RSI GONDANGLEGI

(0341) 879047 - 879205 - 879879 - 878593

REKAP PENGGUNAAN OBAT PER DOKTER PERESEP

1. dr. Niniek Budiarti, Sp.PD - KPTI

1. (1909090001) SYAIFUL BACHRI TN 2019-09-09 JARU92 JARUM NOVOVINE - 5 17.000 0 845
2. (1909090338) SILVIA NUR AZIZAH NN 05:49:00
2019-09-09 ALKO01 ALKOHOL SWAB AMS - 10 3.000 0 845
3. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 CEFT01 CEFTRIAXON 1GR INJ 5 66.000 0 845
4. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 Formularioum
DISP02 DISPOSIBLE 3 CC NIPRO - 12 25.200 0 845
5. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 DISP03 DISPOSIBLE 5 CC NIPRO - 6 16.800 0 845
6. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 5 14.500 0 845
7. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 DISP09 DISPOSIBLE 100UI INSULIN - 1 5.700 0 845
8. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 FARM04 FARMADOL TABLET 4 1.600 0 845
9. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 Formularioum
GAST01 GASTRIDIN INJEKSI - 3 88.800 0 845
10. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 HAND16 HANDSCOON NON STERIL S - 20 14.000 0 845
11. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 INFU15 INFUSAN NS 500 SANBE - 3 47.700 0 845
12. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 INVO03 INVOMIT 8 MG INJ Formularioum 1 90.300 0 845
13. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 JARU06 JARUM 23 TERUMO - 1 3.000 0 845
10:58:41
14. (1909090338) SILVIA NUR AZIZAH NN 2019-09-09 MASK84 MASKER JILBAB - 10 7.000 0 845
15. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 NOVA06 NOVALDO INJ Formularioum 5 56.500 0 845
16. (1909090338) SILVIA NUR AZIZAH NN 10:58:41
2019-09-09 ONET01 ONETIC 4MG INJ Formularioum 6 209.400 0 845
17. (1909090339) MISINEM FITRITIN 10:58:41
2019-09-09 ALKO01 ALKOHOL SWAB AMS - 10 3.000 0 845
AZIZAH NY 11:01:29
18. (1909090339) MISINEM FITRITIN 2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 5 10.500 0 845
AZIZAH NY 11:01:29
19. (1909090339) MISINEM FITRITIN 2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 2 5.800 0 845
AZIZAH NY 11:01:29
20. (1909090339) MISINEM FITRITIN 2019-09-09 GITA02 GITAS INJEKSI Formularioum 5 161.500 0 845
AZIZAH NY 11:01:29
21. (1909090339) MISINEM FITRITIN 2019-09-09 HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
AZIZAH NY 11:01:29
22. (1909090339) MISINEM FITRITIN 2019-09-09 INFU14 INFUSAN D5 SANBE - 3 50.400 0 845
AZIZAH NY 11:01:29
23. (1909090339) MISINEM FITRITIN 2019-09-09 MASK84 MASKER JILBAB - 10 7.000 0 845
AZIZAH NY 11:01:29
24. (1909090339) MISINEM FITRITIN 2019-09-09 RIND09 RINDOPUMP INJ Formularioum 2 264.000 0 845
AZIZAH NY 11:01:29
25. (1909090339) MISINEM FITRITIN 2019-09-09 URSO01 URSOLIC TAB - 3 37.800 0 845
AZIZAH NY 11:01:29
26. (1909090341) PONITI SULIMIN NY 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 10 3.000 0 845
27. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 12 25.200 0 845
28. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 4 11.600 0 845
29. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 FARB02 FARBION INJ - 2 16.000 0 845
30. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 GABA01 GABAPENTIN - 2 10.000 0 845
31. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 GAST04 GASTROFER INJ 40 MG 2 227.800 0 845
32. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 Formularioum
HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
33. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 INFU15 INFUSAN NS 500 SANBE - 2 31.800 0 845
34. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 KETO01 KETOROLAC 30MG INJ 5 40.500 0 845
35. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 Formularioum
MASK84 MASKER JILBAB - 10 7.000 0 845
36. (1909090341) PONITI SULIMIN NY 11:03:14
2019-09-09 ONET01 ONETIC 4MG INJ Formularioum 5 174.500 0 845
37. (1909090344) MARWI KARIM TN 11:03:14
2019-09-09 ALKO01 ALKOHOL SWAB AMS - 10 3.000 0 845
38. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 ALPR01 ALPRAZOLAM 1MG TAB - 1 1.300 0 845
39. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 CERN01 CERNEVIT INJ - 1 182.700 0 845
40. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 CODE03 CODEIN 10MG TABLET 4 3.600 0 845
41. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 Formularioum
DISP02 DISPOSIBLE 3 CC NIPRO - 3 6.300 0 845
42. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 DISP03 DISPOSIBLE 5 CC NIPRO - 3 8.400 0 845
43. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 2 5.800 0 845
44. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 FLUC01 FLUCONAZOL TAB Formularioum 1 33.800 0 845
45. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
46. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 INFU15 INFUSAN NS 500 SANBE - 2 31.800 0 845
47. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 ISOR02 ISORIC 300 TAB Formularioum 1 4.700 0 845
48. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 MASK84 MASKER JILBAB - 10 7.000 0 845
49. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 N-AC01 N-ACE KAPSUL Formularioum 3 9.600 0 845
50. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 NATR01 NATRIUM DIKLOFENAK 50MG 2 800 0 845
11:08:24 TABLET Formularioum
51. (1909090344) MARWI KARIM TN 2019-09-09 ONET01 ONETIC 4MG INJ Formularioum 3 104.700 0 845
52. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 PRAG01 PRAGESOL INJ Formularioum 3 35.700 0 845
53. (1909090344) MARWI KARIM TN 11:08:24
2019-09-09 RIND09 RINDOPUMP INJ Formularioum 1 132.000 0 845
54. (1909090345) MUJIONO PONIMAN TN 11:08:24
2019-09-09 ALKO01 ALKOHOL SWAB AMS - 6 1.800 0 845
55. (1909090345) MUJIONO PONIMAN TN 11:11:44
2019-09-09 AQUA07 AQUABIDEST 25 CC 1 3.500 0 845
56. (1909090345) MUJIONO PONIMAN TN 11:11:44
2019-09-09 Formularioum
DISP04 DISPOSIBLE 10 CC NIPRO - 4 11.600 0 845
11:11:44
09/09/2019 Halaman 1 dari 7
16.07.07
 57. (1909090345) MUJIONO PONIMAN TN 2019-09-09 HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
58. (1909090345) MUJIONO PONIMAN TN 11:11:44
2019-09-09 INFU15 INFUSAN NS 500 SANBE - 2 31.800 0 845
11:11:44
59. (1909090345) MUJIONO PONIMAN TN 2019-09-09 MASK84 MASKER JILBAB - 6 4.200 0 845
11:11:44
60. (1909090345) MUJIONO PONIMAN TN 2019-09-09 REMI02 REMIDI I.V TRANSPARAN - 1 4.300 0 845
61. (1909090345) MUJIONO PONIMAN TN 11:11:44
2019-09-09 RIND09 RINDOPUMP INJ Formularioum 1 132.000 0 845
62. (1909090345) MUJIONO PONIMAN TN 11:11:44
2019-09-09 VENV10 VENVLON 18 - 1 16.800 0 845
11:11:44
63. (1909090345) MUJIONO PONIMAN TN 2019-09-09 ZIBA01 ZIBAC 1 GR Formularioum 3 237.600 0 845
11:11:44
64. (1909090348) TUKIRAN MADRAIS TN 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 10 3.000 0 845
65. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 12 25.200 0 845
66. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 2 5.800 0 845
67. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
68. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 INFU15 INFUSAN NS 500 SANBE - 2 31.800 0 845
69. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 LIVA01 LIVAPRO SS - 2 22.600 0 845
70. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 MASK84 MASKER JILBAB - 10 7.000 0 845
71. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 ONET01 ONETIC 4MG INJ Formularioum 5 174.500 0 845
72. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 PRAG01 PRAGESOL INJ Formularioum 5 59.500 0 845
73. (1909090348) TUKIRAN MADRAIS TN 11:18:52
2019-09-09 RIND09 RINDOPUMP INJ Formularioum 2 264.000 0 845
74. (1909090367) DWI WIDODO TN 11:18:52
2019-09-09 3WAY01 3WAY STOP COCK - 1 47.600 0 845
75. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 ALKO01 ALKOHOL SWAB AMS - 4 1.200 0 845
76. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 ASPI02 ASPILETS - 1 700 0 845
77. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 ATOR01 ATORVASTATIN 20 MG - 1 5.100 0 845
78. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 B000001041 ORIGINAL PERFUSOR 1 59.400 0 845
12:09:41 TUBING WHITE 150 CM -
79. (1909090367) DWI WIDODO TN 2019-09-09 CLOP01 CLOPIDOGREL TABLET - 1 4.700 0 845
80. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 5 10.500 0 845
81. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 ECGE01 ECG ELEKTRODA - 5 24.000 0 845
82. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 FARS05 FARSORBID 5MG TAB 3 900 0 845
83. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 Formularioum
GAST01 GASTRIDIN INJEKSI - 3 88.800 0 845
84. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
85. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 INFU15 INFUSAN NS 500 SANBE - 2 31.800 0 845
86. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 INVI01 INVICLOT INJ - 1 87.200 0 845
87. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 LEVO01 LEVOFLOXACIN 500 INF 2 105.600 0 845
12:09:41 Formularioum
88. (1909090367) DWI WIDODO TN 2019-09-09 MASK84 MASKER JILBAB - 5 3.500 0 845
89. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 ONET01 ONETIC 4MG INJ Formularioum 2 69.800 0 845
90. (1909090367) DWI WIDODO TN 12:09:41
2019-09-09 PERF01 PERFUSOR DISPO 50ML - 1 33.000 0 845
Subtotal 12:09:41
: 3.977.900 0 76.050
2. dr. Saiful Burhan, Sp.B FinaCS
1. (1909090363) SUWATIN SITI 2019-09-09 B000001005 HYPAVIX 5*15 CM - 4 5.600 0 845
KHOTIJAH NY
2. (1909090363) SUWATIN SITI 12:02:35
2019-09-09 FARM04 FARMADOL TABLET 10 4.000 0 845
KHOTIJAH NY
3. (1909090363) SUWATIN SITI 12:02:35
2019-09-09 Formularioum
HAND15 HANDSCON NON STERIL M - 6 4.200 0 845
KHOTIJAH NY
4. (1909090363) SUWATIN SITI 12:02:35
2019-09-09 KASS05 KASSA BESAR - 6 11.400 0 845
KHOTIJAH NY
5. (1909090363) SUWATIN SITI 12:02:35
2019-09-09 MILZ02 MILZIME DF CC - 5 2.000 0 845
KHOTIJAH NY
6. (1909090363) SUWATIN SITI 12:02:35
2019-09-09 POCH04 POCHES 15 CM GUESSETE 15 4.500 0 845
KHOTIJAH NY
7. (1909090363) SUWATIN SITI 12:02:35
2019-09-09 ( CM ) - POCHES 7.5 FLAT ( CM ) -
POCH05 6 600 0 845
KHOTIJAH NY
Subtotal 12:02:35
: 32.300 0 5.915
3. dr. Retno Hardjanti H, Sp.OG
4. dr. Yayuk Widaningrum, SpOG
5. dr. R. Satriyo Aji, Sp.OT
6. dr. Yuni Hisbiyah, Sp.A., MMRS
7. dr. Ungky Agus Setyawan Sp.P
1. (1909090010) TARI JASEMAN TN 2019-09-09 LISI01 LISINOPRIL 10 Formularioum 5 3.500 0 845
2. (1909090010) TARI JASEMAN TN 09:09:18
2019-09-09 RETA01 RETAPHYL SR - 15 39.000 0 845
3. (1909090010) TARI JASEMAN TN 09:09:18
2019-09-09 SYMB01 SYMBICORT TURBUHALER 160 - 1 177.300 0 845
4. (1909090358) ANGGI IRFAN FIRDAUS 09:09:18
2019-09-09 ALKO01 ALKOHOL SWAB AMS - 4 1.200 0 845
TN5. (1909090358) ANGGI IRFAN FIRDAUS 11:05:52
2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 3 8.700 0 845
TN6. (1909090358) ANGGI IRFAN FIRDAUS 11:05:52
2019-09-09 HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
TN7. (1909090358) ANGGI IRFAN FIRDAUS 11:05:52
2019-09-09 LIVA01 LIVAPRO SS - 15 169.500 0 845
TN8. (1909090358) ANGGI IRFAN FIRDAUS 11:05:52
2019-09-09 MASK84 MASKER JILBAB - 4 2.800 0 845
TN9. (1909090358) ANGGI IRFAN FIRDAUS 11:05:52
2019-09-09 N-AC01 N-ACE KAPSUL Formularioum 15 48.000 0 845
TN10. (1909090358) ANGGI IRFAN FIRDAUS 11:05:52
2019-09-09 SALB07 SALBUTAMOL 2MG TAB - 15 3.000 0 845
TN11. (1909090358) ANGGI IRFAN FIRDAUS 11:05:52
2019-09-09 ZIBA01 ZIBAC 1 GR Formularioum 1 79.200 0 845
TN12. (1909090343) R. JEKI AL MARSUKI TN 11:05:52
2019-09-09 AMLO01 AMLODIPINE 5MG TABLET 10 8.000 0 845
11:05:52 Formularioum
13. (1909090343) R. JEKI AL MARSUKI TN 2019-09-09 CAND02 CANDESARTAN 8 MG - 10 36.000 0 845
14. (1909090343) R. JEKI AL MARSUKI TN 11:05:52
2019-09-09 N-AC01 N-ACE KAPSUL Formularioum 15 48.000 0 845
11:05:52
15. (1909090343) R. JEKI AL MARSUKI TN 2019-09-09 RETA01 RETAPHYL SR - 10 26.000 0 845
Subtotal 11:05:52
: 657.200 0 12.675
8. dr. Nofiarni Yusril, Sp.P.,FAPSR
1. (1909090009) KAMISRI MANGUN NY 2019-09-09 4FDC01 4 fdc tab Formularioum 42 0 0 845
2. (1909090009) KAMISRI MANGUN NY 09:01:26
2019-09-09 JARU07 JARUM 25 TERUMO - 5 14.000 0 845
09:01:26
09/09/2019 Halaman 2 dari 7
16.07.07
 3. (1909090009) KAMISRI MANGUN NY 2019-09-09 STRE02 STREPTOMYCIN (OAT) 12 0 0 845
4. (1909090009) KAMISRI MANGUN NY 09:01:26
2019-09-09 Formularioum
VIT 08 VIT B6 25 TABLET Formularioum 15 1.500 0 845
5. (1909090011) KAMISRI MANGUN NY 09:01:26
2019-09-09 DISP03 DISPOSIBLE 5 CC NIPRO - 5 13.000 0 845
6. (2019720323) SUGIANTO SUPARNO TN 09:32:59
2019-09-09 CANG03 CANGKANG 1 - 15 1.500 0 1.375
7. (2019720323) SUGIANTO SUPARNO TN 10:06:31
2019-09-09 CODE05 CODEIN 20MG TABLET 8 15.000 0 1.375
10:06:31 Formularioum
8. (2019720323) SUGIANTO SUPARNO TN 2019-09-09 INTE01 INTERHISTIN TABLET 5 5.000 0 1.375
9. (2019720323) SUGIANTO SUPARNO TN 10:06:31
2019-09-09 Formularioum
MASK84 MASKER JILBAB - 10 7.000 0 845
10. (2019720323) SUGIANTO SUPARNO 10:06:31
2019-09-09 METH14 METHYLPREDNISOLON 4 MG 10 4.000 0 845
TN 10:06:31 Formularioum
11. (2019720323) SUGIANTO SUPARNO 2019-09-09 SYMB01 SYMBICORT TURBUHALER 160 - 1 177.300 0 845
TN12. (1909090326) MUNADI SAMAR TN 10:06:31
2019-09-09 4FDC01 4 fdc tab Formularioum 40 4.000 0 845
13. (1909090326) MUNADI SAMAR TN 10:17:38
2019-09-09 CODE03 CODEIN 10MG TABLET 10 9.000 0 845
14. (1909090326) MUNADI SAMAR TN 10:17:38
2019-09-09 Formularioum
MASK84 MASKER JILBAB - 10 7.000 0 845
15. (1909090326) MUNADI SAMAR TN 10:17:38
2019-09-09 RETA01 RETAPHYL SR - 10 26.000 0 845
16. (1909090326) MUNADI SAMAR TN 10:17:38
2019-09-09 VIT 08 VIT B6 25 TABLET Formularioum 15 1.500 0 845
17. (1909090327) TULUS RAMSO TN 10:17:38
2019-09-09 CODE05 CODEIN 20MG TABLET 15 30.000 0 845
10:20:56 Formularioum
18. (1909090327) TULUS RAMSO TN 2019-09-09 LEVO02 LEVOFLOXACIN 500 TAB 5 6.000 0 845
10:20:56 Formularioum
19. (1909090327) TULUS RAMSO TN 2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
20. (1909090327) TULUS RAMSO TN 10:20:56
2019-09-09 SALB07 SALBUTAMOL 2MG TAB - 10 2.000 0 845
21. (1909090327) TULUS RAMSO TN 10:20:56
2019-09-09 TRAN04 TRANEC TABLET Formularioum 15 63.000 0 845
22. (1909090328) LIA SETYAWATI NY 10:20:56
2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
23. (1909090328) LIA SETYAWATI NY 10:24:59
2019-09-09 SYMB01 SYMBICORT TURBUHALER 160 - 1 177.300 0 845
24. (1909090329) IMAM TAUKHID TN 10:24:59
2019-09-09 ACET02 ACETYLCYSTEINE 200 MG TAB 10 13.000 0 845
10:29:03 Formularioum
25. (1909090329) IMAM TAUKHID TN 2019-09-09 FURO01 FUROSEMIDE 40 MG TAB 10 3.000 0 845
10:29:03 Formularioum
26. (1909090329) IMAM TAUKHID TN 2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
27. (1909090329) IMAM TAUKHID TN 10:29:03
2019-09-09 RETA01 RETAPHYL SR - 10 26.000 0 845
28. (1909090329) IMAM TAUKHID TN 10:29:03
2019-09-09 SYMB01 SYMBICORT TURBUHALER 160 - 1 177.300 0 845
29. (1909090331) YUNARIYAH NY 10:29:03
2019-09-09 B000001039 GASTRIDIN TABLET - 10 57.000 0 845
30. (1909090331) YUNARIYAH NY 10:35:56
2019-09-09 CANG03 CANGKANG 1 - 15 1.500 0 1.375
31. (1909090331) YUNARIYAH NY 10:35:56
2019-09-09 CODE05 CODEIN 20MG TABLET 8 12.750 0 1.375
10:35:56 Formularioum
32. (1909090331) YUNARIYAH NY 2019-09-09 INTE01 INTERHISTIN TABLET 5 4.500 0 1.375
33. (1909090331) YUNARIYAH NY 10:35:56
2019-09-09 Formularioum
LANS01 LANSOPRAZOLE CAP 10 11.000 0 845
34. (1909090331) YUNARIYAH NY 10:35:56
2019-09-09 Formularioum
MASK84 MASKER JILBAB - 2 1.200 0 845
35. (1909090334) MULIONO TARIMAN, 10:35:56
2019-09-09 MASK84 MASKER JILBAB - 2 1.200 0 845
TN36. (1909090334) MULIONO TARIMAN, 10:46:39
2019-09-09 RETA01 RETAPHYL SR - 15 33.000 0 845
TN37. (1909090334) MULIONO TARIMAN, 10:46:39
2019-09-09 SYMB01 SYMBICORT TURBUHALER 160 - 1 147.800 0 845
TN38. (1909090336) SARFII SARMAN TN 10:46:39
2019-09-09 ACET02 ACETYLCYSTEINE 200 MG TAB 20 22.000 0 845
10:54:52 Formularioum
39. (1909090336) SARFII SARMAN TN 2019-09-09 FARM04 FARMADOL TABLET 10 4.000 0 845
40. (1909090336) SARFII SARMAN TN 10:54:52
2019-09-09 Formularioum
FURO01 FUROSEMIDE 40 MG TAB 5 1.500 0 845
10:54:52 Formularioum
41. (1909090336) SARFII SARMAN TN 2019-09-09 LISI01 LISINOPRIL 10 Formularioum 5 3.000 0 845
42. (1909090336) SARFII SARMAN TN 10:54:52
2019-09-09 MASK84 MASKER JILBAB - 2 1.200 0 845
43. (1909090336) SARFII SARMAN TN 10:54:52
2019-09-09 RETA01 RETAPHYL SR - 10 22.000 0 845
44. (1909090337) AGUS DWI PRIYANTO 10:54:52
2019-09-09 2FDC01 2 FDC TAB (TAB TBC) 60 6.000 0 845
TN45. (1909090337) AGUS DWI PRIYANTO 10:57:28
2019-09-09 Formularioum
MASK84 MASKER JILBAB - 2 1.200 0 845
TN46. (1909090337) AGUS DWI PRIYANTO 10:57:28
2019-09-09 VIT 08 VIT B6 25 TABLET Formularioum 15 1.500 0 845
TN47. (1909090347) MARSAID ISMAN TN 10:57:28
2019-09-09 CEFI02 CEFIXIM KAPSUL 200MG 10 24.000 0 845
11:18:14 Formularioum
48. (1909090347) MARSAID ISMAN TN 2019-09-09 MASK84 MASKER JILBAB - 2 1.200 0 845
49. (1909090347) MARSAID ISMAN TN 11:18:14
2019-09-09 METH14 METHYLPREDNISOLON 4 MG 10 4.000 0 845
11:18:14 Formularioum
50. (1909090347) MARSAID ISMAN TN 2019-09-09 N-AC01 N-ACE KAPSUL Formularioum 20 54.000 0 845
51. (1909090347) MARSAID ISMAN TN 11:18:14
2019-09-09 SALB07 SALBUTAMOL 2MG TAB - 10 1.000 0 845
52. (1909090347) MARSAID ISMAN TN 11:18:14
2019-09-09 VENT03 VENTOLIN SPRAY Formularioum 1 60.000 0 845
53. (1909090351) CHICIN SUNDIWI NY 11:18:14
2019-09-09 MASK84 MASKER JILBAB - 2 1.200 0 845
54. (1909090351) CHICIN SUNDIWI NY 11:23:21
2019-09-09 VIT 08 VIT B6 25 TABLET Formularioum 15 1.500 0 845
55. (1909090352) SITI MARIYAM 11:23:21
2019-09-09 ACET02 ACETYLCYSTEINE 200 MG TAB 10 11.000 0 845
SAMPUN, NY 11:25:05 Formularioum
56. (1909090352) SITI MARIYAM 2019-09-09 IBUP01 IBUPROFEN 400MG TAB - 10 4.000 0 845
SAMPUN, NY
57. (1909090352) SITI MARIYAM 11:25:05
2019-09-09 MASK84 MASKER JILBAB - 2 1.200 0 845
SAMPUN, NY
58. (1909090352) SITI MARIYAM 11:25:05
2019-09-09 METH14 METHYLPREDNISOLON 4 MG 10 4.000 0 845
SAMPUN, NY 11:25:05 Formularioum
59. (1909090352) SITI MARIYAM 2019-09-09 RETA01 RETAPHYL SR - 10 22.000 0 845
SAMPUN, NY
60. (1909090352) SITI MARIYAM 11:25:05
2019-09-09 SYMB01 SYMBICORT TURBUHALER 160 - 1 147.800 0 845
SAMPUN, NY
61. (1909090353) SULIYADI DARMIN TN 11:25:05
2019-09-09 ACET02 ACETYLCYSTEINE 200 MG TAB 10 12.000 0 845
11:26:24 Formularioum
62. (1909090353) SULIYADI DARMIN TN 2019-09-09 NASA01 NASAL OKSIGEN DEWASA - 1 10.600 0 845
63. (1909090353) SULIYADI DARMIN TN 11:26:24
2019-09-09 RETA01 RETAPHYL SR - 10 24.000 0 845
64. (1909090353) SULIYADI DARMIN TN 11:26:24
2019-09-09 SYMB01 SYMBICORT TURBUHALER 160 - 1 162.500 0 845
11:26:24
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 65. (1909090354) RACHMAD MOULYONO 2019-09-09 2FDC01 2 FDC TAB (TAB TBC) 36 3.600 0 845
TN66. (1909090354) RACHMAD MOULYONO 11:28:16
2019-09-09 Formularioum
CAVI02 CAVIPLEX KAP - 10 6.000 0 845
TN67. (1909090354) RACHMAD MOULYONO 11:28:16
2019-09-09 MASK84 MASKER JILBAB - 2 1.200 0 845
TN68. (1909090354) RACHMAD MOULYONO 11:28:16
2019-09-09 VIT 08 VIT B6 25 TABLET Formularioum 15 1.500 0 845
TN69. (1909090355) SUPIANI, NY 11:28:16
2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
70. (1909090355) SUPIANI, NY 11:30:07
2019-09-09 RETA01 RETAPHYL SR - 10 26.000 0 845
71. (1909090355) SUPIANI, NY 11:30:07
2019-09-09 SERE02 SERETIDE DISKUS 250Mcg - 1 147.100 0 845
72. (1909090361) SIREP TALIP, NY 11:30:07
2019-09-09 ACET02 ACETYLCYSTEINE 200 MG TAB 20 26.000 0 845
11:48:45 Formularioum
73. (1909090361) SIREP TALIP, NY 2019-09-09 AZIT01 AZITROMISIN 500 MG 3 33.900 0 845
74. (1909090361) SIREP TALIP, NY 11:48:45
2019-09-09 Formularioum
MASK84 MASKER JILBAB - 3 2.100 0 845
75. (1909090362) ANDIK MARIYANTO TN 11:48:45
2019-09-09 4FDC01 4 fdc tab Formularioum 56 5.600 0 845
76. (1909090362) ANDIK MARIYANTO TN 11:50:26
2019-09-09 MASK84 MASKER JILBAB - 3 2.100 0 845
11:50:26
77. (1909090362) ANDIK MARIYANTO TN 2019-09-09 VIT 08 VIT B6 25 TABLET Formularioum 15 1.500 0 845
78. (1909090364) SITI NUR QOMARIYAH 11:50:26
2019-09-09 ALKO01 ALKOHOL SWAB AMS - 4 1.200 0 845
NY79. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 BLOO02 BLOODSET TERUMO - 1 33.700 0 845
NY80. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 4 8.400 0 845
NY81. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 GAST01 GASTRIDIN INJEKSI - 4 118.400 0 845
NY82. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 HAND16 HANDSCOON NON STERIL S - 4 2.800 0 845
NY83. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 INFU14 INFUSAN D5 SANBE - 2 33.600 0 845
NY84. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 INFU17 INFUSAN RL SANBE - 2 32.400 0 845
NY85. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 MASK03 MASKER DISPOSIBLE - 10 6.000 0 845
NY86. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
NY87. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 REMI02 REMIDI I.V TRANSPARAN - 1 4.300 0 845
NY88. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 VENV06 VENVLON 20 - 1 16.800 0 845
NY89. (1909090364) SITI NUR QOMARIYAH 12:02:12
2019-09-09 VIT 08 VIT B6 25 TABLET Formularioum 2 200 0 845
NY90. (1909090371) BUNALI TN. H 12:02:12
2019-09-09 N-AC01 N-ACE KAPSUL Formularioum 20 64.000 0 845
91. (1909090371) BUNALI TN. H 12:24:01
2019-09-09 OMEP02 OMEPRAZOLE GEN TABLET 10 6.000 0 845
12:24:01 Formularioum
92. (1909090371) BUNALI TN. H 2019-09-09 RETA01 RETAPHYL SR - 10 26.000 0 845
93. (1909090372) SUPARMIN HADI 12:24:01
2019-09-09 HAND16 HANDSCOON NON STERIL S - 6 4.200 0 845
PRAYITNO TN 12:25:22
94. (1909090372) SUPARMIN HADI 2019-09-09 N-AC01 N-ACE KAPSUL Formularioum 20 64.000 0 845
PRAYITNO TN 12:25:22
95. (1909090372) SUPARMIN HADI 2019-09-09 RETA01 RETAPHYL SR - 10 26.000 0 845
PRAYITNO TN 12:25:22
Subtotal : 2.373.350 0 83.455
9. dr. Kararawi Listuhayu, Sp.An., M.Kes
10. dr. Radyo Wiranto, Sp.M
1. (1909090369) SUMARTI PAERAN NY 2019-09-09 CEND11 CENDO TOBROSON 0,6ML M.D - 1 36.400 0 845
Subtotal 12:20:17
: 36.400 0 845
11. dr. Luky Santi Ekawirawati, Sp.S
1. (1909090008) PARTIN RIFAI NY 2019-09-09 AMLO02 AMLODIPINE 10MG TABLET 15 16.500 0 845
08:49:00 Formularioum
2. (1909090008) PARTIN RIFAI NY 2019-09-09 GABA01 GABAPENTIN - 15 69.000 0 845
3. (1909090008) PARTIN RIFAI NY 08:49:00
2019-09-09 LISI01 LISINOPRIL 10 Formularioum 15 10.500 0 845
Subtotal 08:49:00
: 96.000 0 2.535
12. dr. Ersty Istyawati, Sp.THT - KL
13. dr. Meitty Christina Hidayati, Sp.Rad
14. dr. Bertiana Prisca Hapsari, Sp. Rad
15. dr. Viva Finhar Insani Nirmala, Sp.PK
16. dr. Etik Mertianti, Sp.PD
17. dr. Ria Damayanti, Sp.S.,M.Biomed
1. (1909090368) MARIYEM MATAHIR NY 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 4 1.200 0 845
2. (1909090368) MARIYEM MATAHIR NY 12:13:22
2019-09-09 HAND16 HANDSCOON NON STERIL S - 6 4.200 0 845
3. (1909090368) MARIYEM MATAHIR NY 12:13:22
2019-09-09 MASK84 MASKER JILBAB - 5 3.500 0 845
4. (1909090368) MARIYEM MATAHIR NY 12:13:22
2019-09-09 PIRA06 PIRACETAM 1200 TABLET - 2 1.800 0 845
Subtotal 12:13:22
: 10.700 0 3.380
18. dr. Agung Adi Prabowo, Sp.KJ
19. dr. Aina Angelina, Sp.PA
20. drg. Dewi Sulistiyo Cahyani
21. dr. Nurdiana Adwi, Sp.KFR
22. Husnul Muttaqin, Dr
23. Navis Yuliansyah, Dr
24. Rani Karunia Febrianti, Dr
25. Istidhatul Luthfi Anita S, Dr
1. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 ANTR02 ANTRAIN 500MG TAB 3 6.090 0 1.375
HAZIMA AN 09:49:58 Formularioum
2. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 COBA01 COBAZYM 1000 CAPSUL - 10 47.000 0 1.375
HAZIMA AN 09:49:58
3. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 FARM04 FARMADOL TABLET 3 1.160 0 1.375
HAZIMA AN 09:49:58 Formularioum
4. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 GLUC05 GLUCOSE - 12 1.200 0 1.375
HAZIMA AN 09:49:58

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 5. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 HAND15 HANDSCON NON STERIL M - 2 1.400 0 845
HAZIMA AN 09:49:58
6. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 HEPT02 HEPTASAN TABLET - 2 800 0 1.375
HAZIMA AN 09:49:58
7. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 L-BI01 L-BIO SACHET - 4 32.400 0 845
HAZIMA AN 09:49:58
8. (1909090012) MUH. REYNAN HAFIZ EL- 2019-09-09 PAMO03 PAMOL 125 SUPP Formularioum 1 13.600 0 845
HAZIMA AN 09:49:58
9. (1909090324) ALI FAROQ TN 2019-09-09 DOLG01 DOLGESIC 50 MG TABLET 6 15.000 0 845
10:10:55 Formularioum
10. (1909090324) ALI FAROQ TN 2019-09-09 HARN01 HARNAL 0,2MG KAPSUL - 6 51.600 0 845
11. (1909090324) ALI FAROQ TN 10:10:55
2019-09-09 METF01 METFORMIN 500TAB 15 3.000 0 845
12. (1909090324) ALI FAROQ TN 10:10:55
2019-09-09 Formularioum
URIN06 URINTER CAP - 10 59.000 0 845
13. (1909090356) WULAN LAILATUS 10:10:55
2019-09-09 FARM04 FARMADOL TABLET 10 4.000 0 845
SAADAH AN 11:32:00 Formularioum
14. (1909090356) WULAN LAILATUS 2019-09-09 METH14 METHYLPREDNISOLON 4 MG 6 2.400 0 845
SAADAH AN 11:32:00 Formularioum
15. (1909090356) WULAN LAILATUS 2019-09-09 MUCE01 MUCERA TAB - 10 15.000 0 845
SAADAH AN 11:32:00
16. (1909090356) WULAN LAILATUS 2019-09-09 TRIF01 TRIFED TABLET - 4 11.600 0 845
SAADAH AN 11:32:00
17. (1909090360) ENI NUR AINI NN 2019-09-09 GITA01 GITAS PLUS TABLET 8 53.600 0 845
18. (1909090360) ENI NUR AINI NN 11:47:12
2019-09-09 Formularioum
TOMM01 TOMAAG SYR Formularioum 1 38.000 0 845
19. (1909090365) KUSPIYEH TIMAN NY 11:47:12
2019-09-09 FARS03 FARSIX 40MG TABLET 2 2.600 0 845
20. (1909090365) KUSPIYEH TIMAN NY 12:08:02
2019-09-09 Formularioum
YALO01 YALONE 4MG Formularioum 2 5.400 0 845
21. (1909090373) SRIATI GIMIN NY 12:08:02
2019-09-09 ANAD04 ANADIUM TAB - 8 75.200 0 845
22. (1909090373) SRIATI GIMIN NY 12:29:43
2019-09-09 CANK01 CANGKANG 00 - 15 1.500 0 1.375
23. (1909090373) SRIATI GIMIN NY 12:29:43
2019-09-09 DOLG01 DOLGESIC 50 MG TABLET 12 30.000 0 1.375
12:29:43 Formularioum
24. (1909090373) SRIATI GIMIN NY 2019-09-09 FARM04 FARMADOL TABLET 10 4.200 0 1.375
25. (1909090373) SRIATI GIMIN NY 12:29:43
2019-09-09 Formularioum
HAND15 HANDSCON NON STERIL M - 2 1.400 0 845
26. (1909090373) SRIATI GIMIN NY 12:29:43
2019-09-09 OMEP02 OMEPRAZOLE GEN TABLET 8 4.000 0 845
12:29:43 Formularioum
27. (1909090373) SRIATI GIMIN NY 2019-09-09 VALD02 VALDIMEX 5MG TAB 6 8.400 0 1.375
Subtotal 12:29:43
: Formularioum 489.550 0 27.585
26. Much. Kamal Hadi, Dr
1. (1909090332) MISARI SANIDIN TN 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 3 900 0 845
2. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 BLOO02 BLOODSET TERUMO - 1 33.700 0 845
3. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 3 6.300 0 845
4. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 FARB01 FARBIVEN NEBULIZER 3 39.600 0 845
5. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 Formularioum
FARM04 FARMADOL TABLET 4 1.600 0 845
6. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 Formularioum
INFU15 INFUSAN NS 500 SANBE - 3 47.700 0 845
7. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 LAME02 LAMESON 125 MG INJ 2 175.600 0 845
8. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 Formularioum
MASK01 MASKER NEBULIZER DEWASA - 1 32.900 0 845
9. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 MASK84 MASKER JILBAB - 5 3.500 0 845
10. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 METH11 METHILPREDNISOLONE INJ 1 33.300 0 845
10:36:34 Formularioum
11. (1909090332) MISARI SANIDIN TN 2019-09-09 N-AC01 N-ACE KAPSUL Formularioum 4 12.800 0 845
12. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 NASA01 NASAL OKSIGEN DEWASA - 1 11.600 0 845
13. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 REMI02 REMIDI I.V TRANSPARAN - 1 4.300 0 845
14. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 ST.N02 ST. NITRILE M - 4 3.600 0 845
15. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 VENV10 VENVLON 18 - 1 16.800 0 845
16. (1909090332) MISARI SANIDIN TN 10:36:34
2019-09-09 ZIBA01 ZIBAC 1 GR Formularioum 3 237.600 0 845
17. (1909090333) HOIRUL HARQI AN 10:36:34
2019-09-09 B000001051 BETHADINE CC - 1 200 0 845
18. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 CEFI03 CEFIXIME SYR Formularioum 1 30.000 0 845
19. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 1 1.900 0 845
20. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 FENR01 FENRIS 60ML SYR Formularioum 1 34.500 0 845
21. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 HAND16 HANDSCOON NON STERIL S - 2 1.400 0 845
22. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 KASS01 KASSA STERIL 16*16 - 10 47.000 0 845
23. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 LOMA02 LOMATUELL H 10X10 - 1 15.000 0 845
24. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 MESC05 MESCULAP 23 - 1 4.400 0 845
25. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 PEHA05 PEHACAIN INJ - 2 7.600 0 845
26. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 POCH04 POCHES 15 CM GUESSETE 15 4.500 0 845
27. (1909090333) HOIRUL HARQI AN 10:44:47
2019-09-09 (UNDE01
CM ) - UNDER PAD AIRLAID - 1 5.200 0 845
28. (1909090342) SONIA ULLUL AZMI NN 10:44:47
2019-09-09 CODE03 CODEIN 10MG TABLET 10 8.000 0 845
11:06:51
29. (1909090342) SONIA ULLUL AZMI NN 2019-09-09 Formularioum
FARM04 FARMADOL TABLET 10 4.000 0 845
30. (1909090342) SONIA ULLUL AZMI NN 11:06:51
2019-09-09 Formularioum
INTE19 INTERMOXIL 500 KAPS 20 82.000 0 845
31. (1909090342) SONIA ULLUL AZMI NN 11:06:51
2019-09-09 Formularioum
OMEP02 OMEPRAZOLE GEN TABLET 10 5.000 0 845
11:06:51 Formularioum
32. (1909090342) SONIA ULLUL AZMI NN 2019-09-09 YALO01 YALONE 4MG Formularioum 10 27.000 0 845
Subtotal 11:06:51
: 939.500 0 27.040
27. April M Rahmat. dr, Sp.A
28. J Sudarwantono Sp.og, Dr
1. (1909090325) PRIMI DYAH MEI WATI 2019-09-09 MOLI01 MOLINFA SOFT CAPS - 20 72.000 0 845
NY2. (1909090335) RIZA KUSUMA WARDANI 10:14:13
2019-09-09 CAVI02 CAVIPLEX KAP - 20 12.000 0 845
NY3. (1909090340) MEI AMALIA MADINATA 10:49:02
2019-09-09 FOLA01 FOLAC TAB Formularioum 20 26.000 0 845
11:03:53
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 4. (1909090340) MEI AMALIA MADINATA 2019-09-09 URGE01 UTROGESTAN 200MG TABLET 10 253.000 0 845
11:03:53 Formularioum
Subtotal : 363.000 0 3.380
29. Randi Sukmana, Dr
30. Cendy Prastiwi, Dr
31. Septalisa Marsha Dea Natasia, Dr
32. Tatok Hadi Kuswoyo, Dr
33. Heny Latifah, Dr
34. Diah Noviartin Ningtyas, Drg
1. (1909090350) SUMITO GADRI TN 2019-09-09 AMOX03 AMOXICILLIN 500MG TAB 6 3.000 0 845
11:22:38 Formularioum
2. (1909090350) SUMITO GADRI TN 2019-09-09 KALI01 KALIUM DIKLOFENAK 50mg 4 2.400 0 845
11:22:38 TABLET Formularioum
3. (1909090350) SUMITO GADRI TN 2019-09-09 METR02 METRONIDAZOL TABLET 6 1.800 0 845
11:22:38 GENERIK Formularioum
4. (1909090357) NAVA ACHMARA NN 2019-09-09 HAND17 HANDSCOON NON STERIL XS - 2 1.400 0 845
5. (1909090357) NAVA ACHMARA NN 11:34:39
2019-09-09 INTE19 INTERMOXIL 500 KAPS 6 24.600 0 845
6. (1909090357) NAVA ACHMARA NN 11:34:39
2019-09-09 Formularioum
KALI01 KALIUM DIKLOFENAK 50mg 4 2.400 0 845
11:34:39 TABLET Formularioum
7. (1909090357) NAVA ACHMARA NN 2019-09-09 METR02 METRONIDAZOL TABLET 6 1.800 0 845
11:34:39 GENERIK Formularioum
8. (1909090357) NAVA ACHMARA NN 2019-09-09 MILZ02 MILZIME DF CC - 9 3.600 0 845
9. (1909090357) NAVA ACHMARA NN 11:34:39
2019-09-09 POCH04 POCHES 15 CM GUESSETE 30 9.000 0 845
10. (1909090359) JEVELLINE LEORA D 11:34:39
2019-09-09 (AMOX03
CM ) - AMOXICILLIN 500MG TAB 8 3.750 0 1.375
HARMONI AN 11:42:37 Formularioum
11. (1909090359) JEVELLINE LEORA D 2019-09-09 GLUC05 GLUCOSE - 12 1.200 0 845
HARMONI AN 11:42:37
12. (1909090359) JEVELLINE LEORA D 2019-09-09 HAND17 HANDSCOON NON STERIL XS - 2 1.400 0 845
HARMONI AN 11:42:37
13. (1909090359) JEVELLINE LEORA D 2019-09-09 KALI01 KALIUM DIKLOFENAK 50mg 8 4.500 0 1.375
HARMONI AN 11:42:37 TABLET Formularioum
14. (1909090359) JEVELLINE LEORA D 2019-09-09 METR02 METRONIDAZOL TABLET 5 1.500 0 1.375
HARMONI AN 11:42:37 GENERIK Formularioum
15. (1909090359) JEVELLINE LEORA D 2019-09-09 MILZ02 MILZIME DF CC - 10 4.000 0 845
HARMONI AN 11:42:37
16. (1909090359) JEVELLINE LEORA D 2019-09-09 POCH04 POCHES 15 CM GUESSETE 45 13.500 0 845
HARMONI AN 11:42:37 ( CM ) -
Subtotal : 79.850 0 15.110
35. dr. Faisal Rosadi, SpAn
36. dr. Irfan Agus Salim, Sp.A
1. (1909090370) ONURRA ARKANANTA 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 8 2.400 0 845
LUCKY PUTRA AN 12:21:20
2. (1909090370) ONURRA ARKANANTA 2019-09-09 AQUA07 AQUABIDEST 25 CC 1 3.500 0 845
LUCKY PUTRA AN 12:21:20 Formularioum
3. (1909090370) ONURRA ARKANANTA 2019-09-09 CEFO01 CEFOTAXIM Formularioum 1 11.300 0 845
LUCKY PUTRA AN 12:21:20
4. (1909090370) ONURRA ARKANANTA 2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 1 2.900 0 845
LUCKY PUTRA AN 12:21:20
5. (1909090370) ONURRA ARKANANTA 2019-09-09 HAND16 HANDSCOON NON STERIL S - 4 2.800 0 845
LUCKY PUTRA AN 12:21:20
6. (1909090370) ONURRA ARKANANTA 2019-09-09 INFU16 INFUSAN D 5+1/4 NACL SANBE - 1 16.900 0 845
LUCKY PUTRA AN 12:21:20
7. (1909090370) ONURRA ARKANANTA 2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
LUCKY PUTRA AN 12:21:20
8. (1909090375) MAHENDRA OKTAVIO 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 8 2.400 0 845
SETIAWAN AN 12:32:06
9. (1909090375) MAHENDRA OKTAVIO 2019-09-09 AQUA07 AQUABIDEST 25 CC 1 3.500 0 845
SETIAWAN AN 12:32:06 Formularioum
10. (1909090375) MAHENDRA OKTAVIO 2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 2 4.200 0 845
SETIAWAN AN 12:32:06
11. (1909090375) MAHENDRA OKTAVIO 2019-09-09 DISP03 DISPOSIBLE 5 CC NIPRO - 1 2.800 0 845
SETIAWAN AN 12:32:06
12. (1909090375) MAHENDRA OKTAVIO 2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 1 2.900 0 845
SETIAWAN AN 12:32:06
13. (1909090375) MAHENDRA OKTAVIO 2019-09-09 GLUC05 GLUCOSE - 4 400 0 1.375
SETIAWAN AN 12:32:06
14. (1909090375) MAHENDRA OKTAVIO 2019-09-09 HAND16 HANDSCOON NON STERIL S - 6 4.200 0 845
SETIAWAN AN 12:32:06
15. (1909090375) MAHENDRA OKTAVIO 2019-09-09 L-BI01 L-BIO SACHET - 1 8.800 0 845
SETIAWAN AN 12:32:06
16. (1909090375) MAHENDRA OKTAVIO 2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
SETIAWAN AN 12:32:06
17. (1909090375) MAHENDRA OKTAVIO 2019-09-09 ONET01 ONETIC 4MG INJ Formularioum 1 34.900 0 845
SETIAWAN AN 12:32:06
18. (1909090375) MAHENDRA OKTAVIO 2019-09-09 OPIM01 OPIMOX 1 GR INJ Formularioum 1 35.700 0 845
SETIAWAN AN 12:32:06
19. (1909090375) MAHENDRA OKTAVIO 2019-09-09 SMEC01 SMECTA - 1 4.400 0 845
SETIAWAN AN 12:32:06
20. (1909090375) MAHENDRA OKTAVIO 2019-09-09 TRID02 TRIDEX 27B - 3 58.500 0 845
SETIAWAN AN 12:32:06
21. (1909090376) AHMAD LUCKY AL 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 6 1.800 0 845
FATHIH AN 12:34:57
22. (1909090376) AHMAD LUCKY AL 2019-09-09 AQUA07 AQUABIDEST 25 CC 1 3.500 0 845
FATHIH AN 12:34:57 Formularioum
23. (1909090376) AHMAD LUCKY AL 2019-09-09 CEFO01 CEFOTAXIM Formularioum 1 11.300 0 845
FATHIH AN 12:34:57

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 24. (1909090376) AHMAD LUCKY AL 2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 2 4.200 0 845
FATHIH AN 12:34:57
25. (1909090376) AHMAD LUCKY AL 2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 3 8.700 0 845
FATHIH AN 12:34:57
26. (1909090376) AHMAD LUCKY AL 2019-09-09 HAND16 HANDSCOON NON STERIL S - 6 4.200 0 845
FATHIH AN 12:34:57
27. (1909090376) AHMAD LUCKY AL 2019-09-09 L-BI01 L-BIO SACHET - 2 17.600 0 845
FATHIH AN 12:34:57
28. (1909090376) AHMAD LUCKY AL 2019-09-09 MASK84 MASKER JILBAB - 2 1.400 0 845
FATHIH AN 12:34:57
29. (1909090376) AHMAD LUCKY AL 2019-09-09 ONET01 ONETIC 4MG INJ Formularioum 2 69.800 0 845
FATHIH AN 12:34:57
30. (1909090376) AHMAD LUCKY AL 2019-09-09 SPAL11 SPALK 15 X 5 CM - 1 8.500 0 845
FATHIH AN 12:34:57
31. (1909090376) AHMAD LUCKY AL 2019-09-09 TRID02 TRIDEX 27B - 1 19.500 0 845
FATHIH AN 12:34:57
32. (1909090376) AHMAD LUCKY AL 2019-09-09 VENV08 VENVLON 24 - 1 16.800 0 845
FATHIH AN 12:34:57
33. (1909090376) AHMAD LUCKY AL 2019-09-09 VERB01 VERBAND 5*4 CM - 1 2.800 0 845
FATHIH AN 12:34:57
Subtotal : 375.400 0 28.415
37. dr. Cholid, Sp.J
38. dr. Umi Safiyah, Sp.An
39. dr. Fahri, Sp.An
40. dr. Muhammad Rodli, Sp.An
41. dr. Ramacandra Rakhmatullah, Sp.An
42. dr. Indra, Sp.An
43. dr. Bhramantya Sedijono, Sp.B
44. dr. Ahamd Feza Fadhlurrahman, Sp.An
45. Dr. Tommy Nugroho Wirawan Sp.A
1. (1909090346) SWASTIKA SASTRA 2019-09-09 ALKO01 ALKOHOL SWAB AMS - 4 1.200 0 845
KIRANA AN 11:16:14
2. (1909090346) SWASTIKA SASTRA 2019-09-09 AQUA07 AQUABIDEST 25 CC 1 3.500 0 845
KIRANA AN 11:16:14 Formularioum
3. (1909090346) SWASTIKA SASTRA 2019-09-09 DISP02 DISPOSIBLE 3 CC NIPRO - 1 2.100 0 845
KIRANA AN 11:16:14
4. (1909090346) SWASTIKA SASTRA 2019-09-09 DISP04 DISPOSIBLE 10 CC NIPRO - 1 2.900 0 845
KIRANA AN 11:16:14
5. (1909090346) SWASTIKA SASTRA 2019-09-09 HAND16 HANDSCOON NON STERIL S - 10 7.000 0 845
KIRANA AN 11:16:14
6. (1909090346) SWASTIKA SASTRA 2019-09-09 L-BI01 L-BIO SACHET - 1 8.800 0 845
KIRANA AN 11:16:14
7. (1909090346) SWASTIKA SASTRA 2019-09-09 MASK84 MASKER JILBAB - 5 3.500 0 845
KIRANA AN 11:16:14
8. (1909090346) SWASTIKA SASTRA 2019-09-09 OPIM01 OPIMOX 1 GR INJ Formularioum 1 35.700 0 845
KIRANA AN 11:16:14
9. (1909090346) SWASTIKA SASTRA 2019-09-09 PARO01 PAROLIT SACHET - 2 3.200 0 845
KIRANA AN 11:16:14
Subtotal : 67.900 0 7.605
>> Total : 9.499.050 0 293.990

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16.07.08