Daftar Pajak Masukan

DAFTAR PAJAK MASUKAN YANG DAPAT DIKERDITKAN ATAS PEROLEHAN BPK / JKP DALAM NEGRI
Daftar Penjual BPK / BPK Faktur Pajak / Dokumen Tertentu

NO. Tidak Berwujud / Pemberi JKP NPWP / Nota retur / Nota Pembatalan DPP ( rupiah ) PPN (rupiah)
Kode & Nomor Seri Tanggal
1 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00014045 1/7/2011 4,157,041 415,704
2 PT. ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00000104 1/7/2011 359,100 35,910
3 PT. ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00000107 1/3/2011 1,809,120 180,912
5 PT. ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.00019300 1/5/2011 2,761,437 276,144
7 PT. BATU RUSA 01.207.460.5-511.000 010.000.11.00000844 1/5/2011 103,680 10,368
8 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00001431 1/6/2011 1,808,080 180,808
9 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00001427 1/6/2011 369,216 36,922
10 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00001415 1/6/2011 387,984 38,798
11 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00000540 1/4/2011 614,000 61,400
12 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00000519 1/4/2011 65,200 6,520
13 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000140 1/13/2011 558,182 55,818
14 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00011062 1/4/2011 600,000 60,000
15 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00010668 1/4/2011 543,750 54,375
16 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00013000 1/6/2011 600,000 60,000
17 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00027485 1/6/2011 1,767,248 176,725
18 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00027484 1/6/2011 372,728 37,273
22 PT. KEBAYORAN 01.308.506.3-073.000 010.004-11.00000301 1/4/2011 4,213,250 421,325
23 PT. KEBAYORAN 01.308.506.3-073.000 010.004-11.00000589 1/6/2011 1,232,773 123,277
24 PT. MILLENNIUM PHARMACON INTERNAT01.300.861.0-054.000 010.028-11.00000010 1/3/2011 16,668,000 1,666,800
25 PT. MILLENNIUM PHARMACON INTERNAT01.300.861.0-054.000 010.028-11.00000154 1/5/2011 276,000 27,600
27 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00029174 1/12/2011 883,776 88,378
33 PT. ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.00066936 1/12/2011 235,625 23,563
34 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00002265 1/8/2011 1,015,360 101,536
35 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00003302 1/11/2011 2,996,800 299,680
36 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00003337 1/11/2011 2,684,424 268,442
37 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00004297 1/13/2011 448,544 44,854
38 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00004308 1/13/2011 610,848 61,085
39 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00004301 1/13/2011 4,507,120 450,712
44 PT. KARYA DHARMA UTAMA 02.359.682.8-032.000 010.000-11.00000003 1/13/2011 1,710,540 171,054
45 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00000452 1/10/2011 1,593,687 159,369
46 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00000976 1/13/2011 1,151,470 115,147
47 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00000456 1/10/2011 832,600 83,260
48 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00020820 1/10/2011 292,500 29,250
49 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00001554 1/11/2011 329,052 32,905
51 PT. MILLENNIUM PHARMACON INTERNAT01.300.861.0-054.000 010.028-11.00000308 1/7/2011 9,862,500 986,250
54 PT. UNITED DICO CITAS 01.301.246-3.073.000 010.010-11.00000883 1/14/2011 1,402,500 140,250
55 PT. UNITED DICO CITAS 01.301.246-3.073.000 010.010-11.00000646 1/12/2011 267,154 26,715
63 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00003574 1/19/2011 1,966,500 196,650
64 PT. BATU RUSA 01.207.460.5-511.000 010.000-11.00006334 1/19/2011 213,750 21,375
65 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00005182 1/15/2011 3,348,080 334,808
66 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00005184 1/15/2011 962,000 96,200
67 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00005189 1/15/2011 54,800 5,480
68 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00005199 1/15/2011 65,200 6,520
69 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00005240 1/15/2011 2,114,640 211,464
70 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00005287 1/15/2011 586,704 58,670
71 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00006121 1/18/2011 28,000 2,800
72 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00006140 1/18/2011 610,848 61,085
73 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00006160 1/18/2011 6,412,240 641,224
74 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00007222 1/20/2011 4,335,440 433,544
75 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00007325 1/20/2011 2,445,540 244,554
76 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00006124 1/18/2011 1,134,312 113,431
77 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000277 1/20/2011 108,182 10,818
78 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000364 1/27/2011 68,182 6,818
89 PT. INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00000514 1/17/2011 231,516 23,152
93 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00001289 1/17/2011 925,099 92,510
94 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00001290 1/17/2011 245,997 24,600
95 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00001793 1/20/2011 161,216 16,122
96 PT. KEBAYORAN 01.308.506.3-073.000 010.004-11.00001955 1/18/2011 1,561,800 156,180
97 PT. KEBAYORAN 01.308.506.3-073.000 010.004-11.00001458 1/13/2011 2,261,000 226,100
98 PT. KEBAYORAN 01.308.506.3-073.000 010.004-11.00001186 1/11/2011 2,712,547 271,255
100 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00003080 1/18/2011 5,382,372 538,237
106 PT. PARAZELSUS INDONESIA 01.868.116.3-056.000 010.023-11.00000688 1/13/2011 780,000 78,000
107 PT. PARAZELSUS INDONESIA 01.868.116.3-056.000 010.023-11.00001070 1/18/2011 1,012,000 101,200
108 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00002953 1/17/2011 240,350 24,035
109 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00002958 1/17/2011 3,634,500 363,450
119 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00010812 1/28/2011 3,592,800 359,280
120 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00007657 1/21/2011 26,000 2,600
121 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00008044 1/22/2011 153,840 15,384
122 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00008046 1/22/2011 1,482,800 148,280
123 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00008054 1/22/2011 629,760 62,976
124 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00009136 1/25/2011 131,000 13,100
125 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00009142 1/25/2011 969,960 96,996
126 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00009172 1/25/2011 602,384 60,238
127 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00009175 1/25/2011 1,214,760 121,476
128 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00010111 1/27/2011 1,450,240 145,024
129 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00010113 1/27/2011 448,544 44,854
130 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00010185 1/27/2011 3,681,168 368,117
131 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00063799 1/25/2011 632,688 63,269
138 PT. KEBAYORAN 01.308.506.3-073.000 010.004-11.00002722 1/25/2011 6,109,747 610,975
141 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00069381 1/24/2011 240,000 24,000
145 PT. UNITED DICO CITAS 01.301.246-3.073.000 010.010-11.00001923 1/28/2011 267,154 26,715
146 PT. UNITED DICO CITAS 01.301.246-3.073.000 010.010-11.00002083 1/31/2011 1,062,500 106,250
147 PT. AKURAT INTAN MADYA 01.698.969.1.029.000 010.000-11.00000378 1/28/2011 1,860,000 186,000
153 PT. BATU RUSA 01.207.460.5-511.000 010.000.11.00008811 1/26/2011 1,703,047 170,305
154 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00011993 1/31/2011 1,579,496 157,950
155 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00011923 1/31/2011 7,020,400 702,040
156 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00011919 1/31/2011 224,272 22,427
157 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00011204 1/29/2011 761,500 76,150
158 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00011055 1/29/2011 2,059,120 205,912
159 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00011032 1/29/2011 814,400 81,440
160 PT. BRATACO 01.130.689.1-441.000 010.010-11.00000883 1/29/2011 181,819 18,182
170 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00002558 1/27/2011 157,320 15,732
171 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00002089 1/24/2011 2,857,161 285,716
172 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00002631 1/27/2011 19,992 1,999
173 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00002904 1/31/2011 44,459 4,446
174 PT. KEBAYORAN 01.308.506.3-073.000 010.004-11.00003032 1/27/2011 2,561,200 256,120
185 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00000387 1/18/2011 518,645 51,865
186 PT. DISTRIVERSA BUANA MAS 01.555.204.5-543.001 010.000-11.00004613 1/31/2011 17,820 1,782
187 PT. DISTRIVERSA BUANA MAS 01.555.204.5-543.001 010.000-11.00002758 1/19/2011 1,820,000 182,000
189 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00000841 1/14/2011 2,383,600 238,360
191 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00002983 1/31/2011 353,128 35,313
192 PT. SAMATOR GAS 01.585.149.6-631.000 010.004-11.00000063 1/12/2011 928,000 92,800
193 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 213210421 1/24/2011 (33,238) (3,324)
419,011,645 41,901,165
Gombong, 19 Februari 2011

Mengetahui, Perekap,
Sr. Bernada, ADM Dwi Indra Anggraeni

4,572,745
395,010
1,990,032
247,500
KETERANGAN
3,037,581
1,485,542
114,048
1,988,888
406,138
426,782 0.909091 16492850
675,400
71,720
614,000
660,000
598,125
660,000
1,943,973
410,001
3,168,000
8,442,390
5,289,983
4,634,575
1,356,050
18,334,800
303,600
2,191,806
972,154
1,309,252
1,644,399
332,805
319,000
510,400
259,188
1,116,896
3,296,480
2,952,866
493,398
671,933
4,957,832
4,045,683
636,727
898,909
105,600
1,881,594
1,753,056
1,266,617
915,860
321,750
361,957
27,500
10,848,750
15,136,000
11,947,100
1,542,750
293,869
4,880,807
231,000
518,925
694,892
523,600
510,400
10,434,635
2,163,150
235,125
3,682,888
1,058,200
60,280
71,720
2,326,104
645,374
30,800
671,933
7,053,464
4,768,984
2,690,094
1,247,743
119,000
75,000
3,881,900
2,078,766
3,928,584
437,693
6,272,750
3,165,283
4,020,668
1,313,686
6,602,588
1,998,282
254,668
87,300
176,392
130,810
1,017,609
270,597
177,338
1,717,980
2,487,100
2,983,802
19,800
5,920,609
3,050,190
34,502
15,625,500
18,117,000
17,567,000
858,000
1,113,200
264,385
3,997,950
345,455
116,160
2,048,200
594,605
1,888,185
3,962,497
1,201,795
7,491,380
250,800
3,952,080
28,600
169,224
1,631,080
692,736
144,100
1,066,956
662,622
1,336,236
1,595,264
493,398
4,049,285
695,957
1,705,165
2,090,000
154,048
7,113,927
6,025,485
2,429,966
6,720,722
1,326,523
180,979
264,000
8,464,500
7,848,500
10,546,250
293,869
1,168,750
2,046,000
5,029,251
518,144
176,000
946,000
255,200
1,873,352
1,737,446
7,722,440
246,699
837,650
2,265,032
895,840
200,001
1,746,360
848,513
5,660,050
6,372,303
1,006,434
176,712
219,046
435,034
22,897
173,052
3,142,877
21,991
48,905
2,817,320
122,513
16,492,850
264,385
391,364
159,885
745,250
147,235
4,741,773
70,180
2,904,000
570,510
19,602
2,002,000
468,270
2,621,960
523,445
388,441
1,020,800
(36,562) RETUR
459,928,571
DAFTAR PAJAK MASUKAN YANG DAPAT DIKREDITKAN ATAS PEROLEHAN BPK / JKP DALAM NEGRI

1 PT. KEBAYORAN FARMA 01.308.506.3-073.000 010.004-11.00003606 2/1/2011 2,244,739 224,474 2,469,213
2 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00000201 2/1/2011 1,276,000 127,600 1,403,600
3 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00000285 2/14/2011 493,000 49,300 542,300
4 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00000285 2/18/2011 464,000 46,400 510,400
5 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00005980 2/1/2011 630,000 63,000 693,000
6 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00005937 2/1/2011 1,103,081 110,308 1,213,389
9 PT. DJAMA MULIA BERSAUDARA 01.675.729.6-508.000 010.000-11.00000010 2/1/2011 4,872,000 487,200 5,359,200
10 PT. ANUGRAH PHARMINDO LESTARI 01.246.832.8.523.000 010.000-11.00223104 2/2/2011 2,357,067 235,707 2,592,774 0.909091
11 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000441 2/2/2011 454,546 45,455 500,001
12 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00013086 2/2/2011 378,104 37,810 415,914
13 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00013162 2/4/2011 1,796,400 179,640 1,976,040
14 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00013175 2/4/2011 3,395,120 339,512 3,734,632
15 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00013125 2/4/2011 1,973,592 197,359 2,170,951
16 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00098917 2/2/2011 1,357,500 135,750 1,493,250
17 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00001646 2/2/2011 9,700,000 970,000 10,670,000
19 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00008046 2/4/2011 1,701,750 170,175 1,871,925
20 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00008081 2/24/2011 355,785 35,579 391,364
21 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00102574 2/4/2011 527,662 52,766 580,428
22 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00288333 2/4/2011 1,323,000 132,300 1,455,300
25 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.02951532 2/5/2011 (1,104,530) (110,453) (1,214,983)
26 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00183744 2/5/2011 (914,940) (91,494) (1,006,434)
34 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00308851 2/7/2011 437,352 43,735 481,087
36 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000023 2/2/2011 1,160,068 116,007 1,276,075
37 CV. PRISNA MEDICA 01.964.173.7-517.000 010.0000-11.00000022 2/2/2011 1,218,182 121,818 1,340,000
38 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00001750 2/22/2011 2,315,000 231,500 2,546,500 0.909091
39 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00014615 2/8/2011 4,444,000 444,400 4,888,400 0.909091
40 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00014563 2/8/2011 1,231,048 123,105 1,354,153
41 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00014609 2/8/2011 378,104 37,810 415,914
45 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00003459 2/7/2011 213,883 21,388 235,271
46 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00003426 2/7/2011 867,967 86,797 954,764
47 PT. ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00003627 2/7/2011 464,000 46,400 510,400
48 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00150941 2/8/2011 638,470 63,847 702,317
49 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00150956 2/8/2011 543,750 54,375 598,125
50 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000027 2/8/2011 545,455 54,546 600,001
51 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000028 2/8/2011 1,340,750 134,075 1,474,825
55 PT. PARAZELSUS 01.868.116.3-056.000 010.023-11.00002261 2/8/2011 472,000 47,200 519,200
56 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00331724 2/9/2011 2,995,228 299,523 3,294,751 0.909091
61 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.0016544 2/10/2011 1,057,320 105,732 1,163,052
62 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00015704 2/10/2011 5,169,680 516,968 5,686,648
64 PT. INDOFARMA GLOBAL MEDICA 01.061.184.6-051.000 010.008-11.00001880 2/9/2011 64,450 6,445 70,895
67 PT. ANUGRAH PHARMINDO LESTARI 01.246.832.8.523.000 010.025-11.00015720 2/9/2011 1,705,920 170,592 1,876,512
68 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00015720 2/10/2011 783,264 78,326 861,590
69 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00002948 2/5/2011 2,805,000 280,500 3,085,500
70 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00002983 2/9/2011 425,000 42,500 467,500
71 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00002971 2/9/2011 1,817,382 181,738 1,999,120
72 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000531 2/10/2011 531,136 53,114 584,250
74 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00003853 2/10/2011 44,972 4,497 49,469
75 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00003852 2/10/2011 1,316,065 131,607 1,447,672
76 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00016618 2/12/2011 3,076,224 307,622 3,383,846
77 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00016621 2/12/2011 7,332,000 733,200 8,065,200
79 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00016577 2/12/2011 672,500 67,250 739,750
83 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00009496 2/11/2011 2,760,175 276,018 3,036,193
84 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00002066 2/11/2011 21,980,000 2,198,000 24,178,000
85 PT. RAJAWALI NUSINDO 01.246.832.8-523.000 010.031-11.00002778 2/11/2011 527,832 52,783 580,615
86 PT. RAJAWALI NUSINDO 01.246.832.8-523.000 010.031-11.00002783 2/11/2011 1,191,800 119,180 1,310,980 0.909091
87 PT. BATU RUSA 01.207.460.5-511.000 010.000.11.00013781 2/9/2011 2,436,750 243,675 2,680,425
94 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00017597 2/14/2011 1,171,576 117,158 1,288,734
95 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00017577 2/16/2011 3,641,760 364,176 4,005,936
96 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00017600 2/14/2011 7,426,560 742,656 8,169,216
103 PT. PARAZELSUS 01.868.116.3-056.000 010.023-11.00002647 2/14/2011 647,280 64,728 712,008
105 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000036 2/14/2011 1,055,114 105,511 1,160,625 0.909091
107 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000037 2/14/2011 1,992,909 199,291 2,192,200
108 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00004172 2/14/2011 185,610 18,561 204,171 0.909091
109 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00004205 2/15/2011 2,532,200 253,220 2,785,420
110 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00004133 2/14/2011 173,250 17,325 190,575
111 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00004132 2/14/2011 44,544 4,454 48,998
112 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00004206 2/15/2011 1,266,100 126,610 1,392,710
113 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11-00004135 2/14/2011 1,162,600 116,260 1,278,860
114 PT. ANUGRAH PHARMINDO LESTARI 01.246.832.8.523.000 010.020-11-00304395 2/16/2011 1,065,011 106,501 1,171,512
115 PT. ANUGRAH PHARMINDO LESTARI 01.246.832.8.523.000 010.000-11.00304414 2/16/2011 65,000 6,500 71,500
116 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00018076 2/16/2011 92,440 9,244 101,684
117 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00018077 2/16/2011 531,936 53,194 585,130
118 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00018199 2/16/2011 2,462,240 246,224 2,708,464
120 PT. RAJAWALI NUSINDO 01.246.832.8-523.000 010.031-11.00003026 2/16/2011 763,181 76,318 839,499
121 PT. RAJAWALI NUSINDO 01.246.832.8-523.000 010.031-11.00003028 2/16/2011 1,884,792 188,479 2,073,271
131 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00019017 2/18/2011 28,000 2,800 30,800
132 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00019020 2/18/2011 1,147,600 114,760 1,262,360
133 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00018994 2/18/2011 1,406,400 140,640 1,547,040
134 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00002930 2/18/2011 10,720,000 1,072,000 11,792,000
135 PT. BATU RUSA 01.207.460.5-511.000 010.000.11.00016267 2/16/2011 2,188,800 218,880 2,407,680
136 PT. ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00004772 2/17/2011 1,575,000 157,500 1,732,500
137 PT. ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00004707 2/17/2011 271,000 27,100 298,100
138 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00004391 2/18/2011 236,572 23,657 260,229
140 PT. KEBAYORAN FARMA 01.308.506.3-073.000 010.004-11.00005445 2/18/2011 3,521,947 352,195 3,874,142 0.909091
141 PT. KEBAYORAN FARMA 01.308.506.3-073.000 010.004-11.00005441 2/18/2011 227,728 22,773 250,501 0.909091
143 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00163199 2/21/2011 585,000 58,500 643,500 0.909091
144 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00153542 2/21/2011 420,000 42,000 462,000 0.909091
147 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00020275 2/22/2011 1,706,800 170,680 1,877,480 0.909091
149 PT. INDOFARMA GLOBAL MEDICA 01.061.184.6-051.000 010.008-11.00002452 2/21/2011 579,416 57,942 637,358 0.909091
151 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000040 2/16/2011 327,273 32,727 360,000 0.909091
153 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00004694 2/21/2011 1,360,760 136,076 1,496,836 0.909091
154 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00004695 2/21/2011 1,168,800 116,880 1,285,680 0.909091
155 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000659 2/23/2011 298,182 29,818 328,000 0.909091
157 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00009888 2/22/2011 2,100,000 210,000 2,310,000 0.909091
159 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00439721 2/22/2011 735,966 73,597 809,563 0.909091
161 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00191286 2/22/2011 727,300 72,730 800,030 0.909091
164 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00021158 2/24/2011 1,476,640 147,664 1,624,304 0.909091
165 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00021165 2/23/2011 2,375,728 237,573 2,613,301 0.909091
166 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00021156 2/24/2011 153,832 15,383 169,215 0.909091
167 PT. ANUGRAH PHARMINDO LESTARI 01.246.832.8.523.000 010.000-11.00360394 2/23/2011 3,976,479 397,648 4,374,127 0.909091
168 PT. ANUGRAH PHARMINDO LESTARI 01.246.832.8.523.000 010.000-11.00360418 2/23/2011 65,000 6,500 71,500 0.909091
169 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00003967 2/25/2011 2,010,673 201,067 2,211,740 0.909091
170 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00003968 2/23/2011 446,963 44,696 491,659 0.909091
177 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000045 2/23/2011 3,138,409 313,841 3,452,250 0.909091
178 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000046 2/23/2011 983,250 98,325 1,081,575 0.909091
179 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000732 2/23/2011 574,545 57,455 632,000 0.909091
180 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00000346 2/24/2011 290,000 29,000 319,000 0.909091
182 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00022133 2/26/2011 2,092,936 209,294 2,302,230 0.909091
183 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.0022131 2/26/2011 2,267,440 226,744 2,494,184 0.909091
184 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00022130 2/26/2011 448,544 44,854 493,398 0.909091
195 PT. BATU RUSA 01.207.460.5-511.000 010.000-11.00019209 2/23/2011 3,178,462 317,846 3,496,308 0.909091
196 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00003390 2/28/2011 1,906,880 190,688 2,097,568 0.909091
197 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00178583 2/25/2011 1,219,035 121,904 1,340,939 0.909091
198 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00022892 2/28/2011 65,200 6,520 71,720 0.909091
199 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00022982 2/28/2011 5,502,240 550,224 6,052,464 0.909091
200 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00023098 2/28/2011 2,148,504 214,850 2,363,354 0.909091
- 0.909091
390,877,417 39,087,742 429,965,159 0.909091
Gombong, 19 Maret 2011


16492850
10670000
7766000
13046000
3935800
24178000
7502000
2849000
11792000
8591000
REFISI
NO. Tidak Berwujud / Pemberi JKP NPWP NO FAKTUR PAJAK / Nota retur / Nota Pembatalan DPP ( rupiah ) PPN (rupiah)
1 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000-11.00000856 RAA/SPJ/1100888 2/28/2011 1,580,000 158,000
2 PT. INDOFARMA GLOBAL MEDICA 01.061.184.6-051.000 010.008-11.00002897 32/NV.02.2011.2964 2/28/2011 160,938 16,094
4 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00002892 132811002823 2/28/2011 17,326,500 1,732,650
5 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00011402 11570 3/1/2011 1,284,180 128,418
6 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00011401 11569 3/1/2011 200,000 20,000
9 PT. KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00006730 ASB11006679 3/1/2011 6,095,200 609,520
10 PT. INDOFARMA GLOBAL MEDICA 01.061.184.6-051.000 010.008-11.00002980 32/NV.02/2011.3047 2/28/2011 832,600 83,260
11 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00024561 FKPWT/201103/00616 3/2/2011 1,057,320 105,732
12 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000835 RBF00785 3/2/2011 105,000 10,500
13 PT. ANUGRAH ARGON MEDIKA 01.129.737.1-308.000 010.000-11.00191175 461211006143 3/2/2011 72,900 7,290
16 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00024653 FKPWT/201103/00832 3/2/2011 455,000 45,500
19 PT. ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.00420590 1330883479 3/3/2011 7,576,830 757,683
21 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00540491 311000365 3/3/2011 969,795 96,980
24 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00005752 INV.18.11.000005782 3/3/2011 742,500 74,250
25 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00540407 111007012 3/3/2011 7,021,655 702,166
26 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00005753 INV.18.11.000005783 3/3/2011 48,462 4,846
28 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000051 03. 0051 3/2/2011 211,250 21,125
29 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000052 03. 0052 3/2/2011 1,373,295 137,330
30 PT. ANUGRAH ARGON MEDIKA 01.129.737.1-308.000 010.000-11.00197691 461211006318 3/4/2011 1,075,899 107,590
34 PT. KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00007002 ASB11006951 3/3/2011 151,265 15,127
41 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00565994 111007377 3/7/2011 12,895,502 1,289,550
56 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00003367 132811003310 3/9/2011 7,350,000 735,000
57 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00004843 FKT1004703 3/9/2011 289,476 28,948
59 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000060 03. 0060 3/9/2011 724,659 72,466
60 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000059 03. 0059 3/9/2011 599,318 59,932
65 PT. INDOFARMA GLOBAL MEDICA 01.061.184.6-051.000 010.008-11.00003429 3519 3/9/2011 168,954 16,895
66 PT. UNITED DICO CITAS 01.301.246.3.073.000 010.010-11.00005061 136482 3/9/2011 1,116,132 111,613
69 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00303028 813406876 3/10/2011 543,750 54,375
70 PT. BRATACO 01.130.689.1-441.000 010.009-11.00000927 RBF00872 3/10/2011 571,818 57,182
74 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00303081 813412312 3/11/2011 1,750,000 175,000
75 PT. ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.00480396 1330886171 3/11/2011 381,187 38,119
80 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00016382 FJ-2220110020832 3/11/2011 572,698 57,270
81 PT. BATU RUSA 01.207.406.5-511.000 010.000-11.00025346 FS01-11-03-000757 3/10/2011 752,400 75,240
82 PT. BATU RUSA 01.207.406.5-511.000 010.000-11.00024622 FS01-11-03-001088 3/11/2011 1,966,500 196,650
83 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00016384 FJ-2220110020837 3/11/2011 2,683,150 268,315
86 PT. ANTAR MITRA SEMBADA 01.246.832.8-523.000 010.015-11.00007187 G5S2594 3/14/2011 580,000 58,000
87 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00006672 INV-18.11.000006706 3/14/2011 1,256,500 125,650
88 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00006542 INV-18.11.000006575 3/11/2011 205,708 20,571
90 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00236163 CD182219566 3/14/2011 292,500 29,250
95 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00006673 INV-18.11.000006707 3/14/2011 1,999,840 199,984
98 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00312553 813430554 3/15/2011 320,000 32,000
105 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000066 03. 0066 3/16/2011 642,500 64,250
106 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000067 03. 0067 3/16/2011 672,727 67,273
108 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00005596 137047 3/16/2011 610,072 61,007
120 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001014 RBF00953 3/16/2011 477,273 47,727
123 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000.11.00001576 RAA/SPJ/1101641 3/17/2011 1,995,000 199,500
136 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00007408 INV-18.11.000007442 3/21/2011 120,150 12,015
154 PT. UNITED DICO CITAS 01.301.246.3.073.000 010.010-11.00006152 137613 3/23/2011 223,482 22,348
158 PT. UNITED DICO CITAS 01.301.246.3.073.000 010.010-11.00006151 137612 3/23/2011 1,108,654 110,865
161 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000072 03. 0072 3/23/2011 1,522,500 152,250
162 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000071 03. 0071 3/23/2011 1,148,409 114,841
166 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00007784 INV-18.11.000007820 3/24/2011 109,693 10,969
168 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000-11.00004198 IKC01078/NU 3/21/2011 10,941,625 1,094,163
174 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000075 03. 0075 3/26/2011 787,500 78,750
175 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000076 03. 0076 3/26/2011 207,350 20,735
188 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00008041 INV-18.11.000008077 3/28/2011 1,608,900 160,890
199 PT. PENTA VALENT 01.305.436.6-056.000 010.000-11.00148278 0142-AR-11-03964 3/30/2011 69,038 6,904
216 PT. AKURAT INTAN MADYA 01.698.969.1.029.000 010.000.11.00001087 31101087 3/24/2011 2,570,455 257,045
467,487,610 46,748,761
Gombong, 19 April 2011

1,738,000
177,032
169,189 0.9090909091
19,059,150
1,412,598
220,000
825,000
663,262
6,704,720
915,860
1,163,052
115,500
80,190
518,925
763,939
500,500
114,840
12,617,000
8,334,513
4,730,616
1,066,775
751,707
338,027
816,750
7,723,821
53,308 0.9090909091
102,086 0.9090909091
232,375
1,510,625
1,183,489
9,625,629
13,810,500
1,001,044
166,392
350,402
1,100,000
2,848,824
104,522
383,023
249,997
14,185,052 0.9090909091
2,910,600
363,000
187,000
70,895
96,653
1,163,052
3,659,084
1,980,422
25,399
76,001
1,980,422
1,555,003
1,099,472
1,420,406
8,085,000
318,424
109,399
797,125
659,250
183,645
311,251
164,001
216,207
185,849
1,227,745 1,233,745
1,527,042
638,000
598,125
629,000 0.9090909091
166,056
7,592,805
1,632,290
1,925,000
419,306
342,144
11,077,000
1,498,961
3,453,067
629,968
827,640
2,163,150
2,951,465
29,040
752,501
638,000
1,382,150
226,279
2,609,772 0.9090909091
321,750
740,098
181,755 0.9090909091
10,997,167
1,379,514
2,199,824
10,856,448
5,850,464
352,000
929,500
237,600
881,661
2,635,490
2,848,824
3,140,544
706,750
740,000
2,946,976
671,079
1,488,513
2,685,625
285,952
218,282
2,346,300
1,584,000
245,830
293,869
13,655,400
2,108,062
1,983,135
525,000
17,246,350
752,400
2,194,500
693,000 0.9090909091
510,400 0.9090909091
207,273 0.9090909091
2,186,250 0.9090909091
2,033,570 0.9090909091
3,222,450 0.9090909091
2,326,104 0.9090909091
3,282,611 0.9090909091
300,960 0.9090909091
1,780,334 0.9090909091
2,181,353 0.9090909091
7,796,732 0.9090909091
132,165 0.9090909091
475,899 0.9090909091
4,950,000 0.9090909091
13,503,600 0.9090909091
933,363 0.9090909091
82,500 0.9090909091
162,562 0.9090909091
8,032,200 0.9090909091
4,443,837 0.9090909091
3,910,500 0.9090909091
110,000 0.9090909091
968,000 0.9090909091
891,000 0.9090909091
3,010,612 0.9090909091
4,580,940 0.9090909091
1,396,996 0.9090909091
506,880 0.9090909091
79,725 0.9090909091
245,830 0.9090909091
1,669,976 0.9090909091
1,028,702 0.9090909091
137,753 0.9090909091
1,219,519 0.9090909091
6,775,808 0.9090909091
3,577,200 0.9090909091
1,674,750 0.9090909091
1,263,250 0.9090909091
1,640,791 0.9090909091
494,612 0.9090909091
5,412,000 0.9090909091
120,662 0.9090909091
363,000 0.9090909091
12,035,788 0.9090909091
868,841 0.9090909091
135,379 0.9090909091
1,562,704 0.9090909091
5,665,000 0.9090909091
3,897,509 0.9090909091
866,250 0.9090909091
228,085 0.9090909091
319,558 0.9090909091
18,708,822 0.9090909091
212,397 0.9090909091
212,479 0.9090909091
1,585,100 0.9090909091
101,684 0.9090909091
87,274 0.9090909091
101,534 0.9090909091
5,571,852 0.9090909091
6,609,988 0.9090909091
14,047,000 0.9090909091
510,400 0.9090909091
1,769,790 0.9090909091
31,000 0.9090909091
209,240 0.9090909091
173,139 0.9090909091
706,750 0.9090909091
1,166,000 0.9090909091
1,936,000 0.9090909091
180,979 0.9090909091
76,197 0.9090909091
2,241,492 0.9090909091
4,950,000 0.9090909091
75,942 0.9090909091
1,437,480 0.9090909091
684,288 0.9090909091
1,214,983 0.9090909091
491,659 0.9090909091
2,447,940 0.9090909091
140,580
2,541,198
293,869
2,842,884
232,320
12,479,500
875,325
4,780,688
1,164,064
3,442,398
1,966,895
2,827,500
514,236,371
467,487,610 46,748,761 514,236,371

NO. Tidak Berwujud / Pemberi JKP NPWP / Nota retur / Nota Pembatalan DPP ( rupiah )
Kode & Nomor Seri No. Faktur Pembelian Tanggal
1 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000-11.00002202 RAA/SPJ/1102291 3/31/2011 360,000
2 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00803892 111010346 3/31/2011 7,317,877
4 PT. KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00010182 ASB11010094 3/31/2011 2,770,200
6 PT. ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.00632034 1330892825 4/1/2011 508,250
7 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001160 OBF01107 3/30/2011 454,546
8 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00037630 FKPWT/201104/00139 4/1/2011 1,743,220
9 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00037596 FKPWT/201104/00082 4/1/2011 448,544
10 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00803935 111010376 3/31/2011 111,427
11 PT. ANTARMITRA SEMBADA 01.345.766.8-062.000 010.015-11.00009198 G5S4605 3/31/2011 630,000
12 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00004647 132811004573 4/1/2011 9,337,500
14 PT. BATU RUSA 01.207.460.5-511.000 010.000-11.00032617 FS01-11-03-003129 3/30/2011 479,967
15 PT. ANUGRAH ARGON MEDIKA 01.129.737.1-308.000 010.000-11.00308887 461211009564 4/4/2011 1,833,314
17 PT. ANUGRAH ARGON MEDIKA 01.129.737.1-308.000 010.000-11.00308885 461211009562 4/4/2011 122,915
18 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000079 03. 0079 3/29/2011 1,393,736
26 PT. INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00004792 32/NV.04.2011.4916 4/5/2011 57,816
29 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00008588 INV-18.11.000008626 3/31/2011 746,300
30 PT. KEBAYORAN PHARMA 01.308.506.3-073.000 010.004.11.00010702 ASB11010609 4/5/2011 1,382,250
31 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00022679 FJ-2220110028321 4/4/2011 190,900
32 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00018469 18721 4/5/2011 62,000
33 PT. BATU RUSA 01.207.460.5-511.000 010.000-11.00034017 FS01-11-04-000103 4/2/2011 479,967
35 PT. MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00018451 18703 4/5/2011 1,908,240
37 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00007248 138753 4/6/2011 534,308
41 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00007249 138754 4/6/2011 223,482
50 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000084 04. 0084 4/6/2011 747,318
51 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000085 04. 0085 4/6/2011 1,163,828
52 PT. KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00011002 ASB11010906 4/7/2011 208,619
55 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.00694029 411002222 4/7/2011 (390,830)
58 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001268 OBF01186 4/7/2011 172,728
59 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000-11.00005198 IKD00332 4/7/2011 2,253,350
63 PT. PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00023450 FJ-2220110029413 4/7/2011 1,102,500
70 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00009054 INV-18.11.000009092 4/8/2011 1,520,000
80 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00009351 NV-18.11.000009389 4/11/2011 494,972
81 PT. KIMIA FARMA 01.061.228.1-051.000 010.020-11.00009350 NV-18.11.000009388 4/11/2011 353,128
82 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00009349 NV-18.11.000009387 4/11/2011 293,772
86 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00007040 FKT1007105 4/11/2011 433,260
89 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00005130 132811005038 4/11/2011 185,000
91 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000-11.00002558 RAA/SPJ/1102655 4/11/2011 1,607,500
92 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00450486 81357768 4/12/2011 338,400
93 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000-11.00002550 RAA/SPJ/1102656 4/11/2011 479,600
95 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000088 04. 0088 4/11/2011 1,136,364
98 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00333423 CD182317737 4/12/2011 234,000
99 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00333426 CD182317740 4/12/2011 1,008,000
101 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00333424 CD182317738 4/12/2011 315,000
103 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000-11.00005573 IKD00707/NU 4/13/2011 5,992,500
106 PT. ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.00718566 1330897393 4/13/2011 2,223,466
111 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001399 OBF01284 4/13/2011 454,546
114 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000091 04. 0091 4/13/2011 1,980,227
115 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000092 04. 0092 4/13/2011 2,982,750
116 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000096 04. 0096 4/15/2011 428,409
120 PT. BATU RUSA 01.207.460.5-511.000 010.000-11.00038040 FS01-11-04-001284 4/13/2011 621,585
136 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00004714 FKT1007677 4/18/2011 1,160,747
139 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00009985 INV-18.11.000010028 4/18/2011 1,908,100
147 PT. AKURAT INTAN MADYA 01.698.969.1.029.000 010.000-11.00001383 41101384 4/15/2011 3,150,000
148 PT. UNITED DICO CITAS 01.301.246.3.073.000 010.010-11.00008228 139890 4/20/2011 1,182,518
150 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000-11.00003022 RAA/SPJ/1103127 4/20/2011 1,690,000
161 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000099 04. 0099 4/20/2011 1,592,727
162 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00000772 0147/SGI/04/11 4/23/2011 1,508,000
165 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001461 OBF01368 4/20/2011 160,909
166 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00010395 INV-18.000010439 4/21/2011 1,817,252
167 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00010394 INV-18.000010438 4/21/2011 175,000
170 PT. ANTARMITRA SEMBADA 01.345.766.8-062.000 010.015-11.00011619 G5S7026 4/21/2011 1,575,000
171 PT. BATU RUSA 01.207.460.5-511.000 010.000-11.00040969 FS01-11-04-002101 4/21/2011 1,539,000
194 PT. AKURAT INTAN MADYA 01.698.969.1.029.000 010.000.11.00001498 41101498 4/26/2011 1,980,000
195 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.013-11.00008060 FKT1008216 4/26/2011 1,048,784
196 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00493842 813674650 4/27/2011 1,090,950
208 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000102 04. 0102 4/27/2011 2,020,636
209 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000103 04. 0103 4/27/2011 736,364
211 PT. KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00013226 ASB11013083 4/28/2011 99,541
213 PT. PARAZELSUS 01.868.116.3-056.000 010.023-11.00006611 4036203753 4/28/2011 1,476,000
215 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001536 OBF01467 4/28/2011 563,636
413,690,412
Gombong, 15 April 2011
Kasie Keuangan Perekap,
Sr. Mikaela, ADM Dwi Indra Anggraeni
Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

PPN (rupiah)
36,000 396,000
731,788 8,049,665
144,000 1,584,000 0.909091
277,020 3,047,220
138,225 1,520,475
50,825 559,075
45,455 500,001
174,322 1,917,542
44,854 493,398
11,143 122,570
63,000 693,000
933,750 10,271,250
126,357 1,389,925
47,997 527,964
183,331 2,016,645
2,640 29,040
12,292 135,207
139,374 1,533,110
1,366,000 15,026,000
370,686 4,077,542
94,843 1,043,271
749,412 8,243,529
318,641 3,505,049
18,461 203,069
220,374 2,424,118
5,782 63,598
2,499 27,485 0.909091
23,136 254,494 0.909091
74,630 820,930
138,225 1,520,475
19,090 209,990
6,200 68,200
47,997 527,964
18,700 205,700
190,824 2,099,064
104,050 1,144,550
53,431 587,739
44,854 493,398
107,784 1,185,624
17,240 189,640
22,348 245,830
239,785 2,637,632
44,400 488,400
161,291 1,774,199
14,580 160,380 0.909091
456,000 5,016,000
72,077 792,843
10,691 117,600
264,600 2,910,600
74,732 822,050
116,383 1,280,211
20,862 229,481
8,545 93,999
450,000 4,950,000
(39,083) (429,913)
(48,400) (532,400)
64,250 706,750
17,273 190,001
225,335 2,478,685
37,246 409,710
46,400 510,400
159,915 1,759,062
110,250 1,212,750
243,000 2,673,000
10,440 114,840
153,832 1,692,152
45,279 498,067
202,728 2,230,008
472,080 5,192,880
152,000 1,672,000
21,870 240,570
152,712 1,679,829
153,444 1,687,881
82,025 902,275
8,859 97,446 0.909091
1,800,565 19,806,211
153,770 1,691,474
60,238 662,622
294,731 3,242,043
49,497 544,469
35,313 388,441
29,377 323,149
11,318 124,500
37,350 410,852
11,697 128,667
43,326 476,586
29,504 324,544
46,750 514,250
18,500 203,500
533,000 5,863,000
160,750 1,768,250
33,840 372,240
47,960 527,560
392,540 4,317,940
113,636 1,250,000 0.909091
16,875 185,625
735,750 8,093,250
23,400 257,400 0.909091
100,800 1,108,800
23,932 263,251
31,500 346,500
156,653 1,723,181
599,250 6,591,750
328,736 3,616,096
262,163 2,883,789
222,347 2,445,813
686,996 7,556,959
109,019 1,199,211
181,000 1,991,000
57,385 631,235
45,455 500,001
206,421 2,270,629
14,086 154,945
198,023 2,178,250
298,275 3,281,025
42,841 471,250
284,205 3,126,255
51,680 568,480
108,724 1,195,968
62,159 683,744
759,900 8,358,900
36,053 396,578
132,300 1,455,300
55,291 608,197
144,000 1,584,000
960,534 10,565,869
138,822 1,527,042
224,033 2,464,361
453,059 4,983,651
40,727 448,001 0.909091
131,643 1,448,068 0.909091
26,289 289,176 0.909091
35,153 386,684 0.909091
1,561,000 17,171,000 0.909091
11,182 123,001 0.909091
116,075 1,276,822 0.909091
59,190 651,088 0.909091
242,563 2,668,193 0.909091
190,810 2,098,910 0.909091
22,683 249,511 0.909091
433,200 4,765,200 0.909091
275,353 3,028,884 0.909091
444,461 4,889,069 0.909091
44,854 493,398 0.909091
66,816 734,976 0.909091
727,419 8,001,611 0.909091
315,000 3,465,000 0.909091
118,252 1,300,770 0.909091
1,112,270 12,234,967 0.909091
169,000 1,859,000 0.909091
142,200 1,564,200 0.909091
64,501 709,506 0.909091
60,000 660,000 0.909091
37,150 408,650 0.909091
41,023 451,252 0.909091
6,000 66,000 0.909091
1,869,500 20,564,500 0.909091
23,563 259,188 0.909091
199,551 2,195,061 0.909091 2860000
137,088 1,507,967 0.909091
159,273 1,752,000 0.909091
150,800 1,658,800 0.909091
50,300 553,300 0.909091
242,435 2,666,785 0.909091
16,091 177,000 0.909091
181,725 1,998,977 0.909091
17,500 192,500 0.909091
123,600 1,359,600 0.909091
35,910 395,010 0.909091
157,500 1,732,500 0.909091
153,900 1,692,900 0.909091
16,453 180,979 0.909091
6,247 68,716 0.909091
315,750 3,473,250 0.909091
45,106 496,170 0.909091
770,066 8,470,722 0.909091
(82,500) (907,500)
(88,800) (976,800)
21,536 236,891 0.909091
15,806 173,862 0.909091
9,750 107,250 0.909091
78,458 863,042 0.909091
384,108 4,225,188 0.909091
151,090 1,661,990 0.909091
363,100 3,994,100 0.909091
12,500 137,500 0.909091
586,000 6,446,000 0.909091
380,886 4,189,745 0.909091
141,667 1,558,340 0.909091
112,294 1,235,230 0.909091
12,137 133,507 0.909091
69,912 769,032 0.909091
234,650 2,581,150 0.909091
198,000 2,178,000 0.909091
104,878 1,153,662 0.909091
109,095 1,200,045 0.909091
94,350 1,037,850 0.909091
683,000 7,513,000 0.909091
22,427 246,699 0.909091
464,248 5,106,728 0.909091
113,377 1,247,147 0.909091
209,037 2,299,406 0.909091
651,940 7,171,337 0.909091
8,681 95,491 0.909091
930,580 10,236,379 0.909091
256,563 2,822,195 0.909091
35,906 394,961 0.909091
202,064 2,222,700 0.909091
73,636 810,000 0.909091
140,250 1,542,750 0.909091
9,954 109,495 0.909091
254,790 2,802,690 0.909091
147,600 1,623,600
48,000 528,000
56,364 620,000
13,991 153,899
23,598 259,578
6,500 71,500
6,000 66,000
183,136 2,014,500
67,282 740,098
429,091 4,720,003
405,446 4,459,909
41,369,041 455,059,453
bong, 15 April 2011
ndra Anggraeni

1 PT. BATU RUSA 01.207.460.5-511.000 010.000-11.00043174 FS01-11-04-002745 4/27/2011 1,655,592 165,559
2 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000106 05. 0106 5/4/2011 2,741,818 274,182
3 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000109 05. 0109 5/7/2011 296,250 29,625
4 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000114 05. 0114 5/11/2011 2,059,886 205,989
5 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000122 05. 0122 5/24/2011 2,814,909 281,491
6 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000105 05. 0105 5/4/2011 1,526,455 152,646
7 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000110 05. 0110 5/7/2011 296,250 29,625
8 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000115 05. 0115 5/18/2011 889,159 88,916
9 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000123 05. 0123 5/24/2011 1,430,318 143,032
13 PT. ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00014643 G5T0051 5/19/2011 464,000 46,400
20 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00417431 46110014682 5/2/2011 3,688,500 368,850
23 PT. ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00443364 461211013309 5/9/2011 329,288 32,929
45 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00034362 PR118749 5/6/2011 351,738 35,174
46 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00039036 PR120136 5/20/2011 1,246,722 124,672
47 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00040639 PR120585 5/25/2011 1,346,625 134,663
48 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00039039 PR120139 5/20/2011 231,000 23,100
79 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001742 OBF01636 5/11/2011 363,182 36,318
80 PT. BRATACO 01.130.689.1-441.000 010.009-11.00001821 OBF01700 5/18/2011 527,273 52,727
81 PT. BRATACO 01.130.689.1-441.000 010.009-11.0001893 OBF01783 5/25/2011 600,000 60,000
83 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000-11.00004031 RAA/SPJ/1104166 5/12/2011 790,000 79,000
86 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00568012 813713101 5/3/2011 543,750 54,375
87 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00568000 813712004 5/3/2011 320,000 32,000
88 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00612297 813796853 5/19/2011 543,750 54,375
89 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00587752 813762072 5/12/2011 500,000 50,000
90 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00620955 813822481 5/24/2011 2,150,727 215,073
123 PT. INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00006498 32/NV.05.2011.6685 5/4/2011 242,758 24,276
147 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00012488 NV-18.11.000012551 5/12/2011 1,237,500 123,750
148 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00012520 NV-18.11.000012583 5/12/2011 1,270,228 127,023
149 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00012280 NV-18.11.000012343 5/10/2011 174,092 17,409
150 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00012742 NV-18.11.000012809 5/16/2011 128,772 12,877
174 PT. MILLENNIUM PHARMACON INTERN 01.300.861.0-054.000 010.028-11.00006867 132811006857 5/11/2011 60,000 6,000
199 PT. RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00009970 FKT1008854 5/4/2011 2,714,410 271,441
206 PT. SAMATOR GAS 01.585.149.6-631.000 010.004-11.00000917 0174/SGI/05/11 5/14/2011 1,044,000 104,400
207 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00007022 IKE00459/ NU 5/9/2011 699,125 69,913
208 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00008131 IKE01568/ NU 5/28/2011 1,530,000 153,000
209 PT. UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00009384 140977 5/4/2011 1,402,500 140,250
446,633,410 44,663,341
Gombong, 15 Mei 2011
Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

1,821,151
3,016,000
325,875
2,265,875
3,096,400
1,679,101 0.909091
325,875 0.909091
978,075 0.909091
1,573,350 0.909091
510,400
704,000
592,900
510,400
357,500
255,200 0.909091
436,389 0.909091
522,500 0.909091
346,500 0.909091
297,990
4,057,350
1,309,645
1,236,305
362,217
2,488,475
572,000
676,500
240,570
1,509,189
889,535
3,021,950 0.909091
1,654,125 0.909091
1,089,893 0.909091
166,379 0.909091
60,500 0.909091
263,251 0.909091
160,380 0.909091
400,950 0.909091
400,950
2,289,920
1,338,409
550,748
1,088,307
4,755,728
108,999
386,912
1,371,394
1,481,288
254,100 0.909091
1,687,673 0.909091
69,960
3,898,228
5,080,803
3,704,474
342,144
246,699
3,052,192
3,777,048
6,833,376
346,368
740,098
101,684
7,247,064
2,692,074
1,163,052
2,230,008
3,707,220
4,164,371 0.909091
1,976,040
8,525,352
2,672,472
814,000 1,008,000
1,480,406 0.909091
3,897,894 0.909091
493,398 0.909091
1,163,052 0.909091
6,563,260 0.909091
2,643,458 0.909091
3,858,298 0.909091
399,500
580,000
660,000 0.909091
1,749,000
869,000
1,133,000 0.909091
26,136 0.909091
598,125
352,000
598,125
550,000 0.909091
2,365,800 0.909091
6,953,210
2,903,736
13,142,875 0.909091
6,248,228
2,151,996
13,430,170
1,336,874
1,584,000
2,233,550
8,102,765
1,437,480
1,797,400
12,552,437
1,584,000 0.909091
1,867,800 0.909091
5,920,200 0.909091
6,883,796 0.909091
12,576,274 0.909091
740,001 0.909091
6,951,639 0.909091
249,997 0.909091
378,741 0.909091
601,920 0.909091
222,842 0.909091
1,336,874 0.909091
601,920 0.909091
929,136 0.909091
1,215,122 0.909091
914,230 0.909091
238,015 0.909091
141,819 0.909091
422,727
267,034
222,957
193,031
108,570
315,002
434,744 0.909091
143,399 0.909091
204,368 0.909091
106,004 0.909091
483,366 0.909091
448,329
1,100,000
1,661,877 0.909091
679,250
2,249,885
1,144,275
3,988,732
1,003,200
726,000
4,446,998
2,497,517 0.909091
256,553
228,670
199,500
1,361,250
1,397,251
191,501
141,649
1,039,940 0.909091
154,462 0.909091
1,796,850 0.909091
174,402 0.909091
1,066,325 0.909091
1,595,411 0.909091
532,385 0.909091
698,198 2860000
554,400 ASKES
38,118
1,726,337
3,130,050
654,500
3,693,250
34,502 0.909091
3,877,522 0.909091
3,461,942 0.909091
361,957 0.909091
51,536 0.909091
3,465,000 0.909091
13,330,900
2,175,250 JKM
12,559,250
66,000
17,683,600
17,204,000
2,277,000
2,428,800
137,500
19,697,700
15,977,500
132,000 0.909091
1,356,300 0.909091
30,101,500 0.909091
4,444,000 0.909091
61,600
2,120,250
968,000
2,057,000 0.909091
968,000 0.909091
3,347,190 0.909091
579,227
232,320
1,936,000
2,420,000 0.909091
232,320 0.909091
70,180 0.909091
264,385 0.909091
2,985,851
354,573
115,095
1,674,774
92,000 0.909091
540,001 0.909091
361,962 0.909091
1,148,400
769,038
1,683,000 0.909091
1,542,750
293,869
375,120
2,130,489 0.909091
916,909 0.909091
671,079 0.909091
483,867,850

1 PT. AKURAT INTAN MADYA 01.698.969.1.029.000 010.000.11.00001728 51101728 5/12/2011 2,700,000 270,000
2 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000127 06. 0127 6/6/2011 704,500 70,450
3 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000130 06. 0130 6/8/2011 2,417,409 241,741
4 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000133 06. 0133 6/15/2011 1,651,659 165,166
5 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000137 06. 0137 6/22/2011 1,347,136 134,714
6 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000125 05. 0125 5/30/2011 793,409 79,341
7 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000128 06. 0128 6/6/2011 18,182 1,818
8 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000126 06. 0126 6/6/2011 672,727 67,273
9 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000131 06. 0131 6/8/2011 3,821,477 382,148
10 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000132 06. 0132 6/15/2011 663,636 66,364
11 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000138 06. 0138 6/22/2011 2,031,136 203,114
12 PT. ANTARMITRA SEMBADA 01.345.766.8-062.000 010.015-11.00016406 G5T1814 6/3/2011 945,000 94,500
44 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00043745 PR121540 6/1/2011 983,250 98,325
45 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00046131 PR122283 6/10/2011 812,250 81,225
46 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00047618 PR122752 6/15/2011 333,450 33,345
47 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00048505 PR123081 6/17/2011 1,106,370 110,637
48 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00050012 PR123535 6/22/2011 1,346,625 134,663
80 PT. BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00074300 FKPWT/201106/10885 6/27/2011 10,043,280 1,004,328
81 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002083 OBF01967 6/8/2011 595,228 59,523
82 PT. BRATACO 01.130.689.1-441.000 010.010-11.00005339 OBF03408 6/9/2011 181,819 18,182
83 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002227 OBF02071 6/15/2011 479,091 47,909
84 PT. BRATACO 01.130.689.1-441.000 010.010-11.00005338 ABF03687 6/11/2011 1,636,364 163,636
85 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002317 OBF02166 6/22/2011 183,636 18,364
86 PT. DISTRIVERSA BUANAMAS 01.555.204.5-521.001 010.000.11.00004595 RAA/SPJ/1104734 5/30/2011 234,607 23,461
90 PT. DISTRIVERSA BUANAMAS 01.555.204.5-521.001 010.000.11.00005242 RAA/SPJ/1105384 6/15/2011 1,580,000 158,000
91 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00659821 813868998 5/31/2011 500,000 50,000
92 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00744078 813948586 6/14/2011 1,087,500 108,750
93 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00801738 814032950 6/28/2011 328,248 32,825
94 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00801875 814037022 6/28/2011 543,750 54,375
119 PT. INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00008278 32/NV.06V2011V8516 6/6/2011 390,624 39,062
154 PT. MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.00554923 CD182541246 6/21/2011 1,008,000 100,800
187 PT. PARAZELSUS INDONESIA 01.868.116.3-056.000 010.023-11.00008133 4036242479 5/31/2011 775,200 77,520
205 PT. SAMATOR GAS 01.585.149.6-631.000 010.004-11.00001059 0004/SGI/06/11 6/1/2011 812,000 81,200
206 PT. SAMATOR GAS 01.585.149.6-631.000 010.004-11.00001204 0149/SGI/06/11 6/22/2011 1,305,000 130,500
207 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00008657 IKF00281/NU 6/7/2011 4,515,625 451,563
208 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00009186 IKF00810/NU 6/15/2011 4,670,750 467,075
424,139,448 42,347,058
Gombong, 15 Juni 2011
Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

2,970,000
774,950 JKM
2,659,150
1,816,825 0.909091
1,481,850
872,750
20,000
740,000
4,203,625
730,000 0.909091
2,234,250 0.909091
1,039,500
83,160
528,000
55,440
346,500
114,502
790,020
510,400
382,800 0.909091
255,200 0.909091
112,517
121,923
73,588
864,875
720,569
746,900
4,622,528
1,442,661
292,134
2,411,930 0.909091
711,233 0.909091
958,650 0.909091
600,024 0.909091
917,950 0.909091
1,741,850 0.909091
5,721,164
108,999
3,534,505
966,689
1,199,437 0.909091
3,387,352 0.909091
1,250,401
1,081,575
893,475
366,795 0.909091
1,217,007 0.909091
1,481,288 0.909091
278,300
3,315,400
2,509,663 ASKES
8,947,752
2,170,951
69,960
863,042
4,073,652
29,040
493,398
1,248,016
3,347,194
3,490,432 REGULER
918,236
493,398
6,962,969
2,326,104 0.909091
715,000 0.909091
5,597,944 0.909091
514,140 0.909091
717,992 0.909091
246,699 0.909091
3,461,427 0.909091 1,008,000
1,336,808 0.909091
2,915,255 0.909091
3,507,759 0.909091
2,982,320 0.909091
346,368 0.909091
3,006,256 0.909091
2,230,008 0.909091
49,720 0.909091
11,047,608 0.909091
654,751
200,001 0.909091
527,000 0.909091
1,800,000 0.909091
202,000 0.909091
258,068 0.909091
497,068
60,500
726,000
1,738,000 0.909091
550,000
1,196,250 0.909091
361,073
598,125
372,846
4,083,167
204,576
100,211
3,008,529
99,336
226,672
1,357,584
5,286,978
15,689,702
1,006,434
9,163,139
4,257,380
514,800
8,897,735
10,967,441
7,798,790 0.909091
999,213 0.909091
782,100 0.909091
1,584,000 0.909091
6,546,803 0.909091
5,764,165 0.909091
958,320 0.909091
7,038,704 0.909091
429,686
152,129
156,450
156,501
152,417
198,000
90,002 0.909091
309,946 0.909091
236,947 0.909091
68,503 0.909091
660,000
1,567,500
109,495
677,160
1,456,159
3,036,000
6,856,245
1,442,100
3,966,102 0.909091
2,200,000 0.909091
1,739,892 0.909091
2,413,950 0.909091
1,508,262 0.909091
2,405,590
1,572,325
2,872,767
2,049,960
35,525 0.909091
273,999
582,932
252,325
119,556 0.909091
208,502 0.909091
141,649 0.909091
269,895 0.909091
1,108,800
415,800
128,700
1,579,996
2,369,994 2860000
23,001 ASKES
378,048
115,005
1,234,024
15,000
504,002
1,191,300
19,059
1,518,000
555,000 0.909091
2,378,946 0.909091
220,000 0.909091
8,646,000 0.909091
5,742,000 JKM
251,625
12,402,500 0.909091
19,030,000
1,078,000
137,500
66,000 0.909091
11,382,525 0.909091
66,000 0.909091
11,216,700 0.909091
9,883,500 0.909091
11,187,000 0.909091
11,797,500 0.909091
7,386,500 0.909091
15,510,000 0.909091
852,720
579,920 0.909091
334,565
1,115,905
408,650
4,192,513
192,500
2,033,570
4,386,250 0.909091
1,936,000 0.909091
1,414,600 0.909091
416,900 0.909091
228,639 0.909091
228,639
1,271,753
1,153,662 0.909091
724,291 0.909091
271,031
893,200
1,435,500 0.909091
4,967,188 0.909091
5,137,825 0.909091
671,079
587,739
245,830
293,869
587,739
2,901,864 0.909091
735,750 0.909091
457,596,718 466,486,506
457,596,718
8,889,789

18 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000181 07, 0181 7/26/2011 1,342,568 134,257
19 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000175 07. 0175 7/21/2011 1,443,364 144,336
20 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000159 07. 0159 7/13/2011 637,000 63,700
21 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000163 07. 0163 7/14/2011 425,455 42,546
22 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000154 07. 0154 7/11/2011 420,000 42,000
23 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000148 07. 0148 7/6/2011 1,715,159 171,516
24 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000142 07. 0142 7/1/2011 1,452,500 145,250
42 PT. ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.01692807 111021692 7/4/2011 40728 4,073
61 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000180 07. 0180 7/26/2011 2,972,273 297,227
62 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000174 07. 0174 7/21/2011 390,909 39,091
63 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000164 07. 0164 7/14/2011 1,061,023 106,102
64 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000160 07. 0160 7/13/2011 336,364 33,636
65 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000147 07. 0147 7/6/2011 2,285,191 228,519
66 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000141 07. 0141 7/1/2011 422,500 42,250
91 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00059253 PR126819 7/27/2011 696,825 69,683
92 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00058023 PR126394 7/22/2011 983,250 98,325
93 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00054097 PR125117 7/8/2011 983,250 98,325
94 PT. BATU RUSA 01.207.460.5-511.000 010.001.11.00052419 PR124373 6/30/2011 235,125 23,513
130 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002751 OBF02499 7/20/2011 500,000 50,000
131 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002639 OBF02423 7/13/2011 710,909 71,091
132 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002498 OBF02339 7/6/2011 569,545 56,955
136 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.00891165 814108198 7/12/2011 160,000 16,000
205 PT. PARAZELSUS 01.868.116.3-056.000 010.023-11.00010650 4036299016 7/26/2011 390,000 39,000
218 PT. SAMATOR 01.585.149.6-631.000 010.004-11.00001397 0209/SGI/07/11 7/16/2011 841,000 84,100
219 PT. SAMATOR 01.585.149.6-631.000 010.004-11.00001305 0032/SGI/07/11 7/4/2011 522,000 52,200
220 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00011736 IKG01622/NU 7/28/2011 4,462,500 446,250
428,931,952 42,893,195
Gombong, 15 Juli 2011
Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

5,850,629 ASKES
1,002,225
790,020 0.909091
395,010
1,111,894
3,176,250
477,000
751,737
6,719,115
81,818
75,744
44,250
65,241
225,485
109,700
4,553,208
141,997
1,476,825 JKM
1,587,700
700,700
468,001
462,000
1,886,675
1,597,750
693,000
693,000 0.909091
142,767 0.909091
302,500
400,950
292,587
91,673
160,380
263,251
330,937
3,088,491
809,563
1,245,099
791,912
148,717
1,608,844
691,860
44,801
1,525,805
293,805 0.909091
162,800
145,067
147,429
627,000
291,500
2,065,910
173,052
1,335,070
130,020
1,025,970
302,500
76,010
485,954
181,555
671,079
293,869
3,269,500 REGULER
430,000
1,167,125
370,000
2,513,710
464,750
510,400
315,698
510,400 1,008,000
2,483,184
3,188,931
442,530
1,660,809 0.909091
2,532,798
1,023,000
5,167,496
534,437
1,058,750
1,482,708
1,104,696
468,250
475,002
1,836,900
356,400
6,780,646
1,337,553
1,732,975
2,210,531
71,500
659,010
766,508
1,081,575 0.909091
1,081,575
258,638
935,616 0.909091
1,163,052
706,750
1,739,936
246,699
3,520,757
246,699
5,190,275
493,398
2,162,424
3,911,248
2,845,480
8,647,056
1,163,052
52,364
1,855,788
3,287,944
2,464,361
101,684
493,398
8,406,864
29,040
246,699
69,960
1,685,772
3,101,648
1,163,052
1,551,792
246,699
6,199,732
1,738,889
500,500
8,879,508 0.909091
493,398 0.909091
2,690,094 0.909091
550,000 0.909091
782,000 0.909091
626,500 0.909091
1,738,000 0.909091
1,738,000 0.909091
72,600 0.909091
176,000 0.909091
1,130,654 0.909091
1,322,750 0.909091
3,346,998 0.909091
1,115,268 0.909091
2,151,996 0.909091
10,508,391 0.909091
1,547,811 0.909091
7,008,871 0.909091
4,950,000 0.909091
9,287,575 0.909091
1,858,032 0.909091
3,588,407 0.909091
9,323,395 0.909091
1,584,000 0.909091
8,477,425 0.909091
2,151,996 0.909091
4,410,646 0.909091
6,003,099 0.909091
1,754,995 0.909091
6,096,599 0.909091
13,262,851 0.909091 ASKES
113,878 0.909091
101,376 0.909091
41,290 0.909091
870,812 0.909091
2,475,000 0.909091
2,453,660 0.909091
7,074,650 0.909091
1,896,675 0.909091
2,763,665 0.909091
946,770 0.909091
10,337,140 0.909091
815,100 0.909091
128,710 0.909091 JKM
1,290,005 0.909091
268,422 0.909091
255,683 0.909091
363,000 0.909091
3,457,925 0.909091
402,940 0.909091
343,005 0.909091
3,419,486 0.909091
654,500 0.909091
3,059,650 0.909091
1,518,000 0.909091
701,250 0.909091
663,262 0.909091
2,772,000 0.909091
467,500 0.909091
7,711,000 0.909091
9,845,000 0.909091
68,750 0.909091
10,409,767 0.909091
66,000 0.909091
4,840,000 0.909091
386,980 0.909091
7,523,450 0.909091
11,415,250 0.909091
68,750 0.909091
871,200 0.909091
8,492,000 0.909091
66,000 0.909091
7,260,000 0.909091
132,000 0.909091
9,680,000 0.909091
14,418,800 0.909091
66,000 0.909091
6,958,600 0.909091
429,000 0.909091
514,250 0.909091
2,033,570
968,000 0.909091
448,001
66,000
1,746,635
2,764,300
4,352,068
514,250
169,884
170,619
1,891,337
925,100
574,200
4,908,750
2,454,375
3,538,040
293,869
293,869
1,382,020
1,821,939
471,825,148 471,825,148
471,825,148

1 PT. MILLENNIUM PHARMACHON INTER 01.300.861.0-054.000 010.028-11.00013130 132811013196 8/19/2011 21,289,850 2,128,985
2 PT. MILLENNIUM PHARMACHON INTER 01.300.861.0-054.000 010.028-11.00012811 132811012860 8/15/2011 9,267,500 926,750
3 PT. MILLENNIUM PHARMACHON INTER 01.300.861.0-054.000 010.028-11.00012812 132811012861 8/15/2011 245,000 24,500
4 PT. MILLENNIUM PHARMACHON INTER 01.300.861.0-054.000 010.028-11.00012719 132811012730 8/12/2011 120,000 12,000
10 PT. BRATACO 01.130.689.1-441.000 010.009-11.00003091 OBF02862 8/18/2011 1,000,000 100,000
11 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002948 OBF02675 8/3/2011 1,139,772 113,977
12 PT. BRATACO 01.130.689.1-441.000 010.009-11.00002883 OBF02636 8/2/2011 134,091 13,409
13 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000210 BS. 08.0210 8/19/2011 2,064,205 206,421
16 PT. ANUGERAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00864575 461211024724 8/22/2011 5,123,913 512,391
24 PT. ANUGERAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.00788627 461211022602 8/3/2011 780,564 78,056
28 PT. INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00011919 32/NV.08.2011.12483 8/8/2011 122689 12,269
30 PT. ANUGERAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.01605921 1330940197 8/16/2011 3,841,701 384,170
39 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.01049703 814293156 8/9/2011 543,750 54,375
40 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.01025980 814251825 8/2/2011 221,088 22,109
41 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.01025985 814253400 8/2/2011 543,750 54,375
49 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00062871 PR128420 8/12/2011 333,450 33,345
50 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00061626 PR127770 8/5/2011 1,205,550 120,555
58 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00012816 IKH00939/NU 8/15/2011 3,276,750 327,675
105 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00001658 0228/SGI/08/11 8/18/2011 696,000 69,600
106 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00001565 0062/SGI/08/11 8/5/2011 1,421,000 142,100
118 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000.11.00007119 RAA/SPJ/1107267 7/30/2011 1,616,363 161,636
366,796,305 36,679,630
Gombong, 15 September 2011

Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

23,418,835
10,194,250
269,500
132,000
18,298,500
17,990,500
8,206,000
1,259,500
13,452,917
1,100,000
1,253,749
147,500
2,270,626
1,261,875
1,340,000
5,636,304
1,353,435
5,958,602
3,344,915
2,494,845
1,371,370
1,309,645
2,463,692
858,620
795,615
127,888
119,550
134,958
122,328
4,225,871
4,529,535
1,153,781
2,190,100
605,000
2,357,806
542,300
512,600
968,000
598,125
243,197
598,125
162,501
836,000
6,976,336
1,843,380
1,938,475
1,740,970
759,000
366,795
1,326,105
1,172,659
2,875,686
57,178
2,772,000
682,000
643,500
964,150
3,604,425
765,600
510,400
1,526,571
73,999
7,039,461
111,209
180,498
544,500
5,114,401
5,230,104
3,942,154
49,720
1,576,828
11,742,623
2,372,568
5,668,652
12,005,646
69,960
338,430
1,007,899
493,398
114,840
87,274
6,308,227
2,230,008
4,480,564
435,613
585,130
2,583,187
1,725,891
6,655,154
1,237,966
11,404,462
14,505,150
10,420,108
5,087,148
7,745,549
1,084,054
3,260,560
7,238,876
902,275
9,634,097
313,424
7,298,418
6,498,416
541,926
765,600
1,563,100
928,400
864,875
928,400
2,200,000
927,300
2,376,000
1,584,000
435,054
760,100
2,660,020
109,700
1,777,999
52,800
2,700,001
252,494
78,404
1,138,753
205,002
35,525
301,070
263,251
142,767 JKM
383,337
558,756
713,198
119,583
5,569,834
5,359,145
1,295,821
262,550
1,615,154
23,001
378,048
57,503
137,457
122,100
55,660
2,356,275
2,387,175
2,536,500
293,869
104,027
178,000
321,750
588,665
869,000
3,077,910
229,500
2,585,880
1,569,567
403,475,935

1 PT. MILLENNIUM PHARMACHON INTERN01.300.861.0-054.000 010.028-11.00013686 132811013790 8/26/2011 125,000 12,500
2 PT. MILLENNIUM PHARMACHON INTERN01.300.861.0-054.000 010.028-11.00013685 132811013789 8/26/2011 11,160,000 1,116,000
3 PT. BRATACO 01.130.689.1-441.000 010.009-11.00003241 OBF02945 8/24/2011 500,000 50,000
9 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.01097013 814377271 8/23/2011 221,088 22,109
11 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00067048 PR129719 8/26/2011 3,783,375 378,338
14 PT. ANTARMITRA SEMBADA 01.345.766.8-062.000 010.015-11.00025608 G5U1017 8/25/2011 789,000 78,900
18 PT. SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00001727 0335/SGI/08/11 8/25/2011 377,000 37,700
27 PT. ANUGERAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.01670620 1330943739 8/24/2011 65,000 6,500
36 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00013352 IKH01475/NU 8/23/2011 3,791,000 379,100
78 PT. MILLENNIUM PHARMACHON INTERN01.300.861.0-054.000 010.028-11.00015515 132811015617 9/28/2011 5,290,000 529,000
148 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00025556 25653 9/29/2011 90,908 9,091
149 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00024414 24511 9/19/2011 254,031 25,403
150 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00024120 24217 9/15/2011 122,008 12,201
151 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00023649 23745 9/12/2011 834,640 83,464
152 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00023343 23439 9/8/2011 994,385 99,439
161 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00014900 IKI01202/NU 9/26/2011 3,000,500 300,050
162 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00014105 IKI00407/NU 9/12/2011 1,700,000 170,000
163 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00071981 PR131597 9/23/2011 1,453,500 145,350
164 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.01197679 814466716 9/13/2011 543,750 54,375
166 PT. ANTARMITRA SEMBADA 01.345.766.8-062.000 010.015-11.00028308 G5U3717 9/23/2011 1,303,500 130,350
167 PT. BRATACO 01.130.689.1-441.000 010.009-11.00003477 OBF03206 9/21/2011 135,000 13,500
172 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000252 09. 0252 9/27/2011 3,101,705 310,171
173 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000245 09. 0245 9/21/2011 529,477 52,948
174 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000230 09. 0230 9/13/2011 672,727 67,273
176 PT. DISTRIVERSA BUANA MAS 01.555.204.5-521.001 010.000.11.00008764 RAA/SPJ/1108933 9/17/2011 470,000 47,000
185 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00025597 25694 9/30/2011 98,876 9,888
186 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00025596 25693 9/30/2011 103,941 10,394
187 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00025198 25295 9/27/2011 53,825 5,383
194 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000253 09. 0253 9/27/2011 1,191,000 119,100
195 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000244 09. 0244 9/21/2011 1,124,227 112,423
196 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000231 09. 0231 9/13/2011 662,909 66,291
197 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000226 09. 0226 9/9/2011 570,000 57,000
205 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00025125 25222 9/26/2011 1,527,239 152,724
206 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00024415 24512 9/19/2011 234,534 23,453
207 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00023605 23701 9/12/2011 21,530 2,153
208 PT. KIMIA FARMA 01.061.228.1-051.000 010.020.11.00023342 23438 9/8/2011 225,503 22,550
451,376,722 45,137,672
Gombong, 15 Oktober 2011

Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM
80,986,417 518,739,514
6,095,348
137,500
12,276,000
550,000
2,714,000
3,067,258
173,472
3,003,462
3,188,900
243,197
3,751,550
4,161,713
632,859
654,500
867,900
211,962
411,312
673,037
414,700
572,000
392,569
171,448
3,410,560
638,026
203,727
134,750
16,533,000
71,500
4,150,744
3,355,000
8,008,880
2,492,619
5,434,000
1,768,140
1,309,000
2,025,650
4,170,100
994,400
330,000
10,180,544
17,578,385
607,750
5,641,596
91,201
671,079
138,956
418,096
245,830
187,378
17,339,905
8,636,408
4,966,500
673,200
101,684
740,098
421,080
29,226,588
68,750
2,088,136
864,875
1,453,025
695,970
399,575
518,925
1,046,548
1,459,753
2,088,136
1,330,547
637,560
1,756,879
121,000
4,030,572
134,750
998,800
411,400
448,001
2,392,885
2,743,785
5,819,000
10,091,235
8,617,235
66,000
11,998,086
7,766,000
7,689,000
66,000
5,137,000
6,479,000
185,625
214,500
957,000
40,480
246,699
101,684
1,685,772
4,442,592
1,327,216
2,813,184
1,248,390
493,398
3,616,853
2,571,360
1,202,256
7,038,240
58,080
1,163,052
4,926,363
338,430
1,253,252
291,720
456,905
493,398
29,040
406,138
1,425,362
1,232,013
206,250
500,500 ASKES
363,000
4,320,499
13,647,178
509,355
6,388,817
10,283,182
5,982,521
2,082,301
751,520
8,452,868
5,162,218 JKM
14,234,826
1,623,600
4,175,240
245,830
587,739
369,334
245,916
149,878
4,450,575
175,132
4,806,793
874,128
747,450
571,087
11,436
654,500
577,500
4,274,707
2,634,678
99,999
279,434
134,209
918,104
1,093,824
357,390
1,419,110
1,512,115
4,002,350
313,500
2,241,492
1,804,000
3,260,400
3,300,550
1,870,000
1,598,850
598,125
510,400
1,433,850
148,500
698,198
109,395
693,000
321,750
3,411,876
582,425
740,000
1,798,500
517,000
1,531,200
516,252 ASKES
1,002,225
143,124
7,840,239
249,997
598,004
6,025,961
108,764
114,335
59,208
390,007
1,920,006 JKM
378,048
608,002
57,503
378,048
1,310,100
1,236,650
729,200
627,000
748,440
181,665
392,003
627,000
153,000
82,882
212,669
1,679,963
257,987
23,683
248,053
176,880
194,784
222,726
320,760
242,381
616,000
2,538,448
192,284
1,485,807
1,706,634
468,419
507,010
242,919
99,508
132,193
264,385
496,514,395

6 PT. INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00015474 32/INV.10.2011.16210 10/15/2011 22,521 2,252
12 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000284 10. 0284 10/19/2011 1,501,705 150,171
13 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000275 10. 0275 10/13/2011 296,250 29,625
14 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000261 10. 0261 10/5/2011 609,091 60,909
18 PT. BRATACO 01.130.689.1-441.000 010.009-11.00003713 OBF03412 10/5/2011 500,000 50,000
19 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.01401739 814719650 10/25/2011 696,000 69,600
20 PT. DOS NI ROHA 01.301.911.2-062.000 010.000-11.01401729 814718844 10/25/2011 407,500 40,750
21 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000-11.00016523 IKJ01243/NU 10/24/2011 2,231,250 223,125
22 PT. SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00015509 IKJ00229/NU 10/5/2011 3,408,500 340,850
69 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00075131 PR132620 10/7/2011 116,586 11,659
70 PT. BATU RUSA 01.207.460.5-511.000 010.001-11.00073528 PR132153 9/30/2011 1,463,211 146,321
79 PT. MILLENNIUM PHARMACON INTERNA01.300.861.0-054.000 010.028-11.00017498 132811017598 10/28/2011 7,719,625 771,962
80 PT. MILLENNIUM PHARMACON INTERNA01.300.861.0-054.000 010.028-11.00017342 132811017394 10/26/2011 19,165,000 1,916,500
86 PT. MILLENNIUM PHARMACON INTERNA01.300.861.0-054.000 010.028-11.00016642 132811016703 10/14/2011 75,000 7,500
149 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000283 10. 0283 10/19/2011 1,750,409 175,041
150 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000276 10. 0276 10/13/2011 296,250 29,625
151 CV. PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000262 10. 0262 10/5/2011 383,409 38,341
273,924,340 27,392,434
Gombong, 15 Oktober 2011
Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

1,584,000 NARKOTIK
435,054
31,000
543,400
286,000
24,773
1,584,000
510,400 REGULER
208,611
1,603,935
137,556
1,651,876
325,875
670,000
375,120
375,120
415,800
550,000
765,600
448,250
2,454,375
3,749,350
1,138,500
869,000
1,754,500
177,032
143,835
618,318
2,260,947
1,398,164
1,428,942
1,084,248
1,762,594
451,252
1,970,518
1,575,989
908,872
259,188
579,926
195,118
1,786,950
1,382,535
239,305
3,292,435
61,982
2,457,840
538,502
1,204,363
742,500
495,000
575,445
1,150,892
705,263
1,542,750
495,000
852,720
1,887,569
2,124,247
7,015,608
902,275
7,245,370
7,617,874
363,825
2,258,850
4,703,931
1,507,275
1,181,374
5,846,693
128,245
1,609,532
1,547,227
121,000
1,728,485
579,227
968,000
30,800
224,400
1,379,400
8,491,587
21,081,500
13,530,000
1,661,000
5,016,000
12,669,250
7,405,200
82,500
66,000
518,100
13,431,000
2,541,000
7,260,000
9,034,850
4,985,200
350,265
1,598,901
350,265
320,290
451,073
2,124,012
2,362,624
6,323,328
262,310
1,388,552
1,876,512
169,215
1,598,960
7,261,597
2,679,301
69,960
7,753,077
225,500
493,398
2,133,912
1,998,392
2,508,299
3,290,285
3,725,304
1,627,472
342,144
444,400
1,163,052
2,629,840
1,185,624
750,640
2,181,353
88,386 ASKES
491,659
666,017
395,010
2,209,526
3,833,192
11,501
11,501
1,948,056
152,800
934,870
245,830 JKM
1,058,970
2,202,945
1,568,140
83,160
693,000
285,952
114,015
96,480
184,533
172,774
136,101
1,925,450
325,875
421,750
440,193
672,700
169,788
256,953
423,500
1,164,323
1,064,950
174,086
29,977
51,460
272,897
222,726
104,764
212,397
34,502
34,502
118,800
396,000
301,316,774

1 ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00035257 G5V0667 11/23/2011 448,875 44,888
2 DISTRIVERSA BUANAMAS 01.555.204.5-521.001 010.000-11.00011890 RAA/SPJ/1112053 11/11/2011 92,727 9,273
3 DISTRIVERSA BUANAMAS 01.555.204.5-521.001 010.000-11.00012365 RAA/SPJ/1112524 11/21/2011 540,000 54,000
4 ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.02954673 311001857 11/14/2011 683,397 68,340
5 ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.02954675 311001859 11/14/2011 3,149,114 314,911
7 KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00036986 ASB11036240 11/29/2011 130,113 13,011
8 MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00065050 65869 11/29/2011 20,910 2,091
10 MERAPI UTAMA PHARMA 01.313.257.6-073.000 010.007-11.00065035 65854 11/29/2011 1,736,400 173,640
11 RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00020571 FKT1021435 11/9/2011 565,910 56,591
13 ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00033205 G5U8614 11/4/2011 315,000 31,500
14 ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.01205543 461211033884 11/17/2011 239,319 23,932
18 BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00129077 FKPWT/201111/08750 11/29/2011 865,000 86,500
21 DOS NI ROHA 01.301.911.2-062.000 010.000-11.01488364 814797739 11/8/2011 108,000 10,800
32 INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00017516 32/NV.11.2011.18426 11/21/2011 234,047 23,405
37 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00030780 INV-18.11.00030883 11/28/2011 956,791 95,679
38 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00030130 INV-18.11.00030233 11/21/2011 59,965 5,997
39 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00029891 INV-18.11.00029992 11/17/2011 141,588 14,159
40 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00029462 INV-18.11.00029563 11/14/2011 283,000 28,300
41 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00029230 INV-18.11.00029331 11/10/2011 490,511 49,051
42 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00028615 INV-18.11.00028715 11/3/2011 59,965 5,997
43 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00028240 INV-18.11.00028240 10/31/2011 1,472,672 147,267
44 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00030030 INV-18.11.000030131 11/19/2011 122,103 12,210
45 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00030031 INV-18.11.000030132 11/19/2011 103,941 10,394
46 MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.01102851 CD183094445 11/23/2011 504,000 50,400
53 PARIT PADANG GLOBAL 01.246.832.8-531.000 010.022-11.00081742 FJ-2220110105543 11/21/2011 112,000 11,200
55 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000337 BS. 11.0337 11/23/2011 1,626,409 162,641
56 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000326 BS. 11.0326 11/16/2011 1,902,227 190,223
57 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000306 BS. 11.0316 11/9/2011 1,306,750 130,675
58 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000310 BS. 11.0310 11/4/2011 1,702,068 170,207
59 UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00024321 156416 11/16/2011 610,072 61,007
60 SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00018126 IKK01076/NU 11/17/2011 3,089,750 308,975
62 ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00033204 G5U8613 11/4/2011 464,000 46,400
63 ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.01249790 461211035019 11/28/2011 1,174,695 117,470
74 ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.02311299 1330974486 11/23/2011 580,367 58,037
75 ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.02311412 1330974606 11/23/2011 143,000 14,300
76 ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.02269152 1330972539 11/16/2011 1,175,931 117,593
79 BATU RUSA 01.207.460.5-511.000 010.001-11.00084459 PR135719 11/25/2011 414,000 41,400
80 BATU RUSA 01.207.460.5-511.000 010.001-11.00082711 PR135161 11/18/2011 222,300 22,230
81 BATU RUSA 01.207.460.5-511.000 010.001-11.00081550 PR134694 11/11/2011 923,400 92,340
82 BATU RUSA 01.207.460.5-511.000 010.001-11.00080354 PR134269 11/4/2011 2,423,187 242,319
83 BATU RUSA 01.207.460.5-511.000 010.001-11.00079549 PR134068 10/31/2011 756,675 75,668
84 BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00128941 FKPWT/201111/08524 11/28/2011 5,006,580 500,658
114 BRATACO 01.130.689.1-441.000 010.009-11.00004223 RBF03964 11/16/2011 572,727 57,273
115 BRATACO 01.130.689.1-441.000 010.009-11.00004071 RBF03824 11/2/2011 550,000 55,000
116 DISTRIVERSA BUANAMAS 01.555.204.5-521.001 010.000-11.00011301 RAA/SPJ/1111466 10/31/2011 1,688,477 168,848
117 DOS NI ROHA 01.301.911.2-062.000 010.000-11.01536692 814872345 11/21/2011 1,087,500 108,750
130 ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.02885108 111037391 11/7/2011 14,880,200 1,488,020
142 KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00036189 ASB11035457 11/22/2011 2,395,900 239,590
149 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00030779 INV-18.11.000030882 11/28/2011 124,056 12,406
150 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00030129 INV-18.11.000030232 11/21/2011 111,816 11,182
151 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00029892 INV-18.11.000029993 11/17/2011 494,225 49,423
152 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00029461 INV-18.11.000029562 11/14/2011 308,636 30,864
153 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00029229 INV-18.11.000029330 11/10/2011 91,064 9,106
154 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00028614 INV-18.11.000028714 11/3/2011 159,090 15,909
155 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00028241 INV-18.11.000028340 10/31/2011 162,691 16,269
167 MILLENIUM PHARMACHON INTERNATIO01.300.861.0-054.000 010.028-11.00019354 132811019407 11/28/2011 8,669,250 866,925
169 MILLENIUM PHARMACHON INTERNATIO01.300.861.0-054.000 010.028-11.00019066 132811019154 11/23/2011 11,980,000 1,198,000
170 MILLENIUM PHARMACHON INTERNATIO01.300.861.0-054.000 010.028-11.00018912 132811018994 11/21/2011 62,500 6,250
181 PARAZELSUS INDONESIA 01.868.116.3-056.000 010.023-11.00014928 4036402012 11/23/2011 775,200 77,520
184 PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00081733 FJ-2220110105532 11/21/2011 1,848,700 184,870
191 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000336 BS. 11.0336 11/23/2011 1,557,727 155,773
192 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000327 BS. 11.0327 11/16/2011 820,341 82,034
193 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000315 BS. 11.0315 11/9/2011 1,516,591 151,659
194 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000311 BS. 11.0311 11/4/2011 2,069,091 206,909
195 PRISNA MEDICA 01.964.173.7-517.000 010.000-11.00000302 BS. 10.0302 10/28/2011 609,091 60,909
197 RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00020570 FKT1021434 11/9/2011 2,354,442 235,444
199 SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00002257 0064/SGI/11/11 11/5/2011 1,102,000 110,200
203 UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00023536 155565 11/5/2011 1,402,500 140,250
396,165,100 39,616,510
Gombong, 15 November 2011
Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

493,763 ASKES
102,000
594,000
751,737
3,464,025
4,236,752
143,124
23,001
71,999
1,910,040
622,501
658,350 JKM
346,500
263,251
361,104
311,630
345,950
951,500
1,001,000
206,250
118,800
107,525
225,984
586,138
1,260,235
3,722,684
124,901
226,384
1,281,062
767,211
1,584,000
257,452
195,930
75,304
319,833
24,773
1,052,470
65,962
155,747
311,300
539,562
65,962
1,619,939
134,313
114,335
554,400
554,400
23,001
2,585,880
57,503 OKT
321,750
110,000
123,200
255,393
1,789,050
2,092,450
1,437,425
1,872,275
671,079
3,398,725 REGULER
389,950
510,400
1,292,165
825,597
1,595,132
994,710
323,811
269,810
679,325
1,740,235
4,718,138
2,358,443
1,279,310
638,404
157,300
1,293,524
1,732,830
1,270,737
455,400
244,530
1,015,740
2,665,506
832,343
5,507,238
423,042
2,230,008
662,614
4,739,856
1,119,518
2,084,456
671,933
7,703,291
69,960
671,933
101,684
5,201,557
2,283,248
4,950,176
3,690,773
2,336,853
225,500
246,699
29,040
2,461,835
2,326,720
6,551,776
1,834,985
3,061,762
1,317,800
1,675,749
9,738,964
1,874,189
1,288,734
630,000
605,000
1,857,325
1,196,250
9,039,949
4,514,837
3,977,125
9,861,272
5,264,424
3,476,550
5,818,830
676,773
929,016
3,955,790
2,343,779
3,537,529
16,368,220
7,042,475
5,041,200
10,465,010
5,494,500
514,800
180,736
213,419
225,778
156,839
929,005
994,122
2,635,490
3,802,559
3,223,792
901,802
1,789,040
1,583,175
3,220,657
136,462
122,998
543,648
339,500
100,170
174,999
178,960
183,398
122,100
282,150
321,750
1,285,625
114,532
654,500
3,898,125
1,262,250
980,100
3,250,500
9,536,175
8,416,375
13,178,000
68,750
8,368,250
309,375
18,095,000
13,167,000
2,321,000
10,384,000
203,500
704,000
272,250
35,838,000
852,720
198,193
107,800
2,033,570
1,379,400
1,034,000
242,000
3,055,311
1,034,000
2,347,400
1,713,500
902,375
1,668,250
2,276,000
670,000
847,717
2,589,886
117,002
1,212,200
81,250
293,869
293,869
1,542,750
435,781,610

NO. Tidak Berwujud / Pemberi JKP NPWP / Nota retur / Nota Pembatalan DPP ( rupiah )
1 UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00026039 158250 12/21/2011 446,963
2 ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.03278699 311002044 12/14/2011 5,675,662
4 ENSEVAL PUTERA MEGATRADING 01.342.572.3-054.000 010.000-11.03181769 311001990 12/5/2011 465,472
5 MERAPI UTAMA PUTERA 01.313.257.6-073.000 010.007-11.00067118 67949 12/8/2011 2,250,000
6 MILLENNIUM PHARMACON INTERNATIONAL 01.300.861.0-054.000 010.028-11.00020130 122811000087 12/9/2011 184,006
8 DISTRIVERSA BUANAMAS 01.555.204.5-521.001 010.000-11.00013041 RAA/SPJ/1113204 12/5/2011 231,818
9 ANTAR MITRA SEMBADA 01.345.766.8-062.000 010.015-11.00037190 G5V2600 12/9/2011 538,650
10 RAJAWALI NUSINDO 01.061.248.9-051.000 010.031-11.00033865 FKT1023832 12/21/2011 41,818
11 INDOFARMA GLOBAL MEDIKA 01.061.184.6-051.000 010.008-11.00019735 20626 12/28/2011 64,930
16 ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.01312547 461211036806 12/12/2011 130,449
19 ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.02477022 1330982211 12/13/2011 99,090
34 KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00039804 ASB11039020 12/22/2011 570,000
36 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00032110 32213 12/12/2011 90,819
37 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00031441 31544 12/5/2011 128,866
38 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033295 33398 12/23/2011 53,825
39 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033265 33368 12/22/2011 285,302
40 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033493 33596 12/26/2011 2,024,490
41 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033953 34056 12/29/2011 2,432,492
42 MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.01209217 CD183201732 12/20/2011 1,008,000
43 MERAPI UTAMA PUTERA 01.313.257.6-073.000 010.007-11.00065680 66503 12/1/2011 72,000
45 PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00088675 FJ-2220110113877 12/12/2011 120,175
48 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000386 BS.12.0386 12/14/2011 1,626,659
49 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000359 BS.12.0359 12/10/2011 548,409
50 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000346 BS.12.0346 12/1/2011 763,209
51 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000411 BS. 12.0411 12/21/2011 1,342,818
52 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000446 BS. 12.0446 12/29/2011 3,060,568
58 AKURAT INTAN MADYA 01.698.969.1.029.000 010.000.11.00004511 121104510 12/9/2011 675,000
63 ANUGRAH ARGON MEDICA 01.129.737.1-308.000 010.000-11.01340844 461211037610 12/19/2011 1,594,678
77 ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.02477251 1330982447 12/14/2011 1,053,116
79 ANUGRAH PHARMINDO LESTARI 01.369.518.4.091.000 010.000-11.02373193 1330977356 11/30/2011 2,385,960
80 BATU RUSA 01.207.460.5-511.000 010.001-11.00090624 PR138004 12/23/2011 1,427,850
81 BATU RUSA 01.207.460.5-511.000 010.001-11.00089224 PR137448 12/16/2011 1,205,550
82 BATU RUSA 01.207.460.5-511.000 010.001-11.00087668 PR136873 12/9/2011 955,035
83 BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00135394 FKPWT/201112/05282 12/19/2011 1,362,744
86 BINA SAN PRIMA 01.588.725.0-091.000 010.025-11.00136778 FKPWT/201112/06667 12/23/2011 224,272
115 BRATACO 01.130.689.1-441.000 010.009-11.00004750 OBF04341 12/21/2011 530,681
116 BRATACO 01.130.689.1-441.000 010.009-11.00004812 OBF04413 12/28/2011 534,540
117 BRATACO 01.130.689.1-441.000 010.009-11.00004514 OBF04161 12/7/2011 640,228
120 DOS NI ROHA 01.301.911.2-062.000 010.000-11.01704499 815084075 1/25/2011 543,750
121 DOS NI ROHA 01.301.911.2-062.000 010.000-11.01704498 815084055 1/25/2011 1,637,664
154 KEBAYORAN PHARMA 01.308.506.3-073.000 010.004-11.00039519 ASB11038740 12/20/2011 2,735,525
161 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00032834 32937 12/19/2011 2,796,300
162 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00032894 32997 12/19/2011 103,941
163 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033264 33367 12/22/2011 165,000
164 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033492 33595 12/26/2011 868,683
165 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033951 34054 12/29/2011 8,505,942
166 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00033296 33399 12/23/2011 28,182
167 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00032111 32214 12/12/2011 129,281
168 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00031440 31543 12/5/2011 127,272
169 KIMIA FARMA 01.061.228.1-051.000 010.020.11.00031235 31338 12/1/2011 232,653
170 MENSA BINA SUKSES 01.315.708.6-007.000 010.000-11.01209229 CD183201744 12/20/2011 504,000
178 MILLENNIUM PHARMACON INTERNATIONAL 01.300.861.0-054.000 010.028-11.00020669 132811020784 12/19/2011 9,642,500
200 PARAZELSUS 01.868.116.3-056.000 010.023-11.00016021 4036427733 12/21/2011 390,000
203 PARIT PADANG GLOBAL 02.998.520.7-004.000 010.022-11.00091749 FJ-2220110118972 12/26/2011 3,201,675
207 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000412 BS. 12.0412 12/21/2011 770,909
208 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000446 BS. 12.0446 12/29/2011 736,364
209 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000385 BS. 12. 0385 12/14/2011 2,236,932
210 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000360 BS. 12. 0360 12/10/2011 436,364
211 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000358 BS. 12. 0358 12/10/2011 1,023,523
212 PRISNA MEDICA 01.964.173.7-517.000 010.000-12.00000347 BS. 12. 0347 12/1/2011 945,455
217 SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00002626 0337/SGI/12/11 12/26/2011 1,015,000
218 SAMATOR GAS INDUSTRI 01.585.149.6-631.000 010.004-11.00002470 0049/SGI/12/11 12/5/2011 1,537,000
219 SURGIKA ALKESINDO 01.899.639.7-073.000 010.000.11.00019678 IKL00728/NU 12/13/2011 3,676,250
220 UNITED DICO CITAS 01.301.246.3-073.000 010.010-11.00027151 159366 12/21/2011 1,669,654
140 KIMIA FARMA 01.061.228.1-051.000 010.020-11.00030881 30984 11/29/2011 244,206
450,857,128
Gombong, 15 DES 2011
Mengetahui,
Dir Umum & Keuangan
Sr. Bernada, ADM

PPN (rupiah)
44,696 491,659 ASKES

567,566 6,243,228
137,455 1,512,003
46,547 512,019
225,000 2,475,000
18,401 202,407
23,182 255,000
53,865 592,515
4,182 46,000
6,493 71,423
173,640 1,910,040
6,625 72,875 JKM
31,500 346,500
63,000 693,000
13,045 143,494
42,810 470,908
31,328 344,604
9,909 108,999
27,273 300,000
173,272 1,905,992
121,534 1,336,874
37,903 416,931
19,011 209,119
68,766 756,426
266,453 2,930,982
27,273 300,000
25,650 282,150
115,438 1,269,820
32,202 354,222
89,747 987,219
15,712 172,829
15,764 173,400
57,000 627,000
85,500 940,500
9,082 99,901
12,887 141,753
5,383 59,208
28,530 313,832
202,449 2,226,939
243,249 2,675,741
100,800 1,108,800
7,200 79,200
5,228 57,503
12,018 132,193
28,000 308,000
3,190 35,090
162,666 1,789,325
54,841 603,250
76,321 839,530
134,282 1,477,100
306,057 3,366,625
32,364 356,000
10,909 119,999
6,728 74,008
10,909 119,999
83,355 916,909
67,500 742,500 REGULER
71,820 790,020
63,000 693,000
46,400 510,400
46,400 510,400
159,468 1,754,146
28,870 317,570
79,249 871,737
62,800 690,800
218,600 2,404,600
186,997 2,056,963
21,600 237,600
45,289 498,177
284,998 3,134,982
33,454 367,992
57,900 636,900
270,581 2,976,387
89,887 988,758
94,739 1,042,124
105,312 1,158,428
94,243 1,036,670
238,596 2,624,556
142,785 1,570,635
120,555 1,326,105
95,504 1,050,539
136,274 1,499,018
314,639 3,461,031
583,976 6,423,736
22,427 246,699
61,085 671,933
355,544 3,910,984
15,383 169,215
308,672 3,395,392
455,820 5,014,020
96,996 1,066,956
611,648 6,728,128
197,359 2,170,951
191,070 2,101,770
44,854 493,398
130,121 1,431,333
320,069 3,520,757
45,502 500,526
118,032 1,298,352
421,656 4,638,216
593,068 6,523,748
369,089 4,059,981
143,712 1,580,832
4,520 49,720
144,530 1,589,834
22,427 246,699
324,232 3,566,552
74,051 814,563
437,696 4,814,656
396,432 4,360,752
253,616 2,789,773
22,427 246,699
6,360 69,960
53,068 583,749
53,454 587,994
64,023 704,251
84,500 929,500
79,000 869,000
54,375 598,125
163,766 1,801,430
54,545 599,999
74,464 819,107
78,245 860,692
82,025 902,275
84,456 929,016
93,636 1,029,996
142,404 1,566,447
174,624 1,920,864
174,937 1,924,307
193,835 2,132,185
202,327 2,225,595
217,800 2,395,800
377,405 4,151,455
442,602 4,868,624
463,158 5,094,733 REGULER
825,947 9,085,417
878,580 9,664,377
900,760 9,908,355
958,825 10,547,074
1,061,341 11,674,748
1,155,194 12,707,133
2,255,218 24,807,395
3,928 43,212
9,609 105,701
26,823 295,053
24,360 267,958
13,080 143,877
273,553 3,009,078
44,490 489,387
46,075 506,825
319,390 3,513,290
172,710 1,899,810
221,018 2,431,193
311,220 3,423,420
279,630 3,075,930
10,394 114,335
16,500 181,500
86,868 955,551
850,594 9,356,536
2,818 31,000
12,928 142,209
12,727 139,999
23,265 255,918
50,400 554,400
45,000 495,000
161,875 1,780,625
104,500 1,149,500
140,250 1,542,750
457,500 5,032,500
42,750 470,250
31,350 344,850
964,250 10,606,750
34,125 375,375
1,260,370 13,864,070
66,500 731,500
6,250 68,750
1,551,400 17,065,400
12,500 137,500
3,578,150 39,359,650
5,119 56,306
1,200,500 13,205,500
33,750 371,250
877,000 9,647,000
16,875 185,625
817,750 8,995,250
128,750 1,416,250
650,000 7,150,000
6,250 68,750
737,250 8,109,750
690,000 7,590,000
173,750 1,911,250
6,000 66,000
39,000 429,000
20,364 224,001
78,986 868,841
320,168 3,521,843
102,818 1,130,993
30,850 339,350
116,050 1,276,550
77,091 848,000
73,636 810,000
223,693 2,460,625
43,636 480,000
102,352 1,125,875
94,546 1,040,001
97,468 1,072,152
32,364 356,000
73,453 807,980
66,530 731,827
101,500 1,116,500
153,700 1,690,700
367,625 4,043,875
166,965 1,836,619
36,721 403,927
34,102 375,120
100,000 1,100,000 OKT
78,000 858,000
144,000 1,584,000
65,000 715,000
24,421 268,627
45,085,713
15 DES 2011
nggraeni

1 SUBUR MAKMUR 1264 12/19/2011 1,650,000
2 PAN GAS 40896 12/19/2011 1,625,000
3 EKA JAYA EK.20.12.2011 12/20/2011 6,413,750
4 DJAMA MULIA 454 12/19/2011 4,198,400
5 NUSA MEDIKA 102010 12/22/2011 2,996,000
6 PAN GAS 40899 12/22/2011 1,625,000
7 BM BINTANG JAYA ABADI 1211011 12/23/2011 840,000
8 PAN GAS 40901 12/24/2011 1,625,000
9 SUBUR MAKMUR 1278 12/26/2011 1,650,000
10 PAN GAS 40905 12/28/2011 1,625,000
11 SUBUR MAKMUR 1510 12/29/2011 550,000
12 NUSA MEDIKA 102020 12/28/2011 656,000
13 KIFA MEDICA 10041090 12/12/2011 3,548,750
14 PAN GAS 40889 12/12/2011 1,625,000
15 SUBUR MAKMUR 742 12/12/2011 1,375,000
16 SUBUR MAKMUR 718 12/5/2011 1,100,000
17 SUBUR MAKMUR 285 12/1/2011 550,000
18 MAHKOTA MAS MEDICA 2.36-111207.0945-026 12/7/2011 200,000
19 PAN GAS 40879 12/2/2011 1,625,000
20 NUSA MEDIKA 101949 12/15/2011 2,617,600
21 NUSA MEDIKA 101940 12/8/2011 856,000
22 NUSA MEDIKA 101931 12/1/2011 1,508,000
23 TRI CIPTA JAYA 1387/XIII/11 12/14/2011 3,604,705
44,064,205 -
1,650,000
1,625,000
6,413,750
4,198,400
2,996,000
1,625,000
840,000
1,625,000
1,650,000
1,625,000
550,000
656,000
3,548,750
1,625,000
1,375,000
1,100,000
550,000
200,000
1,625,000
2,617,600
856,000
1,508,000
3,604,705

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Daftar Penjual BPK / BPK Faktur Pajak / Dokumen Tertentu

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Sr. Mikaela, ADM Dwi Indra Anggraeni

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Daftar Penjual BPK / BPK Faktur Pajak / Dokumen Tertentu

Gombong, 15 September 2011

Kasie Keuangan Perekap,

Sr. Mikaela, ADM Dwi Indra Anggraeni

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Daftar Penjual BPK / BPK Faktur Pajak / Dokumen Tertentu

Gombong, 15 Oktober 2011

Kasie Keuangan Perekap,

Sr. Mikaela, ADM Dwi Indra Anggraeni

Sr. Bernada, ADM

Daftar Penjual BPK / BPK Faktur Pajak / Dokumen Tertentu

Gombong, 15 Oktober 2011

Kasie Keuangan Perekap,

Sr. Mikaela, ADM Dwi Indra Anggraeni

Sr. Bernada, ADM

Daftar Penjual BPK / BPK Faktur Pajak / Dokumen Tertentu

Gombong, 15 November 2011

Kasie Keuangan Perekap,

Sr. Mikaela, ADM Dwi Indra Anggraeni

Sr. Bernada, ADM

Daftar Penjual BPK / BPK Faktur Pajak / Dokumen Tertentu

Gombong, 15 DES 2011

Kasie Keuangan Perekap,

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44,696 491,659 ASKES

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