Dedet Epo

DEPO RAWAT JALAN DINARAWAT JALA DINAS 8/30/2017 8/30/2017 10:28:00 RJD2017H004159
Nama Generik Nama Dagang

VALESCO 80 MG
VALESCO 80 MG
MAX 30 TAB/ BULAN MINIASPI MERS 80 MG
FUROSEMID 40MG YARI
FUROSEMID 40MG YARI
BISOPROLOL 5 MG HEXP
CLINDAMYCIN 300 MG NOVEL
GRATHEOS TAB 50 MG
PERESEPAN MAX UNTUK 10 HARI.HANYA UNTUK PASCEFIXIME DEXA 200MG
VECTRINE DEXA DRY SYR
OTOPAIN EARDROP
NITROKAF RETARD KIFA 2.5 MG
MAX 30 TAB/BULAN HERBESSER CD TANA 200 MG
MAX 30 TAB/BULAN HERBESSER CD TANA 200 MG
ALLOPURINOL 100MG/T
ALLOPURINOL 100MG/T
BETA ONE 2.5 MG KALBE
ROSUFER TAB 20 MG
VERSILON 6 MG MERSI
MECOLIN TAB 500 MCG
ATORVASTATIN 20 MG TAB YARINDO
GLUTROP
ULSIDEX DEXA 500 MG
OMEPRAZOLE HEXP 20 MG
VITAMIN B COMPLEX INFAR
VERSILON 6 MG MERSI
ASAM MEFENAMAT 500 MG (PHAP)
PERESEPAN MAX UNTUK 10 HARI AMOXCILILIN 500MG KIFA
CLINDAMYCIN INFA 150 MG
IBUPROFEN 400 MG
OSTEOCAL NICH 500 MG
FLAMAR EMULGEL 10 MG
CETIRIZINE DROP 12ML INFA
GRAFADON DROP 15 ML
CENDO FLOXA ED 5ML
SUPRAVIT
KURKUMEX SUSP
MAX 1 BOTOL/KASUS CEFIXIM DRY SYR PHAPROS /T
KURKUMEX SUSP
VECTRINE DEXA 300MG CAPS
CEFIXIME 100MG HEXP
NEO STOPFLUAD
UNTUK HIPERTENSI YANG INTOLERANSI TERHADAP CANDESARTAN 8 MG
NERILON 0.1 CR 10 GR
METHYL PREDNISOLON TABLET 8 MAHA
CETIRIZINE 10 MG HEXAPHARM /T
DESOXIMETASONE 0.25 15 GR
PARACETAMOL 500 MG /T
URINTER
TIDAK DIGUNAKAN UNTUK PASIEN USIA < 18 TAHU CIPROFLOXACIN 500 MG NOVELL
VALESCO 80 MG
VALESCO 80 MG
MAX 90 TAB/BULAN ISOSORBID DINITRATE YARINDO 5 MG
FUROSEMID 40MG YARI
FUROSEMID 40MG YARI
ULSIDEX DEXA 500 MG
LANSOPRAZOL NULAB 30MG
ONDANSETRON INFA 4 MG
KURKUMEX SUSP
PROHELIC
SIMVASTATIN 10 MG HEXP
OSSORAL DEXA 200 MG
PROHELIC
GRATHEOS TAB 50 MG
CETIRIZINE HCL SYR INFA 60ML
VITAMIN B12 KF
FLUNARIZINE TAB 10 MG T
LAFIHISTIN
DOMPERIDON 10 MG KIFA
PROFAT SYR
SANBE TEARS TM 8 ML
UNTUK PERDARAHAN MASIF ATAU BERPOTENSI PERASAM TRANEKSAMAT BERN 500 MG
MAX 60 TAB/BULAN METFORMIN BERN 850 MG
LOVEQUIN 500 MG
VALESCO 80 MG
VALESCO 80 MG
HESROID 500MG TAB
LAKTULOSA SYR 60ML
KETOPROFEN 100 MG DEXA
GLUCOSAMINE 500 MG
MELOXICAM TAB 15 MG BERNO
MAX 30 TAB/ BULAN GLUCODEX DEXA 80 MG
ACARBOSE DEXA 100MG E
MAX 30 TAB/ BULAN APTOR 100 TABLET
MAX 30 TAB/ BULAN APTOR 100 TABLET
MAX 30 TAB/BULAN.UNTUK HIPERTENSI YANG INTOLMICARDIS BOEH 80 MG
AMLODIPIN 10 MG HEXP
FOLIC ACID MARIN 1MG
SULTRIM SYR
PARACETAMOL SYRUP 60 ML LCS
SALBUTAMOL GRAF 2 MG
VENTOLIN NEBULES GLAX 25 MG
AMBROXOL 30 MG INFA
KERTAS PERKAMEN HAND BOND
DEXKETOPROFEN 25 MG TAB /T
MAX 30 TAB/BULAN.UNTUK HIPERTENSI YANG INTOLMICARDIS 40 MG BOEH
VALISANBE 2 MG
HESROID 500MG TAB
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
CENDO XITROL EO 3.5 GR
KURKUMEX SUSP
KERTAS PERKAMEN HAND BOND
ISONIAZID 300 MG E
KURKUMEX SUSP
ALOCLAIR GEL KALBE
KURKUMEX SUSP
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
NOPERTEN DEXA 5 MG
NOPERTEN DEXA 5 MG
VERSILON 6 MG MERSI
METFORMIN 500 MG HEXP
GLIMEPIRIDE 1 MG HEXP
GLIMEPIRIDE 1 MG HEXP
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
MECOLIN TAB 500 MCG
GRATHEOS TAB 50 MG
URINTER
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
APIALYS DROPS
NITRAL ACTA 500 MCG TAB
HEPA BALANCE
AMLODIPIN 5MG MDKN
MAX 30 TAB/ BULAN ARISKI 10 MG ACTA
HANYA DIGUNAKAN UNTUK PEMASANGAN STEN JANTU
CLOPIDOGREL DEXA 75MG /T
HANYA UNTUK HIPERTRIGLISERIDIMIA.TIDAK DIANJGEMFIBROZIL PHAP 300 MG /T
ROSUFER TAB 20 MG
VERSILON 6 MG MERSI
MECOLIN TAB 500 MCG
EVITCO 100 MG
SANBE TEARS TM 8 ML
CORALAN TAB 5 MG
HESROID 500MG TAB
EPERISON TAB MEDIKON
AVAMYS GLAX INTRANASAL SPRAY 120 DOSIS
GLUCOSAMINE 500 MG
MECOLIN TAB 500 MCG
RANITIDIN DEXA 150 MG /T
SIMVASTATIN 10 MG HEXP
TROPIDRYL PLUS SYRUP 60ML
PROFAT SYR
LYSCALVIT SYRUP 60 ML
BIONEMI KAPS
FLAZYMEC
GRATHEOS TAB 50 MG
HEPA BALANCE
SUPRAVIT
DULCOLAX BOEH SUPP 10 MG
PROFAT SYR
PURALEX TAB ATTALPUGITE 630 MG
DEPO RAWAT JALAN NON RAWAT JALA NON DINAS 8/30/2017 8/30/2017 13:54:00 RJND2017H017596
INOXIN 400MG
RIFAMPICIN 450 MG INFA
DEPO RAWAT INAP DINASRAWAT INAP DINAS 8/30/2017 8/30/2017 14:41:00 RID2017H001553
CELOCID INJ 750 MG OPL
UNTUK TROMBOEMBOLI DAN SINDROM KORONER AARIXTRA GLAX INJ 2.5 MG
CORMEGA OPL
MINIASPI 80 MG R
ROSUFER TAB 20 MG
DEPO RAWAT INAP NON DRAWAT INAP NON DINAS 8/30/2017 8/30/2017 14:46:00 RIND2017H004969
SUPRAFENID MEF SUPP
ATORVASTATIN 20 MG /T
BRAINACT 1000 8ML INJEKSI
NACL 0.9 500 ML
LEVOFLOXACIN INF 100ML
DISPOSABLE SYRINGE 50 ML TERUMO (LT)
MAX 90 TAB/BULAN CAPTOPRIL HEXP 12.5 MG
MAYO TUBE SIMACLUS 4
URESIX INJ
MAAGSLAANG 16/T
CEFTIZOXIME 1 GR
DISPOSABLE SYRINGE 5 ML TERUMO
IV DRESSING 3M 50
NACL 100ML SANBE
MAX 30 TAB/BULAN CONCOR MERC 2.5 MG
RINGER LAKTAT WIDA 500 ML
DISPOSABLE SYRINGE 10 CC TERUMO (AMP)
NATTO TAB OPL
SURPLUG 3B.30CM LOCK
URESIX INJ
PERFUSOR TUBE WHITE 150 NRC
CORMEGA OPL
ALKOHOL SWAB COSMO
IV CATHETER 24 WING COSMO
INFUSION SET MICRO COSMO
DISPOSABLE SYRINGE 3 CC TERUMO AMP
30A077 ENTIN SURTI00146293 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
30A078 YANI SURYAN00140799 - - -
Jumlah Satuan
10 CAPSUL
10 TAB
30A079 EZRA PRADIP00498609 - - -
Jumlah Satuan
10 TAB
1 BTL
1 BTL
30A080 PONINGRAT 00288208 - - -
Jumlah Satuan
23 TAB
7 TAB
23 CAPSUL
7 CAPSUL
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
30 TAB
30A081 EEN ROHAYA00044381 - - -
Jumlah Satuan
23 TAB
7 TAB
10 TAB
10 CAPSUL
15 TAB
30A082 M. AUFA THO00304746 - - -
Jumlah Satuan
15 CAPSUL
3 CAPSUL
30A083 SIMON GERU00055814 - - -
Jumlah Satuan
10 TAB
5 CAPSUL
30A084 ERVINNA CIT00051138 - - -
Jumlah Satuan
7 TAB
7 TAB
10 TAB
30A090 INDRI JASTO00280186 - - -
Jumlah Satuan
10 TAB
10 TAB
30A092 FENTY, S.HU 00032477 - - -
Jumlah Satuan
10 TAB
10 CAPSUL
30A085 SALWA AMAL00512876 - - -
Jumlah Satuan
20 TAB
20 TAB
1 TUBE
30A086 MUHAMMAD G
00484368 - - -
Jumlah Satuan
1 FLES
1 BTL
30A086 MUHAMMAD G
00484368 - - -
Jumlah Satuan
1 BTL
30A087 AGUNG PERM00227853 - - -
Jumlah Satuan
7 CAPSUL
30A088 TARA HASIAN00513649 - - -
Jumlah Satuan
1 BTL
1 BTL
30A089 MOCH.NUGRA00396115 - - -
Jumlah Satuan
1 BTL
30A091 SABARI 00100315 - - -
Jumlah Satuan
10 CAPSUL
10 CAPLET
30A091 SABARI 00100315 - - -
Jumlah Satuan
15 TAB
69 TAB
21 TAB
23 TAB
7 TAB
23 TAB
7 TAB
30A098 MIMING KAM00115416 - - -
Jumlah Satuan
1 TUBE
14 TAB
10 TAB
1 TUBE
30A093 SAHRONI 00166406 - - -
Jumlah Satuan
10 TAB
10 TAB
10 TAB
30A094 DIAN FARIDA00288478 - - -
Jumlah Satuan
23 TAB
7 TAB
69 TAB
21 TAB
23 TAB
7 TAB
30A095 DWI HERTAN00512905 - - -
Jumlah Satuan
10 TAB
10 CAPSUL
14 TAB
30A096 APRILIA AZW00448431 - - -
Jumlah Satuan
1 BTL
30A099 TANTI KRIST00489951 - - -
Jumlah Satuan
10 TAB
30A100 METRAWATI 00309760 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
30 TAB
30A101 LASMI YUANA00216717 - - -
Jumlah Satuan
5 TAB
5 TAB
30A102 DESY SAFAR 00056630 - - -
Jumlah Satuan
10 TAB
30A103 BAEDOWI. T 00157459 - - -
Jumlah Satuan
10 TAB
30A104 BIMASAKTI 00374654 - - -
Jumlah Satuan
1 BTL
30A106 KOMAROHADI00011661 - - -
Jumlah Satuan
10 CAPSUL
10 TAB
10 TAB
10 TAB
30A108 ANISSA WUL 00466869 - - -
Jumlah Satuan
1 TUBE
10 TAB
1 TUBE
30A112 IRWANSYAH 00448195 - - -
Jumlah Satuan
30 TAB
1 BTL
30A112 IRWANSYAH 00448195 - - -
Jumlah Satuan
1 BTL
30A113 ADRI ANOFEL,
00376441 - - -
Jumlah Satuan
10 TAB
30A113 ADRI ANOFEL,
00376441 - - -
Jumlah Satuan
20 TAB
46 TAB
14 TAB
7 TAB
30A109 ARNIDA THA 00000162 - - -
Jumlah Satuan
23 TAB
7 TAB
15 TAB
23 TAB
7 TAB
30A110 MATULLAH.T 00369924 - - -
Jumlah Satuan
20 TAB
1 BTL
6 TAB
30A111 FEBRI TRI I 00366580 - - -
Jumlah Satuan
20 TAB
20 TAB
20 TAB
30A114 SITI SUPRIAN00254340 - - -
Jumlah Satuan
46 TAB
14 TAB
46 TAB
14 TAB
46 TAB
14 TAB
30A120 ERLI SUPARL00454947 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
7 TAB
23 TAB
30A115 IMAS YUNING00493593 - - -
Jumlah Satuan
30 TAB
30A116 MUHAMMAD S00390853 - - -
Jumlah Satuan
1 BTL
1 BTL
30A117 BY NY WARTI00504438 - - -
Jumlah Satuan
4 TAB
1 VIAL
1 BTL
1 TAB
15 LEMBAR
30A118 OMAH RAHM 00112052 - - -
Jumlah Satuan
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
10 TAB
30A119 LILIS FATIMA00067905 - - -
Jumlah Satuan
20 TAB
30A112 SUHARTO.TN00306889 - - -
Jumlah Satuan
30 TAB
30 TAB
30A123 MADE YADI 00513639 - - -
Jumlah Satuan
1 TUBE
15 TAB
10 TAB
30A124 DONHARVEST00451243 - - -
Jumlah Satuan
1 BTL
30 LEMBAR
18 TAB
30A125 JET JAYDEN 00467326 - - -
Jumlah Satuan
1 BTL
30A126 AGUS SUHAR00104854 - - -
Jumlah Satuan
10 TAB
10 TAB
1 TUBE
30A127 ABYAN ALFAR00314130 - - -
Jumlah Satuan
12 TAB
1 BTL
30A128 MEIDIAN AD 00249388 - - -
Jumlah Satuan
1 BTL
30A130 H. ASEP SUP 00191570 - - -
Jumlah Satuan
30 TAB
1 TUBE
30 TAB
30A131 HJ. LILIS NU 00077387 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
30 TAB
30A131 HJ. LILIS NU 00077387 - - -
Jumlah Satuan
7 TAB
23 TAB
7 TAB
10 TAB
30A132 BUDIYANTO. 00142940 - - -
Jumlah Satuan
46 TAB
14 TAB
23 TAB
7 TAB
30A133 AKHMAD HID00131050 - - -
Jumlah Satuan
20 TAB
10 TAB
1 TUBE
20 CAPSUL
20 TAB
30A134 AMIR HUSEN 00486865 - - -
Jumlah Satuan
10 TAB
10 TAB
30A135 SIDIK PRAM 00513682 - - -
Jumlah Satuan
30 TAB
30 TAB
30A137 ALDI PRANAT00488227 - - -
Jumlah Satuan
1 BTL
30A139 VIRA RIZKY 00275026 - - -
Jumlah Satuan
1 BTL
30A140 VINA DEANIT00299912 - - -
Jumlah Satuan
10 CAPSUL
10 TAB
30A141 TONI PADILA00121266 - - -
Jumlah Satuan
23 TAB
7 TAB
15 CAPSUL
30A142 YANUAR RIZK00031280 - - -
Jumlah Satuan
7 CAPSUL
10 TAB
30A138 KARYONO. T 00056886 - - -
Jumlah Satuan
60 TAB
90 TAB
30 TAB
30A066 HANDY RICA 00293067 - - -
Jumlah Satuan
30 TAB
30A145 NENDEN NUR00427969 - - -
Jumlah Satuan
30 TAB
30 TAB
23 TAB
7 TAB
30 TAB
30A146 AGUS PERMAN
00227098 - - -
Jumlah Satuan
15 CAPSUL
23 TAB
7 TAB
23 TAB
7 TAB
20 TAB
30 CAPSUL
30A138 KARYONO. T 00056886 - - -
Jumlah Satuan
10 CAPSUL
1 BTL
30A091 SABARI 00100315 - - -
Jumlah Satuan
30 TAB
30A143 ICHWAL F 00513691 - - -
Jumlah Satuan
6 TAB
15 TAB
30A154 NI NYOMAN S00513714 - - -
Jumlah Satuan
10 TAB
10 TAB
30A143 ICHWAL F 00513691 - - -
Jumlah Satuan
1 BTL
10 TAB
30A144 MASPUPAH.N00155346 - - -
Jumlah Satuan
20 TAB
20 CAPSUL
30A147 YUSNAENI B 00076126 - - -
Jumlah Satuan
10 TAB
10 TAB
30 TAB
30A148 WIDANINGSIH
00117385 - - -
Jumlah Satuan
14 TAB
15 TAB
7 CAPSUL
1 BTL
1 BTL
30A149 DIDAN RAFA 00423007 - - -
Jumlah Satuan
1 BTL
30A115 IMAS YUNING00493593 - - -
Jumlah Satuan
20 CAPSUL
30A112 IRWANSYAH 00448195 - - -
Jumlah Satuan
30 TAB
30 CAPSUL
30A150 YULIA WARLI00014629 - - -
Jumlah Satuan
10 TAB
30A151 ARUB MUHAM00513703 - - -
Jumlah Satuan
15 TAB
5 TAB
30A022 NOVI HERDIA00287018 - - -
Jumlah Satuan
14 CAPSUL
10 CAPSUL
30A009 SRI ASTUTI 00503229 - - -
Jumlah Satuan
4 SUPP
30A152 RAYHAN INDR00264307 - - -
Jumlah Satuan
15 TAB
15 CAPSUL
1 BTL
20 TAB
30C165 IMAS ENI NU00110024 - - -
Jumlah Satuan
12 TAB
12 CAPLET
PATRIA RAH 00126312 - - -
Jumlah Satuan
3 AMP
ACEP DADI 00219816 - - -
Jumlah Satuan
2 TAB
1 VIAL
2 TAB
1 TAB
1 TAB
1 TAB
FAIZAL AMIN00509461 - - -
Jumlah Satuan
2 AMP
DERAWATI G00001906 - - -
Jumlah Satuan
2 SUPP
NANIH 00513265 - - -
Jumlah Satuan
2 TAB
2 AMP
3 LABU
1 FLES
1 PCS
1 TAB
1 PCS
2 AMP
1 PCS
MIMIN MINTA00090584 - - -
Jumlah Satuan
2 VIAL
1 TAB
3 PCS
1 PCS
4 LABU
1 BTL
1 TAB
1 BTL
1 VIAL
4 PCS
3 TAB
1 PCS
2 AMP
1 PCS
1 TAB
10 PCS
1 PCS
1 PCS
3 PCS
POLI JANTUNG 103,080 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
2,816 64,768
2,816 19,712
146 3,358
146 1,022
141 3,243
141 987
333 7,659
333 2,331
POLI GIGI DAN MULUT 20,020 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT P
Harga Total
1,658 16,580
344 3,440
POLI THT 131,466 0 RISKA PANDIUnchecked BPJS AD KELUARGA
Harga Total
2,840 28,400
50,688 50,688
52,378 52,378
POLI JANTUNG 546,300 0 MULYAWAN Unchecked BPJS AD MIL SATDIK
Harga Total
1,920 44,160
1,920 13,440
5,952 136,896
5,952 41,664
146 3,358
146 1,022
191 4,393
191 1,337
817 18,791
817 5,719
9,184 275,520
POLI SYARAF 109,470 0 RISKA PANDIUnchecked BPJS AD SIPIL
Harga Total
146 3,358
146 1,022
2,197 21,970
1,481 14,810
4,554 68,310
POLI BEDAH UMUM 87,069 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
1,658 24,870
20,733 62,199
POLI JANTUNG 6,550 0 MULYAWAN Unchecked BPJS ANGKATAN DARAT
Harga Total
472 4,720
366 1,830
POLI SYARAF 23,335 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
146 1,022
49 343
2,197 21,970
POLI GIGI DAN MULUT 6,850 0 RISKA PANDIUnchecked BPJS AD KELUARGA
Harga Total
275 2,750
410 4,100
POLI GIGI DAN MULUT 11,740 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
275 2,750
899 8,990
POLI BEDAH ORTHOPEDI 35,820 0 RISKA PANDIUnchecked BPJS UMUM POLRI
Harga Total
239 4,780
716 14,320
16,720 16,720
POLI KESEHATAN ANAK 41,888 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
33,440 33,440
8,448 8,448
POLI MATA 42,980 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
42,980 42,980
POLI P. DALAM 4,599 0 RISKA PANDIUnchecked BPJS AD KELUARGA
Harga Total
657 4,599
POLI KESEHATAN ANAK 31,329 0 RISKA PANDIUnchecked BPJS AD KELUARGA
Harga Total
11,335 11,335
19,994 19,994
POLI KESEHATAN ANAK 11,335 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
11,335 11,335
POLI P. DALAM 65,920 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
5,632 56,320
960 9,600
Harga Total
192 2,880
1,920 132,480
1,920 40,320
888 20,424
888 6,216
817 18,791
817 5,719
POLI KULIT & KELAMIN 64,126 0 RISKA PANDIUnchecked BPJS AD KELUARGA
Harga Total
42,240 42,240
414 5,796
329 3,290
12,800 12,800
POLI BEDAH UROLOGI 27,910 0 RISKA PANDIUnchecked BPJS AD MIL SATBANMIN
Harga Total
212 2,120
1,725 17,250
854 8,540
POLI MATA 99,150 0 RISKA PANDIUnchecked BPJS UMUM ASKES NON T
Harga Total
2,816 64,768
2,816 19,712
116 8,004
116 2,436
141 3,243
141 987
POLI P. DALAM 20,110 0 RISKA PANDIUnchecked BPJS AD MIL SATDIK
Harga Total
472 4,720
692 6,920
605 8,470
POLI KESEHATAN ANAK 11,335 0 RISKA PANDIUnchecked BPJS AD MIL SATBANMIN
Harga Total
11,335 11,335
POLI KEBIDANAN DAN KA 48,390 0 RISKA PANDIUnchecked BPJS AD MIL SATDIK
Harga Total
4,839 48,390
POLI JANTUNG 37,770 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT P
Harga Total
888 20,424
888 6,216
116 2,668
116 812
255 7,650
POLI KEBIDANAN DAN KA 29,955 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
1,152 5,760
4,839 24,195
POLI GIGI DAN MULUT 3,440 0 RISKA PANDIUnchecked BPJS AD SIPIL
Harga Total
344 3,440
POLI KULIT & KELAMIN 3,290 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
329 3,290
Harga Total
12,696 12,696
POLI P. DALAM 54,630 0 RISKA PANDIUnchecked BPJS AD MIL SATDIK
Harga Total
692 6,920
605 6,050
86 860
4,080 40,800
Harga Total
42,240 42,240
507 5,070
12,800 12,800
Harga Total
517 15,510
52,182 52,182
Harga Total
28,653 28,653
POLI THT 3,290 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
329 3,290
POLI P. DALAM 176,712 0 MULYAWAN Unchecked BPJS ANGKATAN DARAT
Harga Total
1,577 31,540
2,091 96,186
2,091 29,274
2,816 19,712
POLI JANTUNG 113,115 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
2,816 64,768
2,816 19,712
275 4,125
817 18,791
817 5,719
POLI BEDAH UMUM 153,526 0 RISKA PANDIUnchecked BPJS AD KELUARGA
Harga Total
5,703 114,060
30,976 30,976
1,415 8,490
POLI BEDAH ORTHOPEDI 70,780 0 RISKA PANDIUnchecked BPJS AD MIL SATBANMIN
Harga Total
1,533 30,660
716 14,320
1,290 25,800
POLI P. DALAM 202,560 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
301 13,846
301 4,214
984 45,264
984 13,776
2,091 96,186
2,091 29,274
Harga Total
201 4,623
201 1,407
6,924 159,252
6,924 48,468
214 1,498
214 4,922
POLI P. DALAM 4,530 0 RISKA PANDIUnchecked BPJS AU KELUARGA
Harga Total
151 4,530
Harga Total
4,731 4,731
4,788 4,788
Harga Total
120 480
5,120 5,120
19,994 19,994
184 184
449 6,735
POLI SYARAF 152,546 0 RISKA PANDIUnchecked BPJS UMUM PENSIUNAN H
Harga Total
4,178 29,246
3,898 89,654
3,898 27,286
146 3,358
146 1,022
198 1,980
POLI BEDAH UMUM 114,060 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
5,703 114,060
POLI BEDAH ORTHOPEDI 56,310 0 RISKA PANDIUnchecked BPJS AD SIPIL
Harga Total
1,533 45,990
344 10,320
POLI MATA 63,177 0 RISKA PANDIUnchecked BPJS AD MIL SATBANMIN
Harga Total
50,512 50,512
275 4,125
854 8,540
POLI KESEHATAN ANAK 28,801 0 RISKA PANDIUnchecked BPJS AD MIL SATDIK
Harga Total
11,335 11,335
449 13,470
222 3,996
Harga Total
11,335 11,335
POLI GIGI DAN MULUT 109,741 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
212 2,120
410 4,100
103,521 103,521
POLI KESEHATAN ANAK 45,415 0 MULYAWAN Unchecked BPJS ANGKATAN DARAT K
Harga Total
2,840 34,080
11,335 11,335
POLI P. DALAM 50,688 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT P
Harga Total
50,688 50,688
POLI BEDAH ORTHOPEDI 72,390 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
1,533 45,990
16,080 16,080
344 10,320
Harga Total
1,920 44,160
1,920 13,440
408 9,384
408 2,856
146 3,358
146 1,022
4,554 136,620
POLI SYARAF 258,936 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
4,178 29,246
6,924 159,252
6,924 48,468
2,197 21,970
Harga Total
121 5,566
121 1,694
249 5,727
249 1,743
POLI BEDAH ORTHOPEDI 90,400 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
1,533 30,660
716 7,160
16,080 16,080
1,481 29,620
344 6,880
POLI BEDAH UROLOGI 20,000 0 RISKA PANDIUnchecked BPJS UMUM PENSIUNAN H
Harga Total
1,725 17,250
275 2,750
Harga Total
1,533 45,990
344 10,320
Harga Total
46,464 46,464
Harga Total
50,688 50,688
Harga Total
692 6,920
605 6,050
POLI JANTUNG 62,220 0 RISKA PANDIUnchecked BPJS AD MIL SATPUR
Harga Total
1,728 39,744
1,728 12,096
692 10,380
POLI P. DALAM 111,239 0 RISKA PANDIUnchecked BPJS ANGKATAN LAUT MIL
Harga Total
15,027 105,189
605 6,050
Harga Total
301 18,060
121 10,890
1,106 33,180
POLI JIWA 732,450 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
24,415 732,450
POLI JANTUNG 536,370 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
7,181 215,430
697 20,910
817 18,791
817 5,719
9,184 275,520
POLI SYARAF 310,850 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
692 10,380
6,924 159,252
6,924 48,468
146 3,358
146 1,022
2,197 43,940
1,481 44,430
Harga Total
3,612 36,120
28,653 28,653
Harga Total
9,293 278,790
POLI BEDAH UMUM 110,613 0 RISKA PANDIUnchecked BPJS AD MIL SATBANMIN
Harga Total
4,178 25,068
5,703 85,545
Harga Total
4,178 41,780
1,439 14,390
POLI THT 133,070 0 RISKA PANDIUnchecked BPJS AD MIL SATBANMIN
Harga Total
129,780 129,780
329 3,290
POLI BEDAH ORTHOPEDI 60,280 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
1,533 30,660
1,481 29,620
Harga Total
279 2,790
716 7,160
255 7,650
POLI P. DALAM 104,655 0 MULYAWAN Unchecked BPJS ANGKATAN DARAT K
Harga Total
2,840 39,760
212 3,180
692 4,844
4,689 4,689
52,182 52,182
POLI KESEHATAN ANAK 4,309 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT
Harga Total
4,309 4,309
POLI P. DALAM 27,460 0 MULYAWAN Unchecked BPJS AU KELUARGA
Harga Total
1,373 27,460
Harga Total
1,824 54,720
366 10,980
Harga Total
344 3,440
Harga Total
2,840 42,600
329 1,645
Harga Total
15,027 210,378
657 6,570
POLI P. DALAM 29,696 0 MULYAWAN Unchecked BPJS AD KELUARGA
Harga Total
7,424 29,696
POLI P. DALAM 103,872 0 RISKA PANDIUnchecked BPJS ANGKATAN DARAT K
Harga Total
2,840 42,600
366 5,490
52,182 52,182
180 3,600
POLI PARU-PARU 17,856 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
376 4,512
1,112 13,344
RUANG PAVILIUN FLAMBO 206,175 1 DINA MARYA Unchecked BPJS ANGKATAN DARAT K
Harga Total
68,725 206,175
RUANG PERAWATAN III 345,063 1 DINA MARYA Unchecked BPJS AD MIL SATBANPUR
Harga Total
1,728 3,456
304,501 304,501
13,250 26,500
605 605
817 817
9,184 9,184
RUANG PAVILIUN MELATI 137,450 1 DINA MARYA Unchecked BPJS UMUM MANDIRI
Harga Total
68,725 137,450
RUANG PAVILIUN MAWAR 7,140 1 DINA MARYA Unchecked BPJS ANGKATAN DARAT K
Harga Total
3,570 7,140
RUANG PERAWATAN III 416,764 1 DINA MARYA Unchecked BPJS UMUM MANDIRI
Harga Total
5,914 11,828
126,126 252,252
8,205 24,615
24,949 24,949
30,272 30,272
82 82
37,120 37,120
7,084 14,168
21,478 21,478
RUANG PERAWATAN III 894,615 1 DINA MARYA Unchecked BPJS UMUM JAMSOSTEK
Harga Total
124,740 249,480
7,181 7,181
2,048 6,144
5,069 5,069
15,228 60,912
50,688 50,688
832 832
9,152 9,152
304,501 304,501
2,560 10,240
10,594 31,782
65,079 65,079
7,084 14,168
44,800 44,800
13,400 13,400
206 2,060
6,016 6,016
5,632 5,632
2,493 7,479
BPJS ANGKATAN DARAT
64,768
19,712
3,358
1,022
3,243
987
7,659
2,331
BPJS ANGKATAN DARAT P
16,580
3,440
BPJS AD KELUARGA
28,400
50,688
52,378
BPJS AD MIL SATDIK
44,160
13,440
136,896
41,664
3,358
1,022
4,393
1,337
18,791
5,719
275,520
BPJS AD SIPIL
3,358
1,022
21,970
14,810
68,310
BPJS ANGKATAN DARAT K
24,870
62,199
BPJS ANGKATAN DARAT
4,720
1,830
1,022
343
21,970
BPJS AD KELUARGA
2,750
4,100
2,750
8,990
BPJS UMUM POLRI
4,780
14,320
16,720
BPJS ANGKATAN DARAT
33,440
8,448
BPJS ANGKATAN DARAT
42,980
BPJS AD KELUARGA
4,599
BPJS AD KELUARGA
11,335
19,994
11,335
BPJS ANGKATAN DARAT
56,320
9,600
BPJS ANGKATAN DARAT
2,880
132,480
40,320
20,424
6,216
18,791
5,719
BPJS AD KELUARGA
42,240
5,796
3,290
12,800
BPJS AD MIL SATBANMIN
2,120
17,250
8,540
BPJS UMUM ASKES NON T
64,768
19,712
8,004
2,436
3,243
987
BPJS AD MIL SATDIK
4,720
6,920
8,470
11,335
BPJS AD MIL SATDIK
48,390
20,424
6,216
2,668
812
7,650
5,760
24,195
BPJS AD SIPIL
3,440
BPJS ANGKATAN DARAT
3,290
BPJS ANGKATAN DARAT
12,696
BPJS AD MIL SATDIK
6,920
6,050
860
40,800
BPJS ANGKATAN DARAT
42,240
5,070
12,800
BPJS ANGKATAN DARAT
15,510
52,182
BPJS ANGKATAN DARAT
28,653
BPJS ANGKATAN DARAT
3,290
BPJS ANGKATAN DARAT
31,540
96,186
29,274
19,712
64,768
19,712
4,125
18,791
5,719
BPJS AD KELUARGA
114,060
30,976
8,490
30,660
14,320
25,800
13,846
4,214
45,264
13,776
96,186
29,274
BPJS ANGKATAN DARAT
4,623
1,407
159,252
48,468
1,498
4,922
BPJS AU KELUARGA
4,530
BPJS AD KELUARGA
4,731
4,788
BPJS AD KELUARGA
480
5,120
19,994
184
6,735
BPJS UMUM PENSIUNAN H
29,246
89,654
27,286
3,358
1,022
1,980
BPJS ANGKATAN DARAT
114,060
BPJS AD SIPIL
45,990
10,320
50,512
4,125
8,540
BPJS AD MIL SATDIK
11,335
13,470
3,996
11,335
2,120
4,100
103,521
34,080
11,335
50,688
BPJS ANGKATAN DARAT
45,990
16,080
10,320
BPJS ANGKATAN DARAT
44,160
13,440
9,384
2,856
3,358
1,022
136,620
BPJS ANGKATAN DARAT
29,246
159,252
48,468
21,970
BPJS ANGKATAN DARAT
5,566
1,694
5,727
1,743
BPJS ANGKATAN DARAT
30,660
7,160
16,080
29,620
6,880
17,250
2,750
45,990
10,320
BPJS AD KELUARGA
46,464
50,688
BPJS ANGKATAN DARAT
6,920
6,050
BPJS AD MIL SATPUR
39,744
12,096
10,380
BPJS ANGKATAN LAUT MIL
105,189
6,050
BPJS ANGKATAN DARAT
18,060
10,890
33,180
BPJS ANGKATAN DARAT
732,450
215,430
20,910
18,791
5,719
275,520
BPJS ANGKATAN DARAT
10,380
159,252
48,468
3,358
1,022
43,940
44,430
BPJS ANGKATAN DARAT
36,120
28,653
BPJS ANGKATAN DARAT
278,790
25,068
85,545
41,780
14,390
129,780
3,290
30,660
29,620
BPJS ANGKATAN DARAT
2,790
7,160
7,650
39,760
3,180
4,844
4,689
52,182
BPJS ANGKATAN DARAT
4,309
BPJS AU KELUARGA
27,460
BPJS ANGKATAN DARAT
54,720
10,980
3,440
BPJS AD KELUARGA
42,600
1,645
BPJS ANGKATAN DARAT
210,378
6,570
BPJS AD KELUARGA
29,696
42,600
5,490
52,182
3,600
4,512
13,344
206,175
BPJS AD MIL SATBANPUR
3,456
304,501
26,500
605
817
9,184
BPJS UMUM MANDIRI
137,450
7,140
BPJS UMUM MANDIRI
11,828
252,252
24,615
24,949
30,272
82
37,120
14,168
21,478
BPJS UMUM JAMSOSTEK
249,480
7,181
6,144
5,069
60,912
50,688
832
9,152
304,501
10,240
31,782
65,079
14,168
44,800
13,400
2,060
6,016
5,632
7,479
VALESCO 80 MG
VALESCO 80 MG
SIMVASTATIN TAB 10 MG MERSI
VALESCO 80 MG
VALESCO 80 MG
SPIRONOLACTONE 100 MG DEXA E
MAX 60 TAB/BULAN. DAPAT DIGUNAKAN UNTUK EPI DEPAKOTE ER ABBT 500 MG
MINIASPI 80 MG TAB /E
ACARBOSE DEXA 50MG
ACARBOSE DEXA 50MG
VALESCO 80 MG
VALESCO 80 MG
MAX 3O TAB/ BULAN BISOPROLOL 5 MG NOVEL
FUROSEMID 40MG YARI
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
FUROSEMID 40MG YARI
VALESCO 80 MG
VALESCO 80 MG
MAX 30/ BULAN, TIDAK UNTUK NYERI AKUT ALLOPURINOL 300 MG HEXP
SPIRONOLACTON DEXA 25 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
PERESEPAN MAX UNTUK 10 HARI.HANYA UNTUK PASCEFIXIME 200 MG
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
HARNAL OCAS 0.4 MG ASTE
GRATHEOS TAB 50 MG
AMBROXOL TAB ETECON 30 MG
RETAPHYL SR KIFA 300 MG
GLUCOSAMINE 500 MG
MECOBALAMIN NOVE 500MCG
LAFALOS CREAM 20GR
VALISANBE 2 MG
MAX 30 TAB/BULAN..HANYA UNTUK GAGAL JANTUNG
DIGOXIN
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
MAX 30/ BULAN, TIDAK UNTUK NYERI AKUT ALLOPURINOL 300 MG HEXP
GRATHEOS TAB 50 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
AMLODIPIN 5MG MDKN
ACARBOSE DEXA 50MG
ACARBOSE DEXA 50MG
VALESCO 160 MG
VALESCO 160 MG
AMLODIPIN 5MG MDKN
PRESTIN 20 MG
BEROTEC 0.1 MG INHALER
VALISANBE 2 MG
CATARLENT TETES MATA 5 ML
SANBE TEARS TM 8 ML
HYDROCORTISON 2.5 CREAM KIFA 5GR
KIFLUZOL KIFA 150 MG
CETRIZINE 10 MG
KETOCONAZOLE 2% KRIM 10 GR HEXP /T
MAX 30 TAB/BULAN..HANYA UNTUK GAGAL JANTUNG
DIGOXIN
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
MAX 3 TAB/ KASUS AZITHROMYCIN 500 MG
VALESCO 80 MG
VALESCO 80 MG
CENDO XITROL TM 5ML
VALESCO 160 MG
VALESCO 160 MG
PIOGLITAZONE 30 MG
PIOGLITAZONE 30 MG
GRATHEOS TAB 50 MG
NACL 100ML SANBE
INFUSION SET MACRO JMS
FOLLEY CATHETER NO. 16 GEA/ROYAL
AMIODARON IV INJ
ALKOHOL SWAB COSMO
IV CATHETER 20/T
CETRIZINE 10 MG
KONIGEN KRIM 10 GR
VALISANBE 2 MG
GLUCOSAMINE 500 MG
KSR MERC 600 MG
FUROSEMID 40MG YARI
PRESTIN 20 MG
GRATHEOS TAB 50 MG
VALISANBE 2 MG
GRATHEOS TAB 50 MG
LANSOPRAZOLE 30 MG NOVELL
VERSILON 6 MG MERSI
MINIASPI 80 MG R
VALISANBE 2 MG
GLIMEPIRIDE 4 MG E
AMLODIPIN 5MG MDKN
GLIMEPIRIDE TAB 4 MG INFION
NEURODEX FC DEXA KOMB
TREMENZA TAB
VERSILON 6 MG MERSI
VERSILON 6 MG MERSI
VALISANBE 2 MG
VALESCO 160 MG
VALESCO 160 MG
FUROSEMID 40MG YARI
AMLODIPIN 5MG MDKN
VERSILON 6 MG MERSI
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
AMLODIPIN 5MG MDKN
GRATHEOS TAB 50 MG
VALESCO 80 MG
VALESCO 80 MG
VERSILON 6 MG MERSI
VALISANBE 2 MG
SANBE TEARS TM 8 ML
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
POLIDEMISIN EYEDROP
GLUCOSAMINE 500 MG
MELOXICAM 7.5 TAB MG T
MAX 60 TAB/BULAN GLIMEPIRIDE DEXA 1 MG /T
KONIGEN KRIM 10 GR
METHYL PREDNISOLON 4 MG BERNO
CEFIXIME 100MG HEXP
METHYL PREDNISOLON TABLET 8 MAHA
DEXAMETASONE 0.5 MG PHAPROS
15 MG/KGBB, MAKSIMAL SELAMA 4 BULAN LANJU ETAMBUTOL 500 MG INFA E
LOVEQUIN 500 MG
PYRAZINAMIDE 500 MG
TANAPRESS TANA 10 MG
TANAPRESS TANA 10 MG
METHYL PREDNISOLON DEXA 8MG
TERASMA MDKN 2.5 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
CETRIZINE 10 MG
PHENYTOIN IKAP 100 MG
15 MG/KGBB, MAKSIMAL SELAMA 4 BULAN LANJU ETAMBUTOL 500 MG INFA E
ISONIAZID 300 MG E
PYRAZINAMIDE 500 MG
VALESCO 80 MG
VALESCO 80 MG
DOXYCYCLINE INFA 100 MG
GRATHEOS TAB 50 MG
MAX 60 TAB/BULAN TRIHEXIPHENIDIL 2 MG
MAX 30KAPS/BULAN FORANSI 10MG
MAX 30KAPS/BULAN FORANSI 10MG
VALESCO 160 MG
VALESCO 160 MG
AMLODIPIN 5MG MDKN
POLIDEMISIN EYEDROP
MOMETASON FUROATE KRIM 01% 10GR
CETRIZINE 10 MG
CETEME TAB 4MG
VITAMIN A 200.000 IU
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
DIVALPI 250 MG
DIVALPI 250 MG
VALISANBE 2 MG
POLIDEMISIN EYEDROP
ULSIDEX DEXA 500 MG
1 BOTOL/ KASUS AMOKSISILIN SYR 60 ML E
PARACETAMOL SYR 60 ML ERRITA T
GRATHEOS TAB 50 MG
VERSILON 6 MG MERSI
VALISANBE 2 MG
VALESCO 80 MG
VALESCO 80 MG
AMLODIPIN 5MG MDKN
AMLODIPIN 5MG MDKN
GRATHEOS TAB 50 MG
VALESCO 160 MG
VALESCO 160 MG
FUROSEMID 40MG YARI
AMLODIPIN 5MG MDKN
AMLODIPIN 5MG MDKN
GRATHEOS TAB 50 MG
FUROSEMID 40MG YARI
KENDARON E
KENDARON E
KETOROLAC 30 MG/ML PHAP /T
OMEPRAZOLE INJ 40MG/T
ROSUFER TAB 20 MG
SERETIDE DISKUS 250 GLAX 250 MCG/PUFF
POLIDEMISIN EYEDROP
LAKTULOSA SYR 60ML
FUROSEMID 40MG YARI
OBH SYRUP 100 ML LUCAS
AMLODIPIN 5MG MDKN
SANBE TEARS TM 8 ML
TIM-OPHTAL 0.5% ED 5ML
URINTER INTR 400 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
TIDAK DIGUNAKAN UNTUK PASIEN USIA < 18 TAHUNCIPROFLOXACIN PHAP 500 MG /T
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
AMLODIPIN 5MG MDKN
CETRIZINE 10 MG
BEDAK SALYCIL 2% KF
ACARBOSE DEXA 50MG
HARNAL D ASTE 0.2 MG
GRATHEOS TAB 50 MG
GLUCOSAMINE 500 MG
OXCAL CAPS
GRATHEOS TAB 50 MG
SANBE TEARS TM 8 ML
URINTER INTR 400 MG
GRATHEOS TAB 50 MG
OXCAL CAPS
GRATHEOS TAB 50 MG
CETRIZINE 10 MG
CETEME TAB 4MG
ALPRAZOLAM 0.5 MG
DIVALPI 250 MG
DIVALPI 250 MG
VALISANBE 2 MG
60 TAB/BULAN CLOBAZAM 10 MG DEXA
KAPSUL KOSONG 00
SANDEPRIL MERS 50 MG
PRESTIN 20 MG
PRESTIN 20 MG
HYDROCORTISON 2.5 CREAM KIFA 5GR
KIFLUZOL KIFA 150 MG
MICONAZOLE 2% KRIM KIFA
LAFIHISTIN D
ILIADIN 0.05SPRAY DEWASA 10ML
CETRIZINE 10 MG
DIVALPI 250 MG
DIVALPI 250 MG
VALISANBE 2 MG
VALISANBE 2 MG
TANAPRESS TANA 5 MG
TANAPRESS TANA 5 MG
AMLODIPIN 5MG MDKN
ROSUFER TAB 20 MG
FUROSEMID 40MG YARI
ALPRAZOLAM 0.5 MG
MOISDERM 20% OPL
TANAPRESS TANA 5 MG
TANAPRESS TANA 5 MG
FUROSEMID 40MG YARI
AMLODIPIN 5MG MDKN
ROSUFER TAB 20 MG
MAX 60 TAB/BULAN GLIMEPIRIDE 2 MG DEXA /T
CEFIXIME 100MG HEXP
AKILEN TTS TELINGA
CEFIXIME 100MG HEXP
CETRIZINE 10 MG
VALISANBE 2 MG
URINTER INTR 400 MG
CETRIZINE 10 MG
AKILEN TTS TELINGA
VALISANBE 2 MG
LEVEMIR FLEXPEN NOVO INJ 3 ML
ULSIDEX DEXA 500 MG
LOVEQUIN 500 MG
FOLIC ACID TAB 1 MG T
FLUCADEX SYR
RECOLFAR 0.5 MG
URINTER INTR 400 MG
GRATHEOS TAB 50 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
GLUCOSAMINE 500 MG
CETRIZINE 10 MG
AMLODIPIN 5MG MDKN
VALISANBE 2 MG
KAPSUL KOSONG 00
RISPERIDONE DEXA 2MG
DIVALPI 250 MG
DIVALPI 250 MG
PRESTIN 20 MG
URINTER INTR 400 MG
ALPRAZOLAM 0.5 MG
VERSILON 6 MG MERSI
VALESCO 80 MG
VALESCO 80 MG
WARFARIN 1 MG TAB
WARFARIN 1 MG TAB
DEXAMETASONE 0.5 MG PHAPROS
LOVEQUIN 500 MG
VALISANBE 2 MG
VALESCO 80 MG
VALESCO 80 MG
VALISANBE 2 MG
VALESCO 80 MG
VALESCO 80 MG
AMLODIPIN 5MG MDKN
VERSILON 6 MG MERSI
VALISANBE 2 MG
VERSILON 6 MG MERSI
OXCAL CAPS
FUROSEMID 40MG YARI
KENDARON E
KENDARON E
WARFARIN 1 MG TAB
WARFARIN 1 MG TAB
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
GRATHEOS TAB 50 MG
HESROID 500MG TAB
VALISANBE 2 MG
LAFALOS CREAM 20GR
GLUTROP
TREMENZA TAB
GRATHEOS TAB 50 MG
HESROID 500MG TAB
GRATHEOS TAB 50 MG
APIDRA SOLOSTAR PEN AVEN INJ 3 ML
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
CETRIZINE 10 MG
VALESCO 80 MG
VALESCO 80 MG
KENDARON E
KENDARON E
ROSUFER TAB 20 MG
VALESCO 80 MG
VALESCO 80 MG
VALESCO 160 MG
VALESCO 160 MG
AMLODIPIN 5MG MDKN
RAMIPRIL 5 MG
VALESCO 160 MG
MAX 30/ BULAN, TIDAK UNTUK NYERI AKUT ALLOPURINOL HEXP 100 MG
ACARBOSE DEXA 50MG
GRATHEOS TAB 50 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
AMLODIPIN 5MG MDKN
VALESCO 80 MG
VALESCO 80 MG
VALESCO 80 MG
VALESCO 80 MG
GLUTROP
METRONIDAZOLE TAB 500 MG /T
AMLODIPIN 5MG MDKN
OXCAL CAPS
GRATHEOS TAB 50 MG
MAX 30 TAB/BULAN SIFROL BOEH 0.75 MG
MAX 30 TAB/BULAN SIFROL BOEH 0.75 MG
ALPRAZOLAM 0.5 MG
LEVOBEN TAB MERSI
LEVOBEN TAB MERSI
MUCOS DROP
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
POLIDEMISIN EYEDROP
KETOPROFEN 100 MG TAB BERNO
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
KONIGEN KRIM 10 GR
GRATHEOS TAB 50 MG
CENDO FLOXA ED 5ML
POLIDEMISIN EYEDROP
FOLAMIL GENIO SOFT KAPSUL
GRATHEOS TAB 50 MG
FUROSEMID 40MG YARI
IBUPROFEN 400 MG
GRATHEOS TAB 50 MG
VALESCO 80 MG
VALESCO 80 MG
HESROID 500MG TAB
CILOSTAZOL TAB 100 MG T
OXCAL CAPS
VALISANBE 2 MG
GRATHEOS TAB 50 MG
ULSIDEX DEXA 500 MG
SANBE TEARS TM 8 ML
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
CEFADROXIL DEXA 500 MG
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
GRATHEOS TAB 50 MG
GLUCOSAMINE 500 MG
ACARBOSE DEXA 50MG
GRATHEOS TAB 50 MG
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
CETRIZINE 10 MG
LAKTULOSA SYR 60ML
LOVEQUIN 500 MG
BEROTEC 0.1 MG INHALER
MAX 20 TAB/MINGGU CODIKAF 20 MG
GRATHEOS TAB 50 MG
LAKTULOSA SYR 60ML
RANITIDINE 150 MG HEXP
GRATHEOS TAB 50 MG
GRATHEOS TAB 50 MG
SANBE TEARS TM 8 ML
OXCAL CAPS
GRATHEOS TAB 50 MG
OXCAL CAPS
EVITCO 100 MG
GRATHEOS TAB 50 MG
LASAL 100ML SYR
PARACETAMOL SYR 60 ML ERRITA T
HEPA BALANCE
EZELIN INSULIN GLARGINE
IKAMICETIN SALEP KULIT
IBUPROFEN 400 MG
CETRIZINE 10 MG
HESROID 500MG TAB
ULSIDEX DEXA 500 MG
MAX30 TAB/BULAN DIAMICRON MR SERV 60 MG
MAX30 TAB/BULAN DIAMICRON MR SERV 60 MG
EZELIN INSULIN GLARGINE
ASCAVIN TAB 4 MG
CENDO VITROLENTA ED 0.6 ML MINI DOSE
SANBE TEARS TM 8 ML
VALESCO 80 MG
VALESCO 80 MG
OBH SYRUP 100 ML LUCAS
GLUCOSAMINE 500 MG
GRATHEOS TAB 50 MG
TREMENZA TAB
GLUTROP
CETRIZINE 10 MG
SANBE TEARS TM 8 ML
CENDO AUGENTONIC 0.6 ML MD
CEFIXIME 100MG HEXP
FOLAMIL GENIO SOFT KAPSUL
CETRIZINE 10 MG
PROFAT SYR
CENDO CONVERS 2 0.6ML MINIDOSE
CETIRIZINE DROP 12ML INFA
BEDAK SALYCIL 2% KF
GRAFADON DROP 15 ML
FUROSEMID 40MG YARI
SANBE TEARS TM 8 ML
SANBE TEARS TM 8 ML
MICONAZOLE 2% KRIM KIFA
LAFIHISTIN D
GLUTROP
METRONIDAZOLE TAB 500 MG /T
RECOLFAR 0.5 MG
LAKTULOSA SYR 60ML
INOXIN 400MG
CORMEGA OPL
MINIASPI 80 MG R
ROSUFER TAB 20 MG
SUPRAFENID MEF SUPP
NACL 0.9 500 ML
URESIX INJ
MAAGSLAANG 16/T
CEFTIZOXIME 1 GR
IV DRESSING 3M 50
NACL 100ML SANBE
NATTO TAB OPL
URESIX INJ
CORMEGA OPL
ALKOHOL SWAB COSMO
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30C109 LISNA FEBRI 00478579 - - -
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30B215 MARTHIN NU00212987 - - -
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30C112 HR. ATIKAH. 00022643 - - -
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1 PCS
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20 PCS
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15 CAPSUL
10 TAB
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30C114 SITI MARYAM00267674 - - -
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30B219 ONI SONTANI00446675 - - -
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30B205 SUWITA 00078101 - - -
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30C119 LINAWULAND00513662 - - -
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30B228 IAH 00216890 - - -
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30C120 RUSLI DARMA00152792 - - -
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30C122 MIRAH TRI 00106681 - - -
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30B229 MAS'UT 00513567 - - -
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30B207 TINTIN SUHA00246553 - - -
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30C123 SUPARYONO 00441416 - - -
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30C124 CUCU MARIAT00235845 - - -
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30C128 AGUS MAULA00497703 - - -
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90 TAB
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30B208 JADI.TN 00101553 - - -
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30C129 GUNAWAN, S.00265234 - - -
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30C127 DANA SUTIS 00383645 - - -
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30C126 PONIMAN. TN00133070 - - -
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30C125 SUTARNA 00432917 - - -
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15 CAPLET
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30 PCS
30B233 SADIMAN P. D00044462 - - -
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20 TAB
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30C131 RIAN PUJIAN00414527 - - -
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30C132 ENGKON KON00081777 - - -
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30B236 LILI RUSTAN 00022130 - - -
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30C134 AAH.NY 00041540 - - -
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1 TUBE
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30B238 YANI WINDRI00010381 - - -
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30B241 NENENG DAR00491666 - - -
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30C135 HAPSOH HJ 00511806 - - -
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30C139 TUSMINI 00000643 - - -
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30B240 ASYER TATO 00352385 - - -
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7 TAB
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30C149 DEWITA ABD00371967 - - -
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30C153 ENTIN KARTI00382807 - - -
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30C170 THERESIA S 00159374 - - -
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10 CAPSUL
30B280 NENENG SITI00383221 - - -
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7 TAB
30 TAB
30C172 RINA RISNAW00469304 - - -
Jumlah Satuan
15 TAB
30 CAPLET
30 TAB
60 TAB
30 TAB
30 CAPSUL
15 TAB
30B282 UTIS BINTI 00484865 - - -
Jumlah Satuan
23 TAB
7 TAB
46 TAB
14 TAB
23 TAB
7 TAB
7 TAB
30B283 ROJIAH 00477470 - - -
Jumlah Satuan
4 TAB
10 CAPSUL
23 TAB
7 TAB
30 TAB
10 TAB
30B284 BINUR ELSYE00498878 - - -
Jumlah Satuan
23 TAB
7 TAB
30 TAB
30 TAB
30B285 DJAMIN 00084572 - - -
Jumlah Satuan
4 TAB
10 CAPSUL
10 TAB
30 TAB
10 TAB
30B286 RASWAN 00132811 - - -
Jumlah Satuan
4 TAB
10 TAB
30 TAB
30B287 J. SOPIAH 00027047 - - -
Jumlah Satuan
4 TAB
30 TAB
30C187 HASANAH 00293857 - - -
Jumlah Satuan
30 CAPSUL
30 CAPSUL
30B288 E.KURAESIN 00512008 - - -
Jumlah Satuan
69 TAB
21 TAB
30 TAB
23 TAB
7 TAB
23 TAB
7 TAB
30B289 OTONG IYAN00432190 - - -
Jumlah Satuan
30 TAB
30C174 SUTARDI TN 00348564 - - -
Jumlah Satuan
20 TAB
20 CAPSUL
20 TAB
30C175 TATANG 00513344 - - -
Jumlah Satuan
7 TAB
10 TAB
30B290 NANI RACHM00461543 - - -
Jumlah Satuan
6 TAB
7 TAB
30B291 SRI WAHYUD00291771 - - -
Jumlah Satuan
10 TAB
30 TAB
10 TAB
30C177 DWI SULISTI00364820 - - -
Jumlah Satuan
10 TAB
1 TUBE
30C178 RAMDAN 00358043 - - -
Jumlah Satuan
6 TAB
10 TAB
3 CAPSUL
30C179 ERWIN HIDA 00513696 - - -
Jumlah Satuan
10 TAB
10 TAB
10 TAB
10 TAB
30C180 INTAN AGUST00502288 - - -
Jumlah Satuan
7 TAB
10 TAB
10 TAB
30C181 SUPRIATIN 00446113 - - -
Jumlah Satuan
9 TAB
30C182 SURANA 00159028 - - -
Jumlah Satuan
10 TAB
30B293 R SITI MARY 00462182 - - -
Jumlah Satuan
1 FLEXPEN
1 FLEXPEN
3 FLEXPEN
1 FLEXPEN
7 CAPSUL
7 CAPSUL
30C183 HERY SUPAR 00098828 - - -
Jumlah Satuan
30 TAB
20 CAPSUL
20 TAB
30C185 H. JAJAT AC 00041658 - - -
Jumlah Satuan
10 TAB
1 TUBE
30B294 FREDDY AMS00415884 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
7 TAB
30 TAB
30B295 SITI SONDAR00479699 - - -
Jumlah Satuan
23 TAB
7 TAB
10 CAPSUL
7 TAB
30B296 RODIAH.NY 00317213 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
30 TAB
7 TAB
30B297 NUMULKILAH00354030 - - -
Jumlah Satuan
23 TAB
7 TAB
30 TAB
30B298 NGADIJONO 00173496 - - -
Jumlah Satuan
23 TAB
7 TAB
30 TAB
30 TAB
30B299 TARSIH 00510318 - - -
Jumlah Satuan
7 TAB
7 TAB
21 TAB
7 TAB
30B301 SUMANTI 00094303 - - -
Jumlah Satuan
30 TAB
30 TAB
60 TAB
90 TAB
10 TAB
30B302 Y. SULISNAW00065132 - - -
Jumlah Satuan
23 TAB
7 TAB
46 TAB
14 TAB
15 TAB
30 TAB
30B303 HASANAH 00023764 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
30B304 SULASMIRAH,00268187 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
7 TAB
30C186 YETI HERYAT00506179 - - -
Jumlah Satuan
3 CAPSUL
30C189 SALMA HANA00512731 - - -
Jumlah Satuan
10 TAB
10 TAB
10 TAB
30B305 SOEGIARTI 00111814 - - -
Jumlah Satuan
10 TAB
30 TAB
30 TAB
30C190 ASIH HALIMA00133612 - - -
Jumlah Satuan
10 CAPSUL
10 TAB
30C191 ENDON TN 00023763 - - -
Jumlah Satuan
7 TAB
30B306 NANIEK SUGI00044144 - - -
Jumlah Satuan
10 TAB
60 TAB
23 TAB
7 TAB
23 TAB
7 TAB
10 TAB
69 TAB
21 TAB
30C192 RAHMAT AEP00413581 - - -
Jumlah Satuan
1 BTL
1 BTL
30C193 MAMAN KAR 00427522 - - -
Jumlah Satuan
20 TAB
20 CAPSUL
20 TAB
30B307 EDI MULYADI00512440 - - -
Jumlah Satuan
23 TAB
7 TAB
90 TAB
90 TAB
30C194 ITAR SUTARS00208688 - - -
Jumlah Satuan
1 BTL
30C195 FITRIA NING 00371019 - - -
Jumlah Satuan
15 TAB
10 TAB
30B308 AISYAH.NY 00359418 - - -
Jumlah Satuan
23 TAB
7 TAB
30 TAB
23 TAB
7 TAB
30C196 ACHMAD SOD00513666 - - -
Jumlah Satuan
1 TUBE
6 TAB
30C197 UU KUSMINA00096259 - - -
Jumlah Satuan
1 BTL
1 BTL
30B309 SOFIAN 00209412 - - -
Jumlah Satuan
23 TAB
7 TAB
30 TAB
23 TAB
7 TAB
30B310 WAWA 00084599 - - -
Jumlah Satuan
4 TAB
23 TAB
7 TAB
30 TAB
30 TAB
30C198 EULIS 00390281 - - -
Jumlah Satuan
10 CAPSUL
30C199 I. BADRIAH 00513695 - - -
Jumlah Satuan
15 TAB
30B311 SUJANA WIJ 00489779 - - -
Jumlah Satuan
60 TAB
15 TAB
30 TAB
60 TAB
30 TAB
30C200 RANI RATNA 00487141 - - -
Jumlah Satuan
5 TAB
30B312 NUR JUMILAH00408669 - - -
Jumlah Satuan
4 TAB
23 TAB
7 TAB
30 TAB
30C201 MUHAMMAD R
00478341 - - -
Jumlah Satuan
1 BTL
1 BTL
30C202 TINA. NY 00513584 - - -
Jumlah Satuan
10 TAB
30B313 ANNA NURYA00415510 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
30C203 ULIAN PARD 00311664 - - -
Jumlah Satuan
9 TAB
6 TAB
30C204 SUPRIYADI 00513664 - - -
Jumlah Satuan
10 TAB
10 CAPSUL
30B314 TARYONO RU00225756 - - -
Jumlah Satuan
23 TAB
7 TAB
30 TAB
10 TAB
30B315 YATIE KOMA 00081086 - - -
Jumlah Satuan
4 TAB
10 CAPSUL
30 TAB
30C205 SUKARYA 00456149 - - -
Jumlah Satuan
10 TAB
30C206 JULAEHA 00509940 - - -
Jumlah Satuan
10 TAB
15 CAPSUL
15 TAB
30B316 MOCHAMAD 00494531 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
7 TAB
30 TAB
30C207 TATI SUPART00091020 - - -
Jumlah Satuan
10 TAB
15 TAB
30C208 TUTI HERAW00513671 - - -
Jumlah Satuan
1 BTL
30C213 RINA SULASM00275653 - - -
Jumlah Satuan
30 TAB
1 TUBE
20 TAB
30C214 SOBIRIN TN 00031400 - - -
Jumlah Satuan
30 TAB
1 TUBE
10 TAB
30C209 PAQUITA PU 00511212 - - -
Jumlah Satuan
10 CAPSUL
10 TAB
30B317 NUR ROSTIK 00403770 - - -
Jumlah Satuan
4 TAB
30B319 SRI SUMIATI 00044751 - - -
Jumlah Satuan
10 TAB
10 CAPSUL
90 TAB
10 TAB
30B320 SUHENDAR 00436073 - - -
Jumlah Satuan
60 TAB
60 TAB
10 TAB
30B321 YUYUN YUNIN00340754 - - -
Jumlah Satuan
7 TAB
30 TAB
60 TAB
30B322 HERBIN SIT 00504710 - - -
Jumlah Satuan
10 TAB
60 TAB
60 TAB
10 TAB
30C210 MULYADI 00493289 - - -
Jumlah Satuan
20 TAB
1 TUBE
20 TAB
30C211 DALIAH MUL 00186998 - - -
Jumlah Satuan
10 TAB
30C212 IIN SUMINEM00409052 - - -
Jumlah Satuan
1 BTL
10 TAB
10 TAB
5 TAB
30C2115 JHONSON SI 00513710 - - -
Jumlah Satuan
1 FLES
10 TAB
5 TAB
30C216 DADAH SUMI00354091 - - -
Jumlah Satuan
5 TAB
1 BTL
5 TAB
10 TAB
5 TAB
30C217 ROSTIKA NY 00296868 - - -
Jumlah Satuan
15 TAB
10 TAB
30C218 SUKRISNA 00200884 - - -
Jumlah Satuan
10 TAB
7 TAB
1 BTL
10 TAB
10 TAB
30C219 MULYANI 00444235 - - -
Jumlah Satuan
7 TAB
10 TAB
30C220 ODELIA SION00347430 - - -
Jumlah Satuan
1 BTL
30C221 AWALUDIN A00498334 - - -
Jumlah Satuan
30 CAPSUL
30C222 HASAN 00513673 - - -
Jumlah Satuan
10 TAB
30C223 ADE TARYA 00512092 - - -
Jumlah Satuan
60 TAB
30 TAB
10 CAPSUL
30C224 NENI JULIYA 00203668 - - -
Jumlah Satuan
10 CAPSUL
6 TAB
30C225 WAFI AKBAR 00513692 - - -
Jumlah Satuan
1 BTL
1 BTL
1 VIAL
1 BTL
30C226 AMINAH 00489318 - - -
Jumlah Satuan
10 TAB
10 TAB
30B323 YANI IRIANI 00164539 - - -
Jumlah Satuan
6 TAB
3 CAPSUL
1 FLEXPEN
1 CARTRID
30C227 EHA JULAEHA00438693 - - -
Jumlah Satuan
10 TAB
1 TUBE
30C228 ENCUM 00450127 - - -
Jumlah Satuan
10 TAB
30C229 SALWA DIA M00513689 - - -
Jumlah Satuan
5 TAB
30C230 ASEP SAEPU 00425962 - - -
Jumlah Satuan
4 TAB
10 TAB
1 BTL
5 TAB
30C242 GANDA IRMA00421186 - - -
Jumlah Satuan
1 TUBE
30C231 YETTY SUMIA00489707 - - -
Jumlah Satuan
7 CAPSUL
30C232 SUPAMI 00390670 - - -
Jumlah Satuan
10 TAB
10 TAB
30C233 J. SOEMARPI 00049661 - - -
Jumlah Satuan
10 TAB
10 TAB
10 TAB
10 CAPSUL
30C234 MARSANIH N00259729 - - -
Jumlah Satuan
30 TAB
30B324 SJARIF 00267379 - - -
Jumlah Satuan
1 BTL
23 TAB
7 TAB
10 CAPSUL
46 TAB
14 TAB
1 CARTRID
30C235 SYINTIAS NO00475790 - - -
Jumlah Satuan
7 TAB
30C236 SRI ANDRIAT00021515 - - -
Jumlah Satuan
1 STRIP
1 BTL
30B325 SUMARNO, H,00491074 - - -
Jumlah Satuan
10 TAB
23 TAB
7 TAB
10 TAB
23 TAB
7 TAB
1 BTL
46 TAB
14 TAB
30C237 TUTY DATIAH00125981 - - -
Jumlah Satuan
20 TAB
20 CAPSUL
20 TAB
30B326 HERRY SUPR 00499378 - - -
Jumlah Satuan
1 FLEXPEN
1 FLEXPEN
1 FLEXPEN
5 CAPSUL
30C238 NI MADE DEW
00505843 - - -
Jumlah Satuan
6 TAB
3 CAPSUL
30C239 NURSAIDAH 00122179 - - -
Jumlah Satuan
10 TAB
1 TUBE
30C241 MANGAPUL G00479682 - - -
Jumlah Satuan
1 BTL
30C240 EKA LESTARI00511797 - - -
Jumlah Satuan
1 STRIP
30C243 ACMAD FADI 00399920 - - -
Jumlah Satuan
10 TAB
10 TAB
30C244 ZAHIRA SAL 00513702 - - -
Jumlah Satuan
6 CAPLET
30C245 WINDA WINA00487676 - - -
Jumlah Satuan
10 CAPSUL
30C246 E.ROHAETI.N00276370 - - -
Jumlah Satuan
10 TAB
5 TAB
30C247 LASMINI.NY 00403783 - - -
Jumlah Satuan
1 BTL
30C248 MUHAMMAD R
00418530 - - -
Jumlah Satuan
1 STRIP
30C249 LENY BY/HA 00464837 - - -
Jumlah Satuan
1 FLES
10 TAB
1 PCS
1 BTL
30B328 LILIS 00064031 - - -
Jumlah Satuan
30 TAB
60 TAB
30B327 CICIH.NY 00236542 - - -
Jumlah Satuan
23 TAB
7 TAB
90 TAB
15 TAB
30 TAB
30C013 D. SUMANTRI00165819 - - -
Jumlah Satuan
1 BTL
30C012 WILLEM GEO00054955 - - -
Jumlah Satuan
1 BTL
30C011 IAH RATIAH, 00105956 - - -
Jumlah Satuan
1 TUBE
15 TAB
1 TUBE
30C010 HJ TATI TAR 00511887 - - -
Jumlah Satuan
10 TAB
3 CAPSUL
15 TAB
30C009 SAFTIA NUR 00271257 - - -
Jumlah Satuan
10 TAB
10 TAB
10 CAPSUL
10 TAB
30C008 OOM KOMARI00205319 - - -
Jumlah Satuan
1 BTL
10 TAB
7 CAPSUL
30C165 IMAS ENI NU00110024 - - -
Jumlah Satuan
12 TAB
12 CAPLET
PATRIA RAH 00126312 - - -
Jumlah Satuan
3 AMP
ACEP DADI 00219816 - - -
Jumlah Satuan
2 TAB
1 VIAL
2 TAB
1 TAB
1 TAB
1 TAB
Jumlah Satuan
2 AMP
DERAWATI G00001906 - - -
Jumlah Satuan
2 SUPP
NANIH 00513265 - - -
Jumlah Satuan
2 TAB
2 AMP
3 LABU
1 FLES
1 PCS
1 TAB
1 PCS
2 AMP
1 PCS
Jumlah Satuan
2 VIAL
1 TAB
3 PCS
1 PCS
4 LABU
1 BTL
1 TAB
1 BTL
1 VIAL
4 PCS
3 TAB
1 PCS
2 AMP
1 PCS
1 TAB
10 PCS
1 PCS
1 PCS
3 PCS
POLI P. DALAM 90,690 0 NUNUNG LESUnchecked BPJS UMUM MANDIRI
Harga Total
2,816 64,768
2,816 19,712
207 6,210
POLI JANTUNG 212,658 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
2,816 64,768
2,816 19,712
1,920 88,320
1,920 26,880
895 9,845
895 3,133
POLI SYARAF 93,807 0 NUNUNG LESUnchecked BPJS UMUM JAMSOSTEK
Harga Total
7,296 51,072
4,178 14,623
3,898 27,286
118 826
POLI P. DALAM 121,998 0 NUNUNG LESUnchecked BPJS ANGKATAN DARAT
Harga Total
50,688 50,688
301 13,846
301 4,214
706 32,476
706 9,884
121 8,349
121 2,541
POLI JANTUNG 98,430 0 NUNUNG LESUnchecked BPJS UMUM ASKES TNI
Harga Total
2,816 64,768
2,816 19,712
324 7,452
324 2,268
141 4,230
POLI JANTUNG 113,220 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN H
Harga Total
2,816 64,768
2,816 19,712
141 3,243
141 987
817 18,791
817 5,719
Harga Total
2,816 64,768
2,816 19,712
1,920 44,160
1,920 13,440
269 8,070
324 7,452
324 2,268
POLI SYARAF 6,150 0 ELSA PRATIWUnchecked BPJS UMUM JAMSOSTEK
Harga Total
212 2,120
49 490
118 3,540
POLI SYARAF 135,103 0 MULYAWAN Unchecked BPJS UMUM ASKES NON T
Harga Total
4,178 14,623
3,898 89,654
3,898 27,286
118 2,714
118 826
POLI JANTUNG 95,985 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
313 7,199
313 2,191
2,816 64,768
2,816 19,712
141 2,115
Harga Total
3,898 89,654
3,898 27,286
118 3,540
POLI SYARAF 135,103 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
4,178 14,623
3,898 89,654
3,898 27,286
118 2,714
118 826
Harga Total
1,920 88,320
1,920 26,880
6,924 159,252
6,924 48,468
POLI THT 30,520 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
212 2,120
2,840 28,400
POLI BEDAH ORTHOPEDI 68,950 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
1,533 45,990
16,080 16,080
344 6,880
POLI BEDAH UROLOGI 45,624 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
6,272 43,904
344 1,720
POLI THT 32,690 0 ELSA PRATIWUnchecked BPJS UMUM JAMSOSTEK
Harga Total
12,696 12,696
19,994 19,994
POLI PARU-PARU 12,385 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
271 5,420
1,344 6,720
49 245
POLI BEDAH ORTHOPEDI 93,926 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN
Harga Total
4,178 29,246
1,533 30,660
897 17,940
16,080 16,080
POLI SYARAF 139,172 0 TITIK NURYAUnchecked BPJS UMUM MANDIRI
Harga Total
4,178 16,712
3,898 89,654
3,898 27,286
118 2,714
118 826
198 1,980
POLI SYARAF 18,163 0 NUNUNG LESUnchecked BPJS UMUM MANDIRI
Harga Total
4,178 14,623
118 3,540
POLI JANTUNG 92,730 0 NUNUNG LESUnchecked NON BPJS UMUM MURNI
Harga Total
134 4,020
2,816 64,768
2,816 19,712
141 4,230
POLI P. DALAM 9,790 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
269 8,070
344 1,720
POLI JANTUNG 178,278 0 NUNUNG LESUnchecked BPJS UMUM JAMKESMAS
Harga Total
2,816 64,768
2,816 19,712
141 4,230
1,106 33,180
817 18,791
817 5,719
4,554 31,878
POLI P. DALAM 71,310 0 TITIK NURYAUnchecked BPJS UMUM ASKES NON T
Harga Total
301 13,846
301 4,214
706 32,476
706 9,884
121 8,349
121 2,541
Harga Total
4,178 14,623
897 8,970
6,924 159,252
6,924 48,468
118 3,540
Harga Total
4,357 100,211
4,357 30,499
324 7,452
324 2,268
329 3,290
1,106 33,180
POLI SYARAF 14,630 0 TITIK NURYAUnchecked BPJS UMUM ASKES NON T
Harga Total
212 2,120
897 8,970
118 3,540
POLI SYARAF 85,680 0 TITIK NURYAUnchecked BPJS UMUM JAMKESMAS
Harga Total
897 6,279
6,924 48,468
4,301 30,107
118 826
POLI PARU-PARU 112,640 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
100,800 100,800
1,344 6,720
5,120 5,120
POLI SYARAF 27,133 0 NUNUNG LESUnchecked BPJS UMUM JAMKESMAS
Harga Total
4,178 14,623
897 8,970
118 3,540
Harga Total
4,178 16,712
118 3,540
198 1,980
POLI MATA 60,509 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
31,856 31,856
28,653 28,653
POLI KULIT & KELAMIN 62,487 0 ELSA PRATIWUnchecked BPJS UMUM JAMSOSTEK
Harga Total
4,105 4,105
23,936 47,872
317 4,438
6,072 6,072
Harga Total
134 2,010
313 7,199
313 2,191
2,816 64,768
2,816 19,712
50,688 50,688
141 4,230
POLI KESEHATAN ANAK 4,309 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
4,309 4,309
Harga Total
10,772 26,930
50,688 50,688
1,344 6,720
POLI P. DALAM 202,560 0 NUNUNG LESUnchecked BPJS UMUM ASKES TNI
Harga Total
301 13,846
301 4,214
984 45,264
984 13,776
2,091 96,186
2,091 29,274
POLI P. DALAM 110,820 0 TITIK NURYAUnchecked BPJS UMUM ASKES TNI
Harga Total
2,816 64,768
2,816 19,712
301 6,923
301 2,107
121 8,349
121 2,541
214 6,420
POLI MATA 41,118 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN H
Harga Total
38,368 38,368
275 2,750
POLI SYARAF 19,633 0 NUNUNG LESUnchecked BPJS UMUM ASKES NON T
Harga Total
4,178 14,623
49 1,470
118 3,540
POLI P. DALAM 328,930 0 NUNUNG LESUnchecked BPJS UMUM ASKES NON T
Harga Total
4,357 100,211
4,357 30,499
301 13,846
301 4,214
5,492 126,316
5,492 38,444
121 5,566
121 1,694
214 6,420
344 1,720
RUANG ICCU 260,484 1 IMALIA NUR Unchecked BPJS UMUM JAMSOSTEK
Harga Total
15,228 60,912
13,095 13,095
2,560 10,240
14,080 14,080
11,071 66,426
44,800 44,800
206 4,120
5,632 5,632
18,875 18,875
2,493 9,972
3,083 12,332
POLI KULIT & KELAMIN 37,896 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN H
Harga Total
1,658 24,870
317 3,170
9,856 9,856
POLI P. DALAM 490 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
49 490
Harga Total
4,178 14,623
118 3,540
198 1,980
POLI P. DALAM 62,863 0 TITIK NURYAUnchecked BPJS UMUM PENSIUNAN
Harga Total
4,178 25,068
1,533 15,330
2,176 21,760
141 705
Harga Total
4,178 14,623
6,924 159,252
6,924 48,468
4,301 30,107
118 2,714
118 826
POLI BEDAH ORTHOPEDI 20,335 0 ELSA PRATIWUnchecked BPJS ANGKATAN DARAT
Harga Total
897 13,455
344 6,880
Harga Total
4,178 29,246
6,924 48,468
118 826
198 1,386
Harga Total
344 3,440
Harga Total
6,924 159,252
6,924 48,468
727 7,270
118 3,540
POLI SYARAF 234,853 0 NUNUNG LESUnchecked BPJS UMUM ASKES TNI
Harga Total
4,178 14,623
897 8,970
6,924 159,252
6,924 48,468
118 3,540
RUANG PERAWATAN XIII 55,555 1 LIA ANDRIANUnchecked BPJS ANGKATAN DARAT K
Harga Total
5,914 29,570
2,197 21,970
605 3,025
198 990
POLI P. DALAM 182,859 0 TITIK NURYAUnchecked BPJS UMUM JAMKESMAS
Harga Total
2,091 96,186
2,091 29,274
360 8,280
1,106 33,180
2,277 15,939
POLI THT 43,090 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
513 5,130
1,599 15,990
2,197 21,970
Harga Total
6,924 48,468
2,197 15,379
118 826
198 1,386
POLI JANTUNG 82,110 0 NUNUNG LESUnchecked BPJS UMUM PENSIUNAN
Harga Total
1,920 57,600
817 24,510
Harga Total
4,178 16,712
897 8,970
6,924 159,252
6,924 48,468
118 2,714
118 826
Harga Total
4,357 100,211
4,357 30,499
141 4,230
1,106 33,180
817 18,791
817 5,719
4,554 31,878
POLI SYARAF 229,690 0 TITIK NURYAUnchecked BPJS UMUM ASKES TNI
Harga Total
6,924 159,252
6,924 48,468
2,197 21,970
POLI JANTUNG 179,998 0 NUNUNG LESUnchecked BPJS UMUM POLRI
Harga Total
2,816 64,768
2,816 19,712
141 4,230
1,106 33,180
817 18,791
817 5,719
344 1,720
4,554 31,878
Harga Total
2,816 64,768
2,816 19,712
1,920 88,320
1,920 26,880
817 18,791
817 5,719
Harga Total
2,197 21,970
118 3,540
198 1,980
POLI MATA 28,653 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
28,653 28,653
POLI BEDAH ORTHOPEDI 68,950 0 ELSA PRATIWUnchecked BPJS AD KELUARGA
Harga Total
1,533 45,990
16,080 16,080
344 6,880
POLI JANTUNG 161,616 0 NUNUNG LESUnchecked BPJS UMUM MANDIRI
Harga Total
2,816 64,768
2,816 19,712
895 9,845
895 3,133
141 4,230
817 18,791
817 5,719
4,554 31,878
118 3,540
Harga Total
212 2,120
897 8,970
6,924 159,252
6,924 48,468
118 2,714
118 826
POLI BEDAH UROLOGI 43,904 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
6,272 43,904
POLI MATA 36,116 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
36,116 36,116
POLI P. DALAM 30,585 0 ELSA PRATIWUnchecked NON BPJS UMUM KONTRA
Harga Total
1,533 22,995
759 7,590
Harga Total
1,009 7,063
121 2,541
POLI JANTUNG 165,558 0 TITIK NURYAUnchecked BPJS UMUM ASKES NON T
Harga Total
3,898 89,654
3,898 27,286
116 3,480
324 7,452
324 2,268
4,554 31,878
118 2,714
118 826
POLI BEDAH UROLOGI 12,606 0 ELSA PRATIWUnchecked BPJS UMUM JAMSOSTEK
Harga Total
275 2,750
9,856 9,856
Harga Total
5,632 56,320
407 4,070
960 9,600
POLI KULIT & KELAMIN 64,126 0 RISKA PANDIUnchecked BPJS AD KELUARGA
Harga Total
42,240 42,240
414 5,796
329 3,290
12,800 12,800
POLI SYARAF 256,050 0 MULYAWAN Unchecked BPJS UMUM MANDIRI
Harga Total
1,112 33,360
49 1,470
174 15,660
735 66,150
2,816 84,480
727 21,810
368 33,120
POLI JANTUNG 181,110 0 TITIK NURYAUnchecked BPJS UMUM ASKES TNI
Harga Total
5,830 134,090
5,830 40,810
207 6,210
Harga Total
727 7,270
Harga Total
443 4,430
5,632 56,320
1,344 8,064
721 21,630
5,120 5,120
Harga Total
313 7,199
313 2,191
2,816 64,768
2,816 19,712
1,920 88,320
1,920 26,880
141 4,230
POLI PARU-PARU 114,207 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
10,772 53,860
5,632 56,320
317 1,585
407 2,442
Harga Total
515 30,900
118 3,540
Harga Total
1,112 16,680
735 5,880
222 3,330
368 11,040
POLI JANTUNG 144,700 0 NUNUNG LESUnchecked BPJS UMUM PENSIUNAN H
Harga Total
443 8,860
2,816 64,768
2,816 19,712
895 20,585
895 6,265
817 18,791
817 5,719
Harga Total
344 3,440
2,840 28,400
344 3,440
POLI JIWA 97,815 0 NUNUNG LESUnchecked BPJS UMUM MANDIRI
Harga Total
113 1,695
3,204 73,692
3,204 22,428
Harga Total
4,357 100,211
4,357 30,499
324 7,452
324 2,268
1,106 33,180
POLI MATA 36,116 0 ELSA PRATIWUnchecked BPJS ANGKATAN DARAT
Harga Total
36,116 36,116
Harga Total
4,554 31,878
Harga Total
50,512 50,512
POLI KULIT & KELAMIN 39,893 0 MULYAWAN Unchecked BPJS UMUM PENSIUNAN H
Harga Total
16,641 16,641
317 3,170
12,800 12,800
6,072 6,072
121 1,210
Harga Total
900 27,000
121 7,260
207 6,210
POLI P. DALAM 38,690 0 NUNUNG LESUnchecked BPJS UMUM PENSIUNAN
Harga Total
1,533 15,330
301 9,030
121 10,890
344 3,440
Harga Total
4,178 14,623
4,179 96,117
4,179 29,253
198 1,980
Harga Total
36,116 36,116
POLI PARU-PARU 67,248 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
472 4,720
50,688 50,688
1,344 6,720
5,120 5,120
POLI KESEHATAN ANAK 63,509 0 ELSA PRATIWUnchecked BPJS AD KELUARGA
Harga Total
50,688 50,688
9,152 9,152
3,669 3,669
Harga Total
4,178 29,246
897 8,970
Harga Total
50,688 50,688
1,344 13,440
407 4,070
POLI GIGI DAN MULUT 3,440 0 TITIK NURYAUnchecked BPJS UMUM ASKES TNI
Harga Total
344 3,440
POLI SYARAF 42,222 0 TITIK NURYAUnchecked BPJS UMUM JAMSOSTEK
Harga Total
4,178 16,712
2,197 21,970
118 3,540
Harga Total
4,178 16,712
214 6,420
118 2,714
118 826
198 1,980
Harga Total
2,816 64,768
2,816 19,712
116 8,004
116 2,436
324 7,452
324 2,268
1,106 25,438
1,106 7,742
Harga Total
329 3,290
POLI P. DALAM 1,376 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
344 1,376
Harga Total
4,357 100,211
4,357 30,499
324 7,452
324 2,268
141 4,230
1,106 33,180
POLI P. DALAM 47,510 0 NUNUNG LESUnchecked BPJS UMUM JAMSOSTEK
Harga Total
121 10,890
1,106 33,180
344 3,440
Harga Total
7,181 50,267
6,924 159,252
6,924 48,468
141 4,230
1,393 32,039
1,393 9,751
RUANG PERAWATAN XIV 89,467 1 SANTIKA ASIUnchecked BPJS ANGKATAN DARAT
Harga Total
2,288 6,864
9,152 27,456
2,560 2,560
25,047 50,094
2,493 2,493
Harga Total
4,178 14,623
3,898 89,654
3,898 27,286
118 3,540
Harga Total
1,920 44,160
1,920 13,440
817 18,791
817 5,719
9,184 64,288
118 3,540
POLI PARU-PARU 147,920 0 MULYAWAN Unchecked BPJS UMUM ASKES NON T
Harga Total
142,800 142,800
5,120 5,120
Harga Total
36,116 36,116
Harga Total
4,178 14,623
49 1,470
118 3,540
Harga Total
30,976 30,976
116 10,440
141 4,230
5,773 5,773
1,106 33,180
Harga Total
28,653 28,653
62,093 62,093
POLI P. DALAM 19,010 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
1,901 19,010
Harga Total
1,728 39,744
1,728 12,096
2,816 64,768
2,816 19,712
324 7,452
324 2,268
141 2,115
118 3,540
Harga Total
727 7,270
214 6,420
4,080 40,800
207 6,210
Harga Total
704 7,040
POLI JANTUNG 131,280 0 NUNUNG LESUnchecked BPJS ANGKATAN DARAT P
Harga Total
313 7,199
313 2,191
2,816 64,768
2,816 19,712
141 4,230
1,106 33,180
POLI KULIT & KELAMIN 17,060 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
443 6,202
317 3,170
7,688 7,688
POLI GIGI DAN MULUT 6,220 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
212 2,120
410 4,100
Harga Total
513 2,565
301 4,214
706 9,884
121 2,541
POLI BEDAH UROLOGI 67,546 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN
Harga Total
9,088 63,616
49 490
344 3,440
POLI BEDAH ORTHOPEDI 8,970 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
897 8,970
Harga Total
1,533 30,660
2,277 22,770
344 6,880
Harga Total
28,653 28,653
Harga Total
6,272 43,904
1,901 19,010
344 3,440
POLI BEDAH ORTHOPEDI 52,420 0 ELSA PRATIWUnchecked BPJS UMUM JAMSOSTEK
Harga Total
2,277 45,540
344 6,880
POLI KULIT & KELAMIN 66,065 0 ELSA PRATIWUnchecked BPJS AD KELUARGA
Harga Total
443 6,645
42,240 42,240
317 3,170
12,800 12,800
121 1,210
Harga Total
4,178 14,623
6,924 159,252
6,924 48,468
162 1,620
4,179 192,234
4,179 58,506
118 3,540
Harga Total
212 2,120
324 9,720
4,554 31,878
Harga Total
212 2,120
5,632 56,320
Harga Total
4,178 14,623
118 3,540
198 1,980
POLI JIWA 196,935 0 NUNUNG LESUnchecked NON BPJS UMUM KONTRA
Harga Total
1,238 56,948
1,238 17,332
192 11,520
3,108 34,188
3,108 12,432
4,301 47,311
4,301 17,204
POLI KULIT & KELAMIN 66,898 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
4,105 8,210
23,936 47,872
4,576 4,576
416 6,240
POLI JIWA 73,245 0 NUNUNG LESUnchecked BPJS UMUM MANDIRI
Harga Total
24,415 73,245
Harga Total
39,681 39,681
317 3,170
Harga Total
4,179 192,234
4,179 58,506
118 3,540
198 1,980
Harga Total
4,178 14,623
6,924 159,252
6,924 48,468
118 3,540
198 1,980
POLI JANTUNG 151,470 0 NUNUNG LESUnchecked BPJS UMUM ASKES NON T
Harga Total
3,126 71,898
3,126 21,882
1,106 33,180
817 18,791
817 5,719
Harga Total
7,181 50,267
1,728 79,488
1,728 24,192
817 18,791
817 5,719
9,184 32,144
118 3,540
POLI JANTUNG 223,095 0 NUNUNG LESUnchecked BPJS UMUM JAMSOSTEK
Harga Total
6,924 159,252
6,924 48,468
324 7,452
324 2,268
141 2,115
118 3,540
Harga Total
4,178 14,623
162 1,134
118 826
Harga Total
7,181 50,267
116 3,480
324 9,720
4,554 31,878
118 3,540
POLI KULIT & KELAMIN 37,300 0 MULYAWAN Unchecked BPJS UMUM PENSIUNAN H
Harga Total
37,300 37,300
Harga Total
1,728 79,488
1,728 24,192
3,126 71,898
3,126 21,882
141 4,230
1,106 33,180
817 18,791
817 5,719
9,184 32,144
Harga Total
3,898 89,654
3,898 27,286
366 3,660
1,873 43,079
1,873 13,111
121 2,783
121 2,541
Harga Total
960 5,760
Harga Total
4,178 14,623
897 6,279
49 343
118 826
Harga Total
59,348 59,348
960 9,600
POLI THT 31,570 0 ELSA PRATIWUnchecked NON BPJS UMUM MURNI
Harga Total
2,840 28,400
317 3,170
Harga Total
4,178 29,246
897 6,279
118 826
198 1,386
POLI P. DALAM 32,330 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN
Harga Total
605 6,050
1,901 19,010
727 7,270
Harga Total
317 3,170
Harga Total
4,178 14,623
6,924 159,252
6,924 48,468
118 3,540
Harga Total
704 7,040
59,348 59,348
Harga Total
4,178 14,623
118 826
198 1,386
Harga Total
271 2,710
212 2,120
2,840 28,400
POLI P. DALAM 1,297,558 0 NUNUNG LESUnchecked BPJS UMUM PENSIUNAN H
Harga Total
107,100 1,071,000
472 4,720
6,924 159,252
6,924 48,468
2,816 8,448
189 5,670
POLI KESEHATAN ANAK 15,157 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
4,309 4,309
10,848 10,848
Harga Total
443 4,430
6,055 60,550
1,901 19,010
2,840 28,400
727 7,270
344 1,720
POLI SYARAF 39,396 0 NUNUNG LESUnchecked BPJS UMUM PENSIUNAN
Harga Total
4,178 29,246
897 8,970
118 1,180
Harga Total
7,296 335,616
7,296 102,144
118 3,540
Harga Total
313 7,199
313 2,191
2,816 64,768
2,816 19,712
141 4,230
817 18,791
817 5,719
Harga Total
1,533 45,990
16,080 16,080
344 6,880
POLI P. DALAM 75,163 0 NUNUNG LESUnchecked BPJS ANGKATAN DARAT
Harga Total
4,178 25,068
1,533 15,330
317 1,585
1,106 33,180
Harga Total
4,178 14,623
6,924 48,468
198 1,386
POLI JIWA 234,217 0 NUNUNG LESUnchecked BPJS UMUM ASKES NON T
Harga Total
1,238 37,140
192 5,760
445 6,675
3,108 24,864
4,179 96,117
4,179 29,253
4,301 34,408
Harga Total
1,901 19,010
727 7,270
Harga Total
4,178 14,623
6,924 159,252
6,924 48,468
162 1,620
2,197 21,970
118 3,540
Harga Total
2,816 64,768
2,816 19,712
324 7,452
324 2,268
4,554 31,878
1,254 28,842
1,254 8,778
118 3,540
POLI SYARAF 157,710 0 MULYAWAN Unchecked BPJS UMUM MANDIRI
Harga Total
212 3,180
1,112 33,360
49 1,470
174 10,440
2,816 84,480
727 21,810
198 2,970
Harga Total
2,816 64,768
2,816 19,712
1,920 88,320
1,920 26,880
817 18,791
817 5,719
4,554 31,878
Harga Total
4,178 14,623
897 8,970
3,898 89,654
3,898 27,286
118 3,540
198 1,980
Harga Total
2,816 64,768
2,816 19,712
1,106 33,180
817 24,510
Harga Total
4,178 14,623
897 8,970
2,197 21,970
118 3,540
198 1,980
Harga Total
4,178 14,623
2,197 21,970
118 3,540
Harga Total
4,178 14,623
118 3,540
Harga Total
897 26,910
2,277 68,310
Harga Total
116 8,004
116 2,436
141 4,230
1,393 32,039
1,393 9,751
1,254 28,842
1,254 8,778
Harga Total
817 24,510
POLI BEDAH ORTHOPEDI 55,480 0 ELSA PRATIWUnchecked BPJS ANGKATAN DARAT K
Harga Total
1,533 30,660
897 17,940
344 6,880
POLI BEDAH UROLOGI 67,056 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
9,088 63,616
344 3,440
Harga Total
5,703 34,218
4,554 31,878
POLI SYARAF 7,640 0 NUNUNG LESUnchecked BPJS AD MIL SATPUR
Harga Total
212 2,120
118 3,540
198 1,980
POLI BEDAH UMUM 21,210 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
513 5,130
16,080 16,080
Harga Total
4,178 25,068
2,840 28,400
20,733 62,199
Harga Total
271 2,710
513 5,130
2,840 28,400
1,599 15,990
Harga Total
9,088 63,616
49 490
344 3,440
Harga Total
5,703 51,327
POLI BEDAH UROLOGI 3,440 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN H
Harga Total
344 3,440
Harga Total
107,100 107,100
107,100 107,100
109,620 328,860
109,620 109,620
897 6,279
366 2,562
Harga Total
1,533 45,990
897 17,940
344 6,880
POLI KULIT & KELAMIN 15,970 0 ELSA PRATIWUnchecked BPJS ANGKATAN DARAT
Harga Total
317 3,170
12,800 12,800
Harga Total
2,816 64,768
2,816 19,712
817 18,791
817 5,719
4,554 31,878
118 3,540
Harga Total
1,393 32,039
1,393 9,751
727 7,270
9,184 64,288
Harga Total
2,816 64,768
2,816 19,712
817 18,791
817 5,719
214 6,420
4,554 31,878
Harga Total
4,357 100,211
4,357 30,499
1,106 33,180
Harga Total
1,920 44,160
1,920 13,440
781 23,430
324 9,720
Harga Total
4,357 30,499
1,009 7,063
121 2,541
214 1,498
Harga Total
99 2,970
301 9,030
706 42,360
121 10,890
344 3,440
Harga Total
2,816 64,768
2,816 19,712
1,920 88,320
1,920 26,880
141 2,115
1,106 33,180
POLI JANTUNG 94,200 0 NUNUNG LESUnchecked BPJS ANGKATAN DARAT
Harga Total
2,816 64,768
2,816 19,712
324 7,452
324 2,268
Harga Total
2,816 64,768
2,816 19,712
324 7,452
324 2,268
4,554 31,878
Harga Total
20,733 62,199
POLI GIGI DAN MULUT 9,730 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
275 2,750
410 4,100
288 2,880
Harga Total
212 2,120
313 9,390
1,106 33,180
Harga Total
2,277 22,770
344 3,440
POLI BEDAH UROLOGI 43,904 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
6,272 43,904
POLI SYARAF 1,185,380 0 NUNUNG LESUnchecked BPJS UMUM ASKES TNI
Harga Total
212 2,120
113 6,780
3,898 89,654
3,898 27,286
16,256 373,888
16,256 113,792
162 1,620
6,336 437,184
6,336 133,056
POLI KESEHATAN ANAK 49,281 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
29,287 29,287
19,994 19,994
Harga Total
1,533 30,660
897 17,940
344 6,880
POLI P. DALAM 229,140 0 MULYAWAN Unchecked BPJS UMUM JAMSOSTEK
Harga Total
6,924 159,252
6,924 48,468
49 4,410
189 17,010
POLI MATA 36,116 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN H
Harga Total
36,116 36,116
POLI KEBIDANAN DAN KA 17,140 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
410 6,150
1,099 10,990
Harga Total
2,816 64,768
2,816 19,712
141 4,230
817 18,791
817 5,719
POLI BEDAH UMUM 11,920 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
9,856 9,856
344 2,064
POLI MATA 79,096 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
42,980 42,980
36,116 36,116
Harga Total
3,898 89,654
3,898 27,286
116 3,480
324 7,452
324 2,268
Harga Total
4,178 14,623
6,924 159,252
6,924 48,468
214 6,420
118 3,540
POLI KEBIDANAN DAN KA 49,280 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
4,928 49,280
Harga Total
344 5,160
POLI JANTUNG 49,545 0 NUNUNG LESUnchecked NON BPJS UMUM MURNI/B
Harga Total
116 6,960
141 2,115
817 24,510
207 12,420
118 3,540
POLI JANTUNG 1,195 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
239 1,195
Harga Total
4,178 14,623
3,898 89,654
3,898 27,286
118 3,540
POLI KESEHATAN ANAK 17,005 0 ELSA PRATIWUnchecked NON BPJS UMUM KARYAW
Harga Total
12,696 12,696
4,309 4,309
POLI BEDAH ORTHOPEDI 3,440 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
344 3,440
Harga Total
2,816 64,768
2,816 19,712
1,920 44,160
1,920 13,440
324 7,452
324 2,268
POLI BEDAH UMUM 123,177 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
5,703 51,327
11,975 71,850
POLI BEDAH ORTHOPEDI 29,810 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
704 7,040
2,277 22,770
POLI SYARAF 213,240 0 NUNUNG LESUnchecked BPJS ANGKATAN DARAT
Harga Total
6,924 159,252
6,924 48,468
118 3,540
198 1,980
POLI SYARAF 27,133 0 NUNUNG LESUnchecked BPJS ANGKATAN DARAT
Harga Total
4,178 14,623
897 8,970
118 3,540
Harga Total
344 3,440
POLI BEDAH UMUM 16,315 0 ELSA PRATIWUnchecked NON BPJS UMUM MURNI/B
Harga Total
472 4,720
366 5,490
407 6,105
Harga Total
7,181 165,163
7,181 50,267
1,728 39,744
1,728 12,096
817 18,791
817 5,719
4,554 31,878
118 3,540
POLI THT 8,270 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
212 2,120
410 6,150
Harga Total
28,653 28,653
Harga Total
1,533 45,990
16,080 16,080
344 6,880
Harga Total
1,533 45,990
16,080 16,080
344 3,440
POLI BEDAH UMUM 9,280 0 ELSA PRATIWUnchecked BPJS UMUM JAMSOSTEK
Harga Total
653 6,530
275 2,750
POLI JIWA 97,660 0 NUNUNG LESUnchecked BPJS UMUM JAMKESMAS
Harga Total
24,415 97,660
Harga Total
1,533 15,330
897 8,970
121 10,890
344 3,440
Harga Total
301 18,060
121 7,260
344 3,440
POLI P. DALAM 92,901 0 NUNUNG LESUnchecked BPJS UMUM JAMKESMAS
Harga Total
513 3,591
1,009 30,270
984 59,040
Harga Total
1,533 15,330
706 42,360
121 7,260
344 3,440
Harga Total
1,533 30,660
16,080 16,080
344 6,880
Harga Total
317 3,170
POLI P. DALAM 53,226 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
30,976 30,976
212 2,120
605 6,050
2,816 14,080
Harga Total
100,800 100,800
443 4,430
1,344 6,720
Harga Total
10,772 53,860
50,688 50,688
2,197 10,985
189 1,890
344 1,720
POLI KEBIDANAN DAN KA 26,405 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
1,577 23,655
275 2,750
Harga Total
704 7,040
6,272 43,904
30,976 30,976
126 1,260
344 3,440
Harga Total
9,088 63,616
344 3,440
Harga Total
28,653 28,653
Harga Total
2,277 68,310
Harga Total
344 3,440
Harga Total
49 2,940
189 5,670
2,277 22,770
Harga Total
3,612 36,120
344 2,064
POLI KESEHATAN ANAK 53,869 0 MULYAWAN Unchecked BPJS UMUM MANDIRI
Harga Total
12,696 12,696
32,384 32,384
5,120 5,120
3,669 3,669
Harga Total
704 7,040
275 2,750
POLI P. DALAM 286,869 0 MULYAWAN Unchecked BPJS UMUM ASKES NON T
Harga Total
4,178 25,068
15,027 45,081
109,620 109,620
107,100 107,100
Harga Total
275 2,750
9,152 9,152
POLI P. DALAM 4,070 0 MULYAWAN Unchecked BPJS UMUM MANDIRI
Harga Total
407 4,070
Harga Total
239 1,195
POLI P. DALAM 56,165 0 ELSA PRATIWUnchecked BPJS UMUM JAMKESMAS
Harga Total
443 1,772
212 2,120
50,688 50,688
317 1,585
POLI MATA 50,512 0 ELSA PRATIWUnchecked BPJS UMUM JAMSOSTEK
Harga Total
50,512 50,512
Harga Total
366 2,562
POLI GIGI DAN MULUT 6,850 0 ELSA PRATIWUnchecked BPJS UMUM MANDIRI
Harga Total
275 2,750
410 4,100
Harga Total
1,577 15,770
5,703 57,030
472 4,720
727 7,270
Harga Total
207 6,210
Harga Total
50,688 50,688
3,830 88,090
3,830 26,810
897 8,970
984 45,264
984 13,776
107,100 107,100
Harga Total
5,421 37,947
Harga Total
40,304 40,304
28,653 28,653
Harga Total
212 2,120
2,816 64,768
2,816 19,712
2,840 28,400
1,873 43,079
1,873 13,111
5,773 5,773
121 5,566
121 1,694
Harga Total
1,533 30,660
897 17,940
344 6,880
POLI P. DALAM 328,170 0 NUNUNG LESUnchecked BPJS UMUM JAMSOSTEK
Harga Total
107,100 107,100
109,620 109,620
109,620 109,620
366 1,830
Harga Total
1,599 9,594
20,733 62,199
Harga Total
317 3,170
6,072 6,072
Harga Total
28,653 28,653
Harga Total
30,448 30,448
POLI GIGI DAN MULUT 6,850 0 ELSA PRATIWUnchecked BPJS AD MIL SATPUR
Harga Total
275 2,750
410 4,100
Harga Total
960 5,760
POLI KEBIDANAN DAN KA 49,280 0 ELSA PRATIWUnchecked BPJS UMUM ASKES NON T
Harga Total
4,928 49,280
Harga Total
513 5,130
317 1,585
Harga Total
52,182 52,182
POLI MATA 22,704 0 ELSA PRATIWUnchecked BPJS UMUM ASKES TNI
Harga Total
22,704 22,704
POLI KESEHATAN ANAK 53,676 0 ELSA PRATIWUnchecked NON BPJS UMUM MURNI
Harga Total
33,440 33,440
410 4,100
7,688 7,688
8,448 8,448
Harga Total
1,009 30,270
121 7,260
Harga Total
3,898 89,654
3,898 27,286
116 10,440
141 2,115
817 24,510
Harga Total
28,653 28,653
POLI MATA 28,653 0 MULYAWAN Unchecked BPJS UMUM ASKES TNI
Harga Total
28,653 28,653
POLI KULIT & KELAMIN 16,888 0 MULYAWAN Unchecked BPJS UMUM ASKES NON T
Harga Total
4,576 4,576
416 6,240
6,072 6,072
POLI BEDAH UMUM 94,919 0 ELSA PRATIWUnchecked BPJS UMUM PENSIUNAN
Harga Total
2,840 28,400
20,733 62,199
288 4,320
POLI P. DALAM 79,480 0 ELSA PRATIWUnchecked NON BPJS UMUM KARYAW
Harga Total
6,055 60,550
407 4,070
727 7,270
759 7,590
Harga Total
30,976 30,976
212 2,120
727 5,089
Harga Total
376 4,512
1,112 13,344
Harga Total
68,725 206,175
Harga Total
1,728 3,456
304,501 304,501
13,250 26,500
605 605
817 817
9,184 9,184
Harga Total
68,725 137,450
Harga Total
3,570 7,140
Harga Total
5,914 11,828
126,126 252,252
8,205 24,615
24,949 24,949
30,272 30,272
82 82
37,120 37,120
7,084 14,168
21,478 21,478
Harga Total
124,740 249,480
7,181 7,181
2,048 6,144
5,069 5,069
15,228 60,912
50,688 50,688
832 832
9,152 9,152
304,501 304,501
2,560 10,240
10,594 31,782
65,079 65,079
7,084 14,168
44,800 44,800
13,400 13,400
206 2,060
6,016 6,016
5,632 5,632
2,493 7,479
BPJS UMUM MANDIRI
64,768
19,712
6,210
64,768
19,712
88,320
26,880
9,845
3,133
BPJS UMUM JAMSOSTEK
51,072
14,623
27,286
826
BPJS ANGKATAN DARAT
50,688
13,846
4,214
32,476
9,884
8,349
2,541
BPJS UMUM ASKES TNI
64,768
19,712
7,452
2,268
4,230
64,768
19,712
3,243
987
18,791
5,719
BPJS UMUM ASKES TNI
64,768
19,712
44,160
13,440
8,070
7,452
2,268
BPJS UMUM JAMSOSTEK
2,120
490
3,540
14,623
89,654
27,286
2,714
826
BPJS UMUM ASKES TNI
7,199
2,191
64,768
19,712
2,115
BPJS UMUM JAMSOSTEK
89,654
27,286
3,540
BPJS UMUM MANDIRI
14,623
89,654
27,286
2,714
826
BPJS UMUM ASKES TNI
88,320
26,880
159,252
48,468
BPJS UMUM MANDIRI
2,120
28,400
45,990
16,080
6,880
BPJS UMUM JAMKESMAS
43,904
1,720
BPJS UMUM JAMSOSTEK
12,696
19,994
BPJS UMUM JAMKESMAS
5,420
6,720
245
BPJS UMUM PENSIUNAN
29,246
30,660
17,940
16,080
BPJS UMUM MANDIRI
16,712
89,654
27,286
2,714
826
1,980
BPJS UMUM MANDIRI
14,623
3,540
NON BPJS UMUM MURNI
4,020
64,768
19,712
4,230
8,070
1,720
BPJS UMUM JAMKESMAS
64,768
19,712
4,230
33,180
18,791
5,719
31,878
13,846
4,214
32,476
9,884
8,349
2,541
BPJS UMUM MANDIRI
14,623
8,970
159,252
48,468
3,540
BPJS UMUM ASKES TNI
100,211
30,499
7,452
2,268
3,290
33,180
2,120
8,970
3,540
BPJS UMUM JAMKESMAS
6,279
48,468
30,107
826
BPJS UMUM MANDIRI
100,800
6,720
5,120
BPJS UMUM JAMKESMAS
14,623
8,970
3,540
BPJS UMUM MANDIRI
16,712
3,540
1,980
BPJS UMUM MANDIRI
31,856
28,653
BPJS UMUM JAMSOSTEK
4,105
47,872
4,438
6,072
BPJS UMUM ASKES TNI
2,010
7,199
2,191
64,768
19,712
50,688
4,230
BPJS UMUM JAMKESMAS
4,309
BPJS UMUM MANDIRI
26,930
50,688
6,720
BPJS UMUM ASKES TNI
13,846
4,214
45,264
13,776
96,186
29,274
BPJS UMUM ASKES TNI
64,768
19,712
6,923
2,107
8,349
2,541
6,420
38,368
2,750
14,623
1,470
3,540
100,211
30,499
13,846
4,214
126,316
38,444
5,566
1,694
6,420
1,720
BPJS UMUM JAMSOSTEK
60,912
13,095
10,240
14,080
66,426
44,800
4,120
5,632
18,875
9,972
12,332
24,870
3,170
9,856
490
BPJS UMUM JAMKESMAS
14,623
3,540
1,980
BPJS UMUM PENSIUNAN
25,068
15,330
21,760
705
BPJS UMUM MANDIRI
14,623
159,252
48,468
30,107
2,714
826
BPJS ANGKATAN DARAT
13,455
6,880
BPJS UMUM MANDIRI
29,246
48,468
826
1,386
BPJS UMUM JAMKESMAS
3,440
159,252
48,468
7,270
3,540
BPJS UMUM ASKES TNI
14,623
8,970
159,252
48,468
3,540
29,570
21,970
3,025
990
BPJS UMUM JAMKESMAS
96,186
29,274
8,280
33,180
15,939
BPJS UMUM ASKES TNI
5,130
15,990
21,970
BPJS UMUM MANDIRI
48,468
15,379
826
1,386
BPJS UMUM PENSIUNAN
57,600
24,510
16,712
8,970
159,252
48,468
2,714
826
BPJS UMUM PENSIUNAN
100,211
30,499
4,230
33,180
18,791
5,719
31,878
BPJS UMUM ASKES TNI
159,252
48,468
21,970
BPJS UMUM POLRI
64,768
19,712
4,230
33,180
18,791
5,719
1,720
31,878
BPJS UMUM ASKES TNI
64,768
19,712
88,320
26,880
18,791
5,719
BPJS UMUM ASKES TNI
21,970
3,540
1,980
28,653
BPJS AD KELUARGA
45,990
16,080
6,880
BPJS UMUM MANDIRI
64,768
19,712
9,845
3,133
4,230
18,791
5,719
31,878
3,540
2,120
8,970
159,252
48,468
2,714
826
43,904
BPJS UMUM JAMKESMAS
36,116
NON BPJS UMUM KONTRA
22,995
7,590
BPJS UMUM MANDIRI
7,063
2,541
89,654
27,286
3,480
7,452
2,268
31,878
2,714
826
BPJS UMUM JAMSOSTEK
2,750
9,856
56,320
4,070
9,600
BPJS AD KELUARGA
42,240
5,796
3,290
12,800
BPJS UMUM MANDIRI
33,360
1,470
15,660
66,150
84,480
21,810
33,120
BPJS UMUM ASKES TNI
134,090
40,810
6,210
7,270
BPJS UMUM MANDIRI
4,430
56,320
8,064
21,630
5,120
BPJS UMUM MANDIRI
7,199
2,191
64,768
19,712
88,320
26,880
4,230
BPJS UMUM ASKES TNI
53,860
56,320
1,585
2,442
30,900
3,540
BPJS UMUM JAMKESMAS
16,680
5,880
3,330
11,040
8,860
64,768
19,712
20,585
6,265
18,791
5,719
BPJS UMUM JAMSOSTEK
3,440
28,400
3,440
BPJS UMUM MANDIRI
1,695
73,692
22,428
BPJS UMUM MANDIRI
100,211
30,499
7,452
2,268
33,180
BPJS ANGKATAN DARAT
36,116
BPJS UMUM ASKES TNI
31,878
50,512
16,641
3,170
12,800
6,072
1,210
BPJS UMUM ASKES TNI
27,000
7,260
6,210
BPJS UMUM PENSIUNAN
15,330
9,030
10,890
3,440
BPJS UMUM JAMKESMAS
14,623
96,117
29,253
1,980
BPJS UMUM MANDIRI
36,116
BPJS UMUM ASKES TNI
4,720
50,688
6,720
5,120
BPJS AD KELUARGA
50,688
9,152
3,669
BPJS UMUM MANDIRI
29,246
8,970
BPJS UMUM JAMKESMAS
50,688
13,440
4,070
BPJS UMUM ASKES TNI
3,440
BPJS UMUM JAMSOSTEK
16,712
21,970
3,540
BPJS UMUM ASKES TNI
16,712
6,420
2,714
826
1,980
BPJS UMUM MANDIRI
64,768
19,712
8,004
2,436
7,452
2,268
25,438
7,742
BPJS ANGKATAN DARAT
3,290
BPJS UMUM MANDIRI
1,376
BPJS UMUM MANDIRI
100,211
30,499
7,452
2,268
4,230
33,180
BPJS UMUM JAMSOSTEK
10,890
33,180
3,440
BPJS UMUM ASKES TNI
50,267
159,252
48,468
4,230
32,039
9,751
BPJS ANGKATAN DARAT
6,864
27,456
2,560
50,094
2,493
14,623
89,654
27,286
3,540
BPJS UMUM PENSIUNAN
44,160
13,440
18,791
5,719
64,288
3,540
142,800
5,120
BPJS UMUM MANDIRI
36,116
BPJS UMUM JAMKESMAS
14,623
1,470
3,540
BPJS UMUM JAMKESMAS
30,976
10,440
4,230
5,773
33,180
BPJS UMUM MANDIRI
28,653
62,093
BPJS UMUM ASKES TNI
19,010
39,744
12,096
64,768
19,712
7,452
2,268
2,115
3,540
BPJS UMUM ASKES TNI
7,270
6,420
40,800
6,210
BPJS UMUM MANDIRI
7,040
7,199
2,191
64,768
19,712
4,230
33,180
BPJS UMUM MANDIRI
6,202
3,170
7,688
BPJS UMUM MANDIRI
2,120
4,100
BPJS UMUM MANDIRI
2,565
4,214
9,884
2,541
BPJS UMUM PENSIUNAN
63,616
490
3,440
BPJS UMUM ASKES TNI
8,970
BPJS UMUM ASKES TNI
30,660
22,770
6,880
BPJS UMUM JAMKESMAS
28,653
BPJS UMUM JAMKESMAS
43,904
19,010
3,440
BPJS UMUM JAMSOSTEK
45,540
6,880
BPJS AD KELUARGA
6,645
42,240
3,170
12,800
1,210
BPJS UMUM JAMSOSTEK
14,623
159,252
48,468
1,620
192,234
58,506
3,540
BPJS UMUM ASKES TNI
2,120
9,720
31,878
2,120
56,320
14,623
3,540
1,980
NON BPJS UMUM KONTRA
56,948
17,332
11,520
34,188
12,432
47,311
17,204
8,210
47,872
4,576
6,240
BPJS UMUM MANDIRI
73,245
BPJS UMUM MANDIRI
39,681
3,170
BPJS UMUM MANDIRI
192,234
58,506
3,540
1,980
14,623
159,252
48,468
3,540
1,980
71,898
21,882
33,180
18,791
5,719
50,267
79,488
24,192
18,791
5,719
32,144
3,540
BPJS UMUM JAMSOSTEK
159,252
48,468
7,452
2,268
2,115
3,540
BPJS UMUM MANDIRI
14,623
1,134
826
BPJS UMUM JAMSOSTEK
50,267
3,480
9,720
31,878
3,540
37,300
BPJS UMUM MANDIRI
79,488
24,192
71,898
21,882
4,230
33,180
18,791
5,719
32,144
BPJS UMUM MANDIRI
89,654
27,286
3,660
43,079
13,111
2,783
2,541
5,760
14,623
6,279
343
826
BPJS UMUM JAMSOSTEK
59,348
9,600
NON BPJS UMUM MURNI
28,400
3,170
BPJS UMUM MANDIRI
29,246
6,279
826
1,386
BPJS UMUM PENSIUNAN
6,050
19,010
7,270
3,170
BPJS UMUM MANDIRI
14,623
159,252
48,468
3,540
BPJS UMUM JAMSOSTEK
7,040
59,348
BPJS UMUM ASKES TNI
14,623
826
1,386
BPJS UMUM MANDIRI
2,710
2,120
28,400
1,071,000
4,720
159,252
48,468
8,448
5,670
4,309
10,848
BPJS UMUM ASKES TNI
4,430
60,550
19,010
28,400
7,270
1,720
BPJS UMUM PENSIUNAN
29,246
8,970
1,180
BPJS UMUM MANDIRI
335,616
102,144
3,540
BPJS UMUM MANDIRI
7,199
2,191
64,768
19,712
4,230
18,791
5,719
BPJS UMUM ASKES TNI
45,990
16,080
6,880
BPJS ANGKATAN DARAT
25,068
15,330
1,585
33,180
BPJS UMUM ASKES TNI
14,623
48,468
1,386
37,140
5,760
6,675
24,864
96,117
29,253
34,408
19,010
7,270
BPJS UMUM MANDIRI
14,623
159,252
48,468
1,620
21,970
3,540
BPJS UMUM MANDIRI
64,768
19,712
7,452
2,268
31,878
28,842
8,778
3,540
BPJS UMUM MANDIRI
3,180
33,360
1,470
10,440
84,480
21,810
2,970
BPJS UMUM PENSIUNAN
64,768
19,712
88,320
26,880
18,791
5,719
31,878
BPJS UMUM JAMKESMAS
14,623
8,970
89,654
27,286
3,540
1,980
BPJS UMUM MANDIRI
64,768
19,712
33,180
24,510
BPJS UMUM ASKES TNI
14,623
8,970
21,970
3,540
1,980
BPJS UMUM ASKES TNI
14,623
21,970
3,540
BPJS UMUM ASKES TNI
14,623
3,540
26,910
68,310
8,004
2,436
4,230
32,039
9,751
28,842
8,778
BPJS UMUM MANDIRI
24,510
30,660
17,940
6,880
BPJS UMUM MANDIRI
63,616
3,440
34,218
31,878
BPJS AD MIL SATPUR
2,120
3,540
1,980
BPJS UMUM MANDIRI
5,130
16,080
BPJS UMUM MANDIRI
25,068
28,400
62,199
BPJS UMUM MANDIRI
2,710
5,130
28,400
15,990
BPJS UMUM JAMSOSTEK
63,616
490
3,440
BPJS UMUM MANDIRI
51,327
3,440
BPJS UMUM MANDIRI
107,100
107,100
328,860
109,620
6,279
2,562
45,990
17,940
6,880
BPJS ANGKATAN DARAT
3,170
12,800
64,768
19,712
18,791
5,719
31,878
3,540
BPJS UMUM JAMKESMAS
32,039
9,751
7,270
64,288
BPJS UMUM ASKES TNI
64,768
19,712
18,791
5,719
6,420
31,878
100,211
30,499
33,180
44,160
13,440
23,430
9,720
BPJS UMUM PENSIUNAN
30,499
7,063
2,541
1,498
2,970
9,030
42,360
10,890
3,440
64,768
19,712
88,320
26,880
2,115
33,180
BPJS ANGKATAN DARAT
64,768
19,712
7,452
2,268
64,768
19,712
7,452
2,268
31,878
BPJS UMUM MANDIRI
62,199
2,750
4,100
2,880
BPJS UMUM ASKES TNI
2,120
9,390
33,180
BPJS UMUM ASKES TNI
22,770
3,440
BPJS UMUM ASKES TNI
43,904
BPJS UMUM ASKES TNI
2,120
6,780
89,654
27,286
373,888
113,792
1,620
437,184
133,056
BPJS UMUM MANDIRI
29,287
19,994
BPJS UMUM ASKES TNI
30,660
17,940
6,880
BPJS UMUM JAMSOSTEK
159,252
48,468
4,410
17,010
36,116
BPJS UMUM MANDIRI
6,150
10,990
64,768
19,712
4,230
18,791
5,719
BPJS UMUM JAMKESMAS
9,856
2,064
BPJS UMUM ASKES TNI
42,980
36,116
89,654
27,286
3,480
7,452
2,268
BPJS UMUM MANDIRI
14,623
159,252
48,468
6,420
3,540
BPJS UMUM JAMKESMAS
49,280
5,160
NON BPJS UMUM MURNI/B
6,960
2,115
24,510
12,420
3,540
BPJS UMUM JAMKESMAS
1,195
BPJS UMUM JAMSOSTEK
14,623
89,654
27,286
3,540
NON BPJS UMUM KARYAW
12,696
4,309
BPJS UMUM JAMKESMAS
3,440
BPJS UMUM MANDIRI
64,768
19,712
44,160
13,440
7,452
2,268
BPJS UMUM ASKES TNI
51,327
71,850
BPJS UMUM MANDIRI
7,040
22,770
BPJS ANGKATAN DARAT
159,252
48,468
3,540
1,980
BPJS ANGKATAN DARAT
14,623
8,970
3,540
BPJS UMUM MANDIRI
3,440
4,720
5,490
6,105
BPJS UMUM JAMSOSTEK
165,163
50,267
39,744
12,096
18,791
5,719
31,878
3,540
2,120
6,150
BPJS UMUM JAMKESMAS
28,653
BPJS UMUM JAMSOSTEK
45,990
16,080
6,880
BPJS UMUM MANDIRI
45,990
16,080
3,440
BPJS UMUM JAMSOSTEK
6,530
2,750
BPJS UMUM JAMKESMAS
97,660
BPJS UMUM ASKES TNI
15,330
8,970
10,890
3,440
BPJS UMUM MANDIRI
18,060
7,260
3,440
BPJS UMUM JAMKESMAS
3,591
30,270
59,040
BPJS UMUM MANDIRI
15,330
42,360
7,260
3,440
BPJS UMUM JAMKESMAS
30,660
16,080
6,880
3,170
BPJS UMUM JAMKESMAS
30,976
2,120
6,050
14,080
BPJS UMUM MANDIRI
100,800
4,430
6,720
53,860
50,688
10,985
1,890
1,720
BPJS UMUM JAMKESMAS
23,655
2,750
BPJS UMUM JAMKESMAS
7,040
43,904
30,976
1,260
3,440
BPJS UMUM MANDIRI
63,616
3,440
28,653
BPJS UMUM JAMSOSTEK
68,310
BPJS UMUM MANDIRI
3,440
BPJS UMUM MANDIRI
2,940
5,670
22,770
BPJS UMUM MANDIRI
36,120
2,064
BPJS UMUM MANDIRI
12,696
32,384
5,120
3,669
BPJS UMUM MANDIRI
7,040
2,750
25,068
45,081
109,620
107,100
BPJS UMUM JAMKESMAS
2,750
9,152
BPJS UMUM MANDIRI
4,070
BPJS UMUM JAMKESMAS
1,195
BPJS UMUM JAMKESMAS
1,772
2,120
50,688
1,585
BPJS UMUM JAMSOSTEK
50,512
BPJS UMUM MANDIRI
2,562
BPJS UMUM MANDIRI
2,750
4,100
BPJS UMUM ASKES TNI
15,770
57,030
4,720
7,270
6,210
50,688
88,090
26,810
8,970
45,264
13,776
107,100
BPJS UMUM JAMKESMAS
37,947
40,304
28,653
BPJS UMUM PENSIUNAN
2,120
64,768
19,712
28,400
43,079
13,111
5,773
5,566
1,694
BPJS UMUM ASKES TNI
30,660
17,940
6,880
BPJS UMUM JAMSOSTEK
107,100
109,620
109,620
1,830
BPJS UMUM MANDIRI
9,594
62,199
3,170
6,072
BPJS UMUM MANDIRI
28,653
BPJS UMUM MANDIRI
30,448
BPJS AD MIL SATPUR
2,750
4,100
BPJS UMUM MANDIRI
5,760
49,280
BPJS UMUM MANDIRI
5,130
1,585
BPJS UMUM JAMKESMAS
52,182
BPJS UMUM ASKES TNI
22,704
NON BPJS UMUM MURNI
33,440
4,100
7,688
8,448
BPJS UMUM ASKES TNI
30,270
7,260
89,654
27,286
10,440
2,115
24,510
28,653
BPJS UMUM ASKES TNI
28,653
4,576
6,240
6,072
BPJS UMUM PENSIUNAN
28,400
62,199
4,320
NON BPJS UMUM KARYAW
60,550
4,070
7,270
7,590
BPJS UMUM ASKES TNI
30,976
2,120
5,089
4,512
13,344
206,175
3,456
304,501
26,500
605
817
9,184
BPJS UMUM MANDIRI
137,450
7,140
BPJS UMUM MANDIRI
11,828
252,252
24,615
24,949
30,272
82
37,120
14,168
21,478
BPJS UMUM JAMSOSTEK
249,480
7,181
6,144
5,069
60,912
50,688
832
9,152
304,501
10,240
31,782
65,079
14,168
44,800
13,400
2,060
6,016
5,632
7,479
OFLOXACIN INF DEXA 100 ML /T
BRAXIDIN TAB
TROPIGESIC CAPS
RANITIDIN INJ 50/2ML/T
DALAM KONDISI TERTENTU, DOKTER DI FASKES TINNOVORAPID FLEXPEN NOVO INJ 3 ML
RINGER LAKTAT SANBE
ALKOHOL SWAB COSMO
IV CATHETER 22/T
DEXKETOPROFEN INJEKSI OPL
NEUROSANBE INJ
RINGER LAKTAT SANBE
ALKOHOL SWAB COSMO
NEUROSANBE INJ
NACL 0.9 500 ML
PHENYTOIN IKAP 100 MG
KSR
CEFOPERAZONE INJ 1 GR YARINDO /T
ALKOHOL SWAB COSMO
ESOME 40 MG INJ
NACL 0.9 500 ML
METRONIDAZOL FRES 5 MG/ML INFUS 100 ML
TROPIGESIC CAPS
IV CATHETER 22/T
RINGER LAKTAT SANBE
ALKOHOL SWAB COSMO
NEUROSANBE INJ
IV DRESSING 3M 50
NACL 0.9 500 ML
LOVEQUIN 500 MG
LANSOPRAZOLE 30MG BERNO /T
ALKOHOL SWAB COSMO
METHYL PREDNISOLON 125 MG INJ MBF
NEUROSANBE INJ
KONDOM CATHETER
NACL 100ML SANBE
INFUSAN M20 500ML
FOLLEY CATHETER NO.18 GEA/ROYAL
URINE BAG COSMO
VERSILON 6 MG MERSI
MINIASPI 80 MG R
VALISANBE 2 MG
NACL 100ML SANBE
TRAMADOL 50 MG/ML AMP 2 ML INFA
ALKOHOL SWAB COSMO
CEFTRIAXONE 1 GR HEXP
NACL 0.9 500 ML
PROSOGAN TAKE 30 MG/ML
PROFAT SYR
AQUABIDEST 500 ML
BISOLVON BOEH 4MG/2ML AMP
COMBIVENT-UDV BOEH 25 ML
IV DRESSING 3M 50
NACL 100ML SANBE
THREE WAY STOP COCK
DISPOSABLE SYRINGE 50 ML TERUMO (LP)
URESIX INJ
ALKOHOL SWAB COSMO
MASKER NONREBREATHING BESMED1
IV CATHETER 22/T
IV CATHETER 20/T
INZON 1 GR INJ
MAX 60 TAB/ BULAN IKALEP
NOPRENIA ORAL SUSP 30 ML
CLOZAPINE 25 MG
NACL 100ML SANBE
PSIDII CAPS 500MG
VITAMIN B COMPLEX COMB
TROPIGESIC CAPS
IV CATHETER 20/T
PROFAT SYR
AMLODIPIN 10 MG
IV DRESSING 3M 50
NACL 0.9 500 ML
NACL 100ML SANBE
MAX 30 TAB/BULAN ACETOSAL 100 MG PHAROS
BRILINTA 90 MG
ALKOHOL SWAB COSMO
IV CATHETER 20/T
ROSUFER TAB 20 MG
NASALCANULA DEWASA FRESCHO
FLUCADEX TAB
NACL 100ML SANBE
MAX 90 TAB/BULAN ISOSORBID DINITRATE 5 MG E
VALESCO 80 MG
MAX 30 TAB/BULAN ADALAT OROS 30 BAYER
NATTO TAB OPL
URESIX INJ
CORMEGA OPL
ALKOHOL SWAB COSMO
NEVODIO 5 MG TAB
IV CATHETER 20/T
CORMEGA OPL
MINIASPI 80 MG R
ROSUFER TAB 20 MG
SUPRAFENID MEF SUPP
NACL 0.9 500 ML
URESIX INJ
MAAGSLAANG 16/T
CEFTIZOXIME 1 GR
IV DRESSING 3M 50
NACL 100ML SANBE
NATTO TAB OPL
URESIX INJ
CORMEGA OPL
ALKOHOL SWAB COSMO
SITI KASIANI00078155 - - -
Jumlah Satuan
2 FLES
4 BTL
2 TAB
3 CAPLET
2 AMP
SARNO 00000034 - - -
Jumlah Satuan
2 TAB
2 AMP
3 PCS
1 FLEXPEN
1 PCS
1 PCS
3 BAG
10 PCS
1 PCS
3 AMP
3 PCS
1 AMP
SUHAMMIN M00513394 - - -
Jumlah Satuan
2 TAB
2 AMP
6 PCS
6 PCS
3 BAG
10 PCS
1 PCS
3 AMP
6 PCS
2 AMP
BOYKE CHAR00513263 - - -
Jumlah Satuan
2 TAB
6 PCS
2 LABU
3 CAPSUL
3 TAB
2 VIAL
1 TAB
4 BTL
10 PCS
1 VIAL
6 PCS
PATRIA RAH 00126312 - - -
Jumlah Satuan
2 LABU
3 BTL
3 AMP
1 PCS
3 CAPLET
1 PCS
3 AMP
SARI WULAN 00083204 - - -
Jumlah Satuan
2 TAB
2 AMP
3 PCS
1 PCS
1 PCS
3 BAG
10 PCS
1 PCS
3 AMP
3 PCS
2 AMP
WAWAT PUR 00467917 - - -
Jumlah Satuan
2 TAB
6 PCS
1 PCS
3 LABU
1 TAB
6 PCS
1 CAPSUL
3 PCS
1 VIAL
3 AMP
6 PCS
3 AMP
OPRASITO T 00117581 - - -
Jumlah Satuan
1 PCS
3 LABU
1 BAG
1 PCS
1 PCS
EUIS MULYAT00321868 - - -
Jumlah Satuan
5 TAB
10 TAB
5 TAB
5 TAB
HARIS RUSPA00472614 - - -
Jumlah Satuan
3 PCS
2 TAB
3 PCS
DERAWATI G00001906 - - -
Jumlah Satuan
6 PCS
3 LABU
3 AMP
3 AMP
3 BTL
6 PCS
10 PCS
2 VIAL
2 AMP
4 PCS
YOAN APREZ 00458943 - - -
Jumlah Satuan
4 LABU
1 VIAL
3 TAB
1 BTL
ASEP BUNYAM
00419726 - - -
Jumlah Satuan
3 AMP
2 VIAL
2 AMP
4 PCS
IMAS HATIM 00246660 - - -
Jumlah Satuan
1 BTL
2 AMP
3 VIAL
2 PCS
1 PCS
3 LABU
1 PCS
1 PCS
3 BTL
1 PCS
1 PCS
2 PCS
4 AMP
1 PCS
10 PCS
1 PCS
1 PCS
1 PCS
4 VIAL
4 PCS
SARAH AGUS00152566 - - -
Jumlah Satuan
1 TAB
1 BTL
2 TAB
DEDIH SAEPU00089218 - - -
Jumlah Satuan
3 BTL
1 PCS
3 BTL
2 AMP
2 PCS
KARYANTO 00510532 - - -
Jumlah Satuan
1 PCS
3 LABU
3 CAPSUL
2 TAB
3 TAB
3 CAPLET
1 PCS
1 PCS
DAVID HERL 00153709 - - -
Jumlah Satuan
3 BTL
1 BTL
3 AMP
2 PCS
ECEP SAMBA 00307087 - - -
Jumlah Satuan
3 BTL
3 PCS
EEM HERMAW00037150 - - -
Jumlah Satuan
3 VIAL
1 TAB
AAT SUDARJA00231751 - - -
Jumlah Satuan
3 VIAL
3 BTL
3 PCS
DIANTINI 00092588 - - -
Jumlah Satuan
1 PCS
2 LABU
3 LABU
1 VIAL
1 TAB
1 PCS
2 PCS
2 TAB
15 PCS
1 TAB
1 PCS
1 TAB
2 PCS
1 PCS
AHMAD BUDI00089124 - - -
Jumlah Satuan
3 BTL
2 VIAL
2 AMP
3 CAPLET
OPRASITO T 00117581 - - -
Jumlah Satuan
6 LABU
1 TAB
NINA RACHM00345997 - - -
Jumlah Satuan
2 TAB
1 TAB
1 PCS
3 TAB
1 TAB
1 TAB
1 PCS
1 PCS
1 VIAL
1 BTL
1 VIAL
1 PCS
3 TAB
1 PCS
2 AMP
1 PCS
1 TAB
10 PCS
1 PCS
1 TAB
1 PCS
1 PCS
CHRISTINE L00011708 - - -
Jumlah Satuan
4 AMP
PATRIA RAH 00126312 - - -
Jumlah Satuan
3 AMP
ACEP DADI 00219816 - - -
Jumlah Satuan
2 TAB
1 VIAL
2 TAB
1 TAB
1 TAB
1 TAB
DERAWATI G00001906 - - -
Jumlah Satuan
2 SUPP
NANIH 00513265 - - -
Jumlah Satuan
2 TAB
2 AMP
3 LABU
1 FLES
1 PCS
1 TAB
1 PCS
2 AMP
1 PCS
Jumlah Satuan
2 VIAL
1 TAB
3 PCS
1 PCS
4 LABU
1 BTL
1 TAB
1 BTL
1 VIAL
4 PCS
3 TAB
1 PCS
2 AMP
1 PCS
1 TAB
10 PCS
1 PCS
1 PCS
3 PCS
RUANG PAVILIUN MELATI 198,952 1 DINA MARYA Unchecked BPJS AD KELUARGA
Harga Total
75,537 151,074
9,152 36,608
1,211 2,422
124 372
4,238 8,476
RUANG ANGGREK 564,798 1 DINA MARYA Unchecked BPJS ANGKATAN DARAT
Harga Total
5,914 11,828
126,126 252,252
2,048 6,144
109,620 109,620
13,095 13,095
2,560 2,560
13,771 41,313
206 2,060
18,875 18,875
31,600 94,800
2,493 7,479
4,772 4,772
RUANG PAVILIUN ANGGREK 460,419 1 DINA MARYA Unchecked BPJS AD MIL SATBANMIN
Harga Total
5,914 11,828
126,126 252,252
2,048 12,288
2,560 15,360
13,771 41,313
206 2,060
6,016 6,016
31,600 94,800
2,493 14,958
4,772 9,544
RUANG PAVILIUN MAWAR 309,753 1 DINA MARYA Unchecked BPJS AD MIL SATDIK
Harga Total
5,914 11,828
2,048 12,288
8,205 16,410
515 1,545
2,176 6,528
77,440 154,880
6,924 6,924
9,152 36,608
206 2,060
45,724 45,724
2,493 14,958
Harga Total
8,205 16,410
12,673 38,019
2,288 6,864
13,095 13,095
124 372
18,875 18,875
4,238 12,714
RUANG PAVILIUN TERATAI 447,091 1 DINA MARYA Unchecked BPJS AD KELUARGA
Harga Total
5,914 11,828
126,126 252,252
2,048 6,144
13,095 13,095
2,560 2,560
13,771 41,313
206 2,060
6,016 6,016
31,600 94,800
2,493 7,479
4,772 9,544
RUANG PAVILIUN OBSERV 217,064 1 DINA MARYA Unchecked BPJS ANGKATAN DARAT K
Harga Total
5,914 11,828
2,048 12,288
5,069 5,069
8,205 24,615
2,816 2,816
2,560 15,360
2,148 2,148
206 618
18,248 18,248
31,600 94,800
2,493 14,958
4,772 14,316
RUANG PAVILIUN TERATAI 149,528 1 DINA MARYA Unchecked BPJS ANGKATAN DARAT
Harga Total
5,000 5,000
15,228 45,684
78,748 78,748
14,080 14,080
6,016 6,016
RUANG PERAWATAN XIII 55,555 1 LIA ANDRIANUnchecked BPJS ANGKATAN DARAT K
Harga Total
5,914 29,570
2,197 21,970
605 3,025
198 990
RUANG PERAWATAN XII 13,849 1 ELIS SUPARTUnchecked BPJS AD MIL SATBANMIN
Harga Total
2,048 6,144
113 226
2,493 7,479
Harga Total
2,048 12,288
15,228 45,684
10,240 30,720
2,288 6,864
9,152 27,456
2,560 15,360
206 2,060
12,672 25,344
4,238 8,476
2,493 9,972
RUANG PERAWATAN XIV 196,863 1 SANTIKA ASIUnchecked BPJS AD MIL SATBANPUR
Harga Total
8,205 32,820
111,498 111,498
121 363
52,182 52,182
Harga Total
2,288 6,864
12,672 25,344
4,238 8,476
2,493 9,972
RUANG HCU 927,743 1 IMALIA NUR Unchecked BPJS ANGKATAN DARAT
Harga Total
24,781 24,781
63,359 126,718
7,296 21,888
2,048 4,096
5,069 5,069
15,228 45,684
20,402 20,402
30,272 30,272
9,152 27,456
37,120 37,120
13,095 13,095
2,560 5,120
7,084 28,336
44,800 44,800
206 2,060
53,504 53,504
18,875 18,875
18,875 18,875
97,405 389,620
2,493 9,972
RUANG PERAWATAN XII 139,500 1 ELIS SUPARTUnchecked BPJS AD KELUARGA
Harga Total
4,555 4,555
130,977 130,977
1,984 3,968
RUANG PERAWATAN XI 81,003 1 ELIS SUPARTUnchecked BPJS AD MIL SATBANMIN
Harga Total
12,673 38,019
2,066 2,066
9,152 27,456
4,238 8,476
2,493 4,986
RUANG PERAWATAN XI 88,127 1 ELIS SUPARTUnchecked BPJS AD MIL SATDIK
Harga Total
2,048 2,048
15,228 45,684
5,576 16,728
854 1,708
73 219
124 372
18,875 18,875
2,493 2,493
RUANG PERAWATAN XI 97,338 1 ELIS SUPARTUnchecked BPJS ANGKATAN DARAT
Harga Total
9,152 27,456
52,182 52,182
4,238 12,714
2,493 4,986
RUANG PERAWATAN X 34,935 1 LIA ANDRIANUnchecked BPJS AD MIL SATPUR
Harga Total
9,152 27,456
2,493 7,479
RUANG PERAWATAN X 22,074 1 SANTIKA ASIUnchecked BPJS ANGKATAN DARAT K
Harga Total
7,296 21,888
186 186
RUANG PERAWATAN X 56,823 1 SANTIKA ASIUnchecked BPJS ANGKATAN DARAT P
Harga Total
7,296 21,888
9,152 27,456
2,493 7,479
RUANG HCU 460,982 1 IMALIA NUR Unchecked BPJS ANGKATAN DARAT P
Harga Total
5,069 5,069
8,205 16,410
15,228 45,684
304,501 304,501
167 167
13,095 13,095
2,560 5,120
9,600 19,200
206 3,090
817 817
18,875 18,875
9,184 9,184
2,493 4,986
14,784 14,784
RUANG PERAWATAN VII 63,241 1 IMALIA NUR Unchecked BPJS AD MIL SATDIK
Harga Total
9,152 27,456
12,672 25,344
4,238 8,476
655 1,965
RUANG PAVILIUN TERATAI 95,448 1 DINA MARYA Unchecked BPJS ANGKATAN DARAT
Harga Total
15,228 91,368
4,080 4,080
RUANG PERAWATAN III 693,789 1 DINA MARYA Unchecked BPJS ANGKATAN DARAT K
Harga Total
5,914 11,828
7,181 7,181
2,048 2,048
113 339
2,816 2,816
4,903 4,903
2,066 2,066
30,272 30,272
111,498 111,498
9,152 9,152
304,501 304,501
2,560 2,560
10,594 31,782
65,079 65,079
7,084 14,168
44,800 44,800
13,400 13,400
206 2,060
5,632 5,632
6,336 6,336
18,875 18,875
2,493 2,493
RUANG PERAWATAN V/VI 274,900 1 LIA ANDRIANUnchecked BPJS AD SIPIL
Harga Total
68,725 274,900
Harga Total
68,725 206,175
Harga Total
1,728 3,456
304,501 304,501
13,250 26,500
605 605
817 817
9,184 9,184
Harga Total
3,570 7,140
Harga Total
5,914 11,828
126,126 252,252
8,205 24,615
24,949 24,949
30,272 30,272
82 82
37,120 37,120
7,084 14,168
21,478 21,478
Harga Total
124,740 249,480
7,181 7,181
2,048 6,144
5,069 5,069
15,228 60,912
50,688 50,688
832 832
9,152 9,152
304,501 304,501
2,560 10,240
10,594 31,782
65,079 65,079
7,084 14,168
44,800 44,800
13,400 13,400
206 2,060
6,016 6,016
5,632 5,632
2,493 7,479
BPJS AD KELUARGA
151,074
36,608
2,422
372
8,476
BPJS ANGKATAN DARAT
11,828
252,252
6,144
109,620
13,095
2,560
41,313
2,060
18,875
94,800
7,479
4,772
11,828
252,252
12,288
15,360
41,313
2,060
6,016
94,800
14,958
9,544
BPJS AD MIL SATDIK
11,828
12,288
16,410
1,545
6,528
154,880
6,924
36,608
2,060
45,724
14,958
16,410
38,019
6,864
13,095
372
18,875
12,714
BPJS AD KELUARGA
11,828
252,252
6,144
13,095
2,560
41,313
2,060
6,016
94,800
7,479
9,544
11,828
12,288
5,069
24,615
2,816
15,360
2,148
618
18,248
94,800
14,958
14,316
BPJS ANGKATAN DARAT
5,000
45,684
78,748
14,080
6,016
29,570
21,970
3,025
990
6,144
226
7,479
12,288
45,684
30,720
6,864
27,456
15,360
2,060
25,344
8,476
9,972
32,820
111,498
363
52,182
BPJS ANGKATAN DARAT
6,864
25,344
8,476
9,972
BPJS ANGKATAN DARAT
24,781
126,718
21,888
4,096
5,069
45,684
20,402
30,272
27,456
37,120
13,095
5,120
28,336
44,800
2,060
53,504
18,875
18,875
389,620
9,972
BPJS AD KELUARGA
4,555
130,977
3,968
38,019
2,066
27,456
8,476
4,986
BPJS AD MIL SATDIK
2,048
45,684
16,728
1,708
219
372
18,875
2,493
BPJS ANGKATAN DARAT
27,456
52,182
12,714
4,986
BPJS AD MIL SATPUR
27,456
7,479
21,888
186
21,888
27,456
7,479
5,069
16,410
45,684
304,501
167
13,095
5,120
19,200
3,090
817
18,875
9,184
4,986
14,784
BPJS AD MIL SATDIK
27,456
25,344
8,476
1,965
BPJS ANGKATAN DARAT
91,368
4,080
11,828
7,181
2,048
339
2,816
4,903
2,066
30,272
111,498
9,152
304,501
2,560
31,782
65,079
14,168
44,800
13,400
2,060
5,632
6,336
18,875
2,493
BPJS AD SIPIL
274,900
206,175
3,456
304,501
26,500
605
817
9,184
7,140
BPJS UMUM MANDIRI
11,828
252,252
24,615
24,949
30,272
82
37,120
14,168
21,478
BPJS UMUM JAMSOSTEK
249,480
7,181
6,144
5,069
60,912
50,688
832
9,152
304,501
10,240
31,782
65,079
14,168
44,800
13,400
2,060
6,016
5,632
7,479
IV DRESSING 3M 50
INFUSAN M20 500ML
ALKOHOL SWAB COSMO
CHLORPROMAZINE TAB 25 MG /T
NEUROSANBE INJ
VERSILON 6 MG MERSI
MINIASPI 80 MG R
VALISANBE 2 MG
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
FUROSEMID 40MG YARI
NACL 100ML SANBE
CEFTIZOXIM VIAL 1 GR NOVELL /T
NACL 100ML SANBE
FOLLEY CATHETER NO. 16 GEA/ROYAL
AMIODARON IV INJ
ALKOHOL SWAB COSMO
IV CATHETER 20/T
AMINOFLUID OTSU 500 ML
IV DRESSING 3M 50
KETESE INJEKSI 50 MG/5 AMP
MEROPENEM 1000 MG DEXA
DOSIS RUMATAN 1 MG/ JAM (24 NG/ HARI), DOSIS SEDACUM DEXA 15MG/3 ML AMP 3 ML
THREE WAY STOP COCK
VIP ALBUMIN SCHACET
PHYTOMENADION PHAPROS INJEKSI
MAX 5 AMPUL/ KASUS FENTANYL 0.05 MG/2ML KIFA E
DEXTROSE 10% WIDA
PARACETAMOL 1OO ML INF DAVA /T
ASERING 500 ML E
ALKOHOL SWAB COSMO
TRANEXAMIC ACID 5% INJ 250MG/5ML DEXA
SUCTION CATH 12/T
IV CATHETER 20/T
ESOME 40 MG INJ
NACL 100ML SANBE
THREE WAY STOP COCK
KSR MERC 600 MG
AMLODIPIN 10 MG
SUCTION CATH 12/T
IV CATHETER 20/T
ESOME 40 MG INJ
CERNEVIT INJ
PANTOPRAZOLE INJ 40 MG PHAPROS /T
DEXAMETHASON 5MG/ML BERNO
DISPOSABLE SYRINGE 20 ML NIPRO
IV DRESSING 3M 50
ALKOHOL SWAB COSMO
ALKOHOL SWAB COSMO
PROFAT SYR
FURAMIN INJEKSI OPL
NACL 0.9 500 ML
OFLOXACIN INF DEXA 100 ML /T
DOMPERIDON 10 MG KIFA
PROFAT SYR
SUMAGESIK OPL
NOPRENIA ORAL SUSP 30 ML
CLOZAPINE TAB 100 MG MERSI
VALESCO 80 MG
VALESCO 80 MG
FUROSEMID 40MG YARI
GLUCOSAMINE 500 MG
LAFALOS CREAM 20GR
GRATHEOS TAB 50 MG
CLOZAPINE 25 MG
A. HANYA DAPAT DIRESEPKAN OLEH DOKTER SPESIAALPRAZOLAM KIFA 0.5 MG 100 TABLET
MAX 60 TAB/ BULAN IKALEP
CLOZAPINE 25 MG
CLOZAPINE 25 MG
VALDIMEX MERS INJ 10 MG/2 ML
MAX 60 TAB/BULAN. MONOTERAPI SCHIZOPHRENIA ONZAPIN ACTA 5 MG
MEROPENEM 1000 MG DEXA
EAS PFIMMER FINU 250 ML
NOCID TAB
IV CATHETER 20/T
NACL 100ML SANBE
KALITAKE DIPA 5 GR
OTSU-D40 OTSU 40 25 ML
CALCII GLUCONAS INJ E
IV CATHETER 20/T
ESOME 40 MG INJ
MINIASPI 80 MG R
MAX 3O TAB/ BULAN BISOPROLOL 5 MG FAHR
IV CATHETER 22/T
PROFAT SYR
AMINORAL
IRBESARTAN INFA 300 MG
KALITAKE DIPA 5 GR
RECOLFAR 0.5 MG
CEFIXIME 100MG HEXP
NACL 100ML SANBE
CEFTIZOXIM INJ 1GR NOVELL R
CEFTIZOXIME 1 GR
NACL 100ML SANBE
KIDMIN INF
LARUTAN 2A
IV DRESSING 3M 50
LOVENOX 0.6
NACL 100ML SANBE
THREE WAY STOP COCK
NASAL CANUL ADULT HOSPITECH
KONDOM CATHETER M
URINE BAG COSMO
IV CATHETER 20/T
HEPA BALANCE
IV DRESSING 3M 50
THREE WAY STOP COCK
KSR MERC 600 MG
INFUSAN M20 500ML
ASERING 500 ML E
DEXTROSE 5% 500 ML SANBE
IV CATHETER 20/T
NEUROSANBE INJ
SALBUTAMOL GRAF 2 MG
AMBROXOL 30 MG BERNO
METHYL PREDNISOLON TAB 8 MG T
RINGER LAKTAT SANBE
NEUROSANBE INJ
OMEPRAZOL 20MG (YARINDO)
PSIDII CAPS 500MG
KSR MERC 600 MG
DEXAMETHASON 5MG/ML BERNO
VERONA CAPS
GRATHEOS TAB 50 MG
KALITAKE DIPA 5 GR
BLOOD TRANFUSION SET COSMO
TANTUM VERDE ORAL RINSE 60 ML
NACL 0.9 500 ML
ONDANSETRON 4 MG MBF INJ
LOVEQUIN 500 MG
LOVEQUIN 500 MG
NACL 0.9 500 ML
VALESCO 80 MG
LOVEQUIN 500 MG
AZITROMYCIN 500 MG
AMBROXOL 30 MG BERNO
NACL 0.9 500 ML
URESIX INJ
MAAGSLAANG 16/T
CEFTIZOXIME 1 GR
IV DRESSING 3M 50
NACL 100ML SANBE
NATTO TAB OPL
URESIX INJ
CORMEGA OPL
ALKOHOL SWAB COSMO
ADE JUNAEDI00431489 - - -
Jumlah Satuan
2 TAB
1 PCS
1 PCS
1 PCS
1 BAG
3 PCS
1 PCS
2 TAB
3 AMP
3 PCS
2 AMP
3 PCS
INE WULAN P00453568 - - -
Jumlah Satuan
5 TAB
5 TAB
5 TAB
5 TAB
30A077 ENTIN SURTI00146293 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
23 TAB
7 TAB
EROS ROSIL 00420937 - - -
Jumlah Satuan
3 VIAL
2 LABU
3 BTL
6 PCS
1 VIAL
2 VIAL
6 PCS
6 PCS
Jumlah Satuan
4 LABU
1 PCS
4 PCS
1 PCS
6 AMP
1 PCS
20 PCS
1 PCS
1 PCS
4 PCS
4 PCS
NANA 00399925 - - -
Jumlah Satuan
1 LABU
4 VIAL
1 PCS
2 AMP
3 VIAL
6 AMP
1 PCS
4 SACH
2 FLES
3 BTL
3 AMP
6 AMP
1 PCS
1 BTL
3 BTL
2 BAG
1 PCS
20 PCS
1 PCS
3 AMP
1 PCS
1 PCS
2 VIAL
NANDI SUNA 00513192 - - -
Jumlah Satuan
4 LABU
6 AMP
1 PCS
1 PCS
1 TAB
6 AMP
1 PCS
4 PCS
2 TAB
1 PCS
1 PCS
2 VIAL
1 PCS
1 PCS
1 VIAL
2 PCS
3 PCS
DJUMI 00316397 - - -
Jumlah Satuan
1 VIAL
1 TAB
1 FLEXPEN
1 VIAL
3 TAB
1 TAB
3 BTL
3 VIAL
3 PCS
1 PCS
8 AMP
1 PCS
3 PCS
Jumlah Satuan
6 PCS
1 PCS
3 AMP
3 AMP
3 BTL
1 PCS
6 PCS
1 PCS
2 AMP
NEHEMIA NAP00513606 - - -
Jumlah Satuan
3 AMP
3 BTL
1 PCS
2 VIAL
1 PCS
ANGEL DEVAN00148522 - - -
Jumlah Satuan
6 PCS
3 TAB
4 BTL
1 PCS
10 PCS
2 VIAL
1 BTL
2 AMP
6 PCS
NANA 00399925 - - -
Jumlah Satuan
3 AMP
AULIA AS-SYI00371346 - - -
Jumlah Satuan
4 LABU
2 FLES
1 VIAL
3 TAB
1 BTL
YUNITA HAS 00303424 - - -
Jumlah Satuan
3 TAB
YUNDI SUCIA00381323 - - -
Jumlah Satuan
2 TAB
1 BTL
1 TAB
30B275 SUPRIYATI N00380572 - - -
Jumlah Satuan
23 TAB
7 TAB
23 TAB
7 TAB
30 TAB
23 TAB
7 TAB
30C171 T. SUTINAH 00135059 - - -
Jumlah Satuan
30 TAB
1 TUBE
20 TAB
IWAN SURYA00513137 - - -
Jumlah Satuan
2 TAB
RYAN ADITY 00225710 - - -
Jumlah Satuan
2 TAB
1 TAB
WIDIA KUSUM
00512776 - - -
Jumlah Satuan
1 TAB
1 TAB
2 TAB
SUHERMAN 00512861 - - -
Jumlah Satuan
2 TAB
4 TAB
NOPIYANA T00513195 - - -
Jumlah Satuan
2 TAB
1 TAB
ELIS FATIMA 00513388 - - -
Jumlah Satuan
1 TAB
TUTI SETIAW00041638 - - -
Jumlah Satuan
1 AMP
2 TAB
1 PCS
3 PCS
ASEP ARASYI00401934 - - -
Jumlah Satuan
1 CAP.SALUT
CACIH 00513426 - - -
Jumlah Satuan
1 TAB
1 TAB
SIROJUDIN 00513217 - - -
Jumlah Satuan
3 VIAL
3 TAB
1 VIAL
SIROJUDIN 00513217 - - -
Jumlah Satuan
1 BTL
PURWANTO T00414277 - - -
Jumlah Satuan
3 VIAL
1 BTL
1 PCS
3 PCS
1 CAPLET
1 PCS
BENI TN 00513612 - - -
Jumlah Satuan
6 PCS
3 LABU
1 SACH
1 VIAL
3 VIAL
2 AMP
3 AMP
1 PCS
2 VIAL
6 PCS
ENTIS WAHY00085598 - - -
Jumlah Satuan
1 TAB
REKAMAS RIZ00513555 - - -
Jumlah Satuan
3 PCS
3 TAB
1 TAB
3 BTL
1 PCS
1 BTL
1 VIAL
PANTJA KOM 00392881 - - -
Jumlah Satuan
2 TAB
1 TAB
2 SACH
2 TAB
2 TAB
TN U.WIHAN 00357220 - - -
Jumlah Satuan
1 VIAL
3 TAB
3 AMP
2 VIAL
SUTRISNO 00512959 - - -
Jumlah Satuan
1 FLES
ATIKAH NY 00513269 - - -
Jumlah Satuan
3 VIAL
1 BTL
3 BTL
1 PCS
2 CAPLET
2 AMP
1 PCS
ABDUL GOFA00424927 - - -
Jumlah Satuan
3 VIAL
4 PCS
3 BTL
1 VIAL
2 AMP
SUMIATI. NY 00513501 - - -
Jumlah Satuan
6 AMP
ENDANG SUM00380621 - - -
Jumlah Satuan
3 VIAL
1 BTL
2 BTL
2 AMP
2 PCS
ATENG TARY 00045393 - - -
Jumlah Satuan
3 VIAL
3 BTL
3 PCS
IMAS MASITO00432070 - - -
Jumlah Satuan
3 VIAL
2 LABU
1 BTL
3 BTL
4 PCS
1 VIAL
2 VIAL
2 PCS
EKO FEBRIA 00513461 - - -
Jumlah Satuan
2 VIAL
3 VIAL
2 LABU
3 BTL
4 PCS
1 VIAL
Jumlah Satuan
1 TAB
I MADE BADE00212567 - - -
Jumlah Satuan
1 BAG
2 BTL
1 PCS
NUR FITRIAN00448170 - - -
Jumlah Satuan
4 AMP
RIKAYAT WIR00148068 - - -
Jumlah Satuan
1 TAB
1 PCS
2 AMP
3 LABU
1 PCS
1 PCS
2 BTL
1 PCS
2 PCS
1 PCS
1 PCS
1 PCS
1 PCS
2 PCS
SUMIATI. NY 00513501 - - -
Jumlah Satuan
2 AMP
3 PCS
2 CAPSUL
1 PCS
1 VIAL
1 PCS
1 FLES
1 PCS
2 TAB
1 PCS
1 PCS
2 PCS
1 BAG
3 BAG
1 PCS
4 BAG
1 PCS
2 AMP
ENGKUS KUS 00269298 - - -
Jumlah Satuan
3 VIAL
3 TAB
3 BTL
3 TAB
2 VIAL
REZA ARTAA 00512613 - - -
Jumlah Satuan
2 TAB
2 TAB
ELIS KURNAE00513546 - - -
Jumlah Satuan
2 TAB
2 AMP
2 PCS
3 BAG
2 PCS
2 AMP
YAYAH YULIA00513353 - - -
Jumlah Satuan
2 BTL
1 TAB
1 TAB
AZZAHRA FEB00327560 - - -
Jumlah Satuan
3 CAPSUL
3 TAB
3 TAB
3 BTL
4 AMP
2 VIAL
1 VIAL
3 CAPSUL
30A150 YULIA WARLI00014629 - - -
Jumlah Satuan
10 TAB
HELARIA 00406160 - - -
Jumlah Satuan
3 TAB
2 SACH
3 PCS
3 BTL
3 PCS
1 PCS
1 BTL
2 VIAL
PEPIE NOVIA00059379 - - -
Jumlah Satuan
3 PCS
3 LABU
2 AMP
3 AMP
3 AMP
1 BTL
1 TAB
1 TAB
3 PCS
ACIH SULASI00135691 - - -
Jumlah Satuan
3 LABU
3 TAB
1 TAB
1 TAB
1 TAB
3 PCS
2 TAB
NANIH 00513265 - - -
Jumlah Satuan
1 TAB
3 TAB
YUYUN YULIA00513590 - - -
Jumlah Satuan
3 AMP
YETTI YULIA 00513497 - - -
Jumlah Satuan
4 AMP
Jumlah Satuan
2 AMP
NANIH 00513265 - - -
Jumlah Satuan
2 TAB
2 AMP
3 LABU
1 FLES
1 PCS
1 TAB
1 PCS
2 AMP
1 PCS
Jumlah Satuan
2 VIAL
1 TAB
3 PCS
1 PCS
4 LABU
1 BTL
1 TAB
1 BTL
1 VIAL
4 PCS
3 TAB
1 PCS
2 AMP
1 PCS
1 TAB
10 PCS
1 PCS
1 PCS
3 PCS
RUANG PAVILIUN ANGGREK 239,510 1 DINA MARYA Unchecked BPJS UMUM MANDIRI
Harga Total
5,914 11,828
5,069 5,069
13,095 13,095
2,560 2,560
78,748 78,748
206 618
6,016 6,016
252 504
31,600 94,800
2,493 7,479
4,772 9,544
3,083 9,249
RUANG PERAWATAN XIII 35,890 1 NUNUNG MARUnchecked BPJS UMUM MANDIRI
Harga Total
4,178 20,890
2,197 10,985
605 3,025
198 990
Harga Total
2,816 64,768
2,816 19,712
146 3,358
146 1,022
141 3,243
141 987
333 7,659
333 2,331
RUANG PAVILIUN ANGGREK 403,660 1 DINA MARYA Unchecked BPJS UMUM ASKES TNI
Harga Total
7,296 21,888
15,228 30,456
9,152 27,456
2,560 15,360
18,248 18,248
128,398 256,796
2,493 14,958
3,083 18,498
RUANG ICCU 260,484 1 IMALIA NUR Unchecked BPJS UMUM JAMSOSTEK
Harga Total
15,228 60,912
13,095 13,095
2,560 10,240
14,080 14,080
11,071 66,426
44,800 44,800
206 4,120
5,632 5,632
18,875 18,875
2,493 9,972
3,083 12,332
RUANG PERAWATAN ICU 1,747,543 1 IMALIA NUR Unchecked BPJS UMUM JAMKESMAS
Harga Total
81,888 81,888
7,296 29,184
5,069 5,069
52,941 105,882
68,053 204,159
40,551 243,306
20,402 20,402
79,002 316,008
24,949 49,898
12,673 38,019
4,544 13,632
51,200 307,200
13,095 13,095
9,600 9,600
33,792 101,376
11,873 23,746
44,800 44,800
206 4,120
5,632 5,632
2,504 7,512
12,692 12,692
18,875 18,875
45,724 91,448
RUANG PERAWATAN ICU 855,277 1 IMALIA NUR Unchecked BPJS UMUM MANDIRI
Harga Total
15,228 60,912
40,551 243,306
20,402 20,402
30,272 30,272
2,176 2,176
51,200 307,200
13,095 13,095
2,560 10,240
186 372
44,800 44,800
5,632 5,632
12,672 25,344
12,692 12,692
18,875 18,875
45,724 45,724
2,493 4,986
3,083 9,249
RUANG PAVILIUN MAWAR 720,191 1 DINA MARYA Unchecked BPJS UMUM ASKES NON T
Harga Total
197,679 197,679
7,181 7,181
109,620 109,620
45,690 45,690
212 636
888 888
12,673 38,019
77,440 232,320
2,560 7,680
44,800 44,800
3,076 24,608
3,591 3,591
2,493 7,479
Harga Total
2,048 12,288
5,069 5,069
10,240 30,720
2,288 6,864
9,152 27,456
13,095 13,095
206 1,236
6,016 6,016
4,238 8,476
Harga Total
2,288 6,864
9,152 27,456
2,560 2,560
25,047 50,094
2,493 2,493
RUANG PAVILIUN BOUGENV 165,647 1 DINA MARYA Unchecked BPJS UMUM ASKES TNI
Harga Total
2,048 12,288
212 636
9,152 36,608
13,095 13,095
206 2,060
12,672 25,344
52,182 52,182
4,238 8,476
2,493 14,958
RUANG PERAWATAN ICU 37,875 1 IMALIA NUR Unchecked BPJS UMUM JAMKESMAS
Harga Total
12,625 37,875
RUANG PERAWATAN XIV 349,125 1 SANTIKA ASIUnchecked BPJS AD KELUARGA
Harga Total
8,205 32,820
75,537 151,074
111,498 111,498
517 1,551
52,182 52,182
RUANG PERAWATAN VII 1,710 1 IMALIA NUR Unchecked BPJS UMUM JAMSOSTEK
Harga Total
570 1,710
RUANG PERAWATAN XII 137,603 1 ELIS SUPARTUnchecked NON BPJS UMUM MURNI/B
Harga Total
113 226
130,977 130,977
6,400 6,400
Harga Total
313 7,199
313 2,191
2,816 64,768
2,816 19,712
141 4,230
817 18,791
817 5,719
Harga Total
1,533 45,990
16,080 16,080
344 6,880
RUANG PERAWATAN XII 226 1 ELIS SUPARTUnchecked BPJS UMUM JAMSOSTEK
Harga Total
113 226
RUANG PERAWATAN XII 2,210 1 ELIS SUPARTUnchecked BPJS UMUM ASKES NON T
Harga Total
113 226
1,984 1,984
RUANG PERAWATAN XII 5,055 1 ELIS SUPARTUnchecked BPJS UMUM JAMKESMAS
Harga Total
274 274
4,555 4,555
113 226
Harga Total
113 226
1,984 7,936
Harga Total
113 226
1,984 1,984
RUANG PERAWATAN XII 24,415 1 ELIS SUPARTUnchecked BPJS UMUM JAMSOSTEK
Harga Total
24,415 24,415
Harga Total
15,488 15,488
113 226
2,066 2,066
2,493 7,479
RUANG PERAWATAN XII 5,759 1 ELIS SUPARTUnchecked NON BPJS UMUM MURNI
Harga Total
5,759 5,759
Harga Total
5,914 5,914
888 888
RUANG PERAWATAN XI 257,820 1 ELIS SUPARTUnchecked NON BPJS UMUM MURNI/B
Harga Total
77,440 232,320
151 453
25,047 25,047
RUANG PERAWATAN XI 50,688 1 ELIS SUPARTUnchecked NON BPJS UMUM MURNI/B
Harga Total
50,688 50,688
RUANG PERAWATAN XI 318,597 1 ELIS SUPARTUnchecked BPJS UMUM ASKES TNI
Harga Total
68,053 204,159
66,780 66,780
13,095 13,095
2,560 7,680
8,008 8,008
18,875 18,875
RUANG PERAWATAN XI 469,552 1 ELIS SUPARTUnchecked BPJS UMUM MANDIRI
Harga Total
2,048 12,288
15,228 45,684
9,857 9,857
11,124 11,124
77,440 232,320
12,743 25,486
2,504 7,512
18,875 18,875
45,724 91,448
2,493 14,958
RUANG PERAWATAN XI 605 1 ELIS SUPARTUnchecked BPJS UMUM MANDIRI
Harga Total
605 605
Harga Total
2,048 6,144
212 636
2,703 2,703
9,152 27,456
18,875 18,875
52,182 52,182
25,047 25,047
Harga Total
7,181 14,362
1,016 1,016
9,857 19,714
6,055 12,110
759 1,518
RUANG PERAWATAN XI 78,534 1 ELIS SUPARTUnchecked BPJS UMUM JAMKESMAS
Harga Total
45,690 45,690
212 636
2,288 6,864
12,672 25,344
RUANG PERAWATAN X 24,949 1 SANTIKA ASIUnchecked BPJS UMUM MANDIRI
Harga Total
24,949 24,949
Harga Total
7,296 21,888
50,688 50,688
9,152 27,456
2,560 2,560
960 1,920
4,238 8,476
2,493 2,493
Harga Total
7,296 21,888
2,048 8,192
9,152 27,456
18,248 18,248
4,238 8,476
RUANG PERAWATAN XIII 190,800 1 NUNUNG MARUnchecked BPJS UMUM JAMSOSTEK
Harga Total
31,800 190,800
RUANG PERAWATAN X 104,342 1 SANTIKA ASIUnchecked BPJS UMUM JAMKESMAS
Harga Total
7,296 21,888
50,688 50,688
9,152 18,304
4,238 8,476
2,493 4,986
RUANG PERAWATAN X 56,823 1 SANTIKA ASIUnchecked BPJS UMUM ASKES NON T
Harga Total
7,296 21,888
9,152 27,456
2,493 7,479
RUANG PERAWATAN X 468,882 1 SANTIKA ASIUnchecked BPJS UMUM JAMSOSTEK
Harga Total
7,296 21,888
15,228 30,456
50,688 50,688
9,152 27,456
2,560 10,240
18,248 18,248
152,460 304,920
2,493 4,986
RUANG PERAWATAN X 357,768 1 SANTIKA ASIUnchecked BPJS UMUM JAMKESMAS
Harga Total
124,740 249,480
7,296 21,888
15,228 30,456
9,152 27,456
2,560 10,240
18,248 18,248
RUANG ICCU 832 1 IMALIA NUR Unchecked BPJS UMUM JAMSOSTEK
Harga Total
832 832
Harga Total
63,001 63,001
10,369 20,738
13,095 13,095
RUANG PERAWATAN V/VI 274,900 1 LIA ANDRIANUnchecked BPJS UMUM JAMSOSTEK
Harga Total
68,725 274,900
RUANG HCU 519,257 1 IMALIA NUR Unchecked BPJS UMUM ASKES TNI
Harga Total
7,181 7,181
5,069 5,069
148,050 296,100
15,228 45,684
20,402 20,402
30,272 30,272
9,152 18,304
11,968 11,968
2,560 5,120
44,800 44,800
4,480 4,480
6,016 6,016
18,875 18,875
2,493 4,986
RUANG HCU 724,065 1 IMALIA NUR Unchecked BPJS UMUM JAMSOSTEK
Harga Total
126,126 252,252
2,048 6,144
15,027 30,054
5,069 5,069
45,690 45,690
20,402 20,402
24,949 24,949
30,272 30,272
2,176 4,352
37,120 37,120
13,095 13,095
2,560 5,120
78,748 78,748
11,873 35,619
44,800 44,800
15,490 61,960
18,875 18,875
4,772 9,544
RUANG PERAWATAN VII 75,936 1 IMALIA NUR Unchecked BPJS UMUM MANDIRI
Harga Total
7,296 21,888
120 360
9,152 27,456
296 888
12,672 25,344
RUANG PERAWATAN IX 1,582 1 ELIS SUPARTUnchecked BPJS UMUM JAMKESMAS
Harga Total
126 252
665 1,330
Harga Total
5,914 11,828
126,126 252,252
2,048 4,096
13,771 41,313
2,493 4,986
4,772 9,544
Harga Total
9,152 18,304
3,898 3,898
523 523
RUANG PERAWATAN IX 124,210 1 ELIS SUPARTUnchecked BPJS UMUM MANDIRI
Harga Total
5,576 16,728
151 453
2,176 6,528
9,152 27,456
3,076 12,304
12,672 25,344
25,047 25,047
3,450 10,350
Harga Total
344 3,440
Harga Total
212 636
9,857 19,714
2,066 6,198
9,152 27,456
2,560 7,680
8,576 8,576
26,612 26,612
12,672 25,344
RUANG PERAWATAN IX 96,949 1 ELIS SUPARTUnchecked BPJS UMUM JAMSOSTEK
Harga Total
2,048 6,144
8,205 24,615
3,071 6,142
10,240 30,720
2,288 6,864
9,152 9,152
2,816 2,816
2,816 2,816
2,560 7,680
RUANG PERAWATAN IX 39,824 1 ELIS SUPARTUnchecked BPJS UMUM ASKES NON T
Harga Total
8,205 24,615
212 636
2,816 2,816
1,009 1,009
2,816 2,816
2,560 7,680
126 252
Harga Total
8,192 8,192
296 888
RUANG PERAWATAN I 206,400 1 IMALIA NUR Unchecked BPJS UMUM JAMKESMAS
Harga Total
68,800 206,400
RUANG PERAWATAN V/VI 274,900 1 LIA ANDRIANUnchecked BPJS UMUM JAMKESMAS
Harga Total
68,725 274,900
Harga Total
68,725 137,450
Harga Total
5,914 11,828
126,126 252,252
8,205 24,615
24,949 24,949
30,272 30,272
82 82
37,120 37,120
7,084 14,168
21,478 21,478
Harga Total
124,740 249,480
7,181 7,181
2,048 6,144
5,069 5,069
15,228 60,912
50,688 50,688
832 832
9,152 9,152
304,501 304,501
2,560 10,240
10,594 31,782
65,079 65,079
7,084 14,168
44,800 44,800
13,400 13,400
206 2,060
6,016 6,016
5,632 5,632
2,493 7,479
BPJS UMUM MANDIRI
11,828
5,069
13,095
2,560
78,748
618
6,016
504
94,800
7,479
9,544
9,249
BPJS UMUM MANDIRI
20,890
10,985
3,025
990
BPJS ANGKATAN DARAT
64,768
19,712
3,358
1,022
3,243
987
7,659
2,331
BPJS UMUM ASKES TNI
21,888
30,456
27,456
15,360
18,248
256,796
14,958
18,498
BPJS UMUM JAMSOSTEK
60,912
13,095
10,240
14,080
66,426
44,800
4,120
5,632
18,875
9,972
12,332
BPJS UMUM JAMKESMAS
81,888
29,184
5,069
105,882
204,159
243,306
20,402
316,008
49,898
38,019
13,632
307,200
13,095
9,600
101,376
23,746
44,800
4,120
5,632
7,512
12,692
18,875
91,448
BPJS UMUM MANDIRI
60,912
243,306
20,402
30,272
2,176
307,200
13,095
10,240
372
44,800
5,632
25,344
12,692
18,875
45,724
4,986
9,249
197,679
7,181
109,620
45,690
636
888
38,019
232,320
7,680
44,800
24,608
3,591
7,479
BPJS UMUM MANDIRI
12,288
5,069
30,720
6,864
27,456
13,095
1,236
6,016
8,476
BPJS ANGKATAN DARAT
6,864
27,456
2,560
50,094
2,493
BPJS UMUM ASKES TNI
12,288
636
36,608
13,095
2,060
25,344
52,182
8,476
14,958
BPJS UMUM JAMKESMAS
37,875
BPJS AD KELUARGA
32,820
151,074
111,498
1,551
52,182
BPJS UMUM JAMSOSTEK
1,710
226
130,977
6,400
BPJS UMUM MANDIRI
7,199
2,191
64,768
19,712
4,230
18,791
5,719
BPJS UMUM ASKES TNI
45,990
16,080
6,880
BPJS UMUM JAMSOSTEK
226
226
1,984
BPJS UMUM JAMKESMAS
274
4,555
226
BPJS UMUM JAMKESMAS
226
7,936
BPJS UMUM JAMKESMAS
226
1,984
BPJS UMUM JAMSOSTEK
24,415
BPJS UMUM JAMKESMAS
15,488
226
2,066
7,479
NON BPJS UMUM MURNI
5,759
BPJS UMUM JAMKESMAS
5,914
888
232,320
453
25,047
50,688
BPJS UMUM ASKES TNI
204,159
66,780
13,095
7,680
8,008
18,875
BPJS UMUM MANDIRI
12,288
45,684
9,857
11,124
232,320
25,486
7,512
18,875
91,448
14,958
BPJS UMUM MANDIRI
605
BPJS UMUM MANDIRI
6,144
636
2,703
27,456
18,875
52,182
25,047
BPJS UMUM MANDIRI
14,362
1,016
19,714
12,110
1,518
BPJS UMUM JAMKESMAS
45,690
636
6,864
25,344
BPJS UMUM MANDIRI
24,949
BPJS UMUM MANDIRI
21,888
50,688
27,456
2,560
1,920
8,476
2,493
BPJS UMUM MANDIRI
21,888
8,192
27,456
18,248
8,476
BPJS UMUM JAMSOSTEK
190,800
BPJS UMUM JAMKESMAS
21,888
50,688
18,304
8,476
4,986
21,888
27,456
7,479
BPJS UMUM JAMSOSTEK
21,888
30,456
50,688
27,456
10,240
18,248
304,920
4,986
BPJS UMUM JAMKESMAS
249,480
21,888
30,456
27,456
10,240
18,248
BPJS UMUM JAMSOSTEK
832
BPJS ANGKATAN DARAT
63,001
20,738
13,095
BPJS UMUM JAMSOSTEK
274,900
BPJS UMUM ASKES TNI
7,181
5,069
296,100
45,684
20,402
30,272
18,304
11,968
5,120
44,800
4,480
6,016
18,875
4,986
BPJS UMUM JAMSOSTEK
252,252
6,144
30,054
5,069
45,690
20,402
24,949
30,272
4,352
37,120
13,095
5,120
78,748
35,619
44,800
61,960
18,875
9,544
BPJS UMUM MANDIRI
21,888
360
27,456
888
25,344
BPJS UMUM JAMKESMAS
252
1,330
BPJS UMUM JAMKESMAS
11,828
252,252
4,096
41,313
4,986
9,544
BPJS UMUM JAMKESMAS
18,304
3,898
523
BPJS UMUM MANDIRI
16,728
453
6,528
27,456
12,304
25,344
25,047
10,350
3,440
BPJS UMUM JAMKESMAS
636
19,714
6,198
27,456
7,680
8,576
26,612
25,344
BPJS UMUM JAMSOSTEK
6,144
24,615
6,142
30,720
6,864
9,152
2,816
2,816
7,680
24,615
636
2,816
1,009
2,816
7,680
252
BPJS UMUM MANDIRI
8,192
888
BPJS UMUM JAMKESMAS
206,400
BPJS UMUM JAMKESMAS
274,900
BPJS UMUM MANDIRI
137,450
BPJS UMUM MANDIRI
11,828
252,252
24,615
24,949
30,272
82
37,120
14,168
21,478
BPJS UMUM JAMSOSTEK
249,480
7,181
6,144
5,069
60,912
50,688
832
9,152
304,501
10,240
31,782
65,079
14,168
44,800
13,400
2,060
6,016
5,632
7,479
DEPO UNIT GAWAT DARU RAWAT JALA DINAS 8/30/2017 8/30/2017 11:27:00 UGD2017H006117
GRATHEOS TAB 50 MG
NITA YUSMIT00513665 - - -
Jumlah Satuan
3 TAB
UNIT GAWAT DARURAT 1,032 0 DESIANA HIDUnchecked BPJS AD MIL SATBANMIN
Harga Total
344 1,032
1,032
DEPO UNIT GAWAT DARU RAWAT JALA NON DINAS 8/30/2017 8/30/2017 10:32:00 UGD2017H006112
NACL 0.9 500 ML
DEPO UNIT GAWAT DARU RAWAT INAP NON DINAS 8/30/2017 8/30/2017 10:32:00 UGD2017H006314
RINGER LAKTAT SANBE
HANYA UNTUK MONOTERAPI RUMATAN PADA PASIEN
SIKZONOATE INJ
NACL 0.9 500 ML
VASELIN SWAB 10X10CM
IV DRESSING 3M 50
INFUSION SET MACRO WELCARE
IV CATHETER NO 20 B BRAUND
PROFAT SYR
ONDANSETRON INJ 4MG/2ML NOVELL /T
LARUTAN 2A
CODIPRONT SYR OPL
LIDOCAIN 2 PHAPROS INJ /T
NACL 0.9 500 ML
URINE BAG COSMO
FOLLEY CATHETER NO. 18 GEA
L-BIO SACH OPL
NURLINA 00507497 - - -
Jumlah Satuan
1 LABU
OPRASITO T 00117581 - - -
Jumlah Satuan
2 BAG
BONNY NIKO00399992 - - -
Jumlah Satuan
1 AMP
1 PCS
MIMIN NY 00337015 - - -
Jumlah Satuan
1 LABU
YETI HERYAT00506179 - - -
Jumlah Satuan
2 PCS
INAH YULIAH00196415 - - -
Jumlah Satuan
2 PCS
1 PCS
1 PCS
1 FLEXPEN
1 PCS
1 PCS
1 BTL
1 VIAL
2 AMP
PURWANTO T00414277 - - -
Jumlah Satuan
1 BTL
1 FLES
AMIR HUSEN 00486865 - - -
Jumlah Satuan
1 AMP
1 LABU
2 PCS
1 PCS
1 PCS
ZHEBEUDEUS00501032 - - -
Jumlah Satuan
2 SACH
POLI KULIT & KELAMIN 8,205 0 DEDEN SETI Unchecked BPJS UMUM MANDIRI
Harga Total
8,205 8,205
RUANG PAVILIUN TERATAI 27,542 1 DESIANA HIDUnchecked BPJS ANGKATAN DARAT
Harga Total
13,771 27,542
POLI JIWA 76,094 0 DEDEN SETI Unchecked BPJS UMUM MANDIRI
Harga Total
73,601 73,601
2,493 2,493
POLI KULIT & KELAMIN 8,205 0 DEDEN SETI Unchecked BPJS UMUM PENSIUNAN H
Harga Total
8,205 8,205
POLI BEDAH UMUM 23,542 0 DEDEN SETI Unchecked BPJS UMUM MANDIRI
Harga Total
11,771 23,542
RUANG PERAWATAN XIV 235,795 1 DESIANA HIDUnchecked BPJS UMUM ASKES NON T
Harga Total
1,457 2,914
2,048 2,048
5,069 5,069
109,620 109,620
10,560 10,560
11,201 11,201
52,182 52,182
25,047 25,047
8,577 17,154
RUANG PERAWATAN XI 78,269 1 DESIANA HIDUnchecked BPJS UMUM ASKES TNI
Harga Total
10,369 10,369
67,900 67,900
POLI BEDAH UROLOGI 31,071 0 DESIANA HIDUnchecked BPJS UMUM PENSIUNAN H
Harga Total
1,479 1,479
8,205 8,205
2,560 5,120
6,016 6,016
10,251 10,251
RUANG PERAWATAN IV 15,840 1 DESIANA HIDUnchecked BPJS AD KELUARGA
Harga Total
7,920 15,840
BPJS UMUM MANDIRI
8,205
BPJS ANGKATAN DARAT
27,542
BPJS UMUM MANDIRI
73,601
2,493
8,205
BPJS UMUM MANDIRI
23,542
2,914
2,048
5,069
109,620
10,560
11,201
52,182
25,047
17,154
BPJS UMUM ASKES TNI
10,369
67,900
1,479
8,205
5,120
6,016
10,251
BPJS AD KELUARGA
15,840
DEPO OK RAWAT INAP DINAS 8/30/2017 8/30/2017 10:54:00 OK2017H000487
ISOFLURANE 250 ML
INFUSION SET MACRO NIPRO
N2O 25 KG
CHROMIC CATGUT APEX 3-0 CAT 26-3
OXYGEN 6M3 / LITER TIRA
ASERING 500 ML E
BLUE MONOLON APEX 3-0 BNC26L-3
IV DRESSING FIXDERM
IV CATHETER 20 PROVEIN
NUPOVEL 10MG/ML INJ R2
AQUABIDEST 50 ML
ISOFLURANE 250 ML
NACL 0.9 500 ML
N2O 25 KG
ASERING 500 ML E
DISPOSABLE SYRINGE 1 ML BD
SURGION APEX 2-0 PGT37L-2
ELASTIS VERBAN 4 INC GOSYEN
DEPO OK RAWAT INAP NON DINAS 8/30/2017 8/30/2017 11:30:00 OK2017H000490
ISOFLURANE 250 ML
N2O 25 KG
CHROMIC 4/0 TS-19 75CM
ASERING 500 ML E
IV DRESSING FIXDERM
FETIK SUPP
KONIGEN KRIM 10 GR
TRAMADOL 50MG/ML AMP 2 ML NOVELL /T
N2O 25 KG
NYLON 4/O TS-19 75 CM
ASERING 500 ML E
IV DRESSING FIXDERM
N2O 25 KG
ASERING 500 ML E
BLUE MONOLON APEX 2-0
SEVODEX 250 ML
SITI KOTIJAH00294154 - - -
Jumlah Satuan
1 PCS
18 ML
1 AMP
1 PCS
2 AMP
120 LITER
1 AMP
1 PCS
120 LITER
1 PCS
2 BAG
1 PCS
1 PCS
1 PCS
1 AMP
1 AMP
I WAYAN ARI00513597 - - -
Jumlah Satuan
1 BTL
1 PCS
14 ML
1 AMP
2 LABU
1 AMP
90 LITER
2 AMP
90 LITER
2 PCS
2 BAG
1 AMP
1 PCS
1 PCS
1 ROL
2 VIAL
1 AMP
TEGAR ADIT 00374224 - - -
Jumlah Satuan
1 PCS
18 ML
1 AMP
1 PCS
1 AMP
120 LITER
1 AMP
120 LITER
1 PCS
2 BAG
1 PCS
1 PCS
1 AMP
1 SUPP
1 TUBE
1 AMP
1 AMP
1 PCS
IMAN TUGIM 00327334 - - -
Jumlah Satuan
1 PCS
1 AMP
1 PCS
1 AMP
120 LITER
1 AMP
120 LITER
1 PCS
2 BAG
1 PCS
1 PCS
1 AMP
1 AMP
1 PCS
PATRIA RAH 00126312 - - -
Jumlah Satuan
1 PCS
1 AMP
1 AMP
60 LITER
1 AMP
60 LITER
3 PCS
1 BAG
1 PCS
1 AMP
1 AMP
20 CC
1 PCS
RUANG PERAWATAN I 618,347 1 FITRI LANGGUnchecked BPJS AD KELUARGA
Harga Total
1,457 1,457
9,152 164,736
52,941 52,941
7,005 7,005
2,288 4,576
308 36,960
51,200 51,200
67,914 67,914
26 3,120
2,560 2,560
11,873 23,746
65,198 65,198
10,701 10,701
23,408 23,408
94,248 94,248
8,577 8,577
RUANG PERAWATAN XIV 684,165 1 FITRI LANGGUnchecked BPJS AD MIL SATPUR
Harga Total
13,517 13,517
1,457 1,457
9,152 128,128
52,941 52,941
8,205 16,410
2,288 2,288
308 27,720
51,200 102,400
26 2,340
2,560 5,120
11,873 23,746
94,248 94,248
2,169 2,169
110,880 110,880
66,880 66,880
12,672 25,344
8,577 8,577
RUANG PERAWATAN I 557,804 1 FITRI LANGGUnchecked BPJS UMUM JAMSOSTEK
Harga Total
1,457 1,457
9,152 164,736
52,941 52,941
7,005 7,005
2,288 2,288
308 36,960
51,200 51,200
26 3,120
53,811 53,811
11,873 23,746
10,701 10,701
23,408 23,408
94,248 94,248
3,380 3,380
9,856 9,856
7,287 7,287
8,577 8,577
3,083 3,083
RUANG PERAWATAN II 369,469 1 FITRI LANGGUnchecked BPJS ANGKATAN DARAT
Harga Total
1,457 1,457
52,941 52,941
7,005 7,005
2,288 2,288
308 36,960
51,200 51,200
26 3,120
50,735 50,735
11,873 23,746
10,701 10,701
23,408 23,408
94,248 94,248
8,577 8,577
3,083 3,083
RUANG PAVILIUN FLAMBO 431,835 1 FITRI LANGGUnchecked BPJS ANGKATAN DARAT K
Harga Total
1,457 1,457
52,941 52,941
2,288 2,288
308 18,480
51,200 51,200
26 1,560
2,560 7,680
11,873 11,873
64,768 64,768
94,248 94,248
8,577 8,577
5,684 113,680
3,083 3,083
BPJS AD KELUARGA
1,457
164,736
52,941
7,005
4,576
36,960
51,200
67,914
3,120
2,560
23,746
65,198
10,701
23,408
94,248
8,577
BPJS AD MIL SATPUR
13,517
1,457
128,128
52,941
16,410
2,288
27,720
102,400
2,340
5,120
23,746
94,248
2,169
110,880
66,880
25,344
8,577
BPJS UMUM JAMSOSTEK
1,457
164,736
52,941
7,005
2,288
36,960
51,200
3,120
53,811
23,746
10,701
23,408
94,248
3,380
9,856
7,287
8,577
3,083
BPJS ANGKATAN DARAT
1,457
52,941
7,005
2,288
36,960
51,200
3,120
50,735
23,746
10,701
23,408
94,248
8,577
3,083
1,457
52,941
2,288
18,480
51,200
1,560
7,680
11,873
64,768
94,248
8,577
113,680
3,083
AQUABIDEST 50 ML
NACL 0.9 500 ML
SPINAL NEEDLE 26 G SPINOCAN
ASERING 500 ML E
BLUE MONOLON APEX 3-0 BNC26L-3
IV DRESSING FIXDERM
ELASTIS VERBAN 6 INC GOSYEN
DISPOSABLE SYRINGE 1 ML BD
NASAL CANUL DEWASA COSMO
SURGEON 1 TAPER/T
REGIVELL INJ 4 ML /R
ISOFLURANE 250 ML
N2O 25 KG
CHROMIC 4/0 TS-19 75CM
ASERING 500 ML E
IV DRESSING FIXDERM
FETIK SUPP
KONIGEN KRIM 10 GR
TRAMADOL 50MG/ML AMP 2 ML NOVELL /T
ISOFLURANE 250 ML
N2O 25 KG
ASERING 500 ML E
IV DRESSING FIXDERM
NACL 0.9 500 ML
OXYTOCIN INJ
CHROMIC CATGUT 2 APEX CAT50-2B
APRON FILM WHITE SURGILAB
SURGION 3-0 PGC2 6-3
METHYLERGOMETRIN INJ
SURGION APEX 1 PGC40L-1B
ERBE NESSY
ASERING 500 ML E
CHROMIC CATGUT 2-0 TAPER/T
ISOFLURANE 250 ML
N2O 25 KG
BRAIDED SILK APEX 1 BST40-IB
ASERING 500 ML E
NACL 0.9 500 ML
OXYTOCIN INJ
CHROMIC CATGUT 2 APEX CAT50-2B
APRON FILM WHITE SURGILAB
SURGION 3-0 PGC2 6-3
METHYLERGOMETRIN INJ
SURGION APEX 1 PGC40L-1B
ASERING 500 ML E
CHROMIC CATGUT 2-0 TAPER/T
SARINA RAT 00427636 - - -
Jumlah Satuan
1 BTL
1 PCS
1 AMP
3 LABU
1 PCS
1 AMP
90 LITER
2 PCS
1 PCS
2 BAG
1 PCS
1 PCS
1 PCS
1 PCS
1 AMP
1 ROL
1 PCS
1 PCS
2 AMP
2 VIAL
1 PCS
1 AMP
1 AMP
1 PCS
ROHAETI NY 00195768 - - -
Jumlah Satuan
1 PCS
1 AMP
30 LITER
1 PCS
1 AMP
1 AMP
TEGAR ADIT 00374224 - - -
Jumlah Satuan
1 PCS
18 ML
1 AMP
1 PCS
1 AMP
120 LITER
1 AMP
120 LITER
1 PCS
2 BAG
1 PCS
1 PCS
1 AMP
1 SUPP
1 TUBE
1 AMP
1 AMP
1 PCS
RIZKY JULIA 00512532 - - -
Jumlah Satuan
1 AMP
AGUNG NUGR00512282 - - -
Jumlah Satuan
1 PCS
18 ML
1 AMP
1 PCS
1 AMP
120 LITER
1 AMP
120 LITER
1 PCS
2 BAG
1 PCS
1 PCS
1 PCS
1 AMP
YETTI YULIA 00513497 - - -
Jumlah Satuan
1 PCS
1 AMP
1 LABU
1 AMP
1 AMP
1 PCS
3 PCS
1 SACH
1 AMP
1 AMP
200 LITER
1 PCS
1 PCS
1 PCS
2 BAG
2 AMP
1 PCS
1 AMP
1 AMP
1 PCS
YUYUN YULIA00513590 - - -
Jumlah Satuan
1 PCS
18 ML
1 AMP
1 AMP
120 LITER
1 AMP
120 LITER
2 PCS
1 PCS
2 BAG
4 AMP
1 AMP
NUR FITRIAN00448170 - - -
Jumlah Satuan
1 PCS
1 AMP
1 LABU
1 AMP
1 AMP
1 PCS
1 PCS
1 SACH
1 AMP
1 AMP
110 LITER
1 PCS
1 PCS
2 BAG
2 AMP
1 PCS
1 AMP
1 AMP
1 PCS
RUANG PERAWATAN I 784,075 1 FITRI LANGGUnchecked BPJS UMUM ASKES NON T
Harga Total
13,517 13,517
1,457 1,457
52,941 52,941
8,205 24,615
7,005 7,005
51,200 51,200
26 2,340
2,560 5,120
40,961 40,961
11,873 23,746
64,768 64,768
65,198 65,198
10,701 10,701
23,408 23,408
94,248 94,248
86,944 86,944
2,169 2,169
6,866 6,866
2,504 5,008
12,672 25,344
113,247 113,247
8,577 8,577
51,612 51,612
3,083 3,083
RUANG PERAWATAN V/VI 158,822 1 FITRI LANGGUnchecked BPJS UMUM JAMSOSTEK
Harga Total
1,457 1,457
51,200 51,200
26 780
2,560 2,560
94,248 94,248
8,577 8,577
RUANG PERAWATAN I 557,804 1 FITRI LANGGUnchecked BPJS UMUM JAMSOSTEK
Harga Total
1,457 1,457
9,152 164,736
52,941 52,941
7,005 7,005
2,288 2,288
308 36,960
51,200 51,200
26 3,120
53,811 53,811
11,873 23,746
10,701 10,701
23,408 23,408
94,248 94,248
3,380 3,380
9,856 9,856
7,287 7,287
8,577 8,577
3,083 3,083
RUANG PERAWATAN II 40,551 1 FITRI LANGGUnchecked BPJS UMUM MANDIRI
Harga Total
40,551 40,551
RUANG PERAWATAN II 453,467 1 FITRI LANGGUnchecked BPJS UMUM MANDIRI
Harga Total
1,457 1,457
9,152 164,736
52,941 52,941
7,005 7,005
2,288 2,288
308 36,960
51,200 51,200
26 3,120
2,560 2,560
11,873 23,746
64,768 64,768
10,701 10,701
23,408 23,408
8,577 8,577
RUANG PERAWATAN V/VI 787,753 1 FITRI LANGGUnchecked BPJS UMUM JAMKESMAS
Harga Total
1,457 1,457
52,941 52,941
8,205 8,205
2,432 2,432
2,288 2,288
81,774 81,774
5,844 17,532
95,634 95,634
51,200 51,200
3,436 3,436
26 5,200
113,652 113,652
40,961 40,961
155,232 155,232
11,873 23,746
2,504 5,008
63,783 63,783
8,577 8,577
51,612 51,612
3,083 3,083
RUANG PERAWATAN I 428,075 1 FITRI LANGGUnchecked BPJS UMUM JAMKESMAS
Harga Total
1,457 1,457
9,152 164,736
52,941 52,941
2,288 2,288
308 36,960
51,200 51,200
26 3,120
2,560 5,120
67,914 67,914
11,873 23,746
2,504 10,016
8,577 8,577
RUANG PERAWATAN V/VI 618,493 1 FITRI LANGGUnchecked BPJS UMUM JAMSOSTEK
Harga Total
1,457 1,457
52,941 52,941
8,205 8,205
2,432 2,432
2,288 2,288
81,774 81,774
5,844 5,844
95,634 95,634
51,200 51,200
3,436 3,436
26 2,860
113,652 113,652
40,961 40,961
11,873 23,746
2,504 5,008
63,783 63,783
8,577 8,577
51,612 51,612
3,083 3,083
13,517
1,457
52,941
24,615
7,005
51,200
2,340
5,120
40,961
23,746
64,768
65,198
10,701
23,408
94,248
86,944
2,169
6,866
5,008
25,344
113,247
8,577
51,612
3,083
BPJS UMUM JAMSOSTEK
1,457
51,200
780
2,560
94,248
8,577
BPJS UMUM JAMSOSTEK
1,457
164,736
52,941
7,005
2,288
36,960
51,200
3,120
53,811
23,746
10,701
23,408
94,248
3,380
9,856
7,287
8,577
3,083
BPJS UMUM MANDIRI
40,551
BPJS UMUM MANDIRI
1,457
164,736
52,941
7,005
2,288
36,960
51,200
3,120
2,560
23,746
64,768
10,701
23,408
8,577
BPJS UMUM JAMKESMAS
1,457
52,941
8,205
2,432
2,288
81,774
17,532
95,634
51,200
3,436
5,200
113,652
40,961
155,232
23,746
5,008
63,783
8,577
51,612
3,083
BPJS UMUM JAMKESMAS
1,457
164,736
52,941
2,288
36,960
51,200
3,120
5,120
67,914
23,746
10,016
8,577
BPJS UMUM JAMSOSTEK
1,457
52,941
8,205
2,432
2,288
81,774
5,844
95,634
51,200
3,436
2,860
113,652
40,961
23,746
5,008
63,783
8,577
51,612
3,083

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