PEMERINTAH PROPINSI KALIMANTAN TIMUR

RSU. A. WAHAB SJAHRANIE

Jl. Palang Merah Indonesia PABX 742055, 742056, 742695, 741793
SAMARINDA

PERINCIAN PEMAKAIAN OBAT-OBATAN

INSTALASI FARMASI RSU.A. WAHAB SJAHRANIE
NAMA : SITI AISYAH / BY NY ANGELINA SONIA RUANGAN : Melati
NO. REG ADELIA (No. KIB: 01.09.16.90)
: 2020.721099 TANGGAL : 15-01-2020

TANGGAL NO. RESEP KODE NAMA OBAT JML HARGA (RP)

15 Jan 2020 12779511 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 3.00 24,731
ALB0637 EXTENTION TUBE 100 CM ONEMED 1.00 7,988
ALB0642 Three Way Stop Cock (OneMed) 1.00 2,560
ALB0643 SPUIT 20 CC /MIRACEN 1.00 2,730
ALK0681 MEDICATH/TROGE PLUS NO.20 1.00 18,150
ALK0742 SPUIT 3 CC/MIRACHEN 2.00 2,003
ALK0751 SPUIT 5 CC /MIRACHEN 2.00 2,313
ALK0752 SPUIT 10 CC /MIRACHEN 2.00 2,860
GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0226 PHENITOIN INJ.(PHAPROS) 2.00 10,303
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
INF0052 Dextrose 5% + 1/4 NS (Wida) Infus 2.00 26,560
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0099 Sagestam 1.00 12,733
INJ0100 Sanpicillin 1 gr 1.00 21,491
SUB TOTAL 26.00 186,705
PEMBULATAN 186,705
15 Jan 2020 12779516 ALB0672 FEEDING TUBE NO.10 (AXIMED) 1.00 10,038
ALK0751 SPUIT 5 CC /MIRACHEN 1.00 1,156
SUB TOTAL 2.00 11,194
PEMBULATAN 11,194
15 Jan 2020 12779577 ALK0695 JET NEBULIZER MASK ANAK 1.00 28,875
SUB TOTAL 1.00 28,875
PEMBULATAN 28,875
15 Jan 2020 12780198 GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0011 GENTAMICIN 80 MG/2 ML INJ 1.00 5,693
GNR0226 PHENITOIN INJ.(PHAPROS) 2.00 10,303
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0242 Bactesyn 0,75 g inj. 2.00 129,258
SUB TOTAL 13.00 250,188
PEMBULATAN 250,188
15 Jan 2020 12780206 ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0742 SPUIT 3 CC/MIRACHEN 2.00 2,003
ALK0751 SPUIT 5 CC /MIRACHEN 2.00 2,313
ALK0752 SPUIT 10 CC /MIRACHEN 2.00 2,860
SUB TOTAL 7.00 15,838
PEMBULATAN 15,838
SUB TOTAL
PEMBULATAN 30,250
15 Jan 2020 12780614 BRR0019 OMNIPAQUE 350 mcl / 50 ML 1.00 264,293
SUB TOTAL 1.00 264,293
PEMBULATAN 264,293
15 Jan 2020 12780808 ALB0383 SURGICAL GLOVES STERIL 6.5 TROGE 1.00 8,244
ALB0643 SPUIT 20 CC /MIRACEN 2.00 5,460
ALK0215 SPUIT 1 ML TUBERCULIN/TERUMO 1.00 1,786
SUB TOTAL 4.00 15,490
PEMBULATAN 15,490
15 Jan 2020 12781093 ALK0205 SLANG OKSIGEN ANAK 1.00 12,375
SUB TOTAL 1.00 12,375
PEMBULATAN 12,375
16 Jan 2020 12782188 GNR0008 DEXAMETHASONE 5 MG/ML INJ 3.00 4,984
GNR0226 PHENITOIN INJ.(PHAPROS) 2.00 10,303
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0099 Sagestam 1.00 12,733
INJ0242 Bactesyn 0,75 g inj. 2.00 129,258
SUB TOTAL 14.00 258,889
PEMBULATAN 258,889
16 Jan 2020 12782195 ALK0612 DISPOSABLE NEEDLE No.26 G 6.00 5,573
ALK0742 SPUIT 3 CC/MIRACHEN 6.00 6,008
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 2.00 2,860
SUB TOTAL 19.00 20,221
PEMBULATAN 20,221
17 Jan 2020 12783663 GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0099 Sagestam 1.00 12,733
SUB TOTAL 8.00 66,306
PEMBULATAN 66,306
17 Jan 2020 12783671 ALK0601 NEOFLON 26 G 2.00 39,130
ALK0612 DISPOSABLE NEEDLE No.26 G 6.00 5,573
ALK0683 MEDICATH/TROGE PLUS NO.24 1.00 18,150
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 24.00 80,790
PEMBULATAN 80,790
17 Jan 2020 12783790 ALK0683 MEDICATH/TROGE PLUS NO.24 1.00 18,150
SUB TOTAL 1.00 18,150
PEMBULATAN 18,150
17 Jan 2020 12784760 ALK0057 CERTOFIK MONO NO. 22 G/ S 110 1.00 996,875
ALK0289 VERBAN 4 " 10 CM 2.00 3,300
SUB TOTAL 3.00 1,000,175
PEMBULATAN 1,000,175
18 Jan 2020 12784770 ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
SUB TOTAL 1.00 10,500
PEMBULATAN 10,500
18 Jan 2020 12784786 GNR0013 LIDOCAINE 2% INJ 1.00 1,601
SUB TOTAL 1.00 1,601
PEMBULATAN 1,601
18 Jan 2020 12785251 GNR0008 DEXAMETHASONE 5 MG/ML INJ 3.00 4,984
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 3.00 10,725
INJ0099 Sagestam 2.00 25,465
INJ0242 Bactesyn 0,75 g inj. 4.00 258,515
SUB TOTAL 15.00 379,164
PEMBULATAN 379,164
18 Jan 2020 12785262 ALK0612 DISPOSABLE NEEDLE No.26 G 6.00 5,573
ALK0742 SPUIT 3 CC/MIRACHEN 10.00 10,013
ALK0751 SPUIT 5 CC /MIRACHEN 10.00 11,563
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 31.00 34,298
PEMBULATAN 34,298
18 Jan 2020 12785534 GNR0010 FUROSEMID 10 MG/ML INJ 1.00 1,944
 INJ0420 ALBUMIN HUMAN BIOTEST 20% 50 ML 1.00 531,893
SUB TOTAL 2.00 533,836
PEMBULATAN 533,836
19 Jan 2020 12786223 GNR0137 SALBUTAMOL 2 MG 1.00 116
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
INH0013 Ventolin Nebulyzer 2,5 mg* 1.00 5,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
SUB TOTAL 5.00 12,816
PEMBULATAN 12,816
19 Jan 2020 12786230 ALK0695 JET NEBULIZER MASK ANAK 1.00 28,875
SUB TOTAL 1.00 28,875
PEMBULATAN 28,875
19 Jan 2020 12786237 GNR0137 SALBUTAMOL 2 MG 1.00 116
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
SUB TOTAL 2.00 666
PEMBULATAN 666
20 Jan 2020 12786640 ALB0383 SURGICAL GLOVES STERIL 6.5 TROGE 2.00 16,488
SUB TOTAL 2.00 16,488
PEMBULATAN 16,488
20 Jan 2020 12787540 GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0137 SALBUTAMOL 2 MG 1.00 116
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 2.00 10,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0099 Sagestam 2.00 25,465
INJ0242 Bactesyn 0,75 g inj. 3.00 193,886
SUB TOTAL 17.00 338,940
PEMBULATAN 338,940
20 Jan 2020 12787548 ALK0612 DISPOSABLE NEEDLE No.26 G 3.00 2,786
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 18.00 20,724
PEMBULATAN 20,724
21 Jan 2020 12789088 GNR0008 DEXAMETHASONE 5 MG/ML INJ 3.00 4,984
GNR0137 SALBUTAMOL 2 MG 1.00 116
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0241 PARACETAMOL INFUS 1.00 14,988
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0099 Sagestam 1.00 12,733
INJ0242 Bactesyn 0,75 g inj. 2.00 129,258
SUB TOTAL 19.00 288,379
PEMBULATAN 288,379
21 Jan 2020 12789096 ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
SUB TOTAL 13.00 15,078
PEMBULATAN 15,078
21 Jan 2020 12789219 BS0103 SET VENTRICULAR DRAINACE EXTERNAL 1.00 3,850,000
SUB(EVDS),MEDTRONIC,910112A
TOTAL 1.00 3,850,000
PEMBULATAN 3,850,000
21 Jan 2020 12789311 ALB0063 TOPI OPERASI TALI 5.00 8,800
ALB0376 Suction Connection tube 300 cm (Enseval) 1.00 26,250
ALB0643 SPUIT 20 CC /MIRACEN 1.00 2,730
ALK0019 BLOOD ADM. SET ( OTSUKA) 1.00 19,938
ALK0162 MERSILK 3/0 W 546 1.00 60,794
 ALK0282 VICRYL 3/0 RAPID W 9923 1.00 92,400
ALK0334 TOPI OPERASI BOUFANT 6.00 2,633
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0501 Surgical Ansel Gamex 7,5 ( PF ) 3.00 58,125
ALK0512 APRON PLASTIK SEDANG 2.00 15,125
BLL0089 HARUM PEN KOULTER 1.00 27,500
GNR0011 GENTAMICIN 80 MG/2 ML INJ 1.00 5,693
INJ0087 Pehacain 3.00 9,923
OBLL0027 UNDERPAD STERIL 60 x 90 onemed 2.00 20,018
PSB0001 Surgical Blade No.10 1.00 3,488
SUB TOTAL 30.00 366,889
PEMBULATAN 366,889
21 Jan 2020 12789508 ALK0217 SPUIT 2,5 / 3 ML/TERUMO 2.00 2,843
BHPAK001 O 2 / liter 20.00 3,800
3
BHPAK001 N 2 O/liter 10.00 5,425
4
GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
INH0012 SEVO - rane 4.00 24,080
INJ0253 Fresofol 10 mg/ml 1 % 20cc 0.50 6,724
INJ0284 Farelax injeksi 0.25 18,047
NRK0016 Fentanyl 2 ml Inj 0.50 27,744
OBLL0009 Soft Lime /menit 60.00 48,075
SUB TOTAL 99.25 140,060
PEMBULATAN 140,060
22 Jan 2020 12790397 ALB0604 MASKER NON REBREATING ANAK-Hi Oxy 1.00 32,340
Mask O2 + Selang (bayi)
ALB0838 Masker 1.00 19,058
SUB TOTAL 2.00 51,398
PEMBULATAN 51,398
22 Jan 2020 12790557 GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0137 SALBUTAMOL 2 MG 2.00 233
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0242 Bactesyn 0,75 g inj. 2.00 129,258
SUB TOTAL 17.00 254,513
PEMBULATAN 254,513
22 Jan 2020 12790566 ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0265 SPALAK 15 x 4 x 4 2.00 17,325
ALK0289 VERBAN 4 " 10 CM 2.00 3,300
ALK0695 JET NEBULIZER MASK ANAK 1.00 28,875
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 21.00 77,938
PEMBULATAN 77,938
23 Jan 2020 12791600 ALB0604 MASKER NON REBREATING ANAK-Hi Oxy 1.00 32,340
SUBMask
TOTAL 1.00 32,340
PEMBULATAN 32,340
23 Jan 2020 12791967 GNR0018 PHENOBARBITAL INJ 3.00 8,006
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
SUB TOTAL 4.00 26,981
PEMBULATAN 26,981
23 Jan 2020 12792361 GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0018 PHENOBARBITAL INJ 2.00 5,338
GNR0137 SALBUTAMOL 2 MG 2.00 233
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0021 KAEN 4 A INFUS 1.00 30,250
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
INH0013 Ventolin Nebulyzer 2,5 mg* 2.00 10,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0242 Bactesyn 0,75 g inj. 2.00 129,258
 SUB TOTAL 16.00 205,625
PEMBULATAN 205,625
23 Jan 2020 12792375 ALK0215 SPUIT 1 ML TUBERCULIN/TERUMO 5.00 8,931
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 20.00 26,869
PEMBULATAN 26,869
24 Jan 2020 12793760 ALB0672 FEEDING TUBE NO.10 (AXIMED) 1.00 10,038
SUB TOTAL 1.00 10,038
PEMBULATAN 10,038
24 Jan 2020 12794035 GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0018 PHENOBARBITAL INJ 2.00 5,338
GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0226 PHENITOIN INJ.(PHAPROS) 2.00 10,303
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0021 KAEN 4 A INFUS 1.00 30,250
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
INJ0099 Sagestam 2.00 25,465
INJ0242 Bactesyn 0,75 g inj. 2.00 129,258
SUB TOTAL 19.00 244,641
PEMBULATAN 244,641
24 Jan 2020 12794049 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 2.00 16,488
ALB0643 SPUIT 20 CC /MIRACEN 1.00 2,730
ALK0132 KASA STERIL 16 X 16 2.00 21,000
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
SUB TOTAL 17.00 66,768
PEMBULATAN 66,768
24 Jan 2020 12794087 INJ0099 Sagestam 1.00 12,733
SUB TOTAL 1.00 12,733
PEMBULATAN 12,733
25 Jan 2020 12795240 GNR0005 CEFTRIAXON 1 GR INJ 4.00 25,250
GNR0008 DEXAMETHASONE 5 MG/ML INJ 6.00 9,968
GNR0018 PHENOBARBITAL INJ 4.00 10,675
GNR0226 PHENITOIN INJ.(PHAPROS) 4.00 20,605
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0026 NACL 3 % 500 ml (Otsuka) Infus 1.00 37,919
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 1.00 5,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
SUB TOTAL 27.00 230,004
PEMBULATAN 230,004
25 Jan 2020 12795248 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 2.00 16,488
ALB0637 EXTENTION TUBE 100 CM ONEMED 1.00 7,988
ALK0132 KASA STERIL 16 X 16 3.00 31,500
ALK0395 BACTIGRAS 10 x 10 CM 2.00 26,950
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 10.00 10,013
ALK0751 SPUIT 5 CC /MIRACHEN 6.00 6,938
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 30.00 117,525
PEMBULATAN 117,525
25 Jan 2020 12795270 INH0013 Ventolin Nebulyzer 2,5 mg* 4.00 20,000
SUB TOTAL 4.00 20,000
PEMBULATAN 20,000
25 Jan 2020 12795650 GNR0185 ASAM TRANEKSAMAT 250 INJ. 2.00 5,113
 SUB TOTAL 2.00 5,113
PEMBULATAN 5,113
27 Jan 2020 12796932 GNR0005 CEFTRIAXON 1 GR INJ 2.00 12,625
GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0018 PHENOBARBITAL INJ 1.00 2,669
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
SUB TOTAL 15.00 144,368
PEMBULATAN 144,368
27 Jan 2020 12796947 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 2.00 16,488
ALB0637 EXTENTION TUBE 100 CM ONEMED 1.00 7,988
ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 21.00 76,888
PEMBULATAN 76,888
28 Jan 2020 12798579 GNR0185 ASAM TRANEKSAMAT 250 INJ. 1.00 2,556
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
SUB TOTAL 7.00 108,156
PEMBULATAN 108,156
28 Jan 2020 12798583 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 2.00 16,488
ALB0637 EXTENTION TUBE 100 CM ONEMED 1.00 7,988
ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 21.00 76,888
PEMBULATAN 76,888
29 Jan 2020 12800031 GNR0005 CEFTRIAXON 1 GR INJ 1.00 6,313
GNR0018 PHENOBARBITAL INJ 1.00 2,669
GNR0137 SALBUTAMOL 2 MG 2.00 233
GNR0185 ASAM TRANEKSAMAT 250 INJ. 1.00 2,556
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0031 Piggy Bag NS 100 ml Infus 1.00 18,975
INH0013 Ventolin Nebulyzer 2,5 mg* 1.00 5,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 3.00 10,725
SUB TOTAL 13.00 52,721
PEMBULATAN 52,721
29 Jan 2020 12800043 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 1.00 8,244
ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 6.00 6,008
ALK0751 SPUIT 5 CC /MIRACHEN 6.00 6,938
ALK0752 SPUIT 10 CC /MIRACHEN 6.00 8,580
SUB TOTAL 20.00 40,269
PEMBULATAN 40,269
30 Jan 2020 12801406 GNR0185 ASAM TRANEKSAMAT 250 INJ. 1.00 2,556
SUB TOTAL 1.00 2,556
PEMBULATAN 2,556
30 Jan 2020 12801409 ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
 ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
SUB TOTAL 12.00 34,763
PEMBULATAN 34,763
30 Jan 2020 12801697 GNR0241 PARACETAMOL INFUS (2.00) (29,975)
INJ0242 Bactesyn 0,75 g inj. (2.00) (129,258)
SUB TOTAL RETURN (4.00) (159,233)
PEMBULATAN (159,233)
30 Jan 2020 12801789 BS0103 SET VENTRICULAR DRAINACE EXTERNAL 1.00 3,850,000
SUB(EVDS),MEDTRONIC,910112A
TOTAL 1.00 3,850,000
PEMBULATAN 3,850,000
30 Jan 2020 12801906 ALB0404 PTR Silk 3/0 S25261 1.00 44,688
ALB1037 MONOCRYL 3/0 MCP4271H 1.00 148,786
ALK0334 TOPI OPERASI BOUFANT 7.00 3,071
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0500 Surgical Ansel Gamex 7 ( PF ) 3.00 58,121
ALK0512 APRON PLASTIK SEDANG 3.00 22,688
ALK0752 SPUIT 10 CC /MIRACHEN 1.00 1,430
INJ0254 Hypobhac 150 mg / 1,5 ml 1.00 180,259
PLS0002 Fixomull Strecth 15 cm X 5 m 0.30 53,475
PSB0003 Surgical Blade No.15 2.00 6,975
SUB TOTAL 20.30 532,968
PEMBULATAN 532,968
30 Jan 2020 12802029 ALK0205 SLANG OKSIGEN ANAK 1.00 12,375
ALK0217 SPUIT 2,5 / 3 ML/TERUMO 2.00 2,843
ALK0218 SPUIT 5 ML/TERUMO 1.00 2,000
BHPAK001 O 2 / liter 150.00 28,500
3
BHPAK001 N 2 O/liter 100.00 54,250
4
INH0012 SEVO - rane 15.00 90,300
INJ0011 Atropin Sulfat (Ethica) 1.00 2,090
INJ0093 Prostigmine 0,5 mg / 1 ml 1.00 10,250
INJ0336 Santagesik inj 1.00 5,859
NRK0016 Fentanyl 2 ml Inj 1.00 55,489
SUB TOTAL 273.00 263,955
PEMBULATAN 263,955
31 Jan 2020 12802785 GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0137 SALBUTAMOL 2 MG 1.00 116
GNR0185 ASAM TRANEKSAMAT 250 INJ. 2.00 5,113
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
INF0021 KAEN 4 A INFUS 1.00 30,250
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
SUB TOTAL 10.00 82,790
PEMBULATAN 82,790
31 Jan 2020 12802793 ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
SUB TOTAL 13.00 15,078
PEMBULATAN 15,078
01 Feb 2020 12803968 ALK0636 MUCUS EXTRACTOR ONEMED 1.00 12,375
SUB TOTAL 1.00 12,375
PEMBULATAN 12,375
01 Feb 2020 12804175 GNR0005 CEFTRIAXON 1 GR INJ 4.00 25,250
GNR0008 DEXAMETHASONE 5 MG/ML INJ 3.00 4,984
GNR0018 PHENOBARBITAL INJ 1.00 2,669
GNR0137 SALBUTAMOL 2 MG 2.00 233
GNR0185 ASAM TRANEKSAMAT 250 INJ. 3.00 7,669
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0261 ACETYLCYSTEIN 200 MG 3.00 1,650
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
 SUB TOTAL 26.00 168,205
PEMBULATAN 168,205
01 Feb 2020 12804213 ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0742 SPUIT 3 CC/MIRACHEN 10.00 10,013
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 22.00 46,919
PEMBULATAN 46,919
02 Feb 2020 12805252 ALK0019 BLOOD ADM. SET ( OTSUKA) 1.00 19,938
SUB TOTAL 1.00 19,938
PEMBULATAN 19,938
03 Feb 2020 12805751 ALB0063 TOPI OPERASI TALI 7.00 12,320
ALB0376 Suction Connection tube 300 cm (Enseval) 1.00 26,250
ALB0404 PTR Silk 3/0 S25261 1.00 44,688
ALB1037 MONOCRYL 3/0 MCP4271H 2.00 297,573
ALK0188 PROFEEL ORTHOPEDI 7,5 1.00 29,563
ALK0219 SPUIT 10 ML/TERUMO 1.00 2,338
ALK0220 SPUIT 20 ML/TERUMO 1.00 3,850
ALK0329 OPSITE 45 x 55 1.00 213,125
ALK0337 GELITASPON 80 x 50 x 10 1.00 82,500
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0512 APRON PLASTIK SEDANG 3.00 22,688
ALK0528 Surgical Ansel Gamex 6,5 ( PF ) 4.00 77,495
ALK0687 OPTIME 3/0 18S20K 1.00 89,623
BLL0039 NEONATAL REM POLYHESIVE 1.00 272,005
BLL0089 HARUM PEN KOULTER 1.00 27,500
GNR0011 GENTAMICIN 80 MG/2 ML INJ 1.00 5,693
GNR0027 NACL 0,9% 500 ml (OGB) 1.00 8,550
INJ0087 Pehacain 3.00 9,923
PLS0002 Fixomull Strecth 15 cm X 5 m 0.30 53,475
PSB0001 Surgical Blade No.10 1.00 3,488
SUB TOTAL 33.30 1,296,118
PEMBULATAN 1,296,118
03 Feb 2020 12805984 ALB0680 SUCTION CATHETER 8 Remedi 1.00 4,000
ALK0235 SUCTION CATHETER 10 Remedi 1.00 4,000
SUB TOTAL 2.00 8,000
PEMBULATAN 8,000
03 Feb 2020 12806187 GNR0005 CEFTRIAXON 1 GR INJ 2.00 12,625
GNR0008 DEXAMETHASONE 5 MG/ML INJ 3.00 4,984
GNR0018 PHENOBARBITAL INJ 1.00 2,669
GNR0019 RANITIDIN INJ 2.00 2,888
GNR0137 SALBUTAMOL 2 MG 1.00 116
GNR0185 ASAM TRANEKSAMAT 250 INJ. 3.00 7,669
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
INF0021 KAEN 4 A INFUS 1.00 30,250
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
SUB TOTAL 18.00 81,901
PEMBULATAN 81,901
03 Feb 2020 12806188 ALK0205 SLANG OKSIGEN ANAK 1.00 12,375
SUB TOTAL 1.00 12,375
PEMBULATAN 12,375
03 Feb 2020 12806189 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 1.00 8,244
ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0411 CUTICELL 10 x 10 cm 1.00 6,498
ALK0742 SPUIT 3 CC/MIRACHEN 6.00 6,008
ALK0751 SPUIT 5 CC /MIRACHEN 6.00 6,938
ALK0752 SPUIT 10 CC /MIRACHEN 6.00 8,580
SUB TOTAL 21.00 46,766
PEMBULATAN 46,766
03 Feb 2020 12806489 BS0116 SET V P SHUNT CSF-FLOW CONTROL 1.00 5,610,000
SHUNT KIT,COUNTURED SMALL,LOW
PRESSURE,MEDTRONIC 9003A
 SUB TOTAL 1.00 5,610,000
PEMBULATAN 5,610,000
03 Feb 2020 12806731 INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
SUB TOTAL 2.00 37,950
PEMBULATAN 37,950
03 Feb 2020 12806928 ALB0680 SUCTION CATHETER 8 Remedi 1.00 4,000
ALK0204 SLANG OKSIGEN BAYI 1.00 7,219
ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0394 LEUKOMED IV 6x8cm 2.00 6,900
ALK0440 MEDICATH/SURFLO FLASH No.26 ( surflo W 3.00 141,075
ALK0742 )SPUIT 3 CC/MIRACHEN 2.00 2,003
ALK0751 SPUIT 5 CC /MIRACHEN 1.00 1,156
ANS0049 ALKOHOL SWAB 2% ONEMED 0.40 8,258
BHPAK001 O 2 / liter 100.00 19,000
3
BHPAK001 N 2 O/liter 65.00 35,263
4
BLL0046 ELEKTRODA SKINTACT 35x50 0.10 9,419
GNR0028 RINGER LACTAT INFUS (Wida OGB) 500 ML 1.00 9,538
INFUS
INH0021 SOJOURN 1cc 6.00 33,165
INJ0284 Farelax injeksi 1.00 72,188
INJ0351 TRADOSIK INJ 1.00 9,241
NRK0016 Fentanyl 2 ml Inj 1.00 55,489
OBLL0009 Soft Lime /menit 60.00 48,075
SUB TOTAL 246.50 470,649
PEMBULATAN 470,649
04 Feb 2020 12807700 GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0021 KAEN 4 A INFUS 2.00 60,500
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
SUB TOTAL 13.00 202,326
PEMBULATAN 202,326
04 Feb 2020 12807711 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 1.00 8,244
ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0411 CUTICELL 10 x 10 cm 1.00 6,498
ALK0742 SPUIT 3 CC/MIRACHEN 6.00 6,008
ALK0751 SPUIT 5 CC /MIRACHEN 6.00 6,938
ALK0752 SPUIT 10 CC /MIRACHEN 2.00 2,860
SUB TOTAL 17.00 41,046
PEMBULATAN 41,046
04 Feb 2020 12808069 ALB0644 SPUIT 50 CC LUBANG SAMPING 1.00 6,721
SUB/MIRACHEN
TOTAL 1.00 6,721
PEMBULATAN 6,721
04 Feb 2020 12808370 ALB0211 SURGICAL GLOVES STERIL 7 TROGE (6.00) (49,463)
ALB0637 EXTENTION TUBE 100 CM ONEMED (2.00) (15,975)
ALK0132 KASA STERIL 16 X 16 (4.00) (42,000)
ALK0395 BACTIGRAS 10 x 10 CM (5.00) (67,375)
GNR0241 PARACETAMOL INFUS (2.00) (29,975)
INF0031 Piggy Bag NS 100 ml Infus (3.00) (56,925)
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) (4.00) (14,300)
SUB TOTAL RETURN (26.00) (276,013)
PEMBULATAN (276,013)
05 Feb 2020 12808703 ALK0132 KASA STERIL 16 X 16 1.00 10,500
SUB TOTAL 1.00 10,500
PEMBULATAN 10,500
05 Feb 2020 12809220 GNR0008 DEXAMETHASONE 5 MG/ML INJ 3.00 4,984
GNR0018 PHENOBARBITAL INJ 2.00 5,338
GNR0019 RANITIDIN INJ 2.00 2,888
GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0185 ASAM TRANEKSAMAT 250 INJ. 1.00 2,556
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
 GNR0226 PHENITOIN INJ.(PHAPROS) 2.00 10,303
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0021 KAEN 4 A INFUS 1.00 30,250
INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
INJ0010 Aqua Pro Inj. 25 ml (Otsuka) 2.00 7,150
SUB TOTAL 23.00 179,248
PEMBULATAN 179,248
05 Feb 2020 12809235 ALB0211 SURGICAL GLOVES STERIL 7 TROGE 1.00 8,244
ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0411 CUTICELL 10 x 10 cm 1.00 6,498
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
SUB TOTAL 16.00 40,319
PEMBULATAN 40,319
05 Feb 2020 12809626 INF0031 Piggy Bag NS 100 ml Infus 2.00 37,950
SUB TOTAL 2.00 37,950
PEMBULATAN 37,950
06 Feb 2020 12810864 GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0019 RANITIDIN INJ 1.00 1,444
GNR0221 MEROPENEM 0.5 GR INJ. 1.00 30,794
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0021 KAEN 4 A INFUS 1.00 30,250
INF0026 NACL 3 % 500 ml (Otsuka) Infus 1.00 37,919
INH0013 Ventolin Nebulyzer 2,5 mg* 2.00 10,000
SUB TOTAL 9.00 132,206
PEMBULATAN 132,206
06 Feb 2020 12811639 GNR0005 CEFTRIAXON 1 GR INJ (6.00) (37,875)
GNR0018 PHENOBARBITAL INJ (4.00) (10,675)
GNR0185 ASAM TRANEKSAMAT 250 INJ. (1.00) (2,556)
SUB TOTAL RETURN (11.00) (51,106)
PEMBULATAN (51,106)
07 Feb 2020 12812095 GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0221 MEROPENEM 0.5 GR INJ. 1.00 30,794
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
INF0021 KAEN 4 A INFUS 1.00 30,250
INH0013 Ventolin Nebulyzer 2,5 mg* 2.00 10,000
SUB TOTAL 6.00 77,856
PEMBULATAN 77,856
07 Feb 2020 12812103 ALB0383 SURGICAL GLOVES STERIL 6.5 TROGE 1.00 8,244
ALK0132 KASA STERIL 16 X 16 1.00 10,500
ALK0289 VERBAN 4 " 10 CM 1.00 1,650
ALK0395 BACTIGRAS 10 x 10 CM 1.00 13,475
ALK0601 NEOFLON 26 G 3.00 58,695
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 5.00 5,006
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 5.00 7,150
SUB TOTAL 23.00 121,001
PEMBULATAN 121,001
08 Feb 2020 12813715 GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0132 RANITIDIN 150 MG 2.00 285
GNR0221 MEROPENEM 0.5 GR INJ. 4.00 123,175
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0021 KAEN 4 A INFUS 1.00 30,250
INH0013 Ventolin Nebulyzer 2,5 mg* 2.00 10,000
SUB TOTAL 12.00 182,020
PEMBULATAN 182,020
08 Feb 2020 12813720 ALB0383 SURGICAL GLOVES STERIL 6.5 TROGE 1.00 8,244
ALK0132 KASA STERIL 16 X 16 2.00 21,000
 ALK0289 VERBAN 4 " 10 CM 1.00 1,650
ALK0411 CUTICELL 10 x 10 cm 2.00 12,995
ALK0742 SPUIT 3 CC/MIRACHEN 6.00 6,008
ALK0751 SPUIT 5 CC /MIRACHEN 5.00 5,781
ALK0752 SPUIT 10 CC /MIRACHEN 6.00 8,580
SUB TOTAL 23.00 64,258
PEMBULATAN 64,258
09 Feb 2020 12814692 GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
SUB TOTAL 3.00 1,243
PEMBULATAN 1,243
10 Feb 2020 12816161 ALK0132 KASA STERIL 16 X 16 2.00 21,000
ALK0411 CUTICELL 10 x 10 cm 1.00 6,498
ALK0601 NEOFLON 26 G 2.00 39,130
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0019 RANITIDIN INJ 2.00 2,888
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0226 PHENITOIN INJ.(PHAPROS) 2.00 10,303
GNR0241 PARACETAMOL INFUS 1.00 14,988
INF0021 KAEN 4 A INFUS 1.00 30,250
INH0013 Ventolin Nebulyzer 2,5 mg* 2.00 10,000
SUB TOTAL 27.00 221,228
PEMBULATAN 221,228
10 Feb 2020 12816519 ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0636 MUCUS EXTRACTOR ONEMED 1.00 12,375
ALK0683 MEDICATH/TROGE PLUS NO.24 1.00 18,150
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0057 CHLORPHENIRAMIN/ CTM 1.00 30
GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0241 PARACETAMOL INFUS 1.00 14,988
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
INF0052 Dextrose 5% + 1/4 NS (Wida) Infus 2.00 26,560
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
SUB TOTAL 26.00 186,120
PEMBULATAN 186,120
11 Feb 2020 12816752 ALK0695 JET NEBULIZER MASK ANAK 1.00 28,875
SUB TOTAL 1.00 28,875
PEMBULATAN 28,875
11 Feb 2020 12817794 ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0683 MEDICATH/TROGE PLUS NO.24 1.00 18,150
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0057 CHLORPHENIRAMIN/ CTM 1.00 30
GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0226 PHENITOIN INJ.(PHAPROS) 1.00 5,151
GNR0241 PARACETAMOL INFUS 1.00 14,988
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0094 Dextrose 5 % + 1/4 NS Sanbe SP (Rutin) Infus 2.00 26,235
 INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
SUB TOTAL 26.00 173,970
PEMBULATAN 173,970
12 Feb 2020 12819078 ALB0243 SURGICAL GLOVES STERIL 6 TROGE 1.00 8,244
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0057 CHLORPHENIRAMIN/ CTM 2.00 60
GNR0138 SALBUTAMOL 4 MG 2.00 285
GNR0181 PHENITOIN 100 MG (Ikapharm) 2.00 380
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0241 PARACETAMOL INFUS 1.00 14,988
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0052 Dextrose 5% + 1/4 NS (Wida) Infus 2.00 26,560
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
SUB TOTAL 27.00 140,628
PEMBULATAN 140,628
12 Feb 2020 12819404 ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0008 DEXAMETHASONE 5 MG/ML INJ 2.00 3,323
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0226 PHENITOIN INJ.(PHAPROS) 2.00 10,303
GNR0241 PARACETAMOL INFUS 1.00 14,988
INH0013 Ventolin Nebulyzer 2,5 mg* 2.00 10,000
SUB TOTAL 18.00 110,963
PEMBULATAN 110,963
13 Feb 2020 12820892 ALB0383 SURGICAL GLOVES STERIL 6.5 TROGE 1.00 8,244
ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0683 MEDICATH/TROGE PLUS NO.24 2.00 36,300
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0008 DEXAMETHASONE 5 MG/ML INJ 1.00 1,661
GNR0057 CHLORPHENIRAMIN/ CTM 1.00 30
GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0181 PHENITOIN 100 MG (Ikapharm) 1.00 190
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0241 PARACETAMOL INFUS 1.00 14,988
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0094 Dextrose 5 % + 1/4 NS Sanbe SP (Rutin) Infus 2.00 26,235
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
SUB TOTAL 28.00 195,403
PEMBULATAN 195,403
14 Feb 2020 12822289 ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0683 MEDICATH/TROGE PLUS NO.24 1.00 18,150
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0057 CHLORPHENIRAMIN/ CTM 1.00 30
GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0181 PHENITOIN 100 MG (Ikapharm) 1.00 190
GNR0221 MEROPENEM 0.5 GR INJ. 2.00 61,588
GNR0241 PARACETAMOL INFUS 1.00 14,988
GNR0261 ACETYLCYSTEIN 200 MG 1.00 550
INF0052 Dextrose 5% + 1/4 NS (Wida) Infus 2.00 26,560
SUB TOTAL 20.00 141,623
PEMBULATAN 141,623
15 Feb 2020 12823916 ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0683 MEDICATH/TROGE PLUS NO.24 1.00 18,150
 ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 6.00 6,008
ALK0751 SPUIT 5 CC /MIRACHEN 6.00 6,938
ALK0752 SPUIT 10 CC /MIRACHEN 6.00 8,580
GNR0029 METRONIDAZOL INFUS 2.00 20,625
GNR0057 CHLORPHENIRAMIN/ CTM 2.00 60
GNR0138 SALBUTAMOL 4 MG 2.00 285
GNR0181 PHENITOIN 100 MG (Ikapharm) 2.00 380
GNR0261 ACETYLCYSTEIN 200 MG 4.00 2,200
SUB TOTAL 33.00 82,388
PEMBULATAN 82,388
17 Feb 2020 12825727 ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0683 MEDICATH/TROGE PLUS NO.24 2.00 36,300
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0029 METRONIDAZOL INFUS 1.00 10,313
GNR0057 CHLORPHENIRAMIN/ CTM 2.00 60
GNR0138 SALBUTAMOL 4 MG 2.00 285
GNR0181 PHENITOIN 100 MG (Ikapharm) 1.00 190
GNR0221 MEROPENEM 0.5 GR INJ. 1.00 30,794
GNR0261 ACETYLCYSTEIN 200 MG 2.00 1,100
INF0094 Dextrose 5 % + 1/4 NS Sanbe SP (Rutin) Infus 1.00 13,118
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
SUB TOTAL 26.00 137,084
PEMBULATAN 137,084
17 Feb 2020 12826075 GNR0221 MEROPENEM 0.5 GR INJ. 1.00 30,794
SUB TOTAL 1.00 30,794
PEMBULATAN 30,794
17 Feb 2020 12826117 INF0021 KAEN 4 A INFUS (1.00) (30,250)
SUB TOTAL RETURN (1.00) (30,250)
PEMBULATAN (30,250)
17 Feb 2020 12826119 ALB0211 SURGICAL GLOVES STERIL 7 TROGE (3.00) (24,731)
ALB0637 EXTENTION TUBE 100 CM ONEMED (2.00) (15,975)
SUB TOTAL RETURN (5.00) (40,706)
PEMBULATAN (40,706)
SUB TOTAL
PEMBULATAN
18 Feb 2020 12827017 ALB0637 EXTENTION TUBE 100 CM ONEMED 1.00 7,988
ALB0642 Three Way Stop Cock (OneMed) 1.00 2,560
SUP0003 Dulcolax Suppositoria Paed. 5 mg 1.00 7,500
SUB TOTAL 3.00 18,048
PEMBULATAN 18,048
18 Feb 2020 12827631 ALB0637 EXTENTION TUBE 100 CM ONEMED 1.00 7,988
ALB0642 Three Way Stop Cock (OneMed) 1.00 2,560
ALK0265 SPALAK 15 x 4 x 4 1.00 8,663
ALK0683 MEDICATH/TROGE PLUS NO.24 2.00 36,300
ALK0737 INFUS SET Y - ADAPTOR 1.00 10,500
ALK0742 SPUIT 3 CC/MIRACHEN 3.00 3,004
ALK0751 SPUIT 5 CC /MIRACHEN 3.00 3,469
ALK0752 SPUIT 10 CC /MIRACHEN 3.00 4,290
GNR0057 CHLORPHENIRAMIN/ CTM 1.00 30
GNR0138 SALBUTAMOL 4 MG 1.00 143
GNR0181 PHENITOIN 100 MG (Ikapharm) 1.00 190
GNR0221 MEROPENEM 0.5 GR INJ. 1.00 30,794
INF0094 Dextrose 5 % + 1/4 NS Sanbe SP (Rutin) Infus 1.00 13,118
INH0013 Ventolin Nebulyzer 2,5 mg* 3.00 15,000
SUP0003 Dulcolax Suppositoria Paed. 5 mg 1.00 7,500
SUB TOTAL 24.00 143,546
PEMBULATAN 143,546
19 Feb 2020 12828199 ALB0243 SURGICAL GLOVES STERIL 6 TROGE 1.00 8,244
 ALB0672 FEEDING TUBE NO.10 (AXIMED) 1.00 10,038
SUB TOTAL 2.00 18,281
PEMBULATAN 18,281

JUMLAH 1,729.35 24,941,459

Terbilang: Dua puluh empat juta sembilan ratus empat puluh satu ribu empat ratus lima puluh sembilan

SELISIH PEMBULATAN 30,250

Samarinda, 19 February 2020

Bagian Instalasi Farmasi
RSU.A. Wahab Sjahranie Samarinda

(___________________________)