RESEP PER DOKTER

Dari Tanggal: 01-Feb-2022 00:00:00

Sampai Tanggal: 28-Feb-2022 23:59:59

No. No. Item Nama Item Jumlah

Adhytiya Dwipa Rama Teguh, dr., Sp.B
1 OBI1514 ALBUFORCE (RANAP) 10
2 OBJ1433 ALBUFORCE (RJ) 25
3 OBI0038 AMLODIPINE 10 MG (RANAP) -2
4 OBI0054 ANALTRAM (RANAP) 15
5 OBJ0054 ANALTRAM (RJ) 40
6 OBJ0077 ASAM MEFENAMAT 500 MG (RJ) 15
7 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 3
8 OBJ0096 BECOM-C (RJ) 15
9 OBI1559 BFLUID 500 ML - B (RANAP) 9
10 OBJ0125 BORRAGINOL-N SUPPO (RJ) 8
11 OBJ1501 CAVIPLEX TABLET (RJ) 20
12 OBJ0170 CEFILA-100 MG (RJ) 50
13 OBI0171 CEFIXIME 100 MG (RANAP) 40
14 OBJ0171 CEFIXIME 100 MG (RJ) 100
15 OBI0173 CEFOTAXIME 1 GR (RANAP) 2
16 OBI0174 CEFSPAN 100 MG (RANAP) 10
17 OBJ0174 CEFSPAN 100 MG (RJ) 20
18 OBI0175 CEFTRIAXONE 1 GR (RANAP) 12
19 OBI0176 CEFXON 1 GR (RANAP) 2
20 OBI0182 CEPHAFLOX 1 GR (RANAP) 3
21 OBJ0203 CITICOLINE 500 MG (RJ) 15
22 OBJ0238 CRAVOX 500 MG (RJ) 10
23 OBI0252 D5% 500 ML OTSU (RANAP) 2
24 OBJ0260 DEXAMETHASONE 0,50 MG (RJ) 10
25 OBI0269 DIGOXIN 0,25 MG (RANAP) 1
26 OBJ0289 DUODERM GEL 15 GR (RJ) 1
27 OBI1716 FIBRINASE (RANAP) 10
28 OBI0381 FURAMIN 10 ML (RANAP) 1
29 OBI0386 FUTROLIT 500 ML (RANAP) 7
30 OBJ0396 GENOINT SALEP KULIT 15 GR (RJ) 2
31 OBJ0397 GENOINT SALEP MATA 0,3% 3,5 GR (RJ) 2
32 OBJ0399 GENTAMICIN 0,1% 5 GR (RJ) 2
33 OBI1599 GLUTROP (RANAP) 4
34 OBI0456 IBUPROFEN 400 MG (RANAP) 55
35 OBJ0456 IBUPROFEN 400 MG (RJ) 115
36 OBJ0462 IMUNOS PLUS (RJ) 20
37 OBI0499 KALTROFEN SUPPO 100 MG (RANAP) 3
38 OBJ1346 KETOPROFEN 100 MG TABLET (RJ) 0
39 OBI1227 KETOROLAC INJEKSI (RANAP) 10
40 OBI1708 LABUMIN (RANAP) 25
41 OBJ1980 LABUMIN (RJ) 55
42 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 17
43 OBI0554 LAPISTAN 500 MG (RANAP) 27
44 OBJ0554 LAPISTAN 500 MG (RJ) 60
45 OBJ0562 LAXADINE 60 ML (RJ) 1
46 OBJ0574 LIDOCAIN 2% (RJ) 7

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 1 / 53

No. No. Item Nama Item Jumlah
47 OBJ0580 LIVRON B-PLEX (RJ) 20
48 OBI0621 METRONIDAZOLE 100 ML (RANAP) 2
49 OBJ0666 NEBACETINE POWDER 5 GR (RJ) 4
50 OBJ1289 NEURODEX (RJ) 10
51 OBJ1457 NEXITRA 500 MG (RJ) 10
52 OBI0701 NS 100 ML OTSU (RANAP) 10
53 OBI0703 NS 25 ML OTSU (RANAP) 8
54 OBI0705 NS 500 ML OTSU (RANAP) 2
55 OBI1201 NS 500 ML SATORIA (RANAP) 16
56 OBJ1222 NS 500 ML SATORIA (RJ) 5
57 OBJ0707 NUCRAL 100 ML (RJ) 1
58 OBI0710 NULAGYL 500 MG 100 ML (RANAP) 5
59 OBI1199 NUTRIFLAM (RANAP) 12
60 OBJ1209 NUTRIFLAM (RJ) 20
61 OBI0719 ODR 4 MG 2 ML (RANAP) 2
62 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 2
63 OBI0738 OSTELOX 15 MG SUPPO (RANAP) 10
64 OBI0748 PANTOPRAZOLE 40 MG (RANAP) 2
65 OBI0749 PARACETAMOL 1000 MG 100 ML (RANAP) -2
66 OBJ0777 PLASMINEX (RJ) 10
67 OBI0787 PRANZA 40 MG (RANAP) 12
68 OBI0794 PRIMPERAN INJEKSI (RANAP) 4
69 OBI0835 RANITIDINE 2 ML (RANAP) 8
70 OBI0837 RANTIN 50 MG 2 ML (RANAP) 2
71 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 3
72 OBI1202 RL 500 ML SATORIA (RANAP) 5
73 OBI1339 ROFIDEN SUPPO 100 MG (RANAP) 4
74 OBI0862 ROXEMID 10 MG/ML 2 ML (RANAP) 1
75 OBI0936 SPORETIK 100 MG (RANAP) 18
76 OBJ0936 SPORETIK 100 MG (RJ) 30
77 OBI0947 SUCRALFATE 100 ML (RANAP) 1
78 OBJ0947 SUCRALFATE 100 ML (RJ) 2
79 OBI0957 TAMOLIV 500 MG 50 ML (RANAP) 3
80 OBI0964 TAXECAP 1 GR (RANAP) 4
81 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 2
82 OBI0980 TERFACEF 1 GR (RANAP) 8
83 OBI0981 TETAGAM P 250 IU (RANAP) 1
84 OBJ0989 THROMBOPHOB GEL 20 GR (RJ) 1
85 OBJ1038 TUZALOS 15 MG (RJ) 12
86 OBI1068 VALSARTAN - NI 80 MG (RANAP) 2
87 OBJ1093 VITAMIN B-COMPLEX (RJ) 10
88 OBJ1097 VITAMIN C 50 MG (RJ) 15
89 OBI1101 VITAMIN K 1 ML (RANAP) 2
Agung Sulistiono, dr., Sp.B
1 OBI1514 ALBUFORCE (RANAP) 10
2 OBJ1433 ALBUFORCE (RJ) 17
3 OBI1467 ANTIHEMOROID SUPPO (RANAP) 17
4 OBJ1456 ANTIHEMOROID SUPPO (RJ) 6
5 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 1
6 OBI0165 CEFADROXIL 500 MG (RANAP) 10
7 OBJ0165 CEFADROXIL 500 MG (RJ) 46
8 OBJ0170 CEFILA-100 MG (RJ) 6

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 2 / 53

No. No. Item Nama Item Jumlah
9 OBI0173 CEFOTAXIME 1 GR (RANAP) 1
10 OBJ0202 CIPROFLOXACIN 500 MG (RJ) 16
11 OBJ1235 CLINDAMYCIN 300 MG (RJ) 10
12 OBJ0229 COTRIMOXAZOLE 480 MG (RJ) 12
13 OBJ0242 CTM 4 MG (RJ) 3
14 OBJ0260 DEXAMETHASONE 0,50 MG (RJ) 6
15 OBJ0289 DUODERM GEL 15 GR (RJ) 1
16 OBJ0338 FARMADOL 500 MG (RJ) 35
17 OBI0386 FUTROLIT 500 ML (RANAP) 1
18 OBJ1453 GLUTROP (RJ) 6
19 OBI0456 IBUPROFEN 400 MG (RANAP) 15
20 OBJ0456 IBUPROFEN 400 MG (RJ) 15
21 OBJ0460 IMUNOS (RJ) 3
22 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 5
23 OBJ0571 LEVOFLOXACIN 500 MG (RJ) 7
24 OBI0603 MEIACT 200 MG (RANAP) 10
25 OBJ0603 MEIACT 200 MG (RJ) 5
26 OBJ0604 MELOXICAM 15 MG (RJ) 36
27 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 10
28 OBI0701 NS 100 ML OTSU (RANAP) 1
29 OBI0703 NS 25 ML OTSU (RANAP) 1
30 OBJ1222 NS 500 ML SATORIA (RJ) 2
31 OBI0710 NULAGYL 500 MG 100 ML (RANAP) 2
32 OBI1199 NUTRIFLAM (RANAP) 5
33 OBJ1209 NUTRIFLAM (RJ) 24
34 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 1
35 OBI1202 RL 500 ML SATORIA (RANAP) 2
36 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 1
37 OBI0980 TERFACEF 1 GR (RANAP) 2
38 OBI1000 TOFEDEX (RANAP) 10
39 OBI1002 TOPAZOL 40 MG (RANAP) 2
40 OBJ1097 VITAMIN C 50 MG (RJ) 75
41 OBJ1126 ZINC 20 MG (RJ) 74
Agus Tri, dr., Sp.An
1 OBJ0687 NIFEDIPINE 10 MG (RJ) 10
Ahmad Ralibi, Sp.B
1 OBI0007 ACRAN 3 ML (RANAP) 6
2 OBJ0044 AMOXSAN 500 MG (RJ) 15
3 OBI0054 ANALTRAM (RANAP) 40
4 OBJ0054 ANALTRAM (RJ) 20
5 OBJ0071 ARDIUM HD 500 MG (RJ) 20
6 OBI0077 ASAM MEFENAMAT 500 MG (RANAP) 45
7 OBJ0077 ASAM MEFENAMAT 500 MG (RJ) 45
8 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 3
9 OBI0096 BECOM-C (RANAP) 6
10 OBJ0096 BECOM-C (RJ) 30
11 OBI1559 BFLUID 500 ML - B (RANAP) 2
12 OBJ0165 CEFADROXIL 500 MG (RJ) 35
13 OBI0170 CEFILA-100 MG (RANAP) 15
14 OBJ0170 CEFILA-100 MG (RJ) 100
15 OBI0171 CEFIXIME 100 MG (RANAP) 50
16 OBJ0171 CEFIXIME 100 MG (RJ) 30

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 3 / 53

No. No. Item Nama Item Jumlah
17 OBI0172 CEFOPERAZONE 1 GR (RANAP) 1
18 OBI0174 CEFSPAN 100 MG (RANAP) 30
19 OBJ0174 CEFSPAN 100 MG (RJ) 30
20 OBI0175 CEFTRIAXONE 1 GR (RANAP) 15
21 OBI0176 CEFXON 1 GR (RANAP) 20
22 OBI0182 CEPHAFLOX 1 GR (RANAP) 2
23 OBI0252 D5% 500 ML OTSU (RANAP) 12
24 OBI0287 DULCOLAX SUPPO 10 MG ADULT (RANAP) 0
25 OBI0338 FARMADOL 500 MG (RANAP) 31
26 OBJ0338 FARMADOL 500 MG (RJ) 25
27 OBJ0355 FLAMAR 50 MG (RJ) 10
28 OBI0368 FORDIN 50 MG / 2 ML (RANAP) 3
29 OBI0386 FUTROLIT 500 ML (RANAP) 4
30 OBI0493 KALBAMIN 500 ML (RANAP) 3
31 OBI0498 KALNEX INJEKSI 250 MG (RANAP) 19
32 OBI1227 KETOROLAC INJEKSI (RANAP) 10
33 OBI1609 LACOSIB 60 MG (RANAP) 15
34 OBJ1883 LACOSIB 60 MG (RJ) 6
35 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 15
36 OBJ0574 LIDOCAIN 2% (RJ) 5
37 OBI0599 MEFINAL 500 MG (RANAP) 30
38 OBJ0599 MEFINAL 500 MG (RJ) 45
39 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 0
40 OBI0621 METRONIDAZOLE 100 ML (RANAP) 6
41 OBJ1971 NOTISIL 2 MG (RJ) 10
42 OBI0701 NS 100 ML OTSU (RANAP) 9
43 OBI0703 NS 25 ML OTSU (RANAP) 7
44 OBI0705 NS 500 ML OTSU (RANAP) 3
45 OBI1201 NS 500 ML SATORIA (RANAP) 2
46 OBI0710 NULAGYL 500 MG 100 ML (RANAP) 1
47 OBI0713 OBH COMBI 100 ML (RANAP) 1
48 OBI0719 ODR 4 MG 2 ML (RANAP) 6
49 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 2
50 OBI0738 OSTELOX 15 MG SUPPO (RANAP) 6
51 OBJ1412 PANTOPUMP TABLET 40 MG (RJ) 15
52 OBI0749 PARACETAMOL 1000 MG 100 ML (RANAP) 6
53 OBJ0777 PLASMINEX (RJ) 20
54 OBI0787 PRANZA 40 MG (RANAP) 4
55 OBI0794 PRIMPERAN INJEKSI (RANAP) 4
56 OBI0827 PUMPISEL 40 MG (RANAP) 1
57 OBI0834 RANITIDINE 150 MG (RANAP) 30
58 OBI0837 RANTIN 50 MG 2 ML (RANAP) 4
59 OBI0852 RHODIUM (RANAP) 15
60 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 2
61 OBI1202 RL 500 ML SATORIA (RANAP) 10
62 OBI1339 ROFIDEN SUPPO 100 MG (RANAP) 2
63 OBJ0870 SAGESTAM 10 GR CREAM (RJ) 1
64 OBI0898 SANMOL 500 MG (RANAP) 20
65 OBJ0936 SPORETIK 100 MG (RJ) 15
66 OBI0937 SPORETIK 200 MG (RANAP) 29
67 OBJ0937 SPORETIK 200 MG (RJ) 50
68 OBI0956 TAMOLIV 1000 MG 100 ML (RANAP) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 4 / 53

No. No. Item Nama Item Jumlah
69 OBI0957 TAMOLIV 500 MG 50 ML (RANAP) 4
70 OBI0964 TAXECAP 1 GR (RANAP) 4
71 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 4
72 OBJ0999 TOFEDEX (RJ) 15
73 OBI1607 TUTOSOL 500 ML (RANAP) 6
74 OBI1121 XYLOCAINE 2% JELLY 10 GR (RANAP) 1
Asli Samadi, dr.Sp.OT
1 OBJ0052 ANALSIK (RJ) 15
2 OBJ0054 ANALTRAM (RJ) 10
3 OBI0063 ANTRAIN 1 GR (RANAP) 2
4 OBJ0095 BECOM ZET (RJ) 30
5 OBI1500 BUFECT 60 ML (RANAP) 3
6 OBJ1436 BUFECT 60 ML (RJ) 3
7 OBI0143 CAL-95 (RANAP) 45
8 OBJ0143 CAL-95 (RJ) 15
9 OBJ0145 CALCIUM LACTATE / CALC 500 MG (RJ) 45
10 OBJ0149 CAPSINAT 500 MG (RJ) 5
11 OBI1526 CEFACEF 200 MG (RANAP) 5
12 OBI0169 CEFILA 30 ML (RANAP) 1
13 OBI0170 CEFILA-100 MG (RANAP) 20
14 OBI0171 CEFIXIME 100 MG (RANAP) 10
15 OBI1133 CEFIXIME 30 ML (RANAP) 1
16 OBI0175 CEFTRIAXONE 1 GR (RANAP) 5
17 OBI0176 CEFXON 1 GR (RANAP) 6
18 OBJ1202 CENDO LYTEERS EYE DROP 15 ML (RJ) 1
19 OBI0183 CEPTIK 100 MG (RANAP) 10
20 OBI0188 CETIRIZINE 10 MG (RANAP) 15
21 OBJ0202 CIPROFLOXACIN 500 MG (RJ) 15
22 OBI1645 COLCHICINE 0,5 MG (RANAP) 8
23 OBI0252 D5% 500 ML OTSU (RANAP) 1
24 OBJ1952 DC2 (RJ) 65
25 OBI1323 DEXAMETHASONE AMPUL (RANAP) 1
26 OBI0296 ELKANA 60 ML (RANAP) 1
27 OBI0386 FUTROLIT 500 ML (RANAP) 12
28 OBJ1453 GLUTROP (RJ) 15
29 OBJ0456 IBUPROFEN 400 MG (RJ) 80
30 OBJ1335 IBUPROFEN 60 ML (RJ) 1
31 OBJ1357 INFELD GEL 15 G (RJ) 9
32 OBI1406 KETOPROFEN 100 MG TABLET (RANAP) 15
33 OBI1445 KETOROLAC 10 MG (RANAP) 25
34 OBJ1984 KETOROLAC 10 MG (RJ) 20
35 OBI1227 KETOROLAC INJEKSI (RANAP) 10
36 OBI1520 KOLKATRIOL 0,25 MCG (RANAP) 45
37 OBJ1389 KOLKATRIOL 0,25 MCG (RJ) 165
38 OBJ1513 LABALIN 75 MG (RJ) 30
39 OBJ1980 LABUMIN (RJ) 8
40 OBJ1883 LACOSIB 60 MG (RJ) 25
41 OBJ1536 LACOSIB 90 MG (RJ) 80
42 OBI0536 LAMESON 4 MG (RANAP) 15
43 OBJ0536 LAMESON 4 MG (RJ) 15
44 OBJ0574 LIDOCAIN 2% (RJ) 4
45 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 2

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 5 / 53

No. No. Item Nama Item Jumlah
46 OBJ0658 MYONEP (RJ) 75
47 OBJ0676 NEUROSANBE (RJ) 30
48 OBJ0679 NEUROSANBE PLUS (RJ) 30
49 OBI0701 NS 100 ML OTSU (RANAP) 7
50 OBI0703 NS 25 ML OTSU (RANAP) 11
51 OBI0705 NS 500 ML OTSU (RANAP) 2
52 OBI1201 NS 500 ML SATORIA (RANAP) 1
53 OBJ1222 NS 500 ML SATORIA (RJ) 2
54 OBJ1989 NUBREX 100 MG (RJ) 45
55 OBI1690 NUBREX 200 MG (RANAP) 25
56 OBJ1942 NUBREX 200 MG (RJ) 15
57 OBI1199 NUTRIFLAM (RANAP) 3
58 OBJ1209 NUTRIFLAM (RJ) 109
59 OBI0719 ODR 4 MG 2 ML (RANAP) 2
60 OBJ0723 OMEPRAZOLE 20 MG (RJ) 60
61 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 1
62 OBJ0736 OSKOM (RJ) 75
63 OBI0737 OSSOVIT (RANAP) 60
64 OBJ0737 OSSOVIT (RJ) 485
65 OBI1403 OSSOVIT 100 ML (RANAP) 2
66 OBJ1360 OSSOVIT 100 ML (RJ) 4
67 OBI0738 OSTELOX 15 MG SUPPO (RANAP) -4
68 OBI0749 PARACETAMOL 1000 MG 100 ML (RANAP) 1
69 OBI0794 PRIMPERAN INJEKSI (RANAP) 1
70 OBJ1874 PROVELYN 50 MG (RJ) 15
71 OBI0835 RANITIDINE 2 ML (RANAP) 2
72 OBJ1369 RINDOCAL (RJ) 30
73 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 1
74 OBI1202 RL 500 ML SATORIA (RANAP) 8
75 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) 1
76 OBI0938 STARXON 1 GR (RANAP) 3
77 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 2
78 OBI0980 TERFACEF 1 GR (RANAP) 3
79 OBI1000 TOFEDEX (RANAP) 40
80 OBJ0999 TOFEDEX (RJ) 60
81 OBI1001 TOFEDEX 50 MG 2 ML (RANAP) 5
82 OBI1646 TORDEX INJEKSI (RANAP) 3
83 OBI1647 TORDEX TABLET (RJ) 70
84 OBJ1022 TRILAC 10 MG 5 ML (RJ) 1
85 OBI1094 VITAMIN B-COMPLEX (RANAP) 10
86 OBJ1093 VITAMIN B-COMPLEX (RJ) 15
Atas Permintaan Sendiri
1 OBJ1298 ACETYLCYSTEINE 200 MG (RJ) 20
2 OBI1369 ATRACURIUM BESYLATE 2,5 ML (RANAP) 1
3 OBJ0095 BECOM ZET (RJ) 70
4 OBJ0096 BECOM-C (RJ) 50
5 OBJ0142 BUSCOPAN PLUS (RJ) 2
6 OBJ0165 CEFADROXIL 500 MG (RJ) 5
7 OBJ1133 CEFIXIME 30 ML (RJ) 1
8 OBJ0188 CETIRIZINE 10 MG (RJ) 12
9 OBJ0214 CLOPIDOGREL 75 MG (RJ) 10
10 OBJ0227 CORTIDEX TABLET (RJ) 10

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 6 / 53

No. No. Item Nama Item Jumlah
11 OBJ1882 CURCUMA FORCE (RJ) 4
12 OBJ1952 DC2 (RJ) 8
13 OBJ0273 DIOVAN 80 MG (RJ) 10
14 OBJ0348 F-G-TROCHES (RJ) 10
15 OBJ0337 FARMACROL FORTE (RJ) 10
16 OBJ0338 FARMADOL 500 MG (RJ) 10
17 OBJ1975 FARNORMIN 50 MG (RJ) 30
18 OBI0359 FLIXOTIDE NEBULES 2 ML (RANAP) 10
19 OBJ0397 GENOINT SALEP MATA 0,3% 3,5 GR (RJ) 1
20 OBJ0409 GLUCOSAMINE 500 MG (RJ) 5
21 OBJ0439 HEPA - Q (RJ) 12
22 OBJ1167 HUFAGRIP FORTE (RJ) 40
23 OBJ0456 IBUPROFEN 400 MG (RJ) 5
24 OBJ1536 LACOSIB 90 MG (RJ) 3
25 OBJ0553 LAPISIV-T (RJ) 10
26 OBI0575 LIDODEX 2 ML (RANAP) 2
27 OBJ1941 MECTINSANBE 12 MG (RJ) 30
28 OBJ0605 MELOXICAM 7,5 MG (RJ) 18
29 OBJ1872 METAMIZOLE SODIUM 2 ML (RJ) 5
30 OBI1344 METHYLERGOMETRINE 0,2 MG 1 ML (RANAP) 3
31 OBJ0614 METHYLPREDNISOLONE 4 MG (RJ) 20
32 OBJ1907 MIXALGIN (RJ) 10
33 OBJ0646 MOVIX 7,5 MG (RJ) 5
34 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 10
35 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 5
36 OBJ1289 NEURODEX (RJ) 5
37 OBJ0677 NEUROSANBE 3 ML (RJ) 5
38 OBJ0679 NEUROSANBE PLUS (RJ) 20
39 OBJ0685 NEW DIATABS (RJ) 4
40 OBI0688 NIFUDIAR 60 ML (RANAP) 2
41 OBI0691 NORAGES 2 ML (RANAP) 1
42 OBJ0691 NORAGES 2 ML (RJ) 3
43 OBJ0695 NOVALGIN 500 MG (RJ) 10
44 OBI1201 NS 500 ML SATORIA (RANAP) 1
45 OBJ1222 NS 500 ML SATORIA (RJ) 4
46 OBJ1209 NUTRIFLAM (RJ) 5
47 OBJ0725 ONDANCENTRON 4 MG 2 ML (RJ) 2
48 OBJ0736 OSKOM (RJ) 5
49 OBI1319 OXYTOCIN INJEKSI (RANAP) 2
50 OBI1722 PAMOL SUPPO (RANAP) 2
51 OBJ0768 PIDOVIX (RJ) 30
52 OBJ0835 RANITIDINE 2 ML (RJ) 3
53 OBJ0898 SANMOL 500 MG (RJ) 32
54 OBJ0899 SANMOL 60 MG 15 ML (RJ) 2
55 OBJ0900 SANMOL 60 ML (RJ) 1
56 OBJ0906 SANTAGESIK 500 MG 2 ML (RJ) 2
57 OBJ0947 SUCRALFATE 100 ML (RJ) 1
58 OBJ1014 TREMENZA (RJ) 13
59 OBJ1953 TRIFEDRIN (RJ) 5
60 OBJ1038 TUZALOS 15 MG (RJ) 23
B. Agus Dwi S., dr., Sp.An
1 OBI0007 ACRAN 3 ML (RANAP) 10

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 7 / 53

No. No. Item Nama Item Jumlah
2 OBI0012 AERRANE 1 ML (RANAP) 85
3 OBJ0032 AMBROXOL 30 MG (RJ) 60
4 OBJ0044 AMOXSAN 500 MG (RJ) 0
5 OBI0054 ANALTRAM (RANAP) 15
6 OBI1524 ANESTICAP 10 MG 20 ML (RANAP) 9.5
7 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 2
8 OBI1369 ATRACURIUM BESYLATE 2,5 ML (RANAP) 3
9 OBIBP0004 ATROPINE SULFAS 0.25 MG 1 ML-B (RANAP) 28
10 OBI0118 BLEDSTOP INJEKSI (RANAP) 15
11 OBI0138 BUNASCAN SPINAL 0,5% HEAVY 4 ML (RANAP) 28
12 OBI1315 CEFAZOLIN 1 G (RANAP) 2
13 OBI0175 CEFTRIAXONE 1 GR (RANAP) 0
14 OBI0176 CEFXON 1 GR (RANAP) 1
15 OBI1343 CETADOP 200 MG 5 ML (RANAP) 1
16 OBI0226 CORTIDEX INJEKSI (RANAP) 10
17 OBI0227 CORTIDEX TABLET (RANAP) 30
18 OBJ0227 CORTIDEX TABLET (RJ) 30
19 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) 2
20 OBI0252 D5% 500 ML OTSU (RANAP) 1
21 OBI1323 DEXAMETHASONE AMPUL (RANAP) 10
22 OBI0263 DEXTROSE 40% / OTSU-D40 25 ML (RANAP) 1
23 OBI1583 DUROGESIC 12,5 (RANAP) 1
24 OBI1379 EPHEDRIN HCL 1 ML (RANAP) 5
25 OBIBP0001 EPINEPHRINE 0,1% 1 ML- B (RANAP) 6
26 OBI0314 ERYSANBE 500 MG (RANAP) 15
27 OBJ0314 ERYSANBE 500 MG (RJ) 45
28 OBI1395 ETANYL 0,05 MG 2 ML (RANAP) 61
29 OBJ0342 FASTOR 20 MG (RJ) 10
30 OBJ1863 FERVIT DROPS (RJ) 1
31 OBJ0349 FIBESCO 300 MG (RJ) 44
32 OBI0374 FORTANEST 5 ML (RANAP) 4
33 OBI0381 FURAMIN 10 ML (RANAP) 9
34 OBI0386 FUTROLIT 500 ML (RANAP) 2
35 OBI0393 GASTRUL 200 MCG (RANAP) 29
36 OBI0397 GENOINT SALEP MATA 0,3% 3,5 GR (RANAP) 1
37 OBI0407 GLUCOPHAGE XR 500 MG (RANAP) 15
38 OBJ0407 GLUCOPHAGE XR 500 MG (RJ) 45
39 OBJ0408 GLUCOPHAGE XR 750 MG (RJ) 7
40 OBI1353 GRANISETRON 1 MG 1 ML (RANAP) 23
41 OBI0430 HALOTHANE / ML (RANAP) 20
42 OBJ1167 HUFAGRIP FORTE (RJ) 60
43 OBJ0456 IBUPROFEN 400 MG (RJ) 0
44 OBI0467 INDUXIN 1 ML (RANAP) 35
45 OBI0498 KALNEX INJEKSI 250 MG (RANAP) 6
46 OBI0499 KALTROFEN SUPPO 100 MG (RANAP) 33
47 OBI1227 KETOROLAC INJEKSI (RANAP) 31
48 OBI0519 KTM 100 MG / ML (RANAP) 44
49 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 21
50 OBI0555 LAPIXIME 1 GR (RANAP) 6
51 OBI0574 LIDOCAIN 2% (RANAP) 5
52 OBI0575 LIDODEX 2 ML (RANAP) 5
53 OBI0609 MEROPENEM 1 GR (RANAP) 1

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 8 / 53

No. No. Item Nama Item Jumlah
54 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 3
55 OBI1344 METHYLERGOMETRINE 0,2 MG 1 ML (RANAP) 12
56 OBI1325 MIDANEST INJEKSI (RANAP) 10
57 OBI1721 MIDAZOLAM INJEKSI (RANAP) 3
58 OBI1299 MISOPROSTOL 200 MCG (RANAP) 17
59 OBI0644 MORPHIN HCL 10 MG 1 ML (RANAP) 10
60 OBI1162 MYLANTA 50 ML (RANAP) 3
61 OBI1527 N-ACE 3 ML SOL. FOR INHALATION (RANAP) 2
62 OBI0691 NORAGES 2 ML (RANAP) 1
63 OBI0701 NS 100 ML OTSU (RANAP) 5
64 OBI0702 NS 1000 ML OTSU (RANAP) 4
65 OBI0703 NS 25 ML OTSU (RANAP) 2
66 OBI0704 NS 3% 500 ML OTSU (RANAP) 1
67 OBI0705 NS 500 ML OTSU (RANAP) 31
68 OBI1201 NS 500 ML SATORIA (RANAP) 33
69 OBI0710 NULAGYL 500 MG 100 ML (RANAP) -1
70 OBI0719 ODR 4 MG 2 ML (RANAP) 44
71 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 18
72 OBI0738 OSTELOX 15 MG SUPPO (RANAP) 86
73 OBI1319 OXYTOCIN INJEKSI (RANAP) 17
74 OBI0787 PRANZA 40 MG (RANAP) 1
75 OBI0794 PRIMPERAN INJEKSI (RANAP) 13
76 OBI1377 PROPOFOL 10 MG 20 ML (RANAP) 11
77 OBI0835 RANITIDINE 2 ML (RANAP) -1
78 OBI0837 RANTIN 50 MG 2 ML (RANAP) 6
79 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 18
80 OBI1202 RL 500 ML SATORIA (RANAP) 23
81 OBI1519 ROCULAX 5 ML (RANAP) 2
82 OBI1339 ROFIDEN SUPPO 100 MG (RANAP) 18
83 OBI0863 RYCEF 1 GR (RANAP) 10
84 OBI0869 SAGESTAM INJEKSI (RANAP) 2
85 OBI0912 SEVOFLURANE 1 ML (RANAP) 175
86 OBI1378 SEVOFLURANE 1 ML - B (RANAP) 375
87 OBI0936 SPORETIK 100 MG (RANAP) 10
88 OBI0938 STARXON 1 GR (RANAP) 4
89 OBI0954 TALK SALICYL / POT (RANAP) 0
90 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 40
91 OBI0979 TERASTARCH 500 ML (RANAP) 9
92 OBI0980 TERFACEF 1 GR (RANAP) -1
93 OBJ0999 TOFEDEX (RJ) 0
94 OBI1001 TOFEDEX 50 MG 2 ML (RANAP) 2
95 OBI1646 TORDEX INJEKSI (RANAP) 2
96 OBI1023 TRILAC 10 MG 5 ML (RANAP) 1
97 OBI1070 VASCON 4 ML (RANAP) 4
98 OBI1071 VASODRIN 1 ML (RANAP) 5
99 OBI1569 VOLULYTE 6% 500 ML (RANAP) 1
100 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 1
Bidan
1 OBJ0470 INLACTA DHA FOR MOTHER (RJ) 5
2 OBI0701 NS 100 ML OTSU (RANAP) 1
3 OBI0703 NS 25 ML OTSU (RANAP) 1
4 OBI1201 NS 500 ML SATORIA (RANAP) 1

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 9 / 53

No. No. Item Nama Item Jumlah
5 OBJ0737 OSSOVIT (RJ) 5
6 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 2
7 OBI1087 VITADION 2 MG/ML (RANAP) 2
Christanto Noer I., drg.
1 OBJ0044 AMOXSAN 500 MG (RJ) 20
2 OBJ0052 ANALSIK (RJ) 6
3 OBJ0054 ANALTRAM (RJ) 76
4 OBJ1432 BETADINE GARGLE 190 ML (RJ) 1
5 OBJ1436 BUFECT 60 ML (RJ) 2
6 OBJ0149 CAPSINAT 500 MG (RJ) 66
7 OBJ0165 CEFADROXIL 500 MG (RJ) 10
8 OBJ0170 CEFILA-100 MG (RJ) 10
9 OBJ1356 CIPREC 500 MG (RJ) 10
10 OBJ0355 FLAMAR 50 MG (RJ) 101
11 OBJ0496 KALIUM DIKLOFENAK 50 MG (RJ) 30
12 OBJ0544 LAPICEF - 250 60 ML (RJ) 5
13 OBJ0545 LAPICEF 500 MG (RJ) 30
14 OBJ0599 MEFINAL 500 MG (RJ) 32
15 OBJ1209 NUTRIFLAM (RJ) 46
16 OBJ0900 SANMOL 60 ML (RJ) 1
17 OBJ0936 SPORETIK 100 MG (RJ) 10
Diah Yuni Istiandari, dr.
1 OBJ0044 AMOXSAN 500 MG (RJ) 10
2 OBJ1529 AZITHROMYCIN 500 MG (RJ) 12
3 OBJ0095 BECOM ZET (RJ) 6
4 OBJ0096 BECOM-C (RJ) 30
5 OBJ1436 BUFECT 60 ML (RJ) 1
6 OBJ0165 CEFADROXIL 500 MG (RJ) 20
7 OBJ0166 CEFAT 500 MG (RJ) 10
8 OBJ0169 CEFILA 30 ML (RJ) 1
9 OBJ0202 CIPROFLOXACIN 500 MG (RJ) 10
10 OBJ0338 FARMADOL 500 MG (RJ) 10
11 OBJ0387 GABAPENTIN 300 MG (RJ) 6
12 OBJBP000 HARNAL OCAS - B (RJ) 5
13 5
OBJ0456 IBUPROFEN 400 MG (RJ) 45
14 OBJ1346 KETOPROFEN 100 MG TABLET (RJ) 12
15 OBJ1949 L-VIT D3 5000 IU (RJ) 6
16 OBJ0524 LACOLDIN (RJ) 30
17 OBJ0530 LACTOPAIN 30 MG 1 ML (RJ) 1
18 OBJ0536 LAMESON 4 MG (RJ) 10
19 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 12
20 OBJ0550 LAPIMOX 500 MG (RJ) 25
21 OBI1565 LAVIT-C 500 MG 5 ML (RANAP) 1
22 OBJ1872 METAMIZOLE SODIUM 2 ML (RJ) 1
23 OBJ0614 METHYLPREDNISOLONE 4 MG (RJ) 10
24 OBJ0676 NEUROSANBE (RJ) 10
25 OBJ0691 NORAGES 2 ML (RJ) 1
26 OBJ1222 NS 500 ML SATORIA (RJ) 1
27 OBI1722 PAMOL SUPPO (RANAP) 4
28 OBI0863 RYCEF 1 GR (RANAP) 2
29 OBI0954 TALK SALICYL / POT (RANAP) 1
30 OBJ0999 TOFEDEX (RJ) 10

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 10 / 53

No. No. Item Nama Item Jumlah
31 OBJ1900 TRIDE (RJ) 6
32 OBJ1038 TUZALOS 15 MG (RJ) 10
Dian Utami Wulaningrum, dr.,Sp.P
1 OBI0080 ASPILETS CHEWABLE (RANAP) 3
2 OBJ1529 AZITHROMYCIN 500 MG (RJ) 10
3 OBI1532 BEROTEC INHALER (RANAP) 1
4 OBJ0171 CEFIXIME 100 MG (RJ) 40
5 OBI0175 CEFTRIAXONE 1 GR (RANAP) 6
6 OBI0176 CEFXON 1 GR (RANAP) -2
7 OBI0188 CETIRIZINE 10 MG (RANAP) -1
8 OBJ0188 CETIRIZINE 10 MG (RJ) 20
9 OBI0190 CHANNA 500 MG (RANAP) 30
10 OBJ0216 CODEIN 20 MG (RJ) 15
11 OBI0235 CPG 75 MG (RANAP) 4
12 OBJ1882 CURCUMA FORCE (RJ) 120
13 OBI0287 DULCOLAX SUPPO 10 MG ADULT (RANAP) 1
14 OBJ0309 EPISAN 100 ML (RJ) 1
15 OBJ0323 ETHAMBUTOL 500 MG (RJ) 60
16 OBJ0338 FARMADOL 500 MG (RJ) 30
17 OBI0342 FASTOR 20 MG (RANAP) 3
18 OBJ0469 INHA 400 MG (RJ) 118
19 OBI0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RANAP) 12
20 OBJ1512 L-ACYS 600 MG EFFERVESCENT (RJ) 6
21 OBI0563 L-BIO CAPSUL (RANAP) 15
22 OBI0534 LAMESON 125 MG 2 ML (RANAP) 1
23 OBI0538 LANSOPRAZOLE 30 MG (RANAP) 10
24 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 40
25 OBI1334 LANSOPRAZOLE INJEKSI (RANAP) 1
26 OBJ0547 LAPIFED (RJ) 10
27 OBJ0557 LASAL 2 MG (RJ) 6
28 OBI1284 LEFOS 750 MG 150 ML (RANAP) 3
29 OBJ0571 LEVOFLOXACIN 500 MG (RJ) 5
30 OBJ1291 LORATADINE 10 MG (RJ) 10
31 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 3
32 OBJ0614 METHYLPREDNISOLONE 4 MG (RJ) 20
33 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 24
34 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 60
35 OBI0676 NEUROSANBE (RANAP) 10
36 OBI0677 NEUROSANBE 3 ML (RANAP) 1
37 OBIBP0003 NOVORAPID - B (RANAP) 1
38 OBI0703 NS 25 ML OTSU (RANAP) 5
39 OBI0705 NS 500 ML OTSU (RANAP) 11
40 OBI0713 OBH COMBI 100 ML (RANAP) 1
41 OBI0748 PANTOPRAZOLE 40 MG (RANAP) 4
42 OBJ0829 PYRAZINAMIDE 500 MG (RJ) 60
43 OBJ0853 RIFAMPICIN 450 MG (RJ) 58
44 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 1
45 OBJ0898 SANMOL 500 MG (RJ) 15
46 OBI1550 SANSULIN LOG-G DISPOPEN (RANAP) 1
47 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) 2
48 OBJ1531 SERETIDE DISKUS 50/250 MCG (RJ) 2
49 OBI0931 SOLVINEX 2 ML (RANAP) 6

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 11 / 53

No. No. Item Nama Item Jumlah
50 OBJ0947 SUCRALFATE 100 ML (RJ) 1
51 OBJ1950 SYMBICORT 160/4.5 TURBUHALER 120 DOSES (RJ) 4
52 OBJ1093 VITAMIN B-COMPLEX (RJ) 10
53 OBJ1091 VITAMIN B6 10 MG (RJ) 45
Didin Mirandani, drg., M. Kes
1 OBJ0159 CATAFLAM FAST 50 MG (RJ) 10
2 OBJ0550 LAPIMOX 500 MG (RJ) 20
3 OBJ0554 LAPISTAN 500 MG (RJ) 20
DOKTER LUAR
1 OBJ1537 ADALAT OROS 30 MG (RJ) 30
2 OBJ0020 ALGANAX 0,5 MG (RJ) 3
3 OBJ0024 ALLOPURINOL 100 MG (RJ) 30
4 OBJ1303 ALPRAZOLAM 0.5 MG (RJ) 5
5 OBJ0052 ANALSIK (RJ) 6
6 OBJ0054 ANALTRAM (RJ) 30
7 OBJ1523 DIOVAN 160 MG (RJ) 30
8 OBJ0289 DUODERM GEL 15 GR (RJ) 1
9 OBJ1944 FAVIPIRAVIR 200 MG (RJ) 40
10 OBJ0382 FUROSEMIDE 40 MG (RJ) 15
11 OBJ0450 HP PRO (RJ) 50
12 OBJ0536 LAMESON 4 MG (RJ) 10
13 OBI0621 METRONIDAZOLE 100 ML (RANAP) 3
14 OBJ0638 MINIASPI 80 MG (RJ) 30
15 OBJ1440 NITROKAF RETARD (RJ) 60
16 OBI0704 NS 3% 500 ML OTSU (RANAP) 1
17 OBJ0794 PRIMPERAN INJEKSI (RJ) 5
18 OBJ1935 PROVE D3 5000 IU (RJ) 10
19 OBJ0830 PYSOLAN 30 MG (RJ) 8
20 OBJ1072 V-BLOC 6,25 MG (RJ) 60
Eva Khristi P., dr., Sp.THT-KL
1 OBJ0003 ACLAM 60 ML (RJ) 1
2 OBJ0026 ALLORIS 10 MG (RJ) 10
3 OBJ0086 AVAMYS SPRAY (RJ) 1
4 OBJ1529 AZITHROMYCIN 500 MG (RJ) 16
5 OBJ0095 BECOM ZET (RJ) 10
6 OBJ0096 BECOM-C (RJ) 10
7 OBJ1432 BETADINE GARGLE 190 ML (RJ) 1
8 OBJ0170 CEFILA-100 MG (RJ) 10
9 OBI0262 DEXTAMINE 60 ML (RANAP) 1
10 OBJ0375 FORUMEN TETES TELINGA 10 ML (RJ) 2
11 OBJ0460 IMUNOS (RJ) 12
12 OBJ1978 KONIBAL (RJ) 10
13 OBJ0525 LACOLDIN 60 ML (RJ) 1
14 OBJ0536 LAMESON 4 MG (RJ) 15
15 OBJ0545 LAPICEF 500 MG (RJ) 10
16 OBJ0605 MELOXICAM 7,5 MG (RJ) 10
17 OBJ0645 MOVIX 15 MG (RJ) 15
18 OBJ0646 MOVIX 7,5 MG (RJ) 30
19 OBJ0723 OMEPRAZOLE 20 MG (RJ) 20
20 OBJ0744 OTOPAIN EAR DROPS 8 ML (RJ) 1
21 OBJ0777 PLASMINEX (RJ) 10
22 OBJ0905 SANTA-E 200 MG (RJ) 10

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 12 / 53

No. No. Item Nama Item Jumlah
23 OBJ0936 SPORETIK 100 MG (RJ) 25
24 OBJ0967 TEBOKAN 40 MG (RJ) 10
25 OBJ1014 TREMENZA (RJ) 5
26 OBJ1239 TRIAMCINOLONE 4 MG (RJ) 45
27 OBJ1038 TUZALOS 15 MG (RJ) 70
28 OBJ1112 X-CAM 15 MG (RJ) 10
29 OBJ1324 ZINC 60 ML (RJ) 1
Fahmi Wahyu Rakhmanda, dr.
1 OBI1507 ALKOHOL 70% 100 ML (RANAP) 6
2 OBJ1303 ALPRAZOLAM 0.5 MG (RJ) 10
3 OBI0052 ANALSIK (RANAP) 29
4 OBJ0052 ANALSIK (RJ) 10
5 OBJ0074 ARKINE 2 MG (RJ) 30
6 OBI0095 BECOM ZET (RANAP) 10
7 OBJ0095 BECOM ZET (RJ) 76
8 OBJ0895 BESANMAG (RJ) 20
9 OBI0102 BETAHISTINE 6 MG (RANAP) 3
10 OBJ0165 CEFADROXIL 500 MG (RJ) 10
11 OBI0175 CEFTRIAXONE 1 GR (RANAP) 1
12 OBI0176 CEFXON 1 GR (RANAP) 2
13 OBI0188 CETIRIZINE 10 MG (RANAP) 12
14 OBJ0202 CIPROFLOXACIN 500 MG (RJ) 10
15 OBJ0227 CORTIDEX TABLET (RJ) 50
16 OBJ1882 CURCUMA FORCE (RJ) 10
17 OBJ0262 DEXTAMINE 60 ML (RJ) 6
18 OBJ0282 DOMPERIDONE 10 MG (RJ) 20
19 OBJ0283 DOMPERIDONE 60 ML (RJ) 2
20 OBJ0317 ERYTHROMYCIN 60 ML (RJ) 3
21 OBI1346 EZOMEB 40 MG (RANAP) 2
22 OBI1329 FLUNARIZINE 5 MG (RANAP) 3
23 OBI0378 FREGO 5 MG (RANAP) 7
24 OBI0387 GABAPENTIN 300 MG (RANAP) 3
25 OBJ0409 GLUCOSAMINE 500 MG (RJ) 2
26 OBJ1357 INFELD GEL 15 G (RJ) 1
27 OBI1718 KONIBAL (RANAP) 38
28 OBJ0524 LACOLDIN (RJ) 10
29 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 1
30 OBJ0536 LAMESON 4 MG (RJ) 10
31 OBI0538 LANSOPRAZOLE 30 MG (RANAP) 10
32 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 40
33 OBJ0581 LODIA 2 MG (RJ) 2
34 OBI0608 MERISLON (RANAP) 7
35 OBI0658 MYONEP (RANAP) 10
36 OBJ0658 MYONEP (RJ) 10
37 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 10
38 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 30
39 OBJ0685 NEW DIATABS (RJ) 1
40 OBI0691 NORAGES 2 ML (RANAP) 3
41 OBI0701 NS 100 ML OTSU (RANAP) 1
42 OBJ0713 OBH COMBI 100 ML (RJ) 1
43 OBI0719 ODR 4 MG 2 ML (RANAP) 9
44 OBI0722 OMEPRAZOLE INJEKSI (RANAP) 1

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 13 / 53

No. No. Item Nama Item Jumlah
45 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 3
46 OBJ0726 ONDANSETRON 4 MG (RJ) 30
47 OBI1722 PAMOL SUPPO (RANAP) 15
48 OBI0748 PANTOPRAZOLE 40 MG (RANAP) 2
49 OBI0751 PARACETAMOL 60 ML (RANAP) 1
50 OBJ0801 PROFENID SUPPO 100 MG (RJ) 2
51 OBJ0811 PROPRANOLOL 10 MG (RJ) 10
52 OBJ1935 PROVE D3 5000 IU (RJ) 70
53 OBI0822 PROVELYN 75 MG (RANAP) 4
54 OBI0835 RANITIDINE 2 ML (RANAP) 9
55 OBI0843 RECOLFAR (RANAP) 6
56 OBJ0898 SANMOL 500 MG (RJ) 20
57 OBJ0900 SANMOL 60 ML (RJ) 1
58 OBJ1224 SILEX 100 ML (RJ) 1
59 OBI0931 SOLVINEX 2 ML (RANAP) 2
60 OBI0932 SPASMINAL (RANAP) 10
61 OBJ0949 SUMAGESIC (RJ) 12
62 OBI0981 TETAGAM P 250 IU (RANAP) 1
63 OBI1617 TRIDE (RANAP) 20
64 OBJ1900 TRIDE (RJ) 58
65 OBI1039 TUZALOS 15 MG (RANAP) 12
66 OBJ1038 TUZALOS 15 MG (RJ) 44
67 OBJ1097 VITAMIN C 50 MG (RJ) 10
68 OBJ1324 ZINC 60 ML (RJ) 2
Finariawan Asrining Santosa., dr., Sp.A
1 OBI0077 ASAM MEFENAMAT 500 MG (RANAP) 5
2 OBI0242 CTM 4 MG (RANAP) 8
3 OBI0260 DEXAMETHASONE 0,50 MG (RANAP) 8
4 OBJ0296 ELKANA 60 ML (RJ) 1
5 OBI0491 KAEN 3B 500 ML OTSU (RANAP) 3
6 OBI0834 RANITIDINE 150 MG (RANAP) 6
7 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 5
8 OBI0897 SANMOL 1000 MG 100 ML (RANAP) 1
9 OBJ1979 THEOBRON 100 ML (RJ) 1
Handy Surya, dr.
1 OBJ0273 DIOVAN 80 MG (RJ) 15
2 OBJ0382 FUROSEMIDE 40 MG (RJ) 30
3 OBJ0403 GLIMEPIRIDE 3 MG (RJ) 30
4 OBJ0580 LIVRON B-PLEX (RJ) 15
5 OBJ0613 METFORMIN 500 MG (RJ) 60
6 OBJ0723 OMEPRAZOLE 20 MG (RJ) 20
7 OBJ0947 SUCRALFATE 100 ML (RJ) 1
Hanik Ruliani, dr., Sp.PD
1 OBJ1220 ACARBOSE 100 MG (RJ) 90
2 OBJ1219 ACARBOSE 50 MG (RJ) 150
3 OBI0020 ALGANAX 0,5 MG (RANAP) 1
4 OBI0024 ALLOPURINOL 100 MG (RANAP) 4
5 OBJ0024 ALLOPURINOL 100 MG (RJ) 8
6 OBJ0025 ALLOPURINOL 300 MG (RJ) 30
7 OBJ1303 ALPRAZOLAM 0.5 MG (RJ) 17
8 OBJ1509 AMINORAL (RJ) 40
9 OBJ0037 AMITRIPTYLINE 25 MG (RJ) 53

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 14 / 53

No. No. Item Nama Item Jumlah
10 OBJ0038 AMLODIPINE 10 MG (RJ) 210
11 OBJ0039 AMLODIPINE 5 MG (RJ) 350
12 OBI0052 ANALSIK (RANAP) 15
13 OBJ0052 ANALSIK (RJ) 145
14 OBJ0054 ANALTRAM (RJ) 25
15 OBI0069 ARCAPEC (RANAP) 25
16 OBJ0075 ARSINAL (RJ) 15
17 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 28
18 OBJ0080 ASPILETS CHEWABLE (RJ) 60
19 OBJ1535 ATEVIR TABLET 0,5 MG (RJ) 30
20 OBJ0081 ATORVASTATIN 20 MG (RJ) 90
21 OBIBP0004 ATROPINE SULFAS 0.25 MG 1 ML-B (RANAP) 1
22 OBJ1529 AZITHROMYCIN 500 MG (RJ) 5
23 OBJ0089 BAMGETOL 200 MG (RJ) 60
24 OBJ0095 BECOM ZET (RJ) 17
25 OBJ0096 BECOM-C (RJ) 15
26 OBJ0895 BESANMAG (RJ) 15
27 OBI0102 BETAHISTINE 6 MG (RANAP) 7
28 OBJ0102 BETAHISTINE 6 MG (RJ) 20
29 OBJ0117 BISOPROLOL 5 MG (RJ) 90
30 OBI0134 BRAXIDIN (RANAP) 80
31 OBJ0134 BRAXIDIN (RJ) 263
32 OBJ1364 CANDESARTAN 16 MG (RJ) 170
33 OBJ0148 CANDESARTAN 8 MG (RJ) 120
34 OBJ0152 CAPTOPRIL 12,5 MG (RJ) 30
35 OBI1526 CEFACEF 200 MG (RANAP) 10
36 OBI0170 CEFILA-100 MG (RANAP) 10
37 OBI0171 CEFIXIME 100 MG (RANAP) 160
38 OBI0174 CEFSPAN 100 MG (RANAP) 13
39 OBI0175 CEFTRIAXONE 1 GR (RANAP) 22
40 OBI0180 CENDO XITROL EYE DROPS 5 ML (TM) (RANAP) 1
41 OBJ0180 CENDO XITROL EYE DROPS 5 ML (TM) (RJ) 1
42 OBI0186 CERNEVIT 750 MG (RANAP) 6
43 OBI1343 CETADOP 200 MG 5 ML (RANAP) 1
44 OBJ0188 CETIRIZINE 10 MG (RJ) 60
45 OBI0207 CLARIHIS 10 MG (RANAP) 18
46 OBJ0207 CLARIHIS 10 MG (RJ) 10
47 OBJ0214 CLOPIDOGREL 75 MG (RJ) 60
48 OBJ0215 CODEIN 10 MG (RJ) 15
49 OBI0216 CODEIN 20 MG (RANAP) 15
50 OBJ0217 CODIPRONT (RJ) 15
51 OBJ0225 CONSTIPEN 120 ML (RJ) 2
52 OBI0239 CRAVOX 500 MG 100 ML (RANAP) 1
53 OBI0248 D10% 500 ML OTSU (RANAP) 3
54 OBI0263 DEXTROSE 40% / OTSU-D40 25 ML (RANAP) 24
55 OBJ0267 DIAFORMIN XR 500 MG (RJ) 45
56 OBJ0269 DIGOXIN 0,25 MG (RJ) 45
57 OBJ0272 DIMENHYDRINATE 50 MG (RJ) 15
58 OBJ1523 DIOVAN 160 MG (RJ) 30
59 OBJ0273 DIOVAN 80 MG (RJ) 30
60 OBI0282 DOMPERIDONE 10 MG (RANAP) 20
61 OBJ0282 DOMPERIDONE 10 MG (RJ) 125

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 15 / 53

No. No. Item Nama Item Jumlah
62 OBJ1919 ENTECAVIR 0.5 MG (RJ) 30
63 OBI0321 ESOLA 40 MG (RANAP) 15
64 OBI0322 ESOMAX 40 MG (RANAP) 6
65 OBI0329 EXOCID 40 MG (RANAP) 5
66 OBJ0332 FAMOCID 20 MG (RJ) 15
67 OBJ1311 FENOFIBRATE 300 MG (RJ) 30
68 OBI0345 FEROSPAT EFF (RANAP) 3
69 OBJ1991 FIBRINASE (RJ) 15
70 OBI1329 FLUNARIZINE 5 MG (RANAP) 3
71 OBJ1290 FLUNARIZINE 5 MG (RJ) 40
72 OBJ0382 FUROSEMIDE 40 MG (RJ) 217
73 OBI0386 FUTROLIT 500 ML (RANAP) 3
74 OBJ0387 GABAPENTIN 300 MG (RJ) 340
75 OBJ0388 GALVUS 50 MG (RJ) 210
76 OBI0389 GALVUSMET 50 MG/500 MG (RANAP) 35
77 OBJ0389 GALVUSMET 50 MG/500 MG (RJ) 25
78 OBJ0400 GLIBENCLAMIDE 5 MG (RJ) 30
79 OBJ0401 GLIMEPIRIDE 1 MG (RJ) 75
80 OBJ0402 GLIMEPIRIDE 2 MG (RJ) 270
81 OBJ0403 GLIMEPIRIDE 3 MG (RJ) 90
82 OBJ0404 GLIMEPIRIDE 4 MG (RJ) 135
83 OBJ0412 GLUCOVANCE 2,5 MG / 500 MG (RJ) 60
84 OBI1599 GLUTROP (RANAP) 5
85 OBIBP0010 HARNAL OCAS - B (RANAP) 10
86 OBI0439 HEPA - Q (RANAP) 2
87 OBJ0439 HEPA - Q (RJ) 67
88 OBI0440 HEPA-BALANCE (RANAP) 2
89 OBI0443 HEPTASAN 4 MG (RANAP) 3
90 OBJ0443 HEPTASAN 4 MG (RJ) 10
91 OBI1370 HUFAGRIP FORTE (RANAP) 10
92 OBJ1167 HUFAGRIP FORTE (RJ) 30
93 OBI0462 IMUNOS PLUS (RANAP) 7
94 OBJ0462 IMUNOS PLUS (RJ) 20
95 OBJ1357 INFELD GEL 15 G (RJ) 1
96 OBI0484 INVOMIT 4 MG (RANAP) 20
97 OBJ0484 INVOMIT 4 MG (RJ) 10
98 OBJ0485 IRBESARTAN 150 MG (RJ) 30
99 OBI0499 KALTROFEN SUPPO 100 MG (RANAP) 1
100 OBI0504 KCL 7,46 25 ML OTSU (RANAP) 1
101 OBJ0509 KETO - G (RJ) 105
102 OBI1227 KETOROLAC INJEKSI (RANAP) 1
103 OBI1433 KSR 600 MG - B (RANAP) 3
104 OBJ1530 L-ACYS 200 MG CAPSUL (RJ) 15
105 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 4
106 OBJ1333 LACTULOSE 60 ML (RJ) 2
107 OBI0538 LANSOPRAZOLE 30 MG (RANAP) 7
108 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 75
109 OBJBP000 LANTUS SOLOSTAR- B (RJ) 1
110 4
OBJ0542 LAPIBAL 500 MG (RJ) 20
111 OBI0558 LASAL EKSPEKTORAN 100 ML (RANAP) 1
112 OBI0559 LASGAN 30 MG (RANAP) 45
113 OBIBP0002 LEVEMIR- B (RANAP) 4

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 16 / 53

No. No. Item Nama Item Jumlah
114 OBJBP000 LEVEMIR- B (RJ) 6
115 1
OBI1337 LEVIN 500 MG 100 ML (RANAP) 3
116 OBJ1316 LISINOPRIL 10 MG (RJ) 30
117 OBJ0577 LISINOPRIL 5 MG (RJ) 30
118 OBI0580 LIVRON B-PLEX (RANAP) 55
119 OBJ0580 LIVRON B-PLEX (RJ) 74
120 OBJ0583 LOPERAMIDE 2 MG (RJ) 6
121 OBI0601 MEFOZ 4 MG 2 ML (RANAP) 4
122 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 24
123 OBJ0613 METFORMIN 500 MG (RJ) 1175
124 OBI0617 METRIX 1 MG (RANAP) 2
125 OBJ0617 METRIX 1 MG (RJ) 60
126 OBJ0618 METRIX 2 MG (RJ) 30
127 OBJ0638 MINIASPI 80 MG (RJ) 120
128 OBI1636 MIXALGIN (RANAP) 15
129 OBJ1907 MIXALGIN (RJ) 105
130 OBI0658 MYONEP (RANAP) 15
131 OBJ0658 MYONEP (RJ) 25
132 OBJ0659 NABIC / BIC NATRIC (RJ) 180
133 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 10
134 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 20
135 OBI0663 NATABION (RANAP) 15
136 OBJ0663 NATABION (RJ) 78
137 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 30
138 OBJ0674 NEURAXON 5000 (RJ) 10
139 OBJ1289 NEURODEX (RJ) 15
140 OBI0677 NEUROSANBE 3 ML (RANAP) 1
141 OBI0691 NORAGES 2 ML (RANAP) 3
142 OBIBP0009 NOVOMIX 30 - B (RANAP) 1
143 OBIBP0003 NOVORAPID - B (RANAP) 2
144 OBJBP000 NOVORAPID - B (RJ) 12
145 3
OBI0701 NS 100 ML OTSU (RANAP) 2
146 OBI0703 NS 25 ML OTSU (RANAP) 27
147 OBI0704 NS 3% 500 ML OTSU (RANAP) 1
148 OBI0705 NS 500 ML OTSU (RANAP) 30
149 OBI1201 NS 500 ML SATORIA (RANAP) 19
150 OBI0707 NUCRAL 100 ML (RANAP) 12
151 OBJ0707 NUCRAL 100 ML (RJ) 10
152 OBI1199 NUTRIFLAM (RANAP) 5
153 OBJ1209 NUTRIFLAM (RJ) 30
154 OBI0719 ODR 4 MG 2 ML (RANAP) 22
155 OBI0723 OMEPRAZOLE 20 MG (RANAP) 83
156 OBJ0723 OMEPRAZOLE 20 MG (RJ) 435
157 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 20
158 OBJ0725 ONDANCENTRON 4 MG 2 ML (RJ) 1
159 OBI0726 ONDANSETRON 4 MG (RANAP) 36
160 OBJ0726 ONDANSETRON 4 MG (RJ) 103
161 OBI0748 PANTOPRAZOLE 40 MG (RANAP) 33
162 OBI1469 PANTOPUMP TABLET 40 MG (RANAP) 30
163 OBJ1412 PANTOPUMP TABLET 40 MG (RJ) 125
164 OBJ0811 PROPRANOLOL 10 MG (RJ) 195
165 OBJ1935 PROVE D3 5000 IU (RJ) 30

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 17 / 53

No. No. Item Nama Item Jumlah
166 OBI0830 PYSOLAN 30 MG (RANAP) 7
167 OBJ0830 PYSOLAN 30 MG (RJ) 90
168 OBJ0834 RANITIDINE 150 MG (RJ) 20
169 OBI0835 RANITIDINE 2 ML (RANAP) 2
170 OBI0844 RENAX (RANAP) 2
171 OBI1677 RENOSAN 500 ML (RANAP) 1
172 OBI1687 REPIMIDE 100 MG (RANAP) 20
173 OBJ1934 REPIMIDE 100 MG (RJ) 70
174 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 15
175 OBI1202 RL 500 ML SATORIA (RANAP) 15
176 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) 28
177 OBJ0911 SEROLIN 10 MG (RJ) 40
178 OBJ0919 SIMVASTATIN 20 MG (RJ) 240
179 OBJ0932 SPASMINAL (RJ) 15
180 OBJ0935 SPIRONOLACTONE 100 MG (RJ) 15
181 OBJ1329 SPIRONOLACTONE 25 MG (RJ) 90
182 OBI0937 SPORETIK 200 MG (RANAP) 10
183 OBJ0937 SPORETIK 200 MG (RJ) 20
184 OBI0947 SUCRALFATE 100 ML (RANAP) 13
185 OBJ0947 SUCRALFATE 100 ML (RJ) 23
186 OBI0949 SUMAGESIC (RANAP) 15
187 OBJ0949 SUMAGESIC (RJ) 60
188 OBI0956 TAMOLIV 1000 MG 100 ML (RANAP) 3
189 OBJ1917 TAZOVELL 30 MG (RJ) 555
190 OBJ1990 TELMISARTAN 80 MG (RJ) 30
191 OBI1002 TOPAZOL 40 MG (RANAP) 9
192 OBJ1006 TRACETATE (RJ) 8
193 OBJ1900 TRIDE (RJ) 11
194 OBJ1025 TROZIN 500 MG (RJ) 10
195 OBI1039 TUZALOS 15 MG (RANAP) 6
196 OBJ1038 TUZALOS 15 MG (RJ) 55
197 OBI1045 UNALIUM 5 MG (RANAP) 3
198 OBJ1044 UNALIUM 5 MG (RJ) 20
199 OBJ1048 URISPAS 200 MG (RJ) 20
200 OBI1052 URSODEOXYCHOLIC ACID 250 MG (RANAP) 32
201 OBJ1051 URSODEOXYCHOLIC ACID 250 MG (RJ) 350
202 OBJ1149 URSOLIC 250 MG (RJ) 30
203 OBI1066 VALISANBE 5 MG 2 ML (RANAP) 1
204 OBJ1976 VELTHROM 10 MG (RJ) 120
205 OBJ1093 VITAMIN B-COMPLEX (RJ) 30
206 OBJ1102 VOMITAS (RJ) 10
207 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 1
208 OBJ1116 XEPAZYM (RJ) 30
209 OBI1121 XYLOCAINE 2% JELLY 10 GR (RANAP) 1
Hendra Nur, drg., Sp.Pros
1 OBJ0054 ANALTRAM (RJ) 40
2 OBJ1432 BETADINE GARGLE 190 ML (RJ) 1
3 OBJ0465 INDANOX 300 MG (RJ) 10
4 OBJ0550 LAPIMOX 500 MG (RJ) 50
5 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 20
6 OBJ1209 NUTRIFLAM (RJ) 10
7 OBJ0754 PEHACAIN 2 ML (RJ) 2

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 18 / 53

No. No. Item Nama Item Jumlah
8 OBJ1093 VITAMIN B-COMPLEX (RJ) 10
Ifa Yuli Astuti, dr., Sp.Rad
1 OBI1051 UROGRAFIN 76% 20 ML (RANAP) 1
2 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 1
3 OBI1119 XOLMETRAS 350 MG 100 ML (RANAP) 2
Indah Baktian R.M., dr.
1 OBJ0052 ANALSIK (RJ) 20
2 OBJ0066 APTOR 100 MG (RJ) 30
3 OBJ0081 ATORVASTATIN 20 MG (RJ) 15
4 OBJ0096 BECOM-C (RJ) 6
5 OBI0102 BETAHISTINE 6 MG (RANAP) 15
6 OBI0175 CEFTRIAXONE 1 GR (RANAP) 2
7 OBI0197 CIFLOS 500 MG (RANAP) 4
8 OBJ0262 DEXTAMINE 60 ML (RJ) 1
9 OBI0272 DIMENHYDRINATE 50 MG (RANAP) 7
10 OBJ1305 EPERISONE HCL 50 MG (RJ) 10
11 OBJ0376 FORXIGA 10 MG (RJ) 30
12 OBI1535 GASTRUCID 60 ML (RANAP) 1
13 OBJBP000 HARNAL OCAS - B (RJ) 10
14 5
OBJ0438 HEMOROGARD (RJ) 10
15 OBJ0525 LACOLDIN 60 ML (RJ) 2
16 OBI0538 LANSOPRAZOLE 30 MG (RANAP) 2
17 OBJ0605 MELOXICAM 7,5 MG (RJ) 10
18 OBJ0614 METHYLPREDNISOLONE 4 MG (RJ) 10
19 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 3
20 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 10
21 OBJ0676 NEUROSANBE (RJ) 26
22 OBI0685 NEW DIATABS (RANAP) 6
23 OBI0691 NORAGES 2 ML (RANAP) 6
24 OBJ0691 NORAGES 2 ML (RJ) 2
25 OBI0719 ODR 4 MG 2 ML (RANAP) 2
26 OBJ0726 ONDANSETRON 4 MG (RJ) 10
27 OBI1722 PAMOL SUPPO (RANAP) 9
28 OBI0794 PRIMPERAN INJEKSI (RANAP) 6
29 OBI0830 PYSOLAN 30 MG (RANAP) 1
30 OBJ0949 SUMAGESIC (RJ) 10
31 OBJ1014 TREMENZA (RJ) 10
Indra Pinarta, dr., Sp.P
1 OBJ0165 CEFADROXIL 500 MG (RJ) 10
2 OBJ0170 CEFILA-100 MG (RJ) 25
3 OBJ0171 CEFIXIME 100 MG (RJ) 30
4 OBJ0177 CELEBREX 100 MG (RJ) 15
5 OBJ0188 CETIRIZINE 10 MG (RJ) 10
6 OBJ0197 CIFLOS 500 MG (RJ) 10
7 OBJ0286 DULCOLAX 5 MG (RJ) 8
8 OBJ1290 FLUNARIZINE 5 MG (RJ) 10
9 OBJ1954 FLUZEP (RJ) 10
10 OBJ0460 IMUNOS (RJ) 20
11 OBJ1530 L-ACYS 200 MG CAPSUL (RJ) 5
12 OBJ1512 L-ACYS 600 MG EFFERVESCENT (RJ) 3
13 OBJ0553 LAPISIV-T (RJ) 20
14 OBJ0554 LAPISTAN 500 MG (RJ) 15

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 19 / 53

No. No. Item Nama Item Jumlah
15 OBJ0559 LASGAN 30 MG (RJ) 5
16 OBJ0658 MYONEP (RJ) 18
17 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 10
18 OBJ0677 NEUROSANBE 3 ML (RJ) 1
19 OBJ0679 NEUROSANBE PLUS (RJ) 5
20 OBJ0775 PLANTACID FORTE 100 ML (RJ) 1
21 OBJ0777 PLASMINEX (RJ) 15
Iskandar Tjitrosasono., dr., Sp.A
1 OBI0171 CEFIXIME 100 MG (RANAP) 10
2 OBI0173 CEFOTAXIME 1 GR (RANAP) 1
3 OBI0188 CETIRIZINE 10 MG (RANAP) 5
4 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) 1
5 OBI1367 D5 - 1/4 NS 500 ML WIDA (RANAP) 3
6 OBI0282 DOMPERIDONE 10 MG (RANAP) 3
7 OBJ1353 LASAL NEBU (RJ) 2
8 OBI0701 NS 100 ML OTSU (RANAP) 1
9 OBI0703 NS 25 ML OTSU (RANAP) 2
10 OBI0719 ODR 4 MG 2 ML (RANAP) 1
11 OBI0751 PARACETAMOL 60 ML (RANAP) 1
12 OBI0835 RANITIDINE 2 ML (RANAP) 2
13 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 6
14 OBI1202 RL 500 ML SATORIA (RANAP) 4
15 OBI0898 SANMOL 500 MG (RANAP) 10
Itawati Santoso, dr. Sp.PD
1 OBJ1220 ACARBOSE 100 MG (RJ) 90
2 OBJ1219 ACARBOSE 50 MG (RJ) 300
3 OBI0005 ACPULSIF 5 MG (RANAP) 16
4 OBI0007 ACRAN 3 ML (RANAP) 1
5 OBI0020 ALGANAX 0,5 MG (RANAP) 8
6 OBJ0020 ALGANAX 0,5 MG (RJ) 20
7 OBJ1150 ALGANAX 1 MG (RJ) 80
8 OBI0021 ALIF 500 MG (RANAP) 44
9 OBJ0021 ALIF 500 MG (RJ) 149
10 OBI0024 ALLOPURINOL 100 MG (RANAP) 8
11 OBJ0024 ALLOPURINOL 100 MG (RJ) 75
12 OBI0025 ALLOPURINOL 300 MG (RANAP) 10
13 OBJ0025 ALLOPURINOL 300 MG (RJ) 167
14 OBI1358 ALPRAZOLAM 0.5 MG (RANAP) 45
15 OBJ1303 ALPRAZOLAM 0.5 MG (RJ) 48
16 OBI0037 AMITRIPTYLINE 25 MG (RANAP) 21
17 OBJ0037 AMITRIPTYLINE 25 MG (RJ) 60
18 OBI0038 AMLODIPINE 10 MG (RANAP) 3
19 OBJ0038 AMLODIPINE 10 MG (RJ) 527
20 OBJ0039 AMLODIPINE 5 MG (RJ) 173
21 OBI0042 AMOXICILLIN 500 MG (RANAP) 15
22 OBJ0042 AMOXICILLIN 500 MG (RJ) 15
23 OBI0052 ANALSIK (RANAP) 123
24 OBJ0052 ANALSIK (RJ) 99
25 OBI0054 ANALTRAM (RANAP) 10
26 OBI0056 ANGINTRIZ MR (RANAP) -4
27 OBJ1456 ANTIHEMOROID SUPPO (RJ) 3
28 OBJ0077 ASAM MEFENAMAT 500 MG (RJ) 21

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 20 / 53

No. No. Item Nama Item Jumlah
29 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 12
30 OBI0079 ASERING 500 ML OTSU (RANAP) 24
31 OBJ0080 ASPILETS CHEWABLE (RJ) 60
32 OBI1352 ATORVASTATIN 20 MG (RANAP) 22
33 OBJ0081 ATORVASTATIN 20 MG (RJ) 97
34 OBI1585 AZITHROMYCIN 500 MG (RANAP) 7
35 OBJ0089 BAMGETOL 200 MG (RJ) 65
36 OBI0102 BETAHISTINE 6 MG (RANAP) 175
37 OBJ0102 BETAHISTINE 6 MG (RJ) 283
38 OBI0117 BISOPROLOL 5 MG (RANAP) 9
39 OBJ0117 BISOPROLOL 5 MG (RJ) 30
40 OBI0130 BRAINACT 500 MG 4 ML (RANAP) 8
41 OBI0134 BRAXIDIN (RANAP) 10
42 OBI0142 BUSCOPAN PLUS (RANAP) 26
43 OBJ0142 BUSCOPAN PLUS (RJ) 91
44 OBI0141 BUSCOPAN TABLET (RANAP) 14
45 OBJ0141 BUSCOPAN TABLET (RJ) 6
46 OBI0145 CALCIUM LACTATE / CALC 500 MG (RANAP) 20
47 OBJ1364 CANDESARTAN 16 MG (RJ) 30
48 OBI0148 CANDESARTAN 8 MG (RANAP) 7
49 OBJ0148 CANDESARTAN 8 MG (RJ) 187
50 OBJ0149 CAPSINAT 500 MG (RJ) 8
51 OBI0152 CAPTOPRIL 12,5 MG (RANAP) 2
52 OBI0153 CAPTOPRIL 25 MG (RANAP) 10
53 OBJ0153 CAPTOPRIL 25 MG (RJ) 150
54 OBI0157 CAR-Q 100 (RANAP) 1
55 OBI1526 CEFACEF 200 MG (RANAP) 2
56 OBI0165 CEFADROXIL 500 MG (RANAP) 20
57 OBJ0170 CEFILA-100 MG (RJ) 15
58 OBI0171 CEFIXIME 100 MG (RANAP) 61
59 OBJ0171 CEFIXIME 100 MG (RJ) 30
60 OBI0173 CEFOTAXIME 1 GR (RANAP) 1
61 OBI0175 CEFTRIAXONE 1 GR (RANAP) 15
62 OBI0176 CEFXON 1 GR (RANAP) 3
63 OBJ0188 CETIRIZINE 10 MG (RJ) 57
64 OBI0197 CIFLOS 500 MG (RANAP) 17
65 OBJ0197 CIFLOS 500 MG (RJ) 10
66 OBI0202 CIPROFLOXACIN 500 MG (RANAP) 23
67 OBJ0202 CIPROFLOXACIN 500 MG (RJ) 40
68 OBI1156 CITICOLINE 500 MG 4 ML (RANAP) 2
69 OBJ1235 CLINDAMYCIN 300 MG (RJ) 10
70 OBI0214 CLOPIDOGREL 75 MG (RANAP) 10
71 OBJ0214 CLOPIDOGREL 75 MG (RJ) 7
72 OBJ0218 CODITAM (RJ) 14
73 OBJ1533 COLCHICINE 0,5 MG (RJ) 7
74 OBJ0224 CONCOR HS 5 MG (RJ) 15
75 OBI0225 CONSTIPEN 120 ML (RANAP) 2
76 OBJ0225 CONSTIPEN 120 ML (RJ) 3
77 OBJ0229 COTRIMOXAZOLE 480 MG (RJ) 10
78 OBI0235 CPG 75 MG (RANAP) 5
79 OBI0238 CRAVOX 500 MG (RANAP) 5
80 OBI0242 CTM 4 MG (RANAP) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 21 / 53

No. No. Item Nama Item Jumlah
81 OBJ0242 CTM 4 MG (RJ) 51
82 OBI0248 D10% 500 ML OTSU (RANAP) 2
83 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) 2
84 OBI0263 DEXTROSE 40% / OTSU-D40 25 ML (RANAP) 13
85 OBI0267 DIAFORMIN XR 500 MG (RANAP) 110
86 OBJ0267 DIAFORMIN XR 500 MG (RJ) 295
87 OBI0272 DIMENHYDRINATE 50 MG (RANAP) 245
88 OBJ0272 DIMENHYDRINATE 50 MG (RJ) 445
89 OBI0273 DIOVAN 80 MG (RANAP) 5
90 OBI0275 DISFLATYL (RANAP) 6
91 OBJ0284 DOPAMET 250 MG (RJ) 30
92 OBI0287 DULCOLAX SUPPO 10 MG ADULT (RANAP) 4
93 OBI1360 EPERISONE HCL 50 MG (RANAP) 8
94 OBJ1305 EPERISONE HCL 50 MG (RJ) 30
95 OBI0319 ESILGAN 1 MG (RANAP) 10
96 OBJ0319 ESILGAN 1 MG (RJ) 52
97 OBI0329 EXOCID 40 MG (RANAP) 13
98 OBI1346 EZOMEB 40 MG (RANAP) 3
99 OBI0337 FARMACROL FORTE (RANAP) 21
100 OBJ0337 FARMACROL FORTE (RJ) 104
101 OBI0338 FARMADOL 500 MG (RANAP) 45
102 OBJ0338 FARMADOL 500 MG (RJ) 167
103 OBI0342 FASTOR 20 MG (RANAP) 4
104 OBJ0342 FASTOR 20 MG (RJ) 60
105 OBJ1944 FAVIPIRAVIR 200 MG (RJ) 40
106 OBJ1311 FENOFIBRATE 300 MG (RJ) 190
107 OBJ0349 FIBESCO 300 MG (RJ) 31
108 OBJ0355 FLAMAR 50 MG (RJ) 24
109 OBI1329 FLUNARIZINE 5 MG (RANAP) 45
110 OBJ1290 FLUNARIZINE 5 MG (RJ) 74
111 OBI0376 FORXIGA 10 MG (RANAP) 24
112 OBJ0376 FORXIGA 10 MG (RJ) 175
113 OBJ0378 FREGO 5 MG (RJ) 39
114 OBI0381 FURAMIN 10 ML (RANAP) 1
115 OBI0382 FUROSEMIDE 40 MG (RANAP) 10
116 OBJ0382 FUROSEMIDE 40 MG (RJ) 85
117 OBI0386 FUTROLIT 500 ML (RANAP) 2
118 OBJ0387 GABAPENTIN 300 MG (RJ) 509
119 OBI0388 GALVUS 50 MG (RANAP) 33
120 OBJ0388 GALVUS 50 MG (RJ) 1001
121 OBI0389 GALVUSMET 50 MG/500 MG (RANAP) 10
122 OBJ0389 GALVUSMET 50 MG/500 MG (RJ) 390
123 OBI1535 GASTRUCID 60 ML (RANAP) 8
124 OBJ1472 GASTRUCID 60 ML (RJ) 2
125 OBJ0400 GLIBENCLAMIDE 5 MG (RJ) 95
126 OBI0401 GLIMEPIRIDE 1 MG (RANAP) 23
127 OBJ0401 GLIMEPIRIDE 1 MG (RJ) 197
128 OBI0402 GLIMEPIRIDE 2 MG (RANAP) 2
129 OBJ0402 GLIMEPIRIDE 2 MG (RJ) 319
130 OBJ0403 GLIMEPIRIDE 3 MG (RJ) 150
131 OBJ0404 GLIMEPIRIDE 4 MG (RJ) 240
132 OBI1468 GLIQUIDONE 30 MG (RANAP) 5

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 22 / 53

No. No. Item Nama Item Jumlah
133 OBJ1411 GLIQUIDONE 30 MG (RJ) 165
134 OBI1389 GLUCODEX 80 MG (RANAP) 16
135 OBJ1327 GLUCODEX 80 MG (RJ) 127
136 OBJ0407 GLUCOPHAGE XR 500 MG (RJ) 30
137 OBJ1334 GLUCOSAMINE 250 MG (RJ) 50
138 OBJ0409 GLUCOSAMINE 500 MG (RJ) 30
139 OBJ0418 GLYCERYL GUAIACOLATE 100 MG (RJ) 21
140 OBI1353 GRANISETRON 1 MG 1 ML (RANAP) 3
141 OBIBP0010 HARNAL OCAS - B (RANAP) 5
142 OBJBP000 HARNAL OCAS - B (RJ) 35
143 5
OBJ0435 HCT 25 MG (RJ) 128
144 OBJ0443 HEPTASAN 4 MG (RJ) 7
145 OBI0450 HP PRO (RANAP) 20
146 OBJ0450 HP PRO (RJ) 90
147 OBJ1996 HYLOQUIN 200 MG (RJ) 30
148 OBI0456 IBUPROFEN 400 MG (RANAP) 15
149 OBI0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RANAP) 10
150 OBI0503 KANDISTATIN 12 ML (RANAP) 1
151 OBJ0507 KEREN 25 MG (RJ) 66
152 OBI1227 KETOROLAC INJEKSI (RANAP) 5
153 OBJ1978 KONIBAL (RJ) 60
154 OBJBP000 KSR 600 MG - B (RJ) 201
155 6
OBJ1530 L-ACYS 200 MG CAPSUL (RJ) 66
156 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 6
157 OBJ1333 LACTULOSE 60 ML (RJ) 1
158 OBI0535 LAMESON 16 MG (RANAP) 1
159 OBI0536 LAMESON 4 MG (RANAP) 1
160 OBJ0536 LAMESON 4 MG (RJ) 60
161 OBI0538 LANSOPRAZOLE 30 MG (RANAP) 75
162 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 165
163 OBI1334 LANSOPRAZOLE INJEKSI (RANAP) 0
164 OBJBP000 LANTUS SOLOSTAR- B (RJ) 1
165 4
OBI0541 LAPIBAL 500 MCG INJEKSI (RANAP) 7
166 OBI1560 LAPIVA 5 MG / 80 MG (RANAP) 5
167 OBI0560 LASIX 2 ML (RANAP) 11
168 OBI0561 LASIX 40 MG (RANAP) 18
169 OBJ0561 LASIX 40 MG (RJ) 4
170 OBIBP0002 LEVEMIR- B (RANAP) 4
171 OBJBP000 LEVEMIR- B (RJ) 7
172 1
OBJ1316 LISINOPRIL 10 MG (RJ) 240
173 OBJ0577 LISINOPRIL 5 MG (RJ) 95
174 OBJ0578 LIVALO (RJ) 35
175 OBI0580 LIVRON B-PLEX (RANAP) 12
176 OBI0583 LOPERAMIDE 2 MG (RANAP) 4
177 OBJ0591 MALTOFER FOL (RJ) 74
178 OBI0594 MAXPRO 100 MG (RANAP) 10
179 OBI0601 MEFOZ 4 MG 2 ML (RANAP) 10
180 OBJ0602 MEGABAL (RJ) 118
181 OBJ0604 MELOXICAM 15 MG (RJ) 20
182 OBJ0605 MELOXICAM 7,5 MG (RJ) 10
183 OBI0608 MERISLON (RANAP) 65
184 OBJ0608 MERISLON (RJ) 144

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 23 / 53

No. No. Item Nama Item Jumlah
185 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 53
186 OBI0613 METFORMIN 500 MG (RANAP) 94
187 OBJ0613 METFORMIN 500 MG (RJ) 4480
188 OBI0614 METHYLPREDNISOLONE 4 MG (RANAP) 60
189 OBI0615 METOCLOPRAMIDE 10 MG (RANAP) 47
190 OBJ0617 METRIX 1 MG (RJ) 143
191 OBJ0618 METRIX 2 MG (RJ) 45
192 OBJ0619 METRIX 3 MG (RJ) 30
193 OBJ0620 METRIX 4 MG (RJ) 35
194 OBJ0638 MINIASPI 80 MG (RJ) 30
195 OBI0658 MYONEP (RANAP) 16
196 OBJ0658 MYONEP (RJ) 126
197 OBI1527 N-ACE 3 ML SOL. FOR INHALATION (RANAP) 9
198 OBI0659 NABIC / BIC NATRIC (RANAP) 35
199 OBJ0659 NABIC / BIC NATRIC (RJ) 311
200 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 66
201 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 31
202 OBI0665 NATRIUM DIKLOFENAK 50 MG (RANAP) 20
203 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 21
204 OBI0674 NEURAXON 5000 (RANAP) 21
205 OBJ0674 NEURAXON 5000 (RJ) 157
206 OBI1328 NEURODEX (RANAP) 14
207 OBJ1289 NEURODEX (RJ) 58
208 OBJ0676 NEUROSANBE (RJ) 1
209 OBI0678 NEUROSANBE 5000 MG (RANAP) 7
210 OBJ0679 NEUROSANBE PLUS (RJ) 20
211 OBI0685 NEW DIATABS (RANAP) 50
212 OBI1277 NITROKAF RETARD (RANAP) 13
213 OBI0691 NORAGES 2 ML (RANAP) 61
214 OBJ0693 NORVASK 5 MG (RJ) 30
215 OBIBP0009 NOVOMIX 30 - B (RANAP) 7
216 OBJBP000 NOVOMIX 30 - B (RJ) 7
217 2
OBIBP0003 NOVORAPID - B (RANAP) 8
218 OBJBP000 NOVORAPID - B (RJ) 5
219 3
OBI0701 NS 100 ML OTSU (RANAP) 8
220 OBI0703 NS 25 ML OTSU (RANAP) 59
221 OBI0704 NS 3% 500 ML OTSU (RANAP) 1
222 OBI0705 NS 500 ML OTSU (RANAP) 80
223 OBI1201 NS 500 ML SATORIA (RANAP) 53
224 OBJ1222 NS 500 ML SATORIA (RJ) 1
225 OBI0710 NULAGYL 500 MG 100 ML (RANAP) 5
226 OBI0719 ODR 4 MG 2 ML (RANAP) 39
227 OBI0723 OMEPRAZOLE 20 MG (RANAP) 10
228 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 24
229 OBI0726 ONDANSETRON 4 MG (RANAP) 9
230 OBJ0736 OSKOM (RJ) 5
231 OBI0738 OSTELOX 15 MG SUPPO (RANAP) 6
232 OBI0748 PANTOPRAZOLE 40 MG (RANAP) 17
233 OBI0749 PARACETAMOL 1000 MG 100 ML (RANAP) 3
234 OBI1138 PLASBUMIN 20% 100 ML (RANAP) 1
235 OBI0780 POLYCROL 400 GEL 100 ML (RANAP) 9
236 OBJ0780 POLYCROL 400 GEL 100 ML (RJ) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 24 / 53

No. No. Item Nama Item Jumlah
237 OBJ0793 PRIMADOL (RJ) 21
238 OBI0794 PRIMPERAN INJEKSI (RANAP) 40
239 OBJ0811 PROPRANOLOL 10 MG (RJ) 117
240 OBI0819 PROSOGAN FD 30 MG (RANAP) 38
241 OBJ0819 PROSOGAN FD 30 MG (RJ) 29
242 OBJ1522 PROVE D3 1000 IU (RJ) 30
243 OBJ0822 PROVELYN 75 MG (RJ) 177
244 OBJ0826 PTU / PROPYLTHIOURACIL 100 MG (RJ) 365
245 OBI0827 PUMPISEL 40 MG (RANAP) 6
246 OBI0830 PYSOLAN 30 MG (RANAP) 72
247 OBJ0830 PYSOLAN 30 MG (RJ) 119
248 OBI0834 RANITIDINE 150 MG (RANAP) 46
249 OBJ0834 RANITIDINE 150 MG (RJ) 84
250 OBI0835 RANITIDINE 2 ML (RANAP) 4
251 OBI0837 RANTIN 50 MG 2 ML (RANAP) 4
252 OBJ0843 RECOLFAR (RJ) 75
253 OBJ0844 RENAX (RJ) 70
254 OBI0857 RILLUS (RANAP) 4
255 OBJ0857 RILLUS (RJ) 15
256 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 31
257 OBI1202 RL 500 ML SATORIA (RANAP) 49
258 OBI0862 ROXEMID 10 MG/ML 2 ML (RANAP) 1
259 OBJ1997 RYZODEG FLEX TOUCH (RJ) 3
260 OBI0871 SALBUTAMOL 2 MG (RANAP) 3
261 OBJ1995 SANDIMMUN NEORAL 25 MG (RJ) 30
262 OBI0897 SANMOL 1000 MG 100 ML (RANAP) 1
263 OBJ0898 SANMOL 500 MG (RJ) 48
264 OBJ0904 SANPRIMA FORTE (RJ) 16
265 OBI1550 SANSULIN LOG-G DISPOPEN (RANAP) 1
266 OBJ1475 SANSULIN LOG-G DISPOPEN (RJ) 3
267 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) 50
268 OBI0911 SEROLIN 10 MG (RANAP) 56
269 OBJ0911 SEROLIN 10 MG (RJ) 259
270 OBJ0918 SIMVASTATIN 10 MG (RJ) 95
271 OBI0919 SIMVASTATIN 20 MG (RANAP) 16
272 OBJ0919 SIMVASTATIN 20 MG (RJ) 185
273 OBJ0925 SISTENOL (RJ) 78
274 OBI0932 SPASMINAL (RANAP) 15
275 OBJ0932 SPASMINAL (RJ) 45
276 OBJ0934 SPEDIFEN 400 MG (RJ) 32
277 OBJ0935 SPIRONOLACTONE 100 MG (RJ) 22
278 OBI0947 SUCRALFATE 100 ML (RANAP) 2
279 OBJ0947 SUCRALFATE 100 ML (RJ) 2
280 OBJ0948 SULCOLON (RJ) 120
281 OBI0951 SUVESCO 20 MG (RANAP) 3
282 OBI0956 TAMOLIV 1000 MG 100 ML (RANAP) 2
283 OBI1640 TAZOVELL 30 MG (RANAP) 17
284 OBJ1917 TAZOVELL 30 MG (RJ) 877
285 OBI0974 TENSICAP 25 MG (RANAP) -8
286 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 6
287 OBI0980 TERFACEF 1 GR (RANAP) 14
288 OBJ0990 THYROZOL 10 MG (RJ) 0

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 25 / 53

No. No. Item Nama Item Jumlah
289 OBJ1987 TIAVELL (RJ) 45
290 OBI1002 TOPAZOL 40 MG (RANAP) 2
291 OBI1007 TRACETATE (RANAP) 6
292 OBJ1006 TRACETATE (RJ) 14
293 OBJ1953 TRIFEDRIN (RJ) 10
294 OBJ1025 TROZIN 500 MG (RJ) 5
295 OBI1037 TUDIAB 500 MG (RANAP) 73
296 OBJ1036 TUDIAB 500 MG (RJ) 275
297 OBJ1038 TUZALOS 15 MG (RJ) 15
298 OBJ1051 URSODEOXYCHOLIC ACID 250 MG (RJ) 37
299 OBJ1149 URSOLIC 250 MG (RJ) 30
300 OBI1064 VALISANBE 2 MG (RANAP) 23
301 OBJ1063 VALISANBE 2 MG (RJ) 10
302 OBI1070 VASCON 4 ML (RANAP) 2
303 OBJ1976 VELTHROM 10 MG (RJ) 75
304 OBI1094 VITAMIN B-COMPLEX (RANAP) 12
305 OBJ1093 VITAMIN B-COMPLEX (RJ) 305
306 OBI1101 VITAMIN K 1 ML (RANAP) 6
307 OBJ1112 X-CAM 15 MG (RJ) 10
308 OBJ1127 ZITANID 2 MG (RJ) 30
Kartika Rahaja S., dr.
1 OBJ0002 ACLAM 500 MG (RJ) 6
2 OBJ0020 ALGANAX 0,5 MG (RJ) 10
3 OBJ0032 AMBROXOL 30 MG (RJ) 22
4 OBJ0038 AMLODIPINE 10 MG (RJ) 50
5 OBI0042 AMOXICILLIN 500 MG (RANAP) 10
6 OBJ0052 ANALSIK (RJ) 10
7 OBJ0065 APIALYS 100 ML (RJ) 2
8 OBJ0069 ARCAPEC (RJ) 12
9 OBI0095 BECOM ZET (RANAP) 10
10 OBJ0095 BECOM ZET (RJ) 36
11 OBJ0096 BECOM-C (RJ) 7
12 OBJ0104 BETASON N 5 GR (RJ) 2
13 OBJ0134 BRAXIDIN (RJ) 10
14 OBJ0142 BUSCOPAN PLUS (RJ) 10
15 OBJ0165 CEFADROXIL 500 MG (RJ) 10
16 OBJ0170 CEFILA-100 MG (RJ) 10
17 OBJ0171 CEFIXIME 100 MG (RJ) 4
18 OBI0186 CERNEVIT 750 MG (RANAP) 1
19 OBI1156 CITICOLINE 500 MG 4 ML (RANAP) 2
20 OBI0214 CLOPIDOGREL 75 MG (RANAP) 1
21 OBJ0214 CLOPIDOGREL 75 MG (RJ) 30
22 OBJ0215 CODEIN 10 MG (RJ) 12
23 OBJ0242 CTM 4 MG (RJ) 0
24 OBJ0269 DIGOXIN 0,25 MG (RJ) 30
25 OBI0282 DOMPERIDONE 10 MG (RANAP) 2
26 OBJ0338 FARMADOL 500 MG (RJ) 22
27 OBI1329 FLUNARIZINE 5 MG (RANAP) 2
28 OBJ0367 FORDIN 150 MG (RJ) 3
29 OBJ0382 FUROSEMIDE 40 MG (RJ) 7
30 OBJ0384 FUTAMEL 15 MG (RJ) 5
31 OBJ0400 GLIBENCLAMIDE 5 MG (RJ) 20

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 26 / 53

No. No. Item Nama Item Jumlah
32 OBJ1357 INFELD GEL 15 G (RJ) 1
33 OBJ0474 INPEPSA 100 ML (RJ) 1
34 OBJ0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RJ) 60
35 OBJ0492 KAFLAM 50 MG (RJ) 12
36 OBJ0506 KENALOG IN ORABASE 5 GR (RJ) 2
37 OBI0521 KUTOIN 2 ML (RANAP) 2
38 OBI0564 L-BIO SACHET (RANAP) 7
39 OBJ1949 L-VIT D3 5000 IU (RJ) 3
40 OBJ0524 LACOLDIN (RJ) 51
41 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 3
42 OBJ0536 LAMESON 4 MG (RJ) 24
43 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 9
44 OBJ0613 METFORMIN 500 MG (RJ) 40
45 OBJ0614 METHYLPREDNISOLONE 4 MG (RJ) 27
46 OBJ0646 MOVIX 7,5 MG (RJ) 10
47 OBJ0676 NEUROSANBE (RJ) 30
48 OBJ0677 NEUROSANBE 3 ML (RJ) 4
49 OBI0701 NS 100 ML OTSU (RANAP) 1
50 OBJ0701 NS 100 ML OTSU (RJ) 1
51 OBI0703 NS 25 ML OTSU (RANAP) 1
52 OBI0710 NULAGYL 500 MG 100 ML (RANAP) 3
53 OBI0787 PRANZA 40 MG (RANAP) 3
54 OBI0794 PRIMPERAN INJEKSI (RANAP) 3
55 OBJ1935 PROVE D3 5000 IU (RJ) 5
56 OBJ0823 PROXIME (RJ) 30
57 OBI0834 RANITIDINE 150 MG (RANAP) 2
58 OBJ0834 RANITIDINE 150 MG (RJ) 10
59 OBJ0898 SANMOL 500 MG (RJ) 12
60 OBI0900 SANMOL 60 ML (RANAP) 1
61 OBJ0902 SANPICILLIN 500 MG (RJ) 10
62 OBI0903 SANPRIMA 60 ML (RANAP) 1
63 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) 1
64 OBJ0934 SPEDIFEN 400 MG (RJ) 10
65 OBJ0947 SUCRALFATE 100 ML (RJ) 2
66 OBI0964 TAXECAP 1 GR (RANAP) 3
67 OBI0981 TETAGAM P 250 IU (RANAP) 1
68 OBJ1181 TETRASANBE 500 MG (RJ) 12
69 OBJ0994 TIRIZ 10 MG (RJ) 10
70 OBI1617 TRIDE (RANAP) 6
71 OBJ1063 VALISANBE 2 MG (RJ) 5
72 OBJ1078 VERAPAMIL 80 MG (RJ) 60
73 OBJ1102 VOMITAS (RJ) 22
Made Uki R., dr., Sp.OT (K) Spine
1 OBJ1913 ACETRO (RJ) 125
2 OBI0025 ALLOPURINOL 300 MG (RANAP) 4
3 OBI0054 ANALTRAM (RANAP) 10
4 OBJ0054 ANALTRAM (RJ) 349
5 OBJ0143 CAL-95 (RJ) 245
6 OBJ0146 CALIX 100 ML (RJ) 1
7 OBJ0169 CEFILA 30 ML (RJ) 1
8 OBI0170 CEFILA-100 MG (RANAP) 15
9 OBJ0171 CEFIXIME 100 MG (RJ) 58

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 27 / 53

No. No. Item Nama Item Jumlah
10 OBI0176 CEFXON 1 GR (RANAP) 3
11 OBI0234 COXIRON 90 MG (RANAP) 4
12 OBJ0338 FARMADOL 500 MG (RJ) 130
13 OBJ0356 FLAMAR EMULGEL 20 GR (RJ) 5
14 OBJ0387 GABAPENTIN 300 MG (RJ) 90
15 OBI0389 GALVUSMET 50 MG/500 MG (RANAP) 9
16 OBI1538 GLUCOSAMINE 250 MG (RANAP) 10
17 OBJ1334 GLUCOSAMINE 250 MG (RJ) 50
18 OBJ0409 GLUCOSAMINE 500 MG (RJ) 40
19 OBIBP0010 HARNAL OCAS - B (RANAP) 4
20 OBJ1992 HYAJOINT PLUS (RJ) 1
21 OBJ0455 IALUSET PLUS CREAM 100 GR (RJ) 1
22 OBJ1389 KOLKATRIOL 0,25 MCG (RJ) 30
23 OBJ1978 KONIBAL (RJ) 130
24 OBJ1883 LACOSIB 60 MG (RJ) 28
25 OBI1604 LACOSIB 90 MG (RANAP) 28
26 OBJ1536 LACOSIB 90 MG (RJ) 74
27 OBJ1333 LACTULOSE 60 ML (RJ) 1
28 OBJ0536 LAMESON 4 MG (RJ) 15
29 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 7
30 OBJ0559 LASGAN 30 MG (RJ) 7
31 OBJ0571 LEVOFLOXACIN 500 MG (RJ) 7
32 OBJ0574 LIDOCAIN 2% (RJ) 2
33 OBJ0599 MEFINAL 500 MG (RJ) 10
34 OBJ0602 MEGABAL (RJ) 30
35 OBJ0605 MELOXICAM 7,5 MG (RJ) 145
36 OBJ0678 NEUROSANBE 5000 MG (RJ) 70
37 OBJ0692 NORAGES 60 ML (RJ) 1
38 OBI0701 NS 100 ML OTSU (RANAP) 1
39 OBI0703 NS 25 ML OTSU (RANAP) 1
40 OBI0719 ODR 4 MG 2 ML (RANAP) -1
41 OBJ0723 OMEPRAZOLE 20 MG (RJ) 90
42 OBI0738 OSTELOX 15 MG SUPPO (RANAP) -2
43 OBJ0739 OSTEOR PLUS (RJ) 80
44 OBJ0775 PLANTACID FORTE 100 ML (RJ) 1
45 OBJ0834 RANITIDINE 150 MG (RJ) 15
46 OBJ1369 RINDOCAL (RJ) 180
47 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 2
48 OBJ0898 SANMOL 500 MG (RJ) 30
49 OBJ0936 SPORETIK 100 MG (RJ) 15
50 OBJ0947 SUCRALFATE 100 ML (RJ) 2
51 OBI0951 SUVESCO 20 MG (RANAP) 2
52 OBI0978 TERANOL 30 MG INJEKSI (RANAP) -1
53 OBJ1010 TRAMADOL 50 MG (RJ) 27
54 OBI1037 TUDIAB 500 MG (RANAP) 5
55 OBI1607 TUTOSOL 500 ML (RANAP) 2
56 OBI1085 VIPALBUMIN 500 MG (RANAP) 20
57 OBJ1127 ZITANID 2 MG (RJ) 40
Maya Purwaningtyas, dr., Sp.OG
1 OBI0007 ACRAN 3 ML (RANAP) 1
2 OBJ1433 ALBUFORCE (RJ) 30
3 OBJ0022 ALINAMIN-F (RJ) 15

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 28 / 53

No. No. Item Nama Item Jumlah
4 OBI0042 AMOXICILLIN 500 MG (RANAP) 10
5 OBI0054 ANALTRAM (RANAP) 40
6 OBJ0054 ANALTRAM (RJ) 35
7 OBI0077 ASAM MEFENAMAT 500 MG (RANAP) 10
8 OBJ0077 ASAM MEFENAMAT 500 MG (RJ) 20
9 OBI1580 ASI-M (RANAP) 95
10 OBJ1431 ASI-M (RJ) 20
11 OBJ0104 BETASON N 5 GR (RJ) 1
12 OBJ0108 BIOPLACENTON JELLY 15 GR (RJ) 1
13 OBJ0143 CAL-95 (RJ) 140
14 OBJ0145 CALCIUM LACTATE / CALC 500 MG (RJ) 125
15 OBI0170 CEFILA-100 MG (RANAP) 60
16 OBJ0170 CEFILA-100 MG (RJ) 10
17 OBI0226 CORTIDEX INJEKSI (RANAP) 5
18 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) -1
19 OBI0252 D5% 500 ML OTSU (RANAP) 8
20 OBJ1180 ELKANA TABLET (RJ) 90
21 OBI0345 FEROSPAT EFF (RANAP) 5
22 OBJ0345 FEROSPAT EFF (RJ) 6
23 OBJ0360 FLORAGYN (RJ) 15
24 OBJ1187 FOLAMIL GENIO DHA (RJ) 45
25 OBJ0364 FOLAPLUS (RJ) 120
26 OBJ0365 FOLAVIT 400 MCG (RJ) 65
27 OBI0381 FURAMIN 10 ML (RANAP) 9
28 OBJ0392 GARDASIL 0.5 ML (RJ) 1
29 OBI0393 GASTRUL 200 MCG (RANAP) 2
30 OBI0464 INBION (RANAP) 10
31 OBJ0464 INBION (RJ) 80
32 OBI0467 INDUXIN 1 ML (RANAP) 5
33 OBJ0470 INLACTA DHA FOR MOTHER (RJ) 30
34 OBJ0484 INVOMIT 4 MG (RJ) 15
35 OBI1227 KETOROLAC INJEKSI (RANAP) -2
36 OBJ0517 KONIDERM CREAM 10 GR (RJ) 1
37 OBJ1980 LABUMIN (RJ) 80
38 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 0
39 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 5
40 OBI0555 LAPIXIME 1 GR (RANAP) 4
41 OBI0574 LIDOCAIN 2% (RANAP) 2
42 OBI0580 LIVRON B-PLEX (RANAP) 10
43 OBJ0580 LIVRON B-PLEX (RJ) 215
44 OBI0599 MEFINAL 500 MG (RANAP) 40
45 OBJ0599 MEFINAL 500 MG (RJ) 40
46 OBJ1508 MICROGEST 100 MG (RJ) 52
47 OBJ1871 MICROGEST 200 MG (RJ) 35
48 OBI1162 MYLANTA 50 ML (RANAP) 2
49 OBJ0667 NEO GYNOXA OVULA (RJ) 5
50 OBJ1457 NEXITRA 500 MG (RJ) 25
51 OBI0687 NIFEDIPINE 10 MG (RANAP) 20
52 OBI0701 NS 100 ML OTSU (RANAP) 2
53 OBI0703 NS 25 ML OTSU (RANAP) 2
54 OBJ1553 NUCALCI EFF (RJ) 2
55 OBI0711 NUTRIBREAST (RANAP) 20

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 29 / 53

No. No. Item Nama Item Jumlah
56 OBI1199 NUTRIFLAM (RANAP) 30
57 OBJ1209 NUTRIFLAM (RJ) 5
58 OBI0719 ODR 4 MG 2 ML (RANAP) 5
59 OBJ0720 ODR 4 MG 60 ML (RJ) 3
60 OBJ1965 OSFIT PLATINUM (RJ) 30
61 OBI0738 OSTELOX 15 MG SUPPO (RANAP) 14
62 OBJ0777 PLASMINEX (RJ) 25
63 OBI0794 PRIMPERAN INJEKSI (RANAP) 3
64 OBJ1294 PROCALMA (RJ) 30
65 OBI0801 PROFENID SUPPO 100 MG (RANAP) 1
66 OBJ1174 PROMAVIT (RJ) 125
67 OBJ1935 PROVE D3 5000 IU (RJ) 35
68 OBI0837 RANTIN 50 MG 2 ML (RANAP) 2
69 OBJ1301 REGUMEN 5 MG (RJ) 38
70 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 14
71 OBI0870 SAGESTAM 10 GR CREAM (RANAP) 1
72 OBJ0870 SAGESTAM 10 GR CREAM (RJ) 1
73 OBJ0898 SANMOL 500 MG (RJ) 10
74 OBI1203 SILEX 100 ML (RANAP) 1
75 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 6
76 OBJ1084 VIPALBUMIN 500 MG (RJ) 15
77 OBJ1091 VITAMIN B6 10 MG (RJ) 20
78 OBJ1097 VITAMIN C 50 MG (RJ) 40
Mia, dr. Sp.,PD
1 OBJ1220 ACARBOSE 100 MG (RJ) 90
2 OBJ1219 ACARBOSE 50 MG (RJ) 330
3 OBJ0019 ALDISA SR (RJ) 10
4 OBI0024 ALLOPURINOL 100 MG (RANAP) 10
5 OBJ0024 ALLOPURINOL 100 MG (RJ) 30
6 OBJ0025 ALLOPURINOL 300 MG (RJ) 30
7 OBJ1509 AMINORAL (RJ) 10
8 OBJ0038 AMLODIPINE 10 MG (RJ) 30
9 OBJ0039 AMLODIPINE 5 MG (RJ) 75
10 OBJ0069 ARCAPEC (RJ) 15
11 OBI0079 ASERING 500 ML OTSU (RANAP) 0
12 OBJ0081 ATORVASTATIN 20 MG (RJ) 60
13 OBJ0102 BETAHISTINE 6 MG (RJ) 30
14 OBI0134 BRAXIDIN (RANAP) 5
15 OBJ0134 BRAXIDIN (RJ) 35
16 OBJ0148 CANDESARTAN 8 MG (RJ) 60
17 OBJ0171 CEFIXIME 100 MG (RJ) 10
18 OBI0183 CEPTIK 100 MG (RANAP) 10
19 OBI0186 CERNEVIT 750 MG (RANAP) 1
20 OBJ0188 CETIRIZINE 10 MG (RJ) 10
21 OBI1595 COBAZIM 1000 MG (RANAP) 10
22 OBJ1302 COBAZIM 1000 MG (RJ) 7
23 OBJ1882 CURCUMA FORCE (RJ) 30
24 OBJ0272 DIMENHYDRINATE 50 MG (RJ) 15
25 OBJ0275 DISFLATYL (RJ) 25
26 OBI0281 DOME 10 MG (RANAP) 21
27 OBJ0281 DOME 10 MG (RJ) 38
28 OBJ1305 EPERISONE HCL 50 MG (RJ) 15

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 30 / 53

No. No. Item Nama Item Jumlah
29 OBJ0337 FARMACROL FORTE (RJ) 15
30 OBJ1311 FENOFIBRATE 300 MG (RJ) 30
31 OBI0349 FIBESCO 300 MG (RANAP) 2
32 OBJ0349 FIBESCO 300 MG (RJ) 0
33 OBJ1290 FLUNARIZINE 5 MG (RJ) 7
34 OBI0382 FUROSEMIDE 40 MG (RANAP) 10
35 OBJ0382 FUROSEMIDE 40 MG (RJ) 100
36 OBJ0388 GALVUS 50 MG (RJ) 270
37 OBJ0402 GLIMEPIRIDE 2 MG (RJ) 90
38 OBJ0403 GLIMEPIRIDE 3 MG (RJ) 60
39 OBJ0404 GLIMEPIRIDE 4 MG (RJ) 30
40 OBJ0409 GLUCOSAMINE 500 MG (RJ) 15
41 OBJBP000 HARNAL OCAS - B (RJ) 15
42 5
OBJ1167 HUFAGRIP FORTE (RJ) 15
43 OBJ0462 IMUNOS PLUS (RJ) 10
44 OBI0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RANAP) 19
45 OBI0509 KETO - G (RANAP) 25
46 OBJ0563 L-BIO CAPSUL (RJ) 19
47 OBJ1513 LABALIN 75 MG (RJ) 30
48 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 20
49 OBJ1869 LAPIGIM 2 MG / 500 MG (RJ) 60
50 OBI0559 LASGAN 30 MG (RANAP) 10
51 OBJ0559 LASGAN 30 MG (RJ) 45
52 OBI0560 LASIX 2 ML (RANAP) 5
53 OBIBP0002 LEVEMIR- B (RANAP) 2
54 OBJBP000 LEVEMIR- B (RJ) 4
55 1
OBJ0580 LIVRON B-PLEX (RJ) 10
56 OBJ0604 MELOXICAM 15 MG (RJ) 20
57 OBJ0613 METFORMIN 500 MG (RJ) 501
58 OBJ0618 METRIX 2 MG (RJ) 20
59 OBJ1907 MIXALGIN (RJ) 45
60 OBJ0658 MYONEP (RJ) 15
61 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 45
62 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 11
63 OBIBP0003 NOVORAPID - B (RANAP) 5
64 OBJBP000 NOVORAPID - B (RJ) 9
65 3
OBI0703 NS 25 ML OTSU (RANAP) 2
66 OBI0705 NS 500 ML OTSU (RANAP) 5
67 OBI0707 NUCRAL 100 ML (RANAP) 2
68 OBJ0707 NUCRAL 100 ML (RJ) 8
69 OBJ1209 NUTRIFLAM (RJ) 25
70 OBI0719 ODR 4 MG 2 ML (RANAP) -1
71 OBJ1299 PREGABALIN (RJ) 20
72 OBI0794 PRIMPERAN INJEKSI (RANAP) 5
73 OBJ0799 PROFAT 100 ML (RJ) 2
74 OBJ0835 RANITIDINE 2 ML (RJ) 1
75 OBJ1934 REPIMIDE 100 MG (RJ) 36
76 OBI1678 RING-AS 500 ML SANBE (RANAP) 5
77 OBJ0898 SANMOL 500 MG (RJ) 10
78 OBJ0919 SIMVASTATIN 20 MG (RJ) 30
79 OBJ0932 SPASMINAL (RJ) 61
80 OBJ0935 SPIRONOLACTONE 100 MG (RJ) 10

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 31 / 53

No. No. Item Nama Item Jumlah
81 OBI0938 STARXON 1 GR (RANAP) 6
82 OBJ0947 SUCRALFATE 100 ML (RJ) 1
83 OBJ1917 TAZOVELL 30 MG (RJ) 8
84 OBI1002 TOPAZOL 40 MG (RANAP) 5
85 OBJ1036 TUDIAB 500 MG (RJ) 150
86 OBI1144 URSOLIC 250 MG (RANAP) 24
87 OBJ1149 URSOLIC 250 MG (RJ) 90
88 OBI1073 V-BLOC 6,25 MG (RANAP) 11
89 OBJ1893 VAXIGRIP TETRA NH (RJ) 1
90 OBI1085 VIPALBUMIN 500 MG (RANAP) 30
91 OBJ1093 VITAMIN B-COMPLEX (RJ) 40
Mirza Thaariq Hapsito dr.,Sp. JP
1 OBJ0001 A-B VASK 5 MG (RJ) 30
2 OBI1233 ADALAT OROS 30 MG (RANAP) 10
3 OBJ1537 ADALAT OROS 30 MG (RJ) 255
4 OBJ0024 ALLOPURINOL 100 MG (RJ) 45
5 OBI0025 ALLOPURINOL 300 MG (RANAP) 8
6 OBJ0025 ALLOPURINOL 300 MG (RJ) 445
7 OBJ0032 AMBROXOL 30 MG (RJ) 10
8 OBI0038 AMLODIPINE 10 MG (RANAP) 3
9 OBJ0038 AMLODIPINE 10 MG (RJ) 180
10 OBJ0039 AMLODIPINE 5 MG (RJ) 919
11 OBI0052 ANALSIK (RANAP) 10
12 OBJ0052 ANALSIK (RJ) 90
13 OBI0056 ANGINTRIZ MR (RANAP) 23
14 OBJ0056 ANGINTRIZ MR (RJ) 115
15 OBI0063 ANTRAIN 1 GR (RANAP) 4
16 OBJ0066 APTOR 100 MG (RJ) 190
17 OBI0080 ASPILETS CHEWABLE (RANAP) 13
18 OBJ0080 ASPILETS CHEWABLE (RJ) 30
19 OBI1352 ATORVASTATIN 20 MG (RANAP) 35
20 OBJ0081 ATORVASTATIN 20 MG (RJ) 1945
21 OBIBP0004 ATROPINE SULFAS 0.25 MG 1 ML-B (RANAP) 2
22 OBJ0102 BETAHISTINE 6 MG (RJ) 20
23 OBI0117 BISOPROLOL 5 MG (RANAP) 23
24 OBJ0117 BISOPROLOL 5 MG (RJ) 1459
25 OBI0130 BRAINACT 500 MG 4 ML (RANAP) 1
26 OBJ0134 BRAXIDIN (RJ) 20
27 OBJ1364 CANDESARTAN 16 MG (RJ) 180
28 OBI0148 CANDESARTAN 8 MG (RANAP) 10
29 OBJ0148 CANDESARTAN 8 MG (RJ) 1080
30 OBI0152 CAPTOPRIL 12,5 MG (RANAP) 6
31 OBI0157 CAR-Q 100 (RANAP) 23
32 OBJ0155 CARDISAN 5 MG (RJ) 30
33 OBJ0165 CEFADROXIL 500 MG (RJ) 10
34 OBI0170 CEFILA-100 MG (RANAP) 10
35 OBI0175 CEFTRIAXONE 1 GR (RANAP) 13
36 OBI0176 CEFXON 1 GR (RANAP) 2
37 OBJ0188 CETIRIZINE 10 MG (RJ) 20
38 OBI1641 CLOBAZAM 10 MG (RANAP) 8
39 OBJ1926 CLOBAZAM 10 MG (RJ) 5
40 OBI0214 CLOPIDOGREL 75 MG (RANAP) 39

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 32 / 53

No. No. Item Nama Item Jumlah
41 OBJ0214 CLOPIDOGREL 75 MG (RJ) 2955
42 OBJ0215 CODEIN 10 MG (RJ) 60
43 OBI0224 CONCOR HS 5 MG (RANAP) 1
44 OBI0235 CPG 75 MG (RANAP) 9
45 OBJ0235 CPG 75 MG (RJ) 97
46 OBI1367 D5 - 1/4 NS 500 ML WIDA (RANAP) 1
47 OBI1711 DIAZEPAM ENEMA 5 MG / 2,5 ML (RANAP) 1
48 OBI0269 DIGOXIN 0,25 MG (RANAP) 20
49 OBJ0269 DIGOXIN 0,25 MG (RJ) 390
50 OBJ0271 DILTIAZEM 30 MG (RJ) 300
51 OBI1295 DIOVAN 160 MG (RANAP) 10
52 OBJ1523 DIOVAN 160 MG (RJ) 435
53 OBJ0273 DIOVAN 80 MG (RJ) 792
54 OBJ0277 DIVASK 5 MG (RJ) 30
55 OBJ0284 DOPAMET 250 MG (RJ) 150
56 OBI0287 DULCOLAX SUPPO 10 MG ADULT (RANAP) 1
57 OBI0296 ELKANA 60 ML (RANAP) 1
58 OBJ0296 ELKANA 60 ML (RJ) 1
59 OBJ1180 ELKANA TABLET (RJ) 20
60 OBIBP0001 EPINEPHRINE 0,1% 1 ML- B (RANAP) 3
61 OBI0321 ESOLA 40 MG (RANAP) 1
62 OBJ1975 FARNORMIN 50 MG (RJ) 60
63 OBI0342 FASTOR 20 MG (RANAP) 6
64 OBJ0342 FASTOR 20 MG (RJ) 30
65 OBJ1311 FENOFIBRATE 300 MG (RJ) 90
66 OBI0350 FIBRAMED 300 MG (RANAP) 6
67 OBI0351 FIBRION 1500000 IU (RANAP) 2
68 OBI1329 FLUNARIZINE 5 MG (RANAP) 13
69 OBJ1954 FLUZEP (RJ) 20
70 OBJ0366 FORASMA 2,5 MG (RJ) 90
71 OBI0376 FORXIGA 10 MG (RANAP) 6
72 OBJ0376 FORXIGA 10 MG (RJ) 30
73 OBI0382 FUROSEMIDE 40 MG (RANAP) 11.6
74 OBJ0382 FUROSEMIDE 40 MG (RJ) 588
75 OBI0386 FUTROLIT 500 ML (RANAP) 3
76 OBJ0388 GALVUS 50 MG (RJ) 30
77 OBJ0402 GLIMEPIRIDE 2 MG (RJ) 30
78 OBI1468 GLIQUIDONE 30 MG (RANAP) 1
79 OBI1389 GLUCODEX 80 MG (RANAP) 7
80 OBJ1327 GLUCODEX 80 MG (RJ) 30
81 OBJ0435 HCT 25 MG (RJ) 75
82 OBJ1248 HERBESSER CD 100 (RJ) 30
83 OBJ1167 HUFAGRIP FORTE (RJ) 10
84 OBJ0475 INTERHISTIN 50 MG (RJ) 10
85 OBJ0480 INTERPRIL 5 MG (RJ) 15
86 OBI0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RANAP) 102
87 OBJ0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RJ) 3665
88 OBI1227 KETOROLAC INJEKSI (RANAP) 7
89 OBJ1978 KONIBAL (RJ) 10
90 OBI1433 KSR 600 MG - B (RANAP) 12
91 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 3
92 OBI0538 LANSOPRAZOLE 30 MG (RANAP) 5

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 33 / 53

No. No. Item Nama Item Jumlah
93 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 95
94 OBI1334 LANSOPRAZOLE INJEKSI (RANAP) 4
95 OBJ1879 LAPIVA 5 MG / 80 MG (RJ) 15
96 OBI1466 LASALCOM 2,5 ML CAIRAN INHALER (RANAP) 2
97 OBI0560 LASIX 2 ML (RANAP) 2
98 OBI0561 LASIX 40 MG (RANAP) 5
99 OBJ0561 LASIX 40 MG (RJ) 105
100 OBI0571 LEVOFLOXACIN 500 MG (RANAP) 5
101 OBI1409 LEVOFLOXACIN 750 MG 150 ML (RANAP) 2
102 OBJ1316 LISINOPRIL 10 MG (RJ) 60
103 OBI0577 LISINOPRIL 5 MG (RANAP) 3
104 OBJ0577 LISINOPRIL 5 MG (RJ) 120
105 OBIBP0008 LOVENOX P.F.S 60 MG / 0,6 ML - B (RANAP) 6
106 OBI0601 MEFOZ 4 MG 2 ML (RANAP) -1
107 OBJ0605 MELOXICAM 7,5 MG (RJ) 80
108 OBJ0638 MINIASPI 80 MG (RJ) 675
109 OBI0659 NABIC / BIC NATRIC (RANAP) -11
110 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 16
111 OBJ1289 NEURODEX (RJ) 30
112 OBI0677 NEUROSANBE 3 ML (RANAP) 6
113 OBJ0678 NEUROSANBE 5000 MG (RJ) 85
114 OBI1277 NITROKAF RETARD (RANAP) 1
115 OBJ1440 NITROKAF RETARD (RJ) 1740
116 OBJ1971 NOTISIL 2 MG (RJ) 120
117 OBIBP0003 NOVORAPID - B (RANAP) 1
118 OBI0701 NS 100 ML OTSU (RANAP) 7
119 OBI0703 NS 25 ML OTSU (RANAP) 14
120 OBI0705 NS 500 ML OTSU (RANAP) 13
121 OBI1201 NS 500 ML SATORIA (RANAP) 4
122 OBI0719 ODR 4 MG 2 ML (RANAP) 2
123 OBJ0723 OMEPRAZOLE 20 MG (RJ) 20
124 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) -1
125 OBI1469 PANTOPUMP TABLET 40 MG (RANAP) 7
126 OBJ1412 PANTOPUMP TABLET 40 MG (RJ) 40
127 OBI0749 PARACETAMOL 1000 MG 100 ML (RANAP) 4
128 OBI0787 PRANZA 40 MG (RANAP) 2
129 OBI0811 PROPRANOLOL 10 MG (RANAP) 17
130 OBJ0811 PROPRANOLOL 10 MG (RJ) 60
131 OBI0819 PROSOGAN FD 30 MG (RANAP) -3
132 OBJ1935 PROVE D3 5000 IU (RJ) 15
133 OBI0823 PROXIME (RANAP) 11
134 OBJ0823 PROXIME (RJ) 30
135 OBI0827 PUMPISEL 40 MG (RANAP) 5
136 OBI1443 RAMIPRIL 5 MG (RANAP) 1
137 OBJ1391 RAMIPRIL 5 MG (RJ) 8
138 OBJ0834 RANITIDINE 150 MG (RJ) 30
139 OBI0835 RANITIDINE 2 ML (RANAP) 9
140 OBJ1934 REPIMIDE 100 MG (RJ) 10
141 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 1
142 OBI1385 ROSTIN 20 MG (RANAP) 9
143 OBJ1465 ROSTIN 20 MG (RJ) 105
144 OBI0862 ROXEMID 10 MG/ML 2 ML (RANAP) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 34 / 53

No. No. Item Nama Item Jumlah
145 OBJ1475 SANSULIN LOG-G DISPOPEN (RJ) 2
146 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) -2
147 OBJ0918 SIMVASTATIN 10 MG (RJ) 10
148 OBJ0919 SIMVASTATIN 20 MG (RJ) 30
149 OBJ0932 SPASMINAL (RJ) 15
150 OBJ0935 SPIRONOLACTONE 100 MG (RJ) 90
151 OBI1396 SPIRONOLACTONE 25 MG (RANAP) 3
152 OBJ1329 SPIRONOLACTONE 25 MG (RJ) 270
153 OBI0947 SUCRALFATE 100 ML (RANAP) 2
154 OBJ0947 SUCRALFATE 100 ML (RJ) 2
155 OBI0957 TAMOLIV 500 MG 50 ML (RANAP) 1
156 OBI0980 TERFACEF 1 GR (RANAP) 2
157 OBI0992 TIARYT INJEKSI (RANAP) 1
158 OBJ1140 TIARYT TABLET (RJ) 345
159 OBJ0994 TIRIZ 10 MG (RJ) 20
160 OBI1002 TOPAZOL 40 MG (RANAP) 3
161 OBI1028 TRUVAZ 20 MG (RANAP) 18
162 OBJ1027 TRUVAZ 20 MG (RJ) 60
163 OBI1037 TUDIAB 500 MG (RANAP) 18
164 OBI1073 V-BLOC 6,25 MG (RANAP) 48
165 OBJ1072 V-BLOC 6,25 MG (RJ) 590
166 OBI1064 VALISANBE 2 MG (RANAP) 52
167 OBJ1063 VALISANBE 2 MG (RJ) 30
168 OBI1068 VALSARTAN - NI 80 MG (RANAP) 7
169 OBI1070 VASCON 4 ML (RANAP) 5
170 OBJ1078 VERAPAMIL 80 MG (RJ) 90
171 OBJ1093 VITAMIN B-COMPLEX (RJ) 490
172 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 2
Muchamad Abusari, dr., Sp. JP
1 OBJ0024 ALLOPURINOL 100 MG (RJ) 50
2 OBJ0038 AMLODIPINE 10 MG (RJ) 60
3 OBJ0039 AMLODIPINE 5 MG (RJ) 60
4 OBJ0052 ANALSIK (RJ) 10
5 OBI0054 ANALTRAM (RANAP) 9
6 OBI0056 ANGINTRIZ MR (RANAP) 10
7 OBJ0056 ANGINTRIZ MR (RJ) 100
8 OBJ0066 APTOR 100 MG (RJ) 37
9 OBJ0081 ATORVASTATIN 20 MG (RJ) 97
10 OBJ0117 BISOPROLOL 5 MG (RJ) 195
11 OBJ1364 CANDESARTAN 16 MG (RJ) 30
12 OBJ0148 CANDESARTAN 8 MG (RJ) 30
13 OBI0197 CIFLOS 500 MG (RANAP) 10
14 OBJ1926 CLOBAZAM 10 MG (RJ) 60
15 OBJ0214 CLOPIDOGREL 75 MG (RJ) 67
16 OBI0235 CPG 75 MG (RANAP) 13
17 OBJ0260 DEXAMETHASONE 0,50 MG (RJ) 30
18 OBJ1523 DIOVAN 160 MG (RJ) 60
19 OBJ0273 DIOVAN 80 MG (RJ) 60
20 OBJ0338 FARMADOL 500 MG (RJ) 10
21 OBI0342 FASTOR 20 MG (RANAP) 13
22 OBI0376 FORXIGA 10 MG (RANAP) 5
23 OBI0378 FREGO 5 MG (RANAP) 19

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 35 / 53

No. No. Item Nama Item Jumlah
24 OBJ0382 FUROSEMIDE 40 MG (RJ) 37
25 OBI0435 HCT 25 MG (RANAP) 11
26 OBJ0435 HCT 25 MG (RJ) 140
27 OBJ1248 HERBESSER CD 100 (RJ) 30
28 OBI1242 HERBESSER CD 200 (RANAP) 13
29 OBJ0480 INTERPRIL 5 MG (RJ) 30
30 OBJ0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RJ) 401
31 OBJ1506 KENDARON 200 MG TABLET (RJ) 7
32 OBJ0510 KETOCONAZOLE (RJ) 30
33 OBJ0512 KETOCONAZOLE 2% 5 GR KRIM (RJ) 2
34 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 20
35 OBIBP0011 LANTUS SOLOSTAR - B (RANAP) 1
36 OBI0559 LASGAN 30 MG (RANAP) 10
37 OBJ0580 LIVRON B-PLEX (RJ) 30
38 OBJ0605 MELOXICAM 7,5 MG (RJ) 20
39 OBJ0638 MINIASPI 80 MG (RJ) 90
40 OBJ0659 NABIC / BIC NATRIC (RJ) 0
41 OBI1277 NITROKAF RETARD (RANAP) 20
42 OBJ1971 NOTISIL 2 MG (RJ) 30
43 OBI0703 NS 25 ML OTSU (RANAP) 1
44 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 3
45 OBI0817 PROSOGAN 30 MG INJEKSI (RANAP) 2
46 OBJ1391 RAMIPRIL 5 MG (RJ) 89
47 OBJ0834 RANITIDINE 150 MG (RJ) 10
48 OBJ1934 REPIMIDE 100 MG (RJ) 10
49 OBJ0918 SIMVASTATIN 10 MG (RJ) 40
50 OBJ1329 SPIRONOLACTONE 25 MG (RJ) 30
51 OBJ1990 TELMISARTAN 80 MG (RJ) 30
52 OBI0974 TENSICAP 25 MG (RANAP) 15
53 OBI0975 TENSILO 10 MG INJEKSI (RANAP) 1
54 OBJ1140 TIARYT TABLET (RJ) 60
55 OBI1037 TUDIAB 500 MG (RANAP) 15
56 OBI1072 V-BLOC 25 MG (RANAP) 13
57 OBJ1072 V-BLOC 6,25 MG (RJ) 120
58 OBJ1093 VITAMIN B-COMPLEX (RJ) 30
Muhammad Nur, dr., Sp.OG.
1 OBI0007 ACRAN 3 ML (RANAP) -1
2 OBI1514 ALBUFORCE (RANAP) 75
3 OBI0038 AMLODIPINE 10 MG (RANAP) 13
4 OBI0042 AMOXICILLIN 500 MG (RANAP) 60
5 OBI0044 AMOXSAN 500 MG (RANAP) 0
6 OBI0054 ANALTRAM (RANAP) 85
7 OBI0063 ANTRAIN 1 GR (RANAP) 2
8 OBI0077 ASAM MEFENAMAT 500 MG (RANAP) 80
9 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 2
10 OBI1580 ASI-M (RANAP) 15
11 OBIBP0004 ATROPINE SULFAS 0.25 MG 1 ML-B (RANAP) 1
12 OBI0118 BLEDSTOP INJEKSI (RANAP) 0
13 OBI0119 BLEDSTOP TABLET (RANAP) 185
14 OBJ0143 CAL-95 (RJ) 7
15 OBI1315 CEFAZOLIN 1 G (RANAP) 8
16 OBI0171 CEFIXIME 100 MG (RANAP) 10

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 36 / 53

No. No. Item Nama Item Jumlah
17 OBI0175 CEFTRIAXONE 1 GR (RANAP) 6
18 OBI0183 CEPTIK 100 MG (RANAP) 85
19 OBI0226 CORTIDEX INJEKSI (RANAP) 4
20 OBI0248 D10% 500 ML OTSU (RANAP) 1
21 OBI0251 D5% 100 ML OTSU (RANAP) 1
22 OBI0252 D5% 500 ML OTSU (RANAP) 10
23 OBI0260 DEXAMETHASONE 0,50 MG (RANAP) 6
24 OBI1323 DEXAMETHASONE AMPUL (RANAP) 8
25 OBI0785 ECODINE IODINE 10% 60 ML (RANAP) 1
26 OBI1535 GASTRUCID 60 ML (RANAP) 5
27 OBJ0464 INBION (RJ) 17
28 OBI0467 INDUXIN 1 ML (RANAP) 11
29 OBJ0470 INLACTA DHA FOR MOTHER (RJ) 30
30 OBI1227 KETOROLAC INJEKSI (RANAP) 21
31 OBI0519 KTM 100 MG / ML (RANAP) 1
32 OBI0527 LACTAFAR (RANAP) 60
33 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 6
34 OBI0580 LIVRON B-PLEX (RANAP) 70
35 OBJ0580 LIVRON B-PLEX (RJ) 10
36 OBI0605 MELOXICAM 7,5 MG (RANAP) 14
37 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 1
38 OBI0621 METRONIDAZOLE 100 ML (RANAP) 4
39 OBJ1508 MICROGEST 100 MG (RJ) 15
40 OBI1603 MICROGEST 200 MG (RANAP) 2
41 OBI1721 MIDAZOLAM INJEKSI (RANAP) 1
42 OBI1299 MISOPROSTOL 200 MCG (RANAP) 6
43 OBI0654 MY JELLY SACHET 5 GR (RANAP) 5
44 OBI1162 MYLANTA 50 ML (RANAP) 4
45 OBI0701 NS 100 ML OTSU (RANAP) 6
46 OBI0703 NS 25 ML OTSU (RANAP) 3
47 OBI1201 NS 500 ML SATORIA (RANAP) 2
48 OBI1199 NUTRIFLAM (RANAP) 30
49 OBI0719 ODR 4 MG 2 ML (RANAP) 9
50 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 3
51 OBJ0737 OSSOVIT (RJ) 17
52 OBI0738 OSTELOX 15 MG SUPPO (RANAP) 12
53 OBI1319 OXYTOCIN INJEKSI (RANAP) 13
54 OBI0794 PRIMPERAN INJEKSI (RANAP) 4
55 OBI0801 PROFENID SUPPO 100 MG (RANAP) 2
56 OBJ1174 PROMAVIT (RJ) 7
57 OBI0837 RANTIN 50 MG 2 ML (RANAP) 2
58 OBI0839 RD 500 ML WIDA (RANAP) 1
59 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 17
60 OBI1202 RL 500 ML SATORIA (RANAP) 19
61 OBI0863 RYCEF 1 GR (RANAP) 16
62 OBI0947 SUCRALFATE 100 ML (RANAP) 1
63 OBI0978 TERANOL 30 MG INJEKSI (RANAP) 4
64 OBI0980 TERFACEF 1 GR (RANAP) 3
65 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 15
Nunuk, dr., Sp.S
1 OBJ0001 A-B VASK 5 MG (RJ) 305
2 OBJ0020 ALGANAX 0,5 MG (RJ) 33

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 37 / 53

No. No. Item Nama Item Jumlah
3 OBI0038 AMLODIPINE 10 MG (RANAP) 5
4 OBJ0038 AMLODIPINE 10 MG (RJ) 585
5 OBJ0039 AMLODIPINE 5 MG (RJ) 413
6 OBJ0052 ANALSIK (RJ) 10
7 OBJ0054 ANALTRAM (RJ) 90
8 OBJ0066 APTOR 100 MG (RJ) 60
9 OBJ0074 ARKINE 2 MG (RJ) 135
10 OBJ1994 ASAM VALPROAT (RJ) 90
11 OBI0080 ASPILETS CHEWABLE (RANAP) 4
12 OBJ0080 ASPILETS CHEWABLE (RJ) 60
13 OBJ0089 BAMGETOL 200 MG (RJ) 180
14 OBI0095 BECOM ZET (RANAP) 95
15 OBJ0095 BECOM ZET (RJ) 293
16 OBI0102 BETAHISTINE 6 MG (RANAP) 2
17 OBJ0102 BETAHISTINE 6 MG (RJ) 41
18 OBJ0117 BISOPROLOL 5 MG (RJ) 15
19 OBJ0143 CAL-95 (RJ) 13
20 OBJ0145 CALCIUM LACTATE / CALC 500 MG (RJ) 46
21 OBJ1364 CANDESARTAN 16 MG (RJ) 30
22 OBJ0152 CAPTOPRIL 12,5 MG (RJ) 150
23 OBI0153 CAPTOPRIL 25 MG (RANAP) 15
24 OBJ0153 CAPTOPRIL 25 MG (RJ) 14
25 OBI0176 CEFXON 1 GR (RANAP) 3
26 OBI1156 CITICOLINE 500 MG 4 ML (RANAP) 13
27 OBI1641 CLOBAZAM 10 MG (RANAP) 30
28 OBI0214 CLOPIDOGREL 75 MG (RANAP) 18
29 OBJ0214 CLOPIDOGREL 75 MG (RJ) 120
30 OBI1650 CURCUMA FORCE (RANAP) 23
31 OBJ1882 CURCUMA FORCE (RJ) 30
32 OBJ1952 DC2 (RJ) 232
33 OBI1323 DEXAMETHASONE AMPUL (RANAP) 2
34 OBI0271 DILTIAZEM 30 MG (RANAP) 5
35 OBJ1523 DIOVAN 160 MG (RJ) 30
36 OBJ0273 DIOVAN 80 MG (RJ) 60
37 OBJ0276 DIVALPI EC 250 MG (RJ) 240
38 OBJ0277 DIVASK 5 MG (RJ) 45
39 OBJ1305 EPERISONE HCL 50 MG (RJ) 84
40 OBI0309 EPISAN 100 ML (RANAP) 2
41 OBJ0309 EPISAN 100 ML (RJ) 1
42 OBI0338 FARMADOL 500 MG (RANAP) 20
43 OBJ0338 FARMADOL 500 MG (RJ) 42
44 OBI0342 FASTOR 20 MG (RANAP) 1
45 OBJ1311 FENOFIBRATE 300 MG (RJ) 30
46 OBJ0365 FOLAVIT 400 MCG (RJ) 30
47 OBJ0401 GLIMEPIRIDE 1 MG (RJ) 30
48 OBJ1327 GLUCODEX 80 MG (RJ) 30
49 OBJ1334 GLUCOSAMINE 250 MG (RJ) 61
50 OBJ0409 GLUCOSAMINE 500 MG (RJ) 8
51 OBJ1330 HEXYMER 2 MG (RJ) 30
52 OBJ1978 KONIBAL (RJ) 87
53 OBJ0520 KUTOIN 100 MG (RJ) 153
54 OBJ0565 L-CORE SACHET (RJ) 10

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 38 / 53

No. No. Item Nama Item Jumlah
55 OBJ1536 LACOSIB 90 MG (RJ) 15
56 OBJ0535 LAMESON 16 MG (RJ) 25
57 OBI0541 LAPIBAL 500 MCG INJEKSI (RANAP) 11
58 OBI0542 LAPIBAL 500 MG (RANAP) 10
59 OBJ0542 LAPIBAL 500 MG (RJ) 981
60 OBJ0553 LAPISIV-T (RJ) 10
61 OBI0559 LASGAN 30 MG (RANAP) 10
62 OBJ0559 LASGAN 30 MG (RJ) 54
63 OBJ1885 LEPARSON (RJ) 120
64 OBI0592 MANNITOL 20% 500 ML (RANAP) 1
65 OBI0608 MERISLON (RANAP) 3
66 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 3
67 OBI0638 MINIASPI 80 MG (RANAP) 8
68 OBJ0638 MINIASPI 80 MG (RJ) 512
69 OBJ1907 MIXALGIN (RJ) 34
70 OBJ0645 MOVIX 15 MG (RJ) 17
71 OBJ0646 MOVIX 7,5 MG (RJ) 155
72 OBI0658 MYONEP (RANAP) 3
73 OBJ0658 MYONEP (RJ) 249
74 OBI0665 NATRIUM DIKLOFENAK 50 MG (RANAP) 6
75 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 164
76 OBI1591 NEUCITI 500 MG (RANAP) 20
77 OBJ1867 NEUCITI 500 MG (RJ) 453
78 OBI0672 NEUCITI-500 MG 4 ML (RANAP) 3
79 OBJ1289 NEURODEX (RJ) 138
80 OBI0677 NEUROSANBE 3 ML (RANAP) 3
81 OBJ1866 NEUROTAM 1200 MG (RJ) 30
82 OBI0689 NIMODIPINE (RANAP) 1
83 OBIBP0003 NOVORAPID - B (RANAP) 1
84 OBI0703 NS 25 ML OTSU (RANAP) 6
85 OBI0705 NS 500 ML OTSU (RANAP) 19
86 OBI1201 NS 500 ML SATORIA (RANAP) 9
87 OBJ1209 NUTRIFLAM (RJ) 58
88 OBI0719 ODR 4 MG 2 ML (RANAP) 13
89 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) -1
90 OBJ0736 OSKOM (RJ) 54
91 OBJ0768 PIDOVIX (RJ) 82
92 OBJ0771 PIRACETAM 800 MG (RJ) 20
93 OBJ0811 PROPRANOLOL 10 MG (RJ) 14
94 OBJ1874 PROVELYN 50 MG (RJ) 44
95 OBJ0823 PROXIME (RJ) 750
96 OBJ0834 RANITIDINE 150 MG (RJ) 10
97 OBI0835 RANITIDINE 2 ML (RANAP) 8
98 OBI0897 SANMOL 1000 MG 100 ML (RANAP) 4
99 OBJ0898 SANMOL 500 MG (RJ) 10
100 OBJ0911 SEROLIN 10 MG (RJ) 10
101 OBJ0918 SIMVASTATIN 10 MG (RJ) 30
102 OBI0919 SIMVASTATIN 20 MG (RANAP) 8
103 OBI0931 SOLVINEX 2 ML (RANAP) 10
104 OBJ0968 TEBOKAN FORTE 120 MG (RJ) 51
105 OBJ0974 TENSICAP 25 MG (RJ) 90
106 OBJ0987 THP / TRIHEXYPHENIDYL 2 MG (RJ) 60

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 39 / 53

No. No. Item Nama Item Jumlah
107 OBI1002 TOPAZOL 40 MG (RANAP) 4
108 OBI1617 TRIDE (RANAP) 5
109 OBI1045 UNALIUM 5 MG (RANAP) 15
110 OBJ1044 UNALIUM 5 MG (RJ) 15
111 OBJ1063 VALISANBE 2 MG (RJ) 94
112 OBJ1093 VITAMIN B-COMPLEX (RJ) 290
PERAWAT
1 OBI0001 A-B VASK 5 MG (RANAP) 1
2 OBI0007 ACRAN 3 ML (RANAP) 1
3 OBI1507 ALKOHOL 70% 100 ML (RANAP) 1
4 OBI0024 ALLOPURINOL 100 MG (RANAP) 3
5 OBJ0025 ALLOPURINOL 300 MG (RJ) 30
6 OBI1358 ALPRAZOLAM 0.5 MG (RANAP) 4
7 OBI1400 AMBROXOL 15 MG 60 ML (RANAP) 1
8 OBJ0032 AMBROXOL 30 MG (RJ) 60
9 OBI0035 AMINOPHYLLINE 10 ML (RANAP) 8
10 OBI0037 AMITRIPTYLINE 25 MG (RANAP) -4
11 OBI0038 AMLODIPINE 10 MG (RANAP) 2
12 OBJ0038 AMLODIPINE 10 MG (RJ) 20
13 OBJ0039 AMLODIPINE 5 MG (RJ) 50
14 OBJ0042 AMOXICILLIN 500 MG (RJ) 25
15 OBJ0044 AMOXSAN 500 MG (RJ) 200
16 OBI0052 ANALSIK (RANAP) 7
17 OBI0063 ANTRAIN 1 GR (RANAP) 1
18 OBJ0064 APIALYS 10 ML DROPS (RJ) 2
19 OBJ0065 APIALYS 100 ML (RJ) 2
20 OBJ0071 ARDIUM HD 500 MG (RJ) 15
21 OBJ0077 ASAM MEFENAMAT 500 MG (RJ) 35
22 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 6
23 OBI0079 ASERING 500 ML OTSU (RANAP) 4
24 OBI1352 ATORVASTATIN 20 MG (RANAP) 9
25 OBI0095 BECOM ZET (RANAP) 5
26 OBJ0095 BECOM ZET (RJ) 298
27 OBJ0096 BECOM-C (RJ) 200
28 OBJ1432 BETADINE GARGLE 190 ML (RJ) 1
29 OBI0102 BETAHISTINE 6 MG (RANAP) 24
30 OBJ0117 BISOPROLOL 5 MG (RJ) 30
31 OBI0129 BRAINACT 1000 MG 8 ML (RANAP) 6
32 OBI0134 BRAXIDIN (RANAP) 10
33 OBJ0142 BUSCOPAN PLUS (RJ) 4
34 OBI0141 BUSCOPAN TABLET (RANAP) 3
35 OBJ0143 CAL-95 (RJ) 6
36 OBI0144 CALCII GLUCONAS 10% 10 ML (RANAP) 5
37 OBJ0148 CANDESARTAN 8 MG (RJ) 30
38 OBI0153 CAPTOPRIL 25 MG (RANAP) 6
39 OBJ1501 CAVIPLEX TABLET (RJ) 30
40 OBJ0164 CEFADROXIL 250 MG 60 ML (RJ) 1
41 OBJ0165 CEFADROXIL 500 MG (RJ) 6
42 OBI1315 CEFAZOLIN 1 G (RANAP) 2
43 OBJ0171 CEFIXIME 100 MG (RJ) 1
44 OBJ1133 CEFIXIME 30 ML (RJ) 3
45 OBI0173 CEFOTAXIME 1 GR (RANAP) 2

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 40 / 53

No. No. Item Nama Item Jumlah
46 OBI0175 CEFTRIAXONE 1 GR (RANAP) 10
47 OBI0176 CEFXON 1 GR (RANAP) -1
48 OBJ1221 CENDO TIMOL 0.5% EYE DROP 5 ML (RJ) 2
49 OBI0186 CERNEVIT 750 MG (RANAP) 2
50 OBJ0202 CIPROFLOXACIN 500 MG (RJ) 10
51 OBI1156 CITICOLINE 500 MG 4 ML (RANAP) 35
52 OBI1641 CLOBAZAM 10 MG (RANAP) 2
53 OBI0214 CLOPIDOGREL 75 MG (RANAP) 5
54 OBJ0215 CODEIN 10 MG (RJ) 10
55 OBJ0220 COMBANTRIN ORANGE 10 ML (RJ) 1
56 OBI0227 CORTIDEX TABLET (RANAP) 10
57 OBJ0227 CORTIDEX TABLET (RJ) 4
58 OBJ0232 COUNTERPAIN 5 GR CREAM (RJ) 1
59 OBI0242 CTM 4 MG (RANAP) 6
60 OBI1650 CURCUMA FORCE (RANAP) 3
61 OBI0248 D10% 500 ML OTSU (RANAP) 2
62 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) 8
63 OBI1367 D5 - 1/4 NS 500 ML WIDA (RANAP) 1
64 OBI0252 D5% 500 ML OTSU (RANAP) 2
65 OBJ1952 DC2 (RJ) 6
66 OBI0256 DEHAF SACHET (RANAP) 13
67 OBJ0258 DESOLEX CREAM 10 GR (RJ) 3
68 OBJ0260 DEXAMETHASONE 0,50 MG (RJ) 40
69 OBI1323 DEXAMETHASONE AMPUL (RANAP) 2
70 OBI0267 DIAFORMIN XR 500 MG (RANAP) 50
71 OBI0274 DIPHENHYDRAMINE 1 ML (RANAP) 2
72 OBI1719 DIUTENSI 2 ML (RANAP) 25
73 OBI0282 DOMPERIDONE 10 MG (RANAP) 10
74 OBJ0282 DOMPERIDONE 10 MG (RJ) 100
75 OBJ1230 ECODINE IODINE 10% 30 ML (RJ) 2
76 OBI0785 ECODINE IODINE 10% 60 ML (RANAP) 2
77 OBI0322 ESOMAX 40 MG (RANAP) 1
78 OBI0325 EUPHYLLIN RETARD (RANAP) 30
79 OBI0329 EXOCID 40 MG (RANAP) -2
80 OBI1346 EZOMEB 40 MG (RANAP) 1
81 OBJ0348 F-G-TROCHES (RJ) 40
82 OBI0336 FARMABES 25 MG INJEKSI (RANAP) 40
83 OBI0338 FARMADOL 500 MG (RANAP) 8
84 OBJ0338 FARMADOL 500 MG (RJ) 60
85 OBJ1975 FARNORMIN 50 MG (RJ) 0
86 OBJ1944 FAVIPIRAVIR 200 MG (RJ) 100
87 OBJ0345 FEROSPAT EFF (RJ) 1
88 OBI0349 FIBESCO 300 MG (RANAP) 1
89 OBI1329 FLUNARIZINE 5 MG (RANAP) 21
90 OBJ1290 FLUNARIZINE 5 MG (RJ) 10
91 OBJ0364 FOLAPLUS (RJ) 20
92 OBJ0365 FOLAVIT 400 MCG (RJ) 10
93 OBI0374 FORTANEST 5 ML (RANAP) 1
94 OBI0378 FREGO 5 MG (RANAP) 1
95 OBI0386 FUTROLIT 500 ML (RANAP) 2
96 OBI1535 GASTRUCID 60 ML (RANAP) 1
97 OBJ0397 GENOINT SALEP MATA 0,3% 3,5 GR (RJ) 1

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 41 / 53

No. No. Item Nama Item Jumlah
98 OBJ0402 GLIMEPIRIDE 2 MG (RJ) 30
99 OBI1389 GLUCODEX 80 MG (RANAP) 1
100 OBJ0418 GLYCERYL GUAIACOLATE 100 MG (RJ) 4
101 OBI0423 GUANISTREP 60 ML (RANAP) 1
102 OBJ0423 GUANISTREP 60 ML (RJ) 1
103 OBJ0438 HEMOROGARD (RJ) 4
104 OBI0440 HEPA-BALANCE (RANAP) 4
105 OBI0450 HP PRO (RANAP) 2
106 OBJ1167 HUFAGRIP FORTE (RJ) 40
107 OBI0460 IMUNOS (RANAP) 10
108 OBJ0460 IMUNOS (RJ) 4
109 OBJ0464 INBION (RJ) 12
110 OBJ0470 INLACTA DHA FOR MOTHER (RJ) 2
111 OBI0491 KAEN 3B 500 ML OTSU (RANAP) 2
112 OBI0493 KALBAMIN 500 ML (RANAP) 3
113 OBJ0496 KALIUM DIKLOFENAK 50 MG (RJ) 36
114 OBJ0510 KETOCONAZOLE (RJ) 10
115 OBJ1346 KETOPROFEN 100 MG TABLET (RJ) 10
116 OBI1227 KETOROLAC INJEKSI (RANAP) 8
117 OBJ0515 KLODERMA CREAM 10 GR (RJ) 3
118 OBJ1978 KONIBAL (RJ) 20
119 OBI1433 KSR 600 MG - B (RANAP) 10
120 OBJ1530 L-ACYS 200 MG CAPSUL (RJ) 120
121 OBJ1980 LABUMIN (RJ) 5
122 OBJ0524 LACOLDIN (RJ) 15
123 OBI0529 LACTONA SKIM 300 GR (RANAP) 2
124 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) -4
125 OBJ0536 LAMESON 4 MG (RJ) 10
126 OBI0538 LANSOPRAZOLE 30 MG (RANAP) 8
127 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 20
128 OBI1334 LANSOPRAZOLE INJEKSI (RANAP) 1
129 OBI0541 LAPIBAL 500 MCG INJEKSI (RANAP) 4
130 OBJ0547 LAPIFED (RJ) 10
131 OBJ0553 LAPISIV-T (RJ) 13
132 OBJ1353 LASAL NEBU (RJ) 1
133 OBI0560 LASIX 2 ML (RANAP) 5
134 OBI1652 LAVIT-C 1000 MG (RANAP) 2
135 OBI1684 LAVIT-C 1000 MG 5 ML (RANAP) 2
136 OBI1565 LAVIT-C 500 MG 5 ML (RANAP) 3
137 OBJ0581 LODIA 2 MG (RJ) 10
138 OBI1373 LODOMER 5 MG/ML (RANAP) 1
139 OBJ1291 LORATADINE 10 MG (RJ) 13
140 OBI0594 MAXPRO 100 MG (RANAP) 10
141 OBJ1941 MECTINSANBE 12 MG (RJ) 10
142 OBI0599 MEFINAL 500 MG (RANAP) 10
143 OBI0601 MEFOZ 4 MG 2 ML (RANAP) 2
144 OBJ0604 MELOXICAM 15 MG (RJ) 20
145 OBI0608 MERISLON (RANAP) 6
146 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 13
147 OBJ1872 METAMIZOLE SODIUM 2 ML (RJ) 28
148 OBI0613 METFORMIN 500 MG (RANAP) 14
149 OBI1308 METHYLPREDNISOLON 125 MG INJEKSI (RANAP) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 42 / 53

No. No. Item Nama Item Jumlah
150 OBJ0614 METHYLPREDNISOLONE 4 MG (RJ) 35
151 OBJ0618 METRIX 2 MG (RJ) 30
152 OBJ1907 MIXALGIN (RJ) 60
153 OBJ0641 MONELL 10 ML (RJ) 1
154 OBI0648 MST CONTINUS 10 MG (RANAP) 5
155 OBJ0648 MST CONTINUS 10 MG (RJ) 20
156 OBI0654 MY JELLY SACHET 5 GR (RANAP) 4
157 OBI0658 MYONEP (RANAP) 3
158 OBJ0658 MYONEP (RJ) 6
159 OBI1527 N-ACE 3 ML SOL. FOR INHALATION (RANAP) 1
160 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 6
161 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 5
162 OBJ0663 NATABION (RJ) 10
163 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 20
164 OBJ0666 NEBACETINE POWDER 5 GR (RJ) 3
165 OBI1591 NEUCITI 500 MG (RANAP) 7
166 OBI0672 NEUCITI-500 MG 4 ML (RANAP) 0
167 OBI0674 NEURAXON 5000 (RANAP) 14
168 OBJ0675 NEUROBION FORTE 5000 MG (RJ) 44
169 OBJ1289 NEURODEX (RJ) 20
170 OBJ0676 NEUROSANBE (RJ) 3
171 OBI0677 NEUROSANBE 3 ML (RANAP) 2
172 OBJ0677 NEUROSANBE 3 ML (RJ) 58
173 OBJ0679 NEUROSANBE PLUS (RJ) 40
174 OBJ0685 NEW DIATABS (RJ) 12
175 OBI1277 NITROKAF RETARD (RANAP) 4
176 OBI0691 NORAGES 2 ML (RANAP) 5
177 OBJ0691 NORAGES 2 ML (RJ) 14
178 OBIBP0003 NOVORAPID - B (RANAP) 1
179 OBI0701 NS 100 ML OTSU (RANAP) 18
180 OBJ0701 NS 100 ML OTSU (RJ) 3
181 OBI0703 NS 25 ML OTSU (RANAP) 54
182 OBI0705 NS 500 ML OTSU (RANAP) 53
183 OBI1201 NS 500 ML SATORIA (RANAP) 61
184 OBJ1222 NS 500 ML SATORIA (RJ) 24
185 OBI0707 NUCRAL 100 ML (RANAP) 1
186 OBJ0713 OBH COMBI 100 ML (RJ) 3
187 OBI0719 ODR 4 MG 2 ML (RANAP) 13
188 OBJ0723 OMEPRAZOLE 20 MG (RJ) 10
189 OBI0722 OMEPRAZOLE INJEKSI (RANAP) 2
190 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 10
191 OBJ0725 ONDANCENTRON 4 MG 2 ML (RJ) 12
192 OBJ0726 ONDANSETRON 4 MG (RJ) 0
193 OBJ0736 OSKOM (RJ) 6
194 OBJ0737 OSSOVIT (RJ) 10
195 OBI0738 OSTELOX 15 MG SUPPO (RANAP) -2
196 OBI1722 PAMOL SUPPO (RANAP) 1
197 OBI0748 PANTOPRAZOLE 40 MG (RANAP) 7
198 OBI0749 PARACETAMOL 1000 MG 100 ML (RANAP) 3
199 OBI0751 PARACETAMOL 60 ML (RANAP) 3
200 OBI0768 PIDOVIX (RANAP) 4
201 OBJ0768 PIDOVIX (RJ) 0

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 43 / 53

No. No. Item Nama Item Jumlah
202 OBJ0769 PIMTRAKOL PLUS 60 ML (RJ) 3
203 OBI1263 PIRACETAM 12 GR 60 ML INFUS (RANAP) 1
204 OBI0771 PIRACETAM 800 MG (RANAP) 5
205 OBJ0774 PLANTACID FORTE (RJ) 6
206 OBJ0788 PREDNISONE 5 MG (RJ) 15
207 OBI0794 PRIMPERAN INJEKSI (RANAP) 1
208 OBI0811 PROPRANOLOL 10 MG (RANAP) 3
209 OBI0813 PRORIS 125 MG SUPPO (RANAP) 1
210 OBJ1935 PROVE D3 5000 IU (RJ) 88
211 OBJ1963 PROVE Z (RJ) 100
212 OBI0827 PUMPISEL 40 MG (RANAP) 1
213 OBI0830 PYSOLAN 30 MG (RANAP) 9
214 OBJ0830 PYSOLAN 30 MG (RJ) 5
215 OBI0835 RANITIDINE 2 ML (RANAP) 20
216 OBJ0835 RANITIDINE 2 ML (RJ) 21
217 OBI0837 RANTIN 50 MG 2 ML (RANAP) 0
218 OBJ1301 REGUMEN 5 MG (RJ) 4
219 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 22
220 OBI1202 RL 500 ML SATORIA (RANAP) 42
221 OBJ1465 ROSTIN 20 MG (RJ) 10
222 OBI0862 ROXEMID 10 MG/ML 2 ML (RANAP) 5
223 OBI0863 RYCEF 1 GR (RANAP) 2
224 OBJ0870 SAGESTAM 10 GR CREAM (RJ) 4
225 OBI0897 SANMOL 1000 MG 100 ML (RANAP) 0
226 OBI0898 SANMOL 500 MG (RANAP) 15
227 OBJ0898 SANMOL 500 MG (RJ) 134
228 OBI0899 SANMOL 60 MG 15 ML (RANAP) 1
229 OBI0900 SANMOL 60 ML (RANAP) 2
230 OBJ0900 SANMOL 60 ML (RJ) 2
231 OBJ0901 SANMOL FORTE 60 ML (RJ) 1
232 OBI1550 SANSULIN LOG-G DISPOPEN (RANAP) 1
233 OBJ0905 SANTA-E 200 MG (RJ) 8
234 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) 16
235 OBJ0906 SANTAGESIK 500 MG 2 ML (RJ) 16
236 OBI0914 SIDIADRYL 15 ML (RANAP) 2
237 OBI1203 SILEX 100 ML (RANAP) 1
238 OBJ0918 SIMVASTATIN 10 MG (RJ) 60
239 OBJ0919 SIMVASTATIN 20 MG (RJ) 60
240 OBI0931 SOLVINEX 2 ML (RANAP) 4
241 OBI0938 STARXON 1 GR (RANAP) 2
242 OBI0947 SUCRALFATE 100 ML (RANAP) 1
243 OBJ0947 SUCRALFATE 100 ML (RJ) 6
244 OBJ0949 SUMAGESIC (RJ) 4
245 OBJ0954 TALK SALICYL / POT (RJ) 1
246 OBI0956 TAMOLIV 1000 MG 100 ML (RANAP) 2
247 OBI0957 TAMOLIV 500 MG 50 ML (RANAP) 0
248 OBI0964 TAXECAP 1 GR (RANAP) -6
249 OBJ1917 TAZOVELL 30 MG (RJ) 50
250 OBJ0968 TEBOKAN FORTE 120 MG (RJ) 30
251 OBI0978 TERANOL 30 MG INJEKSI (RANAP) -3
252 OBI0980 TERFACEF 1 GR (RANAP) 1
253 OBI0989 THROMBOPHOB GEL 20 GR (RANAP) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 44 / 53

No. No. Item Nama Item Jumlah
254 OBI1002 TOPAZOL 40 MG (RANAP) 6
255 OBJ1014 TREMENZA (RJ) 12
256 OBJ1176 TRIATEC 5 MG (RJ) 30
257 OBI1617 TRIDE (RANAP) 12
258 OBJ1900 TRIDE (RJ) 14
259 OBJ1953 TRIFEDRIN (RJ) 3
260 OBI1607 TUTOSOL 500 ML (RANAP) 4
261 OBI1039 TUZALOS 15 MG (RANAP) -2
262 OBJ1038 TUZALOS 15 MG (RJ) 63
263 OBJ1043 UMARONE (RJ) 2
264 OBI1144 URSOLIC 250 MG (RANAP) 3
265 OBJ1063 VALISANBE 2 MG (RJ) 50
266 OBI1066 VALISANBE 5 MG 2 ML (RANAP) 1
267 OBJ1067 VALSARTAN - NI 80 MG (RJ) 30
268 OBI1070 VASCON 4 ML (RANAP) -3
269 OBJ1893 VAXIGRIP TETRA NH (RJ) 1
270 OBI1087 VITADION 2 MG/ML (RANAP) 13
271 OBI1438 WATER FOR IRGT. 1000 ML WIDA (RANAP) 1
272 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 18
273 OBJ1126 ZINC 20 MG (RJ) 5
274 OBI1393 ZINC 60 ML (RANAP) 1
Rahajeng, dr., Sp.KK
1 OBI0134 BRAXIDIN (RANAP) 10
2 OBI0947 SUCRALFATE 100 ML (RANAP) 1
Rahmad Adi Prasetyo, dr.
1 OBJ1298 ACETYLCYSTEINE 200 MG (RJ) 40
2 OBJ0038 AMLODIPINE 10 MG (RJ) 10
3 OBJ0054 ANALTRAM (RJ) 10
4 OBJ0069 ARCAPEC (RJ) 20
5 OBJ1529 AZITHROMYCIN 500 MG (RJ) 35
6 OBJ0095 BECOM ZET (RJ) 5
7 OBI0119 BLEDSTOP TABLET (RANAP) 10
8 OBJ0134 BRAXIDIN (RJ) 9
9 OBJ0141 BUSCOPAN TABLET (RJ) 10
10 OBJ0165 CEFADROXIL 500 MG (RJ) 10
11 OBJ0188 CETIRIZINE 10 MG (RJ) 10
12 OBI0252 D5% 500 ML OTSU (RANAP) 1
13 OBJ0272 DIMENHYDRINATE 50 MG (RJ) 10
14 OBJ0282 DOMPERIDONE 10 MG (RJ) 20
15 OBJ0283 DOMPERIDONE 60 ML (RJ) 1
16 OBI1583 DUROGESIC 12,5 (RANAP) 1
17 OBJ0338 FARMADOL 500 MG (RJ) 10
18 OBJ0365 FOLAVIT 400 MCG (RJ) 10
19 OBJ0461 IMUNOS 60 ML (RJ) 1
20 OBI0499 KALTROFEN SUPPO 100 MG (RANAP) 4
21 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 37
22 OBJ0599 MEFINAL 500 MG (RJ) 10
23 OBI0654 MY JELLY SACHET 5 GR (RANAP) 1
24 OBJ0676 NEUROSANBE (RJ) 5
25 OBJ0726 ONDANSETRON 4 MG (RJ) 6
26 OBI1722 PAMOL SUPPO (RANAP) 16
27 OBI0751 PARACETAMOL 60 ML (RANAP) 1

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 45 / 53

No. No. Item Nama Item Jumlah
28 OBJ1534 PROVE D3 400IU DROPS (RJ) 1
29 OBJ1935 PROVE D3 5000 IU (RJ) 6
30 OBI0834 RANITIDINE 150 MG (RANAP) 1
31 OBJ0834 RANITIDINE 150 MG (RJ) 9
32 OBJ0906 SANTAGESIK 500 MG 2 ML (RJ) 1
33 OBJ0925 SISTENOL (RJ) 10
34 OBJ0943 STESOLID RECTAL TUBES 5 MG / 2,5 ML (RJ) 3
35 OBJ0947 SUCRALFATE 100 ML (RJ) 7
36 OBJ1091 VITAMIN B6 10 MG (RJ) 6
37 OBI1105 VOSEDON 60 ML (RANAP) 1
Rini Kustiani, dr.
1 OBJ0064 APIALYS 10 ML DROPS (RJ) 1
2 OBJ1529 AZITHROMYCIN 500 MG (RJ) 5
3 OBI0095 BECOM ZET (RANAP) 10
4 OBJ0095 BECOM ZET (RJ) 6
5 OBJ0143 CAL-95 (RJ) 6
6 OBJ0152 CAPTOPRIL 12,5 MG (RJ) 1
7 OBJ0155 CARDISAN 5 MG (RJ) 10
8 OBI0165 CEFADROXIL 500 MG (RANAP) 10
9 OBI0226 CORTIDEX INJEKSI (RANAP) 1
10 OBJ1346 KETOPROFEN 100 MG TABLET (RJ) 10
11 OBI1681 L-VIT D3 5000 IU (RANAP) 10
12 OBJ1480 LAGESIL 100 ML (RJ) 2
13 OBI0536 LAMESON 4 MG (RANAP) 10
14 OBJ0545 LAPICEF 500 MG (RJ) 10
15 OBI0547 LAPIFED (RANAP) 10
16 OBJ0599 MEFINAL 500 MG (RJ) 10
17 OBI0654 MY JELLY SACHET 5 GR (RANAP) 2
18 OBI1686 NALITIK 200 MG CAPSUL (RANAP) 10
19 OBJ0676 NEUROSANBE (RJ) 6
20 OBI1722 PAMOL SUPPO (RANAP) 2
21 OBI0801 PROFENID SUPPO 100 MG (RANAP) 2
22 OBJ0801 PROFENID SUPPO 100 MG (RJ) 4
23 OBI0898 SANMOL 500 MG (RANAP) 10
24 OBJ1953 TRIFEDRIN (RJ) 3
25 OBJ1042 ULBAMED 100 MG (RJ) 10
Rony Antonius P.T., dr., Sp.A
1 OBI0007 ACRAN 3 ML (RANAP) 4
2 OBI0017 ALCO ORAL DROPS 15 ML (RANAP) 1
3 OBJ0017 ALCO ORAL DROPS 15 ML (RJ) 2
4 OBI0063 ANTRAIN 1 GR (RANAP) 1
5 OBJ0064 APIALYS 10 ML DROPS (RJ) 2
6 OBJ0110 BIOTHICOL 500 MG (RJ) 187
7 OBJ1436 BUFECT 60 ML (RJ) 1
8 OBI0163 CEFADROXIL 125 MG 60 ML (RANAP) 6
9 OBJ0163 CEFADROXIL 125 MG 60 ML (RJ) 68
10 OBI0164 CEFADROXIL 250 MG 60 ML (RANAP) 1
11 OBJ0164 CEFADROXIL 250 MG 60 ML (RJ) 5
12 OBJ0165 CEFADROXIL 500 MG (RJ) 15.5
13 OBJ0167 CEFAT DS 60 ML (RJ) 1
14 OBJ0168 CEFAT FORTE 60 ML (RJ) 1
15 OBJ1133 CEFIXIME 30 ML (RJ) 4

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 46 / 53

No. No. Item Nama Item Jumlah
16 OBI0172 CEFOPERAZONE 1 GR (RANAP) 1
17 OBI0173 CEFOTAXIME 1 GR (RANAP) 2
18 OBI0184 CEPTIK 30 ML (RANAP) 3
19 OBJ0184 CEPTIK 30 ML (RJ) 6
20 OBI0185 CERINI 10 MG (RANAP) 1.5
21 OBI0188 CETIRIZINE 10 MG (RANAP) 14
22 OBI0248 D10% 500 ML OTSU (RANAP) 1
23 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) 2
24 OBI1367 D5 - 1/4 NS 500 ML WIDA (RANAP) 1
25 OBJ0262 DEXTAMINE 60 ML (RJ) 1
26 OBJ0268 DIGENTA CREAM 10 GR (RJ) 1
27 OBJ0283 DOMPERIDONE 60 ML (RJ) 7
28 OBI0296 ELKANA 60 ML (RANAP) 1
29 OBJ0296 ELKANA 60 ML (RJ) 19
30 OBJ0315 ERYSANBE DS 60 ML (RJ) 1
31 OBJ0337 FARMACROL FORTE (RJ) 25
32 OBI0338 FARMADOL 500 MG (RANAP) 3
33 OBJ1863 FERVIT DROPS (RJ) 8
34 OBI0386 FUTROLIT 500 ML (RANAP) 3
35 OBI1430 GASTRIDIN 50 MG 2 ML (RANAP) 1
36 OBI1535 GASTRUCID 60 ML (RANAP) 3
37 OBJ1472 GASTRUCID 60 ML (RJ) 20
38 OBI0399 GENTAMICIN 0,1% 5 GR (RANAP) 1
39 OBJ0399 GENTAMICIN 0,1% 5 GR (RJ) 3
40 OBI0418 GLYCERYL GUAIACOLATE 100 MG (RANAP) 24.5
41 OBI0423 GUANISTREP 60 ML (RANAP) 3
42 OBJ0423 GUANISTREP 60 ML (RJ) 8
43 OBJ1366 HAVRIX JUNIOR 720 PFS (RJ) 3
44 OBI0453 HYDROCORTISONE 2,5% 5 GR KF (RANAP) 1
45 OBJ0453 HYDROCORTISONE 2,5% 5 GR KF (RJ) 4
46 OBI1713 IMMUCEA 60 ML (RANAP) 12
47 OBJ1558 IMMUCEA 60 ML (RJ) 21
48 OBJ0461 IMUNOS 60 ML (RJ) 1
49 OBJ0468 INFANRIX HEXA (RJ) 12
50 OBJ0476 INTERLAC PROBIOTIC DROPS 5 ML (RJ) 2
51 OBJ0477 INTERLAC SACHET (RJ) 5
52 OBI0481 INTERZINC 60 ML (RANAP) 1
53 OBJ0481 INTERZINC 60 ML (RJ) 2
54 OBJ0482 INTRIZIN 15 ML (RJ) 29
55 OBJ0483 INTRIZIN 60 ML (RJ) 10
56 OBJ1333 LACTULOSE 60 ML (RJ) 4
57 OBI1542 LAGESIL 100 ML (RANAP) 1
58 OBJ1480 LAGESIL 100 ML (RJ) 12
59 OBI1643 LAMESON SYRUP 30 ML (RANAP) 6
60 OBJ1544 LAMESON SYRUP 30 ML (RJ) 83
61 OBJ0543 LAPICEF - 125 60 ML (RJ) 2
62 OBJ0546 LAPICEF DROPS 15 ML (RJ) 1
63 OBJ1353 LASAL NEBU (RJ) 23
64 OBI1466 LASALCOM 2,5 ML CAIRAN INHALER (RANAP) 2
65 OBI1306 METAMIZOLE SODIUM 2 ML (RANAP) 2
66 OBJ0627 MICONAZOLE 2% 10 GR (RJ) 1
67 OBJ0641 MONELL 10 ML (RJ) 4

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 47 / 53

No. No. Item Nama Item Jumlah
68 OBI0668 NEO KAOLANA 120 ML (RANAP) 2
69 OBJ0668 NEO KAOLANA 120 ML (RJ) 11
70 OBI0701 NS 100 ML OTSU (RANAP) 2
71 OBJ0701 NS 100 ML OTSU (RJ) 2
72 OBI0703 NS 25 ML OTSU (RANAP) 19
73 OBI0705 NS 500 ML OTSU (RANAP) 0
74 OBI1201 NS 500 ML SATORIA (RANAP) 5
75 OBJ0712 NYMIKO 12 ML (RJ) 0
76 OBJ1328 NYSTATIN DROP 12 ML (RJ) 4
77 OBJ0720 ODR 4 MG 60 ML (RJ) 4
78 OBI0751 PARACETAMOL 60 ML (RANAP) 3
79 OBI0788 PREDNISONE 5 MG (RANAP) 39
80 OBJ0788 PREDNISONE 5 MG (RJ) 15
81 OBJ0792 PREVENAR (RJ) 14
82 OBJ0797 PROBIOKID SACHET (RJ) 15
83 OBI0818 PROSOGAN FD 15 MG (RANAP) 4
84 OBJ0818 PROSOGAN FD 15 MG (RJ) 19
85 OBJ1534 PROVE D3 400IU DROPS (RJ) 1
86 OBI0834 RANITIDINE 150 MG (RANAP) 22
87 OBI0835 RANITIDINE 2 ML (RANAP) 6
88 OBJ0836 RANIVEL 60 ML (RJ) 1
89 OBI0837 RANTIN 50 MG 2 ML (RANAP) 2
90 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 19
91 OBI1202 RL 500 ML SATORIA (RANAP) 13
92 OBJ0861 ROTARIX (RJ) 10
93 OBI0862 ROXEMID 10 MG/ML 2 ML (RANAP) 1
94 OBI0863 RYCEF 1 GR (RANAP) 12
95 OBI0871 SALBUTAMOL 2 MG (RANAP) 12.5
96 OBJ0896 SANMAG 120 ML (RJ) 1
97 OBJ0898 SANMOL 500 MG (RJ) 15
98 OBI0899 SANMOL 60 MG 15 ML (RANAP) 1
99 OBJ0899 SANMOL 60 MG 15 ML (RJ) 16
100 OBI0900 SANMOL 60 ML (RANAP) 2
101 OBJ0900 SANMOL 60 ML (RJ) 28
102 OBI0901 SANMOL FORTE 60 ML (RANAP) 3
103 OBJ0901 SANMOL FORTE 60 ML (RJ) 10
104 OBJ0908 SEDROFEN 60 ML (RJ) 30
105 OBI0909 SEDROFEN FORTE 60 ML (RANAP) 1
106 OBJ0909 SEDROFEN FORTE 60 ML (RJ) 10
107 OBJ0924 SIRPLUS TABLET (RJ) 5
108 OBI0943 STESOLID RECTAL TUBES 5 MG / 2,5 ML (RANAP) 1
109 OBI0979 TERASTARCH 500 ML (RANAP) 1
110 OBJ0985 THIAMPHENICOL 500 MG (RJ) 1.5
111 OBJ1041 TYPHIM VI (RJ) 2
112 OBJ1343 VAKSIN MMR II (RJ) 1
113 OBJ1227 VAKSIN VARICELLA (RJ) 1
114 OBI1266 VALPROIC ACID SIRUP 120 ML (RANAP) 1
115 OBJ1313 VALPROIC ACID SIRUP 120 ML (RJ) 2
116 OBJ1982 VARIVAX (RJ) 3
117 OBJ1893 VAXIGRIP TETRA NH (RJ) 7
118 OBI1087 VITADION 2 MG/ML (RANAP) 7
119 OBJ1104 VOSEDON 60 ML (RJ) 1

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 48 / 53

No. No. Item Nama Item Jumlah
120 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 12
121 OBJ1109 WATER FOR NJECTION 25 ML OTSU (RJ) 1
122 OBI1393 ZINC 60 ML (RANAP) 1
123 OBJ1324 ZINC 60 ML (RJ) 2
Tanti Mariana Wahono, dr., Sp.OG
1 OBI0007 ACRAN 3 ML (RANAP) 3
2 OBI0042 AMOXICILLIN 500 MG (RANAP) 25
3 OBI1341 ASAM TRANEXAMAT INJEKSI 250 MG (RANAP) 4
4 OBI0119 BLEDSTOP TABLET (RANAP) 25
5 OBJ0143 CAL-95 (RJ) 35
6 OBI1315 CEFAZOLIN 1 G (RANAP) 3
7 OBI0170 CEFILA-100 MG (RANAP) 10
8 OBI0175 CEFTRIAXONE 1 GR (RANAP) 3
9 OBI0226 CORTIDEX INJEKSI (RANAP) 10
10 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) 0
11 OBI0252 D5% 500 ML OTSU (RANAP) 1
12 OBI0293 DUVADILAN 20 MG (RANAP) 14
13 OBJ0293 DUVADILAN 20 MG (RJ) 30
14 OBI0345 FEROSPAT EFF (RANAP) 1
15 OBJ0345 FEROSPAT EFF (RJ) 7
16 OBJ0360 FLORAGYN (RJ) 45
17 OBJ1993 FOLAMIL GOLD (RJ) 30
18 OBJ0365 FOLAVIT 400 MCG (RJ) 30
19 OBI0467 INDUXIN 1 ML (RANAP) 4
20 OBI0498 KALNEX INJEKSI 250 MG (RANAP) 4
21 OBJ1980 LABUMIN (RJ) 10
22 OBI0530 LACTOPAIN 30 MG 1 ML (RANAP) 5
23 OBI0580 LIVRON B-PLEX (RANAP) 20
24 OBJ0580 LIVRON B-PLEX (RJ) 50
25 OBI1308 METHYLPREDNISOLON 125 MG INJEKSI (RANAP) 1
26 OBJ1871 MICROGEST 200 MG (RJ) 35
27 OBI1162 MYLANTA 50 ML (RANAP) 1
28 OBJ0667 NEO GYNOXA OVULA (RJ) 21
29 OBJ1457 NEXITRA 500 MG (RJ) 15
30 OBI0701 NS 100 ML OTSU (RANAP) 1
31 OBI1199 NUTRIFLAM (RANAP) 10
32 OBJ1209 NUTRIFLAM (RJ) 10
33 OBI0719 ODR 4 MG 2 ML (RANAP) 5
34 OBI1632 ONDANE 4 MG TABLET (RANAP) 10
35 OBJ1912 ONDANE 4 MG TABLET (RJ) 20
36 OBI0738 OSTELOX 15 MG SUPPO (RANAP) 6
37 OBJ0777 PLASMINEX (RJ) 40
38 OBI0794 PRIMPERAN INJEKSI (RANAP) 1
39 OBJ1174 PROMAVIT (RJ) 45
40 OBJ1301 REGUMEN 5 MG (RJ) 15
41 OBI0858 RL 500 ML OTSU / RINGER LACTATE (RANAP) 6
42 OBI1202 RL 500 ML SATORIA (RANAP) 2
43 OBJ1224 SILEX 100 ML (RJ) 1
44 OBI1000 TOFEDEX (RANAP) 10
45 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 1
Taufiequrrochman, dr., Sp.KK
1 OBJ0011 ACYCLOVIR 5% 5 GR (RJ) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 49 / 53

No. No. Item Nama Item Jumlah
2 OBJ1193 ASTATIN 4 MG (RJ) 20
3 OBJ0103 BETAMETASON 0,1% 5 GR KRIM (RJ) 1
4 OBJ0156 CARMED 20% 40 GR (RJ) 2
5 OBJ0188 CETIRIZINE 10 MG (RJ) 4
6 OBJ0207 CLARIHIS 10 MG (RJ) 133
7 OBJ0258 DESOLEX CREAM 10 GR (RJ) 8
8 OBJ0260 DEXAMETHASONE 0,50 MG (RJ) 36
9 OBJ0399 GENTAMICIN 0,1% 5 GR (RJ) 2
10 OBJ0460 IMUNOS (RJ) 19
11 OBJ0488 ITZOL 100 MG (RJ) 10
12 OBI0510 KETOCONAZOLE (RANAP) 10
13 OBJ0513 KETOMED CREAM 2% 15 GR (RJ) 3
14 OBJ0515 KLODERMA CREAM 10 GR (RJ) 8
15 OBJ0536 LAMESON 4 MG (RJ) 200
16 OBJ0545 LAPICEF 500 MG (RJ) 70
17 OBJ0574 LIDOCAIN 2% (RJ) 1
18 OBJ1291 LORATADINE 10 MG (RJ) 8
19 OBJ0586 LUSANOC 10 GR (RJ) 3
20 OBJ1289 NEURODEX (RJ) 10
21 OBJ1222 NS 500 ML SATORIA (RJ) 1
22 OBJ0870 SAGESTAM 10 GR CREAM (RJ) 8
23 OBJ0878 SALEP FOBAN, SAGESTAM (RJ) 1
24 OBJ1254 SCABIMITE CREAM 10 GR (RJ) 1
25 OBJ1903 VITALONG C (RJ) 42
Winangku, dr., Sp.S
1 OBI0001 A-B VASK 5 MG (RANAP) 8
2 OBJ0001 A-B VASK 5 MG (RJ) 30
3 OBJ1303 ALPRAZOLAM 0.5 MG (RJ) 14
4 OBI0038 AMLODIPINE 10 MG (RANAP) -2
5 OBJ0038 AMLODIPINE 10 MG (RJ) 10
6 OBJ0039 AMLODIPINE 5 MG (RJ) 194
7 OBI0054 ANALTRAM (RANAP) 15
8 OBJ0066 APTOR 100 MG (RJ) 60
9 OBJ0074 ARKINE 2 MG (RJ) 21
10 OBI1352 ATORVASTATIN 20 MG (RANAP) 20
11 OBJ0081 ATORVASTATIN 20 MG (RJ) 55
12 OBI0102 BETAHISTINE 6 MG (RANAP) 31
13 OBI0129 BRAINACT 1000 MG 8 ML (RANAP) 6
14 OBI0130 BRAINACT 500 MG 4 ML (RANAP) 1
15 OBI0132 BRAINACT ORAL 500 MG (RANAP) 14
16 OBJ0148 CANDESARTAN 8 MG (RJ) 90
17 OBI0152 CAPTOPRIL 12,5 MG (RANAP) 21
18 OBJ0153 CAPTOPRIL 25 MG (RJ) 180
19 OBJ0159 CATAFLAM FAST 50 MG (RJ) 10
20 OBI0175 CEFTRIAXONE 1 GR (RANAP) 4
21 OBI0203 CITICOLINE 500 MG (RANAP) 14
22 OBI1156 CITICOLINE 500 MG 4 ML (RANAP) 4
23 OBI0214 CLOPIDOGREL 75 MG (RANAP) 24
24 OBJ0214 CLOPIDOGREL 75 MG (RJ) 651
25 OBI0235 CPG 75 MG (RANAP) 20
26 OBJ0235 CPG 75 MG (RJ) 30
27 OBI1650 CURCUMA FORCE (RANAP) 15

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 50 / 53

No. No. Item Nama Item Jumlah
28 OBI1366 D5 - 1/2 NS 500 ML WIDA (RANAP) 5
29 OBI0263 DEXTROSE 40% / OTSU-D40 25 ML (RANAP) 1
30 OBJ0277 DIVASK 5 MG (RJ) 30
31 OBI0282 DOMPERIDONE 10 MG (RANAP) 2
32 OBI1360 EPERISONE HCL 50 MG (RANAP) 7
33 OBJ1305 EPERISONE HCL 50 MG (RJ) 10
34 OBI0338 FARMADOL 500 MG (RANAP) 1
35 OBJ0338 FARMADOL 500 MG (RJ) 40
36 OBJ0339 FARMASAL 100 MG (RJ) 30
37 OBI1478 FENOFIBRATE 300 MG (RANAP) 5
38 OBI1329 FLUNARIZINE 5 MG (RANAP) 28
39 OBJ1290 FLUNARIZINE 5 MG (RJ) 56
40 OBI0377 FREGO 10 MG (RANAP) 10
41 OBJ0377 FREGO 10 MG (RJ) 12
42 OBI0378 FREGO 5 MG (RANAP) 27
43 OBJ0378 FREGO 5 MG (RJ) 24
44 OBJ0387 GABAPENTIN 300 MG (RJ) 14
45 OBJ0402 GLIMEPIRIDE 2 MG (RJ) 30
46 OBI1389 GLUCODEX 80 MG (RANAP) 5
47 OBJ1334 GLUCOSAMINE 250 MG (RJ) 30
48 OBJ1330 HEXYMER 2 MG (RJ) 180
49 OBJ0456 IBUPROFEN 400 MG (RJ) 84
50 OBI0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RANAP) 1
51 OBI1227 KETOROLAC INJEKSI (RANAP) 2
52 OBJ1978 KONIBAL (RJ) 178
53 OBJ1513 LABALIN 75 MG (RJ) 60
54 OBJ1883 LACOSIB 60 MG (RJ) 10
55 OBI1604 LACOSIB 90 MG (RANAP) 10
56 OBJ1536 LACOSIB 90 MG (RJ) 7
57 OBJ0538 LANSOPRAZOLE 30 MG (RJ) 29
58 OBI0542 LAPIBAL 500 MG (RANAP) 9
59 OBJ0542 LAPIBAL 500 MG (RJ) 60
60 OBI0560 LASIX 2 ML (RANAP) 2
61 OBJ1515 LATROPIL 400 MG (RJ) 60
62 OBJ1516 LATROPIL 800 MG (RJ) 30
63 OBJ1885 LEPARSON (RJ) 90
64 OBIBP0002 LEVEMIR- B (RANAP) 1
65 OBJ1921 LEVOBEN (RJ) 84
66 OBJ0574 LIDOCAIN 2% (RJ) 1
67 OBJ0577 LISINOPRIL 5 MG (RJ) 30
68 OBJ0604 MELOXICAM 15 MG (RJ) 41
69 OBJ0605 MELOXICAM 7,5 MG (RJ) 14
70 OBI0608 MERISLON (RANAP) 38
71 OBJ0613 METFORMIN 500 MG (RJ) 180
72 OBI0638 MINIASPI 80 MG (RANAP) -2
73 OBJ0638 MINIASPI 80 MG (RJ) 67
74 OBI0648 MST CONTINUS 10 MG (RANAP) 3
75 OBJ0658 MYONEP (RJ) 10
76 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 10
77 OBI0665 NATRIUM DIKLOFENAK 50 MG (RANAP) -3
78 OBJ0665 NATRIUM DIKLOFENAK 50 MG (RJ) 42
79 OBI0672 NEUCITI-500 MG 4 ML (RANAP) 24

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 51 / 53

No. No. Item Nama Item Jumlah
80 OBI0703 NS 25 ML OTSU (RANAP) 2
81 OBI0705 NS 500 ML OTSU (RANAP) 12
82 OBI1201 NS 500 ML SATORIA (RANAP) 16
83 OBI0719 ODR 4 MG 2 ML (RANAP) 10
84 OBI0725 ONDANCENTRON 4 MG 2 ML (RANAP) 2
85 OBJ0736 OSKOM (RJ) 6
86 OBI0768 PIDOVIX (RANAP) 18
87 OBJ0768 PIDOVIX (RJ) 30
88 OBJ0771 PIRACETAM 800 MG (RJ) 74
89 OBJ0811 PROPRANOLOL 10 MG (RJ) 105
90 OBJ1874 PROVELYN 50 MG (RJ) 120
91 OBI0834 RANITIDINE 150 MG (RANAP) 38
92 OBJ0834 RANITIDINE 150 MG (RJ) 225
93 OBI0835 RANITIDINE 2 ML (RANAP) 29
94 OBI0837 RANTIN 50 MG 2 ML (RANAP) 10
95 OBI0897 SANMOL 1000 MG 100 ML (RANAP) 1
96 OBJ0898 SANMOL 500 MG (RJ) 20
97 OBJ0918 SIMVASTATIN 10 MG (RJ) 30
98 OBJ0947 SUCRALFATE 100 ML (RJ) 1
99 OBI0957 TAMOLIV 500 MG 50 ML (RANAP) 4
100 OBJ0987 THP / TRIHEXYPHENIDYL 2 MG (RJ) 63
101 OBJ1514 TINEURON (RJ) 0
102 OBJ0999 TOFEDEX (RJ) 24
103 OBI1015 TREMENZA (RANAP) 3
104 OBJ1022 TRILAC 10 MG 5 ML (RJ) 1
105 OBI1073 V-BLOC 6,25 MG (RANAP) 2
106 OBJ1063 VALISANBE 2 MG (RJ) 24
107 OBJ1127 ZITANID 2 MG (RJ) 14
Y. K. Freddy T.M., dr.
1 OBJ0032 AMBROXOL 30 MG (RJ) 10
2 OBJ0052 ANALSIK (RJ) 5
3 OBI0063 ANTRAIN 1 GR (RANAP) 3
4 OBI1352 ATORVASTATIN 20 MG (RANAP) 3
5 OBJ1529 AZITHROMYCIN 500 MG (RJ) 10
6 OBJ0095 BECOM ZET (RJ) 40
7 OBJ0096 BECOM-C (RJ) 5
8 OBI0110 BIOTHICOL 500 MG (RANAP) 12
9 OBI0129 BRAINACT 1000 MG 8 ML (RANAP) 3
10 OBI0148 CANDESARTAN 8 MG (RANAP) 4
11 OBJ0168 CEFAT FORTE 60 ML (RJ) 3
12 OBJ0170 CEFILA-100 MG (RJ) 20
13 OBJ0171 CEFIXIME 100 MG (RJ) 15
14 OBI0175 CEFTRIAXONE 1 GR (RANAP) 3
15 OBI1156 CITICOLINE 500 MG 4 ML (RANAP) 8
16 OBI0214 CLOPIDOGREL 75 MG (RANAP) 6
17 OBI0226 CORTIDEX INJEKSI (RANAP) 6
18 OBJ0227 CORTIDEX TABLET (RJ) 10
19 OBI0235 CPG 75 MG (RANAP) 1
20 OBI1650 CURCUMA FORCE (RANAP) 12
21 OBJ1882 CURCUMA FORCE (RJ) 75
22 OBJ1932 DEXAMETHASONE AMPUL (RJ) 3
23 OBI0269 DIGOXIN 0,25 MG (RANAP) 3

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 52 / 53

No. No. Item Nama Item Jumlah
24 OBI0338 FARMADOL 500 MG (RANAP) 12
25 OBI0350 FIBRAMED 300 MG (RANAP) 2
26 OBI1535 GASTRUCID 60 ML (RANAP) 1
27 OBJ0460 IMUNOS (RJ) 9
28 OBI0486 ISDN / ISOSORBIDE DINITRATE 5 MG (RANAP) 4
29 OBJ0492 KAFLAM 50 MG (RJ) 20
30 OBJ0506 KENALOG IN ORABASE 5 GR (RJ) 1
31 OBJ1241 KETOROLAC INJEKSI (RJ) 3
32 OBJ0524 LACOLDIN (RJ) 38
33 OBJ0525 LACOLDIN 60 ML (RJ) 4
34 OBI1609 LACOSIB 60 MG (RANAP) 10
35 OBI1334 LANSOPRAZOLE INJEKSI (RANAP) 2
36 OBI0601 MEFOZ 4 MG 2 ML (RANAP) 4
37 OBJ1872 METAMIZOLE SODIUM 2 ML (RJ) 3
38 OBJ0614 METHYLPREDNISOLONE 4 MG (RJ) 10
39 OBI0654 MY JELLY SACHET 5 GR (RANAP) 1
40 OBJ1955 NALITIK 200 MG CAPSUL (RJ) 10
41 OBI0677 NEUROSANBE 3 ML (RANAP) 1
42 OBJ0679 NEUROSANBE PLUS (RJ) 45
43 OBJ0685 NEW DIATABS (RJ) 8
44 OBI0687 NIFEDIPINE 10 MG (RANAP) 20
45 OBI0703 NS 25 ML OTSU (RANAP) 2
46 OBI0705 NS 500 ML OTSU (RANAP) 7
47 OBI1201 NS 500 ML SATORIA (RANAP) 2
48 OBI1319 OXYTOCIN INJEKSI (RANAP) 1
49 OBI1722 PAMOL SUPPO (RANAP) 1
50 OBJ0769 PIMTRAKOL PLUS 60 ML (RJ) 1
51 OBJ0788 PREDNISONE 5 MG (RJ) 30
52 OBI0801 PROFENID SUPPO 100 MG (RANAP) 2
53 OBJ1935 PROVE D3 5000 IU (RJ) 15
54 OBI0830 PYSOLAN 30 MG (RANAP) 3
55 OBI0834 RANITIDINE 150 MG (RANAP) 4
56 OBI0835 RANITIDINE 2 ML (RANAP) 6
57 OBI0837 RANTIN 50 MG 2 ML (RANAP) 1
58 OBI0862 ROXEMID 10 MG/ML 2 ML (RANAP) 3
59 OBI0906 SANTAGESIK 500 MG 2 ML (RANAP) 5
60 OBI1396 SPIRONOLACTONE 25 MG (RANAP) 3
61 OBI1002 TOPAZOL 40 MG (RANAP) 2
62 OBJ1900 TRIDE (RJ) 32
63 OBJ1038 TUZALOS 15 MG (RJ) 10
64 OBI1048 URI-CRAN (RANAP) 2
65 OBI1064 VALISANBE 2 MG (RANAP) 4
66 OBI1110 WATER FOR NJECTION 25 ML OTSU (RANAP) 3
67 OBJ1126 ZINC 20 MG (RJ) 12

Novika Far, 21 Mar 2022 15:09:32 RS Santa Clara Hal 53 / 53