</td>
<td>GUDANG PELURU BARAT IV W/540</td>
<td>NOVA HARIVAN PALOH, TN</td>
 <td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>149</td>
<td>08-10-2018 11:58:00</td>
<td>8210</td>
<td>91279</td>
<td>ANDRIAN NOVA PALOH, BY</td>
<td>06-08-2018</td>
<td>GUDANG PELURU BARAT IV W/540</td>
<td>NOVA HARIVAN PALOH, TN</td>
<td>dr. H. Darlan Darwis, SpA(K) </td>
<td>RAWAT JALAN</td>
<td>1199</td>
<td>ROTARIX 1 ML </td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>374,072.00</td>
<td>374,072.00</td>
<td>0.00</td>
<td>37,407.20</td>
<td>411,479.20</td>

</tr>

<tr>
<td>150</td>
<td>08-10-2018 11:28:00</td>
<td>8212</td>
<td>49028</td>
<td>ISNUR FITRIA ANGGRAINI, NY</td>
<td>17-02-1988</td>
<td>JL. TERATAI PUTIH I/13 NO.59 MALAKA SARI</td>
<td>THORIQ IDHAM SALICH, TN</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>962</td>
<td>LACTO-B </td>
<td>NOVELL </td>
 <td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>4.00</td>
<td>7,080.00</td>
<td>28,320.00</td>
<td>0.00</td>
<td>2,832.00</td>
<td>31,152.00</td>

</tr>

<tr>
<td>151</td>
<td>08-10-2018 11:28:00</td>
<td>8212</td>
<td>49028</td>
<td>ISNUR FITRIA ANGGRAINI, NY</td>
<td>17-02-1988</td>
<td>JL. TERATAI PUTIH I/13 NO.59 MALAKA SARI</td>
<td>THORIQ IDHAM SALICH, TN</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1212</td>
<td>SANMOL DROPS </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>17,880.00</td>
<td>17,880.00</td>
<td>0.00</td>
<td>1,788.00</td>
<td>19,668.00</td>

</tr>

<tr>
<td>152</td>
<td>08-10-2018 11:33:31</td>
<td>8213</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1274</td>
<td>TEMPRA FORTE SYR 60 ML </td>
<td>TAISHO </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>55,936.00</td>
 <td>55,936.00</td>
<td>0.00</td>
<td>5,593.60</td>
<td>61,529.60</td>

</tr>

<tr>
<td>153</td>
<td>08-10-2018 11:33:31</td>
<td>8213</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>705</td>
<td>CEFSPAN DRY SYR.30ML </td>
<td>KALBE FARMA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>150,480.00</td>
<td>150,480.00</td>
<td>0.00</td>
<td>15,048.00</td>
<td>165,528.00</td>

</tr>

<tr>
<td>154</td>
<td>08-10-2018 14:10:50</td>
<td>8216</td>
<td>9628</td>
<td>DESSYRE WELLY, NY</td>
<td>13-01-1973</td>
<td>JL. AREMAN NO.171 C RT.004 RW.008 TUGU</td>
<td>VALERIAN .Z.PELUPESSY.TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>461</td>
<td>TEGADERM 25X10 (1627) </td>
<td>3M </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>46,200.00</td>
<td>46,200.00</td>
<td>0.00</td>
<td>4,620.00</td>
<td>50,820.00</td>
</tr>

<tr>
<td>155</td>
<td>08-10-2018 11:37:14</td>
<td>8218</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>668</td>
<td>CAL-95 </td>
<td>LAPI </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,296.00</td>
<td>218,880.00</td>
<td>0.00</td>
<td>21,888.00</td>
<td>240,768.00</td>

</tr>

<tr>
<td>156</td>
<td>08-10-2018 11:37:14</td>
<td>8218</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Winur Widijanti, SpOG</td>
<td>RAWAT JALAN</td>
<td>1346</td>
<td>VITAMAM 3 </td>
<td>NOVELL </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>28.00</td>
<td>5,211.00</td>
<td>145,908.00</td>
<td>0.00</td>
<td>14,590.80</td>
<td>160,498.80</td>

</tr>

<tr>
<td>157</td>
 <td>08-10-2018 11:45:14</td>
<td>8225</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>4671</td>
<td>NEURODEX FLIM COAT TABLET</td>
<td>DEXA MEDICA </td>
<td></td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>660.00</td>
<td>3,300.00</td>
<td>0.00</td>
<td>330.00</td>
<td>3,630.00</td>

</tr>

<tr>
<td>158</td>
<td>08-10-2018 11:45:14</td>
<td>8225</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>691</td>
<td>CATAFLAM 50MG TAB </td>
<td>NOVARTIS </td>
<td></td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>6,297.22</td>
<td>6,297.22</td>
<td>0.00</td>
<td>629.72</td>
<td>6,926.94</td>

</tr>

<tr>
<td>159</td>
<td>08-10-2018 11:45:14</td>
<td>8225</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
 <td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1052</td>
<td>NEUROBION 5000MG TAB </td>
<td>MERCK </td>
<td></td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>3,158.57</td>
<td>15,792.85</td>
<td>0.00</td>
<td>1,579.29</td>
<td>17,372.14</td>

</tr>

<tr>
<td>160</td>
<td>08-10-2018 11:42:00</td>
<td>8226</td>
<td>91030</td>
<td>ATI PEBRIANTI, NY</td>
<td>03-02-1984</td>
<td>JL. TANGKI NO.89 RT.004/003</td>
<td>NIMROD TARUNA BHAKTI B S, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>457</td>
<td>T-TOWEL (T3) WASHGLOVES </td>
<td>Triton </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>3.00</td>
<td>9,780.00</td>
<td>29,340.00</td>
<td>0.00</td>
<td>0.00</td>
<td>29,340.00</td>

</tr>

<tr>
<td>161</td>
<td>08-10-2018 11:42:00</td>
<td>8226</td>
<td>91030</td>
<td>ATI PEBRIANTI, NY</td>
<td>03-02-1984</td>
<td>JL. TANGKI NO.89 RT.004/003</td>
<td>NIMROD TARUNA BHAKTI B S, TN</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>1445</td>
 <td>MATERAI 3000</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>ADMISI</td>
<td>1.00</td>
<td>3,000.00</td>
<td>3,000.00</td>
<td>0.00</td>
<td>0.00</td>
<td>3,000.00</td>

</tr>

<tr>
<td>162</td>
<td>08-10-2018 13:17:23</td>
<td>8229</td>
<td>89269</td>
<td>KHALIFA AKMAL PUTRA ALAFIT, AN</td>
<td>06-07-2018</td>
<td>JL.BARATA JAYA II NO.665, KARANG TENGAH</td>
<td>ALAFITYANTO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1143</td>
<td>PREVENAR 13 PFS0,5ML </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>815,000.00</td>
<td>815,000.00</td>
<td>0.00</td>
<td>81,500.00</td>
<td>896,500.00</td>

</tr>

<tr>
<td>163</td>
<td>08-10-2018 13:17:23</td>
<td>8229</td>
<td>89269</td>
<td>KHALIFA AKMAL PUTRA ALAFIT, AN</td>
<td>06-07-2018</td>
<td>JL.BARATA JAYA II NO.665, KARANG TENGAH</td>
<td>ALAFITYANTO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
 <td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>164</td>
<td>08-10-2018 13:54:52</td>
<td>8230</td>
<td>81649</td>
<td>HERJUNA YOGASWARA WIBOWO, BY</td>
<td>10-08-2017</td>
<td>JL. H. ALMUM NO.61 RT.005 RW.003 KELAPA DUA</td>
<td>HERMADI WIBOWO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>165</td>
<td>08-10-2018 13:54:52</td>
<td>8230</td>
<td>81649</td>
<td>HERJUNA YOGASWARA WIBOWO, BY</td>
<td>10-08-2017</td>
<td>JL. H. ALMUM NO.61 RT.005 RW.003 KELAPA DUA</td>
<td>HERMADI WIBOWO, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1143</td>
<td>PREVENAR 13 PFS0,5ML </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>815,000.00</td>
<td>815,000.00</td>
<td>0.00</td>
<td>81,500.00</td>
 <td>896,500.00</td>

</tr>

<tr>
<td>166</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
<td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>IGD</td>
<td>4.00</td>
<td>682.00</td>
<td>2,728.00</td>
<td>0.00</td>
<td>272.80</td>
<td>3,000.80</td>

</tr>

<tr>
<td>167</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
<td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>3715</td>
<td>RL WIDA</td>
<td>WIDATRA </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>IGD</td>
<td>1.00</td>
<td>21,199.00</td>
<td>21,199.00</td>
<td>0.00</td>
<td>2,119.90</td>
<td>23,318.90</td>

</tr>
<tr>
<td>168</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
<td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>380</td>
<td>PYREX INFUSION 10MG/ML </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>IGD</td>
<td>1.00</td>
<td>98,800.00</td>
<td>98,800.00</td>
<td>0.00</td>
<td>9,880.00</td>
<td>108,680.00</td>

</tr>

<tr>
<td>169</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
<td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>262</td>
<td>LEUKOMED-IV 72389-00 (6X8CM) </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>IGD</td>
<td>1.00</td>
<td>4,038.00</td>
<td>4,038.00</td>
<td>0.00</td>
<td>403.80</td>
<td>4,441.80</td>

</tr>

<tr>
<td>170</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
 <td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>1051</td>
<td>NEUROBION </td>
<td>MERCK </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>2,173.00</td>
<td>21,730.00</td>
<td>0.00</td>
<td>2,173.00</td>
<td>23,903.00</td>

</tr>

<tr>
<td>171</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
<td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>585</td>
<td>ANALSIK TABLET </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>2,151.00</td>
<td>21,510.00</td>
<td>0.00</td>
<td>2,151.00</td>
<td>23,661.00</td>

</tr>

<tr>
<td>172</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
<td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
 <td>IGD</td>
<td>217</td>
<td>INFUSET TS*A200LK002 </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>IGD</td>
<td>1.00</td>
<td>20,368.00</td>
<td>20,368.00</td>
<td>0.00</td>
<td>2,036.80</td>
<td>22,404.80</td>

</tr>

<tr>
<td>173</td>
<td>08-10-2018 15:23:48</td>
<td>8231</td>
<td>75939</td>
<td>LENNY CHRISTINA L.TOBING, NY</td>
<td>27-01-1984</td>
<td>JL.KS TUBUN NO.26 PETAMBURAN JAKBAR</td>
<td>ROLANDO SIMANULLANG,TN</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>495</td>
<td>VENFLON 20 REFF 393204 </td>
<td>BD </td>
<td>UMUM</td>
<td>BNI LIFE INSURANCE</td>
<td>IGD</td>
<td>1.00</td>
<td>39,847.50</td>
<td>39,847.50</td>
<td>0.00</td>
<td>3,984.75</td>
<td>43,832.25</td>

</tr>

<tr>
<td>174</td>
<td>08-10-2018 14:06:12</td>
<td>8233</td>
<td>73918</td>
<td>RAIF ABRAHAM, BY</td>
<td>25-07-2016</td>
<td>JL. TEBET UTARA 2 E NO. 12 RT.03 RW.01</td>
<td>AZWAR DJALIL, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1132</td>
<td>PRAXION SYRUP 120MG/5ML </td>
<td>Phapros </td>
<td>UMUM</td>
 <td>ADIRA INSURANCE </td>
<td>FARMASI B</td>
<td>1.00</td>
<td>31,920.00</td>
<td>31,920.00</td>
<td>0.00</td>
<td>3,192.00</td>
<td>35,112.00</td>

</tr>

<tr>
<td>175</td>
<td>08-10-2018 14:06:12</td>
<td>8233</td>
<td>73918</td>
<td>RAIF ABRAHAM, BY</td>
<td>25-07-2016</td>
<td>JL. TEBET UTARA 2 E NO. 12 RT.03 RW.01</td>
<td>AZWAR DJALIL, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>962</td>
<td>LACTO-B </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>ADIRA INSURANCE </td>
<td>FARMASI B</td>
<td>12.00</td>
<td>8,968.00</td>
<td>107,616.00</td>
<td>0.00</td>
<td>10,761.60</td>
<td>118,377.60</td>

</tr>

<tr>
<td>176</td>
<td>08-10-2018 14:06:12</td>
<td>8233</td>
<td>73918</td>
<td>RAIF ABRAHAM, BY</td>
<td>25-07-2016</td>
<td>JL. TEBET UTARA 2 E NO. 12 RT.03 RW.01</td>
<td>AZWAR DJALIL, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1357</td>
<td>VOMETA SUSPENSI SYR.60ML</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>ADIRA INSURANCE </td>
<td>FARMASI B</td>
<td>1.00</td>
<td>60,040.00</td>
<td>60,040.00</td>
 <td>0.00</td>
<td>6,004.00</td>
<td>66,044.00</td>

</tr>

<tr>
<td>177</td>
<td>08-10-2018 14:06:12</td>
<td>8233</td>
<td>73918</td>
<td>RAIF ABRAHAM, BY</td>
<td>25-07-2016</td>
<td>JL. TEBET UTARA 2 E NO. 12 RT.03 RW.01</td>
<td>AZWAR DJALIL, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>4662</td>
<td>DEHIDRALYTE SOL 200ML</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>ADIRA INSURANCE </td>
<td>FARMASI B</td>
<td>1.00</td>
<td>22,950.00</td>
<td>22,950.00</td>
<td>0.00</td>
<td>2,295.00</td>
<td>25,245.00</td>

</tr>

<tr>
<td>178</td>
<td>08-10-2018 14:06:12</td>
<td>8233</td>
<td>73918</td>
<td>RAIF ABRAHAM, BY</td>
<td>25-07-2016</td>
<td>JL. TEBET UTARA 2 E NO. 12 RT.03 RW.01</td>
<td>AZWAR DJALIL, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1093</td>
<td>OREZINC SYRUP 60 ML </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>ADIRA INSURANCE </td>
<td>FARMASI B</td>
<td>1.00</td>
<td>48,962.00</td>
<td>48,962.00</td>
<td>0.00</td>
<td>4,896.20</td>
<td>53,858.20</td>
</tr>

<tr>
<td>179</td>
<td>08-10-2018 13:57:06</td>
<td>8236</td>
<td>88110</td>
<td>RAFANDRA AIMAN HARISH, BY</td>
<td>08-05-2018</td>
<td></td>
<td>-</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1143</td>
<td>PREVENAR 13 PFS0,5ML </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>815,000.00</td>
<td>815,000.00</td>
<td>0.00</td>
<td>81,500.00</td>
<td>896,500.00</td>

</tr>

<tr>
<td>180</td>
<td>08-10-2018 13:57:06</td>
<td>8236</td>
<td>88110</td>
<td>RAFANDRA AIMAN HARISH, BY</td>
<td>08-05-2018</td>
<td></td>
<td>-</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>865</td>
<td>FERRIZ DROPS </td>
<td>NICHOLAS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>45,600.00</td>
<td>45,600.00</td>
<td>0.00</td>
<td>4,560.00</td>
<td>50,160.00</td>

</tr>

<tr>
<td>181</td>
<td>08-10-2018 13:57:06</td>
 <td>8236</td>
<td>88110</td>
<td>RAFANDRA AIMAN HARISH, BY</td>
<td>08-05-2018</td>
<td></td>
<td>-</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>182</td>
<td>08-10-2018 13:53:17</td>
<td>8238</td>
<td>89054</td>
<td>RANIA MALAYEKA HARAHAP, BY</td>
<td>05-07-2018</td>
<td>UNIT 2799, APT. SETIABUDI SKYGARDEN JL.SETIABUDI RAYA
NO.2</td>
<td>DIATCHE GUNUNGTUA HARAHAP, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1166</td>
<td>PRORIS SUSPENSI 60ML </td>
<td>PHAROS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>32,832.00</td>
<td>32,832.00</td>
<td>0.00</td>
<td>3,283.20</td>
<td>36,115.20</td>

</tr>

<tr>
<td>183</td>
<td>08-10-2018 13:53:17</td>
<td>8238</td>
<td>89054</td>
<td>RANIA MALAYEKA HARAHAP, BY</td>
<td>05-07-2018</td>
 <td>UNIT 2799, APT. SETIABUDI SKYGARDEN JL.SETIABUDI RAYA
NO.2</td>
<td>DIATCHE GUNUNGTUA HARAHAP, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1143</td>
<td>PREVENAR 13 PFS0,5ML </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>815,000.00</td>
<td>815,000.00</td>
<td>0.00</td>
<td>81,500.00</td>
<td>896,500.00</td>

</tr>

<tr>
<td>184</td>
<td>08-10-2018 13:53:17</td>
<td>8238</td>
<td>89054</td>
<td>RANIA MALAYEKA HARAHAP, BY</td>
<td>05-07-2018</td>
<td>UNIT 2799, APT. SETIABUDI SKYGARDEN JL.SETIABUDI RAYA
NO.2</td>
<td>DIATCHE GUNUNGTUA HARAHAP, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>185</td>
<td>08-10-2018 15:11:02</td>
<td>8239</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
 <td>RAWAT JALAN</td>
<td>4662</td>
<td>DEHIDRALYTE SOL 200ML</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>1.00</td>
<td>22,950.00</td>
<td>22,950.00</td>
<td>0.00</td>
<td>2,295.00</td>
<td>25,245.00</td>

</tr>

<tr>
<td>186</td>
<td>08-10-2018 15:11:02</td>
<td>8239</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1044</td>
<td>NARFOZ SYR 4MG/5ML 60 ML </td>
<td>PHAROS </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>1.00</td>
<td>96,000.00</td>
<td>96,000.00</td>
<td>0.00</td>
<td>9,600.00</td>
<td>105,600.00</td>

</tr>

<tr>
<td>187</td>
<td>08-10-2018 15:11:02</td>
<td>8239</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>1193</td>
<td>RHINOS JUNIOR SIRUP 60ML</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
 <td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>1.00</td>
<td>36,000.00</td>
<td>36,000.00</td>
<td>0.00</td>
<td>3,600.00</td>
<td>39,600.00</td>

</tr>

<tr>
<td>188</td>
<td>08-10-2018 15:11:02</td>
<td>8239</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT JALAN</td>
<td>962</td>
<td>LACTO-B </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>10.00</td>
<td>7,080.00</td>
<td>70,800.00</td>
<td>0.00</td>
<td>7,080.00</td>
<td>77,880.00</td>

</tr>

<tr>
<td>189</td>
<td>08-10-2018 12:41:41</td>
<td>8240</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>342</td>
<td>PEMBALUT BERSALIN(SOFTEX)</td>
<td>SOFTEX </td>
<td></td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>25,840.00</td>
<td>25,840.00</td>
 <td>0.00</td>
<td>2,584.00</td>
<td>28,424.00</td>

</tr>

<tr>
<td>190</td>
<td>08-10-2018 13:18:48</td>
<td>8241</td>
<td>74539</td>
<td>FATIMAH GIBTIYA, NY</td>
<td>13-10-1997</td>
<td>JL. K. NO. 5B ASEM BARIS </td>
<td>AHMAD, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1066</td>
<td>NOVA T </td>
<td>BAYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>380,395.00</td>
<td>380,395.00</td>
<td>0.00</td>
<td>38,039.50</td>
<td>418,434.50</td>

</tr>

<tr>
<td>191</td>
<td>08-10-2018 13:18:48</td>
<td>8241</td>
<td>74539</td>
<td>FATIMAH GIBTIYA, NY</td>
<td>13-10-1997</td>
<td>JL. K. NO. 5B ASEM BARIS </td>
<td>AHMAD, TN</td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>397</td>
<td>SARUNG TANGAN N0 8 </td>
<td>GAMEX </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>27,360.00</td>
<td>27,360.00</td>
<td>0.00</td>
<td>2,736.00</td>
<td>30,096.00</td>
</tr>

<tr>
<td>192</td>
<td>08-10-2018 13:03:39</td>
<td>8243</td>
<td>44555</td>
<td>ETY SUMIYATI NY.</td>
<td>08-12-1966</td>
<td></td>
<td>AHMAD FAIZ TN.</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>1231</td>
<td>SIMVASTATIN 10 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>709.00</td>
<td>7,090.00</td>
<td>0.00</td>
<td>709.00</td>
<td>7,799.00</td>

</tr>

<tr>
<td>193</td>
<td>08-10-2018 13:03:39</td>
<td>8243</td>
<td>44555</td>
<td>ETY SUMIYATI NY.</td>
<td>08-12-1966</td>
<td></td>
<td>AHMAD FAIZ TN.</td>
<td>dr. Regina Ivanovna</td>
<td>IGD</td>
<td>3248</td>
<td>AMLODIPINE 10MG TAB</td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>2,337.00</td>
<td>23,370.00</td>
<td>0.00</td>
<td>2,337.00</td>
<td>25,707.00</td>

</tr>

<tr>
<td>194</td>
<td>08-10-2018 13:07:10</td>
 <td>8247</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1083</td>
<td>OBIPLUZ CAPSUL </td>
<td>DARYA VARIA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>4,809.00</td>
<td>144,270.00</td>
<td>0.00</td>
<td>14,427.00</td>
<td>158,697.00</td>

</tr>

<tr>
<td>195</td>
<td>08-10-2018 13:07:10</td>
<td>8247</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>4301</td>
<td>VITAMIN D3 1000IU</td>
<td>UMUM</td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>4,138.00</td>
<td>124,140.00</td>
<td>0.00</td>
<td>12,414.00</td>
<td>136,554.00</td>

</tr>

<tr>
<td>196</td>
<td>08-10-2018 13:07:10</td>
<td>8247</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
 <td></td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1154</td>
<td>PROLACTA FOR MOTHER </td>
<td>NOVELL </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,220.00</td>
<td>216,600.00</td>
<td>0.00</td>
<td>21,660.00</td>
<td>238,260.00</td>

</tr>

<tr>
<td>197</td>
<td>08-10-2018 13:10:04</td>
<td>8248</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>4394</td>
<td>FLUOMIZIN TABLET</td>
<td>EXELTIS</td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>44,333.00</td>
<td>265,998.00</td>
<td>0.00</td>
<td>26,599.80</td>
<td>292,597.80</td>

</tr>

<tr>
<td>198</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>1564</td>
<td>BABY OIL JOHNSON 125 ML </td>
 <td>Johnson </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.25</td>
<td>29,509.48</td>
<td>7,377.37</td>
<td>0.00</td>
<td>0.00</td>
<td>7,377.37</td>

</tr>

<tr>
<td>199</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>261</td>
<td>LEUKOFIX </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.10</td>
<td>41,663.20</td>
<td>4,166.32</td>
<td>0.00</td>
<td>0.00</td>
<td>4,166.32</td>

</tr>

<tr>
<td>200</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>1442</td>
<td>TOPI BAYI</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>1.00</td>
 <td>12,312.00</td>
<td>12,312.00</td>
<td>0.00</td>
<td>0.00</td>
<td>12,312.00</td>

</tr>

<tr>
<td>201</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>3348</td>
<td>PENENG ADULT/PED 120-18(BLUE)</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>1.00</td>
<td>6,217.00</td>
<td>6,217.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,217.00</td>

</tr>

<tr>
<td>202</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>4521</td>
<td>KAPAS BULAT</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>13,529.00</td>
<td>40,587.00</td>
<td>0.00</td>
<td>0.00</td>
<td>40,587.00</td>
</tr>

<tr>
<td>203</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>125</td>
<td>DESMANOL 500 ML </td>
<td>DEMKA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.01</td>
<td>276,488.00</td>
<td>2,764.88</td>
<td>0.00</td>
<td>0.00</td>
<td>2,764.88</td>

</tr>

<tr>
<td>204</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>1527</td>
<td>AQUA BIDEST 1000 CC INJ/OTSUKA</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.20</td>
<td>32,832.00</td>
<td>6,566.40</td>
<td>0.00</td>
<td>0.00</td>
<td>6,566.40</td>

</tr>

<tr>
 <td>205</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>284</td>
<td>MICROPORE 2 IN </td>
<td>3M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.10</td>
<td>70,224.00</td>
<td>7,022.40</td>
<td>0.00</td>
<td>0.00</td>
<td>7,022.40</td>

</tr>

<tr>
<td>206</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>2101</td>
<td>MAMY POKO NB/14 </td>
<td>UNICHARM </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>3,478.00</td>
<td>6,956.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,956.00</td>

</tr>

<tr>
<td>207</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
 <td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>295</td>
<td>MUCUS EXTRACTOR </td>
<td>JMS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>61,940.00</td>
<td>61,940.00</td>
<td>0.00</td>
<td>0.00</td>
<td>61,940.00</td>

</tr>

<tr>
<td>208</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>88</td>
<td>CELEMEK </td>
<td>JANTRA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>5,069.30</td>
<td>5,069.30</td>
<td>0.00</td>
<td>0.00</td>
<td>5,069.30</td>

</tr>

<tr>
<td>209</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
 <td>331</td>
<td>OXYGEN NASAL CANUL(BAYI)REMEDI</td>
<td>SALTER LAB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>35,045.00</td>
<td>35,045.00</td>
<td>0.00</td>
<td>0.00</td>
<td>35,045.00</td>

</tr>

<tr>
<td>210</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>396</td>
<td>SARUNG TANGAN 6,5 </td>
<td>GAMEX </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>29,340.00</td>
<td>29,340.00</td>
<td>0.00</td>
<td>0.00</td>
<td>29,340.00</td>

</tr>

<tr>
<td>211</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
 <td>FARMASI A</td>
<td>1.00</td>
<td>10,432.00</td>
<td>10,432.00</td>
<td>0.00</td>
<td>0.00</td>
<td>10,432.00</td>

</tr>

<tr>
<td>212</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>4365</td>
<td>VITADION 2MG/ML</td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>19,560.00</td>
<td>19,560.00</td>
<td>0.00</td>
<td>0.00</td>
<td>19,560.00</td>

</tr>

<tr>
<td>213</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>4308</td>
<td>SOFTAMAN 100ML</td>
<td>B.Braun </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>58,680.00</td>
<td>58,680.00</td>
<td>0.00</td>
 <td>0.00</td>
<td>58,680.00</td>

</tr>

<tr>
<td>214</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>3884</td>
<td>M.TELON KONICARE 125ML</td>
<td>Konicare </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.25</td>
<td>53,200.00</td>
<td>13,300.00</td>
<td>0.00</td>
<td>0.00</td>
<td>13,300.00</td>

</tr>

<tr>
<td>215</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>1284</td>
<td>THERMOMETER ALPHA 1 NEW </td>
<td>JAYAMAS MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>31,785.00</td>
<td>31,785.00</td>
<td>0.00</td>
<td>0.00</td>
<td>31,785.00</td>

</tr>
<tr>
<td>216</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>3586</td>
<td>KASSA STERIL PF</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>5,705.00</td>
<td>5,705.00</td>
<td>0.00</td>
<td>0.00</td>
<td>5,705.00</td>

</tr>

<tr>
<td>217</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>245</td>
<td>KAPAS 1 KG </td>
<td>HUSADA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.25</td>
<td>150,784.00</td>
<td>37,696.00</td>
<td>0.00</td>
<td>0.00</td>
<td>37,696.00</td>

</tr>

<tr>
<td>218</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
 <td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>941</td>
<td>KASSA HIDROPHIL </td>
<td>HUSADA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.10</td>
<td>364,800.00</td>
<td>36,480.00</td>
<td>0.00</td>
<td>0.00</td>
<td>36,480.00</td>

</tr>

<tr>
<td>219</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>406</td>
<td>SENSI GLOVES UKURAN M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>6.00</td>
<td>988.00</td>
<td>5,928.00</td>
<td>0.00</td>
<td>0.00</td>
<td>5,928.00</td>

</tr>

<tr>
<td>220</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
 <td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>1314</td>
<td>VACCIN POLIO </td>
<td>BIO FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>1.00</td>
<td>77,099.00</td>
<td>77,099.00</td>
<td>0.00</td>
<td>0.00</td>
<td>77,099.00</td>

</tr>

<tr>
<td>221</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>3943</td>
<td>TERRAMYCIN 1% 3.5GR OINT</td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>18,706.00</td>
<td>18,706.00</td>
<td>0.00</td>
<td>0.00</td>
<td>18,706.00</td>

</tr>

<tr>
<td>222</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
 <td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>17.00</td>
<td>732.00</td>
<td>12,444.00</td>
<td>0.00</td>
<td>0.00</td>
<td>12,444.00</td>

</tr>

<tr>
<td>223</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>825</td>
<td>ENGERIX B 0.5 ML(HEPATITIS B)</td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>106,390.00</td>
<td>106,390.00</td>
<td>0.00</td>
<td>0.00</td>
<td>106,390.00</td>

</tr>

<tr>
<td>224</td>
<td>08-10-2018 18:17:38</td>
<td>8251</td>
<td>91534</td>
<td>BY,NY,NONA DARASYIAHWATI</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>DR.dr.Rinawati R, SpA(K)</td>
<td>RAWAT INAP</td>
<td>112</td>
<td>COTTON BUD ANAK-ANAK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.25</td>
<td>10,534.00</td>
 <td>2,633.50</td>
<td>0.00</td>
<td>0.00</td>
<td>2,633.50</td>

</tr>

<tr>
<td>225</td>
<td>08-10-2018 13:26:46</td>
<td>8252</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1004</td>
<td>MEFINAL 500MG </td>
<td>SANBE FARMA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,923.00</td>
<td>19,230.00</td>
<td>0.00</td>
<td>1,923.00</td>
<td>21,153.00</td>

</tr>

<tr>
<td>226</td>
<td>08-10-2018 13:26:46</td>
<td>8252</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>711</td>
<td>CELOCID 500MG </td>
<td>DEXA MEDICA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>28,880.00</td>
<td>288,800.00</td>
<td>0.00</td>
<td>28,880.00</td>
<td>317,680.00</td>
</tr>

<tr>
<td>227</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>2101</td>
<td>MAMY POKO NB/14 </td>
<td>UNICHARM </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>14.00</td>
<td>3,478.00</td>
<td>48,692.00</td>
<td>0.00</td>
<td>0.00</td>
<td>48,692.00</td>

</tr>

<tr>
<td>228</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>989</td>
<td>M.TELON KONICARE 60ML </td>
<td>Konicare </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.25</td>
<td>28,509.00</td>
<td>7,127.25</td>
<td>0.00</td>
<td>0.00</td>
<td>7,127.25</td>

</tr>

<tr>
<td>229</td>
 <td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>1564</td>
<td>BABY OIL JOHNSON 125 ML </td>
<td>Johnson </td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.25</td>
<td>31,234.06</td>
<td>7,808.52</td>
<td>0.00</td>
<td>0.00</td>
<td>7,808.52</td>

</tr>

<tr>
<td>230</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>112</td>
<td>COTTON BUD ANAK-ANAK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>0.25</td>
<td>11,296.00</td>
<td>2,824.00</td>
<td>0.00</td>
<td>0.00</td>
<td>2,824.00</td>

</tr>

<tr>
<td>231</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
 <td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>407</td>
<td>SENSI GLOVES UKURAN S </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>6.00</td>
<td>1,060.00</td>
<td>6,360.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,360.00</td>

</tr>

<tr>
<td>232</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>1442</td>
<td>TOPI BAYI</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>1.00</td>
<td>13,203.00</td>
<td>13,203.00</td>
<td>0.00</td>
<td>0.00</td>
<td>13,203.00</td>

</tr>

<tr>
<td>233</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>3348</td>
 <td>PENENG ADULT/PED 120-18(BLUE)</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>KAMAR BAYI</td>
<td>1.00</td>
<td>6,667.00</td>
<td>6,667.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,667.00</td>

</tr>

<tr>
<td>234</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>1284</td>
<td>THERMOMETER ALPHA 1 NEW </td>
<td>JAYAMAS MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>31,785.00</td>
<td>31,785.00</td>
<td>0.00</td>
<td>0.00</td>
<td>31,785.00</td>

</tr>

<tr>
<td>235</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>4308</td>
<td>SOFTAMAN 100ML</td>
<td>B.Braun </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
 <td>1.00</td>
<td>58,680.00</td>
<td>58,680.00</td>
<td>0.00</td>
<td>0.00</td>
<td>58,680.00</td>

</tr>

<tr>
<td>236</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>4298</td>
<td>ENFAMIL GENTLE CARE A+ 400GR</td>
<td>MEAD JHONSON </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>210,418.00</td>
<td>210,418.00</td>
<td>0.00</td>
<td>0.00</td>
<td>210,418.00</td>

</tr>

<tr>
<td>237</td>
<td>08-10-2018 15:38:48</td>
<td>8254</td>
<td>91383</td>
<td>BY NY. DESSYRE WELLY</td>
<td>03-10-2018</td>
<td></td>
<td></td>
<td>dr. Meri Yanti, SpA</td>
<td>RAWAT INAP</td>
<td>2101</td>
<td>MAMY POKO NB/14 </td>
<td>UNICHARM </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>16.00</td>
<td>3,478.00</td>
<td>55,648.00</td>
<td>0.00</td>
<td>0.00</td>
 <td>55,648.00</td>

</tr>

<tr>
<td>238</td>
<td>08-10-2018 13:52:08</td>
<td>8255</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>4470</td>
<td>INBUMIN</td>
<td>DEXA MEDICA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>7,600.00</td>
<td>114,000.00</td>
<td>0.00</td>
<td>11,400.00</td>
<td>125,400.00</td>

</tr>

<tr>
<td>239</td>
<td>08-10-2018 13:52:00</td>
<td>8256</td>
<td>46515</td>
<td>PROF.DR.ENDY M MOEGNI, SPOG(K)</td>
<td>26-01-1947</td>
<td></td>
<td>-</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1827</td>
<td>DUROGESIC 25 MCG PATCH </td>
<td>KIMIA FARMA </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>258,600.00</td>
<td>1,293,000.00</td>
<td>0.00</td>
<td>129,300.00</td>
<td>1,422,300.00</td>

</tr>
<tr>
<td>240</td>
<td>08-10-2018 17:28:37</td>
<td>8257</td>
<td>90229</td>
<td>IMELDA PUTRI, AN</td>
<td>30-06-2018</td>
<td>PERUM ARCADIA BLOK H28</td>
<td>LIE KIM IK, TN ( AYAH )</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>241</td>
<td>08-10-2018 17:28:37</td>
<td>8257</td>
<td>90229</td>
<td>IMELDA PUTRI, AN</td>
<td>30-06-2018</td>
<td>PERUM ARCADIA BLOK H28</td>
<td>LIE KIM IK, TN ( AYAH )</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1268</td>
<td>SYNFLORIX 0.5 ML VIAL </td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>683,837.00</td>
<td>683,837.00</td>
<td>0.00</td>
<td>68,383.70</td>
<td>752,220.70</td>

</tr>

<tr>
<td>242</td>
<td>08-10-2018 17:28:37</td>
<td>8257</td>
<td>90229</td>
 <td>IMELDA PUTRI, AN</td>
<td>30-06-2018</td>
<td>PERUM ARCADIA BLOK H28</td>
<td>LIE KIM IK, TN ( AYAH )</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1199</td>
<td>ROTARIX 1 ML </td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>374,072.00</td>
<td>374,072.00</td>
<td>0.00</td>
<td>37,407.20</td>
<td>411,479.20</td>

</tr>

<tr>
<td>243</td>
<td>08-10-2018 18:32:07</td>
<td>8262</td>
<td>68592</td>
<td>ZAVIYAR LEVINE, AN</td>
<td>07-11-2015</td>
<td>JL. SIAGA I A NO. 9 PASAR MINGGU</td>
<td>JAMAL A.N BAMADHAJ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>69.66</td>
<td>1,044.90</td>
<td>0.00</td>
<td>104.49</td>
<td>1,149.39</td>

</tr>

<tr>
<td>244</td>
<td>08-10-2018 18:32:07</td>
<td>8262</td>
<td>68592</td>
<td>ZAVIYAR LEVINE, AN</td>
<td>07-11-2015</td>
<td>JL. SIAGA I A NO. 9 PASAR MINGGU</td>
<td>JAMAL A.N BAMADHAJ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
 <td>RAWAT JALAN</td>
<td>3500</td>
<td>DEXA M TAB 0,75MG</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>218.00</td>
<td>2,180.00</td>
<td>0.00</td>
<td>218.00</td>
<td>2,398.00</td>

</tr>

<tr>
<td>245</td>
<td>08-10-2018 18:32:07</td>
<td>8262</td>
<td>68592</td>
<td>ZAVIYAR LEVINE, AN</td>
<td>07-11-2015</td>
<td>JL. SIAGA I A NO. 9 PASAR MINGGU</td>
<td>JAMAL A.N BAMADHAJ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>285.00</td>
<td>570.00</td>
<td>0.00</td>
<td>57.00</td>
<td>627.00</td>

</tr>

<tr>
<td>246</td>
<td>08-10-2018 18:32:07</td>
<td>8262</td>
<td>68592</td>
<td>ZAVIYAR LEVINE, AN</td>
<td>07-11-2015</td>
<td>JL. SIAGA I A NO. 9 PASAR MINGGU</td>
<td>JAMAL A.N BAMADHAJ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1035</td>
<td>MUCOPECT DROP 7,5MG/ML </td>
<td>BOEHRINGER INGELHEIM </td>
<td>UMUM</td>
 <td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>89,072.00</td>
<td>89,072.00</td>
<td>0.00</td>
<td>8,907.20</td>
<td>97,979.20</td>

</tr>

<tr>
<td>247</td>
<td>08-10-2018 18:32:07</td>
<td>8262</td>
<td>68592</td>
<td>ZAVIYAR LEVINE, AN</td>
<td>07-11-2015</td>
<td>JL. SIAGA I A NO. 9 PASAR MINGGU</td>
<td>JAMAL A.N BAMADHAJ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3318</td>
<td>LASAL 2 CAP</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>1,824.00</td>
<td>3,648.00</td>
<td>0.00</td>
<td>364.80</td>
<td>4,012.80</td>

</tr>

<tr>
<td>248</td>
<td>08-10-2018 18:32:07</td>
<td>8262</td>
<td>68592</td>
<td>ZAVIYAR LEVINE, AN</td>
<td>07-11-2015</td>
<td>JL. SIAGA I A NO. 9 PASAR MINGGU</td>
<td>JAMAL A.N BAMADHAJ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>763</td>
<td>CTM </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>144.00</td>
<td>288.00</td>
 <td>0.00</td>
<td>28.80</td>
<td>316.80</td>

</tr>

<tr>
<td>249</td>
<td>08-10-2018 18:33:00</td>
<td>8263</td>
<td>84776</td>
<td>ZAYN ZAIDEN JAMAL BAMADHAJ, BY</td>
<td>08-01-2018</td>
<td>JL. SIAGA I A NO.9 PEJATEN BARAT</td>
<td>JAMAL BAMADHAJ, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
<td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>250</td>
<td>08-10-2018 18:33:00</td>
<td>8263</td>
<td>84776</td>
<td>ZAYN ZAIDEN JAMAL BAMADHAJ, BY</td>
<td>08-01-2018</td>
<td>JL. SIAGA I A NO.9 PEJATEN BARAT</td>
<td>JAMAL BAMADHAJ, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>
</tr>

<tr>
<td>251</td>
<td>08-10-2018 18:33:00</td>
<td>8263</td>
<td>84776</td>
<td>ZAYN ZAIDEN JAMAL BAMADHAJ, BY</td>
<td>08-01-2018</td>
<td>JL. SIAGA I A NO.9 PEJATEN BARAT</td>
<td>JAMAL BAMADHAJ, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>4573</td>
<td>VACCIN MR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>6.00</td>
<td>63,327.00</td>
<td>379,962.00</td>
<td>0.00</td>
<td>37,996.20</td>
<td>417,958.20</td>

</tr>

<tr>
<td>252</td>
<td>08-10-2018 18:33:00</td>
<td>8263</td>
<td>84776</td>
<td>ZAYN ZAIDEN JAMAL BAMADHAJ, BY</td>
<td>08-01-2018</td>
<td>JL. SIAGA I A NO.9 PEJATEN BARAT</td>
<td>JAMAL BAMADHAJ, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>

</tr>

<tr>
<td>253</td>
<td>08-10-2018 23:09:52</td>
 <td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>406</td>
<td>SENSI GLOVES UKURAN M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>10.00</td>
<td>988.00</td>
<td>9,880.00</td>
<td>0.00</td>
<td>0.00</td>
<td>9,880.00</td>

</tr>

<tr>
<td>254</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>334</td>
<td>PAMPERS DWS (XL'6) </td>
<td>DIAPERS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>17,523.00</td>
<td>35,046.00</td>
<td>0.00</td>
<td>0.00</td>
<td>35,046.00</td>

</tr>

<tr>
<td>255</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
 <td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>60</td>
<td>BLOOD ADMINISTRATION SET </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>41,565.00</td>
<td>41,565.00</td>
<td>0.00</td>
<td>0.00</td>
<td>41,565.00</td>

</tr>

<tr>
<td>256</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>494</td>
<td>VENFLON 18 REFF 393206 </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>42,176.00</td>
<td>42,176.00</td>
<td>0.00</td>
<td>0.00</td>
<td>42,176.00</td>

</tr>

<tr>
<td>257</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
 <td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>262</td>
<td>LEUKOMED-IV 72389-00 (6X8CM) </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>4,330.00</td>
<td>4,330.00</td>
<td>0.00</td>
<td>0.00</td>
<td>4,330.00</td>

</tr>

<tr>
<td>258</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>732.00</td>
<td>1,464.00</td>
<td>0.00</td>
<td>0.00</td>
<td>1,464.00</td>

</tr>

<tr>
<td>259</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
 <td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>10,432.00</td>
<td>10,432.00</td>
<td>0.00</td>
<td>0.00</td>
<td>10,432.00</td>

</tr>

<tr>
<td>260</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>437</td>
<td>SPUIT 10 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>11,899.00</td>
<td>11,899.00</td>
<td>0.00</td>
<td>0.00</td>
<td>11,899.00</td>

</tr>

<tr>
<td>261</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>40</td>
<td>BACTESYN 1,5 GR VIAL </td>
<td>KALBE FARMA </td>
 <td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>279,545.00</td>
<td>279,545.00</td>
<td>0.00</td>
<td>0.00</td>
<td>279,545.00</td>

</tr>

<tr>
<td>262</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>9,128.00</td>
<td>18,256.00</td>
<td>0.00</td>
<td>0.00</td>
<td>18,256.00</td>

</tr>

<tr>
<td>263</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
 <td>2.00</td>
<td>22,494.00</td>
<td>44,988.00</td>
<td>0.00</td>
<td>0.00</td>
<td>44,988.00</td>

</tr>

<tr>
<td>264</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>4086</td>
<td>BACTESYN 0,75 GR VIAL</td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>148,330.00</td>
<td>296,660.00</td>
<td>0.00</td>
<td>0.00</td>
<td>296,660.00</td>

</tr>

<tr>
<td>265</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>207</td>
<td>HYPAVIX 10CM X 5M </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>0.07</td>
<td>226,176.00</td>
<td>15,832.32</td>
 <td>0.00</td>
<td>0.00</td>
<td>15,832.32</td>

</tr>

<tr>
<td>266</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>5</td>
<td>ACETON 100 ML </td>
<td>APOTEK LUAR </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>0.10</td>
<td>22,800.00</td>
<td>2,280.00</td>
<td>0.00</td>
<td>0.00</td>
<td>2,280.00</td>

</tr>

<tr>
<td>267</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>245</td>
<td>KAPAS 1 KG </td>
<td>HUSADA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>0.05</td>
<td>150,784.00</td>
<td>7,539.20</td>
<td>0.00</td>
<td>0.00</td>
<td>7,539.20</td>
 </tr>

<tr>
<td>268</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>941</td>
<td>KASSA HIDROPHIL </td>
<td>HUSADA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>0.05</td>
<td>364,800.00</td>
<td>18,240.00</td>
<td>0.00</td>
<td>0.00</td>
<td>18,240.00</td>

</tr>

<tr>
<td>269</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>1017</td>
<td>MICROPORE 3M 1 INCHI DISPENSE</td>
<td>3M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>0.50</td>
<td>35,687.00</td>
<td>17,843.50</td>
<td>0.00</td>
<td>0.00</td>
<td>17,843.50</td>

</tr>
 <tr>
<td>270</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>346</td>
<td>PENENG ADULT/PED 120-12(PINK)</td>
<td>SINAR RODA UTAMA, PT </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>1.00</td>
<td>6,216.80</td>
<td>6,216.80</td>
<td>0.00</td>
<td>0.00</td>
<td>6,216.80</td>

</tr>

<tr>
<td>271</td>
<td>08-10-2018 23:09:52</td>
<td>8264</td>
<td>91438</td>
<td>WENDY LANGUYU, NY</td>
<td>14-08-1986</td>
<td>BELMONT RESIDENCE TOWER ATHENA JL. LAPANGAN BOLA MERUYA
ILIR</td>
<td>VICTOR MARTAWIDJAJA, TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>3634</td>
<td>MASKER TALI GP CARE</td>
<td>PT.GLOBAL PHARMA</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT INAP</td>
<td>5.00</td>
<td>1,520.00</td>
<td>7,600.00</td>
<td>0.00</td>
<td>0.00</td>
<td>7,600.00</td>

</tr>

<tr>
<td>272</td>
 <td>08-10-2018 19:38:05</td>
<td>8269</td>
<td>76479</td>
<td>RACHMA DYAH AYUNINGTYAS, NY</td>
<td>14-09-1989</td>
<td>PERUMNAS KELUTAN PERMAI BLOK B/12 RT.003 RW.001, KELUTAN</td>
<td>HENRY YOGA WIRAWAN, TN</td>
<td>dr. Fernandi Moegni, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>4870</td>
<td>VOXIB</td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>7,956.67</td>
<td>47,740.02</td>
<td>0.00</td>
<td>4,774.00</td>
<td>52,514.02</td>

</tr>

<tr>
<td>273</td>
<td>08-10-2018 19:38:05</td>
<td>8269</td>
<td>76479</td>
<td>RACHMA DYAH AYUNINGTYAS, NY</td>
<td>14-09-1989</td>
<td>PERUMNAS KELUTAN PERMAI BLOK B/12 RT.003 RW.001, KELUTAN</td>
<td>HENRY YOGA WIRAWAN, TN</td>
<td>dr. Fernandi Moegni, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>8,512.00</td>
<td>8,512.00</td>
<td>0.00</td>
<td>851.20</td>
<td>9,363.20</td>

</tr>

<tr>
<td>274</td>
<td>08-10-2018 19:38:05</td>
<td>8269</td>
<td>76479</td>
<td>RACHMA DYAH AYUNINGTYAS, NY</td>
<td>14-09-1989</td>
 <td>PERUMNAS KELUTAN PERMAI BLOK B/12 RT.003 RW.001, KELUTAN</td>
<td>HENRY YOGA WIRAWAN, TN</td>
<td>dr. Fernandi Moegni, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>20,976.00</td>
<td>20,976.00</td>
<td>0.00</td>
<td>2,097.60</td>
<td>23,073.60</td>

</tr>

<tr>
<td>275</td>
<td>08-10-2018 19:38:05</td>
<td>8269</td>
<td>76479</td>
<td>RACHMA DYAH AYUNINGTYAS, NY</td>
<td>14-09-1989</td>
<td>PERUMNAS KELUTAN PERMAI BLOK B/12 RT.003 RW.001, KELUTAN</td>
<td>HENRY YOGA WIRAWAN, TN</td>
<td>dr. Fernandi Moegni, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>263</td>
<td>LIDOCAIN 2% </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>2.00</td>
<td>2,280.00</td>
<td>4,560.00</td>
<td>0.00</td>
<td>456.00</td>
<td>5,016.00</td>

</tr>

<tr>
<td>276</td>
<td>08-10-2018 18:23:38</td>
<td>8277</td>
<td>81178</td>
<td>ANANDITA WULANSARI, NY</td>
<td>16-09-1978</td>
<td>JL.GUDANG PELURU BLOK I NO.69 JAKSEL</td>
<td>F.BUDI WIBOWO, TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>880</td>
 <td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>277</td>
<td>08-10-2018 18:23:38</td>
<td>8277</td>
<td>81178</td>
<td>ANANDITA WULANSARI, NY</td>
<td>16-09-1978</td>
<td>JL.GUDANG PELURU BLOK I NO.69 JAKSEL</td>
<td>F.BUDI WIBOWO, TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1082</td>
<td>OBIMIN AF (SATUAN) </td>
<td>DARYA VARIA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>25.00</td>
<td>2,127.77</td>
<td>53,194.25</td>
<td>0.00</td>
<td>5,319.43</td>
<td>58,513.68</td>

</tr>

<tr>
<td>278</td>
<td>08-10-2018 18:23:38</td>
<td>8277</td>
<td>81178</td>
<td>ANANDITA WULANSARI, NY</td>
<td>16-09-1978</td>
<td>JL.GUDANG PELURU BLOK I NO.69 JAKSEL</td>
<td>F.BUDI WIBOWO, TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>553</td>
<td>ACYCLOVIR 200 MG TAB </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
 <td>20.00</td>
<td>737.20</td>
<td>14,744.00</td>
<td>0.00</td>
<td>1,474.40</td>
<td>16,218.40</td>

</tr>

<tr>
<td>279</td>
<td>08-10-2018 18:23:38</td>
<td>8277</td>
<td>81178</td>
<td>ANANDITA WULANSARI, NY</td>
<td>16-09-1978</td>
<td>JL.GUDANG PELURU BLOK I NO.69 JAKSEL</td>
<td>F.BUDI WIBOWO, TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>668</td>
<td>CAL-95 </td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>25.00</td>
<td>7,296.00</td>
<td>182,400.00</td>
<td>0.00</td>
<td>18,240.00</td>
<td>200,640.00</td>

</tr>

<tr>
<td>280</td>
<td>08-10-2018 18:10:35</td>
<td>8280</td>
<td>91906</td>
<td>CAROLIEN MAGRIED WELAN, NY</td>
<td>19-01-1949</td>
<td>MT.HARIYONO RESIDENCE APT RT.011/012</td>
<td>-</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>1004</td>
<td>MEFINAL 500MG </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,923.00</td>
<td>19,230.00</td>
<td>0.00</td>
<td>1,923.00</td>
 <td>21,153.00</td>

</tr>

<tr>
<td>281</td>
<td>08-10-2018 18:10:35</td>
<td>8280</td>
<td>91906</td>
<td>CAROLIEN MAGRIED WELAN, NY</td>
<td>19-01-1949</td>
<td>MT.HARIYONO RESIDENCE APT RT.011/012</td>
<td>-</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>2794</td>
<td>LANFIX CAPSUL 200 MG</td>
<td>LANDSON </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>14.00</td>
<td>44,080.00</td>
<td>617,120.00</td>
<td>0.00</td>
<td>61,712.00</td>
<td>678,832.00</td>

</tr>

<tr>
<td>282</td>
<td>08-10-2018 18:07:20</td>
<td>8282</td>
<td>84064</td>
<td>AISYAH RUMMAN HAFIZ, AN</td>
<td>18-11-2017</td>
<td>JL.PERUM TAMAN BUARAN REGENCY BLOK G2</td>
<td>ALMER HAFIZ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>AIA NON ADMEDIKA</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>
<tr>
<td>283</td>
<td>08-10-2018 18:07:20</td>
<td>8282</td>
<td>84064</td>
<td>AISYAH RUMMAN HAFIZ, AN</td>
<td>18-11-2017</td>
<td>JL.PERUM TAMAN BUARAN REGENCY BLOK G2</td>
<td>ALMER HAFIZ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>4573</td>
<td>VACCIN MR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>AIA NON ADMEDIKA</td>
<td>RAWAT JALAN</td>
<td>8.00</td>
<td>63,327.00</td>
<td>506,616.00</td>
<td>0.00</td>
<td>50,661.60</td>
<td>557,277.60</td>

</tr>

<tr>
<td>284</td>
<td>08-10-2018 18:07:20</td>
<td>8282</td>
<td>84064</td>
<td>AISYAH RUMMAN HAFIZ, AN</td>
<td>18-11-2017</td>
<td>JL.PERUM TAMAN BUARAN REGENCY BLOK G2</td>
<td>ALMER HAFIZ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>AIA NON ADMEDIKA</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>

</tr>

<tr>
<td>285</td>
<td>08-10-2018 18:07:20</td>
<td>8282</td>
<td>84064</td>
 <td>AISYAH RUMMAN HAFIZ, AN</td>
<td>18-11-2017</td>
<td>JL.PERUM TAMAN BUARAN REGENCY BLOK G2</td>
<td>ALMER HAFIZ,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>AIA NON ADMEDIKA</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
<td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>286</td>
<td>08-10-2018 17:43:50</td>
<td>8285</td>
<td>38755</td>
<td>MICHELLE BELLUCCI TAWAS, AN</td>
<td>11-07-2011</td>
<td>KOMP MUTIARA SANGRAHA BLOK K6 NO.28 PULO GEBANG</td>
<td>CHRISTOPHER HEAVEN, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>931</td>
<td>ISOPRINOSIN SYR.60ML </td>
<td>DARYA VARIA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>149,626.00</td>
<td>149,626.00</td>
<td>0.00</td>
<td>14,962.60</td>
<td>164,588.60</td>

</tr>

<tr>
<td>287</td>
<td>08-10-2018 17:43:50</td>
<td>8285</td>
<td>38755</td>
<td>MICHELLE BELLUCCI TAWAS, AN</td>
<td>11-07-2011</td>
<td>KOMP MUTIARA SANGRAHA BLOK K6 NO.28 PULO GEBANG</td>
<td>CHRISTOPHER HEAVEN, TN</td>
<td>dr. Eva Devita, SpA</td>
 <td>RAWAT JALAN</td>
<td>740</td>
<td>CLAVAMOX SIRUP 125MG/5ML 60ML</td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>107,800.00</td>
<td>107,800.00</td>
<td>0.00</td>
<td>10,780.00</td>
<td>118,580.00</td>

</tr>

<tr>
<td>288</td>
<td>08-10-2018 17:43:50</td>
<td>8285</td>
<td>38755</td>
<td>MICHELLE BELLUCCI TAWAS, AN</td>
<td>11-07-2011</td>
<td>KOMP MUTIARA SANGRAHA BLOK K6 NO.28 PULO GEBANG</td>
<td>CHRISTOPHER HEAVEN, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>2535</td>
<td>TEMPRA SYRUP 100 ML </td>
<td>TAISHO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>64,448.00</td>
<td>64,448.00</td>
<td>0.00</td>
<td>6,444.80</td>
<td>70,892.80</td>

</tr>

<tr>
<td>289</td>
<td>08-10-2018 17:43:50</td>
<td>8285</td>
<td>38755</td>
<td>MICHELLE BELLUCCI TAWAS, AN</td>
<td>11-07-2011</td>
<td>KOMP MUTIARA SANGRAHA BLOK K6 NO.28 PULO GEBANG</td>
<td>CHRISTOPHER HEAVEN, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>752</td>
<td>COMTUSI SYRUP 60ML </td>
<td>COMBIPHAR </td>
<td>UMUM</td>
 <td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>51,680.00</td>
<td>51,680.00</td>
<td>0.00</td>
<td>5,168.00</td>
<td>56,848.00</td>

</tr>

<tr>
<td>290</td>
<td>08-10-2018 16:15:28</td>
<td>8287</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1396</td>
<td>GENTAMYCIN SALEP 0,1 %</td>
<td>UMUM</td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>2,938.00</td>
<td>14,690.00</td>
<td>0.00</td>
<td>1,469.00</td>
<td>16,159.00</td>

</tr>

<tr>
<td>291</td>
<td>08-10-2018 18:46:13</td>
<td>8288</td>
<td>76762</td>
<td>ISABELLA THEODORUS GREEN, BY</td>
<td>02-10-2016</td>
<td>JL. MANDALA BARAT 3/7, TOMANG</td>
<td>BRYCE WILLIAM GREEN, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>981</td>
<td>LINCOCIN 500 MG </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>15,339.00</td>
<td>76,695.00</td>
 <td>0.00</td>
<td>7,669.50</td>
<td>84,364.50</td>

</tr>

<tr>
<td>292</td>
<td>08-10-2018 18:46:13</td>
<td>8288</td>
<td>76762</td>
<td>ISABELLA THEODORUS GREEN, BY</td>
<td>02-10-2016</td>
<td>JL. MANDALA BARAT 3/7, TOMANG</td>
<td>BRYCE WILLIAM GREEN, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>627</td>
<td>BEDAK KOCOK 50 CC </td>
<td>APOTEK BOULEVARD </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>40,950.00</td>
<td>40,950.00</td>
<td>0.00</td>
<td>4,095.00</td>
<td>45,045.00</td>

</tr>

<tr>
<td>293</td>
<td>08-10-2018 18:46:13</td>
<td>8288</td>
<td>76762</td>
<td>ISABELLA THEODORUS GREEN, BY</td>
<td>02-10-2016</td>
<td>JL. MANDALA BARAT 3/7, TOMANG</td>
<td>BRYCE WILLIAM GREEN, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>763</td>
<td>CTM </td>
<td>OGB </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>144.00</td>
<td>432.00</td>
<td>0.00</td>
<td>43.20</td>
<td>475.20</td>
</tr>

<tr>
<td>294</td>
<td>08-10-2018 18:46:13</td>
<td>8288</td>
<td>76762</td>
<td>ISABELLA THEODORUS GREEN, BY</td>
<td>02-10-2016</td>
<td>JL. MANDALA BARAT 3/7, TOMANG</td>
<td>BRYCE WILLIAM GREEN, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>285.00</td>
<td>285.00</td>
<td>0.00</td>
<td>28.50</td>
<td>313.50</td>

</tr>

<tr>
<td>295</td>
<td>08-10-2018 18:46:13</td>
<td>8288</td>
<td>76762</td>
<td>ISABELLA THEODORUS GREEN, BY</td>
<td>02-10-2016</td>
<td>JL. MANDALA BARAT 3/7, TOMANG</td>
<td>BRYCE WILLIAM GREEN, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>69.66</td>
<td>1,044.90</td>
<td>0.00</td>
<td>104.49</td>
<td>1,149.39</td>

</tr>

<tr>
<td>296</td>
<td>08-10-2018 18:35:51</td>
 <td>8289</td>
<td>71564</td>
<td>AKHTAR RUFIO ARRASYID, BY</td>
<td>01-04-2016</td>
<td>KAVLING CIPAYUNG BLOK T1 NO. 21 RT. 001 RW. 008</td>
<td>AGUNG ARDIYANSYAH, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>702</td>
<td>CEFSPAN 100MG </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>33,440.00</td>
<td>167,200.00</td>
<td>0.00</td>
<td>16,720.00</td>
<td>183,920.00</td>

</tr>

<tr>
<td>297</td>
<td>08-10-2018 18:35:51</td>
<td>8289</td>
<td>71564</td>
<td>AKHTAR RUFIO ARRASYID, BY</td>
<td>01-04-2016</td>
<td>KAVLING CIPAYUNG BLOK T1 NO. 21 RT. 001 RW. 008</td>
<td>AGUNG ARDIYANSYAH, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>25.00</td>
<td>69.66</td>
<td>1,741.50</td>
<td>0.00</td>
<td>174.15</td>
<td>1,915.65</td>

</tr>

<tr>
<td>298</td>
<td>08-10-2018 18:35:51</td>
<td>8289</td>
<td>71564</td>
<td>AKHTAR RUFIO ARRASYID, BY</td>
<td>01-04-2016</td>
<td>KAVLING CIPAYUNG BLOK T1 NO. 21 RT. 001 RW. 008</td>
 <td>AGUNG ARDIYANSYAH, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3318</td>
<td>LASAL 2 CAP</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>1,824.00</td>
<td>5,472.00</td>
<td>0.00</td>
<td>547.20</td>
<td>6,019.20</td>

</tr>

<tr>
<td>299</td>
<td>08-10-2018 18:35:51</td>
<td>8289</td>
<td>71564</td>
<td>AKHTAR RUFIO ARRASYID, BY</td>
<td>01-04-2016</td>
<td>KAVLING CIPAYUNG BLOK T1 NO. 21 RT. 001 RW. 008</td>
<td>AGUNG ARDIYANSYAH, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3500</td>
<td>DEXA M TAB 0,75MG</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>8.00</td>
<td>218.00</td>
<td>1,744.00</td>
<td>0.00</td>
<td>174.40</td>
<td>1,918.40</td>

</tr>

<tr>
<td>300</td>
<td>08-10-2018 18:35:51</td>
<td>8289</td>
<td>71564</td>
<td>AKHTAR RUFIO ARRASYID, BY</td>
<td>01-04-2016</td>
<td>KAVLING CIPAYUNG BLOK T1 NO. 21 RT. 001 RW. 008</td>
<td>AGUNG ARDIYANSYAH, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
 <td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>4.00</td>
<td>285.00</td>
<td>1,140.00</td>
<td>0.00</td>
<td>114.00</td>
<td>1,254.00</td>

</tr>

<tr>
<td>301</td>
<td>08-10-2018 18:35:51</td>
<td>8289</td>
<td>71564</td>
<td>AKHTAR RUFIO ARRASYID, BY</td>
<td>01-04-2016</td>
<td>KAVLING CIPAYUNG BLOK T1 NO. 21 RT. 001 RW. 008</td>
<td>AGUNG ARDIYANSYAH, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>763</td>
<td>CTM </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>144.00</td>
<td>288.00</td>
<td>0.00</td>
<td>28.80</td>
<td>316.80</td>

</tr>

<tr>
<td>302</td>
<td>08-10-2018 16:30:00</td>
<td>8290</td>
<td>30122</td>
<td>ROSE DYANA, NY</td>
<td>18-07-1983</td>
<td></td>
<td>FREDY KURNIAWAN, TN</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>4429</td>
<td>LASAL SYR 100 ML</td>
<td>LAPI </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>1.00</td>
 <td>30,000.00</td>
<td>30,000.00</td>
<td>0.00</td>
<td>3,000.00</td>
<td>33,000.00</td>

</tr>

<tr>
<td>303</td>
<td>08-10-2018 16:30:00</td>
<td>8290</td>
<td>30122</td>
<td>ROSE DYANA, NY</td>
<td>18-07-1983</td>
<td></td>
<td>FREDY KURNIAWAN, TN</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1309</td>
<td>UROTRACTIN </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>3,720.00</td>
<td>37,200.00</td>
<td>0.00</td>
<td>3,720.00</td>
<td>40,920.00</td>

</tr>

<tr>
<td>304</td>
<td>08-10-2018 16:30:00</td>
<td>8290</td>
<td>30122</td>
<td>ROSE DYANA, NY</td>
<td>18-07-1983</td>
<td></td>
<td>FREDY KURNIAWAN, TN</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1132</td>
<td>PRAXION SYRUP 120MG/5ML </td>
<td>Phapros </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>25,200.00</td>
<td>25,200.00</td>
<td>0.00</td>
<td>2,520.00</td>
<td>27,720.00</td>
</tr>

<tr>
<td>305</td>
<td>08-10-2018 16:30:00</td>
<td>8290</td>
<td>30122</td>
<td>ROSE DYANA, NY</td>
<td>18-07-1983</td>
<td></td>
<td>FREDY KURNIAWAN, TN</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1677</td>
<td>CEFIXIME 200 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>4,400.40</td>
<td>44,004.00</td>
<td>0.00</td>
<td>4,400.40</td>
<td>48,404.40</td>

</tr>

<tr>
<td>306</td>
<td>08-10-2018 17:54:00</td>
<td>8292</td>
<td>29865</td>
<td>NAFTALYA JOSEPHINE. AN</td>
<td>16-12-2009</td>
<td></td>
<td>BRYEN SUKENJI TUMANGGOR. TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1684</td>
<td>CELESTAMIN SYRUP 60 ML/BOTOL </td>
<td>SCHERING PLOUGH </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>91,414.00</td>
<td>91,414.00</td>
<td>0.00</td>
<td>9,141.40</td>
<td>100,555.40</td>

</tr>

<tr>
 <td>307</td>
<td>08-10-2018 17:54:00</td>
<td>8292</td>
<td>29865</td>
<td>NAFTALYA JOSEPHINE. AN</td>
<td>16-12-2009</td>
<td></td>
<td>BRYEN SUKENJI TUMANGGOR. TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>931</td>
<td>ISOPRINOSIN SYR.60ML </td>
<td>DARYA VARIA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>149,626.00</td>
<td>149,626.00</td>
<td>0.00</td>
<td>14,962.60</td>
<td>164,588.60</td>

</tr>

<tr>
<td>308</td>
<td>08-10-2018 18:58:28</td>
<td>8294</td>
<td>91304</td>
<td>ELVI LILIANY BONAULI, NY</td>
<td>27-10-1992</td>
<td>JL.PAPANDAYON NO.54 </td>
<td>ANDREW HUMISAR TAMBUNAN, TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>809</td>
<td>DUPHASTON </td>
<td>ABBOT,PT </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>25.00</td>
<td>24,343.00</td>
<td>608,575.00</td>
<td>0.00</td>
<td>60,857.50</td>
<td>669,432.50</td>

</tr>

<tr>
<td>309</td>
<td>08-10-2018 18:58:28</td>
<td>8294</td>
<td>91304</td>
<td>ELVI LILIANY BONAULI, NY</td>
 <td>27-10-1992</td>
<td>JL.PAPANDAYON NO.54 </td>
<td>ANDREW HUMISAR TAMBUNAN, TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>881</td>
<td>FOLAVIT </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>25.00</td>
<td>1,199.00</td>
<td>29,975.00</td>
<td>0.00</td>
<td>2,997.50</td>
<td>32,972.50</td>

</tr>

<tr>
<td>310</td>
<td>08-10-2018 18:58:28</td>
<td>8294</td>
<td>91304</td>
<td>ELVI LILIANY BONAULI, NY</td>
<td>27-10-1992</td>
<td>JL.PAPANDAYON NO.54 </td>
<td>ANDREW HUMISAR TAMBUNAN, TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1310</td>
<td>UTROGESTAN 100 MG CAPS </td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>25.00</td>
<td>40,425.00</td>
<td>1,010,625.00</td>
<td>0.00</td>
<td>101,062.50</td>
<td>1,111,687.50</td>

</tr>

<tr>
<td>311</td>
<td>08-10-2018 18:54:10</td>
<td>8295</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
 <td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>3.00</td>
<td>539.00</td>
<td>1,617.00</td>
<td>0.00</td>
<td>161.70</td>
<td>1,778.70</td>

</tr>

<tr>
<td>312</td>
<td>08-10-2018 18:54:10</td>
<td>8295</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>262</td>
<td>LEUKOMED-IV 72389-00 (6X8CM) </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>3,188.00</td>
<td>3,188.00</td>
<td>0.00</td>
<td>318.80</td>
<td>3,506.80</td>

</tr>

<tr>
<td>313</td>
<td>08-10-2018 18:54:10</td>
<td>8295</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
 <td>IGD</td>
<td>1.00</td>
<td>16,560.00</td>
<td>16,560.00</td>
<td>0.00</td>
<td>1,656.00</td>
<td>18,216.00</td>

</tr>

<tr>
<td>314</td>
<td>08-10-2018 18:54:10</td>
<td>8295</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>4763</td>
<td>NEFROFER 5 ML </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>2.00</td>
<td>81,818.00</td>
<td>163,636.00</td>
<td>0.00</td>
<td>16,363.60</td>
<td>179,999.60</td>

</tr>

<tr>
<td>315</td>
<td>08-10-2018 18:54:10</td>
<td>8295</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>496</td>
<td>VENFLON 22 REFF 393202 </td>
<td>BD </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>31,050.00</td>
<td>31,050.00</td>
<td>0.00</td>
 <td>3,105.00</td>
<td>34,155.00</td>

</tr>

<tr>
<td>316</td>
<td>08-10-2018 18:54:10</td>
<td>8295</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>6,720.00</td>
<td>6,720.00</td>
<td>0.00</td>
<td>672.00</td>
<td>7,392.00</td>

</tr>

<tr>
<td>317</td>
<td>08-10-2018 18:54:10</td>
<td>8295</td>
<td>80895</td>
<td>DENISA RANI, NY</td>
<td>20-12-1990</td>
<td>JL. SALAM 3 GG YUNUS 2 NO. 107</td>
<td>DWI PUTRANTO INDRABASUKI, TN</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>217</td>
<td>INFUSET TS*A200LK002 </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>16,080.00</td>
<td>16,080.00</td>
<td>0.00</td>
<td>1,608.00</td>
<td>17,688.00</td>

</tr>
<tr>
<td>318</td>
<td>08-10-2018 18:27:25</td>
<td>8297</td>
<td>91908</td>
<td>PUTRI AISYAH, NY</td>
<td>20-06-1989</td>
<td>GRAHA EJOHN PEJATEN TIMUR</td>
<td>MOHAMMAD ERIANSYAH, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>668</td>
<td>CAL-95 </td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>7,296.00</td>
<td>109,440.00</td>
<td>0.00</td>
<td>10,944.00</td>
<td>120,384.00</td>

</tr>

<tr>
<td>319</td>
<td>08-10-2018 18:27:25</td>
<td>8297</td>
<td>91908</td>
<td>PUTRI AISYAH, NY</td>
<td>20-06-1989</td>
<td>GRAHA EJOHN PEJATEN TIMUR</td>
<td>MOHAMMAD ERIANSYAH, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>320</td>
<td>08-10-2018 19:13:14</td>
<td>8299</td>
 <td>91179</td>
<td>MARIA ULFA, NY</td>
<td>12-02-1986</td>
<td>JL.CIPINANG BARU UTARA NO.35</td>
<td>NANA DARMANSYAH, TN</td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1345</td>
<td>VITAMAM 2 </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>28.00</td>
<td>5,211.00</td>
<td>145,908.00</td>
<td>0.00</td>
<td>14,590.80</td>
<td>160,498.80</td>

</tr>

<tr>
<td>321</td>
<td>08-10-2018 18:26:16</td>
<td>8300</td>
<td>13965</td>
<td>IMELDA WULANDARI N.F NY.</td>
<td>01-02-1980</td>
<td></td>
<td>ARDIYANTO,DRS MM.TN.</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>2768</td>
<td>SUMAGESIC TAB</td>
<td>UAP </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>651.00</td>
<td>6,510.00</td>
<td>0.00</td>
<td>651.00</td>
<td>7,161.00</td>

</tr>

<tr>
<td>322</td>
<td>08-10-2018 18:26:16</td>
<td>8300</td>
<td>13965</td>
<td>IMELDA WULANDARI N.F NY.</td>
<td>01-02-1980</td>
<td></td>
<td>ARDIYANTO,DRS MM.TN.</td>
 <td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>1238</td>
<td>SMECTA </td>
<td>COMBIPHAR </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>5,067.00</td>
<td>50,670.00</td>
<td>0.00</td>
<td>5,067.00</td>
<td>55,737.00</td>

</tr>

<tr>
<td>323</td>
<td>08-10-2018 18:26:16</td>
<td>8300</td>
<td>13965</td>
<td>IMELDA WULANDARI N.F NY.</td>
<td>01-02-1980</td>
<td></td>
<td>ARDIYANTO,DRS MM.TN.</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>1053</td>
<td>NEW DIATABS </td>
<td>Medifarma </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>847.00</td>
<td>4,235.00</td>
<td>0.00</td>
<td>423.50</td>
<td>4,658.50</td>

</tr>

<tr>
<td>324</td>
<td>08-10-2018 18:50:51</td>
<td>8302</td>
<td>89456</td>
<td>SHAKEIL MUBARAK ILHAMDY, AN</td>
<td>20-06-2018</td>
<td>JL.KEBON KACANG 19</td>
<td>ILHAMDY, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3586</td>
<td>KASSA STERIL PF</td>
<td>UMUM</td>
 <td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>5,320.00</td>
<td>5,320.00</td>
<td>0.00</td>
<td>532.00</td>
<td>5,852.00</td>

</tr>

<tr>
<td>325</td>
<td>08-10-2018 18:50:51</td>
<td>8302</td>
<td>89456</td>
<td>SHAKEIL MUBARAK ILHAMDY, AN</td>
<td>20-06-2018</td>
<td>JL.KEBON KACANG 19</td>
<td>ILHAMDY, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>285.00</td>
<td>570.00</td>
<td>0.00</td>
<td>57.00</td>
<td>627.00</td>

</tr>

<tr>
<td>326</td>
<td>08-10-2018 18:50:51</td>
<td>8302</td>
<td>89456</td>
<td>SHAKEIL MUBARAK ILHAMDY, AN</td>
<td>20-06-2018</td>
<td>JL.KEBON KACANG 19</td>
<td>ILHAMDY, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>41</td>
<td>BACTIGRAS 10X10CM </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>4.00</td>
<td>20,520.00</td>
 <td>82,080.00</td>
<td>0.00</td>
<td>8,208.00</td>
<td>90,288.00</td>

</tr>

<tr>
<td>327</td>
<td>08-10-2018 18:50:51</td>
<td>8302</td>
<td>89456</td>
<td>SHAKEIL MUBARAK ILHAMDY, AN</td>
<td>20-06-2018</td>
<td>JL.KEBON KACANG 19</td>
<td>ILHAMDY, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>69.66</td>
<td>1,044.90</td>
<td>0.00</td>
<td>104.49</td>
<td>1,149.39</td>

</tr>

<tr>
<td>328</td>
<td>08-10-2018 18:50:51</td>
<td>8302</td>
<td>89456</td>
<td>SHAKEIL MUBARAK ILHAMDY, AN</td>
<td>20-06-2018</td>
<td>JL.KEBON KACANG 19</td>
<td>ILHAMDY, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1017</td>
<td>MICROPORE 3M 1 INCHI DISPENSE</td>
<td>3M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>35,687.00</td>
<td>35,687.00</td>
<td>0.00</td>
<td>3,568.70</td>
<td>39,255.70</td>
</tr>

<tr>
<td>329</td>
<td>08-10-2018 18:50:51</td>
<td>8302</td>
<td>89456</td>
<td>SHAKEIL MUBARAK ILHAMDY, AN</td>
<td>20-06-2018</td>
<td>JL.KEBON KACANG 19</td>
<td>ILHAMDY, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>981</td>
<td>LINCOCIN 500 MG </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>4.00</td>
<td>15,339.00</td>
<td>61,356.00</td>
<td>0.00</td>
<td>6,135.60</td>
<td>67,491.60</td>

</tr>

<tr>
<td>330</td>
<td>08-10-2018 18:50:18</td>
<td>8303</td>
<td>65981</td>
<td>IBRA ALGHANI BHADRA, AN</td>
<td>12-06-2015</td>
<td>JL. KEBON KACANG 19 NO. 198</td>
<td>RONAL SAPUTRA,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>674</td>
<td>CALNIC SYR 100 ML </td>
<td>GRACIA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>83,600.00</td>
<td>83,600.00</td>
<td>0.00</td>
<td>8,360.00</td>
<td>91,960.00</td>

</tr>

<tr>
<td>331</td>
 <td>08-10-2018 17:13:18</td>
<td>8307</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>3121</td>
<td>SANMOL TAB</td>
<td>SANBE FARMA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>4.00</td>
<td>410.00</td>
<td>1,640.00</td>
<td>0.00</td>
<td>164.00</td>
<td>1,804.00</td>

</tr>

<tr>
<td>332</td>
<td>08-10-2018 17:48:07</td>
<td>8309</td>
<td>91909</td>
<td>MIRA AFRIANY, NY</td>
<td>22-04-1984</td>
<td>JL. WARGA INDAH KP. BABA LARANGAN</td>
<td>TEGUH, TN</td>
<td>dr. H. Finekri Abidin, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1144</td>
<td>PRIMOLUT N </td>
<td>BAYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>50.00</td>
<td>7,351.00</td>
<td>367,550.00</td>
<td>0.00</td>
<td>36,755.00</td>
<td>404,305.00</td>

</tr>

<tr>
<td>333</td>
<td>08-10-2018 18:17:11</td>
<td>8310</td>
<td>90898</td>
<td>RUBINA RAFCANJANI SOEDJONO, BY</td>
<td>09-09-2018</td>
 <td>KOMP. KEUANGAN NO. 10</td>
<td>ADITYA WIDNUWARDANA, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>8,512.00</td>
<td>8,512.00</td>
<td>0.00</td>
<td>851.20</td>
<td>9,363.20</td>

</tr>

<tr>
<td>334</td>
<td>08-10-2018 18:17:11</td>
<td>8310</td>
<td>90898</td>
<td>RUBINA RAFCANJANI SOEDJONO, BY</td>
<td>09-09-2018</td>
<td>KOMP. KEUANGAN NO. 10</td>
<td>ADITYA WIDNUWARDANA, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1313</td>
<td>VACCIN BCG </td>
<td>BIO FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>209,000.00</td>
<td>209,000.00</td>
<td>0.00</td>
<td>20,900.00</td>
<td>229,900.00</td>

</tr>

<tr>
<td>335</td>
<td>08-10-2018 18:17:11</td>
<td>8310</td>
<td>90898</td>
<td>RUBINA RAFCANJANI SOEDJONO, BY</td>
<td>09-09-2018</td>
<td>KOMP. KEUANGAN NO. 10</td>
<td>ADITYA WIDNUWARDANA, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>230</td>
 <td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>

</tr>

<tr>
<td>336</td>
<td>08-10-2018 18:17:11</td>
<td>8310</td>
<td>90898</td>
<td>RUBINA RAFCANJANI SOEDJONO, BY</td>
<td>09-09-2018</td>
<td>KOMP. KEUANGAN NO. 10</td>
<td>ADITYA WIDNUWARDANA, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>337</td>
<td>08-10-2018 18:17:11</td>
<td>8310</td>
<td>90898</td>
<td>RUBINA RAFCANJANI SOEDJONO, BY</td>
<td>09-09-2018</td>
<td>KOMP. KEUANGAN NO. 10</td>
<td>ADITYA WIDNUWARDANA, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
 <td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
<td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>338</td>
<td>08-10-2018 17:28:00</td>
<td>8315</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Arief Wibowo, SpPD</td>
<td>RAWAT JALAN</td>
<td>1305</td>
<td>URDAFALK CAP 250MG </td>
<td>DARYA VARIA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>14,407.07</td>
<td>432,212.10</td>
<td>0.00</td>
<td>43,221.21</td>
<td>475,433.31</td>

</tr>

<tr>
<td>339</td>
<td>08-10-2018 19:07:35</td>
<td>8316</td>
<td>91495</td>
<td>ANDIKA WULANDARI HS, NY</td>
<td>16-10-1983</td>
<td>APT. MENTENG SQUARE NO. 30E</td>
<td>IFAN REZA ANHAR, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>476</td>
<td>TRANSOFIX 4090500 </td>
<td>B.Braun </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>10,488.00</td>
<td>10,488.00</td>
<td>0.00</td>
<td>1,048.80</td>
 <td>11,536.80</td>

</tr>

<tr>
<td>340</td>
<td>08-10-2018 19:07:35</td>
<td>8316</td>
<td>91495</td>
<td>ANDIKA WULANDARI HS, NY</td>
<td>16-10-1983</td>
<td>APT. MENTENG SQUARE NO. 30E</td>
<td>IFAN REZA ANHAR, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>341</td>
<td>08-10-2018 19:07:35</td>
<td>8316</td>
<td>91495</td>
<td>ANDIKA WULANDARI HS, NY</td>
<td>16-10-1983</td>
<td>APT. MENTENG SQUARE NO. 30E</td>
<td>IFAN REZA ANHAR, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>668</td>
<td>CAL-95 </td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,296.00</td>
<td>218,880.00</td>
<td>0.00</td>
<td>21,888.00</td>
<td>240,768.00</td>

</tr>
<tr>
<td>342</td>
<td>08-10-2018 19:07:35</td>
<td>8316</td>
<td>91495</td>
<td>ANDIKA WULANDARI HS, NY</td>
<td>16-10-1983</td>
<td>APT. MENTENG SQUARE NO. 30E</td>
<td>IFAN REZA ANHAR, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>870</td>
<td>FLADYSTIN OVULA </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>7.00</td>
<td>19,760.00</td>
<td>138,320.00</td>
<td>0.00</td>
<td>13,832.00</td>
<td>152,152.00</td>

</tr>

<tr>
<td>343</td>
<td>08-10-2018 19:07:35</td>
<td>8316</td>
<td>91495</td>
<td>ANDIKA WULANDARI HS, NY</td>
<td>16-10-1983</td>
<td>APT. MENTENG SQUARE NO. 30E</td>
<td>IFAN REZA ANHAR, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>20,976.00</td>
<td>20,976.00</td>
<td>0.00</td>
<td>2,097.60</td>
<td>23,073.60</td>

</tr>

<tr>
<td>344</td>
<td>08-10-2018 18:45:10</td>
<td>8317</td>
<td>91911</td>
 <td>ANNISA DINI KURNIA PURBA, NY</td>
<td>13-07-1989</td>
<td>JL.RAWAMANGUN SELATAN GG.KANA NO.10 RT.006/015</td>
<td>DIMAS SAPUTRA, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>800</td>
<td>DOXYCICLIN 100 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>22.00</td>
<td>605.00</td>
<td>13,310.00</td>
<td>0.00</td>
<td>1,331.00</td>
<td>14,641.00</td>

</tr>

<tr>
<td>345</td>
<td>08-10-2018 18:45:10</td>
<td>8317</td>
<td>91911</td>
<td>ANNISA DINI KURNIA PURBA, NY</td>
<td>13-07-1989</td>
<td>JL.RAWAMANGUN SELATAN GG.KANA NO.10 RT.006/015</td>
<td>DIMAS SAPUTRA, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>4865</td>
<td>STARFOLAT</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>308.00</td>
<td>9,240.00</td>
<td>0.00</td>
<td>924.00</td>
<td>10,164.00</td>

</tr>

<tr>
<td>346</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
 <td>RAWAT JALAN</td>
<td>763</td>
<td>CTM </td>
<td>OGB </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>144.00</td>
<td>288.00</td>
<td>0.00</td>
<td>28.80</td>
<td>316.80</td>

</tr>

<tr>
<td>347</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>702</td>
<td>CEFSPAN 100MG </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>8.00</td>
<td>33,440.00</td>
<td>267,520.00</td>
<td>0.00</td>
<td>26,752.00</td>
<td>294,272.00</td>

</tr>

<tr>
<td>348</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1038</td>
<td>MYCOSTATIN DROPS </td>
<td>TAISHO </td>
<td>UMUM</td>
 <td>SINARMAS</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>78,280.00</td>
<td>78,280.00</td>
<td>0.00</td>
<td>7,828.00</td>
<td>86,108.00</td>

</tr>

<tr>
<td>349</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3500</td>
<td>DEXA M TAB 0,75MG</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>8.00</td>
<td>218.00</td>
<td>1,744.00</td>
<td>0.00</td>
<td>174.40</td>
<td>1,918.40</td>

</tr>

<tr>
<td>350</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1035</td>
<td>MUCOPECT DROP 7,5MG/ML </td>
<td>BOEHRINGER INGELHEIM </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>89,072.00</td>
<td>89,072.00</td>
 <td>0.00</td>
<td>8,907.20</td>
<td>97,979.20</td>

</tr>

<tr>
<td>351</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>69.66</td>
<td>2,089.80</td>
<td>0.00</td>
<td>208.98</td>
<td>2,298.78</td>

</tr>

<tr>
<td>352</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3318</td>
<td>LASAL 2 CAP</td>
<td>LAPI </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>1,824.00</td>
<td>3,648.00</td>
<td>0.00</td>
<td>364.80</td>
<td>4,012.80</td>
</tr>

<tr>
<td>353</td>
<td>08-10-2018 20:01:07</td>
<td>8318</td>
<td>78895</td>
<td>ABHINAAV HARSHA KRISNA, AN</td>
<td>05-04-2017</td>
<td></td>
<td>-</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>4.00</td>
<td>285.00</td>
<td>1,140.00</td>
<td>0.00</td>
<td>114.00</td>
<td>1,254.00</td>

</tr>

<tr>
<td>354</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>3634</td>
<td>MASKER TALI GP CARE</td>
<td>PT.GLOBAL PHARMA</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>5.00</td>
<td>1,520.00</td>
<td>7,600.00</td>
<td>0.00</td>
<td>0.00</td>
<td>7,600.00</td>

</tr>

<tr>
<td>355</td>
<td>08-10-2018 20:45:30</td>
 <td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>DEPO KP</td>
<td>2.00</td>
<td>16,560.00</td>
<td>33,120.00</td>
<td>0.00</td>
<td>0.00</td>
<td>33,120.00</td>

</tr>

<tr>
<td>356</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>86</td>
<td>CEFTRIAXONE INJ 1 GRAM </td>
<td>OGB </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>DEPO KP</td>
<td>2.00</td>
<td>12,000.00</td>
<td>24,000.00</td>
<td>0.00</td>
<td>0.00</td>
<td>24,000.00</td>

</tr>

<tr>
<td>357</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
 <td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>207</td>
<td>HYPAVIX 10CM X 5M </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>0.07</td>
<td>226,176.00</td>
<td>15,832.32</td>
<td>0.00</td>
<td>0.00</td>
<td>15,832.32</td>

</tr>

<tr>
<td>358</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>5</td>
<td>ACETON 100 ML </td>
<td>APOTEK LUAR </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>0.10</td>
<td>22,800.00</td>
<td>2,280.00</td>
<td>0.00</td>
<td>0.00</td>
<td>2,280.00</td>

</tr>

<tr>
<td>359</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>245</td>
<td>KAPAS 1 KG </td>
 <td>HUSADA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>0.05</td>
<td>150,784.00</td>
<td>7,539.20</td>
<td>0.00</td>
<td>0.00</td>
<td>7,539.20</td>

</tr>

<tr>
<td>360</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>941</td>
<td>KASSA HIDROPHIL </td>
<td>HUSADA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>0.05</td>
<td>364,800.00</td>
<td>18,240.00</td>
<td>0.00</td>
<td>0.00</td>
<td>18,240.00</td>

</tr>

<tr>
<td>361</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>1017</td>
<td>MICROPORE 3M 1 INCHI DISPENSE</td>
<td>3M </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>0.50</td>
 <td>35,687.00</td>
<td>17,843.50</td>
<td>0.00</td>
<td>0.00</td>
<td>17,843.50</td>

</tr>

<tr>
<td>362</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>346</td>
<td>PENENG ADULT/PED 120-12(PINK)</td>
<td>SINAR RODA UTAMA, PT </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>1.00</td>
<td>6,216.80</td>
<td>6,216.80</td>
<td>0.00</td>
<td>0.00</td>
<td>6,216.80</td>

</tr>

<tr>
<td>363</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>406</td>
<td>SENSI GLOVES UKURAN M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>10.00</td>
<td>988.00</td>
<td>9,880.00</td>
<td>0.00</td>
<td>0.00</td>
<td>9,880.00</td>
</tr>

<tr>
<td>364</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>437</td>
<td>SPUIT 10 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>DEPO KP</td>
<td>2.00</td>
<td>8,760.00</td>
<td>17,520.00</td>
<td>0.00</td>
<td>0.00</td>
<td>17,520.00</td>

</tr>

<tr>
<td>365</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>4006</td>
<td>CHLORHEXIDINE 2% 10ML</td>
<td>UMUM</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>15,000.00</td>
<td>15,000.00</td>
<td>0.00</td>
<td>0.00</td>
<td>15,000.00</td>

</tr>

<tr>
 <td>366</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>4447</td>
<td>CLIPPER (PISAU CUKUR)9680</td>
<td>3M </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>105,600.00</td>
<td>105,600.00</td>
<td>0.00</td>
<td>0.00</td>
<td>105,600.00</td>

</tr>

<tr>
<td>367</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
<td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>1016</td>
<td>MICROLAX SUPP. </td>
<td>PHAROS </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>22,500.00</td>
<td>45,000.00</td>
<td>0.00</td>
<td>0.00</td>
<td>45,000.00</td>

</tr>

<tr>
<td>368</td>
<td>08-10-2018 20:45:30</td>
<td>8320</td>
<td>50335</td>
<td>LISA TRIASTUTI, NN</td>
 <td>15-05-1969</td>
<td></td>
<td>-</td>
<td>dr. H.MS. Nadir Chan, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>DEPO KP</td>
<td>1.00</td>
<td>7,680.00</td>
<td>7,680.00</td>
<td>0.00</td>
<td>0.00</td>
<td>7,680.00</td>

</tr>

<tr>
<td>369</td>
<td>08-10-2018 19:50:49</td>
<td>8321</td>
<td>70829</td>
<td>ADINDA RACHMADANIA SARI, NY</td>
<td>26-03-1989</td>
<td>JL. GADING MAS BARAT IV BLOK B8 NO.17</td>
<td>BAYU WICAKSONO,TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>693</td>
<td>CAVIT D3 </td>
<td>MERCK </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>15.00</td>
<td>2,252.00</td>
<td>33,780.00</td>
<td>0.00</td>
<td>3,378.00</td>
<td>37,158.00</td>

</tr>

<tr>
<td>370</td>
<td>08-10-2018 19:50:49</td>
<td>8321</td>
<td>70829</td>
<td>ADINDA RACHMADANIA SARI, NY</td>
<td>26-03-1989</td>
<td>JL. GADING MAS BARAT IV BLOK B8 NO.17</td>
<td>BAYU WICAKSONO,TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
 <td>1082</td>
<td>OBIMIN AF (SATUAN) </td>
<td>DARYA VARIA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>15.00</td>
<td>1,658.00</td>
<td>24,870.00</td>
<td>0.00</td>
<td>2,487.00</td>
<td>27,357.00</td>

</tr>

<tr>
<td>371</td>
<td>08-10-2018 19:57:42</td>
<td>8322</td>
<td>80001</td>
<td>DARLING DIANA SARI, NY</td>
<td>04-05-1981</td>
<td>PERUM PD.JAYA JL. BETON BLOK A9/16 RT009/006</td>
<td>ILHAM ERRIANTO, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>1082</td>
<td>OBIMIN AF (SATUAN) </td>
<td>DARYA VARIA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>30.00</td>
<td>1,658.00</td>
<td>49,740.00</td>
<td>0.00</td>
<td>4,974.00</td>
<td>54,714.00</td>

</tr>

<tr>
<td>372</td>
<td>08-10-2018 19:57:42</td>
<td>8322</td>
<td>80001</td>
<td>DARLING DIANA SARI, NY</td>
<td>04-05-1981</td>
<td>PERUM PD.JAYA JL. BETON BLOK A9/16 RT009/006</td>
<td>ILHAM ERRIANTO, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>693</td>
<td>CAVIT D3 </td>
<td>MERCK </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
 <td>FARMASI INHEALT</td>
<td>30.00</td>
<td>2,252.00</td>
<td>67,560.00</td>
<td>0.00</td>
<td>6,756.00</td>
<td>74,316.00</td>

</tr>

<tr>
<td>373</td>
<td>08-10-2018 19:57:42</td>
<td>8322</td>
<td>80001</td>
<td>DARLING DIANA SARI, NY</td>
<td>04-05-1981</td>
<td>PERUM PD.JAYA JL. BETON BLOK A9/16 RT009/006</td>
<td>ILHAM ERRIANTO, TN</td>
<td>dr. Gita Nurul Hidayah, SpOG</td>
<td>RAWAT JALAN</td>
<td>4628</td>
<td>ACETYLCYSTEINE CAPSUL</td>
<td>GENERIC </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI INHEALT</td>
<td>10.00</td>
<td>1,200.00</td>
<td>12,000.00</td>
<td>0.00</td>
<td>1,200.00</td>
<td>13,200.00</td>

</tr>

<tr>
<td>374</td>
<td>08-10-2018 19:59:38</td>
<td>8324</td>
<td>53989</td>
<td>PUTRI KURNIA ROCHMAN, NY</td>
<td>01-09-1991</td>
<td>CITRA RAYA, TAMAN REMBRANT R04 NO.43</td>
<td>DINKY SATRIO PARIKESIT, TN</td>
<td>dr. Fernandi Moegni, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>400</td>
<td>SARUNG TANGAN NO 7,5 </td>
<td>GAMEX </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>31,920.00</td>
<td>31,920.00</td>
<td>0.00</td>
 <td>3,192.00</td>
<td>35,112.00</td>

</tr>

<tr>
<td>375</td>
<td>08-10-2018 19:57:52</td>
<td>8326</td>
<td>27242</td>
<td>ASFA HAVIKA RAFAAT AN.</td>
<td>29-01-2007</td>
<td></td>
<td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>376</td>
<td>08-10-2018 19:57:52</td>
<td>8326</td>
<td>27242</td>
<td>ASFA HAVIKA RAFAAT AN.</td>
<td>29-01-2007</td>
<td></td>
<td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>4573</td>
<td>VACCIN MR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>4.00</td>
<td>63,327.00</td>
<td>253,308.00</td>
<td>0.00</td>
<td>25,330.80</td>
<td>278,638.80</td>

</tr>
<tr>
<td>377</td>
<td>08-10-2018 19:57:52</td>
<td>8326</td>
<td>27242</td>
<td>ASFA HAVIKA RAFAAT AN.</td>
<td>29-01-2007</td>
<td></td>
<td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>

</tr>

<tr>
<td>378</td>
<td>08-10-2018 19:57:52</td>
<td>8326</td>
<td>27242</td>
<td>ASFA HAVIKA RAFAAT AN.</td>
<td>29-01-2007</td>
<td></td>
<td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
<td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>379</td>
<td>08-10-2018 17:46:24</td>
<td>8327</td>
 <td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1036</td>
<td>MUCOPECT PED.ELIX 15/5ML 60ML</td>
<td>BOEHRINGER INGELHEIM </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>71,288.00</td>
<td>71,288.00</td>
<td>0.00</td>
<td>7,128.80</td>
<td>78,416.80</td>

</tr>

<tr>
<td>380</td>
<td>08-10-2018 17:46:24</td>
<td>8327</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1165</td>
<td>PRORIS SUP </td>
<td>PHAROS </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>7,144.00</td>
<td>35,720.00</td>
<td>0.00</td>
<td>3,572.00</td>
<td>39,292.00</td>

</tr>

<tr>
<td>381</td>
<td>08-10-2018 17:46:24</td>
<td>8327</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
 <td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1193</td>
<td>RHINOS JUNIOR SIRUP 60ML</td>
<td>DEXA MEDICA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>45,600.00</td>
<td>45,600.00</td>
<td>0.00</td>
<td>4,560.00</td>
<td>50,160.00</td>

</tr>

<tr>
<td>382</td>
<td>08-10-2018 20:07:56</td>
<td>8328</td>
<td>89377</td>
<td>ALDWYN MARVELLOU SANDJAYA, BY</td>
<td>02-03-2018</td>
<td>JL. PRAPATAN V NO. 16/18, SENEN</td>
<td>MARVIN SANDJAYA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1143</td>
<td>PREVENAR 13 PFS0,5ML </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>815,000.00</td>
<td>815,000.00</td>
<td>0.00</td>
<td>81,500.00</td>
<td>896,500.00</td>

</tr>

<tr>
<td>383</td>
<td>08-10-2018 20:07:56</td>
<td>8328</td>
<td>89377</td>
<td>ALDWYN MARVELLOU SANDJAYA, BY</td>
<td>02-03-2018</td>
<td>JL. PRAPATAN V NO. 16/18, SENEN</td>
<td>MARVIN SANDJAYA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
 <td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>384</td>
<td>08-10-2018 17:48:29</td>
<td>8329</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1035</td>
<td>MUCOPECT DROP 7,5MG/ML </td>
<td>BOEHRINGER INGELHEIM </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>89,072.00</td>
<td>89,072.00</td>
<td>0.00</td>
<td>8,907.20</td>
<td>97,979.20</td>

</tr>

<tr>
<td>385</td>
<td>08-10-2018 17:48:29</td>
<td>8329</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1194</td>
<td>RHINOS NEO DROP </td>
<td>DEXA MEDICA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>65,360.00</td>
 <td>65,360.00</td>
<td>0.00</td>
<td>6,536.00</td>
<td>71,896.00</td>

</tr>

<tr>
<td>386</td>
<td>08-10-2018 20:11:41</td>
<td>8330</td>
<td>84752</td>
<td>AUDREY SHAQUEENA Z, BY</td>
<td>29-12-2017</td>
<td>JL.SUKASARI GG.M RT.007 RW.04 NO.22 HARAPAN MULYA</td>
<td>NOVA FEBRI JUMIADI,TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>4573</td>
<td>VACCIN MR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>AVIVA (ASTRA LIFE)</td>
<td>RAWAT JALAN</td>
<td>4.00</td>
<td>63,327.00</td>
<td>253,308.00</td>
<td>0.00</td>
<td>25,330.80</td>
<td>278,638.80</td>

</tr>

<tr>
<td>387</td>
<td>08-10-2018 20:11:41</td>
<td>8330</td>
<td>84752</td>
<td>AUDREY SHAQUEENA Z, BY</td>
<td>29-12-2017</td>
<td>JL.SUKASARI GG.M RT.007 RW.04 NO.22 HARAPAN MULYA</td>
<td>NOVA FEBRI JUMIADI,TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>AVIVA (ASTRA LIFE)</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>
</tr>

<tr>
<td>388</td>
<td>08-10-2018 20:11:41</td>
<td>8330</td>
<td>84752</td>
<td>AUDREY SHAQUEENA Z, BY</td>
<td>29-12-2017</td>
<td>JL.SUKASARI GG.M RT.007 RW.04 NO.22 HARAPAN MULYA</td>
<td>NOVA FEBRI JUMIADI,TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>AVIVA (ASTRA LIFE)</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>389</td>
<td>08-10-2018 20:11:41</td>
<td>8330</td>
<td>84752</td>
<td>AUDREY SHAQUEENA Z, BY</td>
<td>29-12-2017</td>
<td>JL.SUKASARI GG.M RT.007 RW.04 NO.22 HARAPAN MULYA</td>
<td>NOVA FEBRI JUMIADI,TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>AVIVA (ASTRA LIFE)</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
<td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>390</td>
 <td>08-10-2018 20:11:41</td>
<td>8330</td>
<td>84752</td>
<td>AUDREY SHAQUEENA Z, BY</td>
<td>29-12-2017</td>
<td>JL.SUKASARI GG.M RT.007 RW.04 NO.22 HARAPAN MULYA</td>
<td>NOVA FEBRI JUMIADI,TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1130</td>
<td>PRAXION 100MG DROPS </td>
<td>PHAROS </td>
<td>UMUM</td>
<td>AVIVA (ASTRA LIFE)</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>31,464.00</td>
<td>31,464.00</td>
<td>0.00</td>
<td>3,146.40</td>
<td>34,610.40</td>

</tr>

<tr>
<td>391</td>
<td>08-10-2018 19:51:35</td>
<td>8332</td>
<td>90475</td>
<td>MARSHA RAMADITA TUAKIA, NN</td>
<td>24-03-1990</td>
<td>JL. ANGGREK LESTARI 7A RT002/007</td>
<td>-</td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>786</td>
<td>DIANE 35 </td>
<td>BAYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>148,860.00</td>
<td>148,860.00</td>
<td>0.00</td>
<td>14,886.00</td>
<td>163,746.00</td>

</tr>

<tr>
<td>392</td>
<td>08-10-2018 20:11:02</td>
<td>8333</td>
<td>45950</td>
<td>AUDREY NAFILZA HARRY, BY</td>
<td>03-08-2012</td>
 <td></td>
<td>HARRY DWIYANA K, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>763</td>
<td>CTM </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>144.00</td>
<td>432.00</td>
<td>0.00</td>
<td>43.20</td>
<td>475.20</td>

</tr>

<tr>
<td>393</td>
<td>08-10-2018 20:11:02</td>
<td>8333</td>
<td>45950</td>
<td>AUDREY NAFILZA HARRY, BY</td>
<td>03-08-2012</td>
<td></td>
<td>HARRY DWIYANA K, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>18.00</td>
<td>69.66</td>
<td>1,253.88</td>
<td>0.00</td>
<td>125.39</td>
<td>1,379.27</td>

</tr>

<tr>
<td>394</td>
<td>08-10-2018 20:11:02</td>
<td>8333</td>
<td>45950</td>
<td>AUDREY NAFILZA HARRY, BY</td>
<td>03-08-2012</td>
<td></td>
<td>HARRY DWIYANA K, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>2457</td>
 <td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>285.00</td>
<td>285.00</td>
<td>0.00</td>
<td>28.50</td>
<td>313.50</td>

</tr>

<tr>
<td>395</td>
<td>08-10-2018 20:11:02</td>
<td>8333</td>
<td>45950</td>
<td>AUDREY NAFILZA HARRY, BY</td>
<td>03-08-2012</td>
<td></td>
<td>HARRY DWIYANA K, TN ( AYAH )</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>981</td>
<td>LINCOCIN 500 MG </td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>9.00</td>
<td>15,339.00</td>
<td>138,051.00</td>
<td>0.00</td>
<td>13,805.10</td>
<td>151,856.10</td>

</tr>

<tr>
<td>396</td>
<td>08-10-2018 20:33:23</td>
<td>8334</td>
<td>90742</td>
<td>MIKAEL RAFFASYA RADHITYA, BY</td>
<td>30-08-2018</td>
<td>JL.HARAPAN MULIA 1 NO.148 9/8</td>
<td>ARYA RADHITYA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
 <td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>397</td>
<td>08-10-2018 20:33:23</td>
<td>8334</td>
<td>90742</td>
<td>MIKAEL RAFFASYA RADHITYA, BY</td>
<td>30-08-2018</td>
<td>JL.HARAPAN MULIA 1 NO.148 9/8</td>
<td>ARYA RADHITYA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
<td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>398</td>
<td>08-10-2018 20:33:23</td>
<td>8334</td>
<td>90742</td>
<td>MIKAEL RAFFASYA RADHITYA, BY</td>
<td>30-08-2018</td>
<td>JL.HARAPAN MULIA 1 NO.148 9/8</td>
<td>ARYA RADHITYA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1313</td>
<td>VACCIN BCG </td>
<td>BIO FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>209,000.00</td>
<td>209,000.00</td>
<td>0.00</td>
<td>20,900.00</td>
 <td>229,900.00</td>

</tr>

<tr>
<td>399</td>
<td>08-10-2018 20:33:23</td>
<td>8334</td>
<td>90742</td>
<td>MIKAEL RAFFASYA RADHITYA, BY</td>
<td>30-08-2018</td>
<td>JL.HARAPAN MULIA 1 NO.148 9/8</td>
<td>ARYA RADHITYA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>

</tr>

<tr>
<td>400</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>298</td>
<td>NARFOZ INJ 4 MG/2 ML </td>
<td>PHAROS </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>30,360.00</td>
<td>30,360.00</td>
<td>0.00</td>
<td>0.00</td>
<td>30,360.00</td>

</tr>
<tr>
<td>401</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>1132</td>
<td>PRAXION SYRUP 120MG/5ML </td>
<td>Phapros </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>25,200.00</td>
<td>25,200.00</td>
<td>0.00</td>
<td>0.00</td>
<td>25,200.00</td>

</tr>

<tr>
<td>402</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>233</td>
<td>KA-EN 1B 500ML </td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>26,400.00</td>
<td>26,400.00</td>
<td>0.00</td>
<td>0.00</td>
<td>26,400.00</td>

</tr>

<tr>
<td>403</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
 <td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>248</td>
<td>KCL 25 ML </td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>9,960.00</td>
<td>9,960.00</td>
<td>0.00</td>
<td>0.00</td>
<td>9,960.00</td>

</tr>

<tr>
<td>404</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>2779</td>
<td>ONDANSENTRON 4MG/2ML</td>
<td>OGB </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>8,400.00</td>
<td>8,400.00</td>
<td>0.00</td>
<td>0.00</td>
<td>8,400.00</td>

</tr>

<tr>
<td>405</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
 <td>RAWAT INAP</td>
<td>386</td>
<td>RANITIDIN INJEKSI </td>
<td>OGB </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>3,780.00</td>
<td>3,780.00</td>
<td>0.00</td>
<td>0.00</td>
<td>3,780.00</td>

</tr>

<tr>
<td>406</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>3589</td>
<td>SPUIT 3 CC TERUMO</td>
<td>TERUMO</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>5,520.00</td>
<td>5,520.00</td>
<td>0.00</td>
<td>0.00</td>
<td>5,520.00</td>

</tr>

<tr>
<td>407</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
 <td>INHEALTH MANAGED CARE</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>6,720.00</td>
<td>6,720.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,720.00</td>

</tr>

<tr>
<td>408</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>4</td>
<td>ABBOCATH NO.24 (SURFLO) </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>32,400.00</td>
<td>32,400.00</td>
<td>0.00</td>
<td>0.00</td>
<td>32,400.00</td>

</tr>

<tr>
<td>409</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>262</td>
<td>LEUKOMED-IV 72389-00 (6X8CM) </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>3,188.00</td>
<td>3,188.00</td>
 <td>0.00</td>
<td>0.00</td>
<td>3,188.00</td>

</tr>

<tr>
<td>410</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>2739</td>
<td>DISCOFIX TUBING(4098102)</td>
<td>DEMKA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>42,000.00</td>
<td>42,000.00</td>
<td>0.00</td>
<td>0.00</td>
<td>42,000.00</td>

</tr>

<tr>
<td>411</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>217</td>
<td>INFUSET TS*A200LK002 </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>16,080.00</td>
<td>16,080.00</td>
<td>0.00</td>
<td>0.00</td>
<td>16,080.00</td>
</tr>

<tr>
<td>412</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>233</td>
<td>KA-EN 1B 500ML </td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>26,400.00</td>
<td>26,400.00</td>
<td>0.00</td>
<td>0.00</td>
<td>26,400.00</td>

</tr>

<tr>
<td>413</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>430</td>
<td>SPALK ANAK UK 15 X 5 CM (SEDA</td>
<td>AULIA SPALK </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>23,004.00</td>
<td>23,004.00</td>
<td>0.00</td>
<td>0.00</td>
<td>23,004.00</td>

</tr>

<tr>
<td>414</td>
<td>08-10-2018 20:29:11</td>
 <td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>386</td>
<td>RANITIDIN INJEKSI </td>
<td>OGB </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>3,780.00</td>
<td>3,780.00</td>
<td>0.00</td>
<td>0.00</td>
<td>3,780.00</td>

</tr>

<tr>
<td>415</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>3589</td>
<td>SPUIT 3 CC TERUMO</td>
<td>TERUMO</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>5,520.00</td>
<td>5,520.00</td>
<td>0.00</td>
<td>0.00</td>
<td>5,520.00</td>

</tr>

<tr>
<td>416</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
 <td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>437</td>
<td>SPUIT 10 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>8,760.00</td>
<td>8,760.00</td>
<td>0.00</td>
<td>0.00</td>
<td>8,760.00</td>

</tr>

<tr>
<td>417</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>2.00</td>
<td>539.00</td>
<td>1,078.00</td>
<td>0.00</td>
<td>0.00</td>
<td>1,078.00</td>

</tr>

<tr>
<td>418</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>315</td>
<td>NORMAL SALIN 25 ML </td>
 <td>OTSUKA </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>IGD</td>
<td>1.00</td>
<td>6,960.00</td>
<td>6,960.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,960.00</td>

</tr>

<tr>
<td>419</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>406</td>
<td>SENSI GLOVES UKURAN M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>10.00</td>
<td>988.00</td>
<td>9,880.00</td>
<td>0.00</td>
<td>0.00</td>
<td>9,880.00</td>

</tr>

<tr>
<td>420</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>3634</td>
<td>MASKER TALI GP CARE</td>
<td>PT.GLOBAL PHARMA</td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>5.00</td>
 <td>1,520.00</td>
<td>7,600.00</td>
<td>0.00</td>
<td>0.00</td>
<td>7,600.00</td>

</tr>

<tr>
<td>421</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>346</td>
<td>PENENG ADULT/PED 120-12(PINK)</td>
<td>SINAR RODA UTAMA, PT </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>1.00</td>
<td>6,216.80</td>
<td>6,216.80</td>
<td>0.00</td>
<td>0.00</td>
<td>6,216.80</td>

</tr>

<tr>
<td>422</td>
<td>08-10-2018 20:29:11</td>
<td>8336</td>
<td>70196</td>
<td>SYALOMITHA KRISTEN LEANNY, BY</td>
<td>21-01-2016</td>
<td>APT. GRAND PALACE KEMAYORAN</td>
<td>LEANDRO HANDRY MONINGKEY, TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>1017</td>
<td>MICROPORE 3M 1 INCHI DISPENSE</td>
<td>3M </td>
<td>UMUM</td>
<td>INHEALTH MANAGED CARE</td>
<td>RAWAT INAP</td>
<td>0.50</td>
<td>35,687.00</td>
<td>17,843.50</td>
<td>0.00</td>
<td>0.00</td>
<td>17,843.50</td>
</tr>

<tr>
<td>423</td>
<td>08-10-2018 19:41:14</td>
<td>8337</td>
<td>86620</td>
<td>KIAN KENATRA DAMALIF, AN</td>
<td>20-10-2010</td>
<td>JL CIDURIAN NO.7 CIKINI JAKPUS 13330</td>
<td>DARMUJI KETOT WALUYO, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>69.66</td>
<td>696.60</td>
<td>0.00</td>
<td>69.66</td>
<td>766.26</td>

</tr>

<tr>
<td>424</td>
<td>08-10-2018 19:41:14</td>
<td>8337</td>
<td>86620</td>
<td>KIAN KENATRA DAMALIF, AN</td>
<td>20-10-2010</td>
<td>JL CIDURIAN NO.7 CIKINI JAKPUS 13330</td>
<td>DARMUJI KETOT WALUYO, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>285.00</td>
<td>285.00</td>
<td>0.00</td>
<td>28.50</td>
<td>313.50</td>

</tr>

<tr>
 <td>425</td>
<td>08-10-2018 19:41:14</td>
<td>8337</td>
<td>86620</td>
<td>KIAN KENATRA DAMALIF, AN</td>
<td>20-10-2010</td>
<td>JL CIDURIAN NO.7 CIKINI JAKPUS 13330</td>
<td>DARMUJI KETOT WALUYO, TN</td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>1111</td>
<td>PARACETAMOL 500MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>305.00</td>
<td>1,830.00</td>
<td>0.00</td>
<td>183.00</td>
<td>2,013.00</td>

</tr>

<tr>
<td>426</td>
<td>08-10-2018 19:49:50</td>
<td>8338</td>
<td>47190</td>
<td>HALIDA WIDYANINGRUM,NY</td>
<td>29-05-1978</td>
<td></td>
<td>LUKMAN TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>20,976.00</td>
<td>20,976.00</td>
<td>0.00</td>
<td>2,097.60</td>
<td>23,073.60</td>

</tr>

<tr>
<td>427</td>
<td>08-10-2018 19:49:50</td>
<td>8338</td>
<td>47190</td>
<td>HALIDA WIDYANINGRUM,NY</td>
 <td>29-05-1978</td>
<td></td>
<td>LUKMAN TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>620</td>
<td>BAQUINOR FORTE </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>19,631.00</td>
<td>196,310.00</td>
<td>0.00</td>
<td>19,631.00</td>
<td>215,941.00</td>

</tr>

<tr>
<td>428</td>
<td>08-10-2018 19:49:50</td>
<td>8338</td>
<td>47190</td>
<td>HALIDA WIDYANINGRUM,NY</td>
<td>29-05-1978</td>
<td></td>
<td>LUKMAN TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>476</td>
<td>TRANSOFIX 4090500 </td>
<td>B.Braun </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>10,488.00</td>
<td>10,488.00</td>
<td>0.00</td>
<td>1,048.80</td>
<td>11,536.80</td>

</tr>

<tr>
<td>429</td>
<td>08-10-2018 19:49:50</td>
<td>8338</td>
<td>47190</td>
<td>HALIDA WIDYANINGRUM,NY</td>
<td>29-05-1978</td>
<td></td>
<td>LUKMAN TN</td>
<td>Dr.dr.Eka Rusdianto, SpOG(K)</td>
<td>RAWAT JALAN</td>
 <td>1004</td>
<td>MEFINAL 500MG </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>SINARMAS</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,923.00</td>
<td>19,230.00</td>
<td>0.00</td>
<td>1,923.00</td>
<td>21,153.00</td>

</tr>

<tr>
<td>430</td>
<td>08-10-2018 20:28:37</td>
<td>8340</td>
<td>85614</td>
<td>CALVIN JANINDRA A.W, AN</td>
<td>10-01-2018</td>
<td>JL.CIKINI V NO.7 RT.011 RW.005</td>
<td>ADHI WIHARSA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>431</td>
<td>08-10-2018 20:28:37</td>
<td>8340</td>
<td>85614</td>
<td>CALVIN JANINDRA A.W, AN</td>
<td>10-01-2018</td>
<td>JL.CIKINI V NO.7 RT.011 RW.005</td>
<td>ADHI WIHARSA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>4573</td>
<td>VACCIN MR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
 <td>RAWAT JALAN</td>
<td>8.00</td>
<td>63,327.00</td>
<td>506,616.00</td>
<td>0.00</td>
<td>50,661.60</td>
<td>557,277.60</td>

</tr>

<tr>
<td>432</td>
<td>08-10-2018 20:28:37</td>
<td>8340</td>
<td>85614</td>
<td>CALVIN JANINDRA A.W, AN</td>
<td>10-01-2018</td>
<td>JL.CIKINI V NO.7 RT.011 RW.005</td>
<td>ADHI WIHARSA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>

</tr>

<tr>
<td>433</td>
<td>08-10-2018 20:28:37</td>
<td>8340</td>
<td>85614</td>
<td>CALVIN JANINDRA A.W, AN</td>
<td>10-01-2018</td>
<td>JL.CIKINI V NO.7 RT.011 RW.005</td>
<td>ADHI WIHARSA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>9,728.00</td>
<td>9,728.00</td>
<td>0.00</td>
 <td>972.80</td>
<td>10,700.80</td>

</tr>

<tr>
<td>434</td>
<td>08-10-2018 20:41:45</td>
<td>8341</td>
<td>73229</td>
<td>MARTA, NY</td>
<td>05-05-1979</td>
<td>KRUKUT RAYA NO.35 01/06 LIMO DEPOK</td>
<td>MARTA, NY</td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1149</td>
<td>PROFERTIL </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>MEDIKA PLAZA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>22,800.00</td>
<td>228,000.00</td>
<td>0.00</td>
<td>22,800.00</td>
<td>250,800.00</td>

</tr>

<tr>
<td>435</td>
<td>08-10-2018 20:41:45</td>
<td>8341</td>
<td>73229</td>
<td>MARTA, NY</td>
<td>05-05-1979</td>
<td>KRUKUT RAYA NO.35 01/06 LIMO DEPOK</td>
<td>MARTA, NY</td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1169</td>
<td>PROTHYRA 10MG </td>
<td>SUNTHI SEPURI,PT </td>
<td>UMUM</td>
<td>MEDIKA PLAZA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>7,017.00</td>
<td>70,170.00</td>
<td>0.00</td>
<td>7,017.00</td>
<td>77,187.00</td>

</tr>
<tr>
<td>436</td>
<td>08-10-2018 20:41:45</td>
<td>8341</td>
<td>73229</td>
<td>MARTA, NY</td>
<td>05-05-1979</td>
<td>KRUKUT RAYA NO.35 01/06 LIMO DEPOK</td>
<td>MARTA, NY</td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>893</td>
<td>GLUCOPHAGE 500MG </td>
<td>MERCK </td>
<td>UMUM</td>
<td>MEDIKA PLAZA</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>2,354.00</td>
<td>70,620.00</td>
<td>0.00</td>
<td>7,062.00</td>
<td>77,682.00</td>

</tr>

<tr>
<td>437</td>
<td>08-10-2018 18:58:18</td>
<td>8345</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1106</td>
<td>PANADOL TABLET </td>
<td>GLAXO SMITH KLINE </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,177.00</td>
<td>11,770.00</td>
<td>0.00</td>
<td>1,177.00</td>
<td>12,947.00</td>

</tr>

<tr>
<td>438</td>
<td>08-10-2018 19:38:40</td>
<td>8346</td>
 <td>88550</td>
<td>NILA KHUSNIKA SARI, NN</td>
<td>21-09-1990</td>
<td>JL. KAMP. BALI 23 NO. 231 06/07</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>2768</td>
<td>SUMAGESIC TAB</td>
<td>UAP </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>651.00</td>
<td>6,510.00</td>
<td>0.00</td>
<td>651.00</td>
<td>7,161.00</td>

</tr>

<tr>
<td>439</td>
<td>08-10-2018 19:38:40</td>
<td>8346</td>
<td>88550</td>
<td>NILA KHUSNIKA SARI, NN</td>
<td>21-09-1990</td>
<td>JL. KAMP. BALI 23 NO. 231 06/07</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>723</td>
<td>CETIRIZIN TAB 10 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>866.00</td>
<td>8,660.00</td>
<td>0.00</td>
<td>866.00</td>
<td>9,526.00</td>

</tr>

<tr>
<td>440</td>
<td>08-10-2018 19:38:40</td>
<td>8346</td>
<td>88550</td>
<td>NILA KHUSNIKA SARI, NN</td>
<td>21-09-1990</td>
<td>JL. KAMP. BALI 23 NO. 231 06/07</td>
<td>-</td>
 <td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>3204</td>
<td>LAPIMUC TAB</td>
<td>LAPI </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,170.00</td>
<td>11,700.00</td>
<td>0.00</td>
<td>1,170.00</td>
<td>12,870.00</td>

</tr>

<tr>
<td>441</td>
<td>08-10-2018 19:38:40</td>
<td>8346</td>
<td>88550</td>
<td>NILA KHUSNIKA SARI, NN</td>
<td>21-09-1990</td>
<td>JL. KAMP. BALI 23 NO. 231 06/07</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>696</td>
<td>CEFADROXIL 500 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>1,161.00</td>
<td>5,805.00</td>
<td>0.00</td>
<td>580.50</td>
<td>6,385.50</td>

</tr>

<tr>
<td>442</td>
<td>08-10-2018 19:38:40</td>
<td>8346</td>
<td>88550</td>
<td>NILA KHUSNIKA SARI, NN</td>
<td>21-09-1990</td>
<td>JL. KAMP. BALI 23 NO. 231 06/07</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>3819</td>
<td>CAPSUL NO 1</td>
<td>UMUM</td>
 <td>UMUM</td>
<td>OJK ADMEDIKA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>57.00</td>
<td>570.00</td>
<td>0.00</td>
<td>57.00</td>
<td>627.00</td>

</tr>

<tr>
<td>443</td>
<td>08-10-2018 19:18:28</td>
<td>8347</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>4356</td>
<td>VELUTINE</td>
<td>NOVELL </td>
<td></td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>8,400.00</td>
<td>8,400.00</td>
<td>0.00</td>
<td>840.00</td>
<td>9,240.00</td>

</tr>

<tr>
<td>444</td>
<td>08-10-2018 21:08:46</td>
<td>8349</td>
<td>91913</td>
<td>AMANDA DHANI PREVIA YUDA, NY</td>
<td>25-09-1991</td>
<td>JL.CEMPAKA WARNA NO.6 RT.007/004</td>
<td>ALVIN DWIYANTO, TN</td>
<td>dr. H. Finekri Abidin, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>2961</td>
<td>CDR SWEET ORANGE</td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>GENERALI INDONESIA</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>48,488.00</td>
 <td>96,976.00</td>
<td>0.00</td>
<td>9,697.60</td>
<td>106,673.60</td>

</tr>

<tr>
<td>445</td>
<td>08-10-2018 21:08:46</td>
<td>8349</td>
<td>91913</td>
<td>AMANDA DHANI PREVIA YUDA, NY</td>
<td>25-09-1991</td>
<td>JL.CEMPAKA WARNA NO.6 RT.007/004</td>
<td>ALVIN DWIYANTO, TN</td>
<td>dr. H. Finekri Abidin, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>575</td>
<td>AMOXAN 500MG CAPS. </td>
<td>SANBE FARMA </td>
<td>UMUM</td>
<td>GENERALI INDONESIA</td>
<td>FARMASI B</td>
<td>15.00</td>
<td>4,712.00</td>
<td>70,680.00</td>
<td>0.00</td>
<td>7,068.00</td>
<td>77,748.00</td>

</tr>

<tr>
<td>446</td>
<td>08-10-2018 21:08:46</td>
<td>8349</td>
<td>91913</td>
<td>AMANDA DHANI PREVIA YUDA, NY</td>
<td>25-09-1991</td>
<td>JL.CEMPAKA WARNA NO.6 RT.007/004</td>
<td>ALVIN DWIYANTO, TN</td>
<td>dr. H. Finekri Abidin, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>1106</td>
<td>PANADOL TABLET </td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>GENERALI INDONESIA</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,177.00</td>
<td>11,770.00</td>
<td>0.00</td>
<td>1,177.00</td>
<td>12,947.00</td>
</tr>

<tr>
<td>447</td>
<td>08-10-2018 20:39:19</td>
<td>8350</td>
<td>91761</td>
<td>KEVIN JONATHAN SAPUTRA, AN</td>
<td>02-09-2013</td>
<td>JL.RAYA KALIMALANG NO.14C </td>
<td>BAMBANG SAPUTRA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1783</td>
<td>DEPAKENE SYR </td>
<td>ABBOT,PT </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>238,184.00</td>
<td>238,184.00</td>
<td>0.00</td>
<td>23,818.40</td>
<td>262,002.40</td>

</tr>

<tr>
<td>448</td>
<td>08-10-2018 20:39:19</td>
<td>8350</td>
<td>91761</td>
<td>KEVIN JONATHAN SAPUTRA, AN</td>
<td>02-09-2013</td>
<td>JL.RAYA KALIMALANG NO.14C </td>
<td>BAMBANG SAPUTRA, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1248</td>
<td>STESOLID RECTAL 10MG </td>
<td>ACTAVIS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>54,173.00</td>
<td>54,173.00</td>
<td>0.00</td>
<td>5,417.30</td>
<td>59,590.30</td>

</tr>

<tr>
<td>449</td>
 <td>08-10-2018 20:50:11</td>
<td>8356</td>
<td>65496</td>
<td>LAVANYA ALISHA HELGA, BY</td>
<td>26-05-2015</td>
<td>KOMP. PONDOK INDAH JATISARI BLOK H 16 JL. WIBAWA MUKTI
RAYA</td>
<td>M. ANDI ALFAN,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>2457</td>
<td>SIRPLUS TAB 20GR</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>285.00</td>
<td>570.00</td>
<td>0.00</td>
<td>57.00</td>
<td>627.00</td>

</tr>

<tr>
<td>450</td>
<td>08-10-2018 20:50:11</td>
<td>8356</td>
<td>65496</td>
<td>LAVANYA ALISHA HELGA, BY</td>
<td>26-05-2015</td>
<td>KOMP. PONDOK INDAH JATISARI BLOK H 16 JL. WIBAWA MUKTI
RAYA</td>
<td>M. ANDI ALFAN,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>763</td>
<td>CTM </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>144.00</td>
<td>432.00</td>
<td>0.00</td>
<td>43.20</td>
<td>475.20</td>

</tr>

<tr>
<td>451</td>
<td>08-10-2018 20:50:11</td>
<td>8356</td>
<td>65496</td>
 <td>LAVANYA ALISHA HELGA, BY</td>
<td>26-05-2015</td>
<td>KOMP. PONDOK INDAH JATISARI BLOK H 16 JL. WIBAWA MUKTI
RAYA</td>
<td>M. ANDI ALFAN,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3500</td>
<td>DEXA M TAB 0,75MG</td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>8.00</td>
<td>218.00</td>
<td>1,744.00</td>
<td>0.00</td>
<td>174.40</td>
<td>1,918.40</td>

</tr>

<tr>
<td>452</td>
<td>08-10-2018 20:50:11</td>
<td>8356</td>
<td>65496</td>
<td>LAVANYA ALISHA HELGA, BY</td>
<td>26-05-2015</td>
<td>KOMP. PONDOK INDAH JATISARI BLOK H 16 JL. WIBAWA MUKTI
RAYA</td>
<td>M. ANDI ALFAN,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>1035</td>
<td>MUCOPECT DROP 7,5MG/ML </td>
<td>BOEHRINGER INGELHEIM </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>89,072.00</td>
<td>89,072.00</td>
<td>0.00</td>
<td>8,907.20</td>
<td>97,979.20</td>

</tr>

<tr>
<td>453</td>
<td>08-10-2018 20:50:11</td>
<td>8356</td>
<td>65496</td>
<td>LAVANYA ALISHA HELGA, BY</td>
<td>26-05-2015</td>
<td>KOMP. PONDOK INDAH JATISARI BLOK H 16 JL. WIBAWA MUKTI
RAYA</td>
<td>M. ANDI ALFAN,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>946</td>
<td>KERTAS PUYER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>25.00</td>
<td>69.66</td>
<td>1,741.50</td>
<td>0.00</td>
<td>174.15</td>
<td>1,915.65</td>

</tr>

<tr>
<td>454</td>
<td>08-10-2018 20:50:11</td>
<td>8356</td>
<td>65496</td>
<td>LAVANYA ALISHA HELGA, BY</td>
<td>26-05-2015</td>
<td>KOMP. PONDOK INDAH JATISARI BLOK H 16 JL. WIBAWA MUKTI
RAYA</td>
<td>M. ANDI ALFAN,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>702</td>
<td>CEFSPAN 100MG </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>6.00</td>
<td>33,440.00</td>
<td>200,640.00</td>
<td>0.00</td>
<td>20,064.00</td>
<td>220,704.00</td>

</tr>

<tr>
<td>455</td>
<td>08-10-2018 20:50:11</td>
<td>8356</td>
<td>65496</td>
<td>LAVANYA ALISHA HELGA, BY</td>
<td>26-05-2015</td>
<td>KOMP. PONDOK INDAH JATISARI BLOK H 16 JL. WIBAWA MUKTI
RAYA</td>
<td>M. ANDI ALFAN,TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
 <td>RAWAT JALAN</td>
<td>3318</td>
<td>LASAL 2 CAP</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>1,824.00</td>
<td>3,648.00</td>
<td>0.00</td>
<td>364.80</td>
<td>4,012.80</td>

</tr>

<tr>
<td>456</td>
<td>08-10-2018 19:53:21</td>
<td>8357</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Ariati, SpOG</td>
<td>RAWAT JALAN</td>
<td>4777</td>
<td>VITAMIN D3 5000IU</td>
<td>UMUM</td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,236.00</td>
<td>157,080.00</td>
<td>0.00</td>
<td>15,708.00</td>
<td>172,788.00</td>

</tr>

<tr>
<td>457</td>
<td>08-10-2018 19:55:32</td>
<td>8360</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>1119</td>
<td>PHYSIOGEL LOTION 200ML</td>
<td>STIEFELL </td>
<td></td>
 <td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>267,664.00</td>
<td>267,664.00</td>
<td>0.00</td>
<td>26,766.40</td>
<td>294,430.40</td>

</tr>

<tr>
<td>458</td>
<td>08-10-2018 19:55:32</td>
<td>8360</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>2768</td>
<td>SUMAGESIC TAB</td>
<td>UAP </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>651.00</td>
<td>6,510.00</td>
<td>0.00</td>
<td>651.00</td>
<td>7,161.00</td>

</tr>

<tr>
<td>459</td>
<td>08-10-2018 20:44:22</td>
<td>8361</td>
<td>41834</td>
<td>FELICIA DEBORA IDAMA, NY</td>
<td>27-09-1989</td>
<td>JL TAMAN CENDANA III BLOK P3/15 BEKASI</td>
<td>DAVID JM NAINGGOLAN, TN</td>
<td>dr.Cepi Teguh Pramayadi, SpOG </td>
<td>RAWAT JALAN</td>
<td>1222</td>
<td>SELOXY </td>
<td>FERRON </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,600.00</td>
<td>228,000.00</td>
 <td>0.00</td>
<td>22,800.00</td>
<td>250,800.00</td>

</tr>

<tr>
<td>460</td>
<td>08-10-2018 20:44:22</td>
<td>8361</td>
<td>41834</td>
<td>FELICIA DEBORA IDAMA, NY</td>
<td>27-09-1989</td>
<td>JL TAMAN CENDANA III BLOK P3/15 BEKASI</td>
<td>DAVID JM NAINGGOLAN, TN</td>
<td>dr.Cepi Teguh Pramayadi, SpOG </td>
<td>RAWAT JALAN</td>
<td>893</td>
<td>GLUCOPHAGE 500MG </td>
<td>MERCK </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>2,354.00</td>
<td>70,620.00</td>
<td>0.00</td>
<td>7,062.00</td>
<td>77,682.00</td>

</tr>

<tr>
<td>461</td>
<td>08-10-2018 21:04:48</td>
<td>8362</td>
<td>74726</td>
<td>SENTOSAWATI CATUR PUTRI, NY</td>
<td>24-01-1986</td>
<td>JL. AKASIA V BLOK A NO. 17 RT01/08</td>
<td>HANNAN TAUQIEFIE, TN</td>
<td>dr.Cepi Teguh Pramayadi, SpOG </td>
<td>RAWAT JALAN</td>
<td>870</td>
<td>FLADYSTIN OVULA </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>5.00</td>
<td>19,760.00</td>
<td>98,800.00</td>
<td>0.00</td>
<td>9,880.00</td>
<td>108,680.00</td>
</tr>

<tr>
<td>462</td>
<td>08-10-2018 21:04:48</td>
<td>8362</td>
<td>74726</td>
<td>SENTOSAWATI CATUR PUTRI, NY</td>
<td>24-01-1986</td>
<td>JL. AKASIA V BLOK A NO. 17 RT01/08</td>
<td>HANNAN TAUQIEFIE, TN</td>
<td>dr.Cepi Teguh Pramayadi, SpOG </td>
<td>RAWAT JALAN</td>
<td>1346</td>
<td>VITAMAM 3 </td>
<td>NOVELL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>28.00</td>
<td>5,211.00</td>
<td>145,908.00</td>
<td>0.00</td>
<td>14,590.80</td>
<td>160,498.80</td>

</tr>

<tr>
<td>463</td>
<td>08-10-2018 21:04:48</td>
<td>8362</td>
<td>74726</td>
<td>SENTOSAWATI CATUR PUTRI, NY</td>
<td>24-01-1986</td>
<td>JL. AKASIA V BLOK A NO. 17 RT01/08</td>
<td>HANNAN TAUQIEFIE, TN</td>
<td>dr.Cepi Teguh Pramayadi, SpOG </td>
<td>RAWAT JALAN</td>
<td>2723</td>
<td>VOSECAL CAPLET</td>
<td>LANDSON </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,080.00</td>
<td>182,400.00</td>
<td>0.00</td>
<td>18,240.00</td>
<td>200,640.00</td>

</tr>

<tr>
<td>464</td>
<td>08-10-2018 20:06:29</td>
 <td>8363</td>
<td>15621</td>
<td>YESSY ZAMALIA, NY</td>
<td>14-02-1970</td>
<td>perum jati kramat indah 1 rt01/03</td>
<td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>4675</td>
<td>VACCIN BIO TD</td>
<td>BIO FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>55,176.00</td>
<td>55,176.00</td>
<td>0.00</td>
<td>5,517.60</td>
<td>60,693.60</td>

</tr>

<tr>
<td>465</td>
<td>08-10-2018 20:06:29</td>
<td>8363</td>
<td>15621</td>
<td>YESSY ZAMALIA, NY</td>
<td>14-02-1970</td>
<td>perum jati kramat indah 1 rt01/03</td>
<td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>682.00</td>
<td>682.00</td>
<td>0.00</td>
<td>68.20</td>
<td>750.20</td>

</tr>

<tr>
<td>466</td>
<td>08-10-2018 20:06:29</td>
<td>8363</td>
<td>15621</td>
<td>YESSY ZAMALIA, NY</td>
<td>14-02-1970</td>
<td>perum jati kramat indah 1 rt01/03</td>
 <td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>3589</td>
<td>SPUIT 3 CC TERUMO</td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>6,992.00</td>
<td>6,992.00</td>
<td>0.00</td>
<td>699.20</td>
<td>7,691.20</td>

</tr>

<tr>
<td>467</td>
<td>08-10-2018 20:06:29</td>
<td>8363</td>
<td>15621</td>
<td>YESSY ZAMALIA, NY</td>
<td>14-02-1970</td>
<td>perum jati kramat indah 1 rt01/03</td>
<td>APRUS RIO GILANG, TN</td>
<td>Prof.dr.H.Sofyan Ismael,SpA(K)</td>
<td>RAWAT JALAN</td>
<td>230</td>
<td>JARUM SUNTIK 25G X 5/8" </td>
<td>TERUMO</td>
<td>UMUM</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1.00</td>
<td>3,420.00</td>
<td>3,420.00</td>
<td>0.00</td>
<td>342.00</td>
<td>3,762.00</td>

</tr>

<tr>
<td>468</td>
<td>08-10-2018 20:12:19</td>
<td>8365</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Eva Devita, SpA</td>
<td>RAWAT JALAN</td>
<td>865</td>
<td>FERRIZ DROPS </td>
 <td>NICHOLAS </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>45,600.00</td>
<td>45,600.00</td>
<td>0.00</td>
<td>4,560.00</td>
<td>50,160.00</td>

</tr>

<tr>
<td>469</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>4802</td>
<td>SUCTION CATHEHER NO.8(HOSPITEC</td>
<td>HOSPIRA</td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>11,410.00</td>
<td>11,410.00</td>
<td>0.00</td>
<td>0.00</td>
<td>11,410.00</td>

</tr>

<tr>
<td>470</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>3943</td>
<td>TERRAMYCIN 1% 3.5GR OINT</td>
<td>PFIZER </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI B</td>
<td>1.00</td>
 <td>18,706.00</td>
<td>18,706.00</td>
<td>0.00</td>
<td>0.00</td>
<td>18,706.00</td>

</tr>

<tr>
<td>471</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>825</td>
<td>ENGERIX B 0.5 ML(HEPATITIS B)</td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>106,390.00</td>
<td>106,390.00</td>
<td>0.00</td>
<td>0.00</td>
<td>106,390.00</td>

</tr>

<tr>
<td>472</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>4308</td>
<td>SOFTAMAN 100ML</td>
<td>B.Braun </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>58,680.00</td>
<td>58,680.00</td>
<td>0.00</td>
<td>0.00</td>
<td>58,680.00</td>
</tr>

<tr>
<td>473</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>3586</td>
<td>KASSA STERIL PF</td>
<td>UMUM</td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>5,705.00</td>
<td>5,705.00</td>
<td>0.00</td>
<td>0.00</td>
<td>5,705.00</td>

</tr>

<tr>
<td>474</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>2101</td>
<td>MAMY POKO NB/14 </td>
<td>UNICHARM </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>3,478.00</td>
<td>6,956.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,956.00</td>

</tr>

<tr>
 <td>475</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>4521</td>
<td>KAPAS BULAT</td>
<td>UMUM</td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>13,529.00</td>
<td>40,587.00</td>
<td>0.00</td>
<td>0.00</td>
<td>40,587.00</td>

</tr>

<tr>
<td>476</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>1284</td>
<td>THERMOMETER ALPHA 1 NEW </td>
<td>JAYAMAS MEDICA </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>31,785.00</td>
<td>31,785.00</td>
<td>0.00</td>
<td>0.00</td>
<td>31,785.00</td>

</tr>

<tr>
<td>477</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
 <td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI A</td>
<td>17.00</td>
<td>732.00</td>
<td>12,444.00</td>
<td>0.00</td>
<td>0.00</td>
<td>12,444.00</td>

</tr>

<tr>
<td>478</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>73</td>
<td>CAP (H-231)</td>
<td>JANTRA </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI A</td>
<td>2.00</td>
<td>1,385.50</td>
<td>2,771.00</td>
<td>0.00</td>
<td>0.00</td>
<td>2,771.00</td>

</tr>

<tr>
<td>479</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
 <td>3634</td>
<td>MASKER TALI GP CARE</td>
<td>PT.GLOBAL PHARMA</td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI A</td>
<td>2.00</td>
<td>1,630.00</td>
<td>3,260.00</td>
<td>0.00</td>
<td>0.00</td>
<td>3,260.00</td>

</tr>

<tr>
<td>480</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>396</td>
<td>SARUNG TANGAN 6,5 </td>
<td>GAMEX </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI A</td>
<td>2.00</td>
<td>29,340.00</td>
<td>58,680.00</td>
<td>0.00</td>
<td>0.00</td>
<td>58,680.00</td>

</tr>

<tr>
<td>481</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
 <td>FARMASI A</td>
<td>1.00</td>
<td>10,432.00</td>
<td>10,432.00</td>
<td>0.00</td>
<td>0.00</td>
<td>10,432.00</td>

</tr>

<tr>
<td>482</td>
<td>08-10-2018 22:31:50</td>
<td>8366</td>
<td>91535</td>
<td>BY NY FANNY FITRIA BUDIARTY</td>
<td>08-10-2018</td>
<td></td>
<td></td>
<td>dr. M.Martina S, SpA</td>
<td>RAWAT INAP</td>
<td>4365</td>
<td>VITADION 2MG/ML</td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>YKK BI ( AKTIF )</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>19,560.00</td>
<td>19,560.00</td>
<td>0.00</td>
<td>0.00</td>
<td>19,560.00</td>

</tr>

<tr>
<td>483</td>
<td>08-10-2018 20:19:43</td>
<td>8367</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>2735</td>
<td>VISANNE (DIENOGEST 2MG)</td>
<td>BAYER </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>671,311.00</td>
<td>671,311.00</td>
<td>0.00</td>
 <td>67,131.10</td>
<td>738,442.10</td>

</tr>

<tr>
<td>484</td>
<td>08-10-2018 20:43:24</td>
<td>8368</td>
<td>91915</td>
<td>CATHERINE ORDONO PASCUAL, NN</td>
<td>08-04-1981</td>
<td>JL.YUSUF ADIWINATA #61</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>3204</td>
<td>LAPIMUC TAB</td>
<td>LAPI </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,170.00</td>
<td>11,700.00</td>
<td>0.00</td>
<td>1,170.00</td>
<td>12,870.00</td>

</tr>

<tr>
<td>485</td>
<td>08-10-2018 20:43:24</td>
<td>8368</td>
<td>91915</td>
<td>CATHERINE ORDONO PASCUAL, NN</td>
<td>08-04-1981</td>
<td>JL.YUSUF ADIWINATA #61</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>696</td>
<td>CEFADROXIL 500 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>1,161.00</td>
<td>11,610.00</td>
<td>0.00</td>
<td>1,161.00</td>
<td>12,771.00</td>

</tr>
<tr>
<td>486</td>
<td>08-10-2018 20:43:24</td>
<td>8368</td>
<td>91915</td>
<td>CATHERINE ORDONO PASCUAL, NN</td>
<td>08-04-1981</td>
<td>JL.YUSUF ADIWINATA #61</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>723</td>
<td>CETIRIZIN TAB 10 MG </td>
<td>OGB </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>866.00</td>
<td>8,660.00</td>
<td>0.00</td>
<td>866.00</td>
<td>9,526.00</td>

</tr>

<tr>
<td>487</td>
<td>08-10-2018 20:43:24</td>
<td>8368</td>
<td>91915</td>
<td>CATHERINE ORDONO PASCUAL, NN</td>
<td>08-04-1981</td>
<td>JL.YUSUF ADIWINATA #61</td>
<td>-</td>
<td>dr. Putra Nur Hidayat</td>
<td>IGD</td>
<td>2768</td>
<td>SUMAGESIC TAB</td>
<td>UAP </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>10.00</td>
<td>651.00</td>
<td>6,510.00</td>
<td>0.00</td>
<td>651.00</td>
<td>7,161.00</td>

</tr>

<tr>
<td>488</td>
<td>08-10-2018 20:47:01</td>
<td>8370</td>
 <td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>668</td>
<td>CAL-95 </td>
<td>LAPI </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>7,296.00</td>
<td>218,880.00</td>
<td>0.00</td>
<td>21,888.00</td>
<td>240,768.00</td>

</tr>

<tr>
<td>489</td>
<td>08-10-2018 20:47:01</td>
<td>8370</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>490</td>
<td>08-10-2018 20:47:01</td>
<td>8370</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
 <td>DR.dr. Budi Iman S, SpOG(K)</td>
<td>RAWAT JALAN</td>
<td>679</td>
<td>CANESTEN SD </td>
<td>BAYER </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>162,512.00</td>
<td>162,512.00</td>
<td>0.00</td>
<td>16,251.20</td>
<td>178,763.20</td>

</tr>

<tr>
<td>491</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>262</td>
<td>LEUKOMED-IV 72389-00 (6X8CM) </td>
<td>BSN Medica,PT </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>4,330.00</td>
<td>4,330.00</td>
<td>0.00</td>
<td>0.00</td>
<td>4,330.00</td>

</tr>

<tr>
<td>492</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>60</td>
<td>BLOOD ADMINISTRATION SET </td>
<td>THERUMO </td>
 <td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>41,565.00</td>
<td>41,565.00</td>
<td>0.00</td>
<td>0.00</td>
<td>41,565.00</td>

</tr>

<tr>
<td>493</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>440</td>
<td>SPUIT 5 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>9,128.00</td>
<td>9,128.00</td>
<td>0.00</td>
<td>0.00</td>
<td>9,128.00</td>

</tr>

<tr>
<td>494</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>494</td>
<td>VENFLON 18 REFF 393206 </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>42,176.00</td>
 <td>42,176.00</td>
<td>0.00</td>
<td>0.00</td>
<td>42,176.00</td>

</tr>

<tr>
<td>495</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>10,432.00</td>
<td>20,864.00</td>
<td>0.00</td>
<td>0.00</td>
<td>20,864.00</td>

</tr>

<tr>
<td>496</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>437</td>
<td>SPUIT 10 CC </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>1.00</td>
<td>11,899.00</td>
<td>11,899.00</td>
<td>0.00</td>
<td>0.00</td>
<td>11,899.00</td>
</tr>

<tr>
<td>497</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>40</td>
<td>BACTESYN 1,5 GR VIAL </td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>279,545.00</td>
<td>559,090.00</td>
<td>0.00</td>
<td>0.00</td>
<td>559,090.00</td>

</tr>

<tr>
<td>498</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>314</td>
<td>NORMAL SALIN 100 ML PIGGYBACK</td>
<td>OTSUKA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>22,494.00</td>
<td>44,988.00</td>
<td>0.00</td>
<td>0.00</td>
<td>44,988.00</td>

</tr>

<tr>
<td>499</td>
 <td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>4447</td>
<td>CLIPPER (PISAU CUKUR)9680</td>
<td>3M </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>143,440.00</td>
<td>143,440.00</td>
<td>0.00</td>
<td>0.00</td>
<td>143,440.00</td>

</tr>

<tr>
<td>500</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>4006</td>
<td>CHLORHEXIDINE 2% 10ML</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>24,450.00</td>
<td>24,450.00</td>
<td>0.00</td>
<td>0.00</td>
<td>24,450.00</td>

</tr>

<tr>
<td>501</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
 <td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>DEPO KB</td>
<td>2.00</td>
<td>732.00</td>
<td>1,464.00</td>
<td>0.00</td>
<td>0.00</td>
<td>1,464.00</td>

</tr>

<tr>
<td>502</td>
<td>09-10-2018 07:22:58</td>
<td>8372</td>
<td>91917</td>
<td>SHABRINA SARAYA,NY</td>
<td>08-09-1991</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>Prof.dr.Endy M Moegni, SpOG(K)</td>
<td>RAWAT INAP</td>
<td>334</td>
<td>PAMPERS DWS (XL'6) </td>
<td>DIAPERS </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>17,523.00</td>
<td>17,523.00</td>
<td>0.00</td>
<td>0.00</td>
<td>17,523.00</td>

</tr>

<tr>
<td>503</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>339</td>
 <td>PATIENT SUPPLY LINE/(900RD010)</td>
<td>MADESA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>249,390.00</td>
<td>249,390.00</td>
<td>0.00</td>
<td>0.00</td>
<td>249,390.00</td>

</tr>

<tr>
<td>504</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>1284</td>
<td>THERMOMETER ALPHA 1 NEW </td>
<td>JAYAMAS MEDICA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>31,785.00</td>
<td>31,785.00</td>
<td>0.00</td>
<td>0.00</td>
<td>31,785.00</td>

</tr>

<tr>
<td>505</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>4521</td>
<td>KAPAS BULAT</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
 <td>3.00</td>
<td>13,529.00</td>
<td>40,587.00</td>
<td>0.00</td>
<td>0.00</td>
<td>40,587.00</td>

</tr>

<tr>
<td>506</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>2101</td>
<td>MAMY POKO NB/14 </td>
<td>UNICHARM </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>3,478.00</td>
<td>6,956.00</td>
<td>0.00</td>
<td>0.00</td>
<td>6,956.00</td>

</tr>

<tr>
<td>507</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>3586</td>
<td>KASSA STERIL PF</td>
<td>UMUM</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>5,705.00</td>
<td>5,705.00</td>
<td>0.00</td>
<td>0.00</td>
 <td>5,705.00</td>

</tr>

<tr>
<td>508</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>307</td>
<td>NEONATAL MASK 50MM(REFFRD805)</td>
<td>FISHER & PAYKEL </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>355,340.00</td>
<td>355,340.00</td>
<td>0.00</td>
<td>0.00</td>
<td>355,340.00</td>

</tr>

<tr>
<td>509</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>396</td>
<td>SARUNG TANGAN 6,5 </td>
<td>GAMEX </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>2.00</td>
<td>29,340.00</td>
<td>58,680.00</td>
<td>0.00</td>
<td>0.00</td>
<td>58,680.00</td>

</tr>
<tr>
<td>510</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>825</td>
<td>ENGERIX B 0.5 ML(HEPATITIS B)</td>
<td>GLAXO SMITH KLINE </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>106,390.00</td>
<td>106,390.00</td>
<td>0.00</td>
<td>0.00</td>
<td>106,390.00</td>

</tr>

<tr>
<td>511</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>436</td>
<td>SPUIT 1 CC TUBERCULIN </td>
<td>THERUMO </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>10,432.00</td>
<td>10,432.00</td>
<td>0.00</td>
<td>0.00</td>
<td>10,432.00</td>

</tr>

<tr>
<td>512</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
 <td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>4802</td>
<td>SUCTION CATHEHER NO.8(HOSPITEC</td>
<td>HOSPIRA</td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>11,410.00</td>
<td>11,410.00</td>
<td>0.00</td>
<td>0.00</td>
<td>11,410.00</td>

</tr>

<tr>
<td>513</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>4365</td>
<td>VITADION 2MG/ML</td>
<td>KALBE FARMA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>1.00</td>
<td>19,560.00</td>
<td>19,560.00</td>
<td>0.00</td>
<td>0.00</td>
<td>19,560.00</td>

</tr>

<tr>
<td>514</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
 <td>RAWAT INAP</td>
<td>524</td>
<td>WEBCOL </td>
<td>BD </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>17.00</td>
<td>732.00</td>
<td>12,444.00</td>
<td>0.00</td>
<td>0.00</td>
<td>12,444.00</td>

</tr>

<tr>
<td>515</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>73</td>
<td>CAP (H-231)</td>
<td>JANTRA </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI A</td>
<td>2.00</td>
<td>1,385.50</td>
<td>2,771.00</td>
<td>0.00</td>
<td>0.00</td>
<td>2,771.00</td>

</tr>

<tr>
<td>516</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>3634</td>
<td>MASKER TALI GP CARE</td>
<td>PT.GLOBAL PHARMA</td>
<td>UMUM</td>
 <td>UMUM</td>
<td>FARMASI A</td>
<td>2.00</td>
<td>1,630.00</td>
<td>3,260.00</td>
<td>0.00</td>
<td>0.00</td>
<td>3,260.00</td>

</tr>

<tr>
<td>517</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>3943</td>
<td>TERRAMYCIN 1% 3.5GR OINT</td>
<td>PFIZER </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>18,706.00</td>
<td>18,706.00</td>
<td>0.00</td>
<td>0.00</td>
<td>18,706.00</td>

</tr>

<tr>
<td>518</td>
<td>09-10-2018 08:06:05</td>
<td>8374</td>
<td>91536</td>
<td>BY NY. SHABRINA SARAYA</td>
<td>09-10-2018</td>
<td>JL.TEBET BARAT DALAM V NO.17 </td>
<td>TRIAS FAJAR DEWANTO,TN</td>
<td>dr. Erlin Juwita , SpA</td>
<td>RAWAT INAP</td>
<td>4308</td>
<td>SOFTAMAN 100ML</td>
<td>B.Braun </td>
<td>UMUM</td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>1.00</td>
<td>58,680.00</td>
<td>58,680.00</td>
 <td>0.00</td>
<td>0.00</td>
<td>58,680.00</td>

</tr>

<tr>
<td>519</td>
<td>09-10-2018 07:07:28</td>
<td>8379</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>880</td>
<td>FOLAMIL GENIO </td>
<td>DEXA MEDICA </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>5,320.00</td>
<td>159,600.00</td>
<td>0.00</td>
<td>15,960.00</td>
<td>175,560.00</td>

</tr>

<tr>
<td>520</td>
<td>09-10-2018 07:07:28</td>
<td>8379</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>2723</td>
<td>VOSECAL CAPLET</td>
<td>LANDSON </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>30.00</td>
<td>6,080.00</td>
<td>182,400.00</td>
<td>0.00</td>
<td>18,240.00</td>
<td>200,640.00</td>
</tr>

<tr>
<td>521</td>
<td>09-10-2018 07:07:28</td>
<td>8379</td>
<td>0</td>
<td>UMUM</td>
<td>01-01-1970</td>
<td></td>
<td></td>
<td>dr. Yusfa Rasyid, SpOG</td>
<td>RAWAT JALAN</td>
<td>1026</td>
<td>MOLINFA SOFT CAPS </td>
<td>LANDSON </td>
<td></td>
<td>UMUM</td>
<td>FARMASI B</td>
<td>20.00</td>
<td>4,864.00</td>
<td>97,280.00</td>
<td>0.00</td>
<td>9,728.00</td>
<td>107,008.00</td>

</tr>

<tr>
<td>522</td>
<td>09-10-2018 07:45:26</td>
<td>8386</td>
<td>73266</td>
<td>NOVITA AFIATUL HASANAH, NN</td>
<td>30-11-1992</td>
<td>KP. BABAKAN LURAH RT03/03 RANGKASBITUNG</td>
<td>-</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>3087</td>
<td>ENERVON C STRIP</td>
<td>DARYA VARIA </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>3.00</td>
<td>1,218.61</td>
<td>3,655.83</td>
<td>0.00</td>
<td>365.58</td>
<td>4,021.41</td>

</tr>

<tr>
<td>523</td>
<td>09-10-2018 07:45:26</td>
 <td>8386</td>
<td>73266</td>
<td>NOVITA AFIATUL HASANAH, NN</td>
<td>30-11-1992</td>
<td>KP. BABAKAN LURAH RT03/03 RANGKASBITUNG</td>
<td>-</td>
<td>UMUM</td>
<td>RAWAT JALAN</td>
<td>1195</td>
<td>RHINOS SR </td>
<td>DEXA MEDICA </td>
<td>UMUM</td>
<td>KARYAWAN YPK</td>
<td>FARMASI B</td>
<td>2.00</td>
<td>5,700.00</td>
<td>11,400.00</td>
<td>0.00</td>
<td>1,140.00</td>
<td>12,540.00</td>

</tr>
</table>